PMID- 3624201 TI - Purification and properties of haloalkane dehalogenase from Corynebacterium sp. strain m15-3. AB - A haloalkane dehalogenase was purified to electrophoretic homogeneity from cell extracts of a 1-chlorobutane-utilizing strain, m15-3, which was identified as a Corynebacterium sp. The enzyme hydrolyzed C2 to C12 mono- and dihalogenated alkanes, some haloalcohols, and haloacids. The Km value of the enzyme for 1 chlorobutane was 0.18 mM. Its molecular weight was estimated to be 36,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 33,000 by gel filtration. The isoelectric point was pH 4.5. The optimum pH for enzyme activity was found to be 9.4, and the optimum temperature was 30 to 35 degrees C. The enzyme was stable for 1 h at temperatures ranging from 4 to 30 degrees C but was progressively less stable at 40 and 50 degrees C. PMID- 3624202 TI - Mycelial- to yeast-phase transitions of the dimorphic fungi Blastomyces dermatitidis and Paracoccidioides brasiliensis. AB - The physiological changes that occur during the mycelial- to yeast-phase transitions induced by a temperature shift from 25 to 37 degrees C of cultures of Blastomyces dermatitidis and Paracoccidioides brasiliensis can be divided into three stages. The triggering event is a heat-related insult induced by the temperature shift which results in partial uncoupling of oxidative phosphorylation and declines in cellular ATP levels, respiration rates, and concentrations of electron transport components (stage 1). The cells then enter a stage in which spontaneous respiration ceases (stage 2), and finally, there is a shift into a recovery phase during which transformation to yeast morphology occurs (stage 3). Cysteine is required during stage 2 for the operation of shunt pathways which permit electron transport to bypass blocked portions of the cytochrome system. The mycelial- to yeast-phase transitions of these two fungi are very similar to that of Histoplasma capsulatum. Therefore, these three dimorphic fungal pathogens have evolved parallel mechanisms to adjust to the temperature shifts which induce these mycelial- to yeast-phase transitions. PMID- 3624203 TI - 5-Fluorouracil-resistant strain of Methanobacterium thermoautotrophicum. AB - Growth of Methanobacterium thermoautotrophicum Marburg is inhibited by the pyrimidine, 5-fluorouracil (FU). It was shown previously that methanogenesis is not inhibited to the same extent as growth. A spontaneously occurring FU resistant strain (RTAE-1) was isolated from a culture of strain Marburg. The growth of both strains was inhibited by 5-fluorodeoxyuridine but not 5 fluorocytosine, and the wild type was more susceptible to inhibition by 5 azauracil and 6-azauracil than was strain RTAE-1. The cellular targets for the pyrimidine analogs are not known. When the accumulation of 14C-labeled uracil or FU by the two strains was compared, the wild type took up 15-fold more radiolabel per cell than did the FU-resistant strain. In the wild type, radiolabel from uracil was incorporated into the soluble pool, RNA, and DNA. The metabolism of uracil appeared to involve a uracil phosphoribosyltransferase activity. Strain Marburg extracts contained this enzyme, whereas FU-resistant strain RTAE-1 extracts had less than 1/10 as much activity. Although it is possible that a change in permeability to the compounds plays a role in the stable resistance of strain RTAE-1, the fact that it lacks the ability to metabolize pyrimidines to nucleotides is sufficient to account for its phenotype. PMID- 3624204 TI - Cytokinin production by Agrobacterium and Pseudomonas spp. AB - The production of cytokinins by plant-associated bacteria was examined by radioimmunoassay. Strains producing trans-zeatin were identified in the genera Agrobacterium and Pseudomonas. Agrobacterium tumefaciens strains containing nopaline tumor-inducing plasmids, A. tumefaciens Lippia isolates, and Agrobacterium rhizogenes strains produced trans-zeatin in culture at 0.5 to 44 micrograms/liter. Pseudomonas solanacearum and Pseudomonas syringae pv. savastanoi produced trans-zeatin at levels of up to 1 mg/liter. In vitro cytokinin biosynthetic activity was measured for representative strains and was found to correlate with trans-zeatin production. The genetic locus for trans zeatin secretion (tzs) was cloned from four strains: A. tumefaciens T37, A. rhizogenes A4, P. solanacearum K60, and P. syringae pv. savastanoi 1006. Southern blot analysis showed substantial homology of the Agrobacterium tzs genes to each other but not to the two Pseudomonas genes. PMID- 3624205 TI - Involvement of both cellulose fibrils and a Ca2+-dependent adhesin in the attachment of Rhizobium leguminosarum to pea root hair tips. AB - We have previously described an assay for the attachment of Rhizobium bacteria to pea root hair tips (cap formation) which was used as a model to study the attachment step in the nodulation process. Under all conditions tested, a positive correlation was observed between the percentage of fibrillated cells and the ability of these bacteria to form caps and to adhere to glass, suggesting that fibrils play a role in the attachment of Rhizobium leguminosarum to pea root hair tips and to glass (G. Smit, J. W. Kijne, and B. J. J. Lugtenberg, J. Bacteriol. 168:821-827, 1986). In the present paper the chemical and functional characterization of the fibrils of R. leguminosarum is described. Characterization of purified fibrils by infrared spectroscopy and cellulase treatment followed by thin-layer chromatography showed that the fibrils are composed of cellulose. Purified cellulose fibrils, as well as commercial cellulose, inhibited cap formation when present during the attachment assay. Incubation of the bacteria with purified cellulase just before the attachment assay strongly inhibited cap formation, indicating that the fibrils are directly involved in the attachment process. Tn5-induced fibril-overproducing mutants showed a greatly increased ability to form caps, whereas Tn5-induced fibril negative mutants lost this ability. None of these Tn5 insertions appeared to be located on the Sym plasmid. Both types of mutants showed normal nodulation properties, indicating that cellulose fibrils are not a prerequisite for successful nodulation under the conditions used. The ability of the fibril negative mutants to attach to glass was not affected by the mutations, indicating that attachment to pea root hair tips and attachment to glass are (partly) based on different mechanisms. However, growth of the rhizobia under low Ca2+ conditions strongly reduced attachment to glass and also prevented cap formation, although it had no negative effect on fibril synthesis. This phenomenon was found for several Rhizobium spp. It was concluded that both cellulose fibrils and a Ca2+ -dependent adhesin(s) are involved in the attachment of R. leguminosarum to pea root hair tips. A model cap formation as a two-step process is discussed. PMID- 3624206 TI - Low-affinity potassium uptake system in Bacillus acidocaldarius. AB - Cells of Bacillus acidocaldarius that were grown with 2.7 mM K+ expressed a low affinity K+ uptake system. The following observations indicate that its properties closely resemble those of the Escherichia coli Trk and Streptococcus faecalis KtrI systems: (i) the B. acidocaldarius system took up K+ with a Km of 1 mM; (ii) it accepted Rb+ (Km of 6 mM; same Vmax as for K+); (iii) it was still active in the presence of low concentrations of sodium; (iv) the observed accumulation ratio of K+ maintained by metabolizing cells was consistent with K+ being taken up via a K+-H+ symporter; and (v) K+ uptake did not occur in cells in which the ATP level was low. Under the latter conditions, the cells still took up methylammonium ions via a system that was derepressed by growth with low levels of ammonium ions, indicating that in the acidophile ammonium (methylammonium) uptake requires a high transmembrane proton motive force rather than ATP. PMID- 3624207 TI - Predicting outcome of neuroleptic treatment on the basis of subjective response and early clinical improvement. AB - The predictive value of the subjective response after 4 hours to an oral test dose of haloperidol and the predictive value of early clinical improvement during a 28-day, fixed-dose regimen with haloperidol were tested in 33 newly admitted schizophrenic patients. A significant (p less than .01) correlation was found between subjective response and therapeutic outcome on Day 28. Five of the 7 patients with dysphoric responses to the test dose had poor therapeutic outcomes. Powerful relationships were found between therapeutic outcome on Day 28 and clinical improvement observed from Day 2 on and between the outcome at discharge and improvement measured on Days 5 and 6. PMID- 3624208 TI - Delirium and the resolution of depression. AB - Two cases are presented in which a long-standing depressive disorder remitted after a protracted delirium associated with the exacerbation of a major medical illness. Although improvement in medical conditions may have contributed to the result, the courses of the affective and medical conditions varied independently before and after the episode of delirium. The prospect of a restitutive function for delirium is further supported by a review of six cases of tricyclic-induced delirium in patients with medical depressive syndromes: the three patients who achieved full resolution of the delirium showed affective improvement. PMID- 3624209 TI - Cocaine abuse and adult attention deficit disorder. AB - Cocaine increases dopaminergic tone in the central nervous system, and hyperprolactinemia has been found in chronic cocaine abusers. Dopamine depletion is believed to result from chronic cocaine abuse. Dopamine deficiency has also been associated with attention deficit disorder (ADD) in adults, and dopamine agonists have been effective in the treatment of ADD. Four case reports of cocaine addiction and ADD are presented. ADD was assumed to play an etiologic role in cocaine abuse, and it was postulated that the patients might in part have been self-medicating a dopamine-deficient state. In addition, cocaine addicts without a premorbid history of ADD may experience a temporary cocaine-induced ADD state. In both cases, the dopamine agonist bromocriptine was highly effective for treating ADD and promoting cocaine abstinence. Restoration of the presumed dopamine deficit may permit an easier course of rehabilitation by improving the patient's ability to participate in therapeutic programs. PMID- 3624210 TI - An XX male with schizophrenia: a case of personality development and illness similar to that in XXY males. AB - The case of an XX male suffering from paranoid schizophrenia is presented. Findings in the development of the personality and the illness in this patient support the theory that XX males are genetically similar to XXY males. PMID- 3624211 TI - Trazodone withdrawal and formication. PMID- 3624212 TI - Phencyclidine-associated psychosis. PMID- 3624213 TI - Response to treatment in primary and secondary depression. PMID- 3624214 TI - Hypertension in the black population. PMID- 3624215 TI - Desipramine and phenytoin: a potential drug interaction of therapeutic relevance. PMID- 3624216 TI - Verapamil in the treatment of irritable bowel syndrome. PMID- 3624217 TI - Agoraphobia and paroxysmal cerebral dysrhythmia. PMID- 3624218 TI - Legal liability with psychotropic drug use: extrapyramidal syndromes and tardive dyskinesia. AB - The use of medication has become essential to the practice of modern psychiatry. Despite the enormous benefits associated with the administration of psychotropics, these drugs also carry the risk of significant adverse reactions. The legal implications of side effects of antipsychotic agents are explored. The particular focus is on the potentially serious liability confronting the psychiatrist whose patient develops delayed neuromuscular complications. Whenever neuroleptic medication is used, it is crucial for all psychiatrists to be cognizant of the need to obtain voluntary informed consent in the context of clinically appropriate treatment. PMID- 3624219 TI - Generation of hydrogen peroxide by brown adipose tissue mitochondria. AB - This is the first report on the generation of H2O2 by brown adipose tissue mitochondria. Flavin dehydrogenase-linked substrates like succinate, glycerol-1 phosphate, and fatty acyl CoA were good substrates for the reaction, while NAD+ linked substrates were less effective. In cold-acclimated animals the activity showed a substantial increase (2.5-fold). The Km and Vmax of the reaction were considerably lower than those of the respective dehydrogenase. Metal ions, particularly Cu2+ and Fe2+ were potent inhibitors of the reaction. Nucleoside diphosphates, which were inhibitors by themselves, potentiated the inhibitory action of Fe2+ ions. In most of the properties, the H2O2 generator of brown adipose tissue mitochondria resembled that of liver mitochondria. PMID- 3624220 TI - Structure and antithrombin-binding properties of heparin isolated from the clams Anomalocardia brasiliana and Tivela mactroides. AB - Heparin with high anticoagulant activity was isolated from the two marine clam species Anomalocardia brasiliana and Tivela mactroides. A large portion of the polysaccharide chains of both preparations bound with high affinity to immobilized antithrombin. Titrations monitored by tryptophan fluorescence showed that clam polysaccharide chains with Mr approximately 22,500 contained up to three binding sites for antithrombin and that the binding constants for the interaction of these chains with antithrombin were higher than those reported for mammalian heparin of comparable size. Structural analysis of clam heparin fractions and subfractions of clam heparin with differing affinity for immobilized antithrombin revealed the presence of large amounts (up to 25-30% of the total disaccharide units) of the 3-O-sulfated saccharide sequences (-GlcNSO3) GlcA-GlcNSO3(3-OSO3)- and (-GlcNSO3)-GlcA-GlcNSO3(3,6-di-OSO3)-, previously identified as unique markers for the antithrombin-binding region of heparin. The content of these saccharide sequences was found to increase with increasing affinity of the parent polysaccharide for antithrombin. Structural analysis of the clam heparins also demonstrated the occurrence of a novel saccharide sequence, tentatively identified as (-GlcNSO3)-IdA-GlcNSO3(3,6-di-OSO3)-, that has not previously been found in heparin or related polysaccharides. The contents of this latter sequence, at most 3-4% of the total disaccharide units, showed no correlation with the affinity for antithrombin. PMID- 3624221 TI - Structure and formation of a stable histidine-based trifunctional cross-link in skin collagen. AB - A stable nonreducible trifunctional cross-linking amino acid has been isolated from mature bovine skin collagen fibrils. Previous cross-link peptide isolations and amino acid analyses indicate the compound has properties identical with those of hydroxyaldolhistidine. Its newly proposed structure was verified using fast atom bombardment mass spectrometry, and 1H and 13C nuclear magnetic resonance. The data indicated that the cross-link consists of the prosthetic groups from one residue each of histidine, hydroxylysine, and lysine. The 1H and 13C nuclear magnetic resonance data indicated that imidazole C-2 of histidine is linked to C 6 of norleucine (epsilon-deaminated lysine residue) which in turn is linked to the C-6 amino group of hydroxylysine. Based on the trivial names for other cross linking residues found in collagen and elastin it was given the name histidinohydroxylysinonorleucine. In vitro incubation studies for up to 24 weeks, in aqueous solution at physiological pH and ionic strength, using 6-month-old bovine embryo skin demonstrated a one-to-one stoichiometric relationship between the disappearance of the labile reducible bifunctional cross-link dehydrohydroxylysinonorleucine and the appearance of histidinohydroxylsinonorleucine. These results can partially explain the previously observed disappearance of dehydrohydroxylysinonorleucine with chronological age. PMID- 3624222 TI - The secondary structure of bacteriorhodopsin determined by Raman and circular dichroism spectroscopy. AB - The secondary structure of bacterio-opsin (BO), the retinal free protein component of bacteriorhodopsin (BR), has been determined by Raman spectroscopy. Additional circular dichroism (CD) measurements have revealed only negligible conformational differences between BO in apomembranes and BR in purple membranes. Therefore, the secondary structure of BR was derived from the Raman data of BO. The protein conformation was determined to consist of 72-82% helices, 2-11% beta strands, and 11-17% beta-turns. Only about half of the helical structures correspond to alpha 1-helices, the other half possess non-alpha 1-helical structures. According to the analysis of the Raman data, the derived secondary structure of BR was obtained with high reliability for all structure classes which can be distinguished by this method within the given uncertainty range. This is a remarkable difference from recently published secondary structural data derived from CD measurements where the helix content was reported to be between 50 and 80%. The inherent experimental and methodological uncertainties of the CD technique leading to such a range of variation are critically discussed in comparison to the method of Raman spectroscopy. The combined application of Raman and CD spectroscopy, as performed here, is demonstrated to be a substantial improvement in the secondary structure determination of retinal-containing membrane proteins. On the basis of our results, some of the recently proposed structural models of BR with a beta-strand content of more than 11% can be ruled out. PMID- 3624223 TI - Electrochemical reduction of methemoglobin either directly or with flavin mononucleotide as a mediator. AB - Electrochemical reduction of methemoglobin on a platinum electrode is studied by means of thin layer spectroelectrochemistry. For methemoglobin alone in solution, direct reduction is very slow even for potentials close to those of the reduction of the solvent. The reduction of a methemoglobin-oxyhemoglobin mixture with an imposed potential causes the electrochemical reduction of oxygen, the conversion of oxyhemoglobin into deoxyhemoglobin, and a simultaneous transformation of part of the molecules into methemoglobin. When fixed oxygen has disappeared, reduction of methemoglobin takes place. The reduction of methemoglobin and deoxyhemoglobin is catalyzed by the presence of flavin mononucleotide (FMN). For the oxyhemoglobin-methemoglobin mixture, flavin makes a fast deoxygenation of oxyhemoglobin without a change in the oxidation state of the iron. It also allows the rapid reduction of methemoglobin. In each case, the resulting deoxyhemoglobin solutions do not show any electrolysis-induced modification of the equilibrium curves for oxygen binding. PMID- 3624224 TI - Regulation of mRNA entry into polysomes. Parameters affecting polysome size and the fraction of mRNA in polysomes. AB - The kinetics of labeled histone mRNA entry into polysomes was studied in nuclease treated reticulocyte lysates. Added mRNA rapidly bound 1 or 2 ribosomes. However, the formation of full size polysomes required at least 16 min. The amount of mRNA bound to ribosomes reached a maximum (73%) within 2 min after mRNA addition and then declined slowly for the remainder of the experiment. Two initiation inhibitors, aurintricarboxylic acid and 7-methylguanosine 5'-triphosphate, were found to affect polysome size and the fraction of mRNA in polysomes in an opposite manner. These results suggest that initiation and reinitiation events may be intrinsically different. The relatively long time period required for the formation of large polysomes can be explained by large polysomes having higher initiation and/or reinitiation rates or slower elongation rates. These possibilities are not mutually exclusive. The results suggest that there exist several levels of control which can regulate polysome size and the fraction of mRNA in polysomes. PMID- 3624225 TI - A transport system for coenzyme A in isolated rat heart mitochondria. AB - The ability of isolated rat heart mitochondria to take up coenzyme A (CoA) from the incubation medium was studied. Mitochondria accumulated CoA in a time- and concentration-dependent manner. The accumulation process occurred in two phases. Within the first 30 s of incubation, mitochondrial content of CoA increased, and this phase did not plateau in the concentration range studied. Following this initial increase, a second slower phase of CoA accumulation occurred which plateaued around 50 microM CoA. The initial phase was decreased significantly by ATP or by carboxyatractyloside. In contrast, the presence of ATP or carboxyatractyloside did not affect the second phase. Decreasing the temperature from 30 to 0 degrees C did not affect the initial phase, but the second phase was almost abolished. In the presence of metabolic inhibitors (either 2,4 dinitrophenol or a combination of rotenone and antimycin), the initial "binding" phase was not affected; but the second "uptake" phase was abolished. These results suggest that the first phase of mitochondrial CoA accumulation is probably CoA binding to adenine recognizing sites on the mitochondria while the second phase may represent a specific uptake process for CoA which, although not directly ATP-dependent, is energy-dependent. PMID- 3624226 TI - Effect of subunit size and conformation on the rate of lysosomal degradation of extracellular proteins in cultured mouse peritoneal macrophages. AB - The degradation of nine well-defined proteins was studied in cultured mouse peritoneal macrophages following their uptake by fluid phase pinocytosis. After uptake, approximately one-third of the radioactivity was released into the medium in the form of trichloroacetic acid/phosphotungstic acid-insoluble material. When the time courses for the appearance of trichloroacetic acid/phosphotungstic acid soluble and -insoluble radioactivities were independently analyzed, identical observed rate constants (kobs) were obtained. This is in agreement with an earlier claim that regurgitated protein and low molecular weight products arise from a common intracellular pool of radiolabeled substrates, presumably within lysosomes, and that the traffic of substrates between the plasma membrane and the lysosome is probably bidirectional (Buktenica, S., Olenick, S. J., Salgia, R., and Frankfater, A. (1987) J. Biol. Chem. 262, 9469-9476). When intrinsic degradation rate constants (kd) were calculated, these were found to vary inversely with protein subunit molecular weights, from 0.0347 h-1 for horse heart cytochrome c to 0.0104 h-1 for rabbit muscle phosphorylase b. The proportion of peptide bonds in a protein which are initially available to the action of lysosomal proteases should be proportional to the fraction of the total potential surface of a protein which remains accessible to solvent after polypeptide folding (AS/AT). In agreement, lysosomal degradation rates were observed to correlate well with known or estimated values of AS/AT, and thermal denaturation, which may expose previously buried amino acid residues, increased the rate of degradation of bovine serum albumin. PMID- 3624227 TI - An enhancer element in the far upstream spacer region of rat ribosomal RNA gene. AB - To determine whether far upstream 5'-flanking sequences control rat rDNA transcription, we constructed plasmids containing several 5' and 3' deletions within the nontranscribed spacer region. In vitro transcription of these plasmids identified three enhancer regions, designated A, B, and C, which can dramatically stimulate transcription from the core promoter. Further analysis of region B showed that the enhancer element lies between -2.183 and -2.357 kilobase pairs upstream of the initiation site. The plasmid containing the 174-base pair enhancer element could stimulate rRNA gene transcription as much as 10-20-fold relative to transcription of the plasmid containing only the core promoter. This enhancer was not another promoter domain and could function irrespective of its orientation or distance from the promoter or when inserted downstream of the initiation site. Computer analysis of known sequences of enhancer regions A and C did not reveal any significant homology between these DNA segments and the 174 base pair enhancer element. Competition assay demonstrated that the enhancer element B forms a stable complex with the transcription factor(s) and that interaction between the enhancer and the factor(s) was essential for the stimulation of rDNA transcription. This is the first report of a mammalian ribosomal rDNA enhancer element that exhibits the characteristics of an RNA polymerase II enhancer. PMID- 3624228 TI - Purification and characterization of trichosanthin. Homology to the ricin A chain and implications as to mechanism of abortifacient activity. AB - Trichosanthin, a protein from the Chinese medicinal herb Trichosanthes kirilowii, was purified in two essentially quantitative steps involving CM-Sephadex chromatography and reverse-phase high performance liquid chromatography. The protein was found to have a molecular mass of 25-26 kDa, to contain no cysteine, and to contain no glycosidic linkages. Pure trichosanthin was found to have potent abortifacient activity in pregnant mice. In order to understand the molecular basis of this unique biological activity, we have examined the amino acid sequence of the protein. As purified, trichosanthin was found to contain two amino-terminal sequences which differed only in the absence or presence of a tyrosine at residue 1. Sequence analysis of trichosanthin has allowed for determination of the NH2-terminal 38-amino acid residues. Comparison of this sequence to those present in a data base revealed homology with the ricin A chain. Consistent with this structural homology, we have found that trichosanthin is a potent inhibitor of protein synthesis in a reticulocyte lysate system. PMID- 3624229 TI - Structure-mechanism relationships in hemoproteins. Oxygenations catalyzed by chloroperoxidase and horseradish peroxidase. AB - Chloroperoxidase and H2O2 oxidize styrene to styrene oxide and phenylacetaldehyde but not benzaldehyde. The epoxide oxygen is shown by studies with H2(18)O2 to derive quantitatively from the peroxide. The epoxidation of trans-[1-2H]styrene by chloroperoxidase proceeds without detectable loss of stereochemistry, as does the epoxidation of styrene by rat liver cytochrome P-450, although much more phenylacetaldehyde is produced by chloroperoxidase than cytochrome P-450. Chloroperoxidase and cytochrome P-450 thus oxidize styrene by closely related oxygen-transfer mechanisms. Horseradish peroxidase does not oxidize styrene but does oxidize 2,4,6-trimethylphenol to 2,6-dimethyl-4-hydroxymethylphenol. The new hydroxyl group is partially labeled in incubations with H2(18)O but not H2(18)O2. The hydroxyl group thus appears to be introduced by addition of oxygen to the benzylic radical and water to the quinone methide intermediate but not by a cytochrome P-450-like oxene transfer mechanism. The results support the thesis that substrates primarily or exclusively react with the heme edge of horseradish peroxidase but are able to react with the ferryl oxygen of chloroperoxidase. PMID- 3624230 TI - Macrophage free cholesterol content regulates apolipoprotein E synthesis. AB - The relationship between macrophage cholesterol content and apolipoprotein E (apoE) synthesis was studied in mouse peritoneal macrophages. Incubations in acetylated low density lipoprotein led to a concentration-dependent increase in macrophage free and esterified cholesterol content and apoE synthesis. Enhanced apoE production reflected increased apoE mRNA abundance in cholesterol-enriched cells. Including an inhibitor of acyl-CoA:cholesterol acyltransferase in incubations with acetylated low density lipoprotein did not diminish the apoE response, suggesting that increased macrophage free cholesterol content was responsible for enhancing apoE production. Incubations in 25-OH cholesterol also produced a dose-dependent stimulation of macrophage apoE synthesis. Removing free cholesterol from cells using high density lipoprotein returned apoE synthetic rates toward base line. Macrophage lysate apoE and medium apoE levels changed in parallel during cholesterol loading and efflux indicating that regulation of apoE by free cholesterol was not primarily at the level of secretion. It is concluded that (a) cholesterol enrichment of macrophages increases apoE mRNA abundance and stimulates apoE synthesis and secretion; (b) neither cholesterol esterification nor cholesteryl ester accumulation are required for increased apoE production. PMID- 3624231 TI - Protein kinase activity can be separated from the purified activated rat liver glucocorticoid receptor. AB - Previous studies have shown that the purified rat liver glucocorticoid receptor (GR) has a protein kinase activity. In this report we show that the GR-associated kinase can be partially separated from the 94-kDa steroid-binding protein by DEAE Sepharose chromatography. The kinase elutes from the column at a higher salt concentration than the 94-kDa GR protein. This GR copurifying protein kinase phosphorylates basic substrates such as various histone fractions and protamine. The phosphorylation occurs in the presence of Mg2+ ions, and is not supported by Ca2+ ions. The amino acid residues phosphorylated by the kinase are threonine and serine. This kinase also phosphorylates the 94-kDa GR protein and thus might be of physiological relevance for the GR function. PMID- 3624232 TI - Cooperative interaction between factor VII and cell surface-expressed tissue factor. AB - Assembly of the extrinsic pathway on cell surfaces was investigated by studying the binding and activity of factor VII on the bladder carcinoma cell line J82 which expressed 18,800 milliunits of tissue factor activity/10(6) cells. In binding studies, the association of factor VII to monolayers of cells was time-, temperature-, and calcium-dependent. The ligand binding was specific, reversible, and saturable. This interaction was inhibited by a monoclonal antibody to human brain tissue factor. Factor VII added to the cells was recovered as factor VII rather than factor VIIa when incubated in the presence of factor X neutralizing antibodies, suggesting that these cells produced factor X. Specific factor VII binding to the cell revealed a sigmoidal binding isotherm with half-maximal binding occurring at 314 +/- 145 pM to 38,300 +/- 14,300 sites/cell. Hill plots of the binding data indicated an average slope of 2.1. Binding parameters were also determined kinetically. At maximal factor VII-tissue factor complex formation the apparent Km for factor X was 274 nM, the Vmax was 4.15 nM/min, and the kcat was estimated to be 14 s-1. In the presence of excess tissue factor and factor X, increasing amounts of factor VII added to the J82 cells demonstrated a sigmoidal relationship with the rate of factor Xa formation. Hill plots indicated a slope of 2.0 at the lower factor VII concentrations which changed to 1.0 at the higher input amounts of factor VII. Hanes plots were used to determine the apparent dissociation constant of the interaction (222 +/- 85 pM). The Vmax was 5.54 +/- 1.04 nM/min for the cleavage of factor X. These data are consistent with factor VII binding to at least two sites on tissue factor (receptor) with positive cooperativity. Because at saturation the stoichiometry of the factor VII tissue factor complex is 1:1, tissue factor must be expressed as a dimer on the surface of the J82 cells. PMID- 3624233 TI - Bacteriophage 82 gene Q and Q protein. Sequence, overproduction, and activity as a transcription antiterminator in vitro. AB - Phage 82 gene Q encodes a phage-specific positive regulator of late gene expression, thought, by analogy to the corresponding gene of phage lambda, to be a transcription antiterminator. We have cloned and sequenced the phage 82 gene Q and have overproduced and purified the 82 Q protein. We also have identified and sequenced DNA containing the phage 82 late gene promoter and terminator. We show that purified 82 Q protein is active and specific for DNA containing the 82 late gene promoter in a well defined in vitro transcription reaction: RNA polymerase initiating at the phage 82 late gene promoter and modified by 82 Q protein reads through a downstream transcriptional terminator. We used T1 RNase mapping to confirm that the putative readthrough RNA made in the presence of 82 Q protein is in fact an elongation product of the shorter RNA. PMID- 3624234 TI - Crystallization and preliminary x-ray crystallographic study of NADH-cytochrome b5 reductase from pig liver microsomes. AB - Crystals of the hydrophilic, catalytic domain (30 kDa) of pig liver NADH cytochrome b5 reductase solubilized by the protease (cathepsin D) have been grown in a solution of polyethylene glycol by the vapor-diffusion procedure. The crystals belong to the orthorhombic system, space group P2(1)2(1)2(1) with unit cell dimensions of a = 87.1, b = 73.2, and c = 49.0 A. The asymmetric unit contains one molecule of the enzyme. The x-ray diffraction patterns extend to 2.0 A resolution. On the other hand, the intact enzyme (35 kDa) containing the hydrophobic membrane-binding domain solubilized by the detergent (Triton N-101) has been crystallized also from the polyethylene glycol solution. The crystals are needle-shaped and still too small for x-ray diffraction study. PMID- 3624235 TI - Biosynthesis of human insulin-like growth factor I (IGF-I). The primary translation product of IGF-I mRNA contains an unusual 48-amino acid signal peptide. AB - The human insulin-like growth factor I (IGF-I) gene can specify two primary translation products, IGF-IA and IGF-IB, which differ at their COOH termini and which must undergo extensive proteolytic processing to produce the mature 70 residue circulating peptide. We have used an in vitro transcription/translation/microsomal membrane processing system to define the early events in IGF-I biosynthesis. Our results demonstrate that protein synthesis is initiated at the first in-frame methionine codon for both human IGF IA and IGF-IB mRNAs, yielding primary translation products of 153 and 195 residues, respectively. Both are cotranslationally translocated into the lumen of canine pancreatic microsomes. Cotranslational proteolytic processing results in the removal of an unusually large 48-amino acid signal peptide. Computer-assisted sequence analysis revealed that this prepeptide contains two domains. Its COOH terminal 19 residues possess features which are typically encountered in eukaryotic signal peptides. The rest of the IGF-I signal sequence is represented by an unusual "extended" NH2-terminal domain containing an overall net charge of +5 and 3 clustered cysteines. The size and charge of this NH2-terminal domain distinguish it from comparable regions of other eukaryotic signal peptides including the presegment of human IGF-II. Although no specialized biological role can currently be ascribed to this unique NH2-terminal domain, its remarkable sequence conservation between human and rat suggests an as yet unknown functional significance. PMID- 3624236 TI - Purification to homogeneity and initial physical characterization of secondary amine monooxygenase. AB - Secondary amine monooxygenase from Pseudomonas aminovorans grown on trimethylamine has been purified 265-fold to apparent homogeneity. The purified enzyme exhibits a specific activity of 14.7 mumol of NADPH oxidized per min per mg of protein, a native molecular weight of 210,000, and nondisulfide-linked subunits of molecular weight 42,000, 36,000, and 24,000, each of which is required for activity. The enzyme is extremely labile during purification; rapid handling and the presence of 5% ethanol are essential to enzyme stability. Storage at 77 K in the presence of NADH (1 mM) also confers considerable stability to the purified enzyme. The heme prosthetic group in the enzyme has been identified as protoporphyrin IX. The quantification of prosthetic group components reveals the presence of 1.6 mol of flavin as FMN, 2.0 mol of heme iron, 4.0 mol of acid-soluble (nonheme) iron, and 3.6 mol of free sulfide/210,000 molecular weight enzyme. Ferric and ferrous-CO secondary amine monooxygenase exhibit electronic absorption spectra that are very similar to those of analogous myoglobin derivatives and, therefore, quite distinct from parallel forms of cytochrome P-450, the most extensively studied heme iron-containing monooxygenase. Like myoglobin and, again, in contrast to P-450, this enzyme forms a very stable dioxygen complex. In fact, it is this oxygen-bound form of the enzyme that is obtained from the purification procedure. Once again, the absorption spectrum of oxygenated secondary amine monooxygenase is nearly identical to that of oxymyoglobin. The spectroscopic similarities between secondary amine monooxygenase and myoglobin suggest the presence of an endogenous histidine fifth ligand to the heme iron of the enzymes. PMID- 3624237 TI - Properties of p19, a novel cAMP-dependent protein kinase substrate protein purified from bovine brain. AB - We report the purification from bovine brain and describe some of the properties of a 19-kDa protein, p19, which we have previously shown to undergo hormone dependent, cAMP-mediated phosphorylation in several peptide hormone-producing tumor cells. The procedure for purifying p19 to apparent homogeneity utilized ammonium sulfate fractionation, sequential chromatography on DEAE-cellulose and phenyl-Sepharose, followed by fast protein liquid chromatography using a Mono Q and, finally, a C8 reverse-phase column. The yield was 0.3-0.5 mg of p19/kg of brain. The molecular weight (Mr = 19,000) and frictional ratio (f/f0 = 1.87) of p19, which were derived from its Stokes radius (33 A) and sedimentation constant (s20,w = 1.4), suggest that the native form of p19 is an asymmetrically shaped monomer. We provide evidence to suggest that p19 is isolated as a mixture of molecular forms consisting of an unphosphorylated form and of three phosphoforms indicative of multisite phosphorylation. These forms cosedimented on sucrose density gradients and coeluted on gel filtration, hydrophobic chromatography, and reverse-phase fast protein liquid chromatography. They were resolved from each other by anion-exchange chromatography. The unphosphorylated form (pI 6.2) was phosphorylated by catalytic subunit of cAMP-dependent protein kinase to a stoichiometry of 0.5 mol of P/mol of p19, thereby giving rise to the three phosphoforms (pI 5.8, pI 5.6, and pI 5.2, respectively). We conclude that p19 is a novel cAMP-dependent protein kinase substrate protein that is present in brain and in peptide hormone-producing tumor cells. Its function remains to be identified. PMID- 3624238 TI - Interferons as gene activators. Characteristics of an interferon-activatable enhancer. AB - Previously we linked a 0.8-kilobase segment (including the 5'-flanking region and the 5'-terminal exon) of an interferon-activatable mouse gene (202 gene) to the chloramphenicol acetyltransferase gene and transfected the construct into mouse Ltk- cells (Samanta, H., Engel, D. A., Chao, H. M., Thakur, A., Garcia-Blanco, M. A., and Lengyel, P. (1986) J. Biol. Chem. 261, 11849-11858). Treatment of these cells with mouse beta-interferon increased the expression of the chloramphenicol acetyltransferase gene 5-10-fold. Here we demonstrate that this segment from the 202 gene has characteristics of an interferon-activatable enhancer: (a) it can activate a heterologous promoter (SV40 early promoter), (b) it is active in both the appropriate and the inverted orientation and in either upstream or downstream locations from the promoter activated, and (c) treatment of cells with interferon increases its activity severalfold. PMID- 3624239 TI - Crystallization and preliminary x-ray investigation of sarcoplasmic calcium binding protein from Nereis diversicolor. AB - Crystals of sarcoplasmic calcium-binding proteins from Nereis diversicolor have been grown from solutions of ammonium sulfate. The crystals are monoclinic, space group P2(1); the axes are a = 43.65 (1), b = 56.05 (1), c = 65.77 (1) A, and beta = 92.58 (2) degrees. The crystals are quite stable to x-rays and diffract beyond 2.5 A resolution. The asymmetric unit contains two protein molecules. PMID- 3624240 TI - Inhibition of the catalytic subunit of phosphorylase kinase by its alpha/beta subunits. AB - The subunits of phosphorylase kinase are separated and isolated in high yield by gel filtration chromatography in pH 3.3 phosphate buffer containing 8 M urea. Three protein peaks are obtained: the alpha and beta subunits coelute in the first, whereas the gamma and delta subunits are separate peaks. Upon dilution of the denaturant, catalytic activity reappears, associated only with the gamma subunit. As has been previously observed (Kee, S.M., and Graves, D.J. (1986) J. Biol. Chem. 261, 4732-4737), addition of calmodulin dramatically stimulates the reactivation of gamma. Inclusion of increasing amounts of the alpha/beta subunit mixture in the renaturation progressively decreases the activity of the renatured gamma or gamma-calmodulin. This inhibition by alpha/beta is likely due to specific interactions with the gamma subunit because the inhibition is less at pH 8.2 than at pH 6.8 and less when equivalent amounts of phosphorylated alpha/beta subunits are used (both alkaline pH and phosphorylation are known to stimulate the activity of the holoenzyme). These results suggest that the role of either the alpha or beta subunits, or perhaps both, in the nonactivated (alpha 2 beta 2 gamma 2 delta 2)2 complex of phosphorylase kinase is to suppress the activity of the gamma subunit and that activation of the enzyme, by phosphorylation for instance, is due to deinhibition caused by release of this quaternary constraint by alpha and/or beta upon gamma. PMID- 3624241 TI - Structures of novel sialylated O-linked oligosaccharides isolated from human erythrocyte glycophorins. AB - The O-linked oligosaccharides attached to human erythrocyte glycophorins were extensively characterized. In addition to the previously described disialylated tetrasaccharide, NeuNAc alpha 2----3Gal beta 1----3 (Neu-NAc alpha 2--- 6)GalNAcOH and monosialylated trisaccharide, NeuNAc alpha 2----3Gal beta 1--- 3GalNAcOH, novel trisialylated oligosaccharides were isolated. Methylation analysis, fast atom bombardment-mass spectrometry, and enzymatic degradation were used to elucidate the following novel structures: formula; see text: These results suggest that O-linked oligosaccharides with a disialosyl group, NeuNAc alpha 2----8NeuNAc alpha 2----, may be present in various tissues. PMID- 3624242 TI - Rabbit skeletal muscle myosin light chain kinase. The calmodulin binding domain as a potential active site-directed inhibitory domain. AB - A synthetic peptide modeled after the calmodulin (CaM)-binding domain of rabbit skeletal muscle myosin light chain kinase, Lys-Arg-Arg-Trp-Lys5-Lys-Asn-Phe-Ile Ala10-Val-Ser-Ala-Ala-+ ++Asn15-Arg-Phe-Glycyl amide (M5), inhibited the CaM independent chymotryptic fragment of the enzyme, C35 (Edelman, A. M., Takio, K., Blumenthal, D. K., Hansen, R. S., Walsh, K. A., Titani, K., and Krebs, E. G. (1985) J. Biol. Chem. 260, 11275-11285), with a Ki of 3.2 +/- 2.1 microM. Inhibition was competitive with respect to the peptide substrate Lys-Lys-Arg-Ala Ala5-Arg-Ala-Thr-Ser-Asn10-Val-Phe-Ala and was of the noncompetitive linear mixed type with respect to ATP. M5 and homologues with a serine residue substituted at positions 9, 13, or 14 were phosphorylated with the following order of preference: M5(Ser9) greater than M5(Ser13) much greater than M5(Ser14) greater than M5. The order of preference observed agreed with that predicted by comparison of the sequence of these peptides with the phosphorylation sites of myosin P-light chains. Both inhibition of C35 by M5 and phosphorylation of M5 and its serine-substituted homologues were severely curtailed by the addition of a stoichiometric excess of CaM over peptide. Thus, synthetic peptides modeled after the CaM-binding domain of skeletal muscle myosin light chain kinase can function as calmodulin-regulated active site-directed inhibitors of the enzyme. PMID- 3624243 TI - A new naturally occurring polyamine containing a quaternary ammonium nitrogen. AB - A new polyamine, tetrakis(3-aminopropyl)ammonium, N+ (CH2CH2CH2NH2)4, was identified in cells of an extreme thermophile, Thermus thermophilus. This compound was chemically synthesized and its chemical properties were coincident with those of the amine isolated from the thermophile. PMID- 3624244 TI - Na+/Ca2+ antiport in cultured arterial smooth muscle cells. Inhibition by magnesium and other divalent cations. AB - Cultured smooth muscle cells from rat aorta were loaded with Na+, and Na+/Ca2+ antiport was assayed by measuring the initial rates of 45Ca2+ influx and 22Na+ efflux, which were inhibitable by 2',4'-dimethylbenzamil. The replacement of extracellular Na+ with other monovalent ions (K+, Li+, choline, or N-methyl-D glucamine) was essential for obtaining significant antiport activity. Mg2+ competitively inhibited 45Ca2+ influx via the antiporter (Ki = 93 +/- 7 microM). External Ca2+ or Sr2+ stimulated 22Na+ efflux as would be expected for antiport activity. Mg2+ did not stimulate 22Na+ efflux, which indicates that Mg2+ is probably not transported by the antiporter under the conditions of these experiments. Mg2+ inhibited Ca2+-stimulated 22Na+ efflux as expected from the 45Ca2+ influx data. The replacement of external N-methyl-D-glucamine with K+, but not other monovalent ions (choline, Li+), decreased the potency of Mg2+ as an inhibitor of Na+/Ca2+ antiport 6.7-fold. Other divalent cations (Co2+, Mn2+, Cd2+, Ba2+) also inhibited Na+/Ca2+ antiport activity, and high external potassium decreased the potency of each by 4.3-8.6-fold. The order of effectiveness of the divalent cations as inhibitors of Na+/Ca2+ antiport (Cd2+ greater than Mn2+ greater than Co2+ greater than Ba2+ greater than Mg2+) correlated with the closeness of the crystal ionic radius to that of Ca2+. PMID- 3624245 TI - Oligosaccharide specificities of Phaseolus vulgaris leukoagglutinating and erythroagglutinating phytohemagglutinins. Interactions with N-glycanase-released oligosaccharides. AB - The structural determinants required for interaction of oligosaccharides with leukoagglutinating phytohemagglutinin (L-PHA) and erythroagglutinating phytohemagglutinin (E-PHA) from Phaseolus vulgaris have been studied by immobilized lectin affinity chromatography. Homogeneous oligosaccharides of known structure, purified following release from Asn with N-glycanase and reduction with NaBH4, were tested for their ability to interact with columns of L- and E PHA-agarose. The characteristic elution position obtained for each oligosaccharide was reproducible and correlated with specific structural features. In virtually all cases, L- and E-PHA yielded identical results, indicating that their specificities for reduced oligosaccharides are similar. Both lectins retarded oligosaccharides bearing alpha 2,3- but not alpha 2,6 linked sialic acid. Desialylated oligosaccharides containing one, two, three, or four peripheral N-acetyllactosamine-type branches were retarded to varying extents by both lectins; however, this interaction was decreased or eliminated by removal of Gal. Desialylated oligosaccharides containing a bisecting GlcNAc residue attached to the beta-linked core Man displayed the greatest interaction with both lectins. Structures containing terminal sulfate or GalNAc did not interact with either lectin. In some instances, the specificities of L- and E-PHA lectins for free, reduced oligosaccharides differed from those established using glycopeptides. Therefore, the structural requirements for interaction with lectins such as L- and E-PHA must be fully and systematically defined using the appropriate authentic standards in order to use lectin affinity chromatography for the fractionation and characterization of free oligosaccharides. PMID- 3624246 TI - Lectin affinity high-performance liquid chromatography. Interactions of N glycanase-released oligosaccharides with Ricinus communis agglutinin I and Ricinus communis agglutinin II. AB - The structural determinants required for interaction of oligosaccharides with Ricinus communis agglutinin I (RCAI) and Ricinus communis agglutinin II (RCAII) have been studied by lectin affinity high-performance liquid chromatography (HPLC). Homogeneous oligosaccharides of known structure, purified following release from Asn with N-glycanase and reduction with NaBH4, were tested for their ability to interact with columns of silica-bound RCAI and RCAII. The characteristic elution position obtained for each oligosaccharide was reproducible and correlated with specific structural features. RCAI binds oligosaccharides bearing terminal beta 1,4-linked Gal but not those containing terminal beta 1,4-linked GalNAc. In contrast, RCAII binds structures with either terminal beta 1,4-linked Gal or beta 1,4-linked GalNAc. Both lectins display a greater affinity for structures with terminal beta 1,4-rather than beta 1,3 linked Gal, although RCAII interacts more strongly than RCAI with oligosaccharides containing terminal beta 1,3-linked Gal. Whereas terminal alpha 2,6-linked sialic acid partially inhibits oligosaccharide-RCAI interaction, terminal alpha 2,3-linked sialic acid abolishes interaction with the lectin. In contrast, alpha 2,3- and alpha 2,6-linked sialic acid equally inhibit but do not abolish oligosaccharide interaction with RCAII. RCAI and RCAII discriminate between N-acetyllactosamine-type branches arising from different core Man residues of dibranched complex-type oligosaccharides; RCAI has a preference for the branch attached to the alpha 1,3-linked core Man and RCAII has a preference for the branch attached to the alpha 1,6-linked core Man. RCAII but not RCAI interacts with certain di- and tribranched oligosaccharides devoid of either Gal or GalNAc but bearing terminal GlcNAc, indicating an important role for GlcNAc in RCAII interaction. These findings suggest that N-acetyllactosamine is the primary feature required for oligosaccharide recognition by both RCAI and RCAII but that lectin interaction is strongly modulated by other structural features. Thus, the oligosaccharide specificities of RCAI and RCAII are distinct, depending on many different structural features including terminal sugar moieties, peripheral branching pattern, and sugar linkages. PMID- 3624247 TI - A novel sialylfucopentaose in human milk. Presence of this oligosaccharide is not dependent on expression of the secretor or Lewis fucosyltransferases. AB - We have identified a novel oligosaccharide in human milk that is a fucosyl derivative of sialyltetrasaccharide c (NeuAc alpha 2-6Gal beta 1-4GlcNAc beta 1 3Gal beta 1-4Glc). This oligosaccharide was purified by affinity chromatography on a column of immobilized Ricinus communis I lectin. Structural analyses of radiolabeled oligosaccharides by exoglycosidase digestions, binding by specific anti-carbohydrate antibodies, and analysis of the 3H-labeled glucitol derivative obtained after permethylation and hydrolysis are consistent with the following proposed structure. (formula; see text) The analyses of human milk sialylpentasaccharides from donors typed as Le(a-,b+), Le(a+,b-), and Le(a-,b-) secretor confirmed the secretor gene-dependent expression of the sialylated lacto N-fucopentaose I (Fuc alpha 1-2Gal beta 1-3[NeuAc alpha 2-6]GlcNAc beta 1-3Gal beta 1-4Glc) and the Lewis gene-dependent expression of the sialylated lacto-N fucopentaose II (NeuAc alpha 2-3Gal beta 1-3[Fuc alpha 1-4]GlcNAc beta 1-4Glc). However, the presence of this novel oligosaccharide in human milk is not dependent on the expression of either the secretor gene or the Lewis gene specified fucosyltransferases. PMID- 3624248 TI - Carbohydrate structure of erythropoietin expressed in Chinese hamster ovary cells by a human erythropoietin cDNA. AB - The proper glycosylation of erythropoietin is essential for its function in vivo. Human erythropoietins were isolated from Chinese hamster ovary cells transfected with a human erythropoietin cDNA and from human urine. Carbohydrate chains attached to these proteins were isolated and fractionated by anion-exchange high performance liquid chromatography (HPLC) and HPLC employing a Lichrosorb-NH2 column. The structures of fractionated saccharides were analyzed by fast atom bombardment-mass spectrometry and methylation analysis before and after treatment with specific exoglycosidases. Both erythropoietins were found to contain one O linked oligosaccharide/mol of the proteins, and its major component was elucidated to be NeuNAc alpha 2----3Gal beta 1----3(NeuNAc alpha 2----6)GalNAcOH (where NeuNAc represents N-acetylneuraminic acid) in both proteins. The N-linked saccharides of recombinant erythropoietin were found to consist of biantennary (1.4% of the total saccharides), triantennary (10%), triantennary with one N acetyllactosaminyl repeat (3.5%), tetraantennary (31.8%), and tetraantennary with one (32.1%), two (16.5%), or three (4.7%) N-acetyllactosaminyl repeats. All of these saccharides are sialylated by 2----3-linkages. Tetraantennary with or without polylactosaminyl units are mainly present as disialosyl or trisialosyl forms, and these structures exhibit the following unique features. alpha 2----3 Linked sialic acid and N-acetyllactosaminyl repeats are selectively present in the side chains attached to C-6 and C-2 of 2,6-substituted alpha-mannose and C-4 of 2,4-substituted alpha-mannose. We have also shown that the carbohydrate moiety of urinary erythropoietin is indistinguishable from recombinant erythropoietin except for a slight difference in sialylation, providing the evidence that recombinant erythropoietin is valuable for biological as well as clinical use. PMID- 3624249 TI - An expanded two-state allosteric model for interactions of human hemoglobin A with nonsaturating concentrations of 2,3-diphosphoglycerate. AB - Oxygen binding curves (OEC) for red cell suspensions have a biphasic shape and reduced n50 values when the concentration of 2,3-diphosphoglycerate (DPG) is lowered by aging or experimental procedures. The mechanism for the abnormal shape of the OEC has been related to variations in the activity of free DPG. DPG binds to tetrameric Hb at a single site, and in red cells its normal concentration is equivalent to that of tetrameric Hb. This equivalence renders the oxygen affinity of Hb and the shape of the OEC very sensitive to small changes in the activity of DPG. The OEC for stripped Hb solutions in the presence of nonsaturating concentrations of DPG also exhibit a biphasic shape but with much larger changes in the n values than observed for red cells. Upon addition of chloride, a known competitor of DPG binding to Hb, the shape of the OEC becomes similar to that of red cell suspensions with the same DPG/Hb ratio. Studies on Hb solutions in the presence of varying concentrations of DPG, but without chloride, have revealed that the cofactor shifts the entire OEC to the right, including both its upper and lower asymptotes. This finding indicates that DPG lowers the intrinsic oxygen affinity for both the T and R states. Theoretical considerations leading to a successful modeling of OEC obtained under varying conditions of DPG and chloride require an expanded two-state allosteric model in which allowance is made for DPG dependent variations in the dissociation constants of oxygen for both the T and R conformations. PMID- 3624250 TI - Protein synthesis inhibition in mouse peritoneal macrophages results in increased acyl coenzyme A:cholesterol acyl transferase activity and cholesteryl ester accumulation in the presence of native low density lipoprotein. AB - Cholesteryl ester (CE) accumulation in arterial wall macrophages (foam cells), mediated by the intracellular enzyme acyl coenzyme A:cholesterol acyl transferase (ACAT), is a prominent feature of atherosclerotic lesions. However, native low density lipoprotein (LDL) does not cause activation of ACAT or CE accumulation in cultured mouse peritoneal macrophages despite both substantial LDL uptake and degradation and the presence of ACAT in these cells. We now report that when protein synthesis is inhibited in mouse peritoneal macrophages by treatment with cycloheximide, puromycin, or actinomycin D, native LDL-induced whole-cell ACAT activity and CE accumulation is 10-fold higher than that seen in LDL-treated control cells. The enhancement of ACAT activity was seen 4 h after the addition of cycloheximide, and ACAT activity returned to control values 4 h after the withdrawal of cycloheximide. Postnuclear supernatants and microsomes from cycloheximide-treated mouse peritoneal macrophages also had higher ACAT activity than microsomes from control cells, but the relative enhancement (maximum 3.3 fold) was less than that seen when ACAT was assayed in the intact cell. In contrast to the situation with mouse peritoneal macrophages, cycloheximide treatment of J774 macrophages, which under normal conditions display high ACAT activity and CE accumulation in the presence of native LDL, did not result in further enhancement of either ACAT activity or LDL-induced CE accumulation. From these data we postulate that mouse peritoneal macrophages have a short-lived protein that inhibits ACAT-mediated cholesterol esterification which is responsible for their lack of ACAT response and CE accumulation in the presence of native LDL. The explanation for high ACAT activity and LDL-induced CE accumulation in J774 macrophages may be that these cells lack the putative mouse peritoneal macrophage cholesterol esterification inhibitor. PMID- 3624252 TI - Chromatin structure. Further evidence against the existence of a beaded subunit for the 30-nm fiber. AB - The size distribution of chromatin fragments released by micrococcal nuclease digestion of liver chromatin at various ionic strengths was examined. Below 20 mM ionic strength, gradient profiles with a peak centered at 6 nucleosomes are generated, whereas between 20 and 50 mM the peak is always centered on 12 nucleosomes, and above 50 mM ionic strength the 30-nm fiber becomes less accessible to the nuclease and there is a corresponding increase in the size distribution of fragments in the gradients. However, extensive digestions always give profiles with a peak of 12 nucleosomes as nuclease-resistant dodecamers accumulate. All of these observations are consistent with the winding of the 10 nm polynucleosome chain into a helical coil commencing at about 20 mM ionic strength. The helical turns are stabilized by histone H1 interactions between 20 and 50 mM ionic strength producing stable dodecamers. Above 50 mM ionic strength the coil condenses longitudinally and the profiles are consistent with a random attack of this fiber by the nuclease. Consequently it is not necessary to invoke the existence of a subunit bead to explain the profiles. We further define the conditions at which specific structural transitions take place and provide methodology for the preparation of chromatin at various levels of condensation. PMID- 3624251 TI - Structure of a gene encoding the 1.7 S storage protein, napin, from Brassica napus. AB - A rapeseed chromosomal region containing a gene (napA), which encodes the 1.7 S seed storage protein (napin), was isolated in several overlapping recombinant clones from a phage lambda genomic library. Following restriction enzyme mapping of the genomic region, a subclone containing the napA coding region as well as some 1.1 and 1.4 kilobases of DNA from the 5' and 3' regions, respectively, was mapped and sequenced. The gene turned out to lack introns. Southern blotting analyses utilizing a napin cDNA clone as a probe revealed the presence of on the order of 10 napin genes in the rapeseed genome. The major polyadenylated transcript encoded by these genes was shown to be an 850-nucleotide species, the initiation site of which was mapped onto the napA gene. The major initiation site for transcription is located some 33 nucleotides downstream from a sequence perfectly conforming to the consensus sequence of a TATA box. Further analyses of the sequence revealed several features that may be of relevance for the expression of the napin genes. PMID- 3624253 TI - Chromatin structure. Evidence that the 30-nm fiber is a helical coil with 12 nucleosomes/turn. AB - Sedimentation analysis has been used to compare the structure of 30-nm chromatin fibers, isolated and digested under conditions that maintain the native structure, with relaxed-refolded chromatin. The native chromatin fibers show sharp, ionic strength-dependent changes in sedimentation coefficient that are not apparent in relaxed-refolded fibers. The first transition at approximately 20 mM ionic strength reflects the organization of the 10-nm polynucleosome chain into a loose helically coiled 30-nm fiber. Between 20 and 60 mM ionic strength there is considerable interaction between nucleosomes within the coils to generate a stable helical array with 12 nucleosomes/turn. Above 60 mM ionic strength the helical coil continues to condense until it precipitates at ionic strengths slightly greater than those considered physiological, indicating that there is no end point in fiber formation. The data is incompatible with a solenoid model with 6 nucleosomes/turn and also rules out the existence of a beaded subunit structure. PMID- 3624254 TI - rec-A protein-promoted recombination reaction consists of two independent processes, homologous matching and processive unwinding. A study involving an anti-rec-A protein-monoclonal IgG. AB - recA protein promotes the formation and processing of joint molecules of homologous double-stranded DNA and single-stranded DNA. We studied the effects of an anti-recA protein monoclonal IgG (ARM193) on two processes carried out by the recA protein. The homologous matching, i.e. pairing of double-stranded DNA and single-stranded DNA by forming intermolecular base-pairing at homologous regions was found to occur even in the presence of an excess amount of antibody ARM193. On the other hand, processive unwinding, i.e. the propagation of the unwinding of double-stranded DNA through a processive reaction of recA protein, which occurs even in the absence of single-stranded DNA, was found to be very sensitive to the inhibition by antibody ARM193. Therefore, we conclude that homologous matching and processive unwinding are independent of each other. Analysis of the effect of antibody ARM193 on the various activities of recA protein suggests that the entire reaction of the formation of joint molecules and their processing can be rationalized in terms of these two underlying processes, homologous matching and processive unwinding. This analysis also suggests that homologous matching seems to require only the binding itself of active units of recA protein to single stranded DNA but not necessarily either the cooperativity of the protein or unwinding. PMID- 3624255 TI - Modulation of 3-hydroxy-3-methylglutaryl-coenzyme A reductase by azole antimycotics requires lanosterol demethylation, but not 24,25-epoxylanosterol formation. AB - The lanosterol 14 alpha-methyl demethylase inhibitors miconazole and ketoconazole have been used to assess their effects upon cholesterol biosynthesis in cultured Chinese hamster ovary cells. In Chinese hamster ovary cells treated with either agent, an initial accumulation of lanosterol and dihydrolanosterol has been observed. At elevated concentrations, however, ketoconazole, but not miconazole, causes the preferential accumulation of 24,25-epoxylanosterol and squalene 2,3:22,23-dioxide. These metabolites accumulate at the expense of lanosterol, thereby demonstrating a second site of inhibition for ketoconazole in the sterol biosynthetic pathway. Both demethylase inhibitors produced a biphasic modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in the cholesterol biosynthetic pathway. The biphasic modulation is characterized by low levels of the drugs suppressing HMG-CoA reductase activity which is restored to either control or above control values at higher drug concentrations. This modulatory effect of the lanosterol demethylase inhibitors upon HMG-CoA reductase was not observed in the lanosterol 14 alpha-methyl demethylase-deficient mutant AR45. Suppression of HMG-CoA reductase activity is shown to be due to a decrease in the amount of enzyme protein consistent with a steroidal regulatory mechanism. Collectively, the results establish that lanosterol 14 alpha-methyl demethylation, but not 24,25-epoxylanosterol formation, is required to suppress HMG-CoA reductase in the manner described by lanosterol demethylase inhibitors. PMID- 3624256 TI - In situ accumulation of 3 beta-hydroxylanost-8-en-32-aldehyde in hepatocyte cultures. A putative regulator of 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity. AB - Biphasic modulation of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase) has been demonstrated in primary hepatocyte cultures treated with the lanosterol 14 alpha-methyl demethylase inhibitor miconazole. At concentrations of the drug which lead to suppressed levels of reductase activity, the appearance of a polar, mevalonate-derived sterol is noted. Cochromatography of the identified sterol with 3 beta-hydroxylanost-8-en-32-aldehyde tentatively identified the metabolite as a lanosterol 14 alpha-methyl demethylation intermediate. Subsequent isolation and characterization of the metabolite by gas chromatography/mass spectroscopy confirmed this structural assignment. When the lanosterol 14 alpha methyl demethylase-deficient mutant, AR45, was treated with authentic metabolite, a suppression of HMG-CoA reductase was observed. These results demonstrate that metabolism of the oxygenated biosynthetic intermediate is not required to suppress reductase activity. The results also strongly support the hypothesis that oxygenated 14 alpha-methyl demethylase intermediates are endogenously generated modulators of HMG-CoA reductase activity. PMID- 3624257 TI - Tryptophan in alpha-helix 3 of Tet repressor forms a sequence-specific contact with tet operator in solution. AB - The Tn10-encoded Tet repressor contains two tryptophan residues at positions 43 and 75. The typical tryptophan fluorescence is decreased upon binding of tet operator. The Tet repressor gene was engineered to replace either or both of the Trp codons by Phe codons. The resulting single tryptophan mutants are called F43 and F75 and the double mutant F43F75. The mutant proteins were purified to homogeneity. They recognize tet operator DNA only in the absence of the inducer tetracycline, indicating an intact tertiary structure of the engineered proteins. F75 and wild-type bind tet operator with the same association constant. The association constants of F43 and F43F75 with tet operator are about 3 orders of magnitude smaller. This indicates that Trp43 is important for tet operator recognition. Trp43 fluorescence is completely quenched in the complex with tet operator DNA while Trp75 remains unaffected. Binding to nonspecific DNA leads only to a 40% decrease of Trp43 fluorescence. This is interpreted as the contribution of the changed environment while the complete quench reflects a tight sequence-specific contact of tryptophan 43 to tet operator DNA. Trp43 is solvent-exposed, while Trp75 is buried in the hydrophobic interior of the protein. These results are discussed in light of the alpha-helix turn-alpha-helix DNA binding motif deduced from homology to other repressor proteins. PMID- 3624258 TI - Partial repair of deamidation-damaged calmodulin by protein carboxyl methyltransferase. AB - Modification of calmodulin by protein carboxyl methyltransferase requires deamidation of one or more labile asparagine residues (Johnson, B.A., Freitag, N. E., and Aswad, D. W. (1985) J. Biol. Chem. 260, 10913-10916). We now show that deamidation results in the generation of two altered forms of calmodulin, designated A and B, which can be separated by electrophoresis under nondenaturing conditions. The A form is characterized by a larger apparent molecular radius, has only 10% the activity of native calmodulin when assayed for its ability to activate a Ca2+/calmodulin-dependent protein kinase from rat brain, and serves as an excellent substrate for the methyltransferase. The B form more closely resembles native calmodulin: it has an apparent molecular radius more like the native, exhibits about 40% the activity of native calmodulin, and is a relatively poor methyl acceptor. Evidence suggests that the A and B forms probably contain isoaspartate (A) and aspartate (B) in place of Asn-60 and/or Asn-97. Incubation of the A form with methyltransferase and S-adenosyl-L-methionine converts about half of the A form to an electrophoretic band indistinguishable from the B form. The activity of this partly converted calmodulin rises to 30-50% that of native calmodulin. These observations imply that the methyltransferase may have a biological role in restoring activity to proteins which contain abnormal isoaspartyl peptide bonds resulting from asparagine deamidation. PMID- 3624259 TI - Absence of heat shock protein synthesis in isolated mitochondria and plastids from maize. AB - Examination of the proteins synthesized by isolated mitochondria, chloroplasts, or proplastids from maize tissues showed that a heat treatment at 40 degrees C does not induce or enhance the synthesis of any protein when compared to preparations treated at the control temperature of 28 degrees C. These observations are consistent with the results obtained by labeling proteins in vivo under sterile conditions. In vivo labeling in the presence of cycloheximide during heat shock showed no heat shock protein synthesis. Labeling in the presence of chloramphenicol during heat shock showed a similar heat shock protein pattern as in the absence of the inhibitor. It is concluded that maize organelles do not synthesize heat shock proteins and that, if present, they may be due to bacterial contamination. PMID- 3624260 TI - Isolation and catalytic activity of cytochrome P-450 from ventral prostate of control rats. AB - 5 alpha-Androstane-3 beta, 17 beta-diol hydroxylase (3 beta-diol hydroxylase), a form of cytochrome P-450, was purified from rat ventral prostate, and its regulation as a function of age and 5 alpha-dihydrotestosterone (DHT) treatment was examined. Cytochrome P-450 could be quantitated by its CO difference spectrum only after partial purification from the microsomal membrane, and this was achieved by chromatography on p-chloroamphetamine-coupled Sepharose. Further purification of prostate microsomal P-450 by anion exchange chromatography yielded a preparation with a P-450 content of 8-10 nmol/mg of protein, which upon sodium dodecyl sulfate electrophoresis showed, in the molecular weight region between 50,000 and 60,000 where P-450 is expected to migrate, a single protein band of Mr 54,000. This preparation upon reconstitution with cytochrome P-450 reductase and microsomal lipid catalyzed the formation of three triols, 5 alpha androstane-3 beta, 7 beta, 17 beta-triol, 5 alpha-androstane-3 beta, 6 alpha, 17 beta-triol, and 5 alpha-androstane-3 beta, 7 alpha, 17 beta-triol from 3 beta diol in the ratio 1:7:3. Both turnover number and the ratio of the three products in the reconstituted system were similar to that found in prostate microsomes. These data indicate that a single form of P-450 catalyzes the formation of all three triols and that 3 beta-diol hydroxylase is the major, if not the only, form of P-450 in the prostate microsomes of untreated rats. The yield of P-450 from prostate microsomes varied as a function of age from a high level of 0.05 nmol/mg of microsomal protein in 6-week-old rats to 0.002 nmol/mg of microsomal protein in rats 11 weeks or older. 3 beta-Diol hydroxylase activity followed a similar age-related pattern varying between 2,000 and 4,000 nmol of triols formed/g of tissue/h in 6-week-old rats to 100 nmol of triols formed/g of tissue/h in 11-week old rats. Treatment of 6-week-old rats with DHT did not prevent the age-related decrease in 3 beta-diol hydroxylase activity. However, DHT does play a role in the regulation of this enzyme since castration resulted in a loss of catalytic activity from the prostate and treatment of castrated rats with DHT caused an induction of the enzyme. PMID- 3624261 TI - The respiratory burst oxidase of neutrophils. Separation of an FAD enzyme and its characterization. AB - Pig blood neutrophils were briefly activated by various fatty acids and then fractionated into membrane vesicles with different NADPH oxidase activities. Treatment of these membranes with a detergent, octyl glucoside, resulted in a high yield of solubilized oxidase, which was subjected to isoelectric focusing on gels (pI 4.0-8.0). 1) A distinct band staining with NADPH-nitroblue tetrazolium focused at pI 5.0. The enzyme (pI 5.0) showed high specificity for NADPH and similar characteristics to the oxidase involved in the respiratory burst. 2) The enzyme was extracted from gel slices and analyzed. When measured promptly after its extraction, its NADPH oxidase activity was high, but there was apparent superoxide dismutase-insensitive cytochrome c reduction, probably due to direct electron transfer to the heme protein. However, it could produce superoxide anion (O2-) under some micelle conditions. 3) Therefore, the formation of the enzyme substrate complex of yeast cytochrome c peroxidase was employed for the detection of H2O2. A fresh extract of stimulated cells catalyzed equimolar NADPH oxidation and H2O2 production of 306 and 300 nmol min-1 (mg protein)-1, respectively. The Km value of the enzyme for NADPH was 30 +/- 13 (S.D.) microM. The recovery of the extract (pI 5.0) was 19% of the total activity. 4) The enzyme extract contained 1.1-1.9 nmol of FAD/mg of protein, giving a turnover number of 300-600 min-1 in terms of O2- generation/FAD. No heme protein was found in the enzyme. The enzyme was mainly of 67-kDa molecular mass. PMID- 3624262 TI - Biosynthesis of cathepsin B in cultured normal and I-cell fibroblasts. AB - Biosynthesis and processing of cathepsin B in cultured human skin fibroblasts were investigated using immunological procedures. Upon metabolic labeling with [35S]methionine for 10 min, a precursor form with Mr 44,500 was identified. During an 80-min chase, about 50% of it was converted to an Mr 46,000 form. Further processing yielded mature forms with Mr 33,000 and 27,000, in a final quantitative ratio of about 3:1. Processing of cathepsin B was inhibited by leupeptin, which led to an accumulation of the Mr 33,000 polypeptide. The Mr 33,000 form appeared to be the most active form and showed a half-time of about 12 h. About 5% of newly synthesized enzyme was secreted as precursor, being detectable extracellularly already after 40 min. NH4Cl enhanced the secretion of the precursor about 20-fold. The precursor and the 33-kDa form contained phosphorylated N-linked oligosaccharides. Cleavage by peptide N-glycosidase F or biosynthesis in the presence of tunicamycin yielded a precursor with Mr 39,000. Evidence of a mannose 6-phosphate-dependent transport of cathepsin B in fibroblasts was obtained on the basis of the following results: (i) cathepsin B precursor from NH4Cl-stimulated secretions was internalized in a mannose 6 phosphate inhibitable manner, and (ii) I-cell fibroblasts secreted more than 95% of newly synthesized cathepsin B precursor. In conclusion, cathepsin B from human skin fibroblasts shows an analogous biosynthetic behavior as other lysosomal enzymes. PMID- 3624263 TI - Decreased levels of hepatic epidermal growth factor receptors in obese hyperglycemic rodents. AB - Stimulation of epidermal growth factor (EGF) receptor autophosphorylation by EGF and phosphorylation of a Mr 52,000 protein endogenous to the membrane extracts were decreased 6-12-fold in liver membrane extracts from mice homozygous for either the ob/ob or db/db mutation when compared to controls. Liver membranes from the mutant mice bound 4-5-fold less 125I-EGF/unit of protein than did their normal littermates, but exhibited normal EGF binding affinity. Similar decreases in EGF binding were noted in liver membranes from homozygous fa/fa Zucker rats, another obese, hyperinsulinemic animal model, when compared to values from control animals. We also immunoprecipitated hepatic EGF receptors from mice injected with [35S]methionine, and found that livers from db/db mice contained approximately 35% of the labeled EGF receptors found in control animals. Both ob/ob and db/db mice had serum immunoreactive EGF levels similar to or lower than those found in unaffected littermates, suggesting that ligand-mediated down regulation of receptors was not the cause of the decreased EGF binding. In one mutant, db/db, the decreased binding was associated with a 6-fold decrease in the levels of liver EGF receptor mRNA transcripts; in the ob/ob mice, at most a 2 fold decrease in the level of liver EGF receptor transcripts was observed. EGF binding to cultured peritoneal fibroblasts derived from db/db mice was normal, suggesting that the abnormality in the mutant mice might result from altered environmental or tissue-specific factors rather than an abnormal receptor gene. This was supported by Southern blot analysis of DNA from these animals, which showed identical restriction fragment patterns for the EGF receptor gene in both control and mutant animals. These data indicate that three distinct strains of obese hyperglycemic rodents have decreased levels of hepatic EGF receptors, and suggest that this decrease may result from altered environmental stimuli or tissue-specific factors rather than a primary defect in the EGF receptor gene. PMID- 3624264 TI - Purification and characterization of a transcription termination factor from vaccinia virions. AB - A DNA-dependent RNA polymerase that transcribes vaccinia virus early genes was partially purified from virus cores by deoxycholate extraction and DEAE-cellulose column chromatography. Accurately initiated and terminated RNAs were synthesized by this enzyme in the presence of a linear duplex DNA template. Glycerol gradient sedimentation resolved the in vitro transcription system into two components: fraction I, a rapidly sedimenting RNA polymerase that initiated transcription at an early promoter but transcribed beyond the in vivo 3' terminus to yield a run off transcript, and fraction II, a more slowly sedimenting fraction, itself devoid of RNA polymerase, that restored efficient termination when added back to fraction I. The termination factor was heat-labile, resistant to N ethylmaleimide, and did not exhibit endonucleolytic activity on run-off transcripts. Factor-dependent termination required specific sequence information upstream of the site of termination. The vaccinia termination factor was purified extensively by column chromatography on DEAE-cellulose, heparin-agarose, phosphocellulose, and DNA-agarose, and by velocity sedimentation in a glycerol gradient. At each step, termination factor copurified with the vaccinia mRNA capping enzyme. The preparation was well over 90% pure with respect to the latter enzyme, suggesting that termination activity was tightly associated with, if not intrinsic to, the capping enzyme. Nonetheless, formation of the 5'-cap structure did not appear to be a prerequisite for termination. PMID- 3624265 TI - Cloning and sequence of rat myoadenylate deaminase cDNA. Evidence for tissue specific and developmental regulation. AB - Myoadenylate deaminase is the muscle-specific isoform of AMP deaminase (EC 3.5.4.6), an enzyme which plays a special role in energy metabolism in skeletal muscle. A 2.3-kilobase cDNA encoding this enzyme has been cloned from a lambda gt10 library prepared from rat skeletal muscle using oligonucleotide probes designed from AMP deaminase peptide sequences. This cDNA was sequenced, and the amino acid sequence of this isoform of AMP deaminase was deduced. Sequences homologous to this cDNA are identified in the genome of eukaryotes as diverse as yeast and man. Tissue-specific expression of a 2.5-kilobase AMP deaminase transcript is demonstrated, and the abundance of this transcript as well as the 80-kDa adult, muscle-specific peptide of AMP deaminase increase in parallel during postnatal skeletal muscle development. In the adult animal, the abundance of this transcript and AMP deaminase activity are differentially expressed in various skeletal muscle fiber types. We conclude that AMP deaminase sequences have been highly conserved during evolution, and in mammals there is developmental and tissue-specific control of expression of this gene. PMID- 3624266 TI - Glycerol 1,2-cyclic phosphate in centric diatoms. Observation by 31P NMR in vivo, isolation, and structural determination. AB - We have isolated and identified glycerol 1,2-cyclic phosphate as the compound responsible for a unique prominent resonance at 19.1 ppm in the 31P NMR spectrum in vivo of four species of centric diatoms, where it is responsible for 15 to 30% of the total signals from organophosphates. This appears to be the first observation of this compound as a major metabolite. It was not detectable in nine other species of algae, including four species of pennate diatoms. PMID- 3624267 TI - Polycyclic aromatic hydrocarbon quinones and glutathione thioethers as substrates and inhibitors of the human placental NADP-linked 15-hydroxyprostaglandin dehydrogenase. AB - The human placental NADP-linked 15-hydroxyprostaglandin dehydrogenase catalyzes oxidoreduction at the 9- and 15-positions of many prostaglandins, but its catalytic efficiency (i.e. kcat/Km) for these reactions is low (Jarabak, J., Luncsford, A., and Berkowitz, D. (1983) Prostaglandins 26, 849-868). In the present study, we demonstrate that both K-region and non-K-region o-quinones of polycyclic aromatic hydrocarbons are excellent substrates for this enzyme. These compounds are reduced with kcat/Km values ranging from 3 to 20 X 10(6) S-1 M-1. The glutathione thioethers of menadione and toluquinone are reduced with similar catalytic efficiencies. Furthermore, these substances and certain other glutathione thioethers are potent inhibitors of prostaglandin B1 oxidation ([I50] = 7 X 10(-8) to 5 X 10(-6) M); while several glutathione thioethers also inhibit polycyclic aromatic hydrocarbon quinone reduction ([I50] = 1.7-6.5 microM). These findings raise the possibility that the potential toxicity of quinones of polycyclic aromatic hyrocarbons and other xenobiotic substances may be altered in the placenta by an oxidoreductase for which prostaglandins are relatively poor substrates. They also suggest that the presence in placental tissue of certain glutathione thioethers could influence the reduction of these quinones and other xenobiotic substances by this enzyme. PMID- 3624268 TI - Messenger RNA synthesis in mammalian cells is catalyzed by the phosphorylated form of RNA polymerase II. AB - Mammalian cells contain two subspecies of RNA polymerase II, designated IIO and IIA. The objectives of these studies were to determine the structural relationship between these subspecies and to determine the functional significance of these differences. Subunits IIo and IIa were purified from calf thymus, and the effect of alkaline phosphatase treatment on electrophoretic mobility and immunochemical reactivity was examined. The removal of phosphate converts subunit IIo to a form indistinguishable from that of subunit IIa. These results indicate that subunit IIo is produced by multisite phosphorylation of subunit IIa. The distribution of phosphate within subunit IIo was determined by CNBr cleavage of in vivo labeled HeLa cell RNA polymerase II. 32P-Labeled subunit IIo was purified by immunoprecipitation and cleaved with CNBr, and the resultant peptides were analyzed. The quantitative recovery of 32P in the C-terminal peptide establishes that this domain is the primary site of phosphorylation. In an effort to assess the level of phosphorylation of the transcriptionally active form of RNA polymerase II in HeLa nuclei, transcription was carried out in the presence of 4-thiouracil triphosphate and the nascent labeled transcript cross linked to RNA polymerase. Specific photoaffinity labeling of subunit IIo was observed. Alkaline phosphatase treatment results in an increase in the mobility of photoaffinity labeled subunit IIo to approach that of subunit IIa. These results indicate that subunit IIo is a component of transcriptionally active RNA polymerase II. PMID- 3624269 TI - Steady-state levels of mRNAs coding for the type IV collagen and laminin polypeptide chains of basement membranes exhibit marked tissue-specific stoichiometric variations in the rat. AB - Rat retina, lens, and kidney from 8-week-old animals were assayed for the steady state levels of mRNAs for four basement membrane components: The alpha 1 chain of type IV collagen, the alpha 2 chain of type IV collagen, the B1 chain of laminin, and the B2 chain of laminin. Each tissue exhibited markedly different ratios of the four mRNAs. The mRNA ratio for the alpha 1 chain of type IV collagen to the B1 chain of laminin varied from a value of 0.7 in retina to a value of 17 in lens. Also, the mRNA ratio for the alpha 1 chain to the alpha 2 chain of type IV collagen varied from 1.6 in retina to 17 in lens, and the mRNA ratio for the B1 chain to the B2 chain of laminin varied from 0.6 in lens to 2.9 in kidney. The mRNA coding for the alpha 1 chain of type IV collagen decreased in all three tissues as the animals increased in age from 8 to 16 weeks, with the rate of decline being greater in retina than in lens of kidney. The levels of mRNA coding for the B1 and the B2 chains of laminin decreased in the kidney between 8 and 16 weeks but at different rates. Comparison of mRNAs from kidney of rats over this time period showed that the ratio of alpha 1 to B1 remained relatively constant with age, whereas the ratio of B1 to B2 increased. One possible explanation for the results is that each tissue has elaborate, tissue-specific controls for translation that provide synthesis of basement membrane components in the same proportion, in spite of the varying steady-state levels of the mRNAs. A more likely explanation is that different tissues synthesize type IV collagen and laminin at different rates, and that even the subunit compositions of the type IV collagen and laminin molecules vary from tissue to tissue and in an age-dependent manner. PMID- 3624270 TI - Relaxin structure. Quasi allosteric effect of the NH2-terminal A-chain helix. AB - The NH2-terminal heptapeptide in the relaxin A-chain (Arg-Met-Thr-Leu-Ser-Glu Lys) has been replaced by chemical means with three different helix-promoting peptides (Arg-Met-Ala-Ala-Ala-Ala-Ala-Ala-Ala-Ala-Ala-Ala, and the insulin segment Gly-Ile-Val-Glu-Gln). The partially protected NH2 terminally shortened relaxin derivative (N epsilon A16,N epsilon B8-bis(methyl sulfonylethyloxycarbonyl)des-ArgA1,MetA2 , ThrA3,LeuA4,SerA5,GluA6,LysA7-B29 relaxin) has been prepared by a combination of cyanogen bromide digestion and Edman degradation of the epsilon-amino-protected derivative followed by mixed anhydride coupling with the synthetic peptides. All three derivatives have been isolated and purified by high performance liquid chromatography. Whole relaxins shortened at the NH2 terminus of the A-chain by 4 or more amino acid residues are biologically inactive in the mouse pubic symphysis assay (Bullesbach, E. E., and Schwabe, C. (1986) Biochemistry 25, 5998-6004). The introduction of the artificial peptides causes significant biological activity to reappear (about 30%). The loss of structural integrity of relaxins shortened by 4 or more residues of the A-chain NH2 terminus as observed by circular dichroism spectroscopy is largely reversed by the addition of the synthetic peptides. Our results suggest that no single amino acid in the NH2-terminal region of the A chain is functionally important but that the presence of a helix is required for biological activity. PMID- 3624271 TI - Detection of a glycosylated, incompletely folded form of chorionic gonadotropin beta subunit that is a precursor of hormone assembly in trophoblastic cells. AB - The alpha and beta subunits of human chorionic gonadotropin are secreted both as a combined, noncovalently linked dimer form as well as uncombined, free forms by human trophoblastic cells. We have utilized the cultured choriocarcinoma cell line JAR to determine what regulates the combination of the two subunits. The human chorionic gonadotropin subunits produced by JAR cells were biosynthetically labeled with [35S] cysteine or [3H]mannose by a pulse-chase protocol, purified by immunoprecipitation with specific antisera that recognize free or combined subunits, and separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing or reducing conditions. Radioactively labeled bands were eluted from the gels and analyzed for total counts/minute incorporated, the ratio of free thiols to intramolecular cystine disulfides, and oligosaccharide composition. In some experiments, labeled gel bands were eluted with trypsin under nonreducing conditions, and the trypsin-released peptides were analyzed by high performance liquid chromatography. Using these procedures, the following results were obtained. The earliest, biosynthetically labeled form of the beta subunit detected in JAR cells contains high mannose N-linked oligosaccharides and has one-half of its incorporated cysteines present as free thiols. This form, termed pre-beta 1, has not yet combined with the alpha subunit even though the biosynthetically labeled alpha subunit is present in the cells at the same time. The pre-beta 1 form has a t1/2 of about 4 min and has a precursor product relationship with a more completely disulfide-bonded form, termed pre beta 2, which does combine with the alpha subunit to form a dimer. A subset of beta molecules produced in JAR cells does not attain the same disulfide bonding pattern as the pre-beta 2 form, does not combine with the alpha subunit, and is secreted as a free beta subunit into the culture medium. On the other hand, the earliest detectable form of the alpha subunit in JAR cells has all its thiols present as cystine disulfides, at a time when dimerization with the beta subunit has not yet taken place. These results strongly suggest that intramolecular disulfide bond formation in the beta subunit is the crucial and rate-limiting event in alpha beta dimer formation. The subset of beta molecules that remain free do not appear to form the appropriate intramolecular disulfides and thus do not achieve the correct conformation to combine with the alpha subunit.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3624272 TI - Characterization of a protein C activator from Agkistrodon contortrix contortrix venom. AB - The protease from Southern Copperhead venom that activates protein C was purified to homogeneity by sulfopropyl (SP)-Sephadex C-50 ion-exchange chromatography, Sephadex G-150 gel filtration, and Mono-S fast protein liquid chromatography. The purified enzyme is a glycoprotein containing 16% carbohydrate, and migrated as a single band in sodium dodecyl sulfate-polyacrylamide gel electrophoresis with an apparent molecular mass of 40,000 kDa. The enzyme is composed of a single polypeptide chain possessing an NH2-terminal sequence of Val-Ile-Gly-Gly-Asp-Glu Cys-Asn-Ile-Asn-Glu-His. The purified venom protein C activator hydrolyzed several tripeptide p-nitroanilides. The amidolytic and proteolytic activities of the enzyme were readily inhibited by phenylmethanesulfonyl fluoride, p amidinophenylmethanesulfonyl fluoride, chloromethyl ketones, and human antithrombin III. Covalent binding of diisopropyl fluorophosphate to the enzyme was confirmed using a tritium-labeled preparation of the inhibitor. The venom protease readily activated human and bovine protein C at 1:1000 enzyme:substrate weight ratio. The protease also cleaved human prothrombin, factor X, factor IX, factor VII, and fibrinogen. Prothrombin coagulant activity decreased upon incubation with the venom protease, and the rate of this reaction was reduced in the presence of calcium. Factor X and factor IX coagulant activity increased upon incubation with the venom protease in the presence of calcium, and decreased in the absence of calcium. Human factor VII clotting activity decreased slightly upon incubation with the venom protease. Although the venom protease did not clot human fibrinogen, it nonetheless cleaved the A alpha chain of fibrinogen, and this cleavage appeared to be associated with a measurable increase in the clottability of the protease-treated fibrinogen by thrombin. These data demonstrate that the protein C activator from Southern Copperhead venom is a typical serine protease with a relatively broad specificity. PMID- 3624273 TI - Characterization of an active site peptide modified by the substrate analogue 3 bromo-2-ketoglutarate on a single chain of dimeric NADP+-dependent isocitrate dehydrogenase. AB - The substrate analogue 3-bromo-2-ketoglutarate reacts with pig heart NADP+ dependent isocitrate dehydrogenase to yield partially inactive enzyme. Following 65% inactivation, no further inactivation was observed. Concomitant with this inactivation, incorporation of 1 mol of reagent/mol of enzyme dimer was measured. The dependence of the inactivation rate on bromoketoglutarate concentration is consistent with reversible binding of reagent (KI = 360 microM) prior to irreversible reaction. Manganous isocitrate reduces the rate of inactivation by 80% but does not provide complete protection even at saturating concentrations. Complete protection is obtained with NADP+ or the NADP+-alpha-ketoglutarate adduct. By modification with [14C]bromoketoglutarate or by NaB3H4 reduction of modified enzyme, a single major radiolabeled tryptic peptide was obtained by high performance liquid chromatography with the sequence: Asp-Leu-Ala-Gly-X-Ile-His Gly-Leu-Ser-Asn-Val-Lys. Evidence in the following paper (Bailey, J.M., Colman, R.F. (1987) J. Biol. Chem. 262, 12620-12626) indicates that X is glutamic acid. Enzyme modified at the coenzyme site by 2-(bromo-2,3-dioxobutylthio)-1,N(6) ethenoadenosine 2',5'-biphosphate in the presence of manganous isocitrate is not further inactivated by bromoketoglutarate. Bromoketoglutarate-modified enzyme exhibits a stoichiometry of binding isocitrate and NADPH equal to 1 mol/mol of enzyme dimer, half that of native enzyme. These results indicate that bromoketoglutarate modifies a residue in the nicotinamide region of the coenzyme site proximal to the substrate site and that reaction at one catalytic site of the enzyme dimer decreases the activity of the other site. PMID- 3624274 TI - The primary structure of rat ribosomal protein L7. The presence near the amino terminus of L7 of five tandem repeats of a sequence of 12 amino acids. AB - The covalent structure of rat ribosomal protein L7 was determined in part from the sequence of nucleotides in a recombinant cDNA and in part from the sequence of amino acids in portions of the protein. The complementary analyses supplemented and confirmed each other. Ribosomal protein L7 contains 258 amino acids and has a molecular weight of 30,040. The protein has an unusual and striking structural feature near the NH2 terminus: five tandem repeats of a sequence of 12 residues. Rat L7 appears to be related to ribosomal protein L7 from the moderate halophile Vibrio costicola and perhaps to L30 from Bacillus stearothermophilus, to L7 from the moderate halophile NRCC 41227, and to L22 from Nicotinia tobaccum chloroplast. In addition, there is a sequence of 24 amino acids in rat protein L7 that may be related to segments of the same number of residues in Escherichia coli ribosomal proteins S10, S15, L9, and L22. PMID- 3624275 TI - Crystallographic data for Streptomyces avidinii streptavidin. AB - Crystallization conditions are reported for Streptomyces avidinii streptavidin with and without bound biotin. X-ray examination of the free and bound crystal forms shows the streptavidin-biotin complex crystals to be most suitable for high resolution structure analysis. A complete x-ray data set to 2.6 A resolution was collected for the streptavidin-biotin crystals using a two-dimensional area detector. Reduction and analysis of the x-ray diffraction pattern show that the complex crystallizes in the tetragonal space group I4(1)22 (a = b = 98.4 A, c = 125.8 A), with half of the streptavidin tetramer in the crystallographic asymmetric unit. PMID- 3624276 TI - Production of monoclonal antibodies against RNA polymerase I from nonimmunized autoimmune MRL/lpr mice and their use in rDNA transcription analysis. AB - A hybridoma secreting monoclonal antibodies against RNA polymerase I was produced by the fusion of myeloma cells with spleen cells from a nonimmunized MRL/lpr mouse which is known to produce autoantibodies to RNA polymerase I. The antibodies (McAb-2D11) belong to the IgG2b subclass, reacted specifically with the second largest (120 kDa) subunit of RNA polymerase I, and inhibited accurate transcription of cloned rat rDNA in a fractionated cell extract following immunoprecipitation of RNA polymerase I. McAb-2D11 did not inhibit RNA polymerase II-mediated transcription of the mouse metallothionein-I gene. Immunocytochemical procedures with biotinylated second antibody demonstrated specific immunolocalization of RNA polymerase I in the nucleus. These studies have (a) presented direct evidence that autoantibodies to functional RNA polymerase I are produced in a murine model of systemic lupus erythematosus, (b) demonstrated specificity of the monoclonal antibody for RNA polymerase I, and (c) provided a useful tool for the purification of RNA polymerase I and/or transcription factor(s) associated with RNA polymerase I. PMID- 3624277 TI - Detection of heritable mutations as quantitative changes in protein expression. AB - A computerized search for the appearance of heritable mutations (as indicated by changes in protein expression) was conducted on three sets of mice, whose sires had been either untreated, exposed to 3 gray units of gamma radiation, or treated with 150 mg/kg ethylnitrosourea. Proteins from the livers of approximately 800 mice were separated by two-dimensional electrophoresis, and abundances were measured by using image analysis techniques. Heritable mutations were detected by the appearance of new proteins or by the quantitative decrease in abundance of normally occurring proteins. Measurements of the variability of the protein abundance indicate that at least 48 proteins are consistent enough to be used in searches when mutations are expected to result in a 50% reduction in the normal amount of protein. New proteins were found in four offspring from ethylnitrosourea-treated mice, and in each case a nearby spot was found to be significantly diminished. These mutations were confirmed in subsequent generations. A computer-assisted search detected three of these mutations on the basis of the abundance decrease alone. These results indicate that two dimensional electrophoresis can be used to detect mutations reflected as quantitative changes in protein expression, provided that the proteins to be monitored are quantitatively stable when samples from different individuals are compared. PMID- 3624278 TI - Identification of two testosterone-responsive testicular proteins in Sertoli cell enriched culture medium whose secretion is suppressed by cells of the intact seminiferous tubule. AB - Of 30 proteins identified in medium from primary Sertoli cell-enriched cultures, five of these proteins appear to increase primarily in response to testosterone. Using high performance liquid chromatography, two of these proteins, designated CMB-22 and CMB-23, were purified to apparent homogeneity from medium. Both are monomeric proteins with apparent molecular weights of Mr 37,000 and Mr 40,000, respectively. Both interact with concanavalin A and wheat germ agglutinin on lectin blots. CMB-22 has a pI of 5.8; CMB-23 has two distinctive isoelectric variants with pIs of 5.4 and 5.2, the latter variant was designated CMB-23 Isoform. Polyvalent antisera raised against purified CMB-22 and CMB-23 in rabbits cross-reacted with one another. Removal of carbohydrate from these proteins by either enzymatic or chemical treatments reduced their apparent molecular weights but did not abolish their size differences on sodium dodecyl sulfate polyacrylamide gels. Peptide maps generated by Staphylococcus aureus protease V8 and visualized by silver staining and immunoblots suggest that CMB-22 and CMB-23 are similar but distinctive proteins that share almost identical epitopes. A radioimmunoassay was developed and used to measure total immunoreactive CMB-22 like material (CMB-22 plus CMB-23 immunoreactivity) in culture media, biological fluids, and tissue extracts. The results of these studies showed that the secretion of CMB-22-like material is unique with regard to other proteins that have been identified in Sertoli cell-enriched cultures. That is, CMB-22-like material is secreted by Sertoli cell-enriched cultures, but cannot be detected in media from cultures of intact tubular segments in vitro. In addition, immunoreactive material is also not detected in the testicular fluids from interstitium, tubule, or rete testis. This is in striking contrast to other Sertoli cell proteins which are present in substantial concentrations in these fluids. These observations suggest that the secretion and possibly the hormone responsiveness of CMB-22 and CMB-23 are normally suppressed in the intact tubule both in vivo and in vitro. We propose that studies of CMB-22 and CMB-23 will provide important insights into cell-cell interactions in the seminiferous epithelium. PMID- 3624279 TI - Identification and purification of a novel Mr 43,000 tropomyosin-binding protein from human erythrocyte membranes. AB - A new Mr 43,000 tropomyosin-binding protein (TMBP) has been identified in erythrocyte membranes by binding of 125I-labeled Bolton-Hunter tropomyosin to nitrocellulose blots of membrane proteins separated by sodium dodecyl sulfate-gel electrophoresis. This protein is not actin, because 125I-tropomyosin does not bind to purified actin on blots. Binding of 125I-tropomyosin to this protein is specific because it is inhibited by excess unlabeled tropomyosin but not by F actin or muscle troponins. This protein has been purified to 95% homogeneity from a 1 M Tris extract of tropomyosin-depleted erythrocyte membranes by DEAE cellulose and hydroxylapatite chromatography, followed by gel filtration on Ultrogel AcA 44. The purified protein has a Stokes radius of 3.9 nm and a sedimentation coefficient of 2.8 S, corresponding to a native molecular weight of 43,000. Binding of 125I-tropomyosin to the purified TMBP saturates at one tropomyosin molecule (Mr 60,000) to two Mr 43,000 TMBPs, with an affinity of about 5 X 10(-7) M. The TMBP is associated with the membrane skeleton after extraction of membranes with the non-ionic detergent, Triton X-100, and is present with respect to tropomyosin at a ratio of about one for every two tropomyosin molecules. Because there is enough tropomyosin for two tropomyosin molecules to be associated with each of the short actin filaments in the membrane skeleton, the erythrocyte membrane TMBP, together with tropomyosin, could function to restrict the number of spectrin molecules attached to each of the short actin filaments and thus specify the hexagonal symmetry of the spectrin actin lattice. Alternatively, this TMBP could be homologous to one of the muscle troponins and might function with tropomyosin to regulate erythrocyte actomyosin ATPase activity and influence erythrocyte shape. PMID- 3624280 TI - The role of arginine residues in the rat mitochondrial malate dehydrogenase transit peptide. AB - Arginine residues in the transit peptides of mitochondrial precursors are proposed to be important for uptake into mitochondria. To study this further, we have used cassette mutagenesis to create site-specific amino acid replacements within the transit peptide of rat mitochondrial malate dehydrogenase. Plasmids containing mutant sequences were expressed in vitro and tested in a mitochondrial uptake system utilizing isolated rat liver mitochondria. Substitution for arginine at position 14 with asparagine, glutamine, or alanine decreased the relative import level by 20-30% compared to the wild-type sequence when assayed in 1-h uptake experiments. Although lysine substitution did not alter import, substitution with glutamic acid decreased import by 40%. Alanine substitution for arginines at both positions 14 and 15 also dramatically decreased import. Uptake was partially restored in this mutant when positive charge was inserted at a new location within the transit peptide. Time course experiments showed that the initial rates of import were decreased in these mutants, as were the relative amounts of incorporated protein. These results were best explained by the loss of positive charge following amino acid substitutions for the arginine residues and suggest that the role of the charge is to enhance the efficiency of membrane translocation. PMID- 3624281 TI - Interaction of a protein factor within a thyroid hormone-sensitive region of rat alpha-myosin heavy chain gene. AB - Using a gel mobility-shift assay, a nuclear protein factor was identified in cardiac myocyte which binds specifically to a DNA fragment from the 5' region of the alpha-myosin heavy chain gene shown previously to contain a thyroid hormone sensitive element. Methylation interference experiments located the binding site within a 24-base pair sequence from positions -599 to -576. A double-stranded synthetic oligonucleotide containing this 24-base pair sequence bound to the factor and effectively competed with the natural binding site for factor binding. The factor was present in rat and human fibroblasts, and rat GH1 cells as well as L6E9 myoblasts and myotubes. The specificity with which this factor binds to DNA suggests that it could be involved in regulation of the alpha-myosin heavy chain gene. PMID- 3624283 TI - Regulation of orthopedic devices. PMID- 3624282 TI - The primary structure of rat ribosomal protein L5. A comparison of the sequence of amino acids in the proteins that interact with 5 S rRNA. AB - The covalent structure of rat ribosomal protein L5, which associates with 5 S rRNA in the organelle, was deduced from the sequence of nucleotides in a recombinant cDNA (pL5-6-4) and confirmed from the sequences of amino acids in portions of the protein. Ribosomal protein L5, encoded by pL5-6-4, contains 296 amino acids and has a molecular weight of 34,298. However, a second recombinant cDNA, pL5-8-5, encodes a protein with an additional methionyl residue at position 236 and may be the product of a second active L5 gene. Rat L5 is homologous to yeast YL3 and to Halobacterium cutirubrum HL13, proteins that also bind to 5 S rRNA. No significant structural similarity, however, was found between rat L5 and other 5 S rRNA-binding proteins; not with a second H. cutirubrum protein HL19, nor the Escherichia coli ribosomal proteins, L5, L18, or L25, nor the Xenopus laevis transcription factor IIIA. H. cutirubrum HL19, however, has structural identity with E. coli L5 and seems to be related to yeast YL3 and, hence, may be an evolutionary link between the prokaryotic and eukaryotic 5 S rRNA-binding proteins. A group of ribosomal proteins not known to be associated with 5 S rRNA are also related to rat L5. They include: rat L39, Euglina gracilis chloroplast S7, Saccharomyces cerevisiae L31 and L46, Homo sapiens L32 and, perhaps, several others as well. There is an especially close interrelationship between rat L5, rat L39, yeast L46, human L32, and mouse L32. These results, and others, suggest that ribosomal proteins form an extended family and that L5 may contain in its structure traces of this affinity. PMID- 3624285 TI - Bioethics and applied biomaterials. AB - Rapid growth in the field of applied biomaterials poses new ethical problems in the design, manufacture, evaluation, and regulation of medical devices and implants. This article addresses some of these ethical concerns and points out the ethical responsibilities of the scientists and engineers working in the field of biomaterials. The need for the development of a code of ethics by the Society for Biomaterials is also discussed. PMID- 3624284 TI - Nosocomial graft fragmentation and healing response of an ePTFE angioaccess graft. AB - This investigation was directed toward the tissue reaction and wound healing response of an ePTFE prosthesis implanted in a human subject as an arteriovenous fistulae for over 7 years. Due to the frequent puncture of the prosthesis for hemodialysis access, the pattern of healing is markedly different from that normally observed in ePTFE grafts in humans. The ePTFE graft material of the AV fistula was completely incorporated in fibrous tissue with prominent pseudointima formation (inner capsule), fibrous tissue within the graft and a well-adhered periadventitial layer (outer capsule). In the portion of the graft most frequently punctured, the wall of the graft was composed mainly of fibrous tissue containing dissociated fragments of ePTFE. Biochemical analysis of the fibrous tissue across the wall of the graft revealed that it contained types I, III, and V collagen, with type I greater than III greater than V. The type V collagen was present in largest percentage at the luminal surface and in decreasing percentage in the ePTFE material and outer capsule. This analysis suggests that collagen type deposition in this prosthesis occurs in a manner similar to a normal healing wound, except for the unusual pattern of type V collagen deposition, which may be an adaptive variation of the healing response. PMID- 3624286 TI - Development of a carbon-carbon hip prosthesis. AB - This article deals with the use of carbon-fiber-reinforced-carbon materials for the manufacture of hip prosthesis stems. It considers the manufacturing process of carbon-carbon (C-C) composites made of carbon fibers infiltrated either with dense pyrolytic carbon or silicon carbide (SiC) through chemical vapor infiltration. The chemicophysical properties of these composites are examined according to their structures. The long-term response (2 years) of cortical bone to various types of carbon-carbon was evaluated mainly for bone contact and ingrowth. Carbon-carbon coated with calcium phosphate was found to speed up the bone formation as compared to pyrolytic carbon or SiC coatings. The low modulus of elasticity of the C-C materials could be responsible for quicker bone contact as compared to a much stiffer material like sintered aluminum oxide. The biomechanical performance of C-C hip stems was assessed through (a) implantations into cadaver femurs, (b) fatigue testing, and (c) finite element analysis. These tests showed: (a) a better stress transfer as compared to a metal prosthesis having the same design, (b) no fatigue damage, (c) a computerized stem stress distribution in accordance with the fractures obtained during static mechanical testing. PMID- 3624287 TI - Bioceramics: material characteristics versus in vivo behavior. PMID- 3624288 TI - Divorce in the early years of marriage in England and Wales: results from a prospective study using linked records. PMID- 3624289 TI - Household extension and reproductive behaviour in Taiwan. PMID- 3624290 TI - Variation of the human secondary sex ratio and lethal recessive X-linked mutations. PMID- 3624291 TI - Effects of amniocentesis for genetic purposes on the pregnancy and its outcome. PMID- 3624292 TI - Factors affecting acceptability of long-acting contraceptive injections in a rural Egyptian community. PMID- 3624293 TI - Women's perceptions of the safety of the pill: a survey in eight developing countries. Report of the perceptions of the pill survey group. PMID- 3624294 TI - Fertility and some determinants of fertility decline in Huaibei Plain, Anhui province, China, 1982. PMID- 3624295 TI - Effect of nuptiality, contraception and breast-feeding on fertility in Bangladesh. PMID- 3624296 TI - Determinants of fertility in Nepal: applications of an aggregate model. PMID- 3624297 TI - Preferences for sex of children: a multivariate analysis. PMID- 3624298 TI - Occupational cancer prevention. AB - Studies of occupational cancer are particularly significant for primary prevention of cancer. Firstly, most cancers, once identified, can be prevented by reasonably simple means, without impinging on personal freedom. Secondly, the prevention of occupational cancers represents a saving of lives and the elimination of illness during the most active period of the lifespan. A third reason for investigating occupational cancers is that, in some cases, workers represent a particularly heavily exposed subgroup, and the occupational setting thus serves as a laboratory for the general environment. The protection of human health in the workplace should not depend solely on the epidemiological demonstration of existing risks; it is essential that results of predictive toxicology from long- and short-term laboratory studies also be used in the identification of possible carcinogenic risk factors. PMID- 3624299 TI - Therapeutic ratio of mono or combination bacterial lipopolysaccharide therapy in methylnitrosourea-induced rat mammary carcinoma. AB - Four experiments investigating the antitumor activity of bacterial lipopolysaccharide (LPS) against the autochthonous methylnitrosourea-induced mammary carcinoma are summarized. Administration of LPS alone i.v. caused distinct regression of small tumors following its first injection. This therapeutic effect, however, was short-lived and could not be maintained by administering a second dose. The observed antineoplastic activity of LPS was dose related, whereas no dose-response relationship was observed with respect to its toxicity. A series of experiments in which LPS was combined with other compounds to possibly exploit its activity while reducing the toxicity were performed. Neither the combination with cytotoxic drugs such as 4'-(9-acridinylamino) methansulfone-m-aniside or cyclophosphamide nor that with 1-octadecyl-2-methoxy rac-glycero-3-phosphocholine or hexadecylphosphocholine showed sufficient anticancer activity at acceptable toxicity. In all experiments promising efficacy was observed at high dosages but also high toxicity. When the dosages were reduced, diminished antineoplastic activity was found together with overproportionally high mortality. It might therefore be concluded that the active dose range of LPS cannot be reached clinically because of its inherent toxicity. PMID- 3624300 TI - Efficacy of beta-diketonato complexes of titanium, zirconium, and hafnium against chemically induced autochthonous colonic tumors in rats. AB - Bis-beta-diketonato complexes of titanium, zirconium, and hafnium were tested against autochthonous colorectal tumors in rats. The model was found to reflect the clinical situation most closely. Of the compounds tested, budotitane was the most effective in terms of decrease in tumor weight and number and in increasing the lifespan of the treated animals. The therapeutic efficiency was superior to that of 5-fluorouracil, which so far has been the drug with the best activity in patients suffering from colon cancer. PMID- 3624301 TI - Kinetic and survival response of the M14 cell line to lonidamine associated with adriamycin or hyperthermia. AB - Lonidamine (LND), an indazole-carboxylic acid derivative, was delivered alone and together with adriamycin (ADM) or hyperthermia to the human melanoma cell line M14, and cell survival was assessed. Cell cycle-specific effects were investigated by analyzing sequences of DNA content histograms by means of a suitable mathematical procedure. LND delivered for 1 h at a dose of 50 micrograms/ml did not affect proliferation and survival of the cells. Exposure of the cells for 1 h to ADM (1.0 microgram/ml) followed by LND for 1 h (50 micrograms/ml) produced the highest effect on the survival. Kinetic parameters were affected by the combined treatment slightly more than by ADM exposure alone. Simultaneous delivery of LND (50 micrograms/ml) with hyperthermia (42 degrees C, 1 h) reduced the survival and enhanced the block of cells in the G2M phase, as compared with the heat treatment alone. The effect of the treatments on cell survival appeared to be related to the perturbation of the G2M phase of the cycle. PMID- 3624302 TI - Possible adverse effect of failed adjuvant chemotherapy on the prognosis of women receiving consecutive chemotherapy for recurrent breast cancer. AB - This study tried to evaluate the impact of adjuvant chemotherapy on the induction of chemoresistance in radically operated upon breast cancer patients. Remission rate, remission duration and survival of a group of women (n = 22) treated with combination chemotherapy (adriamycin and cyclophosphamide, AC) for recurrent breast cancer after failed adjuvant therapy (cyclophosphamide, methotrexate, fluorouracil, vinblastine) were retrospectively compared with the clinical data of non-pre-treated patients (n = 28) receiving the same regimen (AC). The two groups of patients were comparable with regard to their risk factors. In the group of women with prior adjuvant chemotherapy only 3 out of 22 had a partial response, lasting 3, 8, and 16 months; the median survival was 50 months. In the group without prior adjuvant therapy 3 complete and 7 partial remissions with a median remission duration of 15.5 months (range 2-54 months) were found; the median survival was 104 months. The percentage of objective responses among the non-pre-treated patients at 36% was almost significantly higher than that of the pretreated women with 14% (p less than 0.1). Responders to chemotherapy after relapse profited in terms of survival within the first 3 years after radical mastectomy, although no statistically significant difference was observed. The survival data shown assume a "shifting" of women from a group with better prognosis to a group with unfavourable prognosis following failed adjuvant chemotherapy. PMID- 3624303 TI - Plasma cell leukemia with an unusual karyotype and prolonged survival following oral alkylating agent therapy. AB - A patient with primary plasma cell leukemia (PCL) is presented who had an excellent response to high-dose cyclophosphamide and prolonged survival. The sole cytogenetic abnormality detected in the bone marrow was monosomy 18. Although this karyotypic aberration has been previously described in PCL, it generally occurs associated with additional abnormalities. The peripheral blood plasma cells from this patient reacted intracellularly with the monoclonal antibody OKM 1, which binds to myeloid cells at and above the level of myelocytes and to monocytes. This finding supports a common precursor cell for plasma cells and cells of the myelomonocytic lineage. PMID- 3624304 TI - Natural cytotoxic cells from rat liver and spleen kill human glioma cells. AB - Natural cytotoxic cells from rat spleen and rat liver, (isolated using the collagenase method) were found to be cytotoxic against different lines of human gliomas: T406, T508, T705, HeRo, HeRoCl 1, HeRoCl 8, and HeRo-SV 7/114. After 18 h the lytic units ranged from 75 to 251 in the liver and from 5 to 24 in the spleen. Analyzing the ratio of lysis at 4 h/18 h, it may be concluded that this natural killing is predominantly macrophage (Kupffer cell)-dependent. Lysis by Kupffer cells cannot be increased by transforming glioma cells with SV40. Experiments with SV40-transformed mouse fibroblasts (3T3) and virus-transformed human cell lines (SV80) suggested a "SV40" receptor on Kupffer cells. Thus Kupffer cells have receptors for glioma cells and SV40-dependent membrane structures. PMID- 3624305 TI - Differentiation of axon-related Schwann cells in vitro. I. Ascorbic acid regulates basal lamina assembly and myelin formation. AB - Rat Schwann cells cultured with dorsal root ganglion neurons in a serum-free defined medium fail to ensheathe or myelinate axons or assemble basal laminae. Replacement of defined medium with medium that contains human placental serum (HPS) and chick embryo extract (EE) results in both basal lamina and myelin formation. In the present study, the individual effects of HPS and EE on basal lamina assembly and on myelin formation by Schwann cells cultured with neurons have been examined. Some batches of HPS were unable to promote myelin formation in the absence of EE, as assessed by quantitative evaluation of cultures stained with Sudan black; such HPS also failed to promote basal lamina assembly, as assessed by immunofluorescence using antibodies against laminin, type IV collagen, and heparan sulfate proteoglycan. The addition of EE or L-ascorbic acid with such HPS led to the formation of large quantities of myelin and to the assembly of basal laminae. Pretreatment of EE with ascorbic acid oxidase abolished the EE activity, whereas trypsin did not. Other batches of HPS were found to promote both basal lamina and myelin formation in the absence of either EE or ascorbic acid. Ascorbic acid oxidase treatment or dialysis of these batches of HPS abolished their ability to promote Schwann cell differentiation, whereas the subsequent addition of ascorbic acid restored that ability. Ascorbic acid in the absence of serum was relatively ineffective in promoting either basal lamina or myelin formation. Fetal bovine serum was as effective as HPS in allowing ascorbic acid (and several analogs but not other reducing agents) to manifest its ability to promote Schwann cell differentiation. We suggest that ascorbic acid promotes Schwann cell myelin formation by enabling the Schwann cell to assemble a basal lamina, which is required for complete differentiation. PMID- 3624306 TI - The ornithine transcarbamylase leader peptide directs mitochondrial import through both its midportion structure and net positive charge. AB - The cytoplasmically synthesized precursor of the mitochondrial matrix enzyme, ornithine transcarbamylase (OTC), is targeted to mitochondria by its NH2-terminal leader peptide. We previously established through mutational analysis that the midportion of the OTC leader peptide is functionally required. In this article, we report that study of additional OTC precursors, altered in either a site directed or random manner, reveals that (a) the midportion, but not the NH2 terminal half, is sufficient by itself to direct import, (b) the functional structure in the midportion is unlikely to be an amphiphilic alpha-helix, (c) the four arginines in the leader peptide contribute collectively to import function by conferring net positive charge, and (d) surprisingly, proteolytic processing of the leader peptide does not require the presence of a specific primary structure at the site of cleavage, in order to produce the mature OTC subunit. PMID- 3624307 TI - Subcellular localization of a variable surface glycoprotein phosphatidylinositol specific phospholipase-C in African trypanosomes. AB - African trypanosomes contain a membrane-bound enzyme capable of removing dimyristylglycerol from the membrane-attached form of the variable surface glycoprotein (mfVSG; Ferguson, M. A. J., K. Halder, and G. A. M. Cross, 1985, J. Biol Chem., 260:4963-4968). Although mfVSG phospholipase-C has been implicated in the removal of the VSG from the trypanosome surface (Cardoso de Almeida, M. L., and M. J. Turner, 1983, Nature (Lond.)., 302:349-352; Ferguson, M. A. J., K. Halder, and G. A. M. Cross, 1985, J. Biol Chem., 260:4963-4968), its precise function and subcellular location have not been determined. We have developed a procedure for the separation of the cell fractions and organelles of Trypanosoma brucei brucei (and other trypanosome species) by differential sucrose and isopycnic PercollR centrifugation. These fractions were tested for mfVSG phospholipase activity using Trypanosoma brucei mfVSG labeled with 3H-myristic acid as substrate. The highest enzyme-specific activity was associated with the flagella and evidence is presented to suggest that it is localized in the flagellar pocket. Some activity was also associated with the Golgi complex. These results suggest that the mfVSG phospholipase is localized primarily in the membrane of the flagella pocket and possibly other membrane organelles derived from and associated with this structure, and may be part of the VSG-membrane recycling system in African trypanosomes. The activity of mfVSG phospholipase amongst various trypanosome species was determined. We show that, in contrast to the bloodstream forms of Trypanosoma brucei, cultured procyclic Trypanosoma brucei and bloodstream Trypanosoma vivax had little or no mfVSG phospholipase activity. The activity found in bloodstream forms of Trypanosoma congolense was intermediate between Trypanosoma vivax and Trypanosoma brucei. PMID- 3624308 TI - Micrometer-scale domains in fibroblast plasma membranes. AB - We have used the technique of fluorescence photobleaching recovery to measure the lateral diffusion coefficients and the mobile fractions of a fluorescent lipid probe, 1-acyl-2-(12-[(7-nitro-2-1, 3-benzoxadiazol-4-yl)aminododecanoyl]) phosphatidylcholine (NBD-PC), and of labeled membrane proteins of human fibroblasts. Values for mobile fractions decrease monotonically with increasing size of the laser spot used for the measurements, over a range of 0.35-5.0 microns. Values for NBD-PC diffusion coefficients increase in part of this range to reach a plateau at larger laser spots. This variation is not an artifact of the measuring system, since the effects are not seen if diffusion of the probe is measured in liposomes. We also find that the distribution of diffusion coefficients measured with small laser spots is heterogeneous indicating that these small spots can sample different regions of the membrane. These regions appear to differ in protein concentration. Our data strongly indicate that fibroblast surface membranes consist of protein-rich domains approximately 1 micron in diameter, embedded in a relatively protein-poor lipid continuum. These features appear in photographs of labeled cell surfaces illuminated by the expanded laser beam. PMID- 3624309 TI - Biosynthesis and interconversion of Drosophila nuclear lamin isoforms during normal growth and in response to heat shock. AB - Two major immunocross-reactive polypeptides of the Drosophila nuclear envelope, distinguishable in interphase cells on the basis of one-dimensional SDS-PAGE mobility, have been localized to the nuclear lamina by immunoelectron microscopy. These have been designated lamins Dm1 and Dm2. Both lamins are apparently derived posttranslationally from a single, primary translation product, lamin Dm0. A pathway has been established whereby lamin Dm0 is processed almost immediately upon synthesis in the cytoplasm to lamin Dm1. Processing occurs posttranslationally, is apparently proteolytic, and has been reconstituted from cell-free extracts in vitro. Processing in vitro is ATP dependent. Once assembled into the nuclear envelope, a portion of lamin Dm1 is converted into lamin Dm2 by differential phosphorylation. Throughout most stages of development and in Schneider 2 tissue culture cells, both lamin isoforms are present in approximately equal abundance. However, during heat shock, lamin Dm2 is converted nearly quantitatively into lamin Dm1. Implications for understanding the regulation of nuclear lamina plasticity through normal growth and in response to heat shock are discussed. PMID- 3624310 TI - The relative contributions of polymer annealing and subunit exchange to microtubule dynamics in vitro. AB - Microtubules that are free of microtubule-associated protein undergo dynamic changes at steady state, becoming longer but fewer in number with time through a process which was previously assumed to be based entirely on mechanisms of subunit exchange at polymer ends. However, we recently demonstrated that brain and erythrocyte microtubules are capable of joining end-to-end and suggested that polymer annealing may also affect the dynamic behavior of microtubules in vitro (Rothwell, S. W., W. A. Grasser, and D. B. Murphy, 1986, J. Cell Biol. 102:619 627). In the present study, we first show that annealing is a general property of cytoplasmic microtubules and is not a specialized characteristic of erythrocyte microtubules by documenting annealing between tryosinolated and detyrosinolated brain microtubules. We then examine the contributions of polymer annealing and subunit exchange to microtubule dynamics by analyzing the composition and length of individual polymers in a mixture of brain and erythrocyte microtubules by immunoelectron microscopy. In concentrated preparations of short-length microtubules at polymer-mass steady state, annealing was observed to be the principal factor responsible for the increase in polymer length, whereas annealing and subunit exchange contributed about equally to the reduction in microtubule number. PMID- 3624311 TI - Low ionic strength solubility of myosin in sea urchin egg extracts is mediated by a myosin-binding protein. AB - We identify a novel myosin-binding protein, designated 53K, which appears to mediate the low ionic strength solubility of myosin in extracts of unfertilized sea urchin eggs. The protein possesses a subunit molecular mass on SDS-PAGE of 53 kD, an S value of 7, may be organized into disulfide-linked oligomers, and is associated with myosin in egg extracts. Both myosin and 53K co-precipitate from extract upon the addition of nucleoside triphosphates and co-sediment with an S value of 24 by sedimentation velocity centrifugation. Myosin in extracts not associated with 53K has an S value of 10. Further, myosin can be immunoprecipitated from extract with antibody to 53K and the 53K in extracts binds to a myosin affinity column. When extract is depleted of 53K, a majority of the myosin precipitates out of extract in a nucleotide-independent manner. Whereas purified myosin precipitates in the absence of nucleotide when recombined with dialysis buffer or myosin-depleted extract, reconstituting 53K and myosin before addition to buffer or myosin-depleted extract partially restores the low ionic strength solubility demonstrated by myosin in fresh egg extracts. The 53-kD protein may represent a new class of authentic myosin-binding proteins that may regulate the supramolecular organization of myosin in nonmuscle cells. PMID- 3624312 TI - Heterokaryon analysis of muscle differentiation: regulation of the postmitotic state. AB - MM14 mouse myoblasts withdraw irreversibly from the cell cycle and become postmitotic within a few hours of being deprived of fibroblast growth factor (Clegg, C. H., T. A. Linkhart, B. B. Olwin, and S. D. Hauschka, 1987, J. Cell Biol., 105:949-956). To examine the mechanisms that may regulate this developmental state of skeletal muscle, we tested the mitogen responsiveness of various cell types after their polyethylene glycol-mediated fusion with post mitotic myocytes. Heterokaryons containing myocytes and quiescent nonmyogenic cells such as 3T3, L cell, and a differentiation-defective myoblast line (DD-1) responded to mitogen-rich medium by initiating DNA synthesis. Myonuclei replicated DNA and reexpressed thymidine kinase. In contrast, (myocyte x G1 myoblast) heterokaryons failed to replicate DNA in mitogen-rich medium and became postmitotic. This included cells with a nuclear ratio of three myoblasts to one myocyte. Proliferation dominance in (myocyte x 3T3 cell) and (myocyte x DD-1) heterokaryons was conditionally regulated by the timing of mitogen treatment; such cells became postmitotic when mitogen exposure was delayed for as little as 6 h after cell fusion. In addition, (myocyte x DD-1) heterokaryons expressed a muscle-specific trait and lost epidermal growth factor receptors when they became postmitotic. These results demonstrate that DNA synthesis is not irreversibly blocked in skeletal muscle; myonuclei readily express proliferation-related functions when provided with a mitogenic signal. Rather, myocyte-specific repression of DNA synthesis in heterokaryons argues that the postmitotic state of skeletal muscle is regulated by diffusible factors that inhibit processes of cellular mitogenesis. PMID- 3624313 TI - Growth factor control of skeletal muscle differentiation: commitment to terminal differentiation occurs in G1 phase and is repressed by fibroblast growth factor. AB - Analysis of MM14 mouse myoblasts demonstrates that terminal differentiation is repressed by pure preparations of both acidic and basic fibroblast growth factor (FGF). Basic FGF is approximately 30-fold more potent than acidic FGF and it exhibits half maximal activity in clonal assays at 0.03 ng/ml (2 pM). FGF repression occurs only during the G1 phase of the cell cycle by a mechanism that appears to be independent of ongoing cell proliferation. When exponentially growing myoblasts are deprived of FGF, cells become postmitotic within 2-3 h, express muscle-specific proteins within 6-7 h, and commence fusion within 12-14 h. Although expression of these three terminal differentiation phenotypes occurs at different times, all are initiated by a single regulatory "commitment" event in G1. The entire population commits to terminal differentiation within 12.5 h of FGF removal as all cells complete the cell cycle and move into G1. Differentiation does not require a new round of DNA synthesis. Comparison of MM14 behavior with other myoblast types suggests a general model for skeletal muscle development in which specific growth factors serve the dual role of stimulating myoblast proliferation and directly repressing terminal differentiation. PMID- 3624314 TI - Bicarbonate/chloride antiport in Vero cells: I. Evidence for both sodium-linked and sodium-independent exchange. AB - The effect of bicarbonate on the ability of cells to regulate the internal pH after acid and alkali loads was studied. In the presence of Na+, the normalization of the internal pH after acid loads occurred more rapidly in the presence than in the absence of bicarbonate. DIDS (4,4'-diisothiocyano-2,2' stilbene-disulfonic acid) strongly inhibited the pH increase, whereas amiloride inhibited it to a lesser extent. The Na+-linked, bicarbonate-dependent pHi increase after an acid load was strongly reduced in cells depleted of Cl-. When cells were transferred to gluconate or mannitol balanced buffers containing bicarbonate, there was a rapid alkalinization of the cytosol, apparently due to influx of bicarbonate induced by chloride efflux. When the internal pH was below 7.0, the pH increase was much more rapid in the presence than in the absence of Na+, whereas at higher internal pH, there was no measurable effect of Na+. The ability of the cells to reduce the internal pH after an alkali load was increased in the presence of bicarbonate. The data indicate that both Na+-linked and Na+ independent bicarbonate/chloride exchange occur in Vero cells. PMID- 3624315 TI - Bicarbonate/chloride antiport in Vero cells: II. Mechanisms for bicarbonate dependent regulation of intracellular pH. AB - The rates of bicarbonate-dependent uptake and efflux of 22Na+ in Vero cells were studied and compared with the uptake and efflux of 36Cl-. Both processes were strongly inhibited by DIDS. Whereas the transport of chloride increased approximately ten-fold when the internal pH was increased over a narrow range around neutrality, the uptake of Na+ was much less affected by changes in pH. The bicarbonate-linked uptake of 22Na+ was dependent on internal Cl- but not on internal Na+. At a constant external concentration of HCO3-, the amount of 22Na+ associated with the cells increased when the internal concentration of HCO3- decreased and vice versa, which is compatible with the possibility that the ion pair NaCO3- is the transported species and that the transport is symmetric across the membrane. Bicarbonate inhibited the uptake of 36Cl- both in the absence and presence of Na+. At alkaline internal pH, HCO3- stimulated the efflux of 36Cl- from preloaded cells, while at acidic internal pH both Na+ and HCO3- were required to induce 36Cl- efflux. We propose a model for how bicarbonate-dependent regulation of the internal pH may occur. This model implies the existence of two bicarbonate transport mechanisms that, under physiological conditions, transport OH(-)-equivalents in opposite directions across the plasma membrane. PMID- 3624316 TI - Colcemid effects on B16 melanoma cell progression and aberrant mitotic division. AB - Mitotic cells selectively harvested after several h of colcemid treatment are routinely used to obtain synchronized cell cultures. DNA flow cytometry shows that when colcemid-treated B16 mitotic cells divide, they give rise to daughter cells in G1, some of which contain abnormal amounts of DNA. Two subpopulations appear to exist, one having a DNA content distribution expected of G1 cells, another having a mean DNA content about 0.8 of expected and an SD of DNA content more than 5 times expected. The effect was dependent on dose and duration of exposure to colcemid. Colcemid was more cytotoxic to cells in G2 + M than to G1 + S phase cells, and it slowed the progression of G1 cells to S. These effects of colcemid were much greater in aneuploid B16 melanoma cells than in pseudodiploid Chinese hamster ovary (CHO) cells. PMID- 3624317 TI - Evidence for two functionally different fibrinogen receptors on hemopoietic cells: the glycoprotein IIb-IIIa and the mitogenic fibrinogen receptor. AB - We have previously established that the mitogenic effect of fibrinogen on hemopoietic cell lines Raji and JM is mediated via a specific receptor (Levesque, J.-P. et al.: Proc. Natl. Acad. Sci. USA 83:6494-6498, 1986). In this study, we have further characterized the fibrinogen domain involved in the binding to the mitogenic receptor. This binding was not inhibited either by a monoclonal antibody against the C-terminal sequence of the fibrinogen gamma chains or by synthetic peptides containing the Arg-Gly-Asp sequence. Such inhibition is specific of the platelet fibrinogen receptor, the glycoprotein IIb-IIIa complex. Fragments containing the fibrinogen D domain were the only plasmin degradation products of fibrinogen which were mitogenic. These fragments acted via direct binding on the mitogenic receptor with a Kd of 2.24 X 10(-6) M. This value was similar to the KI value of unlabeled fragments D (2.47 X 10(-6) M). Our results suggest the presence of two different functional types of fibrinogen receptors: the glycoprotein IIb-IIIa receptor responsible both for platelet aggregation and leukocyte adhesion and killing, and the mitogenic receptor involved in proliferation control of hemopoietic cells. PMID- 3624318 TI - The effects of sulfhydryl inhibitors and cytochalasin on the cytoplasmic and cytoskeletal actin of human neutrophils. AB - To better understand the changes that occur in cytoplasmic actin during cell movement, we studied the effect of inhibitors of cell movement on the molecular conformation of actin and its incorporation into the Triton-insoluble cytoskeleton of human neutrophils. The sulfhydryl reactive compound N ethylmaleimide caused an increase in cellular F-actin as measured by uptake of the F-actin specific fluorescent probe 7-nitrobenz-2-oxadiazole-phallacidin. However, N-ethylmaleimide reduced the amount of actin associated with the Triton insoluble cytoskeleton. Dithiobisnitrobenzoic acid, a sulfhydryl reagent that does not cross cell membranes efficiently, did not alter the F-actin content of neutrophils. The effect of N-ethylmaleimide was blocked by the presence of dithiothreitol, a donor of sulfhydryl groups. N-ethylmaleimide did not affect the polymerization of actin in a cell-free system. Cytochalasin B did not alter F actin content of neutrophils but did decrease actin in cytoskeletons of resting neutrophils. Cytochalasin inhibited the increase in F-actin initiated by the chemoattractant N-formylmethionylleucylphenylalanine. We propose that N ethylmaleimide blocks the stabilization of G-actin in cytoplasm, interferes with the incorporation of F-actin polymer into the cytoskeleton, and depolymerizes the cytoskeleton. In contrast cytochalasin stabilizes G-actin in the presence of chemotactic peptide. These data suggest that reversible conversion of G-actin to F-actin and incorporation of F-actin into the Triton-insoluble cytoskeleton are important for neutrophil movement. PMID- 3624319 TI - Disparity between expression of transferrin receptor ligand binding and non ligand binding domains on human lymphocytes. AB - We compared transferrin receptor (TfR) expression on human peripheral blood lymphocytes (PBL) activated by phorbol myristate acetate (PMA) or L phytohemagglutinin (LPHA) using two techniques: (1) 125I-iron-saturated transferrin (FeTf) binding, (2) reactivity with monoclonal anti-TfR antibodies- OKT9 and B3/25. These monoclonal antibodies do not block FeTf binding, and therefore bind to TfR domains separate from the ligand binding site. Unstimulated PBL bound fewer than 1,000 molecules of 125I-FeTf per cell, and less than 5% of cells expressed TfR antigens detected by OKT9 or B3/25. 125I-FeTf binding and antibody binding increased in parallel on LPHA-activated PBL. After exposure to LPHA for 72 hr, 125I-FeTf binding increased 100-fold to 10(5) molecules per cell and greater than 50% of cells expressed TfR antigens. By contrast, PMA activation of PBL markedly increased binding of OKT9 and B3/25 but not the binding of 125I FeTf. Cell surface expression of TfR antigens seen by OKT9 and B3/25 did not differ between LPHA- and PMA-activated PBL. However, after 72 hr with PMA, 125I FeTf binding increased only 6-fold and consistently remained at less than 10(4) molecules per cell. Therefore, PMA induced a disparity between expression of TfR ligand binding domains and immunological domains at the cell surface. Cell proliferation assessed by fluorescent DNA analysis was similar in cultures stimulated by LPHA or PMA. These data indicate that lymphoid cells may possess a mechanism for modulating TfR expression in which down-regulation of FeTf binding occurs without receptor internalization. Alternatively, it is possible that this observation may reflect a membrane perturbation effect of PMA. PMID- 3624320 TI - Thrombin-induced thromboxane generation by neutrophils and lymphocytes: dependence on enzymic site. AB - We examined the effects of thrombin on thromboxane generation by sheep neutrophils and lymphocytes in vitro. Physiological concentration of thrombin (50 nM) resulted in thromboxane B2 generation from both neutrophils and lymphocytes, which was comparable to that obtained with zymosan activated serum challenge of the cells. Thromboxane B2 generation was dependent on the enzymic region of the thrombin molecule responsible for clotting activity because the complexing of thrombin with hirudin (1:1 U:U mixture of thrombin and hirudin) abolished thromboxane generation from both cell types. Further studies with modified forms of alpha-thrombin (which were produced by irreversible conjugation at the catalytic site and lacked enzymic activity) also showed no generation of thromboxane B2 from neutrophils or lymphocytes. The results indicate that thrombin stimulates thromboxane generation from neutrophils and lymphocytes and that this response is dependent on the proteolytic activity of thrombin. PMID- 3624321 TI - Structure of amplified DNA, analyzed by pulsed field gradient gel electrophoresis. AB - Pulsed field gradient electrophoresis allows the separation of large DNA molecules up to 2,000 kilobases (kb) in length and has the potential to close the resolution gap between standard electrophoresis of DNA molecules (smaller than 50 kb) and standard cytogenetics (larger than 2,000 kb). We have analysed the amplified DNA in four cell lines containing double minute chromosomes (DMs) and two lines containing homogeneously staining regions. The cells were immobilized in agarose blocks, lysed, deproteinized, and the liberated DNA was digested in situ with various restriction endonucleases. Following electrophoretic separation by pulsed field gel electrophoresis, the DNA in the gel was analysed by Southern blotting with appropriate probes for the amplified DNA. We find that the DNA in intact DMs is larger than 1,500 kb. Our results are also compatible with the notion that the DNA in DMs is circular, but this remains to be proven. The amplified segment of wild-type DNA covers more than 550 kb in all lines and possibly up to 2,500 kb in some. We confirm that the repeat unit is heterogeneous in some of the amplicons. In two cell lines, however, with low degrees of gene amplification, we find no evidence for heterogeneity of the repeats up to 750 (Y1 DM) and 800 kb (3T6-R50), respectively. We propose that amplicons start out long and homogeneous and that the heterogeneity in the repeat arises through truncation during further amplification events in which cells with shorter repeats have a selective advantage. Even if the repeats are heterogeneous, however, pulsed field gradient gels can be useful to establish linkage of genes over relatively short chromosomal distances (up to 1,000 kb). We discuss some of the promises and pitfalls of pulsed field gel electrophoresis in the analysis of amplified DNA. PMID- 3624322 TI - Surface membrane electrokinetic properties of polymorphonuclear leucocytes: subpopulation heterogeneity and phagocytic competence. PMID- 3624323 TI - Changes in surface glycopeptides after malignant transformation of rat liver cells and during the regression of hepatoma cells. AB - Normal liver cells, Zajdela's hepatoma cells, and regressing hepatoma cells were metabolically labeled with either radioactive glucosamine or mannose. Glycopeptides obtained by exhaustive pronase digestion of these cells were compared after fractionation by gel filtration on Bio-Gel P-6. Chemical analysis, affinity chromatography on immobilized lectins, alkaline treatment, and susceptibility toward endo-beta-N-acetylglucosaminidase and tunicamycin revealed dramatic changes in the glycopeptide patterns of transformed cells during the recovery of normal phenotype. The most prominent feature was the presence on the surface of hepatoma cells of a large glycopeptide, which was absent from normal liver cells and disappeared almost completely during the regression of hepatoma cells. This large glycopeptide had a Mr of 70,000, contained essentially O glycosidically linked glycan chains, and did not result from a hypersialylation. N-glycosidically linked glycopeptides, high-mannose, and complex-type oligosaccharides were present in distinct proportions according to the differentiation state. Transformation of liver cells led to a reduction of high mannose type oligosaccharides and an increase in the degree of branching of complex-type oligosaccharides. In addition, "bisected" glycopeptides were present only on hepatoma cells. The pattern of N-linked glycopeptides of normal liver cells was recovered during the regression of hepatoma cells. The origin of glycopeptide differences between normal and transformed cells and the evidence of a relation between carbohydrate changes, in particular the appearance of a large glycopeptide, and tumorigenicity are discussed. PMID- 3624324 TI - The pharmacist as prescriber. AB - During the past few years, patients have taken more active roles to provide for their own health needs and to find more economical ways to meet their overall medical care needs. This has created a variety of demands on the health care system. Community pharmacists have responded to these demands by expanding the services and product lines available to the public (e.g. home health care supplies, medical durable equipment, diagnostic home kits, health screening programmes, and public health educational programmes). In Florida, the public pressure for more economical ways to provide health care resulted in the passage of the Pharmacy Self Care Consultant Law. The intent of the law is to provide the consumer with access to effective medications at relatively lower cost and less inconvenience than is involved in seeing a physician for minor self-limiting medical conditions. At the same time, the law has effectively created a third class of drugs which the pharmacist can prescribe. This has given the pharmacist another opportunity to meet the health care needs of the public more effectively. PMID- 3624325 TI - Pilot projects to stimulate adverse drug reaction reporting. AB - Schemes for stimulating adverse drug reporting are described with particular emphasis on a recently introduced Mississippi Adverse Drug Reaction Reporting Programme. PMID- 3624326 TI - Cytotoxic drug reconstitution at the Kuwait Cancer Control Centre. PMID- 3624327 TI - Computer simulation as a teaching aid in pharmacy management--Part 2. Stock control. AB - In the second of two articles on the use of computer simulations in teaching of pharmacy management topics, some applications in the field of stock control are described. PMID- 3624328 TI - [Morbidity factors in Nissen's procedure]. AB - Between 1975 and 1986, 96 adult patients were operated upon for gastro-esophageal reflux using the abdominal approach to Nissen's operation, eight of these patients having undergone previous surgery to treat reflux. Diagnosis in 44 patients was stage III esophagitis, and in 16, symptomatic peptic stenosis. Mortality was 0.9% (1 case) and morbidity 14%. Morbidity was not increased in previously operated patients. Based on these results and a literature review, different technical factors are discussed that could reduce morbidity of Nissen's operation. PMID- 3624329 TI - [Retrocostoxyphoid hernia in children. Apropos of 6 cases. Review of the literature]. AB - Six further cases of retrocostoxiphoid hernia in children are reported, the postoperative course being uncomplicated following supraumbilical laparotomy. The relevant literature is reviewed and emphasis placed on the value of peritoneography for establishing diagnosis prior to operation. PMID- 3624330 TI - [Encapsulating peritonitis. Apropos of a new case]. AB - The physiopathology of the rare affection encapsulating peritonitis is poorly elucidated, but its etiologies are now more clearly defined. Diagnosis is usually at operation, as in the present case, a 65 year old man with known alcoholism and wearing a LeVeen type peritoneo-jugular valve, probably the cause of the peritonitis. PMID- 3624331 TI - [A new case of gastric and peritoneal anisakiasis]. AB - A further case of anisakiasis is reported, its originality residing in the discovery of two localizations of the affection, gastric and then peritoneal, at four months' interval. This digestive disease is provoked by the larvae of nematodes that are parasites of marine mammals and for which human contamination is due to ingestion of raw or incompletely smoked fish. PMID- 3624332 TI - [Inguinal hernia in children]. AB - The authors report 611 cases of inguinal hernias of childhood operated between 1967 and 1985, which represent 28% of operations performed in all children in the same period. The mean age of patients was 33 +/- 4.1 months and the ratio M:F = 5.43:1. The right side was the most frequently affected (64.64%) with a bilaterality of 14.89%. The incarceration, observed at the rate of 13.23%, needed the surgical treatment in urgency in the 35.63% of the cases. A relapsing hernia appeared only two times (0.45%) and the incidence of contralateral metacronous hernias was 7.99%. They perform herniorrhaphy in the only symptomatic side without preoperative herniorrhaphy and operate on the silent contralateral side only when there a hernia will became symptomatic, as they think that herniorrhaphy and bilateral inguinal exploration cause a high number of unnecessary, sometimes harmful operations. PMID- 3624333 TI - [Ilizarov's technic: a sometimes misleading simplicity]. AB - Ilizarov's procedure cannot be reduced to a simple technical improvement, results presented by its inventor being spectacular on occasions. Nevertheless, some degree of caution is necessary in the choice of indication for its use. PMID- 3624334 TI - [Idiopathic anal incontinence. Surgical treatment]. AB - Three patients operated upon for idiopathic anal incontinence are reported. This idiopathic incontinence is due to degeneration of the nerves supplying the pelvic floor muscles and results in partial or total disappearance of the double right angle which normally exists between the anal canal and the rectum. This anorectal angulation is essential in the maintenance of anal continence. The aim of the operation is the reconstruction of a normal anatomy with the restoration of this anorectal angulation. The suture of the levators ani and particularly of the puborectalis muscle proposed by Parks is the operation of choice. The results of the operation 1-3 years later are excellent in two cases and satisfactory in one case. PMID- 3624335 TI - [Preliminary results in 22 operations for terminal constipation in relation to a disorder of rectal stasis]. PMID- 3624336 TI - [Cystic hemolymphangioma of the adrenal gland]. PMID- 3624337 TI - [Perioperative antibiotherapy in surgery of esophageal cancer: cefoxitin or cefoxitin + amikacin]. PMID- 3624338 TI - Analysis of the cis-trans isomerization kinetics of L-alanyl-L-proline by the elution-band relaxation method. AB - The "elution-band relaxation method" has been applied to the analysis of the cis trans kinetics isomerization of the proline of L-Ala-L-Pro using reversed-phase liquid chromatography. A procedure suitable for cases where neither isomer can be injected separately is described. PMID- 3624339 TI - Tandem use of carboxypeptidase Y reactor and displacement chromatograph for peptide synthesis. AB - A packed-bed enzyme reactor with immobilized carboxypeptidase Y was used in tandem with a displacement chromatograph for the preparation of N-benzoyl-L arginyl-L-methioninamide, from N-benzoyl-L-arginine and L-methioninamide. The pumps and valves of the coupled enzyme reactor and displacement chromatograph were controlled by a microprocessor. The enzyme was immobilized on microparticulate amino-silica by glutaraldehyde and packed into a 60 X 4.6 mm I.D. column. The packed-bed reactor was used in the recirculating mode and components of the reaction mixture were subsequently separated by displacement chromatography on a 250 X 4.6 mm octadecyl-silica column using butoxyethoxyethanol as the displacer. Unreacted L-methioninamide was returned to the reaction mixture. Both the progress of the reaction and the extent of separation by displacement chromatography were monitored by high-performance liquid chromatographic analysis. The system was designed so that enzymatic peptide synthesis, separation by displacement chromatography, and column regeneration were carried out simultaneously by using two identical columns in parallel. An amount of 460 mg of N-benzoyl-L-arginyl-L-methioninamide having purity greater than 99% could be obtained in 24 h with this system. The tandem operation of the enzyme reactor and liquid chromatograph operated in the displacement mode offers a means for the synthesis and purification of peptides. PMID- 3624340 TI - Studies on the nucleotide arrangement in DNA. Estimation of sequence isomers in pyrimidine deoxyribo-oligonucleotides. AB - The population of pyrimidine deoxyribo-oligonucleotides obtained from DNA may be separated, first, into fractions comprising identical lengths (isotichs) and, subsequently, into the individual components of an isostich fraction varying in the cytidylic and thymidylic acid composition. At a third level of analysis the proportion of components exhibiting the same composition but different sequence may be determined. Selective removal of cytosine and the subsequent analysis for characteristic thymidine derivatives released during an acid-catalyzed beta elimination reaction allowed estimation of the relative proportion of sequence isomers for pyrimidine isostichs of length two to five. PMID- 3624342 TI - Identification of cosmetic dyes by ion-pair reversed-phase high-performance liquid chromatography. AB - A method based on ion-pair reversed-phase high-performance liquid chromatography with detection at four wavelengths between 400 and 600 nm is reported for the separation and identification of the most common synthetic colour additives in cosmetic products. All the dyes generally employed in the U.S.A. and almost all those in current use in cosmetics in the European Community have been taken into account. The chromatography was performed on a C8 bonded silica packed column, with a 60-min gradient changing from 10 to 95% acetonitrile in water containing 10(-2) M sodium perchlorate (pH 3.0) as mobile phase (flow-rate 2.5 ml/min). Detection limits are in the range 20-100 ng for all dyes investigated. The method has been applied to the analysis of commercial lipsticks. PMID- 3624341 TI - Separation of the enantiomers of fluazifop and other 2-phenoxypropionic acids using chiral metal chelate additives in reversed-phase high-performance liquid chromatography. AB - Most of the work on the use of chiral ligand-exchange systems in reversed-phase liquid chromatography has been focussed on the resolution of the enantiomers of amino acids. This paper describes the novel use of L-prolyl-n-octylamide-Ni(II) in the mobile phase for the resolution of the enantiomers of fluazifop and other phenoxypropionic acids. PMID- 3624343 TI - Factors affecting the relationship between the plate height and the linear mobile phase velocity in gel filtration chromatography of proteins. PMID- 3624344 TI - Reversed-phase high-performance liquid chromatography of metronidazole benzoate in suspension dosage form. PMID- 3624345 TI - Determination of enantiomeric purity of Z-oxylysine by capillary gas chromatography. PMID- 3624346 TI - High-performance liquid chromatography assay for the measurement of benzydamine hydrochloride in topical pharmaceutical preparations. PMID- 3624347 TI - High-performance liquid chromatographic determination of antioxidants in fats and oils. PMID- 3624348 TI - Determination of thyreostatics in meat by reversed-phase liquid chromatography with ultraviolet and electrochemical detection. PMID- 3624349 TI - Determination of uracil, uridine and formic acid in egg products by high performance liquid chromatography. PMID- 3624350 TI - 16th International Symposium on Chromatography. Paris, September 21-26, 1986. Proceedings. PMID- 3624351 TI - Transport, space, entropy, diffusion and flow. Elements underlying separation by electrophoresis, chromatography, field-flow fractionation and related methods. AB - We describe here some elements common among separation methods, including the requirement for separative transport, the sensitive utilization of space, and the dissipative (band broadening) roles of entropy, diffusion, and flow. We focus on the need to carefully manage the unceasing competition between separative and dissipative transport in all high resolution methods. We then examine the more specific roles these elements play in influencing separation in several important analytical separation techniques. We begin with electrophoresis and sedimentation, which are conceptually among the simplest of systems because they require no flow and only a single dimension of space. The conflict between separative and dissipative transport is examined closely for these systems and it is shown that the outcome is a theoretical plate number which can be expressed as a ratio of two energies: a structuring energy--delta mu ext, which organizes the separation, and thermal energy RT, which is responsible for its dissipation. It is explained why optimal separation is most often achieved in thin layers or in capillary tubes. Chromatography and field-flow fractionation are then described as two closely related methods in which flow is powerfully coupled with a simple enrichment process occurring at right angles to flow. Unlike electrophoresis, these systems are intrinsically two-dimensional. It is shown how flow and diffusion processes both assume two diametrically opposite roles: those of aiding separation and simultaneously causing its dissipation. With a few equations it is demonstrated that the dissipative role is best contained by reducing the thickness (diameter) of the system or of certain elements within the system. PMID- 3624352 TI - Determination of vinyl chloride monomer residue in poly(vinyl chloride) at the parts-per-billion level with an automatic purge-and-trap technique. AB - A method for the determination of vinyl chloride residue in poly(vinyl chloride) using a commercial purge-and-trap ancillary unit has been developed. Concentrations lower than 10 ppb (10(9] with relative standard deviations in the region of 10% in up to 24 samples are detectable with fully automatic operation without operator attendance. With multiple extraction of the same sample an external standard is used; the matrix does not have any influence on the recovery of vinyl chloride. PMID- 3624353 TI - Tandem capillary gas chromatography in pesticide residue analysis. AB - Maximum residue levels of pesticides in food and feed are often below the 0.1 ppm level. On capillary columns, the maximum injection volumes are 5-10 microliters in the splitless mode, although of course some (acceptable) overloading of the GC column occurs. Injection of larger volumes (up to 100 microliters) is possible only when the solvent can be removed whilst at the same time the compounds of interest are concentrated in a small zone. The advantage of such a procedure is obvious: the limit of detection is improved by a factor of 10-20, so a concentration step can be omitted. A Chrompack MUSIC (MUltiple Switching Intelligent Controller) kit was connected with a Tracor 550 gas chromatograph with an electron-capture detector for chlorinated compounds. Data are presented that show that gel permeation chromatography on Bio-Beads SX-3 as a clean-up medium in combination with MUSIC allows the detection of sub-ppm levels of organochlorine pesticides in grains, fats and vegetables by splitless injection of a 100-microliters sample on to the chromatographic column. PMID- 3624354 TI - Routine high-performance liquid chromatographic determination of carboxylic acids in wines and champagne. AB - Carboxylic acids have an important influence on the biological stability and the organoleptic properties of wines. A simple, rapid and reproducible high performance liquid chromatographic method for the determination of the main carboxylic acids (tartaric, malic, shikimic, lactic, acetic, citric, succinic, fumaric and propionic acids) in wines is described. There is no interference from either sugars or amino acids. The method does not need any preparation or extraction of the sample. The linearity, the level of detection, the repeatability and the reproducibility were studied for each acid. The results are compared with those obtained by chemical and enzymatic assays. PMID- 3624355 TI - Techniques for the detection of lipids in high-performance liquid chromatography. AB - The use of an infrared detector for the detection of lipids in both normal and reversed-phase chromatography is demonstrated. A system is also described for the derivatisation of lipid molecules containing a C = O group to form the hydroxamic acids and their separation and detection as the iron(III) hydroxamates. PMID- 3624356 TI - New approach to the rapid optimisation of conditions for the isocratic separation of multicomponent mixtures. AB - Despite the rapid advances in chromatographic technology, the development of high performance liquid chromatographic methods remains expensive with respect to both time and materials. A new approach is proposed here which is suitable for the investigation of eluents and packings for the resolution of multicomponent samples. This is based upon the use of a small column to mimic the retentive characteristics of isocratic analytical systems but on a greatly reduced time scale. The general utility of this approach is illustrated by three applications, using data for purines and pyrimidines on both reversed-phase and ion-exchange systems. PMID- 3624357 TI - Microcomputer system for data acquisition and software handling in chromatography. AB - A complete, powerful yet simple and inexpensive microcomputer system for chromatography is described. It consists of an electronic interface card and an exploiting software, both controlled by an independent microcomputer. The interface includes all necessary circuits for digitizing the chromatographic signal and for controlling the actuators and the sensors connected with the chromatograph. The software, clock-interrupted, allows simultaneous data acquisition, mathematical treatment, connected plotting, and printing, and drives injection valves and gradient elution pumps. This system is both suitable for high-speed capillary gas chromatography and for high-performance liquid chromatography. PMID- 3624358 TI - Analysis of triacylglycerols by combined high-performance liquid chromatography and gas-liquid chromatography. AB - A method for the analysis of the triacylglycerols from animal and human adipose tissue has been developed by combining high-performance liquid chromatography and gas-liquid chromatography (HPLC) and (GLC). Following isolation by thin-layer chromatography, the triacylglycerols are chromatographed by HPLC on a 5-micron Spherisorb ODS column with a gradient of 45 to 60% 2-propanol in acetonitrile as the mobile phase. Fractions eluted from the column are collected at intervals ranging from 0.2 to 1.0 min, and the triacylglycerols present are then trans esterified prior to analysis of the resulting fatty acid methyl esters by an automated packed column GLC system. Triacylglycerols eluted from the column may be identified by a combination of their elution volume in HPLC and their fatty acid content. From the GLC data, profiles can be constructed for the distribution of several fatty acids amongst the triacylglycerols present in the adipose tissue sample. The method can be used with solvents such as acetonitrile, 2-propanol and acetone in the mobile phase, and there is no baseline drift during gradient elution. The adipose tissue triacylglycerols of normal and streptozotocin induced diabetic rats have been compared. No differences in the distribution of the fatty acids in the two groups of rats were observed under the conditions of our study. PMID- 3624359 TI - Analysis of fatty acids as their anthrylmethyl esters by high-performance liquid chromatography with fluorescence detection. AB - A reversed-phase high-performance liquid chromatographic method for the analysis of free fatty acids in plasma has been developed which allows the resolution of the major plasma fatty acids in man. A mixture of thirteen fatty acid anthrylmethyl esters is resolved on a Spherisorb 3-micron C8 column at a flow rate of 1 ml/min by gradient elution. The solvent system consists of acetonitrile water (93:7) for 12 min, followed by 5 min at acetonitrile-water (86:14) and 23 min at 100% acetonitrile. The eluent is monitored with a fluorescence detector (excitation 360 nm, emission 420 nm). Three different C18 columns were evaluated, and none were able to resolve all the esters. To optimize the separation on the C8 columns it was necessary to construct plots of log capacity factor vs. percent water in the mobile phase. The slope of the line for arachidonic acid (C20:4) was markedly different from that for the saturated acid derivatives. The method was applied to the analysis of plasma free fatty acids in normal and diabetic subjects. As expected, elevated levels of free fatty acids were found in diabetic subjects. The results were shown to correlate well with an established gas chromatographic assay. PMID- 3624360 TI - Combined use of an automated sample processor and a polymer-based high performance liquid chromatographic column to determine the pharmacokinetics of labetalol in man. AB - An improved high-performance liquid chromatographic (HPLC) assay has been developed for the analysis of labetalol in human plasma. The method is based on the combined use of an automated sample processor, reversed-phase analysis on a microparticulate polymer-based HPLC column and fluorescence detection. The pH stability of the polymeric column packing material allowed the use of a mobile phase adjusted to pH 9.5, which was optimal for the fluorescence of labetalol. Assay validation was undertaken over the labetalol concentration range 2-100 ng/ml. Calibration curves were essentially linear, and the mean coefficient of variation was 5.3%. The assay has been used for the analysis of clinical samples in support of pharmacokinetic studies. PMID- 3624361 TI - High-performance liquid chromatographic analysis of glucuronic acid conjugates after derivatization with 4-bromomethyl-7-methoxycoumarin. AB - In order to enhance the detection sensitivity of various glucuronic acid conjugates (phenol, menthol borneol, estrone and testosterone) in high performance liquid chromatography (HPLC), the compounds were esterified with 4 bromomethyl-7-methoxycoumarin in the presence of potassium carbonate and 18-crown 6 in acetone. The resulting esters were chromatographed on either a normal-phase (NP) column (LiChrospher DIOL) with hexane-ethanol mixtures as eluents or a reversed-phase column (LiChrospher CH-18) with methanol-water mixtures. They were detected by UV spectrophotometry at 328 nm. The structure of the derivatives was confirmed by mass spectrometry by direct introduction and chemical ionization. Prior to this step, their isolation on a semi-preparative scale was performed by NP-HPLC. The extraction of the studied glucuronides from microsomal solutions was tested by ion-suppression and ion-pair liquid-liquid partition and liquid-solid chromatography (on octadecylsilica cartridges). Extraction and chromatographic data are discussed with regard to the determination of glucuronyltransferase activity towards the aglycones cited above. PMID- 3624362 TI - Radio gas chromatography for evaluation of sub-cellular hormone synthesis in the androgen insensitivity syndrome. AB - This paper gives a description of a radio gas-liquid chromatographic method for the evaluation of androgen hormone synthesis patterns in the testicular tissue of a patient suffering from the androgen insensitivity syndrome (AIS). A modified dual-column gas chromatography system, equipped with column switching facilities and a radioactivity monitor run parallel to a flame ionisation detector, enables the monitoring of radioactive intermediates of testosterone anabolism and catabolism, generated from a labelled precursor. Tissue preparations were incubated with tritiated pregnenolone for 45 min at 37 degrees C. Steroid hormones were stripped from the aqueous phase by solvent extraction and analysed by gas chromatography as methoxitrimethylsilyl (MO-TMS) derivatives on a 15 m X 0.32 mm I.D. fused-silica capillary column coated with DB-5. The results reveal abnormal enzyme kinetics due to accelerated precursor utilisation. The findings reflect the pathophysiology of AIS at the sub-cellular level of the androgen hormone target organ. PMID- 3624363 TI - Determination of alpha-alkyl-alpha-amino acids and alpha-amino alcohols by chiral phase capillary gas chromatography and reverse-phase high-performance liquid chromatography. AB - The enantiomeric resolution by fused-silica capillary gas-liquid chromatography (GLC) of non-protein DL-alpha-alkyl-alpha-amino acids of the structure H2NCR1R2COOH (R1 = alkyl, R2 = alkyl, alkaryl) was investigated by using chiral [L-valine-tert.-butylamide, linked to a statistical polymer of dimethylsiloxane and (2-carboxypropyl)methylsiloxane, Chirasil-L-Val, and XE-60-S-Val-S-alpha phenylethylamide] and non-chiral (methylphenylcyanopropylvinylpolysiloxane, CP Sil-19 stationary phases. To evaluate the resolution coefficients, N-acylamino acid n-propyl esters (acyl = acetyl, propionyl, trifluoroacetyl, pentafluoropropionyl, heptafluorobutyryl) and diastereomeric esters with S(-)-2 methyl-1-butanol, S(+)-2-butanol and S(+)-2-octanol were used. Although alpha alkyl-alpha-amino acids in general gave lower resolution coefficients than the enantiomers of protein amino acids, most alpha-alkyl-alpha-amino acids could be resolved by using suitable derivatization procedures and, preferably, isothermal conditions. In addition, a number of DL-alpha-alkyl-alpha-amino acids could be separated by ligand-exchange chromatography (L-hydroxyproline/Cu2+) by both thin layer chromatography (Chiralplate) and high-performance liquid chromatography (HPLC) (Nucleosil Chiral-1). Further, a standard mixture composed of fifteen alpha-amino acids and eleven alpha-amino alcohols could be completely separated by C18 HPLC after derivatization with o-phthaldialdehyde-2-mercaptoethanol (OPA-2 ME). The time and temperature dependences of the relative fluorescence of the adducts were investigated kinetically. PMID- 3624364 TI - Separation of the enantiomers of substituted putrescine and cadaverine analogues by gas chromatography on chiral and achiral stationary phases. AB - Capillary gas chromatography (GC) on chiral stationary phases, i.e., Chirasil-Val [L-valine-tert.-(R)-alpha-butylamide] and XE-60-S-valine-(R)-alpha phenylethylamide, has been applied to the resolution of various substituted analogues of putrescine as their N,N'-perfluoroacyl derivatives. The influence of the nature of the substituent on the retention behaviour and on the resolution of the enantiomers was studied. The results are discussed in terms of volatility and interaction with the chiral stationary phase. The 1,4-disubstituted putrescine analogues with two chiral centres were also clearly resolved into their corresponding stereoisomers. When the chain length between the two amino groups was increased, no clear resolution was obtained of the monosubstituted cadaverine analogues as their N,N'-perfluoroacyl derivatives. However, resolution was obtained after derivatization of the cadaverine analogues with (-)-alpha-methoxy alpha-trifluoromethylphenylacetyl chloride, followed by GC analysis on an achiral phase. PMID- 3624365 TI - Separation of serum carotenoids and vitamin A on chromsil-amino and -cyano phases by a bi-directional gradient elution technique. AB - Vitamin A, beta-carotene, lycopene, beta-cryptoxanthin, lutein and zeaxanthin can be simultaneously separated in human serum extracts by normal-phase liquid chromatography. Two stationary phases (containing amino and cyano groups, respectively) were investigated. With a bi-directional (up-down) gradient-elution technique both packings are useful for the determination of serum levels of carotenoids and retinol in serum extracts. The small sample size, the simplicity of extraction, and a good reproducibility render these procedures ideal for clinical use. PMID- 3624366 TI - Automated sequential process for preparing samples for analysis by high performance liquid chromatography. AB - A new method for the preparation of biological samples prior to high-performance liquid chromatographic analysis is described. The automated technique combines dialysis and trace enrichment. In order to investigate its potential, it has been applied to the estimation of total anticonvulsants and theophylline in serum. PMID- 3624367 TI - On the potential of packed-column micro liquid chromatography with "in-column" fluorescence detection for trace analysis of drugs. AB - Packed fused-silica columns of e.g. 0.32 mm I.D. provide a form of chromatography (micro liquid chromatography) which can be surprisingly simple and highly sensitive. Existing commercial instrumentation with fluorescence detection "in column" (in the packing through the transparent column wall) leads to the determination of sub-picogram amounts of compounds in biological or other fluids. A detailed analysis is described as an example. Some aspects of micro liquid chromatography are discussed. PMID- 3624368 TI - Gas chromatographic measurement of carbon monoxide in hydrocarbon matrices with a redox chemiluminescence detector. AB - The rapid measurement of trace levels of carbon monoxide in ethylene by gas chromatography with redox chemiluminescence detection is described. Linear response for carbon monoxide over three decades and a detection limit in the sub parts per million by volume (ppmv) concentration range were observed without methanation or preconcentration of the sample. Samples containing 0.2 ppmv of carbon monoxide in ethylene were readily quantitated. PMID- 3624369 TI - Chiral high-performance liquid chromatographic studies of 2-(4-chloro-2 methylphenoxy)propanoic acid. AB - The direct enantiomeric resolution of the racemic herbicide 2-(4-chloro-2 methylphenoxy)propanoic acid (CMPP) was demonstrated on an Enantiopac (alpha 1 acid glycoprotein) chiral high-performance liquid chromatographic (HPLC) column. The HPLC separation of various amide derivatives of CMPP on a chiral "Ionic Pirkle" column comprising of N-(3,5-dinitrobenzoyl) (R)-(-)phenylglycine as chiral ligand, was also accomplished. These amides and racemic ibuprofen, however could not be separated on the Enantiopac system. The performance, stability and cost of the two systems were compared. Using optically pure CMPP enantiomers the elution order was determined and shown to reverse between the two systems. It was also shown that negligible racemisation occurred during derivatization. PMID- 3624370 TI - Improved high-performance liquid chromatographic assay of erythromycin in pharmaceutical solid dosage forms. AB - A reversed-phase high-performance liquid chromatography method for the assay of erythromycins in pharmaceutical preparations is described. Detailed experimental procedures and results are given. The major erythromycins are well separated, very good recoveries were obtained and detection limits for erythromycins B and C were estimated. PMID- 3624371 TI - Preparation of the multienzyme system gramicidin S-synthetase 2 with an aqueous three-phase system. AB - The distribution of gramicidin S-synthetase activity from disrupted cells suspended in aqueous two- and three-phase systems was investigated. An optimized three-phase system containing 5% dextran, 8% Ficoll, 11% PEG and 6.7% disrupted cells was found to be effective in extracting gramicidin S-synthetase activity. The activity yield achieved was higher in comparison to other preparation methods, and the subsequent purification steps were greatly facilitated. The time needed for the preparation of the labile gramicidin S-synthetase was considerably reduced. The combination of the aqueous phase extraction with chromatographic methods yielded 19 mg gramicidin S-synthetase 2 in essentially pure form from 30 g (wet weight) of cells. PMID- 3624372 TI - Stability-indicating high-performance liquid chromatography of etoposide at various pH conditions using a reversed-phase octyl column. AB - A stability-indicating reversed-phase high-performance liquid chromatographic assay of etoposide is described. Baseline resolution was achieved with an octyl column for etoposide and its four degradation products, including picrolactone. Peak homogeneity of etoposide was confirmed by quantitating etoposide in degraded samples at 230, 254 and 286 nm, respectively. The assay was reproducible with low within-day and between-day variations. Application of the assay for stability kinetic study was demonstrated. Etoposide in 0.1 M hydrochloric acid (pH 1.29) degraded with a half-life of 2.85 h, which may be responsible for the low oral bioavailability of etoposide. PMID- 3624373 TI - Analysis of formulations containing pralidoxime mesylate by liquid chromatography. AB - An improved liquid chromatography procedure has been devised for the analysis of pralidoxime mesylate (P2S) and its degradation products in solution. An additional degradation product, 2-hydroxyaminoiminomethyl-1-methylpyridinium, has been positively identified and its route of formation and that of another recently identified product, 2-hydroxymethyl-1-methylpyridinium, has been established. Previous problems with the chromatography of 2-formyl-1 methylpyridinium have been resolved and the new method will resolve P2S and eight of its degradation products. PMID- 3624374 TI - Ion chromatographic determination of nitrogen dioxide and sulphur dioxide in the atmosphere using tri-ethanolamine-potassium hydroxide-coated cartridges. AB - Nitrogen dioxide (NO2) and sulphur dioxide (SO2) in air were sampled by the use of a Sep-Pak C18 cartridge impregnated with triethanolamine-potassium hydroxide. The trapped NO2 and SO2 were eluted with a 8 mM sodium carbonate-3 mM sodium hydrogencarbonate solution and simultaneously determined by ion chromatography. In the active sampling mode, NO2 was determined with 5.2% relative standard deviation at 95 ppb and SO2 was determined with 2.4-5.3% relative standard deviation at 54-184 ppb. The recoveries were 85-98% for NO2 and 91-105% for SO2. In the passive sampling mode, the average concentrations of NO2 and SO2 were determined with 2.4-6.8 and 2.8-7.9% relative standard deviation, respectively, at atmospheric levels for 6-24 days. PMID- 3624375 TI - Improvement of chemical analysis of antibiotics. XI. Simultaneous fluorodensitometric determination of polyether antibiotics. AB - A simultaneous determination of three polyether antibiotics, salinomycin, monensin and lasalocid, was established by silica gel and RP-18 high-performance thin-layer chromatography (HPTLC) using 18,19-dihydrosalinomycin and 18,19 dihydro-20-ketosalinomycin as internal standards. Fluorescent derivatives of the polyethers were prepared by reaction of their sodium salts with 1 bromoacetylpyrene and Kryptofix 222 in acetonitrile. A silica gel HPTLC plate with carbon tetrachloride-ethyl acetate-acetonitrile (50:5:10) as a solvent system and a RP-18 HPTLC plate with dichloromethane-ethyl acetate-acetone acetonitrile (15:2:1:55) gave satisfactory separations of the five pyrenacyl esters of salinomycin, monensin, lasalocid, 18,19-dihydrosalinomycin and 18,19 dihydro-20-ketosalinomycin. Under these conditions the internal standard 18,19 dihydrosalinomycin was found to be suitable for the simultaneous determination of salinomycin and monensin, and 18,19-dihydro-20-ketosalinomycin for lasalocid. A linear relationship was obtained between the fluorescence intensity and the amount of each antibiotic in the range 2-14 ng. The detection limit of the three antibiotics was 100 pg. PMID- 3624376 TI - Fluorimetric determination of amino acids by high-performance liquid chromatography using a hollow-fibre membrane reactor. AB - A high-performance liquid chromatographic method has been developed for the determination of primary amino acids. The method involves separation of primary amino acids on a C18 column using sodium heptanesulphonate as an ion-pairing agent, post-column derivatization with o-phthalaldehyde and 2-mercaptoethanol introduced into the main flow stream using a sulphonated hollow-fibre membrane reactor immersed in their solutions and fluorimetric detection of derivatives (lambda ex = 340 nm, lambda em = 450 nm). A higher or similar sensitivity was obtained compared with the conventional post-column derivatization method. The detection limits were 0.2-2.3 pmol at a signal-to-noise ratio of 3. For amounts of 48-110 pmol, the precision was of the order of 1.1-4.0% (relative standard deviation, n = 20). PMID- 3624377 TI - Capillary gas chromatographic-mass spectrometric determination of pyridine bases in environmental samples. AB - A method is described for the determination of pyridine bases in environmental samples such as river water and bottom sediments. After distillation from environmental samples, the pyridine bases are concentrated on a rotary evaporator, extracted with n-hexane and determined by capillary gas chromatography-selected-ion monitoring (GC-SIM). The determination of twenty pyridine bases is possible using a 15 m X 0.53 mm I.D. capillary column coated with DBWAX (equivalent to PEG 20M) followed by SIM. The detection limits were 0.01-0.1 ng and recoveries from river water and bottom sediment were over 90% with coefficients of variation below 4% (n = 7) except for pyridine. This method is capable of the simultaneous determination of twenty pyridine bases with sufficient sensitivity and accuracy to be applicable to environmental samples. PMID- 3624378 TI - Residue analysis of triflumizole and its metabolite in crops by high-performance liquid chromatography. AB - A procedure for high-performance liquid chromatographic (HPLC) determination of triflumizole and its metabolite (Met) in crops was examined. Triflumizole and Met in sample crops were extracted with methanol and re-extracted into methylene chloride. After clean-up of the extract on a Florisil column, triflumizole and Met were determined by HPLC with UV detection at 238 nm. The HPLC column was packed with Nucleosil 5 C18 (ODS, 5 micron) and the eluent was acetonitrile-3 mM carbonate buffer (7:3, v/v, pH 9.0). The detection limit was 0.01-0.02 ppm and the recoveries from spiked crops (0.5 ppm) were 73-99% for triflumizole and 74 94% for Met. Triflumizole and Met were determined simultaneously and the method was shown to be applicable to residue analysis of these compounds in crops sprayed with Trifmine in fields. PMID- 3624379 TI - Thin-layer chromatographic examination of the degradation of centbucridine in aqueous solutions. AB - Centbucridine (9-n-butylamino-1,2,3,4-tetrahydroacridine) is a new potent local anaesthetic. Its degradation in aqueous solutions has been investigated with the help of thin-layer chromatography. Apart from the degradation products 9-amino 1,2,3,4-tetrahydroacridine and 1,2,3,4-tetrahydroacridone, acridone was also found to be present. It is shown that the acridone is produced not through a dehydrogenation reaction but some other unknown pathway. PMID- 3624380 TI - Isolation of the rat transferrin receptor by affinity chromatography. PMID- 3624381 TI - Thermospray high-performance liquid chromatographic-mass spectrometric analysis of the degradation products of piroximone. PMID- 3624382 TI - Simultaneous determination of multiple additives in cosmetics by high-performance liquid chromatography. II. Pre-treatment procedure for oil-rich cosmetics. PMID- 3624383 TI - Assay for epinephrine and its impurities using reversed-phase high-performance liquid chromatography. Application to control of an eye-drop solution. PMID- 3624384 TI - Determination of phosmet by high-performance liquid chromatography. PMID- 3624385 TI - Separation of methyl-substituted benz[c]acridines by reversed-phase high performance thin-layer chromatography. PMID- 3624386 TI - Specific spray reagent for the detection of endosulfan by thin-layer chromatography. PMID- 3624387 TI - Separation of carbohydrates and lectins on carbohydrate-immobilized resins. AB - A few carbohydrate-immobilized resins were prepared by coupling glycamines of mono- and disaccharides to an epoxy-activated methacrylate base, and the elution profiles of various carbohydrates and lectins from columns packed with the resultant resins were compared. The introduction of glucamine, maltamine or lactamine to the methacrylate base had little effect on the separation of stereoisomers of aldoses, though it enabled group separation of pentoses as well as 6-deoxyhexoses from hexoses. On the other hand, the maltamine-immobilized resin showed strong specific affinity for concanavalin A, as well as lentil and pea lectins. The lactamine-immobilized resin was specific to ricinus agglutinin, peanut agglutinin and soy bean agglutinin. These carbohydrate-immobilized resins were also useful for the isolation of a lectin-like substance from rat liver. PMID- 3624388 TI - Determination of endotoxins by gas chromatography: evaluation of electron-capture and negative-ion chemical-ionization mass spectrometric detection of halogenated derivatives of beta-hydroxymyristic acid. AB - The sensitivity and selectivity of gas chromatography for analysing several halogenated ester derivatives of beta-hydroxymyristic acid were studied using both selected-ion monitoring detection with negative-ion chemical-ionization mass spectrometry and electron-capture detection. Six different derivatization methods were compared with respect to yield, chemical stability and formation of by products. Procedures for removal of excess reagents using disposable silica columns and thin-layer chromatography were elaborated. The 3-O-pentafluorobenzoyl methyl ester was the preferred derivative since it provided high sensitivity and had the molecular ion as the base peak in the mass spectrum. The detection limit was 0.5 pg with electron-capture detection and 0.3 pg with the mass spectrometric system. Using beta-hydroxymyristic acid as a chemical marker it was possible to detect Escherichia coli endotoxin in aqueous solution at a level of 1 ng/ml. PMID- 3624389 TI - High-performance liquid chromatographic determination of chloramphenicol and four analogues using reductive and oxidative electrochemical and ultraviolet detection. AB - A high-performance liquid chromatographic procedure is described for the separation, quantitation and identification of chloramphenicol, dehydrochloramphenicol, nitrophenylaminopropanedione, nitrosochloramphenicol and aminochloramphenicol. An isocratic reversed-phase system with ultraviolet and electrochemical detectors in tandem was assembled and used. The system was constructed with special accommodation to enable us to use the electrochemical detector in both reductive and oxidative modes. Retention characteristics, hydrodynamic voltammograms under reductive and oxidative conditions and ultraviolet absorbance are reported. Applicability of the procedure to biological fluids was demonstrated by separation and detection of chloramphenicol after incubation with human blood. PMID- 3624390 TI - Electrochemical immunoassay combined with column liquid chromatography: determination of phenytoin in human serum. AB - A new electrochemical immunoassay combined with column liquid chromatography has been developed for the determination of phenytoin in human serum. Phenytoin was labelled with the electrochemically active nitroxide, and the separation of the free labelled antigen from other electrochemically active compounds in serum was accomplished by the use of gel chromatography. Serum samples were mixed with the antibody and the labelled antigen, incubated for 90 min, and then a 100 microliter aliquot of the mixture was directly injected to the column, which was equipped with an electrochemical detector. With 10 microliter of serum, the smallest detectable concentration of phenytoin was 2 micrograms/ml. PMID- 3624391 TI - High-performance liquid chromatographic determination of norfloxacin in human tissues and plasma with fluorescence detection. AB - A high-performance liquid chromatographic method with fluorimetric detection is described for the quantitative determination of norfloxacin in renal and prostatic tissues and in plasma. It consists of tissue pretreatment, purification by solid-state extraction and separation and quantification by high-performance liquid chromatography on a C8 reversed-phase column. Analytical recoveries ranged from 95.2 to 97.6%. Within-day and between-day precision were assessed by analysing serum containing 50 and 500 ng/ml norfloxacin. At each concentration, the within-day precision was less than or equal to 3.6% (coefficient of variation; n = 10) and the day-to-day precision was less than or equal to 5.3% (n = 10). The limit of detection was 1 ng/ml. PMID- 3624392 TI - Simultaneous determination of zopiclone and its two major metabolites (N-oxide and N-desmethyl) in human biological fluids by reversed-phase high-performance liquid chromatography. AB - A high-performance liquid chromatographic method has been developed for the simultaneous determination of zopiclone and its main metabolites (N-oxide and N desmethyl derivatives) in biological fluids. After selective extraction (dichloromethane-2-propanol) these compounds are chromatographed on a column packed with Spherisorb ODS-2 (5 micron) using monobasic sodium phosphate-methanol (45:55, v/v). The eluted compounds are measured by fluorescence detection. The limit of detection of the method is 5 ng/ml for zopiclone in plasma and urine and 10 ng/ml for its two main metabolites (coefficient of variation less than 10%). This method has been successfully applied to pharmacokinetic studies of zopiclone and its two main metabolites in healthy subjects and patients with chronic renal failure. PMID- 3624393 TI - Selective on-line trace enrichment for the determination of ethynyl steroids in urine by liquid chromatography with precolumn technology. PMID- 3624394 TI - Purification of human urinary erythropoietin. PMID- 3624395 TI - Sensitive and specific high-performance liquid chromatographic assay for 6 thiouric acid. PMID- 3624397 TI - Gas chromatographic-mass spectrometric analysis and preliminary human pharmacokinetics of sertraline, a new antidepressant drug. PMID- 3624396 TI - Comparison of the spectrophotometric and high-performance liquid chromatographic analysis of indocyanine green in estimating systemic clearance in patients with chronic liver disease. PMID- 3624398 TI - Capillary gas chromatographic assay for the routine monitoring of the antidepressant mepirzepine in human plasma. PMID- 3624399 TI - Determination of S-carboxymethyl-L-cysteine in plasma by high-performance liquid chromatography with column switching following precolumn derivatization. PMID- 3624400 TI - Simple, rapid high-performance liquid chromatographic determination of bupivacaine in human plasma. PMID- 3624401 TI - High-performance liquid chromatographic-radioimmunoassay method for the measurement of angiotensin II peptides in human plasma. AB - A highly selective high-performance liquid chromatographic-radioimmunoassay method for the measurement of individual endogenous angiotensin peptides in human plasma is described. This method allows the complete resolution of the immunoreactive angiotensin II peptides. We have also measured the angiotensin peptide levels and compared them in both pooled and individual human plasma. The effects of inhibition of angiotensin-converting enzyme on the angiotensin peptide levels have also been observed in a patient with renovascular hypertension with the plasma angiotensin II level being reduced greater than seven-fold. This new methodology was validated by recovery experiments in plasma over a range of physiological levels using two methods of detection, radioimmunoassay and liquid scintillation counting. Consistent recoveries near 80% have been achieved for each peptide in plasma at concentrations over a physiological range. The described method enables the direct measurement of the circulating angiotensin peptides and the elucidation of their specific roles in physiological and disease states. PMID- 3624402 TI - Highly sensitive assay for alkaline and acid phosphatase activities by high performance liquid chromatography with electrochemical detection. AB - A highly sensitive and specific assay for alkaline and acid phosphatases in biological materials, such as plasma and saliva, has been established. Phenol, formed enzymatically from the substrate phenylphosphate, was determined by high performance liquid chromatography with electrochemical detection. The retention time of phenol was 7 min and no other peaks were observed. The method is rapid and sensitive with a detection limit for phenol of as little as 5 pmol. Thus, as little as 0.5 microliter of rat plasma or 10 microliters of human saliva is required for both alkaline and acid phosphatase assays. The assay is accurate and reproducible. Using this assay, alkaline and acid phosphatase activities in saliva were found to be 1.12 +/- 0.12 nmol/min/ml and 9.79 +/- 1.23 nmol/min/ml, respectively. This new assay method should be applicable to extremely small biological samples. PMID- 3624403 TI - Technique for detection of DNA nucleobases by reversed-phase high-performance liquid chromatography optimized for quantitative determination of thymidine substitution by iododeoxyuridine. AB - A reversed-phase high-performance liquid chromatographic (HPLC) method for quantification of iododeoxyuridine (IdUrd) substitution for thymidine in DNA was developed. IdUrd substitution was determined by HPLC with ultraviolet absorbance in two cell lines (L1210 and HT-29) after incubation in vitro with IdUrd alone or with IdUrd and fluorodeoxyuridine. In addition, radiolabeled IdUrd was used concomitantly with HPLC to evaluate the degree of dehalogenation. This HPLC technique has also been applied to the measurement of IdUrd incorporation in vivo into DNA from peripheral granulocytes of patients receiving IdUrd. This method provides an interesting tool for the quantification of drug substitution into DNA and can be applied to multiple sampling sites in animal and human studies. PMID- 3624404 TI - Reversed-phase high-performance liquid chromatographic separation and electrochemical detection of retinol and its isomers. AB - Baseline separation of the isomers of retinol using reversed-phase high performance liquid chromatography (HPLC) in less than 30 min is presented. A new approach to the detection of retinol using electrochemical detection is developed. The oxidative electrochemistry of retinol is studied at a glassy carbon electrode using coulometry, ultraviolet-visible spectrophotometry and HPLC. Amperometric detection in HPLC for retinol provided a linear response from 0 to 1.5 micrograms/ml and a detection limit of 4.1 ng/ml. Electrochemical detection was compared to ultraviolet-visible absorbance detection for the determination of retinol in human serum extracts. Good agreement is found for the results obtained with the two detectors. PMID- 3624405 TI - Assay of diltiazem and deacetyldiltiazem by capillary gas chromatography. AB - A highly sensitive gas chromatographic method for the analysis of diltiazem and deacetyldiltiazem in plasma or serum is reported. After silylation with bis (trimethylsilyl) trifluoroacetamide, separation was obtained on a cross-linked fused-silica column and detection was by electron-capture. The minimum measurable concentrations were 3 and 1 ng/ml for diltiazem and deacetyldiltiazem, respectively. Intra- and inter-day coefficients of variation were less or equal to 6.0 and 8.0%, respectively, for both compounds. The method was used to study the kinetics of a single oral dose of 60 mg of diltiazem hydrochloride in a patient with renal failure. PMID- 3624406 TI - Ion-pair high-performance liquid chromatographic procedure for the quantitative analysis of theophylline in serum samples. AB - An ion-pair chromatographic system is described for the separation of theophylline and related xanthines from serum samples. The mobile phase consisted of 0.02 M tetrabutylammonium ion and 0.015 M Tris buffer in water-acetonitrile methanol (93:3.5:3.5, v/v/v) at a precisely controlled pH (7.50 +/- 0.02, adjusted with hydrochloric acid). The flow-rate was 1.2 ml/min through a 15 cm X 4.6 mm I.D., 5-micron reversed-phase column (Ultrasphere C18 ion pair). Xanthines were extracted from serum (100 microliter) with 1 ml of acidified chloroform isopropanol (95:5, v/v). After reconstitution in 200 microliter of mobile phase, the extracted xanthines, including theophylline, caffeine, theobromine and 1.7 dimethylxanthine, were baseline-resolved in less than 15 min. The method correlates well with a common clinical immunoassay for theophylline (EMIT Syva, r2 = 0.999) and yields excellent recovery and precision (98-101% and better than 2% at therapeutic levels, respectively). In addition, the use of the ion-pair chromatography mode eliminates many of the interferences noted in the published literature for the common reversed-phase separations of theophylline. PMID- 3624407 TI - Separation of biopolymers and supramolecular structures. PMID- 3624408 TI - Circulating intact parathyroid hormone measured by a two-site immunochemiluminometric assay. AB - A direct immunoassay for circulating intact human PTH (hPTH) is described. The method relies on the formation of an immune complex of labeled antiamino-terminal PTH antibody, intact hPTH, and solid phase antimidregion PTH antibody. A chemiluminescent aryl acridinium ester is used as label. Serum samples (100 microL) are incubated with labeled antibody, and subsequently the bound fraction is separated by the addition of solid phase antibody. The bound luminescence is quantitated in an automatic luminometer. Luminescence intensity is directly proportional to the amount of intact PTH present in the sample. Only intact PTH was found to react in this system; there was no significant interference from PTH fragments. The assay detection limit of 0.8 pmol/L hPTH-(1-84) allowed detection of intact PTH in the serum of all normal subjects tested. A clear distinction was found between hypercalcemic individuals subsequently proven to have primary hyperparathyroidism and those with malignancies. The assay offers several advantages over previously described PTH immunoassays with regard to specificity, rapidity, and reagent stability. It, thus, provides a valuable means of investigating parathyroid physiology and clinical disorders of extracellular calcium metabolism. PMID- 3624409 TI - Metastatic tumors of the sella turcica masquerading as primary pituitary tumors. AB - Tumors metastatic to the pituitary gland are uncommon, but may mimic a typical pituitary adenoma and are an important part of the differential diagnosis of sellar mass lesions. Pituitary metastases were treated by transsphenoidal microsurgical removal in 14 patients. Most tumors appeared in men in the sixth and seventh decades of life. Half of the patients presented with visual loss, 6 had anterior hypopituitarism, and 4 had diabetes insipidus. Primary cancer had been diagnosed and treated previously in 5 patients. In the remaining 9 patients, the transsphenoidal operation provided the initial diagnosis of cancer, and primary lesions subsequently were detected in all but 2. Transsphenoidal surgery also provided satisfactory decompression of the mass effect related to the tumors, improving the presenting symptoms in the majority of patients, and the surgery was free of mortality or serious complications. PMID- 3624410 TI - Relationship of cardiac chamber volume to baroreflex activity in normal humans. AB - The objectives of this study were to examine the effect of incremental lower body negative pressure (LBNP) on cardiac chamber volume and assess the relationship between cardiac chamber volume and baroreflex activation of the neurohormonal axis. Accordingly, echocardiographic determination of cardiac chamber volume and neurohormonal responses were studied in 14 normal subjects during incremental LBNP. LBNP -10 mm Hg decreased left atrial diameter and left ventricular systolic volume index, but did not alter heart rate, systolic or pulse pressure, or stroke volume. During LBNP -10 mm Hg, plasma norepinephrine levels increased, suggesting activation of the sympathetic nervous system. LBNP -40 mm Hg caused a significant decrease in left atrial diameter and left ventricular systolic, diastolic, and stroke volume indices. During LBNP -40 mm Hg, heart rate increased, and systolic and pulse pressure fell. With this more negative level of LBNP, norepinephrine, angiotensin II, aldosterone, and arginine vasopressin concentrations and PRA all increased. The findings that left atrial diameter decreased and plasma norepinephrine concentration increased during LBNP -10 mm Hg suggest that the sympathetic nervous system is sensitive to changes in atrial receptor activity. At higher levels of LBNP (-40 mm Hg), activation of the renin-angiotensin system and release of vasopressin were associated with a fall in left ventricular diastolic volume as well as a decrease in the pressure input to the arterial baroreceptors. Under this condition, the differential contribution of the cardiopulmonary and arterial baroreceptors to the regulation of the renin angiotensin system and vasopressin release cannot be distinguished. PMID- 3624411 TI - Renal metabolism of C-peptide in man. AB - Renal metabolism of C-peptide was studied in nine nondiabetic nonobese patients with normal renal function by the arterial-venous difference technique before and after the oral administration of an amino acid mixture simulating an animal protein meal. In the basal state, the kidney removed 25.7 +/- 7.5% (+/- SD) of the arterial plasma C-peptide. Renal uptake was approximately 7-fold greater than urinary excretion, and thus, more than 85% of the amount extracted was metabolized by the kidney. Renal C-peptide clearance was very high and approximated the glomerular filtration rate, whereas urinary C-peptide clearance was only 14% of its renal clearance. Shortly after amino acid ingestion, arterial C-peptide levels increased by 107%, and C-peptide renal fractional extraction, uptake, and net metabolism also increased markedly (67%, 278%, and 328%, respectively); urinary clearance and excretion did not change. Renal clearance became 2-fold greater than the glomerular filtration rate, indicating that in this phase the kidney removed substantial amounts of C-peptide from peritubular blood as well as by filtration. Both renal uptake and urinary excretion of C peptide were related to its arterial levels (P less than 0.001 and P less than 0.05, respectively), but renal uptake increased much more than urinary excretion for each increment in arterial C-peptide levels. These results indicate that renal C-peptide metabolism is considerable in the postabsorptive state and is even more marked during the postprandial period. The kidney, therefore, plays a key role in both the regulation of circulating plasma levels and the metabolic clearance of C-peptide. PMID- 3624412 TI - Age differences in the plasma clearance mechanisms for epinephrine and norepinephrine in humans. AB - There is an age-related increase in plasma norepinephrine (NE) in humans that is due to both an increase in NE appearance into plasma and a decrease in plasma NE clearance. However, previous studies demonstrated no difference in plasma epinephrine (EPI) in young and old subjects, and the effect of aging on plasma EPI appearance and clearance is unclear. To study age differences in basal NE and EPI metabolism we infused eight young (aged 19-26 yr) and eight old (aged 64-74 yr) normal subjects with [3H]NE or [3H]EPI (15 microCi/m2 bolus dose plus 0.35 microCi/m2/min for 50 min) to achieve steady state conditions on separate days. The old subjects had higher arterialized plasma NE levels [mean, 217 +/- 13 (+/- SE) vs. 149 +/- 12 pg/mL; P less than 0.005] and plasma NE appearance. In contrast, neither plasma EPI levels (98 +/- 8 vs. 104 +/- 10 pg/mL; P = NS) nor EPI appearance rates were different in the old and young subjects. The plasma clearance rates of EPI and NE were nearly identical in the young subjects (1.63 +/- 0.14 vs. 166 +/- 0.09 L/min X m2; P = NS). Plasma NE clearance was lower in the old compared to the young subjects (1.38 +/- 0.06 vs. 1.64 +/- 0.10 L/min X m2; P less than 0.05) and was lower than EPI plasma clearance in the same subjects. Although NE and EPI can be removed by both neuronal and nonneuronal uptake mechanisms, and mean plasma clearance values for NE and EPI are the same in the young, the age-related decline in catecholamine clearance is specific for NE. This finding implies a differential effect of age on a catecholamine removal mechanism that is specific for NE. PMID- 3624413 TI - Dose-related prolactin inhibitory effect of the new long-acting dopamine receptor agonist cabergoline in normal cycling, puerperal, and hyperprolactinemic women. AB - Two different single doses (400 and 600 micrograms) of the new long-acting dopamine agonist cabergoline (CBG) were given to 12 normal cycling women, 17 puerperal women, and 24 hyperprolactinemic women (12 with idiopathic hyperprolactinemia and 12 with pituitary adenoma). Plasma PRL was determined in blood samples collected before and at frequent intervals for 5 days after CBG administration. Both CBG doses induced marked inhibition of PRL secretion in all women. A decrease in plasma PRL levels was evident 1-2 h after CBG administration and persisted for up to 5 days. The 600-micrograms CBG dose had a more potent (P less than 0.05) PRL inhibitory effect than the 400-micrograms dose in normal, puerperal, and hyperprolactinemic women. Moreover, while 400 micrograms CBG prevented lactation in 3 of 7 puerperal women, 600 micrograms CBG prevented lactation in 5 of 5 puerperal women. A moderate blood pressure decrease occurred 3-6 h after CBG treatment, but no other side-effects occurred. These results demonstrate that CBG induces a dose-related inhibition of PRL secretion in normal women as well as in puerperal and hyperprolactinemic women. The potent long lasting PRL inhibitory effect of CBG in conjunction with the absence of side effects typical of dopaminergic compounds suggest that this drug is an advance in the medical treatment of hyperprolactinemia. PMID- 3624414 TI - Cold water stimulation of oropharyngeal receptors in man inhibits release of vasopressin. AB - The act of drinking ameliorates thirst and inhibits the secretion of vasopressin before changes in extracellular fluid volume or osmolality in both animals and man. We evaluated whether this reflex inhibition of vasopressin secretion might be due to the presence of oropharyngeal receptors in humans. After dehydration, normal subjects (n = 4) were allowed to suck on ice chips for 30 min. Despite the absence of changes in plasma sodium (Na+) or osmolality, the mean plasma vasopressin level decreased promptly within 10 min from 2.8 to 1.8 pg/mL, and it remained low for 30 min after ice ingestion. When the dehydration protocol was repeated with the subjects receiving 100 mL water (25 C) for 30 min rather than ice chips, plasma vasopressin levels did not change. These data demonstrate that activation of cold-sensitive oropharyngeal receptors results in inhibition of vasopressin secretion independently of osmotic or gastric factors. In a second study 0.2 mL/kg X min 3% NaCl was administered for 90 min as a second stimulus to vasopressin secretion, and ice chips were given during the last 30 min of infusion. Plasma vasopressin levels increased steadily to 3.3 +/- 0.5 (+/- SEM) pg/mL by 45 min, and despite ice ingestion increased further to 4.6 +/- 0.8 pg/mL by 90 min. Consequently, hypertonicity appears to be a stronger stimulus to vasopressin release, since the suppressive effect of stimulation of oropharyngeal receptors with ice was not evident during the NaCl infusion. Finally, no changes in vasopressin levels were found in subjects holding concentrated NaCl solutions in their mouths for 30 min, indicating that the oropharyngeal receptors are not responsive to local changes in osmolality. The presence of such cold-sensitive oropharyngeal receptors may explain the desire of severely dehydrated patients, e.g. patients with diabetes insipidus, for cold liquids. PMID- 3624415 TI - Identification of human growth hormone messenger ribonucleic acid in pituitary adenoma cells by in situ hybridization. AB - The technique of in situ hybridization was used to examine human GH gene expression in human GH-secreting pituitary adenoma cells. Five somatotroph adenoma specimens obtained at surgery were dispersed into single cell suspensions. Hybridization experiments were performed on cells immediately after dispersal or on cells cultured for 48-72 h in a defined serum-free medium. Tritiated GH cDNA was used to probe fixed cells, and hybridization was determined by liquid autoradiography. Of the freshly dispersed adenoma cells probed with GH cDNA, more than 70% contained GH mRNA, as determined by counting silver grains per cell. Significant cellular grain counts were obtained for GH cDNA-probed cells from all five tumors, while negative controls showed negligible silver grain counts. In cultured cells derived from three of five tumors, an average of 40% contained detectable GH mRNA. Therefore, quantitative in situ hybridization is a useful technique to demonstrate the expression of GH mRNA in human pituitary adenoma cells. PMID- 3624416 TI - Hypogonadotropic hypogonadism in hemochromatosis: recovery of reproductive function after iron depletion. AB - We studied the effect of iron depletion on reproductive function in a 37-yr-old man with hypogonadotropic hypogonadism due to idiopathic hemochromatosis. Before therapy, he was impotent and had no libido, and seminal fluid analysis revealed no spermatozoa. Testicular biopsy showed marked impairment of spermatogenesis, but no iron load deposits. Sixteen months after institution of aggressive phlebotomy therapy, serum LH, FSH, and testosterone were normal, and potency and libido had returned. Twenty months after diagnosis the patient fathered another child. Seminal fluid analysis at that time revealed an average of 65 million spermatozoa/mL. Thus, recovery of reproductive function, documented by hormone measurements, testicular biopsy, and semen analysis, was complete. We conclude that phlebotomy alone may be adequate treatment for hypogonadotropic hypogonadism in men with hemochromatosis. PMID- 3624417 TI - Dental findings in osteogenesis imperfecta: I. Occurrence and expression of type I dentinogenesis imperfecta. AB - Sixty-eight patients with osteogenesis imperfecta (OI) classified according to Sillence were evaluated for dentinogenesis imperfecta (DI). Orthopantomograms of 51 of the 68 were examined. Type I DI was recognized in 22 patients from 16 families. DI was observed in 4/45 patients with type I OI, in one of two patients with type III, and in 13/16 patients with type IV OI. Four of the five patients with an unidentified type of OI had DI. The expression of type I DI was variable. Discoloration and pulpal obliteration were the major manifestations. Teeth from 14 patients from 12 families were studied histologically. Eight of the 14 patients were from six families who had clinical and/or radiographic evidence of DI. Irregularity of the dentin matrix and tubular pattern in the circumpulpal dentin and normal mantle dentin were observed. Interfamilial variability was greater than intrafamilial variability. The expression of DI was mild in one family with type I OI. There was no further relation between the type of OI and the severity of DI. PMID- 3624418 TI - Dental findings in osteogenesis imperfecta: II. Dysplastic and other developmental defects. AB - Orthopantomograms of 49 patients with osteogenesis imperfecta (OI) classified according to Sillence were examined for dysplastic dentin defects and other developmental abnormalities of the teeth. Thistle-tube-shaped pulps in the permanent teeth were observed in five patients. Four of them had pulp stones in several teeth. Apically extended pulp chambers were present in 3/49 patients, and the structure of the mandible was cystic in 1/49. These defects occurred in patients with type I or unclassifiable OI and were mainly not associated with type I dentinogenesis imperfecta (DI). The prevalence rates of invaginations (10.2%) and hypodontia of permanent teeth (18.4%) exceeded those in the normal population. The frequent developmental disturbances of the teeth in OI may be secondary to the connective tissue defect. The relation of the dysplastic defects other than type I DI to OI remains to be clarified. PMID- 3624419 TI - Pattern of mineral uptake in the developing human deciduous enamel. AB - The present study describes the detailed changes in mineral concentration in developing human enamel across the different stages of development from early formation to maturation. The results indicate a stage in the development of deciduous human incisor enamel in which the tissue becomes porous because of a loss of matrix protein, which is subsequently replaced by mineral during the maturation process, with the enamel finally becoming fully mineralized and hard. The importance of this stage with regard to enamel susceptibility to metabolic influences is discussed. PMID- 3624420 TI - Prenatal development of rugae palatinae in mice: scanning electron microscopic and histologic studies. AB - The development and spatial arrangement of rugae palatinae was investigated using sagittal histological sections through the heads of 12- to 19-day mouse (ICR) embryos (appearance of vaginal plug = day 1) and scanning electron microscopy (SEM) visualization. Three distinct, consecutively occurring types of developing rugae were described: 1) rugal anlage (formed by thickened epithelium mostly burrowed in mesenchyme), 2) primitive ruga (transversally oriented band of thickened epithelium protruding to the oral cavity), and 3) definitive ruga (transversally oriented mesenchymal ridge protruding to the oral cavity, covered by epithelium). As the characteristic configuration and spatial patterns were found on each of days 13-19, rugae could be utilized as a natural positional marker (eg, in odontogenesis or palatogenesis studies). The foremost rugae start to differentiate between days 12 and 13. Between days 13 and 14 the number of rugae conspicuously increases in the anterior third of palatal shelf, and by palatal shelf horizontalization (day 15, a.m.) new rugae originate in the middle third. We presume that the origin of rugae is dependent upon inductive epithelial mesenchymal interactions. The presence of developing rugae and the timing of their origin (occurrence of tissue interactions) in the middle versus the anterior third of the palatal shelf appears to be reflected in the mode of cellular arrangement, extracellular matrix (ECM) composition, and, probably, even in the elevation mechanism. Six stages of formation of the ruga were defined, and stage-dependent arrangements of epithelial and mesenchymal cells within the developing ruga were documented. A rearrangement of cells precedes the occurrence of the primitive ruga as well as its transformation to the definitive one. These events are discussed in relation to the hypothetical integrated function of cytoskeletal and ECM components. Regarding the developmental relation of rugae to maxillary dentition in the mouse, a comparison of particular stages of teeth and rugae development and analysis of their similarities and dissimilarities may extend the knowledge of general rules of morphogenesis and differentiation in oral biology. PMID- 3624421 TI - Transmission of human craniofacial dimensions. AB - The transmissibilities of 11 human craniofacial dimensions are estimated by path analysis based upon familial correlations obtained in four different populations. Estimates from both the individual populations and from pooled correlations indicate that the observed variation in craniofacial dimensions is determined by genetic and nongenetic factors in roughly equal measure (.45 less than t 2 less than .60). These results implicate the possibility of complex gene-environment and gene-gene interactions in the development of the size and shape of the head and face and call for more detailed familial studies of these traits. This additional complexity further suggests the need for caution in interpreting such metrical variation, especially from a diagnostic or classificatory viewpoint. PMID- 3624422 TI - Ultrastructure of human cumulus-oocyte complexes from healthy and atretic follicles. AB - Follicular fluids with cumulus-oocyte complexes and granulosa cells were aspirated from antral follicles in healthy women at different stages of the normal menstrual cycle. The cumulus-oocyte complexes were processed for light and electron microscopy and classified as pre-ovulatory, healthy non-pre-ovulatory and atretic by certain light microscopical criteria, i.e. degree of expansion, number of layers and pycnotic nuclei in the cumulus investment, size of the peri vitelline space and oocyte nuclear morphology. Their follicles were similarly classified by follicular steroid measurements and/or flow cytometric DNA analyses of the aspirated granulosa cells. A high degree of correlation between these classifications was found. Moreover, pre-ovulatory and atretic cumulus-oocyte complexes showed particular fine morphological characteristics, some of which were different while others appeared to be identical. Similarities were increased number of lipid droplets in the cumulus cells, widened peri-vitelline space, peripheral displacement or breakdown of the oocyte nucleus and disconnection of the junctions between cumulus cell projections and the oolemma. In addition to the criteria used for the light microscopical classification, pre-ovulatory complexes were characterized by release of the content of cortical granules while atretic ones displayed cumulus cells with pseudopodia-like projections, cumulus cells in the perivitelline space and lipid droplets in the ooplasm. PMID- 3624423 TI - Sexual behaviour during ovarian cycles, pregnancy and lactation in group-living stumptail macaques (Macaca arctoides). AB - Sexual interactions were studied in a large, well-integrated group of stumptail macaques, continuously living together. Copulations with the highest-ranking male and with young males were equally distributed over the ovarian cycle. Copulations with other adults males also occurred during all cycle phases, but were most frequent peri-ovulatory. This was most distinct in conceptive cycles. Copulatory activity continued during early pregnancy, but was virtually absent during the middle and latter part of pregnancy and during lactation. Fluctuations in copulation frequency could be attributed to fluctuations in female attractivity (as measured by directed male masturbations), but not in proceptivity (spontaneous presents) or receptivity (acceptance ratios). However, hormonal influences on attractivity could be overruled by social factors. With regard to the expression of heterosexual behaviour, stumptail macaques seem to be less hormone-dependent than other primate species studied, both in the laboratory and under more natural circumstances. PMID- 3624424 TI - Importance of the use of short and long sperm pre-incubation periods in assessing the fertilizing capacity of human spermatozoa by hamster test. AB - The fertilizing capacity of semen samples of seven fertile men was studied in vitro using zona-free hamster ova (hamster test). Spermatozoa of each sample were pre-incubated 4 or 24 h before ova were inseminated for 3 h. An extended insemination for an additional 3 h was also performed after the shorter pre incubation. The overall ovum penetration rate changed from 0 to 100% (mean 52%) after short (4 h) sperm pre-incubation and from 10 to 100% (mean 55%) after long (24 h) pre-incubation. Taking into account the combination of short and long pre incubation periods, all donors reached a penetration rate of 67 to 100%. The results indicate that both short and long pre-incubation periods must be employed when the hamster test is used diagnostically to assess the fertilizing capacity of human spermatozoa. PMID- 3624425 TI - Uptake of pyruvate by early human embryos determined by a non-invasive technique. AB - Normal levels of pyruvate in freshly collected follicular fluid were found to be 0.45 mM, a value approximately 4 X that of serum. The utilization of pyruvate by human oocytes and early embryos has been measured, non-invasively, using two similar but separate analytical methods. The mature oocyte has a high level of pyruvate uptake (36 pmol/embryo/h). After fertilization this value falls, and then slowly increases to reach a peak just prior to the morula stage of 27 pmol/embryo/h before decreasing. Degenerating oocytes and embryos demonstrated much lower pyruvate uptake rates. The possible usefulness of this method for assessing embryo viability is discussed. PMID- 3624426 TI - Oxygen consumption by human oocytes and blastocysts grown in vitro. AB - Oxygen consumption by human oocytes and blastocysts was analysed using a sensitive micro-spectrophotometric technique. Oocytes were obtained from women undergoing laparotomy for sterilization or hysterectomy, and blastocysts were obtained as spare embryos from the local in-vitro fertilization programme. There was no significant difference between oocyte oxygen consumption on the day of isolation and after 1 day of culture, 0.53 +/- 0.08 (n = 9) and 0.35 +/- 0.06 (n = 5) nl/h oocyte, respectively. Blastocyst oxygen consumption was measured after a culture period of 5-8 days after in-vitro fertilization. Mean oxygen consumption by healthy looking blastocysts was 0.34 +/- 0.03 (n = 15) nl/h blastocyst, and there was no change in oxygen consumption with culture time. This level of respiration was lower than expected, both when compared with the oocytes and when compared with levels reported for blastocysts of other species. PMID- 3624427 TI - Stress proteins in the human endometrium and decidua. AB - Protein synthesis in response to heat shock was induced in the proliferative and secretory human endometrium as well as in human decidua during a 2-h incubation period at 41 degrees C. A major 70 K stress protein and two minor stress proteins of 88 and 94 K were detected after [35S]methionine incorporation followed by SDS polyacrylamide gel electrophoretic separation and autoradiography of dried gels. Two dimensional isoelectric focusing followed by fluorography showed the major 70 K stress protein to consist of at least six polypeptides of pH 4.6 to 5.5, the 88 K to consist of at least four polypeptides, of pH 5.5 to 6.0, and the 94 K to consist of at least three polypeptides of pH 4.6 to 5.2. Stress proteins in the human endometrium and decidua may prove to be of physiological significance in reproductive events. PMID- 3624428 TI - Establishing early pregnancy levels of serum progesterone in functionally agonadal women using polysiloxane vaginal rings and cylinders. AB - Using a polysiloxane cylinder impregnated with crystalline progesterone (P4), combined with a 17 beta-oestradiol (E2) and P4 vaginal ring, we produced first trimester pregnancy levels of serum P4 in six functionally agonadal women scheduled for transfer of donated embryos. With this 4 g P4 cylinder worn from cycle day 15 to day 30, overall mean serum P4 concentrations were 15.03 +/- 1.56 ng/ml, with a mean peak level of 21.34 +/- 1.85 ng/ml. These levels were significantly higher than those obtained by us previously in five subjects using a 2 g P4 cylinder [P = 0.007]. The cylinder produced minor but significant complications including small vulvovaginal lacerations, difficulty in removing the device, and vaginal discharge. We conclude that the steroid impregnated polysiloxane vaginal ring and cylinder system provides: continuous and sustained hormone release, and levels of serum P4 in the normal range for early pregnancy. Side effects however, may limit its clinical usefulness. PMID- 3624429 TI - High- and low-density lipoproteins stimulate progesterone production in cultured human granulosa cells. AB - Cultured human granulosa cells are dependent upon gonadotrophins and exogenous cholesterol for maximal progesterone production. In previous studies low-density lipoproteins (LDLs) have been considered the preferred source of cholesterol, while high-density lipoproteins (HDLs) seemed rather to reduce progesterone synthesis in these cells. In this study, granulosa cells were harvested from 12 women and cultured in medium containing lipoprotein-deficient serum for 3 days. This was followed by 2 days of culture in medium supplied with LDL or HDL fractions, prepared by sequential ultracentrifugation and affinity chromatography. In the presence of LH, both lipoprotein fractions enhanced progesterone secretion in a concentration-dependent fashion while basal progesterone secretion was enhanced to a lesser extent. Progesterone secretion in response to lipoproteins did not differ between cells from pre-ovulatory follicles stimulated with gonadotrophins in vivo and less mature follicles obtained earlier in the menstrual cycle. We conclude that human granulosa cells in vitro can utilize cholesterol carried by HDL as well as LDL for progesterone synthesis. PMID- 3624430 TI - The value of intrauterine insemination with washed husband's sperm in the treatment of infertility. AB - Twenty-nine infertile couples were treated by intrauterine insemination (IUI) of washed sperm from a sub-fertile husband (n = 16), in cases of gynaecological (n = 3), combined (n = 4) or idiopathic (n = 6) infertility; 116 treatment cycles resulted in 11 ongoing pregnancies. Between 0.25 and 0.45 ml of capacitation medium, containing at least 500,000 pretreated spermatozoa, were inseminated. Pre treatment of first split fractions was performed by centrifugation and swimming up of motile spermatozoa. The pregnancy per cycle index (P/C) for IUI was 9.5% for a total of 37.9% of all couples treated achieving pregnancy. These results suggest a substantial benefit compared with a calculated six months' cumulative pregnancy rate of 4.2% independent of treatment, for this infertile population. The value of IUI in selected cases of infertility seems obvious but needs further investigation. PMID- 3624431 TI - Pregnancy after the replacement of a frozen-thawed embryo with less than 50% intact blastomeres. AB - Early embryo freezing with saccharose and propanediol gives a survival rate of 62% of the embryos if 4 cell embryos with only one intact blastomere after thawing are included. The first pregnancy achieved with such an embryo is reported as well as preliminary results obtained in our IVF programme using the French method. PMID- 3624432 TI - Pregnancy rate in relation to number of cleaved eggs replaced after in-vitro fertilization in stimulated cycles monitored by serum levels of oestradiol and progesterone as sole index. AB - A simple model for monitoring ovarian stimulation in in-vitro fertilization cycles was designed using daily serum levels of 17 beta-oestradiol and progesterone as the only index to determine the day of ovum retrieval. Human chorionic gonadotropin was administered in the evening 2 days after a level of 2500 pmol/l oestradiol in serum was exceeded provided the serum progesterone level was less than 5 nmol/l. Ovarian stimulation was initiated in 128 women scheduled for laparoscopic oocyte retrieval. Twelve cycles (9%) were cancelled before ovum pick up due to sub-optimal hormone levels in serum and five for other reasons. In 107 successful laparoscopies, 616 oocytes (mean 5.8 per laparoscopy) were recovered. The cleavage rate after IVF was 65% in the egg replacement group. In 87 women, a total of 271 cleaved eggs (range 1-6, mean 3.1) were replaced. The most important factor for establishing a pregnancy was the number of eggs replaced at the same time. Clinical pregnancies were achieved after 30% of replacements, increasing to 50% after replacement of 5-6 eggs. The ongoing/delivered pregnancy rate after the 18th week of gestation was 69%. It was concluded that the simple monitoring model used was consistent with a high pregnancy rate and a low rate of cancelled cycles. PMID- 3624433 TI - Bilateral femoral neuropathy after microsurgical reversal of tubal sterilization: case report and analysis of contributing factors. AB - A case of bilateral femoral neuropathy after microsurgical tuboplasty for reversal of sterilization is reported. Although the prognosis is favourable and full recovery is usually observed, the disabling effect of the neuropathy may last for several months. This report is an attempt to alert fertility surgeons to the possible occurrence of such a complication disturbing to both patient and physician, by analysing the mechanisms of injury and possible ways of its prevention. PMID- 3624434 TI - Abstracts from the third meeting of the European Society of Human Reproduction and Embryology. PMID- 3624435 TI - Isolation of Stomatococcus mucilaginosus from drug user with endocarditis. AB - Stomatococcus mucilaginosus was isolated from the blood of a patient with endocarditis and a past history of drug abuse and aortic valve replacement. At autopsy, Gram stain of the aortic valve revealed gram-positive cocci. Our isolate was atypical for S. mucilaginosus in that colonies were nonmucoid and nonadherent to agar surfaces. Cellular capsules were demonstrated by light and electron microscopy. Phenotypic characteristics identified by conventional methods as well as profile numbers obtained by using two commercial identification systems for staphylococci, the API Staph-Ident and the dms Staph Trac, are presented. Practical tests that differentiate S. mucilaginosus from the genera Micrococcus and Staphylococcus include growth on nutrient agar containing salt and lysostaphin susceptibility. Additional tests that helped differentiate our isolate from group D streptococci included hydrolysis of L-pyrrolidonyl-beta naphthylamide and streptococcal serogrouping. PMID- 3624436 TI - Nonproduction of toxic shock syndrome toxin 1 by coagulase-negative staphylococci. AB - We tested 187 strains of coagulase-negative staphylococci (CNS) for the production of toxic shock syndrome toxin 1 (TSST-1). A total of 111 CNS strains were isolated from the tampons of menstruating women and 74 were isolated from unused tampons. Two strains were isolated from the genital tract of a patient with toxic shock syndrome. Strains were cultivated by the membrane-over-agar method to enhance production of TSST-1, and culture supernatants were tested by two exquisitely sensitive enzyme-linked immunosorbent assays. None of the 187 CNS strains produced TSST-1. We conclude that CNS colonizing the genital tracts of menstruating women and unused tampons produce TSST-1 infrequently, if ever, and are unlikely to play a role in toxic shock syndrome. PMID- 3624437 TI - Controlled evaluation of modified radiometric blood culture medium supplemented with gelatin for detection of bacteremia and fungemia. AB - Although the addition of 1.2% gelatin to broth blood culture media containing sodium polyanetholesulfonate has been shown to enhance detection of certain bacteria, including Neisseria meningitidis, N. gonorrhoeae, Peptostreptococcus anaerobius, and Gardnerella vaginalis, the effect of such supplementation on the detection of other microorganisms causing bacteremia and fungemia is not known. Therefore, we studied BACTEC 6B medium with and without gelatin in 6,833 paired comparisons to examine the effects of supplementation on both the yield and the speed of detection of sepsis. More aerobic and facultative bacteria grew in the 6B than in the 6B-gelatin medium (P less than 0.001), especially staphylococci (P less than 0.01), Escherichia coli (P less than 0.01), other members of the family Enterobacteriaceae (P less than 0.05), and Acinetobacter spp. (P less than 0.05). When microorganisms grew in both bottles, they did so earlier in 6B than in 6B gelatin (P less than 0.001). We conclude that the 6B medium in its present formulation is superior to 6B medium supplemented with 1.2% gelatin. PMID- 3624438 TI - Analysis of 506 consecutive positive serologic tests for brucellosis in Saudi Arabia. AB - Brucellosis is common in the central region of Saudi Arabia. The major clue to the diagnosis is serologic testing. In 3 years, over 500 positive patients who had a titer of 1:160 or more were identified. Brucella species was the single organism most commonly recovered in all blood cultures, being found in 24% of patients with cultures positive for pathogenic bacteria. The expected greater number of Brucella cultures with high initial recorded titer was confirmed; 31% of the positive high-titer group had positive Brucella cultures. Conclusive correlation was uncommon below the 1:640 titer. The lower titers were less useful as indicators of active disease in this population, in which many people appear to have persistent low antibody levels. PMID- 3624439 TI - Candida tropicalis infection in normal, diabetic, and neutropenic mice. AB - Opportunistic infections caused by Candida tropicalis have been noted with increasing frequency in compromised patients. The pathogenicity of three isolates of C. tropicalis was studied in normal CD-1 mice, streptozotocin-induced diabetic mice, and cyclophosphamide-induced neutropenic mice. Lethal dose 50% endpoints and quantitative distribution of yeast cells in spleen, liver, and kidneys of mice infected intravenously were determined. The virulence of one yeast isolate was greater than that of the other two. The order of susceptibility to mortality and degree of organ colonization was neutropenic greater than diabetic greater than normal. Renal lesions resembling those associated with infection by C. albicans appeared by day 5 postinfection in diabetic and neutropenic mice. Greater numbers of C. tropicalis yeast cells were isolated from homogenates of the affected kidneys, suggesting that the kidney is a target organ for this fungus. This study demonstrates the increased susceptibility of compromised mice to C. tropicalis as compared with normal mice and verifies the ability of these yeasts to cause opportunistic disease. PMID- 3624440 TI - Recovery of Blastomyces dermatitidis from blood of a patient with disseminated blastomycosis. AB - This report describes the first well-documented reported case of the recovery of Blastomyces dermatitidis from the blood of a patient with disseminated blastomycosis. The isolate was recovered by using a lysis-centrifugation method and inhibitory mold agar after 6 days of incubation at 30 degrees C. One of six blood samples collected yielded a positive culture. PMID- 3624441 TI - Effect of dialysate fluids on phagocytosis and killing by normal neutrophils. AB - Inadequate host defenses may partly explain the problem of recurrent peritonitis in patients on continuous ambulatory peritoneal dialysis. It has been suggested that these defenses may be adversely affected by the fluids used for dialysis, and so we examined the effects of unused, effluent, and infected peritoneal dialysis fluids on phagocytosis and killing by normal neutrophils. We used a clinical isolate of Staphylococcus epidermidis as the test organism, as this organism is the most commonly cultured in continuous ambulatory peritoneal dialysis peritonitis; we also used a fungal species, Candida guilliermondii. There was no phagocytosis of either organism in unused dialysate because of lack of opsonins and low pH. Phagocytosis in effluent dialysate did not occur because of inadequate opsonin levels and was variable in infected effluents, depending on quantities of immunoglobulins present. Intracellular killing of both test organisms was normal in unused dialysate in the presence of 5% normal serum, but was reduced in effluent and infected dialysates because of factors inhibiting killing by neutrophils. These factors adversely affected the killing of S. epidermidis more than that of C. guilliermondii. These results may explain why peritonitis recurs, particularly peritonitis due to S. epidermidis, because organisms could be sequestered within the neutrophils and thus be protected from antibiotic action. Reinfection of the peritoneal cavity would then take place following neutrophil breakdown, causing a clinical relapse. PMID- 3624442 TI - Production of toxic shock syndrome toxin 1 by Staphylococcus aureus as determined by tampon disk-membrane-agar method. AB - The influence of 17 commercially available tampons on production of toxic shock syndrome toxin 1 (TSST-1) by Staphylococcus aureus was investigated by using a tampon disk method. Filter membranes overlaying agar medium (with or without blood) in small petri dishes were spread inoculated with a TSST-1-producing strain of S. aureus. Disks cut from unrolled tampons were pressed and laid on the inoculated membranes; incubation was for 19 h at 37 degrees C with 5% CO2 in air. CFU on the membranes and in the disks were enumerated, and the presence of TSST-1 in the disks and in the agar layers was determined. Tampons made of different materials supported characteristic levels of cell growth and toxin production in the tampon. Colonization of the interface surface of the tampon disks was heavy. The number of CFU extracted from the tampon disks ranged from 5 X 10(10) to 82 X 10(10). There was little variation in the CFU recovered from the membranes ([1.9 +/- 0.4] X 10(11)). Sixty to 170 micrograms of TSST-1 was recoverable from the agar, with an additional 10 to 90 micrograms recoverable from tampon disks, depending on the type of tampon disk. The amount of toxin in the agar layer from the various tampon disks was relatively constant and indicated an important contribution of toxin from vaginal S. aureus cells not growing in the tampon. The main role of tampons in toxic shock syndrome may be that of providing a fibrous surface for heavy colonization and sufficient air for TSST-1 production. PMID- 3624443 TI - Production of toxic shock syndrome toxin 1 by Staphylococcus aureus restricted to endogenous air in tampons. AB - All types of four brands of tampons were tested in triplicate by a tampon sac method for their effect on production of toxic shock syndrome toxin 1 (TSST-1). In this method the available air is limited to that which is in the tampon sac. Tampons were weighed and inserted into dialysis sacs inoculated with a TSST-1 producing Staphylococcus aureus strain; the sacs were submerged into brain heart infusion agar, which was allowed to harden around the sacs, and were incubated for 18 h at 37 degrees C. The tampons were removed, weighed, and extracted; the CFU of staphylococci and the amount of toxin present in the extracts were determined. Glass wool was used in place of the tampons as one control, and inoculated empty sacs were used as a second control. The total CFU were consistently greater than 2 X 10(11) for the tampons and glass wool and less than or equal to 10(11) for the empty sac control. Total toxin production for all tampons tested and the glass wool was 2 to 10 times higher than the toxin produced with the empty sac control. These results indicate that tampons provide increased surface area for the staphylococci to grow and adequate oxygen for toxin production. No significant inhibition of growth of the staphylococci or TSST-1 production by any of the tampons tested was noted. PMID- 3624444 TI - Demonstration and partial characterization of parasite-specific immunoglobulin A responses in human strongyloidiasis. AB - By using an enzyme-linked immunosorbent assay, serum immunoglobulin A (IgA) responses directed against Strongyloides stercoralis larvae antigens were measured in 104 presumably immunocompetent individuals with chronic uncomplicated strongyloidiasis and in 15 immunocompromised patients with S. stercoralis infection. Fifty healthy North American adults and 18 patients with other helminthic parasites served as controls. All 50 healthy controls were negative for antibody responses (mean absorbance +/- standard deviation = 0.0724 +/- 0.040). The mean absorbance of the 18 parasitized controls was 0.230 +/- 0.087; two individuals parasitized by Ascaris lumbricoides showed positive antibody responses. The mean absorbance of the immunocompetent patients with strongyloidiasis was 0.680 +/- 0.364, with 91 subjects (87.5%) having a positive value (greater than 0.300). Of the immunocompromised patients (mean absorbance +/ standard deviation = 0.735 +/- 0.538), 11 (73%) had a positive antibody response test. When the IgA responses of these two groups were compared, they were not significantly different. There was no correlation between the levels of total serum IgA and the concentration of specific IgA in the infected patients. Both IgA and IgG immunoreactive bands were detected on immunoblots of sodium dodecyl sulfate-polyacrylamide gel electrophoresis-separated larval antigen protein blots. Nineteen bands were recognized by IgG, and 13 were recognized by IgA from sera of infected patients. Several bands displayed specific IgG or IgA reactivity. The present work shows that most patients with strongyloidiasis mount specific IgA responses against filariform larval antigens. These responses are, for the most part, directed against antigens that are different from those recognized by IgG. The lack of correlation between the magnitude of the specific serum IgA responses and the clinical aspects of the infection suggests that these antibodies may not play a central role in the regulation of this parasitosis. PMID- 3624445 TI - Characteristics and sites of infection of Eubacterium nodatum, Eubacterium timidum, Eubacterium brachy, and other asaccharolytic eubacteria. AB - Three new species, Eubacterium nodatum, Eubacterium timidum, and Eubacterium brachy, were described, primarily from subgingival samples taken from patients with moderate and severe adult periodontitis. Except for the isolation of E. brachy from a pleuropulmonary infection, these species have not been reported from other infected body sites. We report on the isolation of these species and an undescribed group (D-6) of asaccharolytic eubacteria also found in periodontal disease from numerous different sites of infection, mostly the head and neck. A similarity in cellular morphological properties of E. nodatum and Actinomyces sp. was noted previously. Additional similarities, particularly to Actinomyces israelii, that we found are the formation of molar tooth colonies and the isolation from cases of lumpy jaw and from the genital tract of women in association with the use of an intrauterine contraceptive device. E. timidum and E. brachy did not occur more often from any particular site outside of the head, neck, and respiratory tract. The group D-6 strains came from a variety of sites in the trunk and pelvis. These species are all obligately anaerobic, asaccharolytic, and generally nonreactive, and they grow poorly and slowly on media commonly used to isolate anaerobic bacteria. L-Lysine (0.5%) markedly stimulated the growth of E. nodatum and, to a lesser extent, another acetate- and butyrate-producing group, Eubacterium sp. group D-6, but we did not find comparable stimulants for the other species. We found the production of phenyl acetate to be a helpful marker in the identification of E. timidum and Eubacterium sp. group D-6. Although the isolation and identification of most of these species remain somewhat difficult, the evidence from dental infections and the present report suggests that these species are potential pathogens that are likely to be overlooked in infected clinical material without special attention to more prolonged incubation and use of enriched isolation media. PMID- 3624446 TI - Rapid identification using a specific DNA probe of Mycobacterium avium complex from patients with acquired immunodeficiency syndrome. AB - Specific DNA probes (Gen-Probe Corp., San Diego, Calif.) for Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium tuberculosis were compared with conventional methods for the identification of isolates of the Mycobacterium avium complex. A total of 56 isolates of M. avium complex were recovered from 34 respiratory, 13 blood, 6 stool, and 3 urine samples from 23 patients. A total of 33 isolates were tested directly from Middlebrook 7H11 agar plates, and 23 isolates were tested directly from BACTEC radiometric 12B bottles (Johnston Laboratories, Inc., Towson, Md.). Of the 56 M. avium complex isolates, 41 tested positive with the M. avium probe, 4 were positive with the M. intracellulare probe, and 7 were positive with both probes. Four direct tests from BACTEC bottles were initially negative but were subsequently M. avium probe positive when subcultures from Lowenstein-Jensen agar were tested. All 56 strains were negative when tested with the M. tuberculosis probe. PMID- 3624447 TI - Cerebral abscess caused by Klebsiella ozaenae. AB - Klebsiella ozaenae is the putative cause of ozena or atrophic rhinitis. It has also been commonly isolated as a colonizing organism, but recent reports demonstrate its role as an invasive pathogen, especially in immunosuppressed hosts. We report the first known case of a cerebral abscess caused by K. ozaenae. PMID- 3624448 TI - Production and use of a hemagglutinin for detecting antibody to Jamestown Canyon virus. AB - A procedure was developed for producing a hemagglutinin for the California serogroup (family Bunyaviridae, genus Bunyavirus) virus Jamestown Canyon, a human pathogen. Serum samples from humans putatively infected with this virus or with La Crosse virus were tested by hemagglutination inhibition. Each antigen detected antibody to the respective virus, with little cross-reactivity. These results suggest that both antigens should be used when the hemagglutination inhibition test is applied to the diagnosis of human infections with California serogroup viruses in North America. PMID- 3624449 TI - Hydrolysis of indoxyl acetate by Campylobacter species. AB - One hundred and twelve Campylobacter strains comprising 15 species and subspecies were examined for their ability to hydrolyze indoxyl acetate. All strains of C. coli, C. cryaerophila, C. fennelliae, and C. jejuni hydrolyzed the compound, whereas three strains of C. cinaedi were negative and a fourth was weakly positive. Representatives of all other species were negative. Organisms that hydrolyzed indoxyl acetate did so regardless of the medium used. PMID- 3624450 TI - Serratia plymuthica sepsis associated with infection of central venous catheter. AB - Serratia plymuthica was isolated from the blood and from a central venous catheter tip in a 54-year-old man with alcoholic cirrhosis and clinical signs of sepsis. This was the seventh reported isolate of S. plymuthica from a clinical specimen and the first in which the organism was clearly a significant pathogen. PMID- 3624451 TI - Seasonal prevalence of Borrelia burgdorferi in natural populations of white footed mice, Peromyscus leucopus. AB - Borrelia burgdorferi, the etiologic agent of Lyme disease, was isolated from 111 of 237 Peromyscus leucopus captured during all seasons of the year. Borreliae were cultured from tissues of the spleen (101 mice), left kidney (76 mice), and right kidney (73 mice), from blood (12 mice), and from one fetus. Mice were infected during the winter, when immature Ixodes dammini were inactive. The prevalence of infection during the winter (less than or equal to 33%) was more than twofold lower than that during the summer (ca. 75%), a time when nymphal ticks are abundant. Overwintering, infected mice are reservoir hosts for subadult ticks that begin feeding in early spring. Twenty white-footed mice from which B. burgdorferi was isolated from tissues of spleen or kidney but not from blood were parasitized by larval I. dammini or Dermacentor variabilis which harbored borreliae. We conclude that these mice were infectious to feeding ticks, even though borreliae were not isolated from blood. PMID- 3624452 TI - Ocular infection in a newborn caused by Neisseria mucosa. AB - Neisseria mucosa was isolated in pure culture from a purulent ocular infection of a newborn. The initial Gram-stained smear revealed intracellular gram-negative diplococci. The organism showed resistance to vancomycin, colistin, and trimethoprim in susceptibility testing and grew well on Thayer-Martin medium. PMID- 3624453 TI - Effect of inoculum size on results of macrotube broth dilution susceptibility tests with Branhamella catarrhalis. AB - The effect of inoculum size on the results of macrotube broth dilution MICs was assessed with 15 strains of Branhamella catarrhalis versus 22 antimicrobial agents. The study isolates included five beta-lactamase-negative strains, five strains that produced beta-lactamase and for which ampicillin MICs were high, and five beta-lactamase-producing strains for which ampicillin MICs were low. An inoculum effect was observed only with strains in the last group when tested versus the following antimicrobial agents: penicillin G, ampicillin, cephalothin, cefamandole, cefuroxime, and cefaclor. PMID- 3624454 TI - Antibodies in sera from patients with myasthenia gravis do not bind to nicotinic acetylcholine receptors from human brain. AB - Nicotinic acetylcholine receptors (AChRs) from brains of chickens and rats have recently been purified and characterized (Whiting and Lindstrom, Biochemistry, 25 (1986) 2082-2093; J. Neurosci., 6 (1986) 3061-3069; Proc. Natl. Acad. Sci. U.S.A., 84 (1987) 595-599). Using both antisera and monoclonal antibodies prepared to AChRs from rat brain, we have demonstrated the existence of a homologous AChR in human brain. Here we report that antibodies to muscle AChRs in the sera of patients with myasthenia gravis (MG) do not bind to AChRs from human brain. Similarly, there was no binding of sera from patients with Guillain-Barre, amyotrophic lateral sclerosis, multiple sclerosis, or Lambert-Eaton myasthenic syndrome. Additionally, no binding of any of these sera to the alpha-bungarotoxin (alpha-Bgt) binding protein from human brain could be detected. This data is consistent with other data using antibodies to AChRs from muscle and nerve in demonstrating that the AChR in brain is antigenically distinct from the AChR in skeletal muscle AChR, and, together with the lack of central neurological symptoms in MG, suggests that the low concentrations of anti-AChR antibodies in the cerebrospinal fluid of MG patients do not bind to AChRs in brain. PMID- 3624455 TI - Antibodies not directed against the acetylcholine receptor in myasthenia gravis. An immunoblot study. AB - Sera of 45 patients with myasthenia gravis (MG) and of 30 healthy controls were screened for antibodies against muscle antigens in an immunoblotting solid-phase assay using a preparation of human amputated muscle as the substrate. In each group, the sera showed several bands on the blots. The findings are thought to indicate that antibodies against muscle components are normally present in human sera. Sera from patients or controls could be distinguished by differences in the band staining patterns. It is suggested that antibodies which are not directed against the acetylcholine receptor may nonetheless play an important role in the pathogenesis and clinical course of myasthenia gravis. PMID- 3624456 TI - Enhancement of rat lymphocyte proliferation after prolonged exposure to stress. AB - Rats exposed to 5 weeks of isolation, water scheduling (daily consumption restricted to 30 min), and their combination demonstrated significantly enhanced splenic lymphocyte proliferative responses to phytohemagglutinin (PHA) compared to those of group-housed animals (five per cage) maintained under standard vivarium conditions. The increased response found with the combination treatment was of the same magnitude as that found with each stressor alone. Blood lymphocyte responses were similarly increased after 5 weeks of isolation. When animals were exposed to the combination treatment for 12 weeks, both blood and splenic lymphocyte responses were found to be enhanced by greater than 2- and 3 fold, respectively. At the time of sacrifice no changes were found in total white blood cell numbers or plasma corticosterone levels with any of these treatments. These data suggest that prolonged exposure to a stressor results in an enhancement of immune cell activity. PMID- 3624457 TI - Recording electrode site nomenclature. AB - Several additions and extensions to the 10-20 System have been proposed. The major sets of proposals are reviewed here. The principal uses of these additional scalp recording sites are for clinical evoked potential testing and for acquisition of EEGs from very large numbers of scalp sites. Three separate systematic nomenclatures have arisen for filling in the half-step gaps in the 10 20 placements. These are compared and contrasted here. PMID- 3624458 TI - The 1987 annual meeting of the American Electroencephalographic Society. September 17-19, 1987, St. Louis, Missouri. Abstracts. PMID- 3624459 TI - Significance of the strength of the quadriceps muscles in children with myelomeningocele. AB - A study of 109 patients with myelomeningocele indicates that useful assessment of quadriceps power can be made during the first 3 years of life. In 21 of 22 patients assessed in those years as having grade 4 quadriceps power, an increase in power was observed in ensuing years, but no such trend was observed in patients with less quadriceps power. Only four of 51 patients who were initially assessed as having quadriceps power of grade 5 showed deterioration in this muscle power over the ensuing years. Ambulatory ability was closely related to quadriceps muscle power. PMID- 3624460 TI - Talo-calcaneal coalition treated with resection. AB - Three cases of symptomatic talocalcaneal coalition (medial or posterior) have been treated successfully with resection of the connecting bar and fat interposition without fusion. At follow-up (ranging from 1 1/2 to 14 years), the patients had no pain, good function, good range of joint motion, and no regeneration of the bar. Computed tomography scanning was the method of choice for roentgenological diagnosis of talocalcaneal coalition. PMID- 3624461 TI - Risk of iatrogenic septic arthritis in the presence of bacteremia: a rabbit study. AB - This study of rabbits determined the risk of producing iatrogenic septic arthritis by arthrocentesis in the presence of bacteremia. In bacteremic animals, three of 20 knees became infected following joint aspiration, and six of 20 knees became infected on injection of 0.2 ml of bacteremic blood. Spontaneous joint sepsis did not develop, even in bacteremic animals. Prophylactic cefazolin before joint aspiration prevented the development of iatrogenic septic arthritis but did not prevent the recovery of bacteria from an infected joint. Therefore, there is an increased risk of development of joint sepsis in this animal model following a traumatic aspiration in the presence of bacteremia. This risk can be minimized by intravenous antibiotics without decreasing the likelihood of recovery of an organism if the joint is septic. PMID- 3624462 TI - Musculoskeletal manifestations of Lyme disease in children. AB - Lyme disease, caused by a tick-transmitted spirochete, has significant musculoskeletal manifestations in children as well as in adults. A series of 23 children with Lyme disease is examined. Acute arthritis was present in five cases, with the knee being involved in three of these cases. Twelve cases (52%) presented with arthralgias, and 10 cases (43%) presented with myalgias. Neurological manifestations were present in 39% of the cases. Five cases have demonstrated recurrent polyarthralgias. Lyme disease should be considered in the differential diagnosis of arthralgias and arthritis in children. PMID- 3624464 TI - Magnetic resonance imaging of the spinal cord in spinal dysraphisms. AB - Magnetic resonance imaging (MRI) was performed 49 times in 42 patients with spinal dysraphism. Scoliosis and a changing neurological picture were the primary indications. Spinal cord anomalies included hydromyelia, diastematomyelia, lipoma, thickened filum terminali, and spinal cord atrophy. All but one patient exhibited Arnold-Chiari malformation. Twenty-two of the 42 patients had computed tomography (CT) scans, myelograms, or operations that corroborated the 41 MRI findings. Three false-positive MRI findings of hydromyelia and no false-negative studies were observed. MRI is a noninvasive investigative technique that provides more information than myelography or CT in defining spinal cord anatomy in spinal dysraphism. PMID- 3624463 TI - Congenital intraspinal lipomas: clinical presentation and response to treatment. AB - A retrospective review of 29 patients with surgically treated intraspinal lipomas was conducted in a determination of their manner of presentation and response to treatment. The average age at the time of diagnosis for the entire group was 12.8 years. Only five patients were neurologically normal by clinical examination at the time of diagnosis, and these five patients were all less than 6 months old. Orthopedic intervention was judged successful in each of the 11 foot-procedures done after surgery on the lipoma, but in only two of the five foot procedures done before such surgery. We conclude that consideration of intraspinal lipoma is worthwhile in several circumstances, including pediatric foot deformities. PMID- 3624465 TI - Spinal deformity in Marfan syndrome. AB - Fourteen patients with classic Marfan syndrome and spinal deformity treated at Texas Scottish Rite Hospital for Crippled Children (Dallas, TX) after 1975 have been conservatively treated to maturity or are at least 2 years after spinal fusion. Brace treatment was successful in one of nine patients. Nine patients underwent fusion. Three had a solid fusion, two lost 20 degrees of correction, and four required revision for multiple pseudarthroses. These latter four all had or developed a kyphotic deformity. Although Marfan syndrome patients can achieve solid fusion, they require massive bone graft, secure segmental internal fixation, and careful observation for pseudarthrosis. Kyphotic deformities require anterior fusion. PMID- 3624466 TI - Patellar instability in juvenile amputees. AB - Forty-three ipsilateral knees in 41 juvenile amputees were studied for determination of the extent and severity of patellar instability. The amputation was performed for trauma in 13 patients and congenital anomalies in 28 patients. Eleven patients had instability, and three had patellofemoral pain. All symptomatic patients had patella alta, lateral subluxation, and hypoplastic patellae on radiographs. Of the asymptomatic patients, 68% had patella alta, and 35% had hypoplasia. Amputees with patella alta had more below-knee amputations and had worn prostheses longer. It is hypothesized that the pressure of the prosthesis on the patellar tendon may lead to patella alta and predispose to instability. PMID- 3624467 TI - Icelandic-Swedish-New York above-knee prosthetic sockets: pediatric experience. AB - The Icelandic-Swedish-New York (ISNY) above-knee prosthetic socket affords juvenile amputees improved comfort, function, and appearance. The flexible polyethylene socket and rigid frame facilitate accommodation to longitudinal and circumferential limb growth. Review of 10 subjects revealed that all who had worn pelvic band suspension with prior prosthesis having rigid sockets could use total or partial suction to suspend prostheses having ISNY sockets. PMID- 3624468 TI - Burns of the upper extremity in children: long-term evaluation of function following treatment. AB - Hand burns in children represent a severe and possibly deforming injury. This study evaluated 82 patients for type of burn, prognostic indicators, and treatment as it affected function and appearance. The best long-term results were associated with small palmar contact burns, compression garments, early skin grafting except for the palm, and late surgical release of webbing. Range of motion of the joints in the hand and clinical function were related. However, hand appearance had no correlation to clinical function. Various combinations of infection requiring intravenous antibiotics, skeletal suspension failure, fourth degree burns, and/or nerve damage were associated with poor results. PMID- 3624469 TI - Congenital hip dysplasia: problems in the diagnosis and management in the first year of life. AB - Eighty-two infants less than 1 year of age who presented with a diagnosis of congenital hip dysplasia have been reviewed. Forty-one infants had a diagnosis of congenital dislocation of the hip (CDH), of which 14 were bilateral cases. Forty one infants had a diagnosis of acetabular dysplasia, of which none was bilateral. The incidence of breech malposition was higher in the CDH group (34%) than in the acetabular dysplasia group (15%). The metaphyseal edge angle, which accurately discriminates between these two groups, is described. There was evidence of abnormal radiographic development in those children with acetabular dysplasia who were not treated by abduction splintage. PMID- 3624470 TI - Nontraumatic clavicle lesions in children. AB - Sixteen children (average age 7.4 years) with nontraumatic lesions of the clavicle were reviewed. There were six cases of neoplasms, six cases of infection, and four developmental anomalies. The patients with infections all had pain at presentation, with elevated white blood cell counts and erythrocyte sedimentation rates. Tissue biopsy was an important diagnostic tool. PMID- 3624471 TI - Disappearing bone disease: a case report and review of the literature. AB - Disappearing bone disease is a rare condition manifested by massive osteolysis. Its etiology is unknown. Histologically, involved bones show a nonmalignant proliferation of thin-walled vessels. The mechanism of bone absorption remains unclear. No treatment has proven effective in arresting the disease. Cases in which there is extraosseous involvement have a much poorer prognosis. PMID- 3624472 TI - Scoliosis secondary to osteoblastoma of the rib. AB - An 8-year-old girl with a progressive, painless spinal deformity is presented. She was found to have an atypical scoliosis secondary to a stage 3 benign osteoblastoma of the rib. This case is presented to emphasize that atypical scoliosis in skeletally immature individuals requires a thorough investigation for an underlying cause. PMID- 3624473 TI - Use of the AO/ASIF external fixator in children. AB - Sixteen children with 20 fractures were treated with the AO/ASIF tubular fixator (Synthes, Ltd., Paoli, PA). Most of the fractures were open, but the fixator was also used in closed fractures in children with head injuries or other forms of trauma. There were 10 fractures of the tibia, 5 of the femur, 3 of the pelvis, and 2 involving the humerus. Average follow-up was 26 months, with the fixators in place for an average of 7 weeks. Fracture union occurred after an average of 16 weeks. This system is easier to apply, less complicated, and lighter than other types of fixators. PMID- 3624474 TI - Blount disease. PMID- 3624475 TI - Relative hypoplasia of the fibula and associated ankle valgus. PMID- 3624476 TI - Treatment of acquired hip subluxation in cerebral palsy. PMID- 3624477 TI - Chronic recurrent multifocal osteomyelitis. PMID- 3624478 TI - 1987 annual meeting, American Academy of Orthopaedic Surgeons. San Francisco, CA, January 22-27, 1987. Abstracts. PMID- 3624479 TI - Inhibition of endotoxin-induced priming of human neutrophils by lipid X and 3-Aza lipid X. AB - Lipid X, a precursor of lipid A (the toxic moiety of endotoxin), has been shown to protect animals from the lethal effects of endotoxin challenge. We investigated the mechanism of action of lipid X and 3-aza-lipid X, a diamino analogue, in vitro, using the ability of lipopolysaccharide (LPS) to prime neutrophils for an enhanced release of toxic oxygen radicals. Lipid X and 3-aza lipid X inhibited LPS-induced neutrophil priming in a concentration-dependent manner. At high concentrations, 3-aza-lipid X was a partial agonist of priming. Lipid X was found to inhibit LPS-induced priming by directly interacting with the neutrophil in contrast to polymyxin B, which neutralized LPS by binding to it. Increasing concentrations of lipid X shifted the LPS dose response curve of neutrophils rightward but did not prevent maximum priming at higher LPS concentrations, a finding consistent with competitive inhibition. These results suggest that lipid X, a compound structurally related to lipid A, may block neutrophil priming by competing with LPS for cellular binding sites. Lipid X appears to have a novel mechanism of inhibiting LPS effect and may have efficacy in the treatment of gram-negative sepsis. PMID- 3624480 TI - Comparison of effects of dobutamine and ouabain on left ventricular contraction and relaxation in closed-chest dogs. AB - Because catecholamines and digitalis have different effects on the time course of myocardial intracellular calcium concentration, their effects on the time course of left ventricular contraction and relaxation may also be different. To study this question, dogs were instrumented to measure left ventricular pressure and determine left ventricular volume from three ultrasonic dimensions. After full recovery from the instrumentation, the effects of dobutamine (2-10 micrograms/kg), ouabain (0.5 mg i.v.) alone, and ouabain given after propranolol (2 mg/kg i.v.), or phentolamine (5 mg i.v.) and incremental doses of ouabain (0.25-0.75 mg i.v.) were assessed on different days. Left ventricular pressure and volume were varied by caval occlusions. Dobutamine significantly increased the slope of the left ventricular end-systolic pressure-volume relation (Emax) and the slope of the dP/dtmax-end-diastolic volume relation (dE/dtmax), while significantly decreasing the time from end-diastole to end-systole (tmax) and the time constant (T) of the isovolumic fall in left ventricular pressure. Ouabain also increased Emax and dE/dtmax but did not alter tmax or T. Dobutamine produced a greater increase in dE/dtmax than in Emax, whereas ouabain produced similar increases in both. These effects of ouabain were not altered by pretreatment with propranolol or phentolamine. We conclude that although dobutamine and ouabain are both positive inotropes that increase Emax, dobutamine speeds the rate of left ventricular contraction (tmax) and relaxation (T), whereas ouabain does not. These effects of ouabain and dobutamine on global parameters of left ventricular chamber performance mirror their influence on intracellular calcium availability. Furthermore, these observations are consistent with the predictions of the time varying elastance model of the left ventricle and support its usefulness as a conceptual framework to understand and link events occurring during isovolumic contraction, end-systole, and isovolumic relaxation. PMID- 3624481 TI - Effects of antidiuretic hormone on urinary acidification and on tubular handling of bicarbonate in the rat. AB - Paired micropuncture experiments were carried out in plasma-replete volume expanded rats to examine the acute effects of 1-desamino-8-D-arginine vasopressin (dDAVP) on urinary acidification and tubular handling of bicarbonate and chloride. No effect was detected on the fractional absorption of water, total CO2, and chloride at end-proximal and early distal sites of superficial nephrons in intact animals; dDAVP, however, inhibited the fractional absorption of total CO2 in Henle's loop while stimulating that of chloride in thyroparathyroidectomized (TPTX) somatostatin-infused rats. In the distal tubule accessible to micropuncture, net total CO2 secretion was observed during hypotonic volume expansion, which reversed to net total CO2 absorption during dDAVP infusion in intact Wistar rats. Marked stimulation of urinary acidification occurred in all animals as attested by a fall in urine pH and bicarbonate excretion. Net acid excretion almost doubled in intact rats. We conclude that (a) antidiuretic hormone (ADH) inhibits fractional bicarbonate absorption in the thick ascending limb while stimulating that of chloride at least in TPTX somatostatin-infused rats, and (b) ADH stimulates proton secretion (or inhibits bicarbonate secretion) in the distal tubule and cortical collecting ducts, which leads to enhanced urinary acidification. PMID- 3624482 TI - Ischemia induces surface membrane dysfunction. Mechanism of altered Na+-dependent glucose transport. AB - Reversible ischemia reduced renal cortical brush border membrane (BBM) Na+ dependent D-glucose uptake (336 +/- 31 vs. 138 +/- 30 pmol/mg per 2 s, P less than 0.01) but had no effect on Na+-independent glucose or Na+-dependent L alanine uptake. The effect on D-glucose uptake was present after only 15 min of ischemia and was due to a reduction in maximum velocity (1913 +/- 251 vs. 999 +/- 130 pmol/mg per 2 s; P less than 0.01). This reduction was not due to more rapid dissipation of the Na+ gradient, altered sidedness of the vesicles, or an alteration in membrane potential. Ischemia did, however, reduce the BBM sphingomyelin-to-phosphatidylcholine (SPH/PC) and cholesterol-to-phospholipid ratios and the number of specific high-affinity Na+-dependent phlorizin binding sites (390 +/- 43 vs. 146 +/- 24 pmol/mg; P less than 0.01) without altering the binding dissociation constant (Kd). 20 mM benzyl alcohol also reduced the number of Na+-dependent phlorizin binding sites (418 +/- 65 vs. 117 +/- 46; P less than 0.01) without altering Kd. The reduction in Na+-dependent D-glucose transport correlated with ischemic-induced changes in the BBM SPH/PC and cholesterol-to phospholipid ratios and membrane fluidity. Taken together these data indicate the cellular site responsible for ischemic-induced reduction in renal cortical transcellular glucose transport is the BBM. We propose the mechanism involves marked alterations in BBM lipids leading to large increases in BBM fluidity which reduces the binding capacity of Na+-dependent glucose carriers. These data indicate that reversible ischemia has profound effects on the surface membrane function of epithelial cells. PMID- 3624483 TI - Production of platelet-derived growth factorlike protein by rat mesangial cells in culture. AB - Rat mesangial cells (MC) release a factor that competes in a dose-dependent manner with 125I-labeled platelet-derived growth factor (PDGF) for binding to human foreskin fibroblasts (HFF). The competitor activity in mesangial cell conditioned medium (MCCM) is reversible, trypsin sensitive, and inhibited by anti PDGF IgG. MCCM also expresses potent mitogenic activity to HFF. Anti-PDGF IgG, in concentrations that completely abolished the mitogenic activity of pure PDGF and the competitor activity of MCCM, only partially (33-41%) inhibits this mitogenic activity. The PDGF receptor competing activity as well as the total mitogenic activity, coelutes with labeled pure PDGF on Sephacryl S-200 gel chromatography. Cation exchange chromatography of concentrated MCCM yields a major mitogen peak with little competitor activity and a smaller mitogenic peak with comparable competitor activity, suggestive of the presence of other mitogens in MCCM besides the PDGF-like protein. PDGF is a potent mitogen and may play a role at inflammatory sites. The production of PDGF-like protein by MC may provide insights for understanding the pathogenesis of glomerular diseases. PMID- 3624484 TI - Stochastic control of anti-Sm autoantibodies in MRL/Mp-lpr/lpr mice. AB - MRL/Mp-lpr/lpr autoimmune mice consistently show an approximately 25% incidence of the systemic lupus erythematosus marker autoantibody anti-Sm. In the present report, we show that the failure to find anti-Sm antibodies in three-quarters of 5-mo-old MRL/lpr mice was not an artifact of an insensitive assay, but rather that the mice fell into two populations as regards their anti-Sm positivity. Based on an extensive analysis of the incidence of anti-Sm positivity in 5-mo-old mice according to their cage of residence, we found no evidence for genetic, environmental, or parental influences on the propensity of an individual animal to become anti-Sm positive. Also, the gender of the mouse, its Sm antigen level, or its length of survival were not related to anti-Sm antibody, nor was the anti Sm antibody status of either parent. Some animals became anti-Sm positive after 5 mo of age, but this was less likely than becoming positive before 5 mo of age. Finally, a survey of 205 autoimmune C57BL/6-lpr/lpr mice confirmed the uniqueness of the MRL background for this autoantibody response. These results together indicate that the possibility of making anti-Sm antibodies is under genetic control, but that the expression of this capability in an individual animal is governed by stochastic events. We hypothesize further that such random processes may involve the expression of particular immunoglobulin variable-region genes combined with mechanisms of extensive somatic mutation or positive feedback amplification, which would transmute an initial monoclonal response into an eventual polyclonal one. PMID- 3624485 TI - Genetic determinants of bone mass in adults. A twin study. AB - The relative importance of genetic factors in determining bone mass in different parts of the skeleton is poorly understood. Lumbar spine and proximal femur bone mineral density and forearm bone mineral content were measured by photon absorptiometry in 38 monozygotic and 27 dizygotic twin pairs. Bone mineral density was significantly more highly correlated in monozygotic than in dizygotic twins for the spine and proximal femur and in the forearm of premenopausal twin pairs, which is consistent with significant genetic contributions to bone mass at all these sites. The lesser genetic contribution to proximal femur and distal forearm bone mass compared with the spine suggests that environmental factors are of greater importance in the aetiology of osteopenia of the hip and wrist. This is the first demonstration of a genetic contribution to bone mass of the spine and proximal femur in adults and confirms similar findings of the forearm. Furthermore, bivariate analysis suggested that a single gene or set of genes determines bone mass at all sites. PMID- 3624486 TI - Identification of high affinity folate binding proteins in human erythrocyte membranes. AB - Mature human erythrocyte membranes contained specific, high affinity (Kd 3.3 X 10(-11) M) folate binding moieties. Folate binding was pH, time- and temperature dependent, saturable, and was much greater for pteroylmonoglutamate and 5 methyltetrahydrofolate than 5-formyltetrahydrofolate and amethopterin. On detergent solubilization of membranes, two peaks of specific folate binding with Mr greater than or equal to 200,000 and 160,000 were identified on Sephacryl S 200 gel filtration chromatography in Triton X-100, and this corresponded to two similar peaks of immunoprecipitated material when solubilized iodinated membranes were probed with anti-human placental folate receptor antiserum. Age-dependent separation of erythrocytes by Stractan density gradients revealed a sevenfold greater folate binding capacity in membranes purified from younger compared with aged erythrocytes. Since this difference was not reflected in proportionately higher immunoreactive folate binding protein, (as determined by a specific radioimmunoassay for these proteins), or differences in affinity in younger than aged cells, these findings indicate that erythrocyte folate binding proteins become progressively nonfunctional at the onset of red cell aging. PMID- 3624487 TI - Accumulation of plasma triiodothyronine sulfate in rats treated with propylthiouracil. AB - Triiodothyronine sulfate (T3S) is rapidly deiodinated by the propylthiouracil (PTU)-sensitive type I deiodinase. Here we examined the effects of PTU on plasma T3S levels in rats after intravenous administration of radiolabeled T3 or T3S. Sephadex LH-20 chromatography and high-performance liquid chromatography were used to quantify conjugated and nonconjugated iodothyronines, and iodide was measured as the TCA-soluble radioactivity. In control rats, radioiodide was the main metabolite of both T3 and T3S. Plasma T3S was cleared more rapidly than plasma T3 despite increased binding to plasma proteins. PTU reduced plasma iodide levels by 66 and 78% after T3 and T3S, respectively, and decreased plasma clearance of T3S by 81%. However, PTU had no effect on plasma T3 clearance but increased plasma T3S from injected T3 4.2 times. Biliary excretion of injected T3S was less than 20% in normal rats, in contrast to 70% within 4 h in PTU treated rats. In conclusion, T3S is an important intermediate in the in vivo metabolism of T3 in rats and accumulates in plasma if type I deiodination is inhibited. PMID- 3624488 TI - Transport kinetics of amino acids across the resting human leg. AB - Flux rates of amino acids were measured across the leg after an overnight fast in resting human volunteers. A balanced amino acid solution was, after a primed infusion, continuously infused for 2 h at each of three step-wise and increasing rates corresponding to 8.3, 16.7, 33.2 mg N/kg per h that were equivalent to 0.2, 0.4, 0.8 g N/kg per d. Flux of amino acids across the leg was compared with the flux of glucose, glycerol, lactate, free fatty acids, and oxygen. The size of the muscular tissue pool of amino acids was measured. Whole body amino acid oxidation was estimated by means of the continuous infusion of a 14C-labeled mixture of amino acids. Arterial steady state levels were obtained for most amino acids within 30 to 45 min after the primed constant infusion. Leg flux of amino acids switched from a net efflux after an overnight fast to a balanced flux between infusion rates corresponding to 0.2-0.4 g N/kg per d. At 0.8 g N/kg per d essentially all amino acids showed uptake. The infusion of amino acids stimulated leg uptake of glucose and lactate production and decreased FFA release. Oxygen uptake and leg blood flow increased significantly with increased infusion of amino acids. There was significant variability in transport rate among individual amino acids. Branched chain amino acids showed rapid transport and methionine slow transport rate. Only small changes in the muscle tissue concentration of certain amino acids were registered after 6 h of amino acid infusion despite uptake for several hours. When amino acids were infused at a rate corresponding to 0.8 g N/kg per d, the leg uptake of amino acids was 6% and the simultaneous whole body oxidation of infused amino acids was approximately 10%. Net uptake of leucine across the leg per hour was 62% of the muscle pool of free leucine when amino acids were infused at a rate corresponding to 0.4 g N/kg per d. Multiple regression analysis showed that the arterial concentration of an amino acid was the most important factor for uptake, more so than insulin concentration and blood flow. It is concluded that leg exchange of amino acids is large enough to rapidly change the pool size of the amino acids in skeletal muscle, if not counter-regulated by changes in rates of protein synthesis and degradation. Estimates of the capacity for protein synthesis and transfer RNA acceptor sites in muscles agree in order of magnitude with the net uptake of amino acids at high infusion rates of amino acids. Therefore, measurements of the balance of tyrosine, phenylalanine, and particularly methionine at steady state may reflect net balance of proteins across skeletal muscles even in short-time experiments. PMID- 3624489 TI - Relationship between canine transthoracic impedance and defibrillation threshold. Evidence for current-based defibrillation. AB - The electrical parameter used to define defibrillation strength is energy. Peak current, however, may more accurately reflect the field quantities (i.e., electric field strength and current density) that mediate defibrillation and therefore should be a better clinical descriptor of threshold than energy. Though transthoracic impedance is a major determinant of energy-based threshold and is sensitive to operator-dependent changes in impedance (electrode-subject interface), an ideal threshold descriptor should be invariant with respect to these changes in impedance. We therefore compared the relative invariance of energy- and current-based thresholds when transthoracic impedance was altered by one of two methods: (a) change in electrode size (protocol A) or (b) change in electrode force (protocol B). In protocol A, impedance was altered in each dog by a mean of 95%. Energy thresholds determined at both low and high impedance were 44 +/- 21 J (mean +/- SD) and 105 +/- 35 J, respectively, P less than 0.0001. In contrast, peak current (A) thresholds were independent of transthoracic impedance, 22 +/- 5 A (low impedance) vs. 24 +/- 6 A (high impedance), P = NS. Energy and current thresholds showed a similar relationship for animals tested in protocol B. Therefore, current-based thresholds, in contrast to energy thresholds are independent of operator-dependent variables of transthoracic impedance and are invariant for a given animal. These results suggest that redefining defibrillation threshold in terms of peak current rather than energy provides a superior method of defibrillation. PMID- 3624491 TI - Effect of intranasal histamine on nasal mucosal blood flow and the antidiuretic activity of desmopressin. AB - The effects of exogenous histamine on nasal mucosal blood flow and the systemic activity of intranasally administered desmopressin, a vasopressin analogue, were studied in normal volunteers. Ten subjects received either saline or histamine (1, 20, 100, and 500 micrograms) by intranasal spray. Maximal nasal mucosal blood flow response, determined by laser doppler velocimetry, demonstrated a significant (P less than 0.05) linear relationship to histamine dose. Eight additional subjects received each of the following intranasal treatments: 20 micrograms histamine followed by 10 micrograms desmopressin; normal saline followed by 10 micrograms desmopressin; 20 micrograms histamine followed by vehicle; or normal saline and vehicle. Nasal blood flow was determined before and after each treatment. Desmopressin activity was assessed by measuring urine osmolality, flow rate, electrolyte, and creatinine concentration for 24 h after each treatment. The effect of histamine and desmopressin was greater than desmopressin alone, with respect to nasal blood flow response (103 +/- 24 vs. 4 +/- 17%, mean +/- SEM, P less than 0.02), initial urine osmolality (520 +/- 123 vs. 333 +/- 75 mosM, P less than 0.03), urine electrolyte (potassium, 45 +/- 11 vs. 28 +/- 7 meq/liter; sodium, 68 +/- 21 vs. 36 +/- 8 meq/liter, P less than 0.03) and creatinine concentrations (95 +/- 23 vs. 60 +/- 13 mg/dl, P less than 0.03), and the duration of decrease in urine flow rate compared with saline and vehicle. These results suggest that the systemic activity of intranasal desmopressin is enhanced by increasing local nasal blood flow and are consistent with increased transnasal absorption of the peptide. PMID- 3624490 TI - 16, 16 Dimethyl prostaglandin E2 prevents the development of fulminant hepatitis and blocks the induction of monocyte/macrophage procoagulant activity after murine hepatitis virus strain 3 infection. AB - 16, 16 Dimethyl prostaglandin E2 (dmPGE2), a known cytoprotective agent, was examined for its ability to alter the course of fulminant hepatitis in an experimental model of fulminant viral hepatitis, murine hepatitis murine hepatitis type 3 (MHV-3). Fully susceptible BALB/cJ mice, infected with 100 50% lethal doses (LD50) of MHV-3 developed histologic and biochemical evidence of fulminant hepatitis, as evidenced by massive hepatic necrosis with hypoglycemia, metabolic acidosis, and a markedly elevated serum alanine aminotransferase (ALT) (mean, 1,402 +/- 619 IU/liter). In contrast, animals treated with dmPGE2 either before or after infection (up to 48 h) demonstrated a marked reduction in both histologic and biochemical evidence of liver damage as characterized by normal blood glucose, total CO2, and ALT determinations (mean ALT, 63 +/- 40 IU/liter). Treatment of infected mice with PGF2 alpha demonstrated no cytoprotective effects. High titers of infectious virus were recovered from the livers of both dmPGE2-treated and -untreated animals throughout the course of infection. In a parallel in vitro study, dmPGE2 (10(-4)-10(-8) M) demonstrated a similar cytoprotective effect on monolayers of isolated cultured hepatocytes from fully susceptible BALB/cJ mice infected at a multiplicity of infection of 0.1, 1.0, and 10.0. In addition, splenic macrophages recovered from infected and untreated BALB/cJ mice demonstrated a marked augmentation in procoagulant activity (PCA) from a basal 10 +/- 5 mU/10(6) splenic macrophages to a maximum of 615 +/- 102 mU/10(6) splenic macrophages, whereas no increase in macrophage PCA was detected in infected animals treated with dmPGE2. These results suggest that dmPGE2, without detectably altering viral replication or infectivity in vivo, confers a marked cytoprotective effect on hepatocytes both in vivo and in vitro, and prevents the induction of macrophage PCA in vivo in fully susceptible BALB/cJ mice after murine hepatitis virus type 3 infection. PMID- 3624492 TI - Human chorionic gonadotropin and 8-bromo cyclic adenosine monophosphate promote an acute increase in cytochrome P450scc and adrenodoxin messenger RNAs in cultured human granulosa cells by a cycloheximide-insensitive mechanism. AB - Treatment of human granulosa cells with human chorionic gonadotropin (hCG) or an analogue of its second messenger, cyclic AMP (cAMP), promotes a rapid accumulation of the messenger RNAs (mRNAs) for cytochrome P450 side-chain cleavage (scc) and adrenodoxin. A twofold increase in the cellular content of these mRNAs was observed within 4 h of exposure to 8-bromo-cAMP, and was maintained for up to 48 h. Inhibition of protein synthesis by cycloheximide did not prevent the hCG- or 8-bromo-cAMP-stimulated accumulation of either cytochrome P450scc or adrenodoxin mRNAs. We conclude that human granulosa cells respond rapidly to hCG and cAMP analogues with a coordinate increase in levels of the mRNAs encoding two key proteins of the steroidogenic machinery, and that this stimulation does not require synthesis of a protein intermediate. PMID- 3624493 TI - Radioimmunoassays for the enantiomeric components of indacrinone and their phenolic metabolites. AB - MK-286 is a 90:10 mixture of the (+) and (-)-enantiomers of indacrinone, a combination which induces diuresis while maintaining isouricemia. The principal (phenolic) metabolites also possess pharmacological activity and assays for the four entities were needed for clinical studies. Antisera were produced with the stereospecificity required to measure one enantiomer in the presence of the others, but significant cross-reactivity between drug and metabolite necessitated the separation of these two species by means of Sep-Pak cartridges. Recovery was assessed by concurrently fractionated reference samples. The radioligand in each case was a [I-125]-L-iodotyrosine conjugate of the analyte. Absolute assay sensitivities ranged from 2-20 pg/assay tube, corresponding to 0.2-2.0 ng/ml in serum samples. The assay was also applied to urine with analytes at concentrations greater than 16 ng/ml. PMID- 3624494 TI - A solid-phase receptor binding assay for 125I-hCG. AB - A solid-phase radioligand-receptor assay (RRA) to measure the binding of 125I labelled human chorionic gonadotropin (125I-hCG) to target cell membranes has been developed. The binding of 125I-hCG to membranes immobilized on the wells of microtitration plates reached a maximum at about 3 hours at 37 degrees C, was saturable, displayed a high affinity (Ka = 2.4 X 10(9) M-1) and was specifically inhibited by unlabelled hCG. In comparison with RRAs carried out with membranes in suspension, the solid-phase RRA is significantly simpler and much faster to perform as it avoids centrifugation or filtration procedures. The solid-phase RRA was adapted profitably to process large numbers of samples at the same time. It proved particularly useful as a screening assay to detect anti-hCG monoclonal antibodies with high inhibitory activity for binding of 125I-hCG to its receptors. PMID- 3624495 TI - Dissociation of hepatitis B surface antigen (HBsAg) from immobilised anti-HBsAg antibody in a two site immunoradiometric assay: its relevance to hook effect and recycled assay. AB - The mechanism of the hook effect in a two site immunometric assay of hepatitis B surface antigen (HBsAg) was studied using a novel method. The results showed that HBsAg dissociated from immobilized anti-HBsAg at low as well as high doses of antigen (Ag). This probably was not due to lack of immobilized antibody (Ab) or dissociation of HBsAg non-specifically bound to the immobilized Ab. The dissociated Ag sequestered the labelled Ab in the second reaction and contributed to the decrease in percent binding (B%) of the assay and thus the hook effect. The dissociated Ag could contaminate the recovered pooled labelled Ab in recycled assay and give rise to high non-specific binding. Prolonged washing decreased the side reaction but also the B% of the assay. PMID- 3624496 TI - Radioimmunoassay for desciclovir, 2-[(2-amino-9H-purin-9-yl)methoxy]ethanol, a prodrug for the antiviral acyclovir. AB - A direct radioimmunoassay for the detection of desciclovir (DCV)(2) in biological fluids has been developed. The radioimmunoassay was validated by comparing results obtained from human plasma samples analyzed by both this RIA and a gas chromatographic method. None of the crossreactivities noted interfere with the assay system. Although the succinylated antigen has a slightly higher affinity constant, the non-succinylated tritiated antigen was chosen for routine use. The assay is sensitive with an I50 value of 20 nM and with a lower limit of detection of about 3 nM. Intra-assay precision gave sample coefficients of variation which ranged from 2.2 to 9.6% for the standard curve with human plasma and from 2.0 to 8.2% for the standard curve with human urine. Inter-assay precision and accuracy were within acceptable limits. PMID- 3624497 TI - Role of fine needle aspiration cytology in breast cancer screening. AB - In a six year period up to the end of December 1985 fine needle aspiration cytology specimens of the breast were obtained from 562 apparently healthy women invited to participate in a breast cancer screening programme. Of these, 397 had a biopsy and 173 cancers were confirmed histologically. For the diagnosis of cancer, the procedure was less successful than in symptomatic cases. The main factors influencing success were the aspirator, the small size of many cancers, and the occult nature of the lesions seen only on mammography. Retrospective analysis of the figures shows that combining the results of FNA cytology in a triple assessment with physical and mammographical findings for restricted selection means that the number of benign biopsy specimens could be reduced considerably. PMID- 3624498 TI - Influence of 5-hydroxytryptamine on crypt cell production rate of human duodenal mucosa cultured in vitro. AB - The effect of 5-hydroxytryptamine (5-HT) on the crypt cell production rate in normal human duodenal mucosa cultured in vitro was studied using a stathmokinetic technique with crypt microdissection. The addition of 5-HT (2 mg/ml) to the culture medium significantly increased the crypt cell production rate (p less than 0.001), suggesting that this amine may have a trophic effect on crypt cells in vitro. Increased synthesis and release of 5-HT from enterochromaffin cells in patients with coeliac disease may increase the crypt cell production rate and lead to a flattened small intestinal mucosa. PMID- 3624499 TI - Lymph node cellular morphology: comparative study of imprints and cytocentrifuge smears. AB - To assess the usefulness of the lymph node imprint technique in quantitating cell types a comparative study using cytocentrifuge smears as controls was undertaken. The cell dimensions and distribution of cell types were compared in 12 patients with non-Hodgkin's lymphoma (NHL) using semi-automated image analysis. The results show that the imprint procedure introduces selective bias in favour of certain cell types; moreover, certain cell measurements, such as nuclear shape, are easier to see on cytocentrifuge smears. The imprint technique compares unfavourably with cytocentrifuge smears when precise quantitation of cell types is required. PMID- 3624500 TI - Antibody to coliform antigens in urine samples from patients with symptoms of urinary tract infection. AB - An enzyme linked immunoadsorbent assay (ELISA) was used to detect IgG, IgM, and IgA antibody in urine to a crude antigenic mixture prepared from six arbitrarily chosen strains of common coliform urinary pathogens. In a group of patients with symptoms of urinary tract infection 24 of 80 (30%) urine samples were positive on culture by conventional methods, 58 of 80 (72.5%) were positive for polymorphs on microscopy, and 72 of 80 (90%) were positive for antibody by ELISA. Secretory component was detected in 28 of 80 (35%) samples, and this is consistent with local antibody production. The results show that antibody can be detected in a wide range of urine samples using a simple antigen mixture, and this may form the basis of a useful test to diagnose urinary tract infection. PMID- 3624501 TI - Accumulation of ceroid in smooth muscle indicates severe malabsorption and vitamin E deficiency. AB - Four patients had accumulation of ceroid in smooth muscle (lipofuscinosis), which indicated severe or uncontrolled malabsorption, with confirmed vitamin E deficiency in three cases. The distribution of the pigment was systematic, and there seemed to be an association between malabsorption syndrome and vitamin E deficiency. Vitamin E supplementation seems to be indicated in such patients, and it is suggested that studies of smooth muscle function should be made in cases of heavy accumulation of ceroid. PMID- 3624502 TI - Nutritional survey of patients in a general surgical ward: is there an effective predictor of malnutrition? AB - A survey of patients in a general surgical ward was undertaken to establish biochemical and anthropometric standards which could be used to detect malnourished patients in hospital. Results of biochemical and anthropometric tests of nutritional status were compared with assessment by a clinician and the quick nutritional index of Seltzer. Triceps skinfold thickness and serum albumin concentrations indicated that 29% and 35% of patients, respectively, were undernourished compared with 16% by clinical assessment and 17% by the quick nutritional index. Significant correlations (p less than 0.001) between serum albumin and transferrin concentrations and arm muscle area were found for men but not for women. Poor nutritional specificity and sensitivity of some anthropometric and biochemical tests may account for the difference in the level of undernutrition found by these tests and clinical assessment. This shows the importance of the choice of test in influencing the level of undernutrition detected. PMID- 3624503 TI - Staphaurex reappraised: role of protein A in false positive results and recommendations for use. PMID- 3624504 TI - The hepatic injury of monoamine oxidase inhibitors. PMID- 3624505 TI - Imipramine blood levels and clinical outcome. AB - Fifty-one depressed inpatients, after 1 drug-free week, were treated for 5 weeks with imipramine 4 mg/kg day. Plasma levels of imipramine (IMI) and its active metabolite desmethylimipramine (DMI) were measured weekly, 15 hours after the last drug intake. Steady state blood levels (IMI + DMI) ranged from 60 to 585 ng/ml. The mean value for plasma concentration (IMI + DMI) at day 42 was 271 ng/ml. In the same way, therapeutic effectiveness was assessed every week using the Hamilton Rating Scale for Depression (HDRS). There was a significant correlation between plasma concentration and the decrease of Hamilton scores. The IMI/DMI ratio showed a responder-nonresponder difference; 86% patients with a ratio between 0.4 and 1 were responders. Conversely, most patients with a ratio below 0.4 or above 1 were nonresponders. The ideal ratio for clinical response would be 0.68. The ratio is a subject-specific feature, able to be an early predictor of clinical outcome. PMID- 3624506 TI - Tardive dyskinesia in the course of antidepressant therapy: a prevalence study and review of the literature. AB - The authors present a prevalence study of tardive dyskinesia (TD) in the course of antidepressant therapy. Of the 50 patients evaluated, three developed TD. TD developed rapidly and in a short period of time. Withdrawal of antidepressant improved TD in two patients. The literature on TD developing in the course of antidepressant therapy is reviewed, and the different etiological theories are examined. PMID- 3624507 TI - Prospective study of scheduled withdrawal from nortriptyline in children and adolescents. AB - Thirty 6- to 16-year-old subjects were gradually tapered from their maintenance dose of nortriptyline while being monitored for withdrawal effects. Five subjects had brief gastrointestinal distress that did not require the administration of an extra dose. The results of this open study suggest that scheduled tapering of nortriptyline will preclude withdrawal symptoms in most pediatric patients. PMID- 3624508 TI - Antidepressant-related akathisia. AB - Five neuroleptic-free patients exhibited syndromes that were indistinguishable from idiopathic or neuroleptic-induced akathisia in association with antidepressant administration. While antidepressant-related akathisia may be produced by any of a variety of antidepressants, the susceptibility of each individual patient to the development of this disorder may be limited to only one or a few of these agents. A considerably rarer syndrome than neuroleptic-induced akathisia, antidepressant-related akathisia appears to respond to established pharmacologic treatments for neuroleptic-induced akathisia. PMID- 3624509 TI - Desipramine in agoraphobia with panic attacks: an open, fixed-dose study. AB - Fourteen patients who met DSM-III criteria for agoraphobia with panic attacks received 200 mg desipramine (DMI) per day for 12 to 16 weeks on an open basis. Seven of eight patients who responded had steady state plasma DMI levels greater than 125 ng/ml, while five of six nonresponders had DMI levels less than 125 ng/ml. Following increases in dosage sufficient to raise DMI levels to greater than 150 ng/ml, four nonresponders improved dramatically. Implications of these findings are discussed briefly. PMID- 3624511 TI - View from the Nation's Capital. PMID- 3624510 TI - Psychiatric side effects from topical ocular timolol, a beta-adrenergic blocker. AB - Neuropsychiatric side effects have been reported with various systemic betablockers. Data submitted to the National Registry of Drug-Induced Ocular Side Effects appear to indicate similar adverse reactions secondary to topical ophthalmic timolol. One hundred sixty-three of 369 central nervous system cases (44%) reported depression, psychosis, confusion, and hallucinations following topical ophthalmic timolol administration. The psychiatric community should be aware that sudden changes in mental status or onset of common psychiatric conditions, such as depression, may be due to topical ocular timolol. Withdrawal of the drug usually results in disappearance of these effects in 1 to 7 days. PMID- 3624512 TI - View from the Nation's Courts. PMID- 3624513 TI - Verapamil and bipolar illness. PMID- 3624514 TI - Amitriptyline augments and prolongs ethanol-induced euphoria. PMID- 3624515 TI - Trazodone in the treatment of obsessive-compulsive disorder: a case report. PMID- 3624516 TI - Transient facial palsy during lithium toxicity. PMID- 3624517 TI - Delirium secondary to metoclopramide hydrochloride. PMID- 3624518 TI - An adjunctive role for ascorbic acid in the treatment of schizophrenia? PMID- 3624519 TI - Fever caused by lithium in a patient with neuroleptic malignant syndrome. PMID- 3624521 TI - Naming the cyclic antidepressants. PMID- 3624520 TI - Disulfiram and bipolar affective disorder. PMID- 3624522 TI - Lithium allergy. PMID- 3624523 TI - An assessment technique for children with auditory-language processing problems. AB - The purpose of this study was to develop a new multilayer clinical assessment technique to evaluate auditory-language processing abilities in children. Following a 90-min in-service workshop on auditory-language processing problems, 46 nonhandicapped first-, second-, and third-grade students were referred by their classroom teachers for an evaluation of auditory-language processing abilities. Twelve "normally" achieving first-, second-, and third-grade students were randomly selected as controls. Standardized and nonstandardized measures included a pure tone and impedance test, selected subtests of the Clinical Evaluation of Language Functions (Linguistic Concepts, Relationships and Ambiguities, Oral Directions, Spoken Paragraphs, Word Associations, and Model Sentences), the Goldman-Fristoe-Woodcock (GFW) Memory for Sequence Test, Sound Mimicry Test, Sound-Symbol Association Test, and the GFW Test of Auditory Discrimination. Nonstandardized measures included an Observational Profile of Classroom Communication and an informal language sample. Results indicated 87% of 46 (n = 40) children were identified as having auditory-language processing problems. In-service training was an effective means to heighten teachers' awareness for referring subjects. Additionally, the Observational Profile of Classroom Communication was an effective procedure for teachers to systematically observe and document communication behaviors in the context of the classroom. PMID- 3624524 TI - The pronunciation of stops in consonant-vowel-consonant (CVC) words: a comparison between normal and speech-disordered preschool children. AB - A study was made of the pronunciation of stop consonants in CVC words by three groups of preschool children. The two groups of normal children had insignificant problems, but the speech-disordered group had a wide range of errors. Errors in initial position differed from errors in final position. Voicing errors occurred most frequently in initial position, and glottal stop realizations in final position. The incidence of consonant harmony was unexpectedly low, accounting for few errors, and there was no evidence of the "fronting strategy" (Ingram, 1974) in the speech-disordered children. PMID- 3624525 TI - Laryngectomees' and nonlaryngectomees' perceptions of three methods of alaryngeal voicing. AB - The purpose of this investigation was to compare the proficiency ratings made by laryngectomee and nonlaryngectomee judges when evaluating videotaped samples of laryngeal and alaryngeal speakers. A group of laryngectomee judges and three groups of nonlaryngectomized judges completed proficiency ratings for the following speakers: laryngeal (n = 10); electrolarynx (n = 11); esophageal (n = 12); and tracheoesophageal puncture (n = 10). Significant differences between laryngectomee and nonlaryngectomee judges were found when rating alaryngeal speakers, but not when rating normal, laryngeal speakers. Differences in judge group ratings varied according to the voicing method of the speakers and according to the vocal parameter being rated. PMID- 3624526 TI - Concurrent validity of two language screening tests. AB - The importance of ascertaining the validity of clinical instruments used to make decisions about individuals is discussed and the need for additional validation studies is emphasized. Steps that can be taken to confirm the validity for a particular application, setting, or population are described. As an example, the concurrent validity of two language screening instruments, the Fluharty Preschool Screening Test and the Northwestern Syntax Screening Test, and their subtests was examined. Decisions from these screening tests and subtests were compared to a validity criterion of passing or failing the Sequenced Inventory of Communication Development for 182 white middle-class children, ages 36-47 months. The results showed that the screening tests differed in their validity, depending upon the content of the test and each subtest. The consequences of using either screening test are explored, to illustrate how the outcomes of such studies should be interpreted. PMID- 3624527 TI - Effect of peer administered consequences upon articulatory responses of speech defective children. AB - Twenty second-grade lisping children were taught to articulate /s/ and /z/ correctly during three training sessions. Two weeks later, each child was asked to invite three classmates to a fourth session in which the classmates could earn tokens contingent upon the target child's correct articulation of /s/ and /z/ sounds. A response cost procedure was initiated with one group of 10 target children and the invited peers. In addition to tokens given for correct responses, tokens were removed following each of the target child's incorrect /s/ or /z/ responses. This condition resulted in the presentation of aversive consequences as well as helpful comments from the peers administered to the target child. Response cost procedures were not used with the remaining group of 10 target children and peers. Comparison of correct versus incorrect responses in each group revealed target children in the response cost group produced significantly more correct /s/ or /z/ sounds than those in the group receiving only reinforcement. Possible reasons to explain this finding and advisability of using response cost procedures with peers are discussed. PMID- 3624528 TI - Articulatory disorders in speech among Finnish-speaking students according to age, sex, and speech therapy. AB - A group of Finnish-speaking students (n = 451) was examined clinically to study occurrence of articulatory disorders in speech, controlling for the possible effects of age, sex, and previous speech therapy. Distortions of the /s/ sound were found in 16%, of the /r/ sound in 3%, and of the /l/, /n/, or /d/ sounds in about 1% of the subjects; the rarest faultily produced sounds were usually combined with other articulatory disorders. According to fitted log-linear functions, age and sex were not related to prevalence of articulatory disorders in speech among young adults, while there was a tendency for subjects with previous speech therapy to have higher frequencies of articulatory disorders of /s/ and /r/ sounds than subjects with no such treatment, suggesting that exclusion of the treated subjects would have resulted in too low a prevalence of articulatory disorders in the sample. PMID- 3624529 TI - Perception of oral diadochokinetic performances in elderly adults. AB - Twenty speech-language pathologists judged the adequacy of oral diadochokinetic performances by ten normal young adult speakers, ten normal geriatric speakers, and four dysarthric speakers (foils) for the purpose of investigating age-related changes in speech. Listeners rated each speaker according to 11 perceptual dimensions. Significant differences in ratings were found among the three subject groups for 10 of the 11 perceptual dimensions. The performances of elderly normal adult speakers were rated farther from the "normal" endpoint of a seven-point continuum than those of the young normal adults. The listeners also reported lesser degrees of confidence in their ratings of the geriatrics in comparison with both young adult and dysarthric groups. Perceptual characteristics associated with oral diadochokinetic performance appear to be altered with advanced age. Further analysis of clinicians' judgments suggest support for Ryan and Burk's (1974) proposal that the speech of aged adults may fall at the "mild end of a dysarthric continuum." Results emphasized the need for development of clinical standards of speech normality for the geriatric population. PMID- 3624530 TI - Effects of pseudostuttering on normal speakers' self-ratings of beauty. AB - Forty-three undergraduate and 12 graduate students provided numerical evaluations of their own outer beauty and inner beauty, both in class, and immediately following a pseudostuttering assignment. Both groups had significant downshifts in both parameters of beauty. The undergraduate students had greater downshifts in both areas than did the graduate students. It was concluded that, pseudostuttering assignments represent a viable instrument for allowing student clinicians to experience negative feelings as a result of stuttering, and graduate students manifested greater stability in their self-evaluations than did the undergraduate students. PMID- 3624532 TI - Social epidemiology: directions for the future in academic and "shoe-leather" risk analysis. AB - In the past, social epidemiology has been a field of interest to only a few professionals, notably sociologists and a select few epidemiologists. Expansion of the scope of epidemiology beyond infectious diseases and a few chronic diseases has made social epidemiology vitally important in the work of a host of professionals in public health and preventive medicine. These include persons doing risk analysis, persons working in environmental and occupational health, health educators, and persons working in institutions such as labor unions and schools which mediate the effects of risk factors upon population groups. With the expansion of the field, it is becoming apparent that the interrelationships among social risk factors are complex. Some social factors are both predictors of health status and outcome factors. This complexity will require new analytic methods, some of which are outside the present repertoire of most epidemiologists and biostatisticians. This paper examines the changing scope and impact of social epidemiology and suggests directions for the future of teaching and research in the field. If these new directions, guide research and teaching in the field, public health professionals will be able to bring a host of newly acquired skills to their "shoe-leather" epidemiology. Using those skills will require broad interdisciplinary cooperation in health promotion and disease prevention. PMID- 3624531 TI - Long term effect of gynecologic age on somatic growth of children. AB - A sample of New Orleans black primiparous women under 25 years of age, participants in the national collaborative perinatal study, and their singleton children were studied to determine the relationship of maternal gestational age (GeA), gynecologic age (GyA) and size for GeA (S/GeA) on the child's growth over seven years observation. Early childbearers (less than 4 years GyA) had a somewhat higher proportion of preterm births than the late group (greater than or equal to 4 yrs GyA). A repeated measures analysis of variance after correction for maternal prepregnant weight and weight gain, demonstrated the early group remained smaller throughout the seven years in weight, length and head circumference. Preterm infants showed catch up by one year in height and weight in both Early and Late Groups, though the Early Preterm infants failed to catch up with the other groups in head circumference. In this lower socio economic group, the legacy of early childbearing appears to be smaller child body dimensions which are likely permanent. PMID- 3624533 TI - Importance of community size in practice location decisions of final year residents. AB - Final year residents in training in Louisiana were surveyed regarding plans for medical practice and their perceptions of the importance of various factors in choosing practice locations. Most specialty groups selected smaller communities at similar rates. Growing up in small towns is associated with wanting to practice in small towns while concerns about opportunities for the family and income of the region are associated with wanting to practice in a larger city. PMID- 3624534 TI - Health effects from indoor air pollution: case studies. AB - In recent years there has been a growing awareness of the health effects associated with the presence of contaminants in indoor air. Numerous agents can accumulate in public buildings, homes and automobiles as a result of ongoing activities that normally occur in these closed spaces. Ventilation is a major factor in the control of indoor air pollutants since proper movement of air can prevent or minimize the build up of compounds in buildings. The recent emphasis on energy conservation has lead to measures which economize on energy for heating and air conditioning, but which also trap pollutants within a building. Three cases of indoor air pollution were investigated. A typical investigation of indoor air pollutant problems includes the following: interviews with building occupants; history of the building with regard to maintenance, pesticide treatment, etc.; a survey of the building and ventilation; and when warranted, sampling and analysis of air. Each case presented is unique in that atypical situations caused agents to accumulate in a building or section of a building. The indoor air problems in these cases were solved by identifying and removing the source of the offending agent and/or improving the ventilation in the building. PMID- 3624535 TI - Trends in environmental health education. AB - This paper outlines the development of environmental health education from the 1970s to present. Current areas of interest in environmental health are discussed, including hazardous waste management, risk assessment and risk management. Model curricula for each of these subject areas are presented. Future employment opportunities for environmental health specialists are summarized. PMID- 3624536 TI - Contemporary issues in public health. PMID- 3624538 TI - Central terminations of cutaneous mechanoreceptive afferents in the rat lumbar spinal cord. AB - The morphology in the dorsal horn of the lumbar spinal cord of the collateral branches and terminal arborizations of three different types of low-threshold mechanoreceptor innervating the skin of the rat hindlimb has been studied by the intracellular injection of horseradish peroxidase into physiologically characterized afferent fibres. The central terminals of five rapidly adapting glabrous skin mechanoreceptors (RA), six hair follicle afferents (HFA), and four slowly adapting type I afferent fibres (SA I; two from glabrous and two from hairy skin) were recovered for detailed analysis. The number of collaterals per axon varied from eight to 12, and the length of axon stained from 3.5 to 4.7 mm. In each afferent, while the majority (52-67%) of the terminal arborizations displayed extensive branching with large numbers of en passant and terminal synaptic boutons, the arborizations at the caudal and rostral extremes of the terminal field tended to be much simpler and less profuse, with few and in some cases no boutons. This did not appear to be the consequence of inadequate filling. The general pattern of the terminal arborizations was one of mediolaterally compressed, rostrocaudally oriented sheets. In the case of the RA afferents there was no overlap between the adjacent terminal arborizations; a few of the arborizations of the SA I afferents overlapped; most, but not all, of the HFA terminal arborizations overlapped. The terminal arborizations of the HFAs had a distinctive morphology identical to the flame-shaped arbors described in earlier Golgi studies and included synaptic boutons extending from inner lamina II to lamina IV. The morphologies of the RA and SA terminal arborizations were similar to each other, but the former tended to be concentrated in lamina IV with branches in III and V, whereas the latter tended to V with few branches more superficial than lamina IV. There were also differences in the intercollateral spacing between these two types of afferent fibre. While there are similarities between the morphology of the central terminals of cutaneous low-threshold mechanoreceptors in the rat and those previously described in the cat (for example, the longitudinally continuous arrangement of the mediolaterally restricted flame-shaped HFA arborizations and the discontinuous RA arborizations arising from a dorsally located axon), there are also some major differences: the large number of HFA arbors extending to lamina IIi and to lamina IV rather than being restricted to lamina III, the deeper location of the RA arbors (in laminae IV and V rather than lamina III),(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3624537 TI - Hospital record studies as a tool for staff education: a participatory research project in Guatemala. AB - This study examined the educational outcomes of a participatory research project in Guatemala. Using a 33.33% systematic sample of records covering an 11 year period, hospital data were collected on 9500 admissions from a small private hospital. Analysis of the data was performed by the local hospital staff and professional researchers. Interpretation of the information was primarily concerned with hospitalization trends, sociodemographic and economic characteristics, and cultural beliefs. Two of the major impacts of the study were that hospital physicians developed a stronger data orientation and gained an increased awareness of public health issues. The participatory research process led staff members to identify areas of further research and modify health education and community outreach programs. PMID- 3624539 TI - Anatomy and electrophysiology of neurons terminating in the corpora allata of the cockroach Diploptera punctata. AB - Intracellular recording and dye injection were used to study the structure and electrophysiological properties of individual neurons that project to the corpora allata of the cockroach, Diploptera punctata. Neurons in the pars intercerebralis generate long-duration, tetrodotoxin-sensitive action potentials. Dye injection revealed two cell types. One type extends axons to the contralateral nervi corporis cardiaci I, some of which innervate the corpora allata, and another type extends a major axon down each of the circumoesophageal connectives. Neurons in the pars lateralis also generate long-duration action potentials. These neurons extend axons to the ipsilateral nervi corporis cardiaci II, which continue on to terminate in the corpora cardiaca and the corpora allata. Small groups of all the above neuronal types are dye and electrically coupled. Penetration and dye injection into nerve terminals in the corpora allata and corpora cardiaca confirmed the innervation of the corpora allata by neurons located in the pars intercerebralis and pars lateralis and revealed a third class of neurons that have terminals in the corpora allata: intrinsic neurons of the corpora cardiaca. PMID- 3624540 TI - Physiological evidence for branching of peripheral unmyelinated sensory afferent fibers in the rat. AB - Single unmyelinated sensory afferent nerve fibers were recorded in dorsal root filaments in urethane-anesthetized or in decerebrate-spinal rats. The peripheral branch of these axons ran in the sural nerve where they were stimulated by tungsten microelectrodes. All action potentials showed the characteristics of single fiber responses with a fixed all or none shape and a fixed latency at a given stimulus strength. In all units, the action potential evoked from a proximal stimulus site collided with the action potential evoked from a distal stimulus site. Of the 44 single units isolated, 17 showed the expected small progressive decrease of latency of the recorded impulse as the stimulus strength at a fixed point on the sural nerve was progressively raised above threshold. However, in 27 units there was an abrupt jump decrease of latency as the stimulus rose above the threshold. The average size of this latency shortening was 2.2 msec, which occurred as the stimulus strength rose a mean 21% above threshold. As the stimulus rose above threshold, 7 fibers showed 3 different fixed latencies and 2 fibers showed 4 fixed latencies. In order to test the possibility that the peripheral nerve contained 2 branches of the same axon with one conducting slower than the other, the peripheral nerve was stimulated at progressively longer conduction distances. As predicted, the difference between the 2 fixed latencies became larger as the conduction distance increased. We discuss 6 possible explanations for the results and conclude they are consistent with the proposals that some fibers branch distal to the dorsal root ganglion and some branches do not establish a functional sensory ending in the periphery. PMID- 3624541 TI - Glycogen phosphorylase activity in the olfactory bulb of the young rat. AB - The activity of glycogen phosphorylase, the enzyme that controls glycogen breakdown, was histochemically mapped in the olfactory bulbs of 19-day-old rats. The effect of early odor experience on subsequent olfactory bulb phosphorylase activity was also examined. The highest level of phosphorylase staining in the bulb (and seemingly the highest in the brain) was in the glomerular layer, followed by the external plexiform, internal plexiform, granule cell, and olfactory nerve layers. Virtually no activity was visible in the large output neurons of the bulb, mitral, and tufted cells. Early peppermint odor experience, previously shown to increase metabolic activity in specific glomerular foci as measured by 2-deoxyglucose uptake, had no apparent effect on glomerular-layer phosphorylase activity. In some odor-familiar animals, however, patches of activity were seen in the internal plexiform layer in the area of the bulb where foci of high deoxyglucose uptake are seen in response to peppermint. The patches were directly in line with modified glomerular clusters often seen to underlie foci of enhanced deoxyglucose uptake. The existence of particularly heavy activity in the peripheral third of the glomerular layer, where glycogen containing modified Schwann cells have been localized, raises the possibility that the glomerular-layer activity is at least partially glial in origin. Finally, because of its rich noradrenaline and serotonin innervation and high density of insulin receptors, the olfactory bulb is proposed as a model system to study the interaction of glycogen/glucose metabolism with neural activity in a relatively well-defined neuronal circuit. PMID- 3624542 TI - Axonal arborization in the developing chick retinotectal system. AB - The growth and arborization of chicken retinal ganglion cell axons have been investigated by means of an intraaxonally transported fluorescent marker in the developing retinotectal system. The fluorescent dye D282 or diI from the carbocyanine group of dyes is taken up by ganglion cells and labels the axon as well as the axonal growth cones and the terminal arborizations on the tectum. Branching and arborization start in the chick retinotectal system on embryonic day 9 (E9). At this stage retinal axons leave the stratum opticum (SO) and invade the stratum griseum et fibrosum superficiale (SGFS), where arborization takes place. On day E12 several axons were found to arborize in the SGFS. At this stage arbors appear to have small branches with less than 4 branching points. The extension of terminal arbors in the anterior/posterior (A/P) and in the dorsal/ventral (D/V) direction was determined for 50 axonal trees at days E13-14 and for 24 arbors at days E15-16. Few axonal terminals were investigated at day E18. The mean A/P extent of axonal terminal trees increases from 0.23 +/- 0.12 to 0.36 +/- 0.22 mm from E13-14 to E15-16 and seems to stay at this order of magnitude on E18. The mean D/V extent increases from 0.23 +/- 0.17 to 0.30 +/- 0.18 mm in the same embryonic period of development. The number of branching points calculated from the same number of axonal trees increases from 7.50 +/- 2.98 at E13-14 to 11.70 +/- 4.10 at E15-16. This number seems to increase further after day E16 achieving values of about 20 to 25 at E18. This was, however, not quantifiable by the technique used here and represents an approximate value estimated from 6 completely labeled terminal fields at E18. The data presented here suggest that the modeling of the final branching pattern in the chick retinotectal system takes place within a relatively short period of embryonic development. Prior to the beginning of terminal arborization two important events contribute to the formation of a retinotopic projection. One event is the change of the D/V position by a minority of axons lying ectopic in terms of retinotopy. Some axons turn at right angles and change their D/V position. The other event is the appearance of side branches along the A/P axis. PMID- 3624543 TI - Morphology of corticotectal cells in the primary visual cortex of hooded rats. AB - In primary visual cortex of hooded rats, pyramidal cells in layer V may be classified as long, medium, or short, on the basis of the layer in which the apical dendrite terminates. The present study determines which of these types of pyramidal cells project to the superior colliculus. Two different strategies were used to label corticotectal cells with horseradish peroxidase (HRP). In the first set of experiments, a large number of corticotectal cells were labeled by retrograde transport following injection of HRP into the superior colliculus. In the second set of experiments, single unit recording was used to identify corticotectal cells physiologically by antidromic activation from the superior colliculus. These cells were then impaled and labeled by intracellular iontophoresis of HRP. The results from both techniques suggest that only long pyramidal cells send an axon to the superior colliculus. These cells are distinguished by an apical dendrite that extends into layer I. We conclude that in hooded rats corticotectal cells in primary visual cortex are the long pyramids in layer V. PMID- 3624544 TI - Ectosylvian visual area of the cat: location, retinotopic organization, and connections. AB - We have mapped out the ectosylvian visual area (EVA) of the cat in a series of single- and multiunit recording studies. EVA occupies 10-20 mm2 of cortex at the posterior end of the horizontal limb of the anterior ectosylvian sulcus. EVA borders on somatosensory cortex anteriorly, auditory cortex posteriorly, and nonresponsive cortex laterally. EVA exhibits limited retinotopic organization, as indicated by the fact that receptive fields shift gradually with tangential travel of the microelectrode through cortex. However, a point-to-point representation of the complete visual hemifield is not present. We have characterized the afferent and efferent connections of EVA by placing retrograde and anterograde tracer deposits in EVA and in other cortical visual areas. The strongest transcortical fiber projection to EVA arises in the lateral suprasylvian visual areas. Area 20, the granular insula, and perirhinal cortex provide additional sparse afferents. The projection from lateral suprasylvian cortex to EVA arises predominantly in layer 3 and terminates in layer 4. EVA projects reciprocally to all cortical areas from which it receives input. The projection from EVA to the lateral suprasylvian areas arises predominantly in layers 5 and 6 and terminates in layer 1. EVA is linked reciprocally to a thalamic zone encompassing the lateromedial-suprageniculate complex and the adjacent medial subdivision of the latero-posterior nucleus. We conclude that EVA is an exclusively visual area confined to the anterior ectosylvian sulcus and bounded by nonvisual cortex. EVA is distinguished from other visual areas by its physical isolation from those areas, by its lack of consistent global retinotopic organization, and by its placement at the end of a chain of areas through which information flows outward from the primary visual cortex. PMID- 3624545 TI - Stereological analysis of synaptogenesis in the molecular layer of piriform cortex in the prenatal rat. AB - The development of synapses in the molecular layer of the rat piriform cortex was studied at embryonic days 15, 17, 19, and 21. The present study has sought to extend past studies of synaptogenesis by identifying not only changes in numbers of synapses, but also changes in numbers of potential precursors of synapses. A stereological method (Cruz-Orive, '80) was used to make volumetric estimations of the numbers of synapses, axonal puncta, vesicle-associated puncta, and unapposed postsynaptic specializations. This stereological method was preferred to other morphometric methods because it is not influenced by changes in the size, shape, or orientation of the structures of interest. This was considered important since such changes might be expected during development. Large numbers of unapposed axonal specializations (axonal puncta and vesicle-associated puncta) were found in all three sublaminae (lateral olfactory tract, Ia, and Ib) at all ages. The numerical density (number per unit volume of neuropil) and relative frequency of these structures changed significantly with time. In all three sublaminae, these changes were associated with changes in the number of synapses, although the numerical density and relative proportions varied between the sublaminae. These results suggested that axonal puncta could accumulate vesicles, thus becoming vesicle-associated puncta, and that vesicle-associated puncta could contact dendrites, thus forming synapses. In contrast, the numerical density of lone postsynaptic specializations remained low and no significant changes in their relative proportion in the population were found. This suggested that although lone postsynaptic sites were observed, they did not appear to play a major role in synaptogenesis in this region of the cortex. In addition to documenting developmental differences between the three sublaminae in the molecular layer, the results support a synaptogenic hypothesis in which the axon can form surface specializations that appear to be involved in synaptogenesis, independent of direct dendritic contact. PMID- 3624546 TI - Intrinsic circuitry involving the local axon collaterals of corticothalamic projection cells in mouse SmI cortex. AB - The objective of this study was to identify the components involved in a local synaptic circuit in the mouse cerebral cortex. The local axon collaterals of corticothalamic (CT) projection cells in the posteromedial barrel subfield area of primary somatosensory cortex were labeled by the retrograde transport of horseradish peroxidase injected into the ipsilateral thalamus. Thalamocortical (TC) axon terminals in the same region of cortex were labeled by lesion induced degeneration. CT axon terminals synapsed preferentially with dendritic shafts, whereas TC axon terminals synapsed mainly with dendritic spines. Some dendrites received both CT and TC synapses. Dendrites were interpreted to belong to nonspiny multipolar cells. These results indicate that a reciprocal synaptic relationship exists in the cortex between nonspiny multipolar cells and CT projection cells. Both CT projection cells and nonspiny multipolar neurons have been shown previously to receive TC synapses (White and Hersh: J. Neurocytol. 11:137-157, '82; White, Benshalom, and Hersch: J. Comp. Neurol. 229:311-320, '84). These findings imply that a triadic relationship involving afferent input and populations of CT projection and intrinsic neurons is a basic feature of the synaptic organization of the cerebral cortex. PMID- 3624547 TI - Retinal ganglion cells projecting to the accessory optic system in the rat. AB - The present data identify the distribution and morphological features of a homogeneous group of rat retinal ganglion cells. These cells were labelled after injection of either horseradish peroxidase or a fluorescent tracer, Fast Blue, into the medial terminal nucleus (MTN) of the accessory optic system. After retrograde fluorescent labelling, MTN-projecting retinal ganglion cells were intracellularly injected with Lucifer Yellow to reveal their complete dendritic morphology. There were on average 1,750 MTN-projecting cells fairly evenly distributed over the entire retinal ganglion cell layer. Their density ranged from 40-49 cells/mm2 in superior retina to 10-19 cells/mm2 towards the peripheral regions of both inferior and superior retina. The area of highest density formed a nasal-temporal band suggestive of a visual streak. Soma diameters ranged from 8.7 to 14.5 micron centrally and from 9.9 to 17.1 microns peripherally. Maximal dendritic field diameter ranged from 431 to 644 micron and averaged 516 micron with no obvious eccentricity dependence. The majority of MTN-projecting cells were bistratified. Dendrites stratified predominantly in the inner sublamina of the inner plexiform layer (IPL) with a varying number of branches from the remaining dendrites contained within the outer IPL, both strata presumably corresponding to the electrophysiologically determined on-off dichotomy. Cells projecting to the MTN were characterised by higher-order dendritic branching patterns that resulted in a dense dendritic tree with minor dendritic overlap. The slender dendrites had a beaded appearance and displayed spiny protrusions. The dendritic coverage of 5-6, stratification pattern, and overall morphological appearance of rat MTN-projecting cells renders them suitable candidates for on direction--selective cells shown electrophysiologically to be linked with the MTN of the accessory optic system. PMID- 3624548 TI - Organization of amygdaloid projections to the mediodorsal thalamus and prefrontal cortex: a fluorescence retrograde transport study in the rat. AB - Previous studies have shown that the amygdala projects to both the mediodorsal thalamic nucleus (MD) and its cortical projection area, the prefrontal cortex (PFC). In this investigation rats received injections of different fluorescent retrograde tracers (true blue and diamidino yellow) into MD and either the lateral, polar, or medial PFC in order to examine the relationship of amygdaloid neurons with cortical and/or thalamic projections. PFC injections labeled neurons in the basolateral (BL), basomedial (BM), ventral endopiriform (EnV), and rostral lateral nuclei as well as the periamygdaloid cortex (PAC) and the medial part of the amygdalohippocampal area (AHA). In BL, which contained the great majority of neurons projecting to PFC, most labeled cells were concentrated in particular parts of the nucleus and were topographically organized. The overwhelming majority of labeled neurons in BL were large pyramidal or piriform cells that correspond to class I neurons described in Golgi studies. Occasional small neurons with thin dendrites were also observed; these cells may be class II neurons. MD injections labeled numerous cells in the anterior division of the cortical nucleus, medial nucleus, and caudomedial part of the central nucleus. Moderate numbers of labeled cells were found in caudal portions of BM and PAC, whereas scattered cells were observed throughout the rest of the amygdala with the exception of the lateral nucleus. In BL and AHA many MD-projecting neurons were observed along nuclear boundaries and in the adjacent white matter. Neurons in BL, BM, and AHA usually had large elongated or irregular somata and two to four primary dendrites that branched sparingly. Other cells had smaller ovoid somata. The morphology and distribution of MD-projection cells in the basolateral amygdala indicate that they are primarily large class II neurons. Double-labeled amygdaloid neurons, labeled by both cortical and thalamic injections, were observed only in a small number of animals. Control experiments suggest that most of the double-labeled cells in these cases were artifacts caused by spread of the thalamic injectate into the third ventricle with subsequent uptake by fibers in the anterior commissure. Thus the findings of this study suggest that different neuronal populations in the amygdala project to the two poles of the MD-PFC system. In the basolateral amygdala class I neurons are the predominant cell type involved in PFC projections, whereas a subpopulation of class II neurons, hitherto thought to be primarily local-circuit neurons, project to MD. PMID- 3624549 TI - Distribution of acetylcholinesterase in the hippocampal region of the rabbit: II. Subiculum and hippocampus. AB - The distribution of acetylcholinesterase (AChE) has been examined in two areas of the hippocampal region of the adult rabbit, viz., the subiculum and the hippocampus. AChE was demonstrated histochemically by using a modification of the Koelle copper thiocholine method. Moderate amounts of AChE were observed in the subiculum, whereas the hippocampus had a high content of this enzyme. In each area, the AChE staining displayed a distinctly stratified pattern which has been compared in detail with the fields and layers defined on the basis of cyto- and fibro-architectonics. Most of the enzyme activity was confined to the neuropil, but a considerable number of nerve cell bodies were moderately or intensely stained in both the subiculum and the hippocampus. In the subiculum, the plexiform layer showed a complex distribution of AChE, displaying four horizontal, differently stained subzones. In the cell layer, the staining was most intense in two narrow bands, one being immediately beneath the plexiform layer and the other bordering directly on the white matter. The remaining major part of the subicular cell layer generally had a low AChE content. In regio superior of the hippocampus, intense staining was observed in the deep part of the molecular layer, in a narrow suprapyramidal zone of the stratum radiatum, and in the stratum oriens. In regio inferior, very high AChE activity was present in the molecular layer, in two narrow bands bordering the mossy fiber layer superficially and at depth, and in the stratum oriens. The pyramidal cell bodies and the mossy fibers were unstained. The distribution of AChE in the rabbit was compared with that in the rat and guinea pig; the latter two have been reported. The staining patterns of all three species share many conspicuous histochemical features, though notable species-specific traits do exist. Detailed consideration is given to possible structural correlates of the AChE observed in the two areas, in particular the relation to fiber systems known from either normal material or experimental investigations. A considerable portion of the enzyme is probably contained in afferents of septal origin, but it seems very likely that some of the AChE is associated with other fiber systems, the identity of which are unknown at present. A possible role of some of the AChE observed in the hippocampal region in the hydrolysis of substance P and enkephalin is discussed briefly. PMID- 3624550 TI - Trajectory of group Ia and Ib fibers from the hind-limb muscles at the L3 and L4 segments of the spinal cord of the cat. AB - Nineteen physiologically identified group Ia and five group Ib fibers at the L3 and L4 levels of the spinal cord originating from various hind-limb muscles were intraaxonally injected with horseradish peroxidase (HRP). The trajectories of the stained axons were reconstructed. They extended for distances of 8.6 mm-18.0 mm rostrocaudally. Ascending axons ran in various regions of the dorsal funiculus: The ascending axon from a toe muscle (3 microns in diameter) ran in the ventral most part of the paramedian region; those from shank muscles (3.0-5.0 microns) in both dorsal and ventral paramedian regions; those from thigh muscles (5.0-7.0 microns) in both the paramedian and the more lateral regions; and those from hip muscles (6.0-7.0 microns) in the lateral region. Main collaterals arising from the parent fiber were given off at intervals of 0.5-6.2 mm (mean 2.4 mm). Collaterals of a fiber from a toe muscle (1.0 micron in diameter) entered Clarke's column from the dorsomedial side and ramified mostly in the dorsomedial one-third of the column. Collaterals of fibers from shank muscles (1.0-2.0 microns) entered Clarke's column from the dorsal side and terminated in its middle parts as well as in laminae V-VII. Collaterals of fibers from thigh muscles (1.0-2.5 microns) passed lateral to or through the lateral part of Clarke's column and terminated in its ventrolateral part and in laminae V-VIII. Collaterals of fibers from hip muscles (1.5-2.5 microns) passed lateral to Clarke's column and ramified mostly in laminae VII-IX. As the muscle of origin became more proximal, the proportion of termination outside of Clarke's column progressively increased. Thus, the trajectory of group I fibers was somatotopically organized both in the dorsal funiculus and in the gray matter. The long axis of boutons ranged from 0.5 to 17 microns in Ia fibers and from 0.5 to 8 microns in Ib fibers. "Giant" Ia boutons (above 7 microns) were found both in and outside Clarke's column. PMID- 3624551 TI - Variation in the mode of receptor cell addition in the electrosensory system of gymnotiform fish. AB - Age-related changes in ampullary and tuberous receptor organ morphology were studied in six species of gymnotiform weakly electric fish. Cheek skin was silver stained, whole-mounted, and viewed under Nomarski differential interference contrast optics. The ampullary receptor units of all species show an increasing number of receptor organs per afferent fiber with fish size, presumably the result of addition of newly formed receptor organs. Ampullary units composing over a dozen organs were observed in large specimens of a few species. Receptor cells were also added in the tuberous receptor system of all species, but in different ways. As previously reported for Sternopygus, small specimens of Eigenmannia had only a single tuberous receptor organ per afferent. Fish of increasing size retained a population of afferents that innervated only a single receptor organ and, in addition, had a population of afferents that innervated a cluster of receptor organs. The mean number of receptor organs per cluster increased in fish of increasing size. In addition, the mean number of sensory receptor cells per organ increased. New organs presumably derive from older ones, which divide under the stimulus of continued addition of new receptor cells. Apteronotus, Adontosternarchus, and Hypopomus all added more receptor cells to their tuberous organs. In these species, every afferent innervated only a single tuberous organ and there was no indication of division of receptor organs. Gymnorhamphichthys and Gymnotus were intermediate in that they added new receptor cells to each receptor organ, and, in larger fish, these were segregated into discrete patches within a single receptor organ. It is likely that the addition of new receptor cells aids in increasing sensitivity of both ampullary and tuberous receptors as fish grow. PMID- 3624552 TI - Sources of projections to subdivisions of the inferior colliculus in the rat. AB - Brainstem and forebrain projections to major subdivisions of the rat inferior colliculus were studied by using retrograde and anterograde transport of horseradish peroxidase. Retrograde label from injection into the external cortex of the inferior colliculus appears bilaterally in cells of the inferior colliculus, as well as in other brainstem auditory groups including the ipsilateral dorsal nucleus of the lateral lemniscus and contralateral dorsal cochlear nucleus. The external cortex is the only collicular subdivision where an injection labels cells in the contralateral cuneate nucleus, gracile nucleus, and spinal trigeminal nucleus. Other projecting cells to the external cortex are found in the lateral nucleus of substantia nigra, the parabrachial region, the deep superior colliculus, the midbrain central gray, the periventricular nucleus, and area 39 of auditory cortex. Injection of the dorsal cortex of inferior colliculus heavily labels pyramidal cells of areas 41, 20, and 36 of the ipsilateral neocortex. Anterograde label from a large injection of auditory cortex is densely distributed in the dorsal cortex, lesser so in the external cortex, and only slightly in the central nucleus. Labelled cells appear in the central nucleus, dorsal cortex, and external cortex, primarily ipsilaterally, following dorsal cortex injection. Relatively few cells from other brainstem auditory groups show projections to the dorsal cortex. Injection of the central nucleus of the inferior colliculus results in robust labelling of nuclei of the ascending auditory pathway including the anteroventral, posteroventral, and dorsal cochlear nuclei (mainly contralaterally), and bilaterally the lateral superior olive, lateral nucleus of the trapezoid body, dorsal nucleus of the lateral lemniscus, and the central nucleus, dorsal cortex, and external cortex of the colliculus. The medial superior olive, superior paraolivary nucleus, and ventral nucleus of the trapezoid body essentially show ipsilateral projections to the central nucleus. The differential distribution of afferents to the inferior colliculus provides a substrate for functional parcellation of collicular subdivisions. PMID- 3624553 TI - Defects of the fetal forebrain in mice with hereditary agenesis of the corpus callosum. AB - Inbred BALB/c mice are genetically the same, yet less than half of adults show absent or small corpus callosum. Is this because only a minority has prenatal defects of the sling at the telencephalic midline, or do most fetuses have a defective sling but some are able to form a corpus callosum via some other substrate pathway? This question was addressed by comparing large samples of BALB/c fetuses at 17, 18, and 19 days after conception with a series of normal C57BL/6 and hybrid fetuses matched for body size. At 17 days postconception almost all BALB/c fetuses show an unusual widening or bulge in the interhemispheric fissure anterior to the hippocampal commissure. Furthermore, formation of the hippocampal commissure is greatly retarded, although it eventually attains a normal size in adult mice. At 17 days, when mice of normal strains all have a corpus callosum at midplane, almost every BALB/c fetus lacks the structure, but 1 day later 67% of fetuses show delayed formation of this structure and by 19 days all but 7% of fetuses have some callosal axons crossing the midsagittal plane. Many BALB/c fetuses are able to form a corpus callosum without the benefit of a normal sling. The degree of delay of axon crossing is strongly correlated with the severity of sling defects. An unusually small adult corpus callosum occurs because fetal axons are able to follow unusual pathways and actively compensate for absence of the sling, not because of arrested midline development. PMID- 3624554 TI - Cingulate cortex of the rhesus monkey: I. Cytoarchitecture and thalamic afferents. AB - The cytoarchitecture and thalamic afferents of cingulate cortex were evaluated in the rhesus monkey (Macaca mulatta). Area 24 has three divisions of which area 24a is adjacent to the callosal sulcus and has the least laminar differentiation. Area 24b has more clearly defined layers II, III, and Va, and area 24c, which forms the lower bank of the anterior cingulate sulcus, has a particularly dense layer III. Area 23 also has three divisions, each of which has a distinct layer IV. Area 23a is adjacent to the callosal sulcus and has the thinnest layers II IV, which have the same cell density as layers V and VI. Area 23b has the largest pyramids in layers IIIc and Va, and area 23c, in the depths of the posterior cingulate sulcus, has the broadest external and thinnest internal pyramidal layers. Finally, areas 29 and 30 are located in the posterior depths of the callosal sulcus. Two divisions of area 29 are apparent: one with a granular layer directly adjacent to layer I (area 29a-c) and another with differentiation of layers III and IV (area 29d). Area 30 has a dysgranular layer IV. Injections of the retrograde tracer horseradish peroxidase (HRP) were made into subdivisions of cingulate cortex in the monkey. Area 25 received thalamic input mainly from the midline parataenial (Pt), central densocellular (Cdc), and reuniens nuclei as well as from the dorsal parvicellular division of the mediodorsal nucleus (MDpc). A less dense projection also originated in the intralaminar parafascicular (Pf), central superior, and limitans (Li) nuclei as well as the medial division of the anterior nuclei (AM). Areas 24a and 24b received most thalamic afferents from fusiform and multipolar cells in the Cdc and Pf nuclei with fewer from the ventral anterior (VA) and MDpc and MD densocellular (MDdc) nuclei and only minor input from AM. Most input to premotor cingulate area 24c appeared to originate in VA, MDdc, and Li. Area 29 received the most dense input from nuclei traditionally associated with limbic cortex including the anteroventral (AV), anterodorsal (AD), and laterodorsal (LD) nuclei. Areas 23a and 23b, in contrast, did not receive AV, AD, or LD input, but the greatest proportion of their thalamic afferents arose in AM. Less-pronounced input also came from the lateroposterior (LP), medial pulvinar, and MDdc nuclei.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3624555 TI - Cingulate cortex of the rhesus monkey: II. Cortical afferents. AB - Cortical projections to subdivisions of the cingulate cortex in the rhesus monkey were analyzed with horseradish peroxidase and tritiated amino acid tracers. These projections were evaluated in terms of an expanded cytoarchitectural scheme in which areas 24 and 23 were divided into three ventrodorsal parts, i.e., areas 24a c and 23a-c. Most cortical input to area 25 originated in the frontal lobe in lateral areas 46 and 9 and orbitofrontal areas 11 and 14. Area 25 also received afferents from cingulate areas 24b, 24c, and 23b, from rostral auditory association areas TS2 and TS3, from the subiculum and CA1 sector of the hippocampus, and from the lateral and accessory basal nuclei of the amygdala (LB and AB, respectively). Areas 24a and 24b received afferents from areas 25 and 23b of cingulate cortex, but most were from frontal and temporal cortices. These included the following areas: frontal areas 9, 11, 12, 13, and 46; temporal polar area TG as well as LB and AB; superior temporal sulcus area TPO; agranular insular cortex; posterior parahippocampal cortex including areas TF, TL, and TH and the subiculum. Autoradiographic cases indicated that area 24c received input from the insula, parietal areas PG and PGm, area TG of the temporal pole, and frontal areas 12 and 46. Additionally, caudal area 24 was the recipient of area PG input but not amygdalar afferents. It was also the primary site of areas TF, TL, and TH projections. The following projections were observed both to and within posterior cingulate cortex. Area 29a-c received inputs from area 46 of the frontal lobe and the subiculum and in turn it projected to area 30. Area 30 had afferents from the posterior parietal cortex (area Opt) and temporal area TF. Areas 23a and 23b received inputs mainly from frontal areas 46, 9, 11, and 14, parietal areas Opt and PGm, area TPO of superior temporal cortex, and areas TH, TL, and TF. Anterior cingulate areas 24a and 24b and posterior areas 29d and 30 projected to area 23. Finally, a rostromedial part of visual association area 19 also projected to area 23. The origin and termination of these connections were expressed in a number of different laminar patterns. Most corticocortical connections arose in layer III and to a lesser extent layer V, while others, e.g., those from the cortex of the superior temporal sulcus, had an equal density of cells in both layers III and V.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3624556 TI - Development of the rhesus monkey retina: II. A three-dimensional analysis of the sequences of synaptic combinations in the inner plexiform layer. AB - The inner plexiform layer (IPL) of the retina provides a useful model for ultrastructural analysis of synaptic development. In primates, the IPL consists of numerous combinations of neuronal contacts that assume the morphological configuration of either conventional or ribbon synapses. We have determined the sequential development of these combinations by analyzing serial electron microscopic sections from fetal rhesus monkeys. Our analysis reveals an orderly emergence of various pre- and postsynaptic elements: (1) patches of dense filamentous membrane first appear on the dendrites of ganglion (G) cells; (2) membrane densities on ganglion cell dendrites then become apposed to amacrine (A) cell processes still lacking their own membrane densities and synaptic vesicles; (3) amacrine cell processes acquire membrane specializations associated with vesicles at the sites apposing ganglion cell dendrites, thereby establishing the first morphologically complete, A----G subtype of conventional synapse; (4) pairs of amacrine cell processes form A----A subtypes of conventional synapses; (5) next, monad ribbon synapses are established between bipolar (B) and ganglion or amacrine cell processes (B----G; B----A); (6) the three subclasses of dyad ribbon synapses (B----GG; B----GA; B----AA) are subsequently formed by the introduction of additional amacrine or ganglion cell processes in the dyad synapse; (7) concurrently, processes of some amacrine and interplexiform (I) cells form a feedback circuit with bipolar cell axons (A----B; I----B), thereby completing the synaptic microcircuitry of the IPL. Present findings provide evidence that the sequence of synaptic differentiation in the IPL proceeds from the postsynaptic to the presynaptic site. Furthermore, lateral interactions (A----G and A----A) are established prior to the formation of the "straight signal" pathway from photoreceptors (P) via bipolar cells to ganglion cells (P----B----G). Observed developmental events provide new insight into the order of establishment of local neuronal circuits in the primate retina. PMID- 3624557 TI - Inflammation of actinic keratoses from systemic chemotherapy. AB - Seven patients receiving systemic chemotherapy for solid tumors developed an erythematous papulosquamous eruption resembling a drug eruption in sun-exposed areas. Careful examination revealed that the lesions were actually inflamed actinic keratoses. Biopsies of typical lesions in three of the patients confirmed this clinical impression. While one patient was receiving systemic 5-fluorouracil alone, and three were receiving 5-fluorouracil and cisplatin, three others developed inflammatory flares of actinic keratoses while receiving other chemotherapeutic drugs. One patient received doxorubicin and vincristine, one received doxorubicin alone, and one received the combination of dactinomycin, vincristine, and decarbazine. Since this phenomenon appears to be due to the effect of chemotherapy on the atypical keratinocytes present in actinic keratoses, discontinuation of the chemotherapy is not indicated in this situation. PMID- 3624558 TI - Polydactylous Bowen's disease of the nail. AB - We present three patients with Bowen's disease of the fingernail folds and beds in which there was polydactylous involvement and add those to five similarly afflicted patients described by other authors. Bowen's disease of the nail is a distinctive type of squamous cell carcinoma that differs from other variants. It is potentially an autochthonous process that can involve more than one nail with the passage of time. Seven-eighths of the patients described in this series were men. A majority had involvement of both hands. No metastases were seen. PMID- 3624559 TI - Painful piezogenic pedal papules in patients with Ehlers-Danlos syndrome. AB - Painful piezogenic pedal papules were observed in 10 of 29 patients with Ehlers Danlos syndrome. The diagnosis was made by examining each patient while he or she stood with full body weight on the heels and by observing the appearance of the painful papules on the medial, posterior, and lateral aspects of both heels. Biopsy specimens of papules demonstrated a thickened and dense dermis. The subcutaneous fibrous trabeculae were thin, with resultant poor compartmentalization of the fat. Painful piezogenic pedal papules are due to herniation of subcutaneous fat into the dermis, which is possibly due to structural defects of the connective tissue. The high prevalence of painful piezogenic pedal papules in our group of patients (34.5%) makes its direct association with the Ehlers-Danlos syndrome highly feasible, most probably because of the connective tissue defect that occurs in patients with Ehlers Danlos syndrome. PMID- 3624560 TI - Indoor and outdoor efficacy testing of a broad-spectrum sunscreen against ultraviolet A radiation in psoralen-sensitized subjects. AB - The efficacy of a sunscreen containing an investigational drug, butyl methoxydibenzoylmethane in combination with padimate O against the erythemogenic effect of ultraviolet A (UVA) radiation was evaluated in two double-blind studies involving subjects sensitized with topical 8-methoxypsoralen. UVA radiation was supplied from either a filtered solar simulator (indoors) or filtered sunlight (outdoors). Five formulations were tested: 3% butyl methoxydibenzoylmethane and 7% padimate O, 7% padimate O, 5% octyl salicylate, and 3% oxybenzone, 3% butyl methoxydibenzoylmethane alone, 7% padimate O alone, and vehicle. Sunscreen protection against the erythemogenic effect of UVA radiation was expressed as phototoxic protection factors. The phototoxic protection factor for each sunscreen was derived from a ratio of the minimal phototoxic dose of UVA radiation that produced delayed erythema on sunscreen-protected and unprotected skin. The combination of 3% butyl methoxydibenzoylmethane and 7% padimate O provided significantly greater protection than the other sunscreen formulations, and for each sunscreen the phototoxic protection factors determined indoors and outdoors were comparable. PMID- 3624561 TI - Audiologic abnormalities in cases of vitiligo. AB - The audiologic function in 50 patients affected by vitiligo was studied. Eight patients (16%) had sensorineural hypoacusis when first seen by us. The relationships between melanocytes of the inner ear and auditory function are discussed. PMID- 3624562 TI - Nonmelanoma skin cancer in Japanese residents of Kauai, Hawaii. AB - A prospective 3-year survey of nonmelanoma skin cancer in Japanese-American residents of the Hawaiian island of Kauai was conducted beginning in January 1983. The crude rate for basal cell and squamous cell carcinoma was 123/100,000, 88 times higher than the corresponding figure from Japan. This discrepancy may be attributed to an increase in ultraviolet exposure due to lifestyle and latitude, but arsenic exposure may also have played a role. Nonmelanoma skin cancer in Japanese in Hawaii appears to be a significant problem that has not been appreciated because these malignancies are not reportable to tumor registries. PMID- 3624563 TI - Primary care physicians' errors in handling cutaneous disorders. A prospective survey. AB - This study analyzes the errors made by primary care physicians in handling skin disorders in patients seen prospectively over a 20-month period in a dermatologic practice. There were 319 errors in 260 patients. Eighty-eight percent of the errors were in diagnosis. There was a striking tendency to overdiagnose infectious dermatoses such as bacterial pyodermas, superficial mycoses, scabies, and herpes simplex and to underdiagnose inflammatory dermatoses such as contact dermatitis, nummular dermatitis, pityriasis rosea, and psoriasis. In 218 cases (68%) the error probably could have been prevented if the following diagnostic criteria were considered mandatory: positive culture or potassium hydroxide preparation for dermatophytosis or candidiasis, positive Tzanck smear or viral culture for herpes simplex, zoster, or varicella, and demonstration of ectoparasite for scabies. These findings have implications for the medical education of primary care physicians and for the practitioner who handles cutaneous disorders. PMID- 3624565 TI - Recurrent melanocytic nevi: clinical and histologic review of 175 cases. AB - Pigmented nevi, if excised incompletely, often recur and occasionally cause concern to the patient and the physician. In this study of 175 recurrent nevi from 173 patients, the clinical, gross, and microscopic features of recurrent nevi are described and criteria for diagnosis are developed. Rarely, recurrent nevi have atypical features that suggest malignant melanoma. The differential diagnosis entails clinical and histologic criteria that are presented. PMID- 3624564 TI - Pilomatrix carcinoma. AB - A pilomatrix carcinoma presented as a large ulcerated mass in the left axilla. Histologically, irregular nests of basaloid matrix cells with cystic centers containing necrotic debris and "shadow cells" were seen. The tumor invaded adjacent structures and was characterized by areas of cellular pleomorphism, crowding of cells, and numerous mitotic figures. An occasional atypical mitosis was noted. A review of 16 cases reported in the world literature is included, with emphasis on epidemiology and treatment. PMID- 3624566 TI - Facial involvement in pruritic urticarial papules and plaques of pregnancy. PMID- 3624567 TI - Study on the influence of etretinate on biologic activity of oral contraceptives. PMID- 3624568 TI - Toxic epidermal necrolysis due to rifampicin. PMID- 3624569 TI - An unusual presentation of tinea versicolor in an immunosuppressed patient. PMID- 3624570 TI - Steroid therapy of postcryotherapy inflammation. PMID- 3624571 TI - Factitial dermatitis resulting in paraplegia. PMID- 3624572 TI - Effect of minoxidil on chemotaxis of neutrophils. PMID- 3624573 TI - Electrosurgery electrode safety. PMID- 3624574 TI - Pentoxifylline for necrobiosis lipoidica diabeticorum. PMID- 3624575 TI - Use of gloves among dermatologists. AB - Despite evidence that rubber or latex surgeon's gloves appear to prevent or reduce the transmission of hepatitis B virus, physicians continue to perform surgical procedures without wearing gloves. Surveys regarding glove usage among members of the American Academy of Dermatology revealed that a majority of those responding do not regularly wear gloves while performing basic dermatologic procedures, such as shave and punch biopsies and curettage and desiccation. Others are still not wearing gloves regularly while performing excisional surgery, hair transplants, and dermabrasion procedures. PMID- 3624576 TI - Rothmund-Thomson syndrome. A case report, phototesting, and literature review. AB - Rothmund-Thomson syndrome is a rare hereditary syndrome with developmental defects. Characteristics of this syndrome, based on a review of 107 reported cases in the literature, are (in descending order) as follows: early onset of poikiloderma, short stature, absence or sparseness of eyebrow and/or eyelash hair, familial juvenile cataracts, small hands and bone defects, sunlight sensitivity, hypogonadism, defective dentition, nail abnormality, hyperkeratosis, and mental retardation. Recently we encountered a 25-year-old white woman who had developed this syndrome but without juvenile cataracts, hypogonadism, or mental retardation. She had developed a basal cell epithelioma, which has not previously been described in this syndrome. Phototesting with monochromatic radiation and with a solar simulator showed photosensitivity in the ultraviolet A range but not in the ultraviolet B range. This case may represent an example of the Thomson type. The case is described and the literature reviewed. PMID- 3624577 TI - Multiple hamartoma syndrome. AB - Multiple hamartoma syndrome, also known as Cowden's disease, is a rare genodermatosis with multiple organ system involvement affecting tissues derived from ectodermal, endodermal, and mesodermal tissue layers. We describe two previously unreported cases of multiple hamartoma syndrome in a father and daughter. Both show classic features of multiple hamartoma syndrome, as well as other mucocutaneous findings. The father has been shown to have substantial cutaneous deposits of amyloid in the absence of underlying plasma cell dyscrasia or malignancy. Both individuals have undergone excision of a unique fibroma that has features that have been reported only in multiple hamartoma syndrome and should be added to the criteria used to define the entity. PMID- 3624578 TI - Cutaneous squamous cell carcinoma and hypercalcemia. AB - An elderly man was admitted to the hospital with a large squamous cell carcinoma involving the right side of the chest wall. The patient was severely confused, and evaluation revealed pronounced hypercalcemia. With total surgical removal of the tumor, the serum calcium level fell to normal and his confusion cleared. Although hypercalcemia has been reported in association with a number of malignant tumors, including metastatic squamous cell carcinoma, this finding has been encountered only rarely with squamous cell carcinoma localized to the skin. The secretion of transforming growth factor or of another humoral substance has been postulated as the possible cause of hypercalcemia in this patient. PMID- 3624579 TI - Low-dose methotrexate therapy for cutaneous vasculitis of rheumatoid arthritis. AB - A patient with classic rheumatoid arthritis who developed leukocytoclastic vasculitis is described. Low-dose methotrexate produced prompt healing of the skin lesions. After discontinuation of methotrexate, the lesions recurred, with resolution after a second course of the drug. Methotrexate may be useful in the treatment of cutaneous vasculitis associated with rheumatoid arthritis. PMID- 3624580 TI - Localized pili canaliculi and trianguli. AB - A 3-year-old boy presented two patches of light, bright, smooth, uncombable hair that were morphologically different from the rest of the hairs. Examination under scanning electron microscopy showed the morphologic characteristics of pili canaliculi and trianguli. Clinical and ultrastructural features seemed to correspond with a previously undescribed localized form of pili canaliculi et trianguli. Differential diagnosis is discussed. PMID- 3624581 TI - Comparison of the binding properties of A1 adenosine receptors in brain membranes of two congeneric marine fishes living at different depths. AB - The binding properties of A1 adenosine receptors in brain membranes were compared in two congeneric marine teleost fishes which differ in their depths of distribution. Adenosine receptors were labeled using the A1 selective radioligand [3H]cyclohexyladenosine ([3H]CHA). The A1 receptor agonist [3H]CHA bound saturably, reversibly and with high affinity to brain membranes prepared from Sebastolobus altivelis and S. alascanus; however, the mean Kd values differed significantly (Figs. 1-3, Table 1). Saturation data fit to a one site model indicated that the A1 receptor in S. alascanus exhibited a higher affinity (Kd = 1.49 nM) for [3H]CHA whereas A1 receptors in S. altivelis exhibited a significantly lower affinity (Kd = 3.1 nM). Moreover, S. altivelis, but not S. alascanus, parameter estimates for [3H]CHA binding to two sites of receptor were obtained (Fig. 3, Table 1). The mean dissociation constant values for the high and low affinity sites for [3H]CHA in S. altivelis were 0.43 nM and 16.3 nM, respectively. In equilibrium competition experiments the adenosine analogs R phenylisopropyladenosine (R-PIA), N-ethylcarboxamidoadenosine (NECA) and S phenylisopropyladenosine (S-PIA) all displayed higher affinities for A1 receptors in S. alascanus as compared to S. altivelis brain membranes (Table 2, Fig. 6). The specific binding of [3H]CHA was significantly increased by 0.1 and 1.0 mM MgCl2 in both fishes; however, the sensitivity (95-131% increase) of S. altivelis to this effect was significantly greater than that of S. alascanus (48-91% increase) (Fig. 5). The results of kinetic, equilibrium saturation and equilibrium competition experiments all suggest that A1 adenosine receptors of S. altivelis and S. alascanus brain membranes differ with respect to their affinities for selected adenosine agonists. PMID- 3624582 TI - Prothoracicotropic hormone activity in the embryonic brain of the tobacco hornworm, Manduca sexta. AB - Head segments and brains were extirpated from embryos of the tobacco hornworm, Manduca sexta, extracted and the resulting extracts assayed for prothoracicotropic hormone (PTTH) activity on prothoracic glands from day 3 fifth instar larvae and day 0 pupae. Dose-response curves were generated and indicated the presence of PTTH activity in embryonic brains and head segments, suggesting a role(s) for this neurohormone during embryogenesis. Maximal PTTH activity was found in brains from embryos 117 h post-oviposition, just prior to hatching, but activity was also noted in head segments as early as 24 h post-oviposition. These data on PTTH and those on ecdysteroids and juvenile hormones in embryos suggest that these 3 classes of hormones which control insect post-embryonic development, may also be involved in the regulation of developmental processes in the embryo. PMID- 3624583 TI - Transferrin-receptor interaction and iron uptake by reticulocytes of vertebrate animals--a comparative study. AB - Transferrin-receptor interactions and iron uptake were studied in eleven different species of vertebrate animals (3 eutherian mammals, 3 marsupials, 2 reptiles and 1 bird, amphibian and bony fish). In the initial experiments it was shown that the uptake of transferrin-bound iron by immature erythroid cells from marsupial and reptilian species occurs by receptor-mediated endocytosis as in other vertebrate animals. Reticulocytes were incubated with 125I-59Fe-labelled transferrins from heterologous species and the results for iron and transferrin uptake compared with those obtained with the homologous protein. Cells from eutherian mammals were able to take up transferrin and iron from other eutherians and from the bob-tailed lizard but not from marsupials and other submammalian species. With marsupials and reptiles a similar specificity was observed, and the marsupial cells could also utilize chicken transferrin but not vice versa. The results were extended by performing competition experiments in which the cells were incubated with radiolabelled homologous transferrin in the presence of increasing concentrations of non-radioactive heterologous transferrins. From the ability of the heterologous proteins to inhibit uptake of the homologous protein relative association constants (Ka1) for the transferrin-receptor interactions could be calculated. These Ka1 values reflected the patterns observed in the first series of experiments. These studies demonstrate that, although specificity exists in transferrin-receptor interactions throughout the range of vertebrate animals, in several instances reactivity between widely divergent species is also observed. Hence, structural similarities have been maintained throughout evolution. Nevertheless, no evidence of interaction between transferrin and its receptor from the two divisions of the Mammalia, the eutherians and the marsupials, was observed. PMID- 3624584 TI - Lamellar bodies in hyperkeratosis lenticularis perstans. AB - An ultrastructural study of lesional skin from 4 subjects with hyperkeratosis lenticularis perstans (Flegel's disease) demonstrated variable numbers of lamellar bodies of normal size and architecture within cells of the stratum granulosum and the upper stratum spinosum. Their characteristic lamellate inclusions were frequently observed within the intercellular spaces. These observations suggest that the lamellar bodies are qualitatively normal in Flegel's disease. PMID- 3624585 TI - Diabetic microangiopathy in subcutaneous fatty tissue. AB - To evaluate diabetic microangiopathy in the subcutaneous fatty tissue objectively and to clarify the relation between pathogenesis of membranocystic lesion (MCL) and diabetic microangiopathy, specimens obtained from 23 diabetics and 23 nondiabetics were examined histologically. Ten of 23 diabetics and 7 of 23 non diabetics were examined electron microscopically. Using electron micrographs measurements were made of the following areas; entire microvessel section, basal laminae, luminal space, endothelial cells, pericytes, and we scored the following findings: veil cells, cellular debris and vacuoles in the thickened basal laminae, abnormal densities of the endothelial cells. In diabetics, the area of luminal space was smaller and the area of basal laminae was larger than those of non-diabetics. Scored assessment of the veil cells, cellular debris and vacuoles in the thickened basal laminae were statistically significant in diabetics. Veil cells around the subcutaneous microvessels were less frequent and possessed fewer cytoplasmic processes than those around the dermal microvessels. Histologically, MCLs were frequently demonstrated in skin disorders resulting from diabetic microangiopathy, including 3 cases of pigmented pretibial patches, and 1 case of diabetic bulla. MCLs were more frequently demonstrated in diabetic cases with retinopathy, neuropathy, and nephropathy than those without complications. MCLs were detected only on the shins and the feet. MCLs were more frequently seen in cases with larger area of basal laminae than those with smaller area of basal laminae in morphometric measurement of electron micrographs. The present studies suggest that microangiopathy in the subcutaneous tissue is a pathological feature of diabetes mellitus and is a contributory factor to the formation of MCL. PMID- 3624586 TI - Basal cell epithelioma with giant tumor cells: light and electron microscopic study. AB - A case of basal cell epithelioma (BCE) with multiple large nuclei on the right buttock of a 69-year-old woman is reported, and the skin was studied by light and electron microscopy. This represented the only case (0.85%) of giant tumor cells with multiple nuclei among 117 patients with BCE. Ultrastructural studies revealed that giant tumor cells were not different from ordinary tumor cells of BCE, except for large convoluted nuclei. In the cytoplasms of giant tumor cells, we observed autophagic vacuoles which were derived from autophagocytosis. Scattered among the giant tumor cells, there were many degenerate tumor cells, some of which were phagocytized by giant tumor cells with multiple nuclei (referred to as macrophagocytosis). It is indicated that tumor cells have considerable phagocytic activities, and degrade the autophagic vacuoles or the degenerate tumor cells with the lysosomes. These findings suggest that the presence of the giant tumor cells with multiple nuclei does not indicate a increased malignant potential or anaplasia of the tumor, and that autophagocytosis or macrophagocytosis is a factor in initiating giant tumor cell formation. PMID- 3624588 TI - Desmoplastic cartilaginous formation in malignant melanoma. PMID- 3624587 TI - Incontinentia pigmenti: pigmentary changes independent of incontinence. AB - Incontinentia pigmenti is characterized by swirled hyperpigmentation associated with incontinence of pigment. A different pattern may be seen on the legs with light-colored atrophic scarred areas admixed with patches of normal but darker skin. Histologic examination confirms that the darker skin is normal without incontinence of pigment, while the light-colored skin lacks melanocytes and appendages but has dermal fibrosis. PMID- 3624589 TI - Transport of the radioisotopes iodine-131, cesium-134, and cesium-137 from the fallout following the accident at the Chernobyl nuclear reactor into cheesemaking products. AB - The transport of radiation contamination from milk to products of the cheese making process has been studied. The concentration of radioactive iodine and cesium in samples of sheep milk and cheese (Gruyere) products was measured for 10 consecutive production d. Milk with concentration 100 Bq/L in each of the radionuclides 131I, 134Cs, and 137Cs cheese with concentration 82.2 +/- 3.9 Bq/kg in iodine and an average of 42.3 +/- 2.3 Bq/kg in the cesium isotopes is produced. The corresponding concentrations in cream extracted from the same milk are 26.7 +/- 2.8 Bq/kg (131I) and 18.6 +/- 1.9 Bq/kg (134Cs, 137Cs). PMID- 3624590 TI - Effect of exogenous long-chain fatty acids on lipid biosynthesis in dispersed ruminant mammary gland epithelial cells: esterification of long-chain exogenous fatty acids. AB - Dispersed epithelial cells from lactating bovine and goat mammary glands incorporated acetate into all fatty acids (C4 to C16) that were incorporated into mainly triacylglycerols. The cells secreted free fatty acids only into the incubation medium, and this secretion was dependent on the concentration of albumin and the type and amount of exogenous fatty acid added to the medium. Addition of palmitic acid to the incubation medium stimulated synthesis and incorporation of fatty acids synthesized de novo into triacylglycerols, whereas stearic and linoleic acid were inhibitory. PMID- 3624591 TI - Effect of exogenous long-chain fatty acids on individual fatty acid synthesis by dispersed ruminant mammary gland cells. AB - We investigated the effect of exogenously added fatty acids on de novo synthesis of individual fatty acids and their incorporation into triacylglycerols by dispersed lactating ruminant mammary gland epithelial cells. Palmitate addition strongly stimulated synthesis and incorporation of butyrate and, to a smaller extent, palmitate synthesis and incorporation. Oleic acid strongly inhibited synthesis of all fatty acids except butyrate, whereas the effect of lauric acid was nearly neutral. Free fatty acid depletion of the mammary gland cells potentiated the effect of palmitate and made oleate less inhibitory. PMID- 3624592 TI - Regulation of bovine adipose tissue metabolism during lactation. 3. Adaptations of hormone-sensitive and lipoprotein lipases. AB - Activity of lipases in adipose tissue during pregnancy and lactation was investigated in Holstein cows producing 5950 to 10,000 kg milk per 305 d. Activity of cytoplasmic lipoprotein lipase per gram of tissue was 97, 78, 140, 162, 179, and 235% of 30 d prepartum at -15, 15, 30, 60, 180, and 349 d about calving in yr 1. In yr 2, lipoprotein lipase per gram was 100, 259, 838, 791, and 430% of -30 d at -15, 30, 60, 120, and 180 d. Adaptations in activity per milligram cytoplasm protein were similar to those per gram tissue. Hormone sensitive lipase per milligram protein was 161, 251, 114, 126, and 252% of -30 d when measured at 30, 60, 120, 180, and 240 d postpartum. Activity per gram of tissue responded similarly to the lactation state. Lipoprotein lipase is thus not a large contributor to the peripartum bovine adipose adaptation but is important in reattainment of body composition in mid and late lactation. Hormone-sensitive lipase is also increased during peak and midlactation. The pattern of elevated activity of these oppositely directed lipases reflects the dichotomous forces of milk fat production and body fat recovery acting on adipose tissue of lactating heifers. PMID- 3624593 TI - Effect of inoculum preparation and dietary energy on microbial numbers and rumen protein degradation activity. AB - Chilling of whole rumen contents prior to preparation of strained rumen fluid enriched with particle-associated microorganisms resulted in rumen inoculum with the highest microbial dry weight, total bacterial counts, and degradation rates for casein and soybean meal. Strained rumen fluid, whole rumen contents blended with strained rumen fluid, chilled strained rumen fluid, and strained rumen fluid plus particle-associated microorganisms were lower in bacterial counts and microbial dry weight. Except for strained rumen fluid plus particle-associated microorganisms, protein degradation rates were also lower. Three ruminally cannulated cows were used in a 3 X 3 Latin square experiment to determine the effect of diet on rumen microbial numbers and protein degradation rates. Cows were fed the following diets ad libitum: 1) 100% alfalfa hay (20.7% crude protein); 2) 63% alfalfa hay and 37% corn-soybean meal concentrate (18.2% crude protein); and 3) 37% alfalfa hay and 63% corn-soybean meal concentrate (15.1% crude protein). Diet 3 yielded rumen contents with the highest concentration of microbial dry weight, total and viable bacterial counts, total protozoal counts, and fractional degradation rates for casein and bovine serum albumin. However, degradation rate per unit microbial dry matter was not altered by diet. PMID- 3624594 TI - Implication of forage particle length on chewing activities and milk production in dairy goats. AB - Twenty-four primiparous Alpine does fed a high concentrate ration were utilized to study the effect of forage particle length on chewing activity, ruminal components, and milk composition. Treatments were Bermudagrass hay with mean particle length of 2.38 and 3.87 mm. Forage particle length was determined with an oscillating screen particle separator. Feeding forage with 3.87-mm mean particle length to lactating dairy goats resulted in higher total chewing and rumination times, slightly higher milk fat content, and fat-corrected milk production. Results from this experiment support the hypothesis that forage particle length affects chewing activities and production of milk fat precursors in the rumen and alters milk fat content and output of fat-corrected milk. Forage particle length appeared to be an important index for forage quality and a quantitative approach could be feasible to establish a system relating forage particle length to milk production in dairy goats. PMID- 3624595 TI - Effect of environmental temperature and dietary fat on growth and physiological responses of newborn calves. AB - Effects of cold environmental temperature and supplemental dietary fat (energy) on growth rate and physiological responses of young dairy calves fed a milk replacer diet were studied. Thirty-six Holstein bull calves were randomly assigned to one of six treatments allotted in a 2(-4 degrees C or 10 degrees C) X 3(10, 17.5, or 25% dietary fat) factorial arrangement of treatments Calves began the experiment at an average of 6 d of age and received .6 kg dry milk replacer in 4 L of water daily for 3 wk. Average daily gains (kg/d) over the 3-wk trial for calves fed 10, 17.5, and 25% fat diets were-.04, .02, and .09 at -4 degrees C and .15, .22, and .20 at 10 degrees C. Gains were significantly lower for calves housed at -4 degrees C. Rectal temperatures were lower for calves at -4 degrees C than at 10 degrees C and for calves fed 10% versus 25% fat diet. Respiratory rates and water intakes were lower for calves housed at -4 degrees C but were not affected by diet. Concentrations of plasma glucose and prolactin were lower for calves housed at -4 degrees C while concentrations of plasma free fatty acids and growth hormone were not affected by temperature. Plasma free fatty acids were increased by dietary fat, and plasma growth hormone was reduced as dietary fat increased. Calves housed at -4 degrees C had higher maintenance energy requirements (.133 Mcal metabolizable energy/kg.75) than calves housed at 10 degrees C (.101 Mcal metabolizable energy/kg.75).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624596 TI - Genetic parameters for first lactation milk yields at three levels of herd production. AB - A multivariate linear model was used to estimate sire variance and covariance components and residual variance components for first lactation milk yield and logarithms of yield at three herd production levels using Restricted Maximum Likelihood with the Expectation-Maximization algorithm. Data for four separate analyses were 305-d, mature equivalent first lactation milk records from cows sired artificially in the northeastern United States that freshened in 1970, 1971, 1976, and 1984. Respective numbers of records for each year were 42,618, 40,207, 33,581, and 34,196. Corresponding numbers of sires were 298, 289, 305, and 313. Herd production level was defined by mean yield of all cows freshening in same herd-year-season. For untransformed records sire and residual components of variance increased as mean increased, both within and between years. Correlations between sire effects at different production levels were all above .85. Heritabilities increased as production level increased. These results indicate that it may be necessary to account for heterogeneous genetic and environmental variance in sire evaluations. For logarithms of yield, sire components of variance were similar for each of the three production levels within a year. Residual components for logarithms decreased as production level increased. Change in variance from one production level to another was considerably more for logarithms than for untransformed yields. PMID- 3624597 TI - Impact of selection on components of variance and heritabilities of Canadian Holstein conformation traits. AB - Sire and error variance components and heritabilities were estimated for 26 conformation traits using linear type classifications of 175,693 daughters of 6681 Holstein sires in 21,869 herd-round-classifier subclasses. Estimates from first classifications during first lactations were contrasted with estimates from the same 175,693 females' most recent classification, which included reclassifications. Only cows that have their final classification raised a full category receive an official reclassification record; thus, heritability estimates from data that include these reclassification records may be biased. A total of 9420 (5.4%) of the first lactation, first classifications were replaced by reclassifications for the second analysis, which is current practice for official sire evaluations for Holsteins in Canada. Records, expressed as Snell's scores, were preadjusted for age within parity and stage of lactation at classification. Sire and error components of variance were estimated by Henderson's new method. When reclassifications replaced first classifications in the analysis, estimates of sire and error variances increased 7.2 and 11.1% respectively, as compared with the first lactation, first classification estimates. Heritabilities ranged from .07 for rear heel to .38 for stature and decreased by an average of 2.5% when first lactation, first classifications were replaced by reclassifications. Results indicate that the inclusion of reclassifications tends to bias heritabilities downward. PMID- 3624598 TI - Effects of extender and insemination dose on postthaw quality and fertility of bovine sperm. AB - Quality and fertility of sperm extended in egg yolk-Tes-Tris were compared with those of sperm in egg yolk-citrate and homogenized milk extenders. Extended semen was frozen in .5-ml plastic straws at 11, 15, 17, or 22 X 10(6) sperm per insemination dose. Laboratory evaluations at 0, 1, 2, and 4 h after thawing semen utilized four tests of spermatozoal quality. Use of egg-yolk citrate extender resulted in a higher percentage of progressively motile sperm as determined visually at 0 h after thawing than use of egg yolk-Tes-Tris or homogenized milk extenders. Sperm extended in egg yolk-citrate had 18% lower activity of bound amidase at 0 h than sperm extended in egg yolk-Tes-Tris. The 75-d nonreturn rates were affected by insemination dose but not be extender or the interaction of extender and insemination dose. Fertility was lower after insemination of 11 X 10(6) sperm than for pooled data for the three higher insemination doses (64 vs. 68%). Based on all data, postthaw quality of sperm processed in the one-step egg yolk-Tes-Tris extender was similar to that for sperm extended in egg yolk-citrate or homogenized milk. PMID- 3624599 TI - Comparison of on-farm laboratory milk progesterone assays for identifying errors in detection of estrus and diagnosis of pregnancy. AB - A field study was conducted in 10 commercial dairy herds to test the efficacy of a rapid enzyme-linked immunosorbent assay to identify errors in detection of estrus and diagnosis of pregnancy. Milk samples were collected at the milking following detection of estrus and on d 21 postinsemination. Progesterone was measured on-farm by an enzyme-linked immunosorbent assay and in the laboratory by radioimmunoassay. Agreement between the two methods of progesterone analysis (n = 820) was 89.8%. There were 93 cows (18.7%) by laboratory analysis and 126 cows (25.4%) by on-farm analysis for which concentration of progesterone in the sample collected at suspected estrus (n = 497) was higher than normal estrual values. Exclusion of these cases increased the overall accuracy of pregnancy diagnosis by 6.8 and 6.4% for laboratory and on-farm methods. Overall agreement between pregnancy diagnosis by milk progesterone at d 21 postinsemination and diagnosis by return to estrus or palpation of reproductive organs was 80.5 and 75.8% for laboratory and on-farm methods (75.0% and 69.7% for pregnant cows and 94.5 and 93.9% for nonpregnant cows). These results indicate that an enzyme-linked immunosorbent assay for milk progesterone performed on-farm was equal in accuracy to a laboratory radioimmunoassay for identifying errors in detection of estrus and diagnosis of pregnancy. PMID- 3624601 TI - Cultural factors in understanding and assessing psychopathology. PMID- 3624600 TI - Glycosaminoglycans as probes to monitor differences in fertility of bulls. AB - Recently high molecular weight polysaccharides termed glycosaminoglycans have been successfully used to capacitate bull sperm in vitro. Heparin, one class of glycosaminoglycan, binds to sperm in a manner typical of receptor-ligand interaction. Bulls with above average nonreturn rates produce sperm that exhibit a higher frequency of acrosome reactions when exposed to glycosaminoglycans in vitro. In addition, the binding affinity that sperm possess for heparin is related to nonreturn rates of bulls, and binding affinity decreases in semen samples with a high frequency of abnormal sperm. Glycosaminoglycans may be useful probes to evaluate in vitro cellular changes that sperm complete prior to fertilization and serve as markers of sperm membrane defects, which ultimately affect fertility of a bull. PMID- 3624602 TI - Mutual relevance of mainstream and cross-cultural psychology. PMID- 3624603 TI - Cultural factors in clinical assessment. PMID- 3624604 TI - Cultural factors in the clinical assessment of Asian Americans. PMID- 3624605 TI - Rediscovery of the subject: intercultural approaches to clinical assessment. PMID- 3624606 TI - Ethnicity and MMPI performance: a review. PMID- 3624607 TI - Parameters of teenage alcohol use: a path analytic conceptual model. PMID- 3624608 TI - Social competence and parental support as mediators of the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus. PMID- 3624609 TI - Assessment of major and daily stressful events during adolescence: the Adolescent Perceived Events Scale. PMID- 3624610 TI - Effectiveness of psychotherapy with children and adolescents: a meta-analysis for clinicians. PMID- 3624611 TI - Group cognitive therapy and alprazolam in the treatment of depression in older adults. PMID- 3624612 TI - States-of-mind model: cognitive balance in the treatment of agoraphobia. PMID- 3624613 TI - Frequency of MMPI two-point code types among sex offenders. PMID- 3624614 TI - Third-party payment and the outcome of psychotherapy. PMID- 3624615 TI - Objective versus subjective measurement of stress and social support: combat related reactions. PMID- 3624616 TI - Utility of confirmatory factor analysis in test validation research. PMID- 3624617 TI - Memory complaints and abilities among depressed older adults. PMID- 3624618 TI - Practice makes perfect? The role of participant modeling in sexual abuse prevention programs. PMID- 3624619 TI - Nicotine gum and behavioral treatment: a placebo controlled trial. PMID- 3624620 TI - Psychological and pharmacological influences in cigarette smoking withdrawal: effects of nicotine gum and expectancy on smoking withdrawal symptoms and relapse. PMID- 3624621 TI - Premorbid competence, role orientation, and gender differences in DSM-II versus DSM-III schizophrenic patients. PMID- 3624622 TI - Development of the Crisis Call Outcome Rating Scale. PMID- 3624623 TI - Effects of peer support and therapist contact on long-term weight loss. PMID- 3624624 TI - Fingernail drill in bone surgery. AB - The fingernail drill is useful in bone surgery. It is useful in aiding the excision of bone and in the stimulation of granulation tissue in exposed cranial bone. The drill is safe, efficient, and easy to operate. PMID- 3624625 TI - Pyoderma gangrenosum and hairy cell leukemia. AB - Hairy cell leukemia (HCL) is an uncommon hematologic malignancy in which simultaneous cutaneous disturbances of various types have been reported. We report a case of a 62-year-old man with HCL who developed pyoderma gangrenosum (PG) at the site of incision for splenectomy. PG has been reported previously in a patient with HCL. Since splenectomy is important in the treatment of HCL, it is important for the clinician to know that surgical wound dehiscence may not be due to poor technique nor infection, but rather to pathergy. PMID- 3624627 TI - The importance of cardiac monitoring in superficial and deep chemical peeling. PMID- 3624626 TI - Clarifying the origin of cryodiscs. PMID- 3624628 TI - Superpulsed lasers: minimizing thermal damage with short duration, high irradiance pulses. AB - Superpulsed carbon dioxide lasers emit a controlled train of short duration, high power pulses which minimize the protein coagulation effects of the laser. Very high irradiances can be used with superb control of vaporization without significant peripheral heating. In incisional work, superpulsing permits the surgeon to advance the hand piece as slowly and as accurately as desired, while experiencing a fraction of the necrosis attendant to conventional continuous-wave lasers. In vaporizational applications, target tissue volumes are flash vaporized before significant heat can be transferred to surrounding tissue, promoting faster wound healing and reduced scarring. The superpulse feature may significantly change the way in which the carbon dioxide laser is used in cutaneous surgery. PMID- 3624630 TI - New instruments for razor blade surgery. PMID- 3624629 TI - The 15c scalpel blade. PMID- 3624631 TI - Epidermal Langerhans cell density in patients with pulmonary malignancies and chronic obstructive pulmonary disease. AB - To evaluate the relationship between ELC density and pulmonary malignancies, as reported in previous investigations, we examined the nonsun-exposed epidermis of 18 patients with pulmonary cancer (CA) not receiving immunosuppressive therapy, 20 patients with chronic obstructive pulmonary disease (COPD-S), and 10 patients with COPD receiving glucocorticosteroid (GCS) therapy (COPD + S). The ELC density was not significantly different between lung tumor patients (1024 +/- 167) and COPD-S (1072 +/- 200, p less than 0.4) control patients, and we found no significant correlation between ELC density and tumor cell type, presence or absence of metastases, tumor stage, or present smoking status. Although we did detect that systemic GCS therapy significantly reduced the ELC density in COPD + S patients (910 +/- 211, p less than 0.05); use of inhaled or chronic low dose (less than or equal to 20 mg daily) GCS did not appear to significantly alter ELC density. In addition, anergy to epicutaneous dinitrochlorobenzene in CA and COPD + S patients positively correlated with a reduction in ELC density, suggesting a possible functional deficit arising from the numerical change. Further investigation is needed to elucidate whether factor(s) other than a reduction in ELC density are involved in the anergic state. PMID- 3624632 TI - Cardiovascular effects of topical 50% trichloroacetic acid and Baker's phenol solution. AB - Phenol and trichloracetic acid (TCA) are used for cosmetic face peeling. Deaths associated with phenol have been ascribed to the cardiotoxicity. Our purpose has been to study and compare the cardiovascular responses to these two agents in a rat model. Fifteen rats underwent abdominal epilation. Two to six days later a surface area comparable to the human face (16 cm2) was delineated on the abdomen. Baker's phenol or 50% TCA was applied to this area. Cardiac rate and rhythm and arterial pressure were monitored. Once stable, the same agent was applied to the entire abdomen for further study. TCA has been shown to be a safer agent than phenol in this rat model. Assuming that this model simulates the human response, monitoring would appear to be indicated during full-face Baker's phenol peeling. PMID- 3624633 TI - Pitch perception by cochlear implant subjects. AB - Direct electrical stimulation of the auditory nerve can be used to restore some degree of hearing to the profoundly deaf. Percepts due to electrical stimulation have characteristics corresponding approximately to the acoustic percepts of loudness, pitch, and timbre. To encode speech as a pattern of electrical stimulation, it is necessary to determine the effects of the stimulus parameters on these percepts. The effects of the three basic stimulus parameters of level, repetition rate, and stimulation location on subjects' percepts were examined. Pitch difference limens arising from changes in rate of stimulation increase as the stimulating rate increases, up to a saturation point of between 200 and 1000 pulses per second. Changes in pitch due to electrode selection depend upon the subject, but generally agree with a tonotopic organization of the human cochlea. Further, the discriminability of such place-pitch percepts seems to be dependent on the degree of current spread in the cochlea. The effect of stimulus level on perceived pitch is significant but is highly dependent on the individual tested. The results of these experiments are discussed in terms of their impact on speech processing strategies and their relevance to acoustic pitch perception. PMID- 3624634 TI - The application of a capacitive probe technique for direct observation of electromechanical processes in the guinea pig cochlea. AB - The demonstration of evoked mechanical responses of the outer hair cells in the mammalian cochlea by indirect measurements introduces a new range of problems into direct mechanical measurements. Direct and indirect measurements indicate that the frequency spectra of evoked electromechanical responses may extend well into the range of audio frequencies, revealing a need to develop terminology and protocols for distinguishing evoked mechanical responses from the traditional traveling wave when both are apparently superimposed on the motion of the basilar membrane in the normally functioning cochlea. Details are presented of a frequency-modulation capacitive probe technique for measurement of vibrating structures of the guinea pig ear. Considerations include the design of the transducer, calibration, sensitivity, linearity, and sources of noise, as well as the influence of the technique upon the animal preparation, and in particular the issues associated with draining scala tympani for the measurement. Relative advantages and disadvantages of the technique are compared with salient features of other techniques currently available. In view of the apparent complexity of cochlear mechanics some preliminary experiments are required to elucidate some of the key questions about reverse-transduction processes in general. A "simple" first experiment is to test existence of any rectifying or motile response. PMID- 3624635 TI - Frequency-dependent self-induced bias of the basilar membrane and its potential for controlling sensitivity and tuning in the mammalian cochlea. AB - A displacement-sensitive capacitive probe technique was used in the first turn of guinea pig cochleas to examine whether the motion of the basilar membrane includes a displacement component analogous to the dc receptor potentials of the hair cells. Such a "dc" component apparently exists. At a given location on the basilar membrane, its direction toward scala vestibuli (SV) or scala tympani (ST) varies systematically with frequency of the acoustic stimulus. Furthermore, it appears to consist of two parts: a small asymmetric offset response to each gated tone burst plus a progressive shift of the basilar membrane from its previous position. The mean position shift is cumulative, increasing with successive tone bursts. The amplitude of the immediate offset response, when plotted as a function of frequency, appears to exhibit a trimodal pattern. This displacement offset is toward SV at the characteristic frequency (CF) of the location of the probe, while at frequencies either above or below the CF the offset is relatively larger, and toward ST. The mechanical motion of the basilar membrane therefore appears to contain the basis for lateral suppression. The cumulative mean position shift, however, appears to peak toward ST at the apical end of the traveling wave envelope and appears to be associated with a resonance, not of the basilar membrane motion directly, but coupled to it. The summating potential, measured concurrently at the round window, shows a more broadly tuned peak just above the CF of the position of the probe. This seems to correspond to the peak at the CF of the mechanical bias. As the preparation deteriorates, the best frequency of the vibratory displacement response decreases to about a half-octave below the original CF. There is a corresponding decrease in the frequency of the peaks of the trimodal pattern of the asymmetric responses to tone bursts. The trimodal pattern also broadens. In previous experiments the basilar membrane has been forced to move in response to a low-frequency biasing tone. The sensitivity to high-frequency stimuli varies in phase with the biasing tone. The amplitudes of slow movement in these earlier experiments and in the present experiments are of the same order of magnitude. This suggests strongly that the cumulative shift toward ST to a high-frequency acoustic stimulus constitutes a substantial controlling bias on the sensitivity of the cochlea in that same high-frequency region. Its effect will be to reduce the slope of neural rate-level functions on the high-frequency side of CF. PMID- 3624636 TI - A spatial template for the shape of tuning curves in the mammalian cochlea. AB - The shape of the tuning curve of primary auditory neurons of four mammals is characterized using a simple exponential model. The regression analysis formalizes a distinction between the characteristic frequency of a neuron and its "nominal" characteristic frequency in cases of temporary threshold loss in high frequency neurons. Second, the model offers a stronger quality test for sharpness of tuning than the Q10dB since it takes into account the threshold of the neuron at its characteristic frequency and its "characteristic place" of origin along the cochlear partition. Third, the model reveals that the low-frequency side of the tip segment of the tuning curve is bounded by a constraint or template which is most simply expressed in spatial terms. The template describes the basal-side boundary of an "excitatory region" whose length along the cochlear partition is proportional to the square root of the sound pressure. Tuning curve variability arises because biological dependencies influence the basic template. A "spatial filter" hypothesis is developed and its generality is discussed, particularly in regard to the case of the acoustic "fovea" of the horseshoe bat. Finally, the possibility is discussed that the template possesses a simple physiological correlate in the form of a spatially localized region marked by a "dc" shift of the mean position of the basilar membrane which sets the sensitivity of the tuning mechanism [E.L. LePage, J. Acoust. Soc. Am. 82, 139-154 (1987)]. PMID- 3624637 TI - Potentials evoked by the sinusoidal modulation of the amplitude or frequency of a tone. AB - Steady state responses to the sinusoidal modulation of the amplitude or frequency of a tone were recorded from the human scalp. For both amplitude modulation (AM) and frequency modulation (FM), the responses were most consistent at modulation frequencies between 30 and 50 Hz. However, reliable responses could also be recorded at lower frequencies, particularly at 2-5 Hz for AM and at 3-7 Hz for FM. With increasing modulation depth at 40 Hz, both the AM and FM response increased in amplitude, but the AM response tended to saturate at large modulation depths. Neither response showed any significant change in phase with changes in modulation depth. Both responses increased in amplitude and decreased in phase delay with increasing intensity of the carrier tone, the FM response showing some saturation of amplitude at high intensities. Both responses could be recorded at modulation depths close to the subjective threshold for detecting the modulation and at intensities close to the subjective threshold for hearing the stimulus. The responses were variable but did not consistently adapt over periods of 10 min. The 40-Hz AM and FM responses appear to originate in the same generator, this generator being activated by separate auditory systems that detect changes in either amplitude or frequency. PMID- 3624638 TI - Discrimination in neonates of very short CVs. AB - The experiment reported here explores the ability of 4- to 5-day-old neonates to discriminate consonantal place of articulation and vowel quality using shortened CV syllables similar to those used by Blumstein and Stevens [J. Acoust. Soc. Am. 67, 648-662 (1980)], without vowel steady-state information. The results show that the initial 34-44 ms of CV stimuli provide infants with sufficient information to discriminate place of articulation differences in stop consonants ([ba] vs [da], [ba] vs [ga], [bi] vs [di], and [bi] vs [gi]) and following vowel quality ([ba] vs [bi], [da] vs [di], and [ga] vs [gi]). These results suggest that infants can discriminate syllables on the basis of the onset properties of CV signals. Furthermore, this experiment indicates that neonates require little or no exposure to speech to succeed in such a discrimination task. PMID- 3624639 TI - Acoustic parameters measured by a formant-estimating speech processor for a multiple-channel cochlear implant. AB - In order to assess the limitations imposed on a cochlear implant system by a wearable speech processor, the parameters extracted from a set of 11 vowels and 24 consonants were examined. An estimate of the fundamental frequency EF 0 was derived from the zero crossings of the low-pass filtered envelope of the waveform. Estimates of the first and second formant frequencies EF 1 and EF 2 were derived from the zero crossings of the waveform, which was filtered in the ranges 300-1000 and 800-4000 Hz. Estimates of the formant amplitudes EA 1 and EA 2 were derived by peak detectors operating on the outputs of the same filters. For vowels, these parameters corresponded well to the first and second formants and gave sufficient information to identify each vowel. For consonants, the relative levels and onset times of EA 1 and EA 2 and the EF 0 values gave cues to voicing. The variation in time of EA 1, EA 2, EF 1, and EF 2 gave cues to the manner of articulation. Cues to the place of articulation were given by EF 1 and EF 2. When pink noise was added, the parameters were gradually degraded as the signal-to-noise ratio decreased. Consonants were affected more than vowels, and EF 2 was affected more than EF 1. Results for three good patients using a speech processor that coded EF 0 as an electric pulse rate, EF 1 and EF 2 as electrode positions, and EA 1 and EA 2 as electric current levels confirmed that the parameters were useful for recognition of vowels and consonants. Average scores were 76% for recognition of 11 vowels and 71% for 12 consonants in the hearing alone condition. The error rates were 4% for voicing, 12% for manner, and 25% for place. PMID- 3624640 TI - Vowel and consonant recognition of cochlear implant patients using formant estimating speech processors. AB - Vowel and consonant confusion matrices were collected in the hearing alone (H), lipreading alone (L), and hearing plus lipreading (HL) conditions for 28 patients participating in the clinical trial of the multiple-channel cochlear implant. All patients were profound-to-totally deaf and "hearing" refers to the presentation of auditory information via the implant. The average scores were 49% for vowels and 37% for consonants in the H condition and the HL scores were significantly higher than the L scores. Information transmission and multidimensional scaling analyses showed that different speech features were conveyed at different levels in the H and L conditions. In the HL condition, the visual and auditory signals provided independent information sources for each feature. For vowels, the auditory signal was the major source of duration information, while the visual signal was the major source of first and second formant frequency information. The implant provided information about the amplitude envelope of the speech and the estimated frequency of the main spectral peak between 800 and 4000 Hz, which was useful for consonant recognition. A speech processor that coded the estimated frequency and amplitude of an additional peak between 300 and 1000 Hz was shown to increase the vowel and consonant recognition in the H condition by improving the transmission of first formant and voicing information. PMID- 3624641 TI - An acoustic analysis of fluctuations in the voices of normal adult speakers across three times of day. AB - The purpose of this study was to determine the amount of variation for several vocal parameters across three times of the day (morning, noon, and afternoon). Connected speech samples from normal adult males (N = 10) and females (N = 10) were recorded during morning, early afternoon, and late afternoon. Results showed that males produced a statistically significant increase in speaking fundamental frequency (SFF) from morning to afternoon. Females did not demonstrate a statistically significant change in SFF across the three time periods. Vocal amplitude did not change significantly for either group. The SFF variability was higher for the females than for the males. Analysis of individual data revealed that the patterns of vocal change across the three times of day were not consistent among the subjects. PMID- 3624642 TI - Effects of changes in absolute signal level on psychophysical tuning curves in quiet and noise in patas monkeys. AB - Forward masking psychophysical tuning curves (PTCs) were measured in patas monkeys (Erythrocebus patas) at 2, 4, and 8 kHz at signal levels of 10, 30, and 60 dB SL in quiet, and at 10 dB above masked threshold in two levels of wideband noise. Absolute signal levels with masking approximated those at 30 and 60 dB SL in quiet. Results in quiet agree with those reported in the literature, demonstrating broadening of the PTC as signal level is increased. The PTCs measured in noise also demonstrated a similar broadening, or loss of selectivity, at higher SPLs. These later findings differ from those of a previous study [D.M. Green, B.R. Shelton, M.C. Picardi, and E.R. Hafter, J. Acoust. Soc. Am. 69, 1758 1762 (1981)] which used maskers to control the broadened excitation pattern in humans at levels of up to 34 dB above threshold. Differences in findings might be attributed to higher SPLs used in the present study. The data taken in noise backgrounds are not consistent with explanations for broadening based on an increase in the width of excitation patterns, but instead support the suggestion that the filter itself is nonlinear. Moreover, comparisons of PTCs in quiet and noise suggest that "off-frequency" listening acts at any given measurement level to artificially sharpen PTCs. PMID- 3624643 TI - Factors affecting thresholds for sinusoidal signals in narrow-band maskers with fluctuating envelopes. AB - When a signal is higher in frequency than a narrow-band masker, thresholds are lower when the masker envelope fluctuates than when it is constant. This article investigates the cues used to achieve the lower thresholds, and the factors that influence the amount of threshold reduction. In experiment I the masker was either a sinusoid (constant envelope) or a pair of equal-amplitude sinusoids (fluctuating envelope) centered at the same frequency as the single sinusoid (250, 1000, 3000, or 5275 Hz). The signal frequency was 1.8 times the masker frequency. At all center frequencies, thresholds were lower for the two-tone masker than for the sinusoidal masker, but the effect was smaller at the highest and lowest frequencies. The reduced effect at high frequencies is attributed to the loss of a cue related to phase locking in the auditory nerve. The reduced effect at low frequencies can be partly explained by reduced slopes of the growth of-masking functions. In experiment II the masker was a sinusoid amplitude modulated at an 8-Hz rate. Masker and signal frequencies were the same as for the first experiment. Randomizing the modulation depth between the two halves of a forced-choice trial had no effect on thresholds, indicating that changes in modulation depth are not used as a cue for signal detection. Thresholds in the modulated masker were higher than would be predicted if they were determined only by the masker level at minima in the envelope, and the threshold reduction produced by modulating the master envelope was less at 250 Hz than at higher frequencies. Experiments III and IV reveal two factors that contribute to the reduced release from masking at low frequencies: The rate of increase of masked threshold with decreasing duration is greater at 250 Hz than at 1000 Hz; the amount of forward masking, relative to simultaneous masking, is greater at 250 Hz than at 1000 Hz. The results are discussed in terms of the relative importance of across-channel cues and within-channel cues. PMID- 3624644 TI - Effects of auditory fatigue on psychophysical estimates of cochlear nonlinearities. AB - Two-tone-suppression (2TS) effects and cubic-difference-tone (CDT) levels were measured using a forward-masking procedure, before and after exposure to an intense tonal stimulus. Changes in 2TS effects were consistent with a change in the nonlinearity, such that the system became more linear, in addition to changes due to attenuation of the primary stimuli F1 and F2. Changes in CDT levels could be accounted for on the basis of a temporary threshold shift at F1 and F2. These results indicate at least a partial dissociation of the mechanisms underlying 2TS and CDT generation. PMID- 3624645 TI - The perceptual attack time of musical tones. AB - Perceptual attack time (PAT) is defined as the time a tone's moment of attack or most salient metrical feature is perceived relative to its physical onset. Experiments are described that measured the PATs of recorded orchestral instrument tones by means of an interactive procedure with a computer and digital music synthesizer. Some PAT prediction models were then developed and tested against the empirical data. The most successful model had a correlation of 0.995 between measured and predicted PATs. The PAT is dependent on both rise time and listening level, indicating that the slope of the rise function is a key factor. Duration and spectrum can also act as cues to PAT, but are much less influential than amplitude or intensity cues. Possible relations to findings in physiology, particularly to the phenomenon of short-term adaptation in the firing of auditory fibers, are discussed. PMID- 3624646 TI - Derivation of primary parameters and procedures for use in speech intelligibility predictions. AB - The literature on various parameters that appear in the articulation index-type calculations of speech intelligibility is reexamined. Based on the reported data, the best estimates of these parameters and the most appropriate procedures for their use are suggested. These included: (1) the analysis and specification of the importance of various frequency bands to speech intelligibility; (2) the procedures used for measuring threshold and the calculation of threshold-based parameters used for predicting intelligibility of low-level speech; and (3) the calculation and measurement of relevant speech parameters. All results are given so that the calculations can be performed either in critical bands, 1/3 octaves, or octaves. PMID- 3624647 TI - Encoding voice pitch for profoundly hearing-impaired listeners. AB - The ability of five profoundly hearing-impaired subjects to "track" connected speech and to make judgments about the intonation and stress in spoken sentences was evaluated under a variety of auditory-visual conditions. These included speechreading alone, speechreading plus speech (low-pass filtered at 4 kHz), and speechreading plus a tone whose frequency, intensity, and temporal characteristics were matched to the speaker's fundamental frequency (F0). In addition, several frequency transfer functions were applied to the normal F0 range resulting in new ranges that were both transposed and expanded with respect to the original F0 range. Three of the five subjects were able to use several of the tonal representations of F0 nearly as well as speech to improve their speechreading rates and to make appropriate judgments concerning sentence intonation and stress. The remaining two subjects greatly improved their identification performance for intonation and stress patterns when expanded F0 signals were presented alone (i.e., without speechreading), but had difficulty integrating visual and auditory information at the connected discourse level, despite intensive training in the connected discourse tracking procedure lasting from 27.8-33.8 h. PMID- 3624648 TI - The development of skill in producing word-final English stops. AB - This study examined production of word-final English /p/ and /b/ by subjects whose native language does not possess voiced stops in word-final position. Native Chinese adults resembled native English adults, native English children, and native Chinese children in producing /p/ with greater peak oral air pressure than /b/. However, unlike subjects in the other groups, the Chinese adults' /b/ was sometimes misidentified as /p/. This may have occurred, at least in part, because the Chinese adults produced a much smaller difference between /p/ and /b/ in labial closure duration and voicing than the other subjects. The English adults sustained voicing in /b/ significantly longer than subjects in the other three groups. To help determine the basis for this ability, the shape of oral air pressure waveforms was examined systematically. The percentage of "delayed" and "bimodal" waveforms, in which pressure stopped increasing, or decreased, prior to the release of labial constriction, was calculated for each group. Only the English adults showed more such waveforms for /b/ than /p/. Voicing continued 18 ms longer in /b/ tokens with delayed and bimodal waveforms than in tokens in which oral pressure increased continuously. The duration of closure voicing was correlated with the rate at which pressure increased in the English adults' /b/ waveforms. Previous aerodynamic modeling has shown that delayed and bimodal waveforms may result from an active enlargement of the supraglottal cavity. This, together with the pattern of between-group differences observed here, suggests that the English adults learned to enlarge the supraglottal cavity to sustain voicing in /b/. It appears that neither the children nor the Chinese adults had as yet acquired this skill. PMID- 3624649 TI - On the relation between the growth of loudness and the discrimination of intensity for pure tones. AB - The intensity jnd is often assumed to depend on the slope of the loudness function. One way to test this assumption is to measure the jnd for a sound that falls on distinctly different loudness functions. Two such functions were generated by presenting a 1000-Hz tone in narrow-band noise (925-1080 Hz) set at 70 dB SPL and in wideband noise (75-9600 Hz) set at 80 dB SPL. Over a range from near threshold to about 75 dB SPL, the loudness function for the tone is much steeper in the narrow-band noise than in the wideband noise. At 72 dB SPL, where the two loudness curves cross, the tone's jnd was measured in each noise by a block up-down two-interval forced-choice procedure. Despite the differences in slope (and in sensation level), the jnd (delta I/I) is nearly the same in the two noises, 0.22 in narrow-band noise and 0.20 in wideband noise. The mean value of 0.21 is close to the value of 0.25 interpolated from Jesteadt et al. [J. Acoust. Soc. Am. 61, 169-176 (1977)] for a 1000-Hz tone that had the same loudness in quiet as did our 72-dB tone in noise, but lay on a loudness function with a much lower slope. These and other data demonstrate that intensity discrimination for pure tones is unrelated to the slope of the loudness function. PMID- 3624650 TI - Level and age effects in infant frequency discrimination. AB - Frequency difference limens (FDLs) were estimated for 3-, 6-, and 12-month-old infants and for adults using pure tones at 500, 1000, and 4000 Hz. Each listener provided an FDL at 40 dB and at a higher (80 dB, in most cases) sensation level (SL). An observer-based behavioral testing technique was used. The FDLs of 3 month-olds were worse than those of adults at all three frequencies, and increased with increasing frequency. The FDLs of 6- and 12-month-olds were worse than those of adults at 500 and 1000 Hz, but not at 4000 Hz. Decreasing the SL led to an increase in the FDL of about the same magnitude at all ages, and the same age differences were found at both SLs. Thus infant-adult differences in FDL are not a simple consequence of differences in absolute sensitivity. Infant FDLs at one SL were also found to be significantly correlated with the FDL at the other SL. The FDLs at one age were, in general, predictive of the FDL at a later age in a longitudinal sample of infants. Models that might account for these age related differences are discussed. PMID- 3624652 TI - Unit responses in ventral cochlear nucleus reflect cochlear coding of rapid frequency sweeps. AB - This study examines the encoding of rapid frequency sweeps in single units of the ventral cochlear nucleus (VCN). Sweeps were designed to explore the role of cochlear mechanics in shaping the temporal responses across cells in the VCN. The time course of frequency change for rapidly rising frequency sweeps theoretically produced simultaneous displacement maxima by cancelling travel time along the cochlear partition. Rising sweeps with longer time courses only partially canceled travel time, while falling sweeps had time courses of frequency change equal to or greater than travel time. Falling sweeps thus augmented normal travel time. Latency of unit firing to sweeps across unit characteristic frequency (CF) reflected cochlear delay-line mechanics. The latency-CF functions agreed with predictions from travel-time estimates for rising-frequency sweeps, but responses to falling sweeps were less predictable. PMID- 3624651 TI - Auditory duration discrimination in Old World monkeys (Macaca, Cercopithecus) and humans. AB - Auditory duration DLs at 2.0 kHz were measured in Old World monkeys (Macaca, Cercopithecus) and humans using a go, no-go repeating standard AX procedure and positive reinforcement operant conditioning techniques. For a 200-ms standard, monkey DLs were 45-125 ms, compared to 15-27 ms for humans. Weber fractions (delta T/T) for all species were smallest at standard durations of 200-400 ms and increased as standard duration decreased to 25 ms. Varying intensity from 30-70 dB SPL had only minor effects on DLs, except at the lowest levels tested, where DLs were elevated slightly. Monkeys had difficulty discriminating duration decrements, in contrast to humans. Results are discussed in relation to other comparative psychoacoustic data and primate vocal communication, including human speech. PMID- 3624653 TI - Using importance-performance analysis for evaluating university health services. PMID- 3624654 TI - AIDS on campus: a survey of college health service priorities and policies. PMID- 3624655 TI - Clinical and laboratory screening of Chlamydia trachomatis in women at a university health service. PMID- 3624656 TI - Abstracts of the scientific programs of the American College Health Association, sixty-fifth annual meeting. May 28-30, 1987, Chicago. PMID- 3624657 TI - Preoperative left ventricular function: minimal requirement for successful late results of valve replacement for aortic regurgitation. AB - Postoperative survival and left ventricular function were studied in 62 patients who underwent aortic valve replacement for isolated, chronic aortic regurgitation between 1978 and 1985. The average follow-up period was 3.8 years. There were three in-hospital and six late deaths. Five (56%) of the nine postoperative deaths were of cardiac-related causes. The mean 7 year survival rate was 83 +/- 5%. Preoperative left ventricular end-systolic volume index was the most important indicator (p less than 0.001) for subsequent cardiac death. The 6.5 year survival rate was 92 +/- 4% for patients with an end-systolic volume index less than 200 ml/m2 compared with 51 +/- 16% for those whose index was greater than 200 ml/m2. None of the 48 patients with an end-systolic volume index less than 200 ml/m2 died of cardiac-related causes. Twenty-three of the 48 patients with an end-systolic volume index less than 200 ml/m2 (Group 1) and 6 of the 12 patients with a higher index (Group 2) underwent repeat catheterization 26 months postoperatively. Preoperative afterload, assessed by end-systolic wall stress, was elevated in both groups, but decreased postoperatively, becoming identical to the afterload in 20 normal control subjects. Although the preoperative ejection fraction was depressed in both groups, the great majority of patients in Group 1, compared with none in Group 2, exhibited normal ejection fraction postoperatively. Thus, in patients who recently underwent surgery for aortic regurgitation, satisfactory late results in both long-term survival and reversal of left ventricular dysfunction were obtained when the preoperative end-systolic volume index was less than 200 ml/m2. PMID- 3624658 TI - Inferior ST segment changes during acute anterior myocardial infarction: a marker of the presence or absence of concomitant inferior wall ischemia. AB - The significance of inferior ST segment changes during acute anterior myocardial infarction was studied in 60 patients with acute anterior infarction who had angiographic visualization of the entire distribution of the left anterior descending artery after thrombolytic therapy with streptokinase. In 34 patients (Group 1) this artery supplied the anterior wall of the left ventricle up to or including the apex but did not reach the inferior wall; in 16 patients (Group 2) it continued beyond the apex onto the inferior wall of the left ventricle; and in 10 patients with prior inferior infarction (Group 3) it partially supplied the inferior wall of the left ventricle through collateral channels to an occluded right or dominant circumflex coronary artery. Consistent with this anatomy, evidence of inferior wall ischemia was significantly more frequent in Groups 2 and 3 than in Group 1 by thallium-201 scintigraphy (91 versus 7%) and by contrast left ventriculography (91 versus 13%). There was no difference in the magnitude of precordial ST segment elevation among the three groups but the inferior ST segment depression was significantly smaller in Groups 2 and 3 with concomitant inferior wall ischemia than in Group 1 (aVF: -0.5 +/- 0.7; -0.5 +/- 1.0; -1.8 +/- 0.8 mm, respectively; p less than 0.001) with 10 of the 26 patients in Groups 2 and 3 having an elevated or isoelectric ST segment in aVF compared with none of the 34 patients in Group 1 (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624659 TI - Paradoxic elevation of fibrinopeptide A after streptokinase: evidence for continued thrombosis despite intense fibrinolysis. AB - Elevated levels of fibrinopeptide A, a marker of thrombin activity associated with acute myocardial infarction, have been found to decrease after administration of streptokinase when reperfusion occurs. In contrast, in patients without reperfusion and those with reocclusion after streptokinase therapy, fibrinopeptide A remains elevated. In the present study early serial measurements of fibrinopeptide A were used to further characterize this paradoxic increase in thrombin activity after streptokinase and to characterize its response to heparin. In 19 patients with acute myocardial infarction fibrinopeptide A was elevated to 82.3 +/- 43.5 ng/ml (mean +/- SE) before therapy. Thirty minutes after the initiation of streptokinase, fibrinopeptide A increased to 300.1 +/- 117.4 ng/ml (p less than 0.01), consistent with extensive thrombin activity. Fibrinopeptide A remained elevated until 15 minutes after a heparin bolus injection when levels decreased to 15% of the poststreptokinase value (49.2 +/- 13.3 ng/ml) (p less than 0.001). These data document a prompt paradoxic increase in thrombin activity after administration of streptokinase that may be responsible for failure of therapy in some patients. PMID- 3624660 TI - Effect of prior myocardial infarction and extent and location of coronary disease on accuracy of exercise echocardiography. AB - Exercise echocardiography is an emerging technique for the evaluation of patients with suspected coronary artery disease. In this study, rest and immediate postexercise echocardiograms were performed in 123 patients who were stratified on the basis of prior myocardial infarction and the number and location of coronary artery stenoses at cardiac catheterization. The location of wall motion abnormalities on rest and postexercise studies was correlated with the location of coronary artery stenoses. The sensitivity of exercise echocardiography for detecting coronary artery disease in patients with multivessel disease was 97% in those with and 86% in those without prior infarction. The corresponding sensitivity for patients with single vessel disease was 100% and 72%, respectively. Multivessel disease was present in 59 patients, but specifically identified as such in only 32 (54%). Normal rest and exercise echocardiograms were seen in 12 patients with coronary artery disease, 8 of whom had single vessel disease. It is concluded that the subjective analysis of the exercise echocardiogram accurately identifies the majority of patients with coronary artery disease. Its sensitivity is greatest in those with multivessel coronary disease. It is limited in those with single vessel coronary disease and in accurately identifying the subset of patients with multivessel disease. PMID- 3624661 TI - Intraventricular flow during isovolumic relaxation: description and characterization by Doppler echocardiography. AB - This study describes the characteristics of a prominent Doppler flow velocity signal representing intraventricular flow during left ventricular isovolumic relaxation. The flow during the isovolumic relaxation period was demonstrated in 60 subjects, including 7 with a normal heart, 26 with hypertrophic cardiomyopathy, 10 with aortic valve disease, 9 with a transplanted heart and 8 others. All had normal to hyperdynamic left ventricular systolic function with some degree of cavity obliteration as seen in the apical two-dimensional echocardiographic views. In contrast, this isovolumic relaxation period flow could not be demonstrated in the absence of cavity obliteration in any of 20 patients with either normal or diminished left ventricular systolic function. Isovolumic relaxation period flow was best recorded from the apical transducer position and was directed toward the apex in all patients. By pulsed wave, and with two-dimensional Doppler ultrasound, the isovolumic relaxation period flow originated within a narrow area in the medial portion of the left ventricle along the middle or basal segments of the interventricular septum, but was recorded over a larger area toward the apex. The peak isovolumic relaxation period flow velocity was recorded just basal to the area of cavity obliteration, usually at the level of the papillary muscles, and ranged from 0.4 to 2.3 m/s (mean of 1.0 m/s). This isovolumic relaxation period flow started with aortic valve closure and, in 50 of the 60 patients, it lasted throughout isovolumic relaxation until mitral valve opening. In the other 10 patients (all with hypertrophic cardiomyopathy), it lasted for only a part (mean 63%) of this period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624662 TI - Myocardial uptake and clearance of thallium-201 in normal subjects: comparison of dipyridamole-induced hyperemia with exercise stress. AB - Thallium-201 uptake and clearance after dipyridamole infusion may differ from that after exercise stress because the hemodynamic effects of these two interventions are different. In this study of normal volunteers, thallium kinetics after dipyridamole (n = 13) were determined from three serial image sets (early, intermediate and delayed) and from serial blood samples and compared with thallium kinetics after exercise (n = 15). Absolute myocardial thallium uptake was greater after dipyridamole compared with exercise (p less than 0.0001), although the relative myocardial distribution was similar. The myocardial clearance (%/h) of thallium was slower after dipyridamole than it was after exercise. Comparing dipyridamole and exercise, the differences in clearance were large from the early to the intermediate image (anterior, -11 +/- 17 versus 24 +/ 5, p = 0.0005; 50 degrees left anterior oblique, -7 +/- 11 versus 15 +/- 8, p = 0.004; 70 degrees left anterior oblique, 3 +/- 9 versus 21 +/- 6, p = 0.001). In contrast, the differences in clearance were small from the intermediate to the delayed image (anterior, 15 +/- 4 versus 20 +/- 2, p = 0.025; 50 degrees left anterior oblique, 15 +/- 4 versus 19 +/- 3, p = 0.13; 70 degrees left anterior oblique, 15 +/- 3 versus 18 +/- 2, p = 0.047). Thallium uptake and clearance in the liver, splanchnic region and spleen were greater after dipyridamole (p less than 0.001). Blood thallium levels were greater after dipyridamole (p less than 0.05) and cleared more slowly (p = 0.07). Thus, myocardial thallium-201 uptake and clearance after dipyridamole infusion differ from thallium kinetics after exercise. This difference is, in part, related to associated differences in extracardiac and blood kinetics. Diagnostic criteria for the detection of abnormal thallium-201 clearance must be specific for the type of intervention. PMID- 3624663 TI - Mitral valvuloplasty is superior to valve replacement for preservation of left ventricular function: an intraoperative two-dimensional echocardiographic study. AB - To investigate the mechanism and time of onset of ventricular dysfunction after mitral valve replacement, 18 patients with pure, severe mitral regurgitation (of whom 10 underwent mitral valve repair and 8 standard mitral valve replacement with papillary muscle excision) were studied by intraoperative two-dimensional echocardiography immediately before and immediately after the operative procedure. No patient sustained a perioperative myocardial infarction or had any residual mitral regurgitation. Although preoperative hemodynamics were similar, postoperatively the patients with valve repair had a lower pulmonary capillary wedge pressure than did the patients with valve replacement (8.6 +/- 1.9 versus 14.4 +/- 7.5 mm Hg, p less than 0.04). Although intraoperative echocardiographic ejection fraction fell significantly after mitral valve replacement (0.64 +/- 0.11 to 0.40 +/- 0.09, p less than 0.0001), it was maintained after valve repair (0.44 +/- 0.20 to 0.49 +/- 0.16, p = NS). Additionally, regional myocardial contractile abnormalities in the anterior and posterior septum were detected immediately after the procedure by intraoperative echocardiography in the patients with valve replacement, but not in those with repair. These postoperative regional contractile abnormalities after papillary muscle resection have not been described previously. Resection of the papillary muscles may disrupt the muscle bundle alignment and induce contractile abnormalities remote from the excised muscle. This study demonstrated that significant global and regional ventricular dysfunction develops immediately after removal of the papillary muscles, whereas myocardial contractility is preserved in patients undergoing mitral valve repair. Therefore, with intraoperative echocardiography to assure minimal residual regurgitation, surgeons should attempt to preserve ventricular function by performing mitral valve reconstruction in patients with mitral regurgitation. PMID- 3624664 TI - High frequency alternating current ablation of an accessory pathway in humans. AB - High frequency alternating current ablation of an accessory pathway was performed in a patient with incessant circus movement tachycardia using a right-sided, free wall accessory pathway. Antiarrhythmic drugs, antitachycardia pacing and transvenous catheter ablation using high energy direct current shocks could not control the supraventricular tachycardia. A 7F bipolar electrode catheter with an interelectrode distance of 1.2 cm was positioned at the site of earliest retrograde activation during circus movement tachycardia. At this area, two alternating current high frequency impulses were delivered with an energy output of 50 W through the distal tip of the bipolar catheter, while the patient was awake. After the first shock supraventricular tachycardia terminated and accessory pathway conduction was absent without altering anterograde conduction in the normal atrioventricular (AV) conduction system. No reports of pain or other complications were noted. In short-term follow-up of 5 months, the patient had been free of arrhythmias without antiarrhythmic medication. Thus, high frequency alternating current ablation was performed for the first time in the treatment of an arrhythmia incorporating an accessory pathway in a human. This technique may be an attractive alternative to the available transcatheter ablation techniques and to antitachycardia surgery. PMID- 3624665 TI - Incidence and determinants of multiple morphologically distinct sustained ventricular tachycardias. AB - The incidence and determinants of multiple morphologically distinct ventricular tachycardias were examined prospectively in 71 consecutive patients with at least one documented spontaneous episode of sustained monomorphic ventricular tachycardia. Mean frontal and horizontal QRS axes were determined from the 12 lead electrocardiograms (ECGs) of 190 spontaneous and 352 induced tachycardias. Two or more morphologically distinct spontaneous tachycardias were observed in 19 (43%) of 44 patients who had at least two documented spontaneous episodes. In 43 (61%) of the 71 patients, multiple morphologically distinct tachycardias were induced by programmed ventricular stimulation. Overall, 57 (80%) of the 71 patients had at least two morphologically distinct tachycardias. Predictors of multiple tachycardia configurations were selected by multivariate analysis from clinical and angiographic variables and were similar for both spontaneous and induced ventricular tachycardia: presence of multiple previous myocardial infarctions (p = 0.032 spontaneous, p = 0.005 induced) and number of different antiarrhythmic drug treatments during which ventricular tachycardia was documented (p = 0.0089 spontaneous, p less than 0.0001 induced). These data demonstrate that a large majority of patients with sustained monomorphic ventricular tachycardia exhibit more than one distinct QRS configuration when adequate ECG documentation of multiple episodes is obtained during different antiarrhythmic drug treatments. In individual patients, caution should be used in attributing clinical significance to a single unique QRS configuration. PMID- 3624666 TI - Permanent cardiac pacing in patients with the long QT syndrome. AB - A permanent pacemaker was inserted in eight patients with the long QT syndrome. All had recurrent syncope or seizures, six had documented torsade de pointes and four had aborted sudden death. Among the eight patients, permanent pacing was instituted in three who were unsuccessfully treated with both a beta-adrenergic blocking agent and left cardiothoracic sympathectomy, and in two who proved refractory or intolerant to beta-blockers. Another three patients had pacemaker implantation and long-term beta-blocker therapy because of spontaneous atrioventricular (AV) block in one, aborted sudden death in one and patient preference in one. After pacing (70 to 85 beats/min), there was no significant change in the mean corrected QT interval, but the mean QT interval decreased significantly (534.4 +/- 51.4 to 425.6 +/- 18.9 ms, p less than 0.0001). Over a mean follow-up period of 35.1 +/- 18.9 months, all patients are alive and currently free of syncope. One patient without a history of stress-induced syncope had two syncopal episodes (believed to be due to hyperventilation) while under severe emotional stress, but has been symptom free for the past 5 years. One patient with an atrial demand (AAI) pacemaker developed dizziness due to documented episodes of AV block, but remains asymptomatic after conversion to atrial rate-responsive dual chamber (DDD) pacing. Either atrial or ventricular pacing combined with beta-blocker therapy appears to be effective treatment for a subset of patients with the long QT syndrome, by either preventing episodes of torsade de pointes or alleviating symptoms due to bradycardia from beta-blocker therapy. PMID- 3624667 TI - Cardiac and skeletal muscle abnormalities in cardiomyopathy: comparison of patients with ventricular tachycardia or congestive heart failure. AB - Results of cardiac muscle and skeletal muscle biopsies were compared in 22 patients with cardiomyopathy; 11 patients presented with symptoms secondary to ventricular tachycardia (Group 1) and 11 had symptoms of severe congestive heart failure (Group 2). No patient had structural or ischemic cardiac disease. In Group 1 patients, hemodynamic abnormalities were subtle, but invasive study demonstrated dilated cardiomyopathy in two patients and restrictive cardiomyopathy in nine. In Group 2, eight patients had dilated cardiomyopathy and three had restrictive cardiomyopathy. Cardiac biopsy results were abnormal in all 22 patients and the abnormalities were similar for the two groups. Cardiac histologic study revealed a spectrum of abnormalities including fibrosis, dilated sarcoplasmic reticulum, increased numbers of intercalated discs and mitochondrial abnormalities. Histologic abnormalities of skeletal muscle were similar in each group, consisting of endomysial fibrosis and increased lipid deposits. Slightly more than half of the Group 1 and Group 2 patients also had a low concentration of skeletal muscle long chain acylcarnitine. These data demonstrate that abnormalities of both cardiac and skeletal muscle are common in patients with cardiomyopathy; abnormalities are similar whether initial symptoms are due to ventricular tachycardia or congestive heart failure. It is suggested that these patients with cardiomyopathy may have a generalized myopathy. PMID- 3624668 TI - Incessant ventricular tachycardia in infants: myocardial hamartomas and surgical cure. AB - Infants with incessant ventricular tachycardia (occurring greater than 10% of the day) have generally been described in pathologic studies. This report describes 21 patients with incessant ventricular tachycardia present greater than 90% of the day and night; the age at diagnosis ranged from birth to 30 months (mean 10.5 months). The most common clinical presentation was cardiac arrest (11 patients, in 5 after digitalis for presumed supraventricular tachycardia); another 6 patients had congestive heart failure and 4 were asymptomatic. Three patients had coexisting Wolff-Parkinson-White syndrome. The rate of incessant ventricular tachycardia ranged from 167 to 440 (mean 260 beats/min) and the QRS duration from 0.06 to 0.11 second. The most common electrocardiographic (ECG) pattern (10 of 21) was right bundle branch block with left axis deviation, but other right and left bundle branch block patterns were observed. Conventional and investigational antiarrhythmic agents (nine patients received amiodarone) failed to eliminate incessant ventricular tachycardia in all. Electrophysiologic studies localized incessant ventricular tachycardia to the left ventricle in 17 (to the apex in 2, the free wall in 9 and the septum in 6) and to the right ventricular septum in 4. No structural abnormalities were found on the echocardiogram or angiocardiogram. All 21 patients had surgery at an age of 3.5 to 31 months (mean 16). In 15 a tumor was found: 13 myocardial hamartomas (9 discrete, 4 diffuse throughout both ventricles) and 2 rhabdomyomas (1 multiple). Myocarditis was found in one patient (the oldest). In four, only myocardial fibrosis was found; results of one biopsy were normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624669 TI - Disopyramide-pyridostigmine interaction: selective reversal of anticholinergic symptoms with preservation of antiarrhythmic effect. AB - This double-blind, randomized, placebo crossover study was used to evaluate the effects of a cholinesterase inhibitor--slow-release pyridostigmine (180 mg orally every 12 hours)--on the anticholinergic and antiarrhythmic properties of disopyramide. Quantitative side effects questionnaire scores were used to guide disopyramide administration in 20 men with ventricular tachycardia. Disopyramide was given to each patient both with placebo and with active pyridostigmine. The maximal administered dose for each regimen was used in conjunction with corresponding questionnaire scores to calculate an index or estimate of the maximal tolerable dose of disopyramide. Additional evaluations performed at baseline and at each maximal administered dose regimen included tear and saliva quantitation, 24 hour electrocardiogram (ECG), exercise testing and programmed ventricular stimulation. Results showed that the maximal administered dose of disopyramide was greater with active pyridostigmine than with placebo: 295 +/- 75 versus 245 +/- 100 mg every 6 hours (p less than 0.05). The calculated maximal tolerable dose was substantially greater in the presence of pyridostigmine: 355 +/- 90 versus 260 +/- 115 mg every 6 hours (p less than 0.001). Maximal side effects questionnaire scores also reflected decreased anticholinergic activity in the presence of pyridostigmine compared with placebo: 101.9 +/- 2.2 versus 104.6 +/- 2.8, respectively (p less than 0.005). Baseline tear and saliva production was significantly reduced during disopyramide therapy, but was restored toward normal by the addition of pyridostigmine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624670 TI - Systemic and pulmonary hemodynamic responses to nicardipine during graded ergometric exercise in patients with moderate to severe essential hypertension. AB - In 10 patients with moderate to severe hypertension, the hemodynamic effects of ergometric exercise and nicardipine, a dihydropyridine calcium channel antagonist, were characterized under basal conditions and after 1 week of therapy. The responses of plasma renin activity and catecholamines were also assessed. Nicardipine induced significant reductions of systolic, diastolic and mean blood pressure under conditions of rest and peak exercise (p less than 0.001), mediated by reversal of vasoconstriction (p less than 0.001). Overall, cardiac index and stroke volume index responses were not significantly altered by nicardipine. Although rest pulmonary wedge pressure was unchanged (6 +/- 3 to 5 +/- 4 mm Hg), peak exercise pulmonary wedge pressure decreased from 24 +/- 22 to 7 +/- 5 mm Hg (p less than 0.001) with nicardipine therapy. This effect of nicardipine on pulmonary wedge pressure was present across all work loads studied, and was accompanied by reduction of peak exercise pulmonary artery pressure from 43 +/- 10 to 25 +/- 7 mm Hg (p less than 0.001). Oxygen consumption was unchanged, associated with reduction of arteriovenous oxygen difference (p less than 0.02). Both plasma renin activity (p less than 0.05) and norepinephrine (p less than 0.005) were significantly increased with nicardipine therapy. Thus, nicardipine produced significant blood pressure reduction by reversal of vasoconstriction in patients with essential hypertension. The preservation of cardiac output, with markedly reduced pulmonary wedge pressure, indicated that nicardipine improved ventricular performance in response to reversal of vasoconstriction. PMID- 3624671 TI - Regional myocardial blood flow, function and metabolism using phosphorus-31 nuclear magnetic resonance spectroscopy during ischemia and reperfusion in dogs. AB - Postreperfusion regional myocardial dysfunction may be associated with depletion of high energy phosphate compounds during ischemia and with their relatively slow repletion during reperfusion. However, few studies have correlated relatively rapid changes in regional myocardial function (sonomicrometers) and blood flow (microspheres) with high energy phosphate concentrations measured using phosphorus-31 nuclear magnetic resonance spectroscopy in intact large animal models of regional myocardial ischemia. The left anterior descending coronary artery of mongrel dogs was abruptly occluded for 17.1 +/- 1.9 minutes and then completely released; measurements were made for an additional 22 minutes. Transmural blood flow decreased from 1.07 +/- 0.25 to 0.25 +/- 0.10 ml/(min X g) and holosystolic expansion was observed in all dogs (segmental systolic shortening decreased from 9.3 +/- 3.7 to -6.3 +/- 6.0%). Phosphocreatine (PCr) measured during 4.4 minute sampling intervals decreased to steady state within the first sampling period after occlusion and was 45.9 +/- 17.0% of control at the end of the occlusion, whereas beta-adenosine triphosphate (beta-ATP) reached its lowest level early after reperfusion (72.7 +/- 13.3% of control). The ratio of PCr to inorganic phosphate (Pi) decreased during the occlusion (3.34 +/- 0.75 versus 1.01 +/- 0.61) but returned to control level early during reperfusion. The ratio of PCr to beta-ATP also decreased during coronary occlusion (2.16 +/- 0.39 versus 1.29 +/- 0.39) but did not return to control level during reperfusion. Significant correlations were observed between the intensity of ischemia (reduced blood flow) and reductions in regional contractile function, PCr, beta-ATP, myocardial pH and the increase in Pi during the coronary occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624672 TI - Noninvasive quantification of left ventricular myocardial mass by gated proton nuclear magnetic resonance imaging. AB - The validity of cardiac nuclear magnetic resonance imaging for determination of left ventricular myocardial mass was evaluated in nine dogs. A gated spin echo pulsing sequence was used for in vivo imaging, obtaining 0.7 cm thick slices of the heart spaced by 1 cm. On each imaged slice, the left ventricular surface area was reproducibly determined by planimetry and was multiplied by slice spacing and specific gravity of the myocardium (1.05) to obtain slice mass. Total left ventricular mass was calculated by adding slice masses in short-axis (method I), transaxial (method II) and vertical long-axis (method III) orientations using Simpson's rule. With each method, masses of the portions of the left ventricle subject to partial volume effect either were not accounted for or alternatively were estimated from the same or an orthogonal imaging plane. Calculated left ventricular mass was compared with the actual excised left ventricular weight. With NMR imaging of in situ nonbeating hearts, best results were obtained when either method I or method II was used and partial volume effect was estimated either from the same or an orthogonal plane. With in vivo NMR imaging, best results were noted when method I was used and mass of the partial volume apex was calculated from transaxial slices: Y (in vivo NMR image) = 8.3 + 0.99X, r = 0.996, SEE = 3.14. For this method, the interobserver reliability coefficient and standard error of the measurement were 0.97 and 5.4, respectively. Compared with method I, in vivo methods II and III were associated with larger errors (SEE ranging from 13.03 to 19.03) regardless of the approach used to estimate partial volume effect. It is concluded that NMR imaging is a highly accurate noninvasive method for in vivo measurement of left ventricular mass in dogs and offers promise for accurate measurement of left ventricular mass in patients. PMID- 3624673 TI - Effects of catheter-delivered electrical discharges near the tricuspid anulus in dogs. AB - The possibility of using electrical discharges to ablate right free wall accessory pathways by delivering a series of catheter shocks near the tricuspid anulus was assessed in a canine model. Before the shock, the amplitudes of the atrial and ventricular electrograms recorded from the distal electrodes were compared (A/V ratio), and the atrial pacing threshold was determined. To assess effects on function and arrhythmogenicity, right heart pressures were measured and programmed ventricular stimulation was performed before the shock and prior to sacrifice 7 to 10 days after the shock. Nine dogs received a total of 24 discharges at varying energies (50 to 400 J). Nonsustained ventricular tachycardia occurred with 13 shocks (62%) and transient atrioventricular block with 9 shocks (43%). There was no worsening in cardiac or valvular function as determined by right heart pressure measurements or right ventriculography. Programmed ventricular stimulation performed before the shocks and repeated before sacrifice failed to induce ventricular arrhythmias. The endocardial lesion produced by the shock was roughly circular and its area correlated with both the magnitude of the shock as well as the atrial pacing threshold. Transmural necrosis always occurred at the anulus when the A/V ratio was between 1.00 and 1.50 and preshock atrial pacing threshold suggested adequate wall contact (less than 1.5 mA). There was mild inflammation of the adventitia of the right coronary artery near two discharge sites (both 200 J) and inflammation of the media near one discharge site (400 J); no intimal involvement was seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624674 TI - Right ventricular pacing reduces the rate of left ventricular relaxation and filling. AB - Right ventricular pacing alters left ventricular synchrony and loading conditions, each of which may independently influence left ventricular relaxation. Addition of a properly timed atrial contraction by using sequential atrioventricular (AV) pacing minimizes changes in left ventricular loading conditions, but ventricular asynchrony persists. To separate the effects of altered loading from those of asynchrony, the effects of right ventricular pacing and sequential AV pacing on the rate of isovolumic pressure decline (relaxation time constant), myocardial (segment) lengthening rate and chamber (minor axis dimension) filling rate were examined. In 12 open chest anesthetized dogs, left ventricular pressure (micromanometer) and either left ventricular free wall segment length transients (n = 6) or minor axis dimension transients (n = 6) were measured during right atrial, right ventricular and sequential AV pacing; length and dimension were measured using ultrasonic crystals. Compared with right atrial pacing, right ventricular pacing produced a decrease in systolic pressure, a reduction in fractional shortening, a prolongation of the relaxation time constant (23.5 +/- 0.7 to 29.8 +/- 0.8 ms, p less than 0.05), slower peak segment lengthening rate (6.2 +/- 0.6 to 4.6 +/- 0.8 s-1, p less than 0.05) and a slower rate of increase in chamber dimension (3.5 +/- 0.1 to 2.7 +/- 0.1 s-1, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624676 TI - Risk factors for development of amiodarone-induced thyroid dysfunction. PMID- 3624675 TI - Is preoperative left ventricular function predictive of survival and functional results after aortic valve replacement for chronic aortic regurgitation? PMID- 3624677 TI - Frequency and significance of ventricular arrhythmia in patients with reduced ejection fraction (less than or equal to 30%) PMID- 3624678 TI - Fighter pilots are world class athletes. PMID- 3624679 TI - Allergy to rats: quantitative immunoelectrophoretic studies of rat dust as a source of inhalant allergen. AB - The antigenic composition of an extract of rat dust, as a source of aeroallergens for rat-sensitive individuals, has been investigated and compared to the antigenic composition of rat saliva and urine. Of four main antigenic peaks identified by crossed immunoelectrophoresis, one antigenic peak (Ag 4) was demonstrated to be antigenically closely related to and with similar molecular weight (approximately 22 kd) and isoelectric point values as urinary prealbumin, already recognized as a major rat allergen. Ag 4 was present in all dusts studied and was also identified as a minor component of saliva. However, no component with the same electrophoretic mobility or physicochemical characteristics of the alpha 2-euglobulin of male rat urine that shares partial identity with the prealbumin was detected, even in dust collected from a male rat room. A second high molecular weight (greater than 200 kd) component, Ag 1, present in most of the dust extracts, could not be detected in either urine or saliva. Crossed immunoelectrophoresis and skin prick tests confirmed the allergenicity of both these antigens. Analysis of an air filter sample taken within a male rat room revealed significant amounts of the "prealbumin" component, and a monospecific antiserum to this component was used to quantitate levels in dusts collected from various locations. These findings suggest that a major inhalant allergen present in rat dust is closely related to urinary prealbumin but that this and other allergenic components may not be derived predominantly from rat urine or saliva but possibly from secretions originating from the skin of the animals and present in the fur. PMID- 3624680 TI - A double-blind study comparing monomethoxy polyethylene glycol-modified honeybee venom and unmodified honeybee venom for immunotherapy. I. Clinical results. AB - Thirty-five patients were allocated at random to immunotherapy (IT) in a double blind way with either monomethoxy polyethylene glycol (mPEG)-modified honeybee venom (HBV) or HBV. The two groups were well matched regarding age, sex, skin sensitivity, HBV-specific serum IgE and IgG antibodies, and history of reactions after a field sting; mPEG-HBV-treated patients received doses that increased more steeply than doses of the HBV-treated patients. The maintenance dose of the former group (200 micrograms) was greater than that of the latter group (100 micrograms). During IT, both groups had the same frequency of local swellings after injections. Four patients receiving mPEG-HBV developed one mild systemic reaction (SR) during dose increase, whereas 10 patients receiving HBV demonstrated one or more of these reactions, compelling two patients to stop therapy. Following challenge with a honeybee sting after about 14 weeks of IT, six patients with SR were observed, four in the mPEG-HBV-treated group and two in the HBV-treated group. In the HBV-treated group, three patients were not challenged, one because of an insufficient IgG increase and two other patients because they dropped out of IT before reaching maintenance dose because of repeated SRs. Since the mPEG-HBV is extremely well tolerated during IT and the success rate is not significantly lower than with unmodified HBV, we suggest it as an attractive alternative to HBV for the treatment of HBV hypersensitivity. Increase of the maintenance dose may result in an even better clinical efficacy. PMID- 3624681 TI - Prevalence of abnormalities found by sinus x-rays in childhood asthma: lack of relation to severity of asthma. AB - We examined the prevalence of abnormalities found by sinus x-rays in patients with asthma. The overall prevalence of abnormalities found was greater in the patients with asthma, 43 of 138 (31.2%), compared to control patients with dental problems, 0 of 50 (p less than 0.001). However, the percent of patients with abnormalities found by sinus x-rays was the same whether the asthma was mild, requiring minimal medication, or severe, requiring multiple medications. The results provide no support for the hypothesis that sinusitis, as detected by abnormalities found by sinus x-rays, aggravates asthma and promotes increased need for medication to control the asthma. PMID- 3624682 TI - Allergens in Hymenoptera venom. XVII. Allergenic components of Solenopsis invicta (imported fire ant) venom. AB - Pure venom from Solenopsis invicta was collected by having the insects sting into a capillary tube. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS PAGE) demonstrated that three major protein bands were present in the venom. A prototype commercial extract was compared and found to contain the three major venom proteins and additional components as well as high potency and specificity by RAST. Immunoblot studies were performed with sera from allergic individuals with blots prepared from denatured SDS-PAGE gels and from two types of nondenaturing gels. The nondenaturing systems demonstrated the presence of two major allergens and three other allergens, each reacting with a third of the sera. Three of the allergens detected in SDS-PAGE blots were of identical mobility to the three major proteins in the pure venom sample. IgE binding to the SDS-PAGE blots was significantly less than that to nondenaturing blots, suggesting that much of the allergenic activity is conformation dependent. PMID- 3624683 TI - Asthma mortality: a review of recent experience in New Zealand. PMID- 3624686 TI - Recommendations of the Asthma Mortality Task Force. PMID- 3624685 TI - Proceedings of the Asthma Mortality Task Force. November 13-16, 1986, Bethesda, Maryland. PMID- 3624684 TI - Mechanism of leukotriene D4-induced bronchoconstriction in normal subject. AB - Leukotriene (LT) D4 is a potent constrictor of human airways and a putative mediator of asthma. However, its mechanism of action in man has not been established. In the present study we sought to determine the role of upper airway reflexes, cholinergic pathways, and cyclooxygenase products of arachidonic acid metabolism in mediating LTD4-induced bronchoconstriction in man. Six normal subjects underwent bronchoprovocation testing with LTD4 after pretreatment with either aerosolized phosphate-buffered saline, aerosolized atropine (1.5 mg), aerosolized lidocaine (80 to 160 mg), or oral indomethacin (50 mg three times daily for 10 doses). Specific airway conductance (SGaw), the flow rate at 30% of vital capacity from a partial forced expiratory maneuver (V30P), and the FEV1 were measured at each concentration of LTD4. We calculated the provocative concentration of LTD4 required to produce a 35% fall in SGaw (PC35SGaw) or a 30% fall in V30P (PC30V30P) and the slope of the LTD4 dose-response curve. Atropine increased baseline SGaw 49% (p less than 0.01) and V30P 43% (p less than 0.005). Atropine also increased the PC35SGaw and PC30V30P and increased the slope of the LTD4 dose-response curve. However, neither of these opposing effects was significant. Lidocaine had no effect on either baseline function or the airway response to LTD4. Indomethacin produced small decreases in baseline V30P (12%) and FEV1 (3%) (p less than 0.05 for both), but it too had no effect on the airway response to LTD4. These results indicate that the bronchoconstriction produced by aerosolized LTD4 in normal subjects is not mediated by cyclooxygenase products of arachidonic acid metabolism or irritant receptors in the upper airways. Although cholinergic pathways may play some role, the data suggest that bronchoconstriction results, at least in part, from a direct effect of LTD4 on airway smooth muscle. PMID- 3624687 TI - The natural history of asthma. PMID- 3624688 TI - Recent observations reflecting increases in mortality from asthma. PMID- 3624689 TI - Asthma mortality in France. AB - Deaths caused by asthma are now recognized in all western countries, but they were only lately accepted in France because Laennec and Trousseau denied that patients with asthma may die of asthma. The "epidemic" of asthma deaths of the 1960s was not observed. Since 1968, it appears that asthma deaths decreased until 1974 for females and until 1980 for males, and then increased up to 2.9/100,000 in males and 3.6/100,000 for females. In the age group 5 to 34 years, there is a slight increase of deaths caused by asthma with a death rate of 0.35/100,000 in males and 0.39/100,000 in females. The ninth revision of the ICD did not lead to an increase in the number of reported deaths caused by asthma. In Denmark, death rates in the age group 5 to 34 years are similar to those in France, but in Germany they are much greater in number, and a clear increase was noticed. The causes of death of individuals with asthma in France are similar to causes reported in other countries, but deaths caused by specific immunotherapy may be more frequent because asthma is often treated by this form of therapy. Moreover, some deaths were associated with "corticophobia," with many patients preferring to use homeopathy or acupuncture. PMID- 3624690 TI - Asthma mortality and morbidity in Canada. PMID- 3624692 TI - A study of asthma deaths in a coroner's population. PMID- 3624691 TI - Asthma drug therapy trends in the United States, 1972 to 1985. PMID- 3624693 TI - Airways smooth muscle. PMID- 3624694 TI - The eosinophilic leukocyte and the pathology of fatal bronchial asthma: evidence for pathologic heterogeneity. AB - Classically, bronchial asthma is associated with peripheral blood eosinophilia and striking eosinophilia of bronchial tissues and sputum. Evidence exists that eosinophil degranulation commonly occurs during bronchial asthma and eosinophil granule proteins are discharged onto damaged bronchial epithelium. Analyses of 10 patients with fatal asthma showed striking eosinophil participation in eight, whereas two patients showed marked epithelial desquamation in the virtual absence of eosinophils. These results point to the possibility that a pathologic heterogeneity exists in fatal bronchial asthma, with most, but not all, patients showing evidence of eosinophil participation. PMID- 3624695 TI - The presence or absence of bronchial mucus in fatal asthma. PMID- 3624696 TI - Varieties of airway narrowing in severe and fatal asthma. PMID- 3624697 TI - Cardiac pathology in asthma. PMID- 3624699 TI - Asthma mortality and physician competence. PMID- 3624698 TI - The pathogenesis of severe asthma: a consensus report from the Workshop on Pathogenesis. PMID- 3624700 TI - An analysis of fifteen childhood asthma fatalities. AB - There is evidence from pediatric tertiary care centers in the United States that childhood deaths from asthma in hospitalized patients are becoming increasingly rare, while asthma mortality outside the hospital appears to be on the rise. When a young outpatient with asthma dies, the event is apt to be sudden and unanticipated and the victim is likely to be a preadolescent or adolescent who has suffered from asthma most of his or her life and who, despite ongoing bronchodilator therapy, requires hospitalizations for treatment of status asthmaticus. Patients in this age cohort have a strong tendency to underuse, overuse, or neglect to use prescribed medications, possibly as a gesture of emerging independence or because of the depression engendered by a chronic illness. In some instances serious psychosocial pathology accounts for noncompliance. For a patient with chronic asthma with a high-risk profile, any departure from an ongoing treatment regimen may result in respiratory failure. Pathologic complications of asthma may also act to upset the precarious physiologic equilibrium these patients have established. Unsuspected chronic pneumonia may lead to further increases in a chronically high degree of oxygen desaturation. Hypoxic seizures during an asthma attack may precipitate pulmonary edema. Tension pneumothorax has an even greater fatality potential for high-risk patients with asthma than it has for other patients with asthma, and pulmonary hypertension with cor pulmonale may develop because of chronic hypoxia. Some sudden deaths in children with chronic, severe asthma are unassociated with any of the above, making it necessary to entertain still other hypotheses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624701 TI - Asthma deaths in childhood: identification of patients at risk and intervention. PMID- 3624702 TI - Patients at risk for dying of asthma: New Zealand experience. PMID- 3624704 TI - Asthma education programs: their role in asthma morbidity and mortality. PMID- 3624703 TI - Depression and asthma: a potentially lethal mixture. PMID- 3624705 TI - Asthma education: general aspects of childhood programs. PMID- 3624706 TI - Evaluation and implementation of self-management programs for children with asthma. AB - We have reviewed the needs and problems associated with the evaluation and implementation of programs designed to assist children with asthma and their parents to manage the illness. To date, there are several programs that have been evaluated and found to be effective in terms of the objectives and dimensions described. Implementation has presented a larger problem because there are few implementors and because of the major barriers to be overcome by those who would make these programs available to the significant numbers of children and families who would benefit. Unless ways can be found to overcome the medical and reimbursement barriers, asthma self-management programs will not thrive. The growing number of individuals enrolled in some form of health maintenance organization, however, suggests a greater market for asthma self-management programs, under circumstances in which the costs of emergency room use and hospital services must be borne by physicians and hospitals, rather than by their patients. PMID- 3624707 TI - Self-management in the treatment of childhood asthma. PMID- 3624708 TI - The future role of asthma self-management. PMID- 3624709 TI - Can self-reported body weight be used to evaluate long-term follow-up of a weight loss program? AB - The purpose of this study was to determine whether former participants in weight control programs would provide valid weight data by self-report in telephone interviews. Participants were 39 women and 107 men (aged 28 to 63 years) who were in year 4 or 5 post-treatment. These represented 95% of participants who had completed all annual clinic visits. Self-reported body weights obtained by telephone interview were validated against weight measured directly in a university clinic. Overall, self-reported weight was 5.9 lb (2.7 kg) (standard deviation = 7.0 lb) (2.9%) lower than the measured weight. Using regression analysis, the strongest predictor of measured weight was reported weight, for both men and women. The bias in self-report of weight seen here is of about the same magnitude and direction as that seen in population studies. We conclude that the use of self-reported weight is not adequate for the assessment of long-term weight-loss maintenance unless the magnitude of discrepancy is adjusted for. PMID- 3624710 TI - Management of patients using unproven regimens for arthritis. AB - Such treatments as vegetarian diets, fresh or raw diets, allergy diets, no-dairy products diets, fasting, vitamin and mineral supplementation, apple cider vinegar, and honey drinks are touted in the popular press as effective for the treatment of arthritis. In contrast to conventional therapies, the unproven treatments promise not only relief from symptoms but freedom from the disease as long as the diet regimen is followed. Several of the remedies appear to be harmless, but others are dangerous, especially if followed for prolonged periods. Nutrition professionals should be aware of the nature of these treatments and be prepared to offer sound, scientifically based but nonjudgmental care and information. PMID- 3624711 TI - Incorporation of the marketing concept: applications in university contract foodservice management. PMID- 3624713 TI - Factors influencing accuracy in estimating plate waste. PMID- 3624712 TI - Body weight perceptions, body mass index, and dieting practices of South Carolina adults. PMID- 3624714 TI - Proceedings from The Leading Edge in Nutrition Education: Research Enhancing Practice. September 1986, Chicago, Illinois. PMID- 3624716 TI - Response to the use of videodisc technology in nutrition education research. PMID- 3624715 TI - Using videodisc technology and the Index of Nutritional Quality to teach dietary guidance to young adults. AB - A review of the literature indicated a need for nutrition education materials to be current with prevailing scientific knowledge, using advanced instructional technology. Individuals need help in applying nutrition principles to their dietary practices. A nutrition education program utilizing the nutrient density concept and the dietary guidelines for use on videodisc with microcomputer interface was developed and evaluated. The evaluation of the program did not prove to be statistically effective, but learners did show an interest in the program and had positive feedback in regard to the information presented and the technology used. PMID- 3624717 TI - LIFESTEPS: Weight Management Program. AB - Obesity continues to be a major problem for many adult Americans. LIFESTEPS: Weight Management, a nutrition education program for adults developed by the National Dairy Council, was designed to help meet the need for effective programmming in the area of obesity. Based on principles of behavior modification and adult learning, the program is described and key features are discussed. PMID- 3624718 TI - A response to LIFESTEPS: Weight Management: the use of adult education research in teaching nutrition. PMID- 3624719 TI - LIFESTEPS: Weight Management Program: a response from a behavioral perspective. PMID- 3624720 TI - The role of experience in children's food acceptance patterns. AB - Results of studies conducted over the past ten years at the University of Illinois have shown that experience plays a major role in children's food acceptance patterns. Four aspects of experience with food and eating have been found to affect early food acceptance patterns: (1) the frequency of exposure to food; (2) associative conditioning of food cues to physiological consequences of eating; (3) associative conditioning of food cues to social context of feeding; and (4) learning more about which cues--physiological,environmental, cognitive- are relevant in the initiation, maintenance, and termination of eating. In addition, the quality of the social context of feeding has been shown to affect food acceptance and the extent to which children are attuned to cues of hunger and satiety in self-regulating food intake. PMID- 3624721 TI - Comments from a practitioner on Leann Birch's research. PMID- 3624722 TI - Communication theory as a basis for nutrition education. AB - Communication theories are reviewed and then applied in a model for communicating nutrition. The Nutrition Communication Model has two major components: inputs and responses (Figure 1). Inputs include both the decisions nutrition communicators make about the communication strategy (Nutrition Communicator Inputs) and the predispositions receivers bring to the communication event (Receiver Inputs). The combined contributions of receiver and nutrition communicator inputs, as well as the situational context, influence the responses to a communication. Responses occur at two levels: the intervening process and outcomes. Important stages of the intervening process are attention, comprehension, and interaction. The results, or outcomes, of the communication events are the receivers' acceptance or rejection of the changes the communicator intended. Acceptance or rejection may be in the cognitive (knowledge), affective (attitude), and/or behavioral domain (including behavioral intent and actual behavior). PMID- 3624723 TI - Using communication theory: the development of a conceptual framework to map students' thinking about food. PMID- 3624725 TI - Response to using cooperative learning strategies to teach nutrition. PMID- 3624724 TI - Using cooperative learning strategies to teach nutrition. AB - There are three ways in which student-student interaction may be organized for nutrition education. Of the three, cooperation is the only instructional strategy congruent with the goals of nutrition education. The essential elements of cooperative learning and the specific actions teachers need to take to implement it are presented. When cooperative learning is implemented effectively, long-term modifications of nutrition knowledge, attitudes and behavior result. Nutrition education classes will more successfully fulfill their purposes when cooperative learning is primarily used. PMID- 3624726 TI - Applications of the marketing perspective in nutrition education. AB - The marketing paradigm is based on the premise of exchange of value, that is, value received for value given. The role of the nutrition educator as a marketer is to facilitate exchanges of value with consumers. To carry out this role, a strong orientation to the consumer, what she or he wants and needs and is willing to "pay," guides the development of the nutrition education mission, objectives, and strategies. The marketing paradigm calls for a marketing information system that includes internal record keeping, marketing intelligence gathering, and marketing research. The information is used in the marketing audit, which identifies organizational strengths and weaknesses and marketplace opportunities and barriers. Marketing objectives are formulated, and strategies for segmenting, positioning, and developing the marketing mix follow. These are translated in the marketing plan to an action plan, a budget, and profit and loss projections. Use of the marketing paradigm in nutrition education is not a panacea for organizational ills and marketplace problems. Instead, the paradigm raises issues to which nutrition educators must bring their expertise, commitment, ingenuity, and creativity. PMID- 3624727 TI - Teaching nutrition to the fast food freaks: the application of marketing principles to teaching nutrition at the elementary school level. PMID- 3624728 TI - Reaching low-literate adults with printed nutrition materials. AB - A receiver-assisted pamphlet featuring snack information written in the language of the target audience was developed using the language experience approach and compared to a standard sender-produced version written by nutrition professionals. Information garnered through free recall, main idea, content continuation, and signaled stopping statements suggests that the receiver assisted pamphlet was more easily understood and the perception of personal relevance was improved, although content recognition and oral miscue analyses indicated that some of the wording in the receiver-assisted version tended to be more difficult. Subjects who read semantic differential passages gave the receiver-assisted pamphlet more favorable ratings on the neighborly, helpful, sensible, and informative scales. Semantic differential scores of white and nonwhite respondents favored the receiver-assisted version, indicating that the materials are appropriate for use with a racially mixed target audience. PMID- 3624729 TI - Applying futures' research to nutrition education. AB - You, as individuals and as professionals, cannot be expected to solve all the problems of this decade and those projected for the future that I have discussed with you today, but you must accept the challenge to help bring individuals and society to a more holistic approach to a quality of life for all its members. The messages have gone out to children, youth, and adults that a young, thin, and beautiful image is all that is appropriate. Within the context of these messages individuals are confused and overwhelmed by their own inabilities to "be all that they can be." There are mixed messages in the media concerning drugs that are bad and drugs that are good, food that is bad and food that is good, and the connections to the environment. Your role and mine in this future will be to enter into partnerships with all policy-making and administrative agencies and with private sector groups, to work together and to share our many resources, experiences, and creative minds in moving healthy minds and bodies into the 21st century. Choices, Challenges, and Change--a time for new heroes. Who is yours? Mine is Pogo, who said, "I am faced with insurmountable opportunities." PMID- 3624730 TI - The aging thyroid. I. A description of lesions and an analysis of their age and sex distribution. AB - Two types of follicular change in the thyroid are described. The first represents an involutional change in which colloid cysts (macrofollicles) are often found. The second represents a hyperplastic-dysplastic (microfollicular) lesion. Two types of change in calcitonin (C) cells are also described, one of which may represent an involutional process, although this is not certain. The second is a hyperplastic (micronodular) lesion, but without evidence of dysplasia. An infiltration of lymphocytes is also commonly encountered. Only about 15% of cases after age 60 are free of the follicular and lymphoid lesions. Both the macro- and microfollicular lesions show a statistically significant increase with age, as do the lymphoid lesion and its derivative Hashimoto's thyroiditis. C cell micronodules also appear to increase with age, but there are too few such cases for a reliable statistical analysis. An analysis of combinations of the follicular and lymphoid lesions show a particularly frequent association of the microfollicular and lymphoid lesions. Evidence is presented suggesting that many microfollicular lesions may represent clones of mutated cells, and that the lymphocytes may be targeted to these microfollicles. Lymphocytes were rarely found in association with C cell micronodules. Within individual thyroids there is considerable variation in the proportion of each lesion when combinations are present. Thus with advancing age there is an increasing heterogeneity of thyroid structure that may confound attempts to correlate structural and physiological changes with age. PMID- 3624731 TI - The aging thyroid. II. An immunocytochemical analysis of the age-associated lesions. AB - This study utilizing immunocytochemical techniques consists of two segments, 1) an analysis of the changes with age in the hormone content of normal, involuting, macro- and microfollicles, as well as calcitonin (C) cells, and 2) an analysis of the components of the lesion characteristic of lymphocytic thyroiditis. Involuting and macro- (cystic) follicles show a decline in hormone content with age, while microfollicles show a variable pattern with some showing a high and others a low content, as well as some showing an absence of hormone. There also appears to be an increase with age in hormone-containing C cell micronodules, but we were unable to demonstrate a decline in hormone content of individual C cells. Studies on the in vivo binding of immunoglobulins, as an indicator of thyroid antibody binding, showed an increase with age in IgG and IgM binding to follicular epithelium. Much stronger reactions were observed in the epithelium of microfollicles than in that of involuting or macrofollicles. There were also examples of presumptive in vivo antibody binding by C cell micronodules. We were unable to demonstrate an imbalance of helper/suppressor T cell ratio in the thyroiditis lesion, but did find that some lymphocytes contain thyroid hormones, suggesting that the latter may act as cytokines and assist in the perpetuation of the lesion. The epithelial expression of human lymphocyte antigens (HLA) was strong in microfollicles and weak or absent in involuting or macrofollicles in sections with lymphocytic thyroiditis. It was also strong in the epithelium of a microfollicular adenoma without a lymphocytic infiltrate while weak or absent in the epithelium of adjacent normal follicles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624733 TI - Cervical cancer screening in women aged 65 and over. AB - Pap smear screening is an accepted method of detecting cervical dysplasia or malignancy, and use of this test has been shown to reduce the incidence of invasive squamous cervical cancer in young and middle aged women. Conflicting recommendations exist concerning the screening of women over the age of 65, and little information is available concerning the results of screening in this population. Elderly women are routinely omitted from screening, as it is generally believed that they usually refuse testing. This paper reports a study attempting to evaluate the feasibility of screening in women over the age of 64 attending a large urban outpatient geriatric clinic. It demonstrates that pap smear screening is acceptable to this population, particularly if performed by the usual primary care provider. It also confirms previous reports that women in this age group have had very little screening in the past, and that screening uncovers a large number of abnormalities. Of note is the high rate of false positive smears in this population. PMID- 3624732 TI - Alcoholism screening in the elderly. AB - Alcoholism in the elderly is often underidentified because of the differences in the presentation and symptom patterns compared to younger individuals. One way to address this problem is through routine use of screening instruments, but up to this time, none of the instruments used to identify alcoholism in younger populations have been shown to be valid in the elderly. We studied the validity of the Michigan Alcoholism Screening Test, scored both with weighted (MAST) and unit scoring (UMAST), and two short versions: the Brief MAST (BMAST) and Short MAST (SMAST) in 52 hospitalized elderly male alcoholics and 33 nonalcoholic controls. The MAST and UMAST showed excellent sensitivity and specificity, while the SMAST was less specific, and the BMAST less sensitive and less specific. Factor structure of the two brief versions was similar to that found in younger alcoholics, suggesting that symptom constellation is not necessarily different in the elderly. We recommend the use of the MAST or UMAST for screening for alcoholism in the elderly. PMID- 3624734 TI - Hyperkalemia from baby food consumption. A case report. PMID- 3624735 TI - Urinary incontinence. PMID- 3624736 TI - Management of nondeflatable Foley balloon catheter. PMID- 3624737 TI - Decision analysis and INH therapy. PMID- 3624739 TI - Abstracts from the AGS (American Geriatrics Society) and AFAR (American Federation for Aging Research). 1987 annual meeting. New orleans, May 14 to 17, 1987. Part I. PMID- 3624738 TI - More on the association between hearing and cognitive impairment. PMID- 3624740 TI - Some predictions of optometry's future. PMID- 3624741 TI - Delivery of vision care in the 21st century. PMID- 3624742 TI - Correcting diplopia with prism. PMID- 3624743 TI - The mentally handicapped. PMID- 3624744 TI - A critical view of presbyopic add determination. AB - From a previous study at the Optometric Center of Fullerton, it was found that 17.5% of the review clinic population returned due to improper presbyopic reading adds. The population sample for the present study consisted of patients between 40-60 years of age who returned to the clinic between September 1983 and May 1985 due to improper add power. The add power originally prescribed was compared to each of four commonly used methods of add power determination. Our results indicate that the age expected add powers account for the fewest errors while the binocular cross cylinder the most. Upper and lower limits for an acceptable range of add powers versus age were determined. PMID- 3624745 TI - Effects of alcohol on event-related brain potentials produced by viewing a simulated traffic signal. AB - The P-300 event-related brain potential was monitored during simulated traffic signal tasks for 10 subjects who were tested at three levels of mean blood alcohol content: 0.00%, 0.06%, and 0.13%. A significant increase in latency occurred for the 0.13% level indicating that an increased mental processing time was required to determine if a red or a green light had been presented. PMID- 3624746 TI - The Skeffington-Alexander National Optometry Education Learning Center. AB - This article presents a review of the Skeffington-Alexander National Optometry Education Learning Center (s.a. NOEL Center) program. It presents the general philosophy behind the center's activities and further describes its clinical, educational and research activities. PMID- 3624748 TI - Relative hypoplasia of the optic nerve. AB - Meticulous comparison of optic nervehead size has revealed detectable differences in as many as 10% of patients. In many cases the larger nervehead has a larger cup. This may result in the false impression of glaucoma and may be the most common cause of asymmetric cupping in the absence of active, progressive disease. Two cases demonstrating this finding are reviewed with a discussion of its detection and diagnosis. PMID- 3624747 TI - Conjunctival abrasions and lacerations. AB - Although less commonly described in the ophthalmic literature, conjunctival injuries may be encountered by the primary care practitioner on a frequent basis. Both conjunctival abrasion and laceration are described in detail, including their diagnosis, treatment and management. PMID- 3624749 TI - Crocodile tears syndrome. AB - Crocodile tears syndrome was diagnosed in a 51-year-old female complaining of unilateral tearing of several years duration. The diagnosis was not apparent until details of the case history were probed. The present case demonstrates the illusiveness of this diagnosis, since usually, the epiphora will not occur while the patient is being examined. A review of this interesting, but relatively uncommon condition is presented. PMID- 3624750 TI - Trauma-induced altitudinal hemianopsia. AB - A 55-year-old Caucasian female presented with bilateral inferior altitudinal visual field defects which resulted from trauma suffered in an automobile accident. In addition, there was a bilateral reduction in visual acuities and bilateral optic disc pallor. Diagnostic and historical data suggested that the primary site of damage was at the occipital cortex. A subsequent bilateral anterior ischemic optic neuropathy process was also thought to have occurred. PMID- 3624751 TI - Vision screening by opticians. PMID- 3624752 TI - Give and take after 30 years (professional battery charging) PMID- 3624753 TI - The CPF 527 lens. PMID- 3624754 TI - The use of spherical power effect bitoric rigid contact lenses in hospital practice. AB - In this retrospective study of astigmatic contact lens dispensing in the hospital setting, 680 patients were noted to have been dispensed new contact lens prescriptions over a specific 20-month period. Seventy-five patients (11%) received at least one astigmatic rigid or hydrogel contact lens. Forty-nine patients received at least one rigid astigmatic lens; 43 patients (63 eyes)--or about 87% of all rigid lens fittings--were dispensed spherical power effect (SPE) design rigid contact lenses. We find that we usually prescribe bitoric rigid lenses with the flatter (longer) meridian of the lens base curve about 0.50 diopters steeper than the flattest (longest) corneal meridian. Mean diameter was 9.3 mm, and about 80% of lenses were made from rigid gas permeable materials. The majority of patients were successful from a clinical perspective, with most attaining visual acuity equal to or better than with maximum spectacle correction, and with good comfort and physiological results. PMID- 3624755 TI - The influence of letter size on the focusing response of the eye. AB - The monocular and binocular steady state accommodation responses in 10 normal subjects were measured for different letter sizes presented at 6m and 0.4m observation distances. A computer-aided Badal laser speckle optometer system was used to measure accommodative responses. For each subject, and group-averaged data, accommodative responses were independent of letter limb subtense. Binocular and monocular responses averaged across subjects did not differ significantly. The magnitude of accommodative responses was related to the resting focus of accommodation and was independent of subjects' accommodative amplitude, refractive error and pupil size. The implications of these findings for clinical and human factor methods for examining visual performance are discussed. PMID- 3624756 TI - Light filtering lenses as an alternative to cataract surgery. AB - A patient complaining of extreme light sensitivity and "smokey" vision was diagnosed as having developing cataracts. He would not consent to surgery until alternative treatments were attempted. Tinted prescription sunglasses were too dark indoors, interfered with his work and didn't relieve the symptoms. Special light filtering lenses from Corning, ones that block blue light thought to scatter as it enters the eye and cause the glare experienced by cataract sufferers, increased functional vision and offered this patient a comfortable alternative while awaiting surgery. PMID- 3624757 TI - Quadrantanopic field defect associated with intracranial calcification. AB - A homonymous quadrantanopic visual field defect was discovered in a healthy, asymptomatic 43-year-old female. Computerized tomography revealed the source of the field defect. Since visual field defects can be associated with life threatening disorders, eye examinations should include some assessment of the visual field. PMID- 3624758 TI - Benign essential blepharospasm. AB - A 57-year-old female had vague visual complaints of pressure behind her right eye during an ocular examination. One month later the patient was visually impaired due to uncontrollable spasms of both eyelids. A diagnosis of benign essential blepharospasm (BEB) was made, and the patient was eventually treated with botulinum toxin to temporarily relieve her symptoms. I have reviewed and summarized the literature relating to the characteristics and management of this often misdiagnosed and misunderstood ocular muscular condition. PMID- 3624759 TI - Monovision vs. aspheric bifocal contact lenses: a crossover study. AB - Twenty selected presbyopic patients were fitted with both monovision correction and Hydrocurve bifocal contact lens correction in a crossover study. Eighty percent of the population preferred bifocal correction and 20% preferred monovision. The results suggest that bifocal contact lens correction should be explored prior to considering monovision correction. PMID- 3624760 TI - Unilateral pigmented mobile vitreous cyst. AB - A patient presented with a pigmented mobile vitreous cyst in the right eye. The cyst was 6-7 mm in diameter, and was free-floating in the inferior half of the vitreous with no apparent attachments. No other ocular pathology was present in either eye. The patient became symptomatic only when the cyst obscured the visual axis. The literature was reviewed and will be discussed in this report. PMID- 3624761 TI - Delivering bad news: the most challenging task in patient education. AB - Communicating clinical findings that a patient's vision cannot be improved and/or will deteriorate is a challenging patient education responsibility. The bad news will be upsetting for the patient no matter how it is presented. By presenting findings in a thoughtful, step-by-step manner taking into account the patient's shock and distress and providing appropriate patient education information, the practitioner plays a critical role in facilitating the patient's participation in the rehabilitation process. PMID- 3624762 TI - Pyogenic granulomas. AB - Four cases of conjunctival pyogenic granuloma are described. The patients ranged in age from 12-30 years. Surgical trauma preceded the development of two lesions in one patient and a second patient presented with a positive history of recurrent styes, a chalazion, and a questionable history of trauma to the lid. The other two patients had no known antecedent events that would explain development of the lesions. A review of the literature is included in the discussion, which details the etiology, incidence, clinical presentation, histopathology, symptoms, clinical course, differential diagnosis, and treatment of pyogenic granulomas. PMID- 3624763 TI - Legal aspects of prescribing for athletes and sportsmen. AB - Eyewear for athletes and sportsmen must meet legally-recognized standards for impact-resistance. Negligence and product liability claims may result from a failure to observe these standards, which are intended to minimize the risk of ocular injury. Optometrists have a legal duty to warn athletes of the relative impact-resistance of ophthalmic materials, to dispense materials that offer adequate protection, and to verify all materials dispensed to ensure they meet the necessary standards. PMID- 3624764 TI - Office design: Gailmard Eyecare Center. PMID- 3624765 TI - Halothane hepatotoxicity in glutathione depleted rats. AB - Experimental models for halothane hepatotoxicity require microsomal enzyme induction by phenobarbital or triiodo-thyronine pretreatment and hypoxic conditions. The role of GSH in the metabolism of halothane, however, is still unclear. We therefore pretreated male rats with phorone to deplete hepatic GSH, phenobarbital as a microsomal enzyme inducer and exposed them to halothane 1% for 4 h under hypoxia (10% O2). Increases in serum enzyme activities of alanine aminotransferase (GPT) and sorbitol dehydrogenase (SDH) were observed 24 and 48 h later. Histomorphological examinations showed centrilobular hepatic necrosis. In GSH-depleted rats the increments of serum enzyme activities and histomorphological alterations were significantly aggravated as compared with controls. In this model (+)-catechin protected against halothane-induced hepatotoxicity as evidenced by reduced serum enzyme elevations and morphological alterations whereas diethyldithiocarbamate failed to exert any protective effects. Free fluoride concentrations in plasma was used as an index of the non oxidative defluorination of halothane. Increased plasma fluoride levels were observed under conditions which evoked hepatotoxicity but did not correlate with the protective effect of (+)-catechin. Our experimental data indicate that glutathione might be involved in the non-oxidative metabolic pathways of halothane. Furthermore, (+)-catechin seems capable of protecting against the direct toxic effect of halothane metabolites resulting from the reductive pathways. PMID- 3624766 TI - Biotransformation of dimethylarsinic acid in mouse, hamster and man. AB - The metabolism of dimethylarsinic acid (DMA) a common pesticide and the main metabolite of inorganic arsenic in mammals, has been studied in mice, hamsters and man. Mice and hamsters were administered a single dose of 74As-DMA (40 mg As/kg body weight) orally, while a human subject ingested DMA corresponding to 0.1 mg As/kg body weight. Ion exchange chromatography, paper electrophoresis, thin layer chromatography as well as arsine generation--gas chromatography combined with atomic absorption spectrophotometry or mass spectrometry were used to characterize the arsenic metabolites in urine and feces collected over 48 hours after treatment. In mice and hamsters 3.5% and 6.4% of the dose, respectively, were excreted in urine in the form of trimethylarsine oxide (TMAO). No TMAO was found in feces. A DMA-complex was detected in urine and feces. It amounted to about 13% of the dose in mice and 15% in hamsters. About 80-85% of the dose was eliminated in urine and feces in the form of unmetabolized DMA. No demethylation of DMA to inorganic arsenic was observed. In man, about 4% of the dose was excreted in urine as TMAO and about 80% as DMA. PMID- 3624767 TI - Mechanisms of toxicity of 2- and 5-hydroxy-1,4-naphthoquinone; absence of a role for redox cycling in the toxicity of 2-hydroxy-1,4-naphthoquinone to isolated hepatocytes. AB - The mechanisms of toxicity to isolated rat hepatocytes of two structurally related naphthoquinones have been studied. Both 5-OH-1,4-naphthoquinone (5-OH-1,4 NQ; juglone) and 2-OH-1,4-naphthoquinone (2-OH-1,4-NQ; lawsone) caused a concentration-dependent cytotoxicity to hepatocytes which was preceded by a depletion of intracellular glutathione. 5-OH-1,4-NQ caused a depletion of intracellular glutathione when incubated either at 4 degrees C or 37 degrees C whereas 2-OH-1,4-NQ caused a depletion of intracellular glutathione when the hepatocytes were incubated at 37 degrees C but not at 4 degrees C. 5-OH-1,4-NQ but not 2-OH-1,4-NQ reacted with glutathione in buffered solution. These results suggested that the depletion of intracellular glutathione by 2-OH-1,4-NQ is enzyme mediated whereas in the case of 5-OH-1,4-NQ the direct chemical reaction with gluathione may be largely responsible for the depletion. A critical role for depletion of protein thiols in menadione-induced cytotoxicity has been proposed. In agreement with earlier work, menadione caused a decrease in protein sulphydryls prior to cell death, however, at cytotoxic concentrations of both 2 OH-1,4-NQ and 5-OH-1,4-NQ this decrease only accompanied rather than preceeded cell death. The mechanism of toxicity of 5-OH-1,4-NQ is similar to that of other naphthoquinones and involves formation of its corresponding naphthosemiquinone, active oxygen species and redox cycling as it stimulated a disproportionate increase in both microsomal NADPH oxidation and oxygen consumption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624768 TI - Changes in cerebral glycogenolysis and related enzymes in diazinon treated hyperglycaemic animals. AB - Effect of diazinon (10,20 and 40 mg/kg, i.p.) on the level of blood glucose in rats was investigated. Hyperglycaemia peaked 2 h after i.p. treatment with 40 mg/kg diazinon. The cerebral acetylcholinesterase activity was significantly reduced. The blood level of pyruvic acid was unchanged while that of lactic acid was significantly increased. Convulsions and biochemical changes caused by diazinon (40 mg/kg) were prevented by diazepam injected immediately after diazinon. In diazinon-treated hyperglycaemic animals, the glycogen content of the brain was depleted, the activities of glycogen phosphorylase, phosphoglucomutase and hexokinase were significantly increased and the activity of glucose-6 phosphatase remained unchanged. Lactate dehydrogenase activity was also increased by treatment with diazinon. The induced changes may compensate for the energy requirement of stimulatory effects caused by diazinon. PMID- 3624769 TI - A 13-week vapor inhalation study of 3,3-dimethyl-2-butanol in Sprague-Dawley rats. AB - Four groups of male and female Sprague-Dawley rats were exposed for 13 weeks to 3,3-dimethyl-2-butanol (PA) at concentrations of 0.00, 0.20, 1.00 or 5.00 mg/l (1 mg/l = 240 ppm). Exposures were for 6 hr per day, 5 days per week with sacrifices at 7 and 13 weeks of exposure, and at 4 weeks after exposure. The test animals were evaluated for abnormalities in physiology, behaviour, clinical laboratory parameters, and gross and microscopic morphology. No abnormalities were detected in electrocardiograms, respiratory indices, spontaneous activity, passive avoidance activity and open-field behaviour. Clinical signs related to PA exposure included alopecia, ataxia and lacrimation. There were no biologically significant between-group differences in body-weights during the study. The clinical laboratory data demonstrated a 30% increase in serum cholesterol and bilirubin at 7 weeks in high-dose males and an increase in urea nitrogen in intermediate and high-dose males at 13 weeks. There were no abnormalities in hematologic or coagulation parameters. At necropsy there were no significant gross abnormalities; however, examination of organ weights revealed enlarged kidneys in high-dose male rats at 13 weeks, enlarged ovaries in high-dose female rats at 13 weeks, and microscopic study of tissue sections revealed minimal to mild renal tubular injury in high and possibly intermediate dose males at several sacrifices. These findings suggest that the primary target organ of PA, when given by inhalation, is the kidney in male rats and possibly the ovary in female rats. The renal changes in the high-dose males were not fully reversible during the recovery period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624770 TI - Measurement of polycyclic aromatic hydrocarbons and other pollutants. AB - A single point study of atmospheric pollution has been carried out in Granada (Spain); suspended particulate matter, sulphur oxides, ammoniac, nitrogen dioxide and polycyclic aromatic hydrocarbons were determined. There were variations in relation to the month and the day of the week. The PAHs have been determined through HPLC, with a mobile phase of acetonitrile-water (75-25). The results of measurements of benzo(a)pyrene were between 1.006 and 0.485 micrograms m-3 in two different periods of sampling. PMID- 3624771 TI - Sensory irritation of methylisocyanate vapor. AB - The respiratory-depression (RD) profile in mice exposed to methylisocyanate (MIC) vapor is reported. The RD50 value calculated from this profile was 2.9 (2.7-3.2) ppm. Concentrations of MIC that have been reported to be unbearable in humans were of approximately the same magnitude as RD50 concentrations in mice for brief exposures. PMID- 3624772 TI - Comparison of effects of ozone, cadmium chloride and carbon tetrachloride on [14C]antipyrine metabolism in conscious rats. AB - Previously, Graham et al. found evidence that pentobarbital-induced sleeping time was enhanced in various animals following exposure to 1 ppm of ozone in air. The present study was undertaken to investigate whether similar ozone exposure would cause inhibition of metabolism of another model drug, [14C]antipyrine, in conscious rats. Furthermore, this study also investigated whether, like that of ozone, other lipid-peroxidizing agents such as cadmium and carbon tetrachloride would affect metabolism of [14C]antipyrine in conscious rats. The results showed no significant effect of ozone exposure on subsequent metabolism of [14C]antipyrine in conscious rats as revealed by very similar 14CO2 exhalation rate (CER)-time profiles before and after ozone treatment under various exposure protocols. Even though the exposure to ozone caused no inhibition of antipyrine metabolism in conscious rats, cadmium and carbon tetrachloride, on the other hand, markedly inhibited metabolism of this model drug. In agreement with the reported sex-difference in toxic effects of cadmium, during the present study the cadmium-induced inhibitory effect on the CER-time profiles was observed in male but not in female rats. In contrast, no clear sex-dependency was noted in the inhibitory effect of carbon tetrachloride on [14C]antipyrine metabolism. PMID- 3624773 TI - Structure-nephrotoxicity relationships for meta-substituted N-phenylsuccinimides. AB - The N-phenylsuccinimides are being evaluated as experimental agricultural fungicides. The purpose of this study was to examine the relationship between the electron withdrawing or electron donating properties of phenyl ring substituents on meta-substituted N-phenylsuccinimide (NPS) derivatives and the nephrotoxic potential of the corresponding fungicides. Male Fischer 344 rats were administered a single intraperitoneal injection of a succinimide (0.4 or 1.0 mmol/kg) or vehicle (sesame oil, 2.5 ml/kg), and renal function monitored at 24 and 48 hr. Non-halogen-substituted NPS derivatives produced little evidence of nephrotoxicity at the doses used in this study. Among the meta-halogen derivatives of NPS, N-(3-chlorophenyl)succinimide (NCPS) was the most nephrotoxic. NCPS-induced nephrotoxicity was characterized by diuresis, proteinuria, hematuria, elevated blood urea nitrogen (BUN) concentration, decreased organic ion accumulation and proximal tubular necrosis. However, all renal effects produced by NCPS were mild to moderate. These results suggest that the electron withdrawing or donating property of a functional group is not a good predictor of the nephrotoxic potential for the corresponding fungicide. In addition, lipophilicity did not correlate with nephrotoxic potential for the meta substituted NPS derivatives evaluated in this study. PMID- 3624774 TI - Teratologic studies on Alcide Allay gel in rabbits. AB - Alcide Allay gel, a highly effective germicidal compound, was evaluated for teratogenic potential in rabbits. Pregnant rabbits were administered 2 g/kg Allay gel (containing either of two concentrations of sodium chlorite as active ingredient) or placebo topically on days 6-18 of gestation. Moderate to severe erythema was recorded in the high-dose gel group on day 11 (Draize score = 3.5). By day 18, the skin of all rabbits in the high dose treatment group appeared normal. Decreased maternal body weight gain was observed in the low dose and placebo gel groups. Fetal weights and lengths were significantly reduced in all gel groups. There was some incidence of skeletal anomalies in all gel treated groups, however, these incidences were not statistically different from the control group. The commonly occurring skeletal defects were incomplete ossification of skull bones, small or missing sternebrae, and extra ribs. The incidence of visceral abnormalities in all gel groups was not statistically different from control animals. Visceral anomalies included heart displacement, fusion or serration of the liver, and kidney displacement. Alcide Allay gel at 2 g/kg was non-teratogenic to rabbit fetuses. PMID- 3624775 TI - Early biochemical alterations in liver mitochondria from carbon tetrachloride poisoned rats. AB - Covalent binding of reactive metabolites of 14CCl4 were found 1 or 3 h after treatment with the solvent in the lipid and protein fractions of highly purified liver mitochondrial of rats. Most of the label was found in the phospholipid (PL) fraction, much less in cholesterol esters (ChE), and only minor quantities in other lipids. The reactive metabolites of 14CCl4 activated by isolated mitochondria interact mostly with ChE and far less with PL and other fractions. Both in vivo and in vitro covalent binding to PL is decreasing in the following order: phosphatidylethanolamine greater than diphosphatidylglycerol greater than phosphatidylcholine greater than sphingomyelin greater than lysophosphatidyl choline. No evidence of lipid peroxidation was found in liver mitochondrial lipids in the first 6 h and only a slight tendency of decrease in arachidonic acid concentration at 24 h. The incorporation of [14C] leucine in mitochondrial, microsomal or cytosolic proteins decreased as early as 1 h after treatment. These results, in agreement with previous reports suggest the existence of multiple sites in liver cells for the activation of CCl4. The transport of altered phospholipids and proteins and the inhibition of protein synthesis might contribute to the propagation of damage from the endoplasmic reticulum to other organelles. PMID- 3624776 TI - Pithomyces chartarum spore counts in rumen contents and faeces of sheep exposed to autumn pasture at three different grazing pressures. AB - Three groups, each of 18 lambs were grazed during autumn in paddocks which had been divided longitudinally by temporary fencing to give twofold differences in grazing intensity between the groups. During the period when spore numbers were elevated the high grazing pressure (HGP) group lost some body weight (-34 g/day). The low grazing pressure (LGP) group gained +90 g/day and the intermediate grazing pressure (IGP) group gained weight slightly (+14 g/day). There were two spore rises during the experimental grazing period, a minor and a major rise. Peak pasture spore counts were 88,000, 130,000 and 282,000 spores/g grass for the LGP, IGP and HGP groups respectively. These were reflected in the peak rumen content counts which were 6640, 17,050 and 24,470 spores/g and the faecal peak counts which were 141,400, 330,800 and 568,200 spores/g for the LGP, IGP and HGP groups respectively. Liver injury scores were 0.9, 2.6 and 1.7 and peak mean serum GGT levels were 139,312 and 220 U/l for the LGP, IGP and HGP groups respectively. The greater liver injury in the IGP groups was considered due to the greater total consumption of spores caused by the combination of pasture spore concentration and dry matter intake. PMID- 3624777 TI - Effects of the exposure profile on the inhalation toxicity of carbon tetrachloride in male rats. AB - To examine the effect of the exposure pattern on the inhalation toxicity of carbon tetrachloride (CCl4) two 4-week inhalation studies with this compound were carried out in male rats at basic exposure concentrations of 63 and 80 ppm and basic exposure periods of 6 hours per day, 5 days per week. The two main variables studied were interruption of the daily 6-hour exposures by 1.5 hours (2 X 3-hour exposures with a non-exposure interval of 1.5 hour), and peak loads of 5 7 times the basic concentration with or without 1.5-hour interruption of the daily 6-hour exposures. Adverse effects of CCl4 included abnormal activities of several enzymes in serum and liver, decreased quantity of microsomal proteins in the liver, increased relative liver weight, and hydropic and fatty degeneration of hepatocytes. As compared with uninterrupted, interrupted exposures increased more the activities of glutamic oxalacetic and glutamic pyruvic transaminase in serum; peak exposures only slightly affected these enzyme activities. Uninterrupted exposures caused less severe fat accumulation in and hydropic degeneration of liver cells than interrupted exposures with or without peak loads. In addition, uninterrupted exposure to 63 ppm CCl4 with peak loads resulted in more severe hydropic liver degeneration than uninterrupted exposure to the same concentration without peak loads. It was concluded that interruption of the daily 6-hour exposures by 1.5 hour did not result in less severe but rather in slightly more severe hepatotoxicity, and peak loads superimposed on a fixed concentration only slightly aggravated the toxic effects of CCl4 on the liver. PMID- 3624778 TI - Differential response of NADP-linked hepatic aldehyde dehydrogenase toward taurine: implication for behavioural effects of ethanol. AB - The effects of taurine, its initial precursor L-cysteine, and the major metabolite taurocholic acid on two ethanol-mediated responses in rodents were studied. Administration of a single dose of taurocholic acid reduced voluntary intake of a 5% ethanol solution by the rat. In the mouse, taurine had no effect on alcohol drinking or on the central depressant action of ethanol, as measured by the duration of ET-produced loss of the righting reflex. Likewise, taurocholic acid and L-cysteine did not significantly influence the duration of ethanol narcosis time from control mice. Also studied were the effects of acute and short term (7 or 10 days) administration of these compounds on hepatic ethanol and acetaldehyde metabolizing enzymes. Short-term administration of an equimolar concentration of taurine enhanced endogenous NADP-linked rat liver aldehyde dehydrogenase (L-ALDH) as contrasted with inhibition of the same enzyme by L cysteine. Short-term (7 days) treatment with L-cysteine induced rat liver NAD linked ALDH, but acute (single dose) treatment did not. Taurocholic acid short term administration caused an induction and an inhibition of endogenous mouse liver alcohol dehydrogenase (L-ADH) and L-ALDH, respectively. The results suggest that taurine does not directly interact with ethanol. However, its major metabolite, taurocholic acid, may cause rapid metabolic conversion of ethanol to acetaldehyde by induction of L-ADH, which is then slowly metabolized due to a concomitant inhibition of L-ALDH. This may cause a build-up of acetaldehyde and thereby produce adverse reactions similar to those resulting from the combination of disulfiram and ethanol. PMID- 3624779 TI - The effects of cardioteratogenic doses of caffeine on cardiac function in the 3 day chick embryo. AB - The effects on embryonic cardiac function of caffeine administration (two non cardioteratogenic and two cardioteratogenic doses) to Hamburger-Hamilton stage 19 (3-3 1/2 days of incubation) chick embryos were investigated. Using microcinephotoanalysis, we have determined that caffeine (1.0-4.7 mg/egg), within the initial three hours after treatment, produced a dose-dependent decrease in end diastolic volume, stroke volume, cardiac output, and ejection fraction. These effects were sustained for a longer period of time following dosing at a cardioteratogenic level (3.5-4.7 mg/egg). Caffeine (1.0-4.7 mg/egg) also increased cardiac rate with a maximum increase of 30% seen 60 minutes after treatment with doses of 2.7 mg and 3.5 mg. However, the increase in cardiac rate was not related to dose. At 20 hours after treatment, caffeine increased stroke volume, ejection fraction and cardiac output relative to the controls. End diastolic volume and cardiac rate were not changed. These results are evidence for a biphasic effect of cardioteratogenic dosing with caffeine during the first 20 hours after treatment--initially a sustained decrease in cardiac output, suggesting decreased flow through the embryonic heart, followed by an increase in ejection fraction, suggesting increased cardiac workload. PMID- 3624780 TI - Acute effects of isopropyl alcohol exposure on the middle ear mucosa. AB - Guinea pigs were exposed to 400 ppm or 5500 ppm of isopropyl alcohol (IPA) for 24 successive hours, and then middle ear mucosal samples in both proximal and distal sites to the eustachian tube were obtained for functional and morphological examinations. The ciliary activity was examined according to the photoelectric method of Ohashi and Nakai. The morphology of the middle ear lining was examined by transmission electron microscopy. The results showed that IPA at the allowable level of 400 ppm has an acute effect on the mucociliary system of the middle ear mucosa. Recovery from damage occurs within two weeks. At higher levels of exposure to IPA (more than 10 times the allowable level) moderate deterioration of the ciliary activity and severe damage of epithelial cells were observed and recovery within two weeks was not seen. It is concluded that IPA at the allowable level of 400 ppm does not cause significant middle ear disorders, but workers exposed to higher levels of IPA should be given careful otolaryngological examinations and follow-up observations. PMID- 3624781 TI - A comparison of a sheep bioassay and a chemical assay used to estimate the toxicity of lupin stubbles infected with Phomopsis leptostromiformis. AB - Fifteen lupin stubble samples were tested for toxicity using a sheep bioassay and a chemical assay. A good association, in the functional form of a quadratic equation, existed between the results provided by the two assays. Only 16% of the variance of the chemical assay results was not associated with the sheep bioassay results. PMID- 3624782 TI - The assessment of chemically induced liver injury in rats. AB - The object of this investigation was to study the relationship between acute hepatic injury and blood coagulation. Most of the clotting factors are synthesised by the hepatocytes and therefore it would seem likely that hepatic injury would lead to an impairment of blood clotting. Dimethylnitrosamine (DMN) and carbon tetrachloride (CCl4) were selected as model hepatotoxins to induce an acute hepatic lesion. Single doses of each compound were administered to male rats and groups of animals killed 3, 6, 16 and 24 h later in order to study the morphological development of the lesion and to relate this to changes in the haematological profiles. Both compounds produced a centrilobular necrosis, but with DMN there was a haemorrhagic component due to damage to endothelial cells, which contrasts with the classical coagulative necrosis produced by CCl4. After 6 h apoptosis was commonly seen in the centrilobular areas of the DMN treated rats. This process of cell death has not previously been demonstrated in chemically induced acute hepatic injury and was not seen in the CCl4 treated rats. Significantly prolonged clotting times were seen in both DMN and CCl4 treated rats and occurred in parallel with some of the early morphological changes but prior to the appearance of extensive haemorrhagic or coagulative necrosis. This preliminary data suggests that the measurement of blood coagulation times may provide a relatively specific and sensitive indicator of acute hepatic injury in rats. PMID- 3624783 TI - Development of a reconstituted water medium and preliminary validation of the frog embryo teratogenesis assay--Xenopus (FETAX). AB - A reconstituted water medium was developed for use in the Frog Embryo Teratogenesis Assay--Xenopus (FETAX). FETAX solution was then tested on three compounds with known mammalian teratogenicity (ethanol, caffeine, and 5 fluorouracil) as was a non-teratogen (saccharin). The results obtained were then compared with results from tests on these compounds in two other media that had previously been used in the assay. Saccharin was not teratogenic. Ethanol and caffeine were weak and moderate teratogens, respectively. 5-fluorouracil was a strong teratogen. The results compare favorably with those obtained in mammalian studies. The amount of growth inhibition in embryos in the 96 h tests was positively correlated with the degree of teratogenicity of the compound. Final validation of FETAX will allow it to be used to screen and rank compounds for further testing and as a tool for studying the basic mechanisms of teratogenesis. PMID- 3624784 TI - Acute and subchronic toxicity of tetramethylcyclohexanes. AB - The acute oral toxicity in rats was estimated for seven isomers or isomeric ratios of tetramethylcyclohexane (TMCH). Lack of sufficient mortality at the highest dosage test (15.8 g/kg) precluded evaluation of an LD50 for mixed cis, trans-isomers of 1,2,3,4-TMCH, 1,2,3,5-TMCH, 1,2,4,5-TMCH and 1,1,2,3-TMCH, for the separate cis- or trans-forms of 1,1,3,5-TMCH or a 1:1 mixture of c,t-1,1,3,5 TMCH and c,t-1,2,3,4-TMCH. Mixed (c,t-combined) isometric TMCH was administered orally to rats (30/group) and dogs (8/group) for 90 days at dietary levels of 0, 3000, 10,000 and 30,000 ppm TMCH and 0, 100, 300 and 1000 ppm TMCH, respectively. Administration of up to 30,000 TMCH to rats produced no discernible effects on survival, behavior, growth, food consumption, clinical blood picture or urine analysis. Absolute kidney weights of male but not female rats were elevated at all test levels. TMCH-related microscopic lesions were confined to the kidney of male rats in all treated groups. These histopathologic changes were characteristic of tubular nephrosis. No treatment-related effects were observed in groups of dogs fed up to 1000 ppm TMCH for 90 days. PMID- 3624785 TI - Aluminium induced damage of the lysosomes in the liver, spleen and kidneys of rats. AB - The influence of repeated aluminium (Al) administration (0.05 or 0.5 mg 100 g-1 b.w.t. i.p. 5 times weekly for 12 weeks) on the lysosomal enzymes N-acetyl-beta-D glucosaminidase (beta-NAG) and beta-glucuronidase (beta-Gluc) in serum, liver, spleen and kidneys of adult female rats with intact kidneys, (NR), or following partial nephrectomy (5/6 NX) was investigated. After A1 loading, at the high dose only, the beta-NAG in serum and the free beta-NAG in liver, spleen and kidneys increased. Latent beta-NAG levels decreased in all three organs the effect being dose related. Following A1 loading no elevation in total enzyme activity was observed, with one exception. Depending on A1 doses the spleen of the non operated animals, the liver of both groups of animals and the serum showed a decrease in beta-Gluc activity. No effect on beta-Gluc activity was observed in the spleen of 5/6 NX animals or in the kidneys of either group of animals. The results confirm that high doses of Al induce toxic effects and damage the lysosomes in the liver, the spleen and the kidneys. The results indicate that the extent of lysosomal damage correlates with dose and duration of Al loading. Repeated administration of Al also interferes selectively with enzyme synthesis. PMID- 3624786 TI - Toxicological profile of orally administered 1,6-hexane diamine in the rat. AB - The industrial chemical 1,6-Hexane Diamine, or hexamethylenediamine (HMD), has an acute oral LD50 of 980 mg kg-1 in rats. Dietary administration of HMD to groups of rats for 3 months at dosages of 0, 50, 150, and 500 mg kg-1 resulted in a modest retardation in weight gain at the two higher test levels. No other obvious signs of toxicity or changes in the peripheral blood picture or selected clinical pathology parameters were found at any test level throughout the study. Evaluation of absolute and relative weights of 10 selected organs, as well as complete necropsies and microscopic evaluation of over 30 selected tissues and organs, revealed no changes considered related to treatment. The administration of HMD by gavage to pregnant rats at 0, 112, 184 and 300 mg kg-1 day-1 on days 6 15 of pregnancy (day 1 = day sperm detected) did not induce any teratogenic effects. Signs of maternal toxicity were observed only at 300 mg kg-1 day-1. Embryotoxicity was observed at both the 300 and 184 mg HMD kg-1 day-1 dosage levels. No treatment-related effects were observed at 112 mg HMD kg-1 day-1. PMID- 3624787 TI - Role of exposure parameters in toxicity of aerosolized diesel fuel in the rat. AB - Sprague-Dawley rats were exposed to aerosolized diesel fuel (ADF) to determine the potential health effects in military troops during exposure to this visual obscurrant. Acute range finding studies were performed to estimate exposure conditions at which minimal (less than 1%) mortality would occur. This information was used in the design of a repeated exposure study to test the relative significance of the frequency of exposures, the duration of exposure, and aerosol concentration in any toxicity which might occur. Animals were exposed once or three times per week for a total of nine times to concentrations ranging from 1.3 mg ADFl-1 to 6 mg ADFl-1 and exposure durations of 2 or 6 h. Body weight and food consumption were recorded at weekly intervals during the exposure period and in animals that were retained for 2 weeks after the last exposure. Animals were used for a variety of endpoints, including neurotoxicological tests, pulmonary function tests, hematology, clinical chemistry, organ weights, and histopathology, either within 2 days of the last exposure or after the 2-week recovery period. Animals exposed to ADF showed an initial depression in body weight followed by a slower rate of growth than the sham exposed controls. No exposure related changes were observed in any of the neurotoxicology assays. The lung was the primary site of toxicity. Focal accumulations of pulmonary free cells were observed histologically, with thickening and hypercellularity of nearby alveolar walls. The number of lavaged pulmonary free cells increased similarly. Both pulmonary wet and dry weights increased. Lung volumes were altered by exposure, including increased FRC and decreased TLC. Carbon monoxide diffusing capacity was decreased. Histologic abnormalities were not observed in any other organs. Of the exposure parameters tested, the frequency of exposure appeared to be the most significant in relation to degree of toxicity. PMID- 3624788 TI - Maternal toxicity, embryolethality and abnormal fetal development in CD-1 mice following one oral dose of T-2 toxin. AB - An experiment was undertaken to determine the teratogenic effect of oral administration of T-2 toxin, a trichothecene mycotoxin. Firstly, a dose response study using 0, 0.5, 1.0, 2.0, 3.0, 3.5 and 4.0 mg/kg T-2 toxin in propylene glycol, on day 9 of pregnancy, was undertaken. Maternal deaths and toxicity was noted in the 4.0 and 3.5 mg/kg groups post-toxin administration. These groups gained less weight throughout gestation than the rest of the groups, because no fetuses were found in the 4.0 mg/kg group and the 3.5 mg/kg group had significantly fewer fetuses than the remaining groups. The total fetal weight was similar among all groups with fetuses, and normal sex ratio of offspring was seen. More major and minor defects were seen in the 3.0 mg/kg T-2 toxin treated group than any other group. Secondly, a day response trial using a single dose of 3.0 mg/kg T-2 toxin given on either days 6, 7, 8, 10, 11 or 12 of gestation was undertaken. Maternal mortality, with placental hemorrhage, was observed. Fetal loss was greater in the T-2 toxin treated groups than in the starved controls. The greatest number of dead term fetuses was seen in mice treated on day 9 of gestation. Normal sex ratios were present in the offspring. Major skeletal defects were more numerous in mice treated on day 7 of gestation, whereas minor defects, retardations and variants were more common in mice treated on day 8. It was concluded that a single oral dose of T-2 toxin in propylene glycol is primarily maternotoxic and embryolethal, and that defective development was possibly secondary to maternal toxicity. PMID- 3624789 TI - Nuclear enlargement produced in mouse skin by carcinogenic mineral oils. AB - Ten oils of differing origin, degree of refinement and carcinogenicity, were examined for their ability to produce nuclear enlargement in mouse skin following repeated topical exposure over a 3 day period. Application of the oils was made in a vehicle of methyl ethyl ketone incorporating a promoter and assessment of epidermal nuclear size was made on tissue sections using a Quantimet 720 image analyser. One of the oils reported to be non-carcinogenic, was examined initially and its inability to induce enlargement of nuclei beyond the size seen in hyperplastic skin was confirmed. The same oil was then examined in combination with benzo(a)pyrene (BaP) and, from the dose-response obtained, it was clear that the oil did not prevent BaP induced nuclear enlargement. The other nine oils were examined by comparing them with the previously tested non-carcinogenic oil. Two oils gave rise to clear nuclear enlargement; these were non-solvent refined and gave rise to skin tumours in reported long-term studies. One solvent-refined oil, which gave a single papilloma in reported long-term studies, gave borderline (non significant) nuclear enlargement; whereas the other solvent-refined oils, including five reported as non-carcinogenic and one reported as having weak (questionable) carcinogenic activity, gave no nuclear enlargement. Further examination of the data suggested that, within the limited series of oils examined, nuclear enlargement under these test conditions correlated well with carcinogenicity and might be used for predicting the skin carcinogenicity of an oil. Studies on a further 23 oils, on which long-term studies have been carried out but not published, support this conclusion. PMID- 3624790 TI - Increases in plasma catecholamines during naturally elicited defensive behavior in the cat. AB - Defensive behavior was evoked in 12 adult cats by the presentation of both interspecific (barking dog) and intraspecific (hypothalamically stimulated cat) stimuli. Each stimulus was presented 3 times. Concomitant activation of the sympatho-adrenal (SA) system was evaluated by radioenzymatic assay of plasma norepinephrine (NE) and epinephrine (E). The somatic and autonomic displays which accompanied defensive behavior were similar between stimuli, consisting of mydriasis, piloerection, growling, hissing and paw strikes. However, the sympatho adrenal responses associated with interspecific and intraspecific defensive behaviors were different. Interspecific defensive behavior was accompanied by adrenal medullary release of both NE and E, which decreased with successive trials. Intraspecific defensive behavior was initially associated with release of E from the adrenal medulla; the pattern of catecholamine release in successive trials suggested that in later trials NE was released primarily from the sympathetic nerves. Furthermore, increases in plasma NE and E, as well as increases in heart rate and mean arterial blood pressure during the first trial were significantly greater when the behavioral stimulus was a dog. Although aspects of the feline display to threatening stimuli are stereotyped, the data suggest that the sympatho-adrenal response is more specific, and indicates preparation for fighting or escape. PMID- 3624791 TI - Ganglioglomerular nerves respond to moderate hypoxia independent of peripheral chemoreceptors in the cat. AB - The responses of the ganglioglomerular nerve (GGN) to transient changes and steady-state levels of paO2 at a constant paCO2 were studied in 12 anesthetized and spontaneously breathing cats before and after bilateral section of aortic (AN) and carotid sinus nerves (CSN). In two of these cats carotid chemoreceptor activity was monitored simultaneously. Onset of moderate hypoxia, down to paO2 of about 50 Torr, stimulated GGN activity and withdrawal of the hypoxic stimulus promptly eliminated the responses both before and after CSN section. CSN section, however, significantly raised the baseline activity and slightly delayed the GGN response to the onset of hypoxia. These responses to hypoxia are qualitatively similar to the characteristic responses of peripheral chemoreceptors. Thus, the basic oxygen chemosensing mechanism appeared to be present in the sympathetic nervous system, and is expressed in the postganglionic GGN activity. This property allows the sympathetic nervous system to perform physiologically important functions independent of the peripheral chemoreceptors. PMID- 3624792 TI - Cardiac receptors affect regional flow during acute infarction in conscious rats. AB - This study was conducted to determine if cardiac receptors have a role in the control of the regional circulations during small acute myocardial infarction in the conscious rat. Cardiocirculatory dynamics and cardiac output distribution (microspheres) were measured in conscious rats 24 and 48 h after surgery for left main coronary artery ligation or the sham procedure. Data from animals without treatment were compared to data from animals treated to induce chemical cardiac denervation (85% phenol applied to the supraventricular surface of the heart and the root of the great vessels). The results suggest that neurogenic vasopressor stimuli originating from the heart contribute to changes in peripheral resistance secondary to small, acute, experimentally induced myocardial infarction in the conscious rat. PMID- 3624793 TI - Effects of sympathetic nerve stimulation in the presence of specific adrenergic antagonists on Na, K, and Cl transport in perfused rat submandibular duct. AB - The role of beta 1- and beta 2-adrenoceptors in the modification of Na, K, and Cl transport in submandibular main duct of rat perfused with bicarbonate saline solution was studied with direct sympathetic nerve stimulation (4 V, 5 ms, 20 Hz) in the presence of specific adrenergic antagonists. Nerve stimulation in the presence of phenoxybenzamine (3 mg/kg b. wt., i.p.) and butoxamine (3 mg/kg b. w.t., i.p.) enhanced Na (44%) and Cl (35%) absorption but inhibited K (24%) secretion. On the other hand, the nerve-evoked response in the presence of phenoxybenzamine and metoprolol (3 mg/kg b. wt., i.p.) decreased K (19%) secretion without any changes in Na and Cl absorption. Therefore, the data suggest that beta 1- and beta 2-adrenoceptors may be present in the duct cells and activation of these receptors can modify electrolyte transport. Furthermore, prior administration of phenoxybenzamine, butoxamine, and metoprolol suppressed the effects of sympathetic nerve stimulation on transductal fluxes of Na, K and Cl; this indicates that the dosages of antagonists used were sufficiently high to block a nerve-evoked response. PMID- 3624794 TI - [Occlusion of the central retinal vein with occlusion of a cilioretinal artery: apropos of 7 cases]. AB - The seven patients described where suffering from simultaneous occlusion of the central retinal vein and cilioretinal artery. All underwent complete ocular examination including fluorescein angiography and visual field assessment, and general investigation with special emphasis on blood and vascular disorders. All patients had been observed for at least one year. Their age ranged from 35 to 60 years (mean: 46 years); fundus examination showed a common pattern consisting of mild edematous central retinal vein occlusion with few hemorrhages as well as a large area of retinal infarction due to cilioretinal artery occlusion. Despite the presence of this large infarcted area, this cases were very different from the ischemic forms of central retinal vein occlusion since in all cases perfusion of the retinal capillaries in the cilioretinal area recovered in a few days. In 4 of 7 cases, fluorescein angiography also disclosed sectorial hypoperfusion of the optic disc at the acute stage. Recovery of venous occlusion occurred in 3 to 14 weeks and the visual acuity outcome was fairly good, as in 5 of the 7 patients, visual acuity reached at last 0.5. No embolic disease was detected but 3 patients had severe migraine. The pathogenesis of this condition remains unclear. Although cilioretinal infarction is usually thought to be secondary to central retinal vein occlusion, the possible role of primary occlusion of the cilioretinal artery is considered. PMID- 3624795 TI - [Differential diagnosis between retinoblastoma and ocular toxocariasis]. AB - We studied the sensitivity for Toxocara Canis (ELISA technique) in 5 cases of retinoblastoma confirmed by anatomopathological examination. Some presented with a positive reaction in serum and/or in aqueous. Now that surgical technique are available that permit to functionally save eyes affected by toxocariasis, we felt that a safe and reliable differential diagnosis between toxocariasis and retinoblastoma is of major importance. A positive ELISA test even in the aqueous fluid does'nt seem reliable enough for that purpose. We concluded to the necessity to include in preoperative tests some more invasive techniques such as aqueous tap for dosage of lactico-dehydrogenases or vitreous biopsy for cytological examination, at least for the most difficult cases with a positive ELISA test. PMID- 3624796 TI - [The visual field of pseudophakic patients. Perimetric and statistical study]. AB - One hundred and twenty two visual fields were studied in 98 pseudophakic subjects, using cinetic perimetry according to Goldmann, in order to plot the internal (I1), medium (I2) and peripheral (I4) isopters. Computerized processing of data provided average results, allowing the following conclusions: In general, 20% of the total surface is lost in pseudophakia. This loss, as a consequence of prismatic effects of lenses, involves the internal isopters (26%) rather than the peripheral isopters (15%). Individually, these data can be modified by the location of the lens or by the diameter of its optical part: the more anterior or the smaller is the optical part, the narrower does the visual field become. Additional correction, particularly if exceeding 2 diopters is a supplementary factor of reduction. The perimetric consequences of pseudophakia are functionally latent. Nevertheless, the prismatic effects of intraocular lenses could account for the difficulties met in examination of peripheral fundus. PMID- 3624797 TI - [Dacryocystorhinostomy. Retrospective study of 165 cases. Indications. Technic. Results. Comparative study of 25 cases of injury with 165 cases including all etiologies]. AB - A retrospective study of 165 cases of dacryocystorhinostomy (DCR) has been performed in order to establish a relationship between the results and the delay between the initial symptoms and the DCR. The study compares the results obtained in 25 cases of DCR performed for post traumatic injury to those obtained in 165 cases of DCR performed for various etiologies (traumatic cases included). Traumatic cases are more frequent in men 19/ 25 cases (73%); infectious etiologies are more frequent in women 98/ 118 cases. The results are nearly the same for all the etiologies: 87% good results for the overall (147 cases), 88% good results for the traumatic cases (24 cases). The stenosis occurs within the first month in 72% and before the fourth month in all the cases. There is no difference in the results according to the surgical technique however the small number of each group does not allow a statistical analysis. The results are better when the delay between the initial traumatism or the first surgical repair and the DCR is more than six months (15 good results for 15 cases). The results were worse when the delay is less than 6 months (6 success for 9 cases), with p = 0.07 in the statistical analysis. PMID- 3624798 TI - Inhibition of gastric secretion and stress-induced ulcers by intravenous Asu(1,7)eel-calcitonin independent of vasopressin. AB - The effects of different doses of Asu(1,7) eel-calcitonin, peripherally injected, on gastric secretion were studied in conscious Brattleboro rats, which are genetically deficient in vasopressin. Moreover, we evaluated the activity of this analogue on gastric ulcer formation by restraint stress. We found that 5 IU/kg Asu(1,7) eel-calcitonin decreased gastric secretion and inhibited the development of stress-induced ulcers in Brattleboro rats. These data suggest that vasopressin does not play a role in the gastrointestinal activity of Asu(1,7) eel-calcitonin. PMID- 3624799 TI - Long-acting bromocriptine for the acute treatment of large macroprolactinomas. AB - Six patients with hyperprolactinemia, visual impairment and large macroprolactinoma were treated with a long-acting bromocriptine, in dosage of 50 mg as a single im injection. All patients underwent a full assessment of pituitary prolactin (PRL) secretion before treatment and the studies were repeated about every week during 40 days. Following bromocriptine injection a rapid amelioration of the clinical and visual defects occurred in all patients. Likewise, a significant reduction of the hyperprolactinemia was documented in all six patients and in three of them serum PRL levels reached values as low as 20 ng/ml, and a tumor size reduction was demonstrated by cranial computerized tomography in three of the six cases. No side effects were associated with the administration of bromocriptine. From this study we conclude that the long-acting bromocriptine represents an additional option for the initial management of large prolactinomas in particular when they are associated with severe visual impairment. PMID- 3624800 TI - Reduced serum thyroglobulin response to bovine TSH in malignant hypofunctioning solid thyroid nodules: comparison to benign nodular disease. AB - Forty-three euthyroid patients with a single, solid, nonfunctioning thyroid nodule were submitted to fine needle aspiration biopsy and serum thyroglobulin (Tg) was measured before and after (48h) 10 U of bovine TSH. Twenty-two normal subjects were also submitted to the bTSH test. Patients with nonfunctioning nodules were divided in two groups: (I) Benign or Suspicious Cytology (n = 32), (II) Malignant tissue (n = 11). In the latter group all patients underwent surgery and the pathology findings confirmed the presence of thyroid carcinoma. Twenty-one patients with benign or suspicious cytology were also operated upon and the diagnosis was colloid goiter (n = 16) and follicular adenoma (n = 5). In eleven other patients the nodule reduced significantly in size (8) or was no longer palpable after suppressive therapy (3). Normal individuals had a basal serum Tg mean +/- SD value of 12 +/- 7.2 ng/ml and a peak Tg value of 44 +/- 47 ng/ml. Serum Tg values were significantly higher (p less than 0.01) in patients with benign and malignant nodules. However the mean absolute increment (delta Tg) after bTSH was significantly lower (p less than 0.01) in patients with malignant nodules (7.2 +/- 4.8 ng/ml) as compared with normal subjects (22 +/- 16 ng/ml) or subjects with benign nodules (31 +/- 30 ng/ml). The relative (%) serum Tg increment was also significantly lower in patients with malignant tissues (14 +/- 11) as compared to those with benign nodules (77 +/- 86) or normal subjects (247 +/- 173).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624801 TI - Selective availability of protein bound estrogen and estrogen conjugates to the rat kidney. AB - Estrogen glucuronides are selectively cleared by the kidney as compared to estrogen sulfates. The selective trafficking of circulating serum estrogen conjugates to kidney and urine may arise from differential transport properties of the various estrogen conjugates in the renal microcirculation. In the present study, the effects of glomerular and peritubular permeability barriers, and plasma protein binding on the influx of unconjugated and conjugated estrogens into rat kidney were studied. Experiments were carried out utilizing an in vivo double isotope, single injection, timed tissue sampling technique. The extractions of these steroids by the renal cortex were examined utilizing inulin as the reference substance, as it is freely permeable through the glomerular and tubular capillary permeability barriers, but not extracted by tubular epithelial cells. The method was validated by studying the extraction of para-amino hippuric acid (PAH) before and after probenecid treatment. In the absence of plasma proteins, all the estrogens and estrogen conjugates readily diffused through both the glomerular and peritubular capillary permeability barriers and were extracted by tubular epithelia. The addition of 4% albumin to the injection solution led to significant inhibitions of extraction of estradiol (E2) and estrone sulphate (E1 S) only. The extraction of E1-S was reduced to a value less than that of inulin; the extraction of E2 was less than that of control value but significantly more than that of inulin. The addition to the injection solution of human pregnancy sera containing sex hormone binding globulin and albumin was associated with a reduction in the extraction of all estrogens and estrogen conjugates except estriol and E1-S to values approximating that of inulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3624802 TI - Chemotherapy of thyroid carcinoma. AB - On the basis of 8 patients of our own and a survey of the literature, the present state of chemotherapy of thyroid carcinoma is discussed. Chemotherapy is only indicated in cases of progressing disease after exhaustion of all conventional therapies. Only in cases of undifferentiated giant- or spindle-cell thyroid carcinomas can chemotherapy following conventional treatment be approved right from the beginning. The three most widely applied cytostatics are adriamycin, bleomycin and cis-platinum, and it seems that adriamycin monotherapy, is superior to all other therapies, even combinations, except probably for the undifferentiated thyroid carcinoma. In addition to the patient's general condition, a sufficiently high single dose of adriamycin, which should be increased in case of nonresponse, appears to be essential for the therapeutical effect. Due to its low toxicity, especially cardiotoxicity, 4'-epi-adriamycin, which, while being almost as effective, can be applied at higher doses and over longer periods, seems to be promising. Approximately 1/3 of thyroid carcinomas respond to adriamycin monotherapy, the response rate probably being highest for medullary types and lowest for undifferentiated thyroid carcinomas. The highest response is observed in the case of pulmonary metastases, followed by bone metastases and local tumor growth. If thyroid carcinomas respond to chemotherapy- even by no-change behavior only--a prolongation of median survival rates from 3-5 months (nonresponders) to 15-20 months (responders) can be achieved. PMID- 3624803 TI - High prevalence of subacute thyroiditis during summer season in Italy. AB - Eighty consecutive patients with typical subacute thyroiditis were evaluated. Sex distribution showed a higher incidence in females (F/M 3.2/1), with a mean age of 44 yr. In the majority of patients (51/80 = 66%) the onset of the disease was between June and September (46% in July and August). The remaining cases were distributed in the other months without a clear monthly prevalence. These results indicate that the seasonal distribution of subacute thyroiditis is almost superimposable to that of established infections due to some enteroviruses (Echovirus, Coxsackie A and B viruses), suggesting that summer enterovirus infections may be responsible for a large proportion of cases of subacute thyroiditis. PMID- 3624804 TI - Secretion of antimicrobial proteins from the parotid glands of different aged healthy persons. AB - The secretion of three antimicrobial proteins from the parotid glands of 82 generally healthy men and women, 22 to 81 years in age, was examined. No change was observed in the levels of secretory IgA, but statistically significant, modest elevations (approximately 50 to 100%) of lactoferrin, in both unstimulated and stimulated secretions, and lysozyme, in unstimulated secretions, were detected when results were expressed as mg antimicrobial protein/100 ml saliva. However, these alterations were not observed if data were expressed as mg antimicrobial protein/g total protein. Also, no change was detected in an acinar cell exocrine product, the anionic proline-rich proteins, as reported previously by our laboratory. The data are consistent with a maintenance of protective functions in parotid saliva during aging. PMID- 3624805 TI - Culture-age effect on uracil-DNA glycosylase activity in normal human skin fibroblasts. AB - Culture-passage dependent change in the activity of uracil-DNA glycosylase, one of DNA repair enzymes, was characterized in cell-free extracts of normal human fibroblasts from phase II through phase III. During phase II, the enzyme activity was proportional to the DNA synthetic activity in random cultures, and synchronized cells showed the elevation of the enzyme activity only during S phase. However, cell populations of presenescent phase III having retarded growth showed a dysregulated substantial increase of the glycosylase activity during G0 and G1 phases. Finally, the enzyme activity decreased as a linear function of population doubling level during the entire phase III. Werner syndrome (WS) cells also showed a rapid decrease in the enzyme activity during phase III. The thermolability of uracil-DNA glycosylase was identical between presenescent and senescent normal and WS cells. PMID- 3624806 TI - The effect of chronic hydergine treatment on the plasticity of synaptic junctions in the dentate gyrus of aged rats. AB - The number of synapses (Nv), the surface density of contact zones (Sv) as well as the average size (S) of E-PTA stained synapses in the supragranular layer of the dentate gyrus from adult (12 months), old (30 month), and Hydergine-treated old (30 months) rats were measured by using quantitative morphometric techniques. In old animals, Nv and Sv were significantly reduced, whereas S was significantly increased as compared with the values in adult rats. Hydergine (Codergocrine mesylate) treatment of old animals (3 mg/Kg/day for 4 weeks) influenced these three parameters, differentially. The Sv in aged animals receiving Hydergine, relative to that in untreated old rats, was significantly increased; the number and size of synapses in the treated old rats were significantly higher and smaller, respectively, than that in old controls. We interpret the present findings to indicate a modulating effect of Hydergine on the morphological plasticity of synaptic junctions in the dentate gyrus of aged rats. PMID- 3624807 TI - Age differences in the relation between controllability and coping. AB - This study was conducted to examine the relation between generalized and domain specific locus of control and coping strategies as moderated by age differences. Adolescents through older adults were given measures of controllability and coping for both relationship and achievement contexts. For domain-specific measures only, older adults perceived the cause of stressors in both contexts as less controllable than did all other participants. However, no age difference was found in controllability of the outcome. Domain-specific measures were better predictors of coping than generalized measures of locus of control. Domain specific attribution measures were most predictive of the coping mechanism self blame, and this relation was moderated by age and context. Controllability of outcome predicted the use of self-blame among adolescents and, to a lesser degree, among younger adults; internal locus of causality of the stressful event predicted self-blame among older adults. PMID- 3624808 TI - Memory for sex-role consistent and inconsistent actions in young and old adults. AB - Adult age differences in the flexibility of schematic processing were examined by measuring the degree to which a dominant structure (traditional sex-role knowledge) interfered with the operation of a nondominant structure (nontraditional knowledge). In two experiments, young and old adults read statements describing a man performing actions consistent or inconsistent with a prescribed sex role in an impression-formation task. Participants in both age groups altered their processing of the actions, as indicated by reading times and trait ratings, relative to the sex role emphasized, although the effect was stronger for men than women. The expected greater recall for sex role inconsistent than consistent actions was observed only when the traditional sex role was emphasized, and not when the nontraditional role was emphasized, suggesting interference from the dominant schema at recall. However, the lack of age differences in the degree of interference observed during initial processing and recall suggests no aging effects on schematic flexibility. PMID- 3624809 TI - Diagnostic errors using the Short Portable Mental Status Questionnaire with a mixed clinical population. AB - The validity of the Short Portable Mental Status Questionnaire (SPMSQ) was evaluated using two criteria: clinical diagnosis and neuropsychological diagnosis. The 40 study participants represented a mixed clinical sample of neurologic and psychiatric patients, all of whom were or had been inpatients. Laboratory data (CT, EEG, etc.) were available for 45% of the patients. Neuropsychological diagnosis of organic impairment was based on an extensive test battery. The SPMSQ did not significantly relate to either clinical or neuropsychological diagnosis. It is recommended that a "normal" score on the SPMSQ be regarded as nonspecific regarding organic cognitive impairment rather than suggestive of normal brain functioning. PMID- 3624810 TI - What kind of noise increases with age? AB - It was hypothesized that internal representations of visually presented stimuli are noisier because of higher random neural activity or less precise relations among neuronal units in the central nervous systems (CNSs) of older persons than in younger persons. The rationale for and results from manipulations designed to examine predictions derived from this hypothesis are discussed. Age-related differences in an incomplete picture-identification task were found to be similar to those resulting from the addition of random background noise in stimulus displays of young adults. PMID- 3624811 TI - Social networks in adult life and a preliminary examination of the convoy model. AB - This paper examines the social support networks of older adults. Based upon the Kahn and Antonucci (1980) life course social support model, a national sample of adults aged 50 and older (N = 718) was interviewed, generating support networks consisting of an average of 8.9 members. The respondents were asked questions of the structural (e.g., age, sex, closeness, years known, proximity, and frequency of contact) and functional (number and type of supports provided and received) characteristics of their social networks. These characteristics and relationships are described in detail. PMID- 3624812 TI - Double jeopardy to health for black older adults? AB - Previous health research on the double jeopardy of being Black and old is largely based upon subjective assessments of health. This article discusses the measurement of health with the understanding that health indicators vary in their degree of objectivity/subjectivity and examines the double jeopardy thesis with data from a national sample of older adults. The results indicate that older Blacks tend to have poorer health, as judged by perceived health and disability, than older Whites. However, there is no evidence that the health differential between elderly Whites and elderly Blacks varies with age; the results do not support the double jeopardy hypothesis. The analysis also illustrates ways to assess the difference of effects in a multivariate model applied to more than one group. PMID- 3624813 TI - Residential moves by elderly persons to U.S. central cities, suburbs, and rural areas. AB - The 1975-1980 migration stream and net migration patterns of persons younger than 65 and 65 + were examined using data from the 1980 U.S. Census. Central cities and suburbs of metropolitan areas (SMSAs) and nonmetropolitan areas (NonSMSAs) were distinguished as origins and destinations. Most elderly movers relocated within a fairly limited geographic context and revealed strong preferences for metropolitan living. Suburban locations were more favored than central city locations. Net migration findings may provide misleading interpretations of older movers' locational choices. The migration patterns of the 65 + population were similar to those of the 45- to 64-year-old population but differed from those of the more youthful U.S. populations. These findings highlight migration streams of elderly movers who likely have experienced changed in their life styles or personal resources. PMID- 3624814 TI - Characteristics of lung cancer in elderly patients. AB - In order to assist in the definition of the natural history of lung cancer in the elderly population, a number of biological characteristics were studied, retrospectively, by comparing previously abstracted data from a cancer registry for three cohorts of patients: young (ages 40 to 50, n = 364), middle-aged (ages 51 to 69, n = 822), and elderly (ages 70 and above, n = 209). Compared to the younger cohort, the elderly cohort demonstrated more presenting symptoms of dyspnea, fewer symptoms of chest pain but a similar frequency of weight loss as a presenting sign. The elderly cohort contained more chronic, comorbid diseases but demonstrated more localized cancer and less metastatic disease compared to the younger cohorts. More than 80% of both groups did not undergo surgical resection. We conclude that elderly patients may be a relevant subgroup of lung cancer patients who must be included in studies of new strategies for disease detection, treatment, and management, and the identification of biological characteristics that could further define this high-risk subset of cancer patients. PMID- 3624815 TI - Compliance to treatment for hypertension in elderly patients: the SHEP pilot study. Systolic Hypertension in the Elderly Program. AB - Assessing the compliance of people over 60 years of age and older with an antihypertensive treatment regimen was a major objective of the Systolic Hypertension in the Elderly Program (SHEP) pilot study. The study randomized 551 men and women over the age of 60 (mean age = 72 years) to a stepped care treatment that included chlorthalidone or placebo in a double-blind trial. Three measures of compliance to treatment protocol--pill count, self-report, and a urine chlorthalidone assay--all indicated high levels of compliance in 80 to 90% of participants at 3 months and 1 year after randomization. Pill-taking compliance was similar in the active and placebo groups, although the rate of discontinuance from study medications at 1 year was higher in the placebo than in the active group. Compliance was high in all age categories, including those over age 80. These data suggest that elderly patients can achieve high levels of compliance with antihypertensive medications. PMID- 3624816 TI - Use of two-dimensional grid patterns to limit hazardous ambulation in demented patients. AB - Ambulation into potentially dangerous areas or away from necessary monitoring can be a problem for demented patients and their care providers. Current methods of controlling hazardous ambulation usually involve restraint, medication, locked doors, or physical intervention. Capitalizing on the observation that many demented individuals perceive two-dimensional patterns as barriers, we laid out masking tape in different grid patterns in an attempt to prevent ambulation through exit doors. The baseline condition (no tape) yielded a 98% exit-door contact for 8 demented male patients, but the addition of horizontal grids reduced exit-door contact to 42%. Often, complete prevention occurred at the first experimental trial. Advantages and cautions inherent in this approach to managing wandering by demented patients are discussed. PMID- 3624817 TI - [Spontaneous fetal mortality. Role of maternal age, parity and previous abortions]. AB - Analysing the reproductive biographies of samples of women has made it possible to clarify the role of various factors in bringing about a risk of spontaneous fetal death during the reproductive life of the mother. However, attention must be paid to the difficulties in observing the cases and measuring parameters. To make the various features comparable it is necessary to distinguish between apparent intra-uterine mortality (the pregnancy being diagnosed by the woman), recognisable (the pregnancy is diagnosable clinically) and total (from the time of fertilisation). The effect of maternal age is definite and quite independent of parity. Apparent intra-uterine mortality rises from about 120 per 1,000 pregnancies at the age of 20-24 to 200 per 1,000 at 35-39 and 270 per 1,000 at 40 44. If there has been no previous abortion the risks generally are less than 150 per 1,000, but if there has been even one previous abortion they become practically double. This discontinuity can be interpreted as showing the existence of marked changes between women as far as this risk is concerned. PMID- 3624818 TI - [Prenatal origin of parent-child relations. I. Attempt at a schema of development]. AB - All over the world in recent years the increasing awareness of the importance of the relationship between parent and child for the perinatal period has led to changes in the practices of maternity units. Unfortunately, concentrating on the perinatal period has turned attention away from the interaction of the parent with the child over a much longer period before and after birth. We suggest that, under favourable conditions, there is a psychobiological development of the relationship that exists in the perinatal period which has developed in parallel with the physical development of the fetus. This article suggests how the normal process of the antenatal development occurs in this reference and points out certain psycho-social difficulties that can interfere with its progress. Our thesis is that it is essential to understand this process as part of the complete care given in obstetrics. PMID- 3624819 TI - [Vaginal ulceration induced by abuse of tampons]. AB - A large vaginal ulcerated area which came about because super-absorbant tampons had been worn for three years is reported. Cure was obtained when the area was excised and sutured. There was no recurrence after the patient stopped using the tampons. There are 36 cases reported in the literature. Ulceration occurs in young women (25 years), nulliparous or primiparous (79%), who use tampons abnormally during the periods and between the periods (75%). The ulceration is always characteristic in appearance: it is a punched-out area, round or oval in shape, and is situated in the upper third of the vaginal barrel near where the tampon presses on to the vagina. Spontaneous cure occurs in 75% of cases when the tampon is no longer used. Physio-pathological hypotheses as to the causation are given. A suggestion is made as to the relationship between this syndrome and the staphylococcal toxic shock syndrome. The discovery of vaginal ulceration is not usually due to use of menstrual tampons. One has to think of adenosis of the vagina, herpetic ulceration, a syphilitic chancre or cancer, the diagnosis depending a little on the age of the patient. In our case that we report, continuous usage of super-absorbant tampons was accompanied by a large vaginal ulcer. Because of this case we have reviewed the literature about the cases that have been reported and have collected 36 cases. PMID- 3624820 TI - [Cutaneous angiosarcoma of the breast following surgery and irradiation of breast adenocarcinoma]. AB - We are reporting a localised skin angiosarcoma of the breast. As far as we can tell this is only the fourth time this condition has been published. The tumour appeared 6 years after a conservative lumpectomy with removal of lymphatics and follow-up radiotherapy had been carried out for an adenocarcinoma of the breast. This tumour was characterised by the presence of several round blue-coloured nodules in the skin with some inflammation surrounding them. The glandular tissue underneath was normal, as was the opposite breast, and there was no spread. The patient was pyrexial and a syndrome of inflammation persisted until the tumour had been removed by a simple mastectomy. We have discussed the clinical and histological aspects of this case and compared them with those found in the literature. Differential diagnosis with in particular Stewart-Treves syndrome has been emphasized. The treatment consists in wide excision and sometimes followed by radiotherapy or chemotherapy. The prognosis is very poor, survival never having been more than 22 months. Finally the role of irradiation in the causation of this tumour has been discussed. (Our patient is alive after 2 years without any sign of a recurrence). PMID- 3624821 TI - [Sacrococcygeal teratoma in 2 fetuses at 5 and 6 months]. AB - The two large mature sacro-coccygeal teratomas reported seem to be responsible for the death of fetuses in the fifth and sixth months of pregnancy. A review of the literature shows that teratomas are exceptionally rare during this period. Their outcome depends upon the degree of maturity of the tumor, its size, whether its location is pelvic or not, the presence of any associated malformations and upon prematurity. PMID- 3624822 TI - [Fixation of Gore-Tex slings to the pubococcygeal tendons: a simple technic of treating stress urinary incontinence using only the vaginal approach]. AB - A new technique for curing urinary stress incontinence using the vaginal route and a sling of synthetic material, GORE-TEX, is described. The sling is fixed at one end on the junction between the cervix and the urethra in the centre, and at the edges to the tendons of the pubo-coccygeal muscles. The situation is worked out from a urethral profile. Thirty cases have been treated and the results have been satisfactory. If they are confirmed by other operators it will show that a new reliable technique which is very simple and non-aggressive can be used. PMID- 3624823 TI - [Episiotomy and prevention of complete and complicated tears. A study in 3 European countries]. AB - The rates of third-degree tears in deliveries with and without episiotomy were compared in five samples: three French samples, a Belgian one and a Dutch one. Those samples corresponded to 48,430 single vaginal deliveries. The rates of episiotomy ranged from 29.3% to 54.2%. The results demonstrate that the risk of third-degree tears in vertex uncomplicated deliveries without episiotomy is low, and that in numerous cases third-degree tears are not prevented by an episiotomy. When uncomplicated deliveries of primipara were considered, results from four of the five samples showed that third-degree tears were not significantly more frequent in deliveries without episiotomy. PMID- 3624824 TI - Decreased creatine kinase activity in cultured Duchenne dystrophic muscle cells. AB - Muscle cells were cultured from six patients with Duchenne muscular dystrophy and nine normal subjects. Protein and myosin content and pyruvate kinase (PK) activity were similar in normal and Duchenne muscular dystrophy cultures. Creatine kinase (CK) activity was lower in Duchenne muscular dystrophy cultures and the isoenzyme distribution indicated MB-CK was significantly lower, while BB CK was significantly higher in later Duchenne muscular dystrophy cultures. This abnormal isoenzyme pattern suggested aberrant or impaired maturation of Duchenne muscular dystrophy myotubes in vitro. PMID- 3624825 TI - Headache and acute illness in children. AB - Thirty-seven children with headaches who were seen in a walk-in clinic were matched to 37 headache-free controls. Thirty percent of the headache group and 11% of the headache-free control group had a body temperature above 38 degrees C (p less than 0.05). Nonrhythmic pain was more commonly associated with fever than was rhythmic pain (p less than 0.05). Of 34 headache subjects who completed questionnaires, those with more intense headaches reported a greater number of headache-exacerbating factors (p less than 0.01). Bilateral headaches were more painful than unilateral headaches, and in two thirds of the subjects, the intensity of pain paralleled the course of the underlying illness. A family history of migraine was more common in the headache group as compared to the headache-free control group (p less than 0.05). Headaches associated with acute illnesses may be a precursor to later migraine. PMID- 3624826 TI - Introduction to the Kaufman Assessment Battery for Children (K-ABC) for pediatric neuroclinicians. AB - This article introduces the neuroclinician to the Kaufman Assessment Battery for Children (K-ABC), a new test of intelligence and achievement with a strong theoretical base supported by diverse cognitive and neuropsychological research. The K-ABC global scales and their subtests are described in some detail, followed by a discussion of the neuropsychological relevance of the K-ABC subtests. The article also provides discussions of research in the following areas: psychometric properties of the K-ABC and a comparison to the Wechsler scales; interpretation and remediation of sequential-simultaneous processing differences; the value of the K-ABC in the assessment of minority children; and controversy surrounding the K-ABC. PMID- 3624827 TI - Depression and dexamethasone suppression testing in children and adolescents. AB - The authors compare the incidence of dexamethasone nonsuppression in a large group of child and adolescent inpatients (N = 94) diagnosed by two criteria (DSM III and Weinberg criteria). The incidence of dexamethasone suppression test nonsuppression in patients diagnosed with DSM-III major depressive disorder (n = 33) was 55%, compared to 11% in those with no affective disorder (n = 35). This was compared to the incidence of dexamethasone suppression test nonsuppression utilizing Weinberg criteria. In addition, symptoms that to varying degrees discriminated suppressors from nonsuppressors were examined. These included change in school performance and, to a lesser degree, somatic complaints and weight and appetite changes. Differences in the diagnostic criteria are discussed. PMID- 3624828 TI - Norepinephrine and dopamine metabolites and educational variables in boys with attention deficit disorder and hyperactivity. AB - The present study evaluated the biochemical measures of urinary homovanillic acid (HVA) and 3-methoxy-4-hydroxy-phenylglycol (MHPG) in relation to functioning on selected psychoeducational tests in a group of boys with attention deficit disorder and hyperactivity. The Wechsler Intelligence Scale for Children-Revised (WISC-R), the Wide Range Achievement Test (WRAT), and the Peabody Picture Vocabulary Test were administered to 28 hyperactive and 23 control subjects. The findings suggest subtle differences in psychoeducational test performance in relation to specific levels of homovanillic acid and MHPG. PMID- 3624830 TI - Neurodiagnostic studies in Krabbe's disease. PMID- 3624829 TI - Factors modifying the prognosis of Wilson's disease in childhood. AB - The prognosis of Wilson's disease was investigated in 96 patients, in whom the disease had presented before 15 years of age and had begun between 1965 and 1983 (when D-penicillamine was widely available in Japan). In the activities of daily living, the prognosis was poor in those patients presenting with neurological symptoms. Interruption of D-penicillamine treatment was seen in one third of the patients, and it worsened the prognosis. Toxic side effects were seen in about half of the patients, being more frequent in the patients with initial neurological symptoms. A disappointing 17% of patients with slight or no side effects discontinued the drug. Death occurred in eight patients of whom seven had had initial hepatic symptoms. Not only early diagnosis and treatment before the appearance of hepatic failure or neurological symptoms, but also treatment throughout life without interruption is important for improving the prognosis of Wilson's disease. PMID- 3624831 TI - Sinus pericranii discovered at surgery for anticipated epidermoid cyst of the skull: a case report. PMID- 3624832 TI - Famotidine once-a-day in the management of duodenal ulcer: the U.S. placebo controlled experience. PMID- 3624833 TI - Peptic ulcer treatment now and tomorrow. AB - The large-scale use of drug treatment attests to its general value. In Western countries the general problems engendered in treating an increasingly elderly population seem likely to make drug treatment more popular. More potent treatments seem unlikely to bring significant attendant risks, but could improve, in particular, the management of gastrointestinal bleeding and of gastro oesophageal reflux. Nonantisecretory treatments do not seem as yet to have any advantages, and there is no material evidence to suggest that long-term treatment with antisecretory agents is harmful. PMID- 3624834 TI - Persistent hiccups as an unusual manifestation of hyponatremia. AB - In two patients, persistent hiccups were an unusual presenting manifestation of hyponatremia. Persistent hiccups occur in a variety of serious diseases, including metabolic and electrolyte disorders. They may cause the victim significant distress and may be refractory to most treatments. Hiccups lasting more than 24 hours require investigation for an underlying organic etiology, with hyponatremia included in the differential diagnosis. PMID- 3624835 TI - Emergency treatment of papaverine priapism. AB - We report a case of vasoactive-agent-induced priapism successfully treated in the emergency department with 10 mg of metaraminol injected into the corpora cavernosa. PMID- 3624836 TI - Acute dystonic reactions from "street Valium". AB - Four patients presented to the emergency department with acute dystonic reactions 36 hours after the ingestion of "Valium tablets" they purchased on the street. Complete reversal of the symptomatology was achieved with the use of intramuscular diphenhydramine. The pathophysiology, epidemiology, and treatment principles for dystonic reactions are discussed. PMID- 3624837 TI - The effect of on-line medical control centralization on ambulance destination. AB - Controversy regarding the establishment of on-line medical control in a single hospital in a regional Emergency Medical Service System is based, in part, upon the suspicion that ambulances might be diverted to that hospital. Ambulance transports to the University Hospital of Portland, Oregon, were studied over a six year period coinciding with that facilities' assumption of on-line medical control functions. No increases in ambulance transports to that facility could be demonstrated. Other variables resulted in absolute decreases in the number of these transports. PMID- 3624838 TI - Clinical implications of low QRS complex voltage. AB - Low QRS voltage on the 12-lead surface ECG is present when the amplitude of all six standard limb leads is less than 5 mm. This finding may be a normal variant, but necessitates investigation of the patient for an underlying cause. A variety of cardiac and systemic diseases may be responsible. PMID- 3624839 TI - The blue scrotum sign of Bryant: a diagnostic clue to ruptured abdominal aortic aneurysm. AB - A 73-year-old man presented to the emergency department twice with nonspecific abdominal pain. He was diagnosed as having mild diverticulitis and was discharged. Four days later he presented to the emergency department in severe abdominal pain with scrotal and penile ecchymoses. After an initial urologic consultation the correct diagnosis of ruptured abdominal aortic aneurysm was made. We discuss the pathogenesis of the genital discoloration and make the correct historical attribution of this sign to John Henry Bryant, a turn-of-the century physician at Guy's Hospital. PMID- 3624840 TI - The exact location of the black bag. PMID- 3624841 TI - Prehospital pacemakers: are they playing our tune? PMID- 3624842 TI - Naloxone treatment. PMID- 3624843 TI - R-banding pattern of the prometaphase chromosomes of the goat. AB - R-banded prometaphase karyotypes of the goat are presented using both fluorescent and light staining techniques. A model for the standardization of the R-banded prometaphase goat karyotype is suggested. PMID- 3624844 TI - Fox colors in relation to colors in mice and sheep. AB - Color inheritance in foxes is explained in terms of homology between color loci in foxes, mice, and sheep. The hypothesis presented suggests that the loci A (agouti), B (black/chocolate brown pigment) and E (extension of eumelanin vs. phaeomelanin) all occur in foxes, both the red fox, Vulpes vulpes, and the arctic fox, Alopex lagopus. Two alleles are postulated at each locus in each species. At the A locus, the (top) dominant allele in the red fox, Ar, produces red color and the corresponding allele in the arctic fox, Aw, produces the winter-white color. The bottom recessive allele in both species is a, which results in the black color of the silver fox and a rare black color in the Icelandic arctic fox when homozygous. The B alleles are assumed to be similar in both species: B, dominant, producing black eumelanin, and b, recessive, producing chocolate brown eumelanin when homozygous. The recessive E allele at the E locus in homozygous form has no effect on the phenotype determined by alleles at the A locus, while Ed, the dominant allele is epistatic to the A alleles and results in Alaska black in the red fox and the dark phase in the arctic fox. Genetic formulae of various color forms of red and arctic fox and their hybrids are presented. PMID- 3624845 TI - Equine linkage group II: phase conservation of To with AlB and GcS. AB - Blood type analysis of 29 foals in a paternal half-sib family verified linkage of five LGII loci (Es, E, To, Gc, Al). Population and parentage data from other tobiano-spotted horses suggested conservation of a tightly linked (To:GcS:AlB) marker complex. PMID- 3624846 TI - Separation of factors containing R-locus genes in Mormoniella stocks derived from aberrant segregation following incompatible crosses. AB - Four stocks derived from aberrant segregation of R-locus genes in male progeny following incompatible crosses in Mormoniella have shown characteristics suggesting that genes found on added chromosomal fragments in these stocks have separated from each other. In most cases, this separation was associated with elevated temperatures at the time of and subsequent to fertilization. Data also suggest that the R-locus genes involved are adjacent to a centromere, with the O factor being proximal thereto. PMID- 3624847 TI - Green pupa (gp), a male lethal in culex quinquefasciatus. AB - An autosomal recessive mutant, green pupa (gp), in Culex quinquefasciatus has been isolated. The homozygous (gp/gp) females are viable whereas male homozygotes do not develop beyond the pupal stage. The behavior of this mutant character in pedigree studies has been reported. PMID- 3624848 TI - Dominant white spotting in the Chinese hamster. AB - An autosomal dominant white spotting mutant is described for the Chinese hamster. The mutant gene is designated as dominant spot (symbol Ds). The homozygote DsDs is a prenatal lethal while the heterozygote Ds + displays white spotting. The expression of white is variable, ranging from a white forehead spot to extensive white on the body. The venter is invariably white. Growth appears to be normal and the fertility of both sizes shows no impairment. PMID- 3624849 TI - Resolution in EM autoradiography V: 45Ca (and 33P). AB - We devised a specimen to test EM autoradiographic resolution for calcium-45 (and phosphorous-33). A dry emulsion film was used for soluble compounds. We obtained a resolution (HD) value of 2300 +/- 500 A. This value is no larger than that previously obtained for Carbon -14, whose emission is about 1.6-fold lower. This result is as expected on theoretical grounds. PMID- 3624850 TI - Autoradiographic localization of dihydrotestosterone binding in the major salivary glands and other androgen-responsive organs of the mouse. AB - Mouse submandibular glands show an androgen-dependent sexual dimorphism, reflected in higher concentrations in males than in females of bioactive peptides, such as epidermal growth factor (EGF), nerve growth factor, and renin in the cells of the granular convoluted tubules (GCT). Biochemical studies have demonstrated androgen receptors in submandibular gland and other androgen responsive organs in mouse. We have determined the cellular localization of these receptors using steroid autoradiography. Fifteen adult gonadectomized male mice were injected intravenously with 0.13 microgram or 0.26 microgram [3H] dihydrotestosterone (SA 135 Ci/mM); some animals were pre-treated with cyclocytidine to stimulate secretion by GCT cells. Animals were killed 15 min, 1, 2, or 3 hr after isotope injection. Steroid autoradiographs were prepared, and some were stained immunocytochemically for EGF. Of the different cell types of submandibular gland, the acinar cells most frequently and intensely concentrated [3H]-DHT; GCT cells also concentrated the hormone, as did a small number of striated duct cells. In the other major salivary glands, the only cells that concentrated the androgen were interlobular striated duct cells in sublingual gland. In prostate, anterior pituitary, and brain a large number of cells concentrated androgen, as has been previously reported. Androgen binding by the GCT cells was a predictable finding, since androgen-induced alterations in composition and form of these cells are well documented. The intense androgen concentration by the acinar cells was an unexpected finding and suggests a hitherto unknown androgen regulation of these cells. An incidental finding was intense concentration of [3H]-DHT in the nuclei of the endothelial cells of the post-capillary venules of the cervical lymph nodes. PMID- 3624851 TI - A simple two-step labeling procedure for ultrastructural localization of cell surface anionic sites. AB - We propose a new method for ultrastructural localization of cell surface anionic sites. The method consists of sequential interaction of aldehyde-fixed cells with a polycationic reagent, poly-L-lysine (PL), followed by secondary interaction with a negatively charged marker, ferritin. By use of PL of low molecular weight (4000) on aldehyde-pre-fixed red blood cells and macrophages, the reaction resulted in binding of ferritin particles to cell surface anionic sites with a density distribution resembling that of cationized ferritin (CF). The density of the attached ferritin molecules increased in direct correlation with the MW of PL used. The primary PL interaction can be carried out at low pH (less than 2), thus restricting the labeling mainly to membrane-bound sialyl residues. PMID- 3624852 TI - Molecular demarcation of surface domains as established by label-fracture cytochemistry of boar spermatozoa. AB - We used "label-fracture" (J Cell Biol 99:1156, 1984) to establish high-resolution maps of wheat germ agglutinin (WGA) and concanavalin A (ConA) receptor sites on the cell surface of boar spermatozoa and to investigate the possible association of these receptors to integral membrane components. Label-fracture reveals intense WGA labeling over the region of the plasma membrane that overlies the acrosome, including the equatorial segment. The density of WGA receptors decreases from the post-acrosomal area to the posterior ring. The WGA receptor domain changes abruptly into a microdomain with an unusually high density of WGA receptors over a sharply delimited, particle-free zone at the base of the head. Over the tail, the density of WGA receptors in the tail is high and uniform over the midpiece, annulus, and principal piece, but narrow patches of rectilinear arrays of pits close to the annulus are not labeled. Labeling of the entire sperm head by ConA is both intense and uniform, except for the particle-free zone at the base of the head, which is barren of receptors. Over the tail, ConA labeling is strong over the midpiece, absent over the annulus, and sparse over the principal piece and the end piece. In contrast to WGA, ConA receptors co distribute with the intramembrane particles. Our results confirm the potential of label-fracture for high-resolution mapping of the distribution of cell surface receptors. They show that in this specialized cell membrane domains can be sharply defined, i.e., apparent without free lateral diffusion of components. PMID- 3624853 TI - Dense HRP filling in pre-fixed brain tissue for light and electron microscopy. AB - The use of neuroanatomical markers in tissues that have been pre-fixed has been virtually ignored, even though this approach could offer certain advantages over in vivo methods, in terms of convenience of application and choice of markers. We have found that HRP can be used on well-fixed brains of cats and goldfish to fill neurons, dendrites, axons, terminals, glial cells, and glial processes for high resolution light microscopy and electron microscopy. Best results were obtained using brains that were perfusion-fixed with 2.5% depolymerized paraformaldehyde and 1.5% glutaraldehyde. Two methods of HRP application were used: optically guided injections of microliter quantities into various regions of cat brain, and optic nerve fills in goldfish by attaching an HRP-filled polyethylene tube for periods of 1 day to 2 weeks. HRP applied in these ways to pre-fixed tissue was found to fill neurons or glial cells with solid label in the anterograde and retrograde directions. PMID- 3624854 TI - Pyrido[2,1-i]-purines: a new class of fluorescent stains. AB - 7-oxo-pyrido[2,1-i]-purine nucleosides 1a and 1b are highly fluorescent molecules with absorptions and emissions in the visible region. They show little or no cytotoxicity; interactions with isolated enzyme systems could not be detected, and these molecules appear to enter the cell via a purine nucleoside-specific carrier. We demonstrate for one case a specific interaction with cell components. The fluorescence of pyrido[2,1-i]-purine 2 is solvent-dependent and stains the lipophilic parts of a cell. PMID- 3624855 TI - The caveat of lectin studies. PMID- 3624856 TI - F4/80 and peroxidatic activity of macrophages. PMID- 3624857 TI - Effects of hormone deprivation on the karyometric development of the medial and lateral preoptic area of the male mouse. I. Neonatal castration. AB - We have analysed the karyometric development of the nuclear neuronal sizes in the medial and lateral preoptic area of male albino mice castrated within 24 hours of birth. We have analysed six different age groups of animals: 10th, 20th, 35th, 45th, 55th and 85th postnatal day, and we have compared our results to those of a control group of male mice. Both hypothalamic areas respond to neonatal castration showing lower values of the nuclear sizes than those of the control group. The reaction of these areas to gonadal hormone deprivation at birth is more striking than that obtained after prepuberal castration of the animals, studied in a previous report. Neonatal gonadal hormone deprivation also produces changes of the nuclear shape of the nuclei towards sphericity. PMID- 3624858 TI - The cerebellum of the dogfish, Scyliorhinus canicula: a quantitative study. AB - This quantitative study on neuron populations of the dogfish cerebellum reveals noticeable differences in cell size and density between its portions. A remarkable result was the large proportion of granule, Golgi and stellate cells as regards to the Purkinje cells, with some values higher than in many mammals. These results indicate that the complexity level of this Selachian cerebellum is not far from cerebella of some primitive mammals. PMID- 3624859 TI - Contemporary brain morphology in ecological and ethological perspectives. AB - The use of ethological, along with morphological data is presented as a general realistic approach to the understanding of the vertebrate nervous system. While the brain/body size relation, either in ontogeny or phylogeny, is still a mandatory method for describing brain evolution, the interpretation of the allometry equation remains subject to difficulties. A mixed quantitative qualitative relationship between brain and behaviour is defined through the new concept of cociation. Results based on this approach are presented for a number of mammals having a broad variety of sizes and life-habits. The necessity of using brain components, and not only total brains, is emphasized. The functional aspects of relative brain and brain component size, especially with reference to metabolism and behaviour, are commented upon. These aspects require a cautious handling of the causality principle, and a particular conception of progress in brain evolution. The study of brain components in a functional perspective has been characterized, in recent years, by remarkable advances in modular morphology. These are summarized and it is suggested that they might lend themselves to especially significant behavioural correlations. A hypothetical model for a two-level brain, involving both redundancy and configurations, and consistent with a neuroethological approach, is recommended as a potentially promising direction for future progress in brain morphology, in ecological and behavioural perspectives. PMID- 3624860 TI - Quantitative and qualitative morphology of rabbit retinal glia. A light microscopical study on cells both in situ and isolated by papaine. AB - Rabbit retinal glia was studied by light microscopy of both stained sections of frozen retinae and enzymatically isolated cells. In the vast majority of this tissue, except for a small region around the optic nerve head, the glia consists solely of radial glia, i.e. Muller cells whose morphology was found to depend markedly on their topographic localization within the retina. Muller cells in the periphery are short and have thick vitreal processes bearing a single large endfoot. Central Muller cells are long and slender; through the thickening nerve fibre layer they send vitreal processes which are subdivided into several fine branches ending with multiple small endfeet. Muller cells in the retinal centre are far more closely packed than those in the periphery; everywhere, however, a constant ratio of Muller cells: neurons of about 1:15 was found, except for the juxta-optic nerve head region where this ratio is slightly reduced. Where the central retina reaches a thickness requiring Muller cell lengths of more than 130 micron, additional non-radial glial cells occur within the nerve fibre layer. The majority of these cells seem to be astrocytes. Their number per retinal area increases with the thickening of both the whole retina and the nerve fibre layer. The occurrence of these non-radial glial cells leads to an enhancement of the glia:neuron index in the retinal centre. Possible mechanisms of physiological control of gliogenesis are discussed. PMID- 3624861 TI - Comparative studies on the astrocytic reaction in the lesioned central nervous system of different vertebrates. AB - The morphology of the optic nerve of fish, amphibians, reptiles, birds and mammals, with special reference to the membrane architecture of the astrocytes, is described by means of ultrathin sections and freeze-fracture replicas. The reaction patterns of the astrocytes in response lesions of the optic nerve are discussed with respect to the regenerative capacity of the central nervous system (CNS). Astrocytic membranes in the optic nerve of the goldfish and Rana esculenta do not reveal orthogonal arrays of particles (OAP), in contrast to those of the optic nerve of the turtle, lizard, chicken, pigeon and rat. Reactive astrocytes in the crushed optic nerve of goldfish establish tunnel-like structures that are in close contact with the regenerating axons. During the regeneration period the distribution of intramembranous particles (IMP) in the astrocytic membrane is not uniform, in contrast to the situation found after complete regeneration and in the untreated optic nerve. Reactive astrocytes in degenerating optic nerves of chicken and rat form a glial scar. The density of the OAP decreases in reactive astrocytes of adult chicken and rats, whereas the density increases during the degeneration period in the optic nerve of the postnatal rat. HYPOTHESIS: Astrocytes devoid of OAP are only found in regions of the vertebrate CNS capable of regeneration. In contrast, the inability to regenerate coincides with the appearance of OAP. Therefore, it is suspected that the presence of OAP in astrocytic membranes is at least one of several factors involved in the abortive regeneration of nerve fibers. PMID- 3624862 TI - Mechanism of cell contact-mediated inhibition of natural killer activity. AB - Natural killer cell activity is inhibited by primary cultures of monolayer cells. In this study, we analyzed the mechanism of the inhibition. Inhibited NK cells showed unaltered binding capacity to NK sensitive K562 cells. The orientation of the effector cells' actin-containing microfilaments, an event known to occur during the programming for the lysis stage in lytic conjugates, was unaffected by the inhibition. In single cell cytotoxicity experiments, the number of killer cells among conjugate-forming cells was reduced. The capacity of the inactivated NK cells to secrete cytotoxic factors upon stimulation with Con A was also impaired. Both NK-resistant inactivating target cells and NK-sensitive K562 cells were sensitive to the toxic factors secreted by NK cells. Thus, the results indicate that the target cell-mediated inactivation of NK cell is based on a block in the lethal hit stage, possibly due to reduced release of toxic factor(s) from the effector cells. The capacity of inactivated effector cells to mediate antibody-dependent cellular cytotoxicity was unimpaired, suggesting that the contact-mediated inhibition of cytotoxicity selectively affects NK cells. PMID- 3624863 TI - Concomitant immunoglobulin E and immunoglobulin G1 formation in Nippostrongylus brasiliensis-infected mice. AB - The immunoglobulin (Ig)E, IgG subclass, and IgM formation in vivo and in vitro were measured by radioimmunoassays in normal and immunodeficient mice infected with the parasite Nippostrongylus brasiliensis (Nbr). High IgE responder mice had higher IgE serum levels than low responder mice both before (100 to 250 vs 2 to 20 ng of IgE/ml) and after (17,000 to 27,000 vs 1,000 to 5,000 ng of IgE/ml) infection. In vitro, mesenteric lymph node cells formed 5- to 10-fold more IgE than the spleen cells. Nu/nu mice had less than 1 ng before and 5 ng of IgE/ml serum after Nbr infection; no IgE was detectable in cell supernatants. There was no difference in the in vivo and in vitro IgE formation between C57BL/6 and C57BL/6-beige mice. Both in vivo and in vitro Nbr-infected Xid+ mice (CBA/N; (CBA/N X BALB/c) F1 male) formed approximately twice the amount of IgE than Xid- mice. Concomitant with the rise of the IgE serum levels, the IgG1 serum level increased by 100 to 1,500 micrograms/ml over preinfection levels in all strains except nu/nu+ mice. The IgM serum level increased by 100 to 500 micrograms/ml. In contrast, the IgG2a and IgG2b levels decreased in most strains, and the IgG3 levels remained unchanged. Nu/nu+ mice showed an increase of all IgG subclasses after Nbr infection. The antibodies to an Nbr extract were predominantly of IgM and IgG1, except in SJL mice which also had IgG2b and nude mice which only had IgM antibodies. The concomitant increase of IgE and IgG1 formation in all but the nude strains suggests that the regulation of these two Ig isotypes may be linked via regulatory T helper cells, which corroborates recent data on the simultaneous induction of IgG1 and IgE synthesis in vitro by the B cell stimulatory factor 1. PMID- 3624864 TI - The subclass distribution of human IgG rheumatoid factor. AB - The subclass distribution of IgG rheumatoid factor (RF) was determined by a sensitive ELISA assay in sera from patients with rheumatoid arthritis and from normal controls. In both instances, the most important subclasses were IgG1 and IgG4. The IgG4 RF was directed against the Fc region of IgG, and recognized human as well as rabbit IgG. Although human IgG4 myeloma proteins bound to rabbit IgG better than did myelomas of other IgG subclasses, the IgG4 RF activity in rheumatoid sera showed an additional specificity, because the fraction of IgG4 RF/total IgG4 for rheumatoid arthritis sera was far greater than for myelomas. This inference was supported by the observation that there was persistent, albeit diminished, IgG RF activity in pepsin-digested, RF-containing sera (but not myeloma proteins), indicating that a critical component of IgG4 RF activity was contained within the Fab region of the IgG4 molecule. The finding of large quantities of IgG4 RF was not due to a bias of the assay, because the preponderance of IgG4 did not extend to the subclass distribution of antibodies directed against other antigens. The demonstration of an important role for IgG4 as a RF is of special interest because of the relative inability of this subclass to fix complement or to bind to Fc receptors, and because of its potential role as a mediator of increased vascular permeability. PMID- 3624865 TI - Constitutive expression of Slp genes in mouse strain B10.WR directed by C4 regulatory sequences. AB - The murine fourth component of complement (C4) and sex-limited protein (Slp) are two closely related serum proteins that exhibit very disparate patterns of gene expression: all mice constitutively express C4, whereas only adult male mice from a limited number of standard inbred strains express Slp. Several exceptional strains exhibit constitutive (C4-like) Slp expression, a phenotype that correlates with multiple copies of the Slp gene. To determine the molecular basis for constitutive Slp expression we have isolated genomic clones and compared the sequences of 1.5 kb of 5' flanking DNA from 1 C4 gene and three different Slp genes from the Slp-constitutive strain B10.WR. These sequence comparisons demonstrate C4-like regulatory sequences adjacent to two of the Slp genes. By analysis of cDNA clones isolated from a B10.WR liver library we demonstrate that the constitutive Slp phenotype is due primarily to expression of one of these C4/Slp hybrid genes. It appears likely that Slp gene duplication in strain B10.WR came about via homologous unequal crossover events between C4 and Slp genes; this would accommodate both the gene sequence data and the pattern of C4-like Slp expression in mouse strain B10.WR. PMID- 3624866 TI - Rabbit secretory components: identification of a third allotype, t63. AB - A third allotype of rabbit secretory component has been identified. The allotype previously referred to as t62 by our laboratory can now be subdivided into two allotypes, t62 and t63, with alloantisera capable of discriminating between the two. Results of family studies are consistent with a three allele system (t61, t62 and t63) at the t-locus. By SDS PAGE, electrophoretic mobilities of the multiple SC bands for each of the three allotypes are characteristic of the allotype; the apparent molecular sizes of the bands of the t62 allotype are 2 to 3 kDa lower than those for the t61 allotype. The banding patterns of the t61 and t63, although similar, are not identical to each other. Results of serologic cross-reaction studies and of tryptic peptide mapping studies suggest multiple structural differences between the allotypes as well as a closer relationship between t62 and t63 than between either of these allotypes and t61. PMID- 3624867 TI - Activation of human C1: analysis with Western blotting reveals slow self activation. AB - The first component of human complement was separated from C1-INH by sucrose linear gradient ultracentrifugation. Activation of C1 was studied in the absence and presence of immune complexes; activation was monitored by SDS-PAGE and Western blot. When the partially purified native C1 preparation was incubated at 37 degrees C without immune complexes, activated C1s appeared after 30 min in the case of eightfold dilution with respect to the original serum, and after 45 min with 32-fold dilution. Kinetics of appearance of activated C1r was the same as that of activated C1s. From the following results, we concluded that spontaneous activation may be partially due to proteolytic enzymes contaminating the preparation: 1) a nonspecific protease inhibitor, PMSF, completely inhibited spontaneous activation but did not inhibit the activation of C1 by immune complexes; 2) alpha 2-macroglobulin partially inhibited spontaneous activation, and 3) although spontaneous activation in the absence of PMSF was relatively slow, activated C1 accelerated spontaneous activation that was completely blocked by C1-INH. In contrast to spontaneous activation, the partially purified native C1 was rapidly activated by immune complexes: within 5 min almost all C1 was activated by rabbit IgG anti-human IgM-human IgM complexes. These results support conclusions derived from activation studies when using native C1 and hemolytic assays, and do not support those derived from the activation studies with reconstituted C1 and SDS-PAGE analysis. We suggest that the contradictions can be resolved if one assumes that C1 activation can be both an intra- and intermolecular process; which process dominates is determined by the state of C1 and by experimental conditions. PMID- 3624869 TI - Effect of altered membrane structure on NK cell-mediated cytotoxicity. III. Decreased susceptibility to natural killer cytotoxic factor (NKCF) and suppression of NKCF release by membrane rigidification. AB - We have shown recently that alteration of the membrane fluidity of either effector or target cells results in significant and selective inhibition of NK cell-mediated cytotoxicity (NK CMC). However, the localization of the defective stage in the NK lytic pathway is not known. In the present study, we show that rigidification of the NK-sensitive U937 target cell membrane by lipid modulation reduces its sensitivity to lysis by NK cytotoxic factor (NKCF). This resistance was not due to loss of NKCF binding sites on the target cell because target cells with rigid membranes absorbed more NKCF than control cells. The enhanced ability to absorb NKCF by membrane modification was supported by data showing that NK resistant Raji cells lacking NKCF-binding sites absorb NKCF after lipid modification. Furthermore, consistent with the lipophilic nature of NKCF, synthetic lipid vesicles absorb NKCF. In contrast to membrane rigidification, membrane fluidization of the target cell did not change the target cell properties. Rigidification of the NK effector cell membrane abrogates it ability to secrete active NKCF when stimulated by target cells or by mitogens. Membrane fluidization of the NK effector cells did not inhibit their ability to release NKCF. The results of these studies demonstrate that inhibition of NK CMC by rigidification of the target cell membrane results in cells that are inhibited in processing bound NKCF to lysis. Inhibition of NK CMC by rigidification of the NK effector cell results in defective trigger for activation of the NKCF release mechanism. PMID- 3624868 TI - Structural diversity of murine serum amyloid A genes. Evolutionary implications. AB - Mouse serum amyloid A (SAA) gene family comprises four members that are closely linked in the chromosome 7. Two of these genes encoding major mouse SAA isotypes (SAA1 and SAA2) are highly homologous not only in exons but also in introns and flanking regions; this sequence homology extends 280 base pairs upstream of major cap sites and 430 base pairs downstream of polyadenylation sites, and the 5' boundary of this homology unit is marked by the CA/GT repeat. Sequence comparison also shows that one (SAA4) of the other two genes is related to the SAA1/2 gene, whereas the other gene (SAA3) evolved independently. Based on these results and the SAA gene arrangement, we discussed mouse SAA gene evolution. PMID- 3624870 TI - Inhibition of macrophage accessory cell function in casein-treated B6C3F1 mice. AB - Humoral immunity of casein-treated B6C3F1 mice was evaluated. Splenocytes from casein-treated mice sensitized in vitro exhibited a marked suppression in their antibody response to the T-dependent antigen, SRBC (82%) and T-independent antigen, DNP-Ficoll (80%). In contrast, a control response to the polyclonal antigen, lipopolysaccharide (LPS), was observed. Cell fractionation and crossover reconstitution assays of adherent (ADH) and nonadherent (NAD) splenocyte populations from vehicle and casein-treated mice indicated that: 1) ADH splenocytes from casein-treated mice were responsible for suppression of humoral responses, 2) NAD splenocytes from casein-treated mice reconstituted with vehicle or naive ADH cells abrogated the immunosuppression, and 3) suppression of humoral responses in cultures containing casein ADH splenocytes was due to this cell populations inability to function as accessory cells in humoral responses rather than induction of suppressor macrophages. Results from in vivo studies with casein-treated mice sensitized with sheep red blood cells or dinitrophenyl-Ficoll paralleled the in vitro results. PMID- 3624871 TI - Disturbed immune-endocrine communication in autoimmune disease. Lack of corticosterone response to immune signals in obese strain chickens with spontaneous autoimmune thyroiditis. AB - Antigenic challenge as well as injection of lymphokine-containing media lead to a transient increase of serum glucocorticoids, a phenomenon that has been implicated in the regulation of the specificity of immune responses. In the present study we examined the dialogue between the immune and the neuroendocrine systems in Obese strain (OS) chickens, an animal model for human Hashimoto thyroiditis. The following results were obtained: A) OS and normal White Leghorn (NWL) chickens, 5-mo-old, were immunized with sheep red blood cells followed by daily monitoring of corticosterone (CN) serum levels. Whereas in NWL animals CN serum levels markedly increase 3 to 4 days after immunization, OS animals did not respond with CN elevation. B) A single i.v. injection of conditioned medium (CM) from concanavalin A-stimulated spleen cells also led to a transient, dose dependent peak in plasma CN (maximum after 30 min). This CN response to a given CM preparation was significantly lower in OS than in NWL animals. C) CM, whether obtained from OS or NWL splenocytes, were equally effective to stimulate CN production. D) A single i.v. injection of CM leads--concomitantly to the CN peak- to a decrease of the concanavalin A-mediated proliferative response of peripheral blood lymphocytes in both OS and NWL chickens. This suppression, however, was significantly more pronounced in NWL chickens. In summary, these data suggest a disturbance of the immune-neuroendocrine communication in OS chickens with spontaneous thyroid autoimmunity. The possible implications for the generation of "forbidden" autoimmune responses are discussed. PMID- 3624872 TI - Evidence that C5b recognizes and mediates C8 incorporation into the cytolytic complex of complement. AB - The aim of this study was to identify constituents of the intermediate C5b-7 complex of human complement that mediate binding of C8 and formation of C5b-8. Analysis of interactions between purified C8 and C5, C6, or C7 indicate that C5 and C8 associate to form a dimer in solution. This interaction is specific and involves a single C5 binding site located on the beta-subunit of C8. Simultaneous interaction of C8 with C5 and C9 in solution suggests that during assembly of the cytolytic C5b-9 complex on membranes, C8 binds to C5b-7 through association of beta with C5b, after which C9 associates through interaction with the previously identified C9-specific site on the alpha-subunit. Other evidence of interaction with C5b was provided by the fact that C8 can bind purified C5b6. Also, in situ cross-linking experiments showed that within C5b-8, the beta-subunit is in close proximity to C5b. These results indicate that C8 binding to C5b-7 is mediated by a specific C5b recognition site on beta, thus explaining the requirement for this subunit in C5b-8 formation. They also reveal that C5b contains a specific site for interaction with beta. PMID- 3624873 TI - Removal of human polymorphonuclear leukocyte surface sialic acid inhibits reexpression (or recycling) of formyl peptide receptors. A possible explanation for its effect on formyl peptide-induced polymorphonuclear leukocyte chemotaxis. AB - Removal of surface sialic acid specifically inhibits human polymorphonuclear leukocyte (PMN) chemotactic responses to N-formyl-methionyl-leucyl-phenylalanine (FMLP). Neuraminidase-treated (NT)-PMN bound and internalized [3H]FMLP (used as receptor marker) as well as normal PMN. NT-PMN, however, retained more [3H]FMLP associated radioactivity than normal PMN. Subcellular fractionation studies demonstrated that NT-PMN retained more sedimentable (100,000 X G for 180 min) [3H]FMLP-associated radioactivity within light Golgi-containing fractions than normal PMN. Furthermore, NT-PMN exhibited a defect in their ability to reexpress (or recycle) a population of FMLP receptors. Abnormal receptor recycling was associated with inhibition of FMLP-induced PMN chemotaxis. Thus, it appears that recycling of formyl peptide receptors may be necessary for optimal PMN chemotactic responses to FMLP. We postulate that removal of PMN surface sialic acid inhibits FMLP-induced PMN chemotaxis by blocking the reexpression (or recycling) of a population of formyl peptide receptors, perhaps by preventing trafficking of desialated receptors through a light Golgi pathway. PMID- 3624874 TI - Immunologic response to influenza virus neuraminidase is influenced by prior experience with the associated viral hemagglutinin. II. Sequential infection of mice simulates human experience. AB - In man, vaccination with neuraminidase (NA) in H7N2 virus hybrids elicits greater anti-NA response than does N2 NA in H3N2 conventional vaccine, presumably because humans are H3 hemagglutinin (HA) primed and anti-H3 anamnestic response depresses concomitant N2 responses by antigenic competition. In a laboratory model, BALB/c mice were primed by different schedules of infection with H3N1, H3N2, and H3N7 viruses and given H3N2 and H7N2 vaccines equivalent in NA immunogenicity. In schedules using sequential infections, but not after a single infection with any virus, anti-N2 booster response was fourfold greater with H7N2 vaccine and was reciprocal to the magnitude of anti-H3 response. Thus, HA-influenced suppression of immunologic response to viral NA requires adequate HA priming but is not unique to man and can be studied in the murine model. An incidental finding of this study was the sharing of cross-reactive determinants by N1, N2, and N7 NA. PMID- 3624875 TI - Analysis of vesicle immunolysis assays. The direct binding model. AB - Assays based on lysis of lipid vesicles have shown high sensitivity. However, little as yet is known about the quantitative relationships among the various assay parameters, due in part to the lack of a predictive theoretical model. This paper presents the derivation of the equations that describe a simple model assay system in terms of the total fraction of vesicles with bound antibodies and the distribution of vesicles with one, two, or more antibodies bound. The equations show how the binding of antibodies to vesicles is affected by such variables as: vesicle concentration, antigen density on vesicle surfaces, antibody concentration, and antibody affinity. With the distribution functions, experiments can be designed to determine the minimum number of antibodies needed to lyse a vesicle. In addition, it is shown how estimations of the ultimate sensitivity of lipid vesicle lytic assays can be made. The model can be used to optimize vesicle lysis assay systems. PMID- 3624876 TI - A new assay to measure monoclonal antibody-dependent complement or macrophage mediated tumor growth inhibition. AB - A new in vitro assay has been developed to measure the inhibition of tumor growth by antibody and complement or by antibody and macrophages. Tumor cells (1 X 10(5) cells) or a mixture of tumor cells (1.5 X 10(4) cells) and macrophages (1.5 X 10(5) cells) are immobilized in a 1 microliter agarose droplet. Antibody is added to the medium bathing the agarose droplet. Complement is also added to wells containing droplets with tumor cells alone. The area covered by tumor cell monolayer is measured non-destructively from day 0 to day 7 with a split image tracing device. Cell growth is expressed by the increase in the square root of the measured area. This assay does not require isotopes and can be used to test tumor cells freshly dissociated from solid tissues. It permits cell-cell interactions which may change the sensitivity of tumor cells to various treatments. The extended period of observation allows the testing of multiple treatments. Surviving cells can also be recovered for further study. This assay may be useful for testing the efficacy of monoclonal antibody treatment on solid tumors. PMID- 3624877 TI - Conjugation of DNA to erythrocytes. AB - DNA was conjugated to sheep red blood cells (SRBC) by chemical methods using CrCl3, poly-L-lysine or methylated bovine serum albumin as conjugation agents and by a physical method where conjugation was accomplished by incubation at 45 degrees C. The degree of conjugation was estimated using 32P-DNA (mean size 1 kbase pairs). Employing the CrCl3 method 5.8 +/- 3.6 micrograms DNA were conjugated per 10(8) SRBC at a concentration of 70 micrograms DNA/10(8) cells. At the same DNA concentration in the incubation medium 3.0 +/- 0.6 microgram DNA/10(8) cells were conjugated by poly-L-lysine, 4.1 +/- 0.8 microgram DNA/10(8) cells by methylated bovine serum albumin and approximately 4 micrograms DNA/10(8) cells when the cells were incubated at 45 degrees C. Cells conjugated with DNA by CrCl3 showed linearly increasing conjugation with increasing concentration of DNA. Cells conjugated by poly-L-lysine (pLL) or methylated bovine serum albumin seemed to be saturated by DNA at 30 micrograms DNA per 10(8) cells. At 45 degrees C the spontaneous adhesion of DNA to SRBC increased in the concentration range investigated. The degree of conjugation of DNA to SRBC was influenced by pH, and Ca2+.pLL-conjugated DNA-SRBC, but none of the other preparations were lysed in a hemolytic assay using anti-DNA antiserum from a patient with systemic lupus erythematosus. PMID- 3624878 TI - A fluorimetric assay for native C3. The hemolytically active form of the third component of human complement. AB - The content of native C3 in samples of purified C3 may be accurately determined using the fluorescent probe ANS (8-anilino-1-napthalene sulfonate). The assay is based on the 11.5-fold increase in fluorescence intensity of ANS which accompanies proteolytic conversion of native C3 to C3b. The assay may be performed in the presence of hemolytically inactive derivatives of C3 such as C3b and C3(H2O). It exhibits the unique feature of being independent of protein concentration and it does not require a C3 standard, other purified complement components, C3 depleted serum, cells or cell-bound intermediate complexes, such as EAC142. A method utilizing cation exchange chromatography (Mono S, Pharmacia) is also described for the rapid (30 min) analytical or preparative separation of native C3 from inactive forms of C3 and from C3 fragments. PMID- 3624879 TI - A highly specific two-site ELISA for pneumococcal C-polysaccharide using monoclonal and affinity-purified polyclonal antibodies. AB - A two-site ELISA for the detection of pneumococcal C-polysaccharide (PnC) has been developed. A monoclonal antibody directed against the phosphorylcholine residue of the PnC was used as catcher and an affinity-purified polyclonal anti PnC rabbit antiserum for detection. Polyclonal antibodies against the PnC as well as capsular antigens were obtained by immunizing rabbits with type 1 pneumococci. Antibodies against the phosphorylcholine determinant of PnC could be removed by affinity purification. Remaining antibodies reacted in an ELISA with type 1 capsular polysaccharide as well as with PnC. Only in the fraction with the highest antibody activity against PnC, phosphorylcholine exhibited a slight inhibitory action. It is concluded that the purified antibody preparation reacted with an antigenic determinant shared by the two polysaccharides, in all probability a determinant associated with 2-acetamido-4-amino-2,4,6 trideoxygalactose which is the only monosaccharide component in common between PnC and the type 1 capsular polysaccharide. By the use of this affinity-purified antibody preparation, reactions with alpha-streptococci, occurring with non purified serum, were abolished. The sensitivity and specificity of the test was determined using capsulated and non-capsulated pneumococci and alpha-streptococci known to cross-react with unpurified serum against the pneumococcal C polysaccharide. PMID- 3624880 TI - On the buying and selling of organs for transplantation. PMID- 3624881 TI - No interaction between HLA and GM in type 1 diabetes? PMID- 3624882 TI - Electrophoretic resolution of two rat class I alloantigens expressed on (WF X F344)F1 liver cells in primary culture. AB - Polyvalent alloantisera, prepared by reciprocal immunization of F344 (RT1lv1 haplotypes) and WF (RT1u haplotype) rats, as well as monoclonal antibodies, were used to immunoprecipitate class I alloantigens from detergent extracts of monolayer cultures of 35S-methionine-labelled liver cells. Two-dimensional IEF/SDS-PAGE gel analysis resolved the RT1.Alv1 and RT1.Au class I antigens expressed on the liver cells in culture. PMID- 3624883 TI - The expression of murine Qa region gene product(s) in L cell transformants. AB - The cosmid H3.5, containing genes mapping to the murine H-2 Qa region, was used to transfect L cells by the calcium phosphate co-precipitation method. The resultant transfected cells expressed a Qa-like determinant as detected by an immune serum raised against the transfectant cells and Qa specific monoclonal antibodies. Two-dimensional gel analysis revealed the expression of a class I like heavy chain with a similar molecular mass to the Qa2 antigens of the positive strain B10 and B10.A but with a different isoelectric point. The cosmid H3.5 spans 40 kb of DNA and contains at least one complete Qa region gene which encodes the Qa-like determinant detected in this study. PMID- 3624884 TI - [Ureteral dosimetry during gynecological curietherapy. Possible effects on the occurrence of postoperative ureteral complications]. AB - The dosage of radiations delivered during gynaecological brachytherapy is usually calculated for the bladder and the rectum. A new technical approach is described in order to known the dose of radiation received by the terminal portion of the ureter. During placement of the Fletcher suit one of the ureters is catheterized by a special stent which appears on the X-rays control used for dosimetry. Data of 16 pre-operative brachytherapies for carcinoma of the cervix were studied. In half of the cases, the dose debit was higher on the ureter than on the bladder and the rectum. In 7 cases, the dose delivered was also higher on the ureter rather than on the bladder and the rectum. And in 3 cases this dose was higher than 50 grays. It is concluded that the ureter is frequently the most irradiated organ in the pelvis during brachytherapy for carcinoma of the cervix. This may be a physiopathologic explanation for some ureterovaginal fistulas occurring after radical hysterectomy. PMID- 3624885 TI - [Ureterosigmoidostomy with antireflux in children. Apropos of a short series]. AB - Ureterosigmoidostomy with anti-reflux technique (Petit-Leadbetter procedure) was performed in 12 children, mainly after failure to repair an exstrophy. After a mean follow up of 45 months, results were assessed as good from clinical and urographic points of view, although there were 3 possible cases of reflux, one of anastomotic stenosis (operated upon with success) and one of moderate continence only. An anastomotic tumor was not detected, but follow up is of moderate duration only. This operation should be reserved for a limited number of cases: those with irreparable exstrophy and those in whom a skin bypass is unacceptable. PMID- 3624886 TI - [Surgical results of uretero-vesical reimplantations in children. Apropos of 356 cases in 11 years (629 reimplanted ureters)]. AB - 629 ureteric reimplantations were performed in 356 children. Indications for reimplantation were 315 uni or bilateral ureteral reflux, 248 primary reflux and 67 secondary to ureteric duplication, ureterocele, vesical diverticula, neurogenic bladder, bladder neck obstruction, or ureteral obstruction, and 52 megaureters, 38 primary and 14 secondary megaureters. 61 reimplantations (14 megaureters) by Leadbetter-Politano, and 568 reimplantations (58 megaureters) by Cohen procedure were performed. 3 psoas hitching and 15 ureteroplasties, 14 Hendren and 1 Kalicinski procedures, were necessary. Primary results in reflux were 98.5% of success with Cohen operation and 100% with Leadbetter-Politano operation. Results were not so good in megaureter, 70% of success with Leadbetter Politano operation and 75% with Cohen. Results were better with psoas hitching and ureteroplasty (86.5% of success). PMID- 3624887 TI - [Urethral instability. Apropos of 26 cases]. AB - The authors report their experience about 26 cases of urethral instability. This dysfunction is not rare; both sexes are involved, children was well as adults. Diagnosis is based on the data of simultaneous urethro-cystometry. Three clinical patterns are recognized: intermittent urinary leakage (6 cases), frequency and urgency (3 cases) and enuresis (17 cases). The urethral instability was pure in 13 cases and associated to detrusor hyperactivity in the other thirteen. But, in one of these the bladder instability was pure. A treatment based on alpha adrenergic drugs has assured clinical relief and urodynamic stabilization of bladder and urethra. PMID- 3624888 TI - [Epididymitis. Apropos of 82 cases]. AB - The authors report 82 cases of epididymitis, studied from 1976 to 1985: 66 acute epididymitis and 16 chronicle epididymitis. It is the affection of young patients: middle age 39 years. The frequency of epididymitis seems to increase the last years. The coliform organisms were the predominant pathogens isolated from the patients more than 35 years old; for patients less than 35 years old, in most cases, the Chlamydia trachomatis was the cause of infection. Among 12 patients with Chlamydia trachomatis infection, 11 were less than 35 years old. The treatment before the results of the sample has to be the Doxycycline; if Chlamydia trachomatis is not the cause of infection, the treatment will be changed. The corticotherapy is always associated with antibiotics, and his action is discussed. PMID- 3624889 TI - [Gangrenous states of the perineum and genital region]. AB - The authors report on 13 cases of gangrene of the perineum. Eight of the patients presented with a pre-existing infectious or tumoral anorectal lesion. In two cases, gangrene was a complication of a surgically treated prostatic pathology; two other patients had Fournier's disease. The last case was termed "spontaneous" as no causative factor was found. The unexpected recrudescence of this pathology, its severe nature, our limited knowledge of the pathogenic factors involved, and the difficulties encountered in treatment make analysis of this series of cases particularly interesting; moreover, despite the apparent etiological disparity of these observations, there were common anatomic, bacteriologic, and therapeutic elements. As concerns treatment, emphasis is placed on three points: prime role of surgery, the only means of obtaining precise information on lesions, broad indications for bypass colostomy, value of treatment with hyperbaric oxygen. The mortality rate remains high: 4 of the 13 patients died. PMID- 3624890 TI - [Vesicovaginal fistula. Apropos of 600 cases]. AB - A personal series of 600 cases of vesicovaginal fistula is reviewed. Patients could be classified as a function of site of fistula into 3 groups: I. urethrovaginal fistula (31%); II. cervicovaginal fistula (22%); III. vesicovaginal fistula (46%). Etiology was mainly obstetrical (94%), as was multiparity (69%). An associated lesion was detected in 11% of cases (uterine, ureteral and rectal). Surgery was performed after a minimum period of 3 months with the following results. Type I fistulae, using a low approach and requiring urethral refection, showed good results in only 53% of cases. Type II fistulae, usually treated through a low approach (80%), were relieved in 80% of cases, with the reservation that reinforcement of bladder neck was often necessary. Type III fistulae, treated by a high (60%) or low (40%) approach were nearly always corrected (98%). In 2 cases of destroyed urethra unable to benefit from urethral plastic surgery, bladder repositioning with continent cystostomy was satisfactory. 72 cases with irrecuperable destroyed bladder received definitive high diversion: 34 Coffey, 5 Bricker, and since 1975, 33 continent ileocecal bladders using Benchekrouns' technique. PMID- 3624891 TI - [Metastatic vesical tumor of clear-cell renal carcinoma]. AB - The different means of spreading of adenocarcinoma of the kidney as well as the treatment of the two simultaneous tumors shall be discussed. PMID- 3624892 TI - [Transurethral continent vesicostomy]. PMID- 3624893 TI - Mosquito active strains of Bacillus sphaericus isolated from soil and mud samples collected in Israel. PMID- 3624894 TI - Life cycle and mode of infection of Leptolegnia chapmanii (Oomycetes) parasitizing Aedes aegypti. PMID- 3624895 TI - Transplantation of human melanocytes. AB - Recent advances in the culturing of pigment cells from human beings have made it possible to begin the transplantation of autologous melanocytes into areas of skin that are hypopigmented. In a patient with piebaldism we were able to take pigment cells from a shave biopsy of the normally pigmented skin of the back, expand the cells in culture, and return them to an area devoid of pigment cells and get a perfect take. To grow the cells in culture we used 12-O-tetradecanoyl phorbol-13-acetate (TPA) as well as cholera toxin and isobutylmethyl xanthine. At this time, one can substitute basic fibroblast growth factor for TPA. The procedure of using autologous pigment cell cultures opens the door for further advances in the treatment of patients who do not have melanocytes in certain areas of the skin, as seen in patients with vitiligo or piebaldism, or as a consequence of severe mechanical or thermal trauma. PMID- 3624896 TI - Specific biodetection of B16 mouse melanoma in vivo by syngeneic monoclonal antibody. AB - The specific detection of tumors in vivo using a radiolabeled syngeneic monoclonal antibody made by fusion of P3U1 (BALB/c myeloma cells) and C57BL/6 spleen cells primed with syngeneic B16 melanoma cells was investigated by color imaging, autoradiography, and biodistribution. The radiolabeled antimelanoma antibody specifically accumulated only in the tumor lesions, whereas no radioactivity was observed in normal tissues or organs. The distribution patterns of the radioactive antibody in the tumor lesions depended on the sizes of the tumor. Almost the entire region of the small metastatic tumor in lymph nodes was labeled, whereas the radioactive antibody was irregularly localized mainly in the center of the medium-sized tumor. However, only the peripheral region of the large primary tumor was labeled. The highest uptake of radioactivity (tumor:blood ratio) was observed in the small lymph node metastatic tumor lesions rather than in the large primary tumor. Furthermore, high resolution color imaging of B16 melanoma was also obtained by using 125I-labeled monoclonal antibody. Tumor location was specifically visible without subtraction or enhancement methods 3-5 days after injection of the radiolabeled antibody. PMID- 3624897 TI - Collagen gene expression in keloids: analysis of collagen metabolism and type I, III, IV, and V procollagen mRNAs in keloid tissue and keloid fibroblast cultures. AB - Regulation of collagen gene expression was studied in keloids and fibroblast cultures established from keloid biopsies from 9 patients. The collagen concentration in keloid tissue was not different from that in normal skin. The activities of 2 enzymes catalyzing intracellular collagen biosynthesis, prolyl 4 hydroxylase (PH) and galactosylhydroxylysyl glucosyltransferase (GGT) were significantly elevated in the keloids, the mean increase in the former enzyme being 5-fold and in the latter 3-fold with respect to the controls. The mean procollagen production rate in the keloid fibroblasts was at the control level, with only 1 keloid cell line showing a procollagen synthesis rate higher than the mean value + 2 SD of the controls. The mean PH and GGT activities of the keloid fibroblasts were not elevated, but PH activity in 2 cell lines and GGT activity in 1 cell line were higher than the mean + 2 SD for the controls. Cellular type I, III, IV, and V procollagen mRNAs were measured by slot blot hybridization using specific human cDNA clones for the various collagen types. The amounts of type I, III, and V procollagen mRNAs corresponded to the ratios in which these collagen types are produced by fibroblasts. No synthesis of type IV procollagen mRNA by keloid fibroblasts was observed. The total amount of type I and III procollagen mRNAs correlated significantly (p less than 0.01) with the procollagen synthesis rate measured after radioactive labeling of the cells in the keloid and control fibroblasts, indicating that collagen production in these cells is mainly controlled by regulating the final steady state levels of collagen mRNA. The results suggest that fibroblasts isolated from keloids often synthesize normal amounts of collagen. PMID- 3624898 TI - In vitro functional reactivities of cutaneous mast cells from patients with mastocytosis. AB - Cutaneous mast cells from 3 patients with mastocytosis were evaluated for their morphologic characteristics and in vitro functional reactivities to different secretory agonists. By electron microscopy, mastocytosis mast cells appeared larger than normal skin mast cells, frequently had atypical, highly indented or bilobed nuclei, and each contained numerous, elongated cytoplasmic projections. Suspensions of mastocytosis mast cells were obtained from lesional skin biopsy specimens, and their response to both immunologic and nonimmunologic secretagogues was compared with mast cells from normal skin. Lesional skin mast cells had a net histamine release of 12.3% (+/- 1.3 SEM) and 31.1% (+/- 6.0 SEM) following stimulation with the purified human anaphylotoxin C3a and mouse monoclonal antihuman IgE antibodies, respectively. This specific release was similar to the responses observed in normal skin mast cells (11.5% +/- 4.5 SEM and 16.7% +/- 2.1 SEM, respectively). Mast cells from cutaneous lesions of mastocytosis also responded to the nonimmunologic secretagogues, morphine sulfate and calcium ionophore A23187 with a specific histamine release of 15.1% (+/- 1.2 SEM) and 39.8% (+/- 8.7 SEM), respectively. The results of this study demonstrate that mast cells from lesions of mastocytosis are morphologically atypical, but have a histamine content similar to normal skin mast cells and retain their functional reactivities to clinically relevant secretory stimuli. PMID- 3624899 TI - Stimulation of follicular melanogenesis in the mouse by topical and injected melanotropins. AB - The effects of melanocyte-stimulating hormone (alpha-MSH) and related analogs on follicular melanogenesis in the mouse (C57BL/6JA gamma) were studied. [Nle4, D Phe7]-alpha-MSH and the related fragment analogues Ac-[Nle4, D-Phe7]-alpha-MSH4 11-NH2 and Ac-[Nle4, D-Phe7]-alpha-MSH4-10-NH2, stimulated the conversion of pheomelanogenesis to eumelanogenesis when subcutaneously injected at concentrations 100-fold lower than the native hormone, alpha-MSH. In addition, the melanotropin analogs stimulated follicular eumelanogenesis when applied topically to the skin of mice. The melanotropins were transdermally delivered to the systemic circulation as evidenced by the fact that eumelanogenesis was stimulated in hair follicles in areas distant from the site of topical application. These results demonstrate that peptide hormone analogs can be transported across the skin. The unique actions of the melanotropin analogs may relate to the fact that these peptides are nonbiodegradable and thus exert prolonged actions on melanocytes. These compounds may prove important for studies on normal integumental melanogenesis and for the treatment of hypopigmentary disorders in humans. PMID- 3624900 TI - Physicochemical study of percutaneous absorption enhancement by dimethyl sulfoxide: dimethyl sulfoxide mediation of vidarabine (ara-A) permeation of hairless mouse skin. AB - Dimethyl sulfoxide's (DMSO) concentration-dependent influences on its own permeation rate through hairless mouse skin and on the concurrent permeation rates of water and the antiviral drug vidarabine (ara-A) have been studied at 37 degrees C using in vitro diffusion cells. Solubilities of ara-A in DMSO-water mixtures were also determined in order to assess ara-A's relative thermodynamic activity in the binary solvent media used in the mass transfer studies. Solubilities increased exponentially with increasing percentages of DMSO. Activity coefficients decreased accordingly. When the same DMSO medium was placed in each side of diffusion cell (balanced solvent configuration) permeability coefficients for ara-A decreased exactly as ara-A's solubility increased up to a 50% DMSO concentration, indicating the observed decreases in the mass transfer coefficients have thermodynamic origins. When DMSO media were placed in either the donor or receiver side of the cell up to the same 50% concentration point and opposed by a normal saline medium on the other side (asymmetric solvent configurations), the permeability of ara-A did not decrease and at some DMSO levels was substantially increased, behavior in marked departure from thermodynamic control. The behavior disparity between the 2 configurations of the cell suggests that cross-currents of solvents play a role in permeability enhancement. Regardless of solvent configuration, permeability coefficients for ara-A at 90 and 100% DMSO strengths were exaggeratedly large, consistent with severe impairment of the stratum corneum. Similar overall permeability behavior was observed for the 2 solvents, water and DMSO. Possible underlying mechanisms for these effects and the relative importance of the various mechanisms of DMSO enhancement as a function of DMSO's concentration and configuration are discussed. PMID- 3624901 TI - Melanosomes are a primary target of Q-switched ruby laser irradiation in guinea pig skin. AB - The specific targeting of melanosomes may allow for laser therapy of pigmented cutaneous lesions. The mechanism of selective destruction of pigmented cells by various lasers, however, has not been fully clarified. Black, brown, and albino guinea pigs were exposed to optical pulses at various radiant exposure doses from a Q-switched, 40 nsec, 694 nm ruby laser. Biopsies were analyzed by light and electron microscopy (EM). Albino animals failed to develop clinical or microscopic evidence of cutaneous injury after irradiation. In both black and brown animals, the clinical threshold for gross change was 0.4 J/cm2, which produced an ash-white spot. By light microscopy, alterations appeared at 0.3 J/cm2 and included separation at the dermoepidermal junction, and the formation of vacuolated epidermal cells with a peripheral cytoplasmic condensation of pigment. By EM, enlarged melanosomes with a central lucent zone were observed within affected epidermal cells at 0.3 J/cm2. At 0.8 and 1.2 J/cm2, individual melanosomes were more intensely damaged and disruption of melanosomes deep in the hair papillae was observed. Dermal-epidermal blisters were formed precisely at the lamina lucida, leaving basal cell membranes and hemidesmosomes intact. Possible mechanisms for melanosomal injury are discussed. These observations show that the effects of the Q-switched ruby laser are melanin-specific and melanin dependent, and may be useful in the selective destruction of pigmented as well as superficial cutaneous lesions. PMID- 3624902 TI - Regulation of murine contact sensitivity to urushiol components by serum factors. AB - Mice epicutaneously painted with components of poison ivy urushiol oil exhibit contact sensitivity (as detected by ear swelling reactions) that persist for about 25 days. Sera taken from mice at times when the contact sensitization response is waning suppressed the induction of sensitization to 3-n pentadecylcatechol (PDC), a urushiol component, in recipients. The suppressive serum factor was present in greatest amount 25 days after sensitization, but was no longer detectable 40 days post sensitization. Suppression was antigen specific, absorbed out with PDC-immune, but not normal lymph node cells, and transferable with a single 0.6 ml dose 7 days prior to sensitization of recipients. Suppression was transferable by the purified IgG fraction of desensitized mice. Results indicate that contact sensitivity to urushiol in mice is regulated by serum factors. PMID- 3624903 TI - 8-Methoxypsoralen levels in blood. PMID- 3624904 TI - Coagulase-negative staphylococci isolated from cerebrospinal fluid shunts: importance of slime production, species identification, and shunt removal to clinical outcome. AB - We collected and characterized 85 strains of coagulase-negative staphylococci (51 pathogens and 34 contaminants) from cerebrospinal fluid shunts. All isolates were classified by species and characterized by antimicrobial susceptibility and quantitative adherence to plastic tissue culture plates. There were more adherent organisms among pathogens than among contaminants (P less than .01). Species distribution was similar for both groups; however, 20% of the pathogens and none of the contaminants were phosphatase-negative Staphylococcus epidermidis (P less than .05). Resistance to four or more antimicrobial agents was detected in 45% of both groups. Neither species designation nor antimicrobial resistance correlated with clinical outcome. Five (83%) of six infections due to nonadherent (vs. 16 [41%] of 39 due to adherent; P less than .05) coagulase-negative staphylococci were, however, cured with antimicrobial therapy alone. Cure was highly associated with removal of the colonized shunt--38% of infected patients treated with antimicrobial therapy alone were cured, 75% treated with antimicrobial therapy and partial shunt removal were cured, and all treated with antimicrobial therapy and total shunt replacement were cured. PMID- 3624905 TI - Clinical significance of a test for slime production in ventriculoperitoneal shunt infections caused by coagulase-negative staphylococci. AB - Coagulase-negative staphylococci (CNST) are the most-common cause of ventriculoperitoneal shunt infections. Some of these strains produce a slime-like substance. We reviewed 19 episodes of ventriculoperitoneal shunt infections due to CNST in 17 patients. Eleven episodes of infection were caused by slime producing CNST and eight by non-slime-producing CNST. Shunt obstruction and abdominal pain occurred more frequently when infectious episodes were due to slime-producing CNST than to non-slime-producing CNST (P less than .05). Despite appropriate antimicrobial therapy, the mean duration of fever was longer and the failure to eradicate the infecting organisms was more frequent when the infectious episodes were due to slime-producing CNST than to non-slime-producing CNST (P less than .025). Discriminate function analysis found, however, that only failure to eradicate the infecting organism (by antimicrobial therapy) occurred more frequently in infectious episodes due to slime-producing CNST than to non slime-producing CNST (P = .01). PMID- 3624906 TI - Neutrophil uptake of vaccinia virus in vitro. AB - We studied human neutrophils for uptake of vaccinia virus. Uptake was determined radiometrically and by electron microscopy. Vaccinia virus was labeled with 14C or 3H, incubated with neutrophils, and quantified in neutrophil pellets in a new radiometric phagocytosis assay. Better results were obtained from assays of [3H]thymidine-labeled virus; uptake increased through 1 hr and then plateaued. Phagocytosis of 3H-labeled Staphylococcus aureus was normal. Uptake of virus was serum dependent. Hexose monophosphate shunt activity was measured by two methods. No 14CO2 from [14C]1-glucose accompanied uptake of vaccinia virus, in contrast to the respiratory burst accompanying bacterial phagocytosis. Electron microscopy showed intact to slightly digested intraphagolysosomal vaccinia virus. Pock reduction assay showed a decrease in viral content due to neutrophils until 6 hr of incubation, when a modest but significant increase was observed. Thus, neutrophil uptake of vaccinia virus is distinguished from bacterial phagocytosis. PMID- 3624907 TI - Influenza at Lowry Air Force Base in Denver, 1982-1986. PMID- 3624908 TI - Self-infusion of intravenous immunoglobulin by immunodeficient patients at home. PMID- 3624910 TI - Efficacy of a single intravenous dose of amphotericin B in urinary tract infections caused by Candida. PMID- 3624909 TI - Antibody reactivity to HLA classes I and II in sera from patients with hydatidosis. PMID- 3624911 TI - Treatment of pleural blastomycosis: penetration of amphotericin B into the pleural fluid. PMID- 3624912 TI - Argyrophilic, intracellular bacteria in the lymph node of a cat: cat-scratch disease bacilli? PMID- 3624913 TI - Rhabdomyolysis in leptospirosis (Weil's disease). PMID- 3624914 TI - Experimental infections of mosquitoes with Borrelia burgdorferi, the etiologic agent of Lyme disease. PMID- 3624916 TI - Diagnosis of tuberculous meningitis. PMID- 3624915 TI - Accessory cell function of AIDS monocytes. PMID- 3624917 TI - Thymus-derived stromal cell lines. AB - We derived stromal cell lines from mouse thymus using methods previously established for bone marrow stroma. Two main morphologically distinct groups of cell strains emerged: epithelioid and mixed fibroblast-macrophage. Transmission electron microscopy revealed frequent junctional-complex formations between adjacent cells, a feature that characterized almost all of the thymus stromal lines, but was confined to only one of the five distinct subtypes of cell lines from bone marrow. In contrast to marrow stromal cells, the thymus-derived cell lines were all negative with fat-detecting reagents, had low acid phosphatase and no basic phosphatase activities and were unable to support the in vitro proliferation of myeloid progenitor cells (CFU-gm). Leukemia cell inhibitory activity (LCIA) was detected in one of the thymus stromal cell lines. The differences observed between cell lines derived from the stroma of the thymus and those from bone marrow may relate to the functional specificities of these organs. PMID- 3624918 TI - Growth of murine bone marrow under various oxygen conditions in media buffered with HEPES. AB - Increased plating efficiencies were observed for marrow granulocyte-macrophage precursor cells (CFU-gm) cultured in an experimental system at reduced gas-phase oxygen concentrations. However, only a small component of this increase was attributable to decreased oxygen. The changed media buffering system was the more dominant factor contributing to increased plating efficiency, suggesting that other factors in addition to a reduction in oxygen may influence clonogenicity. PMID- 3624919 TI - Enhancement of survival and proliferation of clonogenic cells by monocyte-derived growth factors. AB - Human peripheral blood monocytes release a factor that enhances the clonal growth of human epithelial tumor cells in soft agar. The monocyte-derived growth factor was needed for both cellular proliferation and survival. Survival of SW-13 colony forming cells decreased linearly in the absence of monocyte-conditioned media (MO CM). Cells failed to respond to MO-CM after four days in culture. Although MO-CM enhanced growth when cells were plated at low density, growth was also enhanced when cell density was not a limiting factor. MO-CM increased DNA synthesis of SW 13 cells growing in monolayer culture as measured by tritiated-thymidine incorporation. These findings support evidence indicating inflammatory products may play a role in maintenance of the transformed phenotype. PMID- 3624920 TI - The ultrastructure of erythropoiesis in vitro: description and utilization of a new methodology. AB - A simplified methodology has been developed which makes it possible to examine the ultrastructural details of cells cloned in vitro while retaining the cell/cell relationships within semi-solid cultures. Using mouse erythropoiesis as the model for study, electron microscopy revealed many normal characteristics of red blood cell differentiation and maturation, as well as several distinct dyserythropoietic features. The usefulness of this technology should apply to fine structural studies of clonally-derived material such as hematopoietic cells, tumor cell lines and primary tumor cultures. PMID- 3624921 TI - Improvement of culture conditions for human megakaryocytic and pluripotent progenitor cells by low oxygen tension. AB - The effect of low oxygen tension on the growth of human hemopoietic progenitor cells in bone marrow was investigated using the semisolid methylcellulose colony assay. The clonal growth of granulocyte-macrophage progenitors (CFU-gm), early (BFU-e) and late (CFU-e) erythroid progenitors, megakaryocyte progenitors (CFU meg) and pluripotent progenitors (CFU-mix) improved more markedly incubation at the low oxygen tension (5%) than in conventional air (20%). The thiol compound 2 mercaptoethanol had a strong additive effect on colony growth in conventional air, but little or no effect in the low oxygen tension. These results suggest that enhancement of colony growth in the low oxygen tension may be due to a decrease in the production of oxygen intermediates. PMID- 3624922 TI - In vitro assays for new drug screening: comparison of a thymidine incorporation assay with the human tumor colony-forming assay. AB - Because of technical limitations with the human tumor colony-forming assay (HTCFA), we determined the feasibility of using a thymidine incorporation assay (TIA) for new drug screening. Concordance between the TIA and the HTCFA was obtained (r = 0.840) with twenty coded compounds. Toxic agents without proven clinical efficacy were active in both assays, while non-toxic substances were inactive. Growth rates were higher with the TIA (75%) than with the HTCFA (45%), and the TIA could be completed in 6 days compared to 14-21 days with the HTCFA. We concluded that the TIA is a useful adjunct to in vivo tumor models for screening new anticancer agents. PMID- 3624923 TI - [Effects of RA-RV sequential pacing on the heart with central block of the right bundle branch]. PMID- 3624924 TI - [Extracorporeal systemic hyperthermia in patients with advanced pulmonary cancer]. PMID- 3624925 TI - [Myocardial tissue calcium kinetics in human atria during cardiopulmonary bypass]. PMID- 3624926 TI - [Usefulness of echocardiography in the long-term follow-up study after surgical treatment of annulo-aortic ectasia]. PMID- 3624927 TI - [The experimental evaluation of direct-intrapulmonary balloon pumping (direct IPBP)]. PMID- 3624928 TI - [Improved myocardial protection by pharmacological pretreatment in extended global ischemia based on Mg-lidocaine-induced cardioplegia]. PMID- 3624929 TI - [Experimental study on the hemodynamic effect of venoarterial bypass in acute left heart failure]. PMID- 3624930 TI - [Echocardiographic analysis of abnormal motion of the interventricular septum after mitral valve replacement]. PMID- 3624931 TI - [Surgical treatment of coarctation and interruption complex associated with aortic valve stenosis]. PMID- 3624932 TI - [A case of esophago-cardiac fistula]. PMID- 3624933 TI - [Successful treatment of acute renal failure following the Mustard operation with a new device for continuous peritoneal dialysis]. PMID- 3624935 TI - [A case of successfully resected giant hemangiomatous lesion in the thoracic cavity]. PMID- 3624934 TI - [Successful repair of total anomalous pulmonary venous return of infracardiac type in a 17-hour-old neonate]. PMID- 3624936 TI - [Successful emergency operation of tracheal obstruction caused by aneurysm of the aortic arch]. PMID- 3624937 TI - [Valve replacement for aortic incompetence due to Libman-Sacks endocarditis]. PMID- 3624938 TI - [Tracheo-bronchial stenosis caused by a thrombosed aortic aneurysm after extra anatomic bypass in a dissecting aortic aneurysm]. PMID- 3624939 TI - [Combined surgery of pulmonary vein reconstruction in two cases with advanced pulmonary cancer]. PMID- 3624940 TI - [An inexpensive gradient apparatus for high performance liquid chromatography]. PMID- 3624941 TI - [Simple desalting technic for peptides]. PMID- 3624942 TI - Structure and function of major histocompatibility complex class I genes and proteins. Part I. A symposium. PMID- 3624943 TI - Enhanced endothelial permeability and invasion of leukocytes into the artery wall as initial events in experimental arteriosclerosis. AB - The temporal sequence of the very early events in arteriosclerosis, as induced by electrical stimulation in carotid arteries of rabbits, was examined by combined light microscopy and transmission electron microscopy. After one session (30 min) of DC impulses, the endothelial permeability to horse-radish peroxidase was increased mainly beneath the anode, judging from the massive accumulation of reaction products of peroxidase in the subendothelium. After a further stimulation period, some of the endothelial cells displayed alterations in pattern and size and heavy cytoplasmic deposition of silver salt. However, the endothelium was maintained as a continuous lining. During this initial phase, a considerable number of granulocytes and monocytes was found adhering to the endothelium of the stimulated region and also within the subendothelial space. The invasion of the leukocytes preceded the migration of smooth muscle cells from the media into the intima, a process which began after two days of the electrical stimulation schedule. These initial phases of plaque development may represent a special form of an inflammatory response. PMID- 3624944 TI - The effect of acute and chronic administration of nicotine on lipoprotein lipase activity. AB - Nicotine was injected intraperitoneally to rats and 2 h later lipoprotein lipase was determined in isolated perfused hearts. There was a significant increase in heparin releasable lipoprotein lipase activity which represents the functional pool without increase in total enzyme activity. When 1 microliter/h of a solution of nicotine (120 mg/ml) was delivered for 3 days from subcutaneously implanted miniosmotic pumps, total lipoprotein lipase activity in the heart increased 1.5 3.0 fold. Endogenous lipoprotein lipase activity in plasma doubled and there was a significant fall in plasma triglyceride levels. The effect of nicotine on heart lipoprotein lipase activity was evident also after 6 days of continuous delivery and was accompanied by a fall in adipose tissue lipoprotein lipase activity. No effect was seen when the dose of nicotine was halved. A positive correlation was seen between plasma nicotine levels and heart lipoprotein lipase activity, while adipose tissue lipoprotein lipase correlated negatively with plasma nicotine levels. Chronic administration of nicotine was accompanied by either weight loss or diminished weight gain. It is concluded that in the rat the acute effect of nicotine on the shift of lipoprotein lipase to the functional pool could be related to enhanced beta-adrenergic stimulation. The chronic effect of nicotine could have been mediated by the loss in body weight, due to reduced caloric intake. PMID- 3624945 TI - Some pathogenetic aspects of atherosclerotic lesions. Platelets and atherogenesis. Differences in atherogenesis in different body districts. Regression of arterial lesions in animal models. AB - The first part of the paper is devoted to the role of platelets in atherogenesis because the new ultrastructural techniques have revealed the morphological basis of platelet "activation". In the second part, the delayed involvement of intracranial vs extracranial cerebral arteries, afferent to the brain is examined on the basis of recent work both in man and in experimental animal models. Regression of arterial lesions is considered in the third part chiefly on the basis of contributions in experimental animals, while more data on regression in humans are expected in the near future. PMID- 3624946 TI - Regulation of smooth muscle proliferation by heparin in vitro and in vivo. AB - Smooth muscle cell proliferation is central to the development of atherosclerotic plaques, intimal thickening, and recurrent stenosis in arteries following surgical reconstruction. The factors that might limit this process remain poorly defined. Studies reported recently from several laboratories suggest that heparin administered in pharmacological doses can suppress proliferation of smooth muscle cells. Furthermore, heparin-like molecules are synthesized by vascular wall cells, inhibit smooth muscle growth in vitro, and might act to regulate smooth muscle growth within the arterial wall. PMID- 3624947 TI - Trends in experimental atherosclerosis. PMID- 3624948 TI - Increased contractile responses of isolated arteriosclerotic rabbit carotid arteries to various vasoactive stimuli. AB - Clinical observations indicate that atherosclerotic vessels are prone to develop vasospasm. It was assumed that this property is related to hypercholesterolemia, but the basic mechanisms are still unknown. To investigate further mechanical stimulation experiments were performed with segments of rabbit carotid arteries. Arteriosclerotic lesions were induced in vivo in these arteries by application of DC impulses either in hyper- or normo- cholesterolemic animals. Contractions were evoked by noradrenaline, KCl or hydrogen peroxide. The results show that all the arteriosclerotic segments were hypersensitive to noradrenaline and hydrogen peroxide, compared with the corresponding controls. An increase in contraction force was also found upon application of KCl to lipid-containing plaques. However, in arteriosclerotic segments obtained from normally fed animals, the contraction response to KCl was lower than in controls. This indicates that complex alterations in the contractile properties occur in smooth muscle during atherogenesis which cannot be explained solely on the basis of the influence of cholesterol on the arterial cells. PMID- 3624949 TI - Effects of anti-atherosclerotic substances on smooth muscle cell migration and proliferation analyzed by time-lapse video microscopy. AB - A new approach to analyze possible anti-atherosclerotic effects of substances using time-lapse video microscopy is presented. Time-lapse video recording of cultured cells combined with the quantitative analysis of cellular migration and proliferation provides information on the individual cell behaviour that is not available by other methods. Heparin was used as a model substance to analyze its effect on the migration and proliferation of smooth muscle cells. Subcultured smooth muscle cells were videotaped for 48-72 hours and the interdivision times of all cells were determined. The motility of the cells was quantitated using a morphometric system. While untreated smooth muscle cell clones showed average interdivision times of 14-20 hours, 100 micrograms/ml heparin elongated the interdivision times of about 40% of the clones to average interdivision times of 20-26 hours. While untreated smooth muscle cells showed motility rates ranging up to 45 microns/h, heparin reduced the motility of 90% of the cells to migration rates of 0-15 microns/h. These data indicate a heterogeneous reactivity of different smooth muscle cell subpopulations with respect to heparin effects on migration and proliferation. PMID- 3624950 TI - The induction of smooth muscle cell proliferation in vitro using an organ culture system. AB - Agents which promote vascular smooth muscle cell (SMC) proliferation are still unknown and cannot be readily defined in vivo. To examine this problem, we have developed a technique to maintain arteries in culture for more than two weeks without loss of endothelium and without loss of contractility. These vessel segments were maintained in 30% calf serum, and yet SMC replication rate in the media was found to be below 0.1% per day. No loss of medial cells nor medial necrosis was observed. Gentle endothelial denudation did not cause intimal thickening. If, in addition to denudation, direct mechanical injury was applied, then the replication rate of intimal SMC was found to be 60% per day during the first week. These cells were confirmed to be of SMC origin using cell specific antibodies. Since SMC start to proliferate after mechanical injury and not after application of serum, we conclude in our experimental model that exogenous growth factors play a minor role in the process of induction of proliferation of these cells. PMID- 3624951 TI - Cell biology of smooth muscle in culture: implications for atherogenesis. AB - Smooth muscle cells are one of the most important, if not the most important component of atheromatous plaque. Smooth muscle cells from developing and regenerating arteries, as well as atheromatous plaques, show similar morphological and biochemical characteristics which differ from adult tissue. During primary culture, adult smooth muscle cells alter their morphology to resemble those of the developing, regenerating and atheromatous material. We propose that primary cell culture of smooth muscle cells provides a model for the study of smooth muscle cell changes during atheroma formation. PMID- 3624953 TI - Results of thrombectomy in recent thrombosis of the crural and popliteal veins. AB - Thromboses of the crural and popliteal veins were thrombectomised almost completely in 39 patients within a period of one to three days. Obligatory follow up phlebography demonstrated complete patency of the venous axis in 36 of these patients. Twenty-two patients operated more than three years ago showed preservation of the morphological and functional result. On the basis of our good experiences, we recommend early thrombectomy from the popliteocrural axis also in oligosymptomatic patients in order to prevent the ascending course of the disease. PMID- 3624952 TI - Elastic and thrombogenic properties for different vascular grafts and its influence on graft patency. AB - In a sheep model elastic and thrombogenic properties for various vascular graft materials were studied using peroperative compliance measurements and Indium-111 oxine labeled platelets in vivo. It was found that the least thrombogenic arterial vascular substitute was the autologous vein while a significantly higher thrombogenicity was recorded for the polytetrafluoroethylene (PTFE) graft and the Chinese pure silk graft. The two latter grafts did not differ significantly in thrombogenicity except for that the silk graft revealed a significantly higher peak value for deposited platelets onto its surface than the PTFE graft. Compliance measurements at graft implantation revealed that both the silk and the vein grafts were more elastic than the PTFE graft. The two grafts did not differ in elasticity from each other significantly. Elasticity for all grafts increased during the first 10 weeks after implantation. There was a good correlation between elastic properties and graft patency for all tested graft materials. However, the silk graft with favourable elastic characteristics was found to have less favourable thrombogenic properties and is therefore in its present form not the ideal graft for small caliber artery reconstructions. PMID- 3624954 TI - P31-NMR studies of muscle in patients with venous insufficiency. AB - Increased interest in venous insufficiency has generated investigators to look for new insights to the pathophysiology of this disease. Previous clinical experience has revealed a relationship between venous hypertension and muscle atrophy in this group of patients. Phosphorous nuclear magnetic resonance studies has been done on a group of venous insufficiency patients to discover the biochemical changes. PMID- 3624955 TI - [A new method for automatic analysis of scoliotic deformity]. AB - The Moire method has been widely used in mass school screening for early detection of scoliosis. A new type of automatic analyser for scoliosis, which is the conceptual heir of the Moire method, was developed. This new apparatus consists of a slide projector, video camera and microcomputer system using the principle of three-dimensional robot vision technology. Using this new method, the measurement for one patient is done automatically in less than a half minute. A good correlation is noted between the degrees measured by the new method and Cobb angles on X-ray film. Results suggest the usefulness of this system for the mass screening of scoliosis and to judge the effects of treatment. PMID- 3624956 TI - [Osteoporotic changes in rheumatoid arthritis]. AB - Bone mineral density (BMD) in the distal 1/6 and 1/3 sites of the radius was measured by single photon absorptiometry in 58 female patients with rheumatoid arthritis, not treated with corticosteroids. Half of the patients showed lower values of BMD than those (mean--1SD) of age-matched controls. BMD decreased more significantly with advancement of destructive changes of radiocarpal joint in postmenopausal patients. There was a significant inverse correlation between BMD and duration of the disease. Decreasing rate of BMD was much higher in postmenopausal patients than in premenopausal patients. These results indicated rheumatoid arthritis was not universally associated with osteoporosis. Osteoporosis occurred much more frequently in postmenopausal patients with a long duration of the disease showing marked joint destruction. In premenopausal patients, bone loss was most common in the region of affected joints. But, bone loss in postmenopausal patients occurred not only in the periarticular bone but in the diaphyseal bone. PMID- 3624957 TI - [Biomechanical analysis of scoliosis and back muscles using CT evaluation and the finite element method]. AB - The CT observation of back muscles of an idiopathic scoliosis patient showed increased muscle volume and high CT value on the convex side. Following these muscles by digitizer showed that convex muscle volume increased as the vertebra shifted to convexity. These back muscles were suggested to be transversospinalis muscles. Biomechanical analysis using finite element method (FEM) was done to further investigate this increasing volume of back muscles. A Risser experiment using FEM revealed that initial lordosis configuration model only produces rotation to the convex side by unilateral loading. We, therefore, made the model adding posterior element, regarding contraction of M. transversospinalis. In a normal case, the upper vertebra is rotated over the lower towards the side opposite the muscle contraction. The scoliosis model, however, showed rotation towards the side of muscle contraction. M. transversospinalis can be considered as the agent of this rotation force. PMID- 3624958 TI - [Follow-up study on triple-cup arthroplasty of osteoarthritis of the hip]. AB - Although various operative methods have been applied to relatively young patients with osteoarthritis of the hip, none of them has provided fully satisfactory results. Since 1974 we have been performing triple-cup arthroplasty on these patients. In this paper, the design, operative procedures and postoperative management are described, and the clinical results evaluated by the rating score system set by the Japanese Orthopaedic Association are reported. There were 67 patients consisting of 64 women and 3 men. Their ages ranged from 24 to 72 years (mean 43.5 y). The period of postoperative follow-up ranged from one year to 8.5 years (mean 4.7 y) and revealed high scores in 71% but gradual declination in 29% during five years postoperatively. The main cause of the poor results was thought to be migration of the outer cup leading to recurrence of the hip joint pain. PMID- 3624959 TI - [Morphological and functional study of deep veins in the reverse flow island flap]. AB - Reid and Biemer in 1983 introduced the reverse flow forearm flap and Yoshimura in 1984 reported the reverse flow peroneal flap. No problems were experienced in any of our cases by drainage from valves of the concomitant veins. From our experiments on one cadaver and eight freshly amputated limbs the following comments may be made about the mechanism of drainage in reverse flow in the concomitant vein: Each concomitant vein has many anastomoses and there are resulting by-passes which go around the valves. For that reason, the reflux does not always occur in all valves. It is believed that special valves only in certain parts of the vein are triggered to open when there is a 90-100 cm H2O pressure and at that time reflux occurs. PMID- 3624960 TI - [Calcitonin values in normal human blood]. AB - Since 1969 when Clark, et al. established the radioimmunoassay for human calcitonin, a number of reports have been published. However, the normal value of calcitonin has never been definitely ascertained. The calcitonin value in the blood of 256 normal individuals was measured by radioimmunoassay using the Dai ichi Calcitonin Kit, and the X-ray findings in 133 of this population were studied. The calcitonin value was found to range from less than 10 to 249 (average 49.0) pg/ml. In terms of age, it was shown to be highest in the third decade and tended to decrease from the fourth decade on. In terms of sex, it was higher in females in the second, sixth and seventh decades but higher in males in the third--the fifth decades. There was no relationship between the degree of bone atrophy and the calcitonin value in the blood. PMID- 3624961 TI - [Studies on the mechanical properties of the knee ligament]. AB - To study mechanical properties of the knee ligaments, tension tests at various speeds were performed on the knee of a dog with only the collateral ligament. The results showed that the tensile force was greater in high speed than in low speed test. The difference may be caused in a viscous property of the ligament. The mechanical properties of ligaments can therefore be treated as those of viscoelastic materials and expressed by a modified Voigt model consisting of a non-linear spring element and a dash pot component. Observations regarding the ultrastructure of human knee ligaments using an electron scanning microscope revealed wavy bundles of collagen fiber connected with coarse fibers like network running in parallel with the long axis as the main structure. The above structure and properties were considered to be the decisive factors in the mechanical actions of the knee ligament. PMID- 3624962 TI - [Studies on microcirculation injury of skeletal muscle due to tourniquet-induced ischemia]. AB - Blood flow does not return to all areas after long period of ischemia produced by tourniquet application. The cause of this "no-reflow phenomenon" is still a matter of controversy. The purpose of this study was to investigate the relationship between thrombus formation and the no-reflow phenomenon by comparing the change of platelet function and the findings of vessel lumen observed by scanning electron microscopy. Through the results of a microangiogram, the author confirmed that the no-reflow phenomenon occurred on the first day and disappeared on the fifth day after the tourniquet was released. Mean volume, maximum aggregation and malondialdehyde of platelets decreased at two hours to one day after tourniquet release due to the consumption of larger platelets. There were irregular endothelia and a mural thrombus in the veins of the ischemic leg on the first day following release of the tourniquet. These findings suggest that thrombus formation plays an important role in the development of the no-reflow phenomenon. PMID- 3624963 TI - [Tissue reaction of the bone marrow to glass ceramic powder in the femurs of rats fed on a low-calcium diet]. AB - Glass ceramic powder was injected into the bone marrow of 36 rats which were fed a low calcium (21 rats) or normal (15 rats) diet. They were sacrificed 7 or 8, 32 and 60 days after treatment. Histomorphometrical measurement revealed that the ratio of length of bone tissue which was in contact with glass ceramic mass to the circumference of each mass was larger in 32-day and 60-day groups than in the 7 or 8-day groups. Osteocyte-like cells were observed in the narrow space between ceramics and bone tissue in all specimens. Giant cells were seen in 1-2% of the glass ceramic surfaces in low calcium diet group and in 0.3% in normal diet group. No inflammatory reaction such as aggregation of lymphocytes nor leukocyte infiltration was observed in any specimens. Eighty-two percent of the surface of glass ceramic mass was covered with bone tissue 60 days after treatment in normal diet group. PMID- 3624964 TI - [Experimental study of intraneural circulatory changes in axonal de- and regeneration]. AB - Two experimental studies were made of intraneural circulatory change on axonal de and regeneration using median and ulnar nerves of the Japanese monkey. Experiment 1: Epineural suture was performed on one side, and fascicular suture was performed on the opposite side by removing the interfascicular epineurium. The regenerated axons in the fascicular suture group were fewer in number and smaller in diameter than those in the epineural suture group; this may have been the result of destruction of the interfascicular epineurium. Experiment 2: Inter- and intrafascicular blood circulation was investigated by the electric hydrogen ion gas clearance method with the following results. Blocking of a segment of the blood supply over a length of more than 20 times the nerve diameter caused circulatory disturbance of the intrafascicular blood flow and secondary axonal degeneration. Irreversible intrafascicular blood circulatory disturbance was caused by stripping of the intrafascicular epineurium. In served segments with preserved segmental blood vessels, longer segments preserved more intraneural blood flow than shorter ones. PMID- 3624965 TI - [Cone-shaped epiphyses in the phalanges of the hand--a statistical and experimental study]. AB - To study the incidence of cone-shaped epiphysis (CSE) among Japanese children, roentgenograms of 1,391 hands in 985 children including 600 normal individuals (621 hands), 325 cases with various hand malformations (650 hands) and 60 cases with various systemic diseases (120 hands) were reviewed. A series of animal experiments was carried out to produce a similar pathological picture, by partially interrupting the circulation in the proximal portion of the tibia in young rabbits. RESULTS: 1. CSE was found in 13% of the normal individuals with female predominance (female/male = 2.3). The most common site was the middle phalanx of the little finger. In the hands with congenital malformation or systemic diseases, the overall incidence of CSE was not significantly higher than in normal hands, but the distribution and shape were somewhat different. 2. The animal experiments suggested that a circulatory disturbance of the growth plate may lead to the formation of CSE. PMID- 3624966 TI - The place of the microscope in hand surgery. PMID- 3624967 TI - Pincer reconstruction using second toe transplantation. AB - Nine patients who had suffered mutilating injuries of the hand with preservation of only one digit and loss of the others at metacarpal level have been treated by transfer of the second toe onto a metacarpal stump to restore pincer grip. The transfers did not all survive but those which did gave useful function. PMID- 3624968 TI - Double toe transfers. AB - Ten double toe transfers for mutilating hand injuries have been studied. In two patients with total loss of all digits, pincer pinch was restored by the transfer of two separate toes, one to each side of the stump. Seven patients had survival of the thumb and a three-point chuck pinch was provided by transfer of a second toe plus a wrap-around flap over a bone graft to create a third, but stiff digit. One patient required three fingers and was treated by one single toe transfer and one double toe transfer. PMID- 3624969 TI - Surgical treatment of the thumb in the Rubinstein-Taybi syndrome. AB - In a review of 530 individuals with Rubinstein-Taybi syndrome, 182 (34%) were found to have thumbs in severe radial angulation ("hitch-hiker thumbs"), which prevented opposition and functional gripping strength. Surgery has been performed on 35 thumbs (from 20 patients), usually to correct a delta phalanx deformity. The preferred approach was a closing wedge osteotomy, with a Z-plasty on the concave side to straighten the thumb. In eight and possibly 11 of the 35 thumbs, the angulation deformity or stiffness recurred, emphasizing the importance of proper and careful surgery. We conclude that surgical correction of the deformity is best done before the age of two, so that the thumb is functional during the initial development of hand-eye coordination. Deviation persisting at the age of ten can be corrected by fusing the metacarpophalangeal joint. PMID- 3624970 TI - Congenital radio-ulnar synostosis: compensatory rotation around the wrist and rotation osteotomy. AB - In order to make clear the clinical features of congenital radio-ulnar synostosis, compensatory rotation around the wrist and functional results after rotation osteotomy, 40 cases of congenital radio-ulnar synostosis have been analysed. The mean pronation of the ankylosed forearm in those who complained of disabilities in daily life was 60.7 degrees and that in patients without complaints was 21.2 degrees. In almost all cases with total ankylosis, the forearm had compensatory movement around the wrist, the mean arc being from 76.3 degrees of pronation to 42.9 degrees of supination. 13 limbs in 11 patients treated by transverse rotational osteotomies through the fusion mass have followed up for over two years. The functional results after surgery were satisfactory in all patients. Rotational osteotomy of the forearm is a useful and reliable treatment for congenital radio-ulnar synostosis. PMID- 3624971 TI - A modification of the Kleinert splint for mobilisation of digital flexor tendons. AB - A modification of the Kleinert dynamic splint is described, whereby the rubber band is looped around the hand, rather than attached to the volar aspect of the wrist or forearm. This alters the direction of traction so that the interphalangeal joints are more effectively mobilised. PMID- 3624972 TI - Reduction of grip strength, finger flexion pressure, finger pinch pressure and key pinch following flexor tendon repair. AB - 67 patients with 176 repaired flexor tendons have been reviewed after a mean follow-up interval of 26.4 months. After repair, mean grip strength was 74.5%, mean finger flexion pressure 76.8% and mean finger pinch pressure 74.7% of that of the opposite uninjured hand or digit. For 16 patients with repaired flexor pollicis longus tendons, mean key pinch was 78.7%. Grip strength was reduced after injury to tendons alone, but was especially reduced when there was concomitant damage to the median or ulnar nerves. PMID- 3624973 TI - Use of a previously repaired tendon for tendon transfer. AB - A patient in whom a previously repaired flexor digitorum superficialis tendon was used for transfer to correct a claw deformity is described. I have found this to be possible under optimal conditions of tendon repair, thus providing the hand surgeon with another choice of donor material. PMID- 3624975 TI - Blood supply of the subcutaneous tissue of the upper limb and its importance in the subcutaneous flap. AB - Vascularization of the subcutaneous tissue of the upper extremity is described. Injection of coloured latex or India ink and gelatine solution showed the principal sources of the blood supply. Microdissection and transclarification of Spalteholz allowed for the study of the direct and indirect arterial branches which form the principal network of the subcutaneous tissue. The findings are of practical importance since the subcutaneous tissue can be used as a separate flap for covering soft tissue defects of the forearm and hand. PMID- 3624974 TI - Median nerve as free tendon graft. AB - Four patients are described, all of whom had tendon injuries in which the median nerve was used as a free tendon graft. Three cases involved the repair of a flexor tendon injury, and one the repair of an extensor tendon. In all cases, reconstruction of the median nerve was performed with a free sural nerve graft. The difficulty was that the palmaris longus tendon was missing in all cases. The importance of preoperative clinical testing for the presence of the palmaris longus tendon is emphasized. PMID- 3624976 TI - Restoration of elbow flexion by complete latissimus dorsi muscle transposition. AB - Flexor-plasty of the elbow has been performed using either a tubed complete latissimus dorsi muscle or musculocutaneous transposition in eight patients, six of whom had brachial plexus palsy and two traumatic loss of the anterior brachial musculature and overlying soft tissue. The range of follow-up was from one to eight years. When the postoperative results were evaluated according to the criteria of Segal (1959), the results were excellent in four cases and good in three, with one failure. The indications, operative technique and results are discussed. PMID- 3624977 TI - Diffuse cavernous haemangiomas of the upper limb. AB - In the upper limb, diffuse cavernous haemangiomas occur infrequently but their treatment is often unsatisfactory and the result of surgical excision disappointing. Four cases of these diffuse haemangiomas are described and their management discussed. PMID- 3624978 TI - Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. AB - A bone graft, taken from the medial part of the radial epiphysis can be pedicled on the radial branch of the volar carpal arch, freed back to its origin. The graft can be transferred into the proximal row of the carpus to fill up a loss of bony substance or to provide vascularised bone. This permits the treatment of chronic pseud-arthrosis of the scaphoid where a Matti-Russe operation has failed. In the first three cases operated upon, favourable results have been obtained. PMID- 3624980 TI - Vascularised versus conventional nerve grafting: a case report. AB - A case is described in which two lengths of the lateral cutaneous nerve of the forearm were used, one vascularised and the other not, to reconstruct the two digital nerves of the thumb. The sensory recovery of the two nerves was compared, and the vascularised nerve graft found to result in better sensation. This finding provides further support for the value of vascularised nerve grafts. PMID- 3624979 TI - Enhancement of neuromuscular recovery after nerve repair in primates. AB - This investigation describes the use of the calcium-activated protease inhibitor, leupeptin, as an adjunctive therapy to the microsurgical repair of median nerves in a primate model. Our results indicate that leupeptin facilitates morphological recovery in denervated thenar muscles and in distal sensory and mixed motor sensory nerve trunks and functional recovery measured by motor nerve conduction velocity. Toxicological testing of leupeptin showed that, when administered at a dose of 12 mg/kg, intramuscularly, once daily, haematological and clotting profiles were not adversely affected. PMID- 3624981 TI - Lipofibroma of the median nerve: a report of two cases. AB - Two cases of lipofibroma of the median nerve are described. The literature is reviewed and the clinical and treatment aspects of this unusual condition are discussed. PMID- 3624982 TI - Fibrolipomatous hamartoma of the median nerve. AB - A case of fibrolipomatous hamartoma of the median nerve is presented. The operative findings were characteristic. The diagnosis should be confirmed by histological examination of a biopsy from an involved palmar cutaneous branch, and treatment should be limited to decompression of the ligament or fascia over the involved area. PMID- 3624983 TI - Haemangioma of the median nerve associated with Raynaud's phenomenon. AB - Raynaud's phenomenon was a presenting feature of a cavernous haemangioma of the median nerve. The role of excision by interfascicular microdissection is discussed against the background of a 25 year follow-up. PMID- 3624984 TI - Pathology of the flexor tendon sheath in the spontaneous carpal tunnel syndrome. AB - The histological features of the flexor tendon sheath in the spontaneous carpal tunnel syndrome were studied. The main differences between our findings and previous studies were twofold. Firstly a striking absence of inflammation in our material and secondly the diversity of the pathological changes encountered- alterations in the connective tissue especially the collagen; proliferation with thickening of the tissues of the tendon sheath; fibrosis; amyloid deposition; oedema; vascular lesions including thickening of vessels walls, intimal hyperplasia, and thrombosis; and a foreign body giant cell reaction. Although the lesions described here may not be significant in every case in which they are encountered, they do appear to support the view that pressure in the carpal tunnel and ischaemia are the important factors in a majority of cases of the spontaneous carpal tunnel syndrome. PMID- 3624985 TI - Traumatic rupture of median artery an unusual cause for acute median nerve compression. AB - Previous case reports of haemorrhage into the carpal tunnel causing median nerve compression were extraneural and usually associated with a blood dyscrasia although Watson Jones reported one due to direct trauma and Hayden recorded spontaneous intraneural haemorrhage not associated with trauma. We describe a case of intraneural haemorrhage, involving the median nerve in the carpal tunnel, due to indirect trauma and not associated with a blood dyscrasia. The condition required intraneural decompression to obtain relief. PMID- 3624986 TI - Hypoplastic scaphoid--an unusual cause of carpal tunnel syndrome. AB - A case of median nerve compression within the carpal tunnel, secondary to hypoplasia of the carpal scaphoid and dysplasia of the distal radius, is described in a 15-year-old boy with Spondylo-epiphyseal dysplasia tarda. Hypoplastic carpal bones and a dysplastic distal radius may be a feature of Spondylo-epiphyseal dysplasias, but carpal tunnel syndrome has not been previously reported either in this condition or in association with hypoplasia of the scaphoid. PMID- 3624987 TI - Ulnar nerve laceration--a complication of carpal tunnel decompression: case report and review of the literature. AB - Complications of peripheral nerve injury arising from the surgical treatment of carpal tunnel syndrome are not uncommon. No documented report of the association of ulnar nerve injury with carpal tunnel decompression has been found. This case study describes partial laceration of the ulnar nerve as a complication of carpal tunnel surgery and reviews the literature on this subject. PMID- 3624988 TI - Dislocation of the trapezio-metacarpal joint. AB - Acute traumatic dislocation of the trapezio-metacarpal joint is not invariably associated with instability of the joint after reduction and the injury should not be considered simply as a "Bennett's fracture without a fracture". PMID- 3624989 TI - Dislocation of the carpometacarpal joint of the thumb. AB - A case is reported of traumatic dislocation to the carpometacarpal joint of the left thumb, treated by ligament reconstruction. PMID- 3624990 TI - Hand function after injuries to the collateral ligaments of the metacarpophalangeal joint of the thumb. AB - An assessment was made of 34 patients who had sustained injuries to collateral ligaments of the metacarpophalangeal joint of the thumb. 23 patients had symptoms in the thumb, when seen at a mean of 38.7 months later, but these were minor in all but one patient. Assessment of pinch strength revealed that 43% of patients had less than 80% of the strength of the opposite side. This was not related to the presence of symptoms or to demonstrable instability of the joint, but the incidence of such weakness was greater when the operation had been delayed by more than three weeks. Pinch strength should be measured in two positions (key pinch and lateral pinch) as there is occasionally a large discrepancy between the two. PMID- 3624991 TI - The optimal position for arthrodesis of the metacarpophalangeal joint of the thumb: a clinical study. AB - Arthrodesis of the metacarpophalangeal joint of the thumb is a well-accepted procedure. Recommendations for position of fusion have varied from 0 to 30 degrees of flexion. Two hundred of these joints in normal subjects were measured in thirteen positions of function for different tasks. The mean of all thirteen measured positions was considered to be the "optimal functional position". Based on this study, we recommend the metacarpophalangeal joint of males be fused in approximately 25 degrees of flexion and females in 20 degrees of flexion. PMID- 3624992 TI - Dislocation of carpometacarpal joint of the little finger. AB - A case is reported of late ulno-volar carpometacarpal dislocation of the left little finger, treated by open reduction and internal fixation. PMID- 3624993 TI - Complex dislocation of the metacarpophalangeal joint of the little finger. AB - Complex dislocation of the little finger metacarpophalangeal joint is very rare. In the English literature, we have found only ten published cases. The condition usually requires open reduction, and most authors advocate a dorsal incision. We report two additional cases, treated by the volar approach, which makes a direct access to the incarcerated structures possible. PMID- 3624994 TI - First dorsal interosseous compartment syndrome. AB - Compartment syndromes of the interosseous muscles in the hand are difficult to diagnose because of their atypical presentation, and are often not recognised, especially when the syndrome presents as a chronic affliction. Such a syndrome affecting the first dorsal interosseous muscle in a dominant hand, and undiagnosed for nearly eight years, is described. Simple fasciotomy proved to be the only definitive treatment necessary. PMID- 3624995 TI - A new treatment of painful amputation neuroma: a preliminary report. AB - Two cases of painful amputation neuroma treated by a new method are described. A vascularized island transfer from a less important finger was used, but the accompanying nerve was divided and its distal end sutured to the proximal end of the nerve in the recipient finger, after excision of the neuroma. Four years and two years later, no clinical evidence of neuroma was present at either amputation stump or donor site. PMID- 3624996 TI - Calcification in Dupuytren's disease: a report of two cases. AB - Two cases are presented of calcification within Dupuytren's tissue. Histological appearances of the tissue showed both cartilaginous and osseous metaplasia. This indicates that fibroblasts in Dupuytren's Disease may undergo this type of metaplasia in a similar fashion to fibroblasts elsewhere. PMID- 3624998 TI - Hand injuries due to glass. PMID- 3624999 TI - The use of pre-printed hand assessment charts. PMID- 3624997 TI - Skeletal involvement in sarcoidosis: a case report. AB - A patient is described in whom sarcoidosis caused a pathological fracture of the middle phalanx of the little finger. A bone scan showed increased uptake. She was treated by resection of the diseased area and bone grafting, which led to bone healing. The bony manifestations of sarcoidosis are reviewed. PMID- 3625000 TI - Immunity in sperm and in vitro fertilization. PMID- 3625001 TI - The impact of embryo quality and quantity on implantation and the establishment of viable pregnancies. AB - The role of cleavage rates, number of embryos transferred, and some other variables in pregnancy outcome in 222 human embryo transfers was studied. Pregnancy rates were significantly higher in a group of 117 patients receiving at least one embryo that had reached the four-cell stage at 40 hr postinsemination (26% total pregnancies/transfer and 18% ongoing pregnancies/transfer) than in the 105 patients receiving embryos developing at a slower rate (7% total pregnancies/transfer and 2% ongoing pregnancies/transfer). Of the 23 ongoing or term pregnancies produced, 21 came from transfers of at least one embryo that had reached four-cell stage by 40 hr postinsemination. Pregnancy rates were unaffected in either the fast-cleaving or the slower-cleaving embryos by culturing in vitro for an additional 24 hr. The presence of anucleate cell fragments also had no effect on pregnancy rates. Pregnancy rates increased progressively with the transfer of more embryos per transfer. These results suggest that procedures to improve ovulation induction and in vitro embryo culture technique may better the success of in vitro fertilization by providing a high number of rapidly cleaving embryos for transfer. PMID- 3625002 TI - Effect of oocyte quality and sperm characteristics on the number of spermatozoa bound to the zona pellucida of human oocytes inseminated in vitro. AB - Sperm characteristics and oocyte quality may play a role in in vitro fertilization. The objective of this paper is to analyze the effect of the quality of oocytes, the husband's semen characteristics, and category of the couple's infertility on the number of spermatozoa bound to the zona pellucida. One hundred eighty-one oocytes which failed to fertilize or failed to cleave were fixed in 2.5% glutaraldehyde 40 to 60 hr after insemination in vitro and examined under interference microscopy and the number of sperm bound to the zone pellucida was determined. The means +/- SD of sperm bound to mature, immature, and atretic oocytes were 51.0 +/- 50.7, 7.3 +/- 12.1 10.4 +/- 17.8, respectively. Fertilized mature oocytes (81.0 +/- 53.3) had a significantly higher number of sperm bound to zonae compared to unfertilized oocytes (41.8 +/- 47.3). It is concluded that the number of sperm bound to zonae is functionally important. The sperm motility and the number of motile sperm used to inseminate oocytes were significantly correlated with the number of sperm bound to zonae, whereas sperm morphology and sperm concentration did not correlate. This study supports the notion that sperm motility is the single most important factor influencing fertilization of human oocytes in vitro. PMID- 3625003 TI - Relationship between the steroid and prolactin concentration in follicular fluid and the maturation and fertilization of human oocytes. AB - Seventy-eight follicles and their follicular fluid were aspirated from 46 women undergoing in vitro fertilization (IVF) procedures after stimulation of the ovaries with a low-dose human menopausal gonadotropin/human chorionic gonadotropin stimulation regimen. The concentrations of estradiol (E2), progesterone (P), testosterone (T), and prolactin (PRL) were measured in follicular fluid and related to the maturation of the oocyte-corona-cumulus complex (OCCC) and the fertilization of oocytes. Follicles containing mature oocytes had significantly higher follicular fluid E2 and P levels than follicles with intermediate and immature oocytes. A constant decrease in PRL and T values with advancing follicular maturation was observed. Similar results were obtained when the fertilizing ability of the oocytes was examined. The gradual decline in follicular fluid PRL and T levels during follicular development was connected with increasing E2 and P biosynthesis and therefore seems to be an important precondition for normal follicular and oocyte maturation. PMID- 3625004 TI - Emotional factors and the in vitro fertilization and embryo transfer process. AB - In vitro fertilization is nearly always a treatment of a last resort. This fact, along with the treatment's multiplicity of procedures and intensity, place unique emotional demands on patients. The goal of this research was to describe both the acknowledged emotional state of patients at the time they began the in vitro fertilization and embryo transfer (IVF-ET) process and the emotional experience of the actual procedures themselves. The findings can be used to develop strategies for providing emotional support. Data were collected from self administered questionnaires returned by 94 IVF-ET patients in three Houston programs during a 6-month period. At the time of the IVF procedure, 77% of the population reported that infertility was still a painful concern, not something with which they had learned to live. The loss of control, seen by most patients as infertility's most stressful dimension, left them vulnerable to the intense stresses of in vitro fertilization, less able to handle its multiple demands. Thus for many, the IVF-ET procedures were like an emotional roller coaster on which they experienced a wide range of feelings during a brief period of time. Not surprisingly, emotional strain was a major consideration influencing the decision whether or not to repeat IVF. Patients indicated specific services which the staff could provide to reduce the stress of the procedures. PMID- 3625005 TI - Developmental potential of human oocytes according to zona pellucida thickness. PMID- 3625006 TI - Is delayed capacitation a complicating factor in the treatment of idiopathic infertility by intrauterine insemination? PMID- 3625007 TI - The differential diagnosis of idiopathic inflammatory disease by colorectal biopsy. AB - The differential diagnosis of idiopathic inflammatory bowel disease by colorectal biopsy poses a challenge to the endoscopist as well as the pathologist. Distinguishing non-idiopathic colitis from idiopathic colitis is the fundamental first step. No single histopathologic feature distinguishes between non idiopathic and idiopathic inflammatory bowel disease or between the two forms of idiopathic inflammatory bowel disease (ulcerative colitis and Crohn's disease involving the colon). Interaction between the endoscopist and pathologist is essential in optimizing the contribution of colorectal biopsy to management of patients with inflammatory bowel disease. PMID- 3625008 TI - Follow-up after colorectal cancer--current practice in Wales and south west England. AB - The necessity for follow-up after curative resection of colorectal cancer remains controversial. Many studies have failed to demonstrate the increase in survival which might be anticipated when detailed follow-up methods are used. In the United Kingdom no single policy has evolved. This study has examined, therefore, the current follow-up practice of a large group of British surgeons. Six per cent carried out no routine postoperative follow-up and there was great variation in the methods used and the regularity of visits. There is a need for a rational policy based on controlled studies to determine whether follow-up is of benefit to the patient and to identify the most effective methods. PMID- 3625009 TI - Excision of fistula in ano. PMID- 3625010 TI - Fistula-in-ano. PMID- 3625011 TI - Psoas abscess in Bristol: a 10-year review. AB - A consecutive series of 16 cases of psoas abscess managed over a 10-year period at the Bristol Royal Infirmary is presented. Tuberculosis accounted for 4 patients all normally resident in the United Kingdom. Intraabdominal inflammatory disorders accounted for 9 of the cases with Crohn's disease being the commonest of these with 5 cases. The remaining patients comprised 3 with primary staphylococcal abscesses, one appendicitis, one diverticulitis and 2 with colonic carcinoma. Diagnostic delay was common. Ultrasonography together with guided aspiration of pus was the most useful investigation giving the diagnosis in cases due to tuberculosis and staphylococci. The presence of gut associated organisms was indicative of gastrointestinal pathology. Four patients died and significant morbidity occurred in a further 5. We recommend effective dependent drainage together with resection of diseased gut in the cases of gastrointestinal origin. PMID- 3625012 TI - The Kock continent ileostomy: influence of a defunctioning ileostomy and nipple valve stapling on early and late morbidity. AB - Early and late morbidity was studied in 45 consecutive patients submitted to the Kock continent ileostomy reservoir procedure protected by a temporary loop ileostomy. In 24 patients the nipple valve was made by simple intussusception of the ileal segment after stripping of its mesenteric peritoneum and fat, whereas in 21 patients the nipple valve was stapled in addition. The early complication rate was low with necrosis of the nipple valve occurring in 3 patients and a nipple valve fistula in 1. These complications were easily dealt with and revision was done subsequently on an elective basis. The overall revision rate for late nipple valve dysfunction, mainly caused by sliding of the nipple valve was 29%. The majority of these complications occurred within the first postoperative year. Stapling of the nipple valve did not significantly reduce the rate of sliding. The overall complication rate was significantly less compared with a historical series of 21 patients not provided with a loop ileostomy. A temporary defunctioning ileostomy may reduce early complications and their consequences. Whether it may also lessen the risk of later nipple valve sliding is, however, not clear from this study. The observation that sliding was as common in both unstapled and stapled patients could imply either that the loop ileostomy is beneficial in preventing this complication or that the stapling procedure is in this respect unimportant. Which step or steps among all the measures employed are important in increasing the success rate of this operation remains unclear. Randomised controlled studies are needed for a true evaluation of this issue. PMID- 3625014 TI - Succinate dehydrogenase and mitochondria in the hair cells in the organ of Corti of mature and old shaker-1 mice. AB - The activity of succinate dehydrogenase in the sensory hair cells in the organ of Corti of mature and old shaker-1 mice described as the animals grew older, the outer hair cells being the most effected. The decrease inactivity of this enzyme was closely linked with the degeneration of the mitochondria. When mitochondria were absent or grossly degenerated there was no enzyme activity. It is possible that this defect is linked with the deafness in these mice. PMID- 3625013 TI - Relation between perineal descent and pudendal nerve damage in idiopathic faecal incontinence. AB - In 60 patients with idiopathic anorectal incontinence, without neurological disease, there was a significant relationship, shown by regression analysis, between the pudendal nerve terminal motor latency and the extent of perineal descent during straining (r 0.59; p less than 0.001), and the plane of the perineum on straining (r -0.61; p less than 0.001). These data are consistent with the suggestion that perineal descent can lead to stretch-induced damage to the perineal nerves in this condition. PMID- 3625015 TI - Auditory brainstem evoked potentials in sudden deafness. AB - Auditory Brainstem Evoked Potentials (ABEP) were recorded from 53 adult subjects suffering from sudden deafness at the time of examination. The onset of sudden deafness was up to three years prior to the study. ABEP were recorded in response to 75 dBHL clicks presented at rates of 10/sec and 40/sec. ABEP peak latencies as well as interpeak latency differences, and also the effect of increasing stimulus rate, were determined for each patient and compared with the clinical symptoms. The psychoacoustic and ABEP detection thresholds were also compared. A highly significant correlation was observed between ABEP detection threshold and the psychoacoustically determined hearing threshold, and the differences between them were found to be insignificant. The results of this study indicate a central component in sudden deafness. This impairment manifests itself in abnormal effects of increasing stimulus rate on ABEP, and may be related to reduced central synaptic efficacy. PMID- 3625016 TI - Scleroderma and hearing loss: (histopathology of a case). PMID- 3625017 TI - The use of the Walkman mini-stereo system in the management of tinnitus. AB - The Walkman mini-stereo system was tried on 50 patients who had tinnitus and 86.7 per cent of the patients found it effective and useful. In spite of the few minor disadvantages, its use is recommended, at least before prescribing an expensive tinnitus masker. PMID- 3625018 TI - Steroids for airway problems in glandular fever. PMID- 3625019 TI - Marginal mandibulectomy for malignant disease: indications, rationale, and results. AB - The theoretical basis for performing marginal mandibular resection, as opposed to segmental resection, is discussed; and criteria are suggested. Results are presented that suggest that, in the treatment of malignant disease around the jaw, although the mortality from other tobacco- and alcohol-related diseases remains high, good functional and cosmetic results can be achieved with no loss of local control. PMID- 3625020 TI - Hyponatraemia and hypothyroidism in a previously irradiated case of carcinoma of the tongue. AB - A case of squamous cell carcinoma of the tongue was complicated by post operative hyponatraemia. The criteria for the syndrome of inappropriate secretion of anti diuretic hormone, [ADH] (SIADH) were met but the patient remained hyponatraemic despite adequate treatment. The patient had previously received radical external radiotherapy to the neck and was found to be profoundly hypothyroid. Correction of the hypothyroid state led to clinical and biochemical recovery. The frequency of post-irradiation hypothyroidism and the possible mechanisms of hypothyroid induced hyponatraemia are discussed. PMID- 3625021 TI - Clinical aspects of pseudodysphagia. AB - Pseudodysphagia is the description of the sensation of a feeling of a lump in the throat--commonly known as the globus symptom. A prospective analysis of 145 consecutive patients with this symptom seen by an Otolaryngologist has provided confirmation that a high proportion of these patients have a treatable basis for their complaints and that most can be successfully managed without time-consuming and expensive investigations--provided clinical evaluation includes thorough visualisation of the oropharynx and supraglottis. The explanation for the symptomatology in patients who suffer from reflux oesophagitis is probably referred pain from the region of the lower oesophageal sphincter rather than spasm of the upper sphincter. The expression globus hystericus is outdated and should be discarded, and we recommended describing the symptoms as primary globus pharyngeus when there is no evident cause and secondary globus pharyngeus when the aetiology is detectable. PMID- 3625022 TI - Teflon injection of the vocal cords under general anaesthesia (review of 262 cases). PMID- 3625023 TI - 'Superglue ear'. PMID- 3625024 TI - Cholesteatoma following stapedectomy. AB - Among the possible complications of stapedectomy for otosclerosis, cholesteatoma is extremely rare. We report a case which was secondary to implantation of keratinising squamous epithelium inadvertantly included in the fat graft taken from the ear lobe to seal the footplate. PMID- 3625025 TI - Bilateral carcinoma of the middle ear. AB - We describe the first reported case of bilateral carcinoma of the middle ear. PMID- 3625026 TI - Posterior fossa ganglioglioma--an unusual cause of hearing loss. AB - Intracranial or spinal gangliogliomas of the CNS are rare tumours. Although several cases have been reported over the years, controversy still remains as to their origin, treatment and prognosis. A case of an eight-year-old girl with a ganglioglioma in the cerebellum with extension into the cerebello-pontine angle is described. The histological basis of the diagnosis is discussed and a review of the literature is presented. PMID- 3625027 TI - Pendred's syndrome with episodic vertigo, tinnitus and vomiting and normal bithermal caloric responses. AB - A case of early-onset bilateral sensori-neural deafness with episodic objective vertigo, tinnitus and vomiting, suggestive of Meniere's syndrome, was found to have a diffuse goitre. A Perchlorate discharge test was positive, indicating an organification defect diagnostic of Pendred's syndrome. The case was found to be euthyroid both clinically and on investigations. Tone decay was absent and recruitment was found, thus indicating a cochlear site of lesion. Bithermal caloric tests and clinical tests of vestibular function were within normal limits. X-rays, including petrous tomography, did not show any abnormalities. PMID- 3625028 TI - Breast carcinoma metastatic to the nasopharynx. AB - A case report of a patient with adenocarcinoma of the breast with metastasis to the nasopharynx is described. The patient presented initially with pulmonary metastasis followed later by metastasis to the left jugulo-digastric lymph nodes. A prominent but asymptomatic nasopharyngeal mass was concomitantly discovered on head and neck examination. Three months later, symptoms of panhypopituitarism developed. Invasion of the base of the skull and pituitary were documented. Patients with adenocarcinoma of the breast and high cervical node metastasis should have a thorough otolaryngologic and head and neck evaluation. Metastatic carcinoma to the nasopharynx is an extremely rare occurrence. Only two cases of bronchogenic carcinoma of the lung and two cases of hypernephroma metastatic to the nasopharynx have been reported in the literature (Bernstein et al., 1966). We present what we believe to be the first case of metastatic adenocarcinoma of the breast to the nasopharynx. PMID- 3625029 TI - Growth of a frontal sinus osteoma. AB - The natural growth of a frontal sinus osteoma is documented in a series of radiographs taken over a period of 17 years in a patient attending St. Thomas' Hospital with untreated acromegaly. PMID- 3625030 TI - Haemangiopericytoma of the nose and paranasal sinuses. AB - The uncertain course and rarity of haemangiopericytoma in the nose and paranasal sinuses has interested both pathologists and clinicians. This tumour arises from proliferation of pericytes which invest capillary endothelium. A benign course is more common in the nose and paranasal sinuses. The first nasal haemangiopericytoma was reported by Stout in 1949. Since then only twenty cases have been reported in the literature. We present three further cases. PMID- 3625031 TI - Hemangiopericytoma of the trachea. AB - Malignant neoplasms of the trachea are rare lesions, with no more than 400 cases documented in the literature. Only three tracheal hemangiopericytomas have been reported. We present the fourth case of such a tumour occurring in the trachea. After the first surgical resection the tumour recurred twice in a period of 10 months. The last cervicotomy performed for local recurrence showed wide cervical and mediastinal involvement of the tumour, not resectable surgically. Emphasis is placed on the surgical, pathologic and ultramicroscopic findings. PMID- 3625032 TI - Actinomycotic osteomyelitis in a child. AB - Contrary to what used to be the case, actinomycosis is now a rare disease and only infrequently mentioned in otolaryngological textbooks (Ballantyne, J. and Groves, J. 1979). The disease is a chronic suppurative infection caused by micro organisms from the actinomyces group, most often israelii. Actinomyces species are all oral commensals. They are gram-positive, non acid-fast, anaerobic or microaerophilic filamentous bacteria (Walker et al., 1981; Bennhoff, 1984). Associated flora of both aerobic and anaerobic bacteria are always present, most frequently anaerobic streptococci, fusiform or gram-negative bacilli, and hemophilus species. The associated flora form a kind of symbiosis with the actinomyces species and may cause an anaerobic environment which furthers the growth of these species (Bennhoff, 1984). Topographically, a distinction is made between 3 favorite localizations: 1. Cervico-facial (55 per cent); 2. Abdomino pelvic (20 per cent); and 3. Pulmo-thoracic (15 per cent). PMID- 3625033 TI - Posterior pharyngeal wall schwannoma (case report). AB - A rare case of a schwannoma localized on the posterior pharyngeal wall is presented. It concerns a young man with an inflammatory ulcerated mass in the posterior wall of the pharynx causing severe difficulty in swallowing. Although schwannomas of the lateral pharyngeal wall are common, only one case located on the posterior wall has been described. The origin of these tumours at this particular site is thought to be the sympathetic nervous plexus of the posterior pharyngeal wall. In presenting our case, we comment on the origin of posterior pharyngeal wall schwannomas. PMID- 3625034 TI - Diffuse meningeal melanosis (an unusual presentation). AB - An unusual presentation of diffuse meningeal melanosis with involvement of the temporal bones, the spheno-ethmoidal complex, the pharynx and the viscera is reported. PMID- 3625035 TI - Chemical properties of bile acids. IV. Acidity constants of glycine-conjugated bile acids. AB - The dissociation constants for the carboxyl group of a series of glycine (N-acyl) conjugated and unconjugated bile acids were determined by potentiometric titration using dimethylsulfoxide-water and methanol-water mixtures of varying proportions. The pKa values in water were calculated by extrapolating the experimental values determined in different mole fractions of the organic solvent mixtures. The following values were obtained: 3.9 +/- 0.1 for glycine-conjugated bile acids and 5.0 +/- 0.1 for unconjugated bile acids, as general pKa values for the two classes of bile acids, respectively. The amidation of bile acids with glycine lowers the pKa value because of the proximity of the amide bond to the terminal carboxyl group. Bile acid dissociation constants are independent of the substituents in the steroid nucleus, since inductive effects of the hydroxyl groups on the steroid nucleus are too distant from the acidic group at the end of the side chain to influence its ionization. PMID- 3625037 TI - Effect of apoE on triglyceride emulsion interaction with hepatocyte and hepatoma G2 cells. AB - The uptake and internalization of a triglyceride emulsion by rat hepatocytes in culture less than 24 hr was either inhibited or uninfluenced by apoE. ApoE significantly increased the uptake of these emulsions in later cultures. Specific low density lipoprotein (LDL) binding was similar for hepatocyte monolayers prior to and after 24 hr. Rat hepatocytes in culture for 2 days, which were treated with collagenase, detached and then replated within 1 hr and were apoE-responsive in 2 hr. Heparin inhibited the apoE stimulation in both hepatocytes and hepatoma monolayers. Heparin wash of hepatocytes or hepatoma cells incubated with apoE [14C]triolein emulsions at 4 degrees C resulted in a considerable loss in radiolabeled cell lipid. A similar wash after 37 degrees C incubations produced little loss suggesting internalization. Hepatocytes had lower affinity but similar apoE-emulsion binding capacity compared to hepatoma cells. Triolein emulsions with apoE were significantly more rapidly metabolized by the hepatocyte than unsupplemented emulsions. The apoE-mediated hepatocyte lipid uptake was inhibited by apoC proteins. High molar ratios of free fatty acid/albumin also suppressed hepatocyte apoE-mediated lipid uptake. Both rat high density lipoprotein (HDL) and LDL inhibited with a potency directly related to their content of apoE. Human LDL and HDL without apoE also inhibited the interaction with less potency than the rat lipoproteins. Human HDL inhibition was diminished after removal of apoC proteins. PMID- 3625036 TI - Apoprotein E mediates the interaction of beta-VLDL with macrophages. AB - beta-Very low density lipoproteins (beta-VLDL) isolated from cholesterol-fed rhesus monkeys stimulated cholesteryl ester synthesis and accumulation in mouse peritoneal macrophages. The apoprotein specificity and requirement for the cell surface uptake of beta-VLDL was investigated by treating the beta-VLDL with trypsin (beta-VLDL (T], incubating the beta-VLDL (T) with other lipoproteins or apoproteins, reisolating the beta-VLDL (T) and measuring its biological activity which, for this study, is defined as the ability of the lipoprotein to stimulate cholesterol esterification in the macrophages. Trypsin treatment of beta-VLDL abolished its biological activity. Apoprotein analysis of the beta-VLDL (T) demonstrated the absence of intact apoproteins B-100, B-48, and E. The J774 macrophage-like cell line and mouse peritoneal macrophages responded similarly with respect to cholesterol esterification following incubation with inactive and treated beta-VLDL. The J774 macrophage-like cell line was used to establish the conditions necessary for the restoration of biologic activity to the trypsinized beta-VLDL. The loss of biological activity of beta-VLDL (T) could be reversed by restoring apoprotein E-containing LDL from hyperlipemic monkeys or purified apoprotein E. Apoprotein A-I had no such effect. The restored biological activity of the beta-VLDL (T) was proportional to the amount of apoprotein E acquired by the lipoprotein. beta-VLDL particles composed of apoprotein E and either intact or degraded apoprotein B-100 had comparable biological activity. Thus, intact apoprotein E, without intact apoprotein B, is a sufficient mediator for the biological activity and metabolism of beta-VLDL by macrophages and plays a major role in receptor-lipoprotein interaction. PMID- 3625038 TI - Dietary fat inhibits the intestinal metabolism of the carcinogen benzo[a]pyrene in fish. AB - Following the intestinal absorption of dietary benzo[a]pyrene (BP) by the killifish, this compound becomes incorporated along with dietary triglycerides into membrane-bound fat vacuoles within the intestinal epithelial cell (1985. J. Lipid Res. 26: 428-434). These vacuoles, arising from the smooth endoplasmic reticulum, are important transient structures involved in both the uptake and metabolism of dietary BP and, presumably, other lipophilic toxicants as well. In the present study we used subcellular fractions isolated from the intestines of spot (Leiostomus xanthurus), a teleost fish, to study factors that influence the metabolism of BP in a fat vacuole/microsomal system. Triglyceride-solubilized BP is capable of diffusion from fat vacuoles to microsomal enzymes. Increases in the concentration of fat vacuoles decrease the availability of BP to microsomal BP hydroxylase. The effect of fat vacuoles on the activity of BP hydroxylase becomes more pronounced as the concentration of BP in our test system decreases. Addition of cytosolic glutathione transferases to the fat vacuole/microsomal system enhances the activity of BP hydroxylase. Examination of binding of 3H-labeled BP to killifish (Fundulus heteroclitus) intestinal cytosolic proteins in vivo indicated that a large fraction of the radioactivity was associated within glutathione transferase. These results suggest that dietary fat inhibits metabolism of low levels of BP in the intestine. A consequence of this would be greater exposure of peripheral tissues to dietary carcinogens. PMID- 3625039 TI - Contraceptive steroids increase cholesterol in bile: mechanisms of action. AB - Contraceptive steroids increase the risk of acquiring cholesterol gallstones. The factors responsible include an increase in cholesterol saturation of bile and an increase in rate of secretion of cholesterol into bile. The goal of this study was to investigate the mechanism(s) of these increases in biliary cholesterol. During the use of contraceptive steroids, cholesterol saturation of gallbladder bile and the amount of cholesterol secreted per mole of bile acid increased (P less than 0.05 and P less than 0.02, respectively). Cholesterol absorption, cholesterol synthesis, chylomicron remnant clearance, and the concentration of plasma and lipoprotein lipids were not altered by contraceptive steroids. Despite this apparent lack of effect, important correlations were present during steroid use. LDL (low density lipoprotein) cholesterol increased as dietary cholesterol increased (r = 0.58, P less than 0.025). Cholesterol synthesis correlated directly with VLDL cholesterol concentration (r = 0.64, P less than 0.01), biliary cholesterol secretion (r = 0.68, P less than 0.01) and with molar percent cholesterol in bile (r = 0.49, P = 0.06). Chylomicron remnant clearance also correlated with cholesterol secretion (r = 0.85, P less than 0.001). As either remnant uptake or synthesis increased, the effect of the other source of hepatic cholesterol on biliary cholesterol secretion diminished. These relationships were not observed in the same subjects when they were not taking the hormones. The findings suggest that both newly synthesized and dietary cholesterol contribute to the cholesterol secreted in bile. This is consistent with the hypothesis that cholesterol for secretion into bile and VLDL is derived from a common metabolic pool of free cholesterol. It is proposed that contraceptive steroids exert their effect on biliary cholesterol by increasing cholesterol entering the pool and/or by inhibiting hepatic ACAT (acylcoenzyme A:cholesterol acyltransferase) activity, a known effect of progesterone, so that an increase in free cholesterol entering the pool leads to an increase in output. PMID- 3625040 TI - Arachidonate epoxygenase: identification of epoxyeicosatrienoic acids in rabbit kidney. AB - Epoxyeicosatrienoic acids were isolated and purified from female rabbit kidneys. They were identified as a group, prior to resolution, by packed column gas-liquid chromatography-mass spectroscopic techniques as their methyl esters as well as their trimethylsilyl bromohydrin methyl esters. Initial capillary gas-liquid chromatography-mass spectral analysis of the corresponding hydrogenated pentafluorobenzyl esters revealed the presence of the 8,9- and 14,15 epoxyeicosatrienoate regioisomers. These results, in conjunction with the documented in vitro biological activities of the arachidonate epoxygenase metabolites, suggest a role for them in renal function. PMID- 3625042 TI - Synthesis of a naphthylvinyl-labeled glycerol ether analog of phosphatidylcholine and its use in the assay of phospholipase A2. AB - The synthesis of a naphthylvinyl-labeled glycerol ether analog of phosphatidylcholine, 1-O-[12-(2-naphthyl)-dodec-11-enyl]-2-O-decanoyl-sn-glycerol 3- phosphocholine (NVPC), is described. This involves a Wittig reaction between 2 naphthaldehyde and a phosphonium salt which gives the trans-naphthylvinyl group as the predominant isomer. Lyso NVPC was prepared from NVPC by phospholipase A2 action. NVPC absorbs strongly at 248 nm (epsilon = 58,300 M-1 cm-1) and gives broad fluorescence emission with maxima at 343 nm and 360 nm and a quantum yield of 0.10 in ethanol. An assay for phospholipase A2 was developed using high performance liquid chromatography with fluorescence detection to separate and quantify NVPC and lyso NVPC. Activities as low as 1-2 pmol/min in an assay volume of 0.1 ml can easily be measured. The assay was used with a pure enzyme from cobra venom and a crude enzyme from synovial fluid. Enzyme specificities for phosphatidylcholine and NVPC with cobra venom and porcine pancreatic phospholipases A2 were compared using a titrametric assay. The use of the assay with NVPC to study the metabolism of platelet activating factor is discussed. PMID- 3625041 TI - Regulation of bile acid synthesis in cultured rat hepatocytes: stimulation by apoE-rich high density lipoproteins. AB - Cultured rat hepatocytes obtained by liver perfusion with collagenase in the presence of soybean trypsin inhibitor were used to examine the role of high density lipoproteins (HDL) in supplying cholesterol to the hepatocyte for bile acid synthesis. Within 6 hr of adding HDL (d 1.07-1.21 g/ml) obtained from rat serum there was a significant stimulation of bile acid synthesis and secretion that reached 2-fold after 24 hr. The stimulation by HDL occurred at normal plasma concentrations (i.e., 500 micrograms/ml) and showed further stimulation in a dose dependent manner reaching a maximum stimulation of 2- to 2.5-fold. The stimulation of bile acid synthesis was dependent on the cholesteryl ester content of the HDL. Several lines of evidence show that the HDL is taken up by a receptor mediated process dependent on apoE. These include: 1) at the same concentration (500 micrograms/ml) apoE-poor HDL (not retained by heparin affinity chromatography of HDL isolated from the plasma of rats fasted for 72 hr stimulated bile acid synthesis by 48%, whereas apoE-rich HDL stimulated bile acid synthesis by 110%; 2) reductive methylation totally blocked the stimulation of bile acid synthesis by HDL; 3) HDLC, which contained apoE as its major protein component, also maximally stimulated bile acid synthesis; and 4) human HDL, which contained no detectable apoE, failed to stimulate bile acid synthesis. Additional studies showed that apoE-enriched HDL and HDLC both inhibited cholesterol synthesis (determined by the incorporation of 3H2O) and caused a net accumulation of cholesteryl esters in hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625043 TI - A rapid and sensitive enzymatic-radiochemical assay for the determination of triglycerides. AB - An enzymatic-radiochemical method suitable for the determination of triglyceride levels of cells in culture is described. The method is based on the enzymatic hydrolysis of triglycerides to free fatty acids which then complex with 63Ni. The method is rapid, accurate, and inexpensive. The procedure extends the sensitivity of triglyceride measurement to as low as 0.25 nanomoles. PMID- 3625044 TI - Determination of ganglioside non-hydroxy fatty acid and long chain base by analysis of perbenzoylated derivatives. AB - The non-hydroxy fatty acid and long chain base compositions from as little as 2.7 nmol of ganglioside were ascertained from perbenzoylated ganglioside derivatives. Non-hydroxy fatty acids were determined by mild alkaline methanolysis of the derivatives, followed by gas-liquid chromatography (GLC) of the methyl esters. N acyl and N-benzoyl "gangliosides" that were generated by the methanolysis were hydrolyzed by a standard procedure that utilized aqueous acetonitrile-HCl, followed by high performance liquid chromatography (HPLC) determination of the biphenylcarbonyl derivatives with ultraviolet (UV) detection at 280 nm. A critical aspect of this procedure is a modified workup for the isolation of the biphenylcarbonyl derivatives which eliminates by-products that otherwise interfere with their separation by HPLC, especially when high sensitivity is required. PMID- 3625045 TI - [Aneurysm of the abdominal aorta and horseshoe kidney. Apropos of a case and review of the literature]. AB - A case report of a 75 year old man with abdominal aortic aneurysm and horseshoe kidney is presented. The diagnosis of this unusual association was made prior to surgery and the aneurysmectomy was carried out without great problems, by insertion of a dacron tube combined with reimplantation of an accessory right renal artery. There was an uneventful postoperative recovery and outcome. Previous publications are reviewed. The authors insist of the importance of CT Scan, intravenous pyelogram and aortography to establish a complete preoperative diagnosis of this rare association with anomalous vasculature and pyeloureteral pattern. The prognosis of an aneurysm in association with a horseshoe kidney should not be worse than that of routine resection of an ordinary aneurysm. PMID- 3625046 TI - [Familial protein C deficiency and venous thrombosis]. AB - Constitutional deficiency in C-protein appears to be a very often underestimated or unrecognized cause of thromboembolic disease. C-protein deficiency in a family (father, son and daughter) was associated with clinical manifestations of thrombosis (post-embolic cor pulmonale, fatal pulmonary embolism, post-partum phlebitis), all appearing before 35 years of age. These three cases confirm the absolute need for routine exploration of physiologic inhibitors of coagulation in all young patients with venous thrombosis. PMID- 3625047 TI - [Indirect measurement of residual internal carotid pressure by photoplethysmography during the carotid occlusion test]. AB - A non invasive technique for measuring the systolic arterial pressure in the internal carotid artery during common carotid artery occlusion test is described. Its objective is to predict the efficiency of the collateral circulation through the circle of Willis during surgical carotid artery clamping. Photoplethysmographic curves were recorded on two facial areas supplied by the external carotid artery (earlobe and forehead above the center of one eyebrow). The residual carotid artery pressure during carotid clamping was estimated by considering the ratio of determined by the systolic brachial arterial pressure over the amplitude of the best photoplethysmographic curve obtained, multiplied by the amplitude of the photoplethysmographic curves recorded during the percutaneous compression of the common carotid artery. This method was verified on 15 patients (women: 6, men: 9) with carotid lesions, during carotid endarterectomy. The invasive measurement of the systolic pressure in the internal carotid during carotid clamping was compared with the calculated value. This comparison showed a highly significant correlation between the two values (p less than 0.001). Thus, a simple and non-invasive method of estimating the internal carotid systolic pressure during carotid clamping is described, so that the efficiency of the collateral circulation during this period may be assessed before surgery. PMID- 3625048 TI - [Our experience with carotid restenoses. Value of digital angiography using the arterial approach]. AB - Between January 1980 and December 1985, 721 operations on the internal carotid artery were performed in the Department of Vascular Surgery, Hopital de la Timone, Marseilles. During this 6-year period, carotid artery restenosis was detected in eleven patients. All had been operated upon initially in the department: carotid thromboendarterectomy (10 cases), internal saphenous vein graft (1 case). All but one patient were asymptomatic at time of diagnosis of restenosis, the mean a period of which was 20.5 months. Identification was by cervical murmur (5 cases), routine review Doppler examination (2 cases), digital subtraction angiography by arterial approach (2 cases); this examination being conducted on contralateral carotid artery during preoperative investigations, and conventional arteriography of supra-aortic trunks to determine permeability of a contralateral temporo-sylvian anastomosis in one patient. Digital subtraction angiography by the arterial approach was carried out in 8 of the 11 patients. Apart from the simplicity of repeated examinations (16 times in these 8 patients) this procedure permitted medical treatment to be instituted for 2 cases of restenosis and was sufficient to indicate the need for 5 repeat operations. A total of 6 recovery operations were performed, one in a symptomatic patient and five in asymptomatic patients: rapid surgery was necessary in 4 of these because of an immediate critical restenosis. Surgery was carried out in the last case due to progressive worsening of repeated stenotic lesions on serial angiographic examinations. Operations included venous grafts (crural internal saphenous vein) in 4 cases and angioplasty with venous patch grafts in 2 cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625049 TI - [The risk of aneurysm. Another reason to treat traumatic arteriovenous fistulas surgically]. AB - A new case of late arterial aneurysm proximal to a corrected post-traumatic arterio-venous fistula is compared to 15 similar observations published in the last 20 years. The meantime between the vascular injury and the disclosure of the fistula was 20 years. The arteriomegaly was discovered only after the fistula was closed in 11 of the 16 cases including our case. These arterial dilatation extended primarily or secondarily from the aorta to the fistula area. Late arteriomegaly is a second reason for operating the arterio-venous fistulas. If the fistula is longstanding, the caliber of the proximal artery must be checked during and after the operation. Risks of embolism and rupture being important, all arterial dilatations must be managed by vascular replacement procedures. If the iliac artery seems uninvolved, the patient must be warned that dilatation may occur in the arterial segment proximal to the upper anastomosis. A long term survey is always mandatory. PMID- 3625050 TI - [Flushes, blushing or hot flushes]. AB - Apart from physiological flushes represented by emotional or prudish blushing, post-prandial flushes and menopausal hot flushes, various pathologic flushes exist of various etiologies: endocrine, dysmetabolic, histaminic and iatrogenic. Their pathogenicity is based mainly on local metabolites secretion provoking vasodilatation of the intermediary microcirculation rather than of the terminal microcirculation. Treatment is a function of etiology and therefore of the patient's history and results of clinical examination, functional exploration and standard biologic tests. PMID- 3625051 TI - Stochastic model of leukocyte chemosensory movement. AB - We propose a hypothesis for a unified understanding of the persistent and biased random walk behavior of leukocytes exhibiting random motility and chemotaxis, respectively. This hypothesis is based on a description of the leukocyte as an integrated system sensing and responding to a "noisy" receptor signal: random fluctuations inherent in receptor-sensing of chemo-attractant concentrations underlie the random walk behavior. Noise arises from real fluctuations in the receptor binding process, which translate into perceived fluctuations in receptor measured concentration. The unbiased random walk characteristic of random motility arises from perceived fluctuating gradients without a mean reference direction and the biased random walk in chemotaxis arises due to the occurrence of perceived concentration fluctuations around the mean gradient. Analysis of a stochastic model based on this hypothesis yields an objective index of directional randomness in random motility, the directional persistence time, in terms of model parameters associated with receptor binding, receptor signal transduction, and the cell turning response. Simulation of the model equations yields cell paths from which the orientation behavior in a chemoattractant gradient is characterized in terms of the same model parameters. Our results provide a theoretical relationship between directional persistence and orientation bias and suggest quantitative answers to the questions: Is there an optimal level of persistence with respect to maximizing orientation bias? Do directional persistence and orientation bias both display the same parametric sensitivity? How does this sensitivity depend on the sensing, transduction, and response components of the cell system? PMID- 3625053 TI - Limit theorems for the population size of a birth and death process allowing catastrophes. AB - The linear birth and death process with catastrophes is formulated as a right continuous random walk on the non-negative integers which evolves in continuous time with an instantaneous jump rate proportional to the current value of the process. It is shown that distributions of the population size can be represented in terms of those of a certain Markov branching process. The ergodic theory of Markov branching process transition probabilities is then used to develop a fairly complete understanding of the behaviour of the population size of the birth-death-catastrophe process. PMID- 3625052 TI - Control theory predictions of reproductive allocation in female dusky salamanders. AB - A model of the reproductive ecology of female dusky salamanders was used to investigate the allocation scheme that a female might use to maximize her reproductive success. Analysis of the model with techniques of optimal control theory suggests that fecundity is maximized either by allocating food resources to reproduction for the entire time period prior to egg laying, or by growing first, then switching to reproduction later in the year. The analysis also indicates that egg mortality will be minimized if the female provides maternal care at the maximum level throughout egg brooding. These results are not specific to dusky salamanders, but can be extended to other organisms with similar reproductive characteristics. PMID- 3625055 TI - Tickborne diseases in Georgia, 1986. PMID- 3625056 TI - Fire deaths in Fulton County 1983-1985. PMID- 3625054 TI - Human sleep and circadian rhythms: a simple model based on two coupled oscillators. AB - We propose a model of the human circadian system. The sleep-wake and body temperature rhythms are assumed to be driven by a pair of coupled nonlinear oscillators described by phase variables alone. The novel aspect of the model is that its equations may be solved analytically. Computer simulations are used to test the model against sleep-wake data pooled from 15 studies of subjects living for weeks in unscheduled, time-free environments. On these tests the model performs about as well as the existing models, although its mathematical structure is far simpler. PMID- 3625058 TI - Georgia doctors help medically indigent. PMID- 3625057 TI - Anabolic steroids. PMID- 3625059 TI - Frozen autologous blood--not generally recommended. PMID- 3625060 TI - What about the Social Security medical consultant? PMID- 3625061 TI - Neoadjuvant chemotherapy of cancer. PMID- 3625062 TI - Managing the workload in state mental hospitals. PMID- 3625063 TI - An evaluation of three years of experience with carcinoma of esophagus. PMID- 3625064 TI - The trends of growth of Bangkok children. PMID- 3625065 TI - Normal levels of serum vitamin E in healthy Thais. PMID- 3625066 TI - A simple way to enhance compliance and reduce default in tuberculosis treatment. PMID- 3625067 TI - The perinatal mortality at Ramathibodi Hospital 1978-1985: analysis and trends. PMID- 3625068 TI - Prevalence of dermatophytosis in Siriraj Hospital. PMID- 3625069 TI - Lower respiratory tract infection due to Mycoplasma pneumoniae in Thai children. PMID- 3625070 TI - The first report of Malayan filariasis in Bangkok, Thailand. PMID- 3625071 TI - Erysipelothrix rhusiopathiae endocarditis: report of a case and review of the literature. PMID- 3625072 TI - Epidermoid tumors (cholesteatomas) of neuraxis: report of 4 cases. PMID- 3625073 TI - Immunosuppression. PMID- 3625074 TI - Non melanoma skin cancer and solar keratoses in Australia. PMID- 3625075 TI - Arsenic values in the skin of Thai patients with and without history of arsenic intake. PMID- 3625076 TI - PUVA therapy in Thai psoriatic patients. PMID- 3625077 TI - Enlarging erythematous macule: a cutaneous sign for fatal Aeromonas hydrophila septicemia. PMID- 3625078 TI - Immunopotentiation. PMID- 3625079 TI - Application of basic sciences to problems in pediatric dermatology. PMID- 3625080 TI - The hemopoietic microenvironment in the fetal liver of mice: relationship between developing hepatocytes and erythroblasts. PMID- 3625081 TI - Lectin binding to the luminal surface of bronchiolar neuroepithelial bodies of Balb/C mouse. PMID- 3625082 TI - Ultrastructural visualization of proteoglycans in dentine forming sites of developing rat molar tooth germs by use of ruthenium hexammine trichloride (RHT). PMID- 3625083 TI - Are cytoskeletons involved in establishment of cell polarity in rat salivary glands? PMID- 3625084 TI - A new preparation method for extraction experiments in scanning electron microscopy. PMID- 3625085 TI - Ultrastructural study of new gingival attachment on various root surfaces (Part 6). PMID- 3625086 TI - Secretory process of mucus-secreting cells in mouse colonic mucosa studied by rapid freezing and freeze-substitution. PMID- 3625087 TI - Mouse Leydig cells processed by freeze-substitution, with particular reference to the lamellar arrangement of the smooth endoplasmic reticulum. PMID- 3625089 TI - Stereological method for unfolding size-shape distribution of spheroidal organelles from electron micrographs. PMID- 3625088 TI - Immunoelectron microscopy and the molecular ultrastructure of cells. PMID- 3625090 TI - Scanning electron microscopic observation of the basement membrane in mouse taste buds. PMID- 3625092 TI - Endocrine asymmetry. PMID- 3625091 TI - ICI 176,334: a novel non-steroidal, peripherally selective antiandrogen. AB - Pure antiandrogens, like flutamide, antagonize androgen action both peripherally and centrally at the hypothalamic-pituitary axis, which leads to an increase in LH and testosterone secretion. A new non-steroidal antiandrogen ICI 176,334 [2RS) 4'-cyano-3-(4-fluorophenylsulphonyl)-2-hydroxy-2-methyl-3'- trifluoromethyl)propion-anilide) has now been discovered which causes regression of the accessory sex organs but does not increase serum concentrations of LH and androgens. ICI 176,334 binds to rat prostate androgen receptors with an affinity around fourfold that of hydroxyflutamide. When administered s.c. concurrently with testosterone propionate (200 micrograms/kg) for 7 days to immature castrated rats, ICI 176,334 (10 mg/kg) significantly (P less than 0.001) inhibited growth of the seminal vesicles and ventral prostate gland. Oral administration of ICI 176,334 at doses of 1, 5 and 25 mg/kg for 14 days to adult rats caused a dose related reduction in accessory sex organ weights but had no effect on the testes. None of these doses caused a significant increase in serum LH and testosterone. Flutamide was around fourfold less potent and significantly increased serum LH and testosterone at the higher doses. ICI 176,334 was well tolerated. ICI 176,334 should, therefore, prove useful for the treatment of androgen-responsive benign and malignant diseases. PMID- 3625093 TI - Subcellular distribution of [3H]oestradiol-17 beta and salt resistance of nuclear oestrogen complexes in the rat uterus after in-vivo administration of [3H]oestradiol-17 beta. AB - The distribution of injected [3H]oestradiol-17 beta into nuclear and post-nuclear fractions as well as resistance to KCl (0.6 mol/l) extraction of nuclear oestrogen-binding sites in the rat uterus were studied. Both ovariectomized untreated and oestrogen-treated rats were used. One hour after injection of [3H]oestradiol into ovariectomized rats, 373 and 195 fmol/100 mg uterus were recovered in the nuclear and post-nuclear fractions respectively. About 17% of the nuclear-associated [3H]oestradiol was resistant to KCl extraction. After 18 h, the amount of [3H]oestradiol decreased to about 30% of that found after 1 h, and about 23% of nuclear complex remained resistant to extraction. In cardiac tissue, practically no [3H]oestradiol accumulated in the nuclear fractions and the amount recovered in post-nuclear fractions was about one-third of that in the uterine post-nuclear fractions. In the ovariectomized oestrogen-treated rats the distribution of [3H]oestradiol in nuclear and post-nuclear fractions was very similar and the proportion of the total nuclear fraction inextractable by KCl slightly higher (26%) than in untreated rats. After 18 h, while measurable amounts of [3H]oestradiol were found in post-nuclear fractions, no radioactivity was detected in the nuclear fraction. The results demonstrate the existence of salt-resistant nuclear oestrogen-binding sites in the mature ovariectomized rat uterus in vivo. Further, oestrogenization of ovariectomized rats did not significantly influence the amount or proportion of salt-resistant nuclear sites. PMID- 3625094 TI - Acetylcholine stimulates steroidogenesis in isolated frog adrenal gland through muscarinic receptors: evidence for a desensitization mechanism. AB - The effect of cholinergic agonists on glucocorticoid and mineralocorticoid production by frog interrenal (adrenal) tissue was studied in vitro by means of continuous perifusion. Acetylcholine, at doses ranging from 1 to 100 mumol/l, stimulated both corticosterone and aldosterone output in a dose-dependent manner, with a half-maximal effective dose of 2.5 mumol/l. Corticosteroid production was also stimulated by muscarine (10 mumol/l). In contrast, neither nicotine nor nicotine bitartrate (1-100 mumol/l) enhanced corticosteroid biosynthesis. The kinetics of the response of adrenal cells to acetylcholine and muscarine were similar to those observed during angiotensin II stimulation. In particular, a significant reduction (20-40%) in the spontaneous level of corticosteroid production was recorded after the initial infusion of muscarinic agents, but no further decrease in the basal level occurred after a second cholinergic administration. The effect of acetylcholine was blocked by the muscarinic receptor antagonist atropine (10 mumol/l). These results indicate that acetylcholine can stimulate frog adrenocortical cells through muscarinic receptors. Repeated 20-min pulses of acetylcholine (50 mumol/l) or muscarine (10 mumol/l), given at one pulse per 130 min, resulted in a marked reduction in the secretory response to the second pulse. No reduction in the stimulatory effect of acetylcholine or muscarine was observed when a 6.5-h interval separated two 20 min infusions of the secretagogue. In contrast with these findings, iterative pulses of the muscarinic agonist pilocarpine (in the range 1-100 mumol/l) did not cause any desensitization. These data show that the neurotransmitter acetylcholine can modulate frog adrenocortical function and suggest that, in addition to more conventional regulators, i.e. ACTH and angiotensin II, the cholinergic endings of the splanchnic nerve might participate in the regulation of corticosteroid secretion, at least under some physiological conditions such as neurogenic stress. PMID- 3625096 TI - Influence of bromocriptine and oestrogen on prolactin synthesis, secretion and tumour growth in vivo in rats. AB - The effects of diethylstilboestrol implants and bromocriptine administration on serum prolactin concentrations, prolactin messenger RNA (mRNA) and pituitary tumour weight were examined. Intact female Fischer 344 rats were implanted s.c. with 10 mg diethylstilboestrol (DES) under light anaesthesia. All animals except the control group carried the implant for 7 weeks at which time the rats were subdivided into five groups: A, control; B, DES for 7 weeks; C, DES for 7 weeks followed by withdrawal of DES for 1 week; D, DES for 7 weeks followed by withdrawal of DES and administration of bromocriptine for 1 week; E, DES for 8 weeks with concurrent administration of bromocriptine during the last week. Serum concentrations of prolactin were measured by radioimmunoassay, prolactin mRNA concentrations were measured by dot-blot hybridization and sodium dodecylsulphate polyacrylamide gel electrophoresis of the in-vitro translated mRNA. Pituitary growth was estimated by changes in pituitary weight and assessed by light and electron microscopic examination. Treatment with DES dramatically increased serum prolactin concentrations and prolactin mRNA and induced pituitary tumour formation as shown by histological changes. Withdrawal of DES for 1 week did not lead to a decrease in pituitary tumour weight but was accompanied by a decrease in serum prolactin concentrations and prolactin mRNA from peak concentrations although they remained significantly increased above controls. Treatment with bromocriptine after DES implants were removed led to a significant reduction in pituitary tumour weight and a decrease in serum prolactin concentrations and prolactin mRNA. Histology of the pituitary tumour after the bromocriptine treatment showed pituitary cells similar to those from normal animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625095 TI - Receptors for lactogenic hormones in the porcine corpus luteum: properties and luteal phase concentrations. AB - Homogenates of pig corpora lutea contained specific, high-affinity receptors for ovine prolactin (oPRL) and human GH (hGH). Specific hormone binding was enhanced by divalent metal ions, but only when included in the binding reaction. Divalent metal ions did not act by increasing the recovery of bound hormone by low-speed centrifugation, but appeared to promote the formation of a more stable hormone receptor complex. Both oPRL and hGH tracers were bound in similar amounts and with similar affinities by pig luteal homogenates and the concentrations of either unlabelled hormone required to displace specific binding of either tracer by 50% were identical. In contrast, 125I-labelled oGH failed to bind to pig luteal homogenates and oGH competed poorly for hGH or oPRL binding. Only hormones with prolactin-like activity competed for 125I-labelled oPRL binding. Specific prolactin binding was low in recently ovulated and early luteal phase corpora lutea, increased significantly in the mid-luteal phase and declined once more in the late luteal phase. Receptor concentrations increased with increasing gestational age. PMID- 3625097 TI - Differences in the ovulation rate of the right or left ovary in unilaterally ovariectomized rats: effect of ipsi- and contralateral vagus nerves on the remaining ovary. AB - The possible existence of peripheral asymmetry in the neuroendocrine mechanisms participating in the response of the ovary to gonadotrophins, and the participation of the vagus nerve, was investigated. At oestrus, the ovulation rate (number of ovulating/number of treated rats) of the left ovary in right unilaterally ovariectomized rats was lower than that in the right ovary in left unilaterally ovariectomized rats (42 vs 84%). No differences in the number of ova shed per ovulating animal nor in compensatory ovarian hypertrophy (COH) were observed. Bilateral section of the vagus nerve resulted in reduced COH only in those animals with the left ovary in situ (right unilaterally ovariectomized). Section of the left vagus nerve induced different effects depending upon which ovary was left in situ. When the left ovary was in situ an increase in ovulation rate, COH and number of ova shed was observed; however, when the right ovary was left in place the above three parameters decreased. Section of the right vagus nerve produced a decrease only in COH in both right and left unilaterally ovariectomized animals. It is concluded that in the unilaterally ovariectomized rat the right ovary seems more able to react to compensatory regulatory systems than does the left. The character of the information carried by the left and right vagus nerve is different. PMID- 3625098 TI - Inhibition of progesterone secretion by a 3 beta-hydroxysteroid dehydrogenase inhibitor in pregnant goats. AB - Epostane, an inhibitor of 3 beta-hydroxysteroid dehydrogenase, was administered to goats in late pregnancy in the presence or absence of concurrent treatment with prostaglandin synthetase inhibitors (indomethacin and diclofenac sodium) and the effect on steroidogenesis in the corpus luteum and adrenal cortex determined by measurement of peripheral concentrations of progesterone and cortisol respectively. Concentrations of both steroids were reduced to about 20% of pretreatment levels within 6 h of epostane administration. Cortisol concentrations subsequently increased about 24 h after epostane administration and returned to and exceeded pretreatment values, but progesterone concentrations remained suppressed until premature delivery, which occurred in all animals 44 +/ 2 h (mean +/- S.E.M.) after epostane administration. However, combined administration of epostane and prostaglandin synthetase inhibitor prevented the onset of labour in the majority of animals, but progesterone secretion in animals receiving this combined treatment did not differ from that in animals given epostane alone. It is concluded that progesterone withdrawal is an important component of the mechanisms which initiate parturition in the goat and that increased prostaglandin synthesis is essential for delivery in this species, but perhaps not for luteolysis. PMID- 3625099 TI - Storage and release of secretory granules in human prolactinomas: modification by bromocriptine. AB - Electron microscopic morphometric evaluation of the effects of bromocriptine on human prolactinomas during and after short-term parenteral (7 days) and long-term peroral (4-6 weeks) treatment showed that a reduction in size of prolactinoma cells occurs within a few days (half-time to maximum shrinkage, 2.2 days). The number of secretory granules discharged into the intercellular space increased after short-term treatment by a factor of three but the total volume of stored secretory granules did not change significantly. The total volume of cellular lysosomes, both primary and secondary, decreased significantly to about one-half of the pretreatment value. The amount of stored lipoids, end-products of lysosomal activity, decreased in specimens treated for 7 days, but returned to pretreatment levels in specimens treated for 4-6 weeks, suggesting that lysosomal material is discharged from the cells together with the secretory material. PMID- 3625100 TI - An animal model of the interpersonal communication of interoceptive (private) states. AB - Pigeons were taught to interact communicatively (i.e., exchange discriminative stimuli) based on 1 pigeon's internal state, which varied as a function of cocaine, pentobarbital, and saline administration. These performances generalized to untrained pharmacological agents (d-amphetamine and chlordiazepoxide) and were observed in the absence of aversive stimulation, deprivation, and unconditioned reinforcement. The training procedure used in this study appears similar to that by which humans learn to report on (tact) their internal environments and may be construed as a rudimentary animal model of the interpersonal communication of private events. PMID- 3625101 TI - Devaluation of stimuli contingent on choice: evidence for conditioned reinforcement. AB - Pigeons were presented a concurrent-chains schedule of reinforcement that had terminal links of equal duration. The initial links of the schedule were periodically interrupted by 15-s periods during which an extinction schedule was in effect. The extinction periods were presented on either a response-contingent or a noncontingent basis. Relative response rate for the left alternative decreased when the extinction periods were accompanied by the left terminal-link stimulus. Relative response rate for the right alternative decreased when the extinction periods were accompanied by the right terminal-link stimulus. Relative response rate varied inversely with the frequency of presentation of the extinction periods but was unaffected by presence versus absence of the response contingency in the schedule of extinction-period presentation. Furthermore, relative response rate was unaffected by presentation of extinction periods accompanied by a novel stimulus. When the extinction periods were presented after reinforcement in the left terminal link instead of as interruptions of the initial links, relative response rate for the left alternative was reduced if the postreinforcement extinction period was accompanied by the terminal-link stimulus for the left chain and reduced less if the extinction period was accompanied by the terminal-link stimulus for the right chain. The results demonstrate that the correlation between the terminal-link stimulus and extinction influenced the relative response rate in the initial link. PMID- 3625102 TI - A molecular analysis of choice on concurrent-chains schedules. AB - Six pigeons responded on concurrent-chains schedules with either independent or interdependent equal variable-interval schedules in the initial links and unequal variable-interval schedules, always in a 2:1 ratio, in the terminal links. Relative response rates in the initial links increased across conditions as initial-link duration was shortened and decreased across conditions as terminal link duration was shortened, replicating previous findings. Responses in the initial links were recorded in 5-s bins, and local or molecular relative response rates were calculated in order to ascertain how relative response rate varied as a function of time since the onset of the initial links. Two distinct molecular patterns were found. With interdependent initial links, relative response rates for the preferred key were elevated for the first 10 or 20 s of the initial links and then declined to an asymptotic value. With independent initial links, a negative recency effect was found similar to that reported by Killeen (1970). These two molecular patterns were related to the different momentary reinforcement probabilities resulting from independent and interdependent scheduling. PMID- 3625103 TI - On the distinction between open and closed economies. AB - Open and closed economies have been assumed to produce opposite relations between responding and the programmed density of reward (the amount of reward divided by its cost). Experimental procedures that are treated as open economies typically dissociate responding and total reward by providing supplemental income outside the experimental session; procedures construed as closed economies do not. In an open economy responding is assumed to be directly related to reward density, whereas in a closed economy responding is assumed to be inversely related to reward density. In contrast to this predicted correlation between response-reward relations and type of economy, behavior regulation theory predicts both direct and inverse relations in both open and closed economies. Specifically, responding should be a bitonic function of reward density regardless of the type of economy and is dependent only on the ratio of the schedule terms rather than on their absolute size. These predictions were tested by four experiments in which pigeons' key pecking produced food on fixed-ratio and variable-interval schedules over a range of reward magnitudes and under several open- and closed-economy procedures. The results better supported the behavior regulation view by showing a general bitonic function between key pecking and food density in all conditions. In most cases, the absolute size of the schedule requirement and the magnitude of reward had no effect; equal ratios of these terms produced approximately equal responding. PMID- 3625104 TI - Auditory discrimination: the Konorski quality-location effect. AB - Konorski showed that when a go/no-go procedure was used, sound quality discriminations were rapidly acquired and sound location discriminations were slowly acquired. These findings have been interpreted as a general constraint on the acquisition of auditory discriminations (quality-location effect). However, experiments carried out within an evolutionary framework (Harrison, 1984) have shown that the rate of acquisition of sound location discriminations varies widely as a function of the inclusion or exclusion of naturalistic features. These data suggest that Konorski's findings were a function of the special conditions of the experiments. The first purpose of the present experiments was to assess whether rats showed the effects noted by Konorski when studied under similar conditions. The second purpose was to study the effect of manipulating two natural features (novelty and stimulus-response adjacency) to assess whether the acquisition rates of quality and location discriminations could be greatly modified or made approximately equal, or both. When a go/no-go procedure was used and the other conditions were similar to those of Konorski, rats acquired a quality discrimination but did not acquire a location discrimination. However, when the S+ or S- were presented through a closely adjacent speaker, the sound location discrimination was acquired as rapidly as the quality discrimination. Finally, preexposing the animal to either S+ or S- retarded the rate of or prevented the acquisition of the quality discrimination. The experiments showed that the quality-location effect was determined primarily by the conditions used in Konorski's experiments, and that the effect is not a general constraint on learning. PMID- 3625105 TI - The interaction of stimulus and reinforcer control in complex temporal discrimination. AB - Six pigeons were trained in a discrete-trials signal-detection procedure to discriminate between a fixed-duration stimulus (5 s or 20 s) and a set of variable durations ranging from 2.5 s to 57.5 s in steps of 5 s. For each fixed duration stimulus, the ratio of reinforcer frequencies contingent upon reporting the fixed versus the variable stimulus was systematically manipulated. Detection performance was well controlled by both the stimulus value and the reinforcer ratio. Both the discriminability between the fixed duration and the set of variable durations, and the discriminability between the fixed duration and each of the variable durations, were independent of the reinforcer-frequency ratio when discriminability was measured as log d. The sensitivity of response bias to reinforcement-ratio changes was independent of the value of the fixed duration, but was not independent of the discriminability of the variable durations from the fixed durations. Under current models, discriminability measures in complex temporal discrimination may be independent of biasing manipulations, but bias measures are not independent of stimulus values. PMID- 3625107 TI - Determinative mechanisms in early development. Papers presented at a meeting of the British Society for Developmental Biology. East Anglia, April 1986. PMID- 3625108 TI - Influence of germline modifications of homologous chromosomes on mouse development. PMID- 3625106 TI - Is maternal mRNA a determinant of tissue-specific proteins in ascidian embryos? PMID- 3625109 TI - Parental origin effects in mice. PMID- 3625110 TI - Asymmetric movements of cytoplasmic components in Caenorhabditis elegans zygotes. PMID- 3625111 TI - Molecular analysis of mouse spermatogenesis: isolation of the t-complex polypeptide-1 gene and related sequences. PMID- 3625112 TI - Manipulating the anteroposterior pattern of the Drosophila embryo. PMID- 3625113 TI - Transplantation of localized anterior determinants in Chironomus eggs by microinjection. PMID- 3625114 TI - The stability and movement of mRNA in Xenopus oocytes and embryos. PMID- 3625115 TI - The expression of retroviral vectors in murine stem cells and transgenic mice. PMID- 3625116 TI - Nucleocytoplasmic interactions in the mouse embryo. PMID- 3625117 TI - Developmental strategies during early embryogenesis of Caenorhabditis elegans. PMID- 3625118 TI - The nature of developmental restrictions in Xenopus laevis embryos. PMID- 3625119 TI - Muscle gene activation by induction and the nonrequirement for cell division. AB - We are investigating the mechanism by which animal cells of an amphibian blastula are induced to differentiate as muscle after contact with blastula vegetal cells. After briefly summarizing previous work on this system, we have asked whether this response of animal cells to vegetal induction requires cell division. Animal and vegetal parts of a blastula were placed in contact with each other, and the resulting conjugates cultured in medium containing a sufficient concentration of colchicine or cytochalasin B to inhibit cell division. Muscle differentiation, as indicated by cardiac actin gene transcription, is induced when cell division is inhibited, though at a substantially reduced rate. However, cytoskeletal actin gene transcription, which does not depend on induction, is also much reduced under the same inhibitory conditions. We conclude that, although the cell division inhibitors seem to reduce all gene transcription, they have no preferential effect on the response to induction, and therefore that this process does not require cytoplasmic or nuclear division. PMID- 3625120 TI - DNA-ligase activity in axolotl early development: evidence for a multilevel regulation of gene expression. PMID- 3625121 TI - Telemetered electromyography of the fast and slow extensors of the leg of the brown lemur (Lemur fulvus). AB - Quantitative telemetered electromyography from the four heads of the quadriceps femoris (vastus medialis, rectus femoris, vastus intermedius and vastus lateralis) during normal postures and locomotion (quadrupedal resting, walk/run, gallop and leaping) is presented for the brown lemur, Lemur fulvus. The vastus intermedius is the sole contributor to muscle recruitment during quadrupedal resting postures. It exhibits consistently high levels of electrical activity during all locomotory behaviour. The vastus medialis is recruited least among these muscles during walk/run and tends to be 'saved' for galloping and leaping. The rectus femoris and vastus lateralis are recruited at similarly high levels during all phasic activities. The rectus femoris appears to be used eccentrically, storing 'elastic strain energy' during all phasic activities. The vastus lateralis combines exceptionally high potential effective force with relatively high potential velocity and resistance to fatigue and probably develops the majority of force in all phasic activities. These results support previously documented structural and histochemical data that imply a functional division of labour among these muscle synergists. PMID- 3625122 TI - Electric fish approach stationary signal sources by following electric current lines. AB - African electric fish of a pulse species, Brienomyrus brachyistius (Mormyridae), housed singly in a large, circular arena, were presented with electrical stimuli which mimicked a conspecific intruder. Stimuli were produced with either dipolar or bipolar electrodes in three different geometries. We tracked the unconditioned approach response paths taken by the fish and compared tracks for each of the geometries. The results suggest that B. brachyistius can determine neither the distance nor the direction of an electric dipole from afar, but that they do manage to find the source by maintaining a precise alignment of their body axis parallel to the direction of the local electric field vector (parallel to current lines) while swimming. This behaviour ultimately leads to the current source. We propose that this behaviour may be a simple mechanism mediating the approach response of one electric fish to another. PMID- 3625123 TI - A new microcomputer-based method for measuring walking phonotaxis in field crickets (Gryllidae). PMID- 3625125 TI - How to manage a laboratory? PMID- 3625124 TI - Form cues and content difficulty as determinants of children's cognitive processing of televised educational messages. AB - An experiment was designed to assess the effects of formal production features and content difficulty on children's processing of televised messages about nutrition. Messages with identical content (the same script and visual shot sequence) were made in two forms: child program forms (animated film, second person address, and character voice narration with sprightly music) and adult program forms (live photography, third-person address, and adult male narration with sedate background music). For each form, messages were made at three levels of content difficulty. Easier versions were longer, more redundant, and used simpler language; difficult versions presented information more quickly with less redundancy and more abstract language. Regardless of form or difficulty level, each set of bits presented the same basic information. Kindergarten children (N = 120) were assigned to view three different bits of the same form type and difficulty embedded in a miniprogram. Visual attention to child forms was significantly greater than to adult forms; free and cued recall scores were also higher for child than for adult forms. Although all recall and recognition scores were best for easy versions and worst for difficult versions, attention showed only minor variation as a function of content difficulty. Results are interpreted to indicate that formal production features, independently of content, influence the effort and level of processing that children use to understand televised educational messages. PMID- 3625126 TI - The comparability of ethanol concentrations in peripheral blood and saliva. The phenomenon of variation in saliva to blood concentration ratios. AB - Ethanol appears to reach a higher peak concentration in saliva than in peripheral blood, and to be eliminated from both compartments at different rates. This phenomenon of different elimination rates, which leads to a cross-over of both concentration versus time curves, can be explained by differences in the water content of both body fluids. When the water content is considered, the salivary ethanol concentration parallels the blood level in the elimination phase, more closely in capillary blood than in venous blood. PMID- 3625127 TI - A fully automated method for sample clean-up prior to chromatographic and immunological analysis. AB - A fully automated technique for the extraction and clean-up of low-molecular weight analytes from human serum and urine is presented. Its efficiency for sample clean-up prior to immunological assay is demonstrated for six adrenal and gonadal steroid hormones, calcidiol and the peptide hormones gastrin, insulin and glucagon. A more intensive sample clean-up, which is mandatory for liquid chromatographic analysis, is reported for serum cortisol. With the exception of calcidiol, the extraction of steroids is almost complete. Recovery of peptides is about 80% and depends on the nature of the peptide and on protein-analyte dissociating diluents. Precision of recovery is lower than 7% (CV) for all analytes studied. One hundred serum or urine samples can be cleaned up without loss of efficiency by only one solid-phase cartridge. The technique is in principle applicable to all other analytes with physico-chemical structures similar to the analytes in the present study. PMID- 3625128 TI - Simultaneous determination of chloride, sulphate, orthophosphate and organic anions in human urine by capillary isotachophoresis. AB - The principle of isotachophoresis has been used to develop a simple, specific and sensitive analytical method for the determination of anions in untreated urine. Isotachophoretic separation of anions in the presence of complex-forming counter ions (e.g. Cd2+) enables the quantitative separation and determination of chloride, sulphate and orthophosphate in the same sample and the less accurate measurement of the concentrations of citrate, formate, acetate, hippurate, benzoate and glucuronate. The mean deviation from 100% recovery of chloride, sulphate and orthophosphate added to urine samples is 3.1%. The proposed method shows good agreement with chemical (routine) methods. PMID- 3625129 TI - Filter paper blood sampling for glycated haemoglobin determination and its use in the control of diabetes mellitus. AB - Blood sampling on filter paper was tested for determination of glycated haemoglobin. The method showed coefficients of variation of 3.4% and 4.1%, and linearity coefficients of 0.978 and 0.91 for the microchromatographic and colorimetric methods respectively. A blood sample on filter paper impregnated with 5% ethylene glycol solution remains stable for 8 days at room temperature. In a group of 30 diabetics educated in the filter paper blood sampling technique, no statistically significant differences were registered among the mean values of their blood glucose profiles, glycated haemoglobin levels determined at the hospital and those obtained at home 14 days after discharge. In conclusion, the use of blood spotted on filter paper seems a cheap and convenient method for collecting, storing and transporting samples for analysis of glycated haemoglobins. It is also a useful alternative for home monitoring of diabetics. Moreover, it could also be useful in epidemiological studies of diabetes. PMID- 3625130 TI - [Determination of thromboplastin time with a new standardized thromboplastin from human placenta: results of a cooperative study]. AB - In five centres a new sensitive standardized thromboplastin from human placenta (Thromborel S) for determination of prothrombin time (PT) was evaluated on plasmas from healthy subjects, from patients on oral anticoagulant therapy and from patients with different diseases, especially of the liver. The standardization of the human placenta thromboplastin (HPT) for prothrombin time determination was performed by comparison with a lot of the Reference Preparation British Comparative Thromboplastin (BCT). The obtained International Sensitivity Index (ISI) for 14 differents lots of the new thromboplastin varied between 1.04 and 1.29 (mean value: 1.16). The reagent is highly sensitive to the factors of the extrinsic coagulation pathway and is not affected by heparin at least up to 0.6 IU/ml. From the comparison with the British Comparative Thromboplastin lot No. 235, a therapeutical range for the stable phase of the oral anticoagulation of 2.4-4.0 prothrombin ratio or 15-27% of normal, respectively, was obtained. Comparison of prothrombin time determination using the Human Placental Thromboplastin and the British Comparative Thromboplastin lot No. 235 in 330 patients on oral anticoagulation showed good correlations either in "percent normal" or in prothrombin ratio. PMID- 3625131 TI - Approved IFCC methods. Reference method (1986) for pH measurement in blood. International Federation of Clinical Chemistry (IFCC), Expert panel on pH, blood gases and electrolytes. PMID- 3625132 TI - 20-Dihydroisomers of cortisol and cortisone in human urine: excretion rates under different physiological conditions. AB - The urinary excretion rates of free cortisol and cortisone as well as of their 20 dihydroisomers have been studied in normal subjects under different physiological or pharmacological conditions. For the estimation of steroid excretion rates, a fully automated, liquid-chromatographic method was used. In normal subjects, the median steroid excretion rates of free cortisol, cortisone, 20-alpha dihydrocortisol, 20-beta-dihydrocortisol, 20-alpha-dihydrocortisone and 20-beta dihydrocortisone were 6.7, 8.0, 9.8, 5.2, 5.7 and 1.3 mumol/mol creatinine. The excretion rates measured at three different intervals of the day followed a circadian rhythm similar to that known for the cortisol secreting activity of the adrenal gland. After adrenal stimulation by i.v. application of 250 micrograms of tetracosactide hexaacetate, (Synacthen, corticotropin beta 1-24) excretion of urinary cortisol was significantly higher than those of the other steroids. During a 24 h infusion of corticotropin beta 1-24, the excretion rates of cortisol and its C-20 reduced isomers increased to a significantly greater extent than those of cortisone and its C-20 reduced isomers. During a four-hour infusion of hydrocortisone, the relative increase of cortisol excretion was greater than that of the other steroids. During a five-hour infusion of metyrapone at different dosages, the excretion of all steroids decreased in a dose-dependent manner. The present data indicate that the 20-dihydroisomers of cortisol and cortisone in human urine primarily originate from the peripheral metabolism of cortisol rather than from adrenal secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625133 TI - Interlaboratory survey of the quality of urinary arsenic and thallium assays in the European community. AB - The present investigations were performed to assess the feasibility of an international round robin on biological samples, to assess the overall performance of toxicological laboratories in the European Community (EC) and the applicability of analytical methods used. Twelve laboratories representing 10 member countries within the Community, which could be considered to be well qualified for this type of work, participated in this study. The set-up chosen was that of a so-called long-term interlaboratory survey. It appeared that quality assurance by an international round robin is feasible within the EC. The samples consisted of arsenic and thallium, both at a high and a low level and the results of the individual laboratories as well as interlaboratory data are reported. In general, a good overall performance was seen, and the methods used showed acceptable accuracy and precision. PMID- 3625134 TI - Specific creatinine determination in laboratory animals using the new enzymatic test kit "Creatinine-PAP". AB - The new Creatinine-PAP test kit from Boehringer Mannheim GmbH was evaluated for the determination of creatinine in dogs, rabbits, guinea pigs, rats, and mice. In comparison with methods based on the reaction with alkaline picrate, the enzymatic method gave the lowest serum creatinine values. The differences are caused by serum substances (non-creatinine chromogens) reacting with picric acid. Noticeable differences between the standard inulin clearance and creatinine clearance (e. g., in rats) arise because the non-creatinine chromogens interfere differently in the picric acid methods, and serum and urine contain different concentrations of interfering substances. The concentrations of non-creatinine chromogens are different in the various laboratory animals. Since these substances cannot be entirely removed (e. g., in rats, dogs) by the adsorption procedure with Fuller's earth, we recommend the peroxidase-coupled enzymatic test as a practical and specific method for routine measurements of creatinine in laboratory animals. PMID- 3625136 TI - ECG in ambulatory care. PMID- 3625135 TI - International Federation of Clinical Chemistry, Scientific committee, analytical section: and approved recommendation (1984) on physico-chemical quantities and units in clinical chemistry with special emphasis on activities and activity coefficients. PMID- 3625137 TI - Patient satisfaction. PMID- 3625138 TI - Why don't we diagnose alcoholism in our patients? PMID- 3625139 TI - Tricyclic antidepressant overdose. PMID- 3625140 TI - Complications of vasectomies in the United States. AB - Physicians in the United States were surveyed in 1983 to gather information concerning the number of vasectomies they performed in 1982 as well as their use of anesthesia and complications of those vasectomies. Most urologists performed vasectomies, whereas family physicians and general surgeons were less likely to do so. As expected, most physicians used local anesthesia, occasionally in combination with a sedative; however, 22 percent of physicians reported using general anesthesia for at least some vasectomies. Complication rates were in the ranges reported by previous case series. Physicians who performed between one and ten vasectomies in 1982 had higher rates of hematoma and hospitalization for treatment of a complication than physicians who performed more vasectomies. Maintenance of surgical skills appears to be important in preventing complications of this usually low-risk procedure. PMID- 3625141 TI - Pulmonary function tests in acute bronchitis: evidence for reversible airway obstruction. AB - Acute bronchitis is a common syndrome characterized by upper respiratory tract infection accompanied by productive cough in persons without chronic lung disease. As a first step in investigating the potential role of pulmonary airflow disturbances in acute bronchitis, 27 adult patients with acute bronchitis performed serial pulmonary function tests and daily peak flow measurements and completed daily symptom diaries. Eleven patients (40 percent) had a forced expiratory volume of the first second (FEV1) at entry less than 80 percent of predicted. Mean FEV1, forced midexpiratory flow rate (FEF25-75), and peak flow measures showed steady improvement over the five-week period. Differences between initial and final flow rates were statistically significant. These changes were particularly evident when two groups were created by stratifying by "abnormal" (FEV1 less than or equal to 80 percent predicted) and "normal" (FEV1 greater than 80 percent predicted) initial FEV1. Total duration of cough and subjective ratings of cough severity were not predicted by initial FEV1, but work absence was significantly higher in the abnormal group. The finding of reversible airway obstruction suggests a role for bronchospasm in many cases of acute bronchitis and calls for further research regarding proof of rapid reversibility and treatment with bronchodilators. PMID- 3625142 TI - Diagnosis of alcoholism in a simulated patient encounter by primary care physicians. AB - Although early detection and treatment of alcoholism have been shown to be efficacious, it is widely accepted that primary care physicians often fail to diagnose alcoholism. In this study, a computerized, simulated encounter with an alcoholic patient was used to assess the performance of a randomly selected sample of primary care physicians in diagnosing alcoholism. Of 95 physicians in this study, only 32 percent diagnosed alcoholism with maximal certainty. There was great variability among physicians in the threshold of information needed to diagnose alcoholism. One third of subjects misinterpreted symptoms of alcoholism and erroneously made other psychiatric diagnoses, chiefly anxiety or depression. Results of this pilot study were not associated with the physicians' age, sex, specialty, duration of training, or reported personal impact of alcoholism. This study provides further evidence of the need for additional education of primary care physicians if such physicians are to succeed in reducing the dramatic impact of alcoholism and alcohol abuse on public health. PMID- 3625143 TI - Nicotine chewing gum: effectiveness and the influence of patient education in a family practice. AB - The effectiveness of nicotine chewing gum in a family practice setting was evaluated. Ninety-nine subjects who were given a prescription for nicotine chewing gum were evaluated after one year to determine smoking status. Forty-nine subjects received only the gum, and 50 received the gum along with extensive personal instruction regarding its use. The two groups were compared with a third control group of 40 smokers who expressed no desire to stop smoking. At the end of one year, 12.2 percent of those receiving only gum and 10 percent receiving gum and instruction had stopped smoking, compared with a 20 percent cessation rate for the control group. The observed difference was not statistically significant (P greater than .05). Results of this study suggest that the use of nicotine gum alone may not be a viable alternative for family physicians whose patients desire to quit smoking. PMID- 3625144 TI - Content of the model teaching unit ambulatory care training and continuity of care in six family practice residency programs. AB - This article summarizes the practice content and continuity for 35 senior residents in six family medicine residency model teaching units utilizing a computerized information management system. Comparisons are drawn with the content of family practices in the National Ambulatory Medical Care Survey (NAMCS), showing that family medicine third-year residents provide a large proportion of pregnancy care and general medical examinations and treat a smaller number of chronic illness patients compared with family physicians in practice. Third-year residents performed few surgical procedures in the model teaching units. Continuity of care, though espoused by family medicine residencies in principle, was deficient in the model teaching units studied. Intensive training to compensate for these deficiencies is recommended. PMID- 3625145 TI - An uncommon presentation of a common disease: the hypertension of Cushing's syndrome. PMID- 3625146 TI - Attitudes about marketing among Pennsylvania family physicians. PMID- 3625147 TI - The family physician and health objectives for the nation. AB - Specific, measurable health objectives for the nation have helped guide federal, state, and local policy in disease prevention and health promotion during the 1980s. About one half of these objectives will probably be achieved by 1990. Public awareness of hypertension and its consequences, for example, is at very high levels. Although the physician's office is a key setting for accomplishing many of the objectives, physicians remain largely uninformed about them and uninvolved in the broader process of public health policy formulation. Family medicine, as a specialty concerned about the care of the individual in the context of family and community, has much to contribute to future public health planning efforts. A plan for drafting the year 2000 objectives is beginning. Because the objectives will help shape health policy in the future, family physicians should be involved in developing appropriate health objectives for the nation and helping to implement them. PMID- 3625148 TI - Community hospitals: from the backwaters to the mainstream. PMID- 3625149 TI - The IMC-HMO fiasco: some painful questions. PMID- 3625150 TI - Defensive medicine and the malpractice climate. PMID- 3625151 TI - When will medicine take a close look at itself? PMID- 3625152 TI - Halifax Medical Center. Evolution of a family practice residency program. PMID- 3625153 TI - The cost of illness: a fresh perspective on the non-crisis in health care costs. PMID- 3625154 TI - Pulmonary cryptococcosis: clinical analysis and treatment of 14 cases. PMID- 3625155 TI - Present status of human immunodeficiency virus infection in Taiwan. PMID- 3625157 TI - [Studies on energy expenditure of young Chinese men and women]. PMID- 3625156 TI - [Epidemiological study on hepatitis B virus infection among five ethnic groups in Pingtung County, Taiwan]. PMID- 3625158 TI - [Comparison of 30mCi and higher doses of iodine-131 for postoperative thyroid remnant ablation]. PMID- 3625159 TI - [A study on the clearance of small molecules in single needle dialysis, using a simplified mathematical model]. PMID- 3625160 TI - Hemobilia secondary to liver abscess: report of a case. PMID- 3625161 TI - Congenital hepatic fibrosis: report of a case. PMID- 3625162 TI - [Two cases of choledochal cyst: Todani type II and type IVB]. PMID- 3625163 TI - [Left pyriform sinus fistula complicated by acute suppurative thyroiditis: report of a case]. PMID- 3625164 TI - Computed tomographic and electroencephalographic changes in herpes simplex encephalitis: experience with 5 cases. PMID- 3625166 TI - Characterization of Flavobacterium species by analysis of volatile fatty acid production. AB - Seventy-four Flavobacterium strains were characterized by gas-liquid chromatographic analysis of volatile fatty acids produced in the culture medium. Principal components analysis permitted the graphic representation of the relative positions of the different strains, and aggregation according to the variance enabled a hierarchical classification to be established. The study revealed three subgroups each for F. meningosepticum and F. odoratum. Our F. breve, Flavobacterium sp. group IIb and F. multivorum strains appeared to be homogeneous. These results tallied with those of previous studies on DNA base composition and reassociation, electrophoretic protein profiles and cellular fatty acid composition. PMID- 3625165 TI - Acidosis facilitates spontaneous sarcoplasmic reticulum Ca2+ release in rat myocardium. AB - Previous studies have shown that acidosis increases myoplasmic [Ca2+] (Cai). We have investigated whether this facilitates spontaneous sarcoplasmic reticulum (SR) Ca2+ release and its functional sequelae. In unstimulated rat papillary muscles, exposure to an acid solution (produced by increasing the [CO2] of the perfusate from 5 to 20%) caused a rapid increase in the mean tissue Cai, as measured by the photoprotein aequorin. This was paralleled by an increase in spontaneous microscopic tissue motion caused by localized Ca2+ myofilament interactions, as monitored in fluctuations in the intensity of laser light scattered by the muscle. In regularly stimulated muscles, acidosis increased the size of the Ca2+ transient associated with each contraction and caused the appearance of Cai oscillations in the diastolic period. In unstimulated single myocytes, acidosis depolarized the resting membrane potential by approximately 5 mV and enhanced the frequency of spontaneous contractile waves. The small sarcolemmal depolarization associated with each contractile wave increased and occasionally initiated spontaneous action potentials. In regularly stimulated myocytes, acidosis caused de novo spontaneous contractile waves between twitches; these waves were associated with a decrease in the amplitude of the subsequent stimulated twitch. Ryanodine (2 microM) abolished all evidence of spontaneous Ca2+ release during acidosis, markedly reduced the acidosis-induced increase in aequorin light, and reduced resting tension. We conclude that acidosis increases the likelihood for the occurrence of spontaneous SR Ca2+ release, which can cause spontaneous action potentials, increase resting tension, and negatively affect twitch tension. PMID- 3625167 TI - Adherence to uroepithelial cells of Providencia stuartii isolated from the catheterized urinary tract. AB - The long-term catheterized urinary tract appears to offer a niche for Providencia stuartii, otherwise an unusual clinical isolate. P. stuartii, the most frequent and persistent isolate from the urine of 51 long-term catheterized patients, was recovered from 761 of 1230 (62%) weekly urine specimens. To test the hypothesis that prevalence of this species may be due to adherence properties of the organism, 20 selected strains from 14 patients at two nursing homes, representing six distinct serotypes and harbouring combinations of nine different plasmid species, were tested for adherence to uroepithelial cells (UEC). Optimal conditions were determined for differentiating strains on the basis of in vitro adherence to UEC. These strains, grown in nutrient broth, were incubated with UEC isolated from the urine of a healthy adult female (10(8) bacteria per 10(5) cells). Washed UEC, retained on 8 micron pore diameter filters, were transferred to slides, fixed and stained; bacteria were counted on each of 40 cells. Fourteen of the 20 strains were defined as adherent to UEC by comparison of mean adherent bacteria and percentage of uroepithelial cells with more than 10 bacteria. Adherence was compared to that of a P-fimbriated strain of Escherichia coli. It was not inhibited by 50 mM-mannose. We conclude that the majority of P. stuartii isolates are adherent to UEC in vitro and suggest that this may play a role in the persistence of this organism in the catheterized urinary tract. PMID- 3625168 TI - Hepatic lesions in experimental Campylobacter jejuni infection of mice. AB - Mice orally infected with Campylobacter jejuni developed focal infiltrative necrotic lesions in the liver, as determined by both histology and liver function tests. The initial histopathological feature was a focal infiltrative lesion in the parenchyma and portal triads. Foci of infiltrative lesions became necrotic between days 30 and 60 post-inoculation (p.i.). During this period, portal infiltrates increased in severity. From month 4 p.i., focal areas of infiltrative necrosis in the liver parenchyma became extensive. Study of liver function demonstrated mild elevations of transaminases, alkaline phosphatase and lactic dehydrogenase, and also the presence of hypoalbuminaemia. Although histopathological changes of the liver became gradually more marked after day 30 p.i., liver functions of infected mice were most affected at 2 months p.i. The capacity of C. jejuni to induce hepatic lesions seemed to be related to that of organisms to persist in the gall bladder; there was no correlation between biliary carriage in infected mice and positive faecal culture. PMID- 3625169 TI - Characterization of Enterobacter cloacae and E. sakazakii by electrophoretic polymorphism of acid phosphatase, esterases, and glutamate, lactate and malate dehydrogenases. AB - Acid phosphatase, esterases, and glutamate, lactate and malate dehydrogenases of 34 strains of Enterobacter cloacae and 22 strains of Enterobacter sakazakii were analysed by horizontal polyacrylamide agarose gel electrophoresis and by isoelectrofocusing in thin-layer polyacrylamide gel. The two species could be separated on the basis of distinct electrophoretic patterns of all enzymes analysed. Glutamate dehydrogenase and acid phosphatase were detected exclusively in E. cloacae, whereas esterase bands were more intensively stained in E. sakazakii. For each species, two zymotypes could be distinguished, on the basis of electrophoretic mobilities of malate dehydrogenase and banding patterns of esterase for E. cloacae, and by both isoelectric point and electrophoretic mobilities of an esterase and of lactate and malate dehydrogenases for E. sakazakii. The high degree of enzyme polymorphism within the two species permitted precise identification of strains. The variations in electrophoretic patterns might therefore provide useful epidemiological markers. PMID- 3625170 TI - A revised probability matrix for the identification of gram-negative, aerobic, rod-shaped, fermentative bacteria. AB - The results of the identification of 933 strains of Gram-negative, aerobic, rod shaped, fermentative bacteria (Enterobacteriaceae, Pasteurellaceae, Vibrionaceae) by a probabilistic method, in a computer, are given. The identification rate on the matrix was 89.2%. Many of the strains were atypical and had caused difficulty in identification in medical diagnostic laboratories. The results are given for each taxon by genus and species. PMID- 3625171 TI - A numerical taxonomic study of anaerobic gram-negative bacilli classified as Bacteroides ureolyticus isolated from patients with non-gonococcal urethritis. AB - A numerical taxonomic study of 64 strains of anaerobic Gram-negative bacilli isolated from men with non-gonococcal urethritis, two unclassified laboratory strains of 'corroding bacilli', and 12 other strains of anaerobic Gram-negative bacilli, including nine received as anaerobic curved rods and three as 'Bacteroides corrodens' (B. ureolyticus), isolated from women with bacterial vaginosis, was undertaken. Seventeen reference anaerobic strains belonging to the genera Bacteroides, Fusobacterium, Mobiluncus, Mitsuokella and Wolinella were included. Morphological, biochemical and physiological characteristics were examined in 103 tests. The resemblance between the 95 strains was calculated using the SSM, SJ and DP coefficients for cluster analyses based on the UPGMA method. All three approaches gave similar groupings, and the estimated average probability of test error was 2.46%. The strains fell into 10 phenons. The unclassified strains from men and three from women with lower genital-tract infections, and the laboratory strains of 'corroding bacilli' clustered in one phenon with the reference strains of B. ureolyticus, indicating that they correspond to B. ureolyticus. The other unclassified strains of anaerobic curved rods clustered as a distinct phenon. They correspond to species of the newly described genus Mobiluncus. The taxonomic data and the compilation of diagnostic tables serve as a useful guide for the laboratory identification of clinical isolates regarded as B. ureolyticus. PMID- 3625172 TI - Prevalence of antibody to delta antigen among HBV carriers in Japan. AB - Of 280 hepatitis B virus (HBV) carriers in Kure, Hiroshima Prefecture, Japan, 14 (5.0%) were seropositive for antibody to delta antigen (anti-HD by radioimmunoassay. HBV carriers with chronic liver disease had a greater frequency of seropositivity of anti-HD than asymptomatic HBV carriers (7% vs. 0%, P less than 0.05). Among the various geographic regions of Kure, the east suburban area had a significantly higher prevalence of anti-HD when compared with all other regions combined (9.8% vs. 2.7%, P less than 0.025). It is suggested that hepatitis delta virus (HDV) infection exists in Japan and HDV may be an etiologic agent of chronic liver disease. PMID- 3625173 TI - Anti-delta antibody in various HBsAg positive Argentine populations. AB - One thousand five hundred and seventeen HBsAg carriers from different cities of Argentina were studied for the presence of anti-Delta antibody (anti-HDV) in their sera. One thousand one hundred and sixty-eight were volunteer blood donors and 349 were patients with liver disease. Different liver diseases were diagnosed by clinical, biochemical, and histological parameters. Among blood donors, 16 (1.4%) were positive for the antibody and none was Delta-antigen positive. In 130 patients with acute hepatitis, one (0.77%) was positive for anti-HDV, as well as three (2.22%) out of 135 patients with chronic active hepatitis (CAH), and three (5.77%) out of 52 patients with cirrhosis (C). No anti-HDV positive was found among seven fulminant hepatitis (FH) cases. The presence of HBeAg and anti-HBe was studied in anti-HDV positive sera; eleven (69%) volunteer blood donors were anti-HBe positive, and five (31%) were HBeAg positive. HBeAg was positive in the three CAH cases, and in one out of three C Cases with anti-HDV positive. Hepatitis Delta antigen was also positive in the hepatocytic nuclei in the three patients with C and two of the three CAH cases. The present results show that Delta infection is rare among blood donors in Argentina. A small variation without statistical significance could be found within different geographical areas. Among patients with HBsAg related liver disease, the presence of HDV markers was also low. PMID- 3625174 TI - Prevalence of chronic hepatitis B virus infection in pregnant black women living in Soweto. AB - Urban black children have an appreciably lower hepatitis B virus (HBV) carrier rate than rural Black children. The purpose of this study was to determine the carrier rate in the preceding generation of urban-born Blacks, in order to establish how rapidly the reduction in carrier rate following urbanization has occurred. HBV markers were measured by radioimmunoassay in the serum of 616 urban born and 618 rural-born pregnant Black women living in Soweto. HBV carriage was significantly less frequent in the urban-born (1.3%) than in the rural-born women (4.0%; P less than 0.05). Total HBV exposure was also less common in the urban born women (35.2% compared with 44.7%; P less than 0.001). HBV carrier rates were the same in women whose mothers were urban-born (1.31%) and those with rural-born mothers (1.68%). Only three rural-born and no urban-born women had replicative HBV infection. These findings suggest that the decrease in the HBV carrier rate with urbanization is abrupt, occurring in the first generation born in the urban environment. PMID- 3625175 TI - Extension of the epidemiology of hepatitis B in circumpolar regions through a comprehensive serologic study in the Northwest Territories of Canada. AB - We conducted a seroepidemiologic study of hepatitis B virus (HBV) infection among 14,198 Inuit (Eskimo), Dene (Indian), and non-native inhabitants of the Northwest Territories (NWT, total 1982 population 47,053) between April 1983 and March 1985. Participants represented almost all of the NWT communities and included approximately half of the total indigenous population. Sera were screened for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs) by radioimmunoassay. A total of 428 persons (3.0%) were positive for HBsAg; their mean age was 41.5 years and 68.7% were greater than 30 years old. Anti-HBs was detected concomitantly in 153 (35.7%) of these persons and present as a single marker in 2,943 sera (20.7%). Overall prevalence rates for HBsAg were marginally higher among Inuit than Dene (3.9% and 2.9%, respectively; P less than 0.05), as were rates for anti-HBs (24.5% and 21.5%, respectively; P less than 0.01). Marker rates among the 2,776 participants of other ethnic groups, predominantly whites, were distinctly lower (HBsAg 0.3%, anti-HBs 8.5%) than among Inuit or Dene populations (P less than 0.01). The prevalence of HBsAg and anti-HBs increased with each decade of life in all five geographic regions, but there were marked differences among the regions as well as among communities within regions. The greatest concentration of HBV markers was in the Baffin Region (36.0% positive for HBsAg or anti-HBs). Hepatitis B e antigen (HBeAg) was detected in only 37 of 421 persons (8.8%) positive for HBsAg; most were less than or equal to 20 years old and were clustered in a few communities with the highest HBV marker rates. PMID- 3625176 TI - Mammary immunity in mothers of infants with respiratory syncytial virus infection. AB - Seven of 230 breast fed infants followed prospectively from birth through their first winter contracted RS virus infections. The colostral from five of the mothers of these infants contained antiviral IgA antibodies. In each case antibody levels were above the mean for a group of 36 mothers whose infants were age matched to infected infants but for whom there was no evidence of RS virus infection in their first winter. Four colostral samples from mothers of infected infants also contained antiviral IgG antibody. Colostral lymphocyte reactivity to RS virus antigen was tested in three mothers of infected infants and two showed significant proliferation. There was, therefore, no evidence that mothers of infected infants lacked mammary immunity to the virus. Maternal mammary IgA and IgG responses following diagnosis of RS virus infection in the infant were followed for the seven cases identified prospectively and for a further 23 infants admitted to hospital with RS virus infections of varying severity. There was no evidence that the mothers of more severely affected infants were deficient in IgA or IgG milk antibody. PMID- 3625177 TI - Hepatitis B vaccine in infants from an endemic area: long-term anti-HBs persistence and revaccination. AB - Persistence of anti-HBs in 156 Senegalese infants immunized with hepatitis B vaccine was studied for periods ranging from 2 to 6 years after booster dose administration. Six years after the booster dose, 90.4% of the infants had detectable anti-HBs antibodies, with 78.1% having titers higher than 10 mIU/ml. The geometric mean titer was 60 mIU/ml. Females showed higher anti-HBs values than males. In a group of 11 infants who received no booster dose, anti-HBs antibodies were detectable 7 years after the first dose. However, the geometric mean titer was lower (26 mIU/ml). Revaccination (56 infants) led to an increase of the geometric mean titer to 469 mIU/ml 2 months later. These results show that a booster injection every 5-6 years should provide adequate protective anti-HBs levels in infants. PMID- 3625178 TI - Cloning and characterisation of a delta virus cDNA sequence derived from a human source. AB - We report the extraction of delta virus RNA from the serum of a delta-virus infected patient and the subsequent cloning and analysis of a 380-nucleotide-long cDNA (D380). The nucleotide sequence of D380 shows overall differences of approximately 20% when compared with previously published sequences and does not include the viroid consensus sequence previously reported (Wang et al: Nature 323:508-514, 1986). A potentially coding open reading frame extending over the whole length of the D380 has been identified. Our results demonstrate the existence of genetic heterogeneity amongst different delta virus isolates. PMID- 3625179 TI - ECG of the month. Second degree AV block. PMID- 3625180 TI - Otoplasty for prominent ears. PMID- 3625181 TI - Taking the pain out of cystoscopy: a comparison of rigid with flexible instruments. PMID- 3625182 TI - Recognizing the recluse spider bite in children: necrotic arachnidism. PMID- 3625183 TI - Snake bites in north Louisiana. PMID- 3625184 TI - The course of depressive symptoms in suicidal vs. nonsuicidal depressed inpatients. AB - The present study attempts to delineate the course of depressive illness in suicidal, depressed inpatients as compared with a matched group of nonsuicidal, depressed inpatients. Thirty adult nonpsychotic psychiatric inpatients presenting with symptoms of a major depressive episode participated in the present study. Two subject groups were identified, one suicidal and the other nonsuicidal according to their responses on the Modified Scale for Suicidal Ideation. Subjects were assessed on a variety of self-report measures and several clinical interviews during hospitalization and follow-ups at 4, 10 and 16 months after discharge. Results supported the hypothesis that, although displaying similar levels of depression during hospitalization as well as at long-term follow-up, the two groups differed in the speed of their recovery. Approximately 4 months after discharge virtually all of the nonsuicidal patients had recovered, whereas a majority of the suicidal group remained quite depressed. These results suggest that more time is needed for the recovery process to occur in suicidal patients. Future research in the area of depression and suicide should take into account the different courses seen in these two groups of subjects. Furthermore, those who treat suicidally depressed patients should be cautions of the slow recovery of these patients. PMID- 3625185 TI - Borderline personality disorder and unipolar affective disorder. Long-term effects of comorbidity. AB - This study tracks the baseline clinical presentation and long-term course (average 15 years) of three patient groups defined largely by DSM-III from the Chestnut Lodge follow-up study: unipolar affective disorder (UNI, N = 22), borderline personality disorder (BPD, N = 55), and a comorbid cohort (UNI/BPD, N = 21). Comorbid BPD effects on UNI include earlier onset and absence of psychotic symptoms at baseline and more substance abuse and use of psychiatric treatment at follow-up. Comorbid UNI effects on BPD include better premorbid instrumental functioning, later onset at baseline, and a higher risk for suicide over the long term. Other noteworthy findings are a low rate of suicide (2%) among the noncomorbid BPD patients and a high rate of diagnostic instability (68%) among the noncomorbid UNI patients. Findings demonstrate a lack of syndromal stability within and among all three study groups and highlight the shortcomings of DSM-III for the investigation of comorbidity. PMID- 3625186 TI - Taking the measure of anxiety and depression. Validity of the reconstructed Hamilton scales. AB - The ability of the Hamilton Psychiatric Rating Scale for Depression (HRSD) and the Hamilton Anxiety Rating Scale (HARS) to discriminate major depressive disorder (MDD) from generalized anxiety disorder (GAD) was studied in 120 psychiatric outpatients and cross-validated with another 71 outpatients. Factor and discriminant analyses were used to develop revised anxiety and depression scales that were less positively correlated with each other, showed greater internal consistency, and differentiated MDD and GAD better than the original scales. The recombined scales also displayed higher rates of correctly assigning the samples to these disorders than did the original scales. PMID- 3625187 TI - Antidepressant blood levels in Southeast Asians. Clinical and cultural implications. AB - After long-term treatment with tricyclic antidepressants (TCA), the TCA blood levels of 41 depressed Southeast Asian patients were determined by high-pressure liquid chromatography. No detectable medicine level was found in 25 (61%) of the patients and a therapeutic level by American standards was found in only six (15%), indicating a high incidence of noncompliance. A Cambodian subgroup, however, was significantly more compliant than either the Vietnamese or Mein patients. After patient education and a discussion of problems and benefits of medicine, compliance improved with Vietnamese and Cambodians but not with the Mien. Cultural and educational factors influence compliance with medicine and responsiveness to education. Because the Cambodians also suffered from posttraumatic stress disorder, it is probable that the presence of this illness increased compliance. Preliminary data among these patients indicate that Asians probably need the same dose of imipramine as Americans to achieve a "therapeutic" level. Reports that Asians need lower doses of TCA medicine are limited by the high noncompliance rates with Asians. These high rates probably reflect cultural beliefs about illness and medication usage. It is valuable to perform TCA blood levels on Asian patients for whom antidepressants have been prescribed to monitor compliance and to lead into a discussion of benefits and side effects of the medicine. Evidence of noncompliance can lead to a productive doctor-patient discussion about beliefs and effects of the medication. PMID- 3625188 TI - Precursors of depression in World War II veterans 40 years after the war. AB - The impact of wartime stress and other psychosocial and health variables on depressive illness in the 40 years since the Second World War is examined in this study of Australian male prisoners of the Japanese and other veterans. A random sample of 170 surviving members of the captured Eighth Division of the Australian Army residing in Sydney in 1983 (POWs) was compared with a similar sample of 172 veterans who fought in Southeast Asia during the war but were not imprisoned (non POWs). Multiple regression analysis involving nine predictor variables revealed that self-reported nervous illness during the war and depressive illness since the war had pronounced independent effects on current depression as measured by the Zung Scale. Being married and better educated had significant protective effects against depression for the non-POWs while being employed and having higher socioeconomic status were protective for POWs. A clear linkage was shown from wartime nervous illness to postwar depressive illness to present-day depression. PMID- 3625189 TI - Sweets, chocolate, and atypical depressive traits. AB - An original questionnaire, the Foods and Moods Inventory (FMI) was used to investigate appetite for sweets and chocolate and its relationship to dysphoric mood. The FMI was administered to a group of subjects with an identified interest in chocolate (chocolate group, N = 73), a comparison sample (comparison group, N = 172), and a sample of former alcoholics (N = 22). Those who reported "self medicating" with sweets or chocolate were more likely to have personality traits associated with hysteroid dysphoria, an atypical depressive syndrome. In addition, the tendency to eat compulsively, in general, and appetite for sweets and chocolate, in particular, were significantly greater among women. PMID- 3625190 TI - Acquired immune deficiency syndrome: psychological impact on health personnel. AB - Eight nurses and four physicians involved in the care of an acquired immune deficiency syndrome (AIDS) patient and a matched, non-AIDS patient responded to three self-report measures that assessed the psychological distress associated with working with each patient. While working with the AIDS patient the physicians and nurses experienced increased anxiety, greater interference in nonwork activities, more frequent negative ruminations, and more negative perceptions regarding the AIDS patient's behavior than they did with the non-AIDS patient. Because of the fears and concerns engendered in medical personnel when providing care to AIDS patients, psychological and educational interventions are needed to reduce staff's discomfort and thereby facilitate optimal care of AIDS patients. PMID- 3625191 TI - Normal pressure hydrocephalus presenting as mania. AB - A case of normal pressure hydrocephalus presented as a secondary mania. The patient responded to neurosurgical intervention. Psychiatric aspects of diagnosis and management of normal pressure hydrocephalus are discussed. PMID- 3625192 TI - Repeated imipramine enhances sensitivity of the brain dopaminergic system related to exploratory behavior. AB - The influence of imipramine treatment on apomorphine-induced behavior was studied. Imipramine was administered twice a day for 14 days at 10 mg/kg. The control group received a single dose of imipramine. Both groups were tested at 48 hours after imipramine administration, using open field; the number of line crossings and episodes of rearing and looking into holes were counted as part of the exploratory behavior. Repeated, but not single, administration of imipramine increased the exploratory activity induced by apomorphine injection an effect which was blocked by haloperidol pretreatment. The results indicate that repeated imipramine administration enhances the sensitivity of brain dopamine receptors related to exploratory behavior. PMID- 3625193 TI - Interactions of amineptine with the neuronal dopamine uptake system: neurochemical in vitro and in vivo studies. AB - The effects of amineptine on 3H-dopamine uptake and 14C-dopamine release have been studied simultaneously in double labelling test performed on rat striatal synaptosomes. 3H-dopamine uptake was completely inhibited at 10 microM amineptine, a concentration which produced only a weak 14C-DA release (13% of the 14C-radioactivity stored). The IC 50 for the inhibition of 3H-DA uptake was not modified by a previous treatment with reserpine whereas the IC 50 of (+) amphetamine and the IC 50 of clomipramine were decreased 9 fold and increased two fold, respectively. In binding studies on rat striatal membranes amineptine displaces in vitro the 3H-GBR 12783, bound specifically to a component of the neuronal DA uptake complex. The apparent affinity of amineptine for this binding site was more than 150 times higher than its affinity for the binding site of 3H desipramine on rat cortical membranes. In mice, increasing doses of amineptine injected i.p. reduced in a dose dependent manner the specific retention of radioactivity in the striatum after an i.v. injection of a tracer dose of 3H-GBR 12783. These data indicate that amineptine inhibits DA uptake and is virtually devoid of DA releasing effects. It displays a relatively low affinity for the NE uptake system. Its neurochemical profile in the double labelling test clearly differs from that of (+) amphetamine and from that of classical tricyclic anti depressants. PMID- 3625194 TI - Variations in the monoamine oxidase-inhibitory activity ("tribulin?") in pig's urine. AB - Sandler and his colleagues (see Sandler, 1982) have demonstrated the presence of an endogenous inhibitor of the enzyme monoamine oxidase (MAO) and of benzodiazepine receptor binding in the urine and blood plasma of man and rat. The concentrations of this material increased under stress conditions and it has been named "tribulin". In the present experiments MAO-inhibitory activity was found in extracts of urine and plasma samples of domestic pigs. Evidence was obtained that the inhibitory activity was higher when pigs experienced slight discomfort. Thus it appears that pigs produce a substance similar to tribulin. It may become possible to use such MAO-inhibitory activity as an indicator in the assessment of interaction with the environment in pig husbandry. PMID- 3625195 TI - Platelet MAO in patients with idiopathic pain disorders. AB - Patients with idiopathic pain syndromes have been compared to healthy volunteers and patients with neurogenic pain syndromes as concerns the activity of the enzyme monoamine oxidase (MAO) in thrombocytes. In both patients with idiopathic pain syndromes and in patients with neurogenic pain syndromes an increased frequency of patients with low platelet MAO activity was found. As low platelet MAO activity has been suggested to reflect low central serotoninergic activity the results are in line with findings of reduced concentrations of the serotonin metabolite 5-HIAA in CSF in patients with idiopathic pain syndromes. The results would also give some support for the suggestion that idiopathic pain syndromes might be a variant of depressive disease. PMID- 3625196 TI - Partial protection against hyperbaric oxygen induced convulsions by dopaminergic agents in mice: possible involvement of autoreceptors? AB - In the present report we have investigated the effects of apomorphine, (-)3-PPP, L-DOPA and haloperidol on the elicitation of convulsions induced in mice by exposure to oxygen at high pressure (HBO) (5 ata O2). It was found that the administration of apomorphine (0.025-0.1 mg X kg-1 s.c.), (-)3-PPP (4 mg X kg-1 i.p.) L-DOPA (200-400 mg X kg-1 i.p.) as well as haloperidol (0.25-2.0 mg X kg-1 i.p.) produced a significant protection against HBO-induced convulsions. Haloperidol was the only drug to produce a dose-dependent decrease in respiration, and this effect does probably explain the anticonvulsant effects observed. The low doses at which apomorphine was effective, and the effects produced by (-)3-PPP, indicate an effect mediated via DA autoreceptors. Alternatively, and more likely taking the effects of L-DOPA into account, the DA receptors involved are sensitive enough to disclose postsynaptic agonist properties of apomorphine and (-)3-PPP at the doses employed. PMID- 3625197 TI - Growth-inhibiting effect of crude pineal extracts on human melanoma cells in vitro is different from that of known synthetic pineal substances. AB - The effect was studied of a number of synthetic indoleamines, pteridines, beta carbolines, of AVT and of crude extracts from rat and ovine pineal glands on human melanoma cells in vitro. The identified pineal substances as well as some of their analogues showed an inhibitory effect only at non-physiologically high concentrations. However, crude pineal extracts were more active than the synthetic pineal substances tested. They contain a compound which may have a tumor-inhibiting potency comparable to that of methotrexate but a different mechanism of action. PMID- 3625198 TI - Reduced growth hormone response to apomorphine in schizophrenic patients with poor premorbid social functioning. AB - The apomorphine-induced growth hormone (GH) response of 16 drug-free schizophrenic patients and nine control subjects were studied. The subgroup of nine patients with poor premorbid psychosocial functioning had a significantly lower GH response than the controls. Additional evidence for state dependent effects is provided. PMID- 3625199 TI - Relation of acetylcholine release to Ca2+ uptake and intraterminal Ca2+ concentration in guinea-pig cortex synaptosomes. AB - [14C]Acetylcholine (ACh) release and parallel alterations in 45Ca2+ uptake and intrasynaptosomal free CA2+ concentration ([Ca2+]i) were measured in guinea-pig brain cortex synaptosomes. Depolarization by high K+ concentrations caused a rapid transient increase in Ca2+ uptake, terminating within 60 s (rate constant = 0.060 s-1; t1/2 = 11.6 s). This resulted in a rapid increase (within 1 s) in [Ca2+1]i, which then fell to a maintained but still-elevated plateau level (t1/2 for the decline was 15 s). Peaks of [Ca2+]i showed a sigmoidal dependence on depolarization, contrasting with the simple linear dependence of plateau levels of [Ca2+]i. The K+-evoked ACh release also had two phases: a fast initial increase (t1/2 = 11.3 s), which terminated within 60 s, was followed by a slow additional increase during sustained depolarizations of up to 10 min. Depolarization by veratridine led to a slow gradual increase in Ca2+ uptake (t1/2 = 130 s) over a 10-min incubation period, whereas an elevated plateau level of [Ca2+]i was achieved within 2 min (without a rapid peak elevation). The Ca2+ dependent fraction of the veratridine-evoked ACh release correlated with the increase in [Ca2+]i rather than with Ca2+ uptake. Using two different methods of depolarization partially circumvented the time limitations imposed by a buffering Ca2+ indicator and we suggest that, in the main, ACh is released in bursts associated with [Ca2+]i transients. PMID- 3625200 TI - Myelin galactolipid synthesis in different strains of mice. AB - Previous studies have indicated that the brains of DBA/2J (D2) mice have a more heavily myelinated CNS than those of C57BL/6J (B6) at postnatal days 17-21. However, the amount of myelin in the brains of F1 (B6 X D2) hybrids is even higher than in their parental strains. To investigate further factors involved in regulating myelinogenesis in these mice, we have focused on the synthesis of cerebrosides and sulfatides, galactolipids enriched in myelin. Brain slices from 14-, 17-, and 21-day-old D2, B6, and F1 mice were incubated with [3H]galactose and [35S]sulfate. After incubation, microsomes, myelin, and oligodendroglial cells were isolated, and the galactolipids were analyzed. At 21 days of age, the labeling of cerebrosides in F1 mice was higher than in D2 and B6 mice when the results were expressed as microsomal or myelin radioactivity per gram wet weight. At 14 and 17 days of age, the labeling of cerebrosides in F1 animals was similar to that in D2 mice and was considerably higher than that in B6 mice. The labeling of sulfatides in F1 animals was significantly higher than in the B6 parent at all ages studied, whereas it remained higher than that in the D2 parent only at 17 days of age. A similar relationship among the strains was observed when the synthesis of myelin galactolipids was estimated by measuring the in vitro activity of UDP-galactose:ceramide galactosyltransferase and 3'-phosphoadenylyl sulfate:galactosylceramide 3'-sulfotransferase. The results indicate that the increased accumulation of myelin galactolipids previously reported in the F1 mice is partially due to enhanced synthetic activity. PMID- 3625201 TI - Antisera raised against the drug imipramine. AB - Antisera against 2-aminoimipramine covalently coupled to albumin have been raised in two rabbits. Both antisera bind imipramine and related tricyclic compounds as if to a single class of sites with high affinity and high titres. Displacement/inhibition assays showed that the affinities of various tricyclic compounds for the antisera showed a good correlation with the affinities of these drugs for the tricyclic antidepressant inhibitory sites on plasma-membrane 5 hydroxytryptamine carriers of human platelets and rat brain cortex. 5 Hydroxytryptamine and 5-hydroxytryptamine-uptake-selective drugs did not inhibit [3H]imipramine binding to antisera. The anti-imipramine antibodies were purified using imipramine-Sepharose affinity chromatography and were shown to be IgG class by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and protein A Sepharose precipitation. PMID- 3625202 TI - Interstitial ascorbate in turtle brain is modulated by release and extracellular volume change. AB - The isolated turtle cerebellum was used as a model system to study effects of depolarizing conditions on interstitial ascorbic acid concentration. The depolarizing stimulus was Leao's spreading depression, which is characterized by transient negative extracellular potentials, high potassium levels (20-60 mM), and local depression of neuronal activity. Interstitial concentrations of ascorbate (200-400 microM) and other electroactive species were monitored voltammetrically, using graphite fiber microelectrodes. Total tissue ascorbate (1,810 nmol/g tissue wet weight) was similar to mammalian levels and was several orders of magnitude higher than catecholamine and indoleamine content. During spreading depression, a large (up to 200 microM) increase in concentration of interstitial electroactive species was monitored. Use of Nafion- and ascorbate oxidase-coated electrodes and uricase confirmed that ascorbate was the only substance detected. Simultaneous monitoring of ascorbate, extracellular potential, and extracellular volume (using tetramethylammonium and ion-selective microelectrodes) indicated that (a) the ascorbate increase began with the decrease in extracellular volume during spreading depression, and (b) much of the increase was the result of extracellular volume decrease. In sucrose-substituted medium, in which volume changes are eliminated, a 50 microM increase in interstitial ascorbate, caused by release from intracellular stores, was also seen. The ascorbate concentration increase was prolonged in sucrose medium, suggesting that an uptake process involving sodium may further regulate interstitial ascorbate concentration. PMID- 3625203 TI - Biochemistry of an olfactory purinergic system: dephosphorylation of excitatory nucleotides and uptake of adenosine. AB - The olfactory organ of the spiny lobster, Panulirus argus, is composed of chemosensory sensilla containing the dendrites of primary chemosensory neurons. Receptors on these dendrites are activated by the nucleotides AMP, ADP, and ATP but not by the nucleoside adenosine. It is shown here that the lobster chemosensory sensilla contain enzymes that dephosphorylate excitatory nucleotides and an uptake system that internalizes the nonexcitatory dephosphorylated product adenosine. The uptake of [3H]-adenosine is saturable with increasing concentration, linear with time for up to 3 h, sodium dependent, insensitive to moderate pH changes and has a Km of 7.1 microM and a Vmax of 5.2 fmol/sensillum/min (573 fmol/micrograms of protein/min). Double-label experiments show that sensilla dephosphorylate nucleotides extracellularly; 3H from adenine labeled AMP or ATP is internalized, whereas 32P from phosphate-labeled nucleotides is not. The dephosphorylation of AMP is very rapid; 3H from AMP is internalized at the same rate as 3H from adenosine. Sensillar 5'-ectonucleotidase activity is inhibited by ADP and the ADP analog alpha, beta-methylene ADP. Collectively, these results indicate that the enzymes and the uptake system whereby chemosensory sensilla of the lobster inactivate excitatory nucleotides and clear adenosine from extracellular spaces are very similar to those present in the internal tissues of vertebrates, where nucleotides have many neuroactive effects. PMID- 3625204 TI - Characteristics of [3H]hemicholinium-3 binding to rat striatal membranes: evidence for negative cooperative site-site interactions. AB - The characteristics of [3H]hemicholinium-3 ([3H]HC-3) interactions with rat striatal membranes were investigated. Under the described assay conditions, [3H] HC-3 binds with a saturable population of membrane binding sites having the following regional distribution: striatum much greater than hippocampus greater than or equal to cerebral cortex greater than cerebellum. The specific binding of [3H]HC-3 showed an obligatory requirement for NaCl; other halide salts of sodium or KCl failed to substitute for NaCl. The Scatchard transformation of saturation isotherm data generated a curvilinear plot with high- and low-affinity components of binding. The dissociation of [3H]HC-3 at infinite dilution was also multiexponential. The dissociation could, however, be accelerated if unlabeled HC 3 was included in the diluting buffer, and this increase in dissociation appeared to be dependent on the concentrations of unlabeled HC-3 used, with the maximal increase demonstrable at 100 nM. The dissociation was also dependent on the fractional saturation of binding sites with labeled HC-3, such that, at higher fractional saturation of binding sites, the overall dissociation was faster and the difference in the dissociation observed between "dilution only" and "dilution + unlabeled HC-3" was reduced. This occupancy-dependent change in dissociation could also be influenced by temperature and pH. Based on the results of these kinetic studies, the steady-state [3H]HC-3 binding data were analyzed for a homogeneous population of binding sites undergoing site-site interactions of the negative cooperative type. Such an analysis yielded a KD of 9.3 nM for the high affinity state and a KD of 22.8 nM for the low-affinity state of binding sites, with a Bmax of 434 fmol/mg of protein. Competitive binding studies showed that unlabeled HC-3 was most potent in displacing [3H]HC-3, followed by choline. Other drugs known to have little influence on the synaptosomal sodium-dependent high affinity choline uptake system (SDHACU) had no significant effect on [3H]HC-3 binding sites. Similarities in ionic dependencies, regional distributions, and pharmacological selectivities of [3H]HC-3 binding with synaptosomal SDHACU suggest that [3H]HC-3 selectively labels SDHACU sites located on presynaptic cholinergic neurons in rat CNS. We suggest that the two affinity states of [3H]HC 3 binding sites represent the different "functional" states of the SDHACU system. The binding of HC-3 (or choline) with the high-affinity state of the binding sites induces negative cooperative site-site interactions among the binding sites, resulting in the formation of a low-affinity binding state.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3625205 TI - Ca2+/calmodulin distinguishes between guanyl-5'-yl-imidodiphosphate- and opiate mediated inhibition of rat striatal adenylate cyclase. AB - The inhibition of adenylate cyclase from rat striatal plasma membranes by guanyl 5'-yl-imidodiphosphate [Gpp(NH)p] and morphine was compared to determine whether Gpp(NH)p-mediated inhibition accurately reflected hormone-mediated inhibition in this system. Inhibition of adenylate cyclase activity by Gpp(NH)p and morphine was examined with respect to temperature, divalent cation concentration, and the presence of Ca2+/calmodulin (Ca2+/CaM). Gpp(NH)p-mediated inhibition was dependent on the presence of Ca2+/CaM at 24 degrees C; the inhibition was independent of Ca2+/CaM at 18 degrees C; and inhibition could not be detected in the presence, or absence, of Ca2+/CaM at 30 degrees C. In contrast, naloxone reversible, morphine-induced inhibition of adenylate cyclase was independent of both temperature and the presence of Ca2+/CaM. Mg2+ dose-response curves also reinforced the differences in the Ca2+/CaM requirement for Gpp(NH)p- and morphine induced inhibition. Because Gpp(NH)p-mediated inhibition was independent of Ca2+/CaM at low basal activities (i.e., 18 degrees C, or below 1 mM Mg2+) and dependent on the presence of Ca2+/CaM at higher basal activities (24 degrees C, or above 1 mM Mg2+), the inhibitory effects of Gpp(NH)p were examined at 1 mM Mg2+ in the presence of 100 nM forskolin. Under these conditions, both Gpp(NH)p- and morphine-induced inhibition of adenylate cyclase were independent of Ca2+/CaM. The results demonstrate that the requirement for Ca2+/CaM to observe Gpp(NH)p-mediated inhibition depends on the basal activity of adenylate cyclase, whereas hormone-mediated inhibition is Ca2+/CaM independent under all conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625206 TI - The rapid assessment of visual dysfunction in multiple sclerosis. AB - A consecutive series of patients with normal activity and a diagnosis of multiple sclerosis (10 male and 31 female) underwent extensive ophthalmological examination including visual evoked potentials (VEPs) and a new test of contrast sensitivity, which is described in detail. Seventy three per cent of patients had abnormal contrast sensitivity and 83% had abnormal VEPs. There was no association between abnormalities of the two types, but patients who had impaired contrast sensitivity and normal VEPs were younger than those whose contrast sensitivity was normal but whose VEPs were not. The test of contrast sensitivity (which took less than 5 minutes to administer) was the only examination to reveal visual abnormalities in all nine patients with a history of optic neuritis, and would be a useful supplementary test in the examination of patients with suspected multiple sclerosis. PMID- 3625207 TI - Ganzfeld electroretinographic findings in parkinsonism: untreated patients and the effect of levodopa intravenous infusion. AB - Two groups of patients with primary Parkinsonism were studied with the ganzfeld electroretinogram (ERG): seven patients who had never received dopamimetic agents, and six patients given an infusion of levodopa following a period of medication withdrawal. Patients in the first category had a subtle increase in the latency of their short-wavelength sensitive cone response recorded from the retina ipsilateral to their more symptomatic side. Most patients in the second category demonstrate an improvement in their ERG when the responses recorded following levodopa infusion were compared with baseline responses obtained during the period of medication withdrawal. These results suggest that one role of retinal dopamine may be maintenance of normal retinal responsiveness to flash stimuli. PMID- 3625208 TI - Ocular motor and manual tracking in Parkinson's disease and the effect of treatment. AB - A quantitative analysis of unpredictable saccadic and smooth pursuit ocular motor and manual tracking was performed in 15 mildly affected, previously untreated subjects suffering from Parkinson's disease and in age-matched normal controls. The patients' ocular saccades were characterised by an increased variability of their latencies and reduced accuracy, with normal velocity profiles apart from saccadic duration. Their smooth pursuit had a decreased velocity gain. Similar abnormalities were found with manual tracking. Clinical improvement with dopaminergic drugs was associated with an improvement of saccadic accuracy and smooth pursuit gain. It is postulated that the ocular motor changes seen in Parkinson's disease are contingent upon functional dopamine levels in the basal ganglia. PMID- 3625209 TI - Cortical and cervical stimulation after hemispheric infarction. AB - Cortical and cervical stimulation has been performed in 20 patients with hemiparesis or hemiplegia due to hemispheric infarction and in 20 control subjects. The motor action potentials (MAPs) were recorded from biceps and thenar muscles. MAPs evoked by stimulation of the undamaged hemisphere were normal in 18 out of 20 patients and in two there was a slight increase of central conduction time (CCT). The stimulation of the motor cortex of the damaged hemisphere did not evoke any response in 15 patients; in two the MAPs were absent in one muscle and in the remaining three were delayed in one or both muscles. Cervical MAPs were normal in 18 patients and delayed in the thenar muscle in two patients. PMID- 3625210 TI - Detection threshold for percutaneous electrical stimuli: asymmetry with respect to handedness. AB - Sensory strength-duration curves were obtained using percutaneous true square wave pulses ranging from 0.1 to 20.0 ms produced by an isolated constant current stimulator. In 119 healthy volunteers sensory thresholds were measured bilaterally by stimulating the distal phalange of the little finger. In order to examine the relationship of sensory threshold and handedness the latter was assessed by means of the Edinburgh Inventory. An asymmetry of sensory threshold was found for all the subjects and this was more pronounced with shorter stimuli. Of right-handers tested 73.5% had a lower threshold on the left side while 70.8% of left-handers had a lower threshold on the right side. Although threshold asymmetry is associated with handedness this is not necessarily due to cerebral lateralization. PMID- 3625211 TI - Electrophysiological study on limb myokymia in three women. AB - Physiological studies on three women with limb myokymia were carried out. The patients had diabetic neuropathy, neuromyotonia, and autonomic polyneuropathy, respectively. The EMG discharge pattern, coincident with myokymia, in a patient with myokymia and neuromyotonia differed from those with myokymia without neuromyotonia. In only the first patient did the electrical stimulation of nerves evoke "late repetitive response" (LRR), which resembled the wave forms of the myokymic discharge. Epidural and peripheral nerve blocks abolished myokymia in the first and second cases, but peripheral nerve block was without effect in the third patient. These findings indicate that myokymia originates in multiple sites of alpha motor neurons and that the pathophysiology may vary. PMID- 3625212 TI - Cognitive impairment patterns in schizophrenia and affective disorder. AB - A battery of neuropsychological tasks was used to study 62 schizophrenics, 67 melancholics, and 30 manics satisfying specific research diagnostic criteria, and 42 normal subjects. Two patterns of neuropsychological impairment among patients were identified by factor analysis. The first pattern of bifrontal, non-dominant hemisphere dysfunction was shared by schizophrenics and affectively ill patients, whereas the second pattern of dominant temporo-parietal-occipital impairment was most frequent in a subgroup of schizophrenics. These relationships remained after accounting for the effects of age, gender, handedness and drugs received at time of testing. PMID- 3625213 TI - Bilateral paramedian thalamic artery infarcts: report of eight cases. AB - Eight consecutive patients with CT scan evidence of a bilateral infarct in the territory of the paramedian thalamic artery are reported. In seven cases the infarct also extended to the territory of the polar artery. The main symptoms were: disorder of vigilance which cleared in a few days, and hypersomnolence which lasted longer and in two patients was still present a year later; amnesia, detectable clinically in four patients and only with tests in two patients, which persisted in one patient for three years; changes of mood and bulimia present in five and four patients respectively; and vertical gaze paresis in five patients. Only one patient died, and in the remainder the symptoms tended to subside, but none of the patients who could be followed-up for a year returned to normal behaviour. Clinical and CT scan correlations pointed to the mammillo-thalamic tract as the structure whose damage was responsible for the memory disorders. PMID- 3625214 TI - Affective prosody in the reading voice of stroke patients. AB - Patients with right or left hemisphere strokes were studied for the nature of emotion conveyed in speech, during the reading of three short passages chosen for the differing emotional tone of their content. Both groups of patients had prosodic qualities which led their speech to be rated as like that of depressed patients and different from that of non-depressed controls. None of the stroke patients had significant depression or anxiety at the time of testing, so this prosodic quality is presumed to relate directly to brain damage. PMID- 3625215 TI - MRI in autonomic failure. AB - A significant rank correlation between rigidity and putaminal signal dropout on magnetic resonance imaging (MRI) in patients with multiple system atrophy suggests that putaminal degeneration may cause this clinical finding. Absence of putaminal abnormalities on MRI in patients with pure autonomic failure may prove useful in differentiating these two autonomic disorders. PMID- 3625216 TI - A case of postganglionic cholinergic dysautonomia. AB - A 24 year old female presented with signs and symptoms of postganglionic cholinergic autonomic dysfunction manifested by impaired lachrymation and salivation, mydriasis of the pupil, decreased gastrointestinal motility, atony of the bladder, and sweating and taste disturbance. Clinical and pharmacological studies confirmed that the abnormalities were restricted mainly to the postganglionic cholinergic autonomic systems. The titre of serum complement was low, antinuclear antibodies revealed a diffuse pattern, and anti SS-A antibody was positive, suggesting that this disorder was caused by an immune mechanism. PMID- 3625217 TI - Indices of free radical activity in the cerebrospinal fluid in motor neuron disease. AB - Indices of free-radical activity and lipid peroxidation were studied in cerebrospinal fluid samples obtained from 11 patients with motor neuron disease and 11 reference subjects. No differences were found between the two groups. The significance of this finding is discussed in relation to current views of the possible pathogenesis of this disease. PMID- 3625218 TI - Reduction of arginine-vasopressin in the cerebral cortex in Alzheimer type senile dementia. AB - Arginine-vasopressin (AVP) concentrations in five cortical areas were measured post mortem in nine patients with senile dementia of Alzheimer's type (SDAT), and compared with the control group of comparable ages. In SDAT patients, AVP was significantly reduced in Brodmann areas 4, 7 and 10 (p less than 0.05). In areas 17 and 22, the detectability and the mean concentrations of AVP were also lower than those of control patients, although not significantly. PMID- 3625219 TI - Familial congenital vestibular areflexia. AB - Three cases in one family are presented with oscillopsia due to vestibular areflexia, but without hearing loss. There was no history of other neurological or otological diseases (including infectious diseases) or use of neuro-ototoxic drugs. Laboratory tests, including tests for autoimmune diseases, were undisturbed. Petrosal radiographs and brain CT scans were normal. The pedigree suggested autosomal recessive inheritance. PMID- 3625220 TI - Cerebellar encephalopathy in cat scratch disease. PMID- 3625221 TI - Effects of dexamethasone in myotonic muscular dystrophy. PMID- 3625222 TI - Wernicke aphasia and cardiac embolism. PMID- 3625223 TI - Streptococcus bovis meningitis. PMID- 3625224 TI - Recurrent vertigo: cochlear-vestibular interaction. PMID- 3625225 TI - Normal sural nerve morphometry in acute uraemia. PMID- 3625226 TI - Anterior tibial compartment syndrome secondary to systemic capillary leak syndrome. PMID- 3625228 TI - Bioethics. PMID- 3625227 TI - Changes of inherent muscle stiffness in Parkinson's disease. PMID- 3625229 TI - Phase II study of betaseron (beta ser17-interferon) as treatment of advanced malignant melanoma. AB - Betaseron (beta ser17-interferon) was administered to 19 patients (17 evaluable) with advanced melanoma by two schedules. Patients received either 30 X 10(6) units (mU) by intravenous bolus 5 days a week for 2 weeks followed by 2 weeks rest, or 30 mU daily for 5 days in week 1, 60 mU daily for 5 days in week 2, then twice-weekly doses escalating from 90 to 270 mU. Toxicity commonly included malaise, fatigue, fever, and weight loss. Mild hematologic, gastrointestinal, and hepatic toxicity were also seen, as well as an episode of atrial fibrillation in a patient with mitral valvular disease. No responses to therapy occurred. PMID- 3625230 TI - Antitumor activity of recombinant human tumor necrosis factor in combination with hyperthermia, chemotherapy, or immunotherapy. AB - The antitumor activity of recombinant human tumor necrosis factor (rhTNF) against methylcholanthrene A-induced sarcoma (Meth A sarcoma) and human tumors in vivo was studied. On systemic administration of rhTNF to Meth A sarcoma-bearing mice, tumor regression was achieved with a large dose or with repeated administration of a small dose. Strong antitumor activity could be achieved in the Meth A sarcoma model by administration of a small dose of rhTNF in combination with moderate temperature hyperthermia (p less than 0.005). rhTNF (1,000 U/mouse) combined with moderate hyperthermia (40 degrees C for 40 min) within 2 h after the TNF administration effected 100% complete regression. In contrast, the rhTNF or moderate hyperthermia alone revealed 0% complete regression. The antitumor activity of rhTNF was decreased in combination with cyclophosphamide (0.6 or 1.2 mg/mouse) (p less than 0.005). However, in combination with mitomycin C (30 or 120 micrograms/mouse), the antitumor activity of rhTNF was enhanced (p less than 0.005). In combination with immunotherapy (lentinan or OK 432), the antitumor activity was mostly enhanced. Repeated rhTNF administration also displayed antitumor activity in heterotransplanted human tumors (p less than 0.005). The antitumor activity of TNF was enhanced by repeated administration of even small dosages, in combination with hyperthermia, or in combination with immunotherapy. PMID- 3625231 TI - Monoclonal antibody therapy in malignant melanoma: factors effecting in vivo localization. AB - Thirteen patients with metastatic malignant melanoma received intravenous therapy with the murine antimelanoma monoclonal antibody 9.2.27. Five patients were entered on a dose escalation protocol with twice weekly escalating doses of 10 500 mg, in an extension of a previously reported trial. These patients demonstrated near saturation of available antibody binding sites in vivo following the 500 mg dose, with minimal toxicity. The remaining patients were entered onto a dose schedule comparison study, with a 500 mg dose administered either in a single 2 h infusion or as five daily 2 h infusions of 100 mg to examine the effects of different dose schedules and of an interrupted schedule on subsequent therapy with the same antibody. Intratumor localization of the monoclonal antibody did not appear to vary with respect to the dose schedule; however, interruption in therapy for 4 weeks was accompanied by somewhat poorer localization of antibody. This effect appeared to be primarily attributable to development of human antimurine antiglobulin in 25-30% of patients with resultant decrease in intratumor localization of antibody and more rapid clearance of the 9.2.27 antibody from the circulation. Earlier reports with other antibodies notwithstanding, initial infusions of 500 mg of 9.2.27 did not induce tolerance to the murine immunoglobulin. This study confirms and extends the findings of our initial trial of the 9.2.27 antibody by demonstrating that, although clinical responses were not observed, the antibody can be safely administered at doses up to 500 mg, with good intratumor localization of antibody. The diminished localization of antibody associated with antiglobulin responses indicates the importance of monitoring antiglobulin levels during therapy, and the necessity of controlling or preventing this phenomenon when monoclonal antibodies are administered in multiple doses as drug, toxin, or radionuclide immunoconjugates. PMID- 3625232 TI - Experimental autoimmune inflammatory myopathy. AB - We report an experimental model of autoimmune inflammatory myopathy. Splenic cells from two inbred murine strains (BALB/c and SJL/J) are activated (immunized) in vitro by co-culture with their respective syngeneic skeletal muscle myotubes. Subsequent injection of the activated splenocytes with or without B. pertussis into the respective syngeneic hosts results in inflammatory myopathy in the SJL/J mice but never in the BALB/c mice. The muscle inflammation is very similar in appearance to human autoimmune inflammatory myopathies. The myositis is not effector cell-skeletal muscle specific because splenocytes activated by co culture with smooth muscle will also elicit skeletal muscle lesions. Both strains of skeletal muscle appear to express class II (Ia) antigens and the splenocytes from both strains appear to be equally activated. Thus we postulate that the difference in the expression of myositis between the two strains is in the effector phase of the disease. Since SJL/J mice have vasoactive amine sensitive vascular systems and BALB/c do not, it is likely that activated splenocytes emigrate from muscle microvessels in the SJL/J strain whereas they cannot do so in the BALB/c strain. The most significant contribution of this model may be in its potential for addressing a sine qua non of cellular autoimmune disease, i.e. lymphocyte migration from the vascular compartment into the target tissue. Finally, the data support a cellular more than a humoral pathogenesis in this model. PMID- 3625233 TI - Freeze fracture analysis of muscle plasma membrane in bupivacaine HCl-induced degeneration and regeneration. AB - We did freeze fracture analysis of bupivacaine HCl-induced muscle fiber damage. The muscle plasma membrane in rat extensor digitorum longus and soleus muscle was analyzed for the density of orthogonal arrays and caveolae at periods of five minutes to 60 days after application of the myotoxin. In degenerating muscle a decrease in the density of caveolae was observed. In regenerating extensor digitorum longus muscle, a decrease in the density of orthogonal arrays and an increase in the density of caveolae was present. The results show that freeze fracture alterations in fast twitch regenerating muscle are similar to those seen in the muscles of patients with Duchenne muscular dystrophy. PMID- 3625234 TI - Abnormalities in spinal neurons and dorsal root ganglion cells in Tangier disease presenting with a syringomyelia-like syndrome. AB - A woman with homozygous Tangier disease had progressive syringomyelia-like neuropathy. She died with cardiac failure at age 61. A sural nerve biopsy taken at age 60 had shown lipid storage in Schwann and interstitial cells, and a pronounced loss of unmyelinated fibers. The neurons of the L5 spinal ganglion and, to a lesser extent, all neurons of the sacral spinal cord, contained large lipid inclusions which in electron micrographs differed from those in Schwann and satellite cells. There was no storage material in glial cells. The neuronal inclusions were membrane-bound and consisted of electron-dense and electron lucent components. There was evidence of neuronal death in the spinal ganglion, and a diameter histogram showed that small cytons had preferentially been lost. The inclusions probably were secondary lysosomes or residual bodies, and resembled giant lipofuscin granules. Nevertheless, they were uncolored and displayed weak autofluorescence as compared to the aging pigment in control ganglia. It is tentatively suggested that the syringomyelia-like neuropathy in Tangier disease represents a lysosomal storage disorder preferentially affecting small dorsal root ganglion cells. PMID- 3625235 TI - Pigmentary type of orthochromatic leukodystrophy (OLD): a new case with ultrastructural and biochemical study. AB - A 34-year-old woman with no family history of orthochromatic leukodystrophy (OLD) developed progressive intellectual deterioration, a frontal syndrome and spastic tetraparesis. She died four years after the onset of the clinical illness. Neuropathological studies included light and electron microscopy of cerebral and nerve biopsies, and a complete postmortem examination. Light microscopy demonstrated OLD with pigmented macrophages and glial cells. Electron microscopy showed electron-dense, membrane-bound intracytoplasmic lamellar inclusions with curved or straight parallel arrangement, or fingerprint pattern, in white matter macrophages, astrocytes and oligodendrocytes. Cortical cells contained lipofuscin which was normal in type and amount. This suggests that the material in white matter glial cells and macrophages is ceroid pigment, however, the distribution is not that seen in ceroid-lipofuscinosis. Similar inclusions have been found in oligodendrocytes in other forms of OLD. Biochemical study did not show evidence of demyelination. Galactolipids were normal. Polyunsaturated fatty acids were decreased. The most striking feature was an increase in plasmalogens. PMID- 3625236 TI - Neuropathology of "septo-optic dysplasia" (de Morsier syndrome) with immunohistochemical studies of the hypothalamus and pituitary gland. AB - The de Morsier syndrome, or septo-optic dysplasia, is a developmental anomaly characterized by involvement of the optic system, hypothalamic-pituitary axis and septum pellucidum. Only a few anatomical observations are recorded. We report three new cases and review the pertinent literature. The neuropathological lesions varied as did the clinical features. The hypothalamic nuclei were most commonly involved, followed by the optic system and the septum pellucidum. Other lesions were found in the cerebral cortex, corpus callosum, olfactory system and cerebellum. The hypopituitarism appeared to have been secondary to hypothalamic damage rather than to intrinsic pituitary defect. A virtually normal histology and the usual endocrine cell populations were demonstrated by immunocytochemistry in the adenohypophysis. Damage to the neurophysin-containing cells of the hypothalamus explains the various degrees of clinically observed diabetes insipidus. PMID- 3625238 TI - Fine structure of the autonomic ganglia of the mouse pulmonary vein. AB - The aim of this study was to describe the architecture of a ganglionated nerve plexus found in the loose connective tissue surrounding the pulmonary vein of the mouse. The input to this plexus was from the vagus nerves and from the stellate ganglia. A large ganglion containing more than 200 neurons was commonly found near the primary bifurcation of the pulmonary vein. The neurons were studied by NADH-diaphorase, zinc iodide-osmium and glyoxylic acid-induced catecholamine fluorescence methods at the light microscopic level, by scanning electron microscopy after the removal of connective tissue, and by transmission electron microscopy. The shape of the neuronal cell bodies was generally a smooth ellipsoid with the average major axis about twice the minor axis. The measured maximum cell diameter ranged from 14 to 42 micron (mean 26 micron). The profile area of individual neurons, as measured from wholemount preparations, ranged from 100 to 800 micron2 (mean 340 micron2) and the calculated neuronal volume ranged from 500 to 12,000 micron3 (mean 3300 micron3). Although there was this wide spread in neuronal size, histograms of cell size showed no separate populations of neurons. Almost all of the ganglionic neuronal cell bodies showed no catecholamine-specific fluorescence, but about 1% of the neurons exhibited a weak green fluorescence. Only a few noradrenergic nerve fibres were seen within the ganglia and these were associated with intraganglionic blood vessels. Small, intensely fluorescent cells were only rarely associated with the ganglia. Neurons and satellite cells formed units which were surrounded by an intraganglionic connective tissue space and a perineurium. Some of the intraganglionic capillaries were fenestrated. Neurons were entirely surrounded by satellite cells and did not appear to have any long dendrites. The generally smooth neuronal cell bodies had short spine-like processes, which were confined to within the satellite cell sheath. Preganglionic nerve fibres formed pericellular baskets of varicose fibres around neurons and made synapses either directly on the cell body or on somatic spines in about equal numbers. No synapses were found in the neuropil at a distance from the neuronal cell body. A few nerve processes were deeply embedded within the neuronal cell body. Clusters of vesicles were found in the cytoplasm of most neurons and were associated with subplasmalemmal densities. These synapse-like structures were mostly directed towards satellite cells, but some were associated with incoming synapses. PMID- 3625237 TI - Progressive axonopathy: an inherited neuropathy of boxer dogs. 4. Myelin sheath and Schwann cell changes in the nerve roots. AB - Changes in the myelin sheath have been studied in the nerve roots of dogs with Progressive axonopathy, an autosomal recessive inherited neuropathy. The earliest changes were attenuation of the sheath at the proximal paranode and adjacent internode, probably in response to the axonal swelling which occurs in this area. Myelin bubbles were frequently observed along internodes. As the disease developed, progressively more fibres demonstrated short internodes of irregular length and thin myelin sheaths suggesting extensive remyelination and remodelling of the sheath. Short lengths of axons devoid of myelin, and occasional macrophages were also encountered. Sheaths of both original and newly formed internodes were highly irregular in outline. Occasional intra-axonal projections of adaxonal Schwann cell cytoplasm were observed, but complex interdigitations were unusual. A moderately electron-dense, granular material accumulated within the myelin sheath, becoming more obvious in the advanced disease. This material of unknown origin and composition was located predominantly at the intraperiod line principally between the adaxonal cytoplasm and the inner major dense line, but also at Schmidt-Lanterman incisures and between paranodal loops. Xenografts of the canine nerves into athymic mice failed to demonstrate any of the myelin sheath changes. The temporal and spatial relationship of the myelin sheath and axonal changes and the failure to reproduce the natural lesion in grafts suggest that Schwann cell alterations probably occur in response to the axonal changes. PMID- 3625240 TI - Nerve growth factor protects adult sensory neurons from cell death and atrophy caused by nerve injury. AB - The reaction of dorsal root ganglia (DRG) neurons to axotomy and its alteration by locally supplied nerve growth factor (NGF) were examined in adult rats. Surgically implanted silicone chambers attached to the severed tip of the sciatic nerve acted as reservoirs capable of providing prolonged access of NGF to the site of injury. The time course of NGF activity within the chambers was determined by using the standard NGF chick DRG bioassay. The fluid from chambers filled with the NGF-saline solution maintained NGF activity for periods up to 6 weeks after implantation. By 9 weeks, however, the fluid from most chambers failed to show any NGF activity in the bioassay. Experiments were designed to compare the response in adult rats to injury of DRG neurons receiving chambers filled with either NGF-saline or with only saline. The total neuronal counts in the lumbar fourth and fifth DRG at 3 weeks and 6 weeks after sciatic nerve section showed 22% and 16% cell death, respectively, in those injured neurons receiving saline-filled chamber implants. The animals that received chamber implants which contained an NGF-saline solution showed no cell death in the ipsilateral DRG at either 3 or 6 weeks after injury. Morphometric analysis of injured DRG neurons showed evidence of atrophy in the injured neurons which did not receive NGF. The degree of atrophy among all cell sizes was significantly decreased in those injured neurons receiving NGF. At 3 weeks after section the mean volume of injured neurons not treated with NGF was decreased by 28% as compared with only a 13% decrease in neurons treated with NGF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625239 TI - Lectin binding by resting and reactive microglia. AB - Conjugates of the B4 isolectin from Griffonia simplicifolia seeds and horseradish peroxidase were used as a histochemical reagent for the specific visualization of microglial cells in the rat CNS. Resident microglia bearing galactose-containing glycoconjugates were stained throughout the brainstem and cerebellum. In the first week following axotomy of the facial nerve, a profound and rapid accumulation of reactive microglia, as evidenced by increasing lectin reactivity, was seen to take place in the facial nucleus. Light microscopy of paraffin sections demonstrated binding of lectin-horseradish peroxidase conjugates to microglial cytoplasmic processes. When ultrastructural cytochemistry was performed, reaction product was found localized on microglial plasma membranes, as well as on intracytoplasmic membranes. The glial reaction to axotomy was studied further with double labelling of microglia and astrocytes by lectin histochemistry and immunostaining for glial fibrillary acidic protein, respectively. Our results demonstrated the presence of membrane-associated glycoconjugates containing terminal alpha-D-galactose residues on microglia, but not on other glial cell types. The possible nature and function of these glycoconjugates are discussed. PMID- 3625241 TI - Ultrastructural observations of organelle accumulation in the equine recurrent laryngeal nerve. AB - The left recurrent laryngeal nerves from five horses with sub-clinical neuropathy were examined by light and electron microscopy in a study designed to examine accumulation of axonal organelles at paranodal and internodal locations. Transverse sections of the nerve showed scattered fibres with split myelin sheaths and axonal accumulation of organelles. On longitudinal sections these collections were seen to result from an axonal outpouching in which dense lamellar bodies and mitochondria had accumulated. These paranodal collections, which could be found on both sides of the node, were often associated with infoldings of the terminal loops of myelin and with occasional paranodal demyelination. The fact that many of the organelles in the outpouches were lysosomal in nature was confirmed by their positive staining for cathepsin D activity. Longitudinal sections demonstrated a number of axons which were swollen over a long distance and which contained focal accumulations of similar organelles. In places, however, there was a clear separation between these organelles and the cytoskeletal proteins. In each case these swollen axons were surrounded by Schwann cell nuclei and their processes, forming well-ordered onion bulbs. The possibility that these two types of changes, i.e. the paranodal accumulations and the axonal swellings could result from a disturbance in axonal transport in this distal axonopathy is discussed. PMID- 3625242 TI - Second malignancies from adjuvant chemotherapy? Too soon to tell. PMID- 3625243 TI - Second malignancies after CMF for resectable breast cancer. AB - From June 1973 to May 1978, a total of 845 women with resectable breast cancer and positive axillary nodes were entered into two consecutive randomized studies evaluating adjuvant chemotherapy. All patients were subjected to radical or modified radical mastectomy, none received postoperative radiation, and 666 were administered adjuvant CMF (cyclophosphamide, methotrexate, and fluorouracil). After a median follow-up in excess of 10 years, no cases of acute nonlymphocytic leukemia were detected, but 21 second solid tumors other than contralateral breast carcinoma were documented. The cumulative frequency was 4% +/- 1.9% after surgery alone, and 4.2% +/- 1.03% following adjuvant CMF. No differences were observed between patients aged up to 50 years (surgery, 3.1% +/- 2.2%; CMF, 3.3% +/- 1.3%) or older than 50 years (surgery, 4.5% +/- 2.6%; CMF, 5.2% +/- 1.8%). During the same period, a total of 29 contralateral breast carcinomas were documented for a cumulative frequency of 3.7% +/- 1.7% after surgery alone and of 5.2% +/- 1.4% following adjuvant CMF, respectively. We conclude that, at present, there is no evidence for an increased risk of second malignancies following adjuvant CMF as given in this series. Our findings would suggest that second tumors documented so far cannot be entirely ascribed to treatment with adjuvant chemotherapy, but they could be due to a chance association. PMID- 3625244 TI - Cisplatin, vinblastine, and mitoguazone chemotherapy for epidermoid and adenocarcinoma of the esophagus. AB - Thirty-six patients with adenocarcinoma or epidermoid carcinoma of the esophagus were entered into a phase II trial evaluating the combination of cisplatin 100 mg/m2 intravenously (IV) day 2, vinblastine 1.6 mg/m2 IV days 1 to 4, and mitoguazone (MGBG) 500 mg/m2 IV days 1 and 8. Twenty-nine patients (group A) were newly diagnosed with local-regional disease only and were candidates for transhiatal esophagectomy (THE). These patients received two courses of chemotherapy at 3-week intervals prior to surgery. Response was assessed by measuring changes in the primary tumor length and depth on serial biphasic contrast esophagrams and comparing this result with tumor measurements obtained from the surgical specimen. Complete (CR) and partial responders (PR) received three additional postoperative cycles. Seven patients had recurrent or metastatic disease (group B) and were treated every 4 weeks until disease progression. Of 34 patients evaluable for response, there was one pathologically confirmed CR and 15 PRs (47%). This consisted of 12 of 27 (44%) group A patients (seven of 11 epidermoid, five of 16 adenocarcinoma) and four of seven (57%) group B patients (two of four epidermoid, two of three adenocarcinoma). Toxicity included leukopenia in one third of treatment courses and thrombocytopenia in 21%. Nausea and vomiting occurred in 60% of patients, diarrhea in 18%, transient nephrotoxicity in 18%, peripheral neuropathy in 12%, and ototoxicity in 3%. Twenty-five group A patients underwent resection. Four chemotherapy nonresponders (NR) and one PR had known disease left at surgery; all others (80%) had gross total removal of their disease. The median survival time (MST) of the 29 group A patients was 14 months, with 21% alive at 36 months. The MST of group A chemotherapy responders was 15 months compared with 9 months for NRs (P = .032). Initial sites of recurrence in 14 patients were local-regional in six, distant only in six, both local-regional and distant in two. This regimen, administered in maximally tolerated doses, was active in epidermoid and adenocarcinoma histologies, recurrent disease and newly diagnosed patients. However, nearly all responses were PRs and the MST of resected patients was similar to a prior series of patients treated with esophagectomy alone. Observations from this pilot trial and those of others have led to a follow-up study, in progress, evaluating intensive preoperative chemotherapy and concurrent radiation therapy (RT). PMID- 3625245 TI - Metastatic Ewing's sarcoma: remission induction and survival. AB - Eighteen patients with previously untreated metastatic Ewing's sarcoma (ES) entered a protocol designed to evaluate the response rate to cyclophosphamide and doxorubicin induction therapy delivered before delayed surgery and delayed lower dose, limited-field radiation therapy, (RT), and maintenance chemotherapy. With chemotherapy and delayed surgery, 14 of 18 were rendered free of gross tumor. RT was delivered to the primary site of 11 of these responding patients, plus four of those not free of gross disease. Following RT, two more attained complete clinical remission. Site of primary or metastases did not influence outcome; however, the size of the primary at diagnosis did appear to do so. Ten patients remain disease-free 16 to 82 months (median, 47 months) from diagnosis. PMID- 3625246 TI - Clinical evaluation of recombinant interferon alfa-2a (Roferon-A) in metastatic melanoma using two different schedules . AB - Based on the reports of activity of interferons against metastatic melanomas, we conducted a phase II study of recombinant interferon alfa-2a (Roferon-A, Hoffmann La Roche, Nutley, NJ) in 66 patients with disseminated melanoma. All patients had excellent Eastern Cooperative Oncology Group (ECOG) performance status (0 to 1), and no evidence of brain metastases. Thirty patients had previously received chemotherapy and the remainder were untreated. The first 35 patients were treated on a daily schedule starting with a Roferon-A dose of 3 X 10(6) U/d and escalating to a maximum of 36 X 10(6) U/d over a period of 12 days. Because of excessive toxicity, the second group of 31 patients were treated on a fixed dose of 18 X 10(6) U/d [corrected] three times weekly (TIW). Among the 62 evaluable patients, five achieved an objective response for a response rate of 8% (95% confidence limits, 3% to 18%). Four patients had minor regressions and eight patients had stability of disease. The responses were evenly distributed between the two dose schedules. The major toxicity of interferon consisted of a constitutional syndrome of anorexia, fever, weight loss, and fatigue, which required a dose reduction in 75% of the patients on the daily schedule. Our data revealed a modest level of activity, which was not influenced by prior treatment or by the dose or schedule of interferon. Because of substantial toxicity with the daily schedule, we recommend a dose of 18 X 10(6) U/d [corrected] if interferon is used in the treatment of patients with melanoma. PMID- 3625247 TI - Scintigraphic detection of metastatic melanoma using indium 111/DTPA conjugated anti-gp240 antibody (ZME-018). AB - We evaluated the toxicity, pharmacokinetics, and localization of a monoclonal IgG2 alpha murine anti-human melanoma (gp240) antibody (ZME-018) that recognizes a tumor-associated cell surface glycoprotein of 240,000 molecular weight present in most melanomas. The antibody was conjugated with DTPA (diethylenetriamine pentaacetic acid) and labeled by chelation of 111In. One mg of antibody labeled with 5 mCi of 111In was infused, together with 0 to 40 mg of "cold" carrier ZME 018. The blood clearance, urinary excretion, and in vivo localization were determined in 26 patients. Scintigraphic images were obtained at 24 hours and 72 hours in all patients. Mild toxicity occurred in one patient. The half-time clearance of labeled monoclonal murine antibody (MoAb) from the blood increased from 16.1 hours at an antibody dose of 1 mg to 35.9 hours at 40 mg. Males showed faster clearance from the blood than did females or a single castrated male, perhaps due to selective concentration of antibody in the testes. Nonspecific uptake in liver, spleen, bone marrow, and intestine was seen in all patients. The percentage of known metastatic foci detected increased with the total dosage of antibody, from 23% at doses less than or equal to 5 mg, to 65%, 87% and 78% for 10, 20, and 40 mg, respectively. We conclude that at doses of greater than or equal to 10 mg, ZME-018 is a safe and potentially useful agent for the scintigraphic detection of metastatic malignant melanoma. PMID- 3625248 TI - Estrogen receptor in malignant melanoma. AB - The significance of an estrogen binding protein (ER) in malignant melanoma remains controversial. We have prospectively assayed for ER on 141 patients with malignant melanoma and correlated the presence of the ER with known prognostic variables. The overall incidence of ER was 43%. The incidence of ER in males was 38.7% and 50% in females (not significant). There is an increased incidence of ER+ melanoma in women with extremity lesions (P = .08). The disease-free interval (DFI), survival, and recurrent interval were 42.0 +/- 4.0, 52.3 +/- 4.3, 13.7 +/- 1.7 months in ER- patients; 63.7 +/- 11.6, 76.1 +/- 11.4, 26.5 +/- 7.3 months in ER+ patients (1 to 10 fmol/mg cytosol protein), and 69.8 +/- 17.9, 102.7 +/- 27.9, 29.4 +/- 9.9 months in ER+ patients (greater than 10 fmol/mg cytosol); respectively. When ER+ groups were combined, the DFI in women with ER+ lesions was significantly longer than those with ER- tumors (P less than .05). Cox multivariate analysis demonstrated that ER status is a significant variable of survival along with thickness level and nodal status. These observations suggest that ER may be a marker for a more biologically indolent melanoma. PMID- 3625249 TI - Spontaneous fracture of the catheter of a totally implantable venous access port: case report of a rare complication. AB - A case of spontaneous fracture of the outlet catheter of a totally implantable venous access port (IVAP) is presented. Thirty-seven weeks after implantation, the outlet catheter was broken at the entrance into the left subclavian vein. The distal part was embolized in the left pulmonary artery. The embolized remnant was retrieved in an outpatient setting, using a grasping forcipal catheter through a 7 French longsheath. Experimental study of the catheter revealed that it had been broken due to a local cause, probably the long-standing compression at the narrow space between clavicle and first rib. It is emphasized to ascertain the position and intactness of an IVAP before using it to infuse cytostatic agents. PMID- 3625250 TI - Authors should not compare survival of responders and nonresponders without discussing the limitations of such a comparison. PMID- 3625251 TI - A second look at second-look laparotomy. PMID- 3625252 TI - Early stopping, interim analyses, and monitoring committees: what are the tradeoffs? PMID- 3625253 TI - A reassessment of the role of second-look laparotomy in advanced ovarian cancer. AB - Thirty-nine patients with stage III and IV epithelial ovarian cancer who underwent second-look laparotomy (SLL) at New York University Medical Center and 11 eligible patients who did not undergo reexploration were retrospectively studied with follow-up from 24 to 105 months after diagnosis. Sixteen patients (41%) were found to have macroscopic disease, six (15%) microscopic tumor, and 17 (44%) no disease at SLL. Five of 22 patients who received further therapy based on positive SLL findings have remained without clinical evidence of disease 17 to 65 months after SLL. Nine of 17 patients with negative SLL, in whom treatment was stopped, recurred 8 to 52 months after SLL, five in extraperitoneal sites only. Five of 11 patients not undergoing SLL recurred 16 to 39 months after diagnosis, four intraperitoneally. There was no significant difference in survival between the second-look and no second-look groups for the period of study. Clinical trials are needed to determine if SLL influences longer-term survival and if continued treatment is indicated in a high-risk subgroup despite negative SLL. The value of SLL is limited by the efficacy of second line therapy. The role of routine SLL outside an investigational setting is questioned. PMID- 3625254 TI - Hyperleukocytosis in adult acute nonlymphocytic leukemia: impact on remission rate and duration, and survival. AB - The clinical courses of 353 patients with acute nonlymphocytic leukemia (ANLL) treated between 1971 and 1982 at the Baltimore Cancer Research Program (BCRP) of the National Cancer Institute were reviewed and examined for the impact of presenting WBC count on the initial course and overall outcome of these patients. Group A (WBC greater than 100,000/microL) had significantly more deaths during the first week of therapy than did group C (WBC less than 50,000/microL) (P = .0003). CNS hemorrhage was responsible for a significantly greater number of deaths in group A compared with group C (P less than .004). The group B (WBC 50,000 to 100,000/microL) death rate was intermediate. These findings are consistent with other reports of complications of leukostasis. Rapid intervention with antileukemic therapy and cranial irradiation may have decreased the risk of CNS hemorrhage in group A. If early deaths are removed from analysis, the complete remission rate among patient groups is not significantly different (group A, 59%; group B, 68%; group C, 65%). However, further analyses of patients achieving remission demonstrate significant differences among patient groups based on presenting WBC count. The median complete remission duration of patients in group A (4.2 months) is shorter than that of patients in group B (8.0 months) or C (8.0 months), P = .07. In addition, remission duration has improved with modern aggressive antileukemic therapy in groups B (median before 1977, 7.0 months; after 1977, 22.0 + months) and C (before 1977, 6.0 months; after 1977, 16.0 + months). No such improvement has occurred in group A, in which the median duration of remission was 4.2 months before and after 1977. The same findings are demonstrated in an analysis of survival, with improvement occurring only in groups B (median before 1977, 16.5 months; after 1977, 26.0 + months) and C (before 1977, 13.5 months; after 1977, 24.0 + months). Long-term follow-up (minimum of 4 years) of these patients has allowed an analysis of the effect of presenting WBC count on the overall outcome of adult patients with ANLL. PMID- 3625256 TI - The importance of histologic grade in long-term prognosis of breast cancer: a study of 1,010 patients, uniformly treated at the Institut Gustave-Roussy. AB - In a study of 1,010 patients with solitary, unilateral, nonmetastatic breast cancer, the histologic grade, assessed by a multifactorial analysis (Cox model) to study its significance with other prognostic factors, was found to be an important, independent factor. For 612 operable patients, two laboratory characteristics, the number of histologically positive nodes and the histologic grade, were the most valuable predictors. These two factors alone form a predictive index that may be an excellent and simple guide for the clinical decision of subsequent therapy. For 398 patients with inoperable breast cancer (ie, tumor greater than or equal to 7 cm, N2-3, inflammatory, skin fixation, and clinically rapidly growing forms), the histologic grade (performed on drill or cutting needle biopsy) was again a most important (and with inflammatory forms the most important) predictor of prognosis in these patients. Our data support that performing our modified histoprognostic grading of Scarff and Bloom is simple, reproducible, incurs no additional cost, may be carried out in the simplest histology laboratory, and finally, defines an important risk factor in all patients. It should be routine for all breast cancer specimens. Furthermore, studies of adjuvant therapy should stratify patients for this variable. PMID- 3625255 TI - Are the current criteria for response useful in the management of multiple myeloma? AB - One hundred seventy-three patients with multiple myeloma were treated from the time of diagnosis with standard oral melphalan and prednisone at 28-day intervals until they became refractory to treatment. Response to treatment was determined according to the Chronic Leukemia-Myeloma Task Force (TF) criteria, and independently according to the Southwest Oncology Group (SWOG) criteria. Survival by disease stage and response according to the two sets of criteria were analyzed for patients living longer than 3 months. The median survival of responding and nonresponding (TF criteria) stage II patients was 43.8 and 40.3 months, respectively (P = .29). By SWOG criteria, median survival for responding and nonresponding stage II patients was 48.3 and 39.0 months, respectively (P = .12). In stage III patients, median survival for responders and nonresponders (TF criteria) was 34.0 and 21.7 months, respectively (P = .01), compared with 35.5 and 24.4 months (P = .04) by SWOG criteria. These data would suggest that the TF criteria predicts a survival disadvantage only in very advanced myeloma and that applying the stricter limits for the definition of response of the SWOG does not further aid in selecting a subgroup of myeloma patients with poorer survival. PMID- 3625257 TI - Serum concentration of laminin, and course of the disease in patients with various malignancies. AB - Serum concentration of laminin was measured radioimmunologically in 96 patients suffering from various malignancies. Laminin levels were significantly elevated in patients with carcinomas and leukemias, but not in patients with sarcomas or lymphomas when compared with healthy controls. A good correlation could be found between serum laminin concentration and response to therapy in patients with carcinoma and leukemia. Elevated laminin levels were associated with a progressive course of the tumor condition. Furthermore, a close correlation has been detected between serum concentrations of laminin and carcinoembryonic antigen (CEA) in patients with carcinoma of the colon. The serum laminin level seems to be a valuable parameter for observation of the course of certain malignancies. PMID- 3625259 TI - N-myc amplification in an infant with stage IVS neuroblastoma. AB - N-myc amplification is most frequently found in neuroblastoma from patients with stage III and IV disease. Recently a significant association between genomic amplification and poor prognosis has been demonstrated. The primary tumors studied from patients with stage IVS disease have reportedly had a single copy of N-myc, and these patients are alive without progressive disease. We report a patient with stage IVS neuroblastoma with N-myc amplification who developed widespread metastasis within 6 months of diagnosis. The same correlation between oncogene copy number and progressive disease that has been seen in those patients with stage II, III, and IV disease was seen in this patient with stage IVS neuroblastoma. PMID- 3625258 TI - Ganglioside GD2 specific monoclonal antibody 3F8: a phase I study in patients with neuroblastoma and malignant melanoma. AB - The murine IgG3 monoclonal antibody (MoAb) 3F8, specific for the ganglioside GD2, activates human complement, is active in antibody-dependent cell-mediated cytotoxicity (ADCC), and can target specifically to human neuroblastoma in patients with metastatic disease. In a phase I study, 3F8 was administered intravenously (IV) to 17 patients with metastatic GD2 positive neuroblastoma or malignant melanoma at doses of 5, 20, 50, and 100 mg/m2. Serum 3F8 levels achieved were proportional to the dose of 3F8 infused. However, serum antimouse antibody levels did not increase with the amount of 3F8 administered. Toxicities included pain, hypertension, urticaria, and complement depletion. All acute side effects were controllable with symptomatic therapy. No long-term side effects were detected in patients observed for more than 14 months. None of the 17 patients received any antitumor therapy postantibody treatment. Antitumor responses occurred in seven of 17 patients. These ranged from complete clinical remissions to mixed responses. The murine monoclonal antibody (MoAb) 3F8 has clinical utility for the diagnosis and therapy of neuroblastoma and melanoma. PMID- 3625260 TI - Microbiology of acute periodontal infection in myelosuppressed cancer patients. AB - This study characterized the subgingival microbial flora associated with 27 acute exacerbations of preexistent periodontal disease in 24 patients with chemotherapy induced myelosuppression. All but two acute periodontal infections developed at low granulocyte levels (less than 1,000/microL). Suspected pathogens were detected in high concentrations in subgingival plaque specimens in 17 episodes of acute periodontal infection; a single pathogen was recovered in ten acute infections, and more than one pathogen was recovered in seven acute infections. Staphylococcus epidermidis, Candida albicans, S aureus, and Pseudomonas aeruginosa predominated, with combinations of these detected in some patients. Concomitant bacteremias developed in two of these patients. The subgingival microflora associated with ten acute periodontal infections was characterized by predominantly indigenous microorganisms, which in nine episodes were in abnormal proportions compared with microbial profiles in noncancer patients with similar degrees of periodontal disease. These data demonstrate that pathogens normally associated with infections in myelosuppressed cancer patients, as well as indigenous oral flora, are associated with acute periodontal infections during granulocytopenia. This finding is important, since this body site has not commonly been recognized as a source for acute infection in these patients. PMID- 3625262 TI - Policies for study monitoring and interim reporting of results. AB - Interim analyses of comparative trials are necessary in order to monitor for extreme therapeutic results. However, closing studies and reporting results whenever "trends" appear increases the probability of a false conclusion to well over the desired .05 level. Guidelines for early stopping of comparative trials must be carefully defined to avoid this problem. In addition, to avoid inappropriate early closure of studies due to declining accrual (as investigators draw their own conclusions from early unreliable data), it is recommended that access to interim data be limited to a multidisciplinary monitoring committee responsible for (1) performing and reviewing interim analyses, and (2) deciding when early termination should be considered. Accrual and reporting of studies from two clinical trials groups, one with a policy of limited access to interim data and one without, are compared. The group without monitoring committees had a higher incidence of accrual and reporting problems than the group with monitoring committees. PMID- 3625261 TI - Compliance with oral drug therapy in patients with hematologic malignancy. AB - Compliance with oral self-administered allopurinol (daily medication) and prednisone (intermittent medication) as well as compliance with monthly scheduled clinic appointments, were examined in 108 patients with newly diagnosed hematologic malignancy. Baseline levels of compliance (control group) were compared to results obtained after implementation of three intervention packages, whose aim was to increase compliance. The packages included combinations of education, home psychologic support and restructuring, and training in pill taking. A 24-hour profile of the two drugs and their metabolites was first determined. Serum samples were then obtained monthly over 6 months and analyzed for presence of the drugs. Control patients were fully compliant with allopurinol only 16.8% of the time. This rate increased significantly (44% to 48% of the time) for those who received any one of the intervention programs. With respect to prednisone, control patients were compliant 26.8% of the time, with no real improvement after interventions. Finally, self reports overestimated compliance by a factor of two when compared to drug analysis. The results indicated that full compliance with oral medications was remarkably low among our patients who have treatable and in some cases curable hematologic malignancy. However, compliance can be significantly improved by the use of various intervention packages. PMID- 3625263 TI - Planned interim analysis and its role in cancer clinical trials. AB - Although interim analyses in cancer clinical trials are commonplace, clinical trials are usually designed with the implicit assumption that data analysis will occur only after the trial is completed. The design of randomized trials with planned interim analyses, "group sequential trials," is described and examples are given. A method to redesign trials in which unplanned interim analyses have been undertaken is described. Planned interim analysis should be considered whenever a cancer clinical trial is designed. PMID- 3625264 TI - Hypersensitivity reactions to teniposide in children. PMID- 3625265 TI - On the role of cortical area V4 in the discrimination of hue and pattern in macaque monkeys. AB - Cortical visual area V4 in macaque monkeys has a large proportion of neurons that are sensitive to the wavelength or to the color of light. We tested its role in hue discrimination by removing it in macaque monkeys trained to discriminate small differences in hue. Hue discrimination thresholds were permanently elevated in 4 macaque monkeys in which V4 was removed bilaterally. In contrast, there was no impairment in achromatic intensity thresholds tested in an identical manner. However, the discrimination of pattern and orientation was also conspicuously impaired, indicating that area V4 is not concerned solely with processing information about wavelength. The multiple defect is consistent with evidence that V4 provides the major cortical visual input to the temporal lobe, where a large range of visual properties is registered. The performance of monkeys with V4 ablation was compared with that of unoperated control monkeys and monkeys with removal of cortex in the banks and floor of the rostral superior temporal sulcus (STS). Removal of STS had only slight effects on pattern discrimination and none of hue discrimination. To control for the possible effects of inadvertent damage to the visual radiations when removing V4, the lateral striate cortex was partially ablated bilaterally in a control monkey. This had no effect on any discrimination, despite producing more retrograde damage to the lateral geniculate nuclei than in any monkey with V4 ablation. The visual disorder following removal of visual area V4 strikingly resembles the clinical disorder of mild cerebral achromatopsia with associated apperceptive agnosia for objects and patterns. PMID- 3625266 TI - Morphological changes in leech Retzius neurons after target contact during embryogenesis. AB - Segmental variation in identified neurons may provide an opportunity to examine extrinsic influences on neuronal phenotype, since segmentally homologous neurons must contain much the same intrinsic information, having arisen from very similar or identical precursors. Two large serotonergic Retzius (Rz) cells are found in each segmental ganglion of the leech Hirudo medicinalis. While most Rz cells innervate the body wall in their own segment and, by way of axons in the interganglionic connectives, the body wall of adjacent segments, the Rz cells in ganglia 5 and 6 [Rz(5,6)] lack interganglionic axons and innervate only the reproductive tissue (Glover and Mason, 1986). Here we describe and quantify the development of differences between Rz(5,6) and other Rz cells in peripheral innervation, neuropilar arborization, and soma size. We filled individual Rz cells with Lucifer yellow or HRP in adults and in staged embryos. During the first 72 hr of outgrowth of Rz cell processes, the morphology of Rz(5,6) was indistinguishable from that of other Rz cells. Only after the processes of Rz(5,6) reached the reproductive tissue did they begin to differ from their segmental homologs. This temporal correlation suggests that these morphological differences arise because of some interaction between Rz(5,6) and their target tissue. PMID- 3625267 TI - Segment-specific morphogenesis of leech Retzius neurons requires particular peripheral targets. AB - In most segments of the leech, a pair of Retzius (Rz) cells innervate the body wall musculature and skin; however, in the segments specialized for reproduction (midbody segments 5 and 6), these neurons innervate the reproductive tissue instead. Whereas all Rz cells have the same morphology early in embryogenesis, those in the reproductive segments [Rz(5,6)] become considerably different from their segmental homologs. Unlike standard Rz cells, Rz(5,6) do not have axons in the interganglionic connectives or in the body wall (Glover and Mason, 1986). Rz(5,6) also have significantly smaller somata and fewer branches in the ganglionic neuropil than do standard Rz cells (Jellies et al., 1987). Since these differences between Rz cells do not become apparent until after Rz(5,6) processes appear to contact the reproductive tissue primordia, interactions between Rz(5,6) processes and the reproductive tissue may determine the segmental specializations of these neurons. We have tested this possibility by ablating the reproductive tissue primordia early in embryogenesis and subsequently examining Rz(5,6) morphology. In the absence of reproductive tissue, Rz(5,6) became more like standard Rz cells: they retained axons in the interganglionic connectives, they projected into the body wall, and the density of their arborization within the neuropil increased. These results indicate that the development of some segmental specializations of Rz(5,6) involves an interaction with their unique target tissue. PMID- 3625268 TI - Characterization of an inhibitor of neuronal plasminogen activator released by heart cells. AB - A basic understanding of growth cone dynamics and developmental events involving growth cones requires an understanding of the function and regulation of molecules associated with and released by growth cones. Rat sympathetic neurons in culture release a urokinase-like plasminogen activator from their distal processes and/or growth cones (Pittman, 1985a). When sympathetic neurons are grown in cocultures with heart cells, however, plasminogen activator activity is not detected. The absence of plasminogen activator activity in cocultures of sympathetic neurons and heart cells appears to be due to the release of an inhibitor of plasminogen activator by heart cells. This inhibitor has a molecular weight of approximately 50 kDa in the presence of SDS and apparent molecular weights of approximately 50 and greater than 2000 kDa under native conditions. A significant fraction of the large-molecular-weight form of the inhibitor is converted to the smaller form following treatment with heparinase. Extremely stable complexes of 68 and 80 kDa are formed between the heart inhibitor and the plasminogen activator, urokinase, such that the complexes withstand boiling in SDS/mercaptoethanol. The data are consistent with the formation of an 80 kDa urokinase-inhibitor complex in the presence of heparan sulfate proteoglycan and a 68 kDa complex in the absence of heparan sulfate proteoglycan. A highly purified preparation of the heart inhibitor produces a 2- to 3-fold increase in neurite outgrowth from sympathetic neurons. These data indicate that the activity of the plasminogen activator released by sympathetic neurons can be regulated by a normal target tissue and that this regulation may result in increased neurite outgrowth from the neurons. PMID- 3625270 TI - Medial preoptic sexual dimorphisms in the guinea pig. II. An investigation of medial preoptic neurogenesis. AB - Neurogenesis was studied in the medial preoptic area of the guinea pig by the method of tritiated thymidine autoradiography. Eight cytoarchitectonic divisions were examined, 4 of which display sexual dimorphism and 4 that do not. Neurogenesis in the nonsexually dimorphic divisions was found to end at embryonic day (E) 27, while in each of the sexually dimorphic divisions neurogenesis continued after this and persisted until at least E31 in the central compact and principal portions of the medial preoptic nucleus. Since the testes become active at E25 in the guinea pig (Resko, 1970), it is possible that gonadal secretions influence the proliferation and subsequent developmental processes of neurons destined for the sexually dimorphic nuclei. PMID- 3625269 TI - Medial preoptic sexual dimorphisms in the guinea pig. I. An investigation of their hormonal dependence. AB - The guinea pig exhibits sexually dimorphic patterns of cell density and distribution throughout the medial preoptic area, a region that has been shown to be involved in the regulation of sexually differentiated behavioral and endocrinological reproductive functions (Bleier et al., 1982). The most prominent sex differences involve 2 components of the medial preoptic nucleus (MPN), an anteriorly placed compact subnucleus (MPNa) that is twice as large in females as in males, and a centrally placed compact subnucleus that occupies an approximately 10-fold greater volume in males than in females and corresponds to the sexually dimorphic nucleus described in the rat by Gorski et al. (1978). In the present study the sex differences in both of these cell groups were shown to be unaffected by neonatal gonadectomy and postnatal hormonal manipulations. In contrast, MPNa volume was significantly decreased and MPNc volume significantly increased in genotypic females exposed to testosterone propionate (TP) on gestational days 28-37 or 28-65 but not 38-65. All 3 prenatal TP treatments administered to females significantly increased mounting frequencies and suppressed lordosis, ovulation, and the positive-feedback effects of estrogen and progesterone on luteinizing hormone release. Thus, the volumetric sex differences in MPNa and MPNc alone do not seem to be sufficient to account for the sex differences in the functions of the medial preoptic region. It is, therefore, suggested that androgens continue to exert organizational influences upon the developing brain after cytoarchitectonic patterns have been determined. PMID- 3625271 TI - Modulation of activity of the striatal dopaminergic system during the hibernation cycle. AB - To evaluate how the activity of a well-established neurotransmitter pathway is modulated by a behavioral state, 3H-spiperone binding sites and dopamine (DA) and DA metabolite concentrations were measured in the striata of ground squirrels in 5 phases of the hibernation cycle. Whereas levels of striatal DA and its deaminated metabolite DOPAC did not change significantly, the concentrations of the O-methylated-deaminated metabolite, homovanillic acid (HVA), decreased in all phases of hibernation relative to euthermia. Striatal 3H-spiperone binding sites declined across the hibernation cycle in parallel with the reduction of HVA concentration; receptor binding affinity was unchanged by arousal state. In conjunction with previously reported findings, these results are consistent with the hypothesis that hibernation is associated with a down-regulation of the postsynaptic D2 receptors secondary to increased extracellular DA concentration and reduced DA degradation. PMID- 3625272 TI - Release of cortical catecholamines by visual stimulation requires activity in thalamocortical afferents of monkey and cat. AB - Catecholamine (CA) release was measured in vivo in the monkey and cat visual cortices electrochemically. Stereate-modified, graphite-paste electrodes were used to monitor changes in norepinephrine and dopamine release. Micromolar changes in CA concentration were obtained by stimulation of the eye with nonspecific (strobe) or specific (oriented bars, radial gratings) stimuli. CA release depended on which eye was illuminated. Electrodes passed tangentially through the striate area recorded release following visual stimulation of one eye or the other in succession, and the shift in eye dominance occurred at about 500 microns intervals. The magnitude of CA release was highly correlated with the ocular dominance of neuronal activity measured with tungsten microelectrodes. Light-stimulated release was not recorded in monkey area V2, V4, or somatosensory area 1, but was recorded in cat V2, suggesting that the presence of LGN afferents is associated with CA release. Results are discussed in terms of the role of geniculate activity and the specific role of CAs in cortical information processing. PMID- 3625273 TI - Identification and purification of two precursors of the insect neuropeptide adipokinetic hormone. AB - Our objective was to establish a system for the investigation of neuropeptide biosynthesis in an insect. To achieve this we developed an in vitro organ culture system for the corpora cardiaca (CC) of the locust (Schistocerca gregaria). The CC are the neurosecretory structures containing the adipokinetic hormones AKH I and AKH II. Tritiated amino acids were added to the glands, and we studied the development of label in newly made proteins using size-exclusion and reverse phase liquid chromatography. We performed pulse-chase and pulse-translation block experiments using 3H-tryptophan as tracer. We also raised an antiserum to a synthetic AKH analog and used this in combination with liquid chromatography to identify 2 precursor polypeptides, P1 and P2. Size-exclusion chromatography indicated the presence of a major component of the CC of about 8 kDa that incorporates 3H-tryptophan before AKH I and II. Moreover, in both pulse-chase and pulse-translation block experiments we showed that label is transferred from this 8 kDa component into AKH I. We call this component proAKH; it is recognized by anti-AKH serum in a radioimmunoassay (RIA). Further fractionation of tritium labeled proAKH by reverse-phase chromatography yielded 2 polypeptides, P1 and P2. Both are AKH-immunoreactive and contain 3H-tryptophan after in vitro pulse labeling, and both are proposed precursors of AKH I. The in vitro system we have developed may be a model system for the study of the processes of neuropeptide biosynthesis and its regulation in an intact neurosecretory tissue of an insect. PMID- 3625274 TI - Electrophysiologically identified nigral dopaminergic neurons intracellularly labeled with HRP: light-microscopic analysis. AB - Intracellular recordings were obtained in vivo from neurons of the rat substantia nigra, pars compacta. Neurons that were identified as dopaminergic by a variety of electrophysiological criteria, including antidromic activation from ipsilateral neostriatum or globus pallidus, were microiontophoretically injected with horseradish peroxidase and examined at the level of the light microscope. Dopaminergic neurons were of medium size and had ovoid, polygonal, or fusiform cell bodies that emitted from 3-6 primary dendrites. Much of the sparse and relatively unbranched dendritic arborization of these neurons remained within pars compacta, except for 1 or 2 large dendrites that were directed ventrally or ventrolaterally into pars reticulata, roughly perpendicular to the plane of the pars compacta. In coronal sections, the dendrites of ovoid- or polygonal-shaped pars compacta neurons were oriented mainly along the dorsoventral axis, whereas fusiform-shaped neurons had dendrites that were oriented primarily mediolaterally. Although some of the dendrites of dopaminergic neurons exhibited variations in diameter, most were not markedly varicose. Dendrites were sometimes sparsely invested with spinelike appendages or other dendritic extrusions, particularly along their distal portions. The axons of dopaminergic pars compacta neurons were emitted from primary or proximal secondary dendrites, and were extremely fine processes, 0.5 micron or less in diameter. No local axon collaterals were observed. PMID- 3625275 TI - Single-unit response of noradrenergic neurons in the locus coeruleus of freely moving cats. I. Acutely presented stressful and nonstressful stimuli. AB - The present experiment was designed to explore the stress-relatedness of activity in noradrenergic neurons of the locus coeruleus (LC) of behaving cats. A stressor was defined as a stimulus that elicited a significant sympathoadrenal activation as measured by plasma norepinephrine level and heart rate. According to this definition, exposure to 15 min of 100 dB white noise or 15 min of restraint was stressful in cats. In contrast, exposure to inaccessible rats for 15 min was behaviorally activating but nonstressful. The single-unit activity of noradrenergic neurons in the LC of behaving cats was examined under these conditions. The stressful stimuli elicited a significant increase in LC neuronal activity for the entire 15 min stressor duration, whereas the behaviorally activating but nonstressful stimulus elicited no significant change in the activity of these neurons. These results provide evidence that behavioral activation per se is not sufficient to evoke a tonic activation of these neurons. Rather, these data support the hypothesis that the LC is involved in the CNS response to stress and provide additional evidence that the activity of LC noradrenergic neurons increases in association with sympathoadrenal activation. PMID- 3625276 TI - Single-unit response of noradrenergic neurons in the locus coeruleus of freely moving cats. II. Adaptation to chronically presented stressful stimuli. AB - The preceding paper described a stress-related tonic activation of noradrenergic neurons of the locus coeruleus (LC) of behaving cats. The present study examined the degree to which adaptation to stress was reflected in LC unit activity. Adaptation was defined as a reduction in the magnitude of the physiological stress response of the animal, as reflected in plasma norepinephrine level and heart rate. Adaptation of the physiological stress response occurred after 5 repeated hourly presentations of 100 dB white noise and after 2 hr of restraint. When these stimuli ceased to elicit significant sympathoadrenal activation, they likewise ceased to elicit activation of LC single-unit activity. These results provide further support for the hypothesis that tonic elevations in LC neuronal activity are stress related and that the LC is involved in the CNS response to challenges to the organism. PMID- 3625277 TI - Suppression of oscillatory activity in crustacean pyloric neurons: implication of GABAergic inputs. AB - Generation of rhythmic pyloric motor output in the crustacean stomatogastric ganglion results from synaptic connections and cellular properties of a 14-cell network of pyloric neurons. These cellular properties are under the influences of modulatory inputs, which act, for the most part, in an activating mode, i.e., they enhance the bursting properties of the pyloric neurons and/or their ability to express their regenerative properties. Here we attempt to demonstrate that the pyloric motor output is also under the control of suppressive afferent inputs that are able to stop the pyloric rhythm in a long-lasting manner. Immunohistochemistry, using GABA antibodies, indicates that GABAergic-like fibers are present in both the stomatogastric ganglion and its afferent nerve. Bath applied GABA suppresses spontaneous pyloric rhythmic activity. This is due to an inability of the pyloric pacemakers to express their bursting properties. The suppressive effect of GABA is blocked by picrotoxin and mimicked by muscimol. Isolating the pyloric neurons from all descending spiking influences with tetrodotoxin demonstrates that exogenously applied GABA acts directly on the pyloric neurons. To confirm the existence of a physiological suppressive system for the pyloric motor pattern, we show that the stimulation of an afferent nerve, known to contain GABA-like fibers, also causes the cessation of rhythmic activity and the inability of the pyloric neurons to express their bursting properties. PMID- 3625278 TI - Axonal regeneration and synapse formation in the superior colliculus by retinal ganglion cells in the adult rat. AB - In adult rats, one optic nerve was transected and replaced by a 4 cm segment of autologous peripheral nerve (PN) that linked one eye and the superior colliculus (SC) along a predominantly extracranial course. Retrograde and orthograde studies with the tracers HRP or rhodamine-B-isothiocyanate (RITC), as well as immunocytochemical neuronal labels, indicated the following: (1) Regenerating axons from the axotomized retinal ganglion cells extended along the entire PN grafts, covering a distance nearly twice that of the normal retinotectal projection of intact rats. (2) Some of these axons penetrated the SC and formed terminal arborizations up to 500 microns from the end of the graft. (3) By electron microscopy, the arborizations of these regenerated axons in the SC were seen as small HRP-labeled axonal profiles that contacted neuronal processes in the SC; some of these contacts showed pre- and postsynaptic membrane specializations. These findings indicate that injured retinal ganglion cells in the adult rat are not only able to regrow lengthy axons, but may also form synapses in the SC. PMID- 3625279 TI - Inhibition of in vitro peripheral myelin formation by monoclonal anti galactocerebroside. AB - This work investigates the role of galactocerebroside (GalC) in peripheral myelin formation. A monoclonal antibody against GalC was introduced into a myelinating culture system consisting of rat sensory neurons and Schwann cells, without other cell types. At levels that saturated Schwann cell surface GalC, anti-GalC IgG prevented by more than 99% the appearance of myelin sheaths. Ensheathment and basal lamina deposition were unaffected and many Schwann cells were in the 1:1 relationship that typically develops between Schwann cells and axons prior to myelination. Thus, the anti-GalC antibody did not interfere with the formation of the mesaxon but prevented its elongation. When experimentally restrained from myelination, Schwann cells did not accumulate the myelin proteins PO and basic protein; only low levels were expressed. The proposed mechanism of inhibition is the removal of GalC from Schwann cell surfaces by internalization of the GalC anti-GalC antigen-antibody complex. This apparently prevented the interaction of adjacent cell surfaces during the elongation of Schwann cell membranes that constitute the myelin lamellae. PMID- 3625280 TI - Coordinated release of ATP and ACh from cholinergic synaptosomes and its inhibition by calmodulin antagonists. AB - Isolated cholinergic synaptosomes from elasmobranch electric organ release both ACh and ATP when depolarized in the presence of calcium. The conditions that trigger ATP release are the same as those known to stimulate neurosecretion. The ratio of ACh to ATP released is the same as that found in purified elasmobranch synaptic vesicles. Both ACh and ATP release are inhibited either by the removal of extracellular calcium or the addition of the "calmodulin antagonist" trifluoperazine (TFP). Taken together, these data suggest that both ACh and ATP are released by exocytosis from synaptic vesicles within nerve terminals. A number of drugs, collectively known as calmodulin antagonists, were examined for their effect on neurosecretion. TFP completely inhibited secretion in a rapid and reversible manner. Other related drugs had similar effects, though with relative efficacies different from those reported for inhibiting calmodulin. It therefore seems likely that a calmodulin-like component of the nerve terminal, distinct from calmodulin itself, is essential for the process of neurosecretion. PMID- 3625281 TI - Autoradiographic localization and biochemical characterization of peripheral type CCK receptors in rat CNS using highly selective nonpeptide CCK antagonists. AB - Two potent and highly selective nonpeptide antagonists, L-365,031 [1-methyl-3-(4 bromobenzoyl)amino-5-phenyl-3H-1,4 benzodiazepin-2-one] and 3H-L-364,718 [1 methyl-3-(2-indoloyl)amino-5-phenyl-3H-1,4 benzodiazepin-2-one] were used to localize "peripheral" CCK receptors in rat brain. In autoradiographic experiments, L-365,031 displaced 125I-Bolton Hunter CCK-8 binding from the interpeduncular nucleus (IPN) (IC50 = 7 X 10(-8) M), the area postrema (AP), and the nucleus tractus solitarius (NTS) without influencing specific binding to other areas, such as the cerebral cortex or the spinal tract of the trigeminal nerve. Desulfated CCK preferentially inhibited 125I-CCK binding to cerebral cortex (IC50 = 7 X 10(-8) M) rather than IPN (IC50 greater than 1 X 10(-6) M) or AP-NTS. In the medulla the localization of 3H-L-364,718 binding was similar to L 365,031-sensitive 125I-CCK-8 binding and was found in the AP and medial, but not lateral, aspects of the NTS. In membranes prepared from IPN, NTS, and AP, 3H 364,718 binding was of high affinity (Kd = 0.14 nM), saturable (Bmax = 20 fmol/mg protein), and inhibited by compounds previously shown to act at pancreatic CCK receptors. The receptors labeled by 3H-364,718 were modulated by guanyl nucleotide, which reduced agonist affinity 10-fold without affecting antagonist binding. The localization and high density of CCK receptors in AP and NTS suggest that these receptors may play an important role in processing sensory afferent information. PMID- 3625282 TI - The role of spiking local interneurons in shaping the receptive fields of intersegmental interneurons in the locust. AB - Intracellular recordings were made simultaneously from pairs of spiking local and intersegmental interneurons in the mesothoracic ganglion of the locust Schistocerca gregaria (Forskal). The spiking local interneurons belong to a midline group, and the intersegmental interneurons to a lateral-posterior population that projects ipsilaterally to the metathoracic ganglion. Both respond to mechanosensory inputs from one middle leg. The receptive fields of both types of interneurons were plotted and the contribution of the local interneurons to the shaping of the receptive fields of the intersegmental interneurons was studied. The spiking local interneurons are excited by specific arrays of exteroreceptors and proprioceptors of one leg. They make inhibitory connections with specific intersegmental interneurons which thus have corresponding inhibitory regions to their receptive fields. For example, inhibition from local interneurons with inputs from hairs or campaniform sensilla on the tarsus could sharpen the boundaries of the excitatory receptive field of an intersegmental interneuron by lateral inhibition. Inhibition from local interneurons with inputs from joint proprioceptors suppresses the excitation of an intersegmental interneuron during the antipreferred direction of movement. Rapid alternate movements about one joint can in this way be signaled by an intersegmental interneuron in a phase-locked manner. Certain intersegmental interneurons are excited by exteroreceptive inputs and inhibited by proprioceptive signals, or vice versa. The inhibition could become significant during walking, where the excitatory and inhibitory inputs to an interneuron are likely to be evoked during the different phases of a step cycle. The inhibitory regions of the receptive field of an intersegmental interneuron have never been found to be smaller than the excitatory regions of the receptive field of a presynaptic local interneuron and can result from converging inhibitory inputs from several spiking local interneurons. The inhibitory connections are highly specific: Several local interneurons may be excited by a particular stimulus that also inhibits an intersegmental interneuron, but only a small proportion of the former are the cause of the inhibition in the intersegmental interneuron. PMID- 3625283 TI - The pronator teres syndrome. Clinical and electrophysiological features in six surgically verified cases. AB - Six surgically verified cases of pronator teres syndrome are reported. The anatomy of the median nerve at the upper third of the forearm, the relationships between the nerve and the pronator teres muscle and the serial innervation of the muscles of the forearm supplied by the n. medians are described. Clinical and electrophysiological features are reported in detail and their contribution in diagnosing the lesion is discussed. PMID- 3625284 TI - Intracranial fibromuscular dysplasia. Report of two cases and review of literature. AB - Intracranial fibromuscular dysplasia (IFMD) is a rare angiopathy of unknown origin primarily affecting children and young women. We report here on two cases of IFMD; the patients, two females, aging 29 and 25 years, suffered from acute, complete stroke. In one of them emergency extra-intracranial by-pass was attempted without evidence of positive influence on the patient's outcome. In both patients angiography showed the pathognomonic sign of "string of bead" at the level of intracerebral arteries. Cases of IFMD previously reported in the literature are then reviewed and etiology, clinical presentation, pathology, diagnosis and possible treatment of this rare disease are discussed. PMID- 3625285 TI - Penetrating craniocerebral injuries. Report of two unusual cases. AB - Two unusual cases of craniocerebral injury caused by a fishing harpoon trident are reported. Both patients, in spite of the apparent seriousness of the lesions, recovered satisfactorily. PMID- 3625286 TI - Metastatic spread of benign intracranial meningioma. AB - A case of benign meningioma of the superior sagittal sinus is reported, which recurred three times during a period of six years. At the time of the first recurrence the overlying bone was eroded and the tumor grew subcutaneously; the second recurrence was associated with a pulmonary metastatic deposit of extraordinary size. The literature dealing with remote extracranial spread of meningiomas is briefly reviewed. PMID- 3625287 TI - Brain metastasis from colon cancer. Case report showing a clinical and CT unusual appearance. AB - The authors report the case of a patient harbouring a parietal convexity tumor whose clinical and CT features were suggestive of a meningioma. Unexpectedly the tumor was a well differentiated adenocarcinoma from a colon cancer with a markedly PAS positive intragland content represented by wide areas of mucoid degeneration. Brain metastases from colon cancer are usually late occurrences and it is extremely rare that the brain lesion be discovered while the primary tumor is still unknown. The authors discuss about the pathogenesis of the CT appearance of adenocarcinoma which is, usually, slightly hyperdense. On the basis of the reported findings it is suggested that mucoid degeneration may induce the development of a well defined CT pattern represented by a very high density appearance with no contrast enhancement. PMID- 3625288 TI - Spontaneous obliteration of a carotid-cavernous fistula associated with fibromuscular dysplasia of the internal carotid artery. AB - The authors present a case of spontaneous recovery of a carotid-cavernous fistula associated with fibromuscular dysplasia of the aortocranial vessels in a 31-year old woman. The pathogenesis of the carotid-cavernous fistula and the possible mechanism responsible for its spontaneous obliteration are both discussed. PMID- 3625289 TI - An useful accessory device for nasal speculum utilized in the trans-sphenoidal approach to the sella turcica. Technical note. AB - We present an accessory device for nasal speculum utilized in the transphenoidal approach to the sella turcica. It, stopping the bulging of the superior lip and the soft tissues viciniori between the two opening valves, permits perfect visibility of the operating field and a greater space for surgical manoeuvres. PMID- 3625290 TI - Late neurological dysfunction in adult lumbosacral lipoma. AB - The case of a 53-year-old woman with adult-onset neurological dysfunction secondary to spinal dysraphia and lumbosacral lipoma is presented. This condition not only affects children, but may produce neurological troubles also in adult age. This observation confirms that lumbosacral lipomas do not represent a static condition but carry the potential for late neurological dysfunction and therefore they should be treated in early life to prevent late complications. Besides the adult-onset urinary dysfunction and lumbosacral and sciatic pain should suggest the possibility of spinal dysraphia and lumbosacral lipoma. PMID- 3625291 TI - Physics experiment may cloud future of Los Alamos nuclear medicine program. PMID- 3625292 TI - Functional and scintigraphic evaluation of the silent adrenal mass. AB - Seven patients with unilateral and one patient with bilateral and asymmetric (R greater than L) incidentally discovered adrenal mass abnormalities depicted by computed tomography (CT) were studied by 131I-6 beta-iodomethyl-19-norcholesterol (NP-59) scintigraphy. There was marked lateralization of NP-59 uptake to the side of the mass lesion in the seven patients with unilateral masses and prominent asymmetric, (R greater than L) bilateral uptake in the patient with bilateral masses despite the fact that there were no obvious abnormalities of adrenocortical or adrenomedullary function as determined from peripheral blood and 24-hr urinary hormone measurements. Simultaneous bilateral adrenal vein catheterization (AVC) was employed to measure the levels of hormone effluent from the adrenal cortex and medulla and in all instances the cortisol concentrations were greatest from the side of the mass lesion in those patients with unilateral masses and from the larger of the two adrenals in the patient with bilateral adrenal masses. Thus, there was congruence between the anatomic (CT) and functional (NP-59 scintigraphy and AVC) investigations that depicted asymmetry of the adrenal glands which were not associated with abnormalities of overall adrenal function or hypothalamic-pituitary-adrenal axis integrity. PMID- 3625293 TI - Hepatic visualization on iodine-131 whole-body thyroid cancer scans. AB - This study examines the frequency and significance of diffuse liver uptake on 131I whole-body thyroid cancer scans. Sixty whole-body scans on 27 patients with differentiated thyroid cancer were reviewed. Liver uptake was quantitated on another 21 studies (16 patients). Diffuse hepatic uptake was seen in 44% of patients and 35% of all the studies. It correlated best with the 131I dose administered (r = 0.733) and the product of the 131I percent radioactive iodine uptake (RAIU) and administered dose (r = 0.656), less well with the serum 131I protein bound iodine (r = 0.494) and the RAIU. This study demonstrates that liver visualization is more common than generally appreciated and is related to the 131I dose and indices of thyroid function although other factors may also play a role in liver visualization. PMID- 3625294 TI - Technetium-99m-labeled red blood cells in the evaluation of hemangiomas of the liver in infants and children. AB - The vascular origin lesions of the liver (capillary hemangioma/infantile hemangioendothelioma) that present in infancy or early childhood often have a typical clinical picture of hepatomegaly and congestive heart failure. These lesions rarely present as asymptomatic hepatomegaly, simulating a primary hepatic malignancy. These lesions may also simulate a primary or secondary hepatic malignancy on cross-sectional imaging or angiography. Scintigraphic evaluations with technetium-99m-labeled red blood cells offers an accurate method of identification of these lesions, and allows differentiation from other common primary or secondary hepatic masses in infancy or childhood. This scintigraphic method may also be used to follow these patients after medical, radiation, or embolization therapy. Experience with seven patients with these tumors is reported and compared with eight children with other primary or secondary liver tumors also evaluated by this method. PMID- 3625295 TI - The "critical colloid dose" in studies of reticuloendothelial function. AB - The [99mTc]sulfur colloid distribution in rat organs was investigated after the administration of different amounts of colloid particles. Saturation of the liver and spleen was not observed. Blood clearance was significantly reduced 15 min after injection above approximately 3 X 10(9) particles per kg body weight. With an increasing number of injected particles, lung uptake increased and bone marrow uptake decreased. Microfiltration studies showed that the colloid is unaffected by dilution with saline but may be affected after incubation in normal rat plasma. We conclude that the distribution of [99Tc]sulfur colloid in organs varies with the number of injected particles and therefore, is not dependent upon the blood flow to the reticuloendothelial organs alone. The "critical colloid dose" may differ among the reticuloendothelial organs and cannot, therefore, be evaluated by blood clearance measurements alone. The considerable influence of the number of injected colloid particles on bone marrow uptake should also be recognized when carrying out dosimetric calculations. PMID- 3625296 TI - Radioiodinated biotin derivatives for in vitro radioassays. AB - The synthesis of two radioiodinated biotin derivatives with the biotin-ureido group intact is described. This synthesis was performed by coupling (pH 8.5, 20 22 degrees C, 90 min) N-hydroxysuccinimidobiotin to tyramine, which was radioiodinated prior to this using a modified chloramine-T method. Two derivatives were produced, the N-[beta-(4-OH-3-125I-phenyl)ethyl] and the N-[beta (4-OH-3,5-di 125I-phenyl)ethyl] biotin amides, depending on the amount of tyramine used in the radioiodination reaction. The final products were separated by thin layer chromatography (n-butanol: 2N NH4OH: ethanol, 3:1:1, v/v/v). The radioiodinated derivatives that were synthesized or their resulting mixture were found to complete with biotin for the avidin-binding sites; thus, they were capable of being used as tracers in biotin radioassays. The specific activity of their mixture was high-greater than 350 Ci/mmol-and they were stable for 2 mo at 4 degrees C. PMID- 3625298 TI - Generator-produced yttrium-90 for radioimmunotherapy. AB - Yttrium-90 is often considered to possess many favorable properties for radioimmunotherapy applications. Among these is its availability as a radionuclide generator product by decay of its parent, 90Sr. Nevertheless, most present and planned clinical trials with 90Y-labeled antibodies employ radioactivity obtained not from an in-house generator, but from commercial sources. To prepare for clinical trials at this institution with 90Y labeled to diethylenetriaminepentaacetic acid- (DTPA) coupled antibodies, we have adapted previously published procedures and have developed others to prepare antibodies labeled with generator produced 90Y for human use. Up to 25 mCi of 90Sr have been loaded without evidence of radiolytic degradation to the Dowex 50 cation exchange resin which serves as the solid support for the generator. Using 0.003M ethylenetriaminetetraacetic acid (EDTA) as eluant, elution efficiency averages 98% and 90Sr breakthrough averages 0.002%. The EDTA is destroyed remotely and the activity is dissolved in 0.5M acetate, pH 6. In this form, 90Y may be used to label DTPA-coupled proteins at specific activities of 1-3 mCi/mg (an order of magnitude improvement in specific activity results from the purification of 90Y by cation exchange prior to labeling). When properly labeled, size exclusion HPLC shows 90% or greater radiochemical purity and recovery without postlabeling purification. We conclude that these techniques provide a 90Y-labeled protein preparation which is safe for administration to patients. PMID- 3625297 TI - The effect of hypoxia on thallium kinetics in cultured chick myocardial cells. AB - To assess the effect of hypoxia on cellular thallium-201 (201Tl) uptake and washout independent of coronary flow, we studied thallium kinetics during normoxia and hypoxia in cultured chick ventricular cells. Monolayers of contracting ventricular cells grown on coverslips were placed in a chamber and perfused to asymptote with media containing 201Tl. Perfusates were equilibrated with 5% CO2-95% air or 5% CO2-95% nitrogen for normoxia and hypoxia, respectively. Washout thallium kinetics were then observed during perfusion with unlabeled media. Twenty paired experiments were performed, randomly alternating the sequence of normoxia and hypoxia. Pharmacokinetics for thallium were determined by computer using standard formulae. Thallium uptake and washout were best described by assuming that intracellular thallium was contained within a single compartment. Cellular thallium uptake, as well as transfer rate constants for thallium uptake and for thallium washout during normoxia and hypoxia, were compared using paired t-tests. During normoxia and hypoxia, respectively, thallium uptake was 22 +/- 7% and 19 +/- 7% of asymptote (p less than 0.01); the compartmental rate constant for uptake by the cell was 0.16 +/- 0.07 min-1 and 0.15 +/- 0.06 min-1 (N.S.); and the transfer rate constant for washout from the cell was 0.26 +/- 0.06 min-1 and 0.23 +/- 0.05 min-1 (p less than 0.01). We conclude that there was a small (14%) decrease in thallium uptake during hypoxia. The rate of thallium uptake and washout was slightly less during hypoxia, although only the rate of washout was significantly less. These data show that cellular accumulation of thallium and the rate of washout of thallium were minimally decreased by hypoxia independent of blood flow. PMID- 3625299 TI - Leukocyte labeling with technetium-99m tin colloids. AB - Triple density gradients of metrizamide in plasma (MP) were used to characterize label distribution in human leukocyte preparations incubated with 99mTc tin colloids. Less than 50% of the cell-associated radioactivity was specifically bound to leukocytes when heparinized blood was rotated with stannous fluoride colloid ([Tc]SFC). Labeling efficiency in leukocyte rich plasma (LRP) averaged 44%, of which greater than 90% was specifically bound to leukocytes. MP-gradient analysis also revealed that leukocyte labeling did not occur with stannous chloride colloid, nor when citrate was present during rotation with [Tc]SFC. When citrate was added after labeling to "solubilize" unbound [Tc]SFC, radiocolloid was removed from the leukocytes, indicating that the mechanism of [Tc]SFC labeling is adherence rather than phagocytosis. Technetium-labeled neutrophils exhibited normal in vitro chemotaxis and no lung uptake in vivo. Technetium labeled mononuclear leukocytes, on the other hand, exhibited prolonged lung transit in vivo. Neither [Tc]SFC cell preparation showed signs of in vivo reoxidation to pertechnetate. PMID- 3625300 TI - Effects of varying geometry on dose calibrator response: cobalt-57 and technetium 99m. AB - A joint project between the National Bureau of Standards (NBS) and Biomedical Products Department, E.I. du Pont de Nemours and Company, Inc. compared the indicated activity of (a) cobalt-57 samples in NBS 5-ml ampoules, plastic syringes, Du Pont 27-ml Vial E epoxy- and solution-filled containers, and (b) technetium-99m solutions in NBS 5-ml ampoules, elution vials, and syringes. The measurements were made in ionization chambers from two manufacturers, Capintec and Radcal. The main objective was to examine the use of radionuclides in NBS ampoules and Du Pont Vial E containers as suitable reference sources for ionization chambers used to assay radiopharmaceuticals in elution vials and syringes. The exercise illustrated that regardless of the brand of dose calibrator used, a calibration factor for each geometry should be determined to ensure the highest accuracy. The data show that as much as a 9% difference from the correct activity can be observed for these radionuclides, even when the ampoule reference source gives the appropriate reading. PMID- 3625301 TI - Subacute thyroiditis (de Quervain) presenting as a painless "cold" nodule. AB - A 49-yr-old woman presented with a solid, painless, nontender nodule in the left thyroid lobe. Thyroid scintigraphy revealed a solitary "cold" area in the left lobe and a slightly decreased 24-hr radioactive iodine thyroid uptake (9%). Although there were no specific clinical or biochemical signs suggesting thyroiditis needle aspiration cytology showed the presence of a subacute thyroiditis. Approximately 1 mo later the entire thyroid gland was affected leading to a completely suppressed thyroid radioiodine uptake and elevated serum thyroid hormone concentrations. This case illustrates that in the early phase of the disease, subacute thyroiditis may present as a solitary, painless, "cold" nodule and should be considered in the differential diagnosis of such lesions. PMID- 3625302 TI - Stress fractures and reduced bone mineral density with prior anorexia nervosa. PMID- 3625303 TI - Skeletal tuberculosis resembling metastatic disease on bone scintigraphy. PMID- 3625304 TI - Inadequacy of the 133Xe intrahepatic injection technique for the assessment of hepatic blood flow in man. PMID- 3625305 TI - Analysis of distributions and determination of reference limits in short series of data. Application to RIA. PMID- 3625306 TI - Validation of radioisotopic labelling techniques in gastric emptying studies. PMID- 3625307 TI - Methods and clinical applications of total body absorptiometry. PMID- 3625308 TI - 131I-MIBG uptake in a pelvic metastasis of sporadic thyroid medullary cancer. PMID- 3625309 TI - Diet and health: scientific concepts and principles conference commentary. AB - The conference concluded that dietary guidelines are needed, but that they cannot apply to everyone in the population nor to the same extent. Furthermore, a mechanism or structure is needed in which the guidelines can be periodically reviewed and updated. In making dietary recommendations, genetic variability, age, sex and body size need to be considered. Survival, extension of life span, relief of selected symptoms and biochemical improvements of risk factors are some of the criteria to be used in assessing the role of diet in health and disease. The most important questions that remain unresolved in the nutritional sciences concern the relation of diet to the development of chronic disease. The science of nutritional epidemiology needs to be strengthened and etiologic research in epidemiology ought to be performed and evaluated with the same standards used in other branches of science. Therefore, there is a need to establish guidelines for the validity of methods in assessing dietary intake and for a minimum acceptable correlation for the reproducibility and repeatability of dietary intake data. Research on the role of genetic variation and nutrition, the metabolic effects of omega-3 fatty acids and their relationship to omega-6 fatty acids, the energy expenditure after weight reduction and improving the scientific base of nutritional epidemiology will enhance the scientific basis of nutrition and our understanding of the role of diet in health and disease. PMID- 3625310 TI - Amino acid absorption and endogenous amino acids in the lower ileum and excreta of chicks. AB - Five diets containing protein levels supplying 5-35 g N/kg, and an N-free diet, were fed ad libitum to six groups of 15 chicks each, from 10 to 16 d of age. Soybean meal was the only source of protein. Diets contained magnesium ferrite as marker. Individual amino acid absorption was determined by analysis in the lower ileum or excreta as apparent absorption; true absorption was calculated from the slope of the regression curves, obtained by plotting dietary amino acid levels versus amino acids in the lower ileum or excreta. In the excreta, the true values were higher than the apparent ones determined with the three levels of dietary protein (diets 1-3, respectively, were 34.8, 25.7 and 18.1 g N/kg). This difference is the result of elimination of the endogenous fraction as represented by the intercept of the regression line obtained by the calculation method. In the lower ileum both absorption values, the apparent (diets 1-3) and the true (calculated), are almost similar to the true (calculated) ones in the excreta. The method based on regression analysis allows calculation of true absorption from excreta data, without the need to kill the chicks. This has been validated with soybean meal as the source of protein. The determined endogenous amino acids levels in chicks fed an N-free diet were higher than those calculated from the intercept (the endogenous amino acids related to the feed protein tested), both in the excreta and in the lower ileum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625311 TI - Dietary influences of evening primrose and fish oil on the skin of essential fatty acid-deficient guinea pigs. AB - There have been reports that certain dietary lipids are capable of regulating cellular inflammation and hyperproliferation. To investigate further the role of dietary manipulation involving gamma-linolenic acid (18:3n-6) and eicosapentaenoic acid (20:5n-3) on hyperproliferative cellular components, the effects of orally administered primrose oil (containing 18:3n-6) and menhaden fish oil (containing 20:5n-3) were tested in a cutaneous system using the essential fatty acid (EFA)-deficient guinea pig fed a hydrogenated coconut oil (HCO) diet. The effects of the dietary crossover regimen were determined on epidermal 1) morphology, 2) DNA synthesis, 3) delta 6- and delta 5-desaturase activities and 4) fatty acid composition of skin and liver lipids. Our results demonstrated that dietary fish oil lacked the capacity to reverse the signs of epidermal hyperproliferation, acanthosis and hypergranulosis that are characteristic of EFA deficiency. In contrast, primrose oil feeding reversed the histological and biochemical signs of hyperproliferation. These results suggest that dietary fish oil, which contains largely the 20:5n-3 fatty acid, lacks EFA functional properties in the skin. In addition, substitution of HCO with primrose or fish oil after 6 wk revealed incorporation of 18:3n-6 and 20:5n-3 into epidermal lipids, respectively. The significance of these altered epidermal fatty acid profiles is discussed. PMID- 3625312 TI - Vitamin A status needed to maintain vitamin A concentrations in nonhepatic tissues of the pregnant rat. AB - Vitamin A-depleted pregnant rats were fed diets containing 0, 1, 10 or 100 retinol equivalents (REq)/d during gestation. Maternal tissues of these dams, their placentas and fetuses were assayed for total vitamin A (retinol and its esters) at gestational ages 10, 13, 16 or 19 d. The vitamin A concentrations in placenta and fetuses of dams fed 10 REq/d were significantly different from those of dams fed no vitamin A. This difference was not seen in any of the six other maternal tissues assayed. We suggest that the fetus is at greater risk than other maternal tissues during severe vitamin A deprivation. For vitamin A-deprived dams, linear regression analysis indicated strong relationships between the vitamin A concentrations of nonhepatic tissues and their liver vitamin A concentrations. In contrast, among vitamin A-replete dams, these relationships were not statistically significant. An estimate was made of the minimal vitamin A status corresponding to tissue repletion by solving linear equations described by the data of the depleted dams for the vitamin A concentrations found in tissues of replete dams. This analysis revealed that a maternal vitamin A status of 3 micrograms/g liver was needed to provide the level of vitamin A found in the placenta, whole fetus and maternal tissues of vitamin A-replete dams. PMID- 3625313 TI - Comparison of transketolase activity and thiamin pyrophosphate levels in erythrocytes and liver of rainbow trout (Salmo gairdneri) as indicators of thiamin status. AB - Yearling rainbow trout (Salmo gairdneri) were fed a purified diet with and without thiamin supplementation for 30 wk, at which time overt signs of thiamin deficiency appeared in the deficient group. Overt signs of thiamin deficiency were anorexia, darkening and ataxia. Death rapidly followed the development of overt thiamin deficiency. Transketolase activity and thiamin pyrophosphate levels were measured monthly in erythrocyte and liver samples. Significant differences in erythrocyte transketolase activity between fish fed the thiamin-deficient and control diets were measured after 24 wk of feeding. No significant difference in liver transketolase activity was found between trout fed diets with or without thiamin supplementation. Thiamin pyrophosphate levels were significantly lower in erythrocytes and liver of fish fed the thiamin-deficient diet after 16 wk of feeding. Thiamin pyrophosphate levels in erythrocytes and liver were found to be a more sensitive indicator of thiamin status of rainbow trout than erythrocyte or liver transketolase activity. PMID- 3625314 TI - Influence of usual zinc intake and zinc in a meal on 65Zn retention and turnover in the rat. AB - The influences of zinc in a meal and usual zinc intake on zinc retention and turnover were investigated in 7-wk-old male rats fed diets containing 12-151 mg Zn/kg for 3 wk before and after consuming a 65Zn-labeled meal containing ZnCl2. Retention corrected to zero time and turnover rate were determined by whole-body counting. Percent zinc retention was inversely proportional to the natural logarithm of the meal zinc, between 0.09 and 26 mumol. In comparison to lower doses, higher doses resulted in lower percent retention but greater amounts of zinc retained. Although the latter relationship was slightly curvilinear, there was no indication of a limited capacity for zinc retention with high doses. However, doses above 4 mumol resulted in higher turnover rates in rats accustomed to lower zinc intakes. Percent retention and the reciprocal of the turnover rate were proportional to the reciprocal of the dietary zinc concentration. The greatest differences in retention and turnover occurred between 12 and 26 mg Zn/kg diet. The zinc dose in a meal and the usual dietary zinc separately influenced percent zinc retention. These factors also interacted, such that greater dose effects were observed at lower zinc intakes and greater dietary zinc effects were observed at lower doses. PMID- 3625315 TI - Iron, zinc and copper interactions: chronic versus acute responses of rats. AB - Several methodologies were evaluated to study iron, zinc and copper interactions. In three studies, rats were fed diets containing adequate levels of iron (33-35 micrograms Fe/g diet) and zinc (15-25 micrograms Zn/g diet) and diets with excessive levels of zinc (2441-2470 micrograms Zn/g diet) or iron (1408-3042 micrograms Fe/g diet). Consumption of excess iron for several weeks or in one test meal did not alter tissue levels of zinc or apparent absorption of 65Zn. In contrast rats fed excess zinc throughout the three studies had depressed hematocrits and serum copper levels, apparently absorbed 59Fe less efficiently and retained less 59Fe in livers and tibias than control animals. Nutritional status with regard to iron or zinc, not just the intakes of iron and zinc, also influenced the interactions between zinc and iron. Rats fed excess iron for several weeks retained less 65Zn from a test meal in their tibias than rats fed excessive iron in only the test meal. Although chronic ingestion of excess zinc depressed apparent absorption of 59Fe from a test meal, the ingestion of one test meal with excess zinc did not. Investigators studying nutrient interactions should not rely solely on studies in which unadjusted humans or animals are given a single dose of test substances because acute responses do not reflect all the changes induced by chronic feeding. PMID- 3625316 TI - Lack of an effect of dietary fructose on severity of zinc deficiency in rats. AB - Because feeding rats diets containing fructose as the carbohydrate source reduces copper and selenium status, we investigated whether the type of dietary carbohydrate also affected indices of zinc status. The experimental design was a 2 X 2 factorial study with the source of dietary carbohydrate (cornstarch or fructose) and the level of dietary zinc (0.7 or 31 micrograms Zn/g) as the variables. The experiment utilized 76 weanling male Sprague-Dawley rats randomly assigned to one of four dietary groups. Animals fed a zinc-deficient fructose diet were allowed to consume the diet ad libitum; all other groups were pair-fed to that group to ensure equivalent nutrient and energy intake. The results of the 29-d study showed that the most sensitive indices of zinc status measured, including growth, survival and the zinc concentrations of plasma, femur and testes, were not affected by the type of dietary carbohydrate. This lack of an effect of fructose on the zinc status of the experimental animals indicates that the ability of fructose to exacerbate copper and selenium deficiencies is specific, rather than representing a generalized effect of this simple sugar on the requirements and/or metabolism of all essential trace elements. PMID- 3625317 TI - Selenium-mercury interaction during intestinal absorption of 75Se compounds in chicks. AB - The effects of inorganic (HgCl2) and organic (CH3HgCl) mercury on the intestinal absorption of Se compounds [Na2(75)SeO3, Na2(75)SeO4, L-[75Se]methionine ([75Se]Met)] were determined in 3-wk-old White Leghorn cockerels by the in vivo ligated duodenal loop procedure. The intraduodenal dose contained 0.05 microCi 75Se, 0.01 mM Se, 150 mM NaCl and 0-1.0 mM Hg. In the presence of 1 mM inorganic Hg in the intraduodenal dose, the absorption of the inorganic 75Se compounds was only about 65% of that in the control group, whereas only a slight inhibitory effect on [75Se]Met absorption was observed. Methylmercury had no effect on [75Se]selenite absorption. Precipitation of the 75Se-selenite in the intestinal lumen partly explained the direct interaction between inorganic Hg and Se compounds. Absorption of [75Se]Met and [75Se]selenite was also determined in chicks fed after hatching a purified diet supplemented with varying amounts of Hg (0-500 mg/kg) and Se (0-4 mg/kg). Dietary Hg significantly reduced the transfer of [75Se]selenite to body by enhancing the accumulation of the isotope in the intestinal tissue. Dietary Hg did not affect the absorption of [75Se]Met, but altered the whole-body distribution of this Se compound. Because interaction between Se and Hg was observed mainly between the inorganic compounds and with use of a manyfold excess of Hg over Se, the data suggest that intestinal interaction between these metals is not of great nutritional importance. PMID- 3625318 TI - Growth and cellular composition in rats with intrauterine growth retardation: effects of postnatal nutrition. AB - We evaluated the catch-up growth of rats with intrauterine growth retardation (IUGR) raised in normal litters (8-10 pups) or in large litters (14-16 pups) during the first 2 wk of life. We also studied the influence of nutrition on cellular composition at birth and at 2 wk. Fifty-four pups (27 IUGR and 27 controls) were enrolled into normal or undernutrition groups. Postnatal undernutrition resulted in significantly lower growth in both control and IUGR rat pups than in normally fed pups. In the control group, postnatal undernutrition resulted in a lower liver weight but not a lower brain weight. Underfeeding of the IUGR group produced a greater number of cells of the brain and liver, but with smaller cell size than in normally fed IUGR rats. We conclude that compensatory catch-up growth in the mild-IUGR rat occurs if the postnatal nutrition is adequate. When postnatal nutrition is restricted, the non-IUGR rats became malnourished at 2 wk of age and the mild-IUGR rats did not demonstrate the catch-up growth phenomenon as was seen in those with adequate nutrition. In the severe-IUGR rat, undernutrition further compromised growth rate, so that at 2 wk of age their weights were the lowest of all the groups studied. PMID- 3625319 TI - Effect of dietary restriction during lactation on cardiac output, organ blood flow and organ weights of rats. AB - Cardiac output, organ blood flow and organ weights were examined in rats assigned at d 0 of lactation to a control (C) group fed ad libitum or an acutely restricted (AR) group fed 50% of the intake of C dams. Dams in each group were assigned to subgroups for measurement of milk yield or cardiac output, blood flow and organ weights. At d 14 of lactation, cardiac output and blood flow were measured with radiolabeled microspheres and milk yield with the tritiated water method. In AR dams cardiac output was 55% of that of C dams, but cardiac output relative to body weight did not differ between groups. Mammary gland blood flow and weight were reduced in AR dams. The weight of the kidneys, gastrointestinal tract and liver of the AR dams was less than that of C dams; however, relative blood flow to these organs did not differ between groups. Milk yield was reduced by 58% in AR dams compared to C dams. We conclude that dietary restriction during lactation negatively affects absolute cardiac output, blood flow to the mammary glands and milk yield, and that the reduced milk yield is associated with the decrease in mammary gland weight and blood flow. PMID- 3625320 TI - Replacement of the left ventricle with a single-chambered artificial pump. AB - Early clinical experience with total artificial hearts has stimulated further research and interest in this field. The concept of total heart replacement with a permanent mechanical device has been reevaluated, and its application as a bridge to heart transplantation is becoming more widely accepted. The size of total artificial hearts, however, limits the number of cases in which they can be used. In an effort to solve this problem, we evaluated a single-ventricle artificial pump in six Hereford calves. During surgery, the left ventricle was excised and replaced with a pneumatically actuated polyurethane pump connected to the mitral and aortic valve anulus. The right ventricle provided flow through the pulmonary vasculature, which eliminated the necessity of maintaining elevated right-sided filling pressures. The single-ventricle pump required less space than a biventricular device and was capable of maintaining adequate hemodynamic parameters in experimental animals. In comparison with the biventricular pump, this device offered the advantages of less extensive dissection requirements, ease of anastomosis, and a better anatomic fit. Patients whose pericardial cavities are too small for a biventricular artificial heart may benefit from the single-ventricle pump if they require hemodynamic support while awaiting heart transplantation. PMID- 3625321 TI - Spatial-interval discrimination in the human fovea: what delimits the interval? AB - In this paper we describe four experiments concerned with spatial-interval discrimination. The first experiment demonstrates that perturbations in the internal light distribution of two bright bars alter the perceived separation of the bars without influencing the precision of spatial-interval discrimination. Specifically, alterations in the centroid of the luminance distribution of the bars were found to influence their perceived separation systematically. In the second experiment we investigated separation discrimination for a pair of bright lines, a pair of dark lines, and a pair of lines with opposite polarity (a bright dark pair). For large interline separations, the thresholds for separation discrimination of the three stimuli were equivalent. However, for small separations (less than 4 arcmin) the thresholds for the opposite-polarity pair were significantly higher than those for either bright or dark lines. The third experiment showed that separation discrimination is also impaired when the direction-of-brightness change of adjacent edges is the same. In the fourth experiment, random luminance perturbations were introduced in the interval between two bright bars separated by 1.5 to 8 arcmin by the addition of a dim line within the interval. The effect of these perturbations was also to alter the perceived separation of the bars with no effect on the precision of spatial interval discrimination. Increasing the intensity of the perturbating line (to equal that of the outer lines) elevated thresholds for small separations (less than 4 arcmin) to approximately 6 arcsec but had no effect on the threshold for larger separations. Taken together, these results suggest that large and small separations are processed differently and place strong constraints on models for spatial-interval discrimination. PMID- 3625322 TI - Spectral sensitivity functions derived from brightness matching: implication of intensity invariance color-vision models--comment. AB - The author points out two errors in a reference in a paper by Elzinga and de Weert [J. Opt. Soc. Am. A 3, 1173 (1986)] and their failure to acknowledge the magnitude scaling aspect of B. C. Wilson's work [B. C. Wilson, Ph.D. dissertation (University of Michigan, Ann Arbor, Mich., 1964)]. PMID- 3625323 TI - Equiluminance: spatial and temporal factors and the contribution of blue sensitive cones. AB - Equiluminance ratios for red/green, red/blue and green/blue sine-wave gratings were determined by using a minimum-motion heterochromatic matching technique that permitted reliable settings at temporal frequencies as low as 0.5 Hz. The red/green equiluminance ratio was influenced by temporal but not spatial frequency, the green/blue ratio was influenced by spatial but not temporal frequency, and the red/blue ratio was influenced by both. After bleaching of the blue-sensitive cones, there was no change in equiluminance ratios, indicating no contribution of the blue-sensitive cones to the luminance channel even at low temporal and spatial frequencies. The inhomogeneity of yellow pigmentation within the macular region was identified as the source of the spatial-frequency effect on the blue/green ratio. PMID- 3625324 TI - Incoherent image formation in the presence of scattering eye media. AB - Incoherent image formation in human eyes that have scattering eye media is investigated as a function of the particle size and the optical density of the scattering medium and for test targets that differ in form and size. For single scattering by large particles (much greater than lambda), a point-spread function and the associated modulation-transfer function of the scattered light are derived from diffraction theory. It is shown that object structures with low spatial frequencies are also imaged by the scattered light. Following single scattering by small particles and/or multiple scattering, the scattered light forms an approximately uniform background. Consequently, the retinal contrast is reduced regardless of spatial frequency. The image quality is, contrary to what is found in normal image formation, extremely sensitive to the form and size of the test target. It is shown that the optimal readability of white-on-black letters is obtained at intermediate spatial frequencies. For an extended layer of arbitrary optical density and particle size, the influence of multiple scattering is approximated by using Hartel's scattering theory. It is shown that wavelength has only a small influence on retinal contrast for scattering by particles greater than lambda. PMID- 3625325 TI - Two-point resolution near detection threshold. AB - Resolution thresholds were determined for a configuration of two blobs with overlapping Gaussian spatial and temporal envelopes presented near detection threshold luminance contrast. The resolution thresholds are a constant fraction of the blur parameter of the stimuli over a range of at least two decades. There is no indication for a segmented nature of the resolution discrimination function. PMID- 3625326 TI - Model for the extraction of image flow. AB - A model is presented, consonant with current views regarding the neurophysiology and psychophysics of motion perception, that combines the outputs of a set of spatiotemporal motion-energy filters to extract optical flow. The output velocity is encoded as the peak in a distribution of velocity-tuned units that behave much like cells of the middle temporal area of the primate brain. The model appears to deal with the aperture problem as well as the human visual system since it extracts the correct velocity for patterns that have large differences in contrast at different spatial orientations, and it simulates psychophysical data on the coherence of sine-grating plaid patterns. PMID- 3625327 TI - Variations of visual functions across the visual field. PMID- 3625328 TI - Does cone positional disorder limit resolution? AB - We measure the center-to-center spacings and disorder in spacings between all pairs of cones in a strip of primate retina extending from the foveal center to approximately 5.75 deg of retinal eccentricity along the temporal horizontal meridian. The strip is partitioned into windows, and the positions of the cone centers in each lattice window are digitized for analysis of lattice structure and quality. We find a nearly monotonic increase in cone spacing with eccentricity. The cone mosaic is a high-quality hexagonal lattice near the foveal center, and cone positional disorder (jitter) relative to averaging spacing increases beyond about 1.5 deg. We estimate human acuity measured through the optics of the eye over a retinal region comparable with our lattice strip by pooling the results of previous investigators. When the monkey lattice is scaled to human foveal resolution, application of the sampling theorem to average cone spacing predicts these pooled visual-acuity data from the foveal center to about 1.5 deg and overestimates visual acuity more eccentrically. Orientation reversal, a new technique developed by Coletta and Williams [J. Opt. Soc. Am. 4, 1503 (1987)] for estimating the Nyquist limit, estimates Nyquist frequencies from the foveal edge to beyond 5 deg of retinal eccentricity that agree with the cutoff frequencies predicted on the basis of our average spacing measurements. We conclude that the sampling theorem based on average spacing alone predicts the Nyquist limit from the foveal center to about 5 deg when that limit is measured by using the new aliasing technique.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625329 TI - Cone sampling array models. AB - A model is described for positioning cones in the retina. Each cone has a circular disk of influence, and the disks are tightly packed outward from the center. This model has three parameters that can vary with eccentricity: the mean radius of the cone disk, the standard deviation of the cone disk radius, and the standard deviation of postpacking jitter. Estimates for these parameters out to 1.6 deg are found by using measurements reported by Hirsch and Hylton [Vision Res. 24, 347 (1985)] and Hirsch and Miller [J. Opt. Soc. Am. A 4, 1481 (1987)] of the positions of the cone inner segments of an adult macaque. The estimation is based on fitting measures of variation in local intercone distances, and the fit to these measures is good. PMID- 3625330 TI - Psychophysical estimate of extrafoveal cone spacing. AB - In the extrafoveal retina, interference fringes at spatial frequencies higher than the resolution limit look like two-dimensional spatial noise, the origin of which has not been firmly established. We show that over a limited range of high spatial frequencies this noise takes on a striated appearance, with the striations running perpendicular to the true fringe orientation. A model of cone aliasing based on anatomical measurements of extrafoveal cone position predicts that this orientation reversal should occur when the period of the interference fringe roughly equals the spacing between cones, i.e., when the fringe spatial frequency is about twice the cone Nyquist frequency. Psychophysical measurements of the orientation reversal at retinal eccentricities from 0.75 to 10 deg are in quantitative agreement with this prediction. This agreement implies that at least part of the spatial noise observed under these conditions results from aliasing by the cone mosaic. The orientation reversal provides a psychophysical method for estimating spacing in less regular mosaics, complementing another psychophysical technique for measuring spacing in the more regular mosaic of foveal cones [D.R. Williams, Vision Res. 25, 195 (1985); Vision Res. (submitted)]. PMID- 3625331 TI - Cone spacing and the visual resolution limit. AB - It is commonly assumed that the visual resolution limit must be equal to or less than the Nyquist frequency of the cone mosaic. However, under some conditions, observers can see fine patterns at the correct orientation when viewing interference fringes with spatial frequencies that are as much as about 1.5 times higher than the nominal Nyquist frequency of the underlying cone mosaic. The existence of this visual ability demands a closer scrutiny of the sampling effects of the cone mosaic and the information that is sufficient for an observer to resolve a sinusoidal grating. The Nyquist frequency specifies which images can be reconstructed without aliasing by an imaging system that samples discretely. However, it is not a theoretical upper bound for psychophysical measures of visual resolution because the observer's criteria for resolving sinusoidal gratings are less stringent than the criteria specified by the sampling theorem for perfect, alias-free image reconstruction. PMID- 3625332 TI - Retinal limits to the detection and resolution of gratings. AB - The maximum spatial frequency for the detection and resolution of sinusoidal gratings was determined as a function of stimulus location across the visual field. Stimuli were produced directly on the retina as interference fringes, thus avoiding possible loss of image quality, which may occur when the optical system of the eye is used to form the retinal image. Contrary to earlier reports, we found that subjects could detect gratings with spatial frequencies much higher than the resolution limit. At 5 degrees of eccentricity from the fovea, the detection limit was about three times the resolution limit, and this factor increased to about 10 as the test stimulus was moved 35 degrees into the periphery. Quantitative comparison of the data with retinal anatomy and physiology suggests that pattern resolution is limited by the spacing of primate beta (midget) retinal ganglion cells, whereas pattern detection is limited by the size of individual cones. PMID- 3625333 TI - Aliasing in the parafovea with incoherent light. AB - We compared discrimination and detection in the parafovea for oblique, cathode ray-tube-generated, square-wave gratings. There is a band of frequencies between roughly 10 and 20 cycles/deg wherein such gratings are detected only in an apparently aliased form. The existence of aliasing is consistent with the cone density and optical quality of the parafoveal visual system, but the spatial frequency at which the aliasing is observed is only about half of what is suggested by cone density. The reason for this result is unclear, but one provocative possibility is that the site of the aliasing is neural rather than receptoral. PMID- 3625334 TI - Two-dot vernier discrimination within 2.0 degrees of the foveal center. AB - Vernier acuity (delta v) as a function of two-dot separation (s) was measured at five retinal locations between the foveal center and 2.0 deg of eccentricity. We compare these results with average cone spacing at each of the corresponding retinal eccentricities and find that the angular dot separations at which the delta v versus s function intersects the angular cone spacing at each eccentricity remain nearly constant. Further, we define a vernier Weber fraction delta v/s and find that the average Weber fraction increases by nearly a factor of 2 from the fovea to 2.0 deg of retinal eccentricity. We suggest that both receptor factors and postreceptor factors contribute to limits of vernier acuity within 2 deg of the foveal center. PMID- 3625335 TI - Position sense of the peripheral retina. AB - Position acuity was measured over a wide range of eccentricities, from 3 min to 10 deg in the horizontal meridian, by using both a three-dot bisection task and a three-dot vernier task. A foveal fixation dot appeared for 1 sec before an outer pair of test dots was flashed for 200 msec. Bisection and vernier tasks were used to measure position acuity in the radial and tangential directions, respectively. The vernier data were well fitted by a straight line on linear axes of offset threshold versus eccentricity. The bisection data, on the other hand, were poorly fitted by a single straight line. However, a double-line fit worked very well. The line segment at large eccentricities (greater than 0.5 deg) had an x intercept of about 0.6 deg, in good agreement with previous estimates based on cortical magnification and on hyperacuity in the presence of flanks. These results imply that three-dot vernier thresholds are set by a single orientation mechanism at all eccentricities and that three-dot bisection thresholds are set by a pair of mechanisms. For eccentricities less than 15 min, thresholds are in good agreement with calculations based on spatial-frequency filters. For larger eccentricities, the bisection thresholds agree with scaled anatomical modules that are presumed to exist in the human visual cortex. The thresholds for position acuity in the tangential direction are as low as 0.005 times the eccentricity. In the radial direction, thresholds are poorer, implying that additional cortical factors may further constrain performance. PMID- 3625336 TI - Peripheral hyperacuity: three-dot bisection scales to a single factor from 0 to 10 degrees. AB - Performance of three-dot bisection was determined as a function of the feature separation at eccentricities of 0-10 deg along the inferior vertical field meridian by using dot stimuli scaled in size to compensate for eccentricity. For these briefly flashed dot stimuli, the entire function of three-dot bisection acuity against dot separation worsens away from the fovea with a single scaling factor that is compatible with the change of the cortical magnification factor in area V1. When the presentation duration of the stimulus was lengthened from 150 msec to 1 sec, the improvement was much greater in the fovea than at 10-deg eccentricity for closely separated stimuli. We attribute this difference to a luminance cue (detection of a brightness change) that is present for a long stimulus duration at small separations in the fovea, but not in the periphery. PMID- 3625337 TI - Peripheral hyperacuity: isoeccentric bisection is better than radial bisection. AB - Performance of three-dot bisection was determined as a function of orientation for a variety of feature separations and field meridians at eccentricities of 0 10 deg for two observers. The dot stimuli and separations were scaled in size to compensate for eccentricity. The precision of three-dot bisection was found to depend on the direction of test-feature offset. In the fovea, horizontal and vertical bisections were better than oblique bisections, while at eccentricities of 5-20 deg, isoeccentric (on a tangent to a circle of a given eccentricity) bisection was better than radial bisection. The direction of offset was more important than the orientation of the stimulus. Large separations showed a stronger effect than small separations. The anisotropy of bisection appears different from the meridional effect for resolution and is unlikely to be simply related to a local anisotropy of the cortical magnification factor. PMID- 3625338 TI - Cortical magnification and peripheral vision. AB - In a generalized form, the cortical magnification theory of peripheral vision predicts that the thresholds of any visual stimuli are similar across the whole visual field if the cortical stimulus representations calculated by means of the cortical magnification factor are similar independently of eccentricity. Failures of the theory in spatial vision were analyzed, and the theory was tested with five visual acuity tasks and two hyperacuity tasks. Almost all increases in thresholds with eccentricity were explained by the theory in five of these tasks, which included the two-dot vernier hyperacuity test, the measurement of visual acuities with gratings, the Snellen E test, and two acuity tests that required either separation between dots or discrimination between two mirror-symmetric forms. The two-dot vernier thresholds could be explained as a special case of orientation discrimination, and orientation discrimination at different eccentricities was in agreement with the cortical magnification theory. The increase of thresholds in peripheral vision was larger than predicted by the theory in the Landolt visual acuity and bisection hyperacuity tests, possibly because of retinal undersampling. PMID- 3625339 TI - Estimation of local spatial scale. AB - The concept of local scale asserts that for a given class of psychophysical measurements, performance at any two visual field locations is equated by magnifying the targets by the local scale associated with each location. Local scale has been hypothesized to be equal to cortical magnification or alternatively to the linear density of receptors or ganglion cells. Here, we show that it is possible to estimate local scale without prior knowledge about the scale or its physiological basis. PMID- 3625340 TI - Spatial scaling of central and peripheral contrast-sensitivity functions. AB - Contrast sensitivity was measured as a function of spatial frequency at various eccentricities in the nasal visual field. Eccentricity influenced resolution more for vertical gratings than for horizontal ones, demonstrating a nasal field anisotropy. When grating apertures and spatial frequencies were varied together, by changing viewing distance, peripheral and central contrast-sensitivity functions could not be entirely superimposed by scaling the spatial-frequency stimulus parameter. However, when gratings apertures were designed to project a standard-sized patch on a hypothetical vertical surface at an angle of 9 deg to the line of sight, the superimposition of central and peripheral contrast sensitivity functions improved. Central and peripheral contrast-sensitivity functions can be superimposed by describing the grating stimulus with reference to this putative surface in terms of cycles per surface distance. The surface scaling approach leaves a minor effect of eccentricity on contrast sensitivity for vertical gratings but readily accommodates the vertical-horizontal anisotropy in grating resolution. These findings suggest a novel functional role for gradients in the spatial sampling of the visual field, in relation to the internal representation of the structure and geometry of visible surfaces. PMID- 3625341 TI - Contrast discrimination in peripheral vision. AB - Contrast discrimination provides a psychophysical method for studying contrast coding in vision. Our purpose was to compare properties of contrast discrimination in central and peripheral vision. We used forced-choice procedures to measure contrast-increment thresholds as a function of pedestal contrast. Our stimuli were 2-cycle/deg Gaussian-windowed sine-wave grating patches. They were centered at retinal loci ranging from 10 degrees nasal to 20 degrees temporal on the horizontal meridian. At each eccentricity, curves relating increment threshold to pedestal contrast had the same shape. When increment thresholds and pedestal contrasts were both normalized by the contrast thresholds at the retinal eccentricity in question, the curves became superimposed and fell along the same dipper-shaped contrast-discrimination function. We conclude that, after scaling by the local contrast sensitivity, properties of contrast discrimination are qualitatively and quantitatively similar from 0 degree to 20 degrees on the retina. These findings suggest that mechanisms of contrast coding are similar in central and peripheral vision. PMID- 3625342 TI - Effect of eccentricity on the relationship between detection and identification. AB - The relationship between the ability to detect a low-contrast grating and to identify its spatial frequency or orientation was examined at eccentricities ranging from 0 to 17.5 deg. The form of the relationship between the ability to detect and to identify stimuli as contrast varies was found to be the same for peripheral viewing as for central viewing, i.e., proportionality. Individual variations were seen in the effect of eccentricity on the identification/detection (I/D) performance ratio for a given discrimination. However, the composite data show no effect of eccentricity on the I/D ratio when low-frequency stimuli are used. With high-frequency stimuli, the I/D ratio decreases at large eccentricities. The results support the hypothesis that the primary difference between central and peripheral vision is the scale at which visual information is represented. In particular, the results suggest no change in the bandwidths of tuned mechanisms with respect to spatial frequency and orientation. PMID- 3625343 TI - Comparison of perceived spatial frequency between the fovea and the periphery. AB - A grating viewed in the periphery usually appears to be of higher frequency than the same grating viewed at the fovea, for frequencies below the Nyquist frequency of the periphery. Systematic shifts in perceived frequency between fovea and periphery were found under several experimental conditions: spatially localized or extended sine-wave patterns, test stimuli presented in the superior or the inferior visual field, and stimuli of high or low mean luminance at several different contrasts. A multiple-spatial-frequency channels model can qualitatively account for our results, if it is assumed that each channel has a receptive-field size that increases as a function of eccentricity but has a perceived frequency label that does not change as a function of eccentricity. PMID- 3625344 TI - Analysis of visual modulation sensitivity. III. Meridional variations in peripheral flicker sensitivity. AB - Critical flicker frequency (CFF) and modulation sensitivity were measured throughout the visual field as a function of meridian, eccentricity, and luminance. The stimulus conditions were designed to excite preferentially the long-wavelength-sensitive (R) cones in equal numbers at each retinal location. Temporal-frequency responses under these conditions can be partitioned into two components by following the analysis of Kelly [J. Opt. Soc. Am. 51, 422 (1961)]: a high-frequency linear component unaffected by the mean luminance level and a nonlinear adaptive component that conforms to Weber's law of proportionality to luminance. The results suggest that the time constant of the linear component varies to some extent with meridian at a constant eccentricity, in addition to the substantial increase with eccentricity along all meridians. Retinal variations in sensitivity of the nonlinear, adaptive aspect of the visual response were small when equal numbers of cones were stimulated, and the variations did not account for the changes in CFF with either eccentricity or meridian. PMID- 3625345 TI - Retinal ganglion-cell density and receptive-field size as determinants of photopic flicker sensitivity across the human visual field. AB - At 1, 10, and 50 Hz, photopic flicker sensitivity to a nonpatterned stimulus of constant area and luminance with a small equiluminous surround tended to decrease when eccentricity increased from 0 to 70 deg. The decrease was steeper for lower flicker frequencies. When the stimulus and surround were M scaled by magnifying them in inverse proportion to retinal ganglion-cell sampling density, flicker sensitivity tended to increase with eccentricity. The increase was steeper for higher flicker frequencies. When the stimulus and surround were F scaled by reducing their average luminance in inverse proportion to Ricco's area, flicker sensitivity again decreased with increasing eccentricity, but now the decrease was steeper for higher flicker frequencies. When the stimulus and surround were MF scaled, flicker sensitivity became independent of eccentricity at all flicker rates tested. PMID- 3625346 TI - Spatiotemporal properties of grating motion detection in the center and the periphery of the visual field. AB - Sensitivity to motion was studied by using sinusoidal gratings of contrast 0.4 that were displaced sinusoidally over time. At low motion temporal frequencies, thresholds were proportional to velocity and were independent of spatial frequency. Sensitivity, defined as the reciprocal of the threshold displacement amplitude, declined exponentially with temporal frequencies above the peak. Peak motion sensitivities decreased with visual field eccentricity but could be equalized by applying a spatial scaling function. However, this left a small relative superiority in the periphery for high temporal frequencies of motion, and possible explanations for this residual temporal inhomogeneity are considered. PMID- 3625347 TI - Two mechanisms for the detection of slow motion. AB - The lowest velocity at which motion can be detected, the lower threshold of motion (LTM), has been investigated as a function of eccentricity. Results show that temporal properties of the LTM change with eccentricity, suggesting a dichotomy in the temporal properties of the neural mechanisms subserving this aspect of central and peripheral vision. Suprathreshold drifting sinusoidal gratings were used with a method of constant stimuli (a two-alternative forced choice procedure) to obtain the LTM for different stimulus durations at different eccentricities. Results for central vision support a displacement-based model of movement detection similar to that of Reichardt [in Sensory Communication, W.A. Rosenblith, ed. (Wiley, New York, 1961), p. 303]. The LTM decreases as the stimulus duration increases, thus maintaining a constant minimum displacement. However, the results for the far periphery (35 deg of eccentricity) suggest a different mechanism, in which detection depends not on a constant displacement but on a constant velocity; as the stimulus duration increases, the LTM remains constant. These results for gratings can also be generalized to other stimuli, for example, random-dot patterns presented in apparent motion. PMID- 3625348 TI - Influence of contrast on foveal and peripheral detection of coherent motion in moving random-dot patterns. AB - The detection of coherent motion was studied in stroboscopically displayed moving random-dot patterns disturbed by incoherent noise. We determined the threshold signal-to-noise ratio S as a function of velocity V at eccentricities of 0 degrees, 3 degrees, 6 degrees, 12 degrees, 24 degrees, 48 degrees in the temporal visual field of the right eye. At each eccentricity the measurements of S = f(V) were repeated for a range of rms contrast values from 60% (0 dB) in steps of 3 dB down to 1.9% (-30 dB). All stimuli were scaled with eccentricity to keep the ratio of pixel size to acuity constant (about 2). It is shown that the S values in our paradigm are never determined by contrast-threshold effects. They are true correlational thresholds. Bilocal movement detectors are assumed to underlie the detection of coherent motion. The bilocal correlation proves to be rather insensitive to rms contrast down to contrast levels of about 10%. Despite the eccentricity scaling, which is quite effective at high contrast levels, differences between the eccentricities become noticeable at lower contrast levels (below about 30-20%). The fovea is the least, and the far periphery the most, resistent to contrast degradation. PMID- 3625349 TI - Responses of cat striate neurons to moving light and dark bars: changes with eccentricity. AB - Responses of area-17 neurons to light and dark bars moving over a wide range of speeds were measured over a range of receptive-field locations in anesthetized and paralyzed cats. For both light bars and dark bars, velocity sensitivity shifted to higher speeds with increasing eccentricity, whereas response strength and direction selectivity hardly changed. The good correlation between response strength and velocity sensitivity for light and dark bars suggests that ON and OFF inputs converge upon most area-17 cells. The correlation between direction selectivities for light and dark bars was not better than that between velocity sensitivities for light and dark bars. Only cells with strong direction selectivity were equally direction selective for light bars and dark bars. Comparison with previous studies done with high-contrast stimuli shows that the shift in sensitivity to higher speeds with increasing eccentricity is contrast dependent. PMID- 3625350 TI - Magnitude of lateral chromatic aberration across the retina of the human eye. AB - Lateral chromatic aberration was measured in the right eyes of four adult observers as the physical misalignment between perceptually aligned short- and long-wavelength targets. The magnitude of aberration generally increased with retinal eccentricity but remained less than 10 arcmin within 40 deg of the fovea. At 60 deg, lateral chromatic aberration increased to approximately 30 arcmin but was reducible by refractive correction in the two observers retested. The results are consistent with previous reports of a sizable region of reasonably good optical quality extending into the retinal midperiphery. Within this region, lateral chromatic aberration approximates the average spacing between adjacent retinal cones, indicating that it does not substantially limit peripheral color vision. PMID- 3625351 TI - Calculation of the influence of lateral chromatic aberration on image quality across the visual field. AB - The magnitude of lateral chromatic aberration and its effect on image contrast were computed for a modified, reduced-eye model of the human eye, using geometrical optics. The results indicate that lateral chromatic aberration is a major factor affecting image quality for obliquely incident rays of polychromatic light. Modulation transfer functions for white sinusoidal gratings decline monotonically with spatial frequency, with eccentricity of the stimulus in the peripheral visual field, with grating orientation relative to the visual meridian, and with decentering of the pupil. Image contrast is largely independent of the color temperature of white light over the range 2800 to 12,000 K, but it improves significantly for the polychromatic green light of the P-31 oscilloscope phosphor. Selective filtering by macular pigment increases image contrast by an amount that grows with spatial frequency to about a factor of 1.5 at the foveal resolution limit. Reduced contrast caused by lateral chromatic aberration accounts for most of the threefold loss of acuity that occurs for foveal viewing through a decentered pupil. The aberration probably has negligible effect on peripheral acuity but may act to limit aliasing of peripheral patterns. PMID- 3625352 TI - Accommodation to stimuli in peripheral vision. AB - Can targets in peripheral vision elicit accommodation responses? We used a laser optometer to measure monocular steady-state accommodation for stimuli at retinal eccentricities ranging from 1 degree to 30 degrees. The optical distance from the eye to the stimulus was varied from 0 to -6 D by introducing lenses in front of the eye. The accommodative response was plotted as a function of optical distance to produce an accommodative stimulus-response function. The magnitude of accommodative response was defined as the difference between the maximum and minimum values of this function. The magnitude declined from 4 D at 1 degree to 1 2 D at 30 degrees eccentricity. The relation of the magnitude of accommodative response in peripheral vision to changes in acuity, contrast sensitivity, and depth of focus are considered. The role played by convergence accommodation is also discussed. PMID- 3625354 TI - Texture discrimination at different eccentricities. AB - Differences in preattentive texture discrimination between central vision and peripheral vision were studied with textures composed of random dots. The subject had to discriminate between two textures whose first-order statistics were kept identical but whose second-order statistics were different. For textures of constant retinal size the discrimination was easy in central vision, but the decrease of visual acuity with increasing eccentricity made the textures unresolvable in peripheral vision. When the textures were scaled by the cortical magnification factor derived from the frequency of retinal ganglion cells so that the calculated neural representations of the textures became similar at different eccentricities, texture discrimination became independent of visual field location. This indicates that preattentive texture discrimination based on differences in second-order statistics of random dots operates similarly in central vision and peripheral vision. PMID- 3625353 TI - Magnification factor for adaptation of a visual transient mechanism. AB - After adaptation by an observer to a patch of gradually increasing (or decreasing) luminance, a steady test patch appeared to be gradually dimming (or brightening). These aftereffects did not transfer interocularly. Adaptation to a checkerboard, in which the white squares gradually dimmed while the black squares gradually brightened, gave an aftereffect that was a pattern of intersecting diagonal lines, that is, an extremely blurred checkerboard. The larger the squares of the checkerboard were, the farther into the periphery the aftereffect extended, because small squares were blurred out by the summation areas of the underlying visual channels, which were larger at increasing eccentricities and had diameters of 20 times the resolvable dot separation. The estimated visual acuity of these channels was as low as 20/400. These estimates were confirmed by manipulating separately the local and space-averaged luminances of the adapting stimulus. PMID- 3625355 TI - Lumbar trunk muscle use in standing isometric heavy exertions. AB - A study was conducted to see whether a biomechanical model previously validated for predicting the lumbar spine internal loads imposed by the performance of easy and moderately strenuous physical tasks was also adequate for predicting loads imposed by heavy exertions. Lumbar trunk muscle myoelectric activities were measured in 10 healthy young adult men performing a variety of less strenuous and more strenuous tasks while standing upright, and these were compared to the lumbar muscle contraction magnitudes predicted by the model. For the less strenuous tasks, measured activities and predicted forces showed strong linear correlations, confirming the validity of the model at those load levels. Model predictions for the more strenuous tasks were often found to be inadequate. Contrary to model-incorporated assumptions, substantial antagonistic muscle contractions sometimes occurred, intraabdominal pressurization may sometimes have contributed substantially to the maintenance of structural equilibrium, and the ligamentous tissues of the trunk seemed sometimes to develop substantial passive resistances to bending and twisting moments. PMID- 3625356 TI - Platelet pathology in minimal curve idiopathic scoliosis: an attempt to predict curve progression. AB - Platelets from adolescents with minimal curve scoliosis (mcs) (7-18 degrees) and healthy control subjects were examined for morphometry under the electron microscope and tested for calcium content and surface negative charge. These parameters have previously been found to be abnormal in severe idiopathic scoliosis (is) patients. Significantly more patients than control subjects showed deviations from normal in all tests. Two tests in particular, the average number of dense bodies per cell and an increased surface negative charge, were the most frequent abnormalities. In an attempt to assess the possibility of using platelet tests for prediction of curve progression, statistical comparisons were made and discriminant scores were generated for each patient. The results were compared with the clinical findings after a 2- to 3.5-year follow-up. The predictions proved to be incorrect although each of the five patients who had curve progression had some platelet abnormality. It is concluded that although platelet pathology does occur in early idiopathic scoliosis, it cannot be used as a prognostic indicator of curve progression. PMID- 3625357 TI - The response of the canine intervertebral disc to immobilization produced by spinal arthrodesis is dependent on constitutional factors. AB - Posterior lumbar spinal fusion was performed on five mature greyhounds. Two months prior to death, all of the surgical and five age-matched control greyhounds were given Na2(35)SO4 (1.0 mCi/kg) intravenously. All fusion animals were killed 6 months postoperation, and discs beneath the fusion mass as well as those adjacent to it (parafusion discs) were sampled separately and dissected into the nuclei pulposi and annuli fibrosi (AF). Proteoglycans (PGs) were extracted with 4.0 M GuHCl and then purified by CsCl density gradient ultracentrifugation. These PG monomers were subjected to Sepharose CL-2B chromatography, and their hydrodynamic size and ability to aggregate were determined. The level, extractability, and hydrodynamic size of PGs in the AF of fusion discs were found to be greater than those in control discs, as were the keratan sulfate core protein complexes prepared by chondroitin ABC lyase digestion. The ability of the 60-day-old PG subunit populations, isolated from fusion discs, to aggregate was also higher than controls. There was, however, no difference between the galactosamine/glucosamine, galactosamine/protein, glucosamine/protein, or hexuronate/protein ratios of PGs in fusion and control discs. PMID- 3625358 TI - Surface strain on human intervertebral discs. AB - The biomechanical functions of the internal components of the intervertebral disc are not well understood. The surface deformation of 17 human cadaveric lumbar intervertebral discs was studied by photogrammetry by adhering small optical targets to the disc surface and thereby recording the length, bulge, and vertical height of lines on the disc surface representing annular fibers. Discs were studied in pure compression, flexion and extension, axial rotation, and shear. Two definitions of a fiber were investigated: first with the end-points of the fiber on the vertebra ("bone-to-bone" definition), second, where the end points of the fiber were just before the disc vertebra junction (the "disc-only" definition). Measurements were compared with a "constant-volume" physical model and with a mathematical model of the intervertebral disc. Fiber strains were 6% or less under physiological conditions. Comparison of results from the two definitions of fiber length showed greater strains for the disc-only definition in compressive loading. Fiber strains were less than in the constant-volume model of comparable dimensions in compressive loading by a factor of about two, thus suggesting fluid loss or end-plate deformations in the physiologic conditions. The mathematical model indicated that the surface strain for intervertebral discs is very sensitive to the disc-height: diameter ratio and to fluid loss from the disc but is less sensitive to the helix angle of the fibers. PMID- 3625359 TI - Comparison of the fatigue characteristics of centrifuged and uncentrifuged Simplex P bone cement. AB - Fatigue test specimens of Simplex P bone cement (Howmedica Inc., Rutherford, NJ) prepared according to the manufacturer's instructions and specimens of Simplex P prepared by centrifuging the cement immediately after mixing were subjected to fully reversed tension-compression fatigue tests at initial strain levels ranging from 0.01 to 0.001. S:N curves for both cement preparations were generated and compared on the basis of regression analysis, Weibull analysis, and Student's t tests. Centrifuged Simplex P was able to withstand significantly more fatigue cycles than uncentrifuged Simplex P at all strain levels tested. Importantly, at the more physiologic strain levels of 2,000 and 1,000 microstrain, the centrifuged cement demonstrated superior fatigue life. Specifically, at the 1,000 microstrain level eight of the 11 uncentrifuged specimens fractured before undergoing 10 million cycles. Of those that failed, the average number of cycles to failure was 1.8 million with a range of 560,000 to 4 million cycles. In contrast, all 11 centrifuged specimens tested at 1,000 microstrain remained intact at 10 million cycles. PMID- 3625360 TI - Valgus stability of the elbow. AB - The valgus stabilizers of the elbow have been identified anatomically, but their relative importance has not been quantified. The purpose of this study was to analyze the acute changes of the torque-displacement curve to valgus stress following (a) section of the posterior portion of the medial collateral ligament; (b) excision of the radial head; (c) prosthetic replacement of the radial head; and (d) excision of the anterior portion of the medical collateral ligament. Thirty cadaver specimens underwent load-displacement testing in three positions: 0 degrees, 45 degrees, and 90 degrees of flexion. The anterior portion of the medial collateral ligament was the primary stabilizer of the elbow to valgus stress. The relative contribution of the posterior ligament was minimal. After excision of the radial head alone, the slope of the load-displacement curve decreased an average of 30%. Silicone rubber radial head replacement did not significantly improve the stability to valgus stress after radial head excision. PMID- 3625361 TI - Accuracy and reproducibility of instrumented knee-drawer tests. AB - Instrumented devices for knee-drawer tests have become popular in orthopaedics relatively recently. The objective of the present study was to document the effects of several parameters on the accuracy and reproducibility of anterior posterior (AP) drawer measurements. An instrumented knee-drawer tester for AP laxity evaluations was constructed, based on the differential displacement method, measuring shifts of the tuberosity relative to the patella. The accuracy of the AP-shift was determined with the parallel use of a highly accurate roentgen stereo photogrammetric (RSP) measurement system on two postmortem leg specimens. The effects of relative motion between patella and femur were negligible. In addition to AP shifts, significant knee flexion and tibial rotations occurred, although the foot and the thigh were fixed as well as possible. The differential displacement method was effective in circumventing this problem. The accuracy of the AP shift was greater than 10%. The reproducibility of the AP drawer parameters (shifts and compliances) was determined in normal subjects and patients. Tests were made to evaluate the effects of different observers, time sequences, and different days. In addition, effects of muscle relaxation were studied. Overall, the shift parameters at different forces were found to be reproducible to between 5 and 15%. The slopes (compliances) of the laxity curves, at different forces, were found to be reproducible between 20 and 40%. The reproducibility was principally affected by deviations in the subject positioning procedure. PMID- 3625362 TI - Effect of patellar shaving in the rabbit. AB - Shaving of the articular cartilage on the undersurface of the patella was carried out in mature white New Zealand rabbits to determine whether the removed cartilage reformed or the shaving led to later evidence of degenerative arthritis. The animals were followed for as long as 15 months after surgery, at which time patellae were removed and examined by light and electron microscopy. The depth of shaving varied considerably; however, no evidence of repair and no evidence of degenerative arthritis was noted in either the superficial or deeply shaved patellae. It is concluded that such superficial cartilage defects neither repair or produce subsequent degenerative arthritis. PMID- 3625363 TI - Increased transsynovial transport with continuous passive motion. AB - Thirteen freshly killed immature rabbits were used to study the effect of continuous passive motion (CPM) on regional nutritional pathways of the medial and lateral menisci and the transport of a solute from synovial fluid to the patellar tendon. A bolus of 35SO4 was injected into each knee joint cavity. The right knee underwent CPM for 1 h, whereas the left knee was immobilized (rest extremity). Both knees were then rapidly resected and immediately frozen. The medial and lateral menisci were removed and sectioned into anterior, middle, and posterior thirds for Group 1 animals; in Group 2 animals a portion of patellar tendon was harvested. Radioactivity as counts per minute per milligram of tissue was counted in a scintillation counter. The posterior portion of the lateral meniscus in the rest extremity had significantly higher uptake than the extremity that underwent CPM (p less than 0.001). In the extremity at rest, the posterior third of the lateral meniscus had a significantly higher uptake than that of the middle third (p = 0.04). In Group 2 rabbits, the patellar tendon of the knee undergoing CPM had significantly higher uptake as compared with the patellar tendon of the knee at rest (p = 0.02). These results indicate that diffusion from synovial fluid to meniscal cells is an important mechanism of transport for low molecular-weight nutrients such as sulfate; CPM does not facilitate this mechanism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625365 TI - New experimental procedures to evaluate the biomechanical properties of healing canine medial collateral ligaments. AB - Both clinical and animal studies have indicated that early mobilization and exercise may improve the healing of injured medial collateral ligaments (MCLs). To investigate these effects, transected canine MCLs were subjected to three different treatment regimens: (a) no surgical repair with 6 weeks mobilization; (b) surgical repair with 3 weeks immobilization followed by 3 weeks remobilization; and (c) surgical repair with 6 weeks immobilization. After sacrifice, knee laxity was measured in a newly designed varus-valgus (V-V) laxity device. Each knee was tested subsequently in tension to determine the structural properties of the femur-MCL-tibia complex (FMTC) and the mechanical properties of the healing MCL substance. It was found that the V-V laxity increased for all experimental knees, but that early mobilization enhanced joint stability. The structural properties of the FMTC and the mechanical properties of the MCL substance were also lower than the contralateral controls. Again, the early mobilization groups had better results. PMID- 3625364 TI - Site-related variations in glycosaminoglycan content and swelling properties of bovine flexor tendon. AB - The presence of morphologically distinct tissues within the adult bovine deep flexor tendon presented a model which we examined for correlations between proteoglycan content and tissue swelling properties. The proximal portion which experiences only tensile forces contained low levels of glycosaminoglycan (0.2% glycosaminoglycan hexosamine as percentage of dry weight) that were evenly distributed throughout its length and thickness. Collagen accounted for 80% of tissue mass, and collagen fibers formed parallel arrays running longitudinal to the direction of tensile force. In equilibrium bulk swelling tests, the properties of proximal tissue were uniform throughout the tissue and typical of collagenous tissues in which the response to equilibration in low ionic strength buffers or acid pH is dominated by the collagen network. The anterior aspect of the distal deep flexor tendon articulates with the stiff paratendinous sheath and sesamoid bones and is subjected to compressive and frictional forces in addition to longitudinal tensile forces. Along this anterior surface and extending partially into the tendon is tissue that resembles fibrocartilage with collagen fibers organized as a random network. Greatest glycosaminoglycan hexosamine contents (2-3% of dry weight) were found in the distal surface layer, and large proteoglycans were concentrated at the site receiving direct compressive and frictional loads. Equilibrium bulk swelling tests on distal tissue showed that the articulating surface layer possessed unique material properties. Distal surface layers swelled when counter ions were washed from the tissue, whereas lowered pH had little effect on distal tissue volume. Swelling properties of distal tissue correlated directly with proteoglycan content and were similar to swelling properties of articular cartilage. These results suggest that the articulating layer of distal flexor tendon is adapted for a unique set of mechanical requirements and that an elevated proteoglycan content at the site of compressive and frictional forces contributes to meeting these functional needs. PMID- 3625366 TI - Torsion and bending analysis of internal fixation techniques for femoral neck fractures: the role of implant design and bone density. AB - To evaluate pin/screw/plate fixation for management of femoral neck fractures, 39 proximal femora were tested in both torsion and flexion under physiological loading conditions. Three, four, or five implants of six commonly used multiple fixation devices, and a sliding hip screw with and without an additional 6.5-mm cancellous screw were examined in paired femora. The intact and postfixation femora were initially subjected to a single applied moment, and the torsion and bending stiffness were determined from the load-deformation data. Postfixation femora were also subjected to cyclic loading in flexion at three load ranges, and fixation was judged successful if no failure occurred on or before 1,500 cycles of 667 to 2,000 N of a combined compressive force and moment. Anterior-posterior and lateral radiographs of each specimen were taken after fixation in order to evaluate Singh's index of bone density, fracture reduction, implant placement, and cross-sectional diameter of the femoral neck. Bone density was also evaluated by computed tomography (CT) and physical measurement of core samples obtained from the femoral head. The results indicate that there appears to be no justification for the use of more than three pin/screw implants for management of femoral neck fractures. Bone density was found to correlate with fracture stability and may be a useful predictor of fixation success. PMID- 3625367 TI - Osteonal remodeling in response to screw implantation in canine femora. AB - We examined the patterns of osteonal remodeling associated with the implantation of a screw in the femoral diaphysis of four mongrel dogs. The dogs were killed at intervals ranging from 11 to 93 days after implantation, and resorption spaces and tetracycline-labeled osteons were counted as functions of postimplant time and distance from the screw. The contralateral femur was used as a control. We found that implantation of the screw initiated a sequence of remodeling activity at the screw site; numerous resorption spaces were observed after 3 weeks, followed by numerous refilling osteons at 7 weeks. When sequential sections along the shaft adjacent to the screw were examined, it appeared that the increased resorption and refilling activity subsequently migrated away from the screw site, both proximally and distally. Also, both the implanted and control femurs exhibited occasional zones along the shaft within which the numbers of labeled osteons were sharply reduced. These "extinction zones" were found to be associated with local maxima in resorption space density. We further noted that the ratio of singly to doubly labeled osteons in the experimental control femurs was high as compared with that in humans, but similar to that previously observed in the canine iliac crest. PMID- 3625369 TI - BoneMech database. PMID- 3625368 TI - Production of a reproducible spinal burst fracture for use in biomechanical testing. AB - We have developed a technique to create a reproducible spinal burst fracture of the 12th vertebral body using 6-8-week-old calf spines with ribs, muscles, and vessels resected. We used the entire thoracolumbar segment of 20 calf spines with a standardized 5-mm-deep slice placed onto the body of T12 and the T11-12 disc. We then delivered a proximal-axial impact to the vertically mounted spine, preflexed to 15 degrees of forward flexion, by dropping a 32-kg weight, guided by a 1.55-m steel rod (potential energy = 487 J). Motion was limited to anterior flexion only, at the T12-13 disc, by splinting the rest of the spinal segments. Fractures were documented with the use of radiographs and computed tomography (CT) scans. We noted disruption of the vertebral column and end plates, fracture of the posterior body wall, fracture of the pedicles, and retropulsion of bony fragments into the neural canal. With the production of a reproducible spinal burst fracture model, various spinal fixation devices can be applied and tested. PMID- 3625370 TI - [The University of Pennsylvania Smell Identification Test--on the results of the performed in normal subjects]. PMID- 3625371 TI - [Objective olfactometry by the method of recordings of respiratory resistances]. PMID- 3625372 TI - [Clinical observation of the long-term survivors after treatment of the maxillary malignancies]. PMID- 3625373 TI - [Vibration analysis in middle ear model with artificial ossicles, total ossicular replacement prosthesis (TORP) by holographic interferometry]. PMID- 3625374 TI - [A thermographic studies on the relationships between the nasal skin temperature and nasal airway resistance]. PMID- 3625375 TI - [Equilibrium function of healthy elderly individuals]. PMID- 3625376 TI - [Study of smooth pursuit and saccade using unpredictable target motion]. PMID- 3625377 TI - [Bone conduction hearing in otitis media with effusion]. PMID- 3625378 TI - [Proliferative response of mouse submandibular gland to androgen but not to thyroid hormone]. PMID- 3625379 TI - [A study of body sway by using a stabilometer--fundamental study and clinical significance]. PMID- 3625380 TI - [A cinefluorographic study of hyoid and laryngeal movements during deglutition]. PMID- 3625381 TI - [Activity of the diaphragm and intercostal muscles during the second stage of deglutition]. PMID- 3625382 TI - [Computer analysis of optokinetic nystagmus using principal component analysis]. PMID- 3625383 TI - [Positive intratympanic pressure in the morning and its etiology]. PMID- 3625384 TI - [Tympanoplasty and age]. PMID- 3625385 TI - [Bone destruction in cholesteatoma--Raman spectroscopic analysis on the bone destruction]. PMID- 3625386 TI - [Dynamic behavior of the middle ear--an experimental study of an artificial middle ear model]. PMID- 3625387 TI - [Clinical study of non-Hodgkin lymphoma with involvement of Waldeyer's ring]. PMID- 3625388 TI - [Measurement of comfortable loudness levels--basic study on a new method]. PMID- 3625389 TI - [Three-dimensional computer graphics of the tuba auditiva]. PMID- 3625390 TI - [Clinical histopathological study of the origins of laryngeal carcinoma- influence of smoking on the larynx]. PMID- 3625391 TI - [The inner ear change due to the vibration of a bone-cutting burr]. PMID- 3625392 TI - Fucose-containing antigens in normal and neoplastic human gastric mucosa: a comparative study using lectin histochemistry and blood group immunohistochemistry. AB - The histochemical binding to normal and neoplastic human gastric mucosa of two lectin-peroxidase conjugates which are specific for fucose-containing glycoconjugates is described. The lectins are Ulex europaeus (UEA1) and Lotus tetragonolobus (LTA). Results are compared with ABO and secretor status and the immunohistochemical demonstration of a Type 1 antigen (Lewisa) and two Type 2 antigens (X and H) using monoclonal antibodies. Binding of UEA 1 and LTA to surface mucus cells in normal gastric mucosa is only seen in secretors but is independent of ABO status. In gastric carcinomas lectin binding is reduced. There is a relationship between UEA1 binding and the immunohistochemical demonstration of H Type 2 antigen and secretor activity. In contrast LTA staining is associated with both H Type 2 and Lea antigen but not with secretor status. X antigen is only demonstrable in small amounts. Despite subtle differences in the binding patterns of the two lectins, immunohistochemical studies with monoclonal antibodies against defined oligosaccharides provide greater information. The results of the study are consistent with the hypothesis that competitive interaction between fucosyl and sialyl transferases occurs in gastric malignancy and leads to the expression of abnormal blood group-related antigens. PMID- 3625393 TI - A demonstration of a strain related restriction effect in the formation of experimental metastases. AB - In view of the role of histocompatibility proteins in mediating many types of cell interaction it was decided to investigate their role in the formation of experimental metastatic deposits using the B16 mouse melanoma cell line. The expression of both major histocompatibility complex (MHC) Class I and Class II proteins was studied in vitro. Expression of both MHC Class I and Class II proteins was greater in the highly metastatic F10 cell line as compared with the poorly metastatic F1 line. Intravenous injection of cells into syngeneic and semi allogeneic animals revealed a strain related restriction effect on tumour growth following intravenous injection. However, this was mediated by a locus other than H-2. No restriction of lung trapping of radiolabelled cells or local growth following intraperitoneal injection was found. It is suggested that non-H-2 Class I proteins may mediate some of the stages of metastatic tumour growth independent of the immune system. PMID- 3625394 TI - Airway injury by trichloroethylene: a scanning electron microscopic study. AB - We examined the effects of trichloroethylene (TCE) on the bronchiolar epithelium of mouse lung, using scanning electron microscopy. The lesion elicited by TCE involved predominantly the nonciliated Clara cells of the bronchiolar epithelium. Although there was slight loss of cilia and the mucosal surface exhibited increased deposits of debris throughout the period the tissues were observed, the ciliated cells appeared relatively uninjured. At 24 h following the intraperitoneal administration of TCE (2000 mg/kg) the Clara cells of the bronchiolar epithelium were irregularly distributed on the mucosal surface and reduced in number, indicating loss of cells by exfoliation. The remaining Clara cells appeared deformed and collapsed. This cell population was markedly reduced by seven days after TCE exposure, and the bulging apices characteristic of this cell type were virtually absent, resulting in a flattened epithelial lining. By 15 and 30 days after TCE, reparative processes were evident and micronodules consisting of multiple Clara cells protruded into the airway lumen. The administration of TCE to mice causes severe morphological damage to Clara cells of the bronchiolar epithelium which persists for at least 60 days after chemical exposure. PMID- 3625395 TI - Morphological observations on the gallbladder of ground squirrels fed a lithogenic diet. AB - Richardson's ground squirrels (Spermophilus richardsonii) of both sexes were fed a 2 per cent cholesterol-enriched rat chow diet for intervals of 1, 2, 10 and 20 weeks. Light microscopy and 3H-thymidine autoradiography revealed an increase in cell proliferation prior to the occurrence of macroscopically visible stones, but in the presence of crystals and microliths. Transmission electron microscopy studies showed that columnar epithelial cells undergo mitosis rather than basal cells and that oedematous cells were extruded from the epithelial sheet. Transmission and scanning electron microscopy studies on gallbladders of animals fed the lithogenic diet for 10 and 20 weeks revealed damaged epithelial cells either singly or in groups. Neighbouring cells often slide under the basal aspects of cells being extruded. Hypertrophy, hyperplasia, Rokitansky-Aschoff sinuses, thickening of the lamina propria around the muscle bundles and inflammatory cells in the lamina propria began to occur about the time macroscopically visible stones were present. The epithelium of the Richardson's ground squirrel gallbladder is damaged more slowly than that of other animal models by a cholesterol-enriched, lithogenic diet and may more accurately reflect changes occurring in human cholecystitis. PMID- 3625396 TI - Gastric dysplasia: a stereological and morphometrical assessment. AB - The grading systems of gastric dysplasia suffer from the lack of criteria that separate the changes with an acceptable reproducibility. Repeatable and objective grading of the lesion can be obtained by morphometrically measuring histological criteria normally employed in qualitative grading. In 54 consecutive antrum biopsy specimens in which a blind, independent agreement on the grade of dysplasia had been reached between four independent pathologists, stereological and nuclear morphometrical features have been studied. Single variate, bivariate and multivariate analyses have been performed. Architectural parameters, such as volume and surface densities of glands and epithelium, are especially good discriminators both between mild and moderate, and between moderate and severe dysplasia. Features describing arrangement and shape of nuclei, and nucleolar size are of additional help in improving the objective distinction between moderate and severe dysplasia. PMID- 3625397 TI - Ovarian cancer in women given diethylstilboestrol in pregnancy: two case reports. AB - Two cases of ovarian cancer that developed many years after exposure to large dozes of diethylstilboestrol during pregnancy are reported. This paper is the first such cases reported. PMID- 3625398 TI - Fulminant hepatic failure. PMID- 3625399 TI - Fetal varicella syndrome. PMID- 3625400 TI - Mortality associated with multiple organ system failure and sepsis in pediatric intensive care unit. AB - Seven hundred twenty-six patients from five pediatric intensive care units were studied to determine the association of multiple organ system failure (MOSF) with mortality and to test the hypothesis that MOSF associated with sepsis has a higher mortality rate than MOSF without sepsis. There were 177 (24%) patients with MOSF and 83 (11%) nonsurvivors of MOSF. The mortality rates for two, three, or four or more failed organ systems were 26%, 62%, and 88%, respectively (P less than 0.001). Eighty-four (47%) patients with MOSF had associated sepsis. Sepsis (both bacteremia and clinical sepsis syndrome) did not significantly increase mortality rates in the groups with organ system failure. Mortality rates for patients with sepsis before or within 24 hours of development of MOSF (early sepsis) did not differ from mortality rates for those patients with onset of sepsis more than 24 hours after developing MOSF (late sepsis, 53% vs 33%, P = NS). We conclude that underlying pathophysiologic mechanisms of MOSF other than sepsis are as important as sepsis in critically ill pediatric patients. PMID- 3625401 TI - Corticosteroids in treatment of obstructive lesions of chronic granulomatous disease. AB - Two patients with chronic granulomatous disease had obstructive lesions of the gastrointestinal tract, esophagus, and genitourinary tract, which were successfully treated with corticosteroids. These obstructive lesions, caused by local granuloma formation, have been reported in 18 other patients with chronic granulomatous disease, none of whom received steroids. Our first patient, a 3 year-old boy, had emesis and weight loss associated with antral narrowing and delayed gastric emptying at age 2 years. Antibiotic therapy was ineffective, but intravenous and oral corticosteroid therapy for 10 weeks resulted in clinical cure. One year later, dysuria associated with bladder neck obstruction was also treated successfully with corticosteroids. The second child, a 10-year-old boy, had dysphagia caused by distal esophageal stenosis. Corticosteroid therapy (with concomitant antibiotics) on two occasions reversed this obstruction. Granulomatous cystitis with ureteropelvic obstruction then developed, which also responded to treatment with corticosteroids and antibiotics. Despite the risk of increased susceptibility to infection, corticosteroid therapy is justified in preventing life-threatening obstruction of vital organs. PMID- 3625402 TI - Multiple sclerosis in childhood: clinical profile in 125 patients. AB - Multiple sclerosis (MS) has its usual onset in early adult life (average age of 30 years), but age at clinical onset varies considerably. The implications of the age of onset on the clinical presentation and course of MS are unclear. This population-based retrospective study presents data from a group of 125 patients with onset of MS before age 16 years and can thus be considered as representative of MS occurring in childhood. It demonstrates that childhood MS is more frequent in girls, that it very often has a relapsing-remitting course, that initial bouts usually involve afferent structures of the central nervous system, that recovery from these is often complete, and that the pace of the disease is slow. PMID- 3625403 TI - Management of Chiari II complications in infants with myelomeningocele. AB - Vocal cord paralysis with inspiratory stridor during infancy is a well-recognized complication of the Arnold-Chiari malformation associated with myelomeningocele. Management of these symptoms, however, remains controversial. The outcome in 19 infants with symptoms managed by us during 1978-1984 was therefore reviewed. Ten infants had stridor alone at presentation (clinical grade 1), four infants also had apnea (grade 2), and five infants also had associated cyanotic spells and dysphagia (grade 3). Of 14 ventricular shunt revisions performed, seven were associated with resolution: in five of eight infants with grade 1, two of four with grade 2, and none of two with grade 3 symptoms. Of the 10 posterior fossa decompressions performed, two were associated with clinical resolution: in one of four infants with grade 1, one of two with grade 2, and none of four with grade 3 symptoms. Mortality over 6 months following onset of symptoms was absent among infants with grade 1, one with grade 2, and three with grade 3 symptoms. We propose that differences in outcome among the three groups of infants reflect differences in pathologic processes within the brain stem. We speculate that infants with grade 2 or 3 symptoms have more extensive brain stem damage, such as hemorrhage, infarction, and necrosis. Use of our classification system may be helpful in further studies on intervention modalities in these infants. PMID- 3625404 TI - Comparison of respiratory inductive plethysmography and thoracic impedance for apnea monitoring. AB - Thoracic impedance apnea monitors may fail to detect obstructive apnea, may falsely alarm when the infant is breathing, and may confuse cardiac artifact with respiratory impedance. Therefore, we compared the performance of a respiratory inductive plethysmograph and a thoracic impedance monitor with a reliable measure of airflow, either nasal CO2 or pneumotachograph, during 29 studies in 28 patients referred for sleep laboratory evaluation. Sleep time averaged 72 +/- 37 (SD) minutes. The inductance plethysmography and the impedance monitor detected 99.6% +/- 0.6% and 98.3% +/- 3.0% of breaths, respectively. However, in two studies, the impedance monitor detected many extra breaths, once because of cardiac-induced impedance changes and once because of partial airway obstruction induced impedance changes. In 11 studies, cardiac artifact was sometimes misinterpreted as a breath by the impedance monitor. The impedance monitor, but not the inductance plethysmograph, missed breaths following sighs in 16 of 29 studies. Both monitors detected all 60 episodes of central apnea. The inductance plethysmography detected 35 of 38 episodes of obstructive apnea, but the impedance monitor identified only two such events. Apnea was detected falsely four times by the inductance plethysmograph and 14 times by the impedance monitor. These results suggests that a respiratory inductive plethysmograph would have significant advantages over impedance monitoring, including the ability to detect obstructive apnea, and freedom from cardiac artifact. PMID- 3625405 TI - Risk factors affecting infiltration of peripheral venous lines in infants. AB - The influence of 11 variables on the infiltration of peripheral venous lines (PVLs) was evaluated during 151 infusions in patients younger than 1 year of age. Infusions were followed from the time of cannula placement to discontinuation. Fifty-eight percent of PVLs were infiltrated by 36.30 +/- 33.53 hours (mean +/- SD; median 40 hours, range 10 to 187 hours). No difference between infiltrated and noninfiltrated PVLs was noted with regard to patient age, gender, weight, cannula type, cannula gauge, cannula site, infusion device, potassium or dextrose concentration, medications, or rate of solution administration (P greater than 0.05). Infiltration was observed more often in black than in white infants (P = 0.03) and in patients with lower controller solution head heights (P = 0.01). The time to infiltration was decreased significantly for steel verus Teflon cannulas (P = 0.02), for administration of intravenous medication versus no administration of medication (P = 0.03), for peripheral parenteral nutrition solutions compared with 5% or 10% dextrose solutions (P = 0.014), and with increasing cannula gauge (P = 0.05). The time to infiltration did not differ significantly for gravity controlled versus positive-pressure infusion device delivery (P = 0.51) or for potassium concentrations less than or equal to 20 mEq/L versus greater than 20 mEq/L (P = 0.13). Infusion device occlusion alarms were associated with only 19% of infiltrations. No sloughing of skin or necrosis of tissue occurred related to infiltration. PMID- 3625406 TI - Congenital diaphragmatic hernia: a persistent problem. PMID- 3625407 TI - Corticosteroids for chronic granulomatous disease. PMID- 3625408 TI - Difficulties with ambulatory blood pressure monitoring in children and adolescents. PMID- 3625409 TI - Fusospirochetal ulcerative gingivitis in children. PMID- 3625410 TI - Edema associated with improved glycemic control in an adolescent with type 1 diabetes. PMID- 3625411 TI - Mitral valve prolapse associated with pectus excavatum. PMID- 3625413 TI - Plasma histamine concentrations in evaluation of pediatric mastocytosis. PMID- 3625412 TI - Effects of dietary phosphate restriction in children with chronic renal failure. PMID- 3625414 TI - Ventilatory predictors of pulmonary hypoplasia in congenital diaphragmatic hernia, confirmed by morphologic assessment. AB - We carried out a prospective study in 66 infants with congenital diaphragmatic hernia within the first 6 hours of life to determine whether outcome is related to the degree of underlying pulmonary hypoplasia, as predicted by preoperative PaCO2, when correlated with an index of ventilation (VI = mean airway pressure X respiratory rate) and confirmed by postmortem analysis of the lung. Those infants with PaCO2 greater than 40 mm Hg before surgery had a 77% mortality; when PaCO2 reduction could be achieved only with VI greater than 1000, the mortality was still greater than 50%. After repair, however, the ability to hyperventilate to PaCO2 less than 40 mm Hg proved to be an important determinant of survival; only one of 31 infants in this group died, whereas only two of 27 infants with PaCO2 greater than 40 mm Hg survived. In 16 infants with PaCO2 greater than 40 mm Hg despite hyperventilation, high-frequency oscillatory ventilation was started. This resulted in a rapid fall in PaCO2, but 14 of the 16 infants had only temporary improvement in oxygenation, and died. In five of the infants who died, alveolar number was assessed by postmortem morphometric analysis; there was a severe reduction to less than 10% of published normal neonatal values. Pulmonary vascular changes of increased muscularization were less remarkable than those observed in infants with persistent pulmonary hypertension. Our findings suggest that the degree of pulmonary hypoplasia (which would not be influenced by surgical repair), rather than the pulmonary vascular abnormality, mainly determines survival. Consideration could therefore be given to an initial nonsurgical approach to congenital diaphragmatic hernia, with the expectation that pulmonary function might improve and pulmonary vascular resistance decrease. PMID- 3625415 TI - Effect of surgical repair on respiratory mechanics in congenital diaphragmatic hernia. AB - To determine whether surgical repair of congenital diaphragmatic hernia (CHD) results in improvement in respiratory mechanics, we measured respiratory system compliance in nine patients (five survivors and four nonsurvivors) before and after operation. In all nine infants, CHD was diagnosed within 6 hours of life, and surgical repair was through an abdominal approach after a period of stabilization. Measurements were made noninvasively, using the passive expiratory flow-volume technique. In only one of the nine infants did compliance immediately improve after surgical repair, and in another it showed no change. Both of these infants survived, with an uneventful postoperative course. In the remaining seven infants, however, postoperative compliance immediately decreased to 10% to 77% from the preoperative value. The four infants with more than 50% decrease in compliance died with increasing hypoxemia and acidosis. These results suggest that respiratory mechanics in CHD, far from improving, frequently deteriorate as a result of repair of the hernia. The role of urgent surgery in this malformation should be reevaluated. PMID- 3625416 TI - Reduction of platelet counts induced by mechanical ventilation in newborn infants. AB - The association between platelet counts and mechanical ventilation was assessed in 61 newborn infants with respiratory distress syndrome, 10 infants with congenital diaphragmatic hernia, and 10 infants with tracheoesophageal fistula. A significant decrease in platelet counts was observed during mechanical ventilation: (mean +/- SD) reduction of 39% +/- 5%, 42% +/- 5.6%, and 11.9% +/- 5.4% in the three groups, respectively, independent of other causes. In the group with congenital diaphragmatic hernia, there was a significant correlation between mean airway pressure and the reduction in platelet counts. In a subsequent series of experiments, platelet counts were recorded before and during ventilation in rabbits. A significant mean decrease of 37.3% in platelet counts was associated with ventilation with either air or pure oxygen. Results of these studies indicate that mechanical ventilation itself may cause a major decrease in platelet count in newborn infants. PMID- 3625417 TI - Bone mineralization in preterm infants fed human milk with and without mineral supplementation. AB - The bone mineral status of healthy preterm infants fed maternal milk was compared with that of similar infants fed maternal milk with mineral supplementation. Fifty infants with birth weight less than 1600 g were fed human milk for 1 week until reaching an intake of 120 kcal/kg/d. Thereafter, infants were assigned randomly to one of three diets: (1) continued unsupplemented human milk, providing an intake of 40 to 50 mg/kg/d calcium and 23 to 30 mg/kg/d phosphorus; (2) human milk mixed with a high mineral containing formula, providing total intakes of 130 mg/kg/d calcium and 68 mg/kg/d phosphorus; or (3) human milk alone for 1 additional week, followed by human milk mixed with a powdered fortifier, providing total intakes of 160 mg/kg/d calcium and 90 mg/kg/d phosphorus. Infants fed human milk with formula supplementation, but not those fed human milk with fortifier, had significantly higher serum phosphorus concentrations and significantly lower serum alkaline phosphatase concentrations than did those fed unsupplemented human milk (P less than 0.01). Bone mineral content of the humerus, determined by photon absorptiometry, however, was similar in all three groups; values averaged 0.104 g/cm at the beginning of the study, and remained unchanged irrespective of mineral supplementation. Shortly before hospital discharge, study diets were discontinued and infants were fed standard proprietary formula or were nursed by their mothers. At 44 weeks postconceptional age (7 to 10 weeks after change in diet), infants were reexamined. Serum phosphorus concentrations increased, serum alkaline phosphatase concentrations decreased, and bone mineral content more than doubled to values comparable with those in term infants. Results at follow-up were comparable for all three initial diet groups and for infants who were formula-fed or breast-fed after hospital discharge. The lack of any significant effect of early maternal milk supplementation on bone mineralization by 44 weeks postconceptional age suggests that these methods of supplementation of maternal milk may not be warranted for healthy preterm infants. PMID- 3625419 TI - Localization of surfactant in neonatal lung after exogenous administration. PMID- 3625418 TI - Maturation of antioxidant enzymes in rat small intestine: lack of glucocorticoid stimulation. AB - We report in detail the ontogeny and the response of antioxidant enzymes to glucocorticoids in the rat small intestine. Pregnant rats in the treatment group received four injections of dexamethasone starting on days 18, 19, or 20 of gestation; fetuses were killed 2 days later. Control rats were injected with 0.9% saline solution. Postnatal rats reaching 14, 19, and 104 days of age received four injections of hydrocortisone and were killed 2 days later. Age-matched controls were injected with 0.9% saline solution. The activities of xanthine oxidase, superoxide dismutase, and catalase were measured in small intestines from fetal (20 and 21 days gestation), newborn, and older (aged 16, 21, and 106 days) rats. Xanthine oxidase rose with maturation; the major increase occurred on postnatal day 21. Catalase and superoxide dismutase rose minimally during intrauterine life. On day 16 postpartum, catalase and superoxide dismutase values were 160% and 60%, respectively, higher than at birth. Glucocorticoid administration stimulated maltase and sucrase activities, but had no effect on the antioxidant enzymes or xanthine oxidase. PMID- 3625420 TI - Late hypertriglyceridemia in very low birth weight infants fed human milk exclusively. PMID- 3625421 TI - Outcome of untreated vs treated PKU pregnancies. PMID- 3625422 TI - Solutions for oral rehydration. PMID- 3625423 TI - Endogenous catabolism as source of toxic metabolites in isovaleric acidemia. PMID- 3625424 TI - Occurrence of Cryptosporidium oocysts in sewage effluents and selected surface waters. AB - An existing method for the detection of Cryptosporidium oocysts in water was modified to investigate oocyst prevalence in large volumes of water. Surface waters and sewage effluents were filtered, eluted from the filter, and concentrated using centrifugation. The resultant pellet was then homogenized, sonicated, and placed on a sucrose gradient to separate oocysts from the sediment. The uppermost gradient layer was then examined by immunofluorescence using a labeled monoclonal antibody. Using this technique, average numbers of oocysts detected in raw and treated sewage were 5.18 X 10(3) and 1.30 X 10(3)/L, respectively. Filtered sewage effluents had significantly lower numbers of oocysts (10.0/L). These data show that sand filtration may reduce the concentrations of this parasite in waste waters. Highly variable oocyst numbers were encountered in surface waters. Since Cryptosporidium oocysts are frequently present in environmental waters, they could be responsible for waterborne outbreaks of disease. PMID- 3625425 TI - The response of the intestinal epithelium in B10.A mice to infection with Trichinella spiralis. AB - Previous studies on intestinal trichinosis have dealt mainly with areas other than the intestinal epithelium. Since the epithelium is now known to be the parasite's habitat, its response to infection is important. Infection with Trichinella spiralis in immunologically slow-responding B10.A mice was associated with crypt hyperplasia and villus atrophy. With similar infection levels in both primary and challenge infections, there was no difference in the maximal degree of atrophy or hyperplasia between the 2 groups. However, challenged mice underwent these mucosal changes in about half the time. Expulsion of worms always occurred during regeneration of the intestinal epithelium suggesting that the host's defense mechanism of altering the kinetics of the epithelium was not the prime factor causing expulsion. Pulse labelling of enterocytes with [3H] thymidine showed that there was no significant increase in the relative size of the proliferation zone. This indicates that the crypt cell output was not altered by this parasite. Atrophy of the villus was analysed with respect to its 3 dimensional shape. There was a decrease in both height and width of the villus but not thickness. Thus, there is a real decrease in the size of the enterocyte population per villus. Histochemical staining of the enterocyte brush border by an alkaline phosphatase method showed that (1) hyperplastic crypts have an enlarged maturation zone and (2) the villus epithelium is composed entirely of mature cells. The distribution of the nematode population was compared to these changes in the intestine. Trichinella spiralis showed a marked anteriad (distal to proximal) migration prior to expulsion. Thus, utilizing a novel approach to study intestinal trichinosis, the response of the mucosal epithelium has been characterized. PMID- 3625426 TI - Longitudinal patterns of trypanosome infections in red-spotted newts. AB - Longitudinal data on Trypanosoma diemyctyli infections in individual red-spotted newts, Notophthalmus viridescens, were collected over a 5-yr period. Many newts (37%) retained infections throughout their adult lives and only 4.5% appeared to lose infections following their initial autumn sample. Individual infection levels were higher at their first sample as compared to their second sample. Newts of known age were transplanted between leech-free and leech-infested ponds. The time course of infection between previously exposed and unexposed individuals was similar when both were caged in a leech-infested pond. Previously infected individuals maintained stationary chronic levels for 3 mo in both leech-infected and leech-free ponds. The trends observed in these longitudinal data suggested that transmission by leeches is necessary for infection, that continued transmission does not significantly alter the dynamics of infrapopulation growth and stasis, and that constraints on trypanosome population growth occurred at the host individual level. PMID- 3625427 TI - The effects of gossypol on spermatogenesis and development of the eyefluke, Philophthalmus gralli, and its chicken host. AB - To determine the effects of gossypol, a male antifertility drug, on the eyefluke, P. gralli, this chemical was administered orally to chickens in long-term and short-term regimens. Gossypol acetic acid (GAA), fed to juvenile chickens from 1 to 35 days, caused a decreased weight gain when compared to controls on untreated feed. An FeSO4 supplement to the GAA-fed chickens provided partial protection from the toxic effects of GAA. Worms from GAA-fed chickens were significantly larger than controls, while those from chickens fed GAA + FeSO4 were intermediate in size. Sperm development in these worms was unaffected by GAA. In a second experiment, GAA was administered either in the feed of the hosts from days 35 to 70 or by capsule from days 63 to 77. Worms were exposed to [3H] thymidine, transplanted to the host's eyes, removed on a timed schedule, and processed for autoradiography to determine the rate of spermatogenesis in both GAA-feed and GAA capsule groups. Early stages of spermatogenesis in both groups were unaffected by GAA and later stages developed at a slightly faster rate than reported for worms from chickens on untreated feed. Higher frequencies of testicular anomalies were observed in both groups including 3 testes, 1 testis, no testes, fused testes, degenerating testes, ovarian tissue in the testes, deformed sperm, and encapsulated sperm. Testes from chickens in both groups showed a significantly lower weight and no signs of spermatogenesis when compared to control chickens. PMID- 3625428 TI - Genotype frequency differences in Halipegus occidualis-infected and uninfected Helisoma anceps. AB - Allozyme frequencies in Helisoma anceps infected with the hemiurid trematode, Halipegus occidualis, were compared with those of uninfected H. anceps from a small, North Carolina farm pond. Of 6 loci found to be polymorphic, the frequencies of esterase-1 and leucine aminopeptidase were different in infected and uninfected snails. Genetic heterozygosity, as determined by starch gel electrophoresis, was greater in uninfected H. anceps relative to infected individuals. These observations combined with the high prevalence (up to 60%), complete castration in patent infections, and the absence of an encapsulation response in infected snails, suggest that factors conferring incompatibility may have been selected for in the H. anceps population within the pond. PMID- 3625429 TI - Helminths of the raccoon (Procyon lotor) in western Kentucky. AB - Seventy raccoons (Procyon lotor) from western Kentucky were examined for helminths from December 1985 through May 1986. Twenty-three species of helminths were collected including 10 species of Trematoda (Brachylaima virginiana, Euryhelmis squamula, Eurytrema procyonis, Fibricola cratera, Gyrosoma singulare, Maritreminoides nettae, Mesostephanus appendiculatoides, Metagonimoides oregonensis, Paragonimus kellicotti, Pharyngostomoides procyonis), 2 species of Cestoda (Atriotaenia procyonis, Mesocestoides variabilis), 10 species of Nematoda (Arthrocephalus lotoris, Baylisascaris procyonis, Capillaria putorii, C. plica, Crenosoma goblei, Dracunculus insignis, Gnathostoma procyonis, Molineus barbatus, Physaloptera rara, Trichinella spiralis), and 1 species of Acanthocephala (Macracanthorhynchus ingens). A mean of 6.4 (3-11) helminth species per host was recorded. Fibricola cratera, Atriotaenia procyonis, Mesocestoides variabilis, Arthrocephalus lotoris, Capillaria plica, Dracunculus insignis, Molineus barbatus, and Physaloptera rara were ubiquitous parasites of the raccoon, whereas specific nidi were observed for Eurytrema procyonis, Gyrosoma singulare, Paragonimus kellicotti, Baylisascaris procyonis, Trichinella spiralis, and Macracanthorhyncus ingens. With an overall prevalence of 10% or higher, 15 of the 23 helminth species were considered common parasites of the raccoon in western Kentucky. When the 10% prevalence rate was applied within geographical quadrants to correct for the presence of nidi it was found that 18 of the 23 helminth species were common and 5 were regarded as rare parasites of the raccoon. Two species of nematodes, T. spiralis and B. procyonis, displayed a markedly higher prevalence in male raccoons. PMID- 3625430 TI - In vitro cultivation of Paragonimus miyazakii and P. ohirai. AB - Excysted metacercariae of Paragonimus miyazakii and P. ohirai were cultured in various media at 37.5 C in a 5% CO2 atmosphere. Paragonimus miyazakii grew rapidly and showed a well-developed ovary, uterus, and testes at 172 days in NCTC 109 supplemented with 30% rabbit serum, 50% egg yolk-109, and rabbit red blood cells (RBC's). However, none of the worms formed yolk or eggs in these cultures. On the other hand, P. ohirai grew to the adult stage, in which vitellaria and imperfect ova were formed, in NCTC 109 supplemented with 30% dog serum, 10% yeast extract Earle's solution (YLE), and dog RBC's at 252 days. The maximum body length of these worms measured 7.0 mm (mean 5.5 mm) at 252 days. The dog RBC's were an essential ingredient of the culture medium for the development of P. ohirai. Additions of liver concentrate, chick embryo extract (CEE), and egg yolk 109 in the medium did not provide any additional benefits for the development of worms. Using this supplemented medium, adult worms of P. ohirai removed from rats were maintained in vitro to examine their ability to lay eggs. Egg laying occurred during the first 10-13 days for worms that survived more than 60 days. The number of eggs deposited in this medium was about 2 times that found when Hanks' BSS and NCTC 109 were used. PMID- 3625431 TI - Development of sandfly forms of Leishmania major in sucrose solutions. AB - Stages of Leishmania developing in the vector include different morphs that are exposed first to ingested blood and then to sugar meals. This study sought to determine whether stages occurring in the latter medium could be induced by culturing in sugar-based media. In sucrose solutions, L. major continued to divide and multiplied by 38-46%. Paramastigotes and aflagellates are forms present in late stages of Leishmania infection in Phlebotomus papatasi. They constituted 79% of the forms in sucrose medium, but a maximum of 15% in NNN. Rate and degree of transformation varied as a function of the stage of growth of the NNN starter culture. Motility was lost in sucrose media but was retained in a mixture of sucrose and Ringer's solution. In the latter mixture, the parasites exhibited transformation as well as attachment to the substrate and morphological changes of the flagellum similar to those occurring in the sandfly vector. Parasites from sucrose medium and from P. papatasi reacted similarly, whereas those from NNN reacted differently to a monoclonal antibody. It is suggested that transformation of L. major in sucrose media resembles this process in the vector. PMID- 3625432 TI - Isospora manchacensis n. sp., an intranuclear coccidian from the Louisiana ground skink, Scincella lateralis (Say, 1823) (Lacertilia: Scincidae). AB - Isospora manchacensis n. sp. is described from ground skinks, Scincella lateralis (Say, 1823) from Louisiana. Overall prevalence at 6 sites near Lake Ponchartrain was 43.1% (59/137) and ranged from 8% (1/13) to as high as 60% (6/10). Endogenous stages develop inside the nuclei of epithelial cells in the small intestine. Infected hypertrophic nuclei migrate from the basal lamina of the host cell to the luminal striated border. Oocysts in freshly passed fecal pellets usually contain a single contracted sporont that divides to form 2 sporoblasts. These undergo a brief pyramid stage followed by sporulation within 45-50 hr. Sporulated oocysts have a single-layered wall and measure 25.0 X 22.6 (20.0-28.9 X 18.6 26.0) micron. The lemon-shaped sporocysts measure 12.8 X 10.2 (11.1-15.2 X 9.0 11.0) micron and contain a Steida body, a spherical to oval substeida body, and a dispersed, granular sporocyst residuum. Prepatent periods in skinks fed 700 and 1,400 oocysts ranged from 24 to 32 days. Experimentally infected skinks produced large numbers of oocysts continuously during the 3-4 wk they were monitored after the onset of patency, but exhibited no signs of disease. Experimental doses of 200 oocysts failed to produce infections in skinks monitored for as long as 7 wk. PMID- 3625433 TI - Degenerative changes in the reproductive organs of female schistosomes during maintenance in vitro. AB - Degenerative alteration of the reproductive organs of female schistosomes in correlation with the change in egg-laying rate of schistosome pairs in vitro was studied by electron microscopy. The production of normal eggs by adult S. japonicum pairs decreased after 4 days in vitro followed by an increase of abnormal egg laying up to day 8. In S. mansoni, the yield of both normal and abnormal eggs decreased gradually from the start of maintenance in vitro in spite of a much higher pairing rate than in S. japonicum. The vitelline gland of 14-day in vitro-maintained S. japonicum stained with Fast red B, while that of S. mansoni did not. The ovary of both species exhibited regressive features after 14 days of maintenance in vitro. Ultrastructural examination showed that the vitelline cells and oocytes of S. japonicum and S. mansoni had already lost their structural integrity after 2 days in vitro and continued to exhibit signs of structural degeneration throughout the 14-day in vitro maintenance period. The regressive changes in reproductive potential of female S. mansoni maintained in vitro for 4 days could be reversed by surgically implanting the parasites into mouse mesenteric veins. PMID- 3625434 TI - The role of antibody in African trypanosomiasis. PMID- 3625435 TI - A technique for determining Heligmosomoides polygyrus (Nematoda) worm burden following anthelmintic treatment in mice. PMID- 3625436 TI - Thirty generations of Ancylostoma duodenale in laboratory-reared beagles. PMID- 3625437 TI - Effects of Plasmodium relictum on the metabolic rate and body temperature in canaries (Serinus canarius). PMID- 3625438 TI - A model of the cerebral ganglion in Macracanthorhynchus hirudinaceus (Acanthocephala). PMID- 3625439 TI - Age susceptibility of molluscan intermediate hosts to protostrongylid nematodes. PMID- 3625440 TI - Large genetic distance between Chinese and Philippine Schistosoma japonicum. PMID- 3625441 TI - Natural infection of Plasmodium hermani in the northern bobwhite, Colinus virginianus, in Florida. PMID- 3625442 TI - The use of vacuum in processing intact ticks for histology. PMID- 3625443 TI - Differential susceptibility of snail hosts to Heterobilharzia americana from Texas and Louisiana. PMID- 3625444 TI - Prevalence and intensity of Trichinella spiralis infection in Illinois wildlife. PMID- 3625445 TI - Isolation of mycolic acid-containing glycolipids in Nocardia rubra and their granuloma forming activity in mice. AB - Three classes of glycolipids (TMM (trehalose monomycolate), TDM (trehalose dimycolate) and GM (glucose mycolate] containing mycolic acids as hydrophobic components were isolated from a strain of Nocardia rubra (Rhodococcus rubrum) and their structures have been partially characterized using infrared spectrometry, gas-liquid chromatography and gas chromatography-mass spectrometry. Acid or alkaline hydrolysis of isolated glycolipids revealed that trehalose was the sole water soluble component in TMM and TDM, while glucose was the hydrophilic component in GM. On the other hand, saturated, monoenoic and dienoic mycolic acids with carbon atoms ranging from C36 to C50 contained constituents of fatty acid moiety at C44. From the analytical results, TMM, TDM and GM were tentatively identified as trehalose monomycolate, trehalose dimycolate and glucose monomycolate, respectively. The mycolic acid composition differed significantly by the glycolipid classes: the highest amount of saturated mycolic acids were detected in TMM and GM, while a significant amount of dienoic mycolic acids have been found in TDM and the cell wall bound lipid fraction (BL). All these three classes of glycolipids containing mycolic acids showed strong granuloma forming activity in lungs and spleen of ICR mice 1 week after intravenous injection of 100 to 500 micrograms glycolipid in W/O/W micelles containing Freund's incomplete adjuvant. These results indicated that glycolipids containing shorter carbon chain mycolic acids ranging C40-50, corresponding to less acyl numbers or monosaccharides such as glucose, can also produce foreign body-type granuloma in mice without protein antigens. PMID- 3625446 TI - A possible mode of solubilization of coenzyme Q10 with HCO-60. AB - The redox level of [14C]coenzyme Q10 solubilized with HCO-60 in the livers of guinea pigs at 24 h after intravenous injection was approximately 1/4 (18.2% vs. 63.4%) of that of [14C]coenzyme Q10 solubilized with ethanol-water (1:5 by vol). Further, the redox level of coenzyme Q10 (Q10) solubilized with HCO-60 or ethanol water was 20.2 or 82.3%, respectively, after a 30-min incubation in the liver cytosol. Q10 solubilized with HCO-60 was thus reduced only slightly in vivo or in vitro. The critical micelle concentrations of HCO-60 in the absence and presence of Q10 were 0.02 and 0.002% (w/v), respectively. The concentrations of HCO-60 micelles containing Q10 were estimated to be 0.0048% (w/v) in the incubation mixture with cytosol and 0.0041% (w/v) in blood circulation. These results suggest that HCO-60 micelles containing Q10 would remain more stable not only in blood circulation but also in tissues as compared with ethanol-water emulsion. A possible mode of solubilization of Q10 is discussed. PMID- 3625447 TI - Role of acidic phospholipids in tissue distribution of quinidine in rats. AB - The mechanism of interorgan variation in tissue distribution of quinidine was investigated from a viewpoint of binding characteristics to phospholipids and the composition of phospholipids in various tissues. The order of binding of quinidine to an individual standard phospholipid, expressed as a product of the association constant (K) and the number of binding sites (n), was: phosphatidyl ethanolamine (PhE) less than dipalmitoyl phosphatidyl choline (saturated PhC) less than or equal to phosphatidyl choline (unsaturated PhC) less than phosphatidyl inositol (PhI) less than phosphatidyl glycerol (PhG) less than phosphatidic acid (PhA) less than phosphatidyl serine (PhS). Thus, quinidine was found to bind preferentially to acid phospholipids such as PhS, PhA, PhG, and PhI. The greatest binding was obtained in PhS among the various phospholipids and was more than 300-fold that of neutral phospholipids such as PhC and PhE. The concentration of individual components of phospholipids in the lung, kidney, liver and heart was determined using a two dimensional thin-layer chromatography. The concentration of PhS, highly responsible for the quinidine binding to phospholipids in each tissue, was ranked in the following order: heart less than liver less kidney less than lung. The contribution of PhS to quinidine binding was more than 86% in all tissues. A good correlation between the concentration of PhS in each tissue and the Ct/Cp ratio in vivo was obtained (r = 0.984). Thus, it was concluded that the tissue distribution of quinidine in vivo depended on the composition of phospholipids in tissues and that a determinant of interorgan variation in the tissue distribution of quinidine was the concentration of PhS in the tissues. PMID- 3625448 TI - Effects of some hypolipidemic agents on biochemical values and hepatic peroxisomal enzymes in rats: comparison of probucol, CGA, KCD-232, MLM-160, AL 369 and clinofibrate with clofibrate. AB - The effect of some hypolipidemic agents, which are commercially available and those being developed, on certain biochemical values and on hepatic peroxisomal enzyme activities of rats were examined. Clofibrate (0.25% (w/w) in the diet), p chlorophenoxy-isobutyryl-glycinamide (CGA) (0.25%), clinofibrate (0.1%), KCD-232 (0.1%) and MLM-160 (0.1%) increased the activities of peroxisomal fatty acyl-CoA oxidizing system, carnitine acetyltransferase, and mitochondrial carnitine palmitoyltransferase. Of peroxisomal enzymes, catalase activity was increased by the above agents, whereas the activities of D-amino acid oxidase and urate oxidase were decreased by clofibrate and CGA, and but were increased by KCD-232 and MLM-160 which are structurally unrelated to clofibrate. No influence on these enzyme activities by AL-369 and probucol treatments were observed. Hepatomegaly was induced by clofibrate, CGA, KCD-232 and MLM-160. Concerning serum lipid levels, clofibrate, CGA, clinofibrate, KCD-232 and MLM-160 decreased both cholesterol and triglyceride levels, whereas probucol decreased only cholesterol level. AL-369 had no influence on serum lipid levels under this condition using normolipemic rat. From these results, it was concluded that differing clofibrate and CGA, clinofibrate, MLM-160 and KCD-232 might not induce peroxisome proliferation in hepatic cells, although these have an influence on the enzyme composition of hepatic peroxisomes. PMID- 3625449 TI - Antitumor activity of a new camptothecin derivative, SN-22, against various murine tumors. AB - The antitumor activity of a new camptothecin derivative, SN-22, was evaluated by using various murine tumors. SN-22 showed strong activity against the ascites tumors Ehrlich carcinoma, MM46, CCM, L1210, L5178Y, P388, Meth A, and B16 melanoma. In particular, the maximum increase in life span values for Ehrlich, MM46 and CCM were as high as 253-606% and many mice were cured of these tumors. The effect of SN-22 against solid tumors was also determined. The inhibition ratios were higher than 70% for MM46 and L5178Y. The LD50 of SN-22 in ICR mice was about 1.5 times that of the parent camptothecin. PMID- 3625450 TI - Effects of quinidine and cimetidine on methamphetamine stereotypy in rats. AB - The effects of quinidine and cimetidine on methamphetamine-induced stereotyped behavior were studied in rats. Quinidine (10, 30 and 50 mg/kg) and cimetidine (100, 250 and 500 mg/kg) were administered orally 60 min prior to subcutaneous injection of a fixed dose of methamphetamine (5 mg/kg). It was found that quinidine and cimetidine very markedly potentiated the intensity of methamphetamine stereotypy. The duration of the stereotypy in the group pretreated with either drug was 2.3-4.0 times longer than that in the control group. Furthermore, the urinary pH levels of rats were measured after administrations of methamphetamine alone and of methamphetamine following the drugs in question. Urinary pH was not changed by pretreatments with those drugs, suggesting that the enhancing effects of quinidine and cimetidine on methamphetamine-induced stereotyped behavior are not derived from a change in urinary pH level. The enhancement of methamphetamine-induced stereotyped behavior may be explained by inhibitory effects of quinidine and cimetidine on the metabolism of methamphetamine. PMID- 3625451 TI - Proceedings of the 9th Symposium on the Interaction between Biological Membranes and Drugs. Tokyo. Abstracts. PMID- 3625452 TI - Effects of clobazam on amygdaloid and hippocampal kindled seizures in rats. AB - The effect of clobazam, a 1,5-benzodiazepine, on kindling seizures was compared with the effects of 1,4-benzodiazepines, diazepam and bromazepam, in amygdaloid and hippocampal kindled rats. After kindled seizures were established (stage 5 seizure), the test drugs were administered intraperitoneally. In amygdaloid kindled rats, clobazam significantly suppressed the motor seizures (MS) at doses of 20 and 50 mg/kg and significantly shortened the duration of after-discharge (AD) at doses of 10 to 50 mg/kg. Diazepam at doses of 2 to 10 mg/kg and bromazepam at 1 to 5 mg/kg also significantly suppressed the MS and significantly shortened the duration of AD. Similar suppressive effects by these three benzodiazepines were observed in hippocampal kindled rats. From these results, clobazam was found to have a qualitatively similar but weaker anticonvulsive effect than those of 1,4-benzodiazepines. PMID- 3625453 TI - Pharmacokinetic study of 4-methylumbelliferone in mice. AB - The pharmacokinetic behavior of 4-methylumbelliferone (4-MU), a compound known to be excreted as conjugated metabolites, was studied in mice and the results were compared with those reported in rats. Plasma half-life of the terminal phase (t1/2,beta) of mice after an intravenous administration of 4-MU was approximately one-twenty fifth of that of rats. Mice showed a dose dependency in both hepatic and extrahepatic clearances, though dose dependent hepatic clearance is reported to be the main route of elimination in rats. In the same dose range (10-25 mg/kg), the hepatic intrinsic clearance per unit body weight of mice was approximately 5 times larger than that of rats. The blood-to-plasma concentration ratio and the unbound volume of distribution of tissues of mice were smaller than those of rats. It was concluded that the shorter t1/2,beta of mice than that of rats may be due to the larger hepatic clearance, the presence of extrahepatic clearance and the smaller volume of distribution. PMID- 3625454 TI - Potentiation by bovine serum albumin (BSA) of endothelium-dependent vasodilator response to acetyl glyceryl ether phosphorylcholine (AGEPC). AB - Endothelium-dependent vasodilator responses of isolated rat aortic strips precontracted with norepinephrine to acetyl glyceryl ether phosphorylcholine (AGEPC) were compared in the presence and absence of bovine serum albumin (BSA). In the absence of BSA, AGEPC produced endothelium-dependent relaxation at concentrations higher than 10(-6) M, which was considered to be non-specific because similar relaxations were produced by other phospholipids (e.g., lysolecithin) at the same concentration range. This non-specific relaxation was suggested to be caused by changes in membrane fluidity of endothelial cells, since high concentrations of AGEPC and other phospholipids were found to produce structural changes in endothelial cells by phase contrast and electron microscopic studies; structural changes were never observed after the application of acetylcholine (ACh). In the presence of BSA (2.5 mg/ml), AGEPC caused endothelium-dependent relaxation at concentrations as low as 10(-9)M; however, relaxations by ACh and lysolecithin were not augmented by the presence of BSA. CV 3988 (10(-5)M), a specific antagonist of AGEPC, inhibited the relaxations by AGEPC in the presence of BSA. From these results, it is suggested that, in the presence of BSA, AGEPC may produce endothelium-dependent relaxation in a specific manner, which is different from the non-specific relaxations observed in the absence of BSA. PMID- 3625456 TI - Age-related incidence of pineal gland calcification in children: a roentgenological study of 1,044 skull films and a review of the literature. AB - Anterior-posterior and lateral skull roentgenograms of 1,044 children aged 0-18 yr were examined for pineal gland calcification. Eighty children with pineal calcification were identified. Cranial computed tomograms (CCT) existing for half of the 80 cases provided confirmation. In contrast to existing reports on pineal calcification in the first decade of life, we found a significant percentage of "physiological" calcification even between 0 and 6 yr of age (range 2.9-4.2%). Contrary to current opinion we were not able to detect any signs of pineal gland tumors in these cases. We were able to confirm other reports which note a steep rise of the incidence of pineal calcification during the second decade of life. PMID- 3625455 TI - Multiple forms of arylalkylamine N-acetyltransferases in the rat pineal gland: purification of one molecular form. AB - Rat pineal serotonin N-acetyltransferase (EC 2.3.1.87) activity is isolated in two molecular forms (Mr approximately equal to 10,000 and 95,000) by high performance size exclusion liquid chromatography in the presence of ammonium acetate (0.1 M, pH 6.5). In the presence of sodium citrate (0.1 M, pH 6.5), however, it is eluted as a single peak of intermediate size (Mr approximately equal to 30,000). A highly enriched preparation of one of the molecular forms has been obtained by a two-step purification procedure involving disulfide-exchange and anion-exchange chromatography. The N-acetyltransferase in 250 pineal glands obtained from isoproterenol-treated rats can be purified about 80-fold in 1 day; recovery is about 3%. Polyacrylamide gel electrophoresis of the final preparation indicates that a single major band (Mr approximately equal to 11,000) is present; this appears to be serotonin N-acetyltransferase. PMID- 3625457 TI - The isolation, purification, and characterisation of the principal urinary metabolites of melatonin. AB - Melatonin is metabolised by hydroxylation to form 6-hydroxy-melatonin and by demethylation to form N-acetyl-serotonin, which are excreted as sulphate and glucuronide conjugates. We required these metabolites as pure powders and therefore undertook their isolation and characterisation. Three volunteers ingested 1 g each of melatonin, and their urine was collected and pooled. For the sulphate conjugates, a Lichoprep column was used to concentrate the metabolites and to remove most of the urea. The sulphate conjugates were separated from the glucuronides on a Florisil column and further purified on a fractogel column. They were separated by high-performance liquid chromatography (HPLC) resulting in white powders of 6-hydroxy-melatonin sulphate (SaMT) and N-acetyl-serotonin sulphate (SNAS). For the glucuronide conjugates, an aliquot of the pooled urine was taken to dryness, the residue was dissolved in methanol, and the solution was filtered. The methanol filtrate was taken to dryness, and the residue was applied to a Florisil column. The isolated glucuronide conjugates were recrystallized prior to separation by HPLC, which gave pure white powders of N-acetyl-serotonin glucuronide (GNAS) and 6-hydroxy-melatonin glucuronide (GaMT). Characterisation was achieved by using infrared and ultraviolet spectroscopy, thin-layer chromatography (TLC), and gas chromatography-mass spectrometry (GCMS). These techniques unambiguously confirmed the assigned structures for SaMT and SNAS and fully supported the assigned structures for GNAS and GaMT. Three TLC solvent systems were used, and in each case the individual conjugated metabolite appeared as a discreet spot. Purity, as assessed by GCMS, was shown to be greater than 95% for SNAS, SaMT, and GaMT and to be 88% for GNAS. PMID- 3625458 TI - Lower tryptophan:phenylalanine ratios in culture media increase medium: pineal melatonin ratios in early dark but not late light phase. AB - Pineals from male Long-Evans rats (60-65 days old; adapted to a 0700-1900 photoperiod) were cultured for 6 h either in light (1200-1800) or in dark (1800 2400). The objective was to ascertain the effects of tryptophan (trp) and phenylalanine (phe) levels and ratios in the culture medium on melatonin levels in the pineals and their respective media. Total culture (pineal + medium) melatonin levels, determined by RIA, were similar under all conditions. However, in cultures during the early dark phase (1800-2400) lower trp:phe ratios in the medium led to lower pineal:medium ratios of melatonin content. In cultures during the late light phase (1200-1800) the trp:phe ratio had little impact on the pineal:medium distribution of melatonin. Trp:phe ratio rather than absolute level of either amino acid appeared responsible for this effect. Functionally this means that during early dark phase, but not late light phase, movement of melatonin from cultured pineal to medium is progressively facilitated by lower trp:phe ratios. It remains to be determined to what extent darkness per se and/or endogenous pineal rhythmic mechanisms have a permissive role in the action of trp:phe ratio on pineal melatonin release. A melatonin compartmentalization/release effect of these or other amino acids, or their ratios, has not been reported previously and may possibly contribute to mechanisms for melatonin's transport or release at night. PMID- 3625459 TI - Melatonin, cortisol, prolactin, and calcitonin secretion in primary hyperparathyroidism before and after surgery. AB - The aim of the present study was to determine the diurnal secretion of melatonin, cortisol, prolactin, and calcitonin during chronic parathyroid hormone-dependent hypercalcemia. Eight women, aged 40-76 years, with primary hyperparathyroidism (PHPT) were studied before and after surgical removal of a parathyroid adenoma. The hormone concentrations in blood were determined at 08, 12, 16, 22, 02, 04, and 06 h. Concomitantly, the excretion of melatonin and cortisol in urine between 07-19 h and 19-07 h, and the clearance of calcium and creatinine were measured. Nyctohemeral serum prolactin and calcitonin were unaffected by moderate parathyroid hormone-dependent hypercalcemia. In contrast, serum cortisol and melatonin were significantly higher during active disease than after surgical cure. Mean 24-h variation of serum cortisol was 349 +/- 34 nmol/liter vs. 223 +/- 17 nmol/liter and mean serum melatonin was 0.13 +/- 0.04 nmol/liter vs. 0.06 +/- 0.02 nmol/liter. Endogenous creatinine clearance was similar before and after surgery, while the clearance of melatonin and cortisol significantly increased after surgery, indicating an increased tubular reabsorption of both hormones during active disease. Fasting morning glucose concentrations were also significantly decreased after successful surgery, 6.1 +/- 0.6 vs. 5.2 +/- 0.5 mmol/liter. It is suggested that the relative hypercortisolism may be the cause of the glucose intolerance in primary hyperparathyroidism. Three to 4 months after surgical cure the serum melatonin levels were significantly lower than those seen in age-matched controls, indicating a melatonin insufficiency in patients successfully treated for PHPT. The meaning of this finding is not yet understood but might be of importance in the development of primary hyperparathyroidism. PMID- 3625460 TI - Persistence of photic evoked responses in pineal gland after its pedunculotomy and superior cervical ganglionectomy. AB - The present study analyzes the participation of pineal stalk and superior cervical ganglia (SCG) in the conduction of photic evoked potentials (PEP) to the pineal body (PB) in unanesthetized freely moving rats implanted with semimicroelectrodes. The PEPs were recorded in PB, lateral hypothalamus (LH), and habenular complex (HC). In some rats the pineal stalk was lesioned either by electrolysis or by surgical means. Recordings were begun 3 days after electrode implantation; three recording sessions were performed before and after extirpation of SCG or lesion of pineal stalk. The PEPs recorded in LH and HC were characterized by 3 components (positive-negative-positive: PNP). The average latency of the first wave was 35.3 +/- 1.7 and 38.8 +/- 1.6 ms for LH and HC, respectively. The peaks of PEPs in PB showed different polarity (NPN), and the first component had a latency of 36.1 +/- 1.2 ms. The PEPs persisted in all three structures after extirpation of SCG and after electrolytic lesion or transection of the pineal stalk. These results show that the PEPs recorded in PB are not generated in this structure, since they persist after interrupting its connections with the rest of the central nervous system; this suggests that PEPs could be the result of electrotonic transmission from neighboring structures. PMID- 3625461 TI - Mechanism of inhibition of bovine pineal gland hydroxyindole-O-methyltransferase (EC 2.1.1.4) by divalent cations. AB - The effect of inhibitory cations on hydroxyindole-O-methyltransferase (HIOMT) was investigated in order to elucidate the mechanisms involved. Copper inhibition of HIOMT can be classified as partial, classic noncompetitive inhibition with respect to S-adenosyl methionine and as partial, mixed noncompetitive inhibition with respect to N-acetylserotonin. Binding of copper to the enzyme impaired but did not prevent catalysis, and the difference in inhibitory pattern observed with both substrates may be due to the obligatory order of substrate binding to HIOMT. Calcium and magnesium were uncompetitive inhibitors of HIOMT with respect to both substrates and binding of these cations to the enzyme prevents catalysis. The cations presumably bind to HIOMT in the vicinity of the catalytic site and in some way prevent or impair the catalytic process, possibly by interfering with substrate binding to the enzyme, interfering with methyl transfer or product release after catalysis, or a combination of these effects. The different inhibitory patterns observed may result from differences in molecular size or outer electron shell valence of the cations. PMID- 3625462 TI - Pineal, retinal, serum melatonin, and N-acetylserotonin rhythms in chicks on reversing light regimen and eye covering. AB - After reversing a 12:12-h light-dark regimen of environmental lighting, pineal and retinal melatonin levels of white leghorn chicks recorded at the first mid darkness were greatly enhanced and reached maximum levels after three more days; those recorded during the light periods indicate gradual decline but were far from the nadir of the original light period, even at the end of the experiment. The first mid-darkness serum melatonin levels recorded after photoperiod reversal were not much different from their original mid-light values. However, on continuing with the reversed regimen, the next mid-darkness levels were sharply increased, and maximum levels were reached after a further 2 days. Under the same experimental conditions light had much more drastic effects, and 6 h on the reversed regimen were sufficient to bring down completely the high value of the original mid-darkness period to the level of the starting mid-light nadir. Retinal N-acetylserotonin (NAS) measured simultaneously had a pattern similar to that of melatonin, but the pineal NAS rhythm did invert completely, albeit gradually. Eye covering did not prevent inversion of pineal and serum melatonin rhythms, which were identical in eye-covered and sighted control chicks on the reversed regimen of light. However, retinal melatonin values of the light periods were significantly less depressed in eye-covered than in sighted control chicks. Moreover, eye covering completely prevented the retinal NAS depression under light but did not affect pineal NAS. During darkness retinal and pineal NAS elevation was sluggish in the eye-covered chicks. PMID- 3625463 TI - Phase delay of the rhythm of 6-sulphatoxy melatonin excretion by artificial light. AB - The purpose of this study was to investigate the effect of bright artificial light exposure on the rhythms of 6-sulphatoxy melatonin and cortisol excretion in urine. Six healthy males were exposed to light (greater than 3,000 lux) from 1900 to 0200 h (sunset 1928 h) on one occasion. The artificial light delayed the onset of 6-sulphatoxy melatonin excretion. On the next evening the onset of 6 sulphatoxy melatonin excretion in normal light/darkness was delayed by 1 h. The timing of the peak excretion of cortisol was not affected by the light treatment; however, cortisol excretion rate was maintained at a significantly higher rate in the morning and afternoon after the treatment. These results demonstrate the inhibitory action of high intensity light in humans and suggest that one 6-h period of extra light in the evening can phase delay the melatonin onset. PMID- 3625464 TI - Effects of olfactory bulbectomy, melatonin, and/or pinealectomy on three sublines of the Dunning R3327 rat prostatic adenocarcinoma. AB - Conventional antiandrogen therapy for prostatic cancer generally results in the death of androgen-dependent cells, resulting in shrinkage of the tumor, followed by regrowth of the tumor as androgen-insensitive cells take over. Because of reported antigonadotropic and antineoplastic effects of the pineal hormone melatonin (MEL), we hypothesized that this indole might provide an effective therapy for prostate cancer, as it would be effective against both populations of tumor cells. We used three sublines of the Dunning R3327 rat prostatic adenocarcinoma to determine whether MEL could suppress the growth of these tumors and, if so, by what mechanisms this occurs. In one experiments, we compared the growth of a well-differentiated slow-growing Dunning tumor in rats given MEL combined with the potentiating procedure olfactory bulbectomy (BULBX), with that in rats pinealectomized (PINX) or untreated. Tumor growth in BULBX-MEL rats was significantly suppressed over that in the other two groups, as were the weights of the gonads and accessory sex glands. Tumor morphology, DNA concentration, and androgen receptor concentration and distribution were identical in untreated controls and in BULBX-MEL rats, suggesting that the treatment affected all populations of tumor cells equally. With another strain of well-differentiated slow-growing Dunning tumor, we examined the effects of MEL in rats with and without BULBX. Reproductive parameters were not suppressed in BULBX-MEL rats and, while there was a trend toward slower tumor growth in this group, this was not significant. Intact rats given MEL grew larger tumors than did control rats but, again, differences were not significant. In a third experiment, we examined a fast-growing androgen-insensitive anaplastic Dunning tumor. PINX was without effect on this tumor, but BULBX-MEL resulted in a significant suppression of one of the constants in the logistic equation fitted to the growth curves. This indicates that there were some direct antitumor effects of BULBX-MEL on this tumor strain. We conclude that MEL suppresses growth of some Dunning tumor strains. PMID- 3625465 TI - Gonadal regression induced by caloric restriction is not mediated by the pineal gland in deer mice (Peromyscus maniculatus). AB - The role of the pineal gland in mediating reproductive regression in response to nonphotoperiodic cues was assessed. A proportion of deer mice (Peromyscus maniculatus) undergo gonadal regression subsequent to moderate food restriction. The reproductive regression after inanition qualitatively and quantitatively resembles short-day-induced regression. The physiological mechanisms responsible for gonadal regression after food restriction are unknown. The hypothesis that the mechanisms underlying photoperiodic responsiveness also mediate testicular regression caused by reduced food consumption was tested. Males were pinealectomized or received sham operations. Upon recovery, food availability was restricted to 70% of ad libitum intake. After 8 weeks, the reproductive condition was examined. Pinealectomy did not prevent gonadal regression, suggesting that the pineal gland does not mediate caloric information in this species. PMID- 3625466 TI - Guilt following transgression: an attribution of responsibility approach. AB - People typically experience guilt when they violate sociomoral norms. Using Heider's (1958) attribution of responsibility model in the two experiments reported here, I examined the attributional mediators of posttransgression guilt. The basic design of both studies was a Level of Responsibility X Subject Role factorial. The first study used a role-playing methodology; in the second, subjects generated protocols describing their own past experiences. The second experiment also distinguished between attributions of responsibility, causality, and blame. In both studies, harmdoer guilt was higher following accidental as opposed to intentional transgressions. The discussion focuses on the dynamics of guilt development and reduction and on the importance of maintaining conceptual distinctions among the various attribution measures in future guilt research. PMID- 3625467 TI - Appraisals of control and predictability in adapting to a chronic disease. AB - In a sample of 92 patients with rheumatoid arthritis, we examined interrelations among various control appraisals, illness predictability, psychosocial adjustment, mood, and illness status. Perceiving greater personal control over the disease and symptoms and perceiving greater health-care-provider control over symptoms were associated with greater illness predictability. Patients reported more personal control over their symptoms than over the course of the disease and thought that their health care providers had more control over disease course than they did themselves. Multiple regression analyses showed that perceiving greater personal control over one's medical care and treatment was associated with positive mood and psychosocial adjustment. Negative mood was also associated with the belief that providers have greater control over the patient's daily symptoms. Patients who had a more severe disease and expressed greater personal control over its course reported greater mood disturbance and were rated as exhibiting less positive adjustment, but those who had more severe daily symptoms and expressed greater personal control over their symptoms reported less mood disturbance. These findings are discussed in terms of the possible benefits of patients' active participation in their care and the implications of perceiving personal and others' control over more or less controllable aspects of the illness, especially when the illness is more severe. PMID- 3625468 TI - Reactions of would-be helpers whose offer of help is spurned. AB - An experiment was conducted to test the proposition that rejection of help by a needy recipient constitutes a negative expectancy violation for the would-be helper. The helper will react to this self-threat by expressing negative affect, unfavorable evaluations of the recipient, low attraction to the recipient, and causal attributions for the rejection that cast the recipient in an unflattering light. To test these hypotheses, college freshmen were prompted to offer rules for word construction to a same-sex recipient (a confederate) who was described as needing remediation on vocabulary and who "failed" a practice task. After rejecting/accepting the help, the recipient failed or succeeded on a comparable task. The results were consistent with these predictions. Dispositionally high expectations of interpersonal success served to amplify helpers' reactions to rejection/acceptance. PMID- 3625469 TI - Type A behavior, achievement striving, and a dysfunctional self-evaluation system. AB - We conducted two experiments to examine the relations among characteristics of how Type A individuals strive for achievement, including goal achievement, self evaluation, and psychological distress. We evaluated these relations as subjects performed two sequential general information tests. Experiment 1 indicated that achievement striving associated with the Type A behavior pattern is characterized by a tendency to set personal goals in excess of performance and is associated with a low probability of achieving goals. The results of Experiment 2 indicated that the achievement strategy Type A individuals adopted was associated with low self-evaluation of their actual performance. Furthermore, a pre- and postexperiment self-report questionnaire of psychological state suggested that failure to achieve personal goals was related to increased psychological distress. The results of our study suggest that unrealistically high performance standards and failure to achieve personal goals may be a mechanism that triggers the negative psychological states and performance dissatisfaction associated with the Type A behavior pattern. Our study also supports theoretical conceptualizations that excessive achievement striving can act as a potential motivational mechanism but can also have potential pathogenic consequences through misregulation of achievement expectancy and evaluation. PMID- 3625470 TI - Fantasy proneness and psychopathology. AB - Fantasy prone persons ("fantasizers") selected from "normal" populations report experiences associated with psychopathology in clinical populations (e.g., fantasies that reach hallucinatory proportions, difficulty discriminating reality from fantasy). In Study 1, we administered objective (MMPI) and projective (Rorschach) measures to high fantasy prone individuals (upper 4% of college population), medium fantasy prone individuals (middle range), and nonfantasizers (lowest 4%). Subjects who were fantasizers appeared to use fantasy for defensive or adaptive purposes compared with others and produced 8/9 modal code types on the MMPI. On the basis of the MMPI findings, a subset of fantasizers could be described as exhibiting a significant degree of psychopathology. In Study 2, a second sample of fantasy prone individuals could not be distinguished from comparison groups in contacts with professionals for help with psychological problems, use of psychotropic medication, or number of close friendships. Although fantasizers perceived themselves as less well adjusted than comparison subjects and reported greater difficulty in distinguishing fantasy from reality, most fantasizers rated their psychological functioning as adequate and above and did not differ from less fantasy prone subjects in ratings of positivity of self concept. As demonstrated in Study 1, a subset of fantasizers did appear to be more pathological than other subjects were, with three fantasizers reporting a history of psychiatric hospitalizations. It is estimated that between 10 and 20% of fantasizers exhibit significant signs of maladjustment/psychopathology; however, as a rule, fantasy proneness does not appear to be antecedent to severe manifestations of psychopathology. PMID- 3625471 TI - Does coping help? A reexamination of the relation between coping and mental health. AB - In a longitudinal community survey of 291 adults, we explored the relation between coping strategies and psychological symptoms. Respondents completed the revised Ways of Coping Scale (Folkman & Lazarus, 1985) for a self-named stressful episode. Factor analysis produced eight coping factors: three problem focused, four emotion focused, and one (support mobilization) that contained elements of both. Multiple regression analyses indicated bidirectionality in the relation between coping and psychological symptoms. Those in poorer mental health and under greater stress used less adaptive coping strategies, such as escapism, but coping efforts still affected mental health independent of prior symptom levels and degree of stress. We compared main versus interactive effects models of stress buffering. Main effects were confined primarily to the emotion-focused coping scales and showed little or negative impacts of coping on mental health; interactive effects, though small, were found with the problem-focused scales. The direction of the relation between problem-focused scales and symptoms may depend in part on perceived efficacy, or how the respondent thought he or she handled the problem. Implications for the measurement of adaptive coping mechanisms and their contextual appropriateness are discussed. PMID- 3625472 TI - Attributions and expectations: a confluence of vulnerabilities in mild depression in a college student population. AB - The reformulated model of learned helplessness assumes that attributional style has its impact on depression in part through the intermediary effect of pessimistic or negative expectations about the occurrence of future outcomes. A possible logical next step in testing the model is to measure jointly attributions and expectations and to examine their combined (interactive) contributions. We used a short-term longitudinal design to examine whether attributional style works in combination with other factors, such as expectations, to predispose individuals to depression. Consistent with the initial theoretical analysis, the interaction of attributional style and expectations predicted depression on the Beck Depression Inventory 6 weeks later. We also found that attributional style predicted depression 6 weeks later in interaction with initial level of depression. These findings support our confluence hypothesis, which assumes that vulnerability factors can combine interactively and qualify the effects of attributional style. These interaction effect findings have implications for currently popular cognitive theories of depression and for previous research on vulnerability to depression that has examined only the effects of single cognitive variables (such as attributional style) considered alone. Further study is also necessary to determine the nature of the overlap of the effects of expectation and initial level of depression. PMID- 3625473 TI - A computer-based measure of resultant achievement motivation. AB - Three experiments were conducted to develop a computer-based measure of individual differences in resultant achievement motivation (RAM) on the basis of level-of-aspiration, achievement motivation, and dynamics-of-action theories. In Experiment 1, the number of atypical shifts and greater responsiveness to incentives on 21 trials with choices among easy, intermediate, and difficult levels of an achievement-oriented game were positively correlated and were found to differentiate the 62 subjects (31 men, 31 women) on the amount of time they spent at a nonachievement task (watching a color design) 1 week later. In Experiment 2, test-retest reliability was established with the use of 67 subjects (15 men, 52 women). Point and no-point trials were offered in blocks, with point trials first for half the subjects and no-point trials first for the other half. Reliability was higher for the atypical-shift measure than for the incentive responsiveness measure and was higher when points were offered first. In Experiment 3, computer anxiety was manipulated by creating a simulated computer breakdown in the experimental condition. Fifty-nine subjects (13 men, 46 women) were randomly assigned to the experimental condition or to one of two control conditions (an interruption condition and a no-interruption condition). Subjects with low RAM, as demonstrated by a low number of typical shifts, took longer to choose the achievement-oriented task, as predicted by the dynamics-of-action theory. The difference was evident in all conditions and most striking in the computer-breakdown condition. A change of focus from atypical to typical shifts is discussed. PMID- 3625474 TI - Hemagglutinating activity in phytopathogenic bacteria surface compounds. AB - Extracellular components of plant pathogenic bacteria were obtained from their culture medium as well as from the whole cells by using NaCl 1 M, pH 6.0; 20% sucrose dissolved in 0.03 M Tris buffer, pH 8.0; or 0.05 M Na2EDTA. All the extracts from Erwinia carotovora subsp. carotovora, Xanthomonas campestris pv. campestris, Pseudomonas syringae pv. phaseolicola, Xanthomonas campestris pv. phaseoli, Pseudomonas solanacearum, and Erwinia carotovora subsp. atroseptica, were assayed for hemagglutinating activity on sheep, rabbit and chicken red blood cells (RBCs). The only active extracts were those obtained by NaCl treatment. They agglutinated sheep and rabbit erythrocytes. Extracts from E. carotovora subsp. atroseptica gave rise to the high agglutination titer on rabbit RBCs. These extracts had the lowest polysaccharide/protein ratio. E. carotovora subsp. carotovora extracts showed only a low titer (18.5 units). The agglutinating activity present in NaCl extracts of the bacteria tested was inhibited by different carbohydrates to various extent. Extracts from E. carotovora subsp. atroseptica appeared to be the most sensitive ones while those of E. carotovora subsp. carotovora least sensitive to the presence of sugar. It is suggested that hemagglutinins observed in plant pathogenic bacteria and those in plant host are similar and that both may, in some way, be involved in the plant-parasite relationship. PMID- 3625475 TI - Fatty acids and production of tylosin-like compounds in Streptomyces fradiae. AB - The composition of fatty acids and the spectrum of macrolide antibiotics produced in 7 mutant strains of Streptomyces fradiae, a tylosin producer, were investigated. The strains under investigation differed in the production level and representation of individual tylosin-like compounds. The composition of fatty acids in the mycelium did not depend on the total production. However, the strains producing relomycin in addition to tylosin produced a significantly higher fraction of fatty acids with a higher melting point, and, on the contrary, the strains producing only tylosin or tylosin and desmycosin synthesized a significantly lower proportion of these acids. The results obtained indicate that in addition to the activity and substrate specificity of secondary metabolism enzymes, the composition of the tylosin-like compounds produced can be influenced by the cell membrane and its function. PMID- 3625476 TI - [Demonstration of an NAD-dependent 6-phosphogluconate dehydrogenase in Pseudomonas syringae pv. phaseolicola]. AB - Crude extracts from cells of Pseudomonas syringae pv. phaseolicola, a fluorescent pseudomonad, when grown on glucose contain a NAD-linked 6-phosphogluconate dehydrogenase. The reaction of the enzyme, which produces 14CO2 from 1-14C-6 phosphogluconate, is not inhibited by NaF, a potent inhibitor of the Enter Doudoroff (ED) pathway enzyme 6-phosphogluconate dehydratase. In the presence of phosphate or arsenate ions the NAD-linked glyceraldehyde-3-phosphate dehydrogenase reacts with glyceraldehyde-3-phosphate which, in the ED pathway, is produced from 6-phosphogluconate and overlaps the 6-phosphogluconate dehydrogenase reaction. Only a small proportion of glucose is metabolized via the 6-phosphogluconate dehydrogenase/oxidative pentose phosphate pathway. PMID- 3625477 TI - Preclinical modeling of changes in drug kinetics caused by acute renal failure in rats. AB - The rates of total and extrarenal elimination of amikacin, cefoperazone, ceftriaxone, gentamicin, mesocain, theophylline, tobramycin, and polyfructosane-S were determined in rats with intact kidneys and in those after bilateral nephrectomy. While the values of the elimination constants of the tested drugs were markedly higher in the rats than in man, the ratio of nonrenal and total elimination constants, expressing the fraction of drugs eliminated extrarenally, is close to the value found in man. These findings suggest that the model might be useful in preclinical drug testing and can help in the prediction of changes in the kinetics of drugs caused by renal failure. PMID- 3625479 TI - Protein binding of glycopeptide antibiotics with diverse physical-chemical properties in mouse, rat, and human serum. AB - In previous studies of the pharmacokinetics and urinary excretion of nine glycopeptides with diverse isoelectric points (pI), as pI decreases, the total systemic and renal clearance, urinary recovery, and volume of distribution decrease, whereas the half-life increases. With glycopeptides of similar pI, clearance decreases and half-life increases with increasing lipophilicity. The present study examines the serum protein binding of these glycopeptide antibiotics in mouse, rat, and human serum and calculates the previously reported pharmacokinetic parameters for these drugs based on unbound concentration. Increased negative charge and lipophilicity increase serum protein binding (90 fold, fu 83% to 0.96%), which decreases the renal clearance and total systemic clearance (90-fold, 16.4 to 0.18 ml/min/kg) of these drugs. Increased serum protein binding also decreases the volume of distribution of these compounds, but this change is relatively small (sixfold, 755 to 131 ml/kg) compared with the change in total systemic clearance causing an increase in elimination half-life (25-fold, 20 to 492 min). The results demonstrate that the large differences in the total systemic clearance and half-life of these glycopeptide antibiotics are primarily due to dramatic differences in serum protein binding and not to differences in the intrinsic elimination processes (enzymes or transport proteins). It appears that the same physical-chemical properties that govern the protein binding and pharmacokinetics of small organic molecules govern the disposition of these high-molecular weight glycopeptide antibiotics. PMID- 3625478 TI - Kinetics of ajmaline disposition and pharmacologic response in beagle dogs. AB - Pharmacokinetics and pharmacodynamics of ajmaline were studied in four healthy dogs after intravenous administration of the drug at the infusion rate of 1.0 mg/min for 45 min. Ajmaline exhibited a saturable binding to plasma protein. One kind of binding site was found in the range of observed drug concentrations and its binding capacity showed nearly threefold interindividual difference. The time course of ajmaline concentration in whole blood Cb could be described by the two compartment open model and the unbound concentration of ajmaline in plasma Pf was estimated from Cb by using the hematocrit value and the parameters of plasma protein binding and erythrocyte partitioning. The pharmacologic responses to ajmaline were assessed by recording ECG, and the changes in PQ and QRS interval were studied in relation to ajmaline disposition. When ECG changes were related to the ajmaline concentration, a significant degree of hysteresis was observed. The relationship between the unbound drug concentration and the pharmacologic effect was analyzed by a combined pharmacokinetic-pharmacodynamic model, where the hypothetical effect compartment is connected to the Pf in the central compartment by a first-order process. This model allows estimation of the changes in PQ and QRS intervals after intravenous administration of ajmaline. By comparing the drug effect on PQ and QRS intervals, it was suggested that ajmaline distributes to the atrial and the ventricular tissue in a similar degree and causes a reduction in the conduction rate in both sites with similar activity. PMID- 3625480 TI - Generalizations in linear pharmacokinetics using properties of certain classes of residence time distributions. II. Log-concave concentration-time curves following oral administration. AB - The present approach enables a noncompartmental assessment of log-concave plasma concentration-time profiles following oral drug administration. Observed log concavity corresponds to a nonparametric class of residence time distributions with the following properties: (1) The fractional rate of elimination kB(t) (failure rate of the distribution) increases monotonically until reaching the terminal exponential coefficient kB,Z. (2) The relative dispersion of body residence times CVB2 (ratio of variance to the squared mean, VBRT/MBRT2) acts as a shape parameter of the curve. The role of the input process in determining the shape of the concentration profile is discussed. In this connection evidence is provided for the importance of log-concave percent undissolved versus time plots, introducing the general concept of a time-varying fractional rate of dissolution. The governing factor for the appearance of log-concavity is the ratio of mean absorption time to mean disposition residence time (MAT/MDRT); this factor exceeds a particular threshold value which depends on the distributional properties of the drug. Generalizing previous approaches which are valid for first-order input processes, the "flip-flop" phenomenon and the problem of "vanishing of exponential terms" are explained using fewer assumptions. Upper bounds for the elimination time (more than 90% eliminated) and the cutoff error in AUC determination are presented. The concept of log-concavity reveals general features of the pharmacokinetic behavior of oral dosage forms exhibiting a dominating influence of the absorption/dissolution process. PMID- 3625481 TI - Some clarifications regarding moments of residence times with pharmacokinetic models. AB - The stochastic formulation of linear kinetic models is elaborated in order to introduce some new concepts and help clarify the meaning and role of residence time moments. Certain conditional moments are introduced. Multicompartment and steady-state dosing within the stochastic context are considered. A general model independent formula for steady state volume of distribution and a new concept of steady-state moments are presented. A technique for constructing a model of a given topology from its moments is also given. PMID- 3625482 TI - A note on confidence intervals with extended least squares parameter estimates. AB - It has previously been shown that the extended least squares (ELS) method for fitting pharmacokinetic models behaves better than other methods when there is possible heteroscedasticity (unequal error variance) in the data. Confidence intervals for pharmacokinetic parameters, at the target confidence level of 95%, computed in simulations with several pharmacokinetic and error variance models, using a theoretically reasonable approximation to the asymptotic covariance matrix of the ELS parameter estimator, are found to include the true parameter values considerably less than 95% of the time. Intervals with the ordinary least squares method perform better. Two adjustments to the ELS confidence intervals, taken together, result in better performance. These are: (i) apply a bias correction to the ELS estimate of variance, which results in wider confidence intervals, and (ii) use confidence intervals with a target level of 99% to obtain confidence intervals with actual level closer to 95%. Kineticists wishing to use the ELS method may wish to use these adjustments. PMID- 3625483 TI - Salicylate and mitochondrial monoamine oxidase function in Reye's syndrome. AB - The main objective of this investigation was to study the effect of salicylate on platelet mitochondrial monoamine oxidase (MAO) activity isolated from blood of two patients with Reye's syndrome. Comparative studies were made with hospitalized children without Reye's syndrome (n = 27) and healthy children (n = 19) serving as controls. Platelet MAO was measured by a radioenzymatic technique with [14C]tyramine as a substrate. The results of this study showed that salicylate (1.0 mM) caused an appreciable inhibition of the platelet MAO activity of patients with Reye's syndrome at the onset of the illness. This was demonstrated by a greater than 50% reduction in enzyme maximum velocity (Vmax) value. The salicylate MAO-inhibitory effect was maintained throughout the duration of the illness. Salicylate had only a minimal MAO-inhibitory effect on platelets isolated from blood of recovered Reye's syndrome patients, healthy controls, and non-Reye's hospitalized children, and no apparent effect on enzyme Vmax values. These preliminary findings suggest that salicylate-induced mitochondrial injury may affect MAO function in children with Reye's syndrome. PMID- 3625485 TI - Evaluation of a chronically isolated internal loop in the rat for the study of drug absorption kinetics. AB - A model is described to study absorption kinetics of drugs in the unanesthetized rat. The surgical technique consists of a long-term isolation of an intestinal segment inside the animal. This isolated loop is used in perfusion experiments. In this model the effects of anesthesia and surgical trauma on absorption kinetics are absent. In addition, this model allows for cross-over experimental schemes. Absorption kinetics are evaluated on the basis of steady-state blood levels (Css) of the perfused drug, since the animal can be used in experiments over a long time period. Steady-state blood levels can be used as a measure of the absorption if the compound under investigation shows linear elimination kinetics. Dantrolene sodium was used as a model compound to evaluate this technique. The elimination of dantrolene sodium followed linear kinetics after different intravenous doses in the same rat. The half-life of elimination (t1/2 beta) of dantrolene sodium was approximately 45 min. Perfusions of two different concentrations of dantrolene sodium in the same rat showed that an increase of the perfusate concentration results in a proportional increase in the Css. A prerequisite for performing cross-over experiments is that the absorption characteristics of the isolated segment are constant during the experimental period. This model showed a constant absorption of dantrolene sodium on consecutive days, over a two-week period, in the same rat. PMID- 3625486 TI - Plasma and saliva propafenone concentrations at steady state. AB - Twenty-four healthy male subjects were administered 300 mg of propafenone every 8 h for 6 d in each of two phases that were separated by 2 d. Plasma samples were collected during the approach to steady state for each phase, and plasma and saliva samples were collected frequently at steady state. Both plasma and saliva propafenone were assayed by a specific HPLC method. Two estimates of elimination half-life (t1/2), mean steady-state concentration (CPss), time to maximal concentration (tmax), and maximal concentration (CPmax) were estimated for each subject. Also mean steady-state saliva concentrations (CSss), time to maximal saliva concentration (tSmax), and maximal saliva concentrations (CSmax) were estimated. A large intersubject variance in both t1/2 and CPss were observed in the 24 subjects, with the t1/2 values ranging from 2.1 to 27.2 h and the CPss values from 0.3 to 3.03 microgram/mL. Each subject was quite consistent for the two phases, suggesting a relatively low intrasubject variance for propafenone kinetics. A histogram shows most subjects to have t1/2 values between 2 and 10 h, with diminishing numbers of subjects at greater t1/2 values rather than a bimodal distribution. Saliva concentrations ranged from 12 to 72% of the corresponding plasma concentrations, being 24.7 +/- 11.1% of the simultaneously collected plasma sample overall (mean +/- SD). a significant (p less than 0.001) positive correlation exists between CPss and CSss. PMID- 3625484 TI - Influence of urinary pH on the disposition of methoxyphenamine and three metabolites in humans. AB - The disposition of methoxyphenamine (o-methoxy-N,alpha-dimethylphenethylamine) and three of its metabolites was studied in five healthy volunteers on three occasions, with the urine pH separately under uncontrolled, acidic, and basic conditions. All five volunteers were extensive metabolizers of debrisoquine and methoxyphenamine, the latter with respect to O-demethylation and aromatic 5 hydroxylation. The plasma peak concentration and the area under the curve of methoxyphenamine from 0 to infinity did not differ significantly during the three phases of the study. However, on the average, its renal clearance increased by fivefold and its plasma terminal half-life decreased by twofold in the acidic as compared with the alkaline urine condition. The urinary excretions of methoxyphenamine and its metabolites N-desmethylmethoxyphenamine and O desmethylmethoxyphenamine were significantly enhanced in the uncontrolled pH and the acidic urine conditions as compared with the alkaline urine condition. By contrast, the urinary excretion of the 5-hydroxymethoxyphenamine metabolite was not significantly affected by urinary pH variations. The mean urinary excretion ratios methoxyphenamine: O-desmethylmethoxyphenamine and N desmethylmethoxyphenamine: O-desmethylmethoxyphenamine did not differ significantly during the three phases of the study, whereas the methoxyphenamine:5-hydroxymethoxyphenamine and N-desmethylmethoxyphenamine:5 hydroxymethoxyphenamine ratios were significantly altered during the alkaline phase as compared with the other two phases. Therefore, the ratios in terms of O desmethylmethoxyphenamine are recommended for phenotyping individuals when using methoxyphenamine as a metabolic probe. PMID- 3625487 TI - Bioequivalence and pharmacokinetic profile of promethazine hydrochloride suppositories in humans. AB - A bioequivalence study of promethazine hydrochloride (10-[2 (dimethylamino)propyl]-phenothiazine monohydrochloride) was conducted in 20 male human subjects with the purpose of comparing, under blind condition, the human serum levels of promethazine in three different formulations. The formulations tested were a 50-mg promethazine hydrochloride polyethylene glycol suppository, a 50-mg promethazine hydrochloride cocoa butter-white wax suppository, and a 50-mg oral dose of promethazine hydrochloride syrup. Each subject received single doses of each of the three formulations on each of three different days on a crossover basis. From the measured serum levels, estimates of the bioavailability parameters (area under the serum concentration versus time curve, time-to-peak serum concentration, and peak serum concentration) were obtained by least-squares digital computer fitting. Also, a one-compartment pharmacokinetic open model with two consecutive first-order input steps is proposed. Statistical analysis of the results was performed by using a linear multiple regression approach for the analysis of variance. No significant differences between the syrup and the polyethylene glycol suppositories were obtained (p greater than 0.05) for the above three bioavailability parameters. However, the polyethylene glycol suppositories provided statistically higher peak serum concentration, shorter time-to-peak serum concentration, and larger area under the serum concentration versus time curve than the cocoa butter-white wax suppositories. PMID- 3625488 TI - Evaluation of in vivo drug release by numerical deconvolution using oral solution data as weighting function. AB - Determination of in vivo drug release using compartmental model analysis is hampered by problems such as flip-flop phenomena and vanishing exponential terms. The usefulness of numerical deconvolution to estimate in vivo drug release was evaluated in this study by means of simulated data comparing solid dosage forms with a solution as a reference standard. Concentration-time data were generated using the standard linear two-compartment body model with various first-order release and absorption rate constants. Random errors of 5 and 10% were added to data sets for further analysis. The results of the study using error-free data afforded excellent agreement with the theoretical values except in one case where the release rate constant was overestimated by 6%. When random error was added to the data, the resulting in vivo release profile showed considerable fluctuation and no single rate constant could be assigned. However, further analysis showed that the method does not create additional error during the calculating process, as previously suggested, but merely reflects the inherent error added to the raw data. If the raw data are poor, no useful information can be obtained without using an arbitrary technique such as smoothing or fitting. In this regard, the time course of drug release obtained after numerical deconvolution merits investigation. PMID- 3625489 TI - In vivo percutaneous penetration of some organic compounds related to anatomic site in humans: predictive assessment by the stripping method. AB - The effect of anatomic site on the in vivo relationship between the total penetration of four compounds and the amount of the compounds present in the stratum corneum at the end of application was studied in humans. For each anatomic site, 1,000 nmol of 14C-radiolabeled benzoic acid, benzoic acid sodium salt, caffeine, or acetylsalicylic acid was applied to 1-cm2 area of skin of male Caucasian patients aged 28 +/- 2 years (groups of 6-8). For each molecule and each site, a first application on the right-hand side of the body allowed total absorption to be determined by measuring the amount excreted in the urine. A second application, performed 48 h later on the contralateral site, enabled the total amount of substance present in the stratum corneum at the end of application (30 min) to be assessed after cellophane-tape stripping of the treated area. The results showed that skin permeability varied substantially, depending both on the physicochemical nature of the molecule and on the anatomical location. In general, the rank order in skin permeability of the studied areas appears to be as follows: arm less than or equal to abdomen less than postauricular less than forehead. Whatever the compound applied, the forehead was approximately 2 times as permeable as the arm or abdomen. Independent of the origin of the differences in permeability observed among sites, there exists a linear correlation (r = 0.97, p less than 0.001) between the amounts of substance present in the stratum corneum at the end of application (30 min) and the total amounts which penetrated within a 4-d period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625490 TI - Osmotic water transport through cellulose acetate membranes produced from a latex system. AB - The advisability of a progressive curtailment of organic solvent film coating offers an incentive to develop latex systems. Here, the use of aqueous colloidal dispersions of cellulose acetate, plasticized with water-soluble additives, is proposed as an alternative way to obtain cellulose acetate membranes either by casting or spraying. The osmotic water permeability of both kinds of films was measured, as well as their loss of leachable materials and degree of swelling in a saturated solution of potassium chloride. The permeabilities varied over a wide range depending on the physicochemical properties of the plasticizer and its initial concentration in the latex, and on the conditions for coating (temperature, rate of spraying, and drying duration). High boiling point plasticizers gave more permeable films. Films prepared by casting were found to be sensitive to their sodium dodecyl sulfate content. PMID- 3625491 TI - Concentration-effect relationships of tetrabenazine and dihydrotetrabenazine in the rat. AB - To investigate the pharmacodynamics of tetrabenazine [1,3,4,6,7,11b-hexahydro-3 isobutyl-9,10-dimethoxy-2-H-benzo(a)quinol izine-2- one; 1], the drug of choice in the control of Huntington's chorea and tardive dyskinesia, and its major metabolite, dihydrotetrabenazine (2), ip doses of 3 mg/kg of the drug and the metabolite were administered to rats. Animals were decapitated at 0.0, 0.5, 2, 5, and 12 h. Brain and serum concentrations of 1 and 2, and brain concentrations of dopamine, norepinephrine, and serotonin were measured. Time courses of 1 and 2 in the brain (site of action) were parallel to those in serum, indicating that the brain is a part of the central compartment for both compounds. Despite its greater polarity, 2 was able to readily cross the blood-brain barrier. The monoamine depletions at any time following the administration of 2 were at least equal to or greater than those observed following the administration of the same dose of 1. After both compounds, the maximum serum and brain concentrations and maximum depletions were observed with the first sample at 0.5 h, with dopamine and serotonin being the most and least affected, respectively. The brain levels of the amines returned to the control values a maximum of 12 h after ip injections of either 1 or 2. Sigmoidal relationships were found between the monoamine levels and the corresponding log brain or serum concentrations of 1 or 2. The concentration-response curves of 2 following the administration of 1 and 2 were superimposable, suggesting that the observed activity after tetrabenazine injection is mainly, if not entirely, due to the formation of the active metabolite.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625492 TI - Inimical effects of compaction speed on microorganisms in powder systems with dissimilar compaction mechanisms. AB - Tablets were prepared from powders that were consolidated by plastic deformation and fragmentation mechanisms. Cells of Staphylococcus aureus and spores of Bacillus subtilis were incorporated in the tablets by compaction at various pressures and compression speeds. The extent of inactivation of organisms was dependent on the compression behavior of the powders, on the speed of compaction, and on the degree of densification of compacts. Scanning electron micrographs of fractured compacts revealed that particle rearrangement, fragmentation, and deformation significantly influence the "survivor". The "pressure-survivor plots" showed a linear relationship with greater inactivation in brittle material, while the extent in inactivation was reduced, and followed a nonlinear pattern in those powders exhibiting plastic deformation. PMID- 3625493 TI - Particle design of tolbutamide in the presence of soluble polymer or surfactant by the spherical crystallization technique: improvement of dissolution rate. AB - Poorly soluble crystals of tolbutamide were modified in the presence of a soluble polymer or surfactant by the spherical crystallization technique, the objective being to improve the dissolution rate and to transform platelet crystals into spherical agglomerates. An HCI solution was added to a tolbutamide:NaOH solution containing a water-soluble polymer or surfactant. The tolbutamide crystals were agglomerated with either and were free flowing and spherically compact. The size of the crystals of the agglomerate depended on the viscosity of the solvent and adsorption of the surfactant onto the crystal surface. The tolbutamide agglomerated crystals dissolved isotropically, with no evidence of disintegration. The dissolution process was described in terms of the Hixson Crowell equation. The dissolution rate of the agglomerate was 8 times faster than that of conventionally crystallized tolbutamide. Therefore, the solubility and flow-ability of tolbutamide can be improved using the spherical crystallization technique. PMID- 3625494 TI - Binding mechanism of doxorubicin in ion-exchange albumin microcapsules. AB - The absorption efficiency of cross-linked albumin microcapsules was evaluated as a function of various experimental conditions in an attempt to elucidate the doxorubicin binding mechanism of these microcapsules. The amount of drug absorbed augmented with increasing doxorubicin concentration until saturation was reached. Neither a Langmuir nor a Freundlich isotherm relationship was observed, indicating that the fixation of doxorubicin on the microcapsule walls did not follow a common physical adsorption process. Decreasing the mean particle diameter of the microcapsules increased the absorption rate and the total amount of doxorubicin absorbed, as expected. The absorption rate was enhanced by the elevation of the stirring rate of the aqueous drug solution. Furthermore, the presence of electrolytes in this aqueous solution profoundly altered the absorption profile of doxorubicin. Increasing the NaCl concentration in the solution reduced the total amount of drug absorbed. Moreover, the nature of the cation used also affected the absorption profile. These results suggested that there is a competitive fixation of the cation on the binding sites (identified as R-COO groups) available to the drug molecules. The weakly cross-linked microcapsules acted as cation-exchange resins which can exchange their labile sodium with the protonated drug present in the solution. This was also confirmed by the results of the titrimetric assay of the acidic microcapsules with NaOH. PMID- 3625495 TI - Cyclic voltammetry of quinolinium salts and related compounds: correlation with structure and anticancer activity. AB - Cyclic voltammetry data were obtained for 12 salts of quinolines, one pyridine, and one open-chain imine which possess varying degrees of anticancer activity. The structural features include sidechain bis(2-methylthio)vinyl, 2-methylthio-2 aminovinyl, dithioacetic acid, 2-quinolylvinyl, 2-styrylvinyl, and guanidine sulfide functionalities. Reduction potentials ranged from -0.43 to -1.08 V. The electrochemical results are correlated with structure. A possible mechanism of anticancer action is addressed. PMID- 3625496 TI - Ion-selective electrodes for the H2-receptor antagonists cimetidine and ranitidine. AB - Liquid-membrane and polyvinyl chloride (PVC)-matrix ion-selective electrodes (ISE) that respond to the cationic forms of cimetidine and ranitidine are described. The ion-exchangers were the salts of cimetidine and ranitidine with tetrakis(m-chlorophenyl)borate dissolved in p-nitrocumene or entrapped in PVC polymer in the presence of 2-nitrophenyl octyl ether as plasticizer. The electrodes exhibited a near-Nernstian response in the range 10(-2)-10(-6)M (working pH range 2-7) for ranitidine, and 10(-2)-2 X 10(-5)M (pH 2-6) for cimetidine. Very small PVC-matrix ISE with internal diameters as small as 0.035 inches were constructed and used in combination with small cuvettes, so that measurements could be carried out in 250 muL of stirred solution. The electrodes were applied successfully for the determination of the pKa of the protonated bases and for the determination of the drugs in pharmaceutical preparations. New selective and effective solid-state extraction procedures are described for the extraction of ranitidine from urine and serum samples. Potentiometric methods were developed for the determination of ranitidine in urine and serum samples during a pharmacokinetic experiment. PMID- 3625497 TI - Enzyme-linked immunosorbent assay for LY163502, a potent dopamine agonist. AB - A rapid and sensitive enzyme-linked immunosorbent assay (ELISA) for the potent selective dopaminergic receptor (D2) agonist, LY163502, is described. The ELISA is a competitive assay in which peroxidase-labeled LY163502 competes with unlabeled LY163502 for binding to solid-phase antibodies specific for LY163502. The limit of detection is 8 pg/mL; intra- and interassay coefficients of variation are 7.2 and 12.3% respectively, for human plasma determinations. Recovery of LY163502 from plasma and urine is quantitative. We found two potential metabolites of LY163502, despropyl-LY163502 and N-oxide LY163502, to be 44 and 0.5% cross-reactive at the ED50 level, respectively. However, LY163502 levels measured by the ELISA and by a specific gas-liquid chromatography (GLC) assay are highly correlated [Pearson's correlation coefficient, r = 0.964]. This suggests that the ELISA assay of biological fluids is not affected by cross reactivity due to LY163502 metabolites. Application of the ELISA to the measurement of LY163502 in biological fluids is demonstrated. PMID- 3625499 TI - Older and wiser? PMID- 3625498 TI - Identification and synthesis of O-methylcatechol metabolites of phenobarbital and some N-alkyl derivatives. AB - 5-Ethyl-5-(4-hydroxy-3-methoxyphenyl) barbituric acid was identified as a new, minor metabolite of phenobarbital in man. The identity of this O-methylcatechol metabolite was confirmed by an unequivocal chemical synthesis, and by GC-MS studies. Mephobarbital and the 1,3-dimethyl, 1-ethyl, and 1,3-diethyl analogues of phenobarbital yielded the corresponding N-alkylated O-methylcatechol metabolites, all of which were confirmed by synthesis. The N-alkyl barbiturates each gave additionally at least one O-methylcatechol metabolite in which N dealkylation had occurred. These metabolites accounted for approximately 1-5% of the orally administered dose in man. PMID- 3625501 TI - Basic science research. PMID- 3625500 TI - Podiatric medical literature. Progress, pitfalls, and prognostications. PMID- 3625502 TI - Postgraduate education. PMID- 3625503 TI - Podopediatrics. The past, present, and future challenge. PMID- 3625504 TI - Podiatric dermatology. PMID- 3625505 TI - Podiatric sports medicine. PMID- 3625506 TI - Podiatric surgery. A maturing specialty. PMID- 3625507 TI - A new era for podiatric biomechanics. PMID- 3625508 TI - Podogeriatrics. PMID- 3625509 TI - Podiatric medicine and public health. PMID- 3625510 TI - Pathologic diagnosis in podiatric medicine. PMID- 3625511 TI - Arthroscopic approaches to the joints of the foot. PMID- 3625512 TI - Arthroscopic treatment of transchondral lesions of the talar dome. PMID- 3625514 TI - Computerizing with confidence. Tips for the uninitiated. PMID- 3625513 TI - Medical imaging of the foot and leg. An overview. PMID- 3625515 TI - Intercapsular cataract microsurgery. PMID- 3625516 TI - Intraocular lens calculation formulas for new intraocular lens implants. AB - Several different formulas are available for preoperative calculation of the required implant power for a desired postoperative refraction. However, the application of both theoretical and statistically derived regression formulas to the new generation of soft intraocular lens implants poses several difficulties. In this paper the calculation of an A constant for a specific intraocular hydrogel lens implant, as well as the derivation of a universal theoretical formula, is described. The theoretical formula can be applied to other implant styles with various optical configurations and composed of different biomaterials. The SRK and theoretical formulas have been applied retrospectively to a series of patients receiving an intraocular hydrogel lens implant. A comparison shows that both perform satisfactorily in predicting the desired postoperative refraction. PMID- 3625517 TI - Comparison of the effect of polymethylmethacrylate and silicone intraocular lenses on rabbit corneal endothelium in vitro. AB - An in vitro comparison of corneal endothelial damage caused by polymethylmethacrylate and by silicone intraocular lenses was made. Endothelial damage was assessed by vital staining of corneal endothelium immediately following direct contact with an intraocular lens. Silicone lenses produced less damage than polymethylmethacrylate lenses. The difference could be attributed to a specific type of damage-membrane stripping-seen only after contact with polymethylmethacrylate lenses. PMID- 3625518 TI - Effect of the Nd:YAG laser on polymethylmethacrylate, HEMA copolymer, and silicone intraocular materials. AB - Recent trends of cataract extraction feature both small surgical wounds and preservation of posterior capsules. The development of safe, reliable, and flexible implant materials that can withstand near impact with a Nd:YAG laser during secondary posterior capsule discissions are required. An in vitro experiment was performed to analyze the effects of Nd:YAG laser irradiation on polymethylmethacrylate (PMMA), hydroxyethylmethacrylate (HEMA), hydroxyethylhydroxymethylmethacrylate (HEMA-MEMA) copolymer combination, and a silicone compound. The HEMA and HEMA-MEMA compounds were the least susceptible to Nd:YAG laser damage in this laboratory setting. PMID- 3625519 TI - Intraocular lens implantation in an underdeveloped country. AB - The results of 152 intraocular lens implantations performed at Mbabane Government Hospital, Swaziland, Africa, on 114 African patients with senile cataracts are presented. Surgery was performed with manual equipment and procedures. Lens implantation was accompanied by a low rate of postoperative complications. Uncorrected visual acuity of 20/120 or better was achieved in 79.6% of patients. The advantage of IOL implants over low-cost aphakic spectacles in Third World countries is discussed. PMID- 3625520 TI - Myopic keratomileusis: results with a follow-up over one year. AB - We report one-year follow-up results on 23 eyes in which we performed myopic keratomileusis. The mean refraction changed from -11.09 diopters (D) preoperatively to -3.66 D postoperatively. In all but two cases, keratometry was reduced one year postoperatively. The average corneal thickness decrease was 0.139 mm. In nine eyes, irregular astigmatism severely affected vision. We do not feel that keratometry changes and refractive changes can be statistically related, nor can corneal thickness and postoperative irregular astigmatism. Although myopic keratomileusis is a technically safe treatment, it is not a precise, predictable method for correcting myopia. PMID- 3625521 TI - Vitreous loss in posterior chamber lens implantation. AB - Management of posterior capsule rupture and vitreous loss associated with intraocular lens implantation is described and the results of the procedure statistically analyzed. Vitreous loss occurred in 18 (4.3%) of the 416 eyes treated during a one-year period. Of these 18 eyes, 11 received posterior chamber lenses and seven received anterior chamber lenses; all lenses remained adequately fixated. The visual acuity, incidence of postoperative complications, and endothelial cell loss were not significantly different in the eyes that had posterior capsule rupture and vitreous loss and in the control eyes. Although posterior chamber lens implantation is not necessarily contraindicated in eyes with vitreous loss, instances of high endothelial cell loss suggest the need for greater attention to the endothelial cells during vitrectomy. PMID- 3625522 TI - Prolapse of a rigid anterior chamber lens through an iridectomy: report of ten cases. AB - I have observed ten cases in which a rigid anterior chamber lens prolapsed through the iridectomy. The lens dislocation was associated with cystoid macular edema in four cases and threatened the cornea in two cases. Vitrectomy and replacement with a flexible lens resulted in good vision. Removing the prolapsed lens haptic proved to be easy. Visual prognosis is good. PMID- 3625523 TI - Capsular bag intraocular lens fixation with retention of the anterior capsule. AB - In-the-bag fixation of a posterior chamber intraocular lens (IOL) may be performed with greater protection of the uveal tract if the anterior capsule is retained so the IOL is almost completely enveloped in the capsular bag. A surgical technique for capsular bag fixation without anterior capsulectomy and a bulbous-tipped scratcher devised for use with this technique are described. PMID- 3625524 TI - Roundel phacoemulsification technique for in-the-bag intraocular lens fixation. AB - We introduce a new phacoemulsification technique that removes a cataract and retains a 5-mm round, tear-free opening in the anterior capsule, and present the results in 100 eyes. This technique is extremely useful in retaining the integrity of the capsular bag, which is indispensable for long-term capsular bag fixation, and is also a preliminary step in mastering endocapsular (intercapsular) phacoemulsification. We call this the roundel technique. PMID- 3625525 TI - Computerized case records for the office. PMID- 3625526 TI - Iris pigment loss and hyphema secondary to anteriorly tucked posterior chamber intraocular lens loops. PMID- 3625527 TI - Operating room retinoscopy. PMID- 3625528 TI - Stableflex lens report. PMID- 3625529 TI - Intraocular lens calculations. PMID- 3625531 TI - Anterior chamber lens terminology. PMID- 3625530 TI - Injectable prostaglandin inhibitors prior to cataract surgery. PMID- 3625532 TI - Pale optic disc following cataract surgery. PMID- 3625533 TI - Amygdaloid influences on brain-stem neurones in the rabbit. AB - 1. Electrical stimulation of the central nucleus of the amygdala in the urethane or alpha-chloralose anaesthetized rabbit evokes a bradycardia with a rapid onset and a concomitant fall in arterial blood pressure. 2. Extracellular neuronal activity was recorded in the ipsilateral nucleus tractus solitarius and dorsal vagal nucleus whilst stimulating the ipsilateral central nucleus of the amygdala, the aortic and vagus nerves. 3. A total of 213 neurones were activated by stimulation of at least one of these inputs. 93 of these neurones received a marked excitatory input from the central nucleus with a wide range of latencies (2-100 ms). 50 of these cells also received inputs from either the aortic or vagus nerves, or both. 4. The activity of 42 vagal preganglionic neurones was recorded in the dorsal vagal nucleus of which 22 had properties typical of cardioinhibitory neurones. 9 of these vagal motoneurones received inputs from the central nucleus with latencies between 2 and 100 ms. Of these, 5 had physiological properties indicating they were cardio-inhibitory neurones. 5. We conclude that neurones in the nucleus tractus solitarius and dorsal vagal nucleus can be influenced by descending inputs arising from the central nucleus of the amygdala. Some of these neurones are also likely to be influenced by afferents innervating the thoracic viscera and arterial baroreceptors. The implications of these observations on the role of forebrain-brain-stem interactions in cardiovascular control are discussed. PMID- 3625534 TI - Effects of membrane potential on intracellular calcium concentration in sheep Purkinje fibres in sodium-free solutions. AB - 1. The intracellular Ca2+ concentration [( Ca2+]i) was measured in voltage clamped sheep cardiac Purkinje fibers while recording tension simultaneously. 2. When [Na+]i was elevated (by Na+-K+ pump inhibition) depolarization produced an increase of tonic tension. 3. Replacement of external Na+ by Li+ or choline produced a contracture which then relaxed spontaneously. Following this relaxation, depolarization either had no effect on tonic tension or produced a small decrease. 4. When external Na+ was replaced by Ca2+, depolarization (over the range -120 to -20 mV) produced a decrease of tonic tension and [Ca2+]i. Hyperpolarization increased tonic tension and [Ca2+]i. 5. An after-contraction and accompanying increase of [Ca2+]i were produced by repolarization in both Na+ free and Na+-containing solution. This eliminates the possibility that the stimulus for the after-contraction is the increase of [Ca2+]i during the depolarization and suggests that the stimulus may be the change of membrane potential. 6. The increase of [Ca2+]i on hyperpolarization seen in Na+-free solutions persisted in the presence of ryanodine. 7. These results show, in contrast to previous work, that in Na+-free solutions tonic tension is still sensitive to membrane potential. The results support the hypothesis that, in Na+ containing solutions, the increase of tonic tension on depolarization results from a voltage-dependent Na+-Ca2+ exchange. The reduction of tonic tension on depolarization in Na+-free solutions may be due to the decrease of the electrochemical gradient for Ca2+ to enter the cell. PMID- 3625535 TI - Irregularity of rest and activity: studies on circadian rhythmicity in man. AB - 1. Rectal temperature, electrolyte excretion and performance were studied in young adults who followed an irregular pattern of work and rest for 9 days in an isolation unit. 2. In the analysis, effects evoked by the pattern of work and rest were separated from the oscillatory component, and rhythms for individual days were examined by the cosinor method. 3. During the schedule, rhythms no longer showed a period of exactly 24 h, and this effect was confirmed by studies using a repeated cycle of irregular work and rest and by studies using constant routines. 4. Temperature and urinary constituents differed in the strength and phase of their rhythms when corrected for evoked effects, as well as in the strength of the evoked effects themselves. 5. There was evidence of deterioration in performance during work periods which exceeded 9 h, but there was no evidence of progressive deterioration in performance over the 9 day schedule. PMID- 3625536 TI - Changes in elemental concentrations of rat parotid acinar cells following pilocarpine stimulation. AB - 1. Quantitative electron microprobe analysis was used to measure elemental dry weight concentrations in cytoplasm, secretory granules and nuclei of resting and pilocarpine-stimulated rat parotid gland acinar cells. 2. Secretory granules in resting cells had lower concentrations of Na, Mg, P, Cl and K, and higher concentrations of S and Ca than cytoplasm or nuclei. Nuclei in resting cells had lower S and higher K concentrations than cytoplasm. 3. Three major pilocarpine related changes were found: (i) cytoplasmic dry weight concentrations of Na and Ca increased and the concentration of K decreased, (ii) the nuclear concentration of Na increased while that of K decreased and (iii) the concentrations of Na and Cl increased in secretory granules. 4. These results indicate that the nuclear, and cytoplasmic compartments have different mechanisms for regulating their elemental concentrations relative to the secretory granules. 5. The present results are largely consistent with X-ray microanalysis results from the pilocarpine-stimulated dog submandibular gland. PMID- 3625537 TI - Relations between spinocervical and post-synaptic dorsal column neurones in the cat. AB - 1. In chloralose-anaesthetized cats single-unit micro-electrode recordings were made at the lumbosacral level either from axons in the dorsolateral funiculus and dorsal columns, identified as belonging to the spinocervical tract (s.c.t.) or post-synaptic dorsal column (p.s.d.c.) pathway respectively, or from neurones in the dorsal horn similarly identified. 2. Attempts were made to show that s.c.t. and p.s.d.c. neurones had axons that bifurcated, so that they sent branches into both the ipsilateral dorsolateral funiculus and the dorsal columns. That is, that some, or all, of the presumed s.c.t. or p.s.d.c. axons were common to both populations. In addition, the effects of stimuli applied to the ipsilateral dorsolateral funiculus at C3 and C1 on the resting discharges of p.s.d.c. neurones were examined in order to determine the effectiveness of the link between the s.c.t. and the p.s.d.c. pathway. 3. Thirty-three s.c.t. units (twenty six axonal recordings and seven soma-dendritic recordings) and thirty p.s.d.c. units (twenty-four axonal and six soma-dendritic recordings) were examined for bifurcating axons by electrically stimulating the dorsolateral funiculus at C3 and the dorsal columns at C4. None of the p.s.d.c. units could be antidromically activated from the ipsilateral dorsolateral funiculus with stimulus strengths up to 40 V or seventy times threshold for antidromic activation from the dorsal columns. Similarly, twenty s.c.t. units could not be activated antidromically from the dorsal columns at stimulus strengths up to 30 V or thirty times threshold for their antidromic excitation from the dorsolateral funiculus. Thirteen s.c.t. units were antidromically activated from the cervical dorsal columns, eight at seventeen or more times threshold for their activation from the dorsolateral funiculus and five at between two and nine times threshold. All s.c.t. units that were activated antidromically from both the cervical dorsal columns and the dorsolateral funiculus showed similar latencies for the two responses. 4. Twenty-five p.s.d.c. units were examined for the effects of ipsilateral dorsolateral funiculus stimulation on their resting activity. In thirteen, clear evidence of facilitatory effects from C3 were observed, whereas similar results were seen in only six of these units when C1 was stimulated and the effects were less. The facilitation had a latency of 3-16 ms and lasted for 6 22 ms. In all but one of the twenty-five units, stimulation at both C1 and C3 produced profound inhibition of the resting discharge that began at between 8 and 26 ms and lasted for up to 300 ms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3625538 TI - The effect of potassium on carotid body chemoreceptor discharge in the anaesthetized cat. AB - 1. In exercise the arterial plasma potassium rises; we have investigated the possibility that such rises might affect the carotid body chemoreceptor. 2. Intravenous infusions of KCl were used to produce hyperkalaemia in anaesthetized cats. 3. Intra-arterial catheter tip potassium electrodes were used to monitor changes in plasma potassium. 4. The effects of 5 min infusions of KCl on afferent carotid chemoreceptor preparations were studied. 5. Infusions of KCl, which produced increases in plasma potassium similar to those occurring in exercise in man, caused an initial large increase in mean firing frequency (237% of control). A phase of rapid adaptation of this response was followed by a phase of slower adaptation, but after 5 min of hyperkalaemia mean firing frequency was still significantly greater than control. The amplitude of the breath-by-breath oscillation in frequency appeared to increase in parallel with mean frequency so that the amplitude/mean ratio remained constant. 6. We conclude that plasma potassium changes during exercise may contribute to the chemical drive to breathe. PMID- 3625539 TI - Fluid and electrolyte handling in Long Evans and Brattleboro rats following injection of polyethylene glycol. AB - 1. Intake and output of water, Na+ and K+ were measured in Long Evans and Brattleboro rats (deficient in hypothalamic and pituitary vasopressin) before and after subcutaneous injection of polyethylene glycol (PEG) sufficient to cause a substantial hypovolaemia. 2. In the Long Evans rats an initial fluid retention (due to oliguria and polydipsia) was accompanied by Na+ retention and K+ loss. On the second day there was a diuresis but Na+ retention persisted until days 3 and 4 when there was a natriuresis. 3. Brattleboro rats initially also showed fluid retention but this was achieved by hypodipsia with a greater oliguria; there was an accompanying retention of Na+ and K+. On the second day, a reduced fluid balance was still accompanied by Na+ retention but associated with kaliuresis. Diuresis and natriuresis occurred on the third day after PEG injection. 4. Thus, rats deficient in vasopressin respond to hypovolaemia by retaining fluid. The renal actions of aldosterone do not explain fully the changes in renal electrolyte handling. PMID- 3625540 TI - Capacitance of the rabbit portal vein and inferior vena cava. AB - 1. We used vessel strips and whole vessels in vitro to determine the length tension and pressure-volume relationships of two veins with similar diameter and wall thickness, the portal vein and inferior vena cava of rabbits. 2. Length tension studies indicate that longitudinal and circular strips of the portal vein have significantly smaller elastic moduli than similar strips of the inferior vena cava (P less than 0.05). 3. Pressure-volume relationships of intact vessels indicate that pressures greater than 5 mmHg do not produce significant increases in volume of the inferior vena cava, whereas volume of the portal vein increases significantly over a range of pressures from 2 to 15 mmHg. 4. Activation of smooth muscle with noradrenaline reduces the volume of the vena cava at distending pressures less than or equal to 5 mmHg. In contrast, noradrenaline reduces the volume of the portal vein at pressures up to 10 mmHg. During inactivation in calcium-free solution and activation with noradrenaline, the portal vein is more compliant than the inferior vena cava (P less than 0.05). 5. Morphometric studies demonstrate more collagen in the inferior vena cava than in the portal vein. Differences in capacitance of the vessels may be related, in part, to greater collagen content in the inferior vena cava. PMID- 3625541 TI - The influence of neurohypophysial hormones on renal function in the acutely hypophysectomized rat. AB - 1. Renal function and the effect of neurohypophysial hormone replacement was investigated in anaesthetized, acutely hypophysectomized, male rats. 2. Although urine production was only slightly lower over the 8 h post-operative study period in hypophysectomized rats, sodium excretion was greatly depressed reaching only 3.5 +/- 1.4 mumol/min compared with a peak of 13.2 +/- 1.0 mumol/min in intact animals. 3. In association with a decline in mean arterial blood pressure, glomerular filtration rate in hypophysectomized rats fell to 2.1 +/- 0.2 ml/min 8 h after operation by comparison with a mean rate in intact rats of 3.2 +/- 0.2 ml/min. 4. Plasma corticosterone levels were much lower in hypophysectomized (4 +/- 2 ng/ml) than in intact (36 +/- 4 ng/ml) rats, plasma aldosterone was reduced to a lesser extent (0.41 +/- 0.08 compared with 0.76 +/- 0.04 ng/ml). While oxytocin was not detectable in hypophysectomized rat plasma, trace levels of vasopressin (0.16 +/- 0.04 mu u./ml) were found. In intact unanaesthetized rats basal plasma levels of oxytocin were 0.32 +/- 0.13 mu u./ml and vasopressin were 0.85 +/- 0.19 mu u./ml. 5. Administration of oxytocin at 150 mu u./min, which produced plasma hormone levels (24.0 +/- 2.5 mu u./ml) greatly in excess of basal concentrations, increased renal sodium excretion but did not alter urine flow. Oxytocin administration at the lower rate of 15 mu u./min producing plasma hormone levels of 2.60 +/- 0.1 mu u./ml, did not alter renal sodium excretion. 6. Arginine vasopressin administered at 12 mu u./min induced plasma hormone levels of 1.54 +/- 0.09 mu u./ml and produced a large antidiuresis and small increase in the rate of sodium excretion. 7. The natriuretic response to vasopressin was potentiated by concurrent administration of oxytocin at 15 mu u./min. The peak sodium excretion of 5.8 +/- 1.0 mumol/min, however, remained well below that seen in intact rats. 8. It is concluded that, as restoration of posterior pituitary hormones at or above the physiological range only partially restored sodium excretion, the absence of anterior pituitary factors may also contribute directly or indirectly to the renal sodium retention of the hypophysectomized rat. PMID- 3625542 TI - A synergistic effect of oxytocin and vasopressin on sodium excretion in the neurohypophysectomized rat. AB - 1. Renal function and the effect of oxytocin and vasopressin replacement have been examined in anaesthetized male neurohypophysectomized rats. 2. Rates of urine flow were higher but sodium excretion markedly lower in neurohypophysectomized rats than in intact animals receiving hypotonic saline infusion (33.8 +/- 2.3 vs. 27.0 +/- 0.7 ml and 472 +/- 84 vs. 1946 +/- 124 mumol respectively for the third to sixth hour of study). 3. In intact animals, mean arterial blood pressure stabilized at 106 mmHg. Haematocrit (46%) remained stable but glomerular filtration rates declined slightly over the 8 h of study to 2.5 +/ 0.2 ml/h. These values in neurohypophysectomized rats did not differ significantly from those in intact rats. 4. Although plasma corticosterone levels (54 +/- 13 ng/ml) did not differ significantly from those in intact rats, neurohypophysectomy was associated with greatly reduced aldosterone concentration (0.12 +/- 0.03 vs. 0.76 +/- 0.04 ng/ml). Trace levels of vasopressin (0.17 +/- 0.03 microunit/ml) were found in neurohypophysectomized rat plasma. 5. Oxytocin administration at 15 microunits/min, which produced plasma hormone levels of 1.62 +/- 0.19 microunit/ml, had no detectable effect on sodium excretion but increased urine flow. Arginine vasopressin administration (12 microunits/min) inducing plasma levels of 1.24 +/- 0.08 microunit/ml, reduced urine flow by 80% and produced a small increase in sodium excretion. 6. Concurrent administration of oxytocin (15 microunits/min) potentiated the natriuretic response to vasopressin (12 microunits/min). Total sodium excretion during the 3 h combined hormone infusion (1256 +/- 149 mumol) greatly exceeded that in animals receiving vasopressin alone (549 +/- 132 mumol) and approached that observed in intact animals (1946 +/- 124 mumol). Combined hormone administration at the lower rate of 5 microunits/min oxytocin and 4 microunits/min vasopressin produced a similar large increment in sodium excretion. 7. It is concluded that replacement of both neurohypophysial hormones, at plasma levels within the physiological range, largely reverses the renal sodium retention of neurohypophysectomized rats, oxytocin considerably potentiating the natriuretic action of vasopressin. This synergism between the two neurohypophysial peptides to promote salt excretion may be an important component of the non-steroidal management of sodium. PMID- 3625543 TI - Corticospinal facilitation of hand muscles during voluntary movement in the conscious monkey. AB - 1. The method of spike-triggered averaging has been used to detect a direct influence of pyramidal tract neurones on the activity of hand and forearm muscles in conscious monkeys trained to perform repetitive movements of the hand and fingers. Gross electromyograms (e.m.g.s) from individual muscles were rectified and synchronously averaged with respect to the discharge of single, antidromically identified pyramidal tract cells in the 'hand' area of the pre central gyrus. 2. The presence in an average of a post-spike facilitation which could be revealed reproducibly from successive epochs of recording and was clearly larger than the biggest fluctuations seen in pseudo-randomly triggered averages of the same e.m.g. data, was taken to indicate a direct cortico motoneuronal excitatory influence. 3. 55% of cortical neurones analysed showed post-spike facilitation in one or more recorded muscle and 7% showed post-spike suppression. In terms of the total number of muscle-neurone combinations analysed, the proportions showing post-spike effects were 18 and 1% respectively. These figures have been influenced by the pre-selection of neurones for analysis according to restrictive criteria. The neurones selected (a) were recorded at cortical loci where weak intracortical microstimulation could evoke finger movements, (b) could be activated antidromically at short latency by medullary pyramidal tract stimulation, (c) showed natural discharge activity which was clearly modulated in relation to voluntary finger movements, and (d) were located in the anterior bank of the central sulcus. The results provide some evidence to vindicate these criteria. 4. The strongest post-spike facilitation observed had a peak which was 42% higher than the average pre-spike level of e.m.g. activity, but most were within the range 5-20%. Facilitation peaks below about 3% could not have been resolved from the 'noise' in the averages. The mean latency from cell discharge in the cortex to the start of the post-spike facilitation was 11.2 ms (range 7.4-17.2) for intrinsic hand muscles and 9.8 ms (range 4.1-15.0) for forearm muscles. These latencies were compared with the latencies of responses to intracortical microstimulation and to stimulation of the medullary pyramidal tract. 5. Evidence was obtained suggesting that the latency for cortico motoneuronal activation of an individual motor unit was commonly subject to considerable variability and that different motor units of a muscle could be facilitated by the one cortical neurone at different latencies. These factors are thought to contribute to an elongation of the time course of post-spike facilitation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3625544 TI - Selective facilitation of different hand muscles by single corticospinal neurones in the conscious monkey. AB - 1. Post-spike facilitation of e.m.g. activity by monkey motor cortex neurones has been investigated in different hand and forearm muscles. 2. Seventy-eight neurones were recorded concurrently with between five and ten different muscles. Forty-seven neurones were identified as cortico-motor by the presence of post spike facilitation in the spike-triggered average of at least one of the tested muscles. 3. All forty-seven cortico-motor neurones showed clear increases in activity during performance of a precision grip task by the monkey, and all of them were co-activated with the sampled muscles. 4. To assess the divergence of facilitation from a single cortico-motor neurone to different muscles, spike triggered averages were constructed with all of the concurrently recorded muscles. The number of muscles in the sample, and the number of muscles showing post-spike facilitation, were corrected by excluding any post-spike facilitation which could have arisen by cross-talk between the different pairs of e.m.g. electrodes. 5. Most cortico-motor neurones produced post-spike facilitation in a restricted number of tested muscles. The mean number of post-spike facilitation bearing muscles per cortico-motor cell rose from 1.4 +/- 0.5 (S.D.) when five muscles were sampled to 2.0 +/- 1.5 when ten were sampled. On average, each cortico-motor neurone produced post-spike facilitation in 27% of the tested muscles. Only three of forty-seven cortico-motor neurones gave post-spike facilitation in half or more of the tested muscles. 6. The distribution pattern of post-spike facilitation among the muscles sampled with a given cortico-motor neurone was not altered when the spike-triggered averages were constructed from cortico-motor cell and e.m.g. activity recorded during two different phases of the precision grip task, or during performance of a quite different, power grip, task. 7. Cortico-motor cells which produced post-spike facilitation in two or more different muscles often did so in muscles with synergistic functions. 8. It is suggested that cortico-motor neurones may contribute to relatively independent finger movements by virtue of their selective facilitation of hand muscles leading to a fractionated pattern of muscle activity. PMID- 3625545 TI - A gamma-aminobutyric-acid-mediated baroreceptor input to supraoptic vasopressin neurones in the rat. AB - 1. Extracellular recordings in pentobarbitone anaesthetized male Long-Evans rats examined the influence of electrical stimulation in the diagonal band of Broca on the excitability of 113 putative vasopressin-secreting and 22 putative oxytocin secreting neurosecretory neurones in the hypothalamic supraoptic nucleus. 2. Single pulse or repetitive (5-20 Hz) stimulation in the ventral part of the diagonal band evoked a prominent reduction in the excitability of 83% of vasopressin-secreting neurones with no effect on the remainder. Amongst oxytocin secreting neurones, 59% were unresponsive, 27% responded with an increase in activity while only 14% revealed an inhibitory pattern similar to vasopressin secreting neurones. 3. Diagonal band stimulation-evoked inhibitions were reversibly abolished by local pressure applications of bicuculline methiodide (100 microM) to twenty out of twenty vasopressin secreting cells tested, whereas strychnine sulphate (100 microM) was without effect on four out of four cells tested. 4. In five out of five vasopressin-secreting cells tested, bicuculline applications reversibly abolished the reduction in their activity that follows peripheral baro-receptor activation. Failure to alter baroreflex-evoked depressions in firing during similar trials with prazosin hydrochloride (10 microM, six cells tested), timolol maleate (20 microM, six cells tested) or strychnine sulphate (100 microM, three cells tested) indicated the specificity of bicuculline's action. 5. These findings suggest that a GABAergic pathway from the diagonal band of Broca preferentially innervates vasopressin-secreting neurosecretory supraoptic nucleus (s.o.n.) neurones, and support the view that the baroreflex-induced depression in firing of s.o.n. vasopressin-secreting neurones is mediated in large part through this input. PMID- 3625547 TI - Continuity of orientation columns between superficial and deep laminae of the cat primary visual cortex. AB - 1. Recent reports of a marked and consistent dislocation between orientation columns in the superficial and deep layers of cat striate cortex (Bauer, 1982, 1983) directly contradict the traditional view of the system (Hubel & Wiesel, 1962). This has considerable implications for our current understanding of cortical organization, and in order to clarify the issue we have carried out experiments to test the continuity of the columnar system with depth, in central regions of area 17. 2. In twenty-four penetrations, eighteen of which were placed as perpendicular as possible to the surface of the cortex, orientation preference was assessed at regular intervals both qualitatively and using a randomly interleaved quantitative technique. The distribution of preferred orientations was analysed with reference to a detailed histological reconstruction of the electrode track, including the location of laminar boundaries and the course of radial tiers of cells and capillaries. 3. From a further series of eighteen near perpendicular penetrations, the change in average orientation between one superficial and one deep layer recording site was compared with the deviation of the track from perpendicular to the surface and hence parallel to the orientation columns. 4. In penetrations perpendicular to the surface of the cortex, orientation preference showed little variation between superficial and deep laminae. In oblique penetrations, preferred orientation generally changed according to a single, smooth trend. Those irregularities that were encountered were confined to oblique penetrations, and were distributed throughout the cortical laminae. 5. In conclusion, our evidence does not support the presence of a systematic discontinuity with depth within the orientation columnar system. It is therefore entirely consistent with earlier evidence on the subject. PMID- 3625546 TI - The nature and origin of calcium-insensitive miniature end-plate potentials at rodent neuromuscular junctions. AB - 1. To study the nature and origin of slow-rising, Ca2+-insensitive miniature end plate potentials (m.e.p.p.s) in mammalian muscle we used intracellular recording techniques and drugs which block acetylcholine (ACh) synthesis or the uptake of ACh into synaptic vesicles. Slow m.e.p.p.s were induced in vivo by paralysing the extensor digitorum longus muscle of the rat with botulinum toxin type A or in vitro by the application of 4-aminoquinoline to the mouse diaphragm nerve-muscle preparation. 2. Hemicholinium-3, which blocks ACh synthesis, reduced the amplitude of all synaptic potentials including slow m.e.p.p.s, but only if the nerve was stimulated. 3. 2(4-phenylpiperidino)cyclohexanol (AH-5183), which blocks the active uptake of ACh into synaptic vesicles, reduced both the frequency and the amplitude of slow m.e.p.p.s and did so without requiring nerve stimulation. 4. No correlation was observed between the molecular leakage of ACh from the motor nerve and the frequency and amplitude of slow m.e.p.p.s. 5. We conclude that slow m.e.p.p.s are caused by the release of ACh from the nerve terminal, possibly from a small pool of synaptic vesicle-like structures. PMID- 3625549 TI - Effects of impulse blockade on the contractile properties of rat skeletal muscle. AB - 1. Pressure was used to produce a localized block of impulse conduction in motor nerve fibres supplying rat plantaris and soleus muscles. After 1 week of inactivity both muscles exhibited marked atrophy of type I and type II muscle fibres. 2. In treated plantaris and soleus muscles the specific tetanic tensions were reduced to approximately half those of untreated control muscles; the specific twitch tensions were unchanged. The fall in specific tetanic tension in the nerve-blocked muscles was not associated with impaired excitation of muscle fibres during repetitive stimulation. 3. In nerve-blocked plantaris muscles the contraction and half-relaxation times became significantly prolonged whereas no change could be demonstrated in similarly treated soleus muscles. In both muscles the maximum rates of tetanic tension development increased following nerve block. 4. It is concluded that, in the rat, most of the changes in contractile properties and in muscle fibre size which follow denervation may be attributed to disuse rather than to interruption of axoplasmic transport. PMID- 3625548 TI - Direct evidence of neurally mediated vasodilatation in hairy skin of the human foot. AB - 1. Intraneural stimulation (i.n.s.) was made in the superficial peroneal nerve at the ankle in seventeen healthy subjects. The effect on skin blood flow was monitored by laser-doppler flowmeters and photo-electrical pulse plethysmographs inside and outside the innervation zone of the stimulated nerve fascicle. I.n.s. was applied before and after proximal local anaesthesia of the stimulated nerve. 2. Painful i.n.s. (stimulation strength 0.3-4 V) induced skin vasodilatation with the following characteristics: (a) it occurred on the dorsal side of both feet, (b) the blood flow increase on the opposite foot was blocked by local anaesthesia of the nerve supplying the skin area under study, (c) the blood flow increase on the stimulated foot was abolished by proximal local anaesthesia of the stimulated nerve. The findings show that the vasodilatation was due to activation of a reflex pathway. 3. The reflex vasodilatation was bigger in the stimulated than in the opposite foot. At the same time there were signs of skin vasoconstriction in the fingers. The reflex vasodilatation in the foot was enhanced by body cooling. It was unaffected by atropine or propranolol. 4. After local anaesthesia of the nerve proximal to the stimulation site, i.n.s. with 2-6 times increased stimulation strength produced skin vasodilatation restricted to the innervation zone of the stimulated nerve fascicle. This response had greater amplitude and longer duration than the reflex vasodilatation. 5. Intravenously administered atropine and propranolol did not affect the local dilatation to i.n.s. but after chronic treatment of the skin with capsaicin (1% in ethanol), i.n.s. after a proximal nerve block induced skin vasoconstriction. In five of seven experiments subcutaneous injection of terbutaline (0.25 mg) in the innervation zone abolished the local dilatation. 6. It is suggested that (a) the reflex vasodilatation is of sympathetic nature and is induced by stimulation of thin (A delta?) afferent fibres, (b) the local vasodilatation is due to centrifugally conducted impulses in (afferent?) non-myelinated fibres. PMID- 3625550 TI - Excitatory actions of single impulses in single hair follicle afferent fibres on spinocervical tract neurones in the cat. AB - 1. In cats under chloralose anaesthesia single dorsal root ganglion cells with axons innervating hair follicles were stimulated intracellularly to produce single impulses. At the same time single spinocervical tract (s.c.t.) neurones were recorded extracellularly, from their axons in the upper lumbar cord. 2. When the receptive field of the afferent fibre was contained within the impulse firing zone of the s.c.t. cell, a single afferent impulse increased the probability of firing of the neurone. In thirty-nine pairs of units, where the afferent fibre had a group II conduction velocity, coupling was very efficient and for seventeen pairs the single afferent impulse produced one or more impulses in the s.c.t. cell in at least 90% of trials. The mean number of impulses evoked in s.c.t. cells by a single group II afferent impulse was 1.47. The latencies of the impulses ranged from 1.5 to 14.0 ms, with times to peak and total durations of 2.5-17.5 ms and 4.5-28.0 ms respectively. For two pairs of units where the afferent fibre had a group III conduction velocity the effectiveness of single afferent impulses was much less and the latencies, but not the durations, of the impulses were longer (12 and 17 ms). 3. When the receptive field of the hair follicle afferent fibre was outside, but close to, the firing zone of the s.c.t. neurone there was no indication that single afferent impulses affected the probability of neuronal discharge for thirteen of fifteen pairs of units. Weak excitation was observed in two pairs and this was clear only when two or more afferent impulses were employed. 4. There was a tendency for hair follicle afferent fibres with their receptive fields at or near the centre of the s.c.t. cell's firing zone to be most effective, producing shorter latency responses with more impulses at higher frequencies. When the afferent's field was peripherally located in the s.c.t. neurone's firing zone there was a wide range of responses but these included those with the longest latencies and very few impulses. 5. The results are discussed with reference to previous work on the spinocervical tract and to the known actions of single impulses on other neuronal types. Suggestions are made for the possible excitatory neuronal circuits linking hair follicle afferent fibres to the s.c.t. neurones. PMID- 3625551 TI - Actions of trains and pairs of impulses from single primary afferent fibres on single spinocervical tract cells in cat. AB - 1. In cats under chloralose anaesthesia single lumbosacral dorsal root ganglion cells of hair follicle afferent fibres were stimulated intracellularly to produce trains or pairs of impulses. At the same time, single spinocervical tract (s.c.t.) neurones were recorded extracellularly, from their axons in the upper lumbar spinal cord. Afferent fibre-neurone pairs were chosen in which the receptive field of the fibre was contained within the excitatory receptive field (firing zone) of the neurone. 2. Trains of impulses of 2.0 Hz were less effective in increasing the probability of s.c.t. cell firing than trains at 0.67 Hz, and this latter rate was usually less effective than trains at 0.33 Hz. 3. Successive responses to individual members of a train of hair follicle afferent impulses were variable. In some pairs of units succeeding responses declined until a fairly consistent plateau was reached. In others there was no decline and the responses remained irregular. 4. Pairs or short trains of impulses revealed two phenomena: over the first 5 ms or so following an impulse in a group II hair follicle afferent fibre, a second or small group of impulses produced a greater response from the s.c.t. neurone but at intervals of 25-200 ms there was a profound depression of the responses evoked by the second member of a pair of impulses. For A delta afferent fibres the early facilitation lasted for at least 25 ms. 5. It is concluded that a single impulse in a single hair follicle afferent fibre from within the excitatory receptive field of a s.c.t. neurone has complex actions on transmission through that neurone. An initial excitatory influence is followed by a long-lasting depression that influences transmission through the system for at least 1500 ms. Possible mechanisms underlying this depression are discussed. PMID- 3625552 TI - An intracellular study of spinocervical tract cell responses to natural stimuli and single hair afferent fibres in cats. AB - 1. Intracellular recordings were made from spinocervical tract (s.c.t.) neurones in cats anaesthetized with chloralose and paralysed with gallamine triethiodide. 2. In one series of experiments the cells' receptive fields were examined with the use of natural stimuli. Hair movement within the impulse firing zone of the cell evoked excitatory post-synaptic potentials (e.p.s.p.s) from which impulses were generated; in addition, in the majority of s.c.t. cells tested, areas were found within the impulse firing zone where hair movement elicited both e.p.s.p.s and inhibitory post-synaptic potentials (i.p.s.p.s). Outside the firing zones, both regions evoking e.p.s.p.s and regions evoking i.p.s.p.s were observed in all neurones examined in detail (ten cells). The responses of these neurones to a variety of natural stimuli showed the receptive fields of s.c.t. cells to be more complex than previously thought. 3. In a second series of experiments, intracellular recordings from s.c.t. cells were combined with intracellular recording and stimulation of single dorsal root ganglion cells belonging to group II hair follicle afferent fibres. When the afferent fibres innervated skin within the impulse firing zone of the s.c.t. cell, single afferent impulses evoked e.p.s.p. complexes consisting of both mono- and polysynaptic components; no i.p.s.p.s were observed in response to single hair follicle afferent impulses or to trains. Although the monosynaptic e.p.s.p. component was often large and had a fast rise time, s.c.t. cell impulses usually arose from the later components. Afferent fibres innervating the central region of the s.c.t. cell firing zones tended to evoke relatively large e.p.s.p.s with fast rise times. The rise times and amplitudes of the e.p.s.p.s evoked by afferent fibres from the periphery, however, varied between afferent fibres but included the slowest and smallest in the total sample of synaptically coupled pairs. Afferent fibres from outside the s.c.t. cell's firing zone were usually ineffective in setting up post-synaptic potentials, but one group III hair follicle afferent fibre, from an inhibitory receptive field component, gave rise to i.p.s.p.s. 4. The effects of pairs and trains of afferent impulses at intervals of 10, 25, 50, 100 and 200 ms were examined. At 25 ms the response to the second afferent impulse was profoundly less than that evoked by the first and was still substantially reduced at 200 ms interval. In all synaptically coupled pairs studied, the e.p.s.p. complex evoked by the second afferent impulse was smaller in amplitude than that evoked by the first.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3625553 TI - Inhibition of reticulo-ruminal motility by volatile fatty acids and lactic acid in sheep. AB - 1. A study was made of the influence on reticulo-ruminal motility, recorded by electromyography, of ruminal infusions of volatile fatty acids (VFAs) and lactic acid in twenty-four sheep maintained by intragastric infusion of a complete liquid diet, in three sheep fed grass pellets, and in nine chronically vagotomized sheep; abomasal and duodenal infusions of VFA and lactic acid were tested in five sheep fed grass pellets. 2. Ruminal infusions of VFAs and lactic acid progressively inhibited the amplitude of the reticulo-ruminal contractions. In many experiments there was no effect on contraction frequency until the cessation of all reticulo-ruminal contractions at which point the maximal concentration of VFA recorded in the abomasum was 28 mM, and that of lactic acid was 20 mM. 3. The concentrations of undissociated VFAs causing cessation of reticulo-ruminal contractions in the vagus-intact sheep were very similar to the concentrations causing abolition of the organized intrinsic motility of the chronically vagotomized sheep. 4. The inhibition of reticulo-ruminal motility with ruminal infusions of mixtures of VFAs and of lactic acid together with VFAs could largely be explained by the sum of the effects of the individual acids present. 5. Abomasal infusion of VFA or lactic acid inhibited the amplitude of ruminal, especially primary ruminal, contractions at concentrations of undissociated acid of 60 mM and above and increased the frequency of reticulum and primary ruminal contractions at about 80 mM. 6. Duodenal infusion of VFAs and lactic acid (100 mM, 5 ml/min) strongly inhibited abomasal motility without affecting reticulo-ruminal motility, and at a higher rate (100 mM, 10 ml/min) abolished motility and inhibited both the amplitude and frequency of reticulo ruminal contractions. 7. It is concluded that the initial inhibition of reticulo ruminal motility in ruminal acidosis is unlikely to involve any significant influence from duodenal, or abomasal receptors. The final cessation of reticulo ruminal motility with ruminal acidosis could involve local effects of VFAs in the reticulo-rumen as well as through excitation of acid-sensitive reticulo-ruminal receptors. PMID- 3625554 TI - Lesions in the upper lateral pons abolish the hypoxic depression of breathing in unanaesthetized fetal lambs in utero. AB - 1. The effects of stereotaxically placed lesions made throughout the mid-brain and upper pons were studied in chronically instrumented fetal lambs from 120 days gestation, after recovery in utero. 2. Isocapnic hypoxia caused an increase in the rate and depth of breathing movements in fetuses in which bilateral lesions encompassed the upper lateral pons in the region of and slightly rostral to the principal sensory and motor nuclei of the trigeminal nerve. 3. Fetal lambs with lesions which did not bilaterally encompass the upper lateral pons showed the normal fetal depressive response to hypoxia. 4. None of the lesions induced permanent continuous breathing as previously described in mid-brain transected fetuses, although periods of continuous breathing lasting several hours were seen at times in some fetuses with lesions in the upper lateral pons. 5. It is concluded that an area in the lateral pons close to areas with well known involvement in respiratory control is involved in the hypoxic depression of breathing in the fetal lamb. PMID- 3625555 TI - Calcium transport across the isolated dually perfused human placental lobule. AB - 1. Movements of 45Ca and 3H2O in maternal to fetal (M----F) and fetal to maternal (F----M) directions across the dually perfused isolated human placental lobule were measured under steady-state conditions. 2. M----F values of the clearances (CR) and extractions (ER) of 45Ca relative to 3H2O were 0.371 +/- 0.056 and 0.492 +/- 0.086 (mean +/- S.E. of mean) respectively. The corresponding values for F--- M movements were 0.277 +/- 0.017 and 0.251 +/- 0.010 respectively. The F----M perfusion flow ratio (QF/QM) was 0.34 +/- 0.01 throughout. Comparison with previously published data indicated a significant degree of membrane limitation to Ca transfers. 3. There was evidence of a mismatch between tissues receiving a fetal and those receiving a maternal perfusion. 4. The relative extraction ER was markedly and reversibly enhanced when perfusate total Ca was reduced from 2.4 to 0.1 mM. The effect was present in both M----F and F----M transfers and provided evidence for carrier-mediated uptake of Ca on both aspects of the placental barrier. Small and transient decreases in the relative clearance CR were observed on changing from 2.4 to 0.1 mM-Ca in M----F and to a lesser extent F----M transfers while transient increases were seen on changing from 0.1 back to 2.4 mM Ca. 5. Measurement of net changes in Ca levels in closed-circuit studies indicated a significant release of both ionized (Ca2+) and total (CaT) Ca into the fetal perfusate at total Ringer solution concentrations of 1.4, 1.9 and 2.4 mM-Ca. Release of Ca into the maternal circuit was also observed using 1.4 mM-Ca Ringer solution but when 1.9 and 2.4 mM-Ca Ringer solution was used a net uptake occurred. 6. These findings strongly suggest that mechanisms by which Ca is transferred from M----F circulations in vivo are at least partly preserved in the in vitro human placental preparation. They indicate that this preparation is suitable for the study of these mechanisms and their regulation by hormonal and other factors. PMID- 3625556 TI - Ionic and pharmacological properties of reciprocal inhibition in Xenopus embryo motoneurones. AB - 1. Properties of rhythmic, compound mid-cycle inhibitory post-synaptic potentials (i.p.s.p.s), which constitute one of the three main synaptic drives to motoneurones during fictive swimming in Xenopus embryos, have been examined using ionic and pharmacological manipulation. 2. Mid-cycle i.p.s.p.s are Cl- dependent. They are reversed by intracellular Cl- injection and attenuated by lowered extracellular Cl- concentration. 3. In response to bath application of 100 microM glycine or 100 microM-gamma-aminobutyric acid (GABA), motoneurones show a decrease in cell input resistance of 24 +/- 2.9 M omega (mean +/- S.E. of mean) or 16 +/- 3.7% and 26 +/- 6.0 M omega or 14 +/- 2.0% respectively. This is associated with a weak hyperpolarization or depolarization of 0 +/- 1.5 mV and -3 +/- 1.4 mV respectively. Both responses can be made strongly depolarizing by intracellular Cl- injection. 4. The response to glycine is blocked by 1 microM strychnine but is largely unaffected by bicuculline below 50 microM. The response to GABA is largely blocked by 10 microM-bicuculline but is unaffected by 1 microM strychnine. Both strychnine and bicuculline are therefore specific antagonists in the amphibian embryo preparation. Glycine and GABA are both partially antagonized by 10 microM-picrotoxin. 5. Mid-cycle i.p.s.p.s recorded in motoneurones during fictive swimming are reduced in amplitude by 0.5-1 microM-strychnine but are largely unaffected by 40 microM-bicuculline. In embryos immobilized by ventral root transection, 100 microM-tubocurarine, a likely GABA antagonist in the embryo, has no effect on mid-cycle inhibition. Glycine is suggested to be the probable transmitter released by commissural interneurones and mediating mid cycle inhibition during fictive swimming, acting to increase conductance of Cl-. PMID- 3625557 TI - The transport of pyrimidines into tissue rings cut from rat small intestine. AB - 1. At low concentrations (0.1 mM) the transport of uracil, 5-fluorouracil and thymine into jejunal tissue rings is an active process. 2. The transport of 5 fluorouracil into tissue rings cut from the duodenum and jejunum was greater than the transport into rings cut from the ileum. This difference was abolished by starving the rats for 48 h before the experiment. 3. The active transport can be abolished by replacing the Na+ in the incubation medium with either K+ or mannitol, or by increasing the concentration of the pyrimidine to 1.0 mM. 4. The accumulation of uracil or 5-fluorouracil into the jejunal rings was identical when determined by radioactive tracer or by high-performance liquid chromatography. 5. The apparent Michaelis constant (Km) for 5-fluorouracil transport into jejunal rings was 0.074 mM in the standard Na+ bicarbonate Krebs Ringer solution and 0.394 mM in the K+-substituted bicarbonate Krebs-Ringer solution. 6. Both thymine and uracil inhibited the transport of 5-fluorouracil into jejunal tissue rings: however, cytosine and orotic acid did not. PMID- 3625558 TI - Catecholamines release mediators in the opossum oesophageal circular smooth muscle. AB - 1. Effects of catecholamines applied exogenously to the circular smooth muscle layer of the body of the oesophagus of the opossum (Didelphis marsupialis) were studied, simultaneously measuring changes in the membrane potential, the membrane conductance and the contractility of the muscle, using the double sucrose-gap technique. 2. Superfusion of the smooth muscle with Krebs solution at 27 degrees C containing dopamine (10(-6)-10(-4) M) dose-dependently caused a hyperpolarization of the smooth muscle cells and an increased membrane resistance followed after gradual repolarization by oscillations of the membrane potential, often accompanied by muscle action potentials. During the hyperpolarization, the tendency for the membrane potential to sag during prolonged application of hyperpolarizing currents was reduced and the 'off' depolarization following such currents was increased. This muscle did not develop active tension prior to treatment; it therefore did not relax during the hyperpolarizations, but contracted following the depolarized phase of oscillations. 3. The non adrenergic, non-cholinergic nerve-mediated inhibitory junction potential (i.j.p.) showed a small reduction in amplitude during superfusion with dopamine, explicable as a result of the drug-induced hyperpolarization. The 'off' response following the i.j.p., decreased transiently when the membrane potential was hyperpolarized to its maximum value. Then it increased to values larger than control as the membrane repolarized. Vasoactive intestinal polypeptide (VIP, 10( 6) M) produced a similar response but hyperpolarizations were smaller. 4. Of the tested catecholamines, isoprenaline, phenylephrine, butylated hydroxytoluene-920 (BHT-920) and clonidine were ineffective whereas the potency order for other catecholamines was dopamine greater than noradrenaline greater than or equal to adrenaline greater than DOPA. The catecholamine-induced responses were not affected by alpha- or beta-adrenoreceptor antagonists given alone or in combination. Of the dopamine receptor antagonists tested domperidone was without effect, whereas haloperidol reduced and bulbocapnine blocked the response. The findings suggested that a receptor resembling DA1-type peripheral receptor mediated the effects of dopamine on opossum oesophagus. 5. The catecholamine induced responses and those to VIP disappeared completely in Cl-(-)free medium (isethionate replacement). 6. Conditioning depolarization of the smooth muscle cells decreased but hyperpolarization increased the amplitude of the hyperpolarization (up to 20 mV). With larger hyperpolarizations the responses decreased and disappeared at around 50 mV hyperpolarization.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3625559 TI - Effect of cutaneous nerve stimulation on voluntary and stretch reflex electromyographic activity in wrist flexors in humans. AB - 1. Changes in electromyographic (e.m.g.) activity in the wrist flexors of normal human subjects were studied in response to electrical stimulation of digital nerves and to sudden extension perturbations at the wrist produced by a torque motor. 2. With the subjects maintaining a steady voluntary contraction, stimulation of the digital nerves produced a series of excitatory and inhibitory changes in the tonic e.m.g. activity from the wrist flexors. The most prominent and consistent response was a period of e.m.g. inhibition beginning 39 ms after the stimulus and lasting for approximately 36 ms. 3. The stretch reflex evoked by extension perturbations of the wrist consisted of an early response (M1) with an onset latency of approximately 30 ms, and a late response (M2) with an onset latency of approximately 60 ms. 4. The electrical stimuli and the mechanical perturbations were then delivered together, varying the interval between them so that the period of inhibition resulting from the electrical stimuli occurred at the same time as the M1 or M2 components of the stretch reflex, or during the later voluntary response. 5. The amount of e.m.g. inhibition during the M2 component was significantly greater than that during M1 (P less than 0.02). This result is compatible with the view that M1 and M2 are mediated by separate neural pathways. PMID- 3625560 TI - Photopic spectral sensitivity of the cat. AB - 1. The psychophysical spectral sensitivity of cats was assessed using a two choice visual discrimination task by determining increment thresholds and critical flicker frequency on white and chromatic backgrounds. 2. For large increments, on 0.0, 0.3 and 3.0 cd/m2 white backgrounds, the cats were most sensitive to 497 nm indicating that these backgrounds are scotopic. On 30 and 300 cd/m2 white backgrounds, the cats were most sensitive to about 454 and 561 nm indicating that these backgrounds are photopic. Sensitivity to intermediate wave lengths indicated independent action of 'blue' and 'green' cones. 3. For large increments, thresholds on photopic yellow and magenta backgrounds indicated the additive influence of 'blue' and 'green' cones. 4. Spectral sensitivity functions obtained with a critical flicker frequency criterion of 10 Hz on a 30 cd/m2 white background reflected only the activity of the 'green' cone while at 20 Hz the function reflected an additive contribution of both 'blue' and 'green' cones. 5. For small increments, on a 30 cd/m2 white or 96 cd/m2 orange background, sensitivity reflected only the activity of the 'green' cone. 6. The cat's photopic spectral sensitivity is influenced by the psychophysical test upon which it is based in a manner that is similar to what has been found for other vertebrates. No evidence was found for a 500 nm mechanism active at photopic levels. PMID- 3625562 TI - Effect of lumbar sympathectomy on muscle blood flow: distribution of perfusion measured by hydrogen clearance in skeletal muscle. AB - Measurements of local tissue blood flow using a technique of hydrogen clearance were used to examine the effect of lumbar sympathectomy on skeletal muscle blood flow. Polarographic recordings on 25 hydrogen desaturations were obtained with platinized platinum electrodes. Lumbar sympathectomies were done on five canines leaving the contralateral limb as a control. The hydrogen clearance data were modeled with biexponential curves: the initial rapid component and the second slow component yielded a weighted average perfusion through tissue. Average volumetric blood flow in the control limb was 6.08 +/- 0.45 ml/min/100 g tissue while the sympathectomized limb averaged 9.54 +/- 0.61 ml/min/100 g tissue (p less than 0.005). Average blood flow increases ranged from 33 to 83 percent in the sympathectomized limb over the control limb. This significant increase in muscle blood flow following lumbar sympathectomy, if of prolonged duration, may be cause for re-evaluation of the role of sympathectomy in the management of arteriosclerotic occlusive disease. PMID- 3625561 TI - Inhibitory synaptic potentials recorded from mammalian neurones prolonged by blockade of noradrenaline uptake. AB - 1. Intracellular recordings of membrane potential and membrane current were made from neurones of the rat nucleus locus coeruleus and the guinea-pig submucous plexus. These neurones exhibit inhibitory post-synaptic potentials (i.p.s.p.s) which result from noradrenaline acting on alpha 2-adrenoceptors to cause an increase in potassium conductance. 2. Cocaine (0.2-30 microM) reversibly increased the duration of the i.p.s.p. or inhibitory post-synaptic current (i.p.s.c.) in locus coeruleus neurones and submucous plexus neurones by approximately 750% and 350% respectively. The concentrations of cocaine causing half-maximal prolongation of the synaptic current were 3 microM in locus coeruleus and 0.5 microM in submucous plexus. The prolongation was due entirely to a slower rate of decay of the synaptic response. 3. Cocaine (10 microM) produced a maintained hyperpolarization (2-10 mV) or outward current (20-120 pA) in locus coeruleus neurones; in submucous plexus neurones cocaine increased the amplitude and duration of spontaneous i.p.s.p.s. 4. Outward currents produced by superfusion with noradrenaline were increased by cocaine with maximum effects being observed at 10-30 microM-cocaine. The maximum leftward shift in the relation between outward current or membrane hyperpolarization and noradrenaline concentration was 18- to 100-fold in locus coeruleus neurones and 4-fold in submucous plexus neurones. The concentrations of cocaine which caused a half maximal increase in sensitivity to superfused noradrenaline were similar in both tissues, being 4 microM in locus coeruleus and 2 microM in submucous plexus. 5. These results show that neuronal uptake of noradrenaline released from adrenergic nerves plays a significant role in determining the time course of synaptic potentials mediated by noradrenaline. PMID- 3625563 TI - Development of an Australian standard for wheelchair occupant restraint assemblies for motor vehicles. AB - An Australian Standard for Wheelchair Occupant Restraint Assemblies for Motor Vehicles has been produced. Titled Australian standard 2942-1987, Wheelchair Occupant Restraint Assemblies for Use in Motor Vehicles, it establishes design and performance requirements for these restraints, and includes details of dynamic testing procedures. Under the Standard, a lap belt is the basic occupant restraint required with the wheelchair restrained independently of the occupant. The Standard, instead of specifying a "standard" design for wheelchair occupant restraint assemblies, is intended to ensure effective crash protection for wheelchair occupants with a minimum of restriction on the design of restraints. It requires that instructions for installation and use of restraints be provided. Also included in the Standard is an advisory section providing general information for restraint users such as the types of wheelchairs best suited for use in vehicles. This appears to be the first national Standard for wheelchair occupant restraint assemblies for motor vehicles, and may well form the basis of similar standards elsewhere. PMID- 3625564 TI - Clinical performance of endoprosthetic and total hip replacement systems. AB - A retrospective study of endoprosthetic replacements and total hip prostheses was undertaken to determine factors that have the greatest effect on the success or failure of femoral hip components. A total of 227 endoprostheses were inserted within the years 1970-1985. Of these, 67 components (29.5 percent) required removal for various reasons. For an endoprosthesis, the most significant factor in determining the chances of success appeared to be the initial insertion diagnosis. Patients who received an endoprosthesis for an ailment which affected only the femoral side of the joint (such as traumatic fracture) had a much lower rate of failure than those patients with disease etiologies that could affect the acetabulum (such as osteoarthritis). The opposite was found for total hip prostheses. Of the 641 total hip devices inserted, 148 (23.0 percent) required removal. The highest rate of failure among these total hip components was for those devices inserted for trauma and the lowest rate of failure was for those inserted for osteoarthritis. Age at the time of insertion also proved to be of importance when estimating a hip component's chance of survival. For both endoprosthetic replacements and total hip arthroplasties, patients younger than 50 years of age at insertion experienced a failure rate almost twice that of those patients more than 50 years of age at insertion. PMID- 3625565 TI - Preliminary testing of a dual-channel electrical stimulator for correction of gait. AB - A dual-channel orthotic electrical stimulator was designed for daily use at home by plegic and paretic patients who had completed a hospital rehabilitation program. With two independent channels, two muscle groups can be stimulated in chosen sequences. A microcomputer accommodates the stimulation sequences to the gait cadence of the patient for the stance and swing phase separately. PMID- 3625566 TI - [Changes of erythrocyte deformability induced by calcium accumulation and calmodulin inhibitors]. AB - The deformability of human erythrocytes was investigated with a rheoscope to study the role of intracellular calcium in the dynamic cytoskeletal structure. Calcium was loaded to or depleted from erythrocytes with a calcium ionophore (A 23187) in a Na- or a K-HEPES buffer. (1) After calcium loading in the Na-HEPES buffer, the cell volume of erythrocytes was greatly reduced due to dehydration. On the contrary, upon calcium-loading or -depletion in the K-HEPES buffer, the intracellular calcium content could be varied in the range of 1/4 to 3 times as much as that of control cells without the reduction of mean cell volume. Further incubation without A 23187 and calcium in the K-HEPES buffer enabled the calcium loaded erythrocytes to restore the cell shape and the ATP concentration. (2) When intracellular calcium content was increased to above 1.5 times of the normal value, the deformability was distinctly decreased. On the other hand, the deformability was unchanged when the intracellular calcium content was reduced below the normal level. (3) The deformability, once decreased due to the calcium accumulation, was recovered by the treatment with a calmodulin inhibitor, W-7 or trifluoperazine, while these drugs were not effective on the deformability of control or calcium-depleted erythrocytes. We conclude that the membrane stiffness which influence the deformability of erythrocytes, is modulated by the intracellular calcium content through the interaction between the calcium calmodulin complex and the cytoskeletal proteins. PMID- 3625567 TI - Alcohol and drug use and involvement in automobile accidents. AB - This study examined a hypothesis first presented in the medical literature that persons who drink greater amounts of alcohol are more frequently involved in automobile accidents even though they were not under the influence of alcohol at the time of their accidents. Subjects were 130 undergraduates who contributed self-reports of automobile accidents in the preceding three years, near-miss accidents per week, and questionnaire measures of sociopathy, alcohol and drug use, and distortion (lie scale). No support was found for the alcohol hypothesis or a similar drug hypothesis. A very marginal link, however, was observed between accident involvement and sociopathic tendencies. PMID- 3625568 TI - The effect of humor on aggression catharsis in the classroom. AB - Two studies were designed to measure the cathartic effects of humor on aggressive responses. In the first study, two versions (easy and difficult) of Raven's intelligence test were administered to two groups of high school students. Only the easy version could be solved in the alloted time. Rosenzweig's (1951) Picture Frustration test was then administered and the students' aggressive responses were scored. Results showed that those who did not solve the problems had significantly higher scores on aggressivity than did the others. The second study, using four different groups, was planned according to a modified Solomon design. Two of the four groups of students completed the difficult part of the Raven test, and then two video-tapes were presented: a humorous one to two groups and a neutral one to the others. Finally, the Rosenzweig Picture Frustration test was administered to all four groups. An analysis of variance computed on the aggressivity scores showed one significant difference: frustrated students who viewed the humorous videotape had lower scores than those viewing the neutral one. PMID- 3625569 TI - Tracking the psychosocial predictors of older individuals' television uses. AB - The elderly spend considerable amounts of time with mass media, but little is known about the psychology of their viewing habits. This study compared the relative impact of social, structural, and psychosocial variables on the television uses of elderly viewers. The results of a survey of 113 older respondents indicated that psychosocial factors accounted for variance above and beyond that of demographic and situational factors in viewing of television entertainment programs, parasocial programs (e.g., soap operas), as well as in watching of television for companionship purposes. Emotional loneliness and locus of control proved particularly significant predictors of television behavior. PMID- 3625571 TI - Dynamics and stimulus-dependence of pacemaker control during behavioral modulations in the weakly electric fish, Apteronotus. AB - 1. Weakly electric fish generate around their bodies low-amplitude, AC electric fields which are used both for the detection of objects and intraspecific communication. The types of modulation in this signal of which the high-frequency wave-type gymnotiform, Apteronotus, is capable are relatively few and stereotyped. Chief among these is the chirp, a signal used in courtship and agonistic displays. Chirps are brief and rapid accelerations in the normally highly regular electric organ discharge (EOD) frequency. 2. Chirping can be elicited artificially in these animals by the use of a stimulus regime identical to that typically used to elicit another behavior, the jamming avoidance response (JAR). The neuronal basis for the JAR, a much slower and lesser alteration in EOD frequency, is well understood. Examination of the stimulus features which induce chirping show that, like the JAR, there is a region of frequency differences between the fish's EOD and the interfering signal that maximally elicits the response. Moreover, the response is sex-specific with regard to the sign of the frequency difference, with females chirping preferentially on the positive and most males on the negative Df. These features imply that the sensory mechanisms involved in the triggering of these communicatory behaviors are fundamentally similar to those explicated for the JAR. 3. Additionally, two other modulatory behaviors of unknown significance are described. The first is a non-selective rise in EOD frequency associated with a JAR stimulus, occurring regardless of the sign of the Df. This modulation shares many characteristics with the JAR. The second behavior, which we have termed a 'yodel', is distinct from and kinetically intermediate to chirping and the JAR. Moreover, unlike the other studied electromotor behaviors it is generally produced only after the termination of the eliciting stimulus. PMID- 3625570 TI - Daily changes of structure, function and rhodopsin content in the compound eye of the crab Hemigrapsus sanguineus. AB - The compound eye of the crab hemigrapsus sanguineus undergoes daily changes in morphology as determined by light and electron microscopy, both in the quantity of chromophore substances studied by HPLC and in visual sensitivity as shown by electrophysiological techniques. 1. At a temperature of 20 degrees C, the rhabdom occupation ratio (ROR) of an ommatidial retinula was 11.6% (maximum) at midnight, 8.0 times larger than the minimum value at midday (1.4%). 2. Observations by freeze-fracture revealed that the densities of intra-membranous particles (9-11 nm in diameter) of rhabdomeric membrane were ca. 2000/microns 2 and ca. 3000/microns 2 for night and daytime compound eyes, respectively. 3. Screening pigment granules migrated longitudinally and aggregated at night, but dispersed during the day. Reflecting pigment granules migrate transversally in the proximal half of the reticula layer i.e. cytoplasmic extensions containing reflecting pigment granules squeeze between neighbouring retinula cells causing optical isolation (Fig. 4). Thus the screening pigment granules within the retinula cells show longitudinal migration and radial movement so that the daytime rhabdoms are closely surrounded by the pigment granules. 4. At 20 degrees C, the total amount of chromophore of the visual pigment (11-cis and all-trans-retinal) was 1.4 times larger at night than during the day i.e. 46.6 pmol/eye at midnight and 33.2 pmol/eye at midday. Calculations of the total surface area of rhabdomeric membrane, total number of intra-membranous particles in rhabdomeric membrane and the total number of chromophore molecules in a compound eye, indicate that a considerable amount of chromophore-protein complex exists outside the rhabdom during the day. 5. The change in rhabdom size and quantity of chromophore were highly dependent on temperature. At 10 degrees C both rhabdom size and amount of chromophore stayed close to daytime levels throughout the 24 hours. 6. The intracellularly determined relative sensitivity of the dark adapted night eye to a point source of light was about twice as high as the dark-adapted day eye. Most of the increase in the sensitivity is attributed primarily to the effect of reflecting pigment migration around the basement membrane and, secondarily, to the changes in the amount and properties of the photoreceptive membrane. The results form the basis of a detailed discussion as to how an apposition eye can function possibly as a night-eye. PMID- 3625572 TI - Intracellular recording in the medullary pacemaker nucleus of the weakly electric fish, Apteronotus, during modulatory behaviors. AB - 1. The weakly electric gymnotiform fish, Apteronotus leptorhynchus, can be induced to perform a variety of modulations of its quasi-sinusoidal, electric organ discharge (EOD) in acute physiological preparations. These modulations, many of which are communicatory in function, include the jamming avoidance response (JAR). We have recorded intracellularly from neurons of the medullary pacemaker nucleus which is responsible for maintaining the ongoing EOD frequency during these modulatory behaviors. 2. We have used dye-filled microelectrodes to characterize single cell morphology of the two types of cells in the pacemaker nucleus (relay and pacemaker cells) and to localize anatomically the site of the differing responses we see during frequency modulations. We have also recorded with KCl-filled electrodes and attributed these data to cell type and location on the basis of characteristic behavior during these modulations. 3. Much of our data deals with chirps, brief accelerations of the EOD frequency lasting 10 to 14 ms. We see distinct patterns of activity in the pacemaker nucleus corresponding to different anatomical locations: the relay cell soma and axon, and the pacemaker cell soma and axon. Most of these loci show a marked rise in baseline voltage during the acceleration in spike frequency. The most unusual of these is the pacemaker cell axon which displays an often extreme decline in spike amplitude concurrent with the chirp (Fig. 7A). 4. 'Yodeling' (Dye 1987) appears to involve similar, characteristic changes in the pattern of firing as those seen during chirping. Similar quantitative analyses suggest that the JAR involves a different mechanism, however. PMID- 3625573 TI - Photoreconvertible fluorophore systems in rhabdomeres, Semper cells and corneal lenses in the compound eye of the blowfly. AB - 1. The primary aim of the experiments described in this article was to localize the origin of the complex fluorescence in the compound eye of flies. The eye tissue was dissected and the fluorescence from cells and cell organelles was recorded by microspectrofluorometry. Using this technique, fluorophore systems were detected in the rhabdomeres, Semper cells and corneal lenses. The fluorophore systems are photoreconvertible by UV and blue light. 2. The fluorophore systems in the rhabdomeres and Semper cells are similar. The intensity of the fluorescence from the microvilli is enhanced up to 29 X by adaptation to UV light. The enhancement is inversely related to the rhodopsin content in the microvilli, indicating that the chromophoric group of the fluorophore is not a vitamin A derivative. 3. The enhancement of the fluorescence by UV light strongly depends on pH, suggesting that the photoreconvertible fluorophore systems in the microvilli and Semper cells are photosensitive redox pigments. These redox systems are probably located in the membranes of the microvilli in the photoreceptors, and in the endoplasmic reticulum of the Semper cells, or they are coupled to filaments in the cytoskeleton of both cell types. 4. Preliminary reaction schemes for the photoreactions based on the recorded excitation and emission spectra and photokinetics were developed. A primary pigment in the microvillous structure, AR, or in organelles in the Semper cells, AS, is converted by UV light into an excited state AR* or AS*, which either relaxes to the primary pigment by photon emission, or converts into an intermediate X, which by proton uptake changes into stable products, BR or BS. Blue illumination converts BR and BS into the excited states BR* and BS*, which either relax by photon emission to BR or BS, or convert into an intermediate Y, which after deprotonation reconverts into the primary pigment AR or AS. 5. Estimation of the molecular density showed that the concentration of the fluorophore in the microvilli presumably is almost equal to maximal rhodopsin concentration. The high density suggests that the fluorophores have a specific function in transduction or adaptation of the visual process. PMID- 3625574 TI - Role of short photoperiod and cold exposure in regulating daily torpor in Djungarian hamsters. AB - 1. Male and female Djungarian hamsters (Phodopus sungorus) were gonadectomized or sham-operated after 12 weeks of exposure to short photoperiods (10L:14D). Half of the animals were single housed and transferred to a cold environment (7 degrees C) at week 13 of short days and half were transferred to cold at week 21. The time courses of short photoperiod induced seasonal changes in body weight, pelage color stage, and daily torpor were monitored periodically until the experiment was terminated after 34 weeks of short days. 2. The total duration of short photoperiod exposure was of primary importance compared to the duration of cold exposure in regulating seasonal changes in the frequency of daily torpor, body weight and pelage color exhibited by male and female Djungarian hamsters; that is, the change from long to short days was much more effective as a seasonal time cue than was the onset of cold exposure. 3. Gonadectomy did not prevent the occurrence of seasonal torpor in hamsters of either sex, indicating that these cycles are regulated by a time measuring mechanism (seasonal clock) that is largely independent of the gonadal cycle. However, castration did influence certain aspects of the body weight and torpor cycles exhibited by male hamsters. 4. Some castrated animals showed a delay in terminating the torpor season lending further support to the hypothesis that the spontaneous recrudescence of the testes which occurs toward the end of the torpor season may play a role in the termination of torpor in males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625575 TI - Tonotopic organization and functional characterization of the auditory thalamus in a songbird, the European starling. AB - 1. The diencephalic auditory nucleus of the European starling, the nucleus ovoidalis, shows rostrocaudal and dorsoventral diameters of 500-800 microns and a mediolateral diameter of 800-1000 microns. This small and sharply delimited nucleus is composed of densely packed neurons. 2. Its tonotopic organization consists of evenly spaced isofrequency contours, with best frequencies decreasing ventrally. The frequency range was found to be 150 Hz to 7030 Hz. 3. Apart from tonotopic organization, other characteristics of single units demonstrate the uniformity of the neuronal population. Units have high spontaneous activities (mean 61 pps; Fig. 4a), and show mainly stimulus correlated tonic discharge patterns. In most cases, excitatory frequency bands are enclosed by inhibitory frequency bands. 4. Single units were tested, applying various stimulus classes differing in time structure (BPN, sine, FM up, FM down, SFM, SAM) but sharing a common frequency band. All neurons tested responded to all classes. Evaluation of stimulus class preference, however, revealed that BPN and SFM caused the strongest responses, whereas FM and SAM were less effective. 5. Comparison of the single unit responses in the ovoid nucleus with those known for avian auditory forebrain and midbrain centres strongly suggests a relay function for the diencephalic nucleus. PMID- 3625576 TI - The echolocation and hunting behavior of the bat, Pipistrellus kuhli. AB - The echolocation and hunting behavior of Pipistrellus kuhli was studied in the field using multi-exposure photography synchronized with high-speed tape recordings. During the search phase, the bats used 8-12 ms signals with sweeps (sweep width 3-6 kHz) and pulse intervals near 100 ms or less often near 200 ms. The bats seemed to have individual terminal frequencies that could lie between 35 and 40 kHz. The duty cycle of searching signals was about 8%. The flight speed of hunting bats was between 4.0 and 4.5 m/s. The bats reacted to insect prey at distances of about 70 to 120 cm. Given the flight speed, the detection distance was estimated to about 110 to 160 cm. Following detection the bat went into the approach phase where the FM sweep steepened (to about 60 kHz bandwidth) and the repetition rate increased (to about 30 Hz). The terminal phase or 'buzz', which indicates prey capture (or attempted capture), was composed of two sections. The first section contained signals similar to those in the approach phase except that the pulse duration decreased and the repetition rate increased. The second section was characterized by a sharp drop in the terminal frequency (to about 20 kHz) and by very short pulses (0.3 ms) at rates of up to 200 Hz. Near the beginning of the buzz the bat prepared for capturing the prey by extending the wings and forming a tail pouch. A pause of about 100 ms in sound emission after the buzz indicated a successful capture (Fig. 4).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625577 TI - Topographic representation of vocal frequency demonstrated by microstimulation of anterior cingulate cortex in the echolocating bat, Pteronotus parnelli parnelli. AB - 1. A midline region of brain dorsal and anterior to the corpus callosum, presumably anterior cingulate cortex, has been explored for its role in the production of vocalization in the mustached bat, Pteronotus p. parnelli. 2. Vocalizations elicited by microstimulation were virtually indistinguishable from natural biosonar sounds. The spectral content, relative intensity of harmonic components, and durations of emitted pulses are comparable to spontaneous emissions. 3. The frequencies of elicited vocalizations were within the range typically used by the mustached bat during Doppler-shift compensation. The frequency of the second-harmonic constant-frequency component (CF2) covered the range from 57-62 kHz, but was most commonly emitted at frequencies of 59-61 kHz. 4. An increase in the frequency of vocalizations over a number of consecutive pulses towards a steady-state plateau is evident in both spontaneous vocalizations and emissions elicited by microstimulation just above threshold. Increasing the stimulus intensity caused the frequency of emissions to approach the steady state more rapidly. 5. The anterior cingulate cortex appears to be organized topographically for increasing frequency of elicited biosonar sounds along a rostrocaudal axis. The area from which biosonar emissions were elicited was overrepresented for a 2 kHz band of frequencies just below the bats' CF2 resting frequency. Audible vocalizations with a complex spectrum resembling social cries can also be elicited by microstimulation, but only in an area that is adjacent and posterior to the biosonar region. 6. Some examples of both elicited and spontaneous vocalizations contained a relative intensity pattern of the harmonic components which deviated from the typical pattern. This suggests that mustached bats are capable of actively altering the spectrum of their pulses to subserve different tasks in echolocation. PMID- 3625578 TI - Coding of sinusoidally amplitude modulated acoustic stimuli in the inferior colliculus of the rufous horseshoe bat, Rhinolophus rouxi. AB - Single neuron responses to sinusoidally amplitude modulated (SAM) signals were studied in the inferior colliculus of the horseshoe bat, Rhinolophus rouxi. 57% of the neurons responded to SAM stimuli with periodical discharges synchronized to the modulation cycle. The proportion of cells driven by amplitude modulated signals was independent of the best frequency of the neurons. Best modulation frequencies were at or below 100 Hz in about 70% of the neurons. Synchronized activity could be elicited by modulation frequencies up to 400 Hz. Best SAM responses were observed at stimulus intensities 10 dB above threshold. Generally the BMF of a neuron did not change with intensity. The BMF decreased with decreasing modulation depth of the amplitude modulation. A trend for a topographical organization of neurons according to best modulation frequencies was detected. The results did not reveal any significant specialization of the bat's auditory system for coding of amplitude modulations as compared to other mammals. PMID- 3625579 TI - Evidence for a daily rhythmicity in the acute release of luteinizing hormone in response to electrical stimulation in the Japanese quail. AB - This study was undertaken to examine the effect of electrical stimulation of the hypothalamus at different times of day on luteinizing hormone (LH) secretion in male castrated quail on short days (8L:16D). The posterior hypothalamus was stimulated with square-wave pulses of 80 microA for 2 min through chronically implanted platinum microelectrodes. Stimulation was carried out on each quail at 4 (treatment A), 10 (B), or 14 h (C) after dawn. Plasma LH levels were increased markedly within 2 min of ending the stimulation but reached basal levels again over the next 20 min or so. The absolute increase was significantly greater in treatment B (10 h after lights on) than at the other times tested. This is consistent with a rhythm in hypothalamic responsivity. The results are discussed in the context of the rhythm of photoinducibility which occurs early in the night and which is used by quail as a photoperiodic clock to regulate seasonal reproduction. PMID- 3625580 TI - Daily distribution of sleep states in the rook Corvus frugilegus. AB - Sleep and wake states were monitored polygraphically in the rook Corvus frugilegus, under the natural photoperiod and temperature. The indices of sleep and wake states in the rook were similar to those described previously for birds in general. The appearance of sleep episodes was confined to the dark part of the photoperiod. Slow wave sleep (SWS) showed a tendency to increase during the course of the night, while paradoxical sleep (PS) showed the opposite trend. The distribution of short SWS episodes were clustered into two groups, one group occurred in the period following the onset of sleep and the other, less prominent group occurred towards the end of sleep. The longest episodes of SWS appeared in the second half of the night, whereas those of PS appeared after onset of sleep. PMID- 3625581 TI - Emotional and familial determinants of elevated blood pressure in black and white adolescent males. AB - The relationships between blood pressure and several personality and traditional risk factors were examined in a sample of black and white adolescent males who were enrolled in a health science course in Tampa, Florida. Although a number of personality and traditional risk factors significantly predicted elevated blood pressure for both groups of adolescent males, suppressed anger and weight were the major independent predictors. Among black and white males, those who generally harbored grudges and suppressed their anger had higher systolic blood pressure; diastolic blood pressure was higher only for the white males who frequently held in their angry feelings. Weight and excessive salt usage significantly predicted both elevated systolic and diastolic pressures for white males, while these variables significantly predicted systolic pressures for black males. Familial factors were found to be independent predictors of systolic and diastolic blood pressure only for the white adolescent males. A further examination of the relationship between the frequency that anger is suppressed shows that the shape of the curves relating anger-in scores to blood pressure appears to have a 'threshold'. These findings indicate that adolescent males who are at increased risk for elevated systolic and diastolic blood pressure can be identified by how often angry feelings are held-in and suppressed. PMID- 3625582 TI - Effectiveness of components of self-verbalization training for control of cold pressor pain. AB - The increase of positive self-verbalizations (PSV), the decrease of negative self verbalizations (NSV), their combination (PSV + NSV) and the use of an informational rationale that included a reconceptualization of pain were compared to a test-retest control group for ice water endurance. The Thought-Listing Questionnaire (TLQ) was used to assess participant thoughts. Sixty college women were pretested, given training, and posttested for ice water tolerance. Only the three self-talk treatments (PSV, NSV, PSV + NSV) produced greater pain tolerance. Analysis of TLQ data revealed a relationship between changes in thoughts and self control of pain. Results suggest that, in contrast to some previous research, PSV and NSV were effective pain control techniques. Differences from other studies included using client-generated thoughts, examining client metacognitions, and promoting high compliance with training (tested by the TLQ). Client use of 'spontaneous' coping strategies was also discussed. PMID- 3625583 TI - Psychological effects of stomas--I. Psychosocial morbidity one year after surgery. AB - Sixty eight subjects who had undergone stoma surgery 12 months previously were assessed as to their psychiatric and social outcome. They had been previously also assessed at the 3rd month postoperatively. The majority had a diagnosis of bowel cancer (38) and smaller numbers had inflammatory bowel disease (15) or diverticular disease (15). 22% of the subjects had moderate or severe psychiatric symptoms and most of these had also shown similar disturbance at the 3 month assessment, indicating that the condition was longstanding. There was no significant difference in outcome between the diagnostic groups. The results also showed that ability to perform housework, leisure and sexual activities was affected in a number of subjects. PMID- 3625584 TI - Psychological effects of stomas--II. Factors influencing outcome. AB - Sixteen patients with a moderate or severe anxiety and/or depression one year after stoma surgery were compared with 52 patients who had made a good psychiatric adjustment. Factors that were associated with an increased risk of psychiatric morbidity included a previous psychiatric history, postoperative physical symptoms and complications, inadequate advice and personality traits of neuroticism, anxiety and obsessionality. PMID- 3625585 TI - Heart disease mortality following widowhood: some results from the OPCS Longitudinal Study. Office of Population Censuses and Surveys. AB - Many studies have suggested that following the experience of 'stressful' life events the risks of myocardial infarction, accidents and perhaps other diseases are elevated. In the OPCS Longitudinal Study routinely collected data on deaths, and deaths of a spouse occurring in a 1% sample of the population of England and Wales in the period 1971-1981 are linked together, and with 1971 census records of sample members. The timing and patterns of death following the potentially very stressful event of conjugal bereavement may thus be analysed. Overall the mortality (from ischaemic heart disease) was less than 10% in excess of that in all members of the LS sample. As in many earlier studies, some increases in death rates shortly after widowhood are observed. Unusually, for deaths from all causes these increases are more marked in widows than in widowers with, for example, a two-fold increase in mortality from all causes in the first month after widowhood. However, no peak of post-bereavement mortality from ischaemic heart disease is clearly established in either sex. Although the study is large, with a well-chosen control group, only a limited characterisation of study members from data collected in the census is possible. In particular, no measures of personality, behaviour or diet are available. Investigation of potential effects of social or familial support, as measured by household structure and numbers of children, led to equivocal results. Several possible explanations for the increased mortality rates are examined. Hypotheses based on common marital environment, homogamy or simultaneous accidental death are seen to be of very limited value. The observed patterns, although consistent with an early effect of a stressful life event, do not suggest that stress following bereavement leads to an excess of ischaemic heart disease mortality. PMID- 3625586 TI - Type A behaviour and other psychological factors in peptic ulcer disease. AB - A variety of personality traits and psychological symptom states have been reported to be associated with peptic ulcer disease. In the present study, male patients with confirmed duodenal or gastric ulcer(s) are compared with patient and non-patient control groups in terms of Type A behaviour, the Eysenck personality dimensions, hostility, state and trait anxiety, and depression. By comparison with cardiac patients, the peptic ulcer groups obtained lower Type A scores but were similar on the other variables. By comparison with age and sex matched community controls. GU patients obtained higher trait anxiety and psychoticism scores while the DU group had higher state anxiety levels. The implications of these findings in terms of the role of psychological factors in the aetiology of peptic ulcer disease are discussed. PMID- 3625587 TI - Individual knowledge of emotions in asthmatic children. AB - Twenty male asthmatic children (ages 9-11) and their controls were interviewed regarding their concept of emotion using the interview format developed by Harris et al. (1981). The purpose of the study was to examine the asthmatic children's views on the nature and effects of happiness, anger and fear, together with strategies of self-control. The results indicate that healthy and asthmatic children have a different individual view of emotion. The most relevant finding concerns the different way in which healthy and asthmatic children consider fear: the most frequent view of fear in healthy children is similar to a behaviouristic model of emotion, while asthmatic children express a notion very similar to a cognitive model. Regarding anger, almost all healthy children believe themselves capable of exerting self-control whether on the inner mental components or on its outer expression, where a change of direction of mental processes is the only way asthmatic children see to modify their anger. The implications of these findings both for a description of asthmatic personality and therapy are outlined. PMID- 3625588 TI - The relationship between expectations of pregnancy and birth, and transient depression in the immediate post-partum period. AB - Ninety-eight primiparous women recruited from antenatal classes evaluated their expectations and experiences of pregnancy and delivery before and after birth. On each day they were in hospital post-partum, the women were also asked to rate their level of depression. No correlation was found between anticipated and actual experience of birth. However, women who rated the birth experience as being unpleasant, also reported retrospectively that they were not expecting this to occur. The most consistent predictors of depression in the days immediately after birth were trait anxiety and fear of birth, assessed during pregnancy. Expectation of birth, birth experience, and whether birth was as expected, did not predict post-partum blues. The implications of these results for procedures for preparing women for childbirth are discussed. PMID- 3625589 TI - Descriptive clinical research and medically unexplained physical symptoms. AB - Improving the understanding and classification of physical symptoms presently regarded as medically unexplained is handicapped by a lack of descriptive clinical data. This paper supports the urgent need for descriptive studies in this field, and backs this view by presenting such a study based on sample of patients registered in general practice. It was found that potentially useful subclassifications could be based on descriptive clinical variables such as symptom type (e.g. pain), symptom course, symptom duration and previous consultation pattern. The findings are discussed in relation to conditions such as somatisation disorder, the syndrome of chronic unexplained pain, and panic disorder. PMID- 3625590 TI - The relationship between diabetic control and individual and family characteristics. AB - Thirty eight children and adolescents between the ages of 10 and 17 years were examined for an association between diabetic control and psychological health determined by questionnaires to examine self concept, locus of control and family cohesion and adaptability. The group as a whole had a high score on the self esteem dimension, were moderately external on the locus of control scale and the families were considered close and flexible. HbA1 showed modest correlations with adaptability (p less than 0.05) and with locus of control (not significant on this small sample size). The data suggests, surprisingly, that there is a tendency for good diabetic control sometimes to be achieved by individuals with an external locus of control by a rigid family organisation when there is a danger that the development of autonomy and independence may be at risk. There is also the suggestion that a few individuals have achieved a balance between moderately good diabetic control and psychological health. PMID- 3625591 TI - Sex differences in prolactin change during mourning. AB - Fourteen men and 12 women were interviewed eight weeks after conjugal bereavement to discuss the events prior to the spouse's death and the subsequent bereavement period. Prolactin (PRL) was measured at the beginning and end of the interview. Descriptions of the deceased spouse were obtained during the interview and rated for Developmental Level of Object Representation (DLOR), a measure of the cognitive complexity of the description. There were significant correlations between DLOR and PRL change for both men and women but the correlation for women was positive and the correlation for men was negative. These findings extend the literature on the psychological correlates of PRL change and suggest that the physiological changes associated with mourning are different for men and women. PMID- 3625592 TI - Psychiatric morbidity following mastectomy: preoperative predictors and types of illness. AB - One hundred and twenty-two women with primary operable breast cancer were interviewed before, 3 months after and 12 months after mastectomy. Twenty-six percent of women had psychiatric symptoms 12 months after operation which justified a research diagnostic criteria diagnosis but most of the illnesses were mild; only 5% of women were regarded as being psychiatrically ill by a psychiatrist. The patients psychiatric state preoperatively, the treatment package received by the patient and the patient's marital relationship were related to psychiatric outcome three months after operation. The patient's psychiatric state preoperatively, her marital status, social class and menopausal status were all predictors of psychiatric outcome 12 months after operation. These results are discussed in terms of the practical way in which women at risk of psychiatric illness postmastectomy could be identified preoperatively by a nurse counsellor. PMID- 3625593 TI - The development and preliminary validation of an instrument to assess patients' attitudes toward pain. AB - This paper describes the development and preliminary validation of a questionnaire designed to assess five attitudes considered important in the long term adjustment of chronic pain patients. The specific subscales of the questionnaire were chosen to represent attitudes believed to influence the ways by which chronic pain patients manage their pain. Following the development of five reliable subscales, correlations of the subscales with self-reported pain behaviors and coping strategies were calculated, providing preliminary support for the concurrent validity of the instrument. PMID- 3625594 TI - Effects of induced hyperventilation on electrodermal response habituation to agoraphobia-relevant stimuli. AB - The role of hyperventilation in the aetiology of anxiety disorders was investigated in an analogue study. It was hypothesised that induced hyperventilation would alter subsequent subjective and physiological responses to visually presented agoraphobic material. Three groups (N = 16) of students were used and each was divided into two sub-groups which were presented with slides of either potentially agoraphobic or neutral content. During the first phase of the experiment, subjects were exposed to 10 slides whilst their breathing rate was manipulated. Group FB was instructed to hyperventilate by asking the subjects to breathe fast and deeply, Group SB was instructed to breathe at a slow rate and Group NB breathed normally. After a recovery phase, subjects were re-exposed to the same visual stimuli as used in the first phase of the experiment. Measures of skin conductance response amplitude were obtained for each stimulus in the series. In addition, heart rate and respiration were monitored, and subjective measures of somatic and affective states were obtained. Subjects also rated the pleasantness of the stimuli. The hyperventilation instructions resulted in delayed electrodermal habituation relative to the other groups. This finding could not be accounted for in terms of group differences in either physiological or subjective 'arousal'. PMID- 3625595 TI - Preliminary experience with a vacuum constriction device (VCD) as a treatment for impotence. AB - The VCD is a mechanical device that produces an erection by creating a vacuum of up to 250 mm Hg. Up to now, it has been used in patients with organic impotence (mainly diabetic) with a high level of success and minimal side effects. This study reports preliminary findings on the application of the VCD in both organic (e.g. diabetics) and psychogenic cases of impotence. All subjects were able to develop an adequate erection with the instrument making intercourse possible. However, the frequency of use dropped sharply as the study progressed and some subjects and their sexual partners expressed reservations about continuing with it. Mild numbness in the penis was experienced by several users. PMID- 3625596 TI - Stress injuries of the gastric mucosa. PMID- 3625597 TI - Purification and characterization of ovarian LH/hCG and prolactin receptors. AB - We have purified the luteinizing hormone (LH)/human choriogonadotropin (hCG) receptor to homogeneity by sequential affinity column on wheat germ lectin Sepharose and hCG-Sepharose. The method was designed to allow also the purification of lactogen receptor from the initial starting material. Comparable purification of lactogen receptor can be attained using Con A-Sepharose as initial step. The purified LH/hCG receptor was identified as a single protein of Mr = 75,000 on SDS gel electrophoresis. The lactogen receptor is composed of two dissimilar active subunits of Mr 88,000 and 40,000, the latter probably being an integral part of the larger form. Comparison of Mr's derived from SDS gels with those from fast performance liquid chromatography suggested that the native LH holoreceptor is present in a dimeric form, while the lactogen receptor seems to be composed of aggregates that could represent dimeric or trimeric forms of holoreceptor Mr 80,000. Cross-linking studies performed after binding of hCG (radiolabeled in the individual subunits) to the purified LH/hCG receptor indicated that the hCG alpha-subunit undergoes predominant interaction with the receptor molecule. The influence of the beta-subunit in this interaction seems to occur mainly through its association with the alpha-subunit, presumably by conferring specificity to the alpha-subunit for its interaction with the receptor. The alpha-subunit, which is identical within species, has an important role in the receptor binding interaction and biological activity of glycoprotein hormones. PMID- 3625598 TI - Opposite regulation of serotonin-S2 and dopamine-D2 receptors in rat brain following chronic receptor blockade. AB - Rats were chronically treated with setoperone, a mixed serotonin and dopamine antagonist. Alterations in serotonin-S2 and dopamine-D2 receptors in the brain and changes in behavioural responses to tryptamine and apomorphine were studied along with duration of treatment and drug withdrawal. As with neuroleptics, behavioural supersensitivity to apomorphine and increase in the number of striatal dopamine-D2 receptor sites were apparent after 2 days setoperone treatment, both effects were maximal with 14 days treatment and were maintained over more than 20 days drug withdrawal. In contrast to the changes in the dopaminergic system, the rats showed a decreased response to tryptamine and serotonin-S2 receptor sites in the frontal cortex were significantly reduced in numbers. Both effects developed in parallel over 14 days treatment and extinguished over 10 days drug withdrawal. KD-values of radioligand binding to dopamine-D2 and serotonin-S2 receptor sites were unchanged by the setoperone treatment. The concomitant development and extinction of the in vivo and in vitro effects suggests a causal relationship between them. Chronic treatment with a selective histamine-H1 antagonist (levocabastine) or the tranquilizer diazepam did not affect dopamine-D2 or serotonin-S2 receptor sites. These observations demonstrate that in contrast to the receptor regulation theory, serotonin-S2 receptors are down regulated following persistent receptor blockade. Implications for the clinical use of serotonin antagonists and possible molecular mechanisms involved in the receptor regulation have been discussed. PMID- 3625599 TI - The Torpedo electrocyte: a model system for the study of receptor-cytoskeleton interactions. AB - We have used the electrocyte of Torpedo electric organ as a model system for the study of AchR stabilization in the postsynaptic membrane. Attention was focused on membrane cytoskeleton interactions in particular on a peripheral protein of 43 KD that is believed to participate in AchR immobilization. Using immunocytochemical methods, we have shown that the cortical skeleton in Torpedo electrocyte displays a local differentiation proper for each specialized domain of the plasma membrane. In the postsynaptic membrane, characterized by an accumulation and a geometrical organization of the receptors in the plane of the membrane, the 43 KD protein participates in a submembraneous coating or "postsynaptic densities" that strictly codistribute with the AchR. The 43 KD protein might also account for the anchoring of intermediate-sized filaments. The organization of the postsynaptic domain appears readily different from that of the non-innervated one where the membrane folds are maintained by a cortical meshwork of cytoskeletal proteins such as ankyrin, spectrin and oligomeric actin. In conclusion, the asymmetrical organization of the cortical skeleton in the electrocyte offers a unique opportunity for the study of the specific aspects of membrane-skeleton interactions that take place in the postsynaptic domain. PMID- 3625600 TI - Platelet-binding immunoglobulins in pregnancy-induced hypertension. I. Platelet associated IgM on fetal platelets: evidence of a fetal autoimmune reaction? AB - Pregnancy-induced hypertension (PIH) can be complicated by maternal or fetal thrombocytopenia, or both. In order to investigate possible immunologic causes of these thrombocytopenias, platelet-associated IgG (PAIgG) and IgM (PAIgM) were measured in mothers with PIH and in their infants and compared with those from patients with autoimmune thrombocytopenic purpura (ATP), a known immunodestructive platelet disorder. Many PIH patients (33.3%) and most ATP patients (68.1%) had elevated levels of maternal PAIgG. In both diseases, the amount of PAIgG was directly proportional with the degree of thrombocytopenia (r = 0.446 in PIH and r = 0.668 for ATP). But in neither disease did the degree of maternal thrombocytopenia correlate with the degree of neonatal thrombocytopenia (r = 0.153 for PIH and r = 0.175 for ATP). Umbilical cord samples from PIH patients contained PAIgG (53.3%) and PAIgM (53.8%), whereas the umbilical cord samples from ATP patients had elevated amounts of PAIgG but not PAIgM. PAIgM in the umbilical cord blood could not be accounted for by IgM rheumatoid factors, IgM-containing immune complexes, or non-specific adsorption because of elevated total IgM levels. The umbilical cord blood PAIgM was probably not of maternal origin because it was observed even when the maternal blood contained no PAIgM and maternal IgM is not normally transported transplacentally. Therefore, the PAIgM appears to be of fetal origin. These results suggest that both maternal and fetal immunologic mechanisms may be involved in PIH-induced thrombocytopenia; if so, this is one of the first reported examples of a possible fetal autoimmune response. PMID- 3625601 TI - Platelet-binding immunoglobulins in pregnancy-induced hypertension. II. Origin of circulating IgG and IgM antiplatelet antibodies in the umbilical cord serum. AB - IgG and IgM have been identified on the surface of maternal platelets in both autoimmune thrombocytopenia (ATP) and pregnancy-induced hypertension (PIH). IgG is also found on the umbilical cord platelets of patients with ATP and PIH, whereas IgM is only found on the umbilical cord platelets of patients with PIH. The possible maternal or fetal origins of these umbilical cord blood immunoglobulins were investigated by immunoblot analysis of antibodies in paired maternal and umbilical cord blood sera of ATP and PIH patients. Maternal sera contained IgG and IgM antibodies which reacted with several platelet proteins, however, a large amount of patient-to-patient variation was observed in the specific antigens that were identified. Analysis of paired maternal and umbilical cord sera from patients with ATP or PIH showed identical patterns of antigen specificity, which suggested that the IgG antibodies in the fetal circulation were of maternal origin. Circulating IgM antibodies were not observed in the umbilical cord sera of ATP patients. The umbilical cord sera of PIH patients, however, contained IgM antibodies that reacted against a variety of platelet antigens. In addition, most umbilical cord sera from PIH patients had identical patterns and relative intensities of reactivity, which differed from the patterns observed in the paired maternal sera. Antiplatelet IgM in the umbilical cord blood of PIH patients, therefore, appears to be a product of the fetal immune system. PMID- 3625602 TI - Uptake of lymphocytes fed to suckling rats. An autoradiographic study of the transit of labeled cells through the neonatal gastric mucosa. AB - To determine the potential for transfer of maternal lymphocytes to the newborn during suckling, radiolabeled cells were fed to rat neonates of different ages and autoradiographs prepared from tissue sections obtained from the stomach and small intestine. The entire stomach (including contents) and intestinal walls were observed using semiserial 3 micron methacrylate plastic sections. For these studies 100 X 10(6) [3H]uridine-labeled lymph node cells were fed to 1-4-day-old neonates using a smooth-tipped intubation needle. Some of the lactating female rats had been given radioisotope prior to delivery and "cold" babies were fostered to them to enhance the number of labeled cells in the neonatal digestive tract. Babies were killed at 1, 2, 4, 8, 24 and 48 h after feeding. The stomach contents showed a considerable number of labeled cells (32% at 1 h after feeding) and many of these cells were in close proximity to the epithelium. The gastric epithelium often exhibited gaps between adjacent epithelial cells similar to those we have previously reported in the lactating mammary epithelium, and labeled cells were observed in the immediate area of the gaps. Labeled cells were seen in the neonatal gastric epithelium, lamina propria, mesenteric attachments, in the wall and lumen of small gastric blood vessels and adjacent lymph nodes. Labeled cells were most abundant in the gastric wall at 1-2 h following feeding, indicating that transit through the epithelium occurred rapidly. Although labeled cells were seen in the lumen of the small intestine, none were observed in the tissues of the intestinal wall. When heat-killed labeled cells were fed, no labeled cells were seen in the tissues of the neonatal gastrointestinal tract. It is apparent from these studies that a portion of the leukocytes that are delivered to the neonate during suckling are able to transit the gastric epithelium and establish themselves in the neonate's tissues, presumably to aid in the protection of the immunologically naive infant. PMID- 3625603 TI - Altered humoral immunity during pregnancy in the guinea pig. AB - A guinea pig model was developed to determine whether humoral immune responsiveness is altered during pregnancy. Pregnant animals were immunised at mid-gestation with haptenated protein. The humoral response to antigen was measured as numbers of antibody-producing cells in the spleen, the affinity of the antibody produced by spleen cells and the levels of IgG in the serum. The values obtained were compared with those from an age matched non-pregnant control group. Early in the primary response, there was a significant decrease in the number of IgM antibody-producing cells with an associated decrease in serum IgM levels in pregnant animals. Late in the primary response, pregnant and control animals had similar levels of IgM antibody-producing cells. During the later stages of the response, many of the pregnant animals did not respond with IgG antibody-producing cells or IgG in the serum. When IgG-producing cells were detected, the antibody was of lower affinity than that observed with the control group. A selective lack of responsiveness was detected in the primary response of pregnant guinea pigs. The reduced number of IgG antibody-producing cells in gravid animals suggests that an immune switch from IgM to IgG is impaired in pregnancy. The low affinity of antibody produced indicates the immunoglobulin produced in pregnancy may also be functionally limited. PMID- 3625604 TI - Detection and characterization of human secretory "pregnancy-associated endometrial alpha 2-globulin" in uterine luminal fluid. AB - Pregnancy-associated endometrial alpha 2-globulin (alpha 2-PEG), the major secretory protein of the human endometrium as assessed by in vitro de novo synthesis and secretion, during the mid- to late-luteal phase of the menstrual cycle and early first trimester pregnancy, has now been detected immunochemically in uterine luminal flushings during the luteal phase of the menstrual cycle. Physicochemical characterization of this immunoreactive alpha 2-PEG demonstrated that it exhibited identical properties to the protein isolated from either the cytosol of pregnancy endometrium or medium from in vitro cultures of pregnancy endometrium, i.e. native Mr 56 K, subunit Mr 28 K, eluted from an anion exchange column at 0.11 M NaCl and bound to concanavalin A. These findings, together with other evidence, suggest that a major route of secretion of alpha 2-PEG during the luteal phase of the menstrual cycle in vivo is into the lumen of the uterus. These results are discussed with reference to the hypothesis that alpha 2-PEG, derived from the endometrial glandular epithelium, may represent the human functional analogue of uteroglobin and to the implications for the human of the hypothesized immunosuppressive role of uteroglobin and transglutaminase (Factor XIII) in masking Class I MHC antigens on gametes and the conceptus. PMID- 3625605 TI - Serological detection of early pregnancy in cattle and partial characterization of a serum glycoprotein associated with early pregnancy. AB - Sera from heifers prior to artificial insemination (AI), 1-8 days after AI, and 7 days after embryo removal were investigated by crossed immunoelectrophoresis (CIE) by use of rabbit antiserum produced against bovine early pregnancy serum and intensively absorbed with non-pregnancy serum. One precipitation peak appeared in the alpha-globulin region when sera of non-pregnant heifers were under study. An additional peak could be demonstrated in the same region when sera of early pregnant heifers were investigated. By this method 91.5% of 71 sera samples were classified correctly to be pregnant or non-pregnant. The glycoprotein character of the above two serum components could be shown by binding to concanavalin A (Con A) in lectin affinity CIE. Relative molecular weights were estimated to be about 70,000 and 80,000 for the peptides of these two proteins applying sodium dodecyl sulfate polyacrylamide gel electrophoresis of precipitates cut out from CIE-plates. As shown previously close relation of this early pregnancy associated protein (EPAP) to the early pregnancy factor is supposed because of its characteristics and its ability to affect cellular immunity. PMID- 3625606 TI - The effect of antisera to thymosin alpha 1 on the course of autoimmune ovarian dysgenesis in neonatally thymectomized mice. AB - Thymectomy at 3 days of age (Tx-3) in B6A female mice results in an autoimmune oophoritis that has only been successfully overcome by the transplant of an intact thymus or an injection of T cells. In Tx-3 mice levels of thymosin alpha 1 (TSN alpha 1), a potent thymic hormone involved in the development of helper T cells, was previously shown to be high after 7 days. By 60 days levels of TSN alpha 1 returned to levels found in intact mice. By this age ovarian dysgenesis was also complete and accompanied by high circulating levels of auto-oocyte antibody (AOA), estradiol-17 beta (E2) and testosterone (T). In the present study injections of antisera to TSN alpha 1 were given to Tx-3 mice in an attempt to decrease circulating TSN alpha 1 levels. We reasoned that this treatment should inhibit lymphocyte differentiation, and possibly in turn aid in overcoming the ovarian dysgenesis. After treatment of the Tx-3 mice, dysgenic ovaries persisted and high levels of AOA remained similar to the untreated Tx-3 mice. Levels of E2 and T, however, were returned to those found in intact mice. These results suggest that there is a sensitive balance between the thymus and the ovary that may not be related to changes in only a single thymic hormone. PMID- 3625607 TI - Detection of trophoblast-like cells in maternal blood using specific monoclonal antibodies. AB - Mouse monoclonal antibodies reacting against membrane antigens expressed on syncytiotrophoblast (McAb H315), villous cytotrophoblast (McAb 18B/A5) and placental-type alkaline phosphatase-producing cells (McAb H317) were used in conjunction with flow cytometry to detect placental cells in the maternal circulation. H315 and H317-positive cells were found in uterine veins and peripheral blood of pregnant women, while cells reacting with McAb 18B/A5 were either absent or present in very low numbers. PMID- 3625608 TI - The fertilization antigen (FA-1) causes a reduction of fertility in actively immunized female rabbits. AB - Female rabbits were actively immunized against the fertilization antigen (FA-1) isolated from lithium diiodosalicylate (LIS)-solubilized murine testis. Three trials were performed in order to check the effect of immunization on fertility. In all of these trials, there was a significant (P less than 0.001) reduction of fertility as determined by the percentage of 9-day implants/corpora lutea ratio (FA-1, 0-26.3%; adjuvant control, 79.4-100%). A complete block was observed in animals which received intravenous booster immunization with the antigen. Antisera collected from FA-1-immunized rabbits were negative in the agglutination and the immobilization techniques, and demonstrated modal titers of greater than or equal to 1:2560 in the enzyme linked immunosorbent assay (ELISA) using FA-1. Antisera were tissue-specific and showed binding to the specific protein bands of 47,000 and 23,000 Mr, dimeric and monomeric forms of FA-1, respectively, in the Western blot procedure. Ova collected from rabbits inseminated with sperm which had been treated with antiserum from immunized rabbits showed reduced fertilization rates (anti-FA-1, 3.9-27.7%; control rabbit serum, 87.8%). There was again a reduction in percentage of the 9-day implants/corpora lutea ratio in the rabbits inseminated with treated sperm (anti-FA-1, 10.7%; control rabbit serum, 72.7%). It is concluded that active immunization with FA-1 resulted in a tissue-specific immune response which caused a reduction of fertility in rabbits, by a mechanism(s) involving an inhibition of the fertilization process. PMID- 3625609 TI - Phenotypic heterogeneity and recycling capacity of natural killer cells in normal human pregnancy. AB - Natural killer (NK) cells have the ability to kill a variety of target cell types and the possibility that such cells could mount an effective attack on the developing fetus has not been discounted. The present study extends previous work showing that maternal NK reactivity against K562 target cells (TC) is reduced during pregnancy. Here we demonstrate using cytotoxicity assays at both the population and single cell level that, although depressed in number, maternal NK cells exhibiting the capacity to kill K562 TC are as lytically active in their ability to recycle and destroy multiple TC as NK cells from non-pregnant females. Moreover, two colour immunofluorescence analysis of the NK cell-associated markers Leu-7 and Leu-11b indicates that, in addition to a reduction in the absolute number of TC conjugate-forming cells, pregnant females present in their peripheral blood a larger proportion of TC-binding Leu-7+11- cells. These cells may be lytically immature. Small changes in NK cell profile and activity in maternal peripheral blood may be indicative of much more significant changes at the feto-maternal interface. It is, however, clear that pregnant females retain a population of highly active NK cells, thus minimising the possibility of immunocompromise. PMID- 3625610 TI - Modulation of the natural killer cell activity in pregnant mice alters the spontaneous abortion rate. AB - Effector cells associated with an aborting fetus appear to be both thymus derived (T) and natural killer (NK) cells. In order to test the hypothesis that NK cells are a major effector mediating early spontaneous abortion (less than day 8-10), CBA female mice mated by DBA/2 males were treated with either polyinosinic/cytidylic acid (poly I:C) to boost NK activity, or rabbit anti asialo GM1 (RaASGM1) to decrease NK activity. The results of the NK assays of the spleens of treated mice confirmed that the reagents had the expected effect on NK activity and an inspection of the uteri indicated a significant increase in aborted embryos after poly I:C and a marked decrease in spontaneous abortions after RaASGM1 treatment. Therefore, spontaneous abortions may be mediated in part by the cytotoxic activity of unregulated NK cells. PMID- 3625611 TI - Immunological and morphological characterisation of nucleated cells other than sperm in semen of oligospermic donors. AB - Nucleated cells other than sperm (NCOS) were obtained from semen samples of oligospermic donors. The cells, after separation from sperm, were studied by immunological and morphological techniques including electron microscopy (EM). Using an indirect immunofluorescence (IIF) test, more than 95% of the NCOS reacted with xenoantisera specific for human sperm and germ cells but showed less than 5% reactivity with monoclonal antibodies (MoAbs) directed against surface markers of different leucocyte subsets or cytokeratin. This indicated that the majority of NCOS were germ cells in origin. These results were concordant to those obtained by EM which showed the presence of germ cells at various stages of differentiation. Our data therefore show that the application of immunological techniques could help and may replace laborious EM in the identification of the different cell types among NCOS. Also, the results emphasize that germ cells and not leucocytes appear to be the major cell type among NCOS, a concept which could have therapeutic and biological implications. PMID- 3625612 TI - Capacitation-related changes in antigen distribution on mouse sperm heads and its relation to fertilization rate in vitro. AB - The anti-mouse sperm monoclonal antibody OBF13 did not react with fresh epididymal sperm. However, when sperm were incubated in a culture medium capable of inducing capacitation, the entire head of the sperm began to react with this antibody. This change of reactivity was not observed when sperm were incubated in a Ca2+-free medium. The change of the reactivity to the antibody was studied in relation to the fertilizing ability of sperm as measured in an in vitro fertilization system; a significant correlation was observed between the appearance of head-stained sperm and fertilization rate. PMID- 3625613 TI - Convulsions in hypertensive, proteinuric primiparas more than 24 hours after delivery. Eclampsia or some other cause? AB - A diagnosis of eclampsia has been considered inappropriate when the onset of a convulsion is greater than 24 hours after delivery. The observations presented here provide strong support for waiving the 24-hour rule, at least when convulsions from no other apparent cause and accompanied by hypertension and proteinuria occur in a primipara as late as 10 days postpartum. Late postpartum eclampsia seems an appropriate term for this very uncommon condition. PMID- 3625614 TI - Plasma and platelet norepinephrine in normal and preeclamptic pregnancy. AB - Catecholamines accumulate in platelets, and platelet catecholamine concentrations may give a more stable index of sympathoadrenal activity than do random plasma values. We measured norepinephrine in plasma and platelets from normal, nonpregnant women and from normal and preeclamptic pregnant women with a radioenzymatic assay. Plasma and platelet norepinephrine was not markedly different in normal, pregnant women during the third trimester, intrapartum or postpartum when compared with those levels in nonpregnant women. Platelet norepinephrine was significantly elevated in women with mild preeclampsia, but plasma norepinephrine was not. A linear relationship existed between platelet count and platelet norepinephrine concentrations in women with preeclampsia. These findings are compatible with the hypothesis of increased sympathoadrenal activity in women with mild preeclampsia and normal platelet counts. The lower platelet norepinephrine in thrombocytopenic patients suggests that platelet activation and degranulation have occurred and indicate that platelet catecholamine concentration does not provide a stable index of sympathoadrenal activity when platelets are being consumed. PMID- 3625615 TI - On-line processing of the fetal electrocardiogram. A new direction for fetal monitoring. AB - Digital filtering techniques can be applied to the recovery of the fetal electrocardiogram (ECG) from noise, using optimized digital filters matched to the frequency characteristics of the waveform. By forming a linear model of the fetal ECG, it is possible to measure time constants and characteristics on a real time basis. The technique provides a powerful tool for the detection of subtle changes in the ECG, but the interpretation of these changes is critical to the application of the technique in fetal monitoring. Shifts in the ST segment and changes in T wave configuration are late indicators of fetal asphyxia, whereas the earliest indicators of stress are shortening of the PR interval and inversion of the normal positive relationship between the PR and RR intervals. The method appears to substantially enhance our ability to predict fetal stress at an early stage. PMID- 3625616 TI - Potassium homeostasis in pregnancy. AB - We selectively reviewed potassium (K) metabolism during human gestation, focusing on the influence of progesterone on renal K excretion. Approximately 300 mEq of K is gained during pregnancy. Two-thirds of it are in the products of conception, but little is known about renal K handling during gestation. We have suggested that progesterone may play a role in preventing the kaliuresis that normally occurs when aldosterone levels are elevated and substantial quantities of sodium are presented to distal nephron sites. In addition, we hypothesize that subtle K secretory problems, such as those known to occur in sickle cell disease, may be aggravated during gestation, probably due to elevated circulating levels of progesterone. PMID- 3625617 TI - The blood pressure course in primiparous pregnancy. A prospective study of 383 women. AB - Left lateral recumbent blood pressures were studied throughout pregnancy in all nulliparous women presenting for prenatal care at a single outpatient clinic. Six percent of these women developed preeclampsia. The incidence of preeclampsia was markedly higher among teens (13.6%). Diastolic blood pressure among normal women declined by less than 5 mm Hg from the first trimester to midgestation. During the third trimester the diastolic pressure returned to first-trimester levels. No significant difference was detected in the first- and early-second-trimester group mean blood pressure between normals and women later developing preeclampsia. However, by 25-28 weeks, before the onset of overt preeclampsia, blood pressures were significantly higher among preeclamptics. PMID- 3625618 TI - Maternal C-reactive protein and preterm labor. AB - Maternal C-reactive protein (CRP) was measured in 109 pregnant women: 34 who were in labor before 35 weeks, 25 who were in labor at term and 50 who were not in labor. CRP values were correlated with outcome of tocolysis and with gestational age. Among 34 women in preterm labor, a CRP of greater than of equal to 0.8 mg/dL had a sensitivity of 85% (17/20) and a value of 81% (17/21) in predicting delivery within one week. Ten of the 14 who delivered more than one week following tocolysis had a CRP less than 0.8 mg/dL (71% specificity). Maternal CRP of greater than or equal to 0.8 mg/dL identifies a subgroup of women in preterm labor at highest risk of preterm delivery. PMID- 3625619 TI - Lactation and reproduction in Western Australian women. AB - There has been an increase in the incidence of breast-feeding in industrial areas, particularly in Western Australia, where one in four infants is breast-fed into the second year of life. Most of this increase in the incidence of breast feeding is found in the higher socio-economic groups, pointing to a need to collect data on milk yield in such women. The levels of milk yield in women with infants between 1 and 6 months ranged from a mean of 1.13-1.24 kg/24 h. This is a higher level of milk production than the generally accepted range of 0.7-0.9 kg/24 h. However, this difference is due, in part, to a failure of previous test weighing methods to correct for the evaporative water losses in either the infant or mother. There was no relationship between the introduction of solids and a return to fertility in 38 women breast-feeding on demand. The return of the ovulatory menstrual cycle in women resulted in two acute changes in milk composition. These changes were characterized by a rise in the concentration of sodium and chloride and a fall in the concentration of potassium, glucose and lactose in breast milk. The first change occurred five to six days before ovulation, and the second occurred six to seven days after it. Following the cessation of breast-feeding, the concentration of lactose in breast milk gradually declined, but the concentrations of anti-bacterial proteins (IgA and lactoferrin) gradually increased to high levels over a period of 30-40 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625620 TI - Concurrence of the Holt-Oram syndrome and the Rokitansky-Kuster-Hauser syndrome. A case report. AB - A 15-year-old white woman, karyotype 46,XX, had an absent vagina and uterus (Rokitansky-Kuster-Hauser syndrome) as well as an atrial septal defect and transphalangeal thumb (Holt-Oram syndrome). The concurrence of the above two syndromes has not been reported on before. PMID- 3625621 TI - Calcific constrictive pericarditis in pregnancy. A case report. AB - A woman developed congestive heart failure after a normal delivery. The underlying disease was diagnosed as calcific constrictive pericarditis, and the patient underwent pericardiectomy. PMID- 3625623 TI - Ectopic pregnancy with shock and undetectable beta-human chorionic gonadotropin. A case report. AB - A patient with an ectopic pregnancy presented with intraabdominal hemorrhage, hypotension and a beta-human chorionic gonadotropin (beta-hCG) less than 5 mIU/mL. Although rare, a negative beta-hCG does not rule out the diagnosis of ectopic pregnancy. PMID- 3625624 TI - Sexuality and the arthritic patient--how well are we doing? PMID- 3625622 TI - Pulmonary lymphangiomyomatosis complicating pregnancy. A case report. AB - A 32-year-old primigravida presented with cough and dyspnea at 16 weeks' gestation. Chest roentgenogram revealed a large pleural effusion and diffuse interstitial infiltrates. Moderate arterial hypoxemia and a significant reduction in vital capacity were present. Thoracentesis revealed sterile chyle with no evidence of malignancy. Spontaneous delivery of a healthy infant occurred at 38 weeks, but no change was seen in either the pulmonary infiltrates or chylothorax. Open lung biopsy confirmed the clinical impression of pulmonary lymphangiomyomatosis, and a pleurodesis was performed. Progesterone and estrogen receptor assays on the lung biopsy material revealed only minimal binding. Following two years of therapy with tamoxifen citrate and megestrol acetate, the chylothorax has not recurred, and there has been no other appreciable change in pulmonary function. PMID- 3625625 TI - Autoantibodies and antibodies to microorganisms in rheumatoid arthritis: comparison of histocompatible siblings. AB - A selection of antibodies to microorganisms were assayed on sera from a group of 12 pairs of HLA identical rheumatoid arthritis (RA) discordant siblings. Our results did not show any consistent quantitative or qualitative differences between RA and non-RA. However, autoantibodies were commoner and of higher titer in the subjects with RA. There was a difference in the antibodies to intrinsic antigens in RA which was not reflected in the antibodies to extrinsic antigens. PMID- 3625626 TI - Plasminogen activator in synovial fluid from patients with rheumatoid arthritis. AB - The plasminogen activator in synovial fluid from patients with rheumatoid arthritis (RA) and osteoarthritis (OA) was analyzed on a molecular basis. The level of plasminogen activator in RA was found to be higher than in OA. The plaminogen activators of both RA and OA revealed 3 different molecular weights: 90,000, 55,000 and 33,000. RA demonstrated the 3 plasminogen activators in broadly comparable ratios, but OA had the 55,000 form dominantly. The 90,000 plasminogen activator was a tissue-type plasminogen activator, while the 55,000 and 33,000 plasminogen activators were of the urokinase-type. beta-Methasone suppressed the tissue-type plasminogen activator, and urinary trypsin inhibitor suppressed the urokinase-type plasminogen activators. When urinary trypsin inhibitor was injected clinically into the joint space of a patient with RA, the urokinase-type plasminogen inhibitor was suppressed as in the in vitro study, and the clinical signs and symptoms were markedly improved. Open trials of intraarticular injections of urinary trypsin inhibitor demonstrated improvement of the clinical signs and symptoms. PMID- 3625627 TI - An evaluation of the efficacy of arthroscopic synovectomy of the knee in rheumatoid arthritis: 12-24 month results. AB - Nine patients with rheumatoid arthritis (10 knees) with chronic knee synovitis unresponsive to medical therapy were entered into a prospective study of arthroscopic total synovectomy of the knee. Histopathological examination of the synovium revealed a proliferative synovitis in all knees. Patients were ambulatory and exhibited 90 degrees of knee flexion on the day after surgery and were discharged at 24 to 48 h postoperation. Mean joint tenderness and swelling improved from the preoperative level and was maintained for the initial 12 months of the study. Knee range of movement was improved in all patients (mean 21 degrees). Improvement of joint function in daily activities was also demonstrated, but patients with Grade IV articular cartilage damage failed to show significant improvement. Nine knees were followed for at least 24 months and 4 required repeat surgery. Arthroscopic synovectomy is comparable to synovectomy by arthrotomy in short term reduction of pain and swelling. The chief benefit of arthroscopic synovectomy is a reduction in morbidity, hospital stay and postoperative rehabilitation. PMID- 3625628 TI - Dose relationships in patients with early chloroquine retinopathy. AB - Thirty-five patients with bilateral irreversible chloroquine retinopathy have been identified prospectively since 1980. The dose relationships of chloroquine were examined specifically in these patients with particular reference to daily and total dose of chloroquine. Thirty of the 35 patients received 250 mg of chloroquine/day or less. PMID- 3625629 TI - Changing pattern of drug use in relation to disease duration of rheumatoid arthritis. AB - The prevalent use of antirheumatic drugs in a cohort of 311 middle aged female patients with seropositive and seronegative rheumatoid arthritis (RA) was investigated. Seropositive patients used a greater amount and more aggressive drugs during each decade of disease duration. The overall use of drugs decreased with disease duration, except for a subgroup of seropositive patients with RA who, with increased disease duration, used more aggressive drugs. PMID- 3625630 TI - Platelet antibody binding in systemic lupus erythematosus. AB - Using a combination of enzyme-linked immunosorbent assay and SDS-PAGE with protein blot (Western blotting), increased levels of serum platelet bindable immunoglobulin (SPBIg) were demonstrated in 10 of 10 thrombocytopenic patients with systemic lupus erythematosus (SLE) (7.0-60 fg Ig/platelet) with consistent binding to SDS-PAGE platelet fractions of approximate molecular weight (120 and 80 kDa). This pattern of Ig binding was characteristic of SLE and was not seen in 20 normal volunteers and infrequently seen in 20 patients with idiopathic thrombocytopenic purpura. PMID- 3625631 TI - Differences in clinical and immunological findings of systemic lupus erythematosus related to age. AB - Five hundred and seventy patients with systemic lupus erythematosus were classified into 3 groups (younger onset, adult onset and older onset) according to their ages at the time of diagnosis. There were more patients with HLA-Bw35 and/or DR2 in the younger onset group than the adult onset group. Typically related systemic features and serological abnormalities were more frequently found in the younger onset group than the other groups. The disease patterns of the adult onset group were more heterogeneous than those of the other 2 groups. The causes of death in the older onset group were mainly complications such as infections and perforated peptic ulcers. PMID- 3625633 TI - Phenotypic profile of major synovial cell populations in longstanding psoriatic arthritis. AB - Monoclonal antibody investigations showed that the vast majority of cells infiltrating the synovial tissue of 8 patients with longstanding psoriatic arthritis stained for both mononuclear phagocyte and class II major histocompatibility (MHC) antigens and were therefore referred to as type I synoviocytes. A minor though consistent number of cells bore solely class II MHC antigens and were recognized as type II synoviocytes, a subpopulation that has been reported to be characteristically augmented in immune synovitides. In contrast, no immunophenotypically identifiable lymphoid cells were seen. It is suggested that type I and II synoviocytes represent the late phase of the phlogistic process and contribute to maintaining the tissue injury. PMID- 3625632 TI - Acute hemodynamic effects of ketanserin in pulmonary hypertension secondary to systemic sclerosis. AB - A selective antagonist of S2-serotonergic receptors, ketanserin, was administered intravenously during right heart catheterization to 14 patients with pulmonary hypertension complicating systemic sclerosis. A significant reduction in pulmonary vascular resistance was noted which was accompanied by an increase in cardiac output. Paradoxical increase of pulmonary artery pressure occurred in 3 patients, whereas 2 patients with mild pulmonary hypertension normalized both pulmonary pressure and vascular resistance. Our data support the hypothesis that serotonin, released during in vivo platelet activation, influences pulmonary vascular tone in systemic sclerosis. PMID- 3625634 TI - Redistribution of minerals and trace elements in chronic inflammation--a study on isolated blood cells from patients with ankylosing spondylitis. AB - The mass fraction of calcium (Ca), magnesium (Mg), manganese (Mn), iron (Fe). zinc (Zn), strontium (Sr) and copper (Cu) in isolated granulocytes, erythrocytes and platelets was measured using the nuclear microprobe technique. The cellular profile of metal variation was conspiciously altered in patients (n = 29) with ankylosing spondylitis compared with the profile found in age and sex matched healthy controls. Ca was accumulated in erythrocytes and granulocytes but decreased in platelets (p less than 0.001). Mg was increased in granulocytes but appeared in reduced concentrations in platelets and erythrocytes (p less than 0.001). The cellular amounts of Mn was increased in granulocytes (p less than 0.001), normal in platelets (p greater than 0.05) and subnormal in erythrocytes (p less than 0.001). Zn was reduced in all 3 cell types (p less than 0.001). Fe accumulation was evident in granulocytes and platelets (p less than 0.001). Sr was only measurable in granulocytes from patients. Cu was below the detection limit in the different cell types isolated from patients, but appeared in measurable amounts in erythrocytes and platelets from controls. The granulocyte amounts of Ca, Mg, Mn and Sr were strongly related to the acute phase reaction. Negative correlations were found between erythrocyte Mg and Zn and the inflammatory activity. The patients had increased serum levels of Cu, normal levels of Ca, Mg and Sr and decreased levels of Zn, Fe and Mn. No relationship was found between the serum concentrations of these elements and their respective cellular stores, except for a weak negative correlation between granulocyte and serum Fe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625635 TI - Large artery involvement in Behcet's disease. AB - Ten (2.2%) of 450 patients with Behcet's disease seen over a 10 year period had arterial manifestations. This was demonstrated by occlusion of radial and superficial femoral arteries in 3, aneurysm of subclavian, innominate, common and external iliac arteries and abdominal aorta in 4, both occlusion and aneurysm of pulmonary, external iliac and renal arteries in 3. All patients were male except one. Their ages ranged from 24-36 years with a mean age of 30 +/- 5 years. PMID- 3625636 TI - Bone density in generalized osteoarthritis. AB - The densities of trabecular and cortical bone in the radius were measured by computed tomography in 40 women with generalized osteoarthrosis (osteoarthritis, GOA), and the results were compared to normal values obtained from prediction equations. When age, weight and height were considered, no significant differences were observed between patients with GOA and normal controls. But when age only was considered, trabecular bone density in the distal radius was found to be 7% higher than predicted (p less than 0.05). Increased trabecular bone density is unlikely to be an etiopathogenetic factor in GOA although this cannot be completely excluded from our study. PMID- 3625638 TI - Benign joint hypermobility with neuropathy: documentation and mechanism of tarsal tunnel syndrome. AB - Eleven consecutive patients with tarsal tunnel syndrome were reviewed. All had pes planus, 8 had calcaneal valgus hindfoot, and generalized benign joint hypermobility syndrome was evident in 9. Detailed enquiry was necessary to identify apparently trivial precipitating events. In 6 patients there was superimposed secondary reflex sympathetic dystrophy which tended to obscure symptoms of the causative tarsal tunnel syndrome. Wider recognition of this cause effect mechanism and early management with orthotic footwear and intrinsic foot muscle exercises may obviate the need for surgical intervention in many cases. PMID- 3625637 TI - Sexual quality-of-life of patients with arthritis compared to arthritis-free controls. AB - The influence of arthritis upon sexual satisfaction and activity and patient receptivity to sexual rehabilitation was investigated by interviewing 169 patients with arthritis and 130 controls. Patients differed from controls in their greater loss of sexual satisfaction over time, but they were comparably satisfied with their current sexual adjustment. They reported similar reductions in frequency of intercourse over time. Joint symptoms and fatigue disturbed the sexual adjustment of patients more than controls, but damaged body image, worry about partner interest, loss of libido and loss of lubrication did not. There was receptivity to a program of sexual rehabilitation among patients and controls that was not dependent upon sexual dissatisfaction. PMID- 3625639 TI - Chronic arthritis in two children with partial deletion of chromosome 18. AB - We describe 2 children with a partial deletion of chromosome 18 and chronic arthritis. A boy with r(18)(p11.3; q23) lacked serum IgA and had arthritis affecting both knees. A girl with del (18)(q21.2; q22) had arthritis in 5 joints. Her serum IgA was normal. In both children, the arthritis responded to nonsteroidal antiinflammatory drugs. PMID- 3625640 TI - Sjogren's syndrome: severe upper airways obstruction due to primary malignant tracheal lymphoma developing during successful treatment of lymphocytic interstitial pneumonitis. AB - A wide spectrum of respiratory tract involvement may be seen in Sjogren's syndrome, however, multiple manifestations in one patient are unusual. A 65-year old woman with a 5-year history of Sjogren's syndrome presented with hoarseness and pulmonary infiltrates. Lymphocytic interstitial pneumonitis, tracheobronchitis with subglottic edema and obstructive small airways disease were initially documented. Dramatic radiographic improvement of the lymphocytic interstitial pneumonitis occurred during 14 months of corticosteroid therapy. However, a rare primary malignant lymphoma of the trachea developed and presented with steroid refractory, upper airways obstruction. Subsequent patient management and the dichotomous behavior of the lymphoid infiltrates are discussed. PMID- 3625641 TI - Chronic active hepatitis presenting with rheumatoid nodules and arthritis. AB - Chronic active hepatitis is often accompanied by extrahepatic rheumatic symptoms of mild or moderate severity. We report a 16-year-old girl with this disorder who presented with severe polyarthritis and rheumatoid nodules mimicking juvenile rheumatoid arthritis. Rheumatoid nodules have not previously been described in chronic active hepatitis, and the severity of the rheumatic symptoms in our patient led to a delay in the recognition of the underlying liver disease. Our report provides support for an autoimmune etiology in some patients with chronic active hepatitis, notes the occurrence of rheumatoid nodules in the disorder, and emphasizes that severe extrahepatic symptoms may obscure the diagnosis and institution of therapy in some individuals. PMID- 3625642 TI - A case of drug induced lupus due to carbamazepine. AB - We report a case of drug induced lupus related to carbamazepine. Both clinical and serological data are described. This represents the first documented case of carbamazepine induced lupus erythematosus in the literature with serological confirmation. PMID- 3625643 TI - Multiple osteonecrotic lesions in systemic lupus erythematosus. AB - A patient with systemic lupus erythematosus who developed osteonecrosis in 13 sites is presented. Most lesions occurred while corticosteroid dose was increased during disease exacerbations. Pathogenetic mechanisms are reviewed and possible simulation of polysynovitis is discussed. PMID- 3625644 TI - Scleroderma and hemolytic anemia in a patient with deficiency of IgA and C4: a hitherto undescribed association. AB - We describe a 66-year-old women with CREST variant of scleroderma who developed autoimmune hemolytic anemia responsive to prednisone and demonstrated a deficiency of IgA and the C4 component of complement. This association of clinical, immunologic and genetic findings has not previously been reported. The literature relating to these findings is reviewed and possible mechanisms are discussed. PMID- 3625645 TI - Breast arteritis in polymyalgia rheumatica. AB - A 79-year-old woman with the clinical presentation of polymyalgia rheumatica (PMR) also had breast cancer. Histopathologic evidence of arteritis was found in mastectomy tissue and in a temporal artery, neither of which had produced symptoms before surgery. Previously reported cases are reviewed in the context that breast vasculitis may be more common than in generally recognized in patients with PMR. PMID- 3625646 TI - Septic spondylodiscitis in ankylosing spondylitis. AB - A patient with ankylosing spondylitis (AS) for 10 years suddenly developed localized midback pain after minimal activity. Although he sought immediate medical assistance, recognition of a septic spondylodiscitis was delayed 3 weeks. One day after admission, he developed fever and admitted to intravenous drug use. Staphylococcus aureus empyema and spondylodiscitis were subsequently diagnosed. Clinical differentiation of aseptic from septic spondylodiscitis cannot be ignored in patients with AS. PMID- 3625647 TI - Tuberculous fasciitis with tenosynovitis. AB - A case of tuberculous fasciitis with tenosynovitis is described. No other organs were affected and tissue histology was not diagnostic. The diagnosis was confirmed by tissue culture and our patient was treated by surgical debridement and antituberculous drug therapy. A high index of suspicion for tuberculosis will alert clinicians to the correct diagnosis in unusual clinical presentations. PMID- 3625648 TI - Superior oblique tenosynovitis (Brown's syndrome) as a manifestation of adult Still's disease. AB - A patient with adult Still's disease developed painful ophthalmoplegia due to inflammatory tenosynovitis of the superior oblique muscle and tendon sheath. Diagnosis was confirmed by computed tomographic scanning and resolution promptly obtained with corticosteroid therapy. PMID- 3625649 TI - Monoarthritis as the presenting manifestation of localized Ewing's sarcoma in an older patient. AB - Monoarthritis, infrequently recognized as a manifestation of primary malignant disease of the bone, is rarely associated with Ewing's sarcoma. Our patient presented with knee monoarthritis, and histology established the diagnosis of Ewing's sarcoma. His disease apparently remitted with chemotherapy but recurred in multiple sites one year later, and repeat chemotherapy failed to produce a remission. PMID- 3625651 TI - Prevention of acute attacks of pseudogout with oral colchicine. PMID- 3625650 TI - Antiskeletal muscle antibodies during treatment with penicillamine. PMID- 3625652 TI - Staphylococcal bacteremia complicating septic prepatellar bursitis. PMID- 3625653 TI - Clostridium sordelli septic arthritis. PMID- 3625654 TI - Acute abdomen in systemic lupus erythematosus with spontaneous hemoperitoneum. PMID- 3625655 TI - Cutaneous sclerosis localized to one limb after immobilization in a patient with CREST syndrome. PMID- 3625656 TI - Circulating immune complexes and active rheumatoid arthritis. PMID- 3625657 TI - Three cases of prosthetic knee synovitis in rheumatoid arthritis. PMID- 3625659 TI - An international symposium on osteoarthritis. Quebec, Canada, August 20-26, 1986. Proceedings. PMID- 3625658 TI - Antibodies to peptidoglycan in juvenile ankylosing spondylitis. PMID- 3625660 TI - Risk factors in osteoarthritis--how do they work? AB - Extrinsic risk factors of osteoarthritis (OA) comprise anatomical defects and mechanical insults. They alter the strength and/or the direction of forces inflicted on the matrix. This leads to damage of the fibrous network by as yet conjectural pathways. The main intrinsic risk factor is aging. Some pieces of evidence seem to point to quantitative or qualitative defects in the stabilizing factors of proteoglycan aggregates of old persons. PMID- 3625661 TI - Animal models: a means to study the pathogenesis of osteoarthritis. AB - A number of animal models have been developed to investigate the pathogenesis of osteoarthritis. In general, rabbits, guinea pigs, and dogs have been the animals of choice, although rats, mice, and birds have also been used. The techniques used to induce disease development include: destabilization of a knee joint either by extra- or intraarticular surgical manipulation; immobilization of the knee joint to alter load impact and distribution; or introduction of a foreign substance into the joint space. The success of a particular animal model rests in the ability to parallel, on a temporal basis, the biological changes which characterize osteoarthritic development as seen in the human population. Macroscopic, microscopic, and biochemical evaluations then permit the detailing of the steps which lead to cartilage erosion. In this manner, link proteins have been found to be deficient in osteoarthritic guinea pig cartilage. PMID- 3625662 TI - Histological cartilage changes in a rabbit model of osteoarthritis. AB - The anterior cruciate ligament was severed in the right knee of 36 rabbits which were then killed 12 weeks after surgery. Changes in water content and fixed charge density were correlated with the surface area of induced cartilage fibrillation. Histological changes including cartilage hypertrophy, reduced cell density, matrix alterations, cystic lesions, and enlarged perichondrocytic lacunae were found to precede cartilage fibrillation. The observed histological changes are in agreement with an enzymatic degradation of articular cartilage in osteoarthritis. PMID- 3625663 TI - Cartilage proteoglycan changes in experimental canine osteoarthritis. AB - Articular cartilage contains at least 2 proteoglycans (PGs) which aggregate with hyaluronate: one larger, richer in chondroitin sulphate (CSRPG); the other smaller, relatively richer in keratan sulphate (KSRPG). With maturation the ratio of CSRPG/KSRPG decreases. In order to test the hypothesis that osteoarthritic cartilage contains an increased amount of proteoglycans characteristic of immature cartilage, experimental osteoarthritis (OA) was induced in 11 dogs by transection of the anterior cruciate ligament. Proteoglycan populations were assessed by composite agarose polyacrylamide gel electrophoresis (CAPAGE). The OA cartilage had more proteoglycan and an increased proportion of the slower migrating band on CAPAGE, which corresponds to the CSRPG, supporting the hypothesis that OA cartilage contains an increased amount of proteoglycans characteristic of immature cartilage. PMID- 3625664 TI - Cartilage proteoglycans in degenerative joint disease. AB - Cartilage content of proteoglycans decreases early in induced degenerative hip joint disease. Remaining molecules show structural changes indicating fragmentation. Fragments lost from the articular cartilage are released to the synovial fluid, where they can be quantified by enzyme linked immunosorbent assay. Their amounts are related to the activity of the disease process. PMID- 3625665 TI - Experimental post-contusive osteoarthritis of the knee: quantitative microscopic study of the patella and the femoral condyles. AB - A contusive procedure has been developed for the induction of a predictable and reproducible degenerative joint disease in knees of rabbits. Significant degeneration was observed in patella, condyles, and trochlea. These lesions included fibrillation, ulceration and erosion, clones of chondrocytes, and osteophyte formation. The incidence and distribution of lesions with time following contusion were also investigated. Lesions were observed as early as 1 day post-contusion and increased in number and severity. A global scoring system has been devised to permit comparisons of lesion incidence and severity, specially to test drug efficacy in this model of osteoarthritis. PMID- 3625666 TI - Use of the guinea pig myectomy osteoarthritis model in the examination of cartilage-synovium interactions. AB - Synovium enhances the release of proteoglycan from articular cartilage in organ culture. Biomechanical stress-induced hip osteoarthritis (OA) was produced in guinea pigs by extra-articular myectomy and tendotomy. Organ culture experiments of control or OA cartilage with control or OA synovium were assayed for proteoglycan release. OA cartilage released more proteoglycan than control cartilage when cultured with either control or OA synovium. No significant difference in the effect of control or OA synovium in stimulating proteoglycan release from OA cartilage was detected, but the difference between control and OA cartilage release was significant. PMID- 3625667 TI - The effect of glycosaminoglycan polysulfuric acid ester on articular cartilage in experimental arthritis: effects on collagenolytic enzyme activity and cartilage swelling properties. AB - Some of the effects of the semi-synthetic glycosaminoglycan polysulfuric acid ester (GAGPE) were investigated on the osteoarthritis-like lesions in the Pond Nuki dog model, in respect to histological grade of anatomical lesions, collagenolytic enzyme activity, and a parameter of collagen network integrity. Prophylactic treatment by intra-articular injections twice weekly for 4 weeks caused amelioration of canine cartilage erosions. Preliminary evidence for suppression of collagenolytic enzyme activity, as well as protection of a tight collagen network studied in the canine cartilage was obtained. PMID- 3625668 TI - Chemical model of osteoarthritis--a pharmacological evaluation. AB - For pharmacological testing of drugs with antidegenerative potency we developed an animal model of biochemically induced osteoarthritis (OA) by blocking the glycolytic energy metabolism and synthetic processes in articular chondrocytes. After local injection of sodium iodoacetate osteoarthritic reactions will progress within 2-4 months. Using a standardized radiological, histological, and macroscopical grading we could demonstrate that corticosteroids and some NSAID exert negative effects on articular cartilage, while a few other NSAID showed no influence. Diclofenac had even a pronounced antidegenerative potency which was comparable to the antiosteoarthritic properties of two glycosaminoglycan derivatives investigated in the model of biochemically induced OA in the knee joint of hens and rats. PMID- 3625669 TI - Nonsteroidal antiinflammatory drugs and articular cartilage. AB - Salicylates and some other nonsteroidal antiinflammatory drugs (NSAID) suppress proteoglycan biosynthesis in normal articular cartilage in vitro. Their effect on osteoarthritic cartilage in vitro is even greater than their effect on normal cartilage. Aspirin has a similar effect in vivo on both atrophic cartilage and osteoarthritic cartilage in the dog, although no in vivo effect of salicylate on normal joint cartilage has been observed. While the magnitude of the effects of NSAID on proteoglycan metabolism in cartilage appeared to be inversely related to the proteoglycan content of the matrix, it is possible that some drugs are selectively bound to cartilage matrix components, which could affect their action on the chondrocyte. If NSAID have similar effects in patients with arthritis, this could have implications with respect to articular cartilage lesions. PMID- 3625670 TI - Structural changes in the proteoglycans of human articular cartilage during aging. AB - The structure of the aggregating proteoglycans from human articular cartilage changes continuously from the early fetus to the mature adult, due to variation in both synthetic and degradative processes. The changes due to synthesis are most prominent prior to the end of growth, and are responsible for variations in the structure and abundance of the glycosaminoglycan chains. In contrast, the changes due to degradation occur throughout life, but predominate during aging of the adult. They result in proteolytic fragmentation of both the proteoglycan subunits and the link proteins, with those products possessing hyaluronic acid binding capability accumulating in the tissue. PMID- 3625671 TI - The biosynthetic response of the mature chondrocyte in early osteoarthritis. AB - Metabolic studies in early experimental osteoarthritis (OA) have shown that the rate of proteoglycan synthesis in the diseased articular cartilage may be markedly enhanced relative to normal; elevated rates of synthesis were however accompanied by increased release of new molecules from the tissue so that the response was apparently non-reparative. Described here are experiments with immature and mature chondrocytes in culture which show that aging of chondrocytes in vivo is accompanied by a marked fall in the capacity of these cells to synthesize link protein and to assemble a proteoglycan-rich matrix. It is suggested that poor deposition of proteoglycan by mature chondrocytes in OA may result from insufficient synthesis of link protein for stabilization of aggregates. PMID- 3625672 TI - A growing family of collagens in articular cartilage: identification of 5 genetically distinct types. AB - Cartilage displays an extensive polymorphism of collagen types. All hyaline cartilages are known to contain type II collagen (90-95% of the collagen) and 2 other cartilage-specific minor collagens called types IX (or M) and XI (or 1 alpha 2 alpha 3 alpha). In the present work, the molecular heterogeneity of articular cartilage collagen was investigated in more detail. Two additional genetic types of collagen were found in the mature bovine tissue, types V and VI, each accounting for about 1-2% of the tissue dry weight. Type V, a close relative of type XI, apparently had accumulated after birth. Type VI is a short-helix, microfibrillar collagen of wide tissue distribution but unknown function. In understanding the physical changes in the collagen network of cartilage that are believed to herald the onset of cartilage degeneration in osteoarthrosis, all five of these collagen types deserve attention. PMID- 3625673 TI - Fibronectin as a marker for osteoarthritis. AB - Abnormal cartilage from osteoarthritic canine joints contained up to 20 times more fibronectin than did disease-free cartilage. Fibronectin synthesis in osteoarthritic cartilage was increased and more of the newly made protein accumulated in this cartilage. Data suggested that fibronectin content was increased in cartilage with early osteoarthritic changes whereas glycosaminoglycan content remained unchanged. Immunoperoxidase studies revealed that fibronectin was distributed throughout the matrix of both normal and osteoarthritic cartilage. Fibronectin concentration was increased twofold in synovial fluid from osteoarthritic joints. PMID- 3625674 TI - Development of clinical criteria for osteoarthritis. AB - Clinical criteria for the classification of osteoarthritis (OA) in the knee have been developed and the use of algorithms has been proposed. Criteria for the classification of OA in the hand and hip are still being developed. PMID- 3625675 TI - Anabolic and catabolic responses of human articular cells to growth factors. AB - The responsiveness of human synovial cells and chondrocytes to L-ascorbate, CTAP Ib, III, IV and V was assessed by assays which measured DNA and glycosaminoglycan synthesis and plasminogen activator formation. Differences in behavior were noted between synovial and cartilage derived cells and between normal and OA chondrocytes. PMID- 3625676 TI - The effect of "matrigenin" activity from bone on glycosaminoglycan and proteoglycan synthesis by cultured cells from articular tissues. AB - An activity that stimulates glycosaminoglycan and proteoglycan synthesis by confluent connective tissue cells in culture ("matrigenin" activity) has been partially purified from bovine bone. This activity is expressed on fibroblastic cells from several types of connective tissues, including synovium, and on cartilage tissue, but not on cells of unrelated origin. For synovial fibroblastic cells, matrigenin activity stimulated both hyaluronic acid and proteoglycan synthesis. The major proteoglycan whose synthesis was stimulated, contained primarily chondroitin-6-sulfate chains and eluted in the range of 400-600 Kdaltons. It is suggested that matrigenin activity in bone matrix has the potential to modulate remodelling (repair) in bone and in the synovial and cartilagenous regions abutting on bone. PMID- 3625677 TI - Significance of immune complex deposits in osteoarthritic cartilage. AB - Deposits of immunoglobulins and complement in cartilage with synovial mononuclear cell infiltrates suggest local immune reactions in osteoarthritic joints. The variabilities defined in deposition pattern and synovial histopathology, the patterns and extent of polyarthritis, without evidence of systemic illness, suggest that these immune reactions mark past events in the host's response localized in mechanically prejudiced articulations. The current data give little support for an immune initiation for osteoarthritis nor for the induction of autoimmunity; rather, they suggest episodes of immune insult which may at times initiate and at times prolong clinical inflammation in mechanically deranged sites and which, via the activation of complement and mononuclear cell mediators, accelerate cartilage damage. PMID- 3625678 TI - Immunodetection and characterization of the degradation of cartilage proteoglycans in vitro and in vivo. AB - The large aggregating cartilage proteoglycans can be detected immunologically using antibodies directed against the hyaluronic acid-binding region, core protein, keratan sulfate, chondroitin sulfate, and hyaluronic acid. With radioimmunoassays we have detected proteoglycans released from adult human articular cartilage in vitro and in vivo. In vitro cleavage appears to occur mainly adjacent to the hyaluronic acid binding region with the release of the rest of the molecule. Two distinct populations have been observed, the larger of which is chondroitin sulfate-rich and the smaller keratan sulfate-rich. Although they are a little smaller and probably aggregate less with hyaluronic acid, these populations correspond in size and composition to two similar populations detected in situ in healthy adult human articular cartilage. In vivo studies of synovial fluid have revealed that the proteoglycan fragments are smaller and the most commonly detected fragment is the hyaluronic acid binding region. This suggests that in vivo further degradation occurs, probably due to degradation mediated by the inflamed synovium and polymorphonuclear leucocytes present in the synovial fluid of inflamed joints. PMID- 3625679 TI - The subclinical phase of osteoarthritis. AB - The clinical diagnosis of osteoarthritis (OA) generally requires x-ray confirmation, fastening upon features such as narrowing of the joint and proliferative changes at the joint margins. In the formative phases, because of simple structural reasons, the joint may well not be narrowed and the proliferative changes and geodes may not as yet be apparent. Even symptomatic joint disease at this time may fail of diagnosis because the customary criteria have not yet been met. I submit that all OA is secondary, the inception being remote in time and, unless dramatic, being forgotten or never even noticed. An understanding of some of the mechanical features that characterize the progression to OA and the mechanism of pathogenesis should lead to earlier diagnosis and possible application of preventive measures. PMID- 3625680 TI - Therapeutic options in the selection of nonsteroidal, antiinflammatory drugs in the treatment of osteoarthritis: a review. AB - The size of the consumer market has resulted in an increasing number of antiinflammatory drugs available on prescription for osteoarthritis. Despite the development of newer chemical compounds, similarities in pharmacologic properties, efficacy in clinical trials, and toxicity profiles do not support a claim that any one drug is consistently better than another. Differences in pharmacokinetic profiles and formulations do allow for considerable flexibility in clinical therapeutics. Variabilities in drug action, effects on other organ systems, and drug interactions, particularly in the elderly, must always be considered when prescribing an individual medication. However, variability in patient response to individual drugs (both clinical benefit and toxicity) and the size of the clinical problem largely justify the number of nonsteroidal antiinflammatory drugs available. PMID- 3625682 TI - Is Occam's razor disposable? PMID- 3625681 TI - Implications of antirheumatic drug therapy in elderly patients with osteoarthritis. AB - The choice and dosage regimen of analgesic and NSAID for the elderly patient with osteoarthritis have to be made carefully with particular reference to hepatic and renal function, concomitant drug therapy, and concomitant disease. PMID- 3625683 TI - Science versus non-science in medicine: fact or fiction? PMID- 3625684 TI - Evaluation of family therapy for disturbed children. PMID- 3625685 TI - Alternative medicines and therapies and the DHSS. PMID- 3625686 TI - Plasma catecholamines and lipoproteins in chronic psychological stress. AB - Changes in plasma catecholamines, lipoproteins and dietary intake were examined in 13 medical students during a 3-month period prior to their examinations, and in 12 controls. In the medical students mean +/- s.e.(mean) plasma cholesterol increased over the study period (3.98 +/- 0.16 v. 4.26 +/- 0.16 mmol/l, P less than 0.05) and this was reflected by a rise in low-density lipoprotein cholesterol (2.53 +/- 0.15 v. 2.71 +/- 0.17 mmol/l, P less than 0.05). Both supine adrenaline (0.45 +/- 0.05 v. 0.70 +/- 0.07 nmol/l, P less than 0.01) and noradrenaline (2.74 +/- 0.18 v. 3.40 +/- 0.31 nmol/l, P less than 0.05) increased over this period. Apart from a decline in the modest alcohol consumption (9.1 +/- 3.45 v. 2.6 +/- 1.4 g/day, P less than 0.02) there was no change in dietary intake in the medical students. There were no significant changes in plasma catecholamines, lipoproteins or dietary intake in control subjects over the study period. Changes in catecholamines and lipoproteins occurring in association with chronic psychological stress may contribute to the increased coronary heart disease mortality associated with Type A behaviour and stressful life events. PMID- 3625687 TI - Teaching students of medicine to listen: the missed diagnosis from a hidden agenda. AB - This paper describes the ability of 4 senior students to recognize and deal therapeutically with the hidden agenda of patients--the covert concerns or second diagnosis other than the presenting problem. This naturalistic study was hospital based and used ambulatory patients with common paediatric problems. The patient encounter was videotaped and subsequently analysed to determine the patient's hidden agenda. The findings indicated that the students had some difficulty in correctly diagnosing the patient's presenting problem or primary diagnosis. They also failed to recognize and deal with their patients'/parents' hidden agendas. The relevance of these findings to patients care is discussed. PMID- 3625688 TI - Outcome of supracondylar fractures of the humerus in children. AB - Seventy patients who had sustained supracondylar fractures of the humerus as children were examined. Loss of carrying angle of the elbow occurred if the fracture was immobilized in a varus position during healing. Varus malalignment could have been obviated if comparative radiographs of the other elbow had been taken and the Baumann angles compared. Rotation and posterior displacement at the fracture had little bearing on the outcome. Immobilization of the fracture in a collar and cuff sling was as effective as more elaborate methods. PMID- 3625689 TI - Mass screening for colorectal cancer in Hungary. AB - Haemoccult screening for colorectal tumours was carried out in Hungary in small cities and villages around Budapest. Haemoccult slides were supplied to 17,662 individuals over 40 years of age, and 15,431 (87%) were returned. Of these, 346 (2.2%) were positive and 18 colorectal carcinomas were detected. Additionally, 24 patients with one or more polyps greater than 1 cm diameter were found. Of the screened cases of cancer 39% were in Dukes' stage A and B, a rate twice as good as when screening was not done. The cost per tumour detected amounted to about three times more than one monthly income, indicating that the costs of screening for colorectal cancer are relatively much higher in Hungary than in Western countries. All expenses were met from state funds. PMID- 3625690 TI - Are happy people healthier? Discussion paper. PMID- 3625691 TI - The meaning of illness--holism dissected: discussion paper. PMID- 3625692 TI - Role of research in the rapprochement between conventional medicine and complementary therapies: discussion paper. PMID- 3625693 TI - The causes of asthma--does salt potentiate bronchial activity? Discussion paper. PMID- 3625694 TI - Quality in general practice Czech style. PMID- 3625695 TI - Building or extending a hospital department: radiology. A path through the planning minefield (6). PMID- 3625696 TI - Angiolymphoid hyperplasia with eosinophilia. PMID- 3625697 TI - Psychiatric side effects of bromocriptine therapy for postpartum galactorrhoea. PMID- 3625698 TI - Head injuries: whither specialization? PMID- 3625699 TI - Problems of patients' dependency on doctors. PMID- 3625700 TI - Treatment of giant cell tumour of the femoral head and neck. PMID- 3625701 TI - Indazoles as indole bioisosteres: synthesis and evaluation of the tropanyl ester and amide of indazole-3-carboxylate as antagonists at the serotonin 5HT3 receptor. PMID- 3625703 TI - Analogues of 3-ethyl-3-(4-pyridyl)piperidine-2,6-dione as selective inhibitors of aromatase: derivatives with variable 1-alkyl and 3-alkyl substituents. AB - 3-Ethyl-3-(4-pyridyl)piperidine-2,6-dione (1) is a strong competitive inhibitor of human placental aromatase (Ki = 1.1 microM; testosterone as substrate) that, unlike the structurally related aromatase inhibitor aminoglutethimide (2), is not also an inhibitor of the cholesterol side-chain cleavage enzyme desmolase. An improved synthesis of 1 is described, which was readily adapted to the preparation of homologues in a series of 3-alkyl-3-(4-pyridyl)-piperidine-2,6 diones (6-13). Alkylation of 1 afforded a second series, comprising 1-alkyl-3 ethyl-3-(4-pyridyl)-piperidine-2,6-diones (14-23). Inhibitory activity toward aromatase was maximal in both series for the octyl derivatives. Respective Ki values for the competitive inhibition exerted by the 3-octyl (12) and the 1-octyl (21) analogues with testosterone as substrate were 0.09 and 0.12 microM. The compounds 1, 2, 12, and 21 differed in their relative potencies as inhibitors of the aromatization of testosterone and androstenedione. Respective Ki values were as follows: for 1, 1.1 and 14 microM (ratio 12.7); for 2, 0.6 and 1.8 microM (3); for 12, 0.09 and 0.20 microM (2.2); and for 21, 0.12 and 0.48 microM (4). PMID- 3625702 TI - Nitrogen bridgehead compounds. 66. Bronchodilator nitrogen bridgehead compounds with a pyrimidinone moiety. AB - New types of bronchodilator agents, bi- and tricyclic nitrogen bridgehead compounds with a pyrimidin-4(3H)-one ring, were synthesized and evaluated for bronchodilator activity against serotonin-, histamine-, and acetylcholine-induced spasms in the guinea pig Konzett-Rossler test. The structure-activity relationships are discussed. The effects of some bi- and tricyclic derivatives on the human bronchus were also investigated. The homologous tricyclic compounds 68 and 69 were tested on isolated guinea pig ileum and trachea, and the effects of compound 69 were investigated in pilocarpine-treated dogs. Azepino[2,1 b]quinazoline (69; CHINOIN-1289) was selected for further biochemical and clinical investigations. PMID- 3625704 TI - Resolved cis-10-hydroxy-4-n-propyl-1,2,3,4,4a,5,6,10b- octahydrobenzo[f]quinoline : central serotonin stimulating properties. AB - cis-10-Hydroxy-4-n-propyl-1,2,3,4,4a,5,6,10b -octahydrobenzo[f]quinoline (4) is a centrally acting serotonin (5-HT) receptor agonist of moderate potency. Due to its semirigid character and the obvious similarity between (4aR,10bS)-4 and more potent, centrally acting 5-HT receptor agonist cis-(1S,2R)-8-hydroxy-1-methyl-2 (di-n-propylamino)tetralin (2), we carried out the preparation (via resolution of 6, a precursor of 4) and the pharmacological testing of the enantiomers of 4. We were able to show that the active enantiomers of 4 and 2 coincide in terms of stereochemistry, i.e., that it is the 4aR,10bS enantiomer of 4 that is the more active one. The absolute configuration was assigned on the basis of single crystal X-ray analysis of the precursor (+)-6 of the active enantiomer (-)-4. Conformational analysis with molecular mechanics (MM2) calculations were performed on the N-methyl analogues of compounds cis-(1S,2R)-2 (cis-(1S,2R)-3) and cis-(4aR,10bS)-4 (cis-(4aR,10bS)-7). Both ammonium and free amine forms were subjected to these calculations. The results show a preference for the N equatorial conformation, which is corroborated by the X-ray structure of (+) 6.HCl. The relatively low potency of compound cis-(4aR,10bS)-4 might be explained by unfavorable direction of the N-lone pair (or ammonium hydrogen) bond in this compound as compared to cis-(1S,2R)-2 and trans-(4aR,10bR)-5, which can be predicted to be the more active enantiomer of compound 5. PMID- 3625705 TI - gamma-Aminobutyric acid esters. 3. Synthesis, brain uptake, and pharmacological properties of C-18 glyceryl lipid esters of GABA with varying degree of unsaturation. AB - A series of 14C-labeled and unlabeled di-gamma-aminobutyric acid esters of glyceryl lipids having zero to three double bonds (stearoyl, oleoyl, linoleoyl, and linolenoyl) were synthesized. Measurements of the octanol/water partition coefficients of the compounds showed an increase with decreasing number of double bonds (i.e., from linolenoyl to stearoyl). The brain-uptake index went up from 31.5 (linolenoyl) to 45.1 (stearoyl) and similarly the brain-penetration index went up from 15 (linolenoyl) to 28 (stearoyl). Intraperitoneal injections of these di-GABA lipid esters produced a substantial inhibition of the general motor activity in mice at a dose of 30 mg/kg; the most active molecules were those containing two and three double bonds, i.e., the linolenoyl and linolenoyl derivatives. This is in reverse order to that predicted by brain-uptake and lipid solubility properties, suggesting that the structure of the fatty acid side chain may be an additional factor in influencing biological activity. PMID- 3625706 TI - Potential antitumor agents. 52. Carbamate analogues of amsacrine with in vivo activity against multidrug-resistant P388 leukemia. AB - Study of a series of aniline-substituted 9-anilinoacridines related to the antileukemic drug amsacrine showed that a 1'-carbamate group provided increased activity against the multidrug-resistant P388/ADR leukemia subline in vivo. Since activity against such resistant tumors is of great clinical significance, a series of acridine-substituted carbamate derivatives were evaluated against both wild-type and ADR/resistant P388 leukemia and the Lewis lung solid tumor in vivo. Structure-activity relationships for all three tumor lines were similar, with 3 halo-5-methyl and 3-halo-5-methoxy compounds proving the most active. This substitution pattern also provided the highest DNA binding. Such compounds (particularly the 3-chloro-5-methyl and 3-chloro-5-methoxy) have in vivo activity against wild-type P388 and Lewis lung comparable to that of the best amsacrine analogues previously developed (greater than 50% cures), as well as P388/ADR activity. This work essentially completes the development of the amsacrine series of antitumor agents. PMID- 3625707 TI - 17-Heteroaroyl esters of corticosteroids. 2. 11 beta-Hydroxy series. AB - The preparation and topical antiinflammatory potencies of a series of 17-furoyl and -thenoyl esters of 9 alpha-fluoro-11 beta-hydroxy-16 methyl and 9 alpha chloro-11 beta-hydroxy-16-methyl corticosteroids are described. The 17 alpha esters were introduced to the 9 alpha-fluoro 11-ketones or to the appropriate delta 9(11) compounds by direct acylation with the appropriate heteroaryl carbonyl chloride in the presence of 4-(dimethylamino)pyridine. Functionalization of the C ring was completed by standard methods. The most extensively studied heterocyclic acyl group was 2-furoyl, but 3-furoyl and 2- and 3-thenoyl derivatives were also investigated. Antiinflammatory potencies were measured in mice by a 5-day modification of the Tonelli croton oil ear assay. The most potent topical antiinflammatory agents were 1e, dexamethasone 17-(2'-furoate) 21 propionate, and 2c, the 21-chloro 17-(2'-furoate) in the 9 alpha-chloro series, both being 6 times as potent as betamethasone 17-valerate. Several other 9 alpha chloro-11 beta-hydroxy-17-heteroaryl carboxylates (2a, 2b, 2d, and 2g) were at least 4 times as potent as betamethasone 17-valerate. Evaluation of 2c in the clinic confirmed that the compound is a potent topical antiinflammatory agent in humans. PMID- 3625708 TI - Phosphorus amino acid analogues as inhibitors of leucine aminopeptidase. AB - A variety of phosphorus amino acid and dipeptide analogues have been synthesized and evaluated as inhibitors of the metalloenzyme leucine aminopeptidase from porcine kidney. Two phosphonate dipeptides were found to be modest inhibitors of the enzyme (8e, Ki = 58 microM; 8h, Ki = 340 microM). The phosphinic acid (17-OH) and phosphinamide (17-NH2) analogues related to bestatin were prepared by condensation of the phosphinate amino acid derivative 11, via a trivalent phosphonite ester 12, with leucine isocyanate derivatives 13. These compounds also proved to be unexceptional in their inhibition of LAP (17-O-, Ki = 56 microM; 17-NH2, Ki = 40 microM). A series of simple (alpha-aminoalkyl)phosphonic acid and -phosphinic acids were also evaluated, and the most potent inhibitors were found to be the phosphonic acid analogues of L-Leu and L-Phe [R)-3e, Ki = 0.23 microM; (R)-3h, Ki = 0.42 microM). Slow-binding behavior was observed for (R)-3e (kon = 400 +/- 55 M-1 s-1) and (R)-3h (kon = 445 +/- 50 M-1 s-1). The phosphinic acid analogues of Leu and Phe are 100-fold less potent than the phosphonate derivatives. The fact that tetrahedral phosphorus analogues are less potent inhibitors of LAP than they are of other zinc peptidases suggests that the mechanism of LAP may be fundamentally different than that of the latter enzymes. PMID- 3625709 TI - 1-Amino-substituted 4-methyl-5H-pyrido[3',4':4,5]pyrrolo[3,2-c]pyridines: a new class of antineoplastic agents. AB - In an attempt to find new anticancer agents, a series of pyrido[3',4':4,5]pyrrolo[3,2-c]pyridines were synthesized and evaluated in the standard NCI screening. Among these new compounds, which are structurally related to 9-azaellipticines but differ by deletion of a cycle, those that have a 4 methyl group and a NHCH2CH2CH2NR2 side chain at the 1-position show significant cytotoxicity on L1210 cultured cells and antitumor properties in the in vivo P388 leukemia system. The in vivo antineoplastic activity of the most potent compounds were confirmed on the L1210 leukemia model. PMID- 3625710 TI - Analgesic dipeptide derivatives. 3. Synthesis and structure-activity relationships of o-nitrophenyl-modified analogues of the analgesic compound H-Lys Trp(NPS)-OMe. AB - A series of analogues of the analgesic dipeptide derivative H-Lys-Trp(NPS)-OMe has been designed to determine the influence of the (2-nitrophenyl)sulfenyl (NPS) moiety on the activity. The syntheses and antinociceptive effects of these analogues of general formula H-Lys-Trp(R)-OMe [R = phenylsulfenyl (PS) (9); R = (2-carbomethyoxyphenyl)sulfenyl (CmPS) (10); R = (4-nitrophenyl)sulfenyl (pNPS) (11); R = (2,4-dinitrophenyl)sulfenyl (DNPS) (12); R = [2-(acetylamino)-2 carbomethoxyethyl]sulfenyl (AacCmES) (13); R = [2-(acetylamino)phenyl]sulfenyl (AacPS) (17); R = tert-butylsulfenyl (t-BuS) (23); R = (2 carbomethoxyethyl)sulfenyl (CmES) (24)] are described. Reaction of Z-Lys(Z)-Trp OMe (3) with PS-, CmPS-, pNPS-, DNPS-, and AacCmES-Cl afforded the corresponding 2-(sulfenyl)tryptophan derivatives, which on treatment with boron tris(trifluoroacetate)/trifluoroacetic acid or trimethylsilyl iodide in acetonitrile (Me3SiI/CH3CN) provided 9-13, respectively. Sulfenylation of 3 with NPS-Cl gave Z-Lys(Z)-Trp(NPS)-OMe, which, on catalytic hydrogenation of the nitro group using 10% Pd/C followed by acetylation of the resulting amino function and removal of the protecting Z groups, gave 17. Condensation of 2-(tert butylsulfenyl)- and 2-[(2-carbomethoxyethyl)sulfenyl]tryptophan methyl ester, obtained by reaction of methyl 3a-hydroxy-1,2,3,3a,8,8a-hexahydropyrrolo[2,3 b]indole-2-carboxyla te with the corresponding thiol, with Z-Lys(Z)-OSu afforded Z-Lys(Z)-Trp(t-BuS)-OMe and Z-Lys(Z)-Trp(CmES)-OMe, which on treatment with Me3SiI/CH3CN provided 23 and 24, respectively. Intracerebroventricular administration of 10 elicited a naloxone-reversible antinociceptive effect in mice similar to that of H-Lys-Trp(NPS)-OMe. No analgesia was however found with the phenylsulfenyl or acyclic sulfenyl substituted dipeptides 9, 11, and 17 or 13, 23, and 24. The Trp(DNPS)-containing analogue was neurotoxic. Structure activity studies indicate that the role of the NPS and CmPS moieties could be related to the adoption of a preferential active conformation. PMID- 3625711 TI - 3-Carbonylacrylic derivatives as potential antimicrobial agents. Correlations between activity and reactivity toward cysteine. AB - A number of 3-carbonylacrylic acid derivatives were prepared, with a view to varying systematically the stereoelectronic environment of the conjugated double bond. The rates of reaction with cysteine were measured spectrophotometrically when possible or by stopped flow when very fast. Some of the final reaction products were isolated. Other properties examined were partition substituent constants and antimicrobial activity. On the basis of published data and these studies, the activity appears to be the combined effect of at least two mechanisms, one probably related to the effect of these structures on surface tension, the other to the electrophilic properties of the unsaturated system. PMID- 3625712 TI - Toward a rationalization of the sensitizing potency of substituted p benzoquinones: reaction of nucleophiles with p-benzoquinones. AB - MNDO calculations have been carried out for the contact sensitizers 2,6-dimethoxy 1,4-benzoquinone (6) and 2-methoxy-6-methyl-1,4-benzoquinone (10) and for 2,5 dimethoxy-1,4-benzoquinone (7), which is nonallergenic in contrast to thymoquinone (8) (2-methyl-5-isopropyl-1,4-benzoquinone), which is a relatively strong contact allergen. Theoretical results indicate that the conformational flexibility of methoxy groups substituted at the quinone rings influences the electronic properties of these compounds, in particular their reactivity with regard to nucleophiles. According to theory, 6, 10, and 8 should possess a pronounced reactivity toward nucleophiles while 7 should resist nucleophilic attack. Hence, the allergenic capacity of a quinone seems to depend on their binding interactions with nucleophiles such as amino or thio groups of amino acids. PMID- 3625713 TI - Structural modification study of mitoxantrone (DHAQ). Chloro-substituted mono- and bis[(aminoalkyl)amino]anthraquinones. AB - A number of chloro-substituted [(aminoalkyl)amino]anthraquinones were synthesized and evaluated for their antineoplastic and cytotoxic activity. Treatment of 5,8 dichloroquinizarin with substituted amines in pyridine resulted in the replacement of one halogen atom by the amino group to yield mainly 1-chloro-5,8 dihydroxy-4-(substituted amino)anthraquinones. On the other hand, reaction between the dichloroquinizarin and the amines in butanol gave predominantly 1,4 dichloro-5-hydroxy-8-(substituted amino)anthraquinones. Other compounds in this series were prepared by displacement of chloro, nitro, or tosyl functions of the appropriate anthraquinone derivatives with various amines by conventional methods. 1,4-Dichloro-5-hydroxy-8-[[2-[(2-hydroxyethyl)amino]ethyl]amino] anthraquinone (6b) possesses the highest inhibitory activity against P388 leukemia. Its inhibitory action against B16 melanoma and against the in vitro L1210 screen is also significant. Several other chloro- and hydroxy-substituted aminoanthraquinones (5a, 5b, and 6a) also showed noticeable activity against P388 in vivo and L1210 in vitro. Structure-activity-relationship examination indicated that the hydroxyl group may contribute to the binding of certain chloroaminoanthraquinones for their biological activity and that the [2-[(2 hydroxyethyl)amino]ethyl]amino side chain seems to be the preferred substituent over other amino side chains. PMID- 3625714 TI - Improved synthesis and antitumor activity of 1-deazaadenosine. AB - A more convenient synthetic route to 1-deazaadenosine (1) by reduction of the new nucleoside 7-nitro-3-beta-D-ribofuranosyl-3H-imidazo[4,5-b]pyridine (6) is reported. Compound 6 was obtained by reaction of 7-nitroimidazo-[4,5-b]pyridine with 1,2,3,5-tetra-O-acetyl-beta-D-ribofuranose in the presence of stannic chloride followed by treatment with methanolic ammonia. 1-Deazaadenosine (1) showed good activity in vitro as inhibitor of HeLa, KB, P388, and L1210 leukemia cell line growth, with ID50 values ranging from 0.34 microM (KB) to 1.8 microM (P388). The nitro derivative 6 demonstrated moderate activity against the same cell lines. PMID- 3625715 TI - Anticoagulant peptides: nature of the interaction of the C-terminal region of hirudin with a noncatalytic binding site on thrombin. AB - A series of 20 C-terminal fragment analogues of the anticoagulant peptide hirudin were synthesized by solid-phase techniques in order to investigate the nature of the thrombin-hirudin interaction. Inhibition of plasma fibrin clot formation by thrombin in vitro was used as a measure of anticoagulant activity. In the minimum region necessary for detectable anticoagulant activity, hirudin56-64, positions Phe56, Glu57, Ile59, Pro60, and Leu64 are sensitive to modification. These residues are apparently important for direct interaction with thrombin or for maintaining a favorable conformation for the interaction. On the basis of conformational analysis of this region by computational methods, a "kinked" amphipathic alpha-helical structure, which orients all of the residues most critical for activity on one face of the helix, is proposed. PMID- 3625716 TI - Vitamin requirements of the European house dust mite, Dermatophagoides pteronyssinus (Acari: Pyroglyphidae), in relation to its fungal association. PMID- 3625717 TI - Reproductive success of Psoroptes ovis (Acari: Psoroptidae) on Hereford calves with a previous infestation of psoroptic mites. PMID- 3625718 TI - Mesocyclops aspericornis (Copepoda) and Bacillus thuringiensis var. israelensis for the biological control of Aedes and Culex vectors (Diptera: Culicidae) breeding in crab holes, tree holes, and artificial containers. PMID- 3625719 TI - Rhipicephalus simpsoni (Acari: Ixodidae) development under controlled conditions. PMID- 3625720 TI - Life cycle of Ixodes (Afrixodes) aulacodi (Acari: Ixodidae) in the laboratory. PMID- 3625721 TI - Experimental transmission of Leishmania mexicana to hamsters by bites of phlebotomine sand flies (Diptera: Psychodidae) from the United States. PMID- 3625722 TI - Short-term maintenance system for black fly larvae (Diptera: Simuliidae). PMID- 3625723 TI - Adult survivorship, population density, and body size in sympatric populations of Aedes triseriatus and Aedes hendersoni (Diptera: Culicidae). PMID- 3625724 TI - Evolution of resistance and change in relative density in a Culex tarsalis (Diptera: Culicidae) population under heavy insecticidal control. PMID- 3625725 TI - Incidence of screwworm (Diptera: Calliphoridae) and torsalo (Diptera: Cuterebridae) myiasis on the Yucatan Peninsula of Mexico. PMID- 3625726 TI - Diel and seasonal activity of Culicoides spp. (Diptera: Ceratopogonidae) near Yankeetown, Florida, monitored with a vehicle-mounted insect trap. PMID- 3625727 TI - Linkage relationships between a low-mobility esterase locus and group I markers in larvae of the yellow fever mosquito, Aedes aegypti (Diptera: Culicidae). PMID- 3625728 TI - [Lebanon: medicine in the face of war]. PMID- 3625729 TI - Sclerosing cholangitis secondary to fistulisation of hepatic hydatid cysts into the biliary tree. Presentation of 6 cases. Pathogenic considerations and proposal for an operative protocol. PMID- 3625730 TI - The use of ileo-cecal segment in urological surgery. A case report and review of the literature. PMID- 3625731 TI - Shigella septicemia: a reminder. PMID- 3625732 TI - Brucellar spondylitis. Review of 21 cases. PMID- 3625733 TI - [Knee prostheses. Reflections based on a series of 65 cases]. PMID- 3625734 TI - An AAMC pilot study by 10 medical schools of clinical evaluation of students. AB - In 1979 the Association of American Medical Colleges (AAMC) began a Clinical Evaluation Program. In the first phase of the program, AAMC staff members interviewed more than 500 persons in approximately 40 medical schools and solicited responses from clerkship coordinators in six specialties on the problems encountered in evaluating students' clinical performance. These results were published in 1983. The second phase of the program, which is reported on in the present paper, consisted of developing a set of self-assessment instruments in clinical evaluation and testing these instruments by 10 pilot schools. Clinical faculty members and clerkship coordinators in the pilot schools and residents at affiliated hospitals who worked with the students were asked to identify the problems they faced in evaluating students' clinical performance, and these responses were analyzed in terms of the respondents' specialties. The problems identified by the highest percentages of clinical faculty members and residents were: inadequate guidelines for handling problem students, failure to act on negative evaluations, lack of information about problems that students bring with them into clerkships, and faculty members' unwillingness to record negative evaluations. A rank-ordering of these responses on problems showed that different specialties considered different problems to be severe. In rating difficulties in evaluating problem students, the respondents reported that the type of problem student most frequently encountered was one who cannot focus on what is important. Rank-ordering of these responses showed that each type of problem student poses different evaluation difficulties in each specialty. The respondents also identified the problems they had with the evaluation forms used in their departments. PMID- 3625735 TI - Declining appeal of foreign medical education for U.S. students. AB - Concerns over the poor educational standards of some foreign medical schools and the cost of postgraduate education at a time of a projected physician surplus in the United States have led to efforts to pass federal legislation that would limit or remove access of U.S. graduates of foreign medical schools to residency programs in the United States. However, the need for such legislation has been diminished since the appeal of foreign medical education for U.S. students is on the decline. In this paper, the author reviews the economic and educational environment that in the mid-1970s led to the growth in the numbers of U.S. students who sought foreign medical education and contrasts it with the environment in the mid-1980s. Recent data are cited that support a reversal of that earlier trend. PMID- 3625736 TI - Physician characteristics and training emphasis considered desirable by leaders of HMOs. AB - Health maintenance organizations (HMOs) are growing rapidly and employing increasing numbers of physicians. It is important for medical educators to know what such organizations consider important physician traits and training experiences for their recruitment and retention of physicians. A survey of all HMOs in the United States in 1986, to which 44 percent responded, indicated that they want the curriculum of medical school and/or residency programs to have increased emphasis on cost-effective use of diagnostic and treatment services, utilization review and quality assurance, the role of primary care "gate-keeper," and financing of health services. The most important criteria in selection of physicians by HMOs were the physician's board eligibility, motivation, bedside manner, adaptability to a changing environment, the ability to work in a team, training being done in a U.S. medical school, and ability to relate to nonphysician staff members and the reputation of the physician's residency program. PMID- 3625737 TI - Survey of combined residency programs in internal medicine and pediatrics on curricula. AB - Combined residency programs in internal medicine and pediatrics began to emerge during the past decade. Combined programs provide four years of training that leads to board eligibility in both disciplines. To learn more about the curricula of these programs, the authors sent a questionnaire to the directors of the 81 known combined programs. Sixty-eight such programs were active as of July 1986. Of these, 54 had been active in the 1985-86 academic year and had a total enrollment of 390 residents, an average of 7.2 residents per program. Fourteen new programs were activated in July 1986 and enrolled 46 residents, with an average of 3.3 residents per program. Virtually all the programs emphasized training in primary care and included the use of outpatient clinics where residents often work with nonphysician health-care providers. Many programs provided instruction in the use of community resources, preceptorships, and outpatient-oriented conferences and emphasized data-gathering skills. Areas that need to be addressed by program directors and the accrediting organizations are discussed by the authors. PMID- 3625738 TI - Test of a cardiology patient simulator with students in fourth-year electives. AB - A total of 208 fourth-year students at five medical schools participated in an evaluation of a cardiology patient simulator (CPS). One group (116 students) used the CPS during a fourth-year cardiology elective, while another group (92 students) completed a cardiology elective that did not include use of the CPS. There were no differences between the two groups on a multiple-choice test on cardiology and a skills test on the CPS at the beginning of the clerkship. After the clerkship, the students in the CPS group achieved significantly higher scores on a multiple-choice test, a skills test on the CPS, and a skills test on cardiology patients. Both the students and faculty members expressed very favorable attitudes toward the CPS, but the patients perceived no differences between the two student groups. These data demonstrate that the CPS enhances learning both the knowledge and the skills necessary to perform a bedside cardiovascular evaluation and that the skills obtained from use of the simulator are transferable to use with patients. PMID- 3625739 TI - Levels and causes of stress among residents. AB - Medical and dental residents at the University of Rochester Medical Center were surveyed to measure stress and its causes. Their stress, as measured by the brief symptom inventory, showed levels slightly above those of an adult comparison group. The average levels of stress decreased with the residents' advancing levels of training. Comparison of the top quartile with the lowest quartile of scores of everyday stress showed significantly elevated stress for rotations in the emergency room, greater frequency of being on call, and lesser amount of sleep. The residents' reports showed that the bleakest three days of residency tended to occur in the first year and during intensive care rotations. Stress during these bleakest times was significantly higher than everyday levels. The residents described the major causes of distress during bleakest times as lack of sleep, inadequate support from senior professionals, large patient load, and competition from peers. "High quality" teaching rounds, a night-float system, and sick leave were felt by the residents to lessen stress. To cope with the stress, the residents reported they talked to others, tried to see humor in the situation, or slept. PMID- 3625741 TI - Results of a survey concerning application for residency training. PMID- 3625740 TI - Survey of courses offered in U.S. medical schools on health care delivery and finance. PMID- 3625742 TI - Survey of departments of obstetrics and gynecology in U.S. and Canadian medical schools, 1965 to 1985. PMID- 3625743 TI - Residency directors' perceptions of gender-related differences in the performance of psychiatric residents. PMID- 3625744 TI - A one-week rotation in physical medicine and rehabilitation. PMID- 3625745 TI - Computer instruction as part of a course on analytic medicine for first-year students. AB - The Medical University of South Carolina integrated instruction in information science and computer technology into a required freshman-level course. Analytic and Community Medicine. The advantages of this placement in the curriculum are two-fold. First, the course provides an opportunity to integrate computer methodology with clinically relevant topics such as medical decision-making. This integration enhances the students' view of the computer as a useful tool that can aid the physician in the practice of medicine. Course organizers are convinced that the success of the first offering is attributable to this integration. Second, the instruction comes early in the medical education process and allows the concepts learned to be utilized throughout the students' medical school careers. The degree to which these concepts and methods are actually utilized by students will depend upon the degree of reinforcement of these ideas in the clinical years and residency. Thus, faculty members must act as role models who not only acknowledge the importance of mastering the use of computers in medicine but also manifest those skills. PMID- 3625746 TI - Striving for excellence in medical education. PMID- 3625747 TI - Residency performance. PMID- 3625748 TI - Faculty on call. PMID- 3625749 TI - CME teleconferences. PMID- 3625750 TI - Current developments in oxygen concentrator technology. AB - Oxygen concentrators are electrically powered devices which are designed to provide oxygen for patients who require long-term domiciliary oxygen. The machines have been available for the last 10 to 15 years, but it is only recently that improvements in design have led to them being generally accepted as a reliable and economical means of supplying long-term oxygen therapy. There are two basic types of concentrator currently available: the molecular sieve (MS) concentrator, and the membrane oxygen enricher. In this article the characteristics and principles of operation of these machines are reviewed, together with the development and present state of MS concentrator technology. A summary of a comparative evaluation of seven MS concentrators is presented and the results discussed. Relevant safety standards and current trends in concentrator design are then reviewed. PMID- 3625751 TI - An instrument for testing external cardiac pacemakers. AB - Checking the function of an external pacemaker can be time consuming both as a routine maintenance task and after the repair of a fault. An instrument is described which is easy to use and contributes to a higher standard of maintenance by considerably reducing the time taken and by eliminating the need for the interconnection of specialized test equipment. PMID- 3625752 TI - Evaluation report: heat and moisture exchangers. PMID- 3625753 TI - Purification of human thyroid peroxidase using ion exchange liquid chromatography. AB - We have utilized a one step ion-exchange (FPLC Mono Q) purification procedure for the isolation of human thyroid peroxidase (TPO). The purified TPO had the properties of a major microsomal antigen and inhibited the binding of human microsomal autoantibodies to thyroid microsomal membranes. The isolated TPO was free from thyroglobulin and showed, compared with crude microsomal proteins, a reduced background binding with control sera in enzyme-linked immunoassay (ELISA). SDS-gel electrophoresis of the isolated TPO detected one major band with an apparent molecular weight of 105 kD. The antigenicity of the protein was demonstrated by immunoblotting using sera from patients with autoimmune thyroiditis. These results demonstrate that FPLC Mono Q chromatography offers a rapid, quantitative and precise method for large scale purification of TPO with retained enzymatic and antigenic activity for use in ELISA and for further studies on the structure and function of this protein. PMID- 3625754 TI - A new human trophoblast antigen isolated from immune complexes derived from placental blood and membranes. AB - Immune complexes were prepared from human trophoblast membranes, placental blood serum, non-pregnant female serum and normal male serum by precipitation, gel filtration and affinity chromatography. The purified complexes were subjected to analysis by SDS-PAGE and one common antigenic species was identified. This antigen (mol. wt. 82.8 +/- 2.4 K) was designated the putative trophoblast antigen (TA) and shown to exhibit discrete antigenic homology with human immunoglobulin and HLA molecules. PMID- 3625755 TI - Changes in electrophoretic mobility pattern of erythrocytes in patients with paroxysmal nocturnal hemoglobinuria. AB - The electric surface charge of erythrocytes in patients with paroxysmal nocturnal hemoglobinuria (PNH) was analyzed by means of a fully automated cell electrophoretic instrument (Parmoquant-L). The electrophoretic mobility of PNH erythrocytes decreased significantly and showed a broader pattern. After a blood transfusion, erythrocytes of PNH patients showed a bimodal pattern because of the emergence of the higher mobility peak corresponding to normal erythrocytes. However, the next day after transfusion, this new peak disappeared. Furthermore, the next day after administration of Prednisolone, the main peak of the mobility pattern shifted to the higher side, and after treatment for 7 days, the pattern showed several peaks and tended to disperse. Reticulocytes had higher complement lysis sensitivity, lower cholinesterase activity and lower electric surface charge, and it was shown that PNH erythrocytes consisted of 2 populations. Studies on the electrophoretic mobility patterns of PNH erythrocytes under various conditions can be useful in understanding the properties of erythrocyte membrane surfaces. PMID- 3625756 TI - Renin angiotensin aldosterone axis, including aldosterone binding globulin and blood pressure in three species of nonhuman primates. AB - Variables of renin-angiotensin-aldosterone axis with inclusion of protein binding to specific plasma globulin (ABG), plasma cortisol, and the blood pressure (BP) were measured in 24 chimpanzees, 4 gorillas, and 16 cynomolgus monkeys. ABG activity was readily detected in plasma from the primates. In chimpanzees and gorillas, all the variables under baseline conditions were similar to those in humans. In cynomolgus (Macaca fascicularis), both the ABG binding capacity for aldosterone and the diastolic or systolic BP were significantly higher (p less than 0.001 and p less than 0.01 respectively) than in chimpanzees and gorillas. PMID- 3625757 TI - Blood variables in adult stumptail macaques (Macaca arctoides) living in a captive group; annual variability. AB - Monthly blood samples were collected for more than two years from adult stumptail macaques living in a large captive group. The social organization, feeding pattern, and food composition were stable throughout the study period. No seasonal variability was observed for any of the 30 blood variables studied. It appeared that for each variable, within-animal variance was small relative to between-animal variance. A table of means and reference ranges is presented and discussed. PMID- 3625758 TI - Correlative clinical biochemistry and hematological profiles of laboratory-bred Bolivian squirrel monkeys (Saimiri sciureus). AB - Twenty-five clinical and biochemical parameters were determined on 17 normal, male, laboratory-bred Bolivian squirrel monkeys (Saimiri sciureus). Parallel hematologic parameters were conducted. The correlation of biochemical and hematological observations and the distribution characteristics, range, and standard error of the mean were determined. The purpose of the present communication is to establish baseline biochemical values for laboratory-bred squirrel monkeys and to present a correlative comparison between selected cellular elements and major blood electrolytes. PMID- 3625759 TI - The Na+-independent D-glucose transporter in the enterocyte basolateral membrane: orientation and cytochalasin B binding characteristics. AB - Phloridzin-insensitive, Na+-independent D-glucose uptake into isolated small intestinal epithelial cells was shown to be only partially inhibited by trypsin treatment (maximum 20%). In contrast, chymotrypsin almost completely abolished hexose transport. Basolateral membrane vesicles prepared from rat small intestine by a Percoll gradient procedure showed almost identical susceptibility to treatment by these proteolytic enzymes, indicating that the vesicles are predominantly oriented outside-out. These vesicles with a known orientation were employed to investigate the kinetics of transport in both directions across the membrane. Uptake data (i.e. movement into the cell) showed a Kt of 48 mM and a Vmax of 1.14 nmol glucose/mg membrane protein/sec. Efflux data (exit from the cell) showed a lower Kt of 23 mM and a Vmax of 0.20 nmol glucose/mg protein/sec. D-glucose uptake into these vesicles was found to be sodium independent and could be inhibited by cytochalasin B. The Ki for cytochalasin B as an inhibitor of glucose transport was 0.11 microM and the KD for binding to the carrier was 0.08 microM. D-glucose-sensitive sensitive binding of cytochalasin B to the membrane preparation was maximized with L- and D-glucose concentrations of 1.25 M. Scatchard plots of the binding data indicated that these membranes have a binding site density of 8.3 pmol/mg membrane protein. These results indicate that the Na+ independent glucose transporter in the intestinal basolateral membrane is functionally and chemically asymmetric. There is an outward-facing chymotrypsin sensitive site, and the Kt for efflux from the cell is smaller than that for entry. These characteristics would tend to favor movement of glucose from the cell towards the bloodstream. PMID- 3625760 TI - The elderly mentally handicapped in hospital: a clinical study. AB - In a study of 99 long-stay hospital residents aged 65 years and over, two thirds were functioning in the moderately to mildly handicapped range, two thirds were under the age of 75 years and there was an overall female to male ratio of 2:1. As in the general population, mobility problems, a tendency to falls and fractures, cardiorespiratory disease, deteriorating eyesight, and hearing and urinary incontinence were commonly found; all increased in frequency with age. A fifth exhibited psychiatric disorder: the commonest conditions, as expected, were the psychoses and dementia. It is suggested that retirement provision for the elderly mentally handicapped should be made within the mental handicap services and that the small group with significant geriatric problems would be most appropriately cared for within the generic geriatric services. A plea is made for evaluative studies before large scale implementation of resettlement programmes for the elderly mentally handicapped in hospital. PMID- 3625761 TI - Self-injurious behaviour in people with mental handicap: a total population study. AB - A survey of self-injurious behaviour in people receiving services for mental handicap was carried out in one health region. Six hundred and sixteen adults and children were found to have engaged in self-injurious behaviour sufficient to have caused tissue damage in the previous 4 months and 596 of these were screened. Half were resident in hospital while 28% were in non-hospital residential care and the remainder (21%) were living at home. Nearly one-fifth (19%) showed self-injurious behaviour, of one or more types, at a rate of at least once per hour and a further 13% wore protective or restraining devices for all or part of the day or night. Only 2% were enrolled on formal psychological treatment programmes but nearly half were receiving psychotropic drugs (excluding anticonvulsants). PMID- 3625762 TI - Folate metabolism and problem behaviour in mentally handicapped epileptics. AB - Two groups of mentally handicapped residents were studied consisting of 32 epileptics on anti-epileptic medication and 32 non-epileptic controls. The epileptic group showed a significantly low serum folate level compared with the non-epileptic control group. Serum vitamin B12 and behaviour rating did not show any significant difference between two groups. Comparison of patients receiving phenytoin and those who were not showed significantly lower serum folate in the sub-group receiving phenytoin, but there was no significant difference between the sub-groups with respect to vitamin B12 or behaviour problem rating. PMID- 3625764 TI - Digital dermatoglyphics of Turner's syndrome. AB - The proposition that finger print variability between individuals might be reduced by the absence of an X-chromosome in Turner's syndrome was rejected. In the present study of 58 XO patients, aged 15-50 years, relatives of several cases, unrelated female control samples and three unrelated male samples were investigated. The higher mean value of the TRC among patients supported the hypothesis forwarded by Penrose that an added X- or Y-chromosome reduces the TRC and a missing one increasing it. The figures do not speak against the hypothesis that genes affecting the TRC are located on the X-chromosome. A summary of the major dermatoglyphic investigations in Turner's syndrome is presented. PMID- 3625763 TI - Negative ion effects on hemispheric processing and selective attention in the mentally retarded. AB - The effect of high concentrations of negative air ions on a dichotic digits task was investigated in 19 mentally retarded individuals. Subjects were assigned randomly to an ion or to an unmodified-air placebo condition under double-blind testing. Left and right ears were precued for report order and this order was reversed for the second set of trials. Negative ions promoted greater left hemisphere lateralization on the first set of trials, and enhanced recall when switching to the opposite channels, in the second set of trials. However, the ion induced REA occurred at the expense of selective attention to the left channel and superior left ear recall after the right ear first condition is an anomalous dichotic listening pattern. Such paradoxical results suggest that negative ions are not necessarily beneficial or detrimental to processing. Negative ions may increase arousal, in this case amplifying a time-phased, information processing disorder in the retarded characterized by excessive right hemisphere inhibition during early processing of receptive speech and diffuse interhemispheric excitatory activation during later processing. PMID- 3625765 TI - Intestinal obstruction as a cause of death in the mentally handicapped. AB - This paper reviews the occurrence of symptoms of intestinal obstruction in mentally handicapped people. A retrospective study was done on all residents dying in mental handicap hospitals over a 7-year period. It was noticed that people dying of intestinal obstruction were younger, male, gave a history of constipation, other gastrointestinal problems and dietary indiscretion. PMID- 3625766 TI - Coffin-Lowry syndrome and schizophrenia: a family report. AB - A family is reported in which the mother and 4 of her 6 children are affected by a constellation of abnormalities including mental handicap, abnormal facies, short stature, soft fleshy hands with tapering fingers and skeletal abnormalities. The family is believed to represent a further group of individuals with Coffin-Lowry syndrome. Additionally, one affected daughter has symptoms suggestive of schizophrenia and one affected son has severe sensorineural deafness. PMID- 3625767 TI - Use of a restricted protein diet in the treatment of behaviour disorder in a severely mentally retarded adult female phenylketonuric patient. AB - A 54-year-old profoundly mentally retarded female patient with phenylketonuria and a severe behaviour problem was treated with a restricted protein and high energy diet. After several weeks of dietary intervention the patient's behaviour improved significantly. PMID- 3625768 TI - Comments on the community drug treatment prevalence survey by Davis et al. (1981) PMID- 3625769 TI - Defining the functional domains in the control region of the adenovirus type 2 specific VARNA1 gene. AB - The outer boundaries of the internal transcriptional control region in the VARNA1 gene have been located from positions +10 to +69. To further define the detailed organization of the functional domains in this region and the function(s) of the 5' flanking sequence, and to obtain a more detailed insight into other transcriptionally important sequences, we have constructed 77 mutants with deletion endpoints at almost every one to five base-pairs in the entire region from -30 to +160 for transcriptional studies. Using our highly active crude extract under our assay conditions, and quantitatively measuring the transcriptional efficiency and competing strength of each mutant, we have revealed new features of important transcriptional control sequences and defined the transcriptional functions of several functional domains in this gene. The essential domain is from +59/+63 to +66/+68, which corresponds to the B block sequence. This is smaller than that defined previously. The second most important domain is the region from +12/14 to +40, which includes the A block sequence that dictates the wild-type major start site and amplifies the events started by the B block region, mediated through factors and RNA polymerase III. Furthermore, the domain from -5 to +11 affects the use of certain start site(s). Moreover, the 5' flanking region from -30 to +1 contributes 80 to 90% of the overall transcriptional efficiency of the gene. Finally, our transcriptional studies of mutants deleted of the A block sequence and all of the upstream sequence indicated that an intimate interaction between the two blocks is essential for initiation of transcription. Furthermore, the B block sequence is more important than the A block sequence in the transcription reaction. The mechanism and control of transcriptional initiation in the VARNA1 gene is similar to that in some tRNA genes, but differs from that in others. PMID- 3625770 TI - Recognition and cleavage of the bacteriophage P1 packaging site (pac). II. Functional limits of pac and location of pac cleavage termini. AB - Bacteriophage P1 initiates the processive packaging of its DNA at a unique site called pac. We show that a functional pac site is contained within a 161 base pair segment of P1 EcoRI fragment 20. It extends from a position 71 base-pairs to a position 232 base-pairs from the EcoRI-22 proximal side of that fragment. The 3' and 5' pac termini are located centrally within that 161 base-pair region and are distributed over about a turn of the DNA helix. The DNA sequence of the terminus region is shown below, with the large arrows indicating the positions of termini that are frequently represented in the PI population and the small arrows indicating the positions of termini that are rarely represented in the P1 population. (Sequence: in text). Digestion of P1 virus DNA with EcoRI generates two major EcoRI-pac fragments, which differ in size by about five or six base pairs. While the structure and position of the double-stranded pac ends of these fragments have not been determined precisely, the 5' termini at those ends probably correspond to the two major pac cleavage sites in the upper strand of the sequences shown above. The 161 base-pair pac site contains the hexanucleotide sequence 5'-TGATCAG-3' repeated four times at one end and three times at the other. Removal of just one of those elements from either the right or left ends of pac reduces pac cleavage by about tenfold. Moreover, the elements appear to be additive in their effect on pac cleavage, as removal of one and a half elements or all three elements from the right side of pac reduces pac cleavage 100-fold, and greater than 1000-fold, respectively. PMID- 3625771 TI - Purification, reconstitution and polymorphic transition of halobacterial flagella. AB - Flagellar filaments of Halobacterium halobium have been purified by dissociation and reconstitution. Three different protein bands (23,500, 26,500 and 31,500 apparent molecular weight) are seen on sodium dodecyl sulphate/polyacrylamide gels, thus confirming that all three proteins are intrinsic to the flagellar structure. We designate them as flagellin Fla I (23,500), Fla II (26,500) and Fla III (31,500). Polymorphic transitions from normal to a curly, a ring and a straight form are induced by different pH values and heat treatments. PMID- 3625772 TI - Refinement of the crystal structure of wheat germ agglutinin isolectin 2 at 1.8 A resolution. AB - The crystal structure of wheat germ agglutinin isolectin 2 has been refined by the restrained least-squares method of Hendrickson & Konnert (1980). The asymmetric unit of the C2 crystals contains two chemically identical promoters related by a non-crystallographic 2-fold screw operation. A total of 2290 protein atoms and 186 ordered water sites refined to a final R-factor of 0.179 and an average B-value of 21.6 A2, using 54% (15,601) of the total possible number of reflections in the resolution range 8 to 1.8 A with Fo greater than 3 sigma (Fo). The final model conforms to stereochemically correct bond distances and angles with root-mean-square (r.m.s.) values of 0.018 A and 3.3 degrees, respectively. Accuracy of this model is estimated to be 0.20 A on the basis of a Luzzati plot. Main-chain atomic positions in the two independent promoters, designated I and II, agree with an r.m.s. deviation of 0.30 A (0.58 A for all atoms), indicating identical backbone conformation. The largest discrepancies are seen at flexible surface residues. One error was detected in the amino acid sequence at position 41 (Ser), which refined satisfactorily as a Trp. Loss of electron density for residue A171 during the course of refinement suggests either disorder or absence of this C-terminal residue. The conformation of the polypeptide chain, which is folded into four homologous 43-residue domains (A, B, C and D), was analyzed in terms of dihedral angles, backbone hydrogen bond lengths and CA-atom positions. The four domains were found to be very similar according to all these criteria and superposition of their CA-atoms yielded r.m.s. distances ranging from 0.36 to 0.72 A for the six possible comparisons [corrected]. Large deviations (greater than 1.0 A) are only seen in the five-residue segments that link adjacent domains and at the N and C termini. Refinement has also allowed critical examination of each of the two unique sugar binding sites, referred to as "primary" and "secondary" sites, in different lattice environments. While the essential tyrosyl side-chain in each of these sites (Y73, Y159) assumes precise orientation for optimum hydrophobic contact with the N-acetyl methyl group of the sugar ligand, side-chains involved in hydrogen bonds (S62, E115; and S148, D29) were found to be relatively flexible and able to adapt their conformation to changes in environment. Ordered water structure present in these binding sites is not completely analogous in the different environments.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3625773 TI - Haem-rotational disorder in monomeric allosteric cyano-Met insect haemoglobins monitored by resonance Raman spectroscopy. AB - The haem-rotational disorder (insertion of haem into globin rotated about the alpha, gamma-meso axis by 180 degrees) has been investigated in the cyano-Met form of the monomeric allosteric insect haemoglobins, CTT III and CTT IV, by resonance Raman spectroscopy. The effect of haem disorder on the resonance Raman spectra has been observed in proto-IX, deutero-IX, and meso-IX CTTs. Most importantly, in the absence of overlapping vinyl vibrations, we have identified two Fe-C-N bending vibrations at 401 cm-1 and 422 cm-1 (pH 9.5) for 57Fe deutero IX CTT IV ligated with 13C15N-, which are attributed to the two haem-rotational components. One Fe-C-N bending mode at 422 cm-1 shows a pH-induced shift to 424 cm-1 (pH 5.5) indicating the t----r conformational transition, whereas the other bending mode is pH-insensitive, representing a non-allosteric component. By replacing the unsymmetrical porphyrins with the "symmetrical" protoporphyrin-III we eliminate the haem disorder. Then, sharpening of the Fe-N epsilon(His) (at 313 cm-1) and Fe-CN (at 453 cm-1) stretching modes is observed and a single Fe-C-N bending mode (at 412 cm-1) appears. In cyano-Met proto-IX CTT III two vinyl bending vibrations at 412 cm-1 and 591 cm-1 assigned by deuteration of the vinyl groups also reflect the haem disorder. The 412 cm-1 vinyl vibration is intensity enhanced via through-space coupling with one of the Fe-C-N bending modes (at 412 cm-1). In the cyano-Met form of proto-III CTT III this vinyl vibration is shifted to 430 cm-1 resulting in a dramatic drop in intensity. It is most likely that the specific vinyl-protein interaction at position 4 in one of the haem-rotational components is the origin of the coupling between the Fe-C-N and vinyl bending modes. The Fe-N epsilon(proximal His) and the Fe-CN stretching vibrations as well as the Fe-C-N bending vibration have been identified by 54Fe/57Fe and 13C15N/12C15N/13C14N/12C14N isotope exchange. PMID- 3625774 TI - Systematic method for the detection of potential lambda Cro-like DNA-binding regions in proteins. AB - We have developed and tested a systematic method for the location and statistical evaluation of potential DNA-binding regions of the lambda Cro type in protein sequences. Using this approach to examine proteins expected to contain such regions, we have been able to compile a statistically homogeneous master set of 37 lambda Cro-like DNA-binding domains. Examination of a protein database revealed other prokaryotic proteins that are similar to this lambda Cro-like group. There are also many DNA-binding proteins that are not found to be significantly similar to the lambda Cro group, consistent with previous suggestions that different types of protein sequence may be able to achieve a similar mode of binding and that there exist other modes of sequence-specific DNA binding. A useful feature of the method is that it can be applied without a computer. PMID- 3625775 TI - Proteolysis and binding of myosin subfragment 1 to actin. AB - Rates of proteolytic cleavage of myosin subfragment 1 were measured in the absence and presence of different amounts of actin. The rates of tryptic digestion at the 50K/20K junction and papain digestion at the 25K/50K junction of the myosin head were progressively inhibited with increasing substoichiometric molar ratios of actin to myosin subfragment 1. The percentage inhibitions of digestion reactions corresponded precisely to the molar compositions of actin subfragment 1 solutions and demonstrated that equimolar complexes of these proteins were responsible for the observed changes in the proteolysis of myosin heads. PMID- 3625776 TI - Structure and hydration of purple membranes in different conditions. AB - The unit cell dimension of the bacteriorhodopsin lattice in purple membranes decreases by the same amount (2%) upon drying the membranes at room temperature as when they are cooled to liquid nitrogen temperatures. Neutron diffraction experiments with H2O:2H2O exchange, however, show that whereas in the dry membranes the lipid headgroups are dehydrated and the decrease in dimension is due to a smaller area occupied by the lipid molecules, the water of hydration remains in place in the cooled membranes, and the decrease in dimension is due to thermal contraction only. These data suggest a hypothesis that functional bacteriorhodopsin, in the wet state at room temperature, has a relatively soft environment that would allow large amplitude motions of the protein; in the dry membranes at room temperature (which are inactive), the amplitudes of protein motions would be inhibited by a more close-packed environment as they are reduced, due to thermal contraction, in the cold membranes. PMID- 3625777 TI - Preliminary crystallographic studies of glycosomal glyceraldehyde phosphate dehydrogenase from Trypanosoma brucei brucei. AB - Crystals of glyceraldehyde phosphate dehydrogenase from the glycosome of Trypanosoma brucei brucei have been grown, and a partial data set has been collected using synchrotron radiation. The crystals diffract initially to 2.3 A resolution. The space group is P2(1)2(1)2, with cell dimensions a = 135 A, b = 255 A, c = 115 A, so there are probably at least two tetramers in the asymmetric unit. PMID- 3625778 TI - Preliminary crystallographic study of a complex between the Fab fragment of a monoclonal anti-lysozyme antibody (D1.3) and the Fab fragment from an anti idiotopic antibody against D1.3. AB - An anti-lysozyme antibody, D1.3, was used as immunogen to obtain syngeneic (Balb/c) monoclonal anti-idiotopic antibodies. The complex between Fab D1.3 and the Fab fragment from the anti-idiotopic antibody E225 has been crystallized. The crystals are monoclinic, space group P2(1), with a = 75.7 A, b = 77.4 A, c = 97.2 A, beta = 111.90 degrees and one molecule of the complex in the asymmetric unit. X-ray photographs show reflections extending to a resolution of about 3 A. Although twinning occurs frequently in the large crystals obtained, this material is suitable for high-resolution X-ray analysis. PMID- 3625779 TI - Measurement of rat heart fatty acid binding protein by ELISA. Tissue distribution, developmental changes and subcellular distribution. AB - A class of soluble, low molecular weight proteins collectively called fatty acid binding proteins (FABP) are thought to function in the intracellular movement of fatty acids. To understand more clearly the role of FABP in cardiac metabolism, we used ELISA and immunoblotting techniques to study the distribution of heart FABP in several rat tissues, compare male and female rat heart content, quantitate developmental changes, and determine its subcellular distribution. Immunoreactive protein was found in appreciable amounts in rat heart, red skeletal muscle and kidney. Adult rat heart contained about 1.5 mg FABP/g tissue wet weight with the atrial content being approximately 50% of the ventricular concentration. No significant difference was detected between the sexes. The amount of FABP increased progressively during development from fetal to adult animals, and measureable amounts were found in 17-day-old fetal tissue. Comparisons between myoglobin and FABP showed that FABP appeared earlier than myoglobin in development, but myoglobin was more abundant than FABP at birth. Using immunoblots it was determined that rat heart FABP was localized in the cytosol with no detectable intramitochondrial material. PMID- 3625780 TI - Comparison of contractile state and myosin isozymes of rat right and left ventricular myocardium. AB - We compared myocardial mechanics and myosin isozymes of right and left ventricular papillary muscles from adult (6 to 8 month old) male rats. Analysis of force velocity relations indicate that right ventricular papillary muscles contract more rapidly than left at light loads (2.68 +/- 0.13 vs 2.18 +/- 0.07 muscle lengths/s measured 75 ms following stimulation, at 0.5 g/mm2; P less than 0.01). Right ventricular papillary muscles had significantly more of the alpha heavy chain containing V1 myosin isozyme and less of the V3 containing beta heavy chain myosin isozyme than left ventricular preparations (P less than 0.05). Papillary muscle and ventricular free wall myosin isozyme distribution were not significantly different within their respective chambers. The presence of a relatively larger proportion of the alpha heavy chain containing myosin isozyme (V1) in right ventricle papillary muscles relative to left correlated with the more rapid velocities of shortening seen in right ventricular papillary muscles (r = 0.60; P less than 0.01). PMID- 3625781 TI - Diltiazem and the reduction of reperfusion-induced arrhythmias in the rat: protection is secondary to modification of ischemic injury and heart rate. AB - We have used the isolated rat heart with transient coronary artery occlusion to investigate whether diltiazem has an anti-arrhythmic action against reperfusion induced ventricular arrhythmias. In the first series of studies (early administration group) the drug was administered 5 min prior to the induction of regional ischemia, this resulted in a dose-dependent reduction in reperfusion induced ventricular fibrillation. With 5 X 10(-8), 10(-7), 5 X 10(-7), 10(-6) and 5 X 10(-6) mols of diltiazem/l, total ventricular fibrillation (reversible plus irreversible) was reduced from its control incidence of 100% (12/12) to 91%, 58% (P = less than 0.05), 17% (P = less than 0.001), 0% (P = less than 0.001) and 0% (P = less than 0.001) respectively. Heart rate was also reduced in a dose dependent manner, falling from its control value of 268 +/- 6 beats/min to less than 50% with the highest concentration of diltiazem. Coronary flow was increased in a dose-dependent manner in the diltiazem treated groups. In additional studies with an anti-arrhythmic dose of diltiazem (5 X 10(-7) mols/l), hearts were paced to their drug free control value; under these conditions the anti-arrhythmic effect of diltiazem was lost. In further studies, diltiazem (10(-7) and 5 X 10( 7) mols/l) was administered just prior to reperfusion (late administration group), no anti-arrhythmic effects were observed. In additional studies we determined whether, with early administration, diltiazem (5 X 10(-7) mols/l) exerted its anti-arrhythmic effect by altering the relationship between the vulnerability to reperfusion-induced arrhythmias and the duration of preceding ischemia. In diltiazem-free control hearts a bell-shaped profile was observed with a maximum vulnerability after 10 min of ischemia (100% incidence of reperfusion-induced ventricular fibrillation). In diltiazem-treated hearts, a bell-shaped curve was also observed, however, its optimum was shifted to the right and downwards (20 min of ischemia gave maximum vulnerability [41%] to reperfusion-induced arrhythmias). We conclude that the ability of diltiazem to protect the isolated rat heart against reperfusion-induced arrhythmias is secondary to its anti-ischemic effect and in particular to its negative chronotropic properties. PMID- 3625782 TI - Adenylate cyclase activity, membrane fluidity and fatty acid composition of rat heart in essential fatty acid deficiency. AB - Three groups of male, weanling, Sprague-Dawley rats were fed diets containing 7% hydrogenated coconut oil, 6.6% hydrogenated coconut oil + 0.4% corn oil, or 7% corn oil for 8-17 weeks. These diets provided 0% (EFAD group), 0.5% (MEFAD group) or 5% (CONTROL group) of the total energy as linoleic acid, respectively. Crude plasma membranes were prepared from heart and assayed for adenylate cyclase activity. Both basal and fluoride-stimulated activity was lower in the membranes from EFAD and MEFAD rats than that of the controls. The double bond index of total lipids and phospholipids, and fluorescence polarization of 1,6-diphenyl 1,3,5-hexatriene (DPH) were not appreciably different in the membranes from the three dietary groups. The fatty acid composition of total phospholipids of the membranes, however, was quite different and indicative of biochemical changes typical of an EFA deficiency. Feeding of the control diet to the EFAD or MEFAD rats for up to 6 weeks did not alleviate completely the changes in adenylate cyclase activity although the fatty acid patterns were restored to the normal levels. There was also a decrease in the number of [3H]-DHA binding sites in heart of EFAD rats as compared with their controls. The results suggest that the changes induced by EFA deficiency in the acyl group composition of membrane phospholipids and in the number of beta-adrenergic receptors may be important in regulating adenylate cyclase activity in the heart. PMID- 3625783 TI - Intra- and extracellular potassium activities and the potassium equilibrium potential in partially depolarized human atrial cells. AB - Under tissue bath conditions, isolated specimens of human right atrium are characterized by the presence of large numbers of partially depolarized cells. The basis for the depolarization is still not understood. To determine if reduced intracellular potassium activity (aKi) is responsible for the low levels of maximum diastolic potential (MDP), aKi was directly measured with potassium ion selective micro-electrodes (KISE). The effects of varying bath potassium concentration ([K+]0) on aiK and on the relationship between MDP and the potassium equilibrium potential (EK) also were determined. In 4 mM [K+]0, all specimens studied were partially depolarized (MDP = -43.9 +/- 1.3 mV [mean +/- S.E.]) and beat spontaneously. aKi was 98.1 +/- 1.5 mM, and EK was -93.3 +/- 0.4 mV. Changes in [K+]0 between 2.5 and 40 mM did not change aKi significantly. MDP was relatively insensitive to [K+]0 and was always far positive to EK over the entire range of [K+]0 studied. The ability of the KISE to reliably measure aKi in the face of the spontaneous diastolic depolarization was assessed by using acetylcholine or cooling to depress automaticity. These measures did not significantly alter the calculated aKi. The results indicate that: aKi in human atrial specimens is similar to that in atria from other mammalian species, and the low level of MDP exhibited by human atrial cells subject to conventional tissue bath conditions does not primarily result from low levels of aKi. PMID- 3625784 TI - Effects of the fatty acid blocking agents, oxfenicine and 4-bromocrotonic acid, on performance in aerobic and ischemic myocardium. AB - Two fatty acid blocking agents, oxfenicine (33 mg/kg) and 4-bromocrotonic acid (0.34 mg/kg/min for 70 min), were used to selectively adjust levels of long-chain acyl CoA and carnitine in aerobic and ischemic myocardium. The purpose of the study was to test whether the shift in these amphiphiles was associated with alterations of mechanical function in intact myocardium. The extracorporeally perfused swine heart preparation was used. Hearts were perfused at aerobic levels for 40 min following which flow to the anterior descending (LAD) circulation was reduced by 50% for the final 30 min of perfusion. All hearts were perfused with excess fatty acids to raise serum levels to 1.37 +/- 0.16 mumol/mol throughout the studies. Oxfenicine and 4-bromocrotonic acid affected a 20% (P less than 0.05 and P less than 0.05, respectively) further decline in 14CO2 production from labelled palmitate as compared with placebo hearts during regional ischemia. Accompanying this were downward shifts in acyl carnitine (-27 delta %, NS in aerobic tissue; -70 delta %, P less than 0.001 in ischemic tissue) and acyl CoA ( 13 delta %, NS in aerobic tissue; -33 delta %, P less than 0.01 in ischemic tissue) for oxfenicine and upward shifts of acyl carnitine (+212 delta %, P less than 0.001 in aerobic tissue; -9 delta %, NS in ischemic tissue) and acyl CoA (+78 delta %, P less than 0.001 in aerobic tissue; +29 delta %, P less than 0.025 in ischemic tissue) for 4-bromocrotonic acid. These adjustments in amphiphiles were further associated with improved function (+55 delta % increase in max LV dP/dt, P less than 0.05) in oxfenicine-treated hearts and depressed function (+87 delta % increase in LVEDP, P less than 0.05) in 4-bromocrotonic acid-treated hearts. Thus, at comparable conditions of coronary flow, left ventricular pressure, and fatty acid availability and oxidation between treatments, depletion or build-up of CoA and carnitine esters as affected by selective inhibitors of fatty acid metabolism were causally linked to improved or impaired cardiac performance in intact hearts. PMID- 3625785 TI - Marked sympathetic innervation in the regions of the bundle branches shown by catecholamine histofluorescence. AB - The distribution of sympathetic nerve fibers in the regions of the bundle branches of bovine and rat hearts was examined by the glyoxylic acid-induced method for histofluorescence demonstration of catecholamines and by acetylcholinesterase (AChE) histochemistry. The studies on the bovine heart were concentrated on the nerve fascicles, the arteries and the ganglionic cells, and showed that (1) the AChE-positive nerve fascicles that occur just outside the bundle branches show a positive catecholamine-fluorescence reaction to varying degrees, the paraarterial nerve fascicles showing a uniform reaction; (2) the AChE-positive nerve fascicles within the bundle branches contain a few, mainly varicose, sympathetic nerve fibers; (3) extensive plexuses of sympathetic nerve fibers supply the arterial branches; and (4) sympathetic nerve fibers occur close to some of the ganglionic cells. The pattern of distribution of sympathetic nerve fibers in the region of the SA node was found to be essentially the same. The studies on the rat heart showed that (1) the septal arteries that occur in the proximity of the bundle branches are accompanied by the sympathetic component of innervation; and (2) there is a substantial number of varicose sympathetic nerve fibers within the bundle branches. These observations show that there is a pronounced sympathetic innervation in bundle branch regions and suggest that the paraarterial route is the most important for sympathetic nerve fibers to reach these regions. PMID- 3625786 TI - Effect of exogenous phospholipase A2 treatment on cardiac muscarinic receptors of highly purified canine sarcolemmal vesicles. AB - Effects of phospholipase A2 (PLA2)-catalyzed hydrolysis of sarcolemmal phospholipids on ventricular muscarinic receptors were examined by measuring specific binding of 3H-quinuclidinyl benzilate (3H-QNB) to purified canine sarcolemmal vesicles. Scatchard analysis of 3H-QNB saturation isotherms (25 degrees C, pH 7.4) yielded a dissociation constant (Kd) of 58 +/- 10 pM and maximal binding capacity (Bmax) of 5.7 +/- 1.3 pmol/mg. Pretreatment of the sarcolemmal membranes with PLA2 (1 U/ml) for 5 and 30 mins reduced Bmax to 38% and 7% of control, and increased Kd to 109 +/- 21 and 129 +/- 12 pM, respectively. Washing of PLA2-treated sarcolemmal vesicles with defatted albumin resulted in a partial recovery of Bmax, presumably by removing hydrolysis products. PLA2 also reduced equilibrium binding of 3H-QNB to 43% of control when reactions were started by simultaneous addition of 3H-QNB and 1 U/ml PLA2; however, under these conditions the inhibitory effect of PLA2 could be overcome by increasing 3H-QNB from 30 to 600 pM. PLA2 added at equilibrium (59 mins after reaction start) had no effect on 3H-QNB binding. Lipid hydrolysis by PLA2 was unaffected by the presence of bound 3H-QNB. The ability of ligand occupation and removal of hydrolysis products to attenuate the effects of PLA2-treatment on muscarinic receptor sites may be explained if modification of the membrane lipid bilayer leads to transitions between different states of the receptor. PMID- 3625787 TI - Collagenous abnormalities in the heart of the tight-skin mouse. AB - The tight-skin (TSK) mouse, a possible animal model for scleroderma, has multiple abnormalities including increased dermal thickness, cardiomegaly, emphysematous lungs, and an enlarged skeleton. Previous investigations have demonstrated an increased collagen and glycosaminoglycan (GAG) content in the skin and lungs of these mice. The present correlative investigation of the biochemical and ultrastructural properties of the heart in the TSK mouse also revealed an increased presence of collagen. Analysis of collagen types in the TSK heart showed there was a shift in the ratio of type I: type III: type V from the normal values. Over 90% of the collagen was type I, while both types III and V were decreased in this organ. The ultrastructural examination of the left ventricle demonstrated extensive accumulations of perivascular and intercellular edema fluid, foci of myocytolysis, and areas of moderately increased collagen deposits within interstitial sites. These findings suggest that an increased collagen deposition (type 1) may be a contributing factor to cardiac enlargement in the TSK mouse. PMID- 3625788 TI - Time course of response of individual messenger RNAs in the rat heart to T3. AB - The time course of response of specific mRNAs following administration of triiodothyronine (T3) to hypothyroid rats was examined. We were particularly interested in identifying mRNAs showing a rapid response. Hypothyroid rats were injected with 0.2 mg of T3/100 g body wt and total cardiac RNA was prepared 0.5, 1, 2, 3, 5, 12 and 24 h later. RNA was translated in vitro in the presence of [35S]-methionine, the labeled peptides separated by two-dimensional electrophoresis and quantitated by digital matrix photometry. Of a total of 427 translational products 13 were identified to be selectively responsive to thyroid hormone. A specific mRNA coding for a protein designated as spot 72b (Mr 81,600, pI 5.34) was observed to show the most rapid response to T3. Administration of T3 to the hypothyroid animal resulted in an increase in the level of spot 72b by 2.6 fold within 1 h. The lag time between injection of T3 and response of other specific mRNA species varied between 5 to 24 h. These results demonstrate the diversity of response of individual cardiac mRNAs. The specific T3 responsive mRNA species described in the heart have not been demonstrated in other tissues indicating that induction of distinctive mRNA species is highly tissue specific. Relatively late responses may represent indirect effects of T3 mediated by interaction with other hormonal or metabolic signals. The rapid induction of spot 72b suggests it may result from the interaction of T3 with the nuclear receptor leading to a direct effect on the expression of this gene in the heart.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625789 TI - Protective effects of amiodarone pretreatment on mitochondrial function and high energy phosphates in ischaemic rat heart. AB - The effects of the antianginal and antiarrhythmic drug amiodarone on mitochondrial function and high-energy phosphate content were assessed during normothermic ischaemic cardiac arrest and reperfusion in Langendorff-perfused rat heart. Total ischaemia for 30 min at 37 degrees C produced highly significant changes in mitochondrial oxidative phosphorylation and high-energy phosphate content. Pretreatment of the rats with one single dose of amiodarone (20 mg/kg i.v., 30 min before killing) markedly attenuated the deleterious effect of ischaemia on mitochondrial function and slightly reduced ATP depletion. In normally perfused hearts, amiodarone pretreatment did not modify any parameter of mitochondrial respiratory function nor did it influence high-energy phosphate or glycogen content. After reperfusion for 15 min, amiodarone-treated hearts showed improved recovery of mitochondrial oxidative phosphorylation and tissue high energy phosphate content as compared to control hearts. Pretreatment of hearts with amiodarone did not reduce ischaemia-induced leakage of total adenylic nucleotides but highly significantly reduced lactate dehydrogenase release during reperfusion. These results indicate that amiodarone could exert substantial protection on the infarcting myocardium. PMID- 3625790 TI - The effect of ouabain on hearts of cardiomyopathic hamsters: potentiation by isoproterenol. AB - The isometric twitch properties of papillary muscles from hearts of 30- to 53-day old cardiomyopathic hamsters (BIO 14.6) were studied before and after exposure to the cardiac glycoside, ouabain. The diseased tissue was weakly responsive to ouabain (3 to 100 microM), as compared to a more appreciable positive inotropic response in papillary muscle of similarly aged normal hamsters (BIO F1B). These data suggest that the activity of Na+,K+-ATPase is attenuated in the diseased sarcolemma. Pretreatment with the beta-adrenoceptor agonist, isoproterenol (0.1 microM), slightly increased the sensitivity of normal muscle to ouabain, however the response of myopathic muscle was greatly enhanced. These findings may be of significance to the genesis of cellular calcium overload hypothesized to be involved in the necrosis and degeneration of heart cells in this animal model of genetic cardiomyopathy. PMID- 3625791 TI - A giant step to save American medicine. PMID- 3625792 TI - Cancer profiles from several high-risk Chicago communities. AB - A descriptive epidemiologic study of Chicago's cancer rates during the present decade reveals that the worst cancer mortality rates occur among Chicago's black population.Blacks represent a large percentage of Chicago's total population and a disproportionately high segment of the low socioeconomic group. The excess black cancer mortality rates are directly linked to the multiple problems of the socioeconomically disadvantaged, who are unable to purchase or gain access to state-of-the-art medical services. This same trend is being observed nationally; however, only a few studies have been documented.The Chicago Department of Health recognized the magnitude of this problem in 1980 and initiated this ongoing study of cancer deaths in the city in an attempt to improve these rates in this decade. PMID- 3625793 TI - Competent for what? AB - As the United States population ages, psychiatrists will have increasing requests for consultations to address legal issues involving older persons. Following an overview of competency as a distinct legal issue, specific legal issues are addressed that include hospitalization, consent or refusal of treatment, living will legislation, and guardianship and conservatorship. Relevant cases are cited. PMID- 3625794 TI - Management of vascular trauma. AB - Despite a nationwide 55 mph speed limit, and amid rising interpersonal violence, vascular injuries exact a great toll in morbidity and mortality. The identification, anatomic diagnosis, and repair of civilian traumatic vascular injuries still present a challenge.The concepts and precepts concerning vascular injury learned during World War II were responsible for the improved rates of limb salvage in the Vietnam War and remain pertinent in present-day civilian practice.The key factors concerning clinical evaluation, laboratory diagnosis, and definitive surgical therapy for major vascular injuries are outlined and elucidated. PMID- 3625795 TI - The effect of a summer MCAT performance improvement program on minority medical student acceptance. AB - The effect of a commercial Medical College Admission Test (MCAT) review course on MCAT retake scores and acceptance into medical school for a group of minority students is reported. The review course enhanced MCAT performance in all of the subgroups. The increase in total MCAT score was more pronounced in students with an initial MCAT score below 36 or a high undergraduate total or science grade point average. Results suggest a relationship between MCAT performance and medical school admission. PMID- 3625796 TI - Depression in patients with dementia of Alzheimer type. AB - Depression in dementia of Alzheimer type (DAT) has classically been considered to diminish as the disorder progresses. Using the Zung Self-Rating Depression Scale and the Mini-Mental State Examination to gauge the severity of depression and dementia, respectively, the authors found that the magnitude of depression did not differ as a function of disease severity in patients with DAT. The use of appropriate antidepressant therapy is therefore encouraged at any stage of disease in these patients. PMID- 3625797 TI - Black medical students' perceptions of the academic environment and of faculty and peer interactions. AB - After 10 years of admitting greater numbers of black medical students to North Carolina medical schools, the current study examined perceptions of four classes of black students attending these medical schools. One objective of this study was to gain a sense of how black students perceived the medical school environment. Another objective was to determine those students' levels of negative reactions generated by interactions with faculty and peers. Some of the major findings indicated that black students generally had negative perceptions of the medical school environments, and much of their reported negativism was associated with perceptions of student and white faculty interactions. PMID- 3625798 TI - Tests of small airway function in black smokers and nonsmokers. AB - Tests of small airway function (closing volume, forced expiratory flow in the middle half of the vital capacity, specific airway conductance, and peak expiratory flow) and routine spirometric tests (forced vital capacity, forced expiratory volume in one second, and residual volume) were performed in 848 adult black subjects of both sexes. The group included 422 smokers and 426 nonsmokers. No significant difference was found between smokers and nonsmokers for any of the tests, although some values were higher for men than for women. These findings suggest that reported abnormalities in small airway function in smokers in the general population may not be applicable to black smokers. This may be an important finding in ethnic variability in the incidence of chronic obstructive pulmonary disease. PMID- 3625799 TI - Computed tomography of strangulated gastric hernia complicated by perforation and pneumothorax. AB - A case of traumatic rupture of the diaphragm with partial gastric herniation is reported. The initial radiographic presentation was left lower lobe pneumonia. Subsequent strangulation and perforation of the stomach caused pneumothorax. Serial chest radiographs, computed tomography of the chest and abdomen with oral contrast, and a high index of suspicion were instrumental to the diagnosis. Pneumothorax, though rare, must be recognized as a morbid, obstructive phase complication of traumatic diaphragmatic hernia requiring immediate surgical intervention. PMID- 3625800 TI - Adynamic ileus associated with invasion of the myenteric nerve plexus by a peritoneal mesothelioma. AB - Adynamic ileus due to invasion of the myenteric plexus of the small and large intestine was a significant symptom in a patient with a peritoneal mesothelioma. A record of this unusual complication was not found in the medical literature surveyed. PMID- 3625801 TI - The myelodysplastic syndromes. AB - The myelodysplastic syndromes are a heterogenous group of disorders characterized by abnormalities in the maturation and differentiation of hematopoietic cells. A single diagnostic test is not available but laboratory and clinical features are often characteristic. The French-American-British Co-operative Group has classified these disorders into five subgroups. Despite distinctive morphologic features, this classification identifies only two major prognostic groups. The natural history is variable with some patients rapidly developing acute leukemia, others experiencing complications of pancytopenia in the absence of acute leukemia, while others have minimal symptoms and prolonged survivals. A number of therapeutic modalities have been used including hematinics, steroids, retinoids, low-dose chemotherapy, aggressive chemotherapy, and bone marrow transplantation. Supportive care is the mainstay of treatment for most patients. PMID- 3625802 TI - Maturation of a large neurofilament protein (NF 150K) in rat postnatal development. AB - The mammalian neurofilament is made of three neuron-specific proteins with approximate molecular weights of 70 kilodaltons (kDa) (NF 70K), 150 kDa (NF 150K), and 200 kDa (NF 200K) by SDS-PAGE. As previously reported in the rat by Strocchi et al (J Neurochem 39:1132-1141, 1982) and Nixon et al (J Cell Biol 94:150-58, 1982), NF 150K comprises three molecular weight variants with the same isoelectric point. A fourth lower molecular weight and slightly less acidic variant was identified by monoclonal and polyclonal antibodies reacting with the alpha-helical middle domain of NF 150K. With few exceptions, this lower molecular weight variant did not stain with monoclonal antibodies reacting with the peripheral carboxy-terminal domain. Staining with these antibodies was abolished or markedly reduced following neurofilament dephosphorylation. The distribution of the NF 150K variants varied in different regions of the nervous system. The higher molecular weight variant (component a) was less prominent in brain compared to spinal cord, optic nerve, and sciatic nerve. Furthermore, the lower molecular weight variant (component d) was not identified in optic nerve and sciatic nerve. All four variants were identified in brain and spinal cord extracts of newborn rats with monoclonal and polyclonal antibodies reacting with the alpha-helical middle domain of NF 150K. As a general (see Results for exceptions) monoclonal antibodies reacting with the carboxy-terminal region of NF 150K did not stain the variants in newborn rat brain extracts until day 10 when immunoreactivity of component a first appeared. The adult pattern was first observed on postnatal day 15.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625803 TI - The influence of muscle-conditioned media on chick embryo brainstem neurons in culture. AB - Brainstem pieces from the trigeminal region of the metencephalic basal plate of 10-day chick embryos were dissociated and cultured in control conditions or in the presence of muscle-conditioned medium (MCM). The MCM was derived from age matched target tissue relevant to this neuronal region (jaw musculature), from relevant target tissue of an age at which innervation would initially be taking place (4 days), and from nonrelevant target tissue also of an early stage (4-day limb bud). Neuronal survival and differentiation was assessed daily, for 7 days. Survival and differentiation were significantly enhanced by the 4-day jaw MCM compared to both the controls and the cultures grown with 10-day jaw MCM and 4 day limb MCM. These measures in the presence of 10-day jaw MCM and 4-day limb MCM did not differ, but surpassed that seen in control cultures. The results are compared to the more specific responsiveness seen in earlier (2-day) neural tube cultures, and their relationship to in vivo regenerative nerve fiber outgrowth is considered. PMID- 3625804 TI - Gangliosides fail to enhance behavioral recovery after bilateral ablation of the visual cortex. AB - Postsurgical injections of GM1 gangliosides (30 mg/kg IP) reduced neither behavioral deficits in rats following bilateral ablation of the visual cortex nor the extent of retrograde degeneration of neurons in the dorsolateral geniculate nucleus that typically accompanies large lesions of the visual cortex. Our findings are in contrast to previous research, in which ganglioside treatments have been shown to enhance the rate of functional recovery after lesions in other parts of the central nervous system. The negative findings in the present experiment may be due to the disruption of normal circadian rhythms caused by occipital cortex injury. PMID- 3625805 TI - Experiential factors in the expression of hypermotility produced by intradentate colchicine: lack of effect of GM1 ganglioside on colchicine-induced loss of granule cells and mossy fibers. AB - Adult male Fischer-344 rats were given bilateral injections of 2.5 micrograms colchicine or artificial cerebrospinal fluid into caudal and rostral sites of the dentate gyrus of the hippocampus. One group of rats received 21 consecutive daily injections of 20 mg/kg GM1 gangliosides, i.p., beginning the day prior to surgery. Another group received saline. Colchicine-induced hypermotility was not seen in animals repeatedly handled 21 d after surgery, in spite of significant decreases in granule cell number and decreases in the volume of hippocampal mossy fibers. Pretreatment with GM1 had no effect on behavior and it did not protect against the hippocampal damage produced by colchicine. Rats given colchicine, but not handled for 21 d, showed significant hypermotility, which was associated with decreases in hippocampal granule cells. These data underscore the importance of handling in postlesion functional recovery. PMID- 3625806 TI - Neural pathways that mediate the effects of afferent stimuli on paraventricular nucleus multiunit activity in freely moving rats. AB - The direct involvement of the hypothalamic paraventricular nucleus (PVN) in the control of adrenocortical secretion is now generally accepted. In order to contribute to our understanding of the electrical activity of cells in this region during adrenocortical activation, we have recorded multiunit electrical activity (MUA) in response to acute neural stimuli in freely moving male rats and have examined the pathways involved. Photic, acoustic, olfactory, and sciatic nerve stimulation all increased PVN MUA by between 130% and 250%. These responses were selectively blocked, according to the stimulus modality tested, by radiofrequency lesions of central neural structures. Thus PVN responses to photic stimulation were blocked by lesions of the suprachiasmatic nuclei and reduced by mammillary peduncle lesions but were unaffected by lesions of the bed nuclei of the stria terminalis. Responses to acoustic stimulation were blocked by lesions of the mammillary peduncles but not by those placed in the suprachiasmatic nuclei, the septum, or the bed nuclei of the stria terminalis. Lesions of the septum blocked the response to sciatic nerve stimulation but did not affect the response to olfactory stimulation with amyl acetate fumes, which was blocked by lesions of the bed nuclei of the stria terminalis. The data confirm those obtained in endocrine studies concerning the neural pathways involved in the transmission of neural stimuli that produce adrenocortical activation. PMID- 3625807 TI - Spontaneous tumors in F344/DuCrj rats from 12 control groups of chronic and oncogenicity studies. AB - The types and incidences of spontaneous tumors in F344/DuCrj rats were examined in 960 males and 959 females served as the control groups of separate twelve 2 year chronic and oncogenicity studies carried out during a 1978-1983 period. The major tumors occurred at more than 5% incidence were leukemia (mononuclear cell), testicular interstitial cell tumor, preputial gland adenoma, pituitary anterior adenoma, thyroid C-cell adenoma, adrenal pheochromocytoma and subcutis fibroma for males, and leukemia, uterine endometrial polyp, pituitary anterior adenoma, thyroid C-cell adenoma and mammary gland adenoma/fibroadenoma in females. Analyses on age-related occurrence of tumors revealed that the incidences of most of the major tumors in males attained already to the plateau between 85 and 97 weeks of age while those in females showed a steep rise during the last interval of observation, 98 to 110 weeks of age. An intralaboratory heterogeneity in incidence was observed in the thyroid C-cell adenoma and the adrenal pheochromocytoma for males, and the anterior pituitary adenoma for females. PMID- 3625809 TI - Influence of ptaquiloside on the development of newborn mice. AB - We attempted to induce neurological disorders in mice by a single administration of various doses of ptaquiloside (PT) within 24 h after birth. Animals which survived for a long period after treatment showed a reduction in body weight, but did not develop any gait disturbance. On the other hand, in treated animals which died before beginning to walk, karyorrhexis in the external granular layer of the cerebellum and karyorrhexis and rosette formation in the neuroblastic layer of the retina were present. In addition, treated animals showed karyorrhexis and great reduction in the number of the cells in the thymus, suggesting cytotoxic and cytolytic effects of alkylating agents on lymphocytes in this organ. PMID- 3625808 TI - Suppressing effect of croton oil on intestinal carcinogenesis induced by methylazoxymethanol acetate in rats. AB - The effect of croton oil on intestinal carcinogenesis by methylazoxymethanol acetate (MAM) was examined in ACI/N rats. Twenty seven male and 28 female ACI/N rats were given a single intragastric intubation of MAM at a dose of 25 mg/kg body weight, followed by croton oil at 0.25 ml/kg body weight, 3 times a week, by gastric intubation until the termination of this experiment (365 days). The animals had diarrhea with administration of the croton oil, but the diarrhea had no effect on their gain in weight. Rats from all groups surviving more than 216 days were counted as effective animals. Seventeen out of 54 effective rats which were treated with MAM and croton oil developed intestinal tumors and the incidence of the intestinal tumors was significantly less than that of the group treated with MAM alone (30 out of 50 rats, P less than 0.01). The average number of tumors per rat in the experimental group which was treated with MAM and croton oil (0.6 +/- 1.1) was also smaller than that in the group which was treated with MAM alone (1.0 +/- 1.8), although the difference was not significant. These results suggest that croton oil may suppress some tumor growth at the proper dose in intestinal carcinogenesis which is initiated by MAM. PMID- 3625810 TI - [Physical dependence liability test of 4-(o-benzylphenoxy)-N-methylbutylamine hydrochloride (MCI-2016) in rats]. AB - An acute administration of MCI-2016 at the doses of 30, 100 and 300 mg/kg (p.o.), and 10, 20 and 30 mg/kg (i.p.) produced a slight CNS depression in rats, such as, sedation, ptosis, decrease in motor activity and systemic muscle relaxation. In a direct physical dependence test, rats were fed the MCI-2016-admixed food together with drinking water ad libitum for 24 hours daily for 51-71 days (mean MCI-2016 intake 29.9-210.7 mg/kg/day), on the gradedly increased dosage schedule with a dosage level of 0.25 and 0.5 mg/g food to 4 mg/g food. In a natural withdrawal following administration of MCI-2016, no significant withdrawal signs were observed in any group. In a naloxone-precipitation test the rats that were treated with MCI-2016-admixed food did not show any withdrawal signs. In a substitution test in either morphine or barbital dependent rats, no suppression of withdrawal signs or maintenance of dependence were observed by cross administration of MCI-2016. In conclusion, MCI-2016 was considered to have no physical dependence potential. PMID- 3625811 TI - Proceedings of a satellite symposium on toxicity testing of industrial compounds. July 26, 1986, Tokyo, Japan. PMID- 3625812 TI - Chemical safety evaluation in Japan. PMID- 3625813 TI - Safety evaluation under the Toxic Substances Control Act. PMID- 3625814 TI - Safety evaluation of industrial chemicals in the context of the European region of WHO. PMID- 3625815 TI - Testing of chemicals, safety evaluation and regulation at European Community level. AB - Regulations regarding safety of chemicals are covered by the following main programmes: health and safety at work, internal market and technical harmonization, environmental and consumer protection. The elaboration of draft Community legislation by the Commission for transmission to Council and the European Parliament requires an evaluation of the scientific data together with a determination of the technical possibilities and economic impact. Studies, scientific committees, national experts and tripartite advisory committees are used. For new chemicals premarketing testing is required for labelling. The testing scheme is described. From the legislative point of view chemical safety is considered essentially in terms of six broad categories: air and water pollution and handling of toxic wastes, classification and labelling of dangerous chemicals and preparations, limitations of use of dangerous substances and preparations, occupational health and safety measures, prevention of major industrial chemical accidents, public health measures related to dangerous chemicals. The classification and labelling of carcinogens and the regulation of the various facets of the use of lead will illustrate these regulatory procedures. PMID- 3625816 TI - Safety assessment in the research and development of new chemicals. AB - A variety of testings to be incorporated in the research and development program of new chemicals to assess their fates and effects onto man and his environment should be so designed as to duly furnish reliable preliminary information. A rapid in vivo assay for animal carcinogenicity and a model ecosystem for bioaccumulation in aquatic organisms are discussed as examples of these brief testings, while further research needs are mentioned to ultimately assess the impacts of chemicals to the whole environment. PMID- 3625817 TI - Safety assessment and measures in research and development of substances used for photographic materials. PMID- 3625818 TI - Research strategy in industrial toxicology. AB - While much of industrial toxicology is observational in character, pursuit of specific research is needed to facilitate the overall evaluation of potential toxicity for man. Two such areas are the application of physiologic pharmacokinetic models to inter-species extrapolation of toxic effects and an understanding of the role of cellular oncogenes in the process of spontaneous tumor formation in animals. A physiologic pharmacokinetic model was developed for methylene chloride (MeCl2) which describes the fate of MeCl2 and its metabolic products in numerous species including the mouse, rat, hamster and man. This model has been used to predict specific tissue concentrations of critical metabolic reaction products in target tissues between animals and man. If it is assumed that toxicity is related to target tissue concentrations such methodology provides a means of relating interspecies toxicity to absorbed dose. This methodology precludes the necessity of using arbitrary factors in relating animal toxicity data to man. A particular controversial issue in animal toxicology is the significance of the enhancement of animal tumors in tissues which already have a high spontaneous incidence. Without a better understanding of the basic process of spontaneous tumor formation it remains difficult to interpret results from chemical treatment. In particular spontaneous liver tumors in the B6C3F1 mouse have been shown to contain an activated cellular oncogene identified as H RAS. The activated cellular oncogene is present in tumor tissue only and not in surrounding normal liver tissue. Of particular significance is the high frequency of activation in these mouse liver tumors (82%) compared to a 10-20% incidence of oncogenes present in a variety of human tumors. This suggests the ultra sensitivity of this mouse strain to liver tumor induction. Additional studies in progress are designed to determine whether genotoxic and nongenotoxic hepatocarcinogens show differences in oncogene activation. PMID- 3625819 TI - Meeting new challenges in industrial toxicology. AB - A major challenge facing toxicologists is the development of improved human risk assessment methods based on understanding the mechanisms of chemical carcinogenesis in animal and human cells. Such methods will enable us to close the gap between experimental toxicity data and their relevance to human health. We have used 1,3-butadiene (BD), a potent mouse carcinogen but weak oncogen in the rat, as a model compound to determine if genetic toxicity results from animal and human cells can aid in extrapolating animal toxicity data to man. Sister chromatid exchange and micronucleus induction data for BD parallel the chemical's carcinogenicity in the mouse and rat. Effort is underway to determine BD's genotoxic effects in human cells in vitro and to compare these effects in corresponding cultured rodent cells. This approach will help identify which species is a better predictor of the human response. If the BD research proves useful in assessing its hazard to man, similar methods can be extended to other major chemicals. PMID- 3625820 TI - A balanced approach to the detection, characterisation and mechanism of the toxicity of industrial chemicals. AB - Several thousands of new chemical entities are synthesised each year in the laboratories of the world. Currently there are estimated to be some 100,000 substances used commercially of the 7 million chemicals recorded by chemical abstracts (Ca 1.5%). Public attention is mainly attracted to the potential life threatening and ill health effects of chemicals such as systemic poisoning, carcinogenicity, teratogenicity and mutagenicity, although there are relatively few proven human chemical carcinogens, teratogens or mutagens. Many substances have been examined in animal toxicity studies for their acute toxic effects, far fewer for chronic toxic effects. The public's perception is that chemicals are toxic. In our laboratory, minimal to no lethal toxic effects were recorded for more than 60% of substances examined at doses below 2000 mg/kg/bwt by either oral or dermal routes. A similar spectrum of chemicals did not elicit skin or ocular irritant or skin sensitisation response in 70-80% of studies. Perversely although toxicity studies reasonably predict the probable human response following exposure, they are a focus of a strong public lobby supported by many scientists to curtail studies in experimental animals. Consequently, much effort is devoted towards the development of "alternative" in vitro and ex-vivo procedures. Often these are empirically based without consideration of the underlying fundamental physiology, biochemistry or toxic mechanism of action. Consequently there can be an over-estimation or expectation of their ability to predict potential toxicity. Attention is seldom directed towards the design requirements of the validation studies needed to test, performance and reproducibility and the evaluation of the parameters of sensitivity and specificity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625821 TI - Concept for the sequential testing of industrial chemicals. PMID- 3625822 TI - Need for chemicals safety information. PMID- 3625823 TI - The development of safety control of industrial chemicals in occupational health of China. PMID- 3625824 TI - Toxicity testing of industrial chemicals--the Indian experience. PMID- 3625825 TI - Need for chemicals safety information. PMID- 3625826 TI - Need for chemicals safety information in Thailand. PMID- 3625827 TI - Induction of mutagenic activity of tetracycline by synergistic action with nitrite. AB - Synergistic mutagenicity of tetracycline(TC) and nitrite was investigated by the bacterial mutation test in the Salmonella/microsome system by using the reaction products obtained under neutral condition as well as under acidic condition (in simulated gastric juice). Results from tests using Salmonella typhimurium TA 100 disclosed a significant increase in the appearance of histidine (+) (his+) revertants by the reaction product between TC and nitrite in the presence of the rat liver-microsomal enzyme system (S9 mix), while the mutagenic potency of the reaction product of the two compounds in simulated gastric juice was extremely weak. In the process of the reaction of TC with and without nitrite in the presence of S9 mix, formaldehyde was detected, indicating the demethylation of TC by demethylase in S9. To explain the induction mechanism of the synergistic mutagenicity of TC and nitrite, it was suggested that the alkylating reaction of nitroso compound formed by nitrosation of the 4-demethylated intermediate of TC by the aid of microsomal metabolism is more important than the well known nitrosation mechanism under acidic condition such as in gastric juice in rats and in simulated gastric juice. PMID- 3625828 TI - The metabolism of trichloroethylene and its metabolites in the perfused liver. AB - The metabolism of trichloroethylene (TRI) and its metabolites, chloral hydrate (CH), trichloroethanol (free-TCE) and trichloroacetic acid (TCA), were examined in the isolated perfused rat liver, to clarify the role of the liver in the metabolism of TRI. TRI was rapidly converted to TCE and TCA by the perfused liver. TCA was produced from TRI about 2.5 times greater than was total-TCE. CH was metabolized to TCE and TCA immediately. TCA was also a dominant metabolite of CH over total-TCE. TCE(free type) was speedily conjugated by the liver. A portion of TCE was converted to TCA. Less than 10% of these metabolites produced by the liver were excreted into the bile. Most of them appeared in the perfusate. PMID- 3625829 TI - The epistemology of "addictive disease": the Lincoln-Douglas debate. AB - This research was conducted to examine the social perception of "addictive disease." This study provided an opportunity to gain insight into a representative sample of terms and phrases that were denotative of disease and then factor analyzed how these items clustered to reveal a spectrum of underlying factors that contribute to the perception of disease. It was expected and confirmed that subjects could discriminate between behavioral and biological disorders. In addition, the results support the view that the addictive "disease" model is a symbolic substitute for the moral turpitude model which it replaced. Finally, the findings support the view that non-physicians are capable of making fine distinctions among a number of biologically related "diseases." These results suggest that it may be important for health care providers to carefully and instrumentally apply their language to facilitate patient compliance with treatment protocols. PMID- 3625830 TI - Controversies regarding urine testing. AB - Urine drug testing has become an increasingly controversial issue in today's society. In this paper, several issues involved in urine drug testing are discussed. These include the limitations of the accuracy of urine testing, testing in schools, athletics, the military and industry, and the legalities of drug testing. Also discussed is background information about urine drug screening and key factors in obtaining specimens for testing. Conclusions about the role of urine drug testing in the battle against substance abuse are drawn. PMID- 3625831 TI - New Roads: assessing and treating psychological dependence. AB - The "New Roads" approach provides a practical tool for explaining and assessing dimensions of psychological dependence. It connects common triggers for relapse and the effects that the client intends to achieve through substance use. Among its clinical applications are (a) preventive education, (b) assessing high risk situations, (c) tracing pathways of psychological dependence, and (d) devising alternative coping strategies. This simple technique is compatible with a wide range of treatment settings, goals, and approaches. PMID- 3625832 TI - Diagnostic practices of evaluators of drunken drivers. AB - This study was designed to evaluate the impact of driving under the influence (DUI) arrest history on the diagnostic decisions of DUI evaluators and the reported bases on which alcohol-related diagnostic decisions are made in DUI cases. Subjects were 70 (out of a potential 140) Illinois certified DUI evaluators who responded by mail to one of four case summaries containing different information about a "client's" drinking history and arrest history. Results indicated a significant difference in the frequency with which these DUI evaluators noted whether the "client" had an alcohol problem, with zero, one and two DUI arrests yielding approximately 30%, 15%, and 50% alcohol diagnoses in the absence of DSM-III criteria supporting such a diagnosis. Collaborative reports by significant others and alcohol-related tests (e.g., Michigan Alcoholism Screening Test) were the two most frequently reported bases. The costs of such diagnostic unreliability and the disadvantages of collaborative reports and screening tests are discussed. PMID- 3625833 TI - A blood marker for pharmacodynamic tolerance to alcohol. AB - The treatment of alcoholism may be delayed because of the difficulty in confirming a diagnosis. There are currently no direct blood tests to objectively determine the presence of pharmacodynamic tolerance to alcohol. The state of the membrane fluidity of the peripheral blood erythrocyte may provide a biophysical measurement of the pharmacodynamic tolerance to alcohol. This discussion proposes methods that potentially may be applied to the clinical purpose of diagnosing alcoholism in humans. The methods have been used to successfully measure pharmacodynamic tolerance in animals and humans. The development of the physiologic state of acquired tolerance and dependence is related to alcohol intake. Chronic alcohol consumption that leads to pharmacodynamic tolerance may be assessed by measuring the membrane fluidity of the peripheral blood erythrocyte. Physiologic recovery from tolerance and dependence to alcohol may also be assessed during withdrawal in which the reversal of changes in membrane fluidity is measured in the abstinent state. Relapse to drinking may be detected in the state of the membrane fluidity of the peripheral blood erythrocytes that reflect the return of tolerance and dependence. Tolerance to alcohol may be a manifestation of the inheritability to alcoholism. Alcoholics and high risk individuals appear to have an increased, innate (genetic) tolerance to alcohol. High risk individuals are nonalcoholic, blood relatives of alcoholics. Animal studies suggest that innate (genetic) tolerance and dependence to alcohol may be related to the biophysical state of erythrocyte membrane fluidity. The assessment of these changes in membrane fluidity of the erythrocyte may be performed in the peripheral blood in humans. A trait marker (in the genetically predisposed) for high risk individuals and a state (in the actively drinking) marker for pharmacodynamic tolerance in the erythrocyte might be developed. In this way, a blood test may be used to detect the inheritability for alcoholism and the development of pharmacodynamic tolerance to alcohol. No blood test for pharmacodynamic tolerance is currently available. This article represents an extrapolation from animal and human research data. The proposals contained therein may not be considered readily, clinically applicable. PMID- 3625834 TI - Medical needs of Africa. Proceedings of a conference. London, 27th September 1986. PMID- 3625835 TI - What help can the U.K. give? PMID- 3625836 TI - The resource requirements for basic health care in developing countries, with special reference to Africa. PMID- 3625837 TI - Resource transfer from defence to health care: problems and possibilities. PMID- 3625838 TI - Medical needs of African children--can they be met by the year 2000? PMID- 3625839 TI - Intrauterine pregnancy following conservative treatment of cervical pregnancy. PMID- 3625840 TI - Expression of the hepatitis B virus core gene in vitro and in vivo. AB - The core gene of hepatitis B virus contains two in-phase AUG codons which may both be used in the viral life cycle. By in vitro translation of transcripts produced in vitro, we investigated the corresponding core gene products and their counterparts in vivo. Depending on the location of the 5' end of the transcripts, two major core gene-derived proteins were obtained. In transcripts with both in phase AUGs, only the first one was efficiently used and resulted in synthesis of a 25-kilodalton protein (precore). This protein contains a leader sequence and could be cotranslationally processed to a protein of 22.3 kilodaltons. Translation of transcripts lacking the first AUG of the core gene produced a core protein of 21.5 kilodaltons which comigrated with the core antigen expressed in infected livers. These data suggest that the major nucleocapsid protein expressed in vivo is initiated at the second ATG of the C gene and that a precore protein is probably synthesized as a precursor protein which is cotranslationally processed. Proteins consistent in size with processed and unprocessed precore proteins detected in woodchuck hepatitis virus-infected livers support this conclusion. PMID- 3625841 TI - Immune sera and antiglycoprotein monoclonal antibodies inhibit in vitro cell-to cell spread of pathogenic rabies viruses. AB - Although the cell-to-cell spread of many viruses in vitro is inhibited by antibody, the effect of antibody on such spread of rabies viruses is uncertain. Thus, we examined the effects of anti-rabies virus immune sera and monoclonal antibodies (MAbs) on the in vitro spread of pathogenic rabies viruses in neuronal and nonneuronal cells. Both anti-rabies virus immune sera and neutralizing antiglycoprotein MAbs inhibited the cell-to-cell spread of street rabies virus, challenge virus standard, and ERA rabies viruses in cultures of neuroblastoma cells and of nonneuronal BHK-21 and chicken embryo-related cells. Furthermore, the cell-to-cell spread of virus was inhibited by greater than or equal to 75% with less than 1 IU/ml of human antirabies immunoglobulin. Nonneutralizing antinucleocapsid MAbs did not inhibit viral spread. After the immune serum was removed from the monolayers, virus spread rapidly to uninfected cells. Thus, antibody controlled the cell-to-cell spread of the virus but did not eliminate it from the cultures. Because antibody was more effective in inhibiting viral spread in fibroblast and epithelioid cells than in neuroblastoma cells infected at a high multiplicity of infection, we suggest that the inhibition of viral cell-to cell spread by antibody in vivo would more likely occur at an initial site of exposure and before nerves are infected. PMID- 3625843 TI - Trends in urological manpower in the United States in 1986. AB - Estimated urological manpower needs for the United States are reviewed and correlated with the nationwide urological work load. In addition, a limited attempt is made to assess the ideal urological work load. On the basis of this study a decrease in the production of urologists appears to be less necessary than has been proposed to date. If the present trend of increasing the length of urology residency training to 2 pre-urology years plus 4 years of urology continues, and if the influx of foreign trained graduates continues to decrease the problem of overproduction of urological specialists may be solved, since these 2 measures by themselves would reduce the annual certification in the United States to about 280 diplomates, which is 20 less than the estimated annual attrition of 300 practicing urologists. The 8,236 urologists in the United States counted by the American Medical Association in 1983 performed an average of 204 hospital procedures each, including 43 transurethral prostatic resections. The average load per urologist seems to be adequate to maintain diagnostic, therapeutic and surgical skills. PMID- 3625842 TI - Isolation and characterization of adenovirus core nucleoprotein subunits. AB - Digestion of adenovirus type 2 (Ad2) or Ad5 cores with micrococcal nuclease generated four nucleoprotein species that could be resolved by electrophoresis in low-ionic-strength polyacrylamide gels: these nucleoproteins displayed mobilities equivalent to those of DNA fragments of 900 to 1,025, 775 to 850, 650 to 725, and 525 to 600 base pairs (bp) and thus were readily distinguishable from HeLa cell mononucleosomes. The DNA fragments associated with the core nucleoprotein species were more than 250 to 90 bp long. Nucleoproteins containing 150, 120, or 90 bp of DNA were the most stable. Polypeptide VII was associated with each of the nucleoprotein species liberated from Ad2 cores. These data suggest that polypeptide VII and viral DNA of 90 to 150 bp comprise the unit particle of the Ad2 or Ad5 core nucleoproteins. PMID- 3625844 TI - Renal lesions in tuberous sclerosis. AB - The renal lesion classically associated with tuberous sclerosis is angiomyolipoma. Renal cysts are less frequent, occurring alone or in conjunction with angiomyolipomas. We reviewed the records of 274 patients with tuberous sclerosis registered at our clinic. Of 95 patients evaluated for renal lesions 51 (54 per cent) had positive findings: 45 had angiomyolipomas, 17 had renal cysts and 11 had both lesions. These lesions usually are multiple and bilateral, and are diagnosed most effectively with computerized tomography or ultrasound. Surgery (10 kidneys) was done for life-threatening hemorrhage or suspected malignant lesions. PMID- 3625845 TI - Comparison of results and morbidity of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. AB - Two new therapies, percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy, are revolutionizing the treatment of upper urinary tract calculi. We report the success and morbidity rates in 110 patients undergoing percutaneous nephrostolithotomy and 982 patients treated with extracorporeal shock wave lithotripsy. Staghorn calculi were excluded from this series. The over-all success rate (free of stones plus small asymptomatic residual fragments) was comparable with both modalities (percutaneous nephrostolithotomy 98 per cent and extracorporeal shock wave lithotripsy 95 per cent), although the presence of residual fragments was more common in kidneys treated with extracorporeal shock wave lithotripsy (24 versus 7 per cent). Patient morbidity as measured by temperature elevation, length of postoperative stay, pain and blood loss was significantly less (p less than 0.05) with extracorporeal shock wave lithotripsy than with percutaneous nephrostolithotomy. Re-treatment rates were similar with both procedures, and tended to increase in relation to increasing stone size and stone number. Post-treatment ancillary procedures (cystoscopy and stone manipulation, and percutaneous nephrostomy) were used more frequently with extracorporeal shock wave lithotripsy. Because of its efficacy and low morbidity, we conclude that extracorporeal shock wave lithotripsy is the treatment of choice for upper urinary tract calculi less than 2 cm. in diameter. However, percutaneous nephrostolithotomy will continue to have a primary role in the management of larger stones and cystine stones, and it will be used as a secondary procedure after unsuccessful extracorporeal shock wave lithotripsy treatments. In addition, because of the complimentary nature of these 2 new technologies certain complex stones, such as staghorn calculi, may be handled best by a combination of the 2 techniques. PMID- 3625846 TI - Bladder irrigation with chlorhexidine for the prevention of urinary infection after transurethral operations: a prospective controlled study. AB - The value of postoperative bladder irrigation with the antiseptic agent chlorhexidine was assessed in a randomized prospective controlled study of men after transurethral operations. In patients with sterile preoperative urine the incidence of postoperative bacteriuria was 12.8 per cent, compared to 36.7 per cent in control patients. The difference is significant (chi-square 5.54, p less than 0.02). On the other hand, chlorhexidine irrigation did not eliminate pre existing infection. Small amounts of chlorhexidine were demonstrated in the blood of some patients. There was no evidence of damage to the bladder and no toxic side effects. PMID- 3625847 TI - Bladder replacement after cystoprostatectomy: efforts to achieve total continence. AB - Total bladder replacement with tubular sigmoid colon and detubularized ileocecal bowel segments was performed on 17 patients after cystoprostatectomy for bladder cancer. There were few complications and patient acceptance was excellent. Daytime continence was achieved in most patients but voiding patterns were superior with detubularized segments. However, enuresis was common with both segment types. Total urinary continence (day and nighttime continence) was achieved in 7 patients with an artificial urinary sphincter that was activated only at night. Total bladder replacement is an acceptable form of urinary diversion after cystoprostatectomy in appropriate patients. PMID- 3625848 TI - Painful bladder disease: clinical and pathoanatomical differences in 115 patients. AB - The diagnostic criteria for interstitial cystitis considered as a subgroup of painful bladder disease (that is sensory bladder disease and chronic abacterial cystitis) are not well established. Some urologists rely on symptoms, while others rely on cystoscopic appearance or pathological findings. Among 115 patients with painful bladder disease we compared symptoms, and cystoscopic and urodynamic findings in those with and without detrusor mastocytosis (28 or more mast cells per mm.2) and attempted to elucidate possible differences between the groups. We chose the pathological anatomical criterion of detrusor mastocytosis to be diagnostic for interstitial cystitis. A total of 43 patients had detrusor mastocytosis and other pathological anatomical signs of interstitial cystitis, and 72 had no mastocytosis but the pathological diagnoses of chronic unspecific cystitis, fibrosis of the bladder, detrusor myopathy, intestinal metaplasia and normal findings. When the 2 groups of patients were compared we found no differences in regard to symptoms (pain, dysuria, frequency, nocturia and urgency), frequency of allergy and hysterectomy, duration of symptoms, petechial bleeding during cystoscopy with bladder distension and cystometric findings. The patients with mastocytosis differed from those without mastocytosis in that they were older, and had a higher frequency of hematuria, a higher frequency of a red, scarred and richly vascularized bladder at cystoscopy before distension, and a smaller cystoscopic bladder capacity. We conclude that by dividing patients with painful bladder into 2 groups according to the mast cell counts in the detrusor, certain differences in the clinical findings in the groups can be ruled out. However, in individual patients one cannot note with certainty to which pathological anatomical group the patient belongs, since great overlapping between the groups exists. Whether only patients with detrusor mastocytosis have interstitial cystitis depends on definitions and still remains an open question. PMID- 3625849 TI - Female urethral obstruction after Marshall-Marchetti-Krantz operation. AB - During the last 5 years 13 neurologically normal women were seen with urodynamically proved urethral obstruction after a Marshall-Marchetti-Krantz operation. These obstructed patients were treated by a simple transvaginal procedure consisting of complete urethrolysis followed by a needle urethrovesical resuspension procedure. Postoperatively, 12 patients experienced complete disappearance of the presenting symptoms, return to a normal voiding pattern and decreased residuals of urine to less than 50 cc. The remaining patient, although urodynamically unobstructed, had to remain on intermittent catheterization. The pathophysiology, diagnosis and treatment of this iatrogenic type of female urethral obstruction are discussed. PMID- 3625850 TI - The surgical management of total urinary incontinence in the female patient. AB - A total of 14 female patients with complete urinary incontinence underwent urethral reconstruction by a variety of techniques. Included were 2 patients with acquired urethral defects, 5 with congenitally short urethras, 2 with epispadias, 3 with remnant ureteroceles and 2 with cloacal anomalies. Complete continence was restored in 10 patients, 3 were improved markedly and there was 1 failure owing to obstruction with overflow incontinence. In several patients full control was acquired slowly and was hastened by bladder retraining. Urodynamic studies proved to be extremely valuable for the postoperative as well as preoperative assessment of these patients. PMID- 3625851 TI - Experience with pubovaginal slings for urinary incontinence at the University of Michigan. AB - In July 1983 pubovaginal slings were used first at our university to treat incontinence in female patients with poor urethral function. From then until July 1, 1986, 82 such procedures were performed on a diverse group of patients, including a male patient. Initial success occurred postoperatively in 67 patients, with 15 failures. Of these failures 7 were related to urethral dysfunction. Another sling procedure was done in 2 patients and they are continent, while 3 were treated with medication: 2 became dry and 1 remains wet. A total of 8 patients suffered detrusor-related incontinence postoperatively (2 required augmentation cystoplasty for poor bladder compliance). To date 78 patients (95 per cent) are continent. Of the patients 2 required periodic intermittent catheterization for more than a year postoperatively and 12 are managed by chronic intermittent self-catheterization on a planned basis for neurogenic vesical dysfunction. PMID- 3625852 TI - Pubovaginal sling procedure for the management of urinary incontinence after urethral trauma in women. AB - Traumatic urethral injury in women occurs less frequently than in men and urinary incontinence is a serious potential complication in women. Two female patients are described in whom post-traumatic urinary incontinence resulted from either direct trauma to the urethra or from injury to the innervation of the urethra. Both patients were treated successfully with the pubovaginal sling procedure that directly compresses an incompetent proximal urethra. PMID- 3625853 TI - Incontinence after artificial urinary sphincter placement: the role of perfusion sphincterometry. AB - The systematic, objective evaluation of incontinence after artificial urinary sphincter placement is critically important in the direction of further therapy. The technique and application of perfusion sphincterometry in the evaluation of 9 men with various causes of incontinence after artificial sphincter implantation are described. The perfusion sphincterometry study, which does not require sophisticated urodynamic equipment, helped to define clearly the cause of the incontinence and, thus, facilitated appropriate therapy. PMID- 3625854 TI - Quantitation of corporeal venous outflow resistance in man by corporeal pressure flow evaluation. AB - We describe a technique that allows us to quantify intracorporeal penile venous resistance in papaverine-induced erections. By increasing intracorporeal pressure to greater than the mean arterial pressure by cavernous perfusion with Ringer's lactate solution we can control and measure cavernous flow and pressure, and, therefore, calculate venous resistance. We evaluated 78 impotent men and 6 controls with this method. The most important measure of the integrity of the venous resistance mechanism and of the ability to obtain an adequate erection was a post-distension steady state pressure of 50 mm. Hg or more and a venous outflow resistance of 20 mm. Hg minute per cc or more. Our method aids in the clinical evaluation of the etiology of erectile impotence. PMID- 3625855 TI - Prostate shape, external striated urethral sphincter and radical prostatectomy: the apical dissection. AB - In an anatomical study of 64 gross specimens the external striated urethral sphincter was reconfirmed to extend as a single unit from the proximal penile urethra to the bladder base. The configuration of the external striated urethral sphincter was variable and was related to the shape of the apical prostate. Two basic prostatic shapes were recognized, distinguished by the presence or absence of an anterior apical notch. Whether a notch existed depended upon the degree of lateral lobe development and the position of its anterior commissure. In radical prostatectomy knowledge of the variation in the shape of the prostatic apex can help the surgeon to achieve optimal urethral transection with maximal preservation of the external striated urethral sphincter and other tissues of the continence mechanism. PMID- 3625856 TI - The value of retrograde pyelography for fractionally visualized upper tracts on excretory urography in the evaluation of hematuria. AB - A 5-year retrospective study of 131 hematuria patients (23 with gross and 108 with microscopic hematuria) undergoing retrograde pyelography solely for fractional visualization of the upper tracts on excretory urography revealed no tumors or other significant pathological condition in the 187 renal units (56 bilateral cases) studied. A review of our cases of upper tract urothelial cancer since 1955 revealed 36 patients with complete records of the urological evaluations. None of the cases was diagnosed by retrograde pyelography for fractionally visualized excretory urography and 3 were within 9 months of a previously normal excretory urogram alone or with retrograde pyelography. We believe that retrograde pyelography done solely to evaluate a fractionally visualized upper tract may miss subtle lesions and it should not terminate the evaluation. We recommend that excretory urography, cystoscopy and voided urine cytology studies be performed initially and, if normal, they should be repeated in 6 and 12 months before upper tract urothelial tumors are ruled out. PMID- 3625857 TI - New generation shock wave lithotripsy. AB - Extracorporeal shock wave lithotripsy has been clinically successful for more than 5 years. Currently, several devices commonly termed second generation lithotriptors are under experimental or clinical trials. We present a prototype multifunctional urological table that uses a new mode of shock wave generation along with local coupling to the patient. The results of the first 400 treatments are presented after a brief description of pre-clinical experiments. The prototype has been in operation since March 1986. Particular attention is paid to adjuvant endourological measures, which all have been performed on the same table. PMID- 3625858 TI - Ureteral meatotomy by Sachse urethrotome in the management of lower ureteral stones. AB - From January 1981 to June 1985 inclusive 170 patients were hospitalized for transurethral ureteral stone manipulation. A meatotomy with the Sachse urethrotome was done in 46 of these patients because the stone was impacted in the intramural ureter or the basket containing the stone became impacted. This method resulted in successful endoscopic removal of the stones in 43 patients. PMID- 3625859 TI - Compliance studies, pressure flow measurements and renal function assessment in patients with upper urinary tract dilatation. AB - The compliance index was determined in 38 hydronephrotic kidneys undergoing diagnostic pressure flow studies. A good correlation was found between this index and the result of the pressure flow study but no consistent relationship was observed between the index and relative renal function as assessed by renographic means. The ability of the compliance index to predict functional deterioration in patients with hydronephrosis must be questioned. PMID- 3625860 TI - Post-prostatectomy incontinence: the influence of bladder dysfunction. AB - The urodynamic studies of 38 patients referred for evaluation of incontinence after prostatectomy were reviewed. Only 15 patients (39.5 per cent) had pure sphincteric insufficiency as the sole cause of the incontinence. Of the 38 patients 16 (42 per cent) had sphincteric insufficiency combined with a significant component of bladder dysfunction (detrusor instability and/or low bladder wall compliance) as the cause of the incontinence. A total of 7 patients (18.5 per cent) had no evidence of sphincteric insufficiency but they had post prostatectomy incontinence solely caused by detrusor instability and/or low bladder wall compliance. Of the patients referred for post-prostatectomy incontinence 60.5 per cent had bladder dysfunction as a major factor in the incontinence, which emphasizes the need for comprehensive urodynamic evaluation before treatment is recommended. Of 26 patients whose treatment was based on urodynamic findings and who were available for followup 23 (88 per cent) were adequately continent after treatment, with 35 per cent responding to pharmacological treatment alone and 54 per cent requiring placement of an artificial urinary sphincter with or without associated pharmacological therapy. The potential role of bladder dysfunction as a causative factor in post prostatectomy incontinence must be considered to optimize the results of treatment and to avoid an unnecessary operation. PMID- 3625861 TI - Intestinocystoplasty and total bladder replacement in children and young adults: followup in 129 cases. AB - A review of 129 consecutive young patients (average age 13.4 years) who underwent intestinocystoplasty or total bladder replacement during a 6 1/2-year period at our institution is presented. The most common diagnosis was myelodysplasia and the average followup was 44 months. The clinical and urodynamic aspects of 4 types of intestinocystoplasty (ileocecal, tubular sigmoid, sigmoid patch and ileal patch) are presented. All 4 operations resulted in a significant increase in bladder volume, with a decrease in filling pressure and, thus, improved vesical compliance. In combination with clean intermittent catheterization renal function was maintained or improved in 91 per cent and urinary continence was achieved in 82 per cent of the patients. Hyperchloremic acidosis requiring therapy was noted only in patients with pre-existing renal insufficiency, although mild hyperchloremia after cystoplasty was seen with all 4 types of cystoplasty. There were no operative mortalities. Significant surgical complications occurred in 36 per cent of the patients, the most common of which was vesicoureteral reflux in the ileocecal cystoplasty. Mass unit peristaltic contractions occurred in 34 per cent of the tubular-shaped bowel segments compared to only 10 per cent of the patch segments. These peristaltic contractions contributed to the greater postoperative morbidity noted in the tubular large bowel cystoplasties. The over-all success rate for intestinocystoplasty in this series was 84 per cent. Intestinocystoplasty is an effective procedure when used to increase the compliance of the lower urinary tract. In combination with clean intermittent catheterization it can be applied successfully to patients with neurogenic bladder dysfunction. Large and small bowel seem to have similar clinical and urodynamic properties. The type of intestinal segment used for intestinocystoplasty seems to be of less importance than the size and configuration. Large bowel in its native tubular configuration should be avoided. PMID- 3625862 TI - Incomplete epispadiac urethral duplication with dorsal penile curvature. AB - Incomplete urethral duplication, although not uncommon, usually is associated with insignificant chordee of the penis and it is clinically asymptomatic. We report a case of incomplete urethral duplication with marked dorsal curvature of the penis and other congenital anomalies. Excision of wedge-shaped ellipses of the tunica albuginea from the ventral aspect of the corpus provided an excellent result. PMID- 3625863 TI - Urological complications of sickle cell disease in a pediatric population. AB - We surveyed 321 patients 1 to 18 years old who were followed at the sickle cell clinic at the Children's Hospital of Philadelphia between 1970 and 1984 for urological complications of the disease. Mean followup was 5 years and all patients exhibited a typical spectrum of hemoglobin types. The urological problems encountered were those cited in the literature, namely hematuria, urinary tract infection and priapism. Surprisingly few of our patients experienced significant renal bleeding. Although the number of patients with infection evaluated radiographically was small, the frequency of renal parenchymal scarring was disturbingly high despite the reported rarity of reflux in black subjects. Our survey and a review of the literature indicate that most sicklemic children with urinary infection are not subjected to urological evaluation. We question the wisdom of that policy. Finally, we found that priapism responds most often to nonsurgical therapy and that it rarely results in impotence in young sickle cell patients. PMID- 3625864 TI - Ureteropelvic junction obstruction after percutaneous nephrolithotripsy. AB - Percutaneous nephrolithotripsy is reported to have few complications. However, we have treated 6 cases of complete ureteropelvic junction obstruction that occurred at a number of centers after percutaneous nephrolithotripsy. In 2 patients stones were impacted at the ureteropelvic junction, 3 had pre-existing stenosis and 1 had had no previous structural abnormality. All stones were less than 2 cm. in size and 5 were removed by ultrasonic disintegration. A nephrostogram after percutaneous nephrolithotripsy showed complete ureteropelvic junction obstruction in 4 cases and partial obstruction that progressed to total obstruction in 6 days in 1. In 1 case the nephrostogram was normal but occlusion was noted 2 weeks later. Initial management consisted of nephrostomy drainage for an average of 3.2 months. One patient was treated successfully with a ureteral stent for 6 weeks after balloon dilation, 1 had unsuccessful balloon dilation and 1 had undergone an unsuccessful endoscopic pyelolysis. Pyeloplasty was successful in 3 cases. In 1 patient 2 attempts at pyeloplasty failed and nephrectomy was performed. In the remaining patient ureterocalycostomy failed and interposition of a small segment of ileum was done. Pre-existing stenosis of the ureteropelvic junction or a stone impacted at the junction probably contributed to the obstruction and stenosis in 5 patients. The passage of ureteral guide wires should be avoided in these patients and impacted stones should be dislodged before endoscopic removal. Extracorporeal shock wave lithotripsy is an option in these cases if the stone can be dislodged or bypassed with a stent. Patients with pre-existing ureteropelvic junction obstruction might be treated best by open nephrolithotomy and pyeloplasty or by percutaneous nephrolithotripsy and endoscopic pyelolysis for ureteropelvic junction narrowing. PMID- 3625865 TI - Renal adenocarcinoma and end stage kidney disease. AB - The association of end stage kidney disease with cystic degeneration and renal adenocarcinoma was first recognized in 1977. Since then a number of reports have confirmed this relationship. Duration of dialysis has been the most strongly associated risk factor. We report 8 cases of end stage kidney disease and renal adenocarcinoma. Median duration of hemodialysis was approximately 1 year, and 3 patients never had hemodialysis. Factors other than duration of dialysis, such as toxic metabolites, toxins from dialysis tubing, polyamines or other carcinogens, may be as or more important. PMID- 3625866 TI - Management of locally recurrent renal cell carcinoma after partial nephrectomy. AB - While partial nephrectomy can provide effective treatment for selected patients with renal cell carcinoma, postoperative local tumor recurs in approximately 10 per cent of the cases. We describe 4 patients in whom tumor recurred in a solitary renal remnant after partial nephrectomy for renal cell carcinoma 1 to 6 years previously. The original tumor was pathological stage I in 2 patients and stage III in 2. Neither of the patients with stage I renal cell carcinoma had metastatic disease when locally recurrent carcinoma was noted. A second partial nephrectomy was done in these patients and they are alive 1 and 10 years later. Both patients with stage III renal cell carcinoma also had metastatic disease when locally recurrent carcinoma was noted. One patient died 1 year later and the other is alive 1 year later. Patients who undergo partial nephrectomy for renal cell carcinoma should be followed closely to allow for early detection of local tumor recurrence. When this occurs, secondary surgical treatment may be possible with complete tumor excision and the opportunity for extended survival. PMID- 3625867 TI - Xanthogranulomatous epididymitis: a case report. AB - We report a case of bilateral scrotal masses in a diabetic man with bilateral epididymitis and abscess formation. PMID- 3625868 TI - Extracorporeal shock wave lithotripsy and blood clotting defects. PMID- 3625869 TI - Osbon Erec Aid. PMID- 3625870 TI - Re: Penile neuropathy in insulin-dependent diabetes mellitus. PMID- 3625871 TI - Uropathogenicity in rats and mice of Providencia stuartii from long-term catheterized patients. AB - Providencia stuartii, a frequent and persistent isolate from the urinary tract of chronically catheterized elderly patients, is multiply antibiotic resistant and may cause fatal bacteremia in those patients. We studied P. stuartii strains in rats and mice to determine differences in uropathogenicity. Strains studied varied in expression of factors which contribute to pathogenicity of other bacterial species. Urinary tract responses following challenge with P. stuartii strain HO (factors expressed) were similar to responses reported for uropathogenic E. coli strains both in bacterial persistence and histologic change. In animals similarly challenged with P. stuartii strain RO (factors not expressed), responses were similar to those reported for non-uropathogenic E. coli strains. Results indicate that: a) animal model studies may be useful in differentiating P. stuartii strains based on uropathogenicity, b) P. stuartii uropathogenicity may be related to identifiable factors associated with virulence in other species, and c) the CBA mouse model appears to be the most suitable for studies of P. stuartii uropathogenicity. PMID- 3625872 TI - Calcium oxalate crystal interaction with rat renal inner papillary collecting tubule cells. AB - Rat renal inner papillary collecting tubule cells (RPCT) have been isolated and maintained in primary culture. The cells have been found to be of only one type and they have maintained the characteristics of RPCT cells. The RPCT cells in culture appear as a monolayer with intermittent clumps of rounded cells. When small calcium oxalate monohydrate crystals (COM) or calcium oxalate dihydrate crystals (COD) are added to the monolayer of RPCT cells, the crystals bind on or about these clumps of rounded-up cells. The use of this system as a model for the study of crystal membrane interactions in crystalluria and urolithiasis is discussed. PMID- 3625873 TI - Fluoride concentrations in a collection of urinary calculi. AB - Fluoride concentrations in 42 urinary calculi were determined using a microdiffusion procedure in conjunction with a fluoride sensitive electrode. Mean values of 56, 230 and 1112 ng./mg. fluoride were obtained for uric acid, calcium oxalate monohydrate and apatite/struvite stones, respectively. Fluoride concentration was found to be related to calcium oxalate dihydrate levels as well as to apatite content. It is suggested that the former has zeolithic properties which might trap fluoride while formation and growth of the latter appears to be enhanced by elevated urinary fluoride levels. PMID- 3625874 TI - Coexistence of fast and slow myosin isozymes in human external urethral sphincter. A preliminary report. AB - Human external urethral sphincter muscle was isolated for biochemical research. Myosin samples were prepared and pyrophosphate gel electrophoresis and two dimensional electrophoresis were performed. Assignment in pyrophosphate gel of myosin isozymes of human external urethral sphincter was carried out by making comparisons with those from human rectus abdominis muscle. Myosin light chains in human external urethral sphincter were identified using two-dimensional electrophoresis. Human external urethral sphincter, similar to other voluntary muscles, is composed of fast and slow twitch muscle fibers, since fast and slow myosin components were shown in both pyrophosphate gel and two-dimensional electrophoretograms. PMID- 3625875 TI - A canine model for hemodynamic study of isolated corpus cavernosum. AB - We developed a canine model which permits hemodynamic study of the isolated corpus cavernosum. The arterial and venous flow to the corpus cavernosum was measured and pressure was measured in each corpus cavernosum separately. To provide controlled inflow to the corpora, each side was perfused separately with the aorta clamped. It was demonstrated that arterial and nerve supply to the corpus cavernosum is crossed. During unstimulated corporal perfusion, venous outflow from the corpora increased with increased perfusion rate up to a maximum of 40 ml./min. Following pelvic nerve stimulation, intracorporal pressure increased at much lower rates of perfusion. Moreover, it was noted that intracorporal pressure was not transmitted from one side to the other. Thus, in the canine model, each corpus cavernosum may act as a control for the contralateral one. The technique we used to measure venous outflow from the corpora cavernosa, previously undescribed, permits accurate depiction of the hemodynamics of penile erection. PMID- 3625876 TI - Experimental partial ureteric obstruction: pathophysiological changes in upper tract pressures and renal blood flow. PMID- 3625877 TI - Treatment of claudication with pentoxifylline: are benefits related to improvement in viscosity? AB - Forty-five patients with short-distance claudication were treated with pentoxifylline. The initial claudication distance increased significantly (32.5 m, p = 0.02) and the absolute claudication distance (ACD) increased significantly (49.5 m, p = 0.001) while the patients were receiving pentoxifylline. Patients with initial elevated viscosity levels were more likely to have decreased viscosity with pentoxifylline than were patients with normal viscosity levels (p = 0.01). No significant improvement in ACD or viscosity was noted in 51% of patients. Both ACD and viscosity improved in 15% of patients, viscosity improved without improvement in ACD in 9%, and ACD improved without improvement in viscosity in 25%. PMID- 3625878 TI - Revascularization of the distal profunda femoris artery in the reconstructive treatment of aortoiliac occlusive disease. AB - The distal profunda femoris artery is frequently spared from atherosclerosis and can be used as a recipient vessel in the absence of a satisfactory common or superficial femoral artery. During a 15-year period 53 inflow procedures were done to the distal profunda femoris artery at a point more than 3 cm from its origin. The ankle-brachial systolic pressure index increased an average of 0.27 +/- 0.04 postoperatively. Limb salvage was achieved in 33 of 37 threatened extremities (89%) and claudication improved in 10 of 14 cases (71%). Symptomatic improvement was dependent on an open popliteal segment and a low profundapopliteal collateral index. The overall 4-year patency by life-table methods was 76%, with a patency of 100% for femoroprofunda crossover grafts, 96% for aorto- and ilioprofunda grafts but only 26% for axilloprofunda grafts. Bypass to the distal profunda femoris artery represents a viable alternative when the common and superficial femoral arteries are unsuitable for outflow, with results comparable to procedures done to a healthy common femoral artery. PMID- 3625879 TI - Carotid endarterectomy to correct asymptomatic carotid stenosis: ten years later. AB - The ideal management of the patient with an asymptomatic stenosis of the extracranial internal carotid artery remains controversial. The purpose of this article was to evaluate the effects of prophylactic carotid endarterectomy (CE) done to treat asymptomatic carotid stenosis (greater than 50% diameter reduction by angiography) 10 years later. In 1976, 42 prophylactic CEs were performed. There were no postoperative deaths or strokes. During 10-year follow-up two strokes occurred in the operated hemisphere; one stroke was fatal and was due to an intracranial hemorrhage, whereas the other stroke was thromboembolic in origin. Two other patients suffered strokes in the contralateral hemisphere and seven patients had transient ischemic attacks in the contralateral hemisphere, which necessitated CE. The survival rate at the end of the study period by life table analysis was 57% (mean 8.7 years). Sixteen late deaths occurred, with coronary artery-related disease the most common cause of death. This review with actual 10-year follow-up demonstrated that prophylactic CE may be performed with minimal risk, that late stroke in the operated hemisphere was negligible, and that long-term survival was similar to that of a comparable age-matched population, possibly because late deaths attributed to stroke were reduced. On the basis of long-term follow-up, CE to treat asymptomatic high-grade carotid stenoses appears to be indicated in appropriate patients. PMID- 3625880 TI - Tinnitus originating from an abnormal jugular bulb: treatment by jugular vein ligation. AB - Tinnitus and hearing loss can occur in patients with a high-riding abnormal jugular bulb. Jugular vein ligation in selected patients can cure tinnitus and reverse hearing loss. A 39-year-old woman reported a 4-year history of right sided tinnitus of increasing intensity associated with a mild hearing loss. Extensive evaluation revealed only an enlarged right jugular bulb with dehiscence of the normal petrous bony septum between the bulb and the middle ear. The patient underwent ligation of the right internal jugular vein and noted immediate cessation of tinnitus and the return of normal hearing. Review of the literature suggests that jugular vein ligation is appropriate in selected cases of venous tinnitus. PMID- 3625881 TI - Mechanical stress stimulates aortic endothelial cells to proliferate. AB - The effects of applied cyclic tensional deformation and relaxation on cultured bovine aortic endothelial cells were examined. Endothelial cells from passages 3 to 9 were seeded in flexible-bottomed plates and allowed to attach for 24 hours. Endothelial cells in the experimental group (n = 6 wells per time point) were placed in a vacuum-operated stress-providing instrument that exerted an average elongation of 10% at maximum downward deflection of the culture plate bottom. The stretched endothelial cells were subjected to repeating cycles of 10 seconds elongation and 10 seconds relaxation from days 1 through 7 in culture. Endothelial cells in the control group (n = 6 wells per time point) were subjected to similar incubation conditions as the experimental group but without tensional deformation. Tritiated thymidine was added to cells 24 hours before harvesting. On days 0, 1, 3, 5, and 7 cells were counted and analyzed for trichloroacetic acid-precipitable tritiated thymidine incorporation. The results showed that 3 cycles/min mechanical stretching stimulated deoxyribonucleic acid synthesis and endothelial cell division. We conclude that cyclic tensional deformation may stimulate endothelial cell proliferation. It is possible that naturally occurring cyclic mechanical deformation in vivo, such as the repetitive stretching and relaxation of aortic tissue by the heart, may invoke a particular pattern of synthesis and division in endothelial cells. PMID- 3625882 TI - Management of a complex, posttraumatic, pelvic arteriovenous fistula with the use of cardiopulmonary bypass: case report and review of the literature. AB - A 34-year-old man had a posttraumatic, pelvic arteriovenous fistula (AVF) and false aneurysm of 18 years' duration. He had undergone four previous unsuccessful attempts at operative repair, the last of which almost resulted in exsanguination. After the false aneurysm was exposed, the patient was placed on cardiopulmonary bypass. Core cooling (25 degrees C) allowed the perfusion flow rates to be lowered (less than 0.5 L/min/m2) while the aneurysm was opened, thereby permitting visualization and ligation of the arteriovenous communications within the aneurysm. Total circulatory arrest was not required. There were no complications and the patient was discharged on the eleventh postoperative day. Arteriography 5 months later showed complete ablation of the AVF. We believe that cardiopulmonary bypass with hypothermia and reduced blood flow is a useful adjunct in the repair of complex AVFs and arteriovenous malformations. This technique avoids the use of total circulatory arrest, which increases the risks of air embolism and ischemic organ injury. PMID- 3625883 TI - The contribution of valves to saphenous vein graft resistance. AB - Saphenous vein resistance influences graft flow rates and may affect graft patency in lower limb revascularization. To quantitate specifically the contribution of saphenous vein valves to this resistance, 10 human saphenous veins (mean length 68 cm, diameter 0.42 mm, and 5.2 valves per vein) were perfused with water under carefully controlled pressure gradients designed to simulate different peripheral resistances in the outflow bed. The Reynolds number was maintained at 350 to 600, within the physiologic range for in vivo grafts. Veins were perfused under both venous (10 mm Hg) and arterial (100 mm Hg) mean pressures to determine the effects of distension on the overall resistance of the conduit. The valves were bisected according to Leather's techniques and flow was measured in both directions, antegrade (simulating "reversed" grafts) and retrograde (simulating "in situ" grafts). Data (mean +/- standard error) were normalized to the baseline flow for each vein with intact valves and expressed as a percentage change. Data were analyzed by means of Student's t test (p less than 0.05). Baseline antegrade flow with intact valves averaged 71.0 +/- 3.0 ml/min at pressure gradients (delta P) of 10 mm Hg and 95.0 +/- 2.6 ml/min for delta P = 20 mm Hg. After valve incision, antegrade flow (reversed) increased an average of 29% at both pressure gradients. Retrograde flow (in situ) through the bisected valves was only 19% greater than baseline antegrade flow and was significantly less than antegrade flow through bisected valves. The difference is explained by theoretic considerations of stenosis area and orifice shape. The increases in flow did not correlate with vein length or diameter, nor did flow change with different distension pressures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625884 TI - The role of external carotid revascularization in the treatment of ocular ischemia. AB - During the past 13 years, 16 patients with visual disturbances, ipsilateral internal carotid artery (ICA) occlusion, and external carotid artery (ECA) stenosis have had ECA reconstruction. Indications for operation included amaurosis fugax (AF) in five patients, AF and transient ischemic attacks in four patients, ischemic optic neuropathy in two patients, retinal artery occlusion in one patient, and blurry vision and scotomata in four patients. In 12 cases (75%), there were hemodynamically significant contralateral ICA lesions, including four contralateral ICA occlusions. EC endarterectomies were performed in 15 patients, whereas one patient was treated with a bypass graft. One transient neurologic event occurred in the perioperative period (6%). There were no deaths nor permanent neurologic deficits. Patients were followed up for periods of 1 to 60 months (mean 18.4 months). Two patients had AF postoperatively; in one instance, AF was associated with ECA thrombosis 53 months after operation. One patient had a transient ischemic attack when the ECA thrombosed 24 months after operation. This study demonstrates that visual symptoms can occur despite ipsilateral ICA occlusion. ECA revascularization is effective and can be performed with acceptable morbidity and mortality. PMID- 3625885 TI - Arterialization of reversed autogenous vein grafts: quantitative light and electron microscopy of canine jugular vein grafts harvested and implanted by standard or improved techniques. AB - To provide sequential, quantitative analysis of the cellular events occurring in reversed autogenous vein grafts after implantation and potential modifications of these events, two groups of veins were evaluated. Veins prepared by standard techniques of unmonitored pressure distension with cold heparinized saline solution, tributary ligation adjacent to the wall, and storage at 4 degrees C were morphometrically compared with veins harvested by means of a modified protocol of papaverine irrigation, tributary ligation away from the graft wall, pressure distension to 100 mm Hg with heparinized blood containing papaverine at body temperature, storage in identical solution at 4 degrees C, and implantation while distended. Unilateral jugular veins harvested from dogs with the modified technique (IRJV,N = 9) or standard technique (SRJV,N = 9) were implanted into carotid arteries, retrieved at 30 minutes, 2 days, and 10 days postoperatively along with the contralateral control vein after perfusion fixation in situ, and examined microscopically to quantitate intimal-medial thickness and endothelial damage (denudation and ultrastructural alterations). All IRJVs remained endothelialized, whereas SRJVs had 19% and 40% endothelial denudation at 30 minutes and 2 days, respectively, as well as massive neutrophil, platelet, and monocyte involvement. In contrast, IRJVs had only a modest infiltration of monocytes beginning early after implantation and culminating in their localization beneath endothelial cells; these endothelial cells increased in number during the 10-day period. Although SRJVs exhibited nearly complete reendothelialization over the luminal surface of macrophages by 10 days, endothelial damage was consistently higher than that of IRJVs at all periods and intimal-medial thickness was significantly greater at 10 days (65 +/- 0 vs. 57 +/ 0 micron, respectively; p less than 0.001). These findings suggest that endothelial preservation with improved harvesting techniques inhibits thrombosis and limits wall thickening and also that macrophages may play a protective role by promoting endothelial proliferation. PMID- 3625886 TI - The multiple sequential distal bypass graft: seven-year follow-up. AB - Thirty-nine infrainguinal bypass grafts with multiple sequential distal anastomoses were performed on 35 patients ranging in age from 32 to 79 years (mean 65.8 years) with severe femoropopliteal occlusive disease. Thirty-eight procedures were performed for limb salvage indications. Distal anastomoses were performed to the popliteal-anterior tibial arteries in seven procedures, the popliteal-posterior tibial arteries in six, the popliteal-peroneal arteries in six, the anterior tibial-peroneal arteries in eight, the posterior tibial peroneal arteries in 10, and the posterior tibial-anterior tibial arteries in two. Saphenous vein was the graft material in 31 procedures (in situ in two), polytetrafluoroethylene (PTFE) in four, and saphenous vein-PTFE composite in four. The mean Doppler ankle-arm index was 0.38 +/- 0.14 preoperatively and 0.89 +/- 0.13 postoperatively. The early (30-day) graft patency rate was 93%. With life-table analysis, the long-term primary patency rate was 70% at 1 year, 61% at 3 years, and 52% at 7 years for saphenous vein grafts; the secondary patency rate was 65% at 7 years for saphenous vein grafts. The secondary patency rate for PTFE and PTFE-vein composite grafts was 75% at 1 year, 50% at 3 years, and 17% at 5 years. Cumulative life-table limb salvage rates were 91% at 1 year, 85% at 5 years, and 61% at 7 years. The multiple sequential distal bypass graft is durable and highly efficacious in achieving limb salvage. PMID- 3625887 TI - Femoral anastomotic aneurysms: a continuing challenge. AB - The methods used in management of 102 femoral anastomotic aneurysms (FAAs) were analyzed, and a case control study was performed in an effort to define potential etiologic factors. Most FAAs resulted from host vessel degeneration, although broken sutures, infection, and prosthetic graft dilatation contributed in some cases. Patients forming FAAs after aortofemoral bypass more often were hypertensive, had progression of distal disease, and showed diffuse atherosclerosis when compared with control patients. The use of braided synthetic sutures, woven Dacron grafts, and concomitant femoral endarterectomy correlated with FAA development, whereas diabetes mellitus, multiple femoral operations, local wound-healing problems, and occlusion of the superficial femoral artery did not correlate with the formation of FAAs. Ninety FAAs (88%) were treated surgically with an operative mortality rate of 3%. The most common surgical technique was aneurysmectomy with interposition prosthetic graft replacement. Durability of the repair was better if a simultaneous outflow procedure was performed and if the reconstruction was done before complications developed. Complicated FAAs are still responsible for significant morbidity and loss of life despite aggressive surgical management. Elective FAA repair is the preferred method of treatment. PMID- 3625888 TI - Endothelial cell seeding: problems and expectations. PMID- 3625889 TI - A combined angiographic surgical approach for repair of carotid false aneurysm. PMID- 3625890 TI - Pneumonia in Ottoman vipers (Vipera xanthena xanthena) associated with a parainfluenza 2-like virus. AB - A paramyxovirus related to parainfluenza 2 (PI2) virus was recovered from the lungs of two dead Ottoman vipers from a zoological collection. Snakes of other species in the collection were unaffected. Histologic examination of the vipers' lungs revealed interstitial pneumonia, and degeneration and hyperplasia of bronchial and atrial epithelia. Scattered vacuoles, some of which contain eosinophilic inclusion bodies, were seen in the cytoplasm of several cells of affected epithelial tissues. The virus recovered from pulmonary tissues of the snakes replicated optimally at 30 C in a variety of cell cultures and hemagglutinated chicken erythrocytes. Viral hemagglutination was inhibited by PI2 virus antiserum, but not by antisera to PI1, PI3, respiratory syncytial, and canine distemper viruses. Indirect immunofluorescence with PI2 antiserum specifically stained inclusions in the epithelial cells of respiratory tissues and infected cell cultures. PMID- 3625891 TI - Genital papillomatosis in sperm whale bulls. AB - Examination of 31 male sperm whales (Physeter catodon) caught off the western coast of Iceland revealed three cases of genital papillomatosis involving the unsheathed penis. One subadult and two sexually mature bulls were affected. Gross lesions resembled papillomas common in terrestrial mammalian species. Transmission electron microscopy of these lesions revealed nonenveloped intranuclear virus particles 28-40 nm in diameter and round to hexagonal in shape. In two cases immunoperoxidase staining was negative for group-specific papillomavirus antigen. These findings indicate that the spectrum of animal species affected with virus-associated genital papillomatosis includes at least one globally distributed species of the order Cetacea (whales, dolpins, and porpoises). PMID- 3625892 TI - Experimental duck plague in blue-winged teal and Canada geese. AB - Ten adult blue-winged teal (Anas discors) and six Canada goose (Branta canadensis) goslings were inoculated with liver tissue from a natural case of duck plague in a wild mallard (Anas platyrhynchos). Four additional teal were placed in contact with the inoculated ducks. Inoculated teal died 63.5-68 hr after inoculation; two of the contact teal died 161-162 hr after exposure. Three of the goslings died 119-133 hr after inoculation, the others were killed when moribund 90-133 hr postinfection. The clinical course of disease was extremely rapid in both species. Signs were limited to sudden onset of profound weakness, ataxia, tremors and terminal convulsions. The only consistent gross lesion in the teal was a small dark spleen; half the teal also had inconspicuous foci of epithelial necrosis in the distal esophagus and in the cloaca. Goslings had more severe lesions, with focal hepatic necrosis visible in all, and mucosal necrosis over the intestinal lymphoid tissue, and intestinal hemorrhage in three birds each. Microscopic lesions in both species were similar to those reported in mallards. Duck plague might be overlooked at necropsy of blue-winged teal, because of the paucity of gross lesions. PMID- 3625893 TI - Epizootic necrotic enteritis in wild geese. AB - Outbreaks of a disease characterized by severe necrotic enteritis occurred among Canada geese (Branta canadensis), lesser snow geese (Anser caerulescens), Ross' geese (A. rossi), and white-fronted geese (A. albifrons) on lakes in Saskatchewan and Manitoba during the autumn of 1983, 1984 and 1985. Ducks using the lakes were apparently not affected. Lesions in the geese closely resembled those described in enteritides in other species associated with the proliferation of Clostridium perfringens in the small intestine. Clostridium perfringens was present in large numbers in the affected areas of the intestine of the geese; other pathogens were not identified. It is hypothesized that an abrupt change in diet as geese begin to feed on grain disrupts the intestinal microflora, allowing C. perfringens to proliferate in the upper small intestine. Toxins produced by the bacteria then cause mucosal necrosis. Protease-inhibitory substances in some grains might also have a role in the disease. PMID- 3625894 TI - Epidemiology of Mycobacterium ulcerans infection in koalas (Phascolarctos cinereus) on Raymond Island, southeastern Australia. AB - Mycobacterium ulcerans infections were found in 11 koalas (Phascolarctos cinereus) between 1980 and 1985, in a population of approximately 200 koalas on Raymond Island in southeastern Australia. Ulcers caused by the infection occurred on the face, forearm, rump, groin and footpads. Seven koalas had multiple ulcers. All the infected animals were mature (age classes 4, 5 and 6), and eight were male. The distribution of ulcers corresponded with the distribution of wounds in a sample of 87 koalas. Many of these wounds were associated with social behaviour. PMID- 3625895 TI - Mycobacteriosis in cultured striped bass from California. AB - Striped bass (Morone saxatilis) juveniles raised in an intensive culture system had chronic mortality resulting from infections with Mycobacterium marinum. Approximately one-half of a population of 900 yearlings succumbed to the disease and 80% of those remaining were infected. The bacteria were isolated on Petrignani's medium after 7 days at 25 C and subcultures grew at temperatures from 20 to 37 C. The disease was characterized by systemic nodular lesions in all major organs. Older tubercles contained numerous acid-fast bacilli. Chemotherapy by feeding rifampin (6 mg/100 g of food for 60 days) was not an effective treatment. Subclinical mycobacteriosis in adult striped bass may be the source for vertical transmission to their progeny. PMID- 3625896 TI - Experimental infections of free-ranging Rocky Mountain bighorn sheep with lungworms (Protostrongylus spp.; Nematoda: Protostrongylidae). AB - Twelve free-ranging Rocky Mountain bighorn lambs (Ovis canadensis canadensis), each exposed experimentally to 125-1,000 infective third-stage larvae of Protostrongylus stilesi and P. rushi, shed significantly more first-stage larvae in their feces than did control lambs, but showed no clinical signs of illness and had equivalent summer and overwinter survival as control lambs. Two adult ewes, each exposed to 925 infective larvae, showed no increase in numbers of first-stage larvae in their feces; both survived at least 14 mo postexposure. Experimentally exposed lambs did not differ from control lambs in numbers of larvae in their feces in the following summer. Three experimental lambs had 313 402 adult P. stilesi and 0-97 adult P. rushi on necropsy; two control lambs had 255 and 270 P. stilesi and no P. rushi. The presence of these numbers of lungworms did not appear to be sufficient to precipitate lungworm pneumonia in bighorn lambs under the conditions of this study. PMID- 3625897 TI - Nematode parasites from Burchell's zebras in South Africa. AB - Twenty-five Burchell's zebras (Equus burchelli antiquorum) which were culled at monthly intervals in the Kruger National Park were examined for helminths. Twenty nine species of nematodes belonging to the families Atractidae, Habronematidae, Onchocercidae, Oxyuridae, Strongylidae, Strongyloididae and Trichostrongylidae were recovered. The cyathostomes (small strongyles) most abundant were Cyathostomum tetracanthum, Cylicostephanus calicatus, Cylindropharynx sp. (? C. intermedia Theiler, 1923) and Cylicocyclus auriculatus. Cyathostomum alveatum, Cyathostomum montgomeryi, Cylicostephanus calicatus and Cylindropharynx sp. (? C. intermedia Theiler, 1923) were the most prevalent cyathostomes (small strongyles) while Craterostomum acuticaudatum was the most prevalent of the large strongyles. Of all the species recovered those most abundant were Crossocephalus viviparus and Probstmayria vivipara with intensities of 100 to 3,857,772 and 18,400 to 104,120,467, respectively. Four new species, two Triodontophorus spp. (Strongylidae) and two Habronema spp. (Habronematidae) were identified. Furthermore, this study furnishes a first report of Triodontophorus minor in zebras. The fourth stage cyathostomes as well as the adults of 11 of the 14 species were present in significantly greater intensities in autumn and winter. PMID- 3625898 TI - Salmon poisoning disease in juvenile coyotes: clinical evaluation and infectivity of metacercariae and rickettsiae. AB - Clinical salmon poisoning disease (SPD), and survival of Neorickettsia helminthoeca and metacercariae of Nanophyetus salmincola in fish were evaluated experimentally in 12-wk-old coyotes (Canis latrans) to determine the potential of SPD for biological control of coyotes. Coyotes readily ate fish that contained metacercariae and rickettsiae. They developed diarrhea, anorexia and lethargy within 7 days after feeding. Infected coyotes lost 58% of their body weight when compared to uninfected controls. They died or became moribund and were euthanatized within 17 days after feeding. Rickettsiae were present in the macrophages of lymph nodes of all affected coyotes. Clinical disease occurred in coyotes fed fresh fish, but not in coyotes fed fish stored at 4 C for greater than or equal to 30 days or at -20 C for 14 days. Metacercariae in fish were viable after 60 days at 4 C. These trematodes developed in coyotes, but clinical SPD did not occur. This indicated survival of metacercariae, but not rickettsiae. Metacercariae were not viable after 14 days at -20 C. PMID- 3625899 TI - Echinococcus granulosus (Cestoda: Taeniidae) infections in moose (Alces alces) from southwestern Quebec. AB - Investigation of the distribution of larval Echinococcus granulosus in a moose population from southwestern Quebec revealed a distinct and stable pattern of infection with a prevalence of 44% (n = 580). Positive correlations between moose age and the intensity, mean cyst weight and biomass of the hydatid cysts suggested a process of continued parasite acquisition and cyst growth. The distribution of cyst sizes within individual moose provided circumstantial evidence of interaction between cysts, perhaps mediated through the host's immunological response. PMID- 3625900 TI - Testicular tumors in carp-funa hybrid: annual cycle and effect on a wild population. AB - This study documents the occurrence of testicular tumors in a wild population of carp-funa hybrids. The most prevalent tumor was a dysgerminoma. There were lower prevalences of seminomas, leiomyomas, Sertoli cell tumors, and spermatocytic seminomas. Sex-ratio, gonadosomic index (Gi) and the prevalence of tumors in the monthly catch was analysed for five consecutive reproduction periods (1980 to 1984). Gonadal tumors were found only in males. This may be important to the population dynamics of the carp-funa hybrid, since a high percentage of the fish that die during spawning have these tumors. A schematic model for the reservoir's population is suggested. PMID- 3625901 TI - Urogenital sinus calculi in a sand tiger shark (Odontaspis taurus). AB - Two calculi were found in the urogenital sinus of a 70 kg female sand tiger shark (Odontaspis taurus). The calculi were white in color, rough surfaced, and spherical in shape. Crystallographic examination revealed that they were composed of magnesium ammonium phosphate hexahydrate (80% struvite) and calcium phosphate (15% carbonate apatite). Approximately 5% of the stone matrix consisted of blood and protein and a distinct bacterial nidus was not present microscopically. PMID- 3625902 TI - Paint chip poisoning of Laysan albatross at Midway Atoll. AB - Epizootic mortality occurred in Laysan albatross (Diomedea immutabilis) fledgings at Midway Atoll in 1983. Heavy metal toxicity from ingestion of weathered paint chips was one of the causes. Sick albatrosses were unable to retract their wings, causing a "droop-wing" appearance. Five normal and 12 droop-winged fledglings were captured, killed, and examined. Paint chips found in the proventriculus of the affected fledglings contained up to 144,000 ppm lead. Blood, liver, and kidney concentrations of lead in affected birds were higher than in normal fledglings, and acid-fast intranuclear inclusion bodies were present in the kidneys. Degenerative lesions were present in the myelin of some brachial nerves. Weathered paint samples collected from 12 buildings contained up to 247,250 ppm lead and 101 ppm mercury. Lead poisoning was diagnosed in 10 of the droop-winged albatrosses and was one of the causes of morbidity. Mercury toxicosis and plastic impaction were other possible causes. PMID- 3625903 TI - Lead poisoning in Canada geese on Plum Island, Massachusetts. AB - During December 1983 and early January 1984, about 200 Canada geese (Branta canadensis) died of lead poisoning at Parker River National Wildlife Refuge on Plum Island, Massachusetts. In an effort to determine the source of lead, 100 bottom samples were taken from a refuge impoundment where much of the mortality/morbidity occurred. An average of 157,150 pellets/ha was found with a range of 64,582 to 322,910 pellets/ha. Water levels in this impoundment were low when Canada geese arrived, making shot more readily available to the geese and contributing to the outbreak. To minimize the risk of Canada geese being exposed to lead shot poisoning at this location in the future, we recommend several corrective manipulations of habitat. PMID- 3625904 TI - Goussia-like coccidium in crocodiles. PMID- 3625905 TI - Salt toxicosis in waterfowl in North Dakota. AB - About 150 waterfowl died and another 250 became weak and lethargic from suspected salt poisoning after using White Lake, a highly saline lake in Mountrail County, North Dakota. Frigid temperatures made fresh water unavailable, forcing the birds to ingest the saline waters with resultant toxic effects. Sick birds recovered when removed from the salt water and released into fresh water marshes. Brain sodium levels were higher in dead geese submitted for necropsy than in controls. PMID- 3625906 TI - Capture myopathy in wild turkeys (Meleagris gallopavo) following trapping, handling and transportation in Colorado. AB - Sixty wild turkeys were necropsied following trapping, transporting and handling during the winters of 1980-1981, 1981-1982, and 1982-1983 in order to determine the incidence of subclinical capture myopathy. Gross lesions characterized by small to large patchy, pale white streaked areas within skeletal muscle were found in 13 of 27 birds trapped with a drop net in the winter of 1982-1983. Microscopic lesions within myocardium characterized by irregular areas of coagulative necrosis, collapse of intercellular stroma and myocardial nuclear proliferation were found in two of 14 birds in 1980-1981, five of 19 birds in 1981-1982 and 11 of 27 birds in 1982-1983. Microscopic lesions within skeletal muscle characterized by rhabdomyolysis were found in 16 of 19 birds in 1981-1982 and 25 of 27 birds in 1982-1983. These findings suggest that wild turkeys are susceptible to capture myopathy and particular caution should be exercised in capturing and handling these birds. PMID- 3625907 TI - Deaths from exertional myopathy at the National Zoological Park from 1975 to 1985. AB - A retrospective study was conducted to determine the incidence of deaths from exertional myopathy (EM) in the hoofstock collection at the National Zoological Park (NZP) from 1975 to 1985. The diagnosis of EM was based on history, clinical signs, clinicopathological findings, gross and microscopic lesions. Only bovids, cervids, and equids were included in the study. Data were derived from the medical and pathological records of the NZP. There were 10 cases of EM during this period, but only seven deaths were directly attributable to EM. Five deaths occurred after immobilization. Two deaths occurred after improper transport, but the anesthetic history was not known in these cases. Pathologic changes consistent with EM were incidental findings in an animal killed by dogs, and in two animals euthanized because of suspected infection with Parelaphostrongylus tenuis. Only cervids and bovids were affected. There was no age or sex predilection for developing EM and deaths occurred throughout the year. Deaths associated with immobilization occurred most often after anesthesia with xylazine and etorphine. These are the drugs used most frequently in bovid and cervid anesthesia at the NZP. The overall incidence of deaths from EM after immobilization was 0.25% for the 10-yr period. PMID- 3625908 TI - Cardiovascular and behavioral responses of gray wolves to ketamine-xylazine immobilization and antagonism by yohimbine. AB - Adult wolves (Canis lupus) were immobilized with 6.6 mg/kg ketamine hydrochloride (KET) and 2.2 mg/kg xylazine hydrochloride (XYL) administered intramuscularly. Induction time was 4.6 +/- 0.3 min (mean +/- SE). Immobilization resulted in significant bradycardia and hypertension (P less than 0.05). Twenty min after induction, the wolves were given 0.05-0.60 mg/kg yohimbine hydrochloride (YOH). Yohimbine given intravenously produced dose-related increases in heart rate (HR) with doses greater than 0.15 mg/kg resulting in extreme tachycardia (greater than 300 bpm). All doses of YOH caused a temporary decrease in mean arterial blood pressure (MABP) with some individual animals manifesting profound hypotension (less than 30 torr) at doses greater than 0.15 mg/kg. Increasing the dose of YOH above 0.15 mg/kg did not significantly decrease either arousal or ambulation times. Administering YOH at 40 or 60 min after induction resulted in decreased arousal and ambulation times. Stimulation by weighing and taking repeated blood samples during anesthesia did not shorten arousal times. We recommend that wolves immobilized with XYL-KET be antagonized with doses of YOH less than 0.15 mg/kg. PMID- 3625909 TI - Rapid reversible immobilization of feral stallions using etorphine hydrochloride, xylazine hydrochloride and atropine sulfate. AB - Forty-eight newly captured free-ranging feral stallions (Equus caballus) from two different locations and six captive stallions were immobilized using combinations of etorphine hydrochloride, xylazine hydrochloride and atropine sulfate with or without acepromazine. Six animals were immobilized twice, 1 mo apart. The drugs were administered either intramuscularly (n = 13) or intravenously (n = 44). Mean immobilization time (+/- SE) after intravenous (i.v.) injection of etorphine, xylazine and atropine was 55 +/- 4 sec (range 20 to 185 sec) compared to 708 +/- 131 sec (range 390 to 1,140 sec) for intramuscular (i.m.) injection. Immobilization was reversed with i.v. administration of 3 to 11 mg diprenorphine hydrochloride and 16 to 24 mg yohimbine hydrochloride. Average time from administration to standing and walking was 86 +/- 7 sec (n = 55). Reversal of etorphine-induced immobilization with an amount of diprenorphine equal to the etorphine and administered i.v. was as effective as a 2:1 ratio of diprenorphine to etorphine. Acepromazine had no effect on induction time, but decreased relaxation after immobilization and prolonged ataxia after reversal of the etorphine and xylazine. Eight free-ranging horses were immobilized in 708 +/- 132 sec by darting with 5.5 mg etorphine, 1,300 mg xylazine and 15 mg atropine from a helicopter. Three animals died during the study: one immediately after reversal of an i.v. administration, one from a broken neck during induction from darting, and one was found a week later at the site of darting.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3625910 TI - A solitary case of duck plague in a wild mallard. AB - Duck plague was diagnosed on the basis of pathology and virus isolation in a wild female mallard Anas platyrhynchos found dead near Saskatoon, Saskatchewan. Day old Pekin ducklings and one of two adult mallards died with lesions typical of duck plague following inoculation of tissue from the wild bird. This is believed to be the only reported case of duck plague in a wild bird since a major outbreak occurred in South Dakota in 1973, and the fourth such report in North America. PMID- 3625911 TI - Isolation of Actinobacillus suis from a Canada goose (Branta canadensis). AB - Blindness from conjunctivitis caused by Actinobacillus suis was found in a Canada goose (Branta canadensis) from a wildlife refuge in Kentucky. Lesions were not observed elsewhere and other body organs were grossly normal. Actinobacillus spp. in birds is rare and this is apparently the first report of conjunctivitis resulting from this infection in waterfowl. PMID- 3625912 TI - Avian tuberculosis in wild birds in the Netherlands. AB - Mycobacterium avium was isolated from 82 of 11,664 birds submitted for necropsy in The Netherlands. All isolated M. avium strains belonged to serotype 1, 2 or 3. The greatest number M. avium were from buzzards and falcons. The prevalence of tuberculosis in gulls is extremely low. PMID- 3625913 TI - Trichomonas gallinae in columbiform birds from the Galapagos Islands. AB - Domestic pigeons were introduced into the Galapagos Islands in 1972 or 1973. There is a high prevalence of Trichomonas gallinae among them and some evidence of canker. Trichomonas gallinae can be found also in endemic Galapagos doves in the vicinity of Puerto Ayora on Santa Cruz Island. Doves examined on pigeon-free islands were not found infected. PMID- 3625914 TI - Diplostomiasis (Trematoda: Strigeidae) in Arctic charr (Salvelinus alpinus) from Charr Lake, northern Labrador. AB - The eyes of 273 Arctic charr (Salvelinus alpinus) taken from Charr Lake, the Ikarut River, and Hebron Fiord in northern Labrador were examined for diplostomula. All anadromous charr taken from the Ikarut river and Hebron Fiord were uninfected. The resident fish from Charr Lake were parasitized with large numbers of diplostomula and intensity of infection increased with age and length. Infections of up to 2,852 diplostomula in one fish are the highest recorded. Such infections did not appear to affect the vision of the charr. PMID- 3625915 TI - First record of Lipoptena depressa (Diptera: Hippoboscidae) from Alberta, Canada. AB - Lipoptena depressa is reported for the first time from Alberta on a 2 1/2-mo-old white-tailed deer fawn. This ked fly is one of four species occurring on deer in North America. The fawn had severe hemorrhagic enteritis of undetermined cause. PMID- 3625916 TI - A trichoepithelioma in a wild eastern grey kangaroo (Macropus giganteus). AB - The gross and microscopic pathology of a neoplastic skin lesion from the chest of a wild adult eastern grey kangaroo (Macropus giganteus) was consistent with the diagnosis of a trichoepithelioma. This was a benign lesion of the epithelial cells of the hair follicle and is the second type of skin neoplasm reported from macropodids. PMID- 3625917 TI - Unusual multisystemic pathology in a sperm whale bull. AB - This report describes an unusual combination of lesions and apparent behavioral abnormalities in a sexually mature sperm whale bull taken in whaling operations off Iceland. Lesions included heavy combative scarring of the head, grossly roughened and thickened skin on the lower left flank, cutaneous maculae, genital papillomatosis, partial duodenal obstruction by plastic debris, colo-rectal obstruction by ambergris, cystic degeneration of the right kidney, and a deeply ulcerative gastric nematodiasis. Sealskin was found in the stomach. Gross and histopathologic observations suggested that the disease complex in this animal may have been related both to habitat degradation and health risks naturally associated with its ecology and age. PMID- 3625918 TI - Visceral gout in a rough legged hawk (Buteo lagopus). AB - Visceral gout is reported for the first time in a rough legged hawk (Buteo lagopus). Urate crystals were present on the pericardium, thoracic and abdominal air sacs, and the ventral surface of the liver. The liver and spleen also had urate crystals throughout the parenchyma. There was no indication of articular or renal involvement. The immediate cause of death in this hawk was not identified, but appeared to result from multiple factors, including the visceral gout. PMID- 3625919 TI - Urea concentration in collared peccary milk as an indicator of protein nutritional status. AB - Milk urea nitrogen (UN) concentration was examined as a possible index to protein energy intake in female collared peccaries (Tayassu tajacu). Captive adults were bred and assigned to one of four experimental diets through gestation and lactation. Females fed a high protein diet produced milk with UN concentrations exceeding those of low-protein-fed females. A low energy intake tended to elevate UN concentrations in milk. PMID- 3625920 TI - Differential leucocyte cell counts from the pygoscelid penguins of Antarctica. AB - Differential leucocyte counts were obtained for three cogeneric species of wild antarctic penguins, Pygoscelis adelie (adelie), Pygoscelis papua (gentoo), and Pygoscelis antarctica (chinstrap). Significant differences between the differential leucocyte counts of the three species were not observed. PMID- 3625921 TI - Summer wanes, but dermatologists caution threat of skin cancer remains. PMID- 3625922 TI - Biliary, as well as urinary, calculi become the targets of new, improved shock wave lithotripsy. PMID- 3625923 TI - Another option for gallstone [corrected] removal. PMID- 3625924 TI - ESWL now possible for patients with pacemakers. PMID- 3625925 TI - Research aims at gallstone prevention. PMID- 3625926 TI - Gonorrhea as a marker of chlamydial infection. PMID- 3625927 TI - Autologous and aged blood donors. PMID- 3625928 TI - Postsplenectomy blood salvage in anemic patients. PMID- 3625929 TI - Breast self-examination. PMID- 3625930 TI - Adventures in smoking: add oxygen. PMID- 3625932 TI - Continuing education. What it is and what it is not. PMID- 3625931 TI - The relative impact of smoking and oral contraceptive use on women in the United States. AB - Women who smoke and use oral contraceptives (OCs) are at increased risk for cardiovascular and cerebrovascular disease. To study the prevalence of smoking and OC use and other behaviors affecting health, 28 states and the District of Columbia conducted telephone surveys during 1981 through 1983. More than 22,000 US adults were interviewed, of whom 5779 women aged 18 to 44 years were studied. Data were weighted to represent the US population. Overall, 7.4% of US women aged 18 to 44 years reported smoking and using OCs; 1.1% reported smoking 25 or more cigarettes per day while using OCs. Although women aged 18 to 24 years were most likely to smoke and use OCs, combined smoking and OC use contributed substantially to the number of excess cases of myocardial infarctions occurring among US women aged 35 to 44 years. However, regardless of OC use, smoking accounted for most of the excess cases. Therefore, health care providers need to intensify their efforts to reduce smoking among their patients. PMID- 3625933 TI - Continuing medical education in the United States. An enterprise in transition. AB - The nation's continuing medical education (CME) enterprise is undergoing profound change. Once a simple teacher-to-learner activity, CME has now grown into an immense undertaking that is increasingly complex and costly. Simultaneously, it has evoked reactions from certain critics who find fault with its premises, its methods, and its outcomes. But CME's age-old mission--to help practicing physicians maintain their competence in patient care--has not changed, and even today's unwieldy, perhaps flawed, enterprise has not strayed from that basic commitment. Moreover, CME is showing encouraging indications of a willingness to incorporate into its process sound principles of adult education. Even more encouraging are the signs that CME is beginning to make use of computer and other electronic technologies in ways that promise to mend some of its flaws and restore its historical learner-oriented focus. PMID- 3625934 TI - Continuing medical education in the Union of the Soviet Socialist Republics. Philosophy and approaches. PMID- 3625935 TI - Disseminated intravascular coagulation in prostatic carcinoma reversed by ketoconazole. PMID- 3625936 TI - Conflict of interest and the peer review process. PMID- 3625937 TI - The economic impact of AIDS. PMID- 3625938 TI - Diagnostic and therapeutic technology assessment. Mammographic screening for breast cancer. PMID- 3625939 TI - Biotechnology's bequest: new drugs, diagnostics. PMID- 3625940 TI - Needle sharing and AIDS in minorities. PMID- 3625941 TI - Moonlighter takes on airs: rehydration, aeration, obtundation, and education. PMID- 3625942 TI - Persistence of enlarged pulmonary arteries--22 years after atrial septal defect closure. PMID- 3625943 TI - Painful questions about fibromyalgia. PMID- 3625944 TI - Malignant mesothelioma: a case report from an area with endemic pleural calcification. PMID- 3625945 TI - International exchange of physicians. PMID- 3625946 TI - Efficiency of intensive care. A comparative analysis of eight pediatric intensive care units. AB - To calculate overall pediatric intensive care unit (PICU) efficiency rates, 1668 patients representing 6962 patient-days were studied in eight PICUs. The contributions to inefficiency by two patient groups--low-risk monitored patients and potential early-discharge patients--were quantified using measures of daily mortality risk and therapeutic assessments. Low-risk monitored patients never received a unique PICU therapy and had daily mortality risks less than 1%. Potential early-discharge patients were similar to the low-risk monitored patients except that their unnecessary PICU use came only on their last consecutive day(s) of PICU stay. Efficiency ratings ranged from 0.894 to 0.547 in the eight PICUs. Low-risk monitored patients constituted from 16% to 58% of the PICU patient populations and used from 5.4% to 34.5% of the total days of care. Potential early-discharge patients constituted from 12% to 29% of the populations and the potential early-discharge days of care ranged from 5.1% to 17.2% of the total days of care. These results indicate that large disparity exists in efficiency among PICUs. Efficiency rates of greater than 0.80 seem to be a reasonable goal. PMID- 3625947 TI - An analysis of ambulance accidents in Tennessee. AB - In an effort to improve our program for ambulance crash and related injury prevention, we analyzed 102 consecutive ambulance accidents. Incidents reported included those that resulted in human injury or in which property damage exceeded $200. Multiple logistic regression was used to determine the association between circumstances reported at the time of the accidents and the risk of injury. Twenty-nine accidents contributed to a total of 65 injured victims, with one death. The variable most strongly associated with the probability of an injury accident was use of a passenger restraint device. Darkness and occurrence at an intersection were variables showing increased risk, but were not statistically significant. The interaction of variables did not have a combined influence on the incidence of injury. The mean delay to hospital care after an accident was 9.4 minutes. Based on our data, we conclude that passenger restraints for both ambulance attendants and passengers should be mandatory, and we suggest that traffic signals be strictly heeded at intersections and speed limits in urban settings be obeyed. PMID- 3625948 TI - Training in a primary care internal medicine residency program. The first ten years. AB - We surveyed all 49 graduates of the University of California, San Francisco, residency program in primary care internal medicine to determine whether they chose careers as general internists and whether training in ambulatory care at the expense of hospital-based medicine is adequate preparation for general internal medicine practice. Graduates rated adequacy of training and relevance to their current clinical practice of 87 content and skill areas on five-point Likert scales. Of the 44 respondents, 39 (89%) chose careers as general internists and five (11%) as subspecialty internists. Training in nine of 11 internal medicine disciplines (eg, cardiology) was rated as highly adequate, and the areas as highly relevant. For ten of 15 non-internal medicine areas (eg, ear, nose, and throat), mean relevance scores significantly exceeded adequacy scores, suggesting training underemphasis. Mean relevance scores also significantly exceeded adequacy scores for seven of 11 basic knowledge/skill areas (eg, patient interviewing) and 13 of 14 areas related to clinical practice (eg, quality assurance). We conclude that the vast majority of graduates of the University of California, San Francisco, primary care residency program became general internists and that, rather than feeling deficient in training in hospital-based medicine, graduates reported unmet needs for ambulatory-care experiences and skills related to general internal medicine practice. PMID- 3625949 TI - Changes in antimicrobial resistance of Salmonella isolated from humans in the United States. AB - Changes were examined that occurred in the antimicrobial susceptibility between 1979-1980 and 1984-1985 of Salmonella organisms isolated from humans who resided in a random sample of counties in the United States. Resistance to one or more antimicrobials rose significantly from 16% (82 of 511 isolates) in 1979-1980 to 24% (117 of 485 isolates) in 1984-1985. In addition, statistically significant increases occurred in the proportion of organisms resistant to only one antimicrobial (from 4% to 9%), the rate of resistance of Salmonella typhimurium (from 14% to 26%), and the rate of resistance to tetracycline. For one commonly occurring serotype, Salmonella heidelberg, the proportion of resistant strains fell significantly from 67% in 1979-1980 to 35% in 1984-1985. When epidemiologic characteristics of patients were examined, previous use of antimicrobials for treatment of other illnesses was a significant risk factor for acquiring clinically important infections with antimicrobial-resistant Salmonella. Changes detected in the antimicrobial resistance of Salmonella during this time will ultimately affect the efficacy of antimicrobial therapy in treating human disease. PMID- 3625950 TI - Social barriers faced by adolescent parents and their children. AB - Pregnancy and childbearing are well recognized as having significant, long-term consequences for teenagers. Recent literature documents an array of negative outcomes for children born to adolescents, with a range of factors identified as contributing to the problems observed in these children. These include (1) the characteristics of those teenagers most likely to become parents, (2) the social and economic consequences of early childbearing, (3) the increased biologic vulnerability of children born to teenagers, and (4) the nature of parenting by teenagers. It has been acknowledged that adolescent parents tend to come from high-risk families, have poor academic achievement, and live in our most disadvantaged communities and therefore, biologic, economic, and behavioral factors contribute to the increased likelihood of teenagers having children who are vulnerable to physical and developmental problems. Teenaged parents face many obstacles to economic and social success, and these further influence the environment in which their children grow up. Adolescents also experience many difficulties in adjusting to parenthood and display a range of suboptimal parenting practices. Whereas some of these factors appear highly resistant to change, others have clear clinical, programmatic, and policy implications. PMID- 3625951 TI - Severe toxic reactions and death following the ingestion of diethyltoluamide containing insect repellents. AB - N,N-diethyl-m-toluamide (DEET) is the most commonly used mosquito repellent. This report describes five cases of toxic reactions after ingestion of insect repellents containing DEET. Each patient ingested large amounts of concentrated (47.5% to 95%) products. Their common symptoms and signs were coma, seizures, and hypotension occurring within one hour of ingestion. Two patients died; three survivors had no sequelae. The two patients who died had serum DEET levels of 0.88 mmol/L (16.8 mg/dL) and 1.25 mmol/L (24 mg/dL). It is concluded that the ingestion of DEET can produce severe toxic reactions of rapid onset that may be fatal in some instances. PMID- 3625952 TI - Low prevalence of postural hypotension among community-dwelling elderly. AB - Postural hypotension (PH) has a prevalence of about 20% in most large studies of elderly individuals; however, these studies do not exclude subjects with diseases and medications known to cause PH. We sought to determine the prevalence of PH in healthy, community-living, elderly individuals in contrast to those with known risk factors for the condition. We measured supine and one-minute standing blood pressures in 300 independently living elderly persons who visited a senior citizen health screening program. Subjects were divided into two groups: those with known risk factors (n = 175) and those without (n = 125). The prevalence of PH (systolic decrease, greater than or equal to 20 mm Hg) for for the entire population was 10.7%. In the group with risk factors, the prevalence was 13.7% (24/175), compared with 6.4% in the group without risk factors (8/125). Supine hypertension was associated with PH, but there was no relationship between the presence of PH and age, history of falls, symptoms on standing, or recent meal. These data suggest that PH is a relatively uncommon finding in healthy elderly, its prevalence is significantly related to risk factors, and its association with falls or symptoms may be less than previously reported. PMID- 3625954 TI - Certification: another step for geriatric medicine. PMID- 3625953 TI - Acute, diffuse, nontender edema of the left breast in a 50-year-old woman. PMID- 3625956 TI - Alcohol and athletics don't mix--can the players now learn to say 'nix'? PMID- 3625955 TI - The American Medical Association's program on human immunodeficiency virus infection and acquired immunodeficiency syndrome. PMID- 3625957 TI - Hormone replacement: gynecologists consider the heart of the matter. PMID- 3625958 TI - Will epidemiology answer the estrogen question? PMID- 3625959 TI - Leads from the MMWR. Tuberculosis among Hispanics--United States, 1985. PMID- 3625960 TI - Leads from the MMWR. Pregnant Adolescent Group for Education and Support- Illinois. PMID- 3625961 TI - Leads from the MMWR. Survey of chronic disease activities in state and territorial health agencies. PMID- 3625962 TI - Leads from the MMWR. Cryptosporidiosis--New Mexico, 1986. PMID- 3625963 TI - Physician suicide. PMID- 3625965 TI - Anabolic steroids and sports. PMID- 3625964 TI - Caribbean sponge-related Pseudomonas folliculitis. PMID- 3625966 TI - Cholesterol and mortality. PMID- 3625967 TI - Combined screening: blood pressure and cholesterol. PMID- 3625968 TI - Envenomation by the Eastern coral snake (Micrurus fulvius fulvius). A study of 39 victims. AB - We gathered data on 39 victims of Eastern coral snake bite over a 12-year period. The most common situation resulting in snakebite was erroneous identification of the snake as the nonpoisonous scarlet king snake. While no patient died, several experienced severe envenomation, including bulbospinal respiratory paralysis. We found that neurologic symptoms may be delayed for 12 hours, and then may be precipitous. Envenomation occurs in 75% of the persons bitten by a coral snake. Antivenin is effective and should be intravenously administered early to patients who have been bitten by a positively identified coral snake, depending on the clinical presentation. PMID- 3625969 TI - Declining prevalence of anemia among low-income children in the United States. AB - To determine the anemia trends among low-income US children, hematologic measurements obtained from children aged 6 to 60 months who were enrolled in public health programs in six states that were consistently monitored by the Centers for Disease Control Pediatric Nutrition Surveillance System were studied. Overall, the prevalence of anemia has declined steadily from 7.8% in 1975 to 2.9% in 1985. The prevalence of anemia declined significantly among children seen at preenrollment screening visits, as well as those seen at follow-up visits, suggesting a generalized improvement in childhood iron nutritional status in the United States, as well as a positive impact of public health programs. To ensure that the declining trend of anemia was not a function of a change in the population of children enrolled in the surveillance system, Tennessee nutrition surveillance records were further analyzed; these records were linked with birth records to obtain detailed socioeconomic status (SES) information. Even though the SES composition remained stable from 1975 to 1984, the prevalence of anemia has declined significantly within each SES group. These findings indicate a true decline in the prevalence of anemia among low-income children that is likely the result of improvements in childhood iron nutrition. PMID- 3625970 TI - The changing neurourologic lesion in myelodysplasia. AB - Seventy-nine newborns with myelodysplasia were followed up for 1 1/2 to six years with serial roentgenographic, neurologic, and urodynamic evaluations. Twenty-nine infants (37%) demonstrated changes in external urethral sphincter innervation during the first three years of life. Of the group who changed, 896% (25/29 infants) did so in the first year, 10% (3/29 infants) in the second year, and 4% (1/29 infants) in the third. The risk factor for change was 32%, 6%, and 2%, respectively, during each of these three years. Fifteen infants (19% of the total) experienced neurourologic deterioration while 14 infants (18%) improved. Seven newborns underwent a second neurosurgical procedure resulting in improvement in four, stabilization in two, and further deterioration in one. These findings underline the importance of early and continued neurologic and urologic surveillance in children with myelodysplasia because it is a dynamic disease process. PMID- 3625971 TI - Managing bedside glucose testing in the hospital. AB - The scope and magnitude of bedside testing by personnel without formal laboratory training have recently increased. There has been some question about the reliability of bedside test results produced by nurses, physicians, and other ward staff that are used in clinical decisions. Glucose testing is currently the most widely performed bedside test. Because of the likelihood that the use of bedside testing will increase in the future, this article discusses various issues concerning bedside glucose analysis, including the scope of such testing, staff responsibilities, training and supervision, testing frequency, work flow and result reporting, and the reliability of bedside glucose results, in three institutions. We also suggest an approach to bedside testing quality management. PMID- 3625972 TI - Iron deficiency anemia: have we come far enough? PMID- 3625973 TI - Letting a hundred flowers blossom. PMID- 3625974 TI - Is Institute of Medicine the agency to lead science's attack on AIDS? PMID- 3625975 TI - Neutrons show promise in treating some sarcomas, adenocarcinomas, locally advanced prostate cancers; research continues. PMID- 3625976 TI - JAMA student body: high school to postdoctoral. PMID- 3625977 TI - 1987 Lasker Award recipients announced. PMID- 3625978 TI - Leads from the MMWR. Premature mortality due to suicide and homicide--United States, 1984. PMID- 3625979 TI - Leads from the MMWR. Imported and indigenous dengue fever--United States, 1986. PMID- 3625980 TI - STDs, IVF, and barrier contraception. PMID- 3625981 TI - Sexual intercourse: you, me, and the microbe makes three. PMID- 3625982 TI - The AMA and the future of medicine. PMID- 3625983 TI - Intravenous labetalol in acute aortic dissection. PMID- 3625984 TI - Carcinogenicity of ethylene oxide. PMID- 3625986 TI - The glove compartment is an oven, not a medicine cabinet. PMID- 3625985 TI - Reflux esophagitis and the water bed. PMID- 3625987 TI - Cardiovascular morbidity in relation to change in blood pressure and serum cholesterol levels in treated hypertension. Results from the primary prevention trial in Goteborg, Sweden. AB - The relationship of cardiovascular disease (CVD) to the control of blood pressure (BP) and serum cholesterol levels was studied in 686 treated, middle-aged hypertensive men whose condition was followed up for 12 years. Both mean in-study BP (P less than .001) and serum cholesterol levels (P less than .001) were better predictors for CVD than the respective entry levels (both not significant) in multivariate analysis. Surprisingly, for mean in-study systolic and diastolic BP there seemed to be a level (approximately 150 and 85 mm Hg, respectively) below which further reduction of BP had no additional benefit from treatment. Analyses of CVD morbidity in relationship to changes in BP and serum cholesterol levels clearly showed that a combined reduction of both risk factors was necessary to achieve a substantial reduction in morbidity. These study findings indicate that (1) it may be unfavorable to reduce BP below a certain level in middle-aged hypertensive men; and (2) other risk factor interventions must be improved to improve the patient's prognosis. PMID- 3625988 TI - Senile dementia of the Binswanger type. A vascular form of dementia in the elderly. AB - Computed tomography and magnetic resonance imaging in the elderly have demonstrated the common occurrence of deep white-matter lesions in the aging brain. These radiologic lesions (leukoaraiosis) may represent an early marker of dementia. At autopsy, an ischemic periventricular leukoencephalopathy (Binswanger's disease) has been found in most cases. The clinical spectrum of Binswanger's disease appears to range from asymptomatic radiologic lesions to dementia with focal deficits, frontal signs, pseudobulbar palsy, gait difficulties, and urinary incontinence. The name senile dementia of the Binswanger type (SDBT) is proposed for this poorly recognized, vascular form of subcortical dementia. The SDBT probably results from cortical disconnection most likely caused by hypoperfusion. In contrast, multi-infarct dementia is correlated with multiple large and small strokes that cause a loss of over 50 to 100 mL of brain volume. The periventricular white matter is a watershed area irrigated by long, penetrating medullary arteries. Risk factors for SDBT are small-artery diseases, such as hypertension and amyloid angiopathy, impaired autoregulation of cerebral blood flow in the elderly, and periventricular hypoperfusion due to cardiac failure, arrhythmias, and hypotension. The SDBT may be a potentially preventable and treatable form of dementia. PMID- 3625989 TI - Delirium (acute confusional states). AB - Delirium (acute confusional states), a common and often overlooked psychiatric disorder, can occur at any age, but elderly persons are especially prone to develop it. In later life, it is often a conspicuous feature of systemic or cerebral disease and drug (notably anticholinergic) toxicity, and it may constitute a grave prognostic sign. Its development in a hospitalized patient may interfere with his or her management, disrupt ward routine, and cause medicolegal complications as a result of patient injury. Acute onset of a fluctuating level of awareness, accompanied by sleep-wake cycle disruption, lethargy or agitation, and nocturnal worsening of symptoms, are diagnostic. Early recognition of delirium and treatment of its underlying cause are essential. PMID- 3625991 TI - JAMA's newest international flavor. PMID- 3625990 TI - Cutaneous myiasis of the eyelid due to Cuterebra larva. PMID- 3625992 TI - JAMA, India. PMID- 3625993 TI - Variety of organizations scrutinize tobacco. PMID- 3625994 TI - Dipyridamole-thallium scanning in patients undergoing vascular surgery. PMID- 3625996 TI - Alcohol abuse in medical school. PMID- 3625995 TI - Brain death. PMID- 3625997 TI - 'Blood doping'. PMID- 3625998 TI - Foreign medical graduates in the United States. PMID- 3626000 TI - Defensive medicine. PMID- 3625999 TI - Contact lens care in the Third World. PMID- 3626001 TI - Fibrinogen and risk of cardiovascular disease. The Framingham Study. AB - During the tenth biennial examination of the Framingham Study, 1315 participants who were free of cardiovascular disease had fibrinogen levels measured. During the ensuing 12 years, cardiovascular disease developed in 165 men and 147 women. For both sexes, the risk of cardiovascular disease was correlated positively to antecedent fibrinogen values higher than the 1.3 to 7.0 g/L (126 to 696 mg/dL) range. The magnitude of the risk diminished with advancing age in women but not in men. Risk for coronary heart disease also was significantly related to fibrinogen level. Here, the magnitude of risk displayed diminishing impact with age, again only in women. Risk of stroke increased progressively with fibrinogen level in men but not in women. The impact of fibrinogen value, considered as a separate variable, on cardiovascular disease was comparable with the major risk factors, such as blood pressure, hematocrit, adiposity, cigarette smoking, and diabetes. Fibrinogen values were also significantly related to these risk factors. Taking all these into account in a multivariate analysis, fibrinogen level was still significantly related to the incidence of cardiovascular disease in men and marginally significant in women. For coronary heart disease, the fibrinogen level was significant for both men and women. Elevated fibrinogen level is a predictor of cardiovascular disease that should be added to the cardiovascular risk factor profile. PMID- 3626002 TI - The medical and psychosocial impact of comprehensive care on adolescent pregnancy and parenthood. AB - To assess the medical and psychosocial effects of services provided by a comprehensive adolescent pregnancy and parenthood program, 125 adolescents who received care from a comprehensive program were compared with 135 adolescents who received care from community health providers. Few differences were found in pregnancy outcome measures. At 12 and 26 months after delivery, however, the intervention group scored significantly better on composite measures encompassing medical, psychosocial, and parenting events than did the comparison group, even after accounting for possible confounding factors. This suggests that comprehensive care has little effect on pregnancy outcomes for those adolescents who are already receiving prenatal and nutritional services, but does have a significant effect on events occurring during the first and second postpartum years. PMID- 3626003 TI - Generic drugs and the prescribing physician. AB - While generic substitution is not a new phenomenon, a number of factors have combined to markedly increase generic drug use. The most important factor is a 1984 law, the Drug Price Competition and Patent Term Restoration Act, which facilitates the entry into the marketplace of generic versions of brand name drugs. This law and Food and Drug Administration (FDA) policies are designed to approve for marketing generic drug products that are therapeutically equivalent to their brand name counterparts. With increased availability of generic drugs, physicians have expressed the need for more information about the FDA process for determining that generic versions of brand name drug products are both safe and effective and that generic drug products will produce the same therapeutic results as those achieved by the brand name products. This article describes FDA procedures for approving generic drug products and examines issues important to the prescribing physician, in particular, therapeutic equivalence. The article also describes the role of the states in generic substitution and the availability of information from the FDA on the therapeutic equivalence of drug products. PMID- 3626004 TI - Consensus conference. Newborn screening for sickle cell disease and other hemoglobinopathies. PMID- 3626005 TI - An outbreak of organic dust toxic syndrome in a college fraternity. AB - An explosive outbreak of a febrile respiratory illness occurred among members of a college fraternity. The preponderant signs and symptoms were muscle aches, cough, and low-grade fever. All illnesses occurred within 1.3 to 13 hours of attendance at a party where there was a dense airborne dust from straw that had been laid on the floor. Of the 67 fraternity members who attended the party and answered a questionnaire, 55 became ill (attack rate, 82%). Risk of illness was higher for those who spent more time at the party. Duration of illness ranged from 4.5 hours to seven days. Results of serological studies did not demonstrate an allergic or viral cause for these illnesses. The clinical and epidemiologic features of this outbreak were characteristic of organic dust toxic syndrome, an acute respiratory illness caused by inhalation of molds growing on hay, silage, or other agricultural products. PMID- 3626006 TI - Increased seizure frequency with generic primidone. PMID- 3626007 TI - Organic dust toxic syndrome: animal house fever? PMID- 3626008 TI - Relationship between 24-hour arterial pressure and heart rate variation in normotensives, hypertensives and patients with Shy-Drager syndrome. AB - To investigate a relation between circadian blood pressure and heart rate variation, intra-arterial blood pressure (BP) and heart rate (HR) were recorded during 24 hours in 53 untreated essential hypertensives (EH), 8 secondary hypertensives, 10 normotensives (NT), and 3 patients with Shy-Drager syndrome. Values of systolic BP (SBP) and HR were sampled at about 10 second intervals throughout the 24-hour to calculate the coefficient of correlation between SBP and HR (rSBP-HR). A significant positive correlation was found between SBP and HR levels in each subject of EH with WHO stage I and II, along with NT (average rSBP HR = 0.59, 0.40, and 0.54 respectively, p less than 0.001). Low coefficients of correlation were found in the EH with WHO Stage III (r = 0.16) and the patients with pheochromocytoma (r = 0.05). In contrast, a significant negative correlation was found in the patients with Shy-Drager syndrome (r = -0.44, p less than 0.001). Since HR is controlled mainly by the autonomic nervous system (ANS), the results suggest that the circadian variation of SBP is also mainly controlled by the ANS in the subjects with high rSBP-HR and that of SBP controlled by the other factors in subjects with low rSBP-HR. PMID- 3626009 TI - Thromboxane A2 as an enhancing factor of coronary vasospasticity in variant angina. AB - To clarify the role of thromboxane A2 (TXA2) in evoking coronary spasm, we compared coronary arterial spasticity induced by ergonovine maleate (EM) with coronary sinus thromboxane B2 (TXB2: a stable catabolite of TXA2) in 34 patients with documented variant angina and 11 patients with chest pain syndrome (CPS). We also examined the effect of OKY-1581 (8 mg/kg, i.v.), a TXA2 synthetase inhibitor, on the coronary arterial spasticity of these patients. When blood samples were taken from coronary sinus just before EM test, all patients with variant angina exhibiting markedly augmented TXB2 levels (424 +/- 138 pg/ml), had positive EM test results, while CPS exhibiting lower TXB2 levels (223 +/- 38 pg/ml), had negative EM test. We found that the amounts of EM needed to induce coronary spasm were inversely correlated with TXB2 levels in coronary sinus. In 7 out of these 8 patients, OKY-1581 was found to attenuate the increased spasticity with reduction of coronary sinus TXB2 levels. In 3 patients, an EM rechallenge at symptomatically quiescent stage resulted in negative test with augmented TXB2 levels being markedly decreased. These findings indicate that increased TXA2 in circulating plasma is closely correlated with the hypersensitivity of coronary arteries to EM in patients with variant angina, suggesting a possible role of augmented TXA2 production in the enhancement of coronary vascular spasticity. PMID- 3626010 TI - Differentiation of myocardial ischemia and left ventricular aneurysm in the genesis of exercise-induced ST-T changes in previous anterior myocardial infarction. AB - We attempted to differentiate between myocardial ischemia and left ventricular asynergy as the underlying mechanisms of exercise-induced ST-segment elevation in patients with previous myocardial infarction (MI). Sixty patients with previous anterior MI, who underwent stress myocardial scintigraphy (SMS) and coronary angiography (CAG), which revealed a single vessel disease of the left anterior descending artery, were entered in this study. SMS and CAG were performed within 3 months of MI onset, and SMS and ECG were quantitatively analyzed. T wave changes to a complete upright position with concomitant ST-segment elevation (T dominant ST-elevation) was seen in 56% of the patients with post-MI angina pectoris (N = 16) and in 50% of those with significant redistribution in SMS (n = 20). On the other hand, ST-segment elevation without T wave reversion (ST dominant ST-elevation) was seen in 43% of patients with severe LV asynergy (akinesis and dyskinesis, n = 39) and in 50% of those with severe scintigraphic defect in delayed images (relative thallium uptake less than or equal to 40%, n = 10). When these findings were combined, T-dominant ST-elevation had sensitivity and specificity of 54% and 78%, respectively, for the diagnosis of myocardial ischemia, while the corresponding values for ST-dominant ST-elevation were 44% and 100%, for the diagnosis of severe ventricular asynergy. We conclude that the two underlying mechanisms, ischemia and asynergy, may produce different changes in ST-T shape in patients with previous myocardial infarction. PMID- 3626011 TI - Evaluation of left ventricular contractility in hypertrophic cardiomyopathy from end-systolic pressure-volume relation. AB - To evaluate myocardial contractility in hypertrophic cardiomyopathy (HC), we obtained the end-systolic pressure-volume relation (ESPVR) and the end-systolic stress-volume relation (ESSVR) by changing loading conditions with Angiotensin II. The left ventricular (LV) stress-shortening relation was also analyzed in order to assess myocardial contractility. LV end-systolic pressure, end-systolic volume, end-systolic stress, and ejection fraction were obtained at rest and during Angiotensin II infusion with simultaneous recordings of pressure and volume in 9 patients with hypertrophic cardiomyopathy and 9 normal subjects (N). The slopes of ESPVR, Emax, showed no significant difference (HC: 3.1 +/- 2.3 vs N: 2.6 +/- 1.4 mmHg/ml, ns). The slopes of ESSVR were statistically similar (HC: 5.2 +/- 2.1 vs N: 6.0 +/- 2.8 g/cm2 ml, ns). The slopes of end-systolic stress ejection fraction relation were also in the same range in both groups (HC: -0.09 +/- 0.05 vs N: -0.10 +/- 0.05, ns). From these two different analyses of LV contractility, we conclude that myocardial contractility is normal in hypertrophic cardiomyopathy and not supernormal, at both chamber and muscle levels. Considering the increased muscle mass in hypertrophic cardiomyopathy (HC: 134 +/- 46 vs N: 74 +/- 19 g/m2, p less than 0.01), the presence of increased numbers of contractile units does not result in enhanced overall chamber contractility. PMID- 3626012 TI - The isopotential body surface atrial maps in healthy children of different age groups. AB - Isopotential body surface maps during atrial excitation were examined by ten beats addition method of the P waves in 32 healthy children divided into three age groups. The moving pattern of the maxima and the minima, and the distribution of areas of positive and negative potentials in each group were similar to those of adults. Quantitative analysis of the duration and amplitude of the anterior and the left maximum, and the shift time from the former to the latter were done. In children the duration and amplitude of the anterior maximum were always larger than those of the left maximum in contrast to findings in adults where no significant difference was found in their values. The higher amplitude of the anterior maximum was found mainly in the youngest group. These parameters of the P maps were also examined in 12 cases of atrial septal defect (ASD). The amplitude and duration of the anterior maximum were larger than those of healthy children at each age group, although the P wave by the conventional ECG did not reveal signs of right atrial overload. These results suggest that the body surface maps of the P waves are useful diagnostic methods to detect atrial disorders in children. PMID- 3626013 TI - The effect of cardiac sympathetic nerve stimulation on the right ventricle in canine heart. AB - The change in coronary hemodynamics during right or left cardiac sympathetic nerve stimulation was studied in anesthetized open chest dogs. No difference in the increasing rate of mean coronary blood flow between right coronary artery (RCA) and left anterior descending coronary artery (LAD) was observed. However the increasing rate of right ventricular systolic pressure X heart rate (RVSP X HR) was greater than that of left ventricle (LV). With phentolamine injection, cardiac sympathetic nerve stimulation showed similar changes as the controls. Beta-stimulation by isoproterenol infusion did not cause different effects on the increasing rate of coronary blood flow between RCA and LAD. These results showed that cardiac sympathetic nerve stimulation increased the double product of the right ventricle (RV) more than that of the LV and the increase was not affected by phentolamine. Moreover, cardiac sympathetic nerve stimulation, either the right or the left, caused the greater effects on the RV compared to the LV mainly through beta-adrenoceptors, and that the response of the RV to increase in oxygen demand was possibly, in part, different from that of the LV. PMID- 3626014 TI - Estimation of ventricular source parameters and its load matching state in vivo. AB - Ventriculo-arterial coupling states were estimated by calculating left ventricular hydromotive pressure (Ps), source impedance (Zs) and input impedance (Zl) in 24 mongrel dogs with Fourier transforms of ventricular pressure and aortic flow immediately before and after instantaneous changes of arterial load. Calculated Ps (Psc) were compared with measured left ventricular isovolumic pressures (Psm) in various inotropic and loading states. Psc waveforms coinciding closely with those of Psm were obtained by cutting off higher frequencies within the fifth to tenth harmonics prior to the inverse Fourier transformation. The regression equation was Psc = 1.08 Psm +0.68 (r = 0.978). In control conditions, the ratio of Zs (0) / Zl (0) (function of frequency, 0 = zero Hz) was close to the ratio of ejection phase to one whole cardiac cycle, and the ratio of peak Psm to left ventricular ejection pressure was 1.85 +/- 0.25 SD. These results imply the presence of a ventriculo-arterial load matching state in control conditions. PMID- 3626015 TI - Myocardial oxygen metabolism of the right ventricle with volume loading and hypoperfusion. AB - A comparison of blood flow and myocardial O2 consumption (MVO2) in the right and the left ventricles was made in dogs whose chests had been opened. The effect of volume loading by arterio-venous and arterio-left atrial shunts, and the effect of ventricular hypoperfusion by rapid removal of blood were examined in the presence and absence of the pericardium. Blood flow per unit myocardium was greater in the left anterior descending coronary artery (LAD) than in the right coronary artery (RCA), 75 +/- 4.3 vs. 46 +/- 2.8 (mean +/- SE) ml/min per 100g, respectively. Similarly, the myocardial O2 extraction ratio (EO2) was 59 +/- 2% in the left ventricle and 43 +/- 3% in the right ventricle (p less than 0.001). The MVO2 was greater for the left than for the right ventricle, 8.0 +/- 0.6 vs. 3.5 +/- 0.3 ml O2/min per 100g. Volume loading to both ventricles by arterio venous (AV) shunt increased MVO2 of the right ventricle by augmented EO2 in addition to a rise in the coronary arterial blood flow. Decrease in aortic pressure by rapid removal of blood increased EO2 in both ventricles. The increments of EO2 were greater in the right ventricle than in the left ventricle, 54 vs. 31% (p less than 0.01). When the pericardium was closed with suture, right and left end-diastolic pressure rose, but EO2 and coronary blood flow of both ventricles did not change. We conclude that reserve capacity of myocardial O2 extraction was greater in the right ventricle than in the left ventricle. PMID- 3626016 TI - Spontaneously occurring hypertrophic cardiomyopathy in the rat. I. Pathologic features. AB - The gross anatomic and microscopic appearance of the hearts of young and adult WKY/NCrj rats was examined in comparison with that of normotensive Wistar and SHR/NCrj rats. In a substantial number of the WKY rats, the heart weight and thickness of ventricular septum were much greater than those of the Wistar and SHR rats. The ventricular septum to left ventricular free wall thickness ratio was greater than 1.3 in about one sixth of the WKY rats. In most of the hypertrophied WKY hearts, the transverse area of the left ventricular cavity was smaller in relation to the wall area than in the Wistar and SHR rat hearts, although in a few it was greater. Abnormal fiber arrangement, myocyte hypertrophy, and myocardial fibrosis were far more prominent in the hypertrophied myocardium of the WKY rats compared with the Wistar or SHR rats. Intramural arteries with marked wall thickening existed frequently in the hypertrophied and dilated hearts. Electron microscopic examination revealed marked disarrangement of bundles of myofilaments and widened Z-bands in the hypertrophied myocardium. Blood pressure was not elevated in the rats with cardiac hypertrophy. These findings show that a disease of the myocardium with the pathologic features similar to those of hypertrophic cardiomyopathy in man occurs spontaneously in rats. PMID- 3626017 TI - Factors influencing the clinical course and the long-term prognosis of patients with variant angina. AB - The purpose of this study was to clarify the factors influencing the clinical course and prognosis in variant angina. Also, the mechanism of acute myocardial infarction in variant angina is reviewed. The subjects were 110 patients with variant angina who, after the initial visit or admission, were observed for a period of at least 2 months, the average observation period being 68 +/- 49 months (range: 2 months-16 years). The incidence of acute myocardial infarction was 21.8% of these patients and 87.5% of the infarctions occurred within 1 month of the initial visit or admission. In variant angina, the average rate over 1 year was 2.2%; however, in classical angina the rate was 3.7% and in postinfarction angina 5.0%. The mortality rate was 5.5%, with death in the majority of cases occurring within 1 month, as in myocardial infarction. When treatment was stopped, spontaneous remission occurred in at least 26 of the 110 cases (23.6%). Beyond 3 months, the remission continued in 19 of these 26 cases. Seven cases had acute myocardial infarction in spite of the suppression of anginal attacks with administration of calcium antagonists. Apparently coronary spasm is the cause of anginal attacks, and the cause of acute myocardial infarction in patients with variant angina appears to be coronary thrombus formation. PMID- 3626018 TI - A clinicopathologic correlation study of thallium-201 myocardial scintigraphy in diagnosis of myocardial infarction. AB - In a series of 1,000 consecutive autopsy cases, we evaluated the clinical utility of thallium-201 (Tl-201) myocardial scintigraphy and electrocardiography (ECG) in 101 patients who had been studied while alive. Fifty-five cases had myocardial infarctions (MI) at autopsy. The Tl-201 scintigram and ECG in diagnosis of MI showed sensitivities of 68% and 60%, specificities of 87% and 83%, and diagnostic accuracies of 76% and 70%, respectively. The sensitivity of the Tl-201 scintigram was 70% in anterior MI, 80% in postero-inferior MI, 25% in lateral and subendocardial infarction. The sensitivity was 88% for large massive MI, but was low in scattered (50%) or middle-sized MI (17%). The diagnostic limit of the resolution of Tl-201 scintigrams was 4.5 cm in long diameter. All 8 cases with MI of less than 4 cm could not be diagnosed with the technique. There were 48 cases of large MI (more than 5 cm), but 8 cases could not be diagnosed by scintigraphy because of non-transmural or scattered MI. A comparison of the Tl-201 scintigram and ECG showed that 27 cases out of 60 cases were diagnosed by both methods, 14 only by the Tl-201 scintigram, 9 only by ECG and 10 by neither method. PMID- 3626020 TI - Alterations of ultrastructures and anionic sites in basement membranes of myocardial cells and capillaries in patients with cyanotic congenital heart disease due to tetralogy of Fallot. AB - Electron microscopic cytochemical studies of the basement membranes of myocardial cells and capillaries were performed in 13 patients with tetralogy of Fallot who were divided into 2 groups. Group 1 included 7 patients in the early stage of the disease, ranging in age from 7 months to 5 years. Group 2 consisted of 6 patients in the far advanced stage of the disease, ranging in age from 30 to 46 years. The operatively excised infundibular muscles of the right ventricle were prepared for conventional electron microscopy and electron microscopic cytochemistry. The anionic sites in the basement membranes were characterized by cationic polyethyleneimine. The basement membrane ultrastructures of the myocardial cells and capillaries in the early stage of tetralogy of Fallot showed no apparent alterations with regular distribution of anionic sites, particularly in the external lamina of the basement membranes. In contrast, irregular thickening, wide splitting and lamination of the basement membranes of myocardial cells and capillaries, always associated with derangement and focal loss of anionic sites in the membranes were consistently observed in the far advanced stage of tetralogy of Fallot. The aforementioned results suggest that altered surface membrane integrity of myocardial cells and capillaries resulting from pathologic changes of the basement membranes are an important pathogenetic mechanism responsible for progressive degeneration of infundibular muscle cells and myocardial dysfunction in the course of tetralogy of Fallot. PMID- 3626019 TI - Study on congenital complete heart block in children by 24-hour ambulatory electrocardiographic monitoring. AB - Ambulatory electrocardiographic monitoring was performed in 18 children with a congenital complete heart block (CCHB). They had no cardiac structural anomalies. These patients could be divided into 3 groups according to the pattern of fluctuations in beat-to-beat ventricular rates. Type 1 patients showed rapid and transient fluctuations and demonstrated a high correlation between atrial and ventricular rates. Type 3 patients showed a constant ventricular rate and little variation through the 24 hour period and there was no appreciable correlation between atrial and ventricular rates. Twelve of 18 patients had additional arrhythmias. A few sporadic ventricular premature contractions (VPCs) were found in 9 patients, and bigeminy of VPCs or ventricular tachycardias were seen in 2 patients during exercise. Frequent and sudden prolongation of RR intervals was found during sleep in 3 patients. The longest intervals of ventricular asystoles were 7.2, 3.2 and 3.2 sec, respectively. The mechanism of this phenomenon appeared to be not only an exit block, but also arrest or a lack of automaticity of a subsidiary pacemaker. One of these patients developed frequent Stokes-Adams attacks. Type 3 patients with sudden prolongation of RR intervals and/or frequent ventricular arrhythmias should be under careful observation. Ambulatory electrocardiographic monitoring is recommended for children with CCHB for evaluation of potential risk factors for Stokes-Adams attacks. PMID- 3626021 TI - Hemodynamic characteristics of echocardiographic findings in hypertensive patients with negative U waves and effect of an antihypertensive drug, tripamide. AB - Twenty-four hypertensive patients were divided into a group A with negative U waves (n = 8, mean age, 50 +/- 11 years) and a group B without negative U waves (n = 16, mean age, 49 +/- 11 years). Echocardiographic findings were compared with a group of 20 age-matched normotensive subjects without cardiovascular disease (mean age, 49 +/- 11 years). In addition, the effects of the antihypertensive agent tripamide were assessed in groups A and B. Although hemodynamic parameters such as left ventricular end-systolic and diastolic dimensions, stroke volume and cardiac output were elevated in group A, group B showed an increase in total peripheral resistance. Thus, group A was characterized by high cardiac output, while group B displayed increased peripheral resistance. Tripamide was administered to 14 patients. In group A (6 patients receiving tripamide), left ventricular end-systolic and end-diastolic dimensions were significantly reduced by tripamide along with stroke volume and cardiac output. However, in group B the only significant change in hemodynamic parameters after tripamide administration was a drop in total peripheral resistance. These findings suggest that both the hemodynamics of hypertensive patients and responses to tripamide vary with the presence of negative U waves. PMID- 3626022 TI - Impaired coronary vasodilatory capacity after dipyridamole administration in hypertrophic cardiomyopathy. AB - To investigate mechanisms for a reduced coronary vasodilatory capacity in patients with hypertrophic cardiomyopathy (HCM), maximum coronary blood flow and minimum coronary vascular resistance were measured by administering dipyridamole (0.56 mg/kg) to 19 patients with non-obstructive HCM and to 7 control subjects. The maximum coronary blood flow was significantly lower (131 +/- 46 vs 192 +/- 41 ml/100 g . min, p less than 0.01, mean +/- SD) and the minimum coronary vascular resistance was significantly higher (0.64 +/- 0.23 vs 0.44 +/- 0.13 mmHg/ml/100 g . min, p less than 0.05) in HCM patients. There were no significant correlations between maximum coronary blood flow or minimum coronary vascular resistance and the baseline left ventricular end-diastolic pressure or the severity of systolic narrowing of the left anterior descending artery of the septal perforator. In contrast, the minimum coronary vascular resistance was correlated significantly with the left ventricular muscle mass (r = 0.55, p less than 0.05), but its correlation to small coronary vessel disease could not be studied. In addition, HCM patients with a reduced exercise tolerance (less than 7 metabolic units) demonstrated a significantly lower maximum coronary blood flow and higher minimum coronary vascular resistance than control subjects. These findings suggest that: (1) there is a group of HCM patients who have a reduced coronary vasodilatory capacity, (2) abnormal coronary vasculature is a possible underlining mechanism of HCM, either due to inadequate growth unassociated with left ventricular hypertrophy or as small coronary vessel disease, and (3) a reduced coronary vasodilatory capacity. PMID- 3626023 TI - Effects of the rise in aortic pressure on coronary flow reserve in dogs. Comparison between constriction of the descending thoracic aorta and injection of methoxamine. AB - In order to investigate the effect of a rise in aortic pressure on coronary flow reserve and also on the difference of its effect according to the methods used to raise aortic pressure, this experiment was performed. Using 7 anesthetized dogs with heart rate held constant by a pacemaker, both the resting and the peak reactive hyperemic left circumflex coronary flow were measured following raising of the aortic pressure by either descending thoracic aorta constriction or methoxamine injection. The resting and peak reactive hyperemic coronary flows both increased linearly following the rise in aortic pressure. The magnitude of the resting flow increment and the resting coronary vascular resistance following raising aortic pressure did not differ significantly between the two different methods. However, the magnitude of the peak hyperemic flow increment and the peak hyperemic coronary vascular resistance following raising aortic pressure were significantly smaller with methoxamine injection than with aortic constriction. These data indicate that coronary flow reserve increases proportionally with a rise in aortic pressure. However, the magnitude of the increment of coronary flow reserve is smaller following an alpha-adrenoceptor-mediated rise in aortic pressure, because the maximal coronary vasodilation was reduced by alpha stimulated coronary vasoconstriction. PMID- 3626024 TI - Effects of calmodulin antagonists on norepinephrine release and vascular responsiveness in rat mesenteric vasculature. AB - This study was designed to investigate the role of calmodulin in adrenergic neurotransmission of resistance vessels. The effects of various calmodulin antagonists (trifluoperazine, W-7, calmidazolium, chlorpromazine, fluphenazine) on the vascular responsiveness and norepinephrine overflow from adrenergic nerve endings were examined in perfused rat mesenteric vasculature preparations. Pressor responses to electrical nerve stimulation or exogenous norepinephrine were inhibited dose-dependently by each calmodulin antagonist. Norepinephrine overflow from the sympathetic nerve endings during electrical nerve stimulation was also suppressed by calmodulin antagonists. These results indicate that calmodulin antagonists affected both pre- and post-synaptic sites of adrenergic neurotransmission, suggesting that calmodulin is involved both in neurosecretion and vascular smooth muscle contractions in peripheral resistance vessels. PMID- 3626025 TI - Effects of nicardipine on the systemic and renal hemodynamics in acutely elevated blood pressure induced by vasoactive agents in conscious rabbits. AB - The effects of the calcium antagonist, nicardipine, on blood pressure and renal hemodynamics were examined in rabbits with norepinephrine- and angiotensin II induced elevation of blood pressure. With norepinephrine-infusion, the mean arterial pressure increased from 84 +/- 4 to 118 +/- 4 mmHg accompanied by decreases in heart rate (10%) and renal blood flow (45%). In contrast to the changes in renal blood flow with norepinephrine-infusion, renal blood flow following angiotensin II-induced elevation of blood pressure was decreased by more than 60% at the same degree of elevation of mean arterial pressure. Both intravenous and intrarenal administration of nicardipine (1 microgram/kg) reduced the mean arterial pressure and restored the decreased heart rate and renal blood flow in both norepinephrine- and angiotensin II-infused animals. Intrarenal injection of nicardipine decreased the elevated mean arterial pressure of angiotensin II-induced hypertension more than did intravenous injection (16 +/- 2 vs. 11 +/- 3 mmHg, p less than 0.05). Renal nerve denervation did not lead to any significant effects on the mean arterial pressure, heart rate and renal blood flow following intravenous or intrarenal injection of nicardipine in norepinephrine-infused animals. On the other hand, in angiotensin II-induced elevation of blood pressure, the potentiated hypotensive effect of intrarenal injection of nicardipine was lost in renally denervated animals. In conclusion, the calcium antagonist, nicardipine, was shown to reduce the acutely elevated blood pressure caused by norepinephrine or angiotensin II. In angiotensin II induced elevation of blood pressure, the renal vasculature may play a more important role in both pressor and depressor aspects in the regulation of blood pressure as compared to its role in norepinephrine-induced hypertension. PMID- 3626026 TI - A case showing a rare evolution from hypertrophic obstructive cardiomyopathy to "dilated" cardiomyopathy demonstrated by echocardiography. AB - A 20-year-old woman whose echocardiograms showed a rare evolution from hypertrophic cardiomyopathy (initially with obstruction and 4 years later without obstruction) to dilated cardiomyopathy over an 8-year observation period is described. PMID- 3626027 TI - Myocardial infarction in Graves' disease without coronary artery disease. AB - A 45-year-old female without coronary risk factors showed a 20 kg decrease in body weight, hyperhydrosis, palpitations and dyspnea on exertion for 2 months, and nocturnal dyspnea for 1 month before admission. She did not notice chest pain indicative myocardial infarction or fever suggestive myocarditis. Graves' disease was confirmed by exophthalmos and elevated titers of T3 and T4 thyroid hormones. Cardiac catheterization studies demonstrated no significant coronary artery disease but showed akinesis of the anteroseptal and apical walls which suggested myocardial infarction. Thyroid hormone may directly influence myocardial oxygen supply and demand and, by some unknown mechanism, cause a critical imbalance in coronary circulation resulting in myocardial infarction. PMID- 3626028 TI - Supravalvular and valvular aortic stenosis in homozygous familial hypercholesterolemia. AB - Premature atherosclerosis with a particular predilection to the coronary arteries is a well-known complication of homozygous familial hypercholesterolemia. However, well documented involvement of the aortic root and valve with aortic stenosis has not been recognized frequently antemortem. Clinical, echocardiographic, hemodynamic and angiographic features of a case with valvular and supravalvular aortic stenosis secondary to homozygous familial hypercholesterolemia are described. Surgical relief of the left ventricular outflow obstruction was not attempted because of the patient's refusal. PMID- 3626029 TI - [The criteria of radiotherapy for treating carcinoma of the esophagus]. AB - The criteria of radiation therapy is given for the treatment of a carcinoma of the esophagus, said criteria decided by a committee of the Japanese Association for Radiotherapy Systems at the request of the Japan Radiological Society. The indication for radiation therapy is described and adapted to the new TNM Classification, based on the depth of the invasion of the tumor. The depth of the tumor invasion is divided into 4 stages and the radiological images for each are shown. To evaluate the effect of radiotherapy, cases are divided into curable and non-curable groups, according to the degree of changes of the radiological findings after irradiation, and each group is further subdivided into absolute and relative categories. PMID- 3626030 TI - [Necessary radiological items for radiation therapy of esophageal cancer]. AB - Necessary items for radiation therapy of an esophageal cancer are discussed in detail. These radiological items can be dissolved through the radiological findings by use of the fine double contrast method of treating the esophagus. One method is to dissolve the infiltrative depth of the esophageal cancer; the other is the radiological diagnostic method to dissolve the effect of the radiation therapy on the esophageal cancer. In fact, regarding the former, the classification of the X-ray type is essential and depends upon the infiltrative depth of the cancer and, for the latter, the radiological findings before and after irradiation must be compared. PMID- 3626031 TI - [Alternation of the cellular immunity of patients with head and neck carcinomas under chemotherapy]. AB - In 20 cases of head and neck carcinomas, we have studied the immunological alternation by combined chemotherapy with Cisplatin, Vincristine, and Peplomycin (COP therapy). After COP therapy, the number of peripheral lymphocytes decreased, but the OKT4/8 ratio, the PHA-blastogenesis and the positive rate of skin tests increased. The cellular immunity was distinctly augmented by COP therapy. When compared with results from radiation therapy and operation. This augmentation was suspected to have been caused by the suppressive change of the suppressor T cells. PMID- 3626032 TI - [Clinico-pathological study of atypical adenomas of the thyroid]. AB - A total of five cases of atypical adenomas of the thyroid were clinicopathologically examined to clarify their malignant potential and incidence. These adenomas showed both structural and cellular atypia when compared with follicular adenoma of the usual type, A follow-up study after surgery revealed neither metastasis nor postoperative recurrence. Therefore it has been concluded that an atypical adenoma of the thyroid can be regarded as a benign neoplasm. PMID- 3626033 TI - [The integrated score of prognostic factors with regard to the recurrence of cervical carcinoma]. AB - Eighty-nine patients with carcinoma of the cervix received radical radiation therapy from May 1981 through 1983 at the hospital of the National Institute of Radiological Sciences. After a 2 to 4 year follow-up, primary cancer was found to be controlled in 59 patients, a recurrence was noted in 16 patients but 12 patients had died without precise information concerning recurrence. We examined the correlation between recurrence and seven prognostic factors. Among these factors, the tumor volume, age, and the red blood corpuscle sedimentation rate showed a relatively strong correlation. A multivariable analysis (quantification methods II) was undertaken in order to integrate these prognostic factors and the score that was calculated from this analysis showed a strong correlation to local control. We believe that this score can be used for predicting recurrences and can be applied to the selection of patients for new treatments like hyperthermia or high LET irradiation. PMID- 3626036 TI - [A case report of angiosarcoma of the breast]. AB - The patient was a 24-year-old female, and had received 7-40 mg of prednisolone per day from the age of 19 because of SLE. The tumor occupied almost the entire right breast with a blue-red discoloration of the skin. Histological examination of the tumor disclosed angiosarcoma and a standard radical mastectomy was performed. No metastasis was seen in the regional lymph nodes. The patient received adjuvant chemotherapy with actinomycin D and remained well 26 months after the operation. PMID- 3626035 TI - [A case of extraorbital sebaceous carcinoma]. AB - A case of sebaceous carcinoma of the forehead of a 77-year-old male is reported and discussed and included in a review of all such cases reported in Japan. The patient had a round erosion on the right forehead that had caused itching for 15 months. An excisional biopsy of that lesion disclosed a malignancy and a subsequent wide excision was performed. The tumor recurred several times after excision and partially effective radiation therapy. The patient finally died of aspiration pneumonia 3 years after the first operation. An autopsy revealed that he had a recurrent sebaceous carcinoma extending to the periosteum of the right temporal bone and a solitary pulmonary metastasis. PMID- 3626034 TI - [Organ specificity and common factors in latent tumors]. AB - Materials displaying latent tumors were obtained from autopsy cases and from surgically removed organs at our hospital during the past 20 years. Organ specificity and the common factors of these latent tumors indicated the following: a high incidence of latent tumors was found in the small organs and/or endocrine organs (prostate, thyroid, pancreas). In addition, it was found that these tumorous organs are of sufficient interest for clinicopathologic study (stomach, esophagus). Latent tumors show an increasing tendency to manifestation at an advanced age. Further, shade of difference between females and males has been noted in comparing clinically manifested tumors. Also latent tumors occasionally coexist with multiple primary neoplasms in the same and indifferent organs. The histological characteristics of latent tumors is frequently associated with thickened capsules and fibrosis. It has been speculated that the appearances of a reaction are local autoimmune mechanisms and the hosts suppressive effects against the proliferation of tumors. The biological behaviour of latent and clinical tumors should be considered different. PMID- 3626037 TI - [Gastric carcinoma with prominent reactive lymphoid hyperplasia; report of two cases with an immunohistological study]. AB - An immunohistological study using a Leu 7 antibody, which is a marker for human NK and K cells, was carried out in two cases of gastric carcinomas with prominent reactive hyperplasia. The patients were a 72-year-old man and a 55-year-old man who had shown good postoperative courses in spite of the advanced stage of their tumors. There were many scattered Leu 7 positive cells in the lymphoid hyperplasia, predominantly in the germinal centers and the peri-follicles. The number of Leu 7 positive cells were even more pronounced in a patient whose condition was more advanced. These findings suggest that lymphoid hyperplasia, particularly with regard to the NK and K cell response, plays a significant role in the clinical benignity of the tumors. PMID- 3626038 TI - [Synchronous early double cancers of the stomach and gallbladder]. AB - Presented is a case of a 76-year-old male who had a double cancer, in the stomach and the gall bladder. The gastric tumor was found to be a IIc early cancer that showed invasion into the submucosa, and was, histologically, tubular adenocarcinoma. The carcinoma of the gall bladder was limited to the mucosal layer, and was, histologically a papillary adenocarcinoma. Partial gastrectomy and cholecystectomy were performed. In a review of the literature in Japan, synchronous double cancer, an early gastric cancer and an early carcinoma of the gall bladder, is very rare and 3 only cases have been summarized, including this case. PMID- 3626040 TI - [A case of colonic carcinoma associated with intestinal tuberculosis, and an analysis of 26 cases reported in Japan]. AB - A case of tuberculosis and adenocarcinoma co-existing in the ileocecal region in a 61-yr-old woman is described. The Japanese literature is reviewed and several points discussed regarding the epidemiological and morphological features in a colon carcinoma associated with tuberculosis. (1) Females predominate by a ratio of 17:9 in such cases. (2) The tumor has been found in the right side of the colon in 17 out of 26 cases. (3) The most characteristic histological finding is that of the cancer, which shows a well differentiated adenocarcinoma with a tendency to produce a mucin. These unique findings are consistent with those in our case. It is of interest that these unique findings may support the possibility that the cancer originated from a tuberculous lesion. PMID- 3626039 TI - [A case of type IIa early gastric cancer complicated with multiple endocrine cell micronests in pernicious anemia]. AB - The patient, a 5-year-old male, was diagnosed as having pernicious anemia at our hospital in 1969. By means of an upper G-I series, he was found to have a gastric protruded lesion on the greater curvature of the upper corpus in 1983. After an endoscopic polypectomy, a type II a early gastric cancer was diagnosed which, histologically, showed a well-differentiated adenocarcinoma and a total gastrectomy was performed. From the histologic findings of the resected stomach, the were multiple endocrine cell micronests, that coincided with the distribution of intestinal metaplasia localized in the fundic gland area. PMID- 3626041 TI - [A case of malignant histiocytosis with paraplegia]. AB - A 66-year-old man was admitted for shortness of breath and showed fever, abdominal fullness and paraplegia. Monocytosis amounting to 25% and an elevation of serum LDH (4,281 mIu), were remarkable in the laboratory findings. He died of pulmonary insufficiency about a month after admission. On autopsy hepatomegaly (1950 g), splenomegaly (780 g), but no lymphadenopathy and small infarction in the thoracic spinal cord causing paraplegia was noted. Histopathologically, the invasion of the tumor cells into the liver, spleen, lymph nodes, bone marrow and other organs was observed. Malignant histiocytosis was diagnosed by histologic and immunohistochemical studies (lysozyme positive, S-100 protein negative). PMID- 3626042 TI - Functional domain of fibronectins, their polymorphism and genetic basis. PMID- 3626043 TI - [Cell surface phenotype in chronic lymphocytic leukemia]. PMID- 3626044 TI - [MCOP therapy of malignant lymphoma]. PMID- 3626045 TI - [Cytogenetic study of essential thrombocythemia]. PMID- 3626046 TI - [A case of Crow-Fukase syndrome associated with periodic fever and severe thrombocytopenia]. PMID- 3626047 TI - [Spontaneous regression of lymphadenopathy 89 months after the onset of disease in a patient with sinus histiocytosis with massive lymphadenopathy]. PMID- 3626049 TI - [Acute hepatitis type B complicated by hemolytic anemia]. PMID- 3626048 TI - [Changing complement sensitivity and PNH red cell population during the clinical course in a case of PNH with hypoplastic bone marrow]. PMID- 3626050 TI - [Improvement of clinical symptoms responding to radiation therapy in a case of Castleman lymphoma (plasma cell type)]. PMID- 3626051 TI - [Nonsecretory myeloma with t(14;18)(q32;21) chromosome abnormality]. PMID- 3626052 TI - [Atypical clinical course of aplastic anemia in childhood from hemopoietic dysplasia]. PMID- 3626053 TI - [Ultrastructural study of erythroblasts in the myelodysplastic syndrome]. PMID- 3626054 TI - [Erythroblasts at the ultrastructural level in cirrhotics with abnormal iron metabolism]. PMID- 3626055 TI - [The ultrastructure of erythroblasts in a case of congenital anemia with features of both beta-thalassemia and congenital dyserythropoietic anemia type I]. PMID- 3626056 TI - [Spontaneous rupture of the spleen in 2 cases of malignant lymphoma]. PMID- 3626057 TI - [Introduction of electronic endoscopy and changes in the field of endoscopy]. PMID- 3626058 TI - [Image transmission system of electronic endoscopy and the development of a miniature CCD (charge coupled device)]. PMID- 3626059 TI - [Image processing devices related to electronic endoscopy]. PMID- 3626060 TI - [Characteristics and efficacy of electronic endoscopy. a. Characteristics of the image and future problems]. PMID- 3626061 TI - [Characteristics and efficacy of electronic endoscopy. b. Magnification for the observation of ultrastructures]. PMID- 3626062 TI - [Possibility in image processing in electronic endoscopy]. PMID- 3626063 TI - [Functional characteristics and efficacy of electronic endoscopy. d. Recording of the endoscopic findings and the image filing system]. PMID- 3626064 TI - [Image processing, quantification, and analysis. a. Processing of fine features and enhancement of the image]. PMID- 3626065 TI - [Color and contrast enhancement in electronic endoscopy]. PMID- 3626066 TI - [Study of gastric functions by image analysis, with special reference to the analysis of the mucosal and submucosal blood flow]. PMID- 3626067 TI - [Comparison of electronic endoscopy and fiberscopy. a. Ease of endoscope insertion and the visible fields]. PMID- 3626068 TI - [Comparison between electronic endoscopy and fiberscopy. b. Dynamic and static images]. PMID- 3626069 TI - [Comparison between electronic endoscopy and fiberscopy. On color reproduction]. PMID- 3626070 TI - [Comparison between electronic endoscopy and fiberscopy. d. Detection of minute lesions]. PMID- 3626071 TI - [Comparison between electronic endoscopy and fiberscopy. e. Fiber video endoscopy and electronic video endoscopy]. PMID- 3626072 TI - [Pigment method in electronic endoscopy of the digestive system]. PMID- 3626073 TI - [Infrared lasers and electronic endoscopy]. PMID- 3626074 TI - [Water-loading electronic endoscopy]. PMID- 3626075 TI - [Application of electronic endoscopy to endoscopic therapeutic technics]. PMID- 3626076 TI - [Diagnosis of stomach cancer by electronic endoscopy]. PMID- 3626078 TI - [Shortcomings of electronic endoscopy. a. Endoscopy of the upper digestive tract]. PMID- 3626077 TI - [Diagnosis of ulcerative colitis by electronic endoscopy]. PMID- 3626079 TI - [Shortcomings of electronic endoscopy of the digestive system. b. The upper digestive tract]. PMID- 3626080 TI - [Shortcomings of electronic endoscopy. c. The upper digestive tract]. PMID- 3626081 TI - [Shortcomings of electronic endoscopy, with special reference to the lower digestive tract]. PMID- 3626082 TI - [Shortcomings of electronic endoscopy. e. The lower digestive tract]. PMID- 3626083 TI - [Efficacy of a TV-colonoscope using a bi-plane TV monitor]. PMID- 3626084 TI - [Comparison of various types of commercially available electronic endoscopes based on personal experiences]. PMID- 3626085 TI - [Introduction of various types of commercially available electronic endoscopes and related equipment]. PMID- 3626086 TI - [[Changes in policies related to chronic kidney failure and their future prospect]. PMID- 3626087 TI - [Hemodialysis]. PMID- 3626088 TI - [Home hemodialysis]. PMID- 3626089 TI - [Effect of diethylstilbestrol on contact sensitivity in mice: I. Effect of DES on induction of contact sensitivity by painting with picryl chloride in mice]. PMID- 3626090 TI - [Effect of diethylstilbestrol on contact sensitivity in mice. II. Effect of DES on induction of contact sensitivity by injection with TNP-cells in mice]. PMID- 3626091 TI - [Enzyme activities of cultured skin fibroblasts in Werner's syndrome]. PMID- 3626092 TI - [Autoradiography of epidermal sheet--I. The method]. PMID- 3626094 TI - Influence of stagnation of water pathways on mosquito population density in connection with malaria transmission in the Solomon Islands. AB - Malaria is the major health problem in the Solomon Islands. The area of Guadalcanal plains has been known as the most malarious area of the Solomons. In spite of well executed DDT indoor spraying, malaria transmission was not interrupted. The causative factors responsible for this persisting transmission appeared to rest on three factors: refractoriness of Anopheles farauti to DDT spraying; the habit of people to stay outside late in the evening and a marked outdoor biting tendency of A. farauti. It was found that DDT indoor spraying alone had little impact on interruption of malaria transmission. This study conducted in early 1974 was planned to observe the change of mosquito population density in relation to the constriction of the river-mouth in north Guadalcanal in order to consider alternative means for malaria control. With the result of this study, one can assume, with a reasonable degree of certainty, that the improvement of the malaria situation in north Guadalcanal would be associated with steady flow of the river water by maintaining the river/stream-mouth in an open condition. PMID- 3626093 TI - Common occurrence in Toyama of bronchial asthma induced by chironomid midges. AB - A total of 119 asthmatic children were investigated by prick tests for the hypersensitivity against chironomid antigens. The percentages of cases who showed positive prick tests to the antigens of the adults of Polypedilum kyotoense, Chironomus yoshimatsui and Tokunagayusurika akamusi, that of the larvae of Tokunagayusurika akamusi and of Dermatophagoides farinae were 23.5%, 17.6%, 7.6%, 16.0% and 94.2%, respectively. The correlations among the wheal size in prick test, the threshold dilution in the intradermal test, the RAST score, and the result of the provocation test were significant. The specific IgE antibodies against two additional midge species were measured with the Phadezyme RAST test in a total of 27 asthmatic cases who were positive to either of the 3 adult midge antigens previously tested. RAST was positive in 59.3% with Chironomus plumosus and 100% with Tanytarusus oyamai. In the RAST inhibition tests, the Polypedilum kyotoense antigen causing allergic reaction was shown to be quite independent from Dermatophagoides farinae. These results suggest that the extracts of chironomid midges have strong allergenicity, and are one of the important inhalant antigens causing asthma in Toyama. PMID- 3626095 TI - Lymphographic changes in young dogs after transplantation with adult worms of Dirofilaria immitis into the abdominal cavity. AB - Serial lymphographic studies were made in 4 dogs transplanted with adult worms of Dirofilaria immitis. Several changes of the lymphatic systems of the treated dogs such as dilatation, narrowing, tortuosity, backflow, collateral flow, leakage and lymphorrhea of lymphatics, as well as enlargement and filling defect of lymphnodes were observed at first 2 months after transplantation, comparing with the lymphograms before transplantation. Lymphographies were repeated further 4 and 7 months after transplantation. In our previous studies, the mechanism of chyluria due to human filariasis was not sufficiently explained beyond the speculation of the mechanical obstruction of lymphatic vessels by worm bodies. In the present studies, varied abnormal changes, especially back and collateral flow of the lymph vessels of popliteal and inguinal regions, could be produced in lymphatic systems in dogs by transplantation with adult worms of Dirofilaria immitis into peritoneal cavity. This fact suggests that a mechanism of filarial chyluria is due to systemic responses and changes of the lymphatics by substance of the body of filarial worms. PMID- 3626097 TI - [Clinical evaluation of esophageal ulceration in endoscopic injection sclerotherapy (EIS)]. PMID- 3626096 TI - The effect of attenuated vaccinia virus AS strain on multiple myeloma; a case report. AB - The case of a 67-year-old male with IgA multiple myeloma successfully treated with AS strain of vaccinia virus is reported. The intravenous injection of this virus strain caused a definite decrease in the levels of monoclonal IgA from 1,309 mg/dl in the early stage of the treatment to 432 mg/dl on the 96th day of the regime. NK cell activity rose from 20.0% on the 10th day to 33% on the 106th day of the treatment. No adverse effects were observed throughout the entire course of the treatment. These results strongly suggest that AS strain vaccinia virus is a most promising and safe agent for the treatment of human malignancy. The possible mechanism of the beneficial effects of this virus strain is also briefly discussed. PMID- 3626098 TI - [Changes in gastric mucosal lesions after endoscopic injection sclerotherapy (EIS)--analysis from the standpoints of gastric mucosal microcirculation and liver function]. PMID- 3626099 TI - [Autonomic nervous alterations and mast cell degranulation in the exacerbation of ulcerative colitis]. PMID- 3626100 TI - [Microangiographic study on rat colon tumors]. PMID- 3626101 TI - [Promotive effect of estrogen on hepatocarcinogenesis in rats: the effect of tamoxifen and changes in estrogen receptors]. PMID- 3626102 TI - [Experimental study of intrinsic endotoxemia in liver cirrhotic rats]. PMID- 3626103 TI - [A study on the inhibition of lymphocytes response to mitogens by bile acids]. PMID- 3626104 TI - [Applications of quantitative endotoxin assay using fluorescent probe method- special reference to endotoxin clearance]. PMID- 3626105 TI - [A case of limy bile associated with obstruction of common bile duct]. PMID- 3626106 TI - [Percutaneous microwave coagulation method for obtaining natural bile flow in malignant biliary obstruction]. PMID- 3626107 TI - [The characteristics of senile signs in the respiratory system and their early detection]. PMID- 3626108 TI - [Aging signs in the gastrointestinal tract--endoscopic diagnosis and the significance of gastric intestinal metaplasia]. PMID- 3626109 TI - [Age-related differences of fatty acid composition in serum and red blood cell phospholipids, and the relations of fatty acid composition with cell function and atherosclerosis]. PMID- 3626110 TI - [The mechanisms of bone mineral loss with aging: detection of pathological and physiological loss of bone mineral using single photon absorptiometry]. PMID- 3626111 TI - [Effects of aging on hand coordination--a quantitative analysis of ability to track moving targets]. PMID- 3626112 TI - [The effects of elementary diet for long term treatment on the serum lipids, serum apolipoproteins, blood lipoproteins, blood polyunsaturated fatty acids and blood coagulation-fibrinolysis system]. PMID- 3626113 TI - [The role of parathyroid hormone on the pathogenesis of osteoporosis in the aged females]. PMID- 3626114 TI - [Calcification of aortic arch and ischemic heart disease]. PMID- 3626115 TI - [Assessment of biological aging status]. PMID- 3626116 TI - [A public health view of seamen's wives. Role of the mother during the father's absence]. AB - The health status of 59 wives of seamen during their absence from home being on board a ship was evaluated by THI (Tokyo University Health Inventory). There was no evidence that the absence of their husbands had any undesirable effects on their health, but those who received fewer telephone calls from their absent husbands complained more frequently of subjective symptoms related to mental problems. The same tendency was observed in those who sought advice from their neighbors and others at times of trouble with their children. A qualitative analysis of communication between the wives of seamen and their husbands or other social network and evaluation of the mother-infant relationship should be conducted in the future. PMID- 3626117 TI - [Aplastic anemia and occupational factors in Japanese industries]. AB - Four mail questionnaire surveys were conducted on the incidence of aplastic anemia among industrial workers throughout Japan in collaboration with industrial doctors during a period from 1970 to 1983. The following major results were obtained. 1. Response rates were 55.5% (874/1,574 enterprises) in the first mail questionnaire survey in 1970-1972, 65.3% (294/450) in the second survey in 1973, 49.1% (170/346) in the third survey in 1976-1980, and 76.6% (242/316) in the fourth survey in 1981-1983. There was no significant difference in industrial types among the four surveys. 2. The numbers of aplastic anemia patients newly diagnosed were 145 (112 males/33 females) in the first survey, 21 (16/5) in the second survey, 51 (41/10) in the third survey and 30(24/6) in the fourth survey. Incidence rates per million were 14.7 (14.4 males/15.5 females) in the first and second survey, 14.2 (13.5/18.3) in the third survey and 9.1 (8.6/11.9) in the fourth survey. The rates were almost constant from 1970 through 1980, but the rates decreased thereafter. The rate was higher in females than in males, but the difference was not significant. 3. Incidence rates were high in rubber industry (26.8 per million), paper industry (24.8), and petroleum industry (22.5), but there was no industrial type demonstrating a constantly higher incidence in every survey. Manufacturing industries showed a higher incidence (14.6) than nonmanufacturing industries (11.7). 4. By type of work, non-productive work (67.2%), i.e., clerical (30.8%), administrative (8.9%), technical (7.7%), were the main jobs of 247 registered aplastic anemia patients (193 males and 54 females). 5. Thirty patients had been exposed to noxious agents such as organic solvents (21 cases including 3 exposed to benzene), metals (6), and radiation (1). However, in these cases no causal relationship between exposure and disease onset could be demonstrated. 6. Thirty-nine cases had a drug-intake history before onset of the disease. Drugs given included chloramphenicol (4 cases), other antibiotics (4), antituberculosis agents (8), analgesics (6), and tranquillers (4). The results obtained revealed no positive evidence that occupational factors peculiar to Japanese industries were involved in triggering aplastic anemia. PMID- 3626118 TI - [A neurophysiological study on neurotoxicity of 2,5-hexanedione. Auditory brainstem responses in rats]. AB - Conduction disturbances in the central nervous system (CNS) of rats due to 2,5 hexanedione (2,5-HD) were examined, using auditory brainstem responses (ABRs). Ten male rats (Jcl-Wistar) were given subcutaneous injection of 2,5-HD of 300 mg/kg/day five days a week for three weeks. For the control group, ten male rats (Jcl-Wistar) were employed. One week after the last administration, ABRs in rats were recorded at the scalp with subcutaneously inserted needle electrodes using the monopolar method under anesthesia. Intensity of the click sound stimulation was 25 dB and 60 dB over the threshold of human hearing level (25 dBHL and 60 dBHL). Mixed nerve conduction velocity of the caudal nerve (MNCVca) and somatosensory cortical evoked potentials by electrical stimulation at the forepaw and medulla oblongata (SEP and SEP-M) were simultaneously recorded. The significant findings observed in rats administered 2,5-HD in comparison with the control rats were as follows: 1) Delayed latencies of Ist, IInd, IIIrd, IVth and Vth components of 60 dBHL sound ABR and Ist, IIIrd, IVth and Vth components of 25 dBHL sound ABR; 2) Increased interpeak latencies (IPLs) between Ist and Vth components, IIIrd and Vth components, and IVth and Vth components of 25 dBHL sound ABR and between Ist and Vth components of 60 dBHL sound ABR; 3) Delayed latencies of P1 and N1 components of SEP; and 4) Decreased MNCVca. Prolongation of IPL between IVth and Vth components of 25 dBHL sound ABR was considered to be conduction disturbance of auditory afferent pathway in CNS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626119 TI - [Environmental factors in a health problem]. PMID- 3626120 TI - [Type A behavior pattern in health education]. AB - A cross-sectional study was conducted to clarify the relationship between type A behavior pattern and life styles on 669 male and 60 female workers belonging to a financing company. A self-administered questionnaire was used to collect information on type A behavior pattern (including 11 questions), medical parameters and recent well-being. Principal component analysis was made to select the three major components concerning type A behavior pattern. The first component score represented overall irritability, the second score relaxation, and the third score etiology of irritability. After these component scores were adjusted to age, the following findings were observed. Smoking habits and heavy alcohol intake showed a significant correlation with a high score in the first principal component. General feeling during the past month and fatigability were related to the first and second principal component scores, respectively. Discouragement, bad arousal, little worth of living and apathy were negatively related to the second principal component score. Total cholesterol showed a positive correlation with the second principal component score (r = 0.140, p less than 0.01) in males and obesity index had a positive correlation with the second component score (r = 0.259, p less than 0.01) in females. Other medical parameters including high density lipoprotein, systolic and diastolic blood pressure did not demonstrate any significant correlation with principal component scores. It is important that recognition of type A behavior pattern may be applied to health education programs. PMID- 3626121 TI - [Automatic segmentation and 3-dimensional display based on the knowledge of MRI images of the head]. PMID- 3626122 TI - [Non-stationary analysis of EMG activities prior to a ballistic movement]. PMID- 3626124 TI - [Simulation study of age-specific mortality rate from cancer]. PMID- 3626123 TI - [A digital control system for ventricular loading]. PMID- 3626125 TI - [Space-axis analysis of body surface ECG information]. PMID- 3626126 TI - [Development of an electronic tester for the diagnosis of the functional continuity of the injured peripheral nerve and its clinical application]. PMID- 3626127 TI - [3-dimensional computer simulation of ventricular depolarization and repolarization]. PMID- 3626128 TI - [3-D display of magnetic resonance images by use of multiplex holography]. PMID- 3626129 TI - [Effects of a low-energy laser beam on the cells of the newt embryo]. PMID- 3626130 TI - [A study on the stability of the recording speed of the Holter ECG]. PMID- 3626131 TI - [Improved algorithms of adaptive correlation averaging method and its application to ERP (event-related potential) with mental rotation]. PMID- 3626132 TI - Effects of dietary lactose and purified diet on intestinal microflora of rats. AB - In the rats fed on lactose-containing purified diet (PDL), bifidobacteria remarkably increased in number in both the jejunum and cecum as compared with those fed on control diet (PD) or conventional diet (NMF). Besides, lactobacilli, streptococci, staphylococci, and Escherichia coli increased in number in the jejuna and/or ceca of rats fed on PDL as compared with those fed on PD. The incidence and numbers of Lactobacillus species were remarkably different between the rats fed on PDL and those on any of the other diets. Indole-producing Bacteroides spp. were rarely isolated from the PDL-fed rats. The cecum was markedly enlarged in the PDL rats and reduced in the PD rats as compared with that in the NMF animals. PMID- 3626133 TI - 1H- and 13C-NMR spectroscopic study of glucose metabolism in eggs of Angiostrongylus cantonensis during their development. AB - 1H- and 13C-nuclear magnetic resonance (NMR) spectroscopy was used to study aerobic glucose metabolism in eggs of Angiostrongylus cantonensis in an NCTC-109 medium supplemented with fetal calf serum. Without any pretreatment of the spent medium, we were able to identify and quantitate, by NMR, the end-products of glucose metabolism in eggs after cultivation for 2, 4, and 8 days. We demonstrated that A. cantonensis eggs took up glucose rapidly; among the major end products were found lactic acid, acetic acid and alanine. The eggs are parasitic in a sense that the energy metabolism in them is dependent mainly upon the energy source present in outer medium. PMID- 3626134 TI - Simple and rapid staining for detection of Entamoeba cysts and other protozoans with fluorochromes. AB - Three fluorochromes were applied to stain various parasitic protozoans. By double staining with 4',6-diamidino-2-phenylindole and propidium iodide, differentiation of the nuclei from the cytoplasm can easily be achieved within several seconds. The chromatoid bodies in Entamoeba cysts were stained bright red. Plasmodium yoelii at all stages except late trophozoites and young gametocytes was easily identified. In the oocysts of Cryptosporidium sp., the nuclei and cytoplasm of the sporozoites fluoresced bluish white and red, respectively, whereas the residual body appeared blue or green. The third fluorochrome, Calcofluor white M2R, was suitable for detecting the cysts of Entamoeba spp. and Chilomastix mesnili. PMID- 3626135 TI - [Preparation of anti-human-sweat serum]. PMID- 3626136 TI - Aldehyde pararosaniline staining of acinar cells in the human sublingual and submandibular glands. PMID- 3626137 TI - [The clinical significance of the quantitative analysis of serum Gc protein- influence of inflammation and liver function]. PMID- 3626138 TI - Thin-layer and high performance liquid chromatographic analyses of organic gunshot residues. PMID- 3626139 TI - [Studies on natural antibodies to the 2,4-dinitrophenyl group (DNP) in human sera -1. Variation in reactivity with age]. PMID- 3626140 TI - [Immunogold methods for forensic medical examinations--1. Species identification of biological materials by agglutination and agglutination-inhibition tests]. PMID- 3626141 TI - Erythrocyte S-formylglutathione hydrolase polymorphism in Japanese and the relation to erythrocyte esterase D polymorphism. PMID- 3626142 TI - Effects of ethanol on the course of and the recovery from asphyxia. PMID- 3626143 TI - [Evaluation of radiation-induced hepatic injury using scintigraphic methods]. PMID- 3626144 TI - [An evaluation of shunt flow by the 133Xe clearance method and admittance plethysmography]. PMID- 3626146 TI - [Identification of the location of coronary artery narrowings by stress Tl-201 myocardial scintigraphic imaging]. PMID- 3626145 TI - [Evaluation of portal circulation by 99mTcO4-scintigraphy per-rectal]. PMID- 3626147 TI - [Analysis of pulmonary blood flow dynamics using Tc-99m red blood cells pulmonary scintigraphy]. PMID- 3626148 TI - [A case of stenosis of the internal carotid artery detected as a region of decreased blood flow by Tc-99m HMPAO cerebral blood flow scintigraphy]. PMID- 3626150 TI - [Development of Tc-99m-DTPA-HSA as a new blood pool scanning agent]. PMID- 3626149 TI - [Quantification of bone mineral density at the 3d lumbar vertebra by dual photon absorptiometry in healthy subjects]. PMID- 3626151 TI - [The eighth report on the survey of adverse reactions to radiopharmaceuticals (the 11th survey in 1985). Subcommittee on Radiopharmaceutical Safety Issues, Medical and Pharmaceutical Committee, Japan Radioisotope Association]. PMID- 3626152 TI - Current progress in diagnosis and treatment of anemia. PMID- 3626153 TI - Serum cholesterol level in normal people: association of serum cholesterol level with age and relative body weight. AB - Serum cholesterol level was studied in normal subjects in Kasakake Village. The serum cholesterol levels increased significantly with age, from the third to the fifth decade in males and from the third to the seventh decade in females. Thereafter, the levels were maintained in males while declined in females. The mean peak values (+/- SD) were 178 +/- 31 mg/100 ml in males and 207 +/- 37 mg/100 ml in females. The presumptive values of the zero-year-old obtained from the regression lines calculated from the plot of serum cholesterol values against age were 129 mg/100 ml and 112 mg/100 ml in males and females respectively. Throughout the age-range examined in females, the serum cholesterol level was well correlated with the relative body weight determined with modified Broca's method. A similar, but less obvious correlation was demonstrated in males. However, there was not comparable change in the relative body weight against the trend of the serum cholesterol level in both sexes. In the babies normally delivered with full term, the mean cholesterol level (+/- SD) in the umbilical cord blood serum was 65 +/- 13 mg/100 ml and it increased to 150 +/- 46 mg/100 ml during one to three months after birth which was very close to the presumptive values obtained from the regression lines in the adults. There also was significant correlation between the cholesterol value and the body weight. It is concluded that in normal people, age and relative body weight are major and independent determinants of serum cholesterol level from the start of their life. PMID- 3626154 TI - Incidence of atrophic gastritis with age in Japan and Canada. AB - With methylene blue dye spraying endoscopy 392 Japanese outpatients with gastric diseases, and 253 Japanese and 84 Canadian outpatients free of gross findings in the stomach were investigated on chronic atrophic gastritis in special reference to intestinal metaplasia. Second, with the same technique 176 asymptomatic healthy residents in Kyoto, Japan, were also investigated, in which 50 residents were followed for two years and 32 subjects for four years. In each population subjects, with increasing age the fundic-pyloric (F-P) border shifted cephalad indicating atrophy of the fundic mucosa. Japanese subjects, however, showed greater variation in location of the F-P border, and also greater in symptomatic outpatients than in asymptomatic healthy subjects. The reduction in fundic gland area with aging was followed by intestinal metaplasia. In addition, our follow-up study indicates that atrophic gastritis was most likely to advance gradually with increasing age, even in asymptomatic residents. PMID- 3626155 TI - Bolus methylprednisolone therapy in adult idiopathic thrombocytopenic purpura. AB - Eleven patients with adult idiopathic thrombocytopenic purpura (ITP) were treated with bolus methylprednisolone at doses of 1 g/day for 3 days. In nine of eleven patients the platelet count rose to more than 100 X 10(9)/l during 2-9 days. In two other patients, it rose to 81 X 10(9)/l and 43 X 10(9)/l. In six of eleven patients splenectomy was carried out without any platelet transfusion when the platelets rose to more than 100 X 10(9)/l after bolus mPSL therapy. Bolus mPSL therapy is efficient as a pre-treatment for a planned splenectomy in adult ITP. PMID- 3626156 TI - Dynamics of plasma lipoproteins and lipids during double filtration plasmapheresis (DEP). AB - Plasma lipids and lipoproteins obtained from different places of the circuit of double filtration plasmapheresis (DFP) were measured and effect of DFP therapy on removal of them was examined. When 2A was used as a second filter, 69.8%, 52.4%, 63.0%, 58.0%, 60.8%, 59.2% and 63.9%, respectively of beta-lipoprotein, cholesterol, triglyceride, high density lipoproteins (HDL), phospholipids, free cholesterol and lipoprotein (a) (Lp(a)) were removed from the patient's plasma. When 4A was used as a second filter, 69.0%, 56.8%, 53.2%, 45.4%, 56.0%, 50.9% and 51.7%, respectively of beta-lipoprotein, cholesterol, triglyceride, HDL, phospholipids, free cholesterol and Lp(a) were removed from the patient's plasma. In contrast, concentrations of free fatty acids (FFA) after DFP therapy using filter 4A and 2A increased to 222.8% and 256.4%, respectively. Thus, it was shown that except for FFA, DFP therapy using either 2A or 4A as a second filter is effective in reducing concentrations of plasma lipid and lipoproteins. PMID- 3626157 TI - Peptide YY-like immunoreactivity in normal colon mucosa, muscle layer and adenocarcinoma. AB - Peptide YY (PYY)-like immunoreactivity was detected in the mucosa and muscle layer of normal human colon and rectum and in well to moderately differentiated adenocarcinoma derived from the mucosa of the colon and rectum, using a sensitive and specific radioimmunoassay for PYY. The content of PYY-like immunoreactivity in the mucosa was markedly higher than those in the muscle layer and adenocarcinomatous tissue of any part of the colon and rectum. A high concentrations of PYY-like immunoreactivity was demonstrated throughout the colon mucosa (ascending colon 94.14 +/- 15.34 pmol/g, transverse colon 137.19 +/- 13.44 pmol/g, descending colon 168.89 +/- 15.63 pmol/g, and sigmoid colon 223.69 +/- 35.31 pmol/g), the highest being observed in the rectum (313.15 +/- 45.90 pmol/g). The major molecular form of PYY-like immunoreactivity both in the mucosa and muscle layer of normal human colon and rectum and in adenocarcinomatous tissue was judged by gel exclusion chromatography to be identical to pure porcine PYY. This study revealed the presence of PYY-like immunoreactivity not only in normal tissue of the colon and rectum but also in adenocarcinomas with the same elution pattern, and the mucosal concentrations of PYY-like immunoreactivity were found to be increasing distally throughout the colon and rectum. PMID- 3626158 TI - Doxapram on blunted respiratory chemosensitivity to hypoxia in hypoxemic, chronic obstructive pulmonary disease. AB - We investigated a possible effect of doxapram (a respiratory stimulant) on the peripheral chemoreceptors in man (8 control subjects, 11 bronchitics, and 4 emphysematous). In addition, we determined whether infusion of doxapram could augment blunted chemosensitivity to hypoxia or hypercapnia seen in both chronic obstructive pulmonary disease (COPD) patients and normal subjects. Doxapram infusion caused a significant increase in delta VE/delta SaO2 (p less than 0.05), as well as delta Po.1/delta SaO2 (p less than 0.05) in control subjects, although the changes in both delta VE/delta PeAco2 (where, PeAco2 = end-tidal Pco2) and delta Po.1/delta PeAco2 did not attain significant level. Control subjects with low baseline delta Po.1/delta SaO2 showed significantly larger changes in both delta Po.1/delta SaO2 and delta VE/SaO2 during doxapram infusion than the patients with chronic bronchitis (0.02 less than p less than 0.05). We conclude that doxapram increases chemosensitivity to hypoxia and slightly increase chemosensitivity to hypercapnia, indicating its primary action being stimulation of peripheral chemoreceptors, and doxapram stimulates chemoreceptors little in patients with chronic bronchitis, whereas blunted hypoxic response in normal subjects could be increased markedly. PMID- 3626159 TI - Effect of calcium supplementation on blood pressure in essential hypertensive subjects. AB - The effect of calcium supplementation on blood pressure was studied in three groups: eight normotensive subjects, 14 borderline essential hypertensive subjects, and 11 established essential hypertensive subjects (EEH). All subjects were outpatients and were given 6 g of calcium lactate (779 mg of elemental calcium) daily for 16 weeks. In EEH, systolic blood pressure was decreased significantly by 6 mmHg, but diastolic blood pressure was not decreased significantly (2 mmHg). In other groups, blood pressure was not reduced significantly. In all groups, urinary excretion of calcium was increased significantly but urinary excretion of other electrolytes, such as sodium, potassium and phosphate did not change. Serum electrolytes, various hormones, such as parathyroid hormone, 1-25(OH)2D3, 25OHD3, plasma renin activity, plasma aldosterone, plasma norepinephrine and epinephrine, and cardiac output did not change throughout this study. There were no adverse effects observed during this trial. From these results, it was concluded that daily administration of 6 g of calcium lactate produces a slight antihypertensive effect in EEH, and that this might be useful as a supplementary treatment for essential hypertension, especially in the aged. PMID- 3626160 TI - High-dose intravenous corticosteroids in the treatment of multiple sclerosis. AB - The effectiveness of high-dose intravenous corticosteroid therapy for acute bouts of multiple sclerosis (MS) was evaluated in comparison with the conventional oral prednisolone therapy. Group I comprised 11 cases of MS treated with oral prednisolone, 30-60 mg daily, and group II comprised 16 cases treated with intravenous corticosteroids; 11 cases given 1000 mg of methylprednisolone for the initial 3 days followed by 100 mg of prednisolone, while the remaining 5 were given 100 mg of prednisolone alone. The initial dosage was maintained for 1 or 2 weeks in each group, tailing off with a period of several weeks of oral prednisolone. The clinical status was evaluated using Kurtzke's expanded disability status scale (EDSS) and functional system scale before and 1, 2 and 4 weeks after the initiation of therapy. EDSS score significantly declined from week 0 (before) to weeks 1, 2 and 4 in group II, respectively, whereas no significant decline of EDSS score was observed in group I. The frequency of improvement (0.5 of an increment in EDSS score) in group II was significantly higher than that in group I at weeks 1, 2 and 4. It was thus suggested that high dose intravenous corticosteroid therapy might be more useful in acute bouts of MS, especially for obtaining an early improvement, than conventional oral prednisolone therapy. PMID- 3626161 TI - Short-term prednisolone for inducing seroconversion from hepatitis B e antigen to antibody along with clinical improvement in patients with chronic active hepatitis type B. AB - Short-term prednisolone therapy was instituted on 27 patients with chronic active hepatitis (CAH) type B, in an attempt to induce seroconversion from hepatitis B e antigen (HBeAg) to the corresponding antibody (anti-HBe). Patients with CAH received a four-week regimen of prednisolone with daily dosage tapering from 40 to 10 mg (total 700 mg). Within one year after the withdrawal of prednisolone, 19 (70%) lost HBeAg and 11 of them (41% of the total) developed anti-HBe, at rates significantly higher than 3 (12%) and 1 (4%) who spontaneously showed respective serological changes among 26 matched controls during one year (p less than 0.001). Within two years after the withdrawal, 21 (78%) lost HBeAg and 19 (70%) developed anti-HBe, in contrast to 6 (23%) and 2 (8%) of controls who showed respective changes during that period (p less than 0.001). Seroconversion to anti HBe was invariably accompanied by clinical and biochemical improvements along with loss of DNA polymerase from circulation. Elevation in transaminase levels, reflecting the rebound of steroid withdrawal, always heralded and appeared to be required for the seroconversion, but serious aggravation of hepatitis was not encountered in any of the patients. PMID- 3626162 TI - A case of myasthenia gravis associated with thymoma, multiple schwannomas and monoclonal IgA gammopathy. AB - Myasthenia gravis, malignant thymoma, multiple schwannomas and monoclonal IgA gammopathy coexisted in a 54-year-old Japanese man. Serum acetylcholine receptor antibody activity was located in the IgG fraction, but not in the paraprotein peak. It was speculated that all these disorders might fall under the spectrum of the diseases associated with thymic abnormality or that some growth factors might induce neoplasms and activation of B cell clones of autoantibodies (including acetylcholine receptor antibody) in this case. PMID- 3626163 TI - Pseudoidiopathic hypoparathyroidism: report of a case and review of the literature in Japan. AB - A case of pseudoidiopathic hypoparathyroidism is described. The patient, 47-year old male, developed numbness and muscle spasms in the extremities in July 1980. Physical and laboratory examinations revealed positive Chvostek and Trousseau's signs, hypocalcemea, mild hyperphosphatemia, normal serum magnesium, prolongation of QTc on EKG, normal reaction to Ellsworth-Howard test and high levels of serum PTH. Treatment with calcium lactate and vitamin D was successful. The literature regarding 16 cases reported in Japan was reviewed. PMID- 3626164 TI - A case of acute interstitial nephritis induced by flurbiprofen. AB - Recently, acute interstitial nephritis (AIN) presenting nephrotic syndrome and renal failure induced by nonsteroidal anti-inflammatory drug (NSAID) has been recognized with increasing frequency. We described here a 43-year-old woman who developed this type of nephropathy after taking NSAID for rheumatoid arthritis. Flurbiprofen (Froben) was assumed to be a causal drug based on a clinical course and a positive result of lymphocyte transformation test. Withdrawal of flurbiprofen therapy led no sufficient improvement, and high-dose steroid therapy done 15 months after the onset resulted in only a minor improvement. So far as we know, this was the second case of AIN associated with flurbiprofen and the youngest in NSAID-induced AIN with irreversible chronic renal insufficiency. PMID- 3626165 TI - Water intoxication due to excessive water intake: observation of initiation stage. AB - A patient who had experienced water intoxication despite normal renal function and normal urinary diluting ability was observed during the initiation stage of hyponatremia. Upon the excessive water intake (10 to 15 L) for several days, he developed moderate hyponatremia (121 mEq/L) and headache, an early symptom frequently seen in water intoxication. During this period, his urine was maximally dilute (50 to 60 mOsm/kg H2O), and his urinary sodium excretion increased. This report suggests that 10 to 15 L of water intake for several days can cause water intoxication in subjects with normal urinary diluting ability and that the increase in sodium excretion is prerequisite for the high urine flow rate. PMID- 3626166 TI - Encephalopathy due to inorganic lead exposure in an adult. AB - A 30 years old male presented with acute gastrointestinal symptoms and encephalopathy. History, investigations and the response to chelator therapy led to the diagnosis of lead poisoning. Encephalopathy in an adult resulting from industrial exposure to inorganic lead are the main features of the case. PMID- 3626167 TI - Rhabdomyolysis associated with Crohn's disease. AB - Three cases of Crohn's disease (CD) which showed an elevation of creatine phosphokinase (CPK) during the course were reported. In two cases, elevations of serum myoglobin and aldolase were also observed which indicated rhabdomyolysis. Rhabdomyolysis occurred unrelated to the activity of CD and it was asymptomatic. It was unable to identify an apparent known cause for rhabdomyolysis. All three cases were under elemental diet (ED) but the causality of ED for rhabdomyolysis was uncertain. So far as we know, there is no report on rhabdomyolysis during ED treatment and there are only two reports in which rhabdomyolysis was documented in CD. The latter was rhabdomyolysis due to electrolyte depletion secondary to malabsorption in CD which was not encountered in our cases. Our department dealt only three cases of CD and all of them had an elevation of CPK which had been measured as one of routine blood chemistry in our hospital. These observations led to a following conclusion that subclinical rhabdomyolysis may be one of extra intestinal complications of CD. PMID- 3626168 TI - Symposium on Strategy of Chronic Renal Failure. Present and future. Presented at the 83d annual scientific session of the Japanese Society of Internal Medicine. April 4, 1986, Tokyo. Proceedings. PMID- 3626169 TI - Effects of spatial frequency and orientation on visually evoked cortical potentials. AB - Visually evoked cortical potentials (VECP) were recorded from an array of 4 electrodes along the midline over the occipital cortex in 10 normal subjects. Grating stimuli of different spatial frequencies were presented on a circular test field and spatial tuning curves and potential distribution evoked by vertical, horizontal and oblique stimuli were compared. The peak latencies were the shortest for the stimuli of 2.3 cycles per degree grating oriented vertically. The peak latencies increased for horizontal and further for oblique gratings. The effects of spatial frequency or orientation on the location of the major positive components of the VECP were not significant when recorded on the midline scalp. PMID- 3626170 TI - Electrophysiological studies of spontaneous retinal degeneration in celestial goldfish (chotengan). AB - Spontaneous retinal degeneration of Celestial goldfish was studied histologically and electrophysiologically. Retinal degeneration was divided into three stages. Until the age of 75 days (Stage 0) the retina showed normal histological development and the electroretinograms (ERGs) exhibited dominant b-waves similar to those of adult common goldfish. By the age of 105 days (Stage 1), when the eyeballs began to protrude laterally, histological changes were first observed in the retinal pigment epithelium and photoreceptor layer. The b-wave amplitude decreased to 52% of that of Stage 0 with a prolongation of the peak latency. By the age of 135 days (Stage 2), when eyeballs protruded further anterodorsally, the retinal degeneration extended to the entire retinal layers and no b-waves were detected. The deterioration of the b-wave amplitude was closely correlated to the histological findings of retinal degeneration. The Celestial goldfish is considered to be a new model of hereditary retinal degeneration. PMID- 3626171 TI - Results of silicone oil surgery. AB - The results of silicone oil surgery in a consecutive series of 500 patients are reported. Special emphasis is given to anatomical and functional long-term results, postoperative glaucoma and keratopathy, and to the results following silicone oil removal. PMID- 3626172 TI - Changing attitudes in United States to use of intravitreal silicone. AB - The use of intravitreal silicone oil injection to separate preretinal membranes from the retinal surface in proliferative vitreoretinopathy (PVR) was pioneered in the United States. The anatomical results obtained were encouraging but complications of cataract, glaucoma and keratopathy frequently occurred. This method was therefore discontinued in the United States once the techniques of pars plana vitrectomy and membrane dissection had been developed. More recently, however, it has become clear that in severe PVR treated by vitrectomy procedures, recurrent traction is almost inevitable and prolonged vitreous substitution is required to limit the associated retinal detachment. Silicone has been selectively re-introduced for this purpose. Improved techniques and oil removal in some cases have reduced the incidence of complications. Insoluble gases have also been widely used in the United States to achieve the same objective but have generally been found to be less effective. The comparative merits of these alternative forms of vitreous substitution remain controversial. A randomized clinical trial is currently being conducted in the United States to address this issue. The trial embodies features of multicenter clinical trials used successfully in other prospective clinical studies. Silicone oil is still used less frequently than in Europe or in Japan for the management of diabetic traction detachment and giant tears. PMID- 3626173 TI - Usefulness and limit of silicone in management of complicated retinal detachment. AB - Among various substances used for intraocular tamponade in the treatment of vitreous opacity and complicated retinal detachment, silicone oil is superior to hyaluronic acid or sulfur hexafluoride. Its low gravity and hydrophobic nature permit good tamponade effect to be obtained and its high transparency allows us to detect remnant vitreous traction in the far periphery and/or retinal tears. Furthermore, preretinal membrane can be peeled off easily after silicone oil removal. The hydrophobic nature of silicone prevents clouding due to postoperative hemorrhage and fibrin reaction. It should also be stressed that intravitreal silicone oil suppresses iridial rubeosis or prevents its development. However, the use of silicone has limitations, since it gives rise to various complications that include pupillary block glaucoma, secondary glaucoma, cataract formation and corneal complications including band-shaped keratopathy. Pupillary block in aphakic eyes can be prevented by placing peripheral iridectomy at the 6 o'clock position, since silicone is lighter than water. After silicone injection, glaucoma is more often seen in diabetic aphakic eyes than in phakic or nondiabetic eyes. On the other hand, corneal complications were less frequent in diabetic than in nondiabetic eyes; in nondiabetic eyes the complications were more frequent in aphakic than in phakic eyes. Due to possible complications, silicone should be removed after a certain follow-up period, during which time detection and management of the causes of redetachment of the retina are possible due to the high transparency of silicone. PMID- 3626174 TI - Microangioarchitecture of optic papilla. AB - Two hundred postmortem normal human eyes of 100 cases were studied by four methods to investigate the microangioarchitecture of the optic papilla. The following results have been obtained. The Zinn's circle is important to the blood supply of the optic papilla. It gives off tributaries to the papillar prelaminar and laminar layers and pial vessel network at the retrolaminar portion. The blood supply of the prelaminar layer comes directly from the branches of the short posterior ciliary arteries and Zinn's circle, while the choroidal vessels contribute only a few branches to this area. The above two results are not consistent with Hayreh's idea. Between the central retinal artery system and short posterior ciliary artery system, there are anastomoses at the pial vessel network and in the optic nerve at the retrolaminar portion, but none is found, obviously, in the intraocular portion of the optic nerve. The microangioarchitecture of the optic papilla is accommodated to the nerve in which it resides. The most superficial vessels are radiating, those in the prelaminar and laminar layers are lamellar, and those in the retrolaminar portion are an interwoven network. The caliber of the capillary at the prelaminar and laminar layers is the narrowest, therefore, an ischemic change easily takes place right here. PMID- 3626175 TI - Visual, musculoskeletal and neuropsychological health complaints of workers using videodisplay terminal and an occupational health guideline. AB - A nationwide survey of workers using videodisplay terminals (VDT) was conducted and the data of various health complaints were compiled for a total of 5,097 VDT workers in 23 types of enterprises. Various symptoms or complaints were classified into transient and persistent groups, and attempts were made to determine their causal factors in the working conditions. In the transient complaint group, complaints of the visual function were the most frequent, followed by musculoskeletal and neuropsychological complaints; this indicated that visual loads from the VDT screen and musculoskeletal loads from a fixed working posture constituted the major causes of the complaints. Troublesome factors for the VDT work mainly embraced characteristics of the VDT screen, such as reflection of light, inadequate brightness and blurred margin of the letters, etc, and the arrangement of VDT, documents and keyboards. In the persistent complaint group, neuropsychological complaints appeared most frequently followed by complaints of the visual function and general body discomfort or fatigue. Mental attitude and motivation to the VDT work diverged, at a similar incidence, into two opposite groups, ie, interesting and bored. The complaints of various categories, ie, visual, musculoskeletal, neuropsychological and general body fatigue, were correlated with the working conditions: environmental conditions played a major role in the manifestation of these complaints. On the basis of these analyses, preferable measures were proposed to reduce complaints among VDT workers. PMID- 3626176 TI - Modulation of vascular dynamics by spontaneous contraction of smooth muscle in the isolated carotid artery of the rat. AB - Possible roles of smooth muscle contractions in the vascular dynamics were studied in the isolated rat large artery which has previously been shown to generate spontaneous rhythmic contractions depending upon the extracellular Ca2+. A cylindrical segment of the common carotid artery was superfused externally and perfused intraluminally by Tyrode solution, and the steady state intraluminal pressure (P)-volume (V) relationship of the vessel was obtained. The pressure buffering characteristic (Windkessel effect) of the vascular wall was evaluated by measuring the intraluminal pressure swing during application of external alternating pressure (semi-triangular pressure pulse, 0-120 mmHg, 300 cycle/min, "dynamic pressure load") to the intraluminal space. Effects on these vascular dynamics of inhibition of spontaneous smooth muscle contraction during superfusion of the preparation with nominally Ca2+-free Tyrode solution were investigated. Spontaneous rhythmic fluctuations of the intraluminal pressure (0.2 1.0 mmHg, 2-25 cycle/min), presumably due to contractions of vascular smooth muscles, were detected. The Ca2+-free solution abolished these spontaneous changes in the intraluminal pressure and reduced the baseline intraluminal pressure. The volume distensibility (delta V/(V X delta P] of the preparation at higher intraluminal fluid volumes (or pressures, higher wall stretch) was increased by Ca2+-free solution. The magnitude of intraluminal pressure swing and the maximum rate of changes in the pressure during application of "dynamic pressure load" were decreased in Ca2+-free solution. The results suggest that the inhibition of spontaneous contractions of smooth muscle by Ca2+-free solution may increase the volume distensibility and pressure-buffering function of the large elastic artery. PMID- 3626177 TI - Effects of transient hypoxia on internal intercostal muscle activity in vagotomized rabbits. AB - The effects of transient hypoxia on the responses of internal intercostal (IIC) muscle activity before and after surgical denervation of the carotid sinus nerves were studied in the bilaterally vagotomized rabbits. Bilateral vagotomy caused a complete inhibition of IIC activity in 11 of 13 animals. In the vagotomized animals with no expiratory activity in the IIC muscles, lung inflations with low O2 gas mixture (6% O2 in N2) produced an increase in IIC activity, whereas these excitatory effects were remarkably reduced after sectioning the carotid sinus nerves. In addition, the effects of lung inflation with low O2 gas mixture (6% O2 in N2) on carotid chemoreceptor activity were also studied in the vagotomized rabbits. Lung inflations with hypoxic gas caused an increase in carotid chemoreceptor activity. These results indicate that in the absence of proprioceptive input from the lungs, hypoxic stimulation of the carotid chemoreceptors is capable of activating the expiratory activity in the IIC muscles. PMID- 3626178 TI - Reflex responses of neurons in the inferior mesenteric ganglion to mechanical stimulation of the colon, rectum, anal canal, and urinary bladder in the dog. AB - Unitary discharges were recorded from the inferior mesenteric ganglion of decerebrate dogs. Eighty-one units were identified as sympathetic postganglionic neurons innervating the colon and rectum by collision test performed by stimulation of the lumbar colonic nerve. Discharges of four units were enhanced simultaneously with an increased outflow of the renal nerve by pinching a toe. Thus, those units were regarded as vasoconstrictors of colonic blood vessels. Sixty-five units whose discharges were depressed or not affected by the pinching were regarded as neurons innervating colonic smooth muscle or mucosa (colonic units). Discharges were enhanced in the majority of the colonic units by colonic, rectal, and vesical distension, and mechanical stimulation of the anal canal, while discharges were depressed in a few units by rectal and vesical distension, and the anal canal stimulation. The number and percentage of the depressed units increased not only after cutting the hypogastric nerves and descending branches of the lumbar colonic nerve but also after transection of the caudal pons. The reflex depressions disappeared after transection at the bulbospinal junction, but the reflex enhancements remained. These results indicate that the colonic units are enhanced through a spinal reflex by the inflows from the distal colon, rectum, anal canal, and urinary bladder through the lumbar colonic, hypogastric, pelvic, and pudendal nerves, while a few are inhibited through a supraspinal reflex by inflows through the pelvic and pudendal nerves. PMID- 3626179 TI - Effect of implantation of carbachol pellet near the suprachiasmatic nucleus on the free-running period of rat locomotor activity rhythm. AB - To clarify the effect of a cholinergic agent on free-running period of circadian rhythm, locomotor activities were continuously recorded in the rat implanted with a paraffin pellet mixed with or without carbachol near the suprachiasmatic nucleus. Implantation of carbachol, but not paraffin alone, resulted in shortening of the free-running period under constant darkness. PMID- 3626180 TI - Desensitization of dopamine receptors observed in Aplysia ganglion cells. AB - The time course of the current response produced by a prolonged application of dopamine (DA) was studied in Aplysia ganglion cells with different types of DA receptors. The Na+-dependent fast excitatory receptors were found to be more readily desensitized than K+-dependent inhibitory ones, whereas Na+-dependent slow excitatory ones showed little sign of desensitization. PMID- 3626181 TI - Electrical activity in isolated human tracheal muscle. AB - Isolated strips of the human tracheal muscle had slow fluctuations of membrane potential (slow wave), essentially similar to those of guinea-pig trachea. The average amplitude and frequency of slow wave were 7.7 mV and 19.9/min (n = 9), respectively. There was clear correlation between the electrical activity and mechanical response during the excitation caused by tetraethylammonium (TEA), carbachol, and noradrenaline and also during the inhibition by isoprenaline. The slow wave seems to be related to the basal muscle tone, which is probably maintained by endogenous leukotrienes in human and by prostaglandins in guinea pig. PMID- 3626182 TI - A novel method for measuring the erythrocyte deformability, under oscillatory shear stress. AB - A novel apparatus for detecting a subtle decrease in erythrocyte deformability was developed. The oscillatory shape change of erythrocytes was monitored under an oscillatory shear stress (modulating the oscillation frequency in the range of 9-90 dyn/cm2). The ellipsoidal deformation of intact erythrocytes perfectly followed the oscillatory force of up to about 2 Hz, but the diamide-treated cells showed a phase difference of the oscillatory deformation at 1.7 Hz. PMID- 3626183 TI - Suppression of adjuvant arthritis in rats by cholesterol. AB - Dietary cholesterol suppressed adjuvant arthritis, a chronic inflammatory disease, in rats, but did not significantly affect carrageenin edema, an acute inflammation. When rats were fed a high-cholesterol diet beginning 10 days before injection of adjuvant, the development of the adjuvant-induced arthritis was greatly suppressed. Cholesterol feeding prevented hypertrophy of the adrenal gland in arthritic rats, but had little influence on the serum corticosterone level. A significant positive correlation was observed between the adrenal weight and the severity of the arthritis. These findings suggest that the effect of cholesterol feeding is not due to increased adrenal sterol synthesis. Dietary cholesterol also prevented hypertrophy of the spleen, but had no effect on atrophy of the thymus in adjuvant-treated rats. Cholesterol-fed rats showed a significant decrease in the serum lipid peroxide level and a significant increase in the serum copper level. Adjuvant treatment not only enhanced hypercholesterolemia produced by cholesterol feeding, but also the level of free cholesterol in serum. These results suggest that dietary cholesterol may exert some effect on the immune response through changes in spleen and liver functions. PMID- 3626184 TI - Enhancement by L-methionine of contractile responses to acetylcholine and high KCl in uterine segment. AB - The contractile responses of isolated uterine segments from 17 beta-estradiol-3 benzoate-treated ovariectomized rats to acetylcholine (ACh) and high KCl in Ca depleted modified Locke-Ringer solution on addition of CaCl2 were used as indicators of Ca2+ influxes through ACh receptor- and voltage-operated Ca2+ channels, respectively. L-Methionine (L-Met) significantly enhanced these responses. The enhancement depended on the time of treatment with L-Met and concentration of L-Met. 3-Deazaadenosine (3-DAA) plus homocysteine thiolactone (HCTL), which inhibit S-adenosylmethionine-dependent methylation, caused dose dependent inhibition of these contractile responses to ACh and high KCl. These inhibitory effects of 3-DAA plus HCTL were significantly attenuated in the presence of L-Met. Protein carboxylmethyltransferase and phospholipid methyltransferase activities were detected in the isolated uterine segment under conditions similar to those in which the contractile responses were observed. 3 DAA plus HCTL inhibited these enzyme activities. These findings suggest that S adenosylmethionine-dependent methylations of protein and/or phospholipid in isolated uterine segment are involved in the contractile responses to ACh and high KCl in Ca-depleted modified Locke-Ringer solution on addition of CaCl2. PMID- 3626185 TI - Effects of NC-1300 and its degradation products on gastric secretion and HCl.ethanol-induced gastric lesions in rats. AB - The proton pump inhibitor NC-1300 has antisecretory and cytoprotective activities in rats. The compound is labile at an acidic pH and degrades into various products. We attempted to identify these products after treatment at different pHs in vitro using HPLC. We also examined whether (A) NC-1300 treated at acidic pHs loses its efficacy on gastric secretion and gastric lesions and (B) whether the degradation products of NC-1300 have pharmacological effects in rats. The acidic degradation products proved to be mainly NC-1300-sulfide and partly o dimethylaminobenzylalcohol (o-DMABA) and benzimidazole (BI). NC-1300, pretreated at pH 1.0, 1.25 or 1.5 for 30 min and given p.o. at 30 mg/kg, significantly inhibited gastric acid secretion in pylorus ligated rats and prevented development of HCl X ethanol-induced gastric mucosal lesions. The degree of antisecretory and cytoprotective activities by NC-1300 treated at pH 1.5 was almost the same as that obtained by NC-1300 treated at pH 7.0. NC-1300-sulfide or mixtures of degradation products, with or without unchanged NC-1300, also significantly inhibited the gastric acid secretion and lesion formation. We conclude that while NC-1300 degrades at low pHs, the compound treated at such a low pH exerts pharmacological effects presumably by the unchanged form of NC-1300 and/or its degradation products. PMID- 3626186 TI - Effects of essential oils on erythrocytes and hepatocytes from rats and dipalmitoyl phosphatidylcholine-liposomes. AB - The effect of essential oils, eugenol, thymol and menthol, on erythrocytes, hepatocytes, dipalmitoyl phosphatidylcholine (DPPC)-liposomes and surface tension were studied at various concentrations. Maximal inhibition of eugenol, thymol and menthol on the hypotonic hemolysis in rat erythrocytes were observed at a concentration of 2 mM, 1 mM and 1 mM, respectively. Eugenol at 4 mM and thymol at 2 mM caused an acceleration of hypotonic hemolysis. In isolated rat hepatocytes, thymol caused an increase in GOT leakage, but eugenol at 4 mM and menthol at 0.1 and 0.4 mM inhibited the GOT leakage. The leakage of GPT from hepatocytes was inhibited by eugenol at 0.1 mM and 0.4 to 4 mM and menthol at 0.1 to 0.6 mM. The inhibition of eugenol and menthol on the LDH leakage in hepatocytes were observed at a concentration of 0.001 to 4 mM and 0.1, 0.4 and 0.6 mM, respectively. Thymol caused no change in GPT and LDH leakage. Eugenol, thymol and menthol indicated a depression of surface tension at a concentration of 0.1 mM. The rank by order of surface activity was eugenol greater than thymol. Eugenol, thymol and menthol depressed the phase-transition temperature of DPPC-liposomes. The depression of phase-transition temperature by thymol was greater than that by eugenol and menthol. These results suggest the periapical tissue damage produced by essential oils may be related to membrane lysis and surface activity and that their tissue penetration may be related to membrane affinity and lipid solubility. PMID- 3626187 TI - Antiplatelet effects of fenflumizole, a new anti-inflammatory drug, in dogs. AB - Fenflumizole (2-(2,4-difluorophenyl)-4,5-bis(4-methoxyphenyl) imidazole) was given to dogs in a single oral dose of 3 or 10 mg/kg. The plasma concentrations of fenflumizole and the two metabolites (mono- and di-demethyl forms) attained to the peak level 1-2 hr after dosing of fenflumizole, returning to near the predose levels 8 hr after the dosing. Fenflumizole (10 mg/kg) given orally significantly inhibited collagen- and ADP-induced platelet aggregations ex vivo over 4 hr after the dosing. Fenflumizole effectively inhibited in vitro collagen-induced platelet aggregation, but failed to prevent ADP-induced aggregation. The mono-demethyl form of fenflumizole inhibited in vitro ADP- and collagen-induced aggregations, but the di-demethyl form was ineffective in inhibiting them. PMID- 3626188 TI - The application of DSM-III diagnostic criteria to school refusal. AB - The DSM-III diagnostic criteria were applied to school refusal cases, and the possibility of a subclassification of school refusal through the DSM-III was studied. The subjects were 50 cases diagnosed as school refusal following the criteria defined by Sumi and Tatara. As for the Axis I diagnoses, the subjects fell under the separation anxiety disorder (7 cases), avoidance disorder (13 cases), overanxious disorder (8 cases), identity disorder (5 cases), adjustment disorder (11 cases) and others. On Axis II, no case was diagnosed as having the personality disorder, but 14 cases showed pathological personality traits. On Axis III, nine cases showed some physical disorders or conditions. Among the five major diagnostic groups, there were some definite differences concerning the onset age, clinical course, psychosocial stress, response to therapy and prognosis of disorders. These results suggest the availability of a subclassification of school refusal by means of the DSM-III criteria. PMID- 3626189 TI - Proceedings for the 11th meeting of the Japanese Society of Sleep Research. June 6-7, 1986, Akita. Abstracts. PMID- 3626190 TI - Proceedings for the 5th meeting of the Japanese Association of Adolescent Psychiatry. August 30, 1986, Nagoya. Abstracts. PMID- 3626191 TI - Proceedings of the sixth annual meeting of the Japanese Committee for the International Diagnostic Criteria in Psychiatry (JCIDCP). November 8, 1986, Tokyo. Abstracts. PMID- 3626192 TI - A long-term cortical blindness after head trauma. AB - Here is a case of long-term cortical blindness after a head trauma. Its etiology is ascribed to the cerebral vascular occlusion caused by the head trauma. From the findings of both a computerized tomography (CT) and magnetic resonance image (MRI), the lesions of our case are assumed to be in the bilateral areas 17 (Brodmann), some part of the bilateral areas 18, 19 (Brodmann) and bilateral optic radiations. On determination of the areas of these lesions, the location of the lesion in the bilateral areas 17 has been especially done by using the MRI. The MRI findings in our case have a full significance on this point. PMID- 3626194 TI - Neuropsychiatric disorders in primary hyperparathyroidism. AB - This is a report of two middle-aged women whose diagnosis of PHPT was made on hypercalcemia during treatment of depression and paranoid state, leading to the surgical confirmation of parathyroid adenoma. After the operation, their mental symptoms disappeared as the blood level of calcium was depressed in both cases, and there has been no recurrence for 12 and 18 months, respectively. In Case, 1 antipsychotics were effective, though transiently, for the mental symptoms other than physical ones. In Case 2, levodopa and hypercalcemia might have acted synergistically. Abnormal metabolism of magnesium was not noted in either case. A preoperative EEG showed the presence of sporadic slow waves in Case 1 and low voltage activity in Case 2. After the operation, the EEG showed an improvement to regular hypersynchronous alpha activity in both cases. The mechanism involved in the appearance of mental symptoms and EEG findings in hypercalcemia were discussed. PMID- 3626193 TI - Three cases of chronic bromisoval intoxication: clinical symptoms and application of energy dispersive X-ray analysis (EDX) to detect bromine in serum, urine and cerebrospinal fluid. AB - Bromisoval has been used as a hypnotic for the past several decades, and its abuse was known to cause various neurological as well as psychiatric symptoms. Three patients showed a variety of symptoms which could not be explained neuroanatomically: nystagmus, gait disturbance and hyperreflexia of the limbs in all the cases, dysarthria, double vision, hypotonia, ataxic gait and disturbance of consciousness occasionally and auditory agnosia in one case. For the purpose of determining the diagnosis, an energy dispersive X-ray microanalysis (EDX) was used to detect bromine. Five microliters of specimens were placed on the carbon coated mesh, and using a TN-2000 analyzer, characteristic X-ray peaks of bromine were detected in the serum, urine and cerebrospinal fluid. The sensitivity to detect bromine in the serum was 30 micrograms/ml. PMID- 3626195 TI - Familial mitochondrial encephalomyopathy with stroke-like episodes and episodic disturbances of consciousness: a study of pedigree including three generations with multisystemic abnormalities. AB - We report here two cases in a family with pleomorphic clinical features which include mitochondrial myopathy, encephalopathy, stroke-like episodes, episodic disturbances of consciousness and other multisystemic abnormalities. The other signs observed in multisystemic abnormalities were ophthalmoplegia, short stature, diabetes mellitus, diabetes insipidus, renal dysfunction, optic atrophy, retinal degeneration, impairment of hearing and mental retardation or deterioration. A symptomatological variation was observed in cases in the same family. It is suggested that these widely varying symptoms may be expressions caused by a common biochemical defect which involves different tissues in different individuals in the family. The syndromes observed in the present cases were compared with other possibly-related mitochondrial encephalomyopathies. PMID- 3626196 TI - Individual differences in psychophysiological responses after alcohol ingestion. AB - We have conducted a study on the individual differences in psychophysiological responses to alcohol. The subjects were 12 flushers and 12 non-flushers. In the flushers, significant increases in the blood acetaldehyde (AcH) level, skin temperature and pulse rate were found. In the non-flushers, on the contrary, no significant increase was observed. There was no difference between the flushers and the non-flushers concerning the change in the blood ethanol (EtOH) level nor the change of P1 and P2 latencies in photopalpebral reflex (PPR). Also, no difference was found in the change of the state anxiety level. From these results, we concluded that there exists an obvious discrepancy between the central inhibitory response (elicited by EtOH) and the autonomic response (elicited by AcH) of the human subjects to a small amount of alcohol. PMID- 3626197 TI - Morbidity risk of schizophrenia to parents and siblings of schizophrenic patients. AB - In order to estimate the familial morbidity risk of schizophrenia, parents and siblings of 1,691 inpatients meeting the DSM-III criteria for schizophrenia were investigated on the basis of a review of medical records, family history data and/or personal interviews. The morbidity risks of schizophrenia to parents and siblings of the schizophrenic probands were 4.0% and 4.1%, respectively, which were greater than the morbidity risk in the general population. Siblings of 118 probands whose parents suffered from schizophrenia were at a significantly greater risk of schizophrenia than siblings of 1,493 probands whose parents did not have schizophrenic illness. These findings support the notion of familial transmission of schizophrenia. A total of 16.4% of the schizophrenic probands had at least one first-degree relative with schizophrenia. This is significantly greater in the female probands than in the male probands. PMID- 3626198 TI - Chilaiditi's syndrome in schizophrenic patients. AB - The condition that a part of the digestive tract interposes between the liver and diaphragm has been called Chilaiditi's syndrome. Although it has been reported that this condition had a higher rate of incidence in patients of mental hospitals than in other individuals, there are hardly any enlightening papers of this condition in the domain of psychiatry. Three schizophrenic patients who had this condition are described in this paper. Many factors such as meteorism, the medication of antipsychotic drugs and negative symptoms of schizophrenic patients are considered as risk factors that bring about this condition in them. Psychiatrists should pay more attention to this condition in the chest roentgenograms of patients because this state can possibly develop into more serious conditions such as ileus. PMID- 3626199 TI - Pharmacokinetic profiles and temporal changes in quantitative EEG after imipramine administrations. AB - A study of the relationship between pharmacokinetic profiles and temporal changes in quantitative EEG following imipramine administrations showed that a single dose of imipramine administered by different routes decreased the alpha-power spectra of healthy subjects. The EEG changes were time-related and their latent period and duration depended not on the plasma levels, but on the pharmacokinetic parameters. These effects were produced by imipramine without the influence of its desmethylated product, desipramine. Also, both single and multiple doses after oral or intramuscular imipramine administrations to depressive patients led to two types of EEG responses, with Type 1 patients exhibiting fast improvement of their symptoms. Therefore, chronologically-recorded quantitative EEG should be useful in judging the clinical prognosis of depressive patients after the imipramine treatment. At a steady state, however, neither the EEG recording nor the evaluation of the plasma level is adequate for the judgment. PMID- 3626200 TI - Changes in cholinergic markers following kainic acid lesion of the ventral globus pallidus in rat. AB - Choline acetyltransferase (CAT) and glutamate decarboxylase (GAD) activities and [3H] quinuclidinyl benzilate ([3H]QNB) binding were determined in the rat frontal cortex following damage to the basal forebrain cholinergic system. Pre- and postsynaptic changes in the cholinergic system with the passage of time were also studied. After a unilateral injection of kainic acid into the right ventral globus pallidus, the GAD levels remained unaffected, but the CAT levels decreased to 63.4% after 7 days. After 12 weeks, the CAT levels had returned to 87% of the control value. The Bmax of [3H]QNB binding for the muscarinic receptor was higher in the ipsilateral cortex up to 4 weeks. On the other hand, the KD value at 12 weeks was higher without a change in the Bmax of the [3H]QNB binding. These findings might indicate an ongoing compensatory receptor mechanism of denervation supersensitivity as a response to early changes in presynaptic cholinergic activity and the production of postsynaptic effect with presynaptic cholinergic damage over a long period of time. PMID- 3626201 TI - Purification of acetylcholine receptor-like protein from fetal calf thymus. AB - A cobrotoxin binding protein from the fetal calf thymus was isolated by affinity chromatography after solubilization with sodium cholate. The specific activity as a nicotinic acetylcholine receptor (AChR) was determined by assessing the binding to [3H]-alpha-bungarotoxin (BuTx), using the high-pressure liquid chromatography. An AChR-like protein was detected in the amount of 1.39-2.14 nmol per g protein. The first peak of 420k-protein from gel filtration of the eluate of affinity chromatography on a Sephacryl column showed one major polypeptide band with an Mr of 40k, by polyacrylamide gel electrophoresis in sodium dodecylsulfate, two major protein bands with pI 5.4-5.6 and 9.2 by isoelectric focusing, and reacted with sera from patients with myasthenia gravis. PMID- 3626202 TI - [A study of cyclothymic personality in personality type theory: a structural interpretation of syntonic and immodithymic personalities in the cyclothymic personality type]. AB - This study was undertaken to explore various fundamental characteristics of the cyclothymic personality type. The subjects were 474 students who were classified into three basic personality types -cyclothymic, schizothymic and collathymic- on the basis of their performance on the VERAC Personality Inventory (VPI). Analyses of two questionnaires (TSPS and Self-Differential) completed by the subjects indicated that students classified as cyclothymic had a stronger tendency to recognize their own personality type and to adjust images which could or might be recognized by others. To explore the cyclothymic personality in greater detail, this group was classified into two sub-types -hypomanic and immodithymic types- and two additional tests (EPPS and EFT) were administered to these subjects. Analysis of the responses to these tests revealed that (a) the differences between the two sub-types in EPPS coincided to some degree with earlier reports in the clinical literature, (b) there was no difference between the sub-types in terms of reaction time or number of errors in EFT, and (c) the differences obtained between EPPS and EFT were not so clear as those obtained among the three basic personality types. Overall, these results supported the contention that cyclothymic personality type is a viable sub-category in personality type theory. PMID- 3626203 TI - [Physiological and self-rated affective/cognitive responses of the neurotic personality to an interpersonal stress situation]. AB - The effects of approach by an unacquainted male to high- or low-neurotic (on the MPI scale) female subjects on physiological responses (heart rates and eye blinks) and self-rated affective/cognitive responses (tension, anxiety and apparent size of the male) were examined. (a) In the first trial, non-neurotic subjects showed an abrupt increase of HR near the personal space boundary, however showed a rapid habituation at the second and third trials. In contrast, self-rated affection (tension and anxiety) increased gradually as the male approached, and habituation was slow at the later trials. (b) Neurotic subjects displayed higher tension than non-neurotic subjects, while tension, anxiety and heart rate were less habituating. (c) INDSCAL analysis revealed that these three self-rated indices clustered together, while the physiological ones did not. (d) It was suggested that the eye blink response had a tension reducing function. PMID- 3626204 TI - Poor oxygenation in the lungs of patients with hyperosmolar hyperglycemic non ketotic diabetic coma after cardiac surgery. AB - The ratio of PaO2 to FiO2 was often low (300 or less) in four patients with complications of hyperosmolar hyperglycemic non-ketotic diabetic coma (HHNKDC) following open heart surgery. Four of our patients had poor oxygenation and subsequent spontaneous recovery from in the immediate post-operative period, although HHNKDC occurred only in one during this period. In the 3 others, poor oxygenation without accompanying HHNKDC lasted for 1-6 days and HHNKDC developed about 2 weeks after open heart surgery at time when poor oxygenation reoccurred. If a working diagnosis of congestive heart failure was made only on the basis of the most common probability, and the fluid supply was restricted, HHNKDC would readily occur or be aggravated by the dehydration iatrogenically produced. It is thus concluded that HHNKDC should be included in diagnoses for pulmonary dysfunction. PMID- 3626205 TI - A clinicopathological study of post-bulbar duodenal ulcer--analysis of 6 cases and comparison to usual chronic duodenal ulcer. AB - We investigated the functional and morphological aspects of acid secretion in 6 patients with post-bulbar duodenal ulcer and compared the findings with the events of 40 patients with the usual chronic duodenal ulcer. The post-bulbar ulcer patients showed a much higher acidity, and a biphasic, prolonged acid secretion pattern, presumably representing an enhanced parietal cell function. Histological study of antrectomized specimens revealed that 4 of those with the post-bulbar ulcer had a small antrum in which the fundic gland area expanded distally. The proximal border of the pyloric gland area was within 4 cm of the pylorus. This would suggest the presence of a large parietal cell mass. On the contrary, however, there was no such instance in those patients with the usual duodenal ulcer. Hyperacidity, due to a large parietal cell mass and an enhanced parietal cell function, may play an important role in the pathogenesis of post bulbar duodenal ulcer. PMID- 3626206 TI - Antitumor activities of KW-2152, a new isoquinon agent, against human tumor xenografts transplanted into nude mice. AB - The antitumor activities of KW-2152, a new isoquinon derivative, were examined in thirteen human tumor xenografts, transplanted into nude mice. KW-2152 was administered intravenously at a schedule of q4d X 3, in daily doses of 7.3 mg/kg and 3.6 mg/kg, and q2d X 6 with a daily doses of 7.3 mg/kg, respectively. KW-2152 displayed significant antitumor activities against the human tumor xenografts in 3 out of 13 strains (23.1 per cent) at the schedule of q4d X 3, with a daily dose of 7.3 mg/kg. Depending on the schedule of administration, tumor activity was observed in 8 out of 13 strains (61.5 per cent) at a schedule of q2d X 6, with a daily dose of 7.3 mg/kg. SH-2 and SH-9 gastric tumors were sensitive to KW-2152 and growth was completely inhibited with the schedule of q4d X 3, and a daily dose of 7.3 mg/kg. Thus, KW-2152 seems to have a wide antitumor spectrum, and the possible antitumor effects for clinical use, warrant attention. PMID- 3626207 TI - Five year results of radical mastectomy for breast cancer, by a sternal splitting, intrapleural en bloc resection of the internal mammary lymph nodes. AB - A new operative method of extended radical mastectomy enables complete resection of the axillary and internal mammary lymph nodes. In this paper, we present the histological analysis of the internal mammary involvement, and the estimated 5 year survival rate, of 100 patients with breast cancer of Stage I, II or III, who underwent this operation. The incidences of axillary and internal mammary involvements were 41 per cent and 17 per cent, respectively. The metastases in the internal mammary lymph node chain were located from just below the supraclavicular vein to the third intercostal space along the internal mammary vessels. The types of lymphatic invasion observed in the internal mammary chain were lymph node metastases in 88 per cent, metastatic lesion in the lymphoid tissue in 29 per cent and cancer cell emboli in the lymphatic channel in 71 per cent. The overall estimated 5 year survival rate was 90.5 per cent. Where there was internal mammary involvement, the estimated 5 year survival rates for those with no axillary lymph node metastasis, those with fewer than 3 metastatic axillary lymph nodes, and those with more than 4 metastatic axillary lymph nodes were 100 per cent, 80 per cent and 31.2 per cent, respectively. Although the assumption that more aggressive surgical removal of the primary lesion and the regional lymphatic spread gives a higher cure rate has not been proved, this extended radical mastectomy with adjuvant chemoendocrine therapy seems to give a higher 5 year survival rate for patients with internal mammary involvement. PMID- 3626208 TI - Local recurrence of breast cancer: treatment of nine patients with a recurrence in the skin flap of the chest wall. AB - From 1975 through 1985, nine patients with a local recurrent lesion (LRL) of breast cancer to the skin flap of the chest wall were treated. Four had undergone primary mastectomies in our clinic and the other five were referred from other surgeons, following signs of recurrence. Aggressive topical therapy, such as resection or irradiation, proved effective in eradicating the LRL in all cases, thereby indicating that topical therapy is useful for improving quality of life. Adjuvant systemic chemo-immuno-endocrine therapy is also required for patients with LRL, to increase longevity. Seven of the patients died of a distant metastasis within 66 months after the onset of LRL. PMID- 3626209 TI - The latissimus dorsi muscle flap is useful for the repair of tracheal defects--an experimental study. AB - An experiment was designed to evaluate the limitations of the muscle flap method in treating various locations and sizes of tracheal defects. Five groups of dogs with several types of tracheal defects were prepared. Each defect was covered by the latissimus dorsi muscle flap. Defects of the tracheal membrane (posterior one third of the tracheal wall) were successfully repaired by the muscle flap without stenosis, even if they extended to 10 rings in length or were situated at the carina. Defects in the posterior one-half of the trachea, up to 5 rings long, were repaired, with minimal stenosis. Defects of the posterior two-thirds, or anterior one-third of the trachea, resulted in marked stenosis following muscle flap repair. Tracheal movement as seen in the saver sheath type of tracheomalasia was observed when anterior support of the trachea was lost. On the other hand, the movement seen in the crescent type of tracheomalasia was observed when posterior support of the trachea was lost. We concluded that a defect of less than the posterior one-half of the trachea can be repaired by muscle flap, without inducing respiratory insufficiency. Therefore, muscle flap coverage for tracheal defects should be a useful technique in the combined resection of the tracheobronchial tree in cases of esophageal cancer. PMID- 3626211 TI - Radiation-induced occlusion of the artery in the distal lower extremity--a case report. AB - In a 54 year-old man, a symptomatic occlusion of the popliteal artery and its trifurcation occurred following radiotherapy. Three years following curative radiotherapy to the upper tibia for metastatic renal cell carcinoma, he began experiencing intermittent claudication of the calf, which suddenly progressed to severe rest pain and coldness of the foot, and eventually to ischemic ulcer. Angiogram revealed an atherosclerotic occlusion well localized within the field of the previous irradiation. The significance of this rare entity is discussed from various aspects. PMID- 3626210 TI - Vascularizing the ischemic jejunum by intra-seromuscular implantation of a gastroepiploic vascular pedicle--an application of experimental esophageal reconstruction. AB - Many experimental studies have been done in an attempt to feed various ischemic organs. Of these, both direct intraorganic vascular implantation, and vascular anastomosis, appear to show promise for vascularizing the ischemic gastrointestinal tracts. Preliminary experiments were done in 24 Mongrel dogs to establish the blood flow of the jejunum by direct epiploic vascular pedicle implantation. Morphological development of the communicating vascular system, newly formed between the implanted epiploic vessel and the indigenous vascular network of the jejunum, was clarified by microangiography and histology. In 20 dogs, esophageal reconstruction was successfully accomplished, using the jejunal loop vascularized as described above. The total length of the jejunal segment, and the esophagojejunal anastomotic portion, had neither signs of circulatory disturbance nor necrosis, one, three and twelve months post-operatively. Our experimental findings suggest that direct vascular implantation is the simplest way to vascularize the ischemic intestinal tract and may also be applicable widely in the field of abdominal surgery. PMID- 3626212 TI - The hypertrophic uncinate process of the pancreas wrapping the superior mesenteric vein and artery--a case report. AB - The hypertrophic uncinate process of the pancreas wrapping the superior mesenteric vein and artery was discovered during surgery on a patient with nodular chronic pancreatitis. Such a rare anomaly has never been noted in the English literature so far as we have been able to find. This malformation of the pancreatic uncinate process was considered to be due to excess fusion between the ventral and dorsal pancreatic anlages during embryonic stage. PMID- 3626213 TI - Coexistence of pancreas divisum and intestinal malrotation in a patient with cholecystolithiasis--a case report. AB - An unusual case of a coexistence of pancreas divisum and intestinal malrotation in a patient with cholecystolithiasis is described herein. The diagnosis of pancreas divisum was established by endoscopic retrograde pancreatography, and the intestinal malrotation was diagnosed by duodenography and barium enema. An operation was performed for the cholecystolithiasis. The pancreas was soft, and its shape was almost normal. Cholecystectomy and prophylactic appendectomy were performed, however nothing was done to the pancreas. PMID- 3626214 TI - Occurrence of peptic ulcer in the gastric tube used for esophageal replacement in adults. AB - Reported in this paper are two cases of peptic ulcer which developed in the gastric tube used for esophageal replacement following esophagectomy for esophageal tumors in adults. The results of our cases suggest that acid secretion from the mucosa of the gastric tube, in spite of truncal vagotomy and the state of the tube, seems to play important roles in the pathogenesis of peptic ulcer of the gastric tube after esophageal replacement, even though circulatory disturbances, due to postoperative irradiation and gastric tube formation, have been suspected as the cause. Therefore, in those cases of gastric tube stasis, surgical drainage of the gastric tube should be performed. PMID- 3626215 TI - Intussusception of the appendix with a calcified fecalith. AB - We treated a patient with a complete invagination of the appendix which contained one large laminated calcified fecalithy. Colonofiberscopy showed a dimpling submucosal tumor, which was palpated as a bony hard tumor at laparotomy. This finding suggested that the fecalith caused an intussusception of the appendix and that such an intussusception should be suspected when there is a bony hard dimpling submucosal tumor in the cecum. PMID- 3626216 TI - Undifferentiated carcinoma of the lung with osteoclast-like giant cells. AB - We treated a patient with undifferentiated carcinoma of the lung, with osteoclast like giant cells resembling those of the giant cell tumor of bone. The clinical and morphologic characteristics of this case are documented, and the literature concerning this type of tumor is reviewed. The tumor differed histologically from the pleomorphic carcinoma, which occurs most commonly in the lung, and showed diverse pleomorphic manifestation with benign looking osteoclast-like multinucleated cells and bizarre giant cells. In addition, and undifferentiated carcinoma with a sarcoma-like appearance containing small areas of papillary adenocarcinoma was evident in the tumor. PMID- 3626217 TI - [Clinical study of traumatic lung injury]. PMID- 3626218 TI - [Aortic regurgitation due to aortic valve prolapse]. PMID- 3626219 TI - [Two cases of severe intravascular hemolysis after valve replacement]. PMID- 3626220 TI - [New technic of closed chest catheter atrioventricular ablation in the treatment of refractory supraventricular tachycardia]. PMID- 3626221 TI - [Histological studies on lymphogenous metastasis of thymomas]. PMID- 3626222 TI - [Early clinical results of the new Duromedics bileaflet heart valve]. PMID- 3626223 TI - [Successful thrombolytic therapy of thrombosed Bjork-Shiley aortic valve prosthesis: report of two cases]. PMID- 3626224 TI - [A case of congenital bicuspid aortic valve causing pure aortic regurgitation]. PMID- 3626225 TI - [A case of Marfan's syndrome with funnel chest and type I dissecting aneurysm combined with annuloaortic ectasia]. PMID- 3626226 TI - [An operative case of mediastinal metastasis of primary pleural melanoma]. PMID- 3626227 TI - [A case of multiple pulmonary bronchogenic cysts accompanied with aspergillosis and secondary pyo-pneumothorax]. PMID- 3626228 TI - [A case of aortic regurgitation with severe pulmonary hypertension]. PMID- 3626229 TI - [Blunt trauma to the cervical trachea--report of a case]. PMID- 3626231 TI - [Fracture of the minor strut of a Bjork-Shiley mitral valve: emergency operation with survival]. PMID- 3626230 TI - [A case of successful repair of transposition of the great arteries with the use of a Rygg's valved conduit]. PMID- 3626232 TI - [Studies on the function of the upper urinary tract. XXVI. The influence of the rise of ureteral intraluminal pressure on ureteral peristalsis during ureteral obstruction]. AB - The present investigation was undertaken in order to examine the change in ureteral peristalsis during acute complete occlusion of the ureter. Unilateral ureteral obstruction was produced in 13 mongrel dogs. Parameters consisting of the ureteral intraluminal pressure, ureteral electromyogram (EMG), urine volume, specific gravity of urine, and blood pressure were measured simultaneously during occlusion. The results obtained were as follows: 1) Under the condition of complete occlusion, the resting ureteral pressure inducing the shortest discharge interval (less than 4 seconds) was in the range of 15-20 cmH2O. 2) When the resting pressure increased over 25 cmH2O, the effective contractile pressure due to ureteral peristalsis disappeared in 7 ureters despite their EMGs were persistent. In cases where the contractile pressure was maintained, it tended to decrease gradually. 3) The conduction velocity of peristalsis did not change significantly in both cases. 4) No significant changes were seen in the urine volume, specific gravity of urine, and blood pressure. On the other hand, slight retrograde peristalsis was observed in 8 dogs under the condition of obstruction. PMID- 3626234 TI - [The influence of the rapid rise of intraluminal pressure of the upper urinary tract on ureteral action potentials]. AB - The present investigation was undertaken in order to examine the ureteral action potentials following transient rapid rise of the intraureteral pressure. In 21 adult mongrel dogs, physiological saline and 5% formalin were injected into the left and right obstructed ureters, respectively to produce rapid rise of intraureteral pressure to 60 cmH2O for 7 minutes, and then ureter was released from obstruction. In these experiments, recordings of ureteral electromyogram and intraureteral pressure were made. Histological changes of pelvi-ureteral system were also observed microscopically. Results 1. After injection of physiological saline, discharge intervals were significantly shortened, but normal discharge intervals were restored when the ureters were released from obstruction. Under conditions of reobstruction, the discharge intervals were shortened and intraureteral pressure inducing the shortest discharge interval was 50 cmH2O. 2. After injection of formalin, discharge intervals were significantly shortened, and the action potentials disappeared in 1 minute 28 seconds to 4 minutes 51 seconds after the injection in 18 out of the 21 ureters. No discharge was observed at 7 minutes after the injection in 16 out of the 18 ureters. In 14 out of the 16 ureters, however, the action potentials were restored when the ureters were released from obstruction or after the obstruction was readministered. Under conditions of reobstruction, discharge intervals were shortened, and intraureteral pressure inducing the shortest discharge interval was 20 cmH2O. 3. Histologically, the loss of epithelium, as well as edema and vasodilatation in lamina propria, were observed only in the mucosa of the middle portion of the ureters receiving formalin. The results of the present study show that a transient rapid rise of intraluminal pressure of the upper urinary tract caused by the injection of physiological saline or formalin, dose not have a significant effect on the ureteral action potentials, and that disappearance of the action potentials is refered to pharmacological action of formalin. PMID- 3626233 TI - [New additional operation in the prevention of gastric stasis after selective gastric vagotomy with antrectomy]. AB - The new additional operation for the prevention of the gastric stasis after the selective gastric vagotomy with antrectomy (SV + A) was performed. Our additional operative procedure was followed: After selective gastric vagotomy and antrectomy, gastroduodenostomy was anastomosed at acute angle with the longitudinalis of the stomach. Then, both lesser and greater omentum were incised outside of the gastric vessels. After these procedure, posterior wall sided to lesser curvature was fixed with the edge of the hepatogastric ligament and posterior wall sided to greater curvature was fixed with the retroperitoneum inferior to the pancreas by several sutures. The outcome of these treatments of the additional operation on SV + A enabled to shorten the duration of drainage of gastric juice, as well as smooth intake. By fluoroscopic examination one month after operation, gastric stasis was observed on SV + A due to the contrast medium stored in the ptotic corpus, whereas, in the case of SV + A with our additional operation, smooth gastric emptying was observed without any stasis of the contrast medium, because the corpus was placed upper from the anastomosis portion. In conclusion, our additional operation to SV + A was able to perform easy and safely, and was observed the effective prevention of gastric stasis. PMID- 3626235 TI - [Studies on the motor function of canine gastric tube]. AB - The need for a drainage procedure to facilitate emptying of the gastric tube remains a controversial issue. Then to elucidate whether we need a drainage procedure or not, on both gastric tube without drainage and with drainage, the author investigated the electromyographical changes of antrum and the manometric changes of pyloric portion before and after expansive stimulation, and observed the emptying of gastric tube. The results are summarized as follows: 1. In the gastric tube without drainage procedure, the prolongation of discharge intervals and the acceleration of propagation velocity were noted electromyographically, and the increase of pressure of pyloric portion was noted. When expansive stimulation was added, these findings were more enhanced. 2. In the gastric tube with pyloromyotomy, the states of electromyographical and manometrical excitation were weakened as compared with the gastric tube without drainage, and the reaction to expansive stimulation was also decreased. 3. By addition of pyloromyotomy, the emptying of gastric tube was more accelerated and the pattern of gastric emptying became nearly stabilized. The above results suggested that the gastric tube may need a drainage procedure to facilitate emptying. PMID- 3626236 TI - A survey of abomasal and duodenal nematodes in cattle in Hokkaido, Japan. PMID- 3626237 TI - Relationship between serum total cholesterol level and the number of transferable embryos in relation to milk yield in superovulated cows. PMID- 3626238 TI - Cross resistance against challenge infection in mice infected with Trichinella spiralis or T. pseudospiralis. PMID- 3626239 TI - Isolation of Echinococcus multilocularis from the liver of swine in Hokkaido, Japan. PMID- 3626240 TI - Postprandial changes in serum bile acids concentration and fractionation of individual bile acid by high performance liquid chromatography in normal dogs. PMID- 3626241 TI - Separation of citric acid cycle acids from animal tissues by high-performance liquid chromatography. PMID- 3626242 TI - Evaluation of respiratory lesions in chickens induced by Mycoplasma gallisepticum. PMID- 3626243 TI - Species differences in the changes in heart rate and T-wave amplitude after autonomic blockade in Thoroughbred horses, ponies, cows, pigs, goats and chickens. PMID- 3626244 TI - Two calves of Arnold-Chiari malformation and their craniums. PMID- 3626246 TI - Application of ethidium bromide fluorescence assay to measurement of blastogenesis of swine lymphocytes. PMID- 3626245 TI - Serum sialic acid levels in cattle inoculated with Fusobacterium necrophorum. PMID- 3626247 TI - In vitro fertilization of pig oocytes matured in vivo. PMID- 3626248 TI - Liposarcoma in an old cat. PMID- 3626249 TI - Isolation of influenza A viruses from migratory waterfowls in San-In District Japan in the winter of 1984-1985. PMID- 3626250 TI - Bovine granulocytopathy syndrome of Holstein-Friesian calves and heifers. PMID- 3626251 TI - Increase in trypsin resistance of the posterior portion of the rat sperm head upon entering the epididymis. PMID- 3626253 TI - New law allows exempt license. PMID- 3626252 TI - Neurocysticercosis. PMID- 3626254 TI - [Tuberculosis epidemic in a business office]. PMID- 3626255 TI - [A case of multiple intracranial tuberculoma developed during treatment of miliary tuberculosis]. PMID- 3626256 TI - [Investigation on bacteriological relapses in cases of pulmonary tuberculosis treated with INH and RFP--report of the 27th B series of controlled trials of chemotherapy. Cooperative Study Unit of Chemotherapy of Tuberculosis of National Sanatoria in Japan (CSUCTNS)]. PMID- 3626257 TI - [Biological characteristics of M. gordonae which caused infection in humans]. PMID- 3626258 TI - [Psychological effects of the integrated ambulatory cardiologic rehabilitation of young patients after myocardial infarction]. PMID- 3626259 TI - [Cardiac asystole in glossopharyngeal neuralgia]. PMID- 3626260 TI - [Pregnancy in patients with an artificial heart valve]. PMID- 3626261 TI - [Angina pectoris with normal coronarography--the X syndrome]. PMID- 3626262 TI - [Treatment of the acute phase of myocardial infarction with a lytic cocktail (morphine, chlorpromazine and promethazine)]. PMID- 3626263 TI - [Evaluation of risk factors in sudden cardiac death after myocardial infarction. II. Late ventricular potentials, rhythm disorders and myocardial damage]. PMID- 3626264 TI - [Pre- and postoperative evaluation of 107 patients with multivalvular defects of the heart]. PMID- 3626265 TI - [Diagnosis of primary heart tumors]. PMID- 3626266 TI - [25 years' experience in the surgery of mitral stenosis]. PMID- 3626267 TI - [The status of the topical diagnosis of acquired heart defects in practical public health]. PMID- 3626268 TI - [Disorders of cardiac activity in traumatic arteriovenous fistulae of the extremities]. PMID- 3626269 TI - [Calcium antagonists in the combined treatment of chronic heart failure]. PMID- 3626270 TI - [Reflexotherapy in the early stages of hypertension]. PMID- 3626271 TI - [Functional assessment of the cardiac activity in persons with unstable stenocardia in a sanatorium]. PMID- 3626272 TI - [Initial experience with transluminal laser recanalization in patients with stenosing arteriosclerosis of the lower extremities]. AB - Early experience with transluminal application of low-intensity laser beam (632 nm) to treat atherosclerotic vascular occlusions in 23 patients with combined disorders (Leriche's syndrome and coronary heart disease) is summed up. The beam was carried to the site of occlusion through special laser catheters developed at the A. N. Bakulev Institute of Cardiovascular Surgery (USSR Academy of Medical Sciences). Objective assessment of blood flow recovery in the ischemized limbs was based on angiography, hemodynamic studies, volumetric sphygmography combined with ultrasonic dopplerography and digital subtraction angiography. PMID- 3626273 TI - [Mitral valve dysplasia as a cardiac surgery problem (a clinico-morphological comparison)]. AB - Clinical appearance of mitral incompetence associated with mitral dysplasia (abnormal connective tissue structure in the cusps and chordae, with significant accumulation of acid mucopolysaccharides) is dependent on the extent of regurgitation, its pathogenetic mechanism (sudden or progressive), the presence of the prolapsing cusp syndrome, and attendant complications (endocarditis, chord abruption). Indications for surgery were marked regurgitation in 94% of patients, and septic endocarditis in 6%. PMID- 3626274 TI - [Factors determining the success of the surgical treatment of chronic postinfarct heart aneurysm]. AB - Evaluation of instrumental findings in relation to clinical course of the early postoperative period in 105 patients operated on for chronic postinfarction aneurysm of the heart demonstrated that regional left-ventricular contractility, particularly that of unscarred myocardial tissue, is the principal determinant of surgical success, followed by the severity of attendant coronary sclerosis and, consequently, the adequacy of the chosen surgical procedure. Preoperative congestive heart failure, indicative of disrupted left-ventricular myocardial compensatory potential, is an aggravating factor. PMID- 3626275 TI - [Late results of aortic valve prosthesis (a clinico-hemodynamic analysis)]. AB - Long-term results of aortic-valve ball prosthesis implantation in 184 patients, followed up for about 15 years, are presented. The performance of Soviet-made ball prosthesis in the aortic position has been shown to be fairly satisfactory for a long time. Prostheses of this design are also highly wear-resistant and show satisfactory hydrodynamic properties. PMID- 3626276 TI - [Left ventricular contractility in bioprosthesis of the heart valves]. AB - An assessment of pre- and post-operative left ventricular function has demonstrated that initial hemodynamic conditions of the defect should be taken into account in combined evaluation of preoperative general condition of the patient and the choice of the prosthesis. At the same time, the pattern of change may be used as an indicator of the adequacy of defect correction and prosthetic implant function. PMID- 3626277 TI - [Diagnosis of dysfunctions of heart valve bioprostheses]. AB - Twenty-three cases of bioprosthetic dysfunction due to infectious endocarditis and primary tissue degeneration are reviewed. Twelve bioprostheses were studied morphologically. Follow-up of bioprosthesis-wearers for timely diagnosis of bioprosthetic dysfunction can be based on routine clinical investigation procedures. Echocardiographic detection of calcified vegetations on the cusps, as well as thrombosis, incompetence and marked stenosis of the bioprosthesis are indications for repeated surgery. PMID- 3626278 TI - [Quantitative dynamic assessment of their physical status as a result of sinus rhythm recovery in patients after mitral commissurotomy]. AB - Submaximum bicycle and respiration ergometry was conducted before and after sinus rhythm recovery by means of electric impulse stimulation in 41 patients with atrial fibrillation after effective mitral commissurotomy. Physical working capacity was reduced considerably (by 25.8%), while oxygen spending per unit of work increased by 58.5% in patients with atrial fibrillations, as compared to normal subjects. After sinus rhythm was recovered, physical working capacity increased by 106%, while oxygen spending per 1 kgm work declined by 34.2%. Sinus rhythm recovery is essential as an element of postoperative rehabilitation in cardiosurgical patients. PMID- 3626279 TI - [Changes in the hemodynamics and work capacity of patients following mitral commissurotomy]. AB - A radiocardiographic study of the hemodynamic patterns in 256 patients at different times after mitral commissurotomy and their impact on postoperative working capacity demonstrated that the hemodynamic effect of mitral commissurotomy was more pronounced, earlier and more persistent in patients, operated on during the 3d stage of the disease. More advanced stages of circulatory insufficiency were associated with worse major hemodynamic parameters. The cardiac index can be used as an objective indicator of hemodynamic status and the extent of circulatory insufficiency, as well as a criterion for the assessment of working capacity after mitral commissurotomy. PMID- 3626280 TI - [Procedural characteristics of the surgical treatment of arterial hypertension in bilateral vascular and combined kidney lesions]. AB - Advantages of stepwise surgical correction are illustrated by a review of late results of surgical treatment for arterial hypertension due to bilateral vascular lesions or heterolateral combinations of vascular and parenchymatous renal disorders. The procedure yields better results, so that repeated surgery on the contralateral side may be avoided or postponed until the next relapse of hypertension in some patients. The timing of the contralateral operation in the context of stepwise treatment depends on hypotensive effect of the first correction that is conditioned by the state of terminal arterial bed, and the interstitium of both kidneys. PMID- 3626281 TI - [Middle molecule compounds of the plasma in heart surgery patients in operations with artificial circulation and blood ultrafiltration]. AB - Venous plasma middle molecule compounds (MMC) were determined in 63 cardiosurgical patients, operated on for acquired heart diseases or coronary disease, with assisted circulation (AC) and with or without blood ultrafiltration (BUF). Intraoperative MMC level was superior to that of normal donors, and tended to decrease during AC, while BUF had basically no effect on MMC content, in spite of the latter's withdrawal with the ultrafiltrate. PMID- 3626282 TI - [Thrombocyte function during the performance of plasmapheresis and immunosorption in patients with familial hypercholesterolemia]. AB - The impact of plasmapheresis (PA) and immunosorption (IS) of low density lipoproteins (LDLP) on platelets was examined in patients with familial hypercholesterolemia. PA and IS sessions resulted in a decrease of platelet counts, aggregation activity in relation to TXA2 analogue, U46619, and capacity for adhesion and spreading over type-4 collagen-coated surface. All effects were of similar markedness in both procedures, i.e. they were unrelated to PA or IS specificity, but rather were due to platelet interaction with extracorporeal circulation circuit. Platelet changes seen immediately after the procedure were transitory. Platelet counts and capacity for aggregation and adhesion were recovered by the time of the next procedure (1 or 2 weeks later). Long-term (more than 6 months') use of PA or IS did not essentially affect platelet counts, aggregation and adhesion, but rather undermined platelet spreading capacity. PMID- 3626283 TI - [Vasoactive hormone metabolism in the lungs of patients with congenital heart defects]. AB - The role of pulmonary metabolism of adrenaline, noradrenaline (NA), serotonin and histamine in the pathogenesis of hemodynamic disorders was examined in relation to the magnitude of intracardiac discharge (ID) in 30 patients with septal defects. Irrespective of the magnitude of arteriovenous ID, pulmonary tissue deactivation of NA is shown to be disrupted. Where ID averages 7.7 +/- 2.1 1/min, venous blood NA level is 59.8% higher (p less than 0.05) than that of patients with average ID of 3.1 +/- 0.7 1/min. A positive correlation (r = 0.51) is demonstrated between venous NA levels and ID in the latter group. The data obtained suggest that high ID values are associated with disturbed pulmonary metabolism and increased arterial levels of serotonin and NA, a significant contribution to the development of functional and morphologic vascular disorders of systemic and pulmonary circulation. PMID- 3626284 TI - [Intracardiac hemodynamics following the radical correction of tetralogy of Fallot with residual myocardial hyperfunction]. AB - A study of intracardiac hemodynamics after radical correction of Fallot's tetralogy demonstrated that sympathomimetic agents failed to produce their usual myocardial effect where myocardial hyperfunction persisted. The drugs should be administered in higher doses to achieve therapeutic effect. Marked intracardiac hemodynamic changes were only seen in response to adrenaline. PMID- 3626285 TI - [Central and peripheral hemodynamics against a background of sodium nitroprusside therapy of circulatory disorders in patients after heart valve prosthesis]. AB - Sodium nitroprusside administration to patients with acquired heart defects within early hours after heart surgery produced unidirectional hemodynamic changes, which however followed specific patterns, common to specific conditions. PMID- 3626286 TI - [Fibronectin level of the blood plasma of patients with congenital heart defects]. AB - Enzyme immunoassays have shown mean fibronectin (FN) level to be 241.0 +/- 15.1 micrograms/ml in normal children between 2 and 15 years of age. Similar assays in 57 patients with congenital heart diseases (CHD) before and after surgery demonstrated preoperative FN decrease in 56% of patients, that was directly related to the extent of hemodynamic disorders, while postoperative FN level depended on the range and type of surgical trauma and the presence of inflammatory or suppurative-septic complications. Within 3 postoperative days, FN drops below normal level in 95% of patients. In spite of therapeutic use of blood and blood components, FN deficiency was not compensated for until day 10 after surgical correction of the valvular defect. PMID- 3626287 TI - [Effect of polyunsaturated fatty acids on the functional properties of the thrombocytes and on lipid peroxidation in ischemic heart disease patients]. AB - Platelet function, lipid peroxidation, and levels of cholesterol, triglycerides, high density lipoprotein (HDLP) cholesterol and PGE1 and PGF2 alpha were assessed before and after 28-day administration of polyunsaturated fatty acids (PUFA), contained in olive, corn and cod oil, in 80 coronary patients. The use of PUFA is shown to have a favorable effect on platelet function, decreasing aggregation and increasing disaggregation of platelets. This effect may be due to increased PGE1, producing an antiaggregation effect, while cod oil may also increase HDLP. Additional administration of vitamin E and HDLP prevents unfavorable effects of increased lipid peroxidation. PMID- 3626288 TI - [Ratio of electrical and electromechanical ventricular systoles in the acute period of myocardial infarct and its significance for the late prognosis of sudden death]. AB - The lengthening of the electric ventricular systole in relation to electromechanical systole in acute myocardial infarction is shown to be significant for long-term postinfarction prognosis of sudden death. The use of electromechanical systole as a reference for electrical systole appears to be a more sensitive predictive index, as compared to the electrical systole duration with a correction for heart rate. PMID- 3626289 TI - [Sensitivity to the psycho-emotional test and the characteristics of the psychological status of ischemic heart disease patients]. AB - Sixty-three coronary patients were subjected to mental testing, using the SMALL test and Kettell's 16 PF test. Positive test results were significantly more frequent in patients of the second and third functional classes with neurotic anxiety-depressive disturbances. In patients of the fourth functional class, the results of the tests were not dependent on their psychological status. Patients with the most marked neurotic disturbances may develop an anginal attack accompanied with ischemic ECG changes during the mental test. PMID- 3626290 TI - [Organization of a system of psychological adjustment for myocardial infarct patients at a polyclinic]. AB - A four-year follow-up of myocardial infarction patients enrolled in an outpatient mental adjustment program is reported. A continuous supportive mental adjustment system is proposed for their long-term rehabilitation. The duration and content of the program are discussed as well as the problem of attracting more patients. PMID- 3626291 TI - [Changes in the systemic and intracardiac hemodynamics of healthy persons as affected by emotional tension]. AB - Twenty-four normal subjects were examined during exposure to emotional stress, simulated by mental arithmetic exercise under time shortage and interfering light and sound stimuli. Hemodynamic parameters were determined on the basis of echocardiographic M-records in resting condition and under mental stress. Irrespective of the baseline hemodynamic type, emotional stress produced a hyperkinetic circulatory response. Increased cardiac index resulted from higher heart rate in the presence of unchanged venous return and stroke index. Myocardial contractility increased to a greater extent in individuals with hypokinetic and eukinetic hemodynamics. PMID- 3626292 TI - [Thyroid hormone content of the blood plasma and tolerance for physical loading in ischemic heart disease patients]. AB - Blood thyroid hormones were measured before and after the rationed exercise test in 79 patients with angiographically verified diagnosis of coronary heart disease. A relationship was demonstrated between postexercise blood T3 variation and functional coronary circulation reserve. Hormonal baselines, and exercise induced blood T4 changes were basically similar in patients with coronary disease of different severity. The results are suggestive of pathogenetic importance of thyroid function in these patients. PMID- 3626293 TI - Epidemiology of idiopathic glomerular disease: a prospective study. AB - In this study incidence rates of idiopathic glomerular disease in 1.5 X 10(6) Dutch adults between 16 and 65 years of age were determined, as well as the prevalence of these diseases in terms of indication for renal biopsy. The study was conducted between 1978 and 1985; indications for renal biopsy in decreasing hierarchical order were recently discovered uremia, nephrotic syndrome, chronic hematuria of less than two years duration with or without proteinuria or disturbed renal function, and chronic proteinuria of less than two years duration, of unknown origin. The main findings are fourfold. The incidence of IgA nephropathy and thin glomerular basal membrane lesions was high, 19 and 13 per 10(6) adults respectively, and the prevalence in patients biopsied because of non azotemic chronic hematuria was 31% and 22%, respectively. In the normotensive non azotemic adults biopsied because of chronic, mild proteinuria the prevalence of focal segmental glomerular sclerosis and vascular hyalinosis was both 41%. Of the patients biopsied because of nephrotic syndrome the prevalence of membranoproliferative glomerulonephritis (5%) was low, as was the incidence (less than 2 per 10(6) adults per year). Finally, the prevalence of diffuse sclerosing glomerulonephritis was 25% in patients biopsied because of uremia. This study is useful for the differential diagnosis of idiopathic glomerular disease. PMID- 3626294 TI - Cuprophan reuse and intradialytic changes of lung diffusion capacity and blood gases. AB - The changes in arterial blood gas, pulmonary function tests, leukocyte counts and complement activation were evaluated during first use and subsequent reuse of cuprophan dialyzers. The dialysate buffer was bicarbonate. Reuse of cuprophan dialyzers significantly attenuated the fall in leukocyte counts and the rise in C3a des Arg seen during first use dialysis. First use dialysis also caused a drop in arterial paO2 from 93.0 +/- 12.4 mm Hg to a nadir of 82.8 +/- 12.6 mm Hg at 60 minutes (P less than 0.01). PaO2 levels did not change when reused dialyzers were employed (93.7 +/- 12.2 before dialysis and 96.4 +/- 15.2 mm Hg at 60 minutes, P greater than 0.05). Intradialytic paO2 curves obtained during first use and reuse were significantly different by variance analysis (P less than 0.001). There was also a significant decline in lung diffusion capacity (DLCO, from 30.70 +/- 8.89 to 23.77 +/- 7.76 ml/min X mm Hg, P less than 0.01) and transfer factor (KCO, from 6.07 +/- 1.97 to 5.65 +/- 2.13 ml/min X mm Hg, P less than 0.01), during first use at one hour after initiation of dialysis. This decrease was entirely prevented during reuse, (P less than 0.001 vs. first use by variance analysis). Percentual changes in leukocyte counts and C3a des Arg concentration on one hand, and in paO2, DLCO and KCO on the other were significantly correlated to each other. Other factors with a possible influence on intradialytic pulmonary function such as ultrafiltration volume, dialysate buffer composition, evolution of intradialytic blood pH and cardiac output, were all identical under both experimental conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626295 TI - Progression of chronic renal failure in patients given ketoacids following amino acids. AB - Twelve patients with chronic renal failure who exhibited a progressive decline in 24-hour creatinine clearance, despite being given for 2 to 10 months a diet containing 0.3 g per kg ideal weight of protein and 7 to 9 g mg per kg ideal weight of phosphorus, supplemented with vitamins, CaCO3, and 10 g per day of essential amino acids, were changed to a supplement containing predominantly ketoacids. In six patients whose serum creatinine was 7.5 mg/dl or greater at changeover, progression continued unabated. In six patients with serum creatinine levels at changeover of 6.6 to 7.4 mg/dl, one was non-compliant with the diet and progressed to dialysis. In the other five, progression, measured as the rate of change of a bimonthly radioisotope clearance, has been undetectable during the ensuing one to two years. There has been no change in urea appearance, blood pressure, phosphaturia or proteinuria. Nutrition has been maintained. Thus this ketoacid supplemented regimen apparently halted the progression of moderately severe chronic renal failure for at least a year in a small group of patients in whom restriction of protein and phosphate intake without ketoacids failed to halt progression. In more severe renal failure, no effect on progression was seen. PMID- 3626296 TI - Removal of subepithelial immune complexes with excess unaltered or cationic antigen. AB - Since cationic molecules are known to pass through the lamina densa of the glomerular basement membrane at higher rates than anionic molecules, the ability of cationic antigen to disperse subepithelial glomerular immune deposits was investigated in rats. Subepithelial glomerular immune deposits were formed in rats by the sequential administration of cationized human serum albumin (HSAED) and purified rabbit antibodies to human serum albumin (HSA). In vitro the addition of fifty-fold excess HSA or HSAED to immune precipitates formed with HSAED and antibodies to human serum albumin (antiHSA) solubilized the precipitates to comparable degree. Excess HSA or HSAED was given intravenously to rats which already had HSAED-antiHSA immune deposits in glomeruli. Serial renal biopsies were obtained and examined. Control animals received saline or nonspecific cationic molecules, protamine sulfate or cationized rabbit serum albumin, without any effect on the persistence of immune deposits in glomeruli. The injection of 10 mg of HSAED caused complete disappearance of glomerular immune deposits by 48 hours. In contrast, 100 mg of HSA was required to achieve the same effect. Thus, cationic antigens are more efficient than anionic antigens in the removal of subepithelial glomerular immune deposits. PMID- 3626297 TI - Hypertension in pregnancy: a case discussion. PMID- 3626298 TI - Acetate relaxation of isolated vascular smooth muscle. AB - The vasorelaxant effects of acetate in arginine vasopressin (AVP)-contracted rat tail artery strips were examined in order to study mechanism of action. Dose dependent relaxation by acetate was found in the clinically important range of 4 to 16 mM. Relaxation was not due to complexing of ionized calcium, persisted after mechanical removal of the endothelium, and was not altered by pretreatment with indomethacin. Although acetate also inhibited contraction by alpha-1 and alpha-2 agonists, the relaxant effect was not altered by destruction of sympathetic nerve terminals using 6-hydroxydopamine. The degree of relaxation in this model by various anions correlated with their lyotropic properties; however, the vasorelaxant effect of acetate exceeded that which would be expected on the basis of its position in the lyotropic series. The vasorelaxant effect of acetate was shared by other short-chain fatty acids that can be conjugated with coenzyme A (CoA), such as propionate and malonate. In contrast, a much lesser or absent relaxant effect was found with nonfatty-acid precursors of acetyl CoA, such as pyruvate, lactate, and alanine. The vasorelaxant effect of acetate was abolished by pretreatment with DIDS, an inhibitor of organic anion uptake, suggesting that cellular uptake of acetate is essential to its vasorelaxant action. The results suggest that the relaxant effect of acetate in vascular smooth muscle is non specific, is not mediated by prostaglandins, does not depend upon the presence of either endothelium or the sympathetic nervous system, and may be due to metabolism of acetate to acetyl CoA with attendant conversion of ATP to AMP. PMID- 3626299 TI - Contribution of the urea appearance rate to diuretic-induced azotemia in the rat. AB - Studies were performed to evaluate the contribution of the urea appearance rate to the elevated plasma urea concentration found during diuretic-induced sodium depletion. Negative sodium balance of -1162 + 29 microEq/100 g body wt was induced over a four day period by the administration of furosemide, 20 to 30 mg/kg/d i.p., to rats ingesting a sodium free diet. When compared with sodium replete controls, sodium depletion significantly increased the plasma urea concentration (65.0 +/- 3.1 vs. 26.4 +/- 1.1 mg/dl) through both an increase in the urea appearance rate (160 +/- 5.2 vs. 125 +/- 3.5 mg/day/100 g body wt), and a decrease in the urea clearance rate (1.99 +/- 0.14 vs. 3.16 +/- 0.12 ml/min/kg). The urea appearance rate increased on the first day of diuretic administration, remained elevated three days after stopping diuretics, rapidly returned to control levels after sodium repletion, and was significantly correlated with the magnitude of sodium deficit. Similar results were obtained when diuretic-induced sodium depletion was produced in adrenalectomized animals. After four days of sodium depletion the plasma concentration was increased for some amino acids but not for the plasma total amino acid, nitrogen concentration. The results indicate that sodium depletion increases the urea appearance rate through a mechanism that is independent of adrenal function. Thirty to sixty percent of the elevation in plasma urea concentration that occurs in the rat during diuretic-induced sodium depletion can be accounted for by an enhanced urea appearance rate. PMID- 3626300 TI - Glomerular epithelial cell, polyanion neutralization is associated with enhanced prostanoid production. AB - We have studied the effect of neutralizing the surface charge of rat glomerular epithelial cells (GEC) in culture on prostanoid production. Incubation of rat GEC with polycations poly-L-lysine (PL) resulted in a dose dependent increase of 6 keto-PGF1 alpha (up to 8 to 10-fold) and PGE2 (up to 7 to 8-fold) production. Other polycations such as protamine sulfate (PS) and lysozyme (LY) produced a similar effect. The stimulation of prostaglandin (PG) production by PL treated GEC was prevented by the addition of polyanions such as bovine serum albumin (BSA) and heparin (HP). The effect of PL on prostaglandin (PG) synthesis by GEC was suppressed by the cyclooxygenase inhibitor sulindac sulfide. Addition of exogenous arachidonic acid (C20:4) increased the basal production of PG and under these conditions the effect of PL was masked. We conclude that neutralization of the surface charge of rat GEC by polycations results in profound increase of prostanoid synthesis. The polycation caused increase in PG synthesis appears to be the result of increased availability of intracellular C20:4. PMID- 3626301 TI - Human glomeruli release fatty acids which stimulate thromboxane synthesis in platelets. AB - The cell-free medium of isolated human glomeruli exhibited a procoagulant activity and stimulated thromboxane (TXB2) synthesis in human platelets in a dose dependent manner. The amount of TXB2 measured was 16-fold higher than what could have been predicted (TXB2 synthesized by the platelets under control conditions plus TXB2 present in the glomerular supernatant). The lipid extract of the glomerular supernatant and its purified fraction including the fatty acids was still able to stimulate--although at a lesser degree--TXB2 synthesis in platelets. Stimulation was abolished after treatment of this fraction by charcoal or albumin. Gas chromatography/mass spectrometry analysis demonstrated the presence in the purified glomerular fraction of several long-chain saturated or monoenoic fatty acids at a total concentration of 80 microM with the following order of abundance: stearic, palmitic, myristic and oleic acids. Addition to human platelets of these same exogenous synthetic acids resulted in a dose dependent stimulation of TX synthesis. It was maximum with three or four fatty acids tested in combination, but still present with myristic acid used separately. Arachidonic acid was absent in the glomerular supernatant. Thus the stimulation observed could not be related to a greater availability of substrate. Fatty acids did not act on platelets through a non-specific detergent effect since addition of high doses of detergents inhibited TXB2 formation in platelets. The combination of fatty acids from glomerular origin identified in the present study represents a novel factor involved in the control of intracapillary hemostasis, but different from the procoagulant activity common to many tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626302 TI - "High-dose" calcitriol for control of renal osteodystrophy in children on CAPD. AB - High doses of calcitriol were used prospectively for 11 to 29 months to raise serum calcium levels in an effort to control renal osteodystrophy in 16 children undergoing CAPD. Serum Ca, P, iPTH and alkaline phosphatase were measured monthly; hand radiographs were obtained every six months, and a semiquantitative score of bone abnormalities was evaluated by two independent observers. During the study, serum Ca increased from 9.9 +/- 0.9 to 11.0 +/- 0.6 mg/dl (P less than 0.001); serum iPTH decreased by 113 +/- 131 microliter Eq/ml (P less than 0.005); serum P was unchanged; and serum alkaline phosphatase fell by 33 +/- 46% (P less than 0.02), 530 +/- 397 to 204 +/- 551 IU/liter. The radiographic score fell from 4.8 +/- 4.6 to 0.9 +/- 1.2 (P less than 0.005). The average and maximal doses of calcitriol were 0.61 +/- 0.37 and 0.95 +/- 0.56 microgram/day or 28 +/- 18 and 46 +/- 28 ng/kg body wt/day, respectively. Transient and asymptomatic hypercalcemia occurred in nine patients and two patients had reversible conjunctivitis in association with the hypercalcemia. Thus, "high dose" calcitriol prevented or controlled progression of hyperparathyroid bone disease in most pediatric CAPD patients. The failure to suppress PTH or reverse secondary hyperparathyroidism until the serum Ca rose to 10.5 to 11.0 mg/dl could reflect an increase in the "set point" for PTH suppression by serum calcium in many uremic children. PMID- 3626303 TI - Aluminium-related osteomalacia: response to reverse osmosis water treatment. AB - It is generally accepted that aluminium induces osteomalacia in chronic hemodialysis patients by binding to the calcification front, thereby inhibiting mineralization of osteoid. Because this form of osteomalacia is vitamin D resistant, the condition has often been assumed to be irreversible, although promising results have been achieved recently by using a chelating agent for removal of aluminium from the skeleton. In this paper we present four chronic hemodialysis patients with aluminium toxicity and histologic osteomalacia in whom the mineralization defect greatly regressed after the use of reverse osmosis treated-water for dialysis, but without further treatment. In three other patients, also with aluminium toxicity and histologic osteomalacia, similarly treated, the histological severity of the osteomalacia remained static. Those patients in whom bone mineralization status improved developed hyperparathyroidism after reverse osmosis water-treatment, whereas the static patients remained euparathyroid. The results suggest that resolution of aluminium related osteomalacia may occur with reduction in dialysis fluid aluminium, and that parathyroid hormone plays a role in the healing of aluminium related osteomalacia. The therapeutic implications are twofold: attempts to remove all traces of hyperparathyroidism may be detrimental to the bone mineralization status; and stimulation of the parathyroid glands by means of a mild reduction in dialysis fluid calcium may be of value in the management of those cases with persistent osteomalacia and low bone turnover. PMID- 3626304 TI - [Pulmonary atresias. Recent knowledge on their morphology and clinical significance]. PMID- 3626305 TI - [Clinical significance of cardiac arrhythmias in the newborn infant and infants in the first half year of life. 1: Incidence and prevalence and special pathophysiologic constellations]. PMID- 3626306 TI - [Preoperative diagnosis of heart defects in children: invasive or noninvasive]. PMID- 3626307 TI - [Simple methods in the detection of galactose-1-phosphate and galactitol from samples on filter paper]. PMID- 3626308 TI - [Arteriohepatic dysplasia (Alagille syndrome) with transitory pancreatic insufficiency]. PMID- 3626309 TI - [Fatal course of pulmonary vein occlusion as a cause of autonomic seizures]. PMID- 3626310 TI - [Risk factors of retinopathy of prematurity--results of a matched pair analysis]. PMID- 3626311 TI - [Mesangial sclerosis in the pathogenesis of the familial nephrotic syndrome]. PMID- 3626312 TI - [Transition in the nutrition of eutrophic premature infants from breast milk to Manasan]. PMID- 3626313 TI - [Remote results of the surgical treatment of anorectal defects with genital fistulas in girls]. PMID- 3626314 TI - [Effect of splenectomy on the immunologic reactivity of children]. PMID- 3626315 TI - [Experimental and clinical substantiation of using low-frequency ultrasound in the complex treatment of local peritonitis in children]. PMID- 3626316 TI - [Autonomic inhibition and central analgesia in children during urological surgery]. PMID- 3626317 TI - [Funnel chest in children]. PMID- 3626318 TI - [Characteristics of the clinical course of acute hematogenic osteomyelitis in young children]. PMID- 3626319 TI - [Characteristics of the diagnosis of closed thoracic injuries in chronic nonspecific lung diseases]. PMID- 3626320 TI - [Reconstructive surgery of the sequelae of severe injuries of the perineum and pelvis in children]. PMID- 3626321 TI - [Treatment of intestinal invagination in children 24 hours after onset]. PMID- 3626322 TI - [Acute appendicitis in children with an appendix on the left]. PMID- 3626323 TI - [Chronic disorders of duodenal patency in children]. PMID- 3626324 TI - [Effect of anesthesia and operation on the level of serum immunoglobulins and the incidence of postoperative suppurative complications in children with congenital pyloric stenosis]. PMID- 3626325 TI - [Complete fistula of the vitelline duct in children]. PMID- 3626326 TI - [Clinical aspects and surgical treatment of secondary peritonitis in ulcerative and necrotic enterocolitis in children]. PMID- 3626327 TI - [Acute nonspecific mesenteric lymphadenitis in children]. PMID- 3626328 TI - [Formation of interureteral anastomosis in ectopy of the ureteral orifices]. PMID- 3626329 TI - [Characteristics of isthmoplasty with the left subclavian artery in children with aortic coarctation]. PMID- 3626330 TI - [Catheterization of central veins in children]. PMID- 3626331 TI - [Magnetotherapy in the complex treatment of suppurative-inflammatory diseases of the soft tissues in newborn infants]. PMID- 3626333 TI - [Acute nonspecific diseases of the lymph nodes in children]. PMID- 3626332 TI - [Characteristics of closed irrigation drainage in the treatment of acute hematogenic osteomyelitis in children]. PMID- 3626335 TI - [Organization of medical services for newborn infants with umbilical hernia and congenital eventration in the preoperative period]. PMID- 3626334 TI - [Benign lymphoreticulosis (cat-scratch disease)]. PMID- 3626336 TI - [Results of surgical treatment and sanatorium-health resort rehabilitation of children with chronic suppurative lung diseases]. PMID- 3626338 TI - [Diagnostic difficulties in destructive cholecystitis in children]. PMID- 3626337 TI - [Differential diagnosis of acute appendicitis in children]. PMID- 3626339 TI - [Re-thoracotomy in children in the early postoperative period]. PMID- 3626340 TI - [Successful treatment of large intestine atresia]. PMID- 3626341 TI - [Rare cases of intestinal obstruction in newborn infants]. PMID- 3626342 TI - [Successful treatment of a newborn infant with Ladd's syndrome complicated by infection]. PMID- 3626343 TI - [Comparative evaluation of conservative and operative methods in the treatment of intestinal invagination in children]. PMID- 3626344 TI - [Double intestine in children]. PMID- 3626345 TI - [Cecal invagination of the appendix]. PMID- 3626346 TI - [Left-side appendicitis]. PMID- 3626347 TI - [Acute perforative cholecystitis in a child]. PMID- 3626348 TI - [Cysts of the common bile duct in children]. PMID- 3626349 TI - [Chronic fibrous encapsulated peritonitis in children]. PMID- 3626350 TI - [Surgical treatment of the portal hypertension syndrome in children]. PMID- 3626351 TI - [Acute postoperative pancreatitis in reconstructive surgery of the abdominal aorta and its branches]. PMID- 3626352 TI - [A method of predicting the degree of postoperative arterial pressure in patients with vasorenal hypertension]. PMID- 3626353 TI - [A device for measuring blood pressure in the intramural blood vessels of hollow organs]. PMID- 3626354 TI - [A venoextractor for the surgical treatment of varicose veins]. PMID- 3626355 TI - [A device for creating tunnels in aorto-femoral prosthesis in patients with rupture of the aneurysm]. PMID- 3626356 TI - [Prevention of air embolism during puncture and catheterization of the subclavian vein]. PMID- 3626357 TI - [Prolongation of the viability of ischemic tissues of the extremities after injuries of major blood vessels]. PMID- 3626358 TI - [Giant aneurysm of the carotid artery]. PMID- 3626359 TI - [Traumatic arteriovenous aneurysm of the vertebral artery and internal jugular vein]. PMID- 3626360 TI - [Injury of the aortic arch]. PMID- 3626361 TI - [Successful surgical treatment of rupture of the aorta and diaphragm in closed chest injuries]. PMID- 3626362 TI - [Priapism as a rare complication of reconstructive operations on the arteries of the lower extremities]. PMID- 3626363 TI - [Combined gunshot wounds of the abdominal and small pelvis organs]. PMID- 3626364 TI - [Rupture of a cyst of small intestinal mesentery simulating postoperative peritonitis]. PMID- 3626365 TI - [Myocardial insufficiency after subtotal pericardiectomy]. PMID- 3626366 TI - [Clinical use of the EMIKS and LIKS Russian disk rotation prostheses]. PMID- 3626367 TI - [Microsurgery of the coronary arteries (the first experience and prospects)]. PMID- 3626368 TI - [Surgical treatment of the branches of the aortic arch]. PMID- 3626369 TI - [Intra-aortic prosthesis in dissecting aneurysm of the descending thoracic aorta (experimental study)]. PMID- 3626370 TI - [Surgical treatment of injuries of the vessels of the popliteal fossa]. PMID- 3626371 TI - [Atraumatic reconstructive vascular operations in middle-aged and elderly persons with increased surgical risk]. PMID- 3626372 TI - [Lateral approach in reconstruction of the tibial arteries]. PMID- 3626373 TI - [Thermography in the diagnosis of vascular diseases of the lower extremities]. PMID- 3626374 TI - [Clinical value of regional viscosimetry of the blood in the treatment of arteriosclerotic occlusion of femoral-popliteal arterial segments]. PMID- 3626375 TI - [Surgical tactics in post-thrombophlebitic disease of the lower extremities (I: Principles)]. PMID- 3626376 TI - [Rehabilitation of patients with varicose veins of the lower extremities after phlebectomy]. PMID- 3626377 TI - [Mass screening of patients with a history of acute thrombosis of the deep veins of the lower extremities]. PMID- 3626378 TI - [Segmental esophagoplasty]. PMID- 3626379 TI - [Conservative treatment of tracheobronchial fistulas]. PMID- 3626380 TI - [Organization of medical services for cancer patients at Slovakian surgicenters]. PMID- 3626381 TI - [Anatomo-surgical substantiation of the formation of a scapulo-periscapular skin flap on an arteriovenous pedicle]. PMID- 3626382 TI - [Surgical treatment of acute pyopneumothorax]. PMID- 3626383 TI - [Endourology or modern urology]. PMID- 3626384 TI - [Is the lung mass adequate in congenital diaphragmatic hernia?]. PMID- 3626385 TI - [Late results following reconstructive operations in gastroesophageal reflux in children]. PMID- 3626386 TI - [Chlorazine for improving the oxygenation of newborn infants with congenital diaphragmatic hernia (a preliminary study)]. PMID- 3626387 TI - [Analgesia in the postoperative period for severely ill children]. PMID- 3626388 TI - [Changes in respiratory mechanics, gas exchange and circulation during bronchospasm under general anesthesia]. PMID- 3626389 TI - [Infusion treatment in combined injuries with and without respiratory system involvement in children]. PMID- 3626390 TI - [Current problems in the surgical treatment of Hirschsprung's disease]. PMID- 3626391 TI - [Traumatic hemobilia in childhood]. PMID- 3626392 TI - [Clinical picture, diagnosis and surgical treatment of insufficiency of Bauhin's valve]. PMID- 3626393 TI - [Diagnostic and therapeutic procedures in traumatic injuries to the large intestine, rectum and anus in childhood]. PMID- 3626394 TI - [Endorectal anastomosis syndrome]. PMID- 3626395 TI - [Etiology, pathogenesis and treatment of extrahepatic block of the portal circulation in children]. PMID- 3626396 TI - [5 years of transurethral surgery in the Urology Department of the Research Institute of Nephrology, Urology, Hemodialysis and Transplantation]. PMID- 3626397 TI - [The prevalence of kidney calculi]. PMID- 3626398 TI - [Choledocholithiasis in a female child treated by endoscopic papillosphincterotomy]. PMID- 3626399 TI - [A rare case of malignant hyperthermia in infancy]. PMID- 3626400 TI - [Diagnostic and therapeutic problems of the acute scrotum in childhood]. PMID- 3626401 TI - [Endoprosthesis in surgery of the bile ducts]. PMID- 3626402 TI - [Intraocular ischemic infarcts in injections into the lid and parabulbar region (without perforation of the eye)]. AB - Two outpatients presented with disseminated intraocular ischemic infarctions after injection into the lid and in retrobulbar regions. A 34-year-old patient suffered a sudden and permanent loss of vision due to segmental optic atrophy prior to a chalazion excision under local anesthesia in the right upper and lower lids, with 2 ml Novocain 2%. A 55-year-old patient received parabulbar injections of crystalline cortisone with additional Scandicain 1% in the temporal region of the lower lid. During the injection a sudden complete loss of vision occurred, due to an occlusion of the central retinal artery, resulting in a total simple optic atrophy with complete amaurosis. The disseminated intraocular ischemic infarctions appear to be primarily due to intra-arterial injections, where the ophthalmic artery acts as a "bridge artery" between the extracranial and intracranial circulation. The rise in pressure in the capillaries of the external carotid artery effects a reversal of the circulation, as a result of which embolizing material reaches the ophthalmic artery and its capillaries. It is difficult to decide what role locally admixed vasoconstrictive drugs play in individual cases in which air has accidentally been injected intravasally. Prophylactic measures are discussed. PMID- 3626403 TI - [Combination of phacoemulsification and trabeculectomy. Results of a retrospective study]. AB - Combined trabeculectomy and phacoemulsification was performed on 21 eyes with poorly controlled glaucoma (15 open-angle glaucomas, 5 capsular glaucomas, and one secondary glaucoma) and coexisting cataract. In 20 of these eyes there was severe glaucomatous damage of the optic nerve with visual field loss. With the procedure used by the present authors there was a higher incidence of choroidal detachments, whereas other complications occurred at a lower rate than reported by other authors combining cataract extraction and trabeculectomy. Mean IOP was lowered from 25.7 +/- 6.1 to 17.1 +/- 3.2 mmHg after 18 months. Thirteen patients (62%) required no medication, while 5 (24%) required additional therapy for sufficient control of IOP (less than or equal to 21 mmHg). The results indicate that the combined phacoemulsification and trabeculectomy procedure may be a useful approach in eyes with severe glaucomatous damage and cataract. PMID- 3626404 TI - [Retinal detachment following extracapsular cataract extraction with posterior chamber lens implantation]. AB - Among 866 patients who had undergone extracapsular cataract extraction (ECCE) with implantation of a posterior chamber lens (Simcoe type), 4 cases of retinal detachment were found 1 to 3 years after an uneventful operation. This retinal detachment rate of 0.5% is significantly lower than the rate of 3.5% after intracapsular cataract extraction (ICCE). PMID- 3626406 TI - [Krypton and argon laser coagulation in chorioretinitis centralis serosa]. AB - Central serous chorioretinopathy was treated by laser photocoagulation of the site of fluorescein dye leakage. In 22 cases, in most of which the leakage was located in the nasal macular area or close to the foveola, krypton red was used, and in 85 cases argon blue-green. There was a significantly greater improvement after treatment with the krypton laser, and healing also tended to be faster than with the argon laser. PMID- 3626405 TI - [Indications, technic and results of the balloon operation]. AB - The present paper reports on 100 consecutive cases of retinal detachment treated by the balloon method. The patients were kept under observation for a minimum of 12 months postoperatively. Using the balloon method, a complete and lasting reattachment of the retina was achieved in 94% of the cases. Very careful preoperative evaluation and postoperative management are essential prerequisites for the application of this method. Multiple retinal holes can be treated provided they are close together. In order to reduce the redetachment rate due to material problems, episcleral fixation should be done routinely and the vent of the balloon secured. Additional laser coagulation is sometimes necessary postoperatively the balloon method is not only suitable for managing uncomplicated retinal detachment, but is also excellent for treating certain difficult types of detachment, e.g., in eyes previously operated on and glaucoma cases (because the intraocular pressure can be changed using the balloon). The balloon method is a new management technique for selected cases, enabling the experienced surgeon to reattach the retina with practically no complications. PMID- 3626407 TI - [Lymph drainage of the cornea, limbus and conjunctiva]. AB - Air (n = 30), patent blue (n = 30), Berlin blue (n = 30), Berlin blue and air (n = 30), and Berlin blue and Mercox (n = 30) were injected into the corneas and conjunctivas of 150 enucleated cattle eyes. Using air for injection, so-called Bowman "corneal tubes" form in the cornea, which can easily be filled with pigment (patent blue, Berlin blue). In some cases (n = 3) the conjunctival lymphatics were filled with air during injection into the cornea. Besides the "corneal tubes", larger vessel-like structures can be demonstrated, which seem to be connected to corneal nerves. The significance of these structures as prelymphatics and their importance in the lymph drainage of the cornea are discussed. The injection of patent blue and Berlin blue into the limbus leads to the formation of a delicate network of arch-shaped lymphatics, from which larger lymphatics take their color. In the case of Berlin blue and Mercox, and Berlin blue and air injection, sections of lymphatic vessels in the shape of pointed arches form at the edges of the segments. It can be shown stereomicroscopically that these are not valves or invaginations, but only hump-shaped diverticula of the vessels. Annular constrictions of the lymphatic vessels were found, rather than bicuspid valves. The valveless pump mechanism described by Liebau is discussed as a possible means of lymph transport in the conjunctiva. PMID- 3626408 TI - [Animal experiment model of keratomycosis]. AB - A model of experimental keratomycosis in the rabbit eye is described. Candida albicans strain DSM 70010 (10 microliters; 2.5 X 10(5) cells) is injected intracorneally without employing immunosuppressive measures. This strain is characterized by marked germ-tube formation, which apparently is a major cause of its virulence. All 17 eyes developed an infiltration of the cornea two days after injection. On Day 6 (mean value; standard error +/- 2.34 days) this infiltration developed synchronously to a severe corneal ulcer with hypopyon. The infection remained active for about two weeks and was either complicated by a descemetocele or perforation or led to a reparatory stage with extensive vascularization and successive leukoma. The model presented is reproducible for the first time and is therefore recommended for experimental evaluation of new therapeutic concepts. PMID- 3626409 TI - [Scanning electron microscopy findings in a rigid one-piece polymethylmethacrylate anterior chamber lens with a 30 year duration in the eye]. AB - A rigid one-piece PMMA anterior chamber lens (Scharf type) had to be removed 30 years after implantation because of diffuse bullous keratopathy and painful secondary glaucoma. Scanning electron microscopy showed the IOL to have a crater like surface, while the haptics, having been in contact with intraocular tissues, were superficially and deeply eroded. Comparison with two identical anterior chamber lenses which had not been implanted revealed that the changes seen in the removed IOL must have been the result of degradation of the PMMA material. PMID- 3626411 TI - [Extreme tortuosity of the small retinal arteries]. AB - Extremely pronounced and in some cases convoluted tortuosities of almost all the small retinal arteries, including arterioles and a cilioretinal artery, were diagnosed as a physiologic anomaly. PMID- 3626410 TI - [A new iridocorneal endothelial syndrome]. AB - Three iridocorneal endothelial syndromes are distinguished: essential progressive iris atrophy, iris nevus (Cogan-Reese) syndrome, and Chandler's syndrome. Obviously, there are patients in whom findings do not correspond fully to any one of the three syndromes; signs and symptoms which justify being considered as a new iridocorneal endothelial syndrome are described. PMID- 3626412 TI - [Ophthalmologic findings in 11 q-deletion syndrome]. AB - A 5-year-old boy with deletion of the long arm of chromosome 11 presented with trigonocephaly, bilateral ptosis, epicanthus, antimongoloid lid axes, and bilateral iris coloboma. In order to avoid complication by a torticollis a Guyton Friedenwald fadenoperation was performed. In 1981 Grosse et al. listed among the pediatric symptoms retarded development, ventricular septum defect, mitral stenosis, and skeletal and urogenital anomalies. PMID- 3626413 TI - [Retinal dystrophy with Coats syndrome]. AB - The combination of retinopathia pigmentosa and Coats syndrome is described. The clinical picture shows spotty pigmentations, retinal neovascularizations, peripheral exudative retinal detachment, defects of the retinal pigment epithelium, and changes in the macula. PMID- 3626414 TI - [Automatic measurement of intraocular pressure with an electronic sensor tonometer]. AB - Applanation tonometry based on Imbert-Flick's law and calibrated by Goldmann for clinical application is generally performed today with a standard diameter of the applanation surface of 3.06 mm. This diameter is determined optically by the examiner; the force required for applanation is the measured variable. With electronic, nonoptical definition of the applanation area a reading which cannot be falsified by an error on the part of the examiner can be obtained automatically and considerably faster. PMID- 3626415 TI - [Theory and surgical technic of capsulorhexis]. AB - Kapsulorhexis is a surgical technique for opening the anterior lens capsule with a circular, smooth-edged and continuous margin. Basically, the technique consists of a precisely controlled continuous capsular tear (rhexis), using only a sharp disposable needle with a bent tip. The method is reproducible, requires minimal instrumentation, is compatible with all current techniques of extracapsular surgery, and can be learned at no risk. PMID- 3626416 TI - [Results in pediatric oncology 11. Proceedings of the Society for Pediatric Oncology and the German Working Group for Leukemia Research and Treatment in Childhood]. PMID- 3626417 TI - [Appraisal of the status of pediatric oncology in West Germany]. PMID- 3626418 TI - [Myelodysplastic syndrome: a review]. AB - Myelodysplastic syndromes (MDS) are heterogeneous diseases with cytopenia in the peripheral blood, dysplasia of two or three cell lines, and a low leukemic blast count in the bone marrow and peripheral blood. The syndrome is rare in childhood (1%-2% of all acute leukemias). In the advanced subtypes of MDS with 5% to 30% of blasts the risk of progression into acute leukemia is high, especially in childhood. Cytogenetic abnormalities like monosomy 7 are typical for children with MDS, and probably are an unfavourable prognostic factor. The overall prognosis is almost the same as in adults, with a median survival time of 19 months. There are no well-established therapy strategies in MDS. Intensive chemotherapy may be beneficial, at least in children and young adults, but the decision when to start treatment is difficult. At present allogeneic bone marrow transplantation is the only curative therapy available for MDS. PMID- 3626419 TI - [ Radiotherapy method in the treatment of medulloblastoma]. AB - The extension of the irradiated treatment volume beyond the primary site has produced permanent control in the majority of patients with medulloblastoma. Available technical procedures are described to reduce or prevent side effects and complications. The complexity of high precision radiotherapy, however, requires stringent quality control, particularly if the effectiveness of additional treatment modalities are examined. PMID- 3626420 TI - [A study group on brain tumors in childhood. Introduction, establishment and aims]. AB - Tumors of the central nervous system account for 15.7% of all malignancies registered at the documentation center for childhood malignancies in Western Germany. This group constitutes the largest entity of solid tumors. With the exception of medulloblastoma the five-year survival probability of children with cns tumors in only 54%. Prognosis can only be improved by a interdisziplinary and multicentric approach. Recently, the "Gesellschaft fur Padiatrische Onkologie (GPO)" has set up a special Brain Tumor Study Group. Members of this group will come from several fields such as neuropediatrics, neurosurgery, radiotherapy, pediatric endocrinology, neuroradiology, neuro-/paidopathology, experimental neurooncology, medical statistics, and pediatric oncology. The major aims are standardization of current strategies for diagnosis and therapy including concepts for early diagnosis, aftercare, and rehabilitation. Moreover, it is planned to develop clinical and experimental research facilities and to establish a brain tumor research data bank. PMID- 3626421 TI - [Value of ophthalmoscopy and histology for the prognosis of patients with retinoblastoma]. AB - The predictive value of prognostic factors is of utmost importance for the treatment of patients with retinoblastoma. Functional results, that may be expected following sight saving therapy, can be deducted from ophthalmoscopic findings. Large tumors, tumors located centrally, the presence of extensive retinal detachment or diffuse vitreous seeding are poor prognostic signs. Histopathologic findings of the enucleated eye harbouring retinoblastoma correlate well with the incidence of metastatic disease. Patients in which the tumor has invaded the choroid, optic nerve or sclera have a high risk of developing metastases. PMID- 3626422 TI - [Soft tissue neoplasms--progress and limits of pathologico-anatomic diagnosis]. AB - Current classifications of soft tissue tumors are based principally on the histogenetic type of the tumor thereby abandoning descriptive terms such as spindle cell sarcoma, round cell sarcoma etc. Insight into the histogenesis of a number of soft tissue tumor types has been gained from electron microscopical studies. In addition, these studies provided valuable data to establish certain neoplasms as tumor entities. Thus, the histogenesis of clear cell sarcoma of tendons and aponeuroses has been traced to melanocytes, and it is now universally accepted that biphasic synovial sarcoma consists of epithelial and fibroblastic components. Despite these advances, about 10% of all soft tissue sarcomas remain unclassified when light- and electron microscopy are used in combination. Further improvement in the classification of soft tissue malignancies has been achieved applying immuno-histological techniques. As in other types of malignant tumors mono- and polyclonal antibodies against intermediate filament proteins are especially useful. Other "markers" include protein S-100, neuronspecific enolase (NSE), epithelial membrane antigen (EMA) and panleucocyte antigen (LCA). Regular use of all these markers enabled us to reduce the percentage of unclassified soft tissue sarcomas from 17.6% in the "pre-immune era" to 6.1%. PMID- 3626423 TI - [Results of the treatment of non-rhabdomyosarcomatous soft tissue neoplasms within the scope of the CWS 81 study]. AB - 347 children with all types of soft tissue sarcoma (STS) have been entered between 1981 and April 1986 into the CWS-81 study. Excluding 229 patients with rhabdomyosarcoma, 118 patients with other STS were analysed in the histological subgroups, separately. 33 synovial sarcomas (SyS), 15 undifferentiated sarcomas (US) and 13 extrasceletal Ewing's sarcoma (EES) were treated with a multimodale trial including chemotherapy and radiotherapy after initial not-mutilating resection or biopsy only, Relapse-free survival rate by Kaplan-Meier was 66% in SyS, 48% in EES and 38% in US, respectively. Patients treated according to the guidelines of the CWS-protocol showed better prognosis than patients with major protocol violations or patients with recurrence when entered into the trial. In SyS only 2 of the 7 patients with recurrence developed metastases. The tumor response rate within 7-9 weeks chemotherapy exclusively given was 71% in patients with stage III and IV. Non-responding tumors to chemotherapy had bad prognosis, irrespective of histological subtype or further treatment. EES and US developed earlier recurrence and more often metastases than SyS or rhabdomyosarcomas. The administered VACA-chemotherapy seems not to be very effective in EES and US. In all other varieties of STS recurrence at the primary site assumed relatively greater importance. Chemotherapy and radiation were not administered in all patients. Fibrosarcoma (FS) was diagnosed in 13 patients. Six of these were entered in the trial at the time of local recurrence and 4 of these 6 relapsed again locally, one with metastasis concurrently.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626424 TI - [Determination of the gonadal dose in radiotherapy with thermoluminescent dosimetry]. AB - Thermoluminescence dosimetry was done in patients who had head-neck-, mantel- and abdominal fields with Cobalt 60 or Linac. Critical levels for the gonads were only reached by abdominal irradiation. The testicular dose of 2 Gy accumulated as 5% of a 40 Gy tumor dose may lead to permanent azoospermia. Testicular shielding by 2 or 4 mm lead capsules does not lead to dose reduction. PMID- 3626425 TI - Radionuclide ventriculography and hemodynamic evaluation by right heart catheterization with exercise for assessing the functional significance of coronary artery stenoses. A comparative study. AB - A series of 13 patients with significant coronary stenoses but without prior myocardial infarction were simultaneously studied by right heart catheterization and radionuclide ventriculography to determine the extent to which abnormal responses in left ventricular ejection fraction and wall motion to maximum exercise are paralleled by abnormal left ventricular filling pressures. The correlations of the filling pressure as evaluated by the diastolic pulmonary artery pressure with both the exercise ejection fraction and the rest-to-exercise change in ejection fraction were high (r = -0.89, P less than 0.01 and r = -0.76, P less than 0.01, respectively). In addition, the filling-pressure response to stress separated the patients into distinct radionuclide categories. All the 7 patients with grossly abnormal filling pressures (P greater than or equal to 30 mmHg) developed regional wall motion abnormalities with exercise as evaluated by visual interpretation or quantitative phase analysis. These patients also had a decrease in ejection fraction from rest to exercise ranging from -9% to -32% together with an exercise ejection fraction below 50%. Conversely, these abnormalities were never found in patients with filling pressures below this threshold level. The data suggest that radionuclide ventriculography and measurement of left ventricular filling pressure with exercise yield corresponding results when assessing the functional significance of coronary stenoses in normotensive patients without prior myocardial infarction and normal global left ventricular function at rest. PMID- 3626426 TI - [Homozygous infant in a family with hereditary protein C deficiency]. AB - We report on a female infant homozygous for protein C deficiency in a Jordanian family with frequent intermarriage. A protein C antigen of 0.6% was determined. The parents first noticed painful nodular indurations in subcutanous tissue as well as blue-red skin coloration at the age of 6 months. The girl repeatedly suffered from microthrombotic events in parts of the body with large areas of subcutaneous fat. In contrast, the numerous heterozygous carriers with partial protein C deficiency did not show an increased tendency to thrombosis. From the history an autosomal-recessive inheritance may be inferred. Other authors reporting on homozygous cases also postulate the presence of a recessive gene. It is of interest that the infant described here differs from those in other case reports in the age at manifestation of the disease. The homozygous infant showed the first symptoms as late as the age of 6 months, whereas other case reports describe severe symptoms immediately after birth. All symptoms of disease were treated successfully with prothrombin complex concentrate without additional heparin protection. Microthrombotic events subsided quickly, and a large ulcer in the left flank healed almost completely within 6 days. PMID- 3626427 TI - Iodine vs thyroxine. A changing concept of therapy in endemic goiter? AB - The hypothesis that goitrogenesis in iodine deficiency can be attributed to the stimulatory effect of thyrotropin (TSH) on the thyroid gland and has long been held to be valid. The task of this review is to describe the reasons why this concept is being challenged. In addition, we report on the autoregulation of the thyroid gland and on in vitro investigations dealing with TSH as a growth factor, which have yielded conflicting results. Finally, we summarize preliminary studies comparing the therapeutic effect of thyroxine and iodine on goiter size. In comparison to thyroxine, iodine application in doses of 300-500 micrograms/day may represent an equally effective way of treatment in areas of endemic goiter, especially in younger patients. In this age group, the risk of side-effects, e.g., iodine-induced thyrotoxicosis, should be low. PMID- 3626429 TI - Thymoma presenting as a superior vena cava syndrome remission following therapy. AB - A 45-year-old male developed myasthenia gravis 8 years ago. He received prednisone for 3 years, and resumed complete clinical remission. Five years later, he was admitted with obstruction of the superior vena cava. Invasive thymoma was diagnosed by chest X-ray and an open lung biopsy. Radiation followed by combination chemotherapy with cyclophosphamide, vincristine, and prednisone induced a complete remission. The patient remained disease-free for more than 20 months after the first admission to our department. To the best of our knowledge, superior vena cava syndrome as the presenting symptom of thymoma has never been reported previously. PMID- 3626428 TI - Increased thromboplastic potential in diabetes: a multifactorial phenomenon. AB - Coagulation parameters, platelet aggregation, and thromboxane production as well as metabolic parameters were measured in 31 diabetic patients, 12 without and 19 with clinically manifest late complications, and in 14 healthy control subjects. Spontaneous in vitro aggregation as well as ADP, collagen, and arachidonic acid induced aggregation were higher in both groups of diabetic patients, without an increase in thromboxane B2 production. In diabetic patients with late complications an increase in fibrinogen, fibrinogen cyanogen bromide peptide, factor VIII related antigen, C1-esterase inhibitor, and antithrombin III was observed in comparison to healthy subjects. Fibrinogen, C1-esterase inhibitor, and factor VIII related antigen were already elevated in diabetic patients without clinically manifest late vascular complications. No strict correlations were found between serum glucose, glycosylated hemoglobin, and glycosylated albumin, on the one hand, and coagulation promoting or inhibiting factors, aggregation or thromboxane B2 production, on the other, in either control or diabetic subjects. Also no correlations existed between the coagulation parameters and the aggregation results. In vitro incubation of pooled normal plasma with different glucose concentrations had no influence on the methods by which the coagulation parameters were measured. These data indicate that rather early in the diabetic state many changes take place in different phases of the thrombostatic process, all resulting in an increased hemostatic diathesis. PMID- 3626430 TI - "In vitro" improvement of defective monocyte chemotaxis in intravenous drug abusers after incubation with ascorbic acid. PMID- 3626431 TI - [Morphologic changes in iliac crest trabecular bone in primary hyperparathyroidism and their significance for diagnosis]. AB - Iliac crest bone biopsy specimens of 391 patients with surgically proven primary hyperparathyroidism were investigated. In 60 unselected cases quantitative analysis of trabecular bone changes was performed. The age of the patients ranged between 12 and 85 years. The observed morphological findings were divided into four stages. In a few cases no differences from normal bone tissue could be observed. In 46% occurrence of a nonspecific increase of osteoid seams, osteoblasts, and osteoclasts was observed. Of the cases 50% showed a specific, but very often mild endosteal fibrosis. Only in 4% was there a severe fibroosteoclasia with development of so-called brown tumors. The quantitative analysis showed an increase of trabecular bone mass as well as of remodeling surfaces. But there was an overlap of up to 25% with the normal controls. The results demonstrate the influence of parathyroid hormone peptides on bone morphology. However, the investigation of a bone biopsy specimen is not generally very useful for diagnostic purposes. PMID- 3626432 TI - Autopsy findings in AIDS--a histopathological analysis of fifty cases. AB - Fifty consecutive AIDS autopsy cases were evaluated. All subjects showed one or more opportunistic infections and malignancies included in the AIDS case definition with cytomegalovirus and Kaposi's sarcoma being most prevalent. Mycobacterial and cryptococcal infections occurred only infrequently. Most patients of our series after successful treatment of Pneumocystis carinii pneumonia or cerebral toxoplasmosis later succumbed to less treatable conditions like disseminated cytomegalovirus or fungal infections or malignant lymphoma. In the absence of specific treatment for the HIV infection leading to these lethal complications special emphasis must be put on the prevention of HIV transmission and spread. PMID- 3626433 TI - [Low-dose alpha-interferon treatment of hairy cell leukemia]. AB - Fifteen patients (36-71 years old) with histologically proven hairy-cell leukemia were treated with a low dose of IFN-alpha. The treatment consisted of 1 million I.U. given daily subcutaneously. After 1 month the dose was reduced in all patients 1 million I.U. thrice weekly. Four of the 15 patients have been splenectomized, with two patients receiving chemotherapy prior to the IFN treatment. All patients exhibited at least one cytopenia. The IFN treatment was well tolerated. Only two of the 15 patients experienced mild fever after the first injection, one patient had apathia and mild somnolence after 2 months of therapy. At present 15 patients can be evaluated: 6-18 months after start of therapy two patients showed a complete response with normalization of both peripheral blood and bone marrow, 10 patients experienced a partial response, while one patient showed a slight response with improvement of the thrombocyte count only. Two patients showed no improvement after 3 months of therapy; these patients are presently being treated with 5 million I.U. IFN-alpha thrice weekly. In spite of the low number of patients these data strongly indicate that IFN alpha-2 is effective in hairy-cell leukemia at this low dose. PMID- 3626435 TI - Combined steroid-cyclosporin treatment of chronic autoimmune diseases. Clinical results and assessment of nephrotoxicity by renal biopsy. AB - Twenty-one patients suffering from different autoimmune diseases (14 from systemic lupus erythematosus, 4 from rheumatoid arthritis, one from Sjogren's syndrome, one from systemic hypersensitivity vasculitis, and one from diffuse proliferative glomerulonephritis) were treated with a combined immuno-suppressive regimen. Cyclosporin was given at a dose of 5 mg/kg/day together with steroids. In addition, the rheumatoid arthritis patients also received methotrexate. In all patients a kidney biopsy was performed after a treatment period of 17 to 42 months (mean duration 21.7 months). The cumulative cyclosporin dose at the time of biopsy varied from 1.071 to 4.587 mg/kg. Patients suffering from systemic lupus erythematosus and rheumatoid arthritis were assessed according to a scoring system set up for this purpose. The combined therapy proved useful in these patients as reflected in the diminution of the respective activity scores, improvement of kidney function, and diminution of proteinuria. Histological examination of the kidney biopsy specimens showed only minimal activity in patients with systemic lupus erythematosus. No unequivocal signs of renal toxicity could be detected. In the last group, the condition of the patient with Sjogren's syndrome was stabilized and the patient with systemic vasculitis improved clinically. Neither patient had signs of kidney lesions. The patient with diffuse proliferative glomerulonephritis, in whom kidney biopsy was performed before and after treatment, showed improvement of kidney function, diminution of proteinuria, and diminution of inflammatory activity within the kidney, and no signs of cyclosporin toxicity. PMID- 3626434 TI - [Diagnosis and prognosis of hairy cell leukemia]. AB - During 1966 and 1986 202 patients with hairy cell leukemia in the bone marrow biopsy were observed. All hairy cells were categorized according to their nuclear morphology into ovoid subtype, convoluted subtype and indented subtype. The overall survival of 113 non-splenectomised patients was 11 months. However, the median survival time of each subtype differed considerably with 55 months for the ovoid subtype, 8 months for the convoluted and 6 months for the indented type. The prognosis of splenectomy patients were significantly better at a p-value of less than 0.0001 than the survival of the non-splenectomised patients. The median survival time was 59 months. Also in this group of patients the prognosis was different for the ovoid, convoluted and indented subtype. The median survival time of the ovoid subtype is not yet reached, despite a observation time of more than 180 months. In contrast, the survival time for the convoluted and indented subtypes was 26 months. These data elucidate that at least part of the heterogeneity in the clinical course of this disease can be explained by the morphologically distinct subtypes and that splenectomy prolongs profoundly but to a different degree the survival of patients with all three histological subtypes. The response rate to r.-IFN alpha-2b is higher in patients with the ovoid than with the convoluted and indented subtypes. PMID- 3626436 TI - Increased parathyroid hormone in a patient with sarcoidosis and hypercalcemia. PMID- 3626437 TI - [Dominant autosomal humeroperoneal syndrome with early contractures and cardiomyopathy (Emery-Dreifuss syndrome)]. AB - At least seven members of a family coming from southern Germany (Franconia) have manifested Emery-Dreifuss syndrome within four generations. This syndrome is characterized by slowly progressing atrophic pareses, generally in a humeroperoneal distribution, premature joint contracture, and cardiomyopathy with reduction of functional capacity. Up to now four members of this family have died from cardiac causes between the age of 39 and 46 years. Three family members have now been thoroughly examined; they showed typical muscular atrophies and contractures. The two older patients were diagnosed as having a cardiomyopathy with a complete atrioventricular block and ventricular tachycardia. Electromyographic and histological findings indicate a primary neurogenic process. Regular cardiological examinations combined with effective therapy (for example, implantation of a cardiac pacemaker and treatment with antiarrhythmic drugs) will be necessary in treating the serious arrhythmias. Progressive myocardial insufficiency required heart transplantation in one of our patients, which was successfully performed. Macroscopic and microscopic examination of the explanted heart showed a dilatative cardiomyopathy with hypertrophy and dilatation of both atria and ventricles, differences in the diameters of individual heart muscle cells, and a predominately focal interstitial fibrosis. PMID- 3626439 TI - European Symposium on Purine and Pyrimidine Metabolism in Man. Chateau d'Oex/Switzerland, September 2-4, 1987. Abstracts of lectures, invited discussions, and posters. PMID- 3626438 TI - Human dirofilariasis with reactive arthritis--case report and review of the literature. AB - A 43-year-old German man suffered from an insect bite, which was followed by a severe local inflammation and lymphadenitis. A year later, he developed dry cough, chest pain, and an oligoarthritis of the ankle and knee joints. While other causes of the symptoms could be excluded, serologic findings suggested a dirofilarial infection with reactive arthritis due to the parasite. The observation points out, that in cases of unclassifiable mono- or oligoarthritis, reactive arthritis due to parasites should be considered in the spectrum of differential diagnoses. The disease is rare at present, but its frequency might be underestimated because of the diagnostic difficulties. Dirofilarial infection should be borne in mind after a stay abroad. The present case, however, shows, that the disease also occurs in patients who had not travelled to regions of risk in recent years. PMID- 3626440 TI - [Functional status of the hypophyseal-adrenal and hypophyseal-thyroid systems in acute viral hepatitis]. PMID- 3626441 TI - [Treatment of patients with chronic pancreatitis]. PMID- 3626442 TI - [Renal lesions in psoriasis]. PMID- 3626443 TI - [Treatment of arterial hypertension with corinfar]. PMID- 3626444 TI - [Diagnosis of immunologic disorders of the myocardium]. PMID- 3626445 TI - [Inheritance and the course of the ventricular pre-excitation syndrome]. PMID- 3626446 TI - [Characteristics of dyslipidemia in cardiac insufficiency in patients with rheumatic heart defects]. PMID- 3626447 TI - [Hypereosinophilia in Sjogren's syndrome]. PMID- 3626448 TI - [Long-term drug therapy of internal diseases]. PMID- 3626449 TI - [Specific diagnosis of viral hepatitis]. PMID- 3626450 TI - [Gastroduodenal ulcer as a manifestation of regenerative disorders of the mucous membrane]. PMID- 3626451 TI - [Clinical medicine and pathological anatomy]. PMID- 3626452 TI - [Microelementoses (deficiency of trace elements) in humans]. PMID- 3626453 TI - [25-year experience with the treatment of cardial achalasia]. PMID- 3626454 TI - [Use of the induced effects of glucose and maltose on sodium and chloride transport in the human small intestine as a basis for a diagnostic absorption test]. PMID- 3626455 TI - [Treatment of patients with gastric ulcers associated with duodenal ulcers]. PMID- 3626456 TI - [Clinico-endoscopic evaluation of the rate of healing of gastroduodenal ulcers]. PMID- 3626457 TI - [Inclusion of amino acids into gastric mucosa proteins in patients with chronic gastritis]. PMID- 3626458 TI - [Chronic cholecystitis and dyskinesia of the gallbladder]. PMID- 3626459 TI - [Clinico-morphological characteristics of nonspecific reactive hepatitis in chronic enteritis and peptic ulcer]. PMID- 3626460 TI - [Characteristics and variants of the clinical course of nonspecific reactive hepatitis in patients with diseases of the biliary tract]. PMID- 3626461 TI - [Extrahepatic biliary system and chemical composition of bile in Sjogren's disease and syndrome]. PMID- 3626462 TI - [Role of various gastrointestinal hormones in the regulation of the exocrine function of the liver before and after cholecystectomy]. PMID- 3626463 TI - Some physiological observations on ketamine hydrochloride anaesthesia in the agamid lizard. AB - Some physiological parameters of the agamid lizard (Agama agama agama) were studied after intramuscular injection of diazepam. Heart rates and electrocardiograms were recorded. Respiratory rates were also monitored before and during anaesthesia. The study showed that ketamine given at a dose of 20-30 mg/kg body weight intramuscularly provides optimal anaesthesia for surgical procedures on the agamid lizard. PMID- 3626464 TI - Morphometrical observations on the mandible of five strains of rabbits and strain identification using mandible measurements. AB - In order to clarify the relationships between five strains of rabbits and to identify the strains, principal component and discriminant analyses were carried out using 12 mandibular measurements of three inbred strains (JW-NIBS/Y (JW/Y), NW-NIBS/Y (NW/Y) and Dutch-NIBS/Y (D/Y)) and two outbred strains (JW-NIBS (JW) and NW-NIBS (NW] which were maintained at the Nippon Institute for Biological Science. The results obtained were as follows. (1) Principal component analysis revealed that in the males the mandible of JW was the largest but with considerable variation. D/Y was the smallest of all strains examined. The mandibles of NW and NW/Y were similar to the JW mandibles but had a shape which was shorter and higher. In the females the mandible of NW was the largest of all strains and, as in the males, D/Y was the smallest and JW varied markedly. (2) Discriminant analysis showed the probability of erroneous discrimination to be 14.8% (34/229) when the inbred and outbred strains were combined. In both sexes erroneous discrimination mostly occurred between NW and NW/Y, which have the same origin, and between JW and NW, which have a common ancestor. However, when the inbreds and outbreds were identified separately by discriminant analysis, the probability of erroneous discrimination was low in both cases (4.5% (5/112) and 7.7% (9/117) respectively). These results indicate that strain differences are found in the size and shape of rabbit mandibles and that mandible analysis is effective for strain identification of laboratory rabbits. PMID- 3626465 TI - Isolation of Acholeplasmatales from rabbit faeces. AB - Acholeplasma laidlawii was isolated from the faeces of 23.5% and 24% of groups of 51 conventional and 45 specified-pathogen-free (SPF) rabbits respectively. Isolation of the organism from individual animals could often be repeated, suggesting that infection was not merely transient. Two further acholeplasmas were isolated from two SPF rabbits. One was serologically related to Acholeplasma modicum. The other could not be identified and may be a new species. PMID- 3626466 TI - The effect of neuroleptanalgesia on some cardiorespiratory variables in the rabbit. AB - A technique of neuroleptanalgesia during which rabbits breathed spontaneously for as long as 6 h without any outward sign of stress and with full recovery within 12 h is described. The method involved the constant infusion of a solution comprising fentanyl (0.05 mg/ml) and droperidol (0.13 mg/ml) in 5% dextrose following an intramuscular dose of fentanyl and droperidol. Hourly measurements of blood gases, lung mechanics, mean arterial blood pressure and heart rate were made to assess changes in ventilation and in these physiological parameters for the length of the study. The animals' tracheas were intubated under direct vision with an uncuffed tube. The animals breathed spontaneously and their cardiovascular and respiratory systems were stable throughout the entire monitoring period. There was no statistical difference between the values for all the parameters measured (P less than 0.1). A two-way analysis of variance statistical test was applied to all the measurements. PMID- 3626467 TI - Recirculation anaesthesia for laboratory fish. AB - An economic reliable long-term recirculation anaesthesia system for laboratory fish is described. Anaesthesia of channel catfish (Ictalurus punctatus Rafinesque) was induced within 60 s and was maintained for up to 40 min using tricaine methanesulphonate; recovery occurred within 30-60 s. Various surgical procedures were performed on the fish. No deaths were recorded. All water-quality parameters tested over 19 days use of the system remained stable except for total ammonia nitrogen and, by calculation, un-ionized ammonia which increased to a maximum of 0.23 mg/l. PMID- 3626468 TI - Gastrointestinal pH measurement in rats: influence of the microbial flora, diet and fasting. AB - The pH of the rat intestinal tract was decreased by the presence of a microbial flora, but its influence in the forestomach is less clear. Stomach pH values varied according to the amount of food present at the time of measurement. Fasting increased the pH of the gastrointestinal tract in conventional rats but had little effect in germfree rats. In the conventional rat, feeding a purified diet compared with a commercial diet resulted in a lower pH in the forestomach and a higher pH in the caecal contents. Magnesium trisilicate promoted gastric emptying in conventional rats and its antacid effect was observed only in the caecum and colon. PMID- 3626469 TI - A supernumerary forelimb in a Wistar rat. AB - A fifth limb, quite independent of the others, was found in a pup born in our colony of Wistar rats. The malformation is described. PMID- 3626470 TI - Airborne-induced experimental Bordetella bronchiseptica pneumonia in strain 13 guineapigs. AB - To evaluate the efficacy of a commercial bacterial vaccine in protecting Strain 13 guineapigs against fatal Bordetella bronchiseptica pneumonia, it was necessary to establish the infectivity and disease pathogenesis induced by virulent organisms. When guineapigs were exposed to small-particle aerosols of varying concentrations of virulent B. bronchiseptica, a spectrum of disease was produced that ranged from inapparent illness to fulminant bronchopneumonia. Clinical signs began by day 4 after exposure, and were evidenced by anorexia, weight loss, respiratory distress and serous to purulent nasal discharge. Pathological alterations were limited to the respiratory system. Moribund animals exhibited a suppurative necrotizing bronchopneumonia and necrotizing tracheitis. In animals that survived the challenge, the bacteria were eliminated from the lungs by day 28 but continued to persist in the laryngeal area and the trachea. The median infectious dose and the median lethal dose were estimated to be 4 colony-forming units (CFU) and 1314 CFU respectively. These data suggest that the guineapig will be a valuable model system in which to study interactions between Bordetella species and host cells as well as to evaluate potential B. bronchiseptica immunogens. PMID- 3626471 TI - Induction of ornithine decarboxylase activity in hairless rat epidermis as a pharmacological model: validation of the animal model. AB - We use a mutant hairless Sprague Dawley rat to evaluate the capacity of retinoids to inhibit the epidermal ornithine decarboxylase activity induced by sellotape stripping. In order to minimize the variability introduced by the animals in our model we decided to validate the hairless rats used. A number of animal parameters were examined using a single lot of 50 males and 50 females aged from 4 to 11 weeks and acclimatized to laboratory conditions. The body weight growth curves were established. Nude animals present two periods of hair growth, the first at 6-7 weeks and the second at about 10-11 weeks. Hair development is more pronounced in males. No histological change was observed in the stratum corneum but an increase in epidermal thickness was noted in males aged 9 weeks. Removal of the stratum corneum by sellotape stripping was more effective and reproducible in the females, as determined histologically. Sellotape-stripping induction of ornithine decarboxylase in the epidermis was higher in rats aged 5-6 weeks and reached a plateau in animals aged 6-12 weeks. Individual variations obtained were lower in females (about 5%-10% in females and 10%-20% in males). The present research suggests that female rats aged about 8 weeks provide maximum reproducibility of response and ease of use. PMID- 3626472 TI - Age-related non-neoplastic lesions in the heart and kidneys of Syrian hamsters of the APA strain. AB - Spontaneous cardiac and renal lesions in APA hamsters were examined histopathologically. Myocardial degeneration, valvular thickening, coronary arterial degeneration and increase in heart weight were common in old hamsters. These changes, which suggest cardiac failure, seem to be related to cardiac thrombosis which predominantly affected the left atrium and was found in over 40% of each sex over 16 months of age. Neither glomerular amyloidosis nor arteriolar nephrosclerosis was detected. In general the histopathology of renal lesions in APA hamsters resembled that of the condition known as glomerulonephrosis in rats. Renal lesions occurred more frequently and more severely and developed more rapidly in females than in males. There was no apparent correlation between cardiac thrombosis and renal disease. PMID- 3626473 TI - Simple method for bleeding the unanaesthetized rat by tail venipuncture. AB - A technique is described for the intermittent collection of blood from the rat tail. By using commonly available equipment, blood samples can easily be obtained from rats without the need for anaesthesia. The development of this technique makes the rat more readily available as an animal model for repeated withdrawals of small blood samples for pharmacokinetic or bioavailability evaluations. PMID- 3626475 TI - Record-keeping requirements of the Animals (Scientific Procedures) Act 1986 and how to meet them. AB - The new Animals (Scientific Procedures) Act 1986 has significant implications in terms of record keeping. In many designated establishments, however, most of the records are already collected as part of good working practice and the new Act merely formalizes this situation. Recording the required information may be tedious, but it can be carried out using either a paper-based system or its computerized equivalent. The new legislation imposes no additional record-keeping requirements on personal licence holders and the real burden falls on the project licence holder, particularly for large projects involving several personal licence holders. In the case of an animal house operating a computerized system, considerable assistance with project record keeping can be given by the designated establishment and project status reports will be very helpful in this respect. Computerization also enables automatic production of cage labels which ensures uniformity of labelling and compliance with the Home Office guidelines. PMID- 3626474 TI - A simple technique for endotracheal intubation in rabbits. AB - A technique for endotracheal intubation in rabbits, which eliminates the need for tracheostomies, special devices, laryngoscopes and guide wires, is described. Inhalation anaesthesia with controlled ventilation for major surgical procedures in rabbits is easier to perform than previous reports in the literature suggest. PMID- 3626476 TI - Effective Animal Care and Use Committees. PMID- 3626477 TI - Role of the veterinarian. PMID- 3626478 TI - Role of laboratory animal technicians as committee members. PMID- 3626479 TI - Survey of attitudes of laboratory animal technicians. PMID- 3626481 TI - Consensus recommendations on effective institutional Animal Care and Use Committees. PMID- 3626480 TI - ACUC, who needs it?: the investigator's viewpoint. PMID- 3626482 TI - Are Animal Care and Use Committees really needed? PMID- 3626483 TI - Investigator concerns: Animal Care and Use Committees. PMID- 3626484 TI - Gaining institutional support: Animal Care and Use Committees. PMID- 3626485 TI - Institutional responsibilities: Animal Care and Use Committee. PMID- 3626486 TI - Public concerns for animals in research. PMID- 3626487 TI - Animal Care and Use Committees and the public concern. PMID- 3626489 TI - Unique problems of animal care and use in small institutions. PMID- 3626488 TI - Perspective of a small institution: Animal Use and Care Committees. PMID- 3626490 TI - Animal research review in an industrial facility. PMID- 3626491 TI - Animal Care Committees in the pharmaceutical industry. AB - Management at Syntex is a corporate-wide policy which includes the humane care and treatment of laboratory animals. To that end, humane care and treatment of laboratory animals is a formal goal of all senior managers. Because Syntex wants the specific policies used to be corporate-wide, the AWC and ACC exist. The Committees act together to set policy, implement policy, and to satisfy federal regulations and societal concerns. PMID- 3626492 TI - A primate research center perspective: Animal Care and Use Committees. PMID- 3626493 TI - Animal suffering: how it matters. PMID- 3626494 TI - Analyzing conflicts between the institution, the scientist, the Animal Care Committee, and the concerned public. PMID- 3626495 TI - Technician training: Animal Care and Use Committees. PMID- 3626496 TI - Role of Animal Care and Use Committees in investigator training. PMID- 3626497 TI - Educating the scientist about research animals. PMID- 3626498 TI - Investigator training: Animal Care and Use Committees. PMID- 3626499 TI - Scientists' attitudes toward Animal Care and Use Committees. AB - The major results of this survey of scientists' attitudes toward institutional oversight Committees are: overwhelming support that ACUCs be charged with review of experimental protocols and ensuring compliance with national standards governing humane use of animals. Virtually unanimous agreement that both veterinarians and investigators serve on ACUCs as members. Other types of persons most favored for membership include nonscientists, noninstitutional affiliated people, and laboratory animal technicians. Majority support for ACUC review of student projects involving animals. PMID- 3626500 TI - Investigators' interrelationship with laboratory animals. PMID- 3626501 TI - Regulatory perspectives of the United States Department of Agriculture on functions of Animal Care and Use Committees. PMID- 3626502 TI - Program and objectives of the Canadian Council on Animal Care. PMID- 3626503 TI - Essential functions of Animal Care and Use Committees. PMID- 3626504 TI - Membership issues: Animal Care and Use Committee. PMID- 3626505 TI - Report of a panel discussion on how to run an effective Animal Care and Use Committee. AB - There was a consensus between the Panel and the participants in the audience as follows: All animal use should be reviewed by an Animal Care Committee. The policies and procedures of that Committee must, in the letter and in the spirit of federal guidelines, be developed by each institution, or group of institutions, mindful of its own operational practices and should apply to all research using animals, irrespective of the source of funds. The ACC will be accountable to the public at large for the conduct of animal research. To obtain the support of the community, the ACC must have the active support of the institution, both administratively and financially, and its own academic community who must be involved in ACC activities and, where possible, in the development of its policies and procedures. Education is essential. The Committee must understand its obligations and duties especially as they relate to confidentiality and internal freedom of discussion (this applies particularly to lay members). The faculty, staff, and students must understand the protective role of the Committee for both the community and animal subjects. The institutional community must be prepared to accept the responsibilities of animal use and so accept the need for education and updating in appropriate techniques and experimental design. Individual institutions and organizations, such as the Scientists Center for Animal Welfare, can and will provide information and guidance to those seeking assistance. PMID- 3626506 TI - Doing ethics by committee: problems and pitfalls. PMID- 3626507 TI - Review of experimental protocols: classifying animal harm and applying "refinements". AB - ACUCs and investigators are challenged by the new federal policies requiring review of experimental protocols. They are also challenged by the requirements to consider alternatives and to reduce animal pain wherever possible. Use of a classification system based on degrees of ethical concern for the animals, (e.g. Table 1 page 12) can help in the selection of projects for expedited review. Knowing how to categorize animal experiments according to their degree of invasiveness can also help conceptualize the bioethical issues involving in justifying animal experiments. Scientists are becoming increasingly familiar with the broad concept of alternatives espoused by the three R's of refinement, reduction, and replacement. Expertise in reviewing experimental protocols for animal welfare concerns and actively applying the concept of alternatives is increasing rapidly. This paper describes some alternative refinements which can lessen the ethical costs if introduced into the experimental design. As experience is gained by ACUCs, more refinements will be identified and applied. The Committee's negotiations with investigators can be constructive in improving the welfare of the laboratory animals and also in enhancing the scientific validity of the results. The experience of ACUCs is that investigators generally support this process and are cooperative in incorporating relevant suggestions into their research protocol. PMID- 3626508 TI - Protocol preview and review: Animal Care and Use Committee. PMID- 3626509 TI - Reducing pain in laboratory animals. PMID- 3626510 TI - Assessment of animal pain in experimental animals. PMID- 3626511 TI - Animal pain research. PMID- 3626512 TI - The University of Southern California's Committee in Action. PMID- 3626513 TI - University of Southern California model for the humane care and utilization of animals in research and teaching. PMID- 3626514 TI - University administration of animal care and use programs. PMID- 3626515 TI - Operating principles for Committees on Animal Research. PMID- 3626516 TI - Mixed thyroid carcinoma: a real entity? PMID- 3626517 TI - Medullary thyroid carcinoma with thyroglobulin immunoreactivity. A special entity? AB - Fourteen medullary carcinomas of the thyroid (MCT) immunoreactive for both thyroglobulin and calcitonin were studied by light microscopy and immunohistochemistry. Thyroglobulin immunoreactivity was seen in neoplastic follicles and/or in solid foci in the lymph node metastases of two cases. Colocalization of thyroglobulin and calcitonin was found in the same neoplastic cells of eight cases using a double immunostaining method; in three of these (including one with metastases), thyroglobulin was found to be colocalized with calcitonin gene related peptide as well. Our histological and immunohistochemical results support the assumption that MCT with thyroglobulin immunoreactivity is an unusual variant of the multihormone producing MCT and strengthen the hypothesis that a common stem cell is the origin of these tumors. The available clinical data suggest that thyroglobulin-positive MCT carry a better prognosis than thyroglobulin-negative MCT. PMID- 3626518 TI - Rat glomerular epithelial cells in culture. Parietal or visceral epithelial origin? AB - Isolated glomeruli from rats were explanted under standard culture conditions and outgrowths were studied by light and electron microscopy in order to identify the cells. Rat glomerular samples contained 20 to 30% structurally well-preserved encapsulated glomeruli which had a large rate of attachment to the substrate and very constantly gave rise to cellular outgrowth. In order to label cells from which outgrowth originated the glomerular incorporation of [3H]thymidine was studied in the preattachment phase. By light and electron microscope autoradiograph it was demonstrated that label was located only over visceral and parietal epithelial cells during the first 3 days of culture. Incorporation of [3H]thymidine was seen in mesangial cells after 5 days, i.e., after the glomeruli had attached to the culture vessels and the initial outgrowth had appeared. Consequently the first cells to grow out were of epithelial origin. Glomeruli were then incubated with [3H]thymidine for the first 2 1/2 days of culture in order to label the epithelial cells, then were allowed to attach to the substrate and induce cell outgrowth. By light microscope autoradiography performed with the outgrowths in situ two types of cells with labeled nuclei were seen: (a) a small, polyhedral ciliated cell which grew in colonies where the cells were joined by junctional complexes (type I), and (b) a second very large, often multinucleated cell (type II). Based on the structural resemblance with their counterparts in situ and on comparisons with positively identified visceral epithelial cells in outgrowths from other species it is suggested that type I cells are derived from the parietal epithelium of Bowman's capsule and type II cells from the visceral epithelium. Type I cells proliferated for approximately two weeks around the glomerular explant and then reached steady state while type II cells showed only very limited proliferative capacity. Furthermore, rapidly proliferating cells of supposed mesangial origin (type III cells) grew out later from isolated rat glomeruli. Thus, the present results suggest that outgrowths from rat glomeruli contain three types of cells which can be identified on basis of structure and growth characteristics as visceral and parietal epithelial cells and mesangial cells, while endothelial cells do not proliferate. PMID- 3626520 TI - Glycosaminoglycans of BALB/c 3T3 and B16.F10 melanoma cells. Metabolic differences. AB - When the glycosaminoglycans (GAGs) of BALB/c 3T3 and B16.F10 melanoma cells were compared during parallel studies, substantial differences were found in the cellular content, rates of turnover, and extent of intrinsic sulfated GAG degradation between the two cell types. The 3T3 cells had more than 10-fold more metabolically-labeled [35S]-GAGs per cell under steady state conditions than did the melanoma cells, and in pulse-chase studies they turned this material over at a much slower rate (apparent respective half-times of 30 hours and 8 hours). Moreover, the labeled material released into the medium during the chase periods was approximately 43% low molecular weight polymeric product, eluting in the included volume of Sephadex G50, for the 3T3 cells, as compared with 79% for the B16.F10 line. For both cell lines approximately 86% of total cell layer associated polymeric GAG was accessible to GAG-degrading enzymes under conditions which did not lyse the cells, indicating that the majority of cellular GAGs is present external to the plasma membrane. The extensive digestion of sulfated GAGs in evidence for the melanoma cells suggests the involvement of constitutively high cellular levels of GAG-degrading enzymes. PMID- 3626519 TI - Presence and role of glycosaminoglycans in amyloidosis. AB - Though the presence of glycosaminoglycans in amyloid deposits has been recognized for a long time their role in the pathogenesis of the disorder has remained elusive. As shown here, liver and spleen of human patients with secondary amyloidosis contain 5 to 10 times the amount of glycosaminoglycans as normal organs. Of the three major glycosaminoglycans measured, the heparan sulfate fraction showed the largest increase. In mice where amyloidosis was induced by the injection of casein and enhancing factor (accelerated model) 35SO4-labeled, or Alcian blue stained glycosaminoglycans appeared as early as and at the same location as proteins detected by Congo red staining which was about 2 days after initiation of the procedure. When glycosaminoglycan synthesis was followed in liver and spleen slices of control and experimental animals a significant increase in rate was found in the spleen of the experimental mice. Though there was an increase in heparan sulfate synthesis the major contribution to the overall increase was made by the chondroitin sulfates in the accelerated as well as in the standard induction model. In addition, unlike in the human disorder the chondroitin sulfates were the major glycosaminoglycans which had accumulated in the spleens of animals which had amyloidosis induced by the long term standard procedure (6 weeks) as measured by isolation and uronic acid analysis. The data presented here show that glycosaminoglycans appear to play an important and perhaps direct role in the process of amyloid deposition in the human disease as well as in the experimentally induced disorder in animals. PMID- 3626521 TI - Ontogeny of the responsiveness to intravenous platelet-activating factor. AB - Neonatal and young animals fail to develop antigen-induced, lethal, systemic anaphylactic reactions. Recent evidence has documented that, in the adult rabbit, an unusual phospholipid autacoid, platelet-activating factor, induces almost all of the physiologic events associated with IgE-induced anaphylaxis. Thus, in the present study, the intravascular alterations after intravenous infusion of synthetic platelet-activating factor (1-O-hexadecyl-2-acetyl-sn-glycero-3 phosphocholine; AGEPC) into young rabbits were examined. In comparison to 13-week old, adult rabbits, the intravascular infusion of greater than 1.0 micrograms/kg AGEPC was not lethal in rabbits of 8 weeks of age or less. In dose-response studies, the amount of AGEPC required to induce a lethal response in 50% of the animals tested (LD50) was found to inversely correlate with age. In contrast, AGEPC-induced platelet aggregation in vitro was not affected by the age of the donor animal. Consistent with age-independent platelet responsiveness in vitro, AGEPC-induced thrombocytopenia and intravascular accumulation of platelet factor 4 and thromboxane B2 were also unaffected by animal age. Neutropenia and basopenia, as well as platelet and neutrophil sequestration in the pulmonary microvasculature after intravenous AGEPC infusion also were similarly unaffected by animal age. Although the mechanisms which modulate the profound and lethal physiologic responses following AGEPC infusion in the adult rabbit remain to be established, the current study clearly documents an age-dependent acquisition of systemic physiologic sensitivity to AGEPC and/or other mediators released as a result of intravascular AGEPC administration. PMID- 3626522 TI - Prognostic implications of proliferative activity and DNA aneuploidy in colonic adenocarcinomas. AB - Paraffin-embedded surgical specimens from 120 patients who underwent resections for primary untreated colonic adenocarcinoma were examined for proliferative activity, DNA aneuploidy, DNA index, and the proportion of aneuploid cells by flow cytometry. The results were correlated with survival times and clinical characteristics of the patients. The presence of metastases, both distant and restricted to local lymph nodes, was found to be a more potent adverse prognostic indicator than any DNA flow cytometry-derived parameter. Additional analyses were performed following stratification of patients into two groups on the basis of presence or absence of metastases. Analysis of 60 patients without metastatic involvement revealed a significant correlation between high proliferative activity, defined as more than 20% of cells in S-phase, and DNA aneuploidy. In fact, high proliferative activity was shown to be a more powerful adverse prognostic indicator in relation to survival than DNA aneuploidy in these cases after multivariate analysis. These results suggest that differences in proliferative activity may be an important biologic factor operative in the variable prognosis seen in colonic adenocarcinoma. In addition, they re-emphasize the importance of stratifying patients into groups based on metastatic involvement when evaluating other possible prognostic features in this disease. PMID- 3626523 TI - Morphometric quantitation of histopathologic changes in articular cartilage in an immunologically-induced rabbit model of rheumatoid arthritis. AB - An immune arthropathy was induced in New Zealand white rabbits by intradermal sensitization with complete Freund's adjuvant containing Mycobacterium butyricum followed by intra-articular administration of the bacterial antigen. Half of the animals were treated with 1 mg/kg/day of prednisolone sodium phosphate for 8 weeks by gavage beginning with the day of intra-articular challenge, while the remaining rabbits received the drug vehicle alone. By morphometric analysis (matrix/chondrocyte lacunae area ratio), we observed a significant decrease in cellularity in the arthritic articular cartilages from the vehicle control group. By contrast, there was a significant increase in cellularity in the patella, femoral and tibial cartilages of the steroid-treated animals as compared with that observed in the contralateral control joint. This study suggests that image analysis provides a reliable means for evaluation of architectural changes in the articular cartilage and allows for meaningful quantitation of the chondroprotective effects of drugs like prednisolone. PMID- 3626524 TI - The matrix effect in the cold-vapor atomic absorption analysis of mercury in various biological tissues. AB - The percent recovery of mercury in the cold-vapor atomic absorption analysis of mercury in various biological matrices is measured. Hair digest samples, urine, and fish samples give nearly quantitative recovery. Milk and brain samples give recoveries of approximately 90%, and liver samples 85%. PMID- 3626525 TI - Determination of sodium monofluoroacetate (compound 1080) in tissues and baits as its benzyl ester by reaction-capillary gas chromatography. AB - A reaction-capillary gas-chromatographic procedure using photo-ionization (PID) or flame-ionization (FID) detection was developed for the determination of sodium monofluoroacetate (compound 1080), a pesticide, in tissues and baits. Fluoroacetic acid from tissue (1 g) and bait (10 g) extracts was first partitioned into ethyl acetate and then into 0.5 M benzyldimethylphenylammonium hydroxide. Benzylation was achieved by pyrolysis of the quaternary ammonium salt in the injection port. Chloroacetic acid was used as the internal standard. A linear relationship (r = 0.999) was observed between the peak area ratio of the substrate/internal standard and the fluoroacetic acid concentration. The detection limit for compound 1080 using the described analytical procedure, was 15 micrograms/kg with PID and 100 micrograms/kg with FID. PMID- 3626526 TI - Comparison of a GLC-NPD method with a GLC-MS-SIM procedure for the determination of tilidine and its metabolites in plasma. AB - A gas liquid chromatographic method with nitrogen-phosphorus detection (GLC-NPD) is compared to a GLC-mass spectrometric determination employing selected ion monitoring (GLC-MS-SIM). These two methods of gas chromatographic separation were shown to be suitable for therapeutic monitoring of tilidine, nortilidine, and bisnortilidine in patients. The pharmacokinetic profile of tilidine was also studied in three normal humans after a single oral dose. Pharmacokinetic parameters such as Cmax, tmax, (t1/2) beta, AUC, AUMC, Vd beta, Cltot, beta, and MRT are derived from model independent pharmacokinetic techniques. PMID- 3626527 TI - Examination of blood levels of mercurials in practicing dentists using cold-vapor atomic absorption spectrometry. AB - The toxicity of mercury compounds in dentistry has been an issue of increasing concern. Relatively few data are available concerning the possible in vivo biotransformation of elemental mercury from dental amalgam into more toxic organic mercurials. The present study was designed to evaluate the existence of this in vivo pathway in dentists who work in a confined environment where metallic mercury vapor is constantly present. Two hundred five practicing dentists and 24 nondental controls were asked to participate in this study. The total, inorganic, and organic mercury contents of blood were determined by syringe-injection cold-vapor atomic absorption spectrometry. The student t-test indicates that the total and inorganic mercury levels in blood are significantly different between dentists and nondental controls at the significant level of p less than or equal to 0.05. The organomercurial levels are, however, insignificant at the same test level. This implies that high total and inorganic mercury levels are not correlated with high organomercurial levels in the blood of practicing dentists. Therefore, significant enzymatic conversion of inorganic to organic mercury compounds does not occur in vivo. PMID- 3626528 TI - Qualitative organic analysis. Part 2. Identification of drugs by principal components analysis of standardized TLC data in four eluent systems and of retention indices on SE 30. AB - The principal components (PC) analysis of standardized Rf values in four eluent systems [ethyl acetate/methanol/30% ammonia (85:10:15), cyclohexane/toluene/diethylamine (65:25:10), ethyl acetate/chloroform (50:50), and acetone with the plate dipped in potassium hydroxide solution] and of gas chromatographic retention indices in SE 30 for 277 compounds provided a two principal-components model that explains 82% of the total variance. The scores plot allowed identification of unknowns or restriction of the range of inquiry to very few candidates. Comparison of these candidates with those selected from another PC model derived from TLC data only allowed identification of the drug in all the examined cases. PMID- 3626529 TI - Distribution of trimipramine and its major metabolites in a fatal overdose case. AB - A fatality following ingestion of the tricyclic antidepressant trimipramine (Surmontil) is described. Quantitation was performed by high-performance liquid chromatography. Trimipramine and desmethyltrimipramine concentrations were 4.8 and 2.1 mg/L, respectively, in postmortem blood. The concentration of trimipramine, desmethyltrimipramine, and their respective 2-hydroxy metabolites were also measured in liver and urine. Analysis of gastric contents revealed a tricyclic antidepressant drug. These findings are compared to previously published reports of trimipramine-related fatalities. PMID- 3626530 TI - Verapamil tissue concentrations in fatal cases. AB - Postmortem findings are presented for fourteen cases of Verapamil induced or related deaths. Liver, blood, and stomach concentrations of Verapamil alone or in combination with alcohol or other drugs are given with the age and sex of each victim and with the coroner's findings. The significance of these levels is discussed. Tissue homogenates were digested either by strong acid or enzymically by subtilisin and extracted with dichloromethane or 1-chlorobutane, respectively. Blood was buffered to pH 9 and extracted directly with 1-chlorobutane. Recoveries are reported. Verapamil was quantitated by gas chromatography on a 3% OV-17 column with a nitrogen-phosphorus detector. PMID- 3626531 TI - Saliva concentrations of disopyramide cannot substitute the drug's plasma concentrations. AB - For many drugs the salivary concentration corresponds to the free plasma drug concentration, which may be more closely related to drug activity or toxicity than the total plasma drug concentration. In this study a preliminary investigation was undertaken to determine the feasibility of monitoring saliva levels of disopyramide, an antiarrhythmic drug, for clinical and toxicological purposes. Single oral doses of this compound were administered to healthy volunteers. Stimulated mixed saliva and plasma levels were measured by the EMIT technique. The concentrations of disopyramide in the stimulated mixed saliva tended to be lower than those found in the corresponding plasma sample (fp 0.3 0.5), and the saliva-to-plasma concentration ratio increased with a decreasing salivary pH (pH 6.89, S/P = 0.25; pH 8.15, S/P = 0.08). The correlation between the saliva and the total plasma concentrations was significant but relatively poor, however. Consequently, mixed salivary disopyramide concentrations are a poor indicator of plasma concentrations, even if correction is made for pH change. PMID- 3626532 TI - Identification of two glucuronide metabolites of doxylamine via thermospray/mass spectrometry and thermospray/mass spectrometry/mass spectrometry. AB - Analysis of a high-pressure liquid chromatography fraction containing two urinary glucuronide metabolites of doxylamine by thermospray mass spectrometry (TSP/MS) provided [MH]+ ions for each metabolite. TSP/MS/MS of the [MH]+ ions provided a fragment ion characteristic of these metabolites. The results demonstrate the utility of TSP/MS analysis for biologically derived glucuronide metabolites. PMID- 3626533 TI - Arterial aneurysm model using laser energy. AB - Continuous wavelength laser energy can be used to perform arterial anastomoses, but all experimental series report an incidence of anastomotic aneurysm formation. To elucidate the mechanism of aneurysm production, controlled injuries of the arterial wall were created with a pulsed CO2 laser beam (40-50 mW). One carotid and one femoral artery of 10 New Zealand rabbits were injured with laser and the contralateral vessel was exposed surgically as a sham operation. At reoperation 8 to 11 weeks later, all 40 arteries were patent. None of the carotid shams, one carotid laser, two femoral shams, and eight femoral laser vessels (80%) were aneurysmal. Histologic examination revealed extensive medial necrosis with fragmentation of the internal elastic lamina in the area of these aneurysms. Femoral vessels were significantly smaller than carotids (P less than 0.001) and the high incidence of aneurysm formation in the former may be due to the relatively greater area of injury. This new model of aneurysm formation after laser injury suggests a need for further study prior to clinical application of this technology, especially in vessels smaller than 2 mm in diameter. PMID- 3626534 TI - Serotonin receptor blockade improves cardiac output and hypoxia in porcine ARDS. AB - The effects of the serotonin receptor blocker, ketanserin, were studied in a porcine Pseudomonas adult respiratory distress syndrome model. Swine, weighing 14 30 kg, were anesthetized and ventilated with 0.5 FiO2 and 5 cm H2O positive end expiratory pressure. Three groups were studied: saline control (C, n = 9), continuous intravenous Pseudomonas aeruginosa, 5.0 X 10(8)CFU/kg/min (Ps, n = 8), and Pseudomonas and intravenous ketanserin, 0.2 mg/kg, given at 20 and 120 min after the onset of the Pseudomonas infusion (KET, n = 5). Pulmonary arterial (PAP) and systemic arterial (SAP) pressures, cardiac index (CI), thermal Cardio Green extravascular lung water (EVLW), pulmonary albumin flux (slope index, SI), arterial blood gases, and whole blood serotonin levels were measured and pulmonary shunt and pulmonary (PVRI) and systemic (SVRI) vascular resistance indices were calculated. At 3 hr the Ps group demonstrated significant (P less than 0.05) increases in PAP (34 +/- 1 vs C 13 +/- 2 mm Hg), EVLW (14.4 +/- 2.2 vs C 4.3 +/- 1.2 ml/kg), SI (2.05 +/- 0.23 X 10(-3) vs C 0.38 +/- 0.09 X 10(-3) U/min), pulmonary shunt (67 +/- 15% vs C 9 +/- 3%), PVRI (1599 +/- 89 vs C 184 +/ 14 dyn X sec X cm-5/m2), and SVRI (4542 +/- 774 vs C 2087 +/- 129 dyn X sec X cm 5/m2) and decreases in CI (0.9 +/- 0.1 L/min/m2 vs C 2.8 +/- 0.2 L/min/m2), PaO2 (93 +/- 17 Torr vs C 203 +/- 15 Torr) and arterial blood serotonin concentration (23.5 +/- 13% decrease from basal). Treatment with ketanserin was associated with maintenance of PaO2 (KET 207 +/- 5 mm Hg vs C 203 +/- 15 mm Hg), pulmonary shunt (KET 8 +/- 3% vs C 9 +/- 3%), and CI (KET 2.3 +/- 0.1 L/min/m2 vs C 2.8 +/- 0.2 L/min/m2) at control levels and attenuated the Pseudomonas-induced increase in PVRI (873 +/- 37 vs Ps 1599 +/- 89 dyn X sec X cm-5/m2) and SVRI (2089 +/- 287 vs Ps 4542 +/- 774 dyn X sec X cm-5/m2), but did not alter the development of pulmonary edema. These data indicate that serotonin plays a role in the development of the V/Q mismatch and arterial hypoxemia observed in this model by a mechanism independent of changes in microvascular injury and permeability and was probably a result of reduced peripheral bronchiolar constriction. PMID- 3626535 TI - Effects of wound exudates on in vitro immune parameters. AB - Although local failure of antibacterial host defenses in the surgical wound may contribute to the development of wound infections, little attention has been focused on this problem. The goals of the current study were to determine the biological activity of postsurgical wound exudates (seroma fluids) on normal neutrophil and lymphocyte function and to quantitate the levels of complement and plasma fibronectin in these wound exudates. The wound exudates did not support the opsonophagocytosis and killing of Staphylococcus aureus or Pseudomonas aeruginosa by control neutrophils as well as serum (P less than 0.01) and was inferior to serum as a neutrophil chemoattractant (P less than 0.01). Similarly, the wound exudates did not support mitogen-induced lymphocyte blastogenesis as well as normal serum (P less than 0.01). The impaired function of both neutrophils and lymphocytes incubated in the wound exudates appeared to be due to a lack of normal humoral factors, rather than to the presence of inhibitory factors, since the addition of normal serum to the wound exudates restored cellular activity to normal. The findings of decreased levels of plasma fibronectin and decreased complement hemolytic activity in the wound exudates were consistent with the concept of a local deficiency of immune-related humoral factors. Thus, this study supports the clinical concept that local collections of wound fluids may predispose to wound infections by hampering effective local host defenses. PMID- 3626536 TI - Evaluation of serum proteins in relation to body nitrogen in tumor-bearing rats. AB - Assessment of visceral and somatic protein stores by serum proteins in surgical oncology patients has been difficult to interpret. Tumor-bearing (methylcholanthrene sarcoma) (TB) and nontumor-bearing (NTB) Fischer 344 rats were infused with a total parenteral nutrition solution at either 25, 100, or 175% of an infusion rate that provided sufficient nutrients for normal rat growth: On the fifth day after diet initiation, the rats were exsanguinated, decapitated, eviscerated, and skinned. Serum was analyzed for transferrin (TF), complement C3, albumin (ALB), retinol-binding protein (RBP), and transthyretin (TTR). Carcass (CAR) and organ (VIS) nitrogens were determined by the Kjeldahl method. TTR, TF, and RBP correlated significantly with TB and NTB VIS nitrogen and TB CAR nitrogen. The correlation of NTB VIS nitrogen with TTR, TF, and RBP (r range = 0.70-0.85, P less than 0.001) was higher than for TB rats (r range = 0.53 0.57, P less than 0.005). The correlation of TB carcass nitrogen (r range = 0.47 0.51, P less than 0.01) with TTR, TF, and RBP was higher than for NTB carcass nitrogen which was not significant (r range = 0.25-0.37, P less than 0.57). These data indicate that TTR, TF, and RBP do correlate with components of body nitrogen mass, but factors other than nutrition may influence their metabolism in the TB host. PMID- 3626537 TI - An assessment of monocyte procoagulant activity in patients with solid tumors. AB - Generation of thromboplastin by monocytes has been shown to play a vital role in hypercoagulable states seen in malignancy. The purpose of this study was to compare the procoagulant activity in cancer patients and controls. Recalcification times (RT) of whole blood from 19 normal volunteers, 8 patients with benign polyps, 12 patients previously treated by surgery for head and neck (H&N) or colon cancer, and 13 untreated patients with various stages of H&N or colon cancer were determined. Tests were performed with and without stimulation with Escherichia coli endotoxin. The mean RT in saline (RTS) of untreated patients with early cancer (4.58 +/- 0.83 min) and that of patients with advanced cancer (5.23 +/- 1.16 min) were lower than that of controls (6.55 +/- 0.82 min), P less than 0.01 and P less than 0.05, respectively. The RTS of patients previously treated and of those with benign polyps were no different from those of controls. Activation with endotoxin significantly lowered the recalcification times (RTE) in the early (3.90 +/- 0.58 min) and advanced cancer patients (4.23 +/- 0.66 min) compared to the RTE of controls (5.69 +/- 0.75 min, P less than 0.01 for both groups) as well as compared to those with benign tumors, P less than 0.05. The mean RTE of previously treated patients (4.72 +/- 0.58 min) was also lower than that of controls, P less than 0.05. Our results suggest that RT is significantly reduced in cancer patients compared to that of controls. Furthermore, monocyte activation with endotoxin may enable us to distinguish cancer patients from controls as well as from those with benign tumors. PMID- 3626538 TI - Verapamil crystalloid cardioplegia: an experimental evaluation of dose-response relationships. AB - Calcium channel blockers have been advocated as agents which enhance myocardial protection during ischemia and reperfusion. Unfortunately, while cellular integrity is preserved, myocardial function is depressed as a result of the negative inotropic effects of these agents. In order to assess the efficacy of verapamil cardioplegia, 25 isolated perfused rabbit hearts were studied. A model of normothermic ischemic arrest was utilized, employing either verapamil-free crystalloid cardioplegia or cardioplegia containing verapamil in concentrations of 0.5, 1.0, or 5.0 mg/liter. All three verapamil-treated groups demonstrated increased postischemic left ventricular developed pressure and improved postischemic compliance when compared with the untreated group (P less than 0.05). However, myocardial function was significantly depressed at 15 min of reperfusion in the 1.0 and 5.0 mg/liter verapamil-treated groups when compared with the 0.5 ml/liter group (P less than 0.05). These data suggest that the addition of verapamil to crystalloid cardioplegia results in enhanced myocardial function while minimizing the early reperfusion depression associated with higher dose therapy. PMID- 3626539 TI - Acute pancreatitis in rats: a 31P nuclear magnetic resonance study. AB - High resolution 31P nuclear magnetic resonance (NMR) was used to evaluate the severity of acute pancreatitis in rats. Experimental pancreatitis was induced by intraparenchymal injection of 10% sodium taurocholate. pancreases were removed at various time periods and the NMR spectrum of the whole organ was recorded. Metabolic changes taking place during the progression of the disease were measured and correlated with the pathologic changes. Gradual depletion of the high energy compounds, adenosine triphosphate and phosphocreatine, was observed. The NMR spectral changes paralleled the extension of the pathologic lesions and were found to constitute a reliable indicator of the severity of acute pancreatitis. It is suggested that high resolution NMR may be used to evaluate the pathogenesis and therapy of various forms of experimental pancreatitis. PMID- 3626540 TI - Comparison of washed blood and oxygenator whole blood as vehicles for sanguinous multidose cardioplegia. AB - The effects of washed blood or oxygenator-traumatized whole blood as vehicles for sanguinous cardioplegia were studied utilizing the isolated blood-perfused dog heart preparation. Hearts were subjected to 2 hr of potassium-induced arrest at 27 degrees C followed by 90 min of normothermic reperfusion. Washed blood cardioplegia (n = 7) contained blood washed thrice with saline while oxygenator blood cardioplegia (n = 6) contained whole blood which had been exposed to an extracorporeal circuit for 30 to 45 min. Cardioplegic solutions were administered at a perfusion pressure of 100 mm Hg every 15 min during arrest. While the arrest reperfusion sequence caused minor variations in the mechanical, metabolic, and biochemical parameters tested, generally insignificant differences were found to exist between groups. Differences in coronary washout PCO2 appeared to be due to inherent differences between the two cardioplegic solutions. Thus, while washing blood may be thought to be beneficial and whole blood from the extracorporeal circuit may be theorized to have a deleterious effect on the myocardium, excellent recovery of mechanical function was observed with both cardioplegic solutions. The present study suggests that it is unnecessary to wash the sanguinous cardioplegic solution obtained from the cardiopulmonary circuit. PMID- 3626541 TI - Pancreatic juice in the peritoneal cavity: antibiotics or omental preservation prevent mortality. AB - Pancreatic juice without bile will accumulate if the pancreatic duct communicates with the peritoneal cavity. We tested the effect of antibiotics or omentectomy on mortality in dogs where the pancreatic duct drained into the peritoneal cavity. Under sterile conditions the head of the pancreas was excised, the duodenum was preserved, and the body and tail of the pancreas remained in situ. The pancreatic duct was either ligated or left open to drain into the peritoneal cavity. Thirty two dogs were prepared and divided into four groups by the status of the pancreatic duct, the use of omentectomy, or the administration of two doses of penicillin G procaine (20,000 units/kg) given before and then 24 hr after operation. The dogs were observed for mortality over a 1-month period. If a mortality occurred, the etiology was determined at autopsy. After excision of the omentum, the mortality rate was significantly higher if the pancreatic duct was allowed to drain into the peritoneal cavity than if the duct was ligated. Mortality decreased within the duct open group if only antibiotics were given (significant) or if only the omentum was preserved (not significant). This study indicates the importance of bacterial contamination or omental function when pancreatic juice is present in the peritoneal cavity. PMID- 3626542 TI - Impaired adrenal vascular response to hemorrhagic hypotension by an adreno femoral venous shunt. AB - We studied the influence of an adreno-femoral venous shunt on the regional blood flow in the dog adrenal gland during hemorrhagic hypotension. An adreno-femoral venous shunt was placed transperitoneally in the left adrenal gland while the animal was under pentobarbital anesthesia. The right adrenal gland was left intact. Hemorrhagic hypotension was induced at 50 mm Hg mean arterial blood pressure for 1 hr in six dogs and the other six dogs served as normotensive controls. Nonradioactive microspheres (2 X 10(6), 15 +/- 2 micron) were injected into the ventricle. The adrenal cortical and medullary blood flows were estimated by microscopic counting of the microspheres in the serially sectioned adrenal gland. The total adrenal blood flow (sum of the cortical and medullary blood flows) of two methods was compared; the microsphere method vs timed venous sampling through the shunt. In the intact right adrenal gland, the cortical blood flow was significantly decreased, but the medullary blood flow remained unchanged during hemorrhagic hypotension. Subsequently the total adrenal blood flow was not significantly decreased. In the cannulated left adrenal gland, both the cortical and medullary blood flows were significantly decreased and adrenal vascular autoregulation was inhibited. The total adrenal blood flow calculated by the microsphere method showed a significant correlation with that by timed venous sampling through the shunt. These results indicate that the adrenal medullary vasculature autoregulates during hemorrhagic hypotension and that an adreno femoral venous shunt abolishes this vascular response. PMID- 3626543 TI - The effect of indomethacin on burn-induced immunosuppression. AB - Recent interest in the role of prostaglandin inhibitors as immunomodulators following major injury prompted us to study the effect of indomethacin on burn induced immunosuppression in rats as measured by the delayed-type hypersensitivity (DTH) skin test response, ability to contain an intradermal bacterial challenge (10(8) Staphylococcus aureus 502A injected intradermally), and overall survival from spontaneous burn wound sepsis. Fifty male Sprague Dawley rats sensitized to keyhole limpet hemocyanin (KLH) were subjected to a 30% full-thickness scald burn. Group 1 (n = 24) received indomethacin at 0.5 mg/kg intraperitoneally once daily with the first dose given immediately following the burn. Group 2 (n = 24) received vehicle only. Prostaglandin E2 measured by radioimmunoassay on day 17 was 2553 +/- 832 pcg/ml serum (+/- SEM) in the vehicle group and 1042 +/- 231 pcg/ml in the indomethacin group (P = 0.058, unpaired t test). Burn injury induced a decrease in the DTH response to KLH and an increase in the Staph lesion size (P less than 0.05) which was not corrected by indomethacin treatment. All animals developed spontaneous burn wound sepsis by day 14. Survival after 17 days in the indomethacin group was 100% compared to that of the vehicle group, 79%, P less than 0.05 (Fisher exact test). We conclude that despite unmeasurable corrections of the burn-induced suppression of the DTH response and local nonspecific bacterial defenses, low-dose indomethacin improves survival following burn sepsis. PMID- 3626545 TI - Gastric adaptive changes following experimental gastroplasty. AB - To study the adaptive response of the stomach secondary to partial obstruction imposed by gastroplasty, groups of rabbits with calibrated midgastric constrictions created as a stoma (unreinforced, Group II), as a short channel (Group III), or as a stoma reinforced with polypropylene mesh (Group IV), were compared to controls (Group I). It was found that the unreinforced stoma dilated rapidly while the pouch dilated moderately. In both the channel and reinforced stomas, the pouch dilated markedly. Increased fibrosis was found inside of the polypropylene banding, resulting in a significant incidence of luminal obstruction. The channel dilated in stages, affecting the proximal end first; but obstructive effect remained as long as part of the channel was undilated. We conclude that a narrow stoma is incompatible with a small pouch over time. Since anatomic specifications do not define function, both function (such as emptying) and adaptive changes should be studied in animal models before introduction of any new gastric limiting procedures into clinical practice. PMID- 3626544 TI - Effects of ethanol and prostaglandin on rat gastric mucosal tight junctions. AB - The effect of 16,16 dimethyl prostaglandin E2 (PG) upon tight junctions (TJs) of adjacent surface mucous cells (SMCs) as a possible mechanism by which PGs mediate their protective effects was studied using transmission electron microscopy (TEM) and freeze fracture (FF) techniques. Fasted rats were subcutaneously injected with 10 micrograms/kg of PG or an equal volume of saline, followed 30 min later by 1 ml of oral 100% ethanol or saline. Ten or sixty minutes later, animals were sacrificed and stomach blocks were prepared for TEM or FF using standard techniques. Electron micrographs (X60,000) were obtained and the distance between SMC inner membrane leaflets was measured with a micrometer and expressed as TJ width. Stomach blocks for FF were stored at 4 degrees C, cryoprotected, freeze fractured, and photographed by TEM (X30,000). At 0.5-micron intervals, measurements of TJ strand number and depth were made. No statistical differences were found in TJ width or strand number of SMCs among the various experimental groups when compared with controls at each sacrifice time. At the 60 but not 10 min sacrifice time, TJ depth was greatly increased in cells treated with 10 micrograms/kg PG prior to ethanol exposure (P less than 0.025) in contrast to control mucosae. We conclude that 16,16-dimethyl PGE2 induces no changes in the structural composition of TJs as a possible explanation for its protective properties. The increase in TJ depth observed in ethanol exposed mucosa following PG pretreatment at the 60 min sacrifice time is most likely related to the architectural restructuring that occurs during reconstitution of damaged surface epithelium. PMID- 3626546 TI - Blood flow and distribution in the canine pancreas. AB - Because of a tripartite arterial inflow, accurate determination of canine pancreatic blood flow (QP) in experimental studies remains problematic. Assessment of blood flow using a single electromagnetic flow probe on the anterior pancreaticoduodenal artery (APDA) was compared to the radiolabeled microsphere method. Distribution of QP was based on microsphere density. QP determined simultaneously with the flow probe technique and the microsphere method were 86 +/- 17 and 23 +/- 8 ml/min, respectively, (P less than 0.05). Following occlusion of the splenic artery (SA) and the posterior pancreaticoduodenal artery (PPDA), QP measured by the flow probe increased to 94 +/- 27 ml/min (NS) and decreased to 19 +/- 4 ml/min (NS) using microspheres. Intrapancreatic distribution of QP was not significantly altered by occlusion of the SA and PPDA. Intrapancreatic arterial collateral is adequate to maintain blood flow to the entire pancreas even when arterial inflow is restricted to the APDA. Flow probe determinations of QP are artifactually high because they include flow to the duodenum and may also be subject to methodologic error. PMID- 3626547 TI - Regional doxorubicin delivery reduces testicular toxicity. AB - Many anti-cancer drugs cause infertility. Regional delivery of these agents is a potential method to avoid this problem. We investigated the protective effect of normothermic testicular circulatory arrest on gonadal toxicity during doxorubicin administration in the Sprague-Dawley rat. Four groups of eight rats each were used. Animals in group 1 received no treatment. Rats in group 2 were anesthetized and received a bolus of intravenous doxorubicin (6 mg/kg). In groups 3 and 4, normothermic circulatory isolation of the left testis was induced by cross clamping of the spermatic cord and gubernaculum immediately before doxorubicin administration. This was maintained for 15 min after doxorubicin administration in group 3 and for 45 min in group 4. Cessation and return of testicular blood flow were confirmed by Doppler. On Day 56, all rats were killed and necropsied. Testicular toxicity was evaluated qualitatively by histology and quantitatively by measurement of testicular weight, sperm count, repopulation index, and epididymal index. The results indicated that 15 min of testicular circulatory isolation mitigated testicular toxicity to a small extent and that 45 min of circulatory isolation provided moderate protection against doxorubicin-induced testicular toxicity. PMID- 3626548 TI - Glucocorticoid effects on growth, and androgen receptor concentrations in DDT1MF 2 cell lines. AB - The DDT1MF-2 smooth muscle tumor cell line contains receptors for and is differentially sensitive to androgens and glucocorticoids. Androgens stimulate and glucocorticoids inhibit growth. We now confirm that the latter involves the induction of a block in the G1 phase of the cell cycle. We have developed and characterized in vitro and in vivo a glucocorticoid resistant variant of this cell line, the DDT1MF-2-GR. Glucocorticoids specifically inhibit androgen induced androgen receptor augmentation in DDT1MF-2 cells, but not in the GR variant suggesting that growth inhibition is related to inhibition of androgen receptor augmentation. However, under optimal conditions for cell proliferation, when glucocorticoid inhibited growth is relieved by the exogenous addition of platelet derived growth factor, androgen receptor augmentation is still suppressed. Thus, androgen induced elevation in androgen receptor concentrations is not a prerequisite for cell proliferation. These results imply that in androgen responsive cells, although androgen stimulation of growth can be blocked by antagonism of androgen receptor mediated events, the antagonism can be bypassed by supplying the cells with exogenous growth factors. These results provoke speculation on how cells, which are dependent upon androgens for growth, become autonomous. PMID- 3626550 TI - Studies on the mechanism of glucocorticoid hormone induced alterations in rat thymic transcription--II. Partial purification and characterization of RNA polymerases II from hydrocortisone and control vehicle treated animals. AB - In experiments designed to study the mechanism of glucocorticoid hormone induced reductions in rat thymic transcription, adrenalectomized rats were injected with hydrocortisone (50 mg/kg) or control vehicle 12 h prior to sacrifice. Thymic nuclei were used to prepare soluble nuclear extracts containing RNA polymerase II. Nuclear extract RNA polymerases II were then partially purified (600-fold) on DEAE-Sephadex columns and characterized. The responses of partially purified thymic RNA polymerases II from rats treated in vivo with hydrocortisone or vehicle were similar to: pH, temperature, ionic strength, trypsin proteolysis, and inhibition by alpha-amanitin; however, RNA polymerase II from hydrocortisone treated animals was consistently reduced in activity compared to control RNA polymerase II. Determination of the apparent specific activities of peak RNA polymerase II fractions from DEAE-Sephadex columns suggested that the specific activity of RNA polymerase II from hydrocortisone treated animals was reduced compared to RNA polymerase II activity from control animals. The fact that both nuclear extract and partially purified RNA polymerases II from hydrocortisone treated rats were reduced in activity when assayed in reconstituted transcriptive systems suggests a denatured, defective or modified RNA polymerase II molecule acting as a transcription inhibitor. Thermally denatured nucleoplasmic RNA polymerase II fractions were shown to interfere with transcription by native nucleoplasmic RNA polymerase II in vitro, but did not appear to inhibit transcription to he degree observed in vitro following in vivo hydrocortisone administration. PMID- 3626549 TI - Effect of the antiprogestin RU-486 on progesterone inhibition of occupied nuclear estrogen receptor in the uterus. AB - The ability of the antiprogestin, RU-486, to reverse progesterone (P) antagonism of occupied nuclear E receptor retention was studied in the rat and hamster uterus. RU-486 was shown to effectively displace [3H]P binding from rat uterine cytosolic P receptor in in vitro competition assay. In contrast, no competition by RU-486 for [3H]P binding was observed for uterine cytosolic P receptor from the hamster uterus. In the presence of sustained serum levels (silastic implants) of P and estradiol (E), occupied nuclear E receptor was significantly inhibited in the rat uterus. At 6, 12 and 24h after RU-486 treatment (5 mg/animal, s.c.) uterine receptors for E and P were determined. No significant differences in cytosolic E and P receptors were observed between treated (E + P, + RU-486) and control (E + P alone) animals. However, by 6 h following RU-486 treatment, occupied nuclear E receptor retention increased significantly (0.30 +/- 0.05 vs 0.60 +/- 0.09, pmol/uterus) and reached a peak between 12 h (1.32 +/- 0.09) and 24 h (0.83 +/- 0.09). The increase in nuclear E receptor approached the level observed in animals with an E implant alone (1.55 +/- 0.15). Measurement of uterine fluid accumulation following RU-486 treatment showed an increase which paralleled that observed for occupied nuclear E receptor retention. A similar in vivo experiment in the hamster showed no reversal of P inhibition of occupied nuclear E receptor. These results show that: 1. RU-486 is an effective competitor for rat uterine P receptor but not hamster P receptor; 2. RU-486 can rapidly reverse P inhibition of uterine occupied nuclear E receptor in the presence of sustained serum levels of E and P; 3. The recovery of occupied nuclear E receptor is coincident with a resumption of E action (uterine fluid accumulation). The studies also provide a novel means by which antiprogestin activity can be assessed in vivo in the presence of sustained E and P serum levels, e.g. the reversal of P inhibition of uterine nuclear E receptor retention. PMID- 3626552 TI - Ovine placental aromatase: studies of activity levels, kinetic characteristics and effects of aromatase inhibitors. AB - We have measured microsomal steroid aromatase activity in the fetal component of ovine placental cotyledons collected from pregnant ewes between 124 days and 127 days of gestation. Aromatase activity was determined by quantifying the [3H]water by-product when [1 beta-3H(N)] androstenedione was used as substrate. The mean microsomal aromatase activity (+/- SD) was 5.7 +/- 2.2 pmol.min-1.mg protein-1 (n = 12) and was 9% of the aromatase activity of human placental microsomes [mean (+/- SD) of 66.1 +/- 25.0 pmol.min-1.mg protein-1 (n = 7)]. The apparent Km for ovine placental aromatase for androstenedione, at pH 7.4 and 37 degrees C, was 50 nM while the Vmax was 20.6 pmol.min-1.mg protein-1. The respective concentrations effecting 50% inhibition of ovine placental aromatase activity (the I50) for econazole, 4-hydroxyandrostenedione, imazalil, miconazole, ketoconazole and aminoglutethimide were 0.03, 0.05, 0.15, 0.50, 5.0 and 5.5 microM. The order of relative potencies were similar to those obtained for human placental aromatase. Ketoconazole and aminoglutethimide were approx 10 times more potent inhibitors of the sheep enzyme relative to the human. Aromatase activity was not confined to the microsomal fraction of ovine placental tissue but was distributed throughout all the particulate subcellular fractions. The proportionally high activity of the tissue homogenate (1.75 pmol.min-1.mg protein-1) is suggestive that in the last third of pregnancy, aromatase is not rate limiting with regard to placental estrogen production. It would appear, therefore, that the major factor regulating placental estrogen synthesis in ovine pregnancy is the availability of substrate. PMID- 3626551 TI - Effects of 10-(2-propynyl)-estr-4-ene-3,17-dione (MDL 18,962)--a mechanism-based irreversible inhibitor of aromatase--in cultured human foreskin fibroblasts. AB - In male subjects, peripheral aromatization of androgens accounts for most of the estrogen production, and skin is an important site of such enzymatic activity. We have studied the effects of a mechanism-based, irreversible aromatase inhibitor, 10-(2-propynyl)-estr-4-ene-3,17-dione (MDL 18,962) on androgen action and metabolism in cultured human foreskin fibroblasts. Cells were incubated simultaneously in the presence of substrate, androstenedione, and inhibitor, MDL 18,962. Aromatase activity was linear with time up to 3 h of incubation at 37 degrees C in the absence and presence of 1.0-10 nM inhibitor. The IC50 for four different cell strains ranged from 4.0 to 8.6 nM MDL 18,962. Kinetic analysis of competitive inhibition by the Eadie-Hofstee method yielded an apparent Ki of 2.75 nM for the inhibitor. Preincubation of cells with MDL 18,962 resulted in irreversible inhibition of aromatase activity which was time- and concentration dependent. We calculated a Ki of 7.6 nM for MDL 18,962. Preincubation of cells with 25 nM MDL 18,962 suppressed enzyme activity for up to 6 h following removal of the inhibitor, before a return of enzyme activity due to synthesis of new enzyme. MDL 18,962 (0.2-20 microM) did not influence the 5 alpha-reduction of testosterone (200 nM). In addition, binding of dihydrotestosterone (2 nM) to androgen receptors was not affected by MDL 18,962 (25-1000 nM). In summary, MDL 18,962 is a specific, high potency inhibitor of aromatase. By virtue of its high binding affinity to the enzyme active site, it competes very effectively with substrate, resulting in irreversible inactivation of aromatase. PMID- 3626553 TI - A comparative study of Aldactone and Diane in the treatment of hirsutism. AB - A comparative study has been performed in order to evaluate the relative potency of Diane and Aldactone in reducing hair growth as well as the effect on blood hormone concentrations. Thirty-six women participated in the study and depending on the desire for contraception, 22 were treated with Diane and 14 with Aldactone. The results show that Aldactone (50 mg per day) had little effect on hormone concentrations, only LH was significantly reduced after 12 months of treatment. Despite the lack of effect on hormone levels, all 14 women reported reduced hair growth and after 5 months of treatment, 58% also reported a decrease in the formation in new hair growth. In contrast to the Aldactone treated group, the women on Diane medication demonstrated a marked decrease in circulating hormone levels with a subsequent effect on the hair parameters. The clinical effects were, however, not quite of the same degree as those seen with Aldactone treatment. Approximately 20% exhibited no response for any of the 3 hair parameters (reduced hair growth, formation of new hair and a change to softer hair). The response time before any effect was observed was also longer than that seen with the Aldactone group. The data suggest that, at the dosages employed, Aldactone has a better clinical effect on the hair parameters despite a lack of effect on circulating hormone levels. One should, however, be aware that Diane contains only 2 mg cyproterone acetate (CPA) and a better effect would most probably have been obtained using a higher dosage of CPA. PMID- 3626554 TI - Androgen metabolism in the male hamster--1. Metabolism of testosterone in the pituitary gland and in the brain of animals exposed to different photoperiods. AB - It is known that the metabolism of testosterone in the brain and in the anterior pituitary is different in mammalian and in photoperiodic avian species. In many mammalian species, testosterone is mainly metabolized to 5-alpha-reduced compounds (e.g. 17-beta-hydroxy-5-alpha-androstan- 3-one, 5 alpha-DHT and 3 alpha,17-beta-dihydroxy-5-alpha-androstane, 5-alpha,3-alpha-diol) and, to a smaller extent, to 4-androstene-3,17-dione (androstenedione), while in birds, androstenedione is the main testosterone metabolite and the conversion to the 5 alpha-reduced compounds is quantitatively negligible. In avian species, testosterone is also converted to 5-beta-reduced steroids (mainly 17-beta-hydroxy 5-beta-androstan-3-one, 5-beta-DHT and 3-alpha,17-beta-dihydroxy-5-beta androstane, 5-beta,3-alpha-diol), and there is also evidence that in these species testosterone metabolism in the central structures may be influenced by the photoperiod. Since the hamster is a mammal whose reproductive cycle is controlled by day length, it has been analyzed whether: (a) the central structures of the hamster (cerebral cortex, hypothalamus and anterior pituitary) metabolize testosterone in vitro following a mammalian (5-alpha-reduced derivatives) or an avian (androstenedione and 5-beta-reduced compounds) pattern; and (b) the metabolism of testosterone in the same structures may be modified by the exposure to different photoperiods (LD 14:10 or LD 8:16). The present data indicate that no one of the hamster structures examined produces the 5-beta reduced derivatives. Moreover, the formation of the 5 alpha-DHT is quantitatively low, and is not affected by the photoperiod. In contrast, androstenedione is formed in quite high yields and the exposure of the animals to 60 days of short photostimulation increases the formation of this steroid in the pituitary gland, but not in the brain structures. From these data, it appears that the central structures of the hamster metabolize testosterone with a pattern which is intermediate between that of birds and mammals. PMID- 3626555 TI - The multicomponent analysis of estrogens in urine by ion exchange chromatography and GC-MS--II. Fractionation and quantitation of the main groups of estrogen conjugates. AB - A method for the metabolic profiling of estrogen conjugates in urine is described. It mainly involves protection of carbonyl functions by ethoximation, solid extraction on Sep-Pak C18 cartridges, a number of ion exchange chromatographic steps and quantitation by capillary GC or GC-MS. The acetate form of DEAE-Sephadex is used to initially separate estrogen conjugates into four groups; unconjugated, monoglucuronides, monosulfates and double conjugates. Monoglucuronides are further subfractionated to A- and D-ring glucuronides by carbodiimide methylation of the carboxylic functions and chromatography on the free base form of DEAE-Sephadex. Double conjugates are subfractionated to disulfates and sulfoglucuronides by solvolysis and chromatography on the acetate form of DEAE-Sephadex. After the appropriate enzymatic hydrolysis or solvolysis procedures the liberated free estrogens are purified and fractionated by a series of anion exchange chromatographic steps. Finally, following trimethylsilyl ether derivatization estrogens are analysed by capillary GC or GC-MS. The method permits the quantitation of the main conjugates of all the important estrogen metabolites including catechol estrogens. The method is precise, the sensitivity depending on the quantitation mode employed GC or SIM GC-MS. The method was applied to seven late pregnancy urines the values of which are presented. PMID- 3626556 TI - Studies on the mechanism of the antiandrogenic effect of a putative 5 alpha reductase inhibitor. AB - The mechanism of the antiandrogenic effect of 5,10-seco-19-norpregnane-4,5-diene 3,10,20-trione (secosteroid), reputedly an irreversible inhibitor of 5 alpha reductase, was investigated. Its addition (10 microM) to culture media effectively suppressed the synthesis of rat epididymal proteins specifically induced by 0.1 microM testosterone (T) or dihydrotestosterone (DHT). Under the same conditions, secosteroid did not change the rate at which labeled T was metabolized to 5 alpha-reduced compounds. In a comparative study, secosteroid inhibited 5 alpha-reductase in an isolated microsomal fraction while not affecting the enzyme activity in minced tissue. Secosteroid was shown to be a competitor of the binding of [3H]T and [3H]DHT (both at 4 nM) to the epididymal cytosol androgen receptor, with ID50 of 1 microM for the former and 4 microM for the latter, thus explaining the mechanism involved in its antiandrogenic properties. PMID- 3626557 TI - Surgical approach to malignant melanoma in the gastrointestinal tract. AB - The gastrointestinal (GI) tract is a common site for malignant melanoma. Diagnosis of lesions in the GI tract is usually delayed until complications occur, such as obstruction, bleeding, or perforation of the GI tract. Of 348 patients with malignant melanoma treated during a 10-year period, 11 had GI involvement either in a metastatic form or as a primary melanoma. Three of these patients were treated surgically for metastatic lesions in the small bowel causing intussusception, two for peritonitis secondary to perforation of the small bowel, and one for massive bleeding from metastatic melanoma in the stomach. Another patient had a primary melanoma in the esophagus and underwent esophagectomy. Three patients had primary melanomas of the anal canal and one of the rectum. Three of them underwent abdominoperineal resections, and two had bilateral groin dissection in addition. Six of the patients are alive 6 months to 4 years following diagnosis. The remaining five died of metastatic melanoma from 6 months to 4 years post-surgery. PMID- 3626558 TI - Solitary malignant schwannoma of the pancreas: report of a case and ultrastructural examination. AB - Primary malignant schwannoma of the pancreas is rare. The reported patient, a 40 year-old white female, presented with obstructive jaundice and a large palpable mass in the upper abdomen. A Whipple procedure was performed. Electron microscopic examination of the tumor established the Schwann cell origin of the neoplasm by demonstrating basement membranes, junctional complexes, and interdigitating cytoplasmic extensions infested with basal lamina, dense neurosecretory-like granules, and axon-like structures. The inadequacy of light microscopic examination alone for establishing the diagnosis with certainty is discussed. Review of the literature revealed only one case of a malignant schwannoma of the pancreas that was not resected. This is the first report confirmed by ultrastructural examination. PMID- 3626559 TI - Prognostic significance of lymph vessel involvement in gastric cancer. AB - We studied the prognostic significance of lymph vessel involvement in the gastric wall in 226 patients with advanced gastric cancer. There was no close correlation between the gross morphology of the cancer and the incidence of lymph vessel invasion. However, the more severe the degree of lymph vessel involvement, the higher was the incidence of lymph node metastasis. Severe lymph vessel invasion was found most frequently in poorly differentiated adenocarcinoma of the medullary type. Among patients with scirrhous carcinoma there were some in whom lymph vessel involvement was overlooked on routine histologic examination. Because the depth of lymph vessel invasion of the gastric wall was significantly related to the clinical course, we consider this to be of supplementary predictive value. PMID- 3626560 TI - Postradiation slipped capital femoral epiphyses (SCFE). AB - This study details the case reports of two children who developed slipped capital femoral epiphyses (SCFE) after receiving external irradiation. The clinical and diagnostic features of postradiation SCFE are reviewed and discussed. Guidelines for the management of children who receive pelvic irradiation are presented. PMID- 3626561 TI - Intraoperative interstitial hyperthermia in conjunction with intraoperative radiation therapy in a radiation-resistant carcinoma of the abdomen: report on the feasibility of a new technique. AB - The application of a new technique of intraoperative interstitial hyperthermia (IOHT) and intraoperative radiation therapy (IORT) was investigated for unresectable abdominal carcinoma. A 43-year-old white male presented with severe back pain due to metastatic adenocarcinoma in the left paravertebral area, producing erosion of the body of T12. The disease had not responded to external beam radiation therapy. The tumor was approached through a thoraco-abdominal incision and IOHT was delivered via interstitial electrodes. Temperature was monitored at 16 locations within the tumor. An LCF hyperthermia unit was utilized to deliver RF power and produced a treatment temperature of 43 degrees C for 60 minutes uniformly throughout the treatment volume. Immediately following hyperthermia treatment, the lesion was treated with 15 meV electrons via IORT to a tumor dose of 25Gy. The patient recovered without complication and had complete relief from pain. Posttreatment CT scans have demonstrated control of disease over a 5-month follow-up period. A clinical pilot study has been established to further investigate the application of this combination therapy. PMID- 3626562 TI - NB rat bladder cancer model: evaluation of the subrenal capsular assay system. AB - Since 1978 this laboratory unit has evaluated the Nb rat prostate adenocarcinoma model. More recently, over a 15-month period we have studied the Nb rat number one bladder tumor, a spontaneously appearing tumor in an aged female noble rat. Initial chemotherapeutic experiments have been carried out, revealing activity of this tumor to cyclophosphamide. Herein we report the feasibility of utilizing the subrenal capsular assay in the model. The advantage of this system is that one is able to determine the effect of chemotherapy in a very short time, i.e., 7 days. This method may save considerable expense and may serve as a useful projector for potential future chemotherapeutic trials of bladder cancer. In this assay system, cyclophosphamide, adriamycin, and cis-platinum and methotrexate did result in a significant decrease in tumor volume change. This change paralleled the results that we had seen in the past from the use of chemotherapy with cyclophosphamide alone in treatment of subcutaneous tumor nodules of bladder carcinoma. Further exploration of this method is warranted from a time efficiency as well as from a cost standpoint. PMID- 3626563 TI - Extravascular papillary endothelial hyperplasia. AB - The clinicopathologic features of a unique case of papillary endothelial hyperplasia occurring in an organizing hematoma of the thyroid gland are reported and compared with reported cases of intravascular papillary endothelial hyperplasia. PMID- 3626564 TI - Primary adenocarcinoma of the esophagus. AB - Of 163 patients with carcinomas of the esophagus seen between 1975 and 1982, 11 (6.7%) had a primary adenocarcinoma. Although the high ratio of men to women (10:1) was similar to that seen in patients with squamous cell carcinoma of the esophagus, the mean age of those with adenocarcinoma was younger (57 years). In contrast to squamous cell carcinomas, which predominantly involve blacks, esophageal adenocarcinomas in these patients involved only Caucasians. The great majority of lesions were found in the lower third of the esophagus. Only 3 (27%) of the patients with adenocarcinomas gave a history of a large daily alcohol consumption and only 2 (18%) had a Barrett's esophagus. Although various combinations of surgery, chemotherapy, and radiotherapy could control the primary tumor rather well, the final results were poor. All patients have now expired; median survival time was 16 months. PMID- 3626565 TI - Cellular blue nevus simulating metastatic melanoma: report of an unusually large lesion associated with nevus-cell aggregates in regional lymph nodes. AB - A young Caucasian woman had a large area of blue-gray discoloration on the flank and palpable axillary lymph nodes. The discolored area had enlarged during a recent pregnancy, contained multiple subcutaneous nodules, demonstrated increased cellularity and mitotic activity, and was associated with an axillary lymph node containing black streaks within the capsule. Although the lesion was initially considered to be a metastatic malignant melanoma, re-evaluation showed it to be a benign cellular blue nevus with benign nevus-cell aggregates within a regional lymph node. We report this case to emphasize how cellular blue nevus can simulate malignant melanoma and to increase physician awareness of this benign variant of melanocytic nevus so that inappropriate surgery and chemotherapy can be avoided. PMID- 3626566 TI - Hepatic intra-arterial adriamycin in metastatic leiomyosarcoma: exploiting the steep dose-response curve. AB - We report a case of extensive leiomyosarcoma of the liver that failed on systemic Adriamycin. Hepatic intra-arterial chemotherapy with Adriamycin has resulted in a lasting clinical remission. This report illustrates the importance of the dose response curve of drug to tumor in regional chemotherapy as with Adriamycin used in sarcoma, and the need to further explore such therapy in moderately chemosensitive tumors that are surgically unresectable for anatomic reasons. PMID- 3626567 TI - A simple experimental index for the evaluation of inotropic responses. AB - The validity of the first derivative of systemic arterial pressure (SAdP/dt) as an indirect experimental index for the evaluation of inotropic responses was ascertained in rats anesthetized with pentobarbital sodium (40 mg/kg, i.p.), using the first derivative of left ventricular pressure (LVdP/dt) as the reference. We observed highly significant qualitative and quantitative (p less than 0.001) correlations between these two parameters, under five well established experimental cardiovascular perturbations that are known to promote inotropic actions, viz, vagosympathetic trunk stimulation; intravenous administration of pentobarbital, epinephrine, or phenylephrine; and temporary common carotid artery occlusion. Preliminary experiments using isometric ventricular contraction as the reference also confirmed these observations. It is suggested that the SAdP/dt may qualify, at the systemic level, as an easily accessible experimental index for ventricular contractility. PMID- 3626568 TI - A fully automated system using a microcomputer for the hypertensive activity assays of drugs in the anesthetized rat. AB - A complete system is described for the computerized automation of the determination of activity of hypertensive drugs in the anesthetized rat. The microcomputer used was the Apple IIe, and the automation was performed by a purpose-designed command module. The series of injections of hypertensive drugs was controlled by the microcomputer through the intermediary of the command module. All processing of the signal (hypertension peak), calculation of the data obtained, statistical processing, and archive storage of the results was carried out entirely by the microcomputer. The computer was able unaided to control three work stations simultaneously without requiring synchronization. PMID- 3626569 TI - Chronic renal failure in the rat. A surgical model for long-term toxicological studies. PMID- 3626570 TI - A method for quick and simple construction of push-pull cannulae and their use in recovery of hippocampal amino acids. PMID- 3626571 TI - Modification of an infant incubator for exposure of experimental animals to nitrous oxide. AB - Research with N2O is hampered because it is a gas and must be inhaled by the test subject rather than injected. Described herein is the development of a practical and efficient exposure chamber for such research. A Model C-35 Isolette infant incubator was modified by installation of a manifold system for distribution and opposed-suction fans for a circulation of the gas mixture (N2O in oxygen). An exponential model was developed, predicated on gas concentration uniformity, to track the increasing concentration of N2O during chamber filling and to predict the time required for the chamber to assume a steady-state level of N2O. This model requires that three things be known: the volumetric flow rate of administered gas mixture, the concentration of N2O in that mixture, and the volume of the chamber. The model predicts that X(t)/X infinity = 1 - exp(-t/tau), where X(t) is the concentration of N2O of an instant t; X infinity, the concentration of N2O administered; and tau, the time constant--the ratio of chamber volume to volumetric flow rate. This model was confirmed via mass spectroscopy analysis of gas from the chamber during filling. PMID- 3626572 TI - Method for stable measurement of the electrocardiogram in isolated guinea pig heart. Evaluation of the RR-QT relationship and the effect of quinidine. AB - A method for stable measurement of ECG in an excised guinea pig heart was presented. The effects of quinidine and its major metabolite, 3-OH quinidine, on QT interval were compared using excised guinea pig hearts with A-V nodal rhythm paced at a constant frequency (190 beats/min). The relative potency of 3-OH quinidine to its parent drug was about one-fourth. Taking into account the fact that the free fraction of 3-OH quinidine in blood is larger than quinidine, this metabolite may contribute to the effects of quinidine in man. Changing the frequency of electrical pacing in excised hearts with A-V nodal rhythm, the RR-QT relation was determined to be rather linear, and this relation became more curvilinear after addition of quinidine (2 mg/liter), suggesting that the Bazett's formula for correcting QT interval with the heart rate is not applicable to guinea pig heart and/or after an addition of drug. PMID- 3626573 TI - A systematic method for the compilation of the King & Altman graphs of a steady state enzyme model suitable for manual or computer use. AB - The schematic way of computing the King & Altman (1956) patterns for complex enzyme models is rather tedious. In this paper, a systematic method for the compilation of these patterns is proposed. This method ensures the generation of all the King & Altman patterns including those containing cycles. The importance of such patterns for an automatic recognition of the cyclic pathways of a given model is emphasized. The suggested algorithm is suitable for manual or computer processing. PMID- 3626574 TI - Microtubule dynamics in the spindle. II. A thermodynamic and kinetic description. AB - We have previously presented a model for the assembly and disassembly of mitotic spindle microtubules (MTs) (Pickett-Heaps et al., 1986). In this paper, we describe the thermodynamics of such spindle MT assembly and present equations to describe the polymerization kinetics of different classes of spindle MTs. These equations are used to predict, in terms of kinetics parameters, the magnitude of forces extant on spindle MTs and to define the critical force needed to halt MT assembly. We calculate several of these forces for a hypothetical model cell; our predicted value for the force generated along kinetochore fibers is in close agreement with measured values taken from living cells. The model and its implications are discussed with reference to other recent models of spindle and MT dynamics. PMID- 3626575 TI - Dispersal polymorphisms in subdivided populations. AB - Price's method for analyzing natural selection in subdivided populations is applied to the problem of dispersal polymorphism strategies in a stable habitat. The results agree with the more traditional Mendelian models for this same problem that have recently been published. Further, by using Price's method, the results obtained are simpler and more general, and the causal evolutionary mechanisms underlying the predicted patterns are more easily recognized. The most interesting new result is that the equilibrium proportion of dispersed individuals is a simple function of the risk of dispersing and the regression coefficient of relatedness among individuals who, in the absence of dispersal, would compete for a limited, local resource. This regression coefficient refers to the genotypes that control the dispersal phenotype. For example, when mothers control the phenotype of their progeny, then the regression is from the mother onto an offspring chosen randomly from the local group before dispersal; while when offspring control their own phenotype, the regression is taken directly from offspring onto a randomly chosen cohort member before dispersal. This use of controlling genotypes to calculate regressions explains the form of the parent offspring conflict over dispersal noted by previous authors. The simplicity and generality of these results suggest that Price's method is a useful approach for studying the class of phenomena known as "games among relatives". PMID- 3626576 TI - Genetics of Darwinian fitness. III. A generalized approach to age structured selection and life history. AB - Most models in life history assume that maximization of lambda holds. Demographic genetic theory supports this assumption provided (i) the fecundity of each mating is determined solely by the age and genotype of the female, (ii) the two sexes experience the exact same selection intensities, and (iii) the two sexes are equal in their age specific schedules of survival and fecundity. But these assumptions will often not hold in nature: thus a more general means of analysis closely integrated with a broader genetic treatment is attempted here. First, operators are derived to map sex specific non-overlapping generation models into the more general case in which generations can overlap. Application of such operators then suggests a broader representation of age structured selection in which evolution acts according to a single composite Wrightian topography whose gradient is a weighted mean taken over selective gradients in all of the age classes. Application of this view is straightforward, showing, for example, that (i) the evolutionary maximization of lambda, which is the basis of present optimization theories for life history, is extremely fragile with biological deviation from mathematical assumptions used in its derivation, (ii) the cost of meiosis argument is shown not to conflict with traditional life history theory, although its correct application will depend critically and subtly upon how genic effects on fertility are measured, and (iii) correct weightings for age specific selection converge to those of Hamilton (1966) and Schaffer (1974) only when sex specific differences in fertility and survival are nonexistent or when selection occurs only in the demographically dominant sex. For life history problems beyond assumptions underlying tradition approaches the composite adaptive topography seems to provide a suitable alternate means for analysis. PMID- 3626577 TI - Is your initiator really necessary? AB - There is little hard evidence for the involvement of specific genotoxic initiators in the pathogenesis of the common carcinoma. Recent findings suggest that sporadic carcinogenesis is a dynamic and probabilistic process which requires a critical mass of abnormal cells for its expression, and that this requirement may distinguish the evolution of carcinomas from that of paediatric or haematologic malignancies. The proposal that specific carcinogens are neither necessary nor sufficient for tumourigenesis is consistent with the growing realization that aberrant expression of specific oncogenes is neither necessary nor sufficient for cellular transformation. These new perspectives have major implications for basic research strategy and public health policy. PMID- 3626578 TI - Males, parthenogenesis, and the maintenance of anisogamous sex. AB - The problem of the maintenance of anisogamous sex is addressed by considering the effect of fertilization on the fitness of parthenogenetic females when such fertilization yields inviable triploid progeny. We consider four types of parthenogenesis: (i) apomixis, (ii) homogametic amphimixis, (iii) heterogametic amphimixis, and (iv) homogametic automixis. Homozygous sexual populations are genetically stable if males or selection eliminate the excess females produced by heterozygous parthenogenetic genotypes. Homozygous parthenogenetic populations are stable if the parthenogenetic output of homozygotes exceeds that of heterozygotes. In turn, sex can only invade heterozygous parthenogenetic populations when sexual output of parthenogens is larger than their parthenogenetic output. The existence of interior stable equilibria generally requires the instability of at least one boundary and some degree of heterosis. In a two-locus model, we study the evolution of mechanisms protecting either sex or parthenogenesis in reproductively polymorphic populations. We find that males do not respond to the presence of parthenogenesis in such a way as to eliminate it, but parthenogenesis is subject to selective pressures increasing reproductive isolation, and thus the success of parthenogenesis. The results suggest that reproductively polymorphic populations are ephemeral. PMID- 3626579 TI - The cost of sex in hermaphrodite populations with variation in functional sex. AB - In this paper an analysis is made of a model of selection for asexual reproduction in hermaphrodite (or monoecious) populations in which variation occurs in relative female and male fertilities. It is shown that the advantage of an asexual mutant (the cost of sex) increases with increasing degree of differentiation in functional sex. This effect is very marked at low levels of selfing, but weak with a high selfing rate. In general, the advantage of an asexual mutant in a hermaphrodite population depends on the relative resource allocation to male and female gametes, and increases with increasing bias to femaleness. Thus the cost of sex in gynodioecious populations is (with a low level of selfing) as high as in a dioecious population. This applies, however, to a nuclear genetic determination of gynodioecy, which is presumably rare. In a more realistic model assuming nuclear-cytoplasmic determination of gynodioecy the cost of sex is considerably lower. PMID- 3626580 TI - The population dynamics of acquired immunity to helminth infection. AB - Based on experimental evidence we develop and exploit a mathematical model to describe the role of acquired immunity in host-helminth interactions. We show that the model gives a quantitative description of the population dynamics in a laboratory situation involving a host immunological response. We make practical predictions based on these results. PMID- 3626581 TI - Visual display terminals do not emit UV-A radiation of clinical relevance. PMID- 3626582 TI - Proteins as general crystals. PMID- 3626583 TI - Body size and metabolic rate: calculated exponents are independent of the units used. PMID- 3626584 TI - High frequency electrostimulation of excitable cells. AB - Reactions of nerve fibers to high frequency electrical stimulation are examined with three nerve models. Switching on the signal produces a single AP at the threshold current. Stronger currents lead into a region of repetitive firing. The firing rate depends on the current and the fibers more distant from the electrode will have a lower rate. The AP's are not synchronized. In the "House-Urban" cochlear implant a 16 kHz carrier is used for stimulation. It is modulated by electrical signals derived from sound pressure. An analysis of the modulation shows which signals can produce APs synchronized with the source signal. PMID- 3626585 TI - Progress curves of reactions catalyzed by unstable enzymes. A theoretical approach. AB - When an enzyme is incubated with its substrate, the rate of catalysis will decline with time due to the combined effects of substrate utilization and product accumulation. These effects will be superimposed upon a progressive loss of catalytic activity if the enzyme is unstable, either spontaneously or as a result of an added reagent. In this report, the effect of enzyme inactivation on the progress curve for an enzyme-catalyzed reaction is considered. It is shown that under most circumstances catalysis will stop before the substrate is totally exhausted and that the amount of substrate remaining is related to the inactivation rate constants for various intermediates on the catalytic pathway. A graphical method for estimating these inactivation rate constants is suggested for several situations, including one which encompasses the effect of a suicide substrate. Expressions for the half time of the reaction are also given for some special cases. PMID- 3626586 TI - A mathematical model of pattern formation. AB - This paper presents an explicit mathematical model describing pattern formation in monolayer epithelia. The approach is a generalization of the equations describing soap bubble configurations (Plateau, 1873; Thompson, 1917; Almgren & Taylor, 1976) that allows adjacent cells to adhere with differing intensities (Steinberg, 1962, 1978). The model is a system of simultaneous non-linear equations that considers cell-cell interactions in a two-dimensional sheet. The implementation involves using the equations of the model to predict explicitly the energy-minimizing configuration of a system of cells, based on the adhesivity of their membranes. The model can thus be used to explore the effects of varying adhesions on the dynamics of pattern formation. Following Chichilnisky (1985), such a descriptive system is introduced in this paper, and its predictive properties explored. PMID- 3626587 TI - Chemical dynamic approach to synergetics and instability in biological systems. AB - Based on Haken's theory, self-organization or synergetics is discussed using chemical dynamics to represent an autocatalytic reaction. In a simple case the changes in a self-organizing system are given by a set of two rate equations for a primary and a partial system. When these systems mutually form a feedback loop under the adiabatic condition, the rate equation of self-organization is described by a generalized Gibbs' free energy change delta U (delta x) followed by the reaction. The sign of the parameter k'3 (k0-kex; k0, kex: rate constants with or without an external stimulus) determines the instability of the coupled system in quasi-equilibrium (k'3 approximately greater than 0; k0 greater than kex). When the product exceeds the threshold (k'3 less than 0; k0 less than kex), the system transfers into a new state, or a phase transition appears. Considering the Boltzmann distribution, the transition parameter k'3 is evaluated by an average distribution of the states and the instability is discussed using the reaction velocities vqe and vqe in the quasi-equilibrium state. As an example of this model membrane excitation is discussed briefly. PMID- 3626588 TI - The human erythrocyte membrane skeleton may be an ionic gel. III. Micropipette aspiration of unswollen erythrocytes. AB - We have carried out a theoretical analysis of micropipette aspiration of unswollen erythrocytes using the protein-gel-lipid-bilayer membrane model and taking into account that the modulus of area compression of the membrane skeleton may depend on the environmental conditions. Our analysis shows that the aspiration pressure needed to obtain a certain membrane projection length is strongly dependent on the ratio between the membrane skeleton modulus of area compression and the elastic shear modulus. Our analysis therefore predicts that micropipette aspiration of unswollen erythrocytes may be a sensitive method for detection of changes in this ratio. The analysis thus also shows that micropipette aspiration of unswollen erythrocytes can not be used to determine the membrane shear modulus unless something is known about the membrane skeleton modulus of area compression. PMID- 3626589 TI - Calculation of the conformation of glycosphingolipids. 2. GM1- and GM2 gangliosides. AB - The conformations of GM1- and GM2-gangliosides have been predicted by energy minimization techniques including an orbital force field approach. The global energy minimum conformers for these two gangliosides show marked differences, particularly in the relative orientation of the sugar rings. The predicted structures are compared with those postulated from NMR spectroscopy in relation to the formation of a cation-binding site. The minimum energy conformer of GM2 ganglioside is able to form this binding site whereas this conformer of GM1 ganglioside is not. The nature of the specific interaction of gangliosides with activator proteins is discussed. PMID- 3626590 TI - Analysis of gossypol by high performance liquid chromatography. AB - Several high performance liquid chromatographic methods for the analysis of gossypol in different kinds of sample were developed. (1) Pure gossypol: separation on C18 column with MeOH/H2O/CHCl3 (70:30:40) containing 0.1% H3PO4 as mobile phase or on SO3H column with MeOH/citrate buffer (pH 6.3) (55:45) as mobile phase was recommended. With these systems, minute amounts of contaminants difficult to separate by other HPLC systems could be determined. (2) Plant material: acetone was selected as the extraction solvent. After evaporation of acetone from the extract, the residue was redissolved in 1% HOAc in CHCl3. An aliquot of this solution was chromatographed and quantified by peak area method. The mean recovery of pure gossypol added to plant material was 91.1 +/- 1.1% (S.D.). (3) Plasma sample: a HPLC method with electrochemical detector was developed. A plasma sample with glutathione as protective agent and gossypol dimethyl ether as internal standard was introduced on to a C18 pre-column. By using column-switching technique, a certain part of the eluate containing gossypol and gossypol dimethyl ether was subjected to a C8 analytical column for further separation. MeOH/citrate buffer (pH 3.2) (80:20) was used as the mobile phase. The optimum potential for detection was +0.6 V vs. Ag-AgCl. The assay sensitivity was 5 ng/ml. This method is sensitive and selective, suitable for clinical pharmacokinetic studies. PMID- 3626591 TI - Resolution of racemic gossypol. AB - Treating racemic gossypol with chiral amine (S)-1-methylphenethyl amine gave the expected pair of diastereomeric amino condensates in which the binaphthyl nuclei racemized during further treatment. Acetylation was applied to avoid the change. On acetylation, 7 products were separated. Their structures were assigned based upon their spectroscopic data. After hydrolysis they gave optically active (+)- and (-)-gossypol correspondingly. A simple and practical method of quick separation of the diastereomers was also discussed. PMID- 3626592 TI - Effect of (-)- and (+)-gossypol on fertility in male rats. AB - (+)-Gossypol has neither antifertility effect nor toxicity at the dosage of 30 mg/kg orally for 14 days in male rats, but slight damage was found in the germinal epithelium of the testis in animals dosed for 4 weeks. (-)-Gossypol at 30 mg/kg orally for 7 days clearly had an antifertility effect in male rats. It appears that (-)-gossypol is the active stereoisomer of racemic gossypol. PMID- 3626594 TI - Comparative study on the metabolism of optical gossypol in rats. AB - The comparative metabolism of (+)- and (-)-gossypol in rats was studied. After oral administration of the drugs to rats, the half-lives of (+)- and (-)-gossypol in the gastrointestinal tract were found to be 18.4 h and 13.5 h, respectively. The tissue distribution of (+)-gossypol was very similar to that of (-)-gossypol. After oral administration, high drug levels were found in the liver while moderate concentrations were present in the spleen, lungs, blood, heart and kidneys. The drug levels in the testes and fat were rather low. The excretion rates of the (+)- and (-)-gossypol were quite similar. Most of the ingested drug was excreted in the feces, while only a small fraction was eliminated in the urine. After i.v. injection of the drugs to rats, the half-lives of free (+)- and (-)-gossypol were found to be 7.80 h and 3.96 h, respectively. The clearance rates of the two optical isomers were 7.81 and 29.36 ml/h, respectively. PMID- 3626593 TI - Effect of (+/-)-, (+)- and (-)-gossypol on the lactate dehydrogenase-X activity of rat testis. AB - The effect of (+/-)-, (+)- and (-)-gossypol on testicular lactate dehydrogenase-X (LDH-X) was studied in vitro and in vivo. It was found that racemic gossypol and the two optical enantiomers had similar inhibitory effects on rat testicular LDH X in vitro. However, neither racemic gossypol nor the enantiomers exhibited an inhibitory effect on testicular LDH-X in vivo. It is concluded that inhibition of testicular LDH-X is not likely to be the mechanism of the antifertility action of gossypol. The inhibition of testicular LDH-X in vitro by all three preparations of gossypol is probably non-specific. PMID- 3626595 TI - Hepatotoxicity of gossypol in rats. AB - Gossypol acetic acid (GAA) at the dosage of 30 mg/kg daily for 2 weeks could prolong the sleeping time of pentobarbital, increase the SGPT level, decrease the liver concentration of cytochrome P-450 and GSH content, inhibit the activity of cytochrome C reductase and aminopyrine-N-demethylase, but was without effect on cytochrome b5 and aniline hydroxylase. At a smaller daily dosage (15 mg/kg for 4 weeks), GAA could induce the rise of SGPT level and GSH content without affecting the liver metabolizing enzymes. GAA at both dosages could induce marked pathological changes of liver cells in treated rats, such as vacuolation of mitochondria, dilation of endoplasmic reticulum and widening of perinuclear space as well as proliferation of collagen fibers in Disse's spaces. GAA could induce the formation of O2 and H2O2 and could inhibit Ca2+ sequestration in rat liver microsomes in vitro. [C14]-gossypol could bind to microsomal protein irreversibly either in the presence or absence of NADPH. It may be concluded that GAA is capable of causing damage to liver cells. PMID- 3626596 TI - Reconsiderations of indications for open mitral commissurotomy based on pathologic features of the stenosed mitral valve. A fourteen-year follow-up study in 347 consecutive patients. AB - From January 1972 to December 1984, 347 consecutive patients underwent open mitral commissurotomy for mitral stenosis. Commissurotomy was performed in 86% of 404 patients undergoing mitral valve operations for stenosis during the same period. These 347 patients had three different types of mitral stenosis: type I, mobile cusps without subvalvular changes (43 patients); type II, thickened cusps with subvalvular changes (210 patients); type III, rigid cusps with severe subvalvular changes (94 patients). Concomitant mild mitral regurgitation was seen in 87 patients (25.1%) and mild to moderate valve calcification in 61 patients (17.6%). There were eight early deaths (2.3%) and 12 late deaths (3.5%), yielding an actuarial survival rate of 94.6% (excluding early deaths) 14 years after operation. There were 17 reoperations (5.0%) The actuarial rates of freedom from reoperation were as follows: 83.8% at 14 years for the entire series; 73.5% for type I stenosis; 88.9% for type II; 84.0% for type III; 91.7% for mitral stenosis with calcification; 82.6% for stenosis without calcification; 90.6% for pure mitral stenosis; and 52.5% for stenosis combined with regurgitation (p less than 0.05). Postoperative effective mitral valve areas calculated according to the hydraulic formula were 2.52 cm2 (mean) at rest and 3.06 cm2 during exercise in six patients with type I stenosis, 2.21 and 2.48 cm2, respectively, in 10 with type II, and 1.85 and 1.87 cm2, respectively, in 14 with type III. Our data clearly demonstrated that open mitral commissurotomy provided excellent long-term results with acceptable valve function and a low incidence of reoperation in patients with pure mitral stenosis not combined with regurgitation, even when associated with severe subvalvular changes with or without mild to moderate valve calcification. PMID- 3626597 TI - Poststernotomy mediastinitis treated by omental transfer without postoperative irrigation or drainage. AB - Mediastinitis is an infrequent but life-threatening complication after cardiac operations. We reviewed our experience in treating eight select patients in whom this complication developed. Diffuse mediastinitis was verified at operation, and all patients were treated with the same surgical procedure by the same surgeon. The technique consisted of sternal bone debridement, mediastinal fat and connective tissue excision, pericardiectomy, and transfer of the greater omentum into the mediastinum on a vascular pedicle for obliteration of dead space. The sternum and sternal fascia were closed completely and the skin was closed loosely in each case. Postoperative drainage was not provided and postoperative irrigation was not performed. The mortality rate was 12.5% and the hospital stay averaged 27 days, comparable to other series in which irrigation has been used. We conclude from this review that the approach of omental transfer provides an alternative to prolonged irrigation and drainage of the mediastinum in the surgical management of these critically ill patients. This is neither a radical nor a disfiguring procedure, but is simple and easily done by the cardiac surgeon. Early ambulation, because of a lack of cumbersome irrigation and drainage apparatus, results in improved pulmonary function. Dead space is obliterated with tissue that has demonstrable ability to resist infection. Also, loose closure of the skin allows for primary healing with a good cosmetic result. PMID- 3626598 TI - Replacement of the superior vena cava with polytetrafluoroethylene grafts combined with resection of mediastinal-pulmonary malignant tumors. Report of thirteen cases. AB - From 1979 to 1986, we replaced the superior vena cava with polytetrafluoroethylene grafts in 13 patients to enable resection of malignant mediastinal or pulmonary tumors. Five prostheses could be interposed between a tumor-free proximal superior vena cava and right atrium while eight required separate innominate anastomoses (Y grafts constructed intraoperatively). There were no deaths. Phlebograms obtained 15 to 30 days after the operation demonstrated patency in 12 of 13 patients. Long-term (average 24 months) patency was evident in eight. Five patients are alive at 1, 3, 40, 49, and 60 months, a cumulative survival rate of 27% at 3 years. PMID- 3626599 TI - Primary tissue failure in pericardial heart valves. AB - A number of centers have recorded a significant incidence of primary tissue failure with the standard Ionescu-Shiley pericardial valve. In most cases severe regurgitation was caused by leaflet tears adjacent to the edge of the cloth covered stent. Our early clinical experience (up to 4 years' follow-up) with two new pericardial valves (Ionescu-Shiley low-profile and Hancock pericardial valves) has shown that primary tissue failure also occurs in these new valves. In vitro accelerated fatigue studies on seven of these valves (size 29 mm) showed that in vitro premature leaflet failure was caused by abrasion of the leaflet on the cloth-covering at the edge of the stent. Clinically, endothelialization and host tissue ingrowth on the cloth and the leaflets at the edge of the frame greatly reduced the amount of abrasion and the incidence of tissue failure. In seven of the eight explanted valves studied, leaflet tears occurred at the top of the stent posts where there was less endothelialization and tissue ingrowth, close to the points where sutures pass through the leaflets. It is likely that both abrasion and stress concentration around these sutures contributed to the tissue failures in the clinical valves. PMID- 3626600 TI - Twenty years' experience with the Model 6120 Starr-Edwards valve in the mitral position. AB - A total of 549 nonconsecutive patients underwent isolated mitral valve replacement with a Starr-Edwards valve prosthesis (Model 6120) at the University of Louvain (Belgium) from 1965 to 1985. Ninety-seven percent of the patients could be traced and only 17 patients were lost to follow-up. Cumulative follow-up totalled 3,130 patient-years. Actuarial and linearized statistical techniques were used to describe the survival and the incidence of valve-related complications (according to stringent criteria). Long-term overall survival rate including early deaths was 79% +/- 0.02% at 5 years, 65% +/- 0.03% at 10 years, and 54% +/- 0.04% at 19 years, with a linearized incidence of late deaths of 3.9% +/- 0.5% per patient-year. The incidence of late valve-related deaths was 1.25% per patient-year. Valve-related complications occurred at the following rates: thromboembolism 3.1% per patient-year, anticoagulant-related hemorrhage 1.08% per patient-year, endocarditis 0.26% per patient-year, reoperation and periprosthetic leak 0.45% per patient-year, and structural failure 0% per patient-year. All valve-related mortality and morbidity were calculated at 4.9% per patient-year and the rate of valve failure (deaths and reoperations) at 1.4% per patient-year. Among 376 survivors, 352 clinical functions could be obtained: 95% of patients belong to Class I or II of the New York Heart Association after operation versus 24% before operation. The study shows the structural durability of the Starr Edwards mitral valve with a follow-up over 20 years. The Model 6120 valve may be considered a faithful standard. PMID- 3626601 TI - Phrenic nerve paralysis after pediatric cardiac surgery. Retrospective study of 125 cases. AB - Phrenic nerve paralysis was diagnosed in 125 children (1.6%) from a series of 7,670 cardiac surgical procedures in infants and children during a 12 year period. The incidence was 1.9% for open heart and 1.3% for closed heart operations. In order of decreasing incidence, the open heart procedures included Mustard procedure (6.7%), right ventricular outflow tract reconstruction (5.6%), and repair of tetralogy of Fallot (2.7%). The closed heart procedures included Glenn anastomosis (6.2%), Blalock-Hanlon atrial septectomy (5.9%), and right Blalock-Taussig shunt (5.1%). Procedures following previous operations or thoracotomies had almost twice the incidence of phrenic nerve paralysis: Mustard procedure 9.9%, right ventricular outflow tract reconstruction 10.8%, and tetralogy repair 5.5%. Seven patients (5.6%) with phrenic nerve paralysis died. Patients less than 2 years old with phrenic nerve paralysis were intubated for 0 to 57 (average 15.7) days after their cardiac operations and those over 2 years old for 13 to 35 (average 7.2) days (p less than 0.001). Twelve patients had diaphragmatic plication without mortality and were extubated 0 to 6 (average 2.3) days after plication. We have made the following conclusions: (1) Phrenic nerve paralysis may occur after both open and closed cardiac procedures and is more common in children requiring reoperation; (2) it is associated with considerable morbidity; (3) eventual recovery of phrenic nerve function occurs in 84% of children; and (4) diaphragmatic plication is safe, reliable, and of most value in patients who are under 2 years of age and require mechanical ventilation for more than 2 weeks. PMID- 3626602 TI - Bar calcification of the mitral anulus. A risk factor in mitral valve operations. AB - Between Jan. 1, 1979, and Jan. 1, 1986, 72 septuagenarians had open heart operations for disease of the mitral valve. Thirty-two (44%) had additional operative procedures. Overall seven patients (9.7%) died within 30 days of operation. Eleven patients had bar calcification of the posterior mitral annulus as defined by three criteria and 61 did not. No differences between these two groups were present except for hospital mortality. Three of the 11 patients (27.3%) died at or soon after operation of complications resulting from the calcified annular bar. Only four of 61 patients (6.6%) without bar calcification died early. The difference in early mortality between the two groups is significant (p less than 0.05) and identifies the presence of bar calcification of the posterior mitral annulus as an independent risk factor of mitral valve operations in elderly patients. PMID- 3626603 TI - Treatment of spontaneous bacterial empyema thoracis. AB - The need for decortication to cure primary bacterial (nontuberculous) empyema was evaluated in 112 consecutive patients. Twenty-eight patients (25%) were cured by thoracentesis alone. Intercostal chest tube drainage was required in 43 (39%) and decortication in 41 (36%). Although hospital stay was shortened by 5 days for those who had decortication, the difference was statistically insignificant. Penicillin failed to eradicate infection in nine of 17 patients, four of whom had Bacteroides organisms. There were no therapeutic failures among 46 patients treated with clindamycin and gentamicin. We conclude that conservative therapy, such as thoracentesis, antibiotics directed against anaerobic bacteria, and intercostal tube drainage (thoracostomy), was adequate to achieve clinical and physiologic resolution in about two thirds of all patients with primary bacterial empyema. The remaining one third required decortication. Rib resection and Eloesser flap procedures seem to be unnecessary in the treatment of primary bacterial empyema. PMID- 3626604 TI - Evaluation of explanted polyurethane trileaflet cardiac valve prostheses. AB - Morphologic, chemical, and hemodynamic studies were made of eight prototype polyurethane trileaflet cardiac valve prostheses that had been implanted in juvenile sheep for 17 to 21 weeks in the mitral position. Calcification of the polyurethane leaflet surfaces was the principal finding. Quantitative chemical analyses revealed calcium values with a mean of 42.7 +/- 21 mg/gm dry weight of leaflet. Morphologically, two distinct types of calcification were observed: One was associated with the polyurethane surface or the interface between the leaflet surface and microthrombi or fibrous sheaths; the other was characterized by calcification associated with degenerated cells within thrombotic material and the fibrous sheath. These morphologic findings were in accord with the results of hemodynamic performance studies indicating that these heart valve prostheses had become both stenotic and regurgitant. PMID- 3626605 TI - Tracheal autograft revascularization. AB - A series of experiments were conducted to assess the possibility of revascularizing tracheal homografts with an omental pedicle flap. Three different experiments were performed. In Group I (N = 4) a ten-ring tracheal allograft was embedded into the greater omentum of a recipient animal for 30 days. At reexploration these four allografts were found to have been transformed into a tube consisting mainly of connective tissue. To provide more collateral circulation, we immediately reanastomosed an eight-ring tracheal autograft in Group II animals (N = 7). Collateral blood supply was possibly available from the surrounding mediastinal tissues, the recipient trachea, and the transposed omental graft. Tracheal malacia and loss of rings 4,5, and 6 was a consistent finding and cause of death. A third group of animals (Group III) underwent a similar operation with the addition of free bone grafts being applied to the external surface of the autograft to impede significant tracheal stenosis. The long-term results and the findings when the animals were put to death were the same as in Group II. We conclude that the omental pedicle graft cannot sustain chondrocyte viability. Thus a reliable method for revascularization of a tracheal transplant remains to be found. PMID- 3626606 TI - Dire consequences of the indiscriminate use of Teflon felt pledgets. PMID- 3626607 TI - Partial atrioventricular canal in an adult: mitral valve repair by reverse implantation of a Carpentier ring. AB - A severely incompetent mitral valve of partial atrioventricular canal type was repaired by reverse implantation of a Carpentier ring. The flat segment of the ring was adapted to the lateral leaflet of the valve and the curved segment to the combined left superior and left inferior leaflets. The so-called cleft was sutured. The procedure resulted in a fully competent mitral valve that continues to be competent 2 years after the operation. PMID- 3626609 TI - Prosthetic valve performance: how important is valve type? PMID- 3626608 TI - Surgical resection of giant metastatic leiomyosarcoma of the heart. AB - A 44-year-old woman underwent a hysterectomy for leiomyosarcoma in 1969. Cardiac invasion was detected in 1981 but the tumor was considered inoperable. In 1985, 16 years after hysterectomy, malignant tamponade developed as a result of a massive tumor arising from the left ventricle. Emergency decompression by median sternotomy and tube thoracostomy was followed a week later by tumor resection and simultaneous excision of a lung metastasis with the aid of cardiopulmonary bypass. The cardiac tumor weighed 719 gm. A residual pelvic tumor found on a computed tomographic scan was subsequently removed. She is alive and well 22 months after the operation. Aggressive surgical resection of cardiac and other metastases of this slowly growing tumor can be lifesaving. PMID- 3626610 TI - The effect of cardiac operation on platelets. PMID- 3626611 TI - Low cytidine deaminase levels in human hematopoietic cell lines. AB - Purine and pyrimidine enzyme profiles of human cell lines have been investigated. A novel observation was the finding that most of the cell lines showed very low or undetectable levels of cytidine (deoxycytidine) deaminase, while they possessed pyrimidine 5'-nucleotidase, cytidine and deoxycytidine kinase activities. Most cell lines showed high levels of adenosine deaminase and purine nucleoside phosphorylase activities and low levels of purine 5'-nucleotidase. We propose that high adenosine deaminase and purine nucleoside phosphorylase activities and low cytidine deaminase activity may be of importance for immature hematopoietic cells in order to ensure a balanced synthesis of the DNA precursors. PMID- 3626613 TI - Inhibition of normal human granulopoiesis in vitro by amiloride: evidence for the involvement of facilitated sodium influx in the induction of differentiation. AB - The formation of colonies by normal human bone marrow granulopoietic progenitor cells in vitro in soft agar was inhibited in a simple, dose-dependent manner by amiloride (50% inhibitory concentration 26.4 +/- 3.4 microM, n = 9). Such inhibition was reversible and is evidence for the involvement of amiloride sensitive sodium influx in granulopoietic cell proliferation. Colony-forming cells were capable of some proliferation at concentrations of amiloride 3-fold in excess of that required to inhibit full colony formation. A two-stage model is invoked to explain this observation: an early amiloride-insensitive stage and a late amiloride-sensitive stage which includes terminal differentiation. We conclude that the cellular mechanism by which differentiation is induced includes activation of the amiloride-sensitive sodium influx channel, which would indicate a new approach to the therapeutic induction of differentiation in vivo. PMID- 3626612 TI - Juvenile monosomy 7 syndrome: evidence that the disease originates in a pluripotent hemopoietic stem cell. AB - The present study was undertaken to investigate the hemopoietic cell from which malignant change evolves in juvenile dyshemopoiesis with monosomy 7. Two male patients, aged 18 and 5 months, were studied using progenitor assays combined with cytogenetics. Both had hepatosplenomegaly, cytopenias and a cellular marrow. The karyotype in direct marrow was 45,XY-7/47,XY,+8/46,XY in patient 1 and 45,XY, 7/46,XY in patient 2. Patient 1 received chemotherapy but developed acute nonlymphocytic leukemia after 17 months and died 20 months after diagnosis. During this time marrow metaphases with 45,XY,-7 increased to 100% (25/25). Patient 2 received an allogeneic marrow transplant 4 months after diagnosis which did not engraft. In both patients progenitors of both small (CFU-E) and large (BFU-E) erythroid colonies were present at normal frequencies. However, the colonies produced were small and poorly hemoglobinized with some erythropoietin independent maturation. Progenitors of large granulocyte/macrophage colonies (CFU GM) were present at an elevated frequency in the marrow of patient 1 and in the blood all progenitor classes were markedly increased. Cytogenetic analysis of colonies from this patient showed BFU-E to be 45,XY,-7 or 47,XY,+8 and CFU-GM to be 45,XY,-7 or 47,XY,+8 or 46,XY. In patient 2, most BFU-E were 45,XY,-7, although a few were 46,XY. These data indicate that malignant change in this disease involves hemopoietic stem cells capable of erythroid and in at least some cases, myeloid differentiation. PMID- 3626614 TI - Blood and spleen haematopoiesis in patients with myelofibrosis. AB - Blood nucleated cells collected by leukapheresis and spleen cell suspension from patients with myelofibrosis with myeloid metaplasia (MMM) were studied for their haematopoietic capacity. Using committed progenitor cell assays (CFU-GM, BFU-e) and a one-stage long-term liquid stem cell system, we have shown: (1) a preferential expansion of the circulating committed progenitor cell pool above the more primitive stem cell compartment; (2) the absence of any development of a stromal adherent layer in long-term cultures of peripheral blood nucleated cells suggesting the self-sustaining capacity of the circulating primitive stem cells; (3) that the spleen is only a production site of committed progenitor cells but does not generate primitive stem cells; (4) the presence, in the spleen, of stromal progenitor cells. We conclude that the peripheral blood primitive stem cells in patients with MMM are not of splenic origin. PMID- 3626615 TI - Dissociation and maintenance in vitro of neurones from adult cockroach (Periplaneta americana) and housefly (Musca domestica). AB - A method is described for dispersal and subsequent maintenance in acute culture of neurones dissociated from ganglia of the adult cockroach (Periplaneta americana) and brain of the adult fly (Musca domestica). The effects of different media on the survival and attachment to different substrates have been investigated. About 25% of dissociated neurones survived well for periods greater than 6 days in a cockroach saline supplemented with foetal calf serum and the antibiotics fungizone and gentamicin. Fly neurones were more difficult to disperse. Fly saline supplemented with foetal calf serum and the antibiotics fungizone and gentamicin proved a successful short-term culture medium. Survival times were shorter, most neurones dying after 5 days. The demonstrated viability of such neurones has considerable potential for insecticide mode of action studies using the patch-clamp technique. PMID- 3626616 TI - An "expanded stick" model for coding Golgi-impregnated neuronal morphology. AB - A new model for coding Golgi-impregnated neuronal morphology, which can be implemented in any computer-assisted optical microscope, is described. This model, in addition to storing the three-dimensional coordinates of the selected neuronal points and their topological identifiers, codes for "width", "nature", and "shape". The "width" code digitizes the width of a neuronal process. The "nature" code can identify structures such as perikaryon, axon, apical dendrite, basal dendrite, etc. The "shape" code defines nodules and spines. Computer graphics routines are described for drawing nodules and spines as well as neuronal processes with "width". PMID- 3626617 TI - Quantitative measurement of cerebral cytochrome P-450 by second derivative spectrophotometry. AB - Second order derivative spectrophotometry was used to improve the accuracy and reproducibility of cytochrome P-450 measurements in subcellular fractions obtained from the brain. This method allowed better resolution of the overlapping bands of cytochrome P-450 and other iron proteins, as well as a reduction of the effects of turbidity and non-specific components. Using this method, the cytochrome P-450 content of rat brain mitochondrial and microsomal fractions was measured to be 74.2 +/- 2.3 and 5.9 +/- 0.3 pmol/mg protein, respectively. PMID- 3626618 TI - Coupled intracellular horseradish peroxidase-monoamine oxidase histochemistry: description of the technique and its application to the study of physiologically identified tuberomammillary neurons. AB - A technique is described which couples visualization of intracellular horseradish peroxidase (HRP) with histochemical localization of monoamine oxidase (MAO), permitting simultaneous study of histochemistry, morphology and physiology in a single neuron. Using this technique, individual neurons int he tuberomammillary nucleus of the hypothalamus were stained in a Golgi-like fashion, revealing their somatodendritic morphology in detail. The technique has general applications as a method for conferring cytochemical specificity to intracellular staining of other MAO positive neurons, to retrograde transport of HRP by MAO positive neurons, as well as for ultrastructural studies of positively stained neuronal elements. PMID- 3626619 TI - Semiquantitative evaluation of histochemically detectable calcium binding in mammalian brain slices. AB - A method is described for the electron histochemical demonstration of Ca in the central nervous system, based on fixation on Ca-containing paraformaldehyde solution and the subsequent complexing of Ca by ammonium oxalate. The method resulted in highly electron-dense deposits, with good ultrastructural preservation. The Ca content of the deposits was proved by physico-chemical analysis. The high electron density permitted the counting of deposits and thereby an estimation of their numerical density, via planimetry of electron micrographs. Since pre- and postsynaptic localizations could be distinguished on the basis of ultrastructure, this procedure is regarded as a unique semiquantitative method for estimation of the tissue Ca binding of mammalian brain slices. PMID- 3626620 TI - An automated method for autoradiographic analysis of cultured Schwann cells. AB - A semi-automated analysis system based on video image analysis was developed to count labelled and unlabelled nuclei of Schwann cells which had been exposed to tritiated thymidine followed by processing for autoradiography. A Model 3000 Image Analysis system (Image Technology Corporation, Deer Park, NY) was used to acquire and process the images and provide quantitative measurements based on the distinctive size and shape of the Schwann cell nucleus. The maximum and minimum dimensions for the labelled and unlabelled nuclei were determined. These stored dimensional parameters were then compared with the dimensions of a given field of cell nuclei by the image analysis system. The counts from various fields were collected until a total of 1000 labelled and unlabelled nuclei had been analyzed. A labelling index (LI = ratio of labelled cells to total cells X 100) was then calculated and printed by the system. LIs of autoradiographs determined by automated analysis correlated well with those determined by visual cell counting. The principle of the image analysis program as described here is applicable to other systems for the measurement of LIs of a particular cell type in a mixed population. This automated process eliminates both the subjectivity and fatigue of visual counting and facilitates the rapid measurement of the LI of large numbers of autoradiographs with precision. PMID- 3626621 TI - A microcomputer-controlled response measurement and analysis system for insect olfactory receptor neurons. AB - A microcomputer system has been built to stimulate, record, and analyze responses from peripheral insect olfactory receptor neurons. Software has been developed to sort action potentials (spikes) in extracellular records obtained from multi innervated antennal sensilla, and perform frequency, interspike interval, distributional, and regression analyses on responses in groups of records. The olfactory stimuli can be presented in different patterns, and plots or histograms of analyses, spike records, and individual spikes can be displayed in different formats and hard-copied during a recording session. This report describes the main features of the system and discusses the methods used for sorting spikes, performing analyses, and managing records and analyses in a database. Examples are given of renewal density analyses for 4 classes of peripheral receptor neuron in records from 2 types of olfactory sensillum on the antenna of the cabbage looper moth, Trichoplusia ni (Hubner). PMID- 3626622 TI - A ladder paradigm for studying skilled and adaptive locomotion in the cat. AB - A circular horizontal ladder is described which is suitable for studying skilled and adaptive locomotion in the cat. Four mechanisms built into the ladder require the animal to adapt its normal walking by making either corrective manoeuvres following an unpredictable disturbance, or anticipatory changes informed by vision. In addition to these features, the ladder incorporates a servo-controlled boom to ensure that the cat is almost completely free of any restraint or drag which might otherwise be imposed by leads carrying foot contact, electromyographic and neuronal signals from the animal to the recording equipment. The apparatus is proving in use to be reliable and easy to operate, and our preliminary results clearly implicate supraspinal motor centres in controlling the skilled and adaptive behaviour which the ladder requires. PMID- 3626623 TI - Miniature three-function transmitting system for single neuron recording, wireless brain stimulation and marking. AB - A telemetric micro-transmitting system has been developed for extracellular single unit recording, electrical brain stimulation and marking of the recording and stimulation site in small freely moving animals. The action potentials are transmitted by using frequency modulation for distances up to 10 m. Electrical brain stimulation through the recording electrodes is performed by means of an inductively powered circuit which is combined with the transmitter (mass of the system 2.38 g). Biphasic current pulses can be applied. Pulse frequency and duration are wireless remotely controlled. The recording and stimulation site in the brain can be marked by means of iron deposits. PMID- 3626624 TI - An efficient method for the purification of tumor necrosis factor from rabbit serum. AB - Tumor necrosis factor (TNF) has been purified to homogeneity from rabbit serum. TNF was isolated by a purification scheme consisting of chromatography on DEAE Trisacryl M, concentration on an Amicon YM10 membrane filter, molecular exclusion on TSK-3000 SWG (HPLC), and then either by Reversed phase HPLC on a Vydac C 4 column or by hydrophobic interaction chromatography. This procedure gives a recovery of 50% of pure TNF. The purified material has a specific activity of 2 X 10(8) U/mg in vitro and is active in vivo causing necrosis in Meth A sarcoma bearing mice. It gives a single band at a molecular weight of 17.000 on 15% polyacrylamide gel electrophoresis and 40.000 on gel exclusion chromatography at pH 7.0. The protein has a pI of 5.0 and is stable when heated to 70 degrees C for 10 minutes. PMID- 3626625 TI - Systemic and regional hemodynamic effect of acute magnesium administration in the normotensive and hypertensive state. AB - Recent interest has focused on the role that Mg2+ may play in blood pressure (BP) regulation and in hypertension. The acute effect of intravenous Mg2+ as well as vehicle administration on systemic and regional hemodynamics was determined in both normotensive rats and in rats made hypertensive by uninephrectomy followed by deoxycorticosterone acetate and salt excess (DOCA-salt). Systemic and regional hemodynamics were determined by the radioactive microsphere method in the conscious and unrestrained rat prior to and 1 h following either Mg2+ or vehicle administration. Mg2+ administration significantly increased serum Mg2+ levels in both the normotensive and DOCA-salt hypertensive rats (1.4 +/- 0.02 to 3.5 +/- 0.04 and 1.7 +/- 0.06 to 4.9 +/- 0.4 mEq/l, respectively, both p less than 0.01). The DOCA-salt rats had a significantly greater baseline mean BP, total peripheral resistance (TPR), and heart rate (HR), when compared to the normotensive rats. In the normotensive rats, neither Mg2+ or vehicle administration had any effect on either mean BP or HR. In the DOCA-salt hypertensive rats, vehicle administration had no effect on any systemic hemodynamic parameter. However, in marked contrast, Mg2+ administration significantly decreased mean BP, HR and TPR while not changing cardiac output or index. In both the normotensive and DOCA-salt hypertensive rats vehicle administration did not result in any significant regional organ vascular resistance changes. However, in the normotensive rats, Mg2+ administration significantly decreased vascular resistance in the heart and in the DOCA-salt hypertensive rats Mg2+ administration significantly decreased vascular resistance in the heart, muscle and skin while increasing vascular resistance in the stomach. In conclusion, acute Mg2+ administration significantly decreases blood pressure by peripheral vasodilation in DOCA-salt hypertensive but not in normotensive rats. In addition, acute Mg2+ administration results in a redistribution of blood flow to the heart in both the hypertensive and normotensive state as well as also possibly to the kidney and brain in the hypertensive state. The antihypertensive effect of Mg2+ in the DOCA-salt hypertensive rats as well as the prominent coronary vasodilation seen in both the normotensive and hypertensive rats may have important clinical implications. PMID- 3626626 TI - Values reported for the three inorganic elements in 'lymphocytes'. PMID- 3626627 TI - Suicide: recognition and management. AB - Patient suicide is a common clinical problem. In the United States, 28,000 people commit suicide annually, and most of these victims have had a consultation with a physician during the 6 months preceding death. Two conditions frequently associated with suicide are affective disorders and alcoholism, and recognition and management of these conditions will help to prevent many suicides. Hospitalized patients seem to be at high risk for suicide--particularly apparent victims of "accidents", which may be well-disguised suicide attempts. Physicians should be aware of verbal and behavioral warning signs of suicidal tendencies in patients, such as a morbid preoccupation with death, giving away possessions, and poor work or school attendance. Empathic listening and intervention by the physician should lead to suggestions for alternative resolutions to the problem that prompted the suicidal behavior and should decrease the level of perturbation. Hospitalization should be considered for the suicidal patient with impaired rational thinking or severe depression. PMID- 3626628 TI - General principles of antimicrobial therapy. AB - Use of antimicrobial agents must be tailored to the individual patient, site of infection, and etiologic organism. The choice of drug should be based on efficacy, safety, low toxicity, and acceptable cost. Empiric therapy should be broad enough to cover the pathogens that are suspected of causing the infection, based on the site of infection and the type of host. Definitive therapy may differ from initial therapy and should be started as soon as specific laboratory and clinical data are available. Cautious conservatism is advocated with regard to the use of new antimicrobial agents. The effects of the agents on the microbial ecology and hospital environment should be considered. Judicious use is necessary to prevent antimicrobial pollution. PMID- 3626629 TI - Laboratory tests used to guide antimicrobial therapy. AB - Laboratory tests that can be helpful in guiding antimicrobial therapy include antimicrobial susceptibility testing, determination of bacterial beta-lactamase activity, assay of serum inhibitory and bactericidal activity, and assay of specific antibiotic levels in serum. When any microorganism is isolated from a normally sterile body fluid in a patient with clinical evidence of infection, susceptibility studies should be performed. The standardized disk test provides results that should be comparable from laboratory to laboratory but has the disadvantage of yielding results expressed only as susceptible, intermediate, or resistant. In contrast, dilution methods allow determination of the minimal inhibitory concentration of an agent, which can be correlated with blood, urine, and other body fluid levels of the antimicrobial agent. Accurate measurement of serum concentrations of antimicrobial agents is important when the margin between therapeutic and toxic levels is narrow, such as for aminoglycosides or vancomycin, and when a patient has renal failure and may have accumulation of high levels of antimicrobial agents that would normally be excreted by the kidneys. PMID- 3626630 TI - Nonconvulsive status epilepticus in a patient with leptomeningeal cancer. AB - A 56-year-old man sought medical assistance because of recurrent nonconvulsive status epilepticus without a history of prior seizure activity. Examination of the cerebrospinal fluid disclosed leptomeningeal cancer. To our knowledge, the association of partial complex status epilepticus and leptomeningeal cancer has not been reported previously. If the results of computed tomographic and magnetic resonance imaging studies are normal, examination of cerebrospinal fluid should be considered in patients with nonconvulsive status epilepticus. PMID- 3626631 TI - Black bears and polar bears--still metabolic marvels. PMID- 3626632 TI - Update on antimicrobial agents. PMID- 3626633 TI - The effect of oxidative stress on inbred mice of different ages. AB - The effect of oxidative stress applied for 2 months was compared in adult (14 month-old) and aged (27-month-old) female BALB/c mice. The stress was administered in two ways. One group of animals received a high dose of H2O2 (0.5% H2O2 in drinking water) the other one was given a low dose of H2O2 (0.4 ml of 0.5% H2O2 by esophageal cannula every alternate day). After a 2-month treatment the activity of superoxide dismutase (SOD), catalase and lipid peroxidation capacity were measured in liver homogenates of mice. The activity of catalase and capacity of lipid peroxidation gradually decreased as a function of age while the SOD activity did not reduce even in older mice. The aged-mice could tolerate a high dose of H2O2 mainly by increasing SOD activity. As a result of intake of low dose of H2O2 in old animals SOD activity was decreased and lipid peroxidation capacity was getting higher suggesting that in this life period the liver tissue is very sensitive to chronic, oxidative stress effects of low dose. PMID- 3626634 TI - Evidence for a universal process underlying clonal attenuation. AB - It is shown by computer simulation that an established commitment model of clonal attenuation can account for clone size distribution data obtained from three vertebrate species--chick, hamster and human--from two evolutionarily divergent classes. The different in vitro replicative lifespans of each cell strain can be explained by differences in cell kinetics. These results suggest that the process of clonal attenuation is qualitatively similar in fibroblasts from all vertebrate species. PMID- 3626635 TI - Development of active and passive transport of bile acids in rabbit intestine. AB - Previous studies have indicated that saturable, Na+-bile acid coupled transport is absent in the ileum throughout most of the suckling period and that the maturation of ileal bile acid uptake which occurs during weaning results primarily through an increase in functional bile acid carriers within the ileal brush border membrane. This study was undertaken in weanling and adult rabbits to establish the effect of maturation on the active ileal and passive jejunal and colonic uptake of 8 bile acids. The in vitro uptake of a range of concentrations of cholic (C), taurocholic (TC), glycocholic (GC), chenodeoxycholic (CDC), taurochenodeoxycholic (TCDC), glycochenodeoxycholic (GCDC), deoxycholic (DC) and taurodeoxycholic (TDC) acid was determined. Active ileal uptake of C, TC, GC, DC and TDC was greater in adult than in weanling animals, whereas uptake of CDC, TCDC and GCDC was similar in both groups. The relative permeability for passive uptake of bile acids into the jejunum and colon was similar in young and adult rabbits. Jejunal mucosal surface area was similar in the two groups, but was greater in the ileum in the adult than in the weanling rabbits due to an increase in villus height, width, and number of villi per unit serosal length. However, the age-associated differences in active bile acid uptake were not explained simply on the basis of these differences in ileal mucosal surface area or the concentration of bile acids in the intestinal lumen. Thus, maturation of the rabbit from weanling to adulthood does not influence the relative passive permeability of the jejunum or colon to bile acids, but does increase active ileal uptake of conjugated and unconjugated cholic acid and deoxycholic acid, but not chenodeoxycholic acid. PMID- 3626636 TI - Ageing in vivo does not influence micronucleus induction in human lymphocytes by X-irradiation. AB - To test the hypothesis that the age-related decline in the stability of the genome is the consequence of an increasing deficiency in DNA repair we compared the extent of chromosome damage, after X-irradiation, in lymphocytes from healthy young and old individuals, using the expression of micronuclei as the end-point. Micronuclei have been shown to increase in number with age and they were enumerated using a recently described and improved technique which involves measurement of micronuclei in cells that were blocked from performing cytokinesis. The level of X-ray-induced micronuclei in cytokinesis-blocked cells, after exposure to 75 cGy and 150 cGy, was measured by subtracting the base-line micronucleus frequency in the control unirradiated cultures from the observed micronucleus frequency in the irradiated cultures. There was no difference between the results for the young and old subjects thus indicating that cells from the aged subjects do not exhibit increased chromosomal instability following X-irradiation. These results suggest that repair of those DNA lesions that lead to chromosome breakage does not decline with age. PMID- 3626637 TI - Interaction of multiplication stimulating activity/rat insulin-like growth factor II with skeletal muscle satellite cells during aging. AB - Satellite cells were isolated from the skeletal muscle of 3-, 12- and 24-month old Fischer 344 rats. In vitro growth of these cells was evaluated in serum containing medium and in serum-free medium in response to multiplication stimulating activity/rat insulin-like growth factor II (MSA). Cells from 3-month old rats exhibited a shorter lag phase of growth than cells from 12- or 24-month old animals. Dose-response curves for MSA with each of the three age groups did not differ in the concentrations of MSA required for a half-maximal response or in the magnitudes of the response. Hormone-binding data using [125I]MSA, however, revealed the highest numbers of MSA-binding sites with lowest affinities in the 3 month-old rat muscle cells; cells from the 24-month-old rats were intermediate and cells from the 12-month-old rats had the highest affinity and lowest number of binding sites. The lower affinity and increased number of binding sites in the young rat cells may be due to greater numbers of IGF type I receptors in muscle from young growing rats. PMID- 3626638 TI - Age-dependent changes of the mesenteric lymph node of Fischer F344 rats: morphological and histometric analysis. AB - Changes in mesenteric lymph nodes from Fischer F344 rats ranging from 5 to 37 months were studied by histological and histometric techniques. The most drastic histological changes were observed between 12 and 37 months of age. These changes include: loss of cellularity in the cortex; decrease in the number of germinal centers; distension of the medullary sinuses; decrease in the ratio of cortical area to medullary area; and infiltration of fibroblastic cells in the cortex and the medulla. Our results indicate a general structural disorganization in the mesenteric lymph node with increasing age. Such structural disturbance might be an important extrinsic factor for the decline in lymphocyte functions. PMID- 3626639 TI - In vitro replication potential of serially passaged mammary parenchyma from mice with different reproductive histories. AB - Growth properties of multicellular units (organoids) of mouse mammary parenchyma have been analyzed. These intact units grew differently in collagen-matrix cultures than did dispersed cells prepared from them. The latter actively migrated in the collagen matrix and reorganized themselves into multicellular structures before producing three-dimensional protuberances in gel. Terminal unit (end-bud/alveoli)-enriched fractions grew more extensively than did ducts, as predicted from growth patterns in vivo. To assess the growth potential and the relationships between replication history in vivo and replication potential in vitro in mammary parenchyma, intact terminal units from mammary glands of mice of different ages and with different reproductive histories were isolated and their growth characteristics compared. Terminal-unit organoids were cultured in collagen gel matrix and passaged weekly for up to 5 weeks. Morphology, growth rates, and growth fractions were compared among organoids from young virgin, old virgin, monoparous, and multiparous mice. Morphologies observed in various passages of organoids from the groups of mice were similar. Organoids from old virgin and multiparous mice declined in growth rate for four passages and then growth rate increased again during the fifth passage. (However, fifth-passage organoids failed to form tumors if implanted in syngeneic mice in vivo.) Growth of organoids from either old or young virgin mice was less at any given passage than tissue from multiparous mice of similar age. Growth fractions of organoids from old parous mice were the same as those from old virgin mice but reached the same maximum fraction faster. Later passage organoids from the different mouse groups responded morphologically to the hormone combination of estrogen, progesterone, prolactin, and cortisone but not respond to cholera toxin. These results suggest that an animal's hormonal history (altered profoundly by pregnancy and lactation) may be as important as chronological age in determining subsequent growth potentials of mammary epithelium. PMID- 3626640 TI - Comparison of proto oncogene expression in seven primate fibroblast cultures. AB - In an interspecies comparison of seven primate species, the expression of the erbB proto oncogene was found to be higher in fibroblasts derived from three relatively long-lived species, the human, gorilla, and chimpanzee than in cells from the orangutan, pygmy chimpanzee, squirrel monkey, or red-bellied tamarin. No significant difference was found in the expression of the ras-K, myc, or src proto oncogenes. The difference would not seem to be the result of age differences of the donor animals as we found little variation in the expression of the four proto oncogenes in human fibroblasts derived from donors ranging in age from newborn to 70 years old. In addition, we found little change in expression of the proto oncogenes during long term in vitro culturing, indicating that in vitro age of the individual cultures was not a significant factor in our results. PMID- 3626642 TI - Cerebral blood vessel changes in old people. AB - We give an electron microscopic description of vascular convulates, which occur along with normal brain aging. They consist of up to 10 vessels which are surrounded by a common perivascular space. We can make clear that the convolutes consist exclusively of normal arterioles. Each single vessel shows endothelial cells without pores. The media is mostly composed of a single layer of smooth muscle cells which are surrounded by adventitial cells or their processes. The adventitial cells show a high amount of lipid inclusions. From microangiographic research it is obvious that the absolute increase in length of the vessels is the main factor in the genesis of vascular convolutes. According to experimental animal studies it seems likely that recurrent hypoxic conditions lead to a considerable increase in length in the cerebral arterioles in old people. PMID- 3626641 TI - The effect of mild hypothermia (34 degrees C) and mild hyperthermia (39 degrees C) on DNA damage, repair and aging of human diploid fibroblasts. AB - We used mild hypothermia (34 degrees C) and mild hyperthermia (39 degrees C) to examine aging at the cellular level in relation to DNA damage and repair. With the filter elution technique we monitored spontaneous single-strand breaks (SSBs) and double-strand breaks (DSBs) in DNA during in vitro aging at 34 degrees C, 37 degrees C and 39 degrees C of normal human diploid fibroblasts (HDF). DNA repair was assessed after ionizing and non-ionizing (ultraviolet) radiation of HDF at different population doubling levels (PDLs): the former was assayed by filter elution and the latter by unscheduled DNA synthesis. Survival was assessed by trypan blue dye exclusion and colony formation. Cells at 37 degrees C achieve a higher cumulative PDL (67 +/- 6) than cells at 39 degrees C (60 +/- 5) or at 34 degrees C (55 +/- 6). The level of spontaneous SSBs and DSBs, and radiosensitivity of DNA to either 6 Gy or 100 Gy gamma rays, do not change with in vitro age at any of the three temperatures. Repair of SSBs (induced by 6 Gy) and DSBs (induced by 100 Gy) does not change with in vitro age: rejoining is 86 104% complete by 60 min repair and generally does not differ across temperatures. Response to non-ionizing radiation (254 nm, 75, 150, 300 ergs/mm2) does not change with in vitro age at 37 degrees C or 39 degrees C, whereas excision repair increases with age at 34 degrees C even though cell survival does not. The results do not support the rate of living theory of aging (Pearl, R., The Rate of Living, University of London Press, London, 1928) as applied to temperature effects on HDF aging in vitro (as measured by proliferative lifespan) and on their response to radiation-induced DNA damage. PMID- 3626643 TI - The early and late effect of ultraviolet light exposure on the induction and repair of electron-induced DNA damage in rat epidermis. AB - Experiments were performed to determine the early and late effects of ultraviolet light (UVL) on induction and repair of DNA damage in rat epidermis by electron radiation. The dorsal skin of 28-day-old rats was irradiated with 8.0 X 10(5) or 13.6 X 10(5) ergs/mm2 UVL or weekly exposures of 0.4 X 10(5) ergs/mm2 UVL for 23 or 48 weeks. At 1, 48, 100, 200, or 400 days after single UVL doses or 28 days after last weekly UVL dose, the animals were irradiated with 1200 rads of electrons and the resultant alkaline labile DNA damage and repair quantitated by the S1 nuclease assay. The cytotoxic effect of UVL on basal epidermal cells was assessed by the labeled doublets technique. Single UV doses were capable of inhibiting repair of electron induced DNA damage for up to 5 h, but did not have any measurable late effect (greater than 20 days) on the rate or extent of DNA repair. The rate of DNA repair in epidermal cells from animals exposed to weekly doses of UVL was more rapid than in age-matched controls. The UV doses used on these experiments were shown to be cytotoxic to a large proportion of the basal epidermal cells. The results indicate that exposure of the rat skin to single cytotoxic or multiple exposures of UVL did not accelerate the age related loss of DNA repair capacity. PMID- 3626644 TI - Aged erythrocytes exhibit decreased anion exchange. AB - The rate of transport of [32P] phosphate into human and bovine erythrocytes and of a spin-label analogue of phosphate (Tempo-phosphate) into human erythrocytes was found to decrease with increasing erythrocyte age by 15-20% when comparing 20% most dense cells with 20% of lightest cells. The activation energy of Tempo phosphate transport did not show significant changes upon erythrocyte aging. PMID- 3626645 TI - Circadian rhythms of peripheral blood leukocytes in aging mice. AB - The effect of aging on white blood cell numbers was studied with special reference to the lability in blood cell physiology. Thus, the total numbers of leukocytes, polymorphonuclear granulocytes (PMNs) and lymphocytes were investigated in C3H mice, 3-month-old mice vs. mice aged 16, 21 and 26 months. Strong circadian rhythms were observed in the different cell classes, while there were insignificant seasonal changes. Even the oldest mice had significant variations, especially in the total leukocyte numbers and the PMNs. Subtle age related shifts in the rhythmicity patterns were indicated. When comparing the 24 h means, there was a shift between the different white blood cell classes. A permanent reduction of the lymphocyte number was observed from the age of 16 months, while the number of PMNs steadily increased in the aging mice. The present results may explain inconsistencies among previous studies, demonstrating the significance of a chronobiological approach. PMID- 3626646 TI - Lack of age-dependent changes in rat heart mitochondria. AB - The effects of aging on the composition and function of cardiac mitochondria from rats exhibiting significant decreases in synaptic brain mitochondria composition and function have been studied. Cytochrome content and cytochrome absorbance wavelength maxima do not change in heart mitochondria. Respiratory activities, respiratory control ratios, ADP/O ratios, and H+/O ratios do not change with increasing age. Unlike in brain synaptic tissue, energy output of the heart does not decrease with age. PMID- 3626647 TI - [Blood platelet function in patients treated with verapamil. Comparison with dipyridamole and acetyl salicylic acid]. PMID- 3626648 TI - [Treatment of cirrhotic ascites. Paracentesis again?]. PMID- 3626649 TI - [Malignant histiocytosis. Review of the entity apropos of 2 cases with seldom seen clinical manifestations]. PMID- 3626650 TI - [Convulsions induced by theophylline in adults. Presentation of 4 cases]. PMID- 3626651 TI - [Intrasellar plasmacytoma simulating a pituitary adenoma]. PMID- 3626652 TI - [Amnesia secondary to encephalitis]. PMID- 3626653 TI - [Health education of the type II diabetes patient. The role of primary care]. PMID- 3626654 TI - [Adverse reactions to drugs as ambulatory emergencies at the University Clinical Hospital in Valladolid]. PMID- 3626655 TI - [Percutaneous puncture-aspiration of pulmonary hydatid cysts]. PMID- 3626656 TI - [Mitral valve insufficiency detected using Doppler echocardiography in marathon runners]. PMID- 3626657 TI - [Zinc deficiency and the severity of hepatic cirrhosis]. PMID- 3626658 TI - [Analysis of prognostic factors and predictive models of response to induction chemotherapy in acute non-lymphoblastic leukemia]. PMID- 3626659 TI - [Potential impact of primary health care reform on drug prescription in Spain: the Ciutat Badia experience]. PMID- 3626660 TI - [Usefulness of scintigraphy with technetium-, gallium- and indium-labeled leukocytes in the diagnosis of septic loosening of total hip prostheses]. PMID- 3626661 TI - [Idiopathic midfacial destructive disease associated with IgA nephropathy]. PMID- 3626662 TI - [Benign intracranial hypertension (pseudotumor cerebri) in a patient with Hodgkin's disease]. PMID- 3626664 TI - [Association of idiopathic thrombocytopenic purpura with Graves' disease]. PMID- 3626663 TI - [An 84-year-old man with adenopathies and eosinophilia]. PMID- 3626665 TI - [Adenocarcinoma of the sigmoid colon and hypernephroma: a rare association]. PMID- 3626666 TI - [Prevalence of monoclonal gammopathy in the Cabrera area]. PMID- 3626667 TI - [Urinary pH and plain x-ray of the abdomen in nephritic colic]. PMID- 3626668 TI - [Digoxin-propafenone interaction]. PMID- 3626669 TI - [Systemic manifestations of primary biliary cirrhosis]. PMID- 3626670 TI - [Bacteremic pneumonia caused by Streptococcus pneumoniae: prospective study of 31 cases]. PMID- 3626671 TI - [Coagulation disorders associated with cefamandole: presentation of 2 cases]. PMID- 3626672 TI - [Study of tolerance to antihypertensive medication]. PMID- 3626673 TI - [Hepatorenal polycystic disease in the adult (Potter type III)]. PMID- 3626674 TI - [Results of two 6-month regimens in the treatment of pulmonary tuberculosis]. PMID- 3626675 TI - [Influence of the time of diagnosis on perinatal complications of gestational diabetes]. PMID- 3626676 TI - [Non-alcoholic steatohepatitis. Clinico-analytical study of 40 cases]. PMID- 3626678 TI - [Non-alcoholic fatty liver]. PMID- 3626677 TI - [Up-date in the use of anticoagulant agents in cerebrovascular accidents]. PMID- 3626679 TI - [Cerebral primary lymphoma in a patient with acquired immunodeficiency syndrome]. PMID- 3626680 TI - [Indications of anticoagulants in cerebral ischemia]. PMID- 3626681 TI - [Neuroretinitis as a presenting form of secondary syphilis]. PMID- 3626682 TI - [Angina as the initial symptom of primary cardiac amyloidosis]. PMID- 3626683 TI - [Serum levels of carcinoembryonic antigen (CEA). Preliminary results (benign pathologies) of a comparative study with a monoclonal CEA (SORIN) and polyclonal CEA]. PMID- 3626685 TI - [Clinical research in Spain: types of design used]. PMID- 3626684 TI - [Acquired immunodeficiency syndrome-related complex and Hodgkin's disease]. PMID- 3626687 TI - [Drug consumption]. PMID- 3626686 TI - [Continual use of medications: a study on the consumer]. PMID- 3626688 TI - [Academic research and industrial research in drug development]. PMID- 3626689 TI - [Systemic amyloidosis in Behcet's disease]. PMID- 3626690 TI - [Current treatment of the hyperlipoproteinemias. Risk factor for coronary disease]. PMID- 3626691 TI - [Infectious and contagious diseases among the personnel of a general hospital]. PMID- 3626692 TI - [Thrombocytopenia, pregnancy and systemic lupus erythematosus]. PMID- 3626693 TI - [Survey of vaccine protection in an urban population: prevalence and geographic distribution]. PMID- 3626694 TI - [Maintenance treatment with ranitidine in duodenal ulcer]. PMID- 3626695 TI - [Iatrogenic meningitis]. PMID- 3626696 TI - [The Spanish contribution to international medical literature]. PMID- 3626697 TI - Overview. Multifactorial pathophysiological and therapeutic clinical problem. AB - This volume addresses very important pathophysiological, clinical, and therapeutic considerations concerning that large group of 60 million individuals in the United States with essential hypertension. The concepts of the underlying pathopysiological mechanisms and the role of nonpharmacologic and pharmacologic therapy of these individuals are also addressed. PMID- 3626698 TI - Essential hypertension. PMID- 3626699 TI - Performance evaluation of hospital relational database systems. AB - Performance is one of the principal concerns when considering the utility of database systems in a hospital environment. An evaluation of the performance characteristics of the new user-friendly type of 'relational' hospital database systems and a comparison with a number of possible alternatives is attempted in this article. The overall objective is to test whether such systems are operationally viable in a real-life hospital environment, study the price paid for the convenience offered to the users, and test whether these systems could become acceptable as the basis for the implementation of integrated hospital information systems. The study provides some experimental evidence on the computer resources required and the relationship between the complexity of a query and the times and resources required to process it. Based on the results obtained, a conclusion is finally drawn on the acceptability of the performance characteristics of such systems and the needs for further improvement. PMID- 3626700 TI - An automated procedure for determining patient numbers from episode of care records. AB - Records of in-patient stays which may contain multiple entries for the same patient are linked. These provide a profile of all in-patient hospital contacts for the same patient and statistics from which prevalence measures can be estimated. The linkage procedure is designed to link Scottish Morbidity Records for patients of the Greater Glasgow Health Board. It is suited to in-patient records generated from a relatively small number of hospitals (25-30). The records are selected by diagnosis. A suite of computer programs automates the method, which was initially investigated manually. Two types of linkage are performed. Type 1 links on the unique identifiers of hospital group code and case reference number to link records from the same hospital or group of hospitals. Type 2 linkage is designed to link patient stays in different hospitals or groups and links records with identical surname and date of birth and then identical surname and full unit postcode. The accuracy and efficiency of the automated procedure was estimated by linking records for 6 diagnoses (lung cancer, ischaemic heart disease, cerebrovascular disease, infectious diseases, road traffic accidents and head injuries). The gross difference between the actual number of patients and the number after linkage was between 0.6 and 2.1%. The net difference was within 1% for all diagnoses except lung cancer with a difference of 1.3%. These results compare favourably with other linkage procedures. PMID- 3626701 TI - Combining data on health care utilization and socioeconomic status of a defined population: use of a population oriented health information system for regional planning. AB - Health services planning on a regional or national level needs information on health care utilization as well as data on the population to be served. Health or hospital information systems usually cover services provision and utilization, and population data for planning purposes must be obtained from other sources. In the health information system presented, hospital performance data are combined with census and socioeconomic data of the population. That makes cautious analysis of reasons for variation in health care utilization within the planning area possible. The HIS is regional, including 11 health care providers, and population based, linking data to municipality (38 in all). The system is described, including its structure, input registration, file content and output formats. An output example is presented. Necessary conditions for use of the HIS in planning activities are that the corresponding health care delivery system is comprehensive, the population served well defined, and that good control of patient flow and user behaviour is achieved. Use is limited by the character of information stored in the HIS: it is registered retrospectively and by routine. In a system covering various hospitals and municipalities, engaging different types of clerical and health care personnel, data reliability is also a critical issue. PMID- 3626702 TI - [Magnetic resonance imaging of the spine--a cheap and safe diagnostic method]. PMID- 3626703 TI - [Oxygen administration via a nasal catheter causing severe meteorism in a patient]. PMID- 3626704 TI - [Extracorporeal hemoperfusion in acute fulminant hepatic failure associated with paracetamol poisoning]. PMID- 3626705 TI - [Stenosing tendovaginitis of the thumb in children--a common but often overlooked diagnosis]. PMID- 3626707 TI - [Effects of drugs on analytic results in clinical chemistry]. PMID- 3626706 TI - [Mitochondrial diseases in children--a review]. PMID- 3626708 TI - [TNM classification of malignant tumors: new 1987 edition]. PMID- 3626709 TI - [Vesico-intestinal fissure with meningocystocele--attempt at clarifying an embryologic connection]. AB - The treatment of a boy is reported, who suffered from a combination of vesico intestinal fissure and meningocystocele. Because five of seven patients known to us since 1969 had a similar combination, it should be analysed whether there exists an etiological or embryological connection. Therefore the pertinent literature and clinical data of known patients was collected and evaluated. It can be shown that also in the literature a coincidence of 75% of vesico intestinal fissure and meningomyelocele is reported and both are caused during the 4th week of embryological development. Vesico-intestinal fissure is a disturbance of mesodermal inflow into the lower abdominal wall. The cause for meningocystocele is an abnormal cell proliferation of the neural anlage. Despite a number of possible clues an etiological connection could not be proved. PMID- 3626710 TI - [Quality assurance in surgery by prospective assessment of the risk of complications by a simple point score]. AB - 3654 general surgical interventions were prospectively registered during a 40 month period. Postoperative complications (wound infection, pneumonia, reoperation, mortality) were recorded and were quantified numerically by a complication score which describes the precise number of complications per ten operations. In this way the risk of a single operation can be monitored continuously and quality control programs can do without classification of operations in clean, contaminated and dirty interventions. The length of postoperative hospital stay and the amount of postoperatively applied antibiotics correlated well with the score. PMID- 3626711 TI - [Phrenico-esophageal membrane: anchoring of the terminal esophagus and cardia at the diaphragm]. AB - The esophageal hiatus lies in the muscular part of the diaphragm. The hiatus transmits, in addition to the esophagus, the vagus nerves, the esophageal blood vessels and connective tissue. The connective tissue binding the esophagus to the diaphragm has been termed the phrenico-esophageal membrane. Its strongest part derives from the inferior diaphragmatic fascia, extends some distance above the diaphragm to attach to the adventitia of the esophagus. The variations of the attachments have been described in detail. The importance for the surgical treatment of mobilisation and a supplementary suture of the lower esophagus are discussed. PMID- 3626712 TI - [Antigenicity of the auricular cartilage and its modification by vital preservation. 1. Xenogeneic transplantation of human auricular concha cartilage to the rabbit]. AB - By means of xenotransplantation of human auricular cartilage to rabbits tests were carried out to see, if antigenicity is reduced through storing elastic cartilage either in a nutrient solution (Ham F 12) at 4 degrees C above zero or in a tissue culture (Ham F 12 + 10% serum of a calf-foetus) at 37 degrees C above zero, and if vital preservation prevents degeneration- and resorption processes of cartilage. The results were compared to transplants of fresh, not treated cartilages, and those preserved with cialit and merthiolate. It turned out that these vital preservation methods seem to cause an extensive loss of the cartilages characteristic qualities and that they keep degeneration- and resorption processes at a minimal level. Big differences between storage in nutrient solution and tissue culture could not be observed. PMID- 3626713 TI - [Dynamics and significance of immunoglobulin E (IgE) as an immunological parameter in squamous cell carcinomas of the oral cavity and pharynx]. AB - Disorders of the immune system are supposed to be a factor of tumour pathogenesis. A close correlation of tumour activity and immunoglobulin dynamics (IgE) was described in a number of malignant tumours. In patients with squamous cell carcinomas of the oral cavity, the oropharynx and the hypopharynx (n = 80, male), we investigated IgE level changes in relation to tumour growth during the treatment and follow-up period of 2 years. The study group comprised patients with inactive tumours, active tumours and those with a lethal outcome. Enzyme immunoassays were used for IgE determination. Prior to any type of therapy, mean IgE levels were elevated in all patients showing large interindividual variations. No significant prognostic value could be deduced from pre- and posttreatment levels. However, in patients with tumour recurrences sudden IgE level changes were observed (P less than 5%), as well as drastically decreasing ans low IgE levels in patients with tumour-induced cachexia. PMID- 3626714 TI - [Acinar cell carcinoma of the salivary glands]. AB - Between 1972 and 1985, eleven cases of acinic cell carcinoma were treated at the ENT clinic of the University Hospital Geneva. Eight of them were located in the parotid gland, three in minor salivary glands, two of these on the hard palate and one on the lower lip. Local recurrence occurred in four cases: two were recurrences of a parotid gland carcinoma and two of a minor salivary gland carcinoma. Three patients developed metastases, two in cervical lymph nodes and one in the lungs. Two tumours presented a very aggressive local development. Hence, the acinic cell carcinoma has a significant tendency to recur, to produce metastases, and may have an aggressive evolution. Radical treatment by surgery is necessary. PMID- 3626715 TI - [Computed tomography for the preoperative classification of oral cavity and oropharyngeal carcinomas]. AB - CT scans of 40 patients with oral cavity or oropharyngeal carcinoma were compared with clinical tumour descriptions and operation and pathology reports in order to assess the role of CT scanning in the preoperative work-up and staging of oral and oropharyngeal carcinoma. Overall clinical staging was superior to radiological staging (73% vs 55% correct T stages). However, because of the additional information obtained from CT scans we would still recommend CT evaluation for most oral cavity and oropharyngeal carcinomas. PMID- 3626716 TI - [Experiences with afterloading irradiation of malignant head and neck tumors]. AB - Since the introduction of afterloading (AL) treatment more than twenty years ago, this kind of cancer therapy has become a standard method in other medical disciplines. With the development of new devices with short-term treatment and complete protection of the medical staff, AL became interesting for head and neck cancer treatment. This paper describes the method in detail and reports on initial results of treatment. From our experience with 20 patients it can be concluded that, from a technical point of view, AL is a convincing method. Moreover, it can be expected that in future AL will play a major role as a standard method in head and neck cancer treatment, even though a variety of questions (e.g. indication, fractionation) still require an answer. PMID- 3626717 TI - [Intelligibility of monosyllables in relation to tone hearing in noise-induced hearing loss]. AB - We found a method based on analysis of the pattern of recognition (discrimination) to predict the intelligibility of monosyllables in the speech audiogram from the hearing loss values of the tone audiogram. A pattern of recognition (discrimination) function is required for every monosyllable at every intensity level of the test. The great number of functions (8 X 200) (i.e. 1600 functions) involved requires the accommodation capacity of a computer installed at the place of work. PMID- 3626718 TI - [Assessment of social hearing with a questionnaire in relation to average hearing loss]. AB - In 86 patients with sensorineural hearing loss we checked if the measuring results obtained by conventional audiometric procedures correlate with the subjective impression of hard hearing ascertained via a special questionnaire. For this purpose we compared the average hearing loss (500, 1000, 2000 Hz) of the puretone audiogram with the results obtained via the questionnaire developed by v. Wedel and Tegtmeier for assessing the social hearing handicap (SHH). We can see that there is good correlation between the SHH index values and the average hearing loss with frequencies of 0.5, 1.2 kHz in pancochlear perception hearing loss, whereas in patients with basocochlear perception hearing loss the SHHI cannot be calculated with the help of the puretone audiogram, nor will a widening of the frequency range up to 6 kHz lead to a better correlation between the average hearing loss and SHHI. PMID- 3626719 TI - [The relevance of objective hearing examinations within the framework of pediatric audiological diagnosis]. AB - The methods of "objective" hearing tests are presented and possible mistakes discussed. Two cases are reported pointing to the necessity of confirming the results of "objective" hearing tests in infants via conventional methods of reflex and play audiometry. Diagnosis in infant audiometry should be effected on an inpatient basis. PMID- 3626720 TI - [Extensive recurrent basalioma of the pinna with infiltration of the temporal bone--radical surgical removal of the tumor and primary defect repair (a case report)]. AB - Report on a woman patient, 69 years of age, suffering from a recurrent extensive basalioma of the external ear that was considered inoperable, as the tumour had invaded the petrous bone, the parotid gland, the mandibular joint, and the adjacent nerves. Because of unbearable pain it was decided to perform a radical operation with resection of the tumour, the petrous bone, the parotid gland, the ascending mandibular branch, the facial nerve, and part of the oral mucous membrane. The exposed large cervical vessels, dura mater, and the bony skull--of which the periosteum had to be removed--were primarily covered with a large pectoral muscle island flap and an occipital advanced flap. Twenty-four months after surgery the patient had no relapse and was free from pain. PMID- 3626721 TI - Anatomical relationships of the cochlear nuclei and the pontobulbar body: possible significance for neuroprosthesis placement. AB - The pontobulbar body (PBB) is located in the cerebellopontine angle caudally to the cochlear nuclear complex (CN). We found the common boundary between these two structures on the surface of the brain stem as well as within it. We used the Kluver-Barrera staining technique to characterize different neuronal types adjacent to the boundary. Although the majority of them in the CN were globular, we also saw a substantial number of spherical neurons. Neurons in the PBB were substantially different in shape and were mainly angular. The boundary between the PBB and CN at their closest contact runs around the caudal side of the ventral cochlear nucleus and the most proximal part of the eighth nerve. In the more dorsal region, the PBB is completely separated from the CN by the brain stem tissue. In the ventral region, the PBB runs between the seventh and eighth nerves, and it is adjacent to both. These results might aid accurate placement of the central electroauditory prosthesis and further understanding of the general anatomy of the cerebellopontine angle. PMID- 3626722 TI - Prognostic value of eustachian tube function in pediatric tympanoplasty. AB - Poor eustachian tube function and prevalence of infectious ear disease are thought to be the reasons for less successful outcome associated with tympanoplasty in children. Since both of these factors are related to age, identification of those patients who may benefit by delaying the surgery has been a concern to otolaryngologists. In an effort to investigate the role of eustachian tube function on the outcome, we tested the tubal function in 63 ears (56 children) undergoing tympanoplasty for central perforations. In 49 ears (78%), the graft took; of these, 33 had good middle-ear function, 8 developed persistent or recurrent otitis media, and 8 had severe retraction or atelectasis. There was a significant association (p less than 0.01) between outcome and preoperative tubal function as determined by combining the active and passive function parameters. However, the prognostic value of tubal function testing was low; predictive values for success and lack of success being 68% and 56%, respectively. Other factors, such as graft placement (medial or lateral) contralateral ear status, and child's age, were not associated with outcome. Consistent with other studies, good eustachian tube function was shown to predict good outcome, but poor tubal function was not helpful in predicting poor outcome. PMID- 3626723 TI - Necrotizing tracheobronchitis: a newly recognized cause of acute obstruction in mechanically ventilated neonates. AB - Necrotizing tracheobronchitis (NTB) is an acute inflammatory lesion of the lower airway which can result in total airway obstruction. While potentially treatable, this lesion has been described predominantly in autopsy or animal studies. We observed clinical symptoms which reflect development of this lesion. Symptoms of acute airway obstruction (hypercarbia, respiratory acidosis, decreased chest wall movement) occurred in eight neonates undergoing treatment with high-frequency jet ventilation; five patients treated with HFJV were studied without signs of obstruction. Emergency bronchoscopy using a rigid bronchoscope was performed in the intensive care unit. The diagnosis of NTB was made by the observation of hyperemia, intraluminal debris, or the appearance of eschar formation. Necrotic debris was removed using forceps and/or suction as necessary. All patients survived treatment. Seven were long-term survivors, all with bronchopulmonary dysplasia. In patients who died, autopsy evaluation of the airway revealed a characteristic picture consisting of necrosis, neutrophil infiltration, epithelial erosion, and intraluminal obstruction. PMID- 3626724 TI - "Emergency" laryngectomy and stomal recurrence. AB - The data on 281 patients who underwent surgical therapy for laryngeal carcinoma from 1976 through 1984 were reviewed, revealing 16 patients who presented with an impending obstruction of the airway that was treated by an "emergency" laryngectomy. A review of the patients in our series did not reveal any serious complications from the procedure and it has allowed effective management of these advanced neoplasms. In addition, 10 patients who developed peristomal recurrences were reviewed. Preoperative factors such as location of lesion, antecedent surgery, and previous radiation therapy were assessed and compared to the patients who underwent "emergency" laryngectomy in an attempt to further define risk factors involved in peristomal recurrence. A strong association with subglottic extension was noted. Also associated in this review was antecedent full-course radiation therapy. PMID- 3626725 TI - Surgical salvage for stomal recurrence: a multi-institutional experience. AB - Recurrence of squamous cell cancer following total laryngectomy constitutes an extremely difficult therapeutic problem. Satisfactory management is elusive and frustrating to the head and neck oncologist. Various recommended therapeutic regimens include symptomatic treatment, palliation with chemotherapy and radiation, and aggressive surgical salvage. While surgery offers the only realistic chance at cure, this procedure is fraught with significant morbidity and a poor success rate. In an attempt to clarify the role of surgical salvage in these patients, experience with 57 patients with stomal recurrence presenting to three head and neck surgical groups will be presented. Forty-one of these patients subsequently underwent definitive surgery. The overall 2-year survival for operated patients was 16% with a 24% determinate survival. Further analysis revealed a 45% 5-year survival with type 1 and 2 lesions and 9% survival with types 3 and 4. Recommendations regarding indications for surgery are made based on this experience. PMID- 3626726 TI - The diagnostic accuracy of pharyngoesophagram compared to esophagoscopy in patients with head and neck cancer. AB - Two hundred and fifty-four patients with head and neck cancer were entered into a prospective study comparing the results of pharyngoesophagram to esophagoscopy. All patients had pharyngoesophagram deemed adequate to evaluate the esophagus and rigid esophagoscopy to at least 30 cm from the upper incisor teeth. In 239 (94.1%) patients both the pharyngoesophagram and esophagoscopy were negative. Four esophageal tumors were found. Only one of these tumors (25%) was detected on pharyngoesophagram. We believe that the pharyngoesophagram should be a part of the initial work-up of every head and neck cancer patient and should precede esophagoscopy. However, the barium swallow cannot be relied upon exclusively to detect small simultaneous second primary esophageal malignancies. PMID- 3626727 TI - Positive Delphian lymph node: clinical significance in laryngeal cancer. AB - The significance of metastatic cancer in the Delphian lymph node in patients with laryngeal carcinoma has not been thoroughly discussed. Between 1960 and 1985, we identified 20 cases of histologically proven metastasis to the Delphian node. In 12 of these patients with glottic cancer (T1-T3), the neck was clinically negative but a positive Delphian node was discovered at partial or total laryngectomy; in 6 patients, ipsilateral neck metastasis developed. Eleven of the 20 patients have died from their laryngeal cancer. The frequency of neck metastasis or death, or both, from cancer is unusually high in patients with a positive Delphian node. PMID- 3626728 TI - American Burkitt's lymphoma of the mastoid. AB - Primary clinical presentation of malignant lymphoma in the middle ear is rare. One case of African Burkitt's lymphoma involving the mastoid has been reported, but the case herein presented would appear to be the first case of American Burkitt's lymphoma in the literature. American and African varieties have distinct clinical presentations but are histologically identical. Chemotherapy is effective against these aggressive tumors. A 6-year-old boy with the first known case of American Burkitt's lymphoma of the mastoid is presented. He is doing well 23 months from the onset of symptoms. PMID- 3626730 TI - Midline destructive granuloma: fact or fiction. AB - Although differentiation of Wegener's granulomatosis from other destructive midline lesions is now clearly recognized by clinicians and pathologists, confusion persists regarding the management of what has erroneously been called "lethal midline granuloma." The experiences of 36 patients with destructive midline granuloma supports the view that probably all are manifestations of malignant lymphoma and should be treated as such. Although radical dosage radiotherapy will control most local lesions, dissemination of lymphoma may still occur despite absence of systemic disease at initial diagnostic work-up. Subsequent control with cytotoxic drugs is frequently unsuccessful, and it is suggested that chemotherapy should be given routinely to every patient with primary nasal lymphoma and possibly to those with polymorphic reticulosis or necrosis with atypical cellular exudate (NACE). PMID- 3626729 TI - Blunt laryngeal trauma in children. AB - The diagnosis of laryngeal trauma in an adult trauma patient is usually readily made. It is frequently overlooked in children, however, because of the severity of their concomitant injuries and the unfamiliarity of pediatricians with this type of injury. The child with laryngeal trauma may develop respiratory distress much more quickly than an adult because of the relatively small dimensions of the pediatric airway and the apparent propensity for children to develop edema of the soft tissues of the larynx. This report retrospectively reviews our experience during the past several years with ten children who experienced blunt laryngeal trauma. Emphasis is placed upon the diverse etiologies of laryngeal trauma in children and the importance of both flexible and rigid laryngoscopy in the diagnosis and management of these patients. PMID- 3626731 TI - Treatment of obstructive sleep apnea by uvulopalatopharyngoplasty. AB - Although uvulopalatopharyngoplasty has been proposed as a treatment for obstructive sleep apnea, there is limited objective data concerning its efficacy. We have examined 40 patients with moderate to severe obstructive sleep apnea before and 3 months following uvulopalatopharyngoplasty. A standardized questionnaire and detailed overnight sleep study were performed before and after surgery. In addition, 15 patients were retested 1 year postoperatively. Uvulopalatopharyngoplasty resulted in a statistically significant reduction in symptoms, blood pressure, apnea index, and total apneic time. There was no significant change in patient weight or sleep gas exchange. Seventy-seven percent had a reduction in apnea index of greater than 50%, which is better than other reported series using a more conservative approach. Our more aggressive surgical method will be shown in detail. The 1-year follow-up studies revealed the results were maintained or slightly improved over time. PMID- 3626732 TI - Cartilage-perichondrial composite graft tympanoplasty in the treatment of posterior marginal and attic retraction pockets. AB - The atelectatic retraction pocket (ARP) has been implicated in the development of chronic otitis media and cholesteatoma. The ARP's tendency for persistence or recurrence despite treatment is a significant otologic problem. The purpose of this study is to define and discuss this clinical entity and the use of cartilage perichondrium tympanoplasty as a safe and predictable method of treatment, reducing destructive complications while maintaining ear function. A retrospective analysis of 85 operated ears is presented. PMID- 3626733 TI - Sensorineural hearing loss associated with hypoparathyroidism. AB - The hearing loss of 21 patients with hypoparathyroidism was investigated by pure tone audiometry, short increment sensitivity index (SISI) test, Bekesy audiometry, speech audiometry, and auditory brain stem response. Sensorineural hearing loss was found in 7 of 21 patients (13 of 42 ears) receiving no treatment for hypoparathyroidism or having chronic hypocalcemia. The high SISI score, presence of recruitment, and prolongation of the wave I (N1) latency suggested that the inner ear is responsible for hearing loss in these cases. Inner ear dysfunction was probably due to the low calcium level in inner ear fluid and/or the direct effect of vitamin D deficiency on the inner ear. PMID- 3626734 TI - Treatment of metastatic neck nodes secondary to an occult epidermoid carcinoma of the head and neck. AB - One hundred thirty-eight patients, who were followed for a minimum of 5 years, had either surgery and postoperative radiotherapy (48 patients) or radiotherapy only (90 patients) for metastatic epidermoid carcinoma in cervical nodes from an unknown head and neck primary. All received radiotherapy to the presumed occult sites. Forty-five percent presented with a single unilateral adenopathy. Those who were initially operable had a neck recurrence rate of 17% and a survival rate of 53%. Forty-three percent of initially inoperable patients recurred and only 25% survived. Patients with adenopathy which completely regressed or became resectable after irradiation had an 80% locoregional control. Only 4% developed an overt cancer at an occult site within 5 years. PMID- 3626735 TI - MRI of normal or cancerous laryngeal cartilages: histopathologic correlation. AB - MRI appearances of laryngeal cartilages, normal or invaded by cancer, are still relatively unfamiliar to most clinicians. Twelve primary laryngeal tumors out of a series of 65 patients which have been investigated by MRI were examined postoperatively by macroscopic and microscopic sectioning of the surgical specimens. Images were obtained with a 0.6 Tesla superconductive system using a solenoid surface coil. The authors emphasize the value of a combined use of T1 weighted and balanced (relatively T2-weighted images with still T1 characteristics) Spin Echo images. T1-weighted images permit differentiation between pathological and normal bone marrow. Balanced images allow separation between nonossified cartilage and tumor tissue. MRI is an additional tool in the diagnostic workup of cartilage invasion by tumor. PMID- 3626736 TI - Delayed neck infection following anterior spine surgery. AB - Pharyngoesophageal perforation and neck abscess formation is a rare complication of anterior cervical spine surgery. This complication usually manifests itself within the early postoperative period and is associated with soft tissue trauma at the time of surgery. We describe two cases of retropharyngeal abscesses and persistent pharyngocutaneous fistulae which occurred in a delayed fashion several months after cervical spine surgery. The etiology, diagnosis, and treatment of this problem is discussed with a review of the current literature. PMID- 3626737 TI - Proposed technique for pharyngostoma obliteration. PMID- 3626738 TI - Jet stylet catheter for airway management. PMID- 3626739 TI - Perichondrial attached double cartilage block: a better alternative to the PORP. PMID- 3626741 TI - Cold air calorics. PMID- 3626740 TI - Myofacial pain dysfunction. PMID- 3626742 TI - Acoustic neuroma surgery. PMID- 3626743 TI - The road toward 21st century surgery: new strategies and initiatives in cancer treatment. PMID- 3626744 TI - Study of three laser systems for treatment of superficial varicosities of the lower extremity. AB - Three separate laser modalities were investigated in the treatment of superficial varicosities/telangiectasias of the lower extremities. Sixteen patients were treated and followed for 12 months. The superpulse CO2, the pulsed focally specific CO2, and the Nd:YAG laser transmitted through a diffusing sapphire tip were able to produce cosmetically satisfactory permanent obliteration of vessels after a 12-month follow-up interval. These results were a significant improvement over six-month results indicating a long fading time for laser treatment of leg veins. PMID- 3626745 TI - Acoustic nerve tumor surgery before and since the laser: comparison of results. AB - A random computer selection of 21 patients who underwent 28 operations for acoustic neurinoma between 1974 and 1980 using conventional methods, including the operating microscope and microtechnique, was compared with a cohort of 22 patients who underwent 25 operations between 1980 and 1984 utilizing a carbon dioxide laser. Completeness of tumor removal, anatomical and functional preservation of the facial nerve, preservation of hearing, morbidity and mortality, average hospital stay, and eventual outcome were used as markers and were compared. Utilizing P values, the study demonstrated a significantly superior outcome, and as a result a better life quality, in patients who were operated on utilizing a CO2 laser in addition to conventional microsurgical technique. PMID- 3626746 TI - Examination of tooth pulp following laser beam irradiation. AB - An attempt was made to determine the maximum amount of laser energy which could be utilized without impairing pulpal vitality. Forty rat molar teeth were irradiated in vivo; the Sharplan CO2 laser modality, focused to a 0.2-mm-diameter spot size was used. The energy output was varied by changing the power and/or the pulse duration. Subsequent histological examination of the irradiated teeth showed that the duration of exposure was more significant than the power. A pulse of 0.2 sec/10 W appears to be the safety limit in preserving pulpal vitality. PMID- 3626747 TI - An alternative method of vascular anastomosis by laser: experimental and clinical study. AB - In vascular surgery, it is now very difficult to maintain the long-term patency after a conventional vascular anastomosis, especially for small-caliber vessels. A low-energy CO2 laser was experimentally employed to make a vascular anastomosis with only a few sutures. Subsequently, it could be confirmed that optimal conditions for vascular anastomosis by laser were 20-40 mW in output and 6-12 sec/mm in irradiation time. On the other hand, pressure tolerance test as well as tensile strength test and microscopic examinations at the sites of anastomoses by laser were compared with the conventional suture method. There were no significant differences between laser and suture methods. On the basis of the excellent results of this study, the laser was clinically applied for anastomoses of the peripheral vessels in 35 patients. The first clinical laser application in the world was successful in a 44-year-old female patient with chronic renal failure in 1985. All patients are doing well without any complications from vascular anastomosis by laser. From these experimental and clinical studies, it can be concluded that anastomosis by laser should be recommended for small caliber vessels such as aortocoronary bypass surgery. PMID- 3626748 TI - Morphological and surface temperature changes in femoral arteries following laser irradiation. AB - A low-power carbon dioxide laser was to irradiate rat femoral arteries under the same conditions required to anastomose several human arteries by thermal coagulation. Mean surface temperature changes were measured at the site of laser impact with the artery to evaluate the resultant histopathological changes as a function of laser power. More severe thermal coagulative changes, necrosis, and swelling resulted with increased laser power. Comparison of the temperature-time relationships showed that the peak surface temperature rise at the surface of these arteries was about 25 degrees C for one pulse at 200 mW laser power, compared to an approximate 7 degrees C rise for one pulse at 120 or 150 mW laser power. Increase in the surface temperature resulted in an increased severity of histopathological injury. These results showed that necrosis of medial layer smooth muscle cells occurred beyond the laser exposure site, suggesting that heat conduction could result in significant damage to reconnected vessel and could be a factor in the formation of a weak bond or an aneurysm. PMID- 3626749 TI - Ultrastructural study of arterial wall repair after argon laser micro anastomosis. AB - A carotid end-to-end anastomosis was performed in 50 Wistar rats by means of a Coherent 900 argon laser. The vessel sealing was obtained with laser shots (average 19) of 300 mW power and 5-second duration, the beam being focused in a spot of 150 micron diameter (1,700 W/cm2). From day 0 to day 120, 25 specimens underwent semithin and electron microscopic examinations. The results showed the immediate sealing effect of the argon laser owing to protein denaturation and collagen fusion of the media and adventitia 100 micron in width. Re endothelialization of the anastomotic line began by day 3, while myofibroblast proliferation was observed in the media by day 10. By day 20 media scar was still occupied by numerous myofibroblasts and surrounded by abundant collagen and elastic fibres. At long term the endothelial repair was complete and the anastomotic strength was assured by medial collagenous network. PMID- 3626750 TI - Is an anesthesiologist's presence justified during therapeutic laser endoscopy? AB - Diagnostic endoscopy has generally been done under intravenous sedation. Diazepam and meperidine are the two most frequent drugs used. Even though these drugs produce sedation, analgesia, and amnesia, they do not provide a quiet field. Therapeutic laser endoscopy requires a quiet field. We conclude that an anesthesiologist is needed at the head of the table. Despite the increased cost of the procedure, the anesthesiologist is able to tailor the anesthesia to fit the needs of both the patient and the endoscopist. PMID- 3626751 TI - Safe anesthesia for endoscopic laryngeal laser surgery. AB - Anesthesia safety for endoscopic laryngeal laser surgery has been a major limiting factor for laser applications in the larynx and the hypopharynx. Several anesthesia techniques have been proposed and each technique appears to have its own limitations. This paper will deal with the distinct advantages offered by the malleable copper tube which is used for delivery of the open Venturi system anesthesia for endoscopic laser surgery. A retrospective study of 100 patients who have undergone this modality of anesthesia at our institution will be presented. Our conclusion from this study shows clearly the superiority of the copper tube over the conventional aluminium-foil-wrapped endotracheal tube in safety and the exposure of the larynx during surgery. PMID- 3626752 TI - Residual cervical intraepithelial neoplasia after laser ablation. AB - Some patients with histologically proven residual cervical intraepithelial neoplasia after laser ablation have false negative cytology. The explanation for this is not known, but there was no evidence of buried lesions. Follow-up of all patients treated by selective ablation is necessary. Cytology alone is inadequate and careful, accurate pre- and posttherapy colposcopy is essential. PMID- 3626753 TI - Laser smoke effect on the bronchial system. AB - The photoresection of endobronchial tumors produces smoke which is partly inhaled by the patient as well as the surgical staff. In an animal study we investigated whether a single exposure or repetitive exposures to smoke might have harmful side effects on the airways. Eleven sheep were exposed to smoke produced by laser vaporizing (6,500 J) sections of bronchial tissue (1 cm3) in a Plexiglas chamber. The smoke analysis revealed 0.92 mg/liter particles with a mean particle size of 0.54 micron. Carbon monoxide content was estimated as 0.04%. We measured the effects of one or three separate ten-minute exposures on airway resistance, gas exchange, and mucociliary clearance rate in the trachea. We found that the smoke inhalation resulted in a decrease of arterial PO2 with relatively little change in airway mechanics. Tracheal mucus velocity, a marker of lung mucociliary clearance, was significantly depressed in a dose-dependent manner with increasing smoke exposures. Results of bronchoalveolar lavages performed before and one day after the exposure showed that the smoke inhalation induced a severe inflammation with dramatic increases of inflammatory cells. The total number of cells per milliliter lavage return increased from 3.2 million to 25 million; percent neutrophils increased from 2.3 to 45.6% and percent macrophages decreased from 86 to 41%. These findings indicate that the side effects of smoke inhalation during intrabronchial laser surgery should not be neglected. The impairment of the defense mechanism of the lung combined with the inflammation as well as hypoxia might be fatal in compromised patients. Effective smoke removal devices should be developed to protect the patient as well as the surgeon. PMID- 3626754 TI - Evidence for A1 and A2 adenosine receptors in guinea pig trachea. AB - The adenosine analogs [5'-N-ethylcarboxamideadenosine (NECA), 2-Chloro-adenosine (2-ClA), R-phenylisopropyladenosine (R-PIA), N6-cyclohexyl adenosine (CHA), and N6-cyclopentyladenosine (CPA)] produced both relaxation and contraction responses in isolated guinea-pig trachea. A concentration-related relaxation response was observed in trachea which were precontracted with either histamine or KC1. This response followed an order of analog potency that was indicative of the A2 receptor subtype (NECA greater than 2-ClA greater than R-PIA greater than CPA greater than CHA). Theophylline, an adenosine-receptor antagonist, blocked this relaxation response. In addition, a concentration-related contractile response was produced with adenosine analogs in those trachea that were not previously contracted. In contrast, the contractile response followed an analog potency indicative of the A1 receptor subtype (R-PIA greater than 2-ClA = CPA = CHA). This contractile response was not mediated by cholinergic, adrenergic or histaminergic receptors. 2-ClA induced a biphasic response, while NECA only relaxed these tissue under basal tone. Unlike the relaxation response, these contractile responses were not attenuated by theophylline, but were blocked by 1,3 dipropyl-8-(2 amino-4-chlorophenyl)xanthine (PACPX). These findings confirm the existence of two subpopulations of adenosine receptors in guinea pig trachealis muscle. PMID- 3626755 TI - Dog secretin: sequence and biologic activity. AB - Secretin was purified from the first 50 cm of proximal intestine of a single dog. The purification sequence included extraction in acid-ethanol, differential precipitation with acetone, Sephadex gel filtration and three successive HPLC steps. Dog secretin has the following sequence: HSDGTFTSELSRLRESARLQRLLQGLV. The underlined amino acid represents a substitution of Glu for Asp at position 15 from the NH2-terminus of pig secretin. Dog secretin is equal in potency to pig secretin in stimulating pancreatic ductal flow in a rat bioassay system. PMID- 3626756 TI - Effects of sequential acute stress exposure on stress-induced pituitary luteinizing hormone and prolactin secretion. AB - The present study was carried out to determine the effects of repetitive acute stress exposure on pituitary secretion of both luteinizing hormone (LH) and prolactin (PRL). Adult male rats were exposed to sequential episodes of acute novel environment stress separated by intervals of either 60 or 120 minutes. Serial blood samples were obtained from animals before, during and after each stress episode via indwelling intra-cardiac cannulas. The imposition of 10 minute episodes of novel environment stress on an hourly basis eventually rendered the hypothalamic-hypophyseal LH axis refractory to the stimulatory effect of stress. If sequential stress was imposed at 120 minute intervals, LH release was significantly enhanced during each exposure. A different pattern of PRL release was observed during the same sequential stress schedule. After an initial increase in hormone release in response to the first hourly stress episode, PRL levels were unaltered during the second and third hourly stress exposures. Thereafter, plasma PRL levels showed a trend toward a progressive increase in release during each successive episode, and were significantly elevated above preceding baseline levels during the fourth and fifth hourly stress exposures. In rats exposed to stress every two hours, a significant increase in PRL levels occurred following the first, but not the second stress episode. Hormone release was again enhanced in response to the third exposure to novel environment. The present results demonstrate that the repetitive exposure to acute novel environment stress results in differential alterations in pituitary LH and PRL secretion over time, and that the timing of repeated episodes is an important determinant of continued responsiveness to stress, particularly with regard to LH release. These findings suggest that the LH and PRL hormonal responses to at least this specific stressor are mediated by independent neural mechanisms. PMID- 3626757 TI - Ethanol-induced analgesia. AB - The effect of ethanol (ET) on nociceptive sensitivity was evaluated using a new tail deflection response (TDR) method. The IP injection of ET (0.5-1.5 g/kg) produced rapid dose-dependent analgesia. Near maximal effect (97% decrease in TDR) was produced with the 1.5 g/kg dose of ET ten minutes after injection. At ninety minutes post-injection there was still significant analgesia. Depression of ET-induced nociceptive sensitivity was partially reversed by a 1 mg/kg dose of naloxone. On the other hand, morphine (0.5 or 5.0 mg/kg IP) did not modify ET induced analgesia, while 3.0 minutes of cold water swim (known to produce non opioid mediated analgesia) potentiated ET-induced analgesic effect. The 0.5 g/kg dose of ET by itself did not depress motor activity in an open field test, but prevented partially the depression in motor activity produced by cold water swim (CWS). Thus the potentiation by ET of the depression of the TDR produced by CWS cannot be ascribed to the depressant effects of ET on motor activity. PMID- 3626758 TI - Identification of delta-guanidinovaleric acid in human urine. AB - delta-Guanidinovaleric acid (DGVA) was identified in human urine using thin layer chromatography (TLC), high performance liquid chromatography (HPLC) and gas chromatography/mass spectrometry (GC/MS). In the TLC, all Rfs of sample from urine developed by 6 solvent systems were identical to that of authentic DGVA. In the GC/MS, the mass spectrum of the sample was identical to the trifluoroacetylated dimethylpyrimidyl derivative of DGVA butylester (M+ = 375). In the HPLC analysis, the DGVA peak was observed just before 15 min in either chromatogram obtained by analysis of human urine or authentic DGVA, and the content of DGVA in pooled human urine was calculated at 2.4 nmol/ml. PMID- 3626759 TI - Increasing anticonvulsant effect of AD-810 (zonisamide) in aging BDF1 mice. AB - The anticonvulsant efficacy of a newly developed anticonvulsant, AD-810 (zonisamide, 3-sulfamoylmethyl-1,2-benzisoxazole) was examined in relation to mouse age in three different age groups of female BDF1 mice (7-, 25- and 29-month old). The minimal effective concentration (MEC) of AD-810 in both plasma and brain for abolishing the electroshock-induced maximal seizure steadily decreased with age, the 25- and 29-month values being 50 and 30% of respective 7-month values. The observation in the present study was almost identical to previous observations by the authors on phenytoin, phenobarbital and oxazepam. The present results support our previous contention that the dose and plasma concentration of anticonvulsants can (and probably should) be reduced in the elderly regardless of the drug. Since the anticonvulsant mechanism of AD-810 has been reported to differ from those of previously examined drugs (phenobarbital and oxazepam), the results also suggest that the apparent increase in the pharmacological effect of these anticonvulsants may be due to old animals' lowered response capability for seizures rather than a specific age effect on the pharmacological reaction sites for individual anticonvulsants. PMID- 3626760 TI - The prenatal development of the organ of Zuckerkandl in rats. AB - The effect of maternal glucocorticoid depletion upon the fetal development of the organ of Zuckerkandl (OZ) in rats was determined. Maternal hypophysectomy at 13d8h gestation resulted in a fifty percent decrease in plasma corticosterone levels at 18d8h when compared to both sham operated and unoperated controls. No differences in the volume of the OZ among the three groups of animals were found. The chromaffinity of the OZ was decreased in the hypophysectomized and sham operated groups suggesting a stress-induced depletion of catecholamine stores. The data suggests that the OZ participates in fetal sympathoadrenal activity and that its development is independent of maternal corticosterone titers. PMID- 3626761 TI - Adenosine in hemorrhagic shock: possible role in attenuating sympathetic activation. AB - Changes in plasma purine nucleoside level, autonomic activity and hemodynamic reactions were studied in pentobarbital anesthetized rabbits during hemorrhagic shock. Shock was elicited by bleeding the animals to a mean blood pressure of 40 mmHg and maintained until 60% of the maximum bleeding volume in the reservoir had been taken up spontaneously. The remaining shed blood was reinfused thereafter. Norepinephrine (NE), epinephrine (E), adenosine (AD) and uric acid were measured by HPLC with electrochemical detection, fluorometry or UV absorbance. The results showed hemorrhagic shock caused a significant rise in plasma NE, E, AD, and uric acid levels, but the magnitudes and time profiles were different among them. Plasma NE and E increased during the shock compensatory period then declined in the decompensation period whereas adenosine and its metabolite uric acid were elevated persistently during both periods. It is concluded that a balance between autonomic activity and tissue metabolism is important in the maintenance of hemodynamics during shock. PMID- 3626762 TI - Parathyroid hormone in sodium-dependent hypertension. AB - Plasma parathyroid hormone (pPTH) levels have been assessed in three separate radioimmunoassay systems in samples from Wistar-Kyoto rats. The animals were subjected to one of three dietary regimens throughout the study period: Group 1 animals consumed normal rat chow and drank tap water; Group 2 animals consumed normal rat chow and tap water was replaced with 0.5% saline solution; Group 3 animals consumed normal rat chow to which 2.5% CaCO3 (by weight) had been added and also drank 0.5% saline solution. Animals had consumed these diets for approximately 7 months prior to sacrifice for blood collection. Blood pressure was measured by tail cuff plethysmography in these animals and, as previously reported, saline consuming animals showed a moderate hypertension (Gp 2) only when diets did not contain added calcium (Gp 3). In the week prior to sacrifice, mean blood pressures were: Gp 1: 128.0 +/- 3.46 mmHg; Gp 2: 140.2 +/- 3.15 mmHg; and Gp 3: 133.5 +/- 2.90 mmHg. Three assay systems were used to measure pPTH levels from trunk blood samples obtained by guillotine decapitation. One assay used an antiserum directed toward the vasoactive N terminal fragment 1-34 and produced pPTH measurements of 0.74 +/- 0.05 ng/ml in Gp 1 animals, 1.04 +/- 0.07 ng/ml in Gp 2 animals and 1.12 +/- 0.08 ng/ml in Gp 3 animals. This pattern was consistent with that obtained by another antiserum which had been raised against the intact 1-84 PTH molecule and produced values of 0.25 +/- 0.03 ng/ml in Gp 1 animals, 0.55 +/- 0.07 ng/ml in Gp 2 animals and 0.74 +/- 0.04 ng/ml in Gp 3 animals. Antiserum raised against the C-terminal did not show any difference in pPTH across groups. We conclude that saline consumption may increase some portions of circulating PTH. Such elevation of pPTH may not be a pathophysiological component in the sodium dependent elevation of blood pressure since animals concurrently consuming both saline and calcium supplemented diets retained elevated pPTH levels even though blood pressures did not differ from controls. Rather, elevation of circulating PTH levels may be a response to prolonged increases in sodium consumption. PMID- 3626763 TI - Influence of sodium intake on circulating levels of neuropeptide Y. AB - Neuropeptide Y (NPY) is present in the adrenal medulla, in sympathetic neurons as well as in the circulation. This peptide not only exerts a direct vasoconstrictor effect, but also potentiates the vasoconstriction evoked by norepinephrine and sympathetic nerve stimulation. The vasoconstrictor effect of norepinephrine is also enhanced by salt loading and reduced by salt depletion. The purpose of this study was therefore to assess whether there exists a relationship between dietary sodium intake and the levels of circulating NPY. Uninephrectomized normotensive rats were maintained for 3 weeks either on a low, a regular or a high sodium intake. On the day of the experiment, plasma levels of NPY and catecholamines were measured in the unanesthetized animals. There was no significant difference in plasma norepinephrine and epinephrine levels between the 3 groups of rats. Plasma NPY levels were the lowest (65.4 +/- 8.8 fmol/ml, n-10, Mean +/- SEM) in salt-restricted and the highest (151.2 +/- 25 fmol/ml, n-14, p less than 0.02) in salt-loaded animals. Intermediate values were obtained in rats kept on a regular sodium intake (117.6 +/- 20.1 fmol/ml). These findings are therefore compatible with the hypothesis that sodium balance might to some extent influence blood pressure regulation via changes in circulating NPY levels which in turn modify blood pressure responsiveness. PMID- 3626764 TI - Effects of dopamine agonists and antagonists on gastric acid secretion and stress responses in rats. AB - The dopamine agonists and promoters bromocriptine, bupropion, and p hydroxymethylphenidate (a peripherally acting methylphenidate analog) reduced basal gastric acid secretion in rats, while the dopamine antagonists haloperidol, pimozide and metoclopramide augmented gastric acid output. Stress ulcer formation and plasma corticosterone levels were markedly reduced by l-dopa given either intraperitoneally or intracerebroventricularly as well as by intraperitoneally administered p-hydroxymethylphenidate. Domperidone, a peripheral dopamine receptor blocker, produced variable effects on stress responses, indicating a wider spectrum of action than hitherto realized for this compound. The results strongly support a role for both central and peripheral dopaminergic activity in reducing the pathological consequences of exposure to stress. PMID- 3626765 TI - Toxic effects of phencyclidine on developing chick embryo brain. AB - We studied the effects of Phencyclidine (PCP, Angel Dust) on the developing chick embryo brain. In Group-1, the eggs were injected with PCP on the 7th day of incubation and the embryo brains were studied on the 10th day. In Group-2, eggs were injected twice; first on the 7th day and then on the 10th day of incubation. Group-2 brains were then studied on the 16th day of incubation. PCP significantly depressed the development of embryo brains. Cerebral hemisphere weight, total protein and total DNA were significantly lower on day 10 of incubation in Group 1. Similar results were observed in Group-2. Concomitantly, the concentration of brain serotonin at day 10 was also significantly reduced when PCP was injected into the eggs on the 7th day of incubation. Since serotonin has been reported to influence development of the chick embryo brain, the present finding of the effect of PCP on brain development might be a secondary phenomenon. The possible implications of the effects of PCP on human brain development are also discussed. PMID- 3626766 TI - Anxiogenic properties of cocaine withdrawal. AB - Rats were trained to discriminate an injection of pentylenetetrazol (PTZ), 20 mg/kg, from saline using a two-lever operant procedure with food as a reinforcer. In substitution tests, rats selected the PTZ-appropriate lever after PTZ, but not after cocaine (20 mg/kg). A higher dose of cocaine (40 mg/kg) was behaviorally disruptive which resulted in no lever selection during the test session. Subsequently, training and testing were halted, and cocaine, 20 mg/kg/8-hr, was administered for 7 days. Following this chronic drug regimen, substitution of PTZ for the PTZ stimulus was increased. Furthermore, cocaine (40 mg/kg) substituted for the PTZ stimulus. Following redetermination of the PTZ and cocaine dose response curves, chronic cocaine injections were terminated and spontaneous withdrawal was assessed by determining its substitution for the PTZ stimulus. Cocaine withdrawal progressively substituted for the PTZ stimulus reaching a peak 120 hrs after the last cocaine injection. Diazepam, 5 mg/kg, blocked the PTZ-like stimulus. These data demonstrate that 1) chronic administration of cocaine produced sensitization for the PTZ stimulus, 2) tolerance developed to the behaviorally disruptive effects of cocaine, and 3) cocaine withdrawal produced a PTZ-like stimulus which was blocked by diazepam. PMID- 3626767 TI - Elevated daytime rat pineal and serum melatonin levels induced by isoproterenol are depressed by swimming. AB - Isoproterenol (1 mg/kg) was subcutaneously injected into adult male rats during the day to stimulate pineal N-acetyltransferase (NAT) activity and pineal and serum melatonin levels. Two hours after isoproterenol administration when levels of each of these variables had increased significantly, the experimental animals swam for 10 min in 22 degrees C water. At 15 min after swimming onset, pineal and serum melatonin levels were highly significantly depressed compared to those in control animals that did not swim. The high NAT level was not influenced by swimming. In a second study, isoproterenol injected rats swam for either 1, 3, 6 or 10 min and were sampled 15 min after the onset of swimming. The reduction in the elevated pineal melatonin in these animals was correlated with the length of the swim, i.e., as the duration of swim increased the percent reduction in pineal melatonin also increased. Neither pineal NAT nor hydroxyindole-O methyltransferase (HIOMT) activities were influenced by swimming. The results suggest that elevated pineal and serum melatonin induced by isoproterenol can be depressed with no effect on the activity of the enzymes which convert serotonin to melatonin. PMID- 3626768 TI - Restraint stress depresses prolactin surges in pseudopregnant rats and adrenalectomy does not alter the response. AB - Experiments were performed to determine whether restraint stress decreases the two prolactin (PRL) surges in pseudopregnant (PSP) rats in a manner similar to the stress-induced decrease of the proestrous PRL surge. Adrenal involvement as well as adaptation of the response was also investigated. Vaginal cycles were followed and animals exhibiting 2-3 normal cycles were cervically stimulated (CS) electromechanically to induce PSP. In one experiment the effect of adrenalectomy (ADX) on the nocturnal surge (NS) was investigated and was found to have no effect. In another set of experiments the effect of restraint stress was investigated. Immediately following an initial sample, the animals to be stressed had their hind legs tied together with plastic coated bell wire. Subsequent samples were taken for 3 hours. Restraint stress decreased the NS to 15% of the initial value within 30 minutes. ADX did not alter this response. Furthermore, 6 9 days of 3 hours of restraint stress did not attenuate the stress-induced decrease of the NS. Restraint stress also depressed the diurnal surge in PSP rats. These results indicate that restraint stress applied during the two PRL surges of PSP results in significant decreases in plasma PRL and that this response is not altered by ADX or by habituation to the stimulus. PMID- 3626769 TI - Hepatic prolactin binding is rapidly altered by endotoxin in lactating mice. AB - Endotoxin or lipopolysaccharide (LPS), a component of the outer membrane of gram negative bacteria, produces profound physiologic changes in most mammals. The effects of LPS on ovine prolactin (oPRL) binding by hepatic membranes of lactating mice is explored in this report. Specific 125I-oPRL binding by liver membranes from LPS-responder C3HfB/HeN mice increased two-fold within fifteen minutes of the injection of LPS, while no change was observed in the non responder C3H/HeJ mice. Specific 125I-insulin binding did not change. Scatchard analysis of equilibrium binding of oPRL to C3HfB/HeN liver membranes indicated that within fifteen minutes of LPS injection, a receptor of differing binding affinity appears and then disappears by one hour post-injection. We propose that these rapid alterations in the specific binding of oPRL by liver membranes from LPS-injected, lactating C3HfB/HeN mice are due to the transient creation or unmasking of a novel class of PRL receptor. PMID- 3626770 TI - Ketone formation in the intestinal mucosa of infant rats. AB - The intestinal mucosa of infant rats was found to produce ketones when incubated in Krebs-Ringer-Bicarbonate solution. No production was found in weaned rats. Ketogenesis could be inhibited by D-carnitine or tetradecylglycidic acid (TDGA) an inhibitor of long-chain acylcarnitine transferase, suggesting that ketone production is due to a large extent to break-down of long-chain fatty acids. It is considered possible that both ketones and glucose (also produced by the infant mucosa) serve as substrates for the muscular part of the intestine. PMID- 3626771 TI - Vervet monkey (Cercopithecus aethiops sabaeus) whole blood serotonin level is determined by platelet uptake sites. AB - Whole blood serotonin levels in adult male vervet monkeys living in social groups are sensitive to the animals' social environment. The mechanisms that translate different behavioral and environmental cues into altered whole blood serotonin levels are unknown. In this study, we have measured platelet number, size, serotonin content, and serotonin uptake, as well as the serum concentrations of tryptophan, Mg+2 and Ca+2. Results showed that whole blood serotonin levels, platelet serotonin content, and the serotonin uptake parameter Vmax were stable within animals on repeated sampling. The whole blood serotonin level was highly positively associated with platelet serotonin content, and the platelet serotonin content was highly positively associated with Vmax. These findings suggested that whole blood serotonin levels were a function of the number of platelet uptake sites. PMID- 3626772 TI - Comparison of two radiolabeled quinuclidinyl benzilate ligands for the characterization of the human peripheral lung muscarinic receptor. AB - Quinuclidinyl benzilate, a muscarinic antagonist, has previously been used in its tritiated form ([3H]-QNB) to study the lung muscarinic receptor. We investigated whether a newer iodinated form of QNB ([125I]-QNB) of higher specific activity would be an appropriate ligand to study the human peripheral lung muscarinic receptor. Both the tritiated and iodinated ligands bound specifically to human lung at 23 degrees C. At 37 degrees C the specific binding of [3H]-QNB increased slightly, but no specific binding of [125I]-QNB was found. The data from multiple equilibrium binding experiments covering a wide range of radiolabeled QNB concentrations were combined and analyzed using the computer modeling program, LIGAND. The tritiated QNB identified a single affinity human lung binding site with a Kd of 46 +/- 9 pM and a receptor concentration of 34 +/- 3 fmol/mg protein. The iodinated QNB identified a single higher affinity human lung binding site (Kd = 0.27 +/- 0.32 pM) of much smaller quantity (0.62 +/- 0.06 fmol/mg protein). Competition studies comparing the binding of unlabeled QNB relative to labeled QNB indicated that unlabeled QNB had the same Kd as that measured for [3H]-QNB, but a 5 log greater Kd than that measured for [125I]-QNB. Other muscarinic receptor agonists and antagonists competed with [3H]-QNB, but not [125I]-QNB for binding to muscarinic receptors with the expected magnitude and rank order of potency. We conclude that of the 2 radiolabeled forms of QNB available, only the tritiated form should be used to study the human peripheral lung muscarinic receptor. PMID- 3626773 TI - Effect of synthetic neuromedin U-8 and U-25, novel peptides identified in porcine spinal cord, on splanchnic circulation in dogs. AB - Two novel peptides which exert a potent stimulant effect on rat uterus smooth muscle have recently been identified in porcine spinal cord. These peptides designated neuromedin U-8 and U-25 have been reported to exert a hypertensive effect in rats. But further biological activities are not known. In the present study, the effect of these peptides on blood flow in portal vein, superior mesenteric artery and pancreatic tissue and on blood pressure were examined in dogs, utilizing recently developed ultrasonic transit time volume flow meter and laser Doppler flow meter. Neuromedin Us potently reduced blood flow in superior mesenteric artery. The minimum reductions could be observed even at very small doses of neuromedin U-25 (32 fmol/kg) and U-8 (90 fmol/kg), while the maximal reductions of 48.4 and 51.0% were attained at the doses of 320 pmol/kg (U-25) and 900 pmol/kg (U-8), respectively. These peptides also reduced portal vein blood flow, and the maximal reductions of 42.1 and 37.2% were attained at the doses of 32 pmol/kg (U-25) and 90 pmol/kg (U-8), respectively. On the other hand, blood flow in pancreatic tissue increased slightly with the maximal increases of 13.8% at 3.2 pmol/kg (U-25) and 11.8% at 9 pmol/kg (U-8), respectively. The maximal increases of blood pressure were 5.2% at 320 pmol/kg (U-25) and 4.3% at 90 pmol/kg (U-8). Furthermore, neither neuromedin U-25 nor U-8 influenced the axillary artery blood flow, suggesting their selective effect on splanchnic blood flow. Because of the potent and probably selective activity on splanchnic circulation, neuromedin U-25 and U-8 may well be recognized as physiologically significant novel neuropeptides or hormones. PMID- 3626774 TI - Chiral discrimination in the exchange of alpha-tocopherol stereoisomers between plasma and red blood cells. AB - The transport of 2R,4'R,8'-alpha-tocopherol and 2S,4'R,8'R-alpha-tocopherol from plasma into rat red blood cell membranes occurs with essentially no chiral discrimination. The previously demonstrated (10) preference of red blood cell membranes favoring 2R,4'R,8'R-alpha-tocopherol over the 2S,4'R,8'R stereoisomer is shown to be due to better retention of the former compound, i.e., to preferential retention of natural vitamin E. PMID- 3626775 TI - FAB MS/MS for phosphatidylinositol, -glycerol, -ethanolamine and other complex phospholipids. AB - Fast atom bombardment (FAB) of phosphatidylinositol, phosphatidylethanolamine, cardiolipin, phosphatidic acid and phosphatidylglycerol produces a limited number of very informative negative ions. Especially significant is the formation of (M H)-ions and ions that correspond to the carboxylate portions of these molecules. FAB desorption in combination with collisional activation allows for characterization of fragmentation and determination of structural features. Collisional activation of the carboxylate anion from complex lipids is especially informative. Structural characterization of the fatty acids can be achieved as the released saturated carboxylate anions undergo highly specific charge remote fragmentations that are entirely consistent with the chemistry of carboxylate anions desorbed from free fatty acids. This permits both identification of the modification and assignment of its location on the acid chain. FAB-desorbed alkyl acetyl glycerophosphocholines (platelet-activating factor) do not produce (M-H) ions. However, significant high mass ions are formed, and these can be collisionally activated for structural characterization. PMID- 3626776 TI - Tamoxifen-induced modification of serum lipoprotein phospholipids in the cockerel. AB - The administration of tamoxifen (Tam), a nonsteroidal antiestrogen, or of a diphenylmethane derivative of Tam that does not bind to the estrogen receptor (DPPE) of cockerels results in a marked decrease in the concentration of serum lipoprotein constituents with an apparent alteration in phospholipid composition. To establish the nature of changes in phospholipids, the molecular species of phosphatidylcholine (PC) and sphingomyelin (Sph) were isolated and characterized. Between 9 and 18 hr following the administration of Tam or DPPE, there was a marked decrease in the proportion of molecular species of serum PC containing C16 and C18 fatty acids, but there was an increase in the proportion of molecular species containing C20 and C22 polyunsaturated fatty acids. Fatty acid analyses revealed that this change was due to an increase in arachidonic and docosahexaenoic acids at the expense of oleic and linoleic acids. These proportional changes were due to an absolute decrease in serum of PC molecular species containing palmitic and stearic acids in association with oleic and linoleic acids with very little change in the absolute concentration of molecular species containing arachidonic and docosahexaenoic acids. By contrast, the composition of Sph, which contained palmitic acid as the major fatty acid, was not altered during treatment. It is concluded that the short-term effect of Tam and DPPE on plasma phospholipids of the cockerel is due to a selective conservation of PC containing long chain polyunsaturated fatty acids. PMID- 3626777 TI - Effect of cholestyramine on bile acid metabolism in conventional rats. AB - Effects of cholestyramine on biliary secretion of cholesterol, phospholipids and bile acids and fecal excretion of sterols and bile acids were examined in Wistar male rats. Six rats were fed a basal diet, and the other six were fed a basal diet supplemented with 5% cholestyramine for eight days. Bile flow and biliary secretion of bile acids and phospholipids (per hour per rat) decreased with cholestyramine treatment, while biliary cholesterol secretion (per hour per rat) remained unchanged. In the biliary bile acid composition, a marked increase of chenodeoxycholic acid with a concomitant decrease of beta-muricholic acid was observed in cholestyramine-treated rats. Fecal excretion of total sterols and bile acids increased about three- and four-fold, respectively, after cholestyramine treatment. The increase of fecal bile acids derived from cholic acid was more predominant than that derived from chenodeoxycholic acid, resulting in an increase of the cholic acid group/chenodeoxycholic acid group ratio. PMID- 3626779 TI - Effects on plasma lipids and fatty acid composition of very low fat diets enriched with fish or kangaroo meat. AB - The effects of very low fat diets (less than 7% energy) enriched with different sources of long chain (C20 and C22) polyunsaturated fatty acids (PUFA) on plasma lipid levels and plasma fatty acid composition were studied in 13 healthy volunteers. Three diets provided 500 g/day of tropical Australian fish (rich in arachidonic acid and docosahexaenoic acid), southern Australian fish (rich in docosahexaenoic acid) or kangaroo meat (rich in linoleic and arachidonic acids). The fourth diet was vegetarian, similarly low in fat but containing no 20- and 22 carbon PUFA. Subjects ate their normal or usual diets on weeks 1 and 4 and the very low fat diets in weeks 2 and 3. Weighed food intake records were kept, and weeks 2, 3 and 4 were designed to be isoenergetic with week 1. Plasma cholesterol levels fell significantly on all diets within one week. There were reductions in both low density (LDL) and high density lipoprotein (HDL) cholesterol levels, with effects on HDL cholesterol being more consistent. There were no consistent or significant effects on total triglyceride levels despite the high carbohydrate content of the diets. On all diets the percentage of linoleic acid fell in the plasma phospholipid and cholesteryl ester fractions, while the percentage of palmitic acid in the phospholipids and cholesteryl esters and palmitoleic acid in the cholesteryl ester fraction rose on all diets. The percentage of arachidonic acid rose in the phospholipid and cholesteryl esters on the two diets that were good sources of this fatty acid (tropical fish and kangaroo meat).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626778 TI - Effect of dietary lipids on the lipid composition and phospholipid deacylating enzyme activities of rat heart. AB - Rats were fed lard-enriched (17%) or corn oil-enriched (17%) diets and were compared with rats fed a low fat (4.5%) diet. Cardiac protein, DNA, phospholipid (PL) and fatty acid (FA) compositions were analyzed. Neutral phospholipase A, lysophospholipase and creatine kinase activities in the membrane and cytosolic compartments were also investigated. No significant modification of cardiac protein, DNA nor PL was observed among the three groups. Some alterations appeared in the FA composition. A lard-enriched diet induced a significant increase of 22:5n-3 and 22:6n-3 in heart phosphatidylcholine (PC) and phosphatidylethanolamine (PE), whereas a linoleic acid-rich diet induced a specific increase of 22:4n-6 and 22:5n-6 in these two major PL. Compared to rats fed the low fat diet, membrane-associated phospholipase A activity, measured by endogenous hydrolysis of membrane PC and PE, showed a significant increase (+45%) for both PL in rats fed corn oil. However, the activity of membrane-associated phospholipases, measured with exogenous [1-14C]dioleoyl PC, was not different among the three groups of rats. Cytoplasmic activity was decreased in rats fed corn oil, and lysophospholipase and creatine phosphate kinase activities were not significantly affected by diet. FA modification of the long chain n-6 FA induced by corn oil may be responsible for the observed increase in phospholipase activity. Physiological implications are suggested in terms of membrane degradation and prostaglandin production. PMID- 3626780 TI - Slow recovery of the fatty acid composition of sciatic nerve in rats fed a diet initially low in n-3 fatty acids. AB - The sciatic nerve of rats fed sunflower oil (6 mg 18:3-n-3/100 g of diet) presented dramatic alterations in the long chain polyunsaturated fatty acids in comparison with those fed soy oil (130 mg 18:3n-3/100 g of diet). In both 15-day old and 60-day-old animals fed sunflower oil, 22:6n-3 (cervonic acid) was four fold less, 22:5n-6 was 10-fold greater; adrenic acid (22:4n-6) was slightly greater and arachidonic acid (20:4n-6) was close to that in rats fed soy oil. The percentage distribution of total polyunsaturated fatty acids as well as the individual saturated and monounsaturated fatty acids were the same in both groups. When the sunflower oil-fed animals were switched to a soy oil-containing diet for either 15 or 60 days, the percentage distribution of 22:6n-3 increased slowly to reach the control value 2.5 months later. Conversely 22:5n-6 decreased slowly. The decay of 22:5n-6 was more rapid than the increase of 22:6n-3. PMID- 3626782 TI - Lack of regression of preestablished gallstones in mice. AB - Feeding a high cholesterol, high cholic acid diet to mice for 28 days caused increased concentrations of plasma and liver cholesterol and formation of gallstones. Removal of cholesterol and cholic acid from the diet led to normalization of plasma and liver cholesterol within 28 days. Regression of the preestablished gallstones did not occur within 107 days. PMID- 3626781 TI - An improved method for the colorimetric assay of lipase activity using an optically clear medium. AB - Lipase activity can be spectrophometrically measured in an optically clear medium using long chain fatty thioesters of 1-mercapto-2,3-propanediol or 2 mercaptoethanol as substrates. With hexamethylphosphoric triamide solutions of these thiosubstrates, the Michaelis-Menten constants of lipase from Rhizopus arrhizus were determined. The effects of calcium chloride and of bovine serum albumin on the enzyme activity were established. PMID- 3626783 TI - Purification of high affinity fatty acid receptors in rat myocardial sarcolemmal membranes. AB - High affinity receptors for fatty acid were purified from rat cardiac sarcolemmal membrane using gel filtration, DEAE-cellulose chromatography and affinity chromatography. The purified protein was homogeneous on polyacrylamide gel electrophoresis with the molecular weight of 60 kDa. Binding studies revealed the presence of a single class of high affinity binding sites with an apparent dissociation constant of 1.0 microM and a maximal binding capacity of 12.1 pmol/micrograms protein. PMID- 3626784 TI - Glossary of MR Terms. American College of Radiology. PMID- 3626785 TI - Fluorine-19 NMR spectroscopic studies of the metabolism of 5-fluorouracil in the liver of patients undergoing chemotherapy. AB - Fluorine-19 nuclear magnetic resonance allows direct observation of fluorinated drugs and their metabolites in the human body without background signal from the tissue. A well-known fluorinated chemotherapeutic drug, 5-fluorouracil, and its metabolites were observed noninvasively in the liver of three patients undergoing cancer chemotherapy. Spectra were obtained at 1.5 T with a surface coil centered over the right lobe of the patient's liver. Administration of 1.5 gm of 5 fluorouracil was done after positioning in the magnet. Serial spectra, collected over a 2-h period, revealed both the nature of the metabolites present in the liver, and the time course of each patient's metabolism. These observations represent the first noninvasive NMR study of drugs in human patients and show the feasibility of using in vivo F-19 NMR spectroscopy for human studies of fluorinated compounds. PMID- 3626786 TI - Magnetic resonance imaging of gynecological anatomy. PMID- 3626787 TI - Magnetic resonance imaging in "housemaid's knee" (prepatellar bursitis). PMID- 3626788 TI - Magnetic resonance imaging at 0.02 T in clinical practice and research. PMID- 3626789 TI - Rapid calculation of T1 using variable flip angle gradient refocused imaging. AB - We present a method for rapid measurement of T1 relaxation times using gradient refocused images at limited flip angles and short repetition times. This "variable nutation" techniques was investigated using a T1 phantom. There was a high correlation between measurements obtained with the variable nutation and partial saturation techniques. The ability of this method to create calculated T1 images is also demonstrated. We conclude that the variable nutation method may allow measurement of T1 relaxation times with a significant reduction in acquisition time compared to partial saturation techniques. PMID- 3626790 TI - Biodistribution of GdCl3 and Gd-DTPA and their influence on proton magnetic relaxation in rat tissues. AB - The biodistribution and relative molar effectiveness of the ionic (GdCl3) and chelated (Gd-DTPA) forms of gadolinium (Gd) to enhance proton relaxation rates in rat kidney, liver and spleen were evaluated. Rats were given intravenous injections of either GdCl3 (100 mumol/kg) or Gd-DTPA (178 mumol/kg). Gd-DTPA was primarily contained in the vascular compartment and was quickly accumulated in the kidney after injection with a relaxivity of 4.3 sec-1 (mumol/g kidney)-1. It was eliminated quickly from the body with only 2% of the injected dose remaining after 120 min. After GdCl3 injection, Gd was found primarily in liver and spleen. It accumulated continuously reaching 72% of the injected does in these two tissues after 120 min. Despite this continuous increase in tissue Gd concentration, the relaxation rates showed saturation in liver and spleen. The results suggest that after GdCl3 was injected it distributed either in a protein bound form that was effective at causing relaxation or in a colloid form that was not effective. The biodistribution of GdCl3 was such that it was determined by the phagocytic action of the recticuloendothelial system on a colloid. The biodistribution and tissue relaxivity of Gd-DTPA suggest it will be a useful vascular MRI contrast agent. However, the usefulness of GdCl3 as an MRI contrast agent is limited not only by its acute toxicity but also by its saturable effect on tissue relaxation rates. Consequently, GdCl3 has only a modest influence on tissue relaxivity. PMID- 3626791 TI - Elementary single turn solenoids used as the transmitter and receiver in magnetic resonance imaging. AB - A single turn solenoid, also called a loop-gap resonator, is a device that is efficient for radio frequency spectroscopy on relatively large samples. Thus, the device provides an effective means for magnetic imaging where the single turn solenoid may serve both as the transmitter and receiver coil. The device is readily constructed and provides very efficient use of radio frequency (RF) power for imaging extremities such as breasts, arms, feet, and hands. The resulting magnetic images are acquired in short times with good anatomical resolution and considerable reduction of the RF power delivered to the patient. PMID- 3626792 TI - Whole body slotted tube resonator (STR) for proton NMR imaging at 2.0 Tesla. AB - Design principles of a whole body Slotted Tube Resonator (STR) RF coil are given and fabrication details of the RF coil for a 2.0 Tesla NMR imaging system are presented. Experimental study proved efficient operation of the coil at 2.0 Tesla field and indicated potential for the extension of the technique to the even higher fields. PMID- 3626793 TI - Chemical exchange effects in magnetic resonance. PMID- 3626794 TI - Epidermoid carcinoma of the head and neck: diagnosis. PMID- 3626795 TI - Hypertension in pregnancy. II. PMID- 3626796 TI - Masked depression revisited. PMID- 3626797 TI - The significance of depression in the mechanism of 'compulsive' shoplifting. PMID- 3626798 TI - Accident neurosis revisited. PMID- 3626799 TI - Hilts and knives: a survey of ten years of fatal stabbings. PMID- 3626800 TI - Human fertilization and embryology--a Jewish view. PMID- 3626801 TI - The response of Islamic jurisprudence to ectopic pregnancies, frozen embryo implantation and euthanasia. PMID- 3626802 TI - Contact with the police in early schizophrenia: its nature, frequency and relevance to the outcome of treatment. PMID- 3626803 TI - Changing patterns of suicide in Leeds, 1979 to 1985. PMID- 3626804 TI - Sudden death due to a cardiomyopathy predominantly affecting the right ventricle- right ventricular dysplasia. PMID- 3626805 TI - Forensic usefulness of the Injury Severity Score. PMID- 3626806 TI - Massive brain tissue and fat pulmonary embolism following severe head injury. PMID- 3626807 TI - [Psychiatric consultation: a practice to be avoided?]. PMID- 3626808 TI - [Psychosexual impotence: an encounter with the uncanny]. PMID- 3626809 TI - [Aspects of pseudomutuality between the schizophrenic patient, his family and the patient care team]. PMID- 3626810 TI - [Smoking and its psychophysiologic implications]. PMID- 3626811 TI - [Residential center for alcoholics. A multimodal behavior therapy approach]. PMID- 3626812 TI - [The role of personal distance in the development of human behavior]. PMID- 3626813 TI - [Analysis of the activities and considerations on the experience of the relational psychotherapy work at the Public Service Local Health Unit 12 of the Pisa Area]. PMID- 3626814 TI - [An important endemic in the Marquesas: neural angiostrongylosis]. AB - The authors report on 37 new cases of eosinophilic meningitis collected in two years in an island with a population of 1,800. Recalling first the epidemiology of the disease, they describe the most frequent clinical signs met and the results of rachiocentesis which confirm the diagnosis. The disease strikes more than 1% of the population. It might not rapidly disappear as the only efficient prophylaxis would be to deprive the population, very attached to its traditions, of one traditional dish. PMID- 3626815 TI - [Human brucellosis in Benin: results of a serological survey among exposed workers]. AB - A serological survey was carried out in Benin in order to assess the rate of brucellosis infection among exposed workers (workers in slaughtering-houses and breeders). 221 sera were tested with rose Bengale test, Wright sero-agglutination test, indirect immunofluorescence test and counter-immuno electrophoresis (brucelline). The percentage of positive sera among exposed workers is 17,7%. The rose Bengale and immunofluorescence tests combination permits complete detection of positive sera. These results suggest the existence of human brucellosis in Benin and shows the necessity of a national control programme adapted to the socio-economic problems of this country. PMID- 3626816 TI - [Serological study of toxoplasmosis and echinococcosis in cattle breeders and abattoir personnel in Benin]. AB - In Benin, a serological study of toxoplasmosis and hydatid disease has been effected among bovine stock-breeders and the staff of the slaughter-houses in comparison with a sample of blood donors. Our results reveal the highest rate of toxoplasmosis infection (87%) among the staff of the slaughter-houses, whereas the bovine stock-breeders are the most exposed population to hydatid disease with a 9% prevalence. There is no mention of similar works in Benin in medical literature. PMID- 3626817 TI - [Sudden infant death and sickle cell anemia in the Sahel region of Africa]. AB - The authors investigated the incidence of sudden infant death syndrome (S.I.D.S.) in families of government employees who benefited of free health care. Out of approximately 400 families with around 2000 children, 29 reported at least one infant death meeting the chosen criteria for S.I.D.S. A total of 41 children, mostly males, died between 1 day and 30 months of age, amongst the 149 children born in these families; most of them died during the first 3 months of life. The mothers were generally house wives, aged 26.2 +/- 1.0 years. Sickle cell trait was found in at least one parent of 21 families. In the other 8 families, 11 out of 38 children died, giving a prevalence rate of 6.9/1000 live births for S.I.D.S. in the healthy population. In the sickle cell trait population, the prevalence rate for S.I.D.S. reached 75.0/1000 live births, the prevalence of sickle cell anemia being about 20% in Niger. When very strict criteria were used for diagnosing S.I.D.S., the prevalence rate was 2.5/1000 and 40/1000 live births in the healthy and the sickle trait populations respectively. This study is the first attempt to determine the place of S.I.D.S. in the infant mortality rate in Sahelian Africa. In families with sickle cell disease, the risk of S.I.D.S. was 11.5 times greater than in healthy families. The role of sleep apnea as a cause of S.I.D.S. is discussed. It may represent a common cause of death in both healthy families at risk and sickle cell trait families. PMID- 3626818 TI - [Infant weaning in the Hausa, Jerma and Fulani populations. Retrospective study of 268 mothers in the Department of Niamey (Niger)]. AB - Aiming to evaluate the impact of an official health campaign of information about how to prevent sudden weaning, the authors interviewed 268 African women in Niamey area: 69 Hausa, 102 Jerma and 97 Fulani. All of them had been pregnant at least 4 times. Nearly all (more than 95%) were illiterate. A private interview was systematically made with all of them in a vernacular language with interpreters (Jerma, Hausa) or without any (Fulani). In three groups, the mothers declared they were obliged to make a sudden weaning in 39 to 45% cases because they were pregnant again. Most of those women seemed to be convicted of this old tag that "Milk of a pregnant woman is poison and so is dangerous for the child". On the other hand they wouldn't believe that sudden weaning was responsible for malnutrition. For these 3 groups the infant death rate was high: 16,7 to 22.3% and 50% of deaths occurred after the weaning. Among these, the deaths happened far 50 to 73% cases in the six months after the weaning. When they were asked if one or more of their children died during the weaning period, absolutely all the women answered negatively. These data allow us to say: that the sudden weaning is an usual practice; that it is probably responsible for the death of many children, directly or not; that many women are pregnant before the theoretical end of weaning (24 months); that the health campaign of information have little weight against the mentalities and behaviours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626820 TI - [Case of bilateral pulmonary dystrophy operated on at the Dakar General Hospital]. AB - The authors report one case of large bullous dystrophia of both lungs. It was operated in two phases at the hospital Principal, Dakar, Senegal. They emphasize the technics of anesthesia by thoracic high epidural block, surgical technics. They also point out the clinical improvement, as results of respiratory functional exploration did prove it. PMID- 3626819 TI - [Value of ultrasonically-guided liver puncture biopsy in the diagnosis of primary liver cancer. Apropos of 84 cases]. AB - Ultrasonographicaly guided fine needle aspiration of liver was performed in 84 patients having a confirmed HCC. This technics utilizes a CHIBA type fine needle, after blood coagulation tests have been checked. Out of 84 fine needle aspirations performed: 64 were positive (76,2%), 9 negative (10,7%), 11 (13,19%) were questionable (6) or nonanalysable (5). It is ascertained that the sensibility of this technics is over 75%. It should be possible to improve it by repeating such an exam in previously negative patients. The causes of failure are discussed. Tolerance of the technics is good. It is attraumatic, and of very easily performance. No accident, no mishap was noted. PMID- 3626821 TI - [Parietal fibroplastic endocarditis]. AB - Parietal fibroplastic endocarditis is commonly observed in two main diseases: Loffler' endocarditis and Davies' endomyocardial fibrosis. Endocarditis' damage is explained by the cytolytic effects of basic proteins present in eosinophil granules (major basic protein and cationic protein); long standing and amount of eosinophilic cells condition anatomic lesions. The clinical features are explained by the ventricular seat of endocarditis lesions (right, left, or both). They include in all cases: tricuspid and/or mitral insufficiency, adiastolic syndrome. Two-dimensional echocardiography has improved the diagnosis; ventricular angiocardiography remains the reference examination. Prognosis has been largely improved these recent past years by surgical endocardiectomy and valvular conservative surgery among children. PMID- 3626822 TI - Nerve regeneration through a synthetic microporous tube (expanded polytetrafluoroethylene): experimental study in the sciatic nerve of the rat. AB - Nerve grafts made of expanded polytetrafluoroethylene (PTFE) were used to bridge 10-mm gaps in the sciatic nerves of rats. The most prominent gross and histological finding was abundant neovascularization and capillary ingrowth through the microporous PTFE wall. Organized, myelinated nerve tissue was observed. After 4 months, regeneration through hollow PTFE tubes (N = 16) was equivalent to autogenous nerve grafts (N = 12) as measured by gastrocnemius muscle weights (P = 0.33). Nerve conduction velocity in the hollow PTFE tubes was 21.7 m/sec as compared to 50.6 m/sec in the control nerves (P less than 0.001). PMID- 3626823 TI - Microvascular polytetrafluoroethylene (Gore-Tex) grafts in the infrarenal rat aorta. AB - To evaluate the use of microvascular prosthetic grafts, the infrarenal aorta in 33 male Sprague-Dawley rats was replaced by an interposition graft of PTFE (polytetrafluoroethylene, Gore-Tex). Three groups of experimental animals were studied: Group A consisted of rats with 7-mm-long grafts, group B consisted of rats with 20-mm-long grafts, and group C consisted of rats with 20-mm-long grafts and ligatures of one patent after varying observation periods (6-92 days, median value 28 days, mean value 49 days). In group B all grafts but one (13/14) were patent (0-201 days, median value 198 days, mean value 118 days). In group C two grafts occluded immediately postoperatively, whereas the remaining six were patent (0-24 days, median and mean values 9 days). Twelve of 13 grafts observed for 3 months or more remained patent. There were no signs of infection. Angiography did not reveal any stenosis in the anastomoses of patent grafts. Light microscopy demonstrated a good adaptation between the grafts and the aorta in all animals. In the short grafts observed for 3 months and in the long grafts observed for 6 months, the luminal surfaces were completely covered by endothelial-like cells. In the occluded graft in group B, a stenosis was demonstrated in one of the anastomoses. This was not found in any other specimen. The results of this study document the possibility of using PTFE grafts of 1 mm diameter in experimental microvascular position. PMID- 3626824 TI - Effects of lidocaine concentration on distal capillary blood flow in a rabbit ear model. AB - The laser pulse doppler provides a noninvasive, reproducible method to measure the flux in distal capillary blood flow in a rabbit ear model. The distal capillary blood flow responds proportionally to changes in periarterial lidocaine concentration. The response is biphasic. Flow initially decreased from the baseline in all lidocaine concentrations between 0.5% and 10.0%. Proportional increases in distal blood flow above baseline are noted as the buffered lidocaine concentrations increase from 1.0% to 10.0%. Lidocaine concentration of 0.5% dose not increase distal blood flow above baseline. PMID- 3626825 TI - Ovum recovery after microsurgical reanastomosis of the rabbit oviduct. AB - Causes for failure of pregnancy after tubal reconstructive surgery are incompletely understood. The impact of microsurgical resection reanastomosis on ovum recovery was studied in the rabbit oviduct. One hundred sixty rabbits were divided into three groups: one experimental group in which a resection reanastomosis was made in the ampullar or isthmic tubal segment, respectively, and two control groups. After mating, ovum recovery was evaluated. In ampullary operated oviducts the ovum recovery rate was significantly lower compared with recovery rates in isthmically operated and in control oviducts. Furthermore, in ampullary operated oviducts peritoneal transmigration of ova was frequently observed. Disturbances in ovum pickup from the ovarian surface or the peritoneal cavity seem to be responsible for the decrease in recovery rate found in the ampullary operated oviducts. PMID- 3626827 TI - [Argentine Society of Clinical Investigation, 31st scientific meeting. Mar del Plata, 16-20 November 1986. Abstracts]. PMID- 3626826 TI - Tubal reanastomosis: a comparison between microsurgical and microlaser techniques. AB - In order to evaluate the effect of the carbon dioxide laser as an adjunct to conventional microsurgical techniques, the authors retrospectively reviewed the charts of 53 patients who underwent tubal reanastomosis after elective sterilization. Thirty-two patients had non-laser microsurgical reanastomosis from 1981 to 1985; 21 patients had microlaser tubal reanastomosis from 1983 to 1985. All patients had unprotected intercourse for at least 1 year. In the non-laser group, 15 were known to have conceived, and in the laser group, eight had conceived; success rates were 43.7% and 42.9%, respectively. It is concluded that the carbon dioxide laser's advantages (precision, hemostasis, and the ability to preserve more normal reproductive tissue), although technically beneficial in performing microsurgical tubal reanastomosis, may not prove to be superior to conventional microsurgical technique as pregnancy rates are compared. Additional long-term studies are needed as more experience is gained to further delineate the role of the carbon dioxide laser for microsurgical tubal reanastomosis. PMID- 3626828 TI - [Physiopathogenic hypothesis of alcoholic pancreatitis. Supranormal ecbolic excitation of the "pancreon" secondary to loss of the negative component of pancreatic innervation]. PMID- 3626830 TI - [Current outlook of pathological anatomy services]. PMID- 3626829 TI - [Immunology of reproduction. Maternal influence on the recognition of proper histocompatibility antigens]. PMID- 3626831 TI - [Possibilities of the immunoenzyme assay (ELISA) in the diagnosis of tuberculosis]. PMID- 3626832 TI - [The crotoxin case]. PMID- 3626833 TI - [Undifferentiated Burkitt type lymphoma in Argentina: 16 years later]. PMID- 3626834 TI - [Frequency of microcarcinomas in thyroidectomy specimens]. PMID- 3626835 TI - Immunohistochemical identification of mesenchymal tumors of the gastrointestinal tract. PMID- 3626836 TI - [Values of urinary iodine in population samples of different zones of the province of Cordoba in relation to endemic goiter]. PMID- 3626837 TI - [Paradoxical stroke volume and phase analysis images in radionuclide ventriculography. Correlation with cineventriculography]. PMID- 3626838 TI - [Decreased oxidation of ketone bodies by heart mitochondria in diabetes]. PMID- 3626839 TI - [Poisoning by paralysing mollusk venom (red tide)]. PMID- 3626840 TI - [Apropos of a case of Ormond's disease (idiopathic retroperitoneal fibrosis)]. PMID- 3626841 TI - [Effect of aminophylline in dystrophia myotonica]. PMID- 3626842 TI - [Hyperfiltration and course of renal failure]. PMID- 3626843 TI - [The doctor of doctors]. PMID- 3626844 TI - [The red tide toxin against whom?]. PMID- 3626845 TI - [Efficacy and clinical value of hemocultures during antimicrobial treatment in patients with neutropenia]. PMID- 3626846 TI - Fatal infections in systemic lupus erythematosus: the role of opportunistic organisms. AB - The causes of death were examined in patients with systemic lupus erythematosus (SLE) who were cared for at the University of California, San Francisco and who died after 1969. Of the 44 deaths analyzed, 33 patients had autopsies. Infections were common and often determined to be the cause of death. Overall, infections were present in 55 percent (22/44), and judged to be a cause of death in 30 percent (13/44) of all deaths. The infections could be divided into 2 groups: those due to common bacterial organisms and those due to opportunistic infections. These two types of infections occurred with similar frequency. When compared to common bacterial infections, however, the opportunistic infections were more likely to be first diagnosed at autopsy (p = .001). In only 3 of the 15 patients with an opportunistic infection was the diagnosis made antemortem. Failure to diagnose an opportunistic infection early occurred when the infection simulated active SLE, and when the possibility of an opportunistic infection was not aggressively investigated. The most common opportunistic infections were Candida albicans and Pneumocystis carinii. The most common site of opportunistic infection was the lung. Seventeen patients had 27 common bacterial infections, chiefly sepsis from Staphylococcus aureus and aerobic gram-negative organisms. Eight patients had both a common bacterial and an opportunistic infection. Stepwise linear regression analysis showed that death from infection correlated most strongly with prednisone and cytotoxic drug use in the 3 months before final admission. No measure of lupus activity was found to correlate with death from infection, except that hypocomplementemia correlated with death from bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626847 TI - Central core disease. Clinical features in 13 patients. AB - Findings in 13 patients with central core disease are reported and compared with 62 patients from the literature. Patients with central core disease show wide variation in the clinical spectrum of muscle involvement. Some will have no symptoms and be completely normal on examination, many will show mild to moderate weakness, and a small number will be severely affected. Muscle atrophy is a frequent finding, but progression of muscle weakness is rare and occurs only slowly. Musculoskeletal deformities, including kyphoscoliosis, congenital hip dislocation, feet deformities, and joint contractures, are often seen but generally do not alter the natural history of the disease. Surgical treatment may be required for some of these abnormalities. No relationship appears to exist between the degree of muscle weakness and the presence or type of musculoskeletal deformities. Cardiac abnormalities have rarely been reported in association with central core disease. Mitral valve prolapse was noted in 3 of our patients and 2 others had cardiac arrhythmias. Central core disease and susceptibility to malignant hyperthermia was present in all 11 patients we studied (2 patients with central core disease did not have studies for malignant hyperthermia). These 11 patients came from 4 families. All patients with central core disease should be considered at risk for malignant hyperthermia unless in-vitro contracture tests show that the particular patient is free of the trait. PMID- 3626849 TI - [Use of subjective symptom measurements in evaluating the health effects of exposure of workers to neurotoxic compounds]. AB - To evaluate early health effects in workers exposed to neurotoxic compounds, symptomatological questionnaires have been extensively applied recently. These measure subjective symptoms, i.e. indicators of the central nervous system dysfunction caused by hazards. With the symptomatological questionnaire, called the Questionnaire of Subjective Symptoms, developed by H. Hanninen et al. and adjusted to the Polish conditions, workers of dry-cleaning laundry exposed to tetrachloroethylene and workers of wet-cleaning laundry (controls) have been examined. The results have demonstrated that those exposed to tetrachloroethylene complained more frequently of neurological disturbances of lower and upper limbs, as compared to controls. When compared to Finnish workers, Polish subjects present much more complaints related to all symptoms. PMID- 3626848 TI - Large granular lymphocyte leukemia. Report of 38 cases and review of the literature. AB - LGL leukemia results from a chronic, clonal proliferation of LGL. Chronic neutropenia with recurrent bacterial infection and splenomegaly are common clinical manifestations. Rheumatoid arthritis coexists in some of these patients, who thus resemble patients with Felty syndrome. Other hematologic abnormalities that may occur include pure red-cell aplasia and adult-onset cyclic neutropenia. Lymphoid infiltration of bone marrow, splenic red pulp cords, and hepatic sinusoids is characteristic; lymph node and skin involvement are rare. Multiple serologic abnormalities are frequently present, including positive tests for rheumatoid factor and/or antinuclear antibody, polyclonal hypergammaglobulinemia, and circulating immune complexes. Antineutrophil and antiplatelet antibodies are often present. Leukemic LGL exhibit phenotypic heterogeneity; the most common phenotype in our patients is CD2+, CD3+, CD8+, HNK-1+, CD16-. Despite markedly increased numbers of LGL, functional activity of the cells is usually decreased. The mechanism of cytopenias is uncertain: in pure red-cell aplasia, it appears to be due to suppressive effect on erythropoiesis by abnormal LGL, but in patients with chronic neutropenia it may be antibody-mediated. Although most patients appear to have a relatively benign clinical course, mortality from infections and progressive lymphoproliferation is substantial. Optimal therapy remains undefined. Some preliminary evidence suggests that LGL leukemia may be associated with infection with a retrovirus similar to HTLV-I. Although relatively rare, LGL leukemia is of interest because a better understanding of this disease process may contribute to our knowledge of autoimmune diseases, the immunoregulatory functions of LGL, and the mechanisms controlling normal hematopoiesis. PMID- 3626850 TI - [Evaluation of the effectiveness of medical prevention of pneumoconiosis based on studies of its incidence in selected coal mines]. AB - In a group of 3,938 persons--pit miners of 3 coal mines--employed over 8 years, full-size X-ray pictures of the chest have been taken and through a special questionnaire information has been collected on the length of employment, workstation, risk of dustiness, exposure to fibrogenic dusts outside the mine. Basing on the studies, the mean annual incidence of pneumoconiosis in particular mines has been calculated. The data has been compared with the mean annual incidence rate of pneumoconiosis calculated for 10 years prior to epidemiological studies and based on the primary selection by means of small-size pictures. This comparison indicated that the full-size pictures revealed 3-7 times more pneumoconioses as compared to the hitherto applied system. The comparison of full size and small-size X-ray pictures demonstrated that the lesions visible in full size pictures have not been registered in small-size pictures in as many as half of the cases. The obtained results indicate that the effectiveness of the hitherto applied system of medical prevention of pneumoconiosis is insufficient. A change in this system is indispensable; miniature roentgenography should be replaced by full-size X-ray pictures. PMID- 3626851 TI - Identification of priorities for chemical hazard control. AB - The paper presents the components of the problem of chemical safety as well as the criteria for setting priorities for chemical hazard control. Chemical safety comprises risk identification, estimation, evaluation, and management. The first three issues constitute an integral part known as risk assessment. Their implementation allows to determine the nature, magnitude and distribution of diseases resulting from exposure to chemicals as well as to compare the risk assessed with other socially accepted risks. Risk management can be considered in terms of risk control and decision-making. Risk control refers to the surveillance of the compliance with rules regarding environmental protection, occupational hygiene, nutritional hygiene, and other regulations confining man's exposure to toxic compounds in production, use, waste disposal, and contingency planning. Within the decision-making process, costs and benefits are calculated, as related to the production, possible changes in technology, and protective measures. At that stage, evaluation of existing regulatory controls is essential, as is the decision-making in relation to new or supplementary legal acts. Priority setting is essential for chemical safety. This activity is aimed at rational allocation of financial means for national policy designed to meet social requirements within health care. What is of vital importance is the determination of priority setting criteria. The primary criteria include: biological effects of the chemical concerned, environmental impact, production volume, distribution, and the population exposed. Of value are also some sociological factors such as identification and social acceptance of risk. The paper presents the principles of priority setting. PMID- 3626852 TI - [Factors causing absenteeism due to diseases of the circulatory system: a model analysis]. AB - The rate of absenteeism due to the circulatory system diseases--one of the major causes of work disablement--has largely risen recently. Those diseases constitute a serious health problem within the sickness absenteeism of workers over 40. The presented analysis refers to the impact of the so called non-health-related variables and certain variables indirectly affecting workers' health upon the absenteeism caused by the circulatory system diseases (expressed by the number of absenteeism days annually and average duration of absenteeism case). As investigating tools, multidimensional methods of statistical analysis (multiple regression model) have been used to select the factors bearing a statistically significant effect upon the sickness absenteeism caused by circulatory diseases. The developed models are related to absenteeism of men and women aged 39, over 40 and totally. The results of the analysis demonstrated that both absenteeism of men and women was largely affected by occupational and work-environment-related factors (exposure, worker's affiliation to some working group, piece-work payments). The absenteeism of men over 40 was significantly affected by age, whereas the absenteeism of women was affected by such variables as family "size", and traveling to work. Furthermore, absenteeism caused by circulatory diseases is accounted for by the variables directly determining the health condition, such as health self-estimation and absenteeism rate caused by those diseases prior to the investigation. PMID- 3626853 TI - [Estimated number of expected stochastic changes in the population occupationally exposed to X-rays]. AB - In this paper the life-time effective dose equivalent and expected postradiation stochastic effects number in various subpopulations occupationally exposed to X rays have been estimated. The prognosis of life-time doses absorbed by those occupationally exposed to X-rays and the relationship between the effective dose equivalent and surface exposure dose registered in the individual dosimetry system constituted the basis for this evaluation. The obtained results indicate that under the present X-ray exposure conditions the probability of the occurrence of X-ray adverse health effects in form of post-radiation cancers is insignificantly low. PMID- 3626854 TI - [Evaluation of occupational exposure to tetrachloroethylene (PER) in a dry cleaning business]. AB - In eleven chemical laundries, occupational exposure to perchloroethylene (PER) has been evaluated. The examinations have been carried out with the personal dosimetry technique and involved 99 workers, performing different occupational tasks. Exposure of a magnitude varying with particular occupational groups have been indicated by 253 personal measurements taken. Most exposed to PER have been machine set operators and maintenance technicians. Time-weighted average (8h) concentrations of PER in the breathing zone were, on average, 142 mg/m3 in the machine set operators and 91.8 mg/m3 in maintenance technicians groups. PMID- 3626855 TI - Lack of correlation between plasma 4-hydroxyglutethimide and severity of coma in acute glutethimide poisoning. A case report and brief review of the literature. AB - Glutethimide poisoning is characterised by coma, anticholinergic poisoning syndrome, hypotension, and other complications. Previous studies have shown that the severity of intoxication does not correlate with plasma glutethimide concentrations in individual patients. Glutethimide is partly converted to 4 hydroxyglutethimide, a metabolite which accumulates in the plasma of humans, and which has been thought to contribute to coma after plasma glutethimide concentrations have fallen. We followed plasma concentrations of glutethimide and 4-hydroxyglutethimide in a man who overdosed with glutethimide. Plasma 4 hydroxyglutethimide concentrations did not correlate with the degree of coma in our patient, and actually rose as the patient awakened. Other studies also indicate that 4-hydroxyglutethimide may not play an important role in glutethimide poisoning. PMID- 3626856 TI - Adults with mental retardation. PMID- 3626857 TI - Health care needs of adults with mental retardation. PMID- 3626859 TI - Prevention of psychosocial dysfunction in persons with mental retardation. PMID- 3626858 TI - A program that works. PMID- 3626860 TI - A university-based health maintenance organization for persons with developmental disabilities: an editorial. PMID- 3626861 TI - Community health care services for adults with mental retardation. Basic issues. PMID- 3626862 TI - Community-based prepaid medical care for adults with mental retardation: proposal for a pilot project. PMID- 3626863 TI - Decreased VLDL apoprotein CII/apoprotein CIII ratio may be seen in both normotriglyceridemic and hypertriglyceridemic patients on chronic hemodialysis treatment. AB - Pathogenetic factors that may be related to uremic hypertriglyceridemia were studied in 27 patients who had been undergoing chronic hemodialysis treatment for over two years. They were divided into two groups consisting of 14 hypertriglyceridemic (HTG) patients with fasting serum triglycerides (TG) of 170 mg/dL or higher, aged 45 +/- 11 yr (mean +/- SD) and 13 normotriglyceridemics (NTG) with serum TG less than 170 mg/dL aged 42 +/- 9 yr. Serum lipid, lipoprotein [low density lipoprotein (LDL) and very low density lipoprotein (VLDL)] and apoprotein (Apo) levels, as well as ultracentrifugally obtained VLDL apo subfractions and serum carnitine were compared between the two groups, which enabled us to rule out various factors inherent to uremic state and present in both groups. The HTG group of patients, who showed (by definition) significantly elevated TG (300 +/- 167 mg/dL v 123 +/- 30 mg/dL in NTG) and VLDL levels, concomitantly showed significantly increased serum total cholesterol (P less than .001) and LDL (P less than .001), and significantly decreased apo AI/apo B, or an index of risk of atherogenesis (P less than .05). Serum apo CII (7.3 +/- 3.3 mg/dL v 3.6 +/- 1.0 mg/dL in NTG), apo E (4.8 +/- 2.8 mg/dL v 2.9 +/- 1.3 mg/dL) and VLDL/serum apo CII (38 +/- 18 v 22 +/- 12), ie, the amount of VLDL covered by a unit of apo CII, were elevated in the HTG compared with the NTG group of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626864 TI - Glucose and ketone body turnover in carnitine-palmitoyl-transferase deficiency. AB - Most of the patients with carnitine-palmitoyl-transferase deficiency (CPT) show reduced levels of blood ketone bodies in the postabsorptive state. In the present study, we have evaluated ketone body and glucose kinetics in patients with CPT deficiency. Intermediate metabolites of carbohydrate and lipid metabolism have also been studied. Ketone body (KB) turnover was measured by means of sequential intravenous bolus injections of 3-14C acetoacetate and 3-14C D(-) 3 hydroxybutyrate in four patients with liver, platelet, and muscle deficiency of CPT system and in eight normal overnight fasting subjects. 6-3H glucose was also injected, along with 3-14C ketone bodies to measure glucose turnover rate. Three out of four CPT deficiency patients had normal KB turnover, despite a marked reduction in liver CPT activity. Only one subject, with severe defect of CPT activity in liver, showed a significantly reduced, but still present rate of de novo synthesis of acetoacetate and 3-hydroxybutyrate (40 and 51 mumol/m-2/min-1 respectively) in comparison with control subjects (103 +/- 14 and 157 +/- 22 mumol/m-2/min-1). Blood concentrations of dicarboxylic adipic and suberic acids were significantly higher in CPT deficiency patients (0.035 +/- 0.007 and 0.021 +/- 0.005, mmol/L respectively) than in control subjects (0.008 +/- 0.008 and 0.006 +/- 0.003 respectively). Basal glucose turnover was increased in CPT deficiency patients (505 +/- 13 mumol/m-2/min-1) in comparison with normal subjects (433 +/- 18 mumol/m-2/min-1; P less than .01) as well as clearance rates (127 +/- 3 mL/m-2/min-1 and 91 +/- 11 mL/m-2/min-1, respectively; P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626865 TI - Isotopic test of capillary permeability to albumin in diabetic patients: effects of hypertension, microangiopathy, and duration of diabetes. AB - Capillary permeability to albumin (CPA) was studied by performing an isotopic noninvasive test with venous compression on 87 nonselected diabetics with no edema, no cardiac failure, and no peripheral vascular disease. Excessive albumin retention (AR greater than or equal to 8%) ten minutes after removal of the compression was found in 27 patients (31%). The radioactivity disappearance curve was then analyzed using the Fast Fourier Transform (FFT). An abnormal isotopic CPA test was thus found in at least 45 out of the 87 patients. The prevalence of an abnormal test was not different in type 1 and type 2 diabetics. We studied the independent effects of hypertension, presence of specific clinical signs of microangiopathy (retinopathy and/or significant proteinuria), and duration of diabetes. Among diabetics free of specific clinical signs of microangiopathy, the prevalence of an AR greater than or equal to 8% was significantly higher in those with hypertension (11/19) than in those with normal blood pressure (2/28) and in nondiabetic hypertensive patients (0/16). Among normotensive diabetics, the prevalence of an abnormal test was higher, but not significantly, in patients with specific clinical signs of microangiopathy (8/11) than in those free of them (7/18). Seven normotensive diabetics without specific clinical signs of microangiopathy had an abnormal test; five of them had had diabetes for more than five years. The prevalence of diabetes of more than five years duration was significantly higher in patients with an abnormal test (35/45) than in normotensive diabetics free of specific clinical signs of microangiopathy with a normal test (4/11).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3626866 TI - Integrated study of low density lipoprotein metabolism and very low density lipoprotein metabolism in non-insulin-dependent diabetes. AB - The metabolisms of VLDL, IDL, and LDL and their interconversions have been studied in ten obese untreated male Pima Indian diabetics compared to 16 age-, sex-, and weight-matched nondiabetics. VLDL was elevated in the diabetics and had abnormal composition, as indicated by a significantly higher ratio of triglyceride/apo B. Fractional catabolic rates for both VLDL apoB and VLDL triglyceride were lower in diabetics, and diabetics had increased production of VLDL triglyceride but not VLDL apoB compared to obese nondiabetics. A higher proportion of VLDL apoB was removed without conversion to LDL in diabetics. LDL cholesterol and apoB were higher in diabetics, but production of LDL apoB was not different from nondiabetics. Fractional catabolic rate for LDL apoB, however, was significantly lower in the diabetics. The data indicate that the triglyceride rich VLDL in non-insulin-dependent diabetics are less readily converted to LDL, whereas the elevated LDL in this group of diabetics is due to impaired clearance. Thus, decreased conversion of VLDL to LDL and impaired LDL clearance are two opposing phenomena which may influence the LDL concentration of diabetics in either direction. Thus, despite minimal changes in LDL concentration, there are multiple defects in the metabolism of LDL in non-insulin dependent diabetes which may contribute to the increased atherogenesis in this disorder. PMID- 3626867 TI - Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. AB - Impaired glucose tolerance results from Cr restriction in animals, and Cr supplementation improves glucose tolerance in diabetic animals. These effects are presumably due to the role of Cr in glucose tolerance factor (GTF), a complex of Cr and nicotinic acid believed to facilitate insulin binding. Humans, however, do not uniformly respond to Cr supplementation. The present study was designed to evaluate the possibility that the failure results from inadequate levels of dietary nicotinic acid to serve as substrate for GTF synthesis. Sixteen healthy elderly volunteers were divided into three groups and given either 200 micrograms Cr, 100 mg nicotinic acid, or 200 micrograms Cr + 100 mg nicotinic acid daily for 28 days and evaluated on days 0 and 28. Fasting glucose and glucose tolerance were unaffected by either chromium or nicotinic acid alone. In contrast, the combined chromium-nicotinic acid supplement caused a 15% decrease in a glucose area integrated total (p less than .025) and a 7% decrease in fasting glucose. None of the treatments exerted any effect on fasting or one-hour insulin levels. Thus, these data suggest that the inability to respond to chromium supplementation may result from suboptimal levels of dietary nicotinic acid. PMID- 3626868 TI - Muscle energy metabolism in uremia. PMID- 3626869 TI - Structural and contractile proteins. Part D. Extracellular matrix. PMID- 3626870 TI - Collagen cross-linking amino acids. PMID- 3626871 TI - Isolation and characterization of insoluble and soluble elastins. PMID- 3626872 TI - Regulation of elastin synthesis in organ and cell culture. PMID- 3626874 TI - Isolation and characterization of proteoglycans. PMID- 3626873 TI - Modulation of elastin synthesis: in vitro models. PMID- 3626875 TI - Biosynthesis of cartilage proteoglycan and link protein. PMID- 3626876 TI - Analysis of membrane-associated proteoglycans. PMID- 3626877 TI - Isolation and characterization of the link proteins. PMID- 3626878 TI - Isolation and characterization of collagens and procollagens. PMID- 3626879 TI - Preparation of placental (fetal tissue) fibronectin and its carbohydrates. PMID- 3626880 TI - Isolation and characterization of thrombospondin. PMID- 3626881 TI - Molecular cloning of laminin. PMID- 3626882 TI - Structure and expression of collagen genes. PMID- 3626883 TI - Relative transcription rates and mRNA levels for the two chains of type I procollagen. PMID- 3626884 TI - In vitro translation of procollagen messenger RNAs. PMID- 3626885 TI - Pharmacological studies with (7 alpha,17 alpha)-17-hydroxy-7-methyl-19-norpregn 5(10)-en-20-yn-3-one (Org OD 14). AB - A novel steroid, (7 alpha,17 alpha)-17-hydroxy-7-methyl-19-norpregn-5(10)-en-yn-3 one (code name Org OD 14), was found to possess concomitant weak oestrogenic, androgenic and progestational activities. The effects observed in other tests, viz. inhibition of ovulation in rats, prevention of bone loss following ovariectomy in rats and restoration of sex drive in castrated male rats, corresponded to this hormonal profile. Studies of the metabolites of Org OD 14 in rats suggested that these are involved in the complex endocrinological properties displayed by the compound. PMID- 3626886 TI - Adhesive properties of Proteus genus related to antimicrobial agents resistance. AB - The in vitro attachment of 49 Proteus spp. to human urinary tract epithelial cells was determined. The antibacterial spectrum to all species of the Proteus isolates from hospitalized patients was measured against the most common antibiotics (Amikacin, Cefamandole, Cefoxitin, Ceftriaxone, Cephalothin, Kanamycin, Nalidixic acid, Oxolinic acid, Pipemidic acid, Piromidic acid, Tobramycin). 18 of them were multiresistant and the other 31 expressed susceptibility to the above antibiotics. Bacterial adherence to uroepithelial cells was studied in relation to susceptibility on antibiotics. The mean of bacteria per cell for the 31 strains grouped as susceptible was 20.2 and for the 18 strains grouped as resistant the mean was 55.1. Our results demonstrate a significant relationship between bacterial adhesion and antibiotic susceptibility pattern by Student's t test (P less than 0.01). PMID- 3626888 TI - MSMS sets voluntary advertising code. PMID- 3626887 TI - Cultivation of a pig parvovirus in various cell cultures. AB - The susceptibility of several established cell lines of pig (LLC-PK1 = pig kidney; MPK = minipig kidney; PK15 = pig kidney; ESK = embryonic swine kidney), bovine (EBTr = embryonic bovine trachea), monkey (MA-104 = fetal rhesus monkey kidney) and human (HEL-299 = embryonic human lung) origin to porcine parvovirus was studied. The primary pig kidney cell cultures (pPK) were included in the study as the reference cell system. From the results it appeared that the virus only replicated in cell lines originated from swine. In particular the MPK and ESK cell lines showed a susceptibility similar to that observed for pPK cell cultures. Intranuclear inclusions and plaques were also induced in these cell systems. It appeared therefore that MPK and ESK cell lines both possess all the requirements for use in pig parvovirus studies. PMID- 3626889 TI - MDs: treat your patients and their naivete. PMID- 3626890 TI - MSMS president pledges devotion to liability solutions. PMID- 3626892 TI - Confidential MSMS program reaches impaired physicians. Interview by Sheri W. Greenhoe. PMID- 3626891 TI - Trends in medical malpractice and the golden rules. PMID- 3626893 TI - English as an international language of medicine. PMID- 3626894 TI - Teaching of cardiopulmonary resuscitation by medical students. AB - Ten first-year medical students were taught basic cardiopulmonary resuscitation (CPR) according to the guidelines laid down by the American Heart Association. Following a 7.5-hour instruction period they, in turn, taught 40 secondary school pupils. On formal assessment using models, all the school children were able to perform basic CPR. PMID- 3626895 TI - Introducing training in primary health care programme management into the curriculum. AB - A short account of the objectives and strategies of Gezira Medical School in relation to community medicine and primary health care is given. The introduction of primary health care programme management into the curriculum is described. Preliminary evaluation of the first course reflected positive results for students' achievement and acceptance. The experience proved the feasibility of integrating health care programme management into the undergraduate curriculum. PMID- 3626896 TI - The McMaster philosophy: a student's perspective on implementation. AB - The author visited McMaster Medical School as a fourth-year medical student in 1984 and took part in a 12-week unit 3 course. The present investigation on implementation of the educational principles of the MD programme was performed as an elective. A sample of 30 students out of 100 unit 3 all completed a questionnaire. Only 5 of 18 student groups used the 'cold', i.e. unprepared, approach to problem-solving during tutorials and 15 of 30 practised self-learning related to the last problem. The others spent most time on general reading. From unit 1 to unit 3 a declining number of groups used peer evaluation (less than 50%) and evaluation of groups (greater than 50%). The students felt that the performance of tutors should be improved. Most students attended lectures. It is suggested that tutor and group function may benefit from releasing the tutor from grading students. Despite its implementation problems, the author found the McMaster approach to education more beneficial than that of his own traditional school. PMID- 3626898 TI - Content coverage in problem-based learning. AB - Required learning of the basic medical sciences based on five clinical problems was compiled by teachers and subsequently derived as 'learning needs' by students during the problem-solving process. These lists of topics were compared in terms of number of lecture-hours and when these were taught in the traditional curriculum. The findings indicate that learning from problems is not entirely free-rein and can be largely determined by teachers; topics taught earlier in the course appeared more frequently than latter topics and there was a tremendous overlap of topics in both the traditional and problem-based list. Regardless of whether lectures have been given or not, students recalled facts better if they had encountered the related clinical problem. This study also reveals that problem-based learning can be as efficient as lectures in content coverage and concludes that the lecture method be retained provided the topics are selective and are derived and sequenced appropriately with clinical problems. Problem solving should be adopted as a teaching strategy. PMID- 3626897 TI - Factors underlying performance on written tests of knowledge. AB - The study compares two popular forms of written tests; the multiple choice test (MCQ) and the Modified Essay Question (MEQ). Two factors were varied in the experiment: the format of the questions (multiple choice, directed free response, or open-ended free response) and the context of the questions (in a patient problem or in random sequence). Six problems were developed in each version, and administered to a total of 36 medical students at three educational levels using a Latin-square design. The results showed a significant effect of each factor in the design, amounting to a difference of 8.7% between MCQ and directed free response, 4.2% between directed and open-ended free response and 4.3% between problem and random context. However, the correlation of scores based on content across the formats approached unity after correction for attenuation. A process score, based on the style and presentation in the undirected format, correlated more strongly with the free-response questions. The results suggest that, although the MCQ and MEQ may assess different skills, there is a very strong relationship between content scores derived from the two formats. The free response formats may present the opportunity for assessment of other factors related to presentation if scoring procedures are modified. Finally, the effect of randomizing questions is a deterioration of performance when compared to placing questions in the problem context. PMID- 3626899 TI - Students evaluate MEDFILE, a preprinted medical literature filing system. AB - Medical professionals are highly dependent on personal libraries and reprint files as their sources for current information. A large population of practising doctors have poorly organized medical literature data bases in their professional environment. To expedite the development of a personal library data base by medical students, we created MEDFILE, a preprinted, cross-indexed file folder system for organizing the medical literature. This paper reports the results of two surveys performed in connection with the distribution of the MEDFILE system. One hundred per cent of the students who used MEDFILE found the system to be beneficial. Ninety-seven per cent felt their ability to find their personal literature improved by using MEDFILE, and 65% felt MEDFILE improved their clinical preparation. Of all surveyed recipients of the system, 96.8% felt MEDFILE would be useful in their future studies. PMID- 3626900 TI - Medical education for a changing future: new concepts for revising texts. AB - Recent psychological research suggests how to simplify texts and translate quantitative concepts into the language of clinical medicine. PMID- 3626901 TI - An evaluation of the undergraduate teaching programme in ophthalmology in Sri Lanka and Malaysia. AB - The knowledge and clinical and minor surgical skills acquired by 257 medical students in three universities in Sri Lanka and Malaysia were assessed by a questionnaire after they had completed their training period in ophthalmology. This study showed that many medical students graduating from these universities lacked the basic clinical and minor surgical skills essential for a doctor practising in a community in south-east Asia. The responses also indicated that teaching by consultants in all three universities was inadequate and due to these inadequacies the students requested that the duration of their training period be doubled. Ophthalmology is an important component of clinical practice and proper education in this subject is important. An urgent revision of the aims and objectives of the curriculum in ophthalmology is essential to place greater emphasis on this important and much neglected subject, for which very little curricular time is allotted. PMID- 3626902 TI - Medical students' evaluations of different levels of medical ethics teaching: implications for curricula. AB - Although medical ethics has become a part of the curriculum of almost every medical school, medical students' perceptions of the value of medical ethics have not been documented. This paper reports the evaluations given by 137 preclinical and 216 clinical medical students to different levels of medical ethics teaching at the College of Human Medicine and the College of Osteopathic Medicine of Michigan State University. The results indicate (1) that students' satisfaction with medical ethics teaching is directly linked to how much they receive, (2) that students overwhelmingly prefer the input of both ethicists and doctors to teaching by either alone, and (3) that a preclinical medical ethics course followed by explicit medical ethics teaching in clinical training is a promising model for achieving an adequate level of medical ethics teaching within medical education. PMID- 3626903 TI - Students' attitudes to small-group work in community health. AB - To encourage fourth-year medical students to review their ethnocentric attitudes to the politicized issues of population and undernutrition in South Africa, small group work (SGW) was introduced during a month's teaching in community health at the University of Cape Town. We tested several formats for these sessions and chose one which seemed effective. This study examined the remaining students' attitudes to SGW as a means of briefly examining complex emotive topics. Sixty nine students of a class of 168 were asked to complete a Likert questionnaire on their attitudes to SGW. Fifty-five students (79.7%) agreed that group work had allowed them to engage the topics briefly but usefully and 62 (90%) thought that the topics lent themselves to SGW. While 52 (75.3%) were not confused, 5 (7.2%) were confused by SGW. Thirty-nine students (56.5%) preferred lectures, tutorials or seminars to SGW. Thirty-seven students (53.6%) needed more fact to benefit fully from the SGW. Students found SGW appropriate for briefly examining these topics but wanted more fact to benefit fully from the sessions. The survey yielded valuable feedback from students on SGW as a means of addressing controversial and attitude-laden issues of central importance to the delivery of effective health care in Southern Africa. PMID- 3626904 TI - The stability and attitudinal correlates of warmth and caring in medical students. AB - It is often said that medical school admits students who are compassionate, nurturant and person-oriented, and transforms them into cold, impersonal graduates. These attributes describe two ends of a personality trait continuum referred to as psychological femininity. The Femininity Scale of the Personal Attributes Questionnaire was administered to a class of medical students four times over 3 years. Measures of empathy, attitudes towards doctor-patient relations and attitudes towards professional psychological help were also obtained. Femininity appears to be normally distributed, remarkably stable over a 28-month interval and predictive of attitudinal measures of empathy, readiness to make psychiatric referrals, recognition of one's own need for psychological help, and a non-cynical, person-oriented approach to patient care. Such findings suggest a different state of affairs within medical training than is usually portrayed. Rather than viewing medical school as having a universally adverse effect on student compassion, medical school has virtually no effect on self reports of warmth, kindness, helpfulness, etc. Students at different ends of the femininity continuum may require different interventions aimed at teaching communication skills and interpersonal sensitivity. PMID- 3626905 TI - Performance of men and women medical students at King Saud University, Riyadh: a 10-year retrospective study. AB - This study was carried out using the results of medical students at the College of Medicine at King Saud University, Riyadh between 1975 and 1985. The purpose of the study was to ascertain whether any correlation existed between school performance and college performance, whether results from males were different from results from females, and whether the semester system, in operation since 1981, produced different results from the annual system. Significant correlations were found between school Grade Point Average (GPA) results and college results, being highest for premedical courses and lowest for clinical courses. However, these correlations were too small to be of practical use. Men students were found to perform better at preclinical subjects whereas women had better results at clinical subjects. The overall performance on the semester system was significantly higher than that on the annual system. PMID- 3626906 TI - Improving the psychiatric skills of established general practitioners: evaluation of group teaching. AB - Ten established general practitioners, eight of whom were also trainers, took part in a course designed to improve their psychiatric interviewing skills. Participants were instructed in the problem-based model with audiotape and videotape feedback of real consultations in a group setting. Although those attending were experienced practitioners with a particular interest in the management of psychological problems, evaluation demonstrated a significant improvement in their skills after training. It is suggested that trainers could be trained to provide a similar teaching experience for their own trainees. PMID- 3626907 TI - Is "the trial of forceps" over? PMID- 3626908 TI - Children, bicycles and head injuries. PMID- 3626909 TI - Rotational delivery with Kielland's forceps. AB - A retrospective study over 15 months showed that 10.7% of primigravid women and 1.6% of multigravid women were delivered by Kielland's forceps: a total of 145 babies. The successful vaginal delivery rate for attempted Kielland's forceps was 96.7%. The neonatal outcome was good and there were no perinatal deaths. Traumatic injuries were present in 7.6% of babies and were minor. The data show that even in the presence of fetal distress, Kielland's forceps can be safely employed for rotational delivery from the mid-pelvic cavity. This approach can avoid some caesarean sections without undue risk to the baby, the caesarean rate being 9.5%. As 10.7% of primigravid women required rotational delivery with Kielland's forceps, it is desirable that primigravid women should be cared for by obstetricians who are skilled in the use of the instrument, in order to maintain a low caesarean section rate in this group, with a good neonatal outcome. PMID- 3626910 TI - Head injuries to children riding bicycles. AB - This article examines the characteristics of 150 children who were admitted to Brisbane hospitals with head injuries that were caused by bicycle riding. These children constitute over 20% of all the children with head injuries who were admitted to hospital; accidents involving bicycle riding are the second largest single cause of head injury in these children, after falls. There was one death in the group, and three children were moderately disabled nine months after the injury. These four children all had Glasgow coma scores of less than 9 on their admission to hospital. Only two of the 150 children wore helmets. A survey of a random subgroup of children who had sustained head injuries confirmed our opinion that many children owned helmets but did not wear them for fear of peer derision. It is suggested that this refusal can be overcome by a combination of legislative enforcement, helmet design and promotion. PMID- 3626911 TI - Ingestion of potassium permanganate crystals by a three-year-old boy. AB - We report a case of corrosive burns to the mouth, oesophagus and trachea in a three-year-old boy who ingested potassium permanganate crystals. The pathophysiology and treatment options are discussed. The prevention of accidental ingestion could be improved with careful packaging of the solid tablet or crystalline forms. PMID- 3626912 TI - Drug use by undergraduate students. PMID- 3626913 TI - Mediastinal pancreatic pseudocyst presenting as dysphagia. PMID- 3626914 TI - Persistent neurological sequelae and neuroleptic malignant syndrome. PMID- 3626915 TI - Septic discitis as a presentation of endocarditis. PMID- 3626917 TI - Electroconvulsive therapy. PMID- 3626916 TI - "Burning feet" syndrome. PMID- 3626918 TI - Transportability of in-vitro fertilization technology. PMID- 3626919 TI - Psychotropic drug prescribing in Australia. PMID- 3626920 TI - Drug advertising. PMID- 3626921 TI - Medical ethics need review. PMID- 3626922 TI - Bezoars. PMID- 3626923 TI - The cost of domiciliary oxygen in Japan. PMID- 3626924 TI - Strategies for the reduction of the incidence of hypertension in the community. PMID- 3626925 TI - Where patients with cancer die in South Australia. AB - In a sample of 1582 deaths among South Australian patients with cancer (795 deaths in 1981 and 787 deaths in 1985), 67% of deaths occurred in a hospital, 9% of deaths in a hospice, 10% of deaths in a nursing home, and 14% of deaths in a private residence. More patients died in a hospice or nursing home in 1985 than in 1981, and fewer died in a hospital. With increasing age, fewer patients died in a hospital and more in a nursing home. Compared with men, women were less likely to die at a private residence and more likely to die in a nursing home. A greater proportion of men with a living wife died at a private residence than was so among single or widowed men. However, conjugal status was not associated with the place of death of women. Patients who lived in the more affluent metropolitan suburbs tended more to die at a private residence than did those from poorer suburbs or country areas. Patients with haematological malignancies died in major metropolitan public hospitals more frequently than did patients with other tumours. Possible explanations are given for these findings. PMID- 3626927 TI - Automobile wagons, alcohol ... and drugs. PMID- 3626926 TI - Campylobacter jejuni/Campylobacter coli-associated Guillain-Barre syndrome. Immunoblot confirmation of the serological response. AB - Immunoblot (Western blot) examination of the sera of 45 patients with the Guillain-Barre syndrome demonstrated that between three and five immunoreactive bands that were characteristic of a recent Campylobacter jejuni/Campylobacter coli infection were present in 22 of these patients. The immunoblots paralleled the serological response that is found in campylobacter enteritis and confirmed the specificity of our previous enzyme-linked immunosorbent assays (ELISAs), which indicates that antecedent C. jejuni/C. coli infection is common in patients with the Guillain-Barre syndrome. We postulate that, under certain circumstances, demyelination is initiated by the leakage of campylobacter-specific antibody across the blood-nerve barrier. PMID- 3626928 TI - The "all-Australian" health plan. PMID- 3626929 TI - Outbreak of measles in New South Wales. PMID- 3626930 TI - Rapid detection of Clostridium difficile toxin in faeces. PMID- 3626931 TI - Admissions to a geriatric unit. PMID- 3626932 TI - Infection with Strongyloides stercoralis. PMID- 3626933 TI - Danger of overmedication with no-added-salt diets. PMID- 3626934 TI - Postmenopausal osteoporosis. PMID- 3626935 TI - Anorexia nervosa versus biliary gastritis. PMID- 3626936 TI - The legality of vasectomy. PMID- 3626937 TI - National campaign against drug abuse. PMID- 3626938 TI - Doctors and road safety. PMID- 3626940 TI - The AIDS epidemic--where are we going? PMID- 3626939 TI - Drugs, alcohol and road accidents in Tasmania. AB - Drug analyses were performed on 200 blood samples that were taken for alcohol analysis from road users in Tasmania. Alcohol at a concentration of above 0.5 g was found in 75% of the samples, and other drugs were found in 17% of the samples. Cannabis was the most prevalent of these other drugs: it was detected in 6% of road users; benzodiazepine drugs were detected in 5% of road users; and barbiturate drugs were detected in 2% of road users. Alcohol was found in 50% and other drugs were found in 25%, of drivers, riders and pedestrians who were involved in road accidents that were serious enough to cause death or injury. In addition to alcohol, other drugs may be making a significant contribution to road accidents because all the drugs that were identified are capable of impairing psychomotor performance. Of particular concern is the prevalence of cannabis, which is an illegal drug, and barbiturate drugs, which are now prescribed rarely. A well-controlled study is required to quantitate the contribution of drugs other than alcohol to road accidents. In the meantime, drivers should be warned that drugs that depress the central nervous system can be expected to impair driving ability and to increase the risk of an accident. PMID- 3626941 TI - Technology and diabetes care. PMID- 3626942 TI - The costs of hospital-based medical care for patients with the acquired immunodeficiency syndrome. AB - The costs which were incurred by patients for hospital-based care during the time from the diagnosis of the acquired immunodeficiency syndrome (AIDS) to death, range from pounds 6838 in London, England, to US$147,000 in Atlanta, USA. In 1986, a study was undertaken in Sydney to calculate the costs of the hospital based treatment of patients with AIDS. The medical records of 39 patients who had received all their treatment at one institution were analysed retrospectively, and data were collected on their survival, hospitalizations, investigations and treatments. The mean survival time of the 39 patients was 7.2 months; during this time they had a mean of 4.0 hospital admissions that accounted for an average total stay of 34.6 days. In addition, they made, on average, 9.4 outpatient visits. There was a significant difference in the duration of hospitalization between those who presented with an opportunistic infection and those who presented with a malignancy (38.3 days and 22.4 days, respectively; P = 0.01). The mean cost for hospital-based care was $A22,332 (range, $A4229-$A58,398), of which 95% of costs were incurred for inpatient care. The mean cost of care of those who presented with an opportunistic infection was significantly higher than that of those who presented with a malignancy, but there was no difference according to the age at the time of diagnosis. If the predictions of 3000 cases of AIDS in Australia by 1991 are realized, such cases will represent- conservatively--an additional cost to the community of $A58.5 million. This study emphasizes the need for health authorities to plan for the future financial impact of the hospital-based treatment of patients with AIDS. PMID- 3626943 TI - Beliefs about the spread of the acquired immunodeficiency syndrome. AB - Beliefs about the spread of the human immunodeficiency virus were determined among a community sample (n = 178:98 women; 80 men) of Australians. In order to reduce the statements to manageable clusters, a principal components analysis was computed which was followed by Varimax rotation for eigenvalues that were greater than unity. Five interpretable factors were extracted which dealt with statements that referred to social contact, chance 1, heterosexual activity, biological matters and chance 2. Three-way (sex x age x education) analyses of variance were computed on the total factor scores. No sex differences were found, although age and educational level appeared to have some influence on beliefs. The findings are discussed in the light of the recent television advertising campaign about the acquired immunodeficiency syndrome. PMID- 3626944 TI - Assessment of the Albuscreen microalbuminuria kit in diabetic outpatients. AB - Diabetic patients who have albumin excretion rates of greater than 30 micrograms/min (30 mg/L at normal urine volumes) are at increased risk of the development of diabetic nephropathy. The Albuscreen microalbuminuria kit detects albuminuria at concentrations of 30 mg/L and above by an agglutination-inhibition reaction. One hundred and ninety-five random urine samples from diabetic outpatients were assessed by Albuscreen and Albustix testing for albuminuria and the results were correlated with those of a sensitive radioimmunoassay technique. Albuscreen testing was simple, easy to use and had a sensitivity of 96%, with a specificity of 88%. Albustix testing at a detection level of 50 mg/L revealed a sensitivity of 100% and a specificity of 68% (43 samples, false-positive "trace" readings), while, at 30 mg/L, the sensitivity and specificity were 90% and 71%, respectively. Therefore, Albuscreen testing is well suited as a screening test for the presence of microalbuminuria in a diabetic outpatient setting. However, the role of Albustix in screening for microalbuminuria is less well defined, especially at the 30 mg/L level of detection, and requires further investigation. PMID- 3626945 TI - The effect of the haematocrit value on the determination of glucose levels by reagent-strip methods. AB - Twenty-one patients' blood samples, each with modified haematocrit concentrations of about 20%, 30%, 40%, 50% and 60%, were assayed for the presence of glucose by two reagent-strip methods--the Ames Glucometer with BG reagent strips and the Reflolux reflectance meter with BM-test strips. The reference method was the YSI blood glucose analyser. Both Ames and BM systems were found to have good precision. Ames results were falsely high (mean, 15%) at a haematocrit value of 20% and falsely low (mean, 21%) at a haematocrit value of 60%. BM results also overestimated (mean, 4%) and underestimated (mean, 5%) at the corresponding haematocrit levels. The results showed good agreement between Ames and BM methods and the YSI method for normal haematocrit concentrations of 40% to 50%. Clinicians should be aware of inaccuracies in glucose results by test-strip methods in patients with abnormal haematocrit concentrations. PMID- 3626946 TI - Prejudice not condoms. PMID- 3626947 TI - The management of nausea and vomiting during pregnancy. PMID- 3626949 TI - On the road--the tobacco road to Texas. PMID- 3626950 TI - AIDS and medical ethics. PMID- 3626948 TI - Eosinophilic meningoencephalitis with permanent sequelae. AB - The youngest patient with eosinophilic meningoencephalitis to be reported from Australia, an 11-month-old girl, is presented here. The diagnosis of angiostrongyliasis was based on the exclusion of other possibilities, the strongly-positive results of serological examination and the findings of an environmental survey. Clinical signs of serious brain damage, with persistent blindness, profound mental retardation, spasticity and epilepsy more than three years later, indicate that this infection is not always as benign as is considered generally. PMID- 3626951 TI - Folate deficiency in Northern Territory aborigines. PMID- 3626952 TI - Dual-photon bone densitometry in normal Australian women: the issue of biometry. PMID- 3626953 TI - Postmenopausal osteoporosis. PMID- 3626954 TI - Tarsal tunnel syndrome and "burning feet". PMID- 3626955 TI - Trauma can cause torsion of the testis. PMID- 3626956 TI - Interference with creatinine estimation by a cephalosporin agent. PMID- 3626957 TI - Adjustable prisms in ocular myasthenia. PMID- 3626958 TI - High-dose beclomethasone in the management of elderly patients with corticosteroid-dependent chronic obstructive pulmonary disease. PMID- 3626959 TI - Monoamine oxidase inhibitors. PMID- 3626961 TI - Medical use of English. PMID- 3626960 TI - Hyoscine-N-butylbromide by intravenous infusion. PMID- 3626962 TI - Polytherapy not polypharmacy. PMID- 3626963 TI - [Radiographic study of the thorax. Evaluation of doses administered to the patient]. PMID- 3626964 TI - Immunological aspects of farmer's lung. A family study. PMID- 3626965 TI - [Renal glomerular function and biological indicators of lead in steel industry workers with past absorption of lead]. PMID- 3626966 TI - Free radical scavenging properties of polyvinylpyridine N-oxide: a possible mechanism for its action in pneumoconiosis. PMID- 3626967 TI - [Ambulatory electrocardiographic findings and urinary excretion of catecholamines in ferrochromium smelters]. PMID- 3626968 TI - [Community control of arterial hypertension in a group of workers in small industries]. PMID- 3626969 TI - [A case of acute occupational poisoning by 2-4-6 trichloro-1-triazine (cyanuric chloride)]. PMID- 3626970 TI - [The industrial physician today. And tomorrow?]. PMID- 3626972 TI - [What constitutes staphylococcal disease?]. PMID- 3626973 TI - [Pharmacokinetics and drug interactions. The basis for heterogenous action, II]. PMID- 3626971 TI - [Interaction and synergism in epidemiological studies. The case of smoking and occupational exposure in respiratory pathology]. PMID- 3626974 TI - [Thrombosis prevention with low molecular weight heparin]. PMID- 3626975 TI - Tranexamic acid. PMID- 3626976 TI - [Results of a serologic and virologic examination of wild Mongolian mammals and birds for arboviruses]. PMID- 3626977 TI - [Formation of the peritrophic membrane in the stomach of female Culex pipiens molestus Forsk mosquitoes (Diptera, Culicidae)]. PMID- 3626978 TI - [Effect of the density and number of mosquitoes in a group on their feeding (results of experiments on mosquitoes from natural populations and laboratory cultures)]. PMID- 3626979 TI - [Trials of Xenotoca eiseni (Rutter), 1896 (Cyprinodontiformes, Goodeidae) as a means of controlling mosquito larvae in the field]. PMID- 3626980 TI - [Effect of 2 analogs of juvenile hormone on the metamorphosis of Xenopsylla cheopis Roths]. PMID- 3626981 TI - [Factors determining the possibility of infection with tick-borne encephalitis. 1. Human contact with Ixodes ticks in the central taiga forests of the Khabarovsk area]. PMID- 3626982 TI - [Sources and routes of infection with toxoplasmosis. Discussion on the the article by A. Ia. Lysenko, "Toxoplasmosis: facts and conjectures. 2. Routes of circulation of the agent" (Med. parazitol. 1984, No. 3)]. PMID- 3626983 TI - [4. Analysis of opisthorchiasis infestation among new arrivals in 1 of the endemic foci of the central Ob region]. PMID- 3626984 TI - [Dynamics of changes in peripheral leukocytes and the proteinogram of golden hamsters infested with Opisthorchis felineus before and after treatment with praziquantel]. PMID- 3626985 TI - [Evaluation of the helminthologic situation along the course of the Irtysh- Karaganda channel. 1. Infestation with helminthiases of the population of settlements adjacent to the channel]. PMID- 3626986 TI - [The epidemiologic situation with respect to the chief human parasitic diseases in rural settlements with different levels of public services]. PMID- 3626987 TI - [Classification of research in the area of medical parasitology in accordance with the new edition of the Internal Classification of Inventions]. PMID- 3626988 TI - [Improvement in the method of diagnosing enterobiasis]. PMID- 3626989 TI - [Incidence of copulating pairs of the taiga tick (Ixodes persulcatus Sch., Ixodidae) in nature]. PMID- 3626990 TI - X-ray diffraction computed tomography. AB - Coherent scattering of x-ray photons leads to the phenomenon of x-ray diffraction, which is widely used for determining atomic structure in materials science. A technique [x-ray diffraction computed tomography (CT)] is described, analogous to conventional CT, in which the x-ray diffraction properties of a stack of two-dimensional object sections may be imaged. The technique has been investigated using a first generation (single pencil beam) CT scanner to measure small angle coherent scatter, in addition to the customary transmitted radiation. Diffraction data from a standard CT performance phantom obtained with this new technique and with an x-ray diffractometer are compared. The agreement is satisfactory bearing in mind the poor momentum resolution of our apparatus. The dose and sensitivity of x-ray diffraction CT are compared with those of conventional transmission CT. Diffraction patterns of some biological tissues and plastics presented in a companion paper indicate the potential of x-ray diffraction CT for tissue discrimination and material characterization. Finally, possibilities for refinement of the technique by improving the momentum resolution are discussed. PMID- 3626991 TI - X-ray diffraction measurements of some plastic materials and body tissues. AB - X-ray diffraction allows the investigation of the atomic or molecular structure of materials. The combination of diffractometry with computerized tomography enables spatially resolved imaging of the diffraction properties of extended objects as described in more detail in a companion article [Harding et al., Med. Phys. 14, 515 (1987)]. We present measured diffraction patterns of some plastics and several biological materials, which allow further optimization of our method and the selection of suitable application areas. PMID- 3626992 TI - A method for modulation transfer function determination from edge profiles with correction for finite-element differentiation. AB - In this paper we describe a technique for determining the modulation transfer function (MTF) of an imaging system from an experimentally obtained edge profile. The technique includes an exact correction for the frequency passband of the finite-element differentiation required to obtain the line spread function from the edge spread function. This correction has been ignored by investigators in the past and is required whenever finite-element differentiation is used rather than analytic differentiation of a model fitted to the edge response data. The magnitude of the MTF correction is approximately 11% at f = fc/2 and approximately 57% at f = fc, where fc = fs/2 is the maximum frequency reproducible without aliasing with a sampling rate of fs. The correction is performed in the spatial frequency domain by multiplying the uncorrected MTF by 1/sinc (pi f/2fc). A computer simulation is presented to demonstrate the effect and the correction procedure. An experimental MTF of an x-ray image intensifier system obtained using this technique is found to be consistent with an MTF obtained using a bar pattern test phantom. PMID- 3626993 TI - Image feature analysis and computer-aided diagnosis in digital radiography. I. Automated detection of microcalcifications in mammography. AB - We have investigated the application of computer-based methods to the detection of microcalcifications in digital mammograms. The computer detection system is based on a difference-image technique in which a signal-suppressed image is subtracted from a signal-enhanced image to remove the structured background in a mammogram. Signal-extraction techniques adapted to the known physical characteristics of microcalcifications are then used to isolate microcalcifications from the remaining noise background. We employ Monte Carlo methods to generate simulated clusters of microcalcifications that are superimposed on normal mammographic backgrounds. This allows quantitative evaluation of detection accuracy of the computer method and the dependence of this accuracy on the physical characteristics of the microcalcifications. Our present computer method can achieve a true-positive cluster detection rate of approximately 80% at a false-positive detection rate of one cluster per image. The potential application of such a computer-aided system to mammographic interpretation is demonstrated by its ability to detect microcalcifications in clinical mammograms. PMID- 3626994 TI - Image feature analysis and computer-aided diagnosis in digital radiography. 2. Computerized determination of vessel sizes in digital subtraction angiography. AB - We developed an iterative deconvolution technique to determine the size of a "blurred" vessel in a digital subtraction angiographic (DSA) image by taking into account the unsharpness of the DSA system. Initially, a region of interest over a small segment of the contrast-filled vessel was selected in a DSA image, and the center line of the opacified vessel was determined by polynomial curve fitting of the locations of the peak pixel values along the vessel image. The blurred image profile was then obtained from pixel values across the vessel in a direction perpendicular to the center line. This measured profile was compared iteratively with a calculated profile for various size vessels, which was obtained from a cylindrical vessel model and from the line spread function, until the root-mean square difference between the two profiles was minimized. The size of a cylindrical vessel yielding the matched profile was considered the best estimate of the unknown vessel size. Studies with a blood vessel phantom indicated that vessels larger than 0.5 mm could be measured with an accuracy and precision of approximately 0.1 mm, which is about 1/3 of the pixel size used in our DSA system. Details of our approach and some clinical vessel images with and without simulated stenotic lesions are presented. PMID- 3626995 TI - Dual-energy electronic scanning-slit fluorography for the determination of vertebral bone mineral content. AB - A technique for performing accurate bone mineral content (BMC) determination, using dual-energy scanning-slit fluorography, has been developed. X-ray scatter and veiling glare are suppressed using a multiple scanning-slit device interfaced to a conventional digital subtraction angiography system. The technique employs a pair of calibration step wedges, one tissue and one bone equivalent. The proper use of the step wedges obviates the need for accurate kVp calibration or absolute calibration of the system's response to BMC. Phantom studies intended to simulate vertebral BMC measurement indicate that the technique is capable of measuring BMC with less than 30 mg/cm2 inaccuracy over a wide range of BMC. PMID- 3626996 TI - Monte Carlo evaluation of kerma at a point for photon transport problems. AB - Estimation of collision kerma at a geometric point arising from scattered photons is a potentially important application of Monte Carlo simulation, especially in the presence of steep flux gradients. We examine the usual method of extracting point-kerma estimates from randomly generated photon trajectories which consists of tallying the energy lost by photon collisions occurring in the vicinity of the point of interest. Several other methods derived from the equivalence of track length per unit volume and flux are evaluated as to accuracy and efficiency. Finally, a next-flight estimator is discussed in which the expected contribution of each simulated photon collision to kerma at the point of interest is calculated regardless of proximity of the collision to the point. All of these techniques are shown to involve a trade-off between statistical precision and spatial resolution: increasing the number of contributing collisions requires averaging kerma over a larger volume. Based upon both analytic models and realistic Monte Carlo simulations, use of next-flight and track-length estimators is shown to improve simulation efficiencies by factors of 2 to 20 compared to analog scoring. Practical guidelines as to choice of estimator and successful implementation are presented. PMID- 3626997 TI - A new model for computerized clinical electron beam dosimetry. AB - Clinical electron beams consist of primary electrons, primary bremsstrahlung generated in the regular photon and electron collimator system determining the composite beam, and some short-range contaminant photon and electron scatter arising from the lower parts of the standard or regular electron applicator. Any beam-shaping insert placed inside the applicator causes some extra ("contaminant") bremsstrahlung and electron scatter. The new dose calculation model is based on separate treatment of these components. For the calculation of the primary electron dose we use experimentally determined electron scatter functions and differential electron scatter functions. The primary bremsstrahlung is treated as an unflattened but otherwise regular x-ray beam. The contaminant components arising from the rim area of the regular electron collimator and from beam-shaping inserts are considered separately. The behavior of the in-air ionization profiles is described using the concepts of effective electron source position and effective electron source diameter. The model has been tested for several electron energies. PMID- 3626998 TI - Dose perturbations at interfaces in photon beams. AB - A model based on an approximation called the partial fluence approximation is presented for the calculation of dose distributions in the vicinity of medium interfaces in photon beams. The predictions of the model are compared with dose distributions measured in layered phantoms consisting of aluminum and polystyrene, for photon beams ranging in energy from 60Co to 24 MV. PMID- 3626999 TI - Optimization of activity distribution in brachytherapy. AB - We investigated the problem of how to minimize the dose rate outside a spherical target volume for a given minimal dose rate inside the sphere for 1/r2 photon emitters. An integral equation for an activity distribution is derived from the demand that the dose rate is constant inside the sphere. The solution of this equation is given and it is proven that the resulting activity distribution gives the smallest dose rate at every point outside the target volume. Some other activity distributions are discussed; they are assessed by the required integral activity, which is proportional to the dose rate at some distance from the target volume. Compared with a single point source at the center of the sphere, one can save 50% of the total activity when using the optimal activity distribution. The benefit reduces to about 30% for the other continuous activity distributions and to a few % for symmetrical arrangements of a few point sources. PMID- 3627000 TI - A method for reducing motion induced errors in T2-weighted magnetic resonance imaging. AB - It is known that motion of an object imaged by magnetic resonance imaging leads to errors and artifacts in the image. This effect is especially important when a pulse sequence with long echo time (TE) and long TR is used to provide T2 weighted images. We have modified the usual spin warp imaging pulse sequence in a way which greatly reduces the severity of such errors. The method was tested on both a moving phantom and a living rabbit. The pulsing of the scanner was gated in synchrony to the motion of the phantom; two pulses per mechanical cycle were used to create a special situation which served to verify the validity of a theoretical analysis of the loss of signal with echo time. Under such conditions it was shown that the conventional method led to a progressive loss of signal with increasing TE while the new method gave a pure exponential decay of signal in accordance with the known T2 of the sample. When either the phantom or the animal was scanned without gating, the new pulse sequence showed far less artifacts attributable to motion. The potential application of the technique to improved quantitative imaging of the abdomen in clinical situations is discussed. PMID- 3627001 TI - Sample noise with circular surface coils. AB - Presented is a straightforward derivation of the effective sample resistance presented to the input amplifier of a nuclear magnetic resonance imager when flat circular surface coils are used to image lossy media. The resistance may be used to determine sample noise following the method of Hoult and Lauterbur. PMID- 3627002 TI - Observation of microwave-induced eye lens surface motion in vitro. AB - Previous experiments have shown that murine ocular lenses immersed in saline in vitro suffered microscopic physical damage (including cataractogenic changes) after exposure to pulsed microwaves under conditions in which the temperature rise was negligible. The suspected coupling mechanism is thermoelastic transduction (TET). To test this hypothesis, laser interferometry was used to measure the lens surface motion induced by pulsed microwaves. Although experimental constraints delayed the recording of surface motion data until 0.5 ms after the microwave pulse, damped oscillatory motion was measured over an interval of several milliseconds. A theoretical model is presented to explain the observed motion as natural oscillation modes of an elastic sphere excited by TET waves produced in the surrounding saline. Effects of the lens capsule are also discussed. The conclusions reached are that the observed motion is TET induced, but the lens damage occurs during the passage of the initial excitatory TET waves through the lens, an event which could not be monitored by this experiment. PMID- 3627003 TI - Fluorescence endoscopy instrumentation for improved tissue characterization. AB - An endoscopic instrument for normal optical inspection and simultaneous fluorescence characterization is described. The equipment is primarily intended for early cancer detection using characteristic fluorescence from the tumor seeking agent hematoporphyrin derivative. A dimensionless ratio of two fluorescence intensities is monitored making the equipment insensitive to target distance and surface topography. A measurement example is given and possible improvements are discussed. PMID- 3627004 TI - Gibbs artifact removal in magnetic resonance imaging. AB - Gibbs artifact in magnetic resonance imaging results when band-limited interpolation is used. This is typically done when there are more reconstructed pixels in the phase encoding direction of the image than corresponding phase encoding measurements. Such sampling is effectively an ideal (in a noise sense) low-pass filter which provides a maximal improvement in contrast resolution at the expense of a decrease in spatial resolution. In this paper we demonstrate that an alternate low-pass filter can be used to improve contrast resolution with a loss in spatial resolution and yet not result in Gibbs artifact. We show that the noise performance of this filter can be made to approach that of an ideal filter by properly specifying the number of samples averaged for each phase encoding index. PMID- 3627005 TI - Effects of ionization chamber construction on dose measurements in a heterogeneity. AB - Traditionally, measurements have been made in heterogeneous phantoms to determine the factors which should be applied to dose calculations, when calculating a dose to a heterogeneous medium. Almost all measurements have relied on relatively thin walled ion chambers, with no attempt to match ion chamber wall material to the measuring medium. The recent AAPM dosimetry protocol has established that a mismatch between ion chamber wall and phantom material can have an effect on dose measurement. To investigate the affect of this mismatch of ion chamber wall material to phantom material, two parallel-plate ion chambers were constructed. One ion chamber from solid water, for measurements in a solid water phantom and the other from plastic lung material, for measurements in a plastic lung material phantom. Correction factors measured by matching ion chamber to media were compared to correction factors measured by using a thin-walled cavity ion chamber with no regard for matching wall and media for cobalt-60, 6-, 10- and 20-MV photon beams. The results demonstrated that the matching of ion chamber to measuring media can be ignored, provided that a small, approximately tissue equivalent, thin-walled ion chamber is used for measuring the correction factors. PMID- 3627006 TI - Teletherapy beam characteristics: the first second. AB - The beam characteristics of radiotherapy treatment units are measured and recorded under circumstances in which transient effects are eliminated. Output measurements are done by averaging several readings. Isodose curves are obtained during a period of irradiation which is large compared with that used in patient treatment. When treatments are given, the therapy unit is assumed to deliver radiation beams that match the data acquired during calibration. We have looked at the energy, field uniformity, and output constancy typical of a number of these machines in their initial stages of operation. Although most can provide their "reference" beam characteristics in a short time, there are exceptions. The implications for patient treatment, port filming, and film dosimetry are discussed. PMID- 3627007 TI - Measurement of beam current and evaluation of scatter production in an 18-MeV accelerator. AB - Measurements of dose rate in a 10-MV x-ray beam may indicate considerable variation with collimator setting. This variation is observed even when the peak scatter factor is fixed by holding the field size at the phantom surface constant. The resulting output factor variation may be due to radiation backscattered from the collimators into the monitor chamber. Measurements of charge deposited in the accelerator target were compared with ionization readings for several field sizes. Evaluation of the data indicates that radiation backscattered into the monitor chamber contributes only a small amount to the output factor. PMID- 3627008 TI - A parameterization of the electron beam output factors of a 25-MeV linear accelerator. AB - A new parameterization of the output factors of an electron beam has been developed. The output factors for the electron beams of an AECL Therac-25 have been determined for a variety of square and rectangular fields using ionization measurements and thermoluminescent dosimetry. The data were then least-squares fit by a semiempirical equation which treats the two field dimensions as variables. Such a parameterization allows computer-generated tables of output factors to be manufactured. The calculated values agree with the measured data in most cases to within the +/- 1% experimental uncertainty. A comparison between this method of calculating output factors and two conventional methods is also presented. PMID- 3627009 TI - Skin-sparing effects of neutron beam filtering materials. AB - The skin-sparing effects of several filtering materials for fast neutron beams were studied under various conditions. A parallel-plate ionization chamber was used for the measurements. The parameters which were studied included field size, distance from filter to ion chamber, filter material, and filter thickness. On the basis of this work, Teflon (polytetrafluoroethylene) was chosen for fabrication of flattening filters and wedges. PMID- 3627010 TI - Experimental characterization of the miniannular phased array as a hyperthermia applicator. AB - A series of experiments has been carried out in order to characterize a miniannular phased array applicator prior to possible clinical implementation. The energy deposition patterns over the frequency range of 100 to 200 MHz were determined in several human limb models of different complexities by measuring the electric field strength patterns. The point of maximum energy deposition within a homogeneous, muscle-equivalent cylindrical phantom positioned coaxially within the MAPA was found to be at the center of the applicator. The energy deposition patterns seem to be more uniform at the lower frequencies. Inclusion of a cylindrical bone-equivalent phantom positioned coaxially with this muscle equivalent phantom does not seem to significantly alter the energy deposition patterns in the muscle-equivalent region. For more realistically shaped, homogeneous muscle-equivalent limb models, the resulting energy deposition patterns appear to be confined mostly to the intended treatment region. However, the point of maximum energy deposition was not at the middle of the applicator as with the cylindrical model, but shifted towards a smaller cross-sectional region. This shift in location of the point of maximum energy deposition varies with the location of the MAPA on the limb. A secondary region of high-field strength was also observed at the ankle for a MAPA centered about the knee. In this study, the energy deposition patterns appear to be significantly dependent on the shape of the model. Therefore, this factor must be taken into consideration for the proper prediction and control of the heating patterns resulting from the use of this type of applicator for clinical hyperthermia treatment. PMID- 3627011 TI - Specific absorption rates in simulated tissue media for a 10 x 10 cm 915-MHz waveguide applicator. AB - The use of hyperthermia in combination with radiotherapy is currently being investigated at many cancer treatment facilities. Several different types of heating modalities are presently being used and for each of these systems it is important to determine the power distributions of their hyperthermia applicators in tissue-equivalent phantoms. This information will be used for treatment planning, routine quality assurance, and acceptance testing as well as for comparison between these various modalities and systems. This report describes the power distribution characteristics of the Clini-Therm 10 x 10 cm 915-MHz waveguide applicator measured within muscle tissue phantom materials arranged in several clinically relevant treatment configurations. The net increase in temperature that resulted from 20-s pulses of microwave power was measured at various points within each phantom by the system's implantable fiberoptic temperature sensors. From these temperature measurements the distribution of power was calculated as specific absorption rates (SAR). The results are displayed as two-dimensional ISO-SAR maps which relate power levels throughout the irradiated volume to those obtained on the central axis of the applicator. When the applicator was in direct contact with the muscle phantom the highest SAR measured was 2 cm lateral to its central axis along the muscle surface. On the central axis approximately 50% of the power was attenuated by each centimeter of muscle material. The introduction of either fat, bone, or a water-filled pad between the applicator and the muscle altered the pattern of power distribution within the irradiated volume without substantially altering the relative distribution of power along the central axis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627013 TI - Medical engineering in Japan. Research and development. PMID- 3627012 TI - A study of the homogeneity of the trabecular bone mineral density in the calcaneus. AB - In the past our laboratory has reported a method of measuring trabecular bone mineral density (TBMD) in the calcaneus in vivo by using the coherent-to-Compton scattering ratio. In the present work the distribution of TBMD in the calcaneus has been studied, and the reproducibility of this technique in vivo has been determined. It is found that although the TBMD may vary within the calcaneus, a region exists over which the variation in density is not large. This region coincides with the midportion of the heel and is the site chosen for the measurement of TBMD by the coherent-to-Compton scattering ratio technique. The reproducibility of this technique in vivo has been determined to be 3.4%. PMID- 3627014 TI - Left ventricular image processing. AB - Left ventricular image processing methods of x-ray cineangiocardiograms and ultrasound echocardiograms are discussed. 3-D reconstruction methods of the left ventricle from ultrasound echocardiograms and magnetic resonance images are also discussed. Boundary detection of the left ventricle and the quantitative analysis of the left ventricular function and wall motion are discussed. To reconstruct 3 D shapes, we need several cross sectional shapes or silhouettes of the left ventricle. Several cross sectional echo images of apical long axis view are taken by changing the angles of rotation of the probe of echo transducer around its axis. Gated multi-phase MRI method is used to obtain each 2 cross sectional images in transverse, coronal and sagittal directions. Some results of 3-D shapes of the left ventricle and myocardium reconstructed are shown and 3-D functional images which give us regional functions of the left ventricular wall on three dimensional shape are shown. PMID- 3627015 TI - Body surface potential mapping--its application to animal experiments and clinical examinations. PMID- 3627016 TI - Noninvasive measurement of arterial blood pressure and elastic properties using photoelectric plethysmography technique. AB - The objective of this paper is to review our developed method for measuring noninvasively the arterial blood pressure as well as the mechanical properties of the vascular system in a thin portion of the biological segment such as human fingers or small animal extremities like rat tails and rabbit forelegs. This measurement is based on a principle called the 'volume-oscillometric method'. During the gradual change in cuff pressure, the amplitude of consecutive arterial volume pulsations associated with pulse pressure shows change characteristically due to the nonlinearity of arterial pressure-volume(P-V) relation. Arterial pressure can be accurately determined by detecting this characteristic change in the amplitude, while the arterial elastic properties such as P-V relationship and volume elastic modulus can be noninvasively obtained as a function of arterial transmural pressure, provided that the arterial volume changes are quantitatively determined during this pressure measurement. The validity and accuracy of this pressure and elasticity measurement with photoelectric plethysmography technique for detecting arterial volume changes are clearly demonstrated on the in vitro and in vivo experiments. Considering the simplicity and practicability of this measurement using the photoelectric plethysmography, we present a new portable instrument for the long-term ambulatory monitoring of indirect arterial pressure and a handy fully-automatic instrument for the noninvasive measurement of arterial elastic properties, and a few examples obtained by each instrument are also described. PMID- 3627017 TI - Hepatic assist device, using membrane plasma separator and dialyzer. AB - Our hepatic assist device is composed of a membrane plasma separator, blood and plasma pumps, hemodialyzer and controller. Using this device, the patients plasma is replaced with fresh donor plasma in a 5000 ml amount daily. This procedure of plasma exchange takes place in the intensive care unit, until the patient recovers consciousness or cerebral death is confirmed. In the initial results of this plasma exchange, 5 out of 10 patients with fulminant hepatic failure survived. Even with fatal cases, prolongation of survival time was observed. Our hepatic assist device, performing an easy and safe procedure for plasma exchange, appears to be the most promising method of providing long-term hepatic support for acute liver failure at the present time. PMID- 3627018 TI - Patient monitoring during and after open heart surgery by an improved deep body thermometer. AB - The deep body thermometer developed by Fox was improved by Togawa by thermal insulation of the probe. The present status of medical progress in clinical thermometry through the improved deep body thermometer was reviewed from the view point of cardiac surgery. The forehead and sole temperatures obtained by this improved thermometer were monitored and recorded by a multipotentiometric recorder continuously up to 12 days in the patients admitted to the ICU who underwent open heart surgery. The forehead tissue temperature measured by this thermometer is slightly lower than and parallel to the rectal temperature, being close to the pulmonary arterial blood temperature. On the other hand, the sole tissue temperature fluctuates from room temperature to the forehead tissue temperature, sometimes showing rhythmic changes. The former seems to be the core temperature and the latter, the shell temperature. The dissociation when the two temperatures are more than 7 degrees C apart from each other suggests that the hemodynamical condition is worse than in the convergence when they remain within 2 degrees C. A state of shock can be diagnosed when the arterial systolic pressure is less than 90 mmHg and the urine output less than 1 ml/min/mg in addition to the dissociation. The effect of treatment and the prognosis for the patient are predictable according to the trends of the two temperatures as divergent or convergent. The dynamic thermometry by this thermometer is very informative and the procedure is noninvasive without discomfort to the patient. PMID- 3627019 TI - The development of artificial endocrine pancreas. From bedside-, wearable-type to implantable one. AB - The artificial endocrine pancreas is a feedback controlled instrument regulating insulin delivery on a minute-by-minute basis according to measured blood glucose levels. It has been proven to be useful not only as the therapeutic tool of diabetes mellitus but also as an elegant research tool for investigating the pathophysiology of the disease. The wearable type of closed-loop system has been developed recently for the first time by the authors. The breakthrough is the establishment of needle-type glucose sensor. The trend in development of closed loop glycemic control system which enables perfectly physiological regulation on long-term basis, is directed to implantable devices. Much efforts have been conducted now to realize these devices. PMID- 3627020 TI - Research and development on total artificial heart in University of Tokyo. AB - The research and development on the total artificial heart (TAH) in the University of Tokyo can be divided chronologically into the three stages, i.e., the first stage (1959-1970); trial and error stage to find appropriate hardwares, the second stage (1970-1985); software stage to find how to control pneumatic TAH and to manage the animals, and the third stage (1985- ); final goal to develop implantable TAH for animal and human. This paper reviews the process of research and development in each stage. PMID- 3627021 TI - Functional electrical stimulation for the control of the upper extremities. AB - A multi-channel functional electrical stimulation (FES) system for the restoration of hand function of the quadriplegic is described. The system is composed of a personal computer NEC PC-880lmkII, peripheral electronic circuits and two kinds of sensors, i.e. an analog displacement sensor for volitional control (channel 1) and a logical sensor (high pitch sound or head switch, channel 2). Combination of the two channel signals allow three major function: 1) designation of the desired prehension pattern among cylindrical grasp, key grip and parallel extension grip; 2) selection of the operation status--'start', 'proportional control', 'hold', 'stop'--and, 3) volitional control which can be controlled by the shoulder movement. In the clinical application, Caldwell Reswick type multistrand stainless steel percutaneous electrodes were used. In this FES system, standard multi-channel stimulation patterns were obtained from electromyographical analysis of joint movement of the upper extremities in normal subjects which gave us precise information about a role of each muscle during various kinds of motion. Such stimulation patterns have enabled us to restore motor function of the paralyzed upper extremities for activities of daily living (ADL). PMID- 3627022 TI - Blood flow in the heart and large vessels. PMID- 3627023 TI - An optical-fiber laser Doppler velocimeter and its application to measurements of coronary blood flow velocities. AB - In this paper we describe a laser Doppler velocimeter (LDV) with an optical fiber that measures blood flow velocities accurately in a small sample volume. The principle, optical arrangement, spatial and the temporal resolutions and accuracy for blood flow measurements are delineated, followed by a report of the results of measurements of coronary artery and vein blood flow velocities in dogs. Finally, we touch upon some recent progress made in the LDV with an optical fiber pickup. PMID- 3627024 TI - Current development in Doppler echocardiography. The real-time two-dimensional Doppler flow imaging system. AB - Recent advances in ultrasound instrumentations have provided a new Doppler modality capable of displaying the spatial distribution of blood flow velocities by colors on the monochromatic echo image on the real time basis, called the real time two-dimensional Doppler flow imaging system. With this new Doppler technique, we can noninvasively relate the dynamic flow pattern to the anatomy and the motion of the cardiac structures and can further our understandings of flow dynamics in the circulatory system in health and disease. In clinical cardiology, the Doppler flow imaging technique offeres a quite sensitive approach to the detection of flow abnormalities caused by valvular insufficiency or stenosis and congenital shunt diseases. The spatial distribution of the regurgitant jet flow visualized by the Doppler flow imaging technique provides a semiquantitative approach to the evaluation of the severity of the valvular insufficiency. Furthermore, we can appreciate the spatial and angular orientation of the stenotic or regurgitant jet flow, which allows us to measure the velocity of the jet flow with the optimal beam direction. Though there are some limitations and pitfalls in the Doppler flow imaging system at present, it has provided the mapping of the dynamic distribution of flow velocities, which has never been available with the conventional Doppler technique, and has expanded Doppler capabilities and utilities in clinical cardiology. The Doppler flow imaging system is now widely used as a routine part of noninvasive cardiac examination and is improving its clinical significance. PMID- 3627025 TI - Medical engineering in Japan. Research and development. PMID- 3627026 TI - Solid-state micro sensors. AB - Recent research activities on solid state micro sensors in Japan are reviewed. Many kinds of micro sensors for chemical and physical quantitative analysis have been developed for biomedical instrumentation. Many of these sensors are fabricated with the advanced art of semiconductor technology, which is called micromachining. This technology enables fabrication of sensors so small that they can be used in catheter tubes etc. Moreover, it has brought out integrated sensing systems or multi sensors. In the field of chemical sensors, the development of ISFETs, i.e. ion sensitive field effect transistors, has been much advanced. These have been applied not only as ion sensors but also as biosensors or dissolved gas sensors. On the other hand, the major research activities on micro sensors for physical quantities have been on pressure sensors for measurements in blood vessels etc. PMID- 3627027 TI - Electrical measurement of fluid distribution in legs and arms. AB - Intra- and extra-cellular fluid distribution is very important to know the physiological and clinical state of living subjects. However, it is quite difficult to measure the distribution in vivo. Electrical impedance of living tissue is mainly affected by extra-cellular fluid at an applied frequency lower than the beta-dispersion frequency, and is affected by both extra- and intra cellular fluid at higher applied frequencies than that. In this paper, we discuss the problems of measurement of intra- and extra-cellular fluid distribution in living tissues by means of electrical impedance. The intra- and extra-cellular fluid distribution is related to some physiological parameters, such as blood circulation, metabolism of tissues, and the electrolytic concentration of intra- and extra-cellular fluids. Therefore, the information about the distribution of fluids in tissues is quite useful for the diagnosis of various diseases, the monitoring of seriously ill patients, and in medical treatments such as artificial dialysis. We discuss the method of measurement and the results of experiments. PMID- 3627028 TI - Measurement of electrical bio-impedance and its applications. AB - This paper describes: 1) the measurement method of electrical bio-impedance; 2) presentations of models of bio-impedance and their applications to some impedance analyses; 3) the analyses of steady state and dynamical state of electrical properties of the skin; and 4) the applications of bio-impedance. The applications include: 1) the influence of skin impedance to biological potential measurement; 2) skin moisturization measurement using skin admittance; and 3) gait analysis using lower leg electrical impedance. PMID- 3627029 TI - Recent advances in thromboresistant materials. AB - There are strong demands for innovative antithrombogenic materials, because of their necessity in fabricating artificial organs and progressive surgical prostheses. This paper reviews the recent advances in thromboresistant materials. Special emphasis is placed on the novel feature of the surface characterization of thromboresistant materials by X-ray photoelectron spectroscopy and its biomedical implications. Essential role of crystalline-amorphous microstructured surface in thromboresistant property of semicrystalline segmented copolymer is also discussed in detail. PMID- 3627030 TI - Biomagnetism in Japan. AB - The study of biomagnetic fields originating in a biological body is called biomagnetism. Among various fields of biomagnetism, this paper reviews the research and clinical works in magnetocardiogram, neuromagnetism, magneto oculogram, magnetopneumogram and magnetic measurement for cell motility carried out in Japan. PMID- 3627031 TI - Automatic radiologic reporting system using speech recognition. AB - A radiograph report is usually made from an oral dictation by a radiologist, which is then typed. Typing Japanese is rather inconvenient and consumes many hours. In this paper we introduce a computer-assisted reporting system for radiologic images using speech recognition. The hardware of the reporting system consists of a speech recognizer DP-200(NEC) and a personal computer PC-8801 or PC 9801. The DP-200 has the capability of storing 500 different words spoken by a radiologist. At present, three application programs have been designed. These are for the interpretation of a liver scintigram, a bone scintigram and a chest radiograph. Data entry is done by the radiologist at a CRT display terminal in a conversational manner with predefined and predetermined branching. The time required to make a normal report using the liver or bone scintigram system was within one minute. The reporting time was several minutes in the case of an abnormality report. It is suggested that the system is useful for making an imaging report, for constructing the data base for the interpretation of medical images and for the picture archiving and communication system. PMID- 3627032 TI - [Effect of plasmapheresis treatment with a membrane filter on various parameters of hemostasis]. PMID- 3627033 TI - [Gastroenterologic and neurologic manifestations in acute intermittent porphyria]. PMID- 3627034 TI - [Clinicopathologic conference. Paraneoplastic Cushing syndrome in adenocarcinoma of the lung. A clinical, biochemical and histopathologic study]. PMID- 3627035 TI - Pathophysiology of multiple organ failure with "sepsis". PMID- 3627036 TI - [Yersinia arthritis: a relatively frequent and relatively unknown disease]. PMID- 3627037 TI - Cardiac anesthesia in Jordan--statistical analysis. PMID- 3627038 TI - Malignant hyperthermia in Jordan. PMID- 3627040 TI - Intravenous sedation in dental surgery. AB - A study on intravenous sedation in dental surgery was conducted comparing diazepam and fentanyl with midazolam and fentanyl. The total number of patients was one hundred and eighty patients. One hundred and twenty patients received diazepam and fentanyl, and later when midazolam was available sixty patients received this drug with fentanyl. The cardiovascular effects, the anterograde amnesia and adverse venous sequelae were investigated. Both drugs gave safe and acceptable sedation. The diazepam group had more venous sequelae. The midazolam group had better amnesia effects with no incidence of venous sequelae. PMID- 3627039 TI - Fluid therapy in major trauma. PMID- 3627041 TI - A comparative study of midazolam and thiopentone for induction of anesthesia for short operations. AB - Midazolam has been studied as an induction agent compared to thiopentone in forty patients. Few drawbacks were noted, but these included a fall in systolic and diastolic blood pressures, respiratory upsets and longer induction and recovery times compared to thiopentone. The difference between these two agents is statistically significant. The midazolam group took a longer time (after discontinuation of inhalational anesthetics) to respond to commands and perform certain tasks during the process of recovery. We concluded that thiopentone is preferable to midazolam as an induction agent. PMID- 3627043 TI - Nitrous oxide poisoning--a report on eight cases in Jordan. PMID- 3627042 TI - Flunitrazepam and ketamine anesthesia in plastic surgery. PMID- 3627044 TI - Obstructed wire reinforced latex tubes--a report on five cases. PMID- 3627045 TI - Aluminium load in patients with analgesic nephropathy. AB - It is well-known that plasma aluminium in haemodialysis patients increases with the amount of aluminium hydroxide consumption. In a cross-sectional study at our haemodialysis centre we found that mean plasma aluminium levels are significantly higher in haemodialysis patients with analgesic-associated nephropathy (AAN) than in haemodialysis patients with other kidney diseases (controls) (logarithmic mean +/- SD = 1.93 +/- antilog 0.32 versus 1.21 +/- antilog 0.31 mumol/l; p = 0.001). AAN patients consume a significantly higher amount of aluminium-containing phosphate binders than the controls (21 +/- antilog 0.3 versus 13 +/- antilog 0.4 g/kg body weight/year; p = 0.007). These findings may be explained by the higher incidence of peptic ulcer disease in AAN patients, since hyperacidity decreases the phosphate-binding effect. Analgesic patients also need more aluminium containing stomach medication than do patients with other kidney diseases (0.21 +/- antilog 1.15 versus 0.03 +/- antilog 0.87 g/kg body weight/year; p = 0.0001). A statistically significant correlation was obtained between bone aluminium and duration of phosphate binder consumption (r = 0.6459; n = 14; p less than 0.05). There was no correlation between plasma aluminium and bone aluminium. Anaemia was more pronounced in the AAN patients than in the others (mean haemoglobin 8.4 +/- 1.9 vs. 9.2 +/- 2.0 g%; p less than 0.02). Dialysis dementia was observed in 4 AAN patients. We conclude that the higher plasma aluminium levels in AAN patients represent a higher aluminium load which may be followed by higher aluminium toxicity. PMID- 3627046 TI - Renal handling of sodium, potassium, calcium and phosphate by medulla. AB - The role of renal papilla on solute excretion was studied in rats having one papillectomized kidney (PTX) and one partially nephrectomized kidney with intact papilla (PTN). Glomerular filtration rate (GFR) was similar between the PTX kidney (0.14 +/- 0.01 ml/min/100 g) and PTN kidney (0.16 +/- 0.03 ml/min/100 g). Urinary Na excretion (UNaV = 1.03 +/- 0.36 mu Eq/min) and fractional Na excretion (FENa = 1.72 +/- 0.56%) of PTX kidney were nearly 10-fold greater than those of PTN kidney, respectively (UNaV = 0.11 +/- 0.04, p less than 0.03; FENa = 0.19 +/- 0.05, p less than 0.02) during hydropenia. After 5% saline expansion GFR of PTX kidney (0.23 +/- 0.03 ml/min/100 g) and PTN kidney (0.25 +/- 0.05 ml/min/100 g) were increased significantly. Na excretion was greatly increased in both kidneys; however, PTX kidney still excreted nearly 4-fold more Na than the PTN kidney. Ca and P excretions were not different between the PTX kidney and PTN kidney. Neither was K excretion different between the two kidneys during hydropenia or after KCl infusion. The results indicate that renal papilla does not regulate Ca, P and K excretions in the presence of moderate reduction of GFR; however, it plays an important role in the final excretion of urinary Na. PMID- 3627047 TI - Lack of influence of volume flux on phosphate reabsorption in the proximal tubule. AB - We examined the effects of changes in volume flux, with or without changes in sodium flux, on phosphate reabsorption in the proximal convoluted tubule of the rabbit. Experiments were performed: before and after the addition of 10(-5) M ouabain, with a bath of 260, 290, or 320 mosm/kg and a perfusate of 290, and with change in perfusion rate from 15 to 5 nl/min. With the addition of ouabain, volume reabsorption was completely inhibited and phosphate flux decreased significantly. When volume flux was altered without a corresponding change in sodium flux by altering bath osmolality, no change in phosphate flux was noted even though volume flux increased with the hyperosmotic bath and decreased with the hypoosmotic bath. When perfusion rate was decreased from 15 to 5 nl/min, volume reabsorption decreased by 47% and phosphate reabsorption decreased by 45%. Under these circumstances net sodium flux would be expected to decrease. These results are consistent with a relationship between phosphate and sodium, but not fluid, reabsorption. Furthermore, the absence of a relationship between phosphate and volume flux driven by osmotic gradients would suggest that the paracellular pathway is not a significant route of phosphate flux. PMID- 3627048 TI - Influence of dietary zinc content on sodium and potassium metabolism in the rat. AB - The effect of dietary zinc on the sodium and potassium levels in plasma, soft and peripheral tissues, bone and hair were determined. Sodium levels in plasma, lung and skin of rats fed on a zinc-deficient diet (1.0 microgram/Zn/g) for 4 weeks were significantly lower than those of rats fed on a zinc-sufficient diet (37.5 micrograms Zn/g). Also when rats were fed a zinc-supplemented diet (1 mg Zn/g), sodium levels in hair, femur, muscle and skin were significantly lower than in controls. Interestingly, hair sodium levels were inversely related to the zinc contents in the diets. The potassium levels in fumur, lung, liver, kidney, muscle and skin in zinc-deficient rats and those in hair, femur and skin in zinc supplemented rats were lower than in controls. In heart they were higher than in controls when rats were fed on either a zinc-deficient or zinc-supplemented diet, but the levels in the kidney increased in relation to the zinc contents in the diets. These results suggest that dietary zinc influences the body sodium and potassium status of animals, that the influence of dietary zinc on organ and peripheral tissues is tissue-specific, that zinc supplementation appears to be beneficial for salt balance of kidney, and that hair sodium content may be a new criterion as to the zinc status of human subjects. PMID- 3627049 TI - Renal basolateral membrane Na-Ca exchange is electrogenic. AB - A Na-Ca exchange system is present in highly purified basolateral renal tubular membranes. In the present study we examined the electrogenicity of the system by measuring 45Ca uptake in the presence of favorable electric gradient created by K and valinomycin, by measuring the uptake of the lipophilic cation methytriphenylphosphonium (MTPP+) and by utilizing the voltage-sensitive dye DiS C3(5). In the presence of an inward directed K gradient, 45Ca uptake in basolateral vesicles loaded with Na and suspended in K was significantly higher in the presence than in the absence of valinomycin. Under conditions favoring the operation of Na-Ca exchange system (i.e. outward directed Na gradient and in presence of external calcium) MTPP+ uptake was significantly higher in the presence than in the absence of a Na. Na-dependent Ca uptake was associated with a decrease in the fluorescence of the voltage-sensitive dye DiS-C3(5), indicating hyperpolarization. Conversely, Na-dependent Ca extrusion was associated with an increase in the fluorescence of the dye indicating depolarization. The fluorescence changes seemed to be specific for Na and Ca since they could not be reproduced when Li replaced Na or when Mg replaced Ca. These data demonstrate that the Na-Ca exchange system in renal basolateral membranes is electrogenic with stoichiometry greater than 2:1 Na:Ca ratio. PMID- 3627050 TI - Chloride measurement by microelectrode in cystic fibrosis and normal sweat. AB - The Lazar Ultra-M chloride-specific microelectrode was evaluated in a series of experiments designed to assess its suitability for the routine determination of human sweat chloride concentrations. NaCl solutions were used to construct a standard curve, and same-day variations in experimental results were less than 1%, while day-to-day variation was also less than 1%. Human sweat collected following pilocarpine iontophoresis was used to compare the chloride concentration measured titrimetrically by a hospital laboratory or by liquid chromatography with the value measured by the microelectrode. There was excellent correlation between each of the methods (r = 0.97). No false positive results were reported in 55 patients whose sweat chloride concentrations ranged from 7 to 43 mmol/l and no false negative values were reported from 6 patients with elevated sweat chloride concentrations (60-124 mmol/l). These results indicate that this new chloride microelectrode offers a simple and reliable method for sweat chloride measurement. PMID- 3627051 TI - Evaluation of factors involved in calcium stone formation. AB - The role of urinary calcium oxalate supersaturation in the initiation of calcium stone formation is unclear since 24-hour urine collections from both stone formers and nonstone-formers are supersaturated for calcium oxalate. Urinary supersaturation for calcium phosphate, uric acid, and monosodium urate or decreased excretion of inhibitors of stone formation, citrate and magnesium, may also contribute to calcium stone formation. To assess these possibilities we studied variations within 24 h of determinants for calcium stone formation. Six consecutive 4-hour urine specimens were collected from stone-formers (n = 15) and nonstone-formers (n = 11) during their usual diet and activities. Compared to nonstone-formers, urine from stone-formers had increased calcium concentrations, while pH and oxalate, phosphorus, uric acid, magnesium and citrate concentrations were not different. Urine from both stone-formers and nonstone-formers was always supersaturated for calcium oxalate, uric acid and monosodium urate with no difference between the groups. Urine from stone-formers was always supersaturated for calcium phosphate as brushite, while urine from nonstone-formers was mostly undersaturated for brushite. In addition to these physicochemical studies, we reviewed the composition of 235 stones containing calcium oxalate and analyzed it by crystallography. The center of 67% of these stones contained calcium phosphate. These physicochemical and stone analysis data suggest that precipitation of a calcium phosphate crystal nidus may contribute to the initiation of many calcium stones. PMID- 3627052 TI - Urolithiasis. PMID- 3627053 TI - Cystinuria--an experience in management over 18 years. AB - Data on 23 patients with cystinuria are presented. These have been analysed for age, sex and the incidence of surgical procedure. Urinary amino acid data have been analysed to confirm homozygosity which was achieved in all but one of the cases. Guidelines are presented concerning surgical and medical management of the patients, and some results of percutaneous lithotripsy are presented. PMID- 3627054 TI - Medical treatment to prevent recurrent calcium urolithiasis. A guide to critical appraisal. AB - Among patients with urolithiasis, the recurrence rate is 10-23% per year. We have applied guidelines for critical appraisal to 46 publications addressing the efficacy of thiazides, orthophosphates, cellulose phosphate, allopurinol, magnesium and citrate as prophylaxis against recurrent urolithiasis. The 34 studies which do not have a randomly allocated control group are subject to methodologic deficiencies such as co-intervention, variable outcome measures, variable natural history, statistical regression to the mean, selection bias and incomplete follow-up of patients. These deficiencies make conclusions regarding the efficacy of an intervention suspect. Among the 12 randomized clinical trials are 5 thiazide, 2 orthophosphate, 4 allopurinol and 1 magnesium intervention. The methodologic and statistical questions addressed were: adequacy of randomization, clinical relevance of outcomes, description of patients, clinical and statistical significance, and completeness of follow-up. Based on these methodologic considerations, one could not conclude that orthophosphates, cellulose phosphate, magnesium or citrate were efficacious in preventing recurrent urolithiasis. Two of the 5 thiazide and 1 of the 4 allopurinol randomized clinical trials demonstrate convincing evidence for efficacy of these interventions. With the exception of pilot studies of new interventions, conclusions about efficacy of interventions claimed to decrease the urolithiasis recurrence rate should be based on methodologically sound randomized clinical trials. PMID- 3627055 TI - [Retinopathy of prematurity. 7-year case series]. PMID- 3627056 TI - [Audiologic problems in achondroplastics]. PMID- 3627057 TI - [Omphalocele and congenital heart defects. Clinico-statistical study]. PMID- 3627058 TI - [Computerized management of a pediatric ambulatory care record file]. PMID- 3627060 TI - [Perfusional pulmonary scintigraphy using 99mTc-MISA in newborn infants]. PMID- 3627059 TI - [Acute appendicitis in the 1st three years of life: analysis of diagnostic problems and complications]. PMID- 3627061 TI - [Visceral larva migrans syndrome (toxocariasis). 2 cases in childhood]. PMID- 3627062 TI - [Ring chromosome 22. Description of a clinical case]. PMID- 3627063 TI - [Gaucher's disease type I. Presentation of a clinical case]. PMID- 3627064 TI - [Clinical picture and anatomopathologic findings in a case of the lymphomucocutaneous syndrome (Kawasaki disease)]. PMID- 3627065 TI - [Treatment of juvenile rheumatoid arthritis with gold salts. Follow-up after 2 years of treatment]. PMID- 3627066 TI - [Evaluation of the eradicating capacity of xibornol in pediatric pharyngeal carriers of beta-hemolytic streptococci and study of the interaction between the drug and the chemiluminescent activity of PMN leukocytes]. PMID- 3627067 TI - [Holoprosencephaly. Presentation of a case and review of the literature]. PMID- 3627068 TI - [X-linked lymphoproliferative disorder (Duncan's syndrome). 2 possible clinical cases]. PMID- 3627069 TI - [Partial 3q trisomy. Description of a case and review of the literature]. PMID- 3627070 TI - [Infantile transient erythroblastopenia. Description of a clinical case]. PMID- 3627071 TI - [Idiopathic transient hyperphosphatemia. Description of a case]. PMID- 3627072 TI - [Selective anti-inflammatory therapy in infantile rheumatoid arthritis]. PMID- 3627073 TI - Neonatal behavioural correlates of prenatal exposure to marihuana, cigarettes and alcohol in a low risk population. AB - Infant neonatal behaviour is significantly and differentially related to maternal marihuana, cigarette and alcohol use during pregnancy. Data on 250 babies born to healthy, predominantly middle-class women were analyzed using canonical analysis and multiple regression adjusting for potentially confounding variables. Prenatal marihuana exposure was associated with increased tremors and startles and poorer habituation to visual stimuli, prenatal cigarette exposure with increased tremors and poorer auditory habituation, whereas a relatively low level of alcohol consumption was marginally related to increased neonatal irritability. PMID- 3627074 TI - Prenatal alcohol exposure: effects on acoustic startle and prepulse inhibition. AB - The present study evaluated the effects of prenatal exposure to alcohol on the acoustic startle reflex and prepulse inhibition in rats. Pregnant rats consumed an average of 12.36 g/kg/day of ethanol in a saccharin solution which served as their sole fluid source throughout gestation. Their offspring were found to be developmentally delayed on tests of physical maturation, but were not consistently impaired on tests of neuroreflexive development when compared to pair-fed and ad lib control groups. With development, subjects in the ethanol exposed group exhibited enhanced reactivity to an acoustic startle stimulus, which was evident at 35 but not at 21 days of age. In contrast, general activity levels were similar for all groups at 35 days of age, and there was no apparent disruption of the inhibitory effects of a prepulse stimulus. These results provide evidence that in utero exposure to alcohol may result in age dependent hyperreactivity, with no obvious disruption of normal prepulse inhibition or general activity levels. PMID- 3627075 TI - Influence of prenatal exposure to cimetidine and alcohol on selected morphological parameters of sexual differentiation: a preliminary report. AB - Pregnant rats were administered ethanol, cimetidine or a combination of both drugs from day 14 of gestation until parturition. Ano-genital (AG) distance measured at birth was significantly reduced in males exposed to cimetidine, but not in males or females exposed to alcohol. AG distance in males exposed to both ethanol and cimetidine also was not reduced, indicating a possible protective influence of ethanol against this effect of cimetidine. Birthweights in both sexes were reduced by prenatal ethanol exposure, both alone and with cimetidine exposure. Prenatal cimetidine exposure, both alone and in combination with ethanol significantly reduced seminal vesicle weights of adult males. However, no long-term effects of ethanol or cimetidine were observed on adrenal, testicular or ovarian weights. These results indicate that when fetal alcohol exposure is restricted to the critical prenatal period for hormonal actions on sexual differentiation, testosterone levels are maintained at an adequate level for normal morphological development of the genitalia. PMID- 3627076 TI - Effects of pyrethroid insecticides on operant responding maintained by food. AB - The pyrethroids are potent insecticides with low concomitant mammalian lethality when compared with other major insecticides. While high doses can lead to hyperactivity, tremors, convulsion and death, low doses have not been as well studied. Since operant behavior can be a sensitive measure of CNS function, male Holtzman rats were trained on a VR25 schedule maintained by 45 mg food pellets. Rats were injected IP with one of four different technical grade pyrethroids: permethrin, allethrin, deltamethrin and fenvalerate. All agents were effective in reducing operant responding and did so in a dose-dependent manner at levels 10 to 100 times below their LD50 values. Time course studies indicated a relatively short duration of action for the Type I agents of less than 60 min for permethrin and 15 min for allethrin. Type II agents were generally effective for greater than 60 min. Results of these studies indicate that operant responding maintained by food is a sensitive measure of the behaviorally disruptive effects of subconvulsive doses of pyrethroids. PMID- 3627077 TI - Low level lead exposure during lactation increases rough and tumble play fighting of juvenile rats. AB - Lactating rats were given distilled water or distilled water containing 0.067% lead chloride (500 ppm lead) as their sole source of drinking fluid from Days 1 21 of lactation. Activity, social investigation and rough and tumble play fighting behaviors of the offspring were observed on Day 26 and activity and play solicitation behaviors on Day 36. Although lead treatment reduced the mothers' fluid intake, there were no effects on pup growth and activity or on maternal behaviors. When paired with a group-housed stimulus animal on Day 26, lead treated subjects had increases in the two measures of play fighting (crossover and pinning), and in social investigation, relative to controls. When tested with a scopolamine-treated, non-playful stimulus on Day 36, increased crossover frequencies were observed in lead-treated subjects when compared with controls. Two-min activity levels on Days 26 and 35 were unaffected by lead exposure. These results indicate that social interactive behaviors of juvenile rats are effective tools in the assessment of exposure to toxic substances early in development. PMID- 3627078 TI - Theophylline-induced changes in the mouse brainstem auditory evoked potential. AB - Because theophylline is a widely used analeptic, there is interest in its possible ototoxic and neurotoxic effects. The present study used the brainstem auditory evoked potential (BAEP) to evaluate the acute effects of theophylline on auditory electrophysiology in mice. Adult female C57BL/6 mice were injected intraperitoneally with 150 mg/kg theophylline or saline. The BAEP thresholds and latency-intensity profiles suggested that theophylline induced a rather slight but statistically significant change in auditory function that was suggestive of a temporary recruitment-type sensorineural deficit. This observation raises concerns about the possible ototoxic effects of theophylline, particularly in asthmatic patients and apneic preterm neonates who receive this drug chronically. While there was BAEP evidence of ototoxic effects for theophylline, there was no evidence of neurotoxic effects. PMID- 3627079 TI - Effects of trialkyltins on the schedule-controlled behavior of the pigeon. AB - Male White Carneaux pigeons trained to respond for food under a multiple fixed ratio fixed-interval schedule of reinforcement were given single injections of trimethyltin (TMT), or triethyltin (TET). A dose of 0.3 mg/kg TMT produced no effect on behavior, while a 1.0 mg/kg dose was a threshold dose and 1.75 mg/kg produced behavioral changes that persisted for months in some birds. TMT produced effects on responding under the multiple schedule at approximately the same doses that produce neuronal damage in the hippocampus and the brain stem of the pigeon. Higher doses given to untrained birds produced signs of extensive neurological damage. A dose of 1.0 mg/kg of TET decreased rates of responding under both schedule components three hours after administration, but behavior usually had recovered by the next day. Doses of 3.0 and 5.6 mg/kg had similar effects, but responding did not recover for several days. Some birds showed significant rate increases, especially under the fixed-interval component several days to several weeks after TET administration. Doses greater than 10 mg/kg TET were lethal. Dose effect curves for the effects of d-amphetamine, chlorpromazine and morphine on responding under the multiple schedule were determined for some birds before and one month after 1.0 and 1.5 mg/kg of TMT. TMT shifted the dose-effect curve for d amphetamine to the right, but it did not produce systematic changes in the dose effect curves for morphine and chlorpromazine. PMID- 3627080 TI - Effects of subdiaphragmatic vagotomy on the acquisition of a radiation-induced conditioned taste aversion. AB - The effect of subdiaphragmatic vagotomy on the acquisition of a radiation-induced taste aversion was examined to assess the importance of the vagus nerve in transmitting information on the peripheral toxicity of radiation to the brain. Vagotomy had no effect on taste aversion learning, consistent with reports using other toxins. The data support the involvement of a blood-borne factor in the acquisition of taste aversion induced by ionizing radiation. PMID- 3627081 TI - Diazepam and caffeine administration during the first week of life: changes in neonatal and adolescent behavior. AB - The male offspring of hooded Lister rats were fostered at birth into 23 experimental litters. One pup in each litter was allocated to each of the following treatment groups: vehicle control; caffeine (15 or 30 mg/kg); diazepam (10 mg/kg, alone or plus caffeine 15 or 30 mg/kg). Pups were given daily injections on neonatal days 1-7 and were observed for 15 min following each injection. Diazepam significantly increased paddling and forward walking, particularly on days 5 and 7; caffeine also increased these behaviors, but less markedly. Diazepam increased the incidence of clonic jerks, particularly on day 7 and increased the spontaneous loss of righting reflex. The pups were then left undisturbed until weaning at day 21 and testing from days 35-42. There were no lasting effects of the neonatal treatments in two tests of anxiety, or in passive avoidance performance. Rats that had been treated neonatally with diazepam had significantly lower motor activity scores and reared less in the holeboard than did controls, and neonatal treatment with caffeine also resulted in lower motor activity scores. Neonatal treatment with caffeine made rats more aggressive (increased kicking and pushing) when they were intruding into another rat's territory. Neonatal treatment with diazepam increased aggression in resident rats, and this was counteracted by neonatal treatment with caffeine. Neonatal caffeine treatment enhanced rats' unconditioned preference for the black chamber in a black-white preference test and neonatal diazepam treatment reduced it. PMID- 3627082 TI - Thermoregulation in mice following acute administration of lead acetate. AB - Several reports in the literature suggest a relationship between lead intoxication and thermoregulatory capacity. To investigate the effects of lead on the control of body temperature, mice of the BALB/c strain were injected intraperitoneally with lead acetate (0 to 100 mg/kg) while colonic temperature was measured 30, 60, and 90 min post-injection at ambient temperatures (Ta) of 20 and 30 degrees C. Lead acetate caused a transient hypothermia, an effect which was augmented at cooler Ta's. In a second experiment, mice were injected with 100 mg/kg lead acetate and placed in a longitudinal temperature gradient to measure their preferred Ta. Lead acetate significantly reduced the preferred Ta during the first 30 min post-injection which augmented the lead-induced hypothermia. In a third experiment it was found that lead acetate-induced lethality was potentiated with increasing Ta. Hence, the hypothermic response to acute lead acetate treatment may be beneficial to survival. PMID- 3627083 TI - Latent dichlorvos neurotoxicity detected by vagal tone monitoring in dogs. AB - Dichlorvos (dimethyl 2,2-dichlorovinyl phosphate) was administered orally to German Shorthair Pointer dogs at approximately 60 mg/kg (twice the usual clinical dose). Plasma and erythrocyte cholinesterase (ChE) was monitored prior to, 90 min, and 180 min post-ingestion. 2-PAM (20 mg/kg IV) and atropine sulfate (0.022 mg/kg IM) were administered 90 min after the dichlorvos to paired treated and control dogs. The telemetered electrocardiographic (ECG) signal was analyzed by a Vagal Tone Monitor (VTM) to yield mean heart period (msec) and an estimate of the amplitude of respiratory sinus arrhythmia (V in natural log values of msec2) for five min intervals. Dichlorvos did not cause cholinomimetic symptoms even though blood cholinesterase was significantly inhibited (plasma -51.3% and erythrocyte 43.7%). The atropine sulfate treatment resulted in the expected vagolytic effects in both the control and the dichlorvos treated dogs, but the atropine effects were attenuated in the latter dogs. Three weeks later, ChE activity was not significantly depressed in the dichlorvos treated dogs, and their V responses to atropine were more similar to the responses in control dogs. PMID- 3627084 TI - Neurobehavioral effects of dietary restriction in rats. AB - The effects of reduced body weight gain on nervous system function of young male Fischer 344 rats were examined. The rats were fed 15% ('mild') or 50% ('severe') less than the controls. Mild and severe dietary restriction resulted in 9% and 38% lower body weight compared to the controls. Mild dietary restriction caused slight changes in flash evoked potentials, auditory brainstem responses, caudal nerve action potentials, and body temperature. Severe dietary restriction increased the magnitude of the effects noted in the mild group, as well as causing a significant decrease in grip strength. Somatosensory evoked responses were not affected by either mild or severe restriction. Diet restricted rats were more excitable while restrained for testing. Thus, dietary restriction has significant effects on numerous behavioral and neurophysiological parameters that should be considered in the interpretation of neurotoxicological data when body weight differences are present. PMID- 3627085 TI - Effects of intraperitoneal carbon monoxide on fixed-ratio and screen-test performance in the mouse. AB - The behavioral effects of carbon monoxide (CO) administered via IP injection were investigated in the mouse. Mice were trained to lever press under a fixed-ratio (FR) 100 schedule of water reinforcement. Thirty-min test sessions were conducted either immediately or 30 min following IP injections of air (100 ml/kg) or CO (7.5, 15, 30, 50 or 100 ml/kg). CO produced a decrease in rates of responding which was exhibited earlier and lasted longer with increasing doses. Motor performance was also measured with the inverted-screen test following the same doses of CO at either 5, 15, 30, 60, 120 min or 24 hr post-injection. Performance was affected in a dose- and time-dependent fashion. Peak carboxyhemoglobin (COHb) levels were observed at 15 or 30 min and were 20%, 32%, 42%, 51% and 60% for 7.5, 15, 30, 50 and 100 ml/kg CO, respectively. COHb saturation alone was not always a good predictor of behavioral effects since both level and duration of exposure contributed to behavioral impairment. The results also show that the IP route can be used to study the toxicity of CO. PMID- 3627086 TI - Effect of low level carbon monoxide on compensatory tracking and event monitoring. AB - Experiments by Putz et al. concerning the effect of carbon monoxide (CO) exposure on compensatory tracking and monitoring in healthy young men were replicated. Task and procedural variables were reproduced as closely as practical. Subjects were exposed to either room air or 100 ppm CO. Mean carboxyhemoglobin (COHb) levels in the high CO exposure groups were 5.1% for Putz et al. (70 ppm exposure), and 8.24% for the present study (100 ppm exposure). In both studies elevated COHb produced a statistically significant increase over time in log mean absolute deviation scores (tracking error) with respect to control groups. The magnitude of the effect was smaller in the present study, perhaps because of subtle methodological or training differences between studies. The relationship between task difficulty and magnitude of CO-induced dysfunction remains unresolved. In contrast to Putz et al., no statistically significant effect of COHb in monitoring behavior was found. The failure to replicate this feature of may reflect the large differences in baseline performance, and higher variance in the present study. PMID- 3627087 TI - Maze learning in rats: a comparison of performance in two water mazes in progeny prenatally exposed to different doses of phenytoin. AB - Pregnant Sprague-Dawley CD rats were administered phenytoin by gavage on days 7 18 of gestation in doses of 0, 100, 150 and 200 mg/kg. At 46-53 days of age rat offspring in each litter were divided with half tested in a Biel water maze and half in a new, more complex water maze. On the first test day all rats were tested in a straight channel. On subsequent days rats received 5 trials in the Biel maze or 6 trials in the new maze in path A, followed by 6 trials in path B (in which the start and goal positions were reversed). Analyses showed that phenytoin increased offspring mortality shortly after birth at the highest dose, but did not affect growth at any dose. Phenytoin had no effects on straight channel swimming performance. Analyses of maze performance showed that both mazes differentiated phenytoin offspring from controls, but that the new, more complex maze distinguished the groups more definitively. Maze errors also showed a clear dose-response relationship in the new maze, while no such distinctions were seen in the Biel maze. It was concluded that the new maze design may offer significant gains over the Biel maze in terms of detection sensitivity to prenatally induced CNS injury. PMID- 3627088 TI - Alterations in sensorimotor development: relationship to postnatal alcohol exposure. AB - The sensory, motor, and physical development of rats reared by dams, artificially reared on milk formula alone, or on milk formula combined with alcohol was examined. The rats given alcohol received 6.6 g/kg/day, which was administered either as 12 fractions distributed uniformly over 24 hours and resulted in stable blood alcohol concentrations (BACs) of 85 mg/dl, or condensed into 4 fractions over 8 hours and resulted in maximum and minimum BACs of 411 mg/dl and 45 mg/dl, respectively. Pups were reared artificially from postnatal days 4 to 12 with alcohol exposure occurring on days 4 to 10. A sensorimotor test battery was then administered from postnatal day 12 to postnatal day 30. The condensed alcohol exposure resulted in age-dependent hyperactivity, a delay in tooth eruption, disruption of balance and of the ability to use the hindlimbs in a coordinated fashion, and a delay in the acquisition of the midair righting reflex. The midair righting reflex also was disrupted by uniform alcohol exposure. Thus, postnatal alcohol exposure that produces high BACs causes more severe developmental aberrations than the same daily dose administered in a pattern producing low BACs. PMID- 3627090 TI - Neurocutaneous disorders. PMID- 3627089 TI - Deficits on a spatial navigation task following prenatal exposure to ethanol. AB - Performance on a Morris water task was examined in young rats whose mothers consumed a liquid diet consisting of 35% ethanol-derived calories (EDC) during pregnancy. Offspring of pair-fed (0% EDC) and ad lib lab chow (LC) dams served as controls. Rats were required to find a platform submerged below the surface in a pool of opaque water. A trial ended when the rat remained on the platform for 15 sec, or had been in the tank for 180 sec without reaching the platform. Subjects received 5 trials daily for 3 consecutive days, followed by reversal training on Day 4. Groups did not differ in swimming ability. On Day 1 there were no group differences among females in latency to reach the platform or in distance traveled, but male 35% EDC and 0% EDC animals had shorter latencies than LC controls. On Day 2, latencies and distance traveled of LC and 0% EDC controls decreased while 35% EDC animals showed no change from Day 1, so that alcohol exposed rats took longer to reach the platform and traveled a greater distance than controls. On Day 3, 35% EDC females took longer than controls to reach the platform, and 35% EDC animals of both sexes traveled a greater distance than controls. Search patterns on the first reversal trial on Day 4 suggest the differences are in spatial processing and not learning per se, but more so in alcohol-exposed males than females. The impaired performance on this task suggests that prenatal alcohol exposure alters the ability to process spatial information. PMID- 3627091 TI - [Experimental studies on thermotolerance in hyperthermia treatment of cancer]. AB - Thermotolerance was investigated in hyperthermia using FM3A cells in vitro and in vivo. FM3A cells were heated at 42.0 degrees C, 43.0 degrees C and 44.0 degrees C and the survival rate of the cells was decreased in this order. In in vitro experiments, thermotolerance induced by heating at 43.0 degrees C for 30 min reached at maximum, when the heating interval was 12 hr and thermotolerance induced by heating at 44.0 degrees C for 30 min reached at maximum, when the heating interval was 12 to 24 hr. In in vivo experiments, thermotolerance induced by heating at 42.0 degrees C, 43.0 degrees C and 44.0 degrees C continued for 48 hr after initial heating and disappeared after 96 hr. In the repeated hyperthermia experiments, 7 times with 24 hr interval heating or 4 times with 48 hr interval heating did not show the significant inhibition of tumor growth as compared with the control group at 42.0 degrees C, 43.0 degrees C and 44.0 degrees C. However, twice with 96 hr interval heating indicated the significant inhibition of tumor growth at 42.0 degrees C, 43.0 degrees C and 44.0 degrees C. From these results it is suggested that hyperthermia treatment should be repeated after the disappearance of thermotolerance. PMID- 3627092 TI - [Endotoxemia after surgery in digestive diseases]. AB - The blood level of endotoxin after operations in patients with digestive diseases, mainly liver cirrhosis and obstructive jaundice, and the complications most likely related to the presence of endotoxemia were investigated. Twenty seven patients without either liver cirrhosis or obstructive jaundice showed a minimal elevation of the endotoxin level in blood, as shown by 6.1 +/- 3.9 pg/ml at the first postoperative day and there was only one anastomotic leakage. On the other hand, 18 patients with liver cirrhosis showed a notable and persistent endotoxemia after surgery. The cirrhotic patients who especially underwent splenectomy and hepatectomy showed marked elevations of endotoxin level at the first postoperative day, with values of 151.0 +/- 46.1 pg/ml and 101.3 +/- 36.2 pg/ml, respectively, and one of these patients died of hepatic failure. Thirteen patients with obstructive jaundice developed endotoxemia evidenced by the value of 21.6 +/- 4.8 pg/ml at the first day after surgery. Among these patients, two had gastrointestinal bleeding and one developed DIC. The markedly high and persistent levels of endotoxin in patients with liver cirrhosis or obstructive jaundice may be possibly related with the development of MOF. PMID- 3627093 TI - [Diagnosis of degree of serosal invasion of carcinoma of the colon by angiography]. AB - Angiography (AG) using Prostaglandin E1 was performed on 35 cases of carcinoma of the colon in order to diagnose the degree of serosal invasion. The findings of AG were classified into 4 groups: AG-S3, abnormal change (like irregularity and/or encasement) up to marginal vessels; AG-S2, abnormality up to vasa recta; AG-S1, abnormality of penetrating branches of vasa recta; AG-S0, no distinct findings of above mentioned vessels. 1) Diagnosis of AG is in accord with the visible postoperative findings in 82.9%. 2) Diagnosis of AG is in accord with the histopathological findings in 32.4%. 3) Postoperative examinations confirmed the AG diagnosis precisely but the conflict with histopathological findings should not be overlooked. This may be the results of inflammatory change, adhesion and fibrosis around the carcinoma of the colon. PMID- 3627094 TI - [Experimental and clinical studies on the effect of reticuloendothelial system (RES) potentiator in the depressed RES function in cirrhotics]. AB - Among the patients with liver cirrhosis (LC) who undergo the operation, the postoperative complications are not infrequent and sometimes prove fatal. The impaired hepatic function, especially the impaired reticuloendothelial system (RES) function, has been claimed to be a possible pathogenic factor for these complications. The present experimental and clinical studies were undertaken to investigate the RES function and the effect of preoperative OK-432 administration as an RES potentiator in LC. The results are as follows: 1) CCl4-induced LC rats were evaluated for RES global phagocytic function, Kupffer cell phagocytic function, plasma opsonic activity and plasma opsonic substances such as fibronectin, C3 and IgG. All parameters except IgG showed significant depression compared to those values in normal rats. However, the administration of OK-432 (0.1 KE/rat, ip) improved all these depressed parameters. The OK-432 administration also significantly improved the survival following panperitonitis in LC rats. 2) Among 18 LC patients with hepatocellular carcinoma undergoing partial hepatectomy, the RES global phagocytic function, plasma opsonic activity and plasma opsonic substances were evaluated. Same as the experimental study, all parameters except IgG were significantly depressed among the LC patients compared to those values in the patients with normal liver. However, the preoperative OK 432 administration (5 KE/day sc for 4 days) significantly improved these parameters and consequently decreased the postoperative complications. These results indicate that the preoperative RES activation by the OK-432 was effective and useful for the prevention of the postoperative complications in the LC patients. PMID- 3627095 TI - [Experimental study on mechanism of onset of acute ulcer viewed from blood coagulation and activities of fibrinolysis after hepatectomy in liver cirrhosis]. AB - Using liver cirrhosis rats induced by intraperitoneal administration of 4% thioacetamide (TAA) consecutively for 10 weeks, the authors made a study on the activities of blood coagulation and fibrinolysis in the onset of acute ulcer after hepatectomy. The results were as follows: 1. On the 3rd day after hepatectomy increase in the portal blood pressure, approximate 30% decrease in gastric wall blood flow and increase in fibrinolysis in blood and gastric mucosa were observed. While no bleeding was recognized, edema and hyperemia were noticeable. 2. On the 3rd postoperative day when the maximum increase of fibrinolysis in blood and gastric mucosa was observed water immersion restraint stress was loade. Two hours after loading, fibrinolysis in blood and tissue increased further, and in accordance with it, bleeding and erosion were seen to a high degree in gastric mucosa. On the other hand, in the EACA group, in which anti-fibrinolytic agent, epsilon-amino carpic acid was administered, the increase was moderate in the fibrinolysis in blood and mucosa after loading the stress. Though bleeding and development of erosion were not completely controlled, values of fibriolytic activity of the tissue in the EACA group were lower than those of control group. PMID- 3627096 TI - [Pulmonary resection by microwave tissue coagulator (MTC)--clinical application]. AB - A 55 year old male with metastatic lung and liver cancer was subjected to pulmonary and hepatic resections using Microwave Tissue Coagulator (MTC). No adverse effects were observed in this patient after operation. The resected specimen of the lung had the bronchioli partially accompanied with cartilages. Coagulation for the bronchioli of at least lmm in size, by MTC, could be carried out resulting in no air leakage after operation. PMID- 3627097 TI - [Estrogen receptor kinetics in benign and malignant diseases of the breast and their clinical implication]. AB - Estrogen and progesterone binding capacities in the breast tissues were determined. Unoccupied cytoplasmic estrogen receptor (ERc) levels in 19(37%) out of 52 patients with breast cancer revealed more than 30fmol/mg protein. None of tissues from the benign breast diseases contained higher unoccupied ERc than 30fmol/mg protein. There was no significant difference between the level of unoccupied ERc in the patients with fibroadenoma and that in those with mastopathy. Occupied ERc levels were significantly lower than unoccupied ERc in the breast cancer, but the difference was not observed in benign breast diseases. Occupied nuclear estrogen receptor (ERn) levels were significantly lower than unoccupied ERn only in the premenopausal patients with breast cancer, but no significant difference was observed in the patients with benign breast diseases. The level of progesterone receptor (PgR) was low in both breast cancer and benign breast diseases. Serum estradiol (E2) and progesterone (PRG) concentrations were assayed on patients with the benign breast diseases who had regular menstrual cycles. Significant negative correlations were recognized between the levels of PRG and PgR at a luteal phase, but not between E2 and unoccupied ERc. Four (33%) out of 12 patients with recurrent breast cancer responded to the endocrine therapy. In three (75%) of the four responded patients unoccupied ERc level of the cancer tissue was more than 30fmol/mg protein. PMID- 3627098 TI - [A case of polypoid carcinoma of the left hepatic duct]. AB - A case of polypoid carcinoma of the left hepatic duct in 50-year-old male was reported. Extended left hepatic lobectomy with total caudate lobectomy and resection of the right hepatic duct were performed because the tumor involved the right hepatic duct and bile duct branches of caudate lobe, medial and lateral segment. Papillary growth of the tumor was diagnosed definitely by percutaneous transhepatic cholangioscopy (PTCS) and computed tomography. The tumor infiltrated the liver parenchyma of medial segment and compressed the middle hepatic vein. These findings were revealed by selective middle hepatic venography preoperatively. PMID- 3627099 TI - [Surgery of the patients on anticoagulants following prosthetic valve replacement]. AB - The surgical operations including 5 cholecystectomies, gastrectomy, and graft implantation for abdominal aortic aneurysm were performed on 7 patients 2 to 98 months after valve replacement. Sodium warfarin was routinely used in an amount to reduce the prothrombin activity in a range of 20-30% normal by thrombotest. In all cases, anticoagulants were reduced in doses gradually in the period of 4 to 15 days proceeding to the operation. Heparin therapy was instituted for the prevention of thromboembolism, when prothrombin activity recovered to 50% normal by thrombotest, in 5 of 7 cases. Heparin therapy was interrupted just prior to operations and it was reinstituted soon after operations in 6 cases. Heparin therapy was maintained by continuous intravenous infusion to produce ACT of 130 to 150 seconds. Heparin therapy was stopped when prothrombin activity reached a therapeutic level with sodium warfarin. There were two episodes of hemorrhage required blood transfusion, observed in patients receiving heparin therapy, but there was no thromboembolism. We believe that our method which minimizes the nonanticoagulated time appears safe and effective in patients with prosthetic heart valves who require noncardiac operations. PMID- 3627100 TI - [A case of carotid body tumor. A review of 84 cases in Japanese literature]. AB - We encountered one case of carotid body tumor. The patient was a 63-year-old man. The tumor was 5 cm X 6 cm in size, and it was strongly adhered to the carotid artery. Therefore, the tumor was removed with combined resection of the adherent lesion of the carotid artery. During the operation, we used a temporary external bypass method to prevent brain damage. The resected part of the carotid artery was reconstructed with saphenous vein graft. Angiogram one year after operation showed good patency of the graft. In Japanese literature, this is the second report of carotid body tumor removed by temporary bypass and the first report of use of a external bypass tube. PMID- 3627101 TI - [Evaluation of papillary function by intra-operative manometric study using a new catheter with a balloon]. PMID- 3627102 TI - [Intratumor injection of OK-432-stimulated peripheral blood mononuclear cells: a significance of mononuclear cell-producing tumor inhibitory factor induced by OK 432]. PMID- 3627103 TI - [Mechanism of insulin resistance in response to injury]. PMID- 3627104 TI - Symposium: The role of protein glycosylation in molecular and cellular recognition. December 29 and 30, 1985. Proceedings. PMID- 3627105 TI - Malonate transport in human red blood cells. AB - Kinetic parameters of [2-14C]malonate uptake by the human erythrocyte membrane have been determined as Km, 24 mM and turnover number, 5 X 10(4) s-1. The translocation of this organic dianion is concentration, pH and temperature dependent. Competitive inhibition of malonate uptake by eosin and inorganic anions, strongly implies that a common route exists for both inorganic anions and organic dianions, namely the anion-exchange Band 3 protein. 14C-Malonate which is nonmetabolized in the erythrocyte, could be a useful probe for monitoring anion exchange in reconstituted Band 3 systems. PMID- 3627106 TI - Direct measurement of vitamin K-dependent enzymes in various isolated and cultured tumor and non-tumor cells. AB - A modification of the assay for vitamin K-dependent carboxylase is described with which the enzyme could be detected in relatively low amounts of cells (n = 10(6)). Using this assay, we could demonstrate vitamin K-dependent carboxylase activity in hepatocytes, renal tubular cells, osteoblasts, endothelial cells and macrophages, but not in lymphocytes or platelets. The cultured tumor cells UMR 106, B16 and 5583 also contained vitamin K-dependent carboxylase activity. Vitamin K epoxide reductase activity was demonstrated only in cells where vitamin K-dependent carboxylase activity was present. The tumor cells possessed remarkably less K epoxide reductase activity than the normal cells. When cells were cultured in medium containing warfarin, the K epoxide reductase activity was found to be decreased and the amount of non-carboxylated precursor proteins had increased, suggesting an analogous vitamin K mechanism as in liver. PMID- 3627107 TI - Aminopeptidase P from bovine lung: solubilization, properties, and potential role in bradykinin degradation. AB - Aminopeptidase P was solubilized from bovine lung by sodium deoxycholate extraction of salt-washed, delipidated lung acetone powders. Hydrolysis of the standard aminopeptidase P substrate, Gly-Pro-Hyp, as well as cleavage of Arg-Pro Pro and the Arg1-Pro2 bond of bradykinin, co-eluted from a Mono Q anion exchange column and demonstrated identical inhibitory profiles suggesting that all activities were functions of the same enzyme. The metal chelator, 1,10 phenanthroline, completely inhibited activity suggesting that aminopeptidase P is a metallopeptidase. 2-Mercaptoethanol was both a potent and specific inhibitor of the enzyme (at 4 mM). A variety of other peptidase inhibitors showed either no effect or failed to completely inhibit even at high concentrations. The inhibitory profile and substrate specificity differ considerably from previous reports claiming to study the properties of this enzyme. Evidence is provided that aminopeptidase P may have an important role in the pulmonary degradation of the potent vasoactive peptide, bradykinin. PMID- 3627108 TI - An effect of corticosteroids on thymocytes not mediated by macromolecule synthesis. AB - Rat thymocytes were incubated for 2 min at 37 degrees C and the cells then broken by osmotic shock in 1.5 mM MgCl2 and the nuclei harvested. Treatment with 50 nM dexamethasone for 2 min resulted in about one third of nuclei showing abnormalities in appearance, in shape and density. This was not prevented by prior incubation for 10 min with actinomycin D and cycloheximide, but was when nuclei were isolated in the presence of anions larger than F- and Cl-, including I-, Br-, SO = 4 and citrate identical to. Subsequent addition of Cl- ion, however, resulted in development of abnormalities in steroid-treated nuclei. It is concluded that the steroid induces a mechanism resulting in influx of chloride ion leading to nuclear edema, which is not mediated by processes involving synthesis of macromolecules. PMID- 3627109 TI - Tuftsin induced tumor necrosis activity. AB - Tuftsin induced tumor necrosis activity was investigated. The activity was found in mice serum several days after i.p. injection of tuftsin. Further experiments with adhering peritoneal and spleen cells indicated that macrophages were the source of the observed activity. The same effect was observed when promyelocytic leukemia cells (HL60) were stimulated with different concentrations of the peptide. These showed yet another possible mechanism for tuftsin antineoplastic activity. PMID- 3627110 TI - Rabbit bone marrow glucose-6-phosphate dehydrogenase during erythroid cell development. AB - Studies were carried out on glucose-6-phosphate dehydrogenase (G6P-DH) during the differentiation of rabbit bone marrow erythroid cells. It was found that G6P-DH, although displaying a 7-fold activity decrease, did not change the relative amounts of its three dimeric forms. Using homogeneous enzyme preparations, we observed that from dividing to non-dividing erythroblasts the following properties remained constant: V max dependence on pH and temperature, Km for G6P dependence on pH, heat stability, 2-deoxy glucose-6-phosphate utilization, molecular weight, while the Km for NADP significantly increased in non-dividing erythroblasts. These results indicate that no shift towards the oxidized form of the enzyme and no substantial modifications of the protein take place during cell differentiation. PMID- 3627111 TI - Separation of protein synthesis initiation factor eIF4A from a p220-associated cap binding complex activity. AB - A cap binding complex activity was purified from HeLa cells by a procedure which does not depend on the use of cap-affinity chromatography. The activity co purified with a Mr 220,000 polypeptide (p220), but not with eIF4A. The active complex therefore differs from eIF4F, the complex purified by cap analog-affinity chromatography, in that it lacks the Mr 50,000 subunit which is antigenically identical to eIF4A. The activities of eIF4F, CBP I and the eIF4A-free complex purified here were compared in a fractionated system translating capped globin mRNA. Results indicate that the two complexes have similar activities and that they perform a function which cannot be provided by CBP I alone. Cap binding complex activity can be partly separated from eIF4A activity on sucrose gradients, thus eIF4A provides a function that is distinct from cap binding complex activity. The results indicate that eIF4A can be physically separated from the cap binding complex without affecting the ability of the remaining structure to function in an in vitro translation system. They suggest that the eIF4A-free complex may provide a function that is not a property of either CBP I or of eIF4A, but may be a property of p220. PMID- 3627112 TI - Deoxycytidylate deaminase activity in non-stimulated and phytohemagglutinin stimulated human lymphocytes, and in leukemic cells. AB - Deoxycytidylate deaminase isolated from normal human lymphocytes and from mononuclear leucocytes from patients with acute lymphoblastic leukemia, chronic lymphocytic leukemia and acute monocytic leukemia has been characterized in regard to the substrate, dAMP and the allosteric regulators dCTP and dTTP. The enzymes exhibited sigmoidal initial velocity versus dCMP concentration whereas in the presence of the activator, dCTP, Michaelis-Menten kinetics were obtained. At saturating substrate concentrations dTTP acted as an allosteric inhibitor of the enzyme isolated from non-stimulated as well as from stimulated lymphocytes. However, the enzymes isolated from the leukemic cells had lost the allosteric regulation by dTTP. At low substrate concentrations the competitive inhibitor, dAMP, activated all the enzymes. This activation was abolished in the presence of dCTP which indicates that dAMP might be involved in the regulation of dCMP deaminase activity and thus influence the dCTP and dTTP pools under physiological conditions. PMID- 3627113 TI - Thyroid hormone stimulates adipocyte differentiation of 3T3 cells. AB - Triiodothyronine added at 0.1 nM to 3T3-F442A cells cultured in adipogenic medium having endogenous hormone concentrations similar to those of hypothyroid serum stimulated adipose conversion; activities of both lipogenic enzymes, glycerophosphate dehydrogenase and malic enzyme, increased with hormone treatment. The number of adipocytes was also augmented by L-T3 addition but the number of fat cell clusters remained the same as compared to non-treated cultures, suggesting that thyroid hormone increased the number of adipocytes probably through stimulating selective multiplication of precursor adipose cells. Hormone addition to cells cultured with non-adipogenic medium did not promote conversion showing that L-T3 is not an adipogenic factor by itself. Triiodothyronine added at concentrations similar to those found in hyperthyroidism, from 10 nM up to 10 microM, also increased the proportion of adipocytes without changing the number of fat cell clusters, but they decreased the activity of both lipogenic enzymes and lipid accumulation in mature adipocytes. It can be concluded that during 3T3-F442A differentiation into adipocytes L-T3 increases the number of differentiated adipocytes and, at low concentrations, also enhances lipogenic enzyme activities, whereas at the hyperthyroid hormone levels these enzyme activities are significantly reduced, remaining at levels similar to those of cells cultured with hypothyroid medium. This cloned cell line seems to be a useful model to study thyroid hormone action at both molecular and cellular level. PMID- 3627114 TI - Kinetic mechanisms and interaction of rat liver DNA methyltransferase with defined DNA substrates. AB - DNA substrate analogs were constructed from poly(dC-dG), M13, and XP12 DNA which do not contain a mixture of types of methylation sites. These were used to distinguish different kinetic mechanisms for maintenance and de novo methylation using a highly purified rat liver DNA (cytosine-5) -methyltransferase (DMase+) preparation. De novo methylation on single (ss) and double-stranded (ds) DNA was found to obey Michaelis-Menten kinetics while methylation of hemimethylated sites showed differences depending on size of the hemimethylated region. On long stretches analogous to maintenance methylation of newly replicated DNA, saturation could not be achieved and the kinetics showed non-ideal positive cooperative kinetics, while short stretches showed non-Michaelis-Menten kinetics and rapid saturation. Two types of DMase-DNA complexes could be distinguished by means of affinity chromatography on DNA -agarose matrices and in preincubation assays. The later complex, which is engaged in methyl group turnover, exhibited enhanced stability. The competitiveness of variously configured DNAs was found to parallel the stability of complex formation, e.g., ss, hemi- and ds DNA, respectively. In studies utilizing 5-bromodeoxyuridine, the thymine analog left the basic reaction mechanisms unchanged but increased the km and S0.5 while reducing the velocity of these reactions. PMID- 3627115 TI - Mouse monoclonal antibodies specific for endothelial cells. AB - Balb/c mice were immunized with a human endothelial cell pool. Spleen cells were then fused with a NS-O hybridoma cell line. A number of hybridomas secreted antibodies that reacted with the immunizing endothelial cell pool as well as with every other tested umbilical cord vein derived human endothelial cell. These monoclonal antibodies also stained pig, rabbit and ox aortic endothelial cells indicating their specificity for this cell type. Five of 16 monoclonal antibodies additionally reacted with human fibroblasts (HFIB). The produced monoclonal antibodies did not recognize FVIIIR:AG or MHC determinants. They can therefore be regarded as additional and reliable markers for endothelial cells in vitro. PMID- 3627117 TI - [Endocrinologic diagnosis in childhood and adolescence in girls]. PMID- 3627116 TI - Thermal denaturation of mononucleosomes in the presence of spermine, spermidine, N1-acetylspermidine, N8-acetylspermidine or putrescine: implications for chromosome structure. AB - Putrescine (a diamine) raises the thermal denaturation temperature of mononucleosomes but produces only minor changes in the overall shape of the thermal denaturation curve. This is similar to the effect of sodium ions and is consistent with nonspecific binding to the DNA of the nucleosome. At very low levels of spermidine or spermine the same simple rise in thermal denaturation temperature is seen but at higher levels (above 1 microM for total spermidine concentration) the thermal denaturation curve becomes substantially sharper and the premelt region of the curve diminishes in area. The acetylspermidines display intermediate effects. The change in shape of the thermal denaturation curve was resolved into components (R1 and R2) due to mononucleosomes in their original conformation plus a component (T) induced by the presence of spermidine or spermine. The proportion of component T was substantially reduced with acetylspermidine, compared to equivalent concentrations of spermidine. Hence, we suggest that spermidine acetylation in vivo has the potential to partially destabilise the nucleosome structure, possibly in coordination with histone acetylation. PMID- 3627119 TI - [Conflict and crisis in female adolescence]. PMID- 3627118 TI - [Sexuality and contraception in adolescence]. PMID- 3627120 TI - [Anorexia and bulimia]. PMID- 3627121 TI - [Modern treatment of craniocerebral traumas in childhood. Early and initial late results]. PMID- 3627122 TI - [Long-term changes in behavior and performance following craniocerebral trauma in childhood]. PMID- 3627123 TI - [Assessment and treatment of congenital pigment cell nevi]. PMID- 3627124 TI - [Surgical treatment of congenital heart defects]. PMID- 3627125 TI - [Late results and problems following operation of congenital heart defects]. PMID- 3627126 TI - [Ventricular septal defects]. PMID- 3627127 TI - [Complex heart defects]. PMID- 3627128 TI - [Tetralogy of Fallot]. PMID- 3627129 TI - [Cooperative documentation of neoplasms in childhood. Assessment of over 6,000 new illnesses in West Germany since 1980]. PMID- 3627130 TI - [Histology of solid tumors and its significance for therapy]. PMID- 3627131 TI - [Principles in the treatment of neoplasms in childhood and adolescence]. PMID- 3627132 TI - [Therapy and prognosis of Hodgkin's disease in children]. PMID- 3627133 TI - [Increased intracranial pressure in newborn infants]. PMID- 3627134 TI - [Initial and expanded diagnosis of liver diseases in childhood]. PMID- 3627135 TI - [Excision of the plasmid containing the inserted human satellite DNA from Chinese hamster chromosomes after fusion of hamster and human cells]. AB - Fusion of the Chinese hamster stably transformed Tk+ cells containing chromosomally integrated plasmid with a fragment of human satellite III DNA (HS3), with mitomycin C-treated human cells (B-lymphoma, line Raji) results in amplification and excision of heterogeneous plasmid material from hamster chromosomes. Some of these plasmids contain HS3. Functional activity of HS3 in the initiation of DNA replication is shown in transient transfection experiments. The results indicate that mitomycin C induces in human cells some trans-acting factors (possibly proteins) activating a replication origin within HS3 DNA and leading to plasmid replication in situ and their excision from chromosomes. PMID- 3627137 TI - Formaldehyde has a clastogenic effect in peripheral lymphocytes in vivo. PMID- 3627136 TI - Changes of SCE frequency and chromatin molecular composition in rat progeny whose mothers were treated with oral contraceptives in early pregnancy. AB - Wistar female rats were fed with oral contraceptives (OC, containing ethinylestradiolum and methylnorethrindronum) in early pregnancy. The dosage used for rats was 6.6 times more than the clinical dosage for humans in weight per kilogram. The SCE frequencies of liver and ovary cells and the changes of chromatin molecular composition in progeny of the rats fed with OC were observed. The results showed that the liver and ovary cells of newborns 12 h after birth exhibited increased SCEs value (liver: p less than 0.03; ovary: p less than 0.0004). These elevated SCE frequencies declined to the normal level about the 15th day after birth. The results for the quantity of nonhistone (NHP) and chromatin RNA in mother rats and their progenies also exhibited a significant increase, and declined to the normal level at the same period mentioned above. The results suggested that the high level of NHP and chromatin RNA may be induced by OC fed in early pregnancy and be maintained for some time after withdrawal of the OC pills. The changes of the chromatin molecular composition are perhaps somehow related to the increased SCE frequencies in the rat-liver cells. We suggest that the external steroids and their metabolites may activate more genes which were originally inactive and result in increased junctions between euchromatin and heterochromatin, resulting in more SCEs in quickly dividing embryo cells. The report here suggests that during early pregnancy the pills taken by women following OC failures may have a potential mutagenic effect on their progeny for some time after the pills have been stopped. PMID- 3627138 TI - Induction of DNA strand breaks in transcriptionally active DNA sequences of mouse cells by low doses of ionizing radiation. AB - The efficiency of DNA single-strand break induction was measured in transcriptionally active DNA, transcriptionally inert satellite DNA, and bulk DNA sequences of mouse L929 cells using the alkaline filter elution assay. The cells were exposed to increasing doses of X-radiation up to 1000 rad. DNA which either eluted from or was retained on polycarbonate filters during the assays was collected onto nitrocellulose filters and hybridized against radiolabeled poly(A+)RNA (to probe transcribing DNA sequences) or mouse satellite DNA. The increasing rate and extent of elution of bulk DNA or specific DNA sequences after increasing radiation doses was taken as a measure of the increased frequency of radiation-induced DNA strand breaks. The results indicate that a significant fraction of transcriptionally active DNA contains endogenous strand breaks. With increasing dose, the efficiency of radiation-induced DNA strand breakage in bulk, transcriptionally active and satellite DNA sequences was observed to be the same when the sum of all eluted DNA was considered. However, the early eluting fractions contained DNA which was enriched in active sequences. Since DNA elutes as a function of size, the early fractions contain smaller DNA than later fractions. Therefore, our results indicate that the fraction of active sequences which elutes early resides on smaller fragments on the average than the later eluting DNA, and that even low doses of radiation preferentially cause breaks in regions of DNA containing active sequences. PMID- 3627139 TI - Sister-chromatid exchanges in a special form of xeroderma pigmentosum (form II). AB - The frequency of sister-chromatid exchanges (SCE) was studied in peripheral blood lymphocytes from a xeroderma pigmentosum (form II, XPII) patient. The cells were irradiated with UV or X-rays. In some experiments novobiocin (NB), inhibitor of topoisomerase II, or caffeine (CA), inhibitor of DNA repair were added to the cultures. The level of spontaneous SCE in the patient's lymphocytes was found to be significantly increased in comparison to that in the cells from normal donors. The inhibitors and UV-light caused a rise in the frequency of SCE in the cells taken from normal donors and except for NB, in the lymphocytes from the patient XPII. X-Rays did not increase SCE frequency in normal lymphocytes and lowered it in the patient's cells. SCE frequency rose when inhibitors of DNA replication and repair were used in combination with mutagens. PMID- 3627140 TI - Abnormal mutation frequencies in human repair-defective hybrid cell lines. AB - Two intraspecific human cell hybrids, HD2 and HD1A, produced from fusion between HeLa cells and xeroderma pigmentosum fibroblasts, express XPD-like rates of excision repair and hypersensitivity to UV-radiation. In the present paper we describe unusual patterns of UV-induced mutation in both cell lines. Though HD2 very closely resembles XPD both phenotypically and genetically, in UV-dose response it is hypomutable at the loci for ouabain and diphtheria toxin resistance. At equitoxic dose, however, it shows normal mutability, HD1A, by contrast, is hypermutable as a function either of UV dose or in terms of equitoxicity for these genes. HD1A's mutator phenotype is a dominant characteristic and is not associated with grossly abnormal DNA precursor pool imbalance. The possibility remains that DNA polymerase infidelity underlies its hypermutability. PMID- 3627141 TI - Expression of the truncated E. coli O6-methylguanine methyltransferase gene in repair-deficient human cells and restoration of cellular resistance to alkylating agents. AB - We have constructed a truncated E. coli O6-methylguanine methyltransferase (MT) gene (ada gene) to express the MT activity for O6-methylguanine and O4 methylthymine but not for methylphosphotriester in human cells and transferred it into Mer- HeLa MR cells. The transfectant cells expressed the truncated E. coli MT were resistant to alkylating agents as same as the transfectant cells with the intact ada gene in cell killing, sister-chromatid exchange induction and host cell reactivation of adenovirus 5. These results strongly suggest that methylphosphotriester may not contribute to the biological effect of alkylating agents in human cells. PMID- 3627142 TI - Characterization of a CHO variant in respect to alkylating agent-induced biological effects and DNA repair. AB - From the Chinese hamster ovary line CHO-9 a resistant variant, Cl 3, was isolated after treatment with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Cl 3 cells were much more resistant to the cytotoxic effects of MNNG (D10 of 1.8 microgram/ml MNNG as compared to 0.23 microgram/ml for parental line) and other methylating N nitroso compounds, but they had the same sensitivity to various other alkylating agents. MNNG was equally effective in sensitive parent line and resistant variant in inducing sister-chromatid exchanges (SCEs) and mutations to 6-thioguanine resistance. The increased resistance of Cl 3 was not due to reduced cellular uptake of MNNG, to a more efficient repair of methylated purine bases, or to differences in MNNG-induced inhibition of DNA synthesis. It is concluded that the resistant variant has some unknown tolerance mechanism which alters the cytotoxic, but not the SCE- and mutation-inducing effects of methylating N nitroso compounds. PMID- 3627143 TI - Hypersensitivity of Bloom's syndrome fibroblasts to N-ethyl-N-nitrosourea. AB - Fibroblast cells from two Japanese patients with Bloom's syndrome (BS) and normal donors were studied for the inactivation of colony-forming ability and the induction of sister-chromatid exchanges (SCEs) after N-ethyl-N-nitrosourea (ENU) treatment. The reduction of ENU-induced SCEs as a function of post-treatment incubation time was also compared between BS and normal fibroblasts. BS cells were approximately 4 times more sensitive than normal cells to the lethal effect of ENU and remarkably hypersensitive to the SCE induction by ENU. The post treatment incubation of ENU-treated normal cells in the fresh medium resulted in a time-dependent decrease of the SCE level until 6 h after which time the SCE level remained the plateau of about 50% of the initial level. In contrast, the ENU-induced SCEs in BS cells decreased much more slowly with post-treatment incubation time and its half life was 24 h. These results collectively support the view that BS cells may be defective in the rapid repair of certain type(s) of DNA damages induced by ENU. PMID- 3627144 TI - The endogenous nuclease sensitivity of repaired DNA in human fibroblasts. AB - The limited DNA excision repair that occurs in the chromatin of UV-irradiated growth arrested cells isolated from a xeroderma pigmentosum (XP) complementation group C patient is clustered in localized regions. The repaired DNA was found to be more sensitive to nicking by endogenous nucleases than the bulk of the DNA. The extra-sensitivity does not change with increasing amounts of DNA damage or repair activity in the locally-repaired regions and is retained through a 24-h chase period. We suggest that these results are due to the occurrence of DNA repair limited to pre-existing, non-transient chromatin fractions that contain actively transcribed DNA. A similar extra-sensitivity of repaired DNA was not detected in cells of normal or XP complementation group A strains that exhibit either normal or limited repair located randomly throughout their genomes. The association between endogenous nuclease sensitivity and clustered repair probably defines a normal excision repair pathway that is specific for selected chromatin domains. The repair defect in XP-C strains may be one in pathways targeted for other endogenous nuclease-resistant domains. PMID- 3627145 TI - Recombinational repair of hydrogen peroxide-induced damages in DNA of phage T4. AB - Recently, hydrogen peroxide and its free-radical product, the hydroxyl radical (OH.) have been identified as major sources of DNA damage in living organisms. They occur as ubiquitous metabolic by-products and, in humans, cause several thousand damages in a cell's DNA per day. They are thought to be a major source of DNA damage leading to aging and cancer in multicellular organisms. This raises two questions. First, what pathways are used in repair of DNA damages caused by H2O2 and OH.? Second, a new theory has been proposed that sexual reproduction (sex) evolved to promote repair of DNA in the germ line of organisms. If this theory is correct, then the type of repair specifically available during the sexual process should be able to deal with important natural lesions such as those produced by H2O2 and OH. . Does this occur? We examined repair of hydrogen peroxide damage to DNA, using a standard bacteriophage T4 test system in which sexual reproduction is either permitted or not permitted. Post-replication recombinational repair and denV-dependent excision repair are not dependent on sex. Both of these processes had little or no effect on lethal H2O2 damage. Also, an enzyme important in repair of H2O2-induced DNA damage in the E. coli host cells, exonuclease III, was not utilized in repair of lethal H2O2 damage to the phage. However, multiplicity reactivation, a recombinational form of repair depending on the sexual interaction of two or more of the bacteriophage, was found to repair lethal H2O2 damages efficiently. Our results lend support to the repair hypothesis of sex. Also the homology-dependent recombinational repair utilized in the phage sexual process may be analogous to the homology-dependent recombination which is widespread in diploid eucaryotes. The recombinational repair pathway found in phage T4 may thus be a widely applicable model for repair of the ubiquitous DNA damage caused by endogenous oxidative reactions. PMID- 3627146 TI - Implications of treatment-condition-induced genotoxicity for chemical screening and data interpretation. AB - Ionic and pH alterations appear to be directly responsible for the induction of genotoxic effects in cultured mammalian cells. In vivo studies also associate high ion concentrations and pH changes with tumor enhancement of the glandular stomach and urinary bladder of rats. The implications of these findings are directly relevant to the design of in vitro and in vivo tests and to the interpretation of results from tests using materials likely to produce alterations in ionic and/or pH levels. PMID- 3627147 TI - Genotoxicity produced in cultured mammalian cell assays by treatment conditions. A symposium. June 9, 1986, Amsterdam. Proceedings. PMID- 3627148 TI - Effects of high osmotic strength on chromosome aberrations, sister-chromatid exchanges and DNA strand breaks, and the relation to toxicity. AB - Substantial increases in chromosome aberrations were induced in Chinese hamster ovary cells by medium made hyperosmotic with NaCl, KCl, sucrose, sorbitol or dimethyl methylphosphonate. The increases were associated with cytotoxicity but occurred in the range (e.g., 70% survival) commonly included in in vitro tests for 'genotoxicity'. The relation between increased osmotic pressure and chromosome aberrations is compound-dependent, e.g., some compounds may have a direct effect in addition to an effect mediated by osmotic pressure/ionic strength. Also, glycerol at high osmolality was not toxic and did not induce aberrations, probably because rapid equilibration across the cell membrane precluded severe osmotic stress to the cells. Weak increases in DNA single-strand breaks (NaCl and KCl) and double-strand breaks (NaCl) were also detectable, at higher concentrations and more toxic levels than those required to produce aberrations. Slight elevations in sister-chromatid exchange frequencies caused by hyperosmotic medium were found in the presence of toxicity and severe cell cycle delay. Our data on cell growth inhibition suggest that this is the result of increased incorporation of bromodeoxyuridine per cell due to decreased numbers of growing cells, although other mechanisms cannot be ruled out. The observations on chromosome aberrations demonstrate the need for keeping in vitro test conditions in the physiological range, and provide a means for investigation of indirect DNA damage. PMID- 3627149 TI - Mutagenicity of rat-liver S9 to L5178Y mouse lymphoma cells. AB - Rat-liver S9 preparations became highly mutagenic to cultured L5178Y mouse lymphoma cells when the exposure period was increased to 18-24 h or when S9 mix was preincubated in Fischer's medium at 37 degrees C for 19 h and then used to treat the cells for 4 h. Five different S9 preparations (from untreated and Aroclor 1254-treated Fischer 344 or Sprague-Dawley male rats) behaved similarly. S9 mix, which contained 1 mM NADP and 5 mM isocitrate as cofactors, was more mutagenic than S9 alone. Heat treatment of S9 did not destroy its mutagenic activity, but the addition of cofactors no longer stimulated an increase in mutagenicity, as observed with native S9. Treatment with cofactors was not mutagenic. These results implied the involvement of both energy-independent and NADPH-dependent enzymatic changes in S9 mix in producing mutagenic substances. The mutagenic treatments with S9 or S9 mix induced predominantly small TFT resistant mutant colonies, which suggested that these treatments should be clastogenic to cultured mammalian cells. A warning was given that test chemicals evaluated as mutagenic only in the presence of S9 mix may instead be accelerating the decomposition of S9 mix into mutagens, and it may become necessary to experimentally distinguish between these two mechanisms before a chemical can be regarded as mutagenic. PMID- 3627150 TI - Relationships among cytotoxicity, lysosomal breakdown, chromosome aberrations, and DNA double-strand breaks. AB - Certain chemicals that are either weak or non-carcinogens had been previously shown to induce DNA single-strand breaks in rat hepatocytes, but only at cytotoxic doses. In contrast, stronger carcinogens induced DNA single-strand breaks at non-toxic doses. This report shows that the strong carcinogens and mutagens cadmium sulfate, sodium dichromate, dimethyl sulfate, and N-methyl-N' nitro-N-nitrosoguanidine all induce DNA single-strand breaks at non-toxic concentrations, but that they also induce DNA double-strand breaks at concentrations that are closely correlated with cytotoxicity. Some weak carcinogens produced DNA single- and double-strand breaks, but only at acutely cytotoxic concentrations. We suggest that the DNA double-strand breaks result from a cell-mediated process such as release of DNAase from lysosomes or other cellular compartments, that might occur during cellular response to acutely toxic damage. Experiments with N-dodecyl imidazole (NDI), a lysosomal detergent, show that lysosomal breakdown alone is only a weak inducer of DSBs, but that lysosomal breakdown in combination with prior chemical damage produced by MNNG synergistically induces DNA DSBs in BHK cells. N-Dodecyl imidazole also induces chromosomal aberrations in CHO cells at concentrations which cause cytotoxicity, cell cycle delay, and lysosomal breakdown. These results all suggest that chemical toxicity leads to limited lysosomal breakdown that induces DNA DSBs and chromosomal aberrations. Cells that have been sublethally damaged and that can repair these damages and survive could become transformed by the DNA-damaging mechanisms associated with carcinogenesis. PMID- 3627152 TI - Clusters of premeiotic ring-X chromosome loss are not observed in males of Drosophila melanogaster. PMID- 3627151 TI - Formation of a mutagen, 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine (PhIP) in cooked beef, by heating a mixture containing creatinine, phenylalanine and glucose. AB - When a mixture of creatinine, phenylalanine and glucose in diethylene glycol water solution was heated for 2 h at 128 degrees C, a mutagen, 2-amino-1-methyl-6 phenylimidazo[4,5-b]pyridine (PhIP), was found to be produced, identified by high performance liquid chromatography, and UV-visible and mass spectrometries. The yield of PhIP was 3.6 nmoles/mmole original creatinine. PhIP was originally isolated from cooked beef, and this study shows creatinine, phenylalanine and glucose to be the probable precursors of PhIP in beef. PMID- 3627153 TI - A search for radiosensitive mouse mutants by use of the micronucleus technique. AB - In order to identify radiosensitive mutations in mice, 26 genetically well defined mutations in 26 different combinations of homozygous, hemizygous or heterozygous conditions, together with normal mice and mutagen-sensitive MS/Ae mice were analysed for the induction of micronuclei by X-rays in bone-marrow cells. For each mutant two doses of 0.5 and 1.0 Gy, two sampling times of 18 and 27 h after irradiation and unirradiated controls were studied. Using our criteria, homozygous contrasted allele of steel (Slcon), scabby (scb), viable dominant spotting (Wv), quaking (qk), fidget (fi) and postaxial hemimelia (px), heterozygous lurcher (Lc), hemizygous gyro (Gy), the compounds Slcon/grizzle belly (SlgbH) and Wv/rump-white (Rw) and MS/Ae mice, were regarded as radiosensitive, with Slcon/Slcon the highest in rank order. Homozygous wabbler lethal (wl) and wasted (wst) showed hyposensitivity which for the latter may be connected with enhanced cell killing. PMID- 3627155 TI - Mutagenicity and clastogenicity of adriamycin in L5178Y/TK(+/-)-3.7.2C mouse lymphoma cells. AB - Adriamycin was found to be both mutagenic and clastogenic to L5178Y/TK(+/-) 3.7.2C mouse lymphoma cells. A dose of only 5 ng/ml (survival = 62% or 67%) gave an induced TK mutant frequency of 307 or 296 per 10(6) survivors in two separate experiments. This dose was also clastogenic, inducing 20 chromosome aberrations/100 cells analyzed. The majority of the mutants were small-colony mutants, indicating that adriamycin likely acts primarily by a clastogenic mechanism. PMID- 3627154 TI - Dominant lethal mutations induced in mouse spermatogonia by mechlorethamine, procarbazine and vincristine administered in 2-drug and 3-drug combinations. AB - Male mice were treated with mechlorethamine (2.0 mg/kg), procarbazine (100 mg/kg) and vincristine (0.67 mg/kg) alone, or in 2-drug and 3-drug combinations. 5 weeks later and continuing for 5-8 weeks, embryos fertilized by spermatozoa that were derived from drug-treated spermatogonia were evaluated for drug-induced dominant lethal mutations. Significant mutagenesis was detected for mechlorethamine alone, for 2-drug combinations including mechlorethamine and for 3-drug combinations. Combinations where mechlorethamine was given first were mutagenic whereas combinations where mechlorethamine was not given first were not. Some combinations were more cytotoxic to the germinal epithelium than others. The data suggest that mutagenesis by this combination of drugs which is used extensively in treating Hodgkin's disease is due primarily to the mechlorethamine and that the frequency of mutation-induction may be a function of the order of administration. PMID- 3627156 TI - The effect of L-2-oxothiazolidine on glutathione levels in cultured mammalian cells. AB - Chinese hamster ovary cells were cultured with increasing concentrations (7 X 10( 8) M-7 X 10(-2) M) of L-2-oxothiazolidine in an attempt to increase intracellular glutathione levels in these multiply-passaged mammalian cells. In a series of 7 Expts., intracellular glutathione levels increased significantly at the highest concentrations tested and were protective against oxygen radical-induced genetic toxicity. PMID- 3627157 TI - The use of bromodeoxyuridine labeling in the human lymphocyte HGPRT somatic mutation assay. AB - The autoradiographic assay developed by Strauss and Albertini (1979) to quantitate human in vivo somatic mutation at the hypoxanthine guanine phosphoribosyl-transferase locus uses tritiated thymidine to identify mutant cells by their ability to pass through 'S' phase in the presence of 6 thioguanine. An alternative method, based on the incorporation of bromodeoxyuridine (BrdUrd) into the DNA of proliferative cells, followed by differential staining with the fluorescence-plus-Giemsa method, was used to identify 3 classes of lymphocyte nuclei: (a) small darkly stained nuclei, (b) large, reddish-colored nuclei with an apparent nucleolus, and (c) large, bluish colored nuclei. By double labeling with BrdUrd and tritiated thymidine, it was determined that only the nuclei of the third class had incorporated BrdUrd. These results demonstrate that the technique used for sister-chromatid differentiation can be used to detect putative HGPRT mutants and to determine variant frequencies at the HGPRT locus. PMID- 3627158 TI - Friedreich's ataxia: electrophysiologic and histologic findings in patients and relatives. AB - Peripheral nerve conduction velocity and cortical evoked potentials were investigated in 48 patients with Friedreich's disease and in 35 relatives. There were 14 patients and 2 relatives who underwent sural nerve biopsy. In the patients sensory conduction velocity was moderately slowed, whereas sensory responses were markedly reduced. Nerve biopsy showed a severe loss of large myelinated fibers and no demyelination. On teased nerve fiber preparations, most fibers presented uniformly short internodes. No correlation was seen between sensory conduction findings or histologic abnormalities and clinical disability. In patients SSEP changes, which were constant, and VEPs, which were frequently involved, were unrelated to the severity or duration of clinical disability. There were 14 relatives who showed clinical signs of Friedreich's disease. Slightly decreased distal conduction velocity along sensory fibers was observed in more than half of the relatives. Nerve biopsy was noncontributory. In conclusion, we could not determine whether the abnormalities observed in the siblings were an expression of a heterozygotic condition, or whether they were early signs of the disease. PMID- 3627159 TI - Electrophysiologic evidence of severe distal nerve segment pathology in the Guillain-Barre syndrome. AB - We report the clinical and electrophysiologic findings in 4 patients with Guillain-Barre syndrome (GBS) who, within 48 hours of onset, progressed to flaccid quadriplegia. Evoked muscle action potentials were absent or prolonged in latency and markedly reduced in amplitude within 48 hours of onset of weakness at a time when sensory nerve studies were almost normal. We conclude that pathophysiologic abnormalities may be distal and severe in some patients with GBS and that there is a predilection for motor axons in GBS. PMID- 3627161 TI - Reanalysis: impulse activity and fiber-type transformation. PMID- 3627160 TI - Experimental investigation of muscular neurotization in the rat. AB - Reinnervation of a free muscle graft by nerves from an adjacent intact muscle is called muscular neurotization. This paper investigates the mechanisms and stimuli responsible for muscular neurotization in the rat. Sternohyoid or sternomastoid muscles were transplanted as free muscle grafts to the ventral surface of an intact sternohyoid muscle (feeder muscle). After several weeks the graft and underlying feeder muscle were removed together, frozen, serially sectioned, stained, and carefully examined for the presence or absence of nerves. It was concluded from a series of experiments that in this model muscular neurotization is a form of nerve regeneration. In order for muscular neurotization to occur, it is necessary to have (1) injury to the nerves of the intact feeder muscle and (2) a pathway upon which the regenerating nerves may grow into the graft. PMID- 3627162 TI - Clinical and immunological follow-up of trichophytic kerion celsi. PMID- 3627163 TI - Macroconidial formation in Trichophyton soudanense Joyeux 1912. PMID- 3627164 TI - [A method for the quantitative determination of yeasts]. PMID- 3627165 TI - Identification of a major 72 kilodalton surface antigen in twelve isolates of Leishmania braziliensis braziliensis. AB - The study of the surface antigens of Leishmania braziliensis braziliensis revealed a great homogeneity among ten strains isolated from Bolivia and two reference strains from Brazil and Belize. A 72 kDa major protein, present in all L. b. braziliensis strains, was recognized by both cutaneous and mucocutaneous human sera, but was not recognized by Kala-azar and chagasic sera. No cross reactive antigens were found among strains of Leishmania braziliensis guyanensis, Leishmania braziliensis panamensis, Leishmania mexicana amazonensis and Leishmania donovani chagasi testing these strains with hamster and human anti-L. b. braziliensis sera. Moreover, these strains possessed major antigens with molecular weights different from those of L. b. braziliensis strains. A microheterogeneity of L. b. braziliensis surface antigens was detected for the high molecular weight antigens and seemed to be related to the isoenzymic microheterogeneity. PMID- 3627166 TI - A nuclear magnetic resonance study of the role of phosphoenol pyruvate carboxykinase (PEPCK) in the glucose metabolism of Dipetalonema viteae. AB - 13C-NMR has been applied to the study of the metabolism of [1-13C]glucose by macrofilariae of Dipetalonema viteae under conditions of restricted glucose supply. In a medium buffered with 13C-labelled bicarbonate, succinate labelled in the carboxyl position is formed in good yield. Quinolinic acid, a known inhibitor of phosphoenol pyruvate carboxykinase (PEPCK) has been shown to suppress the formation of labelled succinate from [1-13C]glucose. Both sets of experiments support the formation of succinate through the PEPCK-mediated carboxylation of phosphoenol pyruvate, followed by the operation of a partial tricarboxylic acid cycle. PMID- 3627167 TI - Anaerobic metabolism in Ascaris suum: acyl CoA intermediates in isolated mitochondria synthesizing 2-methyl branched-chain fatty acids. AB - Freshly isolated Ascaris suum mitochondria contained CoASH, acetyl CoA, propionyl CoA, 2-methylcrotonyl CoA, 2-methylbutyryl CoA, 2-methyl-2-pentenoyl CoA, and 2 methylvaleryl CoA, as determined by high-pressure liquid chromatography. Incubation of these mitochondria aerobically in the absence of substrate resulted in the conversion of the branched-chain enoyl CoA's to acetyl CoA and propionyl CoA. With the addition of malate to the incubation medium, succinyl CoA and methylmalonyl CoA accumulated and the levels of propionyl CoA decreased dramatically. However, the branched-chain fatty acids characteristic of A. suum's fermentative metabolism were not formed and it appears that the formation of propionyl CoA may be limiting in these mitochondria. Indeed, the addition of propionate to incubations with malate increased intramitochondrial levels of propionyl CoA and 2-methyl-2-pentenoyl CoA and stimulated significant 2 methylvalerate synthesis. The exclusion of air from these incubations further increased levels of 2-methyl-2-pentenoyl CoA and stimulated 2-methylvalerate synthesis. These studies suggest that in addition to elevated NADH/NAD ratios, elevated enoyl CoA/acyl CoA ratios also are important in the regulation of branched-chain fatty acid synthesis in A. suum mitochondria. PMID- 3627168 TI - Polyamine metabolism in filarial worms. AB - The human and animal filarial parasites Onchocerca volvulus, Dirofilaria immitis, Brugia patei and Litomosoides carinii contained low levels of putrescine but much higher levels of spermidine and spermine as estimated by ion-pair high pressure liquid chromatography; N-acetylated polyamines were present only in minute amounts. Enzyme activities of ornithine decarboxylase (EC 4.1.1.17) and arginine decarboxylase (EC 4.1.1.19), respectively, were not detectable. Experiments carried out with O. volvulus and D. immitis demonstrated the uptake and bioconversion of labeled polyamines. There is evidence for the existence of a complete reverse pathway generating putrescine from spermidine and spermine, respectively, in both worms. N-Acetylating enzyme activities were detected in 100,000 X g preparations of homogenates from D. immitis which were capable to acetylate putrescine, spermidine and spermine. Long term incubation of the worms in the presence of labeled polyamines resulted in the excretion of putrescine and N-acetylputrescine. PMID- 3627169 TI - Echinococcus granulosus: occurrence of ecdysteroids in protoscoleces and hydatid cyst fluid. AB - Both free ecdysteroids and hydrolysable polar conjugated ecdysteroids were detected in protoscoleces of Echinococcus granulosus from the equine host, and in hydatid cyst fluid from the same source. Comparisons were made of hydatid cyst fluid from E. granulosus infections of three intermediate host species: horses, sheep and humans. Ecdysone and 20-hydroxyecdysone were identified in both protoscoleces and hydatid cyst fluids by high-performance liquid chromatography monitoring fractions by radioimmunoassay, and by capillary gas chromatography/mass spectrometry (selected ion monitoring). The free ecdysteroid fractions of hydatid cyst fluid from horses and sheep also contained several unidentified, chromatographically unique, immunoreactive compounds which were refractory to hydrolysis with a crude Helix pomatia aryl sulphatase enzyme preparation. PMID- 3627170 TI - Glycogen metabolism in Schistosoma mansoni worms after their isolation from the host. AB - Adult Schistosoma mansoni worms rapidly degrade their endogenous glycogen stores immediately after isolation from the host. In NCTC 109 or in a diphasic culture medium the glycogen levels slowly recovered again after the initial decrease. The rapid degradation of glycogen could be prevented, even in a simple salt medium, if 100 mM glucose and 1% bovine serum albumin were present. Incubations with 14C labelled glucose under different conditions revealed that the degradation of glycogen was induced by the limited catabolism of external glucose. Conditions are described which induce glycogen degradation or resynthesis by S. mansoni. The physiological function of the glycogen stores is probably to provide substrate during periods of insufficient supply of external glucose. It is speculated that such periods occur when the worm pair moves into the small mesenteric veins of the host. This hypothesis explains the remarkable wandering behaviour of the parasite in the mesenteric veins, since the schistosomes would have to return to larger vessels when their endogenous glycogen stores are exhausted. PMID- 3627171 TI - Chromosome size polymorphisms of Leishmania donovani. AB - A minimum of 22 chromosomes were found in all Leishmania donovani stocks examined by orthogonal field alternation gel electrophoresis (OFAGE). Chromosome sizes ranged from approximately 270 to 4000 kb. Certain chromosomes were polymorphic in size between stocks and chromosomes present in some stocks had no apparent equivalent in others. Specific polymorphisms were useful in distinguishing the subspecies L. d. donovani, L. d. infantum and L. d. chagasi and African L. donovani stocks but there were karotypic differences within these taxa. Radiolabelled DNA derived from whole chromosomes was hybridised to OFAGE Southern blots. Chromosome 1 of L. d. donovani was homologous to two larger chromosomes in all stocks. Chromosome 2 of certain L. d. chagasi and L. d. infantum stocks was homologous to both chromosomes 2 and 3 of L. d. donovani: this suggested that translocation between chromosomes may have contributed to the size polymorphisms. The smallest chromosome seen (270 kb) was unique to the African stock HU3. It was not homologous to small chromosomes in L. d. donovani, L. d. infantum or L. d. chagasi. The small chromosome did hybridise to two small chromosomes in another African stock, Khartoum, and to a large chromosome present in all stocks. The beta-tubulin gene was mapped to chromosomes 21/22, 13 and 7 with strongest hybridisation to 21/22. alpha-Tubulin was mapped to chromosomes 9. The alpha- and beta-tubulin arrangement was highly conserved. PMID- 3627172 TI - Differences in intermediary energy metabolism between juvenile and adult Fasciola hepatica. AB - A comparison of glucose catabolism by juvenile and adult liver flukes, Fasciola hepatica, showed that in the adult the cytosolic degradation of glucose via phosphoenolpyruvate carboxykinase (PEPCK) was the most important route, whereas in the freshly excysted juvenile a large part was degraded via pyruvate kinase (PK). However, it was also shown that the adult did not exclusively use the PEPCK pathway, nor did the juvenile exclusively use the PK pathway. When the juvenile was forced to anaerobic functioning it produced propionate and acetate just like the adult, but this did not imply that it switched to the pathways of the adult: the pathway via PK remained important. Malic enzyme (NADP(H)-dependent) was demonstrated to be present in the cytosol and in the mitochondria of both juveniles and adults. These enzyme activities enable the parasite to use a mixture of malate and pyruvate in any ratio as substrate for the mitochondrial production of propionate and acetate. Pyruvate dismutation was important in the anaerobically functioning juvenile, whereas in the adult malate was the major, but not the only mitochondrial substrate. The pH profiles of PK and PEPCK showed that the pathway of PEP metabolism at the PK/PEPCK branchpoint can be regulated by the pH. However, the end products of glucose breakdown were not dependent on the pH. During its development, the liver fluke will gradually be forced to anaerobic functioning. At first, the acidic end product will favour a partitioning of PEP at the PK/PEPCK branchpoint towards malate formation. Later, a lasting predominance of the PEPCK pathway occurs as PK activity almost completely disappears.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627173 TI - Effect of Plasmodium yoelii nigeriensis infection and chloroquine on the hepatic mixed function oxidase system of mice. AB - Plasmodium yoelii nigeriensis infection in albino mice significantly altered the hepatic microsomal mixed function oxidase system. Cytochrome P-450 (the terminal monooxygenase) and other monooxygenases, viz. aniline hydroxylase, aminopyrine-N demethylase and benzo(a)pyrene hydroxylase were significantly lowered while microsomal heme showed 4-fold increase at 80% parasitaemia. Noticeable impairment in the other components like NADH:cytochrome b5 reductase, NADPH:cytochrome c reductase, cytochrome b5 and glucose-6-phosphatase was also observed. Oral treatment of normal and P. y. nigeriensis infected mice with chloroquine (64 mg per kg body weight for 4 days) caused lowering of mixed function oxidase activities which however showed a recovering trend, a week after cessation of treatment. PMID- 3627174 TI - The natural history of lone atrial fibrillation. A population-based study over three decades. AB - From 1950 to 1980, 3623 patients from Olmsted County, Minnesota, were found to have atrial fibrillation. Ninety-seven of these patients (2.7 percent), who were 60 years old or younger at diagnosis, had lone atrial fibrillation (atrial fibrillation in the absence of overt cardiovascular disease or precipitating illness), and their data were reviewed to determine the incidence of thromboemboli. Twenty of these patients (21 percent) had an isolated episode of atrial fibrillation, 56 (58 percent) had recurrent atrial fibrillation, and 21 (22 percent) had chronic atrial fibrillation. The total follow-up period was 1440 person-years, with a mean of 14.8 years per patient. The mean age at diagnosis was 44 years. Nineteen cardiovascular events occurred in 17 patients; 4 patients had strokes thought to be due to emboli from atrial fibrillation, and 4 had myocardial infarctions without overt evidence of previous coronary artery disease. The probability of survival at 15 years was 94 percent among the patients with lone atrial fibrillation. At 15 years, 1.3 percent of the patients had had a stroke on a cumulative actuarial basis. On an actuarial basis, there was no difference in survival or in survival free of stroke among the patients with the three types of lone atrial fibrillation (i.e., isolated, recurrent, and chronic). We conclude that lone atrial fibrillation in patients under the age of 60 at diagnosis is associated with a very low risk of stroke. This suggests that routine anticoagulation may not be warranted. PMID- 3627175 TI - The spleen as a filter. PMID- 3627176 TI - The National Leadership Commission on Health Care. PMID- 3627177 TI - Decreasing risk of leukemia with prolonged follow-up after chemotherapy and radiotherapy for Hodgkin's disease. PMID- 3627178 TI - The riddle of pygmy stature. PMID- 3627180 TI - Cigarette advertising. PMID- 3627179 TI - Chloroquine cardiotoxicity. PMID- 3627181 TI - Circulating erythroid progenitors in the anemia of prematurity. AB - We studied erythropoiesis in infants with the anemia of prematurity by counting the number of colonies derived from erythroid burst-forming units (BFU-E) in the blood of 11 premature infants before they received transfusions. Colony growth in blood from the infants was compared with growth in blood from adults and umbilical-cord blood from term infants, in the presence of erythropoietin, 0 to 2000 mU per milliliter. Addition of increasing concentrations of erythropoietin resulted in a stepwise increase in the number of colonies derived from BFU-E (P less than 0.0005) of all three groups of subjects. Cultures stimulated with 2000 mU of erythropoietin yielded 28.1 +/- 7.6, 88.0 +/- 19.4, and 121.0 +/- 22.5 bursts (mean +/- SE) per 10(5) cells plated in blood from adults, blood from premature infants, and cord blood, respectively. Although more BFU-E-derived colonies appeared when 200 or 2000 mU were present per milliliter in cultures of the infants' blood and cord blood, the intrinsic responsiveness of BFU-E to erythropoietin was similar in all groups. Although the mean hematocrit was 26 percent, mean serum erythropoietin concentrations (+/- SD) in the infants (20.7 +/- 10.0 mU per milliliter) were not significantly different from those in the adult controls (24.0 +/- 6.5). We conclude that progenitor cells committed to erythroid differentiation are present during the anemia of prematurity, and that the intrinsic responsiveness of the circulating BFU-E pool to erythropoietin is normal. These results implicate inadequate production of erythropoietin as the cause of the anemia of prematurity and suggest that recombinant erythropoietin might provide a therapeutic alternative to transfusion for symptomatic babies with this condition. PMID- 3627182 TI - Deletion in the gene for the low-density-lipoprotein receptor in a majority of French Canadians with familial hypercholesterolemia. AB - We found a large deletion (more than 10 kilobases) in the gene for the low density-lipoprotein receptor in 63 percent of French Canadians with heterozygous familial hypercholesterolemia. The deletion also occurred in homozygous form in four of seven French Canadian homozygotes. The deletion removes the promoter and first exon of the gene, and it abolishes the production of messenger RNA for the low-density-lipoprotein receptor. The high frequency of this mutation is presumably related to a founder effect among the 8000 ancestors of present-day French Canadians, who have had relatively little cross-breeding with groups of other national origins. This deletion has not been observed in any other ethnic group. It can be detected by analysis of genomic DNA from blood leukocytes, thus allowing direct diagnosis of familial hypercholesterolemia in a majority of affected French Canadians. PMID- 3627183 TI - Senile cardiac amyloidosis with myocardial dysfunction. Diagnosis by endomyocardial biopsy and immunohistochemistry. AB - Senile cardiac amyloid discovered at autopsy is usually regarded as an incidental finding. However, in immunohistochemical studies of autopsy material, three distinct forms of senile cardiovascular amyloid have been characterized, including a systemic form that diffusely infiltrates the cardiac ventricles. The systemic form can be identified immunohistochemically with use of antiserum to human prealbumin. We diagnosed senile systemic amyloidosis causing cardiac dysfunction in five men (57 to 72 years old) by using antiserum to prealbumin in myocardial biopsy tissue. Clinically, the five patients were indistinguishable from patients with nonsecretory immunoglobulin-derived primary amyloidosis with cardiac involvement; only immunohistochemical staining of myocardial tissue distinguished between the two entities. This distinction is important, because the treatment and prognosis of the two disorders are different. We recommend immunohistochemical staining of myocardial tissue for prealbumin in patients with biopsy-proved cardiac amyloid in whom no monoclonal immunoglobulin light chain is detectable in the serum or urine. PMID- 3627185 TI - Racial differences in low birth weight. Trends and risk factors. AB - To identify the risk factors responsible for differences in birth weight between blacks and whites, we investigated the effects of four maternal characteristics (age, parity, marital status, and education) on rates of very low birth weight (less than 1500 g) and moderately low birth weight (between 1500 and 2500 g). Using 1983 national data, we found that the black:white rate ratio was 3.0 for very low birth weight and 2.3 for moderately low birth weight. The four maternal factors had directionally similar but quantitatively different effects on very low and moderately low birth weight among blacks and whites. Furthermore, the racial differences in infants' birth weights were greater among low-risk than among high-risk mothers, especially for very low birth weight (black:white ratios of 3.4 and 1.7, respectively). We also examined secular trends in the rates of low birth weight among blacks and whites. Between 1973 and 1983, births of infants with moderately low birth weights decreased more among whites than among blacks, whereas births of infants with very low birth weights increased among blacks and decreased among whites. Fifteen percent of the decline in the rate of moderately low birth weight among whites could be attributed to favorable changes in maternal characteristics (primarily an increase in educational level). Among blacks, adverse changes in maternal characteristics (primarily an increase in births to unmarried women) accounted for 35 percent of the increase in the rate of very low birth weight. The adverse effects of childbearing by teenagers on the outcome of pregnancy among blacks appear to have been overemphasized. The persistence of large racial differences in birth weight, even among mothers at low risk, emphasizes the need for specific targeted interventions to achieve further improvements in infant health. PMID- 3627184 TI - Risk factors accounting for racial differences in the rate of premature birth. AB - In a hospital-based cohort of 8903 black and white women, we investigated medical and socioeconomic risk factors that may explain the known increase in premature births among black women. Among the medical conditions examined, only the maternal hematocrit level (or some related factor) explained a substantial proportion (60 percent) of the increased rate of premature births to black women. Four economic, demographic, and behavioral predictors of prematurity were also examined: age less than 20 years, single marital status, receiving welfare support, and not having graduated from high school. The number of these socioeconomic risk factors occurring in a woman was strongly predictive of premature birth of her infant, regardless of the particular risk factors present. The presence of any one factor was associated with a moderate increase in the risk of prematurity (7.0 percent as compared with 4.6 percent with no risk factors present); the presence of two or more characteristics was associated with a much higher risk (11.2 percent). When the number of these four risk factors pertaining to an individual woman was taken into account, race was no longer a significant predictor of premature birth (odds ratio, 1.22; 95 percent confidence interval, 0.94 to 1.59). When both the maternal hematocrit level and the number of the four socioeconomic risk factors were taken into account, essentially all of the racial variation in prematurity was explained, with the odds ratio for prematurity among blacks being 1.03 (95 percent confidence interval, 0.79 to 1.35). We conclude that the racial difference in the rate of premature birth is attributable to specific medical and socioeconomic characteristics. PMID- 3627186 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 38-1987. A 22-year-old woman with a pulmonary mass and lesions in the bones and brain. PMID- 3627187 TI - Premature births among black women. PMID- 3627188 TI - Suggested personnel additions to department of medicine training programs. PMID- 3627189 TI - Vancomycin-resistant staphylococcus. PMID- 3627190 TI - Transmission of diabetic alleles within the HLA complex. PMID- 3627191 TI - Anti-estrogenic effect of cigarette smoking. PMID- 3627192 TI - Treatment of hypothyroidism with levothyroxine. PMID- 3627193 TI - Percutaneous laser nucleolysis of lumbar disks. PMID- 3627194 TI - Corneal crystals in nephropathic cystinosis. PMID- 3627195 TI - How to make malpractice premiums more equitable. PMID- 3627196 TI - Sickle-cell trait as a risk factor for sudden death in physical training. AB - Case reports of sudden death during exertion have not established an association between the sickle-cell trait (hemoglobin AS) and exercise-related death. To test this association, all deaths occurring among 2 million enlisted recruits during basic training in the U.S. Armed Forces in 1977 to 1981 were classified from autopsy and clinical records as non-sudden deaths or as sudden deaths explained or unexplained by preexisting disease. On the basis of known numbers of entering recruits (according to race, age, and sex) and published prevalence rates for hemoglobin AS (8 percent for black and 0.08 percent for nonblack recruits), death rates (per 100,000) were 32.2 for sudden unexplained deaths, 2.7 for sudden explained deaths, and 0 for non-sudden deaths among black recruits with hemoglobin AS, as compared with 1.2, 1.2, and 0.7 among black recruits without hemoglobin S and 0.7, 0.5, and 1.1 among nonblack recruits without hemoglobin S. Among black recruits the relative risk of sudden unexplained death (hemoglobin AS vs. non-hemoglobin S) was 27.6 (95 percent confidence interval, 9 to 100; P less than 0.001), whereas among all recruits this risk was 39.8 (95 percent confidence interval, 17 to 90; P less than 0.001). The relative risk of sudden unexplained death among all recruits increased with age (P less than 0.04), from 13 (ages 17 to 18) to 95 (ages 26 to 30). We conclude that recruits in basic training with the sickle-cell trait have a substantially increased, age-dependent risk of exercise-related sudden death unexplained by any known preexisting cause. PMID- 3627197 TI - The impact of televised movies about suicide. A replicative study. AB - Gould and Shaffer studied suicides by teenagers in the New York City area before and after three fictional films about suicide were televised, and presented evidence suggesting that the films were followed by a significant increase in teenage suicides. Using their methods, we studied teenage suicides in California and Pennsylvania before and after the television broadcast of the same three films. In these states, there was no evidence of an increase in teenage suicides after the films were shown. This remained true when data for New York from the study of Gould and Shaffer were combined with our data from California and Pennsylvania. We conclude that it is premature to be concerned about possibly fatal effects of fictional televised films about suicide. PMID- 3627198 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 39-1987. Renal failure 64 years after removal of a hypoplastic kidney. PMID- 3627199 TI - The risks of sickle-cell trait: caution and common sense. PMID- 3627200 TI - Duplicate publication on postmenopausal bone loss. PMID- 3627201 TI - Measles outbreak in an immunized school population. PMID- 3627202 TI - Diabetes mellitus and atherosclerosis. PMID- 3627203 TI - Impaired immune response to polysaccharides. PMID- 3627204 TI - Twenty-five-year follow-up of a patient treated with lung lavage for pulmonary alveolar proteinosis. PMID- 3627206 TI - Snoring and calf pain. PMID- 3627205 TI - "Natural" potassium supplements. PMID- 3627207 TI - Alternative to Heimlich maneuver. PMID- 3627208 TI - Pretreatment with corticosteroids to alleviate reactions to intravenous contrast material. AB - The x-ray contrast mediums used over the past three decades have been salts of iodinated acids administered in highly hypertonic concentrations. We conducted a multiinstitutional randomized study of the protective effects of pretreatment with corticosteroids against reactions to intravenous contrast material. We gave 6763 patients two doses of oral corticosteroids (methylprednisolone, 32 mg) approximately 12 hours and 2 hours before challenge with contrast material, one dose of oral prednisolone approximately 2 hours before challenge, or placebo in the same dosages. The two-dose corticosteroid regimen, but not the one-dose regimen, significantly reduced the incidence of reactions of all types (P less than 0.05) except a category of reactions dominated by hives, for which the reduction approached significance (P = 0.055). In recent years, several relatively expensive monomeric nonionic iodinated compounds having approximately half the osmolality of the corresponding ionic compounds and a lower reaction rate have become available. With our two-dose corticosteroid regimen, the incidence of reactions necessitating therapy in patients receiving the ionic medium approximated that reported in an unblinded nonrandomized study of patients receiving a newer intravenous nonionic medium without corticosteroid pretreatment. We conclude that the much less expensive ionic medium, if administered with corticosteroid pretreatment, may serve as a reasonable alternative to intravenous nonionic medium, without loss of safety. PMID- 3627209 TI - Radiographic contrast agents--a perspective. PMID- 3627210 TI - Lead exposure and cognitive development. PMID- 3627211 TI - Hypocalciuria in preeclampsia. PMID- 3627212 TI - Human infection with Ehrlichia canis. PMID- 3627213 TI - Catecholamine cardiomyopathy. PMID- 3627214 TI - Proto-oncogenes and human cancers. PMID- 3627215 TI - "Chronic meningitis"--many causes to consider. PMID- 3627216 TI - Neurologic uncertainty in newborn intensive care. PMID- 3627217 TI - Induction of tumor necrosis factor during extracorporeal blood purification. PMID- 3627218 TI - Hypertrophic cardiomyopathy. PMID- 3627219 TI - Traumatic asphyxiation caused by a motorized parking gate. PMID- 3627220 TI - A significant geographical area for the study of the epidemiological and ecological aspect of Mediterranean sporothricosis. AB - Two cases of sporothricosis originating from the same geographical area (Province of Barcelona) are described, including the circumstances of infection and the isolation of a wild strain of Sporothrix schenckii at the same locality. This finding could classify this particular area as a zone of interest in the epidemiological and ecological study of the mediterranean sporothricosis. PMID- 3627221 TI - Exophiala dermatitidis de Hoog from a valvular aortal prothesis. PMID- 3627222 TI - Fungi associated with urea-formaldehyde foam insulation in Canada. AB - Sixty-eight fungal taxa were identified from samples of urea-formaldehyde foam insulation taken from Canadian residences. Mesophilic taxa were predominant, with Penicillium spp., Trichoderma harzianum and Paecilomyces variotii observed most frequently. Extensive or conspicuous growth also was seen for Hormoconis resinae, Stachybotrys chartarum and Trichoderma viride in some samples. The potential for these fungi to have contributed to the adverse health effects reported in some homes containing UF-foam insulation is discussed. PMID- 3627223 TI - Survival and growth of Ajellomyces (Blastomyces) dermatitidis on oak leaves coated with saliva. AB - Yeast-form cells of Ajellomyces dermatitidis transferred to unsterilized and sterilized oak leaves in a humidity chamber failed to grow and produce mycelium. Transfers of these cells to Mycobiotic agar resulted in the growth of A. dermatitidis from all 5 autoclaved and 4 of the 11 unsterilized leaves. Soaking oak leaves with human airways secretions or saliva and inoculating them with yeast-form cells, and pouring sterile H2O on the leaves 10 days to 2 months later, permitted growth on 11 out of 36 leaves. It was concluded that these two natural substances, airways secretions and saliva, inhibited bacteria and furnished nutriment to A. dermatitidis. PMID- 3627224 TI - Food irradiation legislation due despite public suspicion. PMID- 3627225 TI - Fertilization events. PMID- 3627226 TI - AIDS predictions. PMID- 3627227 TI - A long-term increase in the fluid intelligence of English children. AB - In the early decades of the century a number of geneticists and psychologists believed that intelligence in the economically advanced nations was in secular decline. Contrary to this expectation, recent data for a number of countries have shown that intelligence has been increasing at rates far greater than hitherto considered probable. A compilation of this data by Flynn for 14 economically advanced nations has shown that intelligence quotient (IQ) rises have generally been within the range of 2-12 IQ points per decade. These recent studies raise several questions, among which are precisely what abilities have been increasing over time; and whether existing data are correct in suggesting that the secular rise in Britain is lower than that in other countries. We report here that in English children there has been an increase over the past 50 years of 12.42 IQ points, averaging 2.48 points per decade. The increase has been in fluid intelligence, the mental power that underlies the acquisition of cognitive skills, rather than in crystallized intelligence, which represents the cognitive skills acquired in a particular culture. PMID- 3627228 TI - Chemical structure of the morphogen differentiation inducing factor from Dictyostelium discoideum. AB - Morphogens are signal molecules presumed to exist in embryos and to be involved in establishing the spatial pattern of cells during development. Differentiation inducing factor (DIF) has the properties of a morphogen required for producing the prestalk/prespore pattern in the aggregate formed by cells of the slime mould Dictyostelium in response to starvation. DIF-1, the major bioactive species after purification, has now been identified using a combined microchemical, spectroscopic and synthetic approach. The structure is defined as 1-(3,5-dichloro 2,6-dihydroxy-4-methoxyphenyl)-1-hexanone, and represents a new class of effector molecule. The availability of relatively large quantities of synthetic and isotopically labelled materials should now allow progress towards a detailed understanding of the pattern-forming processes in Dictyostelium development. PMID- 3627229 TI - Cell-cycle regulatory sequences in a hamster histone promoter and their interactions with cellular factors. AB - Knowledge of how genes are regulated during the cell cycle is essential for understanding the process of cell growth on a molecular level. Numerous studies have established that, as mammalian cells go through the cell cycle, histone mRNA levels change, the largest amount being produced in the S phase. Both transcriptional and post-transcriptional mechanisms are responsible for this regulation and it has recently been demonstrated that nucleotide sequences in both the 5' and 3' termini of the histone gene are involved. From deletion analysis of a hamster H3.2 fusion gene, we report here that the crucial control signals for both cell-cycle regulation and high level expression in vivo are contained in a 32-nucleotide (nt) region about 150 nt upstream of the TATA sequence and do not require any histone protein coding sequence. By comparison, the promoter of the herpes simplex virus (HSV) thymidine kinase gene is serum stimulated but not cell-cycle regulated. The cell-cycle control exerted by the histone DNA regulatory element acts at the transcriptional level, as the rate of transcription is stimulated during the DNA synthetic phase of the cell cycle. Using DNA-protein mobility shift experiments, we demonstrate the existence of high affinity cellular factors interacting with the histone H3.2 promoter sequence. The concentration of the protein-DNA complexes shows cell-cycle variation, particularly during the transition from late G1 to the DNA synthesis phase. These data provide evidence for in vivo interactions between the cell cycle transcriptional regulatory factors and the cis-acting DNA domain. PMID- 3627230 TI - The accessible surface area and stability of oligomeric proteins. AB - Protein structures are stabilized by hydrophobic and van der Waals forces, and by hydrogen bonds. The relation between these thermodynamic quantities and the actual three-dimensional structure of proteins can not be calculated precisely. However, certain empirical relations have been discovered. Hydrophobic energy is gained by the reduction of surface in contact with water. For monomeric proteins, the area of the surface accessible to solvent, and of that buried in the interior, is a simple function of molecular weight. Proteins with different shapes and secondary structures, but of the same molecular weight, have the same accessible surface area. It has been argued that there is no similar relationship for large oligomeric proteins. In this paper we show that the surface areas of oligomeric proteins, and the areas of the surface buried within them, are directly related to relative molecular mass. Although oligomers of the same molecular weight bury the same amounts of surface, the proportions buried within and between subunits vary. This has important implications for the role of subunit interfaces in the stability and activity of oligomeric proteins. PMID- 3627231 TI - Investigating the paranormal. PMID- 3627232 TI - Haemodynamics: how giraffes prevent oedema. PMID- 3627233 TI - Seasonal depression: ironies of animal modelling. PMID- 3627234 TI - Contingent contagious constraints. PMID- 3627235 TI - Growth transformation by v-myc. PMID- 3627236 TI - The primate trade and the origin of AIDS viruses. PMID- 3627237 TI - Tobacco companies win round in health battle. PMID- 3627238 TI - UK immigration authorities may use DNA fingerprinting. PMID- 3627239 TI - Rapid removal of Chernobyl fallout from Mediterranean surface waters by biological activity. AB - The sinking of particulate organic matter from the euphotic zone is an important pathway for the vertical transport of many elements and organic compounds in the sea. Many natural and artificial radionuclides in surface waters are readily adsorbed onto suspended particles and are presumably scavenged and removed to depth on time scales commensurate with both particle sinking rate and retention time of the radionuclide on the particle. Previously, abyssal benthic organisms from the northeast Pacific were found to contain short-lived fission products which entered the sea surface as fallout from nuclear testing. The presence of these radionuclides at great depth could not be explained by Stokesian settling of small fallout particles and it was hypothesized that zooplankton grazing in the surface layers packaged these particle-reactive radionuclides into large, relatively dense faecal pellets which rapidly sank to depth. We report here data from a time-series sediment trap experiment and concomitant zooplankton collections which show conclusively that Chernobyl radioactivity, in particular the rare earth nuclides 141Ce and 144Ce, entering the Mediterranean as a single pulse, was rapidly removed from surface waters and transported to 200 m in a few days primarily by zooplankton grazing. PMID- 3627241 TI - Why the world needs population biology to solve its problems. PMID- 3627240 TI - Gravitational haemodynamics and oedema prevention in the giraffe. AB - Because it is so tall, the giraffe, Giraffa camelopardalis, provides an important animal model for investigating adaptive mechanisms to orthostatic (gravitational) pressure changes. Previous physiological studies of the giraffe have concentrated on arterial blood pressures in the heart and neck. Briefly, these investigations revealed that arterial pressure near the giraffe heart is about twice that in humans, to provide more normal blood pressure and perfusion to the brain. Another important question is that of how giraffes avoid pooling of blood and tissue fluid (oedema) in dependent tissues of their extremities. As monitored by radiotelemetry, the blood and tissue fluid pressures that govern transcapillary exchange vary greatly with exercise. These pressures, combined with a tight skin layer, move fluid upward against gravity. Other mechanisms that prevent oedema include precapillary vasoconstriction and low permeability of capillaries to plasma proteins. PMID- 3627242 TI - Treponemal infection in a Pleistocene bear. AB - The age and origins of the organisms that cause syphilis (treponemes) have long been matters for controversy. The widely-held belief that Columbus's ship brought the disease from the New World to Europe rests on identification of the classic lesions in Inca, Aztec and Mississippian bones that date from 1,000 to 3,000 years before present. But these were not confirmed by immunological techniques. We have observed lesions characteristic of treponemal infection in a Pleistocene bear from Indiana (dated 11,500 years BP) which give a positive result when tested with the antisera used by the US Center for Disease Control for verification of syphilis infection. This is the earliest detection of treponemal disease using contemporary techniques. PMID- 3627243 TI - Amelioration of cholinergic neuron atrophy and spatial memory impairment in aged rats by nerve growth factor. AB - In aged rodents, impairments in learning and memory have been associated with an age-dependent decline in forebrain of cholinergic function, and recent evidence indicates that the cholinergic neurons in the nucleus basalis magnocellularis, the septal-diagonal band area and the striatum undergo age-dependent atrophy. Thus, as in Alzheimer-type dementia in man, degenerative changes in the forebrain cholinergic system may contribute to age-related cognitive impairments in rodents. The cause of these degenerative changes is not known. Recent studies have shown that the central cholinergic neurons in the septal-diagonal band area, nucleus basalis and striatum are sensitive to the neurotrophic protein nerve growth factor (NGF). In particular, intraventricular injections or infusions of NGF in young adult rats have been shown to prevent retrograde neuronal cell death and promote behavioural recovery after damage to the septo-hippocampal connections. It is so far not known, however, whether the atrophic cholinergic neurons in aged animals are responsive to NGF treatment. We report here that continuous intracerebral infusion of NGF over a period of four weeks can partly reverse the cholinergic cell body atrophy and improve retention of a spatial memory task in behaviourally impaired aged rats. PMID- 3627244 TI - AIDS tests compulsory. PMID- 3627246 TI - A bacterial calcium-binding protein homologous to calmodulin. AB - Many of the effects of calcium ions in eukaryotic cells are mediated by calcium binding regulatory proteins such as calmodulin, in which each calcium-binding site has a distinctive helix-loop-helix conformation termed the EF hand. Protein S from the spore coat of the Gram-negative bacterium Myxococcus xanthus has been shown to resemble calmodulin in its internally-duplicated structure and ability to bind calcium. However, it has a beta-sheet secondary structure rather than the helix-loop-helix arrangement of the eukaryotic proteins. We have determined the complete amino-acid sequence of a calcium-binding protein from the Gram-positive bacterium "Streptomyces erythraeus" by cloning and sequencing the corresponding gene. It contains four EF-hand motifs bearing remarkable sequence similarity to the calcium-binding sites in calmodulin. This implies that the EF-hand super family may have evolved from ancient proteins present in prokaryotes. PMID- 3627245 TI - Czech uranium miners up in arms over working conditions. PMID- 3627247 TI - Student aspirations decidedly financial. AB - Careers in high-technology industry and scientific research are not top of all graduates' lists, and college leavers are taking a hard-headed approach to employment. PMID- 3627249 TI - Vatican and IVF. PMID- 3627248 TI - Science the only hope? PMID- 3627250 TI - Protein crystallography. Catching up with fast changes. PMID- 3627251 TI - Observing the founder effect in human evolution. PMID- 3627252 TI - Alzheimer's disease. Tangled genes and proteins. PMID- 3627253 TI - Receptor-gene sequence. PMID- 3627254 TI - An octamer oligonucleotide upstream of a TATA motif is sufficient for lymphoid specific promoter activity. AB - The octamer sequence ATGCAAAT or its inverse complement ATTTGCAT is well conserved in all immunoglobulin gene promoters and has been implicated in promoter function by deletion analysis. Although immunoglobulin promoters are tissue-specific, the octamer is also a functional element in non-tissue-specific upstream regions--like those controlling U1 and U2 small nuclear RNA and histone H2B genes--where it is associated with additional canonical elements. Specific interactions occur between the octamer motif and both lymphoid-specific and ubiquitous proteins. By using a synthetic octamer oligonucleotide inserted upstream of the beta-globin TATA box we show here that the octamer element by itself is sufficient for directing lymphocyte-specific RNA synthesis when within 70 base pairs of the start site of transcription. We also demonstrate that mutations in any position of the conserved motif interfere with this function. PMID- 3627255 TI - Indian turmoil over planned US tests of new vaccines. PMID- 3627256 TI - Radiation limits challenged. PMID- 3627257 TI - Hard battles on radiation safety. PMID- 3627258 TI - AIDS clashes in presidential commission. PMID- 3627259 TI - US AIDS education programme on-again, off-again. PMID- 3627260 TI - Safety issues raised by worker's infection with AIDS virus. PMID- 3627261 TI - Databases. PMID- 3627263 TI - Crystallography. Entering a new phase. PMID- 3627262 TI - Protein chemistry. Folding into the right shape. PMID- 3627264 TI - Comments on the sombre view of AIDS. PMID- 3627265 TI - HBLV (or HHV-6) in human cell lines. PMID- 3627266 TI - The blood-brain barrier. PMID- 3627267 TI - Membrane conductance oscillations in astrocytes induced by phorbol ester. AB - Glial cells in the central nervous systems (CNS) have complex functions which are difficult to decipher because of the intimate intertwining of glial cells with neurons. We have therefore developed an essentially neuron-free preparation of CNS astrocytes in the kainic acid lesioned hippocampal slice. With this preparation we have examined the effect of activating protein kinase C in astrocytes with a phorbol ester, TPA (12-O-tetradecanoyl-phorbol-13-acetate). In most cells, TPA induced rhythmic oscillations (0.1-3.0 Hz) of membrane potential which were typically 5-10 mV in amplitude and were associated with increases of up to eightfold in input resistance during the depolarizing phase. These large changes in membrane conductance are the first reported observations of endogenously generated conductance changes in astrocytes of the mammalian CNS and they could influence excitability of surrounding neurons, possibly by altering extracellular ion concentrations. PMID- 3627268 TI - Importance of DNA stiffness in protein-DNA binding specificity. AB - From the first high-resolution structure of a repressor bound specifically to its DNA recognition sequence it has been shown that the phage 434 repressor protein binds as a dimer to the helix. Tight, local interactions are made at the ends of the binding site, causing the central four base pairs (bp) to become bent and overtwisted. The centre of the operator is not in contact with protein but repressor binding affinity can be reduced at least 50-fold in response to a sequence change there. This observation might be explained should the structure of the intervening DNA segment vary with its sequence, or if DNA at the centre of the operator resists the torsional and bending deformation necessary for complex formation in a sequence dependent fashion. We have considered the second hypothesis by demonstrating that DNA stiffness is sequence dependent. A method is formulated for calculating the stiffness of any particular DNA sequence, and we show that this predicted relationship between sequence and stiffness can explain the repressor binding data in a quantitative manner. We propose that the elastic properties of DNA may be of general importance to an understanding of protein-DNA binding specificity. PMID- 3627270 TI - Chernobyl takes macaroni off Japan's menu. PMID- 3627269 TI - Proline isomerism in staphylococcal nuclease characterized by NMR and site directed mutagenesis. AB - Nuclear magnetic resonance (NMR) studies have shown that two distinct folded conformations of staphylococcal nuclease coexist in solution and that these two states can interconvert directly without passing through an unfolded state. These experiments have also revealed that the two forms have very different folding kinetics, although the possibility that one component is an obligatory intermediate for the folding of the other form could be discounted. Here we report NMR data which show that alternative unfolded states are also distinguishable. These observations led us to hypothesize that cis/trans isomerism at a single peptide bond between a proline and its preceding residue might be the origin of the conformational multiplicity. Proline 117 was identified as a likely candidate for the site concerned and a mutant protein, in which Pro 117 was replaced by Gly, was constructed in order to test this. Alternative conformations are not observed in the spectrum of this mutant, lending powerful support to this hypothesis. PMID- 3627271 TI - Medical research on the block. PMID- 3627272 TI - US Congress adds its voice to the genome-sequencing chorus. PMID- 3627273 TI - Architecture for molecular medicine. PMID- 3627274 TI - Detection of sickle cell anaemia and thalassaemias. PMID- 3627275 TI - Amino-acid sequence similarities. PMID- 3627277 TI - Sliding-layer conformational change limited by the quaternary structure of plant RuBisCO. AB - RuBisCO, D-ribulose-1,5-bisphosphate carboxylase-oxygenase (EC 4.1.1.39), converts carbon dioxide to sugar in the first step of photosynthesis. In plants and some bacteria, this enzyme has an L8S8 structure, where L is the large catalytic subunit and S is the small subunit of unknown function. The molecule resembles a keg 105 A along the 4-fold axis and 132 A in diameter at the widest point of the keg. Here we describe the quaternary structure of RuBisCO from N. tabacum, the first L8S8 type known from an X-ray crystallographic study at near atomic resolution (3 A). The structure shows that all eight L subunits are elongated along the 4-fold axis so that the molecule cannot be simply described as layers of subunits, as it had been from studies by electron microscopy. The structure, with its elongated and interdigitated L subunits, is evidence against a large, sliding-layer conformational change in plant RuBisCO, as proposed recently in Nature for the same enzyme from Alcaligenes eutrophus. PMID- 3627276 TI - Molecular cloning and sequencing of a human hepatitis delta (delta) virus RNA. AB - Human hepatitis delta (delta) virus (HDV) is a form of defective virus, which infects humans only in the presence of a co-infecting hepatitis B virus (HBV). HDV superinfection in a chronic HBV carrier often results in severe chronic hepatitis and cirrhosis, whereas acute HDV and HBV co-infection is frequently associated with fulminant hepatitis. HDV consists of a 36-nm particle, which contains an envelope with HBV surface antigen, and a nucleocapsid containing the hepatitis delta-antigen (HDAg) and an RNA genome of 1.75 kilobases (kb). Recently, the genomic RNA from an HDV serially passaged in chimpanzees has been cloned and sequenced in a study which showed that the HDV RNA is a single stranded circular molecule with properties similar to those of viroid or virusoid. However, it is not known whether serial passages in chimpanzees had altered the properties of human HDV. Here we report the cloning and sequencing of an HDV RNA isolated directly from a patient with acute delta-hepatitis. The sequence showed considerable divergence (11%) from that of the chimpanzee-adapted HDV. Five open reading frames (ORFs) of more than 100 amino acids in both genomic and anti-genomic sense were found. The largest ORF in antigenomic sense, which can code for 214 amino acids, may correspond to the HDAg. PMID- 3627278 TI - Biotechnology in Japan and other Asian countries. A computer-based approach to continuous assessment. AB - By combining information about Biotechnology in Japan manually retrieved from Chemical Abstracts (Biochemical Section) with information obtained from Japanese sources, Japanese scientific meetings and from appropriate magazines such as Nikkei Biotech, a basis was formed for a better understanding of the status and perspectives of this field. Through the development of a "biotechnology abstract analyzer" program, these data were further refined and prepared for continuous up date. Thus, assessment of changes in institute structures and trends in research goals became possible. It is evident that similar procedures can be applied to any field of science in other geographic areas. PMID- 3627279 TI - A universal constant in temporal segmentation of human short-term behavior. PMID- 3627280 TI - The acuity of sound localization in the pigeon (Columba livia). PMID- 3627281 TI - Muscarine receptors on the rat phrenic nerve, evidence for positive and negative muscarinic feedback mechanisms. AB - Neuronal transmitter stores of the rat phrenic nerve were labelled by incubation with [3H]choline. Release of [3H]acetylcholine was elicited by electrical nerve stimulation (100 or 1,500 pulses, 5 or 25 Hz) or by high potassium (27 mmol/l) and the effects of the muscarine receptor agonist oxotremorine and the antagonist scopolamine were investigated. Neither oxotremorine nor scopolamine affected the basal tritium efflux. A low concentration of oxotremorine (10 nmol/l) enhanced and a high concentration of oxotremorine (1 mumol/l) reduced the electrically evoked [3H]acetylcholine release. Likewise, the high potassium-evoked [3H]acetylcholine release was reduced by a high concentration of oxotremorine. Both effects of oxotremorine, increase and decrease, were abolished by a pretreatment (30 min before the first stimulation period) with 0.1 mumol/l scopolamine. Scopolamine (0.1 mumol/l) alone, enhanced [3H]acetylcholine release evoked by 100 pulses (5 Hz) or by high potassium. Scopolamine, however, reduced [3H]acetylcholine release evoked by 1,500 pulses (5 Hz or 25 Hz). The concentration-response curves obtained for scopolamine under these latter stimulation conditions were flat-running and biphasic which might indicate the involvement of two opposite effects (increase and decrease) of scopolamine under the present stimulation conditions. Both effects of scopolamine were reduced in the presence of 10 mumol/l neostigmine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627283 TI - Studies on interactions between conditioned and unconditioned behavioural responses to apomorphine in rats. AB - Interactions between the direct (unconditioned) behavioural effects apomorphine and its conditioned effects after pairing with previously neutral stimuli were studied. Rats were injected once daily for 3-12 times, with apomorphine (2.0 mg/kg or 0.5 mg/kg or 0.07 mg/kg s.c. the dose kept constant in each series), in the presence of defined environmental stimuli (a wire cage in association with an acoustic and an olfactory stimulus) as conditional stimuli. The two larger doses produced stereotyped sniffing, licking, and gnawing, the smallest dose akinesia, ptosis, yawning and penile erections. During the conditioning phase, the drug produced most of the effects with increasing intensity and in the case of the stereotypies, there also was a shift to higher scores of stereotypy, with a reduced latency in onset of the signs. On the test day, 1 day after the last administration of apomorphine, the conditioned rats as well as "pseudoconditioned" controls were treated with a test dose of apomorphine in the presence of the conditional stimuli. Pseudoconditioned rats had been treated with the same pharmacological schedule of apomorphine and had the same familiarity with the stimuli, but both were kept separate. A test dose of 0.5 mg/kg of apomorphine produced stereotypies with a significantly higher score and shorter latency in onset in conditioned than in pseudoconditioned rats. Rats conditioned with the lowest dose showed a significantly longer total duration and a shorter latency in onset of akinesia and ptosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627282 TI - Quantitative [3H]dipyridamole autoradiography: evidence for adenosine transporter heterogeneity in guinea pig brain. AB - [3H] Dipyridamole binding in guinea pig brain slices has been characterized. Binding of [3H] dipyridamole to guinea pig forebrain slices was found to be rapid, reversible and saturable. Saturation experiments revealed a class of high affinity binding sites with a Bmax value of 592 +/- 118 fmol/mg protein and Kd value of 10.8 nM +/- 2.1 nM in the analysed concentration range. In competition experiments, the adenosine transport inhibitors hexobendine and dipyridamole itself were the most potent displacers (inhibition constants of 4.6 nM +/- 1 nM and 11.5 nM +/- 3 nM) with "pseudo-Hill" coefficients close to 1. Competition curves with nitrobenzylthioinosine, another adenosine transport inhibitor, however, showed a biphasic profile with a "pseudo-Hill" coefficient of 0.33 +/- 0.04. Just 42% +/- 4% of [3H] dipyridamole binding were inhibited by nanomolar concentrations of nitrobenzylthionosine and only micromolar concentrations displaced the remainder. Subsequent quantitative autoradiography demonstrated regional differences in the inhibition of [3H] dipyridamole binding by submicromolar concentrations of nitrobenzylthioinosine. While in cortical areas of cerebrum and cerebellum 500 nM nitrobenzylthioinosine displaced binding of [3H] dipyridamole to only about one-third of its sites (in the Purkinje cell layer less than 10%), it showed similar potency as dipyridamole in various areas of the brainstem and hypothalamus. This biphasic and regionally heterogenous interaction of nitrobenzylthioinosine with [3H] dipyridamole binding sites in guinea pig brain slices strongly suggests heterogeneity of adenosine transporters. PMID- 3627284 TI - Local cerebral glucose utilization and local cerebral blood flow in conscious rats after administration of flunarizine. AB - The effects of the calcium entry blocker flunarizine on physiologic variables, local cerebral blood flow (LCBF) and local cerebral glucose utilization (LCGU) were investigated. LCBF and LCGU were determined in 37 anatomically discrete brain regions in lightly restrained, conscious rats, using the quantitative, autoradiographic 14C-iodoantipyrine and 14C-2-deoxyglucose techniques. While 5 mg/kg flunarizine given i.v. did not change any of the measured physiologic variables, flunarizine increased LCBF in nearly all gray matter structures compared with saline-treated controls. LCGU was not changed compared to controls. In control as well as in flunarizine-treated rats coupling between LCGU and LCBF was tight. The ratio of LCBF/LCGU was increased after treatment with flunarizine. The data suggest that under normal physiological conditions the calcium entry blocker flunarizine does not change neuronal activity, but exerts primarily a cerebral vasodilating action. PMID- 3627286 TI - Ketoconazole impairs biliary excretory function in the isolated perfused rat liver. AB - The effects of ketoconazole (KT) on the hepatic excretory function was investigated in the isolated perfused rat liver. KT, at the concentrations of 5 X 10(-5) M or 10(-4) M caused dose-dependent decreases of the biliary bile acid concentration and excretion rate, with no significant effect on bile flow rates. Neither dose altered perfusate flow through the liver. Furthermore, at the same two concentrations, KT impaired the sulfobromophthalein transport in a dose dependent manner. In contrast, the drug did not alter 14C-sucrose bile to perfusate ratio and did not cause enzyme release from the liver into the perfusate. The study demonstrates that KT possesses an intrinsic toxicity in the isolated perfused rat liver and suggests caution in the use of this drug in hepatopathic patients. PMID- 3627285 TI - Effects of halothane, enflurane and pentobarbital on brain histamine dynamics in mice. AB - The effects of halothane, enflurane, ketamine and pentobarbital on brain histamine dynamics were examined in mice. Brain histamine and tele methylhistamine, a predominant metabolite of brain histamine, were simultaneously measured by high-performance liquid chromatography with fluorescence detection. Anaesthesia with the four agents had no effect on brain histamine content. The tele-methylhistamine content significantly increased during 1 h and 2 h anaesthesia with halothane (0.051 mmol/l or 0.76 mol/l) and 2 h anaesthesia with enflurane (0.11 mol/l or 0.16 mol/l). Enflurane and pentobarbital significantly inhibited the histamine depletion induced by alpha-fluoromethylhistidine (50 mg/kg, intraperitoneally), a specific inhibitor of histidine decarboxylase, suggesting that these agents decrease the histamine turnover. However, halothane and ketamine were ineffective in this respect. These results emphasize that various anaesthetics have different influences on brain histamine dynamics. Since there have been findings suggesting that brain histaminergic systems are involved in physiological functions such as regulation of blood pressure, body temperature and hormone secretion, changes in the brain histamine turnover should be given due attention with regard to physiological changes during anaesthesia. PMID- 3627287 TI - [3H]-5-methoxytryptoline is not actively accumulated by rabbit platelets. AB - 5-Methoxytryptoline (5-MeO-TLN, 6-methoxytetrahydro-beta-carboline) inhibits with high affinity [3H]-imipramine binding to the serotonin transporter in platelets. To evaluate whether 5-MeO-TLN is a substrate for the serotonin transporter, the accumulation of [3H]-5-MeO-TLN into rabbit platelets was studied in vitro. At short incubation times (5 min), [3H]-5-MeO-TLN accumulation was temperature sensitive, but not saturable over a concentration range from 0.06 mumol/l to 10 mumol/l. Moreover, [3H]-5-MeO-TLN uptake was not affected by 100 mumol/l ouabain, its structural analogs tryptoline and 5-hydroxytryptoline, nor by the serotonin uptake inhibitors imipramine and citalopram. After longer incubation times (60 min), [3H]-5-MeO-TLN accumulation at 0 degree C approached that seen at 37 degrees C and temperature-sensitive [3H]-5-MeO-TLN uptake could no longer be observed. It is concluded that temperature-sensitive accumulation of [3H]-5-MeO TLN is not mediated by the serotonin transporter and most likely represents a passive, diffusional process, the rate of which is temperature-dependent. The present studies thus confirm the hypothesis that 5-MeO-TLN affects [3H] imipramine binding in platelets through a competitive mechanism and not via an allosteric interaction mediated through the substrate recognition site of the macromolecular complex of serotonin transporter. PMID- 3627288 TI - A long lasting gastrin response to apomorphine revealed by inhibitors of gastric acid secretion. AB - Gastrin levels, in the peripheral venous blood of conscious dogs treated with apomorphine (0.05 mg/kg IV), were analysed with a radioimmunoassay. Pretreatment (30 min) with the gastric acid inhibitors cimetidine, ranitidine (H2 receptor antagonists, 4 mg/kg and 1 mg/kg respectively) or omeprazole (H+-K+ ATPase inhibitor, 1.6 mg/kg) prolonged the elevation of gastrin levels occurring in response to an administration of apomorphine. Haloperidol (0.1 mg/kg), but not the peripheral dopamine receptor antagonist domperidone (0.2 mg/kg), abolished the enhanced gastrin response to apomorphine occurring after pretreatment with cimetidine. Cimetidine did not increase the gastrin response to apomorphine in vagotomized dogs. The results are interpreted in terms of an additive gastrin response to apomorphine (different from the short lasting initial peak previously described) which is vagally mediated and inhibited by the gastric acid. PMID- 3627289 TI - Pharmacokinetic and neurochemical studies on N-propargyl-2-phenylethylamine, a prodrug of 2-phenylethylamine. AB - Pharmacokinetic and neurochemical properties of N-propargyl-2-phenylethylamine, a known MAO inhibitor and a potential prodrug of the bioactive trace amine, 2 phenylethylamine, were studied in rats. Intraperitoneal (i.p.) administration of N-propargyl-2-phenylethylamine produced marked elevations in 2-phenylethylamine levels in rat brain, blood and liver; these levels remained significantly above controls for more than 4 h. Neurochemical studies showed the drug to be a preferential MAO-B inhibitor at a dose of 0.1 mmol/kg (i.p.). This selectivity was much more pronounced in liver than in brain. N-Propargyl-2-phenylethylamine produced a significant decrease in whole brain concentrations of noradrenaline, dopamine and DOPAC, but they returned to control values by 3 h after drug administration. Concentrations of 5-HT were unaffected, while 5-HIAA and HVA concentrations increased significantly above controls. Results indicate that N propargyl-2-phenylethylamine is a prodrug of 2-phenylethylamine and a potentially useful pharmacological tool with which to study the functional role of 2 phenylethylamine in the mammalian central nervous system. PMID- 3627290 TI - Pre- and postjunctional adrenoceptor types in the circular muscle of the guinea pig caecum. AB - The sucrose gap technique was used to study the effects of applied adrenoceptor agonists on membrane potential and non-adrenergic, non-cholinergic inhibitory junction potentials (IJPs), in the smooth muscle of the circular coat of guinea pig caecum. Noradrenaline (10 nmol/l-100 mumol/l), phenylephrine (1-100 mumol/l) and isoprenaline (0.1-100 mumol/l) caused hyperpolarisations of the smooth muscle membrane which were rapid in onset and effect. The magnitudes of hyperpolarisations elicited by noradrenaline were significantly reduced by the non-specific alpha-adrenoceptor antagonist phentolamine (10 mumol/l), the alpha 1 adrenoceptor antagonist prazosin (1 mumol/l) and the beta-adrenoceptor antagonist propranolol (5 mumol/l). The alpha 2-antagonist yohimbine (10 mumol/l) did not significantly reduce the magnitude of the hyperpolarisations induced by noradrenaline. Noradrenaline application caused a reduction in IJP amplitude, during hyperpolarisation, by up to 50%. The reduction of the IJP amplitude elicited by noradrenaline was significantly antagonised by yohimbine and phentolamine, but not by prazosin or propranolol. Clonidine caused a reduction of IJP amplitude by up to 20%, but neither phenylephrine nor isoprenaline caused any significant reduction in IJP amplitude. It is concluded that the hyperpolarising responses to exogenous noradrenaline in the circular muscle of guinea-pig caecum are mediated by postjunctional alpha 1- and beta-adrenoceptors, and that the inhibition of IJP amplitude is mediated by prejunctional alpha 2-adrenoceptors. PMID- 3627292 TI - What do behavioral scientists know--and what can they do--about alcoholism? PMID- 3627291 TI - Effect of prolonged clonidine treatment and its withdrawal on noradrenaline turnover in the cerebral cortex and medulla oblongata of the spontaneously hypertensive rat. AB - We have investigated the effect of prolonged treatment with clonidine (delivered intravenously via osmotic minipumps, 0.5 mg . kg-1 X 24 h-1 for 10 days) and of withdrawal of this treatment on ingestive behaviour and on the cerebral turnover of noradrenaline in the adult spontaneously hypertensive rat (SHR). Clonidine amplified the fall in food and water intakes induced by minipump implantation. Ingestive behaviour returned to normal by the 4th to the 5th day in controls and by the 7th to the 8th day in clonidine-treated SHR. Clonidine withdrawal produced an increase in water intake above pre-implantation values. Body weight fell during clonidine treatment, then recovered slightly during withdrawal. After 5 days' treatment total DOPEG levels (an index of noradrenaline turnover) were reduced in cerebral cortex and medulla oblongata. The noradrenaline metabolite levels increased following withdrawal of drug treatment, the increase being more marked and faster in onset in cerebral cortex than in medulla oblongata. Thus prolonged treatment with clonidine decreases noradrenaline turnover and withdrawal of such treatment increases turnover. PMID- 3627293 TI - Alcohol and addictive behavior. PMID- 3627294 TI - Alcoholism: a family interaction perspective. PMID- 3627295 TI - Biological markers for alcoholism: a vulnerability model conceptualization. AB - As the foregoing review indicates, we have made considerable progress in identifying a number of promising metabolic, behavioral, and neurophysiological markers for assessing risks for developing alcoholism. As previously noted, the term "marker" has been extended beyond its current usage in genetic marker studies where typically a blood marker has been used to elucidate the genetic transmission of particular diseases. In these studies the "ideal" marker is one which is itself an inherited characteristic that is polymorphic (there exist two or more discrete forms that are commonly found in the population), has an established mode of inheritance, is unaffected by the presence of the episode (e.g., the ABO system is unaffected by presence of a disorder), and is localizable to a particular chromosome. Few potential markers satisfy all these requirements, yet it is important to keep this in mind as we search for "markers" for vulnerability to developing alcoholism. We have proposed a vulnerability model for alcoholism in an attempt to sort out which potential markers hold promise for identifying individuals who are at risk. We have chosen to look at vulnerability from both biological and psychosocial perspectives realizing that some people may carry biological markers as part of their genetic heritage yet never develop episodes of abusive drinking because they lack psychosocial vulnerability. For example, women appear less likely to develop alcoholism than men because of cultural factors that reduce the chance that they will become heavy drinkers. The greater risk for heavy drinking among men than women appears, however, to be independent of the particular cultures. As mentioned earlier, among the 30 cultures assessed for male and female drinking practices, in no instance did women drink more than men, and in 16 men drank more than women. In the vulnerability model proposed, we assume that alcoholism is not a continuous disorder but that vulnerability, whether biological or psychosocial, is. This vulnerability may remain latent throughout life or may become manifest when triggers sufficient to produce an episode occur. These triggers may be life events or changes in the internal milieu. For example, biological changes may well produce a major affective disorder which in turn may lead to alcohol abuse. That some individuals have only one major episode of abusive drinking and never return to excessive use of alcohol attests to the fact that alcoholism should not be conceived of as a lifelong disease. Therapeutic intervention should be aimed at preventing its initial occurrence or its recurrence.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3627296 TI - The motivation to use drugs: a psychobiological analysis of urges. AB - Traditionally, theories of addiction have stressed that drug urges are characterized by dysphoria, occur in response to decreasing levels of drug or drug effect, and are associated with withdrawal symptoms/signs or drug antagonistic responses arising from a homeostatic mechanism. However, recent research has shown that urges, drug self-administration, and relapse all occur concomitant with both positive and negative affect, rising and falling levels of drug, and with drug-agonistic responses, as well as antagonistic/withdrawal responses. In keeping with recent theorizing about motivation and emotions, we believe that affective responding provides a readout of the motivational status of an organism (e.g., Buck, 1985). We conceive of urges as affects, whose activation mediates drug pursuit and self-administration. Moreover, we believe that affects are represented in neural networks comprising information on affect relevant stimuli, responses, and meaning/expectancy. We believe that there are two types of urge networks. One, a "positive-affect" network, is activated, associatively and nonassociatively, by appetitive stimuli, especially appetitive drug actions that activate "GO" motivational incentive systems. Activation of this network is characterized by positive affect, drug isodirectional responding, attentional focus on a dominant response, and enhanced pursuit of appetitive stimuli--especially the drug. The operating characteristics of the positive affect network, and the associated motivational systems, result in a drug's instating a positive feedback loop. Appetitive drug actions increase the likelihood of the pursuit of appetitive stimuli, and additional drug constitutes a prepotent candidate from among the available appetitive stimuli. This positive feedback loop may account in part for cardinal features of addiction: for example, the great relapse likelihood once any drug is sampled, the attainment of very high blood levels of a drug, and the pursuit of adjunctive appetitive stimuli while using a drug. The second type of urge network we have labeled a "negative-affect" network, and we believe it is activated, associatively and nonassociatively, by inappetitive stimuli or consequences (punishment, signals of punishment, frustrating lack of reward, etc.) and by withdrawal and signals of withdrawal (e.g., drug cues, which during the course of addiction are associated with both direct drug effects and withdrawal). Activation of the network is characterized by withdrawal symptoms and signs, negative affect, and drug seeking.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3627297 TI - Antecedents and consequences of drinking and drinking problems in women: patterns from a U.S. national survey. PMID- 3627298 TI - [New aspects of the pathophysiology of spasticity]. PMID- 3627299 TI - [Pathology and clinical aspects of the posterior thalamus. 4 personal studies and review of the Dejerine-Roussy thalamic syndrome]. PMID- 3627300 TI - [Hemorrhagic cerebral infarcts with ventricular hemorrhage]. PMID- 3627301 TI - [Surgical treatment of ruptured cerebrovascular aneurysm in the elderly patient. Review over a 7-year period]. PMID- 3627302 TI - [Problems in medical expert assessment in cerebral aneurysm ruptures]. AB - On the basis of two cases, the question is discussed as to whether or not rupture of a cerebral aneurysm during working hours can be classed as an industrial accident. The possibility that raised blood pressure during an extraordinary, very atypical effort could be the cause of rupture is discussed in detail. The authors stress their opinion that--from neurosurgical view point--the rupture of a so-called congenital berry aneurysm can never be classed as a working accident but is absolutely fortuitous. Every event of daily life thought to be the cause of aneurysm rupture is completely coincidental. PMID- 3627303 TI - [Diagnostic significance of isolated thenar hypoplasia]. PMID- 3627304 TI - [Clinical experience with intradisk chymopapain administration in lumbar intervertebral disk displacement]. AB - In a retrospective study, complications following 157 chemonucleolyses (CNL) with chymopapain in 139 patients wer studied and the kind of pathological changes as found in the operation after CNL compared with those found in patients who were operated on because free sequesters were suspected on discography. The indications for CNL followed the accepted criterion of clinically, neuroradiologically or electromyographically detected alteration of a lumbar nerve root with clinical signs of sciatica. Free sequesters were found at subsequent operation much more often in those cases with primary indications for CNL, which showed signs of sequestration at discography, than in those who had had poor results after CNL. Discography as a means of finding previously undetected free sequesters should not be abandoned. In addition to procedure related reactions and unspecific complications, as well as immediate or delayed occurrence of severe backache, significant leucocytosis was observed on the first postoperative day. Probably immunological reactions such as severe hypotension after several hours, nausea and vomiting or rise of temperature, also occurred. In ten cases delayed urticarial or large erythematous efflorescences were observed. These reactions do obviously not correspond to the picture of anaphylaxis of the reagine-type such as is mostly described in the mechanism of chymopapain allergy. PMID- 3627305 TI - Tuberculosis--unabated alertness. PMID- 3627306 TI - Effects of human pituitary growth hormone on body composition. PMID- 3627307 TI - Does lowering blood pressure in hypertensive patients reduce the risk of death from coronary heart disease? PMID- 3627308 TI - A patient with miliary tuberculosis and acute adrenal failure. PMID- 3627310 TI - Yersiniosis and sequelae: grossly underdiagnosed? PMID- 3627309 TI - Non-operative treatment of a tuberculous paravertebral abscess. PMID- 3627311 TI - Frusemide and chlorthalidone once daily in normal subjects: differences in diuresis, natriuresis, kaliuresis, and the incidence of hypokalaemia. PMID- 3627312 TI - Inflammatory pseudotumour or retractile mesenteritis. PMID- 3627313 TI - Intractable bladder haemorrhage due to bladder fibrosis and telangiectasia associated with long-term cyclophosphamide therapy. PMID- 3627314 TI - An uncommon variant of Bartter's syndrome. PMID- 3627315 TI - Thyroid function tests in patients undergoing maintenance dialysis: characterization of the 'low-T4 syndrome' in subjects on regular hemodialysis and continuous ambulatory peritoneal dialysis. AB - Thyroid function tests were evaluated in 38 patients on regular hemodialysis (HD), in 36 on continuous ambulatory peritoneal dialysis (CAPD) and in 39 healthy controls. A significant reduction in total thyroxine (TT4), total triiodothyronine (TT3), reverse (rT3), and free T4 (fT4) mean levels and normal TSH, free T3, TBG and albumin concentrations was found in both HD and CAPD patients. A 'low-T4 syndrome' (serum T4 less than 5 micrograms/dl) was found in 9 CAPD (25%) and 20 HD (53%) patients, but none of them had fT4 levels below the normal laboratory range. The only striking difference between low-T4 HD and low T4 CAPD patients was the significantly lower TBG and albumin serum levels in CAPD group. Low-T4 HD displayed normal TBG levels but enhanced fT4/TT4 and fT4/TT4 X TBG ratios. We concluded that: the abnormalities in thyroid function tests in patients on long-term dialysis (HD and CAPD) do not express the existence of a true hypothyroidism; a different pathogenesis of the low-T4 syndrome in the CAPD and HD groups may be hypothesized: in the former it could be attributed to a reduction in serum-binding capacity for thyroid hormones, in the latter the relative increase in fT4 percentage despite normal TBG levels suggests either the presence of T4-TBG-binding inhibitor(s), or structural abnormalities of thyroid hormone-binding proteins. PMID- 3627316 TI - Model for individual substitution of immunoglobulins after membrane plasma separation. AB - Patients who undergo extensive plasma exchanges using albumin replacement may be more susceptible to infection because they develop significant hypogammaglobulinemia. Substitution of IgG in these patients could be beneficial. A model to calculate the individual amount of IgG required is described. The course of IgG during chronic intermittent membrane plasma separation (MPS) therapy was simulated using an one-pool model. Three modes of substitution were considered for their efficacy: infusion after MPS infusion after discarding an equivalent plasma quantity after termination of MPS, and plasma exchange at the end of MPS against an IgG solution. Mode B was shown to be most economical and was subsequently used to check the validity of the substitution model in a prospective test. The difference between predicted and measured IgG levels was 5% both for simulations from one MPS to the next and for the long-term prediction. The data prove that replacement of IgG after plasma separation is practicable. The substitution model allows to fix in advance any plasma limit value for indication and target of the substitution therapy. Thus it permits to give therapeutic recommendations for individual IgG substitution therapy of secondary antibody deficiency after MPS. PMID- 3627317 TI - Aluminum accumulation in the skin in end-stage renal failure. AB - Accumulation of aluminum (Al) of the skin of end-stage renal failure (ESRF) patients was analysed by means of an energy dispersive X-ray spectrometer (Kevex 7000 series). The Al detecting ratio was higher in the hemodialysis (HD) groups than in the non-dialysis ESRF group (p less than 0.025) and the normal volunteer group (p less than 0.01). There were no significant differences between the duration of HD (group I and group II), and between the non-dialysis ESRF and the normal volunteer groups. High Al accumulation detected in the skin of the HD groups may be attributed to the dosing of aluminum hydroxide gel (Al-gel), judging from the fact that all cases in the HD groups had been dosed with Al-gel (0.75-4.5 g/day). High Al detections were observed in 2 cases each of the HD and nondialysis ESRF groups responding HBs-antigen positive. PMID- 3627318 TI - Effect of chronic administration of ammonium sulfate on phosphatic stone recurrence. AB - Urine alkalinization favours the formation of calcium phosphate (CaP) and struvite stones. In this retrospective study we analyze the effect of chronic urinary acidification on phosphatic stone recurrence. Twenty-four patients with CaP-struvite recurrent stones and persistently high urinary pH were divided in two groups: group A, 11 patients who failed to lower the urinary pH below 5.5 during a standard acid load test: group B, 13 patients with preserved acidification power. Ammonium sulfate 2-3 g/day was given for 4.7 and 6.5 years to groups A and B, respectively. A persistent reduction in urinary pH, relative saturation for CaP and stone formation rate was observed in both groups. The treatment did not cause systemic acidosis as long as renal function remained normal. Urinary daily excretion of Ca and P as well as their renal tubular handling did not change with time. Results suggest acidifying agents might be useful in preventing recurrence of CaP-struvite stones even in the presence of a mild acidification defect and encourage undertaking properly controlled prospective trials. PMID- 3627319 TI - Erythrocyte sodium transport in normotensive and hypertensive patients on chronic hemodialysis, acute effect of treatment. AB - Patients on chronic hemodialysis were divided into two groups: normotensive patients (group I) and renal hypertensive patients treated with antihypertensives (group II). The sodium and potassium contents in red blood cells ([Na+]i, [K+]i), ouabain-resistant net sodium uptake (ORNa+ uptake, phi Na), the relative ORNa+ uptake (k), the mean cell hemoglobin concentration (MCHC), and acid-base status were examined just before and after dialysis. The results indicate that in treated renal hypertensive patients k is stimulated and causes lower red blood cell sodium content. The reason for this increase remains obscure: the pattern of alterations of the sodium transport components during dialysis is similar in all patients: [Na+]i and phi Na increase significantly during dialysis, and the increases in [Na+]i are closely related to increases in pH and bicarbonate. PMID- 3627320 TI - Infection-resistant continuous peritoneal dialysis catheters. AB - The techniques of bonding of anionic antibiotics by treatment with cationic surfactants were applied to continuous ambulatory peritoneal dialysis (CAPD) catheters. The elution of 14C-penicillin from tridodecylmethylammonium chloride (TDMAC) treated silicone elastomer catheters in dialysis solution was biphasic, with 95% dissociated from the catheter by 48 h. Forty percent of the TDMAC left the catheter surface during the initial 2 days. The ability of the surfactant TDMAC to bind antibiotics after incubation in dialysis solution correlated directly with the amount of surfactant remaining. Rats with intraperitoneal dialysis catheters were inoculated with exit site and intraluminal bacterial challenges. Intraperitoneal catheter tips treated with TDMAC-penicillin were rendered more resistant to colonization after exit site and intraluminal bacterial challenges. PMID- 3627321 TI - Evaluation of the renal mechanisms for urate homeostasis in uremic patients by probenecid and pyrazinamide test. AB - The tubular transport of urate was studied in 47 uremic patients and in 20 normal subjects using probenecid and pyrazinamide tests. There was a marked increase in urate excretion per nephron as the renal function deteriorated. Presecretory reabsorption of urate per nephron, which was almost complete in normal subjects, showed a diminution with increasing severity of chronic renal failure. Until the creatinine clearance had decreased to less than 10 ml/min, the secreted urate per nephron remained almost constant, while in the end stage of renal failure it was markedly decreased. With the progression of renal disease, the postsecretory reabsorption of urate per nephron diminished. In patients with a creatinine clearance less than 10 ml/min, it was 4 times lower than in normal subjects. These findings indicate that urate secretion does not contribute to the increase of urate excretion per nephron at any level of renal failure, whereas the impairment of both reabsorptive components accounts for the augmented urate excretion per nephron in uremic patients. PMID- 3627322 TI - Urinary prostaglandins and thromboxane in patients with chronic glomerulonephritis. AB - To evaluate the potential contribution of prostaglandins (PGs) and thromboxane (TX) to the development of chronic glomerulonephritis, we measured the urinary excretion of PGE, PGF2 alpha, 6-keto-PGF1 alpha and TXB2 by radioimmunoassay in 36 patients with chronic glomerulonephritis. In patients with nephrotic syndrome, urinary excretion of PGE and TXB2 was highly increased, whereas that of PGF2 alpha and 6-keto-PGF1 alpha remained normal. In patients with non-nephrotic chronic glomerulonephritis, urinary excretion of TXB2 was significantly increased, whereas that of PGE and 6-keto-PGF1 alpha remained normal and that of PGF2 alpha was significantly decreased. In patients with chronic renal failure, the urinary excretion of all PGS and TX was markedly decreased presumably due to a decrease in the number of cells which can metabolize arachidonic acid. These results suggest that TXA2 plays an important role as an exaggerating factor in the development of chronic glomerulonephritis, particularly that accompanying nephrotic syndrome, and that renal synthesis of PGE is compensatorily increased to maintain renal function in nephrotic syndrome. PMID- 3627323 TI - Sodium reabsorption by the Henle loop in humans. AB - In a previous study, we described a new method [3] to measure Na reabsorption by each segment of the human nephron independently. Reabsorption was expressed as equivalent volumes of solute-free water (CH2O) generated by the loop of Henle (CH2O-HL) and by the distal tubule (CH2O-DT), and dissipated by back diffusion (BD) across collecting ducts (CH2O-BD). These data were obtained during maximal water diuresis (MWD). The present study was undertaken to calculate CH2O-HL by experiments performed during maximal antidiuresis (MA). For this purpose, a new theoretical approach was devised, described by algebraic equations which allowed calculations of segmental transport during MA alone, where only CH2O-HL could be calculated independently. The study was performed on 14 normal volunteers who were studied twice by clearance measurements, firstly during MWD and again during MA. In each experiment, clearance periods were performed during baseline conditions and during the administration of furosemide (0.7 mg/kg bolus injection followed by 0.06 mg/kg/min maintenance infusion). From the values measured during either condition, segmental reabsorption was calculated. During MWD, CH2O-HL averaged 19.4 + 10.4, during MA 20.4 + 8.0 ml/min/GFR X 100; p greater than 0.05. The paired measurements were significantly correlated (r = 0.80; p less than 0.01). These data demonstrate that CH2O-HL obtained with the original theory is a reproducible result that can be confirmed with independent measurements obtained during different experimental conditions. Thus, measurements of segmental Na transport in the human nephron are feasible and can contribute important informations on disease states. PMID- 3627324 TI - Altered S(--)-propranolol disposition in bilateral ureter-ligated rats. AB - Previous clinical studies indicate that the metabolic clearance of oral (+/-) propranolol is reduced in end-stage renal failure patients. Animal models are needed to explore the mechanism(s) underlying the observed metabolic inhibition in man. The disposition kinetics of S(-)-propranolol were characterized after intravenous and peroral administration in rats with acute renal failure induced by bilateral ureteral ligation (BUL). No alteration in either the systemic clearance or the apparent volumes of distribution of S(-)-propranolol was observed in renal failure animals after a single intravenous dose of 1.5 mg/kg. In contrast, acute uremia did elicit a change in the bioavailability of orally administered S(-)-propranolol. At 36 h after ureteral ligation, the area under the serum concentration-time curve after a 6 mg/kg oral dose of S(-)-propranolol was significantly elevated in renal failure animals, which corresponded to an approximate two fold increase in its systemic availability (from 7.7 to 20.5%). Such an effect could not be demonstrated at times earlier than 36 h after ureteral ligation. Additional experiments were performed to evaluate whether concomitant changes in gastrointestinal absorption or serum protein binding of S( )-propranolol could have contributed to the apparent increase in oral availability. The results lead to the hypothesis of an inhibited first-pass hepatic metabolism of S(-)-propranolol in acute renal failure and suggest a significant time delay in the onset of inhibition. PMID- 3627325 TI - Role of erythropoietin in the reversal of anemia of renal failure with continuous ambulatory peritoneal dialysis. AB - We report serum erythropoietin levels in a patient who showed significant improvement in hematocrit when switched from hemodialysis to continuous ambulatory peritoneal dialysis (CAPD) treatment. This 22-year-old woman had severe anemia and low serum immunoreactive erythropoietin levels (8.0 +/- 1.2 mU/ml; n = 5) while on hemodialysis for 7 years. Serum erythropoietin levels were 80 and 177 mU/ml, 2 and 3 weeks, respectively, after starting CAPD. This was followed by an increase in reticulocyte count from 3.9 to 22% and hematocrit from 19 to 48%. The serum erythropoietin concentration obtained on CAPD treatment (62.7 +/- 15.2 mU/ml; n = 9) was significantly higher than that obtained on hemodialysis. Our findings indicate that CAPD facilitates increased erythropoietin production compared to hemodialysis and that the anemia of uremia may reverse if sufficient erythropoietin is available. PMID- 3627326 TI - Intravenous or intraperitoneal vancomycin for the treatment of continuous ambulatory peritoneal dialysis associated gram-positive peritonitis? AB - A clinical and pharmacokinetic study was carried out to determine whether an intraperitoneal (IP) loading dose of vancomycin was as effective as an intravenous (IV) load in the treatment of continuous ambulatory peritoneal dialysis (CAPD)-associated gram-positive peritonitis. Each patient continued a 14 day treatment on IP maintenance doses. All cases of peritonitis (10 in each group) were eradicated. Side effects occurred in 3 patients following IV vancomycin and in none following IP vancomycin. Serum and peritoneal vancomycin concentrations equilibrated fully and rapidly with each route. It is concluded that an IP loading dose of vancomycin, followed by IP maintenance doses, is as effective as and produces fewer side effects than an IV loading dose in the treatment of CAPD peritonitis. PMID- 3627327 TI - Acute renal failure due to (+)-cyanidanol-3-induced hemolytic anemia. PMID- 3627328 TI - Malignancy and HLA-DRw13 in patients on maintenance hemodialysis. PMID- 3627329 TI - Plasma 25(OH)D levels in children on long-term hemofiltration. PMID- 3627330 TI - Serum biotin levels in patients undergoing chronic hemodialysis. PMID- 3627331 TI - Hypertriglyceridemia and low-phosphorus, low-nitrogen diet in patients with chronic renal failure. PMID- 3627332 TI - The effect of a high protein intake on renal function of patients with chronic renal insufficiency. AB - In 30 patients with chronic renal disease, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured after 4 weeks of protein restriction and subsequently after adhering to a high protein intake for the same period. Twenty-four patients adhered to their advised diets according to the 24 hour urea excretion. These 24 patients showed a significant increase in GFR, ERPF and proteinuria (n = 15) during a high protein intake, even if their renal function was markedly impaired. It is concluded that although in patients with markedly impaired renal function a meat meal or an infusion of amino acids does not change renal function anymore, prolonged high protein intake is accompanied by an increase in GFR, poorly dependent on GFR after prolonged protein restriction. PMID- 3627333 TI - Urinary histamine excretion in proteinuric states. AB - The kidney possesses the enzymatic steps required for the biosynthesis of histamine and this autocoid may play a role in modulating renal hemodynamics and the local inflammatory response to immunologic injury. We, therefore, measured urinary histamine. N-methylhistamine and N-methylimidazole acetic acid concentrations in patients with proteinuria due to a variety of disease states idiopathic nephrotic syndrome (n = 19), systemic lupus erythematosus (n = 10), refractory focal segmental glomerulosclerosis (n = 10) and control patients (n = 16). Urinary histamine concentration was significantly reduced in treatment responsive idiopathic nephrotic syndrome during disease relapse compared to remission (16.6 +/- 3.6 vs. 28.4 +/- 4.8 mumol/mol creatinine, p less than 0.02). The levels were also depressed in children with other causes of persistent proteinuria, including systemic lupus erythematosus (10.3 +/- 4.0 mumol/mol creatinine) and focal segmental glomerulosclerosis (14.6 +/- 2.8 mumol/mol creatinine) compared to normal controls (31.4 +/- 4.7 mumol/mol creatinine). The decreased urinary excretion of histamine and its metabolites in patients with proteinuria may be a result of immunologically mediated mesangial cell injury or represent a compensatory hemodynamic response to limit urinary protein losses. PMID- 3627334 TI - Increased patchy renal accumulation of 99mTc-methylene diphosphonate in a patient with severe loin pain after exercise. AB - Radionuclide imaging in a patient who had acute renal failure with severe loin pain and patchy renal vasoconstriction is described. The patient was studied 3h after the intravenous bolus injection of 25 mCi99mTc-methylene diphosphonate (99mTc-MDP). An intense patchy renal concentration of 99mTc-MDP was observed. PMID- 3627335 TI - Clinical evaluation and characterization of a unique C3 breakdown factor detected in a patient with acute glomerulonephritis. AB - A unique factor causing breakdown of the third component of complement (C3) was detected in a patient with acute glomerulonephritis (AGN). The activity was detected by conversion of C3 in a mixture with normal human serum using crossed immunoelectrophoresis. This factor capable of C3 breakdown was not blocked in the presence of ethylenediaminetetraacetic acid (EDTA), heat-pretreatment (56 degrees C, 30 min) und dialysis against 0.1 M phenylmethylsulfonyl fluoride (PMSF). The factor was isolated and characterized by immunochemical and physicochemical techniques. It had beta-mobility on electrophoresis and was separated at a lighter sedimentation coefficient than 7S by sucrose density gradient ultracentrifugation. The activity was absorbed on a DEAE-cellulose column and was eluted under definite conditions of relative salt concentration. These data appear to suggest that this factor is distinct from C3 nephritic factor (C3NeF), immunoglobulins, immune complexes, and other C3 convertases previously described. Moreover, it is clear that the factor was mainly responsible for the C3 activation observed in the patient with acute glomerulonephritis. PMID- 3627336 TI - Effect of long-term aluminum administration on the renal structure of the rat. AB - Kidneys of patients on hemodialysis therapy often undergo structural changes leading to acquired cystic disease. A wide variety of chemical compounds are known to induce experimental renal cystic disease. Since aluminum intoxication has been implicated in the development of encephalopathy, osteomalacia and anemia in uremic patients, this study was designed to investigate whether aluminum administration to normal rats could induce renal morphological changes. Male Wistar rats were divided into three groups; Animals of the Low-dose aluminum (LDA) group received 0.2 mg/day of aluminum, animals of the high-dose aluminum (HDA) group received 2 mg/day of aluminum; the third group consisted of controls (C). Aluminum was injected intraperitoneally as aluminum chloride (6 days a week). 13 weeks later, the kidneys were removed and examined by light and electron microscopy. The findings on eight-microscopic examination were normal in all groups. Electron-microscopic examination was unremarkable in the C and LDA group. In HDA rats, ultrasections of the cortex and outer medulla showed changes in the proximal tubules with increased size and number of lysosomes, osmiophilic granular material inside the lysosomes, vacuolisation of organelles and mitochondrial damage of varying degree. No cystic changes were found. PMID- 3627337 TI - Is adult idiopathic nephrotic syndrome food allergy? Value of oligoantigenic diets. AB - To evaluate the prevalence of food hypersensitivity in idiopathic nephrotic syndrome (INS), an oligoantigenic diet was given for 10 days to 13 patients with INS who had not steadily responded to corticosteroids; 5 of these patients were corticodependent, 3 were corticoresistant and 5 had multiple relapses. A history of allergy was present in 8 cases and an increase in total serum IgE levels in 6. Sensitivity to food antigens was documented by skin tests in 5, by the radioallergosarbent test (RAST) in 5 and by the human basophil degranulation test (HBDT) in 11. At the end of the oligoantigenic diet, proteinuria was significantly reduced in the 13 patients as compared to the initial level. It decreased by more than 50% in 9 patients and disappeared completely in 5. It seems that an oligoantigenic diet is helpful in cases of INS that do not respond to corticosteroids. This argues for a role of food hypersensitivity in this disease and suggests that avoidance of specific foods on the longer term may be of benefit. This diet must be tried in INS before the initiation of immunosuppressive therapy. PMID- 3627338 TI - Effect of experimental uremia upon the estrous cycle in rats. AB - By daily vaginal smears, uremic rats showed significantly greater prevalence of irregular estrous cycles compared with sham-operated controls (p less than 0.02). There seems to be a correlation between the degree of renal failure and estrous cycle abnormalities. The lack of LH surge on the afternoon of proestrus, found in uremic animals, suggests a defect in the positive hypothalamic steroid feedback. PMID- 3627339 TI - Acute renal failure following colorectal surgery. PMID- 3627340 TI - Creatinine clearance in chronic renal failure. Comparison of direct measurement and calculation from serum creatinine. PMID- 3627341 TI - Hemomediastinum and hemothorax: a late complication of subclavian catheter insertion for hemodialysis. PMID- 3627343 TI - Selection of patients for clinical trials. AB - Since there is no treatment of proven value in patients with MS it is necessary still to select those patients for inclusion in clinical trials who have most to gain and can demonstrate rapidly the effectiveness or not of each new treatment. Experience gained in these trials can be then extrapolated to the disease as a whole. PMID- 3627342 TI - Vitamin D treatment: a hidden risk factor for aluminum bone toxicity? PMID- 3627344 TI - Analysing the structure of 23 clinical trials in multiple sclerosis. AB - At present many trials appear to be using subjective data, but using these data in an unsystematic and inappropriate way. In this context it is not surprising that subjective measures have a generally low status amongst investigators in clinical trials in MS. A more careful approach to such subjective measures would enable trials to take into account a significantly wider range of features. Controlled trials can then act as an important psychosocial as well as biomedical laboratory in the understanding of MS. PMID- 3627345 TI - Practical problems in the organisation of clinical trials in multiple sclerosis. AB - The problems of organising clinical trials in MS include the general aspects relating to clinical trials in any discipline but extend also to specific problems arising in the assessment of a relapsing remitting condition. These factors relating to the clinical characteristics of the disease, the diagnosis, the selection of patients and the methods of clinical and laboratory assessment are described and discussed. Suggestions are made for the use of internationally accepted diagnostic criteria for MS and a review is made of the other recognised problems in this field. PMID- 3627346 TI - Methodological problems in evaluating hyperbaric treatment of multiple sclerosis. A case study. AB - The paper describes a number of methodological problems experienced in a long term evaluation of hyperbaric treatment for MS. Among the problems discussed are those relating to the locus and logistics of assessment, the reliability of 'subjective' assessments, the feasibility of 'objective' measurements, the identification of outcome categories and patient drop-out and selectivity. PMID- 3627347 TI - Vitamin E deprivation in rats: some behavioral and histochemical observations. AB - Rats deprived of vitamin E from age of 4 weeks were tested in four independent behavioral experiments and compared with a group fed a control diet. During a 14 minute session in a hole-board, no differences in the level and the course of habituation of parameters of activity and exploration were found. A second group of animals was trained in an automatically controlled six-arm radial tunnel maze. Although no differences were found in various activity measurements, the deprived animals showed a slightly impaired spatial concept formation during 8 acquisition sessions. Testing their relearning ability of the same maze 18 days later, the vitamin E deprived animals showed a significant impairment. In a third experiment, animals were trained 16 days in the same maze configuration and at day 17 they were exposed to the mirror image of the radial maze. Both groups mastered this reversal with an increased level of activity but without differences in patrolling efficiency. In a fourth behavioral experiment, the effects of scopolamine on deprived animals were examined. Compared to the controls, the vitamin E deprived animals were relatively insensitive to the effects of scopolamine. Autofluorescent neuronal lipofuscin accumulation was found especially in the hippocampus (CA3) of vitamin E deprived animals. Based on these results, the usefulness of vitamin E deprivation as an animal model for accelerated normal aging is discussed. PMID- 3627348 TI - Effects of long-term restricted feeding on radial maze performance by aged rats. AB - Rats were fed every other day (EOD) from 3-21 months of age prior to training in an 8-arm radial maze with retention intervals of 0, 1 or 5 hr imposed between the fourth and fifth choices. Their performance was compared to that of another aged group fed ad lib throughout life prior to radial maze training and to 3 month old controls. Rats fed ad lib until training adapted to the maze more slowly than young controls and were impaired in acquiring accurate spatial memory. EOD feeding eliminated age-related differences in the initial rate of adaptation to the radial maze but had no effect on the development of accurate spatial memory at any of the retention intervals. These results indicate that differences in deprivation history are probably not responsible for previous findings that radial maze training early in life prevents the appearance of age-related deficits in accurate spatial memory. PMID- 3627349 TI - Hypothesis on the regulation of cytosol calcium concentration and the aging brain. AB - This commentary proposes that neurobiology of aging must look beyond the issue of age related changes in calcium concentrations within the cytosol. The more important question is what causes these changes. Studies of structure, function, and dynamics of membranes may begin to give a better clue about underlying mechanisms of these changes. PMID- 3627350 TI - 'Increased calcium-current' hypothesis of brain aging. AB - Based on evidence that high Mg2+ counteracts age-related declines in synaptic plasticity, and that aged rat hippocampal neurons exhibit prolonged Ca2+ dependent K+ currents, it is proposed that an underlying cause of altered Ca2+ homeostasis during brain aging may be an increased membrane conductance to Ca2+. An apparent Ca2+-mediated inactivation of Ca2+ current, which was recently described in hippocampus, could account for some of the contradictions in the literature. PMID- 3627351 TI - Molecular mechanisms underlying age-dependent alterations in calcium homeostasis: the need for more information and new tools. AB - The picture that emerges from the numerous studies on altered calcium regulation in the nervous system as a function of aging does not permit the formulation of a scheme that accounts for available data. The solution to this dilemma requires a more complete understanding of the calcium regulating systems and new tools with which to probe the molecular events responsible for physiological and behavioral alterations in the aging organism. PMID- 3627352 TI - Problems in assessing altered calcium homeostasis in the aging nervous system. AB - Defining a role for altered calcium homeostasis on functional deficits in the aging brain is not only hindered by the complexity and abundance of the regulatory systems involved, but also by the inability to assess calcium regulation in vivo. PMID- 3627353 TI - Intracellular free calcium and inositol polyphosphate action as potential targets in the ageing process. AB - The concentration of free Ca2+ in the cell cytoplasm is likely to be the most important parameter which should be considered in assessing the contribution of Ca2+ to regulation of neurotransmitter release, memory development and cell growth. Quantitative measurement of the free Ca2+ concentration and elucidation of the membrane transduction systems which control this parameter in aged neuronal cells may make a significant contribution to further define the role of Ca2+ in the ageing nervous system. PMID- 3627354 TI - Comments on review by G. E. Gibson and Ch. Peterson 'Calcium and the aging nervous system'. PMID- 3627355 TI - Cellular and molecular aspects of neural development and regeneration. PMID- 3627356 TI - Are there both low- and high-affinity glutamate transporters in rat cortical synaptosomes? AB - Kinetics of sodium dependent glutamic acid transport have been studied in rat cortical synaptosomes at sufficiently high glutamic acid concentrations ([G]) to delineate the "low affinity" transporter. Computer optimization techniques were used to fit the data to models which account for the sodium and substrate dependence of uptake. The data fit about equally well models consisting of two carriers (Model 1) or one carrier plus a linear component (Model 2). However, the results of further studies were inconsistent with Model 1, but totally consistent with Model 2. Thus the results are incompatible with the presence of both high- and low-affinity carriers. The carrier model found in previous studies of high affinity glutamate transport predicts the effects of high [G] and [Na] observed in the present study. The biphasic effect of [Na] on velocity of uptake is the logical consequence of the operation of this model. The rate equation for this model has been utilized to define and compute kinetic parameters which characterize the transporter. These kinetic functions are remarkably similar in shape and magnitude to previous estimates from the studies of the high affinity transport (low [G]). The results of other studies by the author which corroborate and expand the predictions of the kinetic model are discussed. These have been combined with the present results to formulate a rather comprehensive model of glutamate function. This model can be used to describe function in terms of mathematical equations and to make predictions from these equations. These equations relate velocity of uptake and the kinetic parameters to sodium and substrate concentration, velocity to membrane potential, distribution ratio to the electrochemical potential, and release to time, compartment sizes, and exchange constants. Such processes as concentration in the presynaptic terminal, depolarization induced release, re-uptake following stimulus induced release, and postsynaptic depolarization are all possible consequences of the operation of this model. The wide applicability of the model to the transport of other substrates in addition to glutamate is discussed. PMID- 3627357 TI - Effect of external high potassium and pH on the uptake of choline in glial and neuronal cells in culture. AB - The Vmax of the uptake of choline was increased in nerve cell cultures by lowering (from 7.4 to 6.5) or increasing (from 7.4 to 8.1) the pH. In neurons no effect was observed on the value of the Km's of the uptake of either the apparent high or low affinity components. In glial cells only a low affinity component was measured at pH 6.5 and diffusion was observed at pH 8.1. An excess of K+ ions in the incubation medium reproduced the increase in Vmax observed with changes in pH suggesting a possible dependence of the uptake of choline upon the H+ and OH- gradients. Taking into account the characteristics already known of the transport of choline into nerve cells, such a dependence adds new insight in the mechanisms underlying the transport and indicates another possible regulation of choline entry, eventually directed towards the synthesis of acetylcholine. PMID- 3627358 TI - Stimulation of phospholipase D activity and indication of acetylcholine synthesis by oleate in rat brain synaptosomal preparations. AB - It had been previously demonstrated that the oleate activation of synaptosomal membrane phospholipase D liberated choline which was available for acetylcholine formation. The present investigations were undertaken to determine if oleate might have an effect on choline uptake by synaptosomes. It was observed that oleate interfered with choline uptake when incubations were carried out at 37 degrees C but uptake was stimulated at 3 degrees C. Oleate was the most effective fatty acid of several tested. Preliminary observations suggest the presence of a membranous form of choline acetyltransferase. PMID- 3627359 TI - The relationship between sodium and high-affinity taurine uptake in hypothalamic crude P2 synaptosomal preparations. AB - Two uptake systems for taurine transport in a rat hypothalamic crude synaptosomal preparation were identified. The true transport constants were, for the high affinity uptake system, Km = 240 microM and V (maximum velocity) = 400 nmol/g protein/min, and for the low-affinity uptake system, Km = 5290 microM and V = 1640 nmol/g protein/min. The initial velocity of high-affinity taurine uptake by the crude synaptosomal preparation was studied as a function of sodium and taurine concentration. Hill plots were constructed from these data. The requirement of high-affinity taurine uptake on a sodium gradient was examined by utilizing monensin, and the metabolic poisons, 2,4-dinitrophenol and ouabain. The major findings are as follows: 1) One sodium ion is co-transported with each taurine molecule; 2) the high-affinity uptake process is driven by the sodium concentration gradient across the membrane; 3) sodium increases the maximal velocity rather than the affinity of the high-affinity taurine carrier for the taurine molecule; 4) one taurine molecule is transported per carrier for both the high- and low-affinity taurine uptake systems; and 5) high-affinity taurine uptake is an energy-dependent process. PMID- 3627360 TI - The effect of 2-oxoglutarate or 3-hydroxybutyrate on pyruvate dehydrogenase complex in isolated cerebrocortical mitochondria. AB - The oxidation of pyruvate is mediated by the pyruvate dehydrogenase complex (PDHC; EC 1.2.4.1, EC 2.3.1.12 and EC 1.6.4.3) whose catalytic activity is influenced by phosphorylation and by product inhibition. 2-Oxoglutarate and 3 hydroxybutyrate are readily utilized by brain mitochondria and inhibit pyruvate oxidation. To further elucidate the regulatory behavior of brain PDHC, the effects of 2-oxoglutarate and 3-hydroxybutyrate on the flux of PDHC (as determined by [1-14C]pyruvate decarboxylation) and the activation (phosphorylation) state of PDHC were determined in isolated, non-synaptic cerebro cortical mitochondria in the presence or absence of added adenine nucleotides (ADP or ATP). [1-14C]Pyruvate decarboxylation by these mitochondria is consistently depressed by either 3-hydroxybutyrate or 2-oxoglutarate in the presence of ADP when mitochondrial respiration is stimulated. In the presence of exogenous ADP, 3-hydroxybutyrate inhibits pyruvate oxidation mainly through the phosphorylation of PDHC, since the reduction of the PDHC flux parallels the depression of PDHC activation state under these conditions. On the other hand, in addition to the phosphorylation of PDHC, 2-oxoglutarate may also regulate pyruvate oxidation by product inhibition of PDHC in the presence of 0.5 mM pyruvate plus ADP or 5 mM pyruvate alone. This conclusion is based upon the observation that 2-oxoglutarate inhibits [1-14C]pyruvate decarboxylation to a much greater extent than that predicted from the PDHC activation state (i.e. catalytic capacity) alone. In conjunction with the results from our previous study (Lai, J. C. K. and Sheu, K.-F. R. (1985) J. Neurochem. 45, 1861-1868), the data of the present study are consistent with the notion that the relative importance of the various mechanisms that regulate brain and peripheral tissue PDHCs shows interesting differences. PMID- 3627361 TI - Characterization of [3H]cholecystokinin octapeptide binding to mouse brain synaptosomes: effects of neuroleptics. AB - The presence of high concentrations of both dopamine and cholecystokinin (CCK) in the striatum and in various limbic structures suggests that the CCK may not only influence dopaminergic transmission, but it also may be relevant to the psychopathology of schizophrenia and to the therapeutic effects of neuroleptics. By using a synaptosomal fraction isolated from the mouse cerebral cortex and [propionyl-3H]CCK8-sulphate ([3H]CCK8S) as a ligand, a single binding site for [3H]CCK8 with a KD value of 1.04 nM and a Bmax value of 42.9 fmol/mg protein was identified. The competitive inhibition of [3H]CCK8S binding by related peptides produced an order of potency of CCK8-sulphated (IC50 = 5.4 nM) greater than CCK8 unsulfated (IC50 = 40 nM) and greater than CCK4 (IC50 = 125 nM). The regional distribution of [3H]CCK8S binding in the mouse brain was highest in the olfactory bulb (34.3 +/- 5.6 fmol/mg protein) greater than cerebral cortex greater than cerebellum greater than olfactory tubercle greater than striatum greater than pons-medulla greater than mid brain greater than hippocampus greater than hypothalamus (12.4 +/- 2.1 fmol/mg protein). The repeated administration of haloperidol (2.5 mg/kg/tid) increased the binding of [3H]CCK8S in cerebral cortex from 31.8 +/- 1.7 to 38.9 +/- 5.2 fmol/mg protein. The varied distribution of CCK8S receptors may signify nonuniform functions for the octapeptide in the brain. PMID- 3627363 TI - Ouabain and the membrane transport of amino acids and amines. AB - Evidence is discussed that ouabain has a direct inhibiting effect on the sodium dependent uptake of amino acids and amines from the extracellular space of the mammalian central nervous system rather than the inhibition being a consequence of raised intracellular sodium levels. PMID- 3627362 TI - Paradoxical effect of methyl mercury on mitochondrial protein synthesis in mouse brain tissue. AB - The intraperitoneal administration of a single dose of methyl mercuric chloride (MeHg) (10 or 50 nmol/g body weight) to adult male mice led to a significant stimulation of protein synthesis directed by isolated brain mitochondria in a special cell-free translation system prepared from rabbit reticulocyte lysates. The pre-treatment of the isolated mouse brain mitochondria from MeHg-injected and control (saline-injected) animals with an inhibitor (oligomycin) or inducers (ADP, succinate) of ATP synthesis showed that mitochondrial translation activity was high when ATP synthesis was suppressed and low when ATP synthesis was stimulated. PMID- 3627364 TI - [MRI diagnosis of brain tumors]. PMID- 3627365 TI - [Application of spinal dynamic computed tomography in the diagnosis of spinal cord arteriovenous malformations]. AB - Seventeen cases of spinal cord arteriovenous malformation (AVM) were evaluated by use of spinal dynamic computed tomography (CT). In the intravenous injection method, contrast medium was injected bolusly into the median cubital vein. In the intraarterial injection method, contrast medium was injected slowly into the feeding artery. In both methods, lesions were demonstrated in all cases. Three dimensional localization of the lesions were more clearly demonstrated in the intraarterial injection method. Intravenous injection method was useful in the postoperative follow-up study due to its noninvasiveness. PMID- 3627366 TI - [Follow-up results after STA-MCA anastomosis in cases of middle cerebral artery stenosis]. AB - To elucidate hemodynamic changes and prognosis after STA-MCA anastomosis, thirteen cases with middle cerebral artery stenosis were systematically analyzed from the pre- and postoperative findings of cerebral angiography, CT scan and rCBF. They were followed up about 3 years long on the average postoperatively. Postoperative angiography revealed patent bypass in all cases. No remarkable changes at the site of stenosis were observed in the group A (6 in 13 cases), who had angiographically sufficient inherent collateral circulation. By contrast, group B (7 in 13 cases), who had insufficient inherent collateral circulation, showed remarkable progress in the degree of stenosis and significant changes of flow patterns were observed after operation. However, these postoperative changes did not bring any clinical deterioration. During follow-up period (31.2 months on the average) after operation, no cerebrovascular accident were encountered in all cases and clinically improved. In conclusion, the STA-MCA bypass rendered more beneficial effect to the patient with MCA stenosis when compared with natural histories reported in the literature. PMID- 3627367 TI - Idiopathic thoraco-lumbar spinal epidural hematoma. Case report and review of literature. AB - The authors report a case of a 71-year-old man, who had thoracic pain, flaccid paraplegia, sensory loss below the level of Th10, and disturbance of the sphincter control. CT myelography disclosed an isodensity epidural mass lesion from Th10 to L2, which compressed the spinal cord ventrolaterally. Laminectomy was immediately performed and an epidural hematoma was verified. The literatures of spinal epidural hematoma located in the thoraco-lumber region were reviewed. PMID- 3627368 TI - [A case of myelopathy due to a peculiar anomaly of the axis]. AB - A very rare case of cervical myelopathy due to an anomaly of the axis was encountered. The patient was a 42-year-old man, in whom motor and sensory disturbance of the four extremities had been in progress during the last two years. Neurological examination revealed myelopathy at the high cervical cord. The operative findings were characterized as follows: The lamina on both sides of the axis was separated at the base of the spinous process. The two bony protrusions from the normally shaped spinous process entered the spinal canal, and was attached to the internal surface of the lamina with connective tissue, and this abnormal bone compressed the cervical cord. Following laminectomy of the axis and excision of the abnormal bone, the symptom and the sign of the myelopathy were remitted. The patient had had no episode of trauma, and it was judged that his aging triggered manifestation of this congenital anomaly. Asymptomatic or mild cases may escape from detection by conventional plain films of the cervical spine, which in fact provided little diagnostic information. Plain and metrizamide CT myelographies are considered to be the most promising diagnostic procedures. PMID- 3627369 TI - [Spontaneous arteriovenous fistula of the external carotid artery treated by a detachable balloon--a case report]. AB - Spontaneous arterio-venous fistula (AVF) of the external carotid system is very rare. We successfully treated such a case by the detachable balloon method. The patient, a 2-year-and-9-month-old female who has no history of trauma had a pulsating mass at her right retroauricular region six months after birth. On admission to our clinic she was neurologically free except the pulsating mass (2 X 3 cm) with bruit and thrill. Selective right external carotid angiography revealed a high-flow simple AVF from internal maxillary artery to jugular vein. The normal blood flow of both the external and internal carotid system was decreased. Under local anesthesia, non-detachable balloon catheter was inserted to the internal maxillary artery by the transfemoral approach and inflated at the proximal side of the orifice of AVF until the vascular murmur in the neck disappeared. The balloon catheter was then exchanged with a detachable balloon catheter (Debrun, No. 9) which was inflated by silicone (0.4 ml), and was detached successfully. Follow-up angiography 1 year after the treatment revealed no recurrence of the fistula and almost branches of external carotid artery such as middle meningeal artery, occipital artery, superficial temporal artery and facial artery were clearly seen. PMID- 3627370 TI - [Primary empty sella syndrome treated by transsphenoidal extradural balloon expansion--a case report]. AB - A 34-year-old woman was admitted for the chief complaints of headache and blurred vision. She had bilateral papilledema and slight increase in CSF pressure (175mmH2O) with normal visual acuity and field. Neurological and hormonal examination were normal except for over response of PRL and TSH to TRH test. The sella was enlarged and MRI and metrizamide CT demonstrated intrasellar CSF filling with remodeling of the pituitary gland. The patient was diagnosed as primary empty sella syndrome associated with benign intracranial hypertension. The complaints did not subside for six months. The patient was treated via the transsphenoidal approach. The dura mater of the floor of the sella was elevated by extradural balloon expansion filled with silicone, and subsequently the empty sella was obliterated. Her headache disappeared and amblyopic attack also improved. Obliteration of the empty sella with an extradural silicone balloon via the transsphenoidal approach seemed to have been effective for headache and visual complaints of primary empty sella syndrome which did not respond to medical therapy. PMID- 3627371 TI - [The meningioma within the lateral ventricle in infancy--a case report]. AB - Meningiomas within the lateral ventricle in infancy are extremely rare. The authors report such a case because of its rarity. The presented case is a 23 month-old boy, who had gait disturbance as an initial symptom. At the beginning of May, 1985, his mother found his limping, therefore he admitted to our hospital on May 23. On his admission, clinical features were the left mild hemiparesis, the hyperreflexia of left extremities, and the papilloedema on the both sides. A CT scan revealed a homogeneously enhanced mass at the right trigon. Cerebral angiography showed enlargement and displacement of the left anterior and posterior choroidal arteries. On May 27, an operation was performed with the temporal approach, and the tumor was totally removed. A histological diagnosis is confirmed a fibroblastic meningioma. The postoperative course was uneventful and he was made an almost complete recovery. Intracranial meningiomas in children put the incidence 0.4-2.2% of all primary intracranial tumors. Besides, intraventricular meningiomas in infant younger the age of two years are only five cases (including our case) have been reported in the literature. The three cases of them were reported vaguely, and the other one was an angioblastic meningioma. Therefore, we think that our case is very extremely rare one. Meningiomas of the ventricles are generally become large before symptoms appear. The point agrees with our case, but which had a specific initial complaint of gait disturbance, we think. CT scan and angiography are quite useful for the diagnosis of intraventricular meningiomas. Early diagnosis and surgical removal permits better results. PMID- 3627373 TI - 27th International Neuropsychiatric Symposium. Pula, 16th-20th June, 1987. Abstracts. PMID- 3627372 TI - [Liver abscess secondary to ventriculoperitoneal shunt]. AB - Liver abscess is a rare complication following the ventriculoperitoneal (V-P) shunt operation. There has been only one case reported in the literature. We present a case of liver abscess developed about 3 months after V-P shunt operation. A 31-year-old female was admitted to our hospital in comatose condition due to second bleeding from an aneurysm of the right internal carotid artery on January 1, 1984. Obliteration of the aneurysm was performed on the following day. She received V-P shunt operation for the marked hydrocephalus on February 4, but she developed low spinal fluid pressure syndrome. She was able to walk by herself after the replacement of shunt valve on March 4. In the middle of April, she suffered from abdominal pain with a pyrexia for about 5 days. On May 13, a new peritoneal tube was placed in another part of the peritoneal cavity because of the recurrence of hydrocephalus. On the following day, she developed severe abdominal and back pains with a high fever. Abdominal CT scans and ultrasonogram were performed on May 22, showing a well-defined, cystic mass lesion in the liver and the peritoneal tube lying just beneath the mass lesion. Approximately 100 ml of white creamy pus was aspirated from the cystic mass by ultrasound-guided percutaneous puncture, and a 8.3 French pigtail nephrostomy catheter was left in place for 9 days until purulent drainage stopped. Microbiologic examination demonstrated staphylococcus epidermidis in the cerebrospinal fluid (CSF) from the shunt tube but was negative in the abscess fluid. The ventricular fluid was drained externally with the V-P shunt tube for a while, but the new ventricular drainage was instituted because of continuous positive cultures in the CSF from the shunt tube. Thereafter, the cultures of the CSF became negative and ventriculoatrial (V-A) shunt operation was performed on July 2. Postoperative course was uneventful. It is considered that the formation of the liver abscess seems to be caused by the focal injury to the liver surface by the insidiously infected peritoneal tube with St. epidermidis, and by the decrease in systemic resistance to infection. Percutaneous aspiration and drainage under the guidance of abdominal computed tomography or ultrasonography are very useful and efficient for the diagnosis and the treatment of liver abscess. When patients show signs of infection to the V-P shunt, we should remove the shunting system and place a new external ventricular drainage, and institute a V-A shunt after confirming negative cultures of the CSF. PMID- 3627374 TI - Electrical stimulation of ventral versus dorsal mesencephalic tegmental areas in the conscious rat: effects on luteinizing hormone release. AB - This study examined the effect of electrical stimulation of the ventral mesencephalic tegmentum versus the dorsal tegmentum region on blood LH levels in freely moving, ovariectomized (OVX) rats, as well as in OVX, estrogen-primed rats. In OVX rats, electrical stimulation (with parameters of 30 Hz, 0.4-msec biphasic pulses, 50-100 microA and 10 s on/off for 1 h) of the ventral tegmentum region with the aim of activating the ventral noradrenergic tract (VNT) failed to affect the pulsatile pattern of blood LH levels characteristic of OVX animals. In sharp contrast, electrical stimulation of the dorsal tegmentum region inside the ascending dorsal noradrenergic tract (DNT) markedly inhibited pulsatile LH release in OVX rats; the mean blood LH levels during the 1-hour stimulation period were significantly decreased when compared with prestimulation control values. Electrical stimulation in the same region near but outside the DNT was ineffective. In OVX rats primed with estradiol benzoate, electrical stimulation in the ventral or dorsal tegmentum region failed to alter the low, nonpulsatile blood levels of LH. The results in OVX rats suggest that selective activation of the ascending noradrenergic fibres of the DNT but not the VNT can inhibit pulsatile LH release in the awake, freely moving animal. These data further support the possible existence of an inhibitory noradrenergic system in the modulation of LH release. PMID- 3627375 TI - Growth hormone secretory patterns in young, middle-aged and old female rats. AB - Pulsatile growth hormone (GH) secretion was compared in young (5 months), middle aged (11 months) and old (25-29 months) female Sprague-Dawley rats under nonanesthetized, free-moving conditions. Mean plasma GH levels were 99.1 +/- 9.3 ng/ml in young rats, 56.3 +/- 5.8 ng/ml in middle-aged rats and 49.7 +/- 4.9 ng/ml in old rats (p less than 0.01 for young vs. middle-aged and old rats). In young females, 10 out of 17 rats had GH pulses with peak levels greater than 200 ng/ml, in 6 middle-aged females all GH peaks were below 200 ng/ml, and in old females 13 out of 17 rats showed GH peaks of less than 100 ng/ml. The average peak (amplitude) of GH pulses in the old rats (69.3 +/- 8.3 ng/ml) was lower than in the young rats (130.4 +/- 17.5 ng/ml, p less than 0.01) and somewhat lower than in the middle-aged rats (87.0 +/- 8.9 ng/ml). There was no change in intervals between GH pulses. Pituitary GH content in middle-aged and old females (1,189 +/- 60 and 1,100 +/- 89 micrograms, respectively) was significantly lower (p less than 0.05 and p less than 0.01, respectively) than in young female rats (1,464 +/- 76 micrograms). Somatostatin content in the median eminence of old rats (22.4 +/- 1.9 ng) was significantly lower than in young rats (28.5 +/- 1.6 ng, p less than 0.05). It is concluded that GH secretion is reduced in aging female rats, but unlike in aging male rats the decrease is seen at an earlier age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627376 TI - Immunoreactive prolactin in the rat hypothalamus: in vitro release and subcellular localization. AB - Immunocytochemical studies have identified immunoreactive prolactin (IR-PRL) in the hypothalamus and other areas of the rat brain. However, neither the release of IR-PRL from the hypothalamus nor its subcellular localization have been demonstrated. In this study, the release of IR-PRL from hypothalami obtained from female rats was examined using hypothalamic units incubated in vitro in Krebs Ringer bicarbonate-glucose buffer. Hypothalamic tissue spontaneously released IR PRL, and this release was increased by depolarizing concentrations of potassium by a calcium-dependent mechanism. Hypothalamic IR-PRL was also released from hypothalamic tissue obtained from hypophysectomized rats (14 days). The subcellular localization of IR-PRL was investigated using equilibrium-density centrifugation. Tissue homogenates from intact or hypophysectomized rats were centrifuged at 150 g at 4 degrees C for 10 min, and the supernatants were layered onto continuous sucrose gradients (1.00-1.27 g/ml) and centrifuged at 100,000 g (max.) for 16 h. IR-PRL in pituitary supernatants showed a high equilibrium density peak with a modal density of 1.23 g/ml. Fractionation of the supernatant from ventral or dorsal hypothalamic tissue resulted in two high-equilibrium density peaks, a primary peak with a modal density of 1.23 g/ml and a smaller peak with a modal density of 1.10 g/ml. Both high-density peaks were maintained in tissue obtained from hypophysectomized rats and were disrupted by homogenization in hypo-osmotic medium. Together, these data suggest that hypothalamic IR-PRL is stored in membrane-bound particles which have densities similar to those of secretory granules and is released by a calcium-dependent mechanism when the tissue is depolarized. PMID- 3627377 TI - Rapid naloxone-induced alterations of androgen variables in the growing male rat. AB - Contrary to earlier views on the inability of naloxone to affect androgen variables by way of general circulation, systemically applied naloxone (2.5 mg/kg body weight, single i.p. or i.v. injection) has been shown to rapidly induce (within an hour) a significant fall (-35.7% on the average) of the concentration of serum androgen (testosterone and dihydrotestosterone; (T + DHT) in peripubertal rats (51-58 days old). Such a response to the opiate antagonist was absent, however, in low-androgen prepubertal animals (37-44 days old) and in those among peripubertal rats which still showed subcritical initial levels of androgen in circulation (less than 1.5 ng/ml; experiments with repeated blood sampling in catheterized animals). In peripubertal rats naloxone was also shown to induce a significant decrease (-36%) in basal in vitro androgen production by testes removed 15 or 30 min following the intraperitoneal administration of the opiate antagonist. Such an inhibitory effect on basal steroidogenesis has not been observed in control multiple-dose experiments in which incubated testes from naloxone-naive rats have been directly challenged with naloxone; on the contrary, enhancing direct effects were recorded, but only with the highest concentration of naloxone tested (10(-4) M). The possibility thus remains open that indirect inhibitory effects of injected naloxone may be operational in intact animals. Hypoprolactinemia, known to interfere in an age-dependent manner with the responsiveness of Leyding cells to luteinizing hormone (LH), may be of particular relevance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627378 TI - Interaction between some ergot alkaloids and the reactivity to dopamine of an identified neurone of Helix pomatia. AB - The effect of ergot alkaloids, some of them from the ergosine series, was tested on the response of an identified neurone of Helix pomatia to the application of dopamine (DA) which was membrane hyperpolarization (DA-I response). To evaluate the antagonistic potency of the ergot alkaloids, the dose-response relationship of the response to DA was established first in the absence and later in the presence of the tested compound. The sigmoidal dose-response curves obtained were used to determine the pA2 values of all the antagonists tested. Comparing them it was found that among the ergosines tested, the most potent was dihydroergosine, its pA2 value being (6.27) similar to the values obtained for dihydroergotoxine (6.66) and dihydroergotamine (6.36). The two other unhydrogenated compounds (ergosine and saccharinoergosine) had potencies of the same order as bromoergocryptine. The D-isomer (+) of the saccharino compound was the least potent, but it acted as a DA-receptor antagonists, as well as the dextroisomer of bromoergocryptine, bromoergocryptinine. By comparing the current-voltage relationship of the neurone in the presence and absence of the ergot alkaloids tested it was found that they had no non-specific effects on the membrane. The ergot alkaloids did not change the amplitude of depolarization of the neurone induced by gamma-aminobutyric acid (GABA) and acetylcholine (ACh). PMID- 3627379 TI - (-)-Propranolol and (+/-)-cyanopindolol are mixed agonists-antagonists at serotonin autoreceptors in the hippocampus of the rat brain. AB - The effects of (-)-propranolol, (+)-propranolol and (+/-)-cyanopindolol on the release of [3H]5-hydroxytryptamine [( 3H]5-HT) were investigated in synaptosomes from the hippocampus of the rat, depolarized in superfusion with 15 mM KCl. (-) Propranolol, but not (+)-propranolol, inhibited in a concentration-dependent way the K+-evoked release of [3H]5-HT. (+/-)-Cyanopindolol behaved similarly but was about 10 times more potent than (-)-propranolol. The inhibitory effects of (-) propranolol and (+/-)-cyanopindolol were prevented by the autoreceptor antagonist methiothepin. Both beta-adrenoceptor antagonists antagonized the inhibition by exogenous 5-HT of the K+-evoked release of [3H]5-HT. The data suggest that some beta-adrenoceptor antagonists may behave as mixed agonists-antagonists at the 5 HT autoreceptor. Synaptosomes in superfusion appear to be particularly suitable to study separately agonistic compared to antagonistic activity of compounds having a mixed agonist-antagonist profile. PMID- 3627380 TI - Serotonergic dorsal raphe neurons: subsensitivity to amphetamine with long-term treatment. AB - Rats were pretreated twice daily for six consecutive days with either saline or 1.0, 5.0, or 10.0 mg/kg (+)-amphetamine. On the following day, single-unit recording techniques were used to identify serotonin-containing neurons in the dorsal raphe nucleus (DRN). Pretreatment with amphetamine did not alter the mean spontaneous firing rate of these cells, but in some instances it appeared to produce periods of irregular bursting. Moreover, the response to challenge injections of amphetamine was reduced significantly by pretreatment with the large dose. Thus, whereas an intravenous challenge of approximately 3.0 mg/kg produced a greater than 50% inhibition of activity in the dorsal raphe nucleus in rats pretreated with saline, 1.0 or 5.0 mg/kg (+)-amphetamine, more than twice the challenge dose was required to suppress the activity of serotonergic neurons in rats pretreated with 10.0 mg/kg (+)-amphetamine. These results parallel those previously obtained with dopaminergic neurons, suggesting that both types of cells lose their sensitivity to amphetamine with repeated injections. PMID- 3627381 TI - Behavioural and electrocortical changes induced by muscimol in rats withdrawn from chronic treatment with diazepam. AB - In rats withdrawn from a chronic treatment with diazepam, the effects of muscimol, given into the III cerebral ventricle, on behaviour and spectrum power of activity in the electrocorticogram (ECoG) were studied. In comparison to control rats which received only muscimol, in rats pretreated with diazepam (1 mg/kg/day for 30 consecutive days) the behavioural and ECoG effects of muscimol were significantly reduced or abolished. In fact, in rats pretreated with diazepam a small dose (50 ng) of muscimol did not affect behaviour or ECoG activity, in contrast to control animals in which the same dose produced, after a period of locomotor stimulation and ECoG desynchronization, typical and long lasting behavioural sedation or sleep accompanied by a significant increase in total voltage power and in the lower frequency bands in the ECoG. In addition, larger doses (100 and 200 ng) of muscimol, which in control rats produced a typical biphasic pattern of ECoG and behavioural changes, i.e. an initial period of ECoG desynchronization and behavioural stimulation, followed by a second period of behavioural and ECoG sleep, in animals pretreated with diazepam, produced only an increase in total voltage power and in the lower frequency bands in the ECoG resembling the effects of the smaller (50 ng) dose. The present experiments suggest that, after chronic stimulation of benzodiazepine receptors a decrease in sensitivity of receptors for gamma-aminobutyric acid (GABA) occurs, since the effects of muscimol on behaviour and spectrum power were significantly reduced or abolished. PMID- 3627383 TI - Mu and delta opioid ligands inhibit reflex contractions of the urinary bladder in the rat by different central mechanisms. AB - The supraspinal and spinal mechanisms of opioid-induced inhibition of reflex contractions of the urinary bladder were studied in female rats, anesthetized with urethane. A variety of central manipulations was made to distinguish the effects produced by [D-Ala2-Me-Phe4-Gly(ol)5]-enkephalin (DAGO), a selective mu opioid receptor ligand, from those of the delta ligand [2-D-penicillamine, 5-L penicillamine]-enkephalin (DPLPE), administered by either intracerebroventricular (i.c.v.) or by spinal intrathecal (i.t.) injection. The effect of intraventricular but not of intrathecal administration of DPLPE was abolished 4-5 hr after the systemic administration of reserpine (5 mg/kg, i.p.). Reserpine did not modify the actions of DAGO, given by either route. Pretreatment with 5,7 dihydroxytryptamine (5,7-DHT, 200 micrograms, i.c.v.) attenuated the effect of DPLPE given intraventricularly but not when given intrathecally, measured 7 days later. The effect produced by DPLPE given by either route was unchanged by pretreatment with 6-hydroxydopamine (6-OHDA, 150 micrograms i.c.v.). Neither 5,7 DHT nor 6-OHDA altered the effect of administrations of DAGO. The effect of DPLPE given intraventricularly was attenuated or abolished, in a dose-related and reversible manner, following the administration of naloxone or methysergide intrathecally but not by phentolamine, propranolol or atropine. The effect of DAGO given intraventricularly was antagonised by naloxone but not by any of the other antagonists. These observations suggested that the supraspinally- and spinally-mediated inhibition of reflex contractions of the urinary bladder produced by mu or delta receptor ligands can be dissociated. The supraspinal effect of DPLPE involved a descending serotoninergic, but not adrenergic pathway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627382 TI - Bicuculline-sensitive and insensitive effects of THIP on the binding of [3H]flunitrazepam. AB - The gamma-aminobutyric acid (GABAA) receptor partial agonist THIP inhibits the binding of [3H]flunitrazepam to unwashed membranes from the forebrain of the rat at 0 degrees C in the absence of chloride ions, reducing the affinity and Bmax of benzodiazepine (BZ) receptors. The decrease in affinity of benzodiazepine receptors seems to be due to antagonism by THIP of the effects of endogenous GABA, present in the unwashed membrane preparation. When the binding with washed membranes was determined at 30 degrees C, in the presence of chloride ions, THIP like GABA enhanced the binding of [3H]flunitrazepam through an increase in the affinity of benzodiazepine receptors. The changes in the affinity of benzodiazepine receptors induced by THIP seem to be mediated by bicuculline sensitive receptors. However, in the presence and absence of bicuculline, THIP reduced the total number of benzodiazepine binding sites, probably in a bicuculline insensitive manner. PMID- 3627384 TI - Cerebral activating properties of indeloxazine hydrochloride. AB - The cerebral-activating properties of indeloxazine hydrochloride [(+/-)-2-[(inden 7-yloxy) methyl]morpholine hydrochloride, YM-08054] were examined in comparison with those of calcium hopantenate (a cerebral metabolic enhancer), dihydroergotoxine (a cerebral vasodilator), viloxazine and amitriptyline (antidepressants). Indeloxazine enhanced the acquisition of learned behavior (passive avoidance, active avoidance and maze learning) and desynchronized the spontaneous EEG in rats. Amnesia in scopolamine-treated rats, disturbances of consciousness in concussed mice and synchronized EEG in rabbits with lesions of the internal capsule were improved by the administration of indeloxazine. Calcium hopantenate and dihydroergotoxine also showed cerebral-activating properties in the majority of behavioral and electroencephalographic paradigms; however neither improved scopolamine-induced amnesia and calcium hopantenate had no effects on learning. Neither viloxazine nor amitriptyline enhanced the acquisition of learned behavior. The results indicate that indeloxazine possesses activating effects on cerebral functions, including learning and the EEG, and that the pharmacological profile of indeloxazine is wider than those of dihydroergotoxine and calcium hopantenate in cerebral-activating activity. PMID- 3627385 TI - Perinatal undernutrition alters hypothermic responses to different central agonists in recovered adult rats. AB - Adult rats submitted to a protein deprivation schedule at perinatal age and later rehabilitated with balanced laboratory chow were studied in order to evaluate the hypothermic effect induced by the following central agonists: apomorphine, naphazoline, clonidine, diazepam, 5-MeODMT and oxotremorine. Deprived animals showed an enhanced reactivity to the hypothermic effect of apomorphine, naphazoline and diazepam, while a reduced responsiveness to clonidine was observed. Hypothermic responses to oxotremorine and 5-MeODMT were similar between both groups. These results stressed the functional relevancy of neurochemical changes induced by early undernutrition that may persist into adult life after nutritional recovery. PMID- 3627387 TI - Event-related potentials as a tool in the evaluation of cognitive functions in young subjects through the execution of a simple task. AB - Event-related potentials (ERPs) were recorded in 20 student volunteers. Three recordings were performed using aural stimuli of 4,000 (rare tones) and 250 Hz. In the target recording subjects were asked to count the rare tones. Endogenous and exogenous components of ERP recordings were analyzed. During the target recording N2 and P3 components were observed at 200 ms and approximately 300 ms, respectively, in addition to N1 (100 ms) and P2 (180 ms). The N2 and P3 waves are indicative of analysis at a higher cognitive level and have been termed the 'response set'. The P3 wave appeared to be stable in all subjects and may represent a useful electrophysiological method to explore mnemonic and cognitive functions in man. PMID- 3627386 TI - Isoarecolone can inhibit nicotine binding and produce nicotine-like discriminative stimulus effects in rats. AB - Isoarecolone methiodide has been reported previously to be a potent agonist at peripheral nicotinic-cholinergic receptors. Both isoarecolone methiodide and isoarecolone HCl can produce contractures of the frog rectus abdominis muscle and can inhibit binding of [3H]-(-)-nicotine to rat brain membranes, although the methiodide is much more potent than the hydrochloride. In rats trained to discriminate the effects of nicotine from saline, there is generalization to isoarecolone HCl at doses that reduce overall rates of responding. This effect and the similar relative potencies of isoarecolone and nicotine in the biochemical and behavioural procedures support the view that the high-affinity binding site for [3H]-(-)-nicotine is the receptor mediating the discriminative effect. PMID- 3627388 TI - COMSTAT rule for vigilance classification based on spontaneous EEG activity. AB - For the classification of sleep stages, international standards based on visual EEG analysis have been established and are in common use, although we are well aware of their limitations. Several authors have suggested different procedures for classifying the stages of vigilance during the waking stages. No universally accepted paradigm, however, has yet been developed. The proposed vigilance classification procedures are based either on visual or automatic analysis procedures. Even though the EEG activity and patterns that reflect vigilance changes have been identified and described as indicators of the state of alertness, opinion is divided on how these should be combined in a vigilance classification rule. Automatic methods, on the other hand, have up to now used only part of the information available, the relationship of which to vigilance indicators has only been partially explored. The COMSTAT (Dept. of Computation and Statistics, AFB-Arzneimittelforschung, Berlin, FRG) rule combines visual and automatic analysis procedures. Different vigilance-dependent EEG patterns, such as the proportion of occipital background rhythm under resting conditions and its replacement by either faster or slower waves, the frequency range of the occipital rhythm and the anteriorization phenomena, have been used as information for a latent class analysis (LCA5) with 5 classes (stages of vigilance). There is a high correlation between the results of the LCA5 with visual classification rules made by experts. Using a robust discriminant analysis function which takes into account prior probabilities of the classes, and with a linear cost function for misclassification, an automatic rule with power spectrum variables was fitted to the results of the LCA5. Reclassification and split-half classification showed a high overlap between LCA5 and automatic classification. The result of this procedure is a new vigilance classification rule that is based on an objective mathematical rationale for the combination of different vigilance-indicative EEG activities and patterns but which can be applied to power-spectral estimators in an automatic EEG analysis procedure. PMID- 3627389 TI - Chromosomal aberrations in the lymphocytes of alcoholics and former alcoholics. AB - An elevation of chromosomal aberrations has been found in the lymphocytes of alcoholics compared with those of nonalcoholics. In this study, structural aberrations of chromosomes in peripheral lymphocytes of alcoholics and former alcoholics were examined in order to study the chromosome-breaking activity of alcohol and effects of long-term sobriety on chromosomal aberrations in alcoholics. We have presumed initially that chromosomal aberrations in alcoholics would remain for a long time after abstinence from alcohol. Nevertheless we found a spontaneous reduction of the chromosomal aberrations in former alcoholics who had been dry for periods of 2 years or more. These observations suggest that chromosomal aberrations appearing in alcoholics probably formed by a chronic activity of alcohol and/or its metabolic products and cellular repair mechanisms may recover within a few years of abstinence. PMID- 3627390 TI - Conditional associative learning in drug-free schizophrenic patients. AB - The performance on spatial and nonspatial associative learning tasks was tested in a sample of male drug-free DSM III-diagnosed schizophrenic patients and in a closely matched normal control group. Schizophrenics showed a worse performance on both versions of the task, but especially on the nonspatial one. A significant correlation was observed between some indices of the nonspatial task and the scores on two subscales (affective flattening and anhedonia) of the scale for the assessment of negative symptoms by Andreasen. These results are consistent with the hypothesis of a dysfunction of dorsolateral prefrontal cortex in schizophrenia and with the postulated linkage between such dysfunction and negative schizophrenic symptomatology. PMID- 3627391 TI - Pharmacogenetic study with diazepam in twins. AB - In a study with healthy volunteers (6 monozygotic and 4 dizygotic twin pairs) we followed up diazepam serum levels and psychotropic effects of diazepam after single-dose administration. We found that pharmacokinetic properties of diazepam as well as its influence on memory and performance are probably not under genetic control. On the other hand, genetic factors seem to contribute to effects of diazepam on affectivity. PMID- 3627392 TI - Transdermal scopolamine: effects of single and repeated patches upon psychological task performance. AB - Scopolamine and placebo transdermal patches were applied on alternating days to 12 normal volunteer subjects. Psychological performance tasks, physiological assessments, a subjective feeling state questionnaire, and a sleep questionnaire were completed each day. Transdermal scopolamine produced significant decrements in memory task performance, daytime feelings of alertness, ease of waking, and alertness following waking, while resting heart rates were lowered. Significant drug x patch number interaction effects were present with memory for new information, letter cancellation omission errors, rapid visual information processing reaction time, and self-rated ease of getting to sleep, but there was no consistent pattern to the changes following successive patches. Visual problems (blurred vision, longer visual near point) increased following successive scopolamine patches, but the changes in task performance were not related to these visual changes. PMID- 3627393 TI - Visuomotor tracking performance in schizophrenia: relationship with psychopathological subtyping. AB - 30 schizophrenic outpatients (RDC) under neuroleptic maintenance treatment completed a visuomotor tracking task with four degrees of difficulty. The mean efficiency of performance was measured in bit per second from the difference between the target signal and the tracking signal. Clinical assessment was accomplished with the BPRS, CGI, and GAS. Besides generally poorer tracking performance in schizophrenics compared with healthy volunteers the main finding was a relationship between tracking performance and psychopathological subtyping. Negative symptoms were related to a generally lowered task performance, irrespective of task difficulty. However, this effect disappeared by controlling for illness duration. On the other hand, there was a syndrome-specific interaction effect with task difficulty: Schizophrenics with positive symptoms performed poorly, especially in the most difficult task condition. Generally, there was no significant relationship between daily neuroleptic dose and tracking performance. Results are discussed with respect to a differential deficit in attention in schizophrenic subgroups. PMID- 3627394 TI - EEG fitting: a new method for numerical analysis of EEG. AB - A new method for numerical analysis of EEG is described. It consists of fitting the EEG with orthogonal polynomials in several steps to separate the different frequencies contained in the original recording (high-frequency noise, beta, sigma, alpha, theta, delta, low-frequency noise). The original EEG is separated into 5 different signals with cutoff frequencies at 40, 18, 4 and 0.6 Hz. The activity in these signals is classified into the usual EEG bands by zero crossing. The results are given as integrated values over 1 s in the different EEG bands, or wave by wave, each wave being described by its time of occurrence, amplitude and duration. This method is designed for accurate amplitude measurement in the frequency bands of EEG, particularly for application in psychiatry and psychophysiology. PMID- 3627395 TI - Role of M- and N-cholinergic systems in the recovery of motor functions after ablation of the motor zones of the cat cerebral cortex. PMID- 3627396 TI - Influence of microiontophoretic application of GABA on the formation of the cellular analog of the conditioned reflex. PMID- 3627397 TI - Conditioned reflex changes in relations between afferent inputs from the lateral geniculate body and pulvinar in the cat visual and association cortex. PMID- 3627398 TI - Reactivity of cortical neurons of the rat to acetylcholine. PMID- 3627399 TI - Magnitude of potential induced in a mollusk nerve cell in a low-frequency electric field. PMID- 3627400 TI - Reflection of plastic properties of two neurons with common monosynaptic input by statistical analysis of their firing pattern. PMID- 3627401 TI - Changes in evoked potentials of rabbit visual field during stimulation of raphe nuclei and locus ceruleus. PMID- 3627402 TI - Spectral analysis of the EMG envelope and its role in the study of physiological tremor. PMID- 3627403 TI - Effect of delta-sleep-inducing peptide on the interaction of symmetric cerebral cortical structures after transection of the corpus callosum. PMID- 3627404 TI - Electrophysiological manifestations of the monoaminergic systems' effects on the cerebral cortex. AB - Consideration is given to a possible mechanism of reinforcement during training mediated through the monoaminergic systems in the brain that modulate the effectiveness of intracortical synapses. Various forms of electroencephalographic manifestations of the effect of these systems on the cerebral cortex are discussed. A comparison of the theoretical and experimental results favors the modulating role of the serotoninergic and noradrenergic systems. PMID- 3627405 TI - Change in the activity of cortical neurons under the influence of biogenic amines. AB - Under the conditions of extracellular recording of action potentials, the influence of proposed neuromediators on the structure of background impulse activity of neurons of various regions of the cerebral cortex was studied. Computer analysis of the statistical parameters of impulse flows revealed the presence of a fundamental difference between the effects of neuromediators of cortical and subcortical origin. It was demonstrated that prolonged application of serotonin and noradrenalin evokes a change in structure of cortical neuron impulse activity more complex than the simple inhibition and excitation characteristic of acetylcholine or GABA. Different types were found of the reaction of neurons to the same monoaminergic stimulus, types whose characteristic feature is the dependence of the end result of the influence on the initial level of excitation in the neuron examined. The fundamental difference between the effects of preparations studied in the visual and sensorimotor regions of the cortex was not discovered. The data obtained are considered from the point of view of the modulating role of the biogenic amines in the regulation of the level of excitation of cerebral cortical neurons. PMID- 3627406 TI - Effect of leu-enkephalin on verbal forms of mental activity in alcoholics and healthy persons. PMID- 3627407 TI - Involvement of the catecholamine mechanisms in the activation of mouse hypophyseotesticular complex induced by the female presence effect. AB - We have studied the role of the adrenergic and dopaminergic mechanisms in the activation of the endocrine testicular function of CBA/Lac and A/He male mice induced by the presence of a female in estrus without any tactile contact with a male. The alpha-adrenoreceptor blocker phentolamine inhibited an increase in the peripheral blood plasma testosterone level caused by the receptive female challenge. Propranolol blockade of beta-adrenoreceptors abruptly increased the stimulating effect of the receptive female presence on the blood testosterone level. The expression of the adrenoblocker action on the blood male sex hormone level depended on a male genotype. The dopamine receptor blocker pimozide produced a moderate effect on the blood testosterone but an attempt to separate its influence into the male sex hormone tonic secretion and the blood testosterone level against a background of sexual activation failed. It was concluded that the adrenergic mechanisms were involved in the activation of the hypothalamo-hypophyseotesticular complex induced by the presence of the receptive female. PMID- 3627408 TI - Functional transswitching of dominant motivation in the systemic organization of behavioral acts. PMID- 3627409 TI - Change in functional significance of cat cerebral structures as a result of reorganization of cerebral activity. PMID- 3627410 TI - Characteristics of receptive fields of neurons of the posterotemporal cortical region in the cat. PMID- 3627411 TI - Computed tomography of the cranio-cervical lymphatic system: anatomical and functional considerations. AB - As an initial route of the spread of inflammatory and neoplastic pathology, the complex lymphatic system of the cervical region assumes an important part of the examination in patients with extra-axial disease of the head and neck. In addition, the often overlooked cranio-facial lymphatics must also be routinely investigated in order to forward the understanding and sensitivity of the neuroradiologic evaluation of primary sites of disease propagation from these areas. PMID- 3627412 TI - A quantitative study of physiological cerebral atrophy with aging. A statistical analysis of the normal range. AB - A new method of discriminating pathological cerebral atrophy from physiological atrophy during aging is reported. The authors advocate a pixel counting method using a minicomputer for the quantitative measurement of cerebral atrophy. Five hundred cases were studied with this quantitative method and the normal range of the physiological atrophy was determined statistically. In order to estimate the degree of cerebral atrophy easily, the conventional linear measurement methods were compared with the pixel counting method using multivariant analysis, and a simple formula for the calculation of the degree of cerebral atrophy is proposed. Using this formula and the normal range, pathological cerebral atrophy is easily detectable. PMID- 3627413 TI - MR imaging of epidermoid cysts. AB - After a short review of literature, MRI assessments of four cases of epidermoid cysts (EC) are reported. EC, (characterized in computed tomography by hypo or iso density areas non-enhanced by contrast), are characterized in MRI by: 1) an important variability of signal intensity between the different cases, and sometimes between the different parts of the same cyst, 2) the absence of edema in surrounding parenchyma, in spite of important mass effect, 3) well defined limits, permitting certainty of the extra-cerebral nature of this tumor, 4) the presence of calcifications easily perceptible in MRI. It is proposed that the variability of signal intensity of EC is caused by different relaxation time values corresponding to different concentrations of keratin, cholesterol and water content. PMID- 3627414 TI - High-field spin-echo MR imaging of superficial and subependymal siderosis secondary to neonatal intraventricular hemorrhage. AB - Two cases of superficial siderosis with subependymal siderosis, secondary to neonatal intraventricular hemorrhage, are presented. High-field spin-echo MR imaging (1.5 Tesla) showed marginal hypointensity of the ventricular walls as well as of the subpial regions. These findings were most evident on T2 weighted images, characteristic of hemosiderotic deposits. PMID- 3627415 TI - Dynamic CT of tuberculous meningeal reactions. AB - The technique of intravenous dynamic cranial computed tomography has been applied to the patient population at this location in Saudi Arabia with meningeal tuberculosis. The various manifestations and sequelae including meningitis, arteritis, infarct, and true meningeal tuberculomata all have characteristic if not specific appearances. The dynamic study enhances an otherwise static examination and reveals a great deal about the pathophysiology of tuberculosis involving the cerebral meningeal surfaces. PMID- 3627416 TI - Long term follow-up of 43 pure dural arteriovenous fistulae (AVF) of the lateral sinus. AB - Forty-three patients with arterio-venous fistulae of the dura of the transverse sinus with a complaint of tinnitus are reviewed, with a follow-up of 12 months to 11 years. 34 patients were embolized, 2 treated surgically, and 7 were untreated. Embolization appears to have been beneficial. The frequently benign nature of this abnormality must be emphasized, and serious psychological study of the patient must be made before deciding on therapy. PMID- 3627417 TI - "Top of the basilar" syndrome: clinico-radiological evaluation. AB - Sixteen patients having infarction caused by circulatory disturbance at the top of the basilar artery, that is to say, the "top of the basilar" syndrome, were studied, the diagnosis having been made by computerized tomography. Infarcts were widely distributed in each patient between the thalamus, midbrain, pons, cerebellum, and occipital lobe. Both thalami were involved in 7 cases. When the thalamus was involved bilaterally, the low density areas were symmetrical in size and localization. Angiography revealed that stenosis or occlusion lay within a circle 2 cm in diameter surrounding the five-forked junction at the top of the basilar artery in 84.6%. Recanalization of the occluded artery occurred in 61.5%, suggesting that embolism played an important role in appearance of this syndrome. PMID- 3627418 TI - The preoperative venogram in planning extended craniectomies. AB - A technique of extended craniectomy sometimes allows removal of large central or transtentorial mass lesions at a single operative sitting because it affords better exposure and control of normal structures. While seeking to avoid multiple craniotomies, this method requires permanent ligation of the transverse venous sinus. Unless there is adequate collateral venous drainage from the ipsilateral hemisphere, the patient is at risk for venous infarction in the post-craniectomy period. The purpose of this study is to propose a method of establishing the presence of collateral venous drainage preoperatively. Each carotid artery is injected with the head in a neutral position and with the head turned to the side ipsilateral to the carotid artery injection in an attempt to divert the venous flow. Fifty patients were examined using this method; seven were being evaluated for possible craniectomies. The technique identified nine patients with potential venous collaterals (20%). They would otherwise have been considered nonoperable: two of the six patients eventually operated upon (33%) fell into this category. In general, the operative procedure may be safe more often on the left than the right (45%) vs (20%). Particular attention must be given to the pattern of venous drainage from the posterior temporal lobe to avoid isolation of the venous drainage from this area. PMID- 3627420 TI - Large volume full columnar lumbar myelography. AB - A technique utilizing dilute water-soluble intrathecal contrast medium is described which allows a full columnar upright examination thereby facilitating sensitive simultaneous myelographic evaluation of the lumbar region and thoracolumbar junction. PMID- 3627419 TI - Computed tomography of germinomas in basal ganglia and thalamus. AB - CT findings of 6 cases with germinoma originating in the basal ganglia and thalamus are reported. The early finding of germinoma in this region on plain CT, was an irregularly defined, slightly high density area without mass effect. Repeated CT scanning showed enlarging iso-density lesion accompanied by mass effect to high. Intratumoral cysts and calcifications were frequently observed. The tumor showed mild to moderate and inhomogeneous enhancement by intravenous injection of contrast medium. A tendency to ipsilateral hemicerebral atrophy was found in one case. These findings were somewhat different from those of germinomas in the pineal and suprasellar regions. This phenomenon may be related to the anatomical difference of the brain where the tumor originated. PMID- 3627421 TI - Influence of the spread and period of retention of Iotrolan in the subarachnoid space on the side effects rate in myelography. AB - Fifty patients underwent myelography with the newly developed CSF-isotonic, dimeric, non-ionic contrast medium Iotrolan. Repeat spinal and cranial computerised tomographic studies with measurement of the attenuation values were conducted to demonstrate the administered contrast medium in the spinal canal and intracranial subarachnoid space. The patients were examined neurologically, observed clinically and asked about concomitant symptoms. The period of retention and the spread of the contrast medium in the subarachnoid space was not found to have any influence on the side effects rate. In particular, no association was confirmed between intracranially demonstrable contrast medium and the occurrence of side effects. PMID- 3627422 TI - Side effects after diagnostic lumbar puncture and lumbar iohexol myelography. AB - A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n = 97) and diagnostic lumbar puncture (n = 85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early onset headache occurred significantly more often in the iohexol group (17 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effects after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent. PMID- 3627423 TI - Computed tomography and angiography in MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes); report of 3 cases. AB - Among mitochondrial encephalomyopathies, MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes, Pavlakis et al. 1983) is recognized as a distinct syndrome characterized by generalized convulsions and recurrent stroke-like episodes. The neuroradiological findings of three patients with MELAS are reported here. Retrospective review shows that MELAS should be included in the differential diagnosis of infarct-like lesions of the cerebrum. PMID- 3627424 TI - Computed tomographic imaging of the brain in after hypoglycemia coma. AB - A case of severe hypoglycemic coma was studied by sequential Computed Tomographic Imaging (CT) of the brain. The CT 1) was normal in the early stage, 2) subsequently showed a low density area, which was enhanced by the contrast medium, in the cerebral cortex and the boundary zone between the major cerebral arteries, and 3) revealed marked enhancement in the entire cortical region and hypodensity in the periventricular region in the late stage. These CT findings, representing the course of neural cell damage by severe hypoglycemia, are discussed from the pathophysiological viewpoint. PMID- 3627425 TI - MRI of Listeria rhombencephalitis. AB - A case of Listeria rhombencephalitis in a patient, who was evaluated by MRI, is reported. MRI showed areas of high signal intensity on T2-weighted images in the rhombencephalon and confirmed the clinical diagnosis of a brainstem affection by Listeria monocytogenes. PMID- 3627426 TI - Magnetic resonance imaging in Pelizaeus-Merzbacher disease. AB - Pelizaeus-Merzbacher's disease is a progressive encephalopathy with demyelination of the cerebral white matter. The diagnosis can not be made on clinical or biological grounds: pathological investigation is necessary to confirm tigroid demyelination. CT scanning failed to visualize this type of anomaly but detection is now possible with the advent of magnetic resonance imaging (MRI). The authors studied the case of a boy who, at the age of 8 presented with symptoms characteristic of the disease: rotatory nystagmus, progressive encephalopathy, and inherited X-linked recessive traits. Magnetic resonance imaging revealed a high signal in the supra- tentorial white matter and the usual contrast was inverted. The authors believe that MRI can make an important contribution to the diagnosis of the disease. PMID- 3627427 TI - Tissue inhomogeneity within lumbar costotransverse foramen. PMID- 3627428 TI - Intradural disc herniation with vacuum phenomenon: CT diagnosis. PMID- 3627429 TI - A dehiscent jugular megabulb associated with a dominant occipital sinus. PMID- 3627430 TI - A nomenclature proposal for the chromogranin/secretogranin proteins. PMID- 3627431 TI - Intracerebral transplantation of cultured neurons after reaggregation in a plasma clot. AB - In order to be able to transplant neural cells which have been either manipulated in vitro or maintained in culture for the purpose of cell-type enrichment, we have developed a novel plasma clot method which permits reaggregation of previously dissociated cells such that they can be implanted as highly localized transplants rather than as dispersion-prone cell suspension grafts. To establish the method, enzymatically dissociated cells prepared from hippocampal primordia of late embryonic rats were immediately reaggregated into plasma clots and transplanted to the hippocampal formation of adult recipients. By using fluorescein-labelled bovine plasma to form the plasma clot grafts of reaggregated cells, the fate of the plasma clot protein matrix was followed at different post operative survival times. Initially, 4-5 days post-operative, the plasma clot maintained the grafted cells in a loose sponge-like sack at the site of implantation. After 2-3 weeks, the transplanted cells were more compact and fused with the host neuropil, and the plasma clot matrix had largely been degraded. At 1 month or longer survival, there was no distinguishable boundary between transplant and host, and there was little or no evidence of any remaining plasma clot matrix or proteins. The plasma clot method was subsequently applied to the transplantation of cultures enriched in pyramidal cells. Enrichment for pyramidal cells was achieved by eliminating mitotic cells (dentate granule cells and glia) by brief (200 rad) irradiation of hippocampal primordia followed by dissociation and maintenance in monolayer culture for 4-6 days. Fibres from host dentate granule cells grew into the pyramidal cell-enriched transplants and established mossy fibre terminals on the donor cells. In transplants between embryonic and adult rats, donor cells were identified at long survival times by prelabelling donor cells in utero or in vitro with [3H]thymidine prior to transplantation. In transplants between embryonic and adult mice, donor tissue from A Thy-1.1 strain mice was transplanted to congenic A strain (Thy-1.2) mice such that the donor cells bearing the Thy-1.1 cell surface glycoprotein could be later identified by immunocytochemical staining with antibodies specific for the Thy-1.1 antigen. Reaggregation and transplantation of dissociated cells in a plasma clot thus provides a novel method whereby prior manipulation of neural tissue (separation of neurons and glia, enrichment for specific types of neurons, or glia etc.) can be used to great advantage in studying host-transplant connectivity and in assessing those factors which are critical in sustaining the survival of grafted neural tissue. PMID- 3627432 TI - Factors affecting survival and outgrowth from transplants of entorhinal cortex. AB - The purpose of this study was to examine injury-related effects on the survival and growth of entorhinal tissues transplanted to the adult rat entorhinal area. Embryonic entorhinal cortex was transplanted to the angular bundle region of adults either immediately, or 8-10 days, after severing specific host projections. Graft survival (Nissl stain) and connectivity (acetylcholesterase stain and retrograde labeling with wheat germ agglutinin-horseradish peroxidase) were examined two months post-transplantation. Grafts transplanted 8-10 days after severing the angular bundle were large and contained many cells which innervated the hippocampal formation. Grafts transplanted immediately after severing the angular bundle were small, did not integrate well with the host tissues, and failed to innervate the hippocampal formation. Grafts transplanted without producing any prior lesion, or following lesions which did not damage host entorhinal projections, were intermediate in size, but failed to innervate the hippocampal formation. The data demonstrate that: (1) introducing a delay between the lesion and implant surgeries can significantly enhance graft survival and the establishment of transplant-to-host projections, and (2) transplant derived innervation of the host is significantly impaired when host homologous fibers are intact. These findings suggest that environmental factors, induced specifically by the destruction of host homologous fibers, are responsible for the differences in transplant survival and connectivity observed. PMID- 3627433 TI - Retinotectal reorganization in goldfish--IV. Effects of retinal ganglion cells after half tectal ablation. AB - During compression of the entire retinotectal projection into the rostral half of the tectum after ablation of the caudal half there is widespread sprouting of ganglion cell axons, not only those cut during the operation but also those left intact. However, unlike cut axons those left intact sprout without their cell bodies showing chromatolysis or swelling. Chromatolysis and swelling of the cell bodies of cut axons are more prolonged than after optic nerve section and resolve in more central regions of retina first. The cut axons of cell bodies in these regions tend to be the first to form terminal arborizations during the compression process as judged electrophysiologically. However, there is no clear correlation in individual fish between these measures and the state of compression assessed electrophysiologically. Large areas of retina may contain chromatolysed cells even after compression has occurred. Electrophysiological mapping alone may give a misleading picture of the interactions occurring between retinal and tectal cells during reorganization. PMID- 3627434 TI - The distribution and morphology of identified thalamocortical projection neurons and glial cells with reference to the question of interneurons in the ventrolateral nucleus of the rat thalamus. AB - The distribution and morphology of thalamocortical projection neurons and glial cells in the ventrolateral nucleus of the rat thalamus have been investigated using light and electron microscopic techniques. In this material thalamocortical projection neurons in the ventrolateral nucleus were identified by the retrograde transport of horseradish peroxidase following the placement of multiple injections of horseradish peroxidase in the primary motor and sensorimotor overlap regions of the cerebral cortex. The location of horseradish peroxidase labelled thalamocortical projection neurons varied with the locus of injection in the motor and sensorimotor overlap cortex; caudal injections labelled cells in the rostrolateral region of the ventrolateral nucleus while injections involving successively more rostral regions of the cortex labelled cells in more medial and caudal regions of the nucleus. Labelled thalamocortical neurons were grouped in clusters with neuron pairs often closely applied to each other via non-synaptic junctional complexes. Where the field of labelled neurons was analysed in series of 1-micron-thick sections with phase contrast light microscopy, all neurons in the field were found to be clearly labelled with horseradish peroxidase. Thalamocortical neurons comprised mainly medium-to-large, multipolar ovoid-shaped cells which showed a large centrally placed nucleus with deep invaginations of the nuclear membrane. Two types of glial cells were identified: astrocytes, identified by their characteristic pale-staining ovoid nucleus, showed a close relationship to blood vessels, synaptic complexes and neurons; oligodendrocytes, distinguished by their darkly stained nucleus and cytoplasm, were somewhat smaller and showed a close association with myelinated fibres. These findings show that the rat ventrolateral nucleus comprises a homogeneous population of thalamocortical projection neurons and thus provide indirect evidence suggesting the absence of interneurons in the ventrolateral nucleus of the rat thalamus. PMID- 3627435 TI - Regional and laminar density of the dopamine innervation in adult rat cerebral cortex. AB - The topographic distribution and density of the dopamine innervation in adult rat cerebral cortex were investigated by means of a recently improved radioautographic procedure for the light microscopic visualization and counting of monoamine axonal varicosities. Dopamine terminals were specifically labeled by high-affinity uptake in whole cerebral hemisphere slices incubated for 15 min at 35 degrees C with 10(-6) M tritiated dopamine in the presence of 10(-4) M pargyline and 5 X 10(-6) M desipramine. The slices were subsequently fixed, embedded in Epon and processed for light microscope radioautography as large 4 micron-thick (whole hemisphere) or smaller, semi-thin sections (selected areas). In radioautographs of serial semi-thin sections exposed for various periods of time, the number of labeled axonal varicosities reached a plateau after 12-14 days of exposure. Counts on such sections of increasing thickness allowed to calculate a correcting factor to transform numbers obtained from 4-micron-thick sections into their equivalent for a tissue thickness of 0.5 micron from which all varicosities were detected. The number of labeled varicosities could then be expressed per mm3 of tissue after measuring their mean caliper diameter in electron microscope radioautographs. As visualized at 3 transverse levels representing most of the major cytoarchitectonic divisions of cerebral cortex, two novel aspects were recognized in the topographic distribution of dopamine terminal: (1) the presence of a dopamine innervation in layer VIb of the frontal, parietal, temporal and occipital neocortex, and (2) a significant contingent of dopamine varicosities within the deep and not only upper layers of supragenual cingulate cortex. A fair number of dopamine varicosities were also detected in the upper layers of the dorsomedial frontal area, in the retrosplenial and adjacent occipital cortex as well as in the ventral subiculum and field CAl of the hippocampus. As measured in 10 sectors representing different cortical regions, the highest density of dopamine innervation was found in the supragenual cingulate cortex (1.7 X 10(6] and particularly in its layers II and III (3.1 X 10(6)). A slightly lower density was measured in the anteromedian "prefrontal" cortex (1.0 X 10(6)). The rostrorhinal and the perirhinal cortex showed moderate dopamine innervation (3.0 and 5.5 X 10(5)) with varicosities in every layer. The piriform and the posterior entorhinal cortex were also moderately and ubiquitously innervated (2.5 and 3.0 X 10(5)).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3627436 TI - The laminar distribution of glutamate decarboxylase and choline acetyltransferase in the adult and developing visual cortex of the rat. AB - The activities of choline acetyltransferase and glutamate decarboxylase were measured in individual layers of the adult and developing rat visual cortex. In the adult, the level of choline acetyltransferase activity was highest in layer V followed by layers I, II & III, IV and VI. These measurements are in complete agreement with recent immunohistochemical observations in the same cortical area. Glutamate decarboxylase activity was highest in layer IV and declined significantly in the more superficial and deeper layers. The activities of both enzymes were low during the first postnatal week but increased dramatically between days 8 and 18. Choline acetyltransferase activity in all layers demonstrated a more gradual rise to adult levels from day 18 onward, while glutamate decarboxylase activity reached adult levels by day 24 in all layers, except layer IV, which showed a continuous increase to adulthood. The functional role of the differences in the laminar distribution of these enzymes remains unknown. PMID- 3627437 TI - Distribution of neurons and glia in the visual cortex (area 17) of the adult albino rat: a quantitative description. AB - The neuronal and glial cell composition of the rat visual cortex (area 17) has been determined quantitatively using stereological techniques. The volume numerical densities (number of cells per mm3 of cortex) of neurons and of the principal glial cell types (astroglia, oligodendroglia, and microglia) were calculated from tangential semithin resin sections spaced at regular intervals 50 micron apart throughout the entire depth of the visual cortex. From measurements of cortical and laminar thickness the separate volume numerical densities of neurons and glial cells were derived for each lamina in the cortex. In addition, the absolute numbers of cells in each lamina under 1 mm2 of cortical surface were calculated. The mean cortical volume numerical density of neurons was 60,020 +/- 3840/mm3 (mean +/- SEM; n = 8), and 49,040 +/- 2610/mm3 for the combined glial cell types. Astroglia, oligodendroglia, and microglia were present in a ratio of 6:3:1 respectively. It was determined from neuronal and glial somatic volume estimates that the somata of these cells occupied approximately 13.5% of unit cortical volume, with 81.3% of the unit volume being occupied by cortical neuropil. Using previously published reports that described the laminar composition of neurons in terms of the relative proportions of pyramidal and non pyramidal cells, the laminar volume numerical densities for these neuronal categories have been derived. In addition, it has been estimated that under 1 mm2 of cortical surface there are 79,500 pyramidal and 7790 non-pyramidal neurons distributed throughout layers 1-6 of the rat visual cortex. PMID- 3627438 TI - Distribution of [3H]cholecystokinin octapeptide binding sites in the hippocampal region of the rat brain as shown by in vitro receptor autoradiography. AB - The distribution of binding sites for the neuropeptide cholecystokinin octapeptide in the rat hippocampal region was studied by using quantitative in vitro receptor autoradiography. Biochemical analysis of [3H]cholecystokinin octapeptide binding to tissue sections of the hippocampal region showed it to be of high affinity, to be saturable and approximately 50% specific at saturating concentrations. The binding of [3H]cholecystokinin octapeptide to hippocampal sections was dose-dependently blocked by cholecystokinin octapeptide, cholecystokinin and by pentagastrin. The autoradiographic analysis showed high densities of [3H]cholecystokinin octapeptide binding sites in the hilus of the area dentata, the outer three layers of the retrosplenial area and the presubiculum, layer 3 of the medial, but not the lateral, entorhinal area and the deep and superficial parts of layer 1 and 2, respectively of both the medial and the lateral entorhinal area. Medium binding densities were found in the parasubiculum and remaining layers of the entorhinal area and low densities occurred in the subiculum and in all subfields of Ammon's horn. The angular bundle and fornix-fimbria lacked specific [3H] cholecystokinin octapeptide binding sites. A very similar pattern of binding densities was found for [3H]pentagastrin. Comparisons of the cholecystokinin octapeptide receptor distribution with the cholecystokinin octapeptide innervation of the hippocampal region suggest that there exists a relatively good concordance in some hippocampal subfields such as the presubiculum and the entorhinal area between binding sites for [3H]cholecystokinin octapeptide and cholecystokinin immunoreactive afferent input. PMID- 3627439 TI - Synaptic and extrasynaptic localization of adenosine binding sites in the rat hippocampus. AB - In vitro binding sites for [125I]iodohydroxyphenylisopropyladenosine, an A1 adenosine agonist, were visualized in the CA1 area of the rat hippocampus by electron microscopical autoradiography. By fixing hippocampal slices after incubation in paraformaldehyde and osmium tetroxide, the specifically bound radioactive ligands were preferentially retained and cross-linked to the tissue. Autoradiographic silver grains were localized by a statistical evaluation according to the '50% probability circle analysis' and by measuring the distance of the grains from neighbouring membrane structures. A significant association of silver grains, indicating the presence of A1 adenosine receptors, was found at synaptic complexes and in addition at extrasynaptic sites on dendritic membranes. This suggests that modulation of nerve cell activity by adenosine involves synaptic as well as non-synaptic mechanisms. PMID- 3627440 TI - Origin and trajectory of the cerebello-olivary projection: an experimental study with radioactive and fluorescent tracers in the cat. AB - It was demonstrated with autoradiographic methods that a tract of thin fibers, which is for the most part distinct from the brachium conjunctivum and its crossed descending limb, can be followed from the cerebellar nuclei to the inferior olive. Neurons from all regions of the interposed and dentate nuclei contribute to this tract. With two fluorescent tracers, Fast Blue and Diamidino Yellow Dihydrochloride, the perikarya of neurons in the cerebellar nuclei that project to the inferior olive or thalamus were identified and the possibility of collateral projections from single neurons to both regions was investigated. Numerous retrogradely labeled neurons were seen in the contralateral interposed and dentate nuclei but no double-labeled cells were ever encountered. The mean diameters of the cells projecting to the inferior olive were between 15 and 20 microns while the mean diameters for those projecting to the nucleus ventrolateralis of thalamus were between 25 and 35 microns. Differences in the morphology of the two cell populations were noted. It was also found that the fastigio-olivary projection is small, terminating mainly contralaterally, in the caudal medial accessory olive and subnucleus beta. It is concluded that cerebello olivary fibers are not collaterals of the cerebellothalamic projection and that there are two different populations of neurons in the cerebellar nuclei that give rise to these distinct efferent projections. PMID- 3627441 TI - A histochemical study of the adrenergic innervation of the rat pineal gland: evidence for overlap of the innervation from the two superior cervical ganglia and for sprouting following unilateral denervation. AB - The rat pineal gland receives sympathetic innervation, via the right and left internal carotid nerves, from neurons whose cell bodies are located in the two superior cervical ganglia. Using fluorescence microscopy, we have examined the density and distribution of fluorescent profiles in the pineal gland after lesioning of the internal carotid nerves. Thirty-two hours after sectioning both internal carotid nerves, the density of the fluorescent profiles was 3% of that seen in sham-operated controls, indicating that the lesioned fibers had degenerated. Thirty-two hours after sectioning one internal carotid nerve, the density of the processes was decreased to approximately 50% of the control value. The magnitude of the decrease following a unilateral lesion was similar on both the right and left halves of the gland. Thus, the results suggest that each internal carotid nerve innervates both sides of the pineal gland. The implications of this overlap in the innervation from the two internal carotid nerves for recovery of pineal function after a unilateral lesion are discussed. Sections of pineal glands were also analyzed at later time points after a unilateral lesion. Two weeks after cutting one internal carotid nerve, the density of the fluorescent profiles had increased to greater than 80% of the control value. When the contralateral internal carotid nerve was cut 2 weeks after a unilateral lesion and the pineal gland was examined 32 h later, the density of the fluorescent profiles had decreased to 2% of the sham value. This suggests that all of the compensatory increase in adrenergic processes that takes place following the unilateral lesion is due to sprouting of the contralateral internal carotid nerve rather than to regeneration of the lesioned internal carotid nerve or to sprouting and ingrowth of other adrenergic neurons. It remains to be determined what, if any, functional significance this sprouting has, since the neurally dependent circadian rhythm in serotonin N acetyltransferase activity in the pineal gland is restored to normal within 32 h after a unilateral lesion; that is, before significant sprouting has occurred. PMID- 3627442 TI - Lasting changes in spontaneous multi-unit activity in the chick brain following passive avoidance training. AB - Day-old chicks were trained on a one-trial passive avoidance task by pecking at a small, shiny bead coated with either a bitter-tasting substance (methylanthranilate) or water. The undifferentiated spontaneous multi-unit activity recorded bilaterally from anaesthetized chicks 1-13 h after training on the above task exhibited a significant increase in the methylanthranilate-trained over water-control chicks within three structures of the right hemisphere: the hyperstriatum accessorium (47%, P less than 0.05), the medial hyperstriatum ventrale (49.1%, P less than 0.02) and the medial portion of the paleostriatum augmentatum (47.5%, P less than 0.02). Within the multi-unit record obtained from both groups of chicks there were periods of short duration (15-20 ms) containing high-frequency (400-450 Hz) large-amplitude (greater than or equal to 200 microV; 450 microV max peak-to-peak) spikes. As a consequence of training, there was a massive increase in the occurrence of these bursting epochs in the medial hyperstriatum ventrale of both the left (320%, P less than 0.001) and right (350%, P less than 0.001) hemispheres in methylanthranilate-trained compared to water-trained chicks. In addition, the mean number of spikes per burst at this site increased by 66% (P less than 0.001) with no change observed in any other structure sampled. The statistically significant increase in activity within the right hyperstriatum accessorium and medial paleostriatum augmentatum and the non significant increase in these structures in the left hemisphere was produced almost entirely by tonic spiking. Enhanced spontaneous multi-unit activity recorded under anaesthesia following passive avoidance training in the chick is shown here to be a feature common to several medial forebrain structures. The magnitude of the elevation in bursting frequency and the degree of localization of this effect to the medial hyperstriatum ventrale of methylanthranilate trained chicks would appear to offer strong support to previous biochemical and morphological evidence implicating this structure in the process of memory consolidation for this task. The data reported here represent the first evidence of electrophysiological changes occurring as a consequence of passive avoidance training in the domestic chick. PMID- 3627443 TI - Is ethylcholine mustard aziridinium ion a specific cholinergic neurotoxin? AB - The histopathologic effects of different doses of ethylcholine mustard aziridinium ion infused into the caudate-putamen complex or nucleus basalis were evaluated in rats. Although no non-specific tissue damage was observed at the lowest doses of ethylcholine mustard aziridinium ion examined--0.01 nmol in 1 microliter vehicle and 0.02 nmol in 2-, 5-, and 10-microliters vehicle in both the striatum and nucleus basalis--minimal but definite non-selective pathology, characterized by gliosis and loss of all neuronal elements in the region affected by the nitrogen mustard, was observed in both targets at a dose of 0.02 nmol 1 microliter and more severely at all doses containing 0.05 and 0.1 nmol ethylcholine mustard aziridinium ion. At doses of ethylcholine mustard aziridinium ion containing 0.2 nmol of the cytotoxin and greater amounts, non specific cell loss in intact tissue and extensive cavitation became increasingly the most prominent histologic features of drug action. No statistically significant effects of ethylcholine mustard aziridinium ion on striatal choline acetyltransferase activities were found until doses of 0.4 nmol/1 microliter or greater were injected, concentrations of the cytotoxin at which appreciable non specific pathology was also observed. Levels of dopamine in the caudate-putamen nucleus were reduced by comparatively greater amounts than choline acetyltransferase at doses of 2.5 nmol/2 microliters, 5.0 nmol/2 microliters and 10 nmol/2 microliters cytotoxin, but a significant effect of ethylcholine mustard aziridinium ion on striatal L-glutamate decarboxylase activity was found only at a dose of 10 nmol/2 microliters. As no dose of ethylcholine mustard aziridinium ion was found that reduced choline acetyltransferase without producing considerable non-specific tissue destruction, the usefulness of the cytotoxin in studying the behavioral and physiological consequences of selective cholinergic hypofunction in the brain must be questioned. PMID- 3627444 TI - Brain stem projections of the glossopharyngeal nerve and its carotid sinus branch in the rat. AB - Transganglionic transport of horseradish peroxidase or lectin-conjugated horseradish peroxidase from an application site in the cervical trunk of the glossopharyngeal (IXth cranial) nerve of the rat produced extraperikaryal reaction product characteristic of axon terminal processes in three regions of the brain stem: (1) the nucleus of the tractus solitarius, from approximately 2.5 mm rostral to the obex to approximately 3 mm caudal to the obex; (2) the spinal trigeminal nucleus at the level of obex; (3) the cuneate fasciculus, approximately 3 mm caudal to the obex. In contrast, labelling of the carotid sinus nerve, a branch of the glossopharyngeal nerve which conveys chemoreceptor and baroreceptor afferent fibers from the carotid bifurcation, revealed a restricted central projection to within 1 mm of the obex and corresponding to the intermediate region of the glossopharyngeal nerve projection to the nucleus of the tractus solitarius. Two distinct aggregations of label were observed: (1) rostral to the obex, within the lateral and dorsomedial subnuclei of the nucleus of the tractus solitarius; (2) caudal to the obex, within the commissural and ventrolateral subnuclei of the nucleus of the tractus solitarius. Between these two sites the density of labelling was reduced. Retrogradely labelled neurons were demonstrated in the inferior salivatory nucleus and in the nucleus ambiguus after application of lectin-conjugated horseradish peroxidase to the glossopharyngeal nerve. Of the labelled neurons in the nucleus ambiguus (approximately 100), 25% contributed fibers to the carotid sinus nerve. The concentration of extraperikaryal reaction product located rostral to the obex after labelling of the carotid sinus nerve closely matches descriptions of the region of afferent terminations from carotid and aortic baroreceptors in the cat. The concentration of label caudal to the obex may therefore correspond to the region of afferent terminations from carotid chemoreceptors. This study may therefore provide some basis for a separation of the central synapses of primary afferent fibers from the carotid baroreceptors and chemoreceptors in the rat. The labelled neurons of the nucleus ambiguus provide the anatomical substrate for centrifugal control of carotid chemoreceptor activity. PMID- 3627445 TI - Regional differences in protein and glycoprotein synthesis and their processing in the mouse brain as revealed by the incorporation of [3H]proline, N-6 [3H]acetyl-D-glucosamine and [3H]fucose. AB - The incorporation rate of [3H]fucose, N-6-[3H]acetyl-D-glucosamine and [3H]proline has been compared in five regions of the mouse brain on postnatal day 6. The olfactory bulbs and the cerebellum showed a prevalence of incorporation of [3H]fucose over other brain regions. Less expressed, but still well evident regional differences were observed in [3H]proline incorporation while the incorporation of N-6-[3H]acetyl-D-glucosamine was almost equal in all brain regions. The regional differences were also apparent after considering an actual pool of free isotopes in the individual regions. Gel electrophoresis of [3H]fucose-labelled membrane fraction showed that the higher incorporation of [3H]fucose in the olfactory bulbs is partly due to higher synthesis of low molecular weight glycoproteins, especially in the molecular range of 30,000. The data showed that the protein synthesis and fucosylation, and/or a fast transport of the corresponding molecules, varies more within the brain than the incorporation of N-6-[3H]acetyl-D-glucosamine and possibly also than the "core" part of glycan molecule synthesis. PMID- 3627446 TI - The optic tectum of the gymnotiform electric fish, Eigenmannia: labeling of physiologically identified cells. AB - A total of 47 tectal neurons of the weakly electric fish, Eigenmannia, were studied physiologically and labelled by intracellular injection of Lucifer Yellow. With the exception of two cell types, all cells could be classified in accordance with the Golgi studies of Sas and Maler. The dominant stimulus modality of neurons was correlated with their laminar location. Neurons of the stratum opticum only responded to visual stimuli, such as modulations of the light level or the motion of an object. They showed, however, no directional preferences for motion. Neurons of the stratum griseum centrale were predominantly driven by electrosensory stimuli, most often those associated with the movement of an object, and generally were very sensitive to the direction of motion. Integration of different sensory modalities was found in neurons with dendrites invading laminae with different sensory inputs. In addition, small axons of interneurons appear to relay information across laminae. Large multipolar neurons in the deep tectum responded to the motion of objects, often preferring a particular direction of motion. Some of these large multipolar neurons of the deep tectum also discriminated the sign of the frequency difference between a mimic of a neighbor's sinusoidal electric organ discharge and the animal's own signal. These neurons are potential candidates for the control of the jamming avoidance response. These neurons were morphologically indistinguishable from large multipolar neurons of the deep tectum that either responded to moving objects or to acoustical stimuli. Individual large cells of the deep tectum project to various targets (Fig. 1) and probably contribute to the control of different behavioral responses. This suggests that the nature of such responses would then depend upon the constitution of sets of neurons recruited by a given stimulus situation, and the role of individual tectal neurons would neither be particularly specific nor very significant. PMID- 3627447 TI - Decreased number of cells in the inferior olivary nucleus of the adult mouse (+/sg) heterozygous for the staggerer gene. AB - Light microscopic study and cell counts of the inferior olivary nucleus were performed in adult mouse (+/sg), i.e. heterozygous for the staggerer gene. Two, six, and twelve-month-old animals were studied and compared to (+/+) C57BL6J mice of the same age. The number of cells and their repartition within the four subnuclei of the inferior olivary nucleus were normal in 2-month-old (+/sg) mice but a cell loss appears afterwards and mostly between 6 and 12 months so that about 30% of the olivary cells are missing in (+/sg) mice aged 12 months. The deficit affects the four inferior olivary nucleus subnuclei but predominates in the dorsal accessory olive. This cell loss is the first described expression of the mutation in the (+/sg) mouse, and it is not yet known if the inferior olivary nucleus represents a primary site of gene action or if the deficit is secondary to a hitherto unnoticed abnormality in the heterozygous (+/sg) mouse. PMID- 3627448 TI - Are hypercontracted muscle fibers artifacts and do they cause rupture of the plasma membrane? AB - Muscle fibers with hypercontracted zones (contractures) and plasma membrane defects are relatively frequent in Duchenne dystrophy, but artifacts might account for either. To investigate the problem further, we determined the frequency of hypercontracted muscle fibers in longitudinal, trichrome-stained paraffin sections in 143 muscle biopsy specimens in a wide variety of muscle diseases. The specimens were held at rest length during fixation. The incidence of hypercontracted fibers in Duchenne dystrophy was significantly higher than in any of the other diseases or in normal controls. We also induced contractures in rat muscle by fixation without restraint, electrical stimulation, and cutting the muscle fibers in vivo. Electron-microscopy showed no plasma membrane defects associated with the contractures, except in the cut fibers within 25 micron of their cut ends, which were probably overloaded with calcium. The results indicate that (1) in Duchenne dystrophy the contractures in muscle fibers held at rest length during fixation cannot be accounted for by artifact; (2) contractures occurring in normal muscle during fixation do not in and of themselves cause rupture of the muscle fiber plasma membrane. PMID- 3627449 TI - Subcortical neglect: quantitation, anatomy, and recovery. AB - Fifteen patients with right hemispheric subcortical infarcts localized by CT or MRI were evaluated with a neglect testing battery. Trimodal extinction was present in one case, visual extinction in three, tactile in three, and auditory in six. Although frequent (10 cases), hemispatial neglect was rarely severe (3 cases). Three cases recovered completely. Large posterior internal capsule lesions were associated with more frequent impairment on a cancellation test. The probable mechanism of hemispatial neglect was attentional in one case and intentional in six. Visual and auditory extinction is explained by striatonigral mechanisms. Although subcortical structures participate in attentional and intentional behavior, cortical structures can substitute for their functions. PMID- 3627450 TI - Lumbrical sparing in carpal tunnel syndrome: anatomic, physiologic, and diagnostic implications. AB - Motor axons supplying lumbrical muscles are less severely affected than axons supplying thenar muscles in the carpal tunnel syndrome; sometimes lumbrical motor fibers are less affected than digit 2 sensory fibers. This pattern is consistent with compression of both the anterior and posterior aspects of the median nerve in the carpal tunnel because nerve fibers responsible for thenar, lumbrical, and digit 2 functions lie in an anterior-posterior gradient within the distal median nerve. Recognition of lumbrical sparing supports the electrodiagnosis of carpal tunnel syndrome when the distal latency to thenar muscles or the palm-to-wrist mixed median nerve conduction velocity is normal. PMID- 3627451 TI - Effect of psychotropic medications on seizure control in patients with epilepsy. AB - Psychiatric problems are frequently encountered in patients with epilepsy. In an adult clinic population of 2,000 patients, 219 were identified as having been treated with psychotropic medication (PTM). Of these, 59 patients had adequate documentation of seizure frequency 2 months prior to and 2 months during treatment with PTMs. Contrary to many reports, most patients experienced better seizure control on PTM therapy. This demonstrates that most patients will not have an increased frequency of seizures when psychotropic medication is used in low to moderate doses and is introduced slowly. PMID- 3627452 TI - Mitochondrial studies in Kearns-Sayre syndrome: normal respiratory chain function with absence of a mitochondrial translation product. AB - Intact mitochondria were isolated from skeletal muscle of two patients with Kearns-Sayre syndrome (retinitis pigmentosa, heart block, chronic external ophthalmoplegia), and mitochondrial protein translation was measured. Mitochondrial protein synthesis was up to 10 times greater than in control subjects and SDS-polyacrylamide gel electrophoresis revealed absence of a translation product with the mobility of a 5 KDa protein. State 3 respiration rates were normal with site 1 and site 2 substrates, suggesting that the absent protein was not a functional subunit of a respiratory chain complex. PMID- 3627453 TI - Herpes simplex encephalitis in third trimester of pregnancy: successful outcome for mother and child. AB - A woman with herpes simplex encephalitis (HSE) in the third trimester of pregnancy is described. She was treated with acyclovir and recovered completely to deliver a normal child per vaginam at term. She had no evidence of genital or disseminated herpes virus infection. This paper illustrates that (1) the outcome of HSE in pregnancy can be favorable both for the mother and the offspring, (2) early diagnosis and use of acyclovir therapy is essential for successful outcome, and (3) the use of acyclovir in the third trimester of pregnancy was not harmful to the mother or fetus. PMID- 3627454 TI - Does long-term aggravation of Parkinson's disease result from nondopaminergic lesions? AB - The motor score with and without levodopa was estimated in 193 parkinsonian patients with variable length of evolution. The effect of levodopa on akinesia, rigidity, and tremor remained quite stable during the course of the disease. In contrast, the aggravation of gait disorder, postural instability, and dysarthria was more severe, with decreased percentage of improvement on levodopa in patients with longer evolution. It is suggested that aggravation of Parkinson's disease mainly results from increasing severity of cerebral nondopaminergic lesions. PMID- 3627455 TI - Timber rattlesnake venom-induced myokymia: evidence for peripheral nerve origin. AB - Facial and limb myokymia occurred in four consecutive cases of timber rattlesnake envenomation and represents the "fasciculations" frequently reported in this entity. The facial myokymia disappears within hours of antivenin therapy and the limb myokymia by increasing serum ionized calcium. These observations suggest that the action of the venom is a biochemical one, increasing peripheral nerve excitability. PMID- 3627456 TI - Limb dystonia in progressive supranuclear palsy. AB - Progressive limb dystonia contributed to disability in 8 of 30 patients with progressive supranuclear palsy (PSP). In five, it was present when the patients were on no medication. In four, it had been present before the distinctive ophthalmoplegia permitted a correct diagnosis. The severity of limb dystonia did not correlate with the severity of either ophthalmoplegia or neck dystonia. The importance of dystonia in the pathophysiology of PSP is emphasized, with regard to both the branchial dystonia that underlies several cardinal features of the disease, and to the frequent occurrence of limb dystonia as an early sign. PMID- 3627457 TI - Paroxysmal spontaneous nystagmus and vertigo evoked by lateral eye position. AB - Prolonged lateral eye position to the extreme left for 5 to 20 seconds, without vestibular stimulation, induced intense attacks of nystagmus and rotational vertigo lasting 50-90 seconds in a patient. During the attacks the nystagmus beat to the right and counterclockwise, while the patient could look freely around. Clinical data were suggestive of repeated strokes in the vertebrobasilar territory, mainly affecting the right dorsolateral medulla oblongata including the vestibular nuclei. A paroxysmal attack of nystagmus and vertigo evoked by voluntary lateral eye position is an unusual clinical finding. This is discussed in the light of multisensory integration within the vestibular system, which also includes eye position information. PMID- 3627458 TI - Cerebral vasoconstriction in toxemia. AB - Three patients with toxemia developed acute neurologic deterioration postpartum. In all, cerebral angiography revealed widespread arterial vasoconstriction. Cerebral vasoconstriction may be an important cause of neurologic complications in toxemia. PMID- 3627459 TI - Plasma levels of praziquantel decrease when dexamethasone is given simultaneously. AB - Treatment with praziquantel for neurocysticercosis frequently induces adverse reactions due to acute destruction of parasites; these reactions are suppressed by dexamethasone therapy. However, there is controversy about the most appropriate regimen with praziquantel and dexamethasone. We studied plasma levels of praziquantel in eight patients given the drug alone or with dexamethasone. Plasma levels of praziquantel were 50% lower in the same patient when dexamethasone was given simultaneously. Dexamethasone should not be added to praziquantel therapy as preventive treatment, but should be reserved for transient therapy of adverse reactions. PMID- 3627460 TI - Adrenomyeloneuropathic syndrome in a woman, associated with morphologic abnormalities of muscle mitochondria. PMID- 3627461 TI - Unilateral optic neuropathy in non-Hodgkin's lymphoma. PMID- 3627462 TI - About the cheiro-oral syndrome. PMID- 3627463 TI - Delayed abducens nerve palsies associated with cervical spine fractures. PMID- 3627464 TI - Hyperkinetic mutism. PMID- 3627465 TI - MRI in MS diagnosis. PMID- 3627466 TI - Controlled-release Sinemet. PMID- 3627467 TI - How many neurologists? PMID- 3627468 TI - Microvessels in diabetic neuropathy. PMID- 3627470 TI - Voice tremor and dysarthria. PMID- 3627469 TI - Lorazepam in childhood status. PMID- 3627471 TI - Epileptic aphasia. PMID- 3627472 TI - [Short-term prognostic evaluation of myocardial infarct. Stepwise-type multivariate analysis of clinico-instrumental variables]. PMID- 3627473 TI - [Does physiologic pregnancy determine the compromise of the cardiac function? Non invasive study]. PMID- 3627474 TI - [Complications related to the implant of permanent pacemakers. Our experience]. PMID- 3627475 TI - [Treatment of prosthetic infection in vascular surgery. Personal experience]. PMID- 3627476 TI - [Essential juvenile arterial hypertension]. PMID- 3627477 TI - [Early diagnosis of pulmonary hypertension in chronic obstructive bronchopneumopathy]. PMID- 3627478 TI - [Aorto-caval fistula secondary to rupture of an aneurysm of the abdominal aorta. Observations on 6 cases]. PMID- 3627479 TI - [Surgery of the abdominal aorta and iliac artery. Risk factors and results]. PMID- 3627481 TI - [Hemodilution: importance and validity in the prevention of deep venous thrombosis]. PMID- 3627480 TI - [Prosthetic infections in aorto-iliac-femoral surgery]. PMID- 3627482 TI - [Early diagnosis of low cardiac output syndrome with Swan-Ganz catheter in 703 patients subjected to heart surgery]. PMID- 3627483 TI - [Peridural fentanyl in obstetrical analgesia]. PMID- 3627484 TI - [Hyperkinetic effects of flunitrazepam and diazepam on the fetus]. PMID- 3627485 TI - [Lipid emulsions and complement and immunoglobulin levels of the serum of patients with injuries and infection]. PMID- 3627486 TI - [Report of a case of respiratory depression attributed to the use of peridural buprenorphine]. PMID- 3627487 TI - [Description of a complication of the subclavicular catheterization of the subclavial vein]. PMID- 3627488 TI - [Toxic coma caused by disulfiram, a support drug in the therapy of alcoholism. Description of a clinical case]. PMID- 3627489 TI - [Multifocal early cancer of the esophagus]. PMID- 3627490 TI - [Diverticulitis of the right colon]. PMID- 3627491 TI - [Colorectal tumors in patients under 40 years of age]. PMID- 3627492 TI - [Adenocarcinoma of the appendix]. PMID- 3627493 TI - [Residual calculosis of the bile ducts. Current therapeutic guidelines]. PMID- 3627494 TI - [Considerations and results on 37 cardiopathic patients subjected to thoraco pulmonary surgery]. PMID- 3627495 TI - [Lesions of the soft tissues of the legs. Statistical review of 3588 cases]. PMID- 3627496 TI - [Short-term antimicrobial drug prevention in gastric surgery at high risk for infectious complications]. PMID- 3627497 TI - [Ferritin in colorectal tumor pathology. Value of the preoperative plasma determination]. PMID- 3627498 TI - [Preparation using respiratory physiotherapy of surgical patients at risk]. PMID- 3627499 TI - [Variant technic of hepatic arterialization after porto-caval anastomosis in the rat. Preliminary results]. PMID- 3627500 TI - [Hepatic resection for pathologies of the bile ducts in a tropical environment]. PMID- 3627501 TI - [Role of profundaplasty in revascularization of the extremities. Clinical contribution]. PMID- 3627502 TI - [Venous involvement in upper thoracic outlet syndrome. Our experience]. PMID- 3627503 TI - [Femoro-femoral bypass associated with thromboembolectomy with the Fogarty catheter in acute ischemia of the legs]. PMID- 3627504 TI - [Surgical treatment of esophageal achalasia: role of intraoperative manometry]. PMID- 3627505 TI - [Prognostic factors in the evaluation of survival after surgery for gastric carcinoma]. PMID- 3627506 TI - [Agenesia of the gallbladder. Description of a case]. PMID- 3627507 TI - [Pseudocysts of the pancreas with mediastinal manifestations]. PMID- 3627508 TI - [Lumbar hernias]. PMID- 3627509 TI - [Epidermoid bronchogenic carcinoma in young adult patients]. PMID- 3627510 TI - [Primary and secondary tumors of the chest wall. Surgical treatment in our experience]. PMID- 3627511 TI - [Reinterventions on bilio-digestive anastomoses]. PMID- 3627512 TI - [Surgical therapy in gastroesophageal reflux disease]. PMID- 3627513 TI - [Long-term clinical control and results of surgical treatment of metachronous hepatic metastasis of colorectal carcinoma. Personal experience]. PMID- 3627514 TI - [Value of the clinical examination of the axillary lymph nodes in the staging of carcinoma of the breast. Our experience]. PMID- 3627515 TI - [Role of venous injury in the origin of post-mastectomy lymphedema of the arm. Results of 150 measurements of the venous pressure of the homo- and counter lateral arm in mastectomy]. PMID- 3627516 TI - [Treatment of carcinoma of the thyroid]. PMID- 3627517 TI - [Gastric polyps. Considerations on 162 endoscopic polypectomies]. PMID- 3627518 TI - [Decisional problems on the subject of non-surgical acute abdomen]. PMID- 3627519 TI - [Anatomo-surgical considerations on the muscular system of the anal canal]. PMID- 3627520 TI - [Critical considerations on the complications after mechanical anterior resection of cancer of the rectum]. PMID- 3627521 TI - [Duodenocephalopancreatectomy: personal modifications of Child's technic]. PMID- 3627522 TI - [Gastroesophageal reflux and gastropathy. Value of radioisotopic gastric emptying]. PMID- 3627523 TI - [Study and morphologic control of ulcerative colitis]. PMID- 3627524 TI - [Usefulness of tissue polypeptide antigen in the diagnosis of pancreatic carcinoma]. PMID- 3627525 TI - [Use of a prostaglandin derivative in the treatment of gastroduodenal ulcer and gastroduodenitis]. PMID- 3627526 TI - [Moon phases and ulcerative peptic disease]. PMID- 3627527 TI - [A model of computerized filing for upper digestive endoscopy]. PMID- 3627529 TI - Temperament as a potential developmental influence on attachment. PMID- 3627528 TI - [A case of hypertrophic stenosis of the pylorus and subsequent gastroesophageal reflux in an adult]. PMID- 3627530 TI - Temperament and schooling: meaning of "goodness of fit"? PMID- 3627531 TI - [Emergency ultrasound cardiography in acute precordial pain of cardiovascular origin]. AB - In emergency surgery, the essential prerequisites for success are speed, promptitude and precision. For this reason diagnosis must be equally prompt and precise and may require not only clinical examination but also a number of instrumental examinations designed to confirm or even to formulate the diagnosis which is usually the case in precordialgias of cardiovascular origin. In such syndromes ultrasound cardiography is particularly advantageous for the following reasons: it is non-invasive, provides immediate results and any number of examinations can be performed on the patient in bed. Since such ultrasound techniques are also reliably accurate, they constitute the method of choice when the patient's condition is critical, when a serial study of a single patient is required and when the results are required immediately, as is the case in emergency heart surgery. Four types of ultrasound cardiography are currently available for the diagnosis of precordialgias of cardiovascular origin: 1) one dimensional M-mode echocardiography; 2) two dimensional real time echocardiography; 3) Doppler ultrasound cardiography; 4) the echo-Doppler system in which Doppler ultrasound cardiography is combined with one or two dimensional echocardiography. Acute precordial pain of cardiovascular origin may be due to the following pathological conditions: 1) ischaemic cardiopathy especially acute myocardial infarction and transitory myocardial ischaemia; 2) acute pericarditis; 3) aortic stenosis; 4) idiopathic hypertrophic subaortic stenosis; 5) mitral prolapse; 6) dissecting aneurysm of the aorta; 7) pulmonary thromboembolism. In all these cases the single and two dimensional image and Doppler ultrasound cardiography provide highly sensitive and specific information that is, in some cases, decisive for diagnosis and in others confirms the diagnosis already formulated. In addition these techniques may provide valuable prognostic data. Ultrasound cardiography is indeed useful in all cardiological emergencies, such as those caused by cardiomegaly, new and developing murmurs, peripheral embolisms, cardiac traumas and arrhythmias. It is therefore suggested that every Emergency and Intensive Care Unit should be able to use the resources offered by ultrasound cardiography in diagnosis. PMID- 3627533 TI - [Clinical evaluation of aztreonam in the prevention and therapy of infections in patients subjected to neurosurgical intervention]. AB - Twenty-six neurosurgery patients were given prophylactic treatment with Aztreonam at a dose of 1 g every 8 hours (30 mg/kg every 12 hours in children) for 8-12 days after the operation. In 18 cases 300 mg Clindamycin was also given every 8 hours for 8 days. No local or general infections arose in the postoperative period. Three patients with infections caused by susceptible bacteria were given 1 g Aztreonam every 6 hours (30 mg/kg every 8 hours in children) for 8 days. In all cases all clinical and microbiological signs of the infection had disappeared by the end of treatment. Apart from one episode of mild nausea no side effects were noted. Aztreonam is therefore considered a safe and effective drug for the treatment and prophylaxis of postoperative infections in neurosurgery. PMID- 3627532 TI - [Medium- and long-term clinical study on the use of the new non-steroidal anti inflammatory drug flunoxaprofen in osteoarthrosis]. AB - The efficacy and the tolerability of the new non-steroidal antiinflammatory agent flunoxaprofen was assessed in the long-lasting management of pain and joint motility impairment of 28 patients suffering from radiologically proven osteoarthritis localized on the large joints (hip and knee). The patients were treated with flunoxaprofen 200-400 mg/day per os for 2 months (18 patients) or for 4 months (10 patients) and the following variables were assessed: spontaneous diurnal and nocturnal pain, pain on passive motion, pain on active motion with or without load, quality of sleep, joint motion range, intercondylar and intermalleolar straddles and gluteus-heel straddle; patients' and physician' evaluation of flunoxaprofen efficacy. Moreover a number of clinical and laboratory controls were carried out to study the tolerability of the drug (arterial blood pressure, heart rate, hepatic and renal function tests, haematological examination). The assessments were made before the starting of the treatment and at 15-day intervals thereafter. The results show that all variables for pain intensity greatly and progressively improved during flunoxaprofen treatment; the quality of sleep as well as the joint motion range improvement went along the progressive decrease in pain intensity. None of the clinical and laboratory parameters studied showed any modification during flunoxaprofen treatment. No side-effects were observed in any patients, either after 4 months treatment or using 400 mg/die. It is concluded that flunoxaprofen may be considered an effective and safe non-steroidal antiinflammatory agent in the long lasting management of pain and joint motility impairment of osteoarthritic patients. PMID- 3627534 TI - [Scintigraphic findings with a positive marker in generalized lymphadenopathy syndrome (L.A.S.)]. AB - The behaviour of gallium scintigraphy in a group of 15 drug addicts suffering from LAS is examined. The examination was positive in 11 patients with no pleuro pulmonary lesions that could be demonstrated by clinical or radiological examination. This is in line with similar observations in AIDS cases and may reflect the preactivation of monocytes and macrophages documented in HIV infection. PMID- 3627535 TI - [Thyroid metastasis of carcinoma of the breast. Considerations on 2 cases]. AB - Two cases of thyroid metastasis from breast cancer are reported, both occurring in patients previously given radical mastectomies. It is emphasised that postoperative follow-up should also monitor rarely affected sites of metastasis from breast cancer. PMID- 3627536 TI - [Headache in childhood: clinico-epidemiologic study. Preliminary communication: The headache risk]. AB - After a review of the attempt to relate headache risk factors to the Periodic Syndrome, preliminary data from a clinical epidemiological survey of 980 children (449 M and 531 F aged 4-14 with Idiopathic Headache are reported. The importance of HRFs as predictors of headache is emphasised as is the need to start prophylaxis before headache attacks begin. PMID- 3627537 TI - [Hypopotassemia and megaloblastic anemia. Presentation of a case]. AB - A case of megaloblastic anaemia probably caused by malabsorption is analysed. Blood potassium levels were monitored before and during treatment with vitamin B12. It is concluded that low potassium levels in chronically hypoxic patients may be dangerous and that blood potassium should be monitored constantly during the treatment of this type of anaemia. PMID- 3627538 TI - [Effect of antibacterial agents on human microflora: is it possible to prevent changes?]. PMID- 3627539 TI - [Quantitative analysis of sugars present in acid hydrolysates of full-term placentas from normal pregnant women and pregnant women with rheumatoid arthritis]. PMID- 3627540 TI - [Blood coagulation tests and oral contraceptives]. PMID- 3627541 TI - [Uterine cervix dysplasias and viral implications]. PMID- 3627542 TI - [Incidence and natural history of vulvar carcinoma in the province of Trieste]. PMID- 3627543 TI - [The cytomorphological picture in IUD wearers]. PMID- 3627544 TI - [The risk of contraception with intrauterine devices]. PMID- 3627545 TI - [Vaginal hysterectomy. Considerations on 858 consecutive interventions performed at the Gynecological Clinic of the University of Perugia]. PMID- 3627546 TI - [Bartholin gland cysts: medical or surgical treatment?]. PMID- 3627547 TI - [Analysis of chromosomal changes in a series of 259 cases of spontaneous abortion]. PMID- 3627548 TI - [Bilateral tubal pregnancy. Clinical case]. PMID- 3627549 TI - [Analysis of a case of umbilical cord abnormalities associated with fetal death]. PMID- 3627550 TI - [Experience with preventive gynecology in 5700 university students]. PMID- 3627551 TI - [Induction of ovulation using gonadotropins. Considerations on the hyperstimulation syndrome and multiple pregnancy]. PMID- 3627552 TI - [Usefulness of hysterosalpingography. Apropos of 103 cases]. PMID- 3627553 TI - [Prenatal ultrasonic diagnosis of abnormalities of the urinary tract]. PMID- 3627554 TI - [Clinical significance of endocoelomic cytology in carcinoma of the portio]. PMID- 3627555 TI - [Cesarean hysterectomy. Review of hysterectomies for obstetrical causes from 1951 to 1981 at the Hospital of Pesaro]. PMID- 3627556 TI - Localization of respiratory rhythm-generating neurons in the medulla of brainstem spinal cord preparations from newborn rats. AB - We describe the location of Pre-I neurons, which are important to respiratory rhythm generation, in the rostral medulla of brainstem-spinal cord preparations isolated from newborn rats. This neuronal group was delimited in the reticular formation slightly medial to the caudal area of the facial nucleus and near the ventral surface. The effects of electrical stimulation and lesions in that region were also examined with respect to respiratory rhythm generation. Single shock stimulation induced Pre-I neuron firing and reset the phase of the respiratory rhythm. Electrolytic lesions in the Pre-I neuron region reduced the respiratory rate. PMID- 3627557 TI - Medialis dorsalis thalamic unitary response to tooth pulp stimulation and its conditioning by brainstem and limbic activation. AB - In nembutalized cats tooth pulp stimulation (TPS) was effective in exciting 18% of medialis dorsalis (MD) thalamic units. Facilitation of spontaneous MD unitary discharge followed high frequency stimulation of the lateral amygdala (25%), dorsal hippocampus (22%), mesencephalic reticular formation (20%) and septal nuclei (17%). Conditioning high-frequency stimulation of limbic and reticular structures, strongly facilitated the MD unitary responses to TPS. None of the thalamic neurons involved in nociception seems to project to the cerebral cortex. The conditioning effect on MD response of limbic and reticular stimulation suggests that these central structures may be involved in the modulation of the nociceptive input. PMID- 3627558 TI - In vivo binding of [3H]GBR 12783, a selective dopamine uptake inhibitor, in mouse striatum. AB - [3H]GBR 12783 (1,2-(diphenylmethoxy)ethyl-4-(3-phenyl-2-propenyl)-piperazine), a specific dopamine uptake inhibitor, was tested for in vivo central binding in mice. The difference between the striatal and cerebellar levels of radioactivity was maximal 1 hour after the i.v. injection of a tracer dose of [3H]GBR 12783. The additional accumulation of radioactivity in striatum, relatively to cerebellum, was dose-dependently decreased by dopamine uptake inhibitors. It was unaffected by high doses of dopamine receptor agonists or antagonists and of serotonin or norepinephrine uptake blockers. The intrastriatal injection of 6 hydroxydopamine (6-OHDA) resulted in an almost similar decrease in both the synaptosomal [3H]dopamine uptake and the in vivo [3H]GBR 12783 binding. These data suggest that [3H]GBR 12783 injected i.v. labels the dopamine transport complex in the striatum and thus can be used for the in vivo assessment of the density of dopaminergic nerve endings in brain areas. PMID- 3627559 TI - Inhibition of the preovulatory LH surge after a catecholestrogen (2 hydroxyestrone) antiserum injection in the third ventricle of cycling female rats. AB - Administration of a catecholestrogen (2-hydroxyestrone, 2-OHE1) antiserum (2-OHE1 AS) in the third ventricle of cycling female rats, on the morning of proestrus, leads to a significant reduction in the afternoon LH surge. These responses are dose-dependent and can be observed even when the 2-OHE1-AS is injected on the diestrus morning. Almost similar results were obtained with an antiserum against 17 beta-estradiol (17 beta-E2). Nevertheless, the fact that the central immunoneutralization of 2-OHE1 impedes the preovulatory surge of LH at a time of high peripheral levels of 17 beta-E2 strengthens the idea of a specific role for 2-OHE1 in the control of cycling LH release. PMID- 3627560 TI - Effects of methamphetamine administration on brain neurotensin-like immunoreactivity in rats. AB - The effects of methamphetamine (MAP) administration on neurotensin-like immunoreactivity (NTLI) were investigated in the rat brain. A single administration of MAP induced dose-dependent and reversible increases in NTLI in the caudate-putamen, limbic forebrain and midbrain. NTLI in the caudate-putamen, limbic forebrain and midbrain was also enhanced after repeated administration of MAP. It was assumed that MAP enhanced NTLI in the caudate-putamem, limbic forebrain and midbrain through its action upon the nigrostriatal and mesolimbic dopamine systems. PMID- 3627561 TI - Ipsilateral retinofugal and retinopetal projections in normal and monocular cichlid fish. AB - A previously unknown ipsilateral retinotectal projection in juvenile and adult cichlid fishes is revealed by anterograde labelling with horseradish peroxidase (HRP). Enucleation results in an enlarged ipsilateral projection from the intact eye; after 4 months this projection may cover the tectum almost completely. These data are interpreted as an increase in the normally occurring ipsilateral projection of newly differentiated ganglion cells due to the absence of interocular competition. Conversely, after enucleation cells of the homolateral thalamoretinal nucleus seem, on the basis of retrograde HRP staining to develop a new connection with the remaining eye. PMID- 3627562 TI - Dye and electrotonic coupling between cultured hippocampal neurons. AB - Electrotonic coupling was examined between hippocampal neurons in dissociated cell cultures. Injections of Lucifer yellow indicated that approximately 20% of the neurons were dye-coupled. Propionate, which causes cytoplasmic acidification, significantly decreased dye coupling. Simultaneous intracellular recordings from pairs of cultured neurons directly demonstrated electrotonic coupling. Therefore dissociated cell cultures can be used as a model system for the analysis of hippocampal electrotonic coupling. PMID- 3627563 TI - At least one thalamotelencephalic pathway in cartilaginous fishes projects to the medial pallium. AB - Injections of horseradish peroxidase into the medial pallium of the spiny dogfish, Squalus acanthias, retrogradely labeled cells in the superficial portion of the dorsal pallium, the medial pallium and the septal area of the telencephalon, and in the posterior tubercle and posterior lateral thalamic nucleus of the diencephalon. Except for the septal projection, all projections to the medial pallium are bilateral. Labeled fibers could be traced from the injection site to caudal telencephalic levels but not to the hypothalamus. The projection from the posterior lateral thalamic nucleus, which is known to be an electrosensory relay center in ray and skate, provides evidence that at least one ascending thalamotelencephalic pathway in Squalus and perhaps other elasmobranchs terminates in the medial pallium rather than in the dorsal pallium. In this respect Squalus shows striking similarities to amphibians. PMID- 3627564 TI - Representation of the main branches of the facial nerve within the facial nucleus of the Japanese monkey (Macaca fuscata). AB - The facial nucleus of the Japanese monkey was divided cytoarchitectonically into the ventral, medial, intermediate, dorsal and lateral divisions. When horseradish peroxidase (HRP) was applied to the inferior labial, cervical or posterior auricular branch of the facial nerve, HRP-labeled neurons were seen in the lateral, ventral or medial division of the facial nucleus, respectively. After applying HRP to the anterior auricular-zygomatico-orbital branch, labeled neurons were observed mainly in the intermediate and dorsal divisions. HRP applied to the superior labial branch labeled neurons within the dorsal and lateral divisions. PMID- 3627565 TI - Some electrophysiological characteristics of insular cortex efferents to the amygdaloid central nucleus in awake rabbits. AB - Extracellular single unit recordings were obtained from insular cortex neurons that were activated antidromically from the amygdaloid central nucleus in conscious rabbits. Consistent with previous anatomical data, the majority of these neurons were located within the dorsal agranular insula. Ongoing activity in these neurons was infrequent, and was not altered during the presentation of sensory stimuli or during the expression of Pavlovian conditioned bradycardia. These results provide relevant to the functional organization of forebrain area thought to be involved in autonomic control. PMID- 3627566 TI - Calcium in the mitochondria following brief ischemia of gerbil brain. AB - Calcium was localized in neurons and glial cells of the CA1 region of hippocampus and in neurons of parietal cortex with the oxalate-pyroantimonate electron cytochemical method following recovery from 5-min ischemia of gerbil brain. During the early postischemic recirculation phase a maximum amount of calcium deposits was detected in mitochondria of all investigated cells. A second rise in mitochondrial calcium deposits was observed in parallel with the onset of ultrastructural degeneration of mitochondria and the loss of cellular integrity beginning 6 h postischemia. PMID- 3627567 TI - Single neuron activity of rat hypothalamic paraventricular nucleus during body suspension. AB - Single neuron activity in the hypothalamic paraventricular nucleus (PVN) was recorded during horizontal and 45 degrees head-down tilt suspension in unanesthetized rats. When the rats were raised in the head-down position, 13 of 34 neurons (38%) in the PVN changed activity as follows: gradual decrease (11/13, type I), or gradual increase (2/13, type II). Responses of 6 type I and 1 type II neuron were smaller during horizontal suspension. Intracerebroventricular or intraperitoneal injection of hypertonic saline caused an increase in activity of 4 of 5 type I neurons tested. This hyperosmotic stimulation had no effect during suppressed activity induced by head-down tilt. These results suggest that the activity of PVN neurons is altered during body suspension, probably by information from baroreceptors in the thoracic activity, proprioreceptors and/or the vestibular organ, and these neurons might be involved in regulation of the autonomic and neuroendocrine systems. PMID- 3627568 TI - Papain effects on rat hippocampal neurons in the slice preparation. AB - Intracellular recordings were made from the CA1 stratum pyramidale region of rat hippocampal slices. Papain was applied to the cells via bath perfusion, and its effects on membrane properties, synaptic potentials and responses to pressure application of gamma-aminobutyric acid (GABA) were assessed. Papain did not markedly affect neuronal input resistance, resting potential or action potentials with treatment times lasting over one hour. Synaptic potentials were initially enhanced and then gradually abolished, with the fast inhibitory postsynaptic potential being the most sensitive and the late, potassium-dependent hyperpolarization being the most resistant to enzyme. Responses to GABA were enhanced by papain, the GABA-activated conductance increased, and a slow depolarizing wave appeared which resembled the effect caused by pentobarbital on these neurons. This study indicates that the use of papain in the acutely dissociated neuron preparation is not responsible for the dramatic increase in resting input resistance seen in these neurons. The GABA-activated conductance may be affected by the enzyme. PMID- 3627570 TI - Papers from a symposium: Neural Development, Plasticity, and Regeneration. April 19-21, 1985, Columbus, OH. PMID- 3627569 TI - Atropine potentiates neurogenic vasodilatation of the feline infraorbital artery: possible mechanisms. AB - After treatment with guanethidine to inactivate sympathetic nerves, the feline infraorbital artery (IOA) relaxes in response to activation of periarterial nerves in vitro. This response was 60-65% greater in magnitude and 50% longer in duration in the presence of atropine, thus revealing a significant non adrenergic, non-cholinergic (NANC) dilator response which is potentiated by blockade of muscarinic receptors. Nerve-mediated dilations and the potentiating effect of atropine were endothelial cell-independent. In the presence of atropine the resting membrane potential (-51 +/- 2 mV) of infraorbital vascular smooth muscle cells was not changed by activation of nerves, nor by exogenously applied vasoactive intestinal polypeptide (VIP). Electrical stimulation caused release of VIP from this artery, but atropine did not measurably enhance the degree of release of VIP. Therefore, although presynaptic, muscarinic inhibition of release of a NANC transmitter probably occurs in the IOA, either VIP is not the transmitter involved in this response or the changes in release of VIP are too slight to be detected by the in vitro techniques employed in this study. PMID- 3627571 TI - Reactive synaptogenesis in the CNS. A comparison of regenerating and sprouting systems. AB - Lesion-induced synaptogenesis was compared in the goldfish retinotectal system, which readily regenerates after optic nerve crush, and in the cat spinal cord, in which collateral sprouting has been demonstrated after dorsal rhizotomy. Quantitative electron microscopic methods were used. Reinnervation of the tectum was complete, but was characterized by a prolonged time course. Reinnervation appeared to be achieved by retinal axons and not by sprouting from nonretinal axons. Reinnervation in the cat spinal cord was also virtually complete, but was very rapid and may be mediated by some axons that are similar to those destroyed and by other axons that are different. PMID- 3627572 TI - Partial proceedings of the scientific program of the 17th annual meeting of the American Society for Neurochemistry: Neurochemical consequences of hepatic disease. Montreal, March 16-21, 1986. PMID- 3627574 TI - Alcohol, vitamin A, and zinc. PMID- 3627573 TI - Comparison of methods for analysis of CSF proteins in patients with Alzheimer's disease. AB - Cerebrospinal fluid (CSF) from patients with Alzheimer's disease (AD) and controls was analyzed by one- and two-dimensional gel electrophoresis, electron microscopy, and fluorescence microscopy with thioflavin S staining. In CSF from patients with AD, abnormal proteins were found following two-dimensional gel electrophoresis and silver staining. In CSF samples from most of the AD patients studied, a highly argentophilic material was detected upon silver staining the stacking gel of the one-dimensional gels. Electron microscopy of material eluted from the stacking gel showed fibers of approximately 7-10 nm diameter, with some twisting; properties consistent with paired helical filaments or amyloid. Furthermore, material with the characteristics of amyloid (fiber diameter ranging from 4-10 nm) was found in the CSF sediment. The CSF from AD patients had significantly elevated numbers of yellow fluorescent particles following thioflavin S staining when compared with age-matched, other neurological disease controls. We did not see an increase in autofluorescence, indicating that thioflavin S staining is specific. Our data suggest that AD CSF contains plaque amyloid and possibly proteins from neurofibrillary tangles. The thioflavin S staining method appears to have potential for development as a diagnostic tool. PMID- 3627575 TI - Sterilization of mentally retarded persons. PMID- 3627577 TI - Intravasation during hysterosalpingography using oil-base contrast medium--a second look. AB - Hysterosalpingography is a study performed commonly to assess the upper reproductive tract in infertile women. A risk with hysterosalpingography is either lymphatic and/or venous intravasation with or without embolization. Of 593 consecutive hysterosalpingograms performed with a low-viscosity oil-base medium, intravasation occurred in 41 cases (6.9%). Embolization was documented in six patients. There were no recognized adverse sequelae from either intravasation or embolization. Intravasation was frequently associated with pathology of the upper genital tract, and suspected tubal occlusion was the most common abnormality detected. Proper timing of the procedure and avoidance of excessive instillation pressure will diminish the incidence of this complication. The use of both a low viscosity oil-base medium and high-resolution fluoroscopic image intensification may increase the detection of intravasation. PMID- 3627576 TI - Noncontraceptive estrogens and mortality: long-term follow-up of women in the Walnut Creek Study. AB - The effect of postmenopausal estrogen use on mortality is an important and controversial subject. To address it, we analyzed data from a ten- to 13-year mortality follow-up of the 3437 women enrolled in the Walnut Creek Contraceptive Drug Study who never used either estrogens or oral contraceptives and the 2656 women who used estrogens but not oral contraceptives. By 1983, 109 estrogen users and 110 nonusers had died. After adjusting for age, mortality in estrogen users (1.64 per 1000 woman-years) was lower than in nonusers (2.06 per 1000 woman years) for all categories of cause of death except cancer. The lower mortality from accidents, suicide, and homicide in estrogen users has no plausible biologic explanation, and the observation suggests that life-style differences between estrogen users and nonusers account at least in part for their lower mortality. On the other hand, the observation that the relative risk of mortality due to cardiovascular disease was 0.5 in estrogen users, after adjustment for age and other cardiovascular disease risk factors, is suggestive. PMID- 3627578 TI - Artificial insemination with donor sperm: a review of 108 patients. AB - Artificial insemination with donor sperm (AID) has been a major form of treatment among infertile couples with defects in sperm production. In this report, we review our experience from 1980-1985. A total of 108 patients underwent AID, with 75 resultant pregnancies. Of patients achieving pregnancy, 47% became pregnant after the third cycle and 92% by the twelfth cycle. A higher success rate and/or smaller number of AID cycles were positively associated with patient age of 35 or less and negatively associated with endometriosis. This information is useful in counseling couples interested in pursuing AID. PMID- 3627579 TI - A comparison of labetalol plus hospitalization versus hospitalization alone in the management of preeclampsia remote from term. AB - Two hundred primigravid women with mild preeclampsia at 26-35 weeks' gestation were randomly allocated to treatment with hospitalization alone or combined with labetalol. There were no differences between the two groups in mean systolic or diastolic pressures, mean gestational age, or initial laboratory findings at time of entry. Patients in the labetalol group demonstrated a statistically significant (P less than .005) decrease in blood pressure during treatment. No such decrease occurred in the hospitalization-alone group. Both groups exhibited significant deterioration in proteinuria, creatinine, and uric acid. The average days of pregnancy prolongation (mean +/- SD) were 21.3 +/- 13 and 20.1 +/- 14 days in the hospitalization and labetalol groups, respectively. There were no differences between the groups regarding any of the following: gestational age at delivery, birth weight, number of infants admitted to the special care unit, or cord blood gas measurements. However, the incidence of small-for-gestational-age infants was significantly higher in the labetalol group (19 versus 9%, P less than .05). There were no stillbirths, but one neonatal death in the labetalol group. Treatment of maternal blood pressure in preeclamptic pregnancies with labetalol did not improve perinatal outcome, and was associated with a higher frequency of fetal growth retardation. PMID- 3627580 TI - A prospective study investigating the mechanism of thrombocytopenia in preeclampsia. AB - Hemostatic and platelet function studies were performed prospectively on 61 preeclamptic patients and 24 healthy pregnant control patients to delineate possible causes of thrombocytopenia in preeclampsia. Thrombocytopenia occurred in 50% of the preeclamptic patients, and was accompanied by qualitative platelet defects as shown by an increased bleeding time and decreased biosynthesis of thromboxane A2. All patients had normal routine coagulation and protamine sulphate paracoagulation assays. All nulliparous patients had normal levels of fibrinopeptide A, but approximately 60% of parous patients had slight elevations of fibrinopeptide A. Elevated levels of platelet-associated immunoglobulin G (IgG) were demonstrated in 35% of all preeclamptic patients and were inversely correlated (r = -0.524) with the severity of the thrombocytopenia. This study indicates that, at least in nulliparous patients, thrombin action is not a major contributor to the development of thrombocytopenia in preeclampsia. The observation of elevated levels of platelet-associated IgG suggests that immune mechanisms could contribute to the thrombocytopenia in some patients. PMID- 3627581 TI - Cardiovascular responses to isometric handgrip exercise: an invasive study in pregnancy-induced hypertension. AB - Nine patients with pregnancy-induced hypertension and nine healthy pregnant controls were compared in the last trimester with regard to cardiovascular and sympathoadrenal reactivity during a standardized isometric handgrip exercise test. At rest, the blood pressure elevation with pregnancy-induced hypertension resulted from increased systemic vascular resistance. The test increased the blood pressure, heart rate, cardiac output, stroke volume, and epinephrine and norepinephrine concentrations in arterial plasma, but did not change the calf or systemic vascular resistance. The responses of the two groups did not differ significantly with regard to any of the above variables. Thus, pregnancy-induced hypertension does not seem to be associated with exaggerated cardiovascular or sympathoadrenal reactivity to isometric exercise when compared with normal pregnancy. The mechanism underlying the blood pressure response appears to be similar in the two groups, ie, an increase in cardiac output. PMID- 3627582 TI - Does extra-amniotic infection cause preterm labor? Gas-liquid chromatography studies of amniotic fluid in amnionitis, preterm labor, and normal controls. AB - Gas-liquid chromatography (GLC) was used to identify short-chain organic acid byproducts of bacterial metabolism in amniotic fluid from seven normal control patients, six women with overt amnionitis, and six preterm labor patients. Microbiologic culture for aerobic and anaerobic bacteria was also carried out. Positive GLC findings were generally associated with positive cultures, except in five of the preterm labor patients whose GLCs were positive despite negative cultures. The origin of the short-chain organic acids found in these women is unclear; extra-amniotic bacterial growth may explain this finding. PMID- 3627583 TI - Sarcoidosis and pregnancy. AB - Sarcoidosis is usually a benign and self-limited disease, but it can occasionally be quite severe. It affects individuals most often during the reproductive years. This report reviews cases of sarcoidosis and pregnancy during a ten-year period at Downstate Medical Center. Eleven patients were stable, two experienced disease progression, and two died from complications of severe sarcoidosis. Factors indicating a poor prognosis included parenchymal lesions on chest x-ray, advanced roentgenologic staging, advanced maternal age, low inflammatory activity, requirement for drugs other than steroids, and presence of extrapulmonary sarcoidosis. Management plans are delineated for patients with advanced sarcoidosis. Some patients require evaluation before pregnancy to establish chronicity, baseline pulmonary function, inflammatory activity, roentgenographic staging, and response to treatment. Only then can the patient be given an accurate prognosis for either an uncomplicated pregnancy or one requiring intensive management by the pulmonary and perinatal teams. PMID- 3627584 TI - Utilization of obstetrician-gynecologists and prevention of cervical cancer. AB - In a case-control study, we examined health care utilization histories to determine whether Papanicolaou tests provided by an obstetrician-gynecologist, as opposed to other providers, are more protective of cervical cancer. Women with cervical cancer were less likely than matched controls to have had regular Papanicolaou test screening, to have received a Papanicolaou test within the last five years, or to have obtained a Papanicolaou test from an obstetrician gynecologist. After controlling for traditional risk factors, we found that receiving any Papanicolaou tests within the last five years from an obstetrician gynecologist was more protective than receiving Papanicolaou tests from other providers, although the difference did not attain statistical significance. Among both cases and controls, younger women and women who had used prescription contraceptives were more likely to have had a recent Papanicolaou test by an obstetrician-gynecologist. The results support the importance of regular Papanicolaou test screening among older women and suggest that the obstetrician gynecologist helps prevent cervical cancer by providing continuity of screening services. PMID- 3627585 TI - Psychosocial impact of urinary incontinence in women. AB - This study explored the psychosocial impact of urinary incontinence and investigated its relationship to urodynamic diagnosis and degree of involuntary urine loss. The sample comprised 69 community-dwelling women, ages 55 years and older, who were ambulatory and mentally intact, and who had volunteered in a clinical trial on incontinence. Psychosocial impact was measured by an investigator-designed instrument, the Incontinence Impact Questionnaire. Urodynamic evaluation included detrusor and urethral sphincteric function tests. Subjects were grouped into two urodynamic diagnostic categories: sphincteric incompetence (N = 47) and detrusor instability with or without concomitant sphincteric incompetence (N = 22). Severity of incontinence was determined by a one-week urinary diary and a fluid loss quantitation test. Each of the items on the Incontinence Impact Questionnaire was affected by urinary incontinence, although to varying degrees. Activities involving unfamiliar places where the availability of restrooms was unknown were most affected. Subjects with detrusor instability with or without concomitant sphincteric incompetence reported significantly higher impact than subjects with sphincteric incompetence alone. There were modest correlations between psychosocial impact scores and both the number of weekly incontinent episodes and the quantitation of fluid loss. The results in this study population indicate that the relationships between the perceived impact of incontinence and objective measures of its severity are complex and not directly proportionate. PMID- 3627586 TI - Endometrial cytohistology by the pistol-aspiration technique: clinical applicability. AB - The purpose of this study was to assess the value of the endometrial pistol aspiration technique as an office procedure for diagnosing corpus uteri cancer in symptomatic and asymptomatic women. Review of 3000 pistol aspirations in symptomatic outpatient women from 1974-1981 confirms that this method, with its high specificity and sensitivity, can be used for such women as a preliminary diagnostic procedure, eliminating risks from anesthesia and curettage as well as the cost of hospitalization. Analysis of resident incident cases shows that 82% were localized to the uterus, and more than 85% of these women were already symptomatic. Older women represent particularly difficult problems, both technical (cervical stenosis) and in recruitment. Because the natural history of the precursor lesions of corpus uteri cancer are not yet well established, use of this method for systematic population screening of asymptomatic women is questionable. PMID- 3627587 TI - Keloid scars as a result of CO2 laser for molluscum contagiosum. AB - Molluscum contagiosum is an infectious disease of the skin, found primarily on the thighs and genitalia. It is a sexually transmitted disease of increasing prevalence. The traditional treatment of this condition is surgical ablation, although CO2 laser has been advocated recently as an alternative mode of therapy. Six patients with molluscum contagiosum were treated by either continuous or intermittent CO2 laser. Four of the six have developed severe keloid scars. Removal of lesions by cold knife, however, was not followed by keloid scars. In the same patient, areas affected by human papillomavirus that were treated with CO2 laser did not develop keloid scars. Our results question the use of CO2 laser therapy for molluscum contagiosum. PMID- 3627589 TI - Pride of authorship. PMID- 3627588 TI - Cervical dilation before first-trimester elective abortion: a controlled comparison of meteneprost, laminaria, and hypan. AB - Preoperative cervical dilation makes first-trimester abortion safer, but increases costs and inconvenience to patients if extra visits are required. Eighty-four pregnant primigravid volunteers who requested first-trimester abortion were assigned randomly to one of four study groups: placebo, 16 dimethyl prostaglandin E2 (PGE2) vaginal suppository, 4-mm hypan plastic dilator, or small Laminaria japonica tent. This grouping was done to determine which of three modalities is most effective for cervical dilation within three hours before abortion. After three to four hours of treatment, hypan achieved greater cervical dilation among primigravid women and only modestly increased side effects, as compared with 16 dimethyl PGE2 suppositories or laminaria tents. PMID- 3627590 TI - Obstetric-gynecologic academic manpower--1986. AB - Full-time faculty numbers in academic departments of obstetrics-gynecology have resumed growth in the last three years, and now average 18.3 per department. Women are represented in a larger proportion than among practicing specialists. Faculty subspecialists are increasing in numbers, but their trend is toward practice rather than academic positions. Research involves 61% of the MD faculty. Chairmen predict major growth in faculty positions and in research over the next five years. PMID- 3627591 TI - Acquired immunodeficiency syndrome: suggested protocol for counseling and screening in pregnancy. AB - The Centers for Disease Control (CDC) has recorded 35,900 cases of acquired immunodeficiency syndrome (AIDS) in the United States, including 2447 infected females, as of May 25, 1987. These cases include 503 children under the age of 13, of whom 80% were thought to have been affected through perinatal transmission. The prevalence of AIDS-related complex and human immunodeficiency virus in the United States is far greater than these numbers. The CDC has recommended screening those pregnant women with risk factors for human immunodeficiency virus. With the help of a wide range of professionals, we have developed a screening protocol for human immunodeficiency virus in pregnancy. In the first six months, 3-4% of prenatal patients used this counseling service, and 11 human immunodeficiency virus-positive women delivered. This paper discusses the medical and ethical issues that were raised and the problems that we faced in establishing this protocol. PMID- 3627592 TI - A rapid serum estrogen assay suitable for office use in monitoring follicular maturation. AB - Ovulation induction often requires the determination of serum estradiol levels. A rapid, sensitive, and simple non-radioactive serum estrogen assay was developed by modifying a hemagglutination-inhibition kit (Hi-Estrotec) originally designed to measure total urinary estrogens. With a minimum sensitivity of 100 pg of 17 beta-estradiol, the modified procedure generally takes less than 2.5 hours to complete and requires no special equipment or instrumentation. Randomly obtained serum samples assayed by both the hemagglutination-inhibition assay and radioimmunoassay achieved a correlation coefficient of 0.885 (P less than .001). Comparison of serum obtained from women undergoing ovulation induction with human menopausal gonadotropin-human chorionic gonadotropin measured by both techniques showed the same fluctuation pattern for serum estradiol levels during the stimulated cycles. The rapidity and reproducibility of this serum estrogen assay make it suitable for office use in monitoring ovulation induction and superovulation in in vitro fertilization-embryo transfer programs. PMID- 3627593 TI - Penile nerve block for newborn circumcision. AB - Circumcision in neonates is performed, almost universally, without anesthesia or analgesia. It is associated with pain, crying, agitation, and physiologic stress. Twenty infants receiving penile nerve block for circumcision were compared with ten infants having circumcision without anesthesia. Heart rate and blood pressure rose 34 and 15%, respectively, in unblocked infants, and were unchanged in infants receiving local anesthesia. Oxygen saturation declined 16% in unanesthetized infants compared with 6% in blocked infants (P less than .03). Anesthetized infants were less agitated and cried less. Peak plasma concentrations of the local anesthetic lidocaine averaged 0.51 +/- 0.17 microgram/mL (range 0.1-1.6), well below accepted toxic levels. There were no local or systemic complications. PMID- 3627594 TI - Fetal blood gas and acid-base measurements must be corrected for gestational age. PMID- 3627595 TI - Quantitative transcervical uterine cultures in asymptomatic women using an intrauterine contraceptive device. PMID- 3627596 TI - Comparison of uterine activity induced by nipple stimulation and oxytocin. PMID- 3627597 TI - Acute salpingitis in sterilized women. PMID- 3627598 TI - Fetal hemorrhage from umbilical cord hemangioma. AB - Hemangiomas of the umbilical cord are rare. In this case, an acute, massive fetal hemorrhage from a ruptured umbilical hemangioma occurred after spontaneous rupture of membranes. Ectopic small intestinal mucosa covered the proximal surface of the umbilical cord. Fetal anomalies included a patent vitellointestinal duct remnant and distal ileal atresia. Fetal hemorrhage appears to be another previously unreported and potentially life-threatening complication of umbilical hemangiomas. PMID- 3627599 TI - Fetal supraventricular tachycardia treated with high-dose quinidine: toxicity associated with marked elevation of the metabolite, 3(S)-3-hydroxyquinidine. AB - We observed a patient at 33 weeks' gestation who was administered exceptionally large doses of quinidine to treat a fetal supraventricular tachycardia. The patient had clinical evidence of quinidine toxicity at low to mid-therapeutic levels of quinidine, but markedly elevated levels of the metabolite 3(S)-3 hydroxyquinidine (3-hydroxyquinidine). This pattern is consistent with a "fast metabolism" of quinidine. There is substantial evidence that 3-hydroxyquinidine has pharmacologic activity. We conclude that elevated levels of 3 hydroxyquinidine can be associated with a clinically significant quinidine toxicity. This can occur in the presence of a nontoxic serum quinidine level. We also measured the levels of quinidine and 3-hydroxyquinidine in the amniotic fluid and cord blood. The levels in the cord blood were 31 and 27%, respectively, of those in a simultaneously drawn maternal blood sample. PMID- 3627600 TI - Prenatal diagnosis of minute 5p- deletion: a cytogenetic problem in detection. AB - An unbalanced translocation, 46,XX,der(5)t(5;11) (p15;q25)mat was ascertained by prenatal diagnosis. The mother previously had a liveborn child with cri du chat syndrome. The subtlety of the chromosome rearrangement in this case illustrates the need for the most detailed cytogenetic investigations in cri du chat cases when deletion or translocation are not immediately obvious. PMID- 3627601 TI - Severe fetal supraventricular bradyarrhythmia without fetal hypoxia. AB - Cardiac anatomy and rhythm were evaluated in a fetus at 39 weeks' gestation in a pregnant woman referred because of severe fetal bradycardia with a persistent fetal heart rate of 50-60 beats per minute. M-mode echocardiograms revealed supraventricular bradyarrhythmia. Umbilical cord blood analysis did not, however, reveal fetal hypoxia. Diagnostic methods of fetal bradyarrhythmia are discussed, and the importance of differentiating bradyarrhythmia from bradycardia due to fetal hypoxia is emphasized. PMID- 3627602 TI - Hyperparathyroidism in pregnancy. AB - Two cases of primary hyperparathyroidism in pregnancy are described. One was treated by parathyroidectomy in the late third trimester with good outcome. It appears that parathyroidectomy, although traditionally performed in the second trimester, may in selected cases be a reasonable treatment option in late pregnancy. The other patient was treated successfully with large doses of oral phosphosoda. Hypokalemia in association with this form of therapy, and not related to diarrhea or other known etiologies, is described for the first time. PMID- 3627603 TI - Acute pancreatitis and primary hyperparathyroidism in pregnancy: treatment of hypercalcemia with magnesium sulfate. AB - A patient is described in whom intravenous magnesium sulfate, administered for preeclampsia, successfully treated hypercalcemia associated with hyperparathyroidism. This single case suggests that magnesium sulfate might be an effective alternative to standard medical or surgical treatment of this condition. PMID- 3627604 TI - Cystadenoma of the biliary system presenting as an abdominal mass in pregnancy. AB - Cystadenoma of the biliary system is a benign tumor associated with few symptoms and usually normal laboratory data. This tumor carries a good prognosis with total resection. We present the first case of a biliary cystadenoma complicating pregnancy. PMID- 3627605 TI - Preperitoneal herniorrhaphy: adjunct to cesarean section. AB - A case of inguinal hernia repair at the time of repeat cesarean section is described. The success of the repair and the patient's uneventful recovery suggest that these procedures can be combined conveniently and safely in select cases. PMID- 3627607 TI - Cranial magnetic resonance imaging in eclampsia. AB - Although the precise neuropathologic basis for eclamptic convulsions remains unclear, intracranial hemorrhage is frequently associated with fatal cases. Magnetic resonance imaging (MRI) is a recently developed neuroimaging technique that appears superior to other processes for defining intracranial anatomy and pathophysiology. This technique has not yet been reported in eclampsia. The authors performed serial MRIs on an eclamptic woman, with findings compatible with previously described neuropathologic changes. PMID- 3627606 TI - Intramural pregnancy with fetal survival: case history and discussion of etiologic factors. AB - Intramural implantation is among the rarest sites for ectopic pregnancy. The first intramural pregnancy with fetal survival is described and the possible etiologic role of prior uterine surgery is discussed. PMID- 3627608 TI - Fasting hyperinsulinemic hypoglycemia after ritodrine therapy for premature labor. AB - A 26-year-old woman with a triplet pregnancy was treated prophylactically with ritodrine beginning at 15 weeks' gestation. At 32 weeks, she was admitted in preterm labor, and over the next 12 days received high-dose oral or intravenous ritodrine. Three female infants were delivered by cesarean section after spontaneous rupture of the membranes. Postoperatively, she developed profound hypoglycemia with inappropriately high insulin levels. Maternal hypoglycemia after ritodrine therapy in pregnancy has not been reported previously. We discuss possible mechanisms. PMID- 3627609 TI - Continuous subcutaneous insulin infusion in an obese insulin-resistant pregnant woman with type II diabetes: accelerated fetal growth and neonatal complications. AB - This is the first report to describe prolonged continuous subcutaneous insulin infusion in a massively obese insulin-resistant pregnant woman with type II diabetes. Maternal 24-hour plasma glucose levels became normal by 48 hours, and normoglycemia was maintained with high daily doses of insulin (530 U-333 U/24 hours) from 29 weeks' gestation until delivery at 38.5 weeks. Excellent diabetic control was associated with euglycemia, normal glycosylated hemoglobin concentration, and a significant decrease in mean 24-hour plasma C-peptide (P less than .004) and glucagon (P less than .003) levels. Unexpectedly, fetal growth accelerated during constant insulin infusion despite normal maternal plasma glucose levels. The newborn infant was large (4530 g), with a striking truncal accumulation of fat, hypoglycemia (30-minute plasma glucose 11 mg/dL), and polycythemia (central venous hematocrit 71%). Normalization of maternal plasma glucose levels failed to ameliorate established macrosomia, and did not prevent the neonatal complications that are common in infants of diabetic mothers. PMID- 3627610 TI - Tuberculosis presenting as puerperal fever. AB - Two cases of unusual postpartum fever in foreign nationals are presented. Prolonged work-up led to the diagnosis of pulmonary tuberculosis as a cause of postpartum fever that responded well to antituberculous drugs. The signs and symptoms illustrated by these cases should alert physicians to consider tuberculosis in their differential diagnosis when caring for pregnant immigrants. The changing patterns and diagnostic and therapeutic problems are discussed. PMID- 3627611 TI - Predisposition to psychological complications after stillbirth: a case report. AB - As many as one-third of women bereaved by stillbirth suffer psychological decompensation, and a similar proportion see the obstetric team as unsupportive. A case history is presented of a woman who suffered severe psychiatric illness after delivering a stillborn anencephalic infant. This paper discusses the powerful influence that the behavior of the obstetric team in the delivery room can exert on the long-term outcome of the crisis. This case highlights a number of practical aspects of the psychological management of bereavement by stillbirth. PMID- 3627612 TI - Retroperitoneal teratoma presenting as an abdominal-pelvic mass. AB - Nonovarian teratomas are relatively common neoplasms in children, but are rarely seen in adults. A case of a large retroperitoneal teratoma in a 42-year-old woman is presented. The 21.5-kg tumor originated in the retroperitoneal space inferior to the origin of the superior mesenteric artery, and displaced the contents of the entire abdominal cavity. The duodenum, pancreas, and transverse colon mesentery were incorporated into the tumor's pseudocapsule. Evaluation and operative management are described. Diagnosis and pathogenesis of nonovarian teratomas are reviewed. PMID- 3627613 TI - Menorrhagia due to myometrial hypertrophy: treatment with tamoxifen. AB - A unique case is presented of a 23-year-old nulliparous woman with severe menorrhagia, a grossly enlarged uterus, and pure myometrial hypertrophy, confirmed by full-thickness biopsy. Her condition eventually responded to continuous oral therapy with the antiestrogen tamoxifen, and the uterus returned to normal size after nine months of treatment. PMID- 3627614 TI - Perineal hernia repair using human dura. AB - A patient developed a large perineal hernia and prolapse of a myocutaneous neovagina 13 months after total pelvic exenteration for recurrent squamous cell cancer of the cervix and gracilis myocutaneous vaginal reconstruction. The neovagina was removed and the pelvic floor defect was repaired with preserved human dura. Twelve months postoperatively, the patient remained asymptomatic. Current and potential uses for human dura allografts are discussed. PMID- 3627615 TI - Rotated hypoplastic hemipelvis: a cause of obstructive dyspareunia. AB - Repeat Chiari innominate osteotomy in a young woman with traumatic monoplegia and subsequent hypoplasia of the hemipelvis and leg resulted in rotation of the pubic ramus into the vagina, causing obstructive dyspareunia. Resection of the inferior pubic ramus through a transperineal approach allowed successful intromission with resolution of her dyspareunia. PMID- 3627616 TI - Calyceal rupture with perirenal urinoma in a patient with cervical carcinoma. AB - A patient is presented with calyceal rupture and perirenal urinoma formation secondary to distal ureteral obstruction by cervical carcinoma. Preoperative diagnosis was established with computed tomography and renal scan. Surgical placement of an indwelling ureteral stent resolved the urinoma. Causes of perirenal urine extravasation and approaches to diagnosis and management are reviewed. PMID- 3627617 TI - Ovarian cancer associated with the nephrotic syndrome. AB - A 65-year-old woman was found to have the nephrotic syndrome eight months before the onset of a new left neck mass. Biopsy specimen of the mass showed metastatic adenocarcinoma, which was subsequently found to be from an ovarian primary. Operation and triple chemotherapy has markedly diminished the degree of proteinuria. Although uncommon, ovarian carcinoma must be considered in the differential diagnosis of cancer-related nephrotic syndrome. PMID- 3627618 TI - Malignant melanoma of the vulva: a case report of distal recurrence in a patient with a superficially invasive primary lesion. AB - Malignant melanoma of the vulva is a rare but highly lethal disease traditionally treated by radical surgery. Recently, data has been presented suggesting that less aggressive surgical management for superficially invasive lesions results in low levels of local recurrence and metastatic disease. We present a patient with a Clark level II superficial spreading melanoma of the vulva that developed distal recurrence after wide local excision. PMID- 3627619 TI - Fibro-osteochondroma of the uterus. AB - A very rare case of fibro-osteochondroma arising in uterine musculature was studied histologically. The tumor exhibited three types of cellular proliferation -fibroblastic, cartilaginous, and osseous--all within an abundant collagenous matrix. The three components were intermingled, and varied in the degree of differentiation of cartilaginous and osseous tissue. The more differentiated tissues were usually circumscribed by fibrocellular bands of spindle-shaped cells that seemed to have transformed into rounded cartilaginous cells. Presumably this tumor arose from undifferentiated mesenchymal cells in the myometrium, which proliferated to form fibroblasts, chondrocytes, and osteoblasts. The tumor may be designated fibrio-osteochondroma. It is histologically benign and exceedingly rare. PMID- 3627620 TI - Pseudosarcoma botyroides in pregnancy: report of a case with ultrastructural observations. AB - A case of pseudosarcoma botryoides of the vagina diagnosed in advanced pregnancy is described. The cellular characteristics (atypical cells and abnormal mitoses) suggested malignancy, but ultrastructural studies demonstrated the fibroblastic nature of the cells, thus confirming the diagnosis of pseudosarcoma. Local excision and subsequent cesarean section was the method of treatment. Three years later, another pregnancy was terminated by repeat cesarean section and uncontrollable hemorrhage requiring emergency hysterectomy. The histologic study of the bleeding area revealed very edematous areas and lacunaelike endothelium lined vessels. No cellular abnormalities were observed. PMID- 3627621 TI - Autoerythrocyte sensitization worsened by a copper-containing IUD. AB - Autoerythrocyte sensitization (Gardner-Diamond syndrome) causes painful ecchymoses, and usually occurs in young women. It is rare and of unknown etiology. The young woman in this report probably had the condition beginning at age 14, but the diagnosis was not made until age 19, shortly after a copper containing intrauterine device (IUD) exacerbated her condition. The ecchymoses disappeared when the IUD was removed, but recurred when replaced. A non-copper IUD caused no ecchymoses. Taping a copper penny to the skin caused a similar rash. It seems that in this woman, the Gardner-Diamond syndrome was markedly worsened by exposure to copper. PMID- 3627622 TI - Residual disease after cone biopsy: completeness of excision and follow-up cytology as predictive factors. AB - Residual disease was identified in the hysterectomy specimen in 19 of 65 patients (29%) previously found to have cervical intraepithelial neoplasia and in four of 19 (21%) found to have early stromal invasion on histologic examination of a cone biopsy. Residual disease was found in six of 34 cases (18%) of cervical intraepithelial neoplasia and zero of 12 cases of early stromal invasion after complete excision, and in 13 of 31 cases (42%) of cervical intraepithelial neoplasia and four of seven cases (57%) of early stromal invasion after incomplete excision by cone biopsy. Sixteen of 28 women (57%) with abnormal cytology after cone biopsy were found to have residual disease at the time of hysterectomy. In contrast, no residual disease was found in 35 patients who had no evidence of cytologic abnormality after the initial treatment. The finding of abnormal cytology after cone biopsy is shown to be a more useful prognostic indicator than histologic examination of excision margins. Therefore, we believe that a policy of expectant management, based on regular cytologic examination, is justified when histologic assessment has shown the lesion to extend to the line of excision. PMID- 3627623 TI - Whole-blood serotonin in premenstrual syndrome. AB - Whole-blood serotonin levels in 14 subjects with well documented premenstrual syndrome and 13 age-matched controls were compared. Serotonin levels of premenstrual syndrome subjects were significantly lower during the last ten days of the menstrual cycle. No significant differences were noted in levels of serum estradiol and progesterone. Decreased serotonin is known to be associated with depression in humans, and nonhuman primates have exhibited abnormal behavioral profiles when given serotonin antagonists. The present observation suggests that the physiologic basis of premenstrual syndrome involves an alteration in serotonin metabolism. PMID- 3627624 TI - Response of skin thickness and metacarpal index to estradiol therapy in postmenopausal women. AB - A radiologic method for measuring skin thickness and metacarpal index was used to investigate 41 postmenopausal women treated with estradiol (100-mg) subcutaneous implants (Organon, UK). All the women completed the first six months of the study, and 33 completed one year. Both skin thickness and metacarpal index increased to a statistically significant degree over the one-year period, with most of the increase occurring in the first six months of therapy. Skin thickness showed the largest increases, from a mean of 0.86 mm at the start of the study to 0.97 mm at six months and 1 mm at one year. The metacarpal index increased from a mean of 0.77 at the start of the study to a mean of 0.799 and 0.8 at six months and one year, respectively. PMID- 3627625 TI - Primary malignant melanoma of the vagina: a report of seven cases. AB - Seven patients with primary melanoma of the vagina, five untreated and two recurrent, are reported. The ages ranged from 25-55 years, with an average of 42.3 years. The common symptoms were vaginal bleeding and a vaginal mass, and the most common site was the posterior wall of the vagina (three of seven patients). Two patients survived for more than five years. PMID- 3627626 TI - Clear-cell adenocarcinoma of the lower genital tract: Memorial Hospital 1974 1984. AB - Seventeen previously unreported cases of clear-cell adenocarcinoma originating in the vagina (13) and cervix (four) are presented. The mean age of the patients was 23.6 years. Four patients with cervical tumors and four patients with vaginal tumors underwent radical hysterectomy, bilateral pelvic lymphadenectomy, and partial vaginectomy. A total vaginectomy, with replacement of the excised vagina with a split-thickness skin graft or a segment of sigmoid colon, was added to the above procedure in five patients with vaginal cancer. In four patients, definitive treatment was radiation. All of the patients in the present series are without evidence of disease, with follow-up ranging from 21 months to more than ten years. PMID- 3627627 TI - Adnexal masses in postmenopausal women. AB - Adnexal masses in postmenopausal women were reviewed according to size, pathology, age of the patient, and accuracy of ultrasound versus pelvic examination. Only one of 32 masses less than 5 cm in diameter was malignant. Of 55 masses 5-10 cm in size, six were malignant, including one lymphoma and two borderline tumors. Forty of 63 tumors larger than 10 cm were malignant. The proportion of malignancies increased with age. Pelvic examination missed 10% of tumors less than 10 cm in diameter. Of those palpated, the examination predicted the size of the mass to within 2 cm in 68% of cases. Ultrasonic prediction of size was accurate in 87% of cases scanned. Our findings cast doubt on the concept that all postmenopausal women with minimally enlarged ovaries should undergo laparotomy. PMID- 3627629 TI - Effect of amniotic membrane rupture on length of labor. AB - Between January 1, 1979, and December 21, 1982, 2564 medically and obstetrically normal patients, admitted to the hospital with intact amniotic membranes during the latent phase of labor, were matched for spontaneous or artificial rupture of the membranes at similar cervical dilations. Spontaneous rupture of the membranes occurred earlier and was more likely in the latent phase of labor than was artificial rupture of membranes, which tended to occur nearer to or in the active phase of labor, and at lower pelvic stations. When matched by cervical dilation, spontaneous membrane rupture was associated with more rapid cervical dilation. Stepwise regression analysis confirmed that membrane rupture had a significant but small effect on labor length and rate of cervical dilation. Pelvic station and maternal parity had a smaller association with labor length than did membrane rupture. Cervical dilation at the time of membrane rupture appeared to be the most important factor associated with the length of labor. PMID- 3627628 TI - Acute effects of iron therapy on zinc status during pregnancy. AB - The acute effects of iron therapy on zinc status during pregnancy were investigated. The 20 subjects studied were healthy and had unremarkable obstetric histories. The mean stage of gestation was 27 weeks (range 21-33 weeks). Initial hematologic indices (mean +/- SEM) were: hematocrit 36.5 +/- 0.4%, serum ferritin 32.6 +/- 6.1 ng/mL, and serum iron 117 +/- 13 micrograms/dL. Iron therapy, prescribed by the obstetric caregivers, provided a total average daily elemental iron intake of 261 mg (range 164-395 mg) from therapy and routine supplements. Laboratory studies of zinc status were obtained immediately before iron therapy and at one and four weeks thereafter. Initial plasma zinc was 62.9 +/- 2.1 micrograms/dL. A mean decline in plasma zinc of 4.0 +/- 1.8 micrograms/dL (P less than .05) was observed from baseline to one week. The decline remained statistically significant after adjustment for the expected physiologic decline over the same interval of gestation. No further decline occurred from one to four weeks. No significant treatment-related effects were observed for neutrophil zinc, mononuclear leukocyte zinc, or serum alkaline phosphatase activity. These results indicate that iron therapy in doses typically prescribed by obstetric caregivers in this country has an acute, measurable effect on maternal zinc status. PMID- 3627630 TI - Cardiovascular effects of ritodrine tocolysis: a new noninvasive method to measure pulmonary capillary pressure during pregnancy. AB - The cardiovascular effects of ritodrine tocolytic therapy were assessed by noninvasive simultaneous recordings of indirect carotid pulse, electrocardiogram (ECG), phonocardiogram, and M-mode echocardiogram in 12 patients in preterm labor. The study was performed before and during infusion, and afterward when the patient was on oral drug therapy. Ritodrine therapy increased heart rate, left ventricular fractional shortening, pre-ejection period/left ventricular ejection time ratio, and cardiac index. A progressive rise in pulmonary capillary pressure was observed in all patients, exceeding 18 mmHg (the threshold for the development of pulmonary congestion) in six patients. Systolic arterial pressure, left ventricular end-diastolic dimension, and plasma protein oncotic pressure remained unchanged during therapy. Ritodrine therapy resulted in a significant drop in diastolic blood pressure and peripheral vascular resistance. This noninvasive means of measuring cardiovascular parameters, including pulmonary capillary pressure, may be useful in monitoring patients who develop significant cardiovascular side effects during tocolytic therapy. PMID- 3627631 TI - An active management approach to the postdate fetus with a reactive nonstress test and fetal heart rate decelerations. AB - Reports have shown that a reactive nonstress test (NST) with decelerations in the postdate patient is associated with an increase in perinatal morbidity. Based on these observations, patients who exhibited this fetal heart rate (FHR) pattern during NST had labor induced. The purpose of this report was to determine what impact, if any, this approach had on subsequent maternal and fetal outcome. The pregnancy outcome of 470 patients who delivered during 1984 within seven days of their last NST was compared with data from this institution in 1980. The last NST was reactive in 420 patients (89.4%) and nonreactive in 50 (10.6%). Fetal heart rate decelerations occurred in 130 patients (27.7%); of these, 96 (73.9%) were reactive and 34 (26.1%) nonreactive. Postdate patients whose last NST was reactive with decelerations had similar outcomes to patients with a nonreactive NST on their last test, but less favorable outcomes than patients with reactive tests alone. Comparison with data from our institution in 1980 shows that prompt induction of labor in the postdate patient with a reactive NST and decelerations resulted in significantly lower perinatal morbidity, with no corresponding increase in maternal morbidity. These results lead us to conclude that a reactive NST without FHR decelerations is a reliable indicator of fetal well-being in the postdate pregnancy. However, in the postdate pregnancy with a reactive NST with FHR decelerations, induction of labor is indicated. PMID- 3627633 TI - The designated defendant. PMID- 3627632 TI - Practice environment is associated with obstetric decision making regarding abnormal labor. AB - Nonmedical factors affecting obstetric decisions regarding abnormal labor were investigated in Maine, a rural state. Obstetricians were questioned about practice structure, hospital services, anesthesia support, and legal liability. Cesarean section rates specific for abnormal labor, based on hospital discharge summaries in the previous two years, correlated inversely with improved night coverage support, 24-hour blood bank availability, and more adequate anesthesia services. Neither the payment differential between vaginal and cesarean delivery nor previous legal liability were associated with increased cesarean rates for abnormal labor. We conclude that improved ancillary services may lead to lower dystocia-specific cesarean section rates. PMID- 3627634 TI - Endometrial ablation for intractable uterine bleeding: hysteroscopic resection. AB - Twenty-one patients with intractable uterine bleeding were treated by resectoscopic ablation of the endometrium. All the patients were worked up thoroughly to rule out hormonal or anatomic reasons for their bleeding. In addition, various hormonal regimens were tried to stop the bleeding. Our technique used the modified urologic resectoscope, which is inserted into the uterine cavity. The entire endometrial cavity was ablated using 30 W of coagulating current. Of the 21 patients treated, 14 had blood dyscrasias, four were poor anesthetic risks, and three refused hysterectomy. There were no complications from the procedure. Three patients died from their primary disease, and all the rest, except for one, remained amenorrheic. We conclude that the use of the resectoscope for endometrial ablation is a successful, efficient, safe, and readily available way to treat intractable uterine bleeding. PMID- 3627635 TI - Vaginal removal of the pedunculated submucous myoma: the use of laminaria. AB - Vaginal removal of submucous fibroids was attempted in 92 patients. The procedure, successful in 83 cases, involved dilation of the cervix with laminaria tents and removal of the submucous fibroid by grasping with appropriate instruments. Myomas were successfully removed in 90% of the patients, and hysterectomy or myomectomy were avoided in 88%. Morbidity was minimal. PMID- 3627636 TI - Ready, set, go. Wellness movement focuses business efforts on improved worker fitness, health. AB - From its conception in the mid-1970s to the present, attention to fitness and education regarding preventive measures has increased at a phenomenal rate. Companies are involved in the attempt to keep employees healthy and health care cost-efficient. Reduced absenteeism, less turnover, more positive work attitudes, less strain and tension, improved work performance and health-related savings are but a few of the benefits cited by those involved in maintaining healthy lifestyles. At a time when the health care industry is undergoing major cost containment efforts, it seems most reasonable to adopt a preventive mindset and be concerned with employee fitness and lifestyle programs that lead to a decrease in immediate health care utilization. PMID- 3627637 TI - DuPont 'takes time' for health. PMID- 3627638 TI - Worker problems can be flagged with vision screening program. PMID- 3627639 TI - Training workers in first aid/CPR improves plant accident rates. PMID- 3627640 TI - Evaluation, office improvements can reduce VDT operator problems. PMID- 3627641 TI - When doctors dispense prescriptions, angry pharmacists are bypassed. PMID- 3627642 TI - Containing corporate health care costs requires input from all participants. PMID- 3627643 TI - Emergency responders must learn to handle hazmat incidents properly. PMID- 3627644 TI - New NFPA 1500 standard addresses development of OHS programs. PMID- 3627645 TI - H.E.L.P. team uses office volunteers to improve emergency response. PMID- 3627646 TI - OSHA, NFPA firefighter rules require equipment that saves lives. PMID- 3627647 TI - Ten years and 100 editorials: Strasser reviews the changes. PMID- 3627648 TI - Unemployment affects workers' health; stress targets emotional, physical being. PMID- 3627649 TI - Certain trends demonstrate a need for specific cost-containment actions. PMID- 3627650 TI - Absorptive lenses offer protection from specific hazards of sunlight. PMID- 3627651 TI - AIDS problem calls for education. PMID- 3627652 TI - Low back injury prevention training requires traditional, new methods. PMID- 3627653 TI - The fate of the untreated menopause. AB - The human female climacteric is the phase of life that marks the transition from the reproductive to the nonreproductive years. When symptoms occur, the term "climacteric syndrome" may be utilized. The purpose of this review is to demonstrate that sufficient evidence now exists to confirm that the climacteric syndrome is a specific one that can be regarded as an endocrinopathy. The statement that the human female climacteric represents a pathologic rather than a physiologic state should not generate antagonistic counter-arguments; rather, it should be recognized as a challenge for the identification, prediction, and prevention of organic disease in the woman during the climacteric and after. PMID- 3627654 TI - The menopause. PMID- 3627655 TI - Urogenital atrophy. AB - Urogenital atrophy in the postmenopausal or castrated woman is common with a multifactorial etiology and a varied clinical presentation. The effects of age and estrogen deprivation are, at times, poorly separable. Estrogen replacement may be used to significantly alleviate symptoms due to atrophy but must be used with appropriate surveillance to avoid potential adverse consequences. PMID- 3627657 TI - Depression in the menopause. AB - Epidemiologic studies have demonstrated an increase in complaints of depressed mood and other minor psychological changes from patients in the perimenopause. The etiology of these complaints has been the subject of much controversy. Current evidence supports a biopsychosocial etiological model. Underlying endocrinologic changes trigger emotional complaints in women who are vulnerable by virtue of developmental factors, personality, psychiatric history, known vulnerability to hormonally triggered mood changes, or current social problems. PMID- 3627656 TI - The use of androgens in the menopause and other gynecic disorders. AB - The use of androgens in the treatment of gynecic disorders has had few adherents because of the belief generally held that androgen administration to the female patient is antiphysiologic and antipharmacologic. Testosterone in physiologic doses complements estrogens and is synergestic rather than contraphysiologic. Physiologic doses of testosterone may be used to advantage in the management of the menopause, sexual dysfunction, lichen planus vel atrophicus, fibrocystic disease of the breast, and sexual infantilism resulting from hypopituitarism as well as in several other disorders. PMID- 3627659 TI - [Current methods of pathogenetically oriented microsurgery of post-traumatic glaucoma]. PMID- 3627658 TI - Sexuality in the middle years. AB - Sexual function undergoes natural changes at menopause, reflecting the effects of ovarian hormones on the nervous and cardiovascular systems. Most studies indicate deterioration of function as the impact of the biological changes is compounded by psychological reactions and sociocultural influences. This article reviews studies of sex and menopause and discusses etiological considerations with regard to ovarian hormones and sexual dysfunction. The concluding section describes ways in which the clinician can help the menopausal woman and her partner understand and deal with sexual dysfunction. PMID- 3627660 TI - [Secondary glaucoma in eye injuries]. PMID- 3627661 TI - [Secondary glaucoma in eye injuries complicated by trauma of the crystalline lens]. PMID- 3627662 TI - [Secondary post-traumatic glaucoma (data from a district eye trauma center)]. PMID- 3627663 TI - [Surgical treatment of secondary glaucoma in cataracts of traumatic origin]. PMID- 3627664 TI - [Secondary post-burn glaucoma and its surgical treatment]. PMID- 3627665 TI - [Intraocular lenses: complications and complicated cases]. PMID- 3627666 TI - [Problems of the clinical classification of cataracts]. PMID- 3627667 TI - [Immediate and remote results of the surgical treatment of hemophthalmos by closed vitrectomy method]. PMID- 3627668 TI - [Individual tolerant intraocular pressure and its evaluation in the early diagnosis of primary glaucoma]. PMID- 3627670 TI - [Accommodative function of the eyes in poor-sighted schoolchildren with complicated myopia]. PMID- 3627669 TI - [Static campimetry of the innermost quadrant of the visual field in the diagnosis of primary glaucoma]. PMID- 3627671 TI - [Visual pocket (visual hollow) and the status of the visual field in occlusive processes in the posterior cranial fossa]. PMID- 3627672 TI - [Study of the possibilities of preventing glaucoma]. PMID- 3627674 TI - [Ophthalmosurgical electrocoagulator]. PMID- 3627673 TI - [Changes in corneal ultrastructure after exposure to ultrasound]. PMID- 3627675 TI - [A technic of repeated anti-glaucoma operations]. PMID- 3627676 TI - [Possibilities of using the Soviet-made Volga ultrasonic phacofragmentator in the surgical treatment of penetrating eye injuries and their sequelae]. PMID- 3627677 TI - [Effectiveness of the express method of the early diagnosis of glaucoma]. PMID- 3627678 TI - [Spontaneous regression of bilateral retinoblastoma]. PMID- 3627680 TI - [Accessory lacrimal caruncle]. PMID- 3627679 TI - [Hemangioma of the choroid]. PMID- 3627681 TI - [2 cases of acquired corneal toxoplasmosis]. PMID- 3627682 TI - [A rare case of orbital trauma with a favorable outcome]. PMID- 3627683 TI - Let's not bury the annual physical. PMID- 3627684 TI - The peer review process: new focus, new directions. PMID- 3627685 TI - Scleral reinforcement: two case reports. AB - We report two cases of unilateral scleral reinforcement undergone for progressive pathologic myopia. Examination ten years after the operations showed the supportive effect of the scleral grafts. The effect, however, was localized and did not appear to block the overall progression of posterior staphyloma formation significantly. PMID- 3627686 TI - Lack of beneficial effect of intensive topical steroids and beta irradiation of eyes undergoing repeat trabeculectomy. AB - Sixteen eyes (14 patients) that had previous failed trabeculectomy underwent a further trabeculectomy. In the postoperative period they were treated with intensive topical steroids (hourly) for several months. At the end of one year the overall results of surgery were not improved using this regime when compared with a previously reported series of similar patients who were treated with less steroid. It appeared that the addition of more intensive topical steroid usage was no more successful than steroids given in a four-time-a-day program. Additionally, some eyes were treated with beta irradiation, which did not appear to influence the results. Eyes that had a limbus-based conjunctival flap at reoperation had a more favorable outcome than those having fornix-based flaps. PMID- 3627687 TI - Improved goniolens for YAG sclerostomy. PMID- 3627688 TI - Total facial nerve palsy following modified O'Brien facial nerve block. AB - A 78-year-old white male developed a total facial palsy immediately following a modified O'Brien facial nerve block utilizing mepivacaine 2%, 10 cc. There was no apparent complication at the time of the nerve block. The facial palsy persisted unchanged for three months, at which time recovery of function was first detectable. Recovery was clinically complete nine months after the palsy occurred. The presumed cause was direct trauma by the needle at the time of the injection. PMID- 3627689 TI - The use of a retrobulbar anesthetic in managing pain and nausea from elevated intraocular pressure. PMID- 3627690 TI - Use of Healon in different cataract surgery techniques: endothelial cell count study. AB - The effect of the intracameral application of 1% sodium hyaluronate (Healon) in various cataract extraction techniques was evaluated in four groups of ten cats each whose natural lenses were removed using four different techniques. In a fifth group, the intraocular lenses (IOLs) were implanted over the crystalline lens. Each animal's right eye was treated with Healon and each left eye with balanced salt solution (BSS). Healon-treated eyes lost almost 50% fewer endothelial cells and had a smaller increase in corneal thickness than their counterpart eyes treated with BSS. Lens implantation and phacoemulsification procedures caused the greatest endothelial cell loss, while neodymium YAG laser capsulotomy, a less traumatic procedure, minimized this loss. PMID- 3627691 TI - Scleral patch grafts with Molteno setons. PMID- 3627693 TI - A new lacrimal scissors. PMID- 3627692 TI - Vertical rupture in posterior corneal layers after cataract extraction. AB - The histopathological description of a 3 mm vertical cut in the posterior layers of a corneal button removed for pseudophakic bullous keratopathy is presented. The corneal complications became clinically evident several weeks after extracapsular cataract extraction with placement of a posterior chamber lens implant. Outstanding histological features were: wall-like elevation of the borders of the cut with swelling of the posterior stromal layers; rolled-in edges of Descemet's membrane; double interruption of Descemet's membrane on one side; regional endothelial atrophy; and total lack of any signs of endothelial regeneration. PMID- 3627694 TI - A scleral depressor for infants. PMID- 3627695 TI - Whitnall's sling, not a "new procedure". PMID- 3627696 TI - Peripheral anterior synechiae. PMID- 3627697 TI - Acute posterior multifocal placoid pigment epitheliopathy. A long-term follow-up. AB - Acute posterior multifocal placoid pigment epitheliopathy is now perfectly documented on clinical and angiographic findings. Gass has emphasized the good prognosis and the infrequency of recurrence. Some cases have, however, multiple recurrences and loss of sight. It seems of interest to discuss the long-term prognosis of acute posterior multifocal placoid pigment epitheliopathy. PMID- 3627698 TI - Treatment of retinal detachment after penetrating injury: heavy cryotreatment of the fibrous ingrowth as an adjunct to vitreoretinal microsurgery. AB - Heavy cryotreatment of the fibrous ingrowth remnants at the inner surface of the scleral wound was performed, as an adjunct to vitreo retinal microsurgery, in a series of 32 eyes affected with retinal detachment after penetrating scleral wound. Surgical success, with a follow-up of 6-42 months after gas disappearance, was achieved in 25 eyes (71%). However, permanent retinal reattachment was achieved with a single operation in only 64% of the eyes successfully operated on (16/25). Thirty-six per cent (9/25 eyes) of the retinal detachments that were eventually successfully operated on showed clinical evidence of gradual contraction of the vitreous base in the postoperative course, and required 2 or more operations. Experimental studies on standardized models are required to determine whether destruction of the fibrous ingrowth remnants with heavy cryo is of any value in the management of retinal detachment after penetrating scleral wound. PMID- 3627699 TI - [ Nuclear spin tomography of morning glory syndrome with macular serous retinal detachment]. AB - A case of crater-like excavation of the optic disc associated with macular detachment and morning glory syndrome in the other eye is discussed. Nuclear magnetic resonance examination proves that the submacular fluid is not of cerebrospinal origin. PMID- 3627700 TI - Eye parameters influencing the results of argon laser trabeculoplasty in primary open-angle glaucoma. AB - Argon laser trabeculoplasty (ALT) was performed on 173 eyes of 126 patients affected by uncontrolled primary open-angle glaucoma. All subjects were phakic. An overall decrease of intraocular pressure (IOP) from baseline of 19.1 (+/- 18) were observed. With linear regression analysis, a positive correlation was found between baseline IOP and percentage IOP fall. The effect of ALT in myopes, hyperopes, younger and older patients was also analyzed. Although a less pronounced IOP fall was observed in the subgroups of higher myopes and of younger patients, no direct relationship could be established between amount of IOP change and age or refraction. In subjects treated bilaterally, a significant correspondence of effect was found between the two eyes. PMID- 3627701 TI - Anterior segment surgery with use of a new type of sodium hyaluronate preparation IAL. AB - Over a period of 1 year, a new sodium hyaluronate preparation (IAL) has been studied in eye surgery. The study included 18 cases of extracapsular cataract extraction with intraocular lens (IOL) implantation and 19 cases of penetrating keratoplasty. The trial has shown that this substance presents all the advantages described for use of viscoelastic substances in ocular surgery. The use of this sodium hyaluronate preparation appeared to decrease the risk of the postsurgical ocular hypertension described for analogous substances with different physicochemical characteristics. PMID- 3627702 TI - Neuromuscular investigations in retinitis pigmentosa. AB - Five patients with primary pigmentary dystrophy of the retina (retinitis pigmentosa) were tested on the integrity of their neuromuscular system. Clinical, electrophysiological and biochemical abnormalities were not found. A skeletal muscular biopsy was performed and histochemical, electron-microscopical and biochemical investigations were carried out. Only aspecific or minimal abnormalities were found. The mitochondrial functioning was especially explored and was found intact. Skeletal muscle examination is of no use in the study of retinitis pigmentosa. PMID- 3627703 TI - Lacrimal proteins in Sjogren's syndrome. AB - Tear protein electrophoresis results are studied in a group of 5 patients suffering from Sjogren's syndrome. Decreased globulin fraction and severe diminution of post-gamma protein fraction are the main alterations of lacrimal protein in this disease. PMID- 3627704 TI - Pigment deposition in the anterior segment caused by melanocytoma of the optic disc. AB - A 34-year-old Japanese woman had a melanocytoma of the optic disc with scattered pigment particles in the vitreous in the left eye in 1970. Fifteen years later, we noticed pigment dispersion on the posterior lens surface, iris root, and trabecular meshwork, which resembled findings often caused by ocular malignant melanoma. Because the melanocytoma of the optic disc had decreased in size and the number of dispersed pigment particles in the vitreous cavity was reduced, it appeared that the pigmented particles produced by partial necrosis of the melanocytoma had resulted in the pigmentation of the anterior segment. PMID- 3627705 TI - Value of the S100 protein in the study of nevus and ocular melanomas. AB - Ten cases of melanoma and 5 ocular nevus were studied with the peroxidase antiperoxidase method with S100 protein. All the cases showed positivity for this protein, this is why we can advise its use in the diagnosis of these entities. PMID- 3627706 TI - Red phosphorus as a cause of corneal injury. A case report. AB - A 15-year-old pupil was injured by an explosive mixture of red phosphorus powder and potassium chlorate causing seeding of multiple foreign bodies upon superficial and deep corneal layers. Unlike the few fulminant cases reported in the English literature our case had a benign course and outcome, without any late complications. PMID- 3627707 TI - The ocular complications of boxing. AB - In cooperation with the New York State Athletic Commission, 74 boxers applying for a new or yearly renewal license were sequentially referred over a 2-year period for a complete dilated ocular examination at the Sports Vision Institute of the Manhattan Eye, Ear and Throat Hospital. At least one ocular injury was found in 66% of boxers. Vision-threatening injuries, defined as significant damage to the angle, lens, macula, or peripheral retina occurred in 58% of boxers. Nineteen percent of boxers had angle abnormalities. Nineteen percent of boxers had pathologic cataracts, over 70% of these were posterior subcapsular. Six boxers had macular lesions. A total of 24% of boxers had retinal tears. Standardized photographs were used to distinguish pathologic cataracts from congenital opacities and pathologic retinal tears from atrophic holes. Attempts were made to identify risk factors in boxing that might be predictive for ocular injury. Variables included age, weight division, left- or right-handedness, total number of losses, and total number of bouts. Significant correlations were found between the total number of bouts and the total number of losses, and the presence of retinal tears. College varsity athletes were selected as controls. Significant differences were found between boxers and controls for the total number of injuries, total vision-threatening injuries, and the number of retinal tears. A series of recommendations are proposed to aide in the early detection and prevention of serious ocular injuries. PMID- 3627708 TI - Heparin prophylaxis for intraocular fibrin. AB - The authors have evaluated the use of heparin as a method to prevent postoperative intraocular fibrin clot formation in the rabbit after vitrectomy and cyclocryotherapy. In addition, they have studied the effect of a heparin infusion on intraocular bleeding after sectioning of retinal vessels. Heparin was administered by several different routes. The extent of the postoperative fibrin clot, as well as the number of days until its clearing, were recorded. A single anterior chamber injection, heparin supplementation of the infusion solution, or a single intravenous (IV) injection, all resulted in a statistically significant reduction of postoperative intraocular fibrin. Once daily subcutaneous injections alone did not produce a reduction in postoperative fibrin. No ocular bleeding complications developed postoperatively. A constant heparin intraocular infusion of 10 IU/cc did not change the bleeding time after sectioning of a retinal vessel. PMID- 3627709 TI - Pars plana vitrectomy for vitreous amyloidosis. AB - Thirty-six pars plana vitrectomies were performed on 30 eyes of 17 patients with biopsy-proven vitreous amyloidosis. Reopacification of the retrolental vitreous was the most common reason for vitrectomy revision, required in 24% of patients. Complications of amyloid or vitrectomy included retinal detachment requiring scleral buckling in 17% of eyes and glaucoma requiring filtering surgery in 17% of eyes. After a mean 35-month post-vitrectomy follow-up, 48% of eyes had visual acuities of 20/40 or better, and 32% of eyes had visual acuities between 20/50 and 20/100. Twenty percent of eyes had visual acuities of 20/200 or worse due either to persistent retinal detachment, open angle glaucoma, or residual opacification of the vitreous. PMID- 3627710 TI - Retinopathy of prematurity. Diagnosis, severity, and natural history. AB - This article presents data gathered in a prospective clinical trial of constant monitoring of oxygen therapy on the diagnosis, severity (as coded by a severity index [SI]) and natural history of retinopathy of prematurity (ROP) in 214 surviving infants with birthweights less than or equal to 1300 g. ROP developed in 119 (55.6%) infants and, of these, cicatricial ROP developed in nine (7.6%). The disease was diagnosed at 8-9 weeks on the average in infants with birthweights less than 900 g and 4-5 weeks in infants 900 to 1300 g. Those infants in whom the disease regressed, ROP lasted approximately 15 weeks. The severity of the disease, as defined by the SI, was strongly correlated with the birthweight of the infant and weakly correlated with the total duration of oxygen therapy. PMID- 3627711 TI - Retinopathy of prematurity. A randomized, prospective trial of transcutaneous oxygen monitoring. AB - To determine whether the use of continuous transcutaneous oxygen monitoring (tcPO2) could reduce the incidence of retinopathy of prematurity (ROP) in pre term infants receiving oxygen therapy, a randomized, prospective trial of constant monitoring using the transcutaneous oxygen monitor versus intermittent monitoring of oxygen was performed on a population of premature infants at very high risk for the development of ROP. Two hundred ninety-six infants were randomly assigned to either a constantly monitored (CM) or standard care (SC) group. CM infants had tcPO2 monitored continuously as long as they required supplemental oxygen, whereas SC infants had tcPO2 monitored only during the more acute state of their illness. Management of both groups was otherwise identical. One hundred one of 148 infants in the CM group and 113 of 148 in the SC group survived. The overall incidence of ROP was 51% in the CM group and 59% in the SC group (no significant difference). In infants over 1000 g birthweight, as the weight increased there was increasing risk of developing ROP in the SC group. The odds ratio for the ROPsc:ROPcm reached 7.6 in infants between 1200 and 1300 g in infants with Apgar scores greater than or equal to 8 at 5 minutes. The incidence of cicatricial ROP was similar in both groups: four in the CM and five in the SC group. PMID- 3627712 TI - Histopathology of uveal melanomas treated with charged particle radiation. AB - The authors have treated 255 uveal melanomas with helium ion radiation. Twenty three eyes have been enucleated because of complications and five eyes have been obtained at autopsy. We have evaluated 27 of these eyes. Neovascular glaucoma (10 eyes), painful keratitis (6 eyes), continued tumor growth (4 eyes), and vitreous hemorrhage (2 eyes) were the major complications of treatment that led to enucleation. The degree of tumor necrosis correlated with the size, pigmentation, and anterior extent of the tumor. It did not correlate with the interval from irradiation or with the amount of tumor shrinkage. Mitotic figures were extremely rare in treated tumors, suggesting that the tumor cells have lost their ability to cycle. PMID- 3627713 TI - Validation of the acuity card procedure for assessment of infants with ocular disorders. AB - The acuity card procedure has been shown to be a rapid method for the assessment of monocular and binocular grating acuity in normal infants from birth through 36 months of age. The current study seeks to validate the procedure further by using the acuity cards to assess 20 2- to 8-month-old infant patients with ocular disorders, including aphakia, strabismus, ptosis, and orbital hemangioma. Assessments were made with the acuity cards by two different observers, both blind to the infant's diagnosis, and by a third observer using a traditional forced-choice preferential looking (FPL) procedure. One hundred percent of the infant patients completed both binocular and monocular acuity card testing in an average time of 8 minutes per test. Interobserver agreement between acuity card observers and inter-technique agreement were high, and were sustained in individual cases in which the infant's acuity was not predictable from its visible signs. These results help to establish the potential clinical utility of the acuity card procedure for the assessment of infant patients. PMID- 3627714 TI - Early diagnosis of retinoblastoma based on dysmorphic features and karyotype analysis. AB - Karyotype analysis of two children with congenital dysmorphic features showed chromosome 13 deletion involving band 13q14. Ophthalmic examination prompted by the karyotype findings resulted in early diagnosis of unilateral multifocal retinoblastoma in each child. Therapy at this early stage of disease allowed preservation of vision in the affected eye in each child. PMID- 3627715 TI - Metastatic eyelid disease. AB - The authors conducted a clinicopathologic study of 31 patients with metastatic disease to the eyelid at the Armed Forces Institute of Pathology. Metastasis was found predominantly in women (female/male = 4:1). The mean age was 69 years (range, 3-92). The most common primary sites were breast (35%), skin (16%), and gastrointestinal and urogenital tracts (each 10%). Aside from breast carcinoma, there was no sex predilection for the extramammary malignancies to metastasize to the eyelids. Metastasis was suspected in only 32% of the cases. Most common misdiagnoses were chalazion, cyst, granuloma, and xanthoma. The lid lesions were detected before the primary focus in 45% of the cases. The authors conclude that metastatic disease should be considered in the differential diagnosis of eyelid lesions. PMID- 3627716 TI - Efficacy of surgical treatment for paralytic ectropion. AB - Paralytic ectropion can be corrected with numerous procedures. Advocates of particular procedures have previously been unable to quote statistical rates of success for each procedure over significant lengths of time. This study reviews over 200 cases of paralytic ectropion, representing the spectrum of seventh nerve disease seen at an eye and ear specialty hospital and a general medical facility. Of all eyelid implantation devices 93 to 95% failed to work or needed reoperation by 3 years postoperatively. Soft tissue surgery without prosthetic implants or exoplants provided 60% success after a 3-year follow-up. Eyelid elevation or tightening coupled with surgery for facial reanimation produced a higher rate of success at 3 years (83%). An overwhelming number of patients (62%) complained of some degree of epiphora after any or all procedures. Based on these findings, soft tissue surgery without prosthetic implants or exoplants has a higher rate of success. PMID- 3627717 TI - The incidence of extraocular muscle and cranial nerve palsy in orbital floor blow out fractures. AB - The frequency of extraocular muscle (EOM) or cranial nerve (CN) palsy as the sole cause of diplopia in orbital floor blow-out fractures has not been previously determined. Of 40 blow-out fracture patients studied prospectively, seven had motility disturbances consistent with palsy of one EOM or CN. All seven patients had negative forced ductions, making entrapment, edema, or orbital hemorrhage unlikely causes of diplopia. The diplopia resolved in four patients in 1 year. Persistent diplopia is a common indication for repair of such fractures. If, however, diplopia is due only to EOM or CN palsy, orbital surgery should be deferred (in the absence of significant enophthalmos) in favor of observation and/or later strabismus surgery. PMID- 3627718 TI - Orbital lymphoid tumors located predominantly within extraocular muscles. AB - Lymphoid masses can be centered predominantly within an extraocular muscle (EOM), as exemplified by computed tomography (CT) scanning and biopsy confirmation in the seven cases reported in this study. In these patients, an insidious and painless onset of exophthalmos was overshadowed by ptosis or a motility disturbance (particularly limited upgaze) in the absence of chemosis and lid erythema. The lesions were located in the superior rectus-levator complex (6 cases) and in the medial rectus muscle (1 case). One patient, with an exclusive infiltration of the levator, had a complete ptosis, whereas four others had a partial ptosis. Important clinical clues included palpable masses (4 cases) and preserved downward gaze (all cases), the latter suggesting the absence of fibrotic restriction, as is often seen in Graves' myopathy and the idiopathic myositis of pseudotumor. The biopsy specimens showed spill-over of the hypercellular and stroma-free lymphoid tissue into the orbital fat (all cases) and into the lacrimal gland (3 cases). Full extraocular motility on upgaze was restored after local orbital radiotherapy, although a residual ptosis persisted in five cases. Five patients had well-differentiated lesions and nonocular disease did not develop, whereas a widespread disease developed in one of two patients with a cytologically malignant lymphoma; the patient eventually died. PMID- 3627719 TI - Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction. AB - A series of 427 patients with congenital dacryostenosis involving 572 eyes was seen at the Children's Hospital of Philadelphia. All patients were treated conservatively with antibiotics and massage prior to decision by the parents to request probing. Congenital dacryostenosis, as well as resolution of symptoms, were confirmed by clinical examination and use of a modified dye disappearance test. In 572 eyes, the success rate of initial probing was found to be 97% under 13 months of age. Over 13 months, however, the mean success rate was found to be 54.7%. When broken down into smaller age categories, a stepwise progression was observed from 76.4% between 13 and 18 months to 33.3% for patients probed after 24 months. In addition, the number and complexity of subsequent procedures appeared to increase along with the age at which the initial probing was performed. These data suggest that initial probing should be done prior to 13 months of age depending on the severity of symptoms and parent compliance with medical management. PMID- 3627720 TI - Lacrimal sac cyst. AB - This report details the presentation, workup, and treatment of the largest lacrimal duct cyst ever reported in the ophthalmic literature. Included in this report is the first computed tomographic (CT) image of this unusual lesion. Typical and atypical clinical features of this lacrimal sac cyst are emphasized. PMID- 3627721 TI - Magnetic resonance imaging in the evaluation of optic nerve gliomas. AB - Five patients with optic nerve gliomas were evaluated by magnetic resonance imaging (MRI). Images obtained with MRI were equal to computed tomography (CT) in evaluation of the orbital components of these tumors and superior to CT in evaluating the intracanalicular, chiasmal, and post-chiasmal extension of tumor. MRI is unimpeded by artifacts produced by surrounding bone, as encountered in CT, and also proves to be more sensitive in delineating subtle differences in fat content and hydration of neural tissues. Thus, MRI is extremely valuable in furthering our understanding of the natural and therapeutic response of optic nerve gliomas. PMID- 3627722 TI - Brain stem anesthesia after retrobulbar block. AB - Presented is a series of eight patients in whom neurologic sequelae developed after retrobulbar anesthesia. All patients demonstrated blockade of one or more cranial nerves and six progressed to apnea, requiring intubation and mechanical ventilation. Neurologic findings included amaurosis in the contralateral eye (5 patients), nonreactive pupil in the contralateral eye (6 patients), ductional defects (2 patients), and dysphagia (4 patients). In all cases, these findings resolved in 2 to 12 hours. In patients who progressed to apnea, spontaneous respiration resumed within 30 to 60 minutes. These findings are particularly significant in light of recent decisions to reduce anesthesia coverage for cataract surgery in some regions. PMID- 3627723 TI - Carotid endarterectomy. Who needs it? AB - Although carotid endarterectomy is one of the most frequently performed operations in this country, recent evidence casts doubt on its advisability, particularly for patients with ocular manifestations of cerebral ischemia. The following evidence is that: the risk of future stroke in untreated patients with amaurosis fugax, retinal plaques, and infarcts is less than 3% per year, far lower than that expected for cerebral (hemispheric) transient ischemic attacks (TIAs); the perioperative risk of stroke and death after endarterectomy may be much higher than previously suspected; and aspirin is a comparatively risk-free and moderately effective alternative to endarterectomy. Because of the questions raised about the risk-to-benefit ratio of endarterectomy, patients with ocular manifestations of cerebral ischemia should be considered for this operation only as part of a proposed randomized collaborative study. PMID- 3627724 TI - The relationship between the skin and some bacterial species occurring on it in the Merino. AB - Ten bacterial species were isolated from areas on the skin of Merino sheep affected by a chronic scaly condition leading to retarded wool growth. The growth requirements of the bacteria were studied and it was shown that they could multiply under the conditions prevailing on the skin if moisture was provided. All the bacteria isolated have the ability to stimulate the infiltration of round cells into the dermis, which is the essential feature of the pathological changes in the naturally affected skin. It was concluded that the bacteria have a decided aetiological role. PMID- 3627725 TI - Musca nevilli sp. nov. (Diptera, Muscidae), a dung-breeding fly from South Africa. AB - The adults, puparium and 3rd instar larva of a dung-breeding fly, Musca nevilli sp. nov. are described in the subgenus Eumusca. The adults are characterized by 4 dark postsutural mesonotal vittae, 1-2 bristles dorsally on the stem vein, the hairs on the ventral surface of r4 + 5 confined to the vein base, and the predominantly orange-yellow tergite I + II. The species is compared with other southern African species of the subgenus, especially with Musca xanthomelas Wiedemann, 1824, which it resembles to some extent. PMID- 3627726 TI - The isolation of Leptospira interrogans serovar pomona and related serological findings associated with a mixed farming unit in the Transvaal. AB - This is the first known isolation in the Republic of South Africa (RSA) of the serovar pomona from the organs of porcine foetuses as well as from the renal lymph nodes of slaughter pigs showing chronic nephritis. In addition, the serovar pomona was isolated from the kidneys of 87.5% of the slaughter pigs examined. The success of these isolations was attributed in part to the refining of 2 existing isolation techniques which complement each other. Using the microscopic agglutination test, serum samples taken from the same farming unit showed evidence of antibodies to the serovar pomona in 89 out of the 170 bovines (52%), 9 out of the 52 porcines (17%), 2 of the 2 canines (100%), 5 out of the 13 equines (38%) and 2 out of the 152 ovines (1%) that were tested. As far as is known, serological evidence of the serovar pomona in porcines, ovines, equines and canines has never previously been published in the RSA. PMID- 3627727 TI - Demonstration of growth-inhibitory as well as growth-stimulatory factors in medium conditioned by lung lavage cells stimulated with a chemotactic factor secreted by jaagsiekte tumour cells. AB - Both growth-inhibitory and growth-stimulatory factors were detected in vitro in medium from chemotactically stimulated cultures of lung lavage cells. The macrophage component of the lavage cells was found to produce a growth stimulatory factor that was replaced by a growth inhibitory factor following chemotactic factor stimulation. PMID- 3627728 TI - Parasites of South African wildlife. I. Helminths of bushbuck, Tragelaphus scriptus, and grey duiker, Sylvicapra grimmia, from the Weza State Forest, Natal. AB - Thirteen bushbuck, Tragelaphus scriptus, and 13 grey duikers, Sylvicapra grimmia, were culled in the Weza State Forest, Natal, from May 1983-May 1984. The maximum number of worms recovered from a single bushbuck was 393. Of the total number of worms recovered from all the bushbuck, Paracooperia devossi were the most numerous, followed by Ostertagia harrisi, a Cooperia sp. and Haemonchus vegliai. P. devossi and O. harrisi were more numerous during winter and the Cooperia sp. more numerous during summer. Grey duiker harboured from 0-230 worms. The same Cooperia sp. as was recovered from the bushbuck and Trichostrongylus axei were the most numerous. The larvae of Taenia hydatigena were recovered from 5 duikers. The Cooperia sp. was more numerous during summer and T. axei during winter, the remaining worms showing no seasonal pattern of abundance. Amended lists of the helminth parasites found in these antelope in the Republic of South Africa are provided. PMID- 3627729 TI - Descriptions of incisors of known-age Cape mountain zebras, Equus zebra zebra, from the Mountain Zebra National Park. AB - Twelve sets of incisors of Cape mountain zebras, 9 of which were from known-age individuals ranging in age from 11 months to 19 years, from the Mountain Zebra National Park, are described and depicted to illustrate not only the eruption and replacement sequence, but also the changes with increasing age in the configuration of the occlusal surfaces and of the infudibulum. Infundibula persist in maxillary incisors longer than in mandibular incisors. Shallow infundibula were still present in the maxillary incisors of a 19-year-old mare at least 4 years later than in plains zebras, E. burchelli, from the Kruger National Park. The physiological life span of Cape mountain zebras appears to be at least 26 years. PMID- 3627730 TI - African swine fever. II. Functional disturbances of thrombocytes in pigs infected with virulent haemadsorbing and non-haemadsorbing virus isolates. AB - Increased bleeding time, impaired blood clot retraction and decreased thrombocyte aggregation were observed in pigs infected with virulent haemadsorbing and non haemadsorbing African swine fever virus isolates. These changes appeared to be more frequent and more severe in pigs infected with the haemadsorbing virus isolates than in those infected with the non-haemadsorbing isolate. Moreover, the onset and severity of these changes followed the numerical decrease and morphological damage to these cells apparent in the last 2-3 days of the disease. PMID- 3627731 TI - Antibody response in cattle to oil emulsion rabies and ephemeral fever vaccines. AB - A stable oil emulsion rabies vaccine with a low viscosity was composed by a formula previously employed for Newcastle disease vaccine. Cattle developed high and sustained antibody levels, and guinea pigs were found to be solidly immune after a single injection of this vaccine. Antibody responses in cattle to 2 oil emulsion ephemeral fever vaccines were not satisfactory after a single injection, and severe local reactions were encountered when booster injections were applied. PMID- 3627732 TI - A collapsible, semi-automatic, tent-type, emergence trap, suitable for sampling Culicoides (Diptera: Ceratopogonidae) from a wide range of habitats. AB - A lightweight, collapsible, tent-type, trap of 1 m2 floor-area was developed for the collection of emerging Culicoides from a wide range of habitats. It is cheap; easy to build, transport and erect; withstands adverse climatic conditions well; affects the covered habitat only slightly; and needs little attention. Insects are trapped into 0.5% aqueous "Savlon" solution in a removable, modified, 2 litre plastic bottle. In this, the catch remains fresh for up to 2 weeks and is still suitable for identification and mounting for taxonomic purposes. Emergence numbers of 100 or more Culicoides/m2/day are quite common with this trap. PMID- 3627733 TI - Laryngeal cancer, aryl hydrocarbon hydroxylase inducibility and smoking. A follow up study. AB - In 58 cases with laryngeal cancer (10 supraglottic and 48 glottic), aryl hydrocarbon hydroxylase (AHH) inducibility and smoking habits were studied. All but 2 were smokers and most of them heavy tobacco consumers. The AHH levels were divided into high, intermediate and low groups and were compared to a large healthy control material also divided into the aforementioned groups. A highly significant overrepresentation of patients with a high AHH level (p less than 0.0005) as well as a significant underrepresentation of low AHH levels (p less than 0.025) were found. Smokers with a high AHH level run a fourfold risk of developing laryngeal cancer as compared to non-smokers with low AHH levels. They also develop cancer earlier in life and get recurrences and secondary malignancies more frequently. As in oral and oropharyngeal cancer a high AHH inducibility seems to be of pathogenetic as well as of prognostic importance even in laryngeal cancer. PMID- 3627734 TI - Ultrastructural observations on vasomotor rhinitis. AB - The ultrastructure of the respiratory nasal mucosa of patients suffering from vasomotor rhinitis was studied and compared with the reported ultrastructural findings in cases of chronic perennial allergic rhinitis. The principal ultrastructural differences were the absence of interendothelial gap junctions, the scarcity of eosinophils and plasma cells, and the absence of immunologically stimulated or degranulated mast cells in vasomotor rhinitis. These differences were discussed in the light of the known pathophysiologic facts. PMID- 3627735 TI - Long-term results after septal surgery--submucous resection versus septoplasty. AB - Postoperative controls, 5-9 years after surgery, were made in two groups of patients who had undergone submucous septal resection and septoplasty, respectively. The rate of subjective improvement after septoplasty was higher (77%) than after septal resection (66%). In the septoplasty group, however, the experienced surgeons had an improvement rate of 90%, whereas the untrained surgeons had no better results than after submucous septal resection. Postoperative complications, including septal perforation and deformation of the external nose, were significantly fewer after septoplasty. There were no clear cut correlations between rhinoscopy findings and subjective results at postoperative examinations. The septoplasty technique is advocated, but in the hands of a trained surgeon. PMID- 3627736 TI - [Clinico-roentgenological characteristics and surgical treatment of invertebrate complicated injuries of the cervical spine]. PMID- 3627737 TI - [Disability after uncomplicated compression fractures of the vertebral bodies]. PMID- 3627738 TI - [Experience with the rehabilitation of patients with injuries of the spine and spinal cord]. PMID- 3627739 TI - [Wedge-like spinal resection in scoliosis: its possibilities and prospects]. PMID- 3627740 TI - [Cardio- and hemodynamics in adult patients with funnel chest deformity]. PMID- 3627741 TI - [Experience with the surgical treatment of T-shaped fractures of the distal end of the femur]. PMID- 3627742 TI - [Hemosorption in the treatment of intra-articular fractures complicated by suppurative infection]. PMID- 3627743 TI - [A functional method of treating recent malleolar fractures]. PMID- 3627744 TI - [Classification and treatment of open fractures of the foot bones]. PMID- 3627745 TI - [Congenital hollow foot in children]. PMID- 3627746 TI - [Significance of genetic factors in the etiology and pathogenesis of congenital clubfoot]. PMID- 3627747 TI - [Instrumental and surgical methods in treating arthrogrypotic deformities of the extremities in children]. PMID- 3627748 TI - [Roentgenodensitometric and radioisotope studies of reparative osteogenesis after distraction osteosynthesis]. PMID- 3627749 TI - [Enlarged thymus gland syndrome and osteogenesis imperfecta]. PMID- 3627750 TI - [Evaluation of the results of surgical treatment of congenital clubfoot]. PMID- 3627751 TI - [Problem of the treatment of arthrosis of the 1st metatarsophalangeal joint]. PMID- 3627752 TI - [Objective clinical symptom of fracture of the calcaneal protuberance]. PMID- 3627753 TI - [A method of compression osteosynthesis of ununited fractures of the talus]. PMID- 3627754 TI - [A method of tri-articular arthrodesis of the foot]. PMID- 3627755 TI - [An extrafocal method of stabilization of ruptured intertibial articulation and correction of external subluxation of the foot]. PMID- 3627756 TI - [A device for evaluating the contractile activity of the skeletal muscles]. PMID- 3627757 TI - [The problem of slight leg length inequality]. PMID- 3627758 TI - [A variant of the development anomaly of the arch of the 5th lumbar vertebra]. PMID- 3627759 TI - [Indications and results in the conservative and surgical treatment of younger children with congenital hip dislocation]. PMID- 3627760 TI - [Biomechanical characteristics of the injured segment after one-stage closed reduction of dislocations of the cervical vertebrae by the Richet-Hueter method]. PMID- 3627761 TI - The triose model: glyceraldehyde as a source of energy and monomers for prebiotic condensation reactions. AB - Glyceraldehyde acts as a source of energy and monomers in a new model of the origin of life. The simplest form of the model functions by converting formaldehyde from the environment into glyceraldehyde which spontaneously forms hemiacetal adducts that are oxidized to polyglyceric acid. Polyglyceric acid, in turn, acts as an autocatalyst with a rudimentary replicating ability. A unique property of the model is its ability to unite the origin of metabolism and the origin of polymer synthesis into a single process. Furthermore, the chemical resemblance of the model to glycolysis gives it the potential to develop a biological metabolism in a straightforward manner. PMID- 3627762 TI - Soluble minerals in chemical evolution. II. Characterization of the adsorption of 5'-AMP and 5'-CMP on a variety of soluble mineral salts. AB - The adsorption of 5'-AMP and 5'-CMP was studied in saturated solutions of several soluble mineral salts (NaCl, Na2SO4, MgCl2 X 6H2O, MgSO4 X 7H2O, CaCl2 X 2H2O, CaSO4 X 2H2O, SrCl2 X 6H2O, SrSO4, and ZnSO4 X 7H2O) as a function of pH, ionic strength, and surface area of the solid salt. The adsorption shows a pH dependence; this can be correlated with the charge on the nucleotide molecule which is determined by the state of protonation of the N-1 nitrogen of 5'-AMP or N-3 nitrogen of 5'-CMP and the phosphate oxygens. The adsorption which results from the binding between the nucleotide molecule and the salt surface is proposed as being due to electrostatic forces. It was concluded that the adsorption was reversible in nature. The adsorption shows a strong dependence upon ionic strength and decreases with increasing ionic strength. Surface area is shown to be an important factor in evaluating and comparing the magnitude of adsorption of nucleotides onto various mineral salts. The implications of the results of the study are discussed in terms of the importance of soluble mineral salts as adsorption sites in the characterization of the adsorption reactions of an adsorbed template in biogeochemical cycles. PMID- 3627763 TI - The biogeochemical cycle of the adsorbed template. I: Formation of the template. AB - Experimental results are presented for the verification of the first adsorption step of the 'adsorbed template' biogeochemical cycle, a simple model for a primitive prebiotic replication system. The adsorption of Poly-C, Poly-U, Poly-A, Poly-G, and 5'-AMP, 5'-GMP, 5'-CMP and 5'-UMP onto gypsum was studied. It was found that under the conditions of the experiment, the polymers have a very high affinity for the mineral surface, while the monomers adsorb much less efficiently. PMID- 3627764 TI - Chemical evolution of the citric acid cycle: sunlight photolysis of alpha ketoglutaric acid. AB - Sunlight photolysis of alpha-ketoglutaric acid produces succinic acid as a major product. Other higher molecular weight products are identified by GC-MS analysis. These results provide further support for the important role of succinic acid in chemical evolution. PMID- 3627765 TI - Papers from the 1986 ISSOL meeting. Berkeley, California, July 1986. PMID- 3627766 TI - The formation of amino acid precursors in the reaction of atomic carbon with water and ammonia at 77 K. AB - When atomic carbon is condensed on a surface at 77 K containing ammonia and water, glycine, N-methylglycine, alanine, beta-alanine, aspartic acid and serine are generated. It is postulated that these reactions may mimic those which occur when an extraterrestrial carbon atom condenses on a frozen surface coated with water and ammonia and may provide a route to extraterrestrial amino acids. Experiments designed to elucidate the mechanisms of amino acid formation under these conditions have been carried out. PMID- 3627767 TI - Liposomes with polyribonucleotides as model of precellular systems. AB - A study of the encapsulation of poly(U) and poly(C) within liposomes made from dipalmitoylphosphatidyl choline (DPPC), from egg yolk phosphatidyl choline (PC), and from PC with cholesterol (CHOL) was made. The liposomes were prepared under anoxic conditions following the reverse-phase evaporation method. Determinations showed that 36 to 70% of the available lipids form liposomes and 2 to 5% of the polyribonucleotides can be entrapped by liposomes. The encapsulation of polyribonucleotides has also been measured in the presence of urea, cyanamide and Zn++, condensing agents in prebiotic polymerization reactions. DPPC and PC:CHOL liposomes were formed in the presence of 1.0 M urea, although no PC liposomes were formed. The three types of liposomes were readily formed at 0.01 M urea, but in no case an enhancement of encapsulation efficiency of poly(U) was observed due to the presence of urea. Similar results were obtained with cyanamide. An enhanced encapsulation of poly(U) by the three types of liposomes was observed when Zn++ was in the range of 0.001 to 0.01 M. Poly(U) encapsulation was 15 to 25 times higher when liposomes were prepared from DPPC at 0.01 M Zn++. Similar results were obtained with poly(C). The advantages of DPPC-polyribonucleotide liposomes as precellular systems are discussed. PMID- 3627769 TI - Nucleic acid-like structures. II. Polynucleotide analogues as possible primitive precursors of nucleic acids. AB - Activated derivatives of purine-containing deoxynucleoside- diphosphates spontaneously oligomerize to produce pyrophosphate- linked oligodeoxynucleotide analogues. These analogues are of potential interest as models of primitive, polynucleotide precursors. The efficiency of oligomerization (ImpdGpIm and ImpdApIm much greater than ImpdIpIm) appears to reflect a combination of stacking forces and the specific geometric orientations of the stacked units. Under favorable conditions, chain lengths greater than 20 have been obtained for oligomers containing pdGp in the absence of a template. In the presence of a complementary template, the activated derivatives of pdGp and pdAp oligomerize much more extensively. An acyclo-analogue of G has also been shown to undergo template-directed oligomerization on pol (C). These observations suggest the possibility that primitive information transfer might have evolved in much simpler systems and that this function was taken over by polynucleotides at a later stage in evolution. PMID- 3627768 TI - Kinetic analysis of the template effect in ribooligoguanylate elongation. AB - We have undertaken a complete kinetic analysis of the template-directed oligoguanylate synthesis originated in Orgel's laboratory (Inoue and Orgel, 1982). The reaction of guanosine 5'-phospho-2-methylimidazolide, 2-MelmpG, with ribooligoguanylates all 3'-5' linked, designated n3 with n = 7-12, was studied in the presence/absence of the complementary template polycytidylic acid, poly(C). Conditions were chosen where poly(C) and 2-MelmpG are in large excess over the oligoguanylate. In the absence of the template at 37 degrees C the reaction leads to three isomeric oligomers that are elongated by one monomer unit. They are the 3'-5' linked, (n + 1)3, the 2'-5' linked, (n + 1)2, and the pyrophosphate product, (n + 1)p, formed in an approximate ratio 1:2:5. In the presence of the template the reaction is 20-fold faster and yields products n + 1, n + 2, n + 3 etc. as long as 2-MelmpG is available. Most importantly the formation of the natural, 3'-5' linked isomer, is enhanced selectively by 140-fold at 37 degrees C. Qualitative observations allow the conclusion that this enhancement is temperature dependent and increases with decreasing temperature. For example, at 1 degree C only the 3'-5' linked isomers were detected. Initial rates for the disappearance of the n3 oligoguanylate were determined at 1, 23, and 37 degrees C. It was found that the pseudo-first order rate constant for oligoguanylate elongation was linearly proportional to the 2-MelmpG concentration. This implies that the reaction complex poly(C).n3.2-MelmpG does not accumulate under the reaction conditions, a conclusion which is also supported by infrared data (Miles and Frazier, 1982). The implication of the above results with respect to chemical evolution is that lower temperatures, i.e., close to freezing, enhance the regioselectivity of these template-directed reactions and that one way to improve replication models may be sought in finding conditions that favor stable reaction complexes. PMID- 3627770 TI - Binding of DNA hairpins to an assembler-strand as part of a primordial translation device. AB - A crucial event in the process leading to the origin of life is the emergence of a simple translation device. To approach experimental realization of this device the binding ability of short DNA hairpins to complementary oligonucleotides fixed on a solid support was investigated. The binding is achieved by base pairing between the loop nucleotides of the hairpins containing different numbers of adenosine residues and oligothymidylates covalently linked to cellulose. The loop has to consist of at least five nucleotides to achieve binding. The exact number of established base pairs was determined in two ways. First, the elution temperatures of hairpins and those of oligoadenylates which had the length of the loop were compared. Secondly, the architecture of the loop was analyzed by means of the single-strand-specific nuclease from mung bean acting as structural probe. Only n-2 of n loop nucleotides of a hairpin are able to form base pairs. Therefore, a strong evidence for the formation of a triplet of base pairs between primeval tRNA and mRNA sufficient to stabilize the complex enzyme-free is given. PMID- 3627771 TI - Selective emergence and survival of early polypeptides in water. AB - Oligopeptides essential to primitive cells could not be obtained just by raising the background noise of organic compounds produced by a prebiotic chemistry working at random. Selection pathways were required. Experimental evidence is given for selective condensation of amino acids in water as well as for selective resistance to degradation. It is shown that N-carboxyanhydrides are good candidates for chemical selection in water. They are formed when active esters of amino acids are left in the presence of bicarbonate ions or when N,N' carbonyldiimidazole is used as condensing agent. Polymerization of a mixture of proteinaceous and non-proteinaceous amino acids leads to an enrichment in the proteinaceous ones plus alpha-aminobutyric acid. Selective resistance toward degradation of beta-pleated sheet conformation is used to exemplify a possible accumulation of homochiral sequences made of hydrophilic and strong hydrophobic residues. Amino acids with branched aliphatic side-chains are selected but those having short linear aliphatic side-chains such as alpha-aminobutyric acid or norvaline are not. PMID- 3627772 TI - Search for catalytic properties of simple polypeptides. AB - Simple polypeptides were used as possible supports for nucleotide polymerization, in the absence of any preformed polynucleotide template. Sequential copolymers of alanine and glycine, water soluble polypeptides based on arginine and poly(Glu Ser-Glu) have been tested. No catalytic effect has been found although poly(Glu Ser-Glu) favors the 2'-5' internucleotide linkage. More interestingly, polypeptides containing arginine residues strongly accelerate the hydrolysis of oligoadenylic acids. The influence of pH, temperature, nature of the buffer and polypeptide sequence was investigated. PMID- 3627773 TI - The relationship between the biosynthetic paths to the amino acids and their coding. I: The aliphatic amino acids and proline. AB - The genetic code could not have been fixed until the means for biosynthesis of the amino acids was at hand. The biosynthetic enzymes could not be optimized until the genetic code ceased to be rearranged. Therefore the development of the code and the development of the biosynthesis of the amino acids occurred concurrently. The present day biosynthetic pathways of amino acids, examined from this point of view, help to explain the present set of coded amino acids, in particular the absence of norvaline, norleucine, homoserine, ornithine, and alpha aminobutyric acid. An order of development of biosyntheses is also proposed. Lysine was first, followed by valine and isoleucine. The more common primordial amino acids did not need biosyntheses so early. The central pathways of metabolism probably developed in response to a need for amino acid biosynthesis. PMID- 3627774 TI - Structural elements and organization of the ancestral translational machinery. AB - The molecular mechanisms underlying the primitive translational apparatus have been studied in light of present day protein biosynthesis. Using the structural information available from the contemporary system as a key to its function, both the structural necessities for an early adaptor and the multipoint recognition properties of such adaptors have been investigated. This was done by first critically examining the potential feasibility of right- and left-handed hairpin adaptor models. Second, a molecular model of the contemporary transpeptidation complex has been constructed in order to ascertain the structural requirements of the adaptor molecule needed for peptidyl transfer. Third, a model of the tRNATyr tyrosyl tRNA synthetase complex including the positioning of the disordered region is proposed. This model is used to illustrate those required recognition properties of aminoacyl synthetase which lead to a perspective on the structure of the ancestor synthetase. PMID- 3627775 TI - Information theory and the genetic code. AB - The genetic code, which directs the protein biosynthesis, is an information system. Although all its details are not known at present, its essential characteristics are elucidated, as well for the replication or transcription as for the translation of the genetic message. A coherent picture now appears, which reveals the existence of an universal structure, the most fundamental features of which seem to obey some logic. A systematic approach has been devised, which aims to their integration in a theorectical scheme: many features of the code table can thus be interpreted as resulting from a unique principle of best resistance against the effects of mutations. Any group of triplets or amino-acids can be considered along this line. It is more difficult however, to analyse the coexistence of two (or more) different groups. In this work, we propose to extend our optimization principle into a more general one, which includes the notion of information as defined by Shannon. We explore some consequences of this new principle in the most simple models that one can build for the origin and evolution of the genetic code. PMID- 3627776 TI - Case of intrahepatic calculi with bile duct stenosis caused by portal branch compression. PMID- 3627777 TI - Production and characterization of osteoclast-specific monoclonal antibodies. PMID- 3627778 TI - [Proportion of abnormal karyotypes found in chromosome studies for abnormal phenotypes]. PMID- 3627779 TI - [Increase of non-specific pancreas esterase (E.C.3.1.1.-) in the blood in experimental acute pancreatitis]. PMID- 3627780 TI - [Suicide attempt with Minipress]. PMID- 3627781 TI - [Pulmonary alveolar proteinosis diagnosed by bronchoalveolar lavage]. PMID- 3627782 TI - [Calcitonin therapy in postmenopausal osteoporosis]. PMID- 3627783 TI - [The course of hypertrophic cardiomyopathy with outflow obstruction in patients under treatment]. PMID- 3627784 TI - [Stomach cancer in the scar of a healed ulcer]. PMID- 3627785 TI - [Detection of paraproteins in the cerebrospinal fluid of patients with paraproteinemia and the role of these proteins in the development of clinical symptoms]. PMID- 3627786 TI - [Patients with alcohol problems in a medical ward]. PMID- 3627787 TI - [Prenatal diagnosis of fetal rubella infection]. PMID- 3627789 TI - [The current status of cementless endoprostheses]. PMID- 3627788 TI - [Treatment of severe endocrine ophthalmopathy with cyclosporin A]. PMID- 3627790 TI - [Technology of cementless hip endoprosthetics]. AB - The success achieved with non-cemented hip arthroplasty depends mainly on the stability of the fixation, the quality of the stabilizing bone being just as important as favourable biomechanical conditions. The results of the intensive research and development with respect to the particular features of a non cemented hip endoprosthesis can be divided into the following basic categories: Biomechanical aspects with special reference to bone related to the design of the prosthesis; material characteristics, such as fatigue strength, tribology, corrosion resistance, and biocompatibility; and development of new materials and coatings to permit direct bonding of implant and bone. With regard to the stem of hip prostheses, the different design parameters of various types are examined to determine their typical design characteristics, such as bearing surface of the collar, geometry of cross section, anatomically adapted shaping, and surface of the implant forming the contact with the bone. The latter can be divided into macroprofiles and macro- and micro-porous coated surfaces. On the other hand, the methods of cementless fixation of acetabular cups can be primarily divided into conical and spherical screw fixation and pegged fixation with additional macroprofiles of porous surfaces. In a separate study of the biomechanical aspects of screwed sockets, the special importance of socket shape and thread geometry are presented with reference to primary stability and long-term fixation of prostheses. PMID- 3627791 TI - [Experiences, requirements and development of cement-free hip endoprostheses]. AB - The main problem with endoprostheses, particularly the cementless type, is the transmission of stress from the implant to the bones and vice versa. Cement is a very good solution--at least on a short-term basis. However, the major aim in using cementless endoprostheses is to improve the long-term results as compared with those obtained when using cement. To date, this has not been possible either with more modern cementing techniques (pressurization) or with cementless endoprostheses based on the principle of bony ingrowth. The differences between cementless endoprostheses and those using cement are: the design, the nature of the implant surface, and the operative technique. Experience has shown that histologically, radiologically, and clinically (although not long-term), the results with cement-fixed acetabula are better than those with cementless prostheses. Cement-free shaft endoprostheses, on the other hand, have not yet achieved the consistently good results obtained in the femur shaft by means of pressurization. Under normal circumstances, use of a cementless acetabulum and a cement-fixed shaft is the procedure of choice. In patients under 60 years of age who are still active, as well as in repeat-arthroplasties involving substantial loss of bone, the completely cementless endoprosthesis is indicated. PMID- 3627793 TI - [Cementless fixation in endoprosthetics]. AB - Prostheses have been fixed to the skeleton with polymethylmethacrylate for some 30 years. Many of these prostheses have failed with time, and failure has been blamed on the use of polymethylmethacrylate. Methods of fixing endoprostheses without cement have been developed in recent years. It is argued in this paper that the most important precondition for fixation is stable press-fit of the implant. Other methods of supplementary fixation, such as porous ingrowth, have been developed. However, there is little evidence to suggest that this ingrowth improves the immediate clinical result, if it occurs at all. PMID- 3627792 TI - [Surface structures and bone ingrowth in cement-free fixed prostheses]. AB - Non-cemented implants are used primarily for hip and knee arthroplasties. Bone ingrowth into porous surfaces of different materials is required. Criteria of long-term success are primary stable fixation and the achievement of intimate bone contact by press-fit. However, animal experiments show that interdigitation with porous coating induces osteoporosis of the surrounding cortex. It appears that bony fixation gives rise to fewer problems in the acetabulum than in the femur. The results of animal experiments and follow-up studies in humans are used to compare potential problems of fixation without cement with the results obtained with bone cement. PMID- 3627794 TI - [Current knowledge and future perspectives of cementless endoprosthetics]. AB - The current problems facing the clinician, regarding young patients whose hips and knees have completely deteriorated, involve a return to function, as well as a longer life for the prosthesis than that rendered by cement fixation. The alternatives to cemented primary fixation devices have not yet with stood the test of time. In addition, when aseptic loosening of cemented prostheses occurs, cemented revisions have already demonstrated a high failure rate after a short term follow-up, particularly in the hip. A follow-up period of up to 6 years for a cementless total knee and a short-term follow-up for a cementless hip (up to 3 years), using a porous metal bone contact surface, have shown very satisfactory clinical results in primary total hip and knee prostheses and revision of the total hip without the use of bone cement. These early results justify continuation of this clinical trial. PMID- 3627795 TI - [Personal experiences with uncemented prostheses]. AB - Experience with different types of non-cemented total hip endoprostheses is critically discussed. Three radiological criteria of a good result indicated: the presence of radiolucent lines, cancellous transformation, and a particular appearance and thickness of the cortex. The radiological changes and clinical results make it possible to draw a 'survival curve' for each type of implant. This series shows that unsatisfactory results have been due mostly to primary diaphyseal, distal fixation of the prosthetic stem. The CLS prosthesis, with mainly metaphyseal primary anchorage, is presented. Discussion of the radiologically and histologically established response of bone. PMID- 3627796 TI - [Bone fixation of tumor endoprostheses with cast-on spherules of a cobalt-base alloy]. AB - Special tumor endoprostheses manufactured from cobalt-base alloy with cast-on globules upon the intramedullary shaft and two paracortical flanges for screw fixation can be stabilized at the ends of long bones without using bone cement. Three such implants, retrieved in clinically stable condition after 3 months (proximal tibia), 5 months (distal humerus), and 13 months (distal femur), were investigated microscopically: new bone was found immediately adjacent to the porous surface structures and the fixation screws in many areas. The contribution of bone fragments originating from the preparation of the implant bed to this bone reaction was extremely slight. On the other hand, fibrous tissue layers and a foreign body reaction were found on the remaining surfaces, which may have been related to the compatibility of the implant material and must therefore be regarded as detrimental for the long-term prognosis concerning the fixation of such implants. PMID- 3627797 TI - Effect of imposed retinal image movements on colour vision at a heterochromatic boundary in a stabilized retinal image. AB - A stabilized image, including a straight-line boundary between two areas of different colour was displayed. Movements normal to itself were imposed on this boundary while other boundaries remained stabilized. Broad band filters giving red, yellow, green and blue were used in various pairs. Step movements, pulse movements and oscillatory movements (including sinusoidal, triangular and square wave forms) were applied in turn. Threshold movements to give perception of hue were measured for steps and pulses and signal/photon-noise ratios were calculated for a red/blue boundary. The ratio was found to be constant at a value of about 20 when the retinal illuminance (ER) varied between 5 td and 60 td. When ER was increased (up to 2000 td) the ratio increased rapidly. None of the colour appearances produced by moving the boundary exactly matched the corresponding appearances in an unstabilized image, though the nearest matches were obtained with oscillatory movements of frequency 2 Hz and displacement greater than 5'. PMID- 3627798 TI - Corneal thickness and diameter in the domestic cat. AB - Two sample groups of domestic cats were assessed for (a) central corneal thickness (17 eyes), using optical pachymetry, and (b) horizontal and vertical corneal diameter, using a photographic method (20 eyes). The average corneal thickness was 0.755 +/- 0.33 mm. The mean horizontal diameter was 16.5 +/- 0.60 mm and the mean vertical diameter was 16.2 +/- 0.61 mm. The horizontal corneal diameter was significantly greater than the vertical corneal diameter (p less than 0.001, paired t test). PMID- 3627799 TI - Effects of prolonged forced vergence upon the adaptation system. AB - In previous studies the ability of the oculomotor system to adapt to prism induced heterophoria has been shown. The 'phoria that occurs immediately after a prism has been placed before one eye gradually reduces and returns to its original baseline value as the subject is allowed binocular experience while wearing the prism. Little work has been carried out to determine when the adaptation is complete. In this study we report on the results of two experiments designed to determine when adaptation is complete. In the first, the rate of decay of adaptation, i.e. loss of slow fusional vergence, is measured after varying periods of forced vergence. In the second experiment the rate of adaptation to an additional disparity is measured; this should be the same as that before the induced effect if adaptation is complete. The results of this study indicate that although adaptation may appear complete by the criterion that the 'phoria has returned to its baseline value, the adaptation is unlikely to be truly complete for a much longer period of time has passed. PMID- 3627800 TI - Comparison of Wesson and modified Sheedy fixation disparity tests. Do fixation disparity measures relate to normal binocular status? AB - A new fixation disparity measuring device, the Wesson Fixation Disparity Card, is compared with the modified Sheedy Disparometer. Twenty-eight subjects were divided into normal and abnormal categories of binocular status determined by classical clinical techniques rather than on patients' subjective symptomatology. Fixation disparity curves were generated on all subjects using both instruments. There were significant differences between the two instruments. Neither instrument was able to distinguish between normal and abnormal subjects but, over a five day period, each instrument produced repeatable results. The validity of fixation disparity measurements using either instrument on naive observers, especially children, is questioned. PMID- 3627801 TI - The cortical representation of gradient-adapted multiple-stimulus perimetry. AB - Some stimuli, if scaled in proportion to the reciprocal of inter ganglion cell receptive field separation (M-scaled) exhibit an isosensitivity profile. Perimetric profiles which are isosensitive across the extent of the normal visual field facilitate multiple stimulus perimetry and provide a convenient method for the detection of abnormality. The purpose of the investigation was to establish whether the stimulus diameters necessary to produce an isosensitive perimetric profile were scaled in proportion to M. Sensitivity profiles for a sample of 15 age-matched observers were obtained with the Friedmann VFA Mk II. The stimulus aperture diameters were then measured under 100 X magnification. The observed elliptical apertures, corrected for obliquity of viewing, plate thickness and distance from the eye were represented as diameters of circles possessing an equivalent area to that of the ellipse. The apparent diameters were then M-scaled relative to stimulus pattern h using the equations of Rovamo and Virsu (1979). An overestimation of the M-scaled diameters relative to the apparent diameters was noted which increased with eccentricity for all four cardinal meridians by a factor of up to 3.5 times. It is suggested that the over compensation indicates that the cortical representation of perimetric spot targets at low photopic adaptation levels depends not only upon retinal ganglion cell density but also upon the variation of ganglion cell characteristics with eccentricity. The implications of this finding for perimetric instrument design are discussed. PMID- 3627802 TI - A new photographic-based system for the measurement of contrast sensitivity. AB - A new photographic-based system has been developed for the measurement of contrast sensitivity in human vision. The system has several advantages over other photographic methods and is relatively easy and inexpensive to produce. This paper describes the design of the new system and the methods used in the production of the photographic prints. Preliminary tests show that full contrast sensitivity curves can be obtained with a small number of photographic prints and that these curves are very similar to those obtained using a carefully calibrated electronic pattern generator. PMID- 3627803 TI - Effect of Fresnel prism dispersion on contrast sensitivity function. AB - Fresnel prisms are often used in orthoptics for binocular anomalies and in low vision for visual field defects. These prisms are made of optical polyvinyl chloride (PVC) and this material increases chromatic dispersion and produces a loss of contrast. In this study, the effect of chromatic dispersion on contrast sensitivity is determined. Contrast thresholds over a wide range of spatial frequencies are obtained on a number of subjects with the use of Fresnel prisms ranging from 5 to 30 prism dioptres. As predicted there is a decrease in visual acuity and cut-off spatial frequency threshold as prism power increases. Similarly, a decrease in contrast sensitivity at high and medium spatial frequencies is recorded. PMID- 3627804 TI - Two simple calculating schemes for use in ophthalmic optics--II. Tracing axial pencils through systems including astigmatic surfaces at random axes. AB - A paraxial computing scheme is described for tracing an axial pencil of rays through any system containing astigmatic surfaces with their axes at random. In conjunction with a scheme for tracing oblique rays (Bennett, 1986) it is applied to a problem in visual optics posed by Keating (1982). This involves determining the spectacle magnification for a schematic eye with three strongly astigmatic surfaces, corrected by a spectacle lens of bi-toroidal form, the axes of all five surfaces being mutually oblique. It is shown that the suggested computing schemes yield very similar results to those found by the matrix methods of Keating. Although only two rays are needed to determine the principal dimensions of the basic retinal image of a circle, further insight into its true shape is obtained from a multiple trace, using a computerized version of the ray tracing scheme. PMID- 3627805 TI - Predicting visibility in turbid media. PMID- 3627806 TI - Health cost containment council in high gear. PMID- 3627807 TI - Acupuncture--what we should know. PMID- 3627808 TI - Successful participation in prepaid plans. PMID- 3627809 TI - The Medical Practice Act of 1985. Part VII--General provisions included in the regulations for implementing the act (chapter 16). PMID- 3627810 TI - New drugs for use in 1987--part three. PMID- 3627811 TI - Ten years experience in the treatment of benign cysts of the pancreas. PMID- 3627812 TI - Dietary management in patients with a colostomy. PMID- 3627813 TI - Hysteroscopic retrieval of occult IUD. PMID- 3627814 TI - Hysteroscopy in the study of sterility. PMID- 3627815 TI - Measurements of the increase in the difference between the arterial and venous Hb O2 saturation obtained with daily administration of 200 mg standardized ginseng extract G115 for four weeks. Long-term increase of the O2 transport into the organs and tissues of the organism through biologically active substances. PMID- 3627816 TI - ACE monitoring in pneumoconiosis. Presentation of a case series and review of the literature. PMID- 3627817 TI - Synthetic Diosmin in the therapy of venous diseases. PMID- 3627818 TI - Propionhydroxamic acid in the treatment of infected complex renal calculosis. PMID- 3627819 TI - Data collection on spinal cord injuries: urological outcome. AB - Analysis of 628 consecutive admissions to the Spinal Injuries Unit, Austin Hospital, between July 1978 and December, 1985 illustrates the value of a comprehensive data collection system which has been developed at the hospital since 1978. Some brief epidemiological data is presented, together with a detailed analysis of the urological outcome of patients with traumatic lesions whose discharge has been completed. A high rate of catheter-free status and urine sterility at discharge is reported, and factors affecting these results are analysed. The authors hope that an international system of data collection can be developed in the future to allow meaningful comparison of results between units. PMID- 3627820 TI - The elderly para- and tetraplegic: special aspects of the urological care. AB - This paper evaluates the influence of age on bladder rehabilitation and the incidence of secondary changes in the urinary tract with long standing paraplegia and tetraplegia and its consequences for the elderly patient. It demonstrates that age makes bladder rehabilitation in these patients more difficult, because of the decreased ability of the elderly to cope with the new situation, of pre existing factors interfering with micturition like benign prostatic hyperplasia and cystocele and because of a delayed and at the end sometimes weak detrusor reflect activity. Long standing paraplegia is characterised by a high percentage of secondary structural changes in the lower urinary tract, especially at the bladder outlet. Once these changes are established the outflow resistance is further increased. These findings stress the need for early adequate management of the functional outflow obstruction based on careful urodynamic evaluation, before secondary structural changes occur. In this connection it is pointed out, that passive voiding by abdominal straining or by the Crede technique may cause unphysiologically high intravesical and intra-abdominal pressures and should then be replaced by intermittent catheterisation. PMID- 3627821 TI - Decompression of the spinal cord improves recovery after acute experimental spinal cord compression injury. AB - The value of decompression after spinal cord injury in patients is still an unresolved issue. It has previously been shown in our laboratory that functional recovery in rats after cord compression varied with both the force and time until decompression. However, the longest duration studied was only 15 minutes, which is far less than that usually encountered in clinical practice, and therefore, the present study was undertaken to determine the value of decompression after more prolonged periods of compression. A factorially designed experiment with five rats per cell was used with the clip compression injury model. Forces of 2.3, 16.9 or 53.0 gms were applied at C7-T1 until decompression was performed after 15, 60, 120, or 240 minutes of compression. Functional recovery was assessed weekly for 8 weeks using the inclined plane technique. Maximum and minimum performance limits were established in normal rats and rats with cord transection, respectively. Univariate analysis and multiple comparison tests were used to analyse the data. The major determinant of recovery was the force of the injury. For example, the animals injured by the 2.3 gm clip performed significantly better than those injured at higher forces for all times until decompression (p less than 0.0001), and there was a significant difference in recovery between the groups injured by the 16.9 and 53.0 gm clips, although only for the 15 minutes until decompression group (p less than 0.05). The time until decompression also affected recovery, but only for the lighter compression forces (2.3 and 16.9 gm). For example, animals decompressed after 60 minutes of 2.3 gm compression recovered significantly better than those decompressed after 240 minutes (p less than 0.05). Thus, if the initial injury force is small, decompression is beneficial even after prolonged injury. PMID- 3627822 TI - The diagnosis and management of post traumatic syringomyelia. AB - We have reviewed 21 cases with the clinical diagnosis of Post Traumatic Syringomyelia (P.T.S.). Fifteen of these cases had proven syrinx formation on Contrast Computed Tomography (C.C.T.) and the other 6 had obviously abnormal cords. A much earlier onset of P.T.C.M. was found in complete spinal injuries than in incomplete ones. We have discussed the technique of contrast computed tomography used at this hospital, its value in the diagnosis of this condition and its ability to define actual spinal cord structure. Most cases (91%) benefitted from surgery and several had marked sensory improvement, which previously has been described as unusual. Syringo-cisternal shunting, a new technique for the drainage of cervical and upper thoracic syrinxes is described. A theory is proposed to explain why, in some patients with classical presentations of P.T.S., no syrinx was found on C.C.T., although abnormal cords were found in all cases. It is felt that these abnormal areas of spinal cord are responsible for the presenting symptomatology and may be precursors of syrinxes. PMID- 3627823 TI - The present state of surgical rehabilitation of the upper limb in tetraplegia. PMID- 3627824 TI - Family functioning and functional independence in spinal cord injury adjustment. AB - The relationships among functional independence, perceived family functioning and duration of disability were studied in 41 non-institutionalised post-traumatic spinal cord injury (SCI) families. Correlational analyses revealed that SCI subjects with greater self initiation of activities, increased social involvement and higher overall level of independence perceived their family environment as affectively responsive, open in communication and clear in delineation of role responsibilities. The 'significant other's' (A 'significant other' is designated by the SCI subject as 'the one most involved with you'. The 'significant other' had to be living with or within 25 miles of the SCI subject and in contact at least 3 times a week.) view of the family was unrelated to SCI function. Conversely, for the significant other but not the SCI subject, greater duration of disability predicted more concern for the family's ability to problem solve, delineate roles and maintain standards of behaviour control. Of the functional areas measured, only participation in outside activities increased significantly over time. The results are discussed in terms of the importance of considering the long-term and separate rehabilitation needs of the individual with a SCI and his or her family. PMID- 3627825 TI - Isolation and characterization of a monoclonal anti-P30 antibody resistant mutant of Toxoplasma gondii. AB - Of the possible iodine-labelled Toxoplasma gondii surface proteins, P30 (apparent Mr 30,000) is the principal one recognized by acute and convalescent anti toxoplasma sera. This protein which comprises from 3 to 5% of the total parasite protein was used to raise a panel of parasiticidal monoclonal anti-P30 antibodies. One of these monoclonal antibodies was able to select a resistant mutant from a large population of chemically mutagenized wild-type P strain parasites. This mutant retained the wild type sensitivity to other non-P30 parasiticidal monoclonal antibodies as well as polyclonal anti-P30 rabbit sera. Analysis of surface radioiodinated wild type and mutant parasites showed that the mutant had a quantitative reduction in the amount of P30. A comparison of surface biotin labelled wild type and resistant parasites by two dimensional electrophoresis showed that the mutant lacked one and possibly two of several proteins that make up wild type P30. Western blot analysis indicated that the mutant was devoid of antigenically reactive P30. These findings further support the hypothesis that antigenic variants of T. gondii can be induced and may involve the major surface membrane antigens of the parasite. PMID- 3627826 TI - Trichinella spiralis: intestinal expression of systemic stage-specific immunity to newborn larvae. AB - Rats immunized with newborn Trichinella spiralis larvae i.v. were found to confer a specific anti-newborn larvae immunity in the small intestine. In rats immunized with newborn larvae i.v. and then challenged with adult worms intraintestinally, total newborn larvae recovery was reduced by 75-90% in thoracic duct lymph and in hepatic portal vein blood. No newborn larvae were found in the peritoneal fluid of immunized rats. In addition to an absolute reduction in number, larval migration from the small intestine to the thoracic duct was delayed by 6-12 h and migration to the portal vein was inhibited for at least 8 h. The establishment of adult worms in the small intestine and female worm fecundity were not affected by anti-newborn larvae immunity. Identical quantitative effects on newborn larvae migration from the small intestine were achieved by homologous transfer of anti newborn larvae immune serum i.v. into naive recipient rats. PMID- 3627827 TI - Localization of mucosal mast cells in W/Wv mice after reconstitution with bone marrow cells or cultured mast cells, and its relation to the protective capacity to Strongyloides ratti infection. AB - Localization of mast cells in the intestinal epithelium, villous lamina propria and basal lamina propria of mast cell-deficient WBB6F1 (W/Wv) mice reconstituted with either bone marrow cells or with cultured mast cells (BMMC) was compared to that of mast cell-sufficient C57BL/6 or C57BL/6-bgj/bgj (beige) mice after infection with Strongyloides ratti. In mast cell-sufficient C57BL/6 or beige mice, the maximum number of intestinal mucosal mast cells (MMC) was more than 160 MMC/10 villus crypt units (VCU) and more than 90% of MMC were located in the intestinal epithelium. When W/Wv mice were reconstituted with bone marrow cells of beige mice, worm expulsion was hastened and the MMC response became comparable to that of mast cell-sufficient mice in terms of cell numbers and their intra epithelial localization. On the other hand, when W/Wv mice were reconstituted with BMMC of beige mice, only a few donor type MMC were detected in the intestine. The proportion of intra-epithelial MMC was lower than that of mast cell-sufficient mice or of marrow-reconstituted W/Wv mice. Even repeated injection of BMMC could not fully restore the number of intra-epithelial MMC to the level of that observed in mast cell-sufficient mice. Since mast cell-growth factor-producing activity of W/Wv mice was comparable to that of mast cell sufficient mice, the ineffectiveness of BMMC-transfer in restoring protective activity or MMC responses in W/Wv mice seems to be attributed to the functional immaturity or inactivity of BMMC. PMID- 3627828 TI - [Endogenous intoxication in the pathogenesis of post-resuscitation disease]. PMID- 3627829 TI - [Hyperbaric oxygenation in the therapy of hypoxic brain damage]. PMID- 3627830 TI - [Stages of post-resuscitation disease in patients with massive blood loss and trauma]. PMID- 3627831 TI - [Bioelectrical activity of the subendo- and subepicardial areas of the myocardium in ventricular fibrillation]. PMID- 3627832 TI - [Effect of ionol on acid-base equilibrium and ionic shifts in emotional stress]. PMID- 3627833 TI - [Role of acidosis in the development of postischemic brain edema in rabbits]. PMID- 3627834 TI - [Oxidative phosphorylation in the cerebral hemispheres in experimental myocardial infarct]. PMID- 3627835 TI - [Energy metabolism characteristics and myocardial contractile capacity in rats with various sensitivities to oxygen deficiency]. PMID- 3627836 TI - [Electrocardiographic indices of myocardial changes in animals with different resistance to hypoxia during the development of adrenaline-induced myocardial dystrophy]. PMID- 3627837 TI - [Compensation mechanisms for the activity of the heart and its blood supply in human myocardial infarct]. PMID- 3627839 TI - [Characteristics of coronary blood flow in the area of myocardial ischemic damage under various types of coronary perfusion disorders]. PMID- 3627838 TI - [Effect of hypercholesterolemia on the macroergic content and size of necrotic area in the heart muscle in acute coronary occlusion in rabbits]. PMID- 3627840 TI - [Participation of the lungs in the absorption of middle molecules from the blood]. PMID- 3627841 TI - [Enzymatic activity of microsomal hydroxylation in chronic liver diseases]. PMID- 3627842 TI - [Device for the removal of low-molecular toxic substances from the blood]. PMID- 3627843 TI - [Experimental model of the peroxide toxicity of peroxisomes]. PMID- 3627844 TI - Primary splenic Hodgkin's disease. Case report. PMID- 3627846 TI - Clara cell and type II pneumocyte adenoma. An immunocytochemical and ultrastructural study of three cases. PMID- 3627845 TI - [Latent carcinoma of the prostate. Autopsy study of 100 cases]. PMID- 3627847 TI - [Focal nodular hyperplasia of the liver. Anatomo-pathologic and clinico radiologic evaluation]. PMID- 3627848 TI - [Morphologic and cytochemical analysis of the histiocytic component of needle aspirates of the thyroid]. PMID- 3627849 TI - Primary cerebral malignant fibro-xanthoma. PMID- 3627850 TI - [Cytologic identification of a follicular carcinoma of the thyroid associated with a hyperfunctioning parathyroid adenoma]. PMID- 3627851 TI - [Cytology of carcinoid of the stomach]. PMID- 3627852 TI - [Anatomo-pathologic and medico-legal remarks on so-called "dead on arrivals"]. PMID- 3627853 TI - [Association of a giant cell tumor of the kidney with a papillary carcinoma of the renal pelvis]. PMID- 3627854 TI - Research by pediatric radiologists--past accomplishments and future opportunities. AB - Pediatric radiologists have made numerous and important contributions to the body of medical knowledge. This essay reviews aspects of biomedical and radiological research, analyses the state of scholarship in pediatric radiology today, and examines future research opportunities. The author's research interest in cardiopulmonary malformations and in the use of murine models of human disease serve to illustrate of but one of many investigative areas open to academic pediatric radiologists. Finally, the application process for NIH funding is briefly discussed. PMID- 3627855 TI - Pulmonary hyperinflation and emphysema in infants with the Marfan syndrome. AB - The Marfan syndrome is a dominantly inherited disorder of type I collagen with well recognized skeletal, cardiac and ophthalmological manifestations. Less recognized are the pulmonary manifestations of the disease. Although chronic pulmonary emphysema, interstitial lung disease with honey combing and spontaneous pneumothorax have been sporadically reported, there is no documentation of these abnormalities in the radiological literature. We describe the clinical and radiographic findings in the lungs of four infants with Marfan's syndrome and provide pathologic correlation from autopsy specimens of two of these patients. In addition, we have updated the literature describing the pulmonary abnormalities of this still obscure disorder. PMID- 3627856 TI - Demonstration of ascending aorta in hypoplastic left heart syndrome with aortic atresia by balloon occlusion aortography. AB - Balloon occlusion angiography in the descending aorta produced clear retrograde visualization of the hypoplastic ascending aorta and related structures in eighteen neonates with aortic atresia. Transient bradycardia was the only complication observed. It is technically simpler than retrograde cannulation of the aorta via an arteriotomy and should be the method of choice when cardiac catheterization is required in patients with the hypoplastic left heart syndrome. PMID- 3627857 TI - Analysis of bowel perforation in necrotizing enterocolitis. AB - The most severe complication of necrotizing enterocolitis (NEC) is bowel perforation. Identification of neonates at high risk for perforation and optimization of radiologic imaging to identify bowel perforation are necessary to reduce the high mortality rate associated with this catastrophic event. One hundred and fifty-five cases of NEC were seen at our institution during a 5.5 year period. Nineteen (12%) progressed to perforation. A review of surgical findings, autopsy results and radiographs from these patients shows only 63% had radiographic evidence of free air in the peritoneal cavity at the time of perforation. Twenty-one percent had radiographic evidence of ascites but no pneumoperitoneum, and 16% had neither free air nor ascites. Thus purely radiographic criteria for bowel perforation in NEC are imprecise, and paracentesis is mandatory in NEC patients with ascites or clinical findings indicative of peritonitis. Timing of radiographic studies and site of bowel involvement are also important. Seventy-nine percent of perforations occurred by 30 h from confirmation of diagnosis (by clinical or radiographic criteria). Surgery or autopsy revealed involvement of the ileo-cecal region in 89% of cases with the actual site of perforation occurring in this area in 58% of patients. PMID- 3627858 TI - Small bowel pseudo-obstruction in Kawasaki disease. AB - Between June 1977 and May 1986, 310 patients with Kawasaki disease were admitted to Shizuoka Children's Hospital. Among these patients, seven showed the symptoms of intestinal paralysis during the acute stage. We present three of these cases who showed typical intestinal pseudo-obstruction radiologically, and discuss the treatment of this type of intestinal involvement. PMID- 3627859 TI - Calcifying discopathy in infancy in the cervical spine: evaluation of vertebral alterations over a period of time. AB - Calcifying discopathy in infancy involving in the cervical spine has already been observed and described by many authors, as a well-defined clinico-radiological syndrome with a benign course. The clinical picture is composed of: pain and functional limitation, sometimes with a stiff neck, more rarely slight fever, increase of the erythrocyte sedimentation rate or leukocytosis. The radiographic picture consists of the association of morphological and structural alterations of vertebral bodies adjacent to one or more disc calcifications usually centrally sited, sometimes associated with anterior or posterior herniations. On the basis of the observation of 7 patients of up to 15 years of age, the authors propose to evaluate the changes of both the vertebral bodies and the discs involved in the disease over a period of time. The repetition of even modest alterations, that persist in time, testify to the involvement of the vertebral growth perhaps, more than the discal alterations connected with the calcification. PMID- 3627860 TI - About one case of vertebral chondroblastoma. AB - The authors report the case of a 9-year-old child which suffered from a chondroblastoma of the cervical spine. He had clinical signs of superior mediastinum compression with inflammation of the respiratory upper air-way. Surgery was performed. Diagnosis was established by the pathologist. The recurrence one year later was treated again by surgery and also by radiotherapy. Another recurrence four years later was fatal. The difficulties of the diagnosis and the appearance of recurrences in some cases of chondroblastoma are reviewed in the literature. PMID- 3627861 TI - Unusual facies, arthrogryposis, advanced skeletal maturation and unique bone changes. A new congenital malformation syndrome. AB - Two strikingly similar infant siblings showed the following pattern of anomalies: unusual cranio-facial appearance, arthrogryposis, advanced bone age of the hips and unique skeletal X-ray abnormalities. They represent a previously unrecognised, fatal malformation syndrome. PMID- 3627862 TI - Enterolithiasis in two neonates with oesophageal and anorectal atresia. AB - Enterolithiasis in two neonates with oesophageal and anorectal atresia is reported. The features of the two cases and comparison with the literature, the particular appearance of these intracolonic calcifications and the importance of radiological examinations for associated digestive, urinary and pulmonary malformations are presented. PMID- 3627863 TI - Chondromyxosarcoma: a rare form of bone neoplasm in children. AB - The case described is interesting for its unusual presentation related to its uncommon onset in youth and its revelation by a fracture which led to a first erroneous pathological diagnosis. In fact, retrospective analysis of the CT showing peripheral condensation could suggest the malignant chondroid nature of the tumor. Subsequent radiological follow-up demonstrated the rapid growth of the tumor hence exhibiting a very invasive form. Myxoid differentiation is commonly related to aggressive chondrosarcoma. PMID- 3627864 TI - Pyloric atresia associated with epidermolysis bullosa. PMID- 3627865 TI - Disposition of vitamin E in the eye. AB - To study the effect of exogenous vitamin E on its plasma and eye tissue levels, we administered 100 mg/kg of dl-alpha-tocopherol either by intravenous, intramuscular, or oral routes in 3-day-old newborn kittens. Controls did not receive the drug. alpha-Tocopherol levels in the plasma, retina, choroid, and vitreous were analyzed by high-performance liquid chromatography at selected intervals following drug administration. Our results showed that after intravenous administration of vitamin E, the retinal alpha-tocopherol levels increased 300 and 500% the baseline value at 2 and 4 h, respectively. By contrast, comparable retinal levels were achieved at 24 h following intramuscular administration and 72 h following oral administration. In the intravenous group high retinal levels were maintained up to 168 h, while in the intramuscular and oral groups retinal levels continued to increase up to 192 h. Irrespective of route of administration, the retinal concentration of alpha-tocopherol remained high even when the plasma levels were declining; plasma levels did not reflect retinal levels at any time. Following exogenous vitamin E administration, alpha tocopherol levels increased both in the choroid (4 to 6 times the control) and in the vitreous (1.5 to 4 times the control). Significant differences in tocopherol levels were also seen between the eyes in the same animal in all groups. Our studies suggest a single dose of vitamin E by intravenous, intramuscular, or oral routes increases retinal levels from 3 to 5 times the control levels. However, peak retinal levels are achieved earlier by parenteral than by the oral route.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627866 TI - Circulating molecular variants of growth hormone in childhood. AB - Human growth hormone (hGH) is known to consist of several molecular forms. We examined the molecular nature of circulating hGH in 18 normal children and compared the resulting patterns to those previously obtained in adults. hGH secretion was stimulated with L-dopa, the hormonal forms were extracted from plasma by immunoadsorbent chromatography, and their molecular nature was analyzed by polyacrylamide gel electrophoresis. Circulating monomeric hGH consisted of 73% hGH22K, 16% hGH20K, and 10% of an acidic hGH from (N alpha-acylated or deamidated hGH). These relative proportions are indistinguishable from those found in the plasma of adults. No age or sex differences in the circulating hGH pattern were found. We conclude that the types and proportions of hGH forms in the blood of normal children are the same as those previously established in adults. These data provide a framework against which children with postulated structurally abnormal ("bioinactive") hGH can be compared. PMID- 3627867 TI - Quantitative analysis of cerebral vessels in the newborn puppy: the structure of germinal matrix vessels may predispose to hemorrhage. AB - Intracerebral hemorrhage in premature infants commonly originates in the germinal matrix (GM). We performed a quantitative analysis of cerebral microvasculature from newborn puppies, a model for neonatal periventricular and intraventricular hemorrhage, at the light and electron microscopic level. GM vessels were compared with those of other brain regions in an effort to delineate pathogenetically significant structural features that might predispose to hemorrhage. Light microscopic examination revealed that GM vessel density (103.0 vessels/mm2) was similar to that in white matter (98.3 vessels/mm2), but lower than that of cortex (155.6 vessels/mm2) or caudate (259.9 vessels/mm2). Mean blood vessel diameter was slightly larger in GM (9.0 mu) than cortex (6.9 mu), caudate (7.9 mu), and white matter (8.9 mu). Ultrastructurally, GM vessels were thinner along greater portions of their circumferences than vessels from other brain regions, as shown by their smaller ratio of vessel wall area/vessel lumen area and their greater fraction of vessel wall with thickness less than 0.25 mu. In addition, a significantly larger fraction of GM capillary wall lacked direct contact with perivascular structures. We postulate that the larger size, thinner walls, and diminished support from surrounding neuropil, which characterize GM vessels, may render them more susceptible to both physical (e.g. hypertension) and metabolic (e.g. hypoxia) insults than vessels from other brain regions. PMID- 3627868 TI - DNA and protein synthesis in developing rat pancreas. AB - To define developmental patterns, we determined the rate of protein and DNA synthesis in rat pancreas at birth, 1, 2, 3, 7, 10, 14, 21, 28 days, 2 months, 3 months, and in adults. Fragments of freshly minced pancreas were incubated with [3H]-thymidine and [14C]-leucine and the DNA and protein synthesis rates were measured. We found that DNA content was lowest at birth, rose through day 3, plateaued at about 8 mg/g wet weight through day 14, then slowly decreased to the adult value of about 5 mg/g at 2 months; protein content, although high at birth, decreased rapidly to a value of 80 mg/g at day 3 and slowly rose to the adult value of 160 mg/g; protein synthesis, low at birth, rapidly increased to about five times the adult value by day 3, and remained elevated for the 1st month; DNA synthesis was 15 times the adult rate at birth, increased to 30 times at 3 days of age, then declined slowly in an exponential fashion to the adult value. We conclude that the pancreas at birth is poised biosynthetically to undergo a rapid hyperplastic and hypertrophic response, and this process reaches a maximal rate at about 3 days of age. PMID- 3627869 TI - Serum growth-promoting activity in normal and hypotrophic fetuses at midpregnancy. AB - Blood from 24 human fetuses aged 19-24 wk was collected by ultrasound-guided puncture of the umbilical cord in utero, performed for prenatal diagnosis of mother to fetus transmissible infections. Fetal serum growth-promoting activity (thymidine activity) was measured by its effect on 3H-thymidine incorporation into human lectin-activated lymphocytes. Ten blood samples were obtained at 19-22 wk of pregnancy and 14 at 23-24 wk. The pregnancies were maintained and the fetuses delivered, free of infection, at 38-40 wk, nine of them being small for date and 15 having a normal weight for gestation age. The bioassayable thymidine activity was significantly lower in the hypotrophic (0.84 +/- 0.04 U/ml) than in the normal fetuses (1.28 +/- 0.09 U/ml) whatever the time of sampling. Thymidine activity was significantly negatively correlated with gestational age in the normal for date fetuses, not in the small for date. It is suggested that early measurement of thymidine activity in fetal blood might be of value in the assessment of fetal growth despite the fact that the tissue growth factors may be more important in fetus than are the serum factors. PMID- 3627870 TI - Protein deprivation from the neonatal period impairs lung development in the rat. AB - The effects of early protein-deficiency on lung development were studied in the rat. Newborn male rats were nursed in groups of eight. Control dams and pups received a 15% protein diet during the whole experiment. Test mothers only received 12 and 8% proteins from the 7th and the 14th day of lactation. Test rats fed a diet of 8% protein were weaned at 21 days and maintained on the low protein diet for 1 month. This caused a marked decrease in body weight gain, but lung/body weight ratio was not affected. Lung DNA and protein content, lung protein concentration, but not lung DNA concentration were decreased, suggesting the presence of fewer and smaller cells than in control lungs. Volume-pressure curves were performed on excised lungs. With air-filling, the curve obtained in rats fed a diet with 8% proteins was shifted downward and to the right, even when expressed as percent of maximal volume. Its exponential analysis assessed a decrease in lung compliance. In contrast, with saline-filling, the recoil pressure was decreased in rats fed a diet with 8% proteins. Both with air and saline-filling, the pressure at lung rupture was increased in malnourished rats. It is concluded that protein-deficiency from the neonatal period increases surface forces, decreases tissue elastic forces, and augments resistance of the lung to rupture. PMID- 3627871 TI - The electrophysiologic effects of propafenone hydrochloride in the neonatal canine. AB - The electrophysiologic effects of the new antiarrhythmic agent, propafenone, were investigated in 10 mongrel canine neonates, ages 5 to 11 days. Utilizing standard His bundle recording and stimulation techniques, assessments of sinus and atrioventricular (AV) node function and atrial, AV nodal, and ventricular refractory periods were performed prior to (control) and after cumulative intravenous doses of 1, 2, and 4 mg/kg of propafenone. Propafenone depressed the spontaneous heart rate and prolonged the postatrial pacing recovery times. AV nodal function was depressed as manifested by Wenckebach periodicity occurring at slower pacing rates, increases in AV nodal conduction time, and increases in AV nodal refractoriness. Atrial and ventricular refractory periods were prolonged significantly in a dose-dependent fashion. Prolongation of the His-Purkinje conduction time occurred at the highest dose. Thus, propafenone exerts a generalized depressant effect on neonatal myocardial conduction and refractoriness which suggests that this agent may be useful in the therapy of atrial and ventricular dysrhythmias in the immature heart. PMID- 3627872 TI - Fetal intravenous nutritional supplementation ameliorates the development of embolization-induced growth retardation in sheep. AB - Since decreased transfer of nutrients into the fetus has been documented in many forms of intrauterine growth retardation, we evaluated whether increasing fetal nutrient availability would prevent the development of experimental growth retardation in fetal lambs. Fetuses were separated into three groups: E, animals growth retarded by repetitive uteroplacental embolization (n = 8); ES, animals treated as in E and given fetal femoral venous infusions of 5% glucose and 6.8% amino acids (n = 7); and C, controls (n = 8). The duration and density of embolization were the same in E and ES; initial physical and metabolic characteristics and gestation at delivery were similar in all groups. E birth weight was reduced 26% compared to C (2888 +/- 373 SEM g versus 3880 +/- 277 g, p less than 0.05); fetal/maternal weight ratio was decreased 35% (p less than 0.005) and ponderal index decreased 22% (p less than 0.005). Asymmetric growth retardation was indicated in E by an increased brain/body weight ratio (p less than 0.05). ES fetuses, in contrast, showed no differences from C in birth weight (3601 +/- 190 g) or body proportions. ES were larger than E, with a greater fetal/maternal weight ratio and ponderal index (p less than 0.05 for both). In E and ES, size at birth showed a positive relation to the amount of supplements received. The average daily supplementation rate correlated with the fetal/maternal weight ratio and with the ponderal index (for both r = 0.62, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627873 TI - Lactate production and absence of gluconeogenesis from placental transferred substrates in fetuses from fed and 48-H starved rats. AB - Fed and 48-h starved rats were infused on day 21.5 of gestation for 20 min through the left uterine artery with [U-14C-]-D-glucose, [U-14C]-glycerol, or [U 14C]-L-alanine. The mother and fetuses from both uterine horns were processed separately for radioactivity measurements in plasma and liver. Differences in radioactivity values between fetuses from the left and the right sides are used as indexes of placental transference of the infused tracers prior to their distribution and transformation in the maternal circulation. After infusion of [U 14C]-D-glucose, [U-14C]-glycerol, or [U-14C]-L-alanine, plasma radioactivity values and specific activities corresponding to the respective infused tracer appeared much higher in fetuses from the left than the right uterine side. Plasma 14C-lactate values also were higher in the left than the right fetuses indicating that fetoplacental structures produced lactate from those placentally transferred 14C-metabolites. No difference in plasma 14C-glucose between left and right uterine horn fetuses was observed after maternal infusion with either [U-14C] glycerol or [U-14C]-L-alanine, either in fed or 48-h starved rats. In the mother both [U-14C]-glycerol and [U-14C]-L-alanine were efficiently converted to 14C glucose, and this process was significantly enhanced with starvation. 14C-fatty acids present in fetal liver after maternal infusions with either [U-14C]-D glucose or [U-14C]-glycerol were decreased by starvation whereas no fatty acid synthesis from [U-14C]-L-alanine was detected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627874 TI - Postasphyxial cerebral survival in newborn sheep after treatment with oxygen free radical scavengers and a calcium antagonist. AB - Acute, severe intrapartum asphyxia was mimicked by tying the umbilical cord in the exteriorized fetal sheep. After a standard time period cardiopulmonary resuscitation was instituted. In the treatment group (n = 14) the lambs were given a composition of scavengers of oxygen-derived free radicals and a calcium channel blocker. The control group of lambs (n = 12) was given placebo. The trial was blind and randomized. Hemodynamic and neurophysiological variables were measured from 30 min before asphyxia to 2 h postresuscitation. Mean arterial blood pressure, sagittal sinus venous pressure, heart rate, and cardiac output did not differ between the two groups although dramatic changes took place during asphyxia and resuscitation. Cerebral blood flow measured by 133-Xe washout method increased in both groups immediately after resuscitation. The treated animals retained an augmented cerebral blood flow during the 2 h postresuscitation while the control animals lost the increase of cerebral blood flow. The treated lambs recovered their somatosensory evoked potentials partially or completely in eight of 14 cases while the same figures for the control lambs were one of 12 cases. Immediately after resuscitation the cerebral reactions recovered to some extent in both groups but during the following 2 h the cerebral cortical function deteriorated in the control group but improved in the treated lambs. It is concluded that part of the brain damage in connection with acute, severe asphyxia may be inflicted by oxygen-derived free radicals released during the reoxygenation phase after resuscitation and that oxygen-derived free radical scavengers and calcium channel blockers may find a place in cardiopulmonary resuscitation. PMID- 3627875 TI - Taurine supplementation of a premature formula improves fat absorption in preterm infants. AB - The predominance of taurine (Tau) conjugated over glycine conjugated bile acids in infants fed human milk as opposed to those on formulas without added Tau could account for a more complete absorption of fat. Fifteen low birth weight infants were randomized to either Enfamil Premature or to Enfamil Premature added with 40 mumol/dl of Tau and compared to a third group made up of nine low birth weight infants fed their own mother's preterm milk. Formulas and human milk were fed according to tolerance and constituted the sole nutrition for 3 months. A metabolic study was carried out at 3 wk of age and control of growth was done periodically. Urinary Tau excretion (mumol/dl) was very low (p less than 0.001) in the group fed Enfamil Premature (0.3 +/- 0.1) when compared to the values obtained in infants supplemented with Tau (51.6 +/- 12.5) and in those on human milk (36.3 +/- 7.9). Infants supplemented with Tau (92.5 +/- 1.2) had a coefficient of fat absorption which was higher (p less than 0.05) than the unsupplemented group (87.5 +/- 7.9) and comparable to the human milk-fed group (91.6 +/- 1.4). The effect was more pronounced on the saturated fatty acids and varied inversely with their individual water solubility. There was no effect of Tau on nitrogen retention and growth was identical in the three groups. These data show that the addition of Tau to formula had no effect on growth but improved the absorption of fat especially saturated fatty acids which require higher concentrations of bile acids to form mixed micelles. PMID- 3627876 TI - Intestinal absorption of macromolecules during viral enteritis: an experimental study on rotavirus-infected conventional and germ-free mice. AB - Epithelial transport and degradation of horseradish peroxidase (HRP), a macromolecular tracer, was studied in conventional and germ-free suckling mice following an experimental infection with rotavirus. Conventional and germ-free mice developed diarrhea from days 2 to 8 postinfection (pi), with growth failure. In mucosal homogenates, infectious virus detected by immunofluorescence on MA 104 cells was present from day 2 through day 8 pi in germ-free mice, but persisted longer (day 13 pi) in conventional mice. Only mild histological lesions were observed during diarrhea, but obvious macrovacuolation of epithelial cells and increased cellular density occurred during the convalescence period (days 9 to 13 pi). Intact and degraded HRP fluxes from mucosa to serosa were measured in vitro on segments of jejunum mounted in Ussing chambers. Both groups of mice developed increased HRP permeability during the experimental period, but at different times after inoculation: during the diarrheal period (days 2 and 3 pi) conventional mouse epithelium absorbed five times more HRP than noninfected controls and during the convalescence period (days 9 to 13 pi) HRP absorption in germ-free mice rose 10-fold as compared to its level before infection. In both cases, this increase in HRP permeability was entirely due to an increase in intact HRP absorption, probably via a transcellular route, and occurred without any alteration in degraded HRP transport. These results indicate that in mice, rotavirus infection causes a transient rise in gut permeability to undegraded proteins. The intestinal microflora seems to affect the timing, magnitude, and duration of this increased permeability. PMID- 3627877 TI - Temporal linkage of glycogen and saturated phosphatidylcholine in fetal lung type II cells. AB - The developmental profiles of glycogen and surfactant-associated saturated phosphatidylcholine were investigated in type II cells isolated from fetal rat lung. Incorporation of radiolabeled glucose into glycogen and type II cell unlabeled glycogen content decreased as a function of gestational age. Conversely, an increase was noted in radioactive choline incorporation into saturated phosphatidylcholine and in the content of unlabeled saturated phosphatidylcholine as a function of gestational age. Type II cells from days 19 and 21 of gestation were also studied by electron microscopy. Temporal relationships similar to those noted biochemically were observed by morphometric analysis. A decrease in glycogen content and an increase in lamellar bodies (the storage organelles for the pulmonary surfactant) were noted as gestation progressed. These studies biochemically and morphologically demonstrate a temporal relationship between glycogen degradation and saturated phosphatidylcholine synthesis in type II cells isolated from fetal rat lung. These findings provide further support for the use of such type II cell preparations for studies of development at the cellular level. PMID- 3627878 TI - Effect of salbutamol on respiratory mechanics in bronchiolitis. AB - The effect of inhaled bronchodilators in bronchiolitis has been difficult to evaluate due to problems with techniques for assessing respiratory function in infants. Two new techniques were used to assess the response to inhaled salbutamol in 17 infants with bronchiolitis. With one technique, expiratory flow, volume, and airway occlusion pressure were measured and used to derive compliance (Crs) and conductance (Grs) of the respiratory system from a passive expiration induced by a brief end-inspiratory airway occlusion. With the other technique, the maximum flow at functional residual capacity (VmaxFRC) was measured from a partial maximum expiratory flow-volume curve generated by external chest compression. For the group, there was no change in compliance or conductance after salbutamol, but salbutamol caused a fall in maximum flow at functional residual capacity (p less than 0.01) and in the time constant of tidal expiration (p less than 0.01). The decrease in maximum flow at functional residual capacity with salbutamol is consistent with increased airway collapse on forced expiration. The decrease in tidal time constant suggests that the drug decreases expiratory braking. Presence of such braking activity may be an important strategy for maintaining lung volume. In summary, salbutamol failed to produce a beneficial effect on airways in bronchiolitis, but did produce changes in expiration which may be harmful in some infants. PMID- 3627880 TI - Is moderate drinking during pregnancy associated with an increased risk for malformations? AB - The relationship between heavy drinking during pregnancy and congenital malformations is well known; however, whether moderate or light drinking is teratogenic is controversial. This prospective birth defects study collected information from 32,870 women about alcohol consumption during the first trimester of pregnancy. Total malformation rates were not significantly higher among offspring of women who had an average of less than one drink per day (77.3/1,000) or one to two drinks per day (83.2/1,000) than among nondrinkers (78.1/1,000). An increased risk as small as 12% in the group averaging less than one drink per day and 45% in those averaging one to two drinks per day would most likely have been detected if it were present. Likewise, major malformations were not increased in these drinking groups. Examining malformations by organ system and individual defect revealed that sex organ malformations and all genitourinary malformations increased significantly (P less than .05) with increasing alcohol consumption. These findings suggest that alcohol, at the levels usually consumed during pregnancy, is not a significant cause of malformations. Nonetheless, the possibility that there are some malformations for which no safe drinking level exists requires additional investigation. PMID- 3627879 TI - The effect of glucocorticoids on plasma insulin-like growth factor I concentration in the rat fetus. AB - Radioimmuno- and radioreceptor-assayable insulin-like growth factor I (IGF-I) concentration was determined in plasma pools of rat fetuses on gestation day 21 following treatment of the pregnant rats with pharmacologic doses of betamethasone, dexamethasone, or cortisone on gestation days 12 and 13. Dose related reduction of plasma concentration of IGF-I occurred after betamethasone or dexamethasone treatment. There was no change in IGF-I concentration after cortisone treatment. The changes in fetal IGF-I concentration after steroid treatment were parallel between the two assays. Comparison of the results with previous data showing the effects of identical treatment of pregnant rats on fetal body and organ growth suggests that the IGF-I changes correlate better with reduction of liver/body ratio than with reduction of body weight. The findings indicate that growth retardation after steroid treatment in the fetus is in part the result of factors other than IGF-I. This may include a direct effect of the glucocorticoids on skeletal tissue. Reduced IGF-I concentration may contribute to the growth deficit. PMID- 3627881 TI - Childhood fever: correlation of diagnosis with temperature response to acetaminophen. AB - Many people believe that temperature response to antipyretics in febrile children varies according to diagnosis. To evaluate the validity of this premise, we prospectively studied the temperature response to acetaminophen of febrile children who came to an urban pediatric emergency and walk-in facility. The study group consisted of 1,559 patients between the ages of 8 weeks and 6 years whose temperatures when seen were greater than 38.4 degrees C and who had not received antipyretic treatment within the previous four hours. Acetaminophen (15 mg/kg) was administered to each child and repeat temperatures were taken one and two hours later. Patient management was unaffected by the study, and physicians were unaware of the repeat temperature measurements. Telephone follow-up was conducted with the parents of each child within five days of the initial visit. Children with cultures positive for bacterial disease or chest x-ray films positive for pneumonia had slightly greater one- and two-hour temperature decreases compared with children with other diagnoses. Although statistically significant, we do not consider these differences in response to be clinically useful. We conclude that fever response to acetaminophen is not a clinically useful indicator by which to differentiate the causes of febrile illnesses in young children. PMID- 3627882 TI - Declining prevalence of anemia in childhood in a middle-class setting: a pediatric success story? AB - To study trends of anemia among middle-class children, we collected 6,162 hematocrit measurements from the medical records of 2,432 children, ages 9 months through 6 years, as seen at a private pediatric clinic during the past 18 years. A decline in prevalence of anemia was observed during that period. The overall age-adjusted rate of anemia decreased from 6.2% in 1969 to 1973, 5.8% in 1974 to 1977, 3.8% in 1978 to 1981, and 2.7% in 1982 to 1986. The decline was also observed when trends were determined for three age groups using a single hematocrit measurement per child. The 1982 to 1986 prevalences of anemia for various age groups among this middle-class pediatric population were relatively low: 2.8% among 9- to 23-month-old children, 2.4% among 24- to 47-month-old children, and 2.7% among 48- to 83-month-old children. Most of these recent cases of anemia were mild--most were only slightly less than the hematocrit values used to define anemia--and most did not show strong evidence of iron deficiency based on elevated levels of erythrocyte protoporphyrin. We conclude that iron deficiency is now mild and uncommon in these middle-class children. This improved nutritional status with regard to iron is probably related to increased intake of iron among infants and young children during the past two decades. These findings suggest that the recommended screening schedule for iron deficiency with hemoglobin or hematocrit measurements may need to be reassessed for well-defined populations of low-risk children. PMID- 3627883 TI - Infectious diseases: preventable causes of infant mortality. AB - After almost a century of improvement, the rate of decrease in US infant mortality rates began to level off during the period of 1982 to 1984. Rates actually increased in some states. Because much of the decline in infant mortality in this century can be attributed to advances in infectious disease treatment and prevention programs, we evaluated the current impact of infectious diseases on infant mortality. The National Center for Health Statistics mortality data for 1980 contains information on as many as 20 causes of death for a given individual. Using these data, we found that infectious diseases contributed to 12.5% of all infant deaths and to almost 400,000 years of potential life lost because of infant deaths. Infectious diseases contributed to 9% of deaths of low birth weight infants and to more than 18% of all deaths in the postneonatal period. Compared with white infants, a higher proportion of nonwhite infants died of causes related to infectious diseases. For black infants, the mortality rate related to infectious diseases was twice that for white infants. These data indicate that infectious diseases still are a major contributor to infant mortality, one of the 15 areas targeted for prevention by the federal government, and the data suggest that programs for reducing infant mortality should place increased emphasis on preventing infectious diseases. PMID- 3627884 TI - Acute illnesses in the 2 weeks after hospitalization for bacterial meningitis. AB - The hospital records of 118 2-month-old to 3-year-old children who had been treated for bacterial meningitis were reviewed. Within 2 weeks after hospitalization, one fourth of the patients sought medical attention for an acute illness, but only one was treated for the possible relapse or recurrence of meningitis. Because only five of the 113 patients with available follow-up information required a diagnostic lumbar puncture procedure, it is not recommended that a lumbar puncture be performed following treatment of bacterial meningitis to provide end-of-treatment baseline information. PMID- 3627885 TI - Physician reimbursement by salary or fee-for-service: effect on physician practice behavior in a randomized prospective study. AB - We used a resident continuity clinic to compare prospectively the impact of salary v fee-for-service reimbursement on physician practice behavior. This model allowed randomization of physicians into salary and fee-for-service groups and separation of the effects of reimbursement from patient behavior. Physicians reimbursed by fee-for-services scheduled more visits per patient than did salaried physicians (3.69 visits v 2.83 visits, P less than .01) and saw their patients more often (2.70 visits v 2.21 visits, P less than .05) during the 9 month study. Almost all of this difference was because fee-for-service physicians saw more well patients than salaried physicians (1.42 visits and .99 visits per enrolled patient, respectively, P less than .01). Evaluating visits by American Academy of Pediatrics' guidelines indicated that fee-for-service physicians saw more patients for well-childcare than salaried physicians because they missed fewer recommended visits and scheduled visits in excess of those recommendations. Fee-for-service physicians also provided better continuity of care than salaried physicians by attending a larger percentage of all visits made by their patients (86.6% of visits v 78.3% of visits, P less than .05), and by encouraging fewer emergency visits per enrolled patient (0.12 visits v 0.22 visits, P less than .01). Physicians' interest in private practice, as determined by their career plans, correlated significantly with total number of patients enrolled (r = .48, P less than .05) and total clinic patients seen by each resident during the study (r = .40, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627886 TI - Familial occurrence of sudden infant death syndrome and apnea of infancy. AB - We sought to determine the outcome of infants born to families with multiple victims of sudden infant death syndrome (SIDS) and/or apnea of infancy. Seventy three infants, born to families who had two or more previous siblings who had either died of SIDS or who were monitored at home for apnea of infancy or for abnormal results on polysomnogram and/or pneumogram recording, were prospectively monitored. The infants underwent polysomnogram and pneumogram recordings and were subsequently monitored at home with a cardiorespiratory monitor. All episodes of apnea were immediately reviewed. Thirteen infants (18%) had subsequent severe episodes of apnea and five other infants (7%) died during a subsequent episode. All deaths occurred in families who had two or more SIDS victims. The outcome for the 17 infants who were half siblings was similar to the outcome for full siblings. Clinical data of the infants and results of evaluation were not predictive of outcome. PMID- 3627887 TI - Multiple dose activated charcoal for theophylline poisoning in young infants. AB - Five cases are presented in which multiple doses of activated charcoal were given to infants 6 months of age or less, as treatment of theophylline overdose. This therapy was tolerated in all cases with apparent enhancement of theophylline elimination. Use of multiple dose activated charcoal appears to be a viable option in the treatment of young infants with theophylline poisoning. PMID- 3627888 TI - Acute rheumatic fever in western Pennsylvania and the tristate area. AB - Acute rheumatic fever is reported to have declined and perhaps be vanishing. Prompted by the occurrence of 17 cases of acute rheumatic fever in an 18-month period in 1985 and 1986, we reviewed the records of 243 children with acute rheumatic fever who were cared for at Children's Hospital of Pittsburgh or Mercy Hospital between 1965 and 1986. Acute rheumatic fever was diagnosed using the modified Jones criteria and cases were classified by major criteria as arthritis, arthritis and carditis, carditis alone, carditis and chorea, chorea alone, and arthritis and chorea. Among the 17 recent patients, 59% had carditis, 30% had chorea, and 24% had arthritis alone. The proportion of children who had particular major manifestations was similar in the last two decades and in 1985 to 1986. The recent children with acute rheumatic fever ranged in age from 6 to 13 years with a mean and median age of 10 years. There were 16 white children and one Asian child. Only four children lived in an urban setting. When demographic features of the children were contrasted with those in the previous two decades, a decrease in the proportion of children who lived in urban areas and who were black was noted. Four children had a history of preceding sore throat but only three sought medical care; nine children had no memorable illness and four had either a nonrespiratory illness or a respiratory infection without sore throat. This resurgence of rheumatic fever serves as a reminder that a diligent approach to the diagnosis and therapy of streptococcal infections remains essential. PMID- 3627889 TI - Idiopathic cerebral arterial infarction with paucity of symptoms in the full-term neonate. AB - Two full-term neonates, one with convulsions and intermittent generalized hypotonia and one with poor sucking, temperature instability, and lethargy, are reported. CT scan findings suggested cerebral arterial infarction. Arteriography revealed occlusion of the middle cerebral artery, unilaterally in the first and bilaterally in the second patient. The evolution of the infarct could be followed on serial CT scans. No predisposing factors during pregnancy or delivery were found, and serious neurologic deficits developed in both children. These cases demonstrate that, even in full-term neonates with discrete or moderate neurologic symptoms and born after normal pregnancy and delivery, the possibility of vasoocclusive brain infarction should be considered. The diagnosis is suggested by imaging techniques, of which CT scanning seems to have the greatest value at present. This technique also permits the follow-up of the lesions. The prognosis for neurologic development appears to be variable: minor neurologic deficits as well as unexplained spastic hemiplegia in older children may be the consequence of inapparent cerebral arterial infarction in the neonatal period. PMID- 3627890 TI - Urgent and emergent embolization of lesions of the head and neck in children: indications and results. AB - Indications for and results and complications of embolization of lesions of the head and neck were analyzed retrospectively. The procedures were performed since 1980 on an emergent or urgent basis in 30 infants and children by an experienced interventional neuroradiologist in Bicetre, France. Indications for embolization included hemorrhage, occular occlusion, respiratory obstruction, CNS complications or potential complications, interference with nutrition, and functional impairment related to the effect of the lesion on the developing facial skeleton and teeth. The specific lesions included seven hemangiomas (palpebral, subglottic, and nasal) and 20 vascular malformations (maxillofacial, auricular, dural, cerebral [including three vein of Galen malformations] and spinomedullary). Embolization was efficacious in 28 of 30 patients. Hemangiomas (potentially involutive tumors) responded dramatically with arrest of the proliferative phase and shrinking of the mass. Combined hemovascular lymphatic malformations (hemolymphangiomas) of the tongue demonstrated a variable decrease in size. High-flow evolutive arteriovenous malformations involving the teeth and dura were controlled but required multiple embolizations. One infant with a vein of Galen arteriovenous malformation died. Three local complications occurred in two patients. No cerebral ischemic or femoral artery complications occurred. PMID- 3627891 TI - Phototherapy in the management of neonatal hyperbilirubinemia: efficacy with light sources emitting more than 500 nanometers. AB - The clinical action of green fluorescent lamps, properly filtered to remove wavelengths of less than 500 nm, was investigated in a group of 23 newborns with different initial serum bilirubin concentrations. The serum bilirubin levels were measured at 6, 12, 24, and 48 hours after the beginning of phototherapy. These results are compared with those obtained, under the same experimental conditions, in a group exposed to commercial green lamps. Similar bilirubin decline rates were observed in the two experiments. In general, these data confirm the satisfactory clinical efficacy of the green light in phototherapy and prove, in particular, that the blue component present in the emission spectrum of the commercial green lamps has a negligible effect on the bilirubin degradation process. PMID- 3627892 TI - Hymens in newborn female infants. PMID- 3627893 TI - Overcoming obstacles to breast-feeding in a large municipal hospital: applications of lessons learned. AB - A project to overcome institutional constraints to breast-feeding was implemented in a large municipal hospital. Interventions included staff education, intensive training of a team of physicians and nurses, development of user-tested educational materials, and day and evening staffing by a breast-feeding counselor. A nearby hospital served as a control. Project evaluation entailed chart reviews at the intervention site and a control hospital (n = 812); interviews with mothers during their postpartum hospital stay and at return clinic visits (n = 180); and field observations in all areas of the hospital that provided prenatal, intrapartum, postpartum, and pediatric care. Comparisons of the incidence and pattern of breast-feeding were made before, midway through, and after the project. At the intervention site, the incidence of breast-feeding increased from 15% to 56%, and exclusive breast-feeding for more than 3/4 of feedings increased from 0% to 15%. At the control site, the respective changes were from 28% to 41% and from 5% to 7%. Formula use by breast-feeding women decreased but was nonetheless extensive, and the usual reason given by breast feeding women for supplementation was a perceived insufficiency of breast milk. This may be due, in part, to the fact that bedside assistance to breast-feeding mothers was not integrated into the routine care provided by staff nurses but was relegated to the lactation nurse/counselors who were not available at all times. It is concluded that the process to overcome institutional constraints to breast feeding is difficult but feasible. Repeated and extensive professional education helps create the context whereby clinical and administrative staff can reassess routines and policies. PMID- 3627894 TI - Gastroduodenal motility in neonates: response to human milk compared with cow's milk formula. AB - It is known that breast milk empties more quickly from the stomach than does infant formula. We studied the difference in gastroduodenal motility between neonates fed with human milk and those fed with infant formula. Twenty-four five- to 36-day-old neonates were fed with mother's breast milk or with a cow's milk based formula. Postprandial gastroduodenal contractions were recorded manometrically for three hours. Repetitive, high-amplitude nonmigrating contractions were the dominant wave form during the postprandial period. The number of episodes, duration, amplitude, and frequency of nonmigrating contractions were not different following the different feedings. The migrating myoelectric complex, which signals a return to the interdigestive (fasting) state, appeared in 75% of breast milk-fed infants but only 17% of formula-fed infants (P less than .05) within the three-hour recording period. Because contractions were similar following the two meals, but a fasting state recurred more rapidly in breast-fed infants, we conclude that factors other than phasic, nonpropagated antroduodenal contractions were responsible for the differences in gastric emptying between breast milk and formula. PMID- 3627895 TI - Has routine screening of infants for anemia become obsolete in the United States? PMID- 3627896 TI - Child abuse: the conflict of underdetection and overreporting. PMID- 3627897 TI - American Academy of Pediatrics: Neonatal anesthesia. PMID- 3627898 TI - American Academy of Pediatrics: Exercise for children who are mentally retarded. AB - Pediatricians should encourage participation in exercise and athletic programs for mentally retarded children. The right program can be a therapeutic tool resulting in better weight management, development of physical coordination, maintenance of cardiopulmonary fitness, and improved self-esteem. PMID- 3627899 TI - American Academy of Pediatrics: Physical fitness and the schools. PMID- 3627900 TI - Future training of pediatricians: summary report of a series of conferences sponsored by the American Board of Pediatrics. PMID- 3627902 TI - Treatment of swallowing syncope. PMID- 3627901 TI - Sexual behavior in the home. PMID- 3627903 TI - Blood pressure. PMID- 3627904 TI - Meconium suctioning. PMID- 3627905 TI - Cow's milk protein intolerance. PMID- 3627906 TI - Familial hiatal hernia. PMID- 3627907 TI - Depth on a flat screen. AB - The hypothesis was tested that the coupling of parallax shifts between objects depicted on a monitor screen around a fixation point with the head movements of an observer viewing this screen monocularly around a point coinciding with the fixation point is sufficient to create a convincing depth impression and to enable the observer to make reliable estimations of depth. The estimates were based on monocular vision and involved the aligning of wedges. The investigation consisted of two analogous experiments carried out simultaneously, one on depth estimations virtually in the screen and one on depth estimations virtually in front of the screen. In each experiment three conditions were compared: an active condition in which the coupling of parallax shifts and observer's head movements operated, a passive condition in which it did not, and a real-life set-up to measure the maximum reliability in depth estimation. The hypothesis is confirmed: in the active condition the variances in the alignments are significantly smaller than in the passive condition and approach those in the real-life set-up. This holds not only for estimates in the screen but also for estimates in front of the screen, that is, we can make a thing apparently leap out of the screen towards the observer. Results are interpreted against the background of the debate between the direct and the indirect theories of perception. PMID- 3627908 TI - Construct validity of the Children's Embedded Figures Test. AB - The Children's Embedded Figures Test and the Matching Familiar Figures Test were given to 28 children ranging in age from 5 to 12 yr. (M age = 9.3 yr.) to estimate the construct validity of the Children's Embedded Figures Test. A significant correlation of .65 between age and number of correct embedded figures and a nonsignificant correlation of .32 between number of correct embedded figures and latencies to match familiar figures were found. Implications are examined in the light of earlier findings demonstrating the convergent validity of the Children's Embedded Figures Test. PMID- 3627909 TI - Duration of exposure of Rorschach stimuli. AB - In this study we assessed the influence of duration of exposure of the Rorschach stimuli on the response determinants when the information processing is interrupted using a patterned mask or visual noise. Analysis shows that increasing duration of exposure does not yield a parallel increase in the production of more structured responses. These results are discussed in light of the familiarity of the forms and of the distribution of physical energy or luminance present in the stimulus. PMID- 3627910 TI - Differences in drinking behavior between normal and laryngectomized man. AB - The properties of drinking in normal and laryngectomized groups were examined. Drinking associated with meals was more frequent in the 76 young and 37 older normal subjects than the 25 laryngectomized persons. The laryngectomized group preferred tea and coffee to water to alleviate thirst sensation, while such a preference was hardly seen in either normal group. Results suggest that the larynx may contribute not only to thirst sensation but may be associated with preference in drinking. PMID- 3627911 TI - Relationship between self-actualization and self-reported health practices. AB - To compare the reported health practices of high self-actualizing individuals with those of low self-actualizing individuals, 453 students enrolled in personal hygiene classes at a large southern university completed the Personal Orientation Inventory, a measure of self-actualization. The fifty highest scorers were identified as the high self-actualizing group and the 50 lowest scorers were identified as the low self-actualizing group. The two groups were administered the Health Practices Inventory. The high self-actualizing group reported using better health practices. PMID- 3627912 TI - Stability of individual differences in infants' manipulation and exploration of objects. AB - The purpose of this study was to assess stability of manipulative behavior across time. 29 infants were seen at both 9 and 9.5 mo.; 20 of these infants were seen again at 12 mo. At each visit the infants were presented several objects for familiarization and tested for response to discrepant objects. Each trial was scored for the duration of looking, rotating the object, fingering, mouthing, and banging, the frequency of transferring the object from hand to hand, and the frequency of dropping, throwing and pushing the object away. Analysis of the data yielded moderate to high correlations between 9 and 9.5 mo. for all but one behavior. Correlations between 9 and 12 mo. were in the same range for most of the behaviors. On the test trials, there were fewer significant correlations. When the behaviors were separated into exploratory and nonexploratory categories, there was more stability for the nonexploratory behaviors; summary scores for both were concurrently related to Bayley Mental Development Index at 12 mo., but in opposite directions. The results suggest that there is stability in some manipulative behaviors, and further, that it is useful to conceptualize two types of manipulative behavior. PMID- 3627913 TI - MMPI profiles of normal people who display frequent temporal-lobe signs. AB - Comparisons were made between personality (MMPI) profiles of 26 part-time university students who scored in the upper and 29 students who scored in the lower one-quarter of the range on a scale that measures temporal-lobe signs in the normal population. Compared to the reference group, the subjects who displayed more temporal-lobe signs showed statistically significant elevations above a T score of 70 on Schizophrenia and Hypomania. There were secondary elevations on Psychasthenia and frequency scales. Similar profiles whose high point scores display greater amplitude are typical for patients with schizotypal disorders and for many patients who have long histories of temporal lobe epilepsy. These results support the existence of a continuum of temporal-lobe lability that extends into the normal population. PMID- 3627914 TI - Styles of oroalimentary behavior: relationship with modulation of emotional behavior and myographic tension of the oral region. AB - The relationship between styles of oroalimentary behavior and both modulation of aggressive behavior and myographic tension at rest for some muscles engaged in the process of mastication was examined for 24 women. Our data suggested an inverse relation between outward overt hostility and oral appetitive hyperactivation with or without partial masticatory components. Moreover, the oral appetitive activation was negatively correlated with the myographic tension of oral region, particularly the right masseter. PMID- 3627915 TI - Electroencephalographic correlates of temporal lobe signs and imaginings. AB - Significant correlations (0.50) were observed again between scores for the Wilson Barber Inventory of Childhood Memories and Imagings and the numbers of experiences that are indicative of temporal lobe lability. In addition, positive correlations (0.42) occurred between temporal lobe EEG measures (scalp electrodes) and numbers of temporal lobe signs. The numbers of alpha seconds per minute from the occipital lobes were correlated (0.57) with the Wilson-Barber cluster that indicated interests in "altered states". Scores on the childhood imaginings section of the Wilson-Barber Inventory were correlated (0.44) with the numbers of spikes per minute over the temporal lobes when the eyes were closed. PMID- 3627917 TI - Impoverished written responses and negative features of schizophrenia. AB - Repetition in the written language of schizophrenics and its possible relationships to other aspects of schizophrenic disorders are not well understood. We investigated repetitiousness in written utterances, finding schizophrenic subjects to be more repetitive than affective controls and normal controls. Over-all, written repetitiousness was more strongly correlated with psychopathologic features than oral repetitiousness. As in previous work, thought disordered schizophrenic subjects produced the most repetitive responses. Poverty of content and illogical thinking were correlated with scores for written repetition. Measures of other negative features, disturbed mental functioning and motor behavior were also associated with repetitiousness in both written and oral modes. That these negative features are linked (namely, linguistic repetitiousness, negative formal thought disorder, voluntary motor abnormalities, and deficient mental functioning) is consistent with Crow's concept of a defect syndrome (Type 2) in schizophrenia. PMID- 3627916 TI - Selected sleep disturbances in school children reported by parents: prevalence, interrelationships, behavioral correlates and parental attributions. AB - Epidemiological, behavioral and etiological variables related to sleep disturbances were investigated in a survey of 1695 children in Grades 1 to 12 from 11 randomly selected schools. Sleep-walking, nightmares and sleep-talking were strongly associated with each other as well as to a family history of sleep walking. Enuresis, however, was not related to the other sleep variables. Socioeconomic status of father was weakly related to enuresis and sleep-talking but not to sleep-walking or nightmares. Gender was not related to any of the sleep disturbances. The behavioral variables, physical activity, attention, emotional excitability, and feelings easily hurt showed a small association with the sleep disturbances. Parents most frequently attributed causes of sleep walking and nightmares to over-tiredness and over-excitement. As well, parents' comments indicated that they tend to associate specific events such as illness or more often, frightening TV content with nightmares, but not sleep-walking. PMID- 3627918 TI - Trait of anxiety as self-schemata in memory. PMID- 3627919 TI - On rearranging picture arrangement: data from a clinical sample. AB - Comparisons of the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Adult Intelligence Scale--Revised (WAIS--R) indicate that the two tests are highly similar but not identical. The present study examined the p-values of the WAIS--R Picture Arrangement items for a sample of 123 adults referred for psychological assessment. The current order of the Picture Arrangement items (especially the FLIRT item) does not conform to the expectation of increasing difficulty of subtest items. Implications for diagnosis are discussed. PMID- 3627920 TI - Heart-rate indices of hemispheric asymmetry in a discrete-trials Stroop-paradigm. AB - Heart-rate changes were recorded in a discrete-trials Stroop-paradigm where slides with color-words written in an incongruent color were briefly flashed (200 msec.) either to the left or to the right of a central fixation point. Subjects were required to attend only to the color, ignoring the color-word. The logic behind the paradigm is that a greater conflict should occur for the Stroop-words presented in the right visual half-field due to the relative inability of the left hemisphere to suppress the verbal information. By recording phasic heart rate it would be possible to elucidate 1982 findings of Walker and Sandman that changes in heart-rate are differentially related to the right and left cerebral hemispheres. The results showed a significant initial deceleration during the first trialblock only to stimuli presented in the left half-field. Asymmetrical effects were demonstrated for heart-rate. PMID- 3627921 TI - Geophysical variables and behavior: XLII. Lack of relationship between moon phase and incidents of disruptive behavior in inmates with psychiatric problems. PMID- 3627922 TI - EMG activity with the jaw fixed of orbicularis oris superior, orbicularis oris inferior and masseter muscles of mild and moderate articulatory disordered children. AB - The peak amplitude of EMG activity was measured from the orbicularis oris superior, orbicularis oris inferior, and masseter muscles of 3 mild and 3 moderately articulatory disordered and 3 normal boys repeating a series of /p ae/ syllable trains with the jaw fixed. Analysis showed similar levels of peak EMG amplitude and variability of performance for all subjects across the three muscles. These data were interpreted to suggest that speech-motor equivalence for simple articulatory acts requiring compensation is functioning within normal limits for the disordered subjects studied here. PMID- 3627923 TI - Analyzing aversiveness of denatonium saccharide and quinine in rats. AB - Denatonium saccharide is reported to be the most bitter substance currently known. Two experiments comparing the suppressive capabilities of this compound and the more common bitter, quinine, are presented. Analysis indicated that rats preferred to consume denatonium rather than quinine when afforded a choice between the two. Exp. 2 also indicated that the pairing of quinine with vanilla and almond flavors resulted in subsequent refusal of these flavors. Pairing flavors with denatonium did not produce comparable refusals. Caution is expressed with regard to the use of denatonium saccharide as a rodent repellent. PMID- 3627924 TI - An examination of self-pacing procedures in human time estimation. AB - The main purpose of the present research was to investigate the role of self pacing trial procedures in time estimation. Auditory durations of 1, 4, and 8 sec. were estimated by 12 subjects under the method of reproduction. Different features of performance were investigated using several dependent variables. When left to themselves, subjects chose a relatively short intertrial interval, the duration of which did not differ across the three criterion durations. This finding seemed best explained as an attempt by the subjects to minimize boredom and maximize alertness. Also, subjects waited for a short time before reproducing the criterion duration, and again this period did not differ across the three criterion durations. A significant relationship was found between the duration of the self-paced intertrial interval and self-paced retention interval for all criterion durations. It appeared that subjects were attempting to maximize their time-estimation performance by either minimizing the retention interval or by developing a trial-interval rhythm. Finally, subjects were more variable in their estimates as the criterion duration increased. PMID- 3627925 TI - Absence of a hemispheric superiority in the recognition of European and Asian faces. AB - The present study was designed to examine whether there is a difference in hemispheric superiority in the recognition of European and Asian faces. A visual hemifield-presentation technique involving monocular testing was employed. Ten European subjects were presented a recognition task involving European faces and 10 other European subjects a similar task involving Asian faces. The data indicated no hemispheric superiority in either case; however, subjects made significantly more errors in recognising Asian faces than European faces in both visual hemifields. PMID- 3627926 TI - Changes in central somatosensory pathways accompanying reaction movements. AB - The changes within central somatosensory pathways accompanying reaction movements were examined by subtracting the peak latency of the major response from the cervical area (14 msec.) from that of the primary cortical response (20 msec.) and also measuring the CNV which is dependent on the direction of the subject's attention and level of arousal. These parameters were measured before (at rest), during fast and slow reaction movements, and mental readiness to act. Analysis showed that the difference in N20-N14 potential latencies is the shortest during fast reaction movements and is shorter during movement tasks than during mental readiness and intention to act. Moreover, we confirmed that the CNV amplitudes are significantly higher during fast than during slow reaction movements and also that the difference in N20-N14 potential latencies decreases as the CNV amplitude increases. Accordingly, from the present results and a series of studies conducted by others, it may be concluded that not only are the changes in the central motor area confirmed by the movement-associated cerebral potentials but also those in the central somatosensory area occur prior to reaction movements. PMID- 3627927 TI - Dichotic listening and hypnotizability: variability in ear preference. AB - 28 right-handed, English-speaking subjects were administered two tests, Stanford Hypnotic Susceptibility Scale-Form C and a whole-word dichotic listening test. The latter was given in both waking and hypnotized states. Subjects of low hypnotizability showed the usual right-ear advantage in both waking and hypnotized states. Subjects of high hypnotizability showed a different pattern of ear advantage: half of the group-showed left-ear advantage in the waking state but all showed right-ear advantage in the hypnotized state. Results are interpreted to show that for subjects of high hypnotizability, the narrowed attention characteristic of hypnosis produces the expected lateralizing effect. Subjects of low hypnotizability show a consistent right-ear preference in both the hypnotized and nonhypnotized conditions. The results suggest that much of the atypical ear preference shown in dichotic listening experiments may be associated with the variability in cognitive states found in persons of high hypnotic susceptibility. PMID- 3627928 TI - Running and depression. AB - Two studies on the relationship between running and depression among normal persons are reported. Study 1 investigated whether a group of 21 runners were significantly less depressed, as measured by the Beck Depression Inventory, than a group of 21 nonexercisers who were matched on sex, age, and height/weight ratio. The runners were significantly less depressed than the nonexercisers. Study 2 assessed whether cardiovascular fitness correlated with depression. Using scores on the Beck Depression Inventory as the criterion of depression, 17 depressed subjects and 17 nondepressed subjects took the Harvard "Step Test", the measure of cardiovascular fitness. There was a significant negative r of -.30. It is noted that the basis of the relation between running and depression is still unclear and suggestions for research are presented. PMID- 3627929 TI - Occupational stress and behavioral change. AB - For 25 secretaries employed at Laurentian University, scores on the MMPI Depression Scale, State-Trait Anxiety Questionnaire, Self-esteem Inventory, Jenkins Activity Survey, and Occupational Stress Questionnaires showed no significant change in behavior associated with occupational stress. Characteristics 'hard-driving' and 'speed-impatience' were predictors of Type A behavior. PMID- 3627930 TI - From detection to identification: response to multiple targets in rapid serial visual presentation. PMID- 3627931 TI - Multiple phonemic restorations follow the rules for auditory induction. PMID- 3627933 TI - Representation of locomotor space by the blind. PMID- 3627932 TI - Apparent duration and numerosity as a function of melodic familiarity. PMID- 3627934 TI - A stereo illusion induced by binocularly presented gratings: effects of number of eyes stimulated, spatial frequency, orientation, field size, and viewing distance. PMID- 3627935 TI - Perception of gated, highly familiar spoken monosyllabic nouns by children, teenagers, and older adults. PMID- 3627936 TI - Stereopsis impairment in apparently moving random dot patterns. PMID- 3627937 TI - Delayed auditory feedback with delayed sounds varying in duration. PMID- 3627938 TI - Auditory continuity effects with binaural stimuli. PMID- 3627939 TI - Task-specific serial position effects in comparisons of multiletter strings. PMID- 3627940 TI - Spatial S-R compatibility with unimanual two-finger choice reactions: effects of irrelevant stimulus location. PMID- 3627941 TI - A note on enhancing the Poggendorff illusion. PMID- 3627942 TI - Intracellular neutral carrier-based Ca2+ microelectrode with subnanomolar detection limit. AB - In intracellular electrolyte solutions a Ca2+-selective microelectrode based on the synthetic electrically neutral carrier N,N,N',N'-tetracyclohexyl-3 oxapentanediamide (ETH 129) shows an improved detection limit when compared with the so far widely used Ca2+ microelectrodes based on the neutral carrier ETH 1001. Detection limits are found at pCa = 9.2 in Ca2+ buffers containing an intracellular background of K+ (125 mM). Selectivity studies in mixed solutions show a preference of Ca2+ over Na+ of 6 X 10(5), over K+ of 1.6 X 10(6), and over Mg2+ of 5 X 10(6). The microelectrode does not suffer from significant interference by inorganic and organic inhibitors and by lipophilic cations and anions. The low detection limit is unchanged at least during the first eight hours of continuous contact with Ca2+ solutions. The EMF drift during the first hour of use is between 5 and 10 mV and is then reduced to about 1 mV/h. The changes in EMF induced between solution of pCa = 7 and pCa = 8 are reproducible within 24.7 +/- 0.4 mV (SD, n = 8, about 3 h). These electrode characteristics were found for single-barrelled microelectrodes of one micrometer diameter front filled with a PVC-containing membrane phase. In the absence of poly(vinyl chloride) in the membrane phase irregular EMF response curves were obtained throughout. Preliminary punctures of ferret ventricular muscle cells indicate that the Ca2+ electrode response is not disturbed by the contact of a cytosolic milieu. PMID- 3627943 TI - Contraluminal para-aminohippurate (PAH) transport in the proximal tubule of the rat kidney. I. Kinetics, influence of cations, anions, and capillary preperfusion. AB - In order to study the characteristics of contraluminal para-aminohippurate transport into proximal tubular cells the stopped flow capillary perfusion method was applied. The disappearance of 3H-para-aminohippurate from the capillary perfusate at different concentrations and contact times was measured and saturation type behaviour was found with a Km of 0.08 +/- 0.01 (SE) mmol/l, Jmax of 1.1 +/- 0.1 pmol X s-1 X cm-1 and r, the final extracellular/intracellular distribution ratio of 0.93 +/- 0.03. Omission of Na+ from the capillary test perfusate caused a small reduction of contraluminal PAH uptake at small transport rates (0.1 mmol/l PAH in the test perfusate) but not at high transport rates (1.0 mmol/l PAH in the test perfusate). Change of K+ between 0 and 40 mmol/l and pH between 6.0 and 8.0 did not influence contraluminal PAH uptake. Isotonic replacement of chloride by gluconate, nitrate, sulfate, phosphate, methanesulfonate or increase in bicarbonate to 50 mmol/l did not influence PAH uptake at small transport rates. But isotonic sulfate and phosphate, as well as 50 mmol/l HCO3- and 25 mmol/l Hepes in isotonic solutions reduced PAH uptake at high transport rates. Addition of 5 mmol/l Ca2+, Mg2+, Mn2+, Ba2+, Cd2+ to isotonic Na+-gluconate solution did not influence PAH uptake except for Mg2+ and Mn2+ which inhibited uptake at small transport rates only. Preperfusion of the peritubular capillaries with rat serum, Na+ gluconate (Ca2+- + Mg2+-free), Na+ gluconate (Ca2+- + Mg2+-free) plus 10 mmol/l lactate or pyruvate or 0.1 mmol/l 2 oxoglutarate did not influence PAH uptake at small PAH transport rates, but inhibited at high transport rates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627944 TI - Comparison between hypothalamic thermoresponsive neurons from duck and rat slices. AB - Neuronal thermoresponsiveness in the preoptic and anterior hypothalamic (PO/AH) region of a bird and a mammal were compared in vitro by recording the activity of 48 units from ducks and 37 units from rats in tissue slices subjected to temperature changes. Warm-responsive units were found in similar proportions in duck and rat PO/AH slices. The average degrees of thermoresponsiveness did not differ between the two species. Neurons exhibiting thresholds of warm responsiveness had higher threshold temperatures (2P less than 0.01) in duck (38.8 +/- 0.2 degrees C) than in rat (37.4 +/- 0.4 degrees C) slices (means +/- standard errors). Firing rates at threshold temperatures and thermoresponsiveness below and above thresholds did not differ between ducks and rats. During synaptic blockade in a Ca2+-free/high-Mg2+ medium, warm-responsiveness was retained in 9 out of 13 units in duck slices and in 8 out of 13 units in rat slices. In two instances in ducks and in one case in rats positive temperature coefficients were converted into negative temperature coefficients. Among two cold-responsive units tested in duck slices one retained its cold-responsiveness. It is concluded that in vitro evaluation of PO/AH neuronal thermoresponsiveness in a bird and a mammal has not revealed differences at the single unit level which might explain the diverging contributions of the avian and mammalian hypothalamus to deep body temperature perception. PMID- 3627945 TI - Preparation of isolated mouse olfactory receptor neurons. AB - A method is described for producing large numbers of isolated olfactory receptor neurons from adult mouse nasal epithelium. The dissociated neurons and other cell types isolated from nasal epithelium retain their morphology and can be identified visually. The neurons were judged to be intact and viable by trypan blue dye exclusion, the presence of olfactory marker protein (OMP), and a variety of electrophysiological measurements indicating the presence of substantial membrane potentials, low levels of intracellular Ca2+, and the ability to fire action potentials. The receptor neurons and other cell types produced by this method are amenable to the patch-clamp technique and to immunohistochemical studies. PMID- 3627946 TI - Anion permeability of motor nerve terminals. AB - Motor nerve terminals in mouse and frog display behavior consistent with an appreciable permeability of the nerve terminal membrane to chloride. In mouse diaphragm, in the presence of 15 mM K+ and 2 mM or 8 mM Ca2+, replacement of Cl- by NO3-, Br- or acetate causes a transient increase in the quantal release of acetylcholine, measured as the frequency of spontaneously occurring miniature end plate potentials (FMEPP); a rapid rise in FMEPP is followed by a slow decline, with a half-time of about 4 min, to an equilibration level close to the control level. After equilibration in a solution in which the Cl- is replaced by another anion, return to Cl- -containing solution causes a transient decrease in FMEPP with a subsequent slow recovery. The data are consistent with transient nerve terminal depolarization or hyperpolarization, reflecting a nerve terminal permeability to anions in the sequence Cl- greater than Br- greater than NO3- greater than acetate. In 5 mM K+, changes in nerve terminal excitability, determined using focal stimulation, are also consistent with alteration of nerve terminal membrane potential as a consequence of anion substitution. The time course of relaxation of FMEPP after a change from Cl- to an anion of lower permeability, or vice versa, is considerably slower than that expected if Cl- permeability of nerve terminals is similar to that of skeletal muscle fibres, and if the nerve terminal behaves as a single compartment. In frog cutaneous pectoris, transient changes in FMEPP produced by substitution of anions in the bathing solution were similar to those produced in mouse diaphragm, but more rapid in time course. PMID- 3627947 TI - Psychophysical experiments of thermoperception in human teeth. AB - Clinically inconspicuous anterior teeth of subjects 18-53 years of age were stimulated by means of an electrically controlled thermode of 0.5 degree C, 35 degrees C and 71 degrees C for 60 s. In two sets of experiments testing vital anterior teeth the cold stimuli were correctly identified significantly above chance level, making the existence of cold receptors inside the tooth probable. No evidence of a corresponding warm perception in human anterior teeth was found. These results were corroborated in a third experiment by comparative testing of 75 anterior teeth--25 devital and 50 vital--for a possible stimulus spread to other than intradental neural structures. Local surface anaesthesia of the tissues adjacent to the teeth significantly reduced the subject's ability to correctly identify cold stimuli. Investigating the effect of cold stimulus temperatures (0.5 degree C, 15 degrees C and 25 degrees C), no significant difference in correct cold perception was found when the two lower temperatures were applied, while with the 25 degrees C stimulus correct cold perception was at chance level. The latency of correct cold responses increased significantly when stimuli of 15 degrees C instead of 0.5 degree C were applied (t-test p less than 0.05). The latency of correct cold responses (0.5 degrees C) was not significantly influenced by surface anaesthesia. It increased significantly, however, when devital teeth were tested with the 0.5 degree C stimulus (t-test; p less than 0.01). PMID- 3627948 TI - The effect of acetylcholine on chloride transport across the mouse lacrimal gland acinar cell membranes. AB - The mechanisms of Cl- transport and the effects of acetylcholine (ACh) and electrochemical Cl- potential changes across the basolateral plasma membrane on intracellular Cl- activity in the acinar cells of isolated mouse lacrimal glands were studied using double-barreled Cl- -selective microelectrodes. In the resting state, the basolateral membrane potential (Vm) was about -40 mV and intracellular Cl- activity was about 35 mmol/l. Addition of ACh (10(-9) approximately 10(-6) mol/l) hyperpolarized Vm and decreased the Cl- activity in a dose-dependent manner. ACh (10(-6) mol/l) hyperpolarized Vm by 20 mV and decreased the cytosolic Cl- activity with an initial rate of 16.0 mmol/l X min. Reduction of the perfusate Cl- concentration to 1/9 control depolarized Vm and decreased cytosolic Cl- activity at a rate of 1.9 mmol/l X min. A Vm hyperpolarization of 20 mV produced by DC injection to the adjacent cell decreased Cl- activity at a rate of 4.6 mmol/l X min. DIDS (1 mmol/l) hyperpolarized Vm by 8 mV with little change in Cl- activity and increased the input resistance of the cells by 25%. DIDS decreased the rate of change in Cl- activity induced by low-Cl- Ringer to 35% of control, but had no effect on the ACh-evoked decrease in the Cl- activity. Furosemide (1 mmol/l) slightly hyperpolarized Vm and decreased Cl- activity at a slow rate but affected Cl- movements induced by ACh or low-Cl- Ringer only slightly. Cl- uptake into the cells was inhibited partially by furosemide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627949 TI - Changes of diameter and length in cylindrical segments of canine femoral arteries during activation at different pressures. AB - Changes in diameter and length of cylindrical segments of canine femoral arteries were recorded at different transmural pressures, and these dimensional changes have been compared with those of rings and longitudinal strips of the vessel wall. The segments responded to stimulation (noradrenaline or 40 mmol/l of potassium) with a reduction of the diameter at all transmural pressures applied. The length of the segments increased during stimulation when the transmural pressure was zero, but decreased at higher transmural pressures (60-70 mm Hg). This shortening at normal transmural pressure was converted to a small lengthening when the segment was stretched to in situ length. The factors determining these responses are discussed. PMID- 3627950 TI - Inhibition of diet-induced thermogenesis during pregnancy in the rat. AB - Both virgin and pregnant rats were maintained at two different ambient temperatures (28 degrees C and 10 degrees C) for 19 days. Virgin rats maintained their daily food intake and body weight at both temperatures. At 28 degrees C pregnant rats showed a greater daily food intake and body weight than virgin ones and their brown adipose tissue suffered regressive changes in composition when compared with brown fat of virgin rats. At 10 degrees C the increases in daily food intake and body weight of pregnant rats took place from day 15-16 of pregnancy onward and foetuses taken from these pregnant rats were smaller than those taken from pregnant rats at 28 degrees C. It is concluded that pregnant rats at thermoneutrality, although hyperphagic, do not show diet-induced thermogenesis. However, it is proposed that pregnant rats in the cold may show BAT cold-induced thermogenesis. PMID- 3627951 TI - Effect of bombesin on thermoregulation of the rabbit. AB - Injections of bombesin (BOM, 125, 250 and 500 ng) into the preoptic/anterior hypothalamus caused dose-related decreases of threshold temperatures for metabolic cold defence, cutaneous vasomotor tone and respiratory rate, combined with a reduced sensitivity of these thermoregulatory effectors in response to core temperature changes induced at thermoneutral or warm ambient conditions. Intracisternal (i.c.) injections of BOM (250 ng) produced qualitatively identical thermoregulatory effector changes in response to core temperature changes. Injections of BOM into the posterior hypothalamus did not affect body temperature control. Increased locomotor behavior, licking and grooming was elicited, however, from all injection sites. The results explain the prevailing hypothermic effect of BOM as the consequence of the concerted decrease in threshold temperatures and "gains" of all autonomic thermoregulatory effectors and suggest the activation of warm inputs, relative to cold inputs, at the hypothalamic level as the underlying mechanism. Direct or indirect inhibition of the intrinsic hypothalamic system involving thyrotropin-releasing hormone (TRH) and consequent deactivation of central noradrenergic pathways known to generate the entire autonomic pattern of cold defence might be involved in the neuro-humoral changes resulting in hypothermic effects of centrally applicated BOM. PMID- 3627952 TI - Effects of the antisecretory factor in pigs. AB - The effect of the antisecretory factor (ASF) on experimental porcine enterotoxin induced jejunal secretion was tested. The heat-labile enterotoxin (LT) from Escherichia coli and cholera toxin (CT) was used for challenge in ligated intestinal loops. Less than 10 units of ASF inhibited the LT-induced secretion, while that due to CT required more than 10 units of ASF. ASF was effective only when administered prior to toxin challenge, and could be given either intravenously or intra-intestinally. Mixing of ASF with specific anti-ASF antibodies prior to injection abolished its antisecretory effect. LT- and CT induced secreted fluid contained equal concentrations of Na+, K+ and Cl-, and the ionic concentration was not affected by ASF. Less than 0.1 units of ASF per pituitary gland was present in 3- and 5-week old pigs, while it increased to 4.5 units in 28-week old animals, and to 12.2 units in pigs older than two years. However, after intra-intestinal vaccination with 2.0 mg CT, the pituitary ASF content in the 5-week old animals increased to 2.0 units within 24 h. PMID- 3627953 TI - Adaptation of phosphate transport to low phosphate diet in renal and intestinal brush border membrane vesicles: influence of sodium and pH. AB - The possible role of changes in the sodium (Na) affinity of the carrier for inorganic phosphate (Pi) in the adaptation of Pi transport to low Pi diet was examined in both renal and intestinal brush border membranes vesicles (BBMV) obtained from the same animal. This role was assessed by measuring the Na concentration resulting in half maximal activation of Pi transport (K0.5 Na) in renal and intestinal BBMV prepared from animals adapted to either low (LPD) or high (HPD) phosphorus diet for 7 days. The K0.5 Na was not modified by dietary Pi, in both renal and intestinal BBMV. LPD increased maximal Pi transport from 1794.8 +/- 198.0 to 2964.0 +/- 362.0 in renal and from 28.2 +/- 3.4 to 80.5 +/- 7.2 pmol/mg 10 s in intestinal BBMV. For both LPD and HPD lowering pH from 7.4 to 6 dramatically increased K0.5 Na in renal and intestinal BBMV. As compared to pH 7.4, it was enhanced by approximately 200% in both renal and intestinal membranes. This change of Na affinity with acidic pH prevented the expression of Pi transport adaptation at 100 mM Na concentration. However, at saturating Na concentrations (500 mM for renal, 300 mM for intestinal membranes), Pi transport adaptation was equally expressed at pH 6 and 7.4 in both types of membranes. Hill coefficient analysis indicates a 2:1 stoichiometry of Na to Pi in renal and intestinal membranes isolated from high or low Pi diet animals. This ratio was not modified by changes of the medium pH. PMID- 3627954 TI - Direct measurement of Na influx by 23Na NMR during secretion with acetylcholine in perfused rat mandibular gland. AB - Intracellular Na content (Nain) in the perfused rat mandibular gland was measured by using a 23Na NMR spectroscopy at 24 degrees C. An aqueous chemical shift reagent, dysprosium triethylenetetramine-N,N,N',N",N"'N"'-hexaacetic acid [Dy(TTHA)] was used in order to discriminate between the intracellular and the extracellular Na signal. The mandibular gland of rat was perfused arterially with a modified Krebs solution containing 10 mM Dy(TTHA). At rest, Nain was not changed by blocking the Na+/K+ ATPase with ouabain (1 mM) and atropine (3 microM), implying that, in the absence of stimulation, the spontaneous Na influx across the plasma membrane must have been negligibly small. Following onset of stimulation with acetylcholine (1 microM), Nain increased by 9.1 +/- 1.5 mmol/l intracellular fluid (mean +/- SEM, n = 13), and remained at this level during stimulation. In the initial phase of secretion (0-5 min), about 50 mmol/min/l intracellular fluid of Na was secreted into the luminal space (estimated from the secretory rate by assuming an isotonic primary secretion) but, in spite of the higher secretion rate, Nain increased only at an initial rate of 4.1 mmol/min/l intracellular fluid. During the steady phase of secretion (15-30 min) evoked by acetylcholine (1 microM), ouabain (1 mM) caused an increment of Nain of 44 +/- 8 mmol/l intracellular fluid (mean +/- SEM, n = 4). From the rate of Nain increment, the Na influx rate at the steady phase was estimated as 4.5 mmol/min/l intracellular fluid. These results suggest that the influx of Na is caused by stimulation with acetylcholine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627956 TI - Respiratory depression caused by either morphine microinjection or repetitive electrical stimulation in the region of the nucleus parabrachialis of cats. AB - In chloralose-urethane anesthetized, vagotomized, paralyzed and artificially ventilated cats, respiratory response to either repetitive electrical stimulation or microinjection of morphine in the rostral pons was studied by recording the phrenic nerve discharges. In the region of the nucleus parabrachialis (PBN) and its ventral reticular formation, electrical stimulation delivered in 20 successive expiratory periods caused the respiratory depression to last long after the termination of stimulation. This respiratory-depressant effect could be reversed by naloxone. By a single electrical stimulation delivered in most of these effective sites, a phasic phrenic excitation was consistently elicited in the period of both expiration and inspiration, and the reduction in expiratory duration could be observed when the stimulation was delivered in expiratory period. In the microinjection study of 2.66 nmol morphine in 0.1 microliter in the localized area of the dorsolateral portion of the PBN, a significant reduction in both respiratory outputs and the rate of increase in inspiratory activity could be induced within 1 min after the application. The respiratory depression thus caused by both methods was quite similar in several respiratory variables. Thus an involvement of the PBN region in long-lasting respiratory modulation mediated by endogenous opioid system is suggested. PMID- 3627955 TI - Exercise training induces transitions of myosin isoform subunits within histochemically typed human muscle fibres. AB - Fibre type composition based on histochemical myosin ATPase reaction was studied in cross sections of biopsies from the vastus lateralis muscle of men. In addition, protein composition as well as peptide patterns of isolated myosin heavy chains were examined in batches of individually classified fibres from the same biopsies. High intensity endurance training during 8 weeks induces significant decreases by 31-70% of the type IIB fibre population in 3 of 4 subjects (in one case no change was observed). These decreases were offset by corresponding increases in either type I or type IIA fibres with the type IIC fibres remaining always below 3%. A total of 13 professional cyclists with training periods over several years have a 20 times lower content of type IIB fibres than 4 sedentary controls and a concomitant high content of 80% of type I fibres. The content of type I and type IIB fibres of 8 sprinter athletes did almost not differ from that of controls. Thus the type IIB fibres respond most sensitively with a decrease to aerobic endurance training. Since both type IIA and IIB fibres were identical in protein composition containing the same fast variety of myosin light chains and heavy chains as well as troponin-I, their interconversion could not be seen at the molecular level. However, the slow variety of myosin light chains and of troponin-I started accumulating after 8 weeks of training in type IIA fibres. Furthermore, the myosin heavy chain isoform started shifting by producing new peptide patterns that resemble the digestion pattern of slow myosin heavy chains in fibres which still classified as type IIA. These changes on the molecular level in type IIA fibres mark the beginning of their transition over the intermediate and variable type IIC fibres, towards the slow type I fibre. PMID- 3627958 TI - Role and regulation of glycerophosphorylcholine in rat renal papilla. AB - Glycerophosphorylcholine (GPC)--an organic solute which is considered to be involved in cellular osmoregulation in the renal medulla--was determined by means of an enzymatic assay in various zones of the rat kidney and in papillary tubule suspensions. In antidiuresis, GPC content in cortex, outer medulla and papillary tip was 0.64, 14.6, and 108.9 mmol/kg fresh weight, respectively. Significant concentrations of GPC could not be detected in the urine or in the peripheral plasma. The sharp increase in GPC concentration from cortex to papillary tip was partially abolished by the induction of diuresis by either waterloading or furosemide. These manoeuvres, however, did not change cortical GPC content. Papillary tubule suspensions prepared from hydropenic rats contained only slightly less GPC per g protein than whole papillae from antidiuretic animals. Incubation of tubules over 120 min did not lead to a significant loss of GPC which is in accordance with the low activity of GPC degrading enzymes in papillary tissue. The results confirm the intracellular localization of GPC and provide further evidence that this substance plays a substantial role in the osmoregulation of renal papillary cells. PMID- 3627957 TI - Cell pairs isolated from adult guinea pig and rat hearts: effects of [Ca2+]i on nexal membrane resistance. AB - Cell pairs isolated from adult rat and guinea pig ventricles were used to study the resistance of the nexal membrane, rn. Each cell of a cell pair was connected to a voltage-clamp circuit to obtain simultaneous whole-cell, tight-seal recordings. With this technique, rn was determined under experimental conditions aimed at primarily modifying [Ca2+]i. Moderate changes in [Ca2+]i (produced by trains of depolarizing voltage-clamp pulses activating the slow inward current, or alterations in [Ca2+]o from 0.5 to 10 mM), resulted in no change in rn for normally coupled cell pairs (rn = 5 M omega), but small and reversible changes in slightly uncoupled preparations (rn greater than or equal to 50 M omega). Large increases in rn developed with substantial elevations in [Ca2+]i (secondary to [Na+]o-withdrawal, exposure to strophanthidin in conjunction with isi, or Ca2+ dialysis). Increases in rn brought about via elevation in [Ca2+]i always were accompanied by cell shortening consistent with a sustained contracture. The current-voltage relationship of the nexal membrane was ohmic regardless of whether rn was low (control) or elevated (after increasing [Ca2+]i). PMID- 3627959 TI - Dissociation between apparent volumes of distribution for inulin and sodium by salt adaptation in ducks. AB - In domestic ducks acclimated to 2% saltwater (SW ducks), chronic elevations of plasma osmolality and sodium concentration, and of the circulating levels of antidiuretic hormone and angiotensin II indicate a trend towards dehydration when compared to ducks maintained on freshwater (FW ducks). Under steady state conditions of salt and water balance, with prevailing antidiuresis and no salt gland secretion, the apparent volumes of distribution of 22Na and of radiolabeled inulin were calculated after single injections of the tracers. The sodium spaces as percent body mass of FW ducks (33.3 +/- 0.9) and SW ducks (31.5 +/- 0.5) were not different, but apparent volumes for inulin distribution differed significantly between FW ducks (31.2 +/- 0.7) and SW ducks (24.8 +/- 0.7). Plasma volumes and rates of inulin disappearance from the plasma during both the non uniform and uniform phases of tracer distribution were closely similar in FW and SW ducks and support the hypothesis that the difference between apparent volumes of inulin distribution reflects a difference in extracellular fluid volume which was estimated as 20.9% in FW ducks and 17.2% in SW ducks. For SW ducks the difference between inulin and sodium spaces was significantly greater than for FW ducks. In relation to the extracellular fluid compartment SW ducks have a larger pool of non-extracellular exchangeable sodium. PMID- 3627960 TI - Mechanical properties of passive rat muscle during sinusoidal stretching. AB - The dynamic passive response of the left gastrocnemius medialis muscle of thirty male Wistar rats was studied as a function of muscle dimensions and absolute and relative amount of connective tissue. Values of the absolute active and passive length-force curves (active force, passive force, active working range) correlated well (coefficients of correlation in a range of 0.62-0.92) with morphological variables (such as muscle optimum length, mean muscle fibre optimum length, physiological cross section, muscle weight and amount of intramuscular connective tissue). To eliminate dimensional effects the active and passive length-force curves were normalized taking maximal active twitch force and muscle optimum length as reference values (100%). The width of the normalized active length-force curve (relative active working range) was correlated negatively with muscle weight, muscle optimum length and physiological cross section. Relative amount of connective tissue and passive tension at optimum length (both independent of muscle dimensions) were positively correlated, indicating that passive muscles are stiffer when relative amount of intramuscular connective tissue is higher. Sinusoidal movements with several amplitudes and frequencies of movement were imposed on the passive gastrocnemius medialis muscle over a range of muscle lengths. In accordance with the approximately exponential increase of static passive muscle force with length, muscle length has a large influence on the shape and magnitude of the hysteresis diagrams resulting from sinusoidal movements: the value of all variables selected increases approximately exponentially with muscle length with the exception of the value of loss tangent, a factor indicating the amount of energy dissipated during each cycle relative to the amount of energy stored and released elastically. Velocity of movement has only minor influence on variables of the hysteresis diagrams as is shown by changing the frequency of movement. As loss tangent and relative amount of connective tissue did not vary with muscle dimensions in the muscles studied, it is likely that material properties of the components causing passive resistance were similar in these muscles. PMID- 3627961 TI - Differential effects of reoxygenation on intracellular calcium and isometric tension. AB - We used the bioluminescent Ca2+ indicator, aequorin to record intracellular calcium transients during reoxygenation of hypoxic ferret ventricular muscle in order to determine whether alterations in the amplitude and time course of isometric contraction are mediated by changes in [Ca2+]i. Papillary muscles less than or equal to 1 mm in diameter were removed from the hearts of male ferrets and perfused with a bicarbonate-buffered physiologic salt solution at 30 degrees C. Muscles were stimulated to contract isometrically at 0.33 Hz and were loaded with aequorin by a chemical procedure. Hypoxia was induced by changing the gas mixture bubbling the perfusate to 95% N2, 5% CO2; reoxygenation was accomplished by switching the gas mixture to 95% O2, 5% CO2. Hypoxia produced a decrease in peak Ca2+ and tension that was reversed by reoxygenation. However, the effects on tension of changes in oxygenation were greater than expected from the degree of change in [Ca2+]i. The time courses of the Ca2+ transient and isometric twitch moved in opposite directions and were respectively prolonged/abbreviated by hypoxia and abbreviated/prolonged by reoxygenation. These results indicate that changes in the amplitude and time course of the isometric twitch induced by hypoxia and reoxygenation cannot be attributed alone to changes in intracellular Ca2+ availability and are caused in part by a significant decrease in the calcium sensitivity of the contractile apparatus. PMID- 3627962 TI - Cultivation, morphology, and electrophysiology of contractile rat myoballs. AB - Myoballs were cultured from neonatal rat skeletal muscle without the use of antimitotic drugs. Electron microscopic investigation showed that 7-day-old myoballs are multinucleated syncytia in a state of differentiation where filaments are abundant and already in hexagonal arrays. The resting potential of 142 myoballs kept at 20 degrees C was not correlated with the cell size. Its mean value was -64 mV. Cells with a high resting potential were capable of generating action potentials with a threshold of -51 mV, an overshoot of +31 mV, and a rate of rise of 100 V/s. The steady-state current-voltage relation showed inward rectification on hyperpolarization and outward rectification on depolarization. The dynamic sodium and potassium currents were investigated at 37 degrees C with the whole-cell-recording technique. The sodium current had its maximum at -20 mV. The potassium current showed delayed activation and a very slow and incomplete inactivation. The electrophysiological results from these cultured cells are very similar to those obtained from adult cells. PMID- 3627963 TI - An electrophysiological study of skeletal muscle fibres in the 'muscular dysgenesis' mutation of the mouse. AB - Experiments were performed on muscles of 18-19 day mice fetuses affected with muscular dysgenesis (mdg). Action potentials generated by electrical stimulation or potassium depolarization failed to trigger muscle contraction in mdg muscle fibres. By contrast, muscle contraction could be obtained by caffeine (15 mM) and, to a lesser degree, by nerve stimulation. We conclude that a defect in excitation-contraction (E-C) coupling is the cause of muscle paralysis. An early after potential (EAP) was present in the decay phase of the action potential and a potential 'creep' occurred in response to hyperpolarizing current pulses which can be taken as evidence for the presence of T-tubules in mdg muscle fibres. Data obtained from square pulse analysis and EAP measurements indicate larger input impedance and membrane time constant in mdg as compared to controls, which contrasts with similar surface membrane time constant (as estimated from the foot of the action potential) in both types of muscle. The excitability of the T tubule system was tested by recording action potentials at early stages of TTX (5 X 10(-7) M) perfusion or washout in mdg and control muscles. In both cases, the action potentials decreased in amplitude and rate of rise and displayed two peaks, the second of which was suppressed by detubulation using the formamide treatment. This indicates action potential generation in the T-tubule membrane of mdg muscles. In all the impaled muscle fibers, nerve stimulation evoked epps which were accompanied by a weak local contraction in relation with Ca2+ influx through postsynaptic channels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627965 TI - Influence of chronic dietary acid on renal tubular handling of magnesium. AB - Micropuncture and clearance studies were performed on rats with chronic metabolic acidosis to evaluate the segmental handling of magnesium. Fractional magnesium excretion was 12.6 +/- 2.3% in acidemic rats (blood pH 7.17 + 0.2) compared to 5.1 +/- 1.3% of normal animals (blood pH 7.36 +/- 0.05). Ultrafiltrable magnesium concentrations were similar in both normal and acidotic animals, 0.51 +/- 0.02 and 0.48 +/- 0.03 mM, respectively. Elevation of urinary magnesium excretion was due to diminished reabsorption in the loop of Henle and segments beyond the distal sampling site. Acute correction of the systemic acidosis with NaHCO3 infusions partially corrected the renal magnesium levels as fractional magnesium excretion fell from 12.6% to 3.1 + 0.75%. This was associated with enhanced reabsorption of magnesium in the loop. To determine if acidosis may compromise the renal conservation of magnesium, acidotic rats were subsequently placed on magnesium-restricted diets. Normal and acidotic animals adapted appropriately and to a similar extent when challenged by short-term magnesium-restricted diets. Accordingly, elevation of dietary acid intake and systemic acidosis leads to renal magnesium wasting which is due in part to diminished reabsorption in the loop of Henle. However, chronic acidosis does not compromise the renal adaptive response to dietary magnesium restriction. PMID- 3627964 TI - Effect of potassium adaptation on the distribution of potassium, sodium and chloride across the apical membrane of renal tubular cells. AB - To assess the effect of K adaptation on the electrolyte concentrations of renal tubular cells and on the concentration gradients across the luminal membrane, electron microprobe analysis was employed on freeze-dried cryosections of the renal cortex and on freeze-dried samples of tubular fluid in control and high-K rats. The measurements were performed in individual cells of the proximal and superficial distal tubule and on samples of tubular fluid obtained by free flow micropuncture from proximal and early and late distal collection sites. The ingestion of a potassium-rich diet for at least 10 days together with an acute potassium load of 0.4 mmol/kg/h led to a small increase in potassium concentration of about 7 mmol/kg wet weight (w.w.) in all cell types analysed. In distal convoluted tubule, connecting tubule and principal cells sodium concentration was markedly decreased by 4, 4, and 6 mmol/kg w.w., respectively, while no significant changes in sodium concentration were found in proximal tubule and intercalated cells. No consistent changes in cell chloride could be observed under K adaptation. Analysis of the tubular fluid samples showed that the K concentration gradient across the apical cell membrane of all distal tubular cell types investigated was diminished in the high-K rats. The concentration gradient for sodium entry, however, was clearly enhanced in the distal convoluted tubule, connecting tubule and principal cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627966 TI - Modulation of the vestibulo-ocular reflex by serotonin in the rat. AB - The effects of intraventricular injection of serotonin (5-HT) and its agonists and antagonists on the amplitude of the vestibulo-ocular reflex were studied in chronic implanted rats. 5-HT (10(-5) M) triggers an increase of the amplitude of the reflex which lasts 30 min. Similar results are obtained when N,N-dimethyl-5 methoxytryptamine (10(-3) M) is introduced into the ventricular cannula. The increasing effects observed both with 5-HT and N,N-dimethyl-5-methoxy-tryptamine are abolished by methiothepin, a potent antagonist of 5-HT receptors. Injection of indirect agonists like pargyline, a monoamine oxidase inhibitor, or fluoxetine, a potent inhibitor of 5-HT reuptake, is followed by an increase of the amplitude of the vestibulo-ocular reflex. These results indicate that 5-HT can modulate the activity of the vestibulo-ocular pathway and muscular tone of extraocular muscles. Location and involvement of various modulating 5-HT sites are discussed. PMID- 3627967 TI - Influence of castration on the membrane reactivity of the guinea-pig vas deferens. AB - The guinea-pig vas deferens is a quiescent muscle which after castration undergoes atrophy and shows spontaneous contractions preceded by membrane spike activity. The influence of castration on the spontaneous release of neurotransmitters and on the internal concentration of sodium and potassium ions was studied. Utilizing the microelectrode technique it was shown that castration induces a partial depolarization (10 mV) of the cell membrane, but did not change the frequency of spontaneous excitatory junction potentials (SEJPs) of guinea-pig vas deferens. However, the time-course and the amplitude of the SEJPs were increased after castration, probably because of changes in membrane properties related to organ atrophy. Castration probably promotes a change in the ionic permeability of the smooth muscle fibre, since the ratio pNa/pK was twice that of control muscles. PMID- 3627968 TI - A study on early post-denervation changes of non-quantal and quantal acetylcholine release in the rat diaphragm. AB - The d-tubocurarine (dTC) induced hyperpolarization of antiesterase-treated muscles at the endplate zone, miniature endplate potentials (mepps), resting membrane potentials (RMPs) and the input resistances of single muscle fibres (Rin) were measured in rat diaphragm at various times after denervation. The dTC induced hyperpolarization decreased in two phases: 2 h after denervation it decreased transiently to 25%, after 4 h it had partially recovered to 60% and from 6 h it progressively decreased up to 12 h after which time it changed to depolarization. The initial fall and recovery were also present in muscles from sham-operated animals. The frequency of mepps decreased by 25% and the amplitude diminished by 10% within the first 2-4 h. After 10 h the frequency had decreased by 35% and the amplitude by 65%. After 12 h no mepps were present. The RMP was not significantly changed during the first 16 h after denervation. From 16 to 24 h the membrane became depolarized at a rate of about 1 mV/h. The input resistance of a single muscle fibre was constant for 12 h after denervation and from 12 to 24 h it increased by 25%. It is concluded that the early decrease in the dTC induced hyperpolarization is probably due to the desensitization of acetylcholine (ACh) receptors caused by stress-activated non-quantal ACh release. The later decrease of dTC-hyperpolarization reflects a fall in the non-quantal ACh release. The depolarization of the resting membrane after denervation is related to the decrease in passive membrane permeability which is a secondary consequence of transmission failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3627969 TI - Contraluminal para-aminohippurate transport in the proximal tubule of the rat kidney. III. Specificity: monocarboxylic acids. AB - In order to study the specificity of the contraluminal para-aminohippurate (PAH) transport system, the inhibitory potency of monocarboxylates on the 3H-PAH influx from the interstitium into cortical tubular cells in situ has been determined. The following was found: if a homologous series of fatty acids with increasing chain length is tested, inhibition of contraluminal PAH influx is first seen with valerate (app. Ki 1.4 mmol/l), increasing up to nonanoate (app. Ki 0.06 mmol/l) and remaining in this range up to duodecanoate, the last compound of this series which is sufficiently water-soluble. Similarly, the inhibitory potency of aromatic monocarboxylates increases with increasing hydrophobicity. If the fatty acids are esterified, their inhibitory potency is lost. If they are transformed to the respective aldehydes their inhibitory potency is preserved at a reduced degree. Introduction of a hydrophobic methyl-, ethyl-, or propyl-group increases the inhibitory potency. A beta-, but not an alpha-oxo-group augments the inhibitory potency of phenylpropionate analogs, an OH group diminishes it, and a NH2 group abolishes it. Among phenyl-fatty acids an increase in affinity is observed from phenyl- less than benzoylamine- less than phenoxy- less than benzoyl-acetate and -propionate. All monocarboxylate compounds, so far tested, do not inhibit contraluminal sulfate and Na+/succinate influx. The data indicate that the PAH transporter interacts with monocarboxylates and also with aldehydes which have a hydrophobic moiety. An additional oxo-group facilitates the interaction. Thus, the benzoyl compounds show the highest affinity observed. PMID- 3627970 TI - Further kinetic analysis of the chemically modified acetylcholine receptor. AB - The acethylcholine receptor was chemically modified using bisulfite to add a sulfonate group to a disulfide bond on the alpha subunit, and diamide, an oxidizing agent, to form an interchain disulfide bond between beta subunits of adjacent receptors. In previous work, both reagents increased mepc decay times but produced no change in mean channel open time or conductance as measured by spectral analysis of endplate current fluctuations (Steinacker and Zuazaga 1981). In the current work, we show that, while both chemical modifications increase the decay time of the miniature endplate current, only sulfonation increases the time to peak. Sulfonation also produced an effect on voltage jump current relaxation time, which parallels the increase in miniature endplate current decay time, and an increase in the ratio of the current relaxation amplitudes. Diamide had no effect on voltage jump current relaxation amplitudes or time constants. These data are analyzed in an attempt to correlate changes in specific rate constants to changes in the macroscopic current measurements. PMID- 3627971 TI - A simple gas-flow chamber for cultured cell electrophysiology in a controlled atmosphere. AB - A simple and inexpensive device is described to control the gaseous environment while recording membrane potentials and contractile motion from single cultured cells. This equipment was used to study the electrophysiological and mechanical responses to hypoxia of cultured rat heart cells, but should also be suitable for a wide range of applications with several cell types. PMID- 3627972 TI - The effect of venous blood stream cooling on survival of bacterially infected rabbits. AB - The effect of physical cooling on the mortality rate of rabbits infected with Pasteurella multocida was investigated. Rabbits were cooled for 48 hours after bacterial injection by passing cold fluid through small hollow metal cuffs which had been surgically implanted around the abdominal vena cavae of rabbits. The average body temperatures of the rabbits during the 24-hour period after the intravenous injection of live Pasteurella multocida was 40.92 +/- 0.20 degrees C in control rabbits and 38.98 +/- 0.71 degrees C in cooled rabbits. 90% of physically cooled rabbits survived compared with 46% of control rabbits 48 hours after bacterial injection, suggesting that thermoregulatory effector mechanisms involved in cold defense may enhance survival. PMID- 3627973 TI - A new rice repetitive DNA shows sequence homology to both 5S RNA and tRNA. AB - Moderately repetitive DNA sequences are found in the genomes of all eucaryotes that have been examined. We now report the discovery of a novel, transcribed, moderately repetitive DNA sequence in a higher plant which is different from any of the known repetitive DNA sequences from any organism. We isolated a rice cDNA clone which hybridizes to multiple bands on genomic blot analysis. The sequence of this 352 bp cDNA contains four regions of homology to the wheat phenylalanine tRNA, including the polymerase III-type promoter. Unexpectedly, two regions of the same 352 bp sequence also show homology to the wheat 5S RNA sequence. Using the cDNA as a probe, we have isolated six genomic clones which contain long tandem repeats of 355 bp sequence, and have sequenced nine repeat units. Our findings suggest that the rice repetitive sequence may be an amplified pseudogene with sequence homology to both 5S RNA and tRNA, but organized as long tandem repeats resembling 5S RNA genes. This is the first example showing homology between the sequences of a moderately repetitive DNA with unknown function and 5S RNA. PMID- 3627974 TI - A model for the separation of large DNA molecules by crossed field gel electrophoresis. AB - The idea that large DNA molecules adopt a stretched conformation as they pass through gels suggests a simple mechanism for the separation of DNA by crossed field electrophoresis: at each change in field direction a DNA molecule takes off in the new direction of the field by a movement which is led by what was formerly its back end. The effect of this ratcheting motion is to subtract from the DNA molecule's forward movement, at each step, an amount which is proportional to its length. We find that this model explains most of the features of the separation, and we describe experiments, using a novel electrophoresis apparatus, which support the model. The apparatus turns the gel between two preset orientations in a uniform electric field at preset time intervals. This separation method has the practical advantage over some others that the DNA molecules follow straight tracks. A further advantage is that the parameters which determine the separation are readily predicted from the simple theory describing their motion. PMID- 3627975 TI - The human c-Kirsten ras gene is activated by a novel mutation in codon 13 in the breast carcinoma cell line MDA-MB231. AB - We have detected amplified human Ki-ras sequences in tumorigenic NIH 3T3 cells transfected with genomic DNA from the human breast carcinoma cell line MDA-MB231. Hybridization of synthetic oligonucleotides specific for human Ki-ras sequences showed a mutation at codon 13. The polymerase chain reaction with Ki-ras specific amplimers revealed a guanosine to adenosine transition at the second position of codon 13, resulting in a substitution of glycine by aspartic acid. The codon 13 mutation is also detected in one Ki-ras allele of the MDA-MB231 cell line. PMID- 3627976 TI - Identification of the transcriptional initiation site of ribosomal RNA genes in the crustacean Artemia. AB - The proximal part of the Intergenic Spacer, as well as most of the External Transcribed Spacer of the ribosomal RNA type I genes from the crustacean Artemia have been sequenced. We have identified in the Intergenic Spacer five repeats of around 600 bp in length and, possibly, two imperfect or truncated repeats, derived from the principal ones. These sequences are separated by 485 bp from the 17S rRNA coding sequence. We have also identified the start point of transcription by S1 nuclease analysis. This start point is found 248 bp inside the first repeat. The sequence around the start point shows homology with that described for other members of the same phylum, mostly insects. The most conserved regions are from -1 to +25, and the G residue at position -16. At least the three 600-bp repeats upstream from that containing the promoter also contain the start point sequence, and could therefore act as initiation sites for snPIRNA and/or as enhancer sequences for ribosomal RNA gene transcription. PMID- 3627977 TI - Sequences of the 5' portion of the human c-sis gene: characterization of the transcriptional promoter and regulation of expression of the protein product by 5' untranslated mRNA sequences. AB - The c-sis gene encodes the B polypeptide chain of platelet-derived growth factor (PDGF), and is expressed in a number of normal and pathological conditions. In order to study the control of synthesis of the human c-sis product, we have initiated a study of two regions of this genetic locus which regulate transcription and translation. A clone of the 5' portion of the gene was obtained which included 1361 nucleotides upstream of the RNA initiation site. Transcriptional promoter activity of this region was demonstrated in normal and transformed cells using a plasmid with the sequences upstream of the c-sis RNA initiation site fused to an indicator gene, chloramphenicol acetyl transferase. Experiments were also performed to identify other possible regulatory regions of the c-sis gene. These data demonstrated that a portion of the c-sis first exon encoding the 5' untranslated region of the c-sis mRNA inhibited synthesis of the PDGF B product in vitro. These results define regions of the c-sis gene whose activity may be important in the regulation of transcription and translation under normal conditions and in the pathogenesis several human diseases. PMID- 3627978 TI - Analysis of upstream activation sites of yeast ribosomal protein genes. AB - Transcription of the gene encoding yeast ribosomal protein L25 was previously shown to be activated through tandemly arranged upstream sequence elements that most rp-genes in yeast have in common. A single copy of such a conserved element is now demonstrated to restore transcription of an inactivated heterologous gene, which confirms its role as a genuine UAS: UASrpg. Though a single box is sufficient to activate transcription, most rp-genes harbor two neighbouring elements. Northern analysis of mutants of the L25 upstream region lacking either the gene-distal (RPG1) or the gene-proximal (RPG2) box provided evidence that RPG2 is significantly more effective than RPG1 in vivo. Moreover the sum of the effects of the individual boxes as measured separately is significantly lower than their joint effect, supporting cooperative interaction between the two boxes in vivo. Making use of oligomer-insertion experiments several additional features of the UASrpg were elucidated. First of all we confirmed that the extent of transcription activation by the UASrpg depends upon the orientation of the element. Secondly we show that a certain minimal distance (greater than 100 n) between UASrpg and the transcription initiation site is required for transcription activation. Finally, internal deletion of the L25-upstream region as well as oligomer-insertion shed some light on the nucleotide requirements of the UASrpg. PMID- 3627979 TI - Unique poly(dA).poly(dT) B'-conformation in cellular and synthetic DNAs. AB - Poly(dA).poly(dT), but not B-form DNA, is specifically recognized by experimentally induced anti-kinetoplast or anti-poly(dA).poly(dT) immunoglobulins. Antibody binding is completely competed by poly(dA).poly(dT) and poly(dA).poly(dU) but not by other single- or double-stranded DNA sequences in a right-handed B-form. Antibody interaction with poly(dA).poly(dT) depends on immunoglobulin concentration, incubation time and temperature, and is sensitive to elevated ionic strengths. Similar conformations, for example, (dA)4-6 X (dT)4 6, in the kinetoplast DNA of the parasite Leishmania tarentolae are also immunogenic and induce specific anti-poly(dA).poly(dT) antibodies. These antibody probes specifically recognize nuclear and kinetoplast DNA in fixed flagellated kinetoplastid cells as evidenced by immunofluorescence microscopy. Anti poly(dA).poly(dT) immunofluorescence is DNase-sensitive and competed by poly(dA).poly(dT), but not other classical double-stranded B-DNAs. Thus, these unique cellular B'-DNA helices are immunogenic and structurally similar to synthetic poly(dA).poly(dT) helices in solution. PMID- 3627980 TI - Toxin resistance and/or male fertility reversion is correlated with defined transcription changes in the 1.5 kb AvaI region of cmsT. AB - Reversion of T type cytoplasmic male sterility (cmsT) to fertility is correlated with sequence changes in a 1.5 kb AvaI fragment. This 1.5 kb AvaI fragment is composed of 5' flanking sequences of ATPase subunit 6, one complete open reading frame (ORF 13) and part of the another (ORF 25). The sequence of the 1.5 kb AvaI fragment was compared to the sequences of homologous regions in the N (male fertile) and T revertant V3 mitochondrial DNA. Sequences were found to diverge between ORF 13 and ORF 25 coding regions. To further characterize the transcription of these rearranged sequences, specific probes for ORF 13, ORF 25 and 5' flanking sequences of ATPase 6 were hybridized to Northern blots of N, cmsT and the T revertant V3 and V18 mtRNAs. Each revertant has a single ORF 25 homologous transcript in contrast to the multitranscript pattern in cmsT. ORF 13 homologous transcripts were not detected in either revertant cytoplasm. The loss of ORF 13 and/or altered ORF 25 transcription in the fertile revertants may be responsible for the male fertility and/or toxin resistance in these plants. PMID- 3627981 TI - Synthesis and hybridization studies on two complementary nona(2'-O methyl)ribonucleotides. AB - 2'-O-Methyl derivatives of the common ribonucleosides except for guanosine were synthesized via the 2'-O-methylation of appropriately-protected nucleosides with CH3I in the presence of Ag2O. The 2'-O-methylguanosine derivative was prepared by the monomethylation of a 2',3'-cis-diol system with diazomethane. These derivatives were converted to protected 2'-O-methylribonucleoside 3'-phosphates and used for oligonucleotide synthesis on polymer supports. Thus, oligo(2'-O methyl-ribonucleotides) having the sequence identical to the consensus sequence of the 5'-splice junction CAGGUAAGU and its complement were synthesized in a stepwise manner using the phosphotriester method. Thermal stabilities (Tm's) of the duplex of these 2'-O-methyl ribo-oligomers and eight related duplexes containing ribo- or deoxyribo-oligomers were examined. It was found that the 2'-O methyl oligoribonucleotides can be utilized as an alternative to an oligoribonucleotide probe in RNA hybridizations as the hybrid formed has a high, or a higher Tm, the probe is much easier to synthesize and it is less likely to be enzymatically degraded. PMID- 3627982 TI - Oligo-[alpha]-deoxynucleotides covalently linked to an intercalating agent. Double helices with parallel strands are formed with complementary oligo-[beta] deoxynucleotides. AB - An oligo-[alpha]-deoxynucleotide of sequence (5')d(TCTAAACTC) (3') was synthesized using the alpha-anomers of deoxynucleosides and its 5'-phosphate was covalently linked to a 9-amino acridine derivative via a pentamethylene linker. Two oligo-[beta]-deoxynucleotides containing the complementary sequence in either the 5'----3' or the 3'----5' orientation were synthesized using natural [beta] deoxynucleosides. Complex formation was investigated by absorption and fluorescence spectroscopies. No change in spectroscopic properties was detected with the anti-parallel [beta] sequence. Absorption changes were induced in the visible absorption band of the acridine derivative at 2 degrees C when the acridine-substituted oligo-[alpha]-deoxynucleotide was mixed in equimolecular amounts with the complementary [beta]-sequence in the parallel orientation. Hypochromism was observed in the UV range. The fluorescence of the acridine derivative was quenched by the guanine base present in the second position of the complementary sequence. Cooperative dissociation curves were observed and identical values of melting temperatures were obtained by absorption and fluorescence. An increase in salt concentration stabilized the complex with a delta Tm of 8 degrees C when NaCl concentration increased from 0.1 to 1 M. These results demonstrate that an oligo-[alpha]-deoxynucleotide covalently linked to an intercalating agent is able to form a double helix with an oligo-[beta] deoxynucleotide. The two strands of this [alpha]-[beta] double helix adopt a parallel 5'----3' orientation. The acridine ring is able to intercalate between the first two base pairs on the 5'-side of the duplex structure. PMID- 3627983 TI - Isolation of a sequence which maps close to the human sex determining gene. AB - A sequence mapping close to the human sex determining gene (TDF) has been isolated from a lambda library constructed with DNA derived from a chromosome transfectant hybrid cell line. This sequence is shown to be present in the DNA of X-Y interchange males at a very high frequency and, based on these studies, it is categorised with the sequence defined by the probe, GMGY3, as the closest known Y chromosome derived marker to TDF. In contrast to GMGY3, however, this locus shares no homology with any other human chromosome. Southern blot analysis also reveals specific hybridization to the Y chromosome of other primates. It therefore defines, for the first time, a conserved and Y chromosome unique locus that is near to TDF. PMID- 3627984 TI - The synthesis of protected 5'-amino-2',5'-dideoxyribonucleoside-3'-O phosphoramidites; applications of 5'-amino-oligodeoxyribonucleotides. AB - Synthetic routes to the four appropriately protected 5'-amino-2',5' dideoxyribonucleoside-3'-O-(2-cyanoethyl N,N-diisopropylphosphoramidites) have been developed. The structures of all intermediates were confirmed by 13C n.m.r. spectroscopy. These building blocks have been used to prepare 5'-amino oligodeoxyribonucleotides, which can be coupled to a wide variety of compounds, in particular metal cluster derivatives, but also fluorophores and biotin derivatives, thus generating a variety of very useful probes. Brief mention is made of a tetrairidium cluster derivative of 5'-amino-d[CCGATATCGG], which has been cocrystallised with EcoRV, and will be used for electron microscopy studies. PMID- 3627985 TI - Long range genome structure around the human alpha-globin complex analysed by PFGE. AB - A map encompassing 300 kilobases (kb) in and around the human alpha-globin gene complex shows features with important implications for understanding the structure and function of the human genome. In contrast to other segments of the mammalian genome that have been analysed by pulsed field gradient electrophoresis (PFGE), this region contains an unusually high density of sites for infrequently cutting restriction enzymes that recognise GC rich motifs including the under represented CpG doublet. This suggests that the 26 kilobase (kb) stretch of DNA containing the alpha-globin gene family, which is known from sequence analysis to be 60% GC rich, is itself embedded within a region of high GC content. This long range structure, identified by PFGE, corresponds to a class of GC rich isochores that are thought to represent early replicating DNA present in Giemsa negative chromosomal bands. The identification of such regions by PFGE will be of value in understanding the organisation of human chromosomes and will influence the strategies used to construct a physical map of the genome. PMID- 3627986 TI - Synthesis of oligodeoxyribonucleotide with aliphatic amino or phosphate group at the 5' end by the phosphotriester method on a polystyrene support. AB - Lipophilic protecting groups mTrNH(CH2)n X (mTr:monomethoxytrityl, X = NH,O,S, n = 2,3,4,6) were attached to the 5'-phosphoryl group of 3'-O-protected thymidine. When the diamine derivatives (X = NH2) were used, the time course of the stability of mTr groups on the amino group and the phosphoramidate linkage with 80% aq. AcOH was measured. It was found that the mTr group was removed from the amino group rapidly and that the phosphoramidate linkage was more stable. It's stability depended upon the length of the CH2 linker. Oligonucleotides with an aliphatic amino group at their 5'-ends were synthesized by the phosphotriester method on a polystyrene support using protected nucleotides with P-O or P-S linkages. In the case of product with a P-S linkage, 5'-O-phosphorylated nonadecanucleotide was also prepared by I2-H2O treatment. PMID- 3627987 TI - Chicken histone H3.3B cDNA sequence confirms unusual 3' UTR structure. PMID- 3627988 TI - Hybridization probe size control: optimized 'oligolabelling'. PMID- 3627989 TI - The nucleotide sequences of two human 5S rRNA pseudogenes. PMID- 3627990 TI - Nucleotide sequence of a cDNA encoding rbcS from the desert plant Mesembryanthemum crystallinum. PMID- 3627991 TI - Nucleotide sequence of the gene encoding the Saccharomyces kluyveri alpha mating pheromone. PMID- 3627992 TI - A new natural hGH variant--17.5 kd--produced by alternative splicing. An additional consensus sequence which might play a role in branchpoint selection. AB - From a human pituitary cDNA library, we have cloned 3 distinct human growth hormone (hGH) cDNAs, coding respectively for the 22 K hGH, the 20 K variant, and a yet unknown 17.5 K variant. S1 mapping analysis using human pituitary RNA confirms the existence of at least four distinct hGH mRNAs originating from alternative acceptor sites at the second intron of the primary transcript. We have analysed the hGH gene sequence to explain the high frequency of alternative splicings which occur only at this location. In this study we propose CTTGNNPyPyPy as an additional consensus sequence guiding the selection of the branched nucleotide. PMID- 3627993 TI - Glucocorticoids control phosphoenolpyruvate carboxykinase gene expression in a tissue specific manner. AB - Cytosolic Phosphoenolpyruvate carboxykinase is a key gluconeogenic enzyme which is expressed in a tissue specific manner in the liver, kidney and adipose tissue and is under hormonal control. The effect of glucocorticoids on expression of the gene coding for phosphoenolpyruvate carboxykinase in adipose tissue has been studied in vivo in rats and in vitro in adipose tissue organ culture and mouse 3T3 L1 adipocytes. Glucocorticoids, both in vivo and in vitro, repress the steady state level of phosphoenolpyruvate carboxykinase mRNA in the adipose tissue while increasing it in the kidney. The size of the mRNA and its 5' end are identical in adipose tissue and kidney, thus the same promoter is used in all tissues. The inhibitory effect of glucocorticoids on phosphoenolpyruvate carboxykinase gene expression was located at the level of transcription. As glucocorticoids are known to stimulate transcription of phosphoenolpyruvate carboxykinase gene in the liver and kidney, the inhibitory effect on its transcription in adipose tissue suggests that tissue specific transcription factors may modulate the effect of glucocorticoids. PMID- 3627994 TI - Only two of the four sites of interaction with nuclear factors within the Xenopus U2 gene promoter are necessary for efficient transcription. AB - An analysis, performed by DNase I footprinting, of the interactions between factors present in Molt-4 nuclear extracts and a Xenopus U2 snRNA gene promoter is presented. Four distinct regions of sequence-specific DNA-factor interaction are found. Two of these correspond to the previously identified proximal and distal sequence elements (PSE and DSE) of the promoter. Both of these elements are important in U2 transcription, indicating a functional role for the observed interactions. The other two sites of interaction correspond to a sequence element conserved in many, but not all, vertebrate U snRNA gene promoters (the MSE) and to a region adjacent to the site of transcription initiation (the "cap site"). Site-directed mutants of these latter two elements are constructed which no longer bind nuclear factors. Transcriptional analysis in Xenopus oocytes reveals that these mutants are transcribed as efficiently as wild-type U2. Other possible roles for the two factors are discussed. PMID- 3627995 TI - Identification of nuclear cap specific proteins in HeLa cells. AB - Two polypeptides of apparent molecular mass of 20 and 115 kilodaltons in nuclear fractions from HeLa cells were shown to recognize and be crosslinked to the cap structure of eukaryotic mRNAs in a cap-dependent fashion. Crosslinking of the 20 and 115 kDa polypeptides was sensitive to inhibition by low concentrations of the cap analogue m7GDP and resistant to inhibition by high KCl concentrations. In addition, crosslinking of these polypeptides to the cap structure occurred in nuclear extracts prepared from poliovirus-infected cells, under conditions where cytoplasmic cap binding proteins were incapable of interacting with the mRNA cap structure. The possible function of nuclear cap binding proteins is discussed. PMID- 3627996 TI - 5' proximal sequences of a soybean ribulose-1,5-bisphosphate carboxylase small subunit gene direct light and phytochrome controlled transcription. AB - Two closely related ribulose-1,5-bisphosphate carboxylase small subunit (SSU) genes, SRS1 and SRS4, are transcribed at high levels in soybean plants in response to light. Transgenic petunia plants containing 5' sequences from SRS1 or SRS4 fused to the polypeptide encoding region of a neomycin phosphotransferase (NPTII) gene exhibit selectable kanamycin resistance. Deletion of three ATG codons from the region preceding the normal NPTII translation start site has little effect on the levels of kanamycin resistance in transformed plants. Run-on transcription assays in isolated nuclei demonstrate that transcription of the SRS1/NPTII chimera and the native petunia SSU11A gene subfamily is light regulated and under phytochrome control in leaves of transgenic plants. In young expanding leaves of fully light grown plants, transcription of these genes is markedly reduced within minutes of far-red treatment, while ribosomal DNA and actin gene transcription remains unchanged. This is analogous to the transcriptional response we observed for SRS1 and SRS4 in soybean seedlings. These data suggest (1) that transcription of SSU genes in both soybean and petunia require the continued presence or synthesis of phytochrome in the Pfr form and (2) that 5' sequences are sufficient to direct the phytochrome controlled transcriptional response of the SRS1 gene. In fully expanded mature leaves we found the transcription rates of the native SSU11A gene subfamily, the chimeric SRS1/NPTII gene, the rDNA genes, and several other control genes to be reduced markedly after far-red treatment or after extended periods of darkness. The contrast between results in young and mature leaves is discussed. PMID- 3627997 TI - Visualization of an AAF induced frameshift mutation: molecular views of base displacement in B-DNA from minimized potential energy calculations. AB - Energy minimized structures of base displacement in an AAF modified B-DNA dodecamer are presented. A rational search strategy, beginning with a global search of the conformation space of the modified deoxydinucleoside monophosphate, together with model building by computer graphics, has been employed. A number of different minimum energy conformations have been located which reveal base displaced structures. These show fluorene interstrand stacking, fluorene inter- and intrastrand stacking, and non-stacked fluorene situated in the denatured bulge. The local helix axis is bent to various extents in the different forms, and one or two base pairs are fully denatured. One structure of special interest offers a molecular view that suggests how AAF can induce the -2 deletion mutation observed in AAF modified E. coli. PMID- 3627998 TI - Molecular modelling of the interactions of tetra-(4-N-methylpyridyl) porphin with TA and CG sites on DNA. AB - The molecular structure of the DNA-intercalating ligand tetra-(4-N-methylpyridyl) porphin has been determined by X-ray crystallography. The porphyrin has a precise centre of symmetry; the central core is planar, with the N-methylpyridyl groups inclined to it at angles of 66-72 degrees. Molecular modelling of this structure into TpA and CpG sites of intercalated DNA, has been performed, and approximate energetics calculated. It has been shown that only the CpG site can have full ligand intercalation, since the thymine methyl group sterically hinders such geometry at TpA sites. Modelling indicates the importance of electrostatic effects in the low-energy forms of intercalated and part-intercalated complexes at both sequences. PMID- 3627999 TI - Structural features and hydration of a dodecamer duplex containing two C.A mispairs. AB - X-ray diffraction techniques have been used to characterise the crystal and molecular structure of the deoxyoligomer d(C-G-C-A-A-A-T-T-C-G-C-G) at 2.5A resolution. The final R factor is 0.19 with the location of 78 solvent molecules. The oligomer crystallises in a B-DNA type conformation with two strands coiled about each other to produce a duplex. This double helix consists of four A.T and six G.C Watson-Crick base pairs and two C.A mispairs. The mismatched base pairs adopt a "wobble" type structure with the cytosine displaced laterally into the major groove, the adenine into the minor groove. We have proposed that the two close contacts observed in the C.A pairing represent two hydrogen bonds one of which results from protonation of adenine. The mispairs are accommodated in the double helix with small adjustments in the conformation of the sugar-phosphate backbone. Details of the backbone conformation, base stacking interactions, thermal parameters and the hydration are now presented and compared with those of the native oligomer d(C-G-C-G-A-A-T-T-C-G-C-G) and with variations of this sequence containing G.T and G.A mispairs. PMID- 3628000 TI - DNA glycosylase enzymes induced during chemical adaptation of M. luteus. AB - Five peaks of DNA glycosylase activity showing a preference for MNNG alkylated DNA have been identified from extracts of adapted M. luteus. They are numerically designated as GI to GV in order of their decreasing molecular weights. The first two of these peaks have been highly purified. GI, is a constitutive heat labile protein, 35% stimulated by the presence of 50 mM NaCl, acts exclusively on 3 MeA residues in alkylated DNA, 60-70% inhibited by the presence of 2 mM free 3MeA and has been designated as 3MeA DNA glycosylase enzyme. GII, which is an inducible protein, is heat stable, 28% inhibited by the presence of 50 mM NaCl, removes 3MeA, 3MeG, 7MeA & 7MeG with different efficiency, and has been designated as 3,7 methylpurine DNA glycosylase enzyme. The rate of release of 3 methylpurines is 30 times that of 7MeG. There is no activity of either enzyme on O2-MeC, O2-MeT, O4 MeT or O6-MeG. The apparent molecular weights of GI and GII proteins are 28 Kd and 22 Kd respectively. PMID- 3628001 TI - Alpha-DNA. IV: Alpha-anomeric and beta-anomeric tetrathymidylates covalently linked to intercalating oxazolopyridocarbazole. Synthesis, physicochemical properties and poly (rA) binding. AB - A new set of molecules made of an intercalating agent (oxazolopyridocarbazole, OPC) covalently linked through a polymethylene chain of various length to the 3' end of alpha-anomeric or beta-anomeric tetradeoxynucleotides (alpha- or beta-T4) have been synthesized. The beta-thymidylate modified compound (beta-T4C5OPC) is able to interact with the complementary sequence, beta-poly (rA); this interaction is strongly stabilized compared to the parent compound, beta oligo(dT)4 and is specific for poly (rA). The molecule synthesized from the unnatural alpha-anomer, alpha-T4C5OPC, is also able to interact with poly (rA) leading to the formation of an alpha-beta hybrid stabilized by the energy provided by the OPC moiety. The stoechiometry of the binding reaction shows that an A-T pairing occurs in the alpha-beta heterohybrids. Tm studies reveal that the alpha-beta heterohybrids are more stable than their beta-beta counterparts. PMID- 3628002 TI - An inspection of the domain between putative TATA box and translation start site in 79 plant genes. AB - Over 75 published genomic DNA sequences from several higher plants have been collected and flanking regions of the leader sequences have been analysed. In a majority of the plants, the first AUG codon on processed mRNA acted as a translation initiation site. The consensus sequence for the context was TAAACAATGGCT (on plus strand of DNA). This differed from the earlier suggestion for eukaryotic mRNAs based mainly on data from animals. Leader sequences were generally 40-80 nucleotides in length and were A+T rich. Adenine was present in a majority of the cases at the transcription start site which was flanked by pyrimidine bases. The putative TATA box was present 32 +/- 7 nucleotides upstream from the transcription initiation site. The consensus sequence for TATA box and surrounding region was TCACTATATATAG. PMID- 3628003 TI - Reversibility of the low-salt transition of chromatin core particles. AB - The low-salt transition of chromatin core particles is reversible if the monovalent cation concentration is kept above 0.2 mM. Exposure of the particles to salt concentrations below this value results in a nonreversible secondary transition. The nonreversible changes are relatively slow with a half-time of about 15 minutes. Once exposed to such low ionic strength, the particles then begin to refold with increasing salt in at least two steps over a much higher ionic strength range than is required for the usual low-salt transition. The refolding is very fast, with a half-time less than a minute. Small differences between particles which had or had not been exposed to very low salt persist even when the particles are returned to near physiological ionic strengths. PMID- 3628005 TI - Enzymatic synthesis of RNA oligonucleotides. AB - Using SP6 RNA polymerase and various synthetic DNA oligomers as templates (12-65 b), we have obtained efficient synthesis of RNA transcripts without the need for either primer or promoter. Gel analysis of transcripts made from templates of known size demonstrated a predominant single species, together with some minor bands. For a given template the major band had the same 5'-nucleotide as predicted from the 3'-nucleotide of the template. This synthesis procedure makes it possible to efficiently and conveniently make labeled or unlabeled RNA from synthetic DNA oligonucleotides. PMID- 3628006 TI - Nucleotide sequence of gene t (lysis gene) of the E. coli phage T4. PMID- 3628004 TI - A growth-related mRNA in cultured mouse cells encodes a placental calcium binding protein. AB - We have characterized an mRNA that increases in abundance after serum stimulation of quiescent mouse fibroblasts. This mRNA, designated 18A2, encodes a predicted polypeptide of 101 amino acids with homology to known calcium binding proteins. A variety of mouse tissues express the 18A2 mRNA, with the highest levels detected in the non-pregnant uterus and in the placenta. The concentration of 18A2 mRNA in total placental RNA decreases from day 8 to day 10 of pregnancy, and is below detection throughout the latter half of gestation. In serum-stimulated fibroblasts, the increase in 18A2 mRNA is dependent on protein synthesis. The 18A2 mRNA is similar in size, serum-inducibility, and sequence to the 2A9 mRNA (1), but these mRNAs are derived from distinct genes. This suggests that the mouse genome harbors a family of serum-inducible genes encoding proteins predicted to bind calcium. PMID- 3628007 TI - The cDNA sequence of the major phospholamban mRNA in canine cardiac ventricular muscle. PMID- 3628008 TI - A. tumefaciens pTi A6 and C58 vir C and D promoter alignment. PMID- 3628009 TI - Nucleotide sequence of a full-length cDNA clone encoding preproparathyroid hormone from pig and rat. PMID- 3628010 TI - Sequence of the genes coding for the A-protein and coat protein of bacteriophage fr. PMID- 3628011 TI - Nucleotide sequence of lupin leghemoglobin I cDNA. PMID- 3628012 TI - cDNA and deduced amino acid sequence of rat copper-zinc-containing superoxide dismutase. PMID- 3628013 TI - Chicken non-histone chromosomal protein HMG-17 cDNA sequence. PMID- 3628014 TI - Human alpha satellite DNA--consensus sequence and conserved regions. PMID- 3628015 TI - 5' flanking sequence of the gene for rat hepatic cytochrome P450e. PMID- 3628016 TI - Hsp90, hsc73 and EF-1 alpha gene expression in nonheatshocked and heatshocked LMTK- cells. PMID- 3628017 TI - S1 plasmid from cms-S-maize mitochondria encodes a viral type DNA-polymerase. PMID- 3628018 TI - Electroelution of nucleic acid in microcentrifuge tube. PMID- 3628019 TI - [Myocardial scintigraphy using cationic 99m Tc complexes]. AB - This report summarizes the results which have been achieved by the use of 99mTc labeled cationic complexes for myocardial scintigraphy. Radiopharmacological aspects of 99mTc(III)-Cl2 (DMPE)2 and 99mTc(I)-TBl as well as their scintigraphic behaviour in patients with coronary artery disease are described. In contrast to 99mTc-Cl2 (DMPE)2, 99mTc-TBl could be used successfully for the assessment of ischemic and infarcted myocardial tissue. Yet in general, 201Tl scintigraphic findings remained superior. However, from the considerable improvements achieved it is likely that soon a 99mTc-labeled tracer will be available to serve as clinical useful myocardial imaging agent. PMID- 3628020 TI - Biodistribution of N-isopropyl-p-iodoamphetamine in the rat brain. AB - The biodistribution of N-isopropyl-p-iodoamphetamine (IMP) was studied in the rat brain. 131I-labelled IMP was injected intravenously in awake animals. Activities in the brain of Sprague-Dawley rats were 2.68-3.22 (% dose/g) in the cortex and 0.59-0.66 (% dose/g) in the white matter at 1 min p.i. Activities in the cortex were slightly increased at 60 min p.i., while activities in the white matter increased markedly at 60 min and 6 h p.i. Therefore, the cerebral cortex-to-white matter ratio decreased from 5 to 1 within 60 min after injection. Autoradiograms of the rat brain at 1-10 min p.i. showed high contrasts. Activities were high in the cortex and low in the white matter, but homogeneous at 60 min-6 h. IMP seems to be a useful agent for cerebral perfusion imaging in the early phase after injection. Knowledge of biodistribution of this agent is considered to be indispensable for the interpretation of images. PMID- 3628021 TI - Prevalence and prognostic value of left ventricular dysfunction in non-Q-wave myocardial infarction. AB - Forty-two consecutive patients with non-Q-wave acute myocardial infarction (AMI) and 40 consecutive patients with transmural AMI were comparatively examined by equilibrium gated radionuclide angiography (ERNA) to assess prevalence and prognostic value of left ventricular dysfunction in non-Q-wave AMI. Left ventricular ejection (LVEF) was generally preserved both in anterior and inferior non-Q-wave infarctions and sharply reduced only in anterior transmural infarctions. ERNA cannot assist in identifying any subgroup of patients with non Q-wave AMI at risk of major complications other than left ventricular failure because they may develop such complications in spite of a normal LVEF. PMID- 3628022 TI - [131I-accumulating pulmonary and bone metastases of differentiated thyroid cancer with low serum thyroglobulin levels--an exception in tumor follow-up?]. AB - In the follow-up of differentiated thyroid carcinoma it is discussed whether the tumor-marker thyroglobulin can replace the 131I scan, especially when the thyroglobulin serum level is normal. A positive 131I scan of metastases in the follow-up of patients with differentiated thyroid carcinoma combined with a low serum thyroglobulin level is extremely rare. The literature shows a frequency of about 4%. Recently we found 3 cases with a positive 131I scan demonstrating pulmonary and bone metastases whereas the serum thyroglobulin level was low. PMID- 3628023 TI - [Radioactivity levels of the air inhaled by personnel of a radioiodine therapy unit]. AB - The mean activity concentration of 131I during inhalation by the nuclear medicine personnel was measured at therapeutic activity applications of 22 GBq (600 mCi) per week. The activity concentration reached its maximum in the exhaled air of the patients 2.5 to 4 hours after oral application. The normalized maximum was between 2 X 10(-5) and 2 X 10(-3) Bq X m-3 per administered Bq. The mean activity concentration of 131I inhaled by the personnel was 28 to 1300 Bq X m-3 (0.8 to 35 nCi X m-3). From this the 131I uptake per year was estimated to be 30 to 400 kBq/a (mean = 250, SD = 50%). The maximum permitted uptake from air per year is, according to the German and Austrian radiation protection ordinances 22/21 microCi/a (= 8 X 10(5) Bq/a). At maximum 50% and, on the average, 30% of this threshold value are reached. The length of stay of the personnel in the patient rooms is already now limited to such an extent that 10% of the maximum permissible whole-body dose for external radiation is not exceeded. Therefore, increased attention should be paid also to radiation exposure by inhalation. PMID- 3628024 TI - [169Yb-dichlorodimethionine platinum (II) as a tumor-seeking radiopharmaceutical]. AB - Biodistribution studies of 169Yb-dichlorodimethioninoplatin (II) in mice, bearing Ehrlich or leukemia tumors, showed increased uptake of the complex in the tumors. A large difference in the retention of the total injected activity was found depending on the optical isomeric form of the methionine part of the complex. PMID- 3628028 TI - [Mass screening in the prevention of cancer of the breast and cervix uteri]. PMID- 3628027 TI - [Changes in the levels of sex hormone-binding globulin, estradiol and testosterone in the serum of women with breast cancer during various types of hormone therapy]. PMID- 3628026 TI - [Melanogens in the diagnosis of melanoma]. PMID- 3628029 TI - [Evaluation of scintigraphic detectability of bone metastases in patients with breast cancer observed at the Sklodowska-Curie Institute Oncology Center in Warsaw 1975-1984]. PMID- 3628030 TI - [Use of a pedicled cervical flap in the treatment of cancer of the tongue and oral cavity]. PMID- 3628025 TI - [Clinico-control studies of the role of nutrition in the development of stomach cancer]. PMID- 3628031 TI - [Toxicity of cytostatics for hospital personnel]. PMID- 3628032 TI - [Survival of patients with malignant laryngeal neoplasms]. PMID- 3628033 TI - [Use of a linear-quadratic model for evaluation of late post-radiation complications in the larynx]. PMID- 3628034 TI - [TDF system in cobalt radioisotope teletherapy]. PMID- 3628035 TI - [Evaluation of the mortality of women considered cured of cervical cancer after 5 years observation]. PMID- 3628036 TI - Retinyl acetate effects on the life span and the incidence of cryptogenic neoplasms in C3H mice. AB - The effect of feeding 0.02% retinyl acetate on the development of cryptogenic neoplasms and the life span of C3H/HeJ (+) mice of both sexes was studied. The survival at 105 weeks was 58% in untreated males and 28% in untreated females vs. 39% in treated males and 14% in treated females. The average weight in treated groups was also 10-15% lower. The incidence (percent) of neoplasm-bearing animals and total neoplasms was 87% and 57, respectively, in female controls vs. 93% and 55 in treated females. In male controls, these values were 57% and 39 compared with 50% and 38 in treated males. In treated animals, there was no reduction in the most common neoplasms, that is, neoplasms of the mammary gland and liver. The numbers of ovarian neoplasms and lung adenomas were slightly lower. Therefore, retinyl acetate exerted, at best, only a slight inhibitory effect on development of some types of cryptogenic neoplasms in mice. PMID- 3628037 TI - In vitro inhibitory effect of onion extract on hamster buccal pouch carcinogenesis. AB - In vitro studies were performed that used varying concentrations of onion extract added to cell cultures of an epidermoid carcinoma cell line derived from hamster buccal pouch carcinoma (HCPC-1). The studies demonstrated tumor growth inhibition beginning after 24 hours of incubation at an onion extract concentration of 25% and above in culture media. After 4 days and 10 days of incubation, there was a noted decrease in tumor proliferation. The plating efficiency for 24 hours was observed to produce a 54-89% inhibition in plating density. The results indicated here provide in vitro evidence of the inhibitory and cytotoxic activity on an oral carcinoma cell line. PMID- 3628038 TI - Dietary butylated hydroxytoluene protects cytochrome P-450 in hepatic nuclear membranes of rats fed 2-acetylaminofluorene. AB - We previously reported that during hepatocarcinogenesis which is induced by feeding 2-acetylaminofluorene (AAF) there is an early loss of cytochrome P-450 in the nuclear envelope (Carubelli et al., Chem. Biol. Interact. 58, 125-136, 1986). Cytochrome P-450 participates in the activation in addition to the detoxification of xenobiotics; therefore, these findings suggested that AAF may cause the loss of an important defense for the protection of the genetic material of the nucleus against carcinogenic metabolites of AAF generated by microsomal P-450 which, in contrast to the nuclear envelope cytochrome P-450, remains essentially undiminished during early stages of AAF feeding. Because dietary butylated hydroxytoluene (BHT) affords good protection against AAF carcinogenicity, we decided to investigate the possibility that the BHT effect could be mediated through the preservation of nuclear envelope cytochrome P-450. AAF (0.05% wt/wt) was administered in a purified diet with a high content of polyunsaturated fat (20% wt/wt corn oil), which is known to enhance AAF carcinogenicity. These studies showed that BHT supplementation (0.3% wt/wt) of control in addition to the AAF-containing diets resulted in higher levels of nuclear envelope cytochrome P-450. After 16 weeks of AAF feeding, nuclear envelope cytochrome P-450 could not be detected in rats fed BHT-free diet, whereas in the rats fed the diet containing AAF and BHT, measurable amounts of nuclear envelope P-450 were observed. These results are compatible with the hypothesis that nuclear envelope cytochrome P-450 is needed for protection against AAF and that BHT protects nuclear envelope cytochrome P-450. PMID- 3628039 TI - [Recurrences in the evaluation of the epidemiological status of tuberculosis in Poland]. PMID- 3628040 TI - [Lysosomal enzyme activity in peripheral blood lymphocytes in patients with sarcoidosis of the respiratory system]. PMID- 3628041 TI - [Early results of the treatment of non-small cell lung cancer using the PV3 protocol (cisplatin, vindesine and cobalt therapy)]. PMID- 3628042 TI - [Hypercapnic coma]. PMID- 3628043 TI - [Late diagnosis of a foreign body in the bronchus]. PMID- 3628044 TI - [Annular pancreas and neonatal duodenal occlusion. Presentation of 3 cases]. AB - The authors report 3 cases of anular pancreas and consider the main clinical and differential diagnosis aspects of them. Afterwards they dwell upon the etiopathogenesis of this congenital malformation that is consequent not only upon extrinsic pancreatic compression but also upon a contemporary atresia or stenosis of duodenum. That however conditions the management; it will be apply to remove also the intrinsic obstruction of stenotic intestinal segment. PMID- 3628045 TI - [2 cases of cardial achalasia in childhood. Diagnostic aspects and therapeutic possibilities]. AB - The authors present two case-studies of achalasia in infancy and the emphasize the rarity of the illness in this stage of life. They point out that a correct diagnosis requires a meticulous anamnesis which should be followed by a radiological, endoscopic and manometric study. The authors discuss their therapeutical experience with Nifedipine and they suggest that it should be used while waiting for surgery. PMID- 3628046 TI - [Esophageal achalasia in childhood. Description of a clinical case]. AB - Esophageal achalasia is a very rare pathology in pediatric age. The authors have thought opportune to signal a case in a little girl also in consideration of some symptomatical peculiarities: sudden beginning and worsening course without appreciable repercussions on the state of nutrition. The diagnostic and therapeutic problem is confronted in the light of the latest informations from literature. PMID- 3628047 TI - [Evaluation of the respiratory function in patients with Duchenne's muscular dystrophy]. AB - The purpose of this investigation was to compare the respiratory function of patients with different clinical stages of Duchenne muscular dystrophy (DMD). Twenty-three DMD patients who were followed at Paediatric Department of Florence, were studied. We found a good correlation between the subject's functional capacity and normal predicted values for forced vital capacity (FVC) as well for forced volume at first second (FEV1). Subjects whose FVCs ranging from 10% to 20% were considered mildly involved; subjects with FVCs ranging from 20 to 30% were considered moderately involved, severe involved subjects with FVCs ranging from 30% to 40%. When the FVCs were less than 40% of the predicted values, the subjects were considered to have very severe respiratory impairment. In our study 83% of patients wheelchair bound was characterised by a very severe deterioration of pulmonary function. PMID- 3628048 TI - [Viral arthritis in childhood]. AB - Many viruses can cause arthritis in children. Viral arthritis can mimic other rheumatic conditions as rheumatic fever, septic arthritis or juvenile rheumatoid arthritis. Usually viral arthritis is a self-limited disease; occasionally it may show a chronic course lasting several months. Rubella arthritis follows natural infection or vaccination; it looks the expression of a direct invasion of the synovial tissue by the virus. Hepatitis B arthritis is an immune-complex synovitis occurring during the prodromic stage of HBV infection. PMID- 3628049 TI - [The hematuria symptom. Behavior of the pediatrician]. AB - The authors have reviewed the symptom hematuria in childhood, suggesting a simple flow chart for ambulatorial pediatricians. PMID- 3628050 TI - [Perinatal care in the Marche region 1983. Results of an epidemiologic study]. AB - The purpose of this study was to offer a significant picture of perinatal care in the Region Marche. Natality, perinatal and neonatal mortality of 1983 were analysed with reference to birth weight. The obstetric and neonatal services were subdivided, according to the levels of reproductive medical care, in level III, level II, level I and sublevel. The transfers of newborn to the hospital with a service of neonatal pathology or with a neonatal intensive cure unit were taken into account. Our epidemiological data were compared with epidemiological data of Sweden in 1979 and, for very low birth weight infants, with epidemiological data of the Region Friuli Venezia Giulia in 1980. The results have shown the excessive number of obstetric services in the Region Marche, the lack of centralization of risk pregnancies, the frequent transfers of sick newborns, the positive relationship between transferred infants and a greater neonatal mortality in the services of special and intensive neonatal care. The study indicates that it is suitable a program of regionalization of obstetric and neonatal services for an early individualization and in utero referrals of risk pregnancies, for a planned on regional basis transport of sick infants. PMID- 3628051 TI - [Moya-moya syndrome. Progression of the angiographic picture and therapeutic prospectives]. AB - Moya moya is an obstructive cerebrovascular disease characterised by peculiar cerebral angiographic features consisting of intracranial stenosis or occlusion of the internal carotid artery or its terminal branches associated with telangiectatic vessels at the base of the brain. Opinion is still divided between a congenital versus an acquired aetiology. Recurrent episodes of sudden hemiplegia, headache and convulsive manifestations occur more frequently in paediatric patients, while subarachnoid bleeding is usually the presenting finding in adults. After a progressive course for many years, the disease frequently stabilizes sometimes with residual disability. Surgical approach to improve cerebral blood flow has been developed but there is a high incidence of complications in pediatric patients. To minimize the defects during ischemic phase, a pharmacological therapy might be useful. We report a new case of childhood moya moya disease which developed a typical angiographic progressive pattern during three years between the first and the latest bilateral study. Clinical course of patient suggest that antiaggregating drugs and calcium antagonists might be useful in this disease although controlled studies are of course needed. PMID- 3628052 TI - [Reye's syndrome. Clinical and etiopathogenetic aspects. Case contribution]. AB - In this study the authors report a case of Reye syndrome in a three year old patient. The most likely etiopathogenetic mechanisms are analysed and incidence, clinical features and diagnostic criteria are discussed. The possible association between the development of Reye's Syndrome and the use of salicylates, particularly aspirin, during the preceding viral infection (influenza or chicken pox) is emphasized. We underline the importance of early diagnosis that facilitates the successful management of Reye's Syndrome. PMID- 3628053 TI - [Osteomyelitis caused by atypical mycobacteria in multiple colonies]. AB - The authors describe a seven months and a half little girl, A.B., affected by multiple localization osteomyelitis caused by an Atypical Mycobacterium, with the culture identifies as M. Avium, belonging to the third group of Runjon classification. The radiographic tests show a primary pulmonary complex and some osteolytic areas of the seventh right rib and of the bones of the lower legs (femur and tibia). From the beginning a multiple antituberculous chemotherapy against non tuberculous mycobacterial disease has initiated: Streptomycin (for two months) associated with Rifampicin, Isoniazid and Pyridoxine. The patient responds very slowly to the treatment and only three years later the whole radiologic regression of the lesions occurs. The interest of the case comes from the extreme rarity of disseminated bone localization during an atypical mycobacterial infection, and also from the early beginning of the clinical and radiologic manifestations. PMID- 3628054 TI - [Type of diet and "ambulatory" pathology in the first 6 months of life]. AB - This work is a contribution to the investigation that mainly in the last year have been widely performed to evaluate the protecting action of breast feeding against some typical pathological occurrences in the first months of life. Authors studied, for six months, 117 babies. The respiratory and intestinal illness have been found (in progress or anamnestically) during pediatric monthly or occasionally visits. 33% of the babies were fed with milk formula since the first life months; the remainder 67% were breastfed during one month at least. By statistic correlation of type of feeding and disease frequency, there is evidence of the following: 1) Babies, breastfed during 6 months, have lower frequency of respiratory pathology, when compared (p 0.05) with 6 months bottle fed ones. 2) Babies, breastfed during 2 months have lower frequency of intestinal pathology when compared (p 0.05) with bottle fed ones. Therefore, it seems that the most interesting results coming out from this study is that the protective action of breast feeding concerns not only the intestinal disease, but the respiratory ones too, when, however, the breast feeding period is enough extended. PMID- 3628055 TI - Infantile hypertrophic pyloric stenosis and cow's milk intolerance. AB - Two cases of infantile hypertrophic pyloric stenosis in infants who were exclusively breastfed are reported. In both cases dietetic management succeeded in avoiding surgery. In one case human milk was substituted with casein hydrolysate formula, while in the other cow's milk was excluded from the diet of the mother. A possible casual relationship between cow's milk intolerance and infantile hypertrophic pyloric stenosis is discussed. PMID- 3628056 TI - [Morphologic findings on the terminal tract of the ureter in patients with primary vesico-ureteral reflux]. AB - Primary vesico-ureteral reflux (V.U.R.) in children has been widely investigated in several reports in the last two decades, but the morphologic aspects of refluxing vesico-ureteral junction are still incompletely codified or incompletely described. The authors report the results of a histologic study on the terminal refluxing ureter in a group of 20 patients with primitive V.U.R., random chosen from a series of over 400 subjects who underwent antireflux surgery for primitive V.U.R. at the Pediatric Surgery Department of the University of Bologna. Connections between muscular hypertrophy and reflux degree are herein reported and discussed. PMID- 3628057 TI - [Morphological findings on the terminal tract of the ureter in patients with vesico-ureteral reflux associated with neurogenic bladder]. AB - Vesico-ureteral reflux (VUR) associated to neurogenic bladder dysfunctions is well known as pathologic entity; in particular, its radiologic and urodynamic aspects have been widely debated in recent years, even in infancy and childhood. In our study, histologic features of the vesico-ureteral junction have been investigated in a group of patients with neurogenic bladder and VUR, who underwent antireflux surgery. Structural aspects of these vesico-ureteral junctions have been then compared to refluxing junctions taken from non neurogenic bladders and non-refluxing junctions from normal bladders. PMID- 3628058 TI - [Graft of cryopreserved human amniotic epithelial cells in a subject with type B Niemann-Pick disease]. AB - Implantation of pure cryopreserved epithelial cells obtained by enzymatic digestion of human amnion was successfully carried out in one patient affected by Niemann-Pick disease type B. No host-versus-graft reaction was recorded after implantation. The clinical improvement observed in this patient is supposed to be effect of the documented increase of sphingomyelinase activity in his leukocytes after implantation, confirming the possibility that an effective release of sphingomyelinase from amniotic epithelial cells and enzyme uptake by deficient cells can occur. Separation and cryopreservation of human amnion epithelial cells markedly improve the procedures of implantation and may represent a further step beyond in the enzymatic therapy of many lysosomal storage disorders. PMID- 3628059 TI - [Epidemiology and etiopathogenesis of school accidents]. AB - The study purpose to take a contribution to the Knowledge of circumstance and of consequences in which happen the scholastic incidents. Have been taken into consideration 92 scholastic incidents happened during the school year 83/84 at nursery, primary and secondary schools of the Municipality of Cesena, for a total of 11,856 children and have been compared with 1,185 incidents not scholastic of children with same age, happened in Municipality of Cesena and registered at first aid of the "Bufalini" Hospital of Cesena in months of November-December '83 and March, April, July, August 1984. The frequency of such scholastic and not scholastic incidents results superior at male child and of age more low. The seat of damage of scholastic and not scholastic is prevalently the head for children in age 3-6 years and the limbs for those in age 7-11 and 12-14 years. The type of damage of scholastic and not scholastic incidents are prevalently the wounds abrasions for children in age 3-6 years and the bruises-luxations-stretchings distortions for those in age 7-11 and 12-14 years. The 77% of scholastic incidents applies to treatment of first aid, the prognostic opinions of which are not significantly different from those emitted for not scholastic incidents. The scholastic incidents at nursery school happen prevalently in court on the occasion of recreation activities for falling from a play equipment, at primary school in schoolroom or in corridor on the occasion of recreation for push of schoolfellow, at secondary school in palaestra during time of physical education for falling or traumatic contact with the ball.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628060 TI - [Rupture of the diaphragm in childhood]. AB - Two patients had acute rupture of the diaphragm from blunt trauma. One was a nine year-old girl with an associated fractured pelvis and intraperitoneal injuries. She required emergency repair through a laparotomy-thoracotomy. The second patient, a six-year-old boy, underwent repair of a diaphragmatic laceration, diagnosed after a latent interval. Thoracotomy was used. PMID- 3628061 TI - [Kawasaki's disease. Presentation of 2 clinical cases]. AB - The authors describe two cases of Kawasaki disease, one of whose is an "incomplete" form, and emphasize the importance to know this "new" disease in the differential diagnosis of febrile exanthemas of childhood. A complete diagnostic walk-up failed to find out a probably, while change of some immunological and flogistic parameters has permitted to suppose a probably immuno-mediated pathogenesis of Kawasaki disease. Both patients healed without any sequelae after therapy with low doses of salicylate for ten months, in confirmation of usefulness of this treatment in the prevention of heart complications of Kawasaki disease. PMID- 3628062 TI - Legal factors surrounding drug testing in the workplace. PMID- 3628063 TI - Hemodynamic responses to indoramin at rest and during exercise in congestive heart failure. AB - Twenty patients with congestive heart failure underwent hemodynamic studies before and over 10 hours after the administration of 25, 50, and 75 mg of indoramin, an alpha 1-adrenergic antagonist. Hemodynamic studies were repeated during exercise after the administration of the optimal dose of indoramin. The drug reduced resting and exercise pulmonary capillary wedge pressure, right atrial pressure, systemic blood pressure and vascular resistance, and pulmonary artery pressure and vascular resistance. Resting and exercise stroke volume and cardiac output rose in response to the fall in vascular resistances. Heart rate was not altered at rest or during exercise. The first dose of the alpha 1 blocker indoramin elicits a significant reduction in ventricular preload and afterload and augmentation of ventricular performance in patients with congestive heart failure. PMID- 3628064 TI - Evaluation of a new vancomycin dosing method. AB - Thirty-one patients who were prescribed vancomycin therapy at our institution since January 1, 1986, were dosed using the guidelines as described by Lake and Peterson. Peak and trough vancomycin serum concentrations were measured at steady state: 24 (77%) peak serum concentrations were within the range of 20-30 mg/L, and 24 (77%) trough serum concentrations were within the range of 5-10 mg/L. We have found that the method of Lake and Peterson is satisfactory for initiating vancomycin therapy in most patients. Some, however, may not achieve optimal serum concentrations using these guidelines alone, and their regimens may have to be adjusted based upon actual serum concentration data. PMID- 3628065 TI - Unique use of a tip-deflecting guide wire in removing a catheter embolus from an infant. AB - An umbilical catheter fragment embolus in a neonate was difficult to approach due to fixation of both ends, in the left atrial appendage and the ductus venosus, respectively. A tip-deflecting guide wire was used in unique fashion to free the catheter fragment and allow its percutaneous removal via the femoral vein approach. PMID- 3628066 TI - A protective device for pacemaker generators in children. AB - A protective device comprised of a pad and a holster was devised for the external protection of a pacemaker generator implanted in the left infraclavicular position in children. The device was accepted by the child and their caretakers and presented no problems during sports activities. The psychological side effects were beneficial and encouraged the child to normal activity and participation in organized sports. PMID- 3628067 TI - Transseptal left heart catheterization as an aid in the diagnosis of cor triatriatum. AB - A case of cor triatriatum is described in which transseptal left heart catheterization was useful in making the diagnosis by allowing easy access to the accessory chamber for pressure measurements and angiography. PMID- 3628068 TI - Acute hepatic failure after open-heart surgery in children. AB - Acute hepatic failure (AHF) combined with acute renal failure (ARF) is a well known complication of open-heart surgery in adults. The occurrence of this complication in two children after open-heart surgery for correction of congenital heart disease is reported. Hypotension occurred during the operation and was treated by catecholamine vasopressors. AHF set in during the postoperative course; it was manifested by impaired consciousness, hypoglycemia, hyperbilirubinemia, hyperammonemia, elevated liver enzymes and prolongation of the prothrombin time with failure of hemostasis. ARF also developed in both children. One of the patients survived the acute episode of hepatic failure. The importance of early diagnosis, routine close monitoring, and appropriate selection of vasopressors is emphasized. PMID- 3628069 TI - Surgical management in tetralogy of Fallot and vascular ring. AB - The management of three infants born with a combination of tetralogy of Fallot and a vascular ring causing tracheoesophageal compression is described. There was a double aortic arch in two patients and an aberrant left subclavian artery with left ligamentum arteriosum and right aortic arch in one. Single-stage corrective surgery of both lesions during infancy, performed under profound hypothermia and circulatory arrest, was successful. In our opinion, this is the treatment of choice, when the anatomy of the tetralogy is favorable for primary correction. PMID- 3628070 TI - Scimitar variant. AB - In the classic scimitar syndrome, a pulmonary vein draining all or part of the right lung enters the inferior vena cava. A variant is described with the same roentgenographic appearance, but with drainage of the anomalous pulmonary vein into both the inferior vena cava and the left atrium; the atrial septum was intact. This case, together with six others reported elsewhere, reminds us that the scimitar sign has both false positives and false negatives. Therefore, the diagnosis of scimitar syndrome cannot be made with certainty from a plain x-ray film. PMID- 3628071 TI - A rare case of double aortic arch: right thoracotomy and residual retroesophageal aortic arch. AB - The case of a 2-year-old boy with tetralogy of Fallot and a complete double aortic arch (both arches patent) is reported. The left dominant aortic arch ran retroesophageally to the right and joined with the right smaller arch to form the descending thoracic aorta on the right side. We employed a right thoracotomy and performed a division of the right nondominant arch at the connection with the descending aorta. The surgical implications of an unusual type of double aortic arch are discussed. PMID- 3628072 TI - Discrete subaortic obstruction in a patient with corrected transposition of the great arteries. AB - This report describes a case of corrected transposition of the great arteries (TGA) in which a classic subaortic membrane resulted in significant obstruction to outflow from the morphologically right ventricle. To our knowledge, discrete subaortic obstruction has not been previously reported with corrected TGA. PMID- 3628073 TI - Does connection of the IVC with the LA exist? PMID- 3628074 TI - Total anomalous origin of the coronary arteries from the pulmonary artery in an infant with aorticopulmonary septal defect. PMID- 3628076 TI - Echocardiographic estimate of left atrial pressure in children. AB - Echocardiographic estimates of left atrial pressure using the Q-MVC/AVC-E ratio were obtained from 21 patients in the early postoperative period and compared to simultaneously recorded mean left atrial pressure. A good correlation was obtained between mean left atrial pressure and the Q-MVC/AVC-E ratio (r = 0.81, p less than 0.001) with a regression equation of: left atrial pressure = 11.09 (Q MVC/AVC-E) + 0.84. The present data compared to those of previous investigators reveal that, although there are quantitative differences between each of the studies, the correlation coefficient of each study is good. Echocardiography provides a useful noninvasive estimate the left atrial pressure; however, each laboratory must establish its own normals. PMID- 3628075 TI - Left ventricular end-systolic wall stress to volume relationship before and after surgical closure of ventricular septal defect. AB - Left ventricular function was examined angiographically in 64 patients with ventricular septal defect and 13 postoperative patients with a preoperatively large shunt (postoperative group). The unoperated 64 patients were divided into three groups; small (left-to-right shunt ratio less than 35%), moderate (35% 50%), and large (greater than 50%). The control group consisted of 27 patients with Kawasaki disease. For assessing left ventricular function, left ventricular shape and the end-systolic wall stress to end-systolic volume index ratio, as well as left ventricular ejection fraction were examined. Left ventricular ejection fraction was higher in the small-shunt group (p less than 0.05) than in the control group, but normal in the other groups. Left ventricular end-diastolic shape was normal only in the small-shunt group and more spherical in the other groups. The large-shunt group alone manifested more spherical left ventricular end-systolic shape and lower end-systolic wall stress to end-systolic volume index (p less than 0.001). These findings suggest that the left ventricular dysfunction is present in patients with a left-to-right shunt larger than 50%, but this change was reversible in patients who underwent early repair of ventricular septal defect. PMID- 3628077 TI - Evidence for a novel pituitary protein (7B2) in human brain, cerebrospinal fluid and plasma: brain concentrations in controls and patients with Alzheimer's disease. AB - A novel pituitary protein, designated as 7B2, recently purified in our laboratory was measured using a specific radioimmunoassay in conjunction with immuno affinity extraction, in cerebrospinal fluid (CSF) and in plasma obtained from normal volunteers. The mean concentrations of immunoreactive (IR)-7B2 were 2154 pg/ml in CSF and 29 pg/ml in plasma. Studies by SDS-poly-acrylamide gel electrophoresis revealed that both CSF IR-7B2 and plasma IR-7B2 have an apparent molecular weight of around 20,000-21,000 as previously observed in various rat tissues. IR-7B2 was also measured in various brain regions obtained from control subjects and patients with Alzheimer's disease. IR-7B2 was widely distributed in the human brain, with the highest concentrations in substantia nigra and caudate. IR-7B2 brain concentrations were found to be similar between control subjects and patients with Alzheimer's disease. Gel permeation chromatography of extracts of various brain regions revealed two major peaks with apparent molecular weights of 45,000-50,000 and 11,000-16,000 in hypothalamus, caudate, frontal cortex, hippocampus, putamen and locus coeruleus, and only one peak with an apparent molecular weight of 14,000-16,000 in substantia nigra and globus pallidus. These data suggest that this novel pituitary protein may play a role of consequence perhaps as a neurotransmitter or as a neuromodulator in the human central nervous system. PMID- 3628078 TI - Degradation and aggregation of delta sleep-inducing peptide (DSIP) and two analogs in plasma and serum. AB - The biostability of DSIP (delta sleep-inducing peptide) and two analogs in blood was investigated in order to determine if rates of inactivation contribute to variable effects in vivo. Incubation of DSIP in human or rat blood led to release of products having retention times on a gel filtration column equivalent to Trp. Formation of products was dependent on temperature, time, and species. Incubation of 125I-N-Tyr-DSIP and 125I-N-Tyr-P-DSIP, a phosphorylated analog, revealed slower degradation and, in contrast to DSIP, produced complex formation. An excess of unlabeled material did not displace the radioactivity supporting the assumption of non-specific binding/aggregation. It was concluded that the rapid disappearance of injected DSIP in blood was due to degradation, whereas complex formation together with slower degradation resulted in longer persistence of apparently intact analogs. Whether this could explain the sometimes stronger and more consistent effects of DSIP-analogs remains to be examined. PMID- 3628079 TI - Systemic methionine-enkephalin evokes cardiostimulatory responses in the human. AB - The cardiovascular effects of bolus doses of methionine-enkephalin (Met5-ENK) (1 to 100 micrograms/kg) were studied in 9 subjects in whom, at cardiac catheterization for evaluation of chest pain, patent coronary arteries were found. Met5-ENK produced a simultaneous increase in blood pressure and heart rate beginning within 20 sec, reaching maximal values between 30 and 40 sec, and then terminating by 60 sec. Heart rate, systolic, diastolic, and mean arterial blood pressures increased significantly (p less than 0.0005); pulse pressure remained unchanged. Positive dose-effect relationships were observed for heart rate (p less than 0.002), systolic, diastolic, and mean arterial blood pressures (p less than 0.05). Naloxone (0.5 mg/kg), given to 4 subjects, prevented the heart rate and blood pressure changes associated with Met5-ENK administration, demonstrating that the cardiovascular changes were mediated by opiate receptors. Subjects also described cutaneous paresthesias which were not prevented by naloxone pretreatment. These data suggest a role for peripheral enkephalins in cardiovascular regulation. PMID- 3628080 TI - Extraction of neurotensin-like immunoreactivities from porcine ileal mucosa. AB - The extractability of neurotensin (NT) from porcine ileal mucosa was studied by comparison of eight extraction procedures. Tissue content of neurotensin-like immunoreactivity was quantitated and characterized by sequence-specific radioimmunoassays and gel filtration chromatography. Homogenization prior to boiling in extraction solvent produced higher levels of the intact peptide than the reverse procedure. N-terminal immunoreactivity was not influenced by the sequence of these steps. Tissue levels of intact NT were highest after extraction with 2.0 M acetic acid (mean 79.1 pmol/g, N = 6) and lowest with distilled water (mean 6.5 pmol/g, N = 6). The opposite was the case with levels of N-terminal immunoreactivity (mean 55.2 pmol/g and 105.7 pmol/g respectively, N = 6). Recovery experiments with addition of synthetic NT 1-13 and the N-terminal fragment NT 1-8 indicated that these differences could be explained by differences in recovery of intact NT and N-terminal immunoreactive components in tissue. Gel chromatography confirmed that in acetic acid almost only the intact peptide was extracted from ileal mucosa, and showed that after extraction in water or phosphate buffer several N-terminal components were present. The results suggest that a molecular heterogeneity may be present in ileal tissue. If this concept is supported by further studies differential extraction procedures may be needed in the future. PMID- 3628081 TI - Distribution and characterization of two putative endogenous opioid antagonist peptides in bovine brain. AB - Highly sensitive radioimmunoassays were developed and used in studies of the distribution and chromatographic properties of two mammalian FMRF-NH2-like peptides recently isolated from bovine brain; an octapeptide with the structure Phe-Leu-Phe-Gln-Pro-Gln-Arg-Phe-NH2 (F-8-F-NH2) and on octadecapeptide, Ala-Gly Glu-Gly-Leu-Ser-Ser-Pro-Phe-Trp-Ser-Leu-Ala-Ala-Pro-Gln-Arg-Phe-NH2 (A-18-F-NH2). F-8-F-NH2 and A-18-F-NH2 immunoreactivities are unevenly distributed in bovine brain. The highest concentrations (pmol g-1) of F-8-F-NH2 and A-18-F-NH2 are found in dorsal spinal cord (9.8 and 16.4 respectively), periaqueductal grey (8.6 and 6.8) and pons medulla (7.0 and 8.9); lowest quantities are in cortex, cerebellum and striatum. HPLC analysis coupled with radioimmunoassay reveals that the major immunoreactivities are identical to synthetic F-8-F-NH2 and A-18-F-NH2 while there are additional immunoreactive materials, distinct from NPY, whose structures still remain to be determined. The enrichment of these peptides in dorsal cord and periaqueductal grey, areas important in opioid-mediated pain perception, suggest that they may play a role in mediating antinociception. PMID- 3628082 TI - Iodinated derivatives of vasoactive intestinal peptide (VIP), PHI and PHM: purification, chemical characterization and biological activity. AB - The iodination of vasoactive intestinal peptide (VIP) was studied, using a variety of enzymatic and chemical iodination methods. Reversed phase high performance liquid chromatography (HPLC) was used to purify the reaction products. The lactoperoxidase-glucose oxidase method gave excellent results in terms of reproducibility, iodine incorporation, and yield of the non-oxidized products [Tyr(I)10]VIP and [Tyr(I)22]VIP, and was used to prepare both 125I and 127I labelled derivatives. In both cases, direct application to HPLC and a single column system were used. Although the oxidized peptides [Tyr(I)10,Met(O)17]VIP and [Tyr(I)22,Met(O)17]VIP could be generated to varying degrees directly by iodination of VIP, these were most conveniently prepared by iodination of [Met(O)17]VIP. Iodinated derivatives of the homologous peptides PHI and PHM were likewise prepared by rapid, one-step HPLC procedures. The site and degree of iodination were determined by HPLC peptide mapping of tryptic digests and amino acid analyses, and in the case of [Tyr(I)10]VIP also by sequencing. The vasorelaxant activities of the iodinated peptides in bovine cerebral artery preparations did not differ significantly from those of the corresponding noniodinated peptides, with the exception of [Tyr(I)10,Met(O)17]VIP and [Tyr(I)22,Met(O)17]VIP which, unlike [Met(O)17]VIP itself, had slightly lower potency than VIP. PMID- 3628083 TI - Nodose ganglionectomy reduces angiotensin II receptor binding in the rat brainstem. AB - Angiotensin II (Ang II) receptor binding sites in the dorsomedial medulla of intact and unilaterally nodose ganglionectomized rats were identified and characterized using 125I-sarcosine,isoleucine Ang II. This radioligand bound saturably and with high affinity to rat brain homogenates and to sections of rat brainstem. Specific (1 microM angiotensin II displaceable) binding of 125I sarcosine,isoleucine Ang II was displaced by angiotensin analogues with a potency order similar to that described for angiotensin II receptors. Unilateral nodose ganglionectomy caused a reduction in Ang II receptor binding in the medial solitary tract nucleus, dorsal motor nucleus of the vagus, and area postrema ipsilateral to the lesioned ganglion. This observation suggests that Ang II receptors in the dorsomedial medulla may be located on axon terminals of vagal afferents and cell bodies of vagal efferents. PMID- 3628084 TI - Structural specificity of peptides influencing neuronal survival during development. AB - Vasoactive intestinal peptide (VIP) has been shown to increase the survival of developing neurons grown in dissociated spinal cord cultures. This result was evident when synaptic activity was blocked with tetrodotoxin (TTX) during a critical period of development (days 7-21 after plating). Other neuropeptides, with a close sequence homology to VIP, have now been tested for their effects on neuronal survival in culture. Within the critical period, the survival of spinal cord neurons was significantly decreased (30-35%) after incubation with 1 nM peptide histidyl-isoleucine amide (PHI-27) or 0.1 nM growth hormone releasing factor (GRF). Neuronal cell death produced by these peptides did not exceed that observed from tetrodotoxin treatment alone. Secretin had no detectable effect on neuronal survival at any of the concentrations tested. In tetrodotoxin-treated cultures, PHI-27 and GRF prevented the neuronal cell death produced by TTX, but only at concentrations greater than 0.1 microM. In contrast, VIP significantly increased neuronal survival at concentrations less than 0.01 nM. The presence of 0.1 nM PHI-27 significantly decreased the effectiveness of VIP in preventing TTX mediated neuronal cell death. Addition of PHI-27 or VIP, with or without TTX, to one month-old cultures produced no significant change in the number of neurons compared to control cultures. These studies indicate that the survival-promoting effect of VIP is highly structure-dependent and that this action appears to be confined to a critical period of development. PMID- 3628085 TI - Effects of naloxone on the mechanical activity of isolated rat hearts perfused with morphine or opioid peptides. AB - In isolated rat hearts, the infusion for 10 min of 10(-10), 10(-8) or 10(-6) M ( )naloxone affected the cardiac function by markedly increasing the coronary pressure and by reducing both the heart rate and the developed tension. A lower dose of (-)naloxone (10(-11) M) or a dose of 10(-6) M (+)naloxone, did not modify the cardiac function. Morphine (10(-6) or 10(-5) M) and 10(-10), 10(-8) or 10(-6) M methionine-enkephalin or leucine-enkephalin, both significantly reduced the coronary pressure of the isolated rat hearts, during the first 4-6 min of perfusion, but the coronary pressure progressively increased above the control value in the last 4 min of perfusion. Each opioid also influenced the mechanical activity of the isolated rat heart, by significantly lowering both the heart rate and the developed tension. (-)Naloxone, at all the doses tested, was only able to antagonise the hypotensive effect induced by the opioids on the coronary pressure and was ineffective in counteracting the negative inotropic and chronotropic effects produced by each opioid. The perfusion in the presence of (+)naloxone (even at a dose of 10(-6) M) did not affect the opioid-induced changes on both the coronary pressure and the mechanical performance of the isolated heart. PMID- 3628087 TI - [Alkaptonuria--ochronosis in Poland: the status up to 1980]. PMID- 3628086 TI - Autoradiographic localization and characterization of angiotensin II binding sites in the spleen of rats and mice. AB - Specific binding sites for angiotensin II (Ang II) were localized in the red pulp of the spleen of rats and mice by quantitative autoradiography using 125I-Sar1 Ang II as a ligand. In the rat, the binding was saturable and specific, and the rank order for Ang II derivatives as competitors of 125I-Sar1-Ang II binding correlates well with their affinity for Ang II receptors in other tissues. Kinetic analysis in the rat spleen revealed a single class of binding sites with a KD of 1.11 nM and a Bmax value of 81.6 fmol/mg protein. Ang II binding sites were also localized on isolated rat spleen cells with similar affinity but with much lower Bmax, 9.75 fmol/mg protein. Ang II receptors were not detected in thymus sections from rats or mice, or on isolated rat thymocytes. The binding sites described here might represent a functional Ang II receptor with a role in the regulation of splenic volume and blood flow and in the modulation of the lymphocyte function. PMID- 3628088 TI - [Acetylation phenotype in glomerulonephritis and its clinical significance]. PMID- 3628089 TI - [Results of conservative treatment of vesico-ureteral reflux in infants and young children]. PMID- 3628090 TI - [2 cases of Bourneville's syndrome]. PMID- 3628091 TI - Cardiac involvement by metastatic tumor. PMID- 3628092 TI - Characterization of four main cell types in gastric cancer: foveolar, mucopeptic, intestinal columnar and goblet cells. An histopathologic, histochemical and ultrastructural study of "early" and "advanced" tumours. AB - Gastrectomy specimens of 148 gastric cancers, 40 of them being intramucosal or microinvasive, 27 penetrating the submucosa and 81 invading the muscularis propria, with or without involvement of the serosa and perigastric tissues, have been investigated with conventional histopathologic techniques, mucin histochemistry and electron microscopy to characterize the various lines of tumour cell differentiation and to correlate these with the histologic patterns of tumour growth. More or less differentiated intestinal columnar, intestinal goblet, gastric foveolar or mucopeptic cells were recognized in most tumours, of glandular, diffuse or mucoid type. Although simultaneous expression of more than one cell type into the same tumour occurred very frequently, intestinal columnar cells were more prominent in tubular adenocarcinomas, goblet cells (especially of colorectal type) in mucoid cancers, mucopeptic cells in diffuse cancers of invasive desmoplastic type and foveolar cells in diffuse cancers of intramucosal signet-ring cell type. In general, an increased tendency to foveolar cell differentiation and a reduced tendency to mucopeptic differentiation has been found in intramucosal cancers as compared to invasive cancers. It is concluded that the type of tumour cell differentiation, which might have some influence on the natural history of gastric cancer, is better related with more defined tumour subtypes than with the usually recognized glandular or diffuse patterns. PMID- 3628093 TI - Iron-binding proteins in thyroid tumours. An immunocytochemical study. AB - By immunocytochemistry, the presence of major iron binding proteins (lactoferrin, transferrin and ferritin) was investigated in follicular adenomas (15 cases), Hurthle cell tumours (2 cases) and carcinomas of the thyroid gland (39 cases); normal thyroid tissue was also tested as control. Follicular adenomas showed a negative reaction for all iron-binding antisera, whereas Hurthle cell tumours, follicular and papillary carcinomas exhibited a clear cytoplasmic positivity for lactoferrin and transferrin; ferritin was always absent. Anaplastic carcinomas were unstained with all iron-binding antisera with the exception of giant elements and incorporated follicular structures, which were positive for lactoferrin and transferrin. Medullary carcinomas were constantly unstained. These results are discussed in relation to the increased requirement of iron by neoplastic cells. The authors emphasize the possibility that lactoferrin and transferrin may be utilized in clarifying the differential diagnosis between benign and malignant lesions of follicular cell origin; therefore, these two glycoproteins may be considered useful tools in addition to thyroglobulin. PMID- 3628094 TI - Mitoses in non-Hodgkin's lymphomas. Frequency and prognostic relevance. AB - The frequency of mitoses was investigated in 279 lymph node biopsies from untreated patients with non-Hodgkin's lymphomas. The data were correlated with histological subtypes and survival time. It could be shown that the frequency of mitoses increases parallel to the amount of large tumor cells, except for lymphoblastic varieties. The proliferative activity was not influenced by a plasmacytoid differentiation. The nodules of follicular centroblastic centrocytic lymphomas revealed more mitoses than did the diffuse lymphomas of a similar grade of malignancy which shows that the growth pattern must be considered when the frequency of mitoses is interpreted. Immuno- and centroblastic lymphomas exhibited no marked differences with regard to mitotic activity. If all lymphomas are subdivided into three groups according to the mitotic grade alone, three survival curves are obtained that differ significantly from each other. It is concluded, therefore, that the mitotic activity of malignant lymphomas is a useful prognostic parameter that, until now, has received unduly limited attention. PMID- 3628095 TI - Electron microscopic study of pyelointerstitial reflux scars. AB - In addition to confirming the established light microscopic findings, electron microscopic assessment of renal tissue with pyelointerstitial reflux damage also provides other important information. Isolated tubular epithelial cells and small tubular epithelial cell complexes, the earliest formative phase of thyroid-like lesions, were observed after subtotal tubular destruction. Moreover, secretory granule-like structures, identified by immunohistologic methods as renin granules, were found in tubular epithelium, apparently atrophic and cell-rich glomeruli, and walls of tortuous arterioles. Various stages of glomerular scarring were documented in the early phase of glomerular destruction and electron-dense material (IgM) was identified. Electron microscopy plays an important role in differentiating thin-walled vessels (lymphatic vessels, capillaries, venules). While the presented findings are characteristic for reflux nephropathy, they are not pathognomonic: they also occur, for example, in urinary tract obstructions without reflux mechanism. PMID- 3628096 TI - Malignant lymphomas with primary bone manifestation. AB - 18 malignant lymphomas with initial manifestation in bone were selected from the Bone Tumor Registry of Westfalia at the Munster Institute of Pathology where they had been documented between 1975 and 1985, and evaluated under clinical, radiological and histological aspects. Non-Hodgkin lymphomas were reclassified according to the Kiel nomenclature. Paraffin-embedded material was subjected to immunohistochemical analysis in order to assess the features that could add to the correct characterization of these lymphomas, and to their differentiation from other round cell tumors of bone. Non-Hodgkin lymphomas (NHL) were more common in the collective than Hodgkin's lymphomas (HL). Of 13 NHL, 2 were of low, 11 of high-grade malignancy. The former comprised one centrocytic and one centroblastic/centrocytic, the latter 7 centroblastic, 2 immunoblastic, and 2 lymphoblastic lymphomas. Seven NHL patients with localized tumors survived up to 11 years (mean survival span: 6 yrs) after local therapy (radiation and/or resection). Another NHL patient, however, had multiple bone lesions, and died within a year. Analysis for leukocyte common antigen was positive in 9/12 NHL cases, reaction with Ki-B-3, a marker of B-lymphocytes, was positive in 7/12 cases. No lymphoma cells were found to react positively with lysozyme, alpha 1 antitrypsin, or alpha 1-antichymotrypsin. It is concluded that localized lymphomas of bone respond well to appropriate local therapy; immunohistochemical investigation may be useful to characterize the true cellular origin of these tumors, and may help to differentiate them from other round cell tumors of bone. PMID- 3628097 TI - Enhanced hepatotoxicity of endotoxin by hypoxia. AB - Pathogenesis of hepatic injury often seen in patients with congestive heart failure is obscure, but hepatic hypoxia and endotoxaemia resulting from congestive heart failure may relate to it. The present study was undertaken in rats to ascertain whether hepatic hypoxia potentiates endotoxin-induced hepatotoxicity. Hypoxic condition of hepatocytes ws induced by exposure to 7% oxygen for 3 hours or administration of ethanol. When endotoxin was given immediately before or several hours after hypoxia, elevation of activities of serum transaminases and focal random hepatocellular necrosis in the lobules were induced, although these functional and morphological changes were not observed in rats with hypoxia or endotoxaemia alone. This finding indicates that hepatic hypoxia leads to a potentiation of sensitivity to endotoxin hepatotoxicity which persists for several hours after recovery from hypoxia. Moreover, these experimental data suggest that hepatic injury in patients with congestive heart failure may be caused by enhancement of endotoxin hepatotoxicity by hepatic hypoxia. PMID- 3628098 TI - Quantitative pathology today--a technical view. AB - This paper gives an overview of the different techniques which are currently used in quantitative pathology. Morphometry is used to denote the interactive quantitative analysis of single cells or tissue sections by means of an eyepiece graticule, a projection microscope or a graphic tablet. It is a simple, inexpensive, relatively fast technique, and allows the quantitation of both cell and architectural (tissue) properties. Standard cell and tissue preparations can be employed for such investigations. This requires (minimal) standardization of the cell and tissue handling process. The degree of acidity (pH) of the fixation fluid, such as "neutral" (or buffered) formalin is probably the most important and easy to measure factor, and should be kept between 6 and 8 in order to obtain reproducible nuclear area measurements. Another important factor for reproducible results is the magnification in relation to the size of the particles measured. Careful selection of relevant areas, cells and nuclei done by a skilled pathologist, is often essential, as well as quality control of the measuring process. In static cytometry, a relatively popular application is the measurement of the DNA content of single cells in slides. Although having the advantage of optical control, the measuring technique of the transmission systems is, at the present state of development, laborious. This restricts the measurable number of cells to one hundred or only a few hundred at maximum. As a result, the reproducibility rate, as well as the capacity to detect small differences is only moderate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628099 TI - Sampling in diagnostic morphometry: the influence of variation sources. AB - The variation sources relevant to a diagnostic morphometric study were analysed. The influence of each source was estimated in two experiments, performed in systems applying computer assisted interactive morphometry. In the first experiment one observer measured the areas of a large number of nuclei in a section from a grade II transitional cell carcinoma of the bladder. In the second experiment two groups of researchers, from Ancona and Kuopio, measured one field from five different samples of transitional cell tumours (including the case of grade II carcinoma). It turned out that pure interobserver variation was responsible for about a half of the total variation present in the diagnostic system. When the variation characteristics of the diagnostic system had been determined, the number of nuclei that had to be measured to reach a defined level of accuracy could be estimated. Such an estimate was also dependent on the predefined expectancy probability of reaching a correct estimate. The study showed that group morphometry (statistical, investigative morphometry) and diagnostic morphometry must be understood as two different approaches in histopathology. By applying group morphometry, good research results can be gathered with cruder measurements than in diagnostic morphometry. Because investigations in group morphometry are more standardized than in diagnostic morphometry, a larger number of structures has to be measured in diagnostic histopathology for the same level of accuracy. PMID- 3628100 TI - XIth European Congress of Pathology. Prague, Sept. 6-11, 1987. Abstracts. PMID- 3628101 TI - Conservative scoliosis management. PMID- 3628102 TI - Total segmental spinal stabilization. A means of correcting scoliosis and gaining head control in a patient with congenital myopathy. PMID- 3628103 TI - Effect of viscoelastic insoles on pain. AB - The purpose of this study was to assess the effect of viscoelastic shoe inserts on pain in nursing students. Students (N = 100) were randomly assigned to control and viscoelastic groups. The viscoelastic group used viscoelastic insoles in their work shoes for five weeks. A pain questionnaire was used to measure location and intensity of post-work pain. The questionnaire was administered as a pre-test and after five weeks. Post-test comparisons between groups indicated significant differences which were not present at pre-test. The viscoelastic group reported a significant peripheral shift in pain location from back to lower extremity; the viscoelastic group also showed significant changes in duration of post-work pain and frequency of pain during the workday. The clinical efficacy of viscoelastic shoe inserts for modifying weight bearing-induced back pain is supported. Further clinical research into the therapeutic and prophylactic value of shock-attenuating shoe inserts for healthy as well as patient populations is advocated. PMID- 3628104 TI - Survival of hemiarthroplasties after cervical hip fractures. AB - The survivorship of 434 hemiarthroplasties implanted between 1969 and 1982 was calculated from modified life tables. Nine years after surgery 15% of the endoprostheses had been exchanged to a total hip prosthesis. The risk for such a revision was greatest during the first years. Only one of 51 cemented endoprostheses had to be exchanged. The age of the patients at the hemiarthroplasty averaged 76 years. Within 5 years after surgery 50% of the patients were deceased. PMID- 3628105 TI - Soft tissue interposition following dislocation of a total hip replacement. A case report and introduction of a new technique. AB - Dislocation following total hip arthroplasty is an uncommon event. Soft tissue interposition following reduction is extremely rare. The following is a case report of this unusual problem handled in a unique fashion in that the interposed soft tissue was removed percutaneously. PMID- 3628106 TI - Osteochondritis dissecans. AB - Osteochondritis dissecans were recognized many years ago, but its cause remains debatable. In a case of osteochondritis dissecans in a 24-year-old black man, hemosiderin was found in the loose body that was removed from the patient's knee. The presence of hemosiderin supports injury as the cause, but the patient had no history to indicate injury was a factor. PMID- 3628107 TI - Popliteal cyst. PMID- 3628108 TI - Radiologic case study. Chondroblastoma. AB - Chondroblastoma is a benign cartilaginous tumor nearly always found in the epiphysis of long bones. It is usually a well-defined, radiolucent lesion with a thin, sclerotic margin that varies in size from 1 cm to 4 cm; it may contain small calcifications. Most patients are 5 to 25 years of age and males predominate 2:1. The treatment of choice is curettage; a favorable prognosis is expected. PMID- 3628109 TI - Prosthetic management and functional evaluation of patients with resection of the distal femur and rotationplasty. PMID- 3628110 TI - Pseudomembranous colitis in a patient treated with short-term prophylactic cephapirin. A case report. PMID- 3628111 TI - Traumatic lumbosacral dislocation. A case report and review of the literature. PMID- 3628112 TI - Bone injury and late giant-cell tumor occurrence: a possible relation. A case report. AB - A giant-cell tumor of the upper end of the fibula, five years after a documented bone injury at the same site is reported. The histologic diagnosis was corroborated by the patient's age, tumor localization, radiologic and pathologic aspects. The role of a bone injury as a promoting factor in the development of this tumor is discussed. The tumoral occurrence as a reactive process to trauma in this case may not be ruled out. PMID- 3628113 TI - The week-old hip fracture: indication for prophylactic use of a vena cava filter? Report of two cases. AB - Occasional patients will present a week or more after sustaining a hip fracture. Though these patients are at high risk for asymptomatic deep venous thrombosis and pulmonary embolism, anticoagulation may be contraindicated prior to surgery. Two recent cases involving such a situation are reported. In the first, the patient sustained a fatal intraoperative pulmonary embolism. In the second, a transvenous Greenfield vena caval filter was placed prior to surgery. An extremely high suspicion of asymptomatic deep venous thrombosis is necessary when evaluating a patient whose hip fracture has been untreated for a week or more. If studies demonstrate a deep venous thrombosis preoperatively, placement of an inferior vena caval filter may be indicated. PMID- 3628114 TI - Epithelioid sarcoma. PMID- 3628115 TI - Radiologic case study. Osteogenesis imperfecta. PMID- 3628116 TI - Acute torticollis. Identifying and treating the underlying cause. PMID- 3628117 TI - You are too busy for gobbledygook! PMID- 3628118 TI - The miracle of Code 1. PMID- 3628119 TI - Stinging insect allergy. Avoidance, identification, and treatment. AB - The incidence of anaphylaxis from insect stings is about 0.4%, most commonly caused by Hymenoptera species. Diagnosis is aided if the patient can reliably identify the insect, and more specific diagnosis depends on venom skin testing for individual sensitivity. Radioallergosorbent testing is also used but fails to identify about 15% to 20% of sensitivities. Avoidance of high-risk situations is the best approach for patients with known sensitivity. Treatment includes relief of local symptomatic reactions, pharmacologic arrest of anaphylaxis, and venom immunotherapy. PMID- 3628120 TI - How physicians' families get their medical care. PMID- 3628121 TI - More causes of neck mass. PMID- 3628122 TI - Peer review is not censorship. PMID- 3628123 TI - Pelvic inflammatory disease: updated treatment recommendations. PMID- 3628124 TI - High-dose therapy and risk of malpractice suit. PMID- 3628125 TI - Low vision rehabilitation: a team effort. PMID- 3628126 TI - Brain cardioembolism. Issues in diagnosis and management. AB - The diagnosis of cardioembolism is always based on circumstantial evidence. Echocardiography has a limited useful yield and should be reserved for young patients or older patients with clinical heart disease. Primary prophylaxis with anticoagulants appears to be reasonable for patients with acute anterior wall myocardial infarction, rheumatic valvular disease, or dilated cardiomyopathy and, possibly, for those with chronic nonvalvular atrial fibrillation. Secondary prophylaxis (after an initial embolism) is reasonable for the same conditions and, possibly, for mitral valve prolapse. Acute anticoagulation therapy is warranted when a large infarct is excluded by computed tomography 24 hours after a cerebral embolism. PMID- 3628127 TI - Exercise and pregnancy. How each affects the other. AB - Organized exercise is most likely here to stay. The number of participating women has been gradually increasing and will most likely continue to do so. As a result, the physician will probably receive more and more questions about the advisability of exercise in pregnancy and the problems that might occur. Familiarity with the impact of pregnancy on exercise and of exercise on pregnancy will be of benefit to any physician serving women of child-bearing age. PMID- 3628128 TI - Use of anabolic steroids by athletes. Do the risks outweigh the benefits? AB - The use of anabolic steroids by both competitive and noncompetitive athletes has reached alarming proportions. Although use is most common in bodybuilders and weight lifters, athletes participating in track and field events and football also take the steroids. The recent resurgence in physical fitness awareness has only exacerbated the problem, and the physician needs to acknowledge the potential for abuse in any athlete. Despite the difficulties and ethical problems in designing good controlled studies with high-dose steroids, evidence suggests that steroids do increase muscular strength in certain subgroups of athletes. Unfortunately, numerous side effects and permanent damage may occur, and the athlete may be at risk for the development of fatal liver tumors or cardiovascular disease. PMID- 3628129 TI - Rabies prevention in primary care. A four-step approach. AB - Although most physicians in the United States have not seen a person with rabies, the primary care physician is often confronted with a patient who has been bitten by an animal capable of transmitting rabies virus. Rabies is almost always transmitted by a bite; licks and other nonbite exposures hardly ever cause the disease. The control of rabies in domestic animals has greatly reduced the risk of human disease following the bite of a dog or cat, but rabies in wild animals (especially skunks and raccoons) remains a constant threat. By obtaining epidemiologic information about animal rabies in the area where the exposure occurred, the physician can determine whether the animal in question may have been rabid. If any question remains, owned dogs and cats should be observed for ten days and any other animal should be killed and its brain examined for rabies virus. When postexposure prophylaxis is indicated, it should be administered exactly as recommended herein. PMID- 3628130 TI - Hematuria. When is it cause for alarm? AB - The urine of less than 3% of healthy persons shows more than three red cells per high-power field, which is about the limit of sensitivity of test strips for occult blood. Even minimal hematuria may herald serious problems and must be investigated. Common causes include infection, urethritis, and urethrotrigonitis (25%); stone (20%); and tumor (15%). Although hematuria may be caused by coagulopathy, patients with anticoagulant-induced hematuria must be examined for anatomic defects. Hematuria may originate from the kidney or the urinary tract; red cell casts and dysmorphic red cells suggest a renal source. Hematuria arising from the kidney is classified as glomerular (eg, various forms of glomerulonephritis) or nonglomerular (eg, polycystic kidney disease, cancer). If the urine is pigmented but test strips are negative, or test strips are negative but no red cells are seen, pseudohematuria must be considered. PMID- 3628131 TI - Renal disease from excess uric acid. AB - Excess uric acid or urate deposition is a common element in three different forms of renal disease: acute uric acid nephropathy, chronic urate nephropathy, and uric acid nephrolithiasis. Clinical features vary with each form. Therapy is directed at decreasing production of uric acid, increasing its solubility, or both. When possible, preventive measures are taken. PMID- 3628132 TI - The rooter man taught me about charging for after-hours service. PMID- 3628133 TI - Sports-related CNS injuries in children and adolescents. PMID- 3628135 TI - Patient contract is incentive for weight loss. PMID- 3628134 TI - Headache due to altered sensory threshold. Drug therapy for often intractable deafferentation neuralgia. PMID- 3628136 TI - Drugs for acute infection during pregnancy need careful selection. PMID- 3628137 TI - Epistaxis. How to control the persistent nosebleed. AB - Successful control of unusually persistent epistaxis is most easily accomplished through an organized stepwise progression of treatment options. This begins with a careful physical examination of the nose to look for a specific bleeding site. Most failures in treatment result from initial inattention to this methodical examination, resulting in improperly placed packing materials. With careful preparation prior to nasal manipulation, most nosebleeds should be readily controllable. PMID- 3628138 TI - Oral contraceptives. Who, which, when, and why? AB - The risks of oral contraceptives are very small, and they cluster in a subset of users, although warning signs of cardiovascular complications must be heeded. The best choice of an oral contraceptive is one with an estrogen content of 30 to 35 micrograms. A greater (50 micrograms) content may be necessary if breakthrough bleeding or amenorrhea persists beyond a few treatment cycles. The starting date for the pill can be up to the sixth day of the cycle. Noncontraceptive benefits of the pill may include a protective effect against endometrial and ovarian malignancy, benign breast disease, and infection of the upper genital tract. Both the contraceptive and noncontraceptive benefits of low-dose combination oral contraceptives are desirable. They far outweigh the risks in women who require a high-efficacy, reversible contraceptive and who have no significant contraindication to use of the pill. PMID- 3628139 TI - Loss of function in the frail elderly. A method for determining the underlying causes. AB - Five major functional problems that threaten independent living in the elderly are failure to ambulate or transfer, falling, failure to eat or drink adequately, incontinence, and intellectual impairment. The outline at the end of this article list possible underlying diseases or conditions that may lead to each of these dysfunctions. By asking about details of the functional deficits and seeking clinical clues, the physician can save time in determining underlying causes and constructing a treatment plan. PMID- 3628140 TI - Desipramine-induced conduction disorder mimicking myocardial infarction. PMID- 3628141 TI - Acute renal failure. Managing a devastating illness. AB - Acute renal failure is a frequently encountered clinical event. The causes are varied and may not always be obvious. A logical approach to evaluation and aggressive management with the aid of a nephrologist will ensure the best outcome of an often fatal illness. PMID- 3628142 TI - Serum uric acid, serum glucose and diabetes: relationships in a population study. AB - The relationships between serum uric acid, serum glucose and diabetes have been examined in a survey of 7735 middle-aged men drawn at random from general practices in 24 British towns. There was a positive relationship between serum glucose and serum uric acid concentrations up to about 8.0 mmol/l; at higher levels of glucose, serum uric acid decreased. Uric acid levels were significantly reduced in insulin-dependent diabetics and in those on oral hypoglycaemics and also in 'non-diabetics' with casual glucose levels greater than 10 mmol/l. Both uric acid and glucose concentrations were positively related to body mass index; only uric acid was positively related to alcohol intake. Men on antihypertensive treatment had raised levels of uric acid (significant) and glucose (non significant). The positive relationship between serum uric acid and serum glucose could not be explained by associations with body mass index, alcohol intake, age, social class, gout or treatment for hypertension. It probably reflects the biochemical interaction between serum glucose and purine metabolism, with increased excretion of uric acid during hyperglycaemia and glycosuria. PMID- 3628143 TI - Alcohol and blood pressure: a social comparison in Zimbabwe. AB - The blood pressures of 252 men and 250 women, living in both urban and rural Zimbabwe, were measured on three separate occasions. Food and alcohol intakes were determined using a 3-day weighed diet survey checked by means of a detailed interview. Anthropometric data were also collected. No relationship was found between mean blood pressures and the alcohol intake for any socioeconomic group. Using only the first of the three blood pressure measurements, a correlation between systolic pressure and alcohol intake was found for white males (r = 0.234, P less than 0.05), and just missed statistical significance (r = 0.156, P = 0.065) for black middle class males. No relationship was found between blood pressure and alcohol consumption for black working class males, or for females. Epidemiological evidence suggests that alcohol consumption is associated with increased blood pressure. However, a convincing physiological mechanism is lacking. It is suggested that psychological factors may be partly responsible for this relationship. PMID- 3628144 TI - Post-menopausal breast abscess. AB - Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma. Although the usual treatment of an abscess is incision and drainage, in post-menopausal women, excision of the lesion is helpful for accurate histological diagnosis. PMID- 3628145 TI - The sensation of facial swelling in temporal arteritis: a predictor for the development of visual disturbance. AB - The sensation of facial swelling in temporal arteritis may be an important predictor of the development of visual disturbance. A clinical report of two patients who developed a sensation of puffiness of the face without altered facial appearance, as a presenting symptom of temporal arteritis with visual disturbance is presented. This symptom, though documented previously by us, has not been identified before as a predictor of visual disturbance. PMID- 3628146 TI - Lumbar puncture and subarachnoid haemorrhage. AB - Medical notes of 123 patients with subarachnoid haemorrhage were examined. No patient deteriorated at the time of lumbar puncture. All but 2 patients with associated intracerebral haematomas had markedly impaired consciousness or focal signs. Two of 30 patients with meningitis were initially diagnosed as subarachnoid haemorrhage, and one died without lumbar puncture. If consciousness is not markedly impaired and focal signs are absent, lumbar puncture is safe in patients with subarachnoid haemorrhage. PMID- 3628147 TI - Another family with acute vitamin D intoxication: another cause of familial hypercalcaemia. AB - Acute vitamin D intoxication from an unknown source occurred in a family consisting of a grandmother, mother, father and four children aged 14, 11, 8 and 1 1/2 years old. The clinical presentation and response to treatment (which included a diphosphonate preparation and cholestyramine) are described. PMID- 3628148 TI - Rupture of a cerebral aneurysm associated with nifedipine treatment. AB - We describe rupture of a cerebral arterial aneurysm in a 32 year old hypertensive woman following the introduction of nifedipine treatment. It is suggested this relationship is causal rather than coincidental and mediated through cerebral arterial vasodilatation. PMID- 3628149 TI - Osseous choristoma presenting as a cold solitary thyroid nodule. AB - A hitherto undescribed case of an osseous choristoma of the thyroid presenting as a single cold nodule is presented. The possible origin of the lesion is discussed. PMID- 3628150 TI - Destructive bone lesions in primary amyloidosis. AB - We describe a patient with primary amyloidosis in whom multiple osteolytic lesions caused by amyloid bone tumours developed, and review the clinical features of the 18 cases with primary amyloidosis in whom destructive bone lesions have been reported. In contrast to amyloidosis associated with multiple myeloma, destructive lesions in the primary disease are mainly located to long bones; joint involvement is common, and radionuclide bone scan shows pronounced uptake of 99mTc-PP by the destructive bone lesions. Despite the superficial similarity between the destructive bone lesions associated with primary amyloidosis and multiple myeloma, distinction between these entities on clinical grounds is possible and may be easily confirmed by direct aspiration of the osteolytic infiltrates. PMID- 3628151 TI - Multiple myelomatosis: an unusual cause of small bowel intussusception. AB - A 55 year old woman with multiple myeloma presented with a pathological fracture of the right neck of femur. Following internal fixation, and during subsequent radiotherapy, she developed small bowel obstruction. Laparotomy revealed an intussusception about a small bowel myeloma deposit. This is a previously unreported cause of small bowel intussusception. PMID- 3628152 TI - Crohn's disease in monozygotic twins. AB - A pair of monozygotic twins with Crohn's disease is described. Both have ileocaecal disease and suffered their first symptoms after living apart for 6 years. The pathogenic role of hereditary and environmental factors is discussed in the light of this and previous reports of twins with Crohn's disease. PMID- 3628153 TI - Heart failure in sinus rhythm as the sole manifestation of Graves' disease. AB - A middle-aged man with Graves' disease presented with heart failure in sinus rhythm which preceded the more typical manifestations of the disease by some months. Once suspected, the diagnosis was supported by measurement of systolic time intervals, enabling the instigation of treatment in advance of biochemical confirmation. PMID- 3628155 TI - Intraluminal mucus cast complicating carcinoma of the colon. AB - A previously unreported complication of a stenosing carcinoma of the colon is described. This was first noticed as a rather unusual X-ray appearance, the significance of which only became clear following surgery. PMID- 3628154 TI - Myocardial hypertrophy, fibrosis and infarction following exposure of the heart to radiation for Hodgkin's disease. AB - A 35 year old man was treated for stage IIA Hodgkin's disease by radiation to the upper thorax, axillae and neck. Three years later he presented with intractable and ultimately fatal congestive heart failure. Autopsy revealed massive biventricular hypertrophy with widespread subendocardial fibrosis and myocardial infarction, but with little coronary artery disease. Such a complex of features has not previously been described after radiation therapy and cannot be adequately explained by other known causes of heart muscle disease. Ventricular hypertrophy with extensive subendocardial fibrosis may be part of the spectrum of radiation heart disease. PMID- 3628156 TI - Towards a good hospital guide. PMID- 3628157 TI - Diaphragmatic hernia. PMID- 3628158 TI - Alcohol education for doctors. PMID- 3628159 TI - Immunocompetences and Marek's disease resistance in three pairs of chicken lines selected for different immunological characters. AB - Three pairs of chicken lines selected for high (H) and low (L) graft vs. host reaction (GVHR) competences, serum immunoglobulin G (IgG) levels, and antibody responses to Leucocytozoon caulleryi were examined for their immunocompetences and Marek's disease (MD) resistance. The GVHR-H and GVHR-L lines were further divided into two sublines according to their major histocompatibility B genotype. Immune responses to sheep erythrocytes (SRBC), bovine serum albumin (BSA), and a lipopolysaccharide (LPS) were compared between the high and low lines of each pair of selected lines. Significant differences were found in responses to SRBC and LPS in IgG-selected lines and in response to BSA in Leucocytozoon-selected lines. In all three instances antibody titers of the H line were higher than those of the L line. The GVHR competence expressed by the splenomegaly index (SI) was also significantly different between the H and L lines of all three selected line pairs. The SI values in the GVHR-selected and IgG-selected lines were higher in the H line than in the L line, whereas those in the Leucocytozoon-selected lines were lower in the H line. Differences in MD incidence and in MD mortality were found between the GVHR-selected B11B11 subline and the IgG-selected lines. In both instances the L line was more resistant to MD than the H line. PMID- 3628160 TI - The major histocompatibility complex as a communication gene complex. PMID- 3628161 TI - Genetics and classification of major histocompatibility complex antigens of the chicken. AB - The chicken MHC consists of a gene complex divisable into three chromosomal regions, each producing a series of genetically antithetical molecules with regionally specific functions. Most of the genes (alleles) of each region are present in unique haplotype combinations with genes (alleles) from the other two regions; relatively few haplotypes appear to share identical regional genes. Even with the high degree of polymorphism existing within and between regions, general typing of erythrocytes for MHC haplotypes can still be performed as economically as ever with alloimmune reagents of known specificity. PMID- 3628162 TI - Short-term exposure of laying hens to high dietary sodium chloride levels. AB - Four replicate pens, each containing five individually caged hens received a corn soy basal diet to which .4, 1, 2, 4, or 6% NaCl was added during two 21-day experiments. An additional bilevel treatment, approximating a reported commercial feed production problem, consisted of 6% NaCl for 7 days followed by .4% NaCl for the remaining 2 weeks. Egg production was significantly reduced by 4 and 6% NaCl in Experiment 1 and by 2, 4, and 6% NaCl in Experiment 2. The switchback treatment (6-.4% NaCl) did not statistically alter overall egg production in either experiment. Daily water consumption increased significantly when more than 1% NaCl was added, and subsequently with each feed addition. When 6% NaCl was fed for 7 days feed intake was quickly suppressed; this caused a rapid increase in water intake. Water intake returned to normal levels before the end of the second week. Daily feed intake was significantly reduced by a continuous feeding of 4% or more NaCl. A 1-week exposure to the 6% treatment suppressed feed intake quickly but intake recovered within one week. In both experiments, only the continuous 6% NaCl feeding regime of Experiment 1 resulted in a significant loss of body weight or a significant reduction of overall egg weight averages. Mortality was not a factor in either experiment. These data indicate that at least 2% NaCl in feed was required before any significant effects were noted, and that laying hens recovered from a 1-week exposure to 6% NaCl in feed within the following week. PMID- 3628163 TI - Relationship of parents' age, hatching egg weight, and shell quality to day-old chick weight as influenced by oviposition time. AB - This study was conducted with 840 eggs from commercial breeder hens to determine relationship of parents' age, egg weight, and to oviposition time and shell quality and day-old chick weight. Results indicate that eggs laid in the afternoon were significantly smaller with significantly better shell quality than those laid in the morning (64.1 vs. 64.5 g and specific gravity of 1.077 vs. 1.074, respectively). Also, chicks from afternoon eggs tended to weigh significantly less than those from morning eggs. However, the egg weight: chick weight ratio was not significantly affected by oviposition time; it was the same for morning and afternoon eggs (70.7 vs. 70.1%). The linear relationships between egg weight, age, and chick weight or between egg weight and chick weight were strong (R2 = .78 to .91), but the associations between specific gravity and chick weight were weaker (R2 = .28 to .24). It was possible to use both parents' age and egg weight or egg weight alone to predict chick weight for chicks hatched from morning and afternoon eggs. PMID- 3628164 TI - Effects of eggshell cuticle removal and incubation humidity on embryonic development and hatchability of broilers. AB - The effects of eggshell cuticle removal and two levels of incubation humidity 28.3 C [50% relative humidity (RH)] and 30.0 C (55% RH) wetbulb temperature (WB) on embryonic mortality and hatchability were determined from broiler hatching eggs laid during 38, 42, 48, and 54 weeks of age. Variables measured were: egg weight loss during the first 17 days of incubation, hatch at Days 19.5 and 20.5 of incubation, hatch of fertile eggs, stage of embryonic mortality, and chick weight at 21.5 days of incubation. Day 0 to 17 percentage egg weight loss was increased when the incubation humidity was lowered and the loss was greater than that observed after cuticle removal. A greater percentage of chicks hatched on Day 19.5 at 28.3 C than at 30.0 C WB. The percentage hatch of 38-week fertile eggs was improved at the higher humidity; the higher humidity also decreased late dead and increased pipped embryonic mortalities. Cuticle removal decreased early dead and increased late dead mortality. At Week 38 cuticle removal and lower humidity resulted in a decrease in chick weight at 21.5 days of incubation. For Weeks 42, 48, and 54 combined, pipped mortality was increased by higher humidity and late dead mortality was increased by cuticle removal. Water loss from the egg was increased by cuticle removal or by lowering incubation humidity from 30.0 C to 28.3 C WB, or by both, but lowering humidity was more effective. Changes in humidity and cuticle removal may affect vital gas exchange to different degrees.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628165 TI - Detergent-treated Newcastle disease virus as an agar gel precipitin test antigen. AB - A soluble Newcastle disease virus (NDV) agar gel precipitin (AGP) antigen was prepared by treating 100-fold concentrated NDV with a nonionic detergent. Virus concentration prior to detergent treatment was best accomplished by ultracentrifugation or by a simple, less expensive, and more practical method involving acid (HCl) precipitation of NDV. Virus concentrated by polyethylene glycol precipitation was found to have a low antigen titer and was not considered suitable as an AGP antigen. Antigens derived from the LaSota, Roakin, and Texas GB strains formed at least two lines of identity in the AGP test as early as 24 hr after inoculation of the agar gels. Virus used for AGP antigen production could be grown in chicken embryos from an NDV-immune as well as susceptible breeder flock. The NDV AGP antigen was found to be stable after 20 consecutive freezing and thawing cycles and storage at -20 C or 4 C for at least 6 months. Detergent-treated NDV was used as an AGP test antigen to determine serum antibody responses of chickens following infection and vaccination. Hemagglutination inhibition, virus neutralization, and enzyme-linked immunosorbent assay antibody production was also evaluated for comparative purposes. The AGP test was found to be useful as an aid in diagnosing field infections and assessing inactivated virus vaccination responses. These purposes were achieved by demonstrating an increase in the number of AGP positive chickens between preinfection and postinfection or vaccination bleedings. The ease of performance and low cost of the AGP test favors its use for screening large numbers of serum samples, perhaps in conjunction with a quantitative serological test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628166 TI - Effect of air movement on operant heat demand of chicks. AB - Chicks, 8 days of age, were housed in a wind tunnel at temperatures from 12 to 28 C in increments of 4 C. The tunnel was equipped with a microswitch, an infrared bulb located above the switch, and a small electric fan controlled by a rheostat. Following learning, chicks were exposed at each temperature to air speeds of 0, .5, 1.0, and 1.5 m/s according to a Latin-square design. Chicks readily responded to air speed and temperature changes. For each increase of .1 m/s the effective environmental temperature dropped .6 C. PMID- 3628167 TI - Effects of increasing dietary levels of full-fat canola on performance, nutrient retention, and bone mineralization. AB - Day-old male broiler chickens were fed diets containing 0, 5, 10, 15, or 20% raw, ground, full-fat canola for a period of three weeks. Increasing the dietary proportion of full-fat canola significantly reduced feed intake (P less than .05) and weight gain (P less than .01), without altering feed:gain ratio. Diet had no significant effect on protein retention although there was a significant decrease in fat retention with an increase in dietary levels of full-fat canola (P less than .01). This was accompanied by a significant decrease in metabolizable energy (P less than .01). Increasing the proportion of dietary full-fat canola significantly reduced the concentration of soap in the digesta (P less than .05) and excreta (P less than .01). There was no significant effect of the dietary treatments on calcium or phosphorus retention. There was also no effect of the dietary full-fat canola on bone ash, bone calcium, or phosphorus content. PMID- 3628168 TI - Fasting metabolic rate in hens. 1. Effects of body weight, feather loss, and activity. AB - Environmental factors affecting fasting metabolic rate (FMR) were quantified and a short-time recording system was developed. Discontinuous measurements of gas exchange of 1,120 medium weight brown egg layers were taken after 24 and 36 hr of starvation. Body weight (BW) and shank length (SL) were measured and feather cover and activity evaluated by scores. The FMR increased with deterioration of plumage cover. Differences between hens with complete feather cover (Score 1) and nearly naked birds (Score 4) were 8 kJ2/hr at night and 11 kJ/hr during the light phase. Fully fed hens measured during the light phase showed the same curvilinear relationship as starved birds. Only a small proportion of the heat increment generated by ingested food is used by poorly feathered hens to maintain body temperature. Gaseous exchange was affected by locomotor activity in the respiration chamber. The FMR of resting and quietly standing birds were 29.75 +/- 1.00 kJ/hr and 30.55 +/- 1.00 kJ/hr, respectively. During the prelaying phase, FMR showed an increment of 13 kJ/hr with a peak shortly before oviposition. The following exponential relationships between BW in kilograms, and SL in centimeters with FMR were estimated for light phase FMR = 18.52 BW .59 +/- .05 kJ/hr, R2 = .11; for dark phase FMR = 15.21 BW 54 +/- .04 kJ/hr, R2 = .17 and FMR = .32 SL 1.64 +/- .10 kJ/hr, R2 = .19. In poorly feathered strains, SL was as good a predictor of body size as BW. Correcting FMR data for feather loss changed regression coefficients and allometric functions significantly: for light phase FMR = 15.47 BW .74 +/- .03 kJ/hr and R2 = .15; for dark phase FMR = 13.11 BW .66 +/- .03 kJ/hr and R2 = .28. PMID- 3628169 TI - Hollow fiber-encapsulated pituitary cells for the study of adenohypophyseal regulation of growth in poultry: 1. Preparation and use. AB - A technique for transplantation of viable, functionally active pituitary cells was adapted for use in poultry. Enzymatically dispersed adenohypophyseal cells were prepared from broiler strain donor chicks and loaded into hollow fiber capsules; ultrafiltration membranes consisting of an open-celled, spongy outer layer of polymer material with an internal lumen which is surrounded by a thin skin of tightly controlled pore size. Cell-filled capsules were surgically implanted intracranially into pituitary-intact, recipient birds for extended time periods. Immunoreactive growth hormone (I-GH)-containing cells persisted in hollow fiber capsules for up to 30 days of implantation. Final capsule I-GH reflected starting cell densities. Capsules implanted intracranially became highly vascularized, with capillary endings imbedded in the spongy, open-celled outer surface of the capsule. This provides a means for hormones secreted by cells contained within the capsule to reach the peripheral circulation. Mean plasma I-GH concentration of birds implanted at 10 weeks of age with capsules containing donor cells from 2 to 3-week-old chicks was significantly higher than sham-implanted controls by 2 weeks postimplantation. Thus, hollow fiber encapsulated pituitary cells remain viable for extended time periods when implanted intracranially in pituitary-intact chickens. These capsules provide a means by which naturally secreted pituitary hormones may be administered in vivo and provide a viable model system for studies of adenohypophyseal hormone action. PMID- 3628170 TI - Hollow fiber-encapsulated pituitary cells for the study of adenohypophyseal regulation of growth in poultry: 2. Recipient growth responses. AB - A technique for the encapsulation and transplantation of viable, functionally active adenohypophyseal cells to pituitary-intact poultry by means of hollow fiber units has been developed. Endogenous pituitary glands of broiler pullets that received high density capsules (1.2 X 10(6) cells) were observed 30 days after fiber implantation at 2 weeks of age. Glands were reduced in size and immunoreactive growth hormone (I-GH) concentration in comparison to sham and low density (.3 X 10(6) cells) groups. Although these changes were not significant, the combined reduction in mass and I-GH concentration equates to a 25 to 35% reduction in total pituitary I-GH content for the high density group, in comparison with sham and low density group birds, respectively. These changes suggest a feedback effect of high density cell implants on endogenous pituitary function. Relative gains of each group reflect apparent differences in pituitary I-GH content: high density group birds gained less than shams (P greater than .05) and significantly less than low density group birds. In a second study of older birds, cell implants (.73 X 10(6) cells) resulted in a significantly greater average relative gain (52%) in comparison with shams (33%) over the 6 week implantation period. Mixed adenohypophyseal cell populations transplanted to the hypophysiotropic region of pituitary-intact broiler pullets resulted in changes in endogenous pituitary function and growth of recipient birds. These studies suggest that dosage administered (e.g., cell density) may interact with age at application in determining the ultimate response of birds to exogenous manipulation of endocrine regulation of growth. PMID- 3628171 TI - Effects of slaframine on circulating concentrations of growth hormone and glucose. AB - The ability of slaframine (SF), a parasympathomimetic, to alter blood growth hormone (GH) and glucose concentrations in broiler chicks was investigated. Eighty male broiler chicks (average weight 225 g) were divided into 10 groups and dosed with either saline (control) or 1 mg SF/kg of body weight by oral intubation. Plasma samples were obtained from separate groups of chicks at 1, 2, 4, 8, and 12 hr after SF administration and analyzed for growth hormone and glucose. One hour after SF administration, glucose increased (P less than .05) 21.4% compared with controls. Growth hormone increased (P less than .05) 449 to 948% from 8 to 12 hr after SF administration. Administration of SF at 1 mg/kg of body weight was associated with increased plasma GH. PMID- 3628172 TI - Effect of cage level (tier) on the performance of White Leghorn chickens. AB - Conflicting reports exist in the literature about the effects of cage level (tier) on laying hen performance. Results clearly indicate, under conditions of this study, that performance as measured by egg production, egg weight, and mortality significantly deteriorated in a linear fashion progressing from the bottom to the top in three and four tier cages. Causes may be related to fear associated with differences in light intensity or differences in exposure to visual stimuli between the tiers. PMID- 3628173 TI - Ability of cimetidine to increase intestinal pH of chicks. AB - Cimetidine was tested for its ability to increase the pH of intestinal contents of chicks. In Experiment 1, 18 mg cimetidine injected i.m. per kilogram body weight (BW) increased (P less than .05) proventricular pH within 1 hr, but proventricular pH began to decrease 4 hr postinjection. The pH of the contents of the duodenum was increased (P less than .05) 4 hr postinjection, whereas the pH of the contents of the jejunum was unaffected. In Experiment 2, 36 mg cimetidine injected i.m. per kilogram BW increased (P less than .05) the pH of the contents in the proventriculus and duodenum, but did not alter the pH in the jejunum and ileum. These results show that cimetidine can be used for experimental purposes to increase the pH of the proventricular and duodenal contents in chickens. PMID- 3628174 TI - Testing for contact allergy in experimental animals. PMID- 3628175 TI - Malathion induced alterations in the lipid profile and the rate of lipid peroxidation in rat brain and spinal cord. AB - Malathion, known as a low toxic pesticide, is frequently used in the third world. Neurotoxic manifestations of malathion were evaluated on various lipids and lipid peroxidation in different brain areas following intraperitoneal injections (150 mg/kg body weight for 7 consecutive days) to albino rats. Clinical investigations show that malathion produced hypomotor activity and hyperthermia. Lipid components were differently affected by this pesticide, where total lipids and phospholipids were diminished in the spinal cord and brain stem, respectively. Increased contents of cholesterol were found in the cerebellum and spinal cord. Also, total lipids were increased in the cerebellum. The cholesterol/phospholipids ratio was increased in the cerebellum, brain stem and spinal cord. Rate of lipid peroxidation was found to be increased in all parts of the brain following malathion intoxication. PMID- 3628176 TI - Human pain thresholds after the application of lypressin, a vasopressin analogue. AB - Recent animal studies indicate that vasopressin has analgetic properties. The aim of this study was to find out if lypressin, a vasopressin analogue, produces analgesia in man. The effect of i.n. lypressin (5 and 10 I.U.) on experimental pain was tested in healthy humans. The lower dose proved high enough to produce a significant antidiuretic effect. Lypressin did not have any marked analgetic effect at these doses either on ischaemic, cutaneous thermal, or dental pain. The results indicate that lypressin cannot be used for pain relief in man at doses low enough not to produce a hazardous water retention. PMID- 3628177 TI - A two-generation reproduction-fertility study of cyanamide in the rat. AB - A two-generation reproduction-fertility study of cyanamide in the rat has been carried out. After oral administration of 2, 7 and 25 mg/kg/day of the drug, relevant changes have been noted at the highest dose level. Decrease in dam weight gain, in number of corpora lutea, in number of implantations and in number of neonates have been observed in rats of the Fo generation after treatment with 25 mg/kg/day. This group showed a reduced fertility rate and decreases in the weight of several reproductive organs male rats. In contrast to the findings noted in the Fo generation, changes related to cyanamide treatment have not been observed in the F1 generation. Histopathology of these organs has disclosed a low incidence of bilateral testicular atrophy. Decreased fertility rate due to non specific toxicity associated with a diminished food intake cannot be discarded. PMID- 3628178 TI - Differences in the effects of morphine on the alpha-methyl-p-tyrosine-induced depletion of dopamine and noradrenaline in various areas of the mouse brain. AB - The effect of morphine on the alpha-methyl-p-tyrosine (alpha MT)-induced depletion of dopamine (DA) and noradrenaline (NA) was studied in various brain areas of male NMRI mice, whose locomotor activity is clearly stimulated by morphine. Morphine (10 mg/kg) accelerated the alpha MT-induced DA depletion in the striatum and in the area "rest of forebrain + midbrain", which contains the limbic dopaminergic neurons, but did not clearly alter it in the hypothalamus. The effects were blocked by naloxone. The enhancement of the striatal DA depletion was attenuated when morphine was given after alpha MT or when morphine dose was increased to 30 mg/kg. The smallest dose of morphine to enhance the alpha MT-induced NA depletion in the forebrain + midbrain area was 3 mg/kg, and in the hypothalamus and the lower brain stem 10 mg/kg. The enhancement of the NA depletion was dose-dependent, occurred whether morphine was given before or after alpha MT, and was blocked by naloxone. Our findings suggest that morphine alters the alpha MT-induced depletion of cerebral DA in mice similarly to what has been reported to occur in rats. In contrast its effects on cerebral NA depletion in mice are clearly different from its effects in rats. The substantial activation of cerebral noradrenergic systems, especially of those in the forebrain + midbrain area, in mice could underly the fact that morphine's predominant behavioural effect in mice is stimulation of motor activity. PMID- 3628179 TI - Combined effect of low doses of propranolol and ethanol on cardiac function: a comparative study by radionuclide ventriculography in conscious dogs. AB - Trained, chronically instrumented, conscious dogs were used to evaluate the effect of propranolol (PRO), ethanol (ETH) or their combination (P + E) on the left ventricular (LV) function by first-pass radionuclide ventriculography (RNV). Six dogs were trained prior to a sterile left thoracotomy, where a left atrial catheter was implanted. After recovery of four days RNV was carried out by injecting a bolus of technetium-99m diethylenetriamine pentaacetic acid via the catheter to the left atrium. The data was collected for 12 sec. to a computer by frame rate of 20 frames/sec. from left lateral view of the dog. The experiments were performed both in four-leg standing and in 60-degree head-up tilted positions. After control measurements the data were obtained with 0.5 mg/kg of PRO, 0.45 g/kg of ETH and their combination. The P + E combination increased significantly LV end-diastolic and end-systolic volumes, whereas LV peak ejection rate and ejection fraction were decreased. Upright position diminished the LV volume and increased heart rate, while ejection fraction and cardiac output remained unchanged. The first-pass RNV method proved to be promising for measuring the cardiac pharmacological effects in conscious dogs. The combination of propranolol and ethanol in low doses induced an unexpectedly strong depression of LV function, which is supposed to be followed of latent cardiac depressing effect of ETH revealed by blockade of compensatory adrenergic mechanisms with PRO. PMID- 3628180 TI - Influence of prostaglandins and ketoprofen on contractile responses of human and pig detrusor and trigone muscles in vitro. AB - Detrusor and trigone smooth muscle from pig and man were investigated in vitro. The strips were adjusted to a tension of 1 g. During the first hour detrusor strips relaxed and had to be lengthened repeatedly to maintain tension. The tension of strips from the trigone increased spontaneously during this initial period of recovery and accommodation. Detrusor contractions evoked by transmural electric field stimulation, carbachol, histamine and Ca++ were reduced by ketoprofen (an inhibitor of prostaglandin synthesis), while contractions evoked in trigone strips were augmented by ketoprofen. PGE2 10 nM reversed the effect of prostaglandin synthesis antagonism, augmenting the reduced detrusor response and reducing the augmented trigone response. PGF2 alpha augmented evoked contractions in strips from all regions. Activation of endogenous prostaglandin production can not explain the strip behavior during recovery. After recovery, synthesis of the E-type of prostaglandins seem to dominate over the F-type of prostaglandins, since annulment of the E-type of prostaglandins explains best the alterations of evoked contractions following prostaglandin synthesis antagonism. PMID- 3628181 TI - Alterations in peripheral and central dopamine receptor sensitivity after subchronic treatment with fluphenazine and sulpiride. AB - The effects of subchronic treatment with the antipsychotic drugs fluphenazine and sulpiride on the sensitivity of peripheral neuronal dopamine receptors and central dopamine autoreceptors were evaluated. The ability of apomorphine, a dopamine agonist, to inhibit electrically induced sympathetic vasoconstriction in pithed rats, and apomorphine-induced inhibition of spontaneous locomotor activity in awake rats were used as indices of peripheral and central dopamine receptor sensitivity, respectively. A single injection of fluphenazine decanoate, a long acting preparation of fluphenazine, enhanced the central locomotor inhibitory effect of low doses of apomorphine 4 and 6 weeks after drug administration, whereas the antidopaminergic effect on peripheral dopamine receptors was prolonged and persisted at least up to 6 weeks. In another set of experiments rats were treated with fluphenazine hydrochloride and sulpiride for 10 days and subsequently challenged with apomorphine after various withdrawal times. Both antipsychotic drugs augmented the inhibitory effect of apomorphine in the periphery, although the time courses of the potentiation were different. Both treatments also enhanced the locomotor inhibitory effect of apomorphine. These results are in line with our previous finding that long-term treatment with dopamine antagonists can induce neuronal dopamine receptor up-regulation also outside the central nervous system. Peripheral neuronal dopamine receptors thus show similar adaptive responses to long-term blockade as central dopamine autoreceptors, and may serve as a useful experimental model in studies concerned with mechanisms of dopaminergic autoregulation in the central nervous system. PMID- 3628182 TI - Extrahepatic metabolism of chloral hydrate, trichloroethanol and trichloroacetic acid in dogs. AB - To examine the details concerning that part of TRI metabolism which was carried out by the extrahepatic organs, we studied the extrahepatic metabolism of chloral hydrate (CH), free-trichloroethanol (F-TCE) and trichloroacetic acid (TCA) using a method developed in our laboratory. Bypass and non-bypass dogs were given CH, F TCE and TCA, and we compared the concentrations these substances and their metabolites in the serum and urine of the two groups of animals. In the bypass dogs, F-TCE, TCA and conjugated-trichloroethanol (Conj-TCE) appeared in the blood and urine 30 min. after the CH administration, and TCA and Conj-TCE appeared 30 min. after the F-TCE. All levels of administered substance were higher in bypass dogs than in non-bypass dogs, and the compounds were metabolized in small amounts in the extrahepatic organs compared with the liver. Therefore, administered substances remained at high levels in the serum and were excreted in large amounts in the urine in the form of unchanged substances. The metabolized percentage volumes of CH to TCA in the bypass dogs were 10-20%, and those of F TCE to TCA were very small, while these percentage values of CH to F-TCE were the same or slightly smaller, respectively. Moreover, trichloroethylene (TRI) acts to decrease the leukocyte count in the blood, but the TRI metabolites described above do not have this function. PMID- 3628183 TI - The effect of 2,5-hexanedione on newly formed collagen in granulation tissue. AB - The mechanical strength of newly formed collagen in granulation tissue was investigated by implantation of cellulose sponges into rats intoxicated with 2,5 hexanedione (2,5-HD) and control rats. Intoxication with 2,5-HD caused a significant decrease in mechanical strength after 20 days of implantation. No differences were found between 2,5-HD intoxicated and control groups in the amount of collagen formed in the sponges. The mechanical strength of granulation tissue depends on formation and cross-linking of the newly formed collagen fibrils. 2,5-HD is known to react with epsilon-amino groups of lysine and it is therefore able to interfere with both fibril aggregation and cross-linking of the collagen. On the other hand, 2,5-HD induces the formation of cross-links in intact tendon collagen. Therefore, we stress that it is essential to distinguish between intact and newly formed fibrils when evaluating the effect of 2,5-HD on fibillary proteins. PMID- 3628184 TI - Elimination and toxicity of perfluorooctanoic acid during subchronic administration in the Wistar rat. AB - Perfluorinated fatty acids have been used commercially as corrosion inhibitors, wetting agents, fire extinguishers and surface active agents. In an earlier study the male rats were more susceptible to the toxic effects of perfluorooctanoic acid (PFO) than females. PFO-concentrations in the plasma suggested that there was a sex related difference in the urinary elimination rate. Active tubular secretion was observed only in the female kidney. The aim of the present study was to compare the urinary elimination of PFO between the two sexes during subchronic administration to the Wistar rat. PFO was administered by gavage to 48 newly-weaned animals at 0 mg/kg, 3 mg/kg, 10 mg/kg and 30 mg/kg for 28 consecutive days. The urine was collected on the 7th and 28th day of the study. At the end of the study, blood was collected by cardiac puncture. At necropsy, tissue specimens for histopathologic examination were collected from the controls and from the group receiving 30 mg/kg of PFO daily. Unlike the female rats, on the 7th day of the study all three groups of male rats excreted significant less PFO than their daily dose of PFO, which suggested that the males had not reached a steady state by seven days. On the 28th day, the males excreted an amount of PFO equal to their daily dose. The PFO concentrations in the plasma of the male animals suggested that the binding sites of PFO may become saturated at the chronic daily dose level of 30 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628185 TI - Kinetics of radioiodine released from prelabelled thyroid gland in vivo: influence of propylthiouracil. AB - The kinetics of free and hormone bound blood iodine after stimulation with endogenous thyroid stimulating hormone (TSH) are not satisfactorily characterized. We studied these kinetics in mice injected with 125I and thyroxine. In control mice, the injected 125I is organified within the thyroid and incorporated into thyroid hormones, whereas in mice treated with the thyreostatic drug propylthiouracil (PTU), most 125I remains inorganic, since the thyroperoxidase activity is inhibited by PTU. We found that during blockade of TSH secretion by means of thyroxine, blood 125I activity was significantly higher in PTU-treated animals than in controls, indicating that PTU impaired thyroidal uptake of 125I. On the fourth day after the thyroxine load, the blockade of TSH secretion vanished. This caused the blood 125I activity to increase markedly. The increase of blood 125I was as high in PTU-treated animals as in controls. After the peak, blood 125I was cleared according to first order kinetics, with a half time of 0.72 days (= 17.3 hours) in PTU-treated animals and of 6.3 days in controls (P less than 0.001). It is suggested (1) that PTU impairs thyroidal uptake of iodide, (2) that endogenous TSH stimulates release from the thyroid of inorganic iodide as well as of thyroid hormones, and (3) that inorganic iodide released by the thyroid has a much shorter biological half-life than hormone bound iodine. PMID- 3628186 TI - The effects of haem arginate and haematin upon the allylisopropylacetamide induced experimental porphyria in rats. AB - Biochemical disorders caused by allylisopropylacetamide in various animal species resemble human acute intermittent porphyria. The antiporphyrogenic efficacy and potency of haem arginate, a new haem compound, were compared with those of haematin in experimental porphyria of rats. Both haem arginate and haematin dose dependently decreased the urinary excretions of porphyrin precursors. They inhibited significantly the induction of hepatic delta-aminola-evulinic acid synthase. Haem arginate and haematin could restore the activity of haem oxygenase and after higher doses they increased the activity. The dose-effect relationships of the two haem compounds were demonstrated. PMID- 3628187 TI - The natriuretic effect of an acute peroral load of potassium chloride after inhibition of potassium secretion with amiloride or lithium. AB - The ability of the kidneys to excrete potassium after an acute peroral potassium load was studied in rats in which the kidney function was influenced by administration of amiloride or lithium for one month. Water, potassium chloride, or sodium chloride solutions were given by gastric tube immediately before a 2 hour clearance period. The results showed that a load of potassium given by gastric tube leads to an increase of potassium excretion in rats given either no treatment, amiloride, or lithium but the increase was about 50% lower in the lithium group. KCl administration provoked a considerable increase of sodium clearance (CNa) compared with the increase of CNa in the control group. The exaggerated natriuresis was apparently specific for potassium, since a peroral load of sodium chloride led to a more modest increase of CNa, an increase which was significant in control rats only. The increase of CNa in rats given a peroral load of potassium could not be explained by an increase of the proximal tubular fluid output, since the latter as measured by lithium clearance (CLi) remained unaltered. Since CNa/CLi rose considerably, the effect could be ascribed to an inhibition of the fractional distal sodium reabsorption. PMID- 3628188 TI - [Proliferating tricholemmal cysts. A possible preliminary stage of the pilar tumor of the scalp]. PMID- 3628189 TI - [Posticus hemorrhages in acute coronary death]. PMID- 3628190 TI - [Early pathomorphologic diagnosis of mucoviscidosis. Case report and differential diagnosis]. PMID- 3628191 TI - [Dissecting aneurysms of the aorta and coronary arteries in pregnancy]. PMID- 3628192 TI - [Intestinal manifestation of primary Kaposi sarcoma in AIDS]. PMID- 3628193 TI - [Rational method for macrodocumentation of surgical specimens]. PMID- 3628194 TI - [Organ distribution of radioactive cesium in autopsy material following the Chernobyl catastrophe]. PMID- 3628195 TI - Purification of prealbumin from human serum. AB - A method is presented by which prealbumin (thyroxine-binding prealbumin; tryptophan-rich prealbumin) may be purified to homogeneity from human serum. The method involves precipitation of contaminating proteins with dilute aqueous phenol, ion-exchange chromatography on DEAE-Sephacel, and gel permeation chromatography on Sephadex G-100. The yield is 25-30%, and the prealbumin is homogeneous by polyacrylamide gel electrophoresis at pH 8.9 and pH 3.6. PMID- 3628196 TI - Preparative electrophoresis on agarose submerged gels of two aggregating proteoglycan monomers from articular cartilage. AB - Analytical electrophoresis on polyacrylamide-agarose gels of aggregating proteoglycan monomers from baboon articular cartilage produces two distinct bands, corresponding to two different aggregating monomer populations. A preparative electrophoresis procedure is described for isolating the two monomers. Proteoglycans were extracted from young baboon articular cartilage in 4 M guanidinium chloride containing proteolysis inhibitors and aggregated after hyaluronic acid addition. The aggregates were separated from non-aggregated proteoglycans by isopycnic centrifugation, followed by gel chromatography on Sepharose CL-2B. The monomers of the aggregates were obtained by isopycnic centrifugation under dissociative conditions. Two monomers were separated by preparative electrophoresis on 0.8 % agarose submerged gels. Approximately 60 % of the proteoglycans were recovered from the gel using a freeze-squeeze procedure. Aliquots of the separated monomers gave single bands when submitted to analytical polyacrylamide-agarose gel electrophoresis. Their migration and appearance were similar to that of the two bands present in the non separated preparation of monomers. PMID- 3628197 TI - Dietary fat and colon cancer: animal models. AB - During the past 15 years, human and animal model studies performed in our laboratory indicate that dietary fat plays an important role in the etiology of colon cancer. The effect of dietary fat during the stages of initiation and postinitiation of colon carcinogenesis depends on not only the amount of fat but also the type of fat and its fatty acid composition. Studies conducted in animal models have shown that high intake of dietary corn oil, beef fat, safflower oil, and lard increases colon carcinogenesis, whereas diets high in olive oil, coconut oil, and fish oil are without enhancing effect. The mechanisms by which various types of fat increase colon carcinogenesis are not fully understood; however, in most instances, the high-fat diet seems to enhance colon carcinogenesis through its elevation of agents that act as promoters of tumor development. PMID- 3628198 TI - Can dietary fat influence hormone-induced growth responsiveness of the mammary gland? AB - Hormone-induced mammary gland growth responsiveness was examined in female Balb/c mice fed three different dietary levels (0, 5, and 20%) of fat (corn oil). Increasing the quantity of dietary fat enhanced hormone-induced mammary gland developmental growth processes both in vivo and in vitro. The effect of dietary fat was quite striking when comparing mice fed 0 and 5% fat diets and was less pronounced but still present when comparing mice fed 5 and 20% fat diets. PMID- 3628199 TI - Essential fatty acids and prostaglandins. AB - The World Health Organization's recommendation for dietary intake of essential fatty acids is 3% of energy (en%) of linoleate. Evidence from rat studies suggests that more than 3 en% is desirable for the regulation of eicosanoid metabolism. With such a low level of available linoleate, humans tend to synthesize more prostanoids than they do with 6% or more energy from linoleate. High rates of prostanoid synthesis probably are deleterious, so that the lower rate commensurate with 6-12 en% of linoleate probably is desirable. The amount of linoleate needed for normal function is influenced by the dietary content of other fatty acids, particularly saturated fats and those of the n-3 family. Vitamin E is necessary for normal metabolism of polyunsaturated fatty acids. In a diet providing sufficient available total energy with 30% as fat, the lower range of linoleate (6-8 en%) probably is sufficient if the saturated fatty acid content is 10% or less. With a greater proportion of saturated fatty acids, more linoleate is needed to maintain a polyunsaturated to saturated fatty acid ratio of 0.7 to 1.0. Some n-3 fatty acids probably are required, and more than a minimal amount may be beneficial. Current recommendations are for 0.5-1.0 en% in a diet containing 5-6 en% of linoleate. PMID- 3628200 TI - Summation: which fat/how much fat--animals. AB - Promotion of carcinogenesis in rats by dietary fat depends on the amount and type of fatty acids ingested, mainly as triglycerides. A certain amount of essential fatty acid of the linoleate type (n-6) is required for promotion of mammary cancer and pancreatic cancer and probably also for colon cancer. Promotion is also enhanced by a high level of dietary fat, and this additional effect seems to be relatively independent of the type of fat. Saturated fatty acids, either medium or long chain, and cis and trans monoenoic fatty acids appear to have no specific promoting effects. Fish oils containing long-chain polyunsaturated fatty acids of the linolenate type (n-3) are inhibitory, and this may also be true for rapeseed oil high in erucic acid, a long-chain monoenoic fatty acid. The promoting action of dietary fat can be modified by other components of the diet, such as starch, sugar, and fiber. Promotion is also dependent on the length of time animals are exposed to the high-fat diet. The overall tumor yield can be decreased by reducing the level and degree of unsaturation of the dietary fat after a period of feeding a high polyunsaturated-fat diet. PMID- 3628201 TI - Dietary intervention studies to reduce risk factors related to cardiovascular diseases and cancer. AB - This article reviews data obtained from a series of dietary intervention studies conducted in the United States, Finland, and Italy. The objectives were to determine the effects of reducing animal fat consumption while moderately increasing polyunsaturated fatty acid (PUFA), on blood pressure and lipoproteins. Although the diet was modified to improve risk factors related to cardiovascular disease, it is apparent that the dietary intervention would also apply to cancer. The results obtained for men and women, ages 35-65 years, indicate that plasma total cholesterol and low-density and high-density lipoprotein cholesterol were reduced; blood pressure was reduced among both normotensives and hypertensives; daily intake of meat and dairy products were not reduced but were much lower in fat; carbohydrates were substituted as fruits, vegetables, and grains, which provided more vitamins and minerals; and salt intake was maintained at a level of 8-12 g per day. From the data obtained for lowering blood pressure, it would appear that the requirement for PUFA is between 5 and 10 en%, which is somewhat higher than the recommended dietary allowances but lower than that recommended by health agencies. The results of these studies give support to current dietary recommendations to reduce the risk of cardiovascular disease as well as cancer by dietary intervention. PMID- 3628203 TI - Relationship of bile salt stimulation of colonic epithelial phospholipid turnover and proliferative activity: role of activation of protein kinase C1. AB - The mechanism by which bile salts stimulate the proliferative activity of colonic epithelium is uncertain. One of the striking cellular actions of certain bile salts that enhance the proliferative activity of colonic epithelium, such as deoxycholate (DOC) and chenodeoxycholate, is the rapid stimulation of membrane phospholipid turnover. Increased membrane phosphoinositol turnover may lead to release of diacylglycerol (DAG). The latter is an endogenous activator of the calcium phospholipid-dependent enzyme protein kinase C (PKC) whose stimulation has been correlated with enhanced proliferation in several cell systems. In the present study, we examined the effects of DOC on PKC of colonic epithelium in vitro and in vivo. When added directly in vitro to partially purified soluble preparations of phospholipid, calcium-dependent PKC from crypts isolated from rat colon, DOC suppressed activity by 20%, presumably due to calcium complex formation. By contrast, the tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA), and the DAG derivative, 1-oleoyl-2-acetylglycerol (OAG), increased soluble PKC in vitro twofold. The nontumor promoters phorbol and 4 alpha-phorbol-12,13 didecanoate (4 alpha PDD) were without effect. However, in intact colonic epithelial crypt cells prelabeled with arachidonate, DOC caused rapid release of DAG and markedly increased the fraction of PKC associated with the particulate cell fraction, an index of PKC activation. TPA and OAG caused similar shifts in the subcellular distribution of PKC but did not stimulate DAG release, whereas phorbol and 4 alpha PDD were without effect on any parameter. In vivo intracolonic instillation of DOC, OAG, or TPA each induced a shift of soluble PKC to the particulate fraction of colonic mucosal scrapings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628202 TI - Diet and the excretion and enterohepatic cycling of estrogens. AB - Urinary and fecal excretion and plasma levels of estrogens were measured in pre- and postmenopausal women eating different diets. When premenopausal U.S. women eating a "Western diet," comprising high fat (40% of calories) and low fiber, were compared with age-matched vegetarians eating a moderate-fat (30%), high fiber diet, it was found that the vegetarians excreted threefold more estrogen in their feces, had lower urinary excretion, and had 15-20% lower plasma estrogen levels. When U.S. pre- and postmenopausal women eating a Western diet were compared with recent Asian immigrants eating a very low-fat diet (20-25% of calories), similar results were obtained except that plasma estrogen levels were 30% lower among Orientals compared with those among Western omnivore women. Correlation analysis of dietary components and plasma estrogen showed that plasma estrogen was positively associated with fat and was negatively associated with fiber. The results indicate that diet can alter the route of excretion of estrogen by influencing the enterohepatic circulation and that this, in turn, influences plasma estrogen levels. PMID- 3628204 TI - [Improving the qualifications of lecturers on phthisiology in medical schools at the I.M. Sechenov I Medical Institute in Moscow]. PMID- 3628205 TI - [Epidemiology and clinical aspects of pulmonary mycobacteriosis]. PMID- 3628206 TI - [Diagnosis of tuberculosis in patients with developmental defects of the lungs]. PMID- 3628207 TI - [Determining the etiology of pleurisy by puncture biopsy of the pleura]. PMID- 3628208 TI - [Effect of heliox on ventilation and blood oxygen transport in patients with a restrictive form of ventilatory insufficiency]. PMID- 3628209 TI - [Functional interrelations of biologically active points of the skin in patients with pulmonary tuberculosis]. PMID- 3628210 TI - [Rifampicin in the treatment of tuberculosis in patients with diabetes mellitus]. PMID- 3628211 TI - [Results of the treatment of pulmonary tuberculosis in alcoholic patients at a closed tuberculosis-addiction hospital]. PMID- 3628212 TI - [Surgical treatment of patients with extensive destructive pulmonary tuberculosis]. PMID- 3628213 TI - [Early surgical treatment of patients with caseous pneumonia complicated by acute pyopneumothorax]. PMID- 3628214 TI - [Microdrainage of the pleural cavity in the complex treatment of patients with tuberculous pleurisy]. PMID- 3628215 TI - [Diagnostic value of bacterioscopic and cytologic examinations of sputum collected directly onto slides]. PMID- 3628216 TI - [The main causes in the development of recurrence of tuberculosis of the respiratory organs]. PMID- 3628217 TI - [Characteristics of the clinical course of urogenital tuberculosis in patients with chronic opisthorchiasis]. PMID- 3628218 TI - [Dissemination of information on tuberculosis in foreign periodicals]. PMID- 3628219 TI - [Clinico-epidemiologic aspects of chronic bronchitis among workers in the automobile transportation business]. PMID- 3628220 TI - Ultrastructure and elemental composition of human pancreatic calculi. AB - Scanning electron microscopy (SEM) and energy dispersive x-ray fluorescence (EDXRF) have been used in this study to investigate the morphology, nature, and arrangement of major, minor, and trace elements in human pancreatic calculi (PC) obtained from patients with alcoholic and tropical pancreatitis. The present study has confirmed previous observations that PC are rich in CaCO3 (as calcite) and many other elements. Further, we have shown for the first time that the amorphous nidus contained only iron, chromium, and nickel, whereas the outer shell contained calcium and 17 other elements. Based on our studies, we postulate the formation of PC to be taking place in multilayers and multistages. Formation of inner protein nidus in the form of a cobweb is the first stage, then calcite is deposited on this fibrous network as tiny crystals. Because of their high surface area and high surface activity, other metallic ions are incorporated onto it through co-precipitation, adsorption, and/or lattice substitution. This study has further shown that irrespective of the etiology for chronic pancreatitis, the structure and composition of PC are the same suggesting a common pathway for lithogenesis in the pancreatic duct. PMID- 3628221 TI - Effect of partial versus complete pancreatic denervation on pancreatic secretion. AB - The aim of this study is to compare the effect of various stimuli on pancreatic secretion in two groups of dogs, one undergoing interruption of the cholinergic and adrenergic branches to the pancreas (long arc reflexes), and the second group undergoing total denervation of the pancreas by its isolation from stomach and duodenum (short arc reflexes). Stimulation of pancreatic secretion was accomplished by (a) hormonal, by i.v. secretin and CCK/PZ and (b) reflex stimulation by intraduodenal administration of fat (Na oleate) or amino acids (Aminosyn). After a few weeks of collected data in stimulated controls, the dogs were divided into two groups: (A) Four dogs underwent proximal truncal vagotomy, celiac ganglionectomy, and stripping of the common hepatic and gastroduodenal arteries for 2-3 cm. (B) Four dogs underwent the same procedures, but in addition the pancreas was dissected away from its vascular and nervous attachments to the duodenal wall and pyloric region, as well as from its mesenteric and peritoneal attachments. All animals were then tested with secretin, Cholecystokinin/pancreozymin (CCK/PZ), intraduodenal fat, and intraduodenal amino acids. The data obtained indicate that secretion of pancreatic bicarbonate is dependent on intact local duodeno-pancreatic nervous reflexes. Fat and amino acids stimulate the secretion of bicarbonate only when the attachments of the pancreas to the stomach and duodenum are intact. Stimulation by secretion or CCK, being humoral-hormonal mediators, appears not to be affected by the local denervation. PMID- 3628222 TI - Effect of synthetic protease inhibitor camostate on pancreatic exocrine function in rats. AB - Pancreatic exocrine function in rats given synthetic protease inhibitor camostate (200 mg/kg body weight) perorally once daily for 10 days was investigated. Pancreatic wet weight was significantly increased in the camostate-treated rats. The increase in pancreatic weight was associated with pronounced hypertrophy and moderate hyperplasia. Total amylase, trypsin, and lipase contents in the pancreas were also increased in the camostate-treated group compared with the control rats. Secretory patterns of pancreatic juice and amylase in response to caerulein were similar in both groups, whereas the dose-response curve for pancreatic juice secretion in the camostate-treated rats was shifted tenfold toward higher concentrations of caerulein. Basal and caerulein-stimulated flow rates of pancreatic juice were significantly greater in the camostate-treated rats than the control rats, although both groups showed a threefold increase over basal secretion in response to maximal stimulation. Amylase outputs in basal state and in response to submaximal doses of caerulein were significantly lower, whereas those to maximal and supramaximal doses were significantly greater in the camostate-treated animals than that in the control rats. These results indicate that treatment with camostate induces pancreatic hypertrophy and hyperplasia, and that the secretory function of the hypertrophied pancreas is quantitatively but not qualitatively altered. PMID- 3628223 TI - Cerulein induces hyperplasia of the pancreas in a rat model of chronic pancreatic insufficiency. AB - Chronic pancreatic insufficiency (CPI) was induced in male Wistar rats by the injection of a zein-oleic acid-linoleic acid solution into their pancreaticobiliary ducts. Animals injected developed severe pancreatic atrophy with fibrosis and greater than 90% loss of pancreatic enzyme content. The animals also developed malabsorption of fat and bentiromide. Three weeks after the CPI lesion was induced, animals were randomized to receive cerulein 2 micrograms/kg twice daily subcutaneously or saline twice daily subcutaneously for 2 weeks. Cerulein significantly increased pancreatic trypsinogen (p less than 0.03), amylase (p less than 0.01), lipase (p less than 0.02), DNA (p less than 0.02), and RNA (p less than 0.01) content and improved fat and bentiromide malabsorption as compared to saline (p less than 0.05). We conclude that cerulein therapy can cause significant hyperplasia of pancreatic acinar parenchyma in an animal model of CPI and that this therapy can partially reverse malabsorption. PMID- 3628224 TI - Acceleration of pancreatic regeneration by cholecystokinin in rats. AB - Groups of well-fed adult male rats were either killed at the start of the experiment (initial controls) or injected (i.p.) daily for 8 days with DL ethionine (700 mg/kg) while being fed a protein-free diet to achieve degeneration of the exocrine pancreas. Some animals were killed on the ninth day (degeneration group) while others were fed a commercial rat-chow pellet containing 24% protein for the next 7 days (regeneration period), during which period they were infused subcutaneously (osmotic minipump) with either saline or CCK-8 (300 ng or 600 ng/kg/h). These animals were then killed. Pancreata from all groups were assayed for various parameters of growth as well as for trypsin and chymotrypsin activities. At the end of the degeneration period, pancreatic weight and DNA and protein content of the pancreas (expressed as mg/100 g body weight) were significantly decreased by 62, 47, and 80%, respectively, when compared with the corresponding controls. Pancreatic thymidine kinase (TK), trypsin, and chymotrypsin activities were also found to be significantly lower in the degeneration group than in the initial controls. Regeneration of the pancreas (end of the 7-day experimental period) in the saline-infused group was associated with a significant increment in pancreatic weight, protein content, and the activity of trypsin and chymotrypsin in the pancreas, without affecting DNA content and TK activity when compared with the degeneration group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628225 TI - Pancreatic cancer: nihilism is obsolete! PMID- 3628226 TI - Generalized amyloidosis: a rare complication of cystic fibrosis. AB - A new case of cystic fibrosis complicated with secondary amyloidosis is reported. We reviewed ten cases described up to now in the literature, emphasizing the rarity of this association. The usefulness of serum trypsin concentration as an index of exocrine pancreatic function and the accuracy and simplicity of the abdominal fat biopsy in the histologic diagnosis of amyloidosis were evaluated. PMID- 3628227 TI - Biliary obstruction secondary to an extramedullary plasmacytoma of the pancreas: confusion with pancreatitis on computed tomography. AB - A 29-year-old woman with a history of a maxillary plasmacytoma treated with radiation therapy presented with painless jaundice. A computed tomography (CT) scan revealed biliary dilatation and diffuse pancreatic enlargement suggestive of pancreatitis. Percutaneous transhepatic cholangiography demonstrated encasement of the distal common bile duct by an extrinsic mass. At exploratory laparotomy, a large mass replacing the entire pancreas was found. Pathologic examination confirmed plasmacytoma. This report presents a unique case of extramedullary plasmacytoma involving the pancreas early in a patient's clinical course. The CT appearance was similar to that of acute pancreatitis. PMID- 3628228 TI - Regulation of pancreatic exocrine function: a role for cell-to-cell communication? AB - The effect of heptanol, an alkanol which decreases gap junctional permeability, was investigated in the perfused rat pancreas. Under basal conditions, heptanol (3.5 mM) caused a three- to fourfold increase of pancreatic juice, protein, and amylase outputs. The effect on enzyme secretion was fully reversible upon removal of the alkanol and was not secondary to the release of acetylcholine from nerve endings, since it was not prevented by addition of atropine (10(-6) M) to the perfusate. By contrast, another alkanol, hexanol (3 mM), which does not decrease coupling between acinar cells in spite of anesthetic properties analogous to those of heptanol, did not alter pancreatic secretion. The effect of heptanol was not mediated by a significant stimulation of cyclic AMP, nor did the alkanol increase the secretion of lactic dehydrogenase, a cytosolic marker. Analysis of the numerical density of freeze-fractured and immunolabeled gap junctions between acinar cells did not show differences between heptanol-perfused and control pancreases. In addition, heptanol did not alter carbachol (10(-6) M and 10(-5) M) evoked amylase release. Since heptanol blocks cell coupling, apparently without interfering with the main intracellular pathways triggering enzyme release, we suggest that downregulation of direct cell-to-cell communications increases pancreatic exocrine secretion. Thus, cell coupling is probably involved in the regulation of the secretory activity of acinar cells. PMID- 3628229 TI - Pancreatic responses to endogenous and exogenous gastrin in the dog. AB - Serum gastrin and pancreatic secretion were measured in conscious Thomas fistula dogs during infusion of increasing doses of porcine gastrin, against a background of secretin. Dose-response relationships were calculated for the effects of gastrin on pancreatic secretion. Gastrin release was also measured after a test meal and after vagal stimulation with 2-deoxyglucose. Peak serum gastrin levels after these stimuli were less than the serum gastrin level associated with the minimal effective dose of gastrin. From the dose-response relationship of serum gastrin and pancreatic protein output, it was possible to calculate the protein output corresponding to the peak gastrin levels after 2-deoxyglucose or a meal. These were equivalent to 20-30% of the observed protein response to these stimuli. We conclude that gastrin plays at most a small part in the stimulation of pancreatic secretion after a meal and in response to 2-deoxyglucose. We also found that truncal vagotomy reduces pancreatic sensitivity to gastrin. PMID- 3628230 TI - Potential methodologic problems with in vivo immunoneutralization of pancreatic polypeptide. AB - Dogs with chronic pancreatic fistulae were given 0.5 ml of nonimmune rabbit serum or antibody S5, an antibody raised against the C-terminal pancreatic polypeptide (PP) hexapeptide. A 3-h infusion of secretin (125 ng/kg/h) and CCK8 (50 ng/kg/h) was started 30 min after injecting serum. Exogenous BPP (400 pmol/kg/h) was administered during the middle secretin/CCK hour. In a second protocol, 30 min after injecting nonimmune serum or PP-anti-serum, the animals were fed 15 g/kg cooked ground beef. Pretreatment with S5 enhanced secretin/CCK-induced bicarbonate outputs; protein outputs did not differ. Exogenous BPP inhibited pancreatic secretion, even in S5-treated animals. Meal-induced pancreatic secretion was not altered by S5 pretreatment. Significant increments in PP were measured by radioimmunoassay during administration of secretin/CCK and during BPP infusion. Anti-PP pretreatment abolished the former and significantly decreased, but did not abolish, the latter. The meal evoked significant postprandial increments in PP which were essentially abolished following S5 pretreatment. A physiological role for PP cannot be proved or refuted because antiserum pretreatment failed to block the effects of exogenous hormone. The latter must be established before excluding a peptide's physiological role based on negative in vivo immunoneutralization data. PMID- 3628231 TI - Lipid content of human and rat pancreas. AB - We analyzed the lipid composition of the human pancreas and performed a parallel study on rat pancreas. Some precautions were taken in order to keep the secretory zymogens as inactive precursors in both tissues. The lipid content of the human pancreas corresponded to 5.5% of the tissue wet weight, lower than that found in pancreas of two-month-old Wistar rats (10%). In man, triglycerides and phospholipids were found at comparable levels, respectively, 37 and 30 mg/g of pancreas wet weight, not far from the values of the rat pancreas. In human pancreas, phosphatidylcholines and lysophosphatidylcholines represented about 40% of the total phospholipid fraction, phosphatidylethanolamines and lysophosphatidylethanolamines 21%, and phosphatidylserines and -inositols were found equally represented with 7.5%. The total cholesterol content accounted for about 4.5% of the total lipids; only 30% was esterified. By comparison, in rat, total cholesterol represented 3.3% of lipids and 90% was esterified. The phospholipids in human pancreas contained high amounts of saturated fatty acids (92%) mainly stearic and palmitic, whereas triglycerides contained equal amounts of saturated and unsaturated fatty acids, principally represented by oleic and palmitic acids. In rats the phospholipids contained only 63% saturated fatty acids (palmitic and stearic) and triglycerides contained 61% unsaturated fatty acids (mainly oleic and linoleic). In terms of lipid composition, there is a greater similarity between human and rat pancreas than with other known pancreas, such as the guinea pig and the ox. PMID- 3628232 TI - Effect of bombesin and cholecystokinin on plasma immunoreactive trypsin in humans. AB - Since bombesin is a potent stimulus of the release of cholecystokinin (CCK), it has been suggested that the stimulatory effect of bombesin on pancreatic enzyme secretion is mediated by CCK. The present study was undertaken to determine the role of CCK in the bombesin-induced stimulation of plasma immunoreactive trypsin. Plasma CCK was measured by radioimmunoassay using the antibody T204, which binds to all biologically active sulfated COOH-terminal CCK-peptides. Plasma trypsin was also measured by radioimmunoassay. Infusion of 5 ng/kg/min bombesin in 6 healthy volunteers increased plasma CCK from 1.2 +/- 0.2-8.9 +/- 0.7 pM (p less than 0.0001). The peak increment in plasma CCK during bombesin (9.3 +/- 0.6 pM) was accompanied by a significant rise in plasma trypsin from 206 +/- 21-334 +/- 44 ng/ml (p less than 0.01). However, when similar increases in plasma CCK were achieved by infusion of 0.018 CU/kg/min CCK-33 (9.9 +/- 0.8 pM) or by intraduodenal instillation of 250 ml 20% Intralipid (9.7 +/- 1.9 pM), no significant changes in plasma trypsin were observed. It is therefore concluded that the stimulatory effect of bombesin on plasma immunoreactive trypsin is not mediated by CCK. PMID- 3628233 TI - Alcoholic and nonalcoholic chronic pancreatitis--differences in natural history? PMID- 3628234 TI - Differences in the natural history of idiopathic (nonalcoholic) and alcoholic chronic pancreatitis. A comparative long-term study of 287 patients. AB - Controversies in the literature regarding definition, diagnosis, and therapy of chronic pancreatitis may be related in part to differences in the natural history of alcoholic and idiopathic (nonalcoholic) chronic pancreatitis. In order to evaluate this problem the long-term course of 205 patients with alcoholic (85.4% with calcifications) (group A) and 82 patients with idiopathic (nonalcoholic) chronic pancreatitis (76.8% with calcifications) (group B) has been analyzed prospectively since 1963. The patients were studied at regular intervals with particular regard to pain, pancreatic exocrine, and endocrine function and calcifications. The observation time was 2 years or longer in 230 patients with a median observation time of 6.7 years from diagnosis in group A and 10.6 years in group B. In group B over 50% of the cases had primary painless chronic pancreatitis. Progressive deterioration of exocrine and endocrine function was observed in both groups. However, in group A the rate of progression of exocrine dysfunction after diagnosis was more rapid and the incidence of diabetes in relation to marked exocrine insufficiency was much higher than in group B. Steatorrhea preceded diabetes in 56% (group A) and 80% (group B), respectively. Onset of pancreatic calcifications was closely associated with pancreatic exocrine insufficiency in group A in contrast to group B. In addition lasting pain relief occurred spontaneously in about 30% of patients in group B despite a normal exocrine function for 6 years or longer which is in disaccord with the results in alcoholic chronic pancreatitis. In conclusion group A and B have many features in common, in particular the high incidence of pancreatic calcifications and the progressive pancreatic dysfunction. However, the long-term profile of both groups differs in some important aspects, particularly in the clinical pattern and in the rate of progression of pancreatic dysfunction and morphology. These differences should be appreciated in the discussion of problems regarding definition, diagnosis, and surgical therapy of chronic pancreatitis. PMID- 3628235 TI - Clinical course and prognosis of chronic pancreatitis. AB - Course and prognosis of 125 patients with chronic pancreatitis (CP) were evaluated. Follow-up period ranged from 1-20 years with a median of 6.3 years. The following conclusions were obtained. Recent increase of CP in our clinics was ascribed to alcoholic CP and idiopathic CP in the aged. Of 106 patients with pain, 74 showed improvement or disappearance of pain. Drinking habit and observation period were the main factors determining the rate of pain relief. Serial endoscopic retrograde pancreatography (ERP) showed aggravation in 17/47 patients, cholecystokinin-pancreozymin (CCK-PZ) secretin test in 4/40 patients, and oral glucose tolerance test (OGTT) in 7/25 patients. Exocrine function showed improvement in five patients, whereas endocrine function showed none. Improvement or aggravation of exocrine function was closely related to drinking habit. Main complications included 15 cases of peptic ulcer, 19 of pancreatic pseudocyst, and 15 of bile duct stenosis. Twenty-six patients died, often due to malignant neoplasms and diabetic complications. Those who continued drinking as much showed a lower survival rate than those who discontinued or decreased alcohol intake. The socioeconomic status deteriorated often due to pain or alcoholism. Three patients had to degrade jobs and six fell into inactive social life. PMID- 3628236 TI - The role of splanchnic glucose output in determining glycemic responses after mixed meal in type II diabetic patients and normal subjects. AB - Postprandial serum glucose concentrations are determined by both the rates of glucose appearance and disposal in normal subjects and diabetic patients. The significance of each parameter following mixed meal remains controversial. We have compared the serum glucose and C-peptide responses, as well as glucose fluxes (D[3-3H]glucose technique), after a breakfast mixed meal in type II diabetic patients (n = 6) and normal subjects (n = 7). The mean (+/- SEM) fasting serum glucose and postprandial glycemic responses were significantly (p less than 0.001) higher in the diabetic patients compared with the normal subjects. Mean fasting serum C-peptide levels were similar in both groups. After the mixed meal ingestion, serum C-peptide levels were significantly higher at 20 min (p less than 0.02) and 40 min (p less than 0.01) in the normal subjects compared with diabetic patients. The mean basal hepatic glucose output was 124 +/- 15 vs. 70 +/ 6 mg/m2 min (p less than 0.001) in the diabetics compared with the normal subjects, respectively. After mixed meal ingestion, the incremental integrated areas and rates of splanchnic glucose appearance (RA) and utilization (RU) were significantly (p less than 0.001) higher in the diabetics versus normal subjects. Both basal and post-meal metabolic clearance rate (MCR) were significantly (p less than 0.05) lower in the diabetic patients when compared with the normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628237 TI - A new round in the discussion on the action of secretin on pancreatic protein secretion: a further study on the effect of secretin on pancreatic secretion in dogs. AB - Whether or not secretin stimulates pancreatic protein secretion is a controversial question. In this investigation, dose-response studies with different secretin preparations were performed in dogs with two different types of pancreatic fistulae. Pure natural secretin (Karolinska Institute, Stockholm), synthetic secretin (Hoechst, Frankfurt), synthetic secretin (Hoechst, Frankfurt), synthetic D-Ala17-secretin (Roche, Basel), and natural secretin (Kabi, Munich) were tested in dogs equipped with a Thomas cannula for collection of pure pancreatic juice. The synthetic secretin was also tested in dogs with a modified Herrera fistula. Potency of the pure natural and the unmodified synthetic secretins was similar. Whereas protein output was significantly stimulated by these secretin preparations, protein concentrations fell to approximately 10 mg ml-1 with incremental doses of infused secretin. The high protein concentrations of 60 up to 120 mg ml-1 found in pure basal pancreatic secretion, suggest that pancreatic protein output may have been a "washout" phenomenon, and that the increasing protein output values were due to rising volume flow of pancreatic juice which is not completely protein-free. Impure secretin preparations and indirect collection techniques also lead to an elevation of pancreatic protein output. PMID- 3628238 TI - Release of individual enzymes from guinea pig pancreas following stimulation with CCK-8 or CCK-33. AB - This paper compares the effects of prolonged stimulation with CCK-33 or CCK-8 on the secretion of individual enzymes from the pancreas of the anaesthetised guinea pig. Quantitative analysis of the individual secretory proteins was achieved using a newly developed, reversed-phase, high-performance, liquid chromatography technique. Using this system, it was possible to separate and quantify each of the nine major proteins present in a small sample of pancreatic juice in 40 min. Because spontaneous pancreatic secretion was very slow in the anaesthetised guinea-pig, the cholecystokinin (CCK) peptides were administered against a background infusion of secretin. Secretin alone produced a small rise in total protein release with the secretion of all individual proteins being increased in parallel. Doses of CCK-33 and CCK-8 which increased total protein secretion by a similar amount had contrasting effects on the release of individual proteins. CCK 33 produced a parallel release of all proteins over a period of 2 h. By contrast, after 1-h stimulation with CCK-8, the secretion of proteins became nonparallel. These data suggest that CCK-33 and CCK-8 may provoke slightly different intracellular responses within the pancreatic acinar cell. PMID- 3628239 TI - Endoscopic cystoduodenostomy of cysts of chronic calcifying pancreatitis: a report of 20 cases. AB - This paper reports on the technique and results of 20 endoscopic diversions into the duodenum of cysts complicating chronic pancreatitis in 19 patients. The procedure, performed safely on the condition of visualization of a compression of the duodenal wall by the cyst, was successful 18 times in 17 patients. Complications occurred in four patients: two with bleeding (resulting in the death of one patient), two perforations treated successfully, and one transient cholangitis. Long-term results (average = 20.7 months) in 13 patients who were followed more than 6 months were good nine times, fair three times, and bad in one case. Endoscopic cysto-digestive diversion appears as an interesting alternative to surgery in selected patients with chronic pancreatitis. PMID- 3628240 TI - Peptide YY inhibits nutrient-, hormonal-, and vagally-stimulated pancreatic exocrine secretion. AB - Peptide YY (PYY) is a recently isolated gut peptide that is found primarily in the mucosal endocrine cells of the terminal ileum, colon, and rectum of several mammalian species, including humans. The purpose of this study was to characterize the effect of PYY on pancreatic exocrine secretion in six conscious dogs prepared with pancreatic and gastric fistulas. In control experiments, pancreatic exocrine secretion was stimulated by either intravenous (i.v.) administration of secretin (100 ng/kg/h), cholecystokinin-8 (50 ng/kg/h), neurotensin (5 micrograms/kg/h), or 2-deoxy-D-glucose (75 mg/kg); or by the intraduodenal infusion of hydrochloric acid (4 mEq/h), a mixture of amino acids (phenylalanine + tryptophan at 5 mmol/h), sodium oleate (9 mmol/h), or a liquid meal. On separate days, PYY (12.5, 25, 50, 100, 200, or 400 pmol/kg/h) was given intravenously in combination with one of the above pancreatic secretagogues. Intravenous PYY at 200 and 400 pmol/kg/h inhibited secretin-stimulated pancreatic bicarbonate output significantly (p less than 0.05). Pancreatic bicarbonate and protein responses to all pancreatic secretagogues were reduced significantly (p less than 0.05) by PYY at 400 pmol/kg/h. Intravenous administration of atropine (0.6 mg bolus, followed by 0.02 mg/kg/h) did not abolish the ability of PYY to inhibit secretin-stimulated pancreatic bicarbonate secretion. This study demonstrates that PYY can inhibit nutrient-, hormonal-, and vagally-stimulated pancreatic exocrine secretion in the dog; its mechanism of action appears to be independent of cholinergic innervation. PMID- 3628242 TI - Acute pancreatitis in pancreatic carcinoma. PMID- 3628241 TI - Recalcitrant pancreatitis: eventual control by antioxidants. AB - A woman, 61 years of age at her first attack of pancreatitis, had further attacks every few months during the next two years despite cholecystectomy for gall stones, and pancreato-duodenectomy for pancreas divisum and duodenal diverticulum. Since starting treatment with antioxidants, she has been free of attacks for two years. PMID- 3628244 TI - Early warning of famine: a red herring? PMID- 3628245 TI - The limits to the use of international aid as a means of securing improvements in food production and nutrition. PMID- 3628243 TI - Biological predictors of success of antidepressant drug therapy. AB - The predictive value of patients' characteristics with regard to subsequent success of antidepressant therapy was investigated in a prospective study. Starting from the amine-deficiency hypotheses the sample was randomized and 30 patients were treated with maprotiline, 30 with clomipramine. Sociodemographic data, data about the immediate history of the illness and also most of the psychopathological symptoms before the start of treatment have no predictive capacity. Predictors of a subsequent response to clomipramine proved to be: positive reaction to sleep deprivation, decrease in MAO activity as a result of sleep deprivation, absence of signs of fatigue in the EEG after the first infusion, a serum concentration of at least 75 ng clomipramine/ml serum or 30 ng desmethyl-clomipramine/ml serum on the 7th day of treatment. A negative response to sleep deprivation, an increase in MAO activity as a result of sleep deprivation, the appearance of signs of fatigue (vigilance index) in the EEG after the first infusion as well as obvious autonomic symptoms before the start of treatment are indicative of a response to maprotiline. Diurnal variations of mood point rather to a general responsiveness to antidepressants without preference for a particular antidepressant. The results of this study provide theoretical reasons why unchangeable characteristics of patients, so-called 'static variables', can be of only slight predictive value. In contrast, changeable characteristics, so-called 'dynamic variables', such as reaction to sleep deprivation, EEG changes resulting from the first infusion, etc., could be of predictive value. PMID- 3628246 TI - Teaching programme staff to identify likely food shortages and to tackle their consequences. PMID- 3628247 TI - European food aid as a tool for relief and development in Sub-Saharan Africa. PMID- 3628248 TI - The role of livestock in Africa: are livestock occasionally contributing to famine? PMID- 3628249 TI - Intrinsic labeling of bovine milk with enriched stable isotopes of zinc. AB - Bovine milk was labeled intrinsically with enriched stable isotopic zinc for human bioavailability studies. Intrajugular administration of zinc isotopes temporarily increased the plasma zinc concentration of Ayrshire cows by as much as 76%, but milk zinc concentration and the distribution of zinc between casein and whey did not change appreciably. Milk zinc isotopic enrichment reached 105 and 613 atom % excess for 67Zn and 70Zn, respectively within 4-12 hr of zinc administration and decreased gradually over several days. This degree of isotopic enrichment is sufficient for testing bioavailability to infants of intrinsic zinc from milk-based formulas. PMID- 3628250 TI - Ascorbic acid reduces accumulation of [3H]spiperone in mouse striatum in vivo. AB - [3H]Spiperone was administered (20 microCi/kg, 0.0003 mg/kg, sc) to mice. In agreement with other published reports, 2 hr later the accumulation of tritium was three to four times greater in the corpus striatum than in the cerebellum. Ascorbic acid (100, 1000, 2000 mg/kg, ip, 30 min) reduced the 2-hr accumulation in the corpus striatum 16, 42, and 63%, respectively, with only the highest dose producing any significant (18%) reduction in the cerebellum. The effect was still evident in striatum 18 hr after a single dose of 1000 mg/kg. Striatal minces taken from mice treated 1 or 2 hr earlier with ascorbic acid (2000 mg/kg, ip) showed no reduction in [3H]spiperone binding. However, preincubation of striatal minces for 2 hr with ascorbic acid (10(-3) M) produced an 82% reduction in specific binding while not having any effect on nonspecific binding. While it cannot be certain that the reduction of striatal [3H]spiperone concentrations after ascorbic acid in vivo was not a result of some nonspecific alteration in the pharmacokinetics of [3H]spiperone, the in vitro observation strongly suggests that it resulted from an alteration of binding characteristics at the receptor level. PMID- 3628251 TI - Selective inhibition of erythropoiesis by sera from patients with chronic renal failure. AB - The pathogenesis of anemia in patients with chronic renal failure was studied by analyzing the effect of uremic sera on the in vitro colony growth of erythroid (CFU-E) and granulocyte-macrophage (CFU-GM) progenitor cells. Uremic sera from 20 of 30 patients inhibited erythroid colony growth below 70% of control even when cultured with normal human bone marrow of the same blood type. On the other hand, only one of the sera inhibited colony growth of CFU-GM as compared with normal sera. On Sephadex G-15 gel filtration, the CFU-E-inhibiting activity appeared in two different fractions: the void volume peak and the delayed eluant before the second peak. The inhibiting activity in the former fraction was noted only in uremic sera. The results of this study suggest the existence of a serum inhibitor(s) of erythropoiesis with a relative molecular mass of more than 1500 Da which are virtually impossible to dialyze by conventional membranes. PMID- 3628252 TI - Milk-specific RNase as a marker of differentiation of rat mammary tumors. AB - Various rat mammary tumors were analyzed for the presence of a milk-specific Ca2+ stimulated RNase (Ca2+-RNase). When crude extracts of some differentiated tumors- adenocarcinomas of MT/W9, MT/W9a, R3230AC, DMBA-1, DMBA-8, and DMBA-14 and 3MN squamous cell carcinoma--were assayed for RNase activity under various ionic conditions, it was always highest in the presence of Ca2+/EDTA than under any other ionic condition. The opposite was true in invasive MT/W449a and 13762 adenocarcinomas, poorly differentiated SMT/2A carcinomas, MAMF2/TC fibrosarcoma, and MT/A fibroadenoma. Sephacryl S-200 chromatography separation of tumor extracts confirmed the presence of Ca2+-RNase in those differentiated tumors and absence of the enzyme from other tumors. Expressing the activity as a ratio of Ca2+/EDTA to either Mg2+/EDTA or EDTA alone to more clearly represent the relative level of Ca2+-RNase activity further illustrates the distinct differences between tumor classes. Thus Ca2+-RNase is a sensitive marker for use in the characterization of rat tumors with respect to differentiated mammary functions. PMID- 3628253 TI - 2',5'-Oligoadenylate synthetase and interferon in peripheral blood after rubella, measles, or mumps live virus vaccine. AB - The temporal activation of the human interferon system by infection with virus was studied by serial measurements of both interferon in serum and activity of 2',5'-oligo adenylate synthetase in peripheral mononuclear leukocytes. A frequency distribution of baseline values of synthetase was established for normal individuals. Following subcutaneous inoculation of rubella vaccine virus, serum interferon rose briefly with a peak on Day 14. The peak concentration of synthetase also occurred on Day 14 but remained elevated for greater than 1 week. After measles virus, serum interferon did not rise above baseline, but synthetase peaked on Day 14 and remained elevated. Subcutaneous inoculation of mumps vaccine virus was associated with a brief period of elevation of the synthetase and no interferon in the serum. Thus, the determination of synthetase levels in tissue may be useful in some situations to reflect a small or transient elevation of endogenous interferon. PMID- 3628254 TI - Quantitative comparison of infection of neural cell and fibroblast monolayers by two strains of Toxoplasma gondii. AB - Disease caused by the coccidian Toxoplasma gondii can be confined to the central nervous system, although the parasite is capable of infecting all organ systems. To determine whether neural cells are differentially susceptible to infection and destruction by T. gondii, infection of neonatal mouse brain monolayers was compared to infection of human fibroblast monolayers under the same conditions with equal inocula of two parasite strains. In preliminary experiments there was no difference in total parasite yield or in plaques per monolayer between rodent and human cells. A standardized inoculum of T. gondii RH strain caused 35.6 +/- 6.4 (SD) plaques per well in neural explant monolayers compared to 39.3 +/- 12.5 plaques per well in fibroblasts. T. gondii P strain produced 35.6 +/- 8.9 infected foci per well in neural cells compared to 32.6 +/- 9.3 foci in fibroblasts. Intrinsic properties of neural cells do not appear to cause a higher rate of infection than that in nonneural cells. PMID- 3628255 TI - Competitive analog antagonists of bradykinin in the canine hindlimb. AB - Six structural analogs of bradykinin were tested to determine whether they antagonize the vasodilator response to bradykinin. The dog hindlimb preparation was used as a bioassay. Mongrel dogs were anesthetized and the femoral arteries were isolated and fitted with a noncanulating electromagnetic flow probe. An indwelling catheter was also placed for administration of saline, bradykinin, or the various analogs. The vasodilatory responses of the hindlimb circulation to bolus doses of bradykinin from 1 of 20 ng were tested during vehicle or analog administration at 1 and 10 micrograms/min. Bradykinin analogs which were characterized by amino acid replacement by beta-(2-thienyl)-L-alanine (Thi) at positions 5 and 8, D-phenylalanine (D-Phe) at position 7, and an additional replacement of hydroxyproline at position 2 or 3 were effective antagonists of bradykinin. The decapeptide bradykinin analog (BKA06) D-Arg-(Hyp3-Thi5-D-Phe7 Thi)-BK was the most potent analog tested, producing a full log dose shift in the dose-response curve to bradykinin at the 10 micrograms/min (4 nmole/min) infusion rate. None of the analogs we tested produced vasodilation or had any effect upon systemic blood pressure at the concentrations tested. Our results suggest that these structural analogs of bradykinin may be effective pharmacologic tools to study the role of endogenous kinins in the control of vascular resistance and circulatory homeostasis. PMID- 3628256 TI - Fecal steroid excretion in chickens with hereditary hyperlipidemia. AB - Plasma lipids (cholesterol, triglycerides, and phospholipids; mg/dl) and the fecal excretion (mg/day) of neutral steroids and bile acids were studied in layers (L), hereditary nonlayer hens (NL), and roosters (R) fed a basal cholesterol-free grain diet ad libitum. Each group had significantly (P less than 0.05) different levels of plasma cholesterol, triglycerides, and phospholipids when compared to the other groups. The highest lipid values were found in the NL group (cholesterol, 798 +/- 89; triglycerides, 8914 +/- 679; phospholipids, 2458 +/- 112). There was no difference in the fecal excretion of neutral steroids between L and NL; however, fecal bile acid excretion by these two groups was significantly different (P less than 0.05) (L, 13.1 +/- 1.7 vs NL, 26.9 +/- 3.4). Fecal neutral steroid excretion by R was significantly greater (P less than 0.05) than that by either L or NL (L, 6.4 +/- 1.3; NL, 6.0 +/- 1.4; R, 14.4 +/- 1.2). While fecal excretion of bile acids by R (36.1 +/- 4.0) was also greater than that by either L or NL, only the difference between R and L was statistically significant (P less than 0.05). Since, in the steady state, fecal bile acid excretion is equal to its synthesis, these results suggest that bile acid metabolism in these animals can be affected by both sex and egg-laying status. PMID- 3628257 TI - Bone-targeted carbonic anhydrase inhibitors: effect of a proinhibitor on bone resorption in vitro. AB - Many investigations have indicated a functional role for carbonic anhydrase in the mediation of hormone-stimulated bone resorption. These studies depend heavily on the use of heterocyclic sulfonamide inhibitors of carbonic anhydrase. These drugs have effects on many tissues other than bone, and some of these effects confound the interpretation of studies of the role of carbonic acid in bone metabolism. A novel, "bone-targeted" sulfonamide has been produced to obviate these extraosseous effects. This compound (designated WP-1) is the combination of tetracycline and acetazolamide, such that the acetazolamide is not an active inhibitor. Hydrolysis of WP-1 yields an active carbonic anhydrase inhibitor. WP-1 has a marked affinity for bone mineral, allowing deposition of the drug in bone. At a concentration of 10(-5) M, WP-1 attenuates parathyroid hormone stimulated net release of calcium from neonatal rat calvaria in culture. WP-1 is the first member of a class of drugs which may prove useful as pharmacological probes in the study of bone metabolism. PMID- 3628258 TI - The effects of the chronic administration of phencyclidine hydrochloride on endocrine target tissue in the male rat. PMID- 3628259 TI - The electrogenic effect of sodium taurocholate on rat hepatocyte couplets. PMID- 3628260 TI - The pivotal role at angiotensin III in the brain angiotensin system. PMID- 3628261 TI - The contribution of the N-terminal region of angiotensin II antagonists to receptor binding. PMID- 3628262 TI - Preliminary evidence for decreased red blood cell deformability during blood storage. PMID- 3628263 TI - Pharmacokinetics of radiogallium in humans. PMID- 3628264 TI - Antineoplastic and antimicrobial activities of marine organisms. PMID- 3628265 TI - Dermal absorption of lonapalene, a new anti-psoriatic drug. PMID- 3628266 TI - Calcium channel blockers and smooth muscle motility in vitro. PMID- 3628267 TI - A method for the detection of biologically active chemical agents using a patch microprobe system. PMID- 3628268 TI - Modulation by taurine of calcium binding to phospholipid vesicles and cardiac sarcolemma. PMID- 3628269 TI - The effect of naloxone on blood catecholamine levels in conscious unrestrained morphine dependent rats. PMID- 3628270 TI - Hemodynamic effects of hypercholesterolemia. PMID- 3628271 TI - Angiotensin II induced amplification of the vasoconstrictor response to norepinephrine and clonidine. PMID- 3628272 TI - Intrathecal vasopressin administration alters efferent renal nerve activity. PMID- 3628273 TI - Isoflurane effect on isolated non-pregnant human myometrium. PMID- 3628274 TI - Specificity and sensitivity of antisera produced against non-conjugated urotensin I and related peptides. PMID- 3628275 TI - Effect of taurine on the contractility of arterial smooth muscle. PMID- 3628276 TI - Relative muscarinic potency of five Inocybe species. PMID- 3628277 TI - Microcomputerized data collection for the pharmacology lab. PMID- 3628278 TI - Intrathecal beta-funaltrexamine (beta-FNA) is a long acting agonist in the mouse abdominal stretch test. PMID- 3628279 TI - Cardioprotective effects of superoxide dismutase following coronary artery occlusion in the rat. PMID- 3628280 TI - The effect of chlorpromazine on cholecystokinin induced gallbladder contraction. PMID- 3628281 TI - Effects of the organophosphate cholinesterase inhibitor (DFP) on hypothalamic acetylcholinesterase and pituitary-adrenal activity. PMID- 3628282 TI - N-terminal cyclization of a nonsulfated CCK analogue exhibits opioid antagonist activity in vitro. PMID- 3628283 TI - Acute toxicity of selenium to earthworms. PMID- 3628284 TI - Effect of inflammatory exudates on peripheral and cerebral canine arteries. PMID- 3628285 TI - Cardiovascular effects of centrally administered dopamine agonists and clonidine in the rat. PMID- 3628286 TI - Intrathecal administration of pentobarbital and THIP: evidence for descending excitatory and inhibitory modulation of a spinal reflex. PMID- 3628287 TI - Mechanism of vasopressin induced antipyresis: effects of cool and warm environments on the thermoregulatory actions of central vasopressin. PMID- 3628288 TI - Effect of amniotic fluid on isolated human myometrium. PMID- 3628290 TI - Adenosine receptors in bovine and rat cortex. PMID- 3628289 TI - Involvement of the periaqueductal gray matter and serotonin in the analgesia produced by stimulation of the nucleus tractus solitarius. PMID- 3628291 TI - 3H-nitrendipine binding in hearts from rats fed isocaloric diets of different fatty acid composition. PMID- 3628292 TI - Cardiac responsivity to epinephrine following chronic cocaine administration. PMID- 3628293 TI - Changes in vascular responses of isolated and perfused canine basilar arteries during early stages of experimental subarachnoid hemorrhage. PMID- 3628294 TI - Tissue distribution of digoxin in the presence of calcium channel blockers. PMID- 3628295 TI - Analgesic properties of lithium. PMID- 3628296 TI - Neurochemical and neuropharmacological investigation of N-cyanoethyltryptamine, a potential prodrug of tryptamine. PMID- 3628297 TI - Therapeutic quotient for some angiotensin antagonists determined from antagonist and agonist activities in rat pressor assays. PMID- 3628298 TI - Effect of intrahypothalamic microinjection of neuropeptide Y on gastric acid secretion in the rat. PMID- 3628299 TI - The proenkephalin A fragment peptide E is metabolized centrally to a novel peptide with opioid activity. PMID- 3628300 TI - Relationship of right ventricular electrocardiogram to right coronary driving pressure in experimental acute embolic pulmonary hypertension. PMID- 3628301 TI - Infrarenal aortic clamping and renal hemodynamics. PMID- 3628302 TI - Isoflurane, halothane and survival time in hypoxic mice. PMID- 3628303 TI - Complex effects of the insecticide permethrin on an isolated sensory neuron. PMID- 3628304 TI - Brainstem sites of cholinergic actions on vestibulospinal reflex gain in cats. PMID- 3628305 TI - Selective effects of cholinergic agonists and antagonists on ethanol sensitivity in LS and SS mice. PMID- 3628306 TI - Endogenous digitalis: current status and progesterone derivatives as candidates. PMID- 3628307 TI - Pharmacological demonstration of two EEG theta generators in hippocampal slices. PMID- 3628308 TI - Pharmacologic intrinsic activity in rate coupled receptor systems. PMID- 3628309 TI - An "excited state" receptor theory. PMID- 3628310 TI - Receptor and tissue specific derivatives of histamine: novel immune modulators. PMID- 3628311 TI - Pharmacokinetics of 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(4-ethyl-1 piperazinyl)-3-q uinoline- carboxylic acid (BAY Vp 2674) in chickens. PMID- 3628312 TI - Electrophysiology of guinea pig pancreatic acinar cells. PMID- 3628313 TI - The inhibitory enteric nerves of the gastric corpus and the ileum of the ferret. PMID- 3628314 TI - Activation of hippocampal theta rhythm by opiates in the rat. PMID- 3628315 TI - The modulation of feeding motor output in Helisoma by arginine vasotocin. PMID- 3628316 TI - A descriptive study of nurse impairment in the province of Alberta--a preliminary report. PMID- 3628317 TI - The effect of phenylpropanolamine and amphetamine on fighting behavior and weight change in mice. PMID- 3628318 TI - The mega interactive model of drug abuse (MIMDA). PMID- 3628319 TI - RS-82856, a selective phosphodiesterase inhibitor with inotropic, afterload reduction and antithrombotic properties. PMID- 3628320 TI - Inhibition of thiobarbituric acid reactive products in rat liver homogenate by extracts from pollen grains. PMID- 3628321 TI - Nitrobenzylthioinosine (NBMPR) binding sites in kidney. PMID- 3628322 TI - Oxidation of the pyridine ring: a major pathway of metabolism for the rat hepatocarcinogen, methapyrilene. PMID- 3628323 TI - The effects of indomethacin on gentamicin serum levels. PMID- 3628324 TI - Novel dihydropyridine calcium channel antagonists: structural features which extend duration of action. PMID- 3628325 TI - Effects of age on nocturnal activity rhythms in rats. AB - Running wheel data were analyzed to examine changes in nocturnal activity rhythms with age in Long Evans rats. Five male animals 30 days of age, the same five rats at 70 days of age, and five older animals at 13 months were given free access to activity wheels in a colony room maintained on an LD12:12 cycle. All subjects demonstrated enhancement of activity during the dark phase of the 24-h cycle. A statistically significant decrease in activity of old rats in comparison with weanling rats was observed only in the dark phase (P less than .0001). The age difference was marginal in the light phase compared to that in the dark phase. However, a marked increase in percentage of time spent active in the light phase was observed in the old animals. This may be a combined result of visual hyposensitivity and insomnia that became apparent with increasing age. Mechanisms that control initiation and maintenance of locomotor behavior may become less responsive with age to periodic alternative of light and dark phases. PMID- 3628326 TI - Effect of age and torpor on the circadian rhythms of body temperature, activity, and body weight in the mouse (Peromyscus leucopus). AB - Age-related alterations in homeostatic mechanisms, as measured by changes in circadian rhythms, have been reported in the literature. The purpose of the present study was to determine if changes in the circadian rhythms of motor activity, body temperature, and body weight occur with age in the long-lived mouse, Peromyscus leucopus, and to determine if the incidence of torpor (hypothermia) was age-dependent. Young and old mice were entrained to an LD 12:12 cycle, and then physiological and behavioral performance was monitored by a data acquisition system. The major differences between the 6-month and 60-72-month age groups were the following. Significant episodes of torpor occurred in a high percentage of old mice at 0600 hr on consecutive days, but young mice showed no evidence of torpor when food was provided ab libitum. Torpor in young mice was found to occur only during starvation conditions. Old animals phase in and out of torpor over an interval of several days; high-amplitude rhythms and good synchronization of activity and temperature occurred when torpor was expressed, and low-amplitude rhythms, poor synchronization between temperature and activity, and a phase shift of body-weight acrophase occurred on days when torpor was not expressed. Significant changes in acrophase and amplitude occurred between individual animals and days in the old group; no significant change in acrophase and amplitude was observed in the young group. Population-mean cosinor analysis revealed a significant age-related decrease in amplitude and mesor, but no significant change in acrophase was found. PMID- 3628327 TI - Circadian rhythm of blood pressure in hypertensive adult patients: implications for blood pressure determination. AB - To determine whether traditionally timed (0800, 1600, and 2400 hr) blood pressure assessments by nurses reflect circadian peaks and troughs, blood pressure was measured indirectly every 2 hr for 24 hr with a mercury sphygmomanometer and a Sprague-Rapaport stethoscope in a sample of 31 hypertensive adult patients in a university hospital. Pooled mean systolic and diastolic readings portrayed a circadian rhythm with the peak occurring most frequently at 1600 and the trough at 0400 hr. The mean range of variability was 29.54 mm Hg for systolic pressure and 21.54 mm Hg for diastolic pressure. Two-tailed t tests demonstrated statistically significant (P less than .001) differences between peak and 0800 systolic pressure, peak and 2400 systolic pressure, peak and 0800 diastolic pressure, and peak and 2400 diastolic pressure. No significant differences were found between peak and 1600 systolic and diastolic assessments. There were statistically significant (P less than .001) t test differences between trough systolic and diastolic pressure and traditionally timed blood pressure readings. These findings have clinical nursing implications for the timing of blood pressure assessments of hospitalized hypertensive adult patients. PMID- 3628328 TI - Circadian variability of blood pressure and heart rate in newborns and cardiovascular chronorisk. AB - At present, neonates are being given screening tests for relatively rare diseases, such as phenylketonuria. The time has come to give emphasis to assessing the risk for major handicapping diseases, such as coronary heart disease, stroke, and certain diseases of the kidney. Modern technology for blood pressure and heart rate monitoring and data analysis provides noninvasive means to determine when preventive measures are indicated. PMID- 3628329 TI - Circadian rhythm of ventricular tachycardia. AB - A 24-hr electrocardiographic monitoring was performed in 406 patients (297 with ischemic heart disease). Forty-one episodes of ventricular tachycardia were detected in 32 subjects (7.88%). The average rate of tachycardia was 127.4 (range 180-65). No correlation was observed between the rate of ventricular tachycardia and the heart rate 30, 20, and 10 min before and at the moment of the episode. A circadian rhythm of all the episodes was demonstrated, with an acrophase at 1102 hr. A different acrophase was observed for the QT interval. No significant rhythm was observed for premature ventricular beats in the patients with ventricular tachycardia. The circadian variation of tachycardia suggests that this arrhythmia is related to sympathetic tone, but it will require further studies with a larger number of patients with ventricular tachycardia to clarify this problem. PMID- 3628330 TI - Two circadian rhythms and an infradian rhythm in human cardiac arrhythmia? AB - Circadian and infradian rhythmometry can and should be applied for the "isolation" of components in a broad spectrum of rhythms with different frequencies that can characterize the occurrence, among other pathologies, of ischemia in the electrocardiogram (ECG). Analyses of data from the literature on the recurrence of cardiac ischemia in a 12-day electrocardiographic record show two phase-drifting, internally and externally desynchronized, circadian rhythmic components and an infradian about-half-weekly modulation. ECGs covering spans much longer than 12 days are indicated in order to distinguish transient phase drifts from long-maintained desynchronization. To assess the importance of such phenomena for diagnosis, prognosis, and treatment, a recording with accompanying as-one-goes analyses of data is indicated. PMID- 3628331 TI - Chronobiologic aspects of recurrent transient ischemic attack. AB - An epidemiologic study was conducted from 1979 through 1984 on subjects presenting transitory ischemic attacks (TIA) and admitted into our Institute. We investigated year, season, month, day, and hour of every attack on 80 patients aged between 51 and 88 years. Time-series analysis showed a seasonal pattern of disease onset in early spring. Peaks occurred in March-April, and isolated peaks were also detected in January and October. Concerning TIA-onset day, we observed a peak distribution in the last 10 days of the month. Data on the hour of onset, according to single cosinor (mesor +/- SE = 2.67 + 1.13; amplitude +/- SE = 2.57 + 1.13), yielded a significant (P less than 0.05) acrophase. The acrophase is at 135 degrees (-93 degrees, -245 degrees) for tau = 48 hr. PMID- 3628332 TI - Occurrence of a circadian rhythmicity for blood pressure in patients with circulatory shock. AB - Ten patients hemodynamically in shock were monitored for blood pressure along the 24-hr span while under antishock therapy. Time-qualified data were analyzed by means of the cosinor procedure. The fit of a 24-hr cosine function was able to reject the null hypothesis of amplitude = O in the majority of patients under intensive care. The blood pressure circadian rhythm was found to be independent of whether the patient was responsive or refractory to therapy. This phenomenon demonstrates that the maintenance of a blood pressure circadian rhythm is a characteristic intrinsic to hemodynamic shock even if blood pressure falls to very low values along the time scale. PMID- 3628333 TI - Altered circadian plasma cortisol and aldosterone group rhythms in Cushing's syndrome versus obesity and health. AB - According to textbooks, Cushing's syndrome (CS) is associated with a loss of the circadian rhythmicity in circulating cortisol. Documented cases of a persisting rhythm in CS are regarded as an exception. Herein, we show that a circadian rhythmicity in plasma cortisol, albeit of much reduced amplitude and with altered timing, remains a group characteristic of patients with CS, characterized further by a circadian rhythm in circulating aldosterone. In Lubochna, Czechoslovakia, 28 patients with CS, 120 patients with obesity imitating CS, 70 subjects with simple obesity, and 19 nonobese controls were sampled at 0800, 1600, 2000, 0000, and again at 0800 on the following day. In Rome, five women and three men with CS and 27 women and 30 men in clinical health gave blood for aldosterone determinations at 0600, 0800, 1200, 1800, 2000, and 0000. Results were first analyzed by single cosinor and then summarized by population-mean cosinor. A group rhythm was demonstrated for all categories of subjects by the methods employed, although, compared to health and even to simple obesity or Cushing-imitating obesity, the amplitude of the rhythm in CS was much reduced. Subgrouping according to etiology and individualized assessment in practice are mandatory. The scope of this group rhythm assessment, however, is merely to document that as a general rule the circadian rhythms in circulating cortisol and aldosterone persist in CS documented by surgery or at autopsy. PMID- 3628334 TI - Circadian urinary characteristics of adolescents: sensitive dynamic indices complement mean values as new physiologic endpoints. AB - To introduce the study of physiologic urinary rhythms into secondary education, six girls and 11 boys, 14-18 years of age, collected urine at about 3-hr intervals for 24 hr. The volume and the excretion in urine of creatinine, potassium, and sodium were determined. Blood pressure was measured during the same 24-hr span to teach the students some elements of chronobiologic sampling and analysis in the context of evaluating the risk of developing a high blood pressure later in life. Herein, we examine on urinary excretory rates whether dynamic chronobiologic endpoints such as the amplitude (A) and/or acrophase (phi) may complement the more static mesor (M) in distinguishing groups of adolescents. In a comparison of the two sexes, dynamic characteristics of the urinary excretion of sodium and of the ratio of sodium/potassium do not separate the two groups, while the M does so. The reverse holds true for the excretion of potassium. In the case of urinary creatinine, the circadian A in itself is an index suggesting a "sex" difference; whereas in urinary volume, the M alone, and to a lesser extent the combination of (M, A, phi), yields a P value below the 5% level. The groups are rather small and heterogeneous; a study of ethnicity is beyond our scope. These qualifications notwithstanding, results indicate the need for testing multiple chronobiologic characteristics in comparing groups whether one's interest in the future relates to ethnicity, sex, or other factors. Such studies of urinary rhythms of high-school students serve for instruction and research and to instill responsibility for self-help in preventive health care. PMID- 3628335 TI - Circadian and circannual variations of thyroid function in children 11 +/- 1.5 years of age with and without endemic goiter. AB - A group of 194 children 11 +/- 1.5 years of age from Tirgoviste, Romania, an endemic goiter area, were studied over a 24-hr span (six blood samples at 4-hr intervals) during all four seasons. One hundred thirty-four of the children had some clinical evidence of endemic goiter, and 60 had none. Total and free T3 and T4, reverse T3, thyroglobulin, thyroxin-binding globulin (TBG; three seasons only), and TSH were studied. The circadian rhythms were analyzed by cosinor and the circannual variations by ANOVA. Children with and without endemic goiter showed circadian rhythms in all functions studied except free T4 for which no statistically significant rhythm was detected in the children with goiter. There were differences in the acrophase of total T3, free T3, and TBG, with phase advance in the children with goiter in total T3 and free T3 and a phase delay in TBG. Mesor and amplitude showed no differences except in total T4 for which the amplitude in the children with goiter was statistically significantly lower than in the children without goiter. Children with and without endemic goiter showed seasonal variations in total T4 and free T4 as well as total T3, free T3, and reverse T3, with the highest values in the fall; in thyroxin-binding globulin the highest values were in the winter; and in TSH the highest values were in the summer. There was no significant seasonal variation in thyroglobulin. There was no difference in the circannual variation between children with and without endemic goiter. PMID- 3628336 TI - Clinical relevance of theophylline chronokinetics for asthmatic children. AB - In two studies, 25 diurnally active patients (6-17 years of age) were evaluated for day-night differences in serum theophylline concentration (STC) by frequent blood sampling over two consecutive 12-hr dosing intervals while being treated with Theo-Dur. In both studies, findings were similar; Cmax was greater and Tmax shorter following dosing at 0700 or 0800 vs. 1900 or 2000 with Cmax -Cmin approximately 7 micrograms/ml over the 24 hr. After the morning dosing, 22 of 25 patients exhibited Cmax within 4 hr; 23 of 25 exhibited Cmin 12 hr after this dosing. After the evening ingestion, the situation was very different: Cmin occurred within the initial 4 hr in 21 of 25 patients, whereas Cmax occurred in 22 of 25 patients just prior to the next (morning) dose. The findings indicate the most appropriate time to estimate Cmax in Theo-Dur-treated children is within the 4 hr after the morning ingestion. The best time to estimate Cmin is a few hours after the evening ingestion. Sampling at these times is likely to represent within 10-20% the actual Cmax or Cmin. PMID- 3628337 TI - Circadian rhythm of C-reactive protein in patients with rheumatoid arthritis. AB - Ten men with classic rheumatoid arthritis were studied for 23 days in Badgastein, Austria, in August, 1980. One man (patient 07) showed a marked increase of disease activity after a few days. C-reactive protein (CRP) concentrations increased from 8.7 mg/dl on day 2 to 13.0 mg/dl on day 16. CRP values expressed as percent mean of a day showed a significant circadian rhythm with the acrophase at -30 degrees. For the same patient we also found significant circadian rhythms in grip strength and pearl stringing with acrophases in the evening and a circadian rhythm in walking time with the acrophase in the early morning. Seven of the ten men in the study had elevated CRP concentrations during the 3 weeks of observation. Population-mean cosinor results of CRP, grip strength, pearl stringing, and walking time revealed acrophases similar to the single cosinor results of patient 07. Our results suggest that inflammation in rheumatoid arthritis is a circadian rhythmic process with lowest disease activity in the evening. PMID- 3628338 TI - Ultradian (12-hr) significant component in serum prolactin of healthy women and patients with fibrocystic mastopathy. AB - The 4-hr sampling schedule for a single day demonstrated a prominent circadian rhythm of prolactin (PRL) in clinically healthy women and in mastopathy (FM) patients (with mesor hyperprolactinemia). This chapter reports on differences in time series of serum PRL observed between FM patients and healthy women in the follicular and luteal phases. Thirteen FM patients and six healthy women (controls) were sampled at intervals of 60 min for 24 hr in the two phases of the menstrual cycle. Serum PRL was determined by RIA. The results from spectral analysis of these data showed prominent circadian rhythms and an ultradian (12 hr) significant component in the PRL of controls and FM patients in both phases of the menstrual cycle. The acrophases of the 12-hr rhythms, however, clearly differed in controls and FM patients. PMID- 3628340 TI - Diurnal stage of circadian rhythm of plasma zinc in healthy and psoriatic volunteers. AB - The characteristics of circadian variation of human plasma zinc concentrations in health and psoriasis are compared by the cosinor method. Sequential measurements of plasma zinc were performed at 0800 (fasting), 1000 (1 hr after breakfast), 1330 (1 hr after lunch), and 1900 (1 hr after supper) on groups of 20 patients with psoriasis, a disorder in which zinc metabolism may be disturbed, and 16 clinically healthy individuals. The limited sampling notwithstanding, groups showed a statistically significant circadian rhythm when analyzed by the cosinor method with the least-squares fit of a 24-hr cosine curve. The rhythm's timing in the clinically healthy group was similar to that derived by the same cosinor method from much denser series (covering the entire 24-hr span) published earlier by others. The diurnal portion of the circadian rhythm of human plasma zinc differed in the two groups investigated; this difference was not seen in the mean fasting plasma zinc concentrations. Circadian studies may reveal differences between groups that are not apparent by conventionally used single fasting estimates. More generally, in future studies of zinc, e.g., in skin disease, sampling time and the subjects' routine should be strictly standardized as a minimum, and rhythm characteristics should be quantified as an optimum. PMID- 3628339 TI - Studies on circadian periodicity of plasma 17-hydroxycorticosteroids (17-OHCS) in tropical pulmonary eosinophilia. AB - Circadian periodicity of plasma 17-hydroxycorticosteroids (17-OHCS) was studied in ten healthy controls and 25 patients with tropical pulmonary eosinophilia (TPE). Subjects were synchronized for 1 week with diurnal activity from 0600 to 2200 hr and nocturnal rest; meals were taken at 0830, 1300, and 2030 hr. No medications were administered. TPE patients were divided into three subgroups of fourteen, seven, and four each according to the hour of the worsening of their symptoms. Blood samples were collected at 8-hr intervals at fixed clock hours for 24 hr, starting at 0800 in all four groups. We noted a marked rhythm in plasma 17 OHCS in controls, with significant amplitude and an acrophase at 1033 hr. Similarly, all TPE patients exhibited a definite rhythm in plasma 17-OHCS with significant amplitude irrespective of the time of worsening of symptoms, suggesting thereby no relationship between worsening of symptoms and the rhythm. Thus the circadian nature and normal concentration of plasma 17-OHCS were observed to be similar in healthy controls and TPE patients. PMID- 3628341 TI - Circannual variations in blood pressure, urinary catecholamine excretion, plasma aldosterone, and serum sodium, potassium, calcium, and magnesium in children 11 +/- 1.5 years of age. AB - A total of 194 clinically healthy children 11 +/- 1.5 years of age were studied during different seasons. Systolic and diastolic blood pressure were determined by auscultatory endpoints, and blood and urine were collected at 4-hr intervals over a 24-hr span. Urinary norepinephrine, epinephrine, and dopamine were determined by HPLC, plasma aldosterone by RIA, serum sodium and potassium by ion specific electrode, and calcium and magnesium by colorimetry. The circadian means showed statistically significant circannual variations in all variables except epinephrine. The highest circadian means of systolic and diastolic blood pressure and of urinary norepinephrine occurred during winter; the highest values of plasma aldosterone, serum potassium, and urinary dopamine were found in fall, those of serum calcium and magnesium during the summer, and that of serum sodium in spring. Circannual rhythms characterize functions related to blood pressure regulation in children. The circannual elevation of blood pressure (within the usual range) and of norepinephrine were both found to occur in winter. This time relation may have a functional significance, although a causal relationship is not proven by the temporal coincidence of two rhythms. PMID- 3628342 TI - Studies on circadian periodicity of serum and urinary urate in healthy Indians and renal stone formers. AB - The circadian patterns of serum and urinary urate were studied in 25 healthy Indians and 25 renal stone formers. A marked circadian variation in uric acid concentration was recorded in both the groups with acrophases at 1441 and 1347 hr, respectively (cosinor analysis). Similarly, cosinor rhythmometry confirmed a significant circadian rhythm in urinary uric acid levels during different hours of the 24-hr day-night period in healthy Indians (acrophase at 1229 hr) and renal stone formers (acrophase at 1121 hr). Serum uric acid was found to be elevated at all time points during the 24-hr period in the stone formers compared to healthy subjects. The excretory pattern, however, did not exhibit any significant difference in uric acid levels between the two groups although the excretion was a little higher in the stone formers compared to the healthy controls. Maximum urate excretion at 1121 hr (around midday) might be the peak hour for maximum crystallization of stones containing an admixture of urate in stone formers; if such is true, it could prove to be of clinical significance when trying to inhibit crystallization of renal stones and to minimize the risk of crystal growth (urate admixture) in renal tubules. PMID- 3628343 TI - Chronobiology of catecholamine excretion in different age groups. AB - Urine was collected at 4-hr intervals over a 24-hr span in 87 boys and 106 girls 11 +/- 1.5 years of age and over one or several 24-hr spans in 62 elderly men and in 85 elderly women 77 +/- 8 years of age. Epinephrine, norepinephrine, and dopamine were determined by HPLC. The data were analyzed by cosinor and by one-, two-, and three-way ANOVA. Children and elderly subjects showed circadian rhythms of urine volume and of the excretion of norepinephrine, epinephrine, and dopamine. While the urine volume was higher in the elderly subjects than in the children, norepinephrine, epinephrine, and dopamine excretion in the girls and epinephrine in the boys showed a statistically significantly higher mesor than in the elderly subjects of the same sex. There was a sex difference, with lower values in all variables in the girls and women compared to their male counterparts; the circadian amplitudes of norepinephrine, epinephrine, and dopamine in the girls and of epinephrine in the boys were higher than the circadian amplitudes in the elderly subjects. The circadian timing in urinary excretion between the elderly subjects and the children was different, with a consistent phase delay; the acrophase of the circadian rhythm in the elderly subjects moved in the night hours. In contrast, there was no age difference in the acrophase of norepinephrine and epinephrine excretion or in dopamine in the females. In the males, the circadian rhythm in dopamine excretion in the elderly subjects did not quite reach statistical significance at the P less than 0.05 level. Circannual variations with high values in winter and low values in spring and summer were found in norepinephrine excretion in boys, girls, and elderly women, but not in elderly men. In neither age group was there a statistically significant seasonal variation in epinephrine. Only in girls was a statistically significant circannual rhythm in dopamine excretion found, with highest dopamine values in the fall and lowest values in winter and spring. PMID- 3628345 TI - Effects of timing acupuncture on nuclear volume of neurosecretory cells in rat supraoptic nucleus. AB - To see whether the effects of acupuncture on the nuclear volume of neurosecretory cells in the rat supraoptic nucleus (SON) are circadian stage-dependent, 48 male Wistar rats were divided into eight equal groups and standardized in LD12:12 at 21.5 degrees C with food and water ad libitum. At each of four time points [0, 6, 12, and 18 hours after lights on (HALO)], one group (A) was treated by electric acupuncture at a place equivalent to the human "Yongquan" point; another group (C) was left untreated as a control without acupuncture. The nuclear volumes of neurosecretory cells were calculated after the nuclei were measured with a micrometer under a microscope. Circadian variation in nuclear volume was observed for both A and C groups and showed macroscopically two peaks, one at 18 HALO and another at 6 HALO, and a nadir at the time of lights on (0 HALO). The effects of acupuncture appear to differ at various time points. A circadian change in the ratio of the data from the A and C groups at each time point was observed only in the left SON and peaked at 0 HALO. An asymmetry between the left and right SONs characterized their changes and responses to acupuncture. An analysis of variance established a time effect (P less than 0.001) and an interaction between laterality and treatment (P less than 0.037). The results documenting a circadian change of nuclear volume of the SON neurosecretory cells and a laterality dependent response to acupuncture point to cephalic mechanisms of "Ziwu Liuzhu" chronotherapy by acupuncture and moxibustion. PMID- 3628344 TI - Chronobiologic monitoring and analysis for anesthesiologists: another look at a chronoanesthetic index. AB - A circadian rhythm in anesthetic index is quantified by the single cosinor method in data published earlier. Although the double circadian amplitude, a measure of the extent of predictable change, is only 14%, the assumption of no rhythm (zero amplitude) is rejected at the 1% level of statistical significance. It seems likely that, in the absence of noise, the amplitude of the rhythmic change in the response to the anesthetic will be larger. The broader importance of chronobiology for anesthesiologists is also indicated. Hardware and software for the monitoring of a patient's vital signs before, during, and after surgery provide refined dynamic endpoints from the analysis of data series and lead to time-specified reference values that improve even the interpretation of time specified single values. PMID- 3628346 TI - Circadian periodicity of plasma 17-hydroxycorticosteroids in advanced breast cancer. AB - Circadian periodicity of plasma 17-hydroxycorticosteroids (17-OHCS) was studied in ten patients with advanced breast cancer and ten healthy volunteers. A marked rhythm in plasma 17-OHCS concentration was noticed in normal controls; the maximum concentration occurred at 0800 hr followed by a consistent decline throughout the daytime, reaching a minimum at 0000 hr. The circadian rhythm of plasma 17-OHCS was found to be deranged in six of the patients with breast cancer, but a normal rhythmic pattern was seen in the remaining four patients, although the values remained elevated at all time points of the 24-hr cycle in the patients with breast cancer compared to the healthy volunteers. The normal and altered plasma 17-OHCS rhythms in the patients presumably could be due to individual susceptibility and response to the pathophysiological stress of cancer. PMID- 3628348 TI - Phase manipulation, shift work, and jet lag: an overview. AB - This overview stresses why it is important to avoid the effect of masking and presents a model of the mechanism of circadian synchronization based on circadian changes of nonspecific responsiveness to various zeitgeber qualities. The significance of phase responses, transitory uncoupling, frequency multiplication, and flattening of circadian functions is considered. Even circadian adaptation undergoes a circaseptan reactive periodicity. PMID- 3628347 TI - Oral and cervical temperatures as marker variables for chronoradiotherapy of patients with cervical cancer. AB - Oral and cervical temperatures were measured every 30 min during the time the patients were awake (0800-2200) and hourly during the night in 28 women with stage II-III cervical cancer. Data series averaged over all patients were analyzed to determine the circadian rhythmic pattern of temperatures from both sites as well as of the difference in temperature between the two sites. The characteristics of the 24-hr component, notably the amplitude-acrophase pair, were found to differ between the two sites (P less than 0.001). Harmonics of the 24-hr component were found to contribute with statistical significance to the circadian waveform. Accordingly, the acrophase is compared to the macrophase (time of maximal value) and orthophase (time of maximal value assumed by a multiple component model). The relative merits of these different endpoints should be assessed as a function of clinical outcome. PMID- 3628349 TI - Resynchronization of the circadian system following a 9-hr advance or a delay zeitgeber shift: real flights and simulations by a Van-der-Pol oscillator. AB - After a flight from Germany to California, eight subjects stayed there for 3 weeks and then were flown back to Germany. After both the westbound and the eastbound flights, body temperature was measured for 2 weeks in the new time zone. Data obtained every 3 hr throughout the day and night were analyzed by the complex demodulation technique to visualize phase adjustments and the nonstationary amplitude of the measured circadian rhythms. The response to the zeitgeber delay was very similar in all subjects and consisted of a phase adjustment of 6 hr in the first 2 days following the flight and a subsequent slow completion of the resynchronization with a rate of 0.5 to 1 hr per day. After the eastbound flight the resynchronization was generally slower, and the circadian amplitudes were more reduced than after the zeitgeber delay. In addition, the advance shift led to different patterns of phase adjustment for the individuals. Shortening and lengthening of circadian periods as well as phase jumps by about 12 hr were observed. Simulations with a Van-der-Pol oscillator forced by a rectangular zeitgeber function clearly reflected the divergence in resynchronization between eastbound and westbound flights. The different resynchronization patterns found after the 9-hr zeitgeber advance, including the corresponding duration of readjustment, could also be well simulated. PMID- 3628350 TI - Circadian adaptation to fast and slow rotating shift systems. AB - Healthy male subjects were exposed to various shift systems. Adaptation and adjustment of the circadian systems were followed-up twice a week on so-called control days to reduce masking effects. With respect to the 24-hr minimum of rectal temperature and to the longest spontaneous sleep period on control days, the slower the shift system rotated and the later the individual circadian phase position was, the more subjects were able to follow the different shift systems. Subjects with stable phase shifts between the shift days always exhibited a phase shift of 1 hr per day. PMID- 3628351 TI - Chronohygienic and chronosocial aspects of industrial accidents. AB - A series of 2,772 accidents has been analyzed in two plants. The following aspects were considered: 1) environmental circumstances, 2) accident causes as given by witnesses or victims, and 3) time of day. Activity of the plants or particular groups of workers was assessed by supervisors on a 10-point scale. A circadian rhythm of accidents has been shown. It was determined to be governed by the interrelationships between the following endogenous and exogenous rhythmic factors: human factors, such as fatigue and circadian fluctuation of biological functions; and multiple hygienic and social components, which either promote human performance or suppress it, e.g., high environmental temperature, overcrowding, and noise. The rate of accidents depends on the particular combinations of these factors, all of which change around the clock. In both plants, the circadian rhythm of accidents was approximately parallel to the circadian rhythm of activity of the plant as a whole rather than to the activity of shift workers only, with a peak around 1100 hr. The lowest number of accidents was noted during night shifts; some increase was observed after midnight, however, in spite of the lowest level of plant activity at that time. PMID- 3628352 TI - Human event-related potentials and circadian variations in arousal level. AB - Contingent negative variation (CNV) potentials were recorded from ten male subjects during a single session in divided- and focussed-attention conditions. Beside a strong dependency of CNV and N1 amplitudes and reaction time on task difficulty, the results of the present study show an effect of the subject types, classified by their peak performance times. The slight increase of CNV amplitude form morning to afternoon recording in evening-type subjects contrasted with a substantial decline in the morning-type subjects. Unexpectedly, both task conditions showed remarkably similar time courses of amplitudes. The attempt to model the individual amplitude curves from arousal levels led to inconclusive results. No final conclusions about the relationship of CNV and arousal levels over the course of a day can be drawn. PMID- 3628353 TI - Case study of psychophysiological diary: infradian rhythms. AB - A 4-year case study was made of a 42-year-old white woman as seen through the psychophysiological diary. There was an awakening diary and a bedtime diary composed of 125 variables. The data are divided into two series: series I containing a manic episode, and series II as a control. Spectral analysis shows infradian rhythms in hypoglycemia and fear (11 days) and time to fall asleep (5 days). Depressed feelings showed a circatrigintan (28-day) rhythm, which was not correlated with menses. Mania had an annual rhythm (spring) but no circatrigintan or less rhythm. The following correlations have a P value less than or equal to 0.01: mania was directly correlated with number of sleeping pills, time to really wake up, need for rest, moodiness, and helplessness, and indirectly with expectations, pressure at work, sense of time, and emotional state. Interestingly, awakening pulse is directly correlated with awakening temperature, number of sleeping pills, bedtime pulse, tiredness at bedtime, hypoglycemia, and fear. Bedtime pulse is directly correlated with awakening pulse and awakening temperature. Both pulse and temperature at bedtime are directly correlated with negative variables such as tiredness, moodiness, helplessness, and depression, and inversely correlated with positive variables such as happiness, loving, performance at work, and thinking efficiency. This study demonstrates a significant correlation between physiological variables. PMID- 3628354 TI - Circadian and circannual rhythms of emergency room drug-overdose admissions. AB - All Drug Abuse Warning Network (DAWN) records for 1983 from the University of Illinois Emergency Room were collected: a total of 264 drug-overdose (DOD) admissions. Cosinor, multiple linear regression, cross-tab multivariate, and spectral periodicity statistical analyses were performed on the raw data with particular use made of the BMDP statistical package. More DODs present themselves for admission to the ER around the 1820 hr than any other time of the circadian period. Sex, age, and race have no effect on this circadian relationship. No circatrigintan rhythms were found for any sex, race, or age group. However, there is a circannual rhythm for total DOD admissions with more admissions in late July than any other time of the year. Women, however, appear to exhibit a significantly earlier annual acrophase (late May) than males in early August. There is no evidence for circannual, circadiseptan, circaseptan or circabiseptan rhythms for blacks or hispanics. However, whites, particularly males, show evidence of biweekly (i.e., Monday and Friday) as well as circannual rhythms. Multivariate analyses of circannual rhythms vs. age indicated no significant rhythms for the under-21-year-old but a highly significant circannual rhythm for the over-20-year-old. Therefore, ER personnel should be attentive to the sex, age, and race of their patients in order to gain a degree of predictability as to when the greatest number of patients might present themselves at the ER for treatment of their DOD. Awareness of the temporal effects on DOD admissions can thus improve the quality of ER treatment for DOD patients. PMID- 3628355 TI - Circadian patterns of vigilance and seizure susceptibility in genetically epileptic mice: heuristic aspects in neurology. AB - A circadian paradigm of susceptibility to tonic-clonic convulsions was experimentally analyzed in genetically epileptic mice. In conjunction with behavioral and neurochronobiological studies, we demonstrated from these animal models that the tonic-clonic susceptibility appears to be modulated by the vigilance level. Thanks to biometric and inferential rhythmometric procedures, the chronobiological data obtained and the complementary psychophysiological investigations performed in this study suggest several heuristic perspectives concerning the central pathophysiology of epilepsy. The results obtained within the field of the neurosciences are consistent with the hypothesis suggested by chronobiology that central hyperactivation negatively influences the tonic-clonic susceptibility. Such experiments respectively conducted in chronobiology and fundamental neurology provide a quantitative approach for a better understanding of some brain mechanisms regulating seizure susceptibility. PMID- 3628356 TI - Strain differences in circadian drinking behaviors of ethanol and water in rats. AB - Voluntary drinking responses to an alternating three-bottle, two-choice paradigm to tap water or to 5% ethanol were measured in adult male Fisher (Fshr; N = 14) and spontaneously hypertensive (SP; N = 16) rats for 6-9 days. All animals were singly caged and housed separately in isolation chambers. The animals received light from 0600 to 1800 (CST) daily (LD 12:12) or remained in constant darkness (DD) at room temperature (23 degrees C). Food was freely available. Water and ethanol bottles were changed daily, and volumes of the respective fluids consumed by each rat were measured. A dim red light (approximately 0.5 lux) was used in handling animals in the dark. SP rats demonstrated significant (P less than 0.05) circadian drinking patterns of water and ethanol consumption under LD and DD lighting conditions. Fshr rats, however, exhibited a circadian pattern (P less than 0.02) only with regard to water consumption under an LD 12:12 lighting schedule; they did not exhibit circadian patterns of drinking water (P less than 0.054) in DD or ethanol in LD (P less than 0.24) or in DD (P less than 0.67) conditions. Volumes of ethanol consumption were also greater (P less than 0.05) in SP rats than in Fshr rats. It is concluded that differences exist in circadian drinking behaviors for both water and ethanol intake in two strains of rats. Perhaps variation in circadian patterns is an evolutionary mechanism that programs behavior over an appropriate time span for differences in physiological needs of nocturnal animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628357 TI - Perinatal malnutrition, suprachiasmatic nuclear lesioning, and circadian ultradian aspects of spontaneous behavior of albino rats. AB - The effect of reducing the dietary protein content at different stages of development was investigated. A group of control rats was fed a diet with 25% protein throughout the entire study. Four other groups were fed only 6% protein in a diet isocaloric with the control diet. In an "intrauterine"-deprivation (prenatal) group, the feeding of the low protein diet was limited to the span from mating to delivery. In a "postnatal"-deprivation (lactation) group, the reduced protein diet was limited to the 25 days allowed for lactation. In a "perinatal"-deprivation group, the low-protein diet was fed during both the pregnancy and the 25 days after birth. Protein deprivation in a "preperinatal" group started 1 month before mating and continued throughout gestation and lactation to day 25 after birth. Except for the perinatal group, consisting of two animals, other groups consisted each of three or four rats. Behavioral variables--activity, rest, eating, drinking, exploring, grooming, curling up, and lying down--were studied in rats from each group at 90 days of age for 3 days at consecutive near-12-min intervals for observation spans of 1 min. Two animals subjected to bilateral suprachiasmatic lesions, subsequently validated histologically, and two sham-operated controls were also investigated. Both the population-mean and the single cosinor methods were used for data analysis in conjunction with linear least-squares spectra. Cosinor methods allow the rejection of the zero-amplitude assumption on a group basis for the intact controls (P = 0.007), the intrauterine malnutrition group (P = 0.034), the lactation group (P = 0.059), the preperinatal group (P = 0.055), and on an individualized basis for the two animals constituting the perinatal group (P = 0.007 and 0.002). These results by population-mean cosinor are complemented by the single cosinor demonstration of rhythms for most animals and variables investigated. The results demonstrate, on an individualized basis, the persistence of circadian rhythms under differently timed conditions of protein malnutrition. The data on the behavior of rats with bilateral lesions of the suprachiasmatic nuclei show a circadian to ultradian variance transposition. In most behaviors, there are prominent ultradian rhythms, which, however, require study over longer spans with dense observations on additional animals. PMID- 3628358 TI - Circannual rhythms of laboratory measurements in serum of elderly subjects. AB - A total of 160 elderly subjects 77 +/- 8 years of age were studied in 201 24-hr profiles consisting of six blood samples collected at 4-hr intervals. The sampling sessions were spread over all four seasons. The circadian means were analyzed (one-way ANOVA) for the presence of circannual variations. Statistically significant circannual variations were found in the serum concentrations of albumin, bilirubin, calcium, chloride, CPK, globulin (calculated), glucose, LDH, potassium, sodium, triglycerides, uric acid, and total protein. The data presented indicate that many chemical constituents commonly measured in human serum and urine show seasonal variations in elderly subjects, some of which are large enough to present potential diagnostic problems. Others may not pose diagnostic problems in today's practice of laboratory medicine, but indicate seasonal changes in metabolic functions or, if endogenous in nature, circannual rhythms that may be of physiologic and pathobiologic importance. There is a need to quantify certain of these rhythms as a predictable portion of variability in laboratory values and presumably as an indicator of human health. PMID- 3628359 TI - The circadian control of behavior in the rat affected by the chronic application of methamphetamine. AB - Chronic application of methamphetamine via the drinking water results in an internal desynchronization of food intake, drinking, and locomotor rhythms in rats. It is discussed whether this may be due to an effect on the central pacemaker system or on more peripheral control centers. PMID- 3628360 TI - Individualized principal component analysis of endocrine circannual variability. AB - The technique of principal component (PC) analysis (PCA) of multivariate observations is a method that allows dimension reduction of multivariate data for further analysis. It is here introduced as a means of selecting chronobiologically important variables that can be further studied by an analysis of variance. The use of PCA is illustrated for a study of major temporal sources of human endocrine variability. Contributions to temporal variability by seven steroidal and six nonsteroidal hormones are compared in samples available at 100 min intervals for 24 hr in three seasons for each of three clinically healthy individuals: an adolescent woman, a menstrually cycling woman, and a postmenopausal woman. On an individualized basis, it is ascertained that the first principal component, a new variable, is primarily determined by steroids and that PCA can single out variables displaying interseasonal (circannual) differences validated as statistically significant by a subsequent analysis of variance. The variables here scrutinized and identified as contributing to the PC, however, need not all differ with statistical significance along the scale of the seasons. The steroids contributing the first principal component are DHEA-S and an estrogen in all three individuals studied, cortisol and aldosterone in two of them, and 17-OH progesterone in one case. PMID- 3628361 TI - Circatrigintan rectal temperature and endocrine rhythms of clinically healthy, menstrually cycling women. AB - Rectal temperatures were measured automatically every 10 min for part or most of two menstrual cycles in ten clinically healthy young women, 20-30 years of age, with a wearable instrument, the Polychronor. Occasional malfunction of the instrumentation resulted in corresponding gaps in the series. Data were examined by chronograms, plexograms, and chronobiologic serial sections computed with the fit of a 24-hr period, population-mean cosinor, and linear-nonlinear least squares analyses. Single cosinor-derived circadian parameters were next fitted with a cosine curve of a period equal to the number of days of the corresponding intermenstruum. Second-order infradian inferential statistics were calculated next; the first day of menstruation was used as acrophase reference. A population mean cosinor at the intermenstrual period yields a temperature acrophase of -279 degrees, with the 95% confidence interval extending from -254 degrees to -312 degrees. Since the intermenstruum differs in different subjects and/or in different menstrual cycles of a given woman, this acrophase corresponds to different time intervals from the first day of menstruation in different cases. This acrophase thus indicates the relative timing within the menstrual cycle of overall high rectal temperatures. On four subjects in four stages of their menstrual cycle, plasma was also obtained at 2-hr intervals around the clock. Ten hormones were determined. The sparse endocrine sampling along the menstrual cycle notwithstanding, a circatrigintan rhythm in all hormones investigated was demonstrated for a woman 26 years of age. At the period corresponding to the intermenstrual interval, the acrophases for T3, cortisol, FSH, testosterone, DHEA S, T4, and LH occurred before the circatrigintan rectal temperature acrophase, whereas the acrophases for prolactin, estradiol, and progesterone occurred near or shortly after the rectal temperature acrophase. Whereas earlier circatrigintan mapping of adult women had been summarized on a group basis, this study allows individualized circatrigintan rhythm assessment. Circatrigintan, like circadian and circannual, acrophase and amplitude relations do not necessarily imply causal relations, yet they are an indispensable quantitative reference standard for the study of basic mechanisms and for diagnosis and intervention, including endeavors in planned parenthood that might take into account the organism's dynamics with multiple frequencies. PMID- 3628362 TI - Serial section analysis of circadian rhythms by best-fitting periods. AB - Many human circadian rhythms are asymmetric, displaying a longer proportion of the envelope above the mesor than below it. Asymmetry reduces the percentage of variability (%R) accounted for by a fitted symmetric sine curve calculated with the aid of a fixed 24-hr period chosen because of the basic 24-hr rhythmicity of the investigated parameter. A higher %R would be expected when substituting the best-fitting period (BFT) for the fixed one. A dense serial section analysis of circadian temperature oscillations by 1-hr shifts of a 24-hr window showed that BFT length, calculated separately for each window, cyclically varied through successive sections between tau greater than 24 hr and tau less than 24 hr. Since only the sequence (starting point of the window) of the same temperature readings differed from one window to the other, the varying BFT length and %R were determined by the shape of the envelope in the particular 24-hr section. Thus, BFT is not an unambiguous term in the analysis of asymmetric circadian rhythms. However, a "true" BFT for calculation of sine curve complying best with the shape of the envelope of such a rhythm can be arrived at by selecting the BFT that acquired the highest %R in the course of the serial section analysis. Both single amplitudes should be considered for BFT phase estimation in asymmetric rhythms. The upward-directed single amplitude points out the phase of the peak of the rhythm while the downward-directed single amplitude, postponed by one half of the respective BFT, indicates the phase of the trough, usually with a higher %R than that for the peak amplitude. A program for this specific type of serial section analysis has been written in PASCAL. PMID- 3628363 TI - Sleep troughs as indicators of endogenous and exogenous components of circadian rhythms. AB - The shape of the envelope of apparent circadian rhythms reflects the endogenous oscillatory drive as well as exogenous influences affecting the investigated variable. As long as the two components are in phase, a rather smooth and regular circadian oscillation usually results. Changing the habitual sleep/wake pattern may thus separate the two forces that determine the shape of circadian variations. As demonstrated in three examples, such separation can be revealed by alterations of the shape of the envelope, by phase shifts, and by best-fitting periods (BFT). In a continuous 6-hr split-shift system, the customary shape of significant circadian oscillations of urinary noradrenaline excretion became bimodal, showing two peaks and two troughs within a 24-hr cycle. Deeper sleep troughs at nocturnal off-duty intervals than when asleep during the day indicated a background presence of the original, although weak, endogenous rhythm. The superimposed bimodal and highly significant apparent rhythm (BFT about 14 hr) resulted from the exogenous effects of the split-wake/split-sleep circadian pattern. The effect of slow crossing of eight time zones on urinary potassium excretion was simulated by living for 8 days on either 23-hr (eastward) or 25-hr (westward) days. The rhythmicity of the gradually changing circadian oscillations was ascertained by substituting BFT (higher %R) for fixed 23-25-hr periods in serial section analyses of the results. Increasing lag in the phase shifts indicated a strong endogenous potassium rhythm whose oscillatory expression was only partly affected by exogenous influences of the gradually changing sleep/wake patterns. Continuously recorded rectal temperature visualized the interplay of the endogenous oscillator and of the exogenous effects of sleep/wake habits in experimental work shifts in which sleep was either suddenly delayed or advanced by 7 hr. The degree of persistence of the endogenous rhythm was especially apparent in the deformations of the shape of sleep temperatures. PMID- 3628365 TI - Ultradian rhythmometry by adaptive line enhancer. AB - Widrow's adaptive line enhancer (ALE) was applied to human rectal temperatures at 12-min intervals for 9 days. Changes along the scale of 9 days in circadian pattern suggested the occurrence of infradian variation, resolved by analyses of the entire series by linear-nonlinear rhythmometry. Once the original signal is filtered to extract the circadian component, ultradian components appear. A wide peak with a period of about 100 min, seen each day, may reflect a consistent ultradian component. Other peaks at lower ultradian frequencies (around a period of approximately 8 hr) are unsteady and may correspond to harmonics of the partially extracted circadian oscillation. Ultradian components with periods of approximately 131 and approximately 68 min were also suggested independently by population-mean cosinor summarizing data collected over a total of 158 days. Results show the ability of ALE to detect and reconstruct periodic components in noise and to track their changes in frequency, notably when other methods are also used to assess separately the components and the corresponding uncertainties involved. PMID- 3628364 TI - Bootstrapped potential circadian harbingers if not determinants of cardiovascular risk. AB - Among 12 endocrine variables in blood from clinically healthy adult women sampled systematically around the clock and the year, discriminant analysis methods have singled out certain hormones in certain seasons as classifiers for a high or low risk of developing diseases associated with a high circadian rhythm-adjusted mean (midline estimating statistic of rhythm, MESOR, M) of blood pressure, i.e., risk of M-hypertension (RMH). Before extending the labor intensive, costly data base, showing circadian changes with RMH, we reanalyzed available data by circadian bootstrapping, complementing earlier circannual bootstrapping. Differences in circadian M for aldosterone in all four seasons and for TSH in spring and summer (the only seasons checked), but not for the cortisol M checked in spring and summer, are validated, as are differences in circadian amplitude for TSH in spring and summer and aldosterone in spring. Identification of classifiers provides cost-effective, time-specified endocrine checks complementing the targeted automatic monitoring of blood pressure as part of a system of chronobioengineering for health maintenance. PMID- 3628366 TI - Circadian time structure in the endocrine system of elderly subjects. AB - Six young, healthy males (mean age 27 +/- 0.8 years) and six healthy elderly men (mean age 75 +/- 2.0 years) underwent an evaluation of their circadian rhythms in cortisol, PRL, and TSH; oral body temperature and heart rate also were recorded. In the two groups no differences in the circadian patterns of cortisol, PRL, and body temperature were found. We consider it remarkable that the mesor of PRL values did not differ significantly between young and elderly subjects. A markedly advanced TSH acrophase was found in the elderly compared to the young controls. This change in acrophase could be important, because the hormone is known to be a marker of the function of the hypothalamus-hypophysis axis. In addition, an advance of the acrophase of the heart rate in the elderly compared to the younger age group was observed. PMID- 3628367 TI - Endocrine factors of blood pressure regulation in different age groups. AB - Systolic and diastolic blood pressures were measured and blood and urine were collected at 4-hr intervals over a 24-hr span in 194 diurnally active children 11 +/- 1.5 years of age and in 278 elderly subjects 77 +/- 8 years of age. Plasma aldosterone and cortisol were determined by radioimmunoassay, serum calcium and magnesium on a Dupont ACA, and urinary epinephrine and norepinephrine by high pressure liquid chromatography. In the children, there was a slight but statistically significant positive correlation between the circadian means in systolic blood pressure and norepinephrine excretion and serum calcium, and between diastolic blood pressure and norepinephrine excretion and serum calcium and magnesium. In the elderly subjects, there was a positive correlation between the circadian mean in diastolic blood pressure and aldosterone. In contrast to the findings in the children, however, the elderly subjects showed a negative correlation between the circadian means in norepinephrine excretion and in systolic and diastolic blood pressures. These investigations indicate differences in the regulation of the blood pressure within the "usual range" between children and elderly subjects. This has to be kept in mind in the study of essential hypertension, a syndrome that may be caused by different mechanisms in different age groups. PMID- 3628368 TI - Postural effects on the circadian rhythm of blood pressure and heart rate in young and elderly subjects. AB - This investigation compares the effects of changes in activity-rest patterns on the 24-hr rhythms of blood pressure and heart rate in elderly and young subjects. Blood pressure and heart rate were monitored by means of noninvasive, automatic, quasiportable recording equipment. The subjects either rested both diurnally and nocturnally or were active diurnally and rested nocturnally. Time-qualified data were analyzed for circadian rhythmicity by means of the cosinor procedure. In both activity-rest patterns, elderly subjects showed a dissociation between circadian rhythms of blood pressure and heart rate due to a peculiar shift of acrophases. Because of the particular timing of the acrophase, elderly subjects differed from young individuals in the overall adaptation of the blood pressure and heart rate 24-hr patterns to upright posture and physical activity. Of particular interest is the reduced amplitude in the circadian rhythm of blood pressure, which might contribute to the compromised orthostatic tolerance of older people. PMID- 3628369 TI - The hepatitis delta virus and its infection. Proceedings of an international symposium. Saint Vincent, Italy, June 19 to 20, 1986. PMID- 3628370 TI - Characterization of proteins of hepatitis delta virus. PMID- 3628371 TI - Pathology of hepatitis delta infection in the Amazon basin. PMID- 3628372 TI - Correlation of serum anti-delta with intrahepatic HBV and HDV antigens in patients with chronic active hepatitis. PMID- 3628373 TI - The natural history of chronic delta hepatitis. PMID- 3628375 TI - HDV infection in the Los Angeles area. PMID- 3628376 TI - Symptom regulation induced by some plant virus-associated satellite-like RNAs. PMID- 3628374 TI - The natural history of chronic type B hepatitis in southern Italy: effect of HBV replication and of HDV infection. PMID- 3628377 TI - Replication and pathology of hepatitis delta virus in tobacco plants (Nicotiana sylvestris): a negative report. PMID- 3628378 TI - Clinical significance of HDV RNA in HDV disease. PMID- 3628379 TI - IgM anti-HD in acute hepatitis D: diagnostic and prognostic significance. PMID- 3628380 TI - Autoantibodies in chronic hepatitis delta virus infection. PMID- 3628381 TI - Course and prognosis of acute HDV hepatitis. PMID- 3628382 TI - Inhibition of hepatitis delta virus (HDV) replication by lymphoblastoid human alpha interferon. AB - Lymphoblastoid interferon inhibited hepatitis delta virus (HDV) replication in four out of five HDV carriers with chronic active liver disease. Serum HDV-RNA was undetectable in three patients, but in one of these evidence of continuing intrahepatic HDV replication was present on biopsy one year after treatment. In the four cases which showed total or partial inhibition of HDV replication, there was a transient increase in transaminases during treatment, and in three this was followed by improvement. These effects lasted for longer than one year. The lysis of hepatocytes occurring on exposure to interferon may be related to the induction of 2-5A oligosynthetase which, in the presence of the dsRNA of HDV, activates endonucleases which destroy the rRNA of the infected cells. PMID- 3628383 TI - Treatment of chronic delta hepatitis with recombinant human alpha interferon. PMID- 3628384 TI - Alpha 2 recombinant interferon in the treatment of chronic hepatitis delta virus (HDV) hepatitis. PMID- 3628385 TI - Natural killer cell function during interferon treatment of delta hepatitis. PMID- 3628386 TI - HDV infection from blood and blood products. PMID- 3628387 TI - Epidemiology of HDV infection in Southern Italy. PMID- 3628388 TI - Acute and chronic delta infection in the woodchuck. PMID- 3628389 TI - The temporal trend of delta infection in an endemic area: a possible epidemiologic model. PMID- 3628391 TI - Diffusion of HDV infection in Milan. PMID- 3628390 TI - Prevalence of HBV and HDV markers in families of patients with HBsAg+ chronic liver disease. PMID- 3628392 TI - Epidemiological aspects of delta (HDV) infection in a northern Italy district. PMID- 3628393 TI - Hepatitis D virus (HDV) infection in Lombardia based on the observations of the transfusion services. Hepatitis B Study Group of the Italian Association of Immunohaematology and Blood Transfusion. PMID- 3628394 TI - Epidemiology of HDV infection in Ligurian population. PMID- 3628395 TI - Serum anti-HD in patients with high prevalences of HBV infection. PMID- 3628396 TI - Benign and fulminant HDV hepatitis in Greece. PMID- 3628397 TI - Prevalence of HBV HDV and LAV/HTLV-III infections among Greek drug addicts. PMID- 3628398 TI - Epidemiology of delta infection in Spain. PMID- 3628399 TI - Prevalence of delta infection in drug addicts in Valencia, Spain. PMID- 3628401 TI - Delta infection in Yugoslavia. PMID- 3628400 TI - Clinical and epidemiological significance of hepatitis delta virus (HDV) infection in chronic HBV carriers in Portugal. AB - This study demonstrated that in Portugal HDV infection occurs in 17.3% of HBsAg chronic carriers and chronic HDV infection in 8.4%. As in Northern European countries, HDV infection in Portugal is predominantly found in drug-addicts. Our findings also confirm that HDV infection is associated with an active and progressive liver disease. In delta Ag positive CLD serum HBV-DNA was detected in 10 of 19 cases and was present at low levels. In contrast 52 of 84 delta Ag negative were serum HBV-DNA positive and 48.1% of these had high serum HBV-DNA levels. Ninety per cent of delta Ag positive CLD with serum HBV-DNA positive were drug addicts. These findings indicate that in chronic HDV infection synthesis of HBV is reduced and suggest namely that in drug-addicts their disease derived from the cumulative pathogenic effect of both HBV and HDV. In follow-up biopsy a significantly younger mean age and significantly deterioration of carriers with HDV infection was observed, suggesting that HDV infection accelerates the natural history of HBV related liver disease. PMID- 3628402 TI - Prevalence of hepatitis delta virus infection in Hungary. PMID- 3628403 TI - Prevalence of anti-delta antibodies in selected populations of HBsAg carriers in the Bialystok region, Poland. PMID- 3628404 TI - Search for hepatitis delta virus (HDV) infection in Poland. PMID- 3628405 TI - Epidemiology of delta hepatitis in Switzerland. PMID- 3628406 TI - Delta infection in Germany. PMID- 3628407 TI - Prevalence of anti-delta antibodies in selected Belgian population groups. PMID- 3628408 TI - Frequency of hepatitis D co-infection in acute hepatitis B in the Stockholm region. PMID- 3628409 TI - Prevalence of HD Ag and anti HD by radioimmunoassay in acute and chronic HBV infections in Tunisia. PMID- 3628410 TI - The hepatitis delta virus in Algiers (Algeria). PMID- 3628411 TI - Epidemiology of hepatitis delta virus infection in Ethiopia. PMID- 3628412 TI - Studies on the role of HDV in an outbreak of fulminant hepatitis in Bangui (Central African Republic). PMID- 3628413 TI - Delta infection in patients and HBsAg carriers. PMID- 3628414 TI - Prevalence of hepatitis delta virus infection in three different areas of Turkey. PMID- 3628415 TI - Delta virus infection in Jerusalem. PMID- 3628416 TI - Hepatitis delta virus infection in Pekin ducks chronically infected by the duck hepatitis B virus. PMID- 3628417 TI - Hepatitis delta virus infection in Bombay. PMID- 3628419 TI - Delta agent infection in Taiwan. PMID- 3628418 TI - Hepatitis delta virus infection in Taiwan. AB - In Taiwan the prevalence of anti-Delta was low among asymptomatic HBsAg carriers, patients with HCC and acute type B hepatitis, intermediate in HBsAg carriers on hemodialysis, patients with chronic type B hepatitis and liver cirrhosis, particularly HBeAg negative ones, and very high in intravenous drug abusers. It is important to prevent the spread of HDV infection in this hyperendemic area of HBV. PMID- 3628420 TI - Prevalence of hepatitis delta virus infection in different provinces of China. PMID- 3628421 TI - Lack of evidence of hepatitis delta virus infection in an HBsAg positive urban population in Colombia. PMID- 3628422 TI - Anti-delta antibody in various HBsAg positive Argentine populations. PMID- 3628423 TI - Hepatitis delta virus infection in Chile. PMID- 3628424 TI - Epidemiology of HDV infection in Australia and the Western Pacific Region. PMID- 3628425 TI - The viroid-like structure of the hepatitis delta (delta) genome: synthesis of a viral antigen in recombinant bacteria. PMID- 3628426 TI - Transcription and replication of hepatitis delta virus. PMID- 3628427 TI - Structure and replication of the genome of hepatitis delta virus. PMID- 3628428 TI - Proteins of hepatitis delta virus. PMID- 3628429 TI - Limitations of fluorescence quenching data analysis in dantrolene binding by human albumin. PMID- 3628430 TI - The influence of the bile salts aggregates on the kinetics of chlorpromazine cation radical decay. PMID- 3628431 TI - Clinical evaluation of the effectiveness of aminfluoride fluid, aminfluoride gelee, and strontiumchloride paste in relieving dentine sensitivity. PMID- 3628432 TI - Surfactant-assisted drug release from oxytetracycline and bacitracin ointments. PMID- 3628433 TI - [The influence of different components of a polymer hydrogel in the the fixation and liberation of an active ingredient]. PMID- 3628434 TI - The abolition of the partial reinforcement extinction effect (PREE) by amphetamine: disruption of control by nonreinforcement. AB - Two groups of rats were trained to run in a straight alley. The continuously reinforced (CRF) group received a food reward on every trial. The partially reinforced (PRF) group was rewarded on a quasi-random 50% schedule. d-Amphetamine 1 mg/kg was administered to PRF animals in acquisition in a 2 X 2 design, i.e., drug-no drug on reinforced trials and drug-no drug on nonreinforced trials. In four CRF groups, the drug was administered in the same sequence as in the PRF groups. Following acquisition, all animals were given 4 days of CRF retraining and tested in extinction. No drug was given in retraining and extinction. The PREE, i.e., increased resistance exhibited by PRF animals as compared to CRF animals, was obtained in groups which received placebo on all acquisition trials or amphetamine on rewarded trials and placebo on nonrewarded trials. The PREE was abolished when amphetamine was administered throughout the acquisition trials or on nonrewarded trials, irrespective of drug treatment on rewarded trials. PMID- 3628435 TI - Lisuride inhibits temporarily sexual behavior in female rats. AB - The effect of lisuride (0.1 and 0.2 mg/kg IP) on the sexual behavior was studied in the adult, ovariectomized and chronically estradiol-primed female rats. The behavioral tests were done under dyadic interaction with males 60 min before and 30, 120 and 360 min after lisuride or saline injection. Lisuride induced a prompt, short-termed and dose-dependent loss of the precopulatory patterns (darting, hopping, presenting posture) while the effect on the copulatory (lordosis) behavior was weaker. A partial restoration of the precopulatory behavior was observed in the 120th min, the full restoration of the original precopulatory states was found in the 360th min. The inhibitory effect of lisuride on feminine sexual behavior is in contrast with its facilitatory effect on masculine sexual behavior in rats. The results suggest that the serotonergic system participates in the mediation of both copulatory (receptive) behavior and precopulatory (proceptive) behavioral patterns. PMID- 3628437 TI - Effects of haloperidol on amphetamine-induced increases in ascorbic acid and uric acid as determined by voltammetry in vivo. AB - Amphetamine produces dramatic changes in extracellular ascorbic acid (AA) and uric acid (UA) in rat caudate; the origin of extracellular AA and UA is being widely investigated. In this study, linear sweep voltammetry with carbon paste electrodes was used to monitor extracellular AA and UA levels in conscious behaving rats. Amphetamine (2 and 4 mg/kg) produced a dose-related increase in UA; the increase in AA was very similar at both doses. Haloperidol (0.2 mg/kg) blocked the amphetamine-induced increase in UA but reduced the AA increase only by about 20%. Thus the amphetamine-induced increase in AA is only partly dependent on dopamine (DA) receptor stimulation whereas the amphetamine-induced increase in UA is completely dependent upon DA receptor stimulation. PMID- 3628436 TI - Testosterone and adiposity in the chicken: the effect of breed and sex. AB - The leaning role, previously suggested for testosterone in chickens, was tested in males and females of fatty and lean breeds. The breeds used were the White Leghorn (WL), of which the male is very lean, and the White Giant (WG) and the White Cornish X White Rock (WCWR), in which both sexes accumulate fat. Castration of WL males induced adiposity and replacement therapy with testosterone propionate (TP) reduced the fat to normal. However, in males of the fatty breeds, neither castration nor TP administration had any effect on adiposity. Similarly, long-term supplementation of a high dose of TP had no effect on the level of adiposity in females of both the heavy and the light breeds. Thus, the leaning effect found for testosterone in the WL male is not a general phenomenon in chickens but rather a specific response of the WL male. PMID- 3628438 TI - Ethanol-induced sleep time: interaction with taurine and a taurine antagonist. AB - In male Swiss-Webster mice sleep time (hypnosis) was used as an index of ethanol induced central nervous system depression. Ethanol (4 g/kg, IP) was administered to animals and the onset to sleep time (loss of the righting reflex) and the duration of sleep time were recorded. At the end of the ethanol-induced sleep time, taurine (7.5, 15 or 25 mumol/kg, ICV) was injected. Immediately after the ICV injection of taurine the mice again lost the righting reflex. This effect of taurine occurred in a dose-dependent fashion. In the absence of ethanol, taurine (25 mumol/kg, ICV) did not produce a significant sleep time. In another experiment when TAG, 6-amino-methyl-3-4H-1,3,4-benzothiadiazine-1,1-dioxide HCl, (a taurine antagonist) was given to mice, TAG (0.9 mumol/kg, ICV) significantly reduced the effect of taurine (7.5, 15 and 25 mumol/kg, ICV) to reinstate a sleep time in the presence of ethanol. TAG, however, did not alter ethanol-induced sleep time. These results indicate that taurine (ICV) can enhance the central depressant action of ethanol and that this effect of taurine can be attenuated by TAG. The antagonism of taurine by TAG appears to be noncompetitive in nature. PMID- 3628439 TI - Effects of vomitoxin (deoxynivalenol) on conditioned saccharin aversion and food consumption in adult rats. AB - Vomitoxin is a trichothecene mycotoxin that induces feed refusal. Experiment I evaluated the potential aversive action of vomitoxin in a conditioned taste aversion paradigm. Adult male rats were fed either a control chow diet or a diet adulterated with 640 ppm lithium chloride (positive control) or with 2, 4 or 8 ppm vomitoxin and given access to a 0.1% saccharin solution and tap water during three training days. The rats were then shifted to a plain chow diet during 5 extinction days. Vomitoxin (8 ppm) and the positive control diet induced marked taste aversion commencing on the first day of exposure. Rats fed the 4 and 8 ppm vomitoxin diets ate less food only on the first day of contaminated diet exposure. Experiment II evaluated the potential action of vomitoxin on food palatability. Adult male rats were fed a powdered commercial chow for 5 days and then offered, in a preference test, a choice of chow and either: the same chow or chow adulterated with either 0.25, 0.50, 1.0, 2.0, 4.0 or 8.0 ppm vomitoxin. Relative to the total food intakes and the choice ratios (control chow consumed/total chow consumed) of the chow-chow groups, adulteration with 8 ppm vomitoxin resulted in a significant reduction in overall food intake, but not in food choice ratio and this effect of vomitoxin on feed consumption was observed only on day 1 of exposure. Vomitoxin, at 4 and 8 ppm, does not alter food palatability but does induce conditioned saccharin aversion. PMID- 3628440 TI - The effects of exifone, a new agent for senile memory disorder, on two models of memory in the mouse. AB - The effects of exifone (ADLONE), hexahydro-2,3,4,3',4',5'-benzophenone, were tested in two models of memory in the mouse: habituation of exploratory activity and antagonism of amnesia induced by scopolamine in a passive avoidance task. In the first model, mice which had received exifone (128 and 256 mg/kg IP) 30 minutes before a 3 minute exposure to a staircase exploratory test showed a more marked decrease in exploratory activity in the same apparatus 24 hours later (habituation) than a control group indicating improved memory. Similar results were obtained with piracetam (512 mg/kg, IP). In the second model exifone (512 mg/kg PO), administered 60 minutes before both the learning and retention trials of a standard step-through passive avoidance, task partially antagonized the amnesia induced by 10 mg/kg scopolamine IP administered immediately after the learning trial. Similar results were obtained with piracetam (800 mg/kg PO). Taken together these results suggest that exifone facilitates memory function in simple rodent models in a manner consistent with its supposed therapeutic effects in man. PMID- 3628441 TI - Evidence for the reestablishment of copulatory behavior in castrated male rats with a brain-enhanced estradiol-chemical delivery system. AB - We have developed a redox-chemical system for brain-enhanced drug delivery of estradiol based on an interconvertible dihydropyridine in equilibrium with pyridinium salt carrier. Estradiol, when combined with the carrier, readily crosses the blood-brain barrier and upon oxidation of the carrier is "locked" in the brain. The aim of this study was to evaluate the effects of an estradiol chemical delivery system (E2-CDS) versus an equimolar dose of estradiol-17 valerate (E2-VAL) on copulatory behavior in orchidectomized rats. The data revealed that a single dose of E2-CDS was more efficacious than E2-VAL in stimulating mounting behavior (percent responding) and the effect was 100% through 5 weeks. E2-CDS increased intromission behavior more than E2-VAL through 28 days. Mount and intromission latencies were reduced by E2-CDS to a greater extent and for a longer time (28 days) than E2-VAL. Neither form of estradiol restored ejaculation parameters or penile reflexes. These data suggest that E2 CDS causes a potent and long-acting stimulation of proceptive and consummatory components of male sexual behavior, presumably acting through the local brain release of estradiol. PMID- 3628442 TI - Differential CNS effects of diazepam in elderly adults. AB - The present study examines the effects of 0.07, 0.14 and 0.21 mg/kg of diazepam on the performance of several cognitive and neuromotor tasks, including wheel tracking, digit symbol substitution and standing steadiness. The drug or placebo was administered at 3-week intervals to healthy elderly men (N = 8) and women (N = 8). Both medium and high doses significantly impaired performance on the cognitive tasks, whereas only the latter dose induced similar impairment effects on the neuromotor tasks. Wheel tracking and standing steadiness displayed rapid onset and offset of the drug effect, while acute tolerance developed at a considerably slower rate on the digit symbol substitution tasks. Specifically, the subjects continued to show poorer cognitive performance for over 3 hours after dosing, but were no longer impaired on the basically neuromotor skills at 3 hours. PMID- 3628443 TI - Site of action of anorectic drugs: glucoprivic- versus food deprivation-induced feeding. AB - Feeding induced by 2-deoxyglucose was compared with feeding induced by food deprivation in terms of antagonism by anorectic drugs and of anatomical site of action. Glucoprivic feeding was completely blocked by microinjection of amphetamine, fenfluramine, and mazindol into the paraventricular nucleus of the hypothalamus (PVN). Deprivation-induced feeding was not blocked by amphetamine, fenfluramine, or mazindol microinjected into the PVN. Neither the feeding induced by 2-deoxyglucose nor its reversal by amphetamine were blocked by pretreatment with the beta-adrenergic antagonist, propranolol. Amphetamine and fenfluramine blocked both glucoprivic- and deprivation-induced feeding when microinjected into the perifornical region of the lateral hypothalamus. These data suggest that food consumption induced by 2-deoxyglucose treatment can be antagonized by anorectic drugs acting at recognition sites present in several hypothalamic nuclei, while deprivation-induced feeding acts through different receptor mechanisms which may be specific to the perifornical region of the lateral hypothalamus. PMID- 3628444 TI - Interactions between stimulants: effects on DRL performance and lethality in rats. AB - The Controlled Substances Act of 1970 drastically reduced the supply of amphetamines available to the public. It also inadvertently prompted the emergence of a new drug industry, namely the marketing of caffeine/phenylethylamine combinations packaged to look like many of the previously available amphetamine preparations. The findings of one recent experimental study corroborate anecdotal evidence that the interoceptive "high" produced by these look-alike stimulants mimics that produced by amphetamine. The present study was designed to further characterize the behavioral effects of caffeine/phenylethylamine combinations. The present findings suggest that adding ephedrine and phenylpropanolamine to caffeine markedly enhances the disruption of DRL performance, as well as the lethality of the drug. In addition, different patterns of interactions were obtained between amphetamine and caffeine versus the caffeine/ephedrine/phenylpropanolamine combination. PMID- 3628445 TI - Studies on desglycinamide arginine vasopressin and scopolamine in a modified/lever-touch autoshaping model of learning/memory in rats. AB - Vasopressin administration has been reported to improve acquisition and retard extinction of both conditioned avoidance and food-reinforced behavioral tasks. In the present experiment the effects of a vasopressin analog (DGAVP) and scopolamine (SCOP) were tested in an autoshaped lever-touch model of learning and memory. Rats were food-deprived to 80% of original body weights and tested in modular cages which contained a retractable lever that was presented on a random interval 48 sec schedule. The lever retracted after 15 sec or when it was touched, at which time one 45 mg food pellet was delivered. Subcutaneous injection of 10 micrograms/kg DGAVP 1 hr prior to acquisition and extinction sessions did not alter responding compared to saline controls. DGAVP at doses of 10, 20, and 30 micrograms/kg also failed to affect responding in a more difficult task which included an 8 sec delay between lever retraction and reinforcement. Homozygous Brattleboro rats, which are deficient in vasopressin, did not differ from normal heterozygous littermates in the acquisition of the lever-touch response. Intraperitoneal injection of SCOP (0.1-0.8 mg/kg) 30 min prior to testing caused a dose-related impairment of acquisition compared to saline controls, but did not alter responding in animals which had previously acquired the lever-touch response. These data suggest that manipulations of vasopressin do not affect, while SCOP impairs, the acquisition of a positively reinforced lever touch response in rats. PMID- 3628446 TI - Reexamination of the relationship between alcohol preference and brain monoamines in inbred strains of mice including senescence-accelerated mice. AB - The relationship between voluntary alcohol consumption and brain monoamine levels was studied in the inbred strains of C57BL/6N, C57BL/6J, A/J, BALB/cA, CBA/N, C3H/He and DBA/2cr mice; the congeneric mouse strain, B10.Br/Sg, and the senescence accelerated mouse (SAM P1, SAM P2). The C57BL strains exhibited a high alcohol preference whereas the other strains exhibited a low alcohol preference. A clear positive relationship was found between alcohol intake (g/kg/day) and brain norepinephrine level (r = 0.683, p less than 0.05), and a clear negative relationship between alcohol intake and brain serotonin level (r = -0.628, p less than 0.05). The content of brain dopamine was not clearly correlated with alcohol intake (r = -0.206, p greater than 0.05). These findings suggest that in mice voluntary alcohol preference is influenced by brain norepinephrine and serotonin levels genetically. PMID- 3628447 TI - Interactions between phencyclidine and central nervous system depressants evaluated in mice and rats. AB - The effects of phencyclidine (PCP) alone and in combination with the CNS depressants, pentobarbital (PB) or ethanol (ETOH), were determined in mice using the inverted screen test and in rats using disruption of milk drinking behavior. The effects of PB and ETOH alone, and in combination, were also determined so that the PCP combinations could be compared to this clinically relevant interaction. These homergic drug interactions were analyzed using the dose addition model by isobolographic analyses. Most drug combinations resulted in shifts to the left of the dose-effect curves relative to the dose-effect curves for the drugs alone; in no cases were shifts to the right (antagonism) observed. In general, the interactions between PCP and ETOH or PB were quantitatively less (infra-additive) than the interaction between the CNS depressants (dose-additive) when studied in mice. In the rat studies, the interactions between PCP and ETOH or PB were, overall, quantitatively greater (dose-additive or supra-additive) than the ETOH-PB interactions (infra-additive). Since even infra-additive interactions may result in substantially enhanced effects, these results suggest that coabuse of PCP with CNS depressant drugs could produce marked behavioral toxicity. PMID- 3628448 TI - Effects of chronic ethanol consumption on lactational performance in rat: mammary gland and milk composition and pups' growth and metabolism. AB - The effects of chronic ethanol consumption on lactational performance were studied in the rat on day 15 after delivery by determining mammary gland and milk composition, while growth rate and metabolic parameters were studied in pups coming from untreated mothers but being suckled by ethanol-treated mothers. Alcohol treatment increases the dry weight and lipoprotein lipase activity in the mammary gland, and decreases both absolute and relative mammary gland weight and mammary tissue protein content. The triacylglycerol concentration of milk from treated dams is increased, whereas lactose concentration is decreased in comparison to milk from controls, although the total energy content of milk from alcohol-treated dams is higher than that from controls. Ethanol treatment produces a reduction of daily milk production. Pups nursed by alcoholic mothers show a retarded growth with respect to pups nursed by untreated mothers. Furthermore, they present a reduction in the levels of circulating glucose, insulin, glycerol and free fatty acids, whereas an increase in acetoacetate and in urea levels is observed. Pups from alcoholic mothers show reduced glycogen concentration in the liver while the protein content is increased. Plasma free amino acids in pups nursed by alcoholic mothers are lower than in control pups, the differences in Ala, Glu+Gln, Gly, Pro, 4-OH-Pro, citrulline, Cys, Tyr, Phe and the combined total values being statistically significant. We may therefore draw the conclusion that chronic ethanol treatment impairs lactational performance affecting mammary gland function as shown by the decline in milk production and altered milk composition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628449 TI - Effects of idebenone, a cerebral metabolism activator, on muricidal behavior in rats with raphe lesions. AB - The effects of idebenone, a cerebral metabolism activator, on mouse-killing behavior (muricide) in rats with lesions of the midbrain raphe nuclei were studied. Single administration of idebenone (30 and 100 mg/kg, IP) inhibited the muricidal behavior in the raphe-lesioned rats in a dose-dependent manner. Idebenone also suppressed muricide in the olfactory bulbectomized rats, although the effect was less marked than that shown in the raphe-lesioned rats. In addition, the antimuricidal effect of idebenone was augmented with repeated administration. These results support previous findings that idebenone has an activating action on central serotonergic neurons in rats and in patients with cerebrovascular dementia, and suggest that idebenone may improve some of the depressive symptoms often observed in patients with cerebrovascular lesions and other forms of brain disturbance. PMID- 3628450 TI - Chronic imipramine effects on exploratory behavior in rats. AB - Approximately 100 days old hooded rats, socially isolated or group-housed since weaning, received 15 daily IP injections of isotonic saline, 10 mg/kg or 20 mg/kg of imipramine HCl. Following their last injection, the rats' active choices of a novel environment, frequencies of rearing and grooming, and cells entered in an exploration box were recorded. The drug treatment reduced rearing, ambulation and (for isolated rats only) grooming, but had no effect on novelty choices. There was a significant weight loss with the higher dose and (for males only) with social isolation during the drug treatment period. While imipramine reduced grooming in isolated but not group-housed rats, there were no other interactions between the two forms of treatment. It was concluded that, in spite of its sedative action on motor activity, chronic imipramine did not alter curiosity about a novel environment. PMID- 3628451 TI - The experimental analysis of drug self-administration. PMID- 3628452 TI - Factors controlling drug reinforced behavior. AB - An overview is provided of factors controlling drug reinforced behavior. Drug reinforced behavior is defined, and control procedures for rigorously identifying such behavior are discussed. Factors affecting drug reinforced behavior include the drug itself, animal species, route of administration, current circumstance variables, subject's experimental history, and response consequences. Current circumstance variables concern conditions present during opportunities for drug self-administration and include such factors as stimulus control, food deprivation, drug-access conditions, and brain lesions. Response consequence variables include reinforcement schedule, punishment, drug dose, and competing reinforcers. Drug reinforced behavior is a member of a more general class of behavior, namely operant behavior. Over the last 25 years there has been a rapid increase in understanding drug reinforcement, and this pattern of expanding knowledge suggests that the high rate of progress will continue. PMID- 3628453 TI - Opioid self-administration in rats: pharmacodynamics and pharmacokinetics. AB - This article provides comparative data obtained during opioid self-administration in rats, using our EEG-EMG rat model of addiction. This model allows continuous recording of EEG and EMG activities and programming of intravenous drug injections. Comparative data on opioid self-administration patterns are presented. These studies on the association between EEG and behavioral correlates of opioid self-administration have contributed to the delineation of similarities and differences in pharmacodynamic and pharmacokinetic characteristics of opioids. PMID- 3628454 TI - Genetic and environmental factors in ethanol self-administration. AB - Findings presented in this paper from pharmacogenetic studies of oral ethanol self-administration suggest a correlation between ethanol preference and self administration and indicate that there are important genetic as well as environmental determinants of ethanol reinforced behavior. AA (alcohol accepting) and ANA (alcohol nonaccepting) rats, animals bred selectively for differential ethanol preference, showed large differences in operant responding for ethanol. AA rats drank significantly more ethanol than water, and their intake varied as a function of ethanol concentration. Intake of water and ethanol solutions did not differ in the ANA rats. In two inbred strains of rats, F344 and LEWIS, ethanol maintained higher response rates and was consumed in larger volumes than the water vehicle. In a third series of studies, C57BL/6J mice, which exhibit high ethanol preference and low sensitivity, readily self-administered ethanol in an operant situation. Conversely, BALB/cJ mice, which exhibit low preference and high sensitivity, were not positively reinforced by ethanol. The results demonstrate the experimental control possible by the utilization of genetically defined animals, even when complex learned behavioral sequences are being measured, and indicate that genotype and environment interact in a complex but definable way to determine the degree to which ethanol comes to function as a positive reinforcer. PMID- 3628456 TI - Litorin-like peptides in the skin of five phyllomedusa species other than Phyll.sauvagei and Phyll.rohdei. AB - Methanol extracts of the skin of five Phyllomedusa species, other than Phyll. sauvagei and Phyll.rohdei, were estmined to check their content in litorin-like peptides. Extracts of Phyll.bicolor and Pachymedusa dacnicolor did not contain appreciable amounts of litorin-like activity. However, extracts of Phyll. burmeisteri presented a typical phyllolitorin-like activity and extracts of Phyll.hypochondrialis an activity mimicking that of rohdei-litorin. A particular position is taken by extracts of Phyll.trinitatis, which displayed a litorin-like activity differing, in parallel bioassay, from that of all known natural litorins. PMID- 3628455 TI - Animal models of intravenous phencyclinoid self-administration. AB - Phencyclidine (1-(1-phenylcyclohexyl)piperidine, PCP) self-administration has been demonstrated in rhesus monkeys, baboons, dogs and rats. Generally, an orderly inverted U-shaped dose-response curve for rates of self-injection has been observed. Total drug intake appears to increase slightly with increases in unit dose; however, this increase is much less than might be expected with other CNS depressants such as barbiturates or morphine. Additionally, several arylcyclohexylamine analogues of PCP and some members of the benzomorphan and dioxolane classes referred to collectively as "phencyclinoids" are self administered by primates and dogs. New data are presented in this review profiling the self-administration of some of these drugs in rats, as well as a characterization of the self-administration of higher unit doses of PCP than previously reported. Also, preliminary results of the assessment of the reinforcing efficacy of some PCP analogues measured by the progressive ratio procedure are presented. PMID- 3628458 TI - Mechanism of myocardial protective action of dilazep during ischaemia and reperfusion. AB - The aim of this study was to investigate if dilazep is able to reduce with a direct protective action on the myocardium the deleterious effects caused by ischaemia and reperfusion. For this purpose we used an isolated rabbit heart preparation. The hearts were either perfused aerobically or made totally ischaemic for 60 min (by abolishing coronary flow) or made ischaemic for 60 min and then reperfused for 30 min. Ischaemic and reperfusion damage was measured in terms of alteration in mechanical function, lactate and CPK release, mitochondrial function and tissue content of Adenosine Triphosphate (ATP), Creatine Phosphate (CP) and calcium. Dilazep (10(-5) M) was administered in the perfusate either 20 minutes before ischaemia or only during post-ischaemic reperfusion. Ischaemia induced a decline of the endogenous stores of ATP and CP, followed by an alteration of calcium homeostasis with increase of diastolic pressure, mitochondria calcium overload and impairment of the oxidative phosphorylating capacities. On reperfusion, tissue and mitochondrial calcium increase the capacity of the mitochondria to use O2 for state III respiration was further impaired and the ATP-generating capacity reduced. Diastolic pressure increased and there was only a small recovery of active tension generation associated with massive CPK release. Administration of dilazep before ischaemia induced a negative inotropic effect which, in turn, resulted in a slowing of the rate of CP and ATP depletion during ischaemia. This protected the hearts against the ischemic, and reperfusion-induced decline in the ATP-generating and O2 utilizing capacities of the mitochondria. In addition, there was a less marked increase in tissue and mitochondrial Ca++, CPK and lactate release were reduced and the recovery of developed pressure on reperfusion was significantly increased. Administration of dilazep during reperfusion failed to modify the exacerbation of ischaemic damage caused by the readmission of coronary flow. These data suggest that dilazep benefits the ischaemic myocardium via an ATP sparing action. PMID- 3628457 TI - Effect of tauroursodeoxycholate feeding, with or without taurine supplementation on hepatic bile acids and cholesterol metabolism in the hamster. AB - This study reports the effect of short-term tauroursodeoxycholic acid (TUDCA) and of TUDCA with addition of taurine on the lipid composition of gallbladder bile, on cholesterol and bile acid synthesis and intestinal excretion, in the female hamsters. After either one or two weeks, the percentage of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) in bile of treated hamsters significantly increased. Both treatments (TUDCA alone or TUDCA + taurine) decreased the percentage of cholic acid without affecting 3-hydroxy-3-methylglutaryl CoA (HMG CoA) reductase or cholesterol 7 alpha-hydroxylase activities. Sterol and bile acid content of the feces collected during the period of the study did not show any difference. Bile acid glycine to taurine conjugation ratio (G/T ratio) in TUDCA treated animals was significantly higher in respect to controls after only one week of treatment. On the contrary, bile acid G/T ratio significantly decreased in the group of animals supplemented with taurine, but only after two weeks of treatment. PMID- 3628459 TI - Examination of diltiazem for preservation of myocardial function after brief regional ischemia. AB - Diltiazem (750 micrograms/kg plus 600 micrograms/kg/h X 1 h, i.v.) and vehicle were examined in open-chest anesthetized dogs subjected to 15 min of occlusion of the left circumflex coronary artery (LCCA). Regional segment lengths in myocardium supplied by the LCCA and by the left anterior descending coronary (LAD) were measured with piezoelectric crystals implanted in the subendocardium. Diltiazem decreased heart rate and mean arterial pressure, and increased coronary blood flow, determined with an electromagnetic flowmeter. Vehicle had no significant effects. Occlusion of the LCCA increased end diastolic segment length (EDL), and produced akinesis or paradoxical systolic lengthening: diltiazem -2.5 +/- 2.7% and vehicle 0.0 +/- 1.2% segmental shortening (SS). EDL and SS in the LAD zone showed small increases. After 15 min, the LCCA was reperfused and recovery of SS was followed for 3 h. Significantly greater recovery of SS was observed with diltiazem compared to vehicle throughout reperfusion: at 5 min, diltiazem 105 +/- 22% and vehicle 43 +/- 7% and at 180 min, diltiazem 73 +/- 0% and vehicle 33 +/- 8% of baseline SS. The LCCA and LAD zones both responded to isoproterenol 0.3 microgram/kg given 2.5 h after reperfusion. During the isoproterenol challenge SS for LCCA in the diltiazem group (122 +/- 21%) was not different than that of vehicle (99 +/- 15% of baseline). Calcium entry blockade with diltiazem resulted in improved myocardial function during reperfusion. The stunned myocardium showed significant stimulation of shortening by isoproterenol in both groups. PMID- 3628460 TI - Reversible, narcotic-associated mental status impairment in patients with metastatic cancer. AB - Pain and mental status were assessed in a series of 35 consecutive hospitalized patients with metastatic cancer receiving narcotics for pain that was difficult to control. Forty-five episodes of mental status impairment were detected in 27 of these patients. Fifteen patients had dose-related oversedation or organic brain syndrome. In only 4 could the narcotic dose be decreased without exacerbating the pain. Eleven patients had mental status impairment associated with factors other than the narcotic dose. These factors were: concurrent CNS depressant drugs, presence of fever or infection, or changing from parental to average oral equianalgesic dose of narcotic. When these factors were corrected, mental function improved and remained stable despite resumption of the previous narcotic dose. Delirium occurred more frequently in patients over 65, while oversedation without delirium was more frequent in the younger group. For some patients with advanced metastatic cancer, pain relief and intact mental status cannot coexist. For others, correction of factors other than narcotics which can impair function can often lead to improved mental status without decreasing narcotic dose or decreasing the degree of pain control. PMID- 3628461 TI - Phenobarbital depression of hepatic microsomal benzo[a]pyrene hydroxylation in rats starved and refed a diet containing menhaden fish oil: substrate and fat level dependency. AB - The influence of phenobarbital on the activity of hepatic mixed function oxidases responsible for benzo[a]pyrene hydroxylation was studied in rats fed diets containing menhaden fish oil (rich in n-3 fatty acids). Male rats were starved for 2 days and refed diet devoid of fat or containing 0.5, 10, or 20% menhaden oil for 4 days. Phenobarbital increased the apparent Km value as well as Vmax for benzo[a]pyrene hydroxylase in microsomes from rats fed the 20% menhaden oil diet. The increased Km was due to a progressive decrease in benzo[a]pyrene metabolism at the lower substrate concentrations, even in the presence of increased cytochrome P-450 content. The phenobarbital-induced increase in Km and the decreases in benzo[a]pyrene hydroxylation were not observed in rats fed 0.5% menhaden oil or a diet devoid of fat. PMID- 3628462 TI - Effect of tolbutamide treatment on the pharmacokinetics of intravenously administered sulphamethoxazole in rabbits. AB - Fifteen days of tolbutamide treatment significantly decreased the elimination half life (t1/2), area under the curve (AUC0----infinity) and increased the clearance of sulphamethoxazole (SMZ) in rabbits. No significant difference was observed in the volume of distribution. The percentage of plasma protein binding to SMZ was not altered, while N-acetyltransferase activity in liver and kidney was significantly increased after tolbutamide therapy. The changes observed in the pharmacokinetic parameters of SMZ after tolbutamide treatment is due to the induction of liver N-acetyltransferase activity. PMID- 3628463 TI - Subunit heterogeneity of cationic human hepatic glutathione S-transferases. AB - We have purified the major reduced glutathione (GSH) S-transferases from 3 apparently normal human livers: two obtained at surgery and one at autopsy. Purification was by sequential gel filtration. GSH-affinity chromatography, and chromatofocusing. All three livers exhibited the same two major transferase peaks from chromatofocusing at pH 9.0 and 8.7 (designated C1 and C2, respectively) and several (2-4) minor peaks. Another major form (designated A1) from two livers eluted from chromatofocusing at pH 5.4, whereas the major form from the third liver (designated N1) eluted near neutral (pH 6.8). The transferase from erythrocytes eluted at pH 4.6. Isoelectric focusing revealed that the true pI of A1 was pH 7.1 indicating that C1, C2 and A1 are all cationic. In sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis, C1, C2 and A1 exhibited the same single subunit (25,000) whereas N1 was different (26,000). The erythrocyte enzyme had a smaller subunit (23,500). Urea/SDS-polyacrylamide gel electrophoresis resolved the apparent single subunit of A1, C1 and C2 into two distinct subunits. C1 from all 3 livers was a homodimer of the faster migrating subunit (designated subunit I); C2 was a heterodimer (designated I-II); and A1 was a homodimer of the slower migrating subunit (designated subunit II). Hybridization experiments demonstrated that by mixing C1 and A1 we could produce C2 whereas dissociation and reassociation of the subunits of C2 generated C1 and A1 as well as C2. Rabbit antiserum to C1 recognized C1 and C2, but not A1. Thus, the cationic human hepatic transferases are dimers of two distinct subunits. PMID- 3628464 TI - In vivo and in vitro effects of amrinone and milrinone on hepatic xenobiotic metabolism in rats. AB - Studies were performed on the response of hepatic xenobiotic metabolizing enzymes to in vitro and in vivo exposure to amrinone and milrinone, two new inotropic compounds used in congestive heart failure. Both drugs exerted selective effects on various cytochrome P-450-dependent metabolic activities as well as conjugating pathways. Aminopyrine N-demethylation was selectively inhibited by in vitro addition of milrinone but not amrinone, and laurate hydroxylation was inhibited by both drugs. Cytosolic glutathione-S-transferase activity was profoundly inhibited by in vitro addition of both drugs. In vivo administration of either drug did not lead to significant inhibition of the pathways studied other than laurate hydroxylation which was depressed 20-30%. Irreversible binding of [14C] amrinone-derived radioactivity to microsomal protein was partially NADPH dependent. Inhibition by SKF 525-A, alpha-naphthoflavone and various antioxidants was observed. No binding of [14C]-milrinone-derived radioactivity was seen. It is suggested that amrinone may selectively inhibit certain hepatic drug-metabolizing enzymes through metabolic electrophilic intermediates. PMID- 3628466 TI - Clinical and basic aspects of enzyme induction and inhibition. PMID- 3628465 TI - Use of three probes to assess the influence of sex on hepatic drug metabolism. AB - Clearances of phenytoin (PHT), ethosuximide, and theophylline were estimated by a single-dose, single-sample strategy in healthy, young adult men and women. PHT concentrations were measured in salivary ultrafiltrates, ethosuximide concentrations were measured in saliva, and theophylline concentrations were measured in plasma. Estimates of the clearances of these three probes of hepatic drug-metabolizing enzymes revealed a trend toward slightly lower clearances among women compared to men: mean PHT clearance 15% lower, ethosuximide clearance 27% lower, and theophylline clearance 14% lower. However, only differences in ethosuximide clearances were statistically significant. The use of oral contraceptive steroid (OCS) drugs on PHT and ethosuximide clearance was examined, and no significant effects were detected. PMID- 3628467 TI - In vitro studies of induction and inhibition of drug oxidation in man. PMID- 3628468 TI - Therapeutic use of phenobarbital in intrahepatic cholestasis. Inductions in bile acid metabolism. PMID- 3628469 TI - Influence of mexiletine on caffeine elimination. AB - In an acute experiment in healthy volunteers and in patients under long-term treatment for cardiac arrhythmias, mexiletine inhibits caffeine elimination by about 50%. The clearance of mexiletine is not influenced by caffeine. Some side effects of mexiletine may possibly at least partially be attributable to a retention of caffeine. PMID- 3628470 TI - The influence of ethanol on cyclophosphamide pharmacokinetics and metabolism in tumor-bearing rats. PMID- 3628471 TI - Hydroperoxide metabolism in vitamin E-deficient hepatocytes. Studies on low-level chemiluminescence, lipid peroxidation, and glutathione status. PMID- 3628472 TI - Mechanisms of phenobarbital-type induction of cytochrome P-450 isozymes. PMID- 3628473 TI - Increased cyt P-450 dependent function in healthy HBsAg carriers. PMID- 3628474 TI - The urinary 6 beta-hydroxycortisol excretion in man on inducers and inhibitors of the hepatic mixed function oxidase. PMID- 3628475 TI - Influence of the enzyme induction by rifampicin on its presystemic metabolism. PMID- 3628476 TI - Coordinate induction of peroxisomal beta-oxidation activity and cytosolic epoxide hydrolase activity. AB - The effect of four hypolipidemic compounds (tiadenol, clofibrate, acetylsalicylic acid, 1-benzylimidazole) on the specific activities of peroxisomal beta-oxidation and cytosolic and microsomal epoxide hydrolase of rat liver was investigated. Since specific activity of cytosolic epoxide hydrolase from outbred Sprague Dawley rats showed large interindividual variations (approximately 38-fold), induction studies were performed with inbred Fischer F-344 rats, which showed only low interindividual variations (approximately 2-fold). Clofibrate, tiadenol and acetylsalicylic acid caused a 8-, 13- and 4.5-fold induction of cEH and a 13 , 19- and 5-fold induction of peroxisomal beta-oxidation activity, respectively. Microsomal epoxide hydrolase activity was only slightly increased (less than 1.5 fold). 1-Benzylimidazole induced both cytosolic epoxide hydrolase and peroxisomal beta-oxidation activity about 2-fold, whereas microsomal epoxide hydrolase activity was increased about 4-fold. Increase in cytosolic epoxide hydrolase activity was not due to enzyme activation as demonstrated by in vitro studies. On the other hand, these in vitro studies showed that the increase in microsomal epoxide hydrolase activity by 1-benzylimidazole may partially be due to activation of the enzyme. PMID- 3628477 TI - Formation of reactive intermediates and metabolites: effects of macrolide antibiotics on cytochrome P-450. PMID- 3628478 TI - Methoxyphenamine O-demethylase and 5-hydroxylase: a GLC-ECD assay to study their activities and their inhibition by debrisoquine and sparteine. AB - A GLC-ECD method is described for the determination of the O-desmethyl, N desmethyl and aromatic 5-hydroxy metabolites of methoxyphenamine in liver homogenates. The O-desmethyl and 5-hydroxy metabolites are deficient in poor metabolizers of debrisoquine and sparteine and the Dark Agouti rat model of this human phenotype. The present analytical method can be useful in determining methoxyphenamine O-demethylase and 5-hydroxylase activities as well as identifying those substrates which inhibit these and are worthy of further study. PMID- 3628479 TI - Prevention of acetaminophen hepatotoxicity by disulfiram. PMID- 3628480 TI - Influence of the physical state and straggling on the computation of the radiation dose due to radon daughters deposited in the lung. AB - The effect of the physical state (phase) of the absorbing medium and the energy straggling of the alpha particles on the calculation of the radiation dose due to the daughter products of radon deposited in the lung have been studied in detail. The stopping power data for alpha particles in water and water vapour have been used. It has been found that the effect of straggling on the stopping power calculations is small, and therefore its contribution to dose calculations is negligible. The phase effect has been found to be dependent on the energy of the alpha particles and the depth in the medium. If the stopping power of water vapour is used instead of that for liquid water, the dose may be overestimated by 5-20 and 1-11% for 6 and 7.7 MeV alpha particles, respectively, at the beginning of alpha range, and underestimated by 15 and 40% respectively for the above energies at the end of the range. PMID- 3628481 TI - The in-air scattering of clinical electron beams as produced by accelerators with scanning beams and diaphragm collimators. AB - The electron distribution F(x, y, z, theta x, theta y) in air has been evaluated for a clinical electron beam emanating from a scanning beam accelerator in which the collimation of the beam is performed by means of diaphragm collimators. The multiple scattering theory of Fermi turns out to be adequate in describing this electron distribution. In this theory, the only parameter to be determined experimentally is the angular variance at the level of the collimator blocks. Generally, this angular variance features the same energy dependence as the angular scattering power and its value at an arbitrary energy can be derived from measuring the penumbra widths of off-axis profiles in air, at various distances beyond the collimator blocks. Then, the angular variance at the level of a secondary diaphragm collimator can be calculated, as well as off-axis profiles in air at arbitrary distances. In this way, the relative electron distribution at the surface of patients can be calculated easily. This in turn serves adequately as input to the calculation of patient dose distributions in radiation therapy planning. PMID- 3628482 TI - Megavoltage photon beam dose reduction with retracted tissue compensators. PMID- 3628483 TI - Calibration of radiotherapy dosemeters against secondary standard dosemeters: an anomalous result. PMID- 3628484 TI - Comment on 'The distribution of intracellular alkali metals in reference man'. PMID- 3628485 TI - Comments on 'The noise power spectrum of CT images'. PMID- 3628486 TI - Gait deviations in patients with juvenile rheumatoid arthritis. AB - The purpose of this study was to describe quantitatively the gait patterns of patients with juvenile rheumatoid arthritis (JRA). Thirty children with JRA and 30 healthy children were evaluated using a computerized gait analysis system. Time-distance characteristics and joint angle excursions were studied. The subjects with JRA walked with significantly decreased velocity, cadence, and stride length. We found no significant difference in step width nor in the percentage of time spent in each phase of the gait cycle. The anterior pelvic tilt of subjects with JRA was significantly increased throughout the gait cycle. Hip extension at the end of single-limb stance and ankle plantar flexion during weight release also were significantly decreased for subjects with JRA. No significant difference between the two groups was noted in knee joint excursion. Areas of emphasis for physical therapy of patients with JRA include increasing velocity, cadence, stride length, hip extension, and ankle plantar flexion and decreasing excessive anterior pelvic tilt. PMID- 3628487 TI - Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. AB - Physical therapists require an accurate, reliable method for measuring muscle strength. They often use manual muscle testing or hand-held dynametric muscle testing (DMT), but few studies document the reliability of MMT or compare the reliability of the two types of testing. We designed this study to determine the intrarater reliability of MMT and DMT. A physical therapist performed manual and dynametric strength tests of the same five muscle groups on 11 patients and then repeated the tests two days later. The correlation coefficients were high and significantly different from zero for four muscle groups tested dynametrically and for two muscle groups tested manually. The test-retest reliability coefficients for two muscle groups tested manually could not be calculated because the values between subjects were identical. We concluded that both MMT and DMT are reliable testing methods, given the conditions described in this study. Both testing methods have specific applications and limitations, which we discuss. PMID- 3628488 TI - Mechanical energy patterns in gait of cerebral palsied children with hemiplegia. AB - The mechanical energy costs of walking were studied in 10 cerebral palsied children with hemiplegia to determine whether their values were substantially different from normal and, if so, to discover the movements that were responsible. A two-dimensional, sagittal-plane cinematographic analysis of the subjects' normal walking was undertaken. This technique provided continuous information about the mechanical energy costs of the whole body and each of its parts, the energy types involved, and the amounts of energy conserved. In most cases, the energy costs were above normal and were attributable to poor patterns of exchange between the potential and kinetic energy types of the head, arms, and trunk segment; to very low levels of kinetic energy that precluded exchange; or to both. We concluded that attention should be directed to restoring the sinusoidal pattern of motion and to the fluctuating speeds during each gait cycle when energy costs are a therapeutic consideration. PMID- 3628489 TI - Effects of wheelchair design on metabolic and heart rate responses during propulsion by persons with paraplegia. AB - The purpose of this study was to investigate the metabolic and heart rate (HR) responses of individuals with paraplegia to propulsion in wheelchairs of different design. Eight male and one female wheelchair-bound adults with paraplegia were studied. Each subject propelled a conventional wheelchair and a sports wheelchair on a level wooden surface at four velocities ranging from 1 to 3 m/sec. Steady-rate oxygen consumption (VO2) and immediate postexercise HR measurements were obtained. A linear regression analysis of VO2 (L/min) as a function of velocity (m/sec) revealed a slope and correlation coefficient of 0.614 and .93, respectively, for the conventional chair, and 0.510 and .96, respectively, for the sports chair. The intercepts of these relationships did not differ between wheelchair designs. The data analysis revealed no difference between chair designs in the relationship between velocity and work rate. Thus, the energy cost of propelling the sports chair at a specific velocity was 17% less than that of the conventional chair. The greater efficiency of the sports chair is attributed to differences in wheelchair design, rather than to the total mass of the device. PMID- 3628491 TI - Patellofemoral joint forces during ergometric cycling. AB - We estimated the patellofemoral joint forces generated during pedaling on a bicycle ergometer. Our calculations were based on measurements from a force transducer mounted on the pedal, 16-mm cine-film sequences, and biomechanical models of the cycling motion and of the patellofemoral joint. Six healthy male subjects cycled at different work loads, pedaling rates, saddle heights, and pedal foot positions. The maximum patellofemoral compressive force was 905 N (1.3 times body weight [BW]) when cycling with an anterior foot position at 120 W, 60 rpm, and middle saddle height. The mean peak compressive force between the quadriceps tendon and the intercondylar groove was 295 N (0.4 BW), and the patellar-tendon and quadriceps-tendon strain forces were 661 N (0.9 BW) and 938 N (1.3 BW), respectively. The patellofemoral joint forces were increased with increased work load or decreased saddle height. Different pedaling rates or foot positions did not significantly change these forces. PMID- 3628490 TI - Isometric exercise for an individual with hemophilic arthropathy. AB - Several authors have described nonsurgical rehabilitative techniques for individuals with hemophilia who have single or recurrent hemarthroses. The effects of these low intensity exercise programs are not stated clearly in the literature. In this single-case experimental study, we investigated the effects of a training program of isometric exercise of at least two thirds of maximum voluntary contraction on the knee joint and surrounding muscles of a patient with hemophilia. A 12-year-old subject with severe factor-VIII deficiency and chronic knee arthroses was seen for baseline measurements, three weeks of treatment, and follow-up baseline measurements. The isometric exercise program safely increased right hamstring and quadriceps femoris muscle group strength 40% to 70% without adversely affecting knee range of motion, circumference, or skin temperature and without causing bleeding or discomfort. The use of isometric exercise programs during rehabilitation and maintenance is a promising treatment component for the total care of the individual with hemophilia. PMID- 3628492 TI - Hindfoot pain treated by a leg-hindfoot orthosis. A case report. AB - This case report describes an orthotic management option for the treatment of persistent subtalar and ankle joint pain in a patient with rheumatoid arthritis. Orthotic design, principles of control, and methods of application are discussed in addition to the advantages and disadvantages of prefabricated and custom formed orthotic devices. PMID- 3628493 TI - Physical therapy director as professional value setter. A special communication. AB - The purpose of this special communication is to emphasize the importance of balancing the physical therapy director's dual roles as fiscal manager and professional value setter. We will discuss the need for balancing these roles and our perception that professional values are underemphasized in many hospital based physical therapy departments. The physical therapy director's professional values of commitment to high standards of patient care, professional growth, and self-discipline are presented, in addition to specific methods of conveying these values to others. These specific methods include providing a clear focus for the department, being active in patient care, and providing specific mechanisms to allow professional growth of staff members in a directed, but flexible, environment. Our contention is that these dual roles are required to maximize fiscal productivity and professional growth of the staff. PMID- 3628494 TI - Rheumatology education in an undergraduate program of physical therapy. A new outlook. AB - Few physical therapy education programs offer formal rheumatology courses taught by specialists in the field of rheumatic diseases. We modified, evaluated, and formalized a rheumatology course for undergraduate physical therapy students taught by a rheumatologist and a specially trained physical therapist. Although the course is applicable to our undergraduate program, the process we used to modify and evaluate the course content could be useful to others in their development of similar courses elsewhere. Our intent in discussing this process, the course content, and the rationale for our study is to stimulate a national review of rheumatology course content in physical therapy education programs. PMID- 3628495 TI - Mixed products of thymine and cysteine produced by direct and acetone-sensitized photoreactions. PMID- 3628496 TI - Photochemical sensitization by 7-methylbenz[c]acridine and related compounds. PMID- 3628497 TI - Temperature dependence of phosphorescence parameters of phylogenetically distant apomyoglobins. PMID- 3628498 TI - Photosensitising activity of phthalocyanine dyes screened against tissue culture cells. PMID- 3628499 TI - DNA damage and repair following treatment of V-79 cells with sulfonated phthalocyanines. PMID- 3628500 TI - Action spectra for the induction of pyrimidine(6-4)pyrimidone photoproducts and cyclobutane pyrimidine dimers in normal human skin fibroblasts. PMID- 3628501 TI - The use of specific radioimmunoassay to determine action spectra for the photolysis of (6-4) photoproducts. PMID- 3628502 TI - Tumor localization and photosensitization by sulfonated derivatives of tetraphenylporphine. PMID- 3628503 TI - Necrosis of murine tail skin following photodynamic treatment with meso-tetra-(p sulphophenyl) porphine (TPPS). PMID- 3628504 TI - Changes in the protein complement following UV irradiation and their photoreversal in sea urchin (Hemicentrotus pulcherrimus) embryos. PMID- 3628505 TI - Excitation energy transfer between sensitizing chromophores of phycocyanin 612. PMID- 3628506 TI - Inhibition of nucleic acid synthesis in cells exposed to 200 micrometers radiation from the free electron laser. PMID- 3628507 TI - Fluorescence lifetimes of angular furocoumarins. PMID- 3628508 TI - UV-B radiation effects on photosynthesis, growth and cannabinoid production of two Cannabis sativa chemotypes. PMID- 3628509 TI - Pyrimidine dimer formation in human skin. PMID- 3628510 TI - Potential involvement of free radical reactions in ultraviolet light-mediated cutaneous damage. PMID- 3628511 TI - Monodelphis domestica: a new animal model for studies in photodermatology. PMID- 3628512 TI - Photochemistry and photobiology of melanogenic metabolites: formation of free radicals. PMID- 3628513 TI - Depletion of cutaneous glutathione by ultraviolet radiation. PMID- 3628514 TI - Near-infrared detection of singlet molecular oxygen produced by photosensitization with promazine and chlorpromazine. PMID- 3628515 TI - Certain singlet oxygen quenchers affect the photoreaction between 8-MOP and DNA. PMID- 3628516 TI - Isolation and characterization of the photoadducts of 5,7-dimethoxycoumarin and adenosine. PMID- 3628517 TI - Loss of photoreversibility of sunburn cell induction in Monodelphis domestica. PMID- 3628518 TI - Improved quantitation of DNA-protein crosslinking caused by 405-nm monochromatic near-UV radiation in human cells. PMID- 3628519 TI - 38th annual fall meeting of the American Physiological Society. San Diego, California, October 11-15, 1987. Abstracts. PMID- 3628520 TI - Effect of naltrexone on food intake, hunger, and satiety in obese men. AB - Increasing doses of naltrexone (25 to 200 mg) given over 4 consecutive days reduced intake of laboratory luncheon meals by 30% in 17 obese men. Meal size remained suppressed in the laboratory during the week following naltrexone administration. Water intake in the laboratory and body weight were not affected. Rates of ingestion and subjective ratings suggested that naltrexone reduced appetite rather than promoted early satiation. Nausea and other side effects occurred on 1 or 2 days during the naltrexone week in seven subjects whose food intake was reduced. Food intake was also reduced in seven of the remaining 10 subjects who reported no adverse reactions. These results suggest that a conditioned taste aversion or a conditioned anorexia may have developed in some subjects. PMID- 3628521 TI - Drinking by portacaval shunted rats to regulatory challenges. AB - Male rats received an experimental portacaval shunt (PCS) which diverted all of the hepatic-portal blood from the liver into the vena cava. Several months postsurgery, the regulation of fluid balance was evaluated in PCS and sham operated rats. PCS and Sham groups exhibited increased drinking in response to water deprivation and to an osmotic load, however, in both situations the PCS rats drank more than their surgical controls. Despite this difference in intake (adjusted for differences in body weight), the initial bout parameters of the PCS group following osmotic challenge were not appreciably different from those of the Sham group. The reduction of plasma volume with polyethylene glycol treatment elicited drinking in both PCS and Sham groups, with the former group consuming more fluid than the latter after polyethylene glycol but not after vehicle treatment. The results indicate that even after portacaval anastomosis rats were capable of increasing drinking in response to regulatory challenges and that the greater spontaneous fluid intake of PCS rats relative to controls which has often been observed persists during such compensatory responses. PMID- 3628522 TI - Colchicine-induced lesion of rat hippocampal granular cells prevents conditioned active avoidance with perforant path stimulation as conditioned stimulus, but not conditioned emotion. AB - Successful acquisition of active avoidance by rats with low frequency (15 cps) stimulation of the perforant path as a conditioning stimulus is correlated with a slowly developing long-term enhancement of perforant path-granular cell synapses. After selective destruction of granular cells of the stimulated side by unilateral microinjection of 1.6 micrograms/0.2 microliter colchicine into the dentate area, field potentials could no longer be evoked by test stimuli and animals subsequently failed to acquire the conditioned active avoidance with perforant path stimulation as a CS. However, colchicine-treated animals showed the same development of conditioned emotional responses as saline controls and they could also successfully be conditioned with light and tone as the CS. These results suggest that the granular cells are necessarily involved in the conditioning pathway for the active avoidance with perforant path stimulation as the CS. Other targets of the perforant path, e.g., ipsi- and contralateral CA1 pyramidal cells and contralateral granular cells, or antidromic activation of the entorhinal cortex seem an insufficient substitute for granular cells in the pathway for this conditioned active avoidance, but would probably participate in the conditioned emotional responses. The results additionally support our hypothesis, that post-conditioning LTP in granular cell synapses contribute to the acquisition and/or the storage of a memory trace. PMID- 3628523 TI - Food intake and selection after peripheral tryptophan. AB - Two studies investigated the effects of peripheral (IP) administration of the dietary indispensible amino acid tryptophan, on food intake and macronutrient selection in rats adapted to a 12 hr nocturnal feeding period and a choice of 10% and 60% casein diets. In a dose-response study (35, 55, 75, 95, 115 mg/kg), the threshold dose of 75 mg/kg produced a significant reduction in total food intake (3.6 to 2.3 g, p less than 0.05) during the first hour of feeding. The reduction in carbohydrate intake (2.1 vs. 1.2 g, p less than 0.05) was greater than that for protein intake (1.6 vs. 1.1 g, p less than 0.05). Twelve hr total food intake was also decreased (20.9 to 19.5 g, p less than 0.05) and this was attributable to decreased carbohydrate intake (13.2 to 11.8 g, p less than 0.05). In a second study designed to determine if tryptophan's effects were mediated by the central nervous system, brain tryptophan uptake was blocked by co-injecting valine with tryptophan. The significant reduction in first hour total food intake by tryptophan was not prevented by co-injection of an equal quantity of valine (3.5 to 1.8 g, p less than 0.05). Again the suppression of carbohydrate intake (2.0 to 0.9 g p less than 0.05) was greater than that for protein intake (1.5 to 0.9 g, p less than 0.05). This dose of valine significantly reduced brain tryptophan uptake by 16% (21.3 to 17.8 micrograms/g, p less than 0.05) and when administered alone did not affect first hour total food intake (3.1 vs 3.2 g).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628524 TI - Osmotic thirst suppression in dogs exposed to low ambient temperature. AB - Body temperature, urine output, osmotic and free water clearances, plasma osmolality, sodium and potassium concentrations, blood lactate level, osmotic thirst and central blood volume were measured in dogs exposed to cold (+1 to -8 degrees C) for 1-3 hours and compared to those obtained under control conditions at ambient temperatures (18-20 degrees C). In some additional experiments osmotic thirst threshold and arterial blood pressure during intravenous infusion of norepinephrine were also examined. Exposure to low ambient temperature caused an increase in the osmotic thirst threshold and rise in central blood volume. Transient increase in the urine output and free water clearance accompanied by a decrease in the urine osmolality were also observed. No changes were found in rectal temperature, plasma osmolality and plasma sodium concentration. Infusion of norepinephrine elevated the osmotic thirst threshold in a dose-dependent manner. It is concluded that the cold-induced suppression of osmotic thirst may result from the increased central blood volume. A possible involvement of the sympathetic nervous system in the thirst inhibition in low ambient temperature is also considered. PMID- 3628525 TI - Differences in patterns of pup care in Mus musculus domesticus. VIII. Effects of previous experience and parity in XLII inbred mice. AB - An improvement in two variables of a retrieving test has been shown in eight inbred strains of mice following the second parturition. To test the possible contribution of presence at birth and/or caregiving to a cohabitation effect, retrieval behavior was measured in four groups of XLII inbred mice: one group of biparas, and three groups of primiparas; one without any previous maternal experience, one previously exposed to parturition and caregiving by an alien female, and one exposed to a female with her newborn litter. The two variables do not discriminate between the groups in the same way. The scores on one variable (first retrieval latency) fit into an increasingly complex hierarchy of cohabitational environment with parturient females. The second variable (move away from the pups) discriminates between those primiparas who had a cohabitational experience including both birth and caregiving and those that did not. Dissimilarities between the actions of these two variables are discussed in the light of genetic and ethological mechanisms. PMID- 3628526 TI - Effects of selective lesions of fimbria-fornix on learning set in the rat. AB - The effects of selective partial lesions of the Fimbria-Fornix (FiFx) on reversal and place learning sets were investigated in rats by using a T-maze and a semi circular multiple discrimination apparatus. Lesions restricted to the Fimbria (Fi) produced a significant deficit in reversal and place learning set, whereas lesions to the Fornix (Fx) only disturbed the learning set based on a reversal procedure. Combined Fi + Fx lesions resulted in impairment in the retention of spatial discrimination tested in the two mazes. Ventral Hippocampal Commissure (vhc) had no significant effect on reversal learning set. These results confirm previous data that the hippocampal formation is involved in learning transfer, and suggest that the Fi and the Fx may play a role in learning set. Our data also confirm previous demonstrations of the ability of rats to rapidly acquire place learning set. PMID- 3628527 TI - A reevaluation of the role of the lateral hypothalamus in behavioral temperature regulation. AB - Rats exposed to the cold (-9 degrees C) were trained to depress a lever to obtain pulses of infrared heat. Half of the animals received bilateral electrolytic lesions of the lateral hypothalamus and half were sham operated. Lesioned and control animals performed similarly postoperatively and responded appropriately to changes in reward duration and intensity. Thus, lateral hypothalamic lesions do not impair behavioral thermoregulation. Despite normal behavioral heat intake, body temperature of the lesioned rats fell significantly during the sessions, which can be attributed to an impairment in metabolic heat production due to the lesions. PMID- 3628528 TI - Induction of maternal behavior in incubating and non-incubating hens: influence of hormones. AB - Maternal responses and variations in plasma levels of prolactin and testosterone have been studied in incubating and in non-incubating, non-laying hens during forced adoption experiments. The results demonstrate the ability of incubating hens to display complete maternal behavior as early as the 10th day of incubation after being exposed to stimulation by chicks during one night. Maternal responses also emerged in non-laying hens but more gradually. In both groups, a decline in plasma testosterone occurred after the introduction of the chicks and, in the incubating hens, prolactin levels fell as they abandoned their nests. PMID- 3628529 TI - Effects of centrifugal rotation on analgesia and conditioned flavor aversions. AB - In the first experiment, 48 female Wistar rats were water deprived and given three conditioning days with saccharin-flavored water (1.5 g/liter) followed by 0, 5, 10 or 15 min of centrifugal rotation (150 rpm). Analgesia was measured by the tail flick test immediately after rotation. Over conditioning days, taste aversions developed. In general, taste aversion strength increased with duration of rotation. Analgesia also was in proportion to duration of rotation; however, over days tolerance developed in all rotated groups. In the second experiment 12 female Wistar rats were water deprived and given naloxone (20 mg/kg) or saline prior to 15 min of rotation. Rotation-induced analgesia was not affected by naloxone. It was concluded that somatic and gastrointestinal reactions to rotation are not served by a single mechanism. PMID- 3628530 TI - Central gray modulation of affective defense is differentially sensitive to naloxone. AB - Specific areas of feline central gray (CG) modulate affective aggression elicited by hypothalamic stimulation and produce analgesia, possibly mediated by enkephalins. Despite correlations between opiates and aggressive behavior suggested previously, their relationship has not been clearly demonstrated. The goal of this study was to examine the possible role of endogenous opiate mechanisms in CG modulation of affective aggression. Electrodes were placed in the ventromedial hypothalamus (VM) which, when stimulated, elicited affective attack. Control latency to VM-elicited hiss was established. CG cannula electrodes were then implanted. Response modulation was determined by dual stimulation of CG and VM electrodes, alternated with VM stimulation alone. Naloxone was introduced through the CG electrodes and VM-elicited hiss latency was again determined, followed by paired trials of dual and single stimulation. Six ventral facilitatory and eight dorsal inhibitory sites were identified. Naloxone had no effect on CG facilitation but completely blocked CG inhibition of VM-elicited hissing. In support of these findings, it was observed that D-A1A2 MET5-enkephalin injected directly into CG-inhibitory sites suppressed VM-elicited hissing. These results demonstrate that opiate mechanisms are operative in the inhibitory modulation of intra-specific aggression. PMID- 3628531 TI - Hemispheric lateralization of emotions: absence of electrophysiological arguments. AB - EEG lateralization was examined during happy and sad emotional expression in 24 subjects. Happy and sad emotional states were induced by asking subjects to mentally review previously shown film-sequences. Our results failed to replicate those of previous studies, in that they showed no frontal alpha lateralization as a function of emotion. The authors discuss the literature and suggest caution before asserting the existence of electrophysiological arguments in favor lateralization of emotions in humans. PMID- 3628532 TI - Salivary changes in solution pH: a source of individual differences in sour taste perception. AB - The role of saliva in sour taste perception was investigated in a series of 4 experiments. In one pair of experiments, solution pH was measured before and after acetic, citric or hydrochloric acid solutions were mixed with saliva either normally in the oral cavity or after saliva was directly added to solutions. The results showed that large increases in solution pH occurred over a wide range of acid concentrations and that the changes in pH were related to individual salivary flow rates; greater increases in solution pH occurred among those individuals with higher flow rates. The other pair of experiments measured taste threshold and suprathreshold responses to different volumes of acids. The results demonstrated that individuals with high salivary flow rates were less sensitive to the taste of acids and that large volumes of acid were more easily perceived. The pattern of findings suggest that saliva-induced changes in solution pH are important in sour taste perception. PMID- 3628533 TI - Gonadal function during prolongation of life produced by constant light in hamsters with heart failure. AB - In a prior experiment, we showed that living in constant light prolonged the lives of cardiomyopathic (CM) hamsters dying of heart failure. One possible explanation for this therapeutic effect related to the physiological effects of living in short and long days. The control hamsters for our constant light experiment lived in light/dark 12:12, a short day regimen which produces inhibitory effects on the gonadal function of healthy hamsters. To see whether the CM hamster responded to short days like healthy hamsters, we measured gonadal and seminal vesicle mass and plasma testosterone at 1 year of age in CM hamsters raised in the 2 light conditions and assessed testicular size repeatedly over the lives in a second group of hamsters raised in the 2 light conditions. As in healthy hamsters, we found gonadal function in CM hamsters to be greatly inhibited by LD 12:12. Importantly, we replicated our finding that living in constant light prolongs the life of CM hamsters in heart failure. We also found that the stress and trauma inherent in our repeatedly using surgery to assess testicular size acted as an additional risk factor controlling the lifespan of these animals. Our findings suggest that a photoperiodic effect of day length should be considered as one possible explanation of the mechanism of prolongation of life produced in hamsters with heart failure by constant light. PMID- 3628534 TI - A noninvasive stimulus onset device for use in gustatory research. AB - A simple device for precise, noninvasive measurement of stimulus onset time in gustatory research is described. This device utilizes an ultrafast, self-heated, micro-thermistor to sense the cooling effect of the fluid stream that bathes the tongue. PMID- 3628535 TI - Exposure to magnetic resonance imaging does not produce taste aversion in rats. AB - A taste aversion test was used to evaluate possible toxic effects of magnetic resonance imaging (MRI). Thirty male Sprague-Dawley rats were randomly assigned to four groups: Group One (n = 10) received 30 minutes exposure inside the MRI scanner; Group Two (n = 10) received a sham exposure to the MRI scanner; Group Three (n = 5) was injected with 0.15 M lithium chloride; and Group Four (n = 5) was injected with vehicle. All groups were given 10 minutes access to a 0.1% saccharin solution immediately prior to their respective treatment. The rats treated with lithium chloride displayed a taste aversion to the saccharin solution upon subsequent testing over an eight day period. The two control groups (Two and Four) and the rats exposed to MRI did not display any aversion to the saccharin solution. These results are compared to other studies that have shown that magnetic fields can influence biological systems. PMID- 3628536 TI - Scopolamine disrupts visual reversal without affecting the first discrimination. AB - The effect of scopolamine (0.5 mg/kg) was determined in a brightness discrimination test (Y maze) motivated by electrical shocks (escape avoidance). Male adult Sprague Dawley rats were used. Results show that scopolamine impairs significantly the visual reversal without affecting the first brightness discrimination. The qualitative analysis reveals that the anticholinergic drug induced deficit involves both perseveration, i.e. failure to suppress inappropriate response, and a tendency to adopt a position habit. A parallelism with hippocampal and frontal lobe damage symptoms is discussed and an interpretation in terms of disinhibition and incapacity to solve a more difficult problem is proposed. PMID- 3628537 TI - Asymmetry in responsiveness of the hypothalamus of the female rat to estradiol. AB - Asymmetry of function is an increasingly general principle of neuroanatomy, and right-left asymmetry has been observed in some neuroendocrine functions. We report that the right side of the hypothalamus of female rats is more responsive to estradiol than the left side of the hypothalamus for the induction of sexual receptivity. These results are consistent with previous suggestions that the left side of the hypothalamus is more sensitive to the defemininizing actions of neonatal hormones. PMID- 3628538 TI - The effect of repeated withdrawal episodes on acquisition and loss of tolerance to ethanol in ethanol-treated rats. AB - Male rats were administered ethanol via an intragastric catheter (8.0-12.0 g/kg/day) either continuously for 8 weeks or on a binge schedule with four 2 week cycles of drug administration separated from each successive cycle by a 2 week period of no drug treatment. Older rats were administered ethanol for 2 weeks, to provide an age control for the binge-treated animals as age can alter an animal's sensitivity to ethanol. Acquisition and loss of tolerance to ethanol-induced motor impairment were measured on a dowel task while acquisition and loss of tolerance to ethanol-induced hypothermia were assessed by measuring rectal temperature. Acceleration of tolerance development to both ethanol-induced motor impairment and hypothermia was observed in animals subjected to repeated withdrawal episodes (binge-Study 1) but not in the controls for total dose and duration of drug treatment who experienced withdrawal only once (continuous-Study 2). Persistence of tolerance to ethanol-induced motor impairment occurred in both binge and continuously treated animals while persistence of tolerance to ethanol induced hypothermia was seen only in the binge treated animals. Age (3 to 7 months) did not affect tolerance development or decay. After three cycles of drug treatment (three withdrawal episodes), binge treated animals showed an impairment in motor ability when blood ethanol levels were near zero. This impairment disappeared when the animals were administered ethanol, indicating a normalizing effect of ethanol on motor behavior in animals subjected to repeated episodes of withdrawal. A similar, but not significant, effect was seen in continuously treated animals. Thus, in an animal exposed to prolonged ethanol treatment, persistent changes in responding to the drug were found. The persistence of these changes was enhanced by the experience of withdrawal from ethanol. PMID- 3628539 TI - Psychosocial stress, dietary calcium and hypertension in the spontaneously hypertensive rat. AB - The interactive effects of psychosocial stress and diet on the development of hypertension were investigated in spontaneously hypertensive rats. Psychosocial stress, produced through manipulation of group housing conditions, was evaluated at three levels of dietary calcium and sodium: Low (0.1% Ca2+, 0.25% Na+), Intermediate (1.0% Ca2+, 0.45% Na+), and High (2.0% Ca2+, 1.0% Na+). After 13 weeks of exposure, stressed animals had higher blood pressure and lower serum ionized calcium than nonstressed animals across all diets. Likewise, animals on the low diet had higher blood pressures and lower ionized calcium values than animals on normal or high diets regardless of stress condition. The combination of stress and low diet produced the highest blood pressure and lowest serum ionized calcium values. The results suggest that stress both independently and in combination with dietary Ca2+ altered calcium metabolism. The interaction between psychosocial stress and dietary factors appears to contribute to reductions in serum ionized calcium and elevations in blood pressure in this experimental model of genetic hypertension. PMID- 3628540 TI - Early development in mice. IV: Quantity and gross composition of milk in five inbred strains. AB - An analysis of the gross composition of milk in five inbred strains of mice (NZB, CBA/H, BALB/c, C57BL/6, XLII) was conducted for two different days during the lactating period (6th and 9th day after parturition). The quantity of milk and the concentration of proteins, lactose and lipids were measured. Results show a significant effect for day on the quantity of milk, but not for strain. Day effect was also observed for proteins and lactose; however modifications in the concentration of lactose and lipids from the 6th to the 9th day were not identical across strains. Also, a strain effect was present for proteins, lipids and lactose. PMID- 3628541 TI - Circadian rhythms of the spontaneous meal pattern, macronutrient intake, and mood of humans. AB - Circadian (24-hour) rhythms in the feeding behavior of humans were investigated using diary self-reports of spontaneous food intake. Eight male and 30 female undergraduate students recorded what they ate, when they ate it, and their mood at the time of ingestion in a diary over a consecutive nine day period. Self ratings of depression, energy, and anxiety were made at the beginning of each meal on three seven-point scales. The total amount of food energy in each meal as well as the amount of protein, carbohydrate, and fat, the intervals prior to and following the meals, and the satiety and deprivation ratios were calculated. The food energy contained in the stomach at the beginning and end of each meal was estimated with a mathematical model. These variables were evaluated in relation to the time of meal occurrence during the day. Fluctuations in the levels of self rated energy and anxiety, but not depression, were detected during the day. Clear 24-hour rhythms were identified for the amount eaten and the macronutrients ingested during the day with decreases for males and increases for females. The amount eaten per meal and the meal's content of carbohydrate or fat, but not protein, varied over the day with peaks at the lunch and dinner periods. A clear sex difference without circadian variation was apparent with the deprivation ratios. This suggests that males eat larger meals than females because of a heightened responsivity to deprivation and not to a smaller response to the satiating properties of food. Preprandial correlations were found for meals occurring either during the breakfast or the dinner periods. No postprandial correlations were found. These data demonstrate that the preprandial correlations are not an artifact produced by the 24-hour rhythm and suggests that they reflect a basic regulatory strategy employed by humans. As the day progressed, postmeal intervals and satiety ratios decreased, while premeal intervals increased. This suggests that humans obtain less satiety from a given amount of food later in the day than earlier. It is postulated that this represents eating which anticipates the overnight fast. These data clearly demonstrate the efficacy of the approach and the orderly, analyzable nature of the spontaneous eating behavior of humans. PMID- 3628542 TI - Influence of stimulus intensity on the categories of single-unit responses recorded from olfactory bulb neurons in awake freely-breathing rabbits. AB - This study analyzes the influence of increasing odor intensity on the single-unit activity of olfactory bulb neurons recorded in awake freely-breathing rabbits. Five odorants were delivered at four concentrations over a range of 2 log units. Inspiration-and expiration-related firing activities were analyzed separately to categorize the odor-evoked responses into excitation, suppression and no response. Increasing the odor concentration caused more neurons to show excitatory responses during the inspiratory phase of the respiratory cycle and/or suppressive responses during the expiratory phase. The highest concentration of each odor also caused several units to give suppressive responses during inspiratory phases or excitatory responses during expiratory phases. However, increasing odor concentration caused few responses (less than 2%) to change from excitation to suppression or vice versa. How these results relate to those from studies performed in anaesthetized animals and the implications of the results for olfactory coding will be discussed. PMID- 3628543 TI - Peridural anesthesia disturbs maternal behavior in primiparous and multiparous parturient ewes. AB - Several experiments were carried out to study the effects of peridural anesthesia (Sylvocaine, 6 ml between sacrum and 1st caudal vertebra) performed either at the first signs of birth (early peridural: EP), or little before expulsion (late peridural: LP). When performed late, peridural anesthesia altered maternal behavior only slightly when compared with controls. By contrast severe deficits were observed in the case of EP. Seven out of 8 primiparae failed to show interest for their lamb within 30 min of the birth of the young (vs. 1/9 in LP group, p less than 0.01). In multiparae these proportions were 8/27 and 0/22 respectively (p less than 0.01). Within the EP group the effects of the peridural were more marked in primiparous than in multiparous mothers (p less than 0.05). Even in EP multiparous ewes becoming maternal within 5 min after giving birth a reduction in duration of licking was noted, when compared with the LP group (p less than 0.05). On the other hand, these same ewes established normally a selective bond within 2 hours after giving birth, as did the LP or control ewes. These results confirm the importance of genital stimulation for the rapid onset of maternal behavior in parturient ewes. They failed however to clarify the role played by genital stimulation in the establishment of a selective maternal bond. PMID- 3628544 TI - Attenuation of acoustic and tactile startle responses of vitamin B-6 deficient rats. AB - Vitamin B-6 deficient rats exhibit changes in behavior, sensory function, and other nervous system abnormalities such as convulsive seizures and motor disturbances. Sensorimotor reactivity was evaluated quantitatively by measuring auditory and tactile startle responses in 12 week old female Long-Evans rats fed a diet devoid of added vitamin B-6 (DEF) or a control diet, either ad lib (AL CON) or pair-fed to deficient rats (PF-CON). Deficiency was confirmed with a tryptophan-load test administered to a separate group of rats fed simultaneously according to the same protocol. At week 18, body weight and feed efficiency were different among groups (p less than 0.001), and were lowest in DEF. Amplitude of response to both acoustic and tactile stimuli was depressed in DEF compared to both control groups, which generally did not differ in response. This effect was seen most dramatically in responses to the acoustic stimulus (p = 0.034), and especially to the first presentation (p = 0.017). Latency to maximum response was not affected by diet. Possible mechanisms for this nervous system abnormality, not previously reported in vitamin B-6 deficiency, are discussed. PMID- 3628545 TI - Influence of dietary fat on self-reported menstrual symptoms. AB - The Moos Menstrual Distress Questionnaire (MMDQ) was completed by thirty healthy premenopausal women randomized into one of two sets of weight-maintaining diets, those with a ratio of polyunsaturated to saturated fatty acids (P/S ratio) of 1.0 and those with a P/S ratio of 0.3. After a baseline interval of one menstrual cycle, both groups were fed a high fat diet (40% energy from fat) for four menstrual cycles per subject, followed by a similar interval on a low fat diet (20% energy from fat). There were no significant differences in self-reported menstrual symptoms between the two P/S groups. During both menses and the premenstrual week of the low fat dietary period there were significant decreases in self-reported symptoms associated with water retention. A decrease in symptoms in the group labelled "arousal" during the rest of the menstrual cycle was also reported. PMID- 3628546 TI - Relationship between positive sharp wave bursts and unitary discharges in the cat hippocampus during slow wave sleep. AB - In the cat hippocampus bursts of positive sharp waves (PSWs) appeared sporadically almost exclusively during slow wave sleep. The PSW burst was most often found in cell-rich areas in the CA1 and subiculum, and its occurrence was almost synchronized in different regions. An individual burst was usually composed of 3-5 PSWs of about 10 msec duration and showed a considerable fluctuation in amplitude. It was occasionally followed by a negative-going deflection of large amplitude and long duration (post-PSW negativity). The amplitude of PSWs and post-PSW negativity in the CA1 was high in the area giving a large sized-evoked response after stimulation of the contralateral CA3. The spike discharge rate during the burst was two or three times higher than that during the period just preceding the burst, but the discharge never occurred in the positive phase of the PSWs. During the initial part of the post-PSW negativity the high firing probability was maintained. Even when the PSW burst was not followed by a detectable post-PSW negativity, the firing probability during the period corresponding to the post-PSW negativity was still significantly higher than the pre-PSW period. It was suggested that the PSW bursts and post-PSW negativity were triggered off in cell-rich areas by diffuse excitatory inputs impinging possibly upon the hippocampal pyramidal cells and subicular principal cells. The rhythmic PSWs may be post-synaptic inhibitory potentials produced on the somata of those cells after activation of recurrent interneuronal circuits. PMID- 3628547 TI - Calcitonin as a feeding suppressant: localization of central action to the cerebral III ventricle. AB - Calcitonin suppresses food and water intake. To further study this effect of calcitonin, rats were subjected to various intra-cerebroventricular (ICV) applications of calcitonin. The results show: (1) Intra-third ventricular (III ICV) infusion of calcitonin dose-dependently decreased food intake with short- and long-term effects; (2) Potency was decreased by using non-siliconized materials; (3) Potency decreased with age of rats; (4) Infusion into the aqueduct and cisterna magna decreased short- and long-term food intake less than III-ICV administration; (5) Aqueduct obstruction did not affect feeding suppression by III-ICV calcitonin. Aqueduct obstruction did not affect dipsogenic response to III-ICV infusion of angiotensin II; (6) Results of water intake and food to water intake ratios suggest a greater calcitonin effect on food intake than on water intake. The evidence suggests that the hypothalamus is a main locus for suppression of food intake by ICV administered calcitonin. PMID- 3628549 TI - Effect of localized changes in scrotal and trunk skin temperature on the demand for radiant heat by pigs. AB - Localized warming of the scrotal skin to 42 degrees C decreased the number of operant responses for reinforcements of radiant heat when young pigs were exposed to cold (15 degrees C); warming a similar area of the skin on the trunk had no effect on behaviour. The decrease in responding for heat was more pronounced immediately after a meal than when animals were observed 22 hr after their last meal. Cooling the scrotal or trunk skin to 20 degrees C did not modify operant behaviour. It is concluded that the thermal signal from the scrotum is in disproportion to the surface area of the scrotum indicating either increased concentration of thermal receptors per surface unit of the skin, or processing and amplifying the thermal information along the scrotal-brain neural pathway. The significance of the elicited changes in the demand for radiant heat is discussed in relation to the control of testes temperature. PMID- 3628548 TI - Calcitonin effect on the dipsogenic response to intra-cerebroventricular administration of angiotensin II. AB - Evidence indicates that intra-third cerebroventricular (III-ICV) administration of calcitonin suppresses food and water intake of rats. The purpose of this study was to determine whether calcitonin would influence angiotensin II-induced dipsogenesis when simultaneously administered III-ICV. Administration of calcitonin (0.5 U/rat) suppressed food and water intake in male Wistar rats. III ICV administration of angiotensin II (100 ng/rat) to rats provided with ad lib food and water elicited short latency drinking without affecting food intake. III ICV administration of calcitonin (0.5 U/rat) did not affect the drinking-inducing response to 100 ng/rat of angiotensin II when administered simultaneously. The results suggest that decrease in water intake by III-ICV calcitonin may be a consequence of the food intake suppression, i.e., reduced prandial drinking. PMID- 3628550 TI - Testosterone and its metabolites in male cynomolgus monkeys (Macaca fascicularis): behavior and biochemistry. AB - To extend our previous study on the behavioral effects of testosterone propionate (TP) and dihydrotestosterone propionate (DHTP) to a dose-range producing supra physiological plasma androgen levels, 4 castrated cynomolgus monkeys were tested with the same 4 females during successive 4-week treatment periods while receiving 800 micrograms, 1.6 mg, 3.2 mg, 6.4 mg and 12.8 mg of TP or DHTP SC/day in counterbalanced order (16 pairs, 828 1-hr tests). Both androgens increased male sexual activity, but DHTP was less effective than TP in increasing the numbers of ejaculations per test and failed to restore ejaculations to intact levels. Giving androgen-treated males single injections of 50 micrograms and 100 micrograms estradiol benzoate (EB) was without any additional effect on behavior (16 pairs, 256 tests). To examine hormonal effects in the brain, castrated males were given either 3H-T or 3H-DHT, and tissues were examined by high performance liquid chromatography (hplc). After 3H-T, 3H-E2 and unchanged 3H-T were the major forms of radioactivity in nuclei from hypothalamus, preoptic area and amygdala. After 3H-DHT, unchanged 3H-DHT predominated. The lower behavioral effectiveness of DHT could not be ascribed to its failure to enter the brain. The data suggested a role for unchanged T in the regulation of ejaculatory behavior in a male primate. PMID- 3628551 TI - Postingestional modulation of drinking induced in rats by angiotensin II: intragastric infusion and sham drinking studies. AB - The dipsogenic potency of angiotensin II (ANGII, 200 micrograms/kg, SC) was examined after the removal of various postingestional factors. In the first experiment, rats with intragastric catheters were injected SC with ANGII and allowed water to drink. During the induced drinking, either NaCl (1.5 M) or water was injected into the stomach via the catheter at a rate of 0.1 ml for each ml water ingested orally. The water intake was identical in the two conditions. In a second experiment, rats, fitted with gastric fistulas, were administered ANGII and subsequent water intake with fistulas open was compared to that occurring with the fistulas closed. Rats drank more water during the first trial with fistulas open than with fistulas closed. Water intake during subsequent trials with an open fistula rose above that observed on the first trial. In a third experiment, rats with gastric fistulas were offered 0.15 M NaCl to drink. Intake was greater when the fistula was open than when it was closed. Intake of 0.15 M NaCl increased during the second trial with fistula open. Rats drank more 0.15 M NaCl during the first trial with an open fistula in Experiment 3 than those rats given water to drink on their first trial with fistula open in Experiment 2. These data suggest both oropharyngeal and postingestional factors interact in the control of ANGII-induced fluid intake. PMID- 3628552 TI - Nipple attachment and survival in neonatal olfactory bulbectomized rats. AB - Seven-day-old rat pups were olfactory bulbectomized, cortical lesioned, or sham lesioned, tested for nipple attachment 24 hr after surgery, then housed with their dam and weighed daily for the next 7 days. On the basis of histological findings the bulbectomized animals were divided into two subgroups: Those with removal of all olfactory bulb tissue (n = 9) and those in which some cellular elements remained in the lesioned area (n = 7). There were no differences between sham and cortical lesioned groups for nipple attachment behavior or weight gain. The completely bulbectomized pups did not show nipple attachment, lost weight each day, became moribund and had to be sacrificed by the fifth postoperative day. Deficits in incompletely bulbectomized pups were somewhat less severe and each of these survived and maintained or gained weight in the latter part of the test period. These results suggest that suckling may be critically dependent upon olfaction in 8 day or older pups and that significant savings in this behavior may be mediated by small remnants of olfactory bulb tissue. PMID- 3628553 TI - Photoperiodic modulation of steroid-induced lordosis in golden hamsters. AB - The photoperiodic modulation of steroid-induced receptive behavior was investigated using ovariectomized female hamsters (Mesocricetus auratus) kept in short (6 hr of light/day) or long (16 hr of light/day) photoperiods. When a low dose of estradiol (E) was used, a significantly larger percentage of animals housed in long days displayed lordosis behavior than did animals housed in short days in tests with intact males as stimuli. This effect of photoperiod was reduced when a high dose of E was employed and was absent when E treatment was supplemented with progesterone. These observations suggest that a reduction in behavioral sensitivity to E may contribute to the reproductive quiescence induced by short photoperiods. PMID- 3628554 TI - Conservation of plasmids among plant-pathogenic Pseudomonas syringae isolates of diverse origins. AB - Thirty isolates of Pseudomonas syringae pv. tabaci, pv. angulata (pathogens on tobacco), pv. coronafaciens, and pv. striafaciens (pathogens on oats) were examined for plasmid DNAs. The strains were obtained from plants throughout the world, some over 50 years ago. Of the 22 tobacco pathogens, 16 contain predominantly one type of plasmid, the pJP27.00 type. The remaining six tobacco specific strains do not harbor detectable plasmids. The oat pathogens contain one, two, or three plasmids. DNA homology studies indicate that the plasmid DNAs are highly conserved. More importantly, the plasmids harbored by strains isolated from one host plant are conserved most stringently; e.g., the plasmids from the tobacco pathogens are, with one exception, indistinguishable by restriction endonuclease digestion and Southern hybridization. There is also extensive homology among plasmids indigenous to the oat-specific P. syringae pv. coronafaciens and pv. striafaciens strains. PMID- 3628555 TI - A comparative study of the efficacy of Pavetta indica and Osbeckia octandra in the treatment of liver dysfunction. PMID- 3628556 TI - Assay method for antihepatotoxic activity using complement-mediated cytotoxicity in primary cultured hepatocytes. PMID- 3628557 TI - [Analysis and action of cnicin]. PMID- 3628558 TI - [Chromosome-damaging effect of beta-asaron on human lymphocytes]. PMID- 3628559 TI - Antiviral activity of (+)-odorinol. PMID- 3628560 TI - Identification of a new chemotype in Cannabis sativa: cannabigerol-dominant plants, biogenetic and agronomic prospects. PMID- 3628561 TI - Isopimpinellin is not phototoxic to viruses and cells. PMID- 3628562 TI - Major cardenolide glycosides in embryogenic suspension cultures of Digitalis lanata. PMID- 3628563 TI - Effect of extracts of some medicinal plants on superoxide dismutase activity in mice. PMID- 3628564 TI - Aesthetic augmentation of the malar-midface structures. AB - Based on extensive experience with bone grafts for augmentation of the midface malar region, an implant design has been developed using Proplast. After careful preoperative assessment, a very specific surgical method, described herein, allows precise implant positioning without the need for suture fixation. In many instances, the 6-mm implant can be inserted unchanged. One-hundred and six patients have been operated on using 176 implants over the past 6 years. There were four unilateral infections (2.3 percent of implants and 3.8 percent of patients). None had permanent motor or sensory nerve problems. Fifteen implants (8.5 percent) in 12 patients (11.3 percent) were either removed or repositioned. In those having augmentation for entirely aesthetic reasons, 3 of 60 patients (5.0 percent) required implant removal or repositioning. The incidence of needing to remove or reposition implants has decreased as the technique has evolved. PMID- 3628565 TI - Abnormal carotid arteries in the velocardiofacial syndrome: a report of three cases. AB - Internal carotid arteries of unusual size and tortuosity were found before or at the time of pharyngeal flap surgery in three children who had the velocardiofacial syndrome with velopharyngeal insufficiency. In two cases, medial displacement of the arteries prevented surgery, and in the other, hypernasality persisted because only a narrow, asymmetrical flap could be raised. Medial displacement of the internal carotid arteries inhibits surgical treatment of velopharyngeal insufficiency, necessitating treatment with a prosthetic speech device in such children. Since displacement and tortuosity may be associated findings in the velocardiofacial syndrome, the exact location of the internal carotids should be ascertained when pharyngeal flap surgery is planned. PMID- 3628566 TI - Scalp graft for elevation of the reconstructed auricle. AB - Use of a split-thickness scalp graft for coverage of the retroauricular area after elevation of a reconstructed auricle is reported. Because there is no morbidity of the donor site and the color and texture match is excellent, the scalp can be an ideal donor site for coverage of the retroauricular area of the reconstructed auricle. PMID- 3628567 TI - The impact of augmentation mammaplasty: a follow-up study. AB - Seventy-five women who had undergone augmentation mammaplasty responded to a questionnaire that obtained their perceptions of five areas of their personal and relationship functioning: (1) body and self-image, (2) attractiveness, (3) sensual sensitivity of breasts, (4) sexual life, and (5) relationship with partner. The women's perceptions of these areas before and after surgery were obtained retrospectively (between 3 months and 3 years after surgery). The 54 women in consistent relationships reported positive effects of the surgery on their relationship, although not to the extent that they had anticipated. However, regardless of this finding, these women perceived surgery to have had significant positive effects on their attractiveness, as well as on their body and self-image. Postoperatively, the partners of these women were viewed as having a significantly greater interest in sexual activity, as perceiving the women to be significantly more attractive, and as believing that the sexual relationship was significantly enhanced. The 21 women who were not in a consistent relationship also reported positive postoperative changes, although these were not statistically significant. Neither the women's age, length of time since surgery, nor the duration of the woman's relationship had any effect on the positive changes reported. The quantitative and qualitative data underscored the highly positive benefits of breast augmentation for the respondents. PMID- 3628568 TI - Gynecomastia: suction lipectomy as a contemporary solution. AB - Suction lipectomy is adapted for the correction of gynecomastia. Previous attempts using suction lipectomy for gynecomastia still required the use of sharp dissection for removal of the glandular breast tissue as well as excision of redundant skin. With this new technique, gynecomastia is corrected solely with the use of suction lipectomy. The technique is successful if the gynecomastia is due to excess fat or parenchymal hypertrophy. A 7-mm cannula is inserted first, to remove the adipose tissue. Then a 2.4-mm cannula is used to remove the glandular and ductal tissue. The 7-mm cannula is then reinserted to remove subareolar parenchyma and to make final contour adjustments. The surrounding subcutaneous tissue is easily undermined to avoid a saucer deformity and to allow for skin contraction. Patients return to full activities in 48 hours. A compressive garment is worn for 4 to 6 weeks. The results of 10 patients are discussed. PMID- 3628569 TI - An improved technique for immediate retropectoral reconstruction after subcutaneous mastectomy. AB - Subcutaneous mastectomy is becoming an operation of choice in certain cases of premalignant and other breast pathology. We describe a technique for simultaneous subcutaneous mastectomy and retropectoral implantation of a silicone prosthesis. Gentle blunt prepectoral, retromammary dissection is performed through an axillary incision as far inferiorly as the inframammary fold, where a fibrous bridge between the anterior surface of the pectoralis major muscle and the skin prevents dissection any lower. Through the same incision, the retropectoral space is dissected to about 5 cm below the inframammary fold. A second incision is made in the inframammary fold to join the retromammary plane of the first dissection. The gland is then dissected subcutaneously and removed through the inframammary incision. A silicone implant is introduced retropectorally through the axillary incision, thus avoiding splitting the pectoralis major. Satisfactory results have been obtained in 23 bilateral and 14 unilateral cases; it is important that the dissection be performed carefully in order to prevent the implant from riding up too high in its musculoaponeurotic sling. PMID- 3628570 TI - Management of cutaneous melanomas of the female breast. AB - Primary melanomas of the skin of the breast are uncommon lesions. Fifty-four patients were surgically treated for this lesion during a 13-year period, accounting for 3.8 percent of a total of 1431 patients with cutaneous melanoma. Nineteen patients were female and 35 were male. Most recently, in patients with high-risk lesions, such as those exhibiting an aggressive vertical growth phase or a Clark level IV or V, attempts at curative resection have utilized wide and deep excision to the level of the pectoralis fascia with axillary lymph node dissection in selected cases. Reconstruction of the significant breast deficit in five female patients utilized the latissimus dorsi myocutaneous flap. This technique results in an improved aesthetic appearance when compared to primary closure or skin grafting. Donor-site morbidity is minimal. Long-term cancer surveillance is not impeded, and all five patients expressed satisfaction with the reconstruction. Four of the five female patients are currently alive with no evidence of disease at a mean follow-up of 55 months after definitive therapy. PMID- 3628571 TI - Hand infections in dental personnel. AB - In an attempt to study the incidence of hand infections in dental personnel, a standardized survey was submitted to 715 dental professionals and hygienists throughout the state of Nebraska. Of those surveyed, 508 responded (71 percent). Ninety-eight of the 508 respondents reported an infection (19.29 percent). The rate of infection was found to correlate positively with the number of patients seen per week. The rate of infection was increased in respondents with chronic disease (e.g., diabetes mellitus) versus those without chronic disease (33.33 vs. 18.59 percent). In the dental professionals surveyed, it was found that the rate of infection in those who did not routinely wear surgical gloves was significantly greater than in those who did (28.6 vs. 17.6 percent). The morbidity of infections acquired in dental practice can be substantial. A percentage of individuals must leave their practice for surgical treatment. A number have acquired hepatitis B (although none in this study), and exposure to the HTLV-III is possible. We conclude that some protection from infection can be achieved with the routine use of surgical gloves, and this practice should be considered by all, particularly those with chronic disease. PMID- 3628572 TI - The effect of established infection on microvascular surgery. AB - The success of microvascular anastomoses in the presence of staphylococcal infection was studied using rat femoral arteries. There was a spontaneous thrombosis rate of 19 percent in normal vessels that traversed the area of infection. Vessels with an anastomosis outside the area of infection had a similar thrombosis rate, but if the anastomotic site was within the infected area itself, the thrombosis rate increased to 75 percent. Inflammatory changes with subsequent fibrosis in the media and adventitia appeared responsible for the thrombosis. The intima was unaffected by the presence of infection. This study suggests that when a microvascular anastomosis is necessary in the presence of infection, the anastomosis should be placed outside the area of infection with a pedicle to traverse the infected area. PMID- 3628573 TI - Physician in a nuclear age: a personal past history. PMID- 3628574 TI - Chest-wall deformity following soft-tissue expansion for breast reconstruction. AB - We have presented a case in which the presumed pressure effects of tissue expansion caused multiple nondisplaced rib fractures of the anterior thorax in a patient undergoing breast reconstruction. Although the deformity was severe, a satisfactory cosmetic result was obtained and there have been no clinically significant sequelae during a 1-year follow-up period. The degree of bony deformation was most likely enhanced by the combination of this patient's severe osteoporosis, chronic steroid use, and peripheral vascular disease. The fragility and ease of fracture in the bones of osteoporotic postmenopausal females and the long-term effects of steroids on tissues is well known. We believe this observation to be important, since many reconstructed patients are postmenopausal and have variable degrees of osteoporosis. Many undergo adjuvant chemotherapy with steroids and antihormonal agents, and this group of women may therefore be at a greater risk for the occurrence of pressure deformities. The incidence and long-term significance of such deformities are not known. The reconstructive surgeon should be alert to the possibility of this phenomenon occurring as a result of tissue expansion in the patient with severe osteoporosis, peripheral vascular disease, or chronic steroid use. PMID- 3628575 TI - Does the nail bed really regenerate? AB - From observations of nail bed injuries, the regeneration of the nail bed seemed evident. The nail bed regenerated well in the presence of the nail matrix and poorly in its absence, suggesting that the nail bed regenerated from the nail matrix. Full-thickness skin graft or flap coverage of nail bed defects resulted in the good nail bed regeneration. The nail bed grew back, pushing the graft or the flap distally. The regenerated nail beds were about 70 percent of normal size in guillotine-type amputations and about 90 percent in the presence of an intact distal phalanx. The difference between full- and split-thickness skin grafts seemed to be adherence to the phalangeal bone, the former giving way to the advancing nail bed and the latter staying in the way. In addition, the destination of the moving nail bed cells was discussed. PMID- 3628576 TI - A simple approach to identification of the levator aponeurosis in the correction of eyelid ptosis. AB - A new method of approach for the correction of upper eyelid ptosis is described. This involves both conjunctival and skin incisions. It allows for greater ease of identification of the levator aponeurosis and appears to facilitate in the identification of Muller's muscle. Although advised for all patients requiring ptosis correction, it is particularly recommended in those patients in whom the eyelids are involved with extensive posttraumatic scarring. PMID- 3628577 TI - Methylene blue: a simple adjunct to aid in soft-tissue expansion. PMID- 3628578 TI - The bone pencil and the bone surgeon. AB - While helpful for preoperative skin markings, methylene blue is washed away by irrigation and tissue fluids during bony reconstruction. The bone pencil is an ideal marker for hard tissue because it is indelible to irrigation. Further, the surgeon may draw with ease in areas of limited access (i.e., sagittal split and intraoral vertical ramus osteotomies). The pencil can be obtained from most art suppliers. No adverse effects from use of the pencil have been noted in any of our patients. PMID- 3628579 TI - Plastic surgeon in the writer's eye. PMID- 3628580 TI - Marking the upper lid blepharoplasty. PMID- 3628581 TI - Coumadin-induced necrosis of the breast. PMID- 3628582 TI - Correction of the inverted nipple. PMID- 3628583 TI - Who does the advertising? PMID- 3628584 TI - Abnormal carotid arteries in the velocardiofacial syndrome. PMID- 3628585 TI - The McFarlane flap. PMID- 3628586 TI - Widow's peak anomaly with alopecia. PMID- 3628587 TI - To facilitate the suitable location of the nipple in breast reduction and reconstruction. PMID- 3628588 TI - Breast reconstruction by tissue expansion: a previously unreported complication. PMID- 3628589 TI - The world turned upside down. PMID- 3628590 TI - [Biochemical analysis of the parietal and occipital cortex of post-mortem brains from schizophrenic patients]. PMID- 3628591 TI - [Systems-oriented family therapy for families with schizophrenia-spectrum patients]. PMID- 3628593 TI - ["Selective suspension" of actual feeling--one characteristic aspect of the emotional life of schizophrenics]. PMID- 3628592 TI - [On the therapeutic effect of the group home for schizophrenics]. PMID- 3628594 TI - [A study on the family support system for the mentally disabled from the perspective of its function and resources]. PMID- 3628595 TI - [Hallucinatory voices arguing (described by K. Schneider)]. PMID- 3628596 TI - [Diagnostic value of alpha 1-acid glycoprotein in the cerebrospinal fluid]. AB - Samples from 1415 neurological patients were used to study the diagnostic value of acid alpha 1-glycoprotein in the lumbar cerebrospinal fluid. The value of analysis for this substance is considered to lie in the detection of non-specific acute-phase reactions of various causes in the CNS with special reference to barrier problems. The large number of pathologically elevated values associated with acute inflammations of the meninges and cerebral parenchyme is particularly striking. The results of the studies are analyzed on the basis of comprehensive control investigations (n = 559). PMID- 3628597 TI - [Some selected inpatient psychiatric care data as an orientation in planning and a starting point in performance comparisons]. AB - The paper considers how an increase in the relevance of selected hospitalised psychiatric care data may be achieved for purposes of planning and performance comparison. Data previously obtained are arranged so as to have a relevance in respect of care in regional, institutional, and institution-internal comparison. As a basis for discussion, proposals are made for an optimised inclusion strategy for the individual care data. PMID- 3628598 TI - [Parent counseling and simultaneous treatment of neurotically maldeveloped children and adolescents]. AB - The author's experience is used as a basis to discuss various approaches to parent counselling which are illustrated by examples. Follow-up studies on stutterers show that long-term success obviously depends on the willingness of parents to play an active part in the treatment. PMID- 3628599 TI - [Problems in the psychiatric treatment of foreign patients]. AB - The contribution deals with problems encountered during the psychiatric treatment of foreign patients, particularly with those from developing countries. It has been found that scope for socio- and psychotherapeutic treatment is very restricted and that the frequent necessity of returning these patients to their native countries leads to not unconsiderable conflicts. Questions of transcultural psychiatry are regaining importance in connection with increasing migration. PMID- 3628600 TI - [10 years of a doorkeeper system using patients in geriatric psychiatry in Hochweitzschen--a variation of the open-door system for problem areas in inpatient psychiatry]. AB - The employment of patients as door-keepers represents a version of the open-door principle that can be used to ensure that the door is opened only as necessary in problem areas of psychiatric hospitals where traditional forms of control are not feasible. The experience gained during the use of this system for 10 years serves as a basis for a description of the practical problems involved, system risks, security measures and organizational aspects. PMID- 3628601 TI - Intensive inpatient treatment of young adult chronic patients. AB - Young adults with chronic mental disorders have become a major concern among mental health professionals during the past decade. Many of these patients require frequent hospitalizations, are noncompliant with treatment, experience behavioral crises that threaten themselves or others, abuse drugs and alcohol, and alienate their families and support systems. The authors describe an intensive inpatient program for young adult chronic patients who have repeatedly failed to respond to community-based and standard state hospital care and appear to need extended institutional care. The program, which integrates psychiatric and rehabilitation strategies, has succeeded in increasing the amount of time these patients remain in the community. Although the goal for such patients remains a community-based treatment program, the value of an extended period of active inpatient treatment for some patients may be overlooked in current planning for them. PMID- 3628602 TI - Repeated users of a psychiatric emergency service in a Canadian general hospital. AB - The authors of this study examine the demographic and clinical characteristics of repeated users of psychiatric emergency room services in a general hospital. 37.8% of all the patients (913) seen during one year had one or more visits to the emergency room in the six months preceding the index emergency room consultation. Repeaters were more likely than nonrepeaters to be unmarried, self referred and with a history of previous psychiatric treatment for a chronic psychiatric disorder. Factors affecting frequency of use of psychiatric emergency room services among different diagnostic groups were also studied. These results demonstrated the heterogeneity of the needs of the diverse diagnostic groups who over-utilize costly emergency room services. Our findings showed that in a country with universal health insurance, psychiatric emergency services also tend to reflect the gaps in the delivery of health services in the hospital and the community. PMID- 3628603 TI - The narcissistically vulnerable system: a case study of the public mental hospital. AB - The present paper introduces the concept of the narcissistically vulnerable system by suggesting that organizations may manifest some of the same pathological characteristics as narcissistic individuals. The public mental hospital was chosen as an example of such a system. Reasons for its vulnerability were suggested and specific defenses, employed at the system level, were discussed. Finally, remedies for the repair of the narcissistically vulnerable system were considered. PMID- 3628604 TI - Increase in white blood cell count and serum sodium level following the addition of lithium to carbamazepine treatment among three chronically psychotic male patients with disturbed affective states. AB - Three male chronically psychotic patients (mean age 33.0 +/- S.D. 7.2 years), two with schizoaffective disorder and one with organic affective disorder, received carbamazepine (CBZ) because of affective symptoms (and, in one case, partial complex seizures) refractory to management with antipsychotic drugs. Coincident with CBZ administration (and clinical improvement), hyponatremia developed thought to be due to the antidiuretic effect of this drug. Lithium was added to counteract the antidiuretic effect of CBZ. Further clinical improvement ensured, serum sodium levels became normal, and there was an increase in the white blood cell count in each patient. The clinical implications of our findings are discussed. PMID- 3628605 TI - Physical complaints without organic basis in psychiatric inpatients: report of two cases. AB - Two patients with borderline personality disorder hospitalized for behavior disturbance had physical complaints for which no organic basis could be found. These cases highlight a conceptual difficulty in our current classification system for such physical complaints, raise issues about the interplay of psychiatric syndromes, and illustrate how physical complaints without organic basis complicate psychiatric hospitalization. PMID- 3628607 TI - Psychological depressive symptoms in grade II hypothyroidism in a nursing home. AB - In an effort to explore the relationship between Grade II hypothyroidism and depressive symptoms, 16 nursing home residents with normal free thyroxine index and elevated basal thyrotropin (thyroid-stimulating hormone; TSH) levels were matched for age, sex, nursing level of care, and certain medications with a control group who had normal basal TSH levels. The Geriatric Depression Scale (GDS) was administered to all participants. Basal TSH elevation was not associated with increased psychological depressive symptoms on the GDS. PMID- 3628606 TI - Assessment of adrenal gland volume by computed tomography in depressed patients and healthy volunteers: a pilot study. AB - Excessive adrenocortical activation in depression has been postulated to be the result of overactivity of limbic system-hypothalamic function. In contrast, several studies have suggested the possibility that excessive secretion of cortisol might also result, in part, from a heightened adrenocortical responsiveness to adrenocorticotropic hormone (ACTH), or even a mild adrenal hyperplasia. Because computed tomography (CT) may provide a method for assessing an increase in adrenal size, we performed CT scans of the adrenal glands in depressed patients and healthy volunteers, who also received the dexamethasone suppression test. Eight out of 16 patients (50%) had adrenal volumes in excess of the 95th percentile value of the control distribution for adrenal volume. These observations suggest that there may be demonstrable adrenal hypertrophy during depressive illness. PMID- 3628608 TI - Comparison of lactate-induced anxiety in bulimic patients and healthy controls. AB - Clinical symptomatology and diagnostic interview studies suggest that patients with bulimic disorder have some characteristics in common with patients with generalized anxiety disorder or panic disorder. The purpose of this study was to compare sodium lactate-induced physiological responses and anxiety symptoms in hospitalized normal weight bulimic patients and healthy controls. Bulimic patients had significantly elevated anxiety ratings at baseline, and showed a trend toward greater increases in anxiety ratings after lactate administration. Lactate-induced anxiety did not provoke an urge to binge in the bulimic patients. In keeping with the specificity of lactate-induced panic attacks in panic disorder, none of the bulimic subjects experienced a panic attack during lactate infusion. PMID- 3628609 TI - Urinary trace amine excretion and platelet monoamine oxidase activity in schizophrenia. AB - The relationship between subtypes of schizophrenia classified by ICD-9 and 24 hour urinary beta-phenylethylamine (PEA) and phenylacetic acid (PAA) excretion has been studied. Schizophrenia was divided into two types: paranoid and nonparanoid. Increased urinary PEA excretion was found in paranoid schizophrenics, but urinary PAA excretion did not show any significant difference between schizophrenics and normal subjects. A relationship between platelet monoamine oxidase (MAO) activity and urinary PEA excretion was found. These findings offer some indication that PEA may play a role in the pathogenesis of schizophrenia. PMID- 3628610 TI - Effects of d-amphetamine on aggressive responding of normal male subjects. AB - Male research subjects were administered placebo and three doses of d-amphetamine (5, 10, and 20 mg/70 kg of body weight) under double-blind conditions in a laboratory situation that provided both aggressive and nonaggressive response options. The nonaggressive response was button pressing maintained by the presentation of points which were exchanged for money. The aggressive response was button pressing on a separate manipulandum which ostensibly subtracted points from a fictitious person. Aggressive responding was initially established by subtracting points from the research subjects, which was attributed to the other person. d-Amphetamine increased nonaggressive responding, while aggressive responding was generally decreased. PMID- 3628611 TI - Triiodothyronine potentiation of antidepressant-induced reversal of learned helplessness in rats. AB - Several clinical investigations have suggested that a special relationship exists between thyroid function and affective disorders and/or therapeutic response to antidepressants. The present report describes that the reversal by antidepressants (imipramine, desipramine, and nomifensine) of depressive-like behavior in rats (escape deficits produced by previous exposure to uncontrollable stress) was significantly hastened in animals given daily triiodothyronine (T3). The learned helplessness paradigm might be a useful model for approaching in animals the neurohormonal correlates of affective disorders and the neurobiochemical bases of the reported T3 enhancement of antidepressants. PMID- 3628612 TI - Delusional depression: further evidence for genetic contribution. AB - To quantify the contribution of genetic factors in the pathogenesis of delusional depression, the incidence of major depression in the first degree relatives of 77 delusional, 76 nondelusional depressive patients, and 153 age- and sex-matched controls was calculated in a case-control study. The morbid risk for psychiatric disorders, including major depression and bipolar I disorder, did not distinguish the two proband groups. The segregation analysis showed that the model of multifactorial inheritance fits best to our results. Heritability was estimated on the basis of a threshold model for multifactorial inheritance, and a high contribution of genetic factors for both subgroups was found. PMID- 3628613 TI - Childhood head trauma and psychosis. AB - The medical histories of 200 schizophrenic patients were compared to those of 203 depressed patients, 122 manic patients, and 134 surgical controls. All subjects were hospital inpatients. Charts were specifically examined to record any head injury before age 10 that had required medical attention or caused loss of consciousness. Schizophrenics had a significantly greater history of head trauma than the manics, depressives, and surgical controls. There were no significant differences between manics and depressives or between affective disorders as a group and surgical controls. Childhood trauma may be a contributing factor to the development of psychosis in some individuals. PMID- 3628614 TI - Sympathetic nervous system activity in panic disorder. AB - To assess sympathetic nervous system (SNS) activity in panic disorder, arterialized venous norepinephrine (NE) and epinephrine (EPI) were measured in 10 patients and 10 age- and weight-matched controls. In addition, arterialized plasma NE kinetics were determined using a tritiated NE isotope dilution technique. There were no significant differences between patients and controls for resting, supine plasma NE levels, plasma NE appearance rate, plasma NE clearance, or plasma cortisol. However, plasma EPI levels were significantly higher in panic patients (103 +/- 23 vs. 33 +/- 16 pg/ml). Furthermore, there was a significant correlation between anxiety ratings and plasma EPI levels in panic disorder patients. These findings suggest that during the resting state, panic disorder is associated with a selective activation of the adrenomedullary component of the SNS. PMID- 3628615 TI - Relationship between the dexamethasone suppression test and the L tryptophan/competing amino acids ratio in depression. AB - Levels of L-tryptophan (L-TRP), of the competing amino acids (CAA) valine and leucine, and of postdexamethasone cortisol taken at 8 a.m., 4 p.m., and 11 p.m. were determined in serum samples from 140 depressive patients. The relationships between postdexamethasone cortisol values, the CAA, and the L-TRP/CAA ratio were assessed using Pearson and Spearman correlation coefficients and multiple regression. There was a significant correlation between postdexamethasone cortisol and both L-TRP and the L-TRP/CAA ratio. The highest correlation coefficients were obtained for the 8 a.m. cortisol values. Nonsuppressors, in comparison with suppressors, showed a significantly lower L-TRP value and L TRP/CAA ratio. PMID- 3628616 TI - Effects of desipramine and total sleep deprivation on hormonal levels of healthy subjects. AB - Plasma prolactin (PRL) and growth hormone (GH) were serially measured over a 5 hour morning period in healthy subjects who twice received a single oral dose of 100 mg desipramine (DMI). The study was carried out both after a regular night of sleep and after 1 night of total sleep deprivation. Clinical studies have suggested that sleep deprivation could potentiate the therapeutic effects of antidepressants, and there were reports on DMI stimulation of GH. The basal PRL levels decreased after sleep deprivation, but subsequently increased after DMI, whereas the same dose of DMI did not affect PRL in the absence of after DMI, whereas the same dose of DMI did not affect PRL in the absence of sleep deprivation. The GH levels increased substantially (8- to 10-fold) after DMI in both experimental conditions. Sleep deprivation neither changed GH basal levels nor potentiated the DMI-induced GH increase. PMID- 3628617 TI - Birth order in obsessive-compulsive disorder. AB - Birth order and family size were studied in 392 cases of obsessive-compulsive disorder (OCD) seen in the decade 1975-84. On the basis of Slater's index, there was a nonsignificant excess of earlier-born children in the sample. However, this excess was not present in each individual family size, and was not due to either age of onset or sex. Smaller families had more earlier-born index cases, and larger families had more later-born index cases. First-born and only children were not overrepresented in the sample. PMID- 3628618 TI - Subcortical signal hyperintensities in bipolar patients detected by MRI. PMID- 3628620 TI - Psychoanalysis: a philosophical critique. PMID- 3628619 TI - Gravity feed administration of sodium lactate. PMID- 3628621 TI - Diazepam alters brain 5-HT function in man: implications for the acute and chronic effects of benzodiazepines. AB - The effect of diazepam on brain 5-HT-mediated neuroendocrine responses was studied in healthy male volunteers. An acute dose of diazepam (15 mg) significantly attenuated the prolactin and growth hormone responses to intravenous L-tryptophan. After 3 weeks administration of diazepam (25 mg/d) these responses had returned to normal despite much higher plasma diazepam concentrations, suggesting that tolerance had occurred. A reduction in brain 5-HT function may underlie some of the acute therapeutic actions of benzodiazepines. It is possible that excessive 'rebound' 5-HT activity may contribute to the abstinence syndrome seen on benzodiazepine withdrawal. PMID- 3628623 TI - Tachistoscopic tests of colour naming and matching in schizophrenia: evidence for posterior callosum dysfunction? AB - Neuropsychological studies have shown that the integrity of the posterior corpus callosum is necessary for accurate colour naming in the left visual field (LVF) and colour matching across hemifields. Using this model, 22 schizophrenics, 14 depressive and 16 healthy matched controls were given a battery of tachistoscopic tests of colour perception. The schizophrenics made significantly more errors, in naming colours in the LVF compared to depressives, and in matching colours across fields compared to depressives and normals. There were no differences between groups for right visual (RVF) colour naming or matching within right and left visual fields. These findings support the hypothesis that trans-callosal transmission may be impaired in schizophrenia and are unlikely to be due to a specific disorder of colour perception, neuroleptic drugs or generally impaired performance. Those schizophrenics whose LVF naming errors exceeded RVF errors were more likely to have first rank symptoms and showed less cerebral atrophy but did not differ on other variables. The techniques described may be useful for further research into interhemispheric function in schizophrenia. PMID- 3628622 TI - Neuroendocrine aspects of primary endogenous depression. III. Cortisol secretion in relation to diagnosis and symptom patterns. AB - In order to ascertain the extent of hypothalamo-pituitary-adrenal cortical (HPA) hyperactivity in endogenous depression, we determined circadian serum cortisol patterns, cortisol responses to dexamethasone (DEX) administration, and urine free cortisol excretion before and after DEX administration in 40 definite endogenous depressives diagnosed with the Research Diagnostic Criteria. The cortisol measures ranged from normal to clearly elevated. To elucidate the clinical correlates of these hormone measures in the patients, we examined the relationships of the pre- and post-DEX cortisol measures to the diagnosis of endogenous/melancholic depression by different systems and to the overall severity and specific dimensions of depressive symptomatology. In this group of endogenous depressives, none of the diagnostic schemes for endogenous/melancholic depression which we studied was significantly related to the pre- or post-DEX cortisol measures. Of the other subject and symptom variables, only age and the agitation/anxiety factor of the Hamilton depression scale shown consistent relationships with the cortisol measures. Both were positively correlated, to a moderate degree, with the hormone measures, and they were not correlated with each other. Together they explained approximately 20% of the variance in the cortisol measures. Thus, within a group of moderately to severely ill endogenous depressives, the older and the more agitated anxious patients have a significantly greater likelihood of showing increased HPA activity. These findings indicate that age should be controlled in studies of the HPA axis and that the subjective experience of anxiety may contribute to HPA hyperactivity in endogenous depression. PMID- 3628624 TI - The positive and negative symptoms of schizophrenia reflect impairments in the perception and initiation of action. AB - The CNS maintains a fundamental distinction between actions elicited by external stimuli and actions elicited by internal goals (acts of will). As a result the intact organism can monitor centrally three aspects of its own actions: (1) the action appropriate to current external stimulation (stimulus intention or meaning); (2) the action appropriate to current goals (willed intention); and (3) the action which was actually selected (corollary discharge). In Type I (acute) schizophrenic patients, intentions of will lead to actions, but these willed intentions are not monitored correctly. This apparent discrepancy between will and action gives rise to experiential (1st rank) positive symptoms (e.g. delusions of control and passivity). In Type II (chronic) patients, intentions of will are no longer properly formed and so actions are rarely elicited via this route. This gives rise to behavioural negative signs (e.g. poverty of speech). The behaviour of Type II schizophrenics has surface similarities to that shown by patients with Parkinson's disease and patients with frontal lobe lesions in that all three types of patient show a relative deficit of actions elicited by willed intentions. Dopamine blocking drugs reduce positive symptoms in Type I patients precisely because they induce Parkinsonism, i.e. reduce the likelihood of actions being initiated by willed intentions. This in turn reduces the likelihood that actions will occur for which the patient had no awareness of his intention to act. PMID- 3628626 TI - Remote memory in a patient with amnesia due to hypoxia. AB - It has been suggested that amnesic patients suffer a selective loss of episodic memory while semantic memory remains well preserved. To assess the validity of this idea we studied remote memory in an amnesic patient, (M.R.L.), using several different measures that differ in the extent to which they engage episodic or semantic memory. On two different versions of the Albert et al. (1979) remote memory battery M.R.L. displayed severe retrograde amnesia (RA) extending backwards in time for about 15 years with excellent preservation of older memories. With standard recall instructions his overall performance on the Crovitz test of autobiographical memory was impaired and all of M.R.L.'s specific, temporally dated memories were given from the first half of his life. When asked to reconstruct his past residential history in detail, M.R.L. provide specific and generally accurate information for residences occupied from his boyhood until 1970, but thereafter his memory became quite unreliable. On a test of knowledge of terms commonly employed in the surveying profession, in which he worked for the past 20 years, M.R.L.'s performance was also impaired. The consistent pattern of RA displayed by this patient on all of the tests of remote memory indicates that both episodic and semantic memory are impaired in amnesia. PMID- 3628625 TI - Selective memory loss and global intellectual deficits in alcoholic Korsakoff's syndrome. AB - The principle of distinguishing between selective memory deterioration and global intellectual decline has been applied to 38 patients with alcoholic Korsakoff's syndrome. Indices were developed for each type of deficit and their distributions explored. Considerable variation was seen in both parameters, the transition from pure memory loss to global intellectual deficits appearing to be gradual. Differences were found in the sex and CT scan associations of the indices. The implications of the distinction for future research are discussed. PMID- 3628627 TI - Diagnoses of dementia and depression: a latent trait analysis of their performance. AB - Four diagnostic systems for dementia and depression are compared on a community sample of 274 subjects. They are: DSM-III, Gurland's system, AGECAT and a clinician's ratings. These are compared, not in the usual terms of prevalence rates and cross-tabulations of diagnostic categories, but by examining the performance of each system in terms of hypothetical, continuously distributed traits underlying the symptoms of dementia and depression, as in the latent trait model described by Duncan-Jones et al. (1986). Each diagnosis is characterized by the level of severity (threshold) at which it operates, and its accuracy. Evidence is given to support a dimensional view of dementia. PMID- 3628628 TI - Anhedonia and emotional responses to affect evoking stimuli. AB - The purpose of the present study was to determine whether individuals with unusually high scores on the Scale for Physical Anhedonia (Chapman et al. 1976) would differ from average scorers in their emotional responses to affect-evoking stimuli. Ten male and ten female anhedonics, as well as ten male and ten female control subjects, were each shown brief filmclips that were expected to elicit emotional responses. The subjects' facial expressions were videotaped while they watched the filmclips, and they also completed adjective checklists describing how they felt while watching them. The anhedonics and nonanhedonics did not differ in their self-reports of emotional experience, nor did they differ in their facial expressions of emotion while viewing the filmclips. Compared to men, women reported experiencing more emotion, and their facial expressions also indicated greater responsiveness. PMID- 3628629 TI - Musical inventiveness of five idiots-savants. AB - Accounts of musical ability in idiots-savants have up till now been confined to stressing the astounding musical memory which such persons may possess. The present study investigates compositional and improvisational skills in five idiots-savants. The findings interpreted as indicating that a representational system of musical rules and structures is accessible to persons of low general intelligence, and that such a system may underlie reproductive as well as generative musical capacity. PMID- 3628630 TI - Physical and psychological correlates of severe heart disease in men. AB - Seventy eight men were assessed one month before coronary artery bypass graft surgery using standardized measures of psychiatric morbidity and personality as well as a measure of emotional expression (the CECS). All patients had at least one coronary vessel occluded by 75% or more of its diameter, and functional capacity was assessed by calculating the exercise treadmill time (in seconds) for each patient. Most of the variance in exercise treadmill time was accounted for by the following variables: young age, short duration of symptoms, and less severe angina. Only one of five men was designated a psychiatric 'case'. The only psychological measure significantly associated with atherosclerosis was expression of fear (on the CECS). A measure of Type A behaviour (Bortner score) was related to exercise treadmill time, but not to any of the angiographic or clinical indices of coronary heart disease (CHD). Like other measures of Type A behaviour, the Bortner scale is psychometrically impure and has doubtful validity. More valid behavioural variables (such as those measured by the CECS) require further investigation. Future studies on the relation between psychological factors and the extent of CHD should take account of not only sex differences but also patients without significant CHD: high rates of psychiatric morbidity in such patients confound the relation between psychological trait measures and atherosclerosis. PMID- 3628631 TI - Mood, pattern sensitivity and headache: a longitudinal study. AB - Fifteen persons who admitted to chronic worry were asked to complete morning and evening diaries in which they reported the occurrence of headaches, assessed their mood, and observed a visually stressful pattern, noting the illusions it induced. Results showed an association between both trait and state measures of mood and headache occurrence, and between trait and state measures of headache occurrence and illusion susceptibility. However, mood and illusion susceptibility did not appear themselves to be associated either as trait or state variables. The implications of these results for remediation of headaches are discussed. PMID- 3628632 TI - Dimensions of social insecurity and their relation to coronary-prone behaviour in college undergraduates. AB - Research suggests that Type A behaviour and 'social insecurity' (SI) may represent independent additive task factors for coronary disease. Research examining SI and Type A behaviour, however, has not rigorously evaluated the structure of the SI scale. The present study examined the structure of a previously used eight-item SI scale, and its relation to a questionnaire measure of Type A (the student Jenkins Activity Survey), for a sample of 504 undergraduates. Exploratory and confirmatory factor analyses of responses to the SI items revealed a three-factor solution was most appropriate for Type As, and a two-factor solution for Type Bs. For both As and Bs, the first factor reflected insecurity regarding one's own capabilities and worth (self-specific insecurity), and the second factor reflected insecurity specific to a group or social context (group-specific insecurity). A third factor emerging only for Type As reflected insecurity regarding others' capabilities (other-directed insecurity). Semipartial correlations revealed Type A total score was marginally negatively related to group-specific insecurity and marginally positively related to other directed insecurity, corroborating previous angiographic and prospective medical research. The hard-driving/competitive subscale was significantly negatively related to self-specific insecurity, supporting evidence regarding Type A and interpersonal dominance, competitiveness, and aggression. PMID- 3628633 TI - A longitudinal study of the psychological morbidity in children due to a natural disaster. AB - This longitudinal study examined the psychological impact of a bushfire disaster on a group of 808 children aged from 5 to 12. Contrary to prediction, the prevalence of behaviour and emotional problems 2 months after the fire was less than the prevalence in a carefully selected comparison group. Rather than decrease with time, the prevalence of psychological morbidity increased significantly, being as great 26 months after the disaster as at 8 months. PMID- 3628634 TI - Vulnerability to life events exposure. AB - A theoretical model designed to assess the contribution of systematic factors contributing to vulnerability to life-events exposure is described. This model is applied to six-year longitudinal data on life events exposure for a sample of New Zealand women with school-aged children. The fitted model suggests that in the region of 30% of the variance in life-event reports over the six-year period was attributable to a common vulnerability factor. Modelling of this vulnerability factor suggested that two major determinants of vulnerability to life events were the level of social disadvantage of the woman and her level of neuroticism: women of socially disadvantaged backgrounds and women with high neuroticism scores showed a consistent tendency to report high life-event exposure during the six year period. The implications of these findings are discussed. PMID- 3628635 TI - Locally-based residential services for mentally handicapped adults: a comparative study. AB - The patterns of daily living, occupation and leisure activities, skills, behaviour and the structure and organization of living units were assessed for 2 groups of mentally handicapped adults, first in a large hospital and second, a year later in the new local units to which they were transferred. Similar assessments were carried out for individually matched control subjects who remained in the large hospital. For the less severely handicapped, more sociable residents who moved to an NHS hostel in the community, there were significant improvements on several of these measures. For the more severely handicapped, socially aloof people who moved to a ward in a small converted hospital in the district from which they had originally come, some changes on the environmental measures were found, but on the whole the unit was run along similar lines to the wards of the large hospital. There was little change in the pattern of the residents' day to day life. The controls who remained in the large hospital experienced very little change in environmental and life-style measures. The discussion focuses on the interaction between environmental factors and the handicaps of the individuals, and the influence of this interaction upon quality of care and life-style. The study was carried out during the early stages of the rundown to closure of the large mental handicap hospital. PMID- 3628636 TI - An unusual case of nicotine dependence. AB - The case of a 49-year-old woman who has been brushing her teeth for 12 years with large amounts of snuff is described. She was dependent on the habit and had plasma nicotine and cotinine levels similar to those found in heavy smokers. Historical and cultural aspects of the use of snuff are discussed. PMID- 3628637 TI - Neuropsychological test performance in Framingham: a descriptive study. PMID- 3628638 TI - Machiavellianism and anxiety among Italian children. PMID- 3628639 TI - Peer review in psychology: institutional ranking as a factor. PMID- 3628640 TI - Hypnotic suggestibility and paranormal belief. PMID- 3628641 TI - MMPI differences among three diagnostic groups of Mexican-American state hospital patients. PMID- 3628642 TI - Age perceptions of jobs: convergence of two questionnaires. PMID- 3628643 TI - Depression and self-esteem of teachers. PMID- 3628644 TI - Addiction time and intellectual impairment in heroin users. PMID- 3628645 TI - Depression, sex-roles, and family variables: comparison of bulimics, binge eaters, and normals. PMID- 3628646 TI - Anger, hostility, and the Barron ego strength scale. PMID- 3628647 TI - Murder followed by suicide in those who murder police officers. PMID- 3628648 TI - Effect of diazepam upon verbal recall associated with simple picture recognition. PMID- 3628649 TI - Relationship between psychopathology and cognitive functioning in elderly persons. PMID- 3628650 TI - Cognitive correlates of obesity in a nonclinical population. PMID- 3628651 TI - An interview outline for the evaluation of disruptive adolescents. PMID- 3628653 TI - Use of the Proverbs Test in the assessment of competency to stand trial. PMID- 3628652 TI - Attribution of blame in incest among mental health professionals. PMID- 3628654 TI - Problem-centered psychotherapy. PMID- 3628655 TI - Paruresis: overview and implications for treatment. PMID- 3628657 TI - Undergraduate and graduate students' attitudes towards AIDS. PMID- 3628656 TI - A short Sensation-Seeking Scale. PMID- 3628658 TI - Relationship between self-esteem and depression among children. PMID- 3628659 TI - Fear of animals: correlations between fear ratings and perceived characteristics. PMID- 3628660 TI - Correlates of drug abuse in Jamaican (West Indies) high school students. PMID- 3628661 TI - Nocturnal bruxism and type A-B behavior in college students. PMID- 3628662 TI - Comparison of two depression inventories: an examination of construct validity. PMID- 3628663 TI - Alcohol and aggression: a test of an indirect measure of aggression. PMID- 3628664 TI - Effects on self-actualization of paperbacks about psychological self-help. PMID- 3628665 TI - Family environments of children with school behavior problems. PMID- 3628666 TI - Impulsivity, locus of control and education. PMID- 3628667 TI - Use of the Harris and Lingoes Depression MMPI. Subscales in assessing later life. PMID- 3628668 TI - Pilot study of the physiological subscale of the Revised Children's Manifest Anxiety Scale. PMID- 3628669 TI - Social integration economic hardship and rates of personal violence (suicide and homicide): 1933-1970 in the USA. PMID- 3628670 TI - Month of birth of suicides, homicides and natural deaths. PMID- 3628671 TI - Depressive symptomatology at admission in Hungarian and Swedish depressed patients. AB - Within the framework of an ongoing cross-national study of hospitalized depressed patients the symptomatology of age, sex and diagnosis matched depressives consecutively admitted to a University Department of Psychiatry in Budapest, Hungary and in Umea, Sweden has been compared. Only minor differences in symptomatology were detected between the two groups. PMID- 3628672 TI - Spontaneous fluctuations of electrical skin conductance and the actual clinical state in schizophrenics. AB - The present paper examines in a group of 48 schizophrenics, whether spontaneous fluctuations (SF) in electrical skin conductance show a relationship to psychiatric symptomatology. Subjects participated in an experiment that delivered nonsignal auditory stimuli. Their clinical state was assessed by the Brief Psychiatric Rating Scale (BPRS) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE). An additional set of factors with a possible influence on SF rates was also taken into account. A stepwise regression analysis showed BPRS Activation and NOSIE Manifest Psychosis to be of significance, the BPRS subscale displaying a positive and the NOSIE subtest a negative partial correlation to SF frequency. Results are discussed with regard to their implication for experiments using tonic electrodermal measurement; they are also compared with the literature on phasic electrodermal arousal. PMID- 3628674 TI - Inter-rater reliability of a classification of obsessions and compulsions. AB - Weighted kappa and random error coefficient was used to determine inter-rater reliability of a proposed classification of obsessions and compulsions. A high reliability was found between 3 raters for obsessive and compulsive form and content. This classification allows for greater precision in classifying obsessive-compulsive phenomena in research. PMID- 3628675 TI - Relationship between mood state and information processing of negative versus positive emotional stimuli in brain-damaged patients. AB - The present study investigates the relationship between affective mood state as assessed by self- and hetero-rating scales and information processing of negative versus positive emotional stimuli in unilateral brain-damaged patients. Results show a high positive correlation between depressive mood scores and rating of self-awareness. Left brain-damaged (LBD) patients do not differ significantly from right brain-damaged (RBD) patients on both rating scales. RBD patients mismatch negative emotional stimuli in the nonverbal matching task. Results are discussed with reference to interaction between expression of emotion and cognition. The selective neglect of negative information is interpreted as a more basic emotional impairment. PMID- 3628673 TI - Towards a classification of compulsions in obsessive compulsive neurosis. AB - The aim of this study is to derive a system of classification of compulsive phenomena occurring in obsessive compulsive disorder (OCD). 461 compulsions were found in 65.53% of 412 patients seen during the decade 1975 to 1984. An attempt has been made to break down the compulsions observed into different categories of form and content. The rationale for such a classification has been presented, and earlier attempts at classification of compulsions reviewed. PMID- 3628676 TI - The frequency of Capgras delusions in a psychiatric emergency service. AB - During the 1983 year all patient presentations to the University of Miami Psychiatric Emergency Service (PES) at Jackson Memorial Hospital, a large county hospital, were screened by the author through patient rounds and chart review for the presence of the Capgras delusion (strictly defined). Within 4,200 unduplicated patient presentations, 6 cases were determined to have a Capgras delusion: i.e. 0.14% of all PES unduplicated presentations and 0.17% of all PES psychotic unduplicated presentations. These 6 cases are presented. The majority of these patients presented with the chief complaint of violent behavior towards a significant other and had organic factors as contributors to the psychopathology. PMID- 3628677 TI - Anorexia nervosa in Italy: clinical features and outcome in a long-term follow-up study. AB - Fifty-five patients with a diagnosis of anorexia nervosa hospitalized between 1970 and 1975 in the Departments of Psychiatry and Internal Medicine of the University of Padua were recalled between 1981 and 1983. Forty patients (73%) participated in this follow-up study. At follow-up, using the criteria of Garfinkel et al., 15 patients (37.5%) had an 'excellent' outcome, 10 (25%) were 'much improved', 7 (17.5%) were 'symptomatic', 6 (15%) had a 'poor' outcome and 2 (5%) were deceased. There was, generally, a more marked improvement in weight and menses than in eating habits and mental state. We also found that percentage weight loss, depressive symptoms, abnormal attitudes towards food and weight, the association vomiting/laxative abuse and sexual relations are all significantly associated with a poor outcome. Results are compared with a review of existing literature. PMID- 3628678 TI - Countertransference responses in short-term dynamic psychotherapy. AB - The concept of countertransference is used in a broader sense (Heimann, Kernberg) or a more restricted one (Reich, Dewald) in the psychoanalytic literature. All authors generally agree that it is of great importance 'to have countertransference under conscious awareness and control' (Singer and Luborsky). Our study stresses the importance of the countertransference phenomenon in the context of short-term dynamic psychotherapy (STDP). Three clinical examples were selected to illustrate only the specific issues of this study. Psychotherapies were carried out in the Psychotherapy Unit of the Psychiatric Clinic, Athens University. Therapists were residents in psychiatry and were supervised by psychiatrists with a formal psychoanalytic training and experience. Taking into account the therapeutic processes, three kinds of countertransference responses were discerned: (a) those connected with the patient's transference pattern; (b) those linked with the therapist's character structure, and (c) those manifested in specific stages of STDP, especially during the termination phase. PMID- 3628679 TI - Evaluation of therapeutic outcome: some reflections on methodology. AB - Problems connected with choice of outcome-criteria are discussed. Some results from an outcome study of student-conducted dynamic psychotherapies are presented. The discussion is focused on discrepancies between subjective data and more objective measures, as reflected in Rorschach test results. It is claimed that in order to give a meaningful interpretation of these discrepancies, a conception of hierarchically ordered structures of personality is needed. Such a conception also seems to represent a necessary supplement both to Malan's psychodynamic hypothesis and to outcome-research applying multidimensional outcome measures. PMID- 3628680 TI - Psychosomatic symptoms of postmenopausal women with or without hormonal treatment. AB - The purpose of this study is to compare the psychosomatic symptoms of postmenopausal women who are users of hormonal treatment with the psychosomatic symptoms of nonusers. We studied 68 postmenopausal women receiving estrogen treatment (age range 48-56 years; 51.1 +/- 1.9, mean +/- SD) and 50 postmenopausal women (age range 45-55 years; 50.7 +/- 2.5) as controls. The symptoms we studied were: (1) nightly perspiration; (2) vasomotor flushes; (3) dyspnea; (4) vertigo; (5) headache; (6) disturbance of libido; (7) depression, and (8) anxiety. We found a beneficial effect of estrogen treatment in nightly perspiration (p less than 0.01), vasomotor flushes (p less than 0.001) and disturbance of libido (p less than 0.01). We found no difference between the two groups in dyspnea, vertigo, headache, depression and anxiety. Our findings show that with hormonal treatment in postmenopausal women there is a beneficial effect in only some psychosomatic symptoms. PMID- 3628681 TI - Type A behavior pattern and mortality after recurrent myocardial infarction: preliminary results from a follow-up study of 5 years. AB - The purpose of the current study is to examine the association between the type A Behavior Pattern (TABP) and recurrent myocardial infarction (RMI). Rosenman's Structured Interview was administered to a consecutive series of patients admitted to the hospital for myocardial infarction (n = 88). Incidence and mortality from RMI in relation to TABP categories were evaluated after a follow up period of 5 years. The number of new episodes of myocardial infarction observed in the extreme categories was nearly the same but the number of subjects who dies was nearly twice as large in the B as in the A1 category (10.3% vs. 5.8%, chi 2 = 9.074, p less than 0.0283). No subject was observed to survive after RMI in the B group. In agreement with other recent studies, our preliminary results failed to confirm the association between TABP and RMI, but showed a protection from death for subjects displaying high TABP levels. This finding is discussed in terms of the possibility for type A subjects to cope better with the acute illness. PMID- 3628682 TI - Personality pattern of patients with chronic gastric ulcer: a case control study. AB - Personality factors are thought to play a role in peptic ulcer disease. In this study the psychological profiles of chronic gastric ulcer (GU) patients (n = 28) were compared to matched controls (n = 28) using the Cattell Sixteen Personality Factor Questionnaire Form C. GU patients were characterized by traits of anxiety, dependence, introspection, trustfulness and adaptability. These findings are discussed in the light of the literature on personality and peptic ulcer disease. PMID- 3628683 TI - Therapy motivation in anorexia nervosa: theory and first empirical results. AB - Anorexia nervosa patients are considered to be unmotivated for psychotherapy of eating disorders, because they present a lack of understanding and feeling for their disease. In order to objectify this lack of therapy motivation we formulated two questionnaires for patients and therapists. The items were obtained from 15 theoretically determined fields of both intra- and interpersonal subsets of motivation, and a 'motivation profile' was gained. In a first clinical application these profiles are obtained from an anorexia sample at the beginning and at the end of an inpatient treatment and combined with the corresponding therapist ratings. The results are compared with two control groups (preattended psychosomatics and somatic patients). Results collected hereby are used for the improvement of our questionnaires and for suggestions concerning further studies. PMID- 3628684 TI - Low dominance and high intropunitiveness in ulcerative colitis and irritable bowel syndrome. AB - Two experimental groups of patients with ulcerative colitis (UC) and irritable bowel syndrome (IBS) were compared for hostile personality characteristics and dysthymic states with physically ill patients. Both experimental groups were found to be less dominant, more intropunitive, more anxious and more depressed than the control group. IBS patients, however, were more dominant and less intropunitive than UC patients. Low dominance has been associated with psychosomatic illnesses, and high intropunitiveness with neurotic formation. Both UC and IBS patients have been found to be severely neurotic, a fact reflecting the concurrence of the psychosomatic and neurotic defences in these diseases. More IBS patients had premorbid psychiatric symptoms in comparison with controls and UC patients. PMID- 3628685 TI - Representation of psychosomatic disturbances: metaphor and metonymy. AB - The purpose of this study was to explore the expressive capacities of our psychosomatic patients. We invited them to represent their illness in a drawing through the design test. Following this, we investigated 43 patients affected with bronchial asthma, 30 patients affected with refractory massive obesity and compared them with a control group of 25 'normal' subjects (medical students in a situation where stress and anxiety were strongly suspected as they were awaiting to sit for an examination in the Medical School). The two patient groups showed quite relevant differences as to their own expressive modalities in the use of metaphor and metonymy, which are considered as the graphic representation means of the illness. PMID- 3628686 TI - Extreme denial in breast cancer patients and capacity for object relations. AB - This study tested an assumption of the theoretical hierarchy of defenses: denial reflects primitive ego development. The study hypothesized a positive relationship between extreme denial and immature object relationship functioning. Twenty breast cancer patients who demonstrated extreme denial and delayed help seeking were compared on a measure of object relations with a group of 30 similar patients who did not manifest denial or delay. The central hypothesis was not supported, although trends suggested possible validity. Further study may improve our understanding of the mechanisms which influence symptom recognition, help seeking, and emotional adjustment to cancer. PMID- 3628687 TI - Homogeneous groups as treatment modality for anorectics. AB - The accumulated amount of research studies on anorexia has not until now produced a clear understanding of its etiology, symptoms and treatment. In this paper we deal with one aspect of the symptomatology: the delusion on the part of the anorectic patient of being normal or overweight. This issue, which seems the most obnoxious, is dealt with and discussed through a psychological model of group therapy with the participation of 7 anorectic women. Implications and limitations of further psychological treatment are clarified and revised. PMID- 3628688 TI - Soft clinical research on an inpatient unit: effect of findings on treatment. AB - This paper describes the value of identifying and processing intuitive hunches and impressionistic ideas that arose amongst psychiatrist/clinicians on an inpatient unit. Through semistructured meetings, these hunches generated psychodynamic formulations and therapeutic approaches that were integrated into already existing models of treatment to yield a better understanding of, and a more tailored approach to, the borderline patient and his/her impact on staff. PMID- 3628689 TI - [Structure diagnosis in psychotherapy]. PMID- 3628690 TI - [Autogenic training in the elderly]. PMID- 3628691 TI - [Emotional changes in the menstrual cycle--the premenstrual syndrome]. PMID- 3628692 TI - [Documentation of the interview outcome in psychotherapeutic ambulatory care]. PMID- 3628693 TI - [Assessment of the German health resort from a cultural anthropologic viewpoint]. PMID- 3628694 TI - Study of the rate of passage of food with chromium-mordanted plant cells in chickens (Gallus gallus). AB - Thirty broilers 8-10 weeks old were used to study the rate of food passage in chickens. Wheat bran and rice husks of three different sizes: more than 2 mm, between 1 and 1.5 mm, and less than 0.5 mm, mordanted with chromium, were used as markers. The suitability of these markers to study the rate of food passage in chickens and the possible influence of the size and hardness of the particle on the retention time was the objective of this study. Both T1, the time of first appearance of the marker, and Tm, the mean retention time, have been evaluated. Tm was a better parameter than T1 for studying transit time. Tm was longer with the biggest particles, especially with rice husk. The gizzard, with its grinding activity and pylorus, a selector of particle size, seems to be the transit regulator for solid particles in chickens. No chromium was found in the caecal contents of any case. PMID- 3628695 TI - Involvement of the reflex increase in heart rate in the differences in urinary responses to stimulation of atrial receptors in dogs with different blood volumes. AB - The effect of increasing heart rate by increasing the rate of atrial pacing in the absence of any reflex effects from atrial receptors, by cooling the vagi to 12 degrees C, was studied in two groups of dogs with different blood volumes. In one group of nine dogs with a high blood volume increasing heart rate, by an amount similar to that reflexly obtained in response to stimulation of atrial receptors, resulted in significant increases in urine flow and sodium excretion; in another group of eight dogs with a low blood volume similar increases in heart rate did not result in a diuresis or natriuresis. The findings suggest that the effects of an increase in heart rate in combination with differences in blood volume could contribute to the previously reported differences in the urinary responses that result from stimulation of atrial receptors in dogs with different blood volumes. PMID- 3628696 TI - Peripheral vascular responses to changes in left ventricular pressure in anaesthetized dogs. AB - In dogs anaesthetized with chloralose, cardiac receptors were stimulated by increases in left ventricular systolic pressure effected by changes in aortic root pressure. Left atrial and carotid sinus pressures were controlled. A large step increase in ventricular pressure resulted in transient decreases in heart rate, systemic arterial perfusion pressure and perfusion pressure to a vascularly isolated hind limb. The magnitudes of these responses were about three-quarters of those to either a large change in carotid sinus pressure or aortic root injection of 20 micrograms veratridine. Steady-state responses were smaller. There was no significant change in perfusion pressure to a perfused cutaneous vein. Graded changes in ventricular systolic pressure showed that the most sensitive pressure range was between 20 and 24 kPa. These results indicate that changes in left ventricular pressure result in significant vasodilation in the hind limb and in other regions and that responses are obtained when the pressure is moderately elevated. PMID- 3628697 TI - The possible role of periodontal mechanoreceptors in the control of parotid secretion in man. AB - In man, parotid flow has been recorded bilaterally using modified Lashley cups in response to mechanical stimulation of the teeth. The stimulus was defined and controlled by monitoring the rectified and integrated masseter electromyographic activity (e.m.g.) during repeated clenching on closely fitting bite-blocks placed between the molar teeth. Unilateral clenching on a bite-block resulted in a greater flow from the ipsilateral than the contralateral gland, and both exceeded the control values. There was also a positive correlation between the masseter e.m.g. activity and ipsilateral parotid flow. Parotid flow was also recorded before and during local anaesthesia of various intra-oral branches of the trigeminal nerve. Anaesthesia of two to three inputs always produced significant reductions in ipsilateral flow, but anaesthesia of a single input was not always effective. These results provide evidence in support of the hypothesis that intra oral mechanoreceptors, particularly periodontal mechanoreceptors, are involved in the masticatory-salivary reflex. PMID- 3628698 TI - Attribution of [3H]bumetanide binding to the Na+K+Cl 'co-transporter' in rabbit renal cortical plasma membranes: a caveat. AB - The 3H-labelled loop diuretic bumetanide has been used to investigate loop diuretic binding to purified plasma membranes from rabbit kidney cortex (and outer medulla). Bumetanide binding to partially purified cortical plasma membranes in the range 0-10 microM, in a buffer containing principally Na, K and Cl ions, consists of a linear non-saturable component as assessed by 100 microM unlabelled bumetanide, and a saturable component consisting of high- and low affinity binding sites, half-maximal binding being observed at 1.3 and 220 microM, respectively. The high-affinity site was found to be present in a fraction enriched in basolateral membrane markers when plasma membranes were further purified on a continuous Percoll gradient, whilst bumetanide binding to fractions enriched in brush-border or mitochondrial membrane markers was of lower affinity. Several features of bumetanide binding to basolateral membrane marker enriched fractions are consistent with binding to the Na+K+Cl 'co-transporter' inhibited by loop diuretics: half-maximal binding was observed at 1.8 microM, with a finite maximal binding capacity of 78 pmol/mg. The relative efficacy of several loop diuretics for displacement of [3H]bumetanide was bumetanide greater than piretanide greater than furosemide = ethacrynic acid. Binding of loop diuretic was found to be dependent upon the medium ionic composition, Na, K and Cl being required to give maximal binding. The ability of probenecid and 4,4' diisothiocyanostilbene-2,2'-disulphonate (DIDS) to compete with [3H]bumetanide was tested since these compounds are known inhibitors of anion secretion in the proximal nephron. Both DIDS and probenecid were able to effectively compete with [3H]bumetanide binding. A test of the ability of these compounds to inhibit 'co transport' flux was made in intact MDCK cells using the ouabain-insensitive 86Rb (K) influx. Probenecid, at the concentrations seen to displace [3H]bumetanide binding to renal plasma membranes, was an effective inhibitor of 'co-transport' whereas DIDS was not. The adequacy of present criteria as to the identification of the 'co-transporter' in renal membranes using [3H]bumetanide binding are discussed in the light of this evidence. PMID- 3628699 TI - The effects of feeding either hay or grass diets on salivary phosphorus secretion, net intestinal phosphorus absorption and on the partition of phosphorus excretion between urine and faeces in the sheep. AB - Mature sheep fitted with ruminal and duodenal cannulas were fed either a pelleted hay or a pelleted grass diet with or without supplementary phosphorus. Salivary phosphorus secretion, net intestinal phosphorus absorption and the route of phosphorus excretion were determined. The route of excretion was markedly affected by diet with urinary excretion being much higher and faecal excretion lower when the grass diet was fed. These effects were not due to differences in phosphorus intake or to differences in net intestinal phosphorus absorption. Salivary phosphorus secretion was, however, lower when the grass diet was fed. The significance of these changes in relation to the control of phosphorus balance in ruminants is discussed. PMID- 3628700 TI - The effect of carbimazole on growth and sexual maturity in the pullet. AB - Carbimazole (100 mg/kg diet) was fed to pullets from 8 to 12 or from 12 to 16 weeks of age. Pullets fed carbimazole from 8 to 12 weeks of age matured about 12 d earlier and produced more eggs between 17 and 22 weeks of age. Their body weights and feed intake were significantly lower than those of normal birds. Feeding carbimazole from 12 to 16 weeks of age had no significant effect on the birds except during the course of treatment where their feed consumption was less than that of the controls. PMID- 3628701 TI - Relationships between plasma hormone concentrations, udder development and the production of early mammary secretions in twin-bearing ewes on different planes of nutrition. AB - Ewes carrying twin fetuses were maintained during late pregnancy on a uniformly high plane (well fed), a uniformly low plane (underfed) or a low plane rising to a high plane (refed) of nutrition. The maternal plasma concentrations of hormones concerned with udder development, colostrum production and milk secretion were measured in samples obtained during the last 32 d before and the first 18 h after birth. Udder weights were derived from their linear dimensions, the yields of mammary secretions by hand milking during the first 18 h after birth and the transition from colostrum to milk was indicated by changes in the concentrations of lactose, lipid and immunoglobulin G. Underfeeding reduced prenatal udder development and colostrum accumulation and delayed the post-natal transition to milk secretion. Refeeding previously underfed ewes to a high plane during the last 5 d before birth had no effect on udder growth, but it did return the secretory functions of udder tissue to the levels observed in well-fed ewes. Nutritional effects on the plasma concentrations of insulin, placental lactogen, prolactin, cortisol and oestradiol-17 beta were small or absent. The relative changes in the plasma concentrations of growth hormone and insulin were such that the growth hormone: insulin ratio increased markedly during the last 11 d before birth in the underfed and refed ewes but not in the well-fed ewes. These differences in the growth hormone: insulin ratio were associated with greater increases in udder growth rate in the underfed and refed ewes than in the well fed ewes. The plasma concentrations of progesterone decreased before birth in all ewes, but the decrease was delayed by underfeeding and refeeding rapidly overcame this effect. The slower progesterone withdrawal in the underfed ewes was associated with a delay in lactogenesis. It is concluded that the nutritionally induced changes in the growth hormone: insulin ratio and in the progesterone concentrations were the most likely endocrine determinants of the observed differences in the rates of mammogenesis and lactogenesis, respectively, but possible independent effects of substrate supply to the udder remain to be clarified. PMID- 3628702 TI - The effect of an antibiotic policy on bacterial resistance in patients in geriatric medical wards. AB - In an effort to reduce levels of trimethoprim resistance amongst urinary isolates and faecal organisms two antibiotic policies (policy 1, erythromycin, nitrofurantoin substituted for trimethoprim and ampicillin; policy 2, Augmentin (ampicillin + clavulinic acid) substituted for trimethoprim and ampicillin) were used for 50 weeks on two geriatric acute/rehabilitation wards. The policies were evaluated by comparison with the pre-policy period and between policies. The policies were applied successfully and both were associated with a fall in the proportion of trimethoprim-resistant faecal coliforms and urinary isolates. Policy 1 appeared to affect plasmid-mediated resistance to a greater extent than policy 2. There were no differences in outcome for patients during policy periods. Control of antibiotic usage by formal policies is a viable means of controlling bacterial resistance in geriatric wards. The mode of action of such policies requires further elucidation. PMID- 3628703 TI - Brucella meningitis: presentation, diagnosis and treatment--a prospective study of ten cases. AB - Diagnosis of brucella meningitis was made in 10 patients by serological tests on blood and cerebrospinal fluid using Rose Bengal, standard agglutination, indirect immunofluorescent and enzyme-linked immunosorbent assay (ELISA) tests and by blood and CSF culture. All patients had significantly elevated antibody titres. In three Br. melitensis was isolated both from blood and CSF and in a further three from blood only. Eight patients were 30 years old or less and seven were female. Seven patients had a history of contact with livestock and had consumed raw milk. Meningitis occurred in five, meningoencephalitis with hemiplegia in one, paraplegia and cranial nerve palsies in one and psychosis and/or nightmares in three. Transient Parkinsonism was seen in one patient and generalized rigidity and non-Parkinsonian tremors in another. Computerized tomography revealed ventricular dilation in one patient and punctate hyperdense, non-enhancing shadows in the lentiform nuclei in two others. Treatment with a combination of tetracycline, rifampicin and streptomycin was successful. PMID- 3628704 TI - Acute myopericarditis in influenza A infection. AB - Heart disease is a recognised complication of influenza. We report a unique case in which myopericarditis and collapse due to acute influenza A infection was associated with pericardial effusion and tamponade. In addition, the patient had myositis and pleurisy. Emergency pericardiocentesis and inotropic drugs were needed but recovery was complete. PMID- 3628705 TI - Increased superior mesenteric artery blood flow after glucose but not lactulose ingestion. AB - A transcutaneous Doppler ultrasound method was used to measure the superior mesenteric artery blood flow in nine healthy volunteers in the fasting state and serially for 1 h after the ingestion of 400 ml of an isotonic glucose solution. These measurements were repeated on a second occasion following the ingestion of 400 ml of an isotonic lactulose solution. Superior mesenteric artery blood flow increased by 53 per cent (p less than 0.05) 5 min after the end of ingestion of the glucose solution. The increase persisted at 10 min and declined to 47 per cent at 15 min and to 23 per cent at 30 min. No significant change in blood flow was found following the ingestion of the lactulose solution. Significant differences between the two responses were found at 5, 10 and 15 min (p less than 0.05). The increase in blood flow after a glucose solution and not after lactulose suggests therefore that the process of absorption is an important factor governing postprandial superior mesenteric artery blood flow. PMID- 3628706 TI - Infection and arthritis. PMID- 3628707 TI - Steroid therapy in IgA nephropathy: a prospective pilot study in moderate proteinuric cases. AB - Forty-three patients with IgA nephropathy whose proteinuria persisted between 1.0 and 2.0 g/day were assessed in an uncontrolled pilot study of steroid treatment. Fourteen patients receive an initial dose of 40 mg/day of prednisolone, followed by gradual reduction of the dose over an average period of about 19 months. After discontinuation of corticosteroids, they were treated with non-steroid anti inflammatory drugs and/or anti-thrombocyte drugs to the end of the study. Another 29 patients received non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs throughout the study. Fourteen patients treated with steroids experienced considerable reduction in proteinuria and maintained renal function over 81 months. In 29 patients treated with non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs alone, proteinuria did not decrease and renal function deteriorated significantly during 60 months. At the end of the study, differences in degree of proteinuria and in levels of renal function between the steroid and non-steroid groups were statistically significant. In addition, these differences became more distinct in patients with initial creatinine clearance values 70 ml/min or more in both groups. These results suggest that treatment with steroids in IgA nephropathy may be beneficial, especially in the early stage of the disease. PMID- 3628708 TI - The prevalence of autonomic neuropathy in insulin-dependent diabetes mellitus: a controlled study based on heart rate variability. AB - Autonomic function was investigated by tests of heart rate variation in 506 unselected insulin-dependent diabetics aged 12 to 85 years. Heart rate variability was measured by a computerised technique during rest and in response to a single deep breath, the Valsalva manoeuvre and standing. Changes in heart rate were compared with age-related normal ranges derived from 310 non-diabetic control subjects aged 18 to 87 years. Heart rate responses were found to be below the 5th centile control value in 13 to 23 per cent of diabetics. Impaired heart rate variability occurred more frequently in response to a single deep breath than to the other procedures. Results from all four procedures were combined in each subject to give an 'autonomic score', varying from 0 to 4. This score was greater than 1 in only five of 310 (1.6 per cent) non-diabetic control subjects. A score of 2 or more was therefore defined as abnormal and indicative of cardiac autonomic denervation. Abnormal autonomic scores were found in 84 diabetics (16.6 per cent). In diabetic subjects the autonomic score correlated most closely with heart rate variability at rest and in response to a single deep breath. Abnormal autonomic scores correlated significantly with duration of diabetes (p less than 0.0001) but not with age (p = 0.06). The frequency of abnormal autonomic scores was greatest in diabetics aged 40 to 49 years (24.5 per cent) and those with diabetes of 20 or more years duration (30.7 per cent). PMID- 3628709 TI - High risk acute renal failure. AB - Acute renal failure carries a high mortality and little change in survival rate over the last three decades has been seen. Patients requiring intensive care, most of whom have developed acute renal failure following trauma or surgery, have a worse prognosis. The survival in this series of 100 consecutive patients admitted to one intensive care unit between 1976 and 1985 was 35 per cent. The only factors which differed significantly between the surviving and non-surviving patients were age, requirement for mechanical ventilation and maximum serum creatinine level before the first dialysis. It is difficult to predict outcome for an individual patient at the start of treatment and an aggressive approach to management is advocated. PMID- 3628710 TI - NMR studies of ion binding in biological systems. PMID- 3628711 TI - Proliferation activity of stromal stem cells (CFU-f) from hemopoietic organs of pre- and postnatal mice. AB - Stromal stem cells (CFU-f assay) from hemopoietic organs of fetuses, in contrast to adult animals, exhibit a high proliferation activity. This implies that these CFU-f are radiosensitive and potential target cells after radioactive contamination of fetuses. Furthermore, the percentage of CFU-f in DNA synthesis is correlated with the hemopoietic activity in liver, spleen, and bone marrow. As hemopoiesis starts, high numbers of CFU-f are in S phase. In fetal liver, spleen, and bone marrow, values of 70, 43, and 58%, respectively, are reached. As hemopoietic activity decreases in liver and stabilizes in spleen and bone marrow, mitotic activity of these stromal stem cells becomes undetectable. PMID- 3628712 TI - Effects of protraction of the alpha dose to the lungs of mice by repeated inhalation exposure to aerosols of 239PuO2. AB - To determine the long-term biological effects of protracted alpha irradiation of the lung, 84-day-old C57BL/6J mice were repeatedly exposed by inhalation to aerosols of 239PuO2 every other month for up to six exposures in 10 months to reestablish lung burdens of 20, 90, or 460 Bq. Other mice were exposed only once when either 84 or 460 days of age to achieve desired initial lung burdens of 20, 90, 460, or 2300 Bq. Suitable control groups were maintained. Groups of mice with similar cumulative alpha doses to the lung had 3.4 to 4.4 times greater incidence of pulmonary tumors (adenomas and adenocarcinomas) when the dose to the lung was protracted by the repeated inhalation exposures compared to mice that received a single inhalation exposure. Excess pulmonary tumors per unit dose to the lung were also greater in groups of repeatedly exposed mice compared to those exposed only once. Repeatedly exposed mice also died earlier with pulmonary tumors than did those exposed once. It appears that protraction of an alpha dose to lungs increases the carcinogenic risk of inhaled 239PuO2 in mice. PMID- 3628713 TI - Regional blood-to-tissue transport in an irradiated rat glioma model. AB - To assess vascular permeability in intracerebral grafts of the 36B-10, F-344 rat glioma following 20 Gy 137Cs whole brain irradiation, the blood-to-tissue transport constant, K, of [14C]-alpha-aminoisobutyric acid (AIB) was measured with quantitative autoradiography. Mean, 90th percentile, and 95th percentile values of K were determined in individual tumors and in treatment groups. In 15 day-old unirradiated control tumors, mean, 90th percentile, and 95th percentile values of K were, respectively, 11.3, 18.4, and 20.8 ml kg-1 min-1. In 15-day-old tumors irradiated on Day 14 (Day 1 postirradiation tumors) the K values were 5.9, 9.4, and 10.4, all of which were significantly less than the respective control values (P less than 0.01). In 16-day-old tumors irradiated on Day 14 (Day 2 postirradiation tumors), the K values were 10.8, 15.0, and 16.0, respectively, none of which was significantly different from control tumors. Mean K values for Day 2 vs Day 1 postirradiation tumors (10.8 vs 5.9) yielded P less than 0.05, but the 90th percentile and 95th percentile values for Day 2 vs Day 1 yielded 0.05 less than P less than 0.10. Separate experiments measured AIB and 86RbCl uptake in 36B-10 cells in vitro 1 and 2 days following 20 Gy irradiation to assess whether this radiation dose reduced the capacity of tumor cells to trap AIB or Rb+. Irradiation did not reduce the accumulation of either tracer, but rather was associated with an increased accumulation of AIB. Therefore, the AIB transport data suggest that vascular permeability and/or surface area decreases significantly in the day following 20 Gy irradiation and that this decrease reverses by the second day following irradiation. PMID- 3628714 TI - Protection of Chinese hamster ovary cells from heat killing by treatment with cycloheximide or puromycin: involvement of HSPs? AB - Cycloheximide (CHM) or puromycin (PUR) added for 2 h before heating at 43 degrees C followed by either PUR or CHM during heat greatly protected cells from heat killing. This protection increased with inhibition of protein synthesis. Since treatment with a drug both before and during heating was required for heat protection, and since one drug could be exchanged for the other after the 2-h pretreatment without affecting the heat protection, a common mode of action involving inhibition of protein synthesis is suggested for the two drugs. Drug treatment reduced the synthesis of heat-shock proteins (HSPs) as studied by one dimensional gel electrophoresis by 80-98% relative to 37 degrees C untreated controls. Synthesis of large molecules (greater than 30 kDa) was preferentially inhibited by PUR but not by CHM. Also for CHM, but not for PUR treatment, a 42 kDa band appeared along with a great reduction in the 43 kDa actin band during CHM treatment at both 37 and 43 degrees C. Furthermore, during CHM or PUR treatment, incorporation of [35S]methionine into HSP families 70, 87, or 110 was not increased relative to incorporation into total protein. However, synthesis of the 70 kDa HSP family was selectively suppressed when cells were incubated at 37 degrees C after CHM treatment, but when cells were incubated at 37 degrees C after treatment at 43 degrees C with CHM, synthesis of the 70 kDa HSP family resumed. When cells were labeled for 3 days, there was no preferential accumulation or turnover of HSP families during heating with or without CHM. Therefore, heat protection caused by treatment with CHM or PUR apparently involves a common mode of action not associated with changes in either total levels or synthesis of HSP families during drug treatment before and during heating. The significance of the changes observed in the synthesis of the HSP 70 family after heat is unknown. As thermotolerance developed during 5 h at 42 degrees C without drugs, synthesis of HSP families 70, 87, and 110, as studied with one-dimensional gels, increased 1.4-fold relative to synthesis of total protein, but compared to HSP families in cells labeled for 5 h at 37 degrees C incorporation was reduced by 40%. The increase of unique HSPs, if studied with two-dimensional gels, would probably be much greater.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3628715 TI - Metallothionein induction as a potent means of radiation protection in mice. AB - A striking resistance to lethal damage from a single dose of 6-8 Gy of X rays has been found in mice which had received various pretreatments to induce metallothionein (MT) synthesis in the liver prior to irradiation. Mice were injected with manganese (10 mg Mn/kg) or cadmium (3 mg Cd/kg) salt subcutaneously, or a patch of dorsal skin (2 X 2 cm2) was excised 1 or 2 days prior to irradiation. The increased tolerance of these mice to radiation was established by a marked decrease of mortality rate, an increase of mean survival time, a reduction of weight loss, and a smaller decrease in the number of leukocytes as compared with the control group. The LD50/30 for control mice was 6.3 Gy, while the corresponding values for the groups pretreated with Mn, Cd, and skin excision were 7.5, 7.7, and 7.9 Gy, respectively. The normal level of MT in mouse liver was approximately 25 micrograms/g tissue. This level increased 2.5- to 3-fold 24 h after 6.3 Gy irradiation. The MT levels of mice pretreated with Cd, Mn, and skin excision were increased 8-, 5-, and 7-fold, respectively, prior to irradiation as compared with the preirradiation control. These results indicate that the induction of MT in mouse liver is a significant factor in the mechanism of protection against radiation. PMID- 3628716 TI - The effects of ionizing radiation on the pulmonary vasculature of intact rats and isolated pulmonary endothelium. AB - We studied the effects of ionizing radiation on the morphology of the pulmonary circulation using an in vivo rat model and an in vitro pulmonary artery endothelial cell model. Gamma radiation was given as either an acute (30 Gy) or fractionated (5 X 6 Gy) dose to one hemithorax of rats. An acute 30-Gy dose delivered resulted in a 70% decrease in pulmonary arterial perfusion, using technetium-99m microaggregated albumin (99mTc-MAA), in the irradiated lung by 2-3 weeks after irradiation. Pulmonary microradiographs, using a barium sulfate perfusion method, obtained 2-3 weeks after irradiation demonstrated widespread loss of capillary filling and segmentation of the vessels. Histologic examination demonstrated intact capillaries, suggesting that the alterations in pulmonary perfusion were at the precapillary level. Similar abnormalities in lung perfusion and morphology were found after delivery of fractionated doses of radiation, but the onset of the changes was delayed, occurring 4-6 weeks postirradiation. Using cultured pulmonary endothelial cell monolayers, cell sloughing and retraction from the surface substrate were observed within 24 h after in vitro delivery of 30 Gy. Similar findings occurred in monolayers given fractionated doses (5 X 6 Gy) of radiation 2-3 days after the final dose. The in vivo animal and in vitro endothelial cell models offer a useful means of examining the morphologic alterations involved in radiation lung vascular damage. PMID- 3628717 TI - Characterization of radiolabeled fluoromisonidazole as a probe for hypoxic cells. AB - Radiolabeled fluoromisonidazole has been characterized as a probe for hypoxic cells in vitro and in vivo. The uptake and retention of [3H]fluoromisonidazole and [3H]misonidazole were compared in V-79 cell monolayers and spheroids by varying incubation time and O2 levels in contact with the medium. The two labeled drugs were retained similarly in cell populations isolated from different depths in spheroids, and the amount of each drug bound in cells at the spheroid periphery increased with decreasing O2 level. The labeling patterns in autoradiographs were similar for spheroids incubated with the two labeled drugs, with most silver grains located over a zone of viable and presumed hypoxic cells intermediate between the necrotic center and the periphery of the spheroid. Biodistribution of the two tritiated drugs was compared in C3H mice bearing KHT tumors with 15% radiobiologically hypoxic cells. Tumor:blood and tumor:muscle ratios greater than 5.0 were achieved in mice sacrificed 4 h after the last of three injections of 5 or 20 mumol/kg of [3H]fluoromisonidazole. These ratios are compatible with imaging and are higher than those obtained with 50 mumol/kg misonidazole in a similar administration protocol. TLC analysis of plasma from mice injected with [3H]fluoromisonidazole indicated that the drug was stable in vivo for up to 2 h and that the metabolites formed were too polar to be dehalogenation products. Fluoromisonidazole labeled with 18F at the end of the alkyl side chain would retain the label on metabolites that bind in hypoxic cells in vivo. Fluoromisonidazole binds stably in the same populations of hypoxic cells as does misonidazole, and we conclude that [18F]fluromisonidazole has potential use as a hypoxia imaging agent in vivo. PMID- 3628718 TI - Radiotoxicity of 125I in mammalian cells. AB - The radiotoxicity of 125I in Chinese hamster V79 lung fibroblasts has been studied following extracellular (Na125I), cytoplasmic [125I]iododihydrorhodamine (125I-DR), and nuclear (125IUdR) localization of the radionuclide. Exposure of the cells for 18 h to Na125I (less than or equal to 7.4 MBq/ml) had no effect on survival. A similar exposure to 125I-DR produced a survival curve with a distinct shoulder and with a mean lethal dose (D37) of 4.62 Gy to the nucleus. While this value compares well with the 5.80 Gy X-ray D37 dose, it is in contrast to the survival curve obtained with DNA-bound 125IUdR which is of the high LET type and has a D37 of 0.80 Gy to the nucleus. Furthermore, when the uptake of 125I into DNA is reduced by the addition of nonradioactive IUdR or TdR to the medium and the survival fraction is determined as a function of 125I contained in the DNA, a corresponding increase in survival is observed. This work demonstrates the relative inefficiency of the Auger electron emitter 125I when located in the cytoplasm or outside the cell. It indicates that a high dose deposited within the cytoplasm contributes minimally to radiation-induced cell death and that radiotoxicity depends not upon the specific activity of IUdR but upon the absolute amount of 125I that is associated with nuclear DNA. PMID- 3628719 TI - Initial slope of radiation survival curves is characteristic of the origin of primary and established cultures of human tumor cells and fibroblasts. AB - The published survival curves of 110 human tumor cell lines and 147 nontransformed human fibroblast strains have been reanalyzed using three different statistical methods: the single hit multitarget model, the linear quadratic model, and the mean inactivation dose. The 110 tumor cell lines were classified in two ways: (a) into three categories defined by clinical radiocurability criteria, and (b) into seven categories based on histopathology. The 147 fibroblast strains were divided into eight genetic groups. Differences in the radiosensitivities of both the tumor cell and fibroblast groups could be demonstrated only by parameters that describe the slopes of the initial part of the survival curves. The capacity of the survival level to identify significant differences between groups was dose dependent over the range 1 to 6 Gy. This relationship showed a bell-shaped curve with a maximum at 1.5 Gy for the tumor cell lines and 3 Gy for the fibroblasts. Values for intrinsic radiosensitivity for a number of groups of tumors have also been obtained by primary culture of tumor cells. These values are strictly comparable to those obtained by clonogenic methods. This confirms that intrinsic radiosensitivity is a determinant of the response of tumor cells to radiotherapy and suggests that tissue culture methods may be used as a predictive assay. PMID- 3628720 TI - Effect of gavaged chemical form of 241Am on its retention in mice. AB - The retention of 241Am in mice 48 h after administration by gavage is reported here. The 241Am was given to mice in the form of either 241Am nitrate or 241Am citrate. The 241Am was also injected into rats in the same form. The homogenized livers of those rats were subsequently administered by gavage to another group of mice. The retention of 241Am citrate was 1.5 X 10(-2)% of the original dose and was the highest among the compounds examined. The retention of biologically incorporated 241Am into the liver as 241Am nitrate and as 241Am citrate was 2.4 X 10(-3) and 2.6 X 10(-3)%, respectively, and was similar to the retention of 241Am nitrate, which was 2.8 X 10(-3)%. The ratio of the retention in the carcass to that in the liver for the 241Am citrate was lower than that of the 241Am nitrate and the biologically incorporated 241Am. This difference indicates that the distribution of 241Am in the animal body depends on the chemical form administered. The retention of liver-incorporated 241Am as citrate after autolysis of the liver is similar to that of fresh liver-incorporated 241Am citrate. PMID- 3628721 TI - Retinal dysplasia and progressive atrophy in dogs irradiated during ocular development. AB - Beagle dogs were given a single, whole-body gamma-radiation exposure at various stages during ocular development and were evaluated for the presence of ocular lesions. Dogs were exposed during middle or late pregnancy at 28 or 55 days postcoitus (dpc) or as neonates at 2 days postpartum (dpp). Mean whole-body and ocular doses ranged from 1.0 to 3.8 Gy. Dogs were sacrificed and ocular lesions were evaluated at 70 days, 2 years, or 4 years of age. Retinal dysplasias and atrophy were the most striking lesions related to radiation exposure. These lesions were bilateral and focal to diffuse in nature, and they increased in severity with increasing radiation dose. The stage of development at irradiation had a marked effect on the distribution of retinal lesions, with the most severe changes being present in that portion of the retina undergoing differentiation at the time of the insult. In dogs sacrificed at 70 days of age the lesions were primarily dysplasias consisting of ectopic nuclear aggregates in the photoreceptor layer, retinal folds, and retinal rosettes. With increasing age (up to 4 years), there appeared to be progression of the extent of the clinically evident lesions, and there was a change in the nature of the lesions from dysplasia to atrophy. This was accompanied by marked attenuation of the retinal vasculature. PMID- 3628722 TI - Analysis of the dose-response relationships following the irradiation of amino acids. AB - A comparison is made between results recently reported on the induction of free radicals in irradiated alanine and studies previously published on irradiated amino acids. It is shown that there is good qualitative agreement between the old and the new measurements although several quantitative inconsistencies are noted. A query is raised as to whether the new data can truly be interpreted in terms of the theory of track structure when some of the effects observed are not fully taken into account. PMID- 3628723 TI - [Pulsed radiolysis of aqueous solutions of serum albumin containing naphthoquinones]. AB - As was shown by the pulse radiolysis method the simultaneous presence of naphthoquinone and human serum albumin molecules in an aqueous solution leads to the adsorption of the former on the surface of the latter. It is suggested that in these conditions the protein tertiary structure changes. New conformation reduces the reactivity of albumin toward the hydrated electron. PMID- 3628724 TI - [Inhibition of cell proliferation in the thymus: possibility of detecting natural cell death within the organ and its contribution to the phenomenon of induced interphase cell death]. AB - Parallelism was noted between the suppression of proliferation and the amount of cells dying in mouse thymus after the effects inducing cell destruction. However, inhibition of DNA synthesis under the effect of nontoxic doses of arabinoside cytosine increased insignificantly the number of dying cells as compared to normal. This indicated the absence of the masking effect of reutilization of degradation products of dying cells, minor amounts of cells normally dying in the thymus, and their insignificant contribution to the induced cell death after the effects leading to inhibition of cell proliferation. PMID- 3628725 TI - [Degradation of chromatin in thymus lymphocytes during inhibition of repair of spontaneous DNA damage]. AB - Chromatin degradation and cell death were observed after 6-7 h incubation of mouse thymus lymphocytes with 1-beta-D-arabinofuranosylcytosine and hydroxyurea. The time dynamics of both processes was similar. In this case, just as after gamma-irradiation, nucleosomes and their oligomeres were the products of degradation. Puromycin and cycloheximide prevented the toxic action of DNA synthesis inhibitors on thymocytes. It is suggested that the accretion of unrepaired DNA damages to some critical level triggers the process of the internucleosome degradation of chromatin, i.e. implements the program of lymphocyte death. PMID- 3628726 TI - [Effectiveness of a fast neutron beam to induce DNA damage in Ehrlich ascites carcinoma cells irradiated in a aqueous phantom]. AB - The study of damages to DNA molecules of Ehrlich ascites tumor cells exposed in water phantom to fast neutron beam (mean energy of 6 MeV) showed that changes in the extent of DNA injury did not correlate with the absorbed dose distribution at the phantom depth of 8-12 cm, and also that the dose-response function in the phantom was different from that obtained upon irradiation of cells in the air. PMID- 3628727 TI - [Cytogenetic effect of low-level 60Co gamma-irradiation of cultured human lymphocytes in the G1 phase of the mitotic cycle]. AB - The dose-dependence of the chromosome aberration frequency in human lymphocytes in vitro exposed to 60Co-gamma-radiation at the G1 stage of the mitotic cycle has proved to be unlike that obtained upon exposure of cells at the G0 stage of the cycle. The data obtained are accounted for by partial activation of the repair system at the G1 stage which is attributed mainly to chromatin decondensation. PMID- 3628728 TI - [Repair of chromosome damage in human lymphocytes after fractionated irradiation with fast neutrons]. AB - The frequency of chromosome aberrations in nonstimulated lymphocytes of the peripheral human blood was shown to change after fractionated neutron irradiation of mean energy of 6.0 MeV. At a 2-hour interval between exposures, the number of aberrations exceeded, and at 5-6-hour interval was less than that induced by a single exposure at the same dose. PMID- 3628729 TI - [Quantitative characteristics of radiation injury of the spermatogenic epithelium and the rate of its recovery after exposure to fast neutrons and gamma radiation]. AB - The paper submits the results of studies on the kinetics of spermatogenous epithelium cell number after exposure to fast neutrons (60-300 cGy) and gamma radiation (200-600 cGy). It was shown that a relative decrease in the quantity of spermatocytes is determined by an exponential dose-response curve with D0 of 35 and 120 cGy for neutrons and gamma-radiation respectively. For spermatides and spermatozoa a single D0 value of 20 and 55 cGy was obtained for neutrons and gamma-radiation respectively. As the radiation dose increases the recovery process in the epithelium is substantially decelerated. The equation T1/2 = T1/2(0)e0.0009D well describes the dependence of the half-recovery period T1/2 upon the equivalent dose. PMID- 3628730 TI - [Shortening of the life span in an experiment with chronic external gamma irradiation. The structure of mortality]. AB - The paper submits the statistical analysis of data on the mortality structure obtained by the experiment with chronic external gamma-irradiation within a wide range of dose rates. The cumulative mortality rate was a function of time. The authors discuss whether the shortening of life span resulting from chronic exposure to gamma-radiation is or is not specific. PMID- 3628731 TI - [Shortening of the life span in an experiment with chronic external gamma irradiation. In defense of the aging hypothesis]. AB - Using Homperz's theory the authors quantitatively determined the mortality rate as one of the effects of chronic external irradiation. Two factors were found to be responsible for the mortality rate, they are, the intensity and time of chronic exposure. Premature ageing is discussed as a possible mechanism of life shortening. PMID- 3628732 TI - [Development of radiation injuries and recovery processes in the hematopoietic tissue of mice after repeated exposure to fast neutrons and gamma-irradiation]. AB - A study was made of the number of CFUs and karyocytes in thigh bone and the concentration of functional cells in the peripheral blood of mice subjected to fast neutron- and gamma-irradiation four times at a 60-day interval (210 cGy per fraction). The regenerating potential decreased and the half-recovery time T1/2 increased in the haemopoietic tissue as the number of fractions and total absorbed dose increased. The dependence of T1/2 on the equivalent radiation dose was as follows: T1/2 = T1/2(0)e0.0009D. PMID- 3628733 TI - [Radioprotective effectiveness of bone marrow exfusion in guinea pigs]. AB - In experiments on guinea pigs a pronounced radioprotective effectiveness of the procedure of bone marrow exfusion from shin-bone was demonstrated. The procedure was performed on animals narcotized by Nembutal 1-1.5 h before or 0.5-2 h after irradiation with doses ranging from midlethal to minimum absolutely lethal ones. The effectiveness of the procedure was associated with the season. PMID- 3628735 TI - [Radioprotective activity of aminoarylthiazoles and various mechanisms of action]. AB - The amino group is shown to be the reaction center that is primarily responsible for the radioprotective effect of the thiazoles under study. A phenyl residue also contributes to the radioprotective effect. The influence of thiazoles on DNA biosynthesis on radiosensitive tissues plays an important role in the biochemical mechanism of their radioprotective action. PMID- 3628734 TI - [Comparison of changes in succinate dehydrogenase activity in blood lymphocytes and modification of radiosensitivity by exogenous hypoxia]. AB - Radioprotective efficiency of gas hypoxic mixtures (GHM) containing 5-12% of oxygen and the rate of the reaction of succinate dehydrogenase (VSDG) activity in peripheral blood lymphocytes upon breathing GHM were comparatively studied in rats and dogs. VSDG was 4393.5 (%O2)-2.58 and 130.76 (%O2)-1.42 in dogs and rats respectively. Taking into account that DMF in rats is a function of oxygen concentration in the mixture one can obtain a formula for determining a dose modifying factor (DMF) as a function of the rate of SDG activity reaction. PMID- 3628736 TI - [Effect of ionizing radiation on the functional state of snail neurons. Phospholipid composition and levels of free fatty acids]. AB - A study was made of the effect of ionizing radiation on the phospholipid composition and the level of free fatty acids in nervous ganglia of edible snails (Helix pomatia). Ionizing radiation was shown to decrease the total content of phospholipids and to change certain fractions and accumulation of lysoforms. The increase in the free fatty acid content indicated an activation of endogenous phospholipase hydrolysis. Model experiments on treatment of nervous ganglia with phospholipase A2 demonstrated a similarity of radiation-induced changes in the phospholipid content. PMID- 3628737 TI - [Mechanism of changes in irradiated thymocytes detected by anilinonaphthalenesulfonate]. AB - In experiments on rat thymocytes obtained 15 min, 2 h and 4 h after irradiation of animals with the dose of 10 Gy it was found that 15 min and 4 h following irradiation changes occurred in their membranes increasing the lifetime of the excited state of anilinonaphthalene sulfonate and hydrofobicity and viscosity of its microenvironment. The indicated parameters did not vary from the controls 2 h following irradiation. The analysis of the data obtained prompted a suggestion that the observed changes were associated with the structural rearrangements in the plasma membrane rather than with its destruction. Model experiments on irradiated thymocyte suspensions showed that there was a correlation between changes in the cell membrane and meabolic processes. PMID- 3628738 TI - [Mechanism of reduced binding capacity of plasma corticosteroid-binding globulin in acute radiation sickness]. AB - Injection of various doses of thyroxin to rats was shown to increase a binding capacity of corticosteroid-binding globulin (CSG) of blood plasma after irradiation with doses of 650 and 800 R. The effect of thyroxin was most pronounced at a mid-lethal dose of 650 R and at the early stage of radiation sickness. PMID- 3628739 TI - [Combined effect of ionizing radiation and exertion on various indices of non specific resistance and immunity]. AB - The paper submits the results of studies on the combined effect of a single external (3 Gy) and chronic internal (90Sr, 11.1 X 10(5) Bq/kg/day) X-irradiation and physical exercises of different kind and intensity on some indices of nonspecific protection and immunity of albino mongrel rats and mice. Moderate physical exercises preceding irradiation diminish radiation injury to the parameters under study while intensive exercises and stress may aggravate the damages. PMID- 3628740 TI - [Evaluation of toxemia and peripheral blood indices in dogs irradiated with large doses]. AB - Toxemia and peripheral blood of dogs were studied after irradiation with doses of 2.9, 10, 40, and 80 Gy. Destructive changes were revealed in the blood part of which could not be counted by conventional methods. Toxemia was well pronounced as early as 3 h after irradiation with high doses. PMID- 3628741 TI - [Modifying effect of water-soluble analogs of quinoid radiotoxins on hematopoiesis in gamma-irradiated mice]. AB - It was established that quinoid products of tyrosine oxidation, analogues of natural radiotoxins, when used in the studied doses decreased the radiosensitivity of spleen stem cells and enhanced the restoration of bone marrow cellularity of mice exposed to sublethal gamma-radiation doses. PMID- 3628742 TI - [Carcinogenic effect of long-term fractionated gamma-irradiation]. AB - The incidence of malignant tumors increased and the average life decreased at remote times following long-term fractionated gamma-irradiation. Life shortening only exhibited a strict dependence on the cumulative radiation dose. PMID- 3628744 TI - Percutaneous nephrolithotomy of a staghorn calculus using an electrohydraulic lithotripter: a case study. PMID- 3628743 TI - [Effect of electromagnetic fields of UHF range on dopamine-dependent behavior of rabbits]. AB - SHF radiation of low intensity does not influence on a stereotyped behaviour of rabbits induced by a dopamine receptor stimulator, apomorphine. However, 10% of animals exhibited a marked decrease in the test-response after SHF-irradiation (16 Hz) which was perhaps associated with the increased individual sensitivity of some animals to SHF-radiation. PMID- 3628745 TI - The role of nuclear magnetic resonance imaging in the diagnosis of Arnold-Chiari malformation. AB - The diagnosis and demonstration of an Arnold-Chiari malformation (ACM), in particular the Type I ACM, presents a challenge to the clinician and diagnostic imaging specialist. Various imaging techniques have been used to demonstrate this condition in the past; as with other pathologies, the value of nuclear magnetic resonance imaging (NMRI) will naturally be compared with current techniques in the diagnosis of this abnormality. In this paper the authors give a brief history of the condition, an indication of current imaging techniques, and suggest an important role for NMRI in the demonstration of Arnold-Chiari malformations. PMID- 3628746 TI - The behavioural aspects of breast and cervical screening. AB - The clinical potential of any screening modality is unlikely to be realised unless a majority of the target group participates in the screening. Behavioural studies of screening observe a negative correlation with lower social class, income, education and with higher age. Education and persuasion programmes have increasingly been designed with these factors in mind. More recent studies, however, indicate that the way in which the screening service is made available to women affects their perceptions of it and, therefore, their participation at least as much as social factors; and properly designed presentation may even cancel out the effect of age and social class. This paper describes and discusses the studies which have led to the development of a consumer-oriented, service initiated (COSI) approach. PMID- 3628747 TI - Management budgeting for radiographers. PMID- 3628748 TI - Computed tomography of lymphomatous involvement of mesenteric nodes. PMID- 3628749 TI - Radiology in oral surgery--Part 2. PMID- 3628750 TI - The use of computers in mammography screening. AB - Computers should play an important role in mammography screening. This paper demonstrates the ability of a low-cost microcomputer-based data management system to speed up and make more efficient many aspects of both day-to-day and overall operation of a mammography screening practice. Specific computer procedures are described in sufficient detail to permit an experienced programmer to write the appropriate application software. PMID- 3628752 TI - Breast imaging. PMID- 3628751 TI - Mammography screening: successes and problems in implementing widespread use in the United States. AB - Deterrents to the use of screening mammography include perceived risks of radiation, perceived "unnecessary" biopsies and overdiagnosis, and high cost. In addition, physicians and patients have attitudinal barriers that do not reflect objective realities. Professional and public education efforts are needed to enable women and their physicians to develop a more sophisticated understanding of the usefulness of screening mammography and the role played by the radiologist. As part of their efforts to increase the implementation of screening mammography, the American College of Radiology has developed a Mammography Accreditation Program for radiological facilities and has produced a free Mammography Resource Kit for radiologists, while the American Cancer Society has undertaken the support of local and national campaigns to establish screening programs at reduced cost. Both organizations continue to strive in partnership to increase the acceptance of screening throughout the United States. PMID- 3628753 TI - Use of special mammographic views to maximize radiographic information. AB - Additional x-ray views can offer helpful information in both symptomatic patients (better evaluating the area of clinical abnormality) and screening patients (often preventing unnecessary biopsies). A wide variety of views have been devised to help solve specific problems raised by either suspected clinical or mammographic abnormalities. We have found those views described above to be most useful. PMID- 3628754 TI - Development of mammography and breast services in a community hospital. AB - The growth and development of mammography and related breast services in one community hospital are chronicled and described. With mammography providing the initial stimulus, substantial growth, diversification, and sophistication in diagnosis and treatment of breast disease have developed. The achievement of a cooperative and mutually supportive relationship among radiologists, pathologists, and surgeons committed to the goal of early detection of potentially curable breast cancer has succeeded in identifying increasing numbers of such lesions. The more frequent employment of breast-sparing surgical procedures and the encouraging survival rates in patients detected and treated for these early lesions represents an important contribution to the care of these women. Improvement in the detection of early breast cancer can be achieved by community radiologists, whether in private hospitals or office-based practices. PMID- 3628755 TI - Evaluating the success of mammography at the local level: how to conduct an audit of your practice. AB - Mammography is a single radiologic skill with a single goal, detection of a single disease, breast cancer. Periodic self-assessment of mammography interpretations strengthens patient care through allowing comparison with past performances and current national standards and enhancing mammographers' skills through review of proven cases. This article emphasizes five useful audit measurements for the success of a mammography program. PMID- 3628756 TI - Urokinase versus streptokinase in local thrombolysis. AB - In a retrospective analysis, the efficacy of lysis, the degree of systemic thrombolytic effect, and the rate of complications during local thrombolytic therapy with either streptokinase (SK) or urokinase (UK) were compared in 47 patients. There were 24 infusions of each agent; one patient in the UK group received two infusions. The overall efficacy of lysis was better in the UK treated group (80% vs. 63%). The UK group had a lower frequency of systemic thrombolytic effect and of bleeding complications. SK antibody titers were measured in all patients who received infusions. Patients with high titers who were treated with SK responded poorly (20% lysis); patients with low titers responded at a rate equal to that of UK-treated patients. Three patients with high titers of SK antibodies did not respond to SK, but subsequent successful lysis did occur with UK. In conclusion, UK is believed to be preferable to SK for local thrombolytic therapy due to increased efficacy of lysis and decreased rate of systemic fibrinolytic effect and bleeding complications. PMID- 3628757 TI - Suspected intracardiac masses: evaluation with MR imaging. AB - Electrocardiographically gated magnetic resonance (MR) imaging was used to examine 34 patients believed or known to have intracardiac masses on the basis of results from two-dimensional (2D) echocardiography. Cardiac masses were confirmed in 15 patients on the basis of MR imaging results. In seven patients, MR imaging confirmed the absence of an intracardiac mass but demonstrated an anatomic variant or other abnormality that had been interpreted as a possible mass on the echocardiogram. In 12 patients, MR demonstrated neither an intracardiac mass nor an anatomic variant that was likely to have been misinterpreted as a mass on the echocardiogram. Clinical follow-up in these patients at 10 months to 2 years and repeat 2D echocardiography have not indicated a definite mass. In six patients tissue characterization of the mass with MR imaging added some specificity to the MR diagnosis. Thus, MR imaging can be used to verify intracardiac masses found on 2D echocardiograms and to exclude a mass as the cause of equivocal findings on 2D echocardiography. PMID- 3628758 TI - Intrathoracic aspergilloma: role of CT in diagnosis and treatment. AB - The authors describe the computed tomographic (CT) appearances of aspergilloma in 26 patients. With narrow (3-mm) sections, a bone algorithm, and wide window settings, CT scans enabled accurate identification of both the forming aspergilloma as well as the mature fungus ball in 25 cases. The diagnostic accuracy of CT was confirmed histologically in nine cases. The radiologic concept of the aspergilloma as a solid mass partially surrounded by a crescent of air is no longer tenable as the only definite criterion for diagnosis. In cases in which this classic appearance is seen on CT scans, mobility is easily demonstrated with use of prone and supine positions. In other cases, the aspergilloma appears as an irregular spongework containing air spaces and filling the cavity, obliterating the air crescent sign. The fungus ball is therefore fixed and immobile. Forming aspergillomas can also be identified by the fungal strands that fall into the cavity lumen, trapping air and initiating the sponge-work appearance. The CT appearance in patients with positive precipitins is characteristic and allows earlier diagnosis than does conventional tomography. PMID- 3628759 TI - Episternal ossicles. AB - Eight hundred computed tomographic (CT) scans of the chest were reviewed, and 12 cases of episternal ossicles were found. Eight persons had paired ossicles, and four had unilateral ossicles. The overall frequency in the study population was 1.5% (men, 1.4%; women, 1.7%). Episternal ossicles represent a normal variant and should be distinguished from fracture fragments, sequestra, foreign bodies, calcified lymph nodes, or vascular calcifications. PMID- 3628760 TI - Rheumatoid arthritis of the cervical spine: early and progressive radiographic features. AB - One hundred thirty-three cervical spine radiographs of 50 patients with rheumatoid arthritis were examined. The patients were a representative random sample chosen from among 675 patients followed up for more than 10 years. The frequency of occurrence for each radiographic finding was correlated with the duration of rheumatoid arthritis. The six radiographic findings that occurred in 30% or more of patients with a disease duration of less than 10 years included odontoid erosions, subaxial subluxation, superficial apophyseal joint erosions, apophyseal joint sclerosis at levels C-4 through C-7, and diskovertebral joint narrowing and osteophytosis at C-4 through C-7. Familiarity with these early findings in the cervical spine may be helpful in both diagnosing and managing rheumatoid arthritis. Subaxial subluxation and superficial apophyseal joint erosions did not progressively increase in frequency with increasing duration of disease, but the other four features did. Other features that were uncommon in early disease became significantly more frequent in later decades. PMID- 3628761 TI - Juvenile rheumatoid arthritis: assessment with MR imaging. AB - Thirty-three joints of the appendicular skeleton in 15 children with juvenile rheumatoid arthritis were examined with magnetic resonance (MR) imaging to determine if it could demonstrate synovial hypertrophy and status of the articular cartilage. Presumed synovial hypertrophy was seen in 13 joints as masses of varying sizes of low to intermediate signal intensity on T1- and T2 weighted images; sometimes foci of increased signal intensity, most likely due to fluid or inflammation, were seen on T2-weighted images. Probable abnormal articular cartilage was detected in ten joints, and MR imaging also demonstrated epiphyseal overgrowth, bone erosions, joint effusions, and joint space narrowing. Because MR imaging appears to provide an objective method of evaluating both synovial hypertrophy and status of articular cartilage, it may prove to be useful in monitoring progression of juvenile rheumatoid arthritis and response to therapy. PMID- 3628762 TI - Rheumatoid arthritis: MR imaging manifestations. AB - Radiologic assessment of the stage and treatment response of rheumatoid arthritis (RA) is based on the presence of bone erosions, joint-space narrowing, and osteoporosis. Most radiologic methods for staging RA lack interobserver correlation and are time consuming. Magnetic resonance (MR) imaging provides excellent depiction of soft-tissue abnormalities of the joints affected by RA, which allows detection of early changes. Nineteen joints of 17 patients with RA were studied with surface-coil MR imaging. Measurable abnormalities demonstrated by MR imaging but not clearly seen on plain radiographs included bone erosions, joint effusion, synovial sheath effusion, and cartilage irregularity and thinning. Seven patients of this group underwent MR imaging before and after 6 months of gold therapy. Four patients had significant interval changes on MR images that were not seen on plain radiographs. MR imaging may become a sensitive and objective method for quantitative assessment of the joint changes of RA. PMID- 3628763 TI - Cervical spine involvement in rheumatoid arthritis: MR imaging. AB - Magnetic resonance (MR) imaging of the cervical spine was employed in 18 patients with rheumatoid arthritis and suspected cervical involvement. Fifteen patients had symptoms referable to the cervical spine, and seven had neurologic deficits. In three patients who were asymptomatic with regard to the neck, MR imaging was performed because of abnormal cervical radiographs. Cervical radiographs were available for all patients; bone erosion was evident in 14, subluxation in 17, and no abnormalities in one. MR imaging demonstrated indentation or abnormal signal in the caudal brain stem and/or cervical spinal cord in ten patients, including the seven with related neurologic deficits; discrete indentation or distortion of the dura without visible morphologic effect on the underlying neuraxis was observed in five other patients. In all patients with neurologic symptoms, cord or brain-stem abnormalities were seen on MR images. MR imaging therefore appears to provide valuable information regarding the status of the spinal cord and dura in patients with rheumatoid arthritis. PMID- 3628764 TI - Vertebral hemangiomas: MR imaging. AB - Vertebral hemangiomas, unlike most bone lesions, show increased signal on T1- and T2-weighted magnetic resonance (MR) images. To define the basis for these signal characteristics, a retrospective review was done of the MR imaging findings in ten vertebral hemangiomas (eight patients), and these were correlated with the findings from plain radiographic, computed tomographic (CT), and histopathologic studies. MR images showed mottled increased signal in T1- and T2-weighted images from the osseous portions of the tumors. In three patients, the extraosseous components failed to show increased signal on T1-weighted images. Chemical shift images and histologic studies demonstrated that adipose tissue caused the increased signal on T1-weighted images. The extraosseous components of the tumor contained little, if any, adipose tissue, which explained the lack of high intensity signal on T1-weighted images. These signal changes appear to make a specific constellation of findings for the diagnosis of vertebral hemangioma with MR imaging. PMID- 3628765 TI - Double cortical line in the acetabular roof: a sign of disuse osteoporosis. AB - A double cortical line (DCL) was observed in the acetabular roofs during interpretation of the abdominal radiographs and intravenous pyelograms of patients with paraplegia and quadriplegia. This was investigated by review of the radiographs of 40 paralyzed patients, by postmortem radiographic and histologic examination of the acetabula of one quadriplegic and three nonparalyzed patients, and by observation of the subchondral cortices of various long bones on radiographs of paralyzed and nonparalyzed patients. The DCL resulted from intracortical bone loss caused by severe disuse osteoporosis. It was most prominent in the acetabulum and most frequently found in patients with paraplegia or quadriplegia. The DCL also occurred in other bones, however, and in other conditions associated with severe disuse osteoporosis. PMID- 3628766 TI - The normal temporomandibular joint: MR and arthrographic correlation. AB - Magnetic resonance (MR) images of 28 normal temporomandibular joints were obtained and correlated with respective arthrograms. There was a spectrum in the configuration and thickness of normal articular menisci. The anterior band varied from thin with a flat inferior margin to thick with a bulbous, convex inferior margin. The anatomic configuration of the meniscus as seen with MR correlated directly with normal variations of the anterior recess seen with arthrography. Concavity of the superior aspect of the anterior recess as seen on arthrography was caused by a thick, bulbous anterior band of the meniscus, whereas a flat anterior recess resulted from a thin anterior band without a convex inferior margin. This study emphasizes that the appearance of a concave anterior recess on static arthrograms is not necessarily due to a displaced meniscus. PMID- 3628767 TI - Failed temporomandibular joint prostheses: MR imaging. AB - Magnetic resonance (MR) imaging with surface coils was performed on 43 temporomandibular joints with disk prostheses in 28 patients who had pain, dysfunction, or both after implantation of the prostheses. Fracture was diagnosed prospectively as a discontinuity of the prosthesis on the MR examination; the sensitivity and specificity of MR imaging for this diagnosis was determined on the basis of these studies. All patients underwent surgery, after which the final diagnosis was made. MR imaging was found to have a sensitivity of 0.81 and a specificity of 0.91. Other MR findings included an abnormal amount of soft tissue surrounding the disk, thinning of the disk, osteophytes, and erosion of the condyle. An as yet unexplained artifact was frequently seen and obscured the prostheses in four of the six false-negative studies. The one false-positive case resulted from the interpretation of a markedly thinned but intact region of the prosthesis as a fracture. PMID- 3628768 TI - Major salivary gland masses: comparison of MR imaging and CT. AB - Computed tomography (CT) and magnetic resonance (MR) imaging studies were done prospectively in 21 unselected patients in whom 28 major salivary glands had pathologic changes. Blinded and final readings were used to establish the relationship of the lesion to the plane of the facial nerve (parotid masses), whether the lesion was intrinsic to the gland, and whether the lesion was aggressive. In the blinded reading, CT was superior to MR imaging in eight instances; in the final reading, however, with clinical information available, CT was superior in four cases of inflammatory salivary gland "masses." CT and MR imaging provided the same diagnostic information in all cases of salivary gland neoplasms. T1- and T2-weighted images proved of equal value in detection of salivary gland lesions, and use of both provided no additional specificity. In most cases, T1-weighted images alone provided the information necessary for surgical management. MR imaging is a reasonable first choice if a neoplasm is likely; the potential for improved tissue contrast at the margins of a tumor may be particularly useful. If a mass may be of inflammatory origin, contrast material-enhanced CT is a more reasonable first choice. PMID- 3628769 TI - Cine CT of the mediastinum in pediatric patients. AB - Cine computed tomographic (CT) examinations of the mediastinum were performed in 83 pediatric patients. Lesions imaged include neoplastic, inflammatory, and vascular abnormalities. The 50-msec scan time of cine CT provides for superb depiction of the heart and airway, minimizes motion artifact, allows examinations to be done with little or no sedation, and permits optimal opacification of all vascular structures with as little as 0.5 mL of intravenously administered contrast medium per kg of body weight. Scanning time for an examination in which images in 20 sections are obtained is approximately 10 seconds. Radiation dose is significantly lower than that in comparable CT or plain radiographic studies. Preliminary experience shows cine CT to be an excellent imaging modality for the examination of the mediastinum in children. PMID- 3628770 TI - Nasofrontal duct: CT in frontal sinus trauma. AB - Radiologic evaluation of frontal sinus fractures is instrumental in determining the need for surgery. Computed tomography (CT) is an excellent modality for evaluation of frontal sinus trauma, particularly for anterior and posterior wall fractures. However, fractures of the nasofrontal duct are more difficult to delineate, and judgments about operating for this problem are often made on less than concrete evidence of duct trauma. To evaluate the usefulness of CT in identifying nasofrontal duct trauma, a two-part study was done. First, CT was performed on cadavers to study the anatomic relationship of the nasofrontal duct to midface anatomy. Then, a retrospective study was performed in 19 patients with suspected frontal sinus fractures who underwent frontal sinus surgery. Findings at surgery were compared with preoperative evaluation with CT. Correlations were identified and criteria developed that can be used to identify patients needing surgical intervention in frontal sinus trauma. These criteria include findings of either a fracture involving the base of the frontal sinus or a fracture of the anterior ethmoid complex, or both. PMID- 3628771 TI - Subacute intracranial hemorrhage: contribution of spin density to appearance on spin-echo MR images. AB - The T2 and pseudodensity (proportional to proton density) of intracranial hemorrhages and normal white matter were calculated. The mean T2 (+/- standard deviation) was 120 +/- 62 for hemorrhage and 61 +/- 11 for white matter. Pseudodensity values were normalized to a white matter value of 1, and the value for hemorrhage was 1.56 +/- 0.28. These values were used to determine which components of hemorrhage-white matter contrast are due to T1, T2, and density. The results indicate that on spin-echo (SE) images obtained with a long repetition time (TR)/short echo time (TE) (2,500/0-20 [TR msec/TE msec]), the contrast is mainly due to density differences, with a modest T2 contribution on 20-msec-TE images and nearly no T1 component. At 600/0-20, the contrast continues to be largely determined by density differences, again with a modest T2 component on 20-msec-TE images. If the T1 of hemorrhage is extremely short, the T1 component of contrast on 600/0-20 SE images will be somewhat greater than the density component. Because contrast on short TR/short TE images may be largely or entirely determined by pseudodensity or T2, it is inaccurate to refer to 600/20 images as "T1-weighted". The assumption that high signal intensity at this sequence implies a "short T1" will lead to misleading conclusions. PMID- 3628772 TI - Hemorrhagic and nonhemorrhagic brain lesions: evaluation with 0.35-T fast MR imaging. AB - Two fast magnetic resonance (MR) imaging techniques, advanced Fourier and partial flip imaging, were used at 0.35 T to examine 21 patients with suspected intracranial lesions; the results were quantitatively compared with a conventional spin-echo study. Both of the fast MR techniques yielded a fourfold reduction in imaging time per section. The advanced Fourier sequence showed contrast that was identical to the conventional spin-echo study with signal-to noise ratios of 58% and 57% for the first and second echoes, respectively. The partial-flip sequence showed a contrast of 109% and 57% for lesions versus substantia alba, and 107% and 78% for substantia grisea versus substantia alba relative to the first and second echoes of the conventional spin-echo study. The partial-flip sequence was particularly sensitive to magnetic susceptibility; this produced artifacts that may undermine the usefulness of partial flip for routine screening in certain parts of the brain. However, this susceptibility significantly improved the detection of intracranial hemorrhage when compared with the spin-echo sequence, particularly when combined with phase mapping of the partial-flip study. PMID- 3628773 TI - Intracerebral malignant melanoma: high-field-strength MR imaging. AB - Thirteen patients with intracerebral malignant melanoma underwent high-field strength (1.5-T) magnetic resonance (MR) imaging. The images were correlated with computed tomography (CT) scans (n = 7) and surgical specimens (n = 7). Most commonly, these lesions were hyperintense to normal white matter on T1-weighted images and hypointense to normal white matter on T2-weighted images. Hemorrhage in the lesion may have a greater influence on this unique appearance than does melanin. The increased tissue sensitivity of MR imaging allowed for 22% greater lesion detection than did CT. PMID- 3628774 TI - MR image-guided P-31 MR spectroscopy in the evaluation of brain tumor treatment. AB - Magnetic resonance (MR) image-guided phosphorus-31 MR spectra have been obtained from in situ brain tumors. The volumes of interest used for spectroscopy were defined from hydrogen-1 MR images. Direct comparisons were possible between normal and abnormal tissue, since P-31 spectra from different parts of the brain could be measured in a single examination. P-31 MR spectra of the tumors often showed abnormally high concentrations of phosphomonoesters and low concentrations of phosphocreatines. The effects of pharmacotherapy and radiation therapy were studied in three patients; in each of these cases changes were observed in the P 31 spectra of the tumor. The correlation between MR imaging and P-31 MR spectroscopy was essential for the interpretations of these results. PMID- 3628775 TI - Lumbar disk herniation: diagnosis with CT or myelography. AB - The value of computed tomography (CT) and myelography as single investigations in the diagnostic evaluation of patients with radiating leg pain probably due to lumbar disk herniation (LDH) has been adequately demonstrated. However, the extent to which CT can replace myelography and the conditions in which the examinations should be combined and in which order are still uncertain. Results of CT scans and myelograms from 461 patients with symptoms of lumbar root compression, probably due to LDH, were evaluated and compared with surgical results, if available. The sensitivity of myelography exceeded that of CT (82% vs. 73%), but its specificity was lower (67% vs. 77%). The positive predictive value of myelography only slightly differed from that of CT (93% vs. 94%). These results were used to establish a sequential diagnostic workup for patients with radiating leg pain. If, in this population with a high prior probability for surgery, CT had been the investigation of first choice in patients suspected of having LDH, the number of myelographic procedures performed could have been reduced by two-thirds. PMID- 3628776 TI - MR vascular imaging with a fast gradient refocusing pulse sequence and reformatted images from transaxial sections. AB - The authors present a method for obtaining magnetic resonance (MR) images of intra- and extracranial vessels from thin contiguous transaxial sections. A section-selective gradient refocusing pulse sequence with a short repetition time caused flow-related enhancement from spins that flowed perpendicular to the transaxial sections. The signal was further enhanced by means of flow compensation gradients to rephase any phase shifts resulting from moving spins in the presence of the imaging gradients. Coronal and sagittal sections, reformatted from multiple transaxial sections, are shown to have excellent vessel contrast without the use of contrast material. These images were obtained in 12 minutes of acquisition time from as many as 60 sections of 3-mm thickness. Such a technique shows significant promise for MR angiography. PMID- 3628777 TI - Separation of lipid and water MR imaging signals by chopper averaging in the time domain. AB - A convenient alternative to Dixon's water/lipid imaging technique is proposed. The sequence exploits the automatic paired averaging capability that is used in commercial magnetic resonance imaging systems for data averaging to achieve lipid suppression. This can be easily implemented via a minor modification to an existing partial saturation sequence. This approach provides linear suppression of lipid signals that is independent of the relative abundance of water and lipid contributions, unlike the characteristics of the original Dixon sequence. The proposed sequence can be tuned before the imaging procedure to ensure optimum timing and frequency adjustment. PMID- 3628778 TI - Depth-focused radio frequency coils for MR imaging. AB - Surface coils improve signal-to-noise ratios by the simple expedient of reducing field of view. The uniformity of response of these coils is poor, since signal reception is weighted toward the surface of the object, which generally is of least interest. Furthermore, whole-section transmitter coils excite the subject uniformly, so that weak signals are detected from far regions. A dual-coil arrangement permits avoidance of these problems by combining the nonuniform excitation and reception characteristics of two surface coils. PMID- 3628779 TI - Reduction of radiation scatter with a multiple pencil-beam imaging device. AB - A prototype device consisting of a focused array of several scanning collimator plates that produce multiple pencil beams has been constructed for radiographic imaging. Under normal imaging conditions, the scatter-to-primary ratio resulting from this device is less than 10%. High-contrast radiographs can be produced without increasing patient radiation dose. PMID- 3628780 TI - Focal-spot measurement: comparison of slit, pinhole, and star resolution pattern techniques. AB - The National Electrical Manufacturers Association (NEMA) has established a new standard for x-ray tube focal-spot measurements using a focal-spot camera with a slit instead of a pinhole. Measurements from the slit focal-spot camera are compared and star resolution pattern techniques for 50 focal spots. In addition, measurements were made using direct-exposure film as required by the NEMA standard and an extremity screen-film system, which minimizes x-ray tube loading. The slit, pinhole, and star resolution techniques provided similar results that were within the accuracy required for clinical focal-spot measurements. The focal spot measurements were also similar when a direct-exposure film or an extremity screen-film system was used. A description of the use of the slit focal-spot camera and difficulties with implementing the new NEMA standards in the clinical setting are also presented. PMID- 3628781 TI - Brachytherapy implants with differently spaced Ir-192 seeds: a dosimetric study. AB - Brachytherapy implantations traditionally have been carried out with continuous line sources of radium. With the popularity of afterloading implantations, iridium-192 seeds in plastic ribbons have replaced radium in the United States, although continuous sources, such as iridium wires, are widely used in Europe. The authors analyzed the impact of the use of noncontinuous sources in brachytherapy implants. Computer simulations and film dosimetry of a two-planar implant were carried out. Seeds at standard spacing (1 seed/cm), nonstandard spacing (1 seed/6mm), and continuously arranged seeds were studied. PMID- 3628782 TI - Ovarian carcinoma: adjuvant treatment with P-32. AB - Twenty-eight patients with ovarian carcinoma received 555 MBq of labeled chromic phosphate (P-32) intraperitoneally. Indications for treatment included a high grade tumor, extracapsular involvement, positive cytologic findings, or residual tumor. Fifteen patients (group 1) had stage I, II, or III completely resected tumor; 13 patients (group 2) had microscopic or less than 3-mm lesions at second look laparotomy following combination chemotherapy. A major complication occurred in one patient; two patients had minor complications. Overall, 24 of 28 patients (85.7%) were alive at 11-77 months; 23 (82.1%) had no evidence of tumor. Fifteen of 15 (100%) group 1 patients and eight of 13 (61.5%) group 2 patients did not have tumor relapse after 30 months and 28 1/2 months, respectively. P-32 was found to be an effective adjuvant treatment in a select group of patients with ovarian carcinoma who were at high risk for intraabdominal recurrence. PMID- 3628784 TI - A lower-lobe-seeking pulmonary artery catheter. AB - The Grollman pulmonary artery catheter was modified by turning the pigtail downward to facilitate lower lobar catheterization with the femoral approach. The advantage of this tip configuration was obvious in the 30 cases in which it was attempted. The superiority of this catheter in traversing the tricuspid valve and in entering the right or left pulmonary artery with equal ease was also noted. PMID- 3628783 TI - Hepatic embolization with an open-ended guide wire. AB - Experience in four patients indicates the recently developed open-ended guide wire with the steerable mandril is invaluable in the catheterization of tortuous vessels and can be used without a catheter in the embolization of hepatic arteries. A much more dilute suspension of polyvinyl alcohol foam powder was found to be necessary with this wire so that the wire did not become occluded. A suspension of 0.6 mg polyvinyl alcohol foam powder per milliliter of normal saline was found to be optimum. PMID- 3628785 TI - Rights, roles, and relationships in radiology. PMID- 3628786 TI - Pharmacologic agents in gastrointestinal radiology. PMID- 3628787 TI - Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women. PMID- 3628788 TI - Hemimegalencephaly: MR imaging in five children. AB - Hemimegalencephaly is a rare brain malformation characterized by cerebral asymmetry and cortical dysplasia. Infants with the condition present with early seizures and severe encephalopathy. Five patients were studied with computed tomography and magnetic resonance (MR) imaging. MR imaging was the most efficient diagnostic method for this rare entity. It demonstrated brain hemispheric hypertrophy with lateral ventricle dilatation, abnormal gyral pattern, and a thick cortex on the enlarged side. The images correlate well with the known pathologic data. PMID- 3628789 TI - Stab wounds to the extremities: indications for angiography. PMID- 3628790 TI - Radiologically guided balloon dilation of gastrointestinal strictures. Part I. Technique and factors influencing procedural success. AB - Radiologically guided balloon catheters were used to dilate 94 gastrointestinal strictures in 92 patients over a 6-year period. Fifty strictures were esophageal and 44 nonesophageal (22 gastroenterostomies, 11 antral-pyloric strictures, four colorectal strictures, four enteroenterostomies, and three miscellaneous strictures). Factors influencing the success of stricture intubation included patient age, stricture location (esophageal vs. nonesophageal and proximal vs. distal esophageal), and association with a surgical anastomosis. Malignancy was associated with greater postdilation irregularity and a smaller increase in stricture diameter, as measured radiographically. Procedural failures occurred in 8% of cases (2% of esophageal and 30% of nonesophageal lesions). Two small, asymptomatic mucosal tears were seen after dilation (one esophageal and one colonic); no other procedural complications occurred. Following successful dilation, 16 patients (17%; six with esophageal and ten with non-esophageal strictures) had recurrence of symptoms during short-term (30-day) follow-up. PMID- 3628791 TI - Radiologically guided balloon dilation of gastrointestinal strictures. Part II. Results of long-term follow-up. AB - Balloon dilation catheters were used to treat 94 gastrointestinal strictures in 92 patients over a 6-year period. Long-term follow-up data were obtained for 80 of these patients, with a mean follow-up period of 389 days. Overall, of the patients who underwent a successful dilation procedure, 83% remained symptom free after 1 year, and 69% after 2 years. The location of the stricture did not significantly influence the long-term outcome, nor did procedure characteristics, aside from primary technical failure. Both patients with malignant strictures and those whose strictures were associated with an anastomosis were more likely than other patients to have recurrent symptoms. PMID- 3628792 TI - Esophageal anastomotic leaks: preliminary results of treatment with balloon dilation. AB - Disruption of a cervical esophagogastric or esophagocolonic anastomosis shortly after surgery is a common complication, and fistula drainage from the leaking anastomosis may be prolonged. Narrowing of the anastomosis apparently contributes to the development and maintenance of the fistula. Fluoroscopically guided balloon dilation of anastomotic strictures was performed in three patients with anastomotic leaks. Preliminary results suggest that the procedure is safe and promotes healing of the fistula. PMID- 3628793 TI - Malignant melanoma: correlating abdominal and pelvic CT with clinical staging. AB - Two hundred two patients with malignant melanoma underwent computed tomography (CT) scanning of the abdomen and pelvis. The frequency of metastases in the abdomen and pelvis was correlated with the site, level, and thickness of the primary tumor. The sites of the primary tumors were the trunk (70 patients), the lower extremities (37 patients), the upper extremities (33 patients), the head and neck (29 patients), the eye (nine patients), and the genitourinary tract (six patients). In 18 patients, the primary site could not be identified. In 96 patients, the level and thickness of the primary tumor, based on Clark and Breslow classifications, were correlated with the presence and extent of metastases. CT showed metastases in 122 patients (60%). The head and neck were the most common primary sites associated with metastases (79%), followed by the eye (77%) and genitourinary tract (67%). Thick lesions had the highest frequency of metastases (84%), compared with intermediate (50%) and thin (46%) lesions. Tumors classified as Clark level V had the highest frequency of metastases (87%). PMID- 3628794 TI - Pheochromocytoma and paraganglioma: comparison of MR imaging with CT and I-131 MIBG scintigraphy. AB - To ascertain the magnetic resonance (MR) imaging characteristics of pheochromocytomas and paragangliomas and to compare MR with computed tomography (CT) and iodine-131 metaiodobenzylguanidine (I-131 MIBG), 19 patients (18 with pheochromocytomas, one with a paraganglioma) were studied. The 18 patients with pheochromocytomas had had positive findings with I-131 MIBG scintigraphy. Abdominal pheochromocytomas were generally hypointense compared with normal liver on T1-weighted MR images and extremely hyperintense on T2-weighted MR images. MR imaging was preferable to CT in the evaluation of primary pheochromocytomas due to superior tissue characterization, particularly in the patient with hypertension and borderline catecholamine levels. For patients with recurrent or metastatic disease, the data suggest that I-131 MIBG scintigraphy is the examination of choice. PMID- 3628795 TI - Breast cancer detection: one versus two views. AB - Mammographic examinations of 169 patients with 172 biopsy-proved carcinomas, and of 194 healthy subjects, were interpreted independently and retrospectively by three experienced mammographers, initially as single-view oblique examinations and 6 months later as two-view oblique-cephalocaudal examinations. For the single view examinations of the cancer patients, 67% of the cancers were correctly recommended for biopsy, additional views were requested for 23%, and a "negative" interpretation was made for 10%. For the single-view examinations of healthy subjects, biopsy was recommended for 7% and additional views were recommended for 32%. For the two-view examinations of women with cancer, 80% of the cancers were correctly recommended for biopsy, additional views were requested for 4%, and a "negative" interpretation was made for 16%. For two-view examinations of healthy subjects, biopsy was recommended for 7% and additional views were requested for only 5%. The authors conclude that single-view screening should not be performed, because it would lead to an excessive number of "call-back" examinations of healthy patients, producing additional cost and anxiety that would outweigh any theoretical benefit. PMID- 3628797 TI - Intracranial tumors in infancy and childhood. Basic research, diagnosis and treatment. International Symposium on Pediatric Neurooncology (ISPNO). Toba, November 6-8, 1985. Proceedings. PMID- 3628796 TI - Nonpalpable lesions detected with mammography: review of 512 consecutive cases. AB - The authors reviewed 512 consecutive cases in which biopsies were performed on nonpalpable lesions of the breast detected with mammography from 1970 to 1985. The positive predictive value (PPV) of different radiologic patterns was determined. Biopsy is advised in the presence of patterns such as parenchymal distortion, opacities with undefined borders, strongly suspect microcalcifications (rodlike or branching morphologic features, high spatial density), and stellate opacities, which yielded higher PPVs (0.11, 0.35, 0.56, and 0.75, respectively). The average detection rate of preclinical cancer was 0.7 per 1,000; wide variations were recorded during different periods in the study (0.2 per 1,000 and 1.3 per 1,000 in the first 4 years and the last 4 years of the study, respectively), for the different age groups considered (0.6 per 1,000 and 1.7 per 1,000 for the 30-39-year and over-59-year age groups, respectively), and for different reporting radiologists (0.5-1.9 per 1,000). The ratio of benign to malignant biopsy findings was 2.4:1 for the whole series, with wide variations encountered relative to the variables mentioned above. PMID- 3628798 TI - Problems in the treatment of children with brain tumors. PMID- 3628799 TI - Pathological considerations on follow-up results of optic glioma. PMID- 3628800 TI - Cerebellar astrocytoma in children. PMID- 3628801 TI - Benign brainstem gliomas in children. PMID- 3628802 TI - Intrinsic brain stem tumors of childhood. Surgical indications. PMID- 3628803 TI - Relationship of morphology of ependymoma in children to prognosis. PMID- 3628804 TI - Intracranial ependymomas. PMID- 3628805 TI - Choroid plexus papillomas. PMID- 3628806 TI - Leptomeningeal dissemination of primary brain tumors in children: clinical and experimental studies. PMID- 3628807 TI - Dissemination of primary central nervous system tumors of childhood: incidence and clinical implications. PMID- 3628808 TI - Precocious puberty of cerebral origin: a cooperative study in Japan. PMID- 3628809 TI - Cerebral gangliogliomas of childhood. PMID- 3628810 TI - Intracranial meningiomas of childhood and adolescence. PMID- 3628811 TI - Intracranial germinal tumors. PMID- 3628812 TI - Direct surgery for pineal tumors: occipital-transtentorial approach. PMID- 3628813 TI - Endocrine aspects of tumors arising from suprasellar, third ventricular regions. PMID- 3628814 TI - Craniopharyngiomas. PMID- 3628815 TI - Craniopharyngiomas in children and young adults. PMID- 3628816 TI - Combined trans-sphenoidal and intracranial surgery for craniopharyngioma. PMID- 3628817 TI - Craniopharyngiomas in childhood: analysis of 42 cases. PMID- 3628818 TI - Pituitary adenomas in childhood and adolescence. PMID- 3628819 TI - Special problems with neurosurgical treatments of hormone-secreting pituitary adenomas in children. PMID- 3628820 TI - Medical imaging of pediatric brain tumors. PMID- 3628821 TI - Treatment of medulloblastomas. Experience of different protocols. PMID- 3628822 TI - Treatment of medulloblastoma. PMID- 3628823 TI - Psychopharmacological treatment of panic disorder and related states: a placebo controlled study of alprazolam. AB - The paper consists of two parts. A review of the relationship of panic disorder to the phobic states and the treatment of these disorders by means of tricyclic antidepressants, MAOIs, beta blocking drugs and benzodiazepines. A double blind study of alprazolam and placebo in 118 patients with agoraphobia and panic is presented. In an eight week study alprazolam was found to be significantly superior to placebo in the treatment of panic attacks, phobic avoidance, anticipatory anxiety and general anxiety. PMID- 3628824 TI - Affect and nurturance: mechanisms mediating maternal behavior in two female mammals. AB - This review will discuss hormonal and psychological factors involved in the initiation and maintenance of maternal behavior during the postpartum period in rat and human mothers. Research on primiparous rats suggests that among the ways hormones act to promote maternal responsiveness are by increasing the mother's attraction to odors of young pups, decreasing her natural neophobia and fearfulness, and increasing the ease with which experiences obtained during initial mother-young contacts are retained. Long-term maintenance of elevated maternal responsiveness in the rat is not directly under hormonal control but instead depends on a minimal period of direct interaction with young during the early postpartum. In human first-time mothers, the onset of maternal responsiveness is also directly affected by their mood state as well as their attraction to infants; these factors are, in turn, influenced by the amount of prior experience women have had caring for young. While the role of hormones in mediating maternal behavior in women is still unclear, initial results indicate they may facilitate responsiveness during the puerperium. PMID- 3628825 TI - Premenstrual dysphoric disorder: evaluation, pathophysiology and treatment. AB - A small percentage of women describe a prominent dysphoric disturbance that is present during the premenstrual week, remits soon after the onset of menses and produces significant impairment in domestic, social or occupational functioning. Premenstrual dysphoric disorder must be distinguished from minor premenstrual emotional changes, from dysmenorrhea and from premenstrual exacerbations of psychiatric illness. Diagnostic evaluation should include the prospective assessment of symptoms over at least two complete menstrual cycles. Although the pathophysiology of premenstrual dysphoric disorder is linked to cycling of the intact hypothalamo-pituitary-gonadal axis, many studies have contained serious methodological weaknesses and no single etiological theory has received widespread support. No single pharmacological treatment has been shown to be clearly more effective than placebo in controlled studies and premenstrual dysphoric disorder appears to respond favorably to most interventions in uncontrolled studies. Interruption of pituitary-ovarian cycling will alleviate premenstrual symptoms, but treatments of this type cannot be recommended for general use until potential hazards are clarified. PMID- 3628826 TI - Memory effects of restricted environmental stimulation therapy (REST) and possible applications to ECT. AB - Restricted environmental stimulation (REST) has been shown to facilitate learning and memory in both human and animal experimental subjects. This paper reports early data from a test of the usefulness of REST in reducing post-ECT amnesia in depressive patients. Two such patients were placed in a quiet, dimly illuminated room for 2-4 hrs. after recovering from each ECT administration in a series of treatments; three others, following standard practice, were returned to their normal hospital rooms. Measures of memory (verbal, numerical, nonverbal, life event, and self-rating) were given prior to the first ECT treatment; after the first post-recovery session; after the last post-recovery session; and one week after the last ECT administration. The major difference found was that the REST group showed an improvement in self-rated memory functioning from the first to the last ECT administration that was 15 times as great as that reported by the control group. This finding is interesting because of the major role played by self-reported memory disturbances in the scientific, clinical, and popular evaluation of ECT. The sample size is being increased, as it must be for any reliable conclusions to be drawn from this study. PMID- 3628827 TI - Verapamil in refractory schizophrenia: a case report. AB - Verapamil, a papaverine calcium channel blocker, has been used effectively and safely in the treatment of angina pectoris and auricular arrhythmias, and more recently in the treatment of mania. Many antipsychotic drugs show calcium channel blocking effects similar to verapamil's. A 41 year old male schizophrenic, only partially responsive to haloperidol decanoate and oral haloperidol, was given increasing doses of verapamil concomitantly, and monitored clinically and by the BPRS, electrocardiogramme, and other laboratory measures. The patient's total BPRS score dropped from 79 to 41 and remained stable, after initial worsening at lower doses, at verapamil 80 mg po qid. Mild fatigue was the only side effect. Further investigation of verapamil in the treatment of schizophrenia is warranted. PMID- 3628828 TI - Sequence of affective polarity and lithium response: preliminary report on Munich sample. AB - As an alternative to the bipolar I/II distinction, a subtyping of bipolar affective disorders according to the sequence of polarity (mania or depression) has been proposed. In a study of 93 patients with bipolar affective and bipolar schizoaffective disorders we tested the stability of a subtyping using the sequence of polarity. Furthermore we investigated its relationship to bipolar I/II subtypes and to response to stabilizing therapy with lithium. In the individual patient the first sequence of polarity significantly predicted the same sequence of polarity of further manifestations. However, only half of the patients could be classified as either MDI (mania-depression-interval) or DMI (depression-mania-interval). Subtyping according to the sequence of polarity was not significantly related to the bipolar I/II subgroups. MDI patients showed a significantly better response to stabilizing therapy with lithium than DMI patients. Our findings lend support to the notion that the polarity sequence is of clinical relevance. The observed association between polarity sequence and effectiveness of lithium prophylaxis could be linked to direct consequences of a MDI or DMI sequence (e.g.: different treatment approaches). On the other hand, a difference in polarity sequence might be the clinical expression of a difference in the underlying mechanisms of dysregulation, which in turn might be more or less prone to respond to lithium therapy. PMID- 3628829 TI - A simple method for the study of yawning in man induced by the dopamine receptor agonist, apomorphine. AB - Apomorphine (Apo), a dopamine (DA) receptor agonist, induces yawning by stimulating central DA autoreceptors. Few data are available on Apo-induced yawning in man. A simple method for recording and measuring Apo-induced yawning by measuring the displacement of the lower jaw using a pair of linearlized magnetometers with one sensor attached to the forehead just below the hairline and the other under the chin is described. The output of the magnetometers is fed into a DC amplifier and displayed on a strip chart recorder. Complete concordance between evaluators reading the tracings and between observed yawning and recorded yawns was found. Measuring Apo-induced yawning may provide a simple approach to evaluating DA autoreceptor function in normal subjects and in patients with psychiatric and neurological disorders. Preliminary data show that Apo-induced yawning is more marked in women than in men. This is in contrast to spontaneous and drug-induced yawning in animals which is predominantly a male phenomenon. Sleep appears to inhibit Apo-induced yawning. PMID- 3628830 TI - Effect of apomorphine on melatonin secretion in normal subjects. AB - There is some evidence in animals that dopamine (DA) affects melatonin secretion. The effect of apomorphine (Apo), a selective DA receptor agonist, and placebo on day-time melatonin secretion was studied in six normal men. Apo HCl in a dose (0.5 mg sc) which increased growth hormone secretion in all subjects had no effect on day-time melatonin concentrations in plasma. In keeping with other clinical studies these data suggest that melatonin secretion is not regulated by a DA mechanism in man. PMID- 3628831 TI - Apomorphine-induced penile tumescence in impotent patients--preliminary findings. AB - Apomorphine (Apo), a short acting dopamine (DA) receptor agonist induces penile erections in normal subjects. The erectile response to one or more doses of Apo HCl (0.25, 0.5, 0.75, 1.0 mg sc) or placebo was investigated in eight impotent subjects and penile tumescence monitored using a mercury strain gauge and strip chart recording. Four patients showed a full erection with Apo and one a partial response. Distressing side effects (nausea, sweating) were associated with non response or partial response. Three responders to Apo were treated with low doses of the long acting DA receptor agonist, bromocriptine (2.5-3.75 mg/d po); all three showed complete recovery of erectile function within two weeks. A subgroup of impotent patients may have impaired central DA function. Testing with Apo may provide a diagnostic and predictive test to identify such patients who may respond to treatment with low doses of bromocriptine or other DA receptor agonist. PMID- 3628832 TI - Rapid analysis of beta-phenylethylamine in tissues and body fluids utilizing pentafluorobenzoylation followed by electron-capture gas chromatography. AB - A rapid, sensitive gas chromatographic procedure for analysis of beta phenylethylamine is reported. The procedure involves extraction with a liquid ion pairing compound, back-extraction with HCl, basification and reaction with pentafluorobenzoyl chloride under aqueous conditions. The pentafluorobenzoyl derivative of beta-phenylethylamine is then separated and analyzed on a gas chromatograph equipped with a capillary column and an electron-capture detector. The procedure produces a derivative which has good chromatographic properties and a high degree of stability. The method has been applied to analysis of beta phenylethylamine in a variety of tissues and body fluids. PMID- 3628833 TI - Effect of ascorbic acid on brain amphetamine concentrations in the rat. AB - Ascorbic acid is reported to have antiamphetamine effects in rodents. The effect of ascorbic acid (1 g/kg ip) on the half-life of amphetamine (10 mg/kg) in rat brain using 3H-amphetamine and on amphetamine-induced stereotyped behaviour was investigated. Ascorbic acid had no effect on amphetamine-induced stereotyped behaviour or on the half-life of amphetamine in brain. If ascorbic acid antagonizes amphetamine-induced behavioural responses this is unlikely to be a result of altering the pharmacokinetics of amphetamine. PMID- 3628834 TI - N-(3-chloropropyl)phenylethylamine as a possible prodrug of beta phenylethylamine: studies in the rat brain. AB - N-(3-Chloropropyl)phenylethylamine (CPPEA) was examined as a possible prodrug of the neuromodulator trace amine beta-phenylethylamine (PEA) in rat tissues. CPPEA produced sustained elevation of PEA levels in rat brain, blood and liver. Rat brain concentrations of noradrenaline, dopamine and 5-hydroxytryptamine were decreased by administration of CPPEA. PMID- 3628835 TI - The regional distribution of p-tyramine and m-tyramine in the rat corpus striatum and the effect of monoamine oxidase inhibition. AB - These experiments show that in the rat corpus striatum the highest concentrations of p- and m-tyramine were found in the caudate nucleus while somewhat lower values were observed in the putamen and globus pallidus. Inhibition of monoamine oxidase by pargyline produced an increase in the concentration of both tyramines in the three areas. The effect of pargyline is more marked with p-tyramine, however, the regional distribution of both p- and m-tyramine are preserved after monoamine oxidase inhibition. In addition, the pargyline treatment produced a significant reduction in corpus striatum p-tyrosine while no changes were observed in the tryptophan concentrations. PMID- 3628836 TI - Differential responsivity of corticosterone and prolactin to stress following lesions of the septum or amygdala: implications for psychoneuroendocrinology. AB - Attempts to use neuroendocrine challenge tests to reflect suspected CNS dysfunction are popular, but frought with problems of interpretation. The dexamethasone suppression test of cortisol is thought to reflect limbic system function. Hormone responses to the triple bolus challenge test have also been reported to reflect limbic system dysfunction, but interpretation is dependent upon the hormone chosen for study. Challenge tests using prolactin have fallen out of favour because the final common pathway for its regulation lies outside the blood brain barrier. Thus, the ability of prolactin to reflect CNS and, specifically limbic system activity has been questioned. The present study undertook to determine corticosterone and prolactin responses in response to a variety of stimuli in rats that had selected limbic system damage following stereotoxically placed electrolic lesions. Surgical groups included: normal, sham operated, septal lesion, cortico-medial amygdala lesion or baso-lateral amygdala lesion. All CNS damage was verified histologically. The stimuli chosen for neuroendocrine challenge were 3 minutes of exposure to, a novel environment, noise, ether vapour or cold water. These stimuli were chosen for their presumed level of neural input to the hypothalamic-pituitary axis. In the normal group, prolactin, but not corticosterone evidenced a differential response to the four stimuli. Following surgery, corticosterone responses to all stimuli were significantly influenced only in the septal lesion group. There was no interaction between the location of lesion with the type of stimuli used to elicit the corticosterone response. Prolactin, in contrast, evidenced significantly different responses depending on the location of the lesion, the type of stimulus and an interaction of these two variables. This level of differential responsiveness suggests that prolactin may have potential for diagnosis of limbic system dysfunction if appropriate test stimuli are employed to elicit its response. PMID- 3628837 TI - Perspectives in Canadian neuro-psychopharmacology. Proceedings of the 9th annual meeting of the Canadian College of Neuro-psychopharmacology. Vancouver, British Columbia, May 20-23, 1986. PMID- 3628838 TI - [Eros and the death drive. On deciphering psychoanalytic "mythology"]. PMID- 3628839 TI - [Freudian teachings and philosophical interpretations of Freud--an essay on Paul Recoeur]. PMID- 3628840 TI - [Reveries of knowledge]. PMID- 3628841 TI - [Eros and Thanatos--a history]. PMID- 3628842 TI - [Pathophysiology of the peritoneal dialysis process]. PMID- 3628844 TI - [Factors affecting the effectiveness of peritoneal dialysis]. PMID- 3628843 TI - [Surgical aspects of catheter implantation in peritoneal dialysis]. PMID- 3628845 TI - [Metabolic and hormonal disorders in patients treated by peritoneal dialysis]. PMID- 3628846 TI - [Infectious complications of peritoneal dialysis]. PMID- 3628847 TI - [Continuous ambulatory peritoneal dialysis--a personal experience]. PMID- 3628848 TI - [Effect of the duration of skin eruptions on neutrophil enzyme activity in patients with psoriasis]. PMID- 3628849 TI - [Ischemic changes in the electrocardiographic picture and hemodynamic insufficiency during physical exertion in a mountainous environment in patients after myocardial infarction]. PMID- 3628850 TI - [Role of protein C in regulating blood coagulation and fibrinolysis]. PMID- 3628851 TI - Contrast-enhancing properties of Gd-DTPA at 2.0 Tesla. AB - The contrast enhancing properties of Gd-DTPA in various tissues, including myocardium, liver, brain, skeletal muscle, and subcutis were investigated in vivo at 2.0 Tesla. Employing T1-weighted short pulse sequences (TR = 300 msec, TE = 14 msec) signal intensity of myocardium increased by 88%, brain by 19%, liver by 61%, skeletal muscle by 50%, and subcutis by 52% at 2 min after intravenous injection of 0.2 mmol/kg Gd-DTPA in rats. Signal intensity was highest at 2 min after injection and was relatively decreased at 20 min. Tissue intensities had returned to baseline at 60 min. In a separate experiment, fast (4 sec), repeated spin-echo image acquisitions allowed for assessment of the initial, dynamic distribution pattern of Gd-DTPA between 4 sec and 72 sec after intravenous injection. Tissue signal intensities peaked between eight and 16 seconds after injection and slowly decreased thereafter. This study shows that the contrast enhancing properties of Gd-DTPA can be effectively assessed using T1-weighted short pulse sequences at 2.0 Tesla. PMID- 3628852 TI - New equipment for a radiation therapy simulator: a device for simplifying irregular field shaping and integrating simulator and therapy machine. AB - Shaping of irregular treatment fields was facilitated by our newly developed Niwa Fujikawa irregular field-shaping unit, which was mounted onto a standard radiation therapy simulator. The introduction of a "fieldgraph" led to the functional integration of the simulator and therapy machine. A fieldgraph is a radiograph of an irregular treatment field taken on the Niwa-Fujikawa unit at the same distance as the focus-to-shadow-tray distance of the corresponding therapy machine. The fieldgraph can be taken at the same time as the portal localization film. Through the fieldgraph, which is positioned on the shadow tray of the therapy machine, the irregular treatment field is directly projected onto the skin of the patient. Consequently, marking the irregular field on the skin of the patient is unnecessary. The authors believe that both the new unit and the fieldgraph contribute to greater efficiency and accuracy in daily application of radiation therapy. PMID- 3628853 TI - Natural abundance carbon-13 MR imaging of a human subject. PMID- 3628854 TI - CT of follicular adenoma in the thyroid gland. AB - Computed tomography was performed in 27 lesions of follicular adenoma. About half of them showed heterogeneous low density areas due to retrogressive changes, especially internal hemorrhage. Seven out of 12 lesions whose contours were poorly defined had chronic focal thyroiditis of the adjacent thyroid gland. Internal hemorrhage was another cause of indistinct contour in two lesions. We stress that CT features of follicular adenomas are modified by their retrogressive changes and inflammation of the adjacent gland. PMID- 3628855 TI - Carcinoma of the soft palate treated with irradiation: analysis of results and complications. AB - This is an analysis of 75 patients with squamous cell carcinoma of the soft palate and/or uvula treated with radical radiation therapy alone (64) or in conjunction with planned neck dissection (11) between October 1964 and September 1983. All patients have a minimum follow-up of 2 years and 60 (80%) have a minimum follow-up of 5 years. Patients were excluded from analysis of disease control at the primary site and/or neck if they died within 2 years of treatment with the site(s) continuously disease free. The initial local control rates and ultimate local control rates after surgical salvage of irradiation failures for patients treated with continuous-course irradiation were as follows: T1, 8/8 (100%) and 8/8 (100%); T2, 14/19 (74%) and 16/19 (84%); T3, 5/11 (45%) and 5/11 (45%); and T4, 1/4 (25%) and 1/4 (25%). Overall, 7/55 patients (13%) treated with continuous-course irradiation experienced irradiation-related bone or soft tissue complications; there was only one severe complication. The 5-year determinate survival rates by modified AJCC stage for patients treated with continuous-course irradiation are as follows: I, 83%; II, 78%; III, 38%; IVA, 0/2; and IVB, 25%. PMID- 3628856 TI - Long-term bladder symptomatology following radiotherapy for cervical carcinoma. AB - The prevalence of long-term bladder symptoms 5-11 years after radiotherapy for cervical carcinoma was investigated by postal questionnaire. Sixty-six replies (68%) were received. Only 29 (44%) were asymptomatic and 17 (26%) had severe symptoms. Urgency and urge incontinence were the most common symptoms occurring in 30 women (45%). Significant frequency and nocturia occurred in 23 women (35%) but voiding problems were less common. These results suggest that long-term bladder dysfunction is a common problem following radiotherapy for cervical carcinoma. PMID- 3628857 TI - A randomized phase II trial of aminoglutethimide and hydrocortisone versus combined aminoglutethimide, hydrocortisone and fluoxymesterone in advanced breast cancer. AB - Fifty postmenopausal women with advanced breast cancer were included in the following randomized phase II trial: 25 patients received aminoglutethimide 1000 mg and hydrocortisone 40 mg daily. Twenty-five patients received aminoglutethimide 1000 mg, hydrocortisone 40 mg and fluoxymesterone 20 mg daily. The two groups of patients were comparable in respect to the most important pretreatment characteristics. The majority of patients in both groups had bone lesions. There was a history of response to tamoxifen in all the cases and 17 patients had positive estrogen and progesterone receptors. The evaluation of response was based on the system adopted by the UICC. In the aminoglutethimide hydrocortisone group, 16 (64%) patients obtained a partial remission, 3 (12%) remained stable and 6 (24%) had progressive disease. In the combination treatment group, 17 (68%) patients obtained a partial remission, 3 (12%) remained stable and 5 (20%) developed progressive disease. The median duration of partial remission and stabilization of the disease was 9 and 7 months respectively in both groups. PMID- 3628858 TI - An explanatory hypothesis for early- and late-effect parameter values in the LQ model. AB - The isoeffect equation derived from the linear-quadratic (LQ) model of cell survival contains linear and quadratic terms in dose. Experimental studies have shown that higher-order terms may also be present. These terms have been previously attributed to the fact that the LQ model may be the first two terms in a power series approximation to a more complex model. This study shows that higher-order terms are introduced as a result of heterogeneity in the response of the cell population being irradiated. This heterogeneity is modeled by assuming that the parameters alpha and beta in the LQ model are distributed according to a bivariate normal distribution. Using this distribution, the expected value of cell survival contains third- and fourth-order terms in dose. These terms result in the previously observed downward curvature of Fe plots. Furthermore, these higher-order terms introduce bias in the estimated values of alpha and beta, if only the linear and quadratic terms of the LQ model are used, and higher-order terms are ignored. The bias is such that the estimated value of alpha/beta is substantially increased. Thus the higher values of alpha/beta observed for early effects as compared to late effects may be due to greater heterogeneity of response in early-responding tissues than in later-responding tissues. This differential effect is maintained even if the two cell populations have the same average values of alpha and beta. PMID- 3628859 TI - Multiple carcinomas of the colon and rectum. PMID- 3628860 TI - Avulsion of the pyelo-ureteral junction in close trauma. PMID- 3628861 TI - Thymic involvement in acute disseminated histiocytosis X. PMID- 3628862 TI - Bone scan demonstration of metastatic calcification in multiple myeloma. PMID- 3628863 TI - Immunoscintigraphy of gastric or colon carcinoma with F(ab')2 fragments of anti CEA monoclonal antibody. PMID- 3628864 TI - Bone scintigraphy and C.T. in single structural lesions. PMID- 3628865 TI - Lens dosimetry of radiotherapy treated patients: punctate lens opacity increase as a possible index of radiation exposure. PMID- 3628866 TI - Comparison between interstitial curietherapy and surgery in the treatment of T1 T2 carcinomas of the mobile tongue. PMID- 3628867 TI - Changes in rat liver cyclo(His-Pro) binding sites upon castration and testosterone administration. AB - Histidyl-proline diketopiperazine [cyclo(His-Pro)] binding was compared in livers from male and female rats. Cyclo(His-Pro) binding of female rat liver was very much lower than that of male rat liver. Scatchard analysis showed that the sex difference in cyclo(His-Pro) binding was due to different binding capacity. Cyclo(His-Pro) binding of castrated male rat liver was significantly decreased. Testosterone replacement raised the binding to the control level, and an excess of testosterone increased the specific binding beyond the control level. The testosterone-induced changes in cyclo(His-Pro) binding were also due to variation in the binding capacity. These findings indicate that testosterone is an important factor in the regulation of cyclo(His-Pro) binding in the rat liver. PMID- 3628868 TI - Effects of bestatin on the central cardiovascular regulatory mechanisms in the rat. AB - We evaluated the effects of bestatin, the specific aminopeptidase-B and leucine aminopeptidase inhibitor, on the central cardiovascular regulatory mechanisms in Sprague-Dawley rats anesthetized with pentobarbital sodium (40 mg/kg, i.p.). Intracerebroventricular injection of bestatin (100 or 200 nmol/5 microliters) consistently elevated the basal systemic arterial pressure and heart rate. At the same time, this degradative enzyme blocker increased the sensitivity of the baroreceptor reflex responses as well as the efficacy of the modulatory actions of the medullary nucleus reticularis gigantocellularis on these reflexes. We speculate that enhancing the tonic activities of the endogenous neuropeptides in the brain by protecting them from their catabolic enzymes may affect the central cardiovascular regulatory machinery by modifying the operations of the baroreceptor feedback controls and their modulatory mechanisms. PMID- 3628869 TI - Activation of subfornical organ efferents stimulates oxytocin secretion in the rat. AB - The effects of activation of subfornical organ (SFO) efferents on plasma oxytocin concentrations were examined in conscious freely moving male Sprague-Dawley rats. Blood samples were obtained through chronically implanted atrial catheters and SFO efferents were activated electrically using chronically implanted bipolar stimulating electrodes. Hormone concentrations were measured by radioimmunoassay, and experimental animals were assigned to one of 3 experimental groups according to histologically verified anatomical locations of stimulating electrodes in either the SFO, the hippocampal commissure (HC), or the medial septum (MS). Electrical stimulation in the SFO resulted in increased plasma concentrations of oxytocin from control values of 2.54 +/- 0.9 pg/ml, to a post-stimulation level of 65.6 +/- 27.0 pg/ml. In contrast, stimulation in immediately adjacent structures including HC and MS was found to be without effect on plasma concentrations of oxytocin. These studies provide the first definitive evidence that SFO efferents may play a significant role in controlling the secretion of oxytocin from the posterior pituitary. PMID- 3628871 TI - Rheumatic diseases of childhood. Second Park City conference. March 15-19, 1986. Proceedings. PMID- 3628870 TI - Pediatric rheumatology: the decade since Park City I. PMID- 3628872 TI - Impact of chronic illness on families. AB - Standard scales were used to measure the reaction of the parent and family to long-term disability in a child in terms of family stress, both emotional and financial. The most significant factors that bear upon family impact were the level of education of the respondent, parenteral perception of the health of the child, and the number of limitations of activities of daily living that were experienced by that child. PMID- 3628873 TI - Reflections of a pediatric rheumatologist. AB - Pediatric rheumatology has come of age and has made significant contributions through interdisciplinary care to the health of patients, families, and communities. Our patients have also achieved greater career education than their peers in the general population. Basic research in the rheumatic diseases of childhood is beginning to coexist with strong patient care and clinical research programs. PMID- 3628874 TI - Pediatric rheumatology: a personal perspective. AB - It is suggested that we make a discussion of the fundamental aspects and problems of scientific investigation a part of all pediatric rheumatology meetings as long as needed. It will be important to look for new directions for research, instead of just following the lead of adult rheumatologists. PMID- 3628875 TI - Future directions for pediatric rheumatology as an academic specialty. Survey of pediatric department chairpersons. AB - A survey of pediatric department chairpersons examines the growth and future of pediatric rheumatology training programs. Chairpersons are queried about certain departmental characteristics, in order to determine if any of these correlate with attitudes about pediatric rheumatology. PMID- 3628876 TI - Pediatric rheumatology: fellowship training requirements and survey of specialty needs. AB - This article documents the growth of pediatric rheumatology in the decade since Park City I as an emerging academic pediatric subspecialty. Current staffing patterns are surveyed for our medical schools and estimates of future requirements for fellowship training are provided. Impediments to the necessary growth of this subspecialty for the needs of clinical practice and research are outlined and criteria for certification are reviewed. PMID- 3628877 TI - Natural agglutinins in the Amazonian water buffalo (Bubalus bubalis). PMID- 3628878 TI - Electron microscopy of Hofbauer cells after embedding with placental erythrocytes. PMID- 3628879 TI - [Pulmonary thromboembolism: a clinico-pathological correlation of 510 patients]. PMID- 3628880 TI - [Acute adult respiratory distress syndrome secondary to miliary and bronchogenic pulmonary tuberculosis]. PMID- 3628881 TI - [Polymorphic hepatic acetylation in fibrocystic mastopathy]. PMID- 3628882 TI - [Epidural calcitonin administration in the treatment of the pain caused by bone metastases]. PMID- 3628883 TI - [Devic's syndrome complicating a Mycoplasma pneumoniae infection]. PMID- 3628884 TI - [26-year-old woman with right-sided hypoacusis]. PMID- 3628885 TI - [Pneumonitis from amiodarone. Apropos of 8 new cases]. PMID- 3628886 TI - [Nervous system involvement in brucellosis]. PMID- 3628887 TI - [Surgical acute abdomen induced by auranofin]. PMID- 3628888 TI - [Megaloblastic anemia secondary to pyrimethamine treatment]. PMID- 3628889 TI - [Burkitt's lymphoma as the 1st manifestation of AIDS in a drug addict patient]. PMID- 3628890 TI - [Subacute thyroiditis as a cause of prolonged fever diagnosed by gallium scan]. PMID- 3628891 TI - [Left atrial myxoma in a 68-year-old patient. A rare presenting form]. PMID- 3628892 TI - [Fever of unknown origin. A retrospective study of 45 cases]. PMID- 3628893 TI - [Young woman with pain in the right iliac fossa and fever]. PMID- 3628894 TI - [Granulomatous hepatitis caused by carbamazepine]. PMID- 3628895 TI - [Lead poisoning and drug addiction]. PMID- 3628896 TI - [Sjogren's syndrome and lymphoma. An association to bear in mind]. PMID- 3628897 TI - [Diagnosis and treatment of herpes encephalitis]. PMID- 3628898 TI - [A posterior fossa process: an unusual image]. PMID- 3628899 TI - [Intestinal endometriosis]. PMID- 3628900 TI - [Silent acute myocardial infarct in diabetes mellitus and its relation to cardiovascular autonomic neuropathy]. PMID- 3628901 TI - [Acute rhabdomyolysis in convulsive pathology]. PMID- 3628902 TI - [Pulmonary hemorrhage associated with extracapillary proliferative glomerulonephritis]. PMID- 3628903 TI - [Evaluation of iron deposits in blood donors by determining serum ferritin using radioimmunoassay]. PMID- 3628904 TI - [Chemotaxis of granulocytes in diabetic patients]. PMID- 3628905 TI - [Sign of air meniscus in a case of pulmonary intracavitary hemorrhage]. PMID- 3628906 TI - [Epidemiologic surveillance of hospital infections]. PMID- 3628907 TI - [Digitalis: uses and abuses]. PMID- 3628908 TI - [Mechanical circulatory assistance--the artificial heart]. PMID- 3628909 TI - [Extension of acute myocardial infarct. Diagnostic criteria]. PMID- 3628910 TI - [Quantification of coronary disease using myocardial gammagraphy with thallium 201 in exertion and redistribution. Advantages of computerized analysis]. PMID- 3628911 TI - [Myocardial gammagraphy with thallium-201 and low-doses dipyridamole. Prediction of coronary lesions from segmental defects in perfusion]. PMID- 3628912 TI - [Linear model of the relationship between the QT interval and cardiac rate during stimulation at increasing frequencies]. PMID- 3628913 TI - [Potential recurrence of cardiac myxomas. Apropos of a case involving the tricuspid valve]. PMID- 3628914 TI - [Aortic dissection and pregnancy]. PMID- 3628915 TI - [Late prosthetic endocarditis caused by Candida parapsilosis]. PMID- 3628916 TI - [Diagnosis and localization of an interventricular communication after acute myocardial infarct using Doppler echocardiography]. PMID- 3628917 TI - [Echocardiography data base at the Hospital de la Princesa]. PMID- 3628918 TI - [High-pressure zone in subjects without gastroesophageal reflux: pre- and intra operative study]. PMID- 3628919 TI - [Upper digestive endoscopy in patients in a hemodialysis program for terminal renal insufficiency]. PMID- 3628920 TI - [Epidemiology of diverticular disease of the colon in the province of Santa Cruz de Tenerife]. PMID- 3628922 TI - [Comparative study of gammagraphic and histologic diagnosis in hepatopathies]. PMID- 3628921 TI - [Malignant anorectal melanoma. Presentation of 6 cases and review of the literature]. PMID- 3628923 TI - [Developmental complications of hepatic hydatic cysts]. PMID- 3628924 TI - [Prognostic factors and complications in hepatic injuries]. PMID- 3628925 TI - [Cancer of the esophagus. What to do?]. PMID- 3628926 TI - [Non-ulcerative dyspepsia]. PMID- 3628927 TI - [The liver and mineral elements]. PMID- 3628928 TI - [Bouveret's syndrome. Presentation of a new case]. PMID- 3628929 TI - [Submucous lipoma of the cecum as a cause of ileocolic invagination in adults. Apropos of 2 cases]. PMID- 3628930 TI - [Volvulus of the gallbladder]. PMID- 3628931 TI - [Congenital cyst of the choledochus. Review apropos of a clinical case]. PMID- 3628932 TI - [Intrahepatic bile ducts in Castleman's disease]. PMID- 3628933 TI - [Extensive venous thrombosis, a complication in a case of ulcerative colitis]. PMID- 3628934 TI - [Borderline arterial hypertension. Role of hormonal modulation]. PMID- 3628935 TI - [Behavior of arterial blood pressure in disorders of glucose metabolism. Clinical observations]. PMID- 3628936 TI - [Evaluation of the effectiveness and tolerance of dihydroergotoxine and alpha methyldopa in the therapy of arterial hypertension in the elderly with senile cerebral insufficiency]. PMID- 3628938 TI - [Surgical treatment of hyperthyroidism with a hyperkinetic vascular syndrome. Review of 55 treated cases]. PMID- 3628937 TI - [Disorders of calcium metabolism in arterial hypertension]. PMID- 3628939 TI - [Different types of anemia in ulcerative rectocolitis]. PMID- 3628940 TI - [Acute rhabdomyolysis as a result of body-building]. PMID- 3628941 TI - [Asymptomatic pericardiocoelomic cysts: diagnostic usefulness of computerized axial tomography]. PMID- 3628942 TI - [Malignant mesothelioma of the pleura. Retrospective clinical evaluation of 22 cases]. PMID- 3628943 TI - [Echocardiographic evaluation of cardiac changes in cirrhosis of the liver]. PMID- 3628944 TI - [Biochemical markers in the quantitative evaluation of the necrotic area in acute myocardial infarct]. PMID- 3628945 TI - [Anticardiolipin antibodies: a new sero-immunologic marker in systemic lupus erythematosus?]. PMID- 3628946 TI - [Rheumatoid nodulosis]. PMID- 3628947 TI - [Hiccups during acute myocardial infarction]. PMID- 3628948 TI - [Thrombocytopenic purpura during treatment with pantethine]. PMID- 3628949 TI - [Hormones of the somatotropic axis. Regulation. Peripheral effects. Practical significance. 12th meeting of the Development Group of the Institut National de la Recherche Agronomique (Animal Production). Montpellier, 28-30 May 1986. Proceedings]. PMID- 3628950 TI - [Discovery of a placental variant of human growth hormone: biochemistry, physiology and implication in the secretion of hypophyseal forms]. AB - Using two monoclonal antibodies (Mabs), each specific of two distinct hGH epitopes, we evidenced a decrease in serum 22K hGH in pregnant women and increasing levels of a GH-related factor, different from hPL. This factor was extracted from the placenta and partially characterized. Because of its binding to GH hepatic receptors with at least the potency of 22K hGH, it was named human placental growth hormone (hPGH). This hormone alone or together with hPL could therefore take over the role of the lacking pituitary GH in the mother during the last half of pregnancy. PMID- 3628951 TI - Secretory profiles and production rate of growth hormone in ruminant lambs. AB - Secretory profiles and production rates of growth hormone (GH) were determined in 6 ruminant lambs during winter. The mean GH concentrations (3.78 +/- 2.17 ng/ml) calculated were based upon blood sampling obtained every 3 min using a withdrawal pump. Body clearance (0.162 +/- 0.031 1/h/kg) was calculated from bolus intravenous oGH administration. The data were analysed by non-linear regression analysis; a bicompartmental model was selected to describe the data. production rate was 14.6 +/- 7.98 micrograms/kg/24 h. It has been emphasized that the experimental design used gave an accurate estimate of GH production rate. PMID- 3628952 TI - Plasma concentrations of growth hormone and somatomedin C in dwarf and normal chickens. AB - Sex-linked dwarf chicks, offspring from the mating of heterozygous sires with dwarf females, were used in this study. On days 18 and 20 of incubation, plasma concentrations of growth hormone (GH) and somatomedin C (Sm-C) did not differ between normal chicks and those of the dw-dwdw genotype. After hatching, Sm-C concentrations in normal chicks remained comparable to the embryo values for up to 1 week, but those in dwarf chicks were lower. After 3 weeks Sm-C increased greatly in the controls, whereas in dwarf birds it was far less pronounced up to 18 weeks of age and only increased to control levels on week 12. GH was low during incubation and increased sharply after hatching in normal and dwarf chicks. After 3 weeks and up to 18 weeks, GH levels were higher in dwarf chicks, except at week 12 when they decreased to control concentrations. PMID- 3628953 TI - Effects of hyper- or hypothyroid status on growth, adiposity and levels of growth hormone, somatomedin C and thyroid metabolism in broiler chickens. AB - Relatively few methods involving dietary manipulation of thyroid status have been used to study the effect of that status on growth and body composition as well as on changes in hormone levels and metabolism. The present work examines the influence of either a hyperthyroid status (induced by feeding triiodothyronine: T3 or thyroxine: T4) or a hypothyroid status (induced by feeding methimazole: MMI) on growth, feed consumption and body composition as well as on changes in thyroid hormone levels and metabolism and in hormone levels of the somatotroph axis of broiler chickens. MMI depressed growth but increased fatness. Long-term administration of thyroid hormones decreased both growth and fat deposition, T3 being more effective than T4. The reduced growth of MMI-treated birds was not only related to the hypothyroid state but also to decreased somatomedin C (Sm-C) production, although growth hormone (GH) levels remained high. Thyroid hormone treated birds showed slightly depressed GH levels but unchanged Sm-C levels. MMI induced an increase in hepatic 5'-monodeiodination activity, while T3 and T4 reduced that activity. The T4 administered was largely eliminated as inactive reverse T3. Both of the statuses (hypothyroid and hyperthyroid) profoundly changed peripheral thyroid hormone metabolism and influenced GH/Sm-C relationships, but in the opposite way. Hormonal changes could be related to the observed changes in growth and adiposity of broiler chickens and illustrate the negative correlation between T3 and body fat. PMID- 3628954 TI - Low somatomedin-C (Sm-C) concentrations measured by direct radioimmunoassay in patients with chronic renal failure. AB - Ten patients suffering from chronic renal failure and undergoing regular hemodialysis were tested immediately before and immediately after a 3-hour dialysis. Serum levels of immunoreactive Sm-C, estimated on unextracted non acidified serum at non equilibrium, were significantly lower than in normal controls and no consistent modifications were observed after dialysis. PMID- 3628955 TI - [Somatomedin C/insulin-like growth factor I and in vitro erythropoiesis]. AB - The effect of human somatomedin C/insulin-like growth factor I(SM-C/IGF-1) and human growth hormone (hGH) on colony formation by erythroid precursor cells (CFU E and BFU-E) from children's bone marrow or blood was studied by methylcellulose cloning assay. We found that physiological concentrations of IGF-1, but not of hGH, stimulated erythropoiesis in vitro in the presence of erythropoietin, as demonstrated by the increased activity of a cytosolic enzyme of the heme pathway (uroporphyrinogen I synthase). The results suggest that IGF-I could be involved in the regulation of erythroid differentiation. PMID- 3628956 TI - [Effect of growth hormone on meat production in heifers]. AB - Short-term treatment of bovines with growth hormone (GH) has shown that GH increases nitrogen balance. In the present experiment we studied the effects of exogenous GH on weight gain, feed efficiency, carcass grade and meat quality. Twenty heifers of the Belgian White Blue breed were used. After an 8-week pre experimental period, during which we recorded individual growth rates, the animals were allotted to two groups for 18 weeks; one group (T) received daily 50 micrograms of pituitary GH per kg of liveweight, whereas the other group (C) was given a placebo. Long-term treatment with GH induced weight gain (C: 117.1 +/- 25.5 kg; T: 144.6 +/- 23.7 kg; 23.5% increase, P less than 0.05) and increased feed efficiency (C: 10.34 +/- 2.04 kg DM/kg weight gain; T: 8.24 +/- 1.03 kg DM/kg weight gain). Digestibility of diet dry matter was identical in both groups (C: 60.1 +/- 2.7%; T: 59.8 +/- 2.4%). There were no difference in the classification of group C and T carcasses according to the EUROP pattern and after monocostal segment dissection (7th rib). Furthermore, the meat analysis of the two groups was identical with respect to protein, fat and collagen content. This was also true for tenderness, pH and juice loss after cooking. We concluded that stimulation of bovine weight gain by GH was significant and efficient while meat quality and carcass grade were not improved. PMID- 3628957 TI - Homesharing and congregate housing. State initiatives. PMID- 3628958 TI - Stability of perceived personal control for older black and white men. PMID- 3628959 TI - Homeownership in the older population 1940-1980. PMID- 3628960 TI - The causes and correlates of crime committed by the elderly. PMID- 3628961 TI - The invention of the "new" senior citizen criminal. An analysis of crime trends of elderly males and elderly females, 1964-1984. PMID- 3628962 TI - Children. Their impact on the elderly in declining health. PMID- 3628963 TI - BHA (2(3)-tert-butyl-4-hydroxyanisole)-mediated modulation of acetaminophen phase II metabolism in vivo in Fisher 344 rats. AB - Adult male Fisher 344 rats (190-220 g), were given an intravenous dose (10 mg/rat) of BHA. Pretreated and control rats received an intravenous dose of [G 3H] acetaminophen (25 mg/rat). Bile was collected prior to dosing and for 5-6 hours after dosing at varying time intervals. Separate aliquots of 0.2 ml were incubated with beta-glucuronidase and sulfatase, respectively. These incubation mixtures were then extracted and analyzed by reverse phase HPLC. In all cases control animals showed a greater deceleration in the biliary excretion of the water soluble metabolites when compared with pretreated animals. Increases in both glucuronide and sulfate elimination processes are assumed to be contributory, in part, to the overall effect of BHA on acetaminophen metabolism. PMID- 3628964 TI - Drug interactions affecting the elimination of doxorubicin in the rat. AB - Radioactive 14C-doxorubicin (10 mg/kg iv; 2 microCi/kg) disappeared rapidly from the plasma of anaesthetized male Sprague-Dawley rats. Radioactivity appeared in the bile within 5 to 7 min, reached a peak concentration in 10 to 15 min and declined rapidly thereafter for 150 min during which about 22% of the injected dose appeared in the bile. Tissue concentrations measured 10 min after injection were compared with tissue samples obtained at 150 min. Polyexponential analysis of the amount of doxorubicin remaining in the body (based upon the amount injected minus the cumulative amount excreted) suggested a two-compartment model. In acute studies, the injection of bromosulphophthalein (50 mg/kg) or rifampicin (53 mg/kg) 60 min after the injection of doxorubicin reduced the excretion of doxorubicin. The daily administration of phenobarbital (75 mg/kg X 3) increased the cumulative excretion of doxorubicin; the administration of CCl4 (1 ml/kg, ip) 24 hrs before the experiment reduced the cumulative excretion of doxorubicin. PMID- 3628965 TI - Homocysteine thiolactone, N-homocysteine thiolactonyl retinamide, and platelet aggregation. AB - Because of platelet abnormalities, thrombosis and arteriosclerosis observed in human and experimental homocysteinemia, the effects of several chemical forms of homocysteine were studied in human platelets in vitro. The free base of homocysteine thiolactone caused primary platelet aggregation over a wide range of concentration (4 X 10(-8) to 10 micrograms/ml), but polar salts of homocysteine thiolactone, homocystine, homocysteine, and homocysteic acid were inactive. N homocysteine thiolactonyl retinamide and trans retinoic acid caused aggregation at 100 micrograms/ml. Homocysteine thiolactone caused thromboxane TXB2 and prostacyclin 6-keto-PGF1 alpha formation during aggregation, but there was no release of ATP. This finding demonstrates dissociation between aggregation and release of dense granule content. Accumulation of the free base of homocysteine thiolactone may explain abnormal platelet function and thrombosis in human and experimental homocysteinemia. PMID- 3628966 TI - Cytotoxicity of phenothiazines: studies with aerated and hypoxic cells. AB - A number of phenothiazines have been studied with respect to their cytotoxic activity using an in vitro screening system. All the drugs studied showed some degree of cytotoxic effect under both aerated and hypoxic conditions. Toxicity was found to be influenced by modification of the phenothiazine ring, substitution of CF3 at the 2 position (Trifluoperazine and Trifluopromazine) resulting in enhanced toxicity. Modification of the side chain also changed the cytotoxic potential of the drug, with incorporation of the amino group into a piperazine ring increasing toxicity. The most toxic drug tested was Thioridazine with SCH3 at position 2 and the amino group incorporated into a piperazine ring. Thiorizadine also showed the greatest degree of specificity for hypoxic cells. The ranking of phenothiazines, in terms of cytotoxic activity corresponds with that reported in the literature for calmodulin-inhibiting potency. It is conjectured that the cytotoxic effect of phenothiazines could be wholly or partially explained on the basis of their interaction with calmodulin. PMID- 3628967 TI - On the mechanisms of the CCl4-induced inhibition of liver cytochrome P-450. AB - The role of covalent binding of CCl4 radicals to the microsomal protein in the CCl4-induced inhibition of cytochrome P-450 was investigated. The incubation of liver microsomes with NADPH and CCl4 under anaerobic conditions (to avoid lipid peroxidation) results in an inhibition of cytochrome P-450 similar to that observed in the in vivo intoxication with a standard dose (0.25 ml/100 g body wt) of CCl4, when the level of covalent binding is 5-10 fold higher than that observed in the in vivo condition. When in the in vitro experiments the level of covalent binding is of the same magnitude as that observed in vivo, minimal if any inhibition of cytochrome P-450 is seen. Experiments carried out under aerobic conditions seem to indicate that the CCl4-induced inhibition of cytochrome P-450 depends more on lipid peroxidation than on covalent binding. PMID- 3628968 TI - Nutritional and toxicological effects of short-term ingestion of aluminum by the rat. AB - Aluminum nitrate was given orally to four groups of female Sprague-Dawley rats over a period of one-hundred days at doses of 0, 360, 720 and 3600 mg/kg/day. Rats were monitored for weight gain, food intake, drinking water, hematology and plasma chemistry. The results show that the ingestion of aluminum nitrate by the rat caused a significant decrease in its growth. The nutritional parameters were always significantly lower for the treated animals. Aluminum did not accumulate dose-dependently in the organs and tissues analysed. Histopathological studies, including organ weight determinations, did not show significant changes. The possibility of oral aluminum intoxication in the human would be very low. PMID- 3628969 TI - Monoamine oxidase inhibitory and anticonvulsant properties of some newer indolylimidazolones. AB - Newly synthesized indolylimidazolones were tested for their in vitro monoamine oxidase (MAO) inhibitory activity. These compounds were found to possess analgesic activity and anticonvulsant activity against maximal electroshock induced convulsions in mice. The low toxicity of these compounds was reflected by their high approximate LD50 values. PMID- 3628971 TI - Extracorporeal isolated pig liver perfusion: influence of various blood primes on liver function. AB - Extracorporeal isolated pig liver perfusion was performed in three groups of five piglets each to assess the influence of different blood primes on liver function. All prime volumes were hemodiluted to a hematocrit of 0.3-0.35 and adjusted to a pH of 7.35-7.45 with sodium bicarbonate at a temperature of 38 degrees C. Fresh slaughterhouse blood was collected, mechanically filtered and used in Group A, whereas analogously collected blood was biologically filtered by passage through the organism of the piglet in Group B. In Group C, the priming blood consisted of autologous blood gained during hepatectomy by a special technique. A high potassium concentration (10.4 +/- 0.94 mmol/l) in Group A and impurities of the slaughterhouse blood in both Groups A and B led to rapid edema formation and an increase in vascular resistance of the perfused liver, and a prolonged perfusion was not achieved. In the third group, however, liver perfusion over a period of 5 h without any deterioration of liver function was possible. Beside liver function tests, oxygen consumption, the macroscopic aspect and bile flow of the liver seemed to be the most reliable parameters in assessing the function of the isolated perfused pig liver. Our technique to gain autologous blood can be recommended not only for extracorporeal liver perfusion but also for any other extracorporeal isolated organ perfusion. PMID- 3628970 TI - Temporal sequence of morphological alterations in artery walls during experimental atherogenesis--occurrence of leukocytes. AB - In rabbit carotid arteries arteriosclerotic lesions were induced by repeated local transmural electrical stimulations. The sequence of early morphological alterations in the vessel wall and especially the kinetics of leukocytes were examined by transmission electron microscopy. After a stimulation period of only 1 day monocytes and heterophilic granulocytes adhered to the endothelial surface. In the subendothelium mainly beneath the anode, focal amorphous insudates were present together with mononuclear and granulocytic cells. Thereby, the endothelium was maintained as a continuous lining as shown by surface staining with silver nitrate. However, both pattern and size of the endothelial cells were altered in comparison to the controls. Some of the endothelial cells displayed a heavy cytoplasmic silver salt deposition. After 2 days of the electrical stimulation schedule, the first myocytes occurred in the subendothelial space. The mediamyocytes sending pseudopods through the internal elastic lamina still appeared to be in a contractile phenotype. In the 7-day-old proliferative lesion modulated smooth muscle cells were the predominant cell type; only 10%-20% of the subendothelial cells were identified as macrophages and heterophils. This proportion decreased further, and after a stimulation period of 28 days the granulocytes disappeared completely. At this stage of plaque development, the intimal myocyte population mainly consisted of contractile smooth muscle cells and intermediary states between the contractile and modulated phenotype. The insudation, immigration of white blood cells, and subsequent migration and proliferation of myocytes reinforces the view that the initial phases of arteriosclerotic lesions may represent a special form of an inflammatory response. PMID- 3628972 TI - Tissue protection by allopurinol in the myocardial calcium paradox. AB - The aim of the present study was to evaluate the protective properties of the xanthine oxidase inhibitor allopurinol in the myocardial calcium paradox. Two injury levels, minimal and total calcium paradox, caused by different volumes (5 ml and 45 ml) of calcium-free perfusion (5 min) prior to calcium repletion (15 min) were examined +/- allopurinol (0.15 mmol/l) in the normothermic isolated rat heart model. Allopurinol supplementation (5 min prior to, during and 5 min following Ca2+-free perfusion) had no effect upon tissue injury in the total calcium paradox, but afforded considerable protection as assessed by enzymatic, physiologic, and metabolic parameters in the minimal calcium paradox. When allopurinol was omitted during calcium repletion, tissue protection was less apparent. The presence of verapamil (2 mumol/l) in addition to allopurinol (5 min prior to, during, and 5 min following calcium depletion) afforded only a marginal further protection in the minimal calcium paradox. It is concluded from the present study that tissue protection by allopurinol in the calcium paradox is limited to minimal or less severe calcium paradox models and that the protective action of allopurinol may indicate an inhibition of the xanthine oxidase reaction and the generation of free oxygen radicals. PMID- 3628973 TI - Ontogeny of the androgen receptor in rat ventral prostate during sexual development. AB - Concentrations of cytosolic androgen receptor, DNA and soluble protein, contents of DHT, and in-vivo uptake of 3H-DHT were measured in rat ventral prostates at 5 day intervals during sexual development. Regarding prostate weight two phases of growth were noted being separated by a period of stagnation from Day 40 to 45. Cytosolic androgen receptor, particle-bound DHT, and uptake of 3H-DHT into the 100,000-g sediment showed a clear pattern: a maximum in the prepubertal animal at age Day 20, a minimum at age Day 30 (4 days after the early pubertal rise of LH, testosterone, and DHT) followed by a second maximum on Day 55 (2 days before the beginning of fertility), and a second minimum in the young mature animal on Day 70. An intermediate peak seen at age Day 37 was not significant. Neither the time dependent profile of the cytosolic androgen receptor nor the contents and in vivo uptake of DHT were correlated to concentrations of circulating gonadotrophins, growth hormone, and sex-steroids measured during puberty in the same strain of animals. Therefore, the regulating mechanism remains unclear. PMID- 3628975 TI - Biochemical investigations of cardiomyopathy in the dog. AB - Biochemical investigations were performed on cardiac muscle samples from seven dogs with cardiomyopathy and on cardiac muscle from a varied selection of normal dogs. Biochemical examination of cardiac muscle from clinical cases of cardiomyopathy revealed that the concentrations of three enzymes were significantly altered. These were, catalase, succinic dehydrogenase and malate dehydrogenase. Depressed enzyme concentrations were recorded from both ventricles but were significant only on the left for catalase, on the right for malate dehydrogenase and in both ventricles for succinic dehydrogenase although the depression in this case was also greater on the right. PMID- 3628974 TI - Effect of dimethyl sulfoxide on the function and structure of the intact and ischemic canine ileum. AB - The action of dimethyl sulfoxide (DMSO) was investigated employing an experimental model of intestinal perfusion in vivo of isolated loops of dog ileum before, during, and following 1-h ischemia. DMSO was administered either into the intestinal lumen or by a continuous injection via a branch of the artery supplying the experimental loop. In the intact intestine, intraluminal DMSO significantly decreased the net movement of water, electrolytes, and glucose without affecting either the active transport of phenylalanine and beta methylglucoside or morphology. This inhibition was irreversible since, following DMSO removal, there was only partial recovery of water absorption, while the other parameters remained significantly low. Inhibition by DMSO was delayed when the substance was injected intraarterially (i.a.). Regardless of its route of administration, DMSO did not reduce the extent of ischemic injury in comparison with non-treated "Controls": during ischemia, all functional parameters were practically non-existent. Following the re-establishment of circulation, a net loss of water and electrolytes ensued, and active transport did not improve. In both instances, the structural alterations were those associated with ischemia of the experimental model employed: short, broad, club-shaped villi which had completely lost their epithelium, but fairly intact crypts. It can be concluded from the data presented that in the dog DMSO inhibits absorption in the intact ileum and exerts no protection against ischemic lesion. PMID- 3628976 TI - The afferent innervation of the face of sheep and goats. AB - The sensory innervation of the maxillary hairy skin and buccal mucous membrane was studied in anaesthetised sheep and goats. An electrophysiological technique isolated 47 single afferent units from the infraorbital nerve under chloralose or halothane anaesthesia. Mechanoreceptors of hairy skin were located in association with the following features: sinus hairs (n = 9); central primary hairs (n = 18); clear marginal hairs (n = 7) and skin-not-hair (n = 3). Units responded to hair tip displacement of 35 to 50 microm. Afferent units were also located in the mucous membrane of the cheek either associated with conical papillae (n = 8), or unassociated with papillae (n = 1). Receptor responses associated with hairs were classified as rapidly adapting (n = 18) and slowly adapting (n = 18) mechanoreceptor responses during sustained hair deflection. Seven mechanoreceptors of hairy skin and mucous membrane were excited by a fall in surface temperature. Two specific cold thermoreceptors were found: one in hairy skin and one in the mucous membrane. These units had phasic discharges during abrupt thermal depression and static discharges at constant surface temperatures. All afferent units had myelinated axons as indicated by their conduction velocities (range 20 to 57 m sec-1, mean 34 m sec-1). It is concluded that the mechanoreceptors identified had similarities with those of other mammalian species and some distinct differences. An interesting feature of mechanoreceptors in the buccal mucosa was their cold sensitivity. They therefore shared characteristics with mechanoreceptors in the penile mucosa of the ram and tongue of the sheep. PMID- 3628977 TI - HPLC determination and pharmacokinetics of thiabendazole and its major metabolite 5-OH thiabendazole in equine plasma. AB - Separate high performance liquid chromatographic methods were developed for thiabendazole (TBZ) and 5-hydroxy thiabendazole (5-OH-TBZ) determination in horse plasma using 1-methyl-2-phenyl benzimidazole (MPBZ) as an internal standard. In both methods TBZ and 5-OH-TBZ were extracted from plasma using organic solvents, injected on to a C-18 column, and eluents monitored by a fluorescence detector. However, mobile phase composition, extraction solvent as well as detector wavelength differed in the two methods. The linear range for TBZ was 0.02 to 0.77 microgram ml-1 while that for 5-OH-TBZ was 0.96 to 8.0 micrograms ml-1. A commercially available TBZ oral suspension was administered to four thoroughbred horses in the following manner: days 1 and 2, 44 mg kg-1; days 4 and 5, 440 mg kg 1. Blood samples were collected during the 24 hours after administration and then analysed for TBZ and 5-OH-TBZ. Half-lives (t1/2), maximum plasma concentrations (Cmax), area under plasma concentration time curves (AUC O-alpha), and relative apparent bioavailability (F), were determined using pharmacokinetic equations. The pharmacokinetic parameters varied in the following manner: 1.16 to 13.63 hours (t1/2), 12 to 131 micrograms ml-1 X hours (AUC O-alpha), 3.33 to 8.90 micrograms ml-1 (Cmax), 1.38 to 0.12 (F) after 44 mg kg-1 and 440 mg kg-1 doses, respectively. The ratios of concentrations of TBZ to 5-OH-TBZ after oral administration of TBZ, were significantly lower for 44 mg kg-1 than 440 mg kg-1 doses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3628978 TI - Prevalence of benzimidazole resistance of nematodes in sheep in The Netherlands. AB - A survey was carried out in The Netherlands to determine the prevalence of benzimidazole resistance in sheep nematodes. It was shown that 47 per cent of the 59 investigated flocks harboured trichostrongylid populations with resistance to benzimidazoles, as demonstrated by an LD50 value of 0.12 micrograms ml-1 thiabendazole or higher in an in vitro egg hatch assay. On these farms Haemonchus contortus was found to be the dominant species. In two flocks resistant Ostertagia and, or, Trichostrongylus species populations were found. Farms with resistance were revisited to determine the anthelmintic efficacy in vivo by means of treatment and egg count. In only four of the 19 flocks which showed resistance in vitro was an efficacy of less than 95 per cent in vivo achieved. This means that there is a discrepancy between the in vivo and in vitro results. Resistance was found more frequently on pure sheep farms than on mixed farms. It is suggested that mixed farms offer more refuge for susceptible H contortus populations. PMID- 3628979 TI - Variable nature of border disease on a single farm: clinical and pathological description of affected sheep. AB - The clinical, pathological and virological findings in cases of Border disease occurring on a farm were studied. Fourteen abnormal lambs approximately three months old were obtained and were necropsied within 18 months at death or slaughter. Another lamb born during the study to a persistently infected ewe was also examined. The findings of these 15 animals are presented in three groupings. The animals of group A were persistently viraemic and hypomyelinogenesis was present in two lambs at one and 14 weeks old. Systemic, chronic, multifocal inflammation including nephritis, myocarditis and pneumonitis was found in older sheep. Group B lambs were non-viraemic and the predominant necropsy finding was cystic cerebral cavitation of variable severity. Histological examination showed cerebellar dysplasia and in two animals the retinas also showed multifocal photoreceptor cell atrophy. Lambs in group C were also non-viraemic and although these failed to thrive, no consistent pathological changes were found. It is concluded that the dams of animals in group A were infected in early pregnancy while those of animals in groups B and C were infected at mid-gestation or later. PMID- 3628980 TI - Variable nature of border disease on a single farm: the infection status of affected sheep. AB - Study of the virological and serological status of abnormal sheep derived from a single outbreak of Border disease indicated a relationship between infection status and diverse pathological lesions. Persistent infection was associated with typical Border disease whereas an active, even exaggerated, serological response correlated with severe intracranial malformations which probably resulted from fetal infections occurring during the early stages of acquisition of immune responsiveness. PMID- 3628981 TI - Enzyme-linked immunosorbent assay for the detection of antibodies to the sheep scab mite Psoroptes ovis. AB - An enzyme-linked immunosorbent assay has been shown to detect antibodies in the circulation of sheep infected with Psoroptes ovis. Strong positive reactions were obtained from 19 sheep with four-month-old infections. No cross reaction was observed with sera obtained from sheep infected with either Fasciola hepatica, Nematodirus battus, Ostertagia circumcincta or Damalinia ovis. PMID- 3628982 TI - Scanning electron microscopy of the wall of the ovine cervix uteri in relation to tensile strength at parturition. AB - There was a progressive loosening of the collagenous fibre bundles in the stroma of the ovine cervix during spontaneous parturition. The change from an organ with predominantly thick collagen fibre bundles to one with a loose network of collagen fibrils was associated in time with a threefold increase in softness as measured by the Stretch modulus. Infusion of oestradiol 17 beta (E2 beta) for 18 hours elicited similar changes in the structure and mechanical properties of the cervix. Infusion of sodium meclofenamate for 18 hours significantly (P less than 0.005) reduced the effect of E2 beta administered simultaneously. PMID- 3628984 TI - Influence of chemotactic agents on the locomotion of equine polymorphonuclear and mononuclear leucocytes. AB - Subpopulations of equine leucocytes, polymorphonuclear and mononuclear cells, were separated from whole blood on a discontinuous Percoll gradient and used in studies of chemokinesis and chemotaxis. Polymorphonuclear cells responded to the chemo-attractant properties of zymosan-activated plasma in Boyden chamber and agarose microdroplet assays but they responded only slightly (Boyden chamber) or not at all (agarose microdroplet) to the peptide N-formyl-methionyl-leucyl phenylalanine (FMLP). Equine mononuclear cell movement was increased by FMLP in both assay systems and these cells also responded to zymosan activated plasma in the Boyden chamber assay but not in the agarose microdroplet. It is concluded that factors controlling equine polymorphonuclear and mononuclear cell movements into inflammatory exudates may differ. PMID- 3628983 TI - Pharmacokinetic changes of several antibiotics in chickens during induced fatty liver. AB - The concentrations of five antibiotics (erythromycin, lincomycin, penicillin G, streptomycin and oxytetracycline) were determined in chicken serum before and after induced fatty liver. The pharmacokinetic variables were calculated according to the obtained data. The crossover trial design involved 10 chickens for each antibiotic. The fatty liver was produced by oestradiol-dipropionate injections and monitored by serum malic enzyme activity determinations. Protein binding of the respective antibiotics was determined in vitro in the serum obtained from normal and oestrogen-treated birds. Induction of fatty liver caused several changes in the determined variables. The measured peak concentrations were higher for lincomycin and erythromycin and lower for penicillin and oxytetracycline while streptomycin remained unchanged. The peak concentration of streptomycin appeared earlier and the peak of oxytetracycline later than in the normal chickens. The elimination half-lives were shorter for erythromycin, lincomycin and streptomycin and increased for penicillin and oxytetracycline. The area under the concentration curve (AUC) decreased for erythromycin, penicillin and streptomycin, increased for oxytetracycline and remained unchanged for lincomycin. The body clearance (ClB/f) and the apparent specific volume of distribution (Vd(area'/f) were considerably changed in association with fatty liver induction. Since the fraction of the drug absorbed (f) is not known, it can only be speculated that changes in distribution rather than reduced liver function altered the kinetics. The protein binding was decreased for all the antibiotics, but this did not seem to be the reason for changes in kinetics, except perhaps in the case of penicillin. PMID- 3628985 TI - Use of long-acting oxytetracycline in the immunisation of cattle against Babesia bovis and B bigemina. AB - Forty Friesian one-year-old calves were vaccinated simultaneously with live Babesia bovis and B bigemina vaccines. Three groups of 10 calves each were treated with two, three or four doses of 20 mg kg-1 long-acting oxytetracycline (OTC/LA) at six- to seven-day intervals starting from day 6 after vaccination. Ten animals remained untreated. The treated calves showed considerably fewer days of patency and higher packed cell volumes than the vaccinated untreated calves. All calves developed serum antibodies to both parasites following vaccination. Five months later the 40 vaccinated and 30 new calves were challenged with syringe-transferred virulent parasites of both species. The vaccinated calves showed no parasites or clinical manifestations while calves of the new group exhibited severe clinical babesiosis. These results show that when OTC/LA is administered following anti-babesial vaccination, parasitaemia and red blood cell destruction are significantly reduced without, however, inhibiting the development of immunity. PMID- 3628986 TI - A model for predicting parasitic gastroenteritis in lambs subject to mixed nematode infections. AB - A model previously developed for the prediction of parasitic gastroenteritis in lambs arising from infection by the nematode parasite Ostertagia circumcincta has been adapted to consider mixed infection and retested. The importance of the lambs as a contributing source to the summer wave of infective larvae is highlighted as are certain apparent deficiencies in the use of grass sampling techniques as a means of assessing pasture larval contamination. PMID- 3628987 TI - Effects of calcium and magnesium intakes and feeding level during the dry period on bone resorption in dairy cows at parturition. AB - A study was made of the influence of low and high calcium intakes at two feeding levels (experiments 1 and 2), and of different magnesium intakes (experiment 3) during the dry period, on the cellular resorptive activity in bone of dairy cows at parturition. In experiment 1 (26 cows) the feed intake was 1.12 times maintenance and the calcium intake was either 13.0 g d-1 or 83.5 g d-1. In experiment 2 (33 cows) the feed intake was 1.9 times maintenance and the calcium intake was either 26.4 g d-1 or 87.2 g d-1. In experiment 3 the cows feed intake was 1.4 times maintenance, the calcium intake was 71 to 72 g d-1 and the magnesium intake was either 16.6 g d-1 or 71.0 g d-1. Bone biopsies were taken from the tuber coxae between three and eight hours after parturition. In experiment 1 the cellular resorptive activity in bone from older cows was higher in the cows receiving the low calcium diet. In experiment 2 the differences between the bone resorptive activities of the two groups were small. In experiment 3 the bone resorptive activity was lower in the cows with a deficient supply of magnesium. There were significant relationships in young cows, but not in older cows, between the cellular resorptive activity in bone and the rate of calcium mobilisation measured biochemically. These results suggest that in older dairy cows bone resorption makes only a minor contribution to the total rate of calcium mobilisation at parturition and is therefore of minor importance for the prevention of periparturient hypocalcaemia. PMID- 3628988 TI - Enteric campylobacter infection in gnotobiotic calves and lambs. AB - Gnotobiotic calves and lambs were infected orally with Campylobacter jejuni, C coli or C hyointestinalis to assess pathogenicity. All animals were successfully colonised and excreted mucoid faeces but showed no other clinical signs. Campylobacters colonised the large intestine better than the small intestine, in which bacterial numbers decreased with time after infection. Campylobacters were found occasionally in the lumen of crypts in close proximity to epithelial cells and included in a mucus-like material. Lesions were mostly in the large intestine in calves whereas in lambs they were present in the ileum. In animals inoculated with C jejuni or C coli scattered crypt abscesses, focal inflammatory infiltrates in the lamina propria and goblet cell discharge were found. In lambs inoculated with C hyointestinalis only minor changes were found in the small intestine. Serum antibody response was either absent or present at a low level only from the 19th day after infection. PMID- 3628989 TI - Detection of fish antibody against protein antigen of Aeromonas salmonicida by enzyme-linked immunosorbent assay using biotin-avidin system. AB - Antibody against Aeromonas salmonicida was detected in sera from immunised or experimentally infected rainbow trout by enzyme-linked immunosorbent assay (ELISA) using the biotin-avidin system. The ELISA titre correlated well with the agglutinin titres of the sera, but the ELISA was found to be more sensitive than the agglutination test. When the rainbow trout serum was separated by column chromatography, antibody activity (determined by ELISA and agglutination test) was detected in the IgM fractions. Minimum cross reaction was observed in the ELISA system between antigen prepared from A salmonicida and antibodies against Vibrio species and other species of Aeromonas. The specificity of the ELISA was also confirmed by inhibition test. Immunisation of rainbow trout with a virulent strain of A salmonicida provided good protection, though no correlation was observed between the protection and the ELISA titres of sera. PMID- 3628990 TI - The effects of Eperythrozoon ovis in sheep. AB - Infection of adult sheep with a single strain of Eperythrozoon ovis led to three different situations. First, the animal resisted the organism and no haematological changes occurred. Second, the host developed a controllable parasitaemia in which erythrocyte values fell shortly after peak parasitaemia and then returned to normal. Third, the host failed to control the parasitaemia and chronic low grade anaemia developed. Dexamethasone sometimes caused a resurgence of parasitaemia in sheep. PMID- 3628991 TI - Changing morphology of Eperythrozoon ovis. AB - Light microscopy studies of Eperythrozoon ovis in sheep revealed that Giemsa stain was only less reliable than acridine orange as a means of parasite identification when low parasitaemias were present. The morphology of E ovis altered as the degree of parasitaemia increased. PMID- 3628992 TI - Acid alpha naphthyl acetate esterase reacting lymphocytes in the peripheral blood of chickens challenged with Marek's disease after vaccination with three different vaccines. AB - The average percentage of acid alpha naphthyl acetate esterase reacting lymphocytes (APARL) was enumerated in the peripheral blood of chickens challenged with Marek's disease after vaccination with either turkey herpesvirus (HVT), inactivated Marek's disease virus (IMDV) or a mixture of the two (bivalent vaccine). A gradual increase in APARL value was noticed in the vaccinated chickens from day 7 to 70 after challenge with a virulent Marek's disease virus. The increase was consistent and significantly higher in bivalent (HVT plus IMDV) than in HVT-vaccinated chickens while the slight increase noticed in IMDV vaccinated-challenged birds was inconsistent. PMID- 3628993 TI - Retinopathy of prematurity. Surgical technique. AB - Retinal detachment, as the end result of severe retinopathy of prematurity (ROP), continues to account for many cases of blindness. Vitreous surgery can result in retinal reattachment in a significant percentage of these patients. The authors report their current techniques, which are based on improved understanding of the pathoanatomy and experience with more than 100 cases of retinal detachment in ROP treated with vitreous surgery. PMID- 3628994 TI - Calcified cytoid bodies in acquired immunodeficiency syndrome. AB - The postmortem histopathologic findings of eyes from two patients with acquired immunodeficiency syndrome (AIDS) are presented. Both patients had succumbed to multiple opportunistic infections. All of the eyes demonstrated calcified cotton wool patches of the retina. To date, there have been no prior descriptions of calcification of cotton-wool spots (CWS). The pathophysiologic mechanisms unique to AIDS that allow some of these CWSs to calcify have yet to be determined. PMID- 3628996 TI - Proliferative vitreoretinopathy. Histopathology of retroretinal membranes. AB - Light- and electron-microscopic studies of 43 eyes with retroretinal membranes are presented. Associated features were severe blunt or penetrating injury, total retinal detachment, surbretinal proteinaceous exudate, and concomitant presence of preretinal fibrocellular or fibrovascular proliferations. The retinal pigment epithelium was found to be the major cellular component in early (as soon as 1 week) and chronic retinal detachment cases. Isolated glial-derived membranes were less common and were found in cases with chronic retinal detachment. Macrophages and fibrocytes, along with the retinal pigment epithelium and glia, were detected in mixed membranes. Subretinal proteins are thought to influence migration and attachment of the retinal pigment epithelium, which in turn provides a template for proliferation of the various cell types described. PMID- 3628995 TI - Skin necrosis following fluorescein extravasation. A survey of the Macula Society. AB - Three patients developed cellulitis and skin necrosis following fluorescein dye extravasation. This experience prompted a survey of the Macula Society membership to determine whether this complication of fluorescein angiography is as rare as the paucity of cases in the literature suggests. In addition, the manufacturer was asked to reexamine the dye lot to determine whether an impurity had been introduced unintentionally during the manufacturing process. No impurity was found in the dye lots tested. The survey disclosed only nine additional cases of skin necrosis, leading to the conclusion that skin necrosis probably represents a rare, idiosyncratic reaction. Although fluorescein angiography remains a safe procedure, efforts should be directed toward prevention of dye extravasation. When extravasation does occur, prompt and proper medical attention with close follow-up study may minimize the likelihood of skin necrosis. PMID- 3628997 TI - [Tricuspid valve replacement for Ebstein's anomaly]. PMID- 3628998 TI - [Development of an automated system for assessing respiratory gas exchange--by mixing chamber method]. PMID- 3628999 TI - [Diagnosis of the site of accessory atrioventricular conduction pathways (so called "Kent's bundle") by atrial epicardial isochrone++ mapping--an experimental study]. PMID- 3629000 TI - [Beneficial effects of intravenous diltiazem on supraventricular tachyarrhythmias]. PMID- 3629001 TI - [A case of coronary artery-pulmonary artery fistula associated with variant angina pectoris]. PMID- 3629002 TI - [A case of PDA with severe coronary artery disease and esophago-bronchial fistula in elderly patient]. PMID- 3629003 TI - [Life-saving emergency pulmonary thromboembolectomy in a case of acute massive pulmonary thromboembolism with syncope]. PMID- 3629004 TI - [A case of primary amyloidosis with orthostatic hypotension]. PMID- 3629005 TI - [An autopsy case of dilated cardiomyopathy]. PMID- 3629006 TI - The effects of indomethacin on edema and gas exchange in canine acid aspiration. AB - Previous studies have suggested that prostaglandin synthesis inhibition might alter lung water accumulation in low pressure pulmonary edema. Therefore we studied the effects of indomethacin administration on edema formation, hemodynamics, and gas exchange in canine acid aspiration. Fourteen pentobarbital anesthetized dogs received 1 ml/kg of 0.1 N HCl intratracheally and then 7 received indomethacin (5 mg/kg) and 7 served as time controls. Lung liquid was measured in vivo by a double indicator technique and at the end of the experiment by gravimetric determinations. Following HCl administration, venous admixture (Qva/Qt) increased in both groups. Over the succeeding 4 h Qva/Qt decreased after indomethacin administration by 4.1 +/- 14.2%, but increased in the control group by 10.9 +/- 11.5% (P less than 0.05). Cardiac index remained constant in the control group but decreased after indomethacin from 232 +/- 89 ml X kg-1 X min-1 to 167 +/- 75 ml X kg-1 X min-1. Lung liquid accumulation, however, was similar between both groups. We believe that the changes in Qva/Qt associated with indomethacin can be explained by the known observations that decreases in cardiac output are associated with decreases in intrapulmonary shunt. PMID- 3629007 TI - Mechanoreceptor activity in the gills of the carp. I. Gill filament and gill raker mechanoreceptors. AB - Physiological properties of gill filament and gill raker mechanoreceptors in the gills of spontaneously breathing carp, Cyprinus carpio L., were analysed. Stroking stimuli applied to gill filaments elicited a phasic mechanoreceptive response, which was recorded from neurons in the epibranchial ganglia. Sustained deflection resulted in a short on-off response. The same neurons were also activated by slight movements of lamellae on a gill filament. The receptive field extended over all the lamellae of one filament at most, but generally covered a small part of it, including both dorsal and ventral lamellae. Deflection of gill rakers also elicited a brief response in epibranchial ganglion neurons. The threshold of both filament-related and gill raker mechanoreceptors was relatively high. They did not respond during normal respiration. It was therefore argued that these receptors do not function in normal respiratory control, but rather serve against mechanical damage from excessive pressure or particles in the water. PMID- 3629008 TI - Mechanoreceptor activity in the gills of the carp. II. Gill arch proprioceptors. AB - The presence of gill arch proprioceptors in the gills of a teleost, Cyprinus carpio L., is demonstrated and their firing characteristics are analysed. Spontaneous activity of gill arch proprioceptors was recorded from epibranchial ganglia. In paralysed fish the mean discharge rate for 16 receptors ranged from 11.3 impulses X sec-1 (SD 0.3) to 25.7 impulses X sec-1 (SD 0.4). The discharge rate could be influenced by displacement of the main elements of the respiratory pumping system. The receptors showed a tonic response. Their firing frequency was approximately linearly related to gill arch position and, hence, showed a respiratory modulation during ventilation. Gill arch adduction caused a decrease and abduction an increase in discharge rate. In actively breathing fish the mean firing frequency of 30 neurons ranged from 9.9 impulses X sec-1 (SD 0.7) to 40.1 impulses X sec-1 (SD 6.7). These gill arch proprioceptors are located in the cartilaginous strip between the epibranchial and the ceratobranchial of each gill arch and are innervated by the pretrematic branches of the vagal branchial nerves. The role these proprioceptors play in the regulation of gill movements during both feeding and ventilation is discussed. PMID- 3629009 TI - Respiratory activity in the superior laryngeal nerve of the rabbit. AB - We studied the respiratory modulation of laryngeal afferents and their response to transmural pressure in 24 anesthetized, spontaneously breathing rabbits. Laryngeal afferent activity has a predominant inspiratory augmentation during tracheal breathing or tracheal occlusion that can be accounted for by the respiratory movement transmitted to the larynx through the trachea. During upper airway breathing or upper airway occlusion SLN afferent activity increases in expiration and decreases in inspiration. This respiratory modulation is due to changes in upper airway pressure (Pua). In fact, positive pressure stimulates SLN afferent activity, while negative pressure inhibits it. Mechanical restriction of epiglottal movement reduced the response to Pua changes during upper airway occlusion and application of maintained positive (0.1-0.5 kPa) and negative (-0.1 to -0.5 kPa) pressures (P less than 0.005). Furthermore, surgical removal of epiglottis decreased the baseline activity of SLN to 16.5% of control. These experiments suggest that in the rabbit the epiglottis is the main source of SLN afferent activity and that its displacement, due to changes in Pua, is the most important factor for modulating SLN activity. Most of the laryngeal receptors showed an inspiratory augmentation with tracheal breathing and occlusion, were stimulated by positive pressure and inhibited by negative pressure, reflecting the behavior observed in the whole nerve. PMID- 3629010 TI - Hypoxic ventilatory control in the awake cat five years after carotid body resection. AB - Steady state breathing patterns, alveolar gases, and arterial blood gases and pH were measured during air, acute hypoxia, and acute hyperoxia in four awake cats 5 years after combined carotid body resection (CBR) and aortic depressor nerve section. Steady state breathing patterns and alveolar gases were also measured in these animals following 3 days of hypoxia (PIO2 = 110 Torr). The results show that the awake cat without carotid bodies and aortic depressor nerves hypoventilates during normoxia in relation to intact cats. Acute hypoxia resulted in respiratory acidosis, decreased tidal volume (VT), and decreased breath duration (TTOT). Exposure to hypoxia for three days resulted in no hyperventilation (isocapnia) but increased VT and TTOT from their levels during acute hypoxia. Acute hyperoxia resulted in respiratory alkalosis and increased VT. Moderate degrees of acute inspiratory hypoxia (FIO2 less than 0.12) induced a behavioral 'arousal' in these cats; this is in direct contrast to the lack of response seen shortly after CBR. Presumably, the recrudescence of chemosensitivity via unsectioned aortic chemoreceptor afferents played a key role in the arousal responses. However, there is no evidence in the cat for recrudescent chemoreceptor input to the respiratory control system with measurable steady state effect. We conclude that the peripheral chemoreceptors are essential for normal resting ventilatory control and for acclimation to chronic hypoxia. PMID- 3629011 TI - Dopamine blockade alters ventilatory acclimatization to hypoxia in goats. AB - Dopamine (DA) is generally accepted to be an inhibitory neurotransmitter in the carotid body (CB). It is released and depleted from the CB by acute hypoxia. From this background we made the hypothesis that hypoxic depletion of CB DA could be responsible for a time-dependent increase in CB afferent output and the early phase of ventilatory acclimatization to hypoxia (VAH) in goats. We reasoned, then, that blockade of DA receptors in the CB would accelerate the time course of VAH in the goat, i.e. produce a greater acute response to hypoxia (first 15 min) followed by a reduced rate of change of the subsequent time-dependent hyperventilation. We tested this hypothesis by exposing 7 adult female goats to up to 28 h of hypobaric hypoxia (PB = 380 Torr) on 3 different occasions separated by at least 2 months. The first was as control. During the second and third exposures different doses of the DA antagonist, domperidone, were administered prior to and during the hypoxic exposure (0.5 mg/kg followed by 0.25 mg/kg every 3 h and in the second study 1.0 mg/kg followed by 0.5 mg/kg every 2 h). The time course of acclimatization was assessed by measurement of arterial blood gases and pH in the awake goats. The data obtained in the first 4-5 h of hypoxia in domperidone treated animals appeared to support the hypothesis. Domperidone treated animals had a significantly greater acute ventilatory response to hypoxia followed by a lower rate of progressive hyperventilation in this period. However, variation in control values, greater respiratory alkalosis and a secondary significant hyperventilation after 6-7 h of hypoxia in the domperidone treated animals prevents a clear conclusion as to the precise role of CB dopaminergic mechanisms in acclimatization to hypoxia. Nevertheless, peripheral DA receptor blockade with domperidone does alter the time course and magnitude of hyperventilation during the first 7 h of hypobaric hypoxia in goats. PMID- 3629012 TI - Acetazolamide and cerebrospinal fluid ions in dogs with normal acid-base balance. AB - The purpose of these experiments was to study the effects of acetazolamide, a carbonic anhydrase inhibitor, on cisternal cerebrospinal fluid (CSF) ions during normal acid-base balance. We measured blood and CSF acid-base variables in two groups (n = 6 in each) of anesthetized, paralyzed and mechanically ventilated dogs with bilateral ligation of renal pedicles. After baseline samples were obtained, acetazolamide was administered intravenously within 10 min (group II); group I received equal volume (20 ml) of half-normal saline. During the next 6 h, in both groups arterial blood acid-base variables and plasma strong ions remained relatively normal. In group I, mean values for cisternal CSF PCO2 were 45.3 and 49.3 mm Hg at 0 and 6 h; respective values for CSF [HCO-3] were 24.1 and 22.7 mEq/L. In group II, corresponding values for PCO2 and [HCO-3] were 46.4 and 51.9 mm Hg, and 23.8 and 23.7 mEq/L, respectively. Comparing the two groups, related mean values were not significantly different from each other. Furthermore, acetazolamide had no significant effect on CSF Na+, K+ and Cl- concentrations. Based on the results of this study and those reported previously, we conclude that under normal acid-base balance, acetazolamide does not change ionic composition of cisternal CSF, choroidal CSF or brain extracellular fluid. PMID- 3629013 TI - Control of breathing in an amphibian Bufo paracnemis: effects of temperature and hypoxia. AB - Lung ventilation was measured in the toad, Bufo paracnemis, weight 500-800 g, at 15, 25 and 32 degree C during normoxia and hypoxia (5, 10, and 15% inspired O2). Arterial blood gases were measured during normoxic breathing. Typically breath holds alternated with ventilatory periods, which were initiated by a stepwise pulmonary deflation. Then a series of breaths consisting of both expiratory and inspiratory volumes followed. At the end of the period the lungs were inflated in several steps. Increased temperature markedly augmented ventilation mostly through a five-fold increase in the number of ventilatory periods per unit time. Ventilation was also enhanced by hypoxia and this response was greatest at the highest temperature. Arterial PO2 rose from 35 to 96 Torr when temperature increased from 15 to 32 degrees C. Bufo resembles reptiles regarding these responses. PMID- 3629014 TI - Delivery of health care to male adolescents. PMID- 3629015 TI - Communicating with adolescents in alternative health care sites. AB - Many adolescents have needs that are not always met in traditional medical settings. A number of sociomedical problems known as the new morbidities have presently emerged as national health-related problems among adolescents. However, in a recent national review, the 15 most frequent reasons for adolescent visits to a hospital or practitioner's office did not include these problems. We know that the major causes of death among adolescents are accidents, homicide, and suicide, and they experience untold mortalities related to teenage pregnancy, alcohol abuse, and drug abuse. Special programs are needed to address these problems. Our traditional health care facilities fail to reach the majority of high-risk adolescents. Through innovative programs such as Teen-Link, The Door, The Bridge over Troubled Waters, School Based Health Clinics, and other alternative health care facilities, many of these problems are being identified; and the at-risk population is targeted and served. Health care promotion and education have become major components of these programs. The key to attracting adolescent patients to these facilities has been the ability to reach out and serve them on their ground, and to effectively communicate with them despite their different socioeconomic and cultural backgrounds. No ideal approach to delivering health care exists for adolescent patients; however, a program that addresses their medical, social, educational, vocational, and psychologic needs may be utilized more frequently than programs that do not address the adolescent in a holistic manner. Further evaluation of these existing programs is necessary to assess which components are cost-effective, and which ones significantly affect the life-styles of adolescents as they progress toward adulthood.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3629016 TI - The Let's Talk program. A community approach to adolescent-parent concerns. PMID- 3629017 TI - Communicating with adolescents who have behavior problems. AB - Any clinician providing health care to adolescents needs to be able to communicate with them about behavior problems. For reasons relating both to adolescents and to health care providers, such communication is often challenging and sometimes frustrating. Nevertheless, one can develop a method of communicating with adolescents about their problems that will provide information that can be used therapeutically and will make the practice of adolescent medicine more rewarding for the professional. Numerous skills and techniques have been presented that enable the practitioner to initiate, facilitate, and encourage effective communication. These include both verbal and nonverbal methods. Methods for maintaining communication also have been discussed, since there are numerous ways in which communication with adolescents can go awry once it is established. Many health care providers already have developed other individualized skills and techniques; they are encouraged to consider adding those presented in this article. However, communication skills and techniques are useless unless they are based on an interest in the patient. As Peabody wrote almost 6 decades ago: "The secret of the care of the patient is in caring for the patient." PMID- 3629019 TI - Communication and compliance issues in the diagnosis and treatment of substance abuse in adolescents. PMID- 3629018 TI - A social psychologic model of female adolescents' compliance with contraceptives. PMID- 3629020 TI - Compliance with treatment for sexually transmitted diseases. PMID- 3629021 TI - Compliance in the adolescent with chronic illness. PMID- 3629022 TI - Communication and compliance issues in adolescent medicine. PMID- 3629023 TI - Treating the adolescent: the initial meeting. AB - In this article, we have tried to point out ways in which the initial interview can be facilitated, and in which it can be made to be both a pleasant and informative experience for the adolescent patients, and a productive and enjoyable encounter for the practitioner. The major areas include appropriate attitudes of personnel and the physical environment in which the patient is seen; the way in which a physician can introduce him- or herself to the family; methods of obtaining information from adolescent patients; differences of which one should be aware when interviewing adolescent patients at different developmental levels; and ways in which to establish rapport and to approach especially sensitive issues. Techniques to reduce anxiety in the physical examination and how to conclude the encounter are also reviewed. By using some of the techniques discussed for the initial encounter, and by incorporating those into his or her own style, the ability to care for adolescent patients can be enhance so that the physician can enjoy and, therefore, be willing to address effectively the health needs of adolescent patients. PMID- 3629024 TI - Considerations for the physician who treats adolescents in the office. AB - The purpose of an interview is to obtain information that will assist the physician in evaluating a patient's problem, and that will allow him or her to make appropriate recommendations toward solution of the problem. The major effort by the physician should be to provide the proper setting, and to be an interested, understanding listener. An opportunity to talk to someone who will listen in a caring way may be all that the usually uncommunicative adolescent needs. The primary care physician can obtain the knowledge, arrange for the necessary time, and develop the caring, sensitive attitude to talk with and counsel patients about many subjects, including sensitive ones. Sometimes, however, regardless of how hard one tries, the teenage adolescent patient will be reluctant to discuss his or her concerns. This should not be considered a failure, and the physician should not become discouraged. One should recognize the difficulty the adolescent is having and offer to be available in the near future when the adolescent patient may be ready to express his or her concerns. PMID- 3629025 TI - Communicating with adolescents from culturally varied backgrounds: a model based on Mexican-American adolescents in south Texas. AB - Health care delivery to Mexican-American adolescents requires knowledge of the general health needs of adolescents, as well as culturally determined beliefs about health and illness. Specific concepts about the cause and treatment of a variety of symptoms may cause some Mexican-American families to seek help from parallel systems of health care (i.e., the curandera and the physician). By understanding the family's beliefs about the problem, the physician can incorporate both systems to enhance a positive outcome. The physician needs to be aware of the extent to which the family both suffers with the ill adolescent patient and contributes to the acquisition of the patient's health. Differences in the extent of acculturation between adolescents and their parents may intensify the common parent-adolescent conflicts seen as a developmental phenomenon. As with any adolescent patient, a thorough history will help to assess the problem and will provide clues as to the best methods for intervention. PMID- 3629027 TI - [Effect of immunization in immunodepressed pigs naturally parasitized by Cysticercus cellulosae]. PMID- 3629026 TI - [Different culture media used for the isolation of non-typhi Salmonellae in coprocultures]. PMID- 3629029 TI - Biological aspects of renal cancer and its treatments. PMID- 3629028 TI - [Yeasts of tibi, and feeding tests in chickens and rodents using these zoogloea in the diet]. PMID- 3629030 TI - The pathophysiology of cirrhotic edema: a reexamination of the "underfilling" and "overflow" hypotheses. PMID- 3629031 TI - [Amiodarone does not inhibit pituitary 5'-deiodinase activity in hypothyroid rats]. PMID- 3629032 TI - [Characteristics of atrioventricular conduction during right and left atrial stimulation]. PMID- 3629033 TI - [Thyroid carcinoma in nodular goiter: usefulness of aspiration biopsy]. PMID- 3629035 TI - [Systemic lupus erythematosus without changes in the examination of the urine]. PMID- 3629034 TI - [Usefulness of continuous electrocardiographic monitoring in the differential diagnosis of syncope]. PMID- 3629036 TI - [Detection of antibodies to Brucella canis in man]. PMID- 3629037 TI - [Separation and characterization by high pressure liquid chromatography of delta(4)-3-ketosteroids synthetized from 3H-pregnenolone by an ectopic adrenal tumor treated with ketoconazole]. PMID- 3629038 TI - [Constrictive pericarditis following cardiac surgery]. PMID- 3629040 TI - [Aspiration biopsy in thyroid nodules]. PMID- 3629039 TI - [Byssinosis: an occupational disease of textile workers]. PMID- 3629041 TI - [The training in internal medicine in Chile: critical analysis]. PMID- 3629042 TI - [Hostility in the practice of the internist]. PMID- 3629044 TI - [Diffuse pulmonary hemorrhages]. PMID- 3629043 TI - [Psychosocial factors related to the smoking habit. Study of cases and controls]. PMID- 3629045 TI - Internal quality control in clinical chemistry: a teaching review. AB - This survey introduces the subject of internal quality assessment from a historical point of view, presents a unified approach to notation, concepts and definitions, and describes briefly those quality control procedures that are used most commonly in clinical chemistry. It is not the aim of this report to comment on all the individual contributions made in this field, but rather to concentrate on the principles. Particular emphasis is centered around assessment criteria to compare the efficiencies of selected control procedures for monitoring analyte concentrations in biological fluids. The question of whether to compare control schemes by means of average run lengths, run length distribution functions or average cost functions is considered. A rationalized approach based on the comparison of optimal procedures, using average run length, is adopted. PMID- 3629046 TI - Sample size requirements for reliability studies. AB - This paper provides exact power contours to guide the planning of reliability studies, where the parameter of interest is the coefficient of intraclass correlation rho derived from a one-way analysis of variance model. The contours display the required numbers of subjects k and number of repeated measurements n that provide 80 per cent power for testing Ho: rho less than or equal to rho 0 versus H1: rho greater than rho 0 at the 5 per cent level of significance for selected values of rho o. We discuss the design considerations of these results. PMID- 3629047 TI - Models for temporal variation in cancer rates. I: Age-period and age-cohort models. AB - A main concern of descriptive epidemiologists is the presentation and interpretation of temporal variations in cancer rates. In its simplest form, this problem is that of the analysis of a set of rates arranged in a two-way table by age group and calendar period. We review the modern approach to the analysis of such data which justifies traditional methods of age standardization in terms of the multiplicative risk model. We discuss the use of this model when the temporal variations are due to purely secular (period) influences and when they are attributable to generational (cohort) influences. Finally we demonstrate the serious difficulties which attend the interpretation of regular trends. The methods described are illustrated by examples for incidence rates of bladder cancer in Birmingham, U.K., mortality from bladder cancer in Italy, and mortality from lung cancer in Belgium. PMID- 3629048 TI - Models for temporal variation in cancer rates. II: Age-period-cohort models. AB - Our first paper reviewed methods for modelling variation in cancer incidence and mortality rates in terms of either period effects or cohort effects in the general multiplicative risk model. There we drew attention to the difficulty of attributing regular trends to either period or cohort influences. In this paper we turn to the more realistic problem in which neither period nor cohort effects alone lead to an adequate description of the data. We describe the age-period cohort model and show how its ambiguities surrounding regular trends 'intensify'. We recommend methods for presenting the results of analyses based upon this model which minimize the serious risk of misleading implications and critically review previous suggestions. The discussion is illustrated by an analysis of breast cancer mortality in Japan with special reference to the phenomenon of 'Clemmesen's hook'. PMID- 3629049 TI - Cure rate models: power of the logrank and generalized Wilcoxon tests. PMID- 3629050 TI - Adjustments to the Mantel-Haenszel chi-square statistic and odds ratio variance estimator when the data are clustered. AB - Dependence between observations on a dichotomous variable renders invalid the usual chi-square tests of independence and inflates the variances of parameter estimates. Such a situation occurs, for example, when subjects consist of members of the same family or with repeated observations on the same person. In this paper we describe methods of measuring the extent of correlation (or clustering). We also develop methods of adjusting the Mantel-Haenszel chi-square test statistic and the variance of the Mantel-Haenszel estimate of a common odds ratio in sets of 2 X 2 contingency tables. PMID- 3629051 TI - Analysis of total mortality in the Rotterdam sample of the Kaunas-Rotterdam Intervention Study (KRIS). AB - In 3284 middle-aged Rotterdam men, the dependency of 9-year survival on a number of cardiovascular risk factors is analysed. The purpose of this analysis is twofold. First, there is interest in the relationship between total mortality and the continuous variables blood pressure and plasma cholesterol. In accordance with other studies, the results provide further evidence for a U-shaped relationship. The second purpose is to compare three models theoretically as well as empirically: a piecewise exponential distribution of survival time, Cox's proportional hazards model (both with a long-linear dependency specification of the mortality rate), and a logistic model. The disadvantage of a logistic model is that it is theoretically not appropriate in longitudinal (prospective) epidemiologic studies. The theoretical advantage of the piecewise exponential distribution to Cox's model is that longitudinal (time) effects on the mortality rate can be specified and estimated directly. Empirically, with 342 deaths all three methods yield quite similar estimates and therefore are almost equally capable of detecting relationships between mortality and the risk factors in the data set at hand. PMID- 3629053 TI - Formulae for cause-deleted life tables. PMID- 3629052 TI - The relative efficiency of the sets and the cusum techniques in monitoring the occurrence of a rare event. AB - The efficiency of each of two methods for monitoring the occurrence of a rare event, the cusum, carried out monthly, and the sets techniques, was assessed by use of simulated datasets. The monthly cusum parameters used in this study were those recommended for monitoring of birth defects in a monthly analysis. The sets technique parameters, recommended for monitoring of low-level epidemics, were adjusted to match the average interval between false alarms to the corresponding values observed for the monthly cusum technique. The results indicate that the relative efficiency of the two techniques depends on the baseline frequency of diagnoses. The sets technique is shown to be more efficient than monthly cusum when the number of cases expected in a year is no greater than five, but less efficient otherwise. In the former case, lengthening the interval between cusum analyses can make the cusum technique more efficient than the sets technique. This possibility deserves further exploration and could affect future recommendations. PMID- 3629054 TI - The value of latent class analysis in medical diagnosis. PMID- 3629056 TI - [Local excision in rectal carcinoma]. PMID- 3629055 TI - [Radiological lung changes during an influenza epidemic in 2 schools for Army recruits]. PMID- 3629057 TI - [Depression due to exhaustion in mothers of young children]. PMID- 3629058 TI - [Pruritus, exanthema, icterus and fever]. PMID- 3629059 TI - [The case from practice (80). Patient: Mr. B.A., born 1-30-1953, Turkish migrant worker]. PMID- 3629060 TI - [Locoregional anesthesia versus general anesthesia]. PMID- 3629061 TI - [Prevention and treatment of complications caused by local anesthetics]. PMID- 3629062 TI - [Peridural anesthesia versus spinal anesthesia]. PMID- 3629063 TI - [Nerve block of the lower extremity]. PMID- 3629064 TI - [Nerve block of the upper extremity]. PMID- 3629065 TI - [Regional intravenous anesthesia--what's new?]. PMID- 3629066 TI - [What should be done when faced with an isolated abnormal liver function test?]. PMID- 3629067 TI - [Aminosalicylates and chronic inflammatory diseases of the digestive tract]. PMID- 3629068 TI - [Acute colitis]. PMID- 3629069 TI - [Human chromosomes: a phylogenetic testament]. PMID- 3629070 TI - [The genetics of mucoviscidosis 50 years later]. PMID- 3629071 TI - [Mucoviscidosis: the patient, his family and the pediatrician]. PMID- 3629072 TI - [The vaccines of the future]. PMID- 3629073 TI - [The "Youth and Health" program: evaluation of 3 years of implementation of prevention and health promotion for apprentices and high school students in Vaud]. PMID- 3629074 TI - Role of peripheral afferents and spinal reflexes in normal and impaired human locomotion. AB - For many years, electrophysiological investigations of locomotion were restricted to animals, largely the cat. They concentrated on and emphasized the role of spinal interneuronal networks responsible for the generation of the locomotor pattern. Following the introduction of perturbation impulses and electrical nerve stimulation during stance and gait, information became increasingly available concerning the role of the reflex systems involved in the regulation of gait, their afferent pathways and their control by supraspinal motor centres. During gait monosynaptic stretch reflexes are inhibited. From a knowledge of the behaviour of the cerebral potentials evoked during stance and gait, it can be deduced that during gait the signals of group I afferents are blocked at both segmental and supraspinal levels. Polysynaptic reflex responses are mainly responsible for the compensation of perturbations introduced during gait. They are most probably mediated by group II afferents via a spinal pathway closely connected with the spinal locomotor centres. The functioning of these responses depends on an intact supraspinal control. They are suggested to be incorporated in a more complex e.m.g. pattern mainly determined by central mechanisms. In contrast to the gait condition, segmental stretch reflex activity does contribute to activation of extensor muscles of the leg during fast movements, such as running and hopping. In children at an early stage in the development of gait (around 1 to 2 years of age), as well as in patients with spastic paresis, the polysynaptic reflex responses are reduced or absent, and isolated monosynaptic reflex potentials are present. This suggests a reciprocal modulation of mono- and polysynaptic reflex mechanisms, both being dependant on supraspinal control. When this control is either not yet matured (small children) or impaired (spastic paresis), inhibition of monosynaptic stretch reflexes is absent and associated with a reduced facilitation of polysynaptic spinal reflexes. In spastic muscle hypertonia, the tension developed at the Achilles tendon during gait cannot be explained by gastrocnemius activation alone. In patients with spastic hemiparesis gastrocnemius e.m.g. activity is reduced in the spastic leg as compared to the unaffected one. It can be concluded that the paretic muscle undergoes changes in its mechanical properties, secondary to the supraspinal lesion, which results in the development of spastic muscle hypertonia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3629075 TI - [Auditory hallucinations in lesions of the brain stem]. AB - Since the publication by Jean Lhermitte in 1922 of his paper on hallucinosis, the peduncular type has been described as a purely visual phenomenon. However, limited brain stem lesions can give rise to analogous manifestations in the auditory field. Five cases of auditory hallucinosis are reviewed, the first four resulting from a lesion of tegmentum of pons responsible for contralateral hemi anesthesia and homolateral facial palsy with paralysis of laterality. Central type hypoacusis and a severe disorder of localization of sounds revealed a lesion of trapezoid body. The fifth case resulted from a peduncular lesion in region supplied by superior cerebellar artery, the auditory deficit being related to a lesion of inferior corpus quadrigeminum. In one patient, the auditory hallucinosis was followed by a period of visual hallucinations and oneiric delusions. Both auditory and visual hallucinosis can be related to hypnagogic hallucinations. Dream mechanisms (the geniculo-occipital spikes system) escape from normal inhibitory control exerted by the raphe nuclei. Auditory deafferentation could predispose to auditory hallucinosis. PMID- 3629076 TI - [Multiminicore disease in a rigid spine syndrome]. AB - The case of a 15 year-old girl, who had difficulties in walking from early childhood is reported. The clinical picture was that of the rigid spine syndrome, spine rigidity being associated with retractions and diffuse amyotrophy of the upper limbs. Histochemical and ultra-structural studies of the muscle showed typical multiminicores. The multiminicore myopathy has not particular clinical features. In the rigid spine syndrome various histological changes can be found. For these reasons, we think that the rigid spine syndrome should be classified within the group of congenital myopathies. PMID- 3629077 TI - [Quasi-normal cerebrospinal fluid in patients with acquired immunodeficiency syndrome and cryptococcal meningitis]. AB - We report eight patients with cryptococcal meningitis and a cerebrospinal fluid characterized by few or no white blood cells and chemistries that may be near normal. In four of these patients, only testing for cryptococcal antigen allowed the initial diagnosis. Seven of the patients had a certain diagnosis of AIDS. Six have died. Autopsies performed in two cases indicated a poor meningeal inflammatory response. Contrary to the findings in most immunodeficient patients, in AIDS cryptococcal meningitis may present with few cellular or biochemical abnormalities in the cerebrospinal fluid. In AIDS patients presenting with headache and fever or change in mental status, examination of the cerebrospinal fluid should not be limited to routine studies. PMID- 3629078 TI - [Alexia and agraphia caused by a lesion of the right hemisphere in a non-aphasic right-handed patient]. AB - Oral and written speech centers are commonly attributed to the dominant hemisphere, while body, spatial and facial recognition to the non-dominant. This paper examines the case of a 63 year old entirely right-handed male who presents alexia, agraphia, difficulties in spelling and word-finding together with left spatial and body agnosia, musical, letter and face agnosia, constructional apraxia and left hemianopsia. Computerized axial tomography confirms a right occipital tumor identified as an adeno-carcinoma probably of digestive origin. The role of right hemisphere as a spatial prerequisite to final elaborate speech is discussed. PMID- 3629079 TI - [Spinal epidural dumbbell-shaped cavernous angioma]. AB - A 23 year-old man, with a two month-history of back pain, presented with spastic paraplegia and hypesthesia of both lower limbs. A myelo C.T. revealed a spinal epidural dumb bell-shaped mass extending in the intra and extra vertebral spaces through the enlarged intervertebral foramen. Total recovery was observed three months after surgery. Pathological examination of the tumor showed it to be a cavernous angioma. Primary epidural angioma is rare: in 2 reported dumb bell shaped spinal epidural cavernous angiomas, radiological findings were also suggesting a spinal neurinoma. PMID- 3629080 TI - [Lesions of the basal ganglia in mumps. Clinical and neuroradiological development in a case]. AB - Among mumps complications, encephalitis is the most frequent. Involvement of the basal ganglia has been previously reported associated to some other encephalic lesions. In one case, changes were confined to basal ganglia and occurred at the 10th day of evolution of mumps. Clinically a bilateral extrapyramidal syndrome was present without other neurological disorders. CT scan showed bilateral lesions in the area of the basal ganglia. The course was favorable. The neurological examination and CT scan were normal 6 months later. Such complications should be prevented by vaccination. PMID- 3629081 TI - [Cutaneous ulcerations and osteolysis in the carpal tunnel syndrome]. AB - A case of carpal tunnel syndrome with skin ulcerations and osteolysis is reported. Such cases are unusual. There was a sensory and motor deficit with chronic ulcerations on the palmar surface of the third phalanx of the medius. The distal phalanx of the forefinger had been lost due to osteolysis. Surgical treatment is said to be followed by a healing of the ulcerations. PMID- 3629082 TI - [Intellectual and motor disorders with subacute development. Multiple focal hypodense areas on the CT X-ray scanner. Elevation of the sedimentation rate in a 59-year-old woman]. PMID- 3629083 TI - Hypercapnia and sleep O2 desaturation in chronic obstructive pulmonary disease. AB - There is a wide clinical spectrum in chronic obstructive pulmonary disease (COPD). The extremes of this spectrum, the "pink puffer" (PP) and "blue bloater" (BB) stereotypes differ in their degree of sleep hypoxemia and pulmonary hypertension. Most patients cannot be characterized as either PP or BB. The data amassed in the recent nocturnal oxygen therapy trial provide an opportunity to see to what extent differences in sleep oxygenation and hemodynamics in a large hypoxemic COPD population are related to awake hypoxemia and hypercapnia. From a large hypoxemic COPD population sleep SaO2 was examined in those with (PaCO2 greater than 44 mm Hg) and without (PaCO2 less than or equal to 44 mm Hg) hypercapnia. Hypercapnic patients (mean PaCO2 49.8 mm Hg) had the same PaO2 and degree of airflow obstruction as normocapnic patients (PaCO2 37.4 mm Hg) but had far greater sleep hypoxemia (measured by mean sleep SaO2, low sleep SaO2, and awake-low sleep SaO2, p less than 0.05). In addition, arterial blood gases of the large sleep O2 desaturaters were compared with those of the small desaturaters; PaO2 was similar in both groups, whereas PaCO2 was different (p less than 0.01). Two common subsets of hypoxemic patients were also compared; one was hypercapnic and overweight, the other normocapnic and hyperinflated. We found that patients in the hypercapnic group had far worse sleep hypoxemia, although they had better lung function. We conclude that hypercapnia is a marker for sleep O2 desaturation in hypoxemic COPD. PMID- 3629084 TI - The effect of excessive ethanol ingestion on sleep in severe chronic obstructive pulmonary disease. AB - The effect of a moderately intoxicating dose of ethanol on sleep was evaluated in five patients with severe emphysematous chronic obstructive pulmonary disease (COPD) (mean FEV1 0.83 L, PaO2 75 mm Hg). Mean serum ethanol before sleep was 129 mg/dl. With alcohol, total sleep time per night decreased from a mean of 293 to 238 min. Relative sleep time per stage also changed; NREM time increased, and REM time decreased greater than 50%. Alcohol caused significant O2 desaturation; group mean sleep arterial oxygen saturation (SaO2) decreased from 90.6 to 87.7% with alcohol. Although the decrease in SaO2 was not uniform across all sleep stages, no individual sleep stage accounted for the desaturation. The fall in SaO2 with alcohol was not explained by increasing apneas or hypopneas. Mean heart rate increased significantly from 71.8 to 77.1 with alcohol, with premature ventricular contractions increasing in two subjects. Excessive alcohol ingestion in severe COPD alters total sleep time and stage distribution, decreases SaO2 without significant change in apneas, and increases heart rate. Prior to sleep, patients with severe COPD should strictly limit ingestion of alcohol. PMID- 3629085 TI - Oxygenation and breathing pattern during phasic and tonic REM in patients with chronic obstructive pulmonary disease. AB - Oxygen desaturation in chronic obstructive pulmonary disease (COPD) occurs during sleep and is most marked in REM sleep. REM is not a homogeneous state, consisting of phasic REM (PREM) (REMs, myoclonic twitches) and tonic REM (TREM) (muscle atonia, desynchronized electroencephalogram). In normals, onset of PREM produces transient changes in breathing pattern with a decrease in respiratory amplitude and an increase in frequency, which produce reductions in oxygen saturation (SaO2). Because it is reasonable to expect such breathing pattern changes to cause more desaturation in COPD, and because systematic all-night studies of PREM and TREM have not been reported, we studied 18 patients with severe COPD [Forced expiratory volume in one second (FEV1) = 25.7 +/- 3.5 (SEM) % predicted] during sleep and monitored SaO2 and breathing pattern in PREM and TREM. PREM made up 19.7% of total REM (4.6% total sleep time) but was associated with 81.7% of the total REM desaturations of greater than 5% (57.9% of all sleep desaturations of greater than 5%). With PREM onset, breathing pattern changed 72.5% of the time, most often with a transient decrease in amplitude and increase in frequency. Even though 27.5% of PREM was not associated with changes in breathing pattern and many PREM segments were very short, we were still able to show highly significant SaO2 differences between PREM and TREM. Mean TREM SaO2 was 88.0 +/- 1.2%; mean PREM SaO2 was 86.6 +/- 1.4%, with mean nadir SaO2 for individual PREM segments falling to 84.8 +/- 1.5%. Mean awake SaO2 was 89.7 +/- 0.8%. We conclude that in COPD the transition from TREM to PREM is associated with breathing pattern changes and oxygen desaturation. Differences in breathing pattern with PREM onset may be related to different effects of PREM processes on respiratory neurons and diaphragm motor neurons. PMID- 3629086 TI - Silent partners: the wives of sleep apneic patients. AB - The wives of 10 male patients being treated for sleep apnea, obstructive type, were interviewed and given the Social Adjustment Scale (SAS) and Marital Satisfaction Inventory (MSI). The patients also completed an SAS and a Minnesota Multiphasic Personality Inventory (MMPI). These data were compared with those from a sample of divorced patients from the same pool. The married patients were significantly more depressed and socially isolated than were those divorced. Both marital partners showed poor adjustment in the Marital and Social/Leisure areas, and patients also showed poor adjustment in their Parental Role. Marriages do not necessarily represent social support but appear to be an added burden for sleep apneic patients. PMID- 3629087 TI - Snoring in normal young adults: prevalence in sleep stages and associated changes in oxygen saturation, heart rate, and breathing pattern. AB - Six men and three women, asymptomatic light snorers ranging in age from 25-34 years, were studied during sleep to determine the prevalence of snoring in the different sleep stages, the associated changes in oxygen saturation (SaO2), heart rate (HR), and breathing frequency (f), and the associated breathing arrhythmias. Snoring was defined as a 1-minute epoch with more than 80% of the breaths associated with snores. Most of the snoring epochs as well as the apneas and hypopneas occurred during stage 2, mainly because it is the most prolonged sleep stage. The prevalence of snoring, however, normalized for differences in length of sleep stages, was highest in stages 3 and 4 but low in REM, whereas the converse was true for apneas and hypopneas. Snoring caused no change in the mean SaO2, mean HR, or f, as compared with nonsnoring periods in the same sleep stage. Continuous snoring in normal subjects can occur without significant O2 desaturation or breathing arrhythmia. Continuous snoring and breathing arrhythmia tended to occur together in a given subject but were unrelated in time, suggesting a different pathogenesis. PMID- 3629088 TI - Neuropsychological dysfunction in sleep apnea. AB - To evaluate the effect of intermittent hypoxemia on neuropsychological functioning, neuropsychological tests were administered to 14 sleep apnea patients, a control group of 10 patients with other disorders of excessive somnolence, and another control group of 14 healthy volunteers. The sleep disorder groups were matched on two measures of sleepiness. It was found that sleep apnea patients performed significantly worse than both controls on 7 of 14 neuropsychological measures and on a rating of global neuropsychological impairment. The overall level of performance reflected only moderate impairment. Within the sleep apnea group, hypoxemia severity was significantly correlated with deficits on measures of motor and perceptual-organizational ability. PMID- 3629089 TI - Dynamic in vivo response characteristics of three oximeters: Hewlett-Packard 47201A, Biox III, and Nellcor N-100. AB - Pulse oximeters (Biox III, Nellcor N-100) and a transmittance oximeter [Hewlett Packard 47201A (HP)] were compared for SaO2 measurement and responsiveness during dynamic changes in arterial oxygen saturation and heart rate. Five sleep apnea syndrome patients were studied because they had large oscillations in SaO2 and heart rate in sleep. During sleep, each patient exhibited a series of rapid (18.0 +/- 8.3 s, mean +/- SD) oscillations in oxygen saturation (92.1 +/- 2.6% to 74.2 +/- 7.7%). Oxygen saturation measurements were sampled simultaneously from each oximeter by computer (at 2 Hz). Accuracy was assessed by comparing pulse and transmittance oxygen saturation measurements at the peak and trough of each apnea related oscillation. Oximeter response was defined in terms of the "delay" or absolute time difference between the pulse oximeters and the transmittance oximeter for the determination of the peak and trough saturations. Linear regression analysis was used to establish accuracy and response relationships between pulse oximeter sensors (reusable ear, reusable digit, disposable digit, and disposable nasal sensors) and the transmittance oximeter sensor (reusable ear sensor). Pulse oximeter response delay was highly correlated with heart rate. Pulse oximeter SaO2 measurement and response characteristics varied considerably with sensor type (disposable, reusable) and sensor location (ear, nose, and digit). One must be aware of these differences in clinical and research application. PMID- 3629090 TI - The cardioacceleratory response to arecoline infusion during sleep in narcoleptic subjects and controls. AB - Nine narcoleptic and nine control subjects underwent 4 nights of sleep recordings. On nights 3 and 4, they received continuous intravenous infusions of saline. Additionally, on both nights they received 0.2 mg glycopyrrolate at the end of the first REM period (REM1) and 0.5 mg arecoline or placebo in random order 20 min after the end of REM1. Heart rates were counted for a 40-min period following the end of REM1. There was a significant and similar cardioacceleratory effect after arecoline in both narcoleptic and normal subjects, beginning at 5 min from the start of the infusion and peaking at 9 min. Placebo had no effect. Narcoleptic subjects had consistently higher baseline heart rates than controls on infusion and noninfusion nights, most likely owing to age differences between the two groups. The results suggest that narcoleptic persons do not have increased cholinergic sensitivity, or that the canine model of narcolepsy differs from the human model, or that the muscarinic receptors that play a role in the pathophysiology of narcolepsy differ in sensitivity from those that regulate heart rate. PMID- 3629091 TI - High prevalence of isolated sleep paralysis: kanashibari phenomenon in Japan. AB - In Japan, a set of experiences called kanashibari is considered identical with isolated sleep paralysis. We investigated this phenomenon by means of a questionnaire administered to 635 college students (390 men and 245 women). Of all subjects, about 40% had experienced at least one episode of kanashibari [subjects of K(+)]. Therefore, isolated sleep paralysis is apparently a more common phenomenon than is usually appreciated. About half of the subjects of K(+) reported that they had been under "physical or psychological stress" or in a "disturbed sleep and wakefulness cycle" immediately before the episode. Many subjects of K(+) experienced the first episode in adolescence. In the distribution of age of first attack, the peak occurred at an earlier age in women subjects than in men subjects. These findings suggest that two factors influence the occurrence of the phenomenon. One is exogenous physical or psychological load and the other is endogenous biological development. PMID- 3629092 TI - [Natural killer cells of the lung]. AB - Natural killer cells are lymphocytes which spontaneously destroy tumoral or virus infected cells in vitro. They are identified on morphological criteria (LGL) and/or on the presence of "surface markers". However, none of these criteria is specific, and they can only be defined by their spontaneous cytolytic activity. These cells, present in numerous organs, have been particularly studied in blood and lymphoid tissue. They intervene in defence mechanisms against virus-infected cells, in the graft-versus-host reaction and in immunosurveillance or tumours. Few studies have been devoted to natural killer cells of the lung. They are present in that organ in the same proportion of lymphocyte population as in blood, but their activity is inhibited by the local microenvironment. PMID- 3629093 TI - [Multiple leiomyomatous pulmonary nodules in women. Apropos of 2 cases of metastasizing benign leiomyoma]. AB - Two cases of multiple pulmonary leiomyomas in women aged 51 and 45 years respectively are reported. The lesions were discovered 21 and 11 years respectively after hysterectomy for uterine fibromyoma without abnormal histological features. The pulmonary nodules were bilateral and either stable or growing slowly. They were revealed by non-specific symptoms. At surgical biopsy the histological picture was one of benign leiomyoma without mitosis. In one of the 2 patients a pulmonary nodule was explored for oestrogen and progesterone receptors with positive results. The various theories on the origin of these multiple leiomyomas are reviewed. Initially regarded as malformative tumours, they were later interpreted as metastases of uterine leiomyomas with a potential for dissemination. The finding of hormone receptors demonstrates a relationship between these pulmonary lesions, uterine leiomyomas and other multifocal leiomyomatous diseases, including lymphangioleiomyomatosis. The slow but benign course of these tumours differentiates them from metastases of low-malignancy leiomyosarcomas. PMID- 3629094 TI - [Functional follow-up of pulmonary localization of scleroderma]. AB - Pulmonary lesions of scleroderma are frequent, but little is known of their course, especially where lung function is concerned. We report the results of a longitudinal study performed in 32 patients with generalized scleroderma (ARA criteria) explored on at least 2 occasions with an interval of at least 24 months between the two examinations. Functional alterations seemed to be more pronounced in patients with severe Raynaud's syndrome, but in view of major individual variations no pathognomonic functional profile could be described. PMID- 3629095 TI - [Simultaneous or successive primary multifocal bronchial cancer. Apropos of 12 cases]. AB - Twelve cases of bifocal and bilateral bronchial carcinoma are presented. The two tumours developed successively in 6 cases and simultaneously in 6 cases. Patients' mean age (60 years) was the same as in other lung cancers. Four out of 12 patients produced a history of old ENT or skin cancer. In 11 out of 12 cases the second tumour, undetectable by radiology, was discovered at bronchoscopy. In 2 patients the two tumours had a different histology: adenocarcinoma and squamous cell tumour. In all other cases, both tumours were of the squamous cell type. Treatment of the second contralateral tumour was difficult to determine, especially when the first tumour had been widely excised. However, radiotherapy focused on small endobronchial tumours seemed to give interesting results. PMID- 3629096 TI - [Contribution of iatrogenic pathology to all pleural diseases]. AB - The contribution of iatrogenic pathology to all pleural diseases was evaluated in a series of 562 cases by studying pleural effusions or pneumothoraxes induced by medical interventions. Iatrogenic pathology accounted for 5.5% of all pleural diseases (effusion 2.5%, pneumothorax 3%). The medical interventions most frequently responsible for pleural effusion were surgical operations performed in the thorax, but also on abdominal organs located close to the diaphragm. Pneumothorax was almost always induced by diagnostic manoeuvres: essentially needle biopsy and, less frequently, transbronchial lung biopsy under fibroscopy. It must be pointed out that iatrogenic pleural lesions are small and usually asymptomatic. PMID- 3629097 TI - [Asthma during pregnancy]. AB - The fact that 1% of pregnant women are asthmatic raises the question of possible interactions between asthma and pregnancy. The effects of pregnancy on respiratory physiology are studied in a first chapter, while the second chapter is devoted to the effects of pregnancy on asthma. In round figures, 1/3 of the patients get worse, 1/3 are improved and 1/3 remain stable. The patients who deteriorate are those with very severe asthma and high IgE On the other hand, well-treated asthmas have no influence on pregnancy or foetal growth. All drugs classically used in asthma (theophyllines, beta-adrenergic stimulants [at a distance of delivery], atropine-like compounds and cortico-steroids) may be used by pregnant asthmatic women and should be prescribed in effective doses. PMID- 3629098 TI - [Sarcoidosis associated with significant blood hypereosinophilia. Apropos of a case]. AB - We report the case of a 20-year old girl in whom sarcoidosis (articular, mediastinal, cardiac, lachrymal) and major blood eosinophilia (8,000 eosinophils/mm3) were discovered simultaneously. Clinically, biologically and radiologically, the course of the disease was rapidly favourable without any treatment. After a 13-month follow-up, the patients is now in good health. Since no other cause of blood eosinophilia was found (parasitological and immunological investigations were negative and there were no signs suggesting a myeloproliferative syndrome or a connective tissue disease), we believe that the blood abnormality must have been associated with sarcoidosis. PMID- 3629099 TI - [Spontaneous bacterial peritonitis]. PMID- 3629100 TI - [Serum folic acid in mothers and newborn infants of different stages of maturity and intrauterine growth]. PMID- 3629101 TI - [Hemoglobinopathies: prevalence and variability]. PMID- 3629102 TI - [Free radicals, ischemia and inflammation]. PMID- 3629103 TI - [Malaria and pregnancy]. PMID- 3629104 TI - [Management in isolated pancreatic rupture caused by abdominal contusion]. PMID- 3629105 TI - [Acute edema of the lung, non-cardiogenic, after re-expansion]. PMID- 3629106 TI - [Pure gonadal dysgenesis associated with anosmia]. PMID- 3629107 TI - [Invasive paraganglioma of the carotid body]. PMID- 3629108 TI - [Basal energy expenditure in surgery]. PMID- 3629109 TI - [Esophageal ulcers produced by drugs. Report of a patient]. PMID- 3629110 TI - [Distal stenosis of the esophagus caused by embryonic remnants of tracheobronchial tissue (chondro-epithelial choristoma). Report of a patient]. PMID- 3629111 TI - [Association of Peutz-Jeghers syndrome with 2 primary carcinomas: small intestine and breast. Report of a patient]. PMID- 3629112 TI - [Endoscopy for the patient with AIDS]. PMID- 3629113 TI - [The teaching of gastroenterology]. PMID- 3629114 TI - [Surgical pathology of the cecal appendix. Analysis of 8,950 cases]. PMID- 3629115 TI - [Necrosing lymphadenitis and other histological disorders in typhoid fever]. PMID- 3629116 TI - [100 transoperative cholangiographies]. PMID- 3629117 TI - [Endocarditis in biological prosthesis by Candida parapsilosis]. PMID- 3629118 TI - Rabies in the State of Sao Paulo: the rodents question. PMID- 3629119 TI - Epidemiologic study of bronchopulmonary mycosis in the province of Cordoba, Argentina. PMID- 3629120 TI - Radiometric studies on the oxidation of (1-14C) fatty acids by drug-susceptible and drug-resistant mycobacteria. PMID- 3629121 TI - Morphological and functional abnormalities in platelets exposed in vitro to ioglicinic acid, a new ionic contrast medium. AB - The inhibitory effect on platelet function induced by several radiographic contrast media is still poorly understood. In this study platelet abnormalities caused by in vitro addition of ioglicinic acid, a new ionic contrast medium, were evaluated. The appearance of several granules similar to dense bodies associated with shape change and internal reorganization were detected by electron microscopy techniques. A functional study revealed a marked decrease in the aggregating response of platelets to adenosine diphosphate and calcium ionophore A23187, while aggregation in response to collagen was completely normal. It is suggested that ioglicinic acid induces platelet abnormalities related to the effect on calcium movements and that studies with this contrast medium may help the understanding of some basic events of platelet activation. PMID- 3629122 TI - Liquid chromatographic determination of free serotonin in human plasma. AB - The complex background of interfering substances makes plasma pretreatment necessary before performing liquid-chromatographic quantitation of circulating serotonin. We compared two isolation procedures (extraction into butanol and isolation on a weak cation-exchange resin) before chromatography for measuring free serotonin from human plasma. Sensitivity, specificity and recovery were all evaluated. The cation-exchange resin yielded chromatograms with no interfering peaks, was cheaper and took less processing time than butanol extraction. We conclude that the clean-up of human plasma by a cation-exchange resin is suitable and accurate for routine liquid-chromatographic determination of circulating serotonin. PMID- 3629123 TI - The nasal patho-physiology of headaches and migraines. Diagnosis and treatment of the allergy, infection and nasal septal spurs that cause them. PMID- 3629124 TI - International Symposium on Multiple Sclerosis. Invited lectures and posters. PMID- 3629125 TI - Studies on anti-myelin antibodies in patients with multiple sclerosis. AB - We studied the CSF and sera from 16 patients with MS to detect IgG antibody activity against normal CNS myelin and some of its proteic and lipidic components. IgG binding to a protein band of the same MW of myelin basic protein was detected by "immunoblot" in the sera and/or CSF of 25% of patients with MS and in none of the controls with OND. No IgG antibody reactivity against other components of CNS myelin was detectable in patients with MS, and immunoabsorption of the CSF of MS patients with CNS myelin did not modify the oligoclonal prophile of CSF IgG. Anti-myelin antibodies do not seem to represent the bulk of oligoclonal IgG in MS patients. PMID- 3629126 TI - Experimental allergic encephalomyelitis, a model of demyelination in central nervous system (CNS). AB - Different forms of experimental allergic encephalomyelitis were obtained in 31 guinea pigs. Four groups of animals were studied: 7 adult Hartley guinea pigs (Group 1), 12 adult Hartley guinea pigs (Group 2), 6 juvenile strain 2 guinea pigs (Group 3), 6 juvenile strain 13 guinea pigs (Group 4). The increment of the antigenic load induced different disease courses in the animals. The different disease courses were attributed to differential inactivation of the cell-mediated response to the injected antigens. The intraneural injection of serum withdrawn from guinea pigs affected by EAE induced demyelination in the optic nerve fibers of healthy rats. Areas of demyelination with naked axons were evident 30 days following the injection when Visual Evoked Potential (VEP) delays were of as much as 27 msec. Our experiments demonstrated the activity of EAE sera (probably antiGal-Cer antibodies) on the myelin sheats of nervous fibers. PMID- 3629127 TI - Non-clinical tests for the diagnosis of multiple sclerosis. AB - Liquoral, Neurophysiological and Nuclear Imaging data were investigated in 29 patients suffering from Definite (11 cases), Probable (11 cases) and Possible (7 cases) Multiple Sclerosis (MS). The most sensitive tests were: Visual Evoked Potentials (VEPs), altered in 75% of patients, Motor Evoked Potentials (MEPs), abnormal in 75%, Nuclear Magnetic Resonance Imaging (MRI) in 72.4%. Somatosensory Evoked Potentials (SEPs) were altered in 69.2% in PN-SEPs and in 53.6% in MN SEPs, whilst Brainstem Evoked Potentials (BAEPs) were altered in 30.8% of cases. The results suggest that patients with suspected forms of MS should be submitted, as routine diagnostic protocol, to a battery of EPs, including as a first choice VEPs, MEPs and PN-SEPs. MRI should be performed to confirm a diagnosis not supported by EP data, or for a comprehensive localization of the demyelinating plaques. PMID- 3629128 TI - The quantitative parameters of intrathecal IgG synthesis. A comparison. AB - Cerebrospinal fluid IgG/Albumin, IgG Index, Tourtellotte's formula and Schuller's formula have been calculated in 258 patients with definite Multiple Sclerosis and oligoclonal bands at isoelectrofocusing examination of cerebrospinal fluid. A step wise discriminant analysis was performed on single parameters and on a combination of IgG Index, Tourtellotte's and Schuller's formulas. The latter showed the highest percentage of right classification. PMID- 3629129 TI - Comparison between magnetic resonance imaging and other techniques in 39 multiple sclerosis patients. AB - Till now there are no specific laboratory tests to confirm the diagnosis of Multiple Sclerosis (MS). For this reason the diagnosis of MS is based on the clinical evidence of central nervous system white matter disease with temporal and spatial dissemination of the lesions. Recent advances in neurophysiology and imaging techniques can provide more objective criteria towards more accurate and earlier diagnosis, detecting clinically unsuspected lesions. We evaluated 39 MS patients (23 definite, 7 probable, 9 possible) by Magnetic Resonance Imaging (MRI), CT scan, Evoked Potentials (EPs) testing and Cerebrospinal Fluid analysis. MRI was abnormal in 34 cases (87%) and CT scan in 14 (36%); EPs were also abnormal in 34 cases. 30 patients had both EPs and MRI alterated and 4 patients had alterated only one of the two investigations. The frequency of EPs alterations was: VEP 74%, Median SEP 44%, Tibial SEP 59% and BAEP 54%. The BAEP was more sensitive than MRI in detecting brainstem involvement. On the other hand MRI was more sensitive than SEPs in detecting somatosensory pathways involvement. The combined use of the two techniques allowed a reclassification of 10 out of 16 possible or probable MS cases. PMID- 3629130 TI - The molluscicidal properties of Ambrosia maritima L. (Compositae). 3. A comparative field trial using dry and freshly-harvested plant material. AB - A comparative trial of freshly-harvested and dry forms of the plant molluscicide, Ambrosia maritima is described. The plant was grown near Alexandria, Egypt and gave a weight ratio of 4:1 for fresh: dry, mature plants. Applications of plant material were made to irrigation watercourses at dosage levels of 560 mg . l-1 fresh and 70 and 140 mg . l-1 dry in May and 280 mg . l-1 fresh and 70 mg . l-1 dry in June. Snail numbers were reduced to low levels after two weeks in all treatments. Statistically significant differences could not be detected between the molluscicidal effects of fresh and dry material or their use in May and June. The cultivated plant has a similar order of activity to that collected from the wild. The snail number reduction was maintained to the end of the year in all treatments. This confirms an earlier finding that a correctly-timed, single application of the plant is capable of controlling snails throughout the entire schistosomiasis transmission season in Lower Egypt. PMID- 3629131 TI - Antigenic characterization of excretory-secretory products of Setaria cervi. AB - Excretory-secretory products (ES) of Setaria cervi, a bovine filarial parasite, were prepared by in vitro maintenance of the worms in a protein free defined medium at 37 degrees C. RPMI-1640 medium proved to be the best as the worms remained motile in it for the maximum period of time without change of medium, and approximately 12-15 mg protein per 100 adult worms could be obtained. Crossed immunoelectrophoretic analysis of ES products revealed 11-15 antigens and most of them were common to somatic antigenic preparations from both adult worms and microfilariae. The ES products were also found to contain 3-4 host proteins, including serum albumin. PMID- 3629132 TI - Isoenzymatic typing of 23 Trichinella isolates. AB - Twenty-three Trichinella isolates have been examined by the isoenzyme typing of ten enzyme systems (LDH, ME, 6PGDH, G6PDH, GOT, AK, PGM, ACON, MPI, GPI). Four different zymodemes were obtained. All the examined isolates have shown an electrophoretic behaviour like one or other of four reference strains. The isolates from Italy and Yugoslavia have an electrophoretic mobility like T. nelsoni reference strain. The isolates from France, Holland, Poland and U.S.A. have an electrophoretic mobility like T. spiralis reference strain. For T. nativa and T. pseudospiralis we have only the reference strains. These results support the validity of the taxonomy of Trichinella genus in four good species. PMID- 3629133 TI - Effect of ivermectin in Dipetalonema viteae and Litomosoides carinii infections of Mastomys natalensis. AB - In D. viteae infected M. natalensis oral or subcutaneous (s.c.) treatment with ivermectin on 5 consecutive days with at least 0.05 mg/kg and single dose treatment with 0.1 mg/kg caused a 100% reduction of microfilaraemia throughout the investigation period of 42 days. Using lower doses (lowest dose used 5 X 0.003 mg/kg) animals were free from circulating microfilariae at least until day 7. The drug was active against adult worms. Treatment with doses of 5 X 0.2 mg/kg and above resulted in 81-93% and 38-83% reductions of male and female worms, respectively. Lower doses caused inconsistent macrofilaricidal effects but mainly male worms were affected. After treatment with 5 X 3.25 mg/kg and above increased rates of pathologically altered intrauterine stages were found in surviving female worms. After treatment of L. carinii infected Mastomys with doses of at least 5 X 1.5 mg/kg animals remained amicrofilaraemic until autopsy on day 42 and in case of lower doses (lowest dose used 5 X 0.006 mg/kg) at least until day 7. After single dose treatment (s.c.) with 0.2 mg/kg and above animals were free from microfilariae in the blood throughout the observation period. Single dose treatment with 0.05 and 0.0125 mg/kg removed all microfilariae from the blood until 8 and 48 hours, respectively but microfilariae occurred in the blood again after 14 days. Ivermectin did not affect the numbers of adult L. carinii but female worms isolated 42 days after treatment with 5 X 0.78 mg/kg and above were free from motile, normally shaped microfilariae and contained increased rates of pathologically altered embryonic stages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3629134 TI - Effect of ivermectin on serum dependent cellular interactions to Dipetalonema viteae microfilariae. AB - The effects of ivermectin (Iv) on the filarial infection has been investigated using Dipetalonema viteae--Mastomys natalensis model system. In vitro, Iv (3 micrograms/ml) had no effect on the microfilariae (mf) in the presence or absence of serum from normal or infected Mastomys (NMS, IMS). However, the sera promoted cell-mediated cytotoxicity with macrophages or eosinophils to the mf when Iv was added at 3 ng/ml. Sera isolated from normal or infected Mastomys after subcutaneous treatment with Iv (100 micrograms/kg) (Iv-NMS, Iv-IMS) also induced cellular cytotoxicity to the mf in vitro. Available evidence suggests that Iv mediates the cellular cytotoxicity by complement activation by alternative pathway. Iv treatment of D. viteae infected Mastomys resulted in an initial mobilization of the mf into circulation followed by the death of both the mf and adults in vivo. There was enhanced antibody level in Iv treated infected animals and antibody dependent cellular cytotoxicity mediated by IgM seems to be predominantly involved in elimination of the mf. The serum containing these antibodies was effective in clearing the circulating mf from Mastomys on passive immunization. Thus, Iv seems to synergize host immune factors against D. viteae infection. PMID- 3629135 TI - In vitro drug screening in isolated male Onchocerca gibsoni using motility suppression. AB - A primary in vitro screen was developed to screen for drug activity against isolated Onchocerca gibsoni. The assay estimates variation in motility through the use of a motility meter. Of the seven compounds tested in the screen; ivermectin, CGP 6140, CGP20376, Mel W and furapyrimidone gave MI50 concentrations (the concentration at which the motility was reduced to 50% of the control value at 72 hours) below 10(-4) M, whereas suramin gave variable results depending on the varying susceptibility of individual worms and levamisole at 10(-4) M had no significant effect on the worms. The effects of these drugs were not reversible as removal of the worms into drug-free medium caused no increase in motility. Thus the reduction in motility is regarded as indicating significant metabolic damage. The results compared favourably with reported in vivo tertiary screens for activity against Onchocerca species. This is a quantitative, inexpensive and reproducible method for assessing the effectiveness of drugs against Onchocerca and could be included into the primary screens for activity against filarial worms. PMID- 3629136 TI - Failure of Onchocerca gutturosa to develop in Simulium soubrense and Simulium yahense from Liberia. AB - Laboratory reared female S. soubrense and S. yahense from Liberia were intrathoracically inoculated with bovine skin dwelling microfilariae of Onchocerca gutturosa. Of a total of 174 flies, each injected with 50 fresh microfilariae, the maximum development was to late first-stage larvae. One S. soubrense also contained two second-stage larvae and a maldeveloped third-stage larvae. No development to normal third-stage larvae was observed in any fly despite maintenance at 28 degrees C for up to 10 days following infection. This contrasts with complete development of O. volvulus in both blackfly species under similar conditions. PMID- 3629137 TI - [Role of children in the evaluation of the Onchocerciasis Control Program in West Africa]. AB - Incidence of onchocercal infections is studied in children borne since the start of the larvicidal treatments of the Onchocerciasis Control Programme in West Africa (OCP). A total of 8088 children, originating from 155 villages widely distributed throughout the initial area of the OCP were examined for microfilariae of O. volvulus. 37 were found infected. If there had not been control measures, 652 children would normally have become infected in such a sample. It is considered that in the centre of the OCP area which constitutes approximately 90% of the total, transmission has been interrupted (1 child infected among 5,886 examined in the centre). The remaining 36 cases are spread over two quite distinct marginal zones of the OCP where transmission persisted because of reinvasion by blackflies coming from untreated areas, or because of insecticide vector resistance, or because of occasional treatment failures. The entomological indices confirm perfectly the epidemiological findings in the central region as well as in the marginal zones. PMID- 3629138 TI - The use of diethylcarbamazine cream in the diagnosis of onchocerciasis. AB - Topical application of diethylcarbamazine (DEC) cream was tested as a method of diagnosis in patients with onchocerciasis. Approximately 5 ml of DEC cream (10% w/v) was rubbed into an 8 cm area of skin over the buttocks and the patient reexamined one day later. Twenty-nine patients with varying levels of infection were tested, and the sensitivity of the test was found to be 30.1% compared to standard skin snip assessment. It was not possible to quantify the degree of infection with the DEC cream skin test. It is concluded that the topical application of DEC is not a useful method for diagnosis of onchocerciasis in the field. PMID- 3629140 TI - Human pharmacokinetics of proguanil and its metabolites. AB - The pharmacokinetics of proguanil and its metabolites cycloguanil and p chlorophenylbiguanide were studied in five healthy volunteers taking 200 mg orally for 14 days. A highly sensitive and specific high-performance liquid chromatographic assay was applied, clearly identifying all three compounds in plasma extracts as separate peaks. In four subjects peak plasma concentrations of proguanil (500 to 600 nmol/l) were reached after two to three hours, while cycloguanil and p-chlorophenylbiguanide showed a plateau after three and six hours, respectively. In the fifth subject peak concentrations of proguanil and cycloguanil appeared after seven hours. Trough concentrations (pre-dose in the morning) of proguanil and cycloguanil were about 200 and 100 nmol/l, respectively. Mean half-life of proguanil was estimated to approximately 20 h. The active metabolite cycloguanil constituted 30% of the total plasma drug concentration. The concentration of proguanil was higher in erythrocytes than in plasma, while that of cycloguanil was lower. Relevant clinical studies correlating plasma concentrations to the suppressive activity against malaria will be possible to perform based on the applied method and presented kinetic data. PMID- 3629139 TI - Sensitivity of skin snips in the diagnosis of onchocerciasis. AB - To find the optimum number and combination of skin snips for the diagnosis of onchocerciasis, data of six skin snips (two shoulder, two hip, two calf) taken from 776 Liberians aged 12 to 60 years were examined. From these data, proportions of positive skin snips from the hip, or hip and calf areas, for different levels of skin microfilaria density were calculated. These proportions were used in a mathematical model that examined 20 hypothetical populations with different levels of endemicity and skin microfilaria densities. The sensitivity of using two or four snips was then estimated. If only two snips were taken, two hip snips had the highest sensitivity (ranging from 80.7% to 100% according to the population). When the microfilaria density was high, the addition of two extra snips from the calf did not significantly improve the sensitivity. However, when the microfilaria density was low, the combination of two hip and two calf snips substantially improved the sensitivity (ranging from 80.7% to 94%). If fewer than six skin snips are desired for a particular field study, the choice of how many skin snips to be taken should be based on the expected precision required for that study. This in turn can be determined by skin microfilaria density. If such information is lacking, an estimate can be made from the findings of six snips from a small sample. PMID- 3629141 TI - Laboratory investigations on the survival and fecundity of Phlebotomus duboscqi (Diptera, Psychodidae), a vector of Leishmania major in Kenya. AB - The gonotrophic cycle, survival and reproductive potential of adult female Phlebotomus duboscqi, a vector of Leishmania major in Baringo District, Kenya was investigated in the laboratory. The sandflies were fed on hamster and apples as a sugar source and were placed in vials for oviposition. The feeding and care for oviposition was repeated for as long as the flies lived. The longest period P. duboscqi survived after taking the first blood meal was 45 days. The flies completed up to eight gonotropic cycles resulting into a very high fecundity rate. The implications of this in relation to disease transmission by P. duboscqi is discussed. PMID- 3629142 TI - A macrophage immunosuppression induced by Leishmania major in BALB/c mice. AB - The purpose of the present study is to investigate the status of the reticuloendothelial system (RES) phagocytic function in relation to Leishmania major infection in highly susceptible BALB/c mice. The RES phagocytosis was monitored by: intravascular clearance of carbon colloid; tissue distribution 99mTechnetium labelled sulphur colloid in RES organs; and serum lysozyme enzyme level. The kinetics of RES phagocytosis during L. major infection was also studied at 0, 3, 5, 7 and 8 weeks post-infection. The results revealed that L. major parasite significantly (p less than 0.001) inhibited macrophage phagocytic function. The maximum phagocyte depression was noticed at 7 weeks following infection. The macrophage phagocytic suppression was also associated with a reduction in liver and spleen uptake of 99mTc and decrease in serum lysozyme level. PMID- 3629143 TI - [A new Glossina from the Congo: Glossina (Austenina) frezili sp. nov. (Diptera: Glossinidae)]. AB - The male and female genitalia of Glossina frezili sp. nov., a new tsetse fly occurring in the mangrove forest of the Congo and Gabon are described. G. frezili is related to G. medicorum but clearly distinct from this species by its habitat and the morphology of the genitalia. PMID- 3629144 TI - [Surface coils in magnetic resonance diagnosis of spinal space-occupying lesions]. AB - 190 patients underwent MRI of the spine. In 119 cases pathological changes were detected. 82 of these were located in the extradural compartment, 14 were found in the intradural-extramedullary space and 23 were situated inside the myelon. Routinely, spin echo sequence were performed in sagittal direction (T1-weighted images as well as T2-weighted images), in about 20% combined with transverse sections. All patients were investigated using surface coils of 20 X 40 or 15 X 45 cm; Using a field of view of 350 mm, spatial resolution was 1.3 mm per pixel. The quality of images obtained in this way was clearly superior to techniques using the body coil. PMID- 3629145 TI - Conditions simulating lymphoma in children--a lymphographic study. AB - The lymphographic appearance of lymphoma may be simulated by a variety of other diseases, both malignant and benign, including metastases, lymphangiomatosis, sarcoidosis and lymphadenitis. In addition, non-specific reactive changes of the lymph nodes are common in lymphography of children sometimes simulating lymphoma. PMID- 3629146 TI - [Serous cystadenocarcinoma of the ovary: unusual visualization of calcified intraperitoneal metastases in CT and bone scintigraphy]. AB - In a 45-year old patient with serous cystadenocarcinoma of the ovary CT showed small calcifications in metastases along peritoneal surfaces. These "psammoma bodies" indicated abdominal implants, which in other respects would not have been demonstrable via CT scans because of their small size. During bone scintigraphy the calcifications caused unusual extraskeletal focal uptake of 99mTc-MDP in the abdomen. PMID- 3629147 TI - [Traumatology of the knee joint--radiologic and accident surgery aspects--1]. AB - Lesions of the knee joint are relatively frequent and are on the increase due to the increasing number of sports and traffic accidents. Violent force exercised on the knee can lead basically to two different kinds of injury sequels. As a rule, injuries to the bone do not present diagnostic problems if there is a clear break in continuity. On the other hand, it is often very difficult to detect chondral or osteochondral lesions and also certain types of longitudinal patellar fractures and fractures of the head of the tibia. Their visualisation requires more far-reaching diagnostic measures. Fundamentally more difficult to identify: the second group of lesions, namely, those of the internal structures of the knee, unless there is a marked instability which is usually accessible to clinical examination. Relatively slight osseous tears or ruptures of a ligament often remain unnoticed on the plain x-ray film. Other diagnostic techniques are imperative in such cases. The first part deals specifically with the radiological aspects of knee injuries. The majority of injuries close to the knee region can be visualized by making use of all techniques of roentgenology. However, if the examination methods get too costly and complicated without ensuring an absolutely safe diagnosis, other techniques must be employed. An example in this regard are the chondral or osteochondral lesions. It is here that arthroscopy often yields better results while offering at the same time a possibility to remove individual small fragments. PMID- 3629148 TI - [Traumatology of the knee joint--radiologic and accident surgery aspects--2]. AB - The second part is devoted to the presentation of the accident surgery aspects of knee lesions. For every topographical region the anatomical features, the most frequent causes of fractures, as well as the conventional classification criteria, are described. In each case also the principal surgical methods are described. Lesions of tendons or ligaments have been included only insofar as they have occurred within the context of an osseous lesion. PMID- 3629150 TI - The multiparameter analysis concept in computerized contact breast thermography. PMID- 3629149 TI - Neuronal plasticity- a new field in neuroendocrinology. PMID- 3629151 TI - Chronobiology of serum iron concentration in subjects of different ages at different geographic locations. AB - The circadian rhythm in serum iron concentration was studied in 61 elderly men (74 +/- 6 years of age) and 93 women (78 +/- 8 years of age) in Bucharest, Romania, in 81 clinically healthy boys and 103 girls (11 +/- 1.5 years of age) in Tirgoviste, Romania, in 4 elderly men and 19 women (71 +/- 5 years of age) and in 75 young-adult men (24 +/- 11 years of age) and 52 women (24 +/- 9 years of age) in St. Paul, Minnesota, USA. Six samples were obtained from each subject around a 24-hour span. The sampling sessions in the elderly subjects in Romania and in the children extended over all four seasons. A circadian rhythm statistically verified by Cosinor analysis was evident in all groups in both locations. A statistically significant sex difference with lower circadian mean (mesor) and a lower amplitude in the women was found in the Romanian elderly subjects. The children in Romania showed no sex difference in any circadian rhythm parameters. The young adult subjects in Minnesota showed a significantly higher mesor and a phase delay in the men as compared with the women. The elderly subjects of both sexes at both geographic locations had a lower circadian mesor than the young adults and the children. In the Romanian elderly subjects also the circadian amplitude was lower, which was not the case in the Minnesotans. While the acrophase in the elderly subjects and in the children in Romania was comparable (0928 and 0932 local time resp.), the young adults in Minnesota showed in comparison to the Romanians a phase delay (1132 local time) and the elderly in Minnesota showed a phase advance (0732 local time) in comparison to all other groups. The latter finding will have to be confirmed by more extensive studies. In the elderly subjects in Romania the circadian rhythm in serum iron concentration was in phase with the circadian rhythms in total serum bilirubin and alkaline phosphatase but showed significant phase differences from the circadian rhythms in serum albumin, urea nitrogen (BUN), gammaglutamyl transferase (Gamma-GT), serum globulins, glucose, insulin and total serum proteins. The elderly subjects in Romania showed a statistically significant circadian phase delay in summer as compared to fall but showed no seasonal variation of the mesor. The children showed a circadian phase advance in fall as compared to the other seasons and a seasonal variation of their mesor with higher values in spring and summer as compared with winter and fall.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3629152 TI - The antigonadotropic activity and amino acid composition of a total and dialyzed melatonin-free pineal extract. AB - The antigonadotropic activity of a melatonin-free pineal extract before and after a 24 h dialysis was assessed by the mouse uterine-weight test. In both cases, the uterus-stimulating effect of HCG was inhibited, showing that after dialysis the extract not only retains its effect but that the latter is even higher. The amino acids content established by an amino acid analyzer was the same in two batches of extract obtained from two different stores of pineal powder. The analyzer also showed that the glutamic acid is the prevailing component as a free and bound amino acid in the total extract. It was also found that methionine is absent from the dialyzed extract. Qualitative analysis of the pineal extract revealed 16 amino acids and a concentration of proteins of 1.90-1.96 mg/ml. Quantitatively, the glutamic and aspartic acids, proline and glycine prevail over the other constituents. The glutamic acid concentration was over two times higher than the latter three. PMID- 3629153 TI - [Dietetics and the prevention of hyperlipoproteinemias]. PMID- 3629154 TI - [The hospital in the service of primary care]. PMID- 3629155 TI - [Phlebotomus and leishmaniasis in the province of Almeria]. PMID- 3629157 TI - [Legal reference values and their relation to the chemical quality of drinking water]. PMID- 3629156 TI - [Quality of Granada basin water for human consumption]. PMID- 3629158 TI - [Comparative study of various indicators of biological contamination of irrigation waters]. PMID- 3629160 TI - [The psychiatric present: future perspectives]. PMID- 3629159 TI - [Planning and evaluation of a health education program]. PMID- 3629161 TI - [Excretion of antimicrobial agents through maternal milk]. PMID- 3629162 TI - [Vaginal flora and correlation with cytological aspects]. PMID- 3629163 TI - [Interrelation of the nutritional status of the pregnant woman, smoking during pregnancy, fetal growth and the 1st year of life]. PMID- 3629164 TI - [Health conditions of children of the municipality of Sao Paulo, SP (Brazil), 1984-1985. I--Methodological aspects, socioeconomic characteristics and physical environment]. PMID- 3629165 TI - Decline in cardiovascular disease mortality in the city of S. Paulo, Brazil, 1970 to 1983. PMID- 3629166 TI - [Analysis of health and life conditions of the urban population of Botucatu, SP. I--Description of the sampling plan and evaluation of the sample]. PMID- 3629167 TI - [Disposable vs. reusable hypodermic syringes. Study of possible effects on the virus of live, attenuated measles vaccine]. PMID- 3629168 TI - [Infant mortality by cause in the State of Sao Paulo (Brazil) in 1983. Analysis under the perspective of multiple causes of death]. PMID- 3629169 TI - [First finding of Aedes (Stegomyia) albopictus (Skuse) in the State of Sao Paulo (Brazil)]. PMID- 3629170 TI - Quantitative interpretation of audiological test battery. I. A comparison with ABR in 97 cases of unilateral sensorineural hearing loss. AB - A retrospective study was made of 97 patients with unilateral sensorineural hearing loss who underwent an audiological test battery and ABR during a 2 1/2 year period. The test battery included tone- and speech audiometry, Bekesy audiometry, loudness balance test, tone decay test and impedance measurements (reflex thresholds and reflex decay). A quantitative interpretation of each audiological test was tried out and a mean value of included tests (audiological test score ATS), was compared with results of ABR. The audiological test score showed the same predictive value as ABR for detection of acoustic neurinomas. Among the auditory tests, Bekesy audiometry had the lowest sensitivity. Eight patients with neurinomas were found in the series. Retrocochlear test results prevailed in another 23 ears, most often in combined hearing loss and vestibular dysfunction and in insidious or longstanding hearing loss. Quantitative interpretation of the audiological test battery is valuable for uniformity in classification of sensorineural hearing loss, and will facilitate extended studies on aetiology and course in auditory dysfunction. PMID- 3629171 TI - Preservation of cochlear potentials in a deaf patient fifteen months after excision of an acoustic neuroma. AB - Intraoperative electrocochleographic monitoring has been used in an attempt to protect cochlear nerve function during acoustic neuroma excision. One patient is presented with an apparently intact cochlear nerve and waves N1 and N2 preserved at the end of surgery, but no hearing on subsequent testing. Fifteen months after operation, cochlear microphonics and the summating potential were still present, but N1 and N2 had disappeared. There had been no improvement in her hearing and there were no consistent brainstem auditory evoked potentials on the affected side. A possible explanation for these findings is given. PMID- 3629172 TI - Characteristics of temporary noise-induced tinnitus in male and female subjects. AB - Reversible tinnitus was induced in 10 male and 8 female normal-hearing subjects following a 5 min 110 dB SPL exposure to white noise. Temporary threshold shift (TTS) was measured at 2 and 4 kHz. Characteristics of the tinnitus were determined by means of a written questionnaire administered 5 min following termination of the noise. Most of the subjects experienced a continuous tonal tinnitus of moderate loudness. Characterization of the tinnitus regarding spectral quality, type of sound, and perceived location differed as a function of gender. No difference in TTS measured at 2 and 4 kHz was seen as a function of gender. Positive relationships of fair to moderate strength were revealed between pre-exposure thresholds, TTS, and tinnitus pitch and level. PMID- 3629173 TI - The efficiency of earmuffs against impulse noise from firearms. AB - Young men conscripted into the armed forces still run a risk of suffering hearing damage during their military service. This risk could be reduced by effective personal hearing protectors. The standard tests to determine the attenuation values of hearing protectors cannot be applied to high-intensity impulse noise from firearms, but the protectors should be evaluated under actual firing conditions. The attenuation values of the hearing protectors (earmuffs) most commonly used in the Finnish Army were tested for impulse noise from different weapons. The attenuation was found to be good for pistol shots, moderate for rifle shots and very poor for cannonfire. The tested earmuffs gave only minimal protection against low-frequency impulse energy. PMID- 3629174 TI - Detection functions for the human auditory brainstem response. AB - Previously obtained data characterizing the auditory brainstem response near the threshold for detection in 10 normal-hearing subjects are used to evaluate the detection method applied. The basic detection formula is described in terms of rates of true positive and false positive ABR detection and in combination with the normative ABR values used to calculate the ABR detection functions as well as the corresponding receiver operating characteristics (ROC curves). The observed distribution of the ABR-threshold levels is similar to that derived from the detection function, and therefore verifies the present results which are based partly on theoretical considerations. PMID- 3629175 TI - Linguistic abstraction and hearing handicap. AB - The present study aimed at studying compensatory cognitive functions in the profoundly hearing-impaired. Bransford & Franks' (1971) linguistic abstraction paradigm was employed as a means of testing the hypothesis that the profoundly hearing-impaired engage in a general meaning-abstraction strategy not necessary for the normal-hearing. Twenty profoundly hearing-impaired subjects and 20 normal hearing subjects participated in the experiment and the results unequivocally supported the hypothesis. Clinical implications of the results are indicated and discussed in relation to speech-reading tests and to training programs. PMID- 3629176 TI - The manometric findings at the human pylorus. The evidence against the presence of a tonic sphincter. AB - The results of pyloric manometric studies conflict, some showing evidence of a sphincter at the pylorus, others not: hence the term 'the fickle pylorus'. In this study we used perfused catheters to investigate the manometric properties of the human pylorus, in an attempt to explain the different results of similar experiments. A high-pressure zone (HPZ) of 5.9 mmHg (mean) was found at the pylorus in 53% of 170 measurements. The subjects' position had no effect on the HPZ, nor had duodenal acidification. Eating a meal increased the pressure from 5.0 mg Hg in the fasting state to 8.0 mm Hg after a meal. The results and those of 11 other manometric studies are considered; the evidence is against the presence of a tonic sphincter at the pylorus. PMID- 3629177 TI - Enzyme activities in biopsy specimens from large-bowel mucosa in colorectal adenomas and carcinomas. AB - Biopsy specimens from 29 adenomas, 17 adenocarcinomas, and 6 synchronous adenomas in cancer patients and from uninvolved mucosa of all main segments of the large bowel were examined histologically and assayed for a series of organelle marker enzymes. Six enzymes--lactase, sucrase, alkaline phosphatase, 5'-nucleotidase, acid phosphatase, and N-acetyl-beta-D-glucosaminidase--showed less activity in adenomas than in adjacent uninvolved mucosa and in specimens from controls. Cancer tissue had higher gamma-glutamyltransferase and lower lactase, alkaline and acid phosphatases, and N-acetyl-beta-D-glucosaminidase activities than specimens from uninvolved mucosa in cancer patients and control patients. Enhanced alkaline phosphatase and N-acetyl-beta-D-glucosaminidase activities were seen in uninvolved mucosa of cancer patients as compared with those of adenoma and control patients. Evidence has been found for multienzyme analysis to identify adenomas with signs of malignant transformation and carcinomas with poor prognosis. PMID- 3629178 TI - Modulatory effect of the gastrointestinal tract (gut) on fibrinolysis and fibrinogen derivatives. AB - We have investigated some components of the fibrinolytic system and fibrinogen derivatives in blood samples taken simultaneously from the human portal and cubital veins. In the first series the blood was drawn during laparotomy from 12 cholecystectomized, otherwise healthy patients. The mean value of euglobulin lysis time was significantly lower in the portal than in the cubital vein. The values of the fibrinogen, plasminogen, serial dilution protamine sulfate, and ethanol gelation tests in both samples were quite similar. In the second series blood was taken from eight patients with cancer of the gut and from six cholecystectomized patients. The staphylococcal clumping test (SCT) in serum was performed for fibrin degradation products (FDP) in samples from both veins. In patients with cancer the mean FDP level was significantly higher in the portal than in the cubital vein. In cholecystectomized patients the SCT was negative in samples from both veins. We conclude that fibrinogen pathway metabolism does not differ in the portal and cubital veins under normal conditions, whereas in neoplastic disease fibrinogen degradation is greater in the portal vein. We also suggest that the gut probably modulates fibrinolytic activity in normal conditions. PMID- 3629179 TI - Effects of additional dietary gluten on the small-intestinal mucosa of volunteers and of patients with dermatitis herpetiformis. AB - In an attempt to confirm the existence of latent coeliac disease--dose-related gluten-sensitive enteropathy--we have increased dietary gluten by 20 g daily for 2 weeks, in 6 healthy adults and 11 patients with dermatitis herpetiformis (DH). Six of the DH patients had entirely normal jejunal morphology on a normal diet. Jejunal biopsy specimens were taken before and at the end of the study. Measurements of crypts, villi, and crypt mitoses were made on microdissected specimens; disaccharidases were assayed, and intraepithelial lymphocyte counts performed. In one of the six adult volunteers, gluten loading produced diarrhoea and jejunal biopsy abnormalities. Five DH patients on a gluten-free diet had deterioration of biopsy pathology after the gluten challenge. Features suggestive of a latent gluten-sensitive enteropathy were found in one of the other six DH patients; he developed disaccharidase deficiencies and villus atrophy when 20 g gluten was added to his usual gluten-containing diet. This study supports previous suggestions that a gluten-sensitive enteropathy may be latent and dose related. PMID- 3629180 TI - Campylobacter-like organisms in chronic gastritis, peptic ulcer, and gastric carcinoma. AB - Biopsy samples were taken from the gastric mucosa of 209 patients endoscoped for dyspepsia symptoms. Campylobacter-like organisms (CLOs) were cultured from 74 of 179 (41.4%) cases and seen in sections from 110 of 209 (52.6%) cases and in smears from 119 of 209 (56.9%) cases; totally, 145 of 209 cases were positive, giving a rate of 69.4%. CLOs were positive in 45 of the 57 (78.9%) patients with superficial gastritis, in 52 of the 64 (81.3%) with atrophic gastritis, in 18 of the 21 (85.7%) with gastric ulcer, in 12 of the 14 (85.7%) with duodenal ulcer, and in 8 of the 10 (80.0%) with stump gastritis, whereas only a few CLOs were found in 3 of the 15 (20.0%) histologically normal subjects and in 7 of the 28 (25.0%) patients with gastric carcinoma. The organisms seem to live more frequently in diseased mucosa and are chiefly recognized through their characteristic morphology and habitat. A significant association between the presence of CLOs and chronic gastritis or peptic ulcer disease was noted, and the positive rate and the number of CLOs correlated highly with the activity of chronic gastritis. No such correlation was observed in gastric carcinoma. These findings support the view that CLOs may be etiologically related to chronic gastritis and peptic ulceration, even though their precise role still remains to be determined. PMID- 3629181 TI - Peritoneal lavage combined with volume therapy in porcine hemorrhagic pancreatitis. Effects on hemodynamics, microcirculation, and peritoneal morphology. AB - Acute hemorrhagic pancreatitis was induced in 15 piglets, after which 8 of the piglets were treated with saline infusion only and 7 were treated with saline infusion and peritoneal lavage. Hemodynamic variables were measured hourly. Organ and peritoneal blood flow was determined at 0, 1, and 5 h with radioactive microspheres. Peritoneal morphology was studied at 0, 1, 3, and 5 h with light microscopy and scanning electron microscopy. According to the results, changes in cardiac output, mean blood pressure, and peritoneal blood flow and the peritoneal inflammatory reaction were similar in the two groups. However, a significant increase in heart rate and a significant decrease in the blood flow to the pancreas, liver, and spleen were observed in the saline group, in contrast to the lavage group. In addition, blood flow to the adrenal glands was significantly higher in the saline group after 1 h. In conclusion, peritoneal lavage prevented the increase in heart rate and the development of a significant decrease in pancreatic blood flow in experimental hemorrhagic pancreatitis. The significance of these findings remains to be further evaluated. PMID- 3629182 TI - Do symptoms of gastric ulcer become less frequent with time? AB - It has been claimed that gastric and duodenal ulcer (GU and DU) symptoms decrease in frequency with time, indicating 'burn out' of ulcer. The present study was undertaken to investigate further this phenomenon in GU. The prevalence of symptom experience during 1 year was examined in 447 medically treated patients with GU diagnosed 2-20 or more years previously. When ulcer history length was measured from either first symptom onset or first ulcer diagnosis, reporting of symptoms did not become less frequent as history length increased. This remained true after adjustment for GU location, sex, age, smoking, and analgesic and non steroidal anti-inflammatory drug ingestion. It is concluded that GU symptoms do not decrease in frequency with time. PMID- 3629183 TI - The role of phospholipase in the genesis of gastric ulcers in rats. AB - This study was designed to establish the role of tissue phospholipase (PLase) and prostaglandins (PGs) in the genesis of gastric ulcers. The activity of PLase and levels of PGs in rat gastric mucosa were measured by high-performance liquid chromatography, using water immersion stress ulcer. Four kinds of PGs in gastric mucosa were determined: 6-keto-PGF1 alpha, PGF2 alpha, PGE2, and PGD2. Decreases in PG levels and in PLase activity were observed, depending on the duration of water immersion stress. Either administration of pirenzepine or vagotomy maintained both the PG levels and PLase activity. The longer duration of stress induced a more severe ulcer index. Premedication with pirenzepine or vagotomy prevented ulceration. Furthermore, there was a clear reciprocal correlation between the PLase activity and the ulcer index. The decrease in PG levels observed could be linked with the decrease in the activity of PLase, the initiating enzyme of the arachidonate cascade reaction. Thus, PLase might be a responsible factor in the genesis of stress ulcers. Pirenzepine or vagotomy protected gastric mucosa from ulceration by maintaining the PLase activity and PG levels. PMID- 3629184 TI - Abdominal operations: effect on subsequent experimental faecal peritonitis. AB - Rats were subjected to laparotomy, anaesthesia only (controls), laparotomy plus 1 cm-segment ileum isolation, or no treatment (controls) and were challenged with endogenous faecal peritonitis 1 and 2 weeks later, respectively. Survival rates were 40% for the laparotomy group and 100% for the ileum isolation group, whereas all controls died. The number of peritoneal leucocytes, particularly macrophages and neutrophils, was significantly (p less than 0.05) higher in the laparotomy group than in the control group. The data show that abdominal operations alone- and especially in combination with a minor infectious challenge--entail an increased tolerance to subsequent peritonitis, possibly mediated by the previously stimulated and sensitized leucocytes. PMID- 3629185 TI - In vitro tetraploidy in patients with ulcerative colitis. AB - One hundred and seven patients (57 patients with ulcerative colitis and 50 controls) were investigated for in vitro tetraploidy (IVT) in dermal fibroblast monolayer cultures. There was no difference in incidence of IVT between patients with ulcerative colitis and controls. We advance the hypothesis that the genetic background of the colorectal cancer type found in ulcerative colitis differs from that found in the colon cancer syndromes and in non-hereditary colorectal cancers. Colorectal cancer in ulcerative colitis is probably only dependent on the degree of inflammatory lesions of the colonic mucosa. PMID- 3629186 TI - Comparison of three bile acid provocation tests. Intravenous cholecystokinin, a standard test meal, and an oral bile acid load in healthy subjects. AB - Three different bile acid provocation tests--an intravenous stimulation with cholecystokinin (CCK), a test meal, and an oral bile acid load of 500 mg chenodeoxycholic acid (CDA)--were compared in 12 healthy subjects. Blood samples were drawn every 30 min for 3 h, and serum bile acids (SBA) were measured by an enzymatic method (Enzabile). The CCK stimulation gave significant SBA elevations only at 30 min. After the test meal and the CDA loading tests SBA elevations were observed from 30 min and throughout the observation period. Maximal increases were obtained at 120 min after the test meal but already at 30 min after the CDA loading test. We conclude that among these three bile acid provocation tests the oral CDA loading test is to be preferred because it gives marked and rapid elevation of SBA in all subjects and is independent of bile acid pool size and normal function of the gallbladder. PMID- 3629187 TI - Urinary excretion of aluminium after ingestion of sucralfate and an aluminium containing antacid in man. AB - Eleven subjects with normal renal function were given, on 2 separate days, at least 1 week apart, four tablets of sucralfate or an aluminium (Al)-containing antacid. The total Al load was approximately 976 mg with the antacid and approximately 828 mg with sucralfate. The daily urinary excretion of Al was measured the day before and during 3 days after drug administration. Al excretion increased significantly after both drugs. There was no significant difference between the two products. The median absorption calculated as percentage of Al dose was 0.005% (range, 0.001-0.017%) for sucralfate and 0.006% (range, 0.002 0.060%) for the antacid. Thus, measurable quantities of aluminium is absorbed after administration of sucralfate, and the drug should, like Al-containing antacids, be given with caution to patients with renal failure. PMID- 3629188 TI - Effect of endoscopic sclerotherapy of esophageal varices on liver blood flow and liver function. An experimental study. AB - In 10 Gottingen mini-pigs esophageal varices developed after banding of the portal vein. In five pigs the varices were treated by paravariceal injection of polidocanol, and the rest served as controls. As judged from endoscopy and portography, the varices disappeared after four sclerotherapy sessions within 4 weeks, and at the same time portal venous pressure rose from 19 to 38 mm Hg. No changes were seen in the control group. After 24 weeks of observation the hepatic blood flow in the untreated group was 10 ml/kg/min, and portal angiography showed that nearly all the portal blood bypassed the liver. In the pigs treated with sclerotherapy the hepatic blood flow increased to 28 ml/kg/min, angiography showed a normal hepatogram, and no filling of the collaterals was seen. Sclerotherapy induced only a few changes in liver function, and these may be related to the concomitant increase in liver blood flow. PMID- 3629189 TI - Effect of fundic distension on gastric bicarbonate secretion in man. AB - Human gastric mucosa secretes small amounts of bicarbonate into the mucus layer to maintain the pH at the cell surface as close to neutrality as possible. We have measured gastric bicarbonate secretion continuously with a computer-based system, using recordings of pH and PCO2. The formula of Henderson and Hasselbalch was used in the calculations. Graded fundic distension of the stomach with a balloon in six healthy subjects increased the gastric bicarbonate output by 46% (p less than 0.05), 28% (NS), and 84% (p less than 0.05) during 1 h of distension to 150 ml, 300 ml, and 600 ml, respectively. Continuous fundic distension during 2 1/2 h with a volume of 300 ml elicited a response that peaked after 45 min and vanished after 90 min. The rather short duration of gastric bicarbonate secretion response to fundic distension may be due to a fading caused by a volume adaptation or, alternatively, to an activation of inhibitory mechanisms. Seven duodenal ulcer patients who had undergone proximal gastric vagotomy showed virtually the same gastric bicarbonate secretion response to graded fundic distension. The anticholinergic drug benzilonium bromide totally inhibited the gastric bicarbonate response to 30 min of fundic distension to 150 ml, whereas indomethacin did not significantly affect the response to distension. These studies indicate that the gastric bicarbonate response to fundic distension is mainly mediated by short intramural neural cholinergic pathways and is independent of mucosal production of prostaglandins. PMID- 3629190 TI - The IgA-binding lectin jacalin induces complement activation by inhibition of C-1 inactivator function. AB - Jacalin, a D-galactose-specific lectin from jackfruit, interacts with human IgA and one or two other serum proteins. Incubation of jacalin with fresh human serum was shown to result in activation of the complement system. Therefore the mechanism of complement activation by jacalin was studied. Jacalin was extracted from jackfruit seeds (crude preparation) and purified to homogeneity by affinity chromatography on IgA-Sepharose to yield a pure preparation of jacalin. Both crude and pure jacalin were able to activate complement, accompanied by conversion of C3. Consumption of C1, C4 and C-1-inactivator (C-1-In) indicated involvement of the classical pathway. Aggregated IgG (AIgG) caused partial (38%) and jacalin induced complete consumption of C1-In functional activity. It was found upon Ouchterlony analysis that jacalin forms a precipitation line with purified C-1-In. In addition binding of 125I-C-1-In to jacalin-Sepharose was observed, and this binding was inhibitable by either secretory IgA or D galactose. Next to binding of jacalin to C-1-In, jacalin was also shown to inhibit the functional activity of C-1-In. These results indicate that jacalin induces complement activation by inhibition of C-1-In function and thereby facilitates the activation of precursor C1 in either the absence or presence of low amounts of C1 activators. PMID- 3629191 TI - Induction of salivary antibody responses in rats after immunization in Peyer's patches. AB - We examined salivary, milk, and serum antibody levels after immunization in the Peyer's patches (Pp) of rats with horse spleen ferritin. Priming of the Pp one day after parturition led to the appearance of IgG, but not IgA or IgM, anti ferritin antibodies in saliva 9 days later. IgG and IgM antibodies were detected both in milk and in serum, whereas IgA antibodies could only be demonstrated in milk. During a second lactation period the salivary antibodies had vanished but IgG antibodies could still be detected in milk and serum. During a third lactation period, when the rats were immunized in the Pp a second time, not only IgG but also IgA anti-ferritin antibodies appeared in the saliva. Salivary IgG antibody levels and milk IgG, IgM, and IgA antibody levels were higher than those observed after primary immunization in the Pp. The IgG antibody activity in the saliva was positively correlated to the serum IgG antibody activity. It is concluded that salivary IgA antibody responses can be induced by immunization in the Pp. The results of this study suggests that IgA antibodies detected in saliva are produced locally by cells that have migrated from the intestinal lymphoid tissue to the salivary glands. PMID- 3629192 TI - Meningeal macrophages reflect lymphocytic choriomeningitis virus pathogenic phenotypes. AB - Intracerebral (i.c.) infection of adult mice with lymphocytic choriomeningitis (LCM) virus can result in acute lethal central nervous system (CNS) disease which is the result of the host's thymus-derived lymphocyte (T cell) response against the virus. Whether the specific effector function of the T cell is that of a cytotoxic cell (Tc) or a delayed-type hypersensitivity cell (Td) is still under debate. We assumed that if Td cells were important in pathogenesis then accessory cells in the brain (specifically, glass-adherent macrophages) might vary with the outcome of i.c. infection. We found that accumulation of macrophages in the brain (washed from meninges and skull cap) appeared to be independent of the severity of the infection (controlled by the mouse strain as well as the strain and dose of virus used). However, differentiation of macrophages was clearly linked to whether or not the infection caused rapid death. In mice that were destined to survive, macrophages became large, extensively vacuolated, and phagocytically active. In lethally-infected mice macrophages were small and had poor phagocytic abilities. At present this dichotomy could be viewed as either a cause or a consequence of disease outcome. However, the data are not inconsistent with the hypothesis that Td lymphocytes may be of primary importance in pathogenesis. PMID- 3629193 TI - Evaluating the process-reactive dimension. AB - Harrow et al. (1986) report the limitations of the process-reactive dimension as a long-term outcome predictor for young, early phase DSM-III schizophrenics. Two additional studies are now described contrasting the good success of the process reactive approach as a short-term predictor with DSM-II schizophrenia to its poor success in the same mode with DSM-III schizophrenics. The point is made that the change in diagnostic methods has reduced the heterogeneity of the current population of schizophrenics. The process-reactive conception is suggested as more valuable for a schizophrenia spectrum than for schizophrenia as now defined. Also, a reexamination of current schizophrenic heterogeneity is called for to determine the utility of a process-reactive dimension. PMID- 3629194 TI - Swedish high-risk study: sample characteristics at age 6. AB - High-risk offspring of women with a history of nonorganic psychosis and control offspring of women with no history of psychosis were studied from the mother's pregnancy through 2 years of age and followed up at 6 years of age. The mothers tended to be older and have somewhat higher parity than did Swedish mothers in general. Sample attrition during the 6-year longitudinal period was significantly higher in the high-risk than the control sample, and selective in both groups. A limited set of early-life variables, investigated prospectively, was selected for studying the antecedents of mental disturbance in the offspring at 6 years. In the high-risk group, disturbance in the offspring was related to maternal anxiety during pregnancy, negative maternal attitude toward pregnancy, and maternal psychotic condition during the period from 6 months to 2 years post-partum, and tended to be related to low social class, male child, active maternal-mental disturbance during pregnancy, prolonged labor and low Apgar score at delivery, neonatal neurological abnormality, and anxious attachment to the mother at 1 year of age. None of these relationships (except low social class) appeared in the control group, and no significant antecedents of mental disturbance in control offspring were found among the limited set of variables studied in these analyses. PMID- 3629195 TI - Early indicators of developmental risk: Rochester Longitudinal Study. AB - Early indicators of schizophrenic outcomes were sought in a group of children of chronically ill schizophrenic women. A sample of pregnant women with varying degrees of mental illness were examined during the perinatal period and recruited into a 4-year longitudinal evaluation, which included cognitive, psychomotor, social, and emotional assessments at birth, 4, 12, 30, and 48 months of age. The mothers varied on mental health dimensions of diagnosis, severity of symptomatology, and chronicity of illness. Other factors included in the analyses were socioeconomic status (SES), race, sex of child, and family size. Hypotheses were tested to determine the relative impact of three sets of variables on the child's behavior: (1) specific maternal psychiatric diagnosis, (2) severity and chronicity of disturbance independent of diagnosis, and (3) general social status. We found that a specific maternal diagnosis of schizophrenia had the least impact. Neurotic-depressive mothers produced worse development in their children than schizophrenic or personality-disordered mothers. Both social status and severity/chronicity of illness showed a greater impact on development. Children of more severely or chronically ill mothers and lower-SES black children performed most poorly. These results do not support etiological models based on simple biological or environmental transmission of schizophrenia. The role of social and family environmental factors in predicting child cognitive and social emotional competence was further evaluated using a multiple risk index. Children with high multiple environmental risk scores had much worse outcomes than children with low multiple risk scores. PMID- 3629196 TI - Infant predictors of the longitudinal course of schizophrenic development. AB - This study was begun in 1952 to test the hypothesis that specific neurointegrative disorders in infancy predict vulnerability to later schizophrenia and schizotypal disorder. Twelve offspring of chronic schizophrenic mothers and 12 controls from similar low socioeconomic status (SES) backgrounds have been studied since their births in 1952-53 and 1959-60. The infants were ranked according to the severity of their neurointegrative disorder, or "pandysmaturation" (PDM), based on analysis of Gesell tests and physical growth measures repeated 10 times between birth and 2 years. Twenty-three subjects (96 percent) completed all 10-, 15- and 20/22-year followup examinations. PDM was significantly related to maternal schizophrenia but not to obstetrical complications, SES, sex, or ethnic background. The severity of PDM was significantly related to the blind evaluations of the severity of psychopathology at 10 years. One 26-year risk subject has been chronically schizophrenic since age 17. The author, nonblind, provisionally diagnosed six other risk subjects as schizotypal or paranoid personality. All seven had PDM; six required 6 to 18+ years of treatment; four with "negative" symptoms remain severely impaired. All six sick subjects had severe social-affective symptoms by 3-6 years of age; four had perceptual deficits by 2 years. Some social-affective, cognitive, academic, and vocational impairments included in the "negative" symptoms and "process" traits of schizophrenia had antecedents before 2 years of age. Primary prevention requires research into the mechanisms underlying these dysfunctions in infancy. PMID- 3629197 TI - Emory University Project on Children of Disturbed Parents. AB - Young children (from birth to 5 years of age) of schizophrenic, depressed, and well mothers were studied to assess their intellectual, social, and neuropsychiatric functioning. The sample derived from predominantly black, low income, single-parent families. An extensive battery of laboratory and home-based tests was administered three times, each 1 year apart, to test the stability of findings. Schizophrenic offspring, as a group, had more problems than others. They showed more deficits on social competence, had lower IQ's (the youngest children only), and were overrepresented in the group of children with multiple negative indices. However, both schizophrenic offspring and depressive offspring sometimes performed more poorly than children with well mothers (presence of symptoms of psychiatric disorder and certain categories of social behavior). In certain instances, the children of depressed mothers were worse off than either other group (small for age and showing less social competence at home). Deficits were found in the child-rearing environment provided by the disturbed mothers. Both schizophrenic and depressed mothers were rated as less affectively involved and less responsive than well mothers. Schizophrenic mothers were rated as providing the poorest overall environment: less play stimulation, fewer learning experiences, and less emotional and verbal involvement. The following possible protective factors were identified in the mothers: lesser severity of illness, older age, higher education, higher IQ, work experience, and presence of spouse, boyfriend, or other relative to help in child care. PMID- 3629198 TI - Review of the NIMH Israeli Kibbutz-City Study and the Jerusalem Infant Development Study. AB - The National Institute of Mental Health (NIMH) Israeli Kibbutz-City Study has followed the development of offspring of schizophrenic parents from middle childhood through early adulthood. During childhood, a subgroup of offspring of schizophrenic patients showed clear neurobehavioral deficits often accompanied by poor social competence. Early followup data suggest that this subgroup of high risk children is at greatest risk for adult schizophrenia spectrum illness. The Jerusalem Infant Development Study has followed a similar population of children at risk for schizophrenia from before birth through middle childhood. A subgroup of dysfunctioning in the high-risk children showed sensorimotor dysfunctioning in the first year of life, which was followed by perceptual, motor, and attentional dysfunctioning in childhood--identical to that found in the NIMH cohort. Results from both studies support the hypothesis that schizophrenic illness involves constitutional factors whose expression can be observed as early as infancy. Results also illustrate the importance of using data-analytic approaches that (1) look for subgroups within high-risk groups rather than only group differences between high- and low-risk groups, and (2) examine profiles of behavior rather than only single variables. PMID- 3629199 TI - Risk factors in schizophrenia: the Stony Brook High-Risk Project. AB - The goals of the Stony Brook High-Risk Project are to identify precursor patterns, environmental stressors, and protective factors that are differentially predictive of psychopathology. In phase I we assessed 219 families and 544 children aged 7-15, including 31 families and 80 children with a schizophrenic parent, 70 families and 154 children with a unipolar depressed parent, 58 families and 134 children with a bipolar parent, and 60 normal control families with 176 children. A 3-year followup was conducted on 84 percent of the sample, and an additional followup is underway. Our data include measures of: (1) psychological functioning of the parents; (2) the environment, including family functioning, marital adjustment, and parenting practices; (3) child adjustment, including peer, or teacher, parent, and self-ratings; (4) early signs or precursors to the development of schizophrenia or affective disorder, including cognitive slippage, attentional deficits, hedonic capacity, depressogenic attributional styles, and subsyndromal affective patterns. Considerable deviance in family functioning, expressed in conflict, marital discord, and parenting skills, was characteristic of the families with an ill parent, and this discord was related to child adjustment. Children with a schizophrenic parent showed multiple and extensive cognitive, attentional, and social impairments, and at the 18+ followup, 22.8 percent of them compared with 9.6 percent of the normal controls were assigned a DSM-III diagnosis. PMID- 3629200 TI - The New York High-Risk Project: a followup report. AB - The New York High-Risk Project began in 1971 as a prospective, longitudinal study of (1) children of one or two schizophrenic parents and (2) comparison groups of children whose parents had other or no psychiatric disorders. The former were examined because they were known to be at high risk--some 10-25 percent for children with one affected parent and 35-45 percent with two affected parents- for developing schizophrenia or schizophrenia spectrum disorders during adolescence or adulthood (Erlenmeyer-Kimling 1977; Gottesman and Shields 1982). Children of parents with affective disorders were included because we wished to determine whether variables that might differentiate the children of schizophrenic parents from the children of normal parents also differentiated them from children of parents with other psychiatric disorders. Major goals of the program were (1) identification of biological and behavioral indicators of a genetic liability to develop schizophrenia and (2) longitudinal followup of the subjects to assess the predictive validity and specificity of variables tentatively flagged as early indicators. Other goals have included evaluation of the developmental course of such variables and documentation of the history of the development of schizophrenic disorders. PMID- 3629201 TI - Genetic and psychosocial factors in schizophrenia: the Finnish Adoptive Family Study. AB - A nationwide Finnish sample of schizophrenic mothers' offspring given up for adoption was compared blindly with matched controls (i.e., adopted-away offspring of nonschizophrenic biological parents). The offspring were born 1927-79. To date, a total of 247 adoptive families (112 index and 135 controls) have been investigated and rated. Of the 10 psychotic cases, 8 are offspring of schizophrenics and 2 are control offspring. However, no seriously disturbed offspring is found in a healthy or mildly disturbed adoptive family, and of those offspring who were psychotic or seriously disturbed, nearly all were reared in disturbed adoptive families. This supports the hypothesis that a possible genetic vulnerability has interacted with the adoptive rearing environment. PMID- 3629202 TI - The Copenhagen High-Risk Project, 1962-86. AB - Since 1962 we have followed a sample of 207 children at high risk for schizophrenia as well as 104 control children. For these individuals, the following factors and their interaction are related to an increased risk for schizophrenic breakdown: (1) greater schizophrenia family backgrounds, (2) perinatal trauma, and (3) unstable parenting and public institutional child care. The perinatal difficulties are positively related to adult periventricular atrophy. Results of a subsequent study tentatively suggest that part of the neurological deviance in schizophrenia may be produced by disruption occurring in the second trimester of fetal development. PMID- 3629203 TI - The search for symptoms predictive of schizophrenia. AB - Of several scales developed in our laboratory for identifying psychosis-prone young adults, the most promising appears to be the Perceptual Aberration-Magical Ideation Scale. High-scoring subjects (2 SD greater than the mean) report many psychotic-like and isolated psychotic symptoms. Subjects were seen for a followup interview 25 months after the initial identification and interview. Three of 162 high-scoring perceptual aberration-magical ideation subjects reported having received their first clinical attention for psychosis during the followup period. Additional measures are being used in attempts to eliminate the false positives as well as to distinguish persons prone to schizophrenia from those prone to affective disorder with psychosis. PMID- 3629204 TI - The UCLA High-Risk Project. AB - The UCLA High Risk Project studied a cohort of 64 families over a 15-year followup period. At entry to the study, the families each contained one adolescent who was having behavioral difficulties for whom help was sought from a psychological clinic. Two criteria of the degree of risk for schizophrenia were devised initially, one based on the form of the adolescent's problem and the other on the parental attributes of communication deviance (CD), affective style (AS), and expressed emotion (EE). It was hypothesized that schizophrenia would be the likely outcome when certain patterns of adolescent disturbance and negative communicational and affective patterns were present in the family. The index offspring of 54 of the 64 families were successfully followed up over the 15-year period (mean age = 30 at last followup), and blind psychiatric diagnoses were done. Contrary to the initial hypothesis, the form of the adolescent problem had limited prognostic value; however, the combination of CD and AS correctly identified the overwhelming number of cases who developed schizophrenia and related disorders. CD did even better if the dependent variable was the risk for schizophrenia spectrum disorder in any offspring in the family. PMID- 3629205 TI - Soft-laser therapy of rheumatoid arthritis. AB - The effect of soft-laser therapy on rheumatoid arthritis was evaluated in 17 patients with symmetrical involvement of the metacarpophalangeal joint of the index. Nine treatments with a He-Ne laser, 6 J/cm2, were given on the one hand with a sham irradiation of the other. The study was double-blind. The laser therapy gave some pain relief, but no difference in morning stiffness or joint performance was obtained. It is concluded that the laser therapy is of limited value in rheumatoid arthritis. PMID- 3629206 TI - Hepatotoxicity associated with low-dose, long-term methotrexate treatment of rheumatoid arthritis. AB - Liver biopsies were performed in 17 patients with therapy-refractory rheumatoid arthritis who were treated successfully with 5-15 mg/week methotrexate (mtx). The average duration of exposure to mtx therapy for each patient was 2.8 years (range 1.5-5 years). Total cumulative mtx doses ranged between 633 and 1,655 mg (mean 1,060 mg). The biopsies revealed 16 cases of normal histology, of which 3 showed nuclear variability in the hepatocytes; 4 with mild fatty infiltration, 2 with mild fatty infiltration and portal round cell infiltration. Portal fibrosis was found in one patient who had psoriasis in addition to clinical RA. PMID- 3629207 TI - HLA-DR versus HLA-B5-CREG antigens in rheumatoid arthritis (RA). AB - Thirty caucasian patients suffering from classic erosive rheumatoid arthritis (RA), with a condition persisting for more than 8 years, were examined together with 67 healthy control subjects with regard to associations to HLA-DR and HLA-B CREG antigens (B5-, B8-, B12-, B16- and B27-CREG). We found a significant correlation of seropositive RA (SPRA) with HLA-DR4 (9/14 patients = 64% chi 2 = 11.8, p less than 0.05), and seronegative RA (SNRA) with B5-CREG antigens (14/16 patients = 88%, chi 2 = 7.8, p less than 0.05). This HLA locus-differing association of SPRA and SNRA could, in addition to the known differences in clinicophenomenological parameters, be additional proof of the independent entity of these two forms of illness. PMID- 3629208 TI - Esophageal dysfunction and radionuclide transit in progressive systemic sclerosis. AB - Sixty patients with progressive systemic sclerosis (PSS) were studied by radionuclide esophageal transit (RT) and esophageal cineradiography. Fifty-two patients (87%) had abnormal RT with prolonged transit time and 28 (47%) had stagnation of radionuclide. RT was positively correlated to duration of disease (p less than 0.01). A positive correlation between transit time and the presence of dysphagia was observed. Reduced esophageal motility evaluated by cineradiography was observed in 44 patients (73%). In patients with moderate severe esophageal dysfunction there was a positive association between prolonged RT and hypomotility at the radiological examination (p = 0.001). RT is a safe and non-invasive method which is more sensitive than cineradiography and might be used as a screening test to evaluate esophageal involvement in patients with PSS. PMID- 3629210 TI - [Ehrlichia phagocytophila as the agent of grazing fever in the Berne highlands]. PMID- 3629209 TI - [Sterile, purulent meningitis and generalized vasculitis caused by a new drug for prevention of nidation in the dog]. PMID- 3629211 TI - The welfare of farm animals: an ethological approach. PMID- 3629212 TI - Life at the limits. Considerations on how bacteria can grow at extremes of temperature and pressure, or with high concentrations of ions and solutes. PMID- 3629213 TI - Pattern recognition. PMID- 3629214 TI - Appearance of anti-cancer activity of a masked compound of nitrosourea TA077, 1 (2-chloroethyl)-3-isobutyl-3-(beta-maltosyl)-1-nitrosourea in vitro. PMID- 3629215 TI - Lack of carcinogenicity of potassium bromate after subcutaneous injection to newborn mice and newborn rats. PMID- 3629216 TI - Modified inversion recovery method for nuclear magnetic resonance imaging. PMID- 3629217 TI - A comparison of the primary structures of lactate dehydrogenase isozymes M4 from giant panda, red panda, black bear and dog. AB - Lactate dehydrogenase isozymes M4 have been isolated and purified from red panda (Ailurus fulgens), black bear (Selenarctos thibetanus) and dog (Canis familiars) by affinity chromatography and compared with that from giant panda (Ailuropoda melanoleuca). Experimental results have shown that the N-termini, C-termini and the molecular weights of LDH-M subunits of red panda, black bear and dog are the same as those of the LDH-M subunit of giant panda. Analysis and comparison of HPLC peptide maps from the tryptic digests of the isozymes of red panda, black bear and dog have shown that most of their peptide fragments had the same retention time and amino acid composition as the corresponding peptide fragments from giant panda. Fragments with different retention times and/or amino acid compositions were sequenced. Careful examination of those variant amino acid residues demonstrated clearly that the primary structure of giant panda LDH-M subunit is unique and it appears that the giant panda might be classified as an independent family. PMID- 3629218 TI - Campylobacter pyloridis, peptic ulcers, and gastritis. PMID- 3629219 TI - Outcome indicators: who benefits? AB - Most of the recent work on performance indicators has concentrated on the provision or activities of health services rather than on their impact on the patients and populations who use them. Although the precise relationship between treatment and outcome is often unclear, simple examination of routinely available data can show whether mortality and morbidity are changing in desired directions. This pinpoints topics for more detailed professional review. It is incumbent on doctors to match the concern over the efficient use of health services with information about their effects on people's health. PMID- 3629220 TI - General practitioner assistance with gold and penicillamine therapy of rheumatoid arthritis--a four year prospective study. AB - One hundred patients with active rheumatoid arthritis, uncontrolled by symptom relieving agents, were allocated randomly to intramuscular gold or oral penicillamine therapy. Their general practitioners (97 in all) were requested to assist with blood, urine, skin and mucous membrane monitoring. After four years, 16 patients in each treatment group remained on their original therapy, and three quarters of these continued attending their family doctor for toxicity monitoring. Most GP monitoring problems occurred in the first six months of treatment. Sustained improvement in haemoglobin and ESR was seen in both treatment groups. Second-line drug toxicity monitoring by general practitioners allows specialist time to be diverted to rheumatological problem solving but may make it more difficult to relate rare but serious adverse adverse events to drug therapy. PMID- 3629221 TI - The parallel effects of a very low molecular weight heparin (CY222) on anti Xa activity and thyroid hormone levels in blood. AB - A very low molecular weight heparin fragment (CY222) was administered by subcutaneous injection to a group of normal volunteers. This drug caused increased anti Xa activity with peak levels being observed two hours after injection. This coincided with changes in thyroid hormone levels especially with a fall in red cell thyroxine levels. Larger doses of CY222 caused a fall in serum total thyroxine and triiodothyronine, a rise in free thyroxine and a fall in TSH levels. It was thought that these findings may be due to the production of a circulating inhibitor of cellular uptake of thyroxine and that this might be related to the elevated levels of serum free fatty acids produced by the heparin. PMID- 3629222 TI - Is elective surgery in the elderly worthwhile? AB - In a prospective study 102 patients (median age 70.9 years) were interviewed at home before and after elective surgery to assess whether they would have any difficulties in managing their activities of daily living (ADL) post-operatively. The patients were consecutive admissions in general surgery, gynaecology and urology. All patients were alive six months after surgery and 98 were cured of their condition. Twelve patients suffered a deterioration in their ability to perform various ADLs but none was institutionalised as additional help was given either by a spouse or by a home help. Elective surgery in this age group is worthwhile and carries with it minimal deleterious effects on social rehabilitation and few demands on community resources. PMID- 3629223 TI - Headaches, opiates and kyphoscoliosis--a dangerous mixture. AB - Acute respiratory failure is a recognised complication of kyphoscoliosis, but such individuals exhibit a wide range of cardiorespiratory dysfunction ranging from clinically insignificant disease to severe respiratory failure and eventual death. We report a 49 year old lady with adolescent kyphoscoliosis who presented to her general practitioner with nocturnal headaches of such severity that opiates were given pending transfer to hospital over a distance of 50 miles. This induced acute respiratory failure for which assisted ventilation was required. PMID- 3629224 TI - A case of intravenous and oral mefenamic acid poisoning. AB - A 22 year old heroin addict was admitted with tonic-clonic seizures, confusion and agitation 10 hours after taking mefenamic acid 5 grams orally and 2.25 grams intravenously. This appears to be the first recorded case of intravenous mefenamic acid abuse and, although not fatal, is a cause of concern. This is a commonly used drug and its seizure inducing potential is well recognised. It may therefore be worthwhile considering the possibility of intravenous abuse of mefenamic acid in heroin addicts admitted with confusion or seizures. PMID- 3629225 TI - Meningioma in a chronic schizophrenic. AB - A patient with a 27 year history of schizophrenia is described. Post-mortem revealed the presence of a right sided parietal meningioma. It is possible that this lesion caused the schizophrenic symptoms and that earlier investigation might have led to removal of the lesion. PMID- 3629226 TI - Neuroparalytic keratitis and the effect of cervical sympathectomy following operative procedures for trigeminal neuralgia. AB - A study of 248 patients who underwent operative procedures for trigeminal neuralgia over a nineteen year period is presented, with particular reference to those who developed neuroparalytic keratitis to see if cervical sympathectomy had any protective effect on the cornea. 51 patients underwent cervical sympathectomy, 46 as a prophylactic procedure, and 5 as a treatment for neuroparalytic keratitis. Of these patients 3 (5.9%) developed neuroparalytic keratitis, but 2 of them had had an inadequate sympathectomy. Forty seven patients who did not undergo cervical sympathectomy had either an anaesthetic cornea or a reduced corneal reflex, and of these 11 (23.4%) developed neuroparalytic keratitis. An adequate cervical sympathectomy therefore appears to have a protective effect on the cornea against the development of neuroparalytic keratitis. PMID- 3629227 TI - Radiation induced carcinoma of the anus. AB - The frequent use of radiation in the treatment of malignancy has resulted in an increased incidence of radiation induced tumours. The distal large bowel appears to be most vulnerable to this complication following radiation treatment to the pelvis. The anal canal is notably spared and radiation induced malignancy is very rare indeed. Only one such case appears in the world literature. We report a patient who developed such a tumour seven years following curative radiotherapy for a cervical carcinoma and succumbed to her anal tumour seven years later. PMID- 3629228 TI - Thoraco-abdominal birth injury--presentation, diagnosis and management in an unusual case. AB - As a result of a traumatic delivery a newborn male child developed thoracic and intra-abdominal problems. Haemoperitoneum and chylous ascites were diagnosed; from a scrotal enlargement secondary to bilateral patent processus vaginalis and a chylothorax became apparent during investigation of the scrotal swellings. We discuss the presentation, diagnosis and management of the case and review the literature. PMID- 3629229 TI - Alcoholism treatment. AB - In John Walsh's article "Some refuseniks see no glasnost" (News & Comment, 24 July, p. 356), the Committee for Concerned Scientists was incorrecty identified as the "Union" of Concerned Scientists. PMID- 3629230 TI - Researcher accused of plagiarism resigns. PMID- 3629232 TI - Test scores--are they a distorted proxy for achievement? PMID- 3629231 TI - Animal rightists raid USDA lab. PMID- 3629233 TI - EMBL: "small science" on a European scale. PMID- 3629234 TI - How big can a species be? PMID- 3629235 TI - Japanese quail can learn phonetic categories. AB - Japanese quail (Coturnix coturnix) learned a category for syllable-initial [d] followed by a dozen different vowels. After learning to categorize syllables consisting of [d], [b], or [g] followed by four different vowels, quail correctly categorized syllables in which the same consonants preceded eight novel vowels. Acoustic analysis of the categorized syllables revealed no single feature or pattern of features that could support generalization, suggesting that the quail adopted a more complex mapping of stimuli into categories. These results challenge theories of speech sound classification that posit uniquely human capacities. PMID- 3629236 TI - Chemoattractant-regulated mobilization of a novel intracellular compartment in human neutrophils. AB - A novel mobilizable intracellular compartment was identified in human neutrophils by latent alkaline phosphatase activity. This compartment is mobilized to the plasma membrane much more readily than any identified granule subset and has kinetics of up-regulation in the membrane similar to those reported for a variety of receptor proteins. Triton X-100 permeabilization of both intact human neutrophils and subcellular fractions obtained by density-gradient centrifugation revealed that 70 percent of the alkaline phosphatase is located in an intracellular compartment distinct from primary, secondary, and gelatinase granules and from the plasma membrane. This compartment fully translocates to the plasma membrane after stimulation with nanomolar concentrations of the chemotactic peptide N-formylmethionylleucylphenylalanine. PMID- 3629237 TI - Corresponding spatial gradients of TOP molecules in the developing retina and optic tectum. AB - The topographic map of cell position in the avian retina is inverted in its projection to the optic tectum. Dorsal retinal ganglion cell axons project to ventral tectum, and ventral retinal ganglion cells project to dorsal tectum. Topographic gradients of toponymic (TOP) cell surface molecules along the dorsoventral axes of retina and tectum also are inverted. TOP molecules are most abundant in dorsal retina and ventral tectum and least abundant in ventral retina and dorsal tectum during the period of initial retinal-tectal interaction. Thus, TOP molecules may be involved in orienting the retinotectal map. PMID- 3629238 TI - Carcinogenicity of aflatoxins. PMID- 3629239 TI - MSU faults Strobel for Dutch elm test. PMID- 3629240 TI - War on cattle disease divides the troops. PMID- 3629241 TI - Causality, structure, and common sense. PMID- 3629242 TI - Activated oncogenes in B6C3F1 mouse liver tumors: implications for risk assessment. AB - The validity of mouse liver tumor end points in assessing the potential hazards of chemical exposure to humans is a controversial but important issue, since liver neoplasia in mice is the most frequent tumor target tissue end point in 2 year carcinogenicity studies. The ability to distinguish between promotion of background tumors versus a genotoxic mechanism of tumor initiation by chemical treatment would aid in the interpretation of rodent carcinogenesis data. Activated oncogenes in chemically induced and spontaneously occurring mouse liver tumors were examined and compared as one approach to determine the mechanism by which chemical treatment caused an increased incidence of mouse liver tumors. Data suggest that furan and furfural caused an increased incidence in mouse liver tumors at least in part by induction of novel weakly activating point mutations in ras genes even though both chemicals did not induce mutations in Salmonella assays. In addition to ras oncogenes, two activated raf genes and four non-ras transforming genes were detected. The B6C3F1 mouse liver may thus provide a sensitive assay system to detect various classes of proto-oncogenes that are susceptible to activation by carcinogenic insult. As illustrated with mouse liver tumors, analysis of activated oncogenes in spontaneously occurring and chemically induced rodent tumors will provide information at a molecular level to aid in the use of rodent carcinogenesis data for risk assessment. PMID- 3629243 TI - Toward a universal law of generalization for psychological science. AB - A psychological space is established for any set of stimuli by determining metric distances between the stimuli such that the probability that a response learned to any stimulus will generalize to any other is an invariant monotonic function of the distance between them. To a good approximation, this probability of generalization (i) decays exponentially with this distance, and (ii) does so in accordance with one of two metrics, depending on the relation between the dimensions along which the stimuli vary. These empirical regularities are mathematically derivable from universal principles of natural kinds and probabilistic geometry that may, through evolutionary internalization, tend to govern the behaviors of all sentient organisms. PMID- 3629244 TI - Functional regions of the envelope glycoprotein of human immunodeficiency virus type 1. AB - The envelope of the human immunodeficiency virus type 1 (HIV-1) plays a central role in the process of virus entry into the host cell and in the cytopathicity of the virus for lymphocytes bearing the CD4 molecule. Mutations that affect the ability of the envelope glycoprotein to form syncytia in CD4+ cells can be divided into five groups: those that decrease the binding of the envelope protein to the CD4 molecule, those that prevent a post-binding fusion reaction, those that disrupt the anchorage of the envelope glycoprotein in the membrane, those that affect the association of the two subunits of the envelope glycoprotein, and those that affect post-translational proteolytic processing of the envelope precursor protein. These findings provide a functional model of the HIV envelope glycoprotein. PMID- 3629245 TI - The DNA dragon 1. PMID- 3629246 TI - Risk assessment. PMID- 3629247 TI - The Odyssey of a brochure on AIDS. PMID- 3629248 TI - Human genome: questions of cost. PMID- 3629249 TI - The cognitive unconscious. AB - Contemporary research in cognitive psychology reveals the impact of nonconscious mental structures and processes on the individual's conscious experience, thought, and action. Research on perceptual-cognitive and motoric skills indicates that they are automatized through experience, and thus rendered unconscious. In addition, research on subliminal perception, implicit memory, and hypnosis indicates that events can affect mental functions even though they cannot be consciously perceived or remembered. These findings suggest a tripartite division of the cognitive unconscious into truly unconscious mental processes operating on knowledge structures that may themselves be preconscious or subconscious. PMID- 3629250 TI - Expression of an exogenous growth hormone gene by transplantable human epidermal cells. AB - Retrovirus-mediated gene transfer was used to introduce a recombinant human growth hormone gene into cultured human keratinocytes. The transduced keratinocytes secreted biologically active growth hormone into the culture medium. When grafted as an epithelial sheet onto athymic mice, these cultured keratinocytes reconstituted an epidermis that was similar in appearance to that resulting from normal cells, but from which human growth hormone could be extracted. Transduced epidermal cells may prove to be a general vehicle for the delivery of gene products by means of grafting. PMID- 3629252 TI - Ownership of the human genome. PMID- 3629251 TI - California's proposition 65. PMID- 3629253 TI - Take two pets and call me in the morning. PMID- 3629254 TI - Four researchers honored with Laskers. PMID- 3629255 TI - Fraud reimbursement. PMID- 3629257 TI - When does homology mean something else? PMID- 3629256 TI - The workings of working memory. PMID- 3629258 TI - Biomaterial-centered infection: microbial adhesion versus tissue integration. AB - Biomaterials are being used with increasing frequency for tissue substitution. Complex devices such as total joint replacements and the total artificial heart represent combinations of polymers and metal alloys for system and organ replacement. The major barriers to the extended use of these devices are the possibility of bacterial adhesion to biomaterials, which causes biomaterial centered infection, and the lack of successful tissue integration or compatibility with biomaterial surfaces. Interactions of biomaterials with bacteria and tissue cells are directed not only by specific receptors and outer membrane molecules on the cell surface, but also by the atomic geometry and electronic state of the biomaterial surface. An understanding of these mechanisms is important to all fields of medicine and is derived from and relevant to studies in microbiology, biochemistry, and physics. Modifications to biomaterial surfaces at an atomic level will allow the programming of cell-to-substratum events, thereby diminishing infection by enhancing tissue compatibility or integration, or by directly inhibiting bacterial adhesion. PMID- 3629259 TI - Identification of a novel thyroid hormone receptor expressed in the mammalian central nervous system. AB - A complementary DNA clone derived from rat brain messenger RNA has been isolated on the basis of homology to the human thyroid hormone receptor gene. Expression of this complementary DNA produces a high-affinity binding protein for thyroid hormones. Sequence analysis and the mapping of this gene to a distinct human genetic locus indicate the existence of multiple human thyroid hormone receptors. Messenger RNA from this gene is expressed in a tissue-specific fashion with highest levels in the central nervous system. PMID- 3629261 TI - Thrombolytic agents and treatments. PMID- 3629260 TI - Molecular analysis of a constitutional X-autosome translocation in a female with muscular dystrophy. AB - The gene responsible for Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) maps to the X chromosome short arm, band Xp21. In a few females with DMD or BMD, the Xp21 region is disrupted by an X-autosome translocation. Accumulating evidence suggests that the exchange has physically disrupted the DMD/BMD locus to cause the disease. One affected female with a t(X;21)(p21;p12) translocation was studied in detail. The exchange points from both translocation chromosomes were cloned, restriction-mapped, and sequenced. The translocation is reciprocal, but not conservative. A small amount of DNA is missing from the translocated chromosomes; 71 to 72 base pairs from the X chromosome and 16 to 23 base pairs from the 28S ribosomal gene on chromosome 21. PMID- 3629262 TI - Thrombolytic treatment of acute thrombotic obstruction with disk valve prostheses: experience with 26 cases. AB - Twenty-eight episodes of prosthetic valve thrombosis occurred in 26 patients, and all were treated by thrombolytic drugs. The treatment consisted of UK (4500 IU/kg/hr for 12 hours) or SK (2,000,000 IU over 10 hours). The results were followed clinically and in the laboratory and by the same methods that are used for the diagnosis (echocardiography, fluoroscopy) of these problems. Immediate complete regression was seen in 23 cases. These cases did not undergo cardiac surgery. In three cases, in which clear clinical improvement was obtained while both the echocardiography and cinefluoroscopy showed persistent valve dysfunction, the patients were treated medically in two cases (second thrombolysis) and by surgery in one case. In two other cases thrombolysis was ineffective and the patients underwent emergency valve replacement. There were no significant hemorrhagic complications, but emboli from the thrombolysis occurred in five patients. Laboratory data illustrated changes in the success and improvement groups. There were no changes in the failure group. PMID- 3629263 TI - Endocrine tumors. PMID- 3629264 TI - Endocrine tumors--special problems in diagnosis and management. PMID- 3629265 TI - Gold therapy. I. Historical, chemical, pharmacological and biological profile of anti-arthritic gold compounds. PMID- 3629266 TI - HMO: doing better and feeling better? Some findings from a regional health survey. PMID- 3629267 TI - Mobilization of antibiotic resistance genes among farm animals and human hosts in a developing country (Sri Lanka). PMID- 3629268 TI - Metabolic balance studies of sodium, potassium, nitrogen and phosphorus in premature neonates. PMID- 3629270 TI - Some aspects of sexual knowledge and sexual behaviour of local women--results of a survey: X orgasm (female). PMID- 3629269 TI - Transsphenoidal microsurgery for pituitary adenomas. PMID- 3629271 TI - Foreign bodies in the upper digestive tract. PMID- 3629272 TI - Serum pseudocholinesterase estimation in the management of organophosphate poisoning cases and the effect of PAM on regenerating it. PMID- 3629273 TI - The effect of pirprofen on renal function in man. PMID- 3629274 TI - Methicillin resistant Staphylococcus aureus in a Malaysian neonatal unit. PMID- 3629275 TI - Adenomatoid odontogenic tumour: gross and histological examination of 45 cases. PMID- 3629276 TI - Oncology day ward: an evaluation. PMID- 3629277 TI - Hairy cell leukemia--a rare chronic lymphoproliferative disorder. PMID- 3629278 TI - Management of hyperprolactinaemia--an alternative viewpoint. PMID- 3629279 TI - Multiple skeletal fibroxanthomas: radiologic-pathologic correlation of 72 cases. AB - Out of a series of 900 biopsy-proven cases of skeletal "fibroxanthoma" (nonossifying fibroma, fibrous cortical defect), we studied 72 patients with more than one lesion. Age, sex, coexistent conditions such as neurofibromatosis, and histologic and radiographic appearance of the lesions were evaluated. Multiple skeletal fibroxanthomas are probably more common than previously suspected. (At least 8% of the 900 patients in our archives had multiple lesions). Only a small percentage (5%) of patients with multiple skeletal fibroxanthomas had coexistent neurofibromatosis. These lesions are histologically indistinguishable from their solitary counterparts and most commonly present in the lower extremities. Four radiographic patterns were noted: clustered lesions--usually about the knee. nonclustered lesions--in opposite ends of long bones. coalescent lesions--several lesions coalescing over time. This observation has not been previously reported. emergent lesions--lesions appearing in previously unaffected bone. Familiarity with these features may obviate biopsy. PMID- 3629280 TI - Radiological manifestations of bisphosphonate treatment with APD in a child suffering from osteogenesis imperfecta. AB - A 12-year-old female suffering from osteogenesis imperfecta (OI) was treated with 3-amino-1-hydroxypropylidene-1,1-bisphosphonate (APD) orally, 250 mg daily, for periods of 2 months, alternating with periods of 2 months of abstinence. Total duration of therapy was 1 year. Radiological and clinical improvement was striking. Furthermore, X-rays of the bones showed large, parallel radio-opaque striae, corresponding exactly to the periods of therapy. These were present in all metaphyses. PMID- 3629281 TI - Acute chondrolysis complicating Legg-Calve-Perthes disease. AB - Of 270 children with Legg-Calve-Perthes (LCP) disease, roentgenographic evidence of chondrolysis was noted in 12 (4.5%) within one year after diagnosis and appropriate management. Only in six hips of these 12 patients did the retrospective clinical, histological, and orthopedic findings fulfill the diagnostic requirements for chondrolysis. Sequential roentgenographic findings included initial periarticular osteoporosis and subchondral cortical irregularities, subsequent narrowing of the joint space, premature fusion of the growth plate, and eventual development of degenerative arthritis. The early roentgenographic recognition of chondrolysis is emphasized because it has an untoward effect on the prognosis of LCP and should therefore prompt a different orthopedic approach. PMID- 3629282 TI - The symptomatic hip in childhood: scintigraphic findings in the presence of a normal radiograph. AB - The principal causes in children of a non-acute painful hip are Perthes disease and synovitis (irritable hip). The 99mTc methylene diphosphonate (MDP) bone scan appearances in Perthes disease are well-known; in synovitis, the hip may show a diffuse increase in activity or may be normal. The significance of bone scintigraphy in the clinical setting of non-acute hip symptoms with normal skeletal radiography has been evaluated in 36 symptomatic children. The mean duration of symptoms prior to scan was 3 months (range 1 week-17 months). On the basis of final diagnosis, established by clinical findings, bone scan, X-ray and follow-up, the children were divided into two groups: synovitis or Perthes disease. Of the 33 scans in the 32 children with synovitis, 18 were normal and 15 showed diffusely increased activity on the painful side. All four patients with Perthes disease had focal femoral head abnormalities in the painful hip. Of the 18 children with normal scans, none went on to develop a skeletal disorder. In children with hip pain of over 1 week's duration, the main value of the bone scan is the early detection of Perthes disease. Diffuse increased activity on the painful side suggests synovitis. A normal scan virtually excludes significant skeletal abnormality. PMID- 3629283 TI - Calf hematoma--computed tomographic and magnetic resonance findings. AB - Four patients with hematomas of the calf are presented. The diagnosis was made by computed tomography (CT) in three cases and CT/magnetic resonance imaging (MRI) in one case. In all cases, CT or MRI clarified a confusing clinical picture. CT and MRI can help differentiate the types of calf mass (i.e., hematoma, tumor, Baker cyst, thrombophlebitis) and assist proper clinical management in a rapid, noninvasive fashion. PMID- 3629285 TI - Post-traumatic cyst-like lesions. PMID- 3629284 TI - Productive osseous changes about the wrist in rheumatoid arthritis. AB - Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%.. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in rheumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis. PMID- 3629286 TI - Case report 422: Malignant primary osteoporosis. PMID- 3629287 TI - Case report 430: Ischemic necrosis of osteochondroma of tibia. PMID- 3629288 TI - Case report 433: Aneurysmal bone cyst of T8. PMID- 3629289 TI - Problems of knowledge in contemporary Chinese medical discourse. AB - This study begins by criticizing the epistemological approach in medical anthropology to non-western medical knowledge and practice, arguing that implicit western dichotomies (especially those of theory and practice, reality and symbol) tend to be inappropriately imposed. It then examines some approaches to knowledge and practice in contemporary Chinese discourse on 'traditional' medicine, focussing particularly on recent use of the term 'epistemology' in Maoist writing and in professional commentaries on medicine. Commonalities between medical uses of yin and yang and Maoist dialectics are explored, and the Maoist concept of essence (benzhi) is found to be important in medicine as well. It appears that though theory and practice are beginning to be drawn apart by some practitioners in the PRC, the classic texts that are still in use and the practical experience of senior Chinese doctors act as important constraints on the development of western style epistemological dualities in medical knowledge. PMID- 3629290 TI - The Ayurvedic physician as scientist. AB - This paper is written in response to an article by Robin Horton in which Horton argues that 'traditional' systems of thought are relatively less open to external challenges than is modern scientific thought. Traditional systems of thought are (by definition) past-oriented; they consider truth to have been handed down from past sources and they are consensual rather than competitive in their attitude towards knowledge, Horton claims. Modern scientific thought is future-oriented; it is based upon an ideal of progress, and progress is attained through competition among rival theories or paradigms. According to Horton, the relatively greater openness of modern scientific epistemology accounts for the superior quality of the knowledge that modern science has acquired. In this paper it is argued that past-orientation is consistent with intellectual struggle and open competition among rival theories, as well as with openness to challenges from nature. Overall progress-orientation is not a necessary correlate of these approaches to the acquisition of knowledge. The first part of the paper described the thought and practice of a South Indian Ayurvedic physician. Although this physician employed a mode of gathering knowledge which was based upon a belief that full truth could be found only in the past, he recognized the provisionality of the knowledge he had acquired, and he struggled to adjust his own body of medical theory to the battery of counter-theories which constantly challenged it. He did not ignore external challenges, nor was he unconscious of their effect upon his thought. The second part of the paper illustrates this physician's process of theory-development through analysis of the texts of two interviews that took place between the physician and patients who visited him. PMID- 3629291 TI - An interpretive solution to the problem of humoral medicine in Latin America. AB - The hot-cold categorization of humoral medicine has been referred to as the 'basic cognitive principle' of traditional medicine (TM) in Latin America, and it has been suggested that this 'dichotomy,' 'pathology,' or 'syndrome' could interfere with the delivery of western health care. Such reification and medicalization of humoral ideology and practice is the result of field methodology. By designing eliciting-frames with but two terms along the hot-cold continuum, investigators have produced lists of hot or cold foods, medicines, and illnesses. Behind the use of these reductive techniques is a belief that individuals in a culture--regardless of life experience or special training- share underlying 'emic' or 'native' taxonomies. This premise blinds researchers to differences between the medical epistemologies of lay persons and curers. Inconsistent categorizations from community to community, consultant to consultant, and even from day to day with the same consultant result from the reduction of a continuum to a dichotomy which native consultants then consciously use in a keying-out process. But 'native etic' categorizations are unproductive in constructing 'native emic' taxonomies. These difficulties can be avoided by considering medicine as a local cultural system of symbolic meanings anchored in institutions and interpersonal interactions, and by separating the medical beliefs and activities of laypersons from those of curers. The author, who combines depth interviewing in highland Guatemala, elicitation of curing texts, participation in medical contexts, and formal training in healing, demonstrates that healers do not include hot-cold categories in their explanatory models of illness etiology, and that their treatments are based on empirical knowledge of herbs rather than on humoral reasoning. The use of such reasoning, ranged along an eight-term hot-cold continuum, takes place when individuals engaged in self treatment are uncertain concerning proper diagnosis or treatment, or when anthropologists ask questions couched in humoral terms. PMID- 3629292 TI - Behind shamanism: changing voices of Siberian Khanty cosmology and politics. AB - Siberian shamanism has roots in hunting traditions, kinship organization and soul beliefs which have changed under Soviet rule. Aspects of shamanic epistemology and curing survive, although native medical logic sometimes clashes with modern positivist medicine. Assumptions behind Siberian, particularly Khanty, shamanism are examined through analysis of training, seances and cosmology. The changing social context of shamanism is explored in a framework of Soviet pressure to reject shamanic 'superstitution' and 'exploration.' Shamans themselves have adapted their politics, diagnoses and symbolic actions to an increasingly cold social climate. Data results from ethno-historical and field research, including a summer 1975 trip to the Ob-Ugrian Khanty (Ostiak). PMID- 3629293 TI - The return of Dr Fritz: spiritist healing and patronage networks in urban, industrial Brazil. AB - This paper describes surgeries and other healings performed without antiseptics and anesthesia by two Brazilian spiritist healers. The beliefs of spiritism and its treatment modalities are outlined. The role of hypnosis in healing is discussed. Finally the socio-cultural context within which the healing takes place is examined to show that spiritist healers are reconstructing networks of patronage and dependency similar to those of traditional Brazilian society that provide meaning and security for the ill in the midst of disruptive urbanization and modernization. PMID- 3629294 TI - Cross-cultural communication between doctors and peasants in Bolivia. AB - Practitioners of modern medicine in Bolivia are often ignorant of traditional health practices among Andean peasants in the Department of Oruro. This ignorance makes them less effective agents for improving health. The author describes a method for teaching traditional concepts of health and disease to practitioners of modern medicine (doctors, nurses, and assistant nurses). He discusses workshops offered to these practitioners, where the participants were guided through a series of exercises which assisted them in deciding what aspects of the traditional system to change and what aspects to leave alone. He finally shows how Andean myths can be used as a method for teaching them how to cure disease. The objective is to educate modern medical practitioners in traditional beliefs and to use these beliefs for teaching peasants about modern medicine. PMID- 3629295 TI - Fear of sorcery and the problem of death by suggestion. PMID- 3629296 TI - Beyond the cure: Anthropological inquiries in medical theories and epistemologies. PMID- 3629297 TI - The 'serpent-stone' or the 'black-stone'. PMID- 3629298 TI - The role of massage in south Asia: child health and development. AB - Massage, together with breast-feeding, are the two fundamental nurturing practices of women in south Asia. In Mithila women are expected to massage their infants daily. If they do not, they lay themselves open to censure. Implicit in massage is the idea that a child's health is preserved by fostering its strength and invulnerability. Massage 'works' by instilling fearlessness, hardening bone structure, enhancing movement and limb coordination, and increasing weight. These practices, in turn, are premised on the idea that between birth and weaning the infant is highly impressionable such that its identity can be shaped by the women who nurture it. PMID- 3629299 TI - A measure of the 'sick' label in psychiatric disorder and physical illness. AB - Persons with psychotic disorders receive devalued labels. Despite considerable theorizing, the proposition that these labels affect the course of psychotic illness has rarely been subjected to investigation. The lack of an adequate operational measure for the labeling construct has hampered research. The present report describes the development of the Social Response Questionnaire (SRQ), a measure of the 'sick' label which incorporates moralistic attitudes, fear of dangerousness and negative expectations attached to the role of the severely psychiatrically ill. This 32-item scale, a multidimensional measure of informal labeling, which may be administered in a self-report format or to significant others, permits the study of dose-response relationships. The SRQ is internally stable. It also exhibits construct validity. Schizophrenics and persons with affective psychosis label themselves and are labeled by others more harshly than persons with Crohn's disease or normals. While self-percepts and the perceptions of significant others are fairly congruent for normals and persons with a significant physical illness, there is no agreement between the self-ratings of psychotics and their significant others. Psychotic persons view themselves more negatively than Crohn's disease sufferers or normals, but not as negatively as their therapists, families and friends. Potential uses for the SRQ in longitudinal research are addressed. PMID- 3629300 TI - Living with psychiatric patients: implications for the mental health of family members. AB - Current treatment policy has resulted in large numbers of ex-hospitalized psychiatric patients residing with family members in the community. However, little is known about the emotional consequences for family members. This paper focusses on the relationship between level of chronic strain, as indexed by 'objective' and 'subjective' family burden, and extent of psychological distress among family members of ex-hospitalized psychiatric patients. This relationship is assessed within a multivariate model that also considers eventful experience as an additional source of stress and social support and mastery as potential stress mediators. We found the variable of mastery, or sense of personal control, to be by far the most powerful predictor of distress among family members. When mastery was considered in regression analyses the modest correlations between 'objective' and 'subjective' family burden and distress scores disappeared. However, assessment of interactions indicated that strain is independently associated with distress among those subjects who scored relatively low on the mastery scale. Our most general conclusion is that the presence of some patients tends to be associated with substantial psychological costs for some families. PMID- 3629301 TI - Pharmaceuticals in the Third World: the local perspective. AB - This introduction is a plea in favour of social field research into the local context of the distribution and use of pharmaceuticals in developing countries. This local perspective is conspicuously absent in studies and policy recommendations concerning drug use in the Third World. PMID- 3629302 TI - The use of modern pharmaceuticals in a Filipino village: doctors' prescription and self medication. AB - The use of pharmaceuticals in common childhood illnesses is evaluated. The extent to which drug use is related to doctors' prescription is assessed. Attention is paid to the social context in which pharmaceuticals are applied. The study shows that the majority of the childhood illnesses are treated without consulting a doctor. In half of the cases, in which no doctor is consulted, pharmaceuticals- both prescription and nonprescription--are used. Symptomatic therapies as anti diarrhoeals and cough syrups are found to be most popular. All of the anti diarrhoeals and nearly half of the cough syrups used, are considered unsuitable for use in common childhood illnesses. Prescription practices by doctors have many harmful characteristics in common with self medication. Moreover, the example of doctors' prescriptions seems to encourage the choice for expensive, often dangerous, symptomatic therapy in self medication. To diminish this wasteful and dangerous use of drugs in self medication, reforms in distribution and production of drugs at national level and education in drug use at the community level are recommended. More knowledge of self medication practices is considered crucial in the implementation of such policies. PMID- 3629303 TI - Self-care and the informal sale of drugs in south Cameroon. AB - Self-care, though the most common of all forms of therapeutic action, has been little studied. This paper describes the context of self-medication with western pharmaceuticals in an area of South Cameroon (in 1980). The identity and appropriateness of these pharmaceuticals are briefly discussed. The paradoxical character of self-medication is emphasised: improvement in the quality of self medication implies both growth and loss of self reliance, increase and decrease of medicalisation. People in Cameroon, or indeed anywhere in the Third World, find themselves in a 'double-bind'. PMID- 3629304 TI - Drug prescription and self-medication in India: an exploratory survey. AB - This paper reports a study of the prescribing and dispensing of drugs in India. The drugs supplied to 2400 patients by the public and private medical sectors and by private pharmacies (over the counter dispensing) were recorded, and were analysed with respect to the patient's presenting complaint and diagnosis. The main findings discussed in this paper are: 1. Large numbers of drugs are prescribed by doctors in the private sector. Combination preparations containing 'hidden' classes of drug are often given. Anti-infectives are widely and often inappropriately used. 2. Potentially dangerous drugs are sold over the counter and prescribed for trivial or bizzare indications. Drugs which have been withdrawn as dangerous in the West remain popular first line drugs in India. 3. Food supplements and tonics of dubious nutritional and pharmacological value make up a high proportion of the total drugs bill. It is concluded that a rational drugs policy and/or an essential drugs list will be useless unless accompanied by intensive efforts to improve the education and updating of doctors and pharmacists and to reduce the commercial pressures on doctors to prescribe unnecessary drugs. PMID- 3629305 TI - Drug information and sale practices in some pharmacies of Colombo, Sri Lanka. AB - Three researchers posed as clients in 28 pharmacies in the capital of Sri Lanka. Tetracyclin, a prescription-only drug, could be obtained in all pharmacies without a doctor's prescription. No information was provided with its sale. Personnel in the pharmacies had no pharmaceutical qualification and knew little about the products they sold. They obtained most of their drug-related information from commercial/sales representatives. PMID- 3629306 TI - Abstracts: 81st annual scientific assembly of the Southern Medical Association. November 1-4, 1987, San Antonio, Texas. PMID- 3629307 TI - On the newbonic plague. PMID- 3629308 TI - Cognitive dysfunction in psychiatric consultation subgroups: use of two screening tests. AB - Elderly patients are highly vulnerable to illness-related and drug-induced cognitive changes, especially during the acute phase of a medical or surgical illness. Using a structured cognitive screening examination enhances the accurate identification of patients with cognitive impairment. We compared the cognitive portion of the Alzheimer's Disease Assessment Scale (ADAS-COG) to the Mini-Mental State Examination (MMSE) in screening for the presence of organic brain dysfunction. Using cutoff scores, the two tests were in agreement in 94.4% of 36 cases, with total scores on the two tests correlated at r = -.90 (P less than .01). Of these 36 patients for whom psychiatric consultations were requested, 14 (38.8%) were found to be cognitively impaired. We discuss the relationship of test scores to the stated reason for the consultation, as well as variables influencing test results. Finally, we demonstrate the usefulness of cognitive testing in patients who refuse treatment. PMID- 3629309 TI - Religious life of individuals with affective disorders. AB - We inquired into aspects of the family history, the marital status, and the religious practices of groups of normal subjects and patients with affective disorders. Consistent with past findings in the literature, individuals with affective disorders came from homes where one parent was frequently missing. The affective disorders group did not differ significantly from control subjects in their adult religious behavior, but had shown significantly diminished religious interest during adolescence. We suggest that this sample of patients with affective disorders returned to religious commitment after adolescence. A possibly related finding is a higher rate of intact marriage and lower rates of separation and divorce among these patients, as well as upward social mobility. PMID- 3629310 TI - Endoscopic diagnosis of gastritis: causative factors in 100 patients. AB - The frequency of gastritis in relation to its various predisposing conditions is unclear, as is the respective distribution of damage caused by its predisposing conditions. We studied 100 patients with the endoscopic diagnosis of gastritis. The incidence of gastritis in our university gastroenterology endoscopy service was 23%. A history of aspirin (ASA) or nonsteroidal anti-inflammatory drug (NSAID) use was present in 42%. No predisposing factors were found in 28% of cases. Stress gastritis was present in 10% of patients, all of whom were in the intensive care unit. Alcoholism, gastric resection, and portal hypertension were considered causative in 19%. Multiple predisposing factors were uncommon (3%). Coincident duodenal ulcer(s) and erosive duodenitis were common and were more frequent in the patients having idiopathic gastritis (46%) than in those who used ASA or NSAIDs (29%). The antrum was the portion of the stomach most frequently involved. This antral distribution of damage was predominant in both the ASA/NSAID-associated cases and in the idiopathic group. In contrast, patients with stress gastritis were more likely to have involvement of the gastric fundus and body. PMID- 3629311 TI - Patient preference in upper gastrointestinal studies: roentgenography versus endoscopy. AB - We prospectively compared roentgenography and endoscopy of the upper gastrointestinal tract in terms of patient acceptance and tolerance. Endoscopy was significantly better tolerated and easier overall for patients. Patients found no difference between endoscopy and radiography with respect to pain or life-style interruption. Patients stated that they would prefer endoscopy to roentgenography if repeat evaluation were needed. We conclude that UGI endoscopy is better tolerated and more acceptable to patients than UGI roentgenography. PMID- 3629312 TI - Reconstruction of full-thickness lip defects. AB - We describe the reconstruction of lip defects using a bipedicled musculocutaneous flap for the preservation of form and function. PMID- 3629313 TI - Treatment of plagiocephaly in infancy. AB - Plagiocephaly is commonly attributed to the synostosis of a single coronal suture. Esthetic deformities associated with plagiocephaly range from mild to severe. Because the deformities are progressive, and more difficult to correct in older children and adults, early diagnosis and correction are important. Linear craniectomies, previously widely practiced, have not yielded good results. Current craniofacial techniques allow extensive orbitocranial reconstruction, which can be done safely in infants and in older children as well. These techniques have produced excellent cosmetic results and are routinely used in craniofacial centers. PMID- 3629314 TI - Varicose veins and intracutaneous telangiectasia: combined treatment in 1,500 cases. AB - Surgical stripping of the varicose saphenous venous systems combined with avulsion and extraction of collateral branches through very small incisions has yielded excellent cosmetic and functional results in 1,500 operative procedures. Sclerotherapy of varicose veins is an established procedure. Injection with the patient in the upright position followed by mild short-term compression is a simple method to achieve the desired results, but is reserved for treatment of collateral varicose veins more than 4 mm in diameter. Obliteration of intracutaneous telangiectasia and small subdermal veins of the legs, face, and trunk can be done safely by injecting a 0.1% solution of sodium tetradecyl sulfate through a 30 or 32 gauge needle directly into the lumen of the vessel. Slow intraluminal injection has resulted in uniformly good to excellent results in more than 350,000 puncture sites. By combining surgical and sclerosing techniques, maximal functional and cosmetic results can be obtained by removing or obliterating venous channels. PMID- 3629316 TI - Physicians' use of health resources for terminal cancer patients: clinical setting versus physician specialty. AB - A large proportion of all Medicare reimbursements (22%) are made for terminally ill patients. Alternative methods of care for such patients (for example, hospice care) may be more appropriate and less costly. The role of physician characteristics in determining use of resources for terminal patients is compared with that of care setting (type of facility), using data from the National Hospice Study. Multiple logistic regression reveals a stronger relationship between care setting and resource utilization than between physician "aggressiveness" and utilization. Physician specialty has little effect on utilization. These findings suggest that care setting may influence physician practice behavior. This may be due to self-selection of particular types of physicians or patients, or to a characteristic of the facility itself. PMID- 3629315 TI - Retroperitoneal injuries: pitfalls in diagnosis and management. AB - Retroperitoneal injury caused by penetrating trauma or associated with progressive shock following blunt trauma is usually recognized promptly and managed appropriately. Isolated retroperitoneal injury from blunt trauma, unless accompanied by major hemorrhage or gross hematuria, is often difficult to diagnose and needed treatment may be delayed. Although clinical examination remains the cornerstone of diagnosis, the high incidence of ethanol abuse and/or concurrent head injury in trauma patients has led to increased use of computed tomography in the diagnosis of abdominal trauma. To determine the effect, if any, of CT examination on the diagnosis and management of retroperitoneal trauma, we reviewed our patient experience. During the 16-month period ending in April 1986, 135 patients sustained 177 retroperitoneal injuries (116 by blunt and 19 by penetrating trauma). There were 26 deaths (19% mortality). There were 90 pelvic fractures and 31 lumbar spine fractures, as well as 21 genitourinary, 12 gastrointestinal, five pancreatic, and eight major vascular injuries. Ten patients had isolated retroperitoneal hematomas. We conclude that (1) patients with retroperitoneal injuries and coexisting intraperitoneal injuries should have early operation; (2) isolated retroperitoneal trauma tends to lead to observation unless CT is used as part of the early assessment; and (3) routine use of CT in patients at risk accurately defines the extent of injury and enhances clinical management. PMID- 3629317 TI - Magnetic resonance imaging in evaluating focal liver lesions. AB - We report the results of magnetic resonance imaging (MRI) of the liver in 46 patients with various previously confirmed focal lesions. A characteristic signal pattern was found in hemangiomas (n = 11), with marked signal hyperintensity on T2 and proton weighted images as compared to normal liver tissue. Cysts (n = 7) also showed marked hyperintensity on T2 images, but could easily be differentiated by a lesser intensity on proton weighted images and signal hypointensity on T1 weighted images. Primary liver tumors (n = 4), metastatic liver disease (n = 18), focal nodular hyperplasia (n = 5), and liver adenoma (n = 1) revealed a weak signal hyperintensity on T2 images, with varying signals in T1 and proton weighted modalities. These data combined with other recent communications in the literature indicate that MRI is a promising diagnostic technique in the detection of focal liver lesions and that it may offer a high degree of specificity in the diagnosis of hepatic hemangiomas and benign cysts. PMID- 3629318 TI - Agricultural life-style: a mortality study among male farmers in South Carolina, 1983-1984. AB - After reviewing the death certificates of 2,820 South Carolina agricultural workers (including farmers, farm workers, and others in the agricultural industry) aged 35 to 84 during 1983-1984, we calculated proportional mortality ratios (PMRs). Among both white and nonwhite farmers in South Carolina, the PMR was significantly higher for cerebrovascular disease (whites, PMR = 1.20, P less than .05; nonwhites, PMR = 1.43, P less than .001) and lower for all malignant neoplasms (whites, PMR = 0.86, P less than .05; nonwhites, PMR = 0.78, P less than .001). In addition, external causes of death were elevated, attaining statistical significance for white farmers (PMR = 1.51, P less than .001). Significantly lower PMRs for all malignant neoplasms are attributed to fewer deaths from cancers related to smoking (buccal cavity and pharynx, esophagus, lung, and bladder) and colon and rectal cancers among both white and nonwhite farmers. White farmers did not show significantly elevated PMRs for cancers of the lymphatic and hematopoietic systems found in other studies in the Midwest. These data suggest that agricultural life-style can be improved for the prevention of strokes and for external causes of death. PMID- 3629319 TI - Hemophilia: pathophysiology and musculoskeletal complications. AB - By its nature, hemophilia and its complications are ideally suited to the team care approach. This paper reviews the pathophysiology of hemophilia and its concomitant musculoskeletal involvement, and discusses the approach and contributions of various disciplines. PMID- 3629320 TI - Training and evaluating teams of simulated patients. AB - The purpose of this study was to train and evaluate teams of standardized (simulated) patients as part of a required course in family medicine for second year medical students. During three hours of training, six women were trained to play the same person. These standardized teams played four roles during the 12 week course. Each simulator was interviewed by three student interviewers who were part of six groups of ten to 12 students, each group led by a physician. All sessions were audiotaped, and a coding system was developed. The completeness of response, new unscripted items, and accuracy of information provided by the simulators were measured using the audiotape sessions as sources of data. In addition, the degree of accuracy of the affect of each simulator was assessed by faculty and students in written case histories. The results of the study show that multiple simulators are an effective way of promoting active learning and of teaching basic clinical concepts and skills. Teams of standardized patients give students a consistent learning experience when there are constraints of student group size, time, and scheduling simulations within a traditional curriculum. PMID- 3629321 TI - Pedunculated lipoma of the colon: risks of endoscopic removal. AB - Endoscopic removal of pedunculated submucosal lipomas of the colon has been considered safe and effective. I have reported a case of large submucosal lipoma of the descending colon, in which serosal invagination resulted in the formation of a "pseudopedicle." Endoscopic polypectomy in such a case would have resulted in colonic perforation. Caution should be exercised in endoscopic removal of large lipomas, even when a pedicle is present. PMID- 3629322 TI - Percutaneous organophosphate poisoning. AB - After cutaneous application of the organophosphate insecticide Diazinon for pubic lice, our patient had symptoms of cholinergic excess, lost consciousness, and had a seizure. Because of the high index of clinical suspicion for potentially lethal organophosphate poisoning, the patient received empiric therapy with pralidoxime and atropine and completely recovered. PMID- 3629323 TI - Pseudopseudotumor cerebri: meningeal carcinomatosis presenting as benign intracranial hypertension. AB - We have described a 63-year-old man, taking diethylstilbestrol for adenocarcinoma of the prostate, who had papilledema. Lumbar puncture revealed intracranial hypertension without pleiocytosis. CT scan was normal, consistent with the diagnosis of pseudotumor cerebri. At craniotomy for placement of a ventriculoperitoneal shunt, the dura was found to be infiltrated with adenocarcinoma. In patients with known malignancy and elevated intracranial pressure, lumbar puncture and CT scan alone are not enough to rule out meningeal carcinomatosis; repeated lumbar puncture or cervical cisternal puncture may be necessary to document malignant cytology. PMID- 3629324 TI - Malignant melanoma of the esophagus. AB - We have presented a case of malignant melanoma of the esophagus, which appeared to be a primary neoplasm. Characteristic clinical, histologic, and ultrastructural features are described. This lesion should be suspected clinically when a polypoid mass is found in the esophagus, even in the absence of pigmentation. PMID- 3629325 TI - Bordetella bronchiseptica pneumonia in a patient with chronic lymphocytic leukemia. AB - This case report describes two episodes of pneumonia caused by Bordetella bronchiseptica in a patient with chronic lymphocytic leukemia. There was discrepancy between the in vitro sensitivity testing of the organism and subsequent clinical response to several antimicrobial agents. Human infection with B bronchiseptica is almost always associated with severe underlying disease and contact with an appropriate animal reservoir. PMID- 3629326 TI - Skeletal dysplasia in an infant with hypertelorism, hypospadias, developmental delay, and a complex chromosomal translocation. AB - A male infant with hypertelorism and hypospadias was found to have skeletal changes suggesting metaphyseal dysplasia. Associated findings included congenital nystagmus, hearing impairment, and a complex translocation involving the number 5, 8, and 10 chromosomes. Although some of these abnormalities may be coincidental, they might represent infrequent components of the BBB syndrome. It is just as likely, however, that the syndrome is a new one. PMID- 3629328 TI - "Let genius run free". PMID- 3629327 TI - Severe neutropenia due to sustained-release procainamide. AB - With increased use of sustained-release forms of procainamide in treating common cardiac arrhythmias, more and more cases of severe neutropenia and occasional deaths have been reported. It is unclear whether all sustained-release procainamide preparations are implicated. I recommend that a complete blood count be done every two weeks for the first three months of treatment with these drugs. Any patient who has an unexplained fever or a toxic reaction while taking one of these preparations should have a complete blood count done. PMID- 3629329 TI - Cystic fibrosis in an adult. PMID- 3629330 TI - Pancreatic pseudocysts. PMID- 3629331 TI - Polythelia. PMID- 3629332 TI - Acute adrenal failure with diffuse paroxysmal contracture. PMID- 3629333 TI - Preoperative localization of parathyroid adenomas. PMID- 3629334 TI - Melkersson-Rosenthal syndrome. PMID- 3629335 TI - [Continuity and relations in the activities of sector therapeutics and other specialists in a polyclinic]. PMID- 3629336 TI - [Physical development of children and adolescents residing in different natural environments]. PMID- 3629337 TI - [Outcome and prospects for the implementation of a complex program for the prevention of disease and promotion of public health]. PMID- 3629339 TI - [Problems in the reorganization of public health]. PMID- 3629338 TI - [Organizational-clinical aspects of the prevention of chronic disease]. PMID- 3629340 TI - [Risk factors in the stroke prevention program]. PMID- 3629341 TI - [Medico-hygienic aspects of the life style of physicians]. PMID- 3629342 TI - [Improvement in the forms of preventive examination of the population]. PMID- 3629343 TI - [Production losses as a result of injuries in the cattle industry]. PMID- 3629344 TI - [Professional orientation of students during their classroom and practical work]. PMID- 3629345 TI - [Information provisions for the management of the education and training process in a paramedical training institution]. PMID- 3629347 TI - [Various aspects of the training of medical personnel on the international level]. PMID- 3629346 TI - [Advanced training courses for department heads]. PMID- 3629348 TI - [Methodologic approaches to planning hospital bed utilization taking emergency hospitalization into account]. PMID- 3629349 TI - [Improvement in the management of urban multi-specialty hospitals]. PMID- 3629350 TI - [Consultation services for patients with diseases of the circulatory system in consultative-diagnostic polyclinics]. PMID- 3629351 TI - [Organization of oral medical services in a multi-specialty hospital]. PMID- 3629352 TI - [Makeup of parturients from other cities in Moscow]. PMID- 3629353 TI - [Organization of specialized home care services]. PMID- 3629354 TI - [Role of risk factors in the primary prevention of oncologic diseases]. PMID- 3629355 TI - [Preventive medical examination of gynecologic patients in a large city]. PMID- 3629357 TI - [Medico-geographic approach to studying the health of the population]. PMID- 3629356 TI - [Problems in the diagnosis and prevention of diseases of the digestive system in students]. PMID- 3629358 TI - [Neurologic diseases in children and their need for different types of medical services]. PMID- 3629359 TI - [Persons of working age with chronic diseases]. PMID- 3629360 TI - [Experimental verification of the International Classification of Impairments, Disabilities and Handicaps]. PMID- 3629361 TI - [Promotion of a healthy life style among students]. PMID- 3629363 TI - [Cardiovascular diseases and their prevention in the Scandinavian countries]. PMID- 3629362 TI - [Planning hospital services for the population of the Socialist Republic of Vietnam]. PMID- 3629364 TI - [Combined surgical procedures]. PMID- 3629366 TI - [Changes in central hemodynamics during surgical treatment of mechanical jaundice]. PMID- 3629365 TI - [Circulating immune complexes in salmonellosis]. PMID- 3629367 TI - [Pharmacourography using furosemide]. PMID- 3629368 TI - [Gangrene of the leg with an intact cutaneous integument]. PMID- 3629369 TI - [Ecology and its role in the pathogenesis of sepsis]. PMID- 3629370 TI - [Changes in plasma and erythrocyte lipids during physical training in ischemic heart disease]. PMID- 3629371 TI - [Pathogenesis of pulmonary hypertension in dust-induced bronchitis]. PMID- 3629372 TI - [Glycosylated hemoglobin in the presence of abnormal glucose tolerance]. PMID- 3629373 TI - [Candida carrier state in diffuse toxic goiter and hypothyroidism]. PMID- 3629374 TI - [The helium-neon laser in the treatment of suppurative-inflammatory diseases in diabetes mellitus patients]. PMID- 3629375 TI - [Preventive aspects of diseases of the nervous system]. PMID- 3629376 TI - [Isometric loading of late-middle aged and elderly myocardial infarct patients]. PMID- 3629377 TI - [Dosed external compression of the extremities in the treatment of refractory forms of chronic heart failure]. PMID- 3629378 TI - [Various indices of nonspecific resistance in pneumonia patients]. PMID- 3629379 TI - [Effect of smoking on the efficacy of treating chronic bronchitis at a health resort]. PMID- 3629380 TI - [Surgical treatment of bronchiectasis]. PMID- 3629381 TI - [Clinico-roentgenologic changes in intrathoracic sarcoidosis treated by hemosorption]. PMID- 3629382 TI - [Treatment of the Lyell drug-allergy syndrome]. PMID- 3629383 TI - [Effect of smoking on somatoneurologic manifestations of chronic alcoholic intoxication]. PMID- 3629384 TI - [Electrophoresis of cobamide using sinusoidally modulated currents in the treatment of chronic atrophic gastritis]. PMID- 3629385 TI - [Bile acids in the bile in cholelithiasis]. PMID- 3629386 TI - [Features of the clinical manifestations of anorectal developmental anomalies in adults]. PMID- 3629387 TI - [Immediate results of surgical treatment of incarcerated hernias of the anterior abdominal wall]. PMID- 3629388 TI - [Mucosal blood flow and gastric function in food toxic infections]. PMID- 3629389 TI - [Similarities and differences between yersiniosis and food poisoning]. PMID- 3629390 TI - [Clinical characteristics of acute intestinal diseases caused by Campylobacter jejuni]. PMID- 3629391 TI - [Oral detoxication therapy in acute intestinal infections]. PMID- 3629392 TI - [Causes of death in stage III-IV diabetic angiopathies of the lower extremities]. PMID- 3629393 TI - [Surgical management of thrombosis and embolism of major arteries with prolonged ischemia of the extremities]. PMID- 3629394 TI - Experimental neoplastic spinal cord compression: evoked potentials, edema, prostaglandins, and light and electron microscopy. AB - Spinal cord compression was induced in Fischer rats by percutaneous inoculation of 10(6) cells of malignant fibrous histiocytoma anterior to the T13 vertebral body. Paraplegia and incontinence occurred in all animals after 14-27 days (median, 23 +/- 3.0 days). Autonomic dysfunction and a measurable increase in tumor volume were documented with the use of computer tomography. The tumor penetrated the vertebral bone, invaded the epidural space, and gradually compressed the lumbar spinal segments. Electron-microscopic examination revealed dilated intermyelin spaces containing exuded homogenous material and extravasated leukocytes and erythrocytes. Myelin breakdown was accompanied by the presence of lipid-laden macrophages. Sequential recording of somatosensory evoked potentials (SEP) revealed a progressive increase in the latency of the cervical responses, which preceded the onset of clinical signs. In the presence of paraplegia, spinal cord conductivity was abolished. The levels of the prostaglandins TXB2, 6-keto PGF1 alpha, and PGE2 were measured in the compressed and remote spinal cord segments during the presymptomatic and symptomatic periods. Only PGE2 was significantly elevated (P less than 0.001) in the paraplegic rats, all along the spinal cord segments. A significant increase in water content was measured in the compressed lumbar segments in the presymptomatic period, and when paralysis set in it was increased in the adjacent low thoracic area as well. Tissue specific gravity was significantly increased only in paraplegic rats in the compressed (P less than 0.01) and the adjacent low thoracic areas (P less than 0.05) but no significant change occurred during the presymptomatic period. Multiple mechanisms play a role in the pathogenesis of neurologic symptoms in neoplastic spinal cord compression.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3629395 TI - Influence of halo vest treatment on vital capacity. AB - Respiratory function (vital capacity) was studied in 20 consecutive patients with unstable cervical spine injuries treated with a halo vest. Eight patients were neurologically intact. Twelve patients had incomplete spinal cord injuries that were classified on a neurologic function scale (Sunny-brook) immediately and 3 months after injury. Spirometric tests were done within 1 week of halo vest fixation, after 3 months of treatment, and 1 week after dismounting of the halo vest. The results showed that initial vital capacity was smaller than predicted normal in all patients and 30% less in neurologically impaired patients. Both groups improved during the treatment and somewhat more after removal of the halo vest. In neurologically intact patients, the halo vest caused a respiratory restriction of 10%, which was fully regained after removal of the halo vest. The difference between the groups remained throughout the study. There was no evidence that the halo vest itself affects the vital capacity more in patients with incomplete cord lesions than in neurologically intact patients. All of the cervical spine injuries healed uneventfully. PMID- 3629396 TI - Plain radiographic, discographic, and direct observations of Schmorl's nodes in the thoracolumbar junctional region of the cadaveric spine. AB - The perceivability of Schmorl's nodes in plain radiographs and discograms in the thoracolumbar junctional region (T10-L1) of the cadaveric spine was assessed by comparing the radiologic measurements with bone measurements. Schmorl's nodes in bone specimens were encountered in 19 of 24 spines studied. They were more than two times as common between vertebrae T10-11 and T11-12 as between T12 and L1 (P less than 0.01). When the areas of actual Schmorl's nodes exceeded 0.5 cm2 (corresponding to an aperture with a diameter of 0.8 cm), 47% of the nodes were seen in plain lateral radiographs and 68% in discograms. When the area measured 0.5 cm2 or less, only 24% could be perceived in plain lateral radiographs and 23% in discograms. The clinical significance of Schmorl's nodes remains uncertain as long as they are difficult to detect in vivo. PMID- 3629397 TI - Facet joint orientation, facet and costovertebral joint osteoarthrosis, disc degeneration, vertebral body osteophytosis, and Schmorl's nodes in the thoracolumbar junctional region of cadaveric spines. AB - The disc degeneration in the thoracolumbar junctional region (T10-L1) of 37 male cadaveric spines was recorded with the use of discography. From 24 of these spines the facet joint orientation and degenerative findings of the facet and costovertebral joints, vertebral bodies (osteophytosis) and discs, and Schmorl's nodes were recorded directly from bones. At T11-12, the most common site for the transitional zone between thoracic and lumbar facet type, there was a marked variation in the orientation of facets. The occurrence of degenerative findings and Schmorl's nodes at the three levels in the region differed. At T10-11, disc degeneration, vertebral body osteophytosis, and Schmorl's nodes were most common (anterior degeneration). At T12-L1, facet and costovertebral joint degeneration were dominant (posterior degeneration). At T11-12, disc degeneration, vertebral body osteophytosis, Schmorl's nodes, and facet and costovertebral joint degeneration all occurred (anterior and posterior degeneration). The results point to a pathoanatomic association between degenerative changes and facet orientation. PMID- 3629398 TI - Body height, obesity, and risk of herniated lumbar intervertebral disc. AB - Anthropometric measurements were studied for their prediction of herniated lumbar intervertebral disc in 332 men and women who had been discharged from hospital with this diagnosis during an 11-year follow-up. The patients were compared with 1,205 controls matched individually for sex, age, and place of residence. Men with a height of 180 cm or more showed a relative risk of 2.3 (95% confidence limits, 1.4-3.9) and women with a height of 170 cm or more 3.7 (1.6-8.6), compared with those who were more than 10 cm shorter (1.0). In men, but not in women, increased body mass index proved to be an independent risk factor for herniated lumbar disc, whereas the thickness of triceps skinfold had no predictive significance. Height and heavy body mass may be important contributors to the herniation of lumbar intervertebral disc. PMID- 3629399 TI - Posture-dependent bilateral compression of L4 or L5 nerve roots in facet hypertrophy. A dynamic CT-myelographic study. AB - In 12 patients with myelographic evidence of bilateral root involvement at the L3 L4 or L4-L5 levels postmyelographic computerized tomography (CT) studies were performed in flexion and extension. They showed concentric narrowing of the spinal canal in extension and widening with relief of nerve root involvement in flexion. This could be attributed to the presence of marked degenerative hypertrophy of the facet joints, narrowing the available space for dural sac and emerging root sleeves. In extension of the lumbar spine, bulging of the disc toward the hypertrophic facets causes a pincers mechanism at the anterolateral angles of the spinal canal with the risk of bilateral root compression. This mechanism is enhanced in these cases by marked dorsal indentation of the dural sac because of anterior movement of the dorsal fat pad in extension. The authors believe that the radiologically described mechanism forms the anatomic basis of neurogenic claudication and posture-dependent sciatica. PMID- 3629400 TI - Hypertrophic synovitis of the facet joint forming a para-articular mass in cases of herniated intervertebral disc. PMID- 3629401 TI - A critique of 'The Optimum Spine'. PMID- 3629402 TI - [Intra-arterial chemotherapy and embolization of the hepatic artery in primary liver cancer]. PMID- 3629403 TI - [Biological value of different fractionation schemes as exemplified by pre- and postoperative irradiated mouth tumors. Results of a clinical application of the NSD concept]. PMID- 3629404 TI - [Renal oncocytoma: a difficult preoperative diagnosis]. PMID- 3629405 TI - [Congenital polyps of the posterior urethra in children. Review of the literature and observations on 2 clinical cases]. PMID- 3629406 TI - [Recurrent varicocele]. PMID- 3629407 TI - [Ureteral obstruction secondary to reconstructive surgery of the aorto-iliac femoral axis using a prosthetic bridge]. PMID- 3629408 TI - [Orgotein and La Peyronie's disease]. PMID- 3629409 TI - [Toxicity of plasticizers in hemodialysis]. PMID- 3629410 TI - [Reuse in hemofiltration]. PMID- 3629411 TI - [Removal of aluminum in hemodialysis with a high-efficiency filter. 6-month follow-up]. PMID- 3629412 TI - [Blood ferritin in the periodic monitoring of uremic patients in substitute therapy]. PMID- 3629413 TI - [Iatrogenic risk in the treatment of uremic osteodystrophy]. PMID- 3629414 TI - [Hemoperfusion and plasmapheresis complications]. PMID- 3629415 TI - [HBV infections in dialysis]. PMID- 3629416 TI - [Complications of peritoneal dialysis related to the insertion and/or presence of permanent peritoneal catheters]. PMID- 3629417 TI - [Metabolic disorders in continuous ambulatory peritoneal dialysis]. PMID- 3629418 TI - [Pathology related to the presence of a vascular shunt]. PMID- 3629419 TI - The relationships between public and private pension schemes: an introductory overview. AB - Only recently have social insurance and private pensions, collectively, come to be thought of in terms of a total social security benefit package. The economic problems brought on by the 1974 oil crisis initially triggered consideration of a common, integrated role for the two systems. The second oil crisis reinforced the relative expansion in private pension programs, as a supplement to social security. Before these events, private and public pension programs interacted in only a limited number of ways, confined to relatively few countries. These interactions were largely confined to collective bargaining, whereby private pensions were gradually extended to nearly all employees in France and Sweden; mandating, or legally requiring private supplementation of social security, debated in several countries in the early 1970's, but postponed by the 1974 oil crisis; and contracting out, or covering a part of the social security benefit under a private plan, as in the United Kingdom. Overall, the tradition of private pensions was not very strong or broadbased. The current debate centers on which public/private pension mix is desirable from the point of view of an old-age income-maintenance program. A new element is the rising support for a "third pillar"--individual tax-encouraged savings--not only as a supplement, but as an alternative to social insurance. PMID- 3629420 TI - Income of retirement-aged persons in the United States. AB - This article reviews the composition and level of retirement income in the United States and how this has changed over time, focusing on two overlapping but distinct groups--the entire population aged 65 or older, and recent retirees. Changes in the composition of income of the aged over the past 20-30 years, including greatly expanded Social Security and pension coverage and an increasing number of persons with retirement savings, have improved the economic status of the aged not only in comparison with the aged in earlier years, but also in comparison with younger adults who derive most of their income from earnings. New retired workers are better off than the total aged population in several respects. The younger cohorts now in the labor force will spend more of their working lives in the more favorable conditions now present than was true of past new beneficiaries or the aged as a whole. It is, therefore, not unreasonable to expect that today's workers will enjoy more and larger pensions and increased income from savings to supplement their Social Security benefits when they retire. PMID- 3629421 TI - Results of surgical treatment of stage III lung carcinoma with carinal proximity. The role of sleeve lobectomy versus pneumonectomy and the role of sleeve pneumonectomy. AB - Sleeve lobectomy in specific situations can be an alternative to pneumonectomy. Sleeve pneumonectomy is an aggressive resection for carcinoma involving the tracheobronchial angle, carina, or lower trachea and lung. Sleeve lobectomy is questioned because of its technical difficulties and its postoperative complications. Sleeve pneumonectomy is controversial in that its postoperative mortality and long-term survival rates are similar, it is a technically difficult procedure, and its mortality rate is greater than that of standard pneumonectomy. The indications for the procedures and patient selection are discussed. PMID- 3629422 TI - Evaluation of the mediastinum by invasive techniques. AB - The value of invasive staging of the mediastinum is its greater accuracy in assessing the operability of lung cancer compared to noninvasive techniques. In expert hands, invasive mediastinal exploration results in little morbidity or mortality. For these reasons, we continue to use mediastinoscopy routinely in evaluating the mediastinum prior to advising thoracotomy for resection in the management of lung cancer. PMID- 3629423 TI - The role of surgery in N2 lung cancer. AB - Whereas most physicians believe that long-term survival is unlikely when mediastinal lymph node metastases are present, a significant number of these patients do have resectable tumors with encouraging long-term survival results. Data are presented to support this view, and steps identified to guide the physicians in selecting the patients who can benefit from this surgical approach. PMID- 3629424 TI - Treatment of lung cancer metastatic to the brain. Results of combined excision. AB - Lung cancer with solitary metastasis to the brain has been treated by surgical resection of both lesions over a 25-year period. Survival was 55 per cent at 1 year and 31 per cent at 2 years. Mean survival was 2.3 years, surpassing the 6 month average survival with more conservative therapy. An aggressive surgical approach to lung cancer with solitary cerebral metastasis results in improved survival and a better quality of life. PMID- 3629425 TI - Diagnostic and therapeutic uses of pleuroscopy (thoracoscopy) in lung cancer. AB - Pleuroscopy (thoracoscopy) is a simple procedure to perform that has both diagnostic and therapeutic utility. With a diagnostic accuracy of 90 per cent, it should be readily performed by surgeons who treat patients with lung cancer. A well-performed pleuroscopy may spare many patients the morbidity of an unnecessary thoracotomy. PMID- 3629427 TI - Surgical treatment of lung carcinoma. PMID- 3629426 TI - Management of tracheobronchial lesions with the Nd-YAG laser. AB - Neodymium-YAG laser resection is now a well-accepted and successful treatment modality for the palliation of otherwise inoperable tumors causing symptoms of dyspnea, cough, or hemoptysis. It may provide curative therapy for benign tumors and strictures. There is a learning curve associated with the technique, but numerous "hands-on" courses are now available for acquiring the initial expertise. PMID- 3629428 TI - Impact of early detection on the clinical course of lung cancer. AB - The Memorial Sloan-Kettering Lung Cancer Detection Program is described, and data from this study are reported and analyzed. The program enrolled 10,040 cigarette smoking men who were screened for at least 5 years by annual chest radiographs; half the men randomly selected also had 4-monthly sputum cytologic examinations. Of the 354 lung cancers that developed in these men during the screening period and a 2-year post-screening period, nearly half were adenocarcinomas and nearly one third were epidermoid (or squamous) carcinomas. Lung cancers detected by screening were more likely to be early stage (53 per cent) and resectable (65 per cent) than were those discovered by other means (for example, symptoms) or in the post-screening period (20 per cent early stage, 32 per cent resectable). Sputum cytology was most effective in detecting squamous carcinomas early; chest radiographs were most effective for detecting adenocarcinoma. However, sputum cytology did not reduce lung cancer mortality among these men who were in a program of annual chest radiographic examinations. Overall 5-year survival for all of the men who developed lung cancer was 35 per cent, compared with the national average of 13 per cent. PMID- 3629430 TI - Treatment of stage II lung cancer (T1N1 and T2N1). AB - Adenocarcinoma and large cell carcinoma have a worse prognosis than squamous cell carcinoma in the T1N1 and T2N1 subsets. In addition, local failure is a major problem with squamous carcinoma, whereas the most common sites of first recurrence are systemic, especially the brain, in non-squamous cell carcinoma. It is clear that radiation therapy can prevent local recurrences. In addition, chemotherapy prolongs survival but systemic recurrences--especially in the brain- remain the major obstacle to improved cure rates. PMID- 3629429 TI - The new International Staging System for Lung Cancer. AB - The International Staging System for Lung Cancer provides for classification of six levels of disease extent in five stage groups that relate to patient management and prognosis. Stage 0 is reserved for patients with carcinoma in situ. The Stage I and II definitions provide for classification of two levels of disease extent completely contained within the lung that have different prognostic and therapeutic implications. Definitive resection is the first choice of therapy for patients with non-small cell lung cancer in these stage groups. The Stage II category takes into account the erosion of survival expectations in the optimum group of T1 and T2 patients as a consequence of intrapulmonary lymph node involvement. Although small cell carcinoma is infrequently encountered as Stage I and Stage II disease, these classifications may be useful in the structure of investigational programs involving adjuvant surgery. The exclusion of distant metastases and the division of Stage III into two levels of extrapulmonary disease allow for selection of patients for specific treatment plans. Patients with non-small cell tumors with Stage IIIa disease usually are candidates for definitive surgical treatment. The specificity of the T and N definitions in the Stage IIIa and IIIb categories identifies patients for whom particular radiotherapy treatment plans are structured and protocol assignments are made. It is consistent with patient management concepts that all those with distant metastases are classified as having Stage IV disease. Implications of the system for selection of surgical, radiotherapeutic, and chemotherapeutic regimens are rational for all cell types. The classification meets the requirement for simplicity and can be readily applied in a broad spectrum of clinical and teaching environments. It is, however, sufficiently specific to be useful for reporting results of investigational therapies. Prospective use of the classification should encourage precision in clinical evaluations that exploit full use of refinements in imaging technologies. The cooperative efforts of the Task Force on Lung of the AJCC and the TNM Committees of the UICC to bring this classification system to fruition and international acceptance have been described. It has been adopted by these groups and others, including the International Association for the Study of Lung Cancer, the Japanese Cancer Committee, and the Spanish Society of Respiratory Disease, as their official recommendation for staging lung cancer. PMID- 3629431 TI - Miniresection of small peripheral carcinomas of the lung. AB - A total of 499 miniresective procedures were done for lung carcinoma over a 29 year period to July 1986. The operations were carried out in three groups: patients in whom a previous resection had been done, patients with stage III carcinoma, and those with stage I or II disease. Overall, perioperative mortality was 2.4 per cent. Cumulative survival in 296 patients with stage I or II carcinoma was 52 per cent at 5 years, 31 per cent at 10 years, and 11 per cent at 15 years. PMID- 3629432 TI - Treatment of bronchogenic carcinoma with chest wall invasion. AB - En bloc resection of chest wall and lung for primary non-small cell bronchogenic carcinoma with chest wall invasion, although often associated with a significant operative mortality, can be performed with a reasonable expectation of long-term survival if lymph nodes are not metastatically involved. Older age appears to decrease long-term survival, but age alone should not abrogate surgical resection. Non-small cell carcinoma cell type, tumor size, depth of chest wall invasion, and extent of chest wall or lung resection do not significantly influence survival. PMID- 3629433 TI - Treatment of superior sulcus tumor (Pancoast tumor). AB - It appears that combined preoperative radiation and surgery continue to offer the best survival results in patients with superior sulcus tumors. Patients with involvement of the brachial plexus, Horner's syndrome, rib invasion, and ipsilateral neck node metastases are still candidates for combined modality therapy, with expectations of survival of about 30 to 40 per cent. However, those presenting with invasion of vertebrae, involvement of subclavian vessels, and mediastinal lymph node metastases do poorly. In this latter group, treatment by high-dose external radiation alone may prove to be as effective as combined modality treatment. PMID- 3629434 TI - Methods of skeletal reconstruction following resection of lung carcinoma invading the chest wall. AB - The 5 per cent of patients with carcinoma of the lung directly invading the chest wall present a challenge for treatment. Complete resection of all tumor, including the chest wall, should be done. Immediate reconstruction to prevent a flail chest ensures a smooth postoperative course. Excellent palliation and a 46 per cent 5-year survival rate can be achieved if there is no spread to mediastinal lymph nodes. PMID- 3629435 TI - A ten year study of partial mastectomy for carcinoma of the breast. AB - Since 1970, 334 patients have undergone partial mastectomy, axillary dissection and irradiation for treatment of invasive carcinoma of the breast. The average follow-up period is 59 months. Survival curves were calculated for the entire study group and for patients classified by tumor size, nodal status and stage of disease. The five year over-all survival rate for 334 patients is approximately 87 per cent; the ten year survival rate is approximately 64 per cent. Of the 334 patients, 247 (74 per cent) have been observed for at least two years. Fourteen of these patients (5.7 per cent) have had a recurrence of carcinoma develop within the treated breast. PMID- 3629436 TI - Surgical management of large incisional hernias by an intraperitoneal Mersilene mesh and an aponeurotic graft. AB - The surgical repair of large midline incisional hernias must respect, in part, the loss of abdominal wall substance created by the lesion while, at the same time, recreating a strong abdominal wall. The combination of an intraperitoneal mesh, reinforced by a plasty of the anterior layer of the rectus sheath, fulfills these conditions and provides a good functional result in 130 instances. PMID- 3629437 TI - Preoperative radiotherapy and intra-abdominal metastasis of the lymph node in the surgical treatment of carcinoma of the thoracic esophagus. AB - Esophagectomy was performed upon 84 patients treated surgically for squamous cell carcinoma of the thoracic esophagus from 1965 to 1985 at the Tottori School of Medicine. Forty-four of these patients received preoperatively a total of 30 to 40 grays of cobalt 60 (2 grays per day) to the primary lesions, and 40 patients did not receive preoperative radiation therapy. A decreased tendency in the occurrence of metastasis to the intrathoracic lymph nodes was observed histologically in the group exposed preoperatively to radiation. A significant decrease in the occurrence of metastasis to the intrathoracic regional nodes in patients with carcinoma of the middle part of the thoracic esophagus was observed (p less than 0.02). A significant increase in the occurrence of metastasis to the intra-abdominal lymph nodes was observed in the patients receiving radiation therapy (p less than 0.01). The results indicate that preoperative radiotherapy for carcinoma of the thoracic esophagus may increase the risk of metastasis to the intra-abdominal lymph nodes. PMID- 3629438 TI - Examination of patient selection and outcome for hepatic resection for metastatic disease. AB - Hepatic resection for metastatic disease is now an accepted therapeutic option in a selected group of patients. A series of 56 patients undergoing hepatic resection at a single institution from 1974 to 1985 are presented. Resection was carried out in 27 women and 29 men who ranged in age from 23 to 87 years (a mean of 56 years). The site of primary disease was: colorectal in 41, adrenal gland in two and other sites in 13. Of the 56 hepatectomies, 21 were done for synchronous secondary disease discovered before or at operation for the primary disease. Metachronous lesions were found in 35 patients, from two months to 17 years (a mean of 34 months) after excision of the primary tumor. Estimated five year survival rates using the Kaplan-Meier method was 25 per cent in the patients with colorectal primaries and 35 per cent in the entire group. No difference was demonstrated between synchronous and metachronous resections. Patients with multiple hepatic lesions did much poorer than those with solitary tumors. Patients with metastatic tumor consisting of one large lesion with surrounding satellite nodule or nodules had an expected survival time resembling that for those with true solitary metastases and were included in that group. No difference in survival time was observed in patients with carcinoma of the colon and rectum who had involvement of regional nodes at the time of the primary resection, as compared with patients with negative nodes. Hepatic resection for a secondary malignant growth can be performed safely with a real chance for cure in selected instances. We continue to recommend an aggressive approach to hepatic metastases, especially those of a colorectal origin. PMID- 3629439 TI - Adenocarcinoma in the upper third part of the stomach. AB - Two hundred and twenty-three patients who underwent gastrectomy for adenocarcinoma arising from the cardia and upper third part of the stomach were studied with regard to esophageal invasion. One hundred and twenty-seven (57 per cent) had a malignant invasion into the esophagus and 96 (43 per cent) did not. In the curative instances, 52 of 74 patients (70.3 per cent) without esophageal invasion survived for five years, while 14 of 52 patients (26.9 per cent) with esophageal invasion survived: The prognosis of patients with esophageal invasion was poor regardless of the presence or absence of metastases to the lymph nodes. No patient who underwent noncurative resection survived for five years. To elucidate the high risk factors of esophageal invasion, a proportion of patients with esophageal invasion was statistically compared with patients without esophageal invasion, according to clinicopathologic factors. High risk factors included anatomic location, advanced disease and Borrmann IV type in gross appearance, more than 5 centimeters in diameter, positive serosal in filtration and positive metastases to the lymph nodes. Histologic type and mode of invasion did not relate to the esophageal invasion. The patients with high risk factors had a significantly poorer prognosis than did those without high risk factors. The results of the present study clearly show that high risk factors for esophageal invasion have an untoward effect on the rate of curative resection and the prognosis after removal of a lesion from the upper third part of the stomach. PMID- 3629440 TI - Staging of carcinoma of the colon and rectum. AB - A retrospective study was carried out upon 393 patients diagnosed from the 1 January 1970 through 1 December 1978 for carcinoma of the colon and rectum, 90 per cent of whom had a complete follow-up study during a five year period or until death. A classification system by stage, which has given us good results since there are no crossovers in the survival evolution of the different subgroups, is described. The system shows great uniformity since a linear equation with a slope of 15.76 per cent and a linear correlation coefficient (r) = -0.999 relates almost perfectly the decrease in survival time as the stages advance. PMID- 3629441 TI - A simple procedure for relieving obstruction of sump catheters. AB - A simple technique for the desobstruction of sump drains is described. The technique consists of disassembling the obstructed catheter, leaving the outer part in situ and cleaning the disengaged inner and outer parts. Proper function is regained after reassembly of the catheter. The procedure is indicated when exchange of the sump catheter is impossible due to an immature catheter tract. PMID- 3629442 TI - A new abdominal drain for overflowing lavage in instances of severe pancreatitis with persistent peritoneal contamination. AB - Eight patients with severe acute necrotizing pancreatitis had a new removable drainage device applied which allowed for massive lavage drainage with water tightness and easy repeated abdominal and retroperitoneal revisions. The lavage clears the enzymes and the toxic products that continuously soil the abdomen and affect all other systems. Simultaneously, it acts as a peritoneal dialysis. There were no complications and the 50 per cent survival rate at three months compares favorably with that of corresponding instances in another study (p less than 0.02). PMID- 3629443 TI - Management of presacral bleeding during rectal resection. AB - Severe presacral bleeding is a troublesome and potentially life-threatening complication during low anterior or abdominoperineal resection. We believe that suturing or cauterization should not be used since this will perpetuate the problem of bleeding in most instances. We recommend the use of hemostatic agents plus laparotomy sponges for compression to control the bleeding. If this fails, then the metallic thumbtack can be used as described herein. It is simple and effective. PMID- 3629444 TI - Wedge tracheoplasty in infants. PMID- 3629445 TI - Surgical treatment for advanced epithelial carcinoma of the ovary. AB - The three surgical steps in the management of carcinoma of the ovary--staging laparotomy, cytoreductive operation and second-look laparotomy--must be critically re-evaluated. During the past decade much data has been assembled on platinum based combination chemotherapy. The results of this type of chemotherapy questions the importance of these procedures. Whereas staging laparotomy will continue to determine important issues in the management of early disease, the use of cytoreduction and second-look laparotomy must be questioned as a routine or important determinant of current treatment results. PMID- 3629446 TI - Effect of topical beta APN application on evoked potential conduction in rat sciatic nerve and spinal cord. AB - The purpose of this study is to evaluate possible toxic effects of beta aminopropionitrile fumarate (beta APN), a lathyrogenic agent that inhibits fibrosis. This drug has been considered for use as an adjunct to surgical repair after topical application upon peripheral and central nervous system structures. In vivo and in vitro studies were done using rats to study the dose dependent neurotoxicity of this water soluble chemical. The results indicate that when the neural sheaths are removed the amplitude of the evoked sciatic nerve potential is irreversibly suppressed from 1 to 10 mM concentrations of beta APN. Nerve conduction velocities are relatively less affected with reduction from 43 to 35 m/sec by beta APN immersion. Similarly, the spinal cord studies show that when the dura and arachnoid are opened and damaged, 0.1 mM beta APN causes increased latency (from 9.9 to 14.5 msec) and decreased amplitude (from 79.4 to 56.8 microV) of cortical somatosensory evoked potentials. Possible mechanisms for the neurotoxic effects of beta APN are discussed. PMID- 3629447 TI - Granuloma annulare: a rare occipital lesion in infants and children. AB - Subcutaneous granuloma annulare is a rare scalp lesion that occurs in infants and children. Occurrence in the occipital region, absence of bone involvement, slow growth, and foci of necrosis of collagen surrounded by palisading granulomatous inflammation are characteristic of this lesion. Although the cause remains unknown, it is not infectious and is more likely due to a defect in cell-mediated immunity. The prognosis after excision is excellent. Increased awareness that this peculiar granulomatous lesion can rarely occur in the soft tissue of the occipital region will help prevent confusion with neoplastic or infectious processes. PMID- 3629448 TI - Upward herniation of the posterior fossa cyst in the shunted child. AB - Seventy-two years after Dandy and Blackfan's initial description of the Dandy Walker syndrome, controversies still exist regarding the precise methods of treatment for this disorder. One potential complication of simple lateral ventricular shunting is upward herniation of the posterior fossa cyst, which at times can result in precipitous clinical deterioration. We present three examples of posterior fossa cysts with upward herniation and review the pertinent literature. We advocate contrast studies to determine whether aqueductal communication exists, before shunting is performed, as well as close follow-up of the shunted child. PMID- 3629449 TI - Angiographically occult arteriovenous malformations of the brainstem. AB - Two cases of infratentorial arteriovenous malformations that were occult to angiography but detected by computed tomography are discussed. In both cases a preoperative diagnosis of low-grade glioma was considered. Attention is drawn to the relative paucity of such lesions below the tentorium. PMID- 3629451 TI - Craniometaphyseal dysplasia. PMID- 3629450 TI - Bilateral symptomatic intraspinal T12-L1 synovial cysts. AB - A 72-year-old man presented with several months of increasing lumbar pain, sciatica, lower extremity weakness, numbness in his buttocks and posterior thighs, burning sensations in his scrotum, and urinary incontinence. Myelogram computed tomography scan demonstrated a high grade incomplete block at the T12-L1 level due to bilateral synovial cysts and simultaneously a high grade partial block at L4-L5 due to spinal stenosis. Laminectomy of the T-12 vertebra and partial laminectomy of the L-1 vertebra with excision of both synovial cysts and laminectomies of the L-4 and L-5 vertebrae with foraminotomies resulted in a reversal of the patient's symptomatology. PMID- 3629452 TI - Extradural spinal angiolipoma. PMID- 3629453 TI - Steroid receptors in meningiomas. PMID- 3629454 TI - Leuko-araiosis. PMID- 3629455 TI - An extended middle fossa approach combined with a suboccipital craniectomy to the base of the skull in the posterior fossa. AB - A new approach to the base of the skull in the posterior fossa is described. This approach involves removing the petrous bone without any injury to the labyrinth, and dividing the superior petrosal sinus and tentorium cerebelli. A combined suboccipital craniectomy is used for excision of the portion of tumors that extended inferiorly. Total or subtotal removal of tumors was performed in 11 patients and partial removal in 3 patients, without any operative mortality. The facial nerve was preserved in all patients and hearing was retained in 9 of 12 patients. This approach is useful for large tumors located around the clivus. PMID- 3629456 TI - Subdural hematomas in the newborn. Surgical treatment and results. AB - Subdural hematomas were evacuated in 41 newborns during the first 4 days after birth. Subdural hematomas due to birth trauma may be subdivided into supratentorial, subtentorial, and suprasubtentorial. The location was frequently bilateral. The clinical course and diagnosis are described. Evacuation of the subdural hematoma was performed by subdural taps, linear craniotomies through the coronal and lambdoid sutures, and, in some cases, by combined approaches. The results were favorable in 68.3% of cases. PMID- 3629457 TI - Magnetic resonance imaging: lumbosacral lipoma. AB - To evaluate the clinical efficacy of magnetic resonance imaging (MRI) of lumbosacral lipomas, the magnetic resonance images of nine patients were reviewed. T1- and T2-weighted spin echo sequences were used with a 0.5-T magnetic resonance system. The tethered or low-positioned conus medullaris, the lipoma itself, the lipoma--cord interface, the subarachnoid space, and hydromyelia were clearly disclosed. The nerve rootlets were not as clear. These results indicate the possible discontinuance of myelography and metrizamide computed tomography (CT) cisternography for such imaging. The diagnostic modalities of choice for lumbosacral lipoma imaging are plain spine films, plain CT scan, and MRI. PMID- 3629458 TI - Hyperbaric oxygen and cerebral infarction in the gerbil. AB - The effectiveness of hyperbaric oxygen in reducing the incidence of cerebral infarction during the first 36 hours after occlusion of the right common carotid artery was investigated in gerbils. After carotid ligation, the gerbils were divided into four groups: controls, which breathed air at ambient pressure; group 1, which received hyperbaric oxygen at 1.5 atmospheres absolute pressure (ATA) for 36 hours, with a 5-minute, 1.5-ATA air break each hour; group 2, which received hyperbaric oxygen at 1.5 ATA for 1 hour alternating with 1 hour air at 1 ATA, for 36 hours; and group 3, which received hyperbaric oxygen at 1.5 ATA with hourly 5-minute air breaks for 18 hours, and ambient air for the second 18 hours. Neurological evaluations and staining of the brain with tetrazolium revealed the following results at 36 hours after carotid ligation: 72% of the controls had cerebral infarcts; 26% of the gerbils in group 1 had infarcts, but all animals died at 24-36 hours after beginning hyperbaric oxygen exposure from oxygen toxicity; 44% of the gerbils in group 2 had infarcts; 11% of the gerbils in group 3 had infarcts during the first 18 hours after carotid ligation, and no infarcts developed in the 18 hours that followed. Hyperbaric oxygen reduces the incidence of cerebral infarction after carotid artery ligation, presumably by allowing time for collateral circulation to develop. PMID- 3629460 TI - Tension pneumocephalus following nasal polypectomy. AB - Subdural tension pneumocephalus in a 80-year-old man following nasal polypectomy, presenting clinically with progressive weakness of both legs, is reported and the pathogenesis is discussed. The diagnosis of tension pneumocephalus and the options of management are considered. PMID- 3629459 TI - Hypothalamic glioma. AB - Seven patients from a series of 400 parasellar lesions presenting with visual failure treated in the Gough-Cooper Department of Neurological Surgery, The National Hospital for Nervous Diseases, Queen Square, were found to have low grade gliomas of the hypothalamus. All were retrochiasmatic in site. The median age was 18 years. All showed low-grade astrocytoma, grade 2 and, in 6 of the 7 cases, presentation was with a variety of visual problems including homonymous hemianopia, bitemporal hemianopia, and unilateral scotomata. The other case presented with papilledema. Skull x-rays were, by and large, normal. Computed tomography scanning showed low- or mixed-density midline lesions and angiography showed mass effect and occasionally a capsular blush. All were operated on directly through a variety of approaches, and in each case, a radical subtotal removal was carried out. Postoperatively there were no major complications and no major worsening of symptoms in any patient. Radiotherapy was applied in 6 of the 7 cases. Follow-up periods range from 6 months to 6 years and 5 of the 7 patients remain well. The other 2, who are surviving, have advancing neurological disturbance. PMID- 3629461 TI - Aspergillosis of ethmoid sinus and optic nerve, with arteritis and rupture of the internal carotid artery. AB - A 54-year-old woman had been treated 26 years previously for Hodgkin's disease. Eight months before presentation, the disease had recurred and the patient had received cytotoxic drugs and steroids. She presented with loss of vision of the right eye and died 5 months later from extensive subarachnoid hemorrhage. Postmortem examination revealed an aspergillus abscess of the ethmoid sinus, extending to the right frontal lobe and optic nerve, and to the wall of the right internal carotid artery (ICA). Death was due to rupture of the ICA. Such a presentation of aspergillosis is unusual. Three cases of aspergillus arteritis causing rupture of the ICA have been reported previously. PMID- 3629463 TI - Subarachnoid hemorrhage after embolization. PMID- 3629462 TI - Epidural thoracic spinal cord metastasis presenting with cerebellar gait ataxia. PMID- 3629464 TI - The use of isobutyl-2-cyanoacrylate in embolization. PMID- 3629465 TI - A simple solution to the malpractice crisis. PMID- 3629466 TI - [New aspects in the therapy of laryngeal tumors from the surgeon's viewpoint]. AB - New techniques in tumor diagnosis allow us to improve and to refine the surgical procedure of partial laryngectomy. The first aim remains the radical tumor resection. After that we postulate a better functional surgery. Improvements were also realized using surgical voice restoration during and after laryngectomy. Technique and results are described with the use of voice prosthesis and tracheostoma valves for non-sign language speech. The treatment of laryngeal cancer today means cooperation between radiotherapy, oncology and ENT-surgery. Therefore the discussion of new developments in ENT-tumor surgery is of interest. PMID- 3629467 TI - [Therapy of advanced hypopharyngeal carcinoma]. AB - Patients with hypopharynx carcinoma underwent planned irradiation and surgical treatment (pharyngo-laryngectomy with uni- or bilateral neck dissection) with postoperative planned irradiation. One group of these patients was treated with intraarterial chemotherapy with Methotrexat prior to any other therapy. The group with intraarterial therapy followed by irradiation seems to give the best results. PMID- 3629468 TI - [Liver metastases of colorectal carcinoma: computerized tomographic follow-ups and prognoses in relation to therapy]. AB - Liver metastases of colorectal carcinomas were diagnosed by computed tomography in 116 patients. Several control examinations were made during the course of the disease. The therapeutic effect on the metastases is defined by measurements of the tissular density. Patients submitted to dearterialization or local chemotherapy showed a higher incidence of regressive tumor calcifications and necroses than untreated patients ans patients treated by systemic chemotherapy. The median survival of the untreated patients is 3.6 months, patients treated by systemic chemotherapy have a median survival of 7.9 months, and patients submitted to dearterialization and local chemotherapy show a median survival of 15.7 months. Patients treated by resection survived 36 months, which is about 10 months longer than the survival of patients treated by dearterialization, considering comparable metastatic stages. An increased survival after systemic chemotherapy was only observed in patients of stage 1. PMID- 3629469 TI - On the problem of the characterization of late effects by a linear-quadratic survival function. I. Theoretical and radiobiological aspects. AB - Radiobiological data have been used for an analysis of acute and late tissue responses on the basis of a linear-quadratic survival function SLQ = exp(-alpha d -beta d2). Isoeffect curves of late effects exhibit a steeper slope than those for the corresponding acute effects, and, therefore, late effects may become an essential aspect in the radiotherapy of many kinds of tumours. In this communication, the theoretical and radiobiological view will be presented, whereas in a second part clinical applications will play a dominant role: Thus a statistical analysis of clinical observations has revealed that the volume factor of the irradiated tissue represents an important factor with regard to the characteristic average latency period, when clinical effects will become manifested. PMID- 3629470 TI - Histological examination of combined effects of chemotherapeutic agents and differently fractionated irradiations in transplanted solid Ehrlich carcinoma of mice. II. Observations after dibromodulcitol treatment. AB - Dibromodulcitol treatment induced histological damages in solid Ehrlich carcinoma which increased on the effect of parallelly applied local fractionated X irradiation. Comparing the effect of differently fractionated irradiations of the same total dose combined with dibromodulcitol treatment it can be stated that daily applied low radiation fractions cause more severe histologically demonstrable damage than relatively higher ones given in three to four day intervals. PMID- 3629471 TI - Utility of lymphoscintigraphy in directing surgical therapy for melanomas of the head, neck, and upper thorax. AB - Lymphoscintigraphy with technetium99m antimony sulfur colloid or technetium99m human serum albumin helped direct the surgical management of 24 patients who had melanomas of the head, neck, and upper thorax. Eighteen (75%) patients had documented lymphatic flow to other than a single adjacent predictable lymph nodal group. Nineteen patients underwent lymphadenectomy. Availability of the scan altered surgical management in nine patients (47%) who required resection of nodes in addition to resection of adjacent nodes. The discovery of metastatic disease in one patient was clearly attributable to lymphoscintigraphy. This demonstrates the unpredictable lymphatic anatomy of this region and suggests that preoperative lymphoscintigraphy may be useful in directing the surgical management of cutaneous melanomas in which lymph node dissection is planned. PMID- 3629472 TI - Balloon dilation for the treatment of stomal stenosis complicating gastric surgery for morbid obesity. AB - In a retrospective analysis, we evaluated our results with endoscopic dilation of enterostomy stenoses that complicated gastric procedures performed for the treatment of morbid obesity. Of 541 patients who underwent a gastric procedure for treatment of morbid obesity, we found 19 patients in whom endoscopic dilations of stenoses had been attempted. We also include three patients who had surgery elsewhere but who underwent dilations at our institution. Fourteen had stenoses complicating gastric bypass with Roux-en-Y anastomoses, and eight had stenoses complicating a gastroplasty (gastrogastrostomy). Two different types of dilation were attempted during the interval reviewed--Fogarty balloon dilations and Gruntzig balloon dilations. None of the eight patients with gastroplasties benefited from the attempted dilation, but 10 of the 14 patients with stenoses complicating gastric bypasses have done well. We found no significant difference between Fogarty and Gruntzig balloon dilations. We conclude that balloon dilation is an effective means of treating stenosis that complicates gastric bypass performed with Roux-en-Y anastomoses in cases of morbid obesity. PMID- 3629473 TI - Limb-sparing surgery for soft tissue sarcomas: wound related morbidity in patients undergoing wide local excision. AB - When feasible, limb-sparing surgery has become an accepted form of treatment for sarcoma of the extremities. In a review of 100 consecutive cases of local excisions in patients with soft tissue sarcomas, which were performed at the National Cancer Institute, we identified factors associated with the development of wound-related morbidity. The incidence of these wound complications, which include infection, seromas, and skin loss, was 34.4%. Serious complications that necessitated rehospitalization or reoperation occurred in fewer than 10% of the patients. Preoperative factors associated with wound morbidity were patient age greater than 40 years (P2 less than 0.029) and tumor in the lower extremity (P2 less than 0.014). Treatment-related factors associated with morbidity were increased blood loss (p less than 0.01) and an increased volume (p less than 0.006) and duration (p less than 0.002) of wound drainage. The complications significantly delayed the start of adjuvant radiation therapy and lengthened the hospital stay. Measures to prevent these complications are discussed. PMID- 3629474 TI - Resting energy expenditure and body cell mass alterations in noncachectic patients with sarcomas. AB - Resting energy expenditure (REE), body cell mass (BCM), and body fat (BF) were measured in six male and seven female volunteers and in a homogeneous group of noncachectic patients with sarcoma, (n = 7). The patients all had large localized tumors, no history or clinical evidence of decreased food intake or weight loss, and had received no prior treatment for cancer. Indirect calorimetry (for REE), K40 analysis (for BCM), and anthropometric measurements (for BF) were performed in accordance with established methods. Physical activity and nutritional status were also assessed. As expected, female control subjects had 50% greater percent BF (p less than 0.001) and 13% less percent BCM (p less than 0.01) than male controls. Male patients with sarcoma had equivalent percent BF, but significantly less percent BCM than controls matched for age, sex, and body surface area (BSA) (p less than 0.05). The REE corrected for BSA was similar in male and female controls but was 25% greater in male sarcoma patients than in male controls (p less than 0.05). This difference was doubled when REE was corrected for BCM (p less than 0.01). In patients with sarcomas, REE/BSA varied inversely with percent BCM (r = -0.782; p less than 0.05) while a similar relationship was not observed in healthy volunteers. We conclude that both REE and vital, functional BCM can be significantly altered in sarcoma patients before any overt signs of cachexia develop. The results support the contention that sarcoma alters host energy metabolism and causes abnormal body composition. PMID- 3629475 TI - A prospective evaluation of computerized estimates of risk in the management of obstructive jaundice. AB - This article reports on a prospective study of 46 patients who had undergone treatment for obstructive jaundice. Previously described computer estimates of risk were calculated, as were the K value and the mortality index. The computer was no more accurate than an experienced clinician in the prediction of morbidity. In the prediction of mortality, however, the computer was far more accurate than the clinician. Clinical prediction of mortality was associated with a risk ratio of 3.2, a critically elevated K value with a risk ratio of 21.7, and an elevated mortality index with a risk ratio of at least 70. In conclusion, both measures have some use in providing objective measures of stratification among patients with jaundice. The mortality index is also useful in the determination of a program for clinical management and, in particular, the timing of any surgical intervention. PMID- 3629476 TI - Acceleration of B16 melanoma growth in mice after blood transfusion. AB - Evidence suggests that blood transfusions depress immunologic reactivity; as some tumors are influenced by the immune status of their host, it is possible that transfusions could promote tumor growth by impairing host immunity. The influence of blood transfusion on the growth of a transplantable B16 melanoma was examined in nude (athymic) CBA mice and immunocompetent C57 BL/6J mice. Recipients were given infusions of saline solution or syngeneic or H-2-incompatible allogeneic blood transfusions on two occasions 3 days apart. Infusions were begun 10 days before inoculation of a single cell suspension of B16 melanoma. Growth was determined by measurements of primary tumor volume and tumor weight after excision. There was no statistically significant difference in tumor size or weight between the three recipient groups of athymic mice. However, immunocompetent mice given H-2-incompatible allogeneic blood had higher rates of tumor engraftment--saline solution recipients versus allogeneic recipients: chi 2 = 13.2, df = 1, p less than 0.001; syngeneic recipients versus allogeneic recipients: chi 2 = 2.97, df = 1, p greater than 0.05. In the allogeneic group significantly larger and heavier tumors developed than in mice given syngeneic blood or saline solution. The study indicates that H-2-incompatible allogeneic blood transfusions can influence the growth of a transplantable murine tumor by a mechanism that involves a cell-mediated immune response. PMID- 3629477 TI - Postoperative mechanical ventilation preventing the occurrence of pleural effusion after hepatectomy. AB - To determine factors leading to pleural effusion after hepatectomy, the frequency of pleural effusion was investigated in 68 patients who underwent hepatic resection, with or without dissection of the right coronary ligament. In 36 of 44 patients (81.8%) who underwent hepatic resection with complete dissection of the right coronary ligament, and in two of 24 (8.3%) who underwent the procedure without dissection of this ligament, pleural effusion developed in the right hemithorax (p less than 0.001). Difference in pressure between the abdominal and thoracic cavities was considered to lead to ascites in the chest via the diaphragmatic triangular area (where there is no parietal peritoneum). While investigating the preventive effect of mechanical ventilation following hepatic resection on the occurrence of pleural effusion in 12 patients, we concluded that effusion could be prevented with use of mechanical ventilation--an approach that retained the intrathoracic pressure in a positive state. PMID- 3629478 TI - Prosthetic replacement of the superior vena cava treated with antiplatelet agents. AB - The effects of cepharanthin and dipyridamole depot capsules (RAD) on the fate of Teflon fluorocarbon resin grafts used for replacement of the canine superior vena cava were studied. After short-term observation of 11 implanted grafts, 57 adult mongrel dogs underwent superior vena caval replacement with these Teflon grafts. Cepharanthin (2 mg/kg daily) and RAD (10 mg/kg daily) were administered after surgery to 28 and 14 animals, respectively. Dogs were killed at 12 days to 6 months after graft implantation. Fifteen dogs served as controls. In the cepharanthin-treated group, three grafts exhibited luminal obstruction with severe intimal hyperplasia, but smooth, semitransparent thin neointima was recognized in 25. The endothelial cell lining of the neointima exhibited excellent spread 2 months after implantation. Although one graft was obstructed with hyperproliferative fibrosis in the RAD-treated group, a well-developed neointima with complete coverage of endothelial cells was confirmed in 14 dogs. With regard to the rate of occurrence of luminal obstruction, these data were significantly different from those of the control group, which suggests that intimal hyperplasia can be reduced by treatment with antiplatelet agents. PMID- 3629479 TI - Pathophysiology and natural history of acquired short esophagus. AB - The choice of therapy--whether medical or surgical--for patients with gastroesophageal reflux (GER) is often a subject of debate. After a period in which surgery was almost the exclusive mode of treatment in patients with severe complications resulting from GER or in patients who did not respond to medical therapy, long-term follow-up showed that in 20 cases of GER in which only medical treatment was given, a progressive shortening of the esophagus--frequently in the absence of esophagitis--had developed. To investigate the pathophysiology of acquired short esophagus, we studied 34 patients--20 from the initial group and 14 who already had this condition. Clinical assessment consisted of interview, radiologic examination of the upper digestive tract, endoscopic and histologic examinations, and 24-hour home esophagogastric pH monitoring. We noted that acid GER causes shortening in the presence of severe mucosal lesions, while "nonacid" GER--a combination of gastric, pancreatic, and hepatic secretions--causes shortening of the esophagus even without evident mucosal lesions. Symptom evaluation, acid GER pH recording, and endoscopy are not sufficient for determination of the current choice of therapy. It is also important to quantify GER that results from the mixing of gastric and biliopancreatic secretions with use of the esophagogastric pH recording. This should reduce the possibility of silent shortening of the esophagus. PMID- 3629480 TI - Permeability of red-cell membrane to adenosine triphosphate (ATP) molecules during hemorrhagic shock. AB - The findings of decreased adenosine triphosphate (ATP) levels in liver, kidney, and other tissues of animals in hemorrhagic shock were the rationale for previous experimental attempts to improve cell function by administration of fluids that contained high concentrations of ATP. The beneficial effects of this resuscitation, which are still controversial, were attributed to cellular uptake of ATP--it was assumed that cell membranes are permeable to this substrate. The effect of a high concentration of ATP in extracellular medium on intracellular ATP content was studied by using red blood cells (RBCs) from rabbits in control (normal) and in hemorrhagic shock states. The glucose-depleted RBCs were incubated in medium with 5 mMol/L ATP, and their ATP concentration fell markedly to the same level as seen in glucose-depleted RBCs incubated without ATP. The decrease of ATP in glucose-repleted RBCs, incubated with or without ATP, also did not show any significant difference. Similar to parallel experiments that used normal RBCs, the high extracellular ATP content did not substantially affect the intracellular ATP concentration in RBCs from animals in shock. This study indicates that ATP molecules in extracellular medium cannot penetrate either the normal RBC membrane or the RBC membrane during shock. PMID- 3629481 TI - Thrombofibrinous sheath occlusion of peritoneovenous shunts. AB - Thrombofibrinous sheath occlusion of peritoneovenous shunts is described in two case presentations. In reviewing the literature, we found only 17 other such cases mentioned. Most patients were seen initially with recurrence of ascites and only one with superior vena cava syndrome. A shuntogram documented a characteristic sheath in 17 patients, and relocation was the preferred treatment. Relocation was successful in eight of 11 attempts, but long-term follow-up data were not available. Histologic examination of the sheath in our first case study revealed recent and organized thrombus. This would help explain why only one of three patients was successfully treated with fibrinolytic agents. PMID- 3629482 TI - Cardiac tamponade as a result of endoscopic sclerotherapy: report of a case. AB - Sclerotherapy was used in the treatment of a patient with actively bleeding esophageal varices. Chest pain and a pericardial friction rub became evident on the day after sclerotherapy and resolved without therapy. Six months later the patient manifested cardiac tamponade which required pericardiectomy. The events of this case suggest that chronic pericarditis with cardiac tamponade was a direct complication of sclerotherapy. This report extends the range of reported complications and emphasizes the importance of follow-up of patients in whom transient pericardial friction rub develops after sclerotherapy. PMID- 3629483 TI - Peritoneal fluid in human acute pancreatitis. PMID- 3629484 TI - [Amino acid composition of the blood in patients with diffuse toxic goiter during conservative therapy]. AB - Patients with diffuse toxic goiter were examined for the blood amino acid content and its time-course of changes under the influence of different conservative treatment. Marked abnormalities of the blood amino acid content persisted after isolated thyrostatic therapy. It is evident that in the genesis of dysaminoacidemia of importance is marked deficiency in the body of macroergic compounds, vitamins, trace elements, which is not abolished in the course of substitution therapy. Additional administration of vitamins E, B6, nicotinic acid, panangin, magnesium sulfate and ATP to patients with thyrotoxicosis improves the blood amino acid content and the clinical course of the disease. PMID- 3629485 TI - [Acid phosphatase of leukocytes in patients with diffuse toxic goiter in evaluating the stage of the disease]. AB - Acid phosphatase (AP) of lymphocytes and neutrophils was examined cytochemically in 23 patients with associated diffuse toxic goiter (DTG) and thyrotoxicosis during thiamazol treatment, in 20 persons with a DTG remission, and in 5 patients with postradiation and postoperative hypothyroses. AP activity with multiple granule distribution of the enzyme was high in the majority of the patients with thyrotoxicosis, decreasing with thiamazol treatment. Thyrotoxicosis recurred in 4 out of 11 patients whose lymphocytes had an increased amount of AP during a DTG remission. In 9 patients with normal AP content, no relapses were noted during a DTG remission. Two patients with iatrogenic hypothyroses associated with high lymphocytic AP activity manifested elevated titres of antithyroglobulin immunoglobulins (ATI). In 3 patients with normal content of cellular AP, the ATI titre was low. Cellular AP, a non-specific marker of immunogenesis activity, makes it possible to presumably differentiate the stages of DTG and to evaluate to a definite degree the character of a remission. The preserved high activity of lymphocytic AP in patients with a DTG remission is a prognostically unfavourable factor as regards thyrotoxicosis relapses. The high titre of ATI and activity of lymphocytic AP attest to the predominant autoimmune component of such hypothyroses in part of DTG patients. The authors stress that such patients should receive combined thyroid and glucocorticoid therapy. PMID- 3629486 TI - [Echocardiographic evaluation of hemodynamics in patients with interatrial septal defect during pregnancy]. AB - A total of 48 patients with interatrial septal defect were examined over time during pregnancy and after delivery. Echocardiographic criteria in the assessment of the volume of the arterial-venous blood ejection in this congenital heart defect were used. Correlation between a clinical course of pregnancy and postdelivery period and the basal level of hemodynamic disturbance was obtained. A critical level of shunt with the initial signs of disturbances of myocardial compensatory processes was revealed. PMID- 3629487 TI - [Bicomponent analysis of the contractile capacity of the heart in ischemic lesions of the myocardium (experimento-clinical study)]. AB - A study was made of cardiac pumping capacity in animals with local myocardial ischemia (9 experiments on cats), in 25 healthy persons and 21 patients suffering from coronary heart disease with stage I-IIA circulatory insufficiency using afterload characteristics (ALC). The latter reflected correlation between left ventricular pressure and aortic blood flow in constant blood filling and in a given inotropic heart condition. For combined assessment of ALC one should know its two parameters: power (maximum pressure in the zero blood flow) and rate (maximum blood flow rate in zero antipressure). It was shown that early stages of cardiac insufficiency were characterized both under experimental and clinical conditions by change in the inclination angle of an afterload curve and a shift of a working point on it to the right. PMID- 3629489 TI - [Pathogenesis of Vaughan's erythromyelosis]. PMID- 3629488 TI - [Are any drug admixtures except iron preparations required in the treatment of iron deficiency anemia?]. AB - The aim was to estimate the efficacy of multimodality therapy of iron deficiency anemia with vitamins combined with iron salts and to compare the results of this therapy with that including iron salts only. Besides the results of therapy using iron preparations administered per os and in injections were compared. Altogether 250 women were entered in this study. Chronic posthemorrhagic iron deficiency anemia was diagnosed in 175 patients, in 75 iron deficiency anemia developed against a background of pregnancy 250 women were divided into 10 groups. The last 3 groups included pregnant women. The selection in the first 7 and last 3 groups was randomized. The rate of increment of hemoglobin, erythrocytes and serum iron did not differ in the groups of patients receiving in addition to iron vitamins B12 and B6, copper sulfate, the combination of iron with the vitamin B group and copper sulfate. In the group receiving iron for injection the rate of increment of hemoglobin did not almost differ from that in the study groups, however it was slightly higher. Similar results were obtained for the pregnant women. Subsequent therapy after hemoglobin normalization was shown to make therapeutic results more stable. A conclusion was made of inappropriateness of the use of iron combined with other preparations in view of numerous cases of side-effects and danger of the development of siderosis of internal organs as a result of erroneous drug administration. The use of iron preparations for injections was recommended only in disturbed intestinal absorption of iron. PMID- 3629490 TI - [Plasma heparin precipitate as a source of fibronectin in the treatment of patients with trophic skin lesions]. AB - A study with the help of the hard phase enzyme immunoassay has shown that during incubation in the cold of fresh and fresh-frozen donor plasma in the presence of 10 I. U./ml-30 I.U./ml of heparin over 80% of fibronectin with relation to its basal level in the same plasma sample passes to the residue (heparin precipitate). The effectiveness of local use of the preparation of plasmic heparin precipitate (fibronectin concentration of 1 to 1.5 mg/ml) for therapy of patients with heavy trophic skin lesions was substantiated. PMID- 3629492 TI - [Pathogenesis, clinical aspects and treatment of porphyria]. PMID- 3629491 TI - [A case of macrofocal disseminated pulmonary granulomatosis]. PMID- 3629493 TI - [Myeloma-related nephropathy (incidence, clinical aspects and morphology). Analysis of 95 cases of multiple myeloma]. AB - The authors provided the results of observations of 95 patients with multiple myeloma (MM). Signs of renal involvement in that period were detected in 79% of the patients. The authors analyzed the frequency of various symptoms of myelogenic nephropathy (MN) and its evolution. The comparison of clinicolaboratory findings and the nature of morphological changes of the renal tissue in the MN patients made it possible to define 3 stages in MN development. When the predominance of renal symptomatology made the diagnosis of MM difficult, puncture nephrobiopsy was recommended. It can be performed in the absence of marked hyperproteinemia and hemostatic disorders. PMID- 3629494 TI - [Remote sequelae of the effects of small doses of ionizing radiation on humans]. PMID- 3629495 TI - [Substantiation of the tactics of dynamic observation of patients with lymphosarcoma]. AB - A study of the features of a course of lymphosarcoma made it possible to establish effective time-periods of dynamic examination of patients for timely detection of such manifestations of disease as G. I. tract involvement. The regularity of examination and diagnostic methods depended on a primary focus site and the nature of G. I. tract involvement. PMID- 3629496 TI - [Prognostic factors in lymphosarcoma]. AB - A comparative analysis of the long-term results of treatment of 709 lymphosarcoma patients has shown that the main prognostic factor determining the patients's survival was a morphological tumor type. Therapeutic policy with regard to prognostic factors was proposed for lymphosarcomas. Lymphosarcomas of a high degree of malignancy required intensive therapy using cycle polychemotherapy, whereas monochemotherapy was recommended for patients with lymphosarcomas of a low degree of malignancy. Treatment of stage I-II mediastinal lymphosarcomas should be very intensive and prolonged. PMID- 3629497 TI - [The complement system and circulating immune complexes in the pathogenesis of lymphocytic leukemia]. PMID- 3629498 TI - [Erythron in patients with polycythemia vera during treatment by erythrocytapheresis and bloodletting]. AB - An analysis of the results of determination of erythropoietin in the blood plasma of patients with polycythemia vera and data on the kinetics of erythroid cell proliferation led to a conclusion that erythrocytapheresis more than bloodletting stimulated the production of erythropoietin and the cell proliferative potential. Activation of regenerative processes probably determined by deinhibition of the normal clone of bone marrow erythroid cells, can account for the mechanism of a therapeutic effect of erythrocytapheresis in patients with polycythemia vera. PMID- 3629499 TI - [Compensatory changes in the microcirculatory system and their clinical significance in patients with iron deficiency anemia]. AB - The interrelationship of the microcirculatory state with compensatory changes in central hemodynamics and exercise testing was studied in 212 patients with iron deficiency anemia using conjunctival biomicroscopy, mechanocardiography and bicycle ergometry. Alongside with general pathological disorders of terminal nature the patients with iron deficiency anemia developed compensatory changes (a decrease in the linear density of venules and an increase in their diameter) aimed at ensuring of appropriate high circulation volume and physical working capacity. Registration of compensatory deviations in the microcirculation of the anemic patients enables a physician to estimate in detail not only their general status but also the problems of medical labor examination in a more reasonable fashion. PMID- 3629500 TI - [Activation of fibrinolysis in acute leukemia]. AB - A possibility of life-time fibrinolysis activation with blast cells was studied in 54 patients with different variants of acute leukemia. The study showed that practically in all the variants of acute leukemia the content of fibrinolysis activators in the patients' blood was elevated. Active proteolytic enzymes of non plasma nature were present in myeloid variants. It was shown that only blast cells of the variants with myeloid tumor substrate were capable of direct fibrinolysis activation. PMID- 3629501 TI - [Hemorrhagic telangiectasia as a manifestation of connective tissue dysplasia]. PMID- 3629502 TI - [Cascade use of plasmapheresis and plasma filtration in the treatment of rheumatoid arthritis]. AB - The effect of incorporation of cascade plasmapheresis and plasma filtration in multimodality therapy was studied in 4 patients with rheumatoid arthritis (RA). The result was estimated as "excellent" (complete disappearance of clinical symptoms of the articular syndrome and normalization of the activity laboratory indices) in one patient; "good" (the reduction of clinicolaboratory activity) in 2 patients and "satisfactory" (the reduction of symptoms of the articular syndrome without changes of a degree of general activity of disease) in one patient. Cascade plasmapheresis and plasma filtration significantly improved clinical and many laboratory indices of RA activity and humoral immunity indices during treatment. A long period of observation is required to assess long-term results of the effect of this method. A great advantage of the method is a possibility of decreasing substitution protein solutions without negative effects with relation to the blood total protein level. The absence of a necessity of catheterization of central vessels, more complete blood separation into plasma and erythrocytes make cascade plasmapheresis and plasma filtration more preferable. Good tolerance of the procedure, fast improvement, a chance to avoid side-effects of drug therapy, a lower risk of allergic reactions to plasma substitutes as compared to those in plasmapheresis and lymphocytoplasmapheresis make the method promising for RA treatment. PMID- 3629503 TI - [Intensive plasmapheresis--possible difficulties and complications]. AB - The paper is concerned with an analysis of difficulties and complications resulting from various modes of conducting intensive plasmapheresis using mainly refrigerator centrifuges and plasticized resin containers in 462 patients (a total of 2435 procedures). Emphasis was placed on a necessity of a thorough choice of a vascular access with relation to a patient's condition, a more of plasmapheresis, and an assumed volume of plasma removal. Causes of hemodynamic and temperature reactions, "citrate intoxication" were analyzed; their prevention and therapy were described. Plasmapheresis was accompanied by insignificant variations in the level of leukocytes, platelets, normal immunoglobulins and fibrinogen. Complications during plasmapheresis were often related with the stage of plasmosubstitution. PMID- 3629504 TI - [Clinical effects of combined radiation injuries]. AB - The author interprets the formation of exposure factors in a nuclear reactor accident, causes of the formation of a separated mixture of nuclear fission fragments and their principal radionuclide composition. The ratio of doses of whole-body gamma-irradiation resulting in the development of the acute radiation syndrome, beta-irradiation of the skin causing radiation dermatitis, and additional irradiation of thyroid tissue resulting from inhalation radioiodine contamination was analyzed. The author described the main peculiarities of acute radiation disease caused by combined radiation exposure to radiation gases and sols, the time course of radiation dermatitis, the aggravating effect of multicomponent injury. PMID- 3629505 TI - [Treatment of gastroduodenal ulcer by plasmapheresis and transfusion of thawed out autologous plasma]. AB - Curative plasmapheresis was performed in 21 patients with duodenal ulcer (DU) and in 3 patients with gastric ulcer (12 DU patients and 3 patients with gastric ulcer were taken as controls). The controls were treated by common pharmaceuticals (except Tagamet). Altogether 117 sessions of plasmapheresis were performed (an average of 5 sessions for each patient 2-3 times a week). Fibrogastroscopy was performed before and after a series of plasmapheresis (2-3 weeks after the start of therapy). In the DU patients treated by plasmapheresis ulcer cicatrization occurred in 18 days, in the controls in 27 days (p less than 0.001). In 3 patients with gastric ulcer treated by plasmapheresis cicatrization occurred on the 24th day, in the controls on the 41st day (p greater than 0.2). This method was proposed for patients with severe conditions due to the fact that a positive effect was also obtained in persons with persistently recurrent ulcers. PMID- 3629506 TI - [Criteria for adequate plasma substitution in intensive plasmapheresis]. AB - The authors analyzed 2 plasmosubstituting solutions of entirely different quantitative composition used during intensive plasmapheresis (47 procedures in 24 patients). Indices of central hemodynamics and blood oxygen-transport function served as criteria of the adequacy of plasmosubstitution. Plasmosubstitution in the volume of 110-130% to the volume of plasma exfusion was shown to preserve a stable volume of the circulating blood. Plasmosubstituting solutions should be composed of not less that 70% of protein and colloidal agents. Their lesser content (not more than 40%) revealed the development of noticeable disorder of blood oxygen-transportation function and decompensation of the blood circulation. In adequate plasmosubstitution change of the eukinetic type of blood circulation by the hyperkinetic one is a compensatory reaction of blood circulation. PMID- 3629507 TI - [Dynamics of changes in the levels of myoglobin and anti-myoglobin autoantibodies in the blood serum of patients with myocardial infarction]. AB - The mean level of myoglobin and autoantibodies to myoglobin in the blood of healthy donors was 77.57 +/- 8.17 ng/ml and 18.01 +/- 1.85 micrograms/ml respectively. The level of myoglobin in the blood of patients with primary transmural myocardial infarction was rapidly increased, reaching its maximum in 9 12 h and returning to normal in 9 days. The mean level of autoantibodies was decreased in the first 66 h and got back to normal by the 6th day of disease. In primary large focal nontransmural myocardial infarction the concentration of myoglobin in the blood of patients was also increased, reaching its maximum in 3 9 h and returning to normal by the end of the 2nd day after onset of an angina attack. A decrease in the level of autoantibodies to myoglobin was observed up to the 18th day of disease. The peculiarity of repeated large focal nontransmural myocardial infarction was a two-peak curve of changes in a MG level with maximum levels in 9-12 and 21-24 h after onset of a pain attack. Final normalization of the level of myoglobin in the blood of patients of this group occurred in 69 h. The concentration of autoantibodies to myoglobin was more than once decreased up to the 6th day of disease. The results obtained showed that groups of examinees differed in the time course of changes in the level of myoglobin and autoantibodies to myoglobin. Such differences can be used for diagnostic purposes. PMID- 3629508 TI - Fetal hydantoin syndrome in rats: dose-effect relationships of prenatal phenytoin on postnatal development and behavior. AB - Sprague-Dawley rats were gavaged once daily on days 7-18 of gestation with, 100, 150, or 200 mg/kg of phenytoin. Only the highest dose of phenytoin decreased maternal weight during gestation or increased offspring mortality up to weaning. Offspring were evaluated for activity prior to weaning (pivoting and photocell) and afterwards (figure 8, open-field, and hole-board), dynamic righting development, maze learning (Biel maze), and visual discrimination (Y maze), and for startle reaction to both auditory and tactile stimuli. The highest dose of phenytoin produced increased activity on all tests of activity, delayed dynamic righting development, impaired Biel maze and Y-maze learning, and inhibited tactile startle responses. The two lower doses of phenytoin generally showed a dose-effect relationship with values on most measures intermediate between values for controls and for the highest-dose group. Dose-effect relationships were most evident on measures of early activity (both tests), dynamic righting, and Biel maze learning, whereas only trends were evident on measures of later activity, Y maze, and startle. A dose-related rotational defect was found in a minority of phenytoin offspring, and although these individuals contributed to the behavioral abnormalities observed, they in no instance accounted for the overall pattern of effects seen in the phenytoin offspring. Maternal plasma phenytoin levels at the end of treatment were dose-related. Offspring showed no effects on postnatal growth, total brain weight, or brain protein content as adults. The data support the view that phenytoin is a potent behavioral teratogen at doses well below those causing any evidence of gross teratogenicity or embryotoxicity. PMID- 3629509 TI - Congenital malformations detected in 731 autopsies of children aged 0 to 14 years. AB - A retrospective study of 731 autopsies of children aged 0 to 14 years, performed in the Pathological Anatomy Service of the University Hospital of Porto Alegre from 1977 to 1982, was carried out to determine the frequency, type, and seriousness of congenital malformations. The subjects were divided into five age ranges: stillborn (6), 0 to 24 hours (42), 1 to 30 days (50), 1 to 12 months (24), and 1 to 14 years (9). The malformations were classified as single or multiple (presence of two or more independent defects), and their contribution to death was evaluated. Congenital malformations were detected in 131 autopsies (18%). In most cases the defects were single (91), and the most common ones involved the cardiovascular system (37) and the genitourinary system (21). In the patients with multiple malformations (40), the cardiovascular system (24) and the genitourinary system (19) were also most frequently involved. Defects of the osteoarticular system were also frequently encountered in patients with multiple defects (25), although most of them were deformations caused by mechanical factors. Proportionally, congenital malformations were most frequently detected in the 0 to 24 hours range, which also included the highest proportion of multiple defects in relation to single ones (1:1). Congenital malformations were considered responsible for death in 76% of the 131 cases (87% of the multiple defects patients and 60% of the single defect patients). We believe that the data collected in the present study may contribute to a better understanding of the role played by congenital malformations in child mortality. PMID- 3629510 TI - High prevalence of defective human embryos at the early postimplantation period. AB - Thirty-seven cases of human embryos at the early postimplantation period were procured after induced abortion and examined histologically. Their developmental stages ranged from Carnegie stages 6 to 11, and their standard ages ranged from 14 to 24 days after fertilization. Five cases (13.5%) were grossly abnormal, and seven (18.9%) were degenerating partially or in toto. Gross abnormalities included distorted embryonic disc, disorganized neural groove or tube, and neural tube dysraphism. The high prevalence rate of defective embryos at the early postimplantation period supports the clinical finding that a substantial proportion of human conceptions are eliminated from an early stage of pregnancy, often without the knowledge of the mother. The fate of undifferentiated pathological embryos is uncertain and remains to be determined. PMID- 3629511 TI - Maternal smoking: greater effect on males, fetal tobacco syndrome? AB - We tested the recently proposed criteria for a Fetal Tobacco Syndrome (FTS) on a sample of 925 primiparous black women (including 204 smokers) and their neonates. The proposed FTS criteria included proportional growth retardation (ponderal index greater than 2.26, birth weight less than 2,500 g) in term neonates. Only 19 neonates (2%) in our study fulfilled the FTS morphometric criteria, and of these only 8 had smoking mothers. Nonetheless, the negative effect of maternal smoking on fetal growth (birth weight and length) as reported from earlier investigations was clearly evident in our own data (P less than .01). Separate analysis by fetal sex revealed that the negative effect of maternal smoking upon fetal growth is more pronounced among males than females. We concluded that fetal sex should be taken into account in studies of maternal smoking effects. As for evidence for the existence of the FTS, it remains to be proven. PMID- 3629512 TI - Relative potency of four ethylene glycol ethers for induction of paw malformations in the CD-1 mouse. AB - Time-mated CD-1 mice were orally dosed on gestation day 11 (plug = 0) with distilled water (control) or one of four glycol ethers at a dose of 4 mmol/kg: ethylene glycol monomethyl ether (EGME, 304 mg/kg), ethylene glycol dimethyl ether (EGdiME, 361 mg/kg), diethylene glycol dimethyl ether (diEGdiME, 537 mg/kg), triethylene glycol dimethyl ether (triEGdiME, 713 mg/kg). Fetuses were collected on gestation day 18, weighed, and examined for gross external malformations. Fetuses were cleared and stained to examine paws. There were no signs of treatment-related maternal toxicity, and intrauterine survival was unaffected by glycol ether treatments. Fetal body weights were significantly reduced only in litters treated with EGdiME. There was no treatment-related pattern of gross external malformations other than paw defects. Only triEGdiME failed to produce a significant incidence of malformations. Paw defects were present in 87.5% of EGME-treated litters (68.5% of fetuses), 86.7% of EGdiME treated litters (33.8% of fetuses), and 77.8% of diEGdiME-treated litters (39.7% of fetuses). Hindpaw defects predominated over forepaw, and syndactyly was the most common malformation. The incidences of oligodactyly and short digits were also significantly increased. The similarity of malformations produced by these methyl-substituted glycol ethers is proposed to be attributable to in vivo conversion to a common teratogen, methoxyacetic acid. PMID- 3629513 TI - TCDD-induced hyperplasia of the ureteral epithelium produces hydronephrosis in murine fetuses. AB - TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) has been recognized as a kidney and palate teratogen for many years. The etiology of the kidney abnormality has not been revealed, and there is some confusion about the exact nature of the defect. This study examines C57BL/6N fetal mouse kidneys from day 14 of gestation through day 17. Pregnant females received a single dose of 0 or 12 micrograms TCDD/kg by gavage on day 10 pregnancy. Fetal urinary systems were examined on days 14, 15, 16 (a.m.), 16 (p.m.), and 17 (p.m.). The patency of the ureteric lumen was examined by injection of dye into the bladder. TCDD treatment did not delay or prevent breakdown of the ureteric membrane between days 15 and 16. On days 16 through 17, the ureteric lumina of TCDD-exposed fetuses were narrow and tortuous when compared to the control lumens. Sections of ureter were observed by light microscopy. On day 15 the lumina of TCDD-exposed ureters were occluded by epithelial cells. As a result of hyperplasia of the ureteric luminal epithelium, hydroureter and hydronephrosis became pronounced by day 17. We conclude that the kidney abnormality induced by TCDD is true hydronephrosis, which is defined as the accumulation of urine in the kidney due to obstructed outflow. PMID- 3629514 TI - TCDD alters the extracellular matrix and basal lamina of the fetal mouse kidney. AB - The teratogenic effects of the dioxin 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) have previously been studied in several species, and hydronephrosis has been reported to be a frequent abnormality in near-term fetuses. C57BL/6N female mice, given 12 micrograms/kg TCDD, P.O., on day 10 of gestation were killed on days 14, 15, and 16; fetal kidneys were collected and prepared for either immunofluorescent localization of several extracellular matrix components (ECM) or transmission electron microscopy (TEM). The TCDD-treated and control kidneys showed the same pattern of staining for fibronectin, but TCDD-treated kidneys displayed a diminished overall intensity. The intensity of laminin and type IV collagen immunofluorescence also appeared to be decreased, and deviations in the pattern of antibody binding were detected for differentiating TCDD-treated nephrons. Binding of the laminin antibody to the basal lamina was decreased in the parietal layer of Bowman's capsules in more advanced stages of differentiation. TEM analysis focused on the basal lamina of the tubules and Bowman's capsule. In TCDD-exposed kidneys, ECM components adjacent to differentiating nephrons were less abundant, and the basal lamina of the developing Bowman's capsules had a diminished lamina densa. The earliest nephrons to develop display these defects and comprise the first functional filtration units of the metanephric kidney. These ultrastructural changes noted in TCDD exposed nephrons may promote proteinuria, a condition normally observed in the developing kidney when the filtration barrier is immature. PMID- 3629516 TI - Developmental anomalies induced by all-trans-retinoic acid in fetal mice: II. Induction of abnormal neuroepithelium. AB - All-trans-retinoic acid (RA) in olive oil was given in doses of 0, 40, or 60 mg/kg of body weight to pregnant mice on day 8 of gestation, and 2-6 hr later embryos were fixed in solutions with or without cetylpyridinium chloride (CPC). The neuroepithelium of the presumptive midbrain was processed for light and electron microscopy. Distorted contours of the neuroepithelium were induced by both doses of RA and the incidence and the severity of the disorganized neuroepithelium showed dose-related results. Abnormal neuroepithelium showed wide intercellular spaces with degenerated cytoplasmic processes or cell debris, separation of the apical side from adjacent cells, retention of mitotic and/or postmitotic cells on the apical side, presence of mitotic cells on the basal side, and detachment of degenerated structures from the neuroepithelium. Ultrastructurally, the affected neuroepithelium showed (1) appearance of degenerating filamentous or tubular coagulating bundles in the cytoplasm and the cytoplasmic process of the neural crest cells, (2) dispersal of polysomes into monosomes especially in the degenerating neural crest cells, (3) and a collecting of microfilament-like structures at the contact area between the neural crest cell and the presumptive neuroblast. These morphological changes suggest that RA affects the nature of cytoskeletal elements and the protein synthesis of the neuroepithelial cells. The selective susceptibility of neural crest cells to RA causes more degenerating neural crest cells in the neuroepithelium, which causes nonapproximation of the neural folds and scantiness of the migrating neural crest cells; these results lead to neural tube defects and craniofacial anomalies, respectively. PMID- 3629515 TI - Pregnancy outcomes after weekly oral administration of ethanol during gestation in the pig-tailed macaque (Macaca nemestrina). AB - Ethanol was orally administered once per week to gravid pig-tailed macaques (Macaca nemestrina) in doses of 0.3, 0.6, 1.2, 1.8, 2.5, 3.3, or 4.1 g/kg. A control group received a sucrose solution, isocaloric and isovolemic to the highest ethanol dose. Pregnancy was followed after 116 possible conceptions in 54 females. Peak plasma ethanol concentrations (PPECs) ranged from 24 +/- 6 mg/dl at the 0.3 g/kg dose to 549 +/- 71 mg/dl at the 4.1 g/kg dose. An increased rate of spontaneous abortion was related to ethanol exposure at and above 1.8 g/kg (mean PPEC = 205 mg/dl). Pregnancy failure in the first 30 days of gestation increased at doses above 2.5 g/kg. The effect on pregnancy outcome of weekly exposure to ethanol in this nonhuman primate is comparable to available data on humans. The methodology of this study represents an effective model for studying ethanol teratogenesis in a nonhuman primate. PMID- 3629517 TI - Cardiac and noncardiac malformations: observations in a population-based study. AB - A regional case-control study of congenital cardiovascular malformations (CCVMs) searches for all live-born infants in the community in whom the cardiac diagnosis has been confirmed by echocardiography, cardiac catheterization, surgery, or autopsy. Their families are studied in comparison to those of a representative sample of resident live-born infants. Detailed descriptions of noncardiac abnormalities are obtained from physician reports and maternal interviews expanded by medical record and death certificate data. Among 1,494 cases and 1,572 controls, chromosomal abnormalities, syndromes, heritable disorders, and suspect syndromes occurred with an overwhelming excess in cases (chromosomes, P less than 10(-4); syndromes/heritable disorders, P less than .005). Abnormalities affecting chromosomes 13, 18, and 21 constituted 93% of the cytogenetic defects. Syndromes and heritable disorders were of 39 types. Nonsyndromic abnormalities were three times more frequent in cases than in controls (P less than .005). Case excesses occurred for central nervous system malformations, eye disorders, major abdominal wall defects, and abnormalities of the alimentary and urinary tracts. Severe anomalies frequent among cases were those which also occur in certain recognized syndromes, and it is suggested that paired combinations of cardiac and other midline anomalies may represent "formes frustes" of syndromes with similar though variable phenotypic expressions. Cleft lip and palate, inguinal hernia, and lower limb anomalies occurred with equal frequency, suggesting their association with CCVMs by chance alone. PMID- 3629518 TI - A stage-dependent effect of ethanol on 9.5-day rat embryos grown in culture and the role played by the concomitant rise in osmolality. AB - The effects of ethanol on the rat embryo undergoing organogenesis in vitro have been studied. We have shown that embryopathy is dependent on the stage of development at which explanted embryos were treated. The early neural plate (presomite) stage was highly sensitive to a 4-hour exposure of 300 mg/% ethanol, whereas embryos explanted 5 hours later, at the late head-fold (two to six somites) stage grew normally under the same conditions. We have also established that raised serum osmolality, associated with ethanol in serum, is responsible for some but not all of the teratogenic effect. This was shown by mimicking the rise in osmolality with hyperosmotic serum, containing glycerol, NaCl, or concentrated Hanks' salts. Dilution of this osmotic effect by the addition of distilled water in part reversed these embryopathic effects. PMID- 3629519 TI - A new method to express embryotoxic data obtained in vitro on whole murine embryos. AB - This report proposes to express the effect of drugs in the whole embryo culture system by a new method using an intrinsic reference. Percentages of malformed embryos or other defects in development, expressed as percentages of controls, are plotted against concentrations of the drug expressed as percentages of the concentration inducing 50% embryolethality (ELC50). It is suggested that the slope generated by this method is directly related to the intensity of the in vitro teratogenic potential of the agent and allows an estimation of the specific interference with developmental processes. The method has been applied to data obtained from the literature and pertaining to 22 drugs. The slope generated by these drugs varied widely. The effect of these drugs could be meaningfully compared in spite of the wide range of ELC50 displayed by the drugs. In addition, results obtained for two drugs in different laboratories using different methods and species were in fair agreement when they were compared by using the proposed method. Finally, it is suggested that the method provides an improved means to inquire if there is any relevance of in vitro data to teratological results obtained in vivo. PMID- 3629520 TI - Diazepam-induced cleft palate in the mouse and lack of correlation with the H-2 locus. AB - Cleft palate frequencies were studied in AJ and SW mice following either 1- or 2 day dosing schedules with the anxiolytic drug diazepam (DAZ). In all cases, mice were food and water deprived for 24 and 48 hours in the 1- and 2-day dosing schedules, respectively. High cleft palate frequencies in control mice of both strains resulting from 48-hour food and water deprivation (on days 13.5 and 14.5 of gestation) were reduced in mice deprived for 24 hours, indicating a stress related effect. Two-day dosing with DAZ (400 mg/kg) produced a net increase in cleft palate frequency in SW (33%) and AJ (18%) mice. Mice treated only on day 13.5 had reduced control and DAZ cleft palate frequencies, neither of which were significant. Clefting was significant but reduced following 1-day dosing on day 13/20 of gestation (13 days 20 hours) in SW mice (18%), whereas no clefting was seen in the AJ strain. This strain difference was shown not to be related to differences in developmental timing. Production of cleft palate seen in AJ mice after 2 days of dosing may be indicative of an interaction of DAZ with the stresses resulting from food and water deprivation. Genes of the major histocompatibility locus, H-2, have been shown to regulate cleft palate formation following glucocorticoid and phenytoin administration to mice. Despite pharmacological similarities between DAZ and phenytoin, comparison of cleft palate frequencies following administration of DAZ to various strains of mice of different H-2 haplotypes indicated that genes associated with the H-2 locus do not regulate DAZ-induced cleft palate in these strains. PMID- 3629521 TI - The hazards of drinking alcoholic beverages during pregnancy: should the public be warned? PMID- 3629522 TI - New techniques for the elimination of upper tract urinary stones. PMID- 3629523 TI - Unusual presentation of fibrous dysplasia. PMID- 3629525 TI - The groundless malpractice suit: one remedy, summary judgment. PMID- 3629524 TI - The Texas transfer law: an early assessment. PMID- 3629526 TI - Malignant central nervous system tumors in children: the dawn of a new era. PMID- 3629527 TI - Consent for medical treatment. PMID- 3629528 TI - [Nutritional status and surgical risk]. PMID- 3629529 TI - [Assessment of surgical risk in geriatric patients]. PMID- 3629530 TI - [Cardiac surgical risk in noncardiac operations]. PMID- 3629531 TI - [Recommendations of the pneumologist in the assessment of surgical risk]. PMID- 3629532 TI - [Assessment of surgical risk in patients with decreased liver function]. PMID- 3629533 TI - [Surgical risk in endocrine diseases]. PMID- 3629534 TI - [Risk of developing postoperative thromboembolism]. PMID- 3629535 TI - [Surgical risk in pregnancy]. PMID- 3629536 TI - [Surgical risks in the newborn infant and small infant]. PMID- 3629537 TI - [Craniocerebral trauma: principles, immediate risks and management]. PMID- 3629538 TI - [Malignant hyperthermia: clinical aspects, diagnosis and practical procedures]. PMID- 3629539 TI - Abstracts: XIth International Congress on Thrombosis and Haemostasis. Brussels, Belgium, 6-10 July, 1987. PMID- 3629540 TI - Alloxan-induced hyperglycemia in rabbits and the response of platelets to aggregating agents in vitro and to exposed subendothelium in vivo. AB - Many patients with diabetes mellitus show increased platelet aggregation and prostaglandin synthesis in response to physiological agents such as ADP and collagen when their platelets are tested in platelet-rich plasma or washed platelet suspensions. However, the relationship between increased platelet aggregation in vitro and increased thrombosis in vivo is difficult to establish with certainty. We have developed an in vivo model system in rabbits which tests the response of platelets in circulating native blood to an arterial vessel wall with limited damage such as might occur in arteries of patients with diabetes mellitus. We have used this model system to investigate whether 5 to 9 weeks of alloxan-induced hyperglycemia increases platelet adhesion and aggregation on a damaged vessel wall in vivo as well as platelet aggregation in vitro. Our results show that rabbit platelet function is not affected by extreme hyperglycemia and suggest that alloxan-induced diabetes in the rabbit may not be a good model for human diabetes mellitus. PMID- 3629541 TI - Correlation between chemical stimulation and filtration flow resistance in human platelet aggregates. AB - Human platelet-rich plasma (PRP) was aggregated with ADP to produce varying degrees of reversibility and platelet release, and then the chemical stimulation (as evidenced by optical transmittance) was compared with the flow resistance of physiologically-significant microaggregates, determined by constant-pressure filtration. The aggregate flow resistance was attributed to "weak" aggregates (which occluded the micropore filter at 20 mm Hg but which passed through the filter at 80 mm Hg) and "strong" aggregates (which occluded the filter at 80 mm Hg). As the ADP concentration was increased from 1 microM to 10 microM, the flow resistance of both the "weak" and "strong" aggregates generally increased, as did the maximum transmittance. No consistent trend was seen as the time after ADP addition increased from 5 to 30 minutes. Pretreatment of the PRP with epinephrine increased the maximum transmittance during ADP aggregation, produced less reversible aggregates (less subject to deaggregation by PGE1), and increased the aggregate flow resistance over the range of filtration pressures tested. The addition of PGE1 to the aggregated sample before filtration nearly eliminated the flow resistance of the aggregates at all filtration pressures tested and partially reversed the optically-apparent aggregation. Pretreatment of PRP with PGE1 before epinephrine or ADP addition inhibited both the optically-detected aggregation and the development of flow resistance. The physical (hydrodynamic) strength of platelet aggregates is apparently related to the chemical stimulation of the release reaction and to aggregation irreversibility, possibly through the mediation of adenylate cyclase and cyclic AMP. PMID- 3629542 TI - Monitoring of heparin therapy: should heparin assays also reflect the patient's antithrombin concentration? AB - Chromogenic substrate (CS) assay of heparin may be performed with or without addition of antithrombin (AT) to the test plasma. Both types of assay are used for monitoring of heparin therapy, reflecting either heparin activity (heparin act), or heparin concentration (heparin conc) when AT is added. In plasma samples from 43 patients treated with intravenous heparin for DVT, the ratio between heparin act and heparin conc varied from 0.36 in patients with AT plasma concentration below 0.50 U/ml, to 0.85 in patients with AT above 1.00 U/ml (mean ratio 0.61). A formula expressing heparin act as a function of AT and heparin concentration in the test plasmas of the patients was used to calculate heparin act of the total material comprising 280 patients. Mean heparin act and heparin conc were both significantly correlated to clinical outcomes (bleeding complications, pulmonary embolism and phlebography score). For monitoring heparin therapy, guidelines for plasma heparin activity or concentration ("therapeutic ranges") are requested. When using a heparin act assay, the heparin dose needed in patients with low plasma AT concentration to reach a fixed therapeutic range, may imply undue risk of bleeding. On the other hand, when a heparin conc assay indicate plasma heparin conc within therapeutic range, antithrombotic activity may still be inadequate in patients with low plasma AT concentration. PMID- 3629543 TI - Plasma lipolytic activity after subcutaneous administration of heparin and a low molecular weight heparin fragment. AB - The effect of heparin and a low molecular weight heparin fragment (LMWH, mean molecular weight 4000-6000) on plasma anticoagulation and lipolysis was studied in eight healthy men. The activities of antifactor Xa (antiFXa), lipoprotein lipase (LPL), hepatic lipase (HL) and plasma levels of free fatty acids (FFA) were analysed after the injection of 5000 antiFXa units of heparin or LMWH subcutaneously. In comparison with heparin, the administration of LMWH resulted in a significantly higher antiFXa activity (p less than 0.001) but a lower release of LPL and HL (p less than 0.001), which did not increase plasma FFA. It is concluded that subcutaneous injection of LMWH in men elicits an adequate anticoagulant effect measured as antiFXa activity but has a negligible effect on plasma lipolytic activity. PMID- 3629544 TI - Study of the formation of fibrin clot in cirrhotic patients. An approach to study of acquired dysfibrinogenemia. AB - Alterations in the coagulation system are common in patients with liver disease. We have examined the importance of the species and chains of fibrinogen in 3 groups of cirrhotic patients. The study of the gelation of fibrinogen in cirrhotic patients shows that the lag time increases in 80.3% of them and that the maximum gelation rate is altered in 51% of these plasmas. Also it is observed that 80% of the plasmas from cirrhotic patients have a percentage (23.3 +/- 7.7%) of unpolymerized alpha chain, after highly cross-linked fibrin formation. These alterations, in lag time and in the maximum gelation rate, have no significant correlation with the situation of the fibrinolytic system in these patients. The study of isolated fibrinogen from cirrhotic patients and normal subjects plasma, shows that there are no objective alterations in the percentage of fibrinogen species, the amount of sialic acid or the ratio of polypeptide chains. PMID- 3629545 TI - Plasma-dependent and -independent mechanisms of platelet aggregation induced by human tumour cell lines. AB - Tumour cell induced platelet aggregation (TCIPA) may facilitate haematogenous tumour metastasis. In this study of the aggregatory responses of human platelets to human tumour cell lines, we have found two distinct mechanisms of TCIPA. Colon carcinoma lines Colo 205 and Colo 397 produced TCIPA which was dependent upon thrombin generated through the activation of clotting factor VII, consistent with the expression of tissue factor activity by these cells. This mechanism was calcium dependent and was partially mediated by platelet ADP release as it was inhibited by apyrase. A uterine carcinosarcoma line (Colo 526) produced TCIPA by a novel mechanism which was dependent upon calcium, but was independent of thrombin generation and of the presence of plasma proteins, indicating that this aggregatory response is initiated by a direct platelet-tumour cell interaction. PMID- 3629546 TI - Dependence of thromboplastin activity in cell extracts upon salt concentration. PMID- 3629547 TI - Release of plasminogen activator by pentoxifylline and its major metabolite. PMID- 3629548 TI - Aspirin does not inhibit platelet adherence to and detachment from collagen coated glass. PMID- 3629549 TI - Platelet aggregation and endogenous 5-HT secretion in presence of Ca2+, Sr2+ and Ba2+. Effects of calcium antagonists. AB - Washed rat platelets aggregation and endogenous serotonin release were studied after thrombin stimulation in the presence of different concentrations of Ca2+, Sr2+ or Ba2+. The extent of platelet aggregation and release was found to depend upon the external concentration of these cations. For all of them, an optimum concentration could be defined. Higher concentrations were shown to inhibit both aggregation and release. Efficiency to support thrombin-induced aggregation was in the order Ca2+ greater than Sr2+ greater than Ba2+. Complete inhibition of aggregation and release induced by thrombin was obtained after a 30 second preincubation with 38 uM nitrendipine, 1 mM Cd2+ or 1 mM Mn2+. Inhibition was obtained in the presence of Ca2+, Sr2+ or Ba2+. These results are consistent with the hypothesis that Sr2+ and Ba2+ are able to support platelet activation acting as Ca2+ substitutes. Following thrombin stimulation, they could penetrate the platelets and mimick a rise in cytoplasmic Ca2+. PMID- 3629550 TI - Evidence for a saturable mechanism of disappearance of standard heparin in rabbits. AB - This work demonstrates that after bolus intravenous injection standard heparin (SH) disappearance results from the combination of a saturable and a non saturable mechanism. Pharmacokinetics and pharmacodynamics of SH were studied by measuring the disappearance of increasing doses (5 - 500 anti-factor Xa U/kg) of 125I-heparin and of its biological effects. CPM curves allowed to determine the half lives of heparin according to the dose injected. The half lives were clearly dose dependent and reached a plateau over 100 anti-factor Xa U/kg. The complex curve which describes the amount of heparin cleared per time unit after any given dose has been resolved into its two components reflecting a saturable and a non saturable mechanism of disappearance. For the doses less than 100 anti-factor Xa U/kg the saturable mechanism was preeminent and the anti-factor Xa activity disappearance followed an exponential pattern; for the doses less than 100 anti factor Xa U/kg the contribution of the non saturable mechanism becomes more important and the anti-factor Xa activity disappearance followed a concave-convex pattern. Further experiments showed that the heparin half life shortened as the circulating anti-factor Xa activity decreased; this phenomenon may explain the concave-convex pattern of the curve of the anticoagulant effect observed after injection of large doses of SH. PMID- 3629551 TI - The disappearance of a low molecular weight heparin fraction (CY 216) differs from standard heparin in rabbits. AB - In previous studies, we have reported that standard heparin (SH) was cleared by two mechanisms, a saturable mechanism which predominated at low doses (less than 100 anti-factor Xa U/kg) and a non-saturable mechanism which predominated at higher doses, when the first mechanism became saturated. In this study, we examined the importance of these two mechanisms in the disappearance of a low molecular weight heparin fraction (LMWH) (CY 216), by comparing the pharmacokinetics and the pharmacodynamics of a wide range of doses of SH and CY 216 (1.5 to 500 anti-factor Xa U/kg). Pharmacokinetics was measured as the disappearance of 125I-radiolabelled SH or CY 216. Pharmacodynamics was measured as the disappearance of the anti-factor Xa activity of SH and CY 216. We found that the saturable mechanism contributed little to the disappearance of CY 216 and that it was cleared predominantly by the non-saturable mechanism at all doses tested. Thus, at low doses (less than 100 anti-factor Xa U/kg), SH was cleared more rapidly than CY 216, whereas at higher doses, CY 216 was cleared more rapidly than SH. We conclude that the mechanism of disappearance of LMWH's differ significantly from those of SH, and that this difference may explain the apparent prolonged anticoagulant activity of LMWH's within the therapeutic range doses. PMID- 3629552 TI - Interaction of thrombin, antithrombin III and their complex with hepatocytes: comparison of the molecular components of human and mouse origin. PMID- 3629553 TI - Selective antagonism of platelet-activating factor (PAF)-induced aggregation and secretion in washed rabbit platelets by CV-3988, L-652731, triazolam and alprazolam. AB - Platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphorylcholine or AGEPC) is a potent phospholipid mediator elaborated by a variety of mammalian cells. CV-3988 (a unique structural analog of AGEPC), L-652731 (a lignan derivative of a natural product) and two triazolobenzodiazepines (triazolam and alprazolam) were evaluated for their ability to selectively antagonize aggregation and secretion responses in washed, [3H]serotonin-labeled rabbit platelets stimulated with graded doses of AGEPC. When 0.2 nM AGEPC was used as the stimulus, the concentration of antagonist needed for 50% inhibition (IC50) of secretion was obtained at 0.05 uM, 0.15 uM, 0.6 uM and 2.5 uM, for L-652732, CV 3988, triazolam and alprazolam, respectively. The corresponding IC50 values for aggregation were obtained at 0.2 uM, 0.1 uM, 1.5 uM and 6.5 uM, respectively. The inhibitory effects could be overcome by increasing the amount of AGEPC used to stimulate the platelets. Of the four compounds tested, L-652731 was the most potent antagonist of AGEPC-induced activation of washed rabbit platelets. PMID- 3629554 TI - Aspirin effect on platelet antiplasmins release. AB - Euglobulins of platelet poor plasma containing resuspended washed platelets produced a significant decrease of the lysis areas with regard to euglobulins of platelet poor plasma alone; this decrease correlated with the number of platelets. Euglobulins of platelet poor plasma containing washed platelets activated with collagen (2 and 20 micrograms/ml) showed lower lysis areas on fibrin plates compared with euglobulins containing non-activated platelets (p 0.001). The higher number of platelets, the lower the lysis area. Aspirin had no effect upon antiplasmin activity either in non-activated or in activated platelets. We must consider the possibility that platelet antiplasmins could be released by different metabolic pathways than via the cyclooxygenase pathway or that they are not stored in -granules. PMID- 3629555 TI - Plasma from atherosclerotic patients exerts an increased degradation of platelet activating factor. AB - Platelet-activating factor (PAF) is a naturally occurring phospholipid that exerts diverse biological activities. In the present study the degradation of PAF as well as lipid concentrations were measured both in plasma from 28 patients suffering from peripheral vascular disease and 18 healthy volunteers of comparable age. Beside some changes of the lipoprotein pattern it was also found that the capacity to degrade PAF is significantly elevated in the patient group. In view of this finding the question arises whether there is any link between the degradation of PAF and the development of atherosclerosis. PMID- 3629556 TI - A simple method for determination of the factor VII-phospholipid complex using Normotest. AB - We report here a highly significant positive correlation observed when the factor VII-phospholipid complex (the phospholipase-C sensitive component of factor VII) in plasma was tested in a specific factor VII system and in Normotest (p less than 0.0001). The Normotest system, which is sensitive to variations in coagulation activity within the normal range, was not influenced by phospholipase C when the enzyme was added immediately before the start of the coagulation assay. Normotest is well suited for determination of the factor VII-phospholipid complex in plasma. PMID- 3629557 TI - Comparison of the effect of acetylsalicylic acid on platelet function in male and female patients with ischemic stroke. AB - The aim of this study was to observe whether acetylsalicylic acid (ASA) had different effects in both sexes. Out of the ischemic stroke patients who were admitted to the National Taiwan University Hospital (NTUH), those who had not taken ASA or ASA-like drugs for more than 2 weeks were selected for this study. For the diagnosis of ischemic stroke, computed tomography (CT) of the brain was performed in all cases, and for differential diagnosis, other necessary procedures were employed in a few cases. The serum salicylate (SA) level was measured by Trinder's method, thromboxane B2 (TXB2) and 6-keto-PGF1 alpha by radioimmunoassay, threshold concentration of adenosine diphosphate (ADP) by Born's method, and circulating platelet aggregates (CPA) by Wu and Hoak's method. The present study showed that the means of serum SA levels after administration of the same dose of ASA were not significantly different between the two sexes. After ingestion of ASA, a single dose of 75 mg, 300 mg or 600 mg, or 300 mg 4 times a day, mean plasma TXB2 levels were significantly suppressed and mean threshold concentrations of ADP were significantly elevated in the two sexes. After administration of above-mentioned various doses of ASA, the abnormally high plasma TXB2 levels and abnormally low threshold concentrations of ADP and CPA ratios were significantly normalized in both male and female patients. Plasma 6 keto-PGF1 alpha levels were not influenced by ingestion of ASA 75 mg, but significantly depressed by administration of ASA 300 mg in both sexes. There were no sex differences in the antiplatelet effect of ASA in this experiment. PMID- 3629558 TI - Analysis of immunoglobulins that bind to platelets from serum of patients with immune thrombocytopenia: molecular weight distribution. AB - The nature of platelet- bindable immunoglobulins (PB-Ig) in serum has been investigated. PB-IgG, -A and -M were measured by an ELISA using platelets coated on microtitre plates. This assay detected alloantibodies at high serum dilutions. In 32 patients with idiopathic thrombocytopenic purpura (ITP) or systemic lupus erythematosus (SLE) raised levels of at least one PB-Ig class were found in 18. To distinguish binding due to immune complexes, the molecular weight of PB-IgG was studied by gel filtration on Sepharose 4B. In sera from patients with ITP and SLE, PB-IgG with Mr of primarily 150 Kd was observed, compatible with monomeric IgG antiplatelet antibodies. Levels of PB-IgG in serum were not related to total serum IgG. In sera from the patients with SLE and some with ITP (most of whom had several of the features of SLE), PB-IgG with Mr of 200 Kd - greater than 1000 Kd was seen. In heat-aggregated preparations of normal IgG, PB-IgG with Mr up to 1000 Kd was also found. Rabbit IgG was able to block PB-IgG in fractions of high molecular weight in purified normal IgG, heat-aggregated normal IgG and in patient serum, but had no effect on the 150 Kd peak. In whole serum from patients who had high molecular weight PB-IgG, the inhibitory effects of rabbit IgG were much less than in isolated high molecular weight column fractions. Thus although the majority of PB-IgG is monomeric antiplatelet antibody, some PB-IgG with higher molecular weight, characteristic of immune complexes, occurs in sera of some patients with autoimmune thrombocytopenia and it makes a small contribution to PB-IgG levels measured in whole serum. PMID- 3629559 TI - The N-DSK gamma-chain binds to immunoprecipitated GP IIb-IIIa. AB - The CNBr-split N-terminal disulphide knot of the fibrinogen molecule (N-DSK) binds to ADP-stimulated gel-filtered platelets and immunoprecipitated fibrinogen receptor. To investigate which part of the N-DSK molecule that is involved in this binding, the glycoprotein IIb-IIIa complex (the fibrinogen receptor) was immunoprecipitated in crossed immunoelectrophoresis of Triton X-100 extracts of platelets against rabbit antibodies to whole platelet proteins. The immunoelectrophoresis plates were incubated with solubilized, carboxymethylated 125I-labelled A alpha -, B beta - or gamma-chains of N-DSK, and investigated for binding by autoradiography. The N-DSK gamma-chain, but not the A alpha - or B beta -chains demonstrated binding to the GP IIb-IIIa complex. These results show that the fibrinogen molecule contains a third sequence of amino acids, in addition to the two previously reported ones that can be involved in binding of fibrinogen to the fibrinogen receptor on the platelets. PMID- 3629560 TI - A new variant of thrombasthenia with abnormally glycosylated GP IIb/IIIa. AB - A 15 year-aged Japanese girl with a life long mild purpura was found as a variant type of thrombasthenia. Basic tests revealed prolonged bleeding time, border-line clot retraction, no coagulation defect, no giant platelets and mild thrombocytopenia (70,000-110,000/microliters). Neither ADP, epinephrine nor collagen aggregated her platelet rich plasma. Thrombin (0.1U/ml) caused slightly decreased aggregation of her washed platelets and about 20% normal production of thromboxane B2. PAS-stained SDS-PAGE of her whole platelets showed markedly decreased GP IIb and IIIa. However, crossed immunoelectrophoresis (CIE) against anti-whole platelets antibody showed a normal amount of GP IIb/IIIa complex in her whole platelets solubilized with 1% Triton X-100. CIE using monospecific anti GP IIb/IIIa complex antibody showed normal dissociation of the patient's GP IIb/IIIa complex into two new bands in the presence of EDTA. Crossed affino immunoelectrophoresis with the first dimension containing Concanavalin A revealed that the patient's GP IIb/IIIa was much less shifted to the cathode than controls. Immunoprecipitation lines of her GP IIb/IIIa complex were excised from unstained CIE using anti-GP IIb/IIIa antibody and subjected to the silver-stained reduced SDS-PAGE, which showed two protein bands with molecular weights of 125KD and 108KD, corresponding to GP IIb alpha and GP IIIa, respectively. These results suggest that the platelets of this apparently thrombasthenic patient have an antigenically normal but abnormally glycosylated GP IIb/IIIa complex, which is functionally abnormal because of abnormal glycosylation. PMID- 3629561 TI - Mechanism of anticoagulant action by protein inhibitors from bovine testes and salmon sperm. AB - A protein inhibitor was isolated from commercial preparations of salmon sperm and its physical and anticoagulant properties were compared with an inhibitor isolated earlier from commercial preparation of bovine testicular hyaluronidase. The inhibitor from bovine source was heat and acid labile and had a molecular weight of approximately equal to 35000 while the one from salmon sperm had a molecular weight of approximately equal to 5700 and was stable to heat and acid. To determine the mechanism of the inhibitory effect, a system of purified components consisting of isolated prothrombin, Factor Xa, Factor Va, Ca++, and vesicles of phosphatidylcholine (PCPS, 25% PS) was used. Included also was dansylarginine N- (3-ethyl-1,5-pentanedidyl) amide (DAPA) which binds newly formed thrombin and yields the time course of prothrombin conversion by virtue of enhanced fluorescence of the DAPA - thrombin complex. The inhibitor of bovine testes was effective only when PCPS was the limiting component suggesting that its action was directed against the phospholipid component of the prothrombinase complex. The inhibitor from salmon sperm was found to lower the rate of conversion of prothrombin to thrombin in an in vitro system where thrombin generation was measured by its action on the chromogenic substrate H-D-Phe-Pip Arg-pNa (S-2238). It inhibited the conversion of Factor X to Xa and also the the amidolytic cleavage by Factor Xa of chromogenic substrate N-Benz-Ile-Glu-Gly-Arg pNa (S-2222). PMID- 3629562 TI - A microtitre chromogenic substrate assay for factor XII. PMID- 3629563 TI - Platelet aggregation on whole blood after administration of ultra low dosage acetylsalicylic acid in healthy volunteers. PMID- 3629564 TI - [Health and nutritional status in a province in Afghanistan]. PMID- 3629565 TI - [Solvent-induced encephalopathy. Occurrence, symptoms and diagnosis]. PMID- 3629566 TI - [Genes and intelligence]. PMID- 3629567 TI - [The tick Ixodes ricinus, a spirochaeta vector]. PMID- 3629568 TI - [Tick-borne borrelia spirochete infections in man]. PMID- 3629569 TI - [Chronic erythema migrans and chronic acrodermatitis atrophicans. Tick-borne Borrelia spirochete infections of the skin]. PMID- 3629570 TI - [Use of corticosteroids. Clinical and pharmacological aspects of treatment of acute sport injuries]. PMID- 3629571 TI - [Electric stimulation of the acoustic nerve in the deaf and in patients with severe hearing disorders]. PMID- 3629572 TI - [Fatal cocaine poisoning]. PMID- 3629573 TI - [Rett's syndrome. A new clinical picture]. PMID- 3629574 TI - [Pheochromocytoma. Multiple endocrine neoplasms type III with preoperative onset]. PMID- 3629575 TI - [The T-cell antigen receptor. Structure, gene rearranging and function]. PMID- 3629576 TI - [DNA probes. An important aid in the diagnosis of lymphoma]. PMID- 3629577 TI - [Experiences running a 5-day surgical ward]. PMID- 3629578 TI - The distribution of four lysosomal integral membrane proteins (LIMPs) in rat basophilic leukemia cells. AB - The intracellular distribution of four distinct lysosomal integral membrane proteins (LIMPs), recognized by four monoclonal antibodies, was determined in rat basophilic leukemia (RBL) cells. The monoclonal antibodies were generated against hepatocyte LIMPs and have been characterized previously (Barriocanal et al., 1986a, b). Indirect immunofluorescence microscopy revealed that all four LIMPs are found in secretory vesicles of RBL cells. Ultrastructural immunolocalization, using a pre-embedding peroxidase technique, confirmed these results and also showed the distribution of LIMPs 1 and 4 at the cell surface. The relative, cell surface concentrations of the four LIMPs was determined using a fluorescence activated cell sorter (FACS). In resting RBL cells the concentration of LIMP 1 at the cell surface was highest, followed by LIMP 4. LIMPs 2 and 3 could not be detected at the cell surface. Following stimulation of secretory vesicle exocytosis by A23187, the cell surface concentration of LIMP 4 was increased, whereas the concentration of LIMPs 1-3 remained unchanged. These results are discussed within the context of intracellular sorting during the biogenesis of membrane, secretory vesicle components. PMID- 3629579 TI - Gap junctions and zonulae occludentes of hepatocytes during biliary atresia in the lamprey. AB - Gap junctions and zonulae occludentes of hepatocytes were examined in thin sections and freeze-fracture replicas from livers of larval and juvenile adult lampreys and during the phase of metamorphosis when bile ducts and bile canaliculi disappear (biliary atresia). Larvae possess zonulae occludentes at the canaliculi which are composed of one to five (mean = 2.81) junctional strands that provide a bile-blood barrier. Morphometry demonstrates that during biliary atresia the decreases in number of junctional strands and apico-basal depth of the zonulae occludentes are accompanied by an increase in the frequency of gaps or interruptions in the strands and in a breakdown of the bile-blood barrier. The zonulae occludentes completely disappear during metamorphosis and are not found in the adult liver. Gap junctions of the larval liver occupy 1% of the surface of the plasma membrane and have a mean area of 0.167 micron 2 but, following an initial decline in these parameters during early biliary atresia, they rise sharply in later stages of metamorphosis and in adults are 3.2% and 0.502 micron 2, respectively. The events of alteration in junctional morphology during lamprey biliary atresia is in many ways comparable to the changes in gap junctions and zonulae occludentes during experimental and pathological intra- and extrahepatic cholestasis in mammals. PMID- 3629580 TI - Isolation of cardiac myocytes from the adult newt, Notophthalmus viridescens. an electron microscopic and quantitative light microscopic analysis. AB - This report describes a technique which permits a high yield of viable adult cardiac myocytes from the adult newt using enzymatic separation techniques at low temperature and high enzyme concentrations. Observations by light microscopy showed the isolated myocytes to have a distinctively slender morphology which consisted of a variable number of arm-like appendages radiating from the center of cells which were predominantly mononucleated. Atrial myocytes were typically observed to have two to three arm-like appendages while ventricular myocytes typically had three to six appendages. The majority of myocytes displayed normal fine structure when examined by transmission electron microscopy. Computerized image analysis revealed that atrial cells were significantly greater in cell length (192.9 +/- 53.4 microns) and in nuclear length (25 +/- 5.3 microns) and perimeter (59.2 +/- 10.7 microns) than were ventricular cells (162.8 +/- 39 microns, 23.6 +/- 5.1 microns and 57.4 +/- 11.1 microns, respectively), while cell widths and areas were greater in ventricular cells (16.5 +/- 4.7 microns and 1839.8 +/- 585.0 microns, respectively) than in atrial cells (13.2 +/- 3.1 microns and 1520.3 +/- 527.6 microns, respectively). Comparison of these data with previous descriptions of isolated amphibian and mammalian cardiac myocytes emphasizes species-related differences. PMID- 3629581 TI - Serum unconjugated estriol levels during spontaneous labor. AB - We measured maternal serum unconjugated estriol (SUE3) levels in 244 cases (218 cases with labor and 26 without labor) and investigated the relationships among several obstetrical factors and SUE3 levels. There was no significant difference in the SUE3 level between the group with labor and the group without labor. However, the SUE3 level decreased gradually with prolonged duration of labor in multipara. There were significant positive correlations between the SUE3 levels and birth weights (n = 82, r = 0.375, p less than 0.01) or placental weights (n = 82, r = 0.381, p less than 0.01) in the multipara with labor. The SUE3 levels of fetal distress cases (n = 30, 20.0 +/- 8.6 ng/ml) were significantly (p less than 0.05) lower than those without fetal distress (n = 188, 24.5 +/- 9.7 ng/ml). These data suggest that maternal SUE3 might have been affected with feto placental function, even after the onset of labor SUE3 levels decrease with prolonged duration of labor. PMID- 3629582 TI - The maternal serum cortisol levels after onset of labor. AB - We measured maternal cortisol levels after the onset of labor. Blood from 82 primiparas and 48 multiparas were collected 124 times and 60 times, respectively. When duration of labor was within 3 hr, there were no differences in cortisol levels between the primiparous (n = 11, 50.4 +/- 7.0 micrograms/100 ml, mean +/- S.E.) and multiparous (n = 14, 37.8 +/- 4.3 micrograms/100 ml). However, when duration of labor was from 3 to 6 hr, cortisol levels in the primiparas (n = 20, 59.7 +/- 5.1 micrograms/100 ml) were significantly (p less than 0.05) higher than those in the multiparas (n = 22, 46.8 +/- 2.9 micrograms/100 ml). In cases of duration of labor from 6 to 9, cortisol level of the primiparas (n = 24, 64.3 +/- 4.4 micrograms/100 ml) were also significantly (p less than 0.05) higher than those in multiparas (n = 12, 49.4 +/- 4.7 micrograms/100 ml). When duration of labor was more than 9 hr there was no significant difference in cortisol level between the primiparas and multiparas. Maternal cortisol level had a significant (p less than 0.01) negative correlation (n = 166, r = -0.243, Y = -0.09X + 30.47) with unconjugated estriol level. These data suggest that maternal cortisol levels after the onset of labor are slightly different between the primiparous and multiparous, and that maternal unconjugated estriol levels decrease owing to reduction of the feto-placental blood circulation accompanied with uterus contraction during labor. PMID- 3629583 TI - New additional operation for the prevention of the gastric stasis after selective gastric vagotomy with antrectomy. AB - In order to prevent postoperative gastric stasis, we devised and tested the following improvements in the selective gastric vagotomy with antrectomy. (1) The gastroduodenostomy was made so as to have an acute angle to the longitudinal axis of the remnant stomach, and (2) the downward traction being exerted on the remnant stomach by the transverse colon was eliminated by dissecting the greater omentum, and then (3) the posterior wall of the corpus on the lesser curvature side was fixed to the stump of the hepatogastric ligament, and the posterior wall of the corpus on the greater curvature side was fixed to the retroperitoneum inferior to the pancreas. By these procedures, the corpus was maintained in a position superior to the anastomosis. These operative procedures resulted in preventing the gastric stasis after the start of oral feeding. The two patients on whom this operation was performed have been followed up for 3 to 4 months since the operation, and neither of them has had any complaint of gastric stasis, such as anorexia or a feeling of heaviness of the stomach. PMID- 3629584 TI - Potentiation of vitamin A hepatotoxicity by butylated hydroxytoluene. AB - The interaction between the natural vitamin A ester retinyl acetate (RA) and the phenolic antioxidant butylated hydroxytoluene (BHT) in the induction of biliary hyperplasia and hepatic fibrosis in female Sprague-Dawley rats was characterized. Using a 3 X 3 matrix design, rats were fed diets supplemented with (per kilogram diet) 0, 125, or 250 mg RA and/or 0, 2500, or 5000 mg BHT. The 125-mg dose of RA induced no gross hepatotoxicity, while the 250-mg dose of RA induced a low incidence of hepatic fibrosis in rats examined after 120 and 180 days of exposure. Exposure to BHT alone induced hepatocellular hypertrophy and dose related increases in liver weight, but no hepatocellular pathology. Simultaneous administration of RA plus BHT resulted in significant increases in the incidence of biliary hyperplasia and hepatic fibrosis compared to that induced by RA alone. BHT reduced total hepatic vitamin A content at all RA dose levels. Thus, mechanisms other than increases in liver vitamin A levels must underlie the potentiation by BHT of RA hepatotoxicity. PMID- 3629585 TI - The influence of chirality on the delayed neuropathic potential of some organophosphorus esters: neuropathic and prophylactic effects of stereoisomeric esters of ethyl phenylphosphonic acid (EPN oxon and EPN) correlate with quantities of aged and unaged neuropathy target esterase in vivo. AB - Organophosphate-induced delayed polyneuropathy (OPIDP) is thought to result from organophosphorylation of neuropathy target esterase (NTE), followed by an "aging" of the phosphorylated NTE. Prophylactic against OPIDP should thus be achieved by production of an inhibited but "nonaging" NTE. Resolved stereoisomers of ethyl phenylphosphonic acid esters produce two forms of inhibited NTE; in vitro one form ages rapidly and the other only negligibly. The present study examined the in vivo effects of two preparations of incompletely resolved isomers of EPN oxon (ethyl 4-nitrophenyl phenylphosphonate) and its thionate on adult hen brain and spinal cord NTE and the relationship of inhibition and aging to the development of OPIDP. Single doses of the L-(-)-isomers (Preparation A, 7:3 proportion of isomers, or Preparation B, 9:1) caused severe neuropathy after doses which produced 70% aged inhibited NTE and mild effects after 50-60%. Single doses of the D-(+)-isomers produced either equal amounts of aged and unaged inhibited NTE (Preparation A) or predominantly unaged (Preparation B): the amount of aged was never more than 50% and no clinical OPIDP occurred. Doses of D-(+) which produced 50% unaged inhibited NTE were protective: challenge with the highly neuropathic phenyl saligenin cyclic phosphate did not cause OPIDP. All effects are consistent with the two-stage initiation process which requires both inhibition of NTE and subsequent modification of the protein by an "aging" process. Previously reported neuropathic effects of D-(+)-EPN probably reflect a substantial proportion of L-( )-isomer present in the test material. Neuropathic studies with chiral OP esters should consider the possibility of production of protective unaged inhibited NTE in test animals. PMID- 3629586 TI - The hematologic effects of cefonicid and cefazedone in the dog: a potential model of cephalosporin hematotoxicity in man. AB - Cephalosporin antibiotics cause a variety of hematologic disturbances in man, the pathogeneses and hematopathology of which remain poorly characterized. There is a need for a well-defined animal model in which these blood dyscrasias can be studied. In four subacute toxicity studies, the intravenous administration of cefonicid or cefazedone to beagle dogs caused a dose-dependent incidence of anemia, neutropenia, and thrombocytopenia after 1-3 months of treatment. A nonregenerative anemia was the most compromising of the cytopenias and occurred in approximately 50% of dogs receiving 400-500 mg/kg cefonicid or 540-840 mg/kg cefazedone. All three cytopenias were completely reversible following cessation of treatment; the time required for recovery of the erythron (approximately 1 month) was considerably longer than that of the granulocytes and platelets (hours to a few days). Upon rechallenge with either cephalosporin, the hematologic syndrome was reproduced in most dogs tested; cefonicid (but not cefazedone) treated dogs showed a substantially reduced induction period (15 +/- 5 days) compared to that of the first exposure to the drug (61 +/- 24 days). This observation, along with the rapid rate of decline in red cell mass parameters of affected dogs, suggests that a hemolytic component complicated the red cell production problem and that multiple toxicologic mechanisms contributed to the cytopenia. We conclude that the administration of high doses of cefonicid or cefazedone to dogs can induce hematotoxicity similar to the cephalosporin-induced blood dyscrasias described in man and thus provides a useful model for studying the mechanisms of these disorders. PMID- 3629587 TI - The hematopathology of cefonicid- and cefazedone-induced blood dyscrasias in the dog. AB - Cephalosporin treatment in man has been associated with blood dyscrasias that include a time- and dose-related anemia, neutropenia, and thrombocytopenia, the hematopathology of which remains poorly characterized. A similar hematologic syndrome can be produced in dogs following daily intravenous injections of 540 840 mg/kg cefazedone or 400-500 mg/kg cefonicid for 1-3 months. Using this animal model, histologic and cytologic changes in blood, bone marrow, spleen, and liver were studied over the course of the cephalosporin-induced cytopenias. Peripheral blood cytologic observations included an absence, generally, of erythroid regenerative changes, increased numbers of macroplatelets, spherocytosis, erythroblastemia, and toxic neutrophil morphology. Interim and postmortem cytologic and histologic observations of bone marrow included hypoplastic and toxic changes, primarily in cytopenic dogs receiving high doses of cefonicid, and regenerative changes in hematopoietic tissue of affected cefazedone-treated animals. The latter included variable erythroid hyperplasia, increased megakaryocytes, and decreased marrow fat and was accompanied by evidence of extra medullary hematopoiesis and increased hemosiderin and hemophagocytosis in liver and splenic tissue. The incidence and severity of these changes were dose dependent, corresponded with the cytopenias observed peripherally, and, like the cytopenias, were fully reversible. These observations suggest that the hematologic syndrome associated with cephalosporin treatment in the dog has multiple toxicologic mechanisms, which include peripheral cytotoxic effects and bone marrow damage with depressed or ineffective hematopoiesis. PMID- 3629588 TI - Codeine-mediated hepatotoxicity in isolated rat hepatocytes. AB - Administration of codeine to freshly isolated rat hepatocytes resulted in cytotoxicity characterized by a dose- and time-dependent leakage of lactate dehydrogenase (LDH) out of the cells. Codeine also caused a decrease in hepatic reduced sulfhydryl content. Cytochrome P-450 content and NADPH levels were not changed. Induction and inhibition studies of several potential pathways of codeine biotransformation were carried out in order to determine if codeine must be metabolized to a reactive intermediate to elicit these hepatotoxic effects. Codeine hepatotoxicity as measured by LDH release was not changed after induction of cytochrome P-450 by phenobarbital and was decreased after cytochrome P-448 induction by beta-naphthoflavone. However, codeine hepatotoxicity was inhibited when an inhibitor of cytochrome P-450 metabolism, metyrapone, was added. Inhibition of the other major hepatic oxidative enzyme system, flavin adenine dinucleotide (FAD)-containing monooxygenase, increased the cytotoxicity of codeine. Inhibition of alcohol dehydrogenase had no effect on codeine hepatotoxicity. These results indicate that codeine hepatotoxicity is caused by a cytochrome P-450-generated intermediate of codeine, whereas FAD-containing monooxygenase may metabolize codeine to a nontoxic intermediate. PMID- 3629589 TI - Reversal of methylmercury-induced block of nerve-evoked release of acetylcholine at the neuromuscular junction. AB - Acute bath application of micromolar concentrations of methylmercury (MeHg) blocks the nerve-evoked release of acetylcholine at the neuromuscular junction by presynaptic effects. The goal of the present study was to try to reverse this block of stimulus-evoked release. Experiments were conducted using the phrenic nerve hemidiaphragm of the rat and conventional intracellular microelectrode techniques. Myofibers were cut ("cut muscle") to prevent contractions elicited by stimulation of the phrenic nerve. End-plate potentials (EPPs) were recorded before and during MeHg application and during subsequent reversal attempts. MeHg (100 microM) blocked the EPP within 8-9 min of application. The time to block did not differ if Sr2+ (2 mM) was substituted for Ca2+ prior to exposure to MeHg. Washing the preparation with MeHg-free physiological saline at the time the EPP was blocked failed to reverse the block of synaptic transmission even during protracted washing. Increasing the extracellular [Ca2+] from 2 to 4 mM, or application of 4-aminopyridine (50 or 100 microM) failed to reverse block of the EPP. D-Penicillamine was also ineffective at reversing transmission block when applied at 0.4 mM; however, when applied at 1 mM D-penicillamine caused a return of EPPs in three of eight experiments within 5-20 min of wash. Longer periods of washing with D-penicillamine or use of higher concentrations of D-penicillamine were not effective in reversing transmission block in the refractory preparations. Increasing the intensity or duration of stimulation at the time of EPP block was uniformly successful in reversing MeHg-induced block; in 9 of the 10 preparations tested, EPPs could again be elicited from MeHg-blocked preparations merely by increasing the intensity and/or duration of stimulation, despite the continued presence of MeHg. Following reversal of transmission block by MeHg, continued exposure to MeHg resulted in a subsequent block of the EPP within approximately 3 min. During this subsequent block of the EPP by MeHg, increasing extracellular [Ca2+] or adding 4-aminopyridine did restore synaptic transmission. These results indicate that a temporary reversal of MeHg-induced block of synaptic transmission can be produced and that this effect does not require extracellular Ca2+ during the initial stages, but does seem to require extracellular Ca2+ during later stages. PMID- 3629591 TI - Interaction of cycloheximide and diisopropylphosphorofluoridate (DFP) during subchronic administration in rat. AB - Male Sprague-Dawley rats daily treated with DFP (0.5 mg/kg/day, sc) exhibited signs of cholinergic toxicity such as tremors and muscle fasciculations between Days 3 and 5 comparable to those observed 15 min after a single acute signs producing dose (1.5 mg/kg, sc). Further administration of DFP (0.5 mg/kg/day, sc) for 6-14 days led to tolerance development as evidenced by disappearance of the described toxicity signs. The protein synthesis inhibitor cycloheximide, when given in a nontoxic dose (0.5 mg/kg/day, sc) 1 hr before DFP (0.5 mg/kg/day, sc) administration, potentiated the DFP toxicity and rats died after the fifth injection. DFP-tolerant rats developed toxicity signs when subsequently treated with cycloheximide (0.5 mg/kg/day, sc) and DFP (0.5 mg/kg/day, sc). Each drug when given alone for 4 days caused 30-50% reduction of [14C]valine uptake in vivo into the free amino acids pool as well as its incorporation into proteins of brain and skeletal muscles. A combination of these drugs caused a significantly greater inhibitory effect on [14C]valine incorporation into proteins. Cycloheximide (0.5 mg/kg/day, sc) administered for 4 days did not significantly alter the levels of acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), or carboxylesterase (CarbE) activities but potentiated the DFP-induced inhibition of the activities of these enzymes. It is concluded that the cycloheximide pretreatment potentiates DFP toxicity by a mechanism that is related to inhibition of the synthesis of proteins such as AChE, BuChE, and CarbE. PMID- 3629590 TI - Synergistic interaction between nitrogen dioxide and respirable aerosols of sulfuric acid or sodium chloride on rat lungs. AB - We examined interactions in rats between NO2 gas and respirable aerosols of sulfuric acid (H2SO4) or sodium chloride (NaCl). Rats were exposed for 1, 3, or 7 days to 5 ppm of NO2 gas, alone or in combination with 1 mg/m3 of H2SO4 or NaCl aerosols. The apparent rate of collagen synthesis by lung minces was measured after 7 days of exposure, and the protein content of whole lung lavage fluid was measured after 1 or 3 days of exposure. Responses from rats exposed to 5 ppm of NO2 alone were significantly different from controls by these assays. A synergistic interaction was demonstrated between 5 ppm of NO2 and 1 mg/m3 of either H2SO4 or NaCl aerosol as evaluated by measurement of the rate of lung collagen synthesis. A synergistic interaction was also demonstrated by the criterion of increased protein content of lung lavage fluid in rats exposed to 5 ppm of NO2 and 1 mg/m3 of H2SO4 aerosol after 1 day of exposure and between 5 ppm of NO2 and 1 mg/m3 of NaCl aerosol after 3 days of exposure. These observations with 5 ppm of NO2 alone and in combination with 1 mg/m3 of NaCl aerosol support the hypothesis that formation of nitrosyl chloride may contribute to a synergistic interaction between NO2 gas and NaCl aerosol. These results suggest that, in general, combinations of oxidant gases with respirable acidic aerosols or with acidogenic gases will demonstrate interactive effects on rat lungs. Such a hypothesis is testable and makes specific predictions about effects of inhalation of pollutant mixtures. PMID- 3629592 TI - Decreased pneumotoxicity of deuterated 3-methylindole: bioactivation requires methyl C-H bond breakage. AB - The bioactivation of the pulmonary toxin 3-methylindole has been postulated to proceed via the formation of an imine methide. To test this hypothesis, the toxicity in mice of 3-methylindole has been compared to the toxicity of its perdeuteromethyl analog. Deuteration of the methyl group should slow the rate of production of the corresponding imine methide and diminish the toxicity of deutero-3-methylindole, if C-H bond breakage occurs prior to or during the rate determining step. In agreement with this hypothesis, deutero-3-methylindole was synthesized and was shown to be significantly less toxic (LD50 735 mg/kg) than 3 methylindole (LD50 578 mg/kg). Both compounds produced the same lesion at the LD50 dose, bronchiolar damage and mild alveolar edema, indicating that deuteration of 3-methylindole did not change the pathologic process. However, at a much lower dose (25 mg/kg), 3-methylindole produced a mild bronchiolar lesion whereas deutero-3-methylindole did not damage lung tissue. Additionally, administration of deutero-3-methylindole caused less pulmonary edema compared to 3-methylindole, as assessed by increased wet lung weights. Finally, the depletion of pulmonary glutathione by deutero-3-methylindole was considerably slower than depletion by 3-methylindole. The electrophilic imine methide has been postulated to be the intermediate which binds with and depletes glutathione. Therefore, the evidence presented here supports the involvement of an imine methide as the primary reactive intermediate in 3-methylindole-mediated pneumotoxicity. PMID- 3629593 TI - Effect of the age of B6C3F1 mice on phenobarbital promotion of diethylnitrosamine initiated liver tumors. AB - Chronic exposure to phenobarbital (PB) in the drinking water of male B6C3F1 mice starting at 4 weeks of age and subsequent to a single (ip) injection of diethylnitrosamine (DENA) administered on Day 15 of age has been shown to result in the inhibition of hepatic tumor formation. In this study, we varied the time of onset of PB administration to determine if sexual maturity would affect liver tumor formation and progression. Male B6C3F1 mice were divided into eight groups. Groups 1-4 received a single (ip) dose of 5 mg/kg DENA at 15 days of age while mice in groups 5-8 received saline. At weaning (4 weeks of age), groups 1 and 5 received deionized drinking water (DDW) for 24 weeks; groups 2 and 6 received PB (500 ppm) in the drinking water (PB DW) for 16 weeks followed by DDW for 8 weeks; groups 3 and 7 received DDW for 4 weeks, PB DW for 16 weeks, and then DDW for 4 weeks; and groups 4 and 8 received DDW for 8 weeks and PB DW for 16 weeks. Mice were killed at 28 weeks of age and hepatic lesions were evaluated. Mice which did not receive DENA (groups 5-8) exhibited no liver tumors. Animals in groups 1-4 exhibited hepatocellular foci and adenomas. PB treatment in groups 2, 3, or 4 resulted in a significant decrease in the incidence of DENA-initiated hepatocellular foci and adenomas when compared to those observed in group 1. The number of foci in group 4 was significantly decreased compared to those in groups 2 and 3. There was no significant difference in the adenoma incidence among groups 2, 3, and 4. No significant differences were observed in the sizes of foci or adenomas among groups 1-4. Data from this study suggest that the inhibition of hepatocellular tumorigenesis by PB remains intact even when the start of the administration of PB is withheld up to 12 weeks of age. PMID- 3629594 TI - The carcinogenicity of trichloroethylene and its metabolites, trichloroacetic acid and dichloroacetic acid, in mouse liver. AB - Trichloroethylene (TCE) has previously been shown to be carcinogenic in mouse liver when administered by daily gavage in corn oil. The metabolism of TCE results, in part, in the formation of trichloroacetic acid (TCA) as a major metabolite and dichloroacetic acid (DCA) as a minor metabolite. These chlorinated acetic acids have not been shown to be genotoxic, although they have been shown to induce peroxisome proliferation. Therefore, we determined the ability they have been shown to induce peroxisome proliferation. Therefore, we determined the ability of TCE, TCA, or DCA to act as tumor promoters in mouse liver. Male B6C3F1 mice were administered intraperitoneally 0, 2.5, or 10 micrograms/g body wt ethylnitrosourea (ENU) on Day 15 of age. At 28 days of age, the mice were placed on drinking water containing either TCE (3 or 40 mg/liter), TCA (2 or 5 g/liter), or DCA (2 or 5 g/liter). All drinking waters were neutralized with NaOH to a final pH of 6.5-7.5. The animals were killed after 61 weeks of exposure to the treated drinking water (65 weeks of age). Both DCA and TCA at a concentration of 5 g/liter were carcinogenic without prior initiation with ENU, resulting in hepatocellular carcinomas in 81 and 32% of the animals, respectively. DCA and TCA also increased the incidence of animals with adenomas and the number of adenomas/animal in those animals that were not initiated with ENU. While 2.5 micrograms/g body wt ENU followed by NaCl in the drinking water resulted in only 5% of the animals with hepatocellular carcinomas, 2.5 micrograms/g body wt ENU followed with 2 or 5 g/liter DCA resulted in a 66 or 78% incidence of carcinoma, respectively, or, followed with 2 or 5 g/liter TCA, resulted in a 48% incidence at either concentration. None of the untreated animals had hepatocellular carcinomas. Therefore our results demonstrate that DCA and TCA are complete hepatocarcinogens in B6C3F1 mice. PMID- 3629595 TI - The effect of di- and trivalent iron on the intestinal absorption of aluminum in rats. AB - The effect of iron (Fe) on the intestinal absorption of aluminum (A1) was studied in an in situ perfusion system of rat small intestine in combination with systemic and portal blood sampling. The gut was perfused with media containing 0.0, 10.0, 15.0, 20.0, and 25.0 mmol/liter Al chloride and 5 mmol/liter Fe(II) or Fe(III) chloride at pH 3.0. Neither luminal disappearance nor intestinal absorption of A1 were affected by Fe(III). Fe(II), however, enhanced luminal disappearance and reduced absorption of Al. PMID- 3629596 TI - Teratogenicity of three polychlorinated dibenzofurans in C57BL/6N mice. AB - Polychlorinated dibenzofurans (PCDFs) are widespread environmental contaminants which have been detected in human tissues and implicated in several poisoning incidents. Their toxic effects are similar to those observed with other related halogenated aromatic hydrocarbons such as TCDD. The teratogenic effects of three PCDFs, 1,2,3,7,8-pentachlorodibenzofuran (1-PeCDF), 2,3,4,7,8 pentachlorodibenzofuran (4-PeCDF), and 1,2,3,4,7,8-hexachlorodibenzofuran (HCDF), were assessed in C57BL/6N mice. Pregnant mice were exposed on Gestation Days 10 13 to 10 ml corn oil/kg containing PCDFs. The dams were killed on Gestation Day 18 and maternal and fetal toxicity were assessed. All three compounds were highly teratogenic, with very steep and parallel dose-response curves for the two diagnostic indicators of dioxin-like teratogenicity, hydronephrosis, and cleft palate. 4-PeCDF was the most teratogenic with an ED50 of 36 micrograms/kg for cleft palate and 7 micrograms/kg for hydronephrosis. 4-PeCDF was approximately 4 times as potent as 1-PeCDF and 10 times as potent as HCDF. The teratogenic responses occurred at a dose below that where any obvious maternal or fetal toxicity was detected. Thus, these three compounds cause teratogenic responses similar to those seen with TCDD but are only 1/10 to 1/100 as potent. PMID- 3629597 TI - Organic aciduria in rats fed high amounts of xylitol or sorbitol. AB - The acidification of urine during polyol feeding was investigated with 27 Long Evans male rats (aged 12 weeks) which were fed a xylitol diet (X), a sorbitol diet (S), or a basal diet for 4 weeks. The amount of polyols in the diet was increased from 5% to the final 20% level within 3 weeks. The polyol-fed animals showed reduced weight gain, lowered urine pH (from 6.5 to 5.6), and a 4-fold increase in the titratable acid excretion. X and S increased the daily urine volumes by 49 and 63%, respectively, but did not affect the wet weight or the pH values of the feces. as chromatographic-mass spectrometric analyses of organic acids revealed highly increased amounts of methylmalonic acid (13- to 20-fold) and 2-oxoglutaric acid (4- to 5-fold) in the urine of polyol-fed rats. The urinary excretion of citric acid and malic acid was also increased significantly (2- to 4-fold). The acidity of urine was not reflected in the blood acid-base balance of the animals. The increases in the levels of urinary organic acids in the polyol-fed rats were explained in terms of impaired mitochondrial oxidation of these acids and of impaired conversion of methylmalonic acid to succinic acid. PMID- 3629598 TI - Metabolic activation of the pesticide azinphos-methyl by perfused mouse livers. AB - Perfusion of mouse livers in situ with the phosphorodithioate pesticide azinphos methyl (O,O-dimethyl S-[4-oxo-1,2,3-benzotriazin-3(4H)-ylmethyl] phosphorodithioate; Guthion) resulted in the appearance of the cholinesterase inhibitor azinphos-methyl oxon in effluent perfusate. Since mouse whole blood did not have the capacity to detoxify this toxic oxon rapidly enough to prevent its passage to extrahepatic tissues in vivo, the liver is likely a major source of azinphos-methyl oxon in the mouse following exposure to azinphos-methyl. Alterations in perfusate flow rates in situ had little effect on the hepatic disposition of azinphos-methyl. Conversely, significant increases in the free fraction of azinphos-methyl in perfusate led to marked changes in hepatic distribution and biotransformation of this pesticide. Phenobarbital pretreatment of mice induced hepatic cytochrome P-450 content, as well as microsomal activation of azinphos-methyl in vitro, yet antagonized the acute toxicity of this pesticide in vivo. Interestingly, perfused livers from phenobarbital pretreated mice produced less azinphos-methyl oxon than perfused livers from saline-pretreated mice, thereby accounting for the antagonism of the acute toxicity of azinphos-methyl afforded by phenobarbital pretreatment. The mechanism of this phenobarbital-dependent decrease in appearance of azinphos-methyl oxon in effluent perfusate is unclear. However, it must be emphasized that the hepatic biotransformation of azinphos-methyl is complex, involving several sequential and simultaneous pathways, all of which could be affected by phenobarbital. The metabolic profile observed in effluent perfusate is the net result of all these pathways operating in the intact liver. PMID- 3629599 TI - Intrinsic metabolic clearance of parathion and paraoxon by livers from fish and rodents. AB - The specific activities of hepatic enzymes involved in both the activation and detoxification of the anticholinesterase insecticide parathion were significantly greater in both rats and mice compared to either fathead minnows or rainbow trout. Whereas the rates of parathion desulfuration and hydrolysis were comparable, the specific activity for paraoxon hydrolysis was approximately threefold greater than its rate of formation for all species except trout. The kinetic data, however, indicate that the significantly greater Km for paraoxon hydrolysis limits its detoxification. Accordingly, the data are consistent with the progressive accumulation of this toxic metabolite in liver tissue incubated in vitro with parathion. The similar Km for parathion desulfuration and hydrolysis by rodents is consistent with the proposed mechanism of catalysis involving a common S-oxide intermediate. Due to the slow rates of enzyme catalysis, reliable kinetic estimates for the hydrolytic reactions were not possible for both species of fish. Assuming comparable Km values for paraoxon hydrolysis in rodents and fish, the net accumulation of paraoxon in tissue water may be quite similar between species and metabolic transformation may not be an important determinant of the species-selective toxicity of parathion. PMID- 3629600 TI - Disposition and excretion of 2,3,4,7,8-pentachlorodibenzofuran in the rat. AB - The disposition of 2,3,4,7,8-pentachlorodibenzofuran (PeCDF), a highly toxic environmental contaminant which accumulates in human tissues, was examined in the male Fischer rat after iv and oral exposure. Greater than 70% of an oral dose of 0.1, 0.5, or 1.0 mumol PeCDF/kg body wt was absorbed by the gastrointestinal system. After either oral or iv administration of 0.1 mumol/kg, the dibenzofuran was rapidly removed from the blood and accumulated in the liver and adipose tissue and to a lesser extent in the skin and muscle. Three days after administration, 70% of the iv dose of PeCDF was found in the liver, 7% in the fat, 1% in the skin, and 0.5% in the muscle. Route of exposure had little effect on tissue distribution. TLC analyses indicated that greater than 99% of the [14C] PeCDF-derived radioactivity which had accumulated in the liver and adipose tissue was unmetabolized PeCDF which was eliminated very slowly (t1/2 = 193 and 69 days, respectively). The whole body half-life calculated from the daily fecal excretion rate was approximately 64 days. Excretion occurred primarily via the feces. No radioactivity was detected in expired air and less than 0.02% was detected in the urine. TLC analysis of fecal extracts indicated greater than 90% of the [14C]PeCDF-derived radioactivity in the feces was polar metabolites of the parent compound. Pretreatment with 500 micrograms PeCDF/kg body wt caused biliary excretion to nearly double. Treatment of bile with beta-glucuronidase or arylsulfatase had little effect on the chromatographic profile. Therefore, PeCDF was readily absorbed from the gastrointestinal tract, concentrated primarily in the liver, and was slowly eliminated from the body as polar metabolites. The long half-life and high body burden of PeCDF suggest that the toxicity of this chemical may be enhanced due to bioaccumulation upon chronic low-level exposure. PMID- 3629601 TI - Cross talk between intraspinal elements during progression of IDPN neuropathy. AB - Unusual electrical interactions between neuronal elements of cat spinal cord were examined during the evolution (7-70 days) of proximal paranodally demyelinated axonal enlargements in alpha motor axons induced by beta, beta' iminodipropionitrile (IDPN) treatment, 50 mg/kg ip, once weekly for up to 5 weeks. The electrical cross talk was observed as early as 7 days of the neuropathy, at which time it occurred in 17.0% of all motoneuron perikaryal recordings. The incidence was greater at 14 (39.1%) and 35 (26.1%) days, without preferential involvement of any motoneuron type. The frequency of recordings from axonal swellings increased from 7 to 35 days but without an increase in cross talk per recording. At 70 days of the neuropathy, L7 ventral root was stimulated repetitively to examine a possible influence of potassium on cross talk. Subsequently, action potentials could be elicited in motoneurons by stimulation of additional other ventral root filaments. These studies are in agreement with the lack of direct electrical apposition between excitable membranes in IDPN neuropathy but suggest support for a role for an accumulation of extracellular potassium, due to paranodal demyelination as the axon enlarges, in the pathogenesis of these aberrant electrical interactions. PMID- 3629602 TI - Differential patterns of injury to the proximal tubule of renal cortical slices following in vitro exposure to mercuric chloride, potassium dichromate, or hypoxic conditions. AB - The innate susceptibility of renal cell types to these agents was investigated using precision-cut rabbit renal cortical slices made perpendicular to the cortical-papillary axis. Slices were incubated in DME/F12 medium containing 10 microM, 100 microM, or 1 mM concentrations of either metal for 12 hr or in Krebs Hepes buffer gassed with nitrogen (100%) for 0.75 to 5 hr of hypoxic exposure. To simulate postischemic reperfusion, some slices were transferred to vessels gassed with oxygen after an initial hypoxic period. Mercuric chloride (100 microM) exposure resulted in damage to the straight regions of proximal tubules by 12 hr leaving convoluted regions unaffected. Hypoxia (2.25 hr) and potassium dichromate (100 microM for 12 hr) both caused injury to the convoluted proximal tubules without affecting straight proximal tubular regions. Mercury concentrations of 10 microM and 1 mM had no effect or injured all cell types within the slice, respectively. Similar results were observed for hypoxic periods less than 1.5 hr or greater than 3 hr of exposure. Potassium dichromate had no measurable affect at 10 microM, but at 1 mM focal lesions were observed after 4 hr of exposure, and by 12 hr all cell types within the slice were affected. Intracellular potassium content normalized to DNA correlated well, but always preceded the pathological lesions observed. These results demonstrate that injury to specific regions of the proximal tubule by these agents relates to an innate susceptibility of the intoxicated cell type independent of physiologic feedback or blood delivery patterns proposed as mechanisms of selective injury from in vivo studies. PMID- 3629603 TI - Alteration of mitochondrial structure and heme biosynthetic parameters in liver and kidney cells by bismuth. AB - Ultrastructural and biochemical studies were conducted to evaluate the effects of bismuth, a potentially toxic group V trace metal, on organelle structure and heme biosynthetic parameters in rat liver and kidney cells. Bismuth subnitrate (BiONO3) was administered subcutaneously to male rats in 0, 20, 40, or 80 mg/kg doses 16 hr prior to euthanasia. Electron microscopy revealed swollen mitochondria and distortion of mitochondrial inner membranes in liver and renal proximal tubule cells at 40 and 80 mg/kg dose levels. In liver, dose-related decreases were observed in the activities of the mitochondrial enzymes, delta aminolevulinic acid (ALA) synthetase and heme synthetase, and of the cytoplasmic enzyme, ALA dehydratase, to 51, 48, and 35% of levels seen in untreated controls, respectively. In kidney, ALA synthetase and ALA dehydratase, but not heme synthetase, were depressed in vivo to 32 and 20% of control, respectively. Studies in vitro conducted for 1-hr periods with Bi concentrations at 0, 0.1, 0.2, or 0.4 mM in reaction mixtures revealed that the direct action of the metal on membranal enzymes only partially accounts for the impairment of the activity of membranal enzymes. These studies demonstrate that the initial acute effects of bismuth in liver and kidney cells include distortion of mitochondrial membranes and direct inhibition of specific heme pathway enzymes. Both effects contribute to compromise of membrane-associated enzymatic functions. These findings are comparable to those previously reported of other trace metals with known toxicologic potential and may represent early events in bismuth-induced cell injury. PMID- 3629604 TI - Adult peripheral lung organ culture--a model for respiratory tract toxicology. AB - This report describes procedures to culture 1- to 2-mm-thick cross sections of lung lobes for periods of 4 to 6 weeks. Normal morphologic and macromolecular composition are maintained. Previous attempts to maintain adult peripheral lung cultures for periods beyond 7-10 days or to examine respiratory disorders in vitro other than acute changes have been generally unsuccessful. Eight different, supplemented, serum-free media, mixed with heated liquid agarose were infused into the airways of hamster and rat lungs. Cross sections were explanted onto squares of porous surgical packing material, placed in medium, and incubated for 4 to 6 weeks. The ability of each medium to maintain normal lung was assessed microscopically by quantitative image analysis and by biochemical analyses. The optimal medium formulation for each species is described. The adult peripheral lung culture system may provide toxicologists with a unique model for mechanistic and safety evaluations of potential lung toxicants. PMID- 3629605 TI - Reproductive tract defects induced in adult male rats by postnatal 1,2-dibromo-3 chloropropane exposure. AB - The reproductive tract of the male rat may be particularly susceptible to chemical injury during the early postnatal period since significant developmental changes occur in the tract at that time. The subcutaneous administration of relatively low doses of 1,2-dibromo-3-chloropropane (DBCP, 5-20 mg/kg) on alternate days, from 2 to 20 days of life, resulted in a marked dose-related reduction in the testis, epididymis, and seminal vesicle weights. Histological evaluation revealed degenerative cellular changes in the testes of the 5 mg/kg treated group and obliteration of the seminiferous tubules in the 10 mg/kg treated animals. Biochemical studies showed that the in vitro androgen production capacity per unit weight of testicular tissue was elevated, as a function of the DBCP dose, correlating with the apparent increases in the Leydig cell concentrations observed histologically in the treated animals. Due to the marked reduction in the testes weight of DBCP-treated animals, the in vitro testicular androgen production rate, when expressed on the basis of testes pair weight, was reduced; it was consistent with the observed DBCP-induced decrease in serum androgen levels. Early DBCP exposure also obliterated the androgen responsiveness of the seminal vesicle and epididymis in the adult rat, which may also contribute to the diminution in the weights of these androgen-dependent organs. The present study also indicated that immature rats were more susceptible than sexually matured male rats to DBCP toxicity. Moreover, the results of the critical period study indicated that the first 10 days of life are of particular importance in the reproductive tract toxicity of DBCP. PMID- 3629606 TI - Bronchoalveolar lavage in rats and mice following beryllium sulfate inhalation. AB - The effects of lung injury in rats and mice exposed to an aerosol of beryllium sulfate for 1 hr through nose-only inhalation were evaluated by the method of bronchoalveolar lavage. The lavage fluid of rats exposed to an aerosol of either 3.3 or 7.0 micrograms Be/liter over a 21-day period following exposure indicated lactate dehydrogenase (LDH) and alkaline phosphatase (Alk Pase) activities to be the most sensitive indicators of lung damage. LDH activity peaked at 8 days postexposure while Alk Pase activity was maximum at Day 5. Both values were 30 times greater than comparable controls at these time points. Acid phosphatase activity and albumin levels also increased over the 21-day period, but not to the same extent. The lung lavage of mice exposed to 7.2 micrograms Be/liter showed LDH activity as the most sensitive indicator of lung damage with a maximum response three times greater than that of controls at Day 5. PMID- 3629607 TI - Methoxychlor affects the decidual cell response of the uterus but not other progestational parameters in female rats. AB - The pesticide methoxychlor (MXC) is a proestrogen which is metabolized to a compound that has been shown to exhibit estrogenic activity in vivo and in vitro. Following long-term exposure of female rats to MXC, fertility is reduced and fetotoxicity is evident. However, the effects of MXC on several aspects of maternal reproductive physiology, including the decidual cell response (DCR), ovarian weight, serum progesterone levels, and corpora lutea maintenance, have not been previously described. In the present study, the ability of MXC to interfere with progestational events essential for implantation and the maintenance of pregnancy in the rat was investigated. MXC was administered to pseudopregnant rats, decidualization was induced on Day 4, and the DCR and related parameters were evaluated following euthanasia on Day 9. DCR induction during estrone administration served as a positive control. MXC inhibited decidualization in a dose-dependent manner: while 100 mg/kg/day had no effect, doses of 200, 300, 400, and 500 mg/kg/day produced incremental inhibition of the response. No effects of MXC on ovarian weight, serum progesterone levels, or number of corpora lutea were observed. Estrone also inhibited the DCR in a dose dependent manner. The data suggest that the anti-fertility effect of MXC is mediated by a suppression of decidualization and that such suppression, which is characteristic of estrogenic compounds, is a direct uterine effect. In the DCR model system, the estrogenic activity of MXC is 1/20,000 times the activity of estrone. PMID- 3629608 TI - Role of inflammatory cells in the metabolic activation of polycyclic aromatic hydrocarbons in mouse skin. AB - Oxidants, such as those generated by activated polymorphonuclear leukocytes (PMNs) during inflammation, have been implicated in the metabolic activation of procarcinogens to their ultimate carcinogenic form. In this study we examined the effect of inflammation on the metabolic activation of (+/-)-trans-7,8-dihydroxy 7,8-dihydrobenzo[a]pyrene (BP 7,8-dihydrodiol) to a covalent binding species in mouse epidermis. Interaction of BP 7,8-dihydrodiol with 12-O-tetradecanoylphorbol 13-acetate (TPA)-stimulated murine leukocytes resulted in the generation of both a chemiluminescent intermediate and one that covalently bound to the DNA of cocultured epidermal keratinocytes. Topical treatment of mouse skin with TPA led to an influx of PMNs into the skin beginning several hours after application. Myeloperoxidase activity, a marker for neutrophils, increased 15-fold in the skin by 16 hr after TPA treatment. Dual applications of TPA at both 16 hr before and concurrently with administration of [3H]BP 7,8-dihydrodiol led to a 50% enhancement of the level of carcinogen that was covalently bound to epidermal DNA. However, a single application of TPA, either 16 hr before or concurrently with BP 7,8-dihydrodiol administration, had no enhancing effect, suggesting that both initial recruitment of PMNs into the skin and subsequent stimulation of oxidant production by the PMNs were required to enhance carcinogen binding. By contrast, no enhancement of benzo[a]pyrene binding was observed by TPA treatments in vivo. However, TPA-stimulated neutrophils did not activate this procarcinogen to a chemiluminescent metabolite in vitro. These results suggest that oxidants generated by metabolically stimulated PMNs can activate penultimate polycyclic aromatic hydrocarbons, such as BP 7,8-dihydrodiol, to potentially genotoxic metabolites in vivo and further define a role for inflammation in carcinogenesis. PMID- 3629609 TI - Monoclonal antibodies for dioxin: antibody characterization and assay development. AB - A set of 5 anti-dioxin monoclonal antibodies (mAbs), named DD-1, DD-3, DD-4, DD-5 and DD-6, have been isolated. In order to evaluate the ability of these mAbs to recognize various kinds of polychlorinated dibenzodioxins and dibenzofurans, a competition enzyme-linked immunosorbtion assay (ELISA) was developed. All 5 antibodies recognize tetrachloro- and pentachloro-dibenzodioxins and dibenzofurans. They fail to bind either non-chlorinated, mono-, hexa-, or octa chlorinated dibenzodioxins, nor do they recognize non-chlorinated, octachloro- or 1,2,3,4,8,9-hexachloro-dibenzofurans. Chlorine substitution on both rings appears necessary for antibody recognition. In the course of our experiments, 3 of the mAbs did not recognize any of the polychlorinated biphenyls (PCBs) tested, while 2 mAbs (DD-1 and DD-6) weakly recognized the 3,3',4,4'-tetrachloro congener. DD-4 and DD-5 are the most specific of the antibodies for the dibenzodioxin and dibenzofuran structure. They do not recognize any of a panel of chlorinated phenols, benzenes, or pesticides. Significantly, these antibodies do not react with PCBs, pentachlorophenol, 2,4-dichlorophenoxyacetic acid, trichlorophenol, or 2,4,5-trichlorophenoxyacetic acid (the latter is weakly recognized by DD-6), any or all of which might be present in large quantities in some dioxin-contaminated samples. Finally, the competition ELISA is able to easily detect 0.5 ng of the most toxic dioxin congener, 2,3,7,8-tetrachlorodibenzo-p-dioxin. It should thus prove useful as an environmental screen for contamination. PMID- 3629610 TI - Developmental toxicity of diacetoxyscirpenol in the mouse. AB - Mycotoxins (frequently referred to as secondary metabolites of toxigenic fungi) are commonly found in foodstuffs and are important because of their association with disease. The mycotoxin diacetoxyscirpenol, or 3-hydroxy-4,15-diacetoxy-12,13 epoxytrichothec-9-ene (DAS), is produced by numerous species of Fusarium and is reportedly toxic to humans and animals. The teratogenic potential of DAS was determined in time-mated ICR mice. DAS (dissolved in a 1:9 mixture of propylene glycol/saline) was administered intraperitoneally to pregnant mice at levels of 1.0, 1.5, 2.0, 3.0 and 6.0 mg/kg body weight in a single dose on one of gestation days 7-11 during the period of organogenesis. Term fetuses were examined for anomalies by routine teratologic procedures. Reabsorption frequency was dose related and occurred as follows: 100% at 6.0 mg/kg on all gestation days tested; 90-99% at 3.0 mg/kg on days 7-9 and 100% on days 10 and 11; 26-51% at 2.0 mg/kg on days 7-9 and 100% on days 10 and 11; 9-77% at 1.5 mg/kg on days 7-10 and 100% on day 11; 7-34% at 1.0 mg/kg on days 7-11. A significant reduction in mean fetal body weight and a variety of fetal malformations (i.e. external and skeletal) were observed following maternal exposure to DAS. This is the first report to implicate this mycotoxin as a teratogen. PMID- 3629611 TI - Effect of microsomal enzyme activity modulation on N-(3,5 dichlorophenyl)succinimide-induced nephrotoxicity. AB - N-(3,5-Dichlorophenyl)succinimide (NDPS) is an experimental agricultural fungicide which has been shown to be a selective nephrotoxin. The purpose of this study was to determine if a NDPS metabolite contributes to acute NDPS-induced nephrotoxicity. Male Sprague-Dawley or Fischer 344 rats were pretreated with a microsomal enzyme inducer [phenobarbital (PB) or 3-methylcholanthrene (3-MC)] or inhibitor [cobalt chloride (CoCl2) or piperonyl butoxide (PIBX)] followed by a single intraperitoneal injection of NDPS (0.2, 0.4 or 1.0 mmol/kg) or vehicle (sesame oil, 2.5 ml/kg). Renal function was monitored at 24 and 48 h. CoCl2 or PIBX pretreatment reduced NDPS-induced diuresis, proteinuria and hematuria, and reduced the increases seen in the blood urea nitrogen (BUN) concentration and kidney weight. NDPS-induced decreases in organic ion accumulation were not markedly altered by CoCl2 or PIBX pretreatment. PB pretreatment enhanced all NDPS (0.2 mmol/kg) induced renal effects, while 3-MC pretreatment protected against NDPS-induced diuresis, proteinuria, hematuria, and increases in the BUN concentration observed in both rat strains. Kidney weight and organic ion uptake changes were not substantially different between NDPS-treated rats with or without 3-MC pretreatment. It was concluded that a metabolite(s) contributes to or is responsible for acute NDPS-induced nephrotoxicity and that at least 1 toxic metabolite might be of extrarenal origin. PMID- 3629612 TI - Comparison of hexachlorobenzene-induced alterations of microsomal membrane composition and monooxygenase activity in male and female rats. AB - The effect of hexachlorobenzene (HCB) on microsomal cytochromes P-450 and b5, monooxygenase activity and membrane composition was examined in male and female Fischer rats. Cytochrome P-450 was induced more in male than in female animals while cytochrome b5 was induced only in males. Analysis of patterns of induction of microsomal monooxygenases showed that aminopyrine-N-demethylase activity doubled in both sexes after treatment while aryl hydrocarbon hydroxylase activity was 16 times the control value in the females and 1.5 times in the males. After HCB treatment the phospholipid content of microsomal membranes per gram of liver was increased in both sexes while cholesterol was unchanged. Analysis of the phospholipids (PL) pattern showed that the percentage of sphingomyelin (SPH) decreased significantly (50% of the control value) while phosphatidylcholine (PC), phosphatidylinositol (PI) and phosphatidylethanolamine (PE) did not change. These changes resulted in a reduction of membrane microviscosity and indicate that HCB interferes with the biosynthesis of phospholipids containing choline. Free fatty acid (FFA) content also dropped in both sexes but females were more affected; free arachidonic acid rose in females. HCB induction of microsomal cytochromes and monooxygenases is thus accompanied by marked modifications of membrane composition. Comparing the 2 sexes, HCB showed more pronounced features of 'PB type' inducers in males. PMID- 3629613 TI - Cadmium-metallothionein nephrotoxicity in the rat: transient calcuria and proteinuria. AB - After a s.c. injection of 0.4 mg Cd/kg as cadmium-metallothionein (CdMT) in rats, a marked increase in urinary protein concentration appeared at 16-40 h. There was a peak of urinary Cd content during the first 4 h after the treatment. Urinary Ca was increased at 8 h after the CdMT injection and returned to normal level at 32 h. Luminal and basolateral renal membrane vesicles were isolated from both control group and CdMT (0.4 mg Cd/kg) group at 24 h after the injection. Calcium uptake and binding of both fractions were decreased in the group treated with CdMT. Cd, Zn and MT concentrations in the kidney cortex were increased, but Ca concentration was not significantly changed. Since injected CdMT is probably only partly reabsorbed by tubular cells at the dose level of 0.4 mg Cd/kg as CdMT, excessive plasma CdMT is rapidly excreted in urine, explaining the increased Cd excretion during the first few hours observed in the present experiment. Decreased Ca binding in the luminal membranes as observed in vitro could be one of the mechanisms of production of calcuria if occurring in vivo. Another possible explanation of calcuria is that Cd ions released from CdMT into the cytoplasm of the tubular cell, may exert ionic interference with Ca transport across the luminal membranes and produce decreased Ca reabsorption. It is known that a disturbance of Ca metabolism could influence the membrane stability and such a change may contribute to explaining the proteinuria characteristic of CdMT nephrotoxicity. The reversibility of the proteinuria observed after a single dose of CdMT may be related to the induction of metallothionein synthesis in the renal cells. PMID- 3629614 TI - Rapid halogenated hydrocarbon toxicity in isolated hepatocytes is mediated by direct solvent effects. AB - The toxicity of several halogenated and non-halogenated hydrocarbons (CH2Cl2, CHCl3, CCl4, C6H14, C8H10) in isolated rat hepatocytes were compared. Release of aspartate aminotransferase (AST) activity was rapid and concentration-dependent. Fractional AST release plateaued at 10-60 min following hydrocarbon exposure. Enzyme leakage at 60 min correlated with the oil/water partition coefficient (pi) of the compounds. All compounds, except n-hexane, also caused an immediate inhibition of the rate of cellular respiration. Inhibition of cell respiration also correlated with pi and was reversible. The recovery of cellular oxygen consumption was examined in detail for CCl4 and correlated with evaporation of the compound. These data suggest that acute hydrocarbon-induced injury in isolated hepatocytes is mediated by concentration-dependent direct solvent effects. Since halogenated hydrocarbons are widely used to induce general anesthesia, the clinical implications of possible direct effects by halocarbons on liver function in vivo and the potential relationship to liver injury are discussed. PMID- 3629615 TI - Pertussis toxin induces fatty liver, hyperlipemia and ketosis in hamsters. AB - Pertussis toxin markedly affects lipid metabolism in hamsters. The toxin induces a time-dependent and dose-dependent accumulation of triacylglycerols in the liver (fatty liver) and moderate increases in cholesterol and phospholipids. These toxin produced dramatic increases in the amounts of triacylglycerols, free fatty acids and ketone bodies in the serum and small increases in cholesterol and phospholipids. It is suggested that an enhanced and unregulated lipolysis may play a key role in the induction of these alterations by the toxin. PMID- 3629616 TI - Limbic epilepsy induced in the rat by dendrotoxin, a polypeptide isolated from the green mamba (Dendroaspis angusticeps) venom. AB - Dendrotoxin was isolated from green mamba (Dendroaspis angusticeps) venom and its effects on motor behavior and cortical and subcortical bioelectrical activity were studied in the rat. In chronic experiments, free moving rats injected i.p. with dendrotoxin, presented motor behavior similar to that described in rat amygdaloid epilepsy and bioelectrical signs of epilepsy beginning at the amygdala were observed. In acute experiments, rats anaesthetized with urethane were intracerebrally or intracerebroventricularly injected with dendrotoxin, which produced bioelectrical signs of epilepsy. Following intracerebroventricular injection, signs of epileptic discharge were first observed at the dorsal hippocampus. When dendrotoxin was microinjected in the amygdala or the hippocampus, the seizures appeared at the injection sites with a shorter latency and the bioelectrical epileptic signs lasted longer than when injections were given in non-limbic structures, such as the globus pallidus or the mesencephalic reticular formation. Dendrotoxin is a very powerful toxin that acts effectively at the level of the limbic system. PMID- 3629617 TI - Inhibition of protein synthesis by an extract of the venom sac of the oriental hornet (Vespa orientalis). AB - Venom from young and adult hornets inhibit protein synthesis in human lymphocytes and platelets, but does not affect the synthesis of DNA and RNA. The venom activity is decreased by dialysis, and diminished more by boiling. PMID- 3629618 TI - Amino acid sequences of myotoxins from Crotalus viridis concolor venom. AB - Myotoxins I and II were isolated from the venom of Crotalus viridis concolor. Complete sequences were derived for each reduced, alkylated toxin with data obtained by a single run on a gas phase sequencer and from fragments derived by cyanogen bromide cleavage. The results demonstrate that microheterogeneity is present in myotoxin II. The newly established sequences were compared with 3447 protein sequences in the Protein Information Resource database. The only homologous proteins found were other known myotoxins from rattlesnake venoms, namely myotoxin a, crotamine and peptide C. PMID- 3629619 TI - Depolarization of skeletal muscle cells in culture by a cardiotoxin-like basic polypeptide from the venom of the Taiwan cobra (naja naja atra). AB - A cardiotoxin-like basic polypeptide from the venom of Naja naja atra is homologous to cardiotoxins from the same venom, but much less toxic. To determine if it acts like the cardiotoxins its depolarizing ability was measured. It was about 10 times less potent than the cardiotoxins. Five amino acids are conserved in the sequences studied, on the exposed second and third loops of the toxin backbone. They may be part of the toxins' interactive site. PMID- 3629620 TI - Purification of three antihemorrhagic factors from the serum of a mongoose (Herpestes edwardsii). AB - Three antihemorrhagic factors (AHF-1, AHF-2 and AHF-3) were purified from the serum of H. edwardsii, a mongoose, by a combination of gel filtration on a Sephadex G-200 column and high performance liquid chromatography with a TSK gel DEAE-5PW column. Each of the purified antihemorrhagic factors showed a single band on polyacrylamide gel disc electrophoresis. The three antihemorrhagic factors inhibited the hemorrhagic activity of HR 1 and HR 2, the hemorrhagic principles from the snake venom of Trimeresurus flavoviridis Okinawa. AHF-1, AHF 2 and AHF-3 were stable at temperatures from 0 degrees to 60 degrees C and at pH values between 2.0 and 11.0. The same molecular weight (65,000) was obtained for the three antihemorrhagic factors. No precipitin lines were found for the purified antihemorrhagic factors with the venom of T. flavoviridis Okinawa and its hemorrhagic principles, HR 1 and HR 2. PMID- 3629621 TI - Immunosuppression in mice after inhalation of cadmium aerosol. AB - Aerosol cadmium (CdCl2) exposure of female C57Bl/6 mice was performed to assess the in vivo effects of cadmium on the cellular and humoral immune responses of splenic lymphocytes. Primary cellular and humoral responses of lymphocytes were examined at 5-18 days after a single, 60 min exposure to 0.88 mg Cd/m3 (MMAD = 0.7 +/- 0.3 micron, sigma g = 3.43). Significant decrease of in vitro lymphoproliferative response to allogeneic antigens, LPS and PHA antigens, and inhibition of the primary IgM response to sheep erythrocytes were correlated with a marked decrease in spleen cell viability at 5-8 days after aerosol cadmium exposure. This type of cadmium-induced immunosuppression, which correlated with the direct cytotoxicity of effector cells, appeared to be different from the chronic, oral cadmium-induced suppression of the primary IgM response, in which acute cytotoxicity of the spleen cell population was not observed. PMID- 3629622 TI - Toxicological evaluation of substituted dicyclopentadienyliron (ferrocene) compounds. AB - The acute toxicity of 3 substituted ferrocenes: acetylferrocene, ethylferrocene, and 2,2-bis(ethylferrocenyl)propane (Catocene) were studied in rats, rabbits and monkeys. Acetylferrocene was found to be the most toxic. The oral lethal dose was less than 5 mg/kg for female rats, between 5 and 50 mg/kg for male rats, and between 10 and 100 mg/kg for monkeys. The toxicity of acetylferrocene appeared to be delayed, with most mortality occurring on the third day after dosing. Acetylferrocene was also highly toxic by skin or eye exposure. Gross pathological examination revealed signs of pneumonopathy in both the rats and monkeys. The mechanism by which monkeys are less susceptible than rats to the toxicity of acetylferrocene is not clear. PMID- 3629623 TI - Embryotoxic evaluation of a Prudhoe Bay crude oil in rats. AB - The embryotoxic potential of a Prudhoe Bay crude oil (PBCO) was investigated in rats. PBCO was administered orally to pregnant rats as (i) a single dose on various gestation days, (ii) a single variable dose on gestation day 6, or (iii) as daily doses from day 6 to day 17 of pregnancy. PBCO administered during the earlier stages of pregnancy (day 3, 6 or 11) but not during the later stages, affected the reproductive performance of pregnant rats by significantly increasing the number of resorptions including fetal death and by decreasing the fetal weight. A dose-dependent increase in fetomortality was also observed. Multiple exposure to low levels of crude oil also caused a significant reduction in maternal body weight besides other embryotoxic changes. PMID- 3629624 TI - Interaction of di- and tributyltin chloride with human erythrocyte membrane. AB - Analysis of the binding of tributyltin chloride (TBT) to human erythrocyte membrane indicated a single class of binding site with an affinity of approximately 6.78 X 10(3) M-1, whereas dibutyltin dichloride (DBT) showed the presence of more than one class of binding sites with a high affinity value of 2.53 X 10(4) M-1 and a low affinity value of 2.06 X 10(3) M-1. Membrane protein binding studies revealed that both di- and tributyltin compounds bind significantly with band 3 protein of the erythrocyte membrane. These results indicate the significant interactions of erythrocyte membrane components with alkyltin compounds. PMID- 3629625 TI - Binding of formaldehyde to human and rat nasal mucus and bovine serum albumin. AB - The function of the nasal mucociliary apparatus, an important airway defense mechanism, is inhibited by inhaled formaldehyde. Nasal mucus, which contains significant concentrations of glycoprotein and soluble proteins, is an integral component of this system. This investigation addresses some reactions of formaldehyde with human and rat mucus in vitro in comparison with a model protein, bovine serum albumin. [14C]Formaldehyde was incubated with reconstituted preparations of human and rat nasal mucus or bovine serum albumin. Formaldehyde adducts, stabilized by sodium cyanoborohydride reduction to methylamines, were separated by Sepharose 2B gel filtration. [14C]Formaldehyde bound exclusively to one component of nasal mucus which had an elution volume identical to that of albumin. There was no detectable binding to the large molecular weight glycoproteins. The time course of reaction of formaldehyde to free amino groups was then measured using the fluorescamine technique. Formaldehyde binding was characterized by an initial fast phase (less than 2 min) followed by a slower phase which appeared to approach equilibrium (greater than 60 min). The rate of binding to human and rat nasal mucus was similar to albumin. Irreversible binding of formaldehyde to albumin was insignificant within the first 60 min indicating the reversibility of binding during this time. These data indicate that within the first 60 min, formaldehyde reacts rapidly and reversibly with nasal mucus and that it binds primarily to one component of nasal mucus. Gel filtration analysis suggests this component may be albumin although other low molecular weight proteins cannot be ruled out. PMID- 3629626 TI - Deficiency of selenium intake enhances manifestation of renal toxicity of cis diamminedichloroplatinum in mice. AB - The effect of the dietary level of selenium on lethal and renal toxicity of cis diamminedichloroplatinum (cis-DDP) was investigated using mice fed diets containing 4 different concentrations of selenium (0.009, 0.1, 0.4 or 1.0 ppm) for 6 weeks starting at 4 weeks of age. The groups of mice fed the diets containing 0.009 and 0.1 ppm of selenium showed higher sensitivity to the lethal toxicity caused by a single subcutaneous administration of cis-DDP (32 mumol/kg) than the other groups. The renal toxicity of cis-DDP, indicated by increases in blood urea nitrogen (BUN), serum creatinine and urinary activity of N acetylglucosaminidase (NAG), was significantly enhanced by a decrease in dietary selenium level. These results suggest that the dietary level of selenium affects the manifestation of lethal and renal toxicity of cis-DDP. PMID- 3629627 TI - Acetone effects on N-(3,5-dichlorophenyl)succinimide-induced nephrotoxicity. AB - Acetone has been shown to potentiate the toxicity of many halogenated hydrocarbons. The purpose of this study was to determine if acetone could alter the acute nephrotoxicity produced by the experimental fungicide N-(3,5 dichlorophenyl)succinimide (NDPS). Male Fischer 344 rats were administered acetone (1, 5 or 10 mmol/kg) or acetone vehicle (corn oil, 10 mg/kg) orally followed 16 h later by a single intraperitoneal injection of NDPS (0.2 or 0.4 mmol/kg) or NDPS vehicle (sesame oil, 2.5 ml/kg) and renal function was monitored at 24 and 48 h. Acetone (1 or 5 mmol/kg) did not alter NDPS (0.2 mmol/kg)-induced renal effects while acetone (10 mmol/kg) pretreatment attenuated NDPS (0.4 mmol/kg)-induced increases in blood urea nitrogen (BUN) concentration and kidney weight but had no effect on NDPS (0.4 mol/kg)-induced changes in urine volume or content, organic ion accumulation by renal cortical slices or renal morphology. These results suggest that acetone weakly attenuates NDPS-induced nephrotoxicity. PMID- 3629628 TI - Acute and subchronic toxicology of LY-195115 in rats and dogs. AB - LY-195115 is a new (investigational) inotropic agent. When given orally to either young adult rats or mice, single doses of 2500 or 5000 mg/kg were tolerated with minimal lethality. Clinical signs included muscle weakness, hypoactivity, and evidence of hemorrhage. Dogs and monkeys survived a single oral dose of 10 and 5 mg/kg, respectively; however, there was sinus tachycardia for 6-8 h post dose in both species. Rats (20/sex/group) were fed diets containing LY-195115 in concentrations of 0, 0.005, 0.025, or 0.1% for 3 months. The average daily intake of the compound was approximately 0, 3.5, 17, or 70 mg/kg in both sexes. Deaths occurred only in the high-dose group. Body weight gain, food consumption, and efficiency of food utilization were significantly reduced in males in the 0.1% dose group and animals of both sexes in this group had changes in hematology, clinical chemistry, and urinalysis parameters indicative of renal damage. Crystals containing LY-195115 were present in the urine of animals from the 0.025% and 0.1% treatment groups. Secondary hydronephrosis due to kidney stone formation was observed on gross and microscopic pathologic evaluation in the males of the 0.025% group and animals of both sexes in the 0.1% group. In addition, periarteritis was present in the adventitia and muscularis of small and medium-sized arteries in the pancreas, lymph node, kidney, and stomach of some animals in all LY-195115 treatment groups. No overt signs of toxicity were produced in beagle dogs (4/sex/group) given daily oral doses of 0.03, 0.12, or 0.5 mg/kg of LY-195115 for 3 months. The only adverse effect was the occurrence of focal subendocardial fibroplasia in the heart in 2 high-dose male dogs. Thus, subchronic exposure of rats to doses of LY-195115 as high as 70 mg/kg produced minimal mortality, renal toxicity, and mild, limited vascular changes, while dogs tolerated doses up to 0.5 mg/kg with no evidence of any effect of treatment except minimal histological changes in the heart consequent to the expected cardiotonic action of the compound. PMID- 3629629 TI - Regeneration of the sciatic nerve in mice and rats exposed to trichloroethylene. AB - The effects of trichloroethylene (TCE) on regeneration of the sciatic nerve after a crush lesion was tested in mice and rats. A lesion was made on nerves in unexposed animals and in animals pre-exposed to TCE for 20 days. Experimental animals were then exposed to TCE for an additional 4 days. Exposures were continuous at 150 or 300 ppm. Regeneration was measured by pinching the outgrowing nerve fibers. Regeneration was retarded in the TCE-exposed animals compared to the air-exposed controls. Mice were more sensitive to TCE exposure than rats. Liver weight increased in TCE-exposed mice but there was no correlation between this effect and that on nerve regeneration. PMID- 3629630 TI - A head-only exposure system for controlled exposures of small rodents. AB - We have designed a low-cost, compact, head-only exposure system which is easy to use and allows exposure of up to 8 or 16 small rodents depending on the chamber used with the system. Animals are exposed without anesthesia or extreme restraint. Deflection tubes at the chamber inlet and outlet serve to provide turbulent flow within the chamber. Performance of the exposure system was evaluated by analyzing data which was collected during investigations of the kinetics of respirable nickel chloride (NiCl2) and cobalt chloride (CoCl2) aerosols in Sprague-Dawley rats. Acute 2 h exposure to NiCl2 at concentrations ranging from 129 to 1208 micrograms Ni/m3 (MMAD 0.7-0.9 micron, sigma g 1.2-1.5) had a mean run-to-run coefficient of variation (cv) in chamber concentration of 11.6%, and a mean within-run cv of 8.5%. A 26-day repeated exposure of 3 groups of rats to 18.4 micrograms Ni/m3 gave a mean run-to-run cv of 20.9%, mean within run cv of 10.2%, and within-day cv of 14.5%. Acute exposure studies with CoCl2 at concentrations ranging from 298 to 1371 micrograms Co/m3 (MMAD 0.9, sigma g 1.4) produced a mean run-to-run cv of 8.4% and a mean within-run cv of 7.8%. The repeated exposure of 2 groups of rats for 5 days to CoCl2 at a concentration of 583 micrograms Co/m3 had a mean run-to-run cv of 10.1%, a within-run cv of 7.4% and a within-day cv of 6.8%. The distribution of aerosol within the chamber is shown to have been uniform, and chamber performance was linear over the range tested. This system provides an inexpensive and uniform means of conducting inhalation exposure studies with selected airborne contaminants that might represent a potential health hazard. PMID- 3629631 TI - Effect of length of exposure to malathion on xenobiotic biotransformation in male rat liver. AB - The effect of exposure to malathion on several parameters of hepatic xenobiotic biotransformation was studied in male Sprague-Dawley rats. Groups of rats dosed i.p. daily for 1 or 2 weeks with 40 or 200 mg/kg malathion showed an increase in epoxide hydrolase activity (1 week, 200 mg/kg) and glutathione S-transferase activity (1 week, 200 mg/kg; 2 weeks 40 and 200 mg/kg). Aldrin epoxidation was decreased after 1 week of exposure to 200 mg/kg and by both dosage regimens after 2 weeks. After 9 weeks exposure to 40 mg/kg malathion administered i.p. 3 times per week, however, no changes in hepatic xenobiotic biotransformation were noted. The results demonstrate that only continuous exposure to high doses of malathion results in an induction of epoxide hydrolase and glutathione S-transferase activities. Inductive effects on hepatic cytochrome P-450 monooxygenase activity were not observed irrespective of whether exposure was short- or medium-term. PMID- 3629632 TI - Pharmacokinetic modeling of the lung burden from repeated inhalation of nickel aerosols. AB - The saturable nature of the clearance of soluble nickel compounds from the lung was studied by repeated exposures of rats to respirable submicron-size nickel aerosols. Using Michaelis-Menten type kinetics for removal of nickel lung burdens and a constant rate of deposition, the lung nickel burdens were simulated by computer. The computer simulation was used to design a repeated exposure regimen to test further the hypothesis of saturable clearance. Male Sprague-Dawley rats were exposed for 2 h/day to nickel chloride aerosols at either 90 or 400 micrograms Ni/m3 for up to 14 days. During the 22 h between exposures and up to 3 days post-exposure rats were kept in clean air. The particle size of the aerosol ranged from 0.7 to 0.9 micron mass median aerodynamic diameter with a geometric standard deviation of 1.2-1.4. A steady-state nickel lung burden was observed at 90 micrograms/m3, as predicted from computer modeling, while lung burdens continued to increase with repeated exposure to 400 micrograms Ni/m3. The best fit for the experimental data was obtained with a maximum clearance velocity (Vmax) of 34.6 ng Ni/g X h and a Michaelis-Menten constant for transport (Kt) of 1380 ng Ni/g. The percentage of submicron nickel chloride aerosols retained in the lung was 6.9%. These data support the hypothesis of a saturable clearance mechanism for soluble nickel and provide physiological constants useful for estimating human health risks from nickel inhalation. PMID- 3629633 TI - Surfactant-induced opacity of bovine isolated cornea: an epithelial phenomenon? AB - Incubation of isolated bovine cornea with the surfactants lauryl trimethylammonium bromide (LTAB), sodium lauryl sulphate (NaLS) or Tween 20 in contact only with the epithelium side (outside) of the cornea produced dose related development of opacity. The order of efficacy was LTAB greater than NaLS greater than Tween 20. After incubation and opacity reading the epithelium was surgically removed and the opacity of the remaining de-epithelialized cornea (stroma and endothelium) measured. The results indicate that the surfactants caused opacity predominantly by affecting the epithelium which itself became opaque. PMID- 3629634 TI - Metabolism of caffeine to 6-amino-5-[N-methylformylamino]-1,3-dimethyluracil in the isolated, perfused liver from control or phenobarbital-, beta-naphthoflavone- and 3-methylcholanthrene-pretreated rats. AB - Caffeine metabolism to 6-amino-5-[N-methylformylamino]-1,3-dimethyluracil was studied in the isolated, perfused rat liver. The [2-14C]-labelled drug and metabolites were separated by thin-layer chromatography or high-pressure liquid chromatography. The chemical structure of 6-amino-5-[N-methylformylamino]-1,3 dimethyluracil was confirmed by mass spectrometry and it was quantitatively determined by liquid scintillation counting. 6-Amino-5-[N-methylformylamino]-1,3 dimethyluracil is one of the major metabolites of caffeine found in the perfusion medium. The kinetics of caffeine elimination and of the uracil metabolite formation were studied up to 2 h perfusion time using livers from control rats and rats pretreated with phenobarbital, beta-naphthoflavone or 3 methylcholanthrene. Phenobarbital pretreatment did not modify the rate of caffeine elimination or the extent of 6-amino-5-[N-methylformylamino]-1,3 dimethyluracil formation. In contrast, there was a highly significant inducing effect on both drug elimination and formation of the uracil metabolite in perfusions of livers from beta-naphthoflavone- and 3-methylcholanthrene pretreated animals. PMID- 3629635 TI - The effect of chromate on citrinin-induced renal dysfunction in the rat. AB - Previous studies in this laboratory revealed an effect of chromate to potentiate the nephrotoxic effects of mercuric ion. Citrinin, an organic anion, is a known nephrotoxin. The present study was undertaken to assess the possible interaction of chromate and citrinin on renal function. Male Sprague-Dawley rats were housed in metabolism cages and injected with citrinin (35 mg/kg), chromate (10 mg/kg) or the combination. The combination of nephrotoxicants caused an increased excretion of urine greater than the sum of the individual responses. A similar response was observed with urinary glucose concentrations and glucose excretion without changes in blood glucose levels. These data indicate that chromate can potentiate the nephrotoxic action of citrinin in the rat. PMID- 3629636 TI - Effects of benzimidazoles on mouse and rat limb bud cells in culture. AB - Benzimidazoles exhibited an inhibitory action on the chondrogenesis in a mouse limb bud cell culture system; further, nitro and chloro groups at the 5 position in 2-(2-pyridyl)benzimidazole were found to be potent substituents. However, 2-(2 pyridyl)benzoxazole and 5-methoxy-2-(2-pyridyl)benzothiazole exhibited no inhibitory action under our experimental conditions. Thus, imidazole NH proton seemed to be important in the inhibitory action in the mouse cell system. The concentrations of thiabendazole (TBZ), 5-hydroxy-TBZ (5-HY-TBZ) and N-methyl-TBZ necessary to reduce the amounts of cartilage proteoglycan by 50% (TP50) were estimated to be about 0.35, 0.25 and 0.70 mM, respectively, in the rat limb bud cell culture system. The TP50 of TBZ and 5-HY-TBZ in the rat cell system were 3- to 4-fold higher than those in the mouse cell system. PMID- 3629638 TI - Declining morbidity and mortality of carotid endarterectomy. The Wake Forest University Medical Center experience. AB - The 30-day mortality as well as morbidity for stroke and myocardial infarction were determined by review of the charts for every carotid endarterectomy (N = 389 operations on 356 patients) performed at Wake Forest University Medical Center from 1979 through 1983 to ascertain whether the 16% morbidity and 6% mortality documented in our previous report of 1978 had changed over time. For endarterectomies performed on asymptomatic patients (n = 155), major morbidity included 2 myocardial infarctions and 1 stroke (1.9%). There were 3 fatalities--2 myocardial infarctions and 1 stroke (1.9%). For the symptomatic group (n = 234), major morbidity was 2.1%, mortality 2.6%. The combined morbidity for asymptomatic and symptomatic carotid stenosis was 2%, mortality 2.3%. Perioperative stroke rate (morbidity plus mortality) was 2.6%, 9 ipsilateral to the carotid endarterectomy, suggesting distal embolism as its probable cause. We contend that quality control measures implemented to correct the unacceptable rates reported in 1978 have contributed to dramatic and sustained reductions in complication rates. PMID- 3629637 TI - The use of slotted grids for electron microscopic radioautography. AB - A method for electron microscopic radioautography on slotted grids is presented which allows examination of the distribution of silver grains over sections of entire structural units without interference by grid bars. Tissue sections of a size such as to fit the opening of the grid slot are placed on slides coated with a Formvar film of sufficient strength to permit transfer of the completed radioautograph onto the grid and to support it over the slot. Sections are block stained prior to radioautography to minimize the risk of loss of the radioautograph during the procedure. PMID- 3629639 TI - Disability and use of rehabilitation services following stroke in Rochester, Minnesota, 1975-1979. AB - Medical records of all residents of Rochester, Minnesota, who had a first stroke in 1975-1979 were reviewed to determine level of disability, disposition, and use of rehabilitation services. Of the 292 persons with a first stroke, 251 (86%) (mean age 70 years) survived greater than 1 week. The mean Rankin disability score (Grade 1, no disability, through Grade 5, severe disability) changed from 1.7 before stroke to 2.8 in survivors at hospital discharge; 29% of those discharged required further institutional care. The level of disability in survivors remained relatively constant from 6 months after stroke through 5 years of observation. Of the 112 patients with an admission score of 5, 40 (36%) were alive at 1 year and only 5 of those (13%) improved to relative independence (Rankin scores of 1 or 2). The most common comorbidity contributing to disability was cardiovascular disease (31%). After the first 18 months, the mortality in patients with stroke was similar to that in a normal population having the same age and sex distribution. Of the 251 1-week survivors, 132 (53%) had rehabilitation (physiatrist) evaluations, 127 (51%) received physical therapy, 103 (41%) received occupational therapy, and 33 (13%) received speech therapy. Thirty-four of the 132 patients (26%) referred for rehabilitation evaluations were transferred to the rehabilitation unit. PMID- 3629640 TI - Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years. AB - As part of a prospective study of mood disorders in stroke patients, interviews were obtained from 37 patients at 1 year and 48 patients at 2 years follow-up. In hospital evaluations for these 65 follow-up patients found that 9 patients (14%) had symptom clusters of major depression, 12 patients (18%) had symptom clusters of dysthymic or minor depression, and 44 patients (68%) did not meet the DSM III diagnostic criteria for depression. Although overall prevalence of depression did not change significantly over time, the prognosis for individual patients, depending on diagnostic group, was different. All of the follow-up patients with major depression in-hospital were improved by 2 years, with a significant reduction in their mean depression scores and improvement in their activities of daily living, whereas only 30% of follow-up patients with dysthymic depression improved by this time. There was no significant improvement in their mean depression scores or mean activities of daily living score. Of the patients followed up who were not depressed in-hospital, 34% had developed major or minor depression by 2 years, and their mean depression scores were significantly increased. These data suggest that the prevalence of depression among the follow up patients remains high (between 30 and 40%) for the first 2 years after stroke, but that untreated poststroke major depression has a natural course of about 1-2 years, with associated improvement in activity of daily living scores, whereas the prognosis for poststroke dysthymic depression is frequently unfavorable and often persists for greater than 2 years. PMID- 3629641 TI - Transient cerebral ischemic attacks in a Japanese community, Hisayama, Japan. AB - During a 20-year follow-up of 1,621 men and women aged 40 and over in Hisayama, Japan, 18 were found to have suffered transient cerebral ischemic attacks (TIAs) determined by clinical symptoms based on criteria proposed by the US Joint Committee for Stroke Facilities. The average annual incidence rate for the first TIA was 0.56 per 1,000 residents. Age and high blood pressure were strong determinants of TIAs for men. Nine of the 18 cases with TIAs (50%) subsequently developed cerebral infarction, an incidence significantly higher than that in the 1,603 subjects without TIAs (10.9%). Lacunar infarcts were most commonly found on pathologic examination of patients with TIAs who had had a subsequent stroke. PMID- 3629642 TI - Cerebellar infarction: natural history, prognosis, and pathology. AB - Using clinical and computed tomography (CT) criteria, an analysis of 2,000 consecutive stroke unit patients from 1977 to 1984 revealed 30 patients with cerebellar infarction. The case fatality rate was 23%, higher than for any other location of brain infarction studied over the same period. Death was most often due to concomitant brainstem infarction. Obstructive hydrocephalus occurred in 4 patients (13%), and in 2 cases diagnosis, facilitated by urgent CT scanning, allowed early surgical intervention that was life saving. Patients who survived the acute phase were followed for an average of 21 months, and over that time 22% sustained further brainstem infarction, representing a 13% stroke rate per year. Over the latter 3 years of the clinical study, an autopsy survey revealed 11 cases of cerebellar infarction that had been clinically unrecognized. None of these died as a direct result of their infarction. Mechanisms of infarction inferred from autopsy included in situ thrombosis, embolism, watershed, and lacunar infarction, with in situ thrombosis being the most common. We conclude that the case fatality rate of cerebellar infarction is greater than of any other form of brain infarction, but it may be reduced by prompt recognition of those patients who will benefit from surgical decompression. In survivors, a high risk of subsequent hindbrain stroke exists. More attention needs to be paid to this entity in terms of early diagnosis and prevention of subsequent stroke. PMID- 3629643 TI - Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events. AB - Patient records in 36 consecutively identified patients with typical echocardiographic findings of atrial septal aneurysm were reviewed. Ten of the 36 (28%) had cerebrovascular events. Of these 10, 5 had completed strokes of definite embolic origin on the basis of clinical, angiographic, and computed tomographic findings; 2 had transient ischemic attacks of probable embolic origin. One of the 36 patients had a definite peripheral vascular embolus. Thus, 6 of 36 consecutively identified patients with atrial septal aneurysm (17%) had definite embolic events and 8 of 36 (22%) had definite or possible embolic events. The cause of the association between atrial septal aneurysm and emboli is unknown. While aneurysm-associated thrombus has been suggested, the high proportion (90%) of patients with interatrial shunting demonstrated by contrast echocardiography in this study suggests paradoxical embolization as a potential cause. Whatever its mechanism, the high prevalence of embolic events in this series strongly supports the premise that atrial septal aneurysm is a cardiac abnormality with embolic potential. PMID- 3629644 TI - Middle cerebral artery occlusion: correlation of computed tomography and angiography with clinical outcome. AB - The clinical outcome of 40 cases with middle cerebral artery (MCA) occlusion was examined in relation to the site of occlusion and the findings on computed tomography (CT). Patients were treated conservatively without surgery. A few had decompressive craniotomy when necessary. Outcome in 7 (18%) was good, in 6 (15%) moderate, and in 15 (38%) severe; 12 (30%) died by the follow-up at 3 months. In cases with occlusion at the origin of the MCA, hypodensity on CT scan was usually localized to the basal ganglia, presumably because of collateral circulation through the anterior cerebral arteries; the outcome in these patients was not always favorable. Cases with occlusion of the trunk or branch vessels always showed marked CT hypodensity, and clinical outcome was poor. To assess quantitatively the extent of collateral circulation, the conduction time of contrast medium from the intracranial siphon (IC) to the insular portion of the MCA (M2) through the anterior cerebral arteries was calculated on serial carotid angiograms obtained within 24 hours after stroke onset. An IC-M2 time of 5 seconds was a critical indicator of whether extensive CT hypodensity would develop (the rule of 5 seconds). Furthermore, this method predicted the appearance and extent of infarction before CT revealed hypodensity. The significance of acute reconstructive surgery is also discussed. PMID- 3629645 TI - Protective effects of combined superoxide dismutase and deferoxamine on recovery of cerebral blood flow and function after cardiac arrest in dogs. AB - Oxygen free radicals generated during reoxygenation after cardiac arrest may impair recovery of cerebral blood flow and function. In a randomized study in vivo, we tested the following anti-free radical combination therapy administered at the beginning of cardiopulmonary resuscitation after apnea-induced cardiac arrest of 7 minutes: 1) ventilation with 100% nitrogen for 30 seconds to allow the delivery of therapy before oxygen, 2) 10 mg/kg i.a. superoxide dismutase followed by 10 mg/kg i.v. over 1 hour to scavenge the superoxide anion radical, and 3) 20 mg/kg i.v. deferoxamine over 1 hour to prevent membrane lipid peroxidation. We evaluated the effects of this combined treatment on the recovery of cardiovascular variables, cerebral blood flow and oxygen consumption, and somatosensory evoked potentials in 20 dogs 6 hours after resuscitation. Compared with standard treatment (n = 10), the combined treatment (n = 10) did not affect cardiovascular variables, significantly mitigated cerebral blood flow changes after cardiac arrest, and enhanced recovery of somatosensory evoked potentials. We conclude that oxygen free radicals play a role in the pathogenesis of the arrest-related derangements of cerebral blood flow and function that are effectively reduced by this combined treatment; we recommend evaluation of its components in outcome studies. PMID- 3629646 TI - Lack of association between carotid plaque hematoma and ischemic cerebral symptoms. AB - To investigate the association between carotid plaque hematoma and symptoms of cerebral ischemia a retrospective review of 200 consecutive carotid endarterectomies at the Neurological Institute of New York was carried out. Data analyzed included cerebral ischemic symptoms, angiographic findings, preoperative use of antithrombotic agents, and microscopic pathology of endarterectomy specimens. No association was found between ischemic symptoms ipsilateral to the endarterectomy and presence, size, or age of plaque hematomas. Plaque hematomas were less common among patients who took antithrombotic agents preoperatively than among those who did not. The presence of plaque hematoma was associated with angiographic carotid cross-sectional area stenosis of greater than 75%. Patients with stenosis of less than 75% were more likely than those with stenosis of greater than 75% to have ischemic symptoms ipsilateral to the endarterectomy, suggesting that criteria for surgical treatment of carotid atherosclerosis differ for those who are symptomatic vs. those who are asymptomatic. These results demonstrate the limitation of using a surgical series to extend causal inferences about the relation between plaque hematoma and cerebral ischemic symptoms to the general population of people with carotid atherosclerosis. PMID- 3629647 TI - Effect of acetazolamide on cerebral blood flow in subacute and chronic cerebrovascular disease. AB - Acetazolamide increases cerebral blood flow. The generalized and regional changes in blood flow after administration of acetazolamide were evaluated by the xenon 133 inhalation technique in a series of patients with subacute or chronic focal cerebral ischemia. Acetazolamide augmented interhemispheric asymmetry of cerebral blood flow in patients with unilateral occlusion of major cerebral arteries, whereas no significant side-to-side asymmetry was evident in patients with minor arterial lesions. Low flow areas in relation to computed tomography-verified infarcts tended to be larger after administration of acetazolamide. Hyperfrontality was present at rest and during stimulation with acetazolamide. A decline of cerebral blood flow with advancing age was greater in patients than in normal controls. The vasodilator response to acetazolamide did not change with age. PMID- 3629648 TI - Leukoencephalopathy in patients with ischemic stroke. AB - Thirty-one (16 women, 15 men; mean age 68 years) of 1,000 consecutive patients with an ischemic stroke investigated systematically with computed tomography (CT), Doppler, electrocardiography (ECG), and biological tests had a diffuse hypodensity of the cerebral hemispheric white matter on CT, a sign indicative of leukoencephalopathy. In 25 of the 31 patients, the acute infarct was deep. Leukoencephalopathy was more frequent in patients with a deep infarct (8%) than in patients in whom the cortex was involved (0.8%) (p less than 0.01). A history of progressive intellectual impairment (23%) and the finding of a mild or moderate impairment, or severe dementia (84%) were more frequent in study patients (p less than 0.05) than in 31 sex- and age-matched controls with an acute infarct of same size and topography but without leukoencephalopathy. A history of hypertension (81%) and high blood pressure on admission (166 +/- 19/96 +/- 12 mm Hg) were the most common risk factors and were more frequent in study patients (p less than 0.05) than in controls. On the other hand, study patients had a greater than or equal to 50% stenosis or occlusion of the carotid artery (13%) less often than controls (35%) (p less than 0.05). Diabetes (23%), elevated blood cholesterol (13%), hematocrit greater than 45% (23%), smoking (32%), and myocardial ischemia by history or ECG (45%) did not differ. These findings suggest that hypertension may be more strongly associated with leukoencephalopathy than with deep infarcts. In acute stroke patients, leukoencephalopathy on CT should not be considered a fortuitous finding. PMID- 3629649 TI - White matter lucencies on computed tomography, subacute arteriosclerotic encephalopathy (Binswanger's disease), and blood pressure. AB - Of 1,643 cranial computed tomography (CT) scans done in a primary-tertiary care private hospital over a 1-year period, 11 (0.67%) showed diffuse confluent white matter lucencies of less than 30 Hounsfield units. By retrospective analysis, at least 4 of the 11 were demented. Of these, 3 had clinical evidence of Binswanger's disease--characterized by progressive dementia, incontinence, variable pseudobulbar signs, and acute and subacute motor deficits. Two additional patients suffered only transient ischemic attacks or lacunar strokes; 2 had syncope; 1 had multiple sclerosis. The remaining patients were neurologically asymptomatic. In this small retrospective series, the severity of CT changes did not distinguish the patients with clinical Binswanger's syndrome from neurologically less symptomatic patients. Ten of the eleven patients had disordered blood pressure regulation--hypertension, labile systolic pressure, orthostatic hypotension, or a combination of these factors. The severity of CT changes correlated more clearly with blood pressure instability than with clinical encephalopathy. Asymptomatic adult patients with unexplained CT white matter hypodensity and blood pressure disorders may, however, be at risk for the development of subsequent subacute arteriosclerotic encephalopathy. PMID- 3629650 TI - Regional cerebral blood flow, clinical manifestations, and age in children with moyamoya disease. AB - In children with Moyamoya disease, transient ischemic attacks often occur during hyperventilation, and the frequency of attacks usually decreases with advancing age. To elucidate the mechanism of the attacks, the regional cerebral blood flow was measured during rest and/or hyperventilation in children aged 3-16 with Moyamoya disease. Regional cerebral blood flow during rest was significantly higher in younger children with Moyamoya disease, and it progressively decreased with advancing age through childhood. During hyperventilation, regional cerebral blood flow decreased in all the children, although blood flow in younger children was still higher than that in the older children. Nevertheless, transient ischemic attacks were more readily precipitated by hyperventilation in the younger than in the older children. Cerebral metabolic demand is much higher in the first decade of life than in later decades. Therefore, it seems likely that even a moderate reduction in cerebral blood flow can cause metabolic impairment in young children. Such high cerebral metabolic demand may play an important role in the frequent occurrence of transient ischemic attacks in young children with Moyamoya disease. PMID- 3629651 TI - S-100 protein and neuron-specific enolase in cerebrospinal fluid and serum: markers of cell damage in human central nervous system. AB - The development of a radioimmunoassay for S-100 protein is described. This method was used in combination with a recently developed radioimmunoassay for neuron specific enolase in cerebrospinal fluid and serum from 47 patients with cerebral infarction, transient ischemic attack, intracerebral hemorrhage, subarachnoid hemorrhage, and head injury. In cerebrospinal fluid, increased concentrations of both S-100 and neuron-specific enolase were found after large infarcts, whereas after small infarcts and transient ischemic attacks, only neuron-specific enolase increased. The increased concentrations of S-100 and/or neuron-specific enolase were noted 18 hours to 4 days after cerebral infarction and transient ischemic attacks. Cerebrospinal fluid concentrations of these proteins also reflected the severity of the disease in patients with intracerebral hematoma, subarachnoid hemorrhage, or head injury. Temporal changes in serum S-100 and neuron-specific enolase concentrations reflected the clinical course in 4 patients. In stroke patients, the S-100 and neuron-specific enolase concentrations may reflect the extent of brain damage and could be useful in selecting patients with major stroke for more aggressive treatment during the acute phase. PMID- 3629652 TI - Intracellular acidosis during and after cerebral ischemia: in vivo nuclear magnetic resonance study of hyperglycemia in cats. AB - In vivo 31P nuclear magnetic resonance spectroscopy was used to monitor the time course of intracellular pH in cat cerebral cortex subjected to global cerebral ischemia under control and hyperglycemic pretreatment conditions. Transient (16 minutes) global cerebral ischemia was induced in 14 cats using an inflatable cervical cuff combined with systemic arterial hypotension. Six cats were pretreated with infusion of 1.5 g/kg glucose prior to ischemia. Relative concentrations of high-energy phosphate metabolites and intracellular pH were continuously monitored before, during, and for 2 hours after cerebral reperfusion. During ischemia, intracellular pH fell to the same level and followed a similar time course in both groups. However, during initial reperfusion in the hyperglycemic group, there was a severe further decline (p less than 0.003) in intracellular pH. We suggest that the increased neurologic deficit and mortality found in hyperglycemic animals subjected to cerebral ischemia may be attributed to this transient severe tissue acidosis. PMID- 3629653 TI - Acute effect of angiographic contrast medium on cortical specific gravity after middle cerebral artery occlusion in rats. AB - Early angiography after cerebral arterial occlusion has been cited as potentially detrimental. This investigation evaluates the effect of acute angiographic contrast medium administration on the cortical edema induced by middle cerebral artery (MCA) occlusion. Sixteen rats underwent MCA occlusion, and after 1 hour half the rats underwent ipsilateral internal carotid injection of meglumine diatrizoate, whereas the remainder underwent cervical internal carotid exposure only. Six rats had only sham operations on the MCA and internal carotid, and 4 other rats served as normal controls. Cortical specific gravity was measured to reflect cerebral edema 4 hours after occlusion or sham operation. Specific gravity of the lateral frontal cortex in the hemisphere ipsilateral to occlusion was 1.0396 +/- 0.0011 (mean +/- SEM) when no angiographic contrast medium was administered, significantly less (p less than 0.01) than in rats exposed to contrast medium (specific gravity 1.0442 +/- 0.0005). The latter value was not significantly different from normal. Other cortical areas on the side of the contrast medium injection were also relatively dehydrated compared with normal controls. Early meglumine diatrizoate administration after MCA occlusion results in a decrease in cerebral cortical edema, possible by inducing an osmotic gradient that draws water from the extravascular space. PMID- 3629654 TI - Ultrastructural studies of pial vascular endothelium following damage resulting in loss of endothelium-dependent relaxation. AB - The changes in pial arterioles of 7 cats were examined by electron microscopy after injury that eliminates endothelium-dependent relaxation to acetylcholine or bradykinin. The injury was produced by exposing the vessels to mercury light in situ in the presence of intravascular sodium fluorescein dye. Previous studies showed that, at the time of initial injury and loss of endothelium-dependent responses, the endothelial cells displayed minimal ultrastructural evidence of injury. Because these changes might indicate the beginning of a sequence of irreversible alterations representing or leading to cell death, the present study was carried out 31/2-4 hours later, when ultrastructural evidence of progressive cell degeneration should readily be recognized. No such changes were observed. Instead, most vessels showed only the minimal alterations observed initially (endothelial vacuolation, blebs, and lucencies). Four of 19 vessels were completely normal. The findings fail to support the hypothesis that irreversible cell damage or death caused by the light + dye injury has caused the associated loss of endothelium-dependent relaxation. Rather, the findings support the concept that much lesser degrees of trauma are sufficient to impair the dilating responses of cerebral microvessels. This greatly expands the potential spectrum of pathologic states that might result in loss of endothelium-dependent relaxation. PMID- 3629655 TI - Hypoglycemic hemiplegia: two cases and a clinical review. AB - Hypoglycemic hemiplegia mimics cerebrovascular disease. Two patients are reported who experienced multiple attacks of transient hemiplegia associated with hypoglycemia and who were initially diagnosed as having transient ischemic attacks. In both, angiography was normal and the attacks resolved with reduction of insulin dose. Recognition of hypoglycemia as the cause of transient hemiplegia is important, often obviating the need for cerebrovascular evaluation. PMID- 3629656 TI - Lateral pontine hemorrhage: reappraisal of benign cases. AB - We reviewed 6 computed tomography-documented cases of primary lateral pontine hemorrhage that occurred in our two institutions over a 2-year period. All patients survived the acute stroke, with excellent functional recovery in 4. The level of consciousness of the patient and the size of the hemorrhage had no consistent bearing on outcome. Both of these features have been considered important prognostic indicators in patients with pontine hemorrhage, but in our series benign outcomes were not restricted only to patients who were alert or had small hemorrhages; on the other hand, severe disability was noticed in 1 patient with a small hematoma strategically located in the pontine tegmentum. Our observations suggest that, although some patients with lateral pontine hemorrhage have a good prognosis, there is no single determinant that predicts outcome in a given patient. PMID- 3629657 TI - Prognostic value of peripheral white blood cell count in intracerebral hemorrhage. PMID- 3629658 TI - Carotid endarterectomy in private practice by fellowship-trained surgeons. PMID- 3629659 TI - Ball thrombi in carotid artery plaque. PMID- 3629660 TI - Selecting rational therapies in the neurosciences. PMID- 3629661 TI - The demand for fertility control in sub-Saharan Africa. AB - Recent fertility surveys in Africa reveal that a striking majority of women want more children, even among those who practice modern contraception, and that modern contraceptive prevalence is still low for women most motivated to avert pregnancy. This analysis suggests that whereas there is, as yet, little indication of change in conditions anticipated to shift the underlying demand for children, uncertainties attached to successful childraising due to risks of infertility, failure to thrive, disability, and divorce strongly favor traditional forms of fertility regulation. The two major means of fertility regulation in Africa--avoidance of next pregnancy in reference to the last born child's survival and rearrangement of the timing and tempo of childrearing through fostering--are not equivalent to modern contraception in purpose or practice. Against these general observations, particular demand for fertility control is identified for groups of women who demonstrate interest in nontraditional forms of fertility regulation at specific lifecycle points. A range of focused family planning activities is proposed to address this demand. PMID- 3629662 TI - Birth weight and the effects of birth spacing and breastfeeding on infant mortality. AB - Analyses previously reported, based on data from the World Fertility Survey (WFS), are replicated here with data from the Malaysian Family Life Survey. Comparison of results, when data limitations inherent in the World Fertility Surveys are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. Most significantly, these include the greater importance of both breastfeeding and birth spacing under generally unfavorable conditions, the variability of durations to which some benefit of continued breastfeeding persists, and the observation that the great majority of birth-spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths. PMID- 3629663 TI - Levels of maternal mortality in developing countries. AB - This paper is aimed at improving our ability to assess the magnitude of maternal mortality in developing countries, where reliable data on maternal deaths are scarce. First, the upper and lower limits of maternal mortality in a population are determined based on the general levels of mortality and fertility in a population. The relative importance of maternal deaths as a proportion of death among women of reproductive ages may, therefore, vary from less than 1 percent in low-mortality countries to about 25-30 percent in high-mortality countries. Second, the analysis and interpretation of maternal mortality data from health facilities and vital registration systems can be improved if a variety of other data sources are used, such as coverage of deliveries in hospitals and at home, and all causes of death among women of reproductive age. It is estimated that approximately 515,000 women died annually due to pregnancy-related causes in developing countries between 1980 and 1985. Ninety percent of these deaths took place in Africa and South Asia, where births are frequent and maternal mortality levels are high. PMID- 3629664 TI - Proximate determinants of fertility and policy implications in Beijing. AB - Data from a 1982 sample survey of 3,830 married women below age 50 in a district of Beijing City are applied to the Bongaarts model of the proximate determinants of fertility. A total fertility rate (TFR) of 0.75 births per woman is estimated from the model, compared with a TFR of 1.24 actually observed from the survey. The estimated TFR (0.75) results from the assumed total fecundity (TF) of 15.30 births per woman being inhibited by the indexes of the proximate determinants of fertility, most notably non-marriage (.280), contraception (.315), and induced abortion (.586). The effects of two other proximate determinants, lactational infecundability and spousal separation, were negligible. Comparative data from other countries confirm that the study area has very low levels of fertility and marriage, a very high prevalence of induced abortion, and a small effect of lactational infecundability. The extremely low level of fertility was, thus, achieved through a high level of induced abortion. Future research needs and policy implications associated with the study are discussed. PMID- 3629666 TI - Adverse affect of blood transfusions on survival of patients with gastric cancer. AB - The effect of perioperative blood transfusions on the survival rate of patients with gastric cancer was studied. The survival rate of the transfusion group was significantly lower than that of the nontransfusion group in each of the 5 postoperative years. When no adjuvant immunochemotherapy was performed postoperatively, the prognosis was definitely worse in the transfusion group than in the nontransfusion group. Furthermore, the survival rate of the transfusion group was lower than that of the nontransfusion group in both histopathologic classifications of gastric cancer, and it was lower to a statistically significant extent among the well-differentiated types. These results indicate that transfusions might adversely affect postoperative survival of patients with gastric cancer. PMID- 3629665 TI - The role of information, education, and communication in family planning service delivery in Tunisia. AB - In an effort to measure the value of outreach, a prospective study using an experimental comparison group design was implemented in a rural region of Tunisia, where an outreach program had been implemented in 1981 to increase contraceptive prevalence. The main components of the program included the improvement and expansion of rural health care services through mobile clinics, and the implementation of an information, education, and communication (IEC) outreach program. While the program tended to focus on the implementation of the mobile clinics, service statistics suggested that the IEC outreach component in fact accounted for much of the success of the program. The study shows that the addition of outreach to existing services more than doubles the number of new family planning acceptors, and that outreach has a more positive impact on service output than does the creation of new services. PMID- 3629667 TI - The para-Bombay phenotype in Chinese persons. AB - The para-Bombay phenotype occurs more frequently in Oriental than in white populations. This report describes the immunohematologic findings in 20 cases of the para-Bombay phenotype detected over a period of about 15 months in the Chinese population of Taiwan. PMID- 3629668 TI - The utility of platelet washing using an automated procedure for severe platelet allergic reactions. AB - Increased use of platelets in patients requiring chronic platelet support has increased platelet transfusion reactions. The authors reviewed more than 300 platelet transfusion reactions, evaluated an automated platelet washing technique, and studied the effectiveness of washing platelets to reduce reactions. Febrile reactions (66%) were most frequently reported, followed by moderate and severe allergic reactions (15%), and urticaria alone (19%). Washed platelets were prepared by an automated technique (IBM/COBE 2991). In vitro studies indicated no apparent adverse effects to the platelets due to the wash procedure, and in vivo studies demonstrated good platelet increments in 10 thrombocytopenic patients. Twenty-two patients with histories of platelet transfusion reactions received a total of 554 washed platelet transfusions. Washed platelets were not effective in reducing febrile transfusion reactions in 16 patients receiving 347 washed products. The efficacy of washed platelets in reducing transfusion reactions was demonstrated in six patients with histories of severe allergic reactions who received 207 washed products. Severe allergic reactions were completely alleviated in this group. In conclusion, automated platelet washing is simple and efficacious in preventing or reducing the severity of allergic reactions to platelet transfusions. PMID- 3629669 TI - Storage of platelets on flatbed agitators in polyvinyl chloride blood bags plasticized with tri(2-ethylhexyl) trimellitate. AB - Data are presented showing that platelets in polyvinyl chloride blood bags plasticized with tri(2-ethylhexyl) trimellitate can be stored on flatbed agitators (shakers) without the pH falling below 6.0. The lowest pH seen after 7 days of storage in 46 units with platelet yields ranging from 3.6 to 13.3 X 10(10) per unit was 6.43. These bags have a O2 transmission rate of 13.3 mumol per hour per bag. Platelet bags with a O2 transmission rate of 7.9 mumol per hour per bag experience a pH fall after 5 days of storage on the shaker in units whose platelet yield on average exceeds 10 X 10(10). Platelets can be stored on first generation shakers (70 cycles/min, stroke = 1 inch) without an attempt at manual resuspension of the platelet button. The count after 30 minutes on the shaker averaged 89 +/- 15 percent of the expected count, indicating that resuspension was nearly complete after a relatively short period. Red cells, but not platelets, settled out during storage on the shaker. PMID- 3629670 TI - Leukocyte depletion of red cell units at the bedside by transfusion through a new filter. AB - Standard packed red cell (PRC) units can be depleted of leukocytes and platelets if they are transfused through a blood administration set in which the usual 170 mu filter has been replaced by a leukocyte removal filter (Sepacell R-500). During a 6-month period, 1550 PRC units were transfused through this filter in 611 transfusions to 80 multitransfused patients with thalassemia who had had a patient reaction rate (PRR) of 63 percent and a transfusion reaction rate (TRR) of 13 percent when given standard PRC or buffy-coat-depleted PRC. When given filtered PRC, PRR and TRR became 3.7 percent and 0.5 percent, respectively. The effectiveness of the filter was also evaluated in vitro. By filtering 2 standard PRC units through the same filter, median values (and ranges) for red cell recovery and for residual leukocytes and platelets were 87 percent (83-92), 6.1 X 10(6) (0-100), and 2.7 X 10(9) (0.6-9.7), respectively. Although refinements are needed to improve standardization of the filter and to increase red cell recovery (which is low when 1 unit is filtered through one filter) and blood administration rate, the ability to provide leukocyte-free red cells prepared at the bedside for virtually all recipients appears to be a realistic goal. PMID- 3629671 TI - The use of frozen intravenous crystalloid solutions as the refrigerant for shipping blood. AB - The authors studied whether cooled sterile intravenous crystalloid solutions could be used to refrigerate red cells during shipment. Six 1000-ml bags of 0.9 percent normal saline and lactated Ringers (RL) solutions were supercooled and tested separately at temperatures ranging from 1 to -78 degrees C, with either 5 or 30 units of packed red cells (PRBCs). The PRBCs were shipped in a standard military container that permitted separation of the supercooled solutions from the PRBCs. Cooling RL solutions to 6 degrees C and to -22 degrees C maintained acceptable storage temperatures of the PRBC for 36 and 50 hours, respectively, and did not cause visible damage to the units. No significant changes were observed in various biochemical measurements of the cells and plasma. Cooling the RL solution to -78 degrees C caused a significant (p less than 0.05) increase in plasma potassium concentration. The effectiveness of the crystalloid solutions in refrigerating blood varied with the ratio of the number of PRBCs to the volume of cooled solutions and with the ambient temperature surrounding the container. The results of this study suggest that cooled intravenous crystalloid solutions can be used as refrigerants for PRBCs during shipment. PMID- 3629672 TI - Storage-induced changes in human newborn red cells. AB - Fetal red cells are well suited for intrauterine life; however, little is known about their response to postnatal environments. The purpose of this work was to investigate the metabolic and membrane changes affecting newborn red cells during their exposure to storage in citrate-phosphate-dextrose (CPD) and citrate phosphate-dextrose-adenine (CPDA-1). The findings suggest that newborn red cells are affected more by storage than are adult cells. These accelerated storage changes in the red cells of newborns may be related indirectly to the rapid adenosine triphosphate (ATP) decline. As is the case with adult red cells, fetal cells withstand storage in CPDA-1 better than in CPD. The storage lesion in these cells was partly reversible, as in adult cells, by incubation with adenosine. It was therefore concluded that newborn red cells obtained from placentas and stored for several weeks in CPD or CPDA-1 media or other media that improve the metabolic profile of these cells may be acceptable for transfusion. PMID- 3629674 TI - Preparation and physical characteristics of a hemoglobin solution modified by coupling to 2-nor-2-formylpyridoxal 5'-phosphate. AB - Stroma-free hemoglobin (Hb) solutions were prepared on a 20-I scale. In 3-I batches, the beta chains of hemoglobin were crosslinked with 2-nor-2 formylpyridoxal 5'-phosphate (NFPLP) that was synthesized on a gram scale. The coupling efficiency was 60 to 80 percent. The oxygen dissociation curve of these Hb/HbNFPLP mixtures was shifted to the right with P50 (PO2 for 50% saturation with oxygen) values of 26 to 38 torr versus values of 12 to 16 torr for the nonmodified hemoglobin solutions. Both the H+ Bohr factor and the Hill coefficient were lower for the Hb/HbNFPLP mixture than for the original hemoglobin solution. The oxygen-binding coefficient beta was the same for both types of Hb solutions. The viscosity and the colloid osmotic pressure of both solutions were also the same. During storage at 4 degrees C for 18 months, no precipitation or denaturation of hemoglobin was detectable in either solution. There was also no conversion of the modified hemoglobin molecules, HbNFPLP, to the native hemoglobin tetramers, dimers, or monomers. The percentage of methemoglobin remained at 5 percent for about 6 months; it increased to 26 percent over the next 12 months. The results indicate that intramolecular coupling of hemoglobin with NFPLP yields a stable product with physiologic oxygen carrying properties. PMID- 3629673 TI - Radiolabeled red cell viability. I. Comparison of 51Cr, 99mTc, and 111In for measuring the viability of autologous stored red cells. AB - The simultaneous determination of autologous 99mTc red cell (RBC) and 51Cr RBC viability at 24 hours was measured in 19 normal volunteers whose RBCs had been stored in additive media (Nutracel) for 42 or 49 days. The ratio of the 51Cr:99mTc value was 1.23. In this experiment we also calculated 51Cr RBC viability by both the single-isotope method (extrapolation) and the double isotope method (using 125I human serum albumin for an independent plasma volume) in the same volunteers. The corresponding viability values were not significantly different. The simultaneous determination of autologous 111In-oxine RBC and 51Cr RBC viability at 24 hours was measured in 19 other normal volunteers whose RBCs had been stored in citrate-phosphate-dextrose-adenine (CPDA-1) for 1 or 15 days. The ratio of the 51Cr:111In value was 1.1. Use of these 24-hour viability ratios as conversion factors permits direct comparison of 99mTc or 111In RBC viability with a 51Cr standard, and therefore expands the application of these newer RBC radiolabels. PMID- 3629675 TI - Stability of serum alanine aminotransferase activity. AB - In this study the authors examine the effects of common storage and handling procedures on serum alanine aminotransferase (ALT) levels. Clotted blood samples from 14 subjects were centrifuged at 280 X g for 10 minutes. Serum was tested immediately for baseline ALT levels and aliquots were stored at 22, 4, -20, and 80 degrees C. Additional serums were stored on the clot at 22 and 4 degrees C. ALT quantitation was performed at intervals of 3, 6, 9, and 24 hours and on Days 2, 4, 6, and 8. Unseparated tubes were sampled both proximal and distal to the red cells to determine ALT leakage from red cells lysis. For all storage conditions, gradual loss of activity occurred over time. Mean activity loss in separated serum at 2 days was 6 percent at 4 degrees C and 20 percent at 22 degrees C. Mean loss in unseparated serum was 3 percent at 4 degrees C and 12 percent at 22 degrees C. Marked ALT loss averaging 46 percent by day 6 occurred with storage at -20 degrees C, whereas storage at -80 degrees C resulted in an 8 percent decrease for the same period. For storage of up to 1 week, it is recommended that serum be separated early and retained at 4 degrees C. Frozen samples should be kept at -80 degrees C. Storage of separated or unseparated blood for up to 24 hours at 22 or 4 degrees C, as commonly found in blood centers, will marginally adversely affect the accuracy of ALT determination. PMID- 3629677 TI - A second example of autoanti-Jk3. PMID- 3629676 TI - Plasma free fatty acid metabolism during storage of platelet concentrates for transfusion. AB - New containers allow storage of platelet concentrates (PC) at 22 degrees C for up to 7 days, during which glycolytic and oxidative metabolism is vigorous. Recent evidence suggests that 85 percent of adenosine triphosphate regeneration is based on oxidative metabolism and that substrates other than glucose may be used. Because platelets can oxidize free fatty acids (FFA) as a possible source of energy during storage, the authors studied their availability, distribution, and turnover. Plasma FFA concentration was unchanged after 1 day of PC storage but significantly increased on Days 3, 5, and 7. Platelet-free plasma (PFP) stored under the same conditions as PC demonstrated a progressive increase in FFA, suggesting that some of the FFA accumulating in PC were derived from plasma rather than platelets. Indeed, during PC storage, plasma triglycerides decreased significantly, suggesting that they are a possible source of the increased levels of FFA found on Day 3 and thereafter. Thus, PC have a plasma FFA pool available continuously for oxidation during storage. Studies with radiolabeled palmitate suggested that FFA oxidation by platelets occurs during storage. The current findings show that plasma FFA could be a significant substrate for oxidative metabolism during storage of PC and that the oxidized FFA are replenished at least in part from plasma. These results may allow platelet storage to be improved, particularly in synthetic media. PMID- 3629678 TI - Loss of Era antigen in very low pH buffers. PMID- 3629679 TI - Timing of booster immunizations with hepatitis B vaccine. PMID- 3629680 TI - High potassium levels in stored irradiated blood. PMID- 3629681 TI - Elimination of the crossmatch. PMID- 3629682 TI - Optimal volume of plasma exchange in thrombotic thrombocytopenic purpura. PMID- 3629683 TI - Use of the isolated perfused kidney model to assess the acute pharmacologic effects of cyclosporine and its vehicle, cremophor EL. AB - "Nephrotoxicity" secondary to cyclosporine and its clinically used vehicle, Cremophor EL, was examined in the isolated perfused rat kidney model. This model allows the serial determination of renal hemodynamic and tubular functional studies over a 3-hr duration using a normothermic, low hematocrit (13-15%) perfusion system. Initial studies indicated that the addition of small quantities of Cremophor EL resulted in marked renal vasoconstriction with decreased renal blood flow and deterioration in renal tubular function. These effects were highly significant and were of the same magnitude whether or not cyclosporine was present in the system. Cyclosporine was therefore examined after being dissolved in another vehicle, methanol. A 10% (v/v) amount of plasma was necessary in the perfusate to prevent significant adsorption of cyclosporine to the perfusion apparatus. Cyclosporine at concentrations below 100 ng/ml resulted in minor changes in renal hemodynamics. Beginning at 100 ng/ml glomerular filtration rate dropped significantly and renal vascular resistance increased three-fold. Fractional excretion of sodium significantly increased and the urine:plasma inulin ratio significantly decreased. We conclude that the clinically used drug vehicle, Cremophor EL, has significantly adverse effects on renal hemodynamics and tubular function. In addition, CsA causes similar renal toxicity in a dose dependent fashion. Simultaneous administration of these two nephrotoxic agents could contribute to the high incidence of acute renal failure seen after transplantation. These observations suggest that an alternate vehicle with less renal toxicity might significantly decrease the incidence of this clinical problem. PMID- 3629684 TI - Differential expression of HLA-class II antigens in the human thymus. Relative paucity of HLA-DQ antigens in the thymic medulla. AB - By using well-characterized monoclonal antibodies, HU-20, HOK7(1E4) and HU-18, which specifically recognize either common epitopes of HLA-DR molecules (HU-20, HOK7) or HLA-DQw3 molecules (HU-18), it was demonstrated that there were different distributions of these antigens in human thymus. In the cortex, both DR and DQ antigens were strongly expressed on thymic epithelial cells (TEC). The double stainings revealed simultaneous expression of both antigens on TEC. On the other hand, in the medulla, DQ antigens had more limited expression than DR antigens, the latter antigens being demonstrated in the confluent pattern. The double staining method could show small numbers of dual-positive cells in the medulla, which looked like TEC, indicating that at least some medullary TEC were also DR+,DQ+, although the presence of small numbers of DR-,DQ-, as well as DR+,DQ- TEC in the medulla cannot be excluded. The preponderance of DR over DQ antigen in the medulla was consistently found--from a ten week embryo to a two year-old child--and could be attributed to very weak or no expression of DQ antigens on dendritic cells/macrophages. The distribution pattern of these antigens within the thymus may have correlations with the intrathymic development of T cells through the unique functions of each antigen. PMID- 3629685 TI - Footpad and popliteal lymph node responses to H-Y. PMID- 3629686 TI - Sample pretreatment to minimize interference from whole blood in the radioimmunoassay for cyclosporine. PMID- 3629687 TI - The antiglobulin crossmatch in the cyclosporine era. PMID- 3629688 TI - The effect of verapamil on cellular uptake, organ distribution, and pharmacology of cyclosporine. AB - Verapamil has been shown to potentiate cyclosporine's effect in inhibiting lectin stimulated proliferation of murine and human lymphocytes, and in prolonging graft survival in experimental heterotopic cardiac transplantation in rats. A series of experiments were designed to determine whether verapamil's effect occurred by increasing cyclosporine uptake or decreasing cyclosporine's clearance by lymphocytes utilizing human peripheral blood lymphocytes and radiolabeled cyclosporine. Verapamil had no effect. The distribution of radiolabeled cyclosporine was also studied in mice that had been given verapamil (10 mg/kg) 1 hr prior to cyclosporine injection. No significant changes in organ distribution occurred. Lectin-stimulated release of intracellular ionized calcium was studied using a flurometric technique (Quin-2 and Fura-2). Neither cyclosporine nor verapamil had any effect on either lectin-stimulated or phorbol ester-stimulated release of intracellular ionized calcium. Phorbol ester and subproliferative doses of lectin were used to determine the effect of cyclosporine and verapamil on protein kinase C-mediated lymphocyte activation. Cyclosporine inhibited phorbol ester stimulated proliferation and verapamil potentiated this inhibition. Verapamil does not change cell or organ uptake of cyclosporine, and it does not affect the initial increase in intracellular ionized calcium that occurs with lymphocyte activation. Verapamil potentiates cyclosporine in inhibiting protein kinase C-mediated events in lymphocyte activation. PMID- 3629689 TI - Granular juxtaglomerular cell hyperplasia caused by cyclosporine. AB - Histologic study of kidneys from rabbits given cyclosporine (CsA) revealed a marked hyperplasia of granular cells in the juxtaglomerular (JG) apparatus, but without a significant increase in the total cell number of JG cells. The increase in granular JG cells as compared with the control group was 204% and 406% for 30 mg/kg alternate days and 30 mg/kg daily groups, respectively. The increases for the lower-dosage groups were much smaller, although the increases were statistically significant for all but the 10 mg/kg alternate-days group. Other studies suggest that sympathomimetic activity of CsA may be the mechanism involved in granular JG cell hyperplasia. PMID- 3629690 TI - Combined nephrotoxic effects of cyclosporine and endotoxin. AB - This study presents experimental evidence that cyclosporine (CsA) potentiates the nephrotoxicity of endotoxin. This study was motivated by clinical observations in 4 cyclosporine (CsA)-treated renal allograft recipients who developed severe, and sometimes irreversible, nephrotoxicity after infections. CsA or vehicle was administered intramuscularly to rabbits for 5 days, and subsequently both groups of animals received one dose of endotoxin intravenously. Compared with controls, CsA-treated animals demonstrated significantly higher elevations of blood urea nitrogen and serum creatinine 24 hr after endotoxin. By contrast, both groups of animals developed similar degrees of thrombocytopenia. Histologic evaluation of kidney tissues 24 hr after endotoxin revealed significantly greater tubular toxicity and a higher glomerular polymorphonuclear leukocyte (PMN) infiltration in CsA-treated animals. Semiquantitative scores of tubular damage correlated directly with the mean number of PMN/glomeruli in both groups of animals. Immunofluorescent microscopy of kidney tissues was negative for fibrinogen and for complement deposition in both CsA and control groups. We conclude that CsA enhances endotoxin nephrotoxicity in rabbits. This effect does not appear to be mediated by activation of coagulation factors. However, a role for PMN is suggested. CsA should be used with caution in patients with deteriorating renal function who are suspected of having severe bacterial infections. PMID- 3629691 TI - Effects of immunosuppressive therapy on the induction of skin tumors by ultraviolet irradiation in hairless mice. AB - The effects of therapy with four commonly used immunosuppressants--azathioprine, prednisolone, cyclophosphamide, and cyclosporine, on (UVI)-induced skin carcinogenesis were studied in the albino hairless (HRA/Skh-1) mouse. Following 30 weeks' exposure to UVI (290-400 nm) alone, 87% of mice developed skin tumors; the mean incidence of tumors at that time was 2.4 per mouse; and the tumors were predominantly papillomas (72%), with the remainder being carcinomas (25%) and keratoacanthomas (3%). Mice received immunosuppressive drug therapy beginning shortly after the start of UVI and continuing for up to 28 weeks. All drugs were given at immunosuppressive levels and dosages were comparable on a body weight basis to those used in clinical transplantation. Prednisolone had no effect on UVI-induced tumor development. Cyclosporine caused a moderate reduction in the latent period for tumor induction. Azathioprine and cyclophosphamide had strong promoting effects; the latent period for tumor induction was shortened and the tumor yield per mouse was increased (4.3 and 5.7 tumors per mouse, respectively, at 30 weeks after the start of UVI). Azathioprine, but not cyclophosphamide, also induced a larger proportion of carcinomas (43% and 15%, respectively). The results suggest that for kidney transplant recipients treated with the standard immunosuppressive drug regimen of azathioprine/prednisone, the increased susceptibility of the sun-exposed skin of these patients to squamous cell carcinoma is likely to be contributed to by specific promotion by the azathioprine therapy of the carcinogenic effects of sunlight. PMID- 3629692 TI - Scrub typhus along the Thai-Kampuchean border: new treatment regimen. PMID- 3629693 TI - Paediatric symptoms without signs. Recognition of functional complaints in childhood. PMID- 3629694 TI - Dialysis in the Third World. PMID- 3629695 TI - Strangulated external hernia. PMID- 3629696 TI - Antenatal care in a district hospital. PMID- 3629697 TI - Complication of cervical cerclage. PMID- 3629698 TI - Modifications to the AHRTAG child length measurer. Appropriate Health Resources and Technology Action Group. PMID- 3629699 TI - Influence of health education on local beliefs. Incomplete success, or partial failure. PMID- 3629700 TI - Simple method of vision screening in pre-school clinics. PMID- 3629701 TI - Knowledge of immunization among employees of the University of Benin Teaching Hospital, Nigeria. PMID- 3629702 TI - Vesicovaginal fistula from obstructed labour presenting as gas-filled bladder. PMID- 3629703 TI - Delta virus infections in and around Chandigarh, northern India: evidence for endemicity. AB - Delta virus infections, so far, have not been documented from India. Here we report for the first time the endemicity of delta virus infection in this geographical area. HBsAg positive serum samples from 81 patients and 10 healthy voluntary blood donors were tested for delta antigen. Seven out of 49 (14.3%) sporadic acute hepatitis cases, 3 out of 8 (37.5%) chronic renal failure patients requiring frequent haemodialysis, 1 out of 22 (4.6%) chronic liver disease cases and 1 out of 10 (10%) apparently healthy voluntary blood donors had delta antigenaemia. PMID- 3629704 TI - The incidence of severe leptospirosis in Trinidad. AB - Between February 1977 and September 1982, sera from febrile patients from all areas of Trinidad were examined for leptospiral agglutinins; 158 of 1714 patients (9%) were confirmed as current cases of leptospirosis (annual average 26 or 2.6 per 100,000 population). Of the remaining 1556 patients only 711 provided paired sera; 167 of these (23%) showed evidence of previous leptospiral infection. Of the 845 single samples, 125 were positive. The true incidence of the disease is probably much higher than reported here. Males comprised 74% of the current cases; their highest rate of infection was in the 30-39 year age group, the incidence in late teenage approaching this rate. For females, incidence increased with age up to late middle-age. The presumptive infecting serogroups most commonly recorded among the 158 current cases were Icterohaemorrhagiae (37%), Canicola (16%) and Autumnalis (11%). 13 of the cases died (case fatality rate, 8.2%). PMID- 3629705 TI - Rapid laboratory diagnosis of bacterial meningitis employing coagglutination test. AB - Twenty samples of CSF, 11 from proven meningitis with positive culture and nine negative controls were examined. Ten cases (91%) of meningitis, six caused by Haemophilus influenzae, three by Streptococcus pneumoniae and one by Neisseria meningitidis have been diagnosed by the coagglutination method. Using the Phadebact CSF kit, the test was negative, in one (9%) meningitis case, which was caused by Str. pneumoniae. Subsequently all cases of meningitis were confirmed by isolation of the organisms in CSF culture. None of the nine control CSF gave a positive reaction with coagglutination test or positive culture. The coagglutination test is simple, rapid and requires no special equipment. PMID- 3629706 TI - Rapid etiological diagnosis of pyogenic meningitis by coagglutination, latex agglutination and immunoosmophoresis of cerebrospinal fluid, serum and urine. AB - Three rapid diagnostic methods for the detection of bacterial antigen-COA (Coagglutination), LA (latex agglutination) and IEOP (immunoelectroosmophoresis); DM (direct microscopy after Gram staining) and culture of cerebrospinal fluid (CSF) have been compared in 53 bacterial meningitis patients and in 13 controls. Urine samples were assayed for antigens in connection with CSF in 32 for COA, LA, and IEOP. The cause of meningitis was S. pneumoniae in 31, H. influenzae type b in 16 and N. meningitidis in 6 using the methods for diagnosis by LA in 100%, COA in 94%, culture in 89%, IEOP in 81% and DM in 78% of the CSF samples. None of the CSF from controls were positive by any of the methods. LA and COA detected antigen in CSF in all 4 patients on 4th and 5th day of treatment but none of the tests were helpful 7-10 days later. LA was effective in detecting antigen in urine in 10/10 (100%) H. influenzae type b, 17/20 (85%) S. pneumoniae prior to antibiotic treatment. IEOP was helpful in antigen detection better in serum than in urine in 5/6 H. influenzae type b and 9/11 S. pneumoniae meningitis. In general we have found LA and COA as simple, rapid specific and sensitive tests and can be applied even in field situations and that LA can be used for antigen detection in urine and IEOP in serum. A large scale study is needed in order to standardize methods for antigen detection in serum and urine. PMID- 3629707 TI - Silent coronary artery disease in black African diabetic patients. A prospective study of 50 patients. AB - Silent coronary heart disease (CHD) has been researched among a sample of 50 black African diabetic patients in a prospective study. The diabetic patients were chosen on the following criteria: male sex, age ranging from 40 to 60 years, absence of history of CHD, normal EKG. A stress test was performed in all cases. A coronary arteriography was done each time the exercise test was positive, doubtful or non-conclusive. This study has shown a prevalence of 10% CHD:31 exercise test negatives, 17 exercise test non-conclusives, 2 exercise test positives, 5 coronary arteriography with significant narrowing. There were 3 patients with one vessel disease (LDA: 2 cases, CFX: 1 case), one patient with double vessel disease (CFX, RCA) while another had a triple vessel disease (RCA, LDA, CFX). Proximal lesions were encountered in 5 cases and distal lesions in 3 cases. The authors conclude that CHD exist in a silent state among black African diabetics. Its prevalence is lower than in white diabetics. The coronary lesions are mostly limited. Proximal narrowing and one vessel disease were mostly encountered. PMID- 3629708 TI - The antisickling role of uric acid in sickle cell disease. AB - Based on the antisickling properties of structurally similar compounds, uric acid (urate) was investigated and found to possess antisickling activity on sickle cell erythrocytes, in particular at higher urate concentrations. Serum urate levels were subsequently determined for 60 sickle cell patients of both sexes within the age limit of 1-27 years. The mean serum urate values were computed at discrete age groups, and the values obtained were compared with the mean serum urate concentration for 15 normal subjects of both sexes and similar age range. Although a definite age-dependent trend did exist in the mean serum urate concentration in sickle cell disease (SCD), this elevation could not be truly referred to as "hyperuricaemia'. Hence, any possible contribution by elevated serum urate to a gouty trait and SCD bone crisis remains unclear. However, these observed serum urate values corresponded well with those concentrations which inhibited the sickling of sickle cell erythrocytes in vitro, permitting the speculation that the elevated serum urate might well be beneficial to sickle cell patients in a compensatory way. PMID- 3629709 TI - The haematological, biochemical and clinical--presentation of haemoglobin S in Saudi Arabia (i). Haematological & clinical expression. AB - The haematological and clinical expression of haemoglobin S (Hb S) was investigated in a group of male and female Saudis of haemoglobin genotype AS and SS, and the results compared with those from normal individuals (AA). The influence of alpha thalassaemia in each genotype was also investigated. The total haemoglobin concentration (Hb), red blood cell count (RBC) and packed cell volume (PCV) were significantly lower in the SS group without thalassaemia. In the thalassaemic group Hb, RBC and PCV levels were higher, while MCV and MCH were considerably lower. The clinical investigations reveal that almost 30% of the SS cases had not required blood transfusion, and none of the patients had suffered from leg ulceration or hand and foot syndrome. Comparison of the results obtained for Saudi sickle cell patients with those reported for Jamaicans show several differences, indicating a milder disease in the Saudis. PMID- 3629710 TI - Role of G6PD, ABO incompatibility, low birth weight and infection in neonatal hyperbilirubinaemia. AB - In a random sample of 1,000 neonates from a Delhi Hospital the incidence of jaundice was 53% and of hyperbilirubinaemia (HB) 6%. Rh incompatibility was detected in 4% of the neonates. In 74 cases of HB (excluding those due to Rh incompatibility) collected from the above series and from subsequent hospital admissions, incidences of different factors contributing to HB were: low birth weight in 54%, G6PD deficiency in 35%, ABO incompatibility in 31% and infection in 31%. In 45% of them a single factor was present and in the remaining more than one factor was present. PMID- 3629711 TI - The prevalence of atypical serum cholinesterase in a Nigerian population. AB - The prevalence of the atypical phenotype of pseudocholinesterase was looked for in 345 individuals living in Zaria district of Northern Nigeria by the differential inhibitory actions of dibucaine and sodium fluoride. The frequency of the atypical gene, Ea1 was found to be 0.9% and the frequency of the fluoride insensitive phenotype Ef1, was 0.74%. The atypical enzyme or the intermediate phenotype was not observed in any of the 42 patients with sickle-cell disease. PMID- 3629712 TI - A comparison of skin test reactions in allergic rhinitis and patients with asthma/rhinitis. AB - A comparison of skin test reactions in allergic rhinitis patients and cases of combined allergic rhinitis and asthma shows a significantly higher proportion of positive reactions to all allergens tested in the asthma/rhinitis patients. Both groups of patients exhibited as expected more positive reactions than a group of controls with house dust mite, and house dust eliciting the highest proportion of reactions. The asthma/rhinitis patients also showed a higher ratio of strong (grades III and IV) to weak (grades I and II) reactions than the allergic rhinitis group. This indicates a stronger allergic sensitivity state in the former group and may be of relevance in deciding the modalities of management. PMID- 3629713 TI - Antitoxic immunity of the population against diphtheria in Singapore. AB - A serological study to evaluate the efficacy of the diphtheria immunisation programme in Singapore based on sera collected from 425 healthy persons between 6 months and 40+ years of age showed that 94.6% of the population surveyed possessed protective neutralising antitoxin (greater than or equal to 0.01 IU/ml). No sex or ethnic difference was noted. The most suspectible age-group was adults above 40 years of age in which 14.3% had no protective antitoxic immunity against diphtheria (less than 0.01 IU/ml). The geometric mean titre was generally high with sharp anamnestic type of secondary response elicited by periodic boosters administered. The survey confirmed the efficacy of the childhood immunisation programme which extended from 3 months to 15+ years of age, in maintaining a high level of herd immunity of the population right into adulthood. Further extension of the programme to include routine revaccination of adults was not considered necessary. PMID- 3629714 TI - Clinical presentation of systemic lupus erythematosus in Saudi patients. AB - A study conducted to assess the incidence and clinical expression of systemic lupus erythematosus in the Eastern Province of Saudi Arabia revealed that the disease is uncommon in this region, only 32 cases being recorded in five years. However, the clinical manifestations of the disease are similar to those observed elsewhere. PMID- 3629715 TI - Adult geophagia--report of three cases with review of the literature. AB - This is the first report of three cases of adult geophagia in Saudi Arabia, two with a history of eating mud, and the third of eating pebbles. The presentation in these patients were of abdominal pains, with the radiographs showing very dense opacities within the intestine, especially the colon. These opacities were of varying sizes, and of varying densities, some of them polygonal in shape. These opacities changed in position with time differentiating them from other densities such as renal calculi with which they are may be confused. A review of the clinical and pathological changes of geophagia is given. The association of iron-deficiency anaemia, hepatomegaly, dwarfism and hypogonadism with a geophagia syndrome is noted and its pathogenesis explained. The role of socio-cultural and other predisposing factors in the aetiology of geophagia is discussed. PMID- 3629716 TI - Sarcoidosis presenting with severe haemoptysis. AB - Major haemoptysis is a very uncommon presentation of sarcoidosis inspite of the high rate and extent of pulmonary involvement in this disease. We report a 37 year-old Nigerian who presented with cough and weight loss and in whom haemoptysis was prominent. In developing tropical countries this mode of presentation is almost invariably due to pulmonary tuberculosis. In this case the haemoptysis was found to be due to ulcerations of nasopharyngeal granulomata due to sarcoidosis. Involvement of the upper respiratory tract in itself is an uncommon finding in sarcoidosis. PMID- 3629717 TI - [Delayed disruption of the telomeric links between chromosomes in experimentally induced cells with micronuclei exposed to 5-bromodeoxyuridine in the 1st S period after colcemid administration]. AB - Under a long-term administration of colcemid in the Chinese hamster cell culture some cells with micronuclei are seen to form. In the case of co-treatment with colcemid and 5-bromodeoxyuridine (5-BrdU) at metaphases of the first division of cells with micronuclei polycentric chromosomes were observed. These polycentric chromosomes occur due to delayed disruption of telomeric links, previously existing in the interphase. During colcemid treatment the cells pass through two S-periods: one in mononuclear cells, the other in cells with micronuclei. This phenomenon was tested according to the frequency of metaphases with dicentrics after 5-BrdU-treatment of cells at the first or second S-period or during the two cycles of chromosome replication. The 5-BrdU treatment during the first cycle or two cycles of replication resulted in the same frequency of cells with dicentrics -about 50%. The treatment with colcemid alone during two cycles of replication and administration 5-BrdU at the second S-period results in a considerably lower amount (%) of cells with dicentrics--about 10%. Thus, the delayed disruption of telomeric links between chromosomes may occur under the treatment with 5-BrdU at the first S-period after colcemid administration. It is also concluded that this phenomenon can be reproduced in cell with micronuclei when 5-BrdU is incorporated differentially in the sister chromatids. PMID- 3629718 TI - Livestock production in central Mali: factors influencing growth and liveweight in agro-pastoral cattle. AB - Data on weight and growth of indigenous African cattle under a traditional management system are reported. In semi-arid central Mali (14 degrees N, 6 degrees W) calf birth weight was 16.6 kg, growth rates to weaning at seven months averaged 185 grams per day. Cows did not reach mature weights (230 kg) until after five years of age and work oxen did not achieve a mature weight of 297 kg until after six years. Effects of season of birth were significant on growth throughout life but effects of year of birth only persisted for nine months. Parity of cow, season and year had significant influences on post-partum weight. Seasonal changes in weight were severe for both work oxen (87 to 107% of mean weight) and for cows (88 to 110%). Over a seven year study period the decline in mature weights of oxen was 4% per year equivalent to about 80 kg over the period. For cows the decline was proportionately less severe (2.7%) these animals averaging 40 kg less in 1984 than they did in 1978. The slow growth rates, low mature weights and reduction in adult size is considered to be due to chronic overstocking on already denuded feed resources and to a decline in rainfall over the period. Current research programmes aimed at finding solutions to these problems are outlined. PMID- 3629719 TI - Relationships between body weight, condition score and heart girth changes in Boran cattle. AB - Body weight, heart girth and condition score were monitored in 75 Boran cows over an eight-month period. Condition score was highly correlated with both weight and heart girth when these variables were measured at the end of the dry season. Over the whole period the correlation coefficient between weight and condition score was r = 0.76 and the relationship was linear. When the data were broken down by lactation status the correlation between condition score and weight of lactating cows was lower but was improved by adjusting for differences in cow weight. Heart girth and condition score over the whole period were linearly related as was heart girth and weight. A change of one point in a nine-score system was equivalent to a change of about 24 kg. PMID- 3629720 TI - Mandibular osteodystrophy fibrosa in Indonesian goats fed Leucaena. AB - Four Indonesian goats fed Leucaena leucocephala with a calcium to phosphorus ratio in excess of 6:1 for 472 days developed mandibular osteodystrophy fibrosa to varying degrees ranging from severe to slight. The animals appeared to grow normally but the animal with the most severe clinical symptoms lost weight for 35 days prior to the termination of the experiment. The other three animals either maintained or gained weight during this period. A balance study performed part way through the experiment revealed that the animal which subsequently lost weight was probably not storing calcium or phosphorus whereas the other animals had a positive calcium balance and were probably storing small amounts of phosphorus. Histological examination of tissues taken after a post-mortem revealed that the kidney, parathyroid and thyroid glands and long bones were normal. PMID- 3629721 TI - Use of Vero cells for the isolation and propagation of malignant catarrhal fever virus. AB - Vero cells were compared with primary bovine thyroid (BTh) cultures for the isolation of malignant catarrhal fever virus from infected blood and tissues. Comparative titrations showed Vero cells detected only two-fold less infectivity in rabbit spleen suspensions than BTh cells. Twenty three of 32 bovine buffy coat cell preparations which were positive on BTh cells were also positive on Vero cells. The cytopathic effects (CPE) of virus isolates in Vero cells consisted of syncytia and refractile cytomegalic cells which were as easy to recognise and developed as rapidly as CPE in BTh cells. Two laboratory strains of malignant catarrhal fever virus were readily adapted to and maintained by passage in Vero cells. PMID- 3629722 TI - Vaccination with Anaplasma centrale: response after an experimental challenge with Anaplasma marginale. AB - The haematological and clinical responses to vaccination with Anaplasma centrale and to subsequent challenge with Anaplasma marginale were evaluated. Twenty Holstein steers 14 to 16 months of age were divided into two groups of 12 and eight animals respectively (groups I and II). Group I was inoculated on day zero with 10(7) A. centrale-infected erythrocytes and group II was kept as a control. On day 125 both groups were challenged with 5 X 10(7) A. marginale-infected erythrocytes. A. centrale inoculation produced low parasitaemias (maximum mean 2.7%), moderate packed cell volume (PCV) falls (minimum mean 20.5%) and no clinical symptoms. After the challenge group I had significantly lower parasitaemia (maximum mean 2.3%) and higher PCV (minimum mean 20.1%) than group II (7.5% and 14.5% respectively). Four steers from group II developed acute anaplasmosis and required treatment. PMID- 3629723 TI - Development and survival of Haemonchus contortus larvae on pasture in Iraq. AB - The survival of Haemonchus contortus infective larvae on pasture and soil was studied over a period of 12 months in the Baghdad area. Infective larvae were found on herbage and soil at all times except in the summer months. During autumn and winter infective larvae in pasture survived for periods of up to 32 weeks. Little larval migration into soil was observed during this study and larvae did not survive for long in the faecal pellets during the summer. PMID- 3629724 TI - [Properties of the adenylate cyclase system in the muscle tissue of the mollusk Anodonta cygnea]. AB - The adenylate cyclase system in the muscular tissue of Anodonta cygnea has been studied. A stimulating effect of serotonin, guanine nucleotides and sodium fluoride is found as well as a dependence of the catalytic activity of adenylate cyclase on magnesium and manganese ions. The mollusk enzyme and the vertebral one do not differ in principle in their functional properties. Only serotonin out of the tested biogenic amines (epinephrine, norepinephrine, dopamine, serotonin) stimulates the adenylate cyclase activity, which agrees with the fact that this neurohormone is a main neuromediator in mollusks. The analysis of the obtained results and data available in literature supports the idea about conservatism of the hormonal signal transfer in animals of different phylogenetic level. PMID- 3629725 TI - [Activity of key enzymes of gluconeogenesis in the liver and corticosterone levels of the blood of thymectomized rats]. AB - Thymectomized rats have been studied with the aim to determine the activity of gluconeogenesis key enzymes (phosphoenol pyruvate carboxykinase, fructose-1.6 diphosphatase, glucose-6-phosphatase), the glycogen content in the liver, the corticosterone level in blood and electrolytes concentration in erythrocytes and blood plasma. The activity of glucose-6-phosphatase and the glycogen content in the liver as well as the corticosterone level in the rat blood are shown to diminish after thymectomy. Changes are found in the electrolytic composition of blood as well as in the activity of key enzyme of the pentose cycle in erythrocytes. The data obtained indicate that thymectomy in rats is followed by the pronounced biochemical shifts induced by the thymus hormone deficiency and disturbance of interrelations in the system of neuroendocrine regulation. PMID- 3629726 TI - [Activity of enzymes of ethanol metabolism as a test in evaluating the effectiveness of sensitizing alcohol deterrents]. AB - A procedure is developed for determination of the efficiency of the antialcoholic drugs' action on the system of ethanol oxidation in vitro: alcohol dehydrogenase by the direct and reverse reactions and aldehyde dehydrogenase of subcellular fractions of the rat liver. This procedure is also used to determine the antialcoholic activity of a number of new compounds and to compare them with disulphiram (antabus, teturam), the known antialcoholic drug. PMID- 3629727 TI - [Various metabolic reactions of formate in animal tissues]. AB - A new metabolic reaction of the aldolase condensation between formic acid and acetaldehyde proceeding with the formation of milk acid is detected in the liver of rats. Milk acid has been determined by chemical, enzymic and autoradiographic methods. Homogeneous preparations of the enzyme which catalyzes the mentioned reactions and is called lactate synthase are obtained in the crystalline form. The method for obtaining the lactate synthase from the rat liver is described as well as certain properties of the lactate synthase. PMID- 3629728 TI - [Mechanism of heparin inactivation by thromboplastin (factor III)]. AB - Thromboplastin (a commercial one and that obtained from different tissues) is shown to inactivate heparin in proportion to the quantity of thromboplastin or to the heparin:thromboplastin ratio. A degree of inactivation of heparin changes after the modification of protein component of thromboplastin by proteases, however there is no dependence between the protein amount in the preparation and its antiheparin activity. Inactivation of heparin by thromboplastin is stipulated by the formation of associations due to electrostatic interactions between the clusters of amino acid protein residues (which dissociate under physiological conditions as bases) and heparin sulphogroups. It is suggested that factor III circulating in blood flow participates in the creation of hemostatic potential not only as a result of its ability to catalyze thrombinogenesis, but also due to the decrease of the anticoagulant blood activity. PMID- 3629729 TI - [A nomogram method for calculating the NAD(P)+/NAD(P)H ratio in cell compartments]. AB - A new method to calculate the ratios of free NAD+/NADH and NADP+/NADPH [NAD(P)+/NAD(P)H] in the cytoplasm and mitochondria of cells by means of nomographs is suggested. The method permits estimating the redox state of the tissue with allowance for the content of metabolites in the dehydrogenase systems. The method may be used widely in the biochemical and medical practice. PMID- 3629730 TI - [Transmembrane lipid transport between lecithin liposomes and neuroblastoma C1300 N18 cells]. AB - The method of double isotopic labels was used to study dynamics of lipid metabolism between neuroblastoma C 1300 N 18 A 1 cells and lecithin liposomes which contained 4.5-5 mumol of lecithin in 1 ml of the suspension. The cell lipids were labelled by radioactive carbon and cultivated on the medium with [1 14C] sodium acetate, phosphatidylcholine of liposomes was labelled by tritium. It is shown that 15-30 min long incubation with liposomes causes a sharp decrease of the cholesterol esters amount with a simultaneous fall of the free cholesterol level. The total content of phospholipids in this case remains unchanged though there occurs the noticeable exchange of labelled phospholipids between cells and liposomes. The cholesterol content in the plasma membranes of cells lowers sharply. The neuroblastoma cells are able to compensate arising changes in the cholesterol level for 45-60 min after which they progressively die. 90 min later only an insignificant part of the population (about 10% of cells) is retained. PMID- 3629731 TI - [Effect of prolactin on the phospholipid composition and cholesterol level in liver microsomes of the carp during acclimation to different temperatures]. AB - The phospholipid composition, content of cholesterol and its esters in the carp (Cyprinus carpio L.) liver microsomes depend on the environmental temperature. The free cholesterol amount and cholesterol/phospholipids ratio in microsomes decrease after the lowering of temperature from 20 to 5 degrees C. The temperature elevation to 30 degrees C results in an increase of the cholesterol ester content. The relative proportions of phosphatidyl choline, phosphatidyl ethanolamine, sphingomyelin, phosphatidyl inositol, phosphatidyl serine, phosphatidic acid increase with a significant decrease of the unidentified phospholipids amount at 30 degrees C. Prolactin affects the cholesterol content and phospholipid composition of liver microsomes. The hormone has a more pronounced effect at subextremal temperatures (5 and 30 degrees C). The actions of prolactin and temperature on the cholesterol content are similar. The hormone influence on the membrane phospholipid composition is opposite to the effect of the temperature acclimation. The possible role of prolactin in the temperature adaptation of the membrane lipids metabolism in poikilotherms is discussed. PMID- 3629732 TI - [Stimulation of mitoplast respiration by mitochondrial porin]. AB - Mitochondrial porin (2 ng/ml) being added to the rat liver mitoplasts considerably stimulates the respiration in the third and uncoupled states. As the same effect was observed previously with the addition of outer membrane fraction to the mitoplast suspension, it is concluded that mitochondrial porin participates in regulation of the mitochondria respiration and, probably, is the natural activator of the ADP/ATP carrier function. PMID- 3629733 TI - [Detection of phospholipase D in rat liver mitochondria]. AB - It is determined that the rat liver mitochondria contain phospholipase D. It is active during incubation of the intact mitochondria, their "ghosts", as well as fractions of outer and inner membranes. This enzyme is shown to be able to realize the catalytic transformations of substrates by the reaction of hydrolysis and exchange of bases. PMID- 3629734 TI - [Succinate dehydrogenase activity of the retina and occipital lobe of the brain during emotional stress]. AB - The emotional stress induces changes in redox processes in the visual analyzer at the level of the succinic acid transformation in the Krebs cycle. The stress evokes a particularly sharp decrease in the succinate dehydrogenase activity in the retina under conditions of dark adaptation whereas in the occipital lobes under the same condition a considerable intensification of the succinic acid oxidation is observed. Stress action under ordinary conditions of the day and night change is accompanied by the succinate dehydrogenase activation in the visual analyzer. However, the light load increases the enzyme activity in test animals the same way as in intact animals. PMID- 3629735 TI - Electron-irradiation-induced flattening of negatively stained 2D protein crystals. AB - The thickness of negatively stained 2D crystalline arrays of the bladder membrane does not vary significantly during air drying and exposure to high vacuum. High dose electron irradiation reduces the thickness to about 60% of the native value. These results, together with the fact that the same behaviour has been observed on another 2D system (gap junctions), indicate that the flattening induced by an electron beam on 2D crystals may be general. The implications for 3D reconstruction of negatively stained objects are discussed. PMID- 3629736 TI - Evaluation of noise within the MK 12 SSDS helmet and its effect on divers' hearing. AB - The noise inside the U.S. Navy MK 12 SSDS helmet was measured and its effect on the hearing of divers assessed. Seven male divers completed 20 dives while breathing air at simulated depths ranging from 1.8 to 30.5 msw with dive durations ranging from 40 to 120 min. Microphones recorded sound pressure levels inside the helmet while the diver was in the water and exercising. Average corrected sound intensity levels in the helmet ranged from 90.5 dB(A) at 1.8 msw to 97.3 dB(A) at 30.5 msw. Diver hearing threshold level shifts were recorded as a function of helmet noise exposure; moderate threshold shifts were observed at depths of 9.1 msw or deeper after 120-min dives. The hearing of all divers completing dives up to 120 min returned to predive levels within 24 h after noise exposure. However, dive durations in excess of 120 min at 9.1 and 20.1 msw resulted in substantial auditory shifts in 1 diver, which required 2-3 d to recover to predive levels. These results suggest that the impact of helmet noise on diver hearing should be included in planning operations using the MK 12 SSDS. PMID- 3629737 TI - Electronystagmography and saturation deep diving at 4.6 MPa. AB - In the course of the ENTEX V and VIII saturation deep diving experiments at 4.6 MPa for 12 d, electronystagmography monitoring was performed on divers before, during, and after the stay in the diving chamber. In a vestibular sense, these dives were well-tolerated subjectively, clinically, and infraclinically by the divers. However, a decrease in the nystagmus induced by caloric stimulation was seen in 4 out of 8 divers during the confinement period at 0.2 MPa and in 6 out of 8 divers upon reaching 4.6 MPa, followed by variable responses dependent on the subject, with total recovery on reaching the surface. These results are explained on one hand in terms of the thermal conductivity of helium, and on the other in terms of a rough form of HPNS. PMID- 3629738 TI - Human vascular fluid responses to cold stress are not altered by cold acclimation. AB - Repeated cold water immersion can induce the development of an insulative type of cold acclimation in man. This investigation determined if repeated cold water immersion produced changes in vascular fluid responses to cold stress in addition to the previously reported changes in thermoregulation. Seven male subjects performed a standardized cold air and cold water exposure before and again after a cold acclimation program. The cold acclimation program consisted of daily immersion (90 min) in cold water (18 degrees C, stirred) repeated 5 times/wk for 5 consecutive wk. Cold acclimation did not alter the responses of plasma volume or electrolyte concentrations, nor urinary flow or electrolyte excretion during either cold air or cold water exposure. The percent reduction in plasma volume was larger (P less than 0.01) in cold water (-17%) than in cold air (-12%). Cold water immersion resulted in greater (P less than 0.01) diuresis than cold air exposure. Plasma K+ concentration increased (P less than 0.01) during cold (both air and water) exposure, whereas plasma Na+ concentration was unchanged. Calculated renal clearance and urinary excretion rate of both Na+ and K+ increased during cold (both air and water) exposure. The magnitude of plasma volume reduction during cold exposure was not correlated with either the degree of body cooling or diuresis. It is concluded that a) insulative cold acclimation does not influence vascular fluid responses to cold stress, and b) although vascular fluid shifts, body cooling and diuresis are all greater in cold water than in air, a consistent relationship among these parameters could not be established for an individual's response. PMID- 3629739 TI - Pulmonary mechanics and atelectasis during immersion in oxygen-breathing subjects. AB - It has been suggested that vital capacity (VC) reduction seen during head-out immersion and oxygen breathing is due to atelectasis formation. In this study VC was reduced in 8 healthy subjects by 8.7% as an effect of immersion per se and by a further 14.3% as an effect of oxygen breathing during 30 min of immersion. Every 2nd min during the exposure, functional residual capacity (FRC), dynamic compliance (C-dyn), and static esophageal pressure at end-expiration (Pes-frc) were measured by body plethysmographic technique. Results were compared with an air-breathing, immersed control situation to evaluate any possible atelectasis formation. The only significant changes during immersion were observed after 30 min of air breathing, where FRC decreased linearly by 8.5% and C-dyn by 13.2%. The main conclusion is that atelectases acting solely as volume restrictors cannot explain the whole VC reduction without other additive or synergistic mechanisms. We suggest that the linear decrements in FRC and C-dyn as an effect of immersion time might be explained by either inspiratory muscle fatigue or increasing thoracic fluid compartment during the first 30 min of head-out immersion. PMID- 3629740 TI - Respiratory function in the upright, working diver at 6.8 ATA (190 fsw). AB - The influence of static lung loading on a number of respiratory parameters was investigated in subjects performing graded leg exercise in an upright posture while submerged and breathing air at ambient pressures up to 6.76 ATA. In comparison with a previous investigation of the prone posture, a lesser tendency to dyspnea was observed. Neutral and moderately positive static lung loads were associated with less dyspnea than were negative loads. Several indices of respiratory function remained relatively normal during exercise and exposure to varying static lung loads. However, there was a tendency for hypoventilation and CO2 accumulation during heavy exercise at 190 fsw; this was not strictly correlated with dyspnea or static lung load. We conclude that, if a full face mask is used, breathing gear for divers should provide a static lung load of approximately 0 to +10 cmH2O regardless of the diver's orientation in the water. When possible, divers should assume an upright posture while engaged in strenuous work. PMID- 3629741 TI - Components of the pressure required to breathe dense gases. AB - To elucidate the impact of high gas density on airway flow (during inspiration and expiration) and on gas acceleration (at end-inspiration and end-expiration), I simulated pressures for breathing in man with a) an equation of motion of the respiratory system, b) the assumption that pressure to accelerate gas is directly proportional to density, and c) five different assumptions concerning the relationships among lung volume, density, and the pressure for flow. The results show that accelerative pressure is not an important fraction of the total pressure with attainable densities, tidal volumes, and frequencies when it is assumed that lung volume changes as a sine-wave function of time. High accelerative pressure has a minor effect of making intrapleural pressure tend to be in phase with flow, as it is with high flow resistance. Alternate assumptions about pressure to cause flow led to small changes in the patterns of pressure with time, but had little effect on the overall picture. CONCLUSIONS: Effects of lung volume and density on flow pressure can be characterized successfully in several ways, and the large density effect on flow pressure dominates the energy requirement for breathing in dense-gas environments. PMID- 3629742 TI - Visual reaction time performance preceding CNS oxygen toxicity. AB - The visual reaction time performance of divers experiencing CNS oxygen toxicity was assessed during the development of closed-circuit 100% oxygen breathing diving schedules at the U.S. Navy Experimental Diving Unit. Divers repeatedly performed the visual reaction time test of the Performance Measurement System (PMS) during multiple excursion dives. Each diver wore a Draeger LAR V UBA and performed moderate work on an underwater bicycle ergometer while engaged in the reaction time test. A single subject, repeated measures design was used. Six divers experienced 7 episodes of CNS oxygen toxicity while engaged in the visual reaction time test. Two episodes were preceded by a slowing and increase in variability of reaction time. Five episodes were not preceded by changes in reaction time performance. Other objective and subjective symptoms of toxicity experienced by the divers did not appear to be correlated with reaction time performance. Thus, the PMS visual reaction time test was not reliable method of detecting CNS oxygen toxicity in this study. PMID- 3629743 TI - Decompression sickness in women divers. AB - The comparative incidence of DCS in women has been debated for years. Diving log data from the Naval Diving and Salvage Training Center (NDSTC), Panama City, FL, demonstrate that there is no increased risk of DCS among Navy female divers compared to their male counterparts. Twenty-eight female students were compared to their 487 male classmates on 878 air and helium-oxygen dives between 4.64 and 10.10 ATA (120 to 300 fsw). None of the women experienced DCS while 8 men developed DCS symptoms. The total duration of the dives ranged from 8 min to 2 h and 6 min; bottom times were less than 20 min. Theoretical inert gas supersaturation on these profiles are commensurate with those experienced on 40- to 60-min sport scuba dives. PMID- 3629744 TI - Failure of heparin, superoxide dismutase, and catalase to protect against decompression sickness. AB - The effects of heparin (HEP), superoxide dismutase (SOD), and catalase (CAT) on the course of decompression sickness (DCS) were studied in anesthetized dogs (Canis familiaris). Animals were divided into 4 groups: a drug assay group (n = 4) received HEP + SOD or HEP + SOD + CAT but were not dived; a control group (n = 14) was dived without drug treatment; a HEPSOD group (n = 11) received HEP + SOD predive and postdive; and a HEPSODCAT group (n = 15) received HEP + SOD + CAT before diving. All dived animals were subjected to repetitive air dives to 10 ATA until pulmonary artery pressure at least doubled within 10 min postdive. Physiologic variables were measured for 3 h postdive or until death. Animals were not recompressed. More early deaths occurred in the HEPSOD (7/11) and HEPSODCAT (8/15) groups than in the control group (5/14). All dived animals developed pulmonary hypertension, systemic hypotension, hemoconcentration, acidosis, hypoxemia, and interstitial pulmonary edema postdive. Drug therapy did not alter these responses to decompression. We conclude that without recompression, treatment with either HEP + SOD OR HEP + SOD + CAT does not improve the outcome of severe DCS in this animal model. PMID- 3629745 TI - Intraosseous pressure changes during simulated dives: fact or transducer artifact? AB - Anesthetized rabbits were placed in a compression chamber and the intraosseous pressure (IOP) in one femur was recorded during simulated dives to a depth of 20 m. No change in IOP was observed during any phase of these simulated dives. However the pressure transducer (Statham P23 Dc) used to measure the IOP was found to be affected by changes in the ambient temperature which occurred during compression and decompression. This may account for the changes in canine femoral IOP observed by others during similar experimental conditions. PMID- 3629746 TI - Long-term health consequences of diving accidents. PMID- 3629748 TI - Prostatic epithelium inhibiting factor (PEIF): organ specificity and production by prostatic fibroblasts. AB - The effects of prostate fibroblast conditioned medium on two prostate epithelial cell lines (PC-3, LNCaP) and on two non-prostatic cell lines (MCF-7, K562) was investigated. As prostate fibroblast conditioned medium exerts its main effect on DNA synthesis, 3H thymidine incorporation was monitored to measure factor activity. Conditioned media of all prostatic fibroblast lines investigated were inhibitory for PC-3, LNCaP and MCF-7. Conditioned medium of prostatic fibroblasts was clearly stimulatory for K562. Prostate specificity of production of PEIF was demonstrated by the fact that conditioned medium from skin fibroblasts proved to be stimulatory for PC-3. Inhibitory activity from conditioned medium as well as from a BPH homogenate was precipitated by 33-67% ammonium sulfate. These partly purified fractions were respectively five and ten times as active as "crude" conditioned medium. The physical nature of PEIF (protein or macroglycolipid) as well as the possible function (as a signal messenger between stroma and epithelium) is discussed. PMID- 3629747 TI - Development of an in vivo clonogenic cell assay for rat prostate metastatic tumor -R3327-MatLyLu. AB - The effects of intravenous (iv) inoculation of rat prostate R3327-MatLyLu tumor cells in syngeneic Copenhagen rats have been investigated both qualitatively and quantitatively in order to establish an in vivo clonogenic cell assay. Intravenous injection of tumor cells resulted in formation of tumor nodules only in the lungs. A linear relationship existed between the number of tumor cells injected and the number of measured lung nodules. The distribution patterns of iv injected radiolabelled tumor cells and of non-labelled tumor cells injected in both arterial and venous blood vessels confirmed the major role of the lungs as recipient organ for injected tumor cells. Although a similar distribution pattern was observed after iv injection with radiolabelled fibroblasts, no lung nodules were observed even one year after injection. The sensitivity for measuring drug treatment effects by this in vivo clonogenic cell assay has been compared with that of the in vitro clonogenic cell assay. Information obtained using both in vitro and in vivo clonogenic cell assay will provide a better understanding of efficacy of treatment modalities. PMID- 3629749 TI - Effects of castration compared with total androgen blockade on tissue dihydrotestosterone (DHT) concentration in benign prostatic hyperplasia (BPH). AB - We compared the effect of a variety of drug regimens to lower prostate DHT concentration. Patients with BPH were treated for one week prior to surgery with either tamoxifen, flutamide, megestrol acetate, megestrol acetate plus tamoxifen and megestrol acetate plus DES or ketoconazole. DHT concentration in the surgically resected tissue was compared with tissues obtained from untreated patients. We also obtained prostate tissue at the time of relapse in patients with prostate cancer who had been treated with orchiectomy with or without estrogen therapy. Megestrol acetate plus the mini-dose of DES (0.1 mg) and megestrol acetate plus ketoconazole both decreased DHT concentrations in prostate tissue to levels (0.79 ng/g) significantly below those noted with orchiectomy (1.16 ng/g). The difference between the DHT concentration in the two groups (orchiectomy vs. total androgen blockade) represents the contribution of adrenal androgens to prostate tissue DHT. This small amount of DHT (approximately 0.4 ng/g) may be biologically important in stimulating prostate epithelial cell growth. PMID- 3629750 TI - Zinc, cadmium and selenium concentrations in separated epithelium and stroma from prostatic tissues of different histology. AB - The concentration of Zn, Cd and Se in unseparated tissues and epithelial and stromal fractions of normal prostate gland, BPH and prostatic carcinomas of different histological grading were determined by flameless AAS. There were distinct differences in the content of Zn, Cd and Se in the epithelial and stromal fractions depending on histology. In all cases the concentration of these elements in the epithelial fractions was higher than in stromal fractions. These differences are discussed. PMID- 3629751 TI - Aromatization of androstenedione to estrogen by benign prostatic hyperplasia, prostate cancer and expressed prostatic secretions. AB - Human prostatic tissue and expressed prostatic secretions (EPS) from patients with benign prostatic hyperplasia (BPH) and prostate cancer were incubated with (1 beta 3H) androstenedione. The extent of aromatization was determined by measuring the transfer of 3H from the 1 beta position into water. The amount of 3H2O recovered corresponds to the estrogens formed. Tissue from 5 patients with BPH yielded 2.13 (+/- 1.05) pmol/mg protein/h while the EPS from the same patients yielded 727 fmol/mg protein/h. In patients with prostate cancer the mean formation of estrogens was 388 fmol/mg protein/h (+/- 75). 4-hydroxy androstenedione, an aromatase inhibitor, successfully inhibited aromatization in BPH and prostate cancer 53-98%. PMID- 3629753 TI - Anatomy of the prostate from fetus to adult--origin of benign prostatic hyperplasia. AB - The anatomy of the prostate was studied in specimens from humans ranging from fetal age to 79 years. At all ages, the prostate can be divided into two zones, inner and outer. The distribution and relative size of the prostatic lobes is similar in the fetus and in the adult. In the fetus, the inner zone can be subdivided into lateral, subcervical, and anterior lobes and mucosal glands. The anterior and subcervical lobes usually disappear in prepuberty but may reappear in advanced age. The outer zone can be subdivided into the middle and posterior lobes. Benign prostatic hyperplasia arises from the lateral, subcervical, and anterior lobes of the inner zone and the middle lobe of the outer zone. It is suggested that previous investigators failed to describe a demarcation line or territory between the lateral and posterior lobes. PMID- 3629752 TI - Direct effects of oestradiol on growth and morphology of the Dunning R3327H prostatic carcinoma. AB - Male Copenhagen x Fischer F1 rats were implanted with Dunning R3327H prostatic carcinoma, castrated when the tumours became palpable and were then treated with testosterone, testosterone in combination with oestradiol or oestradiol alone for four weeks. Treatment with oestradiol produced the smallest tumours. The testosterone-stimulated growth of tumours was inhibited by oestradiol. The adenocarcinoma was moderately to well-differentiated. Morphometric analysis of the composition of the tumours showed that oestradiol stimulated tumour stroma and inhibited glandular epithelium. These effects were produced concomitantly with decreased overall tumour growth. Testosterone stimulated all cell types of the tumour. PMID- 3629754 TI - [Pathophysiology of primary renal pelvis outflow stenosis]. AB - Ureteral peristalsis originates in the most proximal parts of the caliceal system. It is then conducted to the ureter by way of myogenic excitation conduction. In the pyeloureteral region, however, there seems to be some sort of physiological blockade and modulation of activity. It depends on the level of diuresis whether only a few or all contractions of the renal pelvis reach the ureter. Morphological and functional investigations show that the pathophysiological disturbance in cases of primary stenosis of the pyeloureteral junction seems to be a complete blockade of myogenic excitation conduction. The principle of open surgical corrections (dismembered pyeloureteroplasty) is not only to create a widely open connection between renal pelvis and ureter but also to remove the misfunctioning pyeloureteral segment and to substitute it by a region of improved myogenic excitation conduction. PMID- 3629755 TI - [Percutaneous pyeloplasty. Indications, technic, results]. AB - The indication for and technique of the percutaneous operation of strictures at the ureteropelvic junction in 117 patients are discussed. The results in 66 followed up cases are presented in detail. The new method was found superior to open surgery in cases of secondary (acquired) stenoses and a success rate of 89% can be expected. The results of its use for congenital stenoses are not as good (73%), however, if this simple and safe technique does fail, open plastic surgery can still be performed. PMID- 3629756 TI - [Initial experiences with the Camey bladder]. AB - The construction of a new continent reservoir after cystectomy has been a major attempt of urological surgery during recent years. We have employed an ileal conduit which was anastomosed to the urethra according to Camey in 10 patients. Two patients died postoperatively because of complications. Eight left the hospital with a sufficiently working new bladder. Capacity, flow, bladder emptying and continence were satisfactory. The results are presented in detail. Most patients were incontinent to some degree during the night. This was handled by micturition, pads and condom urinals. All patients were content with the result. The longest follow up time is 2 years. PMID- 3629757 TI - [Bilateral intrauterine testicular torsion]. AB - Torsion of the testes is the most frequent urogenital emergency in childhood. Bilateral intrauterine torsion of the testes is a rare event. Only 15 cases have been reported up till now. We add two patients. Clinical findings, consequences and therapy of bilateral torsion of the testes are discussed. Etiology and symptomatology of testicular torsion in the newborn and the adult are different. Predisposing factors are lacking in the extravaginal torsion of the newborn but are present in the intravaginal torsion of the adult. The diagnosis is made by inspection, palpation, Doppler sonography and, if necessary, by immediate surgical exploration. Except for the local findings there are usually no symptoms in the newborn. Following bilateral torsion of the testes with consecutive bilateral orchiectomy the loss of exocrine function remains irreversible. Androgenic substitution therapy should begin at the age of 14. The full dose of hormone should not be given before the termination of bone growth. For psychological and cosmetic reasons a testicular prosthesis can be recommended. PMID- 3629758 TI - [Dressing technic with silastic foam following penis operations]. AB - Silastic foam has very good properties as dressing material. After operations on the penile urethra or the corpora cavernosa the liquid foam is applied to the wound area. The foaming material avoids formation of pouches and hollow spaces. The compressive bandage prevents post surgical edemas and hematomas respectively. It can be removed without pain. PMID- 3629759 TI - Subfertility: an etiologic factor in development of testicular cancer? AB - Gonadal dysfunction with resultant subfertility has been implicated as a possible etiologic factor in testicular cancer. A survey of 57 men who had been married before testicular cancer developed revealed that only four marriages (9%) had problems with fertility. Our findings fail to support a premise that testicular carcinoma is associated with prior male infertility. PMID- 3629760 TI - Effects of ultrasound on ultrastructure of human testes. AB - Studies to detect ultrastructural changes in testicular tissues after a fifteen minute exposure to ultrasonic waves were done in 10 men undergoing bilateral orchiectomies for prostatic carcinoma. Examination of Sertoli cells and germ cells in different stages of differentiation failed to reveal significant differences between exposed and control testes. PMID- 3629761 TI - Penile electrodiagnosis: penile peripheral innervation. AB - Many electrophysiologic tests have been performed and have proved useful for diagnosing sexual function. However, there have been limitations to the interpretation of the tests because of paucity of details concerning penile innervation. Therefore, electrophysiologic studies were performed in 3 patients with psychogenic impotence and in 15 patients with organic impotence to assess accurately the peripheral somatic innervation of the penis. The glans penis was innervated by the dorsal nerve of the penis. In some patients dual innervation was present at the ventral aspect of the glans penis by the dorsal nerve of the penis and the perineal nerve. The predominant innervation and fiber spectra of the glans by the dorsal nerve of the penis and the crucial role of the glans in sexual arousal and erectile function provide adequate rationale for the measurement of nerve conduction velocity of the dorsal nerve of the penis in sexual dysfunction. PMID- 3629762 TI - Renal failure and mortality after nephrectomy for severe trauma in multiply injured patient: no inordinate risk. AB - It was recently reported that renal loss by partial or total nephrectomy for renal trauma increases the rates of acute renal failure and death in the multiply injured patient. Because our preference has been for immediate surgical intervention in such patients, a retrospective review was performed to ascertain the effect of partial or total nephrectomy. Eighty-eight patients met the criteria of multiple injuries including severe renal injuries (laceration, rupture, or pedicle injury) and availability of renal function data. Partial or total nephrectomy had been performed in 50 patients, renorrhaphy in 23, and 15 were managed without renal operation. In patients with renal lacerations, the numbers of associated injuries (including intra-abdominal injuries) were similar to those managed conservatively or by operation, and the rates of acute renal failure and mortality were the same with conservative management, renorrhaphy, or nephrectomy. Patients with renal pedicle injuries who had a nephrectomy did have a higher rate of acute renal failure than those managed conservatively (75% vs 0%; p less than 0.05), but they also had more associated injuries (2.8 vs. 1.6/patient; p less than 0.04) and they were older. These two factors, rather than the nephrectomy, probably accounted for the greater rates of acute renal failure and death. PMID- 3629763 TI - Ureteral stump metastases from renal adenocarcinoma. AB - The thirty-second documented case of ureteral stump metastasis from renal adenocarcinoma is presented. It demonstrates well the variable and often unusual presentation of renal adenocarcinoma and the utility of our current diagnostic instrumentation (here ureteroscopy and skinny needle biopsy) in documenting metastatic disease. Also, and in contrast to prior reports, it documents lengthy survival and a lack of extensive metastases in this high risk group of patients. The literature is reviewed and the presentation, metastatic pathways, and management of ureteral stump metastases from renal adenocarcinoma are briefly discussed. PMID- 3629765 TI - Rubinstein-Taybi syndrome. AB - Rubinstein-Taybi (broad thumb and big toe) syndrome, is characterized by mental and motor retardation and skeletal deformities of which broad thumb and large first toe are the most obvious. In addition, defects of the cardiovascular system and the urinary tract may be present. A case of Rubinstein-Taybi syndrome in a boy is presented. PMID- 3629764 TI - Extracorporeal shock-wave lithotripsy (ESWL)-induced erosions in upper gastrointestinal tract. Prospective study in 40 patients. AB - In a prospective study in 40 patients receiving ESWL treatment, gastric and/or duodenal erosions occurred in 32 patients (80%); in 24 (60%) the erosions were in the proximal part of the stomach. There was no direct relation between the patients' weight and the development of erosions. In some patients more erosions developed in relation to the number of shock waves received and the intensity of energy given. In most patients early onset of hematuria indicated development of more erosions. To our knowledge this is the first report in the literature on ESWL-induced erosions in the upper gastrointestinal tract. PMID- 3629766 TI - Bilateral ureteral meatal obstruction after ureteroneocystostomy. AB - Anuria due to complete obstruction at the level of the ureteral meatus was encountered after bilateral ureteral reimplantation. The cause was thought to be due, at least in part, to excessive length of distal ureter drawn into the submucosal tunnel. At reoperation, both ureteral meatus were found to be stenotic and to project intravesically. Bilateral ureteral meatotomy was performed and proved to be curative. PMID- 3629767 TI - Giant ectopic ureter presenting as abdominal mass in infant. AB - A case is presented of an abdominal mass created by massive ureteral dilation in an infant with VATER association. Curiously, only the terminal portion of the ureter was dilated. PMID- 3629769 TI - Spontaneous retroperitoneal hemorrhage: unusual presentation of renal cancer. AB - Spontaneous retroperitoneal hemorrhage as the presenting sign of renal cancer is rare. A case of spontaneous retroperitoneal hemorrhage from a renal carcinoma is described and management possibilities presented. While it is true that renal angiomyolipomas are the main cause of spontaneous retroperitoneal renal bleeding, the possibility of renal cancer should be entertained more often in the differential diagnosis. PMID- 3629768 TI - New method of evaluating sperm morphology with predictive value for human in vitro fertilization. AB - A prospective study was planned to evaluate sperm morphology as a parameter to predict the fertilization outcome in an in vitro fertilization program. Couples applying to in vitro fertilization were admitted into this project when the sperm concentration was greater than 20 million per mL and motility greater than 30 per cent. Based on new strict criteria for evaluating normal sperm morphology, patients were divided prospectively into 2 groups. In group I (25 patients) normal sperm morphology was less than 14 per cent, and in group II (71 patients) normal sperm morphology was greater than 14 per cent, using a threshold established previously. Multiple regression analysis was used to evaluate different parameters: concentration, motility, and morphology against the dependent variables, fertilization, and cleavage. The only factor which was significantly correlated with fertilization and cleavage was normal sperm morphology (P less than 0.0001). The fertilization rate (per oocyte) and the cleavage rate were 49.4 per cent and 47.6 per cent in group I and 88.3 per cent and 87 per cent in group II (P less than 0.0001). The ongoing pregnancy rate per laparoscopy and per embryo transfer was 4 per cent and 5.5 per cent, respectively, in group I and 18.3 per cent and 18.5 per cent, respectively, in group II (no significant difference). This study demonstrates the value of analyzing sperm morphology using the criteria recommended in terms of predicting fertilization and perhaps pregnancy outcome. Patients can be better counseled and the probability of fertilization or no fertilization can be more accurately established. Furthermore a trend is shown in the pregnancy rate that may indicate the importance of the male genome in establishing a pregnancy. PMID- 3629770 TI - Bladder perforation caused by cucumis sativus repaired per vagina. AB - A case of bladder perforation secondary to simulated intercourse with a cucumber is presented. Treatment by primary vaginal repair was successful. PMID- 3629771 TI - Fused vesical calculi. AB - A case is described in which a patient, who initially presented with five separate bladder calculi, was found to have had coalescence of three calculi to produce a large stone. This may be one mechanism in the development of a giant vesical calculus. PMID- 3629772 TI - Splenic abscess as complication of perinephric abscess. AB - Retroperitoneal extension of perinephric abscess with fistulization to intra abdominal and intrathoracic structures has been well documented in the literature. Intraperitoneal rupture is much less common, and exceptionally may not present as an acute abdominal condition. We describe herein 1 such case involving the spleen. Since the extent of the disease may not be apparent radiologically, and often is only ascertained at the time of surgery, we recommend an aggressive approach to renal calculi as the most effective means of preventing complicated perinephritis. PMID- 3629773 TI - Visual internal urethrotome for incision of dense perirenal scar tissue during percutaneous stone removal. PMID- 3629774 TI - Technique for placement of Small-Carrion prosthesis postpriapism. PMID- 3629775 TI - Undeflatable Foley catheter balloons: a simple solution. PMID- 3629776 TI - Retroperitoneal liposarcoma presenting as spermatic cord tumor. AB - A well-differentiated liposarcoma of the retroperitoneum and spermatic cord, contiguous through the inguinal canal, presented clinically as a scrotal mass. Radical orchiectomy was performed with removal of the spermatic cord tumor. The retroperitoneal portion was not discovered until one month postoperatively when a computerized tomographic scan of the abdomen was done. A recommendation is made for preoperative evaluation of the retroperitoneal space prior to extirpation of supratesticular spermatic cord masses. PMID- 3629777 TI - Angiosarcoma of kidney. AB - We describe a forty-six-year-old man who died of disseminated angiosarcoma ten months after a radical nephrectomy and postoperative radiation therapy for a renal angiosarcoma. We found 3 other well-documented reports of renal angiosarcoma, all in men. Two of the 3 cases previously reported also had a rapidly fatal course with hematogenous spread of the neoplasm following nephrectomy. Angiosarcoma of the kidney, although rare, is apparently a highly malignant fatal neoplasm, and effective therapy remains unknown. PMID- 3629778 TI - Voiding dysfunction in tertiary syphilis. AB - After years of decline to near disappearance, there recently has been an increasing incidence of syphilis in America. New cases of tertiary neurosyphilis are being reported which often have associated significant urologic sequelae. For the first time in the English literature, the uro-dynamic findings of a patient with tabes dorsalis are presented. Our findings indicate that treatment of urinary retention associated with tabes dorsalis is better managed by intermittent catheterization than by prostate surgery because of the impaired detrusor activity. A review of neurosyphilis and its urologic implications and urodynamic findings are presented. Prompt recognition of this entity should encourage a full urodynamic evaluation prior to a commitment to prostatic surgery. PMID- 3629779 TI - Case profile: pseudoureterocele following ESWL. PMID- 3629780 TI - [Characteristics of the occurrence and course of ciliochoroidal detachments with the shallow anterior chamber syndrome]. PMID- 3629781 TI - [Iridoplasty in cataract extraction in primary glaucoma patients]. PMID- 3629782 TI - [Results of lensectomy in children]. PMID- 3629784 TI - [Preoperative preparation for cataract extraction in diabetics]. PMID- 3629783 TI - [Fluorescence iridoangiography in assessing iris microcirculation with the implantation of intraocular lenses made of silicon and polymethylmethacrylate]. PMID- 3629785 TI - [Expulsive hemorrhage during eye operations]. PMID- 3629786 TI - [Ophthalmological dispensary care for diabetics]. PMID- 3629787 TI - [Method of diagnosing disorders in impermeability of the eyeball]. PMID- 3629788 TI - [The scleral deformation coefficient as a criterion in choosing the scleroplastic operation in progressive myopia]. PMID- 3629790 TI - [Hemodynamic changes and late vascular complications after thrombosis of the retinal veins]. PMID- 3629789 TI - [Surgical results in retinal detachments with macular rupture]. PMID- 3629791 TI - [Retinal lesions in peripheral uveitis]. PMID- 3629792 TI - [Action on the cornea of pulsed laser radiation at a wavelength of 1.96 mu m]. PMID- 3629793 TI - [Use of low-frequency ultrasound in the therapy of glaucoma]. PMID- 3629795 TI - [Silicon scleroplasty in progressive myopia in children and adolescents]. PMID- 3629794 TI - [Imaging by nuclear magnetic resonance in ophthalmology]. PMID- 3629796 TI - [Correlation between fundus oculi changes and eye dimensions in patients with progressive high myopia]. PMID- 3629797 TI - [Modification of the fenestrated ophthalmic forceps for operations on the lacrimal points and canaliculi]. PMID- 3629798 TI - [Choristoma of the orbit (a practical case)]. PMID- 3629799 TI - [Role of ophthalmoscopic study of the optic disk in congenital glaucoma]. PMID- 3629800 TI - [Status of cerebral hemodynamics in children with neurosensory hearing loss]. PMID- 3629801 TI - [Detection of neurosensory hearing loss in children in the acute stage of bacterial meningitis]. PMID- 3629802 TI - [Audiologic characteristics of presbycusis according to the front discrimination index of a growing acoustic stimulus]. PMID- 3629803 TI - [Radionuclide diagnosis of rhinosinusogenic inflammatory processes in the brain]. PMID- 3629804 TI - [The glycerol test among patients with occupational hearing loss]. PMID- 3629806 TI - [Biophotometry of the palatine tonsils during treatment with helium-neon laser radiation]. PMID- 3629805 TI - [Medico-genetic consultation for families with neurosensory hypoacusis of unknown etiology in both spouses]. PMID- 3629807 TI - [Features of metabolic disorders of the lymphoid tissue of the palatine tonsils in chronic tonsillitis patients]. PMID- 3629808 TI - [Topographo-anatomic basis for an approach to the nasal portion of the pharynx and the lateral parapharyngeal space through the infratemporal fossa]. PMID- 3629809 TI - [Submucosal myoarytenoid resection in laryngeal stenoses of paralytic etiology]. PMID- 3629811 TI - [Occupational-medical disability examination in diseases of the ear, nose and throat]. PMID- 3629810 TI - [Ambulatory surgery using general anesthesia in otorhinolaryngologic practice]. PMID- 3629812 TI - [Dynamics of various indices of nonspecific bodily resistance among ginnery workers inhaling prodigiozan]. PMID- 3629813 TI - [The elongated styloid process syndrome]. PMID- 3629814 TI - [2 cases of cementoma of the paranasal sinuses]. PMID- 3629815 TI - [Recurrences of malignant tumors of the ethmoid labyrinth]. PMID- 3629816 TI - [Foreign body in the nasopharynx of a 1.5-year-old boy]. PMID- 3629818 TI - [Malignant chondroma of the larynx]. PMID- 3629817 TI - [Multiple nodular plasmacytoma of the nasal cavity and paranasal sinuses]. PMID- 3629820 TI - [Foreign body of the maxillary sinus and orbit]. PMID- 3629819 TI - [Use of 5% dioxidine ointment in the treatment of patients with chronic suppurative Highmoritis]. PMID- 3629821 TI - [Long-latency evoked potentials in evaluation of the sensory threshold of the otolithic apparatus]. PMID- 3629822 TI - [Functional surgery of the larynx using radiation therapy and hyperthermia]. PMID- 3629823 TI - [Immunocompetence and malignant degeneration of precancerous diseases of the ENT organs]. PMID- 3629824 TI - [Studies of ototoxicity and its correction in mouse embryo model inner ear organ cultures]. PMID- 3629825 TI - [Postoperative hemobilia (diagnosis and therapeutic procedure)]. PMID- 3629826 TI - [Pseudocoronary syndrome in reflux esophagitis]. AB - The authors have shown that among 173 patients with the insufficient closing function of the cardia there were 18 patients with pseudo-coronary syndrome related with reflux-esophagitis. Operations were performed on 14 of them with good effects. The surgical correction of insufficiency of cardia functions in most cases gives elimination of cardio-vascular disorders resulting from reflux esophagitis. PMID- 3629827 TI - [Treatment of chronic arterial insufficiency of the extremities by quantum hemotherapy]. AB - Quantum hemotherapy--reinfusion of small quantities of UV irradiated autologous blood--was used in 121 patients treated for chronic arterial insufficiency of extremities. Good results of the treatment were obtained in 57% of the cases, satisfactory results in 20%. The use of radionuclide methods gave an objective improvement of the major blood flow and microcirculation. PMID- 3629828 TI - [Use of UV autologous blood irradiation for preventing the occurrence of tracheobronchitis during tracheostomy]. AB - The authors made an analysis of incidence of tracheobronchitis in patients with tracheostomy. It was established that tracheobronchitis followed 15 of 57 tracheostomies. The use of UV autologous blood irradiation in 17 patients with tracheostomy gave only one case of tracheobronchitis while in 40 operated patients without the procedure there were 14 cases of the complication. Thus, the authors believe that the administration of UV autologous blood irradiation in tracheostomy gives 6 times less incidence of tracheobronchitis in the patients, the method being of value in prevention of the complications. PMID- 3629829 TI - [Chemical synovectomy in hemophilia patients]. AB - Results of chemical synovectomy of knee joints with 70 per cent ethyl alcohol were analyzed in patients with hemophilia. The chemical synovectomy proved to be effective at early stages of hemophilic arthropathy and may be used in order to prevent progress of hemophilic arthropathy in patients with recurrent hemarthroses. PMID- 3629830 TI - [Effect of a prolonged peridural block on liver function in cholelithiasis patients]. AB - The authors have shown that peridural blockade used in surgical interventions in patients with mechanical jaundice does not aggravate hepatic insufficiency diagnosed before the operation and facilitates earlier normalization of liver functions in the nearest postoperative period. PMID- 3629831 TI - [Recovery from anaphylactic shock with clinical death following lidocaine administration]. PMID- 3629832 TI - [Successful resuscitation of a female patient with a iatrogenic gas embolism]. PMID- 3629833 TI - [Wound retractor in surgery of the distal portion of the esophagus and cardial portion of the stomach]. PMID- 3629835 TI - [Determination of the degree of surgical risk in treating peptic gastrointestinal hemorrhages]. AB - Based on a complex analysis of case histories of 817 patients operated upon for ulcerous gastro-intestinal bleedings the authors have developed a system of the assessment of a degree of operative risk. High risk degree of the forthcoming surgery necessitates its shorter duration and less traumatic character as well as careful management of the patients in the nearest postoperative period. PMID- 3629836 TI - [Internal drainage of the bile ducts in acute cholecystitis]. AB - An experience with the treatment of 286 patients with acute cholecystitis is described. Cholecystectomy was performed in combination with one of the methods of internal drainage of bile ducts which made up 33.1% of the total number of operations performed for acute cholecystitis. Lethality in this group of patients was 4%. To decrease the amount of postoperative complications and lethality the external drainage of bile eliminating ducts is indicated in the nearest postoperative period. PMID- 3629834 TI - [Device for developing the finger joints]. PMID- 3629837 TI - [Topographic basis for interpreting thermograms in acute pancreatitis]. AB - The decoding of thermograms with special reference to the body built and pancreas topography can considerably diminish the amount of diagnostic errors and hence facilitate solution of the complex problem of surgical tactics. The use of this method has reduced the amount of diagnostic errors from 30% to 15%. PMID- 3629838 TI - [Continuous retroperitoneal infusion of a novocaine cocktail in the combined treatment of severe forms of acute pancreatitis]. AB - Severe forms of acute pancreatitis were treated in 53 patients (25 with a destructive form, 28 with an edematous form) with using permanent infusions of a novocaine cocktail into the retroperitoneal space. General lethality was reduced to 5.7%. In the group of patients with a destructive form of acute pancreatitis lethality was 12%. Nobody died in the group of patients with the edematous form. No complications were noted resulting from the method. PMID- 3629839 TI - [Surgical results in acute cholecystopancreatitis]. AB - An analysis of results of the surgical treatment of 105 patients with acute cholecystopancreatitis has shown that abdominal peritonealization and resection of the necrotized part of the pancreas in combination with radical operations on bile ducts are the most substantiated operations in pancreonecrosis. PMID- 3629840 TI - [Diagnosis and treatment of pneumatic cysts of the lung]. AB - Based on observations of 18 patients with air cysts of the lungs the author analyzes problems of their diagnostics and treatment. Special attention is given to giant air cysts, their differential diagnostics and volume of surgery. PMID- 3629841 TI - [Combined operations in diseases of the large intestine]. AB - An analysis of 153 associated operations for diseases of the large bowel was made. Operations on the abdominal cavity were fulfilled in 25.5% of the patients, the other patients were subjected to perineal interventions. The authors consider that special attention should be given to the preoperative management, detection of concomitant diseases for more exact indications for associated surgical procedures, the latter being shown not to enlarge the amount of complications and the period of staying at the hospital. PMID- 3629842 TI - [Clinical lymphographic diagnosis of posttraumatic edema in the substitution of bone defects]. AB - The method of direct "lower" lymphography of the medial superficial collector was used for the examination of 11 patients with a moderate chronic posttraumatic edema developed against the background of atrophy of muscle tissues before and in the process of substituting bone defects after Ilizarov. In substituting bone defects against the background of a previous posttraumatic blockade of lymph vessels and their alterations there appears a complete or partial decompensation of the lymph flow, resulting in the development of edema in the atrophied earlier segments of lower extremities. In part of the patients with substituted bone defects the edema increased with persistent previous alterations. In other ones there appeared new foci of the rearrangement of lymph vessels. PMID- 3629844 TI - [Active drainage of a wound]. AB - Experimental investigations of the authors have shown active drainage to be optimal at negative pressure in the wound not higher than 80 mm Hg. The application of active drainage in the treatment of 1369 patients has demonstrated the effectiveness of the method for prevention of local complications of the wound process. PMID- 3629843 TI - [Effect of low-frequency ultrasound on non-clostridial anaerobic microflora]. AB - Under analysis is an experience with the treatment of 78 patients with various purulent diseases of soft tissues caused by non-clostridial anaerobic microorganisms in a pure form or in combination with aerobic microflora treated with using low frequency ultrasound. The ultrasound was found not to alter the antimicrobial properties of antibacterial drugs. The degree of bacterial dissemination of the wounds was reliably lower. By the end of the treatment (on the 10-11th days) no growth of microflora was found in 25.7% of the examined patients. The sensitivity of anaerobic microorganisms to antibiotics not only became higher in the process of treatment with ultrasound but there appeared strains sensitive to other antibiotics. PMID- 3629845 TI - [Adipose tissue repair of the bone cavities in treating chronic osteomyelitis]. AB - The substitution of osseous cavities by fat pedicle flaps was performed in 29 patients with chronic osteomyelitis after radical surgical treatment of the osteomyelitic focus. Recovery was achieved in 24 patients after a single operation. Five patients were subjected to reoperations. The authors consider the fat tissue to be a reserve plastic material for surgery of chronic osteomyelitis. PMID- 3629846 TI - [Inflammatory pseudotumors of the lungs]. PMID- 3629847 TI - [Single-stage radical operation for multiple primary synchronous cancer of the stomach and rectum]. PMID- 3629848 TI - [Endoprosthesis of the common bile duct in benign stricture complicated by intrahepatic cholelithiasis]. PMID- 3629849 TI - [Pneumatosis of the ileum combined with peptic stenosis of the pylorus]. PMID- 3629850 TI - [Benign mesenchymoma of the terminal portion of the small intestine with tumor invagination into the cecum]. PMID- 3629851 TI - [Treatment of combined injuries]. AB - An analysis of 120 patients with multiple trauma is given. The authors believe that the question of diagnostics of the injuries, the succession of using diagnostic methods should be solved collectively. A conclusion has been made that urgent surgery in complex with resuscitation measures must be performed in patients with internal hemorrhage, increasing intracranial hematoma, tamponade of the pericardium, increasing hemopneumothorax. PMID- 3629852 TI - [Comprehensive clinical x-ray-radionuclide study of lung function in penetrating chest injuries]. AB - Results of the complex clinico-x-ray-radionuclide research of 52 patients with penetrating injuries of the chest have shown that the morphological and functional state of the injured lung can be assessed by findings of rheography, spirography, scanning and scintigraphy, roentgenography and roentgenoscopy. PMID- 3629853 TI - [Clinical importance of changes in thrombocytic hemostasis in lung cancer]. AB - Clinico-laboratory examinations of 86 patients have shown that lung cancer develops against the background of activation of the thrombocytic link of hemostasis which manifested itself in thrombocytosis, greater degree of destruction of the lysosomal membranes, lower energy resources of the cells, their tendency to slow and little reversible aggregation. The authors consider that the indicators of the ADP-induced aggregation of thrombocytes may be used for prognosis of postoperative pyo-inflammatory and thromboembolic complications. HBO is good for correction of alterations in the thrombocytic link of hemostasis in lung cancer and its suppurative complications. PMID- 3629854 TI - [Clinico-anatomical basis of the mechanism of blunt trauma to the kidneys and the prevention of adrenal insufficiency during left-sided nephrectomy]. AB - The work presents clinico-anatomical grounds of the mechanism of blunt trauma of the kidneys. The variant anatomy of the venous system of the left kidney, adrenals and gonadal veins was studied in 100 adults and children. Morphofunctional investigations were performed in 20 dogs in order to study adrenal functions in left-side nephrectomy. Recommendations for prevention of adrenal insufficiency in left-side nephrectomy are given concerning the level of ligation of the renal vein. PMID- 3629855 TI - [Potentials of rheovasography in assessing circulatory disorders in the postoperative period in children]. AB - Clinical investigations have shown possibilities of using rheovasography of the leg for the complex assessment of alterations of the peripheral blood circulation in children after surgical interventions. A direct relationship between the decreased stroke volume of the heart and the value of the systolic rheographic index on the leg has been established and great informative significance of leg rheography has been proved for the assessment of peripheral disorders as compared with other vascular zones (forearm, finger). The use of leg rheovasography is recommended for the assessment of peripheral blood circulation and choice of a correcting therapy. PMID- 3629856 TI - [Effect of blood transfusion therapy on the course of suppurative septic diseases in children]. AB - The authors have studied the influence of different variants of hemotransfusion therapy on the course of pyo-septic diseases in 189 children aged from 1 month to 14 years. Positive effects of blood transfusions on the parameters of the peripheral blood, homeostasis and coagulating system as well as the stimulating effect on the bone-marrow blood formation and the immune defense system were demonstrated. PMID- 3629857 TI - [Clinical picture and treatment of concealed penis in children]. AB - A method of surgical treatment of 47 patients with microphallus is described. There are two kinds of the surgical treatment of microphallus depending on its form. A new operative method is proposed for a dystopic form. Good long-term results were obtained. PMID- 3629858 TI - [Principles of the surgical treatment of severe forms of chronic osteomyelitis and its sequelae in children]. PMID- 3629859 TI - [Anaerobic gas infection in open injuries in children]. PMID- 3629860 TI - [Menetrier's disease in a child]. PMID- 3629861 TI - [Indications for relaparotomy and its results]. AB - For the recent six years 6855 operations on abdominal organs have been performed which were followed by relaparotomies in 104 patients (1.5%). The authors show that the greatest amount of relaparotomies followed operations for ulcer disease, tumors and cholecystitis. The main causes of relaparotomies were peritonitis, intestinal obstructions and bleedings. The group of greater risk consisted of men aged 50-60. The amount of relaparotomies can be reduced due to unification of medical tactics, strict observation of the operation technique and responsible management of the patients in the postoperative period. PMID- 3629863 TI - Prevalence of nematode parasites in wild fallow deer (Dama dama). PMID- 3629862 TI - Enzyme immunoassay for detection of Mycoplasma bovis antigens in bull semen and preputial washings. AB - A capture enzyme immunoassay was developed for the detection of Mycoplasma bovis antigens in bull semen or preputial washings. IgG prepared from rabbits immunised with M bovis was passively adsorped to 96-well polystyrene plates. This antibody captured M bovis antigens which were then detected by using an IgG preparation from an immunised cow and murine monoclonal antibody to the bovine L-chain conjugated with horseradish peroxidase. The sensitivity of the assay was approximately 200 colour changing units (ccu)/ml and the specificity was excellent in that other species of mycoplasma, ureaplasma or acholeplasma did not react. A blind study of bull semen experimentally contaminated with M bovis detected all specimens with more than 200 ccu/ml. PMID- 3629864 TI - Suspected flurbiprofen toxicity and its treatment in a dog. PMID- 3629865 TI - Bovine quintuplets. PMID- 3629866 TI - Exotic animal medicine. PMID- 3629867 TI - Mammary gland secretion from a newborn calf. PMID- 3629869 TI - New academic approach for new technology? PMID- 3629868 TI - Dosage of ivermectin for birds. PMID- 3629870 TI - Recognition of 'trembler', a hypomyelinating condition in the Bernese mountain dog. AB - An account is given of a hypomyelinating condition, 'trembler', in the Bernese mountain dog. The condition is manifested clinically as a tremor of the limbs and head which becomes more intense with excitement or stress and which disappears with sleep. The tremor, which is first noticeable between two and eight weeks old, may persist throughout life but decline with age. Examination of plastic embedded tissue obtained post mortem from two, nine-week-old animals showed hypomyelination of the spinal cord. Preliminary examination of breeding data suggests that the condition may be inherited as an autosomal recessive. PMID- 3629871 TI - Control of headfly on sheep. AB - Eighteen different treatments against sheep headfly (Hydrotaea irritans) were tested on Scottish blackface and Swaledale ewes and lambs. Gamma-HCH + paradichlorobenzene gave consistently better control than crotoxyphos cream. Pyrethroids in sprays or incorporated into eartags were relatively ineffective. Pyrethroid pour-ons gave good control, but in a year of low headfly attack they were not as effective as HCH + paradichlorobenzene. Liveweight gain was improved by treatment with HCH + paradichlorobenzene and significantly improved by treatment with deltamethrin pour-on. PMID- 3629872 TI - Cryptosporidium in market pigs in southern California, USA. AB - Faecal specimens from 200 market swine (115 feeder pigs and 85 butcher hogs) offered for sale at a southern California livestock auction yard during a three month period, were examined for cryptosporidium oocysts. Of the 10 pigs (5 per cent) found to be excreting the parasite, seven were feeder pigs and three were butcher hogs. Of the feeder pigs four (4.1 per cent) came from the 98 non diarrhoeic pigs and three (17.6 per cent) from 17 diarrhoeic pigs. The 85 butcher hogs were all apparently healthy. PMID- 3629873 TI - Monensin and the control of experimental ovine toxoplasmosis: a systemic effect. PMID- 3629874 TI - Aspects of animal welfare. PMID- 3629875 TI - Deafness in dobermanns. PMID- 3629876 TI - Orf vaccine supplies. PMID- 3629877 TI - Common sense about antibiotics. PMID- 3629878 TI - Identification of factor XI deficiency in Holstein-Friesian cattle in Britain. AB - Blood coagulation tests were performed on dairy cattle in a herd with haemorrhagic problems on a farm in Gloucestershire. The characteristic pattern of prolonged partial thromboplastin time with normal prothrombin time and thrombin time was shown to be associated with a partial factor XI deficiency, a congenital defect previously identified in cattle in North America. PMID- 3629879 TI - Arthroscopic surgery for the removal of an articular foreign body in a horse. PMID- 3629880 TI - Antibiotic use in meat animals. PMID- 3629881 TI - Distemper in imported greyhounds. PMID- 3629882 TI - Adverse reactions to dichlorophen in cats. PMID- 3629883 TI - Preventive medicine. PMID- 3629884 TI - A congenital bovine epidermolysis resembling epidermolysis bullosa simplex of man. AB - Twenty-five of 72 calves sired by a Simmental bull were affected with a congenital skin disease which appeared to be inherited as an autosomal dominant trait. The affected calves showed hypotrichosis, erythema and breaks in the integrity of the skin. The distribution of the lesions and the ease with which excoriations occurred suggested an abnormal vulnerability to trauma. Mortality was high but in affected survivors the clinical signs moderated with age. Histopathologically, dermoepidermal separation and cytolysis of the germinal cell layer of the epidermis were seen. The name bovine epidermolysis is proposed and a relationship with epidermolysis bullosa simplex of man is suggested. PMID- 3629885 TI - Effects of farrowing crate floors on health and performance of piglets and sows. AB - Three types of raised perforated floor were compared with floor-level concrete which had perforated flooring at the rear. Piglets on raised perforated floors grew faster (P less than 0.05) to 21 days than pigs on mainly solid floors (205 g/day and 198 g/day, respectively). The mortality in the first 21 days of all pigs born did not differ between raised (18.4 per cent) and mainly solid floors (18.7 per cent) and there were no effects of individual floor types on overall survival or on deaths due to crushing. The incidence of diarrhoea was not significantly less on raised than on solid floors (27 per cent and 34 per cent of litters, respectively) but antibiotic treatment time was shortened (0.9 days and 1.2 days, P less than 0.05). The incidence of splayleg was highest on fibreglass slats. Concrete floors caused most knee abrasions but the incidence of arthritis was unaffected. Approximately twice as many sows on mainly solid floors went off their feed or had a high rectal temperature compared with sows on raised perforated floors. No differences were observed between narrow or A-frame farrowing crates. PMID- 3629886 TI - Control of parasitic gastroenteritis in calves with the morantel sustained release bolus: effect of prior grazing with adult cattle. PMID- 3629887 TI - Field observations on the longevity of Trichuris suis ova. PMID- 3629888 TI - 'New academic approach for new technology'. PMID- 3629889 TI - Women employees: new laws. PMID- 3629890 TI - Physiological, biochemical and haematological effects on horses of a phenylbutazone paste. AB - Five matched pairs of horses were used to investigate the biochemical, haematological and general clinical effects of a new dosage schedule of a phenylbutazone paste administered under controlled feeding conditions. One group of horses received a loading dose (8.8 mg/kg) on day 1, followed by doses of 3.3 mg/kg daily on days 2 to 8, 10 and 12 with no treatment on days 9 and 11. The second group received equivalent doses of a placebo paste. Bodyweight, skin temperature, respiratory rate, glutamate dehydrogenase activity, packed cell volume, mean corpuscular volume and neutrophil count were altered significantly in the drug-treated but not in the placebo-treated animals. From the direction and magnitude of the changes in these variables, it was concluded that they did not reflect toxic actions of phenylbutazone. Several variables were unaffected by either treatment both during and after dosing and others were significantly altered in both groups of horses. These changes were considered to be toxicologically insignificant. PMID- 3629891 TI - Vaccination against lumpy jaw and measurement of antibody response in wallabies (Macropus eugenii). AB - Successful protection against lumpy jaw disease in a colony of captive wallabies (Macropus eugenii) was induced by vaccination with a commercial ovine footrot vaccine. No mortalities attributable to lumpy jaw were observed in 69 vaccinated animals while six of 42 unvaccinated control wallabies died of the disease. Vaccinated animals exhibited significant increases in antibody titres to Bacteroides nodosus after the first and second doses of vaccine. Titres were measured by an enzyme-linked immunosorbent assay. PMID- 3629892 TI - PML vaccines. PMID- 3629893 TI - Remote injection systems: science and art. AB - The development, practice and potential of remote injection systems are reviewed and the legislation pertinent to the possession and use of darting equipment and immobilising drugs is summarised. The available rifles, pistols, blow-guns and syringes are critically examined in terms of their accuracy with a flexible dart volume, their impact and injection trauma and their efficiency of use, durability, economy and safety. Future developments in remote injection technology are dependent on many factors including welfare, advances in immobilising agents and methods and, most significantly, on demand. The central role of the veterinary profession in the use of remote injection systems is emphasised. PMID- 3629894 TI - Laryngeal chondritis in Texel sheep. AB - An obstructive, upper respiratory tract disease characterised by severe dyspnoea and deaths has been recognised in Texel sheep. It is caused by chronic suppuration within the arytenoid cartilages of the larynx resulting in swelling and occlusion of the lumen. The clinical and pathological features of the disease are described and its possible cause and treatment are discussed. PMID- 3629895 TI - Serological response of calves to a dead salmonella vaccine and its relation to live weight and performance. PMID- 3629896 TI - Investigations into the aetiology of porcine proliferative enteritis. PMID- 3629898 TI - Racehorse treatment warning. PMID- 3629897 TI - Aspects of animal welfare. PMID- 3629899 TI - Ascites syndrome in Newfoundlands. PMID- 3629900 TI - Hypocalcaemia in ewes. PMID- 3629901 TI - The development of eimerian infections during the first eight months of life in unweaned beef calves in a dry tropical region of Australia. AB - The development of coccidial infections in 21 free-ranging, unweaned beef calves from birth to 8 months was investigated by examining faecal samples for oocysts. Most calves commenced shedding oocysts within a month of birth, and had shed all nine species identified by 3-4 months. Oocysts were shed by three calves as young as 12 and 13 days. The oocysts species shed earliest, and the commonest thereafter, were Eimeria bovis, E. ellipsoidalis and E. zuernii. Although several oocyst counts between 5.0 X 10(3) and 114.0 X 10(3)g-1 of faeces of these potentially pathogenic species were recorded there was no clinical disease. Some calves shed oocysts approximately four times more frequently than others, and individual species counts greater than or equal to 5.0 X 10(3)g-1 were confined to 10 of the calves. Intermittent oocyst shedding continued throughout the study with a similar distribution of oocyst species from all calves. PMID- 3629902 TI - Experimental Eimeria debliecki infections in nursing and weaned pigs. AB - Three litters of six, 3-day-old nursing pigs were inoculated via a stomach tube with 8.0 X 10(5), 1.6 X 10(6) or 5.0 X 10(6) sporulated oocysts of Eimeria debliecki and four groups of six, 4-week-old weaned pigs were inoculated with 8.0 X 10(5), 1.6 X 10(6), 5.0 X 10(6) or 1.0 X 10(7) sporulated oocysts of E. debliecki to determine its pathogenicity. Clinical coccidiosis or deaths did not result from infections. Infections were confined to the jejunum and occasionally the duodenum. Microscopic lesions of mild to moderate villous atrophy were observed in one nursing pig given 5.0 X 10(6) oocysts and three weaned pigs given 1.6 X 10(6), 5.0 X 10(6) and 1.0 X 10(7) oocysts and examined 5 days post inoculation. Pathogenic bacteria or viruses were not demonstrated in any pigs. Results of this study indicate that E. debliecki is not a cause of neonatal or weaning diarrhea in pigs. PMID- 3629903 TI - Control of gastrointestinal parasitism in calves in Sweden over six years using the morantel sustained release bolus. AB - During the 6 years 1979-1984, the use of the morantel sustained release bolus (MSRB) was monitored in first year grazing calves. Twenty-four to 30 calves each year were allotted to two groups (controls and MSRB-treated) and turned out at the end of May on the same pasture divided into two equal areas. After housing in October, each group was kept in boxes and fed concentrates, whey and hay. The calves were weighed at monthly intervals until the first animals were sent to slaughter. No cases of clinical ostertagiasis Type I were observed in the control calves during the grazing seasons, but in one year (1983) clinical signs occurred 2 weeks after housing. The number of overwintering larvae was influenced by pasture contamination the previous season and climatic conditions during winter and spring. The fecal egg output of the control animals during the grazing season did not reflect the level of pasture contamination at turnout. The build-up of pasture larval contamination during the later part of the grazing season was influenced by the climatic conditions. The fecal egg output of the treated calves was low during the entire grazing season resulting in a significantly reduced pasture contamination. A significantly reduced live-weight gain in the control calves was demonstrated at housing in five of the six years. When heavily infected at housing, the performance of the control calves was still influenced negatively during the fattening period indoors. PMID- 3629904 TI - Establishment of Ascaridia galli in betamethasone-treated chickens. AB - Twenty-five day-old White Leghorn chickens were each infected orally with 500 (Group I), 1000 (Group II) and 2000 (Group III) infective eggs of Ascaridia galli and were killed 30 days after the infection. A high percentage of the infecting dose (6.5%) established as adult worms in the intestine of chickens receiving the lowest level of primary infection, but as the amount of primary infection given to birds increased, there was a significant fall in the percentage establishment of adult worms in the intestine. A similar pattern of worm establishment was shown by chickens of the same age and receiving similar levels of primary infections, but which were treated with betamethasone at a dose of 2 mg/kg body weight commencing 5 days before and continuing up to 15 days after the infection. Betamethasone-treated birds, however, showed more establishment of worms in the intestine, but lower weight gains in comparison to the birds which were not treated. Different levels of primary infections given, with or without treatment with betamethasone, had no effect on the sex ratio of the resultant male/female worm populations, which became established in almost equal numbers in the intestine of chickens. PMID- 3629905 TI - The extraintestinal stages of Eimeria tenella and E. maxima in the chicken. AB - Donor chickens given feed medicated with one or two levels of decoquinate or given non-medicated feed were infected with oocysts of Eimeria tenella or E. maxima per os. Twelve hours after inoculation with oocysts liver, mid-intestine or ceca homogenates were fed to previously uninfected recipient chickens. The results showed that continuous medication with decoquinate was effective in preventing the transfer of sporozoites from the intestine to the liver. Oocysts were detected in the feces of all recipients of tissue from non-medicated donors, showing that some sporozoites of E. maxima and E. tenella are normally transferred to liver. Young broiler chickens were immunized by oral inoculation of E. maxima oocysts. The immune status of similar chickens inoculated with sporozoites of the same species directly into the liver or spleen were assessed. During the experimental period half of the chicks were provided with non medicated food and the remainder were given feed supplemented with decoquinate; decoquinate was effective in arresting the development of the sporozoites. Two weeks after initial infection the birds were challenged with oocysts of E. maxima per os. Injection of sporozoites into the spleen did not protect against challenge. Birds inoculated with sporozoites into the liver were unable to develop a significant level of immunity. When the drug pressure was removed from these birds, parasitism of the intestine occurred and immunity developed. PMID- 3629906 TI - New approaches in the diagnosis and control of parasitic diseases. Proceedings of the 12th conference of the World Association for the Advancement of Veterinary Parasitology. Montreal, Quebec, Canada, 12-15 August 1987. PMID- 3629907 TI - Biocompatibility of hemodialysis using cuprophane membranes. AB - In a controlled study of the influence of hemodialysis on hemodynamics, complement system, leucocyte- and thrombocyte concentration was studied in two groups of five non-uremic dogs each. During the initial 30 min of dialysis with the commonly used cuprophane membrane, a transient but significant decrease of the mean aortic pressure and cardiac output occurred while simultaneously heart rate and systemic vascular resistance decreased. Thrombocyte concentration decreased significantly during the initial 60 min of dialysis due to sequestration in the dialyzer. Transient leucopenia due to pulmonary leucostasis occurred without decrease of the arterial oxygen tension. The simultaneous occurrence and transient character of the hemodynamic changes, leucopenia and thrombocytopenia suggest a relationship between these phenomena. These results indicate that the biocompatibility of cuprophane dialysis membranes is of importance not only with regard to changes in the leucocyte- and thrombocyte count but also with regard to hemodynamic changes. PMID- 3629908 TI - Acute and short-term toxicity studies on orange II. AB - Inspite of its non-inclusion in the prescribed list of food colors, orange II is extensively employed to color a variety of foodstuffs. Oral LD50 value of orange II in both male and female rats was calculated to be more than 10.56 g/kg body weight. In short-term studies, animals were exposed to diets containing 0.0 (control), 0.1, 0.5 or 3.0% (w/w) of orange II, daily for 90 days. Hematological examination revealed a slight decrease in erythrocyte count and hemoglobin content, whereas leucocyte count, PCV, ESR, MCV, MCH and MCHC showed normal values. There was no change in the activities of LDH, GOT, GPT, alkaline/acid phosphatases and bioconstituents, lactic acid, cholesterol and protein in serum as well as in liver, indicating normal functioning of the liver. Histopathological examination of various body organs such as liver, heart, lung, kidney, testes, adrenal, stomach, large and small intestine presented normal appearance. Animals receiving 3.0% orange II showed marked splenomegaly and deposition of Perl's positive iron pigments. Testicular LDH, hyaluronidase and lactic acid did not reveal any deviation from controls, suggesting normal spermatogenic process. No changes in testicular cholesterol, fructose content of coagulating glands and dorso-lateral prostate, and activities of alkaline phosphatase in seminal vesicle and acid phosphatase in ventral prostate support normal androgenic status. PMID- 3629909 TI - Determination of total phenolics in acorns from different species of oak trees in conjunction with acorn poisoning in cattle. AB - Although acorn poisoning is more commonly seen in cattle as a susceptible animal species, several other factors such as species of acorns also have a distinct bearing on the degree of acorn toxicity. In this study, 3 species of acorns (Quercus alba, Q velutina and Q rubera) were analyzed for their total phenolic contents. Q velutina was found to have the highest level of total phenolics and Q alba the lowest among the 3 species. The total phenolic content in Q rubera was slightly lower than that of Q velutina but markedly higher than that of Q alba. The data suggest that when evaluating a pasture on the likelihood of acorn toxicity, one containing mainly Q alba may be safer than Q velutina and Q rubera. PMID- 3629910 TI - The toxicology and composition of bovine tissues after parenteral administration of high levels of copper salts. AB - Copper toxicity was observed when crossbred cows were injected with 480 mg copper sc. Five head died after copper disodium EDTA (edetate) injections but no losses occurred with copper glycinate. Necropsy, histopathology and plasma enzyme values indicated severe hepatic necrosis in the affected cattle. Plasma copper levels peaked 2 hr postinjection (3.82 micrograms/ml) in cattle that lived after EDTA injections, but about half this level (2.00 micrograms/ml) of copper was observed in the animals that died and 0.65 in the glycinate-treated animals (P less than .01). Ceruloplasmin levels were low in all cattle (2.1 to 7.2 IU/L). Plasma iron increased between 2 (179 micrograms/dl) to 4 (422 micrograms/dl) hr after injection for all cattle and remained high at 8 hr (501 micrograms/dl postinjection; P less than .01). After copper was administered, plasma zinc decreased 45 to 75% of pre-injection levels (P less than .01). Plasma urea nitrogen was not modified by the treatments. Hemolysis was not observed in any of the animals. PMID- 3629911 TI - Effects of 4-methylimidazole in young calves. AB - Clinical signs, gross and histologic necropsy findings and dose response curves of 4-methylimidazole (4-MI) were determined in young Holstein calves. Three-day old Holstein bull calves were given an oral dose of 0,25,50,100,200 or 400 mg 4 MI/kg body weight. Acute clinical signs were hypersalivation, mouth chomping, diarrhea, muscle fasciculations, tremors, hyperexcitability, convulsions, coma and death. Death occurred within 3 hr for calves given the highest dose of 400 mg/kg. Two of 3 calves dosed at 200 mg/kg died within 8 and 3/4 hr of dosing. Only 1 of 3 calves showed mild signs at the 100 mg/kg dose level and no effects were observed at the 50 or 25 mg/kg dose level. Signs due to 4-MI in this experiment were similar to signs observed in calves whose dams were consuming ammoniated hay. No pathological lesions attributable to 4-MI toxicosis were found during gross or microscopic necropsy examination. Blood chemistry values from calves treated with 4-MI were within normal ranges except for potassium, phosphorus and glucose which were elevated (P less than .05) at the time of death for those calves dosed at 400 mg/kg. PMID- 3629913 TI - A letter on electroshock for snakebite. PMID- 3629912 TI - The effects of Ipomoea carnea on goats and sheep. AB - The clinical signs and lesions of Nubian goats and Desert sheep orally dosed with fresh and dry leaves and stems of Ipomoea carnea at 2.5, 5 and 10 g/kg/day were studied. The signs of Ipomoea poisoning were inappetence, depression, weakness of the hind limbs, dyspnea, staggering, and pallor of the visible mucous membranes. The main lesions were focal necrosis and fatty vacuolation of centrilobular hepatocytes, accumulation of fibroblasts in hepatic portal tracts, degeneration or necrosis of the cells of the renal proximal convoluted tubules, hemorrhage in renal cortices, in renal medullas and in cardiac muscle fibers, focal pulmonary edema, and emphysema and straw-colored fluid in serous cavities. Increased serum aspartate amino transferase and ammonia concentrations, and decreased concentrations of total protein, calcium and magnesium in the serum of Ipomoea poisoned animals were detected. Hematological changes indicated the development of normocytic normochromic anaemia. PMID- 3629914 TI - Ingestion of concentrated silver nitrate: a report of two cases. PMID- 3629915 TI - Hmong opiate folk remedy toxicity in three infants. PMID- 3629916 TI - Ingestion and killing of Pasteurella haemolytica A1 by bovine neutrophils in vitro. AB - In this study, various parameters affecting the ability of bovine neutrophils to ingest and kill a virulent strain of Pasteurella haemolytica A1 in vitro were examined. Ingestion of P. haemolytica was serum dependent (optimal serum concentration 10%) and was mediated principally by heat-stable opsonins, presumably antibodies, that could be removed by absorption with formalin-killed P. haemolytica. Ingested P. haemolytica were killed by neutrophils within 1-4 h incubation; the magnitude of killing being directly dependent on the number of neutrophils present. The number of viable P. haemolytica was reduced by approximately 1.5 log at bacterial concentrations of 0.01-100 P. haemolytica per neutrophil; a concomitant reduction in neutrophil viability was observed at the highest bacterial concentration (100:1). Bovine neutrophils underwent a vigorous luminol-enhanced chemiluminescence response after ingesting opsonized P. haemolytica, thus indicating that reactive oxygen intermediates were being formed that could have contributed to the intracellular killing of P. haemolytica. PMID- 3629917 TI - The immune response to experimental Pasteurella haemolytica infection in calves. AB - Four male dairy calves, ages 1-9 months, were inoculated intratracheally (IT), with log dilutions (1.5 X 10(3)-1.5 X 10(6)) of an isolate of P. haemolytica A-1. Doses of bacteria varied according to ages of the calves, older calves receiving the larger doses. All four calves became severely ill within 24 h after inoculation and antibiotic treatment was considered essential. Two months later the four calves remained healthy after IT injection of P. haemolytica, again given in log dilution (2.8 X 10(2)-2.8 X 10(5)). The control calf, given a dilution of only 28 viable P. haemolytica (plate count), developed severe respiratory infection 9 days post inoculation. Antibiotic treatment was given to this calf for 7 days, at which time recovery was evident. All five calves developed direct bacterial agglutination titers to P. haemolytica. Persistent leukocyte migration inhibition indexes of all calves were decreased by greater than or equal to 20% compared to their controls. Although the initial doses administered were low, the calves became ill. Most reports refer to massive doses necessary to produce primary disease and significant agglutination titers. PMID- 3629918 TI - Antiserum against culture filtrate is cross-protective for various serovars of Erysipelothrix rhusiopathiae. AB - The protective effect of porcine antiserum prepared against culture filtrate (CF) of an attenuated strain of Erysipelothrix rhusiopathiae (serovar 2) in mice to challenge with 20 virulent strains of 18 serovars and one type N was investigated. Passively immunized mice survived after challenge with serovars 1a, 1b, 2, 5, 6, 8 (strain Goda), 11, 12, 15, 16, 21 or type N, but 10-30% mortality occurred in immunized mice challenged with each strain of serovars 4, 7, 8 (strain 911), 9, 18 or 19 and 70% mortality to serovar 10 (strain 2179). All immunized mice died after challenge with serovar 20 (strain 2553). Non-treated control mice died after challenge with all serovars and the type tested. PMID- 3629919 TI - [Current concepts of the x-ray diagnosis of acute pneumonias in children]. PMID- 3629920 TI - [Chronic nonspecific lower lobar pneumonia and simple pulmonary hypoplasia complicated by an inflammatory process in children]. PMID- 3629921 TI - [Combined x-ray study in assessing chronic nonspecific lung diseases in children under dispensary observation]. PMID- 3629923 TI - [X-ray diagnosis of hypertrophic cardiomyopathy in children and adolescents]. PMID- 3629922 TI - [X-ray diagnosis of pulmonary mucoviscidosis in children and adults]. PMID- 3629924 TI - [X-ray characteristics of the anomalous origin of the left coronary artery from the pulmonary trunk]. PMID- 3629925 TI - [X-ray signs of a left-sided ascending aorta in congenital heart defects]. PMID- 3629926 TI - [Developmental problems in pediatric roentgenology (for International Child Protection Day)]. PMID- 3629927 TI - [Computed tomography in the diagnosis of chronic subdural hematomas in children]. PMID- 3629928 TI - [X-ray diagnosis of chronic pancreatitis in children]. PMID- 3629929 TI - [Growth disorders of the vertebral bodies in hematogenous spinal osteomyelitis in children and adolescents]. PMID- 3629930 TI - [Current status and prospects for the development of x-ray diagnostic apparatus for the study of children]. PMID- 3629931 TI - [Assessment of the x-ray picture of the lungs of healthy young infants]. PMID- 3629932 TI - [Acute suppurative destructive pneumonia caused by gram-negative flora in children (x-ray aspects)]. PMID- 3629933 TI - [Neurilemmoma of the foot in a child]. PMID- 3629934 TI - [Rare case of a developmental defect of the urogenital system (uropyocolpos) in a 10-moth-old girl]. PMID- 3629935 TI - [Case of pulmonary mycobacteriosis caused by M. fortuitum]. PMID- 3629936 TI - [Case of obstruction of the lower left lobar bronchus by an exfoliated tooth with later development of atelectasis]. PMID- 3629937 TI - The role of basophils in the immunopathogenesis of hypersensitivity to fleas (Ctenocephalides felis) in dogs. AB - Biopsies taken of skin test sites from 10 dogs allergic to fleas were fixed in Karnovsky's fixative and embedded in methacrylate. One micron sections were stained with acid Giemsa for identification of basophils. This cell was identified in most biopsies taken at intervals from 1 hour to 48 hours post injection. The proportion was highest between 4 hours and 18 hours and had substantially fallen by 48 hours. The highest number of basophils recorded as a percentage of the inflammatory infiltrate was 22.1%, with biopsies from 7 of the 10 dogs showing in excess of 10% basophils at some point. The results suggest that cutaneous basophil hypersensitivity may play an immunopathogenic role in flea-bite hypersensitivity in dogs. PMID- 3629938 TI - Investigation of cross-reactivity between commercially available antibodies directed against human, mouse, and rat lymphocyte surface antigens and surface markers on canine cells. AB - Using automated flow cytometry, 23 commercially available antibodies (all but one of them monoclonal) raised against surface antigens of specific populations of human, rat, and mouse lymphocytes were tested for cross-reactivity to peripheral blood lymphocytes from five clinically healthy adult dogs. Of all the antibodies tested, only the polyclonal anti-asialo GM1 directed against mouse NK cells, and the monoclonal antibodies anti-HLA-DR directed against the human class II antigen and anti-B1, a human pan B cell marker, consistently labeled subpopulations of canine lymphocytes. PMID- 3629939 TI - Lymphocyte localization in lymph nodes of pubescent, prepartum, and postpartum sheep. AB - It is generally accepted that lymphocytes associated with the mammary mucosal immune system of non-ruminants may be largely derived from gut-associated lymphoid tissue (GALT). The relationship between the mammary immune system and the GALT of ruminants has not been clearly defined. To address this question, we examined patterns of lymphocyte localization in sheep by 51Cr-labeled lymphocytes following infusion back into donor ewes. We found that lymphocytes taken from mammary lymph nodes of pubescent ewes returned preferentially to mammary nodes, while in prepartum and postpartum ewes, mammary node cells localized equally well in mammary and mesenteric lymph nodes. In contrast, ileal mesenteric lymph node cells from pubescent ewes localized equally well in mammary and mesenteric nodes, but in prepartum and postpartum ewes, localization in mammary nodes was markedly reduced. Comparison of the homing patterns of mammary, mesenteric, and peripheral lymph node cells indicated that mammary node cells behaved similarly to peripheral, rather than mesenteric node cells. This information may be relevant to the extent of communication between the gut and mammary gland in ruminants. PMID- 3629940 TI - Dominance of Chlamydia psittaci-specific IgG2 subclass in the humoral immune responses of naturally and experimentally infected cattle. AB - Indirect enzyme-linked immunosorbent assays were applied to differentiate Chlamydia (C.) psittaci-specific IgG1 and IgG2 levels in 143 individual serum samples from cattle with naturally occurring chlamydial infections and in 190 sequential serum samples from 26 experimentally infected pregnant cows, calves, and a bull. The mean IgG1:IgG2 ratio of naturally infected cattle was 1:4 indicating a significant (p less than 0.001) IgG2 dominance. Similar ratios were detected in the experimentally infected cattle. The dominance of IgG2 was independent of breed, sex, and age. Twenty-nine cattle had significant immunoglobulin levels to both C. psittaci and Coxiella (C.) burnetii simultaneously. The predominance of C. psittaci-specific IgG2, in contrast to the predominance of C. burnetti-specific IgG1 detected in these same individual serum samples under identical conditions, indicates that the ability to preferentially produce either IgG1 or IgG2 was not limited in these individual cattle. A transient yet significant IgG1 response was also developed in cows following chlamydia-induced abortions (immunotype 1) or in cattle infected with the polyarthritis-serositis-encephalomyelitis agents (immunotype 2). IgG1 levels decreased faster than IgG2 levels. These findings have diagnostic implications and identify the need for determining the immunoglobulin classes and subclasses of the humoral immune responses of animals and man to chlamydial infections. PMID- 3629941 TI - In vivo and in vitro effects of moderately virulent African swine fever virus on mitogenesis of pig lymphocytes. AB - Six pigs were infected oro-nasally with a moderately virulent African swine fever (ASF) virus from the Dominican Republic (DR II). The effect of virus infection on the pig's immune system was tested by measuring peripheral leucocyte numbers and the ability of mononuclear leucocytes (MNL) to respond by lymphocyte proliferation (LP) to the mitogens phytohemagglutinin-P (PHA-P), concanavalin-A (Con-A), and pokeweed mitogen (PWM). All 6 pigs developed high viremias between 4 and 18 days post-inoculation (DPI) which became undetectable by 32 to 46 DPI. Virus was found in erythrocytes, plasma, and mononuclear leucocytes from peripheral blood. Overall, virus infection had only minor effects on the number of circulating leucocytes, lymphocytes, monocytes and granulocytes. At the early acute phase of infection slight neutrophilia and lymphocytopenia were observed with mildly elevated monocyte numbers and slightly depressed neutrophil numbers that continued from the time of evident reduction in viremia to beyond the period of viral clearance. The infected pigs readily produced high titers of ASF virus antibody shortly after the onset of viremia. No significant differences in LP responses of MNL from the 6 pigs to PHA-P, Con-A and PWM were observed after infection when compared to those obtained with MNL from normal pigs. The in vitro addition of infectious ASF virus to MNL from normal pigs did not affect LP responses to any of the three mitogens. These results do not support the hypothesis that immunosuppression is a consequence of ASFV infection of pigs. PMID- 3629942 TI - Monolayer system of cultivating bovine polymorphonuclear leukocytes (PMNL): effect of long-term cultivation on the viability and phagocytic function of the cells. AB - A monolayer system of cultivating bovine PMNL is described. Poly-L-Lysine (PLL) significantly (P less than 0.01) enhanced the attachment of bovine PMNL to glass. Long-term cultivation up to seven days, in a mixture of calf serum and RPMI 1640, had no effect on the viability of the cells, but cultivation for 3 days or more significantly reduced the ability of the PMNL to phagocytose bacteria. PMID- 3629943 TI - A topographical study of increased vascular permeability in passive cutaneous anaphylaxis in the chicken. AB - Passive cutaneous anaphylaxis was produced in chickens with bovine serum albumin (BSA) and anti-BSA chicken serum. Colloidal carbon was then given intravenously to identify the leaky vessels. Microscopic examination of cleared unstained skin revealed the topography of labelled vessels. The carbon labelling was confined to venules and small veins only. Examination of the time-course of permeability response revealed a biphasic pattern. PMID- 3629944 TI - Thyroid activity in relation to growth rate and body composition in four breeds of sheep. AB - Four breeds of sheep, Hampshire, Southdown, Cheviot and Scottish Blackface, which differ in mature body size and body composition were intensively reared under an ad libitum or a restricted feeding regime. Thyroid activity was assessed at 13 weeks of age by the 131I uptake method. Slaughter at 24 weeks (ad lib) or 32 weeks (restricted) was followed by carcass dissection. The anticipated differences in body type represented by the 4 breeds was confirmed in terms of size and fatness. The Hampshires had the highest growth rate (liveweight for age) and the lowest thyroid uptake, and the breed differences in thyroid activity were shown to be independent of liveweight. Thyroid activity was positively related to growth rate in the Hampshires and negatively related to growth rate in the 3 other breeds. No association could be found however between the thyroid activity and the proportionate growth of body fat or lean. None of these conclusions were affected by a mild restriction in fed intake. PMID- 3629945 TI - Normal values for radial, peroneal and tibial motor nerve conduction velocities in adult sheep, with comparison to adult dogs. AB - A technique for measuring motor nerve conduction velocities (NCV) in sheep was developed using 15 clinically normal ewes. Mean +/- SD values were determined for the radial (76.3 +/- 12.5 m/s), peroneal (103.9 +/- 12.7 m/s), and tibial (98.6 +/- 13.1 m/s) nerves. The recording needle electrode was located in the extensor carpi radialis, tibialis cranialis, and gastrocnemius muscles, respectively. Latencies, amplitudes and durations of the proximal and distal evoked compound muscle action potentials are given. To investigate further the unexpectedly high NCVs calculated for the peroneal and tibial nerves, analogous stimulating and recording electrode sites were used in 7 clinically normal dogs. The corresponding canine peroneal (88.1 +/- 8.3 m/s) and tibial (89.2 +/- 12.4 m/s) NCVs were higher than the standard sciatic-tibial NCV recorded from the interosseous muscles (68.9 +/- 5.8 m/s), but not as high as for sheep. Myelinated nerve fiber diameters were measured on semithin transverse sections of peroneal and tibial nerve specimens taken from a clinically normal ewe and bitch. A possible explanation for the relative species difference in the proximal peroneal and tibial NCV values is the presence of fibers in both the peroneal and tibial nerves of the sheep which were as much as 3 mu wider than the largest fibers found in the dog. PMID- 3629946 TI - Uterine motility of the sow during the oestrous cycle and early pregnancy. AB - With electromyography and strain gauges the uterine motility of the sow during the oestrous cycle and early pregnancy was studied. Special attention was paid to characterization of myometrial activity at the time of intra-uterine migration of blastocysts. From recordings of 4 animals (3 became pregnant) 3 types of electrical spiking activity (each could be correlated with an elevation of the strain gauge tension) were discerned. Two of them appeared regularly and were suitable for analysis: "High Voltage Slow Acticity" (with relative high amplitude and low frequency of spikes) and "Low Voltage Fast Activity" (with relative low aplitude and high frequency of spikes). The sexual status markedly influenced myometrial activity: during proestrus and oestrus only one type of electrical activity was present whereas the myoelectrical complex (an episode of this activity and the subsequent interval of inactivity) was shorter than 10 min. During dioestrus the myoelectrical complex was longer than 10 min and "High Voltage Slow Activity" (solely on the cervix and bifurcation) and "Low Voltage Fast Activity" occurred simultaneously in episodes which mainly appeared to originate on the bifurcation. The characteristics of uterine activity during pregnancy were similar to those of a cyclic sow until day 12. It was only on day 12 that gestation appeared from an increased frequency of myoelectrical complexes. It is concluded that "Low Voltage Fast Activity" as it was found on the uterine horn at days 8-9 might be involved in the process of intra-uterine migration of blastocysts. In cyclic and in pregnant animals the patterns of "Low Voltage Fast Activity" were similar. Therefore, the occurrence of "Low Voltage Fast Activity" is independent of the actual presence of blastocysts. It seems to be exhibited in dependence on the ovarian hormones. PMID- 3629947 TI - Blood concentrations of 2,3-butanedione monoxime and some blood biochemical changes in Bubalus bubalis after intramuscular administration of this cholinesterase reactivator. AB - The blood levels of cholinesterase reactivator 2,3-butanedione monoxime were determined in buffalo calves following single intramuscular doses of 20 and 50 mg/kg body weight. Blood cholinesterases and other enzymatic activities were monitored at various times. The drug was rapidly absorbed with half-life of 0.09 0.12 h. The peak 2,3-butanedione monoxime blood concentrations of 24.7 +/- 0.3 and 38.9 +/- 1.7 micrograms/ml occurred at 10 min after 20 and 50 mg/kg doses, respectively. The elimination half-life varied between 3.05 +/- 0.12 and 3.80 +/- 0.19 h. Lack of adverse effect of 2,3-butanedione monoxime on blood cholinesterases and other enzymes indicated that intramuscular doses as high as 50 mg/kg may be safely employed in buffaloes. PMID- 3629948 TI - [Epizootiological evaluation of the peroral and vaginal infection of sheep with S. abortus ovis]. AB - Epizootiologic evaluation is made of the oral and the vaginal Salmonella abortus ovis infection in sheep in view of the occurrence and persistence of the infection within the sheep flocks. It has been established that the presence of carriers of infection depends on the physiologic status of the animals at the time of contracting the infection. Abortion, lambing, and the setting in of estrus were shown to affect favourably the existing carrier status. Salmonella abortus ovis organisms were most commonly isolated from the uterus, ovaries, mesenterial lymph nodes, and the duodenum. PMID- 3629949 TI - [Effect of ultrasound-disintegrated spirochetes on blood coagulation and hemodynamics in chickens]. AB - Blood coagulation tests and histopathologic investigations of birds were carried out following the injection of a suspension of spirochaetes destroyed with ultrasound. It was found that the suspension acted as thromboplastin, causing disseminated intravascular clotting of blood after intravenous injection. PMID- 3629950 TI - [Physicochemical and pharmacokinetic research on Pharmachim's thiabendazole]. AB - Studied was the preparation thiabendazole-Pharmachim (TBZ-Ph), produced by the Economic Corporation "Pharmachim". In some of the experiments TBZ-Ph was comparatively studied with the Merck & Sharp and Dom preparation (TBZ-MShD), Switzerland. It was found that the light absorption maximum of TBZ-Ph was at 302 nm. Thermostability studies revealed that the preparation was comparatively stable in the course of 6 months at room temperature and at 4 degrees and 40 degrees C. When stored in the form of 1 per cent medicated feed at room t degrees, 4 degrees, and 40 degrees C it showed no deviations as against the check samples over a period of 70 days. TBZ-Ph was shown to possess slight photosensitivity; it was not hygroscopic. In oral administration to sheep and pigs at the rate of 100 mg per kg body mass, in the form of a 10 per cent water suspension TBZ-Ph was absorbed through the gastro-intestinal membrane. It was retained in the blood serum of sheep up to the 24th hour. The preparation was shown to gain access to almost all viscera and striated muscles, persisting in them for some twenty days. Following the oral application in a dose of 100 mg/kg it reached the mammary gland of lactating ewes and was detected in the milk in maximum concentrations as early as the 3rd hour (5.8 to 12.3 ppm); in the course of the following hours concentrations dropped, and in individual animals the preparation was traced up to the 96th hour. PMID- 3629951 TI - [Oral immunization of suckling piglets against classic swine fever]. AB - Attempts were made to immunize suckling pigs against classic swine fever. The pigs were treated orally, originating from sows which were immunized on the 30th 40th and the 90th-100th day of pregnancy, as well as from sows which were vaccinated one month prior to impregnation. A Bulgarian lapinized K vaccine and a Soviet LK-VNIIVViM cell culture were used (immunization being carried out 1-2 hours before the newborns were allowed to suck) at the rate of 150 doses for both vaccines. It was demonstrated that the application of a live vaccine, which was patterned as cited above, eliminated the inhibiting action of colostral antibodies and induced stable postvaccinal immunity. However, the effectiveness of the immunity conferred depended on the vaccine used in each specific case. The Soviet vaccine, in which the amount of the virus per vaccinal dose was five times as much, was shown to be more appropriate to the needs for oral immunization of suckling pigs of sows that were immune to classic swine fever than the lapinized K vaccine. PMID- 3629952 TI - [Effect of different lighting regimens in the commercial raising of breeders]. AB - Studied was the effect of illumination of varying length and intensity under the industrial raising of broilers. It was found that the use of an illumination programme with an interrupted light regime and low intensity of light affected the live weight, feed intake per unit of produce, and morbidity and mortality rate. The economic effect produced with the introduction of an illumination programme with an interrupted light of low intensity after the first week of BTR 3 regulation consisted in the increase in the production results in the conditions of industrial broiler arising. PMID- 3629953 TI - [Effect of the bacterial count in the air on chickens and laying hens raised commercially]. AB - Investigations were carried out to establish the amount of bacteria in the air on the premises for raising young birds and laying hans as well as in the respiration organs of the birds. Attempts were made to lower the microbism on the premises through the aerosol spray of Lugol solution. It was found that under industrial conditions there existed a rising trend with microbism both on the premises and in the respiratory organs of the birds, parallel to the advance in age which contributed to the enhancement of mortality rate and the drop of productivity. The use of Lugol solution in the form of spray was shown to produce a favourable effect on the health and productivity of birds. PMID- 3629954 TI - [Effect of a Saccharomyces cerevisiae yeast preparation on the quality of pork]. AB - Studies were carried out to ascertain the effect of a preparation produced from yeasts of the Saccharomyces cerevisiae species on some indices characterizing the quality of pork. Studied was the chemical composition, the pH values at the 45th minute and the 24th hour post mortem, the content of tryptophane and oxiproline as well as the colour of meat obtained from musculus longissimus dorsi. It was found that the preparation had no negative effect on the indices, characterizing the quality of meat. PMID- 3629955 TI - [A prophylactic control system--a prospective basis for commercial animal husbandry]. PMID- 3629956 TI - [Use of tribestan on rams with sexual disorders]. AB - An experiment was carried out to define the stimulating effect of Tribestan on rams that were intended for breeding as well as on rams that exhibited sexual impotence and deteriorated semen qualities. The oral application of the preparation, following the pattern suggested by the authors, led to extending the period of sexual activity and to improvement of the semen production of the rams over the service period. The results of Tribestan therapy with rams having affected libido sexualis showed that the animals could recover up to the 7th-8th day with no essential morphologic changes in the structure of both testes and epididymides. The use of the preparation led to considerably influencing the endocrine activity of the testis, raising the testosterone level, and normalizing the sexual activity of rams affected with coital impotence. PMID- 3629957 TI - [Microbial etiology of the MMA syndrome (mastitis-metritis-agalactia) in swine raised commercially]. AB - A total of 147 uterine-cervical exudates and milk samples from 165 lobes of the mammary gland of sows with clinical symptoms of mastitis-metritis-agalactia (MMA) were studied microbiologically. It was found that greatest was the share of Escherichia coli and Staphylococcus aureus organisms taking part in the microbial etiology of the syndrome. Second ranked Staphylococcus epidermidis, Streptococcus pyogenes, and Corynebacterium pyogenes along with some aerobic sporulating bacilli. PMID- 3629958 TI - [Typing of Newcastle virus isolates by mean death time of chickens in the cloacal test]. AB - The mean death time in a cloacal test (MDT/CT) was employed to define the pathogenic type of isolates of the Newcastle Disease virus (NDV) with 5-week-old birds. The results were compared with the use of standard methods for typing--the mean death time with 10-day-old chick embryos as defined by the minimal lethal dose (MDT/MLD), the intracerebral pathogenic index for day-old chicks (ICPI), the intravenous pathogenic index for 6-8-weak-old birds (IVPI). Sixteen local isolates and 6 reference strains of NDV were used in the experiments. Using the author's modified technique to determine MDT/CT the velogenic strains of NDV were strictly differentiated from the local meso- and lentogenic NDV isolates and reference strains. At the same time differentiation was made of the velogenic viscerotropic and of the velogenic-neurotropic isolates (strains). The values of MDT/CT in the experiments with isolates of the velogenic pathotype (14 in number) varied from 4.0 to 7.8 (mean = 5.32 +/- 0.26), and by them the isolates were graded for virulence within the respective (viscero- and neurotropic) group. For the lentogenic (5) and the mesogenic (3) isolates and strains these values were approx. 10. With 6 local NDV isolates of the velogenic-viscerotropic pathotype the test birds showed edema of the head and neck, with swelling of the eyelids, and post mortem the accumulation of semi-liquid fibrinous mass under the skin in these parts of the body and conjunctivitis were found. MDT/CT in the modification employed proved simple and readily applicable, and superior to IVPI in reliability, and is, therefore, suggested for use in typing and differentiating NDV isolates. PMID- 3629959 TI - [Characteristics of Newcastle virus isolated from live vaccine-immunized chickens -the unusual biological properties]. AB - A strain of the Newcastle disease virus, denoted GF, was isolated from birds vaccinated twice with a live vaccine. In some flocks of the farm this strain has caused oligosymptomatic disease, and in others the infection has run a latent course. It was shown that the GF strain possessed unusual biologic properties--an extremely high virulence in vitro combined with a total lack of pathogenicity in vivo. With regard to the tests mean death time with 10-day-old chick embryos (44.6 h) and plaque morphology (a heterogeneous plaque population of clear plaques, sizing 0.5 to 3.5 mm) it was referred to the velogenic group. With regard to the intracerebral pathogenic index (1.21) it belonged to the mesogenic group. In terms of the intravenous pathogenic index (0) it had to be classified with the lentogenic group of of strains of the Newcastle disease virus. All these properties of the strain were shown to be stable. Besides the difficulties with its differentiation the behaviours of this strain pose a number of problems with regard to its origin and the variability of the Newcastle disease virus in nature, which are subject to discussion. PMID- 3629960 TI - [Potential manifestation of fowl typhoid in chicks fed Salmonella gallinarum contaminated feed]. AB - The possibility was checked to infect young birds with fowl typhoid through feeding them with S. gallinarum--contaminated forage. The three test groups of birds were kept on the floor of one and same premise, and a fourth group was kept separately in isolation. The feed offered to the first and second test group was contaminated at the rate of 5.10(8) and 1.2.10(8) microbial cells, respectively. With the first group, where feed contamination was at the rate of 6.10(6) S. gallinarum cells per bird, mortality rate ran as high as 61 per cent, 53 per cent of the total number of birds dying of typhoid septicaemia. With the second group, where feed contamination was 1.2.10(6) S. gallinarum cells per bird the total rate of mortality was 34 per cent, 32 per cent of the birds dying of typhoid septicaemia. With the third group, exposed to air-borne infection and offered Salmonella-free feed only, 8 per cent of the birds died of typhoid. It was found that the manifestation and the intensity of the epizootic process were in direct dependence on the microbial number, and that air played a part in transmitting S. gallinarum to young birds raised on the floor. PMID- 3629961 TI - [Effect of ochratoxin on the health status of broilers]. AB - An experiment was carried out with 7-day-old broiler birds to assess the effect of ochratoxin A on their health. A standard feed mixture, containing 4 mg/kg ochratoxin A in pure substance, was offered to the birds in the course of 21 days. No severe clinical symptoms and death cases were observed during the experimental period. However, both the growth and the development of the birds were arrested along with an increase in the relative weight of the kidneys and changes in their morphology--vascular disturbances and dystrophy more strongly manifested in the kidneys and to a weaker extent seen in the bursa of Fabricius, the thymus, and other organs. PMID- 3629962 TI - [Species structure of Salmonellae isolated from mammals, poultry, feed mixtures and the environment 1976-1980]. AB - Studied was the species structure of Salmonella strains isolated in this country from mammals, birds, food products, combined feeds, and objects of the environment over the 1976-1980 period. Differentiated were a total of 10,794 Salmonella cultures, belonging to 67 serotypes of 10 serologic groups after Kauffmann-White's scheme. Most wide-spread proved to be the S. choleraesuis, S. oranienburg, S. dublin, S. typhimurium, S. gallinarum-pullorum, S. enteritidis, S. derby, S. abortusovis, and S. agona serotypes. Combined feeds and individual components were most often found to be the source of S. senftenberg, S. muenster, S. meleagridis, S. oranienburg, S. mission, and S. agona. A dropping trend was established with the relative share of Salmonella organisms isolated from combined feeds and their components as against the total count of isolated Salmonellae in comparison with the 1970-1975 period (2.51 and 8.12 per cent, respectively). PMID- 3629963 TI - [Biopharmaceutical and clinico-pharmacological research on the intramammary preparation Cephamasten]. AB - An animal drug formula, Cephamasten, for intramammary application in the treatment of mastitis-affected cows, ewes, and goats in the lactation period was worked out on the base of microbiologic, technologic, biopharmaceutic, and clinico-pharmacologic studies. Its active ingredient was the Pharmachim cephalexin-monohydrate. The consistence of Cephamasten has proved suitable for intracisternal introduction. It is tolerated well within the udder of cows, and it rapidly releases the antibiotic incorporated in it. The milk of the treated quarters has proved free from cephalexin after the 72nd hour of the last infusion. Cephamasten has shown high effectiveness in the treatment both of the preclinical and of the acute clinical mastitis. In the first case best results were obtained with the twofold treatment at a 24-hour interval, and in the second case--with the sixfold treatment at 12-hour intervals (intracisternal introduction of the preparation). In the case of generalized mastitis, in dependence on the severity of the process Cephamasten is to be applied at 4-6-12 intervals along with frequent milking and the parenteral application of other agents. PMID- 3629964 TI - [Organic solvents studied for their embryotoxic and teratogenic action on chick embryos]. AB - Tested were the embryotoxic and teratogenic effects of some organic solvents (dioxane, propylene glycol, ethylene glycol, ethyl alcohol, and tween-80). The solvents were introduced into 3-day-old chick embryos at the rate of 0.1 cm3 in the yolk sac. With the exception of the 5th group (20 per cent ethylene glycol) in all other test groups mortality rate reached 100 per cent, manifested up to the 14th day. No teratogenic effects with expressed malformations were observed. PMID- 3629965 TI - [Susceptibility of Yersinia bacteria to antibiotics and disinfectant agents]. AB - Studied was the susceptibility of Yersinia bacteria to antibiotics and disinfection means. Results showed that the reference strains of the Yersinia enterocolitica, Y. pseudotuberculosis, Y. fredericksenii, and Y. intermedia species manifested high sensitivity to gentamycin, nalidixic acid, chloramphenicol, and streptomycin. Serovariety 03 of Y. enterocolitica strains, isolated from milk and sewage water, were most sensitive to gentamycin (100 per cent), chloramphenicol (100 per cent), nalidixic acid (100 per cent), kanamycin (95.8 per cent), and streptomycin (92.8 per cent). The disinfection preparations Dezinfect B (4 per cent solution) and Reiniger Combi (0.5 per cent solution) destroyed V. enterocolitica, Y. fredericksenii, and Y. intermedia for 30 sec., and Y. pseudotuberculosis for 5 minutes. Under productional conditions the same effect was produced for 10 to 15 minutes. PMID- 3629966 TI - [Changes in the iron content, erythrocytes and hemoglobin in the blood of poultry with acute experimental fowl typhoid]. AB - The dynamic was followed up of the concentration of iron in the blood serum and the liver, of the erythrocyte count, of the haematocrit value of blood, and of the haemoglobin level in chickens of the New Hampshire breed at the age of 300 days, with experimentally induced acute typhoid. It was found that blood serum iron dropped abruptly as early as the second day of infection, whereas the level of iron in the liver rose. The erythrocyte count dropped almost twice as early as the second day following infection, the haematocrit value of the blood following the fluctuations of the erythrocyte count. The haemoglobin level dropped considerably on the third day, with gradually lowering values up to the seventh day. All changes that were recorded with these indices of the blood were found to precede the onset of the first clinical signs of the disease. The values of the haematologic indices with birds that survived came back to normal after the fourteenth day of infection. In the author's personal view leading in the pathogenesis of acute typhoid with the New Hampshire chickens was the lowered amount of serum iron, which disturbed the synthesis of haemoglobin and hence the maturity of erythrocytes, substantiating their lower count. The trophism of vitally important organs and tissues was also found to be disturbed. PMID- 3629967 TI - [Transplantation of embryos in sheep breeding]. AB - Intra- and inter-breed transplantations were carried out with Bulgarian fresh embryos and with frozen embryos imported from Poland. A complex biotechnology was worked out, including methods of estrus synchronization, of inducing superovulation, and of producing, morphologic evaluation, storing, and transplantation of sheep embryos. Discussed are the possibilities of using embryo transplantation in sheep breeding for the fuller use of the reproductive potential of elite ewes as donors of embryos, for the introduction of new genotypes by means of importing frozen embryos as well as a modern model for fundamental investigations in the reproductive and cell biology. PMID- 3629968 TI - [Clinical and morphological changes in the hoof sole of large ruminants with inflammatory diseases]. AB - Clinical, morphological, and histomorphological investigations were carried out of the changes taking place in the solar matrix in some more common diseases in cows raised in the conditions on the enlarged farms of industrial cattle breeding. With the traumatic aseptic inflammations of the solar matrix the nova and its effect predetermine histologically the various degrees of changes, consisting in circulation disturbances, oedema of the connective tissue, disintegration of the connective tissue bundles, divergence of the collagen fibres, mucinous dystrophy, fibrinoid-necrotic foci, and heterophilic infiltration around the blood vessels and in their wall (arteriitis and periarteriitis). In suppurative inflammations of the solar matrix the process assumes diffuse character with strongly manifested leukocytic infiltration, with the development of dystrophic necrobiotic processes. As a result of these partially or more widely expressed separation (exungulatio) of the solar horn tissue from the matrix sets in. In the initial stage of the traumatic sole ulcer are observed the signs described for an aseptic inflammation. Later on the processes assume a more strongly manifested course, involving the matrix with atrophy and necrosis, separation of the hoof horn from the matrix. With the secondary complication with pathogenic organisms the signs of purulent and necrotic inflammation are seen, resulting in an ulcus defect. PMID- 3629969 TI - [Content of chemical elements in the liquid manure of swine at a treatment plant using biological purification]. AB - An atom absorption spectrophotometer was used to study 13 chemical elements in samples taken at the entrance of the purification station, at the mechanical step exit, at the biostep exist, and at the laguna exit as well as following treatment of the solid fraction in open surface purification and drying plots. It was found that part of the biogenic chemical elements remained in the liquid fraction after purification and were hazardous in terms of eutrophication of the water receptacle. A technology was worked out to treat the solid fraction, however, it did not provide for preserving the biogenic chemical elements. This lowered the qualities of the fraction in enriching the soil. PMID- 3629970 TI - [Localization of Cysticercus ovis in experimentally infected lambs]. AB - An experimental infection was induced in lambs with 1000, 4000, 7000, and 30000 T. ovis eggs. It was found for the first time that Cysticercus ovis could be established not only in the already known regions of the body, but also in the skin and the subcutaneous connective tissue. The lesions were followed up in the skin on the 10th, 20th, 30th, and 45th day following infection. Later on the cysticerci localized in the skin caused its total piercing. The skin portions above the cysticerci, localized in the subcutaneous tissue, proved unsuitable to treatment and handling and remained defective. Hides that were obtained from animals infected with Cysticercus ovis were shown to be discarded in the leather and fur industries. PMID- 3629971 TI - Two related viral genes are located on a single superhelical DNA segment of the multipartite Campoletis sonorensis virus genome. AB - Campoletis sonorensis virus (CsV) (Polydnaviridae) is a large eucaryotic DNA virus with a structurally complex genome consisting of 28 or more superhelical (SH) DNA segments. Little is known of the relationship between different SH DNAs, but some SH DNAs do cross hybridize, indicating a relatedness between certain SH DNAs. In a previous study of viral expression in parasitized Heliothis virescens larvae, several partially homologous viral mRNAs were also identified (G. W. Blissard, S. B. Vinson, and M. D. Summers, 1986, J. Virol. 57, 318-327). To study the organization of the viral genome and the relationship between two partially homologous viral mRNAs, we analyzed cDNA clones and a cloned SH DNA segment of the CsV genome. Of the two CsV mRNAs examined (1.6 and 1.0 kb), both mRNAs were abundant at 48 hr after parasitization and the 1.6-kb mRNA was detected as early as 2 hr after parasitization. Nucleotide sequence analyses of cDNA clones representing the two partially homologous CsV mRNAs (1.6 and 1.0 kb) show that the two CsV mRNAs share five regions of imperfect homology (68 to 88%) which include a large part of each mRNA. These data indicate that the two mRNAs are transcribed from two separate but closely related CsV genes. Comparison of predicted amino acid sequences shows that the two related viral genes encode proteins with divergent amino acid sequences. Northern and Southern hybridization analyses using cloned cDNAs as probes showed that one CsV mRNA (1.6 kb) is homologous to CsV SH DNAs W, R, and M, while the other mRNA (1.0 kb) shows strong homology only to SH DNA W. By cloning and Southern hybridization mapping of the 15.8-kbp SH DNA W, we demonstrate that the genes for the related 1.6- and 1.0-kb mRNAs are located on different regions of this single 15.8-kbp SH DNA. Alignment of nucleotide sequences from a cloned viral genomic DNA and a cDNA demonstrates that the CsV gene encoding the 1.6-kb mRNA is a spliced gene containing at least two introns. Conservation of splice junctions between the two mRNAs suggests that the 1.0-kb mRNA is also spliced. These data represent the detailed analysis of two closely related CsV mRNAs abundantly expressed in parasitized H. virescens larvae, the first observation of related viral genes in a eucaryotic DNA virus, the demonstration of splicing in the Polydnaviridae, and the cloning and mapping of one of the largest SH DNA segments of the CsV genome. PMID- 3629972 TI - A cultured cell receptor for the small S protein of hepatitis B virus. AB - Human hepatitis B virus (HBV) has not been passaged in established cell culture systems. To determine whether this inability results from the lack of a receptor, 30 cell lines were examined for their abilities to bind 125I-labeled recombinant hepatitis B virus surface antigen (rHBsAg) particles. These particles contained only the small surface (S) protein, which is also found in the envelope of infectious HBV particles. Only two cells lines, both derived from African green monkey kidney, were able to bind a large portion of the 125I-rHBsAg particles. Binding to one of these cell lines, Vero, was found to be specific by three criteria: it was competitively inhibited by nonradioactive particles, it was saturable, and it could be blocked by chimpanzee antiserum raised against the rHBsAg particles. Analysis of the binding data indicated a single major population of high affinity receptor sites: 2.7 X 10(5) sites/cell, Kd = 2.8 nM. Binding was not due to the covalently linked 125I tracer isotope because unlabeled particles also bound, as detected with a monoclonal antibody. Binding was not unique to this recombinant particle preparation since serum-derived particles also bound to Vero cells. These results indicate that the Vero cell line expresses a receptor for the small S protein of HBV and that the small S protein, alone, may function as the HBV attachment protein. PMID- 3629973 TI - Analysis of functional domains on reovirus cell attachment protein sigma 1 using cloned S1 gene deletion mutants. AB - Previously a reovirus (serotype 3) S1 gene cDNA was inserted into the lac cloning site of pUC13 and expressed in Escherichia coli to yield a sigma 1 fusion protein (F-sigma 1) capable of binding to mouse L fibroblasts and of agglutinating human red blood cells (S.A. Masri, L. Nagata, D. C. W. Mah, and P. W. K. Lee, 1986, Virology 149, 83-90). To probe the functional domains on the sigma 1 protein, restriction enzymes which divide the S1 gene into four segments (5'-I-II-III-IV 3') of similar size were used to generate five in-frame deletion mutants (D1-D5). Corresponding mutant forms of sigma 1 were expressed in E. coli and were assayed for (i) host cell (mouse L fibroblasts) binding activity; (ii) glycophorin (reovirus erythrocyte receptor) binding activity (R. W. Paul and P. W. K. Lee, 1987. Virology 159, 94-101 and (iii) recognizability by a library of neutralizing monoclonal anti-sigma 1 antibodies. It was found that mutant sigma 1 forms with segment III or segment IV deleted did not exhibit any detectable L-cell binding activity, whereas mutants with these two segments intact (but lacking segment II or segments I and II) were capable of attaching to L-cell receptors, albeit with reduced efficiencies. On the other hand, only F-sigma 1, but none of the mutants, could bind immobilized glycophorin. These data clearly suggest that the host cell binding domain of sigma 1 is distinct from its hemagglutination domain. Also, the five neutralizing anti-sigma 1 monoclonal antibodies tested were all found to recognize epitopes on either the middle segments or the carboxy-terminal half of sigma 1. PMID- 3629974 TI - Complete nucleotide sequence of the M RNA segment of Uukuniemi virus encoding the membrane glycoproteins G1 and G2. AB - We have determined the complete nucleotide sequence of the virion M RNA segment of Uukuniemi virus (Uukuvirus genus, Bunyaviridae) from cloned cDNA. The RNA that encodes the two membrane glycoproteins G1 and G2 is 3231 residues long (mol wt 1.1 X 10(6)). The 5' and 3' ends of the RNA are partially complementary to each other for some 30 bp, enabling the formation of a stable panhandle structure (delta G = -40 kcal/mol) and the circularization of the molecule. The extreme 5' and 3' terminal nucleotides are identical for 10 to 13 residues to those of the M RNA of Punta Toro and Rift Valley fever viruses, two members of the Phlebovirus genus. A single open reading frame comprising 1008 amino acid residues (mol wt 113,588) was found in the mRNA-sense strand between nucleotides 18 and 3042. This probably corresponds to the previously identified 110,000-Da precursor (p110) of G1 and G2. By comparing the partial aminoterminal sequences of purified G1 and G2 with the deduced protein sequence we confirmed that the gene order is NH2-G1-G2 COOH. Both mature G1 and G2 are preceded by a stretch of 17 predominantly hydrophobic amino acids likely to represent the signal sequences. At their COOH terminal ends, G1 and G2 have a hydrophobic stretch of amino acids, 19 and 27 residues, respectively, that probably anchors the proteins to the lipid bilayer. The sequence indicates that mature G2 is 495 amino acids long (mol wt 54,869), whereas the exact size of G1 is unclear, since the location of the COOH-terminus of G1 is not known. An upper value of 479 amino acids (mol wt 55,181) can, however, be suggested. Both G1 and G2 contain four potential glycosylation sites for Asn-linked glycans and both are unusually rich in cysteines, 6.1% in G1 and 5.4% in G2. Comparison of the amino acid sequence of the M RNA product of Uukuniemi virus with that of Punta Toro and Rift Valley fever viruses showed in both cases a weak homology that was more pronounced for the proteins located at the COOH-terminal end of the precursor. This suggests a distant evolutionary relationship between the Phlebo- and Uukuvirus genera. PMID- 3629975 TI - Analysis of the influence of proteolytic cleavage on the structural organization of the surface of the West Nile flavivirus leads to the isolation of a protease resistant E protein oligomer from the viral surface. AB - In order to analyze the organization of the membrane proteins pre M, M, and E of the West Nile (WN) flavivirus we have studied the influence of proteolytic cleavage of intact virus on the structure of these proteins. The amino acid sequence of all proteins is known, all six disulfides present in the viral E protein have been identified, and it has been suggested that the E protein contains regions R1, L1, R2, L2, and R3, which together form the E protein ectodomain followed by a carboxyterminal membrane anchor region (Th. Nowak and G. Wengler (1987) Virology 156, 127-137). The results of our analyses can be summarized as follows: (1) The surface of the WN virus contains E protein oligomers; the E protein molecules present in these structures contain two segments which are exposed to proteolytic attack; the segments are located in parts L1 and R3 of the E protein. (2) Proteolytic cleavage of these oligomers in these regions neither destroys nor releases the oligomers from the viral surface. (3) The WN virus surface contains a layer of 7-nm ring-shaped subunits identifiable by electron microscopy which are neither destroyed nor released by proteolytic cleavage. (4) An E protein trimer can be isolated from the surface of protease-treated WN virus. This trimer is morphologically similar to the 7-nm ring-shaped element which can be identified on the surface of native and protease treated WN virus by electron microscopy. PMID- 3629977 TI - Proteins synthesized in African swine fever virus-infected cells analyzed by two dimensional gel electrophoresis. AB - At least 74 acidic and 37 basic proteins are synthesized in African swine fever virus (ASFV)-infected monkey cells not detected in uninfected cells analyzed by two-dimensional gel electrophoresis. Essentially all the proteins synthesized early during infection are also observed at late times. The use of inhibitors such as cycloheximide and phosphonoacetate has led to the identification of 34 immediate early and 13 delayed early polypeptides. Therefore 64 proteins were classified as late polypeptides. Several ASFV-induced proteins are phosphorylated as proteins a1, a4, a20, a41, a48, a49, a51, a52, a55, a58, a67, b2, b12, b28, and b32. PMID- 3629976 TI - Infection with frog virus 3 allows transcription of DNA methylated at cytosine but not adenine residues. AB - The genome of the iridovirus, frog virus 3, is highly methylated at cytosine residues by a virus-encoded DNA methyltransferase. We have shown previously that an FV3-induced trans-acting protein alters either host RNA polymerase II or methylated template to allow transcription from promoters inactivated by methylation. We now present evidence that the ability of FV3-infected cells to transcribe methylated DNA is specific for DNA methylated at cytosine residues. Eukaryotic promoters were inactivated by methylation of either adenine or cytosine residues, and tested for transcriptional activity. Only promoters inactivated by cytosine methylation were transcribed in FV3-infected cells. We also show that the dinucleotide sequence in which the methylcytosine is found appears to have no effect on the ability of FV3 to trans-activate the methylated promoters. PMID- 3629978 TI - Structural changes in the haemagglutinin which accompany egg adaptation of an influenza A(H1N1) virus. AB - Antigenic changes are often induced in the haemagglutinin (HA) of human isolates of influenza A(H1N1) and B viruses during their isolation and propagation in embryonated hens' eggs. In this report we describe molecular changes in the HA of an A(H1N1) virus which accompany egg adaptation. The HA1 amino acid substitutions of egg-adapted variants are located in the vicinity of the receptor binding site. This suggests that egg-adapted variants are selected on the basis of altered receptor site specificity with concomitant effects on the antigenic configuration of the HA molecule. In this study, at least three antigenically distinct groups of egg-adapted variants were observed. These observations have implications for the indiscriminate use of egg-adapted viruses in sero-epidemiological studies and vaccine production. PMID- 3629979 TI - Molecular cloning and sequence analysis of the rinderpest virus mRNA encoding the hemagglutinin protein. AB - We cloned the full-length cDNAs corresponding to the mRNA for the hemagglutinin (H) protein of rinderpest virus (RV) and determined the nucleotide sequence of RV H. The gene of RV-H was composed of 1952 nucleotides and contained a single large open reading frame, which was capable of encoding a protein of 609 amino acids with a molecular weight of 68,330 Da. The nucleotide sequence and predicted amino acid sequence were compared with those of the measles virus (MV)-H. The 5' end of the message (nucleotides 1 to 485) was largely conserved, with a homology of 75.1% of the nucleotides and 78.0% of the predicted amino acids. In the middle portion (nucleotides 486-1310), where the potential glycosylation sites exist, 56.6% of the nucleotides and 49.5% of the amino acids were identical. In the 3' end of the message (nucleotides 1311-1850), 63.3% of the nucleotides and 58.1% of the amino acids were identical. Four potential glycosylation sites were found in RV-H protein and three of them were the same as those of MV-H protein. The positions of 13 cysteine residues of RV-H were absolutely identical to those of MV-H. The hydropathy profile of RV-H protein resembled that of MV-H. One major hydrophobic region long enough to be an anchor in the membrane was located near the N-terminus. PMID- 3629980 TI - A nucleotide sequence rearrangement distinguishes two isolates of satellite tobacco ringspot virus RNA. AB - Several strains of tobacco ringspot virus (TobRV) support the replication and encapsidation of satellite tobacco ringspot virus RNA (STobRV RNA). We have compared the nucleotide sequences of four STobRV RNAs, each initially associated with a different isolate of TobRV. A STobRV RNA from a geranium isolate of TobRV and STobRV RNA from the previously analyzed budblight isolate (J.M. Buzayan, W.L. Gerlach, G. Bruening, P. Keese, and A.R. Gould, 1986, Virology 151, 186-199) differed by a single nucleotide residue substitution. STobRV RNAs from TobRV isolates 62L and NC-87 have the same 360-residue nucleotide sequence. This sequence differs from that of the 359-nucleotide residue budblight STobRV RNA principally at locations 100 through 140. The differences between the two sequences in this region are consistent with a rearrangement of blocks of nucleotide residues. The two sequences can be folded with similar patterns of base pairing. All four STobRV RNAs share a sequence of eighty 5'-terminal and of twenty 3'-terminal residues, including the 5' hydroxyl group and 2':3'-cyclic phosphodiester group. PMID- 3629982 TI - [The computer in the sanatorium]. PMID- 3629981 TI - [Means for the development and outlook for research into the medical problems of physical education and sports and the practical introduction of these achievements into public health]. PMID- 3629983 TI - [Treatment of patients with chronic prostatitis complicated by infertility by microwave (460 MHz) action on the area of the thyroid and thymus glands]. PMID- 3629984 TI - [The combined use of physiotherapy methods at the dispensary observation stage with hypertension patients]. PMID- 3629985 TI - [Microcirculatory and central hemodynamic functions of hypertension patients being treated with sodium chloride baths]. PMID- 3629986 TI - [Effect of physical exercises on cerebral hemodynamics (based on rheoencephalographic data) of arterial hypertension patients with initial cerebrovascular manifestations]. PMID- 3629987 TI - [Medico-social effectiveness of one-time and repeated sanatorium-health resort treatment on the southern shore of the Crimea for chronic bronchitis patients living in southwestern Siberia]. PMID- 3629988 TI - [Use of a low-frequency magnetic field in treating patients with atherosclerotic encephalopathy]. PMID- 3629989 TI - [Lithium electrophoresis in treating neurocirculatory asthenia patients]. PMID- 3629990 TI - [Medical gymnastics in the myotenoplastic stabilization of a paralytically unstable hip joint]. PMID- 3629991 TI - [Therapeutic physical exercise in treating children with multiplanar deformities of the proximal femur]. PMID- 3629992 TI - [Horseback riding in the prevention and treatment of scoliosis in children and adolescents]. PMID- 3629993 TI - [Treatment using natural radon waters of patients with obliterating arterial diseases of the extremities]. PMID- 3629994 TI - [Use of an orthostatic test in determining the motor regimen for myocardial infarct patients at the hospital stage of rehabilitation]. PMID- 3629995 TI - [Benzohexonium electrophoresis using sinusoidal modulated currents in treating neural amyotrophy patients]. PMID- 3629996 TI - [Radon therapy in the combined treatment of chronic traumatic osteomyelitis]. PMID- 3629997 TI - [Case of a conservative cure of an organized hematoma]. PMID- 3629998 TI - [Improvement in the therapeutic and diagnostic foundation of sanatorium-health resort institutions based on medical technology requirements]. PMID- 3629999 TI - [An automated setup for preparing an aqueous solution of radon]. PMID- 3630000 TI - [The term "hydrogen sulfide waters"]. PMID- 3630001 TI - [The state of the microsomal oxidative system in the liver of rats with acute osteomyelitis of the mandible]. AB - Duration of hexenal sleep and activity of main microsomal enzymes in hepatocytes were studied in experimental osteomyelitis of rat mandible. Within 7, 10 and 14 days after the osteomyelitis development content of cytochromes P-450 and b5 as well as activities of amidopyrine N-demethylase, aniline hydroxylase and NADPH cytochrome c reductase were decreased in liver cell microsomal fraction. As liver tissue monooxygenase enzymatic system is inhibited in osteomyelitis the elevated pharmacological activity and toxicity of drugs, metabolized in liver tissue, should be considered under conditions of practical use of these drugs. PMID- 3630002 TI - [Glutathione:dehydroascorbate oxidoreductase activity in rabbit eye tissues]. AB - Glutathione: dehydroascorbate oxidoreductase was detected in rabbit eye tissues, activity of which was decreased as compared with that of glutathione reductase. The ratio between glutathione reductase activity and the total activity of the enzymes catalyzing glutathione oxidation (glutathione: dehydroascorbate oxidoreductase and glutathione: H2O2 peroxidase) was above one unit in cornea, ciliary body, sclera vascular tunic and iris of the eye; it was lower than one unit in vitreous body, lens, optic nerve and aqueous humor. Glutathione: dehydroascorbate oxidoreductase is one of the key component in the eye antioxidative system; it regulates the ratio of oxidized and reduced forms of ascorbic acid and glutathione. PMID- 3630003 TI - [Biochemico-pharmacological mechanisms and the relation between the anticalorigenic, hypothermic and antihypoxic effects of adenosine]. AB - Administration of adenosine into mice induced a decrease in oxygen consumption (anticalorigenic effect), body temperature (hypothermal effect) and protected against acute hypoxia (antihypoxic action); all these effects are closely correlated. Isopropyl noradrenaline and theophylline prevented but propranolol and dipiridamol increased these effects of adenosine. Being administered into mice adenosine decreased both cAMP content (in skeletal muscles and kidney) and respiration in kidney homogenates. These adenosine effects appear to be realized via the following chain: A1-receptors----decrease in cellular cAMP content--- inhibition of tissue oxygen consumption----development of anticalorigenic reactions----hypothermal effects----antihypoxic actions. PMID- 3630004 TI - [Stochastic model of hemosorption]. PMID- 3630005 TI - [Determination of lipid peroxidation products using thiobarbituric acid in anaerobic states]. AB - Products of lipid peroxidation were estimated in aerobic and anaerobic conditions using thiobarbituric acid (TBA) test. The main amount of malonic dialdehyde estimated in tissue homogenate in presence of oxygen was found to develop during the analytical procedure as a result of lipid peroxidation. At the same time, content of lipid peroxidation primary products did not correlate with amount of malonic dialdehyde in the sample studied. This suggests that TBA analysis may be carried out only under anaerobic conditions. PMID- 3630006 TI - [Colorimetric method of sequential determination of several dehydrogenases in a smear of human leukocytes]. AB - Activity of several dehydrogenases was estimated by means of sequential incubation of a smear of human leukocytes in various media containing specific substrates for each enzyme and p-nitrotetrazolium violet as an acceptor of electrons. Photometry of the coloured products of redox reactions was carried out in the photoelectrocolorimeter, which was used for registration of steady state kinetics of all the reactions studied under usual conditions. Relative activity of succinate-alpha-glycerophosphate dehydrogenases and NADH/alpha glycerophosphate dehydrogenases was estimated with an error of 2-4% in individual donors, while deviations of these values in leukocytes of the donors constituted +/- 15% as compared with their middle level calculated in 32 donors. PMID- 3630007 TI - [Statistical analysis of results in the determination of steroid hormone receptors]. AB - Statistical evaluation of the data of steroid hormone receptors estimation involved the principle of dependence of each experimentally obtained magnitude of total binding (in presence of a single labelled ligand) on the magnitude of unspecific binding (at the similar content of labelled ligand but in addition of unlabelled substance excess). The principle enabled to calculate: individual values of specific binding as a difference between each value for total and unspecific binding independently on amount of parallel probes of total and unspecific bindings, mean value of specific binding using the calculated magnitudes, standard deviation (dispersion) and standard error of mean value. Statistical method allowed to determine differences between magnitudes of specific binding (content of receptors) at saturating concentrations of ligand as well as to estimate standard deviation of KD and Vmax in a plot. The statistical principles were used for estimation of specific binding of 3H-estra dil-17 beta, 3H-dihydrotestosterone and 3H-5 alpha-and-rostan-3 beta, 17 beta-diol in various rat tissues (hypophysis, prostate, uterus) and human tissues (mammary gland tissue tumor, prostate adenoma). The principle developed may be used for estimation of various receptors of biologically active substances, where the specific binding is calculated as a difference between total and unspecific binding. PMID- 3630008 TI - [A method of determining NADH-methemoglobin reductase activity using amino derivatives of o-benzoquinone]. AB - Rate of methemoglobin reduction was increased in erythrocyte hemolysates in presence of 4-N-(p-sulfanilino)-5-methoxy-1.2-benzoquinone. Kinetic parameters of total reaction and of individual steps showed that the substance and other amino derivatives of ortho-benzoquinone could be used for estimation of methemoglobin reductase activity. PMID- 3630009 TI - [The use of pyridoxal-5-phosphate in determining aminotransferase activity in brain tissue]. AB - When aspartate- and alanine transaminase (AST and ALT, respectively) activities were studied in homogenates of rat cerebellum, brain cortex and brain stem (using a modified procedure by Raitman and Frenkel), addition of 50 microM pyridoxal-5 phosphate (PALP) increased 2-3-fold the activity studied. With an increase in PALP concentration from 6.25 microM up to 200 microM AST- and ALT-activities increased dose-dependently, while at 100-200 microM concentration of PALP saturation of the reaction occurred and 200 microM of PALP decreased the AST activity. 10 min preincubation of these homogenates without and in presence of 0.25 mM PALP led to a distinct increase in amount of ketoderivatives reacting positively with 2,4-dinitrophenyl hydrazine, most markedly elevated in the sample containing PALP. At the same time, prolongation of the preincubation period under standard conditions in presence of an excess of the substrates and 50 microM PALP did not cause any increase in AST- and ALT-activities. During studies of the transaminase activity in brain biopsy, in the material obtained after neurosurgical operations as well as in medico-biological experiments, the activity should be estimated using two sets of conditions: under standard conditions and in presence of 50-100 microM PALP but without preincubation with PALP. PMID- 3630010 TI - [Unresolved problems in teaching biochemistry in medical schools]. PMID- 3630011 TI - [The results of discussions on the teaching of biochemistry in medical schools]. PMID- 3630012 TI - [Fatty acid composition of liver lipids in chronic hepatitis, liver cirrhosis and fatty liver]. AB - Fatty acid spectrum of liver tissue lipids was studied by means of gas-liquid chromatography in 58 bioptic samples from patients with chronic hepatitis, liver cirrhosis and fatty hepatosis. A statistically significant decrease in content of linoleic, arachidonic and docosahexaenic acids as well as an increase in oleic, palmitoleic and myristic acids were found. Under conditions of the diseases studied fatty acid spectrum of liver tissue lipids altered. A decrease in degree of lipid desaturation was especially distinct in liver tissue cirrhosis. PMID- 3630013 TI - [The effect of hyperlipoproteinemia induced by the administration of an atherogenic lipoprotein fraction on various indices of lipid metabolism in rabbits]. AB - Hyperlipoproteinemia, which was developed after intravenous administration of lipoprotein atherogenous fraction, caused the secondary metabolic alterations. These alterations were manifested as a decrease in catabolism of blood serum lipoproteins, accumulation of hydrophobic lipid components in the lipoproteins as well as in a decrease in relative content of high density lipoproteins responsible for elimination of cholesterol from tissues. PMID- 3630014 TI - [Effect of starvation on the intensity of proteolysis and amidation of proteins in tissues of rats of different ages]. AB - Rates of autolysis and degree of amidation of tissue proteins were studied in rats under conditions of ageing and after starvation during 7 days. Proteins with decreased content of amide groups accumulated in brain, liver tissues and skeletal muscles. This phenomenon occurred apparently due to decrease in the rate of protein autolysis observed in ageing. In testes, where the rate of protein autolysis was similar both in young and old animals, the protein amidation was not altered on the course of ageing. Under conditions of severe starvation activation of proteolysis was observed in cells. At the same time, the amide content was restored in liver and muscle proteins of old rats up to the level, estimated in tissues of young animals. These data suggest stimulation of selective degradation of the deamidated proteins. The activation of autolysis and normalization of the protein amide groups content were not observed in brain of old animals under conditions of starvation. PMID- 3630015 TI - [Protective effect of superoxide dismutase against the damage of the rat gastric mucosa during emotional and pain stress]. AB - Patterns of ulcer-hemorrhagic impairments were distinctly decreased in gastric mucose of rats with emotional-painful stress after Cu, Zn-superoxide dismutase administration at a dose of 0.5 mg/kg every 30 min of the experiment. The protective effect of the enzyme was realized via regulation of free radical reactions as well as by means of maintaining of structure-functional activity of lipoprotein complexes in gastric mucose. PMID- 3630016 TI - [The use of a glycomacropeptide of kappa-casein as a substrate for neuraminidase]. AB - Glycomacropeptide from milk was studied; its molecular mass and amino acid composition were evaluated. When the glycomacropeptide was used as a substrate of neuraminidase, it exhibited many advantages as compared with ovomucin (high molecular substrate of the enzyme) due to increased content of sialic acids in the glycomacropeptide composition and to high solubility. PMID- 3630017 TI - [In vitro effect of [D-Ala-4]-dermorphin on the luminol-dependent chemiluminescence of mouse whole blood during phagocytosis]. AB - In vitro effect of biologically active D-Ala4-dermorphin on the phagocytizing and resting cells of mice whole blood was studied using luminol-dependent chemiluminescence. D-Ala4-dermorphin influenced only on chemiluminescence of the phygocytizing cells: maximal effect was observed at 1.015 X 10(-7) M of the peptide. PMID- 3630018 TI - [Urinary excretion of hydroxyproline in funnel chest deformity]. AB - Excretion of hydroxyproline with urine was studied in 16 children with localized form of funnel chest deformation simultaneously with Marfan and Ehlers-Danlos syndromes, in 9 children with the localized form of deformation within 6-8 months after thorax surgical plastic operation as well as in 3 children with Ehlers Danlos syndrome but without funnel chest deformation. Funnel chest deformation of the II-III degree, independently of its form, was accompanied by a decrease of total hydroxyproline in urine as compared with healthy children of the similar age. The hydroxyproline excretion was normalized after thoracoplastic operation in the children with localized form of the chest deformation. In Ehlers-Danlos syndrome, independently on presence or absence of the chest deformation, relative content of free hydroxyproline was increased in urine, while the peptide-bound amino acid was decreased (peptides with molecular mass above 700 daltons); this phenomenon appears to be a characteristic property of the syndrome. PMID- 3630019 TI - [Isolation and characteristics of antithrombin III from human plasma]. AB - Highly purified preparation of antithrombin III (AT III) was obtained from human blood plasma. Efficiency of the procedure developed was corroborated by studies of physicochemical properties of the preparation. The AT III preparation was used for production of monospecific antiserum. The antisera prepared were analogous to the commercially available antisera in content of specific antibodies, affinity properties and might be used for development of sera for serodiagnostics. PMID- 3630020 TI - [Characteristics of prostanoid synthesis in patients with duodenal ulcer complicated by a history of hemorrhage]. AB - After inhibition of the cyclooxygenase pathway of arachidonic acid metabolism by means of indomethacin or aspirin the initially low aggregation activity of thrombocytes was not distinctly decreased, the antiaggregatory function of the blood vessels endothelium was not suppressed, secretion of bicarbonates was 1.5-2 fold less distinctly inhibited as well as secretion of acid and pepsin with gastric juice was less distinctly stimulated in patients with duodenal ulcer accompanied by hemorrhage as compared with healthy persons or the patients with non-complicated form of duodenal ulcer. At the same time, inhibition of bicarbonate secretion correlated with the antiaggregative activity of the blood vessel wall. The data obtained suggest that cyclooxygenase pathway of prostaglandin synthesis was distinctly impaired in the patients with hemorrhagic complications. Alterations in hemostatic and secretory parameters, caused by indomethacin or aspirin, should be considered in prognostic evaluation of the patients with duodenal ulcer, which had an increased risk of hemorrhagic complications. PMID- 3630021 TI - [Changes in the fatty acid composition of erythrocyte and platelet membranes after diet therapy in patients with hyperlipoproteinemia type II]. AB - Fatty acid spectrum of blood plasma, erythrocyte, and thrombocyte membranes as well as its alterations after diet therapy, containing polyunsaturated/saturated fatty acids at the ratio of I and less than 350 mg of cholesterol per a day, was studied in patients with hereditary hypercholesterolemia using gas chromatography. Content of linoleic acid was increased and that of oleic and arachidonic acids--decreased in lipids of the patients blood plasma as compared with healthy persons; an increase of linoleic acid was also detected in thrombocyte lipids. Alterations in fatty acid spectrum of erythrocyte membranes were less pronounced. After the course of diet therapy within I month a further increase in content of linoleic acid was observed in blood plasma. Under these conditions efficiency of essential fatty acids incorporation into lipid structures of thrombocyte membranes was higher and of erythrocytes--lower in the patients as compared with healthy persons. Possible alimentary correction of fatty acid spectrum in blood lipids is discussed. PMID- 3630022 TI - [Effect of methyluracil on lipid peroxidation in the plasma and tissue homogenates from ulcer lesions of the gastric wall in rats]. AB - Dynamics of experimental acetate gastric ulcer healing and lipid peroxidation were studied in rat blood and gastric tissues after treatment with methyluracil. The drug was shown to stimulate reparation and to inhibit lipid peroxidation. The antiulcerogenous effects of methyluracil appear to involve the antioxidative mechanisms. PMID- 3630023 TI - [Physico-chemical characteristics of sorbitol dehydrogenase from the cytoplasm of bovine liver cells]. AB - Partially purified preparation of sorbitol dehydrogenase, isolated from hepatocytes of bovine liver tissue, was active at a wide range of pH exhibiting the maximal activity at pH 9.0 in presence of NAD but not of NADP. The high rate of sorbitol and xylitol dehydration was observed, whereas the enzyme dehydrated ribitol at the 4-fold lower rate. Disc electrophoresis of the preparation in polyacrylamide gel, where sorbitol, xylitol and ribitol were used as substrates for colorimetric detection of the enzyme activity, exhibited six enzymatic zones with Rf 0.387, 0.266, 0.338, 0.193, 0.129 and 0.064. Optimal conditions were developed for storage of the active enzyme. PMID- 3630024 TI - [Complex formation of heparin with the inhibitor of non-enzymatic fibrinolysis isolated from the spleen]. AB - Formation of complexes between heparin and protein inhibitor of non-enzymatic fibrinolysis, isolated from spleen tissue of healthy animals, was demonstrated by means of cross electrophoresis, UV- and IR-spectrophotometries. Suppression of the spleen inhibitor activity towards non-enzymatic fibrinolysis occurred via its complex-formation with heparin, where the inhibitor aminogroups reacted with sulfo- or carboxyl groups of heparin. PMID- 3630025 TI - [Inhibition of the cytotoxic activity of natural killer cells by glycosphingolipids. Effect of the structure of carbohydrate chains]. AB - The ability of various glycosphingolipids to inhibit the cytotoxic activity of natural killer (NK) cells was studied. The inhibitory effect was found to depend on the structure and concentration of the glycosphingolipids. Gangliosides SiaLacCer inhibited the NK activity most effectively and their inhibitory effect depended on the structure of sialic acids: the N-acetyl form was more active than the N-glycoloyl form. Elongation of the carbohydrate chain decreased the inhibitory effect and monosialogangliosides NeuGcGgOse3Cer and NeuAcGgOse4Cer were practically inactive. The inhibitory ability of disialogangliosides depended on the structure of the carbohydrate chain as well as on the structure and attachment site of the sialic acids. Previously it was found that ganglioside (NeuAc)2LacCer, which is absent or very low in normal blood, is produced by a number of tumors and alongside with NeuAcLacCer is present in elevated amounts in the blood of tumor-bearing subjects. Elevated concentration of these gangliosides in the blood of tumor hosts may inhibit apparently the NK activity and thus contribute to the escape of tumor cells from host immune surveillance. PMID- 3630026 TI - [Adenine nucleotide metabolism in the testicular tissue of alloxan diabetic rats]. AB - Content of ATP and AMP, total intracellular pool of adenine nucleotides, the ratio of adenylate cyclase affecting ratio of ATP/ADP, energy change of the adenylate system as well as potential of adenine nucleotides phosphorylation were decreased in testicular tissue of rats with alloxan diabetes. At the same time, content of ADP and inorganic phosphate was increased as compared with control values. The data obtained suggest that energy metabolism was distinctly impaired in rat testes under conditions of alloxan diabetes, which appears to occur as a result of decrease in AMP biosynthesis and in transformation of the nucleotide into ATP during oxidative phosphorylation. These alterations in the pool of adenylates appear to play an important role in impairments of spermatogenic and endocrine functions of testes in diabetes. PMID- 3630027 TI - [Prevention of postoperative complications following combination therapy of malignant neoplasms in the maxillofacial area]. AB - Application of thermometry, polarography and liquid crystal technique for evaluation of microcirculation in the maxillofacial area in patients receiving combined treatment for cancer of the said site aids assessment of the viability of tissues and, thus, planning reconstructive surgery. PMID- 3630028 TI - [Methodologic aspects of the evaluation of the activities of cancer services (comparison of mortality indices)]. PMID- 3630029 TI - [Small non-cleaved follicular cell lymphoma]. AB - A retrospective clinical and histologic analysis of data on 60 cases of lymphoma of small non-cleaved follicular center cells (Lukes-Collins classification) was carried out. 19 cases were classified as Burkitt's lymphoma and 41 as non Burkitt's. Non-Burkitt's lymphomas showed more diverse cellularity. Age distribution was bimodal in both subgroups. Half the patients irrespective of histology had stage III or IV disease. GI tract involvement was similarly frequent in both groups. Lymphadenopathy was slightly more frequent in patients with non-Burkitt's lymphoma. Median survival time was as low as 9.2 months for Burkitt's and 14.8 months for non-Burkitt's lymphoma (difference not statistically significant). PMID- 3630030 TI - [Lung cancer in the elderly and middle-aged in Moscow and its surgical treatment]. AB - Lung cancer morbidity in Moscow in recent years is discussed. Two-thirds of the patients were 60 years of age or older. Lung cancer operability in Moscow has remained relatively stable accounting for 10-15%. The age distribution of the said parameter was as follows: patients under 60 years--30-32%; 60-69 years--12 14% and those over 70--4-5%. Results can be better if more middle-aged and elderly patients are operated on. The authors' clinical data on 842 surgical cases of lung cancer (males and females of varying age) are analysed. PMID- 3630031 TI - [Cytologic diagnosis of fibrous tissue tumors]. AB - A histocytologic examination of 118 cases of tumors of the fibrous tissue (64 benign and 54 malignant) was performed. Cytologic examination provided a means for identification of tumor in 80.5% and histologic pattern in 60% of cases. Intraoperative cytologic examination of tumor prints assured a reliable identification of histologic pattern of fibrous tumors in 85.7%. PMID- 3630032 TI - [Multicentric cancer of the breast]. AB - Multicentric breast carcinoma was identified in 3.7% of 119 patients operated on at the Center Clinics. A slow growth, small size of tumors and infrequent lesions in the regional lymph nodes were registered. A correlation between the degree of malignancy and the number of tumor nodes in breast tissues was established. The best end results--a survival rate of 16.8% at 10 years--were obtained after radical mastectomies. A classification of multicentric breast cancers is suggested. PMID- 3630033 TI - [Possibility of using high-frequency electromagnetic fields for modeling local controlled hyperthermia]. AB - The possibility to use high-frequency electromagnetic fields (13.56 MHz) as a means of controlled local heating of deep and massive tissue areas was shown in 196 experiments on tissue equivalent phantoms and 20 healthy dogs. The advantages of each type of high-frequency emitters were determined. The thermometric evaluation of heat distribution in local high-frequency heating used in complex treatment of 12 patients with sarcomas of the locomotor system confirmed the experimental results. PMID- 3630034 TI - [Carcinogenicity of chloroform]. AB - Carcinogenicity of chloroform for various dosage and route of administration was assessed in CBA X C57B1/6 mice in a chronic experiment (250 or 15 mg/kg body weight in vegetable oil, intra-esophageally via a probe; or 300; 30; 3; 0.3 or 0.03 mg/l in drinking water). Chloroform did not reveal its carcinogenic properties unless a dose of 250 mg/kg was given. PMID- 3630035 TI - [Inoculability and threshold effects in transplantation of experimental tumors]. AB - Inoculability of various experimental tumors (spontaneous, chemically-induced, solid, ascitic and leukemic) versus the amount of inoculated tumor cells (10(0) 10(7)) was studied. With small amounts of cells (10(2)-10(3)), inoculability of some tumors appeared to be nil, while in certain long-passaged neoplasms, particularly, leukemia, as few as 5-10 cells were enough. The data obtained pointed to a threshold in experimental tumor transplantation. However, quantitative analysis failed to establish one in the tumors under study. To assure transplantation, much larger study groups, e. g. of no less than 1500 animals for a breast cancer study, are required, which is hardly practicable. PMID- 3630036 TI - [Methodology of a planned clinical dietetic experiment with a program for processing the results on the Elektronika BZ-34 microcomputer]. AB - Methods of planned clinical experiments on dietotherapy, adapted for the study of food additives in the absence of an adequate placebo, were improved due to the modification of the mathematical analysis. The schedule of the experiment involves exclusion of nonuniformity, reduction of the number of necessary studies and high accuracy of the final results. For the statistical analysis of the data obtained in the experiment a program has been proposed for the microcomputer. PMID- 3630038 TI - [Physiological and hygienic basis for the rational nutrition of female workers in branches of light industry]. AB - The energy expenditures in the nonproductive period in the women-workers of the boot and shoe industry (group I) and the sewing industry (group II) were almost similar: in group I it was on an average 1372 +/- 35.4 kcal, in group II--1384 +/ 27.6 kcal. In the productive period the energy expenditures in the workers of group I fluctuated from 1.56 to 2.09 kcal/min, in those of group II--from 1.78 to 2.27 kcal/min. Summary energy expenditures in the productive period comprised 877 +/- 91.1 kcal (in group I), and 949 +/- 51.1 kcal (in group II). Daily energy expenditures were 2249 +/- 77.1 kcal and 2333 +/- 63.9 kcal, respectively. The energy value of the rations of their actual nutrition insignificantly exceeded their energy expenditures (on an average by 120-150 kcal) due to excessive fat consumption, animal fat, in particular. Their rations were characterized by protein, and, to a lesser extent, carbohydrate deficiency, by imbalanced mineral composition and vitamin A, B1, B2, PP and C deficiency. Microsymptoms of vitamin deficiency (mainly those of vitamin C deficiency) were detected in 64% of the examined subjects, excessive weight was found in 23-26% and obesity in 11-16% of the women. The women working at the modern boot and shoe and sewing industry should be referred to the first category of the work intensity, with respect to the energy requirements and the energy value of the nutrient components of their food rations. PMID- 3630037 TI - [Vitamin A and E allowance of the body in xenobiotic exposure]. AB - The results are presented of the clinico-experimental studies conducted in patients with diseases of the respiratory organs. Providing with tocopherol, lipid metabolism and peroxidation parameters were studied in these patients in the time course of combined drug therapy. Different variants of providing with vitamins A and E were simulated in rats. It was shown that both under clinical and experimental conditions, administration of xenobiotics produced the devitaminizing effect which was manifest in tocopherol and retinol deficiency, activation of lipid peroxidation in the blood, bronchoalveolar lavage, in the lungs and liver. The authors have recommended the control over providing with vitamins A and E during the drug therapy of such patients, as well as differential approach to the corrective dietotherapy with the rations enriched with vitamins A and E; the vitamins are especially necessary for the patients with chronic broncho-pulmonary diseases in the presence of obesity and lipid metabolism disorders. PMID- 3630039 TI - [Medical observations in feeding rations consisting of food concentrates]. AB - Ten therapeutic and surgical patients aged 19-30 received rations composed of food concentrates during 9 days, their state of health was satisfactory during the whole follow-up period. The palatability of the food was highly appreciated by all the patients at the initial period of their feeding with concentrates, and the food was eaten up completely, it was only on day 7-8 that the patients complained of the "monotony" of the dishes proposed to them, especially, of milk foods. The data of the medical follow-up and physiological examination of the patients revealed no functional changes in their body. No allergic reactions were recorded. The patients were discharged from the hospital in due time. PMID- 3630040 TI - [Metabolism and nutrition of young children in a children's home]. AB - Certain parameters of protein and fat metabolism, as well as provision with vitamins A, B1, B2 and mineral substances (calcium, phosphorus and magnesium) were studied in infants aged 1-3 years, at the Tartu Children's Home No. 2. Simultaneously, the infants' nutrition and development were investigated. It was found that the mean parameters of the protein and fat metabolism were within the normal limits, however, vitamin A, B1, D and unsaturated fatty acids deficiency was recorded in the infants studied. Food imbalance, that was greater in spring, led to metabolic disorders, vitamin and mineral deficiency resulted in the infants' growth retardation. It is recommended that infants in the children's homes should be given higher amounts of vegetables, fruit, milk and vegetable oil rich in vitamins, and vitamins in concentrated form, in prophylactic doses. PMID- 3630041 TI - [Effect of a phosphatidylcholine-enriched diet on the structural and functional parameters of rat liver microsomes]. AB - The authors studied the influence of the diet enriched with phosphatidylcholine on the structural-functional parameters of microsomes: lipid peroxidation activity, the levels of cytochromes b5 and P-450, microviscosity of the lipid phase of the membrane. In experiments in vivo it was found that phosphatidylcholine per se, not combined with antioxidants, did not show antioxidant properties. Biological effects of lecithin could be explained by its role as a catalyst of the monooxygenase system in the liver, based on the correlation (r = +0.8) between the high level of cytochrome b5 and the degree of eximerization of the fluorescent probe pyrene in the microsomes. PMID- 3630042 TI - [Scientific analysis of the development of the study of nutrition]. PMID- 3630044 TI - [Immunological disorders in vitamin A and B1 deficiencies]. AB - Atrophy of the thymus, mitogen-induced inhibition of T-lymphocyte blast transformation, and decrease of the humoral immune response were observed in rats with alimentary vitamin A deficiency. Vitamin B1 deficiency induced by administration of oxythiamine led to the thymus atrophy, inhibition of T lymphocyte blastogenic response in mice, and to suppression of delayed hypersensitivity in guinea pigs. PMID- 3630043 TI - [Effect of food carbohydrate quality on monosaccharide utilization for the biosynthesis of glycogen, fat and proteins in the rat liver]. AB - The inclusion of 3H-6-glucose and 14C-fructose metabolites into the rat liver glycogen, lipids and protein was studied in male rats receiving the rations containing 56% of carbohydrates, 18% protein, 26% fat, necessary amount of mineral substances and vitamins, during 25 days. Animals given the ration with starch, as a carbohydrate, were used as controls. In the ration of animals in groups 2, 3 and 4 some portion of starch (30% calorific value) was substituted for glucose, sucrose of the mixture of glucose and fructose (1:1). It was found that in the liver of animals given pure starch, radioactivity from 3H-6-glucose was included mainly into proteins, when starch was partly substituted for monosaccharide--mainly into lipids. These regularities were recorded in the distribution of radioactivity from 14C-fructose, all the parameters being shifted in the direction of increased inclusion of radioactivity into lipids. Partial substitution of starch for sucrose specifically changed the radioactivity distribution between proteins and lipids, thus revealing a distinct "disaccharide" effect. PMID- 3630045 TI - [Specific activity of thiamine and oxythiamine immobilized on modified cellulose]. AB - The effect of thiamine and oxythiamine preparations on the activities of vitamin B1-dependent enzymes in the body of white mice was studied. It was found that the cellulose oxythiamine derivative was similar to the initial compound in the character and intensity of its antivitamin action. It was also shown that the cellulose thiamine derivative had a prolonged effect in the body, which was manifested in a slower increase in the activities of transketolase, pyruvate dehydrogenase and in the amount of thiamine diphosphate in tissues of vitamin B1 deficient animals, as compared to the effect of thiamine. PMID- 3630046 TI - [Effect of physical loading of various intensities on the thiamine allowance and ascorbic acid content of the blood and adrenals of rats of different ages]. AB - Providing with thiamine and the content of ascorbic acid (AA) were studied in 250 male rats with respect to their age and depending on the duration of physical load. In all age groups (from 1 to 1.5 months, from 6 to 12 months and over 12 months) the physical load (swimming) led to a decrease of the body providing with thiamine, that was expressed in the reduction of its content in the blood and liver, in the lowering of transketolase activity and rising of the TDP effect. These changes were more pronounced at the early age and directly depended on the duration of physical load. Physical load induced more manifest reduction of the AA content in the blood of young rats, and in the adrenals of the older group animals. Vitamin B1 and C deficiency induced by high physical load necessitates its correction by administration of additional doses of the vitamins to the animals. PMID- 3630047 TI - [A new type of creamery butter for pediatric and dietetic nutrition]. AB - The paper presents the data on the chemical composition and the technology of manufacturing a new sort of butter for child's and dietetic nutrition. The butter has high biological value due to the introduction of polyunsaturated fatty acids (PUSFA) with vegetable oils and milk-protein ingredients. The milk-protein ingredients also play the role of the butter structure stabilizers. The chemical composition of the new sort of butter, including the vitamin and mineral content, as well as the amino-acid composition of the butter plasma are described. It is shown that the content of PUSFA in the new sort of butter is 10-fold higher than in the routine butter. Various kinds of dessert butter have been developed with different flavoring additives. One of the butter variant has been enriched with bifidobacteria. The new sort of butter is recommended for the dietetic nutrition of children and adults suffering from obesity, as well as for the nutrition of the middle- and old-aged subjects to prevent lipid metabolism disorders. PMID- 3630048 TI - [Characteristics of the action of extracts of pink-stained grain of fusarial and nonfusarial origin on the structure of the organs in growing rat pups]. AB - The characteristics of the toxic effect of rose-stained grain of fusarial and non fusarial nature, as well as the grain experimentally challenged with the toxic strain Fusarium sporotrichiella 53315, were studied basing on the analysis of morphological changes in the internal organs of young rat given orally extracts from the samples studied. The tissue aging processes under the effect of the extract doses producing no irreversible pathologic changes were investigated. It was shown that the extracts of rose-stained natural grain, fusarial and without signs of fusaridiosis, produced similar pathological changes in the morphological structures of the organs in the young rats, the toxicity grew with the increase of the per cent of rose-stained grain. Dystrophic changes in the parenchymatous organs and impairment of the structure of the immunogenesis organs were recorded with a low content of rose-stained grain (3-3.5%), the changes in some organs at the structural and cellular level were also revealed, however, they were less manifest and evidenced a regional antigenic stimulation. PMID- 3630049 TI - [Effect of different types of cooking ammonia-contaminated meat on its ammonia content]. AB - Any unsealing in the ammonium system of refrigerators leads to meat contamination with ammonia. At present the contaminated meat is not used as food. The influence of varying types of culinary treatment (boiling, stewing, frying) on the ammonia content in meat was studied. It was found that boiling in water and frying decreased twofold the ammonia content in meat, while stewing produced no effect. PMID- 3630050 TI - [Optimization of the protein composition of an additive made from blood and milk]. AB - A new protein composition from defibrinated blood and lactic acid paste, prepared from skim milk, has been recommended as a food product. Optimization of protein composition was conducted on the basis of amino acid components and the criterion of "minimal dispersity". PMID- 3630051 TI - [The food value of protein concentrates made from secondary raw oil sources--oil cakes and groats from corn germ, tomato seeds, safflower and flax]. AB - Protein concentrates from oil cake of tomato seeds and corn bud, and groats of safflower and flax were studied for the content of the main food substances: proteins, lipids, carbohydrates, mineral substances, as well as for the fatty acid lipid spectrum, amino acid composition of proteins and the level of available lysine. In experiments on rats given rations containing protein concentrates from oil raw materials (calorific value 5.9 and 18%) as the only source of protein, the NPUtr coefficient and Dtr were determined. The maximum anabolic effectiveness was recorded with the rations containing 9% of all proteins. NPUtr value of the concentrates from oil raw materials was lower as compared to that of casein. Dtr of the concentrates fluctuated from 73 to 93%, and it was maximal when the protein level was 18%. All the protein concentrates from oil raw materials are promising for human nutrition. PMID- 3630052 TI - [Hygienic evaluation of the nutrition of passenger train conductors]. PMID- 3630053 TI - [Breast milk as a source of prostaglandin E for the newborn child]. PMID- 3630054 TI - Plasma exchange treatment in autoimmune hemolytic anemia of the warm antibody type with renal failure. AB - A patient with autoimmune hemolytic anemia of the warm antibody type developed a hyperacute hemolytic crisis with acute renal failure under conventional treatment with corticosteroids. Because of the life-threatening situation it was decided to start a combined treatment with immunosuppression and plasmapheresis. Already after the first plasma exchange the direct antiglobulin test became weakly positive, the hemoglobin level rose from 4.1 to 8.1 g/dl, and the hemolytic crisis subsided. Four more exchanges were performed; thereafter, the patient's clinical condition and laboratory data stabilized. PMID- 3630055 TI - Biochemistry of packed red blood cell concentrates stored in PAGGS-sorbitol solution for 42 days. AB - We investigated metabolic, blood gas and acid-base balance modifications of erythrocyte concentrates resuspended in PAGGS-sorbitol solution during 6 weeks of storage. Glucose utilization was impaired during the last 2 weeks, while the intraerythrocytic ATP level decreased only 50% from the 1st to the 6th week. The K+ and Hb concentration in the medium showed a progressive increase which was more pronounced during the last 2 weeks. The decrease in pH progressed to reach 6.27 at the 6th week of storage. Intraerythrocytic 2,3-DPG dropped rapidly in the course of the 1st week and the percentage of oxyhemoglobin showed a remarkable increase after the 1st week (90%). Our data suggest that erythrocyte concentrates in PAGGS-sorbitol should be transfused, for optimal efficacy, within 4 weeks. PMID- 3630056 TI - 5-day storage of human platelet concentrates in 30 ml of plasma or artificial medium. AB - Optimal conditions for the storage of platelet concentrates were studied by changing 5 environmental parameters: bag composition (PL146 vs. PL732), volume of plasma (60 vs. 30 ml), anticoagulant (CPDA-1 vs. heparin), nutrient (glucose vs. fructose) and medium (plasma vs. artificial medium). A full bilevel factorial study was conducted to evaluate each variable alone and in combination with the other variables for their effects on platelet aggregation and release in response to single and pairs of stimuli. Serotonin uptake, pCO2, platelet count, lactate, glucose, pO2, pH and white blood cell concentration were also measured after 3 and 5 days of storage. Platelets that were stored in PL146 bags had reduced responses to stimulation by 3 days and markedly impaired responses after 5 days relative to platelets that were stored in PL732 bags. There was a large drop in pH and platelet responsiveness when platelets were stored in a volume of 30 ml in PL146 bags; these were not found when platelets were stored in 30 ml in PL732 bags. Replacing plasma with an artificial medium or adding fructose or heparin and calcium to plasma yielded platelets that were equally functional as routine controls in CPD-A1 plasma. It was concluded that replacement of plasma with 60 ml of artificial medium or a reduction of plasma volume with storage in PL732 bags are two possible mechanisms of obtaining more plasma from blood donations without compromising maximum platelet storage life. PMID- 3630057 TI - Post-transfusion purpura associated with anti-Baka and anti-PIA2 platelet antibodies and delayed haemolytic transfusion reaction. AB - The occurrence of post-transfusion purpura (PTP) in a 16-year-old girl with sickle/beta-thalassaemia is described. Clinically this was a typical case of PTP, but it was unusual serologically. Anti-Baka and anti-PIA2 platelet-specific antibodies were identified and the patient's platelets were typed as homozygous PIA1-positive and Baka-negative. The patient also developed red-cell, granulocyte and lymphocytotoxic antibodies in response to the blood transfusion and had a delayed haemolytic transfusion reaction. PMID- 3630058 TI - An enzyme-linked immunosorbent assay utilizing monoclonal antibodies for the characterization of immunoglobulin classes and subclasses of anti-red cell antibodies. AB - The destruction of transfused red cells results from both humoral and cellular immune mechanisms. Numerous factors are likely to affect this destruction. Among them, the class and subclass of antibody-carrying immunoglobulins are of great importance. Compatibility testing routinely realized in vitro in Blood Group Laboratories is not always very helpful in predicting the in vivo significance of alloantibodies. In this sense, we have investigated an enzyme immunoassay that makes it possible to identify the isotype profile of any auto- or alloantibody. This solid-phase immunoassay utilizes mouse monoclonal antibodies specific for individual human IgG subclasses in a double-sandwich test, in which the sample to be analyzed is an eluate obtained by classical absorption-elution methods. PMID- 3630059 TI - [Socialist competition among the research institutes of the Ministry of Health of the UkrSSR]. PMID- 3630060 TI - [Determination of the total dose burden of surface-active agents in the body]. PMID- 3630061 TI - [Autoflora of the skin of phosphorus production workers]. PMID- 3630062 TI - [Effect of pesticides on the health of workers engaged in raising vegetables in protected soil]. PMID- 3630063 TI - [Lipid peroxidation in the tissues of animals as an index of the biological aggressiveness of welding aerosols]. PMID- 3630064 TI - [Detection of diabetes mellitus during mass screening of the population]. PMID- 3630065 TI - [The convulsive syndrome in meningoencephalitis]. PMID- 3630066 TI - [Subdural exudate in meningitis]. PMID- 3630067 TI - [The role of pharmacies in the organization of therapeutic-preventive services to the rural population]. PMID- 3630068 TI - [Furosemide in the complex treatment of patients with diabetic nephropathy]. PMID- 3630069 TI - [Infusion of dopamine and furosemide in the prevention of acute renal failure]. PMID- 3630070 TI - [Changes in capillary resistance in response to balneotherapy]. PMID- 3630071 TI - [Treatment of patients with gastrointestinal diseases in an ambulatory setting]. PMID- 3630072 TI - [Improvement of methods of treating chronic non-ulcerative colitis]. PMID- 3630073 TI - [Status of the autonomic nervous system of peptic ulcer patients]. PMID- 3630074 TI - [Diagnosis of duodenogastric reflux]. PMID- 3630075 TI - [Experience with the work of the extension diagnostic center of the Kiev Municipal First Aid and Emergency Medical Services Station]. PMID- 3630076 TI - [Clinical variants of the course of cancer of the body and tail of the pancreas]. PMID- 3630077 TI - [Indices of local immunity in acute pneumonia patients]. PMID- 3630078 TI - [Bilateral spontaneous pneumothorax in a bronchial asthma patient]. PMID- 3630079 TI - [Features of the diagnosis and clinical course of tuberculosis associated with COPD in late-middle and old age]. PMID- 3630080 TI - [Hemodynamic characteristics of different forms of atrial fibrillation]. PMID- 3630081 TI - [Isoptin in the treatment of ectopic arrhythmias]. PMID- 3630082 TI - [Optimization of dispensary observation of nephrologic patients in the Ukrainian SSR]. PMID- 3630083 TI - [Electrophysiologic studies of the heart conduction system of patients with the paroxysmal form of atrial fibrillation and the sick sinus syndrome]. PMID- 3630084 TI - [Correlation of the results of scalar and vector analyses of the electrocardiograms of ischemic heart disease patients]. PMID- 3630085 TI - [Indices of immunologic reactivity in the diagnosis of the post-infarct syndrome]. PMID- 3630086 TI - [REG indices in the initial manifestations of cerebral circulatory insufficiency and age]. PMID- 3630087 TI - [Features of the syndrome of autonomic-vascular dystonia in the early forms of cerebral atherosclerosis]. PMID- 3630088 TI - [A case of puerperal cardiomyopathy]. PMID- 3630089 TI - [Morphologic changes in the hypothalamus in systemic lupus erythematosus]. PMID- 3630090 TI - [Echocardiogram indices of alcoholic patients]. PMID- 3630091 TI - [Acute autoimmune hemolytic anemia as a manifestation of toxemia of pregnancy]. PMID- 3630092 TI - [Electron-histochemical study of acetylcholinesterase activity in the endotheliocytes of human tongue microvessels in the prenatal period of morphogenesis]. PMID- 3630093 TI - [Correction of the microcirculation of patients with urinary calculi and diabetes mellitus]. PMID- 3630095 TI - [Complex treatment and prevention of neurovegetative disorders of work adaptation in industry]. PMID- 3630094 TI - [Immunotherapy of breast cancer patients]. PMID- 3630096 TI - [Method of early diagnosis of regeneration of injured peripheral nerves]. PMID- 3630097 TI - [Effect of antioxidants on redox processes and free radicals in the skin of psoriasis patients]. PMID- 3630098 TI - [The tasks and developmental prospects of medical geography in the Ukraine under the 12th Five-Year Plan]. PMID- 3630099 TI - [Blood flow and stomach function in patients with acute intestinal infections caused by opportunistic microorganisms]. PMID- 3630101 TI - [Effectiveness of the dispensary care of patients operated on for acquired heart defects]. PMID- 3630100 TI - [Immunomodulating therapy of middle-aged and elderly patients with erysipelas]. PMID- 3630102 TI - [Raising the qualifications of medical personnel in the field of gerontology and geriatrics at local institutions]. PMID- 3630103 TI - [Use of dekametoksin in treating acute suppurative inflammatory diseases of the hand]. PMID- 3630104 TI - [Organization of proctological care in a provincial hospital]. PMID- 3630105 TI - [Respiratory disorders in neurocirculatory dystonia patients]. PMID- 3630107 TI - [Treatment of the edematous-ascitic syndrome in patients with refractory heart failure]. PMID- 3630106 TI - [Effect of cholestyramine on the clinico-biochemical indices of ischemic heart disease patients]. PMID- 3630108 TI - [Importance of determining the specific amount of the blood in vascular beds for the diagnosis of heart failure]. PMID- 3630109 TI - [Tetrapolar rheographic indices in detecting hemodynamic disorders of the lesser circulation]. PMID- 3630110 TI - [The electrocardiotopogram in assessing the effectiveness of physical exercise in patients who have had a myocardial infarct]. PMID- 3630111 TI - [Morphogenesis of dilated cardiomyopathy]. PMID- 3630112 TI - [Case of primary sclerosis of the portal vein]. PMID- 3630114 TI - [Pathogenesis, prevention and treatment of coagulopathic hemorrhages (review of the literature)]. PMID- 3630113 TI - [Effect of corglycon and vasoactive agents on systemic and cerebral hemodynamics in cerebral infarct]. PMID- 3630115 TI - [Physical properties of a condensate of exhaled air in chronic bronchitis patients]. PMID- 3630116 TI - [Chronic diseases of the upper respiratory tracts in persons in the voice and speech professions]. PMID- 3630117 TI - [A case of cough-syncope syndrome]. PMID- 3630118 TI - [A case of sporotrichosis of the lungs]. PMID- 3630119 TI - [Skin microflora and immunological indices of elderly tuberculosis patients]. PMID- 3630120 TI - [Characteristics of the course of acute pneumonias in diabetics]. PMID- 3630121 TI - [Vitamins in the treatment of patients with Addison's disease]. PMID- 3630122 TI - [Noonan's syndrome]. PMID- 3630123 TI - [Morphological changes in the liver in chronic alcoholism]. PMID- 3630124 TI - [Biochemical indices of the bile in cholecystitis patients]. PMID- 3630125 TI - [Cases of primary cancer of the liver]. PMID- 3630126 TI - [Viral hepatitis as a risk factor for the development of diseases of the gastroduodenal system]. PMID- 3630127 TI - [Morphological characteristics of chronic glomerulonephritis with the nephrotic variant of the disease course]. PMID- 3630128 TI - [Genetic indices in Burnett's syndrome]. PMID- 3630129 TI - [Correlation between cognitive reflex and emotional activities]. PMID- 3630130 TI - [A case of acute intermittent porphyria]. PMID- 3630131 TI - [Complication of osteomyelitis of the lumbar spine]. PMID- 3630132 TI - [Clinical picture, diagnosis and treatment of erythropoietic protoporphyria]. PMID- 3630133 TI - [Tuberculin tests in the diagnosis of siderosilicotuberculosis]. PMID- 3630134 TI - [Disorders of cardiac activity in mine rescue workers in acute body overheating]. PMID- 3630135 TI - [Occupational hypoacusis in agricultural machinery operators]. PMID- 3630136 TI - [Risk assessment and the prediction of the development of pneumoconiosis in coal miners]. PMID- 3630137 TI - [The construction of a plasmid genomic library from Bacillus thuringiensis HD-1]. PMID- 3630138 TI - [Kinetics of delta'-dehydrogenation of hydrocortisone by Arthrobacter simplex By 2-13. I. Kinetics of delta'-dehydrogenation of hydrocortisone by free cells of Arthrobacter simplex By-2-13]. PMID- 3630139 TI - [Microbial reduction of C20-keto of corticosteroids by Arthrobacter 9-2. II. Bioconversion of 3 beta,17 alpha,21-triol-5 alpha-pregnan-3-one]. PMID- 3630140 TI - [Biosynthesis of nitrosopiperidine from isobutylamine and NaNo2 by some fungi]. PMID- 3630141 TI - [Identification of Leptospira kunming of the Pomona serogroup]. PMID- 3630142 TI - [Kinetics of delta'-dehydrogenation of hydrocortisone by Arthrobacter simplex By 2-13. II. Kinetics of delta'-dehydrogenation of hydrocortisone by immobilized A. simplex By-2-13]. PMID- 3630143 TI - [The fermentation, isolation and physico-chemical properties of youlemycin]. PMID- 3630144 TI - [Studies on endotoxins of Leptospira. III. The presence of beta-hydroxy-myristic acid in the LPS of Leptospira interrogans serovar Lai]. PMID- 3630146 TI - [Preliminary study on the identification of Coxiella burnetii isolated in China by pyrolysis gas chromatography]. PMID- 3630145 TI - [A new subspecies of Micromonospora genus producing aminoglycoside antibiotics]. PMID- 3630147 TI - [Study on the discrimination of bacteria by gas chromatographic profiles of cellular fatty acids]. PMID- 3630148 TI - [Effect of long-term treatment with panodin on the clinical condition of patients with infectious asthma]. PMID- 3630149 TI - [Reoperations after surgical treatment of neoplasms of the large intestine]. PMID- 3630150 TI - [Schoenlein-Henoch syndrome in children]. PMID- 3630151 TI - [Treatment of precancerous conditions and cancer of the vulva]. PMID- 3630152 TI - [Cranio-cerebral injuries associated with fractures of the pelvis or lower extremities]. PMID- 3630153 TI - [Actinomycosis of the foot]. PMID- 3630154 TI - [Extragenital endometriosis in a case of pseudo-unicorn uterus with a rudimentary active second horn]. PMID- 3630155 TI - [Synthesis of vitamin D by the skin]. PMID- 3630156 TI - [Use of a non-residue diet in the preparation for colonoscopy]. PMID- 3630157 TI - [Cardiovascular polypathy as a cause of death in elderly persons]. PMID- 3630158 TI - [Difficulties in the diagnosis of infectious endocarditis]. PMID- 3630159 TI - [Suppurative pneumonia, empyema and peritonitis]. PMID- 3630160 TI - [Symptomatic incarceration of inguinal and femoral hernia]. PMID- 3630161 TI - [A rare case of double appendix with inflammatory changes]. PMID- 3630162 TI - [Abortive form of the Obrinsky syndrome in a 5-month-old boy]. PMID- 3630163 TI - [Subhyoid injury of the pharynx in attempted suicide]. PMID- 3630164 TI - [Prostatic cancer in a 15-year-old boy]. PMID- 3630165 TI - [Primary prevention of idiopathic arterial hypertension]. PMID- 3630166 TI - [Extensiveness of infection with Trichomonas vaginalis, yeast-like fungi and Neisseria gonorrhoeae in women in the city of Rzeszow and its vicinity]. PMID- 3630168 TI - [Species composition and the extensiveness of invasion of deer by nematoda of the family Protostrongylidae at selected hunting grounds]. PMID- 3630167 TI - [Biology of pulmonary nematoda of the genus Metastrongylus]. PMID- 3630169 TI - [Helminth fauna of the digestive tract of elks and female deer in the Romincka Forest]. PMID- 3630170 TI - [Characteristics of the population of biting lice (Mallophaga) in pheasants (Phasianus colchinus L.)]. PMID- 3630171 TI - [Trichoecius apodemi Fain, Mounting, Lukoschus, 1969 and various other new species of mites (Mycoptidae, Myobiidae, Psorergatidae, Haemogamasidae) among the fauna of Poland]. PMID- 3630172 TI - [Nematoda of Prunella modularis (L.)]. PMID- 3630173 TI - [Problems in preparing the antennal sensilla of insects for scanning studies]. PMID- 3630174 TI - [A modified method of collecting small Monogenea from fish gills]. PMID- 3630175 TI - [Steroid hormone receptors in struma]. AB - Oestradiol and progesterone receptors occur in different hormonally dependent tissues. The presence and number of steroid receptors in malignant breast tumours is well known. Endocrine treatment is effective. An attempt was made to quantify the oestradiol and progesterone receptors in human goitre. The behaviour of steroid receptors was studied in the cytosol of tissue samples from 33 surgically treated patients. Neither oestradiol nor progesterone receptors were found in human goitre tissue. PMID- 3630176 TI - [Aseptic humerus head necrosis--tortuous path of a maker of scythes through expert medicine]. AB - The case report is presented of a 50 year-old scythe smith who produced 1400 scythes daily in piece-work over a period of 17 years. He complained for the first time in 1977 about severe pain in his left shoulder. Six years after the onset of pain aseptic necrosis of the humeral head was finally diagnosed by reviewing old X-rays of 1977, but the patient had meanwhile absolved a troublesome journey through a variety of incorrect-medical diagnostic and therapeutic procedures. The patient's history, previous reports and the actual clinical findings observed in our department are presented in this paper. We consider that this patient is suffering from an occupational disease which should be legally recognised as such. PMID- 3630177 TI - [Comments on the paper by Rosenkranz et al.: Continuously monitored labor versus unmonitored labor. Attempt to objectify the discussion]. PMID- 3630178 TI - [Silibinin: Madaus]. PMID- 3630179 TI - [Pathologic findings in colorectal cancers and discussion of their significance for tumor therapy according to stage]. AB - The histological degree of differentiation is a valuable determinant of the malignancy of colorectal carcinomas. It correlates well with the tumour stage and has a prognostic relevance similar to the Dukes stages. Well and moderately well differentiated colorectal carcinomas showed significantly lower lymph node metastasis (35% and 45% of the cases, respectively) than the poorly differentiated tumours (70%). Among 20 carcinomas limited to mucosa and submucosa, only one poorly differentiated carcinoma produced lymph node metastases. The histological degree of differentiation of a given tumours assessed consecutively in biopsy and surgical material was identical in 81%. The degree of differentiation had to be corrected from moderate to well in only 9% of cases and in 8% from well to moderate. These corrections were without prognostic relevance. The prognostically important correction from moderate to poor histological degree of differentiation had to be made in only 2% of the cases. Therefore, the histological degree of differentiation can be accepted as an important preoperative criterium for the selection of adequate tumour therapy. An increased risk of tumour infiltration of resection margins was found only in cases with resection distances less than 1 cm from the tumour, whereas tumour infiltration of resection margins was minimal (below 1%) for distances of more than 1 cm. Consideration of the histological degree differentiation, clinical stage of tumour and sufficient distances of resection margins from tumours should lead to increased numbers of resections with preservation of sphincter function despite radical surgery. PMID- 3630180 TI - [Campylobacter pylori, gastritis and peptic ulcer]. AB - In the course of routine gastroduodenoscopic examination of 218 patients bioptic mucosal specimens were examined bacteriologically for the presence of Campylobacter (C.) pylori. The organism was isolated from 52 out of 53 patients (98%) with duodenal ulcer, 7 out of 9 with gastric ulcer (78%), 24 out of 31 with mucosal erosions (77%), 10 out of 10 with duodenitis (100%), 16 out of 16 with chronic active gastritis (100%) and from 40 out of 73 patients (55%) with inactive chronic gastritis. By contrast, all specimens from 26 patients with endoscopically and histologically normal mucosa were negative for this bacterium. The rate of elimination of C. pylori from mucosal specimens was investigated as a first step towards studying the influence of antibiotic therapy upon healing of gastric and duodenal ulcers. For this purpose 30 patients with duodenal ulcers were treated either with ranitidine alone (15) or together with bacampicillin (15), which was shown to be highly active in studies with ampicillin in vitro. After 4 weeks the organism was still found in specimens from all patients treated with ranitidine alone, but also in 12 out of 15 patients given combined therapy. This result demonstrates that systemic antimicrobial chemotherapy with bacampicillin is insufficient to eradicate C. pylori from the stomach and the duodenum. PMID- 3630181 TI - [Legalization of medicine]. AB - The regulation concerning discretionary treatment (Paragraph 110, Penal Statute Book) and the privileged status of the physician according to Paragraph 88, Section 2, Number 2 of the Penal Statute Book is taken as a basis, in addition to an examination of the obligation of the physician to provide information on the one hand, and on the other the Personal Data Protection Law, and it is demonstrated that legal regulations are necessary. They do not always lead to a "legalification of medicine" because legislation considers the inherent dangers of the profession. However, hastily determined regulations such as the Personal Data Protection Law provide no solution and confuse and burden the physician. PMID- 3630182 TI - [Eye and headache. Ophthalmologic findings in pseudotumor cerebri and Tolosa-Hunt syndrome]. AB - Tolosa-Hunt-syndrome and pseudotumor cerebri are rare syndromes accompanied by headache and ophthalmological disturbances. Pseudotumor cerebri has to be differentiated against optic nerve lesions with bilateral edema. Tolosa-Hunt syndrome must be delimited from other painful disorders of eye motility. PMID- 3630183 TI - Progress symposium--advances in surgical oncology. PMID- 3630184 TI - The role of lymph node surgery in gastric cancer. PMID- 3630185 TI - Can radical surgery improve survival in colorectal cancer? PMID- 3630186 TI - Progress in gastric cancer surgery in Japan and its limits of radicality. PMID- 3630187 TI - The value of preoperative radiotherapy in esophageal cancer: results of a study of the E.O.R.T.C. PMID- 3630188 TI - Preoperative chemotherapy in esophageal carcinoma. PMID- 3630189 TI - Multidisciplinary management of cancer of the anus. PMID- 3630190 TI - Intraoperative radiotherapy in carcinoma of the stomach and pancreas. PMID- 3630191 TI - The concept of immunochemosurgery in gastric cancer. PMID- 3630192 TI - Adjuvant chemotherapy in gastric cancer. PMID- 3630193 TI - Adjuvant treatment in colorectal cancer: an update. PMID- 3630194 TI - Local procedures in the management of rectal cancer. PMID- 3630195 TI - Surgical strategies in locoregional recurrences of gastrointestinal carcinoma. PMID- 3630196 TI - Resection of liver metastases--when is it worthwhile? PMID- 3630197 TI - Isolated regional perfusion in malignant melanoma of the extremities. PMID- 3630198 TI - Pattern of recurrence in liver resection for colorectal secondaries. PMID- 3630199 TI - Malfunction of peritoneovenous (LeVeen) shunt after tricuspid valvulectomy. PMID- 3630200 TI - Blue book 1987. PMID- 3630201 TI - Disposition and metabolism of indeloxazine hydrochloride, a cerebral activator, in rats. AB - 1. The disposition and metabolism of indeloxazine hydrochloride ((+/-)-2-[(inden 7-yloxy)methyl]morpholine hydrochloride) were studied in male Sprague-Dawley rats. 2. After oral administration of 14C-indeloxazine hydrochloride, the plasma concentration of total radioactivity reached a maximum at 15 min and declined with an apparent half-life of 2.2 h in the first 6 h period and declined more slowly thereafter. Unchanged drug in the plasma represented 13.5%, 5.9% and 0.4% of the total radioactivity at 15 min, 1 h and 6 h respectively after administration and levels decayed with a half-life of 0.9 h. 3. After oral and i.v. administration of the labelled compound, the urinary and faecal excretion of radioactivity in 72 h were 61-65% and 31-36% of the dose, respectively. Biliary excretion in bile duct-cannulated animals amounted to 49% of the dose in 72 h. 4. Seven metabolites have been isolated from the plasma or urine and characterized by i.r., n.m.r. and mass spectrometry. They were derived through dihydrodiol formation in the indene ring, hydroxylation of the indene ring and N-acetylation, oxidation and oxidative degradation of the morpholine ring. Some metabolites were excreted as their glucuronic acid or glucose conjugates. The major metabolite appeared to the trans-indandiol analogue of indeloxazine. 5. Possible metabolic pathways of degradation of the morpholine ring are discussed. PMID- 3630202 TI - Characteristics of the microsomal N-hydroxylation of benzamidine to benzamidoxime. AB - 1. A simple and fast h.p.l.c. analysis of benzamidoxime formed by microsomal N hydroxylation of benzamidine is presented which is well suited for the determination of the N-oxygenation activity of microsomal enzymes. 2. Optimal reaction conditions were determined. The apparent Km and Vmax values were, respectively, 1.61 mM and 0.38 nmol benzamidoxime/min per mg protein. 3. The effects of the inducers phenobarbital, 3-methylcholanthrene and benzamidine itself on hepatic benzamidine metabolizing activity in rabbits were determined. 4. Neither superoxide anion nor hydrogen peroxide is directly involved in the N hydroxylation reaction. 5. The direct involvement of cytochrome P-450 in the N hydroxylation of benzamidine is supported by the observation that inhibitors of cytochrome P-450, in particular carbon monoxide, markedly decreased the rate of N oxygenation. PMID- 3630203 TI - Effect of pretreatment with 3-methylcholanthrene and several phenolic antioxidants on glutathione S-transferase activity in various tissues of female Sprague-Dawley rats. AB - 1. Treatment of female Sprague-Dawley rats with 3-methylcholanthrene, butylated hydroxyanisole, ethoxyquin, propyl gallate or methylcholanthrene plus butylated hydroxyanisole was undertaken to determine the effects on glutathione S transferase activity in liver, small intestine, lung and kidney. 2. A significant increase in hepatic transferase activity was found following all treatments, except after propyl gallate, when 1-chloro-2,4-dinitrobenzene was used as substrate. 3. When 1,2-dichloro-4-nitrobenzene was the substrate, only butylated hydroxyanisole and the combination of butylated hydroxyanisole and methylcholanthrene resulted in a significant increase. 4. In the extra-hepatic tissues using 1-chloro-2,4-dinitrobenzene as a substrate, all treatments caused an increase in transferase activity in the lung; ethoxyquin and combined methylcholanthrene plus butylated hydroxyanisole increased this activity in the kidney, whereas only the combined methylcholanthrene plus butylated hydroxyanisole increased activity in the small intestine. 5. All treatments caused a notable decrease in the composite Km and had varying effects on the composite Vmax of hepatic transferase activity. PMID- 3630204 TI - The reduction of sulphinpyrazone and sulindac by intestinal bacteria. AB - 1. Incubation of human or rabbit faeces with sulphinpyrazone gave greater reduction under anaerobic than under aerobic conditions. Reduction of sulindac by human faeces was more extensive than that of sulphinpyrazone. 2. Growth of mixed cultures of intestinal bacteria in nutrient media containing antibiotics produced a marked inhibition in their ability to reduce sulphinpyrazone. Sulphide formation was inhibited by metronidazole and lincomycin for human faeces and by tetracycline for rabbit faeces/caecal contents. 3. The formation of the sulphides of sulindac and sulphinpyrazone ex vivo was decreased in faeces from patients treated with metronidazole. Metronidazole, but not tetracycline, decreased the extent of reduction of sulphinpyrazone by rabbits in vivo. No reduction of either substrate occurred on incubation with ileostomy effluent. These data indicate that anaerobic intestinal bacteria are important in the reduction of these sulphoxide-containing drugs. 4. However, when incubated anaerobically with over 200 strains of bacteria isolated from human faeces, sulphinpyrazone was reduced by most of the aerobic but not the anaerobic organisms. Sulindac was reduced more extensively by the same aerobes and by some anaerobes. 5. The discrepancy between the apparent importance of anaerobes in vivo and in vitro may be due to their very large number present in the hind gut and to the production of an anaerobic environment suitable for the enzymic activity of other organisms, such as aerobes or facultative anaerobes. PMID- 3630205 TI - Formation of a diazonium cation intermediate in the metabolism of sulphamethazine to desaminosulphamethazine in the rat. AB - 14C-Sulphamethazinediazonium tetrafluoroborate (14C-SDTFB) when orally administered to rats was converted primarily to 14C-labelled desaminosulphamethazine (desaminosulmet) and methanol-insoluble residues in the gastrointestinal tract (gut). 14C-labelled sulphamethazine (sulmet), N4 acetylsulmet, the N4-glucose conjugate of sulmet and other unidentified products were also observed in the tissues and urine of rats given 14C-SDTFB. 2. When 14C sulmet, nitrite and dimethylaniline were simultaneously administered to a rat by the oral route, one of the 14C-labelled products formed in the stomach was isolated and identified as 4-dimethylaminophenyl [4-(N-4,6-dimethyl-2 pyrimidinyl)sulphamidophenyl] diazene, providing evidence that 14C-sulmet was diazotized in the stomach of the animal. 3. SDTFB was weakly mutagenic when evaluated by the Ames test. 4. The methanol-insoluble 14C-labelled residues in the gut of rats dosed orally with 14C-SDTFB and 14C-sulmet + nitrite were partially converted to 14C-labelled desaminosulmet, sulmet, N4-acetylsulmet and other unidentified products when fed to recipient rats. PMID- 3630206 TI - Metabolism in the rat of potassium nonan-5-sulphate, a symmetrical anionic surfactant. AB - 1. The metabolism of potassium nonan-5-[35S]sulphate, a symmetrical secondary alkylsulphate ester, was investigated in the rat. Oral administration of the radiolabelled ester was followed by the elimination of the majority of radioactivity in the urine. 2. Potassium nonan-5-[35S]sulphate is degraded in vivo to produce at least three radiolabelled sulphate esters. 3. The same metabolites were produced by isolated rat livers perfused with potassium nonan-5 [35S]sulphate. 4. The three radioactive metabolites were identified by combined g.l.c.-mass spectroscopy as the unchanged parent ester, nonan-1-ol-5-sulphate and nonanoate-5-sulphate. 5. The nature of the latter two metabolites indicates that potassium nonan-5-sulphate is metabolized by omega-oxidation only and, moreover, the alkylsulphate ester is metabolized only at one end of the molecule. PMID- 3630207 TI - The metabolic sulphation of polyethyleneglycols by isolated perfused rat and guinea-pig livers. AB - 1. It is shown that isolated perfused rat and guinea-pig livers can sulphate polyethyleneglycol 200 at rates of about 5 and 10 nmol/g per min, respectively. 2. In the guinea-pig about equal amounts of sulphated polyethyleneglycol 200 appear in the bile and in the perfusate, while in the rat about 99% appears in the latter. 3. Polyethyleneglycols 400 and 1000 are also sulphated in perfused guinea-pig liver but polyethyleneglycol 6000 is not. 4. Polyethyleneglycols are therefore not suitable solvents for xenobiotics which may undergo sulphation because of the likelihood of competition for sulphate. PMID- 3630208 TI - Disposition of alpha-[(dimethylamino)methyl]-2-(3-ethyl-5-methyl-4-isoxazolyl)- 1H-indole-3-methanol (59-801), a hypoglycaemic agent in rats, dogs and monkeys. AB - 1. The disposition of alpha-[(dimethylamino)methyl]-2-(3-ethyl-5-methyl-4 isoxazolyl)-1H-[3-14C]indole-3-methanol, an oral hypoglycaemic drug, has been studied in the rat, dog and monkey. 2. Oral doses of the drug were almost completely absorbed. The rate of absorption was rapid in the rat but less rapid in dog and monkey. Due to first-pass effect, the absolute bioavailability of the drug was incomplete and ranged from 60-75% in the monkey to 90% in the dog. 3. Intravenous as well as oral doses of the radiolabelled drug were rapidly and extensively distributed to body tissues. In rat, concentrations of radioactivity in all tissues except the brain exceeded, or were similar to, corresponding blood levels. Tissue and blood radioactivity levels were higher in female than in male rats, and increased disproportionately with increasing dose. 4. The drug was partially metabolized before excretion, the extent of metabolism ranging from ca. 50% in the rat to 90% in the monkey. Although only a limited number of animals were used, metabolism appeared to be saturable within the dose range studied in dog and monkey but not in rat. The half-life of unchanged drug was dose independent in the rat (1.4 h), but tended to increase with increasing dose in the dog (4.1-7.2 h) and monkey (2.1-4.5 h). 5. In all three species, the administered radioactivity was recovered predominantly in urine, although biliary excretion also played an important role in drug elimination. Recovery of dose was essentially complete within 1-2 days. PMID- 3630209 TI - Influence of substrate concentration on the phase I and phase II metabolism of 4 methoxybiphenyl by rat isolated hepatocytes. AB - 1. The metabolism of 4-methoxybiphenyl to 4-hydroxybiphenyl and its sulphate and glucuronic acid conjugates has been studied in rat isolated hepatocytes at various concentrations of 4-methoxybiphenyl. 2. The proportions of metabolites produced remained constant at concentrations of 4-methoxybiphenyl less than 25-50 microM, but at higher concentrations the pattern of metabolism changed, there being proportionally more unconjugated 4-hydroxybiphenyl and its glucuronide, and less 4-hydroxybiphenyl sulphate. 3. The amount of 4-hydroxybiphenyl sulphate produced approached a plateau at the highest level of overall metabolism, whereas the amount of 4-hydroxybiphenyl glucuronide produced was linearly related to the amount of unconjugated 4-hydroxybiphenyl detected. 4. These data are consistent with the view that sulphation acts as a high-affinity, low-capacity pathway, whereas glucuronidation acts as a low-affinity, high-capacity pathway. PMID- 3630210 TI - Metabolism of 1-phthalidyl 5-fluorouracil in rat liver and enzyme induction by phenobarbital. AB - 1. When 1-phthalidyl 5-fluorouracil (PH-FU) was incubated with isolated rat hepatocytes, 5-fluorouracil, 2-carboxybenzaldehyde (CBA) and alpha hydroxymethylbenzoic acid (HMB) were detected as the major metabolites. 2. The enzymes involved in the metabolism of PH-FU, PH-FU hydrolase and CBA reductase are cytosolic and were induced by treating the rats with phenobarbital (PB). Treatment of rats with 3-methylcholanthrene (3-MC) did not affect either enzyme activity. 3. The PB-induced PH-FU hydrolase was inhibited by NADH and several aldehydes, while NAD stimulated the hydrolase and protected it from inactivation by SH reagents. 4. Study in vivo revealed that treatment of rats with PB accelerated the metabolism of PH-FU in the liver and markedly decreased the blood PH-FU after its oral administration to rats, which resulted in reduction of the anti-tumour activity of PH-FU. This activity was not affected by treatment of the rats with 3-MC. PMID- 3630211 TI - Molecular electrostatic potential energies and methylation of DNA bases: a molecular orbital-generated quantitative structure-activity relationship. AB - 1. The results of molecular orbital (MO) calculations, by the MINDO/3 method, on DNA bases, are reported; which point to a radical mechanism of alkylation. 2. Molecular electrostatic potential energy maps indicate propensity for alkylation by N-methyl-N-nitrosourea at key atoms on DNA bases. 3. A correlation between the MO-derived parameters net atomic charges on heteroatoms and superdelocalizability with percentage alkylation by N-methyl-N-nitrosourea is shown. PMID- 3630212 TI - Rural Korean housewives' attitudes towards illness. PMID- 3630213 TI - A study of allergy skin tests with Korean pollen extracts. PMID- 3630214 TI - Incidence and clinical significance of deep vein thrombosis after cementless total hip replacement in Korean patient population. PMID- 3630216 TI - Unilateral sudden hearing loss with complete recovery following cardiopulmonary bypass surgery. PMID- 3630215 TI - The effect of pertussis vaccine and cyclosporin on streptozotocin induced diabetic rats. PMID- 3630217 TI - Cutaneous manifestations of leukemia. PMID- 3630218 TI - Restoration of adriamycin and vincristine dependent tumoricidal activity by interferon in mice with implanted tumor cells. PMID- 3630219 TI - [Partnership relations, sexuality and sexual behavior in elderly females and males after age 55. I. Partnership relations and sexuality from the social gynecologic and sociological viewpoint]. AB - Sexuality in elder women and men has a great psychoemotional significance. Satisfaction in sexual experience corresponds with a good quality of life. Sexuality as concrete-historical and social-cultural relation. Moral norms are equivalent with the social order and real way of life. In the socialistic moral of genders is no identification between sexuality and reproduction. Sexuality has a partnership stabilizing intimate function of communication for the elderly women and men. PMID- 3630220 TI - [Partnership relations, sexuality and sexual behavior in elderly females and males after age 55. Partnership relations, sexuality and sexual reactions]. AB - Women and men can have a cultivated sexual experience till a high age. The presume therefore is a sexual active life. Sexual reactions are decelerated in the elderly. The fulfillment of sexual wishes depends on the individual healthy and social situation. Masturbation is only a compensation. PMID- 3630221 TI - [Partnership relations, sexuality and sexual behavior in elderly females and males after age 55. Results of social gynecologic and social medicine studies]. AB - Elder women more then men like traditional norms of moral conditions. The equality of rights is found by the women about 55-65 years old. The sexual activity of the elder men is little after the 52nd year of life. Sexuality and erotic relations are positive qualities of life in the age. PMID- 3630222 TI - [Medico-social and clinico-biochemical aspects of longevity in Siberia]. AB - Over 90-year old inhabitants of districts of Novosibirsk were questioned in connection with sociological studies about their living habits. The authors consider the genetically determined system of monooxygenases for the elimination of foreign bodies (xenobiotics) to be important, but they are also involved in the synthesis of biologically active substances in the organism and thus by no means of minor importance to the phenomenon of longevity. PMID- 3630223 TI - [Diabetes mellitus in advanced age. 6. On the life expectancy following diabetes manifestation (a 23-year mortality follow-up of diabetic patients in a regional district)]. AB - Of all 166 diabetics of all age groups of a rural district detected 23 years ago, the further course of the disease could be followed in 147 patients up to their death and to the present time, respectively. After 8 years 64.6% were still living, after 16 years 29.9% and after 23 years 13.6% of these patients. The body weight at the manifestation of the disease was prognostically only low of relevance. The prognostic importance of the higher-degree adiposity seems to lie prevailingly in the earlier manifestation of diabetes, less in shortening the remaining life span. The trend of the weight development of the patients presently still alive moved towards reaching or keeping normal weight, independent of the initial body weight, while the contrary tendency in long-term diabetics is exceptional. Test admissions covered by a glycosuria screening and deceased meanwhile lived on average 1 year longer than spontaneous admissions, the same age of manifestation supposed. Only 13.4% of all deceased patients had reached the higher expectation of life of a normal population of the GDR of the same age on manifestation, which underlines the presently still unsatisfactory long-term prognosis of the diabetic patients. PMID- 3630224 TI - [Physiologic alveolar regression as a current parameter in geriatrics]. AB - Gerontological findings, especially the biomorphotic become more and more important not only for scientific stomatology, but also for general stomatological practice and its priority dealing with the periodontal problems and, moreover, as a result, in turn, for application in geriatrics. The first part of the mostly theoretical foresight will be followed by the attempt of a practical method and of preliminary results supposing a future simplification in the sense of a pantomographic method according to Paatero for the measurement of the alveolar regression. PMID- 3630225 TI - [Employment and aging--a contribution from the viewpoint of social gerontology]. AB - Issuing from shift work specific respectively occupation specific characteristics of mortality and morbidity the author refer to a possible context between lifetime occupational activity and special forms of aging. It is out the examination of the postulated context within the bounds of gerontological study of Halberstadt. PMID- 3630226 TI - [Occupational medicine aspects of the health needs of elderly workers]. AB - The industrial-medical dispensatory care as an important field of the prophylactic health protection of the population of the GDR ensures the total covering of the working people in youth and in pre-pension age. Between these periods of life there is a special dispensatory care for those workers for whom defined exposures, strains and standards exist at their workplaces. Results of about 500,000 industrial-medical check-ups of the year 1985, occupational diseases, their incidence rates and conclusions for the demand for care are reported under special consideration of the working people from the 45th year of life, differentiated between by their sex. The high rates of findings and the considerable percentage of fitness restrictions in working people from the 45th year of life prevailingly caused by chronic diseases of the locomotor system, cardiovascular diseases, defective vision, defective hearing and by chronic bronchitis necessitate a further improvement of the quality and efficiency of medical care, which is desired by the revised edition of the Methodology of Industrial-Medical Fitness Examinations and Check-Ups from 1987. Possibilities and objectives of the consolidation of the medical check-up conceptions for working people beyond 1990 are referred too. PMID- 3630227 TI - [Accident classification of workers in the construction industry in the 2d half of life]. AB - On the basis of 3,631 accidents from the Surgical Department of the Central Outpatient's Department of construction workers it could be established by means of the industrial-medical diagnostic accident index numbers that an adequate estimation of function, work and capability is also possible in the second half of life. It is in accordance with the biological age characteristics that in the second half of life twice as much moderately severe and severe accidents have been registered as in the first one, and that this also applies to selected injuries such as fractures, contusions and open wounds. PMID- 3630228 TI - [Is everything clear in prevention?]. PMID- 3630229 TI - [Indications-related stress studies in internal medicine and cardiologic practice]. PMID- 3630230 TI - [Results of cellular immunity studies in syphilis]. PMID- 3630231 TI - [Effect of oral hygiene measures on the development of pregnancy-induced periodontal changes]. PMID- 3630232 TI - [After-care of colorectal tumor patients]. PMID- 3630233 TI - [Methodology in health education in preventive health cures]. PMID- 3630234 TI - [A 5-year analysis of injury sequelae following sports accidents]. PMID- 3630235 TI - [The main tasks in its uniting of economic and social politics]. PMID- 3630237 TI - [Arthroscopy and synovial membrane imprint cytology--indications and results in rheumatic diseases]. PMID- 3630236 TI - [Roentgen diagnosis of inflammatory rheumatic joint diseases]. PMID- 3630238 TI - [Scintigraphy in inflammatory joint diseases]. PMID- 3630239 TI - [Thermographic diagnosis with special reference to the hands in inflammatory rheumatic joint diseases]. PMID- 3630240 TI - [Physical therapy in inflammatory and degenerative joint diseases]. PMID- 3630241 TI - [Results of surgical synovectomy in rheumatoid arthritis of the knee and elbow joint]. PMID- 3630242 TI - [Endoprosthetics in rheumatoid arthritis]. PMID- 3630243 TI - [Rehabilitation and occupational medicine aspects of rheumatoid arthritis]. PMID- 3630244 TI - Feasibility of Saudi wheat flour enriched with cottonseed flour for bread making. AB - Three samples of edible grade cottonseed flour (cosf) were utilized each in 5%, 10% and 15% mixtures with Saudi wheat flour for bread making. Addition of cosf increased water absorption of the dough. Times of dough mixing, stability and break-down were slightly increased at the low addition level, but adversely shortened at the higher levels, where mixing tolerance was doubled or tripled. Up to 5%-10% of cosf could be tolerated without deleterious effect on dough properties or bread quality, depending on the source of the additive and method of preparation. An increase of 25%-50% in protein content of bread was expected. PMID- 3630245 TI - [Interaction of lipids and meat proteins. 2. Digestibility of proteins in vitro, thermohydrolysis of collagen, changes in the content of essential amino acids and coefficients of the relative nutritive value of proteins]. AB - Changes in the nutritive value of meat under the influence of an interaction between oxidized fats and proteins were studied in model experiments. Parameters were the digestibility of protein, sensitivity of tissue against thermohydrolysis, changes in the content of essential amino acids and in the RNV coefficient of the protein. Muscle gel and tissue served as meat substrates, methyl ester of linoleic acid and its oxidation products were used as fat substrates. It has been found that reactions of the oxidation products of methyl linoleate with meat proteins lead to a crosslinking of proteins. Hexanal and hydroperoxide of the oxidized methyl linoleate influence the decrease in digestibility of muscle protein and the thermohydrolysis of the collagen. Proteins of pasteurized gels showed losses in essential amino acids, which corresponded to a lower nutritive value (determined in the RNV coefficient). PMID- 3630246 TI - On the occurrence of free glucose in the caecal contents of rats. AB - Free glucose was assayed in the caecal contents of rats. Whereas control animals had less than 60 nmol glucose per g of caecal contents, 230 nmol glucose/g caecal contents were determined 3 hours after the administration of 300 mg Palatinit by gastric intubation. In contrast to an earlier report (8), caecal fluid thus contained less than 3% of the glucose concentration of 11 mumol/ml claimed to occur after Palatinit administration by these authors (8). Since the anaerobic fermentation capacity for glucose by the caecal contents of rats amounted to at least 630 nmol glucose/min X g fresh weight at 37 degrees C, only the low glucose concentrations reported above are plausible. PMID- 3630247 TI - Dietary acetate and cholesterol metabolism in rats. AB - Rats were fed either cholesterol-free or high-cholesterol (1%, w/w) semipurified diets containing acetate (0.5%) or cholestyramine (0.44%) or both compounds for 29 days. The bile-acid binding resin, cholestyramine, did not affect serum and liver cholesterol, irrespective of whether the diet was cholesterol-free or contained cholesterol. In the cholesterol-free diets, acetate tended to lower the concentration of serum cholesterol, but did not influence liver cholesterol. When the diets contained cholesterol, acetate lowered liver cholesterol concentrations by about 20% both in the presence and absence of cholestyramine. Acetate did not affect the excretion of bile acids in feces. The mechanism by which acetate may partly counteract the increase in liver cholesterol seen after cholesterol feeding of rats, remains to be established. PMID- 3630249 TI - [Experimental study of the geometry of the monocular visual field]. PMID- 3630250 TI - [Peak shift: perception related or motivational cause?]. PMID- 3630248 TI - [Nutritional behavior of non-insulin-dependent type II diabetes patients using the KALI 2.1.2 computer program]. AB - Forty patients with non-insulin-dependent diabetes mellitus (NIDDM) were investigated regarding their individual diet history, including dietary pattern and dietary habits. The energy intake in men was 2,180 +/- 460 kcal/day. The carbohydrate content was 192 +/- 57 g/day (38 +/- 7%), protein 93 +/- 20 g/day (19 +/- 3%) and fat 96 +/- 26 g/day (43 +/- 7%). Nutritional intake of saturated fatty acids was 37 +/- 11 g/day, whereas the intake of polyenic acid was 14 +/- 5 g/day. Thus the p/s-quotient was 0.4 +/- 0.1. The cholesterol intake amounted to 396 +/- 165 mg/day. The dietary fibre content was 33 +/- 21 g/day. The caloric intake of women was 1,800 kcal/day. The daily amount of carbohydrate was 154 +/- 46 g/day (37 +/- 6%), of protein 82 +/- 21 g/day (20 +/- 4%), of fat 82 +/- 32 g/day (43 +/- 6%). Saturated fatty acids were 33 +/- 14 g/day, polyenic acid 11 +/- 5 g/day, the p/s-quotient 0.4 +/- 0.2. The cholesterol intake was calculated to be 341 +/- 118 mg/day. The supply of electrolytes, trace elements and vitamins was often marginal. We found that usually practiced diabetes diet is too fatty, rich in cholesterol and poor in carbohydrate and fibre. As a result of the high amount of fat, which comprises 43% of the total calories and the low p/s-quotient of 0.4, the diet must be considered atherogenic. PMID- 3630251 TI - [Biofeedback in chronic headache: is a learning process in physiologic functional parameters detectable?]. PMID- 3630252 TI - [Additive-related measurement of perceived surface size: an experimental procedure for solving test problems]. PMID- 3630253 TI - [Hypochondriasis and hysteria as psychodiagnostic categories]. PMID- 3630254 TI - [Processing structural characteristics of visual stimuli--verbalization as a means of elaboration]. PMID- 3630255 TI - [Relation between prior, stated and realized decisions for or against blood donation]. PMID- 3630256 TI - [Secondary prevention of breast cancer within the scope of mass roentgen screening]. PMID- 3630257 TI - [A method of statistical analysis of the correlation of mixed data, exemplified by follow-up results of formerly underweight newborn infants]. PMID- 3630258 TI - [Problems of various ways of registering work disability in a territory]. PMID- 3630259 TI - [Epidemiologic studies of the effect of air pollutants on the ability of school children to concentrate]. PMID- 3630261 TI - [Imparting knowledge in the field of housing public health]. PMID- 3630260 TI - [Formaldehyde concentration in the air in disinfection measures]. PMID- 3630262 TI - [Results of air ventilation studies in classrooms of the type 80 school building]. PMID- 3630263 TI - [Results of biological exposure tests in relation to passive dosimetry measurements of room air concentrations in occupational exposure to trichloroethylene at metal cleaning sites]. PMID- 3630264 TI - [Retrospective determination of a critical dose for silicogenic dusts in Zwickau bituminous coal mining]. PMID- 3630266 TI - [A measure for stress on the spine]. PMID- 3630265 TI - [Assessment of the lighting of a dental treatment room]. PMID- 3630267 TI - [Sexual behavior in pregnancy]. PMID- 3630268 TI - [Outpatient management of the handicapped exemplified by vocational age recipients of blindness compensation in a large city]. PMID- 3630269 TI - [Risk of radiation exposure and internal medicine]. AB - The paper informs in concise form about the risk which consists in the medical application of the ionizing radiation for physician and patient. In the introduction a short retrospective view on the development of the knowledge of the various radiation injuries is given. Following this is shown which international activities concerning the limitation of the radiation risk are to be registered in view of the world-wide increase of the nuclear and radiation technology. The principle of radiation protection is explained by giving limit values in order to exclude non-stochastic radiation injuries and to limit stochastic injuries to a measure worth being advocated for persons exposed to radiation. The importance of the risk calculation necessary for the derivation of limit values is explained and thereby is referred to the open problems in connection with the dose-effect relations for certain radiation effects. Finally in the light of two examples the actually presumable risk for the physician and his staff and for the patient is demonstrated which altogether is to be classified as extremely low. PMID- 3630270 TI - [Clinical aspects of reperfusion arrhythmia following intravenous thrombolysis in acute myocardial infarct]. AB - In accordance with the majority of the reports in the literature reperfusion arrhythmias were observed in more than 30% of the patients with acute myocardial infarction (n = 25) under or immediately after a highly dosed short-term infusion with streptokinase. With reference to indirect signs the recanalisation rate was assumed with 75%. Only one third of the reperfusion arrhythmias had haemodynamically significant characteristics and required an influence. Though in literature from animal experimental findings directive conclusions for the therapy are to be derived, the procedure in practice is still vastly empirical. In the ventricular tachycardia lidocaine, procainamide and ajmalin may be recommended. In ineffectiveness or particularly threatening situations the electrotherapy (cardioversion, DC-shock) is to be preferred. The concept inaugurated by Corr and Witkowski apply alpha-adrenoreceptor blockers has not yet entered the clinical practice. Possible problems in the treatment of reperfusion arrhythmias in the prehospital phase should at present still be a reason not to antedate the thrombolytic therapy into this phase. PMID- 3630271 TI - [Computerized tomography of the mediastinum--results of a retrospective study]. AB - The results of the CT-investigations of the mediastinum on 500 patients can be described in the following way: the assessment of mediastinal lymph nodes was clearly improved by the CT. About half the positive mediastinal findings in malignant lymphomas was to be proved only in the CT. The diagnostics of mediastinal space-occupations was elevated to a higher degree. Statements concerning the coarse tissue are possible. In myasthenia gravis pseudoparalytica the computed tomography is the best method for demonstrating the morphologic relations. The individual changes of the thymus gland are, however, not certainly to be differentiated from each other. Among the vascular changes aneurysms and an arcus aortae dexter with right descending thoracic aorta can unequivocally be demonstrated. A particular advantage of the computer tomography consists in the possibility to separate the perfused lumen from the thrombotically closed one. The search for a primary tumour in the mediastinum is not useful in negative conventionally radiographic findings. PMID- 3630272 TI - [Determination of central hemodynamics in dynamic stress using impedance cardiography in comparison to radiocardiography]. AB - 77 unselected patients were examined synchronously by impedance and radiocardiography in recumbent position during dynamic exercise. In all cases the load of evaluable impedance curves was possible till 100 watts. Stroke volume, estimated by impedance cardiography, is lower about 30% at rest and during exercise compared to its estimation by radiocardiography. But the percentual increase during exercise is not significantly different between the methods. The stroke volumes, estimated by both methods, correlate significantly at rest and during exercise. This fact shows the usefulness of impedance cardiography for estimating central haemodynamics during dynamic exercise. PMID- 3630273 TI - [Long-term ergometry and echocardiography results in patients following acute myocardial infarct with the best possible completion of rehabilitation phase I in accordance with the indications]. AB - 55 patients (43 males at the age of 60.3 +/- 10.8 years and 12 females at the age of 71.6 +/- 8.4 years) with earliest possible end of the rehabilitation phase I after acute myocardial infarction beginning with the end of the second week were as to their ergometric and echocardiographic parameters compared with an identical control group with usual duration of mobilisation. When discharged from hospital and one year after infarction they obtained with 50 to 23 and 72-26 watt respectively, the same numbers of watt as the patients of the control group. In the two groups the increase in vitality after the first year was obtained exclusively by men. In a short duration of phase I of two weeks they obtained the most favourable values with regard to number of watt, product of pressure rate, diastolic pulmonary pressure, diameter of left ventricle and atrium as well as to the shortening fraction at discharge from hospital and one year after infarction. The values were identical to those in the control group with usual duration of the rehabilitation phase I. PMID- 3630274 TI - [Headache in early syphilis--a case report]. AB - A 16-year-old girl fell ill with headache of uncertain etiology. Some weeks later an exanthem led to the diagnosis of lues. Characteristic changes in serum and liquor parameters were found. Hearing disorder and choked disc improved during the therapy with penicillin. The rare picture of early luetic meningitis remains important for the differential diagnosis of headache. PMID- 3630275 TI - [Treatment of severe digitoxin poisoning with digitalis antibodies]. AB - In a 59-year-old patient who for suicide had taken 75 tablets of digitoxin the symptoms of a severe digitalis intoxication developed. By application of the digitalis antidote BM the life-threatening condition could quickly be mastered. Because of the distinct hyperkalaemia additionally an initial haemodialysis treatment was carried out. PMID- 3630276 TI - [Ambulatory diagnosis and outpatient management of patients with hypophyseal adenomas]. AB - In 88 patients with adenomas of the pituitary gland, among them 24 hormone inactive tumours, 27 somatotropic adenomas and 37 prolactinomas, anamnestic data, clinical, endocrinologic and localisation-diagnostic findings as well as therapeutic measures were evaluated. Main symptoms were headache and visual disturbances. 78 of the 88 patients with adenomas of the pituitary gland were able to work at the time, when the diagnosis was made. In about 32% of the patients partial defects of the visual field were present and in 35% in the cranial computed tomogram a suprasellar and parasellar, respectively, expansion of the tumour and thus an advanced stage of the disease was established. The number of the residual findings and recidivations, respectively was great in all the three forms of the adenomas of the pituitary gland. In the prolactinomas and the somatotropic adenomas of the pituitary gland a medicamentous secondary therapy with dopamine agonists is possible. The therapy with bromocriptine reveals good results particularly in prolactinomas. PMID- 3630277 TI - [Weight of the thyroid gland in the Brandenburg district before introduction of iodized salt]. AB - The first prospective investigation of thyroid weights of over 20 years old adults in the GDR is presented. The material is based on autopsy findings from the Brandenburg area before using salt with iodine. Judging by the results this area appears as an endemiological one. Relationships to iodine content of drinking water, comparisons with autopsy statistics of other countries, and the role of regional epidemiological differences are pointed out. The importance of the investigation for patients care and the possibility of controlling the effect of using salt with iodine is underlined. The examination of relations between thyroid weight and anthropometric data showed no additional results. PMID- 3630278 TI - [Problem-specific grading in disease course assessment and calculation of the likelihood of transition of chronic cardiovascular diseases]. AB - For the course rating of cardiovascular caused drop in efficiency a problem specific grading is introduced, the characterization of which is composed of simple, non-invasive parameters. The grading is specified for 4 clinical diagnostic classes (hypertension, coronary heart diseases, pulmonary heart, "other heart and vessel diseases") and takes into consideration the frequent coincidence or connection of several diagnoses of heart and vessel diseases with each other. The choice of parameter and connection have to fulfil the demand, which is essential for the course rating of heart and vessel diseases, like practicability proportionate with the frequency of heart and vessel diseases, adequate registration of changes in severe degrees, statement about the patient and not about several parameters. Furthermore it has to make it possible to calculate provisional probabilities under variable conditions as well as to make possible a valuation of prognosis. For that purpose the construction of suitable matrixes is shown and an integral projection is represented, which is used for the interpretation of courses dependent on severe degrees. The conception of grading has the function to modify necessary parameters for inclusion in the hierarchy according to medical starting position (for instance primary mode of registration). The model which is applicable to level of population makes possible an electronic data - processing - based evaluation including algorithmic classification. PMID- 3630279 TI - [Acute cerebrovascular disease at the internal medicine hospital]. AB - On the basis of the medical reports of 255 patients with an acute cerebral insult the clinical symptoms, the courses of the illness as well as the diagnostic procedure were discussed. 76 of 255 patients (29.8%) are taken ill before they reach their 65th year, which stresses the sociomedical importance of acute cerebrovascular syndromes. With patients under 65 years the clinical syndrome corresponds to the following stages of the cerebrovascular insufficiency: stage IIa-14.5%, stage IIb-43.4%, stage III and IV-36.8%. A brain embolism is found in 5.3% of the cases. If there is an acute cerebrovascular insufficiency the ultrasonic Doppler detection as a noninvasive procedure should be the beginning of the paraclinical diagnosis. Should the ultrasonic Doppler detection give an indication of extracranial stenosis or obstruction of the A. carotis, then an angiographic diagnosis ought to be started in order to make possible a surgical treatment of the A. carotis. PMID- 3630280 TI - [Characterization of functional disorders of bone marrow by measuring chemiluminescence]. AB - It is reported on first experiences with measurements of chemiluminescence on the bone marrow. Suspensions of the bone marrow show a spontaneous chemiluminescence which can be stimulated by Zymosan. Haematological diseases and changes of the bone marrow under influence of the cytostatic therapy react on the behaviour of chemiluminescence. The size of the changes possibly allows of conclusions to the behaviour of the regeneration of the bone marrow. PMID- 3630281 TI - [Acute arterial occlusive syndrome in streptokinase treatment of deep venous thrombosis--successful therapy with urokinase]. AB - Arterial embolism or thrombosis are very rare complications of the fibrinolytic therapy of deep venous thrombosis. The characteristics symptoms of these illness are the acute arterial failure of the concerned extremity during venous thrombolysis. The diagnosis take place by angiography, by ultrasonics, and in particular cases by the skin thermographic method. If the arterial occlusion is not operable, the thrombolysis by urokinase is discussed. This seems to be the last possible method to support the extremity. PMID- 3630282 TI - [Contractility parameters of the right heart in patients with chronic obstructive lung diseases without pulmonary hypertension]. AB - By means of the radionuclide ventriculography certain contractility parameters of the right heart are presented in 15 patients with chronic obstructive bronchitis without pulmonary hypertension. The results confirm that also without increase of the pulmonary arterial blood pressure the ejection fraction of the right ventricle in rest is decreased in possible dependence upon the size hypoxaemia. The increase of the ejection fraction of the right ventricle under stress is insufficient in 7 out of 15 patients, in which case a connection with the left ventricular ejection fraction is observed. A characteristic valuation of the right- and left-ventricular ejection fraction for pathophysiology and prognosis of the pulmonary heart disease is discussed. The necessity of further investigations is emphasized. PMID- 3630283 TI - [Catheter problems in the use of ventricular cardiovascular assist systems]. AB - The prerequisite for efficient assist-ventricles and impulses in the pulsatile pumping function are sufficiently dimensioned afflux and flowing off connections. In systematic investigations on the hydraulic circulation model the cannulas from an internal parameter of 12 mm with a total length of the connection distance to the inflow and outflow valve, respectively, at the bypass ventricle of 30 cm proved sufficient for performing a volume of output of 5-6 l/min in clinic relevant filling pressures in a hypodynamic circulatory situation. Connection cannulas for the heart-lung machine used in routine work are not sufficient in periodic filling and ejection processes in the pulsatile pumping function for an effective decompression and effective increase of the cardiac output. In case of an ECG-triggered mode of action of the ventricular assist-system an increase of frequency up to 130/min in after that incomplete filling of the assist-ventricle does not remarkably restrict the effectiveness of the assist-system. PMID- 3630284 TI - [Eosinophilic leukemia as a diagnostic problem]. AB - It is reported on a 23-year-old female patient in whom at the beginning enlargements of the lymphatic nodes and a tumour of the pelvic wall were existing and in the course of the an increasing eosinophilia developed. This reached 158.95 X 19(9)/l in maximum values of leukocytes of 201.2 X 10(9)/l and a large proportion of immature eosinophilic cells. The disease which finally had to be explained as eosinophilic leukemia rendered extraordinary differential-diagnostic difficulties and had a therapeutically uninfluencible fatal course. PMID- 3630285 TI - [Contribution to retinopathy in acute pancreatitis]. AB - It is reported on 2 cases of pancreatitic retinopathy in acute pancreatitis. In the first place of the clinical symptoms there are acutely beginning bilateral vision disturbances 2 to 3 days after the onset of the disease which exist for a long time. Causally an obstruction of the precapillary and capillary parts of the vascular system of the retina, but also of the choriocapillary system by fat particles and corpuscular blood elements is discussed. With certainty still other factors play a part, for example preinjury of the vascular parts mentioned by circulating pancreatic enzymes and toxins. In patients with acute pancreatitis vision disturbances should be taken into consideration, even when these changes are very rare. PMID- 3630286 TI - [Behavior of cholinesterase activity in lipid metabolism disorders]. AB - In the serum of 127 patients with hypercholesterolaemia, hypertriglyceridaemia and mixed HLP the cholinesterase activities were determined. In hypercholesterolaemia they did not differ from persons with healthy metabolism, however, in hypertriglyceridaemia and mixed HLP were significantly increased. As the cause of increased cholinesterase activities an increased secretion of VLDL in the liver is discussed. PMID- 3630287 TI - [Adipocyte volume and count in obesity during weight reduction]. AB - In the subcutaneous fatty tissue of 27 adipose patients the number and volume of adipocytes were determined before and after a stationary weight reduction. 47 normal test persons served as comparison. Under stationary weight reduction the volume of adipocytes significantly decreased, whereas the number of adipocytes remained constant. The subdivision of the obesity according to the cellularity of the fatty tissue into a hypertrophic and a hypertrophic hypercellular form is proposed. A possible indication for the determination of the volume of fat cells in adipose patients is given. PMID- 3630288 TI - [Value of systemic streptokinase therapy in thromboembolism diseases]. AB - Among 27,756 cases with stationary treatment 1,532 patients were found in whom a systemic fibrinolysis therapy was taken into consideration. Under strict attention to indications and contraindications 173 patients were treated with streptokinase. The rate of treatment failures in peripheral arterial obstructions was 46%, in venous thromboses 29%. The lethality of pulmonary embolisms could be decreased significantly, in acute myocardial infarction however, it could not be reduced. In 10% of the cases we observed severe therapeutic complications. The systemic streptokinase therapy is therefore a certainly effective, but also high risk method of treatment, which must be performed by an experienced physician. PMID- 3630289 TI - [Calcitonin and glucagon secretion in active nephrolithiasis]. AB - In 76 patients with active nephrolithiasis and in 28 normal subjects the influence of an Ca-load on the calcitonin and glucagon secretion and on the serum calcium, phosphate and magnesium levels was examined. In the patients with active nephrolithiasis a significant suppression of Ca-induced calcitonin secretion and absence of glucagon secretion was found. Simultaneously the patients showed a lower decrease of serum Mg and reduced increase of serum phosphate levels. The authors suggest participation of the above mentioned biochemical and endocrine abnormalities in the pathogenesis of the active nephrolithiasis. PMID- 3630290 TI - [Significance of the genetics of haptoglobin types in the demarcation of subgroups of juvenile chronic arthritis]. AB - According to the at present valid definition and due to its different clinical subgroups as well as to the different therapeutic influencibility and prognosis the juvenile chronic arthritis represents a very heterogeneous feature of a disease. Systems of genetic markers increasingly obtain importance for the exact clinical specification of the juvenile chronic arthritis. The investigations described in this paper show a significant correlation of the genetically determined haptoglobin variants to the subgroups of the juvenile chronic arthritis. By means of the careful nosological differentiation which goes beyond the usual principles of subdivision the type of haptoglobin gives a diagnostic enrichment in the assessment of the juvenile chronic arthritis. PMID- 3630291 TI - [Coronarography findings following systemic short-term lysis of acute myocardial infarct]. AB - In 50 patients with acute infarction who were admitted within 6 hours after the beginning of the complaints randomizedly an intravenous streptokinase short-term lysis or a conventional heparin phenprocoumon treatment was performed and 4 weeks later the results were objectified by coronarography and ventriculography. The patients were subdivided into 3 groups: 1. control group (without fibrinolysis), 2. early lysis (within 4 hours) and 3. late lysis (4-6 hours). Four weeks after the infarction the proportions of the open infarction vessels are approximately of the same size in all three groups, the functional results are best (end diastolic pressure and kinetics of the cardiac wall) in the group of patients who underwent an early lysis. Successfully lysed patients with remaining residual stenosis must be regarded as particularly threatened by infarction and remain under special control (residual angina, ergometrically objectified exercise tolerance, perhaps coronarography) in the phase of rehabilitation. PMID- 3630292 TI - [Secretory performance of eccrine sweat glands from the nephrologic viewpoint]. AB - The question is of nephrological interest, whether the secretory product of eccrine sudoriferous glands apart from the well known function for thermoregulation is useful as excretory product for the therapy of renal insufficiency. In 17 healthy subjects and 39 patients with renal insufficiency thermal sweat was obtained by exposition in the sauna and four-tub bath. Control of the trainability of sweating in 23 patients during six weeks in the Kneipp cure sanatory. For the daily fluid balance remarkable quantities of sweat could be achieved. The sweat performance is trainable. The content of soluta in the sweat of patients with renal insufficiency surmounts that of healthy test persons. The excretion of nitrogen metabolites, electrolytes and acidity is quantitatively different and is analysed individually. Apart from the reliable methods of the conservative and invasive therapy of the uraemia the thermically stimulated sweating can be recommended as an adjuvant therapeutic regime. PMID- 3630293 TI - [Behavior in disability assessment of uncomplicated duodenal ulcer--a study]. AB - There is internationally no standardized therapy of the uncomplicated duodenal ulcer, including the inability to work. In order to obtain a representative behaviour concerning the duration of the inability to work prescribed by specialists for general medicine, internal medicine and surgery, an interrogation was performed. An evaluation of 729 questionnaires shows the following tendency: 1. The younger the attending physician is the longer is the time of inability to work prescribed and the more frequent such a certificate is given. 2. General practitioners in rural districts on an average prescribe a longer time of inability to work. 3. The higher is the qualification of the specialist for internal medicine the shorter is the duration of inability to work attested. 4. In the assessment of the duration of the inability to work the attending physicians increasingly accommodate themselves rather to the symptoms than to the radiological or to the endoscopic control of healing. PMID- 3630294 TI - [Sports therapy in obesity and lipid metabolism disorders]. AB - Lack of movement is an essential cause for the development of obesity and dys- and hyperlipoproteinaemias. These disturbances of metabolism are risk factors for the development of the early coronary heart disease. The medicamentous treatment of these diseases can be decisively supported by dosed application of athletic exercises (sports therapy). Persevering athletic exercises of at least 30 min duration increase the activity of lipocatabolic enzymes (lipoprotein lipase, serum-lecithin-cholesterol-acyl transferase). As measure of exercise in sports therapy perseverance-orientated kinds of sport of altogether 2 hours a week are recommended. PMID- 3630295 TI - [Roentgen findings following incorporation of metallic mercury]. AB - In the light of own cases and the present literature the different possibilities of the incorporation of metallic mercury are indicated, the radiological findings explained and the possible consequences of the proof discussed. PMID- 3630296 TI - [Late clinical and phlebographic findings in Paget-von Schroetter syndrome]. AB - Of altogether 33 patients (20 males and 13 females) with clinical and phlebographically ascertained Paget-von-Schroetter syndrome the informations of the medical records from 1975 to 1985 were retrospectively analysed. From one to nine years 23 patients could clinically be followed up according to different forms of therapy and 17 of them underwent a phlebographic follow-up examination. The self-estimation of the load capacity of the diseased arm was approximately 50 100%. In 30% of the patients we observed subcutaneous dilations of the veins of the shoulder-arm region. Only in three of 17 cases an unhandicapped patency of the veins could be proved phlebographically one, three to four years after treatment. In ca. 80% of the cases the control phlebograms distinctly showed postthrombotic obstruction stenoses and changes of the wall, respectively. By the formation of a widely branched collateral circulation a compensation of the venous outflow is obtained. This functional "healing" reflects also in the good and very good results, respectively, of the clinical after-examination. PMID- 3630298 TI - [42d meeting of the German Society for Digestive and Metabolic Diseases, 19th meeting of the German Society for Gastroenterologic Endoscopy, 20th annual meeting of the Austrian Gastroenterology Society. Salzburg, 9-12 September 1987. Abstracts]. PMID- 3630297 TI - [A new catheter for hemodynamic studies]. AB - It is reported on a new catheter technique for the determination of the cardiac output by means of the method of thermodilution. It consists of a thin sensorcatheter (3 Ch), which contains a microthermistor as temperature sensor and additionally two electrodes. The insertion of the catheter is carried out via puncture of the subclavian vein by means of a special introducer set, the outer sheath of which can used for injecting the cold solution. The positioning of the sensor catheter into the pulmonary artery may be done by intracardiac ECG monitoring with the help of the two electrodes. By means of these electrodes, however, also an electric stimulation of the right ventricle is possible, so that, for instance, haemodynamic investigations depending on stimulation parameters can be performed by only one catheter. The clinical test of the new catheter-set was very successful. PMID- 3630299 TI - [Telethermographic aspects of dermabrasion including the management of postoperative wounds]. AB - If the skin is not cooled, dermabrasion induces local hyperthermia of 36 to 41 degrees C. This temperature goes down again after one minute and is not considered the cause of postoperative hypertrophic scarring. Yet, cooling of the skin during dermabrasion is generally recommended. In small as well as in large excoriated areas, high speed dermabrasion causes a temperature decrease (delta T) of about 2 to 3 degrees C due to the evaporation of exudate. If we assume that the vascular capillary plexus in the stratum papillare is seriously damaged, the subsequent reparation of the upper skin layers must be clinically and thermographically interpreted as wound healing (latent and proliferative period). The exothermic reaction of the early phase of wound healing is superimposed by the cooling effect due to exudation. The covering of the skin defect with the fine-meshed polyvinyl alcohol hydrogel polyester netfoil, Cutinova, seems to have a favorable influence on the wound healing process, if the covering is regularly changed every one or to days. This may be due to the temperature increase caused by the prevention of the evaporation of the exudate. Measurements of sensitivity (to pressure, temperature, and pain) showed that the cutaneous sensation almost completely recovered after about 15 days. PMID- 3630300 TI - [Psoriasis. Sodium, potassium, chloride--analysis in sweat, saliva and urine- selective ultraviolet phototherapy]. AB - It has been recognised that the sweat (extracellular area) excreted from those affected with psoriasis contains twice the amount of sodium and four times the amount of potassium in comparison to those not affected with psoriasis. According to Saalmann, after HUV therapy (SUP) there is a significant reduction of the saliva sodium content (intercellular area) not only with psoriasis patients, but with all other patients receiving radiation therapy as well. This result has never before been described in the literature. Therefore, on the one hand, completely new aspects of psoriasis and therapy can be recognized, and on the other hand, of the effects of SUP. PMID- 3630301 TI - [Increased birth weight in psoriasis vulgaris--an evolutionary advantage?]. AB - With regard to the frequent alterations of insulin secretion and glucose tolerance in psoriatic patients, the birth weights of children of 100 psoriatic mothers were compared with the birth weights of children of 100 carefully matched control mothers. The mean birth weight in the psoriatic group was 140 g higher than that of the control group. A birth weight of more than 4,000 g was observed in the children of 20.4% of the psoriatic mothers and in only 11.3% in the control group. The frequency of diabetes mellitus independent of insulin (type II) in psoriasis recalls the hypothesis of the "thrifty" genotype, which suggests an explanation for the high incidence of diabetes in modern societies. On the basis of our results, this hypothesis may also be applied to psoriasis. In addition, we studied the influence of pregnancy on the course of psoriasis. Improvement was noted in 27.8% (complete remission in 20%), exacerbation in 14.7%; in 46.6% the disease remained unchanged. PMID- 3630302 TI - [Value of detecting pathogens in fertility disorders]. AB - The present study was carried out on 1092 asymptomatic male patients suffering from unexplained infertility without any history or clinical signs of inflammatory diseases of the genital tract. Semen samples were cultured for mycoplasma. In 214 of the patients, we additionally performed bacteriological investigations on seminal fluid, smears from the glans penis or prepuce, and urine specimens. Semen analysis included the common ejaculate parameters. We found significantly elevated counts of mycoplasma in 13% of the semen samples examined; pathogenic isolation rates of bacteria were observed in 36%. Increased counts of various bacterial species associated with high numbers of mycoplasma seem to be one of the causative factors in male infertility. There was not observed any close relationship between the recovery of microorganism and poor semen quality, except for fructose and citrate. When follow-up investigations were carried out in untreated patients, the concentrations of mycoplasma and bacteria in the semen fluid revealed a spontaneous variability of considerable extent, indicating frequent contamination of the semen. Therefore, we recommend to perform a culture control test of the semen prior to specific antibiotic treatment. PMID- 3630303 TI - [Danger of infection by the AIDS virus in members of a household]. PMID- 3630304 TI - [Effect of pulsed dye laser radiation on the capillary vessels of the skin]. AB - Up to now microvaporization has been considered the basic mechanism of vascular damage induced by pulsed dye laser. Regarding the laser-tissue interaction, we present experimental results giving evidence of the significance of sound waves. Thus the transformation of photoacoustic energy is proved, facilitating the explanation of experimental and therapeutic effects. PMID- 3630305 TI - [Disseminated neuroendocrine cancers of the skin--a cutaneous merkeliomatosis. Report of 2 cases]. AB - Two nearly identical cases with about 100 multicentric disseminated neuroendocrine carcinomas of the skin are presented. In the Merkel cell tumors a for epithelial cells specific antigen (MAM-6) was found by immunohistochemical methods. Only in one patient generalized metastases arose after a four year course of the disease. The other patient committed suicide after a three year course of the disease. At autopsy no metastases were seen. We assume these diseases to be a systemic proliferation of malignant neuroendocrine differentiated epithelial cells, for which the term "cutaneous Merkeliomatosis" is proposed. PMID- 3630307 TI - [Preventive treatment: I]. PMID- 3630306 TI - [Psychosocial sequelae of cancer in childhood and adolescence: retro- and prospective studies]. PMID- 3630308 TI - [Relative demands of psychotherapy or pharmacotherapy in the treatment of depressive patients in neurologic practice]. PMID- 3630309 TI - [Understanding psychosomatic and somatopsychological processes. Contributions of psychoanalysis]. PMID- 3630310 TI - [The main image and counterimage in intensive treatment]. PMID- 3630311 TI - [Radiation burden in heart catheter studies--significance of measures for reducing scatter radiation]. AB - During diagnostic and, more particularly, therapeutic intervention, such as transluminal coronary angioplasty, the operator may be exposed to a considerable degree of scatter radiation. In our study, we measured the level of radiation exposure of the head, unprotected knees and lower legs. A flexible lead screen, attached to the catheterization table (0.5 mm Pb) reduced scatter radiation of the lower legs by 95%. In addition, scatter radiation exposure of the head decreased by 54% by covering the patient with a rubber leaden blanket (0.25 mm Pb). Finally, the use of these supplementary yet simple measures did not hinder or interfere with the examination procedure in any way. PMID- 3630312 TI - [Change in the diameter of the coronary vessels following sublingual or intravenous nifedipine administration correlated with the plasma level]. AB - The diameter changes of angiographically normal epicardial coronary arteries were studied in 25 patients in correlation to nifedipine plasma levels. In group 1 (15 patients) 20 mg of s.l. nifedipine were administered. Measurements of the coronary lumen size (automated contour detection system, accuracy 0.12 mm) and detection of plasma levels (gas-chromatography) were done before and 10, 20 and 30 min after drug administration. According to the slope of nifedipine plasma levels, patients were divided into group 1 A (n = 4) and 1 B (n = 11). Plasma levels in both groups were: at 10 min, 27.8 +/- 9.8 and 13.5 +/- 4.5 ng/ml resp.; P less than 0.05; at 20 min, 54.0 +/- 11.7 and 21.7 +/- 6.6 ng/ml resp.; P less than 0.001; at 30 min, 79.1 +/- 9.3 and 28 +/- 9.8 ng/ml resp.; P less than 0.001. The corresponding diameter changes in A and B were: 7.3 +/- 5.1%/.-5.6 +/- 9.0% resp.; P less than 0.01; 11.4 +/- 4.1% and -4.5 +/- 11.3% resp.; P less than 0.01; 14.5 +/- 5.9% and 0.5 +/- 13.6% resp.; P less than 0.05. In group 2 (10 patients) 1 mg nifedipine was administered intravenously within 4 min. Measurements were done at 1 min intervals during infusion as well as 7 and 15 min after beginning and compared to a placebo group (n = 10). Peak plasma levels amounted to 16.7 +/- 5.7 ng/ml after 7 min. The maximum coronary dilation was reached after 4 min (verum 5.0 +/- 6.8%; placebo 3.2 +/- 3.6%). Significant differences between both groups were observed after 7 min (verum 4.1 +/- 5.3%; placebo -3.1 +/- 5.8%, P less than 0.05) and 15 min (verum 1.2 +/- 3.2%; placebo 6.2 +/- 8.4%; P less than 0.05). CONCLUSION: based on significantly different plasma levels following sublingual application of 20 mg nifedipine a classification of patients into "early-" and "late-coronary-responders" could be established. After intravenous infusion of 1 mg nifedipine peak plasma levels were much lower than after sublingual application of 20 mg and coronary diameters showed only a mild increase. PMID- 3630313 TI - [From phonocardiography to phonoanalysis]. AB - We report on a new system for the examination and presentation of heart sounds, the phonoanalysis (PHA). It gives automatically a complete, objective physically founded picture of heart sounds and murmurs by registering the frequency spectrum graphically, as well as presenting in a numeric format, as a whole and as a function of time; in addition, the usual phonocardiographic and electrocardiographic leads may be obtained. A further function is to measure- probably for the first time--quantitatively the "roughness" of heart murmurs. This factor is also essential for the quality of murmurs and independent of the pitch. Therefore, the quantitative assessment of roughness has been proposed as an essential part of the physically founded description of heart murmurs in the auscultation, in addition to the determination of the dominating frequency (pitch). The term 'roughness' should not been confined to the extremely rough low pitched heart murmurs e.g. in typical aortic stenosis. The PHA gives a better insight into the hemodynamic basis of heart murmurs and discloses properties of murmurs not recognized by auscultation and phonocardiography. The PHA can also be used for the examination of vascular, lung, bronchial and abdominal murmurs and also in connection with a stethoscope using an airborne sound microphone. PMID- 3630314 TI - [Cor triatriatum dextrum]. AB - Cor triatriatum dextrum is a rare malformation of the right atrium usually without typical signs or symptoms. Today the intra vitam diagnosis of C.t.d. is done by echocardiography and angiocardiography. Once the diagnosis is established, surgical correction of this anomaly is possible in symptomatic patients. When the presence of an abnormal membrane in the right atrium is not recognized before operation, the outcome may be unsatisfactory. PMID- 3630315 TI - Health behaviour of an elderly population in eastern Finland in 1982. AB - The health behaviour of men and women aged 65 to 74 years residing in eastern Finland was studied by a self-administered questionnaire as a method of data collection. About 27% of the men, but only 3% of the women smoked. About 60% of the men and 23% of the women reported that they drank alcohol at least occasionally. Men drank alcohol in greater amounts than women. Men said that they ate potatoes more often than women, but women ate other vegetables and fresh and frozen berries and fruits more frequently than men. The type of milk drank by men had a higher fat content than that drunk by women. The type of fat usually used both on bread and in cooking was similar for both men and women, and it was mostly butter. Men received more fat from milk and on bread than women. Men drank more coffee and soft drinks than women and ate sweets more frequently than women. The results suggested that the health behaviour of the elderly men was unhealthier than that of the elderly women. Older (70-74 yrs.) men and women received more fat from milk than younger (65-69 yrs.) men and women; this being the most significant difference between the two age groups. The findings showed that there is a need for health education in this elderly Finnish population. The main topics suggested are to decrease fat consumption and to change the type of fat consumed in both genders, to increase root, vegetable, berry and fruit consumption in men and to decrease smoking in men. PMID- 3630316 TI - [Vector analytic evaluation of clinico-gerontologic data]. AB - Using the concept of vector analysis and the mathematically theorized condition and age of patients as vectors in a right angle Cartesian coordinate system, the rate of aging and the functional age difference between males and females can be determined. PMID- 3630317 TI - [Longitudinal aging research over 20 years. Electrocardiogram, blood pressure, body weight, pulse wave velocity, accommodation latitude and retinal arteries of the eye]. AB - We report on a longitudinal study of 80 men - from 10-60 years old at the beginning of the study - in the period 1955-1975, giving the results of ECG, blood pressure, body weight, vital capacity and other measures. A striking change was noted in the ECG, with the axis deviation shifting with age to the left. It is highly significant that the QRS-complex remained stationary, giving an individual indication for the entire life-time. Heart frequency, QRS duration and wave amplitude showed a slight decrease with age, whereas PQ and QTc distances reveal a slight prolongation in the 20 years. The most serious pathologic changes are myocardial infarcts, 2 among 80 working men. Blood pressure becomes higher with age but essential hypertension was seen only in 11.25%. A real health risk is the combination of permanent hypertension and obesity (3 deaths). Vital capacity reaches its maximum between 20 and 30 years of age and then diminishes slowly. The pulse wave velocity augments with aging. Other results are reported in detail. PMID- 3630318 TI - [Clinical evaluation of autopsy in the aged]. AB - On a general medical department with 54 beds, 801 patients (8.6%) expired between 1980 and 1984 in 780 of them (97.3%) autopsy has revealed. 58.4% of expired patients were over seventy years. In this age group autopsy data diverged from the underlying disease in 9.58%, however this ratio of patients under seventy was 8.56%, as well. Mistake of clinical diagnosis in the direct cause of death was 18.9% in the group of under seventy and 21.3% of over seventy. The highest ratio of mistakes in the underlying disease has occurred in diseases of malignancies (progressing with age). Referring to the direct cause of death, undiagnosed pulmonary embolism had in each age group an equal high ratio. Because of the augmented multimorbidity with age the autopsy in the elderly can serve for an improvement of diagnosis. PMID- 3630319 TI - [Roentgen study on the topic of the "aging heart" with special reference to age, clinical diagnosis and therapy]. AB - Volume and linear measures of the heart (absolute as well as relative) are investigated in 640 patients (male + female). The heart size increases with increasing age. Radiological heart size shows in comparison with clinical diagnosis and findings no evidence for an old-age heart. The increasing heart size due to age is rather expression of multimorbidity during lifetime. PMID- 3630320 TI - [Social medicine aspects of increasing longevity and aging]. AB - In all highly industrialized nations the survival curve shows a tendency towards "rectangulation", i.e. forming a plateau with a following decline in the elder ages. The life span remains unchanged as a specificity of the human genus. Morbidity in old age shows the same tendency to rectangulation. The majority of old people today are far more vital and healthy than in the past. Increasing longevity, persisting vitality in old age, in connection with acceleration and postponement of the menopause, is a cultural process of a comprehensive nature and shows the historicity of the human body. PMID- 3630321 TI - [Significance of internal medicine for geriatrics--independent gerontology]. AB - An overview is given of the evolution of gerontology in the German-speaking regions, which really began only after the Second World War. Geriatrics had no support from the official societies of internal medicine, who regarded it only as one of their specialties. Prominent in its future were always not only important developing geriatric cases in some medical university clinics, but the problems of the elderly for the caring heads of medical outpatients' clinics, old peoples' homes and nursing homes. At the same time, medical doctors, psychologists, sociologists and medical staff have been achieving important work in all the social and mental problems of old people. PMID- 3630322 TI - [The founding and activities of a university for the aged in Lodz]. PMID- 3630323 TI - [Analysis with solid phase reagent carriers ("dry chemistry"). Experiences, possibilities, limits]. PMID- 3630324 TI - [Photometric and immunologic determination of prothrombin (blood coagulation factor II) in plasma]. PMID- 3630325 TI - [Spontaneous aggregometer--an instrument for continuous measurement of spontaneous thrombocyte aggregation]. PMID- 3630326 TI - [Gas chromatography fatty acid analysis in the differentiation of Bacteroidaceae]. PMID- 3630327 TI - [Assessment of quality control at a district clinical laboratory using a programmable minicomputer]. PMID- 3630328 TI - [Registration of sample numbers by external input using a strip printer G 3287.500]. PMID- 3630329 TI - [Use of polycation-coated object carriers in cell-concentrating procedures]. PMID- 3630330 TI - [An automated turbidimetric method for determining IgG, IgA and IgM using a kinetic procedure]. PMID- 3630331 TI - [Unusual forms of cilia tips]. PMID- 3630332 TI - Anatomical observations in the arytenoid region of the mouse with special reference to the function of the taste buds. PMID- 3630333 TI - Macrophages in atretic process of maturing ovarian follicles in mouse. PMID- 3630334 TI - The influence of Haloperidolum on white rat kidney after surgical removal of liver lobe. PMID- 3630335 TI - The argentophil reticular cells of the mammal spleen. I. The morphology and the disposition of the reticular cells in the white pulp. PMID- 3630336 TI - [Cells and connective tissue elements of dental pulp]. PMID- 3630337 TI - Lectin-histochemistry of the teleost intestine and liver under normal and starved conditions. PMID- 3630338 TI - Histological, histochemical and ultrastructural study of the hepatic pigment of the frog, Leptodactylus ocellatus, L. PMID- 3630339 TI - Distribution of monoamine-containing neurons in the brain of the weakly electric teleost, Eigenmannia lineata (Gymnotiformes: Rhamphichthyidae). PMID- 3630340 TI - [Morphologic changes in the otoconial membrane of the macula utriculi in pre- and postnatal growing rats]. PMID- 3630341 TI - [Lymphography in Hodgkin's lymphoma. Diagnostic value based on the current status of experience and knowledge]. AB - Lymphography was carried out at least once in 355 patients with Hodgkin's lymphoma (HL). In 229 patients, there was a histological subclassification: 26 LP, 63 NS, 122 NC and 18 LD cases. The lymphographic manifestations could be subdivided empirically into two superordinate groups: 1. lymph nodes closely linked together in chains (LC) with dense structures as well as LC destructions, LC debris and 2. LC of varying size with pathological internal structure. Apart from in the NS type, a correlation between the lymphological appearance and the histological subtype could not be discerned in any other histological subgroup. After lymphography, 61.6% of stages I and II were assigned to stage III. The staging of the lymphography was: stage I 24.5%, stage II 47.3%, stage III 10% and stage IV 9%, and after lymphography: stage I 9.9%, stage II 17.7%, stage III 63.1% and stage IV 9.3%. From a qualitative point of view, lymphography is superior to all other methods in the diagnosis of malignant lymphomas and should hence be carried out obligatorily in suspicion of a malignant lymphoma. PMID- 3630342 TI - [Cases from edema consultation]. PMID- 3630343 TI - [Report of the 10th annual meeting of the German Society for Lymphology. 19-21 September 1986, Gottingen. Abstracts]. PMID- 3630344 TI - [Lymphography in malignant testicular tumors]. AB - Experience and results are reported on the basis of more than 380 lymphographic investigations in patients with a malignant testicular tumor. In 61% of these patients, there was suspicion of a metastatic infiltration of the retroperitoneal lymph nodes. In 75 patients, histological checking of the lymphographic finding was possible on the basis of a retroperitoneal lymphadenectomy. Lymphography was shown to have a precision of 81%. Lymphography is obligatory as a complement to other techniques of investigation such as sonography and computer tomography in patients with malignant testicular tumor, since the greatest diagnostic information can be expected from combined application of all three methods. PMID- 3630345 TI - [Molecular-biologic processes of the dynamics of the emotional-stress reaction]. PMID- 3630347 TI - [Adaptation to extreme conditions and the body's resistance]. PMID- 3630346 TI - [Systemic changes in arterial and venous blood flow during postural reactions]. PMID- 3630348 TI - [Status of the hemostatic system of ischemic heart disease patients exposed to emotional strain]. PMID- 3630349 TI - [Systemic and regional hemodynamics during intense mental work (in a stressful setting)]. PMID- 3630350 TI - [Oligopeptides in the organization of behavior based on self-stimulation of the brain]. PMID- 3630351 TI - [Physiologic basis of space pharmacology]. PMID- 3630352 TI - [Features of central hemodynamics during modeling of the effects of weightlessness using hypokinesia and immersion]. PMID- 3630353 TI - [Ballistocardiographic studies in weightlessness]. PMID- 3630354 TI - [Use of the technic of electrocardiotopography in the diagnosis of myocardial infarction]. PMID- 3630356 TI - [Study of lipid peroxidation processes in the blood of patients with vasculitis and spontaneous panniculitis and their correction with antioxidants]. PMID- 3630355 TI - [Regulation of the arterial lumen determined by endothelial sensitivity to blood flow velocity and viscosity]. PMID- 3630357 TI - [Study of the DNA-binding capacity of the blood serum in evaluating the activity of systemic lupus erythematosus and scleroderma]. PMID- 3630358 TI - [Characteristics of the immune system, hypophyseo-adrenal system and cyclic nucleotide balance in patients with lupus erythematosus]. PMID- 3630359 TI - [Results of serologic reactions in patients with early forms of syphilis before and after treatment with doxycycline and placental extract]. PMID- 3630360 TI - [Various socio-economic aspects of the treatment of patients with gonorrhea]. PMID- 3630361 TI - [Scientific organization of the teaching process--the most important factor in its optimal effectiveness]. PMID- 3630362 TI - [Therapy of ulcerous forms of chronic pyoderma]. PMID- 3630363 TI - [Generalized forms of herpes in lymphocytic leukemia]. PMID- 3630364 TI - [A case of a malignant form of papillaro-pigmentary dystrophy of the skin]. PMID- 3630365 TI - [Use of balneo-, peloid- and centimeter-wave therapy in the complex treatment of patients with circumscribed scleroderma]. PMID- 3630366 TI - [Glucocorticoid function of the adrenal cortex in men with gonorrhea]. PMID- 3630367 TI - [Comparative role of complex acumetry and examination of the cerebrospinal fluid in the diagnosis of central nervous system lesions in early syphilis]. PMID- 3630368 TI - [Role of peroxidation of membrane lipids in the pathogenesis of discoid lupus erythematosus]. PMID- 3630369 TI - [Functional activity of the liver in patients with infectious forms of syphilis during specific and nonspecific therapy]. PMID- 3630370 TI - [Electron microscopy study of skin lymphoma]. PMID- 3630371 TI - [Reflux nephropathy. Pathologic anatomy, differential diagnosis and etiopathogenesis]. PMID- 3630372 TI - [Endoneuronal mechanisms of reinforcement]. PMID- 3630373 TI - [Learning to differentiate microintervals of time using verbal feedback]. AB - Reaction time (RT) and the number of correct estimations of time microintervals (10 and 180 ms) between two visual stimuli were recorded in healthy subjects. It has been shown that 10 ms interval is better estimated when the stimuli are presented in the right visual field, i.e. when they are addressed directly to the left hemisphere. At the same time the number of correct estimations of 180 ms interval is greater and their RT is less when the stimuli are addressed directly to the right hemisphere. This points to different hemispheric mechanisms of time microintervals estimation. Study of the influence of different forms of verbal reinforcement on this learning has shown that after positive reinforcement (the word "good") the number of correct estimations is on average by 10% greater than after negative reinforcement (the word "error"). This may be connected with such processes as isolation and identification of erroneous reaction. PMID- 3630374 TI - [Habituation of auditory evoked potentials and emotional state]. AB - "Fast" and "slow" habituation of N1 and N1-P2 components of auditory evoked potentials was studied in healthy subjects and in depressed patients. In patients, initially more low amplitudes of N1 and N1-P2 were revealed, as well as slowing down of habituation in the beginning of stimuli series and acceleration to its end (in healthy people--the greatest habituation in the initial part of the series and amplitude increase at its end), the absence of power effect in the component N1 at reaching, in the process of habituation, of the same minimum parameters as in healthy subjects. This points to weakening of dishabituation process parallel with well expressed "slow" habituation in patients and allows to suggest at expressed negative emotions a deficit of attention processes as a result of "internal abstraction". PMID- 3630375 TI - [Neurophysiologic analysis of the critical period of delay of a reinforcing stimulus in the dog]. AB - At interval of less than 100 ms between indifferent sound and unconditioned electrocutaneous stimulation, classical defensive conditioned reflex is not elaborated in dogs, in full correspondence with literature data. But intracortical temporary connection is established; this fact is shown by electrographic phenomena, the most specific and demonstrative among them is "conditioned evoked potential". The absence of behavioural (peripheral) and presence of electrographic (central) manifestations allow to assume that for the formation of the conditioned reflex of full value the involvement is necessary of additional activational (motivational) mechanisms, connected with reticular and (or) limbic subcortical structures which do not react to the conditioned stimulus at time deficit in conditions of microdelay. PMID- 3630376 TI - [Asymmetry of the electroencephalographic manifestations of REM and slow-wave sleep in the cat]. AB - Studies were carried out on cats by bipolar electrodes implanted into symmetrical points of somatosensory cortical areas, caudate nuclei, hippocampus, lateral geniculate bodies, reticular formation of the midbrain after section of the half of midbrain tegmentum and commissural systems of the brain. Animals with sections usually have asymmetry of sleep EEG. The phenomenon is revealed of the coexistence of slow-wave and paradoxal sleep in different brain halves. PMID- 3630377 TI - [Conjugate inhibition in the presence of an eyelid reflex dominant in the rabbit]. AB - Conjugated inhibition was studied of the swallowing reflex during formation of dominant focus in the centre of the eye-lid reflex. In the initial period of the dominant focus formation when the dominant passed through the stage of summating reflex, the swallowing reflex was not inhibited. When the dominant turned to optimal stage, i. e. when it was reinforced by stimuli of various modalities, the swallowing reflex was conjugately inhibited. When the dominant turned to pessimal state, summation was not observed in the dominant focus, and conjugated inhibition went on. In the study of the influence of the eye-lid reflex on the swallowing one, it was found that during formation of temporary connection of the type of summating reflex a circular interaction between the centres took place. PMID- 3630378 TI - [Conjugation of unit activity in the visual and sensomotor areas of the rabbit neocortex during a conditioned reflex to sound and light]. AB - Conjugation of unit activity in the visual and sensorimotor neocortical areas was studied by means of histograms of cross- and autocorrelation in rabbits with conditioned reflex to light (1st group) and sound (2nd group). Relative number of neurones pairs acting in correlation in the areas remote from each other, in intersignal intervals both before and after stimuli did not differ in the 1st and 2nd groups. At the same time delays in neuronal discharges in one area after the other were different. In the 1st group animals there was a predominance of the number of visual area neurones discharging after sensorimotor with a delay up to 125 ms, in comparison with the number of sensorimotor area neurones discharging after the visual one. In the 2nd group rabbits the number of visual area neurones with such a delay of discharges after sensorimotor was less and, on the contrary, a predominance of sensorimotor area neurones was observed discharging after the visual one. The obtained results allow to suggest that neurones of the visual and sensorimotor neocortex areas form a single functional system in cases when conditioned and unconditioned stimuli are addressed to these areas and when only one of the studied areas is the projection zone for the combined stimuli. Organization of the neurones activity in systems in these two cases is different. PMID- 3630379 TI - [Activity of key redox enzymes in rabbits with different typologic features]. AB - It has been found that the activity of LDG, PDG, IDG, SDG, NADN-DG, NADFN-DG, CO, G-6-FDG and 6-FGDG in the cerebral cortex, liver and kidneys of rabbits with a strong type of nervous activity, as a rule, is higher than in the animals with a weak type of the nervous system. Between the animals with different types of the nervous system distinctions are also revealed in the character of regulation of a number of metabolic cycles. It is suggested that typological features of the nervous system are determined by the character of metabolic processes. PMID- 3630380 TI - [Behavioral tactics of rats receiving unequally distributed reinforcement in a radial maze]. AB - Rats behaviour was studied in 12-arms radial maze with food reinforcement of different volumes presented only in 6 passages. Dynamics of changes is shown in the process of learning both in the preference of the passages with greater volume of reinforcement and in the number of errors, characterizing the working and referent memories. In the trained rats, their behaviour is determined by at least two behavioural tactics: visiting more remote passages and choice in the beginning of the test of more reinforced passages. PMID- 3630381 TI - [Dominant factors of rat behavior in response to stimuli in stages]. AB - The adequacy of a modified variant of alimentary Y-maze method used by the authors was tested by studying the role of visual stage stimuli in reaction of free choice in rats. It is shown that the role of visual information is insignificant for acquiring the motor habit--finding of the shortest way to food. The dominant factors are: location of the shortest way, changing of which leads to a search behaviour by the method of "trials and errors", as well as ecologically adequate preference of edges to the center of the "distributor" and motor pretuning of the animal. Observed fixation of the choice of longer ways in comparison with the shortest one, and its stability may be explained by insufficient difference in the ways length before the reinforcement for the transformation of the habit of spatial-motor orientation into a visual one. PMID- 3630382 TI - [Effect of a low-frequency alternating magnetic field on the formation of avoidance reflexes in the rat]. AB - Alternating magnetic field with induction of 3 mTl, frequency of 10 Hz, homogenous, with impulses of sinusoidal form and a vector with horizontal direction, produces an inhibitory effect on the formation of avoidance reflexes in white rats. The after-effect of the field lasts less than 1 hour. PMID- 3630383 TI - [Functional topography of afferent projections of the horizontal division of the nucleus of the diagonal band in the dorsolateral neocortex of the cat]. AB - EPs recording under Nembutal anaesthesia during stimulation of the medial section of the horizontal part of the diagonal band nucleus (HNDB) shows a wide spreading of HNDB afferentation over the neocortex: from the frontal area to the medial and some posterior parts of the auditory, parietal areas and Ep zone, with the least activation of the latter three regions and activation increasing intensity correspondingly in the somatic zones II, I (SII, SI), motor and frontal cortex. Such reduction of signals flow intensity oriented both in caudal and ventral directions of the cortex goes with foci of maximal activity of these signals in the motor, parietal areas and zones of representation of various body parts in SI and SII. Traits of similarity and differences of signal's projections in the neocortex from HNDB and thalamic relay nuclei have been revealed. A hypothesis is substantiated on different mechanisms underlying peculiarities of influences of these subcortical nuclei on the cortex depending on the type of their afferent neuronal links in the latter and their functional role in the brain activity. PMID- 3630384 TI - [Functional features of the receptive fields of neurons of the posterior temporal cortex of the cat]. AB - Dynamic characteristics of the visual receptive fields (RF) of neurones in the postero-temporal cortical area (field 21) of alert cat were studied in prolonged repeated testings of RFs in the absence of influence controlled in the experiment. Significant fluctuations of RFs were found in the studied neurones- in changes of RFs form, their size and orientation and also in RF fragmentation, i.e. simultaneous and/or alternating appearance of separate zones (discharge centers) of RFs in the process of testing. It is suggested that plasticity and variability of neurones' RFs in time in this study are mainly due to modulating effects of extravisual structures, uncontrolled in the test,--to reticular inputs in particular. PMID- 3630385 TI - [Functional organization of the cortico-reticular system of the brain in response to physical loads]. AB - An estimation was carried out by factor analysis method of informative value of alpha-like rhythm, EEG theta-rhythm, local cerebral blood filling and oxygen tension (pO2) in estimation of functional state of cerebral structures under submaximal physical loads. Experiments were carried out on 35 rabbits with electrodes chronically implanted in the sensorimotor cortex and reticular formation. The obtained values were processed by a variant of factor analysis--a method of main components. For interpretation of factor loads matrix an orthogonal turn of factor axes was carried out according to varimax criterion. It has been established that informative value of the parameters depends on the brain structure where the given parameters were defined. Dynamics of pO2 and the theta-rhythm mostly influence the changes in other parameters. The states of structures before and during the period of physical load after-effect are mostly characterized by the brain local blood filling and less by the theta-rhythm amplitude. PMID- 3630386 TI - [Thermovision monitoring of neurografts in the rat]. AB - By thermovision technique and images digital processing, thermal fields and reactions of dorsal cortical surface of 15 white rats were studied through the intact skull in various times after transplantation of the embryonal visual cortex, amygdala and hippocampus into the visual cortex. After operation significant thermoasymmetries arise outside transplantation area which in early periods (2-15 days) are dynamic, and in 5-5.5 months become stabilized. At successful implantation, transplantat area in background state in late terms is not thermodistinct, and in pseudo-transplanted animals--is cooled. In transplantat area, a changed thermoreaction to light stimulation is recorded, and in early terms it is connected with thermal flow from neighbouring cortical sites. PMID- 3630387 TI - [Differences in the habituation of the nicotinic and muscarinic cholinoreceptors of Helix neuron PPa4]. AB - Pharmacological division of the snail cholinoreceptors population of the identified neurone RPa4 by cholinoblockators of muscarine (atropine, platyphylline) and nicotine (d-tubocurarine) receptors allowed to reveal differences in the dynamics of reversible reduction of sensitivity of these receptors during their habituation to repeated iontophoretic acetylcholine applications. Maximum desensitization of nicotine receptors is weaker, develops slower and is eliminated faster after the end of rhythmic acetylcholine applications. An assumption is made that a more rapid and deeper lowering of muscarine cholinoreceptors sensitivity is due to an increase of intracellular concentration of free calcium at their activation by the agonist. PMID- 3630388 TI - [Aggression and learning in a strain of rats predisposed to catalepsy]. AB - Noradrenaline content is lower in the diencephalon of rats with genetic predisposition to catalepsy as compared to control Wistar population. Besides, there is a statistically non significant tendency to a lower noradrenaline level in the striatum and hippocampus. Pain stimulus induces in cataleptic rats a smaller decrease in noradrenaline than in Wistar. The shock-induced aggression is higher in cataleptic rats than in Wistar. All these data point to a lower noradrenergic activity in rats with genetic predisposition to catalepsy. In cataleptic rats, both the development and extinction of the conditioned avoidance reaction is slower than in Wistar. The changes of noradrenergic activity and learning are similar to those described in chronic amphetamine intoxication. It is supposed that these changes in learning are caused by increased serotonergic (found earlier) and decreased noradrenergic activity. PMID- 3630389 TI - [Response asymmetry during mental loading in man]. PMID- 3630390 TI - [An electrode for interference-free recording of the ECG of the freely moving rabbit]. PMID- 3630391 TI - [Effect of electric stimulation of raphe nuclei and the locus coeruleus on the synchronization of cortical potentials in the rabbit]. PMID- 3630392 TI - [Role of positive emotional reinforcement in regulating systemic hemodynamics in the hypertensive rat]. PMID- 3630393 TI - [Relation between the circadian rhythm of motor activity and the behavior of the rat in the open field and in the Y-maze]. PMID- 3630394 TI - [Selective stimulation of exploratory behavior in the rat by vasopressin]. PMID- 3630395 TI - [Food-getting activity of the rat after microinjections of an enkephalin-like tetrapeptide into different brain structures]. PMID- 3630396 TI - ["Emotional resonance" responses of rats with different levels of nervous system excitability]. PMID- 3630397 TI - [Method of recording the magnetic field of the human brain]. PMID- 3630398 TI - [Device for restraining small laboratory animals]. PMID- 3630399 TI - [Health and social sequelae of drug abuse]. AB - Recent empirical data on excess mortality and excess morbidity following abuse of dependence producing drugs. The international literature is also analysed with respect to non-pharmacological risk factors, to social consequences and overall costs of drug abuse. PMID- 3630400 TI - [Developmental course of opiate-dependent patients over 6 years (1979-1985)]. AB - Drug addicts of the Basle area have been analysed during 6 years in connexion with the National Research Programme 'social integration' and also a following project. The results are contradictory to the pessimism which exists against changes of development of drug addicts. PMID- 3630401 TI - [Change in the self-concept of drug-dependent patients in inpatient care]. AB - As a rule, drug addicted people show a distinctly diminished estimate of the value of their selves. It is investigated whether this estimate changes during a inpatient stay on a drug rehabilitation ward and whether the selected methods of investigation form an adequate means of evaluating the therapeutic program. It can be shown that under certain conditions (duration of stay, compliance, problem solving ability) this is indeed the case. However, it remains an open question, whether the observed amelioration has to be viewed as a non-specific effect of the change of milieu or whether it depends on the therapeutic program offered on the ward. PMID- 3630402 TI - [Change in the duration of hospitalization and hospitalization incidence of schizophrenic patients--an assessment of an older and younger generation of patients treated at social psychiatry departments]. AB - By 120 schizophrenic patients of the out-patient clinic or the social Psychiatric Service in Zurich, all mental hospital treatments were recorded (dates of admission and discharge). 65 patients, who became ill before 1973, were compared with 55, who first became ill after 1973. The frequency and duration of the hospitalisations were examined. Three variations were employed in the statistical comparisons, regarding: age groups (generations), time periods and a combination of both. None of these three variations showed any significant difference in frequency or duration of hospitalisation. During the first 4 1/2 years of illness, both generations were similarly frequent and long in hospital, namely, on the average, 3 months per year and once every 12 to 15 months. PMID- 3630403 TI - [A vocational promoting course--initial experiences with a rehabilitation program for long-term psychiatric patients]. AB - A new programme to rehabilitate long-term, psychiatric patients with non-manual professions is introduced. The results of a limited follow-up investigation of the first 40 participants and experiences in the practical work, are discussed. 85% of the participants live outside a psychiatric institution, 50% have regular employment again. The high number of those not living in an institution and still unemployed (35%) shows also that the number of available, suital be, simple or protected situations in offices, is low. PMID- 3630404 TI - [The course of schizophrenia in continued marriage and loss of the partner]. AB - A sample representative of 52 schizophrenic patients has been studied five years after the first control. The patients with enduring relationships show a more favorable prognostic than those with a history of separation, divorce or loss of partner--especially concerning the social and professional skills. The enduring partnership is mostly evaluated by the patients as satisfactory even after repeated hospitalisations. PMID- 3630405 TI - [Incidence of broken homes in schizophrenic patients. A study of 239 patients treated at a social psychiatric department]. AB - 259 schizophrenics, 102 women and 157 men, of whom 80 were enlisted from a night clinic, 46 from the Psychiatric University Hospital and 113 from an out-patient clinic, were examined with regard to the frequency of broken home situations during their childhood. 20% had, before they were 18 yrs. old, lost a parent by death and 20% by a traumatic separation. 58% had, before they were 18 yrs. old, lost a parent or had lived together with a parent who was seriously ill or badly disturbed. No relation between the age of first illness and a broken home could, according to these research results, be established. The hypothesis that there is a higher rate of broken home situations by schizophrenics with an early outbreak of the illness, could therefore not be confirmed. Neither could a difference in the occurrence of broken home situations between males and females be observed, with the exception of the frequency of loss of parents by death, which was higher by females. The frequency of the factor 'broken home' in our examines is quite similar to the values round by Bleulers' research, 1940-1945 on male schizophrenics. PMID- 3630406 TI - [Experiences in the training of personnel in homes for the aged]. AB - This paper concerns a proposal in an area of increasing importance to social psychiatry: improving personnel training. A survey in 1980 of old age and nursing homes in the psychiatric region of the Zurich Oberland showed that a quarter of the residents suffer from psychiatric disturbances. As only 12% of the personnel have completed any nursing training, the signs of overwork and the changes in personnel are many. Therefore we have developed 2 successful methods for personnel improvement: A) Patient-centered, ongoing training sessions, and B) Periodic intensive seminars. The goal of both is to increase the professional competence of those working in these homes; to give them skills and confidence to deal with sometimes difficult patients, and to increase the likelihood of their "job loyalty". The evaluation shows a trend that such an approach helps to achieve these goals, to avoid unnecessary psychiatric hospitalizations as well as reduces the turnover of personnel. PMID- 3630407 TI - [Costs of psychiatric treatment: a comparative approach to 3 categories of patients]. AB - Based on methodology similar to that used in international studies, the calculation of costs was carried out for three cohorts of patients: schizophrenics, other psychotics and non-psychotics, taking into account the parameters of sex, age, professional employment/unemployment. Attention is paid particularly to: the preponderance of indirect costs over direct costs, the much higher level of costs for psychotic patients and amongst these above all of schizophrenics, and significant differences in this last group with regard to sex and age. As far as direct costs are concerned, no substitution of hospital costs by outpatient costs is noted; on the contrary, the cumulative effect of these two constituent parts is marked among the three cohorts no matter what parameters of analysis of data are used. PMID- 3630408 TI - [Decentralization--a social psychiatric key idea: experiences at the St. Gallen Canton]. AB - In the St. Gallen county community care was not only organised in a decentralized way but also was anchored regionally by political means. Regional societies and community politicians are responsible for organizing and funding community care. After 17 years of experience, some of the consequences of this direct political influence on community care are reported. PMID- 3630409 TI - [Supervision in social psychiatry]. AB - The clarification of the concept of supervision and its delimitation from therapy and administrative intervention by institutions superiors is followed by a sketch of its specific problems in Social-psychiatry. These are related to the patients personality structure, the patients difficulties and the specific treatment modalities. Supervision is not only important for the amelioration of therapies and the education of the younger colleagues, but for the prevention of professional diseases of psychiatric staff members too. PMID- 3630410 TI - [Characteristics of fibrin formation in stab wounds of the skin, determined by scanning electron microscopy]. AB - In an investigation on fibrin formation in skin cut wounds on guinea pigs using scanning electron microscopy, it was established that immediately after the infliction of cuts on live animals, a fine, netlike fiber structure of fibrin forms that gradually covers the entire wounded surface. In the period early after the cuts blood-forming elements attach to the fibrin net through numerous fine fibrin fibers, which incorporate a great number of thrombocytes. Postmortem investigations of these wounds showed that the fibrin net formed preserves its structure. It was also established that a fibrin net forms over skin wounds that were inflicted at different periods after death. In the wounds in the early periods after death, the fibrin net formed was very similar to the one established on wounds inflicted on living animals. Our investigation describes some peculiar characteristics of the fibrin net formed in living animals; there is a fine fiberlike net and the quantity is definitely larger. These characteristics permit the establishment of whether the wounds occurred before death and how much time has lapsed since then. PMID- 3630411 TI - [Vital reactions in Pacchioni granulations]. AB - By means of histological methods the authors examined the blood and fluid circulatory disturbances associated with cranial and cerebral injuries. The presence of vital reactions was studied by means of the combined histological study of the dura mater, pacchionian granulations and the central nervous system. Samples for histological study were taken from 115 cadavers who had suffered cranial injuries, from 15 individuals who died from destructive cerebral apoplexy caused by a disease and from 30 individuals who died of natural causes. The authors applied a special fixation and sampling technique and, using various histological reactions, the following vital reactions were observed: the appearance of blood-cell elements in the granulation, a moderate fibrin degradation product and hemoglobin phagocytosis, and occasionally lipid phagocytosis. The authors worked out a method that was shown to be highly effective in the more precise determination of the induction time of cerebral apoplexy caused by a disease and that of traumatic injury of the brain. PMID- 3630412 TI - [Hemosiderin findings in the liver, spleen and lung in newborn infants and infants]. AB - The content and distribution of hemosiderin in the liver, spleen and lungs of stillborn children, newborns and infants were determined histologically by Perl's method (Prussian blue reaction). We describe a study of 59 deaths up to the age of 2 years. The hemosiderin content depends on age and decreases with increasing age. No relevant differences were found in cases of sudden infant death syndrome (SIDS). In the liver hemosiderin is localized preponderantly in the periphery of the lobules. The spleen shows a diffuse siderosis of the red pulp. Minimal intrapleural, septal and perivasal depositions of hemosiderin can be found in the lung tissue. The significance of these findings is discussed. PMID- 3630414 TI - DIA3 phenotyping in human semen and seminal stains by isoelectric focusing. AB - The polymorphism of DIA3 was investigated by isoelectric focusing in semen samples from 235 unrelated Japanese volunteers and patients. Besides the three common phenotypes seven samples of the type 3-1 were observed. However, readable isoenzyme patterns were not demonstrated in semen samples of oligospermia under about 10 X 10(6)/ml sperm cells. The allele frequencies were DIA3*1 = 0.821, DIA3*2 = 0.164, and DIA3*3 = 0.015. The DIA3*1 frequency in oligospermia (0.765) was lower than that in normospermia (0.836). The isoelectric focusing method was successfully applied to phenotyping DIA3 in seminal stains; each phenotype was demonstrated at 37 degrees C for up to 4 weeks, at room temperature for up to 8 weeks, and at 4 degrees C for over 12 weeks after stain formation. In vaginal swabs the isoenzyme bands were very faint and not identifiable. PMID- 3630415 TI - [Sudden death in cerebral hemiatrophy]. AB - Hemiatrophia cerebri is a rare disease, and the etiology and pathogenesis remain unclear in most cases. In the present case, the marked hemiatrophy of the brain in a 19-year-old patient who died suddenly is attributed to encephalitis during early childhood and subsequent prolonged seizures. PMID- 3630413 TI - [Changes in the lung connective tissue framework in sudden infant death (SIDS)]. AB - Light microscopy findings are reported on the interstitial connective tissue framework of 45 lungs from babies who died within the first 2 years of life. Thirty were confirmed cases of SIDS and 15 were controls of similar age who died of known causes. The stains applied were H & E, PAS, Prussian blue, Elastica van Gieson, Trichrom (Masson-Goldner), Gomori's silver methenamine and Picro-Sirius polarization (modified). Particular attention was paid to type I and type III collagen, reticulin fibers and ground substance. All investigated cases showed evidence of chronic recurrent interstitial edema in a highly significant frequency and intensity in contrast to the controls. Areas of recent and persistent lymphedema were observed, some of them with reactive fibroplastic activity, which tended towards gradual fibrosis. These changes were irregularly distributed and frequently involved the mural interstitium. Considering the effects of such changes on expansibility, ventilation and perfusion of the lungs, as well as the impairment of gas diffusion, the findings described could be significant in the forensic evaluation of the signs of asphyxia found in most cases of SIDS. PMID- 3630416 TI - Anatomical interposition arthroplasty with dermal graft. A study of 51 elbow arthroplasties on 48 rheumatoid patients. AB - Seventy anatomical interposition arthroplasties of the elbow joint without ulnar nerve transposition were performed on 67 rheumatoid patients by one surgeon during the years 1978-1984. Between 1 and 6 years after arthroplasty, 51 arthroplasties were re-examined, the average follow-up being 3 years. There were 48 patients, 44 female (aged 25 to 66 years, mean 51) and four male, (aged 59 to 69 years, mean 63). The duration of the rheumatoid disease (46 cases of rheumatoid arthritis, 2 of juvenile chronic arthritis) was 4 to 33 years, mean 17 years. The disease was clinically active in 47 cases. ESR ranged from 12 to 82, mean 50. 51 elbow joints, 32 right (31 dominant), 19 left (2 dominant), had been affected for six months to 29 years, mean 8 years. 21 joints had been operated on one to four times before arthroplasty. Preoperative radiological joint destruction was of Larsen grade IV in 45 cases and of grade V in six cases. Flexion contracture was diminished from preoperative 0 degrees to 70 degrees, mean 38 degrees, to postoperative 0 degrees to 70 degrees, mean 25 degrees. Range of flexion was improved from preoperative 20 degrees to 150 degrees, mean 90 degrees, to postoperative 40 degrees to 145 degrees, mean 109 degrees. Before arthroplasty there were ulnar nerve symptoms in 13 cases, two of which had temporary ulnar symptoms postoperatively, too. After arthroplasty, eight patients had ulnar nerve symptoms, five of which had had previous operations of the joint. PMID- 3630417 TI - [Autoradiography studies of the effect of oxaceprol on the metabolism of joint cartilage in vitro and in vivo]. AB - Using the radiolabelled precursors (3H-Glucosamine, 3H-proline) and a new procedure of quantitative microautoradiography we investigated the influence of N acetyl-L-hydroxyproline (Oxaceprol) on anabolic processes in joint cartilage tissue of hens. After in vitro incubation, Oxaceprol stimulated the uptake of 3H glucosamine and 3H-proline in chondrocytes and enhanced the incorporation of 3H proline into the macromolecular structures of the cartilage matrix. Also, after in vivo intra-articular injection of Oxaceprol into the knee joints we could demonstrate a significant increase of intracellular glucosamine uptake. Because in our micro-autoradiographic detection method low molecular substances are excluded, the higher rate of precursor incorporation into cells and matrix can be interpreted as a stimulation of proteoglycan and collagen synthesis. PMID- 3630418 TI - [Percutaneous resorption of salicylic acid methylester from bathing solutions]. AB - Skin uptake of salicylic acid methylester (SAM) by bathing in PERNIONIN -Teilbad (Krewel-Werke, Eitorf) and KNEIPP-Wacholderolbad (Kneipp-Werke, Wurzburg) was researched with pigs and human volunteers. In plasma, no SAM was found, only salicylic acid (SA) and traces of salicyluric acid (SU). Skin uptake increased after every new application in 2 h. About 30 mg SAM permeated through an area of pig's skin of 300 cm2 in this time. Plasma levels after whole body bathing of man with PERNIONIN at 36 degrees C were about 0.63 micrograms/g and with Wacholderolbad about 0.37 microgram/g SA. With Wacholderolbad at 38-42 degrees C plasma levels increased to about 1 micrograms/g SA. In 24 h after bathing at 36 degrees C 329 and 304 mg SU were eliminated in urine and after bathing at 38-42 degrees C only 17.8 mg SU. From these SAM baths we found maximal plasma levels of SS in contrast to any other topical applied SS drug. Tissue levels from the application area were higher than the systemic concentration. SAM bathing is one of the most effective methods of local SS application in rheumatology. PMID- 3630419 TI - [Alexithymia without end? Attempt at a summary]. AB - The explanations for psychosomatic illnesses derived from the concept of "alexithymia" are compared and critically analyzed within the framework of their scientific development. In an attempt to define an independent psychosomatic personality structure different from the neurotic or psychotic personality structure, Ruesch formulated the concept of the "infantile personality" in 1984. During the 1960's and independent of American authors, a French group defined as alexithymic certain characteristics of a psychosomatic personality, the central aspect of which is an affective disorder. This direction in research is then analyzed from the point of view of the limits it sets and the further perspectives it opens up. PMID- 3630420 TI - [Status of indications and therapeutic interaction in dynamic psychotherapy and standard analytic treatment?]. AB - The present study concerns itself with the factors that are important in making an indication-based decision for either dynamic psychotherapy or psychoanalysis. In keeping with the interactional approach of our group, we have considered not only certain characteristics of patients but also particular initial relational patterns in the meeting between therapist and patient that lead to the establishing of indications. Examination of patient characteristics shows that older patients with less education are more likely to enter into dynamic psychotherapy but that therapists tend to be skeptical about the prognosis for therapeutic cooperation. With regard to the interaction of therapist and patient, the following specific contact and relational readiness among patients undergoing dynamic psychotherapy could be determined: These patients emphasize their autonomy by means of an over-compensatory stance in which they reject regression, thus presenting themselves as less needful of help. The therapist reacts to this stance by offering a shorter course of treatment with limited goals and less subordination to an established setting. In the case of psychoanalysis, the situation is reversed. This study further analyzes the elements of personality structure and socio-demographic background behind the relational offer of the groups indicated for treatment. A group of patients for whom there are no indications for psychotherapy is drawn upon for purposes of comparison. PMID- 3630421 TI - [Therapeutic goal of the patient as a criterion for prognosis and success of inpatient psychotherapy]. AB - We assumed that a patient's statements about what he/she wants to achieve by psychotherapy (subjective therapy-goals) may contain information about his/her capability and willingness to cooperate in the therapeutic process; insofar they are relevant for the study of indications and outcome of a psychotherapeutic treatment. We studied therapy-goals given by 480 patients during their first therapeutic contact. We differentiated the data according to contents resp. directions of expectation and conceptualized the level of intended change. 75 of the 480 patients did not receive any treatment, 43 gave up therapy prematurely. In answering the question "what do you want to achieve by psychotherapy?", which forms a part of the first interview as well as of our anamnestic questionnaire, both groups showed prognostically relevant differences in comparison to fully treated patients. For the remaining 362 patients, who had been admitted, their initial goals were compared with finally attained goals. This yielded significant results concerning success of treatment, which were validated by a simultaneous rating of therapy-goals for every individual patient by researchers resp. therapists. PMID- 3630422 TI - [Myocardial infarct (I). A psychosocial illness event]. AB - After decades of morphological, biochemical, experimental, epidemiological and clinical studies it is still not possible to throw light on the pathogenesis of coronary disease, in particular on that of the heart attack. The classical explanation for the clinical picture of heart attack and its main symptom, angina pectoris, as a clinical expression of the morphological illness of coronary sclerosis has proved to be erroneous: There are severe cases of coronary sclerosis with occlusion but no clinical symptom of heart attack, and there are severe coronary infarctions with no arteriosclerotic coronary occlusion. Several years of experimental, epidemiological and clinical study have shown that a diet rich in saturated fats and cholesterol is pathogenetically irrelevant. The solution to the question of the pathogenesis of heart attack lies in the area of psychosomatics. PMID- 3630423 TI - [Love and partnership in adulthood: a continuation or correction of early childhood experiences? A review of theoretical concepts]. AB - In this survey of literature on the subject, we discuss the question of whether or not and if so to what extent a mature, adult ability to love depends on relevant early experience, or whether it functions as a corrective to unfavorable emotional experience in early childhood. There is no compelling connection between certain disturbances of partner relations and concrete family circumstances in the first years of life. Such disturbances are regarded by traditional psychoanalysis as the result of an unresolved infantile conflict; however, since there is no psychoanalytical interaction theory for the description and explanation of interpersonal phenomena, recent discussions have drawn increasingly on a systematic approach. From a historical point of view, psychoanalytical discussions reflect essential changes in theories about the ability to love. More recent empirical studies point to a possible involvement of corrective and compensatory mechanisms for unfavorable early experiences of a medium degree of seriousness. Nevertheless, warm affection based on needs during the first years of life (at best from loving parents with a partner-oriented relationship) provides a basis for the adult's ability to love and form partnerships. PMID- 3630424 TI - [Hemodynamic aspects of bicarbonate dialysis]. AB - About the comparison of the acetate haemodialysis with the bicarbonate haemodialysis different and partly contradictory data are found in literature. In general the bicarbonate haemodialysis is regarded as that variant of therapy which has a less negative influence on the haemodynamics during the dialysis treatment. On 21 patients comparative examinations were performed with the two variants of therapy. The acute complications during the treatment were registered, the circulatory parameters blood pressure, pulse rate and cardiac output (1/min) were measured and the oxygen partial pressure was established. Comparing the two methods of therapy, no essential differences could be found. Patients with evident acetate incompatibility showed significantly more frequently clinical complications under the acetate dialysis. In the acetate dialysis the oxygen partial pressure clearly decreased which is to be discussed as cause for the circulatory instability in this therapeutic method. PMID- 3630425 TI - [Significance of parathyroid hormone (PTH) within the scope of central nervous system disorders in hemodialysis patients]. AB - The role of PTH as possible uraemic toxin within the scope of disturbances of the central nervous system (progressive dialysis encephalopathy, PDE) was investigated in 88 patients undergoing haemodialysis. A radioimmunoassay covering the C-terminal PTH fragment was used. Patients undergoing haemodialysis with a PDE showed the highest values with 2,015.4 +/- 457.9 pg/ml, and also in the preclinical stage of a PDE the PTH values with 1,845.7 +/- 663.1 pg/ml lay significantly above those ones of the patients undergoing haemodialysis without PDE (794.8 +/- 364.7 pg/ml). The findings speak for the importance of PTH in the development of complications of the central nervous system within the scope of the uraemia syndrome. PMID- 3630426 TI - [Massive, unilateral and recurrent hydrothorax in a patient in a chronic intermittent peritoneal dialysis program]. AB - It is reported on a female patient who during the intermittent peritoneal dialysis treatment acutely acquired a hydrothorax. The conservative course of treatment is described-a restitution was achieved. The patient is continued to be treated routinely in the IPD programme. PMID- 3630427 TI - [Effect of the form of anesthesia (pentobarbital, Velonarcon/Faustan) on determination of the glomerular filtration rate in the rat model]. AB - During the renal functional diagnostics at the narcotized rat in various forms of anaesthesia (Pentobarbital and Velonarcon/Faustan) the behaviour of the blood pressure was continuously registered. In contrast to the Velonarcon/Faustan anaesthesia, in which a distinct hypertonic reaction was observed which normalized itself only after 100 minutes with the Pentobarbital anaesthesia an approximately invariable constant blood pressure level lying in the renal autoregulative region could be achieved during the whole period of investigation. PMID- 3630428 TI - [The percutaneous approach to the pediatric kidney]. AB - The percutaneous access also to the infantile kidney increasingly gains significance. It is reported on experience with 16 percutaneous interventions at the kidney in 14 children. Indication, technique and complications are demonstrated, compared with literature and discussed. The percutaneous access to the kidney allows the clarification of certain diagnostic problems, guarantees the protection of the kidney in congenital and acquired obstructions, septic renal diseases, postoperative complications. The drainage of urinomas, the dilation of stenoses of the ureter as well as nephrolitholapaxia and chemolitholysis are with certain restrictions possible also in childhood. PMID- 3630429 TI - [Testicular function in obstructive azoospermia]. AB - The normal histological findings of the testicles with simultaneous azoospermia according to the former opinion renders greatly probable an obstruction of the seminal ducts. The reversed case of an ascertained obstruction, however, must not necessarily contain also normal histological structures or normal hormone tests. In the obstruction syndrome in 6 out of 23 cases we find changes in the diameter of the tubule, reductions of the spermatogenesis and changes at the interstice. Imprint-cytologically an increase of pathological spermatides at the cost of normal cell developments is shown. According to this the FSH-values are slightly but statistically significantly increased. LH, PRL and testosterone are found within the normal. For the diagnostic delimitation of the obstruction syndrome from a production azoospermia according to these findings the performance of a biopsy of the testicles with histological evaluation and the determination of the FSH-value. The relatively discrete tubular changes alone cannot be used for the explanation of the discrepancy between anatomical and functional results of the operative reconstruction of the seminal ducts. PMID- 3630431 TI - [Ureteral obstruction caused by a grenade splinter]. AB - It is reported on a 59-year-old patient who towards the end of the Second World War suffered a shell-splinter injury and was admitted to hospital under the picture of an acute ureteric obstruction with pyonephrosis 40 years after the event. One year after the operative removal of the obstructing shell-splinter again normal contrast medium excretion of the kidney affected and subjective symptom-free state of the patient. The symptom-free interval of 4 decades is remarkable. The difficulties of the establishment of the primary diagnosis as well as possible early and late complications of bullet and splinter injuries of the urinary tract are discussed. PMID- 3630430 TI - [Is there a familial aggregation of glomerulonephritis?]. AB - In the literature sporadically familial incidences of glomerulonephritis are described. As a contribution to this theme the family anamneses of 210 patients with histologically ascertained glomerulonephritis were evaluated. Apart from the genetically caused Alport syndrome an accumulation also of other form of glomerulonephritis were established in about 5% of these 210 patients. It is referred to the necessity of taking into consideration this fact but also the aimed establishment of paraclinical findings, above all of immunological parameters in members of the family in order to better answer the question of familial incidences of Glomerulonephritis. PMID- 3630432 TI - [Desmoplastic fibroma as a rare bone tumor]. AB - A desmoplastic fibroma of the left humerus with a pathological fracture in a 9 year-old girl is presented. The postoperative course was uncomplicated: no recidive occurred. The histological picture of this rare bone tumor (76 similar cases were reported in the literature) is identical both with aggressive fibromatosis and with the desmoid tumor. It contains areas with abundant collagen fibers and densely packed areas composed of fibrocytes, fibroblasts as well as myofibroblasts. Myofilaments have been detected by electron microscopy in the latter cell type. PMID- 3630433 TI - [Oropharyngeal lipoma with osseous metaplasia]. AB - A case report on an oropharyngeal lipoma with excessive osseous metaplasia in a 40-year-old patient is given. Diagnostic problems of this rare tumor type are discussed. PMID- 3630434 TI - [Congenital heart defects. Frequency at autopsy]. AB - Autopsies were performed on 3,071 stillborns and decreased children up to the age of 16 years at the Institute of Pathology of the Charite from 1969 to 1983. Congenital heart disease (CHD) was found in 814, i.e. 26.5% of the autopsies. Results of re-examination of 642 hearts with CHD are discussed. The most common malformations are ventricular septal defects, d-transpositions of the great vessels, tetralogy of Fallot and aortic coarctations. CHD was more frequently found in boys than in girls (1.5 : 1). The majority of the deaths occurred during the first year of life (78.8%). 20.1% of these took place during the perinatal period and 47.2% within the first 6 months of life. Additional cardiac anomalies were associated with the main defect in 81.8% of cases. The most common such associated defects were atrial and ventricular septal defects, aortic coarctations and other aortic arch anomalies. The frequency of extracardiac malformations in CHD was 7.2%. The most common anomalies were of the central nervous system, the gastrointestinal tract and the urinary system. Malformation syndromes were identified in 5.6% of the CHD cases, including Down's syndrome in 1.4%. PMID- 3630436 TI - Malignant oncocytoma of the breast. AB - The histopathological pattern of a malignant oncocytoma of the breast in a 46 year-old woman is described. The electron microscopy of paraffin-embedded tissue revealed an abundance of swollen, vesicular mitochondria and loosely arranged intracytoplasmic microfilaments. PMID- 3630435 TI - [Morphology of IgA nephritis (Berger disease). Immunohistologic, light- and electron microscopic findings]. AB - An IgA nephritis was diagnosed in 109 (24%) out of 445 renal biopsies with glomerular disease in the years from 1977 to 1985. The mean age of the patients in question was 29 years. The male:female sex ratio was 2.6:1. Immunohistologically, the characteristic branching mesangial IgA deposits were uniformly present. In addition 96% showed mesangial C3 and 54% mesangial IgG and/or IgM deposits. Besides, immunoglobulin and/or C3 deposits could be detected at glomerular basement membranes (20%). The histological types of IgA nephritis were minor glomerular abnormalities (10%), focal/segmental glomerulonephritis (29%), diffuse mesangioproliferative (58%), membranoproliferative (1 case), and sclerosing glomerulonephritis (2 cases). Additional tubulointerstitial lesions were found in 55%. Electron microscopically, in 53 cases under study, mesangial electron dense immunodeposits were seen. At the glomerular basement membranes, deposits could be found only in 23 examined cases (43%). The comparison of clinical data with morphological findings showed relationships between the degree of proteinuria and creatinine level increase with the histological type of IgA nephritis and with the degree of glomerular sclerosis, tubulointerstitial lesions, and electron microscopically proved glomerular basement membrane deposits. Hematuria seemed not to correlate with the morphological picture. PMID- 3630437 TI - [Value of cytologic diagnosis of pulmonary carcinoid tumors. A morphologico clinical analysis]. AB - 14 centrally and 16 peripherally located carcinoid tumors of the lung were included in the study. For the centrally situated carcinoids the cytological interpretation of imprints or smears from the surface of the biopsy specimens turned out to be superior to the histological diagnosis based on the same endoscopic bronchial biopsy. 10 out of 12 cytologically investigated cases were correctly diagnosed. In the remaining 2 cases one was misdiagnosed as a small cell carcinoma and the other one raised suspicion of malignancy (Pap-III finding), but no definitive diagnosis could be made. By contrast, out of 11 histologically investigated endoscopic biopsies from central carcinoids 5 were misdiagnosed as small cell carcinomas and in one case the material obtained endoscopically was inadequate. Out of the 16 peripheral carcinoid tumors only 5 were diagnosed cytologically: 3 by catheter aspiration and 2 by transthoracic needle biopsy. The characteristic cytologic feature of carcinoid tumors and the cytological differential diagnosis are described in detail. PMID- 3630438 TI - [A hitherto unrecognized pattern of reactions in vertebrate cells (RiV). 3. Experimental therapy with the help of RiV particle preparations in mice with mammary carcinomas]. AB - The growth of spontaneous mammary carcinomas in mice was significantly suppressed by administration of RiV-particle-preparations of different species origin (duck, cattle), the survival rate being essentially improved. Despite long-time application of RiV-preparations no side effects could be observed. PMID- 3630439 TI - [Concentration methods for the determination of phages in water]. AB - The object of the present study was to find a suitable method for the concentration of phages, especially from drinking water. Five possible ways have been tested. The technique of centrifugation utilizing a phage pre-adsorption to a particular substance (CaHPO4) yielded recoveries up to 42%, whereas no useful results by filtration through paper and membrane filters were obtained. The application of frits after phage pre-adsorption to CaHPO4 resulted in recoveries up to 80%. The method of choice evidently is that of chemical precipitation (flocculation), which allowed to recover up to 100% of the used phages. It requires the least material and technical expense, too. PMID- 3630440 TI - Kinetics of spheroplasts formation from selected yeast strains. AB - The formation of spheroplasts from several Kluyveromyces and Saccharomyces strains was studied with the Coulter counter technique. When yeasts were incubated with zymolyase, the number of intact cells decreased according to first order kinetics after an initial lag. In the concentration ranges studied, the rates were proportional to the cell-lytic enzyme concentrations. The rate (-0.099 min-1) of the most susceptible strain, K. fragilis, was 80-fold higher than that of S. cerevisiae CBS 5495. Compared to the cell sizing technique, the spectrophotometric determination leads to the underestimation of the reaction course. PMID- 3630441 TI - [Paralytic ileus--pathophysiology and clinical aspects]. AB - Causes, pathophysiological aspects, and clinical manifestations of paralytic ileus are summarised in this paper. Reference is made to possibilities and problems in diagnosis and therapy. Prerequisites and indications for and limits to surgical treatment are discussed. PMID- 3630442 TI - [Isolated injuries of the small intestine following blunt abdominal injuries]. AB - Operations were performed on 327 patients for blunt abdominal trauma at the casualty ward of the Istanbul University Hospital, over the past three years. Isolated injuries to small intestines were recorded by laparotomy from 22 of these cases. Peritoneal lavage was applied to 18 patients. Only one patient was operated on with 24-hour delay because of false negative result of lavage. Six of the above 22 patients died (27.2 per cent) despite early surgical action. Five of these six had been admitted to the casualty ward with hypovolaemic shock as well as head and extremity injuries after a traffic accident. PMID- 3630443 TI - [Assessment of postoperative wound infection in legal liability procedures]. PMID- 3630444 TI - [Nonspecific granulomatous ulcerating inflammation of the small intestine as a rare cause of ileus]. PMID- 3630445 TI - [Spieghel hernia]. PMID- 3630446 TI - [45 years of intramedullary nailing in femoral fractures]. AB - A report is given in this paper based on experiences of 814 cases of intramedullary nailing in femoral shaft fractures performed at the author's hospital between 1941 and 1985 (691 by closed and 123 by open technique). Follow up checks were made on 470 patients. Results were found to be excellent in 81.5 per cent of these cases, good in 16.1 per cent, and poor in 2.4 per cent. Infections were recorded from 2.3 per cent. The patients were further subdivided by additional relevant parameters, such as indications, concomitant injuries, and postoperative deaths. PMID- 3630447 TI - [Advantages and problems in acute management of injuries of the capsular ligament system of the knee joint]. AB - Between 1983 and 1985, immediate surgical treatment was received by 34 of 119 patients (28.5 per cent) admitted for acute injuries to capsular ligaments of the knee joint. Good results were achieved in 90 per cent of these cases. Immediate suspicion of acute capsular ligament injury on admission to the outpatient section or casualty ward, nodelay definite diagnosis, surgical action in acute condition as well as subtle and anatomically adequate restoration of all injured structures are the major conditions that must be satisfied for good success of this approved principle. Intensive physiotherapeutic after-care must be another integral component of a clearly defined therapeutic concept. Causes for delays in diagnosis and therapy are analysed, and conclusions are drawn. PMID- 3630448 TI - [Densitometric follow-up of algodystrophy using computerized tomography]. AB - Clinical and radiological findings obtained from diagnosis and follow-up examination of post-traumatic algodystrophy (Morbus Sudeck) are very much open to subjective interpretation. Decisive importance is attributed not only to alteration of soft tissue but also to typical distribution patterns and severity of bone demineralisation. No objectifiable and quantifiable have so far become available for proper assessment but are urgently desirable in view of the great number of therapeutic approaches. Densitometry integrated with computed tomography was applied to nine patients with algodystrophy of hand or foot in the region of spongy bones to determine absorption values which were then compared with those on the clinically intact side. Significant differences between sides proved to be objectifiable and were quantifiable measures by which demineralisation of the effected extremity could be assessed. Repeated examinations were undertaken for follow-up through a period up to nine months. PMID- 3630449 TI - ["Sesamoiditis" of the metatarsophalangeal joint]. AB - Reference is made to three of the authors' own cases and to relevant literature in an account of clinical manifestation, diagnosis, and therapy of osteochondrosis and osteomyelitis of the first metatarsal sesamoid bone. Eighty per cent of the incidence are related to the age groups between 13 and 22 years. The disease is probably based on aseptic ischaemic necrosis. PMID- 3630450 TI - [Irreducible dislocation of a distal interphalangeal joint--a case report]. PMID- 3630451 TI - [Overlooked injuries of the hip joint in polytrauma patients]. PMID- 3630452 TI - [Fistula cancer in chronic osteomyelitis]. PMID- 3630453 TI - [Effect of temperature on compact bone in saw cutting in relation to the conditions of use]. AB - The use of reciprocating saw blades in surgery is accompanied by occurrence of high temperatures which may imply the risk of thermal damage to tissue. The severity of such damage was found to depend on temperature level and length of its action, and this, in turn, depends substantially on tool geometry, bone condition, cutting parameters, use of cooling, and attrition of saw blade. Cutting time can be minimised by increasing of revolutions and thrust force, which will lower the temperature acting on the bone. Temperature can be substantively lowered by use of a coolant, however, at the expense of worsening cutting time. The state of attrition of the saw blade used is of crucial importance to avoidance of thermal damage. A tool getting in contact with metal in the process of saw cutting should be discarded for good. PMID- 3630454 TI - [Current aspects of surgery of benign struma]. AB - Preoperative procedures, surgical techniques, and postoperative management are discussed in this paper, against the background of latest developments and with reference to 443 struma patients who received surgical treatment in 1984 and 1985. The technique of surgical removal has been modified by the author, as compared to what it used to be back to 1964. Ligature of the inferior thyroid artery has been abandoned. The postoperative rate of unilateral nerve palsy recurrence has been reduced from 4.47 to 2.20 per cent, whereas other complications remained unchanged, such as postoperative bleeding and thyreotoxicosis. Other topical aspects resulted from modification of the regime of prophylaxis to prevent recurrence. The substitution therapy applied by late 1985 had been based on daily thyroxine doses as low as 50 micrograms, with the postoperative hypothyreosis rate reaching a level of more than 50 per cent, as early as three months after surgery. The hypothyreosis rate was lowered to something below ten per cent, after the daily T4-therapy had been increased to 75 micrograms, on January 1st, 1986. General life-long and individually adjusted prophylaxis against recurrence is ensured by regular postoperative clinical and TSH follow-up with adequately adapted thyroxine medication. PMID- 3630455 TI - [Surgical treatment of intrathoracic struma]. AB - Surgical treatment was applied to 18 patients for intrathoracic struma. Dyspnoea, dysphagia, recurrent palsy, and dilatated cervical veins with facial flushing were indications for surgery. Surgical access routes depended on localisation of the intrathoracic struma and its connection to the thyroid gland. Goitre located in the anterior mediastinum (substernal) can be extirpated, using the cervical approach (Kocher). Sternotomy was found to be necessary only in cases with tracheal resection. Goitres located in the posterior mediastinum were removed by means of right or left thoracotomy. Postoperative "collapse" of the posterior tracheal wall in patients with extreme dislocation of the trachea was successfully avoided by means of intratracheal intubation for 24 hours. PMID- 3630456 TI - [Oesophagomanometric studies in surgical treatment of esophagocardial achalasia]. AB - Reported in this paper is oesophagomanometry for diagnosis and assessment of early and late postoperative results in 31 achalasia patients. This method was used in a differentiated manner to prevent postoperative gastro-oesophageal reflux. PMID- 3630457 TI - Posterior mediastinal goiter. PMID- 3630458 TI - [Heterotopic pancreatic tissue in the corpus of the stomach]. PMID- 3630459 TI - [Effect of maternal constitutional factors and weight increase in pregnancy on the neonatal measurements of weight and length]. AB - The significance of maternal constitutional factors and of maternal body weight increase during pregnancy for the condition of the newborn was investigated in 9,578 pregnancies. Statistical calculations were made by means of two-dimensional contingency table analyses. The body size of the mother, her relative weight at the beginning of pregnancy and the increase of body weight during pregnancy were correlated positively with the measures of the newborn. The weight of newborn has been mostly influenced by the maternal body size. It seems to be necessary to include the maternal constitution in the clinical valuation of the newborn status. The use of regional correction tables enables a more exact identification of hypotrophic newborns. PMID- 3630461 TI - Amniotic bands associated with early rupture of amnion due to an intrauterine device. AB - Amniotic bands in consequence of early rupture of amnion-membrane was found in a spontaneously aborted gestational sac. This case seems to confirm the theory that amniotic bands develop due to amnion rupture principally caused by exogenous less frequently by endogenous factors. In the reported case the exogenous factor was an intrauterine device, the resulting inflammation presumably responsible for rupture of amnion. PMID- 3630460 TI - [Screening for neurosis in pregnant patients allows better detection of the risk of an underweight child]. AB - A neurosis screening was performed at the outpatient department of pregnant women in the town Karl-Marx-Stadt. In 1985 364 pregnant women received a GDR made questionnaire of troubles at the first consultation in the 12th week of gestation. Probable neurosis was found in 12 per cent. Unmarried women with probable neurosis had a low birthweight infant in 25 per cent, women with abortion or interruptio in their history in 30 per cent. The risk of low birthweight infant can be better detected using a neurosis screening. By this the obstetrician has a chance of better connection with the pregnant women debating their psychic situation. PMID- 3630462 TI - Experiences with the treatment of clinical hyperprolactinaemia. AB - 67 patients with high serum prolactin values were treated by bromocriptine (Parlodel). Parlodel was administered in 56 cases because of functional infertility, and 27 of them became pregnant. The previously given traditional ovulation inductors were ineffective in many cases. According to the authors' experience Parlodel can be favourably combined with clomiphene citrate. On the other hand, Parlodel treatment could be effectively introduced in cases with only moderately high prolactin values (400-800 mIU/ml) to restore fertility. Parlodel can be effective also in the treatment of polycystic ovarian syndrome. PMID- 3630463 TI - [Therapy of endometriosis with dienogest]. AB - Dienogest (17 alpha-cyanomethyl-17 beta-hydroxy-estra-4,9-dien-3-one, VEB Jenapharm, Jena, GDR), an orally active 19-nortestosterone derivative, was used firstly in the treatment of endometriosis. 57 patients (age 17-45 years) have been entered into the study. The diagnosis was confirmed by laparoscopy or laparotomy in 56 cases and in one case clinically. All patients have been treated with 2 mg dienogest per day in a progestin only regimen over a period of 6 month. The day after completing the course of dienogest therapy 51 patients underwent laparoscopy for control. On this basis endometriotic lesions had completely disappeared in 66.7%; in 80.4% a marked improvement was noted, but no effect was visible in 19.6% of the implants. Eighty-four per cent of the women reported symptomatic improvement. The efficacy of dienogest was correlated negative with the age of the treated women. The major side effects were spottings and decrease of libido. Blood pressure as well as mean body weight remained unaltered. No patient discontinued dienogest therapy due to side effects. PMID- 3630464 TI - [Diurnal rhythm of cortisol following spontaneous labor]. AB - The cortisol-day-rhythmic was studied in 93 spontaneously delivered newborns with a enzyme immunoassay. The results indicate that the cortisol-rhythmic is present both in umbilical cord and maternal venous blood. PMID- 3630465 TI - [Therapy of suspected intrauterine fetal retardation]. AB - In a randomized prospective study, performed on 45 pregnancies with clinical and sonographic suspicion for intrauterine fetal growth retardation, examinations were done to evaluate the therapeutic effect of bed rest and of additional daily administered glucose infusions or oral galactose applications respectively on the fetal growth, the hemodynamic, respiratory and endocrine insufficiency of the materno-feto-placental unit as well as selected biochemical parameters of the umbilical blood. There is no positive therapeutic effect, either on the impaired endocrine partial function nor on the reduced respiratory function of the feto placental unit. It is obvious, that despite the improvement of the nutritional supply of the fetus and the revival of the regular fetal growth, the previous lack of fetal growth can not be altered. This can be demonstrated in all three therapeutic groups due to the fact of a resulting high hypotrophy-rate of the newborns. The results prove that the additional supply of the fetus with glucose or galactose does not remarkably improve the therapeutic effectivity as opposed by strict bed rest alone. PMID- 3630466 TI - [Smoking behavior and its modification in pregnancy--initial experiences with a smoking cessation program for pregnant patients]. AB - Smoking attitudes are a big problem because of its wide spread among women and the consequences for their health. Therefore propagation of nonsmoking during pregnancy is an important part of prenatal care. First experiences with a test of a methodical stock elaborated especially for pregnancy make a contribution to reach the aim of stopping smoking during pregnancy. PMID- 3630467 TI - [Clinical value of determining C-reactive protein in the maternal serum in pregnancies with threatened premature labor]. AB - In this article, because of the importance of subclinical infections for triggering premature labor, we have investigated the maternal serum levels of C reactive protein (CRP) in 88 pregnancies with comparable gestational ages at the onset of premature birth symptoms. We found certain associations between possible prolongation of gestation by tocolysis and absence or presence of pathologic values of this acute-phase-protein. Positive CRP-values are associated with significantly lowered prolongation of pregnancy by tocolysis and subsequently lowered gestational age at birth. Though there are no correlations to maternal temperature and white blood cell counts, antenatal CTG-results, amniotic fluid properties and parameters of the neonate, we found probable relations to the detection of Ureaplasmas in the vaginal swabs. Once more we point out to possible associations between mycoplasmas and premature birth. PMID- 3630469 TI - The use of aminopeptidase substrate specificity profiles to identify leptospires. AB - Thirty reference Leptospira strains and twelve leptospire-like cultures were examined for aminopeptidase activity using twenty-two aminoacyl-beta naphthylamide substrates. Aminopeptidase activity was demonstrated in extracts of each of the cultures and their substrate specificity profiles compared using several computer analysis procedures. The specificity profiles were consistent for each of the strains examined. Leptospira were readily differentiated from non Leptospira strains. This was supported by DNA base ratios calculated for the strains. Of the non Leptospira strains, seven appeared similar to the "L. illini" cultured included. Two of these strains, which included the strain "L. parva" sp. nov., formed a subgroup of this "L. illini" group. Substrate specificity profiles for the L. interrogans and L. biflexa strains examined were also different from each other. PMID- 3630468 TI - Demonstration of Legionella antigen in the urine: significance for differential diagnosis. AB - The most effective techniques presently in use for the early diagnosis of Legionnaires' disease are RIA- and ELISA-tests detecting Legionella antigen in urine specimens. We are reporting on our experience with the RIA for the detection of L. pneumophila serogroup 1-antigen in the urine of 30 patients with suspected legionellosis. PMID- 3630470 TI - The role of lipids in the interaction of Acholeplasma laidlawii cells with lymphocytes. AB - The role of A. laidlawii membrane lipids in the organism's interaction with mouse spleen lymphocytes is analyzed. A. laidlawii cells were grown in a lipid-poor medium with unsaturated fatty acids that allowed cells with different degrees of membrane lipid microviscosity to be obtained. The intensity of the binding of A. laidlawii cells and derived liposomes with lymphocytes depended directly on the degree of fatty acid unsaturation. Cholesterol incorporation into the A. laidlawii membrane reduced the fluidity of the lipid bilayer and decrease the binding activity. The intensity of cholesterol transfer from lymphocytes to A. laidlawii also depended on the degree of fatty acid unsaturation in A. laidlawii cells. Cells enriched with cholesterol took up considerably less of this sterol from lymphocytes. The loss of cholesterol as well as the enrichment of lymphocytes by A. laidlawii membrane fatty acids resulted in a decrease in the microviscosity of lymphocyte membrane lipids. It was concluded that the ability of A. laidlawii cells or derived liposomes to stimulate the transport of carbohydrates into lymphocytes depended on the degree of unsaturation of fatty acid incorporated into A. laidlawii. Cholesterol also decreased the stimulatory effect, probably by lowering carbohydrate carrier mobility. PMID- 3630471 TI - The utilization of nitrate and nitrite by Streptococcus salivarius in the saliva. AB - Streptococcus salivarius BU 104 utilizes nitrate and nitrite only under anaerobic conditions and thus adds to the nitrite exposure of the human organism. PMID- 3630472 TI - Effect of culture medium on morphology and virulence of Legionella pneumophila serogroup 1. AB - In a preliminary study, the preparation of a modified charcoal yeast extract by predialysis of yeast extract (CDYE) allowed us to obtain short non filamentous forms of Legionella pneumophila ser 1 (Philadelphia) found to be more virulent in the chick embryo than the long forms grown on conventional media. We confirmed these findings in guinea pigs inoculated by either intraperitoneal injection or aerosol inhalation. LD50s were calculated using the method of Reed and Muench. Survival curves were established using Liddell's method. If for chick embryo the most virulent organisms were those derived from yolk sac culture, organisms grown on CDYE agar were more virulent than those grown on the other media. There was a significant positive correlation between the mean length of the bacilli and the log 10 of the LD50 (r = 0.96; 0.02 less than p less than 0.05). For guinea pigs by either intraperitoneal injection or inhalation we confirmed that the bacteria cultured on CDYE were more virulent than those grown on other solid media. Thus for the guinea pig inoculated intraperitoneally, the LD50s of the CDYE and BCYE cultures were 1.4 X 10(7) and greater than 3 X 10(9) CFU, respectively. The mortality of guinea pigs inoculated by aerosol with CDYE cultures was significantly higher than that of guinea pigs infected with BCYE cultures using suspensions of 10(8) and 10(9) CFU/ml (p less than 0.01) and 10(10) CFU/ml (p less than 0.05). PMID- 3630473 TI - Kinetics of humoral response during the acute and the convalescent phase of human trichinosis. AB - After a common source outbreak of trichinosis in Bitburg, FRG, 107 patients, for whom time and source of infection were precisely known, were prospectively studied for a period of eight months in order to investigate the kinetics of the humoral immune response. Antibodies were assessed by IHA, and by ELISA to quantify IgG, IgM and IgE isotypes. For four different periods of the observation time sensitivity and predictive value of tests to identify acute or convalescent trichinosis were determined. The results demonstrated characteristic kinetics of the different antibody isotypes and varying diagnostic value of the tests. Only IgG-ELISA and double-sandwich IgM-ELISA reliably identified diseased patients shortly after onset of clinical illness and showed a negative predictive value of almost 100% from seven weeks to eight months after infection. IgE antibodies and elevation of total serum IgE occurred only in about 20% of patients and showed no consistent pattern during the course of the disease. Circulating immune complexes were moderately increased four weeks after infection. They rapidly returned to normal values, after the symptoms of the acute phase had disappeared. PMID- 3630475 TI - Abstracts of papers at the session of the Virology Section of the Deutsche Gesellschaft fur Hygiene und Mikrobiologie. Bochum, October 2-5, 1985. PMID- 3630474 TI - The development and application of a bacteriocinogenotyping scheme for Vibrio cholerae non-group O-1 strains. AB - 423 Vibrio cholerae non-group O-1 strains were tested for vibriocin production using a homologous set of 7 indicator strains. Using this scheme, 334 (79.4%) strains proved to be typable. The strains isolated from 7 different geographical areas of Romania exhibited 16 different patterns of vibriocin production. The presence of a predominant pattern per year and per region was revealed. PMID- 3630476 TI - Enterotoxin production by strains of Staphylococcus intermedius and Staphylococcus aureus isolated from dog infections. AB - Sixty-six strains of S. intermedius and 10 of S. aureus isolated from infected dogs were examined for enterotoxin production. 39.5% of the strain (37.9% of S. intermedius and 50% of S. aureus) produced one or more enterotoxins. The predominant types produced by S. intermedius were C1 and C2, and only two of the strains synthesized enterotoxin A. One of the S. aureus strains produced the toxic shock syndrome toxin 1. PMID- 3630477 TI - Isolation and characterization of a staphylococcal enzyme bacteriolytic on streptococci. AB - Staphylococcus hyicus, strain CCM 2368, produced a bacteriolytic enzyme, highly effective on streptococci, some staphylococci and micrococci. Production of the enzyme increased significantly following addition of NaCl (at 1.5%) to the growth medium. The bacteriolytic enzyme could be precipitated from the cell-free staphylococcal culture supernatant with ammonium sulfate at 60% saturation and partially purified by DEAE chromatography. Subsequent isoelectric focusing resulted in complete removal of proteolytic activity and revealed 2 bacteriolytic fractions. One of these (LE IIIa) had an isoelectric point near pH 9.8, the other (LE IIIb) near pH 10.3. LE IIIa lyzed more effectively streptococcal and LE IIIb micrococcal test cells. HPLC gel permeation chromatography also yielded 2 bacteriolytic fractions. The isolated staphylococcal enzyme appeared to be suitable for lysis of streptococci and solubilization of their cell wall structures. PMID- 3630478 TI - Structure of the cell envelope of Mycobacterium avium. AB - In this report the cell wall of Mycobacterium avium is shown as a triple-layered structure where the outermost layer was stained by the ruthenium red staining for polysaccharides. The outermost layer hindered the diffusion of chemotherapeutic agents across the wall thus causing multiple drug-resistance by exclusion. The concerted electron microscopy and chemical analysis of chloroform-methanol and Triton X-100 extracts indicated that the outer layer was made of diverse amphiphil glycolipids (mycosides C, glycolipids, peptidolipids, phospholipids) that formed a matrix in which proteins were embedded. The examination of a spontaneous rough mutant indicated that mutations blocking the synthesis of one or several of the amphiphils must leave unsubstituted mycolic acid residues, thus causing surface hydrophobicity and roughness. Judging from our data, a model describing the overall cell envelope of M. avium was proposed. From the comparative analysis of M. avium, its spontaneous rough mutant, and its spheroplasts, some of the functions of the outermost layer were disclosed. PMID- 3630479 TI - Elimination of Mycoplasma from cell cultures by means of specific bovine antiserum. AB - Heifers were immunized against Mycoplasma arginini, M. fermentans, M. hyorhinis and M. orale and the antisera were applied for elimination of these species from cell cultures. From fifteen out of nineteen contaminated human and animal cell cultures the mycoplasmas could be eliminated by treating the cells with medium with 10% or 20% antiserum (eight cases) or antiserum combined with one or two antibiotics (six cases). In ten cases two treatments were sufficient, in four cases respectively four, six or eight (2 X) treatments were necessary, in one case antiserum combined with a heat treatment (42 degrees C) was successful. The efficacy of the treatment depended on the antibody titer of the serum, the contaminating mycoplasm species (M. arginini being more difficult to eliminate than the other three species) and the cells involved. The bovine sera were not cytotoxic, except for a slight toxicity for a mouse lymphoma cell line. The application of specific bovine antiserum for elimination of mycoplasmas is an easy and often successful method. PMID- 3630480 TI - [Determination of the biological activity of Clostridium difficile toxins in in vivo and in vitro experiments]. AB - The biological activity of the filtrates of 29 C. difficile strains was studied in vivo (suckling white mice) and in vitro (cell cultures of different species and origin). The action of the filtrates on the experimental models in vivo was evaluated from the cytotoxic effect index, while in vitro the intensity of the cytotoxic effect was evaluated from the percentage of dead cells in the monolayer. The results of the comparative determination of toxicity characteristics in vivo and in vitro demonstrated that cell cultures were more sensitive experimental models than suckling white mice. The use of cell cultures permitted the quantitative evaluation of the cytotoxic activity of the filtrates under study, as well as the detection of their cell-directed action at minimal concentrations. PMID- 3630481 TI - [Cellular and humoral immunity and nonspecific resistance factors in chronic opisthorchiasis patients during dispensary observation]. AB - In 116 patients with opisthorchiasis running a cholecystocholangitic variant of the disease course, the characteristics of nonspecific resistance (complement, lysozyme, properdin), cell-mediated and humoral immunity (T- and B-lymphocytes, T gamma-, T mu-, O-, D-, A-cells and auto-rosette-forming cells, IgG, IgA and IgM) have been studied. Essential changes in these characteristics before and after treatment, as well as at the remote periods of dispensary observation, have been established. PMID- 3630482 TI - [Possibility of decreasing the anticomplement activity of human immunoglobulin preparations via chemical modification]. AB - The physicochemical and immunological properties of the experimental batches of the preparations of placental immunoglobulin, obtained by some methods of chemical modification of the molecule of IgG, have been studied. The possibility of abolishing the anticomplement properties of the preparations treated with sulfitolytic agents manufactured in the USSR has been shown. The optimum conditions permitting the production of the preparation with faintly pronounced anticomplement properties and the full monomer structure of its molecule have been established. PMID- 3630483 TI - [Effect of mite allergens on the electrophoretic mobility of guinea pig lymphocytes]. AB - The use of the method of electrophoretic mobility measurement has made it possible to demonstrate that Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens are species-specific and possess common antigenic properties. The allergenic properties of D. pteronyssinus allergens are more pronounced than those of D. farinae allergens. PMID- 3630484 TI - [Trial of pertussis toxin activity in vitro on CHO cells]. AB - The activity of B. pertussis toxin has been tested in the continuous culture of CHO (Chinese hamster ovary) cells. The in vitro method of testing B. pertussis toxin is rapid, highly sensitive and specific. The unit of activity of B. pertussis toxin is higher than in mouse tests by several orders. The specificity of the action of B. pertussis toxin on CHO cells has been confirmed by the test of the neutralization of the toxicity effect with antiserum. PMID- 3630485 TI - [Significance of the rate of isolation of Klebsiella, Enterobacter, Citrobacter and intestinal Yersinia in bacteriological research]. PMID- 3630486 TI - [Analytical survey of the most important achievements in the program named the Procedure for the Vaccinal Prevention of Infectious Diseases 1979-1985]. PMID- 3630487 TI - [Relation between the course of temporal lobe epilepsy and the nature of the initial seizure]. AB - The time course of the paroxysmal syndrome was studied in 92 adult patients who developed temporal epilepsy in childhood. Characteristics of the paroxysmal clinical manifestations are collated with the paroxysmal inclusions observed in the structure of the first generalized or focal attack. Clinical and follow-up studies have shown in the majority of patients with temporal epilepsy a correlation between the onset of the disease and the forming paroxysmal syndrome. The structure of the first epileptic attack may be considered as a prognostic factor of the assessment of the clinical pattern of disease. PMID- 3630488 TI - [Psychoses and dementia in epilepsy (clinical picture, syndromokinesis, prognosis)]. AB - Using clinical, biographic and social parameters the authors analyzed the results of long-term observation on a group of patients (n = 450) with epilepsy accompanied by psychotic disturbances. Prognostic signs of a favourable variant included the predominance of homogeneous attacks and an affective structure of psychotic disorders. In cases with a moderately severe variant paroxysmal manifestations were presented by an array of temporal and unfolded convulsive forms. Psychotic disorders of the hallucinatory-delirious type serve as signs of a late exacerbation of the epileptic process. An unfavourable variant was characterized by polymorphic attacks with predominance of postural and psychomotor components, frequent states of decompensation, an increase in signs of epileptic dementia and a wide spectrum of psychotic disturbances, ranging from overworship ideas to affective-delirious and catatonic-delirious psychoses. PMID- 3630489 TI - [Value of the "startle" symptom in predicting the development of epileptic phenomena in infancy]. AB - This is the first description of the "startle reaction" observed in young children and of the technique of its stimulation. On the basis of the study of 38 children with the given symptom and of 30 control children aged up to 6 months the independence and pathologic nature of the startle reaction have been proved. 12-month follow-up of both groups has allowed the authors to draw up the conclusion about the prognostic significance of the symptom for the development of epileptic phenomena in children. A principle of preventive therapy for the prophylaxis of convulsive manifestations and reducing the duration of the anticonvulsive therapy is proposed. PMID- 3630490 TI - [Clinico-electrographic correlates of free radical pathology in epileptic patients]. AB - In a series of 62 patients with variable forms of epileptic attacks the electrochemiluminescent (ECL) parameters of free radical oxidation (FRO) and antioxidant activity (AOA), the content of malonic dialdehyde (MDA) and free fatty acids (FFA) in the blood and cerebrospinal fluid (CSF) were collated with clinico-electroencephalographic characteristics of the disease. The CSF of all patients showed intensified FRO and inhibited AOA which significantly prevailed in cases of uncontrolled paroxysms; for all cases a progressive course of the disease with the development of encephalopathy and psychopathologic syndromes was characteristic, as well as generalized and frequent attacks, the presence of extraparoxysmal epileptic patterns on the ECG and the postparoxysmal syndrome. The spectrum of FRO and AOA parameters in patients with "forced normalization" and signs of drug poisoning are similar to quantitative characteristics of FRO and AOA in cases of frequent attacks and EEG characteristics of the paroxysmal type. The results of the study allow the conclusion that FRO and the electrochemical substrate of epileptization are two parallel closely related processes. PMID- 3630491 TI - [Deviant behavior of epileptic children]. AB - The main clinical forms of deviant behaviour observed in 300 epileptic children are presented. Behavioural deviations in children are considered as a result of brain organic damage or educational defect or a combination of these factors. Ways for medical and pedagogical correction of deviant behaviour in this group of patients are outlined. PMID- 3630492 TI - [Kinesigenic paroxysmal dyskinesia: an idiopathic variant and a case caused by hypoparathyroidism]. AB - The authors present a brief review of modern literature on paroxysmal dyskinesia. Two cases of kinesigenic paroxysmal dyskinesia (KPD) are described. In the first case (a 22-year-old man) attacks first developed at the age of 14 years. The disease was sporadic in nature and was attended by tapeto-retinal abiotrophy. Attacks were fully eliminated by the treatment with diphenin (phenytoin) or finlepsin (carbamazepin). The second patient, a 14-year-old boy, presented moderate intellectual disorders, parkinsonism and KPD attacks in the absence of a tetanic symptom complex. Some of the KPD attacks in this case, as in the first patient, developed during running, with some of the paroxysms being attended by backward running. Paraclinical examinations made it possible to diagnose pseudohypoparathyroidism. Therapy with dihydrotachysterol and calcium preparations brought about a dramatic clinical improvement, in particular a complete cessation of KPD attacks. PMID- 3630493 TI - [Hemosorption in status epilepticus and serial epileptic seizures]. AB - Hemosorption was performed in 8 patients with a resistant status epilepticus and serial epileptic attacks; arrest of the attacks correlated with significantly faster and stabler normalization of the circulating levels of immune complexes and of the phagocytic activity of neutrophils as compared to the same parameters in patients receiving a course of conventional anticonvulsive and dehydration therapy without hemosorption. The data obtained point to the advisability of the inclusion of hemosorption into a multiple modality treatment of patients with a persistent grand mal status and serial epileptic attacks. High circulating levels of immune complexes in the blood serum may be considered as indication for hemosorption. PMID- 3630494 TI - [Epileptic studies in the Baikal-Amur Main Line zone]. AB - A comprehensive examination has covered 75 epileptic patients. It has been established that there are no specific epileptogenic conditions in the studied region and that the development of cases of epilepsy in the region of the Baikal Amur railway is due to the migration of patients. The development of epilepsy in children is largely related to perinatal factors. PMID- 3630495 TI - [Work capacity prognosis of epilepsy patients based on follow-up data]. AB - The author considers the possibility of predicting the working ability in epileptic patients on the basis of the assessment of the disease gravity on the whole and at various stages of its course. It has been established that the prognosis of the working ability largely depends on clinical (biological) and social factors (working education, familial status, living conditions, etc.). PMID- 3630496 TI - [Rehabilitation of epileptic patients in an outpatient setting]. AB - The work is devoted to the rehabilitation of epileptic patients under outpatient conditions. On the basis of the data of epidemiologic studies the author considers the specific nature of rehabilitation measures provided to patients on an outpatient basis, describes the drawbacks of drug therapy, and proposes new forms of the organization of specialized cost-effective medical care to patients (a regional epilepsy centre). PMID- 3630497 TI - [Value of complamin and seduxen in the correction of hemodynamic disorders of epileptic children and adolescents]. AB - Children and adolescents with an unfavourable course of epilepsy received a multiple modality treatment including complamin (xantinolnicotinate). Thirty of the 36 patients showed positive response which was twice as much as in patients receiving only anticonvulsive drugs. The study of the cerebral hemodynamics with the help of regional cerebral blood flow determination by means of intravenous administration of 133Xe and REG showed a tendency to normalization of the vascular supply to the brain. In 66 of the 87 epileptic patients studied the employment of diazepam improved the microcirculation of the cerebral tissue and the venous outflow from the cranial cavity which allows the recommendation of diazepam as a vasoactive agent. PMID- 3630498 TI - [Folic acid treatment of epileptics]. AB - The author describes the regimen of treatment with folic acid employed in 137 patients with epilepsy. The drug was given to 81 patients to control a complex of disturbances (psychic, neurologic, somatic) caused by folic acid hypovitaminosis secondary to a prolonged use of diphenin, phenobarbital and hexamidine and to another 56 patients to prevent its depletion and to improve the psychic condition. The author considers the questions of the theoretical justification of the pathogenetic treatment with folic acid of epileptic patients. PMID- 3630499 TI - [Prevention of endogenous (multifactorial) mental disorders]. AB - The available knowledge about the pathogenesis of multifactorial ("endogenic") mental diseases is insufficient. The currently employed prophylaxis may, therefore, be characterized as only an initial stage of the development of research programmes. A programme on the identification and study of the constitutional and genetic carrier should be coupled with a programme on the investigation of psychosocial factors which serve as triggers for a hereditarily liable individual. The main and most difficult task associated with it is the determination of the so far evading specificity of interaction of biological factors with those social factors in these individuals which remain nonpathogenic for most people. With regard to secondary prophylaxis of particular importance nowadays becomes the early detection and diagnosis of psychic disturbances at the borderline level, predominantly under general in- and outpatient conditions. PMID- 3630500 TI - [The character of cortico-subcortical relations in neurotic patients (according to EEG findings)]. AB - Electroencephalographic examinations have been carried out in 179 neurotic patients. Five types of the EEG have been identified depending on the nature of cortico-subcortical interrelations. Types 1 and 2 are normal variants; types 3, 4, and 5 are abnormal. It has been ascertained that in patients with hysteria normal EEG types occur less commonly while irritation of the posterior hypothalamus is much more frequent as compared to neurasthenic patients. It has been established that an injury or neuroinfection are responsible for pathologic EEG alterations. PMID- 3630501 TI - [Clinical patterns in the development of hypochondriac disorders within the framework of different mental illnesses]. AB - The authors have examined 106 patients with hypochondriac states developing in the presence of various mental diseases. The patients are divided into three nosological groups: psychogenic, exogenic-organic, and endogenic. Variants of the hypochondriac syndrome occurring in each group of the disease are described. Characteristics of the time-course of hypochondriac symptomatology and the stages of the formation of hypochondriac disturbances in relation to their classification with one or another nosological group are outlined. PMID- 3630502 TI - [Neurologic mechanism of the unconscious craving for alcohol in chronic alcoholic patients]. AB - The author studied cortical mechanisms of the perception of subconscious motivationally meaningful word "vodka" in patients with chronic alcoholism. Clear cut diffuse activation of the cerebral cortex in response to a subconscious verbal stimulus was identified through recording evoked cortical potentials which are a sensitive indicator of reactivity of the cerebral structures to alcohol. The elucidated cortical activation may be one of the nervous mechanisms of stable craving for alcohol which is poorly controlled by the patient's conscious experience. PMID- 3630503 TI - [Clinical picture and genesis of neuropsychiatric disorders in the Morgagni Stewart-Morel syndrome]. AB - On the basis of thorough investigation of 5 patients with Morgagni-Steward-Morel syndrome the authors infer that the formation of endocranial exostoses in these patients is to certain extent independent of the development of other clinical symptoms, including psychopathological ones, and that the latter are nonspecific for the above syndrome. PMID- 3630504 TI - [Various aspects of the pathogenesis, clinical picture and treatment of migraine]. AB - In a series of 108 patients with migraine the authors studied the characteristics of the emotional-personality sphere and autonomic nervous system, as well as the status of the brain nonspecific systems. The findings of nocturnal electropolygraphy were also used in the study. The efficacy of drugs with antiserotonin action versus multiple modality therapy was compared. The observed disorders in the psychic, autonomic and endocrine systems are interpreted as a consequence of dysfunction of the central integrative cerebral apparatuses. The most effective approaches toward the multiple modality therapy of migraine patients have been developed. PMID- 3630505 TI - [Recovery of movement and sensation after suturing the median and ulnar nerves of children and adults]. AB - A clinical study of 32 children and 136 adults followed up for 1 month to 5 years and more after an epineural suture has shown that in children the restoration of movements and sensitivity is 1.5-2 times faster than in adults. Motor function is restored to a fairly good extent in over 60% of both children and adults. Sensitivity in children recovers much better than in adults. PMID- 3630507 TI - [Shunt surgery in occlusive processes in the posterior cranial fossa of children]. AB - Shunting of the cerebrospinal fluid by drainage systems of various design was conducted in 64 children aged from 4 months to 14 years with occlusive processes in the posterior cranial fossa. The occlusion was caused by a tumor in 57 cases and by an arachnoid cyst in 7 cases. All children were related to the high risk group, i. e. the prognosis of direct manipulation on the posterior cranial fossa was poor or doubtful. In 26 children surgery was limited to a shunting operation without subsequent intervention on the posterior cranial fossa. The successful implantation of the drainage system was recorded in 45 children (70.2%). In infants and young children as well as in older ones with sharply manifested hypertensive and secondary stem symptomatology the outcome was much better when the shunting operation was conducted before or at the same time as the intervention on the posterior cranial fossa. The prognosis is poorer in infants and adolescents and in primary tumors of the brain stem. PMID- 3630506 TI - [Sensory-pain adaptation in clinical neurology]. AB - The article presents quantitative (temporal) and qualitative (phenomenological) characteristics of sensory-painful adaptation in clinically healthy subjects of various age and in patients with neuroses and organic lesions of different levels and of variable genesis. It has been ascertained that investigation of sensory painful adaptation may be of a certain diagnostic significance. PMID- 3630509 TI - [Principles for making the diagnosis of craniocerebral injury]. AB - The structure of the diagnosis of craniocerebral trauma in the acute period was elaborated in conformity with its common clinical classification. The authors substantiate the necessity for supplementing the general nosological characteristics of the injuries to the skull and brain with a specification of all anatomical and principal functional components of the trauma, which are listed in order of their importance for the therapeutic policy and the outcomes. PMID- 3630508 TI - [Passive hemagglutination reactions in intracranial and intraspinal neoplasms]. AB - With the use of a system of serological reactions (PHAR) on the basis of erythrocytic diagnosticums in neurosurgical patients (58 with tumors of the brain, 11 with tumors of the spinal cord, 112 with tumor-like diseases of the brain, 50 with lesions of the spinal cord marked by a tumor-like course) and in a control group of individuals (100 donors and 30 patients with tumors of the mammary gland and intestine) results were produced which bore evidence of the high specificity of the methods for detecting signs of brain damage and determining the histological nature of tumors of the brain and spinal cord in most patients. For instance, the histological nature of the tumors was identified in the preoperative period in 79% of patients with intracranial and in 73% of those with intraspinal new growths. PMID- 3630510 TI - [Rheography of the open spinal cord in primary tumors]. AB - The author discusses experience in the study of regional spinal blood filling and vascular tension by rheomyelography in the stages of neurosurgical intervention in 90 patients with primary tumors of the spinal cord. Statistically reliable data were obtained on blood filling of the spinal cord vessels and vascular tension according to the position of the tumor in relation to the diameter and length of the spinal cord, the histological structure of the tumor, and the degree of subarachnoid space block. PMID- 3630511 TI - [Discogenic lumbosacral radiculomyeloischemia]. AB - The perimedular venous system and the anatomotopographic features of the root veins at the level of the lower half of the spinal cord were studied on 15 specimens. Fifty patients with ischemic affection of the spinal cord due to compression of a large root vein by Schmorl's body in the lumbar segment were examined. The diagnosis was verified in all patients by pneumomyelography and during operation. The specific features of the clinical picture of diskogeno venous radiculomyeloischemia are pointed out. The indications for neurosurgical intervention in these patients are discussed from analysis of the outcomes of operative treatment. PMID- 3630513 TI - [Surgical treatment of a suppurating craniopharyngioma]. PMID- 3630512 TI - [Alloplasty of nerves using cryopreserved grafts subjected to total epineurectomy (experimental-clinical study)]. AB - It was demonstrated in experiments on 24 dogs that microsurgical epineurectomy of a cryopreserved peripheral nerve improves the results of neuroplasty due to acceleration and increase of graft revascularization. From application of the developed method in 12 patients it was concluded that microsurgical alloneuroplasty with a cryopreserved graft may be the method of choice in cases in which autoplasty cannot be performed. PMID- 3630514 TI - [Reactions of the thyroid gland in the acute period of craniocerebral injuries]. AB - The authors analysed individual graphic images of the hormonal profile according to the content of thyroid hormones (T4, T3) in blood of 32 patients with severe and moderate brain contusion. Four types of thyroid gland responses can be distinguished according to the severity and clinical features of the contusion, which can be used as a differential-diagnostic and prognostic criterion in certain types of craniocerebral trauma. PMID- 3630515 TI - [Endocytosis and embryonic induction]. PMID- 3630516 TI - [A comparative study of plasminogen activator activity of rat ovarian follicles and the effect of gonadotropins]. PMID- 3630517 TI - [PNA-glycoprotein patterns of the chick retina during embryo development]. PMID- 3630518 TI - [On the excitability of the epidermis and the atypical epidermis of Cynops orientalis embryos]. PMID- 3630519 TI - [Membrane GM1 ganglioside mediated endocytosis of the cholera toxin-horseradish peroxidase complex (CT-HRP) in cultured neurons]. PMID- 3630520 TI - Modulation of the substrate specificity of purified human protein kinase C by its activators. AB - The substrate specificity of purified human protein kinase C was modulated by 12 O-tetradecanoyl-4 beta-phorbol-13-acetate (TPA), dioleoylglycerol, arachidonic acid and lipid A when histone type III-S and myelin basic protein were used as phosphate acceptors. Each activator also showed a distinct pattern in the stimulation of phosphorylation of the kinase itself and of cytosolic placental proteins. The nature of the substrate and the presence of calcium and phospholipid determined the magnitude of the effect observed upon addition of all activators and also the dose dependency of kinase activation by TPA. The apparent Km value for phosphorylation of histone type III-S by the kinase activated by phorbol ester alone and with calcium was 20-30 fold higher than that observed for the enzyme activated by calcium and phospholipid. These observations indicate that the nature and extent of cellular response induced by the activation of C kinase(s) may be determined by the type of cellular stimulus. PMID- 3630522 TI - Determination of thermodynamic constants for agonist binding to muscarinic receptors from rat cerebral cortex. PMID- 3630521 TI - Kinetic resolution in the oxidation of iminium ion to lactam catalysed by aldehyde oxidase. AB - A rabbit liver enzyme preparation oxidised racemic iminium ions 1 and 2 to optically active lactams 3 and 4 with enantiomer ratios ER/S = 5.5 and 0.14, respectively. PMID- 3630523 TI - Influence of injury and nutrition on muscle water and electrolytes: effect of severe injury, burns and sepsis. AB - The changes in water and electrolyte metabolism associated with severe injury and sepsis are well recognized but changes in tissue content have seldom been available. This report combines the experience obtained from muscle biopsies of such patients performed in two centers; one located in Sweden and one in the U.S. Normal values for muscle water and electrolytes in each center are in close agreement. Needle biopsies of muscle were performed in 45 Swedish patients and 17 U.S. patients at intervals after injury or infection from the second to the thirtieth day. The patients' nutrition varied from brief periods of hypocaloric intake to prolonged high calorie parenteral nutrition with and without amino acids, as well as with and without fat. Prominent changes appeared during the first week and persisted up to 30 days regardless of the associated nutritional intake. These changes included an increased total muscle water, extracellular water, sodium and chloride and a decrease in muscle potassium and magnesium. This study demonstrates a simultaneous expansion of extracellular volume and a loss of intracellular components. This is in contrast to the experiences reported with less severe injury such as elective operation, where a more modest expansion of extracellular volume is seen and which is not associated with any loss of potassium or magnesium. The magnitude and persistence of these changes in muscle tissue deserve further study, both as to mechanism and implications for therapy. PMID- 3630524 TI - Pathophysiologic significance of lung granulocytes in human adult respiratory distress syndrome induced by septic or traumatic shock. AB - To evaluate the significance of lung granulocytes in the adult respiratory distress syndrome (ARDS), 12 ARDS patients were studied with bronchoalveolar lavage (BAL) within 4-12 hours after clinical diagnosis of the syndrome. The specificity of pulmonary granulocytes in ARDS was investigated in comparison with five patients requiring ventilator treatment for cardiogenic pulmonary oedema and 17 normal patients about to undergo cholecystectomy. The percentage of granulocytes among recovered BAL cells was significantly higher in ARDS (77 +/- 18, M +/- SD) than in the cardiac (7 +/- 4) or the normal (1.5 +/- 1.0) group. In serial BAL (48-hour intervals) in five ARDS patients, significant reduction of granulocytes 86 +/- 11----32 +/- 10%) accompanied clinical improvement. The percentage of granulocyte in BAL correlated significantly and inversely with the PaO2/FiO2 ratio (r = -0.98), and in ARDS it was significantly higher after septic than after traumatic shock (89 +/- 14 vs. 55 +/- 12). Myeloperoxidase, a specific constituent of neutrophils, was significantly and inversely correlated with PaO2/FiO2 ratio (r = -0.62). The findings suggest a role for activated granulocytes in the lung, with release of tissue-damaging substances, in initial ARDS pathogenesis, notably when the syndrome is sepsis-induced. PMID- 3630525 TI - The effect of hemorrhagic stress on liver gluconeogenesis. An isolated rat liver perfusion study with three-carbon units as substrates. AB - This effect of hypovolemic stress on hepatic gluconeogenesis has been studied using isolated perfused organs obtained from starved rats subjected to 60 min hemorrhagic hypotension at 70 mmHg. Four different substrates were used: lactate, pyruvate, glycerol and alanine. The substrates were added without any stress endocrine stimulation in the perfusate. Using a recirculating system and supraoptimal substrate availability, a significant higher rate of gluconeogenesis was confirmed for the stressed donor livers: glycerol (+100%), alanine (+97%), lactate (+64%) and pyruvate (+62%). Glucose accumulation was linear for all control and experimental groups. In the absence of added stress hormones, known to stimulate gluconeogenesis, the findings are concordant with an in vivo hormone activation of key enzymes in the gluconeogenic pathway, persisting for the 60 min duration of the in vitro perfusion. PMID- 3630526 TI - Response of human monocyte phagocytosis to FAM (fluorouracil, adriamycin, mitomycin). AB - The immunosuppressive effect of chemotherapy associated with surgery is poorly understood. The effect of combination chemotherapy--fluorouracil, adriamycin and mitomycin (FAM)--on monocyte phagocytosis was tested in patients operated on for gastric cancer. The adherence, engulfment and total phagocytic process were studied with a fluorescence-quenching technique 1 hour, 24 hours and 1 week after 19 FAM treatments in nine patients. The engulfment of yeast cells and the total phagocytosis were significantly impaired 1 hour post-treatment (p less than 0.05 and less than 0.01, respectively). These functions had normalized after 24 hours, but after 1 week the engulfment step was significantly depressed (p less than 0.05). Significantly increased adherence of yeast cells (p less than 0.05) was found at the same time. The initial, transient depression of monocyte phagocytosis probably was related to inactivation of cell-surface receptors. The late (1 week) depression probably was due to bone-marrow toxicity. This functional impairment of the blood monocytes was not reflected as clinical liability to infections. PMID- 3630528 TI - An endoscopic study of ulcer recurrence and mucosal changes following vagotomy and excision of gastric ulcer. AB - Follow-up of patients operated on for gastric ulcer--137 with selective gastric vagotomy (SGV), pyloroplasty and ulcer excision (1967-1976) and 72 with proximal gastric vagotomy (PGV) and ulcer excision (1974-1984)--was supplemented with data from recent clinical, endoscopic and biopsy studies in 78 of the patients. Ulcer recurred in 27/137 SGV and 7/72 PGV cases (20.3 and 9.9%). Four patients died of gastric cancer 5-7 years after SGV. Of the endoscopically reexamined patients, 1/42 with SGV and 1/36 with PGV were found to have asymptomatic ulcer. The incidence of gastric stasis with food retention was 35.7% in the SGV, and 8.3% in the PGV group, and the respective incidences of severe gastric mucosal inflammation with fibrinous deposits were 42.9% and 2.7%. Mild or moderate dysplasia was shown in biopsies from 16.6% of the SGV and 8.3% of the PGV group. The high dysplasia incidence, especially after SGV, and the four gastric cancer deaths in that group indicate a need for long-term follow-up evaluation of possibly increased gastric cancer risk following vagotomy. PMID- 3630527 TI - Plasma heparin cofactor II, protein C and antithrombin in elective surgery. AB - The coagulation inhibitors heparin cofactor II (HC II), protein C (PC) and antithrombin (AT) were measured in 14 patients undergoing uncomplicated abdominal, orthopedic or vascular surgery. Marked transient decrease of all the inhibitors was found after all surgical procedures, most prominently in vascular surgery. The greatest mean reduction was in HC II. The fall in PC and AT showed a pattern similar to that of albumin. In contrast to some earlier suggestions our results indicated that, except for HC II, the reduction probably was not due to consumption. Redistribution, hemodilution and, probably, reduced synthesis were the most important contributing factors. Serial measurements of the three coagulation inhibitors may be of prognostic value, but the present study's observed mean decrease of c. 25% in abdominal and 50-62% in vascular surgery must be borne in mind. Still lower inhibitor levels suggest consumption and a complicated postoperative course. PMID- 3630529 TI - Intestinal obstruction with strangulation of the small bowel. AB - The records of 128 patients operated on for adhesive complete mechanical obstruction of the small intestine were retrospectively reviewed. The gut proved to be strangulated in 53 cases, irreversibly in 16 and reversibly in 37, while 75 patients had simple obstruction (12, 29 and 59%). Continuous abdominal pain was more common in strangulation than in simple obstruction and leukocytosis was most common in irreversible strangulation (both differences significant). But no preoperative clinical parameter was specific for strangulation obstruction. Preoperative hospital stay greater than 25 hours was significantly more common in irreversible strangulation obstruction than in the other groups. Strangulation was preoperatively recognized in only 25% of the cases. The overall mortality rate was 5.5%, but with no statistical intergroup difference, possibly because so few patients died. The study showed that strangulation usually is unrecognized preoperatively, and that early operation is essential for obstruction due to intestinal strangulation. Early surgery is therefore indicated in most cases clinically diagnosed as intestinal obstruction. PMID- 3630530 TI - Massive retrogastric bleeding caused by neurofibroma. Case report. AB - A case of massive retrogastric bleeding from a neurofibroma arising from the gastric wall is described. The tumour was removed without opening the gastric mucosa. The possibility of neurofibroma should be borne in mind when there is unexplained bleeding from the digestive tract or the intraperitoneal or retroperitoneal space, particularly in patients with von Recklinghausen's disease. PMID- 3630531 TI - Gardner's syndrome with gastric and ileal polyposis. Case report. AB - A case of Gardner's syndrome with multiple colorectal carcinomas and polyposis of duodenum, ileum and stomach is reported. The patient was treated with colectomy, mucosal proctectomy and ileoanal anastomosis with ileal reservoir. The rationale of saving ileum and the anal function in presence of ileal adenomas and intramucosal rectal cancer is discussed. PMID- 3630532 TI - Massive hematemesis due to an aorto-oesophageal fistula. Case report. AB - A patient with massive hematemesis due to an aorto-oesophageal fistula is presented. An aorto-oesophageal fistula is mostly a fatal disease. In the literature it is pointed out that recognition of the clinical syndrome with midthoracic pain, massive arterial hemorrhage and exsanguination after a symptom free interval might ameliorate the prognosis. In the reported patient the correct diagnosis was not immediately suspected. The patient, however, survived a long operation and exsanguination without any major postoperative complications or sequelae. PMID- 3630533 TI - Histological and histochemical skin changes in insulin-dependent diabetic patients with and without limited joint mobility. AB - We studied 24 skin biopsies of the hand in 24 IDDM patients followed at the National Institute of Endocrinology (NIE). Biopsies of 7 healthy individuals were used as controls. The diabetics were divided into two groups, with limited joint mobility (LJM) and without LJM. We compared the different structural components of the skin, and their changes; we used quantitative, semi-quantitative and qualitative methods. We found that patients with LJM had a greater levelling, less rete pegs and dermal papillae (p less than 0.05), increased alteration of the mucopolysaccharides distribution (p less than 0.005), higher frequency of alterations of the elastic fibers (p less than 0.05) and collagen (p less than 0.005), vessel enlargement (p less than 0.025) acquiring cord shape, and reduction of the vessel lumen (p less than 0.005) in comparison with patients without LJM and controls. This could be a consequence of the chronic hyperglycemia from childhood that affects the structure, architecture and function of collagen fibers. Genetic and immunologic studies could help to elucidate the mechanisms of this alteration. PMID- 3630534 TI - Vitamin E status in normocholesterolemic and hypercholesterolemic diabetic patients. AB - The close relationship between vitamin E, lipid and prostaglandin metabolism stresses the need for an accurate definition of the status of vitamin E in a diabetic population. Plasma vitamin E and plasma lipids were determined in 34 type I and 21 type II normocholesterolemic and in 7 hypercholesterolemic diabetics. They were also measured in 62 age- and sex-matched controls, 34 normocholesterolemic controls for type I, 21 normocholesterolemic controls for type II and 7 hypercholesterolemic individuals. Plasma vitamin E levels were not significantly different in type I and type II diabetics as compared to their respective control groups. Vitamin E levels were significantly increased (p less than 0.001) in hypercholesterolemic individuals, both in diabetics and in non diabetics. The vitamin E/cholesterol ratio in these subjects was, however, not different from that of normocholesterolemic. Plasma vitamin E was correlated with plasma lipids, especially with total and LDL-cholesterol (p less than 0.001). Since vitamin E is mainly transported by plasma lipoproteins, these strong correlations suggest that changes in plasma vitamin E should be considered as an epiphenomenon of altered plasma transport capacity. PMID- 3630536 TI - Evaluation of central nervous conduction by visual evoked potentials in insulin dependent diabetic children. Metabolic and clinical correlations. AB - Peripheral neuropathy is a well-known complication of diabetes, but few data are available on central lesions. Visual evoked potentials (VEPs) seem a reliable and feasible technique for detecting a conduction delay in the central nervous system. Seventy-one insulin-dependent type 1 diabetic children (mean age 15 +/- 3 years) and 33 controls were investigated for central neuropathy. We used a pattern of reversal stimulation with television display of a checker board pattern (15 min and 30 min check size). The latencies of the positive peak (P100 wave) were significantly lengthened in 17 patients (27%) but no correlation was found between VEPs and age, duration of diabetes, insulin requirement and HbA1 level. A negative correlation was found between VEPs and peripheral nervous conduction velocity. VEPs measurement seems a simple and reliable technique for detecting early alterations in CNS function in diabetics. Our data suggest that central and peripheral nervous alterations progress simultaneously. PMID- 3630535 TI - Analysis of membrane fluidity alterations and lipid disorders in type I diabetic children and adolescents. AB - The degree of random orientation of excited diphenylhexatriene molecules in isolated erythrocyte membrane ghosts was investigated in order to determine the possible effect of lipid disorders on membrane structure in children suffering from type I diabetes mellitus with and without diabetic retinopathic lesions. A decrease of cholesterol in the antiatherogenic fraction HDL (1.17 +/- 0.06 in retinopathy vs 1.24 +/- 0.065 in controls) and its increase in atherogenic LDL fraction (3.88 +/- 0.23 vs 2.63 +/- 0.26) as well as developing erythrocyte membrane rigidization in diabetes and retinopathy (0.193 +/- 0.008 and 0.204 +/- 0.014 vs 0.161 +/- 0.008 in controls) were observed. Considerable fluctuations in plasma and membrane cholesterol:phospholipid ratio were most pronounced in subjects exhibiting diabetic background retinopathy. The content of membrane cholesterol compared significantly with both membrane fluidity (r = 0.677), cholesterol of LDL (r = 0.667) and cholesterol:phospholipid ratio in HDL (r = 0.693) which suggests a destructive effect of lipid disorders on cell membrane structure in diabetics. PMID- 3630537 TI - Aspirin and non-enzymatic glycation. PMID- 3630538 TI - Retrospective glycemic status of diabetic patients: glycosylation of blood proteins in diabetes and chronic renal failure. AB - In vivo and in vitro studies were carried out to evaluate the clinical application of glycosylated hemoglobin and plasma proteins in the diagnosis and management of diabetes mellitus. Glycosylated hemoglobin registered an almost 80% fall in diabetic patients following controlled glycemia for two months while glycosylated plasma protein level registered an 80% fall in the patients after fifteen days of blood glucose homeostasis. Human serum proteins were glycosylated in vitro and glycosylation was linearly proportional to the glucose concentration and incubation time. Polyacrylamide gel electrophoresis of glycosylated serum proteins revealed that albumin and transferrin are the major proteins that are significantly glycosylated. Glycosylated hemoglobin and plasma protein levels were also increased in chronic renal failure patients without any history of diabetes. PMID- 3630539 TI - Influence of the environmental temperature on the post-partum testosterone surge in the rat. AB - In the neonatal male rat, a rapid and transient increase in serum testosterone occurs about 2 h after birth. This post-partum testosterone surge (PPTS) has been implicated in the masculinization and defeminization of the central nervous system. The present study shows that environmental temperature can have a profound influence on the PPTS. Male rats were delivered from their mothers by caesarean section on day 22 of gestation. Immediately thereafter, neonatal males were placed at an ambient temperature of either 18, 21, 24 or 30 degrees C. With 2 h of exposure, the body temperature was in close correspondence with the ambient temperature. The PPTS was clearly abolished in the pups exposed for 2 h at either 18 or 21 degrees C. The effect of temperature was reversible: by placing pups at either 18 or 21 degrees C for 2 h after delivery, and then rewarming by placing them with a foster mother, the PPTS was delayed until 4 h after birth, i.e. 2 h after the beginning of rewarming. Thus, environmental cooling appears to retard the development of neural and/or endocrine systems mediating the PPTS. Aberrant maternal care which would produce substantial cooling of the male pups would be expected to affect the PPTS, which in turn might affect the sexuality of male progeny. PMID- 3630540 TI - Short-term exposure to insulin-like growth factors stimulates testosterone production by testicular interstitial cells. AB - The effect of short-term exposure to the insulin-like growth factors (IGF-I and IGF-II) on testosterone production by rat testicular interstitial cells in primary culture has been examined. Both peptides, when present during a 1-h pre incubation period, increased human chorionic gonadotropin (hCG)-stimulated testosterone release over the following 16-h period. The effect of exposure to IGFs was most marked on maximally hCG-stimulated testosterone release. Maximal stimulation following IGF exposure was 80-85% above that seen without IGFs, and the IGF effect was half-maximal at 1.5-2 micrograms/l of IGF-I or IGF-II. Pre incubation with IGFs did not alter the concentration of hCG (0.1 microgram/l) at which half-maximal stimulation of testosterone release was seen. Increasing cell density had a marked effect on the testosterone production rate per 10(5) cells, and the stimulatory effect of IGFs was only seen at relatively high cell density (2.8 X 10(5) cells/ml). Varying the period of pre-incubation with IGFs between 0.5 and 16 h, it was found that a 1-h period gave maximal stimulation. We conclude that a short exposure to IGFs is capable of increasing hCG-stimulated steroidogenesis in Leydig cells, and postulate that this effect may be part of an intratesticular paracrine control mechanism. PMID- 3630541 TI - Blockade of pro-oestrus LH surge and ovulation by GABA increase in the rat locus coeruleus. AB - The effects of gamma-aminobutyric acid (GABA) increase at the nucleus locus coeruleus (LC) on pro-oestrus LH release and ovulation were evaluated in rats. Local microinjection of the GABA-transaminase inhibitor gamma-vinyl-GABA (GVG) produced 6 h later a marked increase in GABA in the LC. Such action caused a significant decrease of plasma LH levels and prevented the pro-oestrus LH surge. In some animals, plasma prolactin levels were also lowered, but in others its plasma concentrations were high and similar to that in controls. Ovulation did not occur in the rats treated with GVG. In additional experiments, the periventricular gray substance (PGS) close to the locus coeruleus was injected with GVG. Results obtained show a LH surge blockade and failure of ovulation in most of these rats. These findings may be interpreted on the basis of GABA action on rostral LC cells that project to the PGS. The results altogether suggest that through neurons of the locus coeruleus, GABA may exert an inhibitory role in the regulation of LH secretion. PMID- 3630542 TI - Effect of food restriction on 24-h serum and pineal melatonin content in male rats. AB - Food restriction (50%) effects on the 24-h rhythm of serum and pineal melatonin (MT) were studied in 260-300 g male Wistar rats under a lighting regimen of 14 h light and 10 h dark. Body weight, testicular weight, accessory organ weights, serum LH, serum testosterone, and 24-h rhythms of serum and pineal MT were determined. One week of food restriction caused a decrease in body weight (18%), accessory organ weights (18%), and serum LH (50%), but had no effect on serum or pineal MT. Three weeks of food restriction suppressed the body weight and accessory organ weights further (35% and 39%, respectively), reduced serum LH (68%) and serum testosterone (53%), reduced pineal MT (12%) and raised serum MT (34%). The increased serum MT may play a role in the reported potentiation of pineal action in food deprived rats. PMID- 3630543 TI - Effect of anaesthetics on PRL and LH secretion in rats. Importance of pre anaesthetic adaptation and involvement of monoaminergic neurons. AB - General anaesthesia has been reported to interact with neuroendocrine functions leading to large variations in basal and stimulated plasma levels of several hormones, but the findings are often contradictory. In the present investigation we have attempted to clarify the importance of the experimental procedure when evaluating the influence of anaesthetics on the secretion of PRL and LH in male rats. One group of rats (non-adapted) were anaesthetized (ip) with pentobarbital (P), urethane (U), ketamine (A), or althesin (A) without being accustomed to the laboratory environment prior to anaesthesia. Another group of rats (adapted) were kept for 90 min in their individual cages before induction of anaesthesia with P or U. In non-adapted rats the plasma concentration of PRL declined rapidly during the first 30 min following administration of all anaesthetics or saline (controls) and attained a steady level after 60 min. Except for a brief rise following U injection, the LH concentration was not affected by anaesthesia in the non-adapted rats. In adapted rats, the concentration of both PRL and LH declined markedly during the pre-anaesthetic adaptation period and had stabilized at the end of that period. Following administration of U, P or saline, no further changes in the hormone concentrations were observed. Injection of the dopamine receptor antagonist pimozide prevented the decrease in plasma PRL during the adaptation period, but had no effect on LH secretion. In pimozide-treated rats, U caused a 5-fold increase in the PRL concentration. This effect of U was inhibited by the serotonin receptor antagonist methysergide. The PRL response to 30 micrograms of histamine was similar in conscious and U-anaesthetized rats, whereas P anaesthesia caused a reduction in the response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630544 TI - Influence of steroid hormones on the incorporation of amino acids in uterine and cervical tissue of pregnant women. AB - The influence of steroids on protein synthesis in cervical and uterine tissue obtained from early and term pregnant women was studied by measuring the incorporation of labelled amino acids into total protein. It was found that oestradiol-17 beta and progesterone significantly reduced the incorporation of [3H]proline. Androstenedione and cortisol had no significant effect on the incorporation of [3H]proline even at high concentrations. The protein synthesis inhibitors puromycin and cycloheximide blocked the incorporation of [3H]proline to 80-85%. However, there was no further reduction in the incorporation in the presence of oestradiol. Oestradiol was found to reduce the incorporation of [14C]glycine but not that of [3H]serine. The results indicate that oestradiol and progesterone reduce protein synthesis in human cervical and uterine tissue and that this reduction, at least partially, involves collagen synthesis. Oestradiol and progesterone were equipotent under in vitro experimental conditions. The tissue concentration of progesterone in the pregnant uterus is, however, much higher than that of oestradiol. It seems therefore probable that progesterone rather than oestradiol restricts unopposed synthesis of proteins, presumably mainly collagen. PMID- 3630545 TI - The cellular mechanism of the antiandrogenic action of nomegestrol acetate, a new 19-nor progestagen, on the rat prostate. AB - Nomegestrol acetate, like other synthetic progestins such as medroxyprogesterone acetate (MPA), chlormadinone acetate, megestrol acetate and cyproterone acetate, is able to modify the physiological actions of androgens. In the present study, the effects of nomegestrol acetate and other antiandrogens on the binding of androgen to the androgen receptor (AR) and on the 'activation' of this receptor were investigated, using rat ventral prostate as target model. Relative binding affinities (RBA) for AR were first estimated in vitro with respect to [3H]testosterone for a series of structurally-related compounds. The values obtained ranged as follows: dihydrotestosterone (DHT) much greater than megestrol acetate greater than or equal to testosterone (T) greater than nomegestrol acetate greater than 19-nor progesterone (19NP) greater than progesterone (P). An assay was established, using two different incubation times (3 h and 24 h) to further investigate relationships between binding affinity and androgenic, or antiandrogenic, activity. The following order (as %) was obtained for progestins as against [3H]mibolerone (DMNT): 1) DMNT (100) much greater than nomegestrol acetate (42) greater than megestrol acetate (29) greater than chlormadinone acetate (9) greater than MPA (8) greater than cyproterone acetate (6) after 3 h and 2) DMNT (100) much greater than MPA (53) much greater than nomegestrol acetate (19) greater than megestrol acetate (12) greater than chlormadinone acetate (14) and cyproterone acetate (8) after 24 h. Since the RBA of nomegestrol acetate declined with time, these results indicate that this substance may act like an antiandrogen rather than an androgen, while the contrary prevails concerning MPA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630546 TI - European Society of Hysteroscopy. Proceedings of the Second World Congress on Hysteroscopy. W. Berlin, September 21-22, 1985. PMID- 3630547 TI - Experience with the hysteroscope. PMID- 3630548 TI - "Office hysteroscopy" experience with Hamou microcolpohysteroscope in 250 patients. PMID- 3630549 TI - Hysteroscopy in daily gynaecologic practice. PMID- 3630550 TI - Office hysteroscopy with small calibre instruments. PMID- 3630551 TI - Diagnostic hysteroscopy today. PMID- 3630552 TI - The accuracy of combined hysteroscopy and line biopsy under ambulatory conditions. PMID- 3630553 TI - Hysteroscopy necessary before IUD? PMID- 3630554 TI - Dating of the endometrium by microhysteroscopy. PMID- 3630555 TI - Interest of microhysteroscopy when used before in vitro fertilization (I.V.F.). PMID- 3630557 TI - Hysteroscopic management of menorrhagia. AB - The hysteroscope has not only the capability of diagnosing abnormal uterine bleeding and managing menorrhagia but also removing space occupying lesions or destruction of the endometrium with electrical or laser treatment. Complications are minimal and success rates are high. PMID- 3630556 TI - Hysteroscopy versus hysterosalpingography. PMID- 3630558 TI - Therapeutic hysteroscopy. AB - It is the responsibility of physicians in gatherings such as ours to set the tone and speak forthrightly about accomplishments and limitations. The fundamentals of diagnostic hysteroscopy are well known and now is the time for us to push forward to ascertain whether this endoscopic approach, in selected patients, is more innocuous than the conventional laparotomy. I have tried to indicate the clinician's dilemma in the search for the proper approach to several types of uterine abnormalities. As enthusiastic hysteroscopists, we must continue to analyze and document our findings, with careful concern so as to avoid poorly substantiated claims. PMID- 3630559 TI - Hysteroscopic lysis of intrauterine adhesions. A report of 61 cases. PMID- 3630561 TI - Hysteroscopic treatment of early pregnancy conceived despite intrauterine contraception. PMID- 3630562 TI - Hysteroscopic chorionic villi sampling: a new approach. PMID- 3630560 TI - Learning hysteroscopy sterilization and the Ovabloc System with Hyskon. AB - A review of the first 100 and the last 100 patients in a series of 268 patients sterilized by hysteroscopic injection of liquid silicone into the fallopian was made to evaluate the success rate as it relates to experience with the procedure. The two groups were similar in composition. While the percentage of patients sterilized increased only from 91% in the first 100 patients to 94% in the last 100 patients the numbers that were sterilized at the time of the first procedure increased by 9%. The two major reasons for repeated procedures were tip separation and tubal spasm. The former may become less of a problem with new manufacturing changes. Tubal spasm was reduced as a problem by controlling the temperature of Hyskon but it remains a difficult problem in a smaller number of patients even in the last group. Other causes for repeated procedures were primarily related to operator inexperience and investigational problems. They appear not to be a significant problem for physicians who will learn this procedure in future. This procedure is well received by patients. Hysteroscopists will find it a valuable outpatient female sterilization technique. PMID- 3630563 TI - Chorionscopy and chorionic villi sampling. PMID- 3630564 TI - An ELISA for antisperm antibody detection in serum: comparison with TAT and SIT in serum, with MAR-test, immunobead-test and TAT in semen and with micro-SIT in cervical mucus. AB - 16 couples belonging to couples with negative or doubtful PCT were selected according to the presence of antisperm immunization. 12 patients, 5 male and 7 female, showed both localized and generalized immunization. The former was diagnosed by means of a positive IgG MAR-Test, direct IgG Immunobead-Test, direct IgG Immunobead-Test and seminal TAT in the male patients, and Micro-SIT in the cervical mucus of the female patients, while for the latter there was simultaneous positivity of both serum TAT and SIT, except for two cases, in which the SIT only was positive. The 4 remaining patients, 2 male and 2 female, did not show any signs of antisperm immunization. The evaluation of the antisperm antibodies by means of the ZER ELISA Antisperm Kit in the serum of the 16 patients examined showed that there were no significant statistical differences between the serum TAT and the SIT. The former showed agreement of the results in 93.75% of the cases, and the latter in 81.25%. A strict correlation was observed between the ELISA for serum antisperm antibodies (ELISA-AS-Abs) and the local immunitary situation, with agreement in 93.75% of the cases. The ELISA-AS-Abs seems to bring the advantage of eliminating the need for fresh semen for antibody titration and also means that there is no subjective interference with the evaluation of the results. PMID- 3630565 TI - Luminometric measurement of ATP concentrations in human semen. AB - A positive correlation is found between the ATP concentration and the sperm motility characteristics. So ATP measurement may contribute to a better selection of patients; in vases of asthenospermia, a differential diagnosis between ultrastructural abnormalities and problems related to energy supply is possible without the expensive electron microscopy. PMID- 3630566 TI - L-carnitine and acetylcarnitine in human sperm with normal and reduced motility. AB - The differences in the acetylcarnitine/carnitine ratio and the percent of the acetylation in sperm seminal samples have been investigated. The impairment of the enzymatic system controlling the reaction carnitine acetylcarnitine may lead to a defective spermatozoal motility. PMID- 3630568 TI - Surgical management of tubal obstruction at the uterotubal junction. AB - The advantages of microsurgical anastomosis for cornual occlusion are evaluated in a series of 82 pure cases of pathologic cornual occlusion. The term pregnancy rate was 44% and the ectopic pregnancy rate was 7%. The following factors were found influencing the pregnancy rate: maximized tubal length; preserved intramural portion; absence of chronic inflammation; absence of tubal inclusions; absence of tubal endometriosis. PMID- 3630567 TI - Qualitative and quantitative changes of acid and alkaline phosphatases in the testis and epididymis of mice in relation to single high dose of alpha chlorohydrin. AB - The present study is designed to know whether the enzymes related to permeability and general metabolism of the cells of testis and epididymis are affected by alpha-chlorohydrin. For this purpose two enzymes, viz., acid and alkaline phosphatases are studied thoroughly by qualitative and quantitative parameters during single high dose (90 mg/kg body weight) treatment after 24 and 48 hours of drug administration. Along with this, the changes in the behaviour of the animals and histological structure of testis and epididymis of mice are also recorded. PMID- 3630569 TI - Approach to immunological male infertility: a comparison between MAR test and direct immunobead test. AB - A comparative study between MAR test and IBT in 142 seminal samples is presented by the authors and their concordance with TAT and SIT is also evaluated. In particular the interest of IBT for the evaluation of involved immunoglobulinic classes is stressed. PMID- 3630570 TI - Hysteroscopy and endometrial biopsy. AB - The role of hysteroscopy for a complete evaluation of luteal phase is discussed by the authors. They affirm that for a thorough evaluation a hysteroscopy may be usefully performed simultaneously to the endometrial biopsy. PMID- 3630571 TI - Hysteroscopy for evaluation of tubal ostium pathology. AB - A comparison between hysterosalpingography and hysteroscopy in the evaluation of tubal ostium pathology is presented by the authors. They stress in particular the role of hysteroscopy in this evaluation. PMID- 3630572 TI - The effect of benzalkonium chloride on ovulatory cervical mucus. AB - Benzalkonium chloride is a potent spermicide belonging to the group of cationic detergents. Changes induced in cervical mucus have been evaluated by using scanning electron microscopy (S.E.M.). PMID- 3630573 TI - Ticarcillin/clavulanic acid treatment of gynecological infections. AB - Forty patients have been treated with a Ticarcillin/Clavulanic acid combination. This drug has proven to be effective in the treatment of gynecological soft tissues and wound infections. PMID- 3630574 TI - The incidence of gonorrhoea in young girls. PMID- 3630575 TI - Pharmacokinetics of ceftriaxone in serum and in gynecological tissues. AB - The suitability of Ceftriaxone in gynecologic infections has been investigated in twenty-two patients. The long half life of Ceftriaxone seems to demonstrate its suitability for an effective preoperative prophylaxis in gynecology. PMID- 3630576 TI - Uterine histoarchitecture during pre and post-implantation periods of rats treated with aqueous extract of Moringa oleifera Lam. AB - The effect of aqueous extract of Moringa oleifera Lam. (roots) has been studied on histoarchitecture of the uterus during pre and post-implantation stages in rats so as to elucidate its antifertility mode of action. The histoarchitecture of the uterus of control pregnant rat had revealed a clear-cut close apposition of the uterine endometrium with reduced lumen and loose stroma. There was a prominent appearance of deciduoma and the uterine glands were enlarged. Glandular cells showed hypertrophy and in the endometrium the leucocytic infiltration was increased. When the aqueous extract of M. oleifera Lam. was administered, no deciduoma was observed on day 5th of pregnancy and the luminal epithelium remained unstimulated. The lumen was enlarged and the uterus was non-oedematous. It has been concluded that the administration of aqueous extract of M. oleifera Lam. to pregnant rats could not stimulate the uterus which remained non-receptive throughout the period of treatment, therefore, the fertilized eggs may not be welcomed by the unprepared uterus. PMID- 3630577 TI - [Rational informative nuclear medicine diagnosis for cardiology]. AB - A combined program in SYMA has been developed. It gives parameters for the left ventricle (LV) as well as for the right ventricle (RV); it also can be used as a basis for more specific details. We tried indeed to get more informations with less costs and time. Studying 163 patients (the mean age was 62 years) we have seen that ejection fraction (EF), wallmotion (WM) and CINE data show good results even in more complex events. From different points of view positive and negative aspects were discussed mainly concerning the role of nuclear medicine in clinic al cardiology. Typical samples have been shown. Final results are built up by two components; primarily the number of theoretical ideas are very helpful but otherwise practical experiences perfect the whole impression. PMID- 3630578 TI - [Natural cellular immunity as the effector mechanism in tumor defense]. AB - According to the immunosurveillance theory, the immune system plays an important role in the control of tumor development. Besides of specific cytotoxic T-cells, natural killer (NK) cells have gained recently in attention as effectors of the aforementioned function. They are lymphoid cells, and lyse tumor cells after having recognized them through a variety of membrane properties. Lymphokines can increase NK cell activity and enlarge their spectrum to previously NK-insensitive targets. Several clinical trials are being conducted at present in order to test the potential of lymphokine activated killer cells to function within this new biologic set-up. PMID- 3630579 TI - Oxygen tension and consumption measured by a tc-PO2 electrode on heated skin before and after epidermal stripping. AB - Oxygen tensions, cutaneous blood flow rate, and skin oxygen consumption rate were determined by tc-PO2 measurements at an electrode temperature of 45 degrees C. The epidermal surface was stripped by 50 applications of adhesive plaster to the surface. Ten healthy, normotensive adults were examined. Cutaneous blood flow rate was 41.2 +/- 8.6 ml X (100 g)-1 X min-1 before and 42.8 +/- 5.9 ml X (100 g) 1 X min-1 after epidermal stripping. Oxygen consumption before stripping was 0.327 +/- 0.065 ml O2 X (100 g)-1 X min-1, and after stripping it was determined at two different saturation levels to be 0.208 +/- 0.072 ml O2 X (100 g)-1 X min 1 and 0.251 +/- 0.096 ml O2 X (100 g)-1 X min-1. Capillary temperature was estimated to be approximately 43 degrees C before and after stripping. At this temperature mean arterial PO2 was estimated to be 18.1 kPa (136 mmHg), which would be reduced by the computed local metabolism to a mean capillary PO2 of 14.4 kPa (108 mmHg) before stripping and 15.2 kPa (114 mmHg) after. Stripping increased mean skin PO2 from 10.9 +/- 0.6 kPa (82.3 +/- 4.7 mmHg) to 14.6 +/- 1.0 kPa (109.4 +/- 7.7 mmHg). Thus, stripping eliminated 82% of the gradient between the capillaries and electrode while reducing the computed oxygen consumption by 23-36%. It is concluded that the epidermal membrane is a significant barrier to oxygen diffusion and that the transcutaneous oxygen electrode has a significant effect on skin PO2 owing to its own even low oxygen consumption. This will reduce the observed skin PO2 significantly. PMID- 3630580 TI - Effects of droperidol on peripheral vasculature: use of cardiopulmonary bypass as a study model. AB - The effects of droperidol on the systemic vascular resistance (SVR) and the venous capacitance were studied during cardiopulmonary bypass (CPB) in 24 patients. CPB was performed with either pulsatile or non-pulsatile flow. During non-pulsatile flow, droperidol (0.15 mg X kg-1 and 0.30 mg X kg-1) decreased SVR and increased venous capacitance. These values were significantly different after the 2nd and the 7th min, respectively. During pulsatile flow, the initial SVR was lower. The decremental effect of 0.30 mg X kg-1 droperidol on SVR was proportional to the preinjection level of SVR (r = 0.64). The increase in venous capacitance related to droperidol was independent of the dose and of the type of flow in all patients. It can be concluded that the vasodilating action of droperidol during CPB on the arterial bed is transient, independent of dose, and related to the preinjection level of SVR. The effect of droperidol on venous capacitance is not as rapid but has a longer duration. PMID- 3630581 TI - Pulmonary ventilation and gas exchange in children anaesthetized with halothane, enflurane and isoflurane. AB - The effects of similar anaesthetic levels of halothane (1.3 MAC), enflurane (1.2 MAC) and isoflurane (1.1 MAC) on pulmonary ventilation and gas exchange were investigated in 24 children subjected to minor and intermediate paediatric surgical procedures. Eight children were anaesthetized with each agent, pneumotachography and capnography were used, and airway as well as oesophageal pressures were measured. Minute ventilation (VE) was lower with enflurane than with halothane (P less than 0.001) and isoflurane (ns). Tidal volumes were, however, similar and variations in VE were thus caused by lower respiratory rates with enflurane than with the two other agents. Alveolar ventilation (VABohr) and carbon dioxide elimination (VCO2) were smaller and end-tidal CO2 tension higher with enflurane. Ventilatory efficiency was, however, somewhat better with enflurane as indicated by lower VDBohr/VT (ns) and VE/VCO2 (P less than 0.05) ratios compared with the two other agents. The effects of all three agents on dynamic compliance were similar, while total pulmonary resistance was less with isoflurane than with halothane and enflurane. It is concluded that although minute ventilation was smaller with enflurane than with halothane and isoflurane, ventilatory efficiency was similar due to a smaller dead space ventilation as a result of the lower respiratory rates in children anaesthetized with enflurane. PMID- 3630582 TI - Changes in breathing pattern and chest wall mechanics after benzodiazepines in combination with meperidine. AB - The effects of repeated sedative i.v. doses of midazolam and diazepam in combination with meperidine on breathing pattern and thoracoabdominal motion were studied in eight healthy male volunteers. At 20-min intervals in a randomized double-blind crossover design the subjects initially received two doses of midazolam 0.05 mg/kg or diazepam 0.15 mg/kg followed by meperidine 0.5 mg/kg and then naloxone 0.4 mg. Breathing pattern and thoracoabdominal motion were measured non-invasively, utilizing a computerized strain gauge technique. The initial injection of both benzodiazepines caused significant decreases in tidal volume, inspiratory time and expiratory time. There were no significant differences between the two drugs in any of these variables. Minute ventilation, mean inspiratory flow and respiratory timing were not significantly affected. The second injection of both benzodiazepines caused only insignificant additional changes. When meperidine was added, the effects on inspiratory time and tidal volume were small and not significant. However, expiratory time increased and was no longer significantly different from control. The injection of naloxone reversed the meperidine-induced changes only, and the breathing pattern was no longer different from that obtained during benzodiazepines alone. The decrease in tidal volume after the benzodiazepines was almost exclusively mediated by a decrease in the abdominal contribution. Additional doses of benzodiazepines did not enhance these changes. However, meperidine caused a further decrease in the abdominal contribution. This decrease was reversed by naloxone. This indicates that the combination of benzodiazepines and meperidine caused a profound decrease in diaphragmatic performance. PMID- 3630583 TI - The efficacy of ranitidine in children. AB - The effect of preoperative oral ranitidine on intragastric pH and volume of aspirate was evaluated in anaesthetized children. Five groups of eight randomly assigned children were evaluated. The first group acted as control and the other groups received 2, 2.5, 3, 3.5 mg kg-1 ranitidine, respectively. The drug was administered 1-4 h preoperatively. The intragastric pH was measured by a pH electrode through an orogastric tube, and the volume of aspirate was recorded every hour. At the time of first measurement oral ranitidine was significantly effective (P less than 0.001) in increasing the pH of intragastric contents to above the safe level of 2.5 in 94% of the children. At the second measurement an hour later, it was effective in all the children. Ranitidine has no significant effect on the volume of gastric aspirate and also there was no significant difference in the effect on the pH of the various doses of ranitidine studied. Oral ranitidine at doses of 2-3.5 mg kg-1 is effective in decreasing gastric acidity in children. PMID- 3630584 TI - Predictive value of skin testing, neutrophil migration and C-reactive protein for postoperative infections in cardiopulmonary bypass patients. AB - Despite antibiotic cover for cardiac surgery the development of postoperative infection remains a feared complication. The present prospective study was designed to evaluate whether it is possible to identify preoperatively those individuals in whom the risk of a postoperative infection is significantly greater. Skin test response, chemotaxis and random migration of neutrophils, and serum levels of C-reactive protein (CRP) were chosen as indicators of host resistance. Pre-operatively and at defined postoperative time intervals, 80 patients undergoing open-heart surgery with the aid of cardiopulmonary bypass were examined. Of all the immunological variables measured in this study, the state of anergy proved the most reliable predictor of postoperative infection. Six of the nine pre-operatively anergic patients developed infections (P = 0.00026) representing one half of the postoperatively infected patients. No predictive role of CRP level or neutrophil chemotaxis can be derived from our data. The pre-operatively decreased random migration of polymorphonuclear leukocytes (PMN) from postoperatively infected patients, however, along with the significant defects in chemotactic and random PMN motility seen after cardiac surgery may partly explain the predisposition to bacterial infection in these patients. In conclusion, a pre-operative skin test makes a valuable contribution to the assessment of the patient's postoperative infectious risk. PMID- 3630585 TI - Effect of chronic bupivacaine infusion on seizure threshold to bupivacaine. AB - Thirty rats were pretreated with a continuous infusion of bupivacaine or placebo. On the fourth day the acute seizure threshold to bupivacaine was determined for both groups. The seizure dose, blood and brain concentration of bupivacaine showed no difference between the groups. The tachyphylaxis seen clinically when bupivacaine is used for a regional nerve blockade does not seem to evolve for the CNS-effects. PMID- 3630586 TI - Cost of a saved life following out-of-hospital cardiac arrest resuscitated by specially trained ambulance personnel. AB - During a 1-year-study period three emergency ambulances manned by specially trained emergency medical technicians (EMTs) were successful in the resuscitation of 28 out-of-hospital cardiac arrest patients, who were admitted to hospital for further treatment. Nineteen patients died in hospital while nine were discharged to their homes, a survival rate corresponding to 3.5 saved lives per 100,000 inhabitants per year. The extra pre-hospital costs and the estimated costs for hospital treatment of the admitted patients amounted to 929,600 Swedish kronor (SEK). The program cost of the early defibrillation by trained EMTs accounted for only 12% of this amount, or 113,600 SEK. The cost of hospital treatment accounted for the remaining 88%, or 816,000 SEK. Intensive care accounted for 53% of the hospital costs, coronary care 4%, treatment in a general ward 33% and in a ward for rehabilitation or long-term care 10%. Non-survivors accounted for 58% of the hospital expenditure. The marginal prehospital cost (program cost) for each survivor was 12,622 SEK or approximately 1800 US dollars. The total cost per life saved was 103,000 SEK or approximately 14,700 US dollars. The estimated cost to each taxpayer of providing this extra emergency resource would be approximately 0.5 SEK a year. PMID- 3630587 TI - Glycopyrrolate compared with atropine in association with ketamine anaesthesia. AB - Atropine and glycopyrrolate given intravenously before the induction of a ketamine anaesthesia to diminish salivary secretion were compared for their effect on psychotomimetic side-effects, awakening time and heart rate. Though atropine is a tertiary amine that crosses the blood-brain barrier, which glycopyrrolate as a quaternary ammonium compound does not, it did not increase the incidence of psychotomimetic side-effects nor did it significantly prolong the awakening time after ketamine anaesthesia. During intubation the increase in heart rate was significantly higher following atropine than following glycopyrrolate. PMID- 3630588 TI - Calcium reverses global and regional myocardial dysfunction caused by the combination of verapamil and halothane. AB - In order to evaluate the effects of the combination of halothane and verapamil on left ventricular function and coronary blood flow (CBF), six sheep were anaesthetized with halothane (1.2% inspired) and given increasing cumulative doses of intravenous verapamil. Regional myocardial function was assessed by sonomicrometry in the areas supplied by the left anterior descending coronary artery (LAD) and the left circumflex coronary artery (LC). Changes in global haemodynamics, atrioventricular conduction, LV relaxation and systolic shortening after 0.32 mg X kg-1 intravenous verapamil indicated impaired left ventricular function. Significant myocardial dysfunction (post-systolic shortening) occurred in the LAD territory, accompanied by a 64% decrease (42 +/- 6 to 15 +/- 3, P less than 0.01) in coronary perfusion pressure (CPP). Coronary blood flow in the LC segment decreased 83% (102 +/- 15 to 17 +/- 13, P less than 0.01) as coronary reserve was exhausted with the decrease in CPP. Calcium chloride reversed the impairment of global and regional myocardial function observed with verapamil, improved the impaired left ventricular relaxation, but did not significantly alter atrioventricular conduction. Thus the combination halothane-verapamil can cause significant left ventricular depression and myocardial dysfunction, possibly by inducing subendocardial ischaemia or by direct pharmacologic effect. Calcium chloride reverses this regional myocardial dysfunction as well as the deleterious global haemodynamic changes caused by halothane-verapamil; however, the changes in atrioventricular conduction are not corrected by calcium. PMID- 3630589 TI - Gastric contents and pH after oral premedication. AB - Forty women, aged 26-40 years, were investigated with regard to gastric contents and pH before general anaesthesia. The patients were divided into two groups (20 in each). Group 100 received 0.3 mg kg-1 diazepam orally with 100 ml of water 2 h before surgery. Group 50 received 0.3 mg kg-1 diazepam with 50 ml of water 2 h before surgery. The amount of gastric content was significantly greater in Group 100 than in Group 50 (P less than 0.05). There was no statistical difference in pH values between the groups. The number of patients with both gastric pH less than 2.5 and gastric volume greater than 25 ml was significantly higher in Group 100 compared to Group 50 (P less than 0.05). We cannot recommend the use of oral premedication using these amounts of water, considering the increased risk of aspiration of gastric contents. PMID- 3630590 TI - In vitro diagnosis of susceptibility to malignant hyperthermia: comparison between dynamic and static halothane and caffeine tests. AB - In vitro tests for the diagnosis of malignant hyperthermia susceptibility were performed in 105 patients and 20 normal controls according to the protocol of the European MH Group. Results of dynamic halothane and caffeine tests (in which muscle bundle length is cyclically changed) were compared to those of static tests (constant muscle bundle length). Overall, no significant differences between dynamic and static tests were found in threshold concentrations eliciting contractures. Identical diagnostic results with dynamic and static tests were obtained in 94.3% with halothane and in 88.9% with caffeine. The magnitude of contractures was, however, significantly greater in the dynamic than in the static halothane test for halothane concentrations less than 3%, but this did not influence diagnosis. The results indicate that dynamic tests are not superior to static tests, but several tests should be performed to enhance diagnostic safety. PMID- 3630591 TI - In vitro diagnosis of susceptibility to malignant hyperthermia: evaluation of tests with halothane-caffeine, potassium chloride, suxamethonium and caffeine suxamethonium. AB - Susceptibility to MH was determined in 77 patients according to the protocol of the European MH Group. Additional muscle bundles were used for diagnostic in vitro tests with caffeine in the presence of 1% halothane, potassium chloride, suxamethonium, and caffeine-suxamethonium. Significant differences between MH susceptible (MHS) and MH-negative (MHN) patients were obtained with the halothane caffeine test and the potassium chloride test, whereas no differences were found with the suxamethonium test. In the test with caffeine-suxamethonium, a different response to caffeine but not to suxamethonium was obtained. In all tests there was an overlap in results between MHS and MHN groups, and the predictive values of the tests ranged between 63 and 95%. Prior small doses of caffeine followed by a 4 mmol/l dose of caffeine elicited significantly smaller contractures than 4 mmol/l given as the first dose of caffeine. This underlines the necessity of a common protocol for performance and interpretation of diagnostic tests for MH. PMID- 3630592 TI - Sympathetic activity and haemodynamic variables during spinal analgesia in man. AB - At present there is a lack of information concerning haemodynamic changes related to the degree of sympathetic blockade during spinal analgesia. In this investigation, involving 36 patients, changes in haemodynamic parameters were studied in 30 patients receiving spinal analgesia and in six patients having "sham spinal" analgesia. Three local anaesthetic solutions were used: bupivacaine without and with glucose and tetracaine with glucose. Skin conductance responses were used to evaluate changes in provoked sympathetic activity. It was found, as in previous studies, that a complete block of sympathetic activity in the foot was seen in only 60% of patients with an average analgesic level of T4. A partial sympathetic blockade was registered up to and above the level of analgesia. In 25/30 cases only minor alterations in cardiac output, heart rate, stroke volume, mean arterial pressure and systemic vascular resistance were seen in spinal analgesia whose level reached on average T4-5. In five cases in whom analgesia reached T4-3, mean arterial pressure fell greater than or equal to 30% with a well-preserved cardiac output, but with complete sympathetic blockade up to T5 and in two cases also in the hand. Only minor differences were observed between the different anaesthetic solutions. PMID- 3630593 TI - Spinal anaesthesia with hyperbaric tetracaine: effect of age and body mass. AB - To discover the influence of age and body mass on spinal analgesia with hyperbaric tetracaine, 60 patients (17-82 years) were administered a subarachnoid injection of 15 mg tetracaine in 3 ml of 5% glucose. The patients were in the lateral position during the injection and in the supine position thereafter. The maximal spread of analgesia (mean T4, range T1-T11) did not correlate with age or body mass. Any variable studied was not significantly different for the different age groups. In 29 patients (48%) the block required supplementation with fentanyl or general anaesthesia (five patients). Tourniquet-induced pain occurred in eight patients (28% of patients with tourniquet). Decreases in systolic arterial blood pressure, greater than 30% of the preanaesthetic value, correlated with the level of analgesia and were more frequent in patients over 50 years (P less than 0.01). Severe hypotension and bradycardia with transient serious changes in QRS complexes occurred in one patient (analgesia level, T3). In conclusion, 15 mg of hyperbaric tetracaine provided a relatively high sensory spinal blockade without correlating with age or body mass. Supplementation of analgesia during surgery was needed in almost half of the patient material. PMID- 3630594 TI - Differences and similarities between human and rabbit neutrophil granulocyte responses in vitro: the effects of zymosan-activated plasma, phorbol myristate acetate and n-formyl-methionyl-leucyl-phenylalanine. AB - The amount of reactive oxygen intermediates (ROI) generated by activated polymorphonuclear neutrophils (PMN), as well as the closeness of contact between PMN and vessel wall, may determine whether PMN activators will induce the adult respiratory distress syndrome. We examined the ROI-generating and aggregating effects of zymosan activated plasma (ZAP), phorbol myristate acetate (PMA) and n formyl-methionyl-leucyl-phenylalanine (FMLP), on isolated human and rabbit PMN. PMA, after a short lag phase, induced a large and long-lasting increase in ROI generation. The initial peak response was higher and more rapid in human than in rabbit cells. The reaction to FMLP occurred almost instantaneously, but was much weaker than that to PMA, and ROI generation returned to near baseline in less than 10 min. No species difference was seen. ZAP caused an FMLP-like ROI response in human cells, whereas no response was observed in rabbit PMN. PMN aggregation was induced by all three activators, most markedly by PMA. No species difference was detected for PMA; FMLP gave a stronger aggregation of rabbit than of human PMN, however, while the opposite was true for ZAP. In conclusion, ZAP was a potent stimulus for PMN aggregation, but had modest (or no) effects on the production of ROI. Marked differences between human and rabbit PMN responses were observed. PMID- 3630595 TI - Effects of zymosan-activated plasma and phorbol myristate acetate on isolated, perfused rabbit lungs. AB - The effects of complement activation on pulmonary vascular permeability are disputed. In rabbit lungs perfused with autologous blood, zymosan activated plasma (ZAP) induced a moderate increase in pulmonary vascular resistance (PVR), but did not detectably change the vascular permeability within 2 h. The stronger neutrophil granulocyte (PMN) activator, phorbol myristate acetate (PMA), usually gave larger PVR increases and also increased pulmonary vascular permeability. Lungs from neutropenic animals, similarly perfused and given PMA, showed unchanged PVR reactions but had no apparent increase in vascular permeability. Lungs perfused with cell-free medium and given PMA displayed modest PVR increases, and no measurable permeability change. The lung preparatory procedure itself markedly influenced leukocyte circulation. Exsanguination of lung donors decreased the concentration of circulating PMN significantly, and they virtually disappeared from the perfusate within minutes after start of lung perfusion. PMN mediated effects must therefore have been caused by cells already sequestered in the lungs. We conclude that ZAP does not induce an increased pulmonary vascular permeability in isolated, perfused rabbit lungs, in contrast to PMA. The permeability effects of PMA appear to be PMN dependent. PMID- 3630596 TI - Intravenous infusion of Diazemuls in the control of status-like epileptic seizures of different etiology. AB - This report concerns three patients in whom continuous intravenous infusion of Diazemuls (diazepam dissolved in soya bean oil and emulsified) diluted in 5.5% glucose was used for the controlling of epileptic seizures (status). Diazemuls infusion was effective in one patient with complex partial status epilepticus; in another patient with convulsion secondary to a brain stem infarct, the convulsions were abolished; while only reduced jerking was achieved in the third patient suffering from myoclonic jerks caused by anoxic brain damage. Infusion time ranged from 15 to 33 h. The serum concentrations of diazepam obtained during the infusions were higher than recommended in the literature for treatment of status epilepticus, but could not be correlated to either clinical efficacy or infusion rate. PMID- 3630597 TI - Postoperative analgesia with intrapleural administration of bupivacaine adrenaline. AB - Twenty-one patients who underwent elective cholecystectomy were studied with regard to the effect of intrapleural administration of bupivacaine-adrenaline solution on postoperative pain and ventilatory capacity. Administration of 10 or 20 ml of 2.5 mg/ml or 5 mg/ml bupivacaine solution resulted in complete analgesia in 143 of 159 administrations. Most patients experienced the maximal pain relieving effect within 1-2 min and analgesia persisted as a rule for 3-5 h. Forced vital capacity and forced expiratory volume in 1 s increased after intrapleural analgesia on average by 56% and 46%, respectively, on the first postoperative day and by 35% and 51%, respectively, on the second day. There was no significant difference in the analgesic effect or in the effect on the ventilatory capacity between the 2.5 mg/ml or the 5 mg/ml solution, in either the 10 ml or the 20 ml dose. Placebo (NaCl) given intrapleurally had no effect on pain or on the ventilatory capacity. The plasma concentration of bupivacaine after intrapleural administration showed a wide interindividual variation, with considerably higher average values when the 5 mg/ml solution had been used than for the 2.5 mg/ml solution. Although no toxic effects were noted, a 2.5 mg/ml solution, which can be given in an initial dose of 20 ml and top-up doses of 10 ml at 3-6 h intervals, is recommended. In four patients minor pneumothorax developed when the catheter was introduced. The pneumothorax was easily evacuated, but underlines the need for great care when introducing the catheter. PMID- 3630598 TI - Peroperative hypothermia prevention. AB - Peroperative thermal losses were studied in 28 patients (mean age 64 years) operated for a total hip prosthesis under controlled hypotension. The patients were split into four groups according to the method of hypothermia prevention used: reflective blanket, heating humidifier of inhaled gases, combination of both techniques or no prevention at all. The thermal loss was quicker and more intense in the last group. The superiority of one prevention method over another could not be demonstrated, but the urgency of its implementation proved to be essential. PMID- 3630599 TI - Thoracolumbar epidural anaesthesia blocks the circulatory response to laryngoscopy and intubation. AB - Laryngoscopy and endotracheal intubation cause a stress reaction resulting in an increase in heart rate and systemic blood pressure. This haemodynamic response is considered to be due to a sympathetic discharge caused by stimulation of the upper respiratory tract. This stress reaction during laryngoscopy and endotracheal intubation was studied in patients with total thoracolumbar epidural anaesthesia (EDA). Nine patients with thoracolumbar EDA including at least the segments T1 to L2 were compared to seven patients without EDA during induction of general anaesthesia. The epidural anaesthesia was achieved with 2% mepivacaine with adrenaline. General anaesthesia was induced with thiopentone 4-5 mg/kg followed by 100 mg suxamethonium. The highest blood pressure value during the first 2 min after intubation was compared to the value immediately before intubation. The epidural anaesthesia caused a reduction of the mean arterial blood pressure (MAP) by 25%, and a reduction of the heart rate (HR) by 7%, but neither the induction with thiopentone nor the laryngoscopy and intubation caused any changes in mean arterial blood pressure or heart rate. However, in the control group MAP increased 29% and HR 16% following intubation. Thus, the T1-L2 epidural anaesthesia with 2% mepivacaine with adrenaline blocked the blood pressure reaction to laryngoscopy and intubation, and consequently the efferent sympathetic nervous system was completely blocked. PMID- 3630600 TI - Choice of anesthetic alters the circulatory shock pattern as gauged by conscious rat endotoxemia. AB - A standardized rat endotoxin shock model was used to assess the differential effects of four commonly used anesthetics upon hemodynamics before and during endotoxin shock. Forty-nine male Sprague-Dawley rats weighing 307 +/- 4 g were divided into five groups:freely-moving conscious, enflurane (2%), isoflurane (1.4%), pentobarbital (6 mg.kg-1.h-1 i.v.), and ketamine (45 mg.kg-1.h-1 i.v.). Anesthetic doses were chosen as 1.0 MAC equivalent. Anesthetized rats were intubated and ventilated with oxygen. The right carotid artery was cannulated with a thermocouple-catheter for aortic blood pressure, heart rate, and thermodilution cardiac output measurements. The right jugular vein was cannulated for measurement of central venous pressure and for i.v. injections. Data were collected over a 30-min baseline period and for 4 h after an i.v. bolus of endotoxin (40 mg.kg-1, LD100 within 24 h). Gross small intestinal pathology was rated on a 0-4 scale. Anesthetic effects were judged in terms of significant deviations from the awake data on each parameter. Despite differing patterns, total deviations were similar for enflurane, ketamine, and pentobarbital, although the latter drug was the least preferable due to particularly high systemic vascular resistance. Significantly less hemorrhagic small intestinal pathology occurred with enflurane. Ketamine offered no advantage over the inhalation anesthetics. Among the four anesthetics tested, results were closest to the awake pattern with isoflurane anesthesia, thus making it the logical choice for hemodynamic studies in experimental shock research. PMID- 3630601 TI - Topography, architecture and structure of the plexus submucosus externus (Schabadasch) of the porcine small intestine in scanning electron microscopy. AB - Whole-mount preparations of the porcine small intestine, consisting of the tela submucosa and the adjacent lamina muscularis mucosae, were used for scanning electron-microscopic investigation of the plexus submucosus externus (Schabadasch) after enzymatic digestion, fixation and HCI hydrolysis. The present results confirm previous light-microscopic data and provide irrefutable proof that within the submucosal plexus, considered by most authors as one ganglionated nerve plexus situated in the entirety of the tela submucosa, two distinct nerve meshworks can be distinguished, one lying close to the lamina muscularis mucosae, i.e., the plexus submucosus internus (Meissner), and the other, i.e., the plexus submucosus externus (Schabadasch), situated in the outer region of the tela submucosa against the circular smooth muscle layer. In addition to the distinct location of both plexuses, they are quite different with regard to the pattern and diameter of their nerve strands and the number and appearance of their ganglia. PMID- 3630602 TI - Decreased arterial vasculature of the epididymal head in XXSxr pseudomale ('sex reversed') mice. AB - The microvasculature of epididymides of mature normal XY mice was found to be similar to that reported for other species. The abundant arterial supply to the initial segment is consistent with reports of extensive blood supply associated with high levels of metabolic activity in this segment. We have previously reported the absence of the initial segment in XXSxr pseudomale ('XX sex reversed') mice. We now present evidence of a decreased arterial supply to the proximal region of the epididymal head in XXSxr pseudomales, including the absence of the dense peritubular microvascular network which surrounds the initial segment in the normal epididymis. PMID- 3630603 TI - [The morphology and innervation of the levator muscles of the ribs in the dog, cat, horse, and pig]. AB - In the anatomical literature there are inconsistencies in the description of the levatores costarum muscles in man and in the domestic animals, and their innervation either by the dorsal or the ventral branches of the thoracic nerves. Therefore we studied the form, structure and, with the aid of the dissecting microscope, the innervation of these muscles in 7 dogs, 8 cats, 5 horses and 12 pigs. In the dog, cat and horse, mm. levatores costarum are present from the second to the last rib. In the pig, these muscles are present from the second to the 15th rib, even in individuals with 16 pairs of ribs. Mm. levatores costarum longi and a levator of the first rib could not be found in the domestic animals although these muscles are described in man. All mm. levatores costarum are innervated by branches of the lateral branch of the ramus dorsalis of the respective thoracic nerve. An additional branch of the r. muscularis proximalis of the intercostal nerves 1-3 innervates the lateral part of the levator muscles of the second to the fourth rib. PMID- 3630604 TI - Comparison of histoenzymological alterations in the contralateral ovary of nulliparous and parous females of the bat Taphozous melanopogon melanopogon Temmnick (Microchiroptera, Mammalia) displaying absolute dextral dominance of the genital tract. AB - Taphozous melanopogon melanopogon is a unique emballonurid microchiropteran which exhibits a 100% dextral dominance of the female genital tract. Folliculogenesis occurs in the contralateral ovaries, but it is only in the right ovary that a single Graafian follicle attains maturity and ovulates. The product of fertilization is implanted in the dextral uterine cornu. Seven types of follicles were identified in the right ovary, as compared with five in the left, on the basis of shape, size and number of associated granulosa cells. In the parous bats, a single, nearly extroverted corpus luteum was discerned in the ovary which survived for 2-2 1/2 months. The left ovary was nearly a vestigial structure during pregnancy. The structural asymmetry of the internal genitalia was observed to be correlated with the histochemical site and pattern of distribution of acid phosphatase and alkaline phosphatase. Differential activities of phosphatases were discerned in the developing primary, secondary, preantral and antral follicles and the interstitial tissues of the contralateral ovary during the nulliparous state. A high enzyme reaction was displayed by follicles undergoing atretic and degenerative changes. In the parous bats, pronounced differences were noted in the histologic constituents of the contralateral ovary. This study shows a significant link between functional asymmetry of the genitalia and the structural and enzymological characteristics of the ovarian tissues. PMID- 3630605 TI - Autonomic nerve terminals in relation to contractile and non-contractile structures in the conduit coronary artery of the dog. AB - The ramus interventricularis anterior (RIA), its first- and second-order branch were prepared for EM (perfused with glutaraldehyde under pressure, or simply fixed with KMnO4). No nerve fibres were found in the tunica media of either of the three consecutive segments. In the tunica adventitia axons with varicosities were found at a distance from the tunica media of 0.5-15 microns (about 50% 0.5 4.5 microns) in the RIA, 0.4-12 microns (about 50% 0.5-3.4 microns) in the first order branch and 0.3-6.0 microns (about 50% 0.3-2.3 microns) in the second-order branch. Varicosities contain small, dense-cored vesicles (35-60 nm) and large, dense-cored vesicles (70-90 nm, exceptionally up to 120 nm); the other type contains small, clear vesicles (35-60 nm) and few large, dense-cored vesicles (70 90 nm). The remarkably large distance between the nerve terminals and smooth muscle cells fits well with the small range of sympathetic control of the conduit coronary artery. Close apposition of nerve terminals to fibroblasts (30-200 nm) was revealed in all three consecutive coronary portions. Moreover, terminal axons often lose the Schwann cell cover on the abluminal site and face the fibroblast. PMID- 3630606 TI - Morphology of globule leucocyte from bovine bronchopulmonary lavage. AB - It has hitherto been assumed that the globule leucocytes (GL) occur as free cells in the airways of animals. The present study provides definite evidence for the occurrence of these cells in the bronchopulmonary lavage of cattle. At the light microscopic level, the GL was a round to elongate cell containing the characteristic large, round, metachromatic granules and an eccentric nucleus with a prominent nucleolus. Ultrastructurally, the cell was round, approximately 15 micron in diameter, and contained round, electron-dense granules which measured approximately 1.25 micron in diameter. The cell nucleus was endowed with abundant heterochromatin. The cytoplasm had only inconspicuous organelles. We conclude that the bovine GL is a specific cell which reaches the airway lumen following migration from the lining of the bronchopulmonary mucous membrane. PMID- 3630607 TI - Study of the cuspal ridges of the upper first molars in a modern Japanese population. AB - Materials used were dental casts of the upper first molars of modern Japanese subjects, comprising 29 males and 25 females. Their molar occlusal surfaces were photographed by moire contourography using the standard trigonal plane. The ridges of a cusp, comprising a central ridge and mesial and distal accessory ridges, were identified from the patterns of the moire fringes. The central ridge was observed in all cusps except for the hypocone in both sexes. Frequencies of the mesial and distal accessory ridges of trigonal cusps were over 90% except for the distal accessory ridge of the metacone, and those of the hypocone were under 25% in both sexes. These values were generally higher in males than in females, especially for the distal accessory ridge of the metacone. The running pattern of the cuspal ridges showed little difference between sexes. The oblique ridge which was higher than the central groove formed a saddle-like structure. This ridge was observed in all materials, but its heights and structural components varied remarkably. In this study, the distal accessory ridge of the metacone was found to be incorporated into the oblique ridge in about 13% of cases. Variability in the running pattern of the ridges within a single cusp was highest in the hypocone and lowest in both the paracone and protocone. The results obtained are considered to represent the stability or reductive tendency of cusps in the upper first molars. PMID- 3630608 TI - [A morphological study of the peri- and epineurium in the compression zone of the median nerve in carpal tunnel syndrome]. AB - The structure of the peri- and epineurium of the median nerve in the carpal tunnel syndrome was studied by light and transmission electron microscopy. Electron microscopy confirms the flattened lamellar arrangement of the perineurial cells, but in contrast to the normal architecture the perineurial component of the median nerve in carpal tunnel syndrome consists of 20-25 layers of ramified squamous-type cells, each layer being separated from the adjacent one by a wide space containing thick bundles of collagen fibrils. The perineurial cells are bounded on both sides by a basement membrane which is of substantial thickness. A prominent feature is the occurrence of multiple pinocytotic vesicles and caveolae opening on both the internal and external aspects of the flattened cells. They also contain bundles of closely aggregated filaments. In the spaces between the perineurial cells we find, in some places, extremely disoriented and individually abnormal fibrils and fine filaments arranged in form of a spider web. Matrix vesicles can also be seen. The epineurium of the median nerve in the carpal tunnel syndrome is also considerably thickened, and the attachment is solid, so that the median nerve is relatively immobile constricted like an hourglass. The thick collagen fibers are orientated predominantly parallel to the axis of the nerve, but circular fibers can also be seen. Apart from fibroblasts, the outer layer of the epineurium contains mast cells and vasa nervorum as well as myelinated nervi nervorum. Variable quantities of fat are also present, particularly in the surrounding loose connective tissue. PMID- 3630609 TI - Evonymus europaeus agglutinin as a marker of endothelial cells in the human. AB - Vascular endothelial cells were marked with Evonymus europaeus agglutinin (EEA) in the major organs of 6 subjects to reveal the anatomical distribution of positive elements in the human after fixation in paraformaldehyde-lysine periodate and embedding in paraffin. EEA may be used as a marker of human adult vascular endothelium in the same way as Ulex europaeus Agglutinin 1, revealing the same positive endothelial and epithelial territories. The intensity of labeling was constant in a given subject of the B blood group. In A or 0 individuals the cerebral endothelium showed a much lower reactivity than the cardiac endothelium. This lectin, equally active in higher mammals, offers the unique advantage of direct comparison between species. PMID- 3630610 TI - Topography, architecture and structure of the plexus submucosus internus (Meissner) of the porcine small intestine in scanning electron microscopy. AB - Scanning electron microscopy of whole-mount preparations of the tela submucosa in the porcine small intestine, examined after trypsin digestion, fixation and HCl hydrolysis, visualized a clear differentiation of the submucosal plexuses, i.e., the plexus submucosus internus (Meissner) and the plexus submucosus externus (Schabadasch). The distinctive features refer to the topography, number, size and shape of the ganglia and the number and diameter of the nerve strands. The plexus of Meissner is closely apposed to the external surface of the lamina muscularis mucosae by the enveloping connective tissue and by connecting strands penetrating the lamina muscularis mucosae. Three distinctive subdivisions of connecting strands can be identified. Since the glial cells covering the ganglia and connecting strands have been preserved, neither individual neuronal cells nor axons can be observed. PMID- 3630611 TI - Collagen concentration and mast cell in perinatal murine uterus. AB - Edema was found in the uterine tissue on the day of parturition. The number of mast cells was increased significantly on this day, indicating that the time of appearance of the edema is identical to the time of a significant increase in the number of mast cells. These results suggest that mast cells induce the high vascular permeability that permits passage of collagenase-activating proteases to the uterine tissue from the serum. PMID- 3630612 TI - Effect of reserpine on the differentiation of the external granular layer of the cerebellum in the chick embryo. AB - In this work we analyse the effect produced by reserpine on the development of thickness and cell number in the external granular layer in the cerebellum of chick embryo. A striking 48-hour histogenetic delay is observed in the treated embryos relative to controls, as show by greater thickness and cell density of this layer in the former, as well as by retarded appearance of a typical radial morphological organization of the external granular layer. PMID- 3630613 TI - Acute administration of chloral hydrate depletes cardiac enzymes in the rat. AB - The arterioles of the left cardiac ventricle were analyzed histochemically to determine the effects of an acute administration of chloral hydrate on key enzymes of aerobic and anaerobic metabolism, as well as the hexosemonophosphate shunt in rats. Significant changes were noted in three of the 5 enzymes examined. Our data suggest that nontoxic levels of chloral hydrate can cause impaired coronary metabolism. PMID- 3630614 TI - Innervation of the dermatomes in the neck of the mouse. AB - The dorsal rami of the cervical and thoracic spinal nerves were investigated using both the in situ cholinesterase staining technique and cholinesterase staining on serial sections of plastic-embedded embryos. In most cases only the dorsal rami of the 2nd to 5th cervical spinal nerve possess cutaneous branches. The area innervated by the cutaneous branch of the dorsal ramus of the 5th spinal nerve borders on an area innervated by the cutaneous branch of the dorsal ramus of the 1st thoracic spinal nerve. The dorsal rami of the cervical spinal nerves 6 8 show no cutaneous branches. Therefore the gap in the series of the dorsal cutaneous branches is due only to the middle part of the nerves of the brachial plexus, which range from the 5th cervical nerve to the 1st thoracic nerve. PMID- 3630615 TI - Ultrastructure of cementum formation on partially formed teeth in dogs. AB - Cementum crystals and matrix vesicles on the root surface of partially formed teeth in dogs were examined with a transmission electron microscope. Fine filamentous crystals were observed in the cementum calcifying fronts. The running pattern was mainly parallel to the root surface in the apical region and perpendicular to the root surface in lateral and coronal regions. Matrix vesicles were observed at the apical half of the periodontium, but not observed at the coronal region. These findings suggest that the parallel-arranged cementum would become the light-microscopic lamellar type and the perpendicular one the light microscopic dense-line structure when fully developed. Moreover, cementum formation occurs due to two kinds of mechanisms: participation of matrix vesicles and secondary calcification (= additional cementogenesis). PMID- 3630616 TI - Effects of mechanical loads on surface morphology of the condylar cartilage of the mandible in rats. AB - Mechanical loads on the condylar cartilage were varied by feeding either a hard diet, a soft diet, or a sequential combination of a soft diet followed by a hard diet to young male and female rats for a total period of 4 weeks, and to mature male rats for 12 weeks. Gross condylar dimensions were greatest in the hard-diet groups, intermediate in the combination soft/hard-diet groups, and smallest in the soft-diet groups. Scanning electron microscopy of the condyle revealed a smooth, nonporous articular surface in the soft-diet groups. Hard-diet condyles had a rougher, more porous articular surface while soft/hard-diet condyles were intermediate between nonporous and slightly roughened condyles. None of the condyles showed ridges or elevations on the articular surface. Sex, age and time of the diets did not significantly affect these results. PMID- 3630617 TI - Papain-induced changes in intracellular lipid levels in cartilage. AB - Loss of proteoglycans from the cartilage matrix of the ears of young rabbits was induced by intravenous injection of papain so as to permit histochemical observation of lipid levels in chondrocytes during both the depletion process and subsequent proteoglycan synthesis by the chondrocytes. Lipid content was quantified using an image analyser. Between 4 and 24 h after injection, loss of proteoglycans was accompanied by a fall in intracellular fat levels. In the 24- to 120-hour post-injection period, matrix proteoglycan levels and basophilia recovered parallel to the intracellular fat content. The function of intracellular lipids in cartilage is discussed in the light of these results. PMID- 3630618 TI - Ependymal foldings and other related ependymal structures in the cerebral aqueduct and fourth ventricle of man. AB - The ependymal lining of the cerebral aqueduct and fourth ventricle of 100 normal humans was studied with the light microscope. Ependymal foldings with normal morphology and a constant distribution pattern were detected in all. The most common sites were the median sulcus and sulcus limitans in the fourth ventricle, and the ventral and lateral walls in the cerebral aqueduct. Rows, islands and rosettes of ependymal cells embedded in normal subependyma were present in 25/82 adults (30%) and in 3/18 children (16%) in a similar distribution pattern as that of the ependymal foldings. We illustrate these normal structures which probably result from fusion between the walls of the ependymal foldings and distinguish them from granular ependymitis and postmortem artifact. PMID- 3630619 TI - Forces acting on the patella during maximal voluntary contraction of the quadriceps femoris muscle at different knee flexion/extension angles. AB - From knee extension moments measured with a dynamometer, the quadriceps muscle force, the patellar ligament force and the reaction force in the patellofemoral joint at various knee angles (0-90 degrees) were estimated. The information needed to calculate the combined effect of both patellofemoral and tibiofemoral joint on the mechanical advantage of the muscle was obtained from lateral-view radiographs of autopsy knees. The results show that the smallest quadriceps force (2,000 N) is exerted at maximal extension, and the largest force (8,000 N) at about 75 degrees of flexion. The patellar ligament force reaches a maximum (5,000 N) at 60 degrees. The reaction force in the patellofemoral joint is the smallest (1,000 N) at extension and is of the same values as the muscle force in a range from 75 to 90 degrees. Especially at large flexion angles, the value of the estimated forces is considerably larger (by 100%) than reported in the literature. This difference is attributed to the influence of the patellofemoral joint on the mechanical advantage of the muscle, which has not been taken into account in other studies. PMID- 3630620 TI - Development of the bovine ileal mucosa. AB - The development of the bovine ileal mucosa was studied with particular reference to maturation during the fetal and neonatal period. In this region, by 4-5 months of fetal development, vacuolation of the epithelial cells had occurred on the villi, and the goblet and absorptive cells in the crypts were present. By 6-9 months, the villi were longer and more numerous than in the previous stages. At the same time, the vacuolated cells could be seen predominantly on the upper half of each villus. The absorptive cells and goblet cells were more distinct in the crypt and lower half of each villus. Moreover, the goblet cells showed differences in mucin, while in the submucosa the lymphoid follicles were seen to have enlarged to become a prominent feature of the Peyer's patches at this stage. At birth, in suckled animals, the ileal cells on the lower area of each villus and in the crypt appeared more like mature cells. In contrast, there were numerous inclusion bodies in epithelial cells on the upper half of each villus. They appeared in the apical portion of the cytoplasm as vacuoles with stainable or dense contents. By 1 week, however, epithelial cells no longer contained inclusion bodies, and absorptive and goblet cell populations had begun to emerge from the crypts. These histological results suggest that the bovine ileal mucosa has two distinct turning points during its development in the fetus and the neonate. Initially all the mucosal structures are present in fetuses at 6-7 months of gestation, and then the vacuolated cells covering the ileal villi are replaced by mature, nonpinocytosing epithelium which emerges from the crypts on or before the 7th day after birth (ileal closure). PMID- 3630621 TI - Adrenomedullary chromaffin cells of the rat. An ultrastructural study. AB - Adrenomedullary chromaffin cells of the rat were studied at the ultrastructural level. Chromaffin cells contained a large population of electron-dense-core vesicles of two types, one very electron-dense (norepinephrine) and the other moderately electron-dense (epinephrine). The vesicles showed an even distribution pattern in the cytoplasmic matrix. No physical contacts were observed between cytoplasmic and vesicle membranes to indicate exocytosis, a mechanism frequently observed in the hamster. For chromaffin cells to be used as a transplantable source of dopamine, both the cells and vesicles must survive the trauma of denervation and vascular elimination or alternatively acquire the two factors from the transplantation site. PMID- 3630622 TI - [Study on the constitution of the human cervical plexus, with special reference to C3 and C4]. PMID- 3630623 TI - [Anomalous drainage of the coronary sinus into the left atrium: an account of two cases]. PMID- 3630624 TI - The surface structure of the dorsal epithelium of tongue in the mouse. PMID- 3630625 TI - [Electron microscopic study on postnatal development of golden hamster taste buds, with special reference to the correlation between their location and development]. PMID- 3630626 TI - Phage types, antibiograms and R-plasmids of Klebsiella and Enterobacter isolated from hospital environment and food. AB - Four-hundred and twenty-two Klebsiella strains and 294 Enterobacter strains were isolated from direct or indirect environment of hospitalized patients, from foodstuffs, foods, culinary utensils and staff in hospital and in catering establishments. Of Klebsiella, the species K. aerogenes (76.5%) of Enterobacter, the species E. cloacae (77.6%) occurred the most frequently in all specimens. Klebsiella strains were typable in 68.5%; 53.1% of the Enterobacter strains were sensitive to phage. Most of the untypable Klebsiella and Enterobacter strains and the multiresistant strains originated from screening in hospitals. Sensitive bacteria as well as those resistant to one or two antibiotics may be potentially dangerous for the patient consuming them, since they may become multiresistant due to R-plasmid transfer. PMID- 3630627 TI - Novel fermentation procedures for the production and the isolation of antibiotics. AB - Novel procedures for the production, in shaken and/or air-agitated fermentations, and the isolation of antibiotics were developed by which active crystalline flavofungin by Streptomyces flavofungini and an antibiotic produced by Streptomyces SK&F, BC-1652 were obtained. PMID- 3630628 TI - Growth of spontaneous BALB/c tumours excised from and retransplanted to autochtonous hosts. AB - Tumours of aged Balb/c mice developed without any conscious experimental interference were excised and retransplanted to the autochtonous hosts. The autotransplantation resulted in tumour take after a prolonged period of latency or in no take for an extended period of observation (more than 80 days) in 6 out of 19 cases. This can be regarded as a sign of antitumoural resistance, although it seems to be ineffective against development of recidives and metastases or second tumours. The sensitivity of the autotransplantation method in detecting antitumoural resistance was compared to that of the transplantation-excision retransplantation assay using a benzpyrene induced Balb/c fibrosarcoma; the autotransplantation method proved to be less sensitive. According to these data the existence of some kind of resistance against spontaneous tumour cells cannot be excluded. PMID- 3630629 TI - Interpretation of the presence of Plesiomonas shigelloides in faecal samples from patients with enteric disease. PMID- 3630630 TI - A comparison of cefonicid with other beta-lactams regarding the effect of human and mouse sera on antibacterial activity. AB - The effect of the addition of 50% human or mouse serum on the antibacterial activity of cefonicid, three first generation cephalosporins and ampicillin was studied. Human serum added to the test system considerably reduced the activity of cefonicid against Staphylococcus aureus and Staphylococcus epidermidis strains, and to a lesser degree against Proteus mirabilis, Escherichia coli and Klebsiella pneumoniae strains. Human serum also reduced, albeit to a lesser extent, the activities of cephalothin, cefazolin, and ampicillin, whereas it increased the activity of cephaloridine. In contrast, mouse serum did not or only insignificantly reduced the activity of cefonicid against some of the bacterial isolates; this is reflected in the excellent protective effect of cefonicid in experimental mouse infections. PMID- 3630631 TI - In vivo and in vitro effect of toxic and radio-detoxified endotoxin preparations on chemiluminescence of peritoneal cells of mice. AB - Chemiluminescence (CL) of peritoneal cells was investigated one and five days after injection of toxic and radio-detoxified endotoxin. The CL was triggered by toxic and radio-detoxified endotoxin. The radio-detoxified endotoxin has less pronounced in vivo activating effect than the toxic endotoxin. As triggering agent the toxic endotoxin was more effective than the radio-detoxified endotoxin. However, the radio-detoxified endotoxin has preserved some in vivo activating and in vitro triggering effect. PMID- 3630632 TI - Detection of Chlamydia trachomatis in the female genital tract by fluorescein labelled monoclonal antibody. AB - Endocervical smears were examined in a high-risk group of women using the Chlamyset "Direct Chlamydia Antigen Detection Test". From the 66 samples 42 were positive for Chlamydia trachomatis with highest incidence in the infertile group and in patients complaining of recurrent discharge. No correlation has been found between chlamydial endocervical infection and infected vaginal smears. PMID- 3630633 TI - Serum phenytoin during pregnancy, labor and puerperium. AB - 111 pregnancies of epileptic women on phenytoin therapy were observed in a prospective study. Maternal serum phenytoin concentrations were measured monthly or bi-weekly during pregnancy, labor and puerperium. The concentration decreased towards the end of pregnancy and was lowest at delivery. In 48% of the patients the drug dosage had to be increased to combat the increased seizure frequency. PMID- 3630634 TI - Alzheimer's disease: neuropathological correlates of cognitive and motor disorders. AB - Correlations between clinical symptoms and changes in brain neuropathology were investigated in 34 patients with Alzheimer's disease, who were compared with 17 non-demented, age-matched controls. The patients were originally found in a community survey of dementia and were followed up prospectively until death. A highly significant correlation emerged between the severity of dementia and the numbers of plaques and tangles in the material as a whole, but no essential difference was found between severely and less severely demented patients. Low brain weight correlated highly with many clinical symptoms and signs and the severity of dementia. A multiple regression model consisting of plaques and tangles in amygdala, gyrus frontalis medius, gyrus angularis, and gyrus temporalis medius, plaques of gyrus rectus, tangles of the hippocampus, gyrus precentralis and gyrus cinguli together with brain weight, emerged to link dementia to neuropathological changes at the level of maximum significance. Dyskinetic movements were associated with damage of several brain areas, implying a multiple etiology. PMID- 3630635 TI - Types of multi-infarct dementia. AB - A series of 79 patients with multi-infarct dementia (MID) were divided into 2 groups designated cortical MID and subcortical MID, according to whether the computed tomography (CT) scan showed the presence or absence of cortical infarcts, and an absent to mild or moderate to severe degree of white matter low attenuation (WMLA). Cortical MID was characterized by repeated atherothrombotic and cardiogenic strokes, moto-sensory hemiparesis, a severer degree of aphasia, and abrupt onset of cognitive failure. Subcortical MID typically showed the following features: lacunar strokes, bulbar signs including dysarthria, pure motor hemiparesis, depression and emotional lability. WMLA was found in all patients with subcortical MID but also in over 60% of those with cortical MID. In the 2 groups CT scans showed equal frequencies of deep infarcts. When divided according to severity of WMLA, 92% of patients in the cortical MID group and 44% of those in the subcortical MID group were found to have at least one cortical infarct on the CT scan. Although cortical and subcortical MID differed in several clinical features, they did not show major differences in the risk factors for stroke, and clearly overlapped each other as regards ischaemic scores and the findings in neurological examinations and CT. Thus, it is still an open question whether cortical MID and subcortical MID, including the lacunar state and Binswanger's disease, are 2 distinct entities or merely represent the expression of biological variation while having the same etiopathogenesis. PMID- 3630636 TI - Crossmodal interaction is reflected in vertex potentials but not in evoked magnetic fields. AB - Magnetic responses and slow vertex potentials evoked by tone bursts and median nerve shocks were recorded in healthy humans to study crossmodal interaction. Stimuli were presented either alone, simultaneously or in pairs separated by 0.5 s; the interstimulus interval was 5 s. Simultaneous or preceding stimuli of another modality did not influence the amplitudes of the magnetic responses, which are known to be generated at modality specific projection areas. However, the electric vertex potentials decreased in amplitude in similar situations, suggesting that the electric and magnetic responses reflect neural events of at least partly different brain areas. Our results do not give support for crossmodal interaction at the sensorimotor or auditory cortices. PMID- 3630637 TI - Muscle antibodies in the cerebrospinal fluid from patients with myasthenia gravis. AB - IgG antibodies to nicotinic acetylcholine receptor (AChR) and to a muscle antigen extracted by citric acid, were quantified in serum and cerebrospinal fluid (CSF) from 28 patients with myasthenia gravis, and the serum:CSF ratios compared with those of total IgG. Agarose-electrophoresis and calculations of the IgG index and Tourtellotte's formula were performed. No evidence of intrathecal antibody synthesis was demonstrated. Compared to the total IgG concentrations in serum and CSF, the CSF concentrations of IgG AChR antibodies were lower than expected. PMID- 3630638 TI - Cerebrovascular deaths before and after the appearance of oral contraceptives. AB - The mortality of cerebrovascular diseases in Denmark was analysed for men and women 15-44 years of age, in a 14-year period before and after the appearance of oral contraceptives (OC) in 1966. 1,670 deaths were registered over 28 years, during which the female incidence of cerebrovascular deaths increased by 19% (P less than 0.025), while the male mortality was unchanged. Women showed a percentage increase in deaths from cerebral thromboembolic attacks (CTA) of 33%, men a fall of 14%. The increase of female CTA deaths was most pronounced in the young fertile group, the age group with a high OC use. A relative risk of CTA of 3.3-4.5 for OC users compared with non-users could explain the CTA trend difference between women and men. No other single risk factor responsible for the observed trends could be identified. Both women and men had a significant increase in the mortality of subarachnoidal hemorrhages, and a significant fall in the mortality of intracerebral hemorrhages. PMID- 3630639 TI - Hypothalamic dysregulation of immune responses in focal dystonia. PMID- 3630640 TI - Bromocriptine long acting (LA) 50 mg intramuscular (IM) for the on-off phenomenon in Parkinson's disease. PMID- 3630641 TI - Cytotoxic response of serum from patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). AB - The serum of 8 patients with chronic inflammatory demyelinating polyneuropathy (CIDP) was tested using a chromium release cytotoxicity assay and cultured Schwann cells. Serum was obtained from all patients prior to treatment by plasma exchange, which was beneficial in some patients only. Those patients with high serum cytotoxicity (high chromium release) were those who showed a positive response to plasma exchange. PMID- 3630642 TI - Skin potentials (SP) recorded from the extremities and genital regions in normal and impotent subjects. AB - Skin potentials (SP) were evoked by peripheral nerve stimulation from the hands and feet of 41 and from the genital skin of 28 male, controls. The same methods were also applied in 10 functionally impotent cases, 32 diabetic impotent and 8 diabetic normopotent cases. The SP was easily obtained from all 3 sites in all normal subjects and in 10 functionally impotent cases. The SP recorded from the genital skin was either absent or abnormal in 53% of diabetic impotent cases with or without polyneuropathy, while the incidence of abnormalities encountered in the hand and/or foot recordings was 28%. In 8 diabetic normopotent cases the SP recorded from the genital and extremity skin were completely normal. SP recorded from the genital skin is a useful method of evaluating the autonomic-sympathetic dysfunction causing impotence, especially in patients who may have autonomic disorders either located in lumbosacral spinal cord and its efferents, or generalized autonomic-peripheral dysfunction. PMID- 3630643 TI - High-dose estrogen-progestagen oral contraceptives: a risk factor for aneurysmal subarachnoid hemorrhage? AB - A 10-year follow-up (1970-79) of a defined general population (n = 159 200) of middle-aged (born in 1911-40), urban, native Swedes, revealed that the prevalence rate of subarachnoid hemorrhage was 2.8 times higher in females than in males. This was mainly due to an accumulation of non-hypertensive aneurysmal subarachnoid bleeds in women born in the period 1932-40. The cases were significantly (P less than 0.001) overrepresented among divorced women, with relative risks of 1.89, 0.98 and 0.63 for divorced women, married women and spinsters (never married), respectively. Since high-dose estrogen-progestagen oral contraceptives have largely been used by the younger members of this study cohort, it may be speculated whether the observed substantial excess prevalence rate of subarachnoid hemorrhage with saccular aneurysm, not reported previously, represents a cohort effect unexpected after the introduction of low-dose oral contraceptives. PMID- 3630644 TI - Motor loss and swallowing difficulty after stroke: frequency, recovery, and prognosis. AB - Data relating to motor loss and swallowing difficulties in a community sample of 976 patients who suffered an acute stroke have been analysed. About 17% of patients seen within one week had no paralysis; at 6 months 48% of survivors had no paralysis and 9% had severe paralysis. The Motricity Index used to study motor loss related to functional loss and walking ability; it seems to be a simple valid measure of motor loss. Severe paralysis was associated with a high fatality rate, and only 6%-10% of survivors of an initially severe paralysis made a full recovery by 6 months. If severe persisted at 3 weeks, full recovery was not observed. Loss of sitting balance was associated with a poor outcome. Of conscious patients seen within one week, 14% choked on attempting to swallow and a further 28% had abnormal swallowing: this 42% of patients had a high fatality rate. PMID- 3630645 TI - CA-antibody: an immunological marker of thymic neoplasia in myasthenia gravis? AB - We have examined sera from 141 patients with myasthenia gravis and 11 non myasthenia gravis patients with thymoma for antibodies to a citric acid extract of skeletal muscle (CA-antibodies). Sera were obtained from 5 different centers. The thymus histology was defined in each case. Sera from 56/66 patients (85%) with thymoma contained CA-antibodies, while such antibodies were only detected in 6/75 (8%) of the non-thymoma patients. None of the patients with thymus hyperplasia had CA-antibodies. One MG patient who developed MG after a bone marrow transplantation, also developed CA-antibodies. The remaining 5 CA positive non-thymoma MG patients were all greater than 65 years and had thymic atrophy. Two of them had myasthenia gravis and polymyalgia rheumatica. In 2 thymoma patients with non-detectable levels of CA-antibodies before thymectomy, such antibodies were demonstrated in high titres after the operation. In 2 other sera from thymoma patients, the titres of CA-antibodies fell to less than 32 after thymectomy. There were 3 sera with CA-antibodies among 11 sera from non-MG patients with thymic tumours. PMID- 3630646 TI - Clinical effects and plasma concentrations of long-term clonazepam monotherapy in previously untreated epileptics. AB - Ninety-three, previously untreated epileptics were subjected to clonazepam monotherapy. The plasma clonazepam concentrations were monitored to achieve optimal therapeutic effects of the drug. Within a mean duration of follow-up of 32 months, 57 (61.3%) of the 93 cases became seizure-free. The drug showed a high efficacy for complete seizure control of more than 80% for both simple partial seizures and primary generalized tonic clonic ones. The mean plasma level of clonazepam giving complete seizure control was 14.7 ng/ml (range: 3.0-34.6 ng/ml) in cases of generalized epilepsy, and 15.6 ng/ml (range: 4.5-42.3 ng/ml) in cases of partial epilepsy. There was a high correlation between the plasma level and the dose, but no correlation between the plasma level and the clinical effect of the drug. The variable therapeutic range and great interindividual differences in the optimal plasma clonazepam level imply that individually tailored regimens are necessary to achieve optimal therapeutic effects of the drug. PMID- 3630647 TI - Sleep movements and associated autonomic nervous activities in patients with Parkinson's disease. AB - Nine parkinsonian patients were studied during one night using the static charge sensitive bed (SCSB) method for the monitoring of respiration, ballistocardiogram (BCG) and body movements. The parkinsonian sleep was more restless than that of the controls. As the SCSB-defined levels of autonomic nervous activity were concerned, the amount of motor active wakefulness (MAW) was significantly (P less than 0.05) increased in parkinsonian patients, who also had less quiet sleep (P less than 0.05) than the controls. Parkinsonian tremor was present during 29.8 +/ 15.8% of the time in bed. Usually it was observed during wakefulness; it disappeared when the patient fell asleep. The frequency of turning-over events in bed was smaller in the parkinsonian patients than in the controls (P less than 0.05). When the heart rate changes associated with sleep movements were studied it was found that the parasympathetic deceleration component in the parkinsonian patients was absent. The motor dysfunction associated with Parkinson's disease is reflected in many ways in the sleep movement activity. Sleep disturbances in PD seem to be secondary in character; i.e. they can be due to impaired motor functions like turning around in the bed, or due to impaired arousal mechanisms during sleep. PMID- 3630649 TI - Characteristics of pyridoxine overdose neuropathy syndrome. AB - A newly recognised neurotoxic syndrome due to pyridoxine (B6) overdose is described. It is the largest series of B6 intoxication hitherto reported. A raised serum B6 level was present in 172 women of whom 60% had neurological symptoms, which disappeared when B6 was withdrawn and reappeared in 4 cases when B6 was restarted. The mean dose of B6 in the 103 women with neurological symptoms was 117 +/- 92 mgs, compared with 116.2 +/- 66 mgs in the control group. There was a significant difference (P less than 0.01) in the average duration of ingestion of B6 in the neurotoxic group of 2.9 +/- 1.9 years compared with 1.6 +/ 2.1 years in controls. The symptoms were paraesthesia, hyperaesthesia, bone pains, muscle weakness, numbness and fasciculation, most marked on the extremities and predominantly bilateral unless there was a history of previous trauma to the limb. These women were taking a lower dose of B6 than previously described (1,2), which may account for the complete recovery within 6 months of stopping B6. PMID- 3630648 TI - Periodic breathing and hypoxia in snorers and controls: validation of snoring history and association with blood pressure and obesity. AB - Fifty-two men (aged 41-50 years) of whom 25 reported habitual and 27 of occasional or never snoring were examined clinically. Whole-night sleep recordings of body and breathing movements, snoring and blood oxygen saturation were made. Hypoxic events exceeding 4% from the baseline were counted. Ninety three percent of those classified snorers by the recordings were habitual or occasional snorers, but 50% of those similarly classified non-snorers had reported habitual or occasional snoring. Four habitual snorers had abnormal breathing indices and polysomnography established obstructive sleep apnea syndrome (OSAS) in one. Thus, self-reported habitual snoring is a reliable OSAS screening method. Estimated prevalence of OSAS based on this study is 0.4-1.4%. In multivariate regression analysis, the hypoxic events were explained by obesity and apneic events. The diastolic blood pressure level was best explained by obesity, but not hypoxic or apneic events or snoring history. PMID- 3630650 TI - Pressure sores common after hip operations. AB - We report the incidence of pressure sores in patients operated on for hip fracture or with total hip replacement. Pressure sores were found in 30 and 4 per cent, respectively. Half of the sores appeared within 1 week postoperatively, and more than half healed in the hospital. Most of the sores were found in patients over 80 years of age. No relation was found between pressure sores and smoking, diabetes mellitus, low hemoglobin, and poor state of nutrition. Patients with pressure sores stayed in the hospital longer and were often discharged to nursing homes. PMID- 3630651 TI - Sequential scintimetry after femoral neck fracture. Methodologic aspects and prediction of healing complications. AB - Forty-five patients with recent cervical hip fractures were included in a prospective, clinical, radiographic and sequential scintimetric study. Striking changes in radionuclide uptake over the entire hip region on the fracture side were found during the first 5 postoperative months. Fractures that healed without complications showed the highest relative femoral head uptake at 1 week and a peak value at 6 weeks, followed by a gradual decline at the subsequent examinations. Fractures with complications (redisplacement, nonunion, or late segmental collapse) showed a lower initial uptake and a more gradual increase and only a slight tendency towards increased uptake after 3 months. The accuracy in predicting nonunion with scintimetric examination alone is high both at 1 and at 6 weeks, and the accuracy is almost equally high with combined scintimetric, radiographic, and clinical assessment 3-5 months postoperatively. PMID- 3630652 TI - Hip replacement in obese patients. AB - In a 5-year follow-up study of 125 hip replacements a. m. Lubinus, 41 obese and 84 nonobese patients were compared. Peroperative blood loss was greater in the obese patients. There was, however, no difference in the operation or hospitalization times between the compared groups. There was no infection, wound dehiscence, or delay in wound healing. No deaths occurred during the immediate postoperative period. The obese patients had a lower preoperative walking-ability score. At follow-up, this difference was eliminated. Radiographic signs of loosening were equally common in the compared groups. Three patients, two of whom were in the nonobese group, had been reoperated on because of prosthetic loosening. Our results indicate that obesity does not increase the risk of surgical complication or prosthetic loosening in hip replacement. PMID- 3630653 TI - Incidence of hip replacement in southern Sweden. AB - During the years 1981-1982, 1,729 hip replacements were performed in the population of 943,000 persons in the nine southernmost orthopedic districts of Sweden. This is equivalent to 7,600 hip replacements per annum in the 8.3 million Swedish population. Based on the highest annual district incidence, the national equivalent increases to 12,500. Arthrosis accounted for 57 per cent of the arthroplasties, hip fracture for 23 per cent, and failed total hip replacement for 10 per cent. PMID- 3630654 TI - Poor function after nonoperative treatment of Kienbock's disease. AB - Twenty-five wrist joints treated with immobilization for Kienbock's disease were reexamined after 8 (1-11) years. Six patients had no pain, but 14 had daily problems with the wrist, and of these, 7 had to change their occupation. Five wrist joints were arthrodesed during the follow-up period. We conclude that nonoperative treatment of Kienbock's disease is ineffective. PMID- 3630655 TI - Compartment syndrome delays tibial union. AB - There has been no previous investigation into the association between compartment syndrome and delayed or nonunion of the tibia following fracture. To establish whether such an association might exist, a retrospective survey of the results of the treatment of closed and Grade I tibial fractures complicated by compartment syndrome was undertaken. The survey showed that there was a significant delay in fracture union in patients over 18 years of age, but not in younger patients. PMID- 3630656 TI - Poor results of double osteotomy for the rheumatoid knee. AB - A series of 27 patients (30 knees) with rheumatoid arthritis was studied 3 to 8 years after double osteotomy of the knee. Long-term results were poor. Double osteotomy should be abandoned in the management of the rheumatoid knee. PMID- 3630657 TI - Antibiotic penetration into the infected knee. A rabbit experiment. AB - We investigated the diffusion of penicillin-G, cloxacillin, clindamycin, and netilmicin into synovial fluid and membrane in rabbits. Purulent arthritis was induced in the right knee of each rabbit by inoculation of Staphylococcus aureus phage type 3C, whereas sterile saline was injected into the left knee to serve as a control. Two days later, concentrations of antibiotics were determined in serum, synovial fluid, and membrane after an intramuscular single dose. All four drugs diffused readily into infected joints, whereas the corresponding concentrations in the normal joints were 2-3 times lower. Clindamycin showed the highest intraarticular penetration, cloxacillin the lowest. The lower penetration of cloxacillin corresponded to its higher protein binding in rabbit serum. Considering the sufficient local concentrations achieved, parenteral treatment obviates the need for local instillation of these antibiotics. PMID- 3630658 TI - Immobilization and retraining of cruciate ligaments in the rat. AB - Fifty male rats, aged 40 days, were assigned to one of five groups to examine the influence of immobilization and retraining on the strength and elastic stiffness of the anterior and posterior cruciate ligaments. Following the experimental treatments, the anterior ligament from the right leg and the posterior ligament from the left leg were tested in tension at a separation speed of 50 mm/min. After 4 weeks of cast immobilization, the separation force of the anterior ligament declined by one fourth and elastic stiffness of both ligaments declined by one fourth and one third, respectively. No changes occurred in the separation force of the posterior ligament. Following a 6-week retraining swimming program, the separation force and elastic stiffness values had returned to control levels. Additionally, there was a transition from avulsion type failures in the immobilized groups of animals to insertion site and intraligament failures in animals subjected to rehabilitative swimming exercise. This was indicative of a return in the strength of the osseous component of the bone-ligament-bone complex following immobilization. PMID- 3630659 TI - Titanium implants in rabbit knee joints. AB - The subchondral bone, cartilage, and synovial tissue adjacent to nonalloyed titanium screws were morphologically evaluated 2, 4, and 6 weeks after insertion in rabbit knee joints. The titanium screws were in direct contact with the surrounding bone. Two weeks postoperatively, bone resorption, as well as formation of new bone on the titanium surface, was evident. The observed inflammatory process was transient, and the amount of bone within the screw threads increased progressively with time. The articular cartilage regenerated and covered the titanium screws. Synovial tissue also regenerated and covered the screws when inserted into a noncartilaginous area of the joint. These findings, together with recent findings in soft tissues, indicate that titanium provides an inert surface for the proliferation of differentiating tissues in vivo. These data, supported by the observation that no inflammation was present in the synovial tissue, suggest that nonalloyed titanium can be used safely intraarticularly. PMID- 3630660 TI - Surgery for neglected congenital torticollis. AB - Nineteen patients were operated on for congenital muscular torticollis after the age of 1 year. Tenotomy gave good results below 5 years of age and resection of the sternocleidomastoid muscle was satisfactory in most of the older children. PMID- 3630661 TI - Arthroscopy of the knee in children. AB - Diagnostic arthroscopy was performed in 174 consecutive patients under the age of 18 years. Eight arthroscopies were bilateral. The clinical diagnosis was confirmed in only three of 17 knees in children under aged 14 years and in 44 per cent of the knees in older children. The most commonly disproved diagnoses were torn meniscus and chondromalacia patella. Arthroscopy seldom changed the diagnosis in cases of osteochondritis dissecans. In 38 per cent of the knees, arthroscopy revealed no surgical treatable abnormality, and unnecessary arthrotomy was avoided. Arthroscopy in acute hemarthrosis revealed that ligamentous tears are rather common in children; in nine of 25 knees a partial or complete tear of the anterior cruciate ligament was demonstrated at arthroscopy. The clinical diagnosis was confirmed in eight knees in cases of hemarthrosis. There was no significant difference between the hemarthrosis group and the remaining group as regards a disproved clinical diagnosis. We conclude that arthrotomy should always be preceded by diagnostic arthroscopy in children and adolescents if the clinical diagnosis leaves any doubt. PMID- 3630662 TI - Delayed skeletal maturation in Perthes' disease. AB - We have studied skeletal maturation and carpal bone development in 27 girls with Perthes' disease by assessing consecutive radiographs during an observation time of 5 years. At the time of diagnosis of Perthes' disease, delayed skeletal maturation was both frequent and considerable and greater than at the end of observation. The mean age at appearance of carpal bones was delayed compared with controls. In bilateral disease, compared with unilateral disease, the onset of ossification in the carpals occurred later. PMID- 3630663 TI - Irreducible fracture of the wrist in a child. Entrapment of the extensor tendons. AB - A previously undescribed fracture-separation of the distal radial and ulnar physis is presented. A Salter-Harris Type II phys-metaphyseal fracture of both radius and ulna, with volar displacement, was found irreducible by closed means. At operation the extensor tendons were found entrapped between the metaphysis and epiphysis of both radius and ulna, which prevented reduction. Reduction was possible only after this entrapment was released. PMID- 3630664 TI - Gouty tenosynovitis simulating an infection. A case report. AB - Gouty tenosynovitis in the hand may be misdiagnosed as infectious or rheumatoid synovitis. Our case initially was treated as infectious tenosynovitis, but at reoperation gouty deposits were found penetrating the flexor tendon sheath. Tenosynovectomy and excision of intratendinous tophi were performed with a good result. Gouty synovitis is diagnosed in specimens fixed with ethanol because formalin destroys the typical crystals of urate. PMID- 3630665 TI - Partial rupture of the distal biceps brachii tendon. A case report. AB - Traumatic rupture of the lacertus fibrosus in the biceps aponeurosis and elongation of a normal-appearing biceps tendon caused weakening in elbow flexion and forearm supination. Normal function was restored by shortening of the biceps tendon and aponeurosis 8 months after the accident. PMID- 3630666 TI - Fracture in progressive ossifying fibrodysplasia. A case report. AB - Progressive ossifying fibrodysplasia is a rare genetic disorder of connective tissue. A 6-year-old boy sustained a fracture of the humerus and afterwards of the femur. The former fracture was treated closed and the latter with internal fixation. Both fractures healed with severe restriction of joint motion. PMID- 3630667 TI - Breakage of a sliding hip screw. A case report. AB - I report a case of breakage of a Richards sliding screw used in treatment of a trochanteric fracture. The mechanism was probably prevention of sliding caused by collision with an extra screw. PMID- 3630668 TI - Musculocutaneous nerve injury after coracoid process transfer for clavicle instability. Report of three cases. AB - During the last 10 years, we have treated 54 cases of fracture or dislocation of the lateral clavicle by transposing the coracoid process onto the clavicle. Recently, a postoperative musculocutaneous nerve injury was observed in 3 cases, all of which recovered spontaneously within 5 months. Our technique seems to entail a certain risk of causing stretch injury to the musculocutaneous nerve. Apart from resting the affected arm for a month or two, the condition does not require specific treatment. PMID- 3630669 TI - Arthroplasty in tuberculosis of the knee. Two cases of missed diagnosis. AB - Active tuberculosis arthritis was diagnosed in two patients after they had undergone total knee replacement. Antituberculous therapy was successful. PMID- 3630671 TI - Proceedings of the Danish Orthopedic Society. Copenhagen, October 24-25, 1986. Abstracts. PMID- 3630670 TI - Proceedings of the Swedish Orthopedic Society. Ostersund, September 10-12, 1986. Abstracts. PMID- 3630672 TI - Clinical and radiological features of osteogenesis imperfecta type IVA. AB - This paper reports a survey of 78 patients with osteogenesis imperfecta (OI) type IVA, the variant that causes the greatest difficulties in differential diagnosis. A subgroup of children aged between five and eleven were compared with a control group from local schools. Among the OI children there were, apart from the high number of fractures, also significantly increased incidences of bruising, nosebleeds, excessive sweating and hypermobility of joints. Although none of the children with OI type IV had the dark blue or grey sclerae of the type I disease, an appreciable number had pale blue sclerae in early childhood. Radiologically normal bone texture was seen at the time of the first fracture in 10 out of 17 patients. Hypertrophic callus was seen in five patients and metaphyseal fractures in four. We hope that the information on this large group of patients will assist in the prevention of diagnostic difficulties. PMID- 3630673 TI - Gastric suction in healthy newborn infants. Effects on circulation and developing feeding behaviour. AB - Gastric emptying of newborn infants is a procedure performed to prevent aspiration of gastric contents. The present investigation was conducted to study the effects of gastric suction on circulatory and behavioural parameters in 21 healthy newborn children (11 cases, 10 controls). A small elevation in mean arterial blood pressure was observed during gastric suction. The incidence of retching was also increased. In all children spontaneous sucking and rooting movements, as well as state of sleep and wakefulness were recorded. In the control group spontaneous sucking and rooting movements started occur 15 min after birth and reached a maximum at 45 and 60 min, respectively. The first hand to mouth movement was observed after a mean of 34 min and the infants found the nipple and started to suckle at about 55 min. This sequence of prefeeding behaviour was disrupted in children who had undergone gastric suction. The physiological side-effects induced by gastric suction are minor, but it seemed to be unpleasant for the child and no clear advantages are gained by the procedure. PMID- 3630674 TI - Neonatal hyperexcitability in relation to plasma ionized calcium, magnesium, phosphate and glucose. AB - Twenty-two full-term babies were examined with a quantitative neurological assessment on days 1, 2 and 5 in order to confirm the clinical impression of hyperexcitability observed at the routine examination on day 1. Ultrasound examination of the head was normal in all cases. Plasma ionized calcium, phosphate and glucose in the hyperexcitability group fell within the neonatal reference ranges, as described previously. However, serum magnesium was significantly lower on day 1, but spontaneously normalized on day 5. Routine check-ups at the well-baby-clinics did not reveal any major illnesses or developmental abnormalities. PMID- 3630675 TI - Iron balances in infant nutrition. AB - Iron balance studies were performed in 17 full term male infants from their 3rd until their 17th week of life. The balance studies were made in the infant's home and comprised 5 periods with an interval of 3-4 weeks, each consisting of three 24-hour collections. Ten infants were breast-fed, 3 received an adapted infant formula (P1, iron content 1.1 mg/l) and 4 were given the same formula enriched with iron, copper and zinc (P2, iron content 10.35 mg/l). From the 3rd to the 17th week of life the breast-fed infants got a mean iron intake of 0.2 mg/kg body weight X 3 days and they retained 0.09 mg/kg b.w. X 3 days. The P1 group received 0.48 and 0.47 mg/kg b.w. X 3 days and retained -0.01 and -0.5 mg iron/kg b.w. X 3 days, while the P2 group had an intake from 5.04 to 6.38 mg b.w. X 3 days and retained between 1.13 and 3.66 mg iron/kg b.w. X 3 days. Comparing the 3 groups it can be concluded that the P1 group retained definitely less iron than the breast-fed group, whereas the P2 group retained 12 to 40 times more iron than the breast-fed babies. PMID- 3630677 TI - Hypothyroidism in children with filter paper TSH of 30 to 50 microU/ml at initial screening. Implication of the TSH cut-off point for recalling of infants at risk. AB - In a systematic screening of newborns in France during the period from 1979 to 1983, 959 infants with hypothyroidism were detected. In 16 cases of confirmed hypothyroidism the initial filter paper TSH (FP-TSH) was between 30 and 50 microU/ml. These cases emphasize the necessity of keeping a "security zone" for FP-TSH value between 30 and 50 microU/ml and of recalling these patients for a second test filter paper TSH. PMID- 3630676 TI - The nutritional role of breast-milk IgA and lactoferrin. AB - The nutritional enigma concerning the extent to which breast-milk immune proteins are digested has been investigated by measuring the intakes and faecal outputs of IgA and lactoferrin over 7 days in 10 exclusively breast-fed (BF) and 9 formula fed (FF) fullterm infants at 6 and 12 weeks post-partum. BF outputs (mg/day) greatly exceeded FF values (p less than 0.001): at 6 weeks secretory-IgA BF = 160 +/- 28, FF = 14 +/- 2, lactoferrin BF = 14 +/- 2, FF = 0.9 +/- 0.1; at 12 weeks secretory-IgA BF = 94 +/- 17, FF = 25 +/- 5, lactoferrin BF = 7 +/- 1, FF = 1 +/- 0.3. Secretory-IgA represented 42% and 27% of BF faecal protein at 6 and 12 weeks compared with 6% for FF infants at both ages. BF secretory-IgA outputs were highly correlated with intakes (r = 0.83, p less than 0.001). IgA and lactoferrin outputs and the presence of faecal secretory-IgA fragments in BF and FF infants were influenced by defaecation rate, suggesting that partial degradation occurred in the large intestine. By 6 weeks post-partum only 1% lactoferrin and 17% secretory-IgA intakes appeared in the faeces and 95% breast-milk protein could be regarded as nutritionally available. The elevated BF outputs of IgA and lactoferrin relative to endogenous excretion suggest, however, that breast-milk may still make a considerable contribution to intestinal defence mechanisms after the neonatal period despite the small proportion of daily intake which escapes digestion. The protective action of IgA and lactoferrin may also depend on their site of degradation and the nature of fragments. PMID- 3630678 TI - Urinary C-peptide excretion at onset of insulin dependent diabetes mellitus in children. AB - The 24-hour urinary excretion of C-peptide and the plasma C-peptide concentration were measured at the onset of insulin dependent diabetes mellitus (IDDM) in children. The excretion of C-peptide was twice as high as that found in normal control subjects, whereas the plasma C-peptide values were markedly lower, indicating increased urinary leakage of C-peptide in this phase of the disease. In the diabetic children under seven years of age the mean value of C-peptide excretion was clearly lower than in the older children. PMID- 3630679 TI - Zinc and copper status of allergic children. AB - Zinc and copper status was examined in 19 healthy and 43 atopic children (22 asthmatics and 21 eczematous) 2-14 years old. Dietary intakes for energy, protein, zinc and copper and some nutritional indices (height, weight, serum protein, albumin, ceruloplasmin) were similar in the allergic and in the control group. The proton-induced X-ray fluorescence technique was used to assess zinc and copper concentrations in serum and hair. No difference was detected in serum zinc concentration between allergic and healthy children. In contrast, mean hair zinc level was lower (p less than 0.05) in allergic than in healthy children (99 +/- 6 vs. 147 +/- 9 micrograms/g). Mean serum copper content was higher in asthmatic than in control children while mean hair copper was higher (p less than 0.05) in asthmatic and eczematous children than in the control group. These findings suggest a different zinc and copper nutritional status between allergic and healthy subjects. Allergic children, in particular, seem to be a risk of zinc deficiency. PMID- 3630680 TI - Factors affecting the occurrence of acute otitis media during the first year of life. AB - A regional birth cohort of 5,356 infants was enrolled into a follow-up study in order to investigate the determinants of the development of infectious diseases in children. The infants were examined at three months, six months and twelve months of age by the physicians at the well-baby clinics. At these occasions the number of episodes of acute otitis media in the infants, the duration of breast feeding, the number of siblings, the type of day care, parental smoking, the presence of animal pets at home and the number and type of other illnesses than otitis were registered. Two thirds of the infants had no episodes of acute otitis media. The median age for the first episode of acute otitis media was eight months. About 10% of the infants had experienced recurrent otitis media (three episodes or more) during their first year of life. Significant associations were found between the occurrence of acute otitis media and the number of siblings, the type of day care, the sex of the infant, the duration of breast feeding, maternal socioeconomic status and prematurity. PMID- 3630681 TI - Acute illnesses in young children and family response. AB - Swedish speaking parents of 446 children, all around one year of age and living in the suburbs of Stockholm, participated in a three-week diary study. The aim was to describe the pattern of illnesses in children and the measures taken in the family and to correlate the findings with the socio-economic conditions of the family. A health complaint, most frequently running or blocked nose or a cough, was recorded for about 1/3 of the days of observation. Some form of family action was recorded on 70% of these days. Medicines were given on 39% of the complaint days and relatives, friends or a health professional were contacted on less than 10% of the days. In case of acute respiratory infection medicines were given or a health professional contacted more often if the symptom was recorded as severe. Most frequently the Child Health Centre nurse was consulted. The measures taken by the parents were judged to be rational. However, one quarter of the parents expressed uncertainty about the care of the acute infectious disorders of the child. Correlations between family response and socioeconomic factors were weak. PMID- 3630682 TI - Growth of 519 small for gestational age infants during the first two years of life. AB - The physical growth of 519 small for gestational age infants (SGA), with a birth weight below the 10th percentile on our own growth curve, born in the region of University Central Hospital of Turku during the period June 1, 1981-May 31, 1982, was studied. The study population consists of 4,517 term, appropriate for gestational age (AGA) infants, 488 term SGA infants, 320 preterm AGA infants and 31 preterm SGA infants. The degree of intrauterine growth retardation (IUGR) seemed to have an effect on physical growth in term SGA infants. Those term SGA infants with a low Ponderal Index (PI) (type II) were taller and had a larger head circumference at the age of 24 months than term SGA infants with adequate PI (type I). Among the preterm SGA infants the degree of IUGR seemed to have no effect on later growth. Smoking is still one of the main risk factors associated with poor intrauterine growth. In this study we also found that smoking has an effect on later growth; the children of smoking mothers were smaller than those of non-smoking mothers in the AGA group. Among the SGA infants the infants of non smoking mothers were bigger than those of smoking mothers. This difference could be explained by other factors associated with SGA. We found that in spite of the catch-up growth during the first months, 26% of the severely SGA infants (birth weight below the 2.5th percentile) still had a weight below the 2.5th percentile at the age of 24 months. PMID- 3630683 TI - Eventration of the diaphragm in infants and children. AB - The study reviews 18 infants and children with eventration of the diaphragm who were treated over a period of eight years. The affected diaphragm and pulmonary tissue were examined by light and electron microscopy. The 18 patients, ranging in age from 10 days to 6 years, were divided according to Thomas' classification into a group with the congenital (10 patients) and a group with the acquired type (8 patients). Fifteen of these patients underwent surgery with diaphragmatic plication. On microscopic examination, biopsies of the lung showed atelectasis and pneumonia. These pathological changes became increasingly diffuse and severe with age. The diaphragm in patients with the congenital type of eventration was occupied by diffuse fibroelastic tissue. In patients with the acquired type, the cross-striated muscles of the diaphragm showed degenerative changes such as fragmentation, and interstitial fibrosis of the diaphragm became prominent with age. The results of this clinical study suggest that, in order to reduce the pathological changes in the lung, early surgical plication should be performed even in patients with the acquired type, if respiratory and digestive symptoms are noted. PMID- 3630684 TI - Survival of the weakest. Improving prospects for surgery in infants of birthweight less than 1,200 grams. AB - Over a six-year period seventeen infants of birthweight less than 1,200 grams (including nine of birthweight less than 1,000 grams) underwent major gastrointestinal surgery. Fourteen of the seventeen (82%) survived, a higher rate than previously reported. Nine infants had necrotising enterocolitis, three had oesophageal atresia and five had other types of intestinal obstruction. Six infants who were unfit to be transferred to the operating theatre underwent surgery on the neonatal unit: of these, four survived. We feel the outlook is optimised by conservative surgical intervention and by maximal medical support with intensive care monitoring, post-operative mechanical ventilation and intravenous alimentation. Survival after surgery is now very much the rule in the extremely low birthweight infant, even in those who are too sick to be transferred to the operating theatre. PMID- 3630685 TI - Partial remission of nephrotic syndrome during whooping cough. PMID- 3630686 TI - Prevalence and characteristics of coeliac disease in type 1 diabetes mellitus. PMID- 3630687 TI - Bacterial etiology of neonatal septicemia in relation to prior antibiotic treatment. PMID- 3630688 TI - Blood concentrations of chlorhexidine in neonates undergoing routine cord care with 4% chlorhexidine gluconate solution. PMID- 3630689 TI - Plasma pipecolic acid concentration in normal pregnant women, children and adults. PMID- 3630690 TI - Treatment of caffeine intoxication by exchange transfusion in a newborn. AB - The symptoms of acute poisoning after accidental administration of ten times the usually prescribed dosage of caffeine in a premature infant included the following neurological signs: incessant tremors, hypertonia, continuous opisthotonos posture, whining and crying and digestive disturbances. The very high serum caffeine levels, 160 mg/l, determined 66 hours after the first administration was confirmed by the very high cerebrospinal fluid caffeine concentration 115 mg/l. Two exchange transfusions performed at an interval of 16 hours produced a large decrease in serum caffeine levels of approximately 40 mg/l each time, and a similar decrease in the cerebrospinal fluid concentration. The clinical status of the infant improved very rapidly and the child's psychomotor development was normal at 3 months of age. PMID- 3630691 TI - Vipera berus bites in children--experience of early antivenom treatment. AB - Children are a risk group for snake bites. Treatment with antivenom is controversial. Three cases of snake bite (Vipera berus) in children are reported. Antivenom was given due to serious toxic reactions. The clinical course in these three cases indicate that in children treatment with antivenom should be seriously considered at an early stage when there are signs of exposure to a considerable amount of poison, i.e. hypotension, drowsiness or confusion, acidosis and leucocytosis. Allergic diathesis is a relative contraindication. PMID- 3630692 TI - Circulating autoantibodies to thyroid hormones: a diagnostic pitfall. AB - Circulating autoantibodies to thyroid hormones are occasionally detected and may cause confusion, because symptoms and signs are inconsistent with the measured thyroid hormone values. We present a 5 1/2 year old girl with Hashimoto's thyroiditis and false high concentrations of free thyroxine and total triiodothyronine. PMID- 3630693 TI - Serial section analysis of the lesions in diffuse panbronchiolitis. AB - Diffuse panbronchiolitis (DPB) is clinically and pathologically an independent entity and should be discriminated from the usual bronchiolitis obliterans. The lesions of 20 cases of DPB were serially sectioned and reconstruction was made focusing on the region from the terminal to the respiratory bronchioles. Morphological changes in the region of the respiratory bronchioles were clearly understood and were classified into three types by the presence and the size of the intraluminal granulation tissue. The walls of the respiratory bronchioles were thickened with cell infiltration and granulation tissue in all foci (28 in total), and 26 foci showed intraluminal granulation tissue whereas only 2 foci did not exhibit intraluminal plugs. Xanthoma cells were mostly observed in the interstitial tissue of the alveolar ducts, sacs, and septal walls distal to the stenotic sites as well as in the alveolar spaces in the marked cases. PMID- 3630694 TI - Clinicopathological studies on pulmonary hypoplasia in very low birth weight infants. AB - Seven VLBW infants with pulmonary hypoplasia (P.H.) were studied retrospectively and their necropsied lungs were analyzed morphologically and histometrically in an attempt to establish the clinical and pathological criteria of P.H. Clinically they had various features as follows; 1) causes with oligohydramnios due to amniotic fluid leakage, 2) bell-shaped chest and/or small lung radiographically, 3) severe respiratory distress immediately after birth, 4) frequent complications with air leaks, lethal within several hours after birth. Pathologically they showed a series of changes; 1) remarkably decreased LW: BW ratios, less than 0.015, 2) decreased number of alveoli per alveolar duct, less than 3 or 4 alveoli/duct compared with 6.5 of normal controls at 28 weeks' gestation, 3) immature duct system and increased interstitium which suggested delay in growth and structural maturation of the lungs. It is suggested that the tendency to develop pulmonary air leaks is not only due to high pressure ventilation but also to histological immaturity of the lungs. PMID- 3630695 TI - Dysplasia of gallbladder. Its pathological significance. AB - Twenty-three cases of dysplasia of the gallbladder and 38 cases of carcinoma with surrounding dysplasia were investigated. The dysplasia did not show any remarkable lesion and consisted of atypical basophilic cells with oval or round nuclei. The ratio of nucleus to cytoplasm (N/C) ratio was usually larger than the normal epithelial cells. For the combined dysplasia, it has been considered that 1) the dysplasia arose as well-differentiated carcinoma, 2) appeared synchronously, 3) arose secondarily, and 4) appeared as a precancerous lesion. Intestinal metaplasia, dysplasia, and carcinoma showed similar characteristics as to location and mucin-chemistry. According to CEA stain by PAP method, the dysplasia and carcinoma showed similar characteristics. It may be considered that the sequence of intestinal metaplasia-dysplasia-carcinoma is important. PMID- 3630696 TI - Ultrastructural localization of endogenous peroxidase activity in benign thyroid diseases. AB - Ultrastructural localization of endogenous thyroid peroxidase under benign pathological conditions such as toxic diffuse goiter, non-toxic multinodular goiter, and adenoma, and in normal tissue was studied. Peroxidase activity was visualized by a cytochemical reaction for electron microscopy. In toxic diffuse goiters and most non-toxic multinodular goiters, reaction product for peroxidase was observed not only in the cytoplasm but also at the external surface of microvilli of follicular cells. In normal thyroid tissues and adenomas, peroxidase was visualized only in the cytoplasm. Peroxidase activity at the external surface of microvilli of the follicular cells was found in the tissues obtained from the goiters which showed "hot" radioiodine scintigram. These findings suggest that follicles with peroxidase activity at the external surface of microvilli in non-toxic multinodular goiter are "autonomous follicles" and that peroxidase at the external surface of microvilli plays some role in active iodine uptake. PMID- 3630698 TI - Primary trabecular carcinoid of the ovary. AB - A case of primary trabecular carcinoid of the ovary apparently occurring from the foregut element of a mature cystic teratoma was reported. The tumor was found incidentally and resected surgically from a 56-year-old female. The cystic teratoma found in the tumor was composed of only respiratory epithelium except a colliculus which showed a picture of tonsil-like tissue. No thyroid tissue was found. The trabeculae of the tumor cells were longer and wavier near the cystic teratoma, while they were straight and short at the periphery. The tumor cells had argyrophil granules but negative in argentaffin granules. The electronmicroscopy revealed many round neurosecretory granules measuring from 170 to 290 nm in diameter. The histogenesis was also discussed. PMID- 3630697 TI - Argyrophilic adenocarcinoma of the prostate with Paneth cell-like granules. AB - A prostatic adenocarcinoma with argyrophilia and many Paneth cell-like granules in a 91-year-old man is reported. The initial symptom was pollakisuria, and the laboratory data showed no significant abnormality except for moderate anemia. Through radiologic examinations a right hydronephrosis and metastatic cancer of the lumbar vertebra were suspected. Because prostatic cancer was suspected, a needle biopsy of the prostate was performed. Routine histologic examinations revealed a moderately differentiated adenocarcinoma of the prostate. By hematoxylin and eosin stain, eosinophilic large granules like those of Paneth cells were found in many cancer cells. In addition, argyrophilic cancer cells were seen by Grimelius' stain. Immunoperoxidase staining elucidated a definite reactivity for lysozyme in the granules like Paneth cells. Ultrastructurally, the granules of Paneth cell-like cancer cells were electron-dense spherical bodies with a medium diameter of 540 nm. Prostatic adenocarcinoma with argyrophilia is rare, and the argyrophilic adenocarcinoma with Paneth cell-like granules is very rare in the prostate. PMID- 3630699 TI - Ultrastructural characteristics of a pleomorphic liposarcoma. A possible involvement of myofibroblast. AB - A pleomorphic liposarcoma originated from the epicardial fatty tissue was studied with an electron microscope. The transmission electron microscopic examination revealed fibroblastic, myofibroblastic and primitive mesenchymal cells. Fibroblastic cells characterized by irregular nucleus with abundant heterchromatin and dilated cisternae were most frequently encountered, and the myofibroblastic cells, secondly in frequency, contained bundles of microfilaments with occasional dense bodies and outlined by discontinuous thin basal lamina. The primitive mesenchymal cells had mainly oval nucleus and electron lucent cytoplasm with poorly to moderately developed cell organellae. Some of the multinucleated giant cells relatively frequently observed revealed the aggregates of filaments with dense bodies at the cell margin. Many of them, irrespective of cell types, contained lipid droplets in the cytoplasm with various sizes. These observations suggest that a pleomorphic liposarcoma, at least a few of them, might contain not only fibroblastic, primitive mesenchymal but also myofibroblastic tumor cells with morphological varieties. PMID- 3630700 TI - Disseminated visceral giant cell arteritis. AB - Autopsy findings of disseminated visceral giant cell arteritis in a 78-year-old man who was in chronic renal failure for two years were presented. Arteritis had not been suspected clinically and definite diagnosis was made after the autopsy. Only small arteries and arterioles were involved. The arteritis was characterized by granulomatous lesion with exclusively multinucleated giant cells. Fibrinoid necrosis with polymorphonuclear leukocyte infiltration was found only in one arteriole of the stomach. The arteritis was distributed in the heart, lungs, kidneys, gastrointestinal tract, liver, gallbladder, pancreas, prostate, and lymph nodes, but not in the aorta and brain. This peculiar type of arteritis was reported only by LIE and the entity was designated as disseminated visceral giant cell arteritis. PMID- 3630701 TI - Exfoliative cytopathology of alveolar rhabdomyosarcoma. AB - Exfoliative cytopathology of alveolar rhabdomyosarcoma is presented. A 34-year old male was found to have alveolar rhabdomyosarcoma of the retroperitoneum at autopsy. Ascites was recognized in the course of this disease. Cytological features in the ascites were characterized by relatively small-sized ovoid cells observed singly or in loose clusters. The neoplastic cells possessed small amount of rather vesicular cytoplasm and an eccentric nucleus. The nucleus characteristically revealed multiple deep indentations in the nuclear membrane, a few prominent eosinophilic nucleoli and finely granular or evenly distributed chromatin pattern. These cytological findings, especially the nuclear features, might be useful to differentiate alveolar rhabdomyosarcoma from other neoplasms which consist of relatively small-sized ovoid cells even if the striated muscle origin cannot be confirmed by immunoperoxidase staining. PMID- 3630702 TI - Malignant ganglioglioma of the spinal cord. AB - A case of tumor of the spinal cord with a long clinical history was described. At autopsy, the tumor was composed of a mixture of two elemental cells, i.e. matured but neoplastic ganglionic cells and anaplastic glial cells. The clinical manifestations suggested that the tumor in this case developed in a benign form with malignant evolution occurring during the latter part of its clinical course. The malignant evolution, however, was due to aggressive and anaplastic growth only of the elemental glial cells, while the cytologic features of the elemental ganglionic cells remained always benign. PMID- 3630703 TI - Papillary adenoma in a lateral cervical cyst. AB - A lateral cervical cyst located in the left lower neck and had no connection with the thymus, thyroid or parotid gland has been described. Its origin might be the remnant of thymic duct, since Hassal's corpuscle-like structure was found in the cystic wall, although established thymic tissue could not be detected. The most interesting feature of the cyst was that the lining showed papillary adenoma approximately in one-fifth of the luminar surface, whereas the rest was lined by either cuboidal to columnar, nonciliated epithelial cells or metaplastic squamous epithelial cells. This is the first documented case of papillary adenoma in a lateral cervical cyst of possible thymic duct origin. PMID- 3630704 TI - Ventriculo-coronary micro-communications in pulmonary atresia and sequential changes of coronary arteries. AB - In the present paper, numerous micro-communications between myocardial sinusoids and small branches of coronary arteries are studied which existed in a rudimentary right ventricle of a female neonate with pulmonary atresia and an intact ventricular septum, who was born on the 40th week of gestation. Cardioangiography revealed a large fistulous subepicardial communication. At autopsy, myocardium of the right ventricle appeared spongy with extensive sinusoid slits. In addition to the large communication which was connecting a deeply extending sinusoid of the right ventricle to the main trunk of the anterior descending artery, numerous micro-communications were found between myocardial sinusoids in the rudimentary right ventricle and intramural small branches of the coronary artery. Furthermore, morphometrical analysis demonstrated that the medias of the intramural arteries in both ventricles of the present case were significantly hypertrophic, as compared with those in the control cases without communications (p less than 0.05). These facts indicate the significance of hemodynamic factors on the persistence of embryonic sinusoid coronary communication. PMID- 3630706 TI - Clinicopathological study on small renal cell carcinomas with metastases. AB - Seven metastasizing small renal cell carcinomas smaller than 30 mm in the greatest diameter were clinicopathologically studied for a better understanding of their characteristic features as compared to those of small tumors without metastases. Grayish-white infiltrating tumors in gross appearance and alveolar or solid microscopic structure consisting of granular or spindle cells and of atypical nuclei were suggestive of having metastases. Two tumors which had positive reactions to the lower nephron markers such as SBA, PNA, and/or DBA were considered to be of lower nephron origin and displayed poor prognosis. PMID- 3630705 TI - Classification of cardiac rupture complicated in myocardial infarction. Pathological study of 32 cases. AB - Thirty of 32 cases with cardiac rupture (CR) complications in the myocardial infarction were found out of a total of 91 cases of acute myocardial infarction (AMI). The mean age of the ruptured group in females was significantly younger than that of the non-ruptured group. Twenty-one cases showed free wall rupture of the left ventricle, six perforation of ventricular septum and three double rupture. All cardiac ruptures occurred in cases of transmural infarction. The age of AMI was histologically estimated. Nine cases complicated within the first 24 hours of AMI showed rupture of the left anterior wall. CR in the periphery within the infarct occurred at any time during the first week after onset, and cases of the central rupture were increased in number after the 3rd day of AMI. Pathologic findings indicated that elevated wall tension was considered to be most closely related to the cause of CR. Thirty two cases of CR were classified into three types: (1) blowout type, (2) hemorrhagic dissecting type, and (3) thinning-with rupture type. Hemorrhagic dissecting type was characterized by multiple endocardial ulcers and fissure canals extending from the ulcer with hemorrhage in the surrounding myocardium. Complex fissure was seen in two cases of this type. PMID- 3630707 TI - Diisopropanolnitrosamine (DIPN) induced rat thyroid lesions. I. A histological classification. AB - DIPN induced localized lesions of the rat thyroid gland are described histologically and classified into three major types: type 1, foci of cellular alteration; type 2, proliferative nodules; and type 3, overt carcinomas. Follicular, papillary and mixed papillofollicular subtypes are recognized in the type 2 lesions, and follicular, papillary, anaplastic and mixed subtypes in the type 3 lesions. The nature of the individual lesions is discussed. PMID- 3630708 TI - Cerebellar foliation in rats. 5. Structural relations between Purkinje cells and heterotopic external granular layer in normal and protein deprived foetal rats. AB - Different types of heterotopia of granule cells and of the external granular layer (EGL) occur naturally in the cerebellum of rats. In the present study sagittal plastic sections of the cerebellum of 75 normal and protein deprived rat foetuses from the four last days of gestation were examined. Perivascular nests of EGL cells were present in all of the rat foetuses examined without obvious differences between normal and protein deprived foetuses. They were most frequent in regions adjacent to the fissures. It was found that the EGL nests affected the orientation and position of Purkinje cells when passing through this layer. In 2 out of 37 protein deprived foetuses, there were continuous layers of Purkinje cells surrounding some EGL nests in the sub-cortical region associated with a malformation of the posterior lobe. These heterotopic Purkinje cells had an apical process mostly pointing towards the EGL nests and there was a primitive molecular layer lying between the heterotopic Purkinje cells and the EGL cells. These findings indicate that migration of Purkinje cells towards the perivascular EGL had occurred possibly as a consequence of transfer of the endfeet of radial glial cells from the pial to the vascular mesodermal surface. Similar mechanisms may be involved in nervous system malformations such as cerebellar polymicrogyria in man. Experimental protein deprivation has not previously been reported to result in major malformations of the central nervous system. Although two protein deprived foetuses had cerebellar malformation which were not seen in normal foetuses, the present material does not allow any conclusions with regard to a causal relation between the protein deprivation and the malformations. PMID- 3630709 TI - Cytogenetic studies in Hodgkin's disease. AB - Cytogenetic analysis was attempted in 20 patients with Hodgkin's disease. No mitoses were found in 2 cases, normal metaphases in 7, and normal metaphases with nonclonal aberrations in 7. Of the 4 cases with clonal aberrations, one had +16 as the sole change, whereas the remaining tumors had multiple numerical and structural changes. PMID- 3630710 TI - Experimental pneumococcus infection in mice: correlation of bactericidal activity in vitro with the effect in vivo for gentamicin, netilmicin and tobramycin. AB - An experimental model in mice, incorporating the intraperitoneal inoculation of a Streptococcus pneumoniae type 3, was used to evaluate the effect in vivo after single-dose administration of the three aminoglycosides, gentamicin, tobramycin and netilmicin, and to correlate this effect with their in vitro activity against the pathogen, in particular the bactericidal rate. The minimal inhibitory concentrations (MIC's), which were equal to the minimal bactericidal concentrations (MBC's), were 12.5 micrograms/ml for netilmicin, and 25 micrograms/ml for the two other aminoglycosides, respectively. All three antibiotics showed excellent bactericidal activities even at concentrations 1/4 times the MIC's, but the bactericidal rate was clearly lower for tobramycin than for the two other aminoglycosides. The effect in vivo measured as the 50% effective dose (ED50) closely reflected the relative bactericidal activities of the drugs. Of the pharmacokinetic parameters investigated on dosages equal to the ED50's for the three drugs, the best to correlate with the bactericidal rates in vitro were the peak serum concentrations. PMID- 3630711 TI - The pneumococcus and the mouse-protection test: correlation of in vitro and in vivo activity for beta-lactam antibiotics, vancomycin, erythromycin and gentamicin. AB - The mouse-protection test with intraperitoneal inoculation of Streptococcus pneumoniae type 3 was employed to compare the effect in vivo and to correlate with activity in vitro of ampicillin, piperacillin, methicillin, cefuroxime, erythromycin, vancomycin and gentamicin. The MICs for these drugs were lowest for the beta-lactam antibiotics, highest for vancomycin and gentamicin. Relative to the MIC, gentamicin and vancomycin showed the highest bactericidal rates against the pneumococcus. Vancomycin was the most effective in vivo as measured by the 50% effective dose (ED50) after single doses 1 h post-inoculation. Serum vancomycin concentrations measured after doses equal to the ED50 were below the minimal concentration measurable by our bioassay (i.e. less than 3.7 micrograms/ml). For the other drugs, peak concentrations in serum were higher than those produced even by high doses in man. Among pharmacokinetic parameters studied at dosages equal to the ED50s, the period during which the serum concentration exceeded the MIC (delta T(MIC] was the factor which varied the least for the beta-lactam antibiotics (range, 2-5 h). For gentamicin and probably also for vancomycin the delta T(MIC) was below 20 min, while it was considerably longer (i.e. 19 h) for erythromycin, although the bactericidal activity of this drug in vitro was comparable to that of the beta-lactam antibiotics. PMID- 3630712 TI - In vitro susceptibility of Campylobacter jejuni and Campylobacter coli isolated in Denmark to fourteen antimicrobial agents. AB - The in vitro susceptibility of 95 recent Danish human clinical isolates of Campylobacter jejuni and Campylobacter coli to 14 antimicrobial agents was determined by an agar dilution technique. C. jejuni and C. coli were considered together. Doxycycline, ciprofloxacin, gentamicin, clindamycin, nitrofurantoin and erythromycin were the most active drugs. 2% of the strains tested were resistant to erythromycin (MIC greater than 3.1 micrograms/ml). Therefore susceptibility testing is suggested if antimicrobial therapy with erythromycin is considered to be indicated. Ciprofloxacin might prove to be an alternative to erythromycin. Susceptibility testing in a CO2 atmosphere affected the determination of MICs of doxycycline, erythromycin, gentamicin and clindamycin, probably reflecting pH changes in the media during incubation under increased CO2 tension. PMID- 3630713 TI - Post-antibiotic effect and killing activity of ciprofloxacin against Staphylococcus aureus. AB - The effect of ciprofloxacin on eight strains of Staphylococcus aureus were examined. A post-antibiotic effect was observed in all strains, varying between 1.65 and 2.75 hours, with concentration of ciprofloxacin at 5 times the Minimum Inhibitory Concentration (MIC) exposed for 1 hour. Killing-kinetic studies at 5 times the MIC showed a decrease in the numbers of organisms by approximately 2.1 log10 after 6 hours, independent of the growth phase. A significantly increased susceptibility of S. aureus to the bactericidal activity of ciprofloxacin during recovery from the PAE-phase was demonstrated. PMID- 3630714 TI - Short-chain fatty acids in seven sterile thioglycollate media. AB - Short-chain fatty acids (SCFAs) were analysed by gas chromatography in 7 sterile fluid thioglycollate media. The total SCFA concentration varied from 250 mumol/l to 1720 mumol/l. Acetic acid (52.0%-91.3% of total SCFA concentration) and n butyric acid (5.8%-48.0% of total concentration) were the main acids in all sterile media; low concentrations of propionic, isobutyric, isovaleric, and n valeric acid were present in most media. In studies of bacterial metabolism, or when analyses of SCFAs are used for identification of bacteria, testing of the sterile medium is necessary. PMID- 3630715 TI - Human alveolar macrophages and monocytes generate the functional classical pathway of complement in vitro. AB - Binding of labelled protein to EIgM kept with macrophage or monocyte cultures with 3H-leucine under serum-free conditions, shows that de novo synthesis of protein with affinity to EIgM takes place. We find that monoclonal anti-C3c and anti-C3g antibodies and polyclonal anti-C4 and anti-C5 antibodies bind to such erythrocytes. This demonstrates that C4b, C3b and iC3b are deposited on the EIgM. Additional evidence for complement synthesis is the increase in binding of anti C4 antibodies to EIgM when the incubation time was increased from 48 to 96 hours. Stimulation of the mononuclear phagocyte cultures with ET was necessary to obtain significant amounts of erythrocyte-bound complement proteins. From these results we conclude that the functional classical pathway of complement is produced in vitro by the monocytes and macrophages. PMID- 3630716 TI - Mononuclear cells in synovial fluid of rheumatoid arthritis patients undergoing joint surgery. AB - Analysis of synovial fluid from patients with rheumatoid arthritis (RA) and a long history of RA, who were undergoing synovectomy and joint surgery, revealed that 71 +/- 15% of the mononuclear cells in the synovial fluid were lymphocytes. 3 +/- 2% lymphoid blast cells, and 26 +/- 15% of monocytes/macrophages. The lymphocyte population consisted mainly of T cells, and 72 +/- 15% of lymphocytes were OKT11-positive. OKT8-positive cells (48 +/- 9%) dominated over OKT4-positive (32 +/- 8%) cells with a mean OKT4/OKT8 ratio of 0.69. On the basis of Ia- and Tac-markers, very few of the lymphocytes were activated. Few B cells (12 +/- 7%) and no plasma cells were seen. The results are discussed in relation to previous reports. PMID- 3630717 TI - Complement components in normal pregnancy. AB - Sixteen complement components were analysed at three different occasions during a normal pregnancy. Samples were also obtained at delivery and six weeks post partum. All factors but C1 IA and D increased during the pregnancy. Six weeks after the delivery, the levels of all components but C1s, C4 and C6 showed a beginning normalisation. In 15 per cent of the women, C1 IA was functionally inactive at delivery. PMID- 3630718 TI - Prevention of ischaemic acute renal failure with superoxide dismutase and sucrose. AB - The preventive effects of intravenously administered superoxide dismutase (SOD) and of SOD combined with sucrose on acute renal failure were investigated in rat kidneys exposed to 45 min of warm ischaemia. Superoxide dismutase (20 mg) given just before primary ischaemia and in the early recirculation phase was found to ameliorate the red cell aggregation in the renal medulla, in particular, in the inner stripe of the outer zone the volume of trapped red cells decreased from 11.2 +/- 1.6% in untreated animals to 0.02 +/- 0.001%, thus allowing improved restoration of medullary blood flow. This was also accompanied by an expected restoration of the urine osmolality reaching almost 400 mOsm kg-1 after administration of SOD + sucrose. Superoxide dismutase also restored the capillary macromolecular permeability as evidenced by normalization of plasma to lymph transport of proteins. Micropuncture studies showed that in ischaemically damaged but untreated kidneys the tubules were obstructed and that the proximal tubular pressure rose to such a level that the net driving force for filtration approached zero. This explains the marked decrease in glomerular filtration rate (GFR) from a normal value of about 1 ml min-1 to 0.01 +/- 0.02 ml min-1. After treatment with SOD the tubules were still largely obstructed, resulting in a depression of the net driving force and a decrease in single nephron glomerular filtration rate (SNGFR) to about 11 nl min-1, that is, to only 25% of the normal SNGFR. The total filtration was 0.09 +/- 0.04 ml min-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630719 TI - Depressor and pressor actions of purine nucleosides and nucleotides in the anaesthetized rat. AB - In pentobarbitone-chloralose anaesthetized rats, the effects of aortic administration of various purine compounds on systemic arterial pressure were investigated. All animals were pretreated with atropine and guanethidine to (largely) eliminate reflex neurogenic cardiovascular adjustments, and drugs influencing purine receptors, prostaglandin synthesis, etc. were used for analytical purposes. The compounds used were adenosine (AD) and its slowly degradable analogue, 2-chloroadenosine (2-chloro), adenosine-5'-triphosphate (ATP) and its slowly degradable analogues beta, gamma-methyleneATP (beta,gamma meATP) and alpha,beta-methyleneATP (alpha,beta-meATP). Control cardiac output measurements before, at and after the peak pressure changes in some experiments revealed that they were at least 80% due to changes in systemic resistance, i.e. dominated by shifts in resistance vascular tone. Adenosine, 2-chloro, ATP and beta,gamma-meATP all elicited depressor (vasodilator) responses. 2-chloro was more potent than AD. Furthermore, the results suggest that the depressor action of ATP involves P1-purinoceptors, following the rapid degradation of ATP to AD, and probably also other mechanisms. The stable ATP analogues caused prompt pressor (vasoconstrictor) responses, where alpha,beta-meATP was more potent than beta,gamma-meATP. The latter compound also produced delayed (probably P1 purinoceptormediated) depressor actions, presumably via slow degradation to AD. PMID- 3630720 TI - Bleeding-induced decrease in duodenal HCO3- secretion in the rat is mediated via alpha 2-adrenoceptors. AB - This study was performed on chloralosed rats in order to examine the influence of a minor blood loss on duodenal HCO3- secretion. The HCO3- output was measured by in situ titration in a duodenal segment. Blood loss of 0.6 ml per 100 g body wt (approximately 10% of total blood volume) reduced duodenal HCO3- secretion by about 30%. Pretreatment with guanethidine did not affect basal output of HCO3- but markedly reduced the bleeding-induced response. The alpha 2-adrenoceptor antagonist yohimbine did not affect the basal secretion but almost abolished the depression of duodenal HCO3- secretion due to blood loss. Pretreatment with the alpha 1-adrenoceptor antagonist prazosine or the beta-adrenoceptor antagonist propranolol did neither change basal duodenal HCO3- secretion nor the bleeding induced decrease in duodenal HCO3- secretion. It is suggested that a small blood loss by means of a reflex activation of the sympathetic nervous system, and via the release of transmitter substances from adrenergic nerve endings, reduces the duodenal HCO3- secretion. The inhibitory effect is mainly due to activation of alpha 2-adrenoceptors. PMID- 3630721 TI - Lack of casual relationship between medullary blood congestion and tubular necrosis in postischaemic kidney damage. AB - The effect of haemodilution on medullary blood congestion and tubular necrosis was investigated in the rat kidney. Male Sprague-Dawley rats were subjected to 60 min of unilateral, kidney ischaemia and 24 h of reperfusion. Haemodilution was performed by replacing blood by homologous serum and was done either before induction of ischaemia or during the ischaemic period. Cellular necrosis was evaluated morphologically by a histochemical staining for calcium and a dye exclusion test. Trapped erythrocytes were visualized by the DAB reaction. It was found that haemodilution could totally prevent medullary congestion. In spite of this, the extent and distribution of necrotic tubular cells in the outer stripe of the outer medulla were the same whether the animal was subjected to haemodilution or not. Our results strongly suggest that the cellular necrosis and the medullary congestion are two separate phenomena occurring at the same time, but without a causal relationship to each other. PMID- 3630722 TI - Release of vasoactive intestinal polypeptide anally of a local distension of the feline small intestine. AB - The peristaltic reflex is elicited by a local distension of the intestine and consists of an ascending contraction and a descending inhibition of the smooth muscle layer. The transmitter mediating the inhibition of the smooth muscle cells is not known but vasoactive intestinal polypeptide (VIP) has, among others, been proposed to mediate the descending inhibition of a distension. An in vivo preparation of a segment of the feline intestine was designed to allow collection of the venous effluent and determination of the VIP release orally and anally of a distension. The release of VIP rose significantly more on the anal side of the intestinal distension, and so did the blood flow. Division of the myenteric plexus prevented the asymmetry of the VIP release to a large extent. These effects of distension on the release of VIP are consistent with the hypothesis that VIP mediates the descending inhibition of the peristaltic reflex. PMID- 3630723 TI - The effect of amiloride on biliary HCO3- secretion in the anaesthetized pig. AB - The present study was performed on 29 anaesthetized pigs and shows that the bile acid ursodeoxycholic acid (UDCA) produces a flow of bile rich in HCO3- compared with taurocholic acid (TCA). The slope relating biliary HCO3- secretion to bile acid secretion was 0.59 (0.44-0.82) and 0.33 (0.29-0.38) during venous infusion of UDCA and TCA, respectively. We next wanted to evaluate the importance of Na+/H+ ion exchange for biliary HCO3- secretion. High doses of amiloride were employed in order to impair the hepatic Na+/H+ ion exchanger. It was reasoned that any reduction in H+ efflux through the hepatic Na+/H+ ion exchanger involved in causing biliary HCO3- secretion would be translated into an equimolar fall in biliary HCO3- secretion. We found that amiloride (2.0 X 10(-4) mol l-1 plasma) reduced UDCA-dependent canalicular HCO3- secretion by 26 (14-35)% without concurrently reducing bile acid secretion. Amiloride (2.9 X 10(-4) mol l-1 plasma) did not significantly reduce secretin-dependent ductular HCO3- secretion. In this group of animals amiloride reduced bile acid secretion by 13 (5-22)%. It is concluded that Na+/H+ ion exchanger is essential for UDCA-dependent canalicular HCO3- secretion, but not for secretin-dependent ductular HCO3- secretion. PMID- 3630724 TI - Influence of oxygen tension and substrates on basal and luteinizing hormone stimulated progesterone production and energy metabolism by isolated corpora lutea of adult pseudopregnant rats. AB - The effect of substrate reduction on in vitro progesterone production by isolated corpora lutea of pseudopregnant rats was studied. Pseudopregnancy was induced by mating adult females with vasectomized males. The rats were killed at different luteal ages and the corpora lutea of pseudopregnancy were identified, dissected free and incubated for 3 h. Six-day-old corpora lutea were incubated in the presence of different oxygen tensions as well as different glucose and amino acid concentrations and basal as well as luteinizing hormone (LH)-stimulated progesterone production was studied. When the oxygen tension was reduced, both basal and LH-stimulated progesterone production was decreased. At 6 and 0 kPa, the stimulatory effect of LH on progesterone production was abolished. Lowering the oxygen tension decreased the levels of adenosine-5'-triphosphate (ATP) in the tissue and increased lactic acid accumulation in the medium. Omitting both glucose and amino acids while maintaining oxygen tension at 100 kPa abolished the stimulatory effect of LH on progesterone production and decreased the levels of ATP. The present study shows that the corpus luteum in vitro is dependent on a high oxygen tension for maintenance of its progesterone production and LH responsiveness. It is suggested that the amount of ATP available is critical to the degree of LH response. Hypoxia increased luteal glycolysis, but this could only marginally compensate for a low oxygen tension. PMID- 3630725 TI - Changes in elemental composition of human muscle fibres following surgery and immobilization. An X-ray microanalytical study. AB - X-ray microanalysis of single muscle fibres visualized in the electron microscope has been applied to human muscle biopsies to quantify changes of intracellular elements after knee-surgery with subsequent immobilization for 6 weeks. An increase of intracellular chlorine (Cl; P less than 0.001) and of sodium (Na; P less than 0.1) concentrations were found 1 and 6 weeks post-surgery. Intracellular potassium (K), phosphorus and sulphur concentrations were not significantly changed. The increased Cl and Na concentrations may be an indication of a decreased activity of the ATPase-dependent Na/K-pump in the sarcolemma and/or of an increased sarcolemmal permeability for Na and Cl. PMID- 3630726 TI - Repeated isokinetic plantar flexions at different angular velocities. AB - Peak torque (PT), contraction work (CW) and mean power (CP) were measured for each of 200 repetitive isokinetic (maximum effort) plantar flexions. Simultaneous recording of integrated electromyograms (iEMG) were obtained from the three parts of the triceps surae muscle. Four tests at different angular velocities (30, 60, 120 and 180 degrees s-1 (degrees X s-1] were performed with at least 2 weeks between each test. The subjects were eight clinically healthy females (24-36 years). At all four angular velocities CW, CP and PT decreased steeply during the first approximately 70 contractions, followed by a steady-state level with no further significant decreases. The relative decreases of PT and CP were significantly smaller than for CW at all velocities. The relative CW decline increased with angular velocity; the relative PT and CP decreases were not velocity dependent. Also iEMG activity decreased in two phases during the 200 contractions and were on a significantly lower relative level at 180 degrees X s 1. However the reduction of range of motion was significantly greater at 180 degrees X s-1 and when the iEMG activity was compensated for this decrease the relative decreases in electromyographic activity were similar at the four angular velocities. The results indicated that CW was more sensitive to fatigue than PT and CP and that CW fatigue was dependent on angular velocity. PMID- 3630727 TI - Mean power frequency and integrated electromyogram of repeated isokinetic plantar flexions. AB - Peak torque (PT), contraction work (CW), mean power (CP), and time for contraction (t) were recorded for each of 200 full range-of-motion repetitive isokinetic (maximum effort) plantar flexions at the preset angular velocity 60 degrees s-1 (degrees X s-1). The subjects were 12 healthy males (42-46 years). Simultaneous recordings of electromyographic activity of the three parts of the triceps surae muscle were made. The electromyograms were truly integrated and the mean power frequency was also calculated for each of the contractions. The mechanical variables decreased steeply during approximately the first 70 contractions (the fatigue phase) followed by a steady-state level (the endurance level) with no further significant decrease. The fatigue phase was composed of two parts. The first was characterized by decreases in CW, MPF and in the ratio CW/iEMG, while iEMG and iEMG/t were unaltered. During the second part decreases in iEMG and iEMG/t occurred while MPF and CW/iEMG had stabilized. During the endurance level all the variables were stable but lowered when compared with the initial contractions of the fatigue phase. The results indicated that the mechanical fatigue went through two parts before the steady-state level was established. PMID- 3630728 TI - Intrathecal noradrenaline has a dose-dependent inhibitory or facilitatory effect on the flexion reflex in the rat. AB - The effect of intrathecal noradrenaline (NA) on the hamstring flexion reflex to subcutaneous electrical shocks was examined in unanaesthetized, decerebrate, spinalized rats. Low doses of NA (200 ng and 2 micrograms) depressed and high doses (20 micrograms and 200 micrograms) facilitated the reflex. It is suggested that the primary effect of NA in the dorsal horn is inhibitory and in the ventral horn excitatory. Furthermore, the neurons mediating these effects are more sensitive to NA in the dorsal horn than in the ventral horn. PMID- 3630729 TI - Endurance, what is it? Muscle morphology after an extremely long distance run. AB - Biopsies of m. vastus lateralis of a well-trained 46-year-old man were analysed before and after an extremely long distance run (3529 km in 7 weeks). After the period of running, both a decrease of fibre size and a neuromuscular pathology were found. Muscle fibre degeneration and regeneration, especially of type 2 (fast-twitch) fibres, was seen as well as signs of damage to the peripheral nerves. The relative amount of type 1 (slow-twitch) fibres was higher after the run. The relationships between light and electron microscopical characteristics normally present could not be found in the specimens of this man. The changes in fibre size as well as the other microscopical characteristics may express an adaptation through more or less complete fibre transformation. However, we could not rule out that a selective elimination of fibres also contributed to the observed changes. In that case, the underlying pathophysiology might have been a peripheral arterial insufficiency which was related to the extreme functional demands. These disturbances may have affected type 2 fibres more than type 1 fibres. Endurance may, on this basis, express an adaptation of the muscle through elimination of weak fibres, that is, fibres related to limited functional capacities. PMID- 3630730 TI - Motility in auditory sensory cells. AB - Three different procedures were employed to induce contraction of isolated cochlear outer hair cells. When cells were permeabilized and exposed to calcium and ATP both a shortening of cell length (14%) and a decrease in cell diameter (12-16%) was observed indicating a longitudinal and a circumferential contraction. When intact cells were treated with positively charged ferritin a shortening of about 10% was observed together with an increase in cell diameter. Application of solutions containing high potassium concentrations gave similar but more rapid results as compared with positively charged ferritin. The observed responses of inner ear sensory cells together with their morphological and immunohistochemical characteristics further support the idea that the hearing organ acts as a motile system. PMID- 3630731 TI - Reduction of extracellular dopamine levels can be dissociated from suppression of exploratory behaviour in rats. PMID- 3630732 TI - Altered shape and size of red blood cells in obese hyperglycaemic mice. AB - Red blood cells (RBCs) from hyperglycaemic ob/ob-mice, normoglycaemic controls, and a healthy man were sucked into a narrow capillary, photographed and measured. Mouse RBCs had a smaller diameter than human ones. Although of normal diameter, the ob/ob-mouse RBCs exhibited increased area and volume, and more frequently than control RBCs had a minimum cylindrical diameter greater that 3 micron. Cross sectional profiles with minimum bending resistance were computed for RBCs of mean area and volume. The diameters of these theoretical profiles agreed closely with those empirically observed, in both mice and man. The profile of ob/ob-mouse RBCs predicted a greater resistance to corpuscle bending than the control profile. It is concluded that changes in shape and size explain the decreased filtrability of diabetic ob/ob-mouse RBCs. The results also suggest that the actually occuring smooth biconcavity is in general the RBC shape with maximum flexibility. PMID- 3630733 TI - Source of calcium for contractions induced by depolarization and muscarinic receptor stimulation in rabbit urinary bladder. AB - Omission of calcium or the inclusion of lanthanum in the bathing medium resulted in an almost complete inhibition of contractile responses induced by either K+ depolarization or carbachol in strips of rabbit urinary bladder. D-600 inhibited K+-induced contractions significantly more than carbachol-induced responses. The influx of 45Ca into cells was stimulated both by K+ depolarization and carbachol. Over a 2-min period the increase in 45Ca influx induced by high K+ and carbachol was 98 and 65%, respectively. Both lanthanum and D-600 blocked 45Ca influx stimulated by either K+ depolarization or carbachol. The inhibition of 45Ca influx by these calcium-channel blocking agents, particularly by D-600, was dependent on the length of exposure. Application of carbachol during 45Ca efflux in pre-loaded muscle strips had no effect on the rate of 45Ca efflux. These results indicate that the contractile responses of the urinary bladder to depolarization and to carbachol are highly dependent on an extracellular source of calcium. PMID- 3630734 TI - Role of dopamine2-receptors in mediating renal vascular response to low dose dopamine infusion in the rat. AB - The effects of the interaction of dopamine (DA) and the DA2-receptors on regional blood flows and cardiac output have been studied in the rat. By means of the microsphere technique the blood flow (BF) and vascular resistance (VR) were determined in the kidney, duodenum, spleen, liver, and lung during infusion of DA in the absence and presence of selective DA2-receptor blockade with S-Sulpiride (S-SP), and during infusion of a selective DA2-receptor agonist (LY-171555, LY). In order to evaluate the role of the presynaptic DA2-receptor, the experiments were performed without alpha- and beta-adrenergic blockade. Dopamine was given in such low doses that stimulation of the adrenergic receptors should be negligible. Dopamine, LY and DA + S-SP did not significantly influence BF and VR in the spleen, liver and lung. Dopamine significantly increased BF and decreased VR in the kidney and the duodenum; LY significantly increased BF in the the kidney but not in the duodenum and decreased VR in both the kidney and the duodenum. In the presence of selective DA2-receptor blockade, DA did not significantly influence BF or VR in the kidney but in the duodenum BF increased and VR decreased to the same extent as in the absence of blockade. In conclusion; the kidney and the intestine are more abundantly supplied with vascular DA-receptors than other organs. In the kidney the interaction between DA and the DA2-receptors significantly contributes the the DA-induced vasodilation. The interaction between DA and the DA2-receptors is of less importance for the DA-induced vasodilation in the intestine. PMID- 3630735 TI - Interaction of changes in the third ventricular CSF tonicity, central and systemic AVP concentrations and water intake. AB - Arginine vasopressin (AVP) is assumed to be involved as a central transmitter or modulator in the control of autonomic functions including thirst. In conscious dogs AVP concentration in cerebrospinal fluid (CSF) from the anterior part of the third ventricle (A3V) was analysed before and after local elevation of CSF osmolality by intracerebroventricular (i.c.v.) infusion of 0.35 M NaCl and after i.c.v. AVP infusion at 46 and 138 fmol ml-1 for 10 min. In addition, the effects of these i.c.v. infusions on water intake, plasma AVP concentration and blood pressure were investigated. In euhydrated dogs 0.35 M NaCl i.c.v. did not alter AVP concentration in the CSF during the subsequent 2 h. In contrast, plasma AVP concentration had increased significantly from 3.4 +/- 0.3 (control) to 6.4 +/- 0.7 and 4.7 +/- 0.3 fmol ml-1, 4 and 16 min, respectively, after the hypertonic stimulus. Drinking was stimulated with an average water intake of 14.5 +/- 3.7 ml kg-1 body wt. However, AVP infusion into the A3V did not elicit water intake despite increases of AVP concentration in the A3V by factors up to 40 above control. The same animals responded with spontaneous drinking to 0.35 M NaCl i.c.v. administered 160 min after the end of AVP infusions. Exogenously administered AVP disappeared from the A3V with a time constant of 13.8 min. The results do not support the view that AVP in the A3V CSF per se stimulates drinking. PMID- 3630737 TI - Biological activities of lipoxin A include lung strip contraction and dilation of arterioles in vivo. AB - Lipoxin A ([5S,6R,15S]-5,6,15-trihydroxy-7,9,13-trans-11-cis-eicosatetraenoic acid), a recently characterized lipoxygenation product of arachidonic acid, in submicromolar concentrations elicited long-lasting contractions of the guinea-pig lung strip. The response to lipoxin A was not due to release of acetylcholine, histamine, noradrenaline or cyclo-oxygenase products. 15 hydroperoxyeicosatetraenoic acid (15-HPETE), one precursor of lipoxin A, also contracted the lung strip, but 15-HPETE was less potent on the guinea-pig trachea whereas 15-HPETE relaxed this preparation. Lipoxin A was also inactive on the guinea-pig ileum. Intravital microscopy of the hamster cheek pouch disclosed that lipoxin A, as well as 15-HPETE, induced arteriolar dilation but had no effects on microvascular permeability or leucocyte adherence to venular endothelium. Taken together, the leucocyte product lipoxin A displayed a pattern of activity in spasmogenic assays and on the microvasculature that was distinct from those known for prostaglandins, thromboxanes and leukotrienes. The findings indicate that lipoxin A is an additional arachidonic acid derived autacoid with biological actions on smooth muscle in vitro and in vivo. PMID- 3630736 TI - Comparison of VIP and beta 2-adrenoceptor-induced relaxations in the circular and longitudinal smooth muscle layers of the rat portal vein. AB - The relative importance of VIP in reduction of vascular tone was studied in circular and longitudinal preparations of the VIP-innervated rat portal vein. Exogenous VIP inhibited the methoxamine-evoked contractures in the atropine blocked preparations with a lower potency in the inner, circular (pD2 = 6.4 +/- 0.5, n = 6) than in the outer, longitudinal layer (pD2 = 7.7 +/- 0.1, n = 6). VIP was also a less efficient relaxant (intrinsic activity (alpha) = 0.60 +/- 0.16, n = 6) of the inner than of the outer layer (alpha = 1.00). The selective (salbutamol) and the non-selective (isoproterenol) beta 2-agonists completely relaxed the methoxamine contractures in both layers and the potency (isoproterenol) was higher in the inner (pD2 = 6.39 +/- 0.32, n = 6) than in the outer layer (pD2 = 5.67 +/- 0.34, n = 6). Plasma from the portal-mesenteric vein of anaesthetized, fasting rats contained 0.036 nM VIP (median, n = 17), that is, several orders of magnitude lower than the range of VIP concentrations relaxing the methoxamine contracted vein preparations via VIP receptors of the apamin blockable category. The results support the hypothesis that alpha 1-adrenoceptor induced contractions in the circular layer are predominately relaxed via beta 2 adrenoceptors while relaxation of the outer layer may occur via VIP receptors, probably activated by local release of the neuropeptide. PMID- 3630738 TI - Mechanical, morphological and pharmacological properties of oesophageal varices and small mesenteric veins in portal hypertensive rabbits. AB - The properties of isolated small oesophageal and mesenteric veins were investigated in a rabbit model subjected to a 4-week period of portal vein stenosis. The animals developed oesophageal varices and these together with the small mesenteric veins were mounted on a myograph. Compared with sham-operated controls portal hypertension resulted in an increased normalized inner radius and media thickness of the oesophageal veins resulting in a non-significant increase in the media to lumen ratio, while the inner radius decreased as media thickness increased in mesenteric veins resulting in a significant (P less than 0.01) increase in the media to lumen ratio. When activated, the active wall tension of both the oesophageal and mesenteric veins was increased following portal hypertension, but the active media stress was unchanged. The EC50 for noradrenaline and angiotensin II did not change in portal hypertensive vessels compared with controls and was equal in oesophageal and mesenteric vessels. The ability of isoprenaline and serotonin to relax pre-contracted vessels of both types was reduced by the portal hypertension. The results of these studies suggest that the development of oesophageal varices is not only due to increased portal venous pressure. PMID- 3630739 TI - Sprinters and marathon runners. Does isokinetic knee extensor performance reflect muscle size and structure? AB - In order to evaluate relationships between structure and concentric function of the quadriceps muscle, isokinetic maximum knee extensor output at different velocities of angular motion (30-180 degrees s-1), integrated electromyographic activity (iEMG), cross-sectional area (CSA) of m. quadriceps and fibre composition of m. vastus lateralis were analysed in five sprinters and five marathon runners (all males). Both output and input parameters, concerning peak torque (PT), instantaneous power (IP), contractional work (CW) and the summed iEMG were closely correlated to the m. quadriceps CSA, as well as to the calculated absolute type II (A + B), IIA and IIB fibre areas of m. vastus lateralis. When PT, IP, CW and the summed iEMG were corrected for CSA, such relationships were found only at 180 degrees s-1 and only for type IIA fibre area. The electromyographic findings indicate that m. vastus lateralis was representative for the total mechanical output. The calculated mean power output (CW s-1) and output/input balance (CW/iEMG) describe similar relationships with the velocity of angular motion and were not related to the CSA or to the absolute area of any fibre type. The calculated optimal CW per second and CW/iEMG occur for sprinters at about 450 degrees s-1 and for marathon runners at about 270 degrees s-1, that is, velocities well above the capacity of the isokinetic dynamometer. Our observations indicate that the peak torque or instantaneous power, during single maximum knee extensions, at least at 180 degrees s-1, express characteristics of the muscle structure. PMID- 3630740 TI - Isoflurane hyperpolarizes neurones in rat and human cerebral cortex. AB - The effect of the anaesthetic gas isoflurane was studied by intracellular recordings in neurones from rat hippocampal cortex and neurones from human neocortex in vitro. Anaesthetic concentrations of isoflurane abolished spontaneous activity and reduced synaptically evoked activity without rendering individual cells inexcitable or preventing evoked synaptic activity to increased afferent input. Induced epileptiform activity was not observed. Isoflurane reversibly hyperpolarized the cell membrane in a dose-dependent manner, isoflurane 1.5, 3 and 5% causing 4 +/- 1, 6 +/- 2 and 8 +/- 2 mV (mean +/- SD) hyperpolarization, respectively. The hyperpolarization was accompanied by a reduction in the input resistance, 18 +/- 3% for 3% isoflurane. The effects remained unchanged after synaptic transmission was blocked. Five experiments with intracellular recordings from human cortical neurones in vitro showed identical results. PMID- 3630741 TI - Adrenal function of the rat in relation to peroral administration of xylitol: depression of aldosterone. AB - The effect of peroral administration of xylitol (5% or 20% in food) on adrenal function was investigated in thirty-five Long-Evans male rats. The control rats were fed either a non-substituted stock diet or a 20% glucose diet. Glucose elevated and 20% xylitol reduced the growth of the rats (P less than 0.001), but 5% xylitol had no effect on the body weight. The concentrations of serum glucose and lactic acid decreased in rats fed 20% and 5% xylitol, respectively, but those of insulin, glucagon, corticosterone and aldosterone were not affected. In the adrenal glands, 20% xylitol loading was associated with increased epinephrine (P less than 0.05) and norepinephrine (P less than 0.001), but with decreased aldosterone (P less than 0.001) concentrations. The weights and histological picture of adrenal glands were normal. The urinary pH of xylitol-fed rats decreased significantly (P less than 0.01). Although peroral xylitol affected the levels of aldosterone and catecholamines, a normal glucocorticoid metabolism was permitted. The reduced aldosterone levels were regarded as secondary reactions, possibly resulting from alterations in electrolyte and/or acid-base balance. The increased catecholamine synthesis may be associated with the promoting effect of xylitol on intestinal calcium absorption. PMID- 3630742 TI - Functional development of the visual system in normal and protein-deprived rats. IV. Latencies in the specific visual pathway of adult rats. AB - It was recently shown that an increase in latency of the cortical visual evoked response (VER) seen in young malnourished animals persists in adult rats given a low protein diet. In the present paper the VER latencies of the specific visual pathway were measured in order to establish the level at which the latency increase occurs in protein-deprived rats. The VER in the dorsal lateral geniculate nucleus (dLGN) showed no significant differences to onset or peak latencies between control (C) and the protein-deprived (PD) rats. The dLGN activity was higher in C rats than in PD rats. Late components differed in median values between the two groups, but the individual variations were large. Generally, the VER of the dLGN in PD rats was more stereotype compared with the C rats. Intracortical VER at a depth of 0.4-0.5 mm showed a small negative component of short onset latency in both C and PD rats. This component preceded the onset of the initial positivity recorded from the cortical surface by 1-2 ms in C rats and by 3-6 ms in PD rats. Following electrical stimulation of the dLGN, no differences in onset latency of the first cortical activity (monosynaptic response) were recorded between C and PD rats, whereas later activity was significantly delayed in PD compared with C rats. The laminar potential pattern was less distinct in PD compared with C rats, and the late components of the evoked response from deep cortical layers were markedly attenuated or lacking.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630743 TI - Functional development of the visual system in normal and protein-deprived rats. V. Specific cortical response and repetitive stimulation in adult rats. AB - Recent studies on the specific visual system have indicated that early induced protein deprivation results in an impaired transmission from cell to cell in the cortex. To further investigate cortical mechanisms the response to repetitive light flashes and to electrical stimulation of the optic tract (OT) and the dorsal lateral geniculate nucleus (dLGN) were examined. The first potential of the surface visual evoked response (VER) and the monosynaptic response to OT and dLGN stimulation showed similar sensitivity to repetitive stimulation in C and PD rats. In PD rats later activity was significantly more sensitive to repetitive stimulation than in controls. By using paired stimuli with a short inter-stimulus interval, similar inhibitory mechanisms in PD and C rats were demonstrated. The results support the view that protein deprivation results in impaired cortical synaptic activation. The results are discussed in relation to previously described impairment at the cortical level in malnourished animals. PMID- 3630745 TI - Canadian trends in mortality from mental disorders, 1965-1983. AB - This report describes trends in the death rate for all mental disorders, presenile and senile dementia, and alcoholic psychoses and alcohol abuse/dependence in Canada for the period 1965-1983. It is demonstrated that overall there has been an increase in the death rate for each of these causes of mortality, both for males and females, and that in the case of presenile and senile dementia the increase has been particularly rapid. The older age groups appear to be contributing most to the observed changes. Conjectures are made as to the underlying reasons for the observed trends. PMID- 3630746 TI - Patterns of coverage of psychiatric emergencies. AB - A massive change in the detection of psychiatric cases in the emergency room was recorded when pattern of coverage was changed from "on-call" basis to "continuous physical presence" of psychiatry residents in the emergency room. PMID- 3630744 TI - Functional development of the visual system in normal and protein-deprived rats. VI. Evoked responses in adult rats, protein deprived in early life and nutritionally rehabilitated from weaning. AB - Previous studies have shown an increase in latency of the visual evoked response (VER) recorded from the cortical surface of adult rats subjected to protein deprivation (PD) during pre- and postnatal development. This alteration has been shown to originate mainly from the cortex itself. In the present study the possibility of normalizing such VER alterations by nutritional rehabilitation after early protein deprivation (R-PD) was investigated. Male rats were subjected to pre- and early postnatal protein deprivation through their mothers. Nutritional rehabilitation was started from weaning. The rats gained weight rapidly compared with rats subjected to protein deprivation throughout postnatal development but never reached the weight of controls (C) of the same age. Food consumption in relation to body weight was similar to that of controls. Rehabilitation continued until adult age when neurophysiological experiments were performed. The VER recordings from the dorsal lateral geniculate nucleus (dLGN) showed latencies similar to those reported previously for adult C and PD rats. The latencies of onset and first peaks of the cortical response recorded from the surface were increased by 5-6 ms in R-PD compared with C rats and hence similar to the latencies of adult PD rats. Intracortical responses to electrical stimulation in the dLGN were also similar to those of adult PD rats showing an normal onset latency but an increased latency of the peaks of the monosynaptic and late responses compared with C rats. The present results imply that the increased VER latencies noted in adult PD and R-PD rats are due to changes installed by protein deprivation during early development since they can not be reversed by nutritional rehabilitation starting at weaning. PMID- 3630747 TI - Sleeping and dreams in learning-disabled boys. AB - Ten learning-disabled (LD) boys were compared with eight control boys. The boys with learning difficulties reported shorter sleep latency but more frequent awakenings, longer nocturnal sleep, and increased complaints of daytime sleepiness than the controls. The dreams of the LD boys were less bizarre than those of the controls, and the LD boys used fewer words to describe their dreams. The findings may reflect a functional relation between experienced sleep-related difficulties, some components of dreams, and learning disabilities in school children. PMID- 3630748 TI - Psychiatric classification as a reflection of uncertainties. AB - Some problems of psychiatric classification are discussed and a shift of viewpoint is suggested. The existence of a natural and inherent structure for the class of psychiatric disorders is a matter of dispute, and it is postulated that a continuous search for such natural structure may be futile. Clinical psychiatry shall try to answer a series of questions which can be formulated as a hierarchy of uncertainties. It is now suggested that the existing pool of information used for psychiatric description may be a reflection of these uncertainties. The pool shall be analysed for core-syndromes which are the reliable components of an alternative classification. PMID- 3630749 TI - Suicides in close connection with psychiatric care: an analysis of 57 cases in a Swedish county. AB - Among 523 suicides committed in 1977-1984, 10 took place in a psychiatric hospital ward, 17 after the patient had left the ward without permission, 21 while the patient was on leave and nine 0-7 days after discharge. These 57 subjects were compared with 271 suicides committed more than 7 days after discharge or during outpatient care only (PCO). The male:female ratio was 1.0 in the former (PCI) group and 2.0 in the PCO group. The median age of the PCI subjects was 38 years. The suicide method was hanging in all 10 suicides (2 males, 8 females) committed in the psychiatric hospital ward. Depressive syndromes and, particularly schizophrenic and paranoid psychoses were more frequent among the PCI than among the PCO subjects. The extent of psychiatric care, as assessed by the number of admissions, was much greater in the PCI than in the PCO subjects. Environmental factors that might have been of causative importance for the suicidal act were of various kinds and differed to some extent between the two groups. Among the PCI subjects women seemed to have experienced family troubles more often than men, and situations of stressful psychiatric rehabilitation were more common among men. PMID- 3630750 TI - Female alcoholics. V: The relationship between family history of alcoholism and outcome 3-10 years after treatment. AB - In a long-term follow-up study of 44 female alcoholics, a family history of alcoholism was related to younger age of onset of problem drinking, but did not necessarily imply a poorer outcome within this highly selected group of individuals. Alcoholism in father and his family was not related to either antisocial or borderline personality disorder nor outcome. However, alcoholism in mother and her family correlated with both borderline personality disorder and a significantly poorer outcome. The findings are discussed within different frames of reference, considering genetic mechanisms, psychodynamic factors and family systems theory. PMID- 3630751 TI - An analysis of the nature of depressive phenomena in primary health care utilising multivariate statistical techniques. AB - The nature of depressive phenomena in primary health care was explored with data obtained from three primary health care clinics situated in the periphery of the city of Calcutta in India. The Self-Reporting Questionnaire (SRQ) and the Screening for Depression Questionnaire (SDQ-9) were used as the first stage and the Clinical Interview Schedule (CIS) and the Hamilton Rating Scale for Depression (Hamilton) as the second stage instruments respectively. Health workers with limited training administered the first stage instruments to consecutive adult clinic attenders. Principal components analysis followed by multiple linear regression analysis and discriminant function analysis were applied to the data. It was concluded that depressive phenomena in primary health care settings were largely undifferentiated in nature. PMID- 3630752 TI - The relationship between cognitive failures, psychoneurotic symptoms and sex. AB - As Broadbent et al's (1) original analysis of the relationship between the Cognitive Failures Questionnaire (CFQ) and the Middlesex Hospital Questionnaire (MHQ) was conducted on an altered version of the MHQ, the present study undertook this same analysis using the full MHQ. In addition, the relationship was examined to see if it was mediated by the differences in the scoring of males and females on each questionnaire. Our results support and strengthen Broadbent et al's conclusion that high rates of cognitive failure are associated with psychoneurotic symptoms. The sex difference on the CFQ is discussed in terms of vulnerability to stress to account for the higher incidence of psychoneurotic symptoms in females. PMID- 3630753 TI - Anxiety disorders: a long-term prospective and retrospective follow-up study of former inpatients suffering from an anxiety neurosis or phobia. AB - Psychopathological status and psychosocial functioning of 40 former inpatients suffering from an anxiety neurosis (ICD 300.0) or phobia (ICD 300.2) were followed up over a period of 6-8 years using standardized instruments. In addition, the course of illness, the utilization of medical services and the periods of work disabilities were assessed. With regard to psychopathology, in more than half of the patients course and outcome could be regarded as chronic and severe; only one third of the patients were free of marked or severe psychopathological symptoms during the 12 months preceding the reexamination. Although on the psychosocial outcome level 67% of the 40 former inpatients showed marked or severe difficulties in most social role areas, especially in the field of personal interaction, the great majority of these patients seemed to have adapted somehow to their life situations. Only 13% could be regarded as severely impaired and in continuous need of supervision and guidance. Coping difficulties with everyday demands and dissatisfaction with their social functioning and their anxiety-related restrictions were most prominent in all anxious patients. In contrast to some other long-term follow-up studies, most of which were carried out on outpatients, the results suggest a rather unfavourable course and outcome of anxiety disorders. PMID- 3630754 TI - Patterns of outpatient consultation: a survey of outpatients attending a metropolitan psychiatric hospital. AB - A survey of all outpatients (n = 1135) attending a regional psychiatric hospital during a 3-month period. Psychoses constituted 72% and non-psychotic disorders 25%. Psychoses had a greater proportion of long-term attenders while non psychotic disorders, though frequent (43%) among recent attenders, showed a high attrition rate. Demographic characteristics, patterns of attendance, selected clinical features, level of functioning and difficulties of management of the different diagnostic groups are presented and discussed. Reasons are adduced to explain why patients who were deemed suitable for transfer to other care had not been discharged from hospital. Steps taken to reduce the patient load and increase the efficiency of the services are described. PMID- 3630755 TI - From unipolar depression to bipolar illness: 29 who changed. AB - We studied 29 patients who were admitted to a psychiatric hospital for depression, never had had a previous mania, and developed the mania in follow-up. When compared to patients who were stable unipolars, the potential bipolars had a history of more episodes prior to their onset of mania, more hospital admissions, more marked self-reproach and guilt; in follow-up, they had more hospitalizations. PMID- 3630756 TI - Suicides among 523 persons in a Swedish county with and without contact with psychiatric care. AB - Among 523 (350 males, 173 females) suicides in 1977-1984, subjects who had had contact with psychiatric care (PC) (63%) were compared with those who had never had such contact (NPC) (37%). The male:female ratios in the PC and NPC groups were 1.6 and 3.0, respectively. Intoxication with drugs and or alcohol was the main method of suicide among the PC subjects, and hanging and intoxication with carbon monoxide predominated among subjects of the NPC group. High percentages of divorces and widows/widowers were characteristic of both groups. Among men and women of the PC group the age groups in which the highest mean suicide rates per 100,000 were found were 45-54 and 55-64 years respectively. The corresponding age groups in the NPC group were greater than or equal to 75 and greater than or equal to 70 years. In the PC group the number of admissions to psychiatric hospitals was more than three in 55% of the subjects and more than eight in 25%. Seventy-three percent had had psychiatric contact within 6 months before the suicide. About 40% in each group had had depressive syndromes. Somatic disease of relevance to the suicides was found among 10% of the PC subjects and 20% of the NPC. About 1/4 of the subjects in both groups had expressed serious suicidal intent shortly before the suicide. The importance of information and education about suicide problems among personnel and relatives is underlined. PMID- 3630758 TI - Post psychotic depression: the Fulbourn cohort. AB - A comparison is reported, based on a 10 year follow-up, between an index sample of 29 subjects suffering from schizophrenia and post psychotic depression and a control sample of 41 subjects suffering from schizophrenia alone, all having had their first admission to the same hospital in 1974. The index subjects were significantly older on onset of schizophrenia and exhibited more auditory hallucinations. Follow-up patients with post psychotic depression were admitted more often, but their admissions were shorter. No difference was found between the two groups in the frequency of family history of affective disorder, in the duration of treatment with depot neuroleptics or in the dose level of the depot injection received immediately prior to readmission. PMID- 3630757 TI - Who became revolving door patients? Findings from a nation-wide cohort of first time admitted psychiatric patients. AB - A cohort representing all first-time admissions to Danish psychiatric institutions during the period April 1, 1970 to March 31, 1971 was followed for 10 years in the psychiatric register. The cohort comprised 5,881 males and 6,856 females aged 15 years or above. The revolving door population was delineated as (1) patients with minimum four admissions and no admission or discharge period lasting for more than one fourth of the observation period or (2) patients with minimum four admissions during the first one fourth of the observation period. The incidence rate was 3.14 males and 3.55 females per 1,000. Revolving door patients were younger than others, single or divorced, and lived in larger cities. They were more frequently referred to out-patient aftercare and discharged to their own home. A male diagnostic profile of schizophrenia, demential or organic psychoses, personality disorders and abuse emerged together with a female profile of manic depressive and psychogenic psychosis and neurosis. Twenty-one point nine percent of males and 13.0% of females had more than 10 admissions and 4.5% of males and 3.7% of females spent more than 5 years in hospital. High risk groups were 15-24 years old as 21% and 13% of young males respectively females became revolving door patients, and schizophrenics, as 46% of male and 30% of female schizophrenics became revolving door patients. PMID- 3630759 TI - Urban environment, marital status and mental disorders. An investigation of psychiatric new referrals to outpatient clinics from a geographically defined sector. AB - This study examines the distribution of sex, marital status and mental disorders among new referrals to outpatient clinics from two different urban environments. Differences in the distribution of marital status among patients and inhabitants in the two urban environments were tested with the "chi-square" method for each sex separately. In proportion to the population, significantly more married, separated and divorced women were referred from satellite communities than from traditional urban areas. When DSM-III diagnoses were taken into account, there were significantly more married women with "affective and anxiety disorders" in satellite communities. Similar differences were not observed among men in satellite and traditional urban communities. Social environment seems to be a major contributor to mental disorders in women. In addition, sex role plays an important part in the development of "affective and anxiety disorders" in married women. Sex role alone does not explain the findings of this study. PMID- 3630760 TI - Extra-anatomical bypass formation and exclusion of thoracic aortic aneurysms by "paired clamp method": the development of hind leg paralysis, the thrombus formation and the pressure ratio between the excluded cavity and the aorta. AB - The extra-anatomical bypass formation and the exclusion of thoracic aortic aneurysms by the "paired clamp method" applied to the thoracic aorta of mongrel dogs, and the development of hind leg paralysis was studied experimentally in relation to the ratio between the mean excluded cavity pressure and the mean aortic pressure ratio (EA-ratio). The relationship between thrombus formation in the excluded cavity and the EA-ratio was also studied. Animals were divided into 4 groups: Group 1 underwent the cross-clamping of the descending thoracic aorta for 8 min; Group 2 underwent exclusion of the entire thoracic aorta under permanent bypass; Group 3 underwent ligation of 2/3 of the proximal intercostal arteries which branched from the excluded thoracic aorta; and Group 4 underwent division of the excluded thoracic aorta into 3 parts by ligation. No animals in group 1 developed paralysis. When EA-ratios were higher than 0.48, animals in groups 2 and 3 were not paralyzed, whereas all but 1 animals with EA-ratios lower than or equal to 0.48 were paralyzed. There was statistically significant difference between the EA-ratio of the non-paralyzed animals and that of the paralyzed animals in groups 2 and 3. Four out of 5 animals in group 4 were paralyzed. However, there was no statistically significant difference between the EA-ratio in these 4 paralyzed animals and that in the non-paralyzed animals in groups 2 and 3. When the EA-ratio was lower than or equal to 0.59, all but 1 excluded cavities of groups 2 and 3 animals were fully thrombosed 7 or 8 days after the operation. None of these animals showed the aggravation of the paralysis during the observation period and, conversely, the paralysis of almost all animals was ameliorated. These results suggested that the EA-ratio is useful in predicting the development of paralysis and thrombus formation in the excluded cavity after the operation of thoracic aortic aneurysms by the "paired clamp method". PMID- 3630762 TI - Temporal bone histopathology in trisomy 18 syndrome: a report of two cases. AB - Temporal bone histopathological findings of two patients with trisomy 18 syndrome are described. Many of the abnormalities previously described were seen in the present cases; namely, atresia of the external auditory canal, aberrant course of the tensor tympani muscle, malformed stapes, aberrant course of the facial nerve with an obtuse angulation at the first genu and displacement of geniculate ganglion cells into the internal auditory canal, shortened cochlea with decreased spiral ganglion cell population, and vestibular anomalies, such as bony and membranous blockage of the superior semicircular canal. Moreover, an extremely underdeveloped malleus and incus continuous with a persistent Meckel's cartilage were observed. PMID- 3630761 TI - Differentiation between eclampsia and cerebrovascular disorders by brain CT scan in pregnant patients with convulsive seizures. AB - Six pregnant women with convulsions between 25 to 40 weeks of gestation were experienced. Among them, 4 patients were diagnosed as having intracranial hemorrhage and two as simple eclampsia. With the aid of brain CT scan, one case of arteriovenous malformation was detected and treated surgically with good prognosis for both the mother and the fetus. Two patients were diagnosed to have cerebral hemorrhage with subsequent penetration into the lateral ventricles and were treated conservatively. Their fetuses were delivered alive by cesarean section, but the mothers expired. The other patient with cerebral hemorrhage was treated surgically, and both the mother and the fetus survived. One of the simple eclampsia patients was noted to have a growth retarded fetus at 32 weeks of pregnancy with subsequent intra-uterine death, but the mother recovered after conservative treatment. Another patient at 40 weeks of pregnancy was also treated conservatively and both the fetus and the mother survived. Brain CT scan findings differed between these two eclampsia patients; local brain edema for the second patient and generalized brain edema for the first patient. Thus more active application of brain CT scan is recommended in managing pregnant patients with convulsions. PMID- 3630763 TI - Effects of afferent stimulation of the lingual nerve on gastrointestinal motility in the rat. AB - Effects of afferent stimulation of the lingual nerve (LNAS) on gastrointestinal motility and the reflex pathways which mediate the response to LNAS were investigated in rats. LNAS induced excitatory, inhibitory or biphasic responses in the stomach, duodenum and proximal colon. These responses continued after bilateral vagotomy, but were abolished after additional bilateral splanchnicotomy or transection of the spinal cord between Th4 and Th5. The inhibitory, excitatory and biphasic responses induced by LNAS were not affected by decerebration. Both after administration of atropine (0.2 mg/kg, i.v.) and guanethidine (3-5 mg/kg, i.v.), LNAS-induced excitatory and inhibitory responses were abolished in most cases, but the slight inhibitory response in the stomach and duodenum to LNAS remained in a few cases. These results suggest that the reflex centers which cause LNAS-induced excitatory and inhibitory responses are located in the dorsal nucleus of vagus and that the reflex pathways include the vagus and splanchnic nerves. PMID- 3630764 TI - Palmar interosseous muscle of the human thumb. AB - The adductor pollicis muscle was studied in fifty hands of Japanese adult cadavers of both sexes. The radial portion of the oblique head of the adductor pollicis muscle has carpal and metacarpal origins and an insertion into the wing tendon of the extensor apparatus. This portion was located dorsal to the palmar metacarpophalangeal articular nerve and superficial palmar metacarpal artery. Thus, the radial portion of the oblique head of the adductor pollicis muscle (more strictly, the slips dorsal to the palmar-penetrating twig of the ulnar nerve) is similar to the palmar interosseous muscles, except that its slips cannot be clearly distinguished from each other. PMID- 3630765 TI - II Symposium on Clinical Haemorheology. Part III. Clinical approach. Lisbon, October 12-13, 1984. Proceedings. PMID- 3630766 TI - Blood rheology in diabetes mellitus. PMID- 3630767 TI - The red cell in human arterial hypertension. PMID- 3630768 TI - [Behavioral perinatology]. PMID- 3630770 TI - [Treatment of paraquat poisoning. Plasmapheresis versus hemodialysis]. PMID- 3630769 TI - [Longitudinal study of the concentration of serum fructosamine in diabetic patients (type 1 and type 2)]. PMID- 3630771 TI - [Regulation dynamics of consciousness stages in the first month of life]. PMID- 3630772 TI - [A case of Hodgkin's disease with bone involvement]. PMID- 3630773 TI - [Competence and behavior of the newborn infant: mode and significance of their evaluation]. PMID- 3630774 TI - Inhibitory effect of normal high density lipoproteins on lecithin:cholesterol acyltransferase activity in fish eye disease plasma. AB - The lecithin:cholesterol acyltransferase (LCAT) activity of lipoprotein depleted normal and fish eye disease (FED) plasma was assayed in a modified Glomset-Wright incubation system where the enzyme was allowed to act on three different normal lipoprotein substrates consisting of an authentic mixture of very low (VLDL), low (LDL) and high (HDL) density lipoproteins to assay total LCAT activity, HDL to assay alpha-LCAT activity and combined VLDL and LDL to assay beta-LCAT activity, respectively. However, using normal plasma depleted of HDL, leaving its combined VLDL and LDL as enzyme substrate, resulted in a more than twofold increase in the LCAT activity of FED plasma from the two patients compared to the activity obtained with HDL present in the incubation mixture, indicating an inhibitory effect of HDL on the beta-LCAT activity present in FED plasma. This inhibitory effect of normal HDL could also be demonstrated by autoincubation of FED plasma mixed with isolated HDL2 or HDL3. Both these HDL subfractions had a pronounced inhibitory effect on the cholesteryl ester formation in FED plasma. The present study thus clearly demonstrates that normal HDL inhibits the beta-LCAT activity present in FED plasma, esterifying the free cholesterol of combined VLDL and LDL, derived from controls as well as from the two FED patients. PMID- 3630775 TI - Alpha-lecithin:cholesterol acyltransferase deficiency. Lack of both phospholipase A2 and acyltransferase activities characteristic of high density lipoprotein lecithin:cholesterol acyltransferase in fish eye disease. AB - The phospholipase A2 and acyltransferase activities characteristic of human plasma lecithin: cholesterol acyltransferase have been evaluated in incubation mixtures of lipoprotein depleted plasma of fish eye disease patients and autologous HDL or homologous normal HDL3. Both enzyme activities were strongly reduced as compared to those of normal controls. These findings further support the claim that fish eye disease plasma has a specific lack of high density lipoprotein lecithin:cholesterol acyltransferase (alpha-LCAT deficiency), although the cholesterol esterification of combined VLDL and LDL in such plasma proceeds at a normal rate. PMID- 3630776 TI - Predictive value of prodromal symptoms in myocardial infarction. AB - Prodromal symptoms within four weeks prior to an acute event leading to coronary care unit admission have been studied in 276 consecutive patients interviewed within 24 hours after arrival at hospital. Coronary heart disease (CHD) was diagnosed in 237 patients, 140 of whom did develop acute myocardial infarction (AMI) (Group 1) and 97 who did not (Group 2). Of the remainder, 15 had miscellaneous heart diseases (Group 3) and 24 no heart disease (Group 4). Unstable angina pectoris was equally frequent among CHD patients with and without development of AMI and was related to a higher hospital mortality in AMI patients. Less specific symptoms occurred with equal frequency in the four groups. Patients who developed AMI were not possible to identify by prodromal symptoms. PMID- 3630777 TI - Mitral annulus calcification and embolism. AB - Of 388 patients consecutively referred to echocardiography, 49 were suspected of having a cardiac source of systemic arterial embolism (SE). Mitral annulus calcification (MAC) was revealed in 27% of the patients with SE and in 8% of the remaining patients (p less than 0.05). The group of patients with SE were slightly older (median age 67 years) and included more female patients (47%) compared to the group without SE (62 years, p less than 0.05; 40% female patients, p greater than 0.05). However, the small differences in age and sex distribution did not explain satisfactorily the considerably increased prevalence of MAC in the group of patients with SE. Our preliminary data indicated that thromboembolism caused by left atrial dilatation and atrial fibrillation might be the most important cause of the condition in patients with MAC and SE. However, the significance of the possible mechanisms of embolism in patients with MAC and the incidence of the complication should be further clarified before therapy and prophylaxis can be suggested. PMID- 3630778 TI - Effect of guar gum on the arterial blood pressure. AB - Forty moderately overweight men with high waist/hip girth ratio and mild hypertension participated in a trial with gel-forming fiber--guar gum. After two weeks of familiarization and controlled food intake, ensuring weight stability, the participants received 7 g of guar three times daily during two weeks. Patients were then followed during a 5-week wash-out period. There were no changes in body weight and body composition but total cholesterol decreased during guar treatment. Blood pressure measured at standing, supine and sitting positions decreased after two weeks of guar treatment by 9.8% systolic and 9% diastolic and did not revert to pre-treatment values until after three weeks of the wash-out period. There was also a decrease in both systolic (8%) and diastolic (7%) blood pressures during exercise on the ergometer bicycle at 50 and 100 W (4.6 and 4.7% respectively) submaximal work load. It is concluded that guar gum exerts a lowering effect on the blood pressure in moderately obese men even in the absence of any change in body weight. If confirmed in further long-term studies, guar may be a valuable alternative to pharmacological preparations in the treatment of mild hypertension. PMID- 3630779 TI - Outcome of the glucagon test depends upon the prevailing blood glucose concentration in type I (insulin-dependent) diabetic patients. AB - The outcome of 97 paired glucagon and meal tests was related to the prevailing fasting blood glucose concentrations on the two test days. At blood glucose concentration less than 7 mmol/l both the C-peptide responses and the maximal (6 min) C-peptide concentrations during the glucagon tests were significantly lower than the corresponding values found during the meal tests. During the glucagon tests, a direct relationship was found between the responsiveness of the pancreatic beta-cells and fasting blood glucose values when these were between 3 and 7 mmol/l. No significant difference was found between the outcome of the two tests when the fasting blood glucose concentration was greater than 7 mmol/l. The results indicate that the outcome of the glucagon test in Type I patients depends upon the prevailing fasting blood glucose concentration and that the predictive value of the glucagon test as to how the beta-cells will respond to a meal during everyday life is low when fasting blood glucose is less than 7 mmol/l. PMID- 3630780 TI - Electromagnetic field focusing (EFF) probe--a new neurosurgical tool. AB - The electromagnetic field focusing (EFF) probe is capable of producing well circumscribed, intense heat at the point of contact with the tissue. Experimental studies were carried out to assess this probe as a neurosurgical tool using 38 rats and 4 mice with mammary carcinoma. The study on the rats included study of the cutting, coagulating and vaporizing effect on brain tissue including study of blood brain barrier disruption and heat dissipation. The study on the mice included the study of vaporizing property of the probe on solid tumours. The probe proved to be an excellent tool for cutting, coagulating and vaporizing purposes with very minimal disruption of blood brain barrier and demonstrated well circumscribed heating pattern. The study indicates that this tool combines the beneficial effect of both the YAG and CO2 laser. PMID- 3630781 TI - An experimental model of communicating hydrocephalus in C57 black mouse. AB - The authors report a new experimental model for the study of hydrocephalus. Hydrocephalus was produced in C57 black mouse by transplanting human glioma cultured cells. 20% of the animals developed hydrocephalus while the incidence of spontaneous hydrocephalus is only 1%. The transplanted cells disappeared within 72 hours. The mouse developed progressive hydrocephalus. There was no evidence of blockage of CSF pathways. The only abnormal microscopic finding was a scattered collection of lymphoid cells in some of the animals, which may be a hypersensitivity reaction to the cells. A similarly hypersensitive reaction to the foreign maternal protein which may enter the foetal circulation is suggested as the cause of hydrocephalus in some of the cases of congenital hydrocephalus. PMID- 3630782 TI - European Association of Neurosurgical Societies. Eighth European Lecture, Winchester, United Kingdom, February 21, 1987. Teaching and learning neurosurgery. PMID- 3630783 TI - Incidence of wound infection in patients undergoing craniotomy: influence of type of shaving. AB - How the method of shaving affects the incidence of deep postoperative wound infections was examined in 475 patients. It is shown that the rate of infection is not lower after wet shaving than after dry shaving. The overall infection rate was 4.2%, 2.9% in patients who had been shaved wet versus 5.5% in patients shaved dry. The difference is, however, not significant on the 5% level. With respect to dry shaving, the infection rate was not affected by whether the hair was removed with electric clippers alone (2.8%) or whether a disposable razor was also used for additional hair removal in the area of skin incision (3.2%). PMID- 3630784 TI - Intrathecal administration of netilmicin in gentamicin-resistant ventriculitis. AB - In ventriculitis caused by Gentamicin-resistant staphylococcus aureus and staphylococcus epidermidis, Netilmicin was administered intrathecally to 19 patients under continuous control of the Netilmicin concentration in cerebro spinal fluid (CSF). This therapy was able to bring these otherwise lethal infections under control, usually within 10 days. Pharmacokinetic studies with different doses have shown that doses of 2 X 3 mg are to be recommended in moderately severe cases of ventriculitis, and in most severe infections 3 X 3 mg daily intraventricularly for adults. In infants daily intraventricular injections of 2 X 0.4-0.5 mg Netilmicin are a sufficient dose to produce an effective antibiotic concentration level. PMID- 3630785 TI - Benign subarachnoid haemorrhage (subarachnoid haemorrhage of unknown aetiology). AB - Forty three patients of subarachnoid haemorrhage of unknown aetiology have been studied for their clinical presentation, rebleed rate, morbidity and mortality. The results have been compared with other similar studies. The present study and those of others indicate a very good prognosis in acute stage. The rebleed rate ranged between 0 and 7% over a period of two to three years. The mortality rate ranged between 0 and 5% during the same period of follow-up. Majority of the patients returned to their full working capacity. The benign nature of this subgroup as compared to the poor outcome of subarachnoid haemorrhage as a whole prompted us to call it "Benign subarachnoid haemorrhage". PMID- 3630786 TI - Absence of hydrocephalus in spite of impaired cerebrospinal fluid absorption and severe intracranial hypertension. AB - Four patients are described presenting papilloedema, increased pressure and reduced CSF absorption--caused by either spinal tumours, leptomeningeal carcinomatosis or encephalitis. Remarkably they all had a normal CT without signs of hydrocephalus. A 24-hour intracranial pressure monitoring showed a mean pressure of 30-35 mm Hg, recurrent plateau waves and high occurrence of B waves. Conductance to CSF outflow studied by a constant perfusion test was severely reduced 0.010-0.026 ml min-1 mm Hg-1 (normal greater than 0.12 ml mm Hg-1 min-1). Despite these findings no ventricular enlargement was seen on serial CT scans. The reason therefore remains unknown. Disappearance of papilloedema and a variable clinical improvement followed shunt-insertion. PMID- 3630787 TI - Haemodynamic stress in lateral saccular aneurysms. An experimental study. AB - The flow velocities in lateral glass and silastic aneurysm models were quantitatively measured with the non-invasive laser Doppler method. The influences of the elasticity of the wall, the pulse wave and the properties of the perfusion medium on the intra-aneurysmal circulation were investigated. As shown previously, the inflow into the aneurysm arose from the downstream lip and was directed toward the centre of the fundus. Backflow to the parent vessel took place along the walls of the fundus. With non-pulsatile perfusion, flow velocities in the centre of the standardized aneurysms varied between 0.4 and 2% of the maximum velocity in the parent vessel. With pulsatile perfusion, flow velocities in the centre of the fundus ranged between 8 and 13% of the flow velocity in the axis of the parent vessel. Flow velocities in the aneurysms were slower with a macromolecular perfusion medium with blood like properties compared to a glycerol/water solution. Flow velocity measurements near the aneurysmal wall allowed the estimation of the shear stresses at critical locations. The maximum shear stresses at the downstream lip of the aneurysm were in the range of the stresses measured at the flow divider of an arterial bifurcation. The present results suggest that in human saccular aneurysms intra-aneurysmal flow and shear stress on the wall are directly related to the pulsatility of perfusion, i.e. the systolic/diastolic pressure difference and that the tendency to spontaneous thrombosis depends on the viscoelastic properties of the blood, namely the haematocrit. PMID- 3630788 TI - Serum levels of B subunit creatine kinase isoenzymes measured by a RIA method in patients with brain tumors and stroke. Preliminary results. PMID- 3630789 TI - Adrenoleukodystrophy: a genetic, clinical, biochemical and computed tomographic study of four patients in three different families. PMID- 3630790 TI - Sleep spindles in amyotrophic chorea-acanthocytosis disease. PMID- 3630791 TI - A numerical procedure for assessing between-group differences in cerebral CT localization. PMID- 3630792 TI - Paradoxical neurovegetative symptoms in organophosphate intoxication. A case report. PMID- 3630793 TI - Huge calcified subdural hematoma undetected for half a century. A case report in an old patient. PMID- 3630794 TI - Associated spinal meningioma and neurinoma. A case report. PMID- 3630795 TI - Endodermal-auto-hemo-therapy in the treatment of schizophrenia. An uncontrolled open clinical investigation. PMID- 3630796 TI - Extrapyramidal side-effects of flunarizine. PMID- 3630797 TI - Adolescent drug use in a behavioral matrix: a confirmation and comparison of the sexes. AB - An account is given of the desirability of considering non-medical drug use among young adolescents within a perspective involving other behaviors. 1008 boys and 1040 girls took part in the study. Major correlates of the use of marijuana, alcohol, and tobacco were sexual behavior, delinquency, and social behavior. Minor correlates were achievement and religiosity. Very few differences between the sexes were observed--and these were small in magnitude, though of interest. PMID- 3630798 TI - Alcohol treatment outcome evaluation methodology: state of the art 1980-1984. AB - The methodology of alcohol treatment outcome studies published during two sequential intervals from 1976 through mid-1984 is critically reviewed. Although considerable methodological improvements have occurred over time, major methodological deficiencies continue to characterize much of the literature, with inadequate reporting of subjects' pretreatment characteristics (e.g., severity of dependence) being the most striking problem. Pervasive differences across studies regarding the types of data gathered and the ways in which findings are reported seriously impede attempts to compare studies and weaken the types of conclusions that can be drawn about treatment efficacy in general. It is suggested that journal editors establish standards of reporting for follow-up studies. PMID- 3630800 TI - Recruitment into treatment and effects of treatment for female problem drinkers. AB - Literature on treatment of female problem drinkers is reviewed, focusing on the following topics: Recruitment of female problem drinkers into alcoholism treatment agencies, the fate of women in traditional mixed-sex treatment institutions, special treatment approaches for women, methodological problems and needs for future research. Several studies indicate that fewer women than men are recruited into alcoholism treatment agencies and that the referral routes in many ways differ from the referral routes of men. The women also report more negative effects of treatment, and are commonly looked upon as receiving less attention and less adequate care in the mixed-treatment institutions. On the other hand, a substantial number of studies of treatment outcome have shown that women seem to do just as well in treatment in mixed-sex institutions as men do. Several reports of all-female treatment programmes have been presented. Some treatment techniques may seem to have special significance for female problem drinkers, for instance self-assertiveness training and family therapy. But very few controlled studies of such programmes have been carried out up to now. PMID- 3630799 TI - Pathological gambling among high school students. AB - Eight hundred and ninety-two high school students from four New Jersey high schools were given a questionnaire concerning their gambling behavior. Ninety-one percent of the students had gambled at least once in their lifetime, 86% gambled in the last year and 32% gambled at least once a week. Using an index which was validated in other research (Lesieur, Blume, & Zoppa, 1986) 5.7% of the students showed clear signs of pathological gambling. The pathological gambling signs index was found to be correlated with sex, parental gambling problems, grade average, and the extent of gambling by the student. PMID- 3630801 TI - Weight gain following smoking cessation: a possible role for nicotine replacement in weight management. AB - This study examined nicotine dependence as a factor in weight gain following smoking cessation in a group of 104 recent ex-smokers. Nicotine dependence was measured using the eight-item Fagerstrom Tolerance Questionnaire. Findings support the hypothesis that weight gain following smoking cessation is greater among more nicotine dependent persons. Heavier smokers (greater than or equal to 26 cigs/day), those who reported smoking when they are ill, and those who reported smoking their first cigarette of the day within 30 minutes of waking up reported the greatest increases in weight one month after quitting. Twenty subjects reported using nicotine gum to help them quit smoking. A significant inverse correlation (r = -.17) was found between weight gain and the number of pieces of nicotine gum chewed per day. Stratification by the number of cigarettes smoked daily (greater than or equal to 26 cigs/versus less than 26 cigs/day) indicated that the correlation between weight gain and the number of pieces of nicotine gum chewed per day was significant only for heavy smokers (r = -.37 versus r = -.08). This finding suggests that nicotine replacement may help prevent weight gain following smoking cessation, especially for the more dependent smokers. PMID- 3630802 TI - Appearance changes associated with participation in a behavioral weight control program. AB - Relationships among objectively-measured weight changes, perceived changes in weight, and perceived changes in attractiveness of participants in a behavioral weight control program were examined. Participants in the program were weighed and photographed before and after treatment and at a six-month follow-up session. These photographs were then rated on the dimensions of perceived weight and perceived attractiveness by the same participants, who were kept blind to the times at which the photographs were taken. Correlational analyses indicated that there was little correspondence between objectively-measured weight change and perceived weight changes or between objectively-measured weight change and perceived change in attractiveness. Perceptions of weight change and perceptions of attractiveness change were, however, strongly related. PMID- 3630803 TI - Epidemiology of bulimia and bulimic behaviors. AB - A number of studies in recent years have attempted to establish prevalence rates for bulimia as defined by the DSM-III criteria and for bulimic behaviors such as binge eating, purging, and restrictive dieting. The literature has reported widely differing estimates of these behaviors. A critique of these studies suggests that a variety of methodological issues probably accounts for the lack of consistency across reports. A review of the literature indicates that some behaviors which could be considered bulimic are extremely widespread. Some recent work highlights the importance of using both behavioral and attitudinal variables in an assessment of clinically significant bulimia associated with life impairment, which is much less prevalent. PMID- 3630804 TI - Nicotine fading, behavioral contracting, and extended treatment: effects on smoking cessation. AB - Twenty-eight subjects were randomly allocated to either a nicotine fading or a maintenance condition. The maintenance condition utilized behavioral contracting and extended treatment in addition to the nicotine fading to improve treatment outcome and avoid relapse. The maintenance condition achieved superior outcome on smoking measures at post-treatment and follow-up periods for self-reported smoking levels. Carbon monoxide levels were significantly lower for the maintenance condition at post-treatment, three month and six month follow-up. Saliva thiocyanate levels were significantly lower for the maintenance condition at the three month follow-up. Changes in health functioning indicated significantly lower diastolic and systolic blood pressure at six month follow-up for the maintenance condition. Additional research on nicotine regulation during nicotine fading and thiocyanate levels during experimental smoking would be useful. The use of behavioral contracting to enhance maintenance without therapeutic support warrants further research as well. PMID- 3630805 TI - Problem behavior theory and adolescent alcohol use. AB - The prevalence of adolescent alcohol use has prompted interest in identifying the factors associated with its use. A comprehensive theory that provides a framework for understanding alcohol use is Jessor and Jessor's Problem Behavior Theory (PBT). We adopted PBT in a study of alcohol use among 226 Catholic high school students. PBT explained 38% of the variation in quantity-frequency of alcohol use and 31% of the variation in problem drinking. The three major systems (personality, perceived environment, behavioral) of the theory were about equally predictive of alcohol use. PMID- 3630806 TI - Effects of cigarette smoking on phobic anxiety. AB - Smokers report that smoking reduces anxiety. However, experimental research on the anxiety-reducing effects of smoking is limited to two self-report studies, both of which have methodological problems. We tested the effects of smoking on self-reported anxiety and avoidance behavior in a behavioral avoidance test (BAT) using a large white rat. In a counterbalanced within subjects design, 20 rat phobic female smokers smoked or were smoking deprived in two separate administrations of the BAT. A second group of 20 rat phobic nonsmokers also received two BATs. Subjects manifested substantial anxiety during BATs. However, neither smoking condition nor smoker versus nonsmoker status affected self reported or motoric anxiety. Although smoking did not reduce anxiety in this study, smoking may affect anxiety in other situations, such as social settings, where the stimulus is more diffuse or less intense. It may also affect anxiety in individuals who are heavier smokers than our subjects, who smoked only 10-20 cigarettes per day. PMID- 3630807 TI - Time course of cigarette withdrawal symptoms during four weeks of treatment with nicotine chewing gum. AB - Ratings of withdrawal symptoms were obtained from 52 Smokers Clinic clients who abstained throughout a four week group treatment programme involving use of nicotine chewing gum. Mean ratings of irritability, depression, hunger, restlessness, and inability to concentrate were significantly higher in the first week of abstinence than at baseline, although only a minority of smokers experienced severe withdrawal symptoms. Disturbance of mood and concentration returned to baseline within four weeks while increases in hunger persisted. The average amount of time spent with the urge to smoke started to decline early in treatment, but the average strength of urges and overall difficulty not smoking did not decline until the fourth week. At the end of treatment 35% were still experiencing strong urges to smoke and 23% reported finding it difficult keeping themselves from smoking. The findings have practical implications for preparing smokers for cessation with the aid of nicotine gum. PMID- 3630808 TI - Beliefs about control of smoking and smoking behavior: a comparison of different measures in different groups. AB - This study investigated several measures of beliefs about controlling smoking as predictors of cessation and reduction at one and six months after a medically based control program. Smokers (n = 250 total) attending general medicine clinics at University and Veterans Administration facilities received advice to quit from both physicians and nurses. Beliefs about difficulty resisting urges to smoke in 15 situations, their frequency of occurrence, and general level of difficulty were assessed at baseline. For the University group of patients, significant relationships were found between both general and specific indexes and both cessation and reduction at one month. Although a greater change in smoking was seen at six months, few belief measures remained predictive. At one month, global measures were as useful as specific ones, although difficulty in situations of negative emotion was a consistent and strong predictor. Marked differences between the two sites were found; virtually no measure of difficulty proved predictive for the VA group. PMID- 3630809 TI - A cross-cultural application of a drinking behaviour questionnaire. AB - A British Questionnaire for Drinking Behaviour (HDBQ) measuring the severity of alcoholism was applied cross-culturally to 96 Arab-Muslim alcoholics while receiving treatment in Kuwait Psychiatric hospital. Though HDBQ proved valid in differentiating Arab alcoholics drinking categories, it gave significantly lower scores for the Arab sample when compared to scores of a British sample. Statistical analysis of the responses of various categories showed that Arab patients tended to respond in absolute negatives significantly more than the British sample did. Cultural factors underlying this tendency were discussed. Suggestions are offered for improvements of this and similar diagnostic instruments to make them more usable transculturally. PMID- 3630810 TI - Descriptions: a model of nonstrategic memory development. PMID- 3630811 TI - Reactivation of infant memory: implications for cognitive development. PMID- 3630812 TI - Gender segregation in childhood. PMID- 3630813 TI - Piaget, attentional capacity, and the functional implications of formal structure. PMID- 3630814 TI - The development of conditional reasoning: an iffy proposition. PMID- 3630815 TI - Experiences with Filshie clip sterilization. AB - Between June 1980 and April 1986 796 cases of female sterilization were performed in a private clinic in Malaysia using Mark IVa and Mark VI Filshie clips. There was one failure. Technical failure, surgical difficulties and complications were minimal. PMID- 3630816 TI - Estradiol medicated IUDs: release and influence on menstruation pattern. AB - In a double blind trial of 90 women with three types of IUD (MLCu250; MLCu250 + 0.3 mg estradiol releasing about 1 microgram per day; and MLCu250 + 1.0 mg estradiol releasing about 3 micrograms per day) no difference in intensity or duration of bleeding was found. PMID- 3630817 TI - Pain reduction during and after insertion of an intrauterine contraceptive device. AB - The intrauterine contraceptive device (IUD) is an established method of fertility regulation despite certain problems. The major problems relating to IUD use are unwanted pregnancy, excessive bleeding, genital infection, occasional uterine perforation, device translocation, and pelvic pain. All fertility regulation personnel are aware that a very large number of potential IUD acceptors are concerned about the possibility of pain before, during and after device insertion. Pain is recognized as one of the major reasons for termination of the use of the IUD. Despite this, and unlike other IUD problems, IUD-related pain has been very poorly studied. At a recent workshop on intrauterine contraception there was not one presentation on this topic. The reason for this is that IUD related pain is difficult to study, requiring careful analysis of subjective rather than objective data. Nevertheless a thorough understanding of the mechanisms, causes, prevention and treatment of IUD-related pain is important for fertility regulators in both developed and developing countries. PMID- 3630818 TI - The Ombrelle-380 IUD: a pilot study. AB - The initial results of a pilot trial (314 insertions and 3784 woman-months of experience at 18 months) suggest the low expulsion rate (0.0) and high clinical effectiveness (pregnancy rate 0.0) of the Ombrelle-380, a new high-load copper releasing IUD of French origin. PMID- 3630819 TI - Rare events occurring at insertion of an intrauterine device--a review of an international experience. AB - Events occurring at the time of insertion of an intrauterine device (IUD) are rarely studied, especially for parous women for whom, in theory, IUD contraception is most suitable. These events, although rare, cause personal distress, embarrassment and inconvenience and can have a negative impact on IUD acceptance. Sixty million women worldwide are using IUDs. Thus, even a rare event may have important public health implications. To avoid such occurrences, the risk factors of these rare events need to be delineated. The large international IUD data set compiled by Family Health International (FHI) since 1972 provides a unique opportunity to achieve this purpose. Four IUD insertion-related rare events have been studied, namely: insertion failure, uterine perforation, syncope and other vasovagal reactions, and severe insertional pain. This review paper summarizes the important findings from these as well as other relevant studies. This broad experience should form the basis by which health personnel inserting IUDs can improve the quality of care for women requesting a device for contraception. PMID- 3630820 TI - Immediate postpartum insertion: performance of the Nova-T-PP and randomized comparison with the Nova-T. AB - Clinical evaluation of the Postpartum Nova-T or Nova-T-PP (a Nova-T IUD adapted for postpartum insertion) was based on 412 insertions and showed that this model- besides being effective and safe--had a low expulsion rate (7.2% at 1 year). To prove that the Nova-T-PP's low expulsion rate is indeed the result of its special design, a randomized trial was conducted to compare the Nova-T-PP with the parent model (Nova-T) when inserted within 10 minutes of delivery of the placenta. The result of this study (408 insertions, 203 of them Nova-T) indicate that there is no significant difference in expulsion rate between the two IUD models, suggesting that the addition of two extra arms to the original Nova-T model does not improve the retention of the adapted IUD model. PMID- 3630821 TI - Does a gradually decreasing menstrual blood loss (MBL) in women wearing a Cu-IUD indicate a risk for an accidental pregnancy? AB - In three separate series, comprising 71 women using either a Gravigard, a Nova-T or a Multiload contraceptive device, the menstrual blood loss (MBL) was quantitatively assessed before and after insertion of each respective IUD. In three women, an involuntary pregnancy was registered with the IUD in situ. In these three women a successively diminishing MBL was registered during the last 3 months before conception, while none of the remaining women included in the series experienced any accidental pregnancy or any reduction of the MBL. Thus, this report emphasizes the potential risk for an accidental pregnancy in women wearing a Cu-IUD if successively diminishing MBLs are observed. PMID- 3630822 TI - Measurement of the endometrial cavity length using Wing Sound I. AB - Parity is a factor that influences the axial length of the uterus. The knowledge of different measurements will help in the fitting of the IUD. In this paper, 657 cavimetries have been studied in relation to parity. A progressive increase of both the total uterine length and the endometrial cavity length have been observed in relation to parity, but none regarding the cervical length. PMID- 3630823 TI - Return of fertility after use of IUDs (Nova-T, MLCu250 and MLCu375). AB - In a randomized prospective study of three copper-containing IUDs, those women who terminated contraception in order to become pregnant were studied for return of fertility. The gross cumulative pregnancy rate was 79.3 after 11 months and 90.4 after 23 months of observation. There were no significant differences in the return of fertility related to the type of IUD, duration of use, parity or maternal age. However, parous women showed a tendency to initiate pregnancy more easily than nulliparous women (p less than 0.10). The seven women who did not conceive within 18 months of IUD removal had a fertility work-up. Five of these women later became pregnant after clomiphene stimulation. In no case could tubal pathology be identified as the sole explanation for infertility. After 35 months of observation, 95 out of 97 past users of IUDs have conceived. The use of copper containing IUDs does not seem to affect subsequent fertility among women living in stable relationships. PMID- 3630824 TI - Histologic and microbiologic findings in the fallopian tubes of IUD users. AB - Non-microbial inflammatory changes are more frequent in the oviducts of IUD users than in those of former users and never users. No correlation was found between the incidence of non-microbial tubal inflammation and the interval between IUD use and tubal sterilization, pelvic inflammation and surgery, and parity. Inflammatory response was more common among women using copper devices than among those wearing a non-copper IUD. PMID- 3630825 TI - Gestoden, an innovative progestogen. AB - The estrogen component used in virtually all oral contraceptive pills today was synthesized in the laboratories of Schering AG in 1938. The progestogen component varies, but levonorgestrel has become the standard among the lowest-dose pills available. Various attempts to modify the levonorgestrel molecule have resulted in new progestogens like norgestimate and desogestrel without much greater biological activity; therefore, further reduction in dose is unlikely. Gestoden, the newest progestogen from the levonorgestrel class, synthesized in Schering AG's laboratories, is different. Its enhanced biological activity allows for a progestogen content in a fixed combination pill half that in other low-dose pills available today. Furthermore, it has an improved pharmacologic profile with favorable dissociation of the androgenic and progestogenic activities. A unique anti-mineralocorticoid action is seen resembling natural progesterone, a property not presently shared with other synthetic progestogens. Results will be presented from clinical trials with a new monophasic gestoden preparation. PMID- 3630826 TI - Ovarian actinomycosis during first-trimester pregnancy. AB - A case of actinomycotic ovarian abscess ruptured during early gestation and related to IUD use is reported. The patient was treated by antibiotic therapy and oophorectomy. Further evolution of the pregnancy was irrelevant. PMID- 3630827 TI - Mechanisms of lymphocyte activation and immune regulation. Proceedings of an International Conference on Lymphocyte Activation and Immune Regulation. February 28-March 2, 1986, New Post Beach, California. PMID- 3630828 TI - Expression of the c-fos gene during differentiation. PMID- 3630829 TI - Activation of natural killer (NK) cells and mechanism of their cytotoxic effects. PMID- 3630830 TI - Molecular mechanism of natural killer cell-mediated cytotoxicity. PMID- 3630831 TI - Phaeochromocytoma and adverse drug reactions. PMID- 3630832 TI - Breast augmentation: a review of subglandular and submuscular implantation. AB - A study of 156 patients who underwent augmentation mammoplasty at the Medical College of Georgia from June 1980 to July 1985 is presented. Complete records on 89 patients with 196 implants were obtained. A retrospective analysis with respect to capsular contracture was undertaken. Possible influential variables including age of patient, type of prosthesis, operative blood loss, use of local steroids, and site of insertion (i.e., submuscular versus subglandular) were considered. The site of implant insertion was the only statistically significant factor affecting capsular contracture. The incidence of capsular contracture was 9.4% with the submuscular approach and 58.0% with subglandular contracture. The followup time for the submuscular group was 17.4 months (range of 6-36 months) with the mean time of capsule contracture occurring 4.5 months after insertion. There were no significant differences in intraoperative blood loss or elapsed operating time between the submuscular and the subglandular placements of the prosthesis. This study confirms the submuscular technique of augmentation mammoplasty as the most reliable method of reducing the high incidence of capsular contracture. PMID- 3630833 TI - Breast reduction: evolution of a technique--a single vertical scar. AB - In the past 20 years, patients have become more critical about the result of a breast reduction operation. Natural lasting shape and minimal residual scarring are now expected by most of the candidates to that surgery. In 1969 the author described a vertical technique that achieved reduction and good shape but the end of the vertical scar could be seen below the brassiere line. In 1977 the author modified the technique by adding a small horizontal scar that eliminated the visible part of the vertical scar. In this article the author demonstrates that the same technique he described in 1969 and modified in 1977 can produce a single residual vertical scar if properly used. PMID- 3630834 TI - Reduction mammaplasty: a medicolegal hazard? AB - In spite of the potential for complications and poor results, reduction mammaplasty remains a procedure with a high degree of patient satisfaction. Although thousands of cases are done annually, only a small percentage of the patients are unhappy enough to consider a law suit. A questionnaire was sent to the members of the ASPRS. Thirty-eight percent of the members responded and 11% indicated that they had been sued at least once for this procedure. A review of the results of the questionnaire and suggestions for reducing the number of dissatisfied patients are presented. PMID- 3630835 TI - Evaluation of transcutaneous oxygen tension monitoring during cosmetic surgery. AB - Transcutaneous oxygen monitoring during rhytidectomy surgery under local anesthesia was evaluated in 18 patients. Blood gas analysis of samples of arterial blood obtained from the superficial temporal arteries during rhytidectomy was compared with transcutaneous PO2 values. Simple linear regression analysis indicated that the transcutaneous PO2 correlates strongly with arterial PO2. Transcutaneous PO2 monitoring could be a reliable, inexpensive, and continuous method of assessing gradual or sudden changes in arterial PO2, provided the sensor is fastidiously maintained and properly applied, elements which are critical to relying on this particular device. However, this instrument has no advantages over the digital pulse oximeter. PMID- 3630836 TI - Acute normovolemic hemodilution in aesthetic plastic surgery. AB - Acute normovolemic hemodilution (ANH) is indicated and useful in all procedures of plastic surgery in which great blood loss is expected. Here we present the advantages of ANH such as avoidance of incompatibility reaction, no risk of disease transmission, better microperfusion, economic and psychological advantages, and saving blood. PMID- 3630837 TI - Otoplasty for prominent ears. AB - A technique for correction of prominent ears is described. It combines the advantages of simplicity and accuracy and provides satisfactory results. Essential points of the technique are perichondrial cartilage scratching at the superior crus and antihelical fold according to Stenstrom, mattress sutures applied to the perichondrium and soft tissues at the medial surface, and to these we add the trimming of the tail of the helix, thinning of the antitragus, and a double-spindle skin excision at the medial auricular surface. In patients with insufficient curling of the helical rim ("shell-ear" deformity) the base of the helical arch is scratched at its medial surface. PMID- 3630838 TI - Otoplasty for lop ears. AB - The classification of malformations of the auricle is reviewed. Hinderer's technique is described. It is based on long oblique skin and cartilage flaps of the upper pole of the ear, taken in opposite directions for expansion of the helical arch, thus preventing a later visible notching at the helical rim. The remaining scapha is straightened and the superior crus and antihelical fold are formed by scratching and sandpaper abrasion of the lateral surface. A deep concha is treated by a cartilage strip expansion from the posterior conchal wall. PMID- 3630839 TI - Macrotia. AB - Techniques for treatment of severe and moderate macrotia and for hypertrophy of the earlobe are described. For macrotia, the excision of cartilage at the scapha, helical arch, and skin are performed at different levels to prevent a notching, mainly at the helix. For hypertrophies of the earlobe, through-and-through excisions of two triangular pieces are used with reinsertion of the remaining earlobe at the base. PMID- 3630840 TI - The treatment of prominent ears: a 25-year survey of the island technique. AB - The authors report on a 25-year retrospective study of 488 cases of prominent (protruding) ears corrected by the island technique of Pitanguy. PMID- 3630841 TI - Liposuction in cervical rejuvenation. AB - Superficial musculoaponeurotic system (SMAS) has represented a confusing anatomical structure because descriptions of it in classical treatises of anatomy are contradictory. Also, utilization of this system in facial rejuvenation also does not coincide with the true anatomical facts regarding the superficial musculo-aponeurosis. A macroscopic and histological study of the region was carried out in order to determine the areas of fat deposits and the distribution of the true cervical superficial aponeurosis, partly in accordance with the statements by Jost and leaving aside the concept proposed by Mitz and Peyronie. Cervical liposuction was combined with the techniques for cervicofacial rhytidectomy. PMID- 3630842 TI - The atypical presentation of infection in old age. AB - A study was designed to determine the incidence of atypical or geriatric presentation of infection in a long-term-care-hospital population of aged veterans. During the 6-month period of surveillance there were 65 instances of functional decline among the 143 veterans, with 50 episodes of infection. Although the symptoms and signs of infection were attenuated in many patients, a diagnosis was reached by careful examination and investigation. The majority of patients had a temperature of at least 38 degrees C in the presence of infection and it is concluded that the afebrile response to infection is rare in this population. During the course of this study the death rate in this institution dropped to about half of what was anticipated, and returned to previous levels following completion of the study. Infection can be recognized at a very early stage despite an atypical geriatric presentation and early treatment reduces morbidity and mortality. PMID- 3630843 TI - Diuresis bacteriuria in physically dependent elderly women. AB - Among 34 women aged 74-96 years, residents of a Home for the Aged, with reduced mobility and repeatedly negative urine cultures, 16 (47%) responded to a rapid hydration and 20 mg frusemide administered intravenously with a transient bacterial excretion usually trailing the diuresis. Antibody-coated bacteria were detected in 11 of the 13 Gram-negative isolates tested. Women with urine turning positive had significantly lower glomerular filtration rates and more advanced renal tubular defects than the steadily nonbacteriuric subjects of the same age. Progress to renal insufficiency was somewhat faster and all-causes mortality at 1 year was higher in subjects with urine turning positive. Diuresis bacteriuria originating from the upper urinary tract along with frank bacteriuria may be detected in up to 70% of women in their mid-80s and represents a likely source of the most common infection in man's last period of life. PMID- 3630844 TI - Significance of single serum urate estimations in acutely hospitalized elderly patients. AB - Clinical, pharmacological and biochemical correlates of hyperuricaemia were studied in 399 consecutive patients aged over 70 years admitted to hospital with acute medical illness. Hyperuricaemia was significantly related to renal impairment and to the use of diuretics, but to no other recognized associations of gout, including typical or atypical joint symptoms. 'Routine' measurement of serum uric acid alone or as a component of biochemical profiles in acute illness in the elderly appears unjustified, particularly since raised levels may encourage inappropriate use of urate-lowering therapy. PMID- 3630845 TI - Medical audit in geriatric medicine. AB - A form developed to audit the case notes of general medical patients was modified for use in geriatric medicine. The case notes of 41 admissions to the geriatric wards of a teaching hospital were audited with the new form and their contents did not come up to the standard set. Deficiencies were found in those parts of the notes considered to reflect the distinctive features of the specialty, e.g. the functional history, the assessment of mobility and the recording of multidisciplinary case conferences. The introduction of a standard history and examination form to meet the needs of patients admitted to geriatric wards, better training in geriatric medicine for junior doctors and closer scrutiny of medical records by consultants are suggested as ways of improving documentation in the case notes. PMID- 3630846 TI - Fibreoptic bronchoscopy in the elderly. AB - To evaluate the efficacy and safety of fibreoptic bronchoscopy in the elderly, the bronchoscopy records of 1000 patients were retrospectively reviewed. Of these, 423 were in-patients aged 65 years or over. This population was further subdivided into 'young' elderly (65-74 years old) and 'old' elderly (75+ years old). The indications for bronchoscopy in each group were similar and included haemoptysis, chest radiographic changes suggestive of collapse or consolidation, and hilar or paratracheal shadowing. The results in each group were also comparable and bronchoscopy was not tolerated in only five. A visible tumour was present in 165 patients. We conclude that, like upper gastrointestinal endoscopy, fibreoptic bronchoscopy in the elderly is safe, well tolerated and has a significant diagnostic yield. PMID- 3630847 TI - Acute myocardial infarction: diagnostic difficulties and outcome in advanced old age. AB - The diagnostic features and outcome of acute myocardial infarction in 100 very elderly (aged 85 years or more) hospitalized patients are reviewed and compared with those in a group of younger elderly (aged 65-84 years). The diagnostic triad of chest pain, sequential ECG changes and raised cardiac enzymes was present in only 24 very elderly patients and in 27 the diagnosis was not initially suspected. Presenting symptoms were often atypical and characteristic ECG changes could not be demonstrated in 25 patients. Very elderly patients had a higher mortality during the first few days in hospital, despite no greater incidence of cardiac failure and similar infarct size to the younger patients. Subsequent in hospital mortality was similar in both groups. A higher index of suspicion of myocardial infarction in acutely ill very elderly patients should lead to earlier diagnosis, more appropriate management and may improve immediate prognosis. PMID- 3630848 TI - Change in fibre size, not number, in ageing skeletal muscle. AB - Skeletal muscle fibre loss and other changes were evaluated in 25 female rats aged 6-24 months. Soleus (SOL) and extensor digitorum longus (EDL) muscles were removed bilaterally. Left SOL and EDL muscles were digested in nitric acid, then, using a dissecting microscope, total fibre numbers for each muscle were obtained. Right muscles were frozen, sectioned and stained with ATPase and alkaline phosphatase to assess fibre-type distribution and capillary number. No significant change in total fibre number was seen with age in either muscle. Atrophy was common after age 12 months but was not found consistently. No reduction in capillary number was observed, even among atrophic fibres. Results suggest that atrophy and not fibre loss, per se, occurs with ageing and that atrophy is not due to capillary loss. PMID- 3630849 TI - Elderly immigrants--a disadvantaged group? AB - Asian, Caribbean and British born Nottingham hospital discharge rates of people of pensionable age for a variety of diagnoses and elective surgery were compared. No evidence of under-utilization of services by immigrants was found, but marked excess discharges were observed for tuberculosis, diabetes, asthma, gastrointestinal bleeding and cataract surgery. Increased hospital use for most diagnoses probably reflects true differences in disease risk between immigrants and the indigenous population. PMID- 3630850 TI - Acute appendicitis in the elderly: a 5-year retrospective study. AB - Acute appendicitis in elderly patients has not been studied extensively in the United Kingdom. Studies were performed prior to the regular use of broad spectrum antibiotics and tended to include younger patients. We studied retrospectively all elderly patients (n = 30, mean age = 72 years) who presented in the years 1980-85 and a younger group (n = 30, mean age = 23 years) who had a confirmed pathological diagnosis of appendicitis. We found a significant reduction in accurate pre-operative diagnoses, a longer duration of hospital stay and increased complication and mortality rates in the elderly group. Our study suggests that diagnostic accuracy, mortality and morbidity have not improved in comparison to earlier overseas studies. PMID- 3630851 TI - Image quality of abdominal computed tomography in the elderly. AB - The hard copy images of 96 randomly selected patients ranging in age from 45 to 84 years who underwent routine abdominal computed tomography (CT) have been assessed. There was little variation in image quality with age although the best images were found in the younger men. The worst images were obtained in the younger women. Advanced age is not, by itself, a contra-indication for good quality abdominal CT on a modern unit. PMID- 3630853 TI - Preliminary studies on the inflammatory stimulus induced proteins in mouse resident peritoneal macrophages. AB - Chemotaxis, release of lysosomal enzymes, synthesis of eicosanoids and phagocytosis are some of the important functions mediated by macrophages. Active protein synthesis have been implicated as an essential step in the mediation of these vital physiological functions. The proteins synthesized during the inflammation with microbial agents have not been identified. In the current investigation, we report the synthesis of five proteins of molecular weights 72,000; 70,000; 40,000; 34,000; and 32,000 in mouse peritoneal macrophages after incubation with inflammatory stimuli derived from microorganisms. A possible role for these proteins in phagocytosis was suggested. PMID- 3630854 TI - Quantitative analysis of intestinal ulceration induced by indomethacin, in rats. AB - It has been developed a new simple method for the evaluation of intestinal ulceration induced by indomethacin or other drug in rats. It is well known that the erosion caused by ulcerogenesis leads to the weakening of the strength of the intestinal wall. Simply measuring the tensile strength of intestinal wall, by inflatation, in the experimental animals provides quantitative indices of the severity of ulceration. PMID- 3630852 TI - Reliability and practicability of the fluorometric-fluoroenzymatic histamine determination in pathogenetic studies on peptic ulcer: detection limits and problems with specificity. AB - Histamine, among various "biologic-physiologic" abnormalities, is considered as a pathogenetic factor in chronic duodenal ulcer disease. The 10-30 per cent difference between its concentration in gastric and duodenal mucosa of patients compared to healthy controls, however, has to be demonstrated to be specific for the disease. It has to be shown to be neither a methodological artefact nor a common effect, concomitant factor or consequence. This study, after a series of pathogenetic trials examines systematic errors (biases) in the fluorometric fluoroenzymatic histamine assay under the conditions of field studies including tests on specificity over a time period of 10 years. It concentrates on sensitivity (detection limits) and specificity of a standard technique described herein. A modified Shore procedure for large scale assays in human biopsies was developed including reference luminescence values for all reagents, cleaning material and glassware, reduction of OPD concentration to 0.05%, purification of n-heptan, omission of centrifugation steps in the extraction procedure and use of 2 ml 1 M HClO4 in the homogenization step to prevent losses of histamine due to adherence to the mechanical homogenizer. This assay was sensitive enough to measure histamine without difficulty in any biopsy taken. The detection limit was 3 ng/biopsy, but the smallest quantities of the amine ever obtained were 10.6 and 18.3 ng/biopsy (depending on both histamine content and biopsy weight). A series of problems had to be solved both in achieving and demonstrating specificity. It had to be defined not only for the assay in general, but also for assessing the difference in histamine content between ulcer patients and healthy controls. Exogenous more than endogenous fluorescing material interfering with the determination had to be excluded. A series of pitfalls were detected which had to be overcome in demonstrating the specificity of the assay by physicochemical and enzymatic tests. The specificity of the identification tests was more often impaired than the histamine assay itself. Fluorescing material interfering with the assay occurred in the homogenization, extraction and condensation steps, was found in water, OPD, the organic solvents, the cleaning material and in all kinds of plastic vessels. Plasticizers were shown by physicochemical characteristics including fluorescence spectra to be most likely responsible for this interfering material. Rules were developed to exclude such hazards in specificity in longterm pathobiochemical studies. Enzymatic identification test were applied to exclude endogenous fluorecing substances interfering with the standard technique. Simil PMID- 3630856 TI - Synergism of organic zinc salts and sulfhydryl compounds (thiols) in the protection of mice against acute ethanol toxicity, and protective effects of various metal salts. AB - Organic zinc salts such as zinc aspartate, zinc orotate, zinc histidine and zinc acetate protected mice against the lethality of an acute intraperitoneal challenge with ethanol. A similar activity was also provided by salts of cobalt, zirconium, lithium and magnesium. Organic zinc salts acted synergistically with sulfhydryl compounds in protecting the mice and potentiation between the two categories of agents was seen. The results are in analogy to radioprotective effects by zinc and thiols and imply that organic zinc salts may, alone or in conjunction with thiols, reduce in a wider context tissue injury caused by free radical-mediated mechanisms. PMID- 3630855 TI - Investigations on the mode of action of the fungus toxin orellanine on renal cell cultures. AB - The effects of the fungal nephrotoxin orellanine, of 2,2'-bipyridine and of 4,4' bipyridine on monolayers of LLPCK1-cells were tested. It is shown by the E.C.50 on growing cells that orellanine is the most toxic of the tested bipyridyls. Orellanine causes disruption of confluent monolayers and decreases the activities of membrane bound alkaline phosphatase and of cytosolic lactate dehydrogenase. Also 3H-leucine and 3H-thymidine incorporation are reduced. In contrast to this, ATP- and NADPH-levels remain constant. The cell membrane is not affected. This indicates an intracellular mechanism of action. PMID- 3630858 TI - Effects of ranitidine on the enzyme cholinesterase and the rat anococcygeus muscle. AB - Ranitidine in lower doses, (100 ng and 1 microgram) accelerated the rate of reaction of the enzyme acetylcholinesterase with the substrate acetylthiocholine. However, in higher doses (10 micrograms and 100 micrograms) it inhibited the enzyme activity. In rat anococcygeus muscle preparation, the responses to acetylcholine were significantly inhibited in lower doses whereas in higher doses there was a dose-dependent potentiation of the responses to acetylcholine by ranitidine. The responses to carbachol were however, not affected by ranitidine in the same preparation. Our data suggest cholinomimetic as well as cholinolytic activity of ranitidine. PMID- 3630857 TI - Comparative absorption of zinc picolinate, zinc citrate and zinc gluconate in humans. AB - The comparative absorption of zinc after oral administration of three different complexed forms was studied in 15 healthy human volunteers in a double-blind four period crossover trial. The individuals were randomly divided into four groups. Each group rotated for four week periods through a random sequence of oral supplementation including: zinc picolinate, zinc citrate, and zinc gluconate (equivalent to 50 mg elemental zinc per day) and placebo. Zinc was measured in hair, urine, erythrocyte and serum before and after each period. At the end of four weeks hair, urine and erythrocyte zinc levels rose significantly (p less than 0.005, p less than 0.001, and p less than 0.001) during zinc picolinate administration. There was no significant change in any of these parameters from zinc gluconate, zinc citrate or placebo administration. There was a small, insignificant rise in serum zinc during zinc picolinate, zinc citrate and placebo supplementation. The results of this study suggest that zinc absorption in humans can be improved by complexing zinc with picolinic acid. PMID- 3630860 TI - Short-term clinical trials of anti-rheumatoid drugs--an opinion. PMID- 3630859 TI - Histamine metabolism after adverse reactions due to d-tubocurarine administration. AB - We investigated histamine release in five female patients, submitted for gynaecological surgery, after intravenous administration of the neuromuscular blocking agent d-tubocurarine. In these patients, we measured the plasma levels of histamine and its metabolites, N tau-methylhistamine and N tau methylimidazoleacetic acid, making use of mass fragmentographic methods. The newly developed determination of plasma N tau-methylimidazoleacetic acid had a within-day coefficient of variation of 2.7% (n = 10). Normal values of N tau methylimidazoleacetic acid in plasma ranged from 41.3-75.6 nmol/l (n = 13). All five patients developed anaphylactoid reactions: two patients showed severe systemic reactions, one patient a minor systemic reaction and two had skin reactions only. Plasma histamine and N tau-methylhistamine levels appeared to be the most reliable biochemical parameters for confirming both the occurrence and severity of an anaphylactoid reaction. In comparison with plasma histamine, the determination of plasma N tau-methylhistamine is less hampered by artefacts caused by blood collection and plasma preparation. Together with the fact that the increase in plasma N tau-methylhistamine levels after anaphylactoid reactions lasts much longer than the increase in plasma histamine levels, this leads to the conclusion that the determination of plasma N tau-methylhistamine is a useful retrospective parameter for histamine release in this type of pathological state. The plasma N tau-methylimidazoleacetic acid levels fluctuated considerably, showing only a significant increase after administration of d-tubocurarine in the two patients who had severe anaphylactoid reactions. This parameter is, therefore, less useful in such studies. PMID- 3630861 TI - The rat C-reactive protein--isolation and response to experimental inflammation and tissue damage. AB - A new isolation procedure of rat C-reactive protein (CRP) by affinity chromatography on amino-coupled phosphorylcolamine-Sepharose is described. CRP serum level of rats injured by turpentine injection or two different arthritis models was determined to test the potency of this protein as an marker of inflammation. The influence of repeated administration of carbon tetrachloride as a hepatotoxic agent was investigated in the same way. It was shown that CRP determination is a useful method to observe the course of experimental inflammations and other tissue injuries as well. PMID- 3630863 TI - Games of the "medical revolution". PMID- 3630862 TI - PAF-acether in chronic arthritis. AB - Platelet activating factor (PAF-acether) is a potent pro-inflammatory mediator. The possible involvement of this molecule in the pathogenesis of chronic erosive arthritis has been investigated using an animal model, antigen-induced arthritis in the rabbit, which closely resembles rheumatoid arthritis. The arthritic joint fluids from rabbits with antigen-induced arthritis contained low levels of PAF acether in the acute stages of the disease. However, PAF-acether was not detectable in the chronic stages of the lesion. The biologically inactive precursor/metabolite of PAF-acether, lyso-PAF-acether, was detectable in both control and arthritic joint washes. However, the levels of lyso-PAF-acether in the arthritic joint fluids were significantly elevated above those of control in the acute stages of the disease, but not in the chronic stages. Intra-articular injection of PAF-acether at doses up to 100 times the levels detected in the acute stages of this model did not induce joint swelling or leucocyte accumulation in normal rabbits. This study suggest that PAF-acether may contribute to the acute phase of antigen-induced arthritis but is less likely to be involved in the chronic processes. PMID- 3630864 TI - Non-Hodgkin's lymphoma presenting initially as a sleep-apnea syndrome. PMID- 3630865 TI - Should patients with inoperable localized brochogenic carcinoma receive aggressive radiotherapy? PMID- 3630866 TI - Reading achievement of prelingually deaf students and its relationship to parental method of communication: a review of the literature. PMID- 3630867 TI - More on the effects of early manual communication on the cognitive development of deaf children. PMID- 3630868 TI - Loneliness and the mainstreamed hearing impaired college student. PMID- 3630870 TI - Word recognition versus sentence comprehension on a speechreading task. PMID- 3630869 TI - Code switching in deaf adults. PMID- 3630871 TI - Developing written literacy in deaf children through analyzing sign language. PMID- 3630872 TI - Thoughts on legal advocacy, National Commission, parental rights and Gallaudet University. PMID- 3630873 TI - Considerations on deafness and homosexuality. PMID- 3630874 TI - Diabetes, diet and exercise. PMID- 3630875 TI - Hearing loss in the elderly. AB - Family physicians play an important role in detecting auditory impairment in the aged and in referring these patients for audiologic evaluation. Although most elderly patients with impaired hearing do not benefit from medical or surgical treatment, aural rehabilitation is often successful. Acceptance of a hearing device is critical to rehabilitation. PMID- 3630876 TI - Stress fractures. PMID- 3630877 TI - Seed ticks. AB - Seed ticks, the first-stage larvae of hard ticks, are not always recognized. They are tiny (0.6 mm) and have six legs, rather than the eight legs found on nymphal and adult ticks. Seed ticks may transmit Rocky Mountain spotted fever, tularemia, babesiosis and Lyme disease. Pediculocides are effective in removing the larvae. PMID- 3630878 TI - Cellulitis and related skin infections. AB - The location, appearance and clinical course of a skin infection can be used to make a reasonable assumption about its etiology. By carefully considering such factors as entry site and immunocompetence, the physician can make a rational decision about hospitalization and treatment. When appropriate, traditional antibiotics should be used initially, thereby avoiding the temptation to "overkill" the infection with newer, more expensive agents. PMID- 3630879 TI - Ectopic thyroid tissue. AB - Abnormalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue, which may occur on the midline in any position from the base of the tongue to the mediastinum. Although ectopic thyroid tissue may be asymptomatic, local obstructive, hemorrhagic or other complications may occur. Radionuclide thyroid scan is confirmatory when the diagnosis is suspected. Hypothyroidism is common in lingual thyroid, and thyroid supplementation is generally required. PMID- 3630880 TI - Infantile colic. AB - Defined as three hours of crying per day occurring more than three days in any one week, colic affects 10 to 20 percent of infants during the first three to four months of life. Food allergy, parental attitude, flatulence, maternal medication and parental smoking have been implicated. Dietary modification, pharmacotherapy and increased physical contact with the infant have been useful. Normal growth and development are not affected. PMID- 3630881 TI - Dysfunctional uterine bleeding. AB - The causes and treatment of abnormal uterine bleeding vary with the patient's age and health. The evaluation can be organized according to physiologic age groups: menarche through adolescence; the childbearing period, and the perimenopausal and postmenopausal years. Dysfunctional bleeding is a diagnosis by exclusion and is related to the basic physiology of normal menstruation. Endometrial sampling, hysteroscopy, and dilatation and curettage are useful in evaluating the post teenage patient. PMID- 3630882 TI - Amebic hepatic abscess. AB - Amebic hepatic abscess can mimic other hepatic disorders and is a commonly missed diagnosis. It occurs when Entamoeba histolytica infection of the cecum remains untreated and there is embolic spread to the liver. Symptoms include acute or insidious onset of fever, with or without chills, pain in the right hypochondrium or epigastrium with evidence of hepatomegaly, and intercostal or subcostal tenderness. Diagnosis is established by a combination of radiologic and nuclear scanning procedures, serologic tests and aspiration of the abscess. PMID- 3630883 TI - Accidents in equestrian sports. AB - In a five-year study, 160 accidents occurred among 46,351 six-through 21-year olds engaged in horse activities. Of these, 130 were riding accidents, 20 were horse-related and 10 did not involve horses. Bruises and abrasions were the most frequent injuries, and the area of the body most commonly injured was the head and face. The low accident rate may result from the requirement that riders wear approved protective headgear. PMID- 3630884 TI - Basal cell carcinoma. AB - Basal cell carcinoma is increasing rapidly in the United States. Difficulties in diagnosis are presented not only by the carcinoma's pleomorphic nature but also by its close resemblance to several benign cutaneous neoplasms. Early diagnosis and appropriate treatment require a thorough understanding of the clinical types and the varying clinical behavior of this multifaceted tumor, as well as the advantages and limitations of the therapeutic options. PMID- 3630885 TI - Childhood reactions to illness and hospitalization. AB - Emotional and cognitive developmental stages have a bearing on how children cope with illness and hospitalization. Within this framework, a general treatment strategy for helping children and parents deal with illness can be formulated. Parents and physicians who listen, educate, reassure and promote active mastery in the child help the child cope with serious illness and hospitalization. PMID- 3630886 TI - Use of antidepressants. PMID- 3630887 TI - Cyclosporine: an immunologic breakthrough. PMID- 3630888 TI - Epilepsy and pregnancy. PMID- 3630889 TI - Psychological stress and silent myocardial ischemia. AB - Episodes of transient myocardial ischemia during daily life were investigated in 30 patients on two separate occasions, by ambulatory Holter ST monitoring. The first occasion was at a time of uncertainty in the patients' lives, when the results of coronary angiography and the need for surgery were to be discussed. The second was at a later date, when there had been time to adjust to the decision-making process. There were 515 episodes of myocardial ischemia of which 174 were associated with pain and 341 were asymptomatic. Silent ischemia was significantly more frequent during the first period of monitoring compared to the second (p less than 0.02). Patients who had more silent ischemia on the first occasion also entered more self reports of "emotional upset" (tension, worry, etc.,) in their diaries compared to the second occasion. The level of urinary cortisol was taken as a measure of uncertainty and worry, and was significantly higher on the first occasion (p less than 0.03). Differences in urinary noradrenaline excretion were taken as a measure of subjective stress. Patients who excreted more noradrenaline on the first compared to the second occasion had significantly more silent ischemia (p less than 0.007) and longer total ischemic time (p less than 0.01). We suggest that psychological stress may exacerbate myocardial ischemia which is frequently painless. PMID- 3630890 TI - Effect of discontinuance of type A behavioral counseling on type A behavior and cardiac recurrence rate of post myocardial infarction patients. AB - Three hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.5 years as controls in the RCPP Study, thus receiving no type A behavioral counseling, volunteered to receive such counseling for 1 year. Eleven of the 300 previously type A counseled RCPP participants were lost to follow-up at the end of the additional year. The remaining 289 subjects at risk were found to have maintained their previously reduced intensity of type A behavior. Their previously observed relatively low cardiac recurrence rate during the additional year also did not significantly change. Ten of the 114 previous control RCPP participants were lost to follow-up at the end of the additional year. The remaining 104 subjects who had received a year's type A behavioral counseling showed a significantly reduced intensity of type A behavior and a similar significant decrease in both the cardiac mortality and morbidity rate. These results suggest that the decline in the intensity of type A behavior and also in the cardiac recurrence rate previously observed in post infarction subjects exposed to type A behavioral counseling persists for at least 1 year after cessation of such counseling. PMID- 3630891 TI - Coronary vasoconstrictor response to cold pressor test in variant angina: lack of relation to intracoronary thromboxane concentrations. AB - To test the hypothesis that intracoronary concentrations of thromboxane (Tx)A2 could influence the response to cold pressor test (CPT) in variant angina, great cardiac vein blood flow (by thermodilution) and the concentration of TxB2 (the stable metabolite of TxA2) in the great cardiac vein and aorta were measured under control conditions and during CPT in 14 patients with angina at rest associated with transient ST-segment elevation in the anterior leads. In seven patients pretreated with aspirin (intravenous administration of 3.6 mg/kg lysine salt of acetylsalicylic acid, corresponding to 2 mg/kg aspirin), TxB2 baseline concentrations were lower in both the great cardiac vein (47 +/- 19 vs 176 +/- 88 pg/ml; p less than 0.005) and the aorta (45 +/- 16 vs 109 +/- 56 pg/ml, p less than 0.02) than in seven patients who were not taking cyclooxygenase inhibitors. In the two groups, great cardiac vein flow and anterior region coronary resistance were similar under control conditions. During CPT anterior region coronary resistance increased in patients pretreated with aspirin (from 1.97 +/- 0.99 to 2.22 +/- 1.11 mm Hg/ml/min; p less than 0.02) and in patients without aspirin pretreatment (from 1.94 +/- 0.43 to 2.06 +/- 0.34 mm Hg/ml/min; p less than 0.05), and the difference between the two groups was not statistically significant. Therefore the vasoconstrictor response of coronary vessels to CPT in variant angina is not influenced by the intracoronary TxB2 concentrations and is not modified by aspirin pretreatment. PMID- 3630892 TI - Comparison of intravenous dipyridamole thallium cardiac imaging with exercise radionuclide angiography. AB - Sixty-eight patients underwent dipyridamole thallium imaging and exercise blood pool imaging in order to determine the functional significance of various dipyridamole thallium imaging redistribution patterns. Serial thallium images and blood pool regional wall motion were interpreted by three independent observers. Rest and exercise left ventricular ejection fractions were calculated by two observers and were averaged. Transient thallium defects were associated with normal rest and exercise left ventricular ejection fraction and regional wall motion. Mild persistent thallium defects were associated with normal ejection fraction and regional wall motion at rest, with a deterioration in both with exercise. Severe persistent thallium defects were associated with reduced ejection fraction and regional wall motion at rest, but no further deterioration with exercise. These data support the following postulates: Transient dipyridamole thallium defects are due to mild coronary artery stenoses that cause no detectable functional consequence during levels of exercise achieved in this study. Mild persistent defects are due to more severe stenoses that do cause a functional reduction in wall motion during exercise. Although appearing qualitatively persistent, these defects probably represent very slow thallium redistribution and ischemia rather than scar. Finally, severe persistent defects probably represent myocardial scar. PMID- 3630893 TI - Variation in coronary arterial dimension (distensible abnormality) after disappearing aneurysm in Kawasaki disease. AB - Distensible abnormality of the coronary arteries was evaluated in children with Kawasaki disease. The internal diameter of the left coronary artery (diameter) was measured by cineangiography. Among 38 children with Kawasaki disease, 17 developed aneurysms which later disappeared (disappearance group) and 21 had no aneurysm (no aneurysm group). Eleven children had no history of the disease (control group). The maximal diameter was recognized in systole and the minimal diameter in diastole. The mean distensibility index ([maximal diameter-minimal diameter]/minimal diameter) was 5.7% in the disappearance group, 7.9% in the no aneurysm group, and 11.3% in the control group. There were significant differences among the three groups. We demonstrated that distensibility in the coronary arteries in children with Kawasaki disease decreased and that in the no aneurysm group distensibility ranged between the values in the control group and those in the disappearance group. PMID- 3630894 TI - The antiarrhythmic effects of d-sotalol. AB - The antiarrhythmic properties of d-sotalol were studied in 38 patients undergoing electrophysiologic studies. Programmed electrical stimulation studies were performed in 28 men and in 10 women with a mean age of 67 years and a mean ejection fraction of 37 +/- 3%. All patients had inducible ventricular tachycardia while they were off all antiarrhythmic therapy. D-sotalol was given as a 2 mg/kg infusion over 15 minutes and did not significantly change the PR, QRS, or QTc intervals from baseline values in the group as a whole. In the group protected by d-sotalol, the percent change in the QTc interval as well as the percent change in refractoriness was significantly increased as compared to the group not protected. D-sotalol also significantly decreased heart rate. D-sotalol prevented the induction of ventricular tachycardia in 18 of the 38 patients, while significantly slowing the rate of the ventricular tachycardia in the group that could still have tachycardia provoked. Seventeen patients were tested on procainamide and only four were protected, while d-sotalol prevented the induction of ventricular tachycardia in 7 of these 17. Eleven patients were discharged on oral d-sotalol doses ranging from 100 to 400 mg twice daily. One patient died 1 month post discharge due to an acute myocardial infarction, and one patient had a cardiac arrest while on d-sotalol and survived and was switched to amiodarone therapy. The remaining nine patients are alive and well at 14 +/- 3 months. D-sotalol appears to be an effective antiarrhythmic drugs and appears to be well tolerated. PMID- 3630895 TI - Effects of intravenous sotalol in patients with atrioventricular accessory pathways. AB - Effects of intravenous injection of 0.6 mg/kg sotalol, a beta-blocking agent with additional class III properties, were studied by means of electrophysiologic techniques in 14 patients, seven with the Wolff-Parkinson-White syndrome and seven with concealed atrioventricular (AV) accessory pathways. Sotalol brought about a significant increase in the retrograde effective refractory period of the anomalous pathway, whereas changes in the antegrade effective refractory period were more variable. In five of nine patients with electrically induced reciprocating tachycardia sotalol prevented the initiation of sustained reentry. In most cases the suppression of the circus movement was the result of the development of AV nodal block. Thus our data support the use of sotalol for the treatment of tachycardias incorporating anomalous AV conduction pathways. PMID- 3630896 TI - Enhanced antiarrhythmic efficacy of propafenone when used in combination with procainamide or quinidine. AB - This study evaluated the efficacy and safety of combining propafenone with procainamide or quinidine for treating ventricular arrhythmias in patients in whom procainamide or quinidine therapy alone failed to suppress arrhythmias. In 30 patients, the addition of propafenone resulted in a significant reduction of premature ventricular contraction (PVC) frequency compared to drug-free baseline (406 PVC/hr vs 33, p less than 0.001) and to procainamide or quinidine monotherapy (211 PVC/hr vs 27, p less than 0.01). Propafenone alone was also more effective than either procainamide or quinidine and resulted in significant suppression of PVC compared to the drug-free state (406 PVC/hr vs 38, p less than 0.001). However, higher propafenone doses were necessary during monotherapy as compared to propafenone therapy combined with procainamide or quinidine (730 mg/day vs 480 mg/day, p less than 0.001). Of the 30 patients, 22 required an increase in propafenone dose during monotherapy as compared to combination therapy. Thus, propafenone is an effective antiarrhythmic agent when used in combination with type IA antiarrhythmic drugs. With these combinations, lower doses of propafenone can be utilized effectively than with propafenone alone. PMID- 3630897 TI - Cellular electrophysiologic characteristics of surviving subendocardial fibers in chronically infarcted right ventricular myocardium susceptible to inducible sustained ventricular tachycardia. AB - Permanent occlusion of the right coronary artery (RCA) is associated with inducible sustained ventricular tachyarrhythmias (VT) during days 3 to 10 post RCA occlusion period in the conscious dog; VT could no longer be induced beyond this post occlusion period. The aims of the present study were to determine if subendocardial (SE) fibers in the infarcted right ventricle (RVI) during both inducible and noninducible phases of VT remain viable, and if so, to characterize their transmembrane potential properties with the microelectrode and to assess their morphologic features. The RCA was occluded in 13 closed-chest anesthetized dogs with intracoronary balloon inflation. In one group (N = 7), the infarcted tissues were isolated during the VT inducible phase and in another group (N = 6) these tissues were isolated during the VT noninducible phase. Resting membrane potential, action potential amplitude, maximum upstroke velocity, and action potential duration of the surviving SE Purkinje fibers (PF) and ventricular muscle (VM) in the IZ (first layer) were not significantly different in the two groups. Conduction velocity for both basic and premature stimuli from the base to the apex were similar in the two groups. Rapid stimulation at cycle lengths of 300 to 200 msec failed to induce triggering of automatic activity in the two groups. Electron microscopy of SEPF in the IZ showed a drastic reduction in cytosolic lipid droplet accumulation when compared to 24-hour-old infarct. We conclude that: (1) SEPF and VM network in the infarct zone remain electrically viable during the chronic phase of RVI; (2) transmembrane potential properties of this fiber network remain constant and independent of temporal changes of VT inductibility; and (3) ultrastructural improvement of this fiber network suggests an evolution toward normalcy. PMID- 3630898 TI - Evaluation of normal prosthetic valve function by Doppler echocardiography. AB - Previous investigations have suggested that Doppler echocardiography is useful in detecting dysfunction in aortic (AVR) and mitral prostheses (MVR). However, to diagnose abnormalities, the spectrum of normal velocities through these valves must be established. Therefore, we used Doppler echocardiography to study 100 patients with 105 prosthetic valves that had no clinical evidence of valve dysfunction 9 +/- 8 days postoperatively. There were 66 Carpentier-Edwards (C-E), 23 St. Jude (S-J), and 16 Ionescu-Shiley (I-S) valves. In 70 AVR, the peak instantaneous gradient was 26.4 +/- 8.2 Hg, mean systolic gradient was 15.6 +/- 5 mm Hg, and gradients varied inversely with valve size, although differences were significant only when comparing the smallest vs the largest valve sizes (p less than or equal to 0.03). Peak instantaneous gradients greater than 36 mm Hg occurred only in AVR size 23 or smaller. There were no significant differences in gradients among C-E, S-J, and I-S AVR. In 35 MVR, mean gradient was 6.9 +/- 2.3 mm Hg and valve area was 2.7 +/- 0.8 cm2; neither varied significantly with valve size. However, S-J MVR group had smaller mean gradients and larger effective valve area than C-E bioprosthetic MVR (p = 0.01 and p = 0.05, respectively). Regurgitation was more common in AVR (26%) than in MVR (9%), p = 0.04, although all instances were mild and clinically silent. We conclude that normal AVR and MVR of a given size and type have a predictable range of Doppler echocardiographic parameters. Doppler evidence of mild regurgitation is a frequent finding in normal AVR and MVR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630899 TI - Age-related digoxin effects in an intact canine model. AB - The inotropic and electrophysiologic effects of digoxin were studied in anesthetized neonatal and adult dogs to test the hypothesis that digoxin had comparable effects in these groups. Recordings of the ECG and central arterial pressure were made starting at 5.75 hours after an intravenous injection of 50 micrograms/kg of the drug. Parameters measured were heart rate (HR); PR interval; mean, systolic, and diastolic blood pressure; preejection period (PEP); and ejection time (ET). Two indices of systolic function were calculated, the systolic time interval (STI = PEP/ET) and total electromechanical systole (TMS = PEP + ET), which was indexed for HR. There was no significant difference from control animals in either the adult or neonatal groups in the PR interval or blood pressure. In the neonatal dogs, HR and STI were also not significantly different from control. However, in the neonatal dogs, there was a significant decrease in the indexed TMS, 288 +/- 7 vs 270 +/- 11 msec (p less than 0.01). In the adult animals, HR decreased from 116 +/- 35 to 66 +/- 25 bpm (p less than 0.01), STI decreased from 0.559 +/- 0.059 to 0.447 +/- 0.069 (p less than 0.01), and indexed TMS decreased from 333 +/- 10 to 291 +/- 13 msec (p less than 0.001). Two-way analysis of variance demonstrated that digoxin differed significantly in its effects on HR (p = 0.005), STI (p = 0.018), and TMS indexed for HR (p = 0.003) in neonatal compared to adult dogs. Pharmacokinetic studies showed a rapid distribution phase and equilibrium conditions at the time of physiologic measurements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630900 TI - Outpatient dobutamine and dopamine infusions in the management of chronic heart failure: clinical experience in 21 patients. AB - Dobutamine (and dopamine) are potent positive inotropic drugs which are frequently given to treat decompensated congestive heart failure. This study reports on the use of ambulatory dobutamine (and dopamine) infusions in 21 outpatients with advanced congestive heart failure. Each patient was initially hospitalized, and hemodynamic and clinical efficacy to dobutamine (and dopamine) was assessed. These 21 patients were carefully selected from a larger population of approximately 40 patients referred for this therapy. Chronic venous access was established and a drug infusion pump was supplied. Patients and family members were trained in the use of these devices. Eleven patients were treated with intermittent dobutamine infusions for 48 consecutive hours weekly, six patients with continuous (i.e., 24 hours daily) dobutamine infusions, and four patients with continuous, daily dobutamine and dopamine infusions. Significant (p less than 0.001) increases in cardiac index (1.8 +/- 0.6 to 2.7 +/- 0.7 L/min/m2) occurred during the initial dobutamine titrations. Functional classification (3.8 +/- 0.4 to 2.8 +/- 0.7) also improved significantly (p less than 0.01) during the 1.8 to 24 (mean 7.8) months of outpatient infusion therapy with dobutamine (and dopamine). Complications during outpatient therapy included drug tolerance (two instances), infection (two with bacteremias, eight with exit site infections), drug extravasation (three instances), and pump malfunction (two instances). Twenty patients have died: eleven from heart failure, four suddenly (one of them 9 months after dobutamine was stopped), and five from noncardiac causes. Our data suggest that outpatient dobutamine (and dopamine) infusions may be an effective form of therapy for selected patients with severe congestive failure who are refractory to more conventional treatment or who are awaiting cardiac transplantation. PMID- 3630901 TI - Twenty-five-year experience with ventricular septal defect in infants and children. AB - Three hundred eighty-one children with isolated VSD were catheterized from 1960 through 1985, 228 of whom were first catheterized in the first year of life. Defect size was defined by the right-to-left ventricular systolic pressure ratio. Patients with small VSD had a good outcome, with no pulmonary vascular disease. Seventy-five percent of patients with moderate VSDs did not require surgery, and 58% had normal pulmonary artery pressures documented on a second catheterization. Of those patients with large VSDs who underwent serial catheterizations in the first year of life before surgery, 62% had partial closure, and pulmonary vascular resistance rose in 21%. None developed pulmonary vascular disease after surgery. Fewer large-restrictive than nonrestrictive VSDs required surgery in infancy (12% vs 51%; p less than 0.005), and more closed enough to never require surgery (62% vs 27%; p less than 0.005, chi square). Surgery is rarely necessary for patients with small and moderate-sized VSDs in the first year and is usually never necessary because of the expected decrease in size. Few patients with large restrictive VSDs have an increase in pulmonary vascular resistance, many defects decrease in size, and most patients never need surgery. Patients who have a nonrestrictive VSD have an excellent prognosis with appropriate management. PMID- 3630902 TI - Silent myocardial ischemia. I. Pathophysiology, frequency of occurrence, and approaches toward detection. PMID- 3630903 TI - Mitral valve prolapse with mobile polypoid cul-de-sac thrombus and embolism to brain and lower extremity. PMID- 3630904 TI - Atrial septal hematoma: two-dimensional echocardiographic findings after blunt chest trauma. PMID- 3630905 TI - Transient severe mitral and tricuspid regurgitation following blunt chest trauma. PMID- 3630906 TI - Late-onset unprecedented complete atrioventricular block after tetralogy of Fallot repair: electrophysiologic findings. PMID- 3630907 TI - Ventricular tachycardia revealing a hydatid cyst. PMID- 3630908 TI - Transient appearance of the ECG pattern of acute transmural anterior myocardial infarction during exercise stress testing. PMID- 3630909 TI - Late failure of bioprosthesis excision for treatment of recurrence of Pseudomonas aeruginosa tricuspid valve endocarditis previously treated by valve replacement. PMID- 3630910 TI - Impact of lung scanning on the management of suspected pulmonary embolism. PMID- 3630911 TI - Women pharmacists in the pharmaceutical industry. Their preparation, satisfaction, and outlook. PMID- 3630913 TI - We've come a long way... or have we? PMID- 3630912 TI - Reducing inventory cost through better inventory management. PMID- 3630914 TI - The challenge of dealing with alcohol and drugs. PMID- 3630915 TI - When your patient asks you about osteoporosis. PMID- 3630916 TI - Survey of ethylene glycol ether exposures in Belgian industries and workshops. AB - From 1983 onward, 2654 air samples from 336 different plants from the northern part of Belgium were analyzed for the presence of ethylene glycol ethers. One or more ethylene glycol ethers were detected in 262 air samples (9.9%) covering 78 plants or small establishments (23.2%) from a wide variety of industries. Ethylene glycol ethers were mainly present in establishments or operations where printing pastes, inks, paints and varnishes were used. About one third of the air samples covered various other industries. Car repair shops took a major part of this group. It was not always clear, however, in what precise operation the glycol ethers were involved. The ethylene glycol ethers most frequently identified were ethylene glycol monoethyl ether (EGEE) and its acetate (EGEE-Ac). Furthermore, ethylene glycol monomethyl ether (EGME), its acetate (EGME-Ac), and ethylene glycol monobutyl ether (EGBE) also were present in a large number of air samples. The glycol ethers were not distributed equally among the various groups of operations. Most exposure levels were far below the respective Threshold Limit Value (TLVs) (approximately less than 0.5 x TLV). About 25% of ethylene glycol concentrations, however, were higher than the current TLV. Most of the excursions were slight to moderate, although in selected cases extremely high concentrations were recorded. The majority of air samples revealed complex mixtures of ethylene glycol ethers with other solvents, the glycol ethers often being minor components. The possible implication of these other solvents on glycol ether toxicity and metabolism is discussed. PMID- 3630917 TI - Concurrent video filming and measuring for visualization of exposure. AB - A method has been developed for simultaneous video filming and exposure measurement with a presentation of the current exposure level mixed into the picture. With the aid of special equipment, the video camera and the instruments are coupled together in such a way that the outgoing video signal will give a picture carrying superimposed information as to the current level of the exposure. It is intended to serve as an aid in the evaluation of various measures for reducing the exposure and in connection with the training of personnel performing work involving exposure. The method has been tried out for air pollutants in seven different cases where exposure to organic solvents, carbon monoxide, wood dust and fume from welding occurred. The result, in the form of a film, showed with great clarity what working operations were critical with regard to the current exposure. In one plant where the method was used in connection with spray-painting, a study was undertaken in order to see how the exposure could be reduced by simple measures. The results showed that the exposure was reduced drastically. The method is usable for air pollutants and also for other measurable environmental factors. The method is ready for use, but there are many ways in which the system could be improved. Further evaluation is also necessary. PMID- 3630918 TI - Comparison of United States (NIOSH Lifting Guidelines) and European (ECSC Force Limits) recommendations for manual work limits. AB - In the early 1980's two different guidelines for manual lifting were established: the NIOSH Work Practices Guide for Manual Lifting and the European Coal and Steel Community's Force Limits in Manual Work. A comparison of the two guidelines indicates some discrepancies in their predictive capabilities and a significant nonlinear relationship between the two limits. These discrepancies may be explained by differences in respective predictive equations, assumptions and underlying concepts. PMID- 3630919 TI - LISA: a new aerosol generation system for sampler evaluation. AB - A Large Inorganic Sampler Assembly (LISA) system has been built for the evaluation of particulate sampling devices, including the device used in the NIOSH method for respirable silica (Method 7500). Significant features of LISA are the following: 1) The accommodation of up to 30 filter cassettes or 12 cyclone samplers; 2) high precision of particulate deposition (Sr = 2.2%); 3) micro-computerized reduction of optical particle counter data; and 4) special design features to facilitate ease of operation. The system has been used to evaluate sampler systems for a number of different airborne dusts. PMID- 3630920 TI - Evaluation and application of a plasma ashing method for STEM fiber analysis in human lung tissue. AB - A preparation technique for fiber analysis in human lung tissue has been developed that involves freeze-drying and low-temperature ashing. Analysis is made in the analytical scanning transmission electron microscope at a magnification of 10,000 x. With the use of a special counting method, the sensitivity is approximately 80,000 fibers per gram dry tissue with lengths less than 5 microns and 40,000 fibers per gram dry tissue with lengths greater than or equal to 5 microns. In spite of the leaching and contamination effects described in the literature--even for chrysotile fibrils taken from the lung, elemental spectra do not differ essentially from the asbestos standard. In order to carry out a complete check of the preparation method, a suspension of standard crocidolite fibers in water was gelatinated. No changes in length, diameter or aspect ratio distribution occurred. After preparation, at least 40% of the fibers were recovered. Compared to the wide range of fiber concentrations observed in human lung tissue, these recovery rates appear adequate for fiber analysis in lung dust for medical or legal purposes. To date, 70 lung dust specimens have been analyzed. These are discussed in the paper. PMID- 3630921 TI - A study of the relationship between airborne contaminants and environmental factors in Dutch swine confinement buildings. AB - A total of 171 swine confinement buildings were studied to determine the concentrations of airborne total and D50 less than or equal to micron 8.5 dust fractions, total and gram-negative bacteria, bacterial endotoxin and NH3. The concentrations of these airborne contaminants then were correlated statistically to a number of environmental factors such as feeding practices, number of animals and ventilation parameters. The results showed that airborne dust, endotoxin, bacteria and NH3 are commonly in high concentrations within the swine confinement buildings and that these are at levels where health effects have been observed in other studies. Correlation of these airborne contaminants to a number of environmental factors showed that while ventilation is an important criteria for airborne contaminants, there are a number of farming practices that significantly contribute to the levels of airborne contaminants currently found. Pearson correlations indicate a number of important criteria that the industrial hygienist should measure when faced with problems in agricultural confinement buildings. PMID- 3630922 TI - Classification of supraventricular tachycardias. AB - An ideal approach to classification of supraventricular arrhythmias would be based on exact knowledge of the pathophysiology and mechanism of the arrhythmia. Unfortunately, the mechanism may not be apparent from electrocardiographic data or indeed may not be known after extensive invasive and non-invasive studies. Difficulties are encountered in applying and extrapolating to patients criteria that are known to exist in experimental preparations. The traditional methods of classification have used electrocardiographic features and atrial rate. Although such classifications are simple, the criteria are arbitrary and electrocardiographically similar arrhythmias may have different mechanisms. A realistic classification must incorporate both electrocardiographic description and mechanism. The classification should be such that it can readily incorporate new knowledge in an additive way without completely restructuring the classification. A classification fulfilling these requirements would begin with electrocardiographic descriptors and end with mechanism, known or unknown. For example, a tachycardia may be characterized as supraventricular, atrial rate 300, 1:1 atrioventricular relation, with atrioventricular nodal reentry mechanism. It could then be qualified by further clinical descriptors such as incessant, paroxysmal or repetitive. With this approach, the initial descriptive category will always be constant and the mechanism known or unknown. As more data are obtained in future years, the "mechanism" segment of the descriptor may be added or revised. PMID- 3630923 TI - Efficacy and safety of intravenous nadolol for supraventricular tachycardia. AB - In a double-blind, placebo-controlled, parallel trial of intravenous nadolol in the treatment of sustained supraventricular tachycardia (SVT), 29 patients (20 men, 9 women) were studied. Mean age was 55 years and all patients were required to have well-documented SVT with a ventricular rate greater than or equal to 120/min that was sustained for at least 30 minutes. Patients received sequential doses of 0.01, 0.02 and 0.04 mg/kg of nadolol or placebo at 10 minute intervals. The maximum total dosage of nadolol was 10 mg. Measurements taken during 10 minute monitoring periods after each administration included heart rate, ventricular rate and systolic and diastolic blood pressures. A positive response was defined as a greater than or equal to 20% decrease in heart rate, heart rate less than or equal to 100 beats/min or conversion to normal sinus rhythm. Eleven (79%) of patients given nadolol and 3 (20%) of placebo-treated patients demonstrated a positive response. Of the 11 responders to nadolol, 9 patients responded after the first dose, one after the second dose and one after the third dose. Significant (p less than 0.001) mean reductions in heart rate and ventricular rate were observed with nadolol, but not with placebo. Five (36%) of the patients given nadolol and only 2 (14%) of the patients who received placebo were converted to normal sinus rhythm. Adverse effects were limited to 1 episode of asymptomatic hypotension and 1 episode of wheezing with nadolol and 1 episode of asymptomatic hypotension with placebo. Nadolol is effective in controlling ventricular response in patients with sustained SVT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630924 TI - Influence of reperfusion on serum concentrations of cytosolic creatine kinase and structural myosin light chains in acute myocardial infarction. AB - The kinetics of cytosolic and structural marker protein release from myocardium were studied in 44 patients with acute myocardial infarction. After intracoronary infusion of streptokinase, there was early recanalization of the infarct-related artery in 8 patients and late recanalization in 18. In 18 patients the infarct related artery remained occluded. Creatine kinase (CK) level peaked and normalized significantly earlier in patients with early reperfusion than in patients with late reperfusion, and in patients with late reperfusion earlier than in patients with permanent occlusion. Thus, the interval of absolute diagnostic sensitivity of CK depends on early infarct perfusion. In contrast, release of myosin light chains was not significantly changed by recanalization of the infarct-related artery compared with that in nonreperfused myocardial infarction. Thus, in patients with acute myocardial infarction, myosin light chains may be superior to CK as a diagnostic means and for estimation of infarct size. PMID- 3630925 TI - Importance of coronary collateral circulation for kinetics of serum creatine kinase in acute myocardial infarction. AB - The effect of coronary collateral perfusion on the kinetics of creatine kinase (CK) was examined in 32 patients undergoing intracoronary thrombolysis within 6 hours after the onset of a first acute myocardial infarction (AMI). Blood sampling for CK was performed every 2 to 4 hours for a period of 72 hours after AMI. The cumulative CK release was determined using the integrated appearance function curve with the individual disappearance rate. In 19 patients in whom thrombolysis was successful (group A), time to peak CK level was 11 +/- 1 (standard error of the mean) hours after AMI and cumulative CK release was 2,599 +/- 424 U/liter. In 6 patients who had a significant collateral circulation to the infarct-related coronary artery and unsuccessful reperfusion (group B), the time to peak CK was 16 +/- 1 hours (p less than 0.05 compared with group A) and cumulative CK release was 1,897 +/- 478 U/liter (difference not significant compared with group A). In the remaining 7 patients, with neither recanalization nor significant collateral perfusion group C, time to peak CK was 21 +/- 1 hours and significantly (p less than 0.05) longer than groups A and B. Cumulative CK release (2,707 +/- 776 U/liter) was not significantly different from groups A and B. Thus, collateral perfusion is an important determinant of the CK time-activity curve during AMI. Early peaking of CK levels does not reliably identify spontaneous or drug-induced recanalization of the infarct-related coronary artery. PMID- 3630926 TI - Serial acquisition of data to predict one-year mortality rate after acute myocardial infarction. AB - Eight hundred sixty-six patients with acute myocardial infarction (AMI) were enrolled in a prospective study to determine optimal predictors of long-term prognosis. During 12-month (mean) follow-up there were 65 cardiac deaths and 21 nonfatal repeat AMIs. Twenty-nine variables (from the history, physical examination, serum chemistries, ambulatory monitor, radionuclide ventriculogram and exercise test) were arranged into in 5 sequential groups according to the time at which results became available during hospitalization. Multivariate analysis (logistic regression) and receiver-operator characteristic curves were used to assess improvement in prediction of mortality or repeat AMI by addition of each group of variables. The first group of independent predictors included rales, left bundle branch block and symptom status at 1 month before admission. Addition of information from ambulatory monitoring or serum chemistry did not improve prediction. Radionuclide ejection fraction made a statistically significant, independent contribution to mortality prediction. Of the final group the only exercise test variable that contributed independently to prediction was whether the patients took the test. However, receiver-operator characteristic curves showed that improvement in sensitivity and specificity by addition of information from the radionuclide scan and exercise test was clinically insignificant. Our results imply that costly tests after AMI should be reserved for specific indications and not applied universally for prognosis. Although these tests were highly predictive individually, each test generally added little to preexisting prognostic information. PMID- 3630927 TI - Electrocardiographic differentiation of occlusion of the left circumflex versus the right coronary artery as a cause of inferior acute myocardial infarction. AB - To determine whether the admission electrocardiogram can identify left circumflex or right coronary artery occlusion as the cause of an inferior acute myocardial infarction (AMI), findings from electrocardiography and coronary angiography performed within 12 hours of each other were retrospectively assessed in 41 consecutive patients with inferior AMI. All patients had ST-segment elevation in 1 or more inferior leads (II, III or aVF). Of the 12 patients with circumflex coronary artery occlusion, 10 (83%) had ST-segment elevation in 1 or more lateral leads (aVL, V5 or V6) without ST-segment depression in lead I. Similar electrocardiographic findings were noted in only 1 of 29 patients (4%) with right coronary occlusion (p less than 0.001). ST-segment depression in precordial leads V1-V3 was equally prevalent in both groups. Thus, the presence of both ST-segment elevation in 2 or more inferior leads and ST-segment elevation in 1 or more lateral leads with an isoelectric or elevated ST segment in lead I identified circumflex coronary occlusion with a sensitivity of 83%, specificity of 96%, positive predictive accuracy of 91% and negative predictive accuracy of 93%. When these criteria were prospectively applied to an additional cohort of 19 consecutive patients with inferior AMI (5 with left circumflex and 14 with right coronary artery occlusion), presence of left circumflex coronary artery occlusion was predicted with a sensitivity of 80%, specificity of 93%, positive predictive accuracy of 100% and negative predictive accuracy of 93%. Thus, the admission 12 lead electrocardiogram can assist in differentiating left circumflex from right coronary artery occlusion in patients with inferior AMI. PMID- 3630928 TI - Effects of nicardipine on exercise- and pacing-induced myocardial ischemia in angina pectoris. AB - To define the effects of nicardipine, a new dihydropyridine calcium antagonist drug, on exercise- and pacing-induced myocardial ischemia, 15 men with coronary artery disease were studied during cardiac catheterization. Nicardipine was administered intravenously as a 2-mg bolus followed by an infusion titrated to maintain a 10- to 20-mm Hg decrease in systolic arterial pressure. At rest, nicardipine decreased systemic and coronary vascular resistances, left ventricular end-diastolic pressure and increased coronary blood flow, heart rate and myocardial oxygen consumption. During bicycle exercise-induced myocardial ischemia, nicardipine significantly prolonged exercise duration and time to 1 mm of ST-segment depression. These changes were associated with no alteration in the product of systolic pressure and heart rate, decreased left ventricular end diastolic pressure, systemic and coronary vascular resistances and increased coronary blood flow, as well as myocardial oxygen consumption. During atrial pacing, the heart rate threshold for myocardial ischemia was not changed by nicardipine administration, despite improvement in the ratio of coronary blood flow to myocardial oxygen consumption and hemodynamic changes otherwise similar to those during exercise. Nicardipine favorably influenced myocardial metabolic state, as indexed by lactate extraction during pacing-induced ischemia. Nicardipine is a potent coronary and systemic vasodilating drug that improves exercise tolerance and myocardial metabolic response to pacing stress, the mechanism for which appears to be partially mediated through increased coronary blood flow. PMID- 3630929 TI - Usefulness of twice-daily isosorbide-5-mononitrate in preventing development of tolerance in angina pectoris. AB - Development of tolerance to nitrates during long-term therapy is a major concern. It has been suggested that isosorbide-5-mononitrate (IS-5MN), an active metabolite of isosorbide dinitrate, administered twice daily 12 hours apart does not lead to development of tolerance. The duration of effects of IS-5MN at a dose of 20 and 40 mg and of placebo was studied in patients with angina pectoris who responded to nitrates after the first dose (n = 12) and after 1 week of twice daily therapy (n = 9). The study was double-blind, randomized and crossover in design. Compared with placebo values, after the first dose of 20 and 40 mg IS 5MN, exercise duration was higher at 2 hours (p less than 0.001) and 6 hours (p less than 0.02). After 1 week of twice-daily therapy at these doses, exercise duration increased at 2 hours (p less than 0.05) but not at 6 or 10 hours after the dose. After the first dose of 20 and 40 mg IS-5MN, standing systolic blood pressure decreased at 2 hours (p less than 0.02). Blood pressure did not change significantly after chronic therapy. Tolerance to antianginal effects during twice-daily therapy with 20 and 40 mg of IS-5MN developed despite higher plasma IS-5MN concentrations at 2 and 6 hours during twice-daily therapy than after the first dose. The tolerance during twice-daily therapy with IS-5MN was characterized by a reduced peak effect at 2 hours and shortened duration of action compared with first-dose effects. PMID- 3630930 TI - Effect of oral levodopa and carbidopa on coronary spasm in variant angina pectoris. AB - The effect of oral administration of 500 mg of levodopa with 50 mg of carbidopa, a peripheral dopadecarboxylase inhibitor, on coronary vasomotion during vasoconstrictor stimuli was examined in 15 patients with variant angina presenting with hyperventilation-induced myocardial ischemia. Patients were studied during 3 noninvasive sessions and 1 angiographic session. In all sessions the basic protocol consisted of provocation of coronary spasm by hyperventilation before and 2 hours after levodopa and carbidopa administration. During angiography, great cardiac vein blood flow, right atrial and aortic pressures were measured, and coronary angiograms were recorded at baseline and 1 to 4 minutes after each hyperventilation. Samples for dopamine plasma levels were drawn before and throughout the studies. In 3 selected patients, levodopa and carbidopa were associated with 30 mg of domperidone, an antagonist of dopamine peripheral receptors. Levodopa and carbidopa consistently prevented the occurrence of ischemia after hyperventilation in 6 of the 15 patients. This was due to inhibition of local coronary spasm in 2 patients and reduced coronary constriction in 4. Ischemia due to hyperventilation was still prevented despite addition of domperidone with levodopa and carbidopa. Plasma dopamine levels were 23 +/- 15 before and 739 +/- 284 pg/ml 2 hours after administration of levodopa and carbidopa. These findings are consistent with either a decreased central dopaminergic activity and associated disregulation of vasomotor tone, or a peripheral vasodilatory effect of increasing dopamine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630931 TI - Circadian variation in occurrence of transient overt and silent myocardial ischemia in chronic stable angina and comparison with Prinzmetal angina in men. AB - Circadian periodicity was examined in 68 patients with chronic stable angina and in 9 patients with Prinzmetal angina. The frequency and duration of transient ischemic episodes were determined from analysis of 1 or more 24-hour Holter recordings by the compact analog technique. Ninety percent of the episodes in both syndromes were silent; 80% of the episodes of Prinzmetal angina were associated with ST-segment elevation and all episodes of chronic stable angina had ST-segment depression. Ischemic episodes were shorter (3 +/- 2 vs 18 +/- 23 minutes, p less than 0.0005) but more frequent (21 +/- 18 vs 6 +/- 4 per 24 hours, p less than 0.0001) in patients with Prinzmetal angina than in those with chronic stable angina. In patients with chronic stable angina, both silent and painful episodes had a peak occurrence in the morning and early afternoon hours (between 8 AM and 3 PM); the fewest episodes were between 1 AM and 5 AM. This distribution was not random by chi-square test (p less than 0.001). Cosinor analysis of ischemic episodes periodicity showed the acrophase at 1 PM, which was not different from that (3 PM) of the circadian rhythmicity for heart rate. In case of Prinzmetal angina, the acrophase of heart rate changes was at 5 PM, but a clear periodicity in the distribution of the ischemic episodes was not found. These differences in the circadian periodicity may reflect differences in the mechanism of ischemia in chronic stable angina and in Prinzmetal angina and are likely to be of therapeutic significance. PMID- 3630932 TI - Pain threshold and tolerance in women with syndrome X and women with stable angina pectoris. AB - A recent report showed that during Holter monitoring of patients with syndrome X (typical anginal pain, positive exercise test response [at least 0.1 mV of ST segment depression], no evidence of coronary spasm and angiographically normal coronary arteries), 50% of episodes of ischemic ST-segment depression were painful. This proportion is considerably higher than that in patients with chronic stable angina, which is about 30%. A significantly lower threshold and tolerance to painful stimuli was seen in a group of patients with chronic stable angina in whom 50% of episodes were painful compared with a group in whom only 5% of episodes were silent. Hence, patients with syndrome X may have enhanced sensitivity to painful stimuli. To investigate whether this difference was due to a lower threshold for painful stimuli in general, 12 patients with syndrome X and 10 (age- and sex-matched) with chronic stable angina were studied using the same battery of painful stimuli. Patients with syndrome X had a significantly lower threshold and tolerance for forearm ischemia (-36%, p less than 0.05, and -40%, p less than 0.001) and electrical skin stimulation (-37%, p less than 0.01, and 35%, p less than 0.001); the cold pressor test did not show significant differences (-7%, p = 0.391, and -1%, p = 0.818). Thus, patients with syndrome X in this study had significantly lower threshold and tolerance values for forearm ischemia and for electrical skin stimulation. These differences in sensitivity to pain may partly explain a higher incidence of painful ischemic episodes detected by ambulatory electrocardiographic monitoring during unrestricted daily life. PMID- 3630933 TI - Usefulness of a high-dose dipyridamole-echocardiography test for diagnosis of syndrome X. AB - This study assesses whether the high-dose dipyridamole-echocardiography test (DET, 2-D echocardiographic and 12-lead electrocardiographic monitoring during dipyridamole infusion, up to 0.84 mg/kg over 10 minutes) can help to identify patients with syndrome X. DET was performed in 10 control subjects (group A) and in 19 patients with syndrome X (group B). Patients in group B had chest pain on effort, a positive exercise stress response (more than 0.1 mV of ST-segment depression), negative ergonovine test response and normal left ventricular function and coronary angiographic findings. During DET no subject in group A showed transient asynergy or ST-segment depression and none had chest pain; in group B, no patient had transient asynergy, 13 (68%) had chest pain and 16 (84%) had more than 0.1 mV of ST-segment depression. Percent fractional shortening was not significantly different in the 2 study groups, either basally (group A, 35 +/ 7; group B, 37 +/- 8) or at peak hyperkinesia during DET (group A, 48 +/- 8; group B, 54 +/- 10). Thus, dipyridamole-induced chest pain and ST-segment depression in patients with syndrome X are not associated with impaired regional or global left ventricular function. This entity of echocardiographically silent myocardial ischemia during DET may be a clue to noninvasive detection of syndrome X. PMID- 3630934 TI - Effects of titrated beta blockade (metoprolol) on silent myocardial ischemia in ambulatory patients with coronary artery disease. AB - This study investigates effects of beta-adrenergic blockade on total silent ischemic time assessed by ambulatory electrocardiographic monitoring and its relation to heart rate and time of day in ambulatory men with coronary artery disease. Metoprolol, when titrated to optimal dose in a controlled trial in 9 patients, reduced both total silent ischemic time (from 156 +/- 65 to 20 +/- 15 minutes, p = 0.04) and frequency of silent ischemic episodes (from 8 +/- 2 to 2 +/- 2 episodes, p = 0.03) compared with placebo. Mean daily heart rate was reduced, from 82 +/- 2 beats/min during placebo to 58 +/- 1 beats/min, as was heart rate at onset of 1 mm of ST-segment depression (106 +/- 2 to 74 +/- 4 beats/min, both p less than 0.001). Heart rate increased 10 +/- 1 beats/min during silent ischemia with placebo therapy, but increased only 4 +/- 1 beats/min during metoprolol treatment (p less than 0.03). During placebo administration the largest proportion of silent ischemic time occurred between 0600 and 1200 hours. Metoprolol attenuated this circadian variation in silent ischemia while reducing (p less than 0.05) total silent ischemic time in all periods. Thus, beta adrenergic blockade reduces the frequency of silent myocardial ischemic episodes and total silent ischemic time, while mean daily heart rate and heart rate at onset of ischemia and maximal ischemia decrease. Metoprolol treatment also attenuates circadian variation of silent ischemia. These data may be interpreted to suggest that beta-adrenergic activation operates in the pathogenesis of silent myocardial ischemia and its circadian variation. PMID- 3630935 TI - Validation of a real-time electrocardiographic monitor for detection of myocardial ischemia secondary to coronary artery disease. AB - A new real-time electrocardiographic (ECG) monitor (QMED Monitor OneTM) was evaluated to assess its accuracy in detecting ischemic ST-segment changes in 43 patients (34 men, 9 women, mean age 56 +/- 11 years) during exercise stress testing. The output of QMED was compared with ST-segment measurements from a Marquette CASE-II computer (ECGM) using a bipolar lead CM5, defining a positive ECG as at least 1 mm of planar or downsloping ST depression. Results were concordant in 33 patients, 15 with both positive and 18 both negative responses, yielding an accuracy (expressed as sensitivity, specificity, positive and negative predictive accuracy) of 83%, 72%, 68% and 86%, respectively. Seven false positive QMED episodes occurred: 4 due to excess baseline wander or noise in the control ECG, which may have been prevented by reapplication of electrodes, and all 7 episodes were correctly discounted by inspection of the sample ischemic ECG output, yielding an accuracy of 81%, 100%, 100% and 85%. Mean duration and maximal magnitude of ST depression in patients with a positive ECG response was 7.9 +/- 7 minutes and 1.7 +/- 0.6 mm for QMED and 8.9 +/- 7 minutes and 2.2 +/- 0.7 mm for ECGM. The 3 false-negative QMED events were relatively brief and mild ischemic episodes and slight differences in electrode placement between the 2 systems may account for this discrepancy in 2 of the patients. Real-time ST monitoring with QMED is sufficiently reliable for clinical use. Optimal specificity depends on the ability to inspect sample ECG traces to verify a stable baseline and confirm episodes of ischemic ST-segment shift. PMID- 3630936 TI - Effect of eating on thallium-201 myocardial redistribution after myocardial ischemia. AB - To determine whether eating a high-carbohydrate meal between initial and delayed postexercise thallium-201 (Tl-201) imaging affects detection of Tl-201 redistribution during exercise stress testing, 16 patients with stable angina performed 2 Tl-201 treadmill exercise stress tests within a 14-day interval. Immediately after initial postexercise imaging, patients either drank a commercially available instant breakfast preparation for the intervention test or drank an equivalent volume of water for the control test. Comparable exercise workloads were achieved by exercising patients to the same heart rate for both tests. The order of the 2 (intervention and control) tests were randomized. All patients had at least 1 region of Tl-201 myocardial redistribution on either their eating or control test scans, although only 7 of the 16 had positive treadmill exercise test responses. Forty-six regions showing Tl-201 myocardial redistribution were identified in all 144 regions examined. Significantly more of these regions were identified on control test scans than on eating test scans: 11 of 46 on both test scans, 6 of 46 only on eating test scans and 29 of 46 only on control scans (p less than 0.001). Consistent with results of the quantitative regional analysis, the percentage of Tl-201 clearance over 4 hours in the 46 Tl 201 myocardial redistribution regions was 39 +/- 8% for the eating tests and 29 +/- 8% for control tests (mean +/- standard deviation, p less than 0.003). In 4 patients diagnosis of transient ischemia would have been missed because their 14 Tl-201 myocardial redistribution regions were detected only on the control test scans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630937 TI - Contrast perfusion echocardiography: distribution and reproducibility of myocardial contrast enhancement in coronary artery disease. AB - A qualitative assessment was undertaken of the echocardiographic distribution of myocardial contrast enhancement after selective intracoronary injections of 2 ml of hand-agitated Urografin solution. The reproducibility and duration of contrast enhancement has also been examined. Forty-five contrast injections were given, 36 into the left and 6 into the right coronary arteries and 3 into bypass grafts of 28 patients undergoing diagnostic arteriography. Myocardial contrast enhancement occurred in 91% of cases. Although contrast enhancement appeared within the expected area of distribution of the artery infused, in no case was enhancement homogeneous. In 4 patients (1 of whom had undergone coronary bypass surgery), contrast enhancement also appeared in areas remote from the expected perfusion territory, in each case due to well established collateral supply seen angiographically. The contrast effect persisted for 71 +/- 26 seconds. Repeat injection in 5 patients (using identical echocardiographic windows) confirmed the reproducibility of the technique. No patient had symptoms related to the injections, although transient left ventricular wall motion abnormalities were observed in 3 cases. High-grade coronary stenoses did not affect distribution of myocardial contrast enhancement, although coronary occlusions produced well defined deficits. Thus, selective intracoronary injections of hand-agitated echocardiographic contrast medium produce regional myocardial enhancement, which probably reflects the perfusion territory of the artery. The technique is safe and reproducible in human subjects. Nevertheless, because regional enhancement after selective coronary injections is not homogeneous, analysis of enhancement deficits is unlikely to provide a clinically useful means of evaluating the functional significance of coronary stenoses. PMID- 3630938 TI - Importance of left atrial timing in the programming of dual-chamber pacemakers. AB - To determine the hemodynamic effect of different programmed atrioventricular (AV) delays and the importance of the actual timing of left atrial (LA) depolarization, 16 patients with dual-chamber pacemakers were studied and all were found to have an optimal programmed AV delay for cardiac function. However, randomly chosen AV delays of 150, 200 or 250 ms actually provided worse stroke volume than VVI pacing in 7 patients. The optimal programmed AV delay was variable between patients and was related to the interatrial conduction delay, measured as the time from right atrial pacing artifact to LA depolarization (mean 144 +/- 82 ms, range 70 to 380.) Patients with short interatrial delays (less than or equal to 90 ms) were served better by shorter programmed AV delays (150 ms), and patients with longer interatrial delays (greater than or equal to 120 ms) were served better by longer programmed AV delays (greater than or equal to 200 ms) (p less than 0.05). Furthermore, as pacing mode changed from dual-chamber sequential pacing (DVI) to atrial synchronous ventricular pacing (VDD), the LA to ventricular sequence increased from 6 +/- 81 ms to 137 +/- 50 ms (p less than 0.001). This change in the LA to ventricular sequence with mode change produced a significant decrease in stroke volume (p less than 0.05). Thus, the optimal programmed AV delay in patients with dual-chamber pacemakers is predicted by the relation of LA and ventricular activation. Because interatrial conduction delays vary widely, optimal programming requires knowledge of the LA to ventricular sequence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630939 TI - Amiodarone for maintenance of sinus rhythm after conversion of atrial fibrillation in the setting of a dilated left atrium. AB - Previous reports suggest that the finding of left atrial (LA) dilatation (greater than 45 mm) by echocardiography identifies patients not likely to maintain sinus rhythm after conversion of atrial fibrillation (AF). However, these studies antedate the availability of amiodarone, an antiarrhythmic agent that reportedly is effective in patients with AF in whom other drug therapy has failed. To analyze the relation between LA size and the ability to maintain sinus rhythm with amiodarone therapy, 28 patients, aged 32 to 87 years (mean 61), with an LA dimension greater than 45 mm (range 46 to 78, mean 57) were studied. Thirteen patients (46%) had valvular heart disease, 10 (36%) dilated cardiomyopathy and 5 (18%) miscellaneous disorders. In 25 patients (89%) quinidine therapy had failed. After therapy with amiodarone, sinus rhythm returned in all patients and was maintained. Therapy was judged completely successful in 10 patients (alive and still in sinus rhythm with at least 1 year of follow-up), partially successful in 11 (maintaining sinus rhythm for at least 6 months before a change in status) and failed in 7. Completely successful therapy was accomplished in 9 of 18 patients with an LA dimension between 46 and 60 mm, but in only 1 of 10 patients with an LA dimension greater than 60 mm (p less than 0.05). Thus, patients with LA dimensions between 46 and 60 mm who are significantly compromised by AF can often be maintained in sinus rhythm with amiodarone therapy. However, in patients with larger LA dimensions. AF is likely to return despite aggressive antiarrhythmic therapy with amiodarone, a drug with potentially serious side effects. PMID- 3630940 TI - Relation between clinical presentation and induced arrhythmias in the Wolff Parkinson-White syndrome. AB - Electrophysiologic testing is warranted in patients with the Wolff-Parkinson White (WPW) syndrome presenting with rapid atrial fibrillation (AF) or ventricular fibrillation. Indications are less clear in patients presenting only with atrioventricular reentrant tachycardia (ART). A knowledge of propensity of this latter group to show a rapid ventricular response in the event of AF and the ability of electrophysiologic testing to reproduce the type and rate of clinical arrhythmias are relevant to this decision. The records of 126 symptomatic patients with manifest WPW syndrome were reviewed and separated into 4 groups according to presentation: group 1--AF; group 2--ART; group 3--palpitations suggesting ART; and group 4--AF and ART. All patients except those in group 3 had electrocardiographically documented clinical arrhythmias, and these arrhythmias were compared with those induced during electrophysiologic testing. The shortest RR interval during induced AF and the cycle length of induced ART correlated well with those occurring clinically (r = 0.72, p less than 0.00001), as did the cycle length of induced ART (r = 0.79, p less than 0.00001). Patients presenting with AF (65%) had a higher incidence of atrial vulnerability (48%) and sustained AF at electrophysiologic testing than those presenting with ART (16% and 5%) or undocumented palpitations (27% and 21%). Forty-one percent of patients with ART and 51% with undocumented palpitations had potentially lethal rates (shortest RR interval less than 250 ms) during induced AF. The ability to reproduce clinical arrhythmias and the frequency of rapid rates during AF induced in patients presenting with only ART or undocumented palpitations supports the recommendation for electrophysiologic testing in symptomatic patients with WPW. PMID- 3630941 TI - Changes in ventricular activation time on the signal-averaged electrocardiogram in the first year after acute myocardial infarction. AB - Repeat signal-averaged electrocardiograms were used in 40 patients to document changes in ventricular activation time and delayed potentials in the first 12 months after acute myocardial infarction. Beta-blocking and antiarrhythmic drug use was stopped for 1 week before each recording. Patients with reinfarction during follow-up were excluded. Signal-averaged electrocardiograms were first performed 1 to 4 weeks after infarction. They were repeated at 6 and 12 months in 31 patients in whom spontaneous ventricular tachycardia (VT) did not develop and were repeated after VT in the other 9 patients. Of the 9 patients in whom VT developed, all had delayed potentials at initial study and 8 (89%) still had delayed potentials at restudy after VT. In the VT patients, mean ventricular activation time was similar before and after VT (178 ms and 174 ms, respectively). In the 11 patients who had delayed potentials initially and in whom VT did not develop, the proportion with delayed potentials was 55% (6 of 11) at 6 months and did not change (55%) at 12 months. Mean ventricular activation time in these patients was 164 ms at initial study, decreasing to 147 ms at 6 months (p less than 0.05) and 148 ms at 12 months. In 20 patients with no delayed potentials initially, none had delayed potentials at 6 months and only 2 (10%) had delayed potentials detectable at 12 months. Mean ventricular activation time in these patients increased slightly, from 120 ms at initial study to 128 ms at 12 months (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630942 TI - Role of extrastimulus prematurity and intraventricular conduction time in inducing ventricular tachycardia or ventricular fibrillation secondary to coronary artery disease. AB - The influence of extrastimulus prematurity and changes in intraventricular conduction time on ventricular tachycardia (VT) inducibility were evaluated in 78 patients with coronary artery disease undergoing electrophysiologic study. In a retrospective portion, the effect of adding ventricular extrastimuli vs shortening the ventricular drive cycle length on extrastimulus prematurity and VT inducibility was evaluated in 59 consecutive patients with inducible ventricular arrhythmias (group I). In a prospective component, changes in intraventricular conduction of the last ventricular extrastimulus and the relation to initiation of VT were evaluated in 19 consecutive patients undergoing programmed electrical stimulation (group II). Single (V2), double (V3) and triple (V4) ventricular extrastimuli were introduced during ventricular drive pacing (V1) at multiple cycle lengths. Although reduction of drive cycle length facilitated arrhythmia induction in 25% of patients, addition of an extrastimulus was a more potent method in group I patients. However, the mechanism of arrhythmia induction is not dependent on attainment of shorter coupling intervals with either method. In group II patients QRS duration and intraventricular conduction time of the extrastimuli increased as the coupling interval was reduced. Significant changes in QRS duration and intraventricular conduction time of the extrastimuli that initiated VT were not observed. PMID- 3630943 TI - The resetting response of ventricular tachycardia to single and double extrastimuli: implications for an excitable gap. AB - To evaluate the influence of local tissue refractoriness and delay in intervening tissue on the ability of single ventricular extrastimuli to reset and characterize a resetting response pattern in ventricular tachycardia (VT), single ventricular extrastimuli were delivered during 81 VTs and double ventricular extrastimuli in 45 of the 81 VTs. Resetting of VT was recognized as a less than fully compensatory pause after stimulation and was seen in 43 of 81 VTs (53%) with single ventricular extrastimuli and 35 of 45 (78%) with double ventricular extrastimuli. Double ventricular extrastimuli reset 16 VTs not reset by single ventricular extrastimuli. The return cycle, the interval from the extrastimulus to the first VT beat after extrastimuli, has 1 of 3 distinct response patterns: flat, increasing, and flat plus increasing. In 19 VTs, resetting was seen with both single ventricular extrastimuli and double ventricular extrastimuli; 4 flat responses with single ventricular extrastimuli became flat plus increasing with double ventricular extrastimuli. All other patterns were unchanged. In the 19 VTs reset by both single and double ventricular extrastimuli, the estimate of both the total reset zone (94 +/- 36 vs 56 +/- 32 ms) and the flat portion of the reset zone (52 +/- 42 vs 42 +/- 28 ms) was significantly longer with double ventricular extrastimuli (p less than 0.001 and p less than 0.02, respectively). IN CONCLUSION: (1) when single ventricular extrastimuli failed to reset a VT, double ventricular extrastimuli from the same site may reset the VT. PMID- 3630944 TI - Role of cycle length, cycle length alternans, and electrocardiographic lead in electrical alternans with rapid atrial pacing. AB - The role of cycle length and cycle length alternans in the induction of tachycardia-related QRS electrical alternans was investigated using an atrial pacing protocol in 16 patients. Pacing was performed at a cycle length less than 400 ms in 5 patients, greater than 400 ms in 5 and at both in 6 with 0, 6, 10, 20, 40 and 60 ms of atrial cycle length alternans. A 12-lead electrocardiogram and high right atrial, His bundle and right ventricular apical electrograms were simultaneously recorded after 30 to 60 seconds of pacing. Alternans was produced in 88% of patients. Alternans was 3 times more frequent at short (less than 400 ms) than long paced cycle lengths (greater than 400 ms) (66% vs 22%, p less than 0.0001). Alternans increased with increasing cycle length alternans and occurred with very little (less than or equal to 10 ms) atrioventricular nodal, His Purkinje and ventricular cycle length alternans when paced cycle length was short. Alternans was more frequent in the precordial than the limb leads (45% vs 17%, p less than 0.001) and was most frequent in V3 and V2 (sensitivity 69% and 65%) and least frequent in leads I and aVL (sensitivity 4% and 10%). More leads per electrocardiogram showed alternans at short compared with long paced cycle lengths and the number of leads per electrocardiogram increased with increasing cycle length alternans. Occurrence of alternans was highly related to QRS amplitude by Spearman rank correlation (p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630945 TI - Intraoperative comparison of sequential-pulse and single-pulse defibrillation in candidates for automatic implantable defibrillators. AB - Sixteen survivors of cardiac arrest underwent intraoperative comparison of the effectiveness of sequential-pulse and single-pulse defibrillation. Defibrillation was tested alternately with the single-pulse or sequential-pulse technique 10 seconds into an episode of ventricular fibrillation that was induced with alternating current. The sequential-pulse defibrillation technique using truncated exponential pulses was performed with a right ventricular endocardial catheter and a left ventricular epicardial patch electrode. The first pulse was delivered between the right ventricular apical and the superior vena caval electrode on the right ventricular endocardial catheter. The second pulse was delivered between the right ventricular apical electrode and the left ventricular patch electrode 0.2 ms after termination of the first pulse. Single-pulse defibrillation was performed with a standard intracardiac defibrillation system in which a single truncated exponential pulse was delivered across 2 epicardial patch electrodes positioned over the anterolateral right ventricle and the posterolateral left ventricle. During defibrillation threshold determination, voltage and current waveforms were recorded and integrated to determine delivered energy. Average defibrillation threshold leading-edge voltage for the sequential pulse technique was 496 +/- 140 V, compared with 365 +/- 157 V for the single pulse technique (p less than 0.005). Defibrillation threshold leading-edge current for the sequential-pulse technique was 6.0 +/- 2.3 A, compared with 10.6 +/- 5.1 A for the single-pulse method (p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630946 TI - Effects of upright posture on anterograde and retrograde atrioventricular conduction in patients with coronary artery disease, mitral valve prolapse or no structural heart disease. AB - To assess the effects of posture on anterograde and retrograde atrioventricular conduction, electrophysiologic testing was performed in 25 patients in both the supine and 45 degrees upright positions on a tilt table. Retrograde conduction was present during ventricular pacing in 17 patients in the supine position; all 17 continued to manifest retrograde conduction in the upright position. In all patients with absent retrograde conduction while supine, retrograde conduction could not be demonstrated while upright. Upright posture significantly (p less than 0.05) shortened the sinus cycle length (from 808 +/- 34 to 678 +/- 26 ms, mean +/- standard error of the mean), AH interval during sinus rhythm (78 +/- 6 to 69 +/- 6 ms), and AH interval during atrial pacing at cycle length 500 ms (123 +/- 13 to 91 +/- 9 ms). Total atrioventricular conduction time during atrial pacing shortened significantly (from 169 +/- 13 to 136 +/- 10 ms), as did ventriculoatrial conduction time during ventricular pacing (from 192 +/- 9 to 178 +/- 7 ms). Upright posture also significantly shortened both anterograde block cycle length (390 +/- 20 to 328 +/- 17 ms) and retrograde block cycle length (466 +/- 27 to 354 +/- 18 ms). However, the effect of upright posture on retrograde block cycle length was significantly greater than on anterograde block cycle length: a 21% decrease retrograde vs a 14% decrease anterograde (p less than 0.05). These effects may produce clinically important changes in characteristics of arrhythmias that depend on the properties of anterograde and retrograde conduction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3630947 TI - International Society and Federation of Cardiology: Working Group on Classification of Calcium Antagonists for Cardiovascular Disease. PMID- 3630948 TI - Optimal transesophageal atrial pacing. PMID- 3630949 TI - Late thrombotic obstruction of aortic porcine bioprostheses. PMID- 3630950 TI - Unreliability of the electrocardiogram in predicting left ventricular function recovery after thrombolysis. PMID- 3630952 TI - The low risk coronary male. PMID- 3630951 TI - Preoperative treatment of acute cardiac tamponade due to continuous intrapericardial bleeding. PMID- 3630953 TI - Opossum adrenal medulla: I. Postnatal development and normal anatomy. AB - The anatomy and histology of the adrenal gland in the adult opossum were found to be typical for mammals. The development of the adrenal medulla was also found to follow the typical mammalian pattern. Primitive sympathetic cells were found in both intra- and extra-adrenal locations in the newborn at a time when chromaffin precursor cells were migrating to the adrenal anlage. Pheochromoblasts first appeared within the forming medulla where at a later stage chromaffin cells could be observed forming columns of cells between adjacent sinusoids. Unlike in other mammals, much of this development takes place postnatally when the neonate is in the mother's marsupium. The value of the developing opossum adrenal medulla as an experimental model is stressed, since a significant amount of development takes place in an environment that is accessible to experimental manipulation. PMID- 3630954 TI - Opossum adrenal medulla: II. Differentiation of the chromaffin cell. AB - The ultrastructure of the opossum adrenal medulla was examined in its postnatal development. Maturation of chromaffin cells and genesis of chromaffin vesicles were of particular interest. The primitive sympathetic cell was seen to contain few organelles with no apparent polarity. Initial pheochromoblasts contained more organelles with some polarity. Endoplasmic reticulum and the Golgi complex increased as the pheochromoblasts matured, which suggested increased synthetic activity. Structures resembling Golgi/endoplasmic reticulum/lysosome (GERL) systems were seen in the pheochromoblasts. It is suggested that some of the components of the chromaffin vesicle may be processed by the GERL while others come directly through the Golgi complex. It is stressed that the developing pheochromoblast in the opossum presents an interesting model in which to study the genesis of the chromaffin vesicle. PMID- 3630955 TI - Projection of cervical dorsal root fibers to the medulla oblongata in the brush tailed possum, Trichosurus vulpecula. AB - This study describes the projection of cervical spinal afferent nerve fibers to the medulla in the brush-tailed possum, a marsupial mammal. After single dorsal roots (between C2 and T1) were cut in a series of animals, the Fink-Heimer method was used to demonstrate the projection fields of fibers entering the CNS via specific dorsal roots. In the high cervical spinal cord, afferent fibers from each dorsal root form a discrete layer in the dorsal funiculus. The flattened laminae from upper cervical levels are lateral and those from lower cervical levels are medial within the dorsal columns. All afferent fibers at this level are separated from gray matter by the corticospinal fibers in the dorsal funiculus. All cervical roots project throughout most of the length of the well developed main cuneate nucleus in a loosely segmentotopic fashion. Fibers from rostral roots enter more lateral parts of the nucleus, and fibers from lower levels pass to more medial areas; but terminal projection fields are typically large and overlap extensively. At more rostral medullary levels, fibers from all cervical dorsal roots also reach the external cuneate nucleus. The spatial arrangement here is more complex and more extensively overlapped than in the cuneate nucleus. Rostral cervical root fibers reach ventral and ventrolateral areas of the external cuneate nucleus and continue to its rostral pole; more caudal root fibers project to more dorsal and medial regions within the nucleus. These results demonstrate that projection patterns of spinal afferents in this marsupial are similar to those seen in the few placental species for which detailed data concerning this system are available. PMID- 3630956 TI - Decidual cells in the human ovary at term: II. Morphometric analysis of cytoplasmic processes and organelles. AB - Morphometric analysis of human ovarian decidual cells was performed with a Videoplan computer, and mean values were established for the area and perimeter of cellular processes and organelles. Two-hundred forty electron micrographs representing 160 cells were analyzed. The mean decidual cell area was 218.7 microns2, of which 34.5 microns2 was occupied by the nucleus (15.8% of the cytoplasmic area); the nucleus contained 1.74 micron2 of nucleolar material (0.8%). The endoplasmic reticulum occupied 13.63 microns2 (6.2%). Mitochondria occupied 7.3 microns2 (3.3%) and the Golgi network 5.49 microns2 (2.5%). Decidual secretory bodies occupied 0.91 micron2 (0.42%) and cytoplasmic processes 1.89 micron2 (0.94%). The remainder of the cytoplasm, containing inclusions and cytoskeleton, represented 71% of the cell area. Perimeter measurements indicated an average decidual cell was surrounded by 87.8 microns of plasma membrane. The mean nuclear membrane measured 28.3 microns (representing 32.3% of the plasma membrane, pm, or 4.1% of total cellular membranes, cm). Outer mitochondrial membranes measured 156.6 microns (178% pm, 23.5% cm); endoplasmic reticulum membranes measured 350.3 microns (400% pm, 52.6% cm); Golgi membrane measured 30.77 microns (35% pm; 4.5% cm) and membrane surrounding secretory bodies measured 9.8 microns (11.2% pm; 1.4% cm). A mean of 280 secretory bodies per ovarian decidual cell was calculated. The plasma membranes of evaginated cytoplasmic processes represented 22.3% of the total pm (19.6 microns or 2.9% cm). A mean of seven such processes was observed per 87.8 microns of plasma membrane (160/cell). These morphometric data provide a baseline for comparisons of human ovarian decidual cells with uterine decidua, in vivo and in vitro, as well as with decidual cells of other species. PMID- 3630957 TI - Ultrastructure of cardiocyte degeneration and myocardial calcification in the dystrophic hamster. AB - The myocardium of the Bio 14.6 cardiomyopathic hamster was examined with the electron microscope to identify cellular and organelle changes during the acute lesioning stage, a period typified by concomitant cardiocyte destruction and calcium elevation. Most cardiocytes retained their normal histologic and ultrastructural features, but scattered foci of altered and necrotic cells were observed in association with degenerative calcifying lesions. Prenecrotic alterations of myocytes included cellular edema; varying degrees of distension of sarcoplasmic reticulum and T-tubules; contraction bands and other myofibrillar abnormalities; mitochondrial clustering and hyperplasia; a wide spectrum of mitochondrial changes such as altered sizes, shapes, and cristal patterns, and increases in the number and size of osmiophilic matrix inclusions. Morphologic features consistent with substantial calcium excess were not observed in most altered but prenecrotic cells. Instead, calcium deposition within extruded mitochondria and upon degenerating organelle debris was observed only after cardiocyte disruption. Some calcifying cell remnants were phagocytized by macrophages, whereas large calcified plaques and other deposits remained in the interstitium. Mitochondrial calcification in vascular smooth muscle cells and fibroblasts was evident in highly calcified lesions. These observations suggest that most of the morphologically identifiable calcium deposition present in this cardiomyopathy results from secondary calcification subsequent to sarcolemmal disruption. PMID- 3630958 TI - Biological time and the effects of hydroxyurea on DNA synthetic activity of bone marrow and tumor cells in mice bearing the Ehrlich ascites carcinoma. AB - The objective of this experiment was to attempt to induce, with hydroxyurea (HU), significant quantitative differences in the level of DNA-synthetic activity (DNA SA) between a neoplastic cell population (the Ehrlich ascites carcinoma or EAC) and bone marrow in the same animal. Mice bearing a 5-day-old EAC were standardized to and kept on an LD 12:12 cycle (light 0600-1800 hr). They were treated with 500 mg/kg HU at 0500 hr (23 hr after lights on, or HALO) or at 1700 hr (11 HALO). DNA-SA was determined by liquid scintillation counting of 3H thymidine incorporation into chemically isolated DNA. DNA-SA in bone marrow and EAC cells was monitored over the next 60 hr with subgroups of ten mice each killed every 3 hr beginning 3 hr after treatment with HU. The circadian system of the host influenced the response of the bone marrow to HU; i.e., the response to HU administered at 0500 hr was different both qualitatively and quantitatively from that for HU given at 1700 hr. Comparisons of DNA-SA in bone marrow and EAC from the same animal revealed time points after treatment with HU when DNA-SA in the EAC was high, but DNA-SA in bone marrow was low. These differences in the level of DNA-SA between a tumor cell population and bone marrow should be of therapeutic value; i.e., executor doses of anti-DNA-SA drugs such as cytosine arabinoside could be given at that point in time after treatment with HU when DNA SA in the tumor was high, but DNA-SA in the bone marrow was low. PMID- 3630959 TI - The American Board of Nutrition: perspectives and directions. PMID- 3630960 TI - Body composition of Peruvian children with short stature and high weight-for height. II. Implications for the interpretation for weight-for-height as an indicator of nutritional status. AB - In some child populations, low height-for-age, suggesting chronic undernutrition, may paradoxically be accompanied by relatively high weight-for-height, suggesting obesity. This growth pattern was investigated with anthropometric assessment and body composition studies using H2(18)O stable isotope dilution in 139 preschool age Peruvian children. Results suggested low height-for-age (15th percentile National Center for Health Statistics [NCHS]) and high weight-for-height (60th percentile NCHS). Skinfold thicknesses were lower whereas arm muscle areas were more similar to NCHS reference values. Total body water (as percent body weight) was greater than reference values, consistent with lower body fat. Differences in body proportions did not account adequately for the high weight-for-height. The data suggest that the high weight-for-height in these children is not obesity but is associated with lower body fat and greater lean tissue or lean tissue hydration that may reflect dietary, environmental, or genetic influences. Weight for-height cutoffs for wasting or obesity may require different interpretations for different populations. PMID- 3630962 TI - Plasma carnitine compartment and red blood cell carnitine compartment of healthy adults. AB - Carnitine is needed for a variety of important physiological functions in energy metabolism. Assessment of the carnitine status of an individual is compromised by limited data on the number of metabolic compartments of carnitine and their interrelationship, if any. Possible compartmentalization of carnitine in the blood of healthy adults was investigated because blood is one of the more readily available samples for the assessment of carnitine status. The data suggest that blood carnitine is partitioned into a plasma carnitine compartment and a red blood cell carnitine compartment, compartments that are separate and distinct metabolic compartments. PMID- 3630961 TI - Effect of a moderate fish intake on blood pressure, bleeding time, hematology, and clinical chemistry in healthy males. AB - This paper describes the outline and first results of an international study to investigate the effect of a reasonable amount of dietary fish on some aspects of cardiovascular risk. In Maastricht and Zeist, The Netherlands, and Tromso, Norway, healthy male volunteers were given a dietary supplement consisting of 100 g/d of mackerel or meat for a 6-wk period. Compliance was monitored on the basis of the urinary excretion of lithium, which was added to the supplements. Average compliance was approximately 80% and this decreased slightly in time. Systolic blood pressure decreased in both groups to a comparable degree; consequently no specific effect of the fish supplement was observed. The fish supplement significantly prolonged bleeding times. Hematology was hardly affected but platelet counts decreased significantly. No indications were obtained for adverse effects of the fish supplement. PMID- 3630963 TI - Taste and eating disorders. AB - Taste responses to sucrose and fat-containing stimuli were examined in a population of young women with eating disorders. Anorectic-restrictor and anorectic-bulimic patients were compared with normal-weight bulimic patients and with normal-weight control subjects. Sensory estimates of sweetness and fat content of 20 different mixtures of milk, cream, and sugar did not differ among subject groups. In contrast, relative preferences for sugar vs fat as determined by the Response Surface Method differed between patients with eating disorders and control subjects. Normal-weight bulimic patients preferred sweeter stimuli than did control subjects. Anorectic-restrictor and anorectic-bulimic patients liked sweet but disliked high-fat stimuli and showed elevated optimal sugar:fat (S:F) ratios. This pattern of response did not change following weight regain. The stability of preference profiles suggests that taste responsiveness may be independent of diagnostic categories, bulimic behaviors, or acute changes in body weight. PMID- 3630964 TI - Activity as a function of body weight. AB - Thirty-one undergraduate men and women who weighed more (overweight) or who weighed less (underweight) than the normal weight limits for their height wore actometers on all four limbs 24 h each day for 14 consecutive days. All groups were found to be equally active. This result fails to replicate previously reported results that overweight men and women are hypoactive. This discrepancy is explained in terms of differences in percent overweight between the present and previous samples. The possibility of a catastrophic decline in activity as a function of percent overweight is discussed. PMID- 3630965 TI - Phytic acid and calcium affect the in vitro rate of navy bean starch digestion and blood glucose response in humans. AB - Carbohydrate foods that are slowly digested appear beneficial in the management of diabetes and hyperlipidemia. This study determined the effect of endogenous and added phytic acid as well as Ca on the in vitro rate of starch digestion and in vivo blood glucose response to navy bean flour, prepared as unleavened bread. Removal of phytic acid from and addition of Ca to navy bean flour increased the starch digestion in vitro and raised the glycemic response in vivo while readdition of phytic acid to dephytinized flour produced the opposite effect. Carbohydrate malabsorption assessed by breath H2 measurement related negatively to glycemic response but the changes observed were much lower than the changes in glycemic response. This study confirmed the role of both added and endogenous phytic acid in slowing the in vitro rate of starch digestibility and in vivo glycemic response to legumes and the ability of Ca to modify this effect. PMID- 3630966 TI - Levels of alpha- and gamma-tocopherol in human eyes: evaluation of the possible role of IRBP in intraocular alpha-tocopherol transport. AB - Alpha-tocopherol was distributed almost equally between the retina and its underlying pigmented layers (pigment epithelium and choroid). Only 8.4% of the total alpha-tocopherol occurred in the iris and ciliary body. Alpha-tocopherol content was expressed as amount per eye, per cm2, and per 100 g wet weight. The combined retina and pigment epithelium-choroid contained 2.9 +/- 1.0 mg/100 g wet weight (means +/- SD, n = 30 donors). Gamma-tocopherol represented 20.9 +/- 12.2 mol % of the alpha-tocopherol. The anterior tissues contained 0.4 +/- 0.2 mg/100 g (n = 19 donors). No significant correlation with age was found. Purified bovine interstitial retinol-binding protein (IRBP) bound exogenous 3H-alpha-tocopherol, which could be displaced by unlabeled all-trans retinol (KD = 10(-6) M). Much higher concentrations of unlabeled alpha-tocopherol were required to achieve a partial displacement of bound 3H-all-trans retinol. No endogenous alpha tocopherol could be detected in bovine interphotoreceptor matrix. PMID- 3630968 TI - Intestinal absorption, liver uptake, and excretion of 3H-folic acid in folic acid deficient, alcohol-consuming nonhuman primates. AB - Nonhuman primates fed folic acid-deficient diets +/- 30% kcal ethanol were used to determine alcohol effects on megaloblastic anemia development and folate bioavailability. Lower hemoglobin (Hb) and red blood cell (RBC) counts and higher mean corpuscular volume (MCV) occurred after 13 wk in alcohol-fed monkeys, later in controls. Plasma, RBC, and liver folate declined and urinary formiminoglutamic acid (FIGLU) was elevated in both groups with FIGLU increasing more among alcohol fed monkeys at 38 wk. After 40 wk, the bioavailability of oral 3H-folic acid was investigated and showed increased fecal and reduced urinary tritium excretion in alcohol-fed monkeys compared with controls while plasma uptake and liver and whole body tritium retention were similar in both groups. These observations demonstrate that chronic alcohol consumption impairs folate coenzymes, accelerates appearance of hematologic indices of megaloblastic anemia, and causes possible malabsorption of enterohepatically circulated folates in folate deficiency even when other essential nutrients are provided. PMID- 3630967 TI - Tocopherol distribution and intracellular localization in human adipose tissue. AB - Adipocytes, isolated from human adipose tissue, were disrupted and then centrifuged, resulting in three fractions: oil, interface between the oil and the hypotonic buffer (containing lipid droplets surrounded by unilamellar membranes), and pelleted portion (containing bilayer membranes, intracellular organelles, and debris). The ratios of tocopherol:cholesterol and tocopherol:triglyceride were similar for adipose tissue, adipocytes, oil, and interface. The bulk lipid (oil plus interface fractions) of the adipocytes contained 99% of the tocopherol, 98% of the triglyceride, and 91% of the cholesterol. The tocopherol:cholesterol ratio was nearly eightfold greater in the bulk lipid than in the bilayer membrane fraction. By use of radioactively labeled tocopherol and cholesterol, it was demonstrated that the isolation protocol did not alter the distribution of the intracellular lipids; furthermore, the tocopherol in the lipid droplet did not readily exchange. Thus, the majority of tocopherol in adipose tissue is located in the bulk-lipid stores. PMID- 3630969 TI - Tryptophan deficiency and picolinic acid: effect on zinc metabolism and clinical manifestations of pellagra. AB - In five experiments, rats were fed tryptophan (Tryp)-deficient diets with 6-12 micrograms/g zinc (Zn) and, in one experiment, a Zn-deficient diet to test the effect on clinical manifestations, plasma and bone Zn, and ability of picolinic acid (PA) or extra (12 micrograms/g) Zn to compensate. Tryp deficiency caused classical manifestations of pellagra although niacin intake was in excess of normal requirements. At marginal Zn intakes, oral PA caused a significant increase of plasma Zn and, compared with Tryp-adequate controls, Tryp deficiency resulted in lower plasma Zn and plasma:bone Zn ratios. Extra Zn (total 24 micrograms/g) was ineffective. Subcutaneous PA showed a tendency to lower plasma Zn. PA had no effect on clinical manifestations. We conclude that a Tryp metabolite other than nicotinic acid is necessary in the prevention of pellagra. Our hypothesis links this finding with the observed Tryp and PA effect on Zn metabolism. PMID- 3630970 TI - Competitive inhibition of folate absorption by dihydrofolate reductase inhibitors, trimethoprim and pyrimethamine. AB - Trimethoprim and pyrimethamine, inhibitors of dihydrofolate reductase (DHFR), cause folate deficiency in some patients. We investigated impairment of intestinal folate absorption by these drugs. By use of the in vivo intestinal loop methods in rats, absorption of [3H] folic acid was significantly decreased in the presence of either drug. Kinetic studies using the influx chamber method demonstrated a pattern of competitive inhibition of folate transport. [3H] folic acid absorption from jejunal loops was determined 3-16 h after IV administration of methotrexate; this treatment abolished DHFR activity in the small intestine. In rats pretreated with methotrexate, luminal disappearance and systemic absorption of folic acid were significantly enhanced with respect to controls. Trimethoprim and pyrimethamine are weak competitive inhibitors of intestinal folate transport and folate absorption inhibition occurs at the site of membrane transport and appears to be unrelated to concurrent inhibition of DHFR activity in enterocytes. PMID- 3630971 TI - Muscle function and nutritional status. PMID- 3630972 TI - Sinus histiocytosis with massive lymphadenopathy. A nodal and extranodal proliferation of S-100 protein positive histiocytes? AB - Four cases of sinus histiocytosis with massive lymphadenopathy (SHML) from Finland were studied clinically and immunohistologically. Three patients had histologically verified extranodal manifestations that often caused the most prominent clinical symptoms. Upper respiratory tract obstruction resulting from SHML lesions was present in two cases, multiple bone lesions in one case, and skin lesions in one case. Clinical remission was observed in all cases, but the course was often protracted. Immunohistochemical studies revealed S-100 protein and alpha-1-antichymotrypsin (ACT) positivity in most large pale cytoplasmic histiocyte-like cells in all cases, whereas lysozyme was not present in these cells. Sinus cells in ordinary sinus histiocytosis were constantly positive for ACT and variably positive for lysozyme and were generally negative for S-100 protein. The large histiocyte-like cells in SHML resemble interdigitating reticulum cells and Langerhans' cells in their S-100 protein positivity but differ from these cells by morphologic characteristics and the presence of alpha 1-antichymotrypsin, a marker constantly seen in ordinary histiocytes. These results suggest that SHML is a proliferative condition of histiocyte-related cells, which share some properties of histiocytes and some of interdigitating reticulum cells. Further studies are necessary to clarify the nature of the peculiar histiocyte-like cells in SHML. PMID- 3630973 TI - Utility of the three-part leukocyte differential count. AB - The utility of the automated three-part leukocyte differential count was evaluated in an acute care hospital setting. The manual method was specified in 92 of 223 (41%) requests for differentials on one day. For the others, 79 three part differentials (60%) were completed; 19 (15%) were rejected for histogram abnormalities ("R-flags") or could not be computed; and 33 (25%) were rejected for out-of-range values that were later verified by slide review. The automated method missed 4 of 39 (10%) band elevations and 2 of 2 (100%) cases of eosinophilia reported on manual differentials, but those results had no apparent influence on patient management. In 98 cases of septicemia, automated and manual methods showed similar overall sensitivity (87% and 83%, respectively). Selectively combined with a qualitative slide review, the three-part differential was applicable to 84% of all specimens submitted for a differential count, with acceptable sensitivity and accuracy and substantial savings in personnel time. PMID- 3630974 TI - A new assay for quantifying human reticulocytes. AB - The authors describe a new method for quantitative reticulocyte analysis. The assay uses a conventional clinical blood cell analyzer to size a patient's red blood cell neocyte population, which relates to the reticulocyte fraction in a linear fashion. Blood is layered atop Stractan (arabino-galactan polysaccharide) and centrifuged for 30 minutes at 1,500 X g. This density medium fractionation process enriches the Stractan layer with neocytes by up to 20-fold as determined by G6PD enzyme analysis. The mean corpuscular volume (MCV) of the red blood cells partitioning in the Stractan layer and the starting whole blood is then measured. The ratio of the two MCV measurements is then related to the reticulocyte percentage by a standard curve. In 93 patients, the derived MCV ratio was linearly correlated with manual reticulocyte counts (r = 0.96/slope = 0.99). Agreement of results obtained for single samples was within 0.2%. The assay's within-run and between-run precision is excellent (coefficient of variation less than 1%). The assay provides data on the percentage of reticulocytes in whole blood with an accuracy and precision that is at least 20 times greater than conventional microscopic technics. PMID- 3630975 TI - Ethanol ingestion inhibits human whole blood platelet impedance aggregation. AB - The authors investigated the effect of ethanol on platelet impedance aggregation in whole blood (WB-PIA). Healthy moderate drinkers were given ethanol, 1 mL/kg body weight, to drink. Thirty minutes after ingestion of ethanol, WB-PIA was significantly inhibited when compared with baseline values. There was no significant inhibition when the same volunteers ingested water instead of ethanol. These observations suggest that WB-PIA is a sensitive technic for the detection of the effect of ethanol on platelets. These findings also support the view that blood ethanol levels achievable during social drinking impair platelet function, thus possibly accounting, at least in part, for the reported "protection" from ischemic heart disease in moderate drinkers. The sensitivity of human platelets to the inhibitory effect of ethanol suggests that continued drinking will adversely influence the incidence of initial bleeds and of rebleeding in gastrointestinal hemorrhage associated with alcoholism. PMID- 3630976 TI - A comparison between chemical analysis and magnetic resonance imaging with the clinical diagnosis of multiple sclerosis. AB - Ninety-five patients suspected of having multiple sclerosis (MS) were evaluated by medical history and neurologic examination. Based on this evidence they were divided into three groups: clinically definite MS, not-definite MS, and not MS. The adjunct tests, chemical analysis, and magnetic resonance imaging (MRI), were also performed to assess the diagnosis of MS. Chemical analyses of paired serum and cerebrospinal fluid (CSF) samples were performed to identify oligoclonal immunoglobulin bands and to estimate both the albumin quotient and the IgG index. A positive correlation was found between the chemical test results and definite MS in 73 of 73 cases. In 11 of 12 cases of not-definite MS the chemical results were positive for MS. A positive correlation was also found between ten of ten cases that were not MS and negative chemical test results. MRI scans were positive for MS in 48 of 51 clinically definite MS cases and in 4 of 4 not definite MS cases. MRI scans were negative for MS in five of six cases that were not MS. These findings demonstrate that combined determinations of serum and CSF proteins by simple zone electrophoresis and commercial immunochemical tests can be useful laboratory aids in the diagnosis of MS. The MRI scans provide additional evidence to support the diagnosis of MS. PMID- 3630977 TI - An incomplete form of familial lipoprotein lipase deficiency presenting with type I hyperlipoproteinemia. AB - The author reports the case of a patient with an incomplete form of familial lipoprotein lipase deficiency associated with type I hyperlipoproteinemia manifesting an autosomal recessive pattern of inheritance. The patient presented with hepatosplenomegaly, abdominal pain, and fasting chylomicronemia. A Western diet elicited a steep increase in plasma triglyceride concentration and the appearance of floating chylomicrons over a clear infranatant in fasting plasma. Postheparin lipoprotein lipase activity was moderately reduced to 38% of control values. Adipose tissue lipoprotein lipase activity was 10% of normal, whereas his muscle enzyme activity was within the reference range. Two-dimensional electrophoresis of plasma apolipoproteins revealed the presence of normal activator (apolipoprotein C-II). These results confirm the importance of the adipose tissue enzyme for the clearance of diet-derived plasma triglycerides. PMID- 3630978 TI - Special report: transfusion risks. AB - The benefits of blood transfusion must be considered and evaluated in terms of risk factors relating to the adverse effects of transfusion. Transfusions may result in either serious or troublesome complications. Although the risk of transfusion-associated acquired immune deficiency syndrome (AIDS) is of paramount concern in the patient population, it has been virtually eliminated because of testing of donor units for antibody to human immunodeficiency virus. Serious and troublesome adverse effects of blood transfusion are listed and ranked in order of approximate frequency. About 20% of all transfusions result in some type of adverse effect. The major serious risk of blood transfusion today continues to be transfusion-associated viral hepatitis. This entity is usually subclinical but frequently results in serious chronic liver disease. Transfusions should be avoided unless patient care would be compromised if withheld. PMID- 3630979 TI - Yellow IRIS urinalysis workstation. Results not corrected. PMID- 3630980 TI - The visualization of 'yeast cells' in stools: a clue to the presence of Cryptosporidium. PMID- 3630981 TI - Efficacy of regionalization of perinatal/neonatal care. PMID- 3630982 TI - Biological activity of calcitriol. PMID- 3630983 TI - Vasopressin dosage adjustment. PMID- 3630984 TI - Intravenous narcotics in sickle cell crises. PMID- 3630985 TI - Hemostasis defects and periventricular-intraventricular hemorrhage. PMID- 3630986 TI - Risk factors or intraventricular hemorrhage in premature infants. PMID- 3630987 TI - Indomethacin therapy for patent ductus arteriosus. PMID- 3630988 TI - The Pediatric Residency Program of the Future. II. Tomorrow's private pediatric practice: a change in roles. PMID- 3630990 TI - Nutritional rickets in San Diego. AB - Despite the ability of infants to synthesize vitamin D through exposure to sunlight, nutritional rickets occasionally develops in infants even in areas with perennially sunny climates. In San Diego, a 1-year-old breast-fed infant presented with classic signs of nutritional rickets. Unsupplemented breast milk, limited exposure to sunlight, and darkly pigmented skin were predisposing factors. Because of this occurrence, we conducted a survey of vitamin supplementation practices among pediatricians in San Diego. Twenty-nine percent of 160 respondents do not prescribe vitamin D supplements for breast-fed infants. Those in practice less than ten years were even less likely to prescribe a vitamin supplement compared with their older colleagues. The patient report, coupled with a literature review, suggest the need for vitamin D supplementation for all nursing infants. PMID- 3630989 TI - Young maternal age and adverse neonatal outcome. AB - Young maternal age has been associated with adverse neonatal outcome, particularly an increased incidence of low birth weight (less than 2500 g) and neonatal mortality. Very young adolescents (less than 15 years old) and multiparous adolescents are at particularly high risk. Very young maternal age is probably a marker for one or more other maternal risk factors known to adversely affect neonatal outcome. Current studies do not provide adequate data to determine which risk factors account for the less-than-optimal outcome of the neonates of very young adolescents. Risk conditions that are potentially treatable include poor nutrition, substance use, and genital infections. PMID- 3630991 TI - The laboratory method as a variable in the diagnosis of hyperbilirubinemia. AB - Algorithms based on fractionation of bilirubin into direct-reacting and indirect reacting fractions by diazo methods are frequently utilized for investigation of hyperbilirubinemia. Unfortunately, direct-reacting and indirect-reacting fractions do not correspond precisely with conjugated and unconjugated pigment. Advances in analytical methods allow accurate quantitation of the individual fractions of bilirubin in serum. Three cases of hyperbilirubinemia are presented in which bilirubin fractionation by diazo methods suggested an erroneous diagnosis. Analysis of the serum samples by high-performance liquid chromatography for bilirubin conjugates confirmed the correct clinical diagnosis. Diazo methods for bilirubin analysis are subject to marked discrepancies. While the new methodology utilizing high-performance liquid chromatography is not practical for routine bilirubin analysis, optimization of diazo methods utilizing rigid and meticulous protocol is suggested. Laboratories performing diazo bilirubin determinations should correlate their results with those of other laboratories and clinical data. Clinicians need to be aware of the reliability of a particular test result before embarking on a lengthy and expensive evaluation. PMID- 3630992 TI - Chronic diarrhea and soy formulas. Inhibition of diarrhea by lactose. AB - Soy protein formulas are often poorly tolerated by infants with chronic nonspecific or postinfectious diarrhea syndrome. We found that these adverse responses may be prevented by using lactose, instead of sucrose or dextrimaltose, in soy formula. We studied 40 infants diagnosed as soy intolerant. They were given soy formula with differing carbohydrate contents in a randomized, blinded prospective study. Stool output, stool sodium content, and symptoms were significantly improved in infants receiving a soy-lactose formula; no difference was seen in formulas with sucrose or maltose. Improvement occurred in three to five days in most infants. Furthermore, the characteristic frequency distribution of the favorable response to lactose suggested a specific mechanism for the inhibition of water and electrolyte losses through the bowel. The results indicate that, in the absence of lactose intolerance, a soy-lactose formula could be useful in treating chronic diarrhea and secondary protein intolerance. PMID- 3630993 TI - Congenital familial transient hypothyroidism secondary to transplacental thyrotropin-blocking autoantibodies. AB - Three patients demonstrated transient neonatal hypothyroidism, presumably secondary to maternally derived thyrotropin (TSH)-blocking antibodies. Although transient, this disorder might not have been benign in the first child, who exhibited significant developmental delay. A thyroid scan was not helpful in making this diagnosis. Although uncommon, this disorder should be suspected in infants with a maternal history of autoimmune thyroid disease, multiple siblings with congenital hypothyroidism, or a clinical course characterized by continually suppressed TSH levels, despite low doses of levothyroxine sodium replacement. Measurement of TSH-blocking antibodies may be used in the diagnosis of transient neonatal hypothyroidism at birth and is becoming more readily available from reference laboratories. Once diagnosed, the patient may then be prepared for monitored withdrawal of levothyroxine replacement therapy at 2 to 3 years of age and will not be committed to lifelong replacement therapy. PMID- 3630994 TI - Remission in children with hyperthyroidism treated with propylthiouracil. Long term results. AB - We treated 69 hyperthyroid children with propylthiouracil, of whom 53 remained under surveillance. Of these children, 34 (64%) had an initial remission, but relapses were frequent (47%). At this writing, 24 patients (45%) were in remission, with a mean duration of remission of 55 months (range, ten to 132 months). We found that the triiodothyronine level took significantly longer than the thyroxine (T4) level to return to normal. Thus, based on the T4 level alone, treatment may have been stopped prematurely in some patients, causing the relapse rate to be falsely high. The response to therapy did not depend on the size of the goiter nor on the initial levels of T4 or triiodothyronine. Six patients had adverse reactions, which were serious in two patients. PMID- 3630995 TI - Munchausen's syndrome by proxy and its professional participants. AB - Physicians and legal and protective service agencies may unwittingly participate in Munchausen's syndrome by proxy (MSP) when they fall to recognize MSP, treat the true disorder, and effect a favorable outcome for the child. Five patients with MSP are described, emphasizing a variety of presentations, often with a delay in diagnosis. In addition, features in the family unit are identified to aid in early recognition of the disorder, and a management protocol used at Children's Hospital of Pittsburgh is presented. Finally, the need for better care, recognition, and reporting to help determine the true incidence of the disorder and aid in educating involved professionals is emphasized. PMID- 3630996 TI - Safe immunization of allergic children against measles, mumps, and rubella. AB - A series of 135 subjects (134 children and one adult) with documented or suspected systemic allergy were prick-tested before a measles, mumps, and rubella (MMR) vaccination. Atopic eczema was documented in 68, asthma in 47, and cow's milk allergy in 11 examinees; eight children were evaluated because of severe systemic reactions following diphtheria-pertussis-tetanus, measles, or inactivated polio (Salk) vaccinations. In one child, there was only a suspicion of general allergy. The undiluted MMR prick test gave negative reactions in 126 cases (93%). The highest rate of nonreactivity was observed in those with atopic eczema (96%) and in children with asthma (91%) or cow's-milk allergy (82%). All examinees with systemic reactions after other vaccinations also had negative prick-test reactions. A total of 122 (95%) of the 129 examinees were eventually vaccinated with MMR. No untoward reactions developed, except mild generalized urticaria or fever in two vaccinees. We conclude that at least 95% of children with common forms of systemic allergy can be vaccinated safely with MMR and, in general, that allergic diseases should not interfere with execution of the vaccination programs. PMID- 3630997 TI - Prediction of arterial blood pressure in the premature neonate using the oscillometric method. AB - The noninvasive oscillometric measurement of blood pressure (BP) in preterm neonates has become a common practice in intensive care nurseries. The method has gained acceptance primarily through its correlation with direct arterial measurement. In this study, the oscillometric method (using Dinamap 1846) was compared with direct intra-arterial BP monitoring in 15 preterm infants. The 95% prediction intervals for individual oscillometric measurements were wide, ranging from 17 mm Hg for the mean BP to 20 mm Hg for the systolic and diastolic BP. The oscillometric method also underestimated intra-arterial systolic and mean BP and overestimated diastolic BP. Caution must be used when oscillometrically measuring BP in premature neonates. PMID- 3630998 TI - A chronic lung disorder following abdominal pregnancy. AB - Abdominal pregnancy is a rare condition that is associated with a high infant mortality, as well as orthopedic and pulmonary deformations. This article describes the clinical and radiological courses of two infants born after abdominal pregnancies. Evidence of pulmonary hypoplasia secondary to fetal compression was present. The morbidity and mortality for infants born of abdominal pregnancies may depend on the extent of pulmonary involvement, which may relate to the length of fetal compression. PMID- 3630999 TI - Atresia of the colon. PMID- 3631000 TI - Polycythemia in hypothyroid infants. AB - Twenty-three infants with congenital hypothyroidism were evaluated for the presence of anemia. Though no patient was found to be anemic, six (26%) had elevated hemoglobin levels, some with significant elevations. Pathogenesis of this finding is unclear, as none of the effects of thyroxine on erythropoiesis previously described would result in polycythemia. Pediatricians caring for hypothyroid infants should be aware of this association so as to be better prepared for any complication related to the hyperviscosity syndrome. PMID- 3631001 TI - Influence of the legal imperative and medical guidelines on the incidence and management of the meconium-stained newborn. AB - Following a legal action that resulted from the death of a newborn with the meconium aspiration syndrome, I investigated the incidence and management at a community hospital of the meconium-stained newborn during March in each of the years 1973 through 1985. During March in 1973 through 1981, 4.3% of all live births (1368) were meconium stained. After the newborn's death, which initiated a period of legal negotiations, the incidence of meconium staining increased to 14.4% among 582 live births during March of 1982 through 1985. Laryngoscopy increased to include 64.3% of meconium-stained newborns, and endotracheal suctioning was associated with laryngoscopy in 72.2% of the patients. Also, oxygen administration to newborns with and without meconium staining increased from 10.5% in March of 1973 through 1981 to 45.7% in March of 1982 through 1985. There was no improvement in outcome from the increased recognition and more aggressive management. While the issuance of medical guidelines alone had little effect on the incidence and care of the meconium-stained newborn, the combination of the legal imperative with medical guidelines had a profound and corruptive effect. PMID- 3631002 TI - Effect of infant cereals on zinc and copper absorption during weaning. AB - Zinc and copper absorption from five infant cereal products mixed with water, human milk, or cow's milk was measured using an in vivo absorption model (rat pup) involving gastric intubation of extrinsically radiolabeled diets. Whole-body copper 64 uptake, nine hours after intubation, ranged from 14% to 31% of the dose given for the different cereal combinations. The resultant bioavailability of copper from human milk-cereal combinations (23% to 26%) was significantly lower than that from human milk alone (38%). Whole-body zinc 65 uptake, nine hours after intubation, ranged from 13% to 54% of the dose given for the different cereal combinations. These values were significantly lower than the whole-body zinc 65 uptake from milk alone (61%). Zinc availability was lower (13% to 25%) from dry cereal combinations that contained phytic acid (oatmeal and high-protein varieties) compared with the ready-to-serve cereal-fruit combinations (24% to 54%). The highest zinc uptake (37% to 54%) was from rice-fruit combinations that do not contain phytic acid. We estimated the amounts of zinc and copper that would be absorbed from these cereal products and speculated on the potential impact of these foods on the weaning infant's zinc and copper nutriture. Depending on the feeding practices employed during the weaning period, it is apparent that infant cereals may compromise utilization of zinc and copper from milk diets during weaning. PMID- 3631003 TI - Further delineation of the McKusick-Kaufman hydrometrocolpos-polydactyly syndrome. AB - Six cases of the McKusick-Kaufman syndrome (MKS), including two cases that were diagnosed prenatally, were studied. Review of the 54 previously described cases indicates that postaxial polydactyly and hydrometrocolpos in female patients are the hallmark features of this entity. Other manifestations, such as malformations of gastrointestinal, cardiovascular, and ophthalmic structures, occur less consistently. Affected children require careful medical follow-up. Recurrence of hydrometrocolpos following surgical repair may lead to serious sequelae, such as chronic renal failure. We believe that MKS is a distinct panethnic genetic entity, inherited in an autosomal recessive fashion, and that the diagnosis should be made only in female patients with hydrometrocolpos and polydactyly or in male patients with polydactyly who have an affected female relative. PMID- 3631004 TI - Explaining the phenomena of near-death experiences. PMID- 3631005 TI - Pediatric autopsy. PMID- 3631006 TI - Confessions of a ripper. PMID- 3631007 TI - Pediatric training in family practice programs. PMID- 3631008 TI - Firearm safety. PMID- 3631009 TI - How dress affects perceptions of house officers. PMID- 3631010 TI - Reduced prevalence of abuse in low-birth-weight survivors. PMID- 3631011 TI - Announcement of the National Epidermolysis Bullosa Registry. PMID- 3631012 TI - Lyme disease as cause of childhood arthritis. PMID- 3631014 TI - Arterial access in the newborn. PMID- 3631013 TI - Agent A. Genetics and litogens. PMID- 3631015 TI - Experience with percutaneous indwelling peripheral arterial catheterization in neonates. AB - We present an experience with indwelling peripheral arterial catheters in preterm and term neonates. During a 12-month interval, 158 peripheral arterial lines were inserted in 115 infants. Eighty-eight infants required a single line while 27 infants required more than one line. Ninety-one catheters (57.6%) were electively removed, and 67 (42.4%) had to be discontinued prematurely. Vessels used included 110 radial arteries (69.6%), 27 posterior tibial arteries (17.1%), and 21 temporal arteries (13.3%). There were only two major complications (1.27%), both related to infections. The technique is described in detail. In our experience, with appropriate precaution, peripheral arterial cannulation has been a safe and reliable alternative to umbilical arterial catheterization. PMID- 3631016 TI - Cerebral infarction in persistent pulmonary hypertension of the newborn. AB - Persistent pulmonary hypertension of the newborn and its attendant hypoxemia may place the infant at high risk for hypoxic-ischemic injury. In 19 infants with persistent pulmonary hypertension of the newborn, 16 of whom suffered intrapartum asphyxia, we evaluated a series of electroencephalograms (EEGs) for evidence of major focal cerebral injury, ie, persistent voltage attenuation and/or focal electrical-seizure activity. Of the 15 infants (78.9%) with such EEG findings, nine infants (47% of the total population) had cerebral infarction documented by cranial sonograms, computed tomographic scans, or autopsy findings. In eight (89%) of the nine infants with infarction, electrical seizures were noted during periods of muscle paralysis. We recommend (1) the use of electroencephalography in this population, particularly during periods of muscle paralysis, to detect underlying cerebrovascular lesions and (2) the use of cranial computed tomography if persistent, focal EEG abnormalities are noted. PMID- 3631017 TI - Phenytoin-induced IgA depression. AB - In a survey of 1011 pediatric patients with seizure disorders, 93 children (9.2%) were found to have depressed serum IgA concentrations when compared with age matched controls; 27 of these values were less than 0.1 g/L (less than 10 mg/dL). Two thirds (64/93) of these patients were being treated with phenytoin, and ten had been previously treated with phenytoin. No relationship between IgA deficiency and serum phenytoin concentration nor use of other anticonvulsant medications was found. The prevalence of phenytoin-induced IgA depression was similar in patients with "primary" or "secondary" seizure disorders. Approximately 40% of the patients with low serum IgA concentrations had mild to moderate depression of serum IgG and/or IgM concentrations when compared with age matched controls. PMID- 3631018 TI - Lack of association of cleft uvula with otitis media in Apache Indian children. AB - Cleft uvula occurs in approximately 20% of Athabaskan Indians. The association of cleft uvula with otitis media was examined in a cohort of 175 Apache Indian children followed up prospectively from birth. No association was found between the occurrence of cleft uvula and the rate, frequency, or timing of otitis media attacks. PMID- 3631019 TI - A computer primer for pediatricians. PMID- 3631020 TI - Serum testosterone response to training in adolescent runners. PMID- 3631021 TI - Can pediatrics meet the challenge of social ill health? AB - The American Academy of Pediatrics mission statement equates physical, mental, and social health--indeed a major challenge for the profession. This article outlines the magnitude and evolution of physical, mental, and social problems presented to pediatricians during this century. Included are manifestations, and some causes, of social ill health; the response of research and education to the problems; and future steps needed if the challenge is to be met. The unanswered and disturbing question presents itself: Can, or should, pediatrics seriously attempt to meet the challenge of social ill health? PMID- 3631022 TI - Telephone assessment of parents' knowledge of home-care treatments and readmission outcomes for high-risk infants and toddlers. AB - Medical technology is enabling many high-risk infants and toddlers to be cared for at home. However, techniques for evaluation of home-care and discharge planning outcomes have not been well documented. Using 60 subjects, we performed telephone assessment of home-care givers' knowledge base in basic knowledge of treatment, operation and maintenance of supplies and equipment, and vendor information, using standard questions, 48 hours following discharge from the hospital. Families giving apnea monitoring or Broviac catheter care as a single treatment scored 100% in all three areas. However, the scores for care givers providing gastrostomy care (54%, 100%, and 91%), tracheostomy care (80%, 70%, and 50%), or total parenteral nutrition (88%, 50%, and 100%) as single treatments were lower. Care givers providing multiple home-care treatments had the lowest scores (65%, 65%, and 76%). However, care givers of patients who were subsequently readmitted scored well (80%, 85%, and 85%), and none of the readmissions were due to a failure of home-care management. Telephone assessment 48 hours after discharge can be used to document home-care and discharge-planning outcomes for high-risk infants and toddlers. PMID- 3631023 TI - Pediatric hypertension. A challenge for pediatricians. AB - The efforts of physicians involved in the early detection and treatment of hypertension in children and adolescents will be greatly enhanced with the recent publication of the National Heart, Lung, and Blood Institute's Task Force on Blood Pressure Control in Children. Although little is known regarding the relationship of hypertension in childhood and later cardiovascular morbidity and mortality, such preventive efforts toward controlling hypertension should not be delayed. In addition, the availability of distribution curves in children based on repeated observations, and using phase V of Korotkoff sound for the diastolic blood pressures, would be particularly helpful during the transition period from childhood to adolescence. Prospective studies in children in areas of relatively stable population and from the different parts of the world will promote our understanding of pediatric hypertension. PMID- 3631024 TI - Autosomal recessive inheritance in the Setleis bitemporal 'forceps marks' syndrome. AB - We present the clinical findings in two children with the Setleis bitemporal "forceps marks" syndrome. The striking features include the following: (1) bitemporal scarring, an anomaly that resembles forceps marks; (2) periorbital puffiness with wrinkling of the skin; (3) abnormalities of the eyebrows; (4) anomalies of the eyelashes; (5) flattening of the nasal bridge with a bulbous nasal tip; (6) increased mobility of the skin, associated with severely redundant facial soft tissue; and (7) normal growth and development. The evidence that suggests that this unusual syndrome is inherited in an autosomal recessive fashion includes the following: (1) seven of the patients have come from the relatively isolated towns of San Sebastian and Aguadilla in Puerto Rico; (2) two sets of affected siblings have been described, and, in both cases, the siblings' parents were normal; and (3) one of the children described herein is the product of a consanguineous mating. Although the pathogenetic mechanism is unknown, Setleis syndrome is clearly inherited as an autosomal recessive trait. PMID- 3631025 TI - Radiological case of the month. Subarachnoid malposition of femoral vein catheter. PMID- 3631026 TI - The response of black mothers to the birth of an albino infant. AB - The nature of the response of 37 black mothers to their albino infants, in comparison with matched controls, was investigated longitudinally by means of interviews and observations. Mothers were found initially to be depressed and unhappy, uncomfortable with close contact with their infants, and reluctant to hold and breast-feed them. When observed in interaction with the infants, the mothers showed fewer behaviors in comparison with the controls. Three months later the mothers appeared to be interacting normally with their infants, but they expressed feelings of unhappiness that persisted until the infants reached 9 months of age. The birth of an albino infant seems to cause a delay in maternal attachment and a sadness similar to that described in connection with the birth of an infant with other congenital disorders. PMID- 3631027 TI - Pulmonary aspiration studied by radionuclide milk scanning and barium swallow roentgenography. AB - We have examined the use of radionuclide milk scanning to detect aspiration and have compared the clinical features of patients with demonstrated aspiration with those of patients in whom aspiration was not demonstrated. One hundred twenty children underwent radionuclide milk scanning for three different clinical indications, namely, respiratory tract symptoms (n = 56), gastroesophageal (GO) reflux (n = 20), and near-miss sudden infant death syndrome (SIDS) (n = 44). Ninety-eight (82%) of the 120 patients had a GO reflux demonstrated on the radionuclide milk scan. The incidence of aspiration was high in the respiratory (23%) and near-miss SIDS groups (20%) but low in the GO reflux group (5%). Only four of the 19 patients with an aspiration-positive scan had an aspiration positive barium swallow film. The clinical symptoms and signs of those patients with aspiration-positive results were not significantly different from those of patients in whom aspiration was not demonstrated. We conclude that radionuclide milk scanning is more sensitive than barium swallow roentgenography in detecting aspiration; however, the clinical significance of such aspiration is undetermined. In view of the high incidence of GO reflux demonstrated in the absence of aspiration by the use of radionuclide milk scanning, the sole finding of GO reflux in a child with respiratory tract symptoms should not be taken as presumptive evidence that aspiration is contributing to those symptoms. PMID- 3631028 TI - Comparison of esophageal manometric characteristics in asymptomatic subjects and symptomatic patients with high-amplitude esophageal peristaltic contractions. AB - The aim of this study was to examine systematically the manometric characteristics of symptomatic patients with high-amplitude peristaltic esophageal contractions, or the nutcracker esophagus (n = 20), in comparison to normal subjects (n = 30). In both normals and patients, amplitude and duration of contractions were more at 5 cm than at 10 cm above the lower esophageal sphincter. The patients differed significantly from normals not only in amplitude at 5 cm, but also at 10 cm and in duration at both sites. Bipeaked waves were seen more frequently in patients than in normals at either 5 or 10 cm above the sphincter. Two patients, but none of the normal subjects, had triple-peaked waves. Lower esophageal sphincter pressure was significantly elevated in patients as compared to normals. Although percent relaxation of the sphincter was the same in patients and normals, the postrelaxation residual, or nadir, sphincter pressure was higher in patients. We conclude that patients with high-amplitude peristaltic contractions may also have abnormalities in duration of contractions, percent bipeaked waves, triple-peaked waves, or in parameters of the lower esophageal sphincter. PMID- 3631030 TI - Development of a new insertion technique in push-type enteroscopy. AB - A new insertion method of push-type enteroscopy was reported. We used a new scope (SIF-10L) and a stiffening tube. By introducing the stiffening tube beyond the duodenojejunal junction, the extent of insertion was remarkably advanced. PMID- 3631029 TI - Effects of acute administration of a prostaglandin E2 analog, trimoprostil, on esophageal motility in man. AB - The effect of trimoprostil, and oral trimethyldesoxy prostaglandin E2 analog with antisecretory and cytoprotective activity, on esophageal motility was evaluated in a double-blind, three-way crossover study. Using antisecretory and cytoprotective single oral doses, 0.75 and 1.5 mg of trimprostil was compared with placebo in 12 healthy male volunteers. Motility parameters measured included lower esophageal sphincter pressure, amplitude, velocity, and duration of esophageal contractions. Unlike most previously reported prostaglandin E2 infusion studies, our study demonstrated that oral trimoprostil at low or high doses, when compared with placebo, had no effect on lower esophageal sphincter pressure or distal esophageal peristaltic amplitude in response to wet swallows. Therefore, oral administration of methylated prostaglandin E2 analogs would not be expected to contribute to esophageal reflux. PMID- 3631031 TI - Incidence of idiopathic ulcerative colitis in Jewish population subgroups in the Beer Sheva region of Israel. AB - The epidemiology and clinical features of idiopathic ulcerative colitis in different Jewish population groups in the Beer Sheva district of Israel were studied retrospectively over the period 1961-85. The average annual age-adjusted incidence rate increased (p less than 0.05) in all population groups during this period. The incidence rate in the total population in 1981-85 was 5.8 per 10(5) population per yr. In European and American born subjects the incidence rate was twice as high as in Asian and African born and Israeli born subjects. The mean age of onset of ulcerative colitis was significantly lower in Israeli born persons (26.8 yr) than in the other population groups; when the total population was stratified by age, this difference was shown to be caused by the relative youthfulness of the Israeli born subpopulation. Despite these striking epidemiological differences, clinical features were similar in the three population groups. PMID- 3631033 TI - Diuretic-associated pancreatitis: a collective review and illustrative cases. AB - Three patients are presented as illustrative examples of severe necrotizing pancreatitis associated with diuretic therapy. The presumed initiating factor was use of a benzothiadiazine (chlorothiazide, hydrochlorothiazide) or phthalimidine (chlorthalidone) diuretic to control hypertension, after the exclusion of other etiologies. We present these illustrative cases and a collective review, emphasizing that pancreatitis associated with these widely prescribed medications can be fatal and may be more common that previously thought. PMID- 3631034 TI - Medical education and gastrointestinal fellowship training: maintaining stability during socioeconomic turmoil. PMID- 3631032 TI - Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire. AB - Ninety-eight (40%) of 243 acquired immune deficiency syndrome inpatients at Mama Yemo Hospital, Kinshasa, Zaire, presented with a history of diarrhea for at least 1 month. To determine the predictive value of persistent diarrhea for human immune deficiency virus (HIV) infection, 128 consecutive patients presenting at Mama Yemo Hospital with persistent diarrhea were tested for the presence of HIV antibodies. One-hundred seven (84%) of the 128 patients with diarrhea lasting at least 1 month were found to be HIV seropositive. HIV seropositive patients with persistent diarrhea more often had a generalized papular pruritic eruption (p = 0.02), a genital herpes simplex infection (p = 0.05), a history of herpes zoster (p = 0.08), and infection with cryptosporidia (p = 0.006) than HIV seronegative patients with persistent diarrhea. Bacterial enteric pathogens were found in 5 (7%) of the 76 seropositive and in none of the 14 seronegative patients in whom stool cultures were performed. Presently persistent diarrhea in adults in central Africa is strongly associated with HIV infection, but the pathophysiological mechanisms causing this diarrhea remain unclear. PMID- 3631035 TI - The use of plasmapheresis in patients with liver disease. PMID- 3631036 TI - Distribution, molecular forms, and bioactivity of immunoreactive gastrin in a patient with metastatic gastrinoma. AB - A patient with metastatic gastrinoma whose plasma gastrin ranged from 7.6 nmol X ml-1 at presentation to 18.9 nmol X ml-1 just before death 4 yr later has been studied. The presence of such high circulating levels facilitated study of the biological and immunological activities as well as the molecular forms of gastrin in plasma, ascitic fluid, urine and cerebrospinal fluid. The results indicate: 1) the 34 amino acid gastrin (G34) was the only molecular form detectable in the body fluids studied; 2) bioactivity of G34 is maintained despite passage across the renal endothelium and the blood brain barrier; 3) the blood brain barrier significantly limits diffusion of G34. PMID- 3631037 TI - Hepatic tissue in gastroscopic biopsy: evidence of hepatic penetration by peptic ulcer. AB - We describe a patient with peptic ulcer of the stomach penetrating into the liver, in whom diagnosis was made by histological examination of the gastroscopic biopsy. The liver tissue affected by this local "peptic hepatitis" displayed marked inflammatory and regeneratory atypia that could raise suspicion of an adenocarcinoma. The possibility of finding liver cells and tissue (or pancreatic and splenic tissues) in the gastric biopsy and brushing/washing material should be kept in mind in cases of large peptic ulcers. PMID- 3631038 TI - Primary gastrointestinal Kaposi's sarcoma in a patient with acquired immune deficiency syndrome. AB - Gastrointestinal involvement by Kaposi's sarcoma in patients with cutaneous or lymph node involvement is common. Since the advent of the acquired immune deficiency syndrome in 1981, primary gastrointestinal involvement, i.e., without skin or lymph node involvement, has not been adequately documented. We describe a patient with acquired immune deficiency syndrome and primary gastrointestinal involvement by Kaposi's sarcoma. PMID- 3631039 TI - Superior mesenteric artery syndrome after resection of an arteriovenous malformation in the cervical cord. AB - Any disease process decreasing the angle between the superior mesenteric artery and the abdominal aorta can result in the external compression of the duodenum and subsequent intestinal obstruction. This unusual type of intestinal obstruction known as superior mesenteric artery syndrome is a well-recognized clinical entity. It is diagnosed radiologically by an abrupt, vertical cutoff of barium flow in the third portion of the duodenum. The management is primarily medical but occasionally surgical correction is required. Herein, the diagnosis of superior mesenteric artery syndrome was made in an incomplete quadriplegic woman who had recently undergone surgical resection of an arteriovenous malformation in the cervical cord. This case was managed successfully with gastrointestinal decompression, proper positioning in the side-lying position, and adequate nutrition. PMID- 3631040 TI - Spontaneous closure of an end biliary fistula. AB - Most biliary cutaneous fistulas are side fistulas that communicate with the main biliary ductal system. As long as distal obstruction is not present, nearly all fistulas will close spontaneously. The present case of an end biliary fistula due to transection of an aberrant bile duct during cholecystectomy and its successful nonoperative management demonstrate that end fistulas can sometimes be managed without operative intervention. PMID- 3631041 TI - Isolation of Vibrio fluvialis, and unusual pathogen in acute suppurative cholangitis. AB - We report a case of acute suppurative cholangitis, from which were isolated Enterobacter aerogenes and Vibrio fluvialis. There have been no previous reports of the isolation of V. fluvialis in this disease. It is usually found in seawater and various seafoods and may cause acute diarrhea, but this is the first report in which it has been associated with acute suppurative cholangitis. PMID- 3631042 TI - Incidentally discovered carcinoma of the pancreas: a potentially indolent lesion. AB - As examples of unusually indolent behavior of pancreatic carcinoma, two cases are discussed in which the diagnosis was made serendipitously, without symptoms referable to the pancreas. In both cases dystrophic calcification was noted, and pleomorphic giant cells were aspirated from the tumor. In one case, the patient survived 2 yr after diagnosis, dying from unrelated causes. Findings from ultrasound, computed tomography, and magnetic resonance imaging are discussed. Incidental discovery of a pancreatic carcinoma does not preclude a protracted asymptomatic course. PMID- 3631043 TI - Cecal volvulus: decompression and detorsion with a colonoscopically placed drainage tube. AB - Cecal volvulus is an uncommon cause of intestinal obstruction. Operative management is the accepted form of treatment. We report a patient with cecal volvulus who was a poor surgical risk and was successfully treated by decompression and detorsion with the use of a decompression tube inserted through the colonoscope. PMID- 3631044 TI - Pruritus in diseases with cholestasis: pruritogen and serum bile acids. PMID- 3631045 TI - The use of antimuscarinic drugs in upper gastrointestinal tract endoscopy. PMID- 3631046 TI - Protection by low-titer anti-HBs against HBe antigen-positive blood transfusion. PMID- 3631047 TI - Gastric epithelioid leiomyosarcoma. PMID- 3631048 TI - The effect of genetic susceptibility on causal inference in epidemiologic studies. PMID- 3631049 TI - Cancer in a group at risk of acquired immunodeficiency syndrome (AIDS) through 1984. AB - Using a proportional morbidity analysis method, the authors examined changes in the risk of malignancy among never-married men 20-49 years old (a surrogate population for homosexual men) in a high AIDS-risk area (City of San Francisco) and other lower AIDS-risk areas. This approach easily detected increases in Kaposi's sarcoma (odds ratio (OR) comparing 1973-1978 to 1984: 2,479-fold, proportional increase = 99.9%) and in non-Hodgkin's lymphomas (OR = 4.2-fold in 1984, p for trend less than 0.0001, proportional increase = 70%) in the City of San Francisco, with excesses especially in the Burkitt-like lymphomas and immunoblastic lymphomas. Extranodal lymphomas of the brain, but not other sites, were especially prominent (proportional increase = 96%). In addition, nonsignificant increases were seen for Hodgkin's disease (p for trend = 0.13) and for hepatoma (p for trend = 0.08). A posteriori, the authors noted increases in urinary tract tumors and acute lymphoblastic leukemia which warrant monitoring. Other tumors suggested to be AIDS-associated did not occur excessively in this population. Among single young men outside of San Francisco, Kaposi's sarcoma also increased significantly (OR = 182 in 1984), suggesting a lag of about three years behind the increases in the City of San Francisco. Some tumors may require a longer latent period before an association becomes manifest. In the meantime, however, these data indicate that the increases in AIDS-related cancers are limited to only a few malignancies. PMID- 3631050 TI - Detection of hepatitis B virus DNA in asymptomatic hepatitis B surface antigen carriers: relation to sexual transmission. AB - The authors tested, by molecular hybridization, for hepatitis B virus DNA in serum specimens of 182 asymptomatic hepatitis B surface antigen (HBsAg) Greek carriers who were heterosexual partners of patients with acute hepatitis B (group A: 96 cases) or healthy subjects who were susceptible to hepatitis B (group B: 86 cases). The mean age (34.1 +/- 10.4 vs. 33.9 +/- 8.4 years) and the mean duration of sexual contact (6.9 +/- 8.9 vs. 7.2 +/- 6.3 years) were similar in the two groups of carriers. Hepatitis B virus DNA was detected significantly more frequently in group A than in group B (59.4% vs. 11.6%, p less than 0.001). In particular, in group A, hepatitis B virus DNA was detected in 96.9% of hepatitis B e antigen (HBeAg)-positive and 41% of antibody to HBeAg (anti-HBe)-positive carriers. In contrast, in group B, hepatitis B virus DNA was identified in only 10.8% of anti-HBe-positive carriers (p less than 0.001). These differences were especially significant in the young and middle-aged carriers (16-49 years old) and during the first four years of sexual contact. These data suggest that 1) there is a positive correlation between the presence of hepatitis B virus DNA in serum and the epidemiologic evidence of sexual transmission of hepatitis B virus, 2) hepatitis B virus DNA is a better indicator of infectivity than HBeAg/anti HBe, and 3) the detection of hepatitis B virus DNA in serum probably identified carriers with high infectivity and potentially higher risk of transmitting hepatitis B virus to their sexual partners. PMID- 3631051 TI - The role of contraceptive use in cervical cancer: the Maryland Cervical Cancer Case-Control Study. AB - Recent evidence on the importance of sexual history and sexually transmissible agents in cervical cancer has been reported. Case-control studies have frequently demonstrated increased risk of cervical cancer for women using oral contraceptives, while laboratory results have shown that vaginal spermicides inactivate various sexually transmissible agents. To determine the role of contraceptive use in cervical cancer, 153 cases of Maryland women with invasive cervical cancer and age, race, and residence-matched controls were interviewed in 1985, focusing on sexual history, health care utilization patterns, screening history, contraceptive use, and smoking. Overall, lifetime use of contraceptives was protective of cervical cancer (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.2-0.7). Use of oral contraceptives (OR = 0.48), diaphragm (OR = 0.29), and vaginal spermicides (OR = 0.28) were more frequent in controls than cases. After adjustment for behavioral factors (age at first intercourse, smoking, gaps in Papanicolaou smear testing, and obstetrician-gynecologist visits), use of vaginal spermicides remained significant (OR = 0.30), although use of oral contraceptives and barrier methods of contraception failed to remain significant. The effectiveness of vaginal spermicides in preventing cervical cancer may be due to their antiviral action. PMID- 3631052 TI - Childhood nervous system tumors--an evaluation of the association with paternal occupational exposure to hydrocarbons. AB - Paternal occupational exposures to hydrocarbons have been associated with childhood nervous system cancer, but study results have not been consistent. This population-based case-control study was designed to examine this association using a large sample size to increase the precision of risk estimates. The birth certificates of 499 children who died in Texas from intracranial and spinal cord tumors were compared with 998 control certificates randomly selected from all Texas live births. Information on parental job title and industry at the time of birth was obtained from the birth certificates. No significant associations were identified for the dichotomized variable of all hydrocarbon-related occupations combined, as variously defined in previous studies, or for most of the specific jobs affiliated with exposures to hydrocarbons. Significant, relatively stable odds ratios (OR) were found for printers and graphics arts workers (OR = 4.5; 95% confidence interval (CI) = 1.4-14.7) and chemical and petroleum workers with high exposure levels (OR = 3.0; CI = 1.1-8.5). A discussion of the biases involved in this type of study design is presented. PMID- 3631053 TI - Lipoproteins as mediators for the effects of alcohol consumption and cigarette smoking on cardiovascular mortality: results form the Lipid Research Clinics Follow-up Study. AB - Because alcohol consumption is associated with increased high density lipoprotein (HDL) cholesterol and decreased low density lipoprotein (LDL) cholesterol, and cigarette smoking is associated with lower HDL cholesterol and higher LDL cholesterol, there has been speculation that the protective effect of moderate alcohol consumption and/or the noxious effect of cigarette smoking for cardiovascular disease might be mediated in large part by a lipoprotein mechanism. The authors examined this question in a prospective study of 7,461 men and women in 10 North American populations initially seen in 1972-1976 and followed for an average of 8.5 years. Moderate alcohol consumption was weakly protective for cardiovascular disease, while cigarette smoking was strongly and significantly associated with cardiovascular disease mortality. As expected, LDL cholesterol was positively related and HDL cholesterol was inversely related to cardiovascular disease mortality. However, multivariable analysis of cardiovascular disease mortality alternately excluding and including HDL cholesterol and LDL cholesterol as covariates indicated that the effect of alcohol consumption on cardiovascular disease mortality was independent of an LDL cholesterol pathway and only partially mediated by an HDL cholesterol pathway, while the effect of cigarette smoking was independent of both the HDL cholesterol and LDL cholesterol pathways, suggesting alternative biologic mechanisms of action for both alcohol consumption and cigarette smoking on cardiovascular disease. PMID- 3631054 TI - Ischemic heart disease risk factors in middle-aged Seventh-day Adventist men and their neighbors. AB - Seventh-day Adventists in California have much lower mortality from ischemic heart disease than do other Californians, but the risk factors have not been well documented previously for a representative sample. This study, conducted in 1982, chose a random sample of 160 Californian non-Hispanic white middle-aged Adventist men, 160 of their similar-aged male neighbors, and documented traditional ischemic heart disease risk factors. Results show major dietary differences between the two groups as expected, this being reflected in significant differences in consumption of total fat, saturated fat, dietary cholesterol, and crude fiber. Questionnaire data suggested that the Adventists also exercised 50% more, rarely smoked, but had identical Framingham Type A/B scores. There were no differences in obesity or blood pressure levels, but serum total cholesterol was significantly lower in the Adventists (190.1 vs. 203.5 mg/dl, p less than 0.001), as was low density lipoprotein cholesterol (125 vs. 134.0 mg/dl, p less than 0.03) and high density lipoprotein (HDL) cholesterol (42.3 vs. 46.0 mg/dl, p less than 0.005). Consequently, the ratio of total cholesterol/HDL cholesterol was virtually identical between the two groups. Possible explanations for some of these findings are discussed. PMID- 3631055 TI - The relation of urinary cations to blood pressure in boys aged seven to eight years. AB - A study on the relation between urinary cations and blood pressure was conducted in Wuhan, China. A total of 148 boys aged 7-8 years entered the study from November 23, 1984, to January 13, 1985. Seven consecutive 24-hour urine specimens were collected and blood pressure was measured on the seven successive days corresponding to urine collection. The multiple regression showed that none of the sodium, potassium, calcium, and magnesium cations was statistically significantly related to blood pressure. However, the ratio of sodium/calcium or potassium/calcium in the urine was positively correlated with systolic pressure in multivariate analysis. The results suggest that there may be a complex interaction between sodium and calcium in their effects on blood pressure, and genetic background might have some influences on the sodium/calcium (or potassium/calcium)-blood pressure relation in the 7-8-year-old boys in the study. PMID- 3631057 TI - Factors associated with glucose tolerance in adults in the United States. AB - Glucose tolerance data from the second National Health and Nutrition Examination Survey were analyzed to determine factors predicting fasting plasma glucose levels and glucose tolerance in a representative US population. Central adiposity (subscapular skinfolds), age, and family history of diabetes were the major predictors of fasting levels and of glucose tolerance. For women, having a diabetic mother was significantly related to fasting glucose and glucose tolerance, but for men the proportion of siblings with diabetes was positively related. Multiple regression analyses, after adjustment for age and subscapular skinfolds, identified white cell count, systolic blood pressure, natural logarithm total iron binding capacity, and family history variables as being significant predictors of glucose tolerance in both sexes. In addition, several other variables were predictive for men or women, but not for both. These data confirm the importance of the major predictors of glucose tolerance and suggest provocative new associations in the general population. PMID- 3631056 TI - Socioeconomic status, John Henryism, and hypertension in blacks and whites. AB - The joint influence of socioeconomic status and John Henryism on risk for elevated blood pressure was examined in a biracial, community sample of 820 adults, aged 21-50 years, who resided in Edgecombe County, North Carolina, and were interviewed in 1983. John Henryism refers to a strong personality predisposition to cope actively with psychosocial environmental stressors. In keeping with an earlier finding for black men, it was hypothesized that the inverse association between socioeconomic status and blood pressure would be stronger for persons who scored high on John Henryism than for persons who scored low. Using race-specific definitions of socioeconomic status, the study found support for the hypothesis among blacks. At low levels of John Henryism, socioeconomic status differences in hypertension prevalence were small (1.6%), whereas at high levels of John Henryism, low socioeconomic status blacks were nearly three times as likely to be hypertensive as higher status blacks (31.4% vs. 11.5%, p = 0.02 for the socioeconomic status X John Henryism interaction term). The findings for systolic and diastolic blood pressures were in a similar direction but did not reach statistical significance. The study hypothesis was not supported among whites. Analyses of the correlates of John Henryism as well as the blood pressure findings are discussed in terms of the different socioeconomic circumstances that characterize the lives of blacks and whites in this rural, southern community. PMID- 3631058 TI - Risk factors for urinary tract infection. AB - The authors carried out a case-control study in 1982-1983 to investigate the possible influence of behavioral factors on the risk of urinary tract infection. Study participants were college women attending a student health service. Cases were 43 women with culture-confirmed urinary tract infection. There were two control groups: 149 women with upper respiratory infection and 227 women visiting the gynecology clinic. Using each set of controls, the study confirmed that sexual intercourse is a risk factor and that there is a dose-response effect for increasing levels of coital frequency. The study also found that use of the diaphragm was significantly associated with urinary tract infection (odds ratios 3.0, 2.3), an association which remained significant even after controlling for possible confounding by coital frequency. The findings did not show an association with many of the factors commonly believed to be important such as type of clothing worn and volume of fluids consumed. PMID- 3631059 TI - Misclassification of nutrient intake of individuals and groups using one-, two-, three-, and seven-day food records. AB - In this study, 6,844 food records were collected during three years (1979-1982) from 106 volunteer Wisconsin women, aged 35-65 years. Subjects recorded all intake of food, and vitamin/mineral supplements on a structured, precoded form. One-, two-, three-, and seven-day records were compared with usual intake of calcium, kilocalories, vitamin A, and vitamin C. Usual intake was calculated using 37-72 food records per subject. Estimates of group means from a small number of records were not significantly different from mean usual intake (p greater than 0.05). Correlations with usual intake ranged from 0.43-0.64 and from 0.71-0.90 for the one day and the seven-day estimates, respectively. For the one day record, 43-67% of subjects were correctly classified to the extreme quintiles of intake, 52-76% for the seven-day record. Classification was least good for vitamin A, better for other nutrients with lower intraindividual variance. However, overall agreement with usual classification of assignment to quintiles even with the seven-day record was less than 55% for all four nutrients. Effects at extremes of intake might be more easily analyzed than dose-response relations. PMID- 3631060 TI - Social network ties and mortality among the elderly in the Alameda County Study. AB - Seventeen-year mortality data from the Alameda County Study are used to examine the relative importance of social ties as predictors of survival at different ages, ranging from 38-94 years at baseline. Previous analyses of Alameda County data by Berkman and Syme (Am J Epidemiol 1979;109:186-204) have shown that such ties are significant predictors of lower nine-year mortality risk for persons aged less than 70 years at baseline. Proportional hazard analyses indicate that social ties are also significant predictors of lower 17-year mortality risks for those aged 70 and older after adjusting for age, sex, race, baseline health status, perceived health, depression, and health practices (relative hazard = 1.49 for Berkman-Syme Social Network Index; 95% confidence interval (CI) = 1.09 2.05). Comparisons of the relative importance of four types of social ties reveal an interesting shift across the age groups. Marital status assumes primary importance for those aged less than 60 years at baseline (relative hazard = 1.6 and 1.4 for those aged 38-49 and 50-59, respectively; 95% CI = 1.12-2.29 and 1.02 1.91, respectively). However, ties with close friends and/or relatives assume greater importance for those aged 60 and older (relative hazard = 1.17 comparing those reporting five or more contacts per month to the more socially isolated who report less than five such contacts per month; 95% CI = 0.98-1.89). PMID- 3631061 TI - Time series designs of potential interest to epidemiologists. AB - Recent developments in time-series designs that may be useful in epidemiology are described. The hypothesis that increased employment affects the rate of accidental injuries per worker month among manufacturing workers is tested to demonstrate the methods. Results suggest that increased employment increased the monthly rate of accidental injuries in San Diego and Los Angeles Counties in the 11-year period 1974 through 1984. PMID- 3631062 TI - A possible mechanism of increased sodium influx in red cells with abnormal membrane lipid levels induced by phospholipase A2. AB - Membrane transport--sodium (Na+) influx and calcium (Ca2+) uptake--was examined in human mature red cells treated with phospholipase A2 (PLase A2) from snake venom. PLase A2-induced conversion of phosphatidyl choline (PC) to lysophosphatidyl choline (L-PC) was associated with a marked increase in Na+ influx and Ca2+ uptake. After L-PC was removed from the cell membrane of the PLase A2-treated red cells in the presence of albumin, an additional increase in Ca2+ transport was observed. These results indicate that membrane lipid abnormalities, such as increased L-PC and/or a loss of total lipids, appear to induce increased membrane transport. PMID- 3631063 TI - Cyclosporin A for the treatment of aplastic anemia refractory to antithymocyte globulin. AB - Antithymocyte globulin (ATG) is an established form of therapy for severe aplastic anemia (SAA). However, in patients who do not respond to this treatment and who are not candidates for bone marrow transplantation few successful therapeutic alternatives exist. We report two such patients who have shown a therapeutic response to Cyclosporin A (CSA) (Sandimmune, Sandoz). Case 1, a 15 year old male, and Case 2, a 34 year old female, were diagnosed as having SAA in September 1984 and May 1984 respectively. Treatment with high dose Methylprednisolone (MPN) and ATG in Case 1 and MPN, ATG and Oxymetholone in Case 2 for ten days was ineffective in both cases. Case 1 developed anaphylaxis with both repeat ATG and ALG (antilymphoblast globulin), and Case 2 failed to respond to repeat ATG. Both required frequent packed cells and platelet transfusions. At five and six months respectively following completion of ATG therapy, CSA was started at 10 mg/kg/day in divided doses orally. Renal and liver functions and CSA blood levels were followed. Within six weeks both patients exhibited a hematologic response and were no longer transfusion dependent. On maintenance therapy of 4 mg/kg/day (Case 1) and four months after discontinuing CSA (Case 2) the hematologic values are as follows: hemoglobin 160 and 130 g/L, absolute granulocyte count 3100 and 1640 X 10(9)/L, and platelets 132 and 84 X 10(9)/L respectively. Side effects included hypertrichosis, gingival hyperplasia and mild reversible nephrotoxicity. CSA appears to represent an effective form of therapy for patients with SAA refractory to ATG. PMID- 3631064 TI - Modified end-point glycerol hemolysis assay as a screening test for hereditary spherocytosis that requires no venipuncture. AB - The high specificity of the "pink test" for the detection of hereditary spherocytosis has been confirmed. A modification of the test is proposed that requires only 10 microliter of blood taken without anticoagulant (a "direct pink test"), thus eliminating the necessity of venipuncture, especially cumbersome in newborns and infants. PMID- 3631065 TI - Systemic necrotizing vasculitis in sickle cell disease. AB - A patient with sickle cell disease and systemic necrotizing vasculitis is reported. Although there are a number of immune defects in patients with sickle cell disorders, this association has not been previously reported. We suspect that immunologic disorders frequently are unrecognized in these patients because the symptoms are attributed to complications of sickle cell disease. PMID- 3631066 TI - Osteonecrosis in a patient with immune thrombocytopenic purpura. AB - We report a case of osteonecrosis in a 26-year-old woman treated with prednisone for immune thrombocytopenic purpura. The unusual complication occurred after a much shorter course of steroids of a considerably smaller cumulative dose than in previously reported cases. PMID- 3631067 TI - Clinical aspects of glomerular diseases. AB - This article discusses the current concepts of the pathophysiology of disturbed glomerular structure and/or function that lead to the cardinal clinical manifestations of glomerular disease, ie, alterations in glomerular filtration rate, disturbances in sodium homeostasis, proteinuria, and hematuria. The functional and anatomic bases of these alterations include changes in filtering surface area, filtration pressure and/or nephron mass, primary and secondary renal sodium and water retention, defects in size and/or charge-selective barriers to filtration of plasma proteins, and defects in capillary wall integrity. Longitudinal evaluation of albuminuria/gamma globulinuria and the investigation of dysmorphic hematuria may be helpful approaches to the study of glomerular disease. PMID- 3631068 TI - Histologic features that correlate with the prognosis of patients with lupus nephritis. AB - This study stresses the significance of accurate assessment of renal biopsy material in patients with lupus nephritis in order to determine prognosis. The size of the biopsy sample is important because of the focal nature of the disease. The number of glomeruli that must be present to judge the extent of focal involvement was computed. The correct categorization of a patient's disease is essential to avoid "stage migration." Class III lupus nephritis (focal, segmental) should be divided into mild, moderate, and severe. The amount of prednisone administered was calculated, and it was found that the severity of the renal lesion was of greater prognostic significance than the choice of treatment given. While a classification that includes consideration of chronicity appears useful, this study indicates that the amount of acute inflammatory change in the glomeruli is also an important prognostic indicator. PMID- 3631069 TI - The glomerular basement membrane abnormality in Alport's syndrome. AB - The characteristic electron microscopic abnormality in Alport's syndrome is thickening of the glomerular basement membrane with splitting and lamellation of the lamina densa. It is commonly accompanied by severe attenuation of the basement membrane and sometimes by disruption of capillary walls. The ultrastructural abnormality is secondary to a more basic defect in the chemical structure of the glomerular basement membrane. Clues to chemical abnormalities have come from immunochemical studies, which suggest a lack of or alteration in that part of the noncollagenous portion of type 4 collagen related to Goodpasture antigen. Variability in the results of immunochemical studies suggest biochemical heterogeneity that still needs to be correlated with the known evidence of genetic heterogeneity in Alport's syndrome. PMID- 3631070 TI - Factors affecting urine volume in chronic renal failure. AB - Twenty-four-hour urine volume was studied in 80 determinations from 12 patients with chronic renal failure (creatinine clearances between 7.1 and 38.9 L/d) hospitalized on a metabolic ward. Urine volume ranged from 0.91 to 4.51 L/d. Various components of urine that might affect urine output, ie, osmolar excretion, sodium excretion, urea nitrogen excretion, free water clearance, and potassium excretion, were correlated with urine volume to determine their relative effects. Total osmolar excretion correlated highly with urine output (r = .92, P less than .001), while correlation with free water clearance was weak. Of the three osmotic components, total urea nitrogen excretion correlated best with urine volume (r = .86, P less than .001), while the correlation with sodium excretion was less pronounced (r = .75, P less than .001). The relatively greater impact of urea excretion on urine volume was confirmed by multiple regression analysis. However, total cation excretion (sodium plus potassium) gave nearly as good a regression with urine volume (r = .83, P less than .001). Our findings confirm that total osmolar excretion is a major determinant of urine volume in chronic renal failure and suggest that urea excretion may play the most important role in determining output. PMID- 3631071 TI - Clinical significance of renal biopsies showing mixed mesangial and global proliferative lupus nephritis. AB - Renal biopsies of 70 children with systemic lupus erythematosus were categorized, according to the World Health Organization classification, as normal (five, 7%), mesangial (23, 33%), focal segmental proliferative (11, 16%), diffuse global proliferative (20, 29%) (ie, greater than or equal to 80% of glomeruli showing mesangioendothelial cell proliferation and/or deposition of immune complexes along the subendothelial margin of glomerular capillaries), and membranous (six, 8%) lupus nephritis (LN). In addition, five (7%) biopsies showed global proliferative LN in less than 80% of glomeruli and mesangial LN in the others. We assessed the renal status of these five patients at the time of renal biopsy and at outcome following prednisone treatment, with or without azathioprine. Four patients improved and later had either a normal urinalysis or only trace proteinuria. A low chronicity index was calculated on the biopsies of these patients. The fifth patient, whose condition did not improve, demonstrated a high chronicity index on renal biopsy. Overall, the renal status at outcome in the patients showing mixed mesangial and global proliferative LN more closely resembled that of patients with mesangial than diffuse global proliferative LN. PMID- 3631072 TI - Long-term survivors on peritoneal dialysis. AB - To obtain information about predialysis characteristics and long-term outcome of patients on peritoneal dialysis (PD) for more than 4 years, we reviewed all patients starting PD who performed continuous ambulatory peritoneal dialysis (CAPD) and were at risk for more than 4 years. Sixty-two patients started; 42% were diabetic and 35% over age 60. Three recovered renal function, seven received transplants, and 12 switched to hemodialysis. Nineteen survived more than 4 years (long-term survivors, LTS), eight diabetic and 12 male. Twenty-one died on CAPD in less than 4 years (short-term survivors, STS). In comparison to STS, LTS were younger, with less prior cardiac disease, yet had higher predialysis serum creatinine values and lower hematocrits. LTS were observed for a mean of 65.3 +/- 3 months (48 to 91 months), and STS for a mean of 21 +/- 2 months. When compared to STS, LTS had fewer hospital days, hospital days for peritonitis, and a lower peritonitis rate, although the incidence of Staphylococcus aureus peritonitis was greater in LTS. Cardiovascular and thromboembolic events were less frequent in LTS, but bone fractures were seen more often in the LTS diabetic patients. Weight gain, especially in males, and hernias were noted in both groups. BP improved, and vision was maintained in both groups. Non-PD-related infections causing hospitalization were low in both groups. Improved mean hematocrit and hemoglobin A, values were seen only in LTS. Mean serum cholesterol values increased with time in LTS. This study reveals that potentially high-risk patients such as diabetics and the elderly can have prolonged survival on PD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631073 TI - Severe lactic acidosis as a presenting feature of pheochromocytoma. AB - High plasma concentrations of epinephrine and norepinephrine have the potential for generating substantial hyperlactatemia by virtue of their metabolic and vasoconstrictor effects; both these influences affect lactate metabolism in the direction of overproduction and underutilization. Nonetheless, lactic acidosis is not a recognized presenting feature of pheochromocytoma. In this report, we describe a patient with pheochromocytoma in whom the endogenous outpouring of epinephrine and norepinephrine resulted in severe lactic acidosis that featured prominently in the clinical presentation. Pheochromocytoma should be listed among the clinical entities associated with or predisposing to lactic acidosis. PMID- 3631074 TI - Analysis of genetic interrelationship among HLA-associated diseases. AB - We have developed a method to study the genetic relationship between any two HLA associated diseases. We have considered the following hypotheses: (1) both diseases are caused by a common allele; (2) different alleles at the same locus predispose to the two diseases; (3) one disease is predisposed by two alleles, one of which can also lead to the second disease; and (4) different HLA-linked loci are involved in the etiology of each disease. For each hypothesis, we have derived the expected HLA haplotype-sharing distribution in sib pairs who are affected with two diseases. The comparison of the expectations indicate that, in many cases, the alternate hypotheses can be distinguished, if the sample size is appropriately large. The knowledge of the mode of inheritance of each disease is not usually necessary; however, it can greatly increase the power of the test. Analyses of data on pairwise combinations of rheumatoid arthritis (RA), autoimmune thyroid disease (ATD), and insulin-dependent (type I) diabetes mellitus (IDDM) suggest that (a) IDDM is predisposed by two HLA-linked alleles, one of which also predisposes to ATD, (b) one of the IDDM alleles also confers susceptibility to RA, and (c) although the HLA-linked susceptibilities to RA and ATD appear to be primarily due to distinct alleles, the ATD allele may also have a minor role in predisposition to RA. PMID- 3631075 TI - Characterization of human centromeric regions of specific chromosomes by means of alphoid DNA sequences. AB - The alphoid DNA family is composed of tandemly repeated sequences whose organization is chromosome specific. Under stringent conditions of hybridization, subsets of these sequences localize specifically to the centromeric region of a given chromosome. The alphoid clone, 308 (D6Z1), is a 3-kb BamHI DNA fragment that is repeated at the centromere of chromosome 6. Sequences homologous to 308 are organized as 2-kb BamHI repeats on X. We used 308 to screen a 2-kb BamHI genomic library and obtained the cloned homologue, XC, which hybridizes, in situ, to the centromere of X. These probes provide a means of analyzing the centromeric region on two different human chromosomes. The complete nucleotide sequence of 308 shows that it is composed of 20 variant 173-bp repeats. The organization of the 173-bp monomers is not a repetitious but a symmetric pattern, and an inversion is present. The chromosome specificity of 308 to chromosome 6 is determined by the entire 3-kb sequence and not by an amplified 173-bp monomer, because the divergence among the 173-bp units on chromosome 6 is as great as that between monomers on chromosomes 6 and X. Therefore, the organization of monomers is specific for a chromosome, and the monomers themselves are not specific. Analysis of the sequence data from these two alphoid sequences and other published sequences shows that some chromosomes have sequences that are more homologous than others. These subsets of alphoid sequences reflect the latters' chromosomal distribution and evolution. By using probes 308 and XC, we found that alphoid repeats from specific chromosomes are similar in that there is no evidence for their transcription in lymphoblasts and fibroblasts, and we demonstrated the possibility that all of these sequences are late replicating. PMID- 3631077 TI - Genetic studies of low-abundance human plasma proteins. V. Evidence for a second orosomucoid structural locus (ORM2) expressed in plasma. AB - Orosomucoid (ORM) or alpha-1-acid glycoprotein is an acute-phase protein of human plasma whose function is suggested to be the competitive inhibition of cellular recognition by infective agents. Genetically determined variation in ORM has been reported, with two major alleles segregating in all populations studied to date. Isoelectric focusing-immunoblotting studies of ORM revealed the presence of isoprotein species that did not segregate with the predominant alleles at the ORM locus and suggested the expression of a second structural gene locus for orosomucoid (ORM2). Genetically independent variation consistent with expression of the ORM2 locus was observed in plasma samples from American blacks but was not observed in U.S. whites or sampled populations of North- and South-American Indians, Eskimos, Aleuts, or New Guinea Highlanders. The population allele frequencies for this locus were .958, .025, .006, and .011 for alleles ORM*1, ORM2*2, ORM2*3, and ORM2*4, respectively. Family studies confirm the autosomal codominant inheritance of the observed phenotypes. PMID- 3631076 TI - Structural analysis of normal and mutant insulin receptors in fibroblasts cultured from families with leprechaunism. AB - Leprechaunism is an inherited disorder characterized by insulin resistance and intrauterine growth restriction. In this study we analyze insulin binding and subunit structure of the insulin receptor in dermal fibroblasts cultured from three unrelated families whose probands (Ark-1, Atl, and Minn) were affected by leprechaunism. Cells cultured from all three probands had markedly reduced insulin binding at equilibrium. Fibroblasts cultured from the parents of Ark-1 and Atl had partial and differing degrees of impairment in insulin binding. The structure of the alpha subunit of insulin receptors was analyzed by cross-linking 125I-insulin to plasma membranes. A major band of 350 kilodaltons (kD) (corresponding to the heterotetrameric insulin receptor alpha 2 beta 2) was observed in control and leprechaun fibroblasts. The relative amount of radioactivity cross-linked to plasma membranes reflected the genetic variations seen in insulin binding to intact cells. In reducing gels, 125I-insulin was cross linked equally to a 250-kD (alpha-alpha dimer) and a 125-kD (alpha monomer) protein in cells from controls, the parents of Ark-1 and Atl, and probands Atl and Minn. By contrast, cells from the Ark-1 proband had diminished cross-linking of alpha-alpha dimers. The ratio of dimer to monomer in cells from controls was 0.93 +/- 0.06, and that in cells from Ark-1 was 0.31 +/- 0.19 (P less than .01). Beta-subunit structure and function was analyzed by studying insulin-enhanced autophosphorylation. Although maximal stimulation of beta-subunit phosphorylation was reduced to 30% in proband Ark-1 fibroblasts, this reduction was quantitatively related to reduced insulin binding. These results indicate that mutations causing severe insulin resistance and defective insulin binding are transmitted with autosomal recessive patterns of inheritance and that heterogeneity exists for these mutations. The mutation in pedigree Ark-1 most likely produces conformational changes in alpha-subunit interaction. PMID- 3631078 TI - Glycosaminoglycan-free small proteoglycan core protein is secreted by fibroblasts from a patient with a syndrome resembling progeroid. AB - A male patient, 4 years 9 mo old and having progeroidal appearance, exhibited delayed mental development and multiple abnormalities of connective tissues including growth failure, osteopenia of all and dysplasia of some bones, defective deciduous teeth, loose but elastic skin, delayed wound healing with formation of thin atrophic scars, scanty scalp hair, hypotonic muscles, and hypermobile joints. Skin fibroblasts of the patient converted only about half of the core protein of the small proteodermatan sulfate to a mature glycosaminoglycan chain-bearing proteoglycan. The remaining core protein, which contained complex-type asparagine-bound oligosaccharides, was secreted with almost normal kinetics. Xylosyltransferase activity and the synthesis of other proteoglycan types were normal. Normal induction of glycosaminoglycan synthesis occurred in the presence of 1 mM, but there was very little induction in the presence of 0.01 mM p-nitrophenyl-beta-xyloside. An antibody against an N terminal pentadecapeptide of the core protein recognized the glycosaminoglycan free core protein from the patient less well than the chain-bearing protein treated with chondroitin ABC lyase. Though these results do not define the basic defect unambiguously, they provide the first report of a disorder being due to an abnormality in small proteoglycan biosynthesis. PMID- 3631079 TI - Mortality in achondroplasia. AB - Standardized mortality ratios (SMRs) were determined for a historical cohort of achondroplastic individuals identified through the Medical Genetics Clinics of the University of Texas Health Science Center at Houston and Johns Hopkins Hospital, Baltimore. Mortality was increased at all ages, with an overall SMR of 2.27 (95% confidence interval 1.7-3.0). Sudden death accounted for the excess deaths in those less than 4 years of age, and brain-stem compression was identified as the cause in half of these deaths. Central nervous system and respiratory causes were not significantly increased but accounted for half of the deaths in those 5-24 years of age. SMRs were not significantly increased for those greater than 34 years of age. However, deaths attributed to cardiovascular causes were increased in the 25-54-year-old age group, accounting for 10 of 17 deaths. The overall cardiovascular SMR was 5.2 (95% confidence interval 2.5-9.6). Within this group, severe disability resulting from marked spinal canal stenosis was present in a majority of individuals and may have been a contributing factor in these deaths. This study suggests that the bony abnormalities associated with achondroplasia--i.e., foramen magnum and spinal canal stenosis--may have a significant effect on mortality at all ages but particularly in children. Efforts to minimize these complications are recommended. PMID- 3631080 TI - Does the karyotype of a spontaneous abortion predict the karyotype of a subsequent abortion? Evidence from 273 women with two karyotyped spontaneous abortions. AB - At least two spontaneous abortions were karyotyped in 273 women during cytogenetic surveys in New York City and Honolulu. These pairs were analyzed using maximum-likelihood logistic-regression analysis to adjust for maternal age and location. There was a significantly increased risk for a chromosomally normal spontaneous abortion after a previous abortion with a normal karyotype. There was no increased risk for trisomy in a second spontaneous abortion following either a previous trisomic abortion or an abortion with another abnormal karyotype. This is unexpected, given the increased risk for trisomy found among live births and at prenatal diagnosis in young women with a previous trisomic birth. The most likely explanation is that the increased recurrence risk for trisomy is restricted to trisomy for only one or a few chromosomes, for reasons such as parental trisomy mosaicism. These data predict no increased risk of chromosome abnormality in future pregnancies after either (1) spontaneous abortions with trisomies of a kind that are always lethal in utero or (2) multiple early abortions in the presence of normal parental karyotypes. PMID- 3631081 TI - The effect of age on the frequency of sperm chromosomal abnormalities in normal men. AB - It has been suggested that advanced paternal age (independent of maternal age) is associated with an increased incidence of trisomy. However, studies of human liveborn offspring and of data from prenatal diagnosis have yielded conflicting results. To investigate this possible paternal age effect, we have studied sperm chromosome complements from 30 normal men of proven fertility stratified by age, with five males in each of six age categories (20-24, 25-29, 30-34, 35-39, 40-44, and 45+ years). Sperm chromosome complements were visualized after penetration of golden-hamster oocytes. A minimum of 30 complements were analyzed for each male. The analysis was performed blindly, without knowledge of the donor's age. The mean frequency of sperm chromosomal abnormalities in the individual men was 10.4% with means of 4.7% for numerical abnormalities and 6.2% for structural abnormalities. There was no relationship between age and the frequency of numerical abnormalities in sperm. Since there was a significant difference between the frequency of hyperhaploid and hypohaploid complements, these two types of numerical abnormalities were analyzed separately. There was no correlation between the frequency of hypohaploid complements and age. There was a significant negative correlation between age and the frequency of hyperhaploid complements. For structural abnormalities, there was a highly significant positive correlation with age. Thus, our results do not support the hypothesis of an increased risk of trisomy with paternal age. PMID- 3631082 TI - Clinical performance of a system for semiautomated chromosome analysis. AB - Until recently equipment for automated chromosome analysis has not been used for routine purposes in clinical cytogenetic laboratories. During a 3 1/2-year period the chromosome laboratory of Rigshospitalet has tested the Magiscan chromosome system under routine conditions and performed the first evaluation of its clinical performance. The system consists of an image processor with a light pen for manual interaction connected to a hard-copy printer and a microscope with a TV camera and a motorized scanning stage for eight slides. Automated metaphase finding takes place without operator assistance. An operator is involved in the analysis after the metaphases are located. Using two of these complete systems, we have performed a total of 4,691 chromosome analyses comprising a count of 10 metaphases, of which three were "eyeball" karyotyped and one was "machine" karyotyped. Presently, two-thirds of our prenatal analyses (amniotic-cell cultures) are carried out with these two machines. A third Magiscan system without scanning stage is used as a "karyotyping-only" system to produce hard copy karyograms in those cases in which metaphases are manually located and counted in the microscope. Since the end of 1984, 4,773 additional machine karyograms have been produced with this system. With a complete system, a prenatal analysis can be carried out in an average of 35 min. The average time for a machine karyotype is 7 min. Since 1984 the productivity of the laboratory has increased 17%-20% without enlarging the staff. PMID- 3631084 TI - Program and abstracts: the American Society of Human Genetics. 38th annual meeting. San Diego, California, October 7-10, 1987. PMID- 3631083 TI - Thymidine kinase activity in individuals with galactokinase deficiency. PMID- 3631085 TI - Exposure time for microwave thawing of admixtures. PMID- 3631086 TI - Incompatibility between chlorpromazine and metacresol. PMID- 3631087 TI - Technical personnel in pharmacy. PMID- 3631088 TI - Group purchasing: an overview. AB - The various types and operational methods of purchasing groups are described, and evaluation of groups is discussed. Since group purchasing is increasing in popularity as a method of controlling drug costs, community and hospital pharmacy managers may need to evaluate various groups to determine the appropriateness of their services. Groups are categorized as independent, system based, or alliance or association based. Instead of "purchasing," some groups develop contracts for hospitals, which then purchase directly from the vendor. Aside from this basic difference between groups that purchase and groups that contract, comparisons among groups are difficult because of the wide variation in sizes and services. Competition developing from diversification among groups has led to "super groups," formed from local and regional groups. In evaluating groups, advantages and disadvantages germane to accomplishing the member's objectives must be considered. To ensure a group's success, members must be committed and support the group's philosophies; hospital pharmacists must help to establish a strong formulary system. To select vendors, groups should develop formal qualification and selection criteria and should not base a decision solely on price. The method of solicitation (bidding or negotiating), as well as the role of the prime vendor, should be studied. Legal implications of group purchasing, especially in the areas of administrative fees and drug diversion, must also be considered. The most advantageous group for each organization will include members with common missions and will be able to implement strategies for future success. PMID- 3631089 TI - Technicians and the future of pharmacy. AB - Ways in which pharmacists and pharmacy technicians can grow professionally to fulfill pharmacy's fundamental responsibility for appropriate drug use in patients are described. From the 1985 "Hilton Head Conference" on directions for clinical practice in pharmacy, the idea grew that pharmacists' traditional functions should be melded with a clinical orientation to provide pharmacy's maximum contribution to patient care. When the focus shifts from discrete activities of individual pharmacists to overall responsibilities of the department, each pharmacist and technician can see his or her contribution to the clinical endeavor; technicians assigned with a pharmacist to a specific group of patients are likely to take a more active interest in their jobs. Instead of ratios, patient outcome and job satisfaction should be the determinants of staffing patterns. Delineation of roles as judgmental or nonjudgmental should be replaced by clear job descriptions and procedures and an understanding of the complementary roles of pharmacists and technicians. Important elements in technician training include seminars presented by professional staff members and planned jointly by pharmacists and technicians, departmentwide seminars, policies that encourage technicians to join and participate in professional organizations, and liberal tuition-reimbursement policies. For career advancement, the pharmacy organizational structure might contain three levels: technician trainee, technician, and technician specialist. Pharmacists and technicians can overcome barriers between them by realizing the enormous growth potential and value of the services that both provide. PMID- 3631090 TI - Functional and structural prerequisites for clinical pharmacy services. AB - Pharmacy directors and pharmacists in charge of clinical services at 46 medium sized hospitals were surveyed to identify possible explanations for previously documented inconsistency in the implementation of clinical pharmaceutical services. There were three study objectives: to determine the extent to which basic structural and functional management prerequisites have been implemented at these institutions; to determine whether a relationship exists between the kind and number of clinical services offered and implementation of these prerequisites; and to identify discrepancies between responses of the pharmacy director and the pharmacist in charge of clinical services at the same hospital to the same questions. One hundred hospitals providing clinical pharmaceutical services were randomly selected from a master list of 190 hospitals that had been grouped into nine geographic areas. Of 17 functional and structural prerequisites studied, 4 to 13 of them had been implemented at the hospitals surveyed. Only 24% of the hospitals had implemented the basic functional prerequisites of unit dose drug distribution and decentralized pharmaceutical services. Of nine clinical pharmaceutical services, one to eight were being delivered. A weak correlation between the number of prerequisites implemented and the number of clinical services provided was found. Significant disagreement was found between the directors and their pharmacists about which prerequisites and clinical services were being implemented. This pilot study suggests that pharmacy directors and clinical pharmacists need to assess how effectively basic management prerequisites are being put into practice in the delivery of clinical pharmaceutical services. PMID- 3631091 TI - Qualifications for future hospital pharmacy directors as perceived by pharmacy directors and hospital administrators in Wisconsin. AB - Hospital pharmacy directors and administrators in Wisconsin were surveyed to determine their perceptions of the responsibilities, skills, postgraduate education, training, and experience necessary for hospital pharmacy directors during the next 10 years. Packages containing two identical questionnaires were mailed in April 1985 to the pharmacy directors at all 159 hospitals in Wisconsin. The pharmacy director and his or her immediate supervisor were asked to use a 5 point Likert-type scale to rate the importance of various responsibilities and skills and also to rank the most important responsibilities, skills, and issues. In addition, respondents answered forced-choice questions about postgraduate education and training and an open-ended question about academic coursework. All responses were compared by respondent characteristics and hospital size. There was a response rate of 48.1% to the questionnaire, representing 60.7% of the pharmacy directors (n = 96) and 34.6% of the administrators (n = 55). Both groups agreed on which responsibilities and issues will be very important (mean importance rating of greater than 4) for future pharmacy directors. However, administrators rated clinical and technical skills as significantly more important than did pharmacy directors. Only 48% of pharmacy directors believed that a residency is essential and preferred either a general or administrative residency coupled with an advanced degree, whereas more than 50% of the responding administrators favored residencies not affiliated with a degree program. The majority of pharmacy directors and administrators believed that both general staff and administrative experience is necessary for future pharmacy directors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631092 TI - Shadowing program to increase student awareness of hospital pharmacy practice. AB - A shadowing program designed to acquaint second-year pharmacy students with the professional responsibilities of a hospital pharmacist is described. The program developed by the Toledo Area Society of Hospital Pharmacists allowed second-year pharmacy students to "shadow" a staff pharmacist for three to four hours. The program required the cooperation of area hospital pharmacists to develop rotations at each site. Eight hospitals provided shadow rotations for 87 students during the program's first offering. Reactions were positive from both students and pharmacists. Direct pharmacist-student interaction, low cost, and flexibility were important factors in the program's success. The shadowing program has proven to be an effective method of introducing hospital pharmacy career options to prepharmacy students. PMID- 3631093 TI - Pharmacy-based drug education program for critical-care nurses. PMID- 3631094 TI - "Ask your pharmacist" consumer phone-in program in North Carolina. PMID- 3631095 TI - Estimating shelf-life of drugs in solution. AB - The use of pseudo-first-order chemical reaction kinetics and Arrhenius thermodynamic principles in estimating the effect of temperature on shelf-life of drug solutions is described. The degradation of many drugs in aqueous solutions occurs by hydrolysis. Equations using activation energy of the hydrolysis reaction (Ea) derived from Arrhenius principles, rate constants, and temperature are used to illustrate the exponential decrease in drug shelf-life proportional to an arithmetic increase in temperature. Use of the Q value, a factor based on Ea, rate constants, and temperature change, is described. The range of Ea for pharmaceutically important degradation reactions is relatively limited; thus, near room temperature, Q values of 2-5 can be used to estimate the effect of temperature change on shelf-lives of drugs in solution. To conservatively estimate effect on shelf-life when Ea is not known, a Q value of 2 is used to predict the increase in shelf-life obtained by decreasing storage temperature, and a Q of 5 is used to predict decrease in shelf-life from increasing the temperature. Sample calculations are used to show the application of equations based on these principles to practical temperature-dependent problems regarding shelf-life. Given information about shelf-life at a certain temperature, pharmacists can estimate safe shelf-life under other temperature conditions by using these equations. PMID- 3631096 TI - Advertising in the American Journal of Hospital Pharmacy. PMID- 3631097 TI - Emerging alternative delivery systems for pharmaceuticals. PMID- 3631098 TI - Alternative packaging needed for injectable drugs. PMID- 3631100 TI - Content uniformity more important than dissolution in hand-filled capsules. PMID- 3631099 TI - Hospital cost crisis, antimicrobial agents, and democracy. PMID- 3631101 TI - Antiarrhythmic versus antidysrhythmic: antiarrhythmic is preferable. PMID- 3631102 TI - Pharmacy directors need vision, not advanced clinical training. PMID- 3631103 TI - Effective communication with health professionals needed. PMID- 3631104 TI - Inaccurate perceptions (of pharmacy practice) PMID- 3631105 TI - Harvey A.K. Whitney lecture. Intimations on a profession: retrospect and prospect. AB - The evolution and development of institutional pharmacy and its pathfinders are discussed, and future directions for the profession are suggested. From the Bulletin of the American Society of Hospital Pharmacists to the American Journal of Hospital Pharmacy, hospital pharmacy literature has helped the profession evolve by providing specialized information while continuing to meet practitioners' changing needs over time. Editorials help to establish unity of purpose among members by encouraging consensus development. Other publications and programs of ASHP extend its mission into institutions nationwide. To achieve unity of purpose, the profession relies on the formal organization (ASHP and its chapters) for providing order and the informal organization (meetings) for exchanging information and providing motivation. Pharmacy "trains its own" via residency programs, whose prototypes, nonacademic internships, were designed by pathfinder preceptors like Harvey A. K. Whitney. These programs have ensured continuity in improving practice standards and a source of skilled professionals. Women have been leaders in the history and development of hospital pharmacy. The sound economic management of the Society has led to accelerated developments for institutional pharmacy. In the future, ASHP should seek to become more involved in public policy issues concerning health care in general; develop a written set of ethical standards to guide institutional practitioners; and prepare an updated history of ASHP and the hospital pharmacy movement, including an interpretation of events, or a cultural perspective. ASHP has established a strong foundation for hospital pharmacy as envisioned by the early pathfinders; young pharmacists are the pathfinders for future progress. PMID- 3631106 TI - Group purchasing: evaluating groups. AB - Factors that should be considered when a pharmaceutical group purchasing program is being evaluated are discussed and presented in checklist format. The ability to purchase at maximum effectiveness is critical in today's healthcare environment. There are a number of group purchasing programs in which pharmacists participate, and this business is in a state of flux. Cost savings is the most obvious factor to determine in evaluating a program, but group purchasing is a service business and there are numerous additional considerations. A list of questions that may be used as a checklist for rating one group purchasing program against another is provided. Pharmacy departments should consider the type of group purchasing program, its interactions with suppliers, services offered, input of participants, and costs when evaluating pharmaceutical group purchasing programs. PMID- 3631107 TI - Pharmacy preferred-provider organizations. AB - The structure, features, and evolution of pharmacy preferred-provider organizations (PPOs) are described. Pharmacy PPOs may be sponsored by insurers, employers, providers, or independents (wherein the PPO functions as a third-party administrator); insurer and provider sponsorship are the most common. The advantages and disadvantages of these four types of sponsorship are described. Ways that pharmacy PPOs contain costs include the following: using drug product selection formularies (wherein providers are paid at prospective prices for generic products, regardless of the product dispensed or prescribed), reducing drug use by employing use-review mechanisms, and eliminating fraud and abuse through audits. Another cost-management feature being planned is the use of prescribing protocols. PPOs benefit pharmacies by increasing patronage and traffic flow, protecting market share, and improving cash flow by expediting payment of claims. Factors to consider in choosing a pharmacy PPO include the organization's market share, financial health, payment record, quality of claims processing, and long-term goals. As the pharmacy PPO industry matures, PPO financing will evolve from fee-for-service arrangements to moderate-risk contracting to full-risk contracting with plan buyers, using a negotiated amount per subscriber per month. Increasing competition and adoption of a credentialing process should result in more specific quality-of-care and performance standards for pharmacy PPOs. PMID- 3631108 TI - Effect of pharmacist counseling on ambulatory patients' use of aerosolized bronchodilators. AB - Patients' use of a newly prescribed inhaler was evaluated on the basis of pulmonary function test (PFT) results and the number of steps of an 11-step inhaler sequence that were completed correctly. Adult male outpatients with mild to moderate chronic obstructive pulmonary disease were assigned to a counseled (n = 10) or noncounseled (n = 9) group. Patient characteristics were similar in both groups. The counseled group was instructed by a pharmacist on the correct use of the inhaler; the noncounseled group was not. Counseled patients had a significantly higher mean percentage change in forced expiratory volume in one second (FEV1) after inhaler use than did the noncounseled group. The mean number of steps missed was significantly greater for the noncounseled group, and there was a significant negative correlation between the number of steps missed and the percentage change in FEV1. Evaluation of the 11-step inhaler sequence identified three steps ("shake the inhaler," "use one puff at a time," and "shake between puffs") that correlated with PFT results and appeared to contribute to improved bronchodilation. Of the five patients who achieved adequate response, only four (all in the counseled group) performed these steps correctly. Instruction with demonstration and practice resulted in better patient understanding and performance of the correct steps for inhaler use, with improved bronchodilation as measured by PFTs. PMID- 3631109 TI - Retrospective evaluation of vancomycin use in a university hospital. PMID- 3631110 TI - Predictions in personal computing. PMID- 3631111 TI - Rethinking pharmaceutical industry relationships. PMID- 3631112 TI - Thrombolytic therapy in cardiovascular diseases. Current practices and future directions. Proceedings of a symposium. October 25, 1986, New Orleans, Louisiana. PMID- 3631113 TI - Objectives of thrombolytic therapy in acute myocardial infarction. AB - The objectives of thrombolytic therapy in acute myocardial infarction are to restore coronary artery patency, salvage myocardium, reduce infarct size, and facilitate coronary artery repair. Urokinase and streptokinase are the two most frequently used thrombolytic agents. Both dissolve thrombi by converting circulating plasminogen, an inert precursor, into plasmin. One possible advantage of urokinase and streptokinase over new clot-specific agents is that the former have systemic fibrinolytic effects. This reduces blood viscosity and prevents other thrombi from forming. Angiography is the most objective technique for assessing reestablished arterial patency, but being invasive, it present disadvantages. Noninvasive criteria for coronary reperfusion include lowering of elevated ST-segments, shifting creatine kinase isoenzyme MB curves, and the appearance of reperfusion arrhythmias. Techniques for assessing myocardial salvage include thallium uptake, assessment of wall motion and myocardial thickening, ejection fraction, and positron emission tomography to assess infarct size. The role and appropriate timing of coronary artery repair after thrombolytic therapy are being studied. PMID- 3631114 TI - Coronary thrombolysis with intravenous urokinase in patients with acute myocardial infarction. AB - Regional left ventricular wall motion, about two to three weeks after acute myocardial infarction (MI), is perhaps the best clinical measure of myocardial salvage and limitation of infarct size by thrombolytic therapy. Normal or only slightly depressed wall motion at the site of infarction indicates significant limitation of infarct size, whereas markedly abnormal wall motion indicates irreversible myocardial damage. Early studies found significant improvement in regional wall motion in only 40 percent of patients undergoing successful intracoronary thrombolytic therapy after the onset of symptoms of acute MI. Why only 40 percent of these reperfused patients demonstrated salvage of ischemic myocardium could not be answered at that time. Animal experiments show that the duration of coronary occlusion is an important factor in determining myocardial salvage after reperfusion. To study whether this time dependency also exists under clinical circumstances in patients with coronary artery disease, the relationship between regional wall motion (as an index of infarct size) and the time to thrombolytic therapy after the onset of symptoms (as an index of duration of coronary occlusion) was examined. After showing that such time dependency does indeed exist in patients with acute MI, the efficacy and safety of intravenous bolus injections of urokinase were then demonstrated. PMID- 3631115 TI - Thrombolytic agents: a clinician's perspective. AB - Clinicians and researchers often have different perspectives: Clinicians deal with patients as individuals; researchers deal with them as members of groups whose characteristics can be defined statistically. Clinicians should be cautious and skeptical about new therapies, therefore, because the applicability of group successful treatment to individual subjects is not always appropriate. In deciding whether to use the new thrombolytic therapy in acute myocardial infarction, clinicians should consider the factors that limit as well as those that support its use. As a clinician, I ultimately favor its use because intracoronary thrombosis is almost ubiquitous in acute infarction, and thrombolytic therapy addresses this basic problem. Fortunately, acute infarction is an evolutionary process, giving us time to take action. Since the extent of necrotic myocardium determines prognosis, and reperfusion can limit infarction size, salvaging myocardium should improve the outcome. Thrombolytic therapy can usually be administered quickly, easily, and safely. It requires minimal laboratory monitoring but careful clinical monitoring. Signs of successful therapy are easily recognized clinically, as are the signs of reocclusion if it occurs. The problem of the best treatment to follow thrombolytic therapy remains unsolved. But the thrombolytic component of overall management of a patient with acute myocardial infarction is worthwhile. PMID- 3631116 TI - Role of thrombolysis in peripheral arterial occlusion. AB - In an initial study, 85 patients with 93 thromboembolic occlusions of peripheral arteries or grafts were treated with urokinase by direct intra-arterial infusion. Urokinase was infused directly into the proximal portion of the clot at 4,000 IU/minute for two hours. Arteriography was then repeated. If a channel had been lysed in the proximal part of the clot, but the distal part remained occluded, the catheter was gently advanced into the still occluded portion of the clot and the infusion was resumed at 4,000 IU/minute until antegrade blood flow was reestablished. Then the catheter was repositioned to be proximal to all of the remaining clot. The urokinase dosage was reduced to 1,000 IU/minute and the infusion continued with reexaminations at eight-hour intervals. The infusion was continued until complete clot lysis was accomplished. A search for a flow limiting lesion on which to perform a percutaneous transluminal angioplasty was then performed. The lack of at least a 10 percent reduction in clot length after a 500,000-IU cumulative infusion dose of urokinase was an indication for termination of the regimen. Seventy-five percent of the 93 infusions resulted in complete clot lysis, even though in nine patients (10 percent) the infusion could not be completed. Eighty-one percent of the 84 completed infusions resulted in complete clot lysis, and the incidence of clinical improvement was 89 percent. The average duration of infusion was 18 hours. Major bleeding (requiring transfusion) occurred in only 4 percent of the patients. This regimen has now been applied to 150 occlusions, and the results are approximately the same. Review of our experience demonstrated that the ability to easily advance an angiographic guide wire through an occlusion has been the best predictor that a given clot would lyse irrespective of the clot's location or the duration of symptoms. Easy guide wire traversal appears to rule out the presence of either advanced changes of clot organization throughout the occlusion or a rare completely obstructing atherosclerotic lesion. A review of the published experience of 155 direct intra-thrombus infusions of 5,000 IU/hour of streptokinase demonstrated only a 45 percent incidence of complete clot lysis. Also, infusion times were quite prolonged (41 hours), and major bleeding complications were surprisingly common (13 percent). The results with urokinase thus indicate that it is preferable to streptokinase since it produces fewer complications and accomplishes more rapid recanalization and a higher incidence of total clot lysis. PMID- 3631117 TI - New trends and therapeutic options in the management of non-insulin-dependent diabetes mellitus. PMID- 3631118 TI - Evaluation of first-generation sulfonylureas and glipizide in non-insulin dependent diabetes mellitus. AB - The current study examines the impact of glipizide, a second-generation sulfonylurea, on diabetes control in patients in whom adequate control was not achieved while receiving treatment with first-generation agents. The interim results of this multicenter study are presented in which patients in whom euglycemia was not achieved based on fasting and two-hour postprandial plasma glucose criteria with first-generation sulfonylureas were given glipizide therapy for 24 weeks. Twenty-three percent of the patients who had only fair results with first-generation sulfonylureas (fasting plasma glucose level of more than 140 mg/dl, postprandial plasma glucose level of more than 175 mg/dl) had good to excellent results with glipizide therapy alone (fasting plasma glucose level of less than 140 mg/dl or less than 115 mg/dl, respectively). Overall, 15.4 percent of patients with fair to poor control using first-generation agents had good to excellent control using glipizide. At least a 25-mg/dl decrease in fasting plasma glucose and postprandial plasma glucose levels was also seen in 47 and 46 percent of patients given treatment with glipizide who had poor control (fasting plasma glucose level of more than 200 mg/dl, postprandial plasma glucose level of more than 235 mg/dl) with first-generation agents. Glipizide was extremely well tolerated, with no significant side effects. Preliminary data indicate that glipizide may provide a significant advantage in terms of safety and efficacy over first-generation agents. PMID- 3631119 TI - Bayesian and least-squares methods for vancomycin dosing. AB - The authors assessed the performance of a Bayesian and a least squares method for predicting individual pharmacokinetic parameters for vancomycin. For clearance, the best performance of both methods was an absolute error of approximately 5%. This level of accuracy required 4 serum vancomycin concentrations with the least squares method but could be achieved with a peak and trough concentration with the Bayesian method. For volume of distribution, the best performance occurred with 3 or 4 levels with both methods and amounted to an error of about 15%. In conclusion, both methods of estimating vancomycin pharmacokinetics perform comparably, but the Bayesian method appears to require fewer data. PMID- 3631120 TI - The effect of N,N'-p-phenylenedimaleimide (PMD) on deoxygenation-induced K loss in sickle erythrocytes. AB - A variety of thiol reactive agents have been found to have antisickling properties thought to be due to the ability of these drugs to bind to hemoglobin, resulting in increased hemoglobin-oxygen affinity. Because thiol reactive agents also influence K movements in red cells and deoxygenation leads to K loss and Na gain in sickle erythrocytes, the authors investigated the possibility that deoxygenation-induced K loss could be influenced by thiol agents, independent of an effect on hemoglobin-oxygen affinity. Experiments were performed with the thiol crosslinking agent N,N'-p-phenylenedimaleimide (PMD). The authors found that PMD inhibited deoxygenation-induced K loss in sickle erythrocytes. This effect was not due to sickling inhibition as PMD-treated cells gained Na with deoxygenation, nor could the effect be explained by monofunctional PMD binding to membrane sulfhydryl groups, as a monofunctional analogue of PMD was not able to retard deoxygenation-induced K loss. These findings support a role for membrane sulfhydryl groups in deoxygenation-induced K movements in sickle red cells and suggest that this K loss may be prevented by crosslinking of certain membrane sulfhydryl groups. PMID- 3631121 TI - Prolonged vancomycin-associated neutropenia in a chronic hemodialysis patient. AB - A chronic hemodialysis patient developed severe marrow granulocytic hypoplasia and peripheral blood neutropenia related to vancomycin therapy for an infected arteriovenous fistula. Neutropenia was prolonged and associated with sustained serum levels of vancomycin that persisted for more than 4 weeks following the last dose of vancomycin. No vancomycin-dependent leukoagglutinins were demonstrable in the patient's serum. Although a direct toxic effect on marrow granulocyte production seems likely, a vancomycin-dependent immune suppression of granulopoiesis cannot be ruled out. PMID- 3631122 TI - Haemophilus parainfluenzae vertebral osteomyelitis. AB - Haemophilus parainfluenzae is a normal inhabitant of the nose and oropharynx. The authors report a case of adult vertebral osteomyelitis due to this organism that occurred 3 months after nasal septoplasty. Successful therapy was accomplished by a combination of inpatient and outpatient therapy. PMID- 3631123 TI - Chronic Acinetobacter calcoaceticus var anitratus pneumonia. AB - Gram-negative bacteria most often affect the lung in an acute, suppurative process; however, these organisms may also produce chronic pneumonia. Acinetobacter calcoaceticus has not been reported previously as a cause of chronic pneumonia. We present a patient with fatal, chronic community-acquired Acinetobacter pneumonia with chest wall invasion at autopsy. PMID- 3631124 TI - Routine culturing for Legionella in the hospital environment may be a good idea: a three-hospital prospective study. AB - The source for nosocomial Legionnaires' disease is the water distribution system. However, the implications for legionella contamination in a hospital without known Legionnaires' disease is unclear. Therefore, culturing for Legionella pneumophila in the environment has not been routinely recommended. The authors conducted a prospective pneumonia study in three hospitals, none of which was known to have a major problem with endemic legionellosis. The water system of Hospital 1 was colonized with L. pneumophila, serogroup 1; Hospital 2 was colonized by L. pneumophila, serogroup 5 (which is rarely associated with disease); Hospital 3 was essentially free of L. pneumophila. Sputum culture on selective legionella media, direct fluorescent antibody testing, and serology were performed for all nosocomial pneumonias regardless of clinical impression. At the end of the study the incidence of nosocomial legionnaires' disease was found to be 9%, 0%, and 0% in Hospitals 1, 2, and found to be 9%, 0%, and 0% in Hospitals 1, 2, and 3, respectively. In Hospital 1, monoclonal antibody subtyping confirmed that the patient isolates were identical to the environmental isolates. The authors conclude that environmental culturing, despite the absence of known Legionnaires' disease, is useful. Positive cultures from the hospital water supply would mandate the introduction of legionella testing into the laboratory and stimulate physicians to consider Legionnaires' disease when encountering nosocomial pneumonias. PMID- 3631125 TI - Tetrasomy 9p caused by idic (9) (pter----q13----pter). AB - Cytogenetic investigation on a malformed male infant showed an extra chromosome similar to chromosome 9 in all metaphases studied. GTG, CBG, and G-11 staining suggested that the extra chromosome was an abnormal 9, permitting the identification of the chromosome constitution as 47,XY,+idic (9) (pter----q13--- pter). PMID- 3631126 TI - Congenital anomalies: mortality and morbidity, burden and classification. AB - This study has attempted to assess the burden imposed by congenital anomalies in terms of postnatal mortality and morbidity, which were in turn used to classify anomalies as severe and mild types. Factors studied were postnatal mortality through age 7 years and morbidity, as measured by neurologic and psychologic abnormalities, histories of major surgery, prolonged hospitalization, and chronic infections. The study was based on a prospective study of 52,332 liveborn singletons of the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke. In general, the highest degree of burden was observed in syndromes and sequences, followed by multiple and single major anomalies. The burden due to major abnormalities as measured by attributable risk ranged from 0.436 for prolonged hospitalization up to one year, to 0.010 for chronic infections in subjects 1-7 years of age. In terms of mortality, the total attributable risk was 0.164, and the mean potential years of life lost was 5,020 per 10,000 population, which is considerably greater than that reported in other studies. An index constructed from mortality, neurologic, psychologic, and surgical variables provides a reasonable and objective means for classifying anomalies into severe and mild types. PMID- 3631127 TI - Walker-Warburg syndrome with cleft lip and cleft palate in two sibs. AB - Two sibs are reported with Walker-Warburg syndrome including hydrocephalus, agyria, anterior chamber dysgenesis, and encephalocele. In addition, both had cleft lip and cleft palate and intrauterine growth retardation, findings not previously noted in this condition. PMID- 3631128 TI - Animal model: dysmorphogenesis and death in a chicken embryo model. AB - The chicken embryo is a useful animal model for investigating problems in developmental biology and teratology. Here we report data that further define the causes of 2 different patterns of malformation (one associated with amnion abnormalities, the other with isolated neural tube defects) and death induced by making a window in the shell and subshell membranes during the first day of incubation. The interpretation of these data suggests to us the following hypotheses. An early amnion deficit spectrum or syndrome (EADS) in chicken embryos is caused by a brief (less than 10 sec) perturbation that occurs during the windowing procedure. This perturbation results in an acute increase in mechanical tension to the developing embryo and support structures, dehydration localized to the area of the blastoderm, and/or increased friction between the blastoderm and overlying vitelline and shell membranes. Isolated neural tube defects (NTDs) are caused by a longer perturbation (greater than 3 hr) consisting of increased mechanical stress across the blastoderm. The mechanical stress is associated with the introduction of a new air space over the animal pole of the yolk during windowing. The new air space causes the shape of the yolk to change (ie, to be deformed), resulting in an increase in mechanical tension across the vitelline membrane and blastoderm. NTDs involving the head are associated with significant early embryonic mortality, whereas those involving the trunk are not. Death may also be caused by cardiovascular anomalies observed in EADS. It is concluded that disturbances in morphogenesis and death in this model are, therefore, the result of extrinsic forces (eg, mechanical stress, localized dehydration, or friction) acting on different tissue types at various critical times in development. Intensity and duration of these forces on the developing blastoderm are important variables. PMID- 3631129 TI - Phenotypic spectrum of 45,X/46,XY individuals. AB - We report on five patients with 45,X/46,XY mosaicism. In these subjects, as well as in 58 individuals from the literature with a similar chromosome constitution, we did not find a preponderance of 46,XY cells among patients showing ambiguous to abnormal male external genitalia when compared to those patients with slight or no virilization. However, the average frequency of 46,XY cells in blood in these mosaic individuals suggests that this sample includes mainly individuals whose mosaicism originated early in embryonic cell division. Those individuals whose mosaicism originated later are not significantly represented in this sample and would have higher frequencies of 46,XY cells. These individuals would be excluded from an intersex sample if they had well-virilized genitalia. This ascertainment bias suggests that the degree of virilization depends on the frequency of 46,XY cells. PMID- 3631130 TI - Frequency of carriers of chronic (type I) Gaucher disease in Ashkenazi Jews. AB - In this study we estimate the frequency of carriers of chronic (type I) Gaucher disease among Ashkenazi Jews by examining the glucocerebrosidase activity in leukocytes in a population of 635 blood donors (441 Ashkenazi) and 57 obligatory heterozygotes. Estimation using the defect in the enzyme glucocerebrosidase (beta glucosidase) in leukocytes is complicated by the existence of considerable overlap between enzyme activity in normals and in heterozygotes. The assay was carried out with a natural substrate labeled with 14C. Discriminant analysis was used to establish an optimal cutoff point between the obligatory heterozygotes and normal (non-Ashkenazi) subjects for the purpose of estimating frequency of carriers. Applied to the Ashkenazi group, the cutoff point identified 3.17% as heterozygotes. Corrected for errors in classification, the carrier rate was estimated as 4.67%. This figure is in good agreement with a carrier rate of 4% estimated from the number of known cases of clinical Gaucher disease ascertained in Israel. PMID- 3631131 TI - The use of measured genotype information in the analysis of quantitative phenotypes in man. II. The role of the apolipoprotein E polymorphism in determining levels, variability, and covariability of cholesterol, betalipoprotein, and triglycerides in a sample of unrelated individuals. AB - Recent advances in molecular biology provide measures of genotypes at loci involved in lipid metabolism. Genotypes for apolipoprotein E (apo E) and quantitative levels of total plasma cholesterol, betalipoprotein, and triglycerides were measured in a sample of 223 unrelated individuals from Nancy, France. The frequencies of the epsilon 2, epsilon 3, and epsilon 4 alleles are 0.13, 0.74, and 0.13, respectively, in this sample. Significant differences among apo E genotypes were detected for these lipoprotein phenotypes. The average effect of the epsilon 2 allele was to reduce total plasma cholesterol and betalipoprotein levels by 0.52 mmol/L and 0.98, respectively, while the epsilon 4 allele raised these levels by 0.26 mmol/L and 0.61, respectively. Apo E genotype specific correlations suggest that this locus also has an effect on the coordinated metabolism between cholesterol and triglycerides. We infer that approximately 17% of the genetic variability in total plasma cholesterol may be attributable to this apo E polymorphism. No other single locus has been identified with such a large contribution to cardiovascular disease risk factors in the general population. PMID- 3631132 TI - De novo X;Y translocation associated with imperforate anus and retinal pigmentary abnormalities. AB - Cytogenetically detectable translocations of Y chromosome material onto the distal short arm of an X chromosome are rare and result in a variable and poorly defined phenotype of short stature and short limbs occasionally associated with mental retardation. We report on a patient with a de novo 46,X,t(X;Y)(p22;q11) chromosome constitution who has additional features not previously described with this chromosome abnormality, including abnormal retinal pigmentation, imperforate anus, and hydronephrosis. Our patient extends the phenotype associated with X;Y translocations, raising new considerations for the clinical management and genetic counseling of such patients and their families. PMID- 3631134 TI - Delineation of the male phenotype in carniofrontonasal syndrome. AB - We are reporting on a 4-generation family in which 6 individuals had frontonasal dysplasia with variable extracranial abnormalities. All affected persons had hypertelorism, bifid or broad nose, and highly arched palate. Associated abnormalities included cleft lip and palate (1/6), webbed neck (2/6), Sprengel anomaly (2/6), pseudoarthrosis of the clavicle (2/6), pectus excavatum (3/6), narrow, sloping shoulders (3/6), diaphragmatic hernia (2/6), broad first toe (4/6), brachydactyly (3/6), fifth finger clinodactyly (5/6), longitudinal grooves of nails (5/6), shawl scrotum (2/3 males), first degree hypospadias (1/3), and mild mental retardation (1/6). Only one affected female had brachycephaly and right coronal synostosis. Four other affected relatives had varying degrees of facial asymmetry, but normal skull contour. No male to male transmission is observed, and both daughters of an affected male were affected. Based on the phenotype of the 3 affected females, craniofrontonasal syndrome (CFNS) is the likely diagnosis. However, there are 3 affected males in this kindred, and 2 of the 3 had significant anomalies. Affected males also had genital abnormalities and pectus deformity of the chest, not previously reported in this condition. Two of the 3 males have posterolateral diaphragmatic hernia. This family expands the phenotype of affected males. PMID- 3631133 TI - Segregation and linkage analyses of dopamine-beta-hydroxylase activity in a six generation pedigree. AB - Serum dopamine-beta-hydroxylase (DBH) levels and 30 polymorphic markers were determined on 178 individuals of the HGAR 29 family, ascertained through six probands who had clinical and electrocardiographic evidence of myocardial infarction. Individuals in this pedigree with a history of heart attack had significantly lower levels of DBH, but this difference was partly confounded with age differences. Pedigree segregation analysis showed evidence of a codominant gene for DBH segregating in the family. Linkage analysis between the putative DBH locus and 30 polymorphic marker loci, assuming a codominant model, yielded a largest lod score of 0.53, with ABO at 20% recombination. Adding this to the lod scores obtained by Elston et al [1979] and Goldin et al [1982], we obtain combined lod scores of 2.49 and 2.50 at 0.0 and 10% recombination respectively. PMID- 3631135 TI - New syndrome: mixed hearing loss, mental deficiency, growth retardation, short clubbed digits, and EEG abnormalities in monozygous female twins. PMID- 3631136 TI - Apparently new autosomal recessive syndrome of mental retardation, distal limb deficiencies, oral involvement, and possible renal defect. AB - This paper illustrates a syndrome of distal limb deficiency and oral defects in two sibs, a moderately mentally retarded man and his mildly retarded sister. Both have microretrognathia, microstomia, normal tongue, and symmetric severe limb deficiencies. This seems to be a previously undescribed syndrome. The nosology of the different orofacial syndromes associated with distal limb deficiencies is discussed. PMID- 3631137 TI - Urofacial (ochoa) syndrome. AB - Between 1965 and 1986 we saw 36 children with enuresis and urinary tract infection in association with "inversion" of facial expression when laughing. Urologic work-up of these patients disclosed characteristic findings of mild neuropathic bladder in all cases, with severe urinary tract damage in most of them. The clear association of distortion in facial expression and neuropathic bladder with resultant damage to the genitourinary tract should prompt urological evaluation of individuals with "inversion" of facial expression. About two thirds of the patients also had moderate to severe constipation. We suggest the term urofacial syndrome for this disorder. The occurrence of the disorder in multiple sibs, normal parents, increased parental consanguinity, and equal sex ratio indicate autosomal recessive inheritance. PMID- 3631138 TI - Genetic ascertainment with heterogeneous risk. AB - Analysis of the bias of ascertainment is reformulated to deal with more general patterns commonly encountered in practice. The goal is to provide a unifying theory that will both replace the traditional, rather piecemeal, treatment of the problem and free it from certain restrictive assumptions. A compact algebraic method is furnished for analyzing the properties of the distributions by means of the probability generating function (PGF). The scope of the generalization is illustrated by applying it to the various classical patterns of bias of ascertainment. It is extended to other patterns in which the conditions of ascertainment, though more plausible, are also logically more complicated. It also accommodates cases hitherto inadequately dealt with, such as where the segregation ratios are heterogeneous (for example because of age-dependence); and cases where the ascertainment function is of arbitrary form and denies us such valuable, but demanding, assumptions as independence. Not only is the result unifying, but it leads to usable results in specific application such as diseases that depend on age or birth order. While the commonest applications are in human genetics, there are many other issues (such as the use of batteries of tests) in which it is equally important. PMID- 3631139 TI - Waardenburg syndrome, Hirschsprung megacolon, and Marcus Gunn ptosis. AB - A patient with Waardenburg syndrome type II associated with Hirschsprung megacolon and Marcus Gunn ptosis is presented. It is suggested that these different anomalies are manifestations of the same neurocrestopathy. PMID- 3631140 TI - Duplication 7p in a family with t(7;11): association with anomalies of the anterior cranial base. AB - Duplication 7p has been observed in association with several balanced translocations. Of eight previously recorded cases, only one exhibited duplication of the entire short arm of chromosome 7. We report on a newborn infant with multiple congenital anomalies and an abnormal chromosome constitution: 46,XX,-11,+der(11),t(7;11) (p11.1;p15.5)mat. The proposita appeared to possess an isolated duplication of the entire short arm of 7. The patient died at age 4 days because of respiratory complications of meconium aspiration. Clinical and postmortem findings included craniocerebral asymmetry, craniosynostosis of a lambdoid suture, arhinencephaly, hypertelorism, anomalies of the ethmoidal portion of the cranial base, large anterior fontanelle, low set ears, ventricular septal defect (VSD), dysplastic tricuspid and pulmonic valves, hypoplastic genitalia, bilateral dislocated hips, and other minor limb malformations. PMID- 3631141 TI - Isolation of human Y chromosomal major repetitive sequences from a flow-sorted Y chromosomal library. AB - The human Y chromosome is highly heterochromatic and consists mainly of repetitive sequences, of which 3.4 kb HaeIII or EcoR1 fragments represent the most abundant species. From a flow-sorted human Y chromosomal library, we isolated 15 clones containing sequences highly homologous to this major repetitive sequence. Although the size of inserts varied from 0.7 to 3.8 kb, their hybridization patterns to human genomic DNA were indistinguishable from each other. These repetitive sequences unambiguously detected the presence of the Y chromosome in a male-female DNA mixture of which 5% was derived from male cells. Thus, these clones would be useful molecular tools to detect contaminating male cells in clinical materials. PMID- 3631143 TI - Comment on COVESDEM syndrome. PMID- 3631142 TI - Pterygium colli medianum and midline cervical cleft: midline anomalies in the sense of a developmental field defect. AB - We report on 2 patients (and review a third) with a vertical midline neck web which extends from the lower symphysis of the mandible to a variable extent down to the jugular notch. This uncommon congenital anomaly, previously reported primarily in the (plastic) surgery literature, is interpreted as the mildest form and most dorsal extension of anterior midline cleft defects which include the supraumbilical raphe and cleft sternum with or without congenital hemangiomata. By analogy with the former, and the fact that in a boy with a severe cervical midline web there was a cleft of the upper sternum, we interpret this neck-web as a developmental field defect. It is a sporadic anomaly but may be associated with other midline malformations including congenital heart defect(s). Thus, finding such a web at birth should prompt a careful search for other anomalies. PMID- 3631144 TI - Noonan and Klinefelter syndromes in a child. PMID- 3631145 TI - Abdominal distension in Kaufman-McKusick syndrome. PMID- 3631146 TI - Announcement of the National Epidermolysis Bullosa Registry. PMID- 3631147 TI - Eosinophilia in the diagnosis of atheroembolic renal disease. AB - We report 6 patients with eosinophilia and atheroembolic renal disease. Histologic examination of biopsy of kidney or skin revealed extensive atheroembolic in the vasculature. However, no evidence of vascular or tubulointerstitial inflammation was observed. Eosinophil count ranged from 540 to 2,000 cells/mm3. Upon review of the literature, 80% (29 out of 36) of patients with adequately reported total and differential leukocyte counts had eosinophilia in association with atheroembolic disease. In contrast, review of the clinical records of 40 consecutive patients with acute renal failure seen during an 18 month period uncovered only 1 case of eosinophilia (2.5%). This latter patient was established as having acute interstitial nephritis. Thus eosinophilia appears to be a helpful diagnostic clue to the presence of atheroembolic renal disease. PMID- 3631148 TI - An increase in circulating IgA antibodies to gliadin in IgA mesangial glomerulonephritis. AB - In IgA glomerulonephritis (GN), the pathogenic role of IgA is well documented, but the specificity of these IgA is unknown. Cases of celiac disease associated with IgA GN have been reported and led us to investigate the role of gliadin sensitivity. We measured IgA, IgG and IgM antibodies to gliadin, beta lactoglobulin and ovalbumin by ELISA (results expressed as optical density; OD) in 27 patients with primary IgA GN, 14 with membranous GN (MGN), 21 with idiopathic nephrotic syndrome (INS) and 21 healthy controls. The normal value for antigliadin IgA was less than 0.650 OD. 19/27 patients with IgA GN had a raised level versus 2/14 in MGN and 2/21 INS (p less than 0.001: IgA GN vs. MGN, INS and controls). Antibodies to beta-lactoglobulin were rarely found and were not more frequent in IgA GN. Cross-reactivity with reticulin was investigated in 16 patients who were serum-positive for IgA antigliadin: no reticulin antibodies were detected by immunofluorescence. Antigliadin IgA are of diagnostic value for distinguishing IgA GN from other GN, with a sensitivity of 70%, a specificity of 89%, a positive predictive value of 83% and a negative one of 79%. PMID- 3631149 TI - Diagnosis of hypothyroidism in patients with end-stage renal disease. AB - Hypothyroidism may occur more commonly in patients with end-stage renal disease (ESRD) than in the general population. The signs and symptoms of both hypothyroidism and uremia may be similar. To evaluate the usefulness of clinical and routine laboratory findings in the diagnosis of hypothyroidism in patients with ESRD, we compared 6 patients with documented primary hypothyroidism who had serum thyrotrophin (TSH) levels above 20 microU/ml with 12 euthyroid patients. The euthyroid patients were divided into two groups. The first was matched with the hypothyroid patients for age, renal disease and duration of dialysis, while the second group was matched for serum total thyroxine and free T4 index values. Serum TSH levels were normal (less than 10 microU/ml) in both of these latter groups. There were no significant differences in the clinical manifestations among the three groups of patients, except for hoarseness of voice which was significantly more common in the hypothyroid uremic patients (p = 0.03). No significant differences were noted on electrocardiogram, physical examination, chest x-ray or echocardiography. Routine laboratory values were not different. Therapy of the uremic hypothyroid patients with L-thyroxine was associated with improvement or resolution of many of the symptoms and signs of hypothyroidism that otherwise would have been attributed to the uremic state. Our results indicate that the diagnosis of hypothyroidism in uremic patients cannot be made by clinical or routine laboratory values and rests on the presence of an overtly elevated serum TSH concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631150 TI - Noninvasive diagnosis of uremic osteodystrophy: uses and limitations. AB - 45 bone biopsies from patients with chronic uremia were reviewed to define which noninvasive investigations were of value in predicting the histological diagnosis and to quantify the spectrum of uremic bone disease at a center that has consistently used an aluminum-free dialysis bath. 17 biopsies were taken postmortem. 15 patients received conservative treatment, the rest were on maintenance dialysis. 13 patients had symptomatic bone disease. Virtually all patients with a uremia duration greater than 3 years had uremic osteodystrophy. All patients with clinical bone disease, hypercalcemia or raised alkaline phosphatase activity had osteodystrophy, but the specific histology was not indicated. Greatly raised parathyroid levels suggested secondary hyperparathyroidism, but the test was only 100% specific when 20 times normal. Total aluminum consumption was highly indicative of bone aluminum concentration (p less than 0.0001) and aluminum-related osteomalacia (5 cases), suggesting that a considerable proportion of uremic bone disease is iatrogenic. Serum aluminum was of some use in the diagnosis of aluminum-related osteomalacia, but was not wholly reliable. Bone mineral content (BMC) using both forearm measurements and total body bone mineral levels (TBBM) were assessed in 32 patients and were found to be reduced in 12, with a preponderance of secondary hyperparathyroidism. BMC and TBBM were negatively correlated to resorbing surfaces and bone formation rate, suggesting that secondary hyperparathyroidism is the uremic bone disease that represents the greatest threat to bone mass. It is concluded that while noninvasive investigations give considerable information, reliable diagnosis requires the use of histological methods. PMID- 3631151 TI - Quiz of the month. Secondary hyperaldosteronism caused by surreptitious vomiting, diuretic abuse, or Bartter's syndrome. PMID- 3631152 TI - Poststreptococcal glomerulonephritis in the elderly. Report of a case and review of the literature. AB - Acute poststreptococcal glomerulonephritis (PSGN) is uncommonly seen in the elderly population and its diagnosis is not without some difficulty because clinical manifestations may mimic other diseases. Renal biopsy for diagnosis and early intervention, if indicated, is very valuable in such a situation. We present here a case of an elderly patient with PSGN and a review of the literature. In addition to the typical clinical manifestations of the disease, dyspnea and pulmonary congestion are commonly present in elderly patients, probably a result of excessive salt and water retention in the face of compromised cardiovascular function. Elderly patients with PSGN appear to have a remarkably poor prognosis, with significant incidences of acute mortality and chronic renal disease. Our patient had the unusual finding of a large number of glomerular crescents with near complete clinical recovery after short-term follow up. PMID- 3631153 TI - Proteinuria, hypertension and renal failure in a patient with unilateral renal agenesis. PMID- 3631154 TI - A prospective comparative study of the extended nonstress test and the nipple stimulation contraction stress test. AB - The nonstress test and the nipple stimulation contraction stress test were performed at the Medical College of Georgia and the University of Mississippi Medical Center, with the use of common maternal state protocols, minimum criteria for baseline fetal heart rate reactivity, and follow-up of abnormal test results. At the Medical College of Georgia, 656 patients were studied with nonstress tests used as the primary test, whereas at the University of Mississippi Medical Center, 614 patients were managed with the nipple stimulation contraction stress test used as the primary test. Both populations were comparable in regard to pregnancy complications, gestational age, birth weight, perinatal outcomes, cesarean section rates, and the incidence of positive contraction stress tests. Specificity and positive and negative predictive values were similar for both tests. The extended nonstress test had higher sensitivity but also required significantly longer mean duration of testing. The corrected perinatal mortality rate for a reactive nonstress test or negative nipple stimulation contraction stress test was zero within one week of the last test. We conclude that both tests provide excellent primary methods of fetal surveillance and that the decision to use one test rather than the other should be made on the basis of considerations of cost, convenience, time availability, and the presence of specific test contraindications or pregnancy complications. PMID- 3631155 TI - Evaluation of the atypical Pap smear. AB - Two hundred thirty-six consecutively referred patients with "atypical" but not dysplastic Pap smears were evaluated by colposcopy and directed biopsies to assess the significance of this ambiguous result. Additionally the histologic diagnosis was compared with the results obtained by repetition of the Pap smear, interpretation of cervigrams, and the visual impression of the coloposcopist to evaluate the accuracy of these three modalities as intermediate screening procedures. Fifty-eight patients (25%) had biopsy-proved cervical intraepithelial neoplasia. Repeat Pap smears identified only 17% of these patients. Colposcopists noted atypical transformation zones in 97% of the patients with cervical intraepithelial neoplasia. Cervigrams identified 81% of the cervical intraepithelial neoplastic lesions but had a 15% method failure (uninterpretable). The time-honored tradition of repeating atypical smears before definitive diagnostic procedures are performed is to be condemned. Neither colposcopy nor cervicography was judged to be an ideal intermediate screening procedure, but both were superior to Pap smear repetition. PMID- 3631156 TI - Regional program for prevention of premature birth in northwestern North Carolina. AB - We present our experience with introducing and implementing a prematurity prevention program in a 20-county region in northwest North Carolina. The program is based on the risk assessment and educational model. In the first 25 months of results available, 17,370 births occurred in women enrolled in the project. During 1985, 42.5% of all births in the region occurred in the project. During the time span examined, a downward trend was seen for rates of low birth weight births in public and private patients and for very low birth weight births in private patients. During 1985, private births in the project were significantly less likely to be low birth weight or very low birth weight than private births to women not in the project. These results suggest that regional implementation of prematurity prevention programs is feasible and that such programs are particularly appropriate for private patients. PMID- 3631157 TI - Urogynecology: comments and caveats. AB - Historically, the routine workup of the incontinent woman has focused on clinical parameters including history, pelvic examination, cotton swab test, and radiographic imaging of the bladder and urethra. Data are presented to support the concept that urinary symptoms and pelvic findings do not accurately define the causes of incontinence. Because urinary incontinence is both a dysfunctional and a structural problem, evaluation of the urodynamic response of the lower urinary tract should be part of the workup of the incontinent woman. PMID- 3631158 TI - Necrotizing fasciitis of the vulva. AB - Sixteen cases of necrotizing fasciitis arising from or involving the vulva are presented. Fifteen of the 16 women had diabetes mellitus. Five of them died. All but one of these cases were managed by very extensive excision of all involved tissues. These cases demonstrate the extreme seriousness of any infection involving the vulva in a diabetic patient. Such patients should have the infected area explored while they are under anesthesia as soon as possible. If any necrosis is found, radical excision to include removal of all necrotic, indurated, and pale tissues is mandatory. PMID- 3631159 TI - Mechanical intestinal obstruction in patients with gynecologic disease: a review of 368 patients. AB - To review the management of intestinal obstruction associated with gynecologic disease, the authors studied the records of 368 patients with acute intestinal obstruction. Most patients (83%) had gynecologic malignancies. Obstruction of the small intestines was more common than obstruction of the large intestines (77% versus 23%). Major causes of mechanical small bowel obstruction included extrinsic neoplasms (62%, mostly ovarian carcinomas), radiation therapy associated strictures and adhesions (17%), postoperative adhesions (14%), and inflammatory strictures and adhesions (3%). Obstruction of the colon was caused mainly by extrinsic neoplasms (45%), strictures and adhesions associated with radiation therapy (26%), fecal impaction (9%), and intrinsic neoplasms (8%). Gastrointestinal intubation successfully relieved 81% of small bowel obstructions caused by postoperative adhesions. Tube suction alone was rarely successful when the obstruction was caused by malignant neoplasms. The prognosis was dependent on the cause of the underlying disease. The cases studied in this report were compared with a large number of cases of bowel obstruction in general surgery. It is concluded that bowel obstruction associated with gynecologic disease has unique features deserving wider recognition. PMID- 3631160 TI - Another look at the second-assessment procedure for ovarian epithelial carcinoma. AB - Over a 10-year period, 65 of 196 patients (33%) with ovarian epithelial malignancy, previously treated with chemotherapy, had a second-look operation if the disease was clinically absent. All procedures were done by one of three gynecologic oncologists, and 48% of the patients had a positive second-look procedure. Of patients with original stage I, II disease, 25% had a positive second-look operation, contrasting with 61% of patients with stage III, IV. Significant perioperative morbidity occurred: one patient had intraoperative vascular collapse; 15% had prolonged ileus; 17% had small bowel resections at the time of the second-look operation or in the postoperative period. Of all patients with negative second-look operations, 24% have had recurrent disease from 5 to 23 months after the procedure. These recurrences were in the liver or distant sites in 63% of the patients. Second-look operations, if still indicated by negative noninvasive techniques, should be performed in tertiary care centers under study situations in a standard fashion. PMID- 3631161 TI - Endometrial metaplasia associated with endometrial adenocarcinoma. AB - Endometrial metaplasia is a complex group of epithelial proliferations. The relationship of metaplasia, other than squamous metaplasia, to endometrial adenocarcinoma has not been clearly established. Between 1969 and 1979, 183 patients diagnosed as having Stage I endometrial adenocarcinoma (according to International Federation of Gynecology and Obstetrics) were treated at the University of Virginia Medical Center. Sixty of the patients were treated with hysterectomy without preoperative irradiation. A histopathologic review was performed without knowledge of the clinical outcome and subsequent clinicopathologic correlations were analyzed. On review, 32/60 had carcinoma without metaplasia and 15/60 had both carcinoma and metaplasia. Thirteen of the 60 patients were judged not to have cancer: 12 had both hyperplasia and metaplasia and one had hyperplasia without metaplasia. None of the 12 patients reclassified as having metaplasia had a recurrence or died of endometrial carcinoma. Patients with both metaplasia and carcinoma were significantly younger than patients with only carcinoma and the associated carcinomas were more frequently well differentiated. PMID- 3631162 TI - Conservative surgical management of isthmic ectopic pregnancies. AB - During the 12-month study interval ending March 30, 1986, there were 203 ectopic pregnancies at Grady Memorial Hospital, a ratio of one ectopic gestation per 34 deliveries. Twenty patients with isthmic ectopic pregnancies were selected for treatment by one of three operative modalities. Seven patients with ruptured isthmic ectopic pregnancies underwent segmental tubal resection without reanastomosis. All four patients who underwent segmental tubal resection with primary microsurgical reanastomosis had postoperative hysterosalpingograms demonstrating bilateral tubal patency. One pregnancy has occurred in this group. Nine patients underwent linear salpingostomy. In five of the six patients who had postoperative hysterosalpingography, patency of the involved fallopian tube was demonstrated. Four of these nine patients, including one patient with contralateral tubal occlusion, have conceived. We conclude that linear salpingostomy for isthmic ectopic pregnancies is as effective as segmental tubal resection with primary microsurgical reanastomosis in achieving tubal patency. PMID- 3631163 TI - Hysterosalpingographic evaluation of tubal patency after ectopic pregnancy. AB - In the period 1983 to 1985, hysterosalpingography was performed in 76 women after laparotomy to manage ectopic gestations. Clinical characteristics of these women, including their operative findings, were then correlated with the follow-up hysterosalpingography. Study participants were classified into five groups according to surgical management of the ectopic gestation. In each of the five groups, a substantial percentage of those women with a nonpatent fallopian tube (contralateral to the tube bearing the ectopic gestation) on hysterosalpingography had a normal-appearing fallopian tube at laparotomy. Approximately 50% of women with a history of previous pelvic inflammatory disease were found to have nonpatent contralateral fallopian tubes on follow-up hysterosalpingography. PMID- 3631164 TI - The relationships among the fetal biophysical profile, umbilical cord pH, and Apgar scores. AB - The relationships among the fetal biophysical profile, umbilical cord blood pH, and Apgar scores were investigated in 124 patients undergoing cesarean section before the onset of labor. Based on a standard for the diagnosis of fetal acidosis of an umbilical cord arterial pH less than 7.20, the sensitivity, specificity, and positive and negative predictive values of the fetal biophysical profile score were 90%, 96%, 82%, and 98%, respectively. When the combination of a nonreactive nonstress test and absent fetal breathing was used as the "abnormal test," the sensitivity, specificity, and positive and negative predictive values were 100%, 92%, 71%, and 100%, respectively. The efficacy of the fetal biophysical profile to indicate fetal acidosis was found to be superior to the 1- and 5-minute Apgar scores in sensitivity and positive predictive value. These data suggest that the biophysical profile is very accurate in the identification of the fetus with acidemia. The first manifestations of fetal acidosis are nonreactive nonstress testing and loss of fetal breathing; in advanced acidemia fetal movements and fetal tone are compromised. A new protocol of antepartum fetal evaluation is suggested based on individual biophysical components rather than the score alone. PMID- 3631165 TI - Chronic oral terbutaline tocolytic therapy is associated with maternal glucose intolerance. AB - Plasma glucose determinations were performed 1 hour after a 50 gm oral glucose load in 30 patients receiving long-term terbutaline therapy (20 to 40 mg/day for at least 1 week) and 247 normal control patients. A total of 63% of patients receiving terbutaline had an abnormal 1-hour value (greater than or equal to 140 mg/dl), an incidence much higher than that of control subjects (17.8%) (p less than 0.0001) for a relative risk of 3.54 (95% confidence intervals of 2.29 to 5.42). Mean 1-hour values were 112.1 mg/dl for control subjects and 149.8 mg/dl in the terbutaline group (p less than 0.0001). All abnormal values were followed by a 3-hour 100 gm oral glucose tolerance test. A total of 15.9% of the glucose tolerance tests performed in the control group (2.8% overall) were abnormal as opposed to 52.6% (33.1% overall) in patients receiving terbutaline (p less than 0.01). Nine patients were studied before and after terbutaline therapy. Results obtained during administration of terbutaline were significantly higher (102.2 mg/dl before therapy versus 145.2 mg/dl during therapy). We conclude that treatment with oral terbutaline appears to be associated with impairment of glucose tolerance in pregnancy. PMID- 3631166 TI - Fetal echocardiographic screening for congenital heart disease: the importance of the four-chamber view. AB - The four-chamber view of the heart has been proposed as a screening method for obstetrical sonographers to assess the fetus for the presence of congenital heart disease. We examined the fetuses in 1022 pregnancies and found 74 structurally abnormal hearts. Seventy-one of these (96%) were found to have an abnormality as seen in the four-chamber view. The four-chamber view of the heart had 92% sensitivity and 99.7% specificity in the detection of congenital heart disease. The positive predictive value was 95.8%, and the negative predictive value was 99.4%. We conclude that the four-chamber view may be a useful screen for the presence of congenital heart disease and should be included as a part of all routine obstetric ultrasound examinations. PMID- 3631167 TI - Management of the diethylstilbestrol-exposed pregnant patient: a prospective study. AB - Over a 5-year period we have managed 63 diethylstilbestrol-exposed pregnant patients with a standardized protocol requiring weekly cervical examination and decreased physical activity of the patient. Twenty-six patients (42%) underwent a prophylactic cerclage for a history of second-trimester loss or a hypoplastic cervix on initial clinical examination (group I). Thirty-six patients (58%) were followed expectantly (group II). Sixteen patients (44%) in group II demonstrated cervical change and required an emergency cerclage. Twenty-one patients were managed expectantly with no cerclage. The gestational age at delivery for group I was 37.7 +/- 2.80 versus 34.5 +/- 6.9 weeks for patients without a cerclage (p = 0.04). There were no perinatal deaths if a cerclage was performed, whereas there were five deaths (24%) in the group without cerclage. The five deaths occurred at a mean gestational age of 24.40 +/- 4.0 weeks and a mean birth weight of 614.00 +/- 441.73 gm. Patients with a hypoplastic cervix or prior reproductive loss had a better outcome with early cerclage than patients with a normal cervix followed expectantly. We presently lack a reliable method to detect the diethylstilbestrol exposed patient at greatest risk for perinatal loss. Based on our experience we believe that placement of a cerclage early in pregnancy should be a strong consideration. PMID- 3631169 TI - Cocaine use during pregnancy: adverse perinatal outcome. AB - Cocaine use has increased dramatically in the United States during the past decade. The life-threatening cardiovascular and central nervous system complications of cocaine have been well documented; however, few studies have examined the risks of cocaine use during pregnancy. In this report the perinatal outcome data of 70 women receiving care at the Perinatal Center for Chemical Dependence of Northwestern University, whose pregnancies were complicated by cocaine abuse, were compared with those of matched control subjects. The use of cocaine during pregnancy was associated with lower gestational age at delivery, an increase in preterm labor and delivery, lower birth weights, and delivery of small for gestational age infants. PMID- 3631168 TI - Status of infants at birth and risk for adverse neonatal events and long-term sequelae: a study in low birth weight infants. AB - We evaluated the relationship of infant status at birth to neonatal morbidity and long-term development in 246 low birth weight infants (600 to 1750 gm). Nineteen percent of infants had 1-minute Apgar scores of less than or equal to 3, and 8% had an umbilical artery pH of less than or equal to 7.2. Acidosis was associated with an increased risk of grade 3 to 4 intracranial hemorrhage (odds ratio = 3.3). Low 1-minute Apgar score was associated with an increased risk of death (odds ratio = 4.8). Grade 3 to 4 intracranial hemorrhage was a strong risk factor for cerebral palsy among survivors (odds ratio = 16.1), as was low 1-minute Apgar score (odds ratio = 2.9). Only 15% of cases of cerebral palsy in this study were associated with acidosis at birth. PMID- 3631170 TI - Verified self-monitored blood glucose data versus glycosylated hemoglobin and glycosylated serum protein as a means of predicting short- and long-term metabolic control in gestational diabetes. AB - Glycosylated hemoglobin and glycosylated serum protein have been suggested as tools for evaluation of long- and short-term glycemic control, respectively. Twenty-six patients with gestational diabetes were prospectively studied to determine the relationship of glycosylated hemoglobin and glycosylated serum protein to metabolic control. To verify the accuracy of blood glucose data, a memory-based reflectance meter was used for subjects with gestational diabetes who tested 6.5 +/- 1 times per day. Our analysis revealed that despite a statistically positive correlation between glycosylated hemoglobin, glycosylated serum protein, and verified data, their use as a clinical tool is limited because of their poor predictability. PMID- 3631171 TI - Chorionic villus sampling is associated with normal fetal growth. AB - Seventy-eight singleton term neonates, delivered of women who were 35 years of age or older after chorionic villus sampling at 9 to 11 weeks' gestation, were compared with 1335 singleton control neonates delivered at term of mothers 35 years of age or older before the clinical application of chorionic villus sampling at our institution. No statistically significant differences were found in birth weight, crown-heel length, or ponderal index between control neonates and neonates delivered after chorionic villus sampling. The sample sizes necessary to detect a 5% difference in population means at an alpha error level of 0.05 and beta error level of 0.1 were calculated for the measured variables and achieved before analysis. This study suggests that patients undergoing chorionic villus sampling are not at increased risk for the development of decreased fetal growth or intrauterine growth retardation. PMID- 3631172 TI - The origin of increased serum iron in pregnancy-induced hypertension. AB - Serum iron was measured in 30 patients with pregnancy-induced hypertension and 24 normal pregnant women. The mean iron concentration was significantly higher in the group with pregnancy-induced hypertension (111 +/- 26 micrograms/ml) than in the controls (69 +/- 17 micrograms/ml) (p less than 0.0001). Readily available laboratory variables were used to determine whether the increased serum iron was the result of (1) hemolysis, (2) hepatocellular injury, or (3) intravascular volume contraction leading to hemoconcentration. It appears that a clinically silent, ongoing hemolytic reaction is responsible for the increase in serum iron seen in patients with pregnancy-induced hypertension. PMID- 3631173 TI - The effects of long- and short-term maternal caffeine ingestion on human fetal breathing and body movements in term gestations. AB - The possible effects of long- and short-term maternal ingestion of caffeine during normal human pregnancy on the breathing and body movements of third trimester fetuses were studied in 14 patients, selected by a dietary questionnaire, and divided into two equal groups: high consumers (greater than 500 mg/day) (group 1) and low consumers (less than 250 mg/day) (group 2). All mothers followed a standard study protocol and underwent overnight fasting; studies began with a 30-minute control period, followed by oral administration of 200 mg caffeine, and a 180-minute subsequent observation period with continued maternal fasting. Blood samples for glucose and caffeine were obtained every 30 minutes and continuous recording of fetal breathing and body movements were entered on a microcomputer for off-line analysis. The two groups were similar for all obstetric outcome features. Plasma glucose levels were similar and constant in both groups whereas caffeine levels increased significantly at 60 minutes after administration; mean plasma caffeine levels were significantly higher in group 1 than in group 2 at all intervals. Fetal breathing rates and body movement incidences were similar in both groups before and after caffeine administration. Fetal breathing movement incidence decreased significantly in group 2 but was sustained at baseline levels in group 1 throughout the study. High long-term ingestion of caffeine during pregnancy is associated with higher maternal plasma caffeine levels and fetal breathing activity when compared with low caffeine ingestion. Short-term administration of 200 mg caffeine does not appear to have a significant physiologic impact on these activities. PMID- 3631174 TI - Leukocyte esterase activity in human amniotic fluid for the rapid detection of chorioamnionitis. AB - Chorioamnionitis plays an important role in perinatal morbidity and mortality. Fast and accurate diagnosis poses a major problem. A prospective study was performed to assess the value of positive leukocyte esterase test (Chemstrip 9) for the diagnosis of chorioamnionitis during labor. We evaluated 21 patients with chorioamnionitis in labor at term and used 21 matched control subjects. The sensitivity and specificity of leukocyte esterase activity were compared with those of amniotic fluid cultures, Gram stains, maternal pyrexia and leukocytosis, and fetal tachycardia. The sensitivity in diagnosing chorioamnionitis was 91% and the specificity was 95%. The use of this test strip could provide a rapid, inexpensive screening test for chorioamnionitis. PMID- 3631175 TI - Pregnancy outcome in medically complicated and uncomplicated patients aged 40 years or older. AB - Patients (183) who were delivered at age greater than or equal to 40 years were studied to ascertain the nature and frequency of maternal and fetal complications at a single institution in a recent time period. These patients were further grouped into those of low parity, those who began pregnancy without underlying disease, and those who began pregnancy with underlying medical disorders. For the entire group preeclampsia, premature labor, precipitate labor, and malpresentation were significantly more common. The rate of vaginal delivery was substantially decreased, and serious postpartum morbidity was relatively common. The incidence of stillbirth, perinatal mortality, and abnormal birth weight was significantly increased. There were some differences in the nature and frequency of complications encountered among the subgroups, but no subgroup had a complication rate comparable to our general obstetric population. PMID- 3631176 TI - Patterns of human fetal heart rate accelerations from 26 weeks to term. AB - Computerized analysis of the distribution of 2598 fetal heart rate accelerations in 83 healthy fetuses at 26 to 40 weeks' gestation demonstrated that the currently used definition of an acceleration as greater than or equal to 15 beats/min for greater than or equal to 15 seconds is applicable only after 30 weeks' gestational age in fetuses with a basal fetal heart rate of less than or equal to 128 beats/min. A significant negative correlation was found between the mean hourly basal fetal heart rate and the mean amplitude of fetal heart rate accelerations from 30 weeks to term. There was also a significant maturational process in the pattern of fetal heart rate and fetal heart rate accelerations that occurred between 26 and 28 and between 30 and 32 weeks; this was characterized by a decrease in basal fetal heart rate, an increase in the amplitude of fetal heart rate accelerations, and an increase in long-term fetal heart rate variability. PMID- 3631177 TI - Riboflavin concentration in maternal and cord blood in human pregnancy. AB - Riboflavin concentration was measured in sera of a control population and in a series of paired maternal and cord sera. The assay technique was carefully validated and appears to be specific and reproducible. The mean riboflavin concentration in 12 apparently healthy adults was 116 +/- 46 nmol/L (SD). In 20 uneventful pregnancies the cord serum concentration was generally higher than the maternal concentration (158 +/- 47 nmol/L versus 113 +/- 35 nmol/L; p = 0.001). The cord-to-maternal ratio in paired sera averaged 1.45 +/- 0.44. There was no detectable difference in binding of riboflavin to cord and maternal serum proteins as measured by equilibrium dialysis (59.0% +/- 17% versus 60.8% +/- 16%). Comparison of protein binding by paired cord and maternal sera yielded a ratio of 0.99 +/- 0.13. The transplacental gradient of riboflavin concentration is unrelated to protein binding and is consistent with active transport by the placenta, as previously demonstrated in vitro. PMID- 3631178 TI - The significance of one abnormal glucose tolerance test value on adverse outcome in pregnancy. AB - A matched control study of 126 women equally divided into three groups (normal oral glucose tolerance test, one abnormal test value, and gestational diabetes mellitus) was undertaken to examine the relationships among oral glucose tolerance test results, glycemic control in pregnancy, and adverse perinatal outcome. Characterization of metabolic control for the one abnormal oral glucose tolerance test value and the gestational diabetes mellitus groups (before treatment) showed no significant difference. After the start of treatment, however, a significant (p less than 0.01) difference between the groups in level of control was found. While no significant difference in the average birth weight between the three groups was discovered, the incidence of large infants (macrosomia and large for gestational age) was found to be significantly higher in the one abnormal oral glucose tolerance test group when compared with the normal (34% versus 9%; p less than 0.01) and gestational diabetes mellitus group (34% versus 12%; p less than 0.01). No significant difference for the incidence of an infant large for gestational age was found between the normal group and the patients with gestational diabetes mellitus after treatment. Neonatal metabolic disorders were found to be significantly higher for the one abnormal oral glucose tolerance test group (15%) when compared with the control and the gestational diabetes mellitus groups (3%). We conclude that, if left untreated, one abnormal value on an oral glucose tolerance test is strongly associated with adverse perinatal outcome. PMID- 3631179 TI - Drug prescribing for thromboembolic disease during pregnancy. PMID- 3631180 TI - Lymphocyte-reactive antibodies and recurrent early pregnancy failure. PMID- 3631181 TI - A randomized study of 5-fluorouracil and filtration surgery. AB - We conducted a randomized study of 26 patients with a poor prognosis undergoing filtration surgery with and without a low dose of 5-fluorouracil. Mean preoperative intraocular pressure (+/- S.E.M.) in the 5-fluorouracil group (n = 14) was 38.4 +/- 3.08 mm Hg; in the control group (n = 12) it was 41.2 +/- 5.0 mm Hg. Mean postoperative intraocular pressure (+/- S.E.M.) at six to 18 months was 14.4 +/- 1.4 mm Hg in the 5-fluorouracil group and 30.7 +/- 3.9 mm Hg in the control group (P less than .01). Of 14 patients in the 5-fluorouracil group, 12 had a successful outcome at 12 months. Of 12 patients in the control group, three had a successful outcome during this same interval. PMID- 3631182 TI - The effect of intracameral carbachol on intraocular pressure after cataract extraction. AB - We randomly assigned 44 patients undergoing extracapsular cataract extraction and posterior chamber lens implantation to two equal groups. The treatment group received intracameral carbachol during the operative procedure, and the control group received only balanced salt solution. Intraocular pressures were measured preoperatively, and at three, six, nine, and 24 hours postoperatively. Preoperatively, the mean pressures in the two groups were not significantly different. Three hours postoperatively, the mean pressure in the control group was 3.9 mm Hg above the preoperative baseline, whereas in the treatment group the mean pressure was 3.1 mm Hg below the baseline. This difference was statistically significant (P = .002). Similar differences between the two groups persisted throughout the study period. PMID- 3631183 TI - The effect of refractive error on automated global analysis program G-1. AB - We determined the effect of induced refractive errors on the visual field indices of the Octopus global analysis program G-1. After cycloplegia, refractive errors were introduced randomly in ten nonglaucomatous eyes of ten patients. Mean defect values (+/- S.D.) were lowest (2.4 +/- 0.8 dB) with full cycloplegic correction. With increasing ametropia, the mean defect increased significantly; it was 3.6 +/ 0.8 dB (P less than .0001) with the addition of +1.00 diopter and 5.3 +/- 0.9 dB (P less than .0001) with +2.00 diopters of sphere over the full cycloplegic correction. No significant differences in corrected loss variance, skew, short term fluctuation, or reliability factor could be determined with changes in refractive error. PMID- 3631184 TI - Scleral flap surgery for modification of corneal astigmatism. AB - We performed resections and recessions of scleral flaps on human cadaver eyes in order to measure the induced change in keratometric astigmatism. We prepared 3-mm scleral flaps that were 3, 5, 7, or 10 mm long and resected or recessed these flaps up to 1 mm in 0.25-mm increments. Scleral flap resection resulted in up to 10.1 D of net corneal steepening along the meridian of the incision. Scleral flap recessions resulted in up to 7.7 D of net corneal flattening along the meridian of the incision; the effect increased with increasing flap length in the recessed eyes. There was a tendency toward mean corneal flattening with resections and mean corneal steepening with recessions. PMID- 3631185 TI - Evisceration with eversion of the scleral shell and muscle cone positioning of the implant. AB - Six patients underwent a new surgical procedure to repair extruding evisceration implants. The scleral shell was everted and used as an anterior wall for the placement of a donor sclera-encased implant within the muscle cone. Early results showed good cosmesis and no recurrent extrusions. PMID- 3631186 TI - Proteinuria and blood glucose levels in a population with diabetic retinopathy. AB - In a population-based study of all insulin-treated diabetic patients on the Swedish island of Gotland, we compared the prevalence and severity of retinopathy with those of nephropathy as measured by proteinuria and serum creatinine levels. Of 365 diabetic patients, 66 (18%) had proteinuria. Of these 66, 39 (59%) had retinopathy. Proteinuria and serum creatinine correlated with increasing severity of retinopathy (P less than .001). Of 47 patients with proliferative retinopathy, 19 (40%) had proteinuria. Of 124 patients with retinopathy of other grades of severity, 20 (16%) had proteinuria. Visual acuity in the best eye was negatively correlated to proteinuria, which was present in 17 of 203 (8.4%) patients with a visual acuity of 20/20, compared with eight of 15 (53%) of those with a visual acuity of 20/200 or less. Blood glucose, determined two hours postprandially, was satisfactory (less than 10 mmol/l) in 162 patients (44%), unsatisfactory (10 to 14 mmol/l) in 89 (24%), and poorly regulated (greater than 14 mmol/l) in 114 (31%). Increasing mean blood glucose correlated to retinopathy (P less than .05). PMID- 3631187 TI - Noncontact retinal photocoagulation at the slit-lamp biomicroscope. AB - Four patients had either ocular conditions that made the use of a contact lens for retinal photocoagulation undesirable, or optical aberrations of the ocular media that made photocoagulation with a conventional contact lens difficult. A hand-held 90-diopter lens permitted retinal photocoagulation to be performed at a conventional slit-lamp biomicroscope laser without corneal contact and assisted in delivering laser burns under physical or optical circumstances that would be difficult or impossible with conventional contact lenses. Four patients without ocular surface or media abnormalities were also treated by this method. PMID- 3631188 TI - Hyperbaric oxygen treatment for chronic cystoid macular edema after branch retinal vein occlusion. PMID- 3631189 TI - Spontaneous fungal corneal ulcer as an ocular manifestation of AIDS. PMID- 3631190 TI - Lesions resembling trantas dots in a patient wearing soft contact lenses. PMID- 3631191 TI - Treatment of contact lens-associated corneal erosions. PMID- 3631192 TI - Ocular palpation in pseudophakia. PMID- 3631193 TI - Disinfectant receptacle for applanation tonometers. PMID- 3631194 TI - Modified Watzke sleeve spreader. PMID- 3631195 TI - Pars planitis and autoimmune endotheliopathy. PMID- 3631197 TI - Symposium on Management of Binocular Anomalies: Efficacy of Vision Therapy. December 10, 1985, Atlanta, Georgia. Proceedings. PMID- 3631196 TI - Spasm of the near reflex associated with organic disease. PMID- 3631198 TI - Management of anomalous correspondence: efficacy of therapy. AB - The last paper to review thoroughly the success of treatment for esotropia with anomalous correspondence was published by Flom in 1963. In reviewing the literature of that era, which included surgical intervention, Flom found documented cures in only 11 of 262 esotropic patients with anomalous correspondence--a cure rate of less than 5%. We evaluated recent reported success rates for treatment and present an estimate of the prognosis for successful binocular re-education of patients with esotropia and anomalous correspondence. Based on current therapy techniques reported in the literature, with careful aggressive therapy, 50% of esotropic patients with anomalous correspondence should be expected to achieve binocular vision provided sufficient time (up to 12 months) can be devoted to binocular re-education. PMID- 3631199 TI - Reduction of asthenopia after accommodative facility training. AB - Five patients reporting asthenopia secondary to accommodative deficiencies underwent automated accommodative facility training. A matched-subjects, crossover design was used to control for placebo effects. All patients receiving automated accommodative training showed a marked increase in accommodative amplitude along with a concurrent reduction of asthenopia. Decreases of blur and increases of reading time were the most frequently reported changes by patients. This experiment shows the effectiveness of automated accommodative training in reducing asthenopia and improving accommodative facility. PMID- 3631200 TI - Clinical method for measuring adaptation of tonic accommodation and vergence accommodation. AB - Previous work indicates that tonic adapters of accommodation and vergence have indirect effects on accommodative vergence and vergence accommodation and that these crosslink responses interact with one another to produce clear and single vision. Clinical measurements of tonic accommodation, tonic vergence, vergence accommodation (CA/C ratio), and accommodative vergence (AC/A ratio) are therefore of value in determining possible binocular vision abnormalities. Currently, clinical methods are only available for measuring the tonic vergence (phoria) and the AC/A ratio. We have determined a fast and accurate method for evaluating both tonic accommodation (accommodative phoria) and vergence accommodation (CA/C ratio). In both procedures, the loop of accommodation was opened with a 0.2 cpd difference of Gaussian (DOG) target. This target was found to be incapable of stimulating any reflex accommodation, yet it is localized in space and can easily stimulate binocular fixation. Our results indicate that opening the loop of accommodation with a pinhole Maxwellian view or with a 0.2 cpd DOG produces similar response values for tonic accommodative aftereffects and vergence accommodation responses. The decay rate of tonic accommodative aftereffects as well as changes in the resting focus of accommodation caused by vergence accommodation (CA/C) can be measured clinically using dynamic retinoscopy in combination with the DOG target. Clinical values of the CA/C ratio obtained with these techniques were highly correlated (r = 0.92) with laboratory measures obtained with an objective infrared optometer and eye trac monitor. PMID- 3631201 TI - Clinical significance of hemorrhages in the optic disc. AB - A consecutive series of 8029 first visit optometric examinations revealed 20 patients having hemorrhages of the optic disc. Assessment of optic disc contour, intraocular pressure (IOP), and visual fields was undertaken at detection of the hemorrhage and at follow-up not less than 3 months later. The disc hemorrhage patients were assessed for the presence of systemic occlusive disease. The sensitivity of disc hemorrhage as a sign of glaucoma was 0.3 in the sample. There was some risk of visual field loss after detection of a hemorrhage in eyes having glaucoma (1 of 6 eyes); a similar risk was observed in non-glaucomatous eyes in which bleeding occurred (4 of 14 eyes). Hemorrhages occurred in 8 eyes that remained clinically normal during the course of follow-up. Notching of the neural rim of the disc was common but overall changes in contour of the disc were observed in only one patient. An association between disc hemorrhage and systemic disease could not be established. PMID- 3631202 TI - Nonius alignment apparatus for measuring vergence. AB - The present paper describes an apparatus designed for the assessment of vergence. Based on the Nonius alignment system of viewing dichoptic stimuli, this apparatus provides a compact, portable, easily constructed, and easily maintained piece of equipment. It can be used for the assessment of vergence under a wide variety of viewing conditions and laboratory demands. Also included are an example of one way in which the apparatus may be set up, the equations for finding vergence angle using that set-up, and data concerning the validity and reliability of measurements made with the apparatus. PMID- 3631203 TI - Color stereoscopy: a new view? PMID- 3631204 TI - Meridional corneal components of myopia progression in young adults and children. AB - Records were selected from a data pool of myopic private practice patients to study the relation of refractive error change and keratometer power change in young adulthood. Selection was on the basis of three or more refractions and keratometer readings at and/or after 18 years of age. There were significant correlations between rate of myopia progression and rate of keratometer power change. Linear regression slopes of rate of refractive error change on rate of keratometer power change were in the neighborhood of 0.7. These findings were in contrast to the lack of correlation between myopia increase and corneal steepening in childhood myopia progression. Young adulthood myopia progression also appeared to be accompanied by a slight tendency toward a with-the-rule astigmatic shift. PMID- 3631205 TI - Aspects of tonic accommodation in emmetropia and late-onset myopia. AB - An objective infrared optometer was used to investigate the influence of cognitive demand on tonic accommodation (TA) for two groups of young emmetropes (N = 15) and late-onset myopes (N = 15). TA was measured under a passive condition and while subjects carried out a reverse counting task. The TA of myopes under the passive condition (mean = 0.81 D, SD = 0.46 D) was shown to have lower values than the TA of emmetropes (mean = 1.14 D, SD = 0.46 D). For the myopic group the counting task induced a positive shift in TA (mean = +0.35 D, SD = 0.31 D) that was significantly higher than that for the emmetropic group (mean = +0.07 D, SD = 0.27 D). The implications for theories of refractive error development are discussed. PMID- 3631206 TI - Effect of filters upon object color naming. AB - Color constancy refers to the phenomenon that the perceived colors of objects are largely unaltered by changes in the illuminant or by viewing through colored filters. Deviations from perfect constancy, induced by filters similar to ophthalmic tints, were investigated in this study. Munsell color chips were forced-choice categorized into R, Y, G, or B. This accurately located the boundaries between these colors on the chip color circle. Testing was performed through 23 different adaptive conditions and chromaticity shifts created by filters. The technique simulates real world situations in which the chromaticity of the objects and the adaptation of the observer both change. Generally, color constancy held quite well. The boundaries between the four colors shifted for some filters, indicating some deviation from perfect constancy. Red filters resulted in more color chips appearing red, blue and green filters resulted in more chips appearing blue, and filters along the Planckian locus resulted in more chips appearing green. PMID- 3631207 TI - Effect of reading in low illumination on fixation disparity. AB - Fixation disparity has been shown to be produced by prism stress, and it has therefore been proposed that its presence constitutes a sign that binocular vision is under stress (decompensated heterophoria). Fixation disparity can be present in the absence of any other indication of stress, and therefore may have a physiological basis. This study investigates the effect on fixation disparity and visual discomfort of placing the visual system under a different type of stress, that of requiring the subject to read under conditions of inadequate illumination. In 50 young adults, it was found that fixation disparity increased under inadequate illumination and that this was accompanied by symptoms in the form of visual discomfort. After a period of rest from any near-vision task, the fixation disparity decreased and the symptoms were reduced. PMID- 3631208 TI - Contrast sensitivity: characteristics of a large, young, adult population. AB - Contrast sensitivity functions and complete eye examinations were obtained from 103 normal, healthy young adults (ages 21 to 40 years). Descriptive statistics were compiled for the group in order to provide normative information. Subsets of the population were evaluated with respect to the relations among the attributes of accommodation, visual acuity, refraction, spectacle wear, and contrast sensitivity. The influence of age in this restricted population was seen only at 16 cpd. In those subjects with better than 6/6 (20/20) Snellen acuity, there were statistically significant relations with the parameters of the contrast sensitivity function as compared to those observers with 6/6 (20/20) or poorer acuity. High spatial frequency resolution was significantly better for those observers with better than 6/6 (20/20) acuity in either eye. In addition, this study provides a broad base of normative data for variability from a large population confined to a specific age range and with refractive errors that ranged from minimal to more than average. PMID- 3631209 TI - Changes in corneal topography and tear film stability due to a single Meibomian cyst. AB - Lid pressure may affect corneal curvature. A change in lid pressure due to a Meibomian cyst may cause a change in corneal topography and possibly in refractive status. External infection or epithelial surface disruption may affect the stability of the precorneal tear film by causing changes in tear formation or an increase in the rate of evaporation of water from this film. This report concerns a male patient who showed changes in corneal topography and tear film stability due to a Meibomian cyst. PMID- 3631210 TI - Comparison of visual characteristics in children with and without learning difficulties. AB - This report compares the refractive status, visual acuity, binocular status, vergence/accommodation facility, perceptual skills, and ocular health of 261 children with learning difficulties (LD) and 496 No-LD children, all between the ages of 6 and 12 years. Data reveal that among conditions diagnosed routinely by optometrists, hyperopia and perceptual skills dysfunction were more prevalent in LD children and myopia in No-LD children. No other significant between-group differences were found. PMID- 3631211 TI - Dehydration of hydrogel lenses during overnight wear. AB - We studied the extent of dehydration of hydrogel lenses during overnight wear. Seven subjects used a hand refractometer to measure the water content of five different lenses (Hydron zero-6 (nominal water content 38.6%), -0.50 D; Snoflex 50 (52.5%), -0.50 and + 15.00 D, and Hydron Z-67 (67.5%), -0.50 and + 15.00 D) before and after 7 h of both open- and closed-eye wear. No statistically significant difference was observed in dehydration between open and closed eye lens wear. Thick and thin lenses made of the same material were found to dehydrate to an equal extent. Contrary to expectations, the medium water content Snoflex 50 lenses displayed a greater absolute decrease in water content than the higher water content Hydron Z-67 lenses (p less than 0.01). Factors that may influence the extent of dehydration under open- and closed-eye wearing conditions, and the clinical implications of these results, are discussed. PMID- 3631212 TI - OSHA(Occupational Safety and Health Act) and the optometrist. AB - The purpose of this article is to describe the Occupational Safety and Health Act (OSHA) and how this law affects optometry. The mandate, coverage, and administration of OSHA will be highlighted. A brief perspective on developments since the beginning of OSHA will be presented. Caution is advised in view of the uncertainties in a political process that involves labor, business, and government in the complex subject of occupational safety and health. PMID- 3631213 TI - Pinealoma. AB - A patient was admitted to the Emergency Department of the Montreal General Hospital and referred to the Ophthalmology Clinic. He reported disorientation, dizziness, frontal headaches, and near vision problems. He had reduced near vision, binocular vision anomalies, Collier's sign, and abnormal pupil sizes, shapes, and responses. A diagnosis of pinealoma with a poor prognosis due to metastases was made. PMID- 3631214 TI - Optical management of posterior chamber lens tilt. AB - A pseudophakic patient reported blurred vision and diplopia one year after the surgery. We suspected that the origin of both these problems was subluxation of the intraocular lens. His blurred vision was eliminated by a cylindrical spectacle lens at an oblique axis. Monocular diplopia could only be eliminated occasionally. The displacement of the IOL is shown photographically in this report. PMID- 3631215 TI - Refractive error changes in law students. AB - We report two separate studies: a retrospective survey and a longitudinal study; both were designed to assess the changes in refractive error of a group of young adult law students. The retrospective survey compared the previous spectacle correction to the current refractive error in the ocular examination records of 87 members of the class of 1982 law students who were examined at the University of California, Berkeley School of Optometry. Forty-one students (47.1% of the sample, 12.9% of the entire class of 318) increased at least -0.50D in myopia in at least one eye. In the longitudinal study, we followed 16 first year law students for 6 months, measuring refractive error. Five eyes (15.6%) became at least +0.50D more hyperopic, and 12 eyes (37.5%) became at least -0.50D more myopic. These data represent analysis of a small number of eyes over a short period of time. An adult myopic shift is nonetheless evident. A methodology for accumulation of more meaningful data on the specific ocular component changes responsible for this effect is discussed. PMID- 3631216 TI - Presbyopia and ambient temperature. PMID- 3631218 TI - Proceedings of the second international symposium and workshops on surgery of the inner ear. Snowmass-Aspen, Colorado. Part 1. PMID- 3631217 TI - A new concept of basal cell epitheliomas based on the three-dimensional growth pattern of the superficial multicentric type. AB - Little is known about the growth characteristics of basal cell epitheliomas (BCEs), largely because of the difficulty in studying these tumors, both in situ and in vitro. In this study, the authors report that a scanning electron microscopic examination of 2 cases of superficial BCEs reveals that the tumor proliferates centrifugally as a monolayer beneath the epidermis as well as over the surfaces of hair follicles, while eroding and replacing the original basal architecture. Behind the leading edge of this monolayer, the cells split away from the epidermis to form a round border resembling a carpet being rolled up. This border then develops into a mass lesion, which represents the tumor cell foci seen in routine paraffin sections. These findings have led the authors to propose a fundamentally different explanation for the pathogenesis of these tumors: BCEs are conditioned neoplasms that require contact with the epidermal or hair follicular epithelium in order to grow. This hypothesis could explain the behavior of BCEs as well as the clinical and pathologic varieties observed in clinical practice. PMID- 3631219 TI - Workshop: surgical anatomy and radiographic imaging of cochlear implant surgery. PMID- 3631220 TI - Pathophysiology of tinnitus: a special case--hyperacusis and a proposed treatment. AB - The occurrence of hyperacusis is rare. In our Tinnitus Clinic, where more than 4,000 patients have been seen, hyperacusis has been seen only four times. Treatment of hyperacusis has been a combination of protection from external sounds along with desensitization to sound. Desensitization has been produced by very low intensity masking which is gradually increased every two to four weeks. The process of desensitization requires a great deal of time. PMID- 3631221 TI - Can tinnitus be masked by band erased filtered masker? Masking tinnitus with sounds not covering the tinnitus frequency. AB - In this study, the effectiveness of masking sound not covering the tinnitus frequency was tested against that of conventional masking sound in 117 subjects. Successful masking was observed in 72% of the former and 70% of the latter. There was no remarkable difference between the two maskers regarding the acceptability and intensity. The duration of residual inhibition, however, was smaller in the masker not covering the tinnitus frequency. The masking sound tested could be useful as an alternative when the conventional one is not accepted. PMID- 3631222 TI - Implantable hearing aid using an ossicular vibrator composed of a piezoelectric ceramic bimorph: application to four patients. AB - Direct driving of the stapes by an ossicular vibrator composed of a piezoelectric ceramic bimorph is the key functional mechanism of the partially implantable hearing aid reported in this article. Acoustic signals from a microphone are transmitted to the vibrator by means of electromagnetic induction. The devices were implanted into four patients with mixed deafness due to chronic otitis media. In the first patient, the device has continued to function for two years. The highly efficient sound transmission achieved by the direct driving of the stapes produced excellent sound perception. The functional principle, surgical procedure, and indications for this new device for hearing rehabilitation are described together with the clinical results obtained in the four patients. PMID- 3631223 TI - Panel discussion: cochlear implants--basic science. PMID- 3631224 TI - Our experience with cochlear implants: have we erred in our expectations? AB - Many clinicians feel that single-channel cochlear implants are limited in the information they can provide. This has led to some common misconceptions regarding single-channel and multichannel systems. At the House Ear Institute, a growing number of children with the 3M/House single-channel implant are demonstrating open-set understanding of speech on measures designed to test such abilities in children. As a result, we have revised our thinking regarding the potential of this device. PMID- 3631225 TI - Titanium implants in the otic capsule: development of a new multichannel extracochlear implant. AB - Preliminary data are presented on the development of a new approach for multi channel stimulation of the cochlea. The approach is based upon the use of small titanium implants in the lateral wall of the inner ear which act as anchor points for platinum-iridium stimulating electrodes. These holders allow contact of the stimulating electrode with the lateral surface of the membranous labyrinth. Observations in monkeys indicate that some degree of anchoring of the titanium implant in the otic capsule is achievable, including the formation of a close bone-metal interface. We propose that this approach may yield an alternative strategy for the development of a multichannel extracochlear prosthesis. PMID- 3631226 TI - Preliminary results for the cochlear corporation multielectrode intracochlear implant in six prelingually deaf patients. AB - The preliminary results from this study indicate that some prelingually deaf patients may get worthwhile help from a multiple-electrode cochlear implant that uses a formant-based speech processing strategy. It is encouraging that these improvements can occur in young adults and teenagers. The results for two children are also encouraging. A 10-year-old child obtained significant improvement on some speech perception tests. It was easy to set thresholds and comfortable listening levels on a 5-year-old child, and he is now a regular user of the device. There are, however, considerable variations in performance among the prelingual patients, which may be related to the following factors: whether they have had some hearing after birth, the method of education used, the motivation of the patient, and age at implantation. PMID- 3631227 TI - The effects of varying the number of cochlear implant electrodes on speech perception. AB - The purpose of this investigation was to evaluate the speech perception of a patient fitted with a multichannel processor under different electrode conditions. The subject was evaluated with the speech processor programmed with electrode arrays varying in number from one to nineteen. The results suggested that with an increased number of programmed electrodes, the subject's speech perception improved. Comparisons were also made among three speech processing strategies. The processor was programmed with: (1) one electrode pair that provided fundamental frequency information; (2) nineteen electrode paris that provided fundamental frequency plus second formant information (F0/F2); and (3) nineteen electrode paris that provided fundamental frequency plus first and second formant information (F0/F1F2). The subject did better with the F0/F2 strategy compared to the F0 strategy and best with the F0/F1F2 strategy. PMID- 3631228 TI - Workshop: cochlear implants in children. PMID- 3631229 TI - Workshop: evaluation of the cochlear implant candidate. PMID- 3631230 TI - Proceedings of the second international symposium and workshops on surgery of the inner ear. Snowmass-Aspen, Colorado. Part 2. PMID- 3631231 TI - The Portmann procedure after sixty years. AB - This article recalls the technique described by Georges Portmann in 1926 for the opening of the endolymphatic sac in cases of Meniere's disease. Criteria of indication used at the time are critically analyzed. Modifications of the original operation proposed by various authors, particularly those of T. Naito, W. House, A.W. Morrison, and I.K. Arenberg, are then described. Finally, the current technique and indication criteria implemented in Bordeaux are analyzed, with stress on electrocochleographic determination of the summation potential and its disappearance under the effect of glycerol. According to the author, these latest examination techniques contribute to improving results by providing a better selection of cases likely to be treated by the opening of the endolymphatic sac. PMID- 3631232 TI - Meniere's disease: results of treatment with the endolymphatic subarachnoid shunt compared with the endolymphatic mastoid shunt. AB - The senior author has performed 346 endolymphatic sac operations since 1971. Questionnaires were sent to these patients to evaluate the results of this surgery. One hundred ninety-six questionnaires were returned and formed the basis for this report. The results of surgery are reported by the new American Academy of Otolaryngology--Head and Neck Surgery criteria as well as by the older method of reporting. There is no significant difference in results between the endolymphatic subarachnoid shunt and the endolymphatic mastoid shunt. Because of the lower morbidity of the latter procedure the authors prefer the endolymphatic mastoid shunt. The new method of reporting is superior to the older method. PMID- 3631233 TI - Endolymphatic sac surgery for Meniere's disease: eighteen years' experience with the Kitahara sac operation. AB - From 1968 to 1983, 162 cases of Meniere's disease were treated surgically with our intramastoid drainage technique. One hundred forty of these cases could be followed up for two years or more. Treatment results were calculated according to the 1972 AAOO criteria and the 1985 AAO-HNS criteria. Using our technique, definitive vertigo spells could be controlled completely in 78% of cases and substantially controlled in 94%. Hearing worsened in only 15% of all cases. Therefore, prevention of worsening of hearing, especially in bilateral cases, and control of vertigo spells in patients with frequent attacks were considered absolute indications for our technique. In this study critical observations were made based on the number of cases hitherto reported by surgeons (the average number of patients undergoing surgery in our clinic was fourteen per year). The need for careful selection of patients for surgery is emphasized. PMID- 3631234 TI - Ten-year follow-up on the first five inner ear valve implants for intractable vertigo in Sweden. AB - Ten-year clinical results are reported on the first five inner ear valve implants done in Sweden in 1975 and 1976. If the patient had a positive glycerol dehydration test (n = 4) the chances of excellent results for hearing at one year as well as complete elimination of vertigo were high. At ten years, two of the four patients with positive glycerol dehydration tests maintained excellent hearing and complete elimination of vertigo. One patient's hearing deteriorated, but he was still completely free of vertigo at ten years. One patient had a labyrinthectomy at three years, but now we would have considered a revision valve implant before a destructive procedure. The patients who had clinical evidence of bilateral disease did not do as well at ten years as patients with unilateral disease. With ten year follow-up it has been shown that the inner ear valve implant is a safe and effective nondestructive alternative to labyrinthectomy for salvaging patients who failed medical therapy. PMID- 3631235 TI - Endolymphatic sac enhancement. Principles of diagnosis and treatment. AB - Principles of diagnosing and treating Meniere's disease using endolymphatic sac enhancement are described. Based on a current understanding of the natural history and pathogenesis of this disease, the terminology, diagnosis, and thereby are discussed. Techniques (methods) and surgical objectives of endolymphatic sac enhancement are designed to counteract the pathogenesis (endolymph malabsorption). Current surgical methods and results are presented for 100 patients selected at random from a larger group. Discussion of this method of treatment and reporting criteria follow. PMID- 3631236 TI - Valve implants compared to other surgical methods. AB - The results of eighty-seven inner ear valve implant procedures for Meniere's disease are compared to those of 181 other surgical procedures performed during the same period, and 339 cases reported in our previous series. Indications are that all procedures give comparable results, although it is suggested that in isolated cases the inner ear valve implant can improve hearing by much greater margins than can be achieved using alternative surgical methods. In spite of this advantage, however, there is a possibility that the approach to the endolymphatic duct used in the implant procedure may jeopardize the inner ear function, and thus it should still be used with caution. PMID- 3631237 TI - Valved implants in endolymphatic sac surgery. AB - This study demonstrates the superiority of a valved implant (Denver-Arenberg valve) over simple sac decompression surgery for Meniere's disease. The valved implant has the advantage of better hearing results. Effectiveness in the relief of vertigo is equal for the two types of procedures. The phenomenon of enhanced high-frequency hearing gain has been observed only with valved implants. Rather spectacular hearing gains in a minority of patients have occurred primarily with the valved implant. Although the numbers are too small to draw any firm conclusions, it would seem that the valved implant is also useful in treating cochlear hydrops. Whether other therapeutic modalities will prove to be more beneficial than either of these procedures is not addressed in this article. PMID- 3631238 TI - Pneumolabyrinth in perilymphatic fistula: report of three cases. AB - In three patients with perilymphatic fistula, exploratory tympanotomy revealed air bubbles emerging through the ruptured round window membrane. Review of the literature disclosed three case reports in which air was demonstrated in the labyrinth in association with perilymphatic fistula. Experimental evidence that air could enter the labyrinth through a defect of the round window membrane was described in two articles. In our patients, the perilymphatic fistula was produced by implosive force. When a perilymphatic fistula was produced by implosive force, or in the case of a pre-existing perilymphatic fistula, we assume, air may enter the scala tympani through the defect of the round window membrane if the middle ear pressure rises beyond a certain limit. Sudden onset of deafness and reversibility of hearing in perilymphatic fistula could be attributable to the presence of air bubble in the scala tympani--pneumolabyrinth- which might disturb propagation of the traveling wave of the basilar membrane. PMID- 3631239 TI - Fluid flow in the cochlear aqueduct and cochlea-hydrodynamic considerations in perilymph fistula, stapes gusher, and secondary endolymphatic hydrops. AB - There is convincing evidence that the cochlear aqueduct is normally patent in humans and is of relatively constant size. It probably plays an important role in the balance between the perilymphatic, endolymphatic, and cerebrospinal fluid pressures. The flow rate of liquids through tubes is a linear function of pressure, viscosity, and length of the tube but is a fourth degree power function of the radius of the lumen. For this reason, the radius is the most critical factor determining the flow rate. Small variations in size of the cochlear aqueduct can cause very large variations in flow rate through it. PMID- 3631240 TI - Familial Meniere's disease: a genetic investigation. AB - Familial forms of Meniere's disease in which the main etiologic factor is probably genetic are described. Among ninety-one patients with Meniere's disease from the county of Uppsala, the disease could be classified as being of familial origin in 14%. Different modes of inheritance were revealed. Aberrations in chromosome 7 were found in one mother and her daughter. PMID- 3631241 TI - Serum osmolality in Meniere's disease. AB - Serum osmolality in patients with Meniere's disease was measured by a Wescore 5100B osmometer to reveal the relationship between a vertiginous attack, the effect of isosorbide, the effect of glycerol, and the osmolality. The following results were obtained: First, the osmotic pressure of the control group ranged from 275 mOsm/kg to 285 mOsm/kg, and that of the Meniere's group ranged from 270 mOsm/kg to 290 mOsm/kg. Both groups showed normal distribution, and mean values of both were 284 mOsm/kg. There was no statistically significant difference between them with regard to serum osmolality. Second, patients with values of 283 mOsm/kg or less were more often in a vertiginous attack period, and patients with values of 284 mOsm/kg or more were more often in an attack-free period. Third, patients with values of 283 mOsm/kg or less were more often in the positive glycerol test group; those with values of 284 mOsm/kg or more were more often in the negative glycerol test group. Finally, there was no significant difference in serum osmolality between patients receiving isosorbide therapy and patients given no treatment. PMID- 3631242 TI - Induction of experimental endolymphatic hydrops by immunologic techniques. AB - Immunologic techniques have been used by many investigators to produce experimental endolymphatic hydrops models. These techniques, however, have achieved little success in producing models simulating the idiopathic endolymphatic hydrops of Meniere's disease, in which no inflammatory changes occur in the perilymphatic spaces. In this study, the antigen horseradish peroxidase (HRP) was injected into the endolymphatic sacs of ninety guinea pigs that had been systematically sensitized to this antigen. Endolymphatic hydrops was induced in sixty-seven of the subjects, sixty-four of which showed no inflammatory changes in the perilymphatic spaces. The endolymphatic sacs of the affected guinea pigs were packed with soft granulation tissue induced by immunologic mechanisms; it is felt that the hydrops was caused by disturbances in endolymph absorption resulting from these tissue formations. Our results suggest that the introduction of antigens into the endolymphatic sac may prove useful in producing endolymphatic hydrops with characteristics similar to those occurring in Meniere's disease. PMID- 3631243 TI - Results of endolymphatic sac to mastoid shunt surgery for Meniere's disease refractory to medical therapy. AB - In the ten-year period ending July 1, 1986, 5475 dizzy patients were evaluated and treated medically at the Colorado Ear Clinic. Of these, 214 patients (4%) were diagnosed as having classic Meniere's disease refractory to medical therapy and underwent endolymphatic sac to mastoid shunt surgery. These patients were followed for a minimum of one year after surgery. The average audiometric follow up was 35.1 months. Based on the American Academy of Otolaryngology-Head and Neck Surgery 1985 criteria for reporting results at one year, 60.3% had lower audiometric thresholds postoperatively (H1) or unchanged thresholds (H2) relative to the worst preoperative audiogram. Elimination of all vertiginous attacks was achieved in 73.9% (Vo). Adjunctive spells were not assessed. Disability was eliminated (Do) in 86%. Based on a prospective computerized analysis of forty pertinent variables, a profile of a classic Meniere's disease patient who has failed to improve with medical, allergic, dietary, exercise, or other conservative treatment and would be likely to benefit from endolymphatic sac to mastoid shunt surgery is established. PMID- 3631244 TI - Panel discussion: The surgical anatomy and fine points of endolymphatic system surgery. PMID- 3631245 TI - Panel discussion: Perilymphatic fistula. PMID- 3631246 TI - Dependence of tonic tension on extracellular calcium in rat extraocular muscle. AB - Ca2+-free saline containing 3.0 mM Mg2+ virtually abolishes the tonic tension evoked by depolarization with a high K+ concentration of the tonic multiply innervated fibers of rat extraocular muscles. The tonic tension abolished by Ca2+ withdrawal is restored when Ca2+ is substituted by Sr2+ but not by Ni2+. The increase of Mg2+ reduces the tonic tension and displaces the tension-log K+ relationship to the right. Cd2+ significantly reduces the tension amplitude but does not shift the tension-log K+ relationship. The organic blocker of Ca2+ channels, nifedipine (1-10 microM), has no effect on the tonic tension. In contrast, diltiazem (20 microM) reduces the amplitude of the responses without changing the tension-log K+ relationship. Both foreign anions NO3- and SCN- potentiate tonic tension without changing the tension-log K+ relationship. SCN- increases the resting tension of the muscle; this effect depends on Ca2+. In conclusion, the disappearance of tonic tension after Ca2+ withdrawal is not due to depolarization of the fibers or inactivation of the contractile responses. It is suggested that entry of extracellular Ca2+, via a voltage-dependent Ca2+ conductance, or specific interactions of Ca2+ with membrane sites involved in the regulation of excitation-contraction coupling play a role in evoking tension in tonic fibers. PMID- 3631247 TI - Dependence of L-arginine accumulation on membrane potential in cultured human fibroblasts. AB - The cell-to-medium distribution ratios at steady state of L-arginine (RArg) and of the lipid-soluble cation tetraphenylphosphonium (RTPP) were studied as a function of the membrane potential (Em) in adult human fibroblasts. The relationship between RArg and Em was qualitatively similar to that of RTPP and Em. Quantitatively, RArg and RTPP differed in that 1) RTPP was much greater than RArg when Em was near zero, indicating a significant binding component in the uptake of TPP+ but not of L-arginine, and 2) after a correction for binding when Em is near zero, RTPP was still greater than RArg so that RT/F . ln RTPP exceeded RT/F . ln RArg by 10-25 mV. The pattern of the redistribution of accumulated TPP+ and arginine after an alteration of Em was identical. In null-point experiments, the external [K+] for which there were no changes in cellular TPP+ or L-arginine in the presence of high valinomycin (the null points) were very similar for the two probes. Em calculated from the null-point measurements (-70(-)-80 mV) was also very similar to RT/F . ln RArg and thus smaller than RT/F.ln RTPP. It was concluded that 1) there was an additional TPP+ binding as cellular [TPP] rose in response to more negative membrane potentials, 2) the transport system for L arginine in these cells (system y+) operates as a facilitated diffusion system driven by the membrane potential, and 3) in some circumstances, L-arginine could be employed as a probe of Em. PMID- 3631248 TI - Effects of rest duration and ryanodine on changes of extracellular [Ca] in cardiac muscle from rabbits. AB - Cumulative depletions of extracellular Ca were measured using double-barreled Ca sensitive microelectrodes in the extracellular space of rabbit ventricular muscle. Depletions were produced by 1-Hz stimulation after rest intervals of 10 s to 10 min. With longer rest intervals, depletion size increased while the first postrest contraction decreased in a reciprocal manner. The depletions may represent refilling of sarcoplasmic reticulum (SR) Ca stores that have become partially depleted of Ca during the rest. Within this interpretive framework, the longer the rest interval the lower the SR Ca content, so the SR is then capable of taking up larger amounts of Ca. This may be related to the rest decay of tension of the first postrest beat, since this is thought to be SR dependent. Ryanodine (1 microM) increased the size of the depletions after short rest intervals (less than 2 min) but not after longer (greater than or equal to 2 min) intervals. Ryanodine also increased the rate of Ca loss from the cell on cessation of stimulation. This increased rate of Ca loss with ryanodine may deplete the SR of Ca such that more Ca can be taken up during subsequent stimulation than in untreated muscles. Thus cumulative depletions after short rest intervals are enhanced by ryanodine. When a Ca load was produced during 1) quiescence [by removal of extracellular Na (Nao)] or 2) continuous stimulation (in the presence of 3 microM acetylstrophanthidin), addition of ryanodine (5-10 microM) did not produce any apparent Ca loss. Caffeine (10 mM), added after ryanodine, induced contractures accompanied by Ca efflux, implying there was Ca in the SR after ryanodine exposure. The results of other investigators have suggested that ryanodine may inhibit cardiac SR Ca release. The present study suggests that ryanodine also enhances the loss of cellular (and probably SR) Ca on cessation of stimulation but not when applied during continuous stimulation or quiescence. PMID- 3631249 TI - Ryanodine and the calcium content of cardiac SR assessed by caffeine and rapid cooling contractures. AB - The ability of rabbit ventricular muscle sarcoplasmic reticulum (SR) to accumulate and retain Ca during Na-free perfusion was assessed using caffeine contractures and rapid cooling contractures (RCC). Muscles were exposed to a Na free medium for 15 min, during which time a transient contracture developed and relaxed back to the resting tension level. Muscles were then either exposed to 20 mM caffeine or rapidly cooled to less than 5 degrees C, both of which produced large contractures. The magnitudes of those contractures are believed to be a relative index of SR Ca content. Reduction of extracellular [Ca] from 2 to 0.2 mM did not significantly alter the magnitude of either Na-free caffeine contractures or RCC. These are not the maximum contractures that can be obtained. The possibility that low extracellular [Ca] ([Ca]o) may increase passive Ca permeability is suggested in explanation of this effect. After equilibration with 100 nM ryanodine, both Na-free caffeine contractures and RCC are virtually eliminated. This suggests that even if the SR could accumulate Ca during the initial Na-free exposure in the presence of ryanodine, it could not retain that Ca in Na-free medium. It is proposed that the sarcolemmal Ca pump can extrude Ca from the cells at a rate sufficient to deplete the ryanodine-treated SR. When removal of Na was accompanied by increase of [K]o (to 12, 20, or 30 mM), the Na free RCC were enhanced. Increasing [K]o during Na-free superfusion in the presence of ryanodine resulted in demonstrable RCC that were graded with [K] and completely suppressed by nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631250 TI - Sulfate transport in apical membrane vesicles isolated from tracheal epithelium. AB - Sulfate uptake in apical membrane vesicles isolated from bovine tracheal epithelium is shown to occur into an osmotically sensitive intravesicular space, via a carrier-mediated system. This conclusion is based on three lines of evidence: 1) saturation kinetics; 2) substrate specificity; and 3) inhibition by the anion transport inhibitors SITS and DIDS. The affinity of the transport system is highest in low ionic strength media (apparent Km = 0.13 mM) and decreases in the presence of gluconate (apparent Km = 0.68 mM). Chloride appears to cis-inhibit sulfate uptake and to trans-stimulate sulfate efflux. Cis inhibition and trans-stimulation studies with a variety of anions indicate that this exchange system may be shared by HCO3-, S2O3(2-), SeO4(2-), and MoO4(2-) but not by H2PO4- or HAsO4(2-). Studies indicate that protons may play two distinct roles in sulfate transport in this system. 1) Their possible modifier role is suggested by the fact that protons affect SO2-4 transport in an uncompetitive manner. 2) The possibility that the proton gradient may act as an energy source for a secondary active transport is indicated by the fact that the imposition of a proton gradient stimulates a transient movement of sulfate in to the tracheal apical membrane vesicle, against its concentration gradient, causing an "overshoot" phenomenon. Our studies show that the carrier-mediated system can function in the absence of chloride. The overshoot observed in the presence of a proton gradient (OH- gradient) indicates that under those conditions the mechanism of transport may be a SO4(2-)-OH- exchange. The fact that chloride cis inhibits and trans-stimulates SO4(2-) transport indicates that SO2-4 uptake may also occur via a SO4(2-)-Cl- exchange. Studies carried out so far do not enable us to conclude unequivocally whether the tracheal apical membrane system displays two distinct carrier activities (SO4(2-)-Cl-; SO4(2-)-OH-) or one anion exchanger, which like the erythrocyte anion exchanger, may interact with SO4(2-), Cl-, and H+. The fact that the anion transport inhibitors DIDS and SITS inhibit SO4(2-) transport in the presence or absence of chloride suggests that the latter possibility may be the case. PMID- 3631251 TI - ATP depletion in slow-twitch red muscle of rat. AB - Rat slow-twitch muscle, in contrast to fast-twitch muscle, maintains its ATP content near normal during intense stimulation conditions that produce rapid fatigue. An extensive depletion of adenine nucleotide content by the deamination of AMP to IMP + NH3, typical of fast-twitch muscle, does not occur. We evaluated whether this response of slow-twitch muscle could be simply due to failure of synaptic transmission or related to cellular conditions influencing enzyme activity. Stimulation of soleus muscles in situ via the nerve or directly in the presence of curare at 120 tetani/min for 3 min resulted in extensive fatigue but normal ATP contents. Thus the lack of ATP depletion must be related to cellular events distal to neuromuscular transmission. Even nerve and direct muscle stimulation (with curare) during ischemia did not cause a large depletion of ATP or a large elevation of lactate content (12.0 +/- 0.7 mumol/g), even though the decline in tension was essentially complete. However, if the same tension decline during ischemia was prolonged by stimulating for 10 min at 12 tetani/min a large decrease in ATP (2.24 +/- 0.09 mumol/g) and increase in IMP (2.47 +/- 0.16 mumol/g) and lactate (30.4 +/- 2.0 mumol/g) content occurred. Thus adenine nucleotide deamination to IMP can occur in slow-twitch muscle during specific contraction conditions. The cellular events leading to the activation of AMP deaminase require an intense contraction condition and may be related to acidosis caused by a high lactate content. PMID- 3631252 TI - Myofibrillar M-band structure and composition of physiologically defined rat motor units. AB - The isometric contraction time of 19 fast and slow rat motor units in the soleus and the anterior tibial muscles were recorded. The motor unit fibers, subsequently distinguished by glycogen depletion, were histochemically differentiated into fiber types and analyzed immunohistochemically for high molecular weight M-band proteins, as well as ultrastructurally for M-band fine structure, Z-disc width, and volume density of mitochondria. All fibers belonging to slow-twitch motor units in both the anterior tibialis and soleus muscles were histochemically classed as type 1. They lacked the Mr 165,000 M-protein, showed ultrastructurally a four-line M-band pattern, and had broad Z-discs, whereas the volume density of the mitochondria varied considerably. Muscle fibers belonging to the fast-twitch motor units were histochemically classed as types 2A and 2B in anterior tibialis and type 2A in soleus. They contained a three- or a five-line M band pattern and medium-to-thin Z-discs in the anterior tibialis and a five-line M-band pattern and broad Z-discs in the soleus. Furthermore, the volume density of mitochondria showed considerable variation within and in between soleus and anterior tibialis type 2 fibers. As the differences in M-band composition and structure between fiber types overrode the intragroup variability in contraction times of slow and fast units within and between the two muscles, it is concluded that the M-band composition and structure is fundamentally related to whether the fiber is innervated by a slow or fast motor neuron, whereas other parameters such as contraction time, Z-disc width, and mitochondrial content of fibers of fast and slow units are relative and vary between muscles. Thus the M-band appearance can be used as a reliable marker to distinguish between fibers of slow- and fast twitch motor units in rat leg muscles. PMID- 3631253 TI - Stiffness of active smooth muscle during forced elongation. AB - The stiffness of isometrically contracting mesotubarium superius and ovarian ligament smooth muscle from estrous female rabbits was measured continuously by using sinusoidal length perturbations (at 80 Hz, less than 15 microns peak to peak). Muscles were stimulated with alternating current fields, and all records were digitized using a microcomputer system. Phase-angle data were used to resolve computed stiffness into elastic and viscous components. Stiffness measurements were continued during long ramp-type stretches (up to 25% of muscle length) delivered as soon as force was maximal. To use the period of isometric tension development as a standard for comparison, the expected stiffness was computed during the long stretch. Stiffness was reduced in approximate proportion to the ramp stretch rate, and the reduction was confined largely to the elastic component. Cooling the muscle increased the stiffness deviation at a given stretch rate. It is proposed that the long stretch detaches cross bridges that can reattach to new sites as myofilaments shear past one another. At higher shearing speeds, less time is available for reattachment and stiffness is further reduced. PMID- 3631254 TI - Nervous control of glycogenolysis and blood flow in arterially and portally perfused liver. AB - In a recently developed model for the simultaneous perfusion of isolated rat liver via both the hepatic artery (120 mmHg, 20-35% flow) and the portal vein (10 mmHg, 80-65% flow), the arterial and portal nerve plexuses were stimulated (20 V, 2 ms, 2.5-20 Hz for 0.33-5 min) either jointly in the liver hilus or separately at the common hepatic artery and the mesenteric vein, respectively. Stimulation of the arterial plexus alone caused an increase of glucose output, a shift from lactate uptake to output, and a decrease of arterial and, "transhepatically," also of portal flow. Stimulation of the portal plexus alone elicited the same yet clearly smaller metabolic and transhepatic hemodynamic effects. The sum of the metabolic actions of single arterial and portal stimulations but not the sum of the hemodynamic actions was equal to the effects of simultaneous separate stimulations of the hepatic artery and mesenteric vein or joint stimulations in the liver hilus. Half-maximal and maximal effects were reached during 5-min stimulation periods within the physiological range of frequencies, i.e., at 5-6 and 10 Hz for metabolic alterations and at 8 and 20 Hz for hemodynamic changes. At a frequency of 10 Hz, half-maximal and maximal effects were observed with stimulation periods of 0.5 and 1 min for metabolic alterations and with 2 and 5 min for hemodynamic changes. The described model of isolated rat liver perfusion is well suited for the study of the complex metabolic and hemodynamic actions of the arterial and portal nerves, their mutual interactions, and modulations by circulating factors. PMID- 3631255 TI - A primed-infusion technique for rapid estimation of the metabolic clearance rate of 1,25(OH)2D3. AB - We have developed a rapid primed-infusion technique for the measurement of the metabolic clearance and production rate of 1,25-dihydroxyvitamin D3 in normal human subjects and experimental animals. With this method, an estimate of the metabolic clearance rate of 1,25-dihydroxyvitamin D3 can generally be made within 3 to 4 h. Initial studies in five dogs using 1,25-[3H]-dihydroxyvitamin D3 (180 Ci/mmol) allowed us to determine the optimal ratio of loading dose to infusion rate that resulted in the most rapid attainment of steady-state levels of plasma radioactivity. By use of this technique we found that the metabolic clearance rate of 1,25-dihydroxyvitamin D3 in dogs was 6.3 +/- 1.2 ml/min (mean +/- SD); the production rate of the hormone was 0.40 +/- 0.25 microgram/day (20.4 +/- 14.4 ng . kg-1 . day-1). In eight normal women, aged 28-51 yr, the metabolic clearance rate for 1,25-dihydroxyvitamin D3 was 25.9 +/- 4.7 ml/min; the production rate was 1.38 +/- 0.45 microgram/day (20.7 ng . kg-1 . day-1). The advantages of this method relative to ones used in the past are that it can be performed quickly (generally within 3-4 h) with the use of only tracer amounts of this hormone (equivalent to 1.1% of the production rate). With this method, no assumptions about the most appropriate model to which to fit the data need to be made. Because of its rapidity, no metabolites of the injected 1,25-dihydroxyvitamin D3 are formed during the study interval. PMID- 3631256 TI - Optimal response of key enzymes and uncoupling protein to cold in BAT depends on local T3 generation. AB - We have examined the activity of three lipogenic enzymes [malic enzyme (ME), glucose-6-phosphate dehydrogenase (G-6-PD), and acetyl coenzyme A (CoA) carboxylase], the activity of the mitochondrial FAD-dependent alpha glycerolphosphate dehydrogenase (alpha-GPD), and the mitochondrial concentration of uncoupling protein (UCP) in brown adipose tissue (BAT) of euthyroid and hypothyroid rats, both at room temperature and in response to acute cold stress. These enzymes and UCP are important for the thermogenic response of BAT in adaptation to cold. The basal level of the lipogenic enzymes was normal or slightly elevated in hypothyroid rats maintained at 23 degrees C, but the levels of alpha-GPD and UCP were markedly reduced. Forty-eight hours at 4 degrees C resulted in an increase in the activity of G-6-PD, acetyl-CoA carboxylase, and alpha-GPD and in the concentration of UCP both in euthyroid and hypothyroid animals, but the levels reached were invariably less in hypothyroid animals, indicating that thyroid hormone is necessary for a full metabolic response of BAT under maximal demands. Of all variables measured, the most affected was UCP (only one-fifth of the response of euthyroid rats to cold) followed by alpha-GPD (approximately 50% the euthyroid response). The administration of replacement doses of triiodothyronine (T3) to hypothyroid rats for 5-7 days did not normalize any of the BAT responses, whereas the replacement of thyroxine (T4) for only 2 days sufficed to normalize them all. This effect of T4 was abolished by preventing its conversion to T3 with iopanoic acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631257 TI - Pathophysiology of type A hypoxic lactic acidosis in dogs. AB - Hypoxic lactic acidosis (HLA) was induced in dogs by ventilating them with a hypoxic gas mixture of 8% O2-92% N2. The animals were studied both in the control state and after development of HLA, where arterial lactate was above 5 mM, pH was below 7.2, bicarbonate was below 12 mM, and arterial PO2 was between 26 and 30 Torr. After hypoxia had been present for 90 min, most of the increase in arterial lactate vs. control was due to increased lactate production from gut and carcass in the presence of a decreased capacity of the liver to extract lactate. The capacity of the liver to extract lactate in the normoxic state was evaluated in another group of six dogs after infusion of L-lactic acid such that arterial pH, lactate, and bicarbonate were similar to hypoxic values. In these experiments it was found that the capacity of the liver to extract lactate was 14.8 +/- 1.7% of the delivered load vs. 4.9 +/- 1.3% observed in hypoxic animals. The decreased liver lactate extraction in HLA was probably secondary to both a decrease in liver oxygen uptake and a decrease in liver intracellular pH and was paralleled by an increase in liver tissue lactate levels. Cardiac output, in contrast to other forms of lactic acidosis, was increased by 40% vs. control and femoral artery flow by 35%, whereas liver blood flow was unchanged and renal blood flow decreased. Hypoxic lactic acidosis thus is the consequence of overproduction of lactate by both gut and carcass, in the presence of impaired utilization of lactate by the liver.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631258 TI - Plasma catecholamine and serum cortisol responses to experimental cardiac arrest in dogs. AB - The plasma catecholamine and serum cortisol responses to cardiac arrest (ventricular fibrillation), cardiopulmonary resuscitation (CPR), and ventricular defibrillation were examined in 10 intact (sham-operated controls) and 10 bilaterally adrenalectomized dogs. One hour after surgery, the cardiac ventricles were electrically fibrillated, and 30 s later Standard American Heart Association CPR was begun. After 12 min of CPR, the ventricles were defibrillated. Cardiac arrest per se results in a massive increase in plasma epinephrine and norepinephrine concentrations and indicates that the adrenal medullas are the predominant source of this response. Although the epinephrine response was virtually nonexistent in the adrenalectomized dogs, the norepinephrine response was approximately 30% of that in the sham-operated control animals. Thus there is an adrenomedullary, and perhaps a sympathetic neural, component to the sympathochromaffin response to cardiac arrest. Resuscitation from experimental cardiac arrest tended (P greater than 0.05 less than 0.1) to be lower in the adrenalectomized dogs (1 of 10) than in the animals with intact adrenal glands (6 of 10). PMID- 3631259 TI - Distribution of free and sulfate-conjugated catecholamines in human platelets. AB - Sulfate conjugation represents a major pathway for the inactivation of catecholamines and is presumed to occur at sites, including platelets, where phenylsulfotransferase activity has been identified. This study examines the relative distribution of free and conjugated norepinephrine, epinephrine, and dopamine in the platelets and plasma of resting subjects. As active uptake of free catecholamines into platelets has been reported in vitro; the possibility of a similar mechanism, operating for sulfate conjugates, was also investigated. The presence of sulfated catecholamines in platelets is confirmed. The proportion of total catecholamines existing in the free form was 78 +/- 4% (mean +/- SE) for norepinephrine, 52 +/- 5% for epinephrine, and 50 +/- 10% for dopamine, which was considerably higher than for plasma. Increases in plasma free and conjugated catecholamines achieved by bicycle exercise and oral administration of amines, respectively, were not accompanied by corresponding increases in platelet levels. The origin of platelet conjugates would appear to be the result of intraplatelet sulfation of free amines rather than direct uptake from plasma. Because acute elevation of plasma free and conjugated amines are not reflected in increased platelet levels, it is unlikely that platelet uptake mechanisms play a significantly role in the disposal of circulating catecholamines. PMID- 3631260 TI - Physiological increments in epinephrine stimulate metabolic rate in humans. AB - Markedly elevated plasma epinephrine is known to increase metabolic rate (MR), but such levels of epinephrine are encountered infrequently in normal free-living subjects. We studied whether epinephrine levels common in usual daily activities can affect MR and thus possibly regulate caloric expenditure. To aid definition of a MR threshold, we first measured the hourly and daily variation in MR within individuals by measuring the MR of four individuals by indirect calorimetry for 6 h on six separate occasions without any intervention. We found that hour-to-hour variation (2.0 +/- 0.9%) and the day-to-day variation (2.7 +/- 0.9%) were low, thus allowing confident detection of small increments in metabolic rate during epinephrine infusion. To define a threshold for epinephrine's effect to increase MR, we studied five normal-weight postabsorptive young men on four separate occasions. During the 1st h of each 5-h study period, saline was infused intravenously. Then, during the subsequent 4 h, subjects received intravenous infusion of saline or epinephrine at 0.1, 0.5, and 1.0 microgram/min (randomized). A significant increase in MR (3.6 +/- 1.0% SE) was measured with the lowest epinephrine infusion rate (venous plasma concentration, 94 +/- 32 pg/ml). The increases in MR correlated (r = 0.85, P less than 0.001) with increases in plasma epinephrine. The threshold concentration (upper 95% confidence limit) of epinephrine to affect MR was 90 pg/ml, a concentration frequently occurring in daily life. Thus epinephrine may play an important role in weight maintenance by affecting energy expenditure. PMID- 3631261 TI - Motility's morass. PMID- 3631262 TI - Motor patterns of small intestine determined by closely spaced extraluminal transducers and videofluoroscopy. AB - In the canine small intestine several simple (S) and complex (C) patterns of propulsive and nonpropulsive activities were found. The nonpropulsive activity consisted of 1) stationary individual contractions (S) and 2) stationary clusters of contractions (C). Patterns leading to aboral propulsion of luminal contents were 1) propagating contractions (S), 2) propagating power contractions (S), 3) phase III of the migrating motor complex (C), and 4) migrating clusters of contractions (C). The propagation velocities of the propulsive motor patterns differed markedly; they increased in the following order: phase III, migrating clustered contractions, propagating power contractions, propagating contractions. A retrograde transport of luminal contents was produced by two different activities: 1) retrograde propagating contractions (S) and 2) retrograde power contractions (S). They were accompanied with enterogastric reflux. PMID- 3631263 TI - Distribution and partitioning of cholesterol and beta-sitosterol in micellar bile salt solutions. AB - The distribution of cholesterol and beta-sitosterol in micellar bile salt solutions was studied using an ultrafiltration technique to separate micellar aggregates from monomers present in the intermicellar aqueous phase. The partitioning and the rates of influx across the brush-border membrane of these two sterols from micellar solutions were determined using polyethylene discs and everted jejunal sacs, respectively. Micellar solubilities of cholesterol and beta sitosterol were not significantly different, whereas the monomer concentration of beta-sitosterol in the intermicellar aqueous phase was significantly lower than that of cholesterol [0.21 +/- 0.02 microM for beta-sitosterol and 25.0 +/- 2.71 (SE) microM for cholesterol, P less than 0.001]. There was no difference in the partitioning nor was there a difference in the rates of influx between cholesterol and beta-sitosterol from micellar solutions containing a similar amount of the two sterols. It is concluded that monomer concentration of beta sitosterol in the intermicellar aqueous phase is extremely low compared with that of cholesterol, but their partitioning and rates of influx across the membrane are similar. This is primarily attributable to a much higher membrane/monomer partition coefficient of beta-sitosterol than cholesterol and to a direct interaction between micelle and membrane. PMID- 3631264 TI - Hormonal effects on development of the secretory apparatus of chief cells. AB - We used light microscopy, transmission electron microscopy, and stereological point-counting methods to investigate the response of rat gastric chief cells to corticosterone and thyroxine during postnatal development. Administration of corticosterone or thyroxine to normal animals in the first two postnatal weeks increased relative numbers of chief cells in the fundic mucosa but did not change the absolute number of total cells in each gland. The chief cells displayed more rough endoplasmic reticulum, zymogen granules, and Golgi saccules in corticosterone- or thyroxine-injected rats than in normal control rats. When rats were either adrenalectomized or made hypothyroid using propylthiouracil, the number of chief cells dramatically decreased. Ultrastructural studies of chief cells from adrenalectomized or hypothyroid rats showed retarded differentiation as indicated by increased free ribosomes, less rough endoplasmic reticulum, fewer zymogen granules, and poorly developed Golgi apparatuses. In adrenalectomized animals, thyroxine replacement alone failed to induce the histological maturation of chief cells, but addition of corticosterone stimulated chief cell differentiation. In hypothyroid animals, either thyroxine or corticosterone replacement restored the differentiation of chief cells to normal levels. Our data indicate that 1) corticosterone is necessary for gastric chief cell maturation during postnatal development, 2) a decrease or loss in either corticosterone and/or thyroxine results in retarded chief cell differentiation and functional activity, and 3) the effect of thyroxine on chief cell development is secondary to an accompanying increase in serum corticosterone. PMID- 3631265 TI - Hormonal effects on development of the secretory apparatus of parietal cells. AB - The effect of corticosterone and thyroxine on the development of parietal cells was studied in 20-day-old rats. Either corticosterone or thyroxine injection significantly increased the amount of mitochondria, tubulovesicles, and intracellular canaliculi in normal rat pup parietal cells. However, the ultrastructure of parietal cells did not change when rats were adrenalectomized or made hypothyroid by propylthiouracil (PTU) during the first week of life. Corticosterone had the same effect in hypothyroid rats as in normal rats, increasing the volume fraction of mitochondria and the surface density of tubulovesicles and intracellular canaliculi in the parietal cell. However, thyroxine failed to do so in adrenalectomized animals. When 20-day-old adrenalectomized or hypothyroid rats were challenged with secretagogues, there was no increase in maximal acid output over the basal secretory rate, while normal rats showed a 40-50% increase. We conclude that 1) normal parietal cells respond to additional thyroxine or corticosterone with increases in volume fraction of mitochondria and surface density of tubulovesicles and intracellular canaliculi; 2) the dramatic decreases in acid secretion observed in adrenalectomized or PTU-treated rats are not explained by the morphology of parietal cells that remains normal; 3) the effect of thyroxine on the development of acid secretion is mediated by corticosterone; and 4) unlike chief cells the morphological development of parietal cells does not appear to depend on corticosterone or thyroxine after postnatal day 7. PMID- 3631266 TI - Stimulation-induced changes in cytosolic calcium in rat parotid acini. AB - The concentration of cytosolic, free calcium (Ca2+i) in collagenase-isolated rat parotid acini was measured by use of the fluorescent dye fura-2 (G. Grynkiewicz, M. Poenie, and R. Y. Tsien, J. Biol. Chem. 260: 3440-3450, 1985). Ca2+i was measured in unstimulated acini and in acini stimulated with cholinergic, alpha adrenergic, and beta-adrenergic agonists, respectively. In unstimulated acini suspended in 1 mM Ca media, Ca2+i amounted to 155 +/- 38 nM (mean +/- SD, n = 14). After stimulation with the cholinergic agonist carbachol, Ca2+i increased transiently with a peak value of 640 +/- 90 nM (n = 3) obtained 4-6 s after stimulation. The peak value of Ca2+i was reduced when the extracellular calcium concentration decreased, and at 2 nM external calcium, Ca2+i amounted to 50% of the peak value observed at 1 mM external calcium. It was calculated that at least 50% of the rise in Ca2+i observed under physiological conditions (1 mM external calcium) after cholinergic stimulation is due to calcium mobilizations from intracellular pools. Stimulation with the nonspecific adrenergic agonist adrenaline caused a rise in Ca2+i of a similar magnitude as the rise observed after cholinergic stimulation. However, stimulations with the alpha-adrenergic agonist phenylephrine and the beta-adrenergic agonist isoproterenol caused a rise in Ca2+i amounting to 60 and 10%, respectively, of the rise observed after cholinergic or adrenergic stimulation. PMID- 3631267 TI - Stimulation of ornithine decarboxylase activity in digestive tract mucosa. AB - Refeeding fasted rats with normal rat food and with a variety of amino acids increases ornithine decarboxylase (ODC) activity considerably. The time course of that increase, the areas of the digestive tract directly affected, and the effective concentrations of stimulants are unknown. By use of isolated 5-cm segments of rat jejunum, we determined that maximal activation of ODC occurred after a 2-h exposure to 0.6 M glycine. Increased activity was first apparent after a 1-h exposure to glycine and was significant after a 2-h exposure to 0.05 M glycine. ODC activity increased the most in segments of jejunum, followed by segments of ileum and then duodenum. Glycine (0.4 M) failed to increase ODC activity in gastric and colonic mucosa. Interestingly, D-alanine was more effective than L-alanine in stimulating ODC activity in the jejunum. Enzyme activity was not dependent on osmotic activity of the test substances. Glucose increased enzyme activity, but mannitol and fructose were without effect. The effects of glycine were significantly greater than those of glucose. In summary, ODC of the small intestinal mucosa is increased by direct contact with amino acids and glucose within 2 h after exposure. Increased enzyme activity depends on the nature of the stimulant rather than the osmotic activity of the solution in contact with the mucosa. PMID- 3631268 TI - Responses of feline gastroesophageal junction to changes in abdominal pressure. AB - The responses of the lower esophageal sphincter (LES), stomach, and diaphragm and their contribution to changes in the high-pressure zone (HPZ) at the gastroesophageal junction were determined during extrinsic abdominal compression or intragastric balloon distension in anesthetized cats. Abdominal compression consistently induced an increase in intraluminal end-expiratory LES and gastric pressure (P less than 0.01). Changes in LES pressure significantly exceeded the changes in gastric pressure (P less than 0.01). In contrast, the LES response during gastric distension was variable in the group of animals despite a consistent volume-dependent increase in gastric pressure. Mean LES pressure for the group was unchanged, although 33% of individual animals exhibited a decrease in LES pressure during gastric distension. Both abdominal stimuli induced sustained inhibition of crural (P less than 0.01), but not costal, diaphragmatic electromyographic activity. Vagotomy affected the LES but not the gastric or diaphragmatic responses to both stimuli. In the group of animals, the combined effect of the changes in the three measured variables on the HPZ resulted in maintenance of the antireflux barrier during abdominal compression but a significant decrease in the barrier during gastric distension. PMID- 3631269 TI - Effect of systemic acid-base balance on ileal secretion. AB - We previously reported that systemic pH and HCO3 concentration affect ileal water and electrolyte absorption. To determine whether these effects could influence an ongoing secretory process, we measured transport in ileal loops exposed to either saline or 50-75 micrograms cholera toxin in mechanically ventilated Sprague Dawley rats anesthetized with pentobarbital sodium. The effects of acute respiratory and metabolic acidosis and alkalosis were then examined. Decreases in systemic pH during respiratory acidosis caused equivalent increases in net water (54 +/- 8 microliters . cm-1 . h-1) and Na absorption (7 +/- 1 mu eq . cm- . h-1) and smaller increases in Cl absorption in cholera toxin compared with saline loops. These increases reversed the net secretion of these ions observed during alkalemia in the cholera toxin loops to net absorption. Metabolic acidosis and alkalosis and respiratory compensation of systemic pH of these metabolic disorders also altered cholera toxin-induced secretion in a direction consistent with the pH change. The increase in net HCO3 secretion caused by cholera toxin was unaffected by the respiratory disorders and did not vary with the HCO3 concentration in the metabolic disorders. These findings suggest that the systemic acid-base disorders that characterize intestinal secretory states may themselves alter intestinal absorptive function and fluid losses. PMID- 3631270 TI - Influence of sacral nerves on the internal anal sphincter of the opossum. AB - The purpose of the present studies is to 1) compare the effects of stimulation of different sacral nerves (S1-S5) on internal anal sphincter (IAS) pressures and 2) examine the nature of synaptic transmission in the sacral inhibitory pathway to the IAS. Pressures from the IAS of alpha-chloralose-anesthetized opossums were recorded using a low-compliance continuously perfused catheter assembly. Electrical stimulation of the third and fourth sacral nerves (S3 and S4) caused frequency-dependent IAS relaxation, whereas stimulation of other sacral nerves was without significant effect on the IAS. Relaxation of the IAS in response to S4 stimulation was not significantly modified by atropine, pirenzepine dihydrochloride, hexamethonium chloride, or adrenergic antagonists. However, a combination of either atropine and hexamethonium or pirenzepine and hexamethonium caused a significant antagonism of sacral nerve-stimulated relaxation without modifying the inhibitory responses of local transmural nerve stimulation and isoproterenol. From these studies we conclude that 1) in the opossum the sacral nerves primarily exert inhibitory influences on the IAS and 2) the sacral inhibitory pathway involves the release of acetylcholine from preganglionic fibers, which in turn causes the activation of both muscarinic (M1) and nicotinic receptors on postganglionic, noncholinergic, nonadrenergic inhibitory neurons. PMID- 3631271 TI - Hepatic taurine transport: a Na+-dependent carrier on the basolateral plasma membrane. AB - Highly purified rat basolateral liver plasma membrane vesicles were used to examine the mechanism and the driving forces for hepatic uptake of the beta-amino acid, taurine. An inwardly directed 100 mM NaCl gradient stimulated the initial rate of taurine uptake and energized a transient twofold accumulation of taurine above equilibrium ("overshoot"). In contrast, uptake was slower and no overshoot was detected in the presence of a KCl gradient. A negative intravesicular electrical potential generated by the presence of permeant anions or an outwardly directed K+ gradient with valinomycin increased Na+-stimulated taurine uptake. External Cl- stimulated Na+-dependent taurine uptake independent of effects on the transmembrane electrical potential difference. Na+-dependent taurine uptake showed a sigmoidal dependence on extravesicular Na+ concentration, suggesting multiple Na+ ions are involved in the translocation of each taurine molecule. Na+ dependent taurine uptake demonstrated Michaelis-Menten kinetics with a maximum velocity of 0.537 nmol.mg protein-1.min-1 and an apparent Km of 174 microM. [3H]taurine uptake was inhibited by the presence of excess unlabeled taurine, beta-alanine, or hypotaurine but not by L-glutamine or L-alanine. In summary, using basolateral liver plasma membrane vesicles, we have shown that hepatic uptake of taurine occurs by a carrier-mediated, secondary active transport process specific for beta-amino acids. Uptake is electrogenic, stimulated by external Cl-, and requires multiple Na+ ions for the translocation of each taurine molecule. PMID- 3631272 TI - Involvement of calmodulin-calcium complex in regulation of O2 uptake in regions of the liver lobule. AB - In livers from phenobarbital sodium-treated rats, O2 uptake was two- to three fold higher in periportal than in pericentral regions during perfusions in the anterograde direction confirming previous studies. The purpose of this study is to evaluate the role of calmodulin in the regulation of local rates of O2 uptake. O2 uptake was inhibited up to 80% in a dose-dependent fashion by the calmodulin inhibitor, W-7 (I0.5 = 50-60 microM). In isolated mitochondria, however, W-7 had minimal effects on state 3 and 4 rates of O2 uptake. Moreover, fructose increased O2 uptake in perfused liver to a similar extent in the presence and absence of W 7, indicating that a direct effect of W-7 on mitochondria in the perfused liver can be ruled out. In perfusions in the anterograde direction, W-7 (100 microM) decreased O2 uptake from 129 to 45 mumol . g-1 . h-1 in upstream periportal regions of the liver lobule and from 47 to 36 mumol . g-1 . h-1 in downstream pericentral areas. When perfusion was in retrograde direction, however, O2 uptake was twofold higher in upstream pericentral areas. Under these conditions, W-7 decreased O2 uptake from 160 to 59 mumol . g-1 . h-1 in upstream pericentral areas and from 58 to 43 mumol . g-1 . h-1 in downstream periportal regions. Thus W-7 decreased O2 uptake predominantly in upstream regions of liver lobule irrespective of the direction of flow. Increases in O2 uptake caused by epinephrine (0.1 microM) and angiotensin II (5 nM), hormones that increase intracellular Ca2+, were blocked totally by W-7.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631273 TI - Fructose prevents hypoxic cell death in liver. AB - Perfusion of livers from fasted rats with nitrogen-saturated buffer caused hepatocellular damage within 30 min. Lactate dehydrogenase (LDH) was released at maximal rates of approximately 300 U . g-1 . h-1 under these conditions, and virtually all cells in periportal and pericentral regions of the liver lobule were stained with trypan blue. Infusion of glucose, xylitol, sorbitol, or mannitol (20 mM) did not appreciably change the time course or extent of damage due to perfusion with nitrogen-saturated perfusate. However, fructose (20 mM) completely prevented damage assessed by LDH release, trypan blue uptake, and ultrastructural changes for at least 2 h of perfusion. Neither glucose, xylitol, sorbitol, nor mannitol (20 mM) increased lactate formation above basal levels during hypoxia. On the other hand, fructose (0.4-20 mM) caused a concentration dependent increase in lactate formation that reached maximal rates of approximately 180 mumol . g-1 . h-1. The dose-dependent increase in glycolytic lactate production from fructose correlated well with cellular protection reflected by decreases in LDH release. ATP:ADP ratios were also increased from 0.4 to 1.8 in a dose-dependent manner by fructose. The results indicate that fructose protects the liver against hypoxic cell death by the glycolytic production of ATP in the absence of oxygen. PMID- 3631274 TI - Luminal digestion of lactoferrin in suckling and weanling rats. AB - The development of luminal digestion of lactoferrin was evaluated in vitro by incubating 125I-labeled lactoferrin with fluid flushed from the stomach and small intestine of 12-day-old suckling and 31-day-old weanling rats, followed by measurement of radioactivity in trichloroacetic acid-soluble material. Gastric hydrolysis of lactoferrin at pH 3.2 in the weanling was 20-fold greater than that in the suckling. In the small intestine at neutral pH, luminal degradation of lactoferrin was minimal in the suckling but increased significantly after weaning, with maximal degradative capacity demonstrable in the midjejunum. Sephadex G-75 chromatography of intestinal acid-soluble breakdown products revealed two peaks of radioactivity, each comprising 40-45% of the total product; analysis of intestinal acid-precipitable products by polyacrylamide gel electrophoresis yielded several discrete lower molecular weight species. Food deprivation for 12 h/100 g body wt decreased lactoferrin degradation in the weanling jejunum and midjejunum. Our findings suggest that lactoferrin digestion may vary with respect to postnatal age of the organism, segment of the gastrointestinal tract, and dietary state. In the young animal, lactoferrin degradation is minimal, and consequently its potential for biological function may be high. PMID- 3631275 TI - Evidence for carrier-mediated Cl-SO4 exchange in rabbit ileal basolateral membrane vesicles. AB - In rabbit ileal basolateral membrane (BLM) vesicles, an outwardly directed Cl gradient ([Cl] in/out = 60/6 mM) stimulated the initial velocity of SO4 uptake compared with uptake in the absence of Cl. Under Cl gradient conditions, SO4 was transiently accumulated at a concentration twice that found at equilibrium ("overshoot"). Chloride gradient-stimulated SO4 uptake was markedly reduced by inhibitors of anion exchange (4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid, 4-acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid) and was saturable (SO4 Km = 0.302 +/- 0.064 mM; Vmax = 1.59 +/- 0.22 nmol SO4 . mg protein-1 . min 1). SO4 uptake by BLM vesicles was not stimulated by imposition of an inside positive electrical potential, suggesting that the stimulation by a Cl gradient was not due to an induced electrical potential. Oxalate, nitrate, iodide, and bromide inhibited the initial velocity of Cl gradient-stimulated SO4 uptake, whereas phosphate, beta-hydroxybutyrate, lactate, and p-aminohippurate had no effect. When SO4 uptake by BLM vesicles was compared with that of brush-border membrane vesicles, Cl gradient-stimulated SO4 uptake was found predominantly in the BLM preparation. In conclusion, these findings provide evidence for a carrier on the ileal basolateral membrane that mediates Cl-SO4 exchange. PMID- 3631276 TI - Tissue distribution and vitamin D dependence of IMCAL in the rat. AB - Integral membrane calcium-binding protein (IMCAL) is a vitamin D-dependent integral membrane protein that binds calcium with relatively high affinity (J. Biol. Chem. 225: 10834-10840, 1980). Specific immunoassays for IMCAL utilizing rabbit polyclonal and mouse monoclonal antibodies were developed and applied to studies of its tissue distribution and regulation by vitamin D3 and dietary calcium in the rat. The results indicate that vitamin D-dependent, cross-reactive protein is present in small intestinal mucosa, cecal mucosa, bone, kidney, brain, testis, heart, lung, spleen, and skin. Rats maintained on a low- (0.02%) compared with & high- (2.0%) calcium diet had significantly higher content of IMCAL in duodenal mucosa, cecal mucosa, bone, kidney, brain, testis, and heart. Treatment of rats on the high-calcium diet with 1,25-dihydroxyvitamin D3 increased the IMCAL content of the duodenal mucosa, cecal mucosa, and kidney. The widespread tissue distribution of vitamin D-dependent IMCAL, its close correlation in intestinal mucosa with the calcium transport mechanism, and its occurrence in isolated preparations of enterocyte plasma membranes (microvillus and basolateral membranes) suggest that the protein is involved in the regulation of calcium flux in a number of cell types. PMID- 3631277 TI - Effect of protein-restricted diet on renal response to a meat meal in humans. AB - To study the influence of preceding dietary protein intake on the renal response to a protein meal we examined renal hemodynamic and excretory responses to a meat meal in six normal human subjects either taking their normal-protein diet (NPD, 75 +/- 5 g/day) or after 3 wk of a low-protein diet (LPD, 43 +/- 3 g/day; P less than 0.005). Glomerular filtration rate (GFR) was lower on LPD than on NPD (107 +/- 7 vs. 124 +/- 5 ml X min-1 X 1.73 M-2, respectively; P less than 0.01), as was renal plasma flow (RPF) (NPD, 666 +/- 44; LPD, 605 +/- 43 ml X min-1 X 1.73 M 2; P less than 0.05). Filtration fraction (FF) was not different (NPD, 0.19 +/- 0.01; LPD, 0.18 +/- 0.01). Urinary excretion of albumin was also lower after LPD than NPD (2.1 +/- 0.5 vs. 4.2 +/- 0.8 micrograms/min; P less than 0.05). After an 80-g protein meat meal, GFR rose to a ceiling significantly higher on NPD than on LPD (132 +/- 4.8 vs. 120 +/- 5.2 ml X min-1 X 1.73 M-2; P less than 0.02), even though the percent changes were greater on LPD than on NPD (12.7 +/- 3.3 vs. 6.6 +/- 1.5%, respectively; P less than 0.05). There was a rise in RPF that was entirely attributable to a fall in renal vascular resistance, and FF did not change. On both diets, oral protein loading produced a 200-300% increase in the urinary excretion and fractional clearance of albumin and IgG, but failed to alter that of beta 2-microglobulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631278 TI - Effects of cadmium on canine renal cortical adenylate cyclase. AB - The present studies examine the effects of cadmium (Cd2+) on adenylate cyclase activity in basolateral renal cortical membranes from normal dogs. Cd2+, in the dose range of 1 to 200 microM caused a dose-dependent inhibition of adenylate cyclase activity due to competitive inhibition with respect to the allosteric activator Mg2+ (increase in the Kact for Mg2+ from 13.8 to 37.2 mM). In addition, increasing Cd2+ concentrations from 0 to 25 microM resulted in a purely competitive inhibition with respect to ATP. The Km for ATP increased from 61 to 128 microM. When Mn2+ at a concentration of 20 mM was substituted for Mg2+, Cd2+ maintained its inhibitory effect at concentrations lower than 25 microM. At higher concentrations it stimulated enzyme activity in a dose-dependent fashion. In the absence of other divalent cations Cd2+ was a potent stimulator of basal adenylate cyclase activity, far more potent than the physiological activator of the system Mg2+. Kact for Cd2+ was 1.0 mM (Kact for Mg2+ 20 mM), whereas the Vmax showed a fourfold increase compared with the Mg2+-stimulated membranes. However, under these conditions, synthetic bovine parathyroid hormone (1-34) or 5' guanylylimidodiphosphate did not stimulate adenylate cyclase. It is concluded that Cd2+ behaves as a partial agonist in this system, due to its ability to form a new enzymatic substrate complex: Cd-ATP, which competes with the physiological substrate Mg-ATP at the catalytic site of the enzyme. In addition, Cd2+ in the absence of other divalent cation stimulates basal enzyme activity, presumably through interaction at an additional site, closely related to the allosteric metal regulatory site of this enzyme system. PMID- 3631279 TI - Succinate and citrate transport in renal basolateral and brush-border membranes. AB - Properties of the Na-dependent transport of succinate and citrate were determined in brush-border and basolateral membrane vesicles (BBMV and BLMV, respectively) isolated from the rabbit renal cortex. As has been shown in previous studies, the initial rate of uptake of these substrates into BBMV was markedly stimulated (50- to 150-fold) by an inwardly directed Na gradient. In BLMV, uptake of 5 microM succinate was also stimulated (150-fold) by a Na gradient, and the profile of the time course of accumulation was qualitatively and quantitatively different from that in BBMV. In contrast, basolateral uptake of 2 microM citrate was stimulated only one- to fivefold by a Na gradient. The external pH had little effect on uptake of succinate into BBMV or BLMV, or on uptake of citrate into BLMV. Uptake of citrate into BBMV, however, was stimulated 10-fold by reducing external pH from 8 to 5.5. Valinomycin-induced K diffusion potentials stimulated succinate uptake into BBMV and BLMV, suggesting that Na-coupled succinate transport across both membranes is electrogenic. The Jmax and apparent Kt for uptake into BBMV were much greater than those in BLMV (90 vs. 5 nmol X mg-1 X min-1 and 0.61 vs. 0.01 mM, respectively). Inhibition of succinate uptake by several polycarboxylates suggested that the BLMV transporter had a higher apparent affinity for dicarboxylates than for tricarboxylates, compared with the BBMV transporter. We conclude that BLMV possess a low-capacity, high-affinity Na dependent transport pathway showing a high degree of specificity for dicarboxylic, rather than tricarboxylic, acids. PMID- 3631280 TI - H+ gradient-driven dipeptide reabsorption in proximal tubule of rat kidney. Studies in vivo and in vitro. AB - Microinfusion of glycylsarcosine into superficial nephron sections showed that the dipeptide was reabsorbed mainly in late portions of the rat proximal tubule. In vivo microperfusion data demonstrated a saturable, high-capacity, low-affinity dipeptide reabsorption mechanism that was inhibited by other peptides but not by amino acids or peptidase inhibitors. The reabsorption was enhanced by lowering the luminal pH from 7.5 to 5.5. In vitro studies with rat cortical brush-border vesicles showed that glycylsarcosine uptake was independent of a Na+ gradient and greater uptake occurred when the extravesicular pH was acidic compared with the intravesicular pH. An inward-directed H+ gradient stimulated glycylsarcosine uptake and caused a transient accumulation of the dipeptide inside the vesicles above the equilibrium value. The presence of a proton ionophore abolished the H+ gradient-dependent uptake. An inside-negative membrane potential stimulated the initial uptake of the dipeptide. The uptake process was saturable and inhibited by other peptides but not by amino acids. The vesicle studies also showed that there are at least two peptide transport systems functioning in these vesicles, one a high-affinity, low-capacity type and the other a low-affinity, high capacity type. PMID- 3631281 TI - Effects of PDGF on inositol phosphates, Ca2+, and contraction of mesangial cells. AB - Platelet-derived growth factor (PDGF) is a potent mitogen and vasoactive polypeptide for aortic smooth muscle. Because contractile glomerular mesangial cells synthesize a PDGF-like molecule and may respond to PDGF released by infiltrating cells at the site of glomerular inflammation, we studied the effects of exogenous, highly purified PDGF on 1) contraction of cultured rat mesangial cells and 2) membrane phosphoinositide turnover and cytosolic free calcium ([Ca2+]i), as putative mechanisms of membrane signal transduction. PDGF, 10(-11) and 10(-10) M, contracted 56.1 +/- 5.2 and 72.9 +/- 6.4% of the cells, respectively, with an average decrease of cross-sectional area of 22.0 +/- 2.6 and 28.1 +/- 2.7% of basal, as assessed by image-analysis microscopy. PDGF also rapidly increased total water-soluble inositol phosphates, measured after anion exchange chromatography on perchloric acid-extracted cells, and simultaneously raised [Ca2+]i, measured by the fluorescent intracellular probe fura-2, from basal levels of 83.1 +/- 6.8 to a peak of 229.4 +/- 20.0 nM. We conclude that PDGF stimulates contraction of rat mesangial cells via a phospholipase C dependent pathway, with potential relevance to the control of glomerular hemodynamics and mesangial proliferation in immune-mediated glomerular disease. PMID- 3631282 TI - Anion exchange pathways for Cl- transport in rabbit renal microvillus membranes. AB - We evaluated the mechanisms of chloride transport in microvillus membrane vesicles isolated from the rabbit renal cortex. The presence of Cl-formate exchange was confirmed. Outward gradients of oxaloacetate, HCO3, acetate, lactate, succinate, sulfate, and p-aminohippurate (PAH) stimulated the rate of Cl uptake minimally (less than 25%) or not at all. However, an outward gradient of oxalate stimulated Cl uptake by 70%, and an outward Cl gradient induced uphill oxalate uptake, indicating Cl-oxalate exchange. Moreover, an outward formate gradient induced uphill oxalate uptake, indicating formate-oxalate exchange. Studies of inhibitor and substrate specificity indicated the probable operation of at least two separate anion exchangers in mediating Cl transport. The Cl formate exchanger accepted Cl and formate as substrates, had little or no affinity for oxalate, was sensitive to inhibition by furosemide, and was less sensitive to inhibition by 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS). The Cl (formate)-oxalate exchanger also accepted Cl and formate as substrates but had high affinity for oxalate, was highly sensitive to inhibition by DIDS, and was less sensitive to inhibition by furosemide. The Cl-formate exchanger was electroneutral, whereas the Cl (formate)-oxalate exchanger was electrogenic. We conclude that at least two separate anion exchangers mediating Cl transport are present on the luminal membrane of the rabbit proximal tubule cell. These exchangers may play important roles in mediating transtubular Cl and oxalate transport in this nephron segment. PMID- 3631283 TI - Thiazide-sensitive sodium chloride cotransport in early distal tubule. AB - At least two pathways mediate sodium absorption across the luminal membrane of the renal distal tubule. One pathway is a conductive channel and the other appears to be a coupled Na-Cl cotransport pathway. The distal tubule comprises three segments: the distal convoluted tubule, the connecting tubule, and the initial collecting duct. To provide information about cellular locations of the proposed sodium transport pathways, we perfused early (14-38% of whole distal length) and late (61-83% of whole distal length) segments of whole distal tubules separately in vivo in anesthetized rats. When perfused with a solution that resembles fluid normally arriving at the distal tubule (75 mM Na, 68 mM Cl), rates of sodium absorption were similar in early and late segments (early 68 +/- 29.6, late 67 +/- 27.5 pmol X min-1 X mm-1). When perfused with a solution that resembles interstitial fluid (148 mM Na, 110 mM Cl), sodium transport was significantly higher in early than in late segments (276 +/- 28.4 vs. 113 +/- 29.7 pmol X min-1 X mm-1). Chlorothiazide (10(-3) M), which blocks sodium and chloride absorption in whole distal tubules, reduced sodium and chloride transport to zero in early distal tubules but had no significant effect in late distal tubules. Removing all chloride from perfusion solutions reduced sodium transport in early but not late distal segments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631284 TI - Chloride-dependent potassium secretion in early and late renal distal tubules. AB - Potassium transport by subsegments of the rat surface distal tubule was studied using a modified in vivo microperfusion method. The nephron segments between 14 and 38% and between 62 and 83% of total distal length distance between macula densa region and confluence of tubule with another) were perfused separately. The first of these two segments is composed primarily of distal convoluted tubule (DCT) cells; the more distal segment is made up primarily by initial collecting tubule (ICT) epithelium. Experiments were performed to measure potassium secretion via two pathways: a diffusion mechanism driven by a favorable electrochemical gradient for potassium, and a cotransport mechanism activated when lumen chloride concentration is low. In a first series of experiments, both the DCT and the ICT secreted potassium when perfused with an artificial control solution resembling fluid normally present at the beginning of the distal tubule. Absolute rates of potassium secretion were higher in the ICT than in the DCT. Decreasing lumen Cl concentration stimulated potassium secretion more in the ICT than in the DCT. In a second series of experiments, the subsegments were perfused with a solution in which ion concentrations were raised to levels found in interstitial fluid. Under these circumstances, potassium secretion was lower in both segments. Decreasing lumen Cl concentration resulted in higher rates of potassium secretion in the DCT than those seen in the first series with low chloride; rates of potassium secretion in the ICT were as high as in the first series.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631285 TI - A model of osmotic and hydrostatic pressure effects on volume absorption in the proximal tubule. AB - A computer model of the proximal tubule of the rabbit is described in which the tubule is treated as a single cylindrical barrier to the flow of solute and water between lumen and bath, and volume absorption is assumed to be driven exclusively by hydrostatic and osmotic pressure differences across this barrier. The model mimics the function of the tubule in two in vitro preparations: in simulations of the isolated tubule perfused under oil, the model correctly describes the solute concentration gradients that exist between the perfusate and absorbate and predicts differences in solute concentrations among absorbate droplets on the same tubule if luminal concentration becomes limiting. This prediction was tested experimentally with glucose and found to be correct. In simulations of the tubule perfused in an aqueous bath, the role of transmural hydrostatic pressure was explored; it is predicted that, at normal rates of in vitro perfusion (approximately 10 nl/min), increases in pressure have very little effect on volume absorption but can greatly alter the osmotic differences present across the wall of the tubule, especially with high values of osmotic water permeability. At high rates of perfusion, the ability of the tubule to produce a lumen hypotonic to the bath is reduced, but the direct effects of pressure on volume absorption become more apparent, resulting in relatively little effect of perfusion rate on volume absorption if the osmotic water permeability is sufficiently high. A similar relationship was seen experimentally. In all, this simple model provides a good prediction of function in isolated perfused tubules without any assumptions of hypertonic compartments within the epithelium. PMID- 3631286 TI - Effects of flow rate on proximal tubule ultrastructure. AB - In this study we investigated the ultrastructure of the proximal tubule during alterations in fluid flow to determine whether previously observed changes in solute and water reabsorption may be related to alterations in cell ultrastructure. In each kidney, two proximal tubules (S2 segments) were perfused simultaneously at 5 and 45 nl/min. Subsequently, cell ultrastructure of control and experimental tubules was examined by electron microscopy in combination with morphometry. Changes in flow rate greatly modified the geometry of the tubule epithelium. Enhanced flow increased luminal diameter and decreased cell height. The number of microvilli per square micrometer of luminal epithelial surface area decreased with increased flow rate from a control value of 42.5 to 35.5 at high flow. However, the total number of microvilli per millimeter tubule length did not change. Thus the distance between microvilli was dependent on flow rate and was estimated to be 621, 741, and 904 A in low flow, control, and high flow tubules, respectively. We suggest that increased flow rate, perhaps by altering transepithelial hydrostatic pressure gradients, leads to an increase in the distance between the microvilli and to other alterations in cellular ultrastructure that may contribute to the augmentation of solute and water reabsorption. PMID- 3631287 TI - Frequency-dependent myocardial depression induced by verapamil in conscious dogs. AB - To determine the effects of calcium entry-blocking drugs on the frequency dependent rate of peak positive left ventricular pressure development [(+)dP/dtmax] we evaluated the effects of incremental left atrial pacing during verapamil, diltiazem, and nifedipine under equivalent loading conditions in seven conscious preinstrumented mongrel dogs. To eliminate the effects of reflex sympathetic stimulation the animals were pretreated with propranolol (2 mg/kg). Prior to atrial pacing (+)dP/dtmax was similar for verapamil [2,392 +/- 416 (SD) mmHg/s], diltiazem (2,661 +/- 606 mmHg/s), and nifedipine (2,731 +/- 636 mmHg/s), P = NS among drugs. At a common peak paced heart rate (150 beats/min) under equivalent loading conditions, (+)dP/dtmax was significantly reduced from the corresponding preatrial pacing value only after verapamil (2,131 +/- 415 mmHg/s, P less than 0.03) and was significantly lower than after either diltiazem (2,547 +/- 550 mmHg/s) or nifedipine (2,633 +/- 705 mmHg/s, P less than 0.04). No significant linear relation was observed between stimulation frequency and (+)dP/dtmax during atrial pacing alone (slope = -2.2 +/- 1.3, r = -0.30 +/- 0.23, P = 0.12), during atrial pacing with beta-blockade alone (slope = 1.7 +/- 1.5, r = 0.24 +/- 0.25, P = 0.25), or beta-blockade combined with diltiazem (slope = 0.91 +/- 1.3, r = 0.02 +/- 0.23, P = 0.38) or nifedipine (slope = -1.2 +/- 1.3, r = 0.01 +/- 0.23, P = 0.48). By contrast, a significant negative force-frequency relation was seen during incremental atrial pacing after verapamil (slope = -4.1 +/- 1.3, r = -0.80 +/- 0.23, P = 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631288 TI - Relaxation time constant of isolated rabbit left ventricle. AB - Experiments were performed on isolated rabbit left ventricles. Controlled ejections during otherwise isovolumic contractions were studied. The time constant of relaxation was defined as the slope of the linear approximation of the ln(P)-t relation over a 40-ms period starting 20 ms after the minimum of the first time derivative of left ventricular pressure (dP/dt) of the isovolumic contraction. Variations in time of ejection, its amplitude, and velocity are applied independently. No direct effect of the variations in time and velocity of the ejection on the time constant of relaxation was found. This is in conflict with the findings of Hori et al. (Circ. Res. 55: 31-38, 1984). The difference is due to the influence of the recovery of pressure directly after the end of ejection in their study. This effect is present especially when ejection was timed to take place late in the contraction phase. The effect of the variation of the amplitude of the ejection on the time constant was similar to the effect of the end-diastolic pressure on the end-diastolic volume. It is concluded that the time constant of relaxation depends linearly on the same processes that are responsible for the height of the end-diastolic pressure. PMID- 3631289 TI - Effects of thyroid state on respiration of perfused rat and guinea pig hearts. AB - The effects of thyroid state on the respiration of the isolated heart were investigated using retrograde perfused rat and guinea pig hearts. In both species, hypothyroidism caused a marked depression in circulating thyroid hormone concentrations and in the respiration of the isolated, retrograde perfused heart. The effects on myocardial respiration could be attributed to changes in the contraction frequency and in the oxygen consumption per beat, with little contribution from basal respiration. Treatment of animals with thyroxine elevated plasma thyroid hormones to a similar extent in rats and guinea pigs. In the latter, thyroxine treatment was associated with substantial increases in the contraction frequency and the oxygen consumption per beat of the isolated heart. In contrast, only small changes were apparent in the retrograde perfused rat heart, observations that were confirmed in rat hearts perfused at near physiological work loads. It was concluded that rat hearts isolated from normal animals function at near maximal thyroid state, in contrast to the guinea pig heart, which requires higher circulating concentrations of thyroid hormones to attain maximal responses. PMID- 3631290 TI - Effect of area postrema lesion on low-frequency arterial pressure oscillations in dogs. AB - To explore the possibility that chronic inactivation of the area postrema (AP) may alter the frequency distribution of oscillations in blood pressure, the power spectra for mean arterial pressure (MAP) were evaluated in conscious dogs before and after heat coagulation (n = 4) or sham lesions (n = 6) of the AP. No significant changes in MAP were observed in either group of dogs after surgery. Tachycardia was seen in AP-lesioned animals after surgery; no consistent changes in heart rate were found in sham-lesioned dogs. Spectra were averaged to provide a group spectral estimate for the AP-lesioned and sham-lesioned groups, respectively, for each experimental period. In the sham-lesioned group a variance peak was observed at approximately 0.03 Hz both before and after surgery. The same peak was seen in the AP-lesioned group during the control period but disappeared following AP lesion, apparently because a greater proportion of the variance was shifted toward frequencies below 0.03 Hz. In addition, a peak related to respiratory rate was present in both groups before surgery but was selectively abolished by AP lesion. AP lesion also substantially reduced the power associated with frequencies between 0.1 and 0.4 Hz. The use of spectral analysis has allowed us to demonstrate that a low-frequency oscillation of MAP in conscious, resting dogs requires the integrity of the AP and that the 0.1- to 0.4 Hz components of the variability of MAP are attenuated after removal of the AP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631291 TI - Blood viscosity in small tubes: effect of shear rate, aggregation, and sedimentation. AB - Apparent viscosity was determined in vertical glass tubes (ID 30.2-132.3 microns) with suspensions of human red cells in A) serum, B) saline containing 0.5 g/100 ml albumin, C) plasma, and D) plasma containing Dextran 250 at a feed hematocrit of 0.45. Pressure-flow relationships were obtained in a range of pseudo-shear rates (mu) between 0.15 and 250 s-1. Relative viscosities in the nonaggregating suspensions (A and B) were found to increase monotonically with decreasing mu. The Fahraeus-Lindqvist effect was present in the entire range of mu. In the two aggregating suspensions (C and D), viscosities increased initially in larger but not small tubes with declining mu and fell in all tubes at some characteristic mu (usually below 10 s-1). Viscosity reduction was greater in the larger tubes and in suspensions with greater aggregation tendency. With suspension D, the Fahraeus Lindqvist effect was eliminated in the lowermost shear-rate range. The cell-free marginal zone increased in width (to a maximum of approximately 40% of tube radius) as viscosity declined. Measurements of viscosity and cell-free marginal zone were also performed with suspension C in tubes mounted in horizontal position. In contrast to vertical tubes, a monotonic increase in viscosity was found with decreasing mu, associated with cell sedimentation and development of a cell-free layer only in the upper portion of the tubes. PMID- 3631292 TI - Effects of aminophylline on behaviorally induced coronary blood flow increases. AB - It has been proposed that adenosine is a metabolic vasodilator that matches myocardial oxygen supply to demand by regulating coronary blood flow. In the present study, the adenosine antagonist aminophylline (Am) was used to evaluate the role adenosine plays in the coronary blood flow increase elicited by a controlled aversive stress, namely, classical aversive conditioning (a 30-s tone reinforced with a 1-s shock). Fifteen mongrel dogs were chronically instrumented to measure left circumflex coronary blood flow (CBF), left ventricular pressure (LVP), and heart rate. Am significantly (P greater than 0.01) attenuated the CBF response to the aversive stress without affecting the prestress levels (pre-Am control 40.9 +/- 2.4, peak 64.6 +/- 3.3 ml/min; post-Am control 41.7 +/- 2.2, peak 55.0 +/- 2.5 ml/min). The maximal CBF increase was reduced by 38.9 +/- 6.7% when compared with the control (no drug) condition. In a similar manner, neither heart rate nor LVP was affected by Am. However, Am significantly increased prestress level of first derivative of left ventricular pressure with reference to time [LV dP/dt] (pre-Am control 3,793.5 +/- 289.8 and Am 4,599.6 +/- 331.2 mmHg/s, respectively). These data suggest that adenosine contributes significantly to the regulation of CBF during a controlled emotional stress. PMID- 3631293 TI - Hypoxia, bradykinin, and prostaglandins stimulate ischemically sensitive visceral afferents. AB - Ischemia of abdominal visceral organs is known to reflexly stimulate the cardiovascular system. The purpose of this study was to determine which of several potential chemical stimuli present during ischemia either directly stimulate or sensitize these afferents to respond to ischemia. Impulse activity was recorded in the right splanchnic nerve of anesthetized cats. First, we determined whether the afferents were ischemically sensitive by subjecting them to 2-6 min of regional ischemia through occlusion of the descending thoracic aorta. We then examined the afferents' response to systemic hypoxia by decreasing the inspired O2 and arterial injection of bradykinin or the prostaglandins (PG) E2, PGF2 alpha, or prostacyclin (PGI2). Sixty-one percent of the rapidly adapting A fibers and 47% of the C fibers were stimulated by ischemia, and of these, 78% of the A fibers and 44% of the C fibers tested were stimulated by hypoxia. The latency of response to hypoxia (60 +/- 12 s) was significantly longer than the chemoreceptor-induced pressor response (45 +/- 11 s). Each afferent stimulated by ischemia and/or hypoxia innervated a receptive field in the pylorus, intestine, porta hepatis, gallbladder or biliary tract, pancreas, or mesentery. Ninety percent of the ischemically sensitive A fibers and 80% of the ischemically sensitive C fibers responded to bradykinin, whereas 40% of the A fibers and 62% of the C fibers responded to PGE2, PGF2 alpha, or PGI2. Several endings responded to ischemia or hypoxia only after bradykinin or PGI2 had been injected. Thus approximately 50% of slowly adapting A and C fiber endings in abdominal visceral organs respond, or can be sensitized by bradykinin or PGI2 to respond, to ischemia and/or hypoxia. However, they are not as sensitive to hypoxia as carotid and aortic body chemoreceptors, since they respond well after the chemoreceptor induced pressor response. PMID- 3631294 TI - Coordinated diameter oscillations at arteriolar bifurcations in skeletal muscle. AB - The spontaneous rhythmical luminal changes (vasomotion) at bifurcations in the microvasculature of the rabbit tenuissimus muscle were investigated by means of a microscope video photometric system. Video scenes, containing two terminal arterioles originating from one transverse arteriole, showed that adjacent terminal arterioles constricted synchronously in 26 out of 31 contraction cycles. The onset of 60 constrictions in the parent transverse vessels was synchronized with the activity in terminal arterioles in 75% of the cycles and delayed in 25%. Vasomotion in the parent transverse vessels was notably smaller than in the terminal vessels. All the terminal arterioles in the different animals oscillated at the fundamental frequency of 18.9 +/- 3.5 cycles/min. We conclude that in the skeletal muscle microcirculation 1) coordinated spontaneous diameter oscillations occur in arterioles that are in proximity, 2) diameter changes are most pronounced in the terminal arterioles, and 3) coordinated vasomotion in this tissue exhibits a characteristic narrow band frequency. The presence of a microvascular pacemaker is hypothesized. PMID- 3631295 TI - Dexamethasone potentiates hypoxic vasoconstriction in salt solution-perfused rat lungs. AB - Isolated rat lungs perfused with blood or plasma develop good hypoxic pressor reactivity, but those flushed of blood and perfused solely with physiological salt solution (PSS) show decreased or no hypoxic vasoconstriction. Because the handling of rats during collection of blood increases the plasma corticosterone levels, we wondered whether the difference between blood and PSS perfusion was due partly to higher glucocorticoid activity with blood than with PSS. Treatment of lung donors with the synthetic glucocorticoid dexamethasone (2 mg/kg im 3 h before isolation) or addition of dexamethasone (4.2 X 10(-6) M) to the perfusate increased markedly the hypoxic pressor reactivity of rat lungs perfused with PSS plus albumin (4 g/100 ml). In comparison, dexamethasone did not cause a significant increase in the already vigorous hypoxic pressor reactivity of blood perfused lungs, but it reversed the blunted pressor reactivity of lungs perfused with blood collected from adrenalectomized rats. The potentiation of hypoxic vasoconstriction by dexamethasone required greater than 40 min to develop and was inhibited by a 100-fold higher concentration of progesterone, a glucocorticoid receptor antagonist. Although dexamethasone and the cyclooxygenase blocker meclofenamate (3.1 X 10(-5) M) caused similar decreases in perfusate levels of cyclooxygenase metabolites, the glucocorticoid was much more effective in inducing hypoxic vasoconstriction in PSS-perfused lungs. Thus a reduction of cyclooxygenase metabolism might have contributed to, but did not fully account for, the glucocorticoid effect. Dexamethasone also caused small increases in base line perfusion pressure and in pressor reactivity to angiotensin II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631296 TI - Tachycardia of carotid chemoreceptors originates in apneic asphyxia in dogs. AB - Using various anesthetics, we investigated the heart rate changes resulting from apneic asphyxia in paralyzed artificially ventilated dogs with 1) low control heart rate (LCHR) and 2) high control heart rate (HCHR). We observed that apneic asphyxia produced by stopping the ventilation pump for 1 min evoked tachycardia in dogs with LCHR and bradycardia in dogs with HCHR. In dogs breathing 100% O2 in the preapneic period, the tachycardia response was almost wholly abolished, whereas the bradycardia response was attenuated. Intracarotid injection of sodium cyanide induced a tachycardia response in dogs with LCHR and a bradycardia response in dogs with HCHR. The results suggest that 1) apneic asphyxia evokes tachycardia or bradycardia response depending on whether the resting cardiac vagal tone is high or low, respectively, and 2) both types of heart rate responses are in part due to stimulation of carotid chemoreceptors. PMID- 3631297 TI - Aortic arch reflex control of total systemic vascular capacity. AB - The ability of the aortic arch baroreceptors to change vascular capacity was measured and, in the same animal, compared with carotid sinus reflex changes in capacity. Seven dogs were anesthetized with pentobarbital sodium and perfused with constant flow. Changes in external reservoir volume reflected reciprocal changes in total systemic vascular capacity and changes in arterial pressure parallel changes in total peripheral resistance. The aortic arch and carotid sinus baroreceptor areas were isolated, and the pressures were controlled separately. With carotid sinus pressure held constant at 125 mmHg, aortic arch pressure was increased and decreased between 225 and 50 mmHg, and the changes in reservoir volume and systemic arterial pressure were measured. Results from increasing and decreasing aortic arch or carotid sinus pressure were not significantly different and were averaged. The mean change in reservoir volume was 1.9 +/- 0.2 ml/kg and the change in mean arterial pressure was 18.7 +/- 3.7 mmHg. The changes in reservoir volume and arterial pressure caused by the aortic arch reflex were not influenced by the level of carotid sinus pressure. Carotid sinus pressure changes between 200 and 50 mmHg at a constant aortic arch pressure caused reservoir volume and arterial pressure to change by 7.2 +/- 0.9 ml/kg and 45.1 +/- 4.1 mmHg, respectively. The level of aortic arch pressure did not modify these responses. PMID- 3631298 TI - Lung morphological and permeability changes induced by intravascular coagulation in dogs. AB - The objectives of this study were to describe the morphological alterations of the pulmonary microvasculature in anesthetized dogs infused intravenously with alpha-thrombin (111-233 NIH U/kg) and to measure the protein reflection coefficient (sigma d), an index of pulmonary vascular permeability to proteins. Quantitative electron microscopy of lung biopsies from a group of four dogs showed an increase in the volume density of the alveolar interstitium and an increase in intravascular fibrin at 30 min after the thrombin infusion. The pulmonary microvascular endothelium was often swollen, blistered, highly vacuolized, or rarefied when close to or in contact with fibrin but appeared normal when not closely associated with fibrin. Fibrin-endothelial interactions often included projections of endothelium surrounding fibrin, the presence of fibrin within endothelial cells, 10- to 15-nm bridges connecting fibrin and endothelium, and disruption of the endothelial plasmalemma in contact with fibrin. Alveolar epithelial cells were unaffected by the thrombin infusion. Pulmonary lymph was collected from an afferent lymphatic to the left tracheobronchial lymph node in a second group of five dogs anesthetized with pentobarbital sodium intravenously. Thrombin increased pulmonary lymph flow by sevenfold and also increased the extravascular lung water-to-bloodless dry lung weight ratio. Left atrial pressure was elevated after thrombin infusion until a filtration-independent state was approached for the calculation of sigma d. Thrombin decreased sigma d from a normal value of 0.62 +/- 0.02 to 0.53 +/- 0.02. Thus thrombin-induced intravascular coagulation in dogs produced focal disruptions of the microvascular endothelium associated with intravascular fibrin and increased the pulmonary vascular permeability to proteins. PMID- 3631299 TI - Dynamics of cardiac muscle: analysis of isotonic, isometric, and isochronal curves. AB - Canine papillary muscle force-length-time relation (F-L-t) was investigated under pentobarbital sodium anesthesia. The time intervals taken from end diastole to any point (P) on the force-length plane was determined for isometric (t1) and isotonic (t2) systole and corrected for excitation contraction coupling duration. The ratio t1/t2, designated km, was approximately constant for widely scattered positions of P chosen systematically. The km in the 10 dogs ranged from 0.36 to 0.94 with means +/- SD of 0.66 +/- 0.16; km correlated negatively with muscle average cross-sectional area (r = -0.82; P less than 0.005). Assuming constancy of km, a general relationship was derived between (delta F/delta t)t1L, the rate of isometric force development at P; (delta L/delta t)t2F, the velocity of isotonic shortening at P; (delta F/delta L)(t1,t2)t, the stiffness; and (delta L/delta F)(t1,t2)t, the compliance of the myocardium (all taken at P) as follows (delta F/delta L)t1,t2t = -km(delta F/delta t)t1L/(delta L/delta t)t2F and (delta L/delta F)t1,t2t = -km-1(delta L/delta t)t2F/(delta F/delta t)t1t. The ratio of (delta F/delta t)t1L to (delta L/delta t)t2F defines functional proclivity and measures the differential propensity to force development relative to shortening. Thus myocardial stiffness or compliance determines functional proclivity by acting as an impedance-matching transformer that steps up or steps down force development of shortening as warranted by the loading conditions. PMID- 3631300 TI - Metabolism and electrophysiology in subendocardial Purkinje fibers after infarction. AB - Subendocardial Purkinje fibers (SEPF) have been implicated in the genesis of fatal arrhythmias that occur 24-48 h after infarction but little is known about the metabolic processes involved. Quantitative microchemical and electrophysiological studies were performed on normal and infarcted hearts removed 24 h after coronary artery occlusion. ATP, ADP, AMP, total adenine nucleotide content, phosphocreatine (PCr), and inorganic phosphate in superficial subendocardial Purkinje fibers from infarct preparations decreased approximately 30% compared with normal preparations. The phosphate potential decreased 45% in the infarct group. Similar changes were observed in adjacent contractile muscle between normals and infarcts. Action potentials of SEPF from infarct hearts had increased automaticity, markedly prolonged action potential durations at 50 and 90% repolarization (APD50 or APD90), but unchanged resting membrane potentials. The decrease in ATP, total adenine nucleotides, and the phosphate potential correlated linearly with APD50 and APD90. No correlation was found between PCr and APD90. This combined biochemical and electrophysiological approach provides a promising new way to further probe the biochemical basis of the abnormal electrical properties of subendocardial Purkinje fibers after myocardial infarction. PMID- 3631301 TI - Hemodynamic fluctuations and baroreflex sensitivity in humans: a beat-to-beat model. AB - A beat-to-beat model of the cardiovascular system is developed to study the spontaneous short-term variability in arterial blood pressure (BP) and heart rate (HR) data from humans at rest. The model consists of a set of difference equations representing the following mechanisms: 1) control of HR and peripheral resistance by the baroreflex, 2) Windkessel properties of the systemic arterial tree, 3) contractile properties of the myocardium (Starling's law and restitution), and 4) mechanical effects of respiration on BP. The model is tested by comparing power spectra and cross spectra of simulated data from the model with spectra of actual data from resting subjects. To make spectra from simulated data and from actual data tally, it must be assumed that respiratory sinus arrhythmia at rest is caused by the conversion of respiratory BP variability into HR variability by the fast, vagally mediated baroreflex. The so-called 10-s rhythm in HR and BP appears as a resonance phenomenon due to the delay in the sympathetic control loop of the baroreflex. The simulated response of the model to an imposed increase of BP is shown to correspond with the BP and HR response in patients after administration of a BP-increasing drug, such as phenylephrine. It is concluded that the model correctly describes a number of important features of the cardiovascular system. Mathematical properties of the difference-equation model are discussed. PMID- 3631302 TI - Modeling mechanical alternans in the beating heart: advantages of a systems oriented approach. AB - A model employing an original discrete method is proposed to explain mechanical alternans in the beating heart. This is compared with analysis using the difference-equation method, which has been utilized in some other areas of science and found to better represent the cardiac beat-to-beat behavior. The model shows the critical role of a slope with an exact value of 2 in the functional dependence between stroke volume (SV) and the end-diastolic volume (EDV). The implications of this model with respect to the factors causing sustained mechanical alternans (SMA) in the heart are shown. A criterion for determining whether SMA is caused by variations in EDV is described. However, this possibility is ruled out on the basis of experimental findings. It is further shown that SMA caused primarily by alterations in the contractile state leads to secondary variations in EDV. In this case the model predicts that the mean slope of SV as a function of EDV, as determined by the two alternating beats, has a value of 2 and is independent of the SV-EDV relation. This prediction concerning the relationship between SV and EDV is confirmed by available experimental data. The implications and advantages of the modeling approaches are explored. PMID- 3631303 TI - Role of neutrophils in ischemia-reperfusion-induced microvascular injury. AB - Recent studies indicate that polymorphonuclear neutrophils (PMNs) infiltrate the intestinal mucosa during ischemia and after reperfusion. To determine whether PMNs mediate the increased microvascular permeability produced by ischemia reperfusion (I/R) we treated cats with either saline, antineutrophil serum (ANS), or a monoclonal antibody specific for the beta-chain of the CD18 complex (MoAb 60.3) that prevents neutrophil adherence and extravasation. Intestinal microvascular permeability to plasma proteins was measured in control preparations (0.08 +/- 0.007), in preparations subjected to 1 h of ischemia then reperfusion (I/R, 0.32 +/- 0.02), I/R preparations treated with ANS (0.13 +/- 0.01), and I/R preparations treated with MoAb (0.12 +/- 0.003). Our results indicate that both PMN depletion (to less than 10% control) and prevention of PMN adherence significantly attenuate the increased microvascular permeability induced by I/R. These findings, coupled to previous results obtained from this model, support the hypothesis that neutrophils, which accumulate in the mucosa in response to xanthine oxidase activation, mediate the oxyradical-dependent injury produced by reperfusion of the ischemic bowel. PMID- 3631304 TI - Effects of hypothalamic stimulation and lesion on adrenal nerve activity. AB - Activity changes of efferent adrenal sympathetic nerves in response to bilateral manipulations of the hypothalamus, partly after intra-third cerebroventricular injection of 2-deoxy-D-glucose (2-DG) were investigated in anesthetized rats. Stimulation of the middle part of the lateral hypothalamic area (LHAm) increased adrenal nerve activity, whereas lesion caused rapid and remarkable decrease. Stimulation of the anterior part of the LHA (LHAa) tended to decrease the activity, and lesion produced either rapid decrease or late moderate increase. Stimulation of the ventromedial hypothalamic nucleus (VMH) did not affect the nerve activity, but lesion increased it gradually and then remarkably. Cerebroventricular infusion of 2-DG caused remarkable increase in activity that was suppressed by LHAm lesion. Subsequent infusion of 2-DG during the period of suppressed activity was no longer effective. The increased firing rate after 2-DG was suppressed by stimulation of the VMH, whereas lesion caused no change. These findings indicate that the central regulation of adrenal nerve activity is connected with individual hypothalamic regions and consequently depends on the degree and mode of activation of the sympathoadrenal system. PMID- 3631305 TI - Effect of naloxone on regional cerebral blood flow during endotoxin shock in conscious rats. AB - Maintenance of cerebral blood flow (CBF) is vital during cardiovascular shock. Since opioids have been implicated in the pathophysiology of endotoxin shock and have been shown to alter cerebral perfusion patterns, we determined whether opioids were responsible for any of the changes in regional CBF observed during endotoxin shock and whether the use of naloxone might impair or aid in the maintenance of CBF. When blood flow (BF) is studied with microspheres in rats, the left ventricle of the heart is often cannulated via the right carotid artery. Questions have arisen concerning the potential adverse effects of this method on CBF in the hemisphere ipsilateral to the ligated artery. We measured right and left regional CBF by use of this route of cannulation. Twenty-four hours after cannulations were performed, flow measurements were made using radiolabeled microspheres in conscious unrestrained male Sprague-Dawley rats (300-400 g) before and 10, 30 and 60 min after challenging with 10 mg/kg Escherichia coli endotoxin (etx) or saline. Naloxone (2 mg/kg) or saline was given as a treatment 25 min post-etx. We found no significant differences between right and left cortical, midbrain, or cerebellar BF at any time in any treatment group. After etx, the whole brain received a large share of the depressed cardiac output. Thus global CBF was not significantly reduced below its pre-etx value, an effect unaltered by naloxone. Regionally, BF was reduced to cerebellum and midbrain by 30 min post-etx. Naloxone prevented this depression. No region was affected to a greater or lesser degree than others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631306 TI - Further evidence for hepatic control of salt intake in rats. AB - We examined the contributions of oral and hepatic factors to the control of salt intake in rats made "salt hungry" by combined dietary sodium restriction and furosemide treatment. A 7.5-ml preload of 0.5 M NaCl, which was either voluntarily ingested or slowly infused (7.5 ml/90 min) into the hepatic portal vein, decreased subsequent 0.5 M NaCl intake by approximately 7.5 ml in both cases. Hepatic portal infusions were probably acting in the liver because slow jugular infusions (7.5 ml/90 min) did not influence salt drinking, although rapid (7.5 ml/5 min) infusions by both routes reduced salt intake. If salt was ingested but drained through a gastric cannula, rats showed little sign of reducing salt in a 2-h test. These results suggest that the quantity of salt ingested by salt hungry rats is regulated by a postabsorptive mechanism that is probably located in the liver. PMID- 3631307 TI - Responses of vasopressin and enkephalins to hemorrhage in adrenalectomized dogs. AB - To study responses of methionine enkephalin-like substance (MELS) and vasopressin (AVP) to hemorrhage, plasma MELS, AVP, and catecholamine levels and mean arterial blood pressure (MAP) and central venous pressure (CVP) were investigated in intact and adrenalectomized dogs (n = 34) under pentobarbital anesthesia. Plasma MELS increased significantly following a hemorrhage-induced rise in plasma epinephrine in intact dogs (n = 6). Plasma AVP rose concomitantly with a fall in CVP before MAP fell, but the subsequent fall in MAP was accompanied by a further elevation in plasma AVP concentration. In nonhemorrhaged control dogs (n = 6) these parameters did not change during the experiment. In adrenalectomized dogs (n = 6) the hemorrhage-induced increase in plasma MELS and AVP was significantly attenuated despite similar decreases in MAP as in intact dogs. In sham-operated dogs (n = 10) changes in these parameters were similar to those in intact dogs. The differences between plasma MELS in the superior vena cava and thoracic aorta did not change during hemorrhage in intact dogs (n = 6), but the differences in plasma AVP rose significantly, indicating a release of the hormone from the head. These results indicate that MELS release elicited by hemorrhage may largely arise from the adrenal gland and not the brain. Adrenalectomy attenuated AVP response to hemorrhagic hypotension. PMID- 3631308 TI - Analysis of BP response and Ca2+ metabolism using the saturation kinetics model. AB - The provision of supplemental dietary calcium (dCa) lowers blood pressure (BP) in the spontaneously hypertensive rat (SHR). Whether calcium's antihypertensive effects can be expressed in the presence of potentially hypertensinogenic nutrients is not known. Furthermore, the amount of dCa required to attenuate hypertension in the SHR remains undetermined. Along with establishing the effects of dCa on BP under conditions of a high Na+ intake, we sought to define the lowest dose of dCa associated with the greatest attenuation in arterial pressure in the young SHR. Thirty-five 6-wk-old SHR were fed one of five diets containing either 0.1, 0.25, 0.5, 1.0, or 2.0% dCa. All diets contained 1.0% Na+. The rates of change (delta) in body weight, BP, and serum ionized calcium were determined between 6 and 20 wk of age. Bone density (BD) was measured only at 20 wk of age. The data were analyzed using the saturation kinetics model. Results indicate that the half-maximal dose (K50) of dCa needed to lower pressure is 0.67 +/- 0.18%, which is higher than the K50 for weight (0.23 +/- 0.18) and BD (0.36 +/- 0.22). It is concluded that supplemental dCa lowers BP despite a high Na+ intake. Furthermore, a dose of approximately 1.5 dCa is sufficient to attenuate the rate of hypertension in the young growing SHR. PMID- 3631309 TI - Drinking, oropharyngeal signals, and inhibition of vasopressin secretion in dogs. AB - Ingestion of water leads to a rapid fall in plasma levels of vasopressin in 24-h water-deprived dogs. The rapid inhibition of vasopressin secretion is not due to absorption of water and dilution of plasma nor is it due to gastric distension. Blood pressure rises sharply during drinking, and this may provide the afferent signal leading to inhibition of vasopressin secretion. Other possibilities include a generalized increase in oropharyngeal motor activity or simply the sight of water. To test these hypotheses, 24-h water-deprived dogs were given either phenylephrine, to mimic the rise in blood pressure observed during drinking, offered canned meat, to induce oropharyngeal motor activity and swallowing, or presented with a bowl of water that was placed just out of reach. Administration of phenylephrine, ingestion of food, and the presence of water all caused increases in blood pressure, which were similar to the rise in blood pressure during drinking. However, none of these paradigms caused a fall in plasma vasopressin. In contrast, ingestion of water consistently led to a significant fall in plasma vasopressin, which was detectable within 3 min of drinking and well before changes in plasma osmolality. Therefore we conclude that the mechanism by which ingestion of water causes rapid inhibition of vasopressin secretion in dehydrated dogs cannot be dependent on a rise in blood pressure, a nonspecific increase in oropharyngeal motor activity, or the presence of water. PMID- 3631310 TI - Neuropeptide Y increases food intake in mice. AB - Neuropeptide Y (NPY) stimulates eating in a number of species. In the studies reported here, intracerebroventricular administration of porcine NPY increased eating in mice. In the presence of food, NPY caused enhancement of water intake, whereas in the absence of food, NPY suppressed water intake. Behavioral analysis showed that NPY decreased the latency to eat, increased the time spent eating, and decreased grooming. Human NPY also increased food intake, whereas the free acid of NPY was inactive. Although some minor discrepancies in response were noted overall, NPY was as effective at stimulating food intake in genetically obese (ob/ob) mice compared with their lean littermates (ob/-), in genetically diabetic mice (db/db) and their nondiabetic heterozygote control (db/m), in streptozocin-induced diabetic mice and their controls, and in adult (8 mo old) compared with old (25 mo old) mice. PMID- 3631311 TI - Optimal experiment design for nonlinear models subject to large prior uncertainties. AB - Classical experiment design generally yields an experiment that depends on the value of the parameters to be estimated, which are, of course, unknown. Assuming that the model parameters belong to a population with known statistics, we propose to take the a priori parameter uncertainty into account by optimizing the mathematical expectation of a functional of the Fisher information matrix. This optimization is performed with a stochastic approximation algorithm that makes robust experiment design almost as simple as classical D-optimal design. The resulting methodology is applied to the choice of measurement times for multiexponential models. PMID- 3631313 TI - The prognostic relevance of delusions in depression: a follow-up study. AB - To determine whether delusional depression has a different clinical course from other types of depression, the authors followed up 31 unipolar delusional depressed patients, 28 unipolar nonpsychotic depressed patients, and 51 schizophrenic patients 14 months after hospital discharge. Patients were assessed on 1) overall outcome, 2) psychotic, anxiety-neurotic, and depressive symptoms, 3) social and work functioning, and 4) rehospitalization. The delusional depressed patients showed significantly more mood-incongruent delusions at follow up. Surprisingly, the nonpsychotic depressed patients exhibited more depressed mood and significantly more anxiety at follow-up. The findings suggest that the diagnostic distinction between delusional and nonpsychotic depression is relevant to the clinical course of major depression. PMID- 3631312 TI - Use of caffeine to lengthen seizures in ECT. AB - During a course of ECT, seizure duration may become too brief for clinical benefit. Use of higher-energy stimuli may lengthen seizures but may also increase the risk of toxicity, and it is not possible when maximum settings are reached. The authors present the cases of six drug-free depressed inpatients whose seizure durations in ECT declined despite maximum settings on three different ECT devices. In all cases, pretreatment with caffeine lengthened seizures (mean increase = 107%), and clinical improvement followed. Caffeine was well tolerated, even in patients with cardiovascular diseases. PMID- 3631314 TI - Stressful life events and the onset of a generalized anxiety syndrome. AB - In a study of 2,902 subjects from the National Institute of Mental Health Epidemiologic Catchment Area Project in North Carolina, the association between life events and the onset of new cases of generalized anxiety syndrome varied across demographic subgroups and type of life event measure. Men reporting four or more life events had a risk of generalized anxiety syndrome 8.5 times that of men reporting zero to three life events; no association was found for women. Both men and women reporting one or more unexpected, negative, very important life events had a threefold increase in the risk of developing generalized anxiety syndrome. PMID- 3631315 TI - The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers. AB - The South Oaks Gambling Screen is a 20-item questionnaire based on DSM-III criteria for pathological gambling. It may be self-administered or administered by nonprofessional or professional interviewers. A total of 1,616 subjects were involved in its development: 867 patients with diagnoses of substance abuse and pathological gambling, 213 members of Gamblers Anonymous, 384 university students, and 152 hospital employees. Independent validation by family members and counselors was obtained for the calibration sample, and internal consistency and test-retest reliability were established. The instrument correlates well with the criteria of the revised version of DSM-III (DSM-III-R). It offers a convenient means to screen clinical populations of alcoholics and drug abusers, as well as general populations, for pathological gambling. PMID- 3631316 TI - The Washington University Sentence Completion Test compared with other measures of adult ego development. AB - One hundred seven men who had been studied prospectively from age 18 to age 63 completed the Washington University Sentence Completion Test at age 55 +/- 2 years. Ego level as assessed by the Sentence Completion Test correlated significantly with psychosocial maturity, with number of psychiatric visits, and, perhaps, with creativity. Ego level as assessed by the Sentence Completion Test did not correlate with mental health, psychopathology, or maturity of defenses. The authors discuss possible reasons for these findings. PMID- 3631317 TI - New technology in convulsive therapy: a challenge in training. PMID- 3631318 TI - Facilitation of ECT by caffeine pretreatment. AB - In this study, eight patients participated in a standardized protocol to assess the effects of caffeine on seizures in ECT. Caffeine sodium benzoate (500-2000 mg) was administered intravenously 10 minutes before ECT, and seizure duration was compared with that of a previous treatment unmodified by caffeine. Seizure duration was significantly increased during ECTs preceded by caffeine. Three other patients given caffeine when seizures of adequate duration could no longer be elicited at maximal stimulus levels experienced longer seizures. Administration of caffeine was not associated with significant cardiovascular or other (including cognitive) adverse effects. PMID- 3631320 TI - Survivors of imprisonment in the Pacific theater during World War II. AB - Data were obtained from 41 survivors of imprisonment by the Japanese during World War II. Interview data suggested that these individuals, despite the 40 years that had passed since their prisoner of war experiences, showed manifestations of posttraumatic stress disorder, notably a sleep disturbance marked by recurrent nightmares. MMPI data suggested significant pathology, characterized as an anxiety state, in this group. Half of the subjects met the full set of DSM-III criteria for posttraumatic stress disorder. PMID- 3631319 TI - Augmentation of haloperidol by ascorbic acid in phencyclidine intoxication. AB - The authors studied 40 white men with acute phencyclidine (PCP) intoxication. On a random basis, 10 were treated with ascorbic acid, 10 with placebo, 10 with haloperidol, and 10 with a combination of ascorbic acid and haloperidol. While haloperidol was significantly more effective than ascorbic acid, the combination was significantly more effective than either used alone. This combination may have a specific antipsychotic role in the emergency treatment of PCP psychosis. PMID- 3631321 TI - Increased adrenal weight in victims of violent suicide. AB - Adrenal weight was significantly higher in 16 victims of violent suicide than in 10 subjects who died suddenly from other causes. Since approximately half of suicide victims are depressed, these results support an association between depression and hypertrophy of the adrenal cortex. PMID- 3631322 TI - Increased ventricle-to-brain ratio in late-onset schizophrenia. AB - For 29 patients with schizophrenia that began after age 44, the mean ventricle-to brain ratio was significantly higher than for 23 age-matched normal subjects but significantly smaller than for 23 patients with Alzheimer's disease and hallucinations or delusions. PMID- 3631323 TI - Association of elevated plasma anticholinergic activity with delirium in surgical patients. AB - In a surgical intensive care unit, plasma anticholinergic activity was significantly higher in nine delirious patients than in 16 patients without delirium. The delirium may have been related to medications that are known to be associated with delirium and/or anticholinergic activity. PMID- 3631324 TI - Profound hypoglycemia with the addition of a tricyclic antidepressant to maintenance sulfonylurea therapy. AB - Cases of profound hypoglycemia after the initiation of tricyclic antidepressant therapy in two patients taking sulfonylureas are described. To the authors' knowledge, this is the first report of a potential drug interaction between tricyclic antidepressants and sulfonylureas. PMID- 3631325 TI - DSM-III diagnoses associated with dyspepsia of unknown cause. AB - The frequencies of DSM-III diagnoses in 30 patients with dyspepsia of unknown origin and 20 patients with organic dyspepsia were compared. Dyspepsia of unknown origin was associated with a higher prevalence of psychiatric diagnoses (86.7% versus 25.0%), particularly anxiety disturbances (66.7%). PMID- 3631326 TI - Treatment of catatonia with low-dose lorazepam. AB - The authors describe three patients who each had a catatonic syndrome associated with affective psychosis and who responded dramatically to low doses of lorazepam. PMID- 3631327 TI - Relief of obsessive-compulsive symptoms by LSD and psilocin. PMID- 3631328 TI - Treatment of premature ejaculation with lorazepam. PMID- 3631329 TI - Identical twins' nonidentical responses to lithium. PMID- 3631330 TI - Haloperidol as an alternative to lithium in pregnant women. PMID- 3631332 TI - Heroin addiction treated by atropine coma. PMID- 3631331 TI - Possible toxic interaction between cyproheptadine and phenelzine. PMID- 3631333 TI - Reversal by bethanechol of imipramine-induced ejaculatory dysfunction. PMID- 3631334 TI - AIDS delusions: a symptom of our times. PMID- 3631335 TI - Compact camcorders for teaching psychiatric interviewing. PMID- 3631336 TI - Nicotine and panic attacks. PMID- 3631337 TI - Nontartrazine allergy with desipramine. PMID- 3631338 TI - How long should drug therapy for depression be maintained? PMID- 3631339 TI - Sleep reduction: factor in the genesis of mania? PMID- 3631340 TI - Psychiatrist-patient sexual contact. PMID- 3631341 TI - Transitional object use and borderline personality. PMID- 3631342 TI - DST status not predicted by serum sodium levels. PMID- 3631343 TI - Longing for twinship and lesbianism. PMID- 3631344 TI - Psychotherapy in a changing postindustrial society. AB - Psychotherapy in a postindustrial society will differ markedly from that practiced in the past and present. It will be necessary for psychotherapists to comprehend the interrelationships of macrosocial as well as microsocial forces in relation to intrapsychic dynamics. In a parallel fashion the psychotherapist will find it necessary to be aware of the interrelationship of biodynamic and psychodynamic processes. This paper outlines the sociologic and technologic forces that are likely to mold the postindustrial era and their relationship to psychologic stress and illness as they will be in the period 2000-2025. PMID- 3631345 TI - The future of psychotherapy: one psychologist's perspective. AB - The inefficient manner in which psychotherapy is delivered renders mental-health practitioners vulnerable to the new emphasis in health-cost containment. It is estimated that in 1995 most health-care delivery will be controlled by five or six giant health corporations. Fifty percent of the mental-health practitioners in independent practice today are unlikely to survive. Those who do survive will either have learned the new delivery system, or they will be employees of corporate health. As frightening as these predictions may seem, there is also a window of opportunity for psychotherapists to get their house in order and to meet the challenge. PMID- 3631346 TI - The role of the psychiatrist in the practice of psychotherapy. AB - Historically, psychiatry has played a dominant role in psychotherapeutics, but recently, other mental-health professionals are challenging the role. This paper discusses psychiatrists' different conceptualization of problems and underlines the special contributions they are qualified to make because of their medical training. Patients should be free to choose the type of treatment approach- psychiatric or nonpsychiatric--that best serves their needs. PMID- 3631347 TI - Psychotherapy and the clinical social worker. AB - Social work's long and historical involvement in psychotherapy has resulted in many significant contributions to practice such as the use of time, family and group therapy, the development of innovative settings and practices, and skill in using action communication. In addition, social workers have developed expertise in working with many that others have considered unsuitable for psychotherapy. Differences between psychiatric social work and the present more commonly used term, clinical social work, are related to issues of identity and autonomy, and essential practices and values that differentiate the clinical social worker from other professionals. These are a preference for the term client rather than patient, an emphasis upon person-in-situation, and a valued belief in client self determination. However, special educational preparation is needed for the practice of psychotherapy which is considered a specialty within social work. PMID- 3631348 TI - Psychiatric nurses and the practice of psychotherapy: current status and future possibilities. AB - Up to now not many patients have interacted with trained psychiatric nurses, since their numbers have been small. It is only a recent development that nurses are continuing their education to the Master's and Ph.D. levels. Suggestions for courses are made. Because of the growing convergence of the biological and behavioral sciences, nurses will be in a strong position to provide effective patient management. Their traditional involvement in the community, the work place, the schools, as well as the fact that they are in close contact with medical and surgical patients in particular stressful situations, may enable them not only to treat but even mitigate emergent psychopathology. Nurses would be uniquely placed to interact with other members of the mental health professions and to supplement their work. PMID- 3631349 TI - The treatment of abused children: the natural sequence of events. AB - Abused and neglected children and parents who were maltreated as children tend to follow a sequence of seven phases of progression in their treatment: realization, protest, dealing with guilt, working through despair, reevaluating relationships, reconciliation, and the reconstruction of their lives. PMID- 3631350 TI - Cognitive therapy with adolescents. AB - Cognitive immaturity and distortion are frequently observed in normal adolescents, as well as those with severe psychiatric and behavioral disorders. Misunderstandings of the therapy process and an unstable therapeutic alliance often complicates treatment. Cognitive therapy provides a paradigm for therapeutic intervention and management of therapeutic-alliance problems with adolescents. PMID- 3631351 TI - Compulsive hoarding. AB - Four cases of compulsive hoarding are described, all sharing the following characteristics: (1) onset in the twenties, (2) preoccupation with hoarding to the exclusion of work and family, (3) diminished insight, (4) little interest in receiving treatment, (5) no attempt to curb their compulsion. They do not show clear psychotic features. The implications of these characteristics for the diagnosis of hoarding are discussed. PMID- 3631352 TI - Clinical dimensions of anger management. AB - This paper provides a theoretical model of anger arousal based on Leventhal's Perceptual-Motor Theory of Emotion and elucidates a number of dimensions of anger that must be considered from a therapeutic viewpoint. Means of assessing these dimensions and specific treatment approaches are discussed. PMID- 3631353 TI - Emotional distress among spouses of psychiatric outpatients in Holland. AB - Interviews with spouses of individually referred psychiatric outpatients reveal relevant complaints about the ways the spouses have been approached by previous psychotherapists of their patient-partner. Suggestions are given to incorporate these complaints into efficient strategies for the involvement of spouses in the treatment of the patients. PMID- 3631354 TI - Working through: a cornerstone of psychotherapy. AB - The concept of working through, initially addressed by Freud in 1914, and elaborated upon over the past seventy years, remains controversial. Theoretical elaborations of this concept are reviewed and the central role of working through in the psychotherapeutic process is emphasized. Methods for evaluating working through are also suggested. PMID- 3631355 TI - Genital self-mutilation in males: psychodynamic anatomy of a psychosis. AB - This paper describes a man who mutilated his genitals while psychotic. His personal case history is analyzed and compared to the findings earlier described in similar patients. The present article attempts to make a psychotic process understandable both in light of the individual patient's history and in light of shared common unconscious themes. PMID- 3631356 TI - Portrait of a sadist as a young man. AB - Treatment of chronically violent patients poses problems for the therapist in a number of ways. Institutional demands, concern for one's personal safety, and psychotic transferences are common. This case details the treatment of one young violent offender. PMID- 3631357 TI - Foreign privatization of national health systems. PMID- 3631358 TI - Murder at work. PMID- 3631359 TI - Public health: moving from debt to legacy. PMID- 3631360 TI - Multinational operations of US for-profit hospital chains: trends and implications. AB - The expansion of United States for-profit hospital chains into the international arena is a new and important development. Experiences with contract management of middle eastern hospitals in the early 1970s gave the American firms impetus to pursue ownership of health facilities in other parts of the world. US companies now operate over 95 foreign hospitals. The reasons for this involvement include the political receptivity of the government of the host nation; the potential for rapid growth and profits; the lack of indigenous competition; and the ability to occupy a distinct niche within the extant health services organization. The political and ideological implications of the growth of private medicine, particularly in the United Kingdom, in terms of its effects on the National Health Service are discussed. Questions for future research are posed. PMID- 3631361 TI - Homicide while at work: persons, industries, and occupations at high risk. AB - The purpose of this study is to identify and describe, epidemiologically, work related homicides in California from 1979 through 1981. Using the California State Computer Mortality File, an algorithm was developed and a search of the death certificates was made using three factors: "injury at work," injury at a work location, and pertinent external-cause-of-death codes. Only 30 per cent of the 466 homicide deaths identified were also found in the logs of the state Occupational Safety and Health agency. The average annual rate of work-related homicides was 1.5 per 100,000 workers. The male-to-female-rate ratio was 4.2:1. Police and security guards and persons in occupations having frequent public contact involving exchange of money, particularly in late afternoon or evening hours, were at highest risk. Controlling exposures of high-risk individuals and developing strict standards for reducing such exposures might greatly reduce assaults and thus prevent senseless loss of life in the workplace. PMID- 3631362 TI - Workplace homicides of Texas males. AB - A review of Texas death certificates for 1975-84 identified 779 civilian males whose deaths were homicides that occurred in the workplace. Injuries from firearms caused 81 per cent of the deaths. The overall rate of workplace homicide was 2.1/100,000 male workers/year. Males employed in taxicab service had the highest rate of workplace homicide. 78.2/100,000 male workers/year. Males employed in certain retail trade industries, law enforcement, and the private security industry also had high rates of workplace homicide. Male workers greater than or equal to 65 years old were at especially high risk, with a workplace homicide rate 3.5 times that of younger workers. A review of medical examiners' records in five urban counties indicated that 32 per cent of victims who had worked in eating-and-drinking places and 5 per cent of other workers had blood or cerebrospinal-fluid alcohol levels greater than or equal to 0.10 g/dl. These results provide a base for designing effective strategies to prevent workplace homicides. PMID- 3631363 TI - Occupation, smoking, and alcohol in the epidemiology of bladder cancer. AB - We conducted a case-control study to evaluate the effects of occupation, smoking, and alcohol consumption on bladder cancer risk. A total of 823 male cases and 2,469 age-matched controls were identified through the Missouri Cancer Registry. Relative risk estimates of 2.0 or greater were observed for janitors and cleaners, mechanics, miners, and printers. Current cigarette smoking was associated with a two-fold excess risk of bladder cancer, whereas alcohol consumption showed no association with bladder cancer risk. PMID- 3631365 TI - An application of the Sentinel Health Event (Occupational) concept to death certificates. AB - This article describes a computer-based application of the Sentinel Health Event (Occupational) [SHE(O)] concept, developed in conjunction with five states, to monitor deaths which are occupationally related. The states have coded their state death certificate files for industry and occupation, using the decedent's usual occupation and industry as reported on the death certificate. From these files, the SHE(O) computer program selects deaths which are likely to be work related, based on a previously published SHE(O) list of 50 disease rubrics and associated industries and occupations. The computer program matches the SHE(O) list with the recorded industry, occupation, and underlying cause of death. The program has been tested using 1984 death certificate data from Maine, upstate New York (excluding New York City), North Carolina, Pennsylvania, and Rhode Island. Approximately 1 to 2 per cent of all deaths were selected by the program, with lung cancer and coal workers' pneumoconiosis being the most frequent cause of death. The SHE(O) program may be useful for identifying deaths which are potentially occupationally related, but its utility and its application to death certificates needs further evaluation before recommending widespread use. Limitations are discussed, as well as plans for improving the application of the SHE(O) concept to death certificates. PMID- 3631364 TI - Determinants of quitting smoking. AB - Factors associated with quitting smoking were examined in 3,778 male and 1,486 female ever-smoking patients hospitalized with non-tobacco-related conditions interviewed between 1977 and 1985. Quitters were defined as those who had stopped smoking at least one year prior to admission. More than 80 per cent of male and female quitters had stopped more than five years prior to diagnosis. The lifetime quit rate (no. ex-smokers/no. ever smokers) X 100 was higher in males than in females, and in both sexes the quit rate increased with increasing age, education level, and occupational level. Jews had higher quit rates compared to non-Jews, and Whites had higher quit rates than Blacks. Those who were divorced or separated had lower quit rates than those who were not. In both sexes, light smokers and heavy smokers had elevated quit rates. The quit rate also increased with increasing interval between waking and smoking the first cigarette of the day. Logistic regression models were used to adjust simultaneously for the role of different variables. PMID- 3631366 TI - Health behavior of elderly Hispanic women: does cultural assimilation make a difference? AB - The role of cultural assimilation in Hispanic health behavior has received little empirical examination. Prior studies have operationalized assimilation primarily in terms of language preference and have obtained weak or no effects. We interviewed 603 elderly Hispanic women residing in Los Angeles to evaluate the usefulness of cultural factors as predictors of preventive health behavior (e.g., physical examination, screening for breast cancer) more rigorously. Factor analysis of responses yielded four dimensions of cultural assimilation: "language preference", "country of birth", "contact with homeland", and "attitudes about children's friends." After controlling for education and age, no dimension of assimilation associated strongly or consistently with health behavior. Of the four dimensions, use of English language associated most closely with increased screening, although most of the effects for language were small in magnitude. These findings, coupled with those of other studies, strongly suggest that cultural factors may have little impact on the health behavior of Hispanics. Access to and availability of services, affective reactions toward screening, and sociodemographic factors are stronger determinants of Hispanic health practices. PMID- 3631367 TI - Racial contrasts in hemoglobin levels and dietary patterns related to hematopoiesis in children: the Bogalusa Heart Study. AB - Racial differences in hemoglobin (Hgb) levels were explored in two groups of children at different maturational stages, the pre-adolescent (10-year-olds: Whites n = 160, Blacks n = 56,) and the adolescent (15-year-olds; Whites n = 60, Blacks n = 44). Mean Hgb levels were higher for Whites than Blacks in both age groups. When all the dietary components (i.e., iron, zinc, copper, folacin, ascorbic acid and vitamins B12, E and B6) were considered as a group, they accounted for 8.4 per cent of the Hgb variance in 10-year-olds and 10.1 per cent of variance in 15-year-olds. However, even after controlling for the variations in dietary patterns of the adolescents and pre-adolescents, race still accounted for a notable proportion of Hgb variance in both age groups (9.1 per cent in 10 year-olds and 7.0 per cent in 15-year-olds). Within each race, gender accounted for a greater percentage of the Hgb variance in the adolescents than in the pre adolescents. Our results indicate that in all likelihood racial differences in Hgb levels during childhood exist independent of racial differences in intake of specific "blood building" nutrients and maturational changes. PMID- 3631368 TI - Hospital nurse counseling of patients who smoke. AB - Smoking-related diseases comprise a large portion of hospital admissions. This paper reports the attitudes and behaviors of a group of hospital-based nurses toward counseling patients on smoking cessation. The majority of nurses do not counsel patients who smoke. Counseling practices vary with the smoking status of the nurse. Barriers to increased nursing participation in counseling efforts include the lack of counseling training and physician failure to utilize nurses in this role. PMID- 3631369 TI - Outbreak of scombroid fish poisoning, Taiwan. AB - Fish implicated in outbreaks of scombroid poisoning have usually undergone prolonged storage at an inadequate temperature. We report an outbreak of scombroid poisoning in which fish stored on ice for two days caused illness after standing at room temperature for only three to four hours; fish from the same catch did not cause illness after standing at room temperature only one hour. This outbreak suggests scombrotoxins may be produced more rapidly than previously thought possible. PMID- 3631370 TI - Battered and pregnant: a prevalence study. AB - We interviewed 290 pregnant women randomly selected from public and private prenatal clinics, 80 per cent of whom were at least five months pregnant (ages 18 43, 42 per cent Latino, 22 per cent Black). Twenty-four women reported physical battering during this pregnancy (44 reported physical battering before the current pregnancy). Eight of the 24 pregnant women had sought medical treatment for injuries sustained; none reported having been assessed by prenatal care providers for abuse. PMID- 3631371 TI - Smokers' challenge: immediate and long-term findings of a community smoking cessation contest. AB - The present study examined the effectiveness of a community-based smoking contest in helping 500 smokers maintain three months postcontest and one year postcontest abstinence. The majority were chronic smokers with a limited number of previous quit attempts. The three- and 12-month postcontest quit rates were 19 per cent and 15 per cent, respectively, rates exceeding naturally occurring community cessation rates. The contest was found to be more cost-effective than quit smoking classes. PMID- 3631372 TI - Characteristics of participants in community health promotion programs: four-year results. AB - Four years of participant tracking data (N = 24,995) for community-based programs targeting cardiovascular disease risk factors are presented. Over two-thirds of contacts were female; age segment representation in these programs was comparable to the city's demography. However, the data show that programs of varying formats which target specific risk factors attract different types of participants. Implications for marketing strategy are discussed. PMID- 3631373 TI - Injuries in relation to chronic disease: an international view of premature mortality. AB - Injuries are compared with heart disease, cancer, and cerebrovascular disease, using 1980 mortality data for the United States, France, Japan, West Germany and the United Kingdom. Emphasis is on premature mortality, measured by a rate of potential years of life lost between ages one and 65. Injuries are the leading cause of male premature mortality, and rank first, or second to cancer, in females. The United States sustains the greatest injury losses of these five countries. PMID- 3631374 TI - Preventing rubella: assessing missed opportunities for immunization. AB - Cases of rubella continue to occur among adults in the United States because 10 20 per cent of persons in this age group remain susceptible. To evaluate the potential preventability of these cases, we present a method for assessing missed opportunities for rubella immunization, based on immunization recommendations of the Immunization Practices Advisory Committee (ACIP) of the US Public Health Service (PHS). Immunization programs faced with limited resources can use analysis of missed opportunities to focus on those gaps in implementation contributing most to the remaining rubella cases. PMID- 3631375 TI - The development of a surveillance system to monitor emergency food relief in New York State. AB - A representative sample of emergency food relief (EFR) programs was selected on the basis of a census of 1,488 EFR programs in New York State. The census was a two-stage telephone survey. EFR was provided in every county although there was considerable variation in the amount of EFR per county. The soup kitchen and food pantry components of EFR had to be differentiated. The surveillance system was operational one year after the census began. PMID- 3631376 TI - The Women's Health Care Program at Columbia University. PMID- 3631377 TI - Screening for HIV exposure. PMID- 3631378 TI - Physician training in Latin America. PMID- 3631379 TI - Effects of age misstatement. PMID- 3631380 TI - Interpretation of spermicide study data. PMID- 3631381 TI - Muscularis mucosa of urinary bladder. Importance for staging and treatment. AB - We report the results of a histologic evaluation of muscle (muscularis mucosa) in the lamina propria of the urinary bladder performed on 100 consecutive cystectomy specimens. Muscle fibers were found in the lamina propria lying parallel to the mucosa and forming a distinct muscularis mucosa in three cases; they were interrupted or discontinuous in 20 cases, and dispersed or scattered, forming thin bundles, in 71 cases. In six cases, there were no muscle fibers in the lamina propria. In addition, we noticed that the lamina propria contains large vessels that run along the length of the lamina propria in a continuous or interrupted fashion. When muscle fibers are present, they are associated with these vessels. Since prognosis and management of muscle invasive carcinomas (stage B) is different from that of lamina propria-invasive tumors (stage A), pathologists and urologists should be aware of the presence of a muscularis mucosa in the urinary bladder. PMID- 3631382 TI - Round atelectasis. Pathologic and pathogenetic features. AB - Round atelectasis is an uncommon pulmonary condition usually presenting in an asymptomatic individual as a peripheral parenchymal opacity on a chest roentgenogram. Pathologic examination of eight cases revealed localized fibrosis of the visceral pleura overlying the roentgenographic abnormality in all instances. Beneath the region of fibrosis, the pleura showed extensive wrinkling and folding, occasionally with deep invaginations into the pulmonary parenchyma. No discrete mass corresponding to the roentgenographic opacity was identified; however, lung parenchyma adjacent to the fibrotic and folded pleura appeared compressed, and in some cases, showed interstitial fibrosis. These findings support the hypothesis that round atelectasis is due to contraction of a focus of visceral pleural fibrosis that results in buckling of the pleura and collapse of underlying lung parenchyma. PMID- 3631383 TI - Diffuse pulmonary hemorrhage. An uncommon manifestation of Wegener's granulomatosis. AB - We report two cases of Wegener's granulomatosis with the unusual manifestation of diffuse alveolar hemorrahge. One patient with well-documented Wegener's granulomatosis developed alveolar hemorrhage 4 weeks after leukopenia necessitated the discontinuation of cyclophosphamide. The second patient presented with pulmonary hemorrhage and died 10 days after an open-lung biopsy in which histologic features of Wegener's granulomatosis were overshadowed by alveolar hemorrhage. Lung biopsies in both cases showed marked alveolar hemorrhage and pulmonary capillaritis. The importance of recognizing capillaritis and other subtle histologic features of Wegener's granulomatosis are emphasized. PMID- 3631384 TI - Histology of the liver. AB - The embryology, gross morphology, and histology of the normal human liver--the single largest organ in the human body--are described. It is emphasized that liver biopsy specimens must be processed with special care in order to obtain optimal sections. Immunohistologic studies of liver tissue have the potential to yield more information than electron microscopy. In surgical and autopsy liver specimens, some histologic alterations may be prominent, but they often have little significance. On the other hand, some morphologic changes, particularly in needle biopsy specimens, are frequently subtle, but may be of diagnostic importance. The pathologist must be familiar with these histologic variations from the normal liver. PMID- 3631385 TI - Spinal synovial cyst (ganglion). Review and report of a case presenting as a retropharyngeal mass. AB - A synovial cyst (ganglion) of the anterior longitudinal ligament of the cervical spine, which presented as a retropharyngeal mass, is reported. Synovial cysts occur at various spinal sites and should always be included in the differential diagnosis of intraspinal extradural and paraspinal cysts. PMID- 3631386 TI - Artifactual signet ring cells. PMID- 3631387 TI - Hemangioma of male breast. PMID- 3631388 TI - Complications encountered with the use of the Greenfield filter. AB - The Greenfield filter can be used with a low complication rate provided one adheres to certain principles. First, preoperative venography to define the inferior vena caval anatomy will help avoid difficulties associated with anatomic variations. At the time the study is carried out, it would be extremely useful if the radiologist places a radiopaque marker at the level of the renal veins. This will ensure that filters will be placed in the infrarenal position when appropriate, thus preventing occasional inadvertent discharge, particularly into the right renal vein. Second, use of a guide wire greatly facilitates passage of the introducer and accurate intracaval positioning. Third, intraoperative technical errors must be recognized and promptly corrected. Finally, meticulous postoperative follow-up is essential, and recurrent embolism or any change in filter position requires repeat roentgenography of the vena cava to guide appropriate corrective treatment. PMID- 3631389 TI - Iliocaval compression syndrome. AB - Iliocaval compression syndrome is a significant disorder in a number of patients who have lower extremity venous complaints. The diagnosis may be suspected by positive findings on exercise strain gauge venous plethysmography and unilaterally increased ambulatory venous pressures. The diagnosis is confirmed by ascending and, in some instances, descending venography which demonstrates the iliocaval compression with or without intraluminal web formation. Transstenosis pressure gradients may be measured to confirm the hemodynamic significance of the lesion. We advocate direct operative repair of the iliocaval junction with rerouting of the iliac artery and excision of the iliocaval webs with cephalic vein patch angioplasty. It provided good results in the present study when coupled with an adjunctive regimen of perioperative subcutaneous heparin and warfarin. Further investigation into the exact prevalence and significance of the iliocaval compression syndrome is needed. Only an aggressive approach to patients with lower extremity venous complaints will help clarify the exact prevalence and natural history of this disorder. PMID- 3631390 TI - Prospective comparison of noninvasive techniques for amputation level selection. AB - This study prospectively compared the following tests for their accuracy in amputation level selection: transcutaneous oxygen, transcutaneous carbon dioxide, transcutaneous oxygen-to-transcutaneous carbon dioxide, foot-to-chest transcutaneous oxygen, intradermal xenon-133, ankle-brachial index, and absolute popliteal artery Doppler systolic pressure. All metabolic parameters had a high degree of statistical accuracy in predicting amputation healing whereas none of the other tests had statistical reliability. Amputation site healing was not affected by the presence of diabetes mellitus nor were the test results for any of the metabolic parameters. PMID- 3631391 TI - Outflow resistance measurement during infrainguinal arterial reconstructions: a reliable predictor of limb salvage. AB - Criteria for abandoning infrainguinal arterial reconstructions in favor of major amputations should include reliable predictors not only of graft patency, but more importantly, of limb salvage. To evaluate the efficacy of intraoperative outflow resistance measurements in predicting limb salvage after infrainguinal bypasses, we have reviewed 134 such operations (64 femoropopliteal and 70 femorodistal bypasses) performed for critical ischemia. Outflow resistance measurements were divided into quartiles for femoropopliteal bypasses (Group A 0.17 mm Hg/ml/min or less, Group B 0.18 to 0.24 mm Hg/ml/min, Group C 0.25 to 0.4 mm Hg/ml/min, and Group D greater than 0.4 mm Hg/ml/min) and femorodistal bypasses (Group A 0.4 mm Hg/ml/min or less, Group B 0.4 to 0.58 mm Hg/ml/min or less, Group C 0.6 to 1 mm Hg/ml/min, and Group D 1 mm Hg/ml/min or greater). One year limb salvage rates for patients who underwent femoropopliteal bypass were 95 percent, 92 percent, 87 percent, and 67 percent from the lowest to the highest quartile (difference not statistically significant), and for those who had femorodistal bypass, they were 51 percent, 75 percent, 48 percent, and 0, respectively (p less than 0.05). Interestingly, 12 month graft patency and limb salvage rates for patients who underwent femorodistal bypass with outflow resistances between 0.59 and 1 mm Hg/ml/min did not correlate well (22 percent and 48 percent, respectively), whereas for those with outflow resistance greater than 1 mm Hg/ml/min, they were 22 percent and 22 percent, respectively. Thus, measurement of intraoperative outflow resistance is a very accurate predictor of limb salvage after infrainguinal bypass operations. PMID- 3631392 TI - Continuous epidural anesthesia and postoperative epidural narcotics in vascular surgery. AB - A combination epidural technique using local anesthetics intraoperatively and morphine postoperatively is shown to offer many advantages. These benefits include inhibition of the surgical stress response, decreased cardiorespiratory depression, decreased blood loss, decreased intubation and pulmonary infection, decreased thromboembolism, decreased hyperglycemic and hypertensive response, nitrogen sparing, a stable resting metabolic rate, prevention of immunosuppression, simplification of cerebral status monitoring, and earlier ambulation and hospital discharge. The main disadvantage in patients undergoing vascular procedures is the risk of epidural hematoma. A review of the literature confirms the extreme rarity of this risk and, in view of the emerging benefits, argues for reconsideration of epidural technique in vascular patients. The addition of epidural morphine to this combined technique affords a postoperative pain-free continuum unmatched by any other method. This significantly decreased pain stress in cardiac patients increases safety and comfort. In conclusion, epidural anesthesia and postoperative epidural narcotics provide a safe and reliable method of management for patients undergoing vascular procedures. PMID- 3631393 TI - Recognition and treatment of vascular steal secondary to hemodialysis prostheses. AB - Ischemic symptoms of the distal extremity developed in 4 patients from a group of 55 in whom a primary polytetrafluorethylene prosthesis was placed for purpose of hemodialysis. Diagnosis of vascular steal syndrome was suggested by clinical symptoms of pain and coolness of the distal part, as well as trophic changes of the hand. The diagnosis was confirmed by placing a cuffed photoplethysmograph transducer on one or more of the digits of the affected limb and recording the waveform before and during manual compression of the arterial end of the prosthesis. The findings showed essentially a flat waveform converting to pulsatile waveform when the proximal graft was compressed. Two patients underwent controlled operative banding of the arterial end of the polytetrafluoroethylene prosthesis using this same method. A polytetrafluoroethylene cardiovascular patch was cut to a width of 1 cm and then cut again to form two shoelace tails each 0.5 cm in width. The band was placed around the proximal part of the prosthesis and progressively tightened until an adequate digital pulse wave returned. Preservation of flow through the prosthesis was maintained so as to allow dialysis and prevent thrombosis. The technical aspects of the procedure have been discussed. Vascular steal syndrome appears to be more common in the diabetic. PMID- 3631394 TI - Is limb loss avoidable in civilian vascular injuries? AB - Limb salvage is virtually guaranteed when arterial injury is associated with a gunshot or stab wound. In this setting, associated injury is limited, and arterial injury is uniformly suspected, deliberately sought, and expeditiously repaired. Blunt trauma and massive injuries to the soft tissue, bones, and joints of the extremities augur amputation. In a patient with blunt trauma and loss of distal pulses, liberal, early use of angiography helps to avoid amputations secondary to missed or delayed diagnosis. Deliberate local anticoagulation and effective venous drainage is recommended in the management of dual-complex popliteal injuries. Discriminate amputation merits consideration when arterial trauma is accompanied by massive soft tissue and bony injuries with extensive loss of soft tissue. PMID- 3631395 TI - Adequacy of central hemodynamics versus restoration of circulation in the survival of patients with acute aortic thrombosis. AB - Acute aortic thrombosis is an infrequent clinical occurrence, but when it does occur, it is a true cardiovascular catastrophe. Our experience with 34 patients over a 12 year period was reviewed and factors influencing outcome were analyzed. Seventeen women and 17 men had various clinical presentations, although 74 percent of the patients had the classic picture of ischemia. Preoperative assessment of left ventricular function was carried out in all but one patient with intraoperative and perioperative monitoring to guide therapy in addition to revascularization procedures. While extent of the preexisting disease and number of additional operations did influence the outcome, the predominant factor for survival was the left ventricular functional state perioperatively. Fifteen of the 16 patients with adequate left ventricular function survived, whereas 15 of the 17 patients with a failing myocardium died (88 percent). Extraanatomic operations are preferable in patients with demonstrated inadequate left ventricular function. Expeditious restoration of circulation alone does not ensure a favorable outcome. The key to successful therapy is understanding, preventing, and effectively treating the mechanical and metabolic dysfunction of the heart. Review of the literature on acute aortic thrombosis revealed only few isolated case reports except for a recent report of eight patients. Our report of 34 patients over a 12 year period represents the largest experience to date from a single institution. Detailed analysis of hemodynamic parameters and the significance of determination of left ventricular function has not been reported so far in this subset of critically ill patients. PMID- 3631396 TI - Anatomic and pathophysiologic studies of the human internal jugular valve. AB - The results of anatomic and hemodynamic studies of the human internal jugular valve, which is the only venous valve between the right atrium of the heart and the brain, have been reported. Tricuspid internal jugular valves were present in two cadaver subjects without any observed compromise in competency. Most valves tested were competent, with the exception of those from one cadaver which were apparently congenitally incompetent. Acquired or congenital internal jugular valve incompetence may impair cerebral venous return, especially when intrathoracic pressure is increased by positive-pressure ventilation. Screening for internal jugular valve incompetence with a Doppler flowmeter before utilizing this type of mechanical ventilation may help prevent the deleterious effects of cerebral venous congestion. PMID- 3631398 TI - The value of aortic arch study in the evaluation of cerebrovascular insufficiency. AB - In evaluation of extracranial carotid vascular disease, the use of arteriography has long been considered essential. With increasing expertise in noninvasive testing, the importance of extensive dye studies is being questioned. The data presented herein indicate that proper preangiographic evaluation of the patient population drastically reduces the possibility of missing significant intrathoracic pathologic processes. Two subsets of patients should be recommended routinely for dye studies: those patients with unequal upper-extremity blood pressures and those without pathologic neck findings on noninvasive testing to account for their symptoms. When these patients are recognized as having the potential for intrathoracic disease, dye studies can be performed in situations that will generate the highest yield. Even with the continued use of dye studies in evaluation of cerebrovascular insufficiency, elimination of the aortic arch study will drastically reduce the dye load and, thus, the associated morbidity. PMID- 3631397 TI - Atherosclerosis in the younger patient. Results of surgical management. AB - One hundred fifty-three patients under 50 years of age with atherosclerosis were studied. Hospital and office records were reviewed to determine risk factors, operations performed, postoperative course, and long-term results. These data were then compared with the data in the group of patients over 50 years of age. Results of this study indicate that survival in the younger patient is better than that in the patient over 50. Survival in the younger patient compared favorably to that in the general population through 5 years. Limb salvage rates after aortofemoral bypass and femoropopliteal bypass in both age groups were the same; however, limb salvage after femorotibial bypass in patients under 50 was not as good as in the older patient. Based on these results, the disease process in patients under 50 years of age does not appear more virulent than in those over 50 years of age. Smoking is the most significant risk factor in patients under 50 with atherosclerotic peripheral vascular disease. PMID- 3631399 TI - Diagnostic and surgical considerations in the treatment of thoracoabdominal and suprarenal aortic aneurysms. AB - Thoracoabdominal and suprarenal aortic aneurysms may occur more frequently than originally thought. A review of our operative experience with aortic aneurysm during a 4 1/2 year period disclosed 17 (8 percent) aneurysms of the thoracoabdominal and suprarenal aorta. Acute rupture in five patients (29 percent) emphasizes the possible need for urgent treatment precluding transfer to a major university referral center. Nine patients (53 percent) had previously been operated on for aortic aneurysm, illustrating the systemic nature of aortic aneurysm disease and the need for lifelong follow-up. All patients survived, but paraplegia resulted in 2 patients (12 percent) with ruptured aneurysms. Pulmonary insufficiency was the major cause of postoperative morbidity. The high incidence of paraplegia reported for extensive chronic dissecting aneurysms has influenced our decision to postpone resection and carefully follow three additional patients with such lesions. PMID- 3631401 TI - The crucial role of the practicing surgeon in securing permission for organ donation. PMID- 3631400 TI - Popliteal-to-tibial in situ saphenous vein bypass for limb salvage in diabetic patients. AB - This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb threatening ischemia. Distal calf or pedal outflow sites were required in all but two patients who had sequential bypass performed to tibial sites. Postoperative ankle-brackial indices were calculated. Eleven patients had transcutaneous mapping surrounding the pedal skin envelope injuries. The mean lowest and highest transcutaneous oxygen values have been reported as a guide to successful healing. PMID- 3631402 TI - Medical education: a continuum in disarray. AB - I have addressed the issue of medical education from the standpoint of a person who has been actively involved in the field for more than 30 years. The enthusiasm for technologic advancements and the emphasis on a regulated life with adequate creature comforts has made the teaching of the basics of good medicine, that is, listening carefully to the patient and examining carefully all of the patient, at best, a secondary effort. This has been enhanced by the emphasis in medical schools on research and the results of research, publications which are more often than not counted or weighed rather than read. Suggestions for change include (1) putting the patient first in the health care equation; (2) rewarding teaching and clinical care equally with research; (3) placing real clinicians on medical school faculties; and (4) establishing a national health service in which all medical school graduates must serve in physician-sparse areas for a period of time after graduation, preferably without a single computerized tomography scanner, magnetic resonance imaging unit, or advanced radiologic imaging device within reach. PMID- 3631403 TI - Thoracoscopy under regional anesthesia for the diagnosis and management of pleural disease. AB - Over a 3 year period, 52 patients underwent thoracoscopy for the diagnosis and management of a variety of pleural diseases. In 46 of the 52 patients, thoracoscopy was performed under regional anesthesia. The procedure was associated with no operative deaths and essentially no morbidity. In all 52 patients, thoracoscopy averted the need for formal thoracotomy. Thoracoscopy proved valuable as (1) the ultimate diagnostic tool for determining the presence or absence of pleural malignancy in patients with recurrent pleural effusions; (2) a method for obtaining tissue in cases where cytologic study was inadequate for diagnosis; (3) a highly successful approach to chemical pleurodesis in patients with malignant pleural effusions, multiloculated effusions, or failed tetracycline pleurodesis; (4) a means for determining whether a loculated fluid collection was intrapleural or parenchymal in location when radiologic study had failed to clarify this; (5) a way to completely drain the pleural space in patients with multiloculated empyemas not amenable to tube thoracostomy; and (6) an alternative to open lung biopsy in the immunosuppressed patient with diffuse pulmonary infiltrates. Thoracoscopy is a safe, effective, and relatively simple procedure which can be easily performed under regional anesthesia, even in ill or elderly patients. It is an often overlooked alternative to thoracotomy and should be used more widely. PMID- 3631404 TI - Needle localization of mammographically detected lesions in perspective. AB - Needle localization of mammographically detected lesions has been shown to detect early breast cancer. One hundred seven patients who underwent needle localized biopsy from June 1977 to September 1985 were reviewed. Eighty percent of the biopsies were benign and 20 percent were cancers (22 patients). In patients undergoing modified radical mastectomy, 80 percent of the axillary specimens were node-negative. During the same 8 year period, 570 breast cancers were diagnosed. Needle localization was responsible for only 4 percent of all cancers found. Though needle localization represents an advance in the detection of early breast cancer, the majority of cancers are found by physical examination. The importance of routine examination by a physician and self-breast examination remains paramount. PMID- 3631405 TI - Adhesive small bowel obstruction. A review of 321 cases in a Thai hospital. AB - A retrospective study was carried out on 321 cases of adhesive small bowel obstruction in 289 patients admitted at the Chulalongkorn Hospital over an 8 year period. Appendectomy was the most common operation preceding the obstruction. Early operation was performed in 54 cases with two deaths, and nonviable and borderline bowel was found in 30.2 percent. Continuous abdominal pain, generalized tenderness, guarding, and distension appeared to influence the attending surgeons' decisions to operate early. A trial of conservative treatment with nasogastric decompression was carried out in 267 cases with one death. Conservative treatment was successful in 126 cases, but in 140 cases, there was no improvement or the condition became worse and a delayed operation was required. There was no mortality in the delayed operation group and nonviable and borderline bowel was found in 22.8 percent of cases. The incidence of nonviable and borderline bowel did not increase with the length of delay, but was more frequent in those whose condition grew worse after conservative treatment. No preoperative factors that could reliably predict bowel strangulation were found. However, the results in this series justify a trial of conservative treatment with close observation in patients without clinical evidence of strangulation or marked abdominal distension. PMID- 3631406 TI - Collagen metabolism in small intestinal anastomosis. AB - Collagen metabolism in the small intestinal wall during the first week of anastomotic healing in operated and nonoperated rats was studied. During this period, marked changes in anastomotic strength have been observed. A general and marked increase of collagen synthesis was found throughout the intestine already on the second day. This resulted in increased collagen content. Collagen concentration remained relatively unchanged despite an increase in collagen content as a result of concomitant increase of noncollagenous substances. The previously reported loss of anastomotic strength in the early phase of healing could not be explained by changes in collagen content or metabolism in this study. Cutting of sutures seems to be due to a local process. After 4 days, collagen content increased predominantly in the anastomotic region. It correlated well to the previously observed increase of anastomotic strength. PMID- 3631407 TI - Aggressive management of cholecystitis during pregnancy. AB - Nonoperative management of symptomatic cholelithiasis has generally been recommended for pregnant patients. However, a review of our experience with 44 patients at the Los Angeles County-University of Southern California Medical Center indicates that conservative management is associated with recurrent episodes of biliary tract symptoms, often requiring multiple hospitalizations, as well as a significant rate of fetal loss; whereas operation performed during the second trimester was associated with little maternal morbidity, no fetal loss, and a substantial reduction in total hospital days. PMID- 3631408 TI - Incidence of necrotizing pancreatitis and factors related to mortality. AB - Of 348 cases of acute pancreatitis presenting between 1980 and 1985, extensive retroperitoneal necrosis with bacterial or fungal superinfection developed in only 17 (4.8 percent). However, in 14 of the 17 patients (80 percent), multiple surgical interventions and intensive supportive therapy failed to control the process, and they died from complications. Deaths occurred after a prolonged in hospital course characterized by sequential failure of organ systems. If the salvage of these patients is to be optimized, as in some reports, the timing of the first surgical procedure has to be very carefully made based on the clinical and laboratory findings, and most importantly, the results of computerized tomography. Exploration is probably best carried out through an extended subcostal incision, and a determined attempt must be made to remove all of the necrotic tissue. Little reliance can be placed on the possibility that significant amounts of residual necrotic tissue can be aspirated through sump catheters or evacuated by irrigations. We believe that the poor results in this series lend strong support to those who have already advocated much more universal application of the open abdomen technique in the management of these patients with widespread anterior pararenal space necrosis. PMID- 3631409 TI - Gangrene of the lower limbs in diabetic patients: a malignant complication. AB - Diabetic foot lesions are a common medical problem with major socioeconomic impact. Gangrene is usually a late and sometimes fatal complication. A series of 118 diabetic patients who underwent amputation of the lower limb at our institution over a 10 year period has been presented. Forty-two patients underwent amputation of the toes or part of the foot, 48 underwent below-knee amputation, and 18 underwent above-knee amputation. In 24 (20.3 percent), the necrotic process advanced postoperatively and necessitated additional amputation. The average hospital stay was 33.6 days. Twenty-eight patients (23.7 percent) died during the postoperative period, and the main cause of death was sepsis. Patients who presented with extensive gangrene had a higher mortality rate. There was no correlation between mortality and the duration of conservative treatment, number of repeated operations, the treatment of diabetes before hospitalization, onset of symptoms, or status of the peripheral pulses. The solution to the problem is early and vigorous preventive treatment. This could be accomplished through highly specialized clinics within the community. PMID- 3631410 TI - Effect of force on anastomotic suture line disruption after carotid arteriotomy. AB - Static and dynamic forces exerted on 6-0 polypropylene suture material after carotid arteriotomy were measured in 22 adult mongrel dogs. Force was measured in 11 normotensive animals (Group I) before and 6 weeks after carotid artery repair. Force was measured in the remaining animals during normotension and induced hypertension before and 6 weeks after operation. The tensile strength of each suture used in the study was measured by the manufacturer. The mean force required to break a 6-0 polypropylene suture measured 436.9 +/- 2 g, whereas knotting of the suture decreased the tensile strength to 316.9 +/- 3.9 g (p less than 0.001). The static and dynamic axial forces exerted on the suture after carotid arteriotomy in Group I was in the range of 26 g and decreased to 18 g at 6 weeks, whereas the 45 degree force exerted during the static dynamic phase measured in the range of 23 g and decreased to 16 g at 6 weeks (not statistically significant). The axial and 45 degree forces exerted on 6-0 polypropylene suture material in Group II under normotensive conditions were in the range of 14 g after carotid arteriotomy and ranged between 12 to 14 g at 6 weeks. Systolic hypertension did not result in a significant increase in axial or 45 degree forces during static or dynamic measurements, both in the range of 15 g after carotid arteriotomy. Measurements were similar at 6 weeks and ranged between 14 and 16 g. Our data indicate that 6-0 polypropylene suture material is an appropriate choice for repair of the carotid artery and that the suture material has sufficient inherent tensile strength to withstand forces generated in the neck region. Furthermore, our data indicate that spontaneous carotid artery suture line disruption is most likely related to damage to the suture strand during carotid artery repair rather than an inherent weakness in the suture material. PMID- 3631411 TI - Use of the Foley catheter in the repair of adult indirect inguinal hernias. AB - A widely opened internal ring and weakness of the transversalis fascia are the major defects in adult indirect inguinal hernia. Reducing the size of the ring and reinforcement of the transversalis fascia prevent hernial recurrence. During the repair, introduction of a Foley catheter into the internal ring and inflation of its balloon displaces the inferior epigastric vessels medially and the spermatic cord laterally. This position of the balloon enables a safe reconstruction of the internal ring without injury to the epigastric vessels and prevents tightening of the cord. This technique was successfully employed on 75 adult patients who underwent repair of an indirect inguinal hernia without complications. PMID- 3631412 TI - An improved double-lumen biliary catheter for cholangiography. AB - A double-lumen biliary catheter was developed to aid in the performance of cholangiography and bile duct stone extraction. A prototype catheter was used in four cadavers. Excellent cholangiograms were obtained and a cryoprecipitate coagulum easily formed in the bile ducts without waste. Extraction of the coagulum from the bile ducts was aided by use of the catheter. The catheter also can aid in routine balloon catheter bile duct stone extraction, and thus is useful for both diagnosis and treatment of bile duct stones. PMID- 3631413 TI - Autologous blood transfusion is underutilized. PMID- 3631414 TI - Difficulty diagnosing papillary stenosis. PMID- 3631415 TI - Meniere's disease in children. AB - Fourteen children (aged 14 years or younger) with typical Meniere's triad with cochlear sensorineural hearing loss, tinnitus, and intermittent vertigo attacks lasting from minutes to hours were investigated in four different neuro-otologic centers. Nine children, labeled as having "idiopathic Meniere's disease," developed the auditory and vestibular symptoms without any detectable causative factor. Five children, labeled as suffering from "secondary Meniere's syndrome," had histories of an initial hearing loss following mumps, hemophilus influenza meningitis, temporal bone fracture, or congenital or embryopathic complications in the ear that developed into the full Meniere's triad 5 to 11 years later. The 14 children represent 1% of all cases affected with idiopathic or secondary Meniere's disease (or syndrome) that have been detected during the past five years in the four collaborating centers. PMID- 3631416 TI - The source of far-field antidromic facial nerve potentials. AB - Most electrodiagnostic tests of facial nerve function are based on recordings of the distal muscle action potentials evoked by a proximal electrical stimulus. In contrast, retrograde or antidromic nerve action potentials can be recorded by near-field (directly from the nerve) or far-field (scalp) techniques. Clinical and surgical applications of far-field antidromic recording recently have been suggested because of such potential benefits as obviating the need to await axonal degeneration distal to the stylomastoid foramen. Critical to far-field recording is an understanding of the source from which the distant response is derived. This study was undertaken to identify the generator sites of the far field antidromic facial nerve response in dogs. The results suggest the following for the montage and stimulus protocol employed: 1) the far-field antidromic response is a volume-conducted nerve action potential generated primarily from the mastoid segment, 2) complete transection of the facial nerve at the cerebellopontine angle has little effect on the responses, and 3) there appears to be no significant supranuclear generator site. PMID- 3631417 TI - Effect of stimulation of the horizontal limb of the diagonal band on rat olfactory bulb neuronal activity. AB - Reports suggest that patients with Alzheimer's disease have deficient olfactory sensitivity and disruption of the cholinergic pathways. Elucidation of the cholinergic system in the olfactory bulb is essential to the understanding of this disease for diagnostic and therapeutic advances. Possible cholinergic projection to the olfactory bulb was studied in rats with transected medial forebrain bundles by stimulating the horizontal limb of the diagonal band, which contains cholinergic perikarya. Electrical stimulation of the horizontal limb of the diagonal band evoked negative potentials in the granule cell layer. Neurons in the granule cell layer were excited, and those in the mitral cell layer and external plexiform cell layer showed inhibition, often followed by excitation. These responses were attenuated by the administration of the cholinergic blocker, atropine. The role of cholinergic projection to olfactory bulb neurons is discussed. PMID- 3631418 TI - Three-dimensional computer graphics of the eustachian tube. AB - Images of the eustachian tube from various directions were obtained using computer graphics. Serial cross sections of a human temporal bone specimen including the eustachian tube were digitized for reconstruction. Wire-frame models of the structures such as the eustachian tube lumen, the tubal cartilage, the tensor veli palatini muscle, and the levator veli palatini muscle were drawn. Through observation of the eustachian tube from various directions with the tubal muscles attached or detached, the physiology of the eustachian tube system could be understood more clearly. PMID- 3631419 TI - Persistent mal de debarquement syndrome: a motion-induced subjective disorder of balance. AB - Six patients with a distinct syndrome of persistent sensations of imbalance are presented. Common features included onset following a period of motion exposure, symptoms lasting months to years, mild unsteadiness and anxiety, minimal relief from antivertiginous medication, and normal neurologic and quantitative vestibulo ocular examinations. One patient experienced recurrent episodes. Mal de debarquement refers to sensations of motion experienced on return to stable land after adaptation to motion lasting from hours to days in normal individuals. The presented patients exemplify a syndrome of persistent mal de debarquement. The entity is found in a relatively small number of dizzy patients. Persistent mal de debarquement is discussed in the context of what is known about long-term vestibulo-ocular adaptation to alterations of visual or vestibular environments. PMID- 3631420 TI - Mucosal pathology of an experimental otitis media with effusion after X-ray irradiation. AB - Ten guinea pigs were irradiated with 30 Gy of x-radiation. Five were killed on the eighth day after irradiation, and the remainder were killed at the sixteenth day after irradiation. At the time of death, examination was made of the ciliary activity and the fine structure of the middle ear mucosa. Serous effusion was found in each tympanic cavity of all animals. It was shown also that the guinea pig, when irradiated with 30 Gy of x-radiation, exhibits pathologic abnormalities similar to those in humans with otitis media with effusion: degeneration of cilia or ciliated cells and changes in the vascular system (capillary injury and increased capillary permeability). Functional examinations showed that x-ray irradiation has delayed effects on ciliary activity, and the effects are much greater at the sixteenth day than at the eighth day. We speculate that the accumulation of effusion can be, at least partially, a consequence of ciliary dysfunction. The induction of sterile effusion by the use of x-ray irradiation provides a unique animal model for chronic otitis media with effusion of the serous type. PMID- 3631421 TI - Reduction in snoring with phosphocholinamin, a long-acting tissue-lubricating agent. AB - The efficacy of a long-acting lubricating and coating agent, phosphocholinamin, in reducing snoring was tested in 12 persons, six of whom received the agent as nose drops and six of whom received a placebo (tap water nose drops). In all subjects, the noise level was measured continuously by using a microphone taped near the cricothyroid notch. In the group treated with phosphocholinamin, the maximum nocturnal decibel level was reduced by a mean +/- SD of 13 +/- 3%, and the snoring index (defined as the number of snores per hour of sleep) was reduced by 25 +/- 12%. In the group treated with placebo, the maximum nocturnal decibel level increased 9 +/- 22% and the snoring index increased 1 +/- 20%. The differences between the two groups were statistically significant (P less than .05). It is concluded that phosphocholinamin can provide a useful medical alternative in the treatment of snoring and that further trials of this agent are indicated. PMID- 3631422 TI - Effects of chloral hydrate, pentobarbital, ketamine, and curare on the auditory middle latency response. AB - Changes in threshold, latency, and amplitude of the auditory middle latency response (MLR) with anesthesia and neuromuscular paralysis were studied in guinea pigs. Although each component of the surface-recorded MLR was altered by barbiturate and nonbarbiturate agents, the early positive wave (wave A) was always present, and the later waves were generally identifiable at moderate levels of anesthesia. MLR threshold was not affected by anesthesia or curare. Pentobarbital, chloral hydrate, and ketamine each caused an increase in the latency of all MLR components, with increases progressively marked for later waves. Amplitude changes were more complex. Wave A increased in amplitude with anesthesia, while wave C decreased or disappeared temporarily. Wave B showed mixed amplitude changes. Changes in MLR associated with anesthesia were generally more pronounced at a stimulation rate of 10/sec as compared to 4/sec. No changes in waveform morphology or latency were seen with neuromuscular paralysis. The results provide evidence in support of separate neurogenic substrates for the different components of the guinea pig temporal lobe MLR. The presence of the MLR with moderate levels of anesthesia indicates that this animal is an appropriate model for studying the MLR in experiments requiring anesthesia and immobilization. PMID- 3631423 TI - [Current views on treatment with estrogens]. PMID- 3631424 TI - [Amniotic fluid and placentas of women with premature deliveries]. PMID- 3631425 TI - [Modified method for detachment of an inseparable placenta]. PMID- 3631426 TI - [Method of delivery and status of the newborn infant with IUGR]. PMID- 3631427 TI - [Attempt to eliminate residual somnolence and disorientation with nivaline after anesthesia with ketalar and diazepam for minor obstetrical and gynecologic surgery]. PMID- 3631428 TI - [Depressive states in pregnant women and parturients]. PMID- 3631429 TI - [Concentration of selenium, zinc, copper, iron and magnesium in the umbilical cord serum of healthy term newborn infants]. PMID- 3631430 TI - [Prognostic value of the pH of the milk of parturients with mastitis with respect to the course of the healing process]. PMID- 3631431 TI - [Incidence of mastitis, galactostasis and rhagades among parturients with deformed nipples and nipples with reduced erectility]. PMID- 3631432 TI - [Diagnosis of pelvic inflammatory disease]. PMID- 3631433 TI - [Effect of bioshik (tinidazole) on fetal growth in pregnant rats]. PMID- 3631434 TI - [Menstrual function of female workers chronically exposed to chemical industrial hazards]. PMID- 3631435 TI - [Problems in the pharmacologic prevention and treatment of menopausal osteoporosis]. PMID- 3631436 TI - [Epididymal cysts and infertility--late results of surgical treatment]. PMID- 3631437 TI - [Prolonged abdominal pregnancy]. PMID- 3631438 TI - [A case of ovarian carcinoma subjected to repeated surgery]. PMID- 3631439 TI - [Drug therapy of pregnant women]. PMID- 3631440 TI - Abstracts from the satellite symposium at the 28th annual meeting of the JSCN on mitochondrial myopathies and mitochondrial encephalopathies and related problems. Japanese Society of Child Neurology. May 31, 1986, Tokyo. PMID- 3631441 TI - Proceedings of the 28th annual meeting of the Japanese Society of Child Neurology. Matsue, June 5-6, 1986. Abstracts. PMID- 3631442 TI - Twenty ways to stay alive longer in Anchorage. PMID- 3631443 TI - Hot tub folliculitis. PMID- 3631444 TI - Monoclonal antibodies in diagnostic dermatopathology. PMID- 3631445 TI - Dysplastic melanocytic nevus. Electron-microscopic observation as a diagnostic tool. AB - Dysplastic melanocytic nevi (DMN) are distinctive cutaneous nevomelanocytic lesions that possess unique clinical and histopathological features. In our previous study, we showed that the fine structure of melanosomes in epidermal melanocytes of DMN are abnormal and reveal deranged melanogenesis. This study is an extension of our previous study and clarifies the fine structure of melanosomes in both epidermal melanocytes and keratinocytes with observations in an additional 10 cases of DMN with and without a marked mesenchymal response. We found that a poor mesenchymal response does not exclude fine structural abnormality of melanosomes in DMN; that abnormal melanosomes are manifested by a spherical shape with either fine granules or incompletely developed lamellae and/or both; that melanization occurs unevenly on the spherical granular and/or incompletely on the lamellar matrices; and that these abnormal melanosomes are transferred to keratinocytes before being completely melanized, and they reveal marked degradation. We suggest that the fine structural characterization of abnormal melanosomes is a new adjunct for histopathological diagnosis of DMN. PMID- 3631446 TI - Three-dimensional reconstruction of the superficial multicentric basal cell carcinoma using serial sections and a computer. AB - By means of a serial horizontal microscopic sections and a special computer, three-dimensional reconstruction of seven superficial multicentric basal cell carcinomas was carried out. All foci of tumor were observed to be interconnected, which suggests a unicentric origin for this subtype of basal cell carcinoma. PMID- 3631447 TI - Anthrenus sp. The paraffin block eater bug. AB - Review of several years-old, paraffin-embedded specimens showed unusual damage, especially of the sectioned surface of hyperkeratotic lesions. The larva of Anthrenus sp., feeding on the embedded material, was identified as the causative agent. Normally found in birds' nests, this species prefers keratin for nutrition, and can therefore damage histopathology collections. PMID- 3631448 TI - Mast cells in sun-exposed and non-sun-exposed skin. An autopsy study. AB - One hundred ten skin biopsies were taken from 55 consecutive autopsies to evaluate the number and location of mast cells in the dermis. For each autopsy, one biopsy was taken from the V of the neck (sun-exposed area) and the other from the upper thigh (non-sun-exposed area). Normal-appearing skin was biopsied. There were 28 men and 27 women ranging in age from 16 to 94 years. Fifty-three patients were Caucasian and two were Negro. Mast cells were counted in 10 random high power fields in the papillary dermis only. The average number of mast cells per high-power field (X 400) in sun-exposed skin for both men and women was 8.19 (65/mm2 or 13,000/mm3) with one standard deviation of 4.08, while that of non-sun exposed skin was 7.52 (60/mm2 or 11,900/mm3) with one standard deviation of 3.62. The difference between the number of mast cells in sun-exposed and non-sun exposed skin was not statistically significant. In addition, no statistically significant differences were observed for the average number of mast cells per high-power field in regard to sex or the presence of malignancies. PMID- 3631449 TI - Microanatomy of the dermis in relation to relaxed skin tension lines and Langer's lines. AB - The microanatomy of the dermis was studied by optical and scanning electron microscopy in order to visualize the relationship between orientation of fibers and skin tension lines. In the reticular dermis of the normal adult human, skin tension lines have an anatomical counterpart consisting of a preferential parallel orientation and a straightening of thin collagen bundles and elastic fibers. This was observed only when mechanical tensions normally present in the skin were preserved during the processing of the samples, but was not observed in those that had retracted during biopsy. A comparative study of the fetal skin of calves, where relaxed skin tension lines were absent, offered further evidence that the presence of tension lines in the skin depends on the interrelationship between elastic fibers and collagen fibers, as well as on the anchorage of collagen bundles one upon another. PMID- 3631450 TI - Clear cell syringoid eccrine carcinoma. AB - A case of syringoid eccrine carcinoma (SEC) is reported. The tumor was mainly formed by clear cells laden with glycogen. This feature, rarely found in syringoma, had not previously been reported in SEC. The authors assume that SEC is an infiltrating and locally destructive but not metastasizing neoplasm. They propose that SEC is a clinicopathologic entity with a histopathologic spectrum from the more differentiated syringomatoid ones to so-called primary cutaneous adenoid cystic carcinoma. A possible nexus between the more syringomatoid cases and the sclerosing sweat duct (syringomatous) carcinoma is also discussed. PMID- 3631451 TI - Punched-out porokeratosis. A histological variant of disseminated superficial actinic porokeratosis. AB - This paper describes an unusual histological variant of disseminated superficial actinic porokeratosis in which there were areas of full-thickness coagulative epidermal necrosis. The diagnosis of porokeratosis was confirmed with a further biopsy, which demonstrated a coronoid lamella and some underlying basal cell liquefaction. The significance of the pathology is discussed. PMID- 3631452 TI - Papillary eccrine adenoma. Light-microscopic, histochemical, and immunohistochemical studies. AB - In 1977, Rulon and Helwig described 14 cases of a benign sweat gland tumor that they termed papillary eccrine adenoma. These neoplasms have a characteristic morphology, consisting of dilated ducts that contain eosinophilic secretion and are often associated with intraluminal papillations. They also stressed the benign clinical behavior of these neoplasms. Since their original description, occasional single cases have been reported. We describe herein four new cases and their immunohistochemical characteristics, including the presence of cytokeratins, S100 protein, and carcinoembryonic antigen. PMID- 3631453 TI - Verruga peruana mimicking malignant neoplasms. AB - We have shown that in some cases fully developed florid verruga peruana nodules, as well as late-resolving, deeply situated lesions, can histologically suggest a variety of tumors to experienced pathologists. The compact proliferation of endothelial cells characteristic of florid verruga lesions can give rise to two pseudoneoplastic histologic patterns. One consists of sheets or islands of cells arranged in an epithelioid or pseudoepithelioid pattern (cases 1 and 2) in which the following histologic diagnoses were considered: squamous carcinoma, sweat gland carcinoma, epithelioid hemangioendothelioma, epithelioid sarcoma, melanoma and metastatic carcinoma. The other pattern of the florid lesion is characterized by a predominantly spindle cell arrangement (case 3) and in it the following diagnoses were made: Kaposi's sarcoma, fibrosarcoma, melanoma and leiomyosarcoma. The dense lymphoplasmacytic and histiocytic infiltrates of the late-resolving, deeply situated nodules (case 4) suggested the following histologic conditions: malignant lymphoma, nodular Hodgkin's disease, reticuloendotheliosis, and reticulosarcomatosis. Some histologic features thought to be of value to help in the differential diagnoses are discussed. It is emphasized that only the finding of Rocha-Lima's inclusions on light-microscopic studies and/or the demonstration of bartonella organisms in the lesions by electron-microscopic studies can objectively establish a diagnosis in a given lesion. However, knowledge of the epidemiologic data and particularly the presence of other lesions in the patient make it relatively easy to rule out neoplasia. PMID- 3631454 TI - Acquired "tufted" angioma (progressive capillary hemangioma). A distinctive clinicopathologic entity related to lobular capillary hemangioma. AB - Three young patients affected by intradermal and subcutaneous vascular proliferations are presented. The lesions were acquired and developed as solitary or multiple erythematous patches and plaques in the upper thorax, neck, and scalp. Light-microscopic examination revealed a deep-seated vascular growth with a distinctly lobular pattern. Ultrastructural and immunocytochemical studies demonstrated the cellular proliferation to be composed of endothelial and perithelial cells, the latter predominating. These cases are interpreted as examples of the vascular disorder described as progressive capillary hemangioma and acquired "tufted" angioma. We believe that it represents a distinctive clinicopathologic entity that is closely related histogenetically and perhaps pathogenetically to the entity recently renamed lobular capillary hemangioma. PMID- 3631455 TI - Ripple pigmentation of the neck in atopic dermatitis. AB - Ripple pigmentary lesions of the neck were observed in 12 patients with atopic dermatitis. Biopsy specimens from three cases revealed no amyloid substances. From the review of cases with either atopic dermatitis or ripple pigmentation seen in our hospital, it was concluded that ripple pigmentation of the neck was always associated with atopic dermatitis and appeared in 1.7% of all 751 patients with atopic dermatitis. It is suggested that ripple pigmentation is not necessarily specific or diagnostic of amyloidosis, as is generally believed. Possible relationships involving ripple pigmentation, atopic dermatitis, and macular amyloidosis are also discussed. PMID- 3631456 TI - Gout presenting as lobular panniculitis. AB - A 37-year-old man presented with panniculitis of the legs that, on biopsy, showed aggregates of crystals whose appearance suggested sodium urate. Based on this finding, a uric acid level was obtained which proved to be markedly elevated. The patient subsequently developed gouty arthritis. Gout should be added to the differential diagnosis of causes of panniculitis, and biopsy specimens of panniculitis should be carefully examined for crystals. PMID- 3631457 TI - Solitary labial papular acantholytic dyskeratoma in an immunocompromised host. AB - A 42-year-old white man presented with a solitary labial papule 4 years after cardiopulmonary transplantation. Pathological examination of the excised papule revealed a tumor with prominent acantholytic dyskeratosis. Risk factors for skin tumors in this patient included habitual tobacco chewing, chronic unprotected solar exposure, and an immunosuppressive regimen comprising prednisone and cyclosporin-A. This is the first report of an acantholytic dyskeratoma in association with these predisposing conditions. PMID- 3631458 TI - Freakish forms and mildewed meanings. PMID- 3631459 TI - Chronic borreliosis, type acrodermatitis chronica atrophicans, in the Mosan region of Belgium. PMID- 3631460 TI - Congenital granular cell neoplasms. PMID- 3631461 TI - Nebulization and selective deposition of LTD4 in human lungs. AB - The process of nebulization and deposition of LTD4 was studied in detail. The concentration of LTD4 in a saline solution decreased by approximately 90% after 2 min of nebulization in a DeVilbiss 35B ultrasonic nebulizer. This decrease was prevented by diluting LTD4 in a phosphate buffer, pH 7.4. Nebulization of tritiated LTD4 in this phosphate buffer did not cause any appreciable deterioration of the leukotriene, as demonstrated by an unchanged ratio between radioactivity and LTD4 concentration in the test solution before and after nebulization as well as in the condensed aerosol. The aerosol generated by the DeVilbiss 35B ultrasonic nebulizer was shown to generate particles with a mass median diameter of 1.3 microns (dry particle size). Interposition of a settling bag reduced the amount of large particles, reducing the mass median diameter to 0.84 microns (dry particle size). Nine healthy volunteers were challenged on separate days with 40 nmol LTD4 or 100 mumol histamine, and the changes in FEV1 and partial flow volume curves initiated at 50% of vital capacity (Vmax30) were measured. A relative diffuse deposition pattern was ensured by inhalation via a settling bag. These results were compared to challenges with a relatively central deposition pattern as ensured by inhalation directly from the nebulizer with brisk inhalation maneuvers. The diffuse deposition pattern caused minimal changes in FEV1 but pronounced effect in Vmax30. The effects of LTD4 and histamine on FEV1 and Vmax30 changed in parallel when the deposition of the mediators was changed to a more central pattern. This indicates that the two mediators do not differ with respect to any selective effects on different parts of the airways. PMID- 3631462 TI - Comparison of Dermatophagoides pteronyssinus allergens from culture medium extract and whole body extract by using the same probe of pooled human serum. AB - Two distinct allergens of Dermatophagoides pteronyssinus were isolated from culture medium extract and whole body extract monitored by the same probe of pooled human serum and compared. IgE-binding activity of allergens from the two sources was detected by microplate-ELISA with the same probe throughout the column chromatography. An allergen obtained from culture medium extract (Ag-CME) had a molecular weight of 27,000 by SDS-polyacrylamide gel electrophoresis (PAGE) and two isoelectric point ranges, pI 4.0-4.7 and 5.9-6.8. Another allergen from whole body extract (Ag-WBE) had a molecular weight of 15,000 by SDS-PAGE and an isoelectric point range, pI 4.8-5.3 Ag-CME and Ag-WBE are probably the same allergens as antigen P1 and DpX, respectively. PMID- 3631463 TI - Flowers and other trigger factors in asthma and rhinitis--an inquiry study. AB - Six hundred and eighty adult patients with asthma and/or rhinitis were questioned about symptoms elicited by 46 different flowers and 10 common non-specific environmental trigger factors listed in a questionnaire. Flowers or birch twigs were reported to elicit symptoms in 79% of the patients, somewhat more often in rhinitis than in asthma patients, and caused symptoms as often in non-atopics as in atopics. Birch twig and marguerite most frequently induced symptoms, followed by strongly smelling flowers such as hyacinth, lilac, and lily of the valley. Unspecific irritants caused symptoms in 98% of the asthmatics and in 67% of patients with rhinitis. Tobacco smoke and perfumes were the most important troublemakers. A significant positive correlation was found for elicitation of symptoms from flowers and from certain non-specific irritants. It is concluded that non-specific hyperreactivity as well as reaginic hypersensitivity are the mechanisms involved when birch twigs and flowers elicit symptoms. PMID- 3631464 TI - Proposed guidelines for quantitative skin prick test procedure to determine the biological activity of allergenic extracts using parallel line assay. AB - Guidelines are proposed for determining the potency of allergenic extracts in relation to a reference extract using parallel line bio-assay. The practical performance, limitations, and advantages of skin prick test are discussed. PMID- 3631466 TI - [The esophageal tracheal Combitube (ETC): animal experiment results with a new emergency tube]. AB - Prompt and effective ventilation, essential for patients with cardiopulmonary arrest, may be provided by a new airway for emergency resuscitation. The "Esophageal Tracheal Combitube (ETC)" offers endotracheal or esophageal obturator ventilation according to choice. Ventilation is therefore always possible after blind intubation. Experimental studies in dogs showed encouraging results during oesophageal placement of the ETC; blood gas analyses and cardiovascular parameters, in particular, were comparable to conventional endotracheal ventilation. Satisfying results were achieved during routine surgical operations in humans. We intend to use the ETC as a device for emergency cardiopulmonary resuscitation in humans. It is especially suitable for medical personnel not trained in endotracheal intubation. The ETC has been conceived to bridge the gap of the prehospital phase. PMID- 3631465 TI - [Effect of premedication and fentanyl administration on the endocrine stress reaction during halothane anesthesia]. AB - The influence of two different premedication regimens (diazepam versus pethidine/promethazine with fentanyl substitution before induction) on the endocrine stress-response during halothane anaesthesia was investigated in twenty orthopedic surgery patients. After premedication, the levels of plasma catecholamines, ADH, ACTH and cortisol were lower in the pethidine/promethazine than in the diazepam-group. The levels of adrenaline remained significantly lower during the whole observation period. Thirty minutes after extubation all endocrine parameters except noradrenaline were lower in the pethidine/promethazine-group than in the diazepam-group. PMID- 3631467 TI - [Anesthesiological care of female patients with cerebrovascular aneurysms in pregnancy]. AB - This is a report on a patient who suffered subarachnoid haemorrhage from an aneurysm of the a. cerebri media during the 28th week of pregnancy. The aneurysm was clipped under neuroleptanalgesia. Besides monitoring of heart rate, blood pressure and central venous pressure as well as the treatment parameters including end-expiratory CO2, the foetal heart rate was deduced by Doppler sonography. She was hyperventilated intraoperatively with a paCO2 of 3.8-4.1 kPa. During the actual aneurysm surgery, artificial hypotension by 20 mmHg to b.p. values around 100/160 mmHg was initiated by means of nitroglycerin. It is evident from the literature compiled on this occasion that it is mandatory to monitor foetal heart rate during controlled hypotension in pregnancy. Sodium nitroprusside should not be used to initiate artificial hypotension during pregnancy, since it may result in toxic cyanide levels in the foetus. As usual in neurosurgery, hyperventilation can be performed also during pregnancy, since placental blood flow decreases only if the CO2 concentration drops to a very low level. PMID- 3631468 TI - Minimal monitoring and vigilance. PMID- 3631469 TI - Serum fluoride levels in morbidly obese patients: enflurane compared with isoflurane anaesthesia. AB - Obese patients are known to metabolise anaesthetic agents more than patients of normal weight. The extent of this was investigated by the measurement of serum fluoride concentrations in 10 morbidly obese patients undergoing gastroplasty. Five were allocated to receive enflurane and five to receive isoflurane supplemented anaesthesia. The mean peak serum fluoride concentrations after enflurane anaesthesia were greater (22.7 mumol/litre, SE 2.9) than after isoflurane anaesthesia (6.5 mumol/litre, SE 0.6). The mechanisms and implications of this finding are discussed. PMID- 3631470 TI - Nalbuphine for obstetric analgesia. A comparison of nalbuphine with pethidine for pain relief in labour when administered by patient-controlled analgesia (PCA). AB - A double-blind, randomised study of 60 patients who received intravenous increments of nalbuphine 3 mg or pethidine 15 mg by patient-controlled analgesia during the first stage of labour, was carried out. Pain intensity, sedation, uterine contractions, maternal cardioventilatory variables and fetal heart rate were recorded as well as any side effects. Apgar scores, time to sustained respiration and resuscitative measures required for the neonate were noted at delivery. Modified neonatal neurobehavioural studies and a retrospective assessment of maternal analgesia, satisfaction and tolerance were also carried out. Group mean values of pain scores of nalbuphine-medicated primiparous women were statistically significantly lower than those of pethidine-medicated patients (p less than 0.01). Other assessments did not demonstrate a statistical significance between the two groups. PMID- 3631472 TI - Peak intratracheal pressure during controlled ventilation in infants and children. A computer study of the Servo 900C ventilator. AB - The mathematical relationship between peak ventilator breathing system pressure displayed on the digital meter of the Siemens SV900C ventilator, and peak intratracheal pressure measured at the distal end of the tracheal tube, was defined and incorporated into a computer program. The mean difference between peak airway pressure calculated by the computer and directly measured peak intratracheal pressure was 0.02 kPa (SD 0.10) in 18 infants and children. The mean difference between ventilator breathing system pressure and intratracheal pressure in the same group was 0.82 kPa (SD 0.91). Bench tests established that the decrease in peak pressure displayed by the ventilator (from 1.36 to 0.38 kPa) while inspiratory time was increased from 20 to 80% of the respiratory period, concealed an increase (from 0.2 to 0.38 kPa) in intratracheal pressure which occurs during this process; and that the large increase in pressure displayed by the ventilator (from 0.3 to 6 kPa) while respiratory frequency was increased from 20 to 120 breaths/minute, concealed a small increase in peak intratracheal pressure (0.2-0.3 kPa) which occurs during this process. These changes were accurately predicted by the computer program. The increase in intratracheal pressure associated with prolonged inspiratory times explains the high incidence of barotrauma which has recently been associated with this procedure in infants. PMID- 3631471 TI - Gastric emptying and small bowel transit times in volunteers after intravenous morphine and nalbuphine. AB - Gastric emptying half-times and small intestinal transit times were measured in a double-blind crossover study of 17 volunteers who received an intravenous injection of nalbuphine (5 or 10 mg), morphine (5 mg) or placebo. Both times were monitored using a gamma camera after a radioactive test meal and gastric emptying half-time was calculated. Small intestinal transit time was measured by the appearance of radioactivity in the caecum and also of hydrogen in end tidal air. Gastric emptying was prolonged over placebo by nalbuphine 10 mg, which had more effect than nalbuphine 5 mg or morphine 5 mg; morphine 5 mg had less effect than nalbuphine 5 mg. Small intestinal transit time was prolonged over placebo by nalbuphine 10 mg more than by nalbuphine 5 mg or morphine 5 mg, which had approximately equal effects. In these respects, the potency ratio of nalbuphine appears roughly equivalent to morphine. Small intestinal transit times measured by end tidal hydrogen concentration and gamma camera showed close agreement. PMID- 3631473 TI - Minimum fresh gas flow requirements of anaesthetic breathing systems during spontaneous ventilation: a graphical approach. AB - A general solution is presented to the problem of finding the minimum fresh gas flow requirements, during spontaneous ventilation, of anaesthetic breathing systems in the Mapleson classification. The solution is applicable to any pattern of breathing, dead space volume and tidal volume. The method is graphical and its use and understanding require no mathematical skills. However, if an analytical form of the respiratory waveform is known, the method is easily extended by use of calculus to obtain a precise analytical solution. PMID- 3631474 TI - Unstable cervical fracture. Anaesthetic management for an urgent caesarean section. AB - The anaesthetic management of a 26-year-old woman who sustained an unstable fracture of C2 when 40 weeks pregnant, is described. PMID- 3631475 TI - Gross hypernatraemia associated with the use of antiseptic surgical packs. AB - A severely ill patient with gas gangrene developed hypernatraemia associated with the use of wound packs soaked in a hypertonic solution called Eusol substitute, a commonly used stable alternative to true Eusol. PMID- 3631476 TI - Fatal disseminated intravascular coagulation following a monoamine oxidase inhibitor/tricyclic interaction. AB - In spite of intensive therapy, an otherwise fit 34-year-old man died following the hyperpyrexial reaction to an interaction between tranylcypromine and clomipramine. There was no evidence of drug overdose, but severe disseminated intravascular coagulation developed which proved fatal. PMID- 3631477 TI - A laryngoscope adaptor for difficult intubation. AB - Tracheal intubation may be hindered by difficulty in insertion of the laryngoscope blade into the patient's mouth because the handle impinges on the patient's chest or on the hand of an assistant applying cricoid pressure. An adaptor is described which modifies the standard Penlon laryngoscope to enable lateral swivelling of the handle, thus avoiding the obstruction. PMID- 3631478 TI - Smoking and anaesthesia. PMID- 3631479 TI - Rapid inhalation induction. PMID- 3631480 TI - Quality of axillary brachial plexus block. PMID- 3631481 TI - Pressure-flow relationships in intravenous infusion systems. PMID- 3631482 TI - Cardiac dysrhythmia after subtrigonal phenol. PMID- 3631483 TI - Risk of infection from water bath blood warmers. PMID- 3631484 TI - Another hazard with the Penlon off-line vaporizer mounting system. PMID- 3631485 TI - Possible safety hazard on anaesthetic machines. PMID- 3631486 TI - Re-insertion of minitracheotomy. PMID- 3631487 TI - Misplacement of a minitracheotomy tube. PMID- 3631488 TI - Speed of epidural injection. PMID- 3631489 TI - The pulse oximeter--an early warning device? PMID- 3631490 TI - [Continuous Midazolam infusion for sedation of respirator patients]. AB - Most intensive care (ICU) patients need pharmacological sedation during ventilatory support. The short-acting drug midazolam might be preferable to neuroleptic agents and opiates because of its anxiolytic and sedative properties. The dosage of a drug given in a continuous infusion is based upon knowledge of its clearance and of the function of concentration and effect. METHOD: A midazolam infusion (7.5 or 15 mg/h) was given to 16 patients receiving ventilatory support for 24 h. Clearance was estimated using the rule Cl = R/C (R = rate of infusion, C = concentration in steady state). To estimate the concentration of midazolam necessary for good sedation, the amount of supplementary injected neuroleptic during midazolam infusion was compared with that of the day before. Plasma cortisol and parameters of energy metabolism, electrolytes, and liver and kidney function were measured. RESULTS: Patients with disease of abdominal organs showed the lowest values for clearance (1.0-2.92 ml/min/kg). Some of the injured patients showed elevated values for clearance (3.0-21.36 ml/min/kg). Elimination half-life ranged from 1.5-50 h. Changes in intestinal perfusion or cardiac output might be responsible for the wide range. For good sedation, plasma midazolam concentrations had to be above 600 ng/ml. Plasma cortisol levels were not affected by midazolam, nor were metabolism, electrolytes, or liver and kidney function. CONCLUSION: Continuous infusion of midazolam is a useful way of sedation for ICU patients, but the wide range of clearance values must be considered. PMID- 3631491 TI - [High-dose short time fibrinolytic treatment with streptokinase of massive lung embolism in the early postoperative period]. AB - The treatment of a massive or fulminant pulmonary embolism (PE) occurring in the early postoperative phase by embolectomy or fibrinolysis with streptokinase (SK) or urokinase (UK) differs with regard to success and mortality. Embolectomy has a higher mortality and is not practicable in every hospital. Fibrinolysis differs according to substance (SK or UK), dosage, and duration. Five days after extirpation of a leiomyosarcoma--located retroperitoneally in the pelvis--a 72 year-old woman had a massive PE (scintigraphy diagnosis) (Fig. 1). On PEEP breathing, nitroglycerin (66 micrograms/min), and dobutamin (416 micrograms/min), paO2 and SaO2 showed an increasing tendency, but 4 days after the diagnosis of PE -on the 8th postoperative day--paO2 and SaO2 dropped again (Fig. 3). Fibrinolysis was undertaken with 1.5 million units of SK over a period of 40 min through a Swan-Ganz catheter located in the pulmonary artery. A few hours after the fibrinolytic treatment, paO2 increased at a significant rate and FIO2 could be markedly reduced from 0.7 to 0.4. Twenty-four hours after SK lysis the pulmonary artery pressure (PAP) had still not decreased, but the cardiac output (CO) showed an increasing tendency. The scintigraphic control 17 days after the diagnosis of PE (Fig. 2) correlated with the clinical parameters. The patient was discharged. High-dose ultra-short fibrinolysis with SK in the early postoperative period is discussed in connection with efficiency and bleeding complications ("plasmin lysis" versus "activator-lysis"). PMID- 3631492 TI - [NORMAC--a simple instrument to measure the inspiratory and end- expiratory concentrations of halothane, enflurane, and isoflurane. Clinical use and laboratory investigations]. AB - In 47 gas mixtures particularly made for that purpose the concentration of halothane, enflurane, or isoflurane was estimated with Normac; the estimated and measured values were found to be identical on the average. To verify precision, 40 measurements of one specimen were performed; the standard deviation was 0.03 vol-% (ca. 1% relative error). Any influence of the carrier gas components O2, N2, N2O, and H2O proved to be negligible. The practical clinical application of the apparatus was easy and without malfunctions. PMID- 3631493 TI - [Puncture of the vena brachiocephelica]. PMID- 3631494 TI - [Emergency call and medical missions. A six-months' prospective clinical system analysis of the Mannheim area]. AB - The prehospital care of emergency patients has proved to be highly efficient for traumatic and coronary care cases. The critical factor for the rescue mission is the quality of the alarming information. In a prospective 6-month study with two mobile rescue units, all rescue missions were documented in a computerized form. Times for arrival and activities, times for return, type of alarming information, type of emergency, difference between primary and final diagnosis, cases of under and overestimation of the primary diagnosis, and outcome of external cardiopulmonary resuscitations were listed. A guiding list including medical emergency symptoms and general emergency situations for assistance in deciding to alarm the rescue unit proved to be valid. Of a total of 2151 missions, 88.7% were primary rescue missions, 10.3% failed operations, and 1% secondary missions. The timetable and frequency of operations are shown in Figs. 1 and 2. In 34% of cases simultaneous emergency calls for two different places were received. The spectrum of 1908 missions included 34.8% internal medicine, 24.7% surgery, 14% intoxication, 12% neurological/psychiatric disease, 7.5% cardiopulmonary resuscitation, 4.6% others, and 2.7% primary death (Fig. 3). In 77.6% the primary diagnosis was confirmed by the clinician. Intoxication and epilepsy were overestimated at primary diagnosis, whereas myocardial infarction were underestimated in view of further clinical development. Only in 37.6% of patients reported to be unconscious could the unconsciousness be confirmed. Of 110 patients with prehospital cardiac arrest, 38% could be resuscitated with success; 5.5% of the total could leave the hospital (Fig. 5).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631496 TI - [Anesthesia for congenital diaphragmatic hernia]. AB - Hypoplasia of the lungs is the cause of the high mortality of newborns with diaphragmatic hernia. Survival depends mainly on the development of the contralateral lung. Eighty percent of diaphragmatic hernias are postolateral hernias of the left side. The most serious postoperative complication is a relapse into fetal circulation with increased pulmonary vascular resistance and right-to-left shunting (Fig. 2). The clinical signs of diaphragmatic hernia are cyanosis and tachypnea. Intermittent suction via a nasogastric tube and early intubation without mask ventilation should be performed. The inspiratory pressure should not exceed 25 cm H2O to minimize the risk of pneumothorax. Survival of the baby is unlikely if the initial blood gas analysis shows pH less than 7.10, pO2 less than 50 mmHg, and pCO2 greater than 65 mmHg. Hypothermia should be strictly avoided because it leads to increased oxygen consumption. Intraoperative monitoring should include a precordial stethoscope, ECG, blood pressure, and rectal temperature. Anesthesia is maintained with fentanyl 0.02-0.03 mg/kg body wt. and pancuronium 0.08-0.1 mg/kg. One dose of atropine (0.02 mg/kg) is administered before fentanyl. Intraoperative ventilation is performed by hand or by use of a Siemens Servo ventilator. Thirty newborns were anesthetized for repair of a congenital diaphragmatic hernia with no intraoperative complication and an overall mortality of 27%. PMID- 3631495 TI - [Midazolam and pethidine/promethazine for intramuscular premedication]. AB - The main reason for premedication is the reduction of preoperative stress. Despite the proven fact that benzodiazepines best reduce preoperative stress, combinations of opioids and neuroleptic drugs are preferred for premedication by many on reviewing the journal Der Anaesthesist. This double-blind study was performed to investigate midazolam and meperidine/promethazine for intramuscular premedication. Method. 60 patients undergoing minor gynecological surgery were randomly assigned to receive either 5-7.5 mg midazolam or 50-75 mg meperidine and 25-50 mg promethazine intramuscularly 30-90 min before surgery. Anxiety, depression, and asthenia were assessed by the patient before and after premedication but before induction of anesthesia using visual analogue scales and a nominal scale. Sedation was assessed by an observer. Heart rate and blood pressure were the physiological stress parameters. Parameters of acceptance and side effects were registered perioperatively. Results. Midazolam had a significantly better anxiolytic and antidepressive effect. There were no differences in the other parameters except for adverse effects. Meperidine/promethazine produced significantly more side-effects than midazolam. The parameters of acceptance assessed the day after surgery were comparable. Conclusions. We conclude from these results that anesthesiologists still premedicate with meperidine/promethazine because the patients accept this premedication very well when asked the day after surgery. Nevertheless, premedication with midazolam provides significantly better anxiolytic and antidepressive effects with significantly less side-effects. Therefore, midazolam should be preferred to meperidine/promethazine for intramuscular premedication. PMID- 3631497 TI - [Inhalation anesthesia or "balanced anesthesia"? A comparative perioperative study in geriatric patients]. AB - During a prospective randomized trial, 50 geriatric patients underwent surgery for a fractured femoral neck. The perioperative circulatory and respiratory effects of anesthesia with enflurane or balanced anesthesia with enflurane and fentanyl were compared. We were particularly looking for postoperative respiratory depression after a standard dose of fentanyl given during balanced anesthesia. Method. In 25 patients anesthesia was induced with 0.2 mg/kg etomidate and 1 mg/kg succinylcholine and maintained with 0.15 mg/kg alcuronium and enflurane. Twenty-five patients received a additional dose of 5 micrograms/kg fentanyl divided into 0.1 mg/kg 2 min before endotracheal intubation and the remainder 5 min before the start of surgery. Systolic and diastolic arterial pressures, heart rate, central venous pressure, hemoglobin, hematocrit, and electrolytes were measured and arterial blood gases were analyzed. Results. There was no important difference between the two methods: during careful use of both techniques circulation remained stable. No marked postoperative respiratory depression occurred even after 5 micrograms/kg fentanyl. Conclusions. Both anesthetic procedures are suitable for hip surgery in elderly patients. In the early postoperative period geriatric patients should be observed carefully in the recovery room for at least 2 h. In some patients--especially if fentanyl is used intraoperatively--this time must be prolonged. PMID- 3631498 TI - [Complications of anesthesia in elderly patients]. AB - Progress in surgery and anesthesia has contributed to lowering operative risk and expanding the indications for operations in higher age groups. The goal of treatment in the elderly is to achieve the best possible degree of reducing discomfort and increasing personal independence. Methods. A brochure with a clinical study on 1,021 patients chosen at random shows the frequency of complications arising during the peri- and post-operative course in patients around 60 years of age and older. Operative areas were general and emergency surgery, vascular surgery, neurosurgery, and urology. Operations were carried out in regional or general anesthesia. Patients were divided into groups below and above age 60. Evaluation of the data was carried out according to an integrated data processing concept. This program enables quantitative and qualitative data to be combined at will, taking into consideration that evaluating criteria can be varied considerably. Results. The results demonstrate that patients over 60 have significantly more complications than patients under 60. Analysis of the influence of the factors associated with surgical risk reveals that factors related to the operation such as type, length, and extent do not increase the risk as much as the numerous accompanying illnesses in both age groups. As far more elderly patients are affected by multimorbidity, the conclusion may be drawn that the increased risk observed is not due mainly to age, but rather to the patient's condition prior to surgery. The results indicate clearly that an exact analysis of the initial condition as well as avoiding failure or malfunction of certain organs must have priority in both age groups. PMID- 3631499 TI - [Calculation of the allowable blood loss before transfusion with a programmable pocket calculator]. AB - Introduction. The amount of blood loss during surgery that requires transfusion is frequently estimated with a linear formula (1) using blood volume--calculated on a volume per weight basis--, preoperative hemoglobin concentration, and an established minimum hemoglobin concentration. This formula, however, underestimates allowable pretransfusion blood loss, because it implies that all blood lost contains the initial hemoglobin concentration. In addition, hemodilution by infusion therapy prior to surgery is usually not taken into consideration. Methods. In order to estimate allowable pretransfusion blood loss more accurately and conveniently, a program was developed for a programmable pocket computer. This program calculates (number of equation in parenthesis): blood volume (2a, 2b) expansion of blood volume prior to surgery (3) hemodilution prior to surgery (4) allowable blood loss during isovolemic hemodilution (5). The applicability of the program to the situation during orthopedic operations was tested in a study in which allowable pretransfusion blood loss was estimated for one group of patients and was calculated with the computer program for another group of patients. Eighty patients undergoing major orthopedic surgery were studied. After preoperative evaluation the attending anesthetist established a minimum hemoglobin concentration and the type of cardiocirculatory monitoring to be used. Patients were divided at random into two groups: for one group blood volume was estimated on a volume per weight basis and allowable blood loss was calculated using equation (1); for the second group allowable blood loss was calculated with the computer program. During the evaluation of the data the computer calculations were also carrier out for group 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631500 TI - Temporal characterization of perfluorinated ion exchange coated microvoltammetric electrodes for in vivo use. PMID- 3631501 TI - Capillary zone electrophoresis with electrochemical detection. PMID- 3631502 TI - Laser-excited atomic fluorescence spectrometry with a laboratory-constructed tube electrothermal atomizer. PMID- 3631503 TI - Carbon-13 nuclear magnetic resonance spectrum simulation methodology for the structure elucidation of carbohydrates. PMID- 3631504 TI - Determination of serum cholesterol by near-infrared reflectance spectrometry. PMID- 3631505 TI - Measurement of fluorescence lifetimes during liquid chromatography. PMID- 3631506 TI - Photochemical amplifier for liquid chromatography based on singlet oxygen sensitization. PMID- 3631507 TI - Enzymatic determination of carbon-14 labeled L-alanine in biological samples. PMID- 3631508 TI - Individual and simultaneous determination of ethanol and acetaldehyde in wines by flow injection analysis and immobilized enzymes. PMID- 3631509 TI - Electrochemical pretreatment of carbon fibers for in vivo electrochemistry: effects on sensitivity and response time. PMID- 3631510 TI - Measurement of electroactive antibiotic drugs in the bloodstream of rats with a catheter electrode. PMID- 3631511 TI - Comparison of sample loops constructed of several different materials for gas chromatographic analysis of parts-per-billion-level organic gas mixtures. PMID- 3631513 TI - Selection of representative wavelength sets for monitoring in liquid chromatography with multichannel ultraviolet-visible detection. PMID- 3631512 TI - Preparation of biological tissue for determination of arsenic and selenium by graphite furnace atomic absorption spectrometry. PMID- 3631514 TI - Selection of wavelengths for absorbance ratio monitoring in liquid chromatography. PMID- 3631515 TI - Effect of primary ion beam parameters on the secondary ion emission of biomolecules from liquid matrices. PMID- 3631516 TI - High-mass ion fragmentation as a function of time and mass. PMID- 3631517 TI - Location of conjugated diene position in an aliphatic chain by mass spectrometry of the 4-phenyl-1,2,4-triazoline-3,5-dione adduct. PMID- 3631518 TI - Liquid-solid extraction conditions predicted by liquid chromatography for selective isolation of sulfoconjugated steroids from equine urine. PMID- 3631519 TI - High-resolution gas chromatographic/high-resolution mass spectrometric analysis of human serum on a whole-weight and lipid basis for 2,3,7,8-tetrachlorodibenzo-p dioxin. PMID- 3631520 TI - Radioimmunologic determination of human C-peptide and proinsulin in plasma with anti-C-peptide serum after prepurification by high-performance liquid chromatography. PMID- 3631521 TI - Modified cell for stripping voltammetry using the static mercury drop electrode. PMID- 3631522 TI - Electrochemical biosensors. PMID- 3631523 TI - Possible microapocrine-type secretion developing in prostatic secretory epithelial cells of older rats in the early stage of castration. AB - Secretory epithelial cells at 1 and 2 d after castration became higher than those of control as the result of convex protrusion of the apical cytoplasm into the acinar lumen, which was quickly followed by pinching off the small balloon-like cytoplasmic process developing on its surface. At the same time, the secretory vacuoles became more numerous, while the well-developed Golgi region, prominent rough endoplasmic reticulum and its dilated end facing the Golgi region remeined. On 7 and 14 d after castration, secretory epithelial cells became markedly low and they had very few secretory vacuoles, regressed Golgi region and a markedly reduced amount of rough endoplasmic reticulum. At 7 d after castration, marcrophage-like cells appeared among secretory epithelial cells and acinar basal lamina. These findings might suggest that the involutionary process of secretory epithelial cells was started by apical convex protrusion and accompanied by microapocrine secretion of its subsurface cytoplasm followed by phagocytosis of the remaining disintegrated cytoplasm by macrophage-like cells. PMID- 3631524 TI - A quantitative estimation of the divergence between the trabecular system and the stress trajectories in the upper end of the human femoral bone. AB - In the frame of the widely accepted theory that the internal architecture of the cancellous part of the bones is strongly influenced by the mechanical stresses that predominate inside them, a quantification of the convergence between the direction of the principal stresses and that of the trabeculae has been attempted, by measuring the angle between these 2 directions, in frontal sections of the upper end of a series of femoral bones (left and right), taken out from embalmed human cadavers. This study suggests that there is a fairly good convergence between trabeculae and stress (compressive as well as tensile), since the angles which have been measured have a mean value of +/- 7 degrees. It is further observed that this convergence is better (i.e. the angle is lesser) in those parts of the section where the corresponding stress (compressive or tensile) is greater. This result may prove particularly useful in connection to the effort of elucidating the mechanism that governs the influence of bone stress to osteogenesis. PMID- 3631525 TI - Some new aspects of dexamethasone-induced cleft palate in mice. AB - Pregnant mice were treated intramuscularly with dexamethasone in a single dose of 10 or 50 mg/kg once on day 13 of pregnancy at one of 4 fixed times. On day 18 palate condition of live fetuses and the number of resorptions were recorded and the relation of the incidence of palatal defect and serum corticosterone level was examined. The results suggest that there are different susceptibilities to teratogen-induced cleft palate during a 24-h period. The frequency of cleft palate was increased among term fetuses when there was a drop in the endogenous glucocorticoid of the dams. PMID- 3631526 TI - [Craniofacial growth under the influence of blood supply. 5. Brain weight after unilateral interruption of the common carotid artery]. AB - After unilateral ligature of the common carotid artery in rats aged 42 d, the fresh weight of the brain does not deviate from that associated with normal growth in the course of subsequent postnatal development. This is believed to be due to the age at which the ligature was applied and to arterial compensatory mechanisms. The sensitive phases of cerebral development have already come to an end 42 d post partum. Ligature of the right common carotid artery can be fully compensated by circulus arteriosus (Willis), which provides hemodynamic pressure compensation. PMID- 3631527 TI - [The problem of incisions and orifices in the supraorbital margin in man]. AB - The authors have conducted craniometric measurement of 226 skulls (118 male and 108 female). They introduce their own criteria of metric classification of features enabling anatomical determination of incisures and foramen with a probability of over 90% and find statistically significant sexual dimorphism and asymmetry in the position incisura (seu foramen) frontalis and incisura (seu foramen) supraorbitalis. Their co-occurrence is generally symmetric, but frequent in women. PMID- 3631528 TI - Submicroscopic study of the tunica propria of the seminiferous tubules of the Brazilian white-belly opossum (Didelphis albiventris). AB - The components of the white-belly testicular tunica propria are the same as observed in the testis of eutherian mammals, i.e., basal lamina, collagen fibrils, oxytalan and elaunin fibers, myoid cells and fibroblasts. The main structural difference between the tunica propria in white-belly opossum (methatheria) and other mammals is the presence of fibroblasts internally located to the myoid cells in the white-belly opossum tunica propria. PMID- 3631529 TI - Electron microscope observations on the cytoplasmic granules of a freshwater teleost (Pimelodus maculatus) leucocyte. AB - In the present study, a hitherto undescribed granule type in the leucocytes of the freshwater teleost Pimelodus maculatus is reported. This membrane bounded elliptic granule contains straight tubules measuring from 8 to 10 nm in diameter. Almost all granules present 1 or 2 electron dense inclusions more often than not with a geometrical form. A comparison with the granules found in Prochilodus scrofa leucocytes is made. PMID- 3631530 TI - Early implantation and embryonic development of the baboon: stages 5, 6 and 7. AB - Implantation stages of the olive baboon, Papio cynocephalus anubis, showing embryonic development equivalent to Carnegie stages 5, 6 and 7 of development, were collected by hysterotomy and examined histologically. The younger specimens (stage 5) consisted of a thick trophoblastic plate composed of cytotrophoblast and syncytiotrophoblast with multiple small clefts, and a bilaminar disk embryo with a small slit-like amniotic cavity. An epithelial plaque response was present in the uterine epithelium immediately peripheral to the implantation site, within an area of pronounced uterine edema. The bilaminar embryonic disk consisted of columnar epiblast cells underlying the amniotic cavity, and thickened visceral endodermal cells that form part of the yolk sac. The slightly further developed placenta (stage 6) consisted predominantly of cytotrophoblast including primary villi and syncytiotrophoblast lining large spaces containing maternal blood. Secondary placental villi were present in the oldest group (stage 7), and there was modest decidualization of the uterine stroma. An epithelial plaque response persisted, but varied in extent. The sequence of events in early development in the baboon is similar to that in the rhesus monkey insofar as blood space formation and endometrial responses are concerned. However, the plaque response is not so great as in the rhesus; there is no secondary placenta, and the decidual response is slightly more extensive. PMID- 3631531 TI - Motor innervation of the bursalis muscle (nictitating membrane) in the lizard Callopistes maculatus. AB - The motor neurones which innervate the bursalis muscle of the lizard Callopistes maculatus were identified by means of intra-axonal retrograde transport of horseradish peroxidase. These neurones were distributed in the oculomotor abducens and accessory abducens nuclei. In the oculomotor nucleus one group of neurones was located in the ventral subnucleus of the contralateral side while the other group was found in the dorsolateral subnucleus of the ipsilateral side. In the abducens and accessory abducens nuclei all the neurones were in the ipsilateral side. The accessory abducens cells, although less numerous, were larger and had a prominent dendritic field in close relationship with the nucleus descendens nervi trigemini. PMID- 3631532 TI - The human muscle-tendon junction. A morphological study during normal growth and at maturity. AB - The myotendon junction of human paravertebral skeletal muscle was studied by light and electron microscopy. Transverse and longitudinal sections of myotendinous regions of normal multifidus muscles were examined at three chronological stages from birth to maturity. Variations in the appearance of surface extensions at the terminal ends of muscle fibers consisted of brush-like evaginations at birth and villous-like projections in the adult. Regardless of age, they were invariably covered by a prominent external lamina, and mutually interdigitated with connective-tissue elements in the adjacent tendon. Various stages of myofibrillar assembly and sarcomere alignment were evident in the muscle fiber terminus at birth. With advancing age, splitting of terminal sarcomeres at Z bands commonly gave rise to diverging myofilament bundles that attached to electron-dense patches under the sarcolemma. In these regions, leptomeric organelles were also encountered in neonatal and adolescent myotendons. At all stages, the ends of muscle fibers possessed cytological features consistent with active synthesis and secretion. Densely-packed sarcoplasmic organelles including multiple Golgi complexes, clusters of ribosomes, mitochondria, cytoplasmic vesicles, and elements of rough- and smooth surfaced endoplasmic reticulum were prevalent. Peripheral and centrally-placed heterochromatic nuclei with prominent nucleoli were arranged singly or in groups at the ends of muscle fibers. Satellite cell profiles and unmyelinated axons in the subjacent tendon were also identified at these sites in the adult. Fibroblasts in growing tendon were plentiful, and at all stages, possessed morphological features indicative of high metabolic and secretory activities. PMID- 3631533 TI - Cholinergic traits in rat mandibular processes observed by electron microscopy. AB - Cholinergic traits in rat mandibular processes were examined histochemically, under the electron microscope, at early developmental stages (Stages 20 to 23, by Christie's nomenclature). The histochemical reaction for detection of enzymes was performed by the thiocholine method. Nonspecific cholinesterase (EC 3.1.1.8) activity was found in ectomesenchymal cells, vascular endothelial cells, and in some epidermal cells at stages 20 and 21. The enzymatic activity was localized in the perinuclear and endoplasmic reticular cisternae. At stage 22, the number of cells with enzymatic activity decreased gradually, except in the case of the capillary endothelial cells. At stage 23, when the trigeminal nerve fiber was obvious in the mandibular processes, nonspecific cholinesterase activity was restricted to some of the endothelial cells and trigeminal ganglionic cells. In contrast, acetylcholinesterase activity was found on the membrane of trigeminal nerve fiber. Thus, the transient, nonspecific, cholinesterase activity, found in rat mandibular processes, may serve some functions in transmission, lipid metabolism or destruction of toxic cholinesters during the period that precedes organogenesis. PMID- 3631534 TI - Differentiation of gut endoderm in dependence of the notochord. AB - Presumptive intraembryonic endoderm, either isolated or together with adhering mesoderm, from 19-h chick embryos, was grafted to the coelom of 50-h host embryos. The viability of such grafts was low and endodermal differentiation was poor. In a second series the endoderm (with or without adhering mesoderm) was combined with a fragment of notochordal tissue from 48-60-h donor embryos. Then the recovery was much higher, notably after longer periods of in vivo culture. After 10 days of cultivation well-developed entero-endocrine (argyrophilic) cells were found among the regular enterocytes in both series. PMID- 3631535 TI - Developmental analysis of cephalic axial dysraphic disorders in arsenic-treated hamster embryos. AB - Parenteral injection of pregnant golden hamsters with inorganic arsenic salts early in gestation results, by term, in markedly elevated embryonic-fetal mortality (approximately equal to 50%) and, in surviving fetuses, a high (approximately equal to 90%) incidence of cephalic axial dysraphic disorders ("neural tube defects"), particularly exencephaly/anencephaly and encephaloceles. The present investigation traces the day by day development of these embryopathic effects of arsenic in the hamster with an emphasis on the pathogenesis of cephalic axial dysraphic disorders. Pregnant golden hamsters were given an intraperitoneal injection of sodium arsenate (20 mg/kg) on the 8th day (08.00) of their 16 day gestation period. Matched control dams were injected with an equivalent volume of distilled water by the same route and at the same stage of gestation. Experimental and control dams were sacrificed beginning 24 h after treatment and at regular daily intervals thereafter until term. Embryos and fetuses delivered from sacrificed dams were examined for abnormalities both grossly and histologically. In embryos delivered earliest after treatment (24-48 h) the principal deleterious effect of arsenic observed was retarded growth (elevation, approximation, and fusion) of the cephalic neural folds. This growth retardation ranged in severity among embryos. In the most severely afflicted there was a site wherein the opposing cephalic neural folds had completely failed to appose and fuse ("closure"). This failure of closure of all four tissue components of the neural folds (surface ectoderm, paraxial mesoderm, neural crest cells, neuroectoderm) resulted in a persistent dorsal opening in the head, i.e., cranioschisis aperta. The extent and appearance of this opening varied from a small, ovoid aperture in the dorsal midbrain (mesencephalic) region of the head to a widely open cleft involving the fore and hindbrain regions as well as the midbrain region. In less severely afflicted early embryos, the cephalic neural folds had elevated and met in the dorsal midline but had only incompletely fused, i.e., cranioschisis occulta. Microscopic study of these latter embryos revealed that in the affected region(s), complete closure of the surface ectoderm component of the neural folds had taken place, but only partial closure of the mesoderm, neural crest and neuroectoderm components. The different types of cephalic axial dysraphic disorders presenting in arsenic-treated fetuses delivered at later gestational stages (predominantly exencephaly and encephaloceles) could all be traced back and related to one or the other of these early forms of disturbed neurulation. PMID- 3631536 TI - The structural relationship between mesangial cells and basement membrane of the renal glomerulus. AB - It has been shown by many studies that mesangial cell contraction exerts considerable influences on glomerular filtration dynamics. However, experimental findings about the geometrical changes within the glomerular tuft going along with mesangial cell contractions are lacking. This study analyzes the geometry of mesangial cells and their relationship to glomerular capillaries, especially to the glomerular basement membrane (GBM). By applying a new staining technique of unosmicated specimens for TEM, the cellular outlines of glomerular cells (mesangial, endothelial and epithelial) and the distribution of extracellular matrices can be more easily studied than in conventionally osmicated specimens. It became obvious that mesangial cells and the GBM are extensively connected with each other, either by direct attachments or indirectly by microfibrils. These connections are especially prominent at mesangial angles, i.e. at sites where the GBM deviates from its pericapillary course and covers the mesangium. Thereby, the GBM is not only coupled to the mesangium but--via mesangial cell processes--also to the GBM at the opposing mesangial angle. It seems possible that contraction of mesangial cells can bring the GBM from opposing mesangial angles closer together. Therefore we conclude that the GBM and the contractile mesangial cells together establish a biomechanical unit capable of developing wall tension in glomerular capillaries and of changing the geometry of glomerular capillaries following mesangial contraction or relaxation. PMID- 3631537 TI - Capillary sprouts in ovaries of immature superstimulated golden hamsters: a SEM study of microcorrosion casts. AB - A new polyester resin of low viscosity was used to study the three-dimensional structure of capillary sprouts of mature follicles and of corpora lutea. Vascular microcorrosion casts were obtained from ovaries of immature golden hamsters between days 4 and 7 after stimulation with pregnant mares' serum gonadotrophin (PMSG). On days 4 and 5 after PMSG, a nodular appearance of the organ was due to mature follicles and corpora lutea. Capillary sprouts were seen as dead-ending structures originating from the thecal capillary network. The sprouts were either concentrated around (follicle type 1) or towards (follicle type 2) the center of the antrum. Increased vascular permeability resulted in resin leakage only in type 2. Intact corpora lutea were characterized by radially grown capillary sprouts. Regressing corpora lutea showed a marked reduction of the vascular bed as displayed by filling defects in casts on day 6 and 7 after PMSG. It is assumed that: 1. Dead-ending capillary structures, resin leakage, and filling defects are not always artifacts of the microcorrosion cast technique, but can express functional microcirculatory changes. 2. The concentric growth of thecal capillary sprouts may be related to the presence of an intact follicular basal membrane, and the radial growth of sprouts be taken as a sign of a digested basal membrane. PMID- 3631538 TI - Formation of extra-digits induced by surgical removal of the apical ectodermal ridge of the chick embryo leg bud in the stages previous to the onset of interdigital cell death. AB - In the present work we have studied the mechanism of formation and the possible morphogenetic significance of the process of ectopic chondrogenesis induced by surgical removal of AER of the interdigital spaces of the chick leg bud at stage 28-30 (Hurle and Ganan 1986). Our results show that ridge removal causes condensation and rounding of the underlaying mesenchymal cells followed by chondrogensis. The long-term study of the fate of these ectopic cartilages shows that in a high percentage of the cases the cartilages undergo morphogenesis taking by day 10 of incubation the appearance of the two distal phalanges of an extra-digit. These extra-digits lack tendons and are joined by thin interdigital membranes to the neighboring digits. PMID- 3631539 TI - Differences in glycocalyx composition between cells of the cortical thick ascending limb of Henle and the macula densa revealed by lectin-gold cytochemistry. AB - The glycocalyx composition of cells from the macula densa and the cortical thick ascending limb of Henle was examined in rabbit kidney by means of the lectin-gold technique. A quantitative evaluation at the ultrastructural level showed that macula densa cells had a considerably greater affinity for Helix pomatia lectin than adjacent cells of the thick ascending limb. Wheat germ lectin and concanavalin A bound equally well to both cell types. This difference in plasma membrane glycocalyx composition may be an important aspect of the functional differentiation of cell types in this specialized nephron segment. PMID- 3631540 TI - A stereological comparison of the muscle-tendon junctions of fast and slow fibers in the chicken. AB - Transmission of contractile tension from skeletal muscle fibers to connective tissue elements is thought to occur at the muscle-tendon junctions, specialized regions at the extreme ends of the fibers. Previous work has suggested that the structure of this region may be quantitatively modified to match the contractile properties of the fibers. Using scanning electron microscopy, transmission electron microscopy, and stereological analysis, we have analyzed the three dimensional structure, and have quantitatively compared the muscle-tendon junctions, of slow and fast fibers of the anterior (ALD) and posterior (PLD) latissimus dorsi muscles of the chicken. The ends of ALD and PLD fibers are found to be structurally different in some respects but to be similar with respect to their surface specializations, which are believed to function in the transmission of tension. Quantitative analysis of these specializations indicates that, when referred to similar cross-sectional areas of myofilaments, the fast fibers of the PLD have approximately 40% more surface area devoted to force transmission than do the slow fibers of the ALD. These observations are consistent with the idea that the amount of cell surface specialized for force transmission is related to the functional properties of the muscle fiber. PMID- 3631542 TI - Structure and neural control of the pectoralis in pigeons: implications for flight mechanics. AB - The pectoralis muscle in pigeons (Columba livia) is composed of two heads (sternobrachialis, thoracobrachialis) that are separately innervated and have different fiber orientations. High-speed film and electromyographic studies of free-flying pigeons reveal that the pectoralis is activated prior to wing depression (the power stroke) and that its two heads are differentially recruited during takeoff, level flight, and landing. The electrical activity patterns of both heads support an interpretation that intramuscular elasticity provides energy storage. The pectoralis is not only the prime wing depressor but is also capable of adjusting the excursion of the wing during different phases of flight. PMID- 3631541 TI - Physiological role of skeletal muscle glycogen in starved mice. AB - To study the physiological role of skeletal muscle glycogen in starved animals, effects of starvation on glycogen and glycogen phosphorylase (EC 2.4.1.1.) activity were studied in muscle fibers (morphologic study) and in whole muscles (biochemical study) of the rectus femoris muscle of mouse. Glycogen content in the liver of the starved animals was also measured. PAS reaction, strong in muscle fibers of fed animals, became weak predominantly in type IIB fibers after 2 days and almost disappeared after 4 days of starvation. Glycogen particles, numerous in the sarcoplasm between myofibrils of muscle fibers, decreased markedly predominantly in type IIB fibers after 2 days and almost disappeared after 4 days. Phosphorylase a activity, undetected in fibers of fed mice, appeared weak in type IIB fibers and very weak in type IIA fibers after 2 days and became moderate in type IIB fibers and weak in type IIA fibers after 4 days. Muscle glycogen content did not differ by 16 hours from the values of corresponding fed animals. However, liver glycogen content had already decreased after 8 hours and markedly so after 12 hours. The results support our hypothesis "skeletal muscle glycogen is used for maintaining the blood glucose level in starved mice" (Hirose et al.: Anat. Rec., 216:133-138, 1986)-and show that type IIB fibers play a main role in maintaining the glucose level and that muscle glycogen is utilized after depletion of liver glycogen. PMID- 3631543 TI - Stereological analysis of the muscle-tendon junction in the aging mouse. AB - Transmission of contractile tension from skeletal muscle fibers to connective tissue elements is thought to occur at the muscle-tendon junctions, specialized regions at the extreme ends of the fibers. Previous stereological studies on adult mouse and chicken fibers have shown that, with reference to equal cross sectional areas of myofibrils, the muscle-tendon junctions of faster fibers have significantly more surface membrane devoted to force transmission than do those of slower fibers (Trotter et al.: Anat. Rec. 213:16-25, 1985a; Trotter et al.: Anat. Rec. 213:26-32,1985b; Trotter and Baca: Anat. Rec. 218:256-266, 1987). In the present study we have analyzed the muscle-tendon junctions of 30-month-old mice, employing techniques for scanning and transmission electron microscopy and for ultrastructural stereology which are identical to those previously used to study the same muscles in 4-month-old mice. Whereas the principal structural features of the muscle-tendon junctions of fibers from adult and aged mice are indistinguishable, stereological analyses of the fiber-tendon interfaces indicate that, in aging animals, the interfacial ratio (the ratio of the surface area of force-transmitting membrane to the cross-sectional area of force-generating myofibrils) is significantly reduced. While the interfacial ratio of fast-twitch fibers of the adult plantaris is about 14.5, the corresponding ratio in aged animals is about ten. In the predominantly slow-twitch fibers of the adult soleus, the interfacial ratio is about ten at the insertion and about 12.7 at the origin, whereas the corresponding ratios in the aged animals are both about ten.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631544 TI - The elasmobranch renal corpuscle: fine structure of Bowman's capsule and the glomerular capillary wall. AB - The fine structure of the renal corpuscle of the marine elasmobranch fish, the little skate (Raja erinacea), and two species of dogfish sharks, the spiny dogfish (Squalus acanthias) and the smooth dogfish (Mustelus canis), was studied by light microscopy and by transmission (thin sections, freeze-fracture replicas) and scanning electron microscopy. Bowman's capsule was lined by ciliated cells, similar to those of the first part of the tubule, at the urinary pole and squamous cells in the zone between urinary and vascular poles. At the vascular pole the visceral epithelial cells had some closely apposed cuboidal cell bodies with a few processes inserted along the basement membrane, but foot processes were absent. These cuboidal cells were continuous with podocytes, which had primary, secondary and tertiary processes from which the pedicels arose. An inconsistently present slit membrane bridged the pedicels at varying distance from the urinary space. Small maculae and large fasciae occludentes joined the podocytes and/or their processes among which gap junctions were observed. In the skate kidney, the podocyte plasma membrane facing the basement membrane contained orthogonal arrays of particles. The epithelial basement membrane of the glomeruli in all elasmobranchs was consistently thick. The mesangial cells were numerous and partially enveloped in a basement membrane; their long processes almost completely circumscribed the capillary walls. The mesangial matrix was abundant and consisted of loosely arranged collagen fibrils, microfibrils and occasional anchoring fibrils. The endothelial cells had irregularly distributed fenestrations of various sizes and lay on their discontinuous basement membrane which was separate from that under the epithelial cells. The filtration apparatus resembles that of immature mammals and lower vertebrates. PMID- 3631546 TI - Unusual example of a persistent stapedial artery in a human. AB - A complete dissection of a persistent stapedial artery and its companion venous sinuses revealed several noteworthy features. The proximal portion of the stapedial artery stem was missing, and the entire stapedial system was supplied through an anastomosis between the occipital artery and the ramus posterior of the stapedial artery; a similar type of collateral supply occurs in some xenarthrans and bats. The ramus posterior is a component of the primitive eutherian stapedial system and one that has not been reported previously in a primate. Both the anterior and posterior divisions of the ramus superior were present. The posterior division is identified here for the first time in a primate. The anterior and posterior divisions were accompanied by the cranio orbital and petrosquamous sinuses, respectively. These sinuses were incomplete and attenuated relative to the primitive eutherian condition. PMID- 3631545 TI - Accumulation and distribution of sulfated materials in the maturing mouse lens capsule. AB - Lenses of late gestational and postnatal normal-eyed mice were tested for accumulated sulfated materials by using Spicer's high-iron-diamine staining method and also for newly incorporated sulfate autoradiographically following administration of 35SO4 either in vivo or in isolated and organ-cultured lenses. Accumulated and newly incorporated sulfate was observed in all lenses for each age group tested. Discrete regional differences were seen in histochemical staining patterns for sulfate on the lens capsule in specimens of all ages, and distinct laminar zonations were seen in the various regions of the capsule in older specimens. Typically, the anterior and equatorial regions of the capsule demonstrated three histochemically distinct laminar zones while the posterior capsule usually demonstrated two laminar zones. Autoradiographic results indicated that sulfate was indeed being incorporated into these regions, and in the same general pattern as seen with histochemistry. The materials were largely insensitive to testicular hyaluronidase but were preferentially sensitive to nitrous acid digestion, indicating the presence of capsular heparan sulfates. Autoradiographic results from organ-cultured lenses indicated that this tissue itself is a primary source of these materials. PMID- 3631547 TI - Differential effects of tissue processing on human embryonic and fetal skin. AB - To most accurately evaluate quantitative data from studies of developing epidermis, the effects of tissue processing on human embryonic and fetal skin (8 20 weeks gestational age) were examined using two different techniques: 1) EDTA separated epidermal sheets that were briefly fixed in 2% paraformaldehyde, processed through Permount infiltration, and prepared as whole mounts on glass slides, and 2) skin that was fixed in Karnovsky's fixative and embedded in Epon. Based on en face measurements of surface area before and after tissue processing, both procedures caused differential, age-dependent shrinkage. However, the trend of increasing shrinkage was inversely related to increasing age in the paraformaldehyde-fixed epidermal sheets (y = 57.14 + 1.26x, where x = gestational age in weeks and y = % of original surface area), but directly correlated with aging in the Karnovsky-fixed skin (y = 955.62 - 232.77x + 20.38x2). Shrinkage of epidermal sheets occurred during the dehydration and clearing steps, whereas most of the dimensional changes in whole skin took place during fixation in Karnovsky's. These differences are probably due to greater cross-linking of proteins and longer fixation time in the more concentrated and fast-acting Karnovsky's, as well as the influence of increasing quantities of fibrous proteins in the dermis of whole skin. PMID- 3631548 TI - Scanning electron microscopic observations on the epithelium of the human prostatic urethra. AB - The human prostatic urethra has been investigated by means of scanning electron microscopy. On the posterior wall of the urethra, the seminal colliculus with the orifices of the ejaculatory ducts is clearly detectable. The upper portion of the prostatic urethra shows a typical transitional epithelium with large superficial cells of a ruffled appearance. In the lower portion of the organ (underneath the openings of the ejaculatory ducts), the apical pattern of the cells varies considerably. Four main aspects are recognizable: apices provided with microvilli, dome-shaped apices with an almost smooth surface, large apices with labyrinthic microplicae and ciliated apices. Also, apices showing intermediate characteristics can be noted. The functional significance of the morphological patterns as well as the possibility of a transition among the various types of surface structures are discussed. PMID- 3631549 TI - Sperm characteristics of infertile and fertile Zairian men at the University Clinic of Mont Amba (Kinshasa). AB - The best interpretation of different sperm characteristics of zairian men consulting for infertility results from comparative studies with the sperm characteristics of fecund men. In this study four sperm variables permitted us to distinguish infecund from fecund men: sperm count, total sperm count, morphology and motility at the 24th-26th hour. No differences have been observed about aspect, odor, pH and volume of ejaculate. PMID- 3631550 TI - [Cytologic classification of immature germ cells in the spermatological "syndrome" of increased desquamation of spermatogenic cells]. AB - The spermatological phenomenon of increased exfoliation of immature germ cells (IGC) not commonly known until now, can be defined quantitatively as a number of above 4% IGC in relation to the sperm count. The variable aspect of premature germ cells may be confusing and their degenerative alterations complicate definite classification. Items for the classification of IGC have been elaborated employing comparative cytological studies. Based on these criteria exfoliated IGC within the ejaculate can be grouped into: cells reliably allied to spermatogenesis; cells probably allied to spermatogenesis; cells not exactly classifiable by conventional cytology. Analysing the ejaculates of 20 patients with increased exfoliation of IGC (16-50%), we mainly found cells exfoliated from the adluminal cell compartment of seminiferous tubules (spermatocytes II and spermatids). During conventional light microscopy about one third of the "round cells" in ejaculate smear preparations remained unclassifiable. Pathogenetic reasons of increased output of IGC are unclear so far. This phenomenon, usually accompanied by asthenozoospermia as well and mild to severe teratozoospermia, is very often also combined with decreased sperm counts (5-20 mio/ml ejaculate). PMID- 3631551 TI - On the morphology of the transitional zones from the rete testis into the ductuli efferentes and from the ductuli efferentes into the ductus epididymidis. Investigations on the human testis and epididymis. AB - Transitions from the rete testis into the ductuli efferentes and from the ductuli efferentes into the ductus epididymidis were examined in the epididymes of 4 patients with prostatic cancer aged 65, 72, 77 and 78 years, in the epididymis of a 19 year-old accident victim and in the epididymis of an embryo of the 12th week. Concerning the former area, the results published up to now were confirmed. But according to our examinations, the transition from the ductuli efferentes into the ductus epididymidis is different from what has been described in the literature so far. In the adult human, the ductuli efferentes do not show end-to side connections with the ductus epididymidis, but end-to-end junctions with "extensions" of the ductus epididymidis which finally join the ductus epididymidis end-to-side. However, in the epididymis of the embryo, one still finds end-to-side connections of ductuli efferentes and the ductus epididymidis. It was concluded that the extensions of the ductus epididymidis are formed during the development of the system of canaliculi in the epididymis from the embryonal stage to adult age. PMID- 3631552 TI - Tail stump sperm defect in Ayrshire bulls: morphogenesis of the defect. AB - Three cases of tail stump sperm defect have been presented in Finnish Ayrshire bulls. The semen samples of the bulls showed markedly reduced number of sperm with almost total absence of tails. Transmission and scanning electron microscopy of the testicular samples revealed the testicular origin of the defect. The anlagen of the implantation fossa, proximal and distal centrioles, connecting piece, nuclear ring, manchette and annulus were demonstrated, but the axoneme formation was completely blocked. A separate population of spermatids showed nuclear bending and was possibly destroyed by the phagocytic activity of Sertoli cells. The pedigree of the bulls supports the concept that the defect is inherited by a single recessive autosomal gene. PMID- 3631553 TI - Penetration ability of human spermatozoa into standardized bovine cervical mucus (Penetrak) in patients with normal and pathological semen samples. AB - Semen samples from 89 men were analyzed and evaluated with a standardized bovine cervical mucus penetration test (Penetrak). 29 patients had a normozoospermia, 22 patients a teratozoospermia and 38 patients an oligozoospermia of various degree. The most important parameters of semen analysis were compared with sperm mucus penetration. The sperm mucus penetration test correlated best with progressive motility (r = 0.6758), followed by total motility (r = 0.6302), sperm count (r = 0.6190), and % normal spermatozoa (r = 0.5493) (p less than 0.01 for each correlation coefficient). In the group of patients with normozoospermia 6 cases had been detected with insufficient sperm mucus penetration and in both groups with subfertility 15 cases with adequate sperm mucus penetration. 8 semen samples with normal sperm count and normal sperm motility were used for IVF. Only 6 patients with normal sperm penetration (greater than 30 mm/90') the spermatozoa fertilized the ova, but not from two patients, who had a sperm mucus penetration of less than 30 mm/90'. The study demonstrated that standardized bovine mucus penetration test detects disturbances of sperm motility which may not be discovered by conventional semen analysis. PMID- 3631554 TI - Absence of acrosome reaction in polyzoospermia. AB - Using the recently described triple-stain technique the time course of the acrosome reaction in a group of patients with polyzoospermia was evaluated and was compared to that of a group of normozoospermic men and a group of men with proven fertility. Polyzoospermia (greater than 250 Mill. spermatozoa/ml) has been repeatedly associated with subfertility. This investigation shows that most of the spermatozoa of polyzoospermic men do not undergo the acrosome reaction in vitro. This renders the spermatozoa incapable to penetrate the outer investments of the oocyte which might be one of the reasons for the reduced fertility observed in this patient group. PMID- 3631555 TI - Coital death. AB - Generally speaking one can state that there exists insufficient information to be alarmed about coital death; indeed, there are almost no studies known about coital death of heart patients. All the same an epidemiologic research is absolutely necessary for profylaxis of heart attacks caused by sexual activity, even more whilst the present population shows an increased rate of arteriosclerosis and disposes over more spare time. It is remarkable that apart from medico-legal practicians, cardiologists and revalidation doctors, other disciplines as psychiatry and sexuology, still haven't paid any attention to the problem of coital death. It certainly is high time to draw this phenomenon out of its taboo-sphere. PMID- 3631557 TI - Characterization of a testis specific antigen in the mouse. AB - The partial characterization of a mouse hydrosoluble testis specific protein by crossed immunoelectrophoresis, ion-exchange chromatography and SDS-Page was made. This protein presented a low electrophoretic motility at pH 8.6. It was not adsorbed to DEAE-Sephacel at pH 8.6, but was slightly adsorbed at pH 9.0, while in CM-Sephadex it was readily adsorbed at pH 6.0, indicating the basic nature of this protein. The apparent molecular weight was determined to be of 28 Kd by SDS Page. The previously reported testis specificity of this protein was corroborated by its absence in a liver extract. PMID- 3631556 TI - Determination of total protein in human seminal plasma. AB - Methodological problems are encountered in determinating human seminal protein content since results are influenced especially by techniques which are used, and by modifications due to liquefaction process. In order to test these two points, three methods (Folin, Biuret and Meulemans's reactions) were applied to the same seminal samples and results were compared. The differences seem principally due to the high level of glycoproteins. To determine the modifications of total protein content with time after semen collection, each sample was separated in aliquot fractions and proteolysis was blocked at different times for each fraction. There is an increase of the protein concentration during the first fifteen minutes that follows semen collection. The cause of this phenomenon is discussed. PMID- 3631558 TI - The SCMC test: a accurate indicator for spermatozoal antibodies. AB - Eighteen couples (12.9%) were selected from a group of 138 infertile couples for a special study about the reliability of the SCMC test, when compared with spermantibody titres in the cervical mucus and or seminal plasma and corticosteroides as treatment for immunologic infertility. It can be demonstrated that there exists a reliability of the SCMC test as an immunologic assay for sperm antibody activity in the semen and the cervical mucus. PMID- 3631559 TI - [Impotence in diabetes mellitus. Etiological factors and therapeutic possibilities]. AB - The neurovascular causes of diabetic impotence are presented. 55 men presenting impotence and diabetes mellitus were examined in an extended diagnostic program. Nocturnal penile tumescence and Papaverin-test showed psychogenic impotence in 10 of these men, which lead to psychosexual therapy of the couple. Because of regional erectile lesions (Mb. Peyronie, penile trauma, inborn penile deviation, Priapism) 8 further diabetics were successfully operated. The remaining 37 patients with diabetes mellitus showed vascular erectile lesions (increased venous drainage in 7 and decreased arterial inflow in 30 men) and were operated upon with the following methods: Microsurgical arterialisation of the penile vein via a V. saphena-graft to the iliaque artery was done in 4 patients. There was an amelioration in 2 and a longterm failure in the remaining 2 men. Vein ligation of both internal iliaque veins and lateral penile veins in 7 patients resulted in 2 short term improvements and 5 failures. Flexible penile prostheses (AMS- and Jonas-prostheses) in 26 patients showed good results in 24 and infectious complications in 2 of them (Explanation of both prostheses, ones partial penile amputation). Vascular interventions for diabetic impotence seem to be of questionable value and therefore the implantation of penile prostheses should be preferred. In diabetics, infection of the alloplastic implants is particularly dangerous and may lead to septicemia and penile amputation. PMID- 3631560 TI - Erythrocyte fragility screening is not a tool for diagnosis of human malignant hyperthermia. AB - The fragility of erythrocytes from 21 patients undergoing in vitro skeletal muscle contracture testing for malignant hyperthermia (MH) susceptibility was examined. Osmotic fragility was determined by the degree of hemolysis in buffered saline solutions of decreasing osmotic strength. Halothane-induced fragility was determined in an isotonic solution containing increasing percentages of halothane saturated solution. The effects of six different incubation conditions prior to performing fragility tests were examined in an attempt to optimize discrimination of MH susceptible patients, including the following: 1) no preincubation; 2) 24 hr incubation at 4 degrees C; 3) 72-hr incubation at 4 degrees C; 4) 24-hr incubation at 37 degrees C; 5) 24-hr incubation at 22 degrees C with plasma from an MH-susceptible patient; and 6) 24-hr incubation at 22 degrees C with plasma from a normal patient. Despite examining six different incubating conditions and the two methods of hemolysis induction, no differences in erythrocyte fragility were detected between patients diagnosed as MH susceptible or normal. Erythrocyte fragility testing is not useful for diagnosing MH susceptibility. PMID- 3631561 TI - Effects of lidocaine infusion on the sympathetic response to abdominal surgery. AB - Activation of afferent nerves in the area of surgery is a cause for surgical pain and stress. Intravenous (IV) lidocaine has been shown to inhibit postoperative pain. In the present double-blind study, the effects of a continuous IV infusion of lidocaine (2 mg/min) on the sympathoadrenal stress response to surgery were evaluated in 38 patients scheduled for elective cholecystectomy who were randomly assigned to two groups. In one group, lidocaine infusion was started 30 min before the operation and continued for 24 hr after surgery (n = 18). In the second group (n = 20), saline was infused. The increases in heart rate and blood pressure after tracheal intubation were not significantly different between the groups, but tachycardia and hypertension associated with extubation was prevented in patients given lidocaine. Differences in blood pressure and heart rate between the two groups were otherwise not significant intra- or postoperatively, nor were differences in blood glucose or plasma catecholamine concentrations during the first 24 hr after skin incision. Urinary catecholamine concentrations did not differ significantly in the two groups during the first postoperative day, but during the second postoperative day urinary output of epinephrine and norepinephrine were significantly less in the group of patients receiving lidocaine infusion. It was concluded that the IV infusion of lidocaine during and after major abdominal surgery suppresses extubation-induced hypertension and tachycardia but does not inhibit the general sympathetic response during the first postoperative day. However, lidocaine infusion reduces urinary output of catecholamines during the second postoperative day, suggesting a more rapid decline in the sympathoadrenal response postoperatively in the experimental group. PMID- 3631563 TI - Thiopental dose-response relations in unpremedicated infants, children, and adults. PMID- 3631562 TI - Accidental epidural magnesium sulfate injection. PMID- 3631564 TI - Hemodynamic and metabolic effects of two anesthetic techniques in children undergoing surgical repair of acyanotic congenital heart disease. PMID- 3631566 TI - Sympathetic blockade and tourniquet pain in surgery of the upper extremity. PMID- 3631565 TI - Alternating periodic leg movement induced by spinal anesthesia in an elderly male. PMID- 3631567 TI - Intravenous lidocaine: optimal time of injection before tracheal intubation. PMID- 3631568 TI - Postoperative quadriplegia after spinal fusion for scoliosis with intraoperative awakening. PMID- 3631569 TI - Malignant hyperthermia in a three-month-old American Indian infant. PMID- 3631570 TI - Relationship between esophageal temperature gradient and heart and lung sounds heard by esophageal stethoscope. PMID- 3631571 TI - A simple way to monitor inspired oxygen concentration in nonrebreathing circuits. PMID- 3631572 TI - Hypertensive reaction to indigo carmine during transurethral resection of a bladder tumor. PMID- 3631573 TI - Blitz intubation--a useful synonym. PMID- 3631574 TI - Physostigmine reversal of general anesthesia: associated EEG changes. PMID- 3631575 TI - Use of succinylcholine in patients with decreased plasma cholinesterase activity. PMID- 3631576 TI - Epinephrine reduces systemic absorption of extradural diacetylmorphine (heroin) PMID- 3631577 TI - Epidural blood patch in a Jehovah's Witness. PMID- 3631578 TI - Improving anesthesia mask fit in edentulous patients. PMID- 3631579 TI - Seizures after anesthesia: identifying the causes. PMID- 3631580 TI - Nitrous oxide should not be used during laser endoscopic surgery. PMID- 3631581 TI - Delayed filling of the breathing bag due to a portable vaporizer. PMID- 3631582 TI - Detection of systemic to pulmonary shunt by end-tidal carbon dioxide concentration. PMID- 3631583 TI - A hitherto unreported virtue of the isolated power system. PMID- 3631584 TI - Preoxygenation and electroconvulsive therapy. PMID- 3631585 TI - A breathing-circuit stethoscope for continuous monitoring of breath sounds. PMID- 3631586 TI - Radial arterial foreign body as a cause of wrist pain. PMID- 3631587 TI - Removal of endotracheal tube connectors. PMID- 3631588 TI - The influence of acidosis on the distribution of lidocaine and bupivacaine into the myocardium and brain of the sheep. AB - To test the hypothesis that acidosis can increase the toxicity of bupivacaine more than that of lidocaine by increasing the distribution into the brain, myocardium, or both, studies were performed to measure the in vivo tissue:blood partition coefficients during continuous steady state intravenous infusions of these agents in anesthetized sheep during normal acid-base status and during combined respiratory-metabolic acidosis. Acidosis decreased the partition coefficient of both agents into the myocardium and that of bupivacaine into the brain but did not systematically change that of either agent into skeletal muscle or fat. Total body and hepatic drug clearances were not affected systematically, but plasma binding of both agents was decreased. Thus predictions based on the pH partition hypothesis about the effects of acidosis on myocardial:blood partition coefficients being a basis for explaining the relative toxicity of these agents were not supported. PMID- 3631589 TI - Lack of size-related differential sensitivity to equilibrium conduction block among mammalian myelinated axons exposed to lidocaine. AB - This study sought to evaluate the sensitivity of individual, relatively thick myelinated axons of mammalian nerve to equilibrium conduction block by lidocaine, and to compare this to the incidence of conduction block previously measured in individual thinner myelinated axons. The incidence of conduction block by lidocaine 0.3 and 0.6 mM (8.1-16.2 mg/dl) was determined on 35 individual axons in dissected filaments of rabbit recurrent laryngeal nerve (RLN) in which the control conduction velocity ranged from 28 to 77 m/sec. Thirty-four axons (97%) remained excitable in lidocaine 0.3 mM; 2 axons (6%) remained excitable in lidocaine 0.6 mM. These proportions did not differ significantly (P greater than 0.2) from those in thinner axons of vagus, either in comparisons with previous data from extracellular recordings or with new data from filament recordings. The results imply that differential blocks observed under clinical conditions probably depend on factors other than a size-related difference in the minimal equilibrium blocking concentration among myelinated axons. Equilibrium depression of the amplitude of RLN compound action potentials by lidocaine 0.3 and 0.6 mM was disproportionately great relative to the incidence of equilibrium conduction block in individual axons, confirming that depression of the compound action potential is not a reliable measure of nerve conduction block. PMID- 3631590 TI - Toxicity of chloroprocaine and sodium bisulfite on human neuroblastoma cells. AB - The effects of commercial and crystalline solutions of chloroprocaine (CP) (1.6 X 10(-3)-0.4 X 10(-3)M) and sodium bisulfite (SB) (0.8 X 10(-3)-0.08 X 10(-3)M) were studied on the multiplication of human neuroblastoma cells. These cells were chosen because of putative neurotoxicity associated with CP; cell multiplication (measured as colony-forming ability-CFA) was studied because CFA is a reliable in vitro test for drug toxicity at the cellular level. CFA was dramatically reduced (86%) after 20-hr exposure to commercial solutions of CP. Shorter exposure times (3 hr) resulted in a marginal toxic effect (32%). At similar concentrations and after 20-hr exposure time, CP crystalline solutions induced a 37.5% inhibition that decreased with decreased time in culture. Sodium bisulfite reduced cell multiplication to a degree that varied with different samples of SB. With a 3-hr exposure time, CFA was reduced 72-92% by SB-1 and 57-72% by SB-2. The variability of SB toxicity and the difference in toxicity with commercial and crystalline solutions of CP are discussed in terms of possible clinical toxicity. PMID- 3631591 TI - End-tidal PCO2 measurements sampled at the distal and proximal ends of the endotracheal tube in infants and children. AB - To determine whether the site of gas sampling affects end-tidal gas measurements in pediatric patients, end-tidal PCO2 was measured continuously from the distal and proximal ends of the endotracheal tube in 60 infants and children ventilated with an Air-Shields Ventimeter and a partial rebreathing circuit. These data were compared with simultaneous arterial PCO2 measurements. In infants and children weighing greater than or equal to 12 kg, both distal and proximal end-tidal PCO2 values approximated arterial PCO2 measurements. In infants and children weighing less than 12 kg, however, only distal end-tidal PCO2 measurements approximated arterial PCO2 measurements. It is concluded that in infants and children weighing less than 12 kg, accurate end-tidal measurements can be obtained only from the distal end of the endotracheal tube. PMID- 3631592 TI - Spinal anesthesia with glucose-free bupivacaine: effects of age on neural blockade and pharmacokinetics. AB - Effects of age on spinal anesthesia using glucose-free 0.5% bupivacaine without epinephrine were studied in two groups of patients, one between 20 and 55 yr old, the other older than 55 yr. All patients received 15 mg bupivacaine. The time to onset of analgesia in caudad segments and the time to maximal motor blockade decreased with age. The upper level of analgesia did not change significantly with increasing age. The times to recovery from analgesia at T12 and for the total disappearance of analgesia were longer in the older patient group. Effects of age on duration of motor blockade could not be demonstrated. Peak plasma concentrations of bupivacaine were significantly greater and the total plasma clearance significantly decreased in older patients. Age had no effect on time to peak concentration or the terminal half-life. PMID- 3631593 TI - Partition coefficients of I-653 in human blood, saline, and olive oil. AB - The purpose of this study was to determine partition coefficients for a new, inhaled anesthetic, I-653. Blood samples were taken from 11 patients scheduled for elective surgery who were ASA physical status I-III and ranged in age from 25 to 76 yr. At 37 degrees C, we found a blood/gas partition coefficient of 0.424 +/ 0.024 (mean +/- SD); a saline/gas partition coefficient of 0.225 +/- 0.002; and an oil/gas partition coefficient of 18.7 +/- 1.1. These values indicate that I 653 will have a minimum alveolar concentration (MAC) required for anesthesia that is four to five times that of isoflurane and that I-653 will produce a rapid induction of and recovery from anesthesia. PMID- 3631594 TI - MAC of I-653 in rats, including a test of the effect of body temperature and anesthetic duration. AB - The anesthetic potency of a new fluorinated volatile anesthetic, I-653, was tested preliminary to testing its toxic and metabolic characteristics in rats. The minimum alveolar concentration (MAC) of I-653 at 37.9 +/- 0.2 degrees C (mean +/- SD) in eight rats was 5.72 +/- 0.40%. In five rats, we reduced the rectal temperature to 28 degrees C in two steps of 5 degrees C. MAC decreased by 0.238 +/- 0.036% I-653 per degree centigrade decrease in temperature. That is, MAC decreased 42% as temperature decreased 10 degrees C. We restored the temperature to 38 degrees C and redetermined MAC. This value (5.66 +/- 0.75%) did not differ from the average MAC obtained before hypothermia (5.84 +/- 0.36%). PMID- 3631595 TI - Rates of awakening from anesthesia with I-653, halothane, isoflurane, and sevoflurane: a test of the effect of anesthetic concentration and duration in rats. AB - The low blood solubility of two new inhaled anesthetics, I-653 (human blood/gas partition coefficient, 0.42) and sevoflurane (0.69), suggested that awakening from these agents should be more rapid than awakening from currently available anesthetics such as isoflurane (1.4) and halothane (2.5). This prediction proved valid in a study of these four agents in rats given 0.4, 0.8, 1.2, or 1.6 MAC for 2.0 hr or 1.6 MAC for 0.5 or 1.0 hr. At a given dose and duration, awakening was most rapid with the least soluble agent and longest with the most soluble agent. For example, recovery of muscle coordination at 1.2 MAC administered for 2 hr required 4.7 +/- 3.0 min (mean +/- SD) with I-653, 14.2 +/- 8.1 min with sevoflurane, 23.2 +/- 7.6 min with isoflurane, and 47.2 +/- 4.7 min with halothane. PMID- 3631596 TI - Stability of I-653 in soda lime. AB - Stability is an important characteristic of a halogenated volatile anesthetic because breakdown may produce toxic compounds. The resistance to breakdown by soda lime of a new halogenated volatile anesthetic, I-653, was compared with the resistances found for halothane, isoflurane, and sevoflurane. The four anesthetics were injected concurrently into flasks containing 500 ml of gas and 100 g of soda lime maintained at 40, 60, and 80 degrees C. Four or five flasks were tested at each temperature. The rate of anesthetic degradation increased as temperature increased. Degradation was greatest with sevoflurane and least with I 653. At 80 degrees C, the rate of degradation per hr was 92.2 +/- 5% with sevoflurane; 16.0 +/- 1.6% with halothane; 13.1 +/- 3.7% with isoflurane; and 0.44 +/- 0.26% with I-653 (means +/- SD). The in vitro stability of I-653 suggests that it may strongly resist biodegradation. PMID- 3631597 TI - Lack of influence of cimetidine on bupivacaine levels during parturition. AB - The concurrent use of cimetidine as a prophylactic antacid and bupivacaine as a local anesthetic for epidural anesthesia for cesarean section has been promoted. However, cimetidine is known to inhibit clearance of many drugs by reducing hepatic blood flow and by inhibiting cytochrome P-450 enzymes. The purpose of this study was to determine whether cimetidine during epidural anesthesia alters the metabolism, disposition, protein binding, or placental transfer of bupivacaine. Thirty-six patients undergoing cesarean section with 0.5% bupivacaine for epidural anesthesia were studied. Sixteen patients received cimetidine (300 mg IM) 1-4 hr before cesarean section and 20 control patients received sodium citrate (30 ml PO) 10 min preoperatively. Bupivacaine and its inactive metabolite, 2,6-pipecolylxylidine (PPX) were quantitated by gas chromatography/mass spectrometry. Maternal plasma concentration time curves, fetal/maternal ratios at delivery, cord vein/cord artery ratios. PPX/bupivacaine ratios, and maternal and neonatal urinary excretion were compared between the two groups. No significant differences could be found between the groups in any of the outcome variables. However, in the presence of cimetidine, the percentage of unbound bupivacaine significantly increased from 1.36 +/- 0.63 to 1.66 +/- 0.78%. The results suggest that a single 300-mg IM dose of cimetidine does not significantly affect bupivacaine disposition or metabolism in parturients when given 1-4 hr before anesthesia. PMID- 3631598 TI - Bunegin-Albin catheter improves air retrieval and resuscitation from lethal venous air embolism in dogs. AB - Three types of catheters, the single-orifice Sorenson CVP kit catheter, the right atrial (RA) port of an American Edwards 7F Swan-Ganz catheter, and the Cook Bunegin-Albin multi-orifice CVP catheter were evaluated for their ability to retrieve venous air emboli and effect on the success rate of resuscitation from venous air emboli. The catheters were inserted in anesthetized dogs in the prone position. Swan-Ganz catheters were positioned with the RA port just above the junction of the superior vena cava (SVC) and the RA, single-orifice Sorensen catheters with the orifice tip located either just above the SVC-RA junction or in the mid-RA, and Bunegin-Albin multiorifice catheters with the proximal orifice just above the SVC-RA junction and the distal orifice near the mid-RA. Dogs were then given a predetermined lethal dose of air (5 ml/kg) over 30 sec via the femoral vein. Attempts to aspirate venous air emboli were begun with first decrease in expired CO2. The amounts of air retrieved and the incidence of successful resuscitation were compared. Significantly greater percentages of injected venous air were retrieved with the Bunegin-Albin catheter (60 +/- 7%) than with the Sorenson catheter in the SVC (16 +/- 6%), with the Sorenson catheter in the mid-RA (10 +/- 3%) or with the Swan-Ganz RA port (4 +/- 1%). Resuscitation was significantly more often successful with the Bunegin-Albin catheter (six of nine dogs) than with either Sorenson catheter (zero of seven in both groups) or the Swan-Ganz RA port (one of seven).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631599 TI - The effects of age, epinephrine, and operative site on duration of caudal analgesia in pediatric patients. AB - The effects of age, operative site (penoscrotal or inguinal), and the addition of epinephrine 1:200,000 to bupivacaine on duration of postoperative analgesia after caudal block were prospectively and blindly evaluated in 341 children aged 13 months to 17 yrs. At the conclusion of the surgical procedures under halothane/N2O/O2 anesthetics (n = 419), caudal blocks were performed with 0.5 ml/kg of either 0.25% bupivacaine or 0.25% bupivacaine with 1:200,000 epinephrine injected at a rate of 0.5 ml/sec. The duration of analgesia was noted by parents or nurses who had been instructed how to identify, in a standard manner, the onset of postoperative pain. The mean duration of analgesia was significantly longer in young children (P less than 0.001), in children having penoscrotal operations (P less than 0.001), and when epinephrine was added to bupivacaine (P less than 0.001). There were no major complications. The authors conclude that duration of analgesia is significantly influenced by age, operative site, and the addition of epinephrine 1:200,000 to bupivacaine. PMID- 3631600 TI - Measuring central vascular pressures: a surprisingly complex problem. PMID- 3631601 TI - Do premature infants require anesthesia for surgery? PMID- 3631602 TI - Accurate, automated, continuously displayed pulmonary artery pressure measurement. AB - A computerized signal processing technique that removes low-frequency respiratory variation from pulmonary artery pressure and other central vascular pressure measurements, and produces a waveform devoid of respiratory artifact, has been developed. This technique has been integrated into a portable bedside monitor. The authors tested the technique in critically ill patients, and found that, compared to physician readings of conventional strip charts, it proved to be a very convenient and accurate method of determining pulmonary artery pressures continuously, regardless of ventilation. PMID- 3631603 TI - The minimum alveolar concentration (MAC) of isoflurane in preterm neonates. AB - Studies in fetal lambs suggested that the minimum alveolar concentration (MAC) in preterm neonates may be less than that in full-term neonates and older infants. To determine the MAC of isoflurane in preterm neonates, 20 patients less than 32 weeks gestation at birth and 16 patients 32-37 weeks gestation at birth, all less than 1 month post-natal age, were studied. Following tracheal intubation, the neonates were anesthetized with a predetermined end-tidal concentration of isoflurane in oxygen and air. The move-no move responses to skin incision were recorded, and MAC was determined using the "up-and-down" technique. Heart rate and systolic arterial pressure were recorded awake, before skin incision, and after skin incision. MAC (mean +/- SD) of isoflurane in preterm neonates less than 32 weeks gestation was 1.28 +/- 0.17%, and MAC in neonates 32-37 weeks gestation was 1.41 +/- 0.18% (P less than 0.05). Although heart rate did not decrease significantly in either group during the study, systolic arterial pressure decreased between 20 and 30% below awake values both before and after skin incision in both age groups (P less than 0.01). We conclude that the MAC of isoflurane in preterm neonates less than 32 weeks gestation is significantly less than that in preterm neonates 32-37 weeks gestation, and that systolic arterial pressure decreases to a similar extent at approximately 1 MAC isoflurane in both age groups. PMID- 3631604 TI - Effects of graded exercise on leg exchange of energy substrates in malignant hyperthermia susceptible subjects. AB - It has been speculated that, in malignant hyperthermia-susceptible (MHS) individuals, an abnormality of sympathetic activity is seen during stressful situations, such as exercise. The authors investigated whether muscle metabolism in eight MHS subjects, at rest and during moderate and heavy short-term exercise, is different then that in normals. Leg exchange of energy substrates (glucose, lactate, and glycerol) was quantified by measuring leg blood flow and arterial venous concentration differences. Muscle biopsies were also performed, and ATP, glycogen, and lactate were analyzed. Catecholamines and oxygen uptake were also measured. The study was performed at rest with subjects in the supine position and during two periods (40% and 80% of the subjects maximal oxygen uptake, respectively) on a bicycle ergometer. The principal finding of the study was that there was no major difference in oxygen uptake or leg exchange of glucose, lactate, and glycerol between MHS-subjects and previously standard normals during different grades of exercise. Furthermore, muscle metabolites and plasma catecholamines did not differ between the groups. This study indicates a normal sympathetic activity and muscle metabolism in MHS subjects during rest, as well as during moderate and severe exercise. The authors' results do not support the opinion that persons with positive in vitro tests for MH should restrict their physical activity. PMID- 3631605 TI - Cerebral vascular and metabolic effects of fentanyl and midazolam in young and aged rats. AB - Cerebral blood flow (CBF) and cerebral oxygen consumption (CMRO2) were measured, and electroencephalogram (EEG) was recorded in young (6-month-old) and aged (28 month-old) rats during ventilation with 70% N2O/30% O2 and following fentanyl or midazolam administration. Cerebral blood flow (CBF) was measured with radioactive microspheres, and cerebral oxygen consumption (CMRO2) was calculated from the arterial-sagittal sinus oxygen content difference and CBF measurements. Fentanyl at the highest dose used (200 micrograms/kg and 400 micrograms.kg-1.h-1) depressed the EEG and decreased CBF 49% and CMRO2 39% in young rats, whereas in old rats, this fentanyl dose decreased CBF 37% and CMRO2 34%, both significantly less than in young rats (P less than 0.05). Midazolam at the highest dose used (5.75 mg/kg) also depressed EEG in both age groups, and decreased CBF 51% and CMRO2 38% in young rats. This depression was significantly less than the 62% decrease in CBF and 59% decrease in CMRO2 produced by midazolam in old rats (P less than 0.05). These results indicate that aging attenuates the cerebrovascular and cerebral metabolic depression produced by fentanyl, but potentiates the same effects produced by midazolam. The enhanced cerebral metabolic depression produced by midazolam in the aged is similar to that seen with phenobarbital, and suggests a similar action of these drugs at the central GABA-benzodiazepine barbiturate receptor complex. PMID- 3631606 TI - Effect of an intubating dose of succinylcholine and atracurium on the diaphragm and the adductor pollicis muscle in humans. AB - This study compares the neuromuscular blocking effect of succinylcholine (0.8 mg . kg-1) and atracurium (0.6 mg.kg-1) on the diaphragm (D) and the adductor pollicis (AP) in 20 patients anesthetized with nitrous oxide, oxygen, and fentanyl. The diaphragm was monitored by measuring transdiaphragmatic pressure following bilateral phrenic nerve stimulation. After succinylcholine, the time from injection of succinylcholine to maximum depression of the single twitch response (onset time) was of 50 +/- 11 s (+/- SD) for D compared to 80 +/- 24 s for AP (P less than 0.001). After succinylcholine, recovery from paralysis was earlier for D than AP. Single twitch height (TH) returned to 25% of its control value (T25) after 5 +/- 2 min for D compared to 7 +/- 3 min for AP (P less than 0.001). Complete recovery of TH (T100) was achieved after 9 +/- 4 min for D and 11 +/- 5 min for AP (P less than 0.01). Recovery index (T25-75) was of 2 +/- 1 min for both muscles. After atracurium, the onset time for D was of 137 +/- 31 s compared to 181 +/- 45 s for AP (P less than 0.001). The T25 was achieved after 38 +/- 7 min for D compared to 63 +/- 13 min for AP (P less than 0.001). The TH of D returned to T100 after 60 +/- 12 min compared to 87 +/- 17 min for AP (P less than 0.01). The train-of-four ratio returned to 1 after 64 +/- 15 min for D compared to 99 +/- 21 min for AP (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631607 TI - Morphine and fentanyl hypnotic interactions with thiopental. AB - The effects of morphine-thiopental and fentanyl-thiopental combinations on the righting reflex were studied in rats. Doses that block the righting reflex for the agents given alone and for their combinations were determined with a probit procedure and compared with an isobolographic analysis. Interaction between morphine or fentanyl and thiopental on blockade of the righting reflex were both found to be synergistic. The degree of synergism was relatively small for the fentanyl-thiopental combination; the maximal deviation from additive interaction (expected/observed ratio) for ED50 dose level was 1.15 (P less than 0.01). The degree of synergism was greater for the morphine-thiopental combination; the maximal deviation from additive interaction was 2.27 (P less than 0.001). Comparison of the results with the outcomes of opioid-barbiturate interactions in relation to blockade of purposeful movement response to tail clamping, which was antagonistic, shows that the combination of a barbiturate with an opioid gives different outcomes for different end-points of anesthesia. This suggests that the anesthetic effect of an agent is composed of several components, each with a different mechanism of action. PMID- 3631608 TI - Isoflurane when compared to enflurane and halothane decreases the frequency of cerebral ischemia during carotid endarterectomy. AB - Data from the records of patients who underwent 2223 carotid endarterectomies at the Mayo Clinic between January 1, 1972, and December 31, 1985, were abstracted to compare the effects of isoflurane, enflurane, and halothane on the critical cerebral blood flow (CBF) (i.e., the CBF below which the majority of patients develop EEG ischemic changes within 3 min of carotid occlusion), the incidence of EEG ischemic changes, and the neurologic outcome. In a total of 2196 of these procedures, the patient received one of the three volatile anesthetics and, in 2010 of these, both the EEG and the CBF were monitored. Chronologically, halothane was the primary agent from 1972-1974; enflurane progressively replaced halothane during 1975-1981; and isoflurane was used almost exclusively since 1982. This analysis confirmed a previous study that the critical CBF during isoflurane anesthesia (703 procedures) was approximately 10 ml X 100 g-1 X min-1, as contrasted to that of approximately 20 ml X 100 g-1 X min-1 during halothane anesthesia (467 procedures). This analysis also established that the critical CBF during enflurane anesthesia (840 procedures) was approximately 15 ml X 100 g-1 X min-1. The incidence of EEG ischemic changes was significantly less (P less than 0.001) during isoflurane anesthesia (18%) than during either enflurane (26%) or halothane (25%) anesthesia. This difference occurred despite the fact that the preoperative risk status was greater in the patients given isoflurane. There was no difference in neurologic outcome between the three anesthetics, and none was expected, since all patients with EEG changes were immediately shunted, if possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631609 TI - Closed-loop feedback control of methohexital anesthesia by quantitative EEG analysis in humans. AB - A combined pharmacokinetic and pharmacodynamic model of methohexital was used to establish and evaluate feedback control of methohexital anesthesia in 13 volunteers. The median frequency of the EEG power spectrum served as the pharmacodynamic variable constituting feedback. Median frequency values from 2-3 Hz were chosen as the desired EEG level (set-point). In 11 volunteers, the feedback system succeeded in maintaining a satisfactory depth of anesthesia (i.e., unresponsiveness to verbal commands and tactile stimuli). During feedback control, 75% of all measured median frequency values were in the preset range of 2-3 Hz. This distribution of median frequency was obtained by applying random stimulation (six different acoustic and tactile stimuli) to the volunteers approximately every 1.5 min. The decrease of median frequency from baseline to anesthetic values was primarily induced by increasing the fractional power in the frequency band of 0.5-2 Hz from 12.6 +/- 4.5% (mean +/- SD) to 46.0 +/- 2.5%. The median time to recovery (as defined by opening eyes on command) after cessation of the feedback control period was 20.6 min (10.7-44.5 min) when median EEG frequency was 5.2 Hz (4.7-8.4 Hz). The average requirement of methohexital (mean +/- SD) during the 2 h was 1.02 +/- 0.16 g. It is concluded that pharmacokinetic pharmacodynamic models of intravenous anesthetics established previously may be used to form a suitable background for model-based feedback control of anesthesia by quantitative EEG analysis. This approach gives a possible solution to the problem of adapting pharmacokinetic and pharmacodynamic data to individuals when using population mean data as starting values for drug therapy. PMID- 3631610 TI - Hepatic effects of repeated halothane anesthetics in the hypoxic rat model. AB - The hepatic effects of repeated anesthesia of phenobarbital-induced Fischer 344 rats with 1% halothane/14% oxygen were investigated, after anesthetics were administered at either 1-day or 5-day intervals. Urinary excretion of fluoride, a product of reductive halothane metabolism, was increased in the 24-h period following anesthesia, but was the same after the first, second, and third anesthetics. Rats killed 24 h after a single anesthetic all had centrilobular hepatocellular necrosis. All animals killed 24 h after the second or third anesthetic also had centrilobular necrosis, but, in most animals, this was no more extensive than that following a single anesthetic, regardless of whether the interval between anesthetics was one or five days. PMID- 3631612 TI - The effect of volatile anesthetics on the pH dependence of calcium uptake by cardiac sarcoplasmic reticulum. AB - The effect of volatile anesthetics (VA) on the pH dependence of calcium uptake by cardiac sarcoplasmic reticulum (SR) was studied. SR was incubated at 37 degrees C with 45CaCl2 in the control state (no anesthetic) and in the presence of each of the VA from pH 6.6-7.6. The VA used were: halothane, 1.3%; enflurane, 1.8%; and isoflurane, 1.2%. In the control state, the initial rate of calcium uptake, measured after a 2-min incubation, was maximal at pH 6.8 (mean +/- SEM: 665 +/- 37 nmoles/mg) and markedly inhibited at pH 7.6 (107 +/- 9 nmoles/mg). In the presence of the VA, the calcium uptake rate was mildly depressed (7-32%) at pH 6.6-6.8, unchanged at pH 7.0, and greatly enhanced (52-78%) at pH 7.2-7.6, when compared to control. The maximal uptake of calcium by the SR at a calcium concentration of 10(-6)M, measured by a 20-min incubation, had a similar pH dependence in the control state, with a decline first evident at pH 7.2 and a 50% drop in the maximal uptake of calcium from pH 7.0-7.6. The presence of the VA was associated with a uniform depression of the maximal uptake of calcium by the SR at all pH levels measured. In view of these findings, it appears that pH does affect SR function in the presence of VA. This alteration of the pH effect by VA may be a factor responsible for discrepancies in results previously reported by investigators studying the effects of VA on the uptake of calcium by the SR. PMID- 3631611 TI - Effect of halothane on regional cerebral blood flow and cerebral metabolic oxygen consumption in the fetal lamb in utero. AB - The effects of halothane on maternal and fetal hemodynamics, distribution of fetal cardiac output, regional cerebral blood flow, and fetal cerebral oxygen consumption were studied in the ewe (N = 9) using radionuclide-labeled microspheres. An adjustable uterine artery occluder was used to produce a controlled state of fetal asphyxia. Measurements were taken during three periods of study: 1) control, 2) asphyxia, and 3) asphyxia plus 15 min of 1% maternal halothane. The fetal cardiovascular response to asphyxia was acidosis, hypoxia, hypertension, bradycardia, and preservation of vital organ blood flows. There was a significant drop in maternal blood pressure when halothane was administered but uterine blood flow was maintained, 308 ml X min-1 during asphyxia versus 275 ml X min-1 with halothane. Fetal blood pressure during asphyxia plus halothane (54 mmHg) was significantly lower than that during asphyxia alone (59 mmHg), while heart rate was significantly higher: 172 beats per minute (bpm) versus 125 bpm (P less than 0.05). Despite these changes, the administration of halothane during asphyxia did not produce a reduction in vital organ flows. Cerebral blood flow was maintained: 357 +/- 37 ml X 100 g-1 X min-1 during asphyxia alone and 344 +/- 26 ml X 100 g-1 X min-1 after halothane administration (P = NS, mean +/- SEM). Cerebral oxygen delivery also was maintained: 8.3 +/- 0.8 ml X 100 g-1 X min-1 during asphyxia alone versus 9.7 +/- 1.5 ml X 100 g-1 X min-1 after halothane, compared with 11.2 +/- 1.1 ml X 100 g-1 X min-1 during the control period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631613 TI - Evaluation and comparison of the distributions of gastric pH and hydrogen ion concentration. AB - The shapes of the distributions of gastric pH and hydrogen ion concentration [H+] were determined for each of 68 groups of patients scheduled for elective surgery under general anesthesia. The 68 groups comprised a total of 1,326 patients who had served as subjects in 13 of the authors' previously published studies. In general, the results showed that neither pH nor H+ was normally distributed; most of the pH distributions (47 of 68 = 69%) and most of the H+ distributions (53 of 68 = 78%) showed significant departure from the normal distribution. Moreover, the shapes of the distributions varied, depending upon the conditions under which gastric acidity was assessed. Groups receiving no medication for gastric acidity had positively skewed pH distributions (nonsymmetrical distribution with tail pointing to right and majority of cases in lower range), and groups receiving medications for the reduction of acidity had negatively skewed pH distributions (nonsymmetrical with tail pointing to left and majority of cases in upper range). The medications produced an inverse relationship between mean pH and skewness such that the skewness of the groups decreased from positive to negative as mean pH increased. For H+, all groups had positively skewed distributions, but the distributions were more positively skewed for groups receiving medications for gastric acidity. Again, the medication conditions produced an inverse relationship between mean acidity and skewness such that the groups became more positively skewed as the mean H+ decreased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631614 TI - Epidural fentanyl/bupivacaine mixtures for obstetric analgesia. PMID- 3631615 TI - Intravenous labetalol for treatment of postoperative hypertension. PMID- 3631616 TI - Continuous hypopharyngeal pH during anesthesia via mask. PMID- 3631617 TI - Every dose given in epidural analgesia for vaginal delivery can be a test dose. PMID- 3631618 TI - Prevention of postherpetic neuralgia. PMID- 3631619 TI - Midazolam in obstetric anesthesia. PMID- 3631620 TI - Potential eye damage from reusable masks. PMID- 3631621 TI - Translaryngeal cannula ventilation: continuing misconceptions. PMID- 3631622 TI - Hyperthermia and hypothermia as complications of extracorporeal shock wave lithotripsy. PMID- 3631624 TI - Abstracts of scientific papers. 1987 annual meeting. American Society of Anesthesiologists. PMID- 3631623 TI - Modifying the fetal monitor may be hazardous. PMID- 3631625 TI - [Colloid-osmotic plasma pressure during and after artificial circulation]. PMID- 3631627 TI - [Changes in renal function and its humoral regulation system in oncosurgical patients operated on under various methods of anesthesia]. PMID- 3631626 TI - [Effect of pulsating and non-pulsating flow on various parameters of artificial circulation]. PMID- 3631628 TI - [Status of immunologic defense, anesthesia and intensive care during relaparotomy]. PMID- 3631629 TI - [Electro- and drug anesthesia in lung surgery]. PMID- 3631630 TI - [Effect of hyperbaric oxygenation on the restoration of central nervous system function after long-term circulatory arrest]. PMID- 3631631 TI - [Analysis of the mechanisms of action of various systems of hyperbaric oxygenation on gas exchange, metabolism and structure of the lung tissue]. PMID- 3631632 TI - [Effect of hyperbaric oxygenation on pulmonary circulation and central hemodynamics in patients with closed chest injury]. PMID- 3631633 TI - [Blood levels and biological activity of middle weight molecules in critical conditions of the body]. PMID- 3631634 TI - [Changes in the rheological properties of the blood and their correction in patients with mushroom poisoning]. PMID- 3631635 TI - [A formalized automated card for dynamic observation for a department of resuscitation and intensive therapy]. PMID- 3631636 TI - [Use of the Soviet-made microcomputer MK-54 for the calculation of heparin and protamine sulfate doses during operations with artificial circulation]. PMID- 3631637 TI - [An improved method of tracheal intubation using a guiding device]. PMID- 3631638 TI - [The role of surgery in the treatment of postphlebitic disease of the legs]. PMID- 3631639 TI - [Intestinal revascularization]. PMID- 3631640 TI - [Spleno-renal shunt using the retroperineal approach in the treatment of renovascular arterial hypertension]. PMID- 3631641 TI - [Development of the arteries of the leg and foot in human fetuses: angiographic study]. PMID- 3631642 TI - Functional vascular disorders: treatment with pentoxifylline. AB - A group of 11 female patients (mean age 33.7 +/- 8 years) with a clearly proven primary Raynaud's syndrome of up to five years' duration were subjected to a two month oral treatment with 3 X 400 mg pentoxifylline per day. The following parameters were studied without and with exposure to cold conditions: hemodynamics (finger photoplethysmography), red cell deformability (filtration test), various clotting variables (prothrombin activity, antithrombin III, plasma fibrinogen, partial thromboplastin time, thrombin time, thrombelastogram), and clinical symptomatology. After treatment 7 of the 11 patients showed a distinct improvement of peripheral blood flow and of symptoms (decrease or removal of asphyxia attacks, pain, color change) under basal conditions, as well as after exposure to cold. Red cell filtration was significantly (p less than 0.05) improved, increasing by 35% under normal conditions and by 30% after exposure to cold. Positive changes were also found in respect to antithrombin III (increase) and plasma fibrinogen (decrease). The thrombelastogram was unchanged. Clinical and instrumental improvements were probably ascribable to better microcirculatory flow due to increased red cell deformability, reduced viscosity, and decreased fibrinogen, all capable of influencing in various degrees the blood flow at the microcirculatory level. PMID- 3631643 TI - 31P in-vivo spectroscopic study by high-field whole-body MR system--an application to a case with arteriosclerosis obliterans. AB - 31P in-vivo spectroscopy was performed by a 1.5-tesla whole-body MR system. The 31P spectrum for the calf muscle in a patient with arteriosclerosis obliterans having intermittent claudication was obtained every two minutes. When the spectrum after the workload was compared with that at rest, an increase in inorganic phosphate (Pi) and a decrease in phosphocreatine (PCr) were observed, resulting in a strong decrease in the PCr/Pi ratio. This method can measure the ischemic and recovery stages of energy metabolism in skeletal muscle noninvasively and continuously in addition to magnetic resonance imaging. PMID- 3631644 TI - Fibrinogen enhances and albumin reduces RBC aggregation. PMID- 3631645 TI - Pulmonary artery sarcoma--unusual pulmonary angiographic findings--a case report. AB - The authors report unusual angiographic findings in a patient with pulmonary artery sarcoma who presented with clinical features suggestive of recurrent pulmonary emboli. These angiographic findings have not been described previously in pulmonary artery sarcoma. PMID- 3631646 TI - An autopsy case of long survival with intermediate type of endocardial cushion defect--a case report. PMID- 3631647 TI - Right atrial thrombus and recurrent pulmonary emboli secondary to permanent cardiac pacing--a case report and short review of literature. AB - A patient with a right atrial thrombus and recurrent pulmonary emboli secondary to permanent pacemaker insertion is described. Possible precipitating factors were damage to the subclavian vein, congestive heart failure, paroxysmal atrial fibrillation, and immobilization. Venography demonstrated a large atrial thrombus in the superior vena cava and right atrium. The patient was successfully treated with heparin and subsequently with warfarin and dipyridamole. PMID- 3631648 TI - Prolonged beneficial effects of dobutamine in refractory heart failure--case histories. AB - Two patients with refractory congestive heart failure were treated with dobutamine for forty-eight to seventy-two hours with close monitoring of weight and symptomatology. After two to four cycles of dobutamine treatment, 1 patient showed sustained hemodynamic benefit after six months, whereas the second patient had partial improvement. At the end of a one-year follow-up, both had sustained improvement in effort tolerance, documented by a stress test. The quality of life has markedly improved, and they have not required further hospital care. PMID- 3631649 TI - Communicating hydrocephalus as a complication of isolated CNS angiitis--a case report. AB - A sixty-six-year-old man presented with headache, left hemiparesis, right crural monoparesis, and urinary and fecal incontinence. A picture consistent with cerebral angiitis was seen angiographically. After systemic angiitis and CNS infection were excluded, the diagnosis of isolated angiitis of the central nervous system was made. The patient responded well to corticosteroid therapy. However, a few months after initial presentation, he developed signs and symptoms suggestive of hydrocephalus. Serial CT scans of the head and radioisotope cisternography confirmed this diagnosis. The communicating hydrocephalus that developed was considered a complication of the CNS angiitis. A review of the literature on angiitis of the CNS is presented and the mechanism of the development of hydrocephalus is discussed. PMID- 3631650 TI - Congenital vascular abnormalities in Okihiro's syndrome--a case report. AB - In this report, the authors describe the angiographic findings in the forearm and hand in Okihiro's syndrome. To the best of their knowledge, it has not been described before. Okihiro et al described hypoplasia of the thenar eminence in association with a congenital disorder of ocular motility previously reported in Duane's syndrome. PMID- 3631651 TI - Failure to thrive and orocutaneous candidiasis in a 3-month-old female. PMID- 3631652 TI - Humoral immunity in bronchiectasis. AB - Bronchiectasis occurs in patients with immunodeficiency and fungal hypersensitivity disorders. To assess the prevalence of abnormal humoral immune parameters in bronchiectasis, a retrospective study was carried out on sera from 30 patients. Studies included immunoglobulin quantitation and specific antibody to fungal species. Eleven patients were found to have immunodeficiency (nine with panhypoglobulinemia and two with selective IgM deficiency). Six patients had elevations of serum IgA and four patients had elevations of serum IgE. Six patients had elevated total antibody to Aspergillus or Candida species and six had precipitin bands to one or more fungal antigens. This study indicates that immunodeficiency is prevalent and plays a causative role in some patients with bronchiectasis. Hypersensitivity reactions to Aspergillus, Candida, and other ubiquitous environmental fungi may also play an etiopathogenic role in this disease (bronchiectasis, humoral immunity, immunodeficiency). PMID- 3631653 TI - Hypersensitivity reaction to pine nuts (pinon nuts--pignolia). AB - This report describes two patients with allergic reactions due to the ingestion of pine nuts. Skin testing to the aqueous allergen revealed immediate positive prick test reactions suggesting an IgE-mediated response. No reported cases have been found previously in a review of the medical literature. PMID- 3631654 TI - Performance characteristics of immunoenzymatic allergosorbent testing for total and specific immunoglobulin E. AB - Paper disc-based solid phase radioimmunoassays are widely used in vitro diagnostic test kits for measuring total IgE (Phadebas PRIST) and specific IgE antibodies (RAST). Recently, these kits have been modified by the substitution of an enzyme-linked immunosorbent assay detection system (Phadezym PRIST/RAST). We studied the performance characteristics of Phadezym PRIST and RAST kits. Phadezym PRIST was sensitive to 0.5 IU/mL IgE. Reproducibility was excellent in the range of 5 to 200 IU/mL IgE and adequate in the range of 5 to 1000 IU/mL using 1:10 serum dilutions (average inter-assay coefficient of variation = 19%). Phadezym RAST was specific, but sensitivity was limited by absorbances in the RAST class 1/0 range indistinguishable from background values. Average inter-assay coefficient of variation was 29% for the semi-quantitative 'Phadezym RAST Unit' (PRU) reporting system. We modified the test kit procedure by disc incubations in microtiter plate wells with rotational agitation and use of ELISA-dedicated spectrophotometer and computer software. These microplate accelerated computerized assays ('MacPRIST' and 'MacRAST') were shown to perform similarly to the conventional Phadezym procedures with advantages in speed, ease, and handling of data. PMID- 3631655 TI - Effect of an electronic air cleaner and negative ionizer on the population of indoor mold spores. AB - We evaluated the ability of an electrostatic air cleaner and negative ionizer (Bionaire 1000, Biotech Electronics, Ltd) to cleanse indoor air of mold spores. Significant reductions in the number of mold colonies were observed when the air cleaner was operated alone. We found no significant decrease in the circulating amounts of mold spores over baseline with the additional use of the negative ionizer. Though there were day-to-day variations in the numbers of spores, these changes remained significant. PMID- 3631656 TI - Asthma in Thai children: a study of 2000 cases. AB - Two thousand Thai children with asthma were studied prospectively. Boys were more frequently affected than girls, with the ratio of 1.54:1. Fifty percent of patients developed their first attacks within the first 2 years of life. Attacks during the night were common and the seasons in which attacks usually occurred were the winter and the rainy season. Viral respiratory infections were the most common precipitant of attacks. The majority of the cases (61.25%) were moderately severe, while 29.15% of cases were mild and 9.60% of cases were very severe. Among our patients, 32.45% had been hospitalized with asthma and 6.85% had received corticosteroid treatment for asthma. In this study, 63.15% of cases had asthma associated with other allergic diseases, and 79.25% had family history of allergic diseases. Absolute blood eosinophil counts of less than 500 cells/mm3 were found in 39.8% of patients. Positive skin tests to important antigens were noted in 93.7% of cases, and these were house dust, epidermals, house dust mite, molds, weeds, cockroach, grasses, kapok, and foods. PMID- 3631657 TI - Transient chemotactic defect in a child with elevated IgE. AB - Leukocyte function was studied in a child with elevated IgE and many infections. At age 7 months, chemotaxis was decreased, but improved first toward formylated peptides and finally toward complement. Polarization and nitroblue tetrazolium reduction also were transiently impaired. Functional and clinical improvements were concomitant although IgE remained elevated. PMID- 3631658 TI - Survey of airborne pollen and fungal spores at Dehra Dun, India. AB - A survey of airborne pollen and fungal spores was carried out using a gravity settling device at Dehra Dun for two consecutive years (1980-81). The daily, seasonal, and annual variations recorded for the dominant pollen and spore types are analysed in detail. Two distinct peak pollen periods, February-April and August-October, have been recognized although pollen was found present in the atmosphere throughout the year. In contrast, fungal spores did not exhibit any distinct seasonal pattern. July through October has been observed as the period of higher spore catch as compared to other months. Pollen grains of Pinus are recorded as the most dominant type at Dehra Dun followed by Broussonetia, Rosaceae, Poaceae, Debregeasia, Rumex, and Morus. Among fungal types, Cladosporium, Alternaria, smut spores, Curvularia, Ascospores, Nigrospora, Aspergilli/Penicilli, and Epicoccum dominated the atmosphere in order of their prevalence. PMID- 3631659 TI - [Peritoneal dialysis in the treatment of the low cardiac output after extracorporeal circulation]. AB - Low cardiac output after cardiopulmonary bypass is not uncommon. This per- and postoperative cardiac depression is accompanied by an impairment of renal function, which recovers with the improvement of the low cardiac output. These two correlated failures may become resistant to cardiotonic and diuretic drugs. Indeed the fluid balance is strongly disturbed, although venous pressure is only moderately increased. The only possible treatment could be water withdrawal. Nine patients are reported, all suffering from cardiac and renal failure after cardiopulmonary bypass. They were successfully treated with the method of continuous ambulatory peritoneal dialysis. This method allowed us to stop all intravenous cardiac drugs within 36 h, whilst diuresis reappeared together with a better efficacy of diuretic drugs. This beneficial haemodynamic effect of water withdrawal is discussed. This phenomenon may be related to an influence of right ventricular filling on the left ventricle. Low cardiac output may occur as a result of septal displacement, especially if there is concomitant myocardial suffering. Withdrawing a small volume of water may have modified the septal displacement, and improved cardiac output. Continuous ambulatory peritoneal dialysis was simple and well tolerated; it seemed to have contributed to the haemodynamic recovery of all the nine patients. PMID- 3631660 TI - [Effects of flunitrazepam on the baroreflex control of heart rate and on adrenergic activity]. AB - The effects of intravenous flunitrazepam (25 micrograms . kg-1) on the baroreflex control of heart rate and plasma catecholamine levels were determined in ten ASA 1 unpremedicated patients. Plasma concentrations of flunitrazepam were also measured. The data was obtained before and 5, 10 and 15 min after flunitrazepam administration. The baroreflex gain was significantly decreased at 5 min, the time of the highest flunitrazepam plasma concentration. Catecholamine plasma levels were decreased at each study time. It was concluded that flunitrazepam induced a transient depression in baroreflex function and a sustained decrease in adrenergic activity. PMID- 3631662 TI - [The value of monitoring arterial oxygenation saturation by pulse oximetry in neuroleptanalgesia]. AB - Anaesthesia can induce hypoxaemia. Pulse oximetry gives continuous non invasive monitoring of arterial oxygen saturation. No arterial puncture is needed. Ninety four patients were monitored by pulse oximetry during neuroleptanalgesia for colonoscopy. Eighteen patients showed desaturation episodes of less than 90%, eight linked to opioid-induced respiratory depression. In all patients, pulse oximetry gave clinicians an immediate awareness of the incident. Treatment was facilitated. Pulse oximetry made anaesthesia safer. PMID- 3631661 TI - [Ambulatory surgery in pediatrics. The value of caudal anesthesia]. AB - Ambulatory surgery appears to minimize lasting psychological upset in children. Patients must be properly selected. It is essential that the children and their parents should have a visit with an anaesthetist prior to the patient's admission. Laboratory investigations should be prescribed at that time after questioning and examining the patient. Caudal anaesthesia is a useful regional technique for postoperative pain relief in children. Sacral canal puncture is carried out after the induction of general anaesthesia. Only a light state of general anaesthesia is required. The local anaesthetic mixture is made of equal volumes of 1% lidocaine and 0.5% bupivacaine without adrenaline. Rapid awakening, early feeding and pain relief increase reliability and comfort. PMID- 3631663 TI - [Pulse oximeter. Clinical assessment in the recovery room]. AB - Fifty unselected recovery room patients were monitored using a Nellcor N101 pulse oximeter. Non invasive SaO2 values were compared with simultaneous spectrophotometric measurements made on arterial blood samples (Co-oximeter). Mean pulse oximeter SaO2 was 86.9 +/- 6.08%, with extreme values of 68 and 95.5%. Arterial blood SaO2 was 91.25 +/- 6.28%, with extreme values of 66 and 100%. Linear regression analysis showed a good correlation between the two sets of measures (r = 0.97; p less than 0.005). Twenty one patients had a SaO2 below 90% (mean: 84.83 +/- 5.93%); their measured arterial SaO2 was of 86.14 +/- 6.32%. The correlation between the two sets of low values was good (r = 0.96; p less than 0.05). Pulse oximetry was a non invasive reliable method, but there were some limits to its clinical use. Hypothermia or shock vasoconstriction precluded the measurement of SaO2. Restlessness or shivering were responsible of probe dysfunction and false alarms. False SaO2 readings may result from high levels of carboxyhaemoglobin or dye infusion. Also, each disposable finger probe was reused for a mean of five patients, its cost being relatively high (170 FF, i.e. 28.3 US dollars). PMID- 3631664 TI - [Laryngospasm and pulmonary edema]. PMID- 3631665 TI - [Anesthetic equipment in hospitals]. PMID- 3631666 TI - Bacteriology of the freshwater environment: implications for clinical therapy. AB - Water and animal tissue samples were obtained from sources in Tennessee, California, and Florida. Purified bacterial colonies were isolated and organisms identified. Fifty-eight isolates were recovered. Twenty-seven Gram-negative isolates were identified. Gram-positive organisms were of the coryneform group or Bacillus species. Antibiotic susceptibility testing showed that Aeromonas species were relatively resistant to a wide variety of antimicrobials, which included trimethoprim, cefazolin, and ampicillin. Antibiotics effective against more than 90% of Gram-negative isolates included ciprofloxacin, imipenem, ceftazidime, and trimethoprim-sulfamethoxazole. Freshwater Gram-positive organisms did not display any unexpected susceptibility features. Recommendation for treatment are based on sensitivity in culture and the potentially serious nature of infections caused by Aeromonas species. PMID- 3631667 TI - Cardiovascular responses to face immersion (the diving reflex) in human beings after alcohol consumption. AB - The diving reflex is a complex cardiovascular-respiratory response to immersion. This multireflex response in animals consists of apnea; bradycardia (the experimental parameter most often measured); peripheral vasoconstriction (resulting in preferential perfusion of the brain and heart); decreased cardiac output (with a maintained or increased stroke volume); and an increase in mean arterial blood pressure. These cardiovascular alterations act in a manner that conserves oxygen for the heart and brain. Because alcohol is often involved in water accidents with associated submersions, these initial experiments dealt with human volunteers who consumed alcohol to a blood level of 0.1 g% (legal level of intoxication). The diving reflex was elicited before and after alcohol consumption. Heart rate, blood pressure, and cardiac output were measured before, during, and after face immersion in 4 C water. In the sober state, immersion decreased heart rate, increased stroke volume, increased blood pressure, and increased total peripheral resistance. In comparison to the sober state, alcohol consumption increased pre-immersion heart rate, but did not significantly alter pre-immersion blood pressure or stroke volume. Following alcohol consumption, facial immersion decreased heart rate, but not to the same low rate as in the sober state. Alcohol consumption also evoked a lesser increase in blood pressure and failed to increase stroke volume significantly. PMID- 3631668 TI - Human studies concerning thermal-induced shivering, postoperative "shivering," and cold-induced vasodilation. AB - Human reaction to cold stress and hypothermia involves shivering. Another form of overt shaking, postoperative shivering, has been attributed as a thermoregulatory response to postoperative hypothermia. Analysis of the normal human shivering pattern showed a synchronized, slow amplitude modulation (six to eight cycles/min) over all muscles sampled. In addition, there was a frequency of 8 to 10 Hz associated with each low-frequency amplitude modulation. EMG signals from postoperative patients revealed none of the major patterns seen in thermal induced shivering. Cold-induced vasodilation also was studied and found to occur simultaneously in all cold-stressed fingers regardless of size or innervation. Thermal shivering and cold-induced vasodilation are considered to be manifestations of central neural oscillators. PMID- 3631669 TI - Multicenter hypothermia survey. AB - A multicenter survey evaluated the clinical presentation, treatment, and outcome of accidental hypothermia. Data were collected from 13 emergency departments, with 401 of the 428 cases presenting during a two-year study period. Core temperatures ranged from 35 C to 15.6 C (mean, 30.57 C +/- 3.53) with 272 cases (63.6%) less than or equal to 32.2 C. There were no significant differences by age in presenting temperature, rewarming strategies, or mortality. The first hour rewarming rate was significantly (P less than .05) faster in the population less than or equal to 59 years (1.08 +/- 1.39 C/hr) than in those greater than or equal to 60 years (0.75 +/- 1.16 C/hr). Male core temperatures averaged 30.27 +/- 3.44 C versus female temperatures of 31.1 +/- 3.61 C. There were no clinically significant differences in male (N = 296) versus female (N = 132) profiles. High ethanol levels (315 to 800 mg%) did not affect outcome. Nine of 27 (33%) patients who received CPR initiated in the field survived, versus six of 14 (43%) with CPR begun in the ED. The profile of the CPR versus non-CPR population differed significantly (P less than .05) in location (outdoors), initial temperature (24.8 +/- 3.77 C vs 30.94 +/- 3.12 C), third-hour rewarming rate (2.28 +/- 1.53 C vs 1.17 +/- 1.18 C/hr), and numerous laboratory parameters. Tracheal intubation was performed without incident in 117 cases, of which 97 were less than or equal to 32.2 C. There were 73 fatalities (17.1%). Of these, 84.9% (N = 62) were less than or equal to 32.2 C. Predisposing conditions in this group included "serious" illness (30), systemic infection (28), trauma (15), immersion (ten), frostbite (seven), and overdose (two). The initial pulse, hemoglobin, and first-hour rewarming rate was lower in the deceased population, while the potassium, urea nitrogen, creatinine, and phosphorus were elevated. Excluding treatment combinations, outcome with exclusive use of a single rewarming strategy was passive external rewarming, 14 deaths below 32.2 C, 13 above; active external rewarming, six deaths below 32.2 C, two above; active core rewarming, 38 deaths below 32.2 C, none above. Refinements of the American Heart Association's CPR standards in hypothermia and a Hypothermia Survival Index are proposed. PMID- 3631670 TI - Experimental and clinical observations on frostbite. AB - Experimental ischemia by the classic frostbite rabbit ear model clearly defined the role of thromboxane as a mediator of progressive dermal ischemia in frostbite injuries. The therapeutic groups consisted of the antiprostanoids, methylprednisolone, and aspirin combined with anti-thromboxane agents Aloe vera and methimazole, while the control group received no therapy. Survival was measured by planimetry for all groups. No tissue survival was evident in the frostbite control group. Methimazole treatment allowed 34.3% survival, Aloe vera 28.2% survival, aspirin 22.5% survival, and methylprednisolone 17.5% survival. The data compare the results of a modified frostbite protocol using ibuprofen with therapeutic modalities used by other clinical services. Of 154 patients treated for frostbite from 1982 to 1985, 56 were treated with our frostbite protocol; 98 were treated with other modalities. Of the 56 protocol patients, 18 suffered 1st degree frostbite, 25, 2nd degree frostbite, and 13, 3rd degree frostbite. For all degrees of frostbite, 67.9% healed without tissue loss, 25.0% healed with partial tissue loss, and 7% required amputation (P less than .001). Of the patients not on protocol, 11 suffered 1st degree frostbite, 51, 2nd degree frostbite, and 36, 3rd degree frostbite. Of these, 32.7% healed without tissue loss, 34.6% healed with tissue loss, and 32.7% required amputation. The morbidity of progressive dermal ischemia in frostbite may be decreased by the therapeutic use of inhibitors of the arachidonic acid cascade. PMID- 3631671 TI - The National Weather Service warning system. AB - The National Weather Service (NWS) is the federal agency solely responsible for issuing weather forecasts and warnings of weather hazards. Additional facets of NWS operations that pertain to public safety are dissemination of weather warnings, weather hazard awareness, and the weather preparedness program. These are interrelated to form a successful warning program. NWS field operations encompass many types of atmospheric phenomena, each requiring different action in order to protect life and property. The NWS weather forecast and warning program is of little value if local officials or citizens are unprepared to take necessary precautions. Many deaths and serious injuries that occur due to hazardous weather are preventable. Although the weather-related death toll has decreased significantly since the 1960s, the potential for catastrophic loss of life remains in many areas of the United States. An excellent preparedness/awareness program can minimize the possibility of loss of life. PMID- 3631672 TI - The role of the epidemiologist in natural disasters. AB - Natural disasters continue to be a major cause of morbidity and mortality. Natural disaster epidemiology has led not only to the scientific measurement and description of disaster-associated health effects, but also to strategies for preventing adverse health consequences and improving post-impact health care delivery. Results of epidemiologic studies of natural disasters provide clues to diagnosis, help medical care providers match resources to needs, and permit better contingency planning. Well-documented medical records are an essential resource for disaster epidemiologists. Cooperation between health care personnel and epidemiologists can help lessen the public health impacts of natural disasters. PMID- 3631673 TI - Catastrophic disasters and the design of disaster medical care systems. AB - The National Disaster Medical System (NDMS) is aimed at medical care needs resulting from catastrophic earthquakes, which may cause thousands of deaths and injuries. Other geophysical events may cause great mortality, but leave few injured survivors. Weather incidents, technological disasters, and common mass casualty incidents cause much less mortality and morbidity. Catastrophic disasters overwhelm the local medical care system. Supplemental care is provided by disaster relief forces; this care should be adapted to prevalent types of injuries. Most care should be provided at the disaster scene through supplemental medical facilities, while some can be provided by evacuating patients to distant hospitals. Medical response teams capable of stabilizing, sorting, and holding victims should staff supplemental medical facilities. The NDMS program includes hospital facilities, evacuation assets, and medical response teams. The structure and capabilities of these elements are determined by the medical care needs of the catastrophic disaster situation. PMID- 3631674 TI - Acetaminophen levels. PMID- 3631675 TI - Varicella pneumonia in adulthood: acyclovir therapy may be of benefit. PMID- 3631676 TI - Cervical immobilization collars. PMID- 3631677 TI - Myoglobin latex agglutination test. PMID- 3631678 TI - Proceedings of the 1987 UAEM/IRIEM research symposium on environmental emergencies. University Association for Emergency Medicine/International Research Institute for Emergency Medicine. PMID- 3631679 TI - Symposium on environmental emergencies. Envenomations and toxinology. PMID- 3631680 TI - Past, present, and future immunotherapy of snake venom poisoning. AB - Management of snake venom poisoning with antivenin has been the time-proven and medically accepted standard in virtually every country, including the United States. All antivenins are equine in source, and administration to patients exposes them to all the adverse effects of heterologous antisera. The purity and specificity of neutralizing antibody titers in antivenin products vary among manufacturers. Research in the early 1980s demonstrated that immunosorbent affinity chromatography could purify a highly specific IgG(T) from equine hyperimmune antisera. This IgG(T) provided superior efficacy and reduced adverse effects as compared to commercial antivenin. The advent of newer biotechnical processes has now opened the doors for novel antibody and antibody fragment treatment of snake venom poisoning. PMID- 3631681 TI - The diagnosis and treatment of brown recluse spider bites. AB - We reviewed our experience with 95 patients who carried the diagnosis of brown recluse spider bite between 1983 and 1986 and identified a reference group of 17 with confirmed bites. Eight men and seven women, average age 32 years, presented within 33 hours following the bites. The most common symptoms were pain, pruritus, malaise, chills, sweats, and rash. Patients were randomized into three treatment groups: dapsone, brown recluse spider antivenom, or combination therapy. All patients were treated with erythromycin. If two patients with very severe lesions were excluded, patients in all groups healed their wounds in an average of 20 days. A comparison of our treatment was attempted with all other bites previously confirmed in the literature, but historical data were incomplete and no conclusions could be drawn. PMID- 3631682 TI - Differential diagnosis of poisoning by North American mushrooms, with particular emphasis on Amanita phalloides-like intoxication. AB - It is possible to determine the management and prognosis of mushroom poisoning from the history and initial symptoms with a high degree of confidence. The most important intoxications are those involving Amanita phalloides or other potentially fatal amatoxin-containing mushrooms, which have a latent period of ten to 12 hours before the patient becomes symptomatic. Because aggressive gastroenteric decontamination can reduce the extent of hepatic damage, it is important to attempt to determine during this asymptomatic period whether amatoxin exposure has occurred. Various laboratory methods that might be useful are reviewed. PMID- 3631683 TI - Actinobacillus suis-like organisms in horses. AB - Actinobacillus suis-like organisms have been recognized in equine specimens at the University of California Veterinary Medical Teaching Hospital since 1975. The most common source (65%) of the organism was transtracheal washings. The organism was gram-negative, produced hemolysis on blood agar, and gave a positive reaction for oxidase, urease, o-nitrophenyl-beta-D-galactopyranoside, and esculin. Carbohydrate reactions were variable, consisting of 4 main patterns. Actinobacillus suis-like organisms were (90%) sensitive to therapeutic concentrations of amikacin, cephalothin, chloramphenicol, gentamicin, kanamycin, tetracycline, and trimethoprim-sulfamethoxazole. Other aerobic and anaerobic bacteria were recovered frequently with the organism. PMID- 3631684 TI - Isolation of Cache Valley virus and detection of antibody for selected arboviruses in Michigan horses in 1980. AB - Blood samples collected in September and November 1980 from 87 horses in southwestern Michigan were examined for virus isolation and for plaque-reduction neutralizing antibody against selected arboviruses. Cache Valley virus was isolated from the blood of a clinically normal horse in St Joseph County in September. The age-specific antibody prevalence for Cache Valley virus indicated enzootic transmission in the study area. The high antibody prevalence and the lack of age-specific antibody prevalence indicated sporadic, but intense, exposure to Jamestown Canyon virus. Low prevalences of antibody were detected for Highlands J, snowshoe hare, St Louis encephalitis, and trivittatus viruses. PMID- 3631685 TI - Pathogenicity and immunogenicity of a mutagen-attenuated Rift Valley fever virus immunogen in pregnant ewes. AB - A mutagenized clone of Rift Valley fever virus (RVFV; MV P12) used in inoculation of 3 pregnant ewes was immunogenic, nonpathogenic, and nonabortogenic. In contrast, inoculation of a matched group of 3 pregnant ewes with parent RVFV induced clinical disease and abortions. Ewes given MV P12 delivered healthy lambs that had RVFV antibody titers of less than 1:10 at birth, increasing to greater than or equal to 1:80 after ingestion of colostrum. Ewes inoculated with parent RVFV developed marked viremia, followed by RVFV antibody titers greater than or equal to 1:1,280; ewes inoculated with MV P12 developed low viremia titers and RVFV antibody titers of 1:80 to 1:320. Postpartum challenge exposure of the previously MV P12-inoculated ewes with virulent Zagazig human 501 strain RVFV indicated that the ewes were protected from clinical disease. The RVFV susceptible female Culex pipiens that fed on the MV P12-inoculated ewes failed to transmit RVFV to hamsters; mosquitoes that fed on the parent RVFV-inoculated ewes became infected and transmitted RVFV to hamsters. PMID- 3631686 TI - Ceftiofur sodium, a broad-spectrum cephalosporin: evaluation in vitro and in vivo in mice. AB - Ceftiofur sodium, a broad-spectrum beta-lactamase-resistant cephalosporin, was evaluated in vitro and in vivo in mice. Ceftiofur is the sodium salt of (6R, 7R) 7[( 2-amino-4-thiazolyl)-Z- (methoxyimino)acetyl]amino)-3-[( (2 furanylcarbonyl)thio]methyl)-8-oxo-5- thia-1-azabicyclo-[4.2.0]oct-2-ene-2 carboxylate. Minimal inhibitory concentration values were obtained with 264 strains representing 9 genera and 17 species of bacterial pathogens from cattle, swine, sheep, horses, poultry, dogs, cats, and human beings. Ceftiofur was more active than was ampicillin against all strains tested including beta-lactamase producing organisms. In mice with systemic infections, ceftiofur was more active than or equivalent to ampicillin, cephalothin, cefamandole, cloxacillin, cefoperazone, or pirlimycin. These protection tests included infections with Escherichia coli, Haemophilus pleuropneumoniae, H somnus, Pasteurella haemolytica, P multocida, Salmonella typhimurium, or Staphylococcus aureus. In infant mice with E coli-induced lethal diarrhea and in mice with S aureus and E coli-induced mastitis, ceftiofur was comparable or more active than was ampicillin. PMID- 3631688 TI - In vitro immune serum-mediated protection of pig monocytes against African swine fever virus. AB - Serum samples from pigs that had recovered from infection with a Dominican Republic isolate of African swine fever virus (ASFV) were mixed with dilutions of the virus, then assayed in microcultures of normal pig mononuclear leukocytes to determine whether the samples contained antibodies that protected monocytes against the virus. Protection was determined by the difference in titer (log10) between virus mixed with healthy pig serum and virus mixed with immune pig serum, using 50% cytopathogenic effect end points; protection was expressed as an immune serum-protection index. After addition of virus-serum mixtures to mononuclear leukocyte microcultures, a time-dependent decrease in protective index and production of infectious virus (determined by use of yield reduction assays) were observed. Protective effects were associated with the immunoglobulin fraction of serum, were rapidly lost on dilution, and were independent of complement. Antibody was most protective for the homologous Dominican Republic isolate of ASFV, with decreased protection against Lisbon '60 ASFV, and no protection against foot-and-mouth disease virus or bluetongue virus. Low concentrations of protective antibody were found during the acute viremic phase in infected pigs; antibody increased to maximal concentrations as the viremia decreased. PMID- 3631687 TI - Rhinitis, pneumonia, and defective neutrophil function in the Doberman pinscher. AB - Eight closely related Doberman Pinschers with chronic rhinitis and pneumonia had normal or increased numbers of structurally normal leukocytes. Serum concentrations of immunoglobulins and complement were above or within normal ranges. Lymphocyte transformation indices for 3 mitogens were normal in 7 of the 8 dogs; the remaining dog had low values for all mitogens. Neutrophils phagocytized bacteria normally, but had impaired bactericidal ability. The bactericidal defect may have been related to the inability of neutrophils to generate normal numbers of oxygen radicals after stimulation, as determined by decreased ability of neutrophils to reduce nitroblue tetrazolium and to produce superoxide following opsonized zymosan stimulation. These observations, plus finding chronic inflammatory disease in the lungs of one dog, indicated that the disease may have some similarity to chronic granulomatous disease or to complement receptor deficiency in man. PMID- 3631689 TI - Conjunctival and intramuscular vaccination of pigs with a live avirulent strain of Salmonella cholerae-suis. AB - An avirulent mutant strain of Salmonella cholerae-suis was cloned for resistance to streptomycin and nalidixic acid. The mutant strain 33-13 also was used because of its avirulence and immunogenicity in mice. Weaned pigs were vaccinated with live strain 33-13; 5 pigs were vaccinated by conjunctivally administered 5.5 X 10(7) organisms (low dose), 5 were conjunctivally administered 5.5 X 10(9) organisms (high dose), and 5 pigs were administered 5.5 X 10(9) organisms (high dose) IM. Transient fever and transient fecal shedding of the vaccine strain developed in pigs vaccinated IM, but not in 2 groups of pigs vaccinated conjunctivally. After intratracheal administration of virulent strain 38-9, nonvaccinated control pigs (n = 9) developed persistent high fever, anorexia, bacteremia, diarrhea, and fecal shedding of strain 38-9, whereas vaccinated pigs remained afebrile and clinically normal. Nonvaccinated and uninfected sentinel pigs (n = 8) were kept in units of 2 pigs with each group of experimental pigs, and remained healthy throughout the experiment. Thirteen vaccinated and 7 nonvaccinated control pigs were killed 42 days after vaccination, and 2 vaccinated, 2 nonvaccinated, and 8 sentinel control pigs were killed 58 days after vaccination. Ten organs were evaluated by quantitative bacteriology on necropsy of all pigs for the presence of vaccine strain 33-13, and for virulent strain 38-9. Strain 33-13 was not found. Lung and liver, lesions were found in most of the nonvaccinated control pigs, with a high frequency of recovery of large numbers of strain 38-9 from the mesenteric lymph nodes, lungs, liver, and ileum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631690 TI - Dental dolorimetry for the evaluation of an analgesic agent in the horse. AB - A monopolar electrode was implanted surgically in the canine tooth dentine layer to evaluate pain threshold responses of horses. A constant-current stimulator was used to deliver a known electrical current to the tooth pulp nerve. A single stimulus of 2-ms duration, repeated at greater than or equal to 20-s intervals, was used to elicit a head lift response. The lowest current level that produced 3 positive head lift responses was recorded as the pain threshold of the horse. The testing technique, dental dolorimetry, was easily performed. Tooth pulp pain thresholds (TPPT) were established on 8 nonmedicated adult male horses. Electrodes were nonreactive and remained functional for up to 98 days. Base-line TPPT values were consistent with repeated measurements on the same day and measurements on subsequent test days. The quantity of electrical current necessary to elicit the TPPT was increased after administration of xylazine HCl as a test analgesic. PMID- 3631691 TI - Comparative analgesia of xylazine, xylazine/morphine, xylazine/butorphanol, and xylazine/nalbuphine in the horse, using dental dolorimetry. AB - Xylazine, morphine, butorphanol, and nalbuphine were evaluated in 5 adult male horses, using dental dolorimetry. Comparisons were made at 30, 60, and 100 minutes after IV drug administration. Peak analgesia and the time to develop peak analgesia also were compared. Xylazine induced a marked increase in the tooth pulp pain threshold measurements as did the xylazine/narcotic combinations. Statistical differences were not detectable between these treatments. Xylazine and xylazine/butorphanol were better analgesics than was butorphanol alone at 30 and 60 minutes. Xylazine resulted in peak analgesia faster than did butorphanol or the combination of xylazine/butorphanol. Additive analgesic effects were not detected with the combined treatments. PMID- 3631692 TI - Plasma lidocaine concentrations in conscious horses after cervicothoracic (stellate) ganglion block with 1% lidocaine HCl solution. AB - Arterial and/or central venous plasma concentrations of lidocaine were determined in 12 nonmedicated adult horses (422 +/- 59 kg of body weight, mean +/- SD) after injecting a 1% lidocaine HCl solution into the cervicothoracic ganglion (CTG). A mean dosage of 2.9 +/- 0.5 mg of lidocaine/kg of body weight was used to induce unilateral CTG blockade in 8 horses and 4.8 +/- 0.8 mg was used to induce bilateral CTG blockade in 4 horses. Blood samples were collected before and at 5, 15, 30, 45, 60, 75, 90, 105, and 120 minutes after injection. The plasma lidocaine concentrations were determined by use of gas chromatography (sensitivity less than 0.01 microgram/ml). Cervicothoracic sympathetic blockade was characterized by Horner's syndrome and by profuse sweating over the face, neck, and thoracic limbs. Mean maximal venous concentrations of lidocaine were 0.86 +/- 0.33 microgram/ml at 26.3 +/- 6.9 minutes after unilateral CTG blockade, and 1.14 +/- 0.25 micrograms/ml at 31.2 +/- 18.9 minutes after bilateral CTG blockade. The mean venous and arterial concentrations of lidocaine were not significantly different at 45 and 120 minutes after injection. Venous concentrations of lidocaine were consistently higher than were concentrations in simultaneously collected arterial blood samples in 2 horses in which the right CTG and brachial plexus were temporarily anesthetized after repeated administration of 100 ml of lidocaine into the right CTG.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631693 TI - Posologic evaluation of clindamycin, using a canine model of posttraumatic osteomyelitis. AB - Posttraumatic osteomyelitis attributable to Staphylococcus aureus infection was experimentally induced in 30 dogs, after which the dogs were treated with clindamycin at various dosage regimens. Of the regimens evaluated, oral administration of 11 mg of clindamycin/kg of body weight twice daily for 28 days was the most effective treatment for the osteomyelitis. PMID- 3631694 TI - Effects of collection time and food consumption on the urine protein/creatinine ratio in the dog. AB - Effects of collection time and food consumption on the variability of the urine protein/creatinine ratio were determined in 10 healthy dogs. In trial 1, dogs were fasted for 12 hours, and urine specimens were obtained by bladder catheterization every 2 hours over an 8-hour collection period during the day. After a 1-week rest, the dogs were entered into trial 2. Dogs were fed at least 60 kcal of a high protein meal/kg of body weight, and urine specimens were obtained every 2 hours over an 8-hour period during the day. Urine total protein and urine creatinine concentrations and the urine protein/creatinine ratio were determined for each urine specimen obtained. Friedman's 2-way analysis by ranks was used to determine the constancy of this ratio over the 4 periods in the 2 trials (fasted and fed). There was no significant variability (P greater than 0.05) in ratios over the 8-hour collection periods in the fasted or fed trial. Feeding did not significantly alter this ratio, because there was no significant difference (P greater than 0.05) in the urine protein/creatinine ratios of the dogs when they were fasted, compared with those of the dogs when they were fed. Seemingly, urine specimens obtained anytime during the day from dogs in both trials (fasted and fed) reflected the urine protein/creatinine ratio. PMID- 3631695 TI - Effects of dexamethasone, levamisole, and dexamethasone-levamisole combination on neutrophil function in female goats. AB - Effects of dexamethasone, levamisole, or combined dexamethasone-levamisole administration on polymorphonuclear neutrophil (PMN) function in healthy, adult female goats were studied. Goats were assigned to treated (n = 6) and control (n = 6) groups. In experiment 1, treated goats were given levamisole (6 mg/kg of body weight, IM). In experiment 2, treated goats were given 0.1 mg of dexamethasone/kg, IV, for 3 consecutive days, 1 mg of dexamethasone/kg, IV, for 6 consecutive days, and 6 mg of levamisole/kg, IM, with a 4th injection of 1 mg of dexamethasone/kg. All injections were administered 12 hours before blood collection. The PMN were evaluated for random migration and chemotaxis under agarose, ingestion of Staphylococcus aureus, cytochrome C reduction, iodination, and antibody-dependent cell-mediated cytotoxicity. Levamisole alone did not alter the function of caprine PMN. Both doses of dexamethasone caused increased random migration and decreased cytochrome C reduction and iodination. Dexamethasone resulted in no changes in chemotaxis, S aureus ingestion, and antibody-dependent cell-mediated cytotoxicity. Random migration and cytochrome C reduction returned toward base line in cells from dexamethasone and levamisole-treated goats. Although iodination activity in cells from dexamethasone-treated goats remained significantly (P less than 0.05) lower than those of controls after levamisole administration, a rebound toward base-line activity occurred. PMID- 3631696 TI - In vitro calibration and surgical implantation of electromagnetic blood flow transducers for measurement of left coronary blood flow and cardiac output in the pony. AB - Electromagnetic flow transducers were implanted via left thoracotomy in 8 ponies (122.7 to 263.6 kg) around the main pulmonary and left main coronary arteries for continuous measurement of mean and pulsatile blood flow. Flow transducers were calibrated in vitro with a gravity flow system. The mean +/- SE pulmonary flow was 73.1 +/- 5.1 ml/kg of body weight/min. Left coronary flow was 0.95 +/- 0.07 ml/kg/min (1.3% of cardiac output) and was not believed to be an accurate measurement. This was caused by the inability to implant a zero-flow occluder, requiring the use of minimum flow during systole as zero-flow base line. However, relative changes in left coronary flow were measured. Ponies were maintained up to 5 weeks with no adverse effects. Measurement of mean pulmonary flow with chronically implanted electromagnetic flow transducers provided an accurate continuous measurement of cardiac output with a minimum of restraint. PMID- 3631697 TI - Technique for repeated collection of blood that has just perfused the pineal gland of sheep. AB - A long catheter was inserted into the superior sagittal sinus of sheep and was maneuvered to the level of the rectus sinus. The catheter was then secured to the head, neck, and shoulder of the animal. The distal end of the catheter was connected to a 3-way valve through which blood samples were collected and heparin was injected. Blood loss during surgery was minimal; recovery was quick and complete. The simple surgical technique enabled the collection of blood that has just perfused the pineal gland. PMID- 3631698 TI - An antegrade surgical uterine flush technique for ova collection in the ewe. AB - A surgical uterine flush technique was evaluated for percentage of ova/corpora lutea (CL) collected and development of reproductive adhesions in 79 superovulated ewes. The median collection rate for ova/CL was 70%, and 47 of 79 ewes had greater than or equal to 67% ova/CL. At 50 to 80 days after uterine flushing, celiotomies were performed on 50 of the 79 ewes to evaluate the reproductive tract for adhesions. Adhesions of the reproductive tract were not found. Thirty ewes were given prostaglandin F2 alpha, were mated, and became pregnant. The ova collection rates were comparable with rates reported in ewes in which oviductal flush methods were used; however, adhesions did not develop and reproductive function was maintained after surgery. PMID- 3631699 TI - Immunoglobulin M-specific enzyme-linked immunosorbent assay for serodiagnosis of bovine respiratory syncytial virus infections. AB - An antibody-capture enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin (Ig) M antibodies to bovine respiratory syncytial virus (BRSV) in cattle was developed. Monoclonal antibody to bovine IgM was used as the catching antibody. The IgM-ELISA was used, as well as a BRSV-specific IgG ELISA to determine the kinetics of IgM and IgG antibody responses to BRSV infections in cattle. High IgM and IgG antibody titers developed after naturally occurring or induced BRSV infection of calves (6 to 7 months old). Induced infection resulted in an IgM response that was first detectable at postinoculation day (PID) 11 reached a maximum at PID 13, and became undetectable again about PID 28. An IgG response also was detected by PID 11. However, a maximum response was not reached before PID 23, and titers remained high (until PID 80). In naturally occurring infection, IgM and IgG responses in calves were observed in the acute phase of epizootics of respiratory tract disease. Patterns of IgM and IgG response curves were similar to those observed in experimentally infected calves. The involvement of BRSV in an epizootic of respiratory tract disease in 8 calves (2 to 3 weeks old) was demonstrated by the detection of BRSV in several lung lavage samples. All calves had existing IgG antibodies to BRSV which were interpreted to be maternally derived. None of the calves responded with an increase in IgG antibody titer. However, a weak but distinct BRSV IgM antibody response occurred in 6 calves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631700 TI - Enzyme-linked immunosorbent assay for detection of antibodies to Rift Valley fever virus in ovine and bovine sera. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the rapid detection of antibodies to Rift Valley fever virus (RVFV) in ovine and bovine sera. Conditions to reduce nonspecific reactions were optimized. The ELISA results correlated with those of a plaque-reduction neutralization test, revealing 100% specificity and 90.7% sensitivity. In sera from sheep and cattle inoculated against RVFV, the hemagglutination-inhibition test in combination with the ELISA provided a better indication of response to killed RVFV vaccine than did either test alone. PMID- 3631701 TI - In vitro platelet release by rat megakaryocytes: effect of metabolic inhibitors and cytoskeletal disrupting agents. AB - Development of an in vitro visual assay facilitated the study of large numbers of megakaryocytes undergoing proplatelet formation in short-term cultures. Approximately 9% of megakaryocytes formed platelets during a 24-hour period. In the presence of an inhibitor of anaerobic glycolysis (NaF), proplatelet formation was inhibited, whereas inhibitors of respiration (NaCN) did not significantly (P greater than 0.05) decrease proplatelet formation. Presence of the microtubule disrupting agents colchicine and vincristine sulfate in culture medium inhibited proplatelet formation, whereas the microfilament-disrupting agent cytochalasin B had a less pronounced inhibition. PMID- 3631702 TI - In vitro platelet release by rat megakaryocytes: effect of heterologous antiplatelet serum. AB - A visual assay to study megakaryocyte platelet release via proplatelet formation in vitro was established. Samples of megakaryocyte-enriched rat bone marrow were incubated (37 C) in RPMI-1640 medium with 15% autologous serum in specially prepared chambers. In the culture system, approximately 6% of megakaryocytes formed proplatelet processes within 24 hours. Inclusion of a heterologous antiplatelet antibody in the culture system inhibited proplatelet formation, compared with that in controls. PMID- 3631703 TI - Neurophysiologic maps of cutaneous innervation of the external genitalia of the ram. AB - The area of skin innervated by the afferent fibers in a peripheral nerve is called the cutaneous area (CA) of that nerve. Mapping of those areas that were responsive to movement of wool/hairs in the genital region of 18 anesthetized rams, combined with subsequent identification of spinal nerves and dissection of the pudendal nerve plexus, indicated considerable differences in the extent of the CA and the origins of cutaneous branches from the pudendal plexus. The CA of the proximal and distal cutaneous branches of the pudendal nerve (or plexus) overlapped craniocaudally by approximately one-half, and the latter included most of the skin of the ipsilateral half of the scrotum. The CA of the deep perineal and caudal rectal nerves lay immediately adjacent to the anus. The CA of the scrotal branches of the pudendal nerve were restricted primarily to the scrotum. Fascicles in the dorsal nerve of the penis irregularly supplied CA along the length of the prepuce and consistently supplied the cranial free end of the prepuce. The CA of the ventral cutaneous branches of the caudal thoracic spinal nerves, the first 2 or 3 lumbar spinal nerves, and the genitofemoral nerve extended to the midline of the prepuce. Overlapping of CA was extensive, especially on the prepuce. PMID- 3631704 TI - Fascioliasis in cattle in Louisiana: development of a system to predict disease risk by climate, using the Thornthwaite water budget. AB - A system correlating climate with the annual risk of fascioliasis in cattle in central Louisiana was developed, using the Thornthwaite water budget and a 6-year data base that included records on herd prevalence rates, transmission to fluke free sentinel calves, and snail population dynamics. The system developed was compared with modifications of the wet-day and Mt forecasting systems previously developed for use in the oceanic climate zone of western Europe. The wet-day system correlated poorly with transmission data, whereas the Mt and Thornthwaite water budget-derived systems correctly ranked 5 of the 6 years in terms of annual numbers of flukes transmitted to sentinel calves. Compared with the Mt system, the water budget-based system more closely correlated with transmission data, on the basis of statistical regression analysis. The water budget system was calculated by use of a microcomputer software program, and provided a means of measuring the effect of moisture stress and flooding in snail habitats that serve as foci of transmission of Fasciola hepatica to cattle on pastures. PMID- 3631705 TI - Methionine toxicosis in cats. PMID- 3631706 TI - Evaluation of granulocyte transfusion in healthy neonatal pony foals. AB - Granulocyte transfusions (GT), 0.98 X 10(9) neutrophils/kg of body weight, were performed on 7 healthy pony foals between 2 and 7 days old. The mean neutrophil count of the foals was significantly (P less than 0.05) greater than base line (4,830 +/- 1,260/microliter) 1 hour after GT (8,870 +/- 3,350/microliter) and was similar to base line by 15 to 18 hours after GT (6,550 +/- 2,310/microliter). Leukocyte concentrates (LC) used for GT were harvested from clinically normal adult horses by continuous-flow centrifugation leukapheresis (CL), 3 to 6 hours after hydrocortisone sodium succinate was administered to increase the blood neutrophil count. The mean neutrophil count of the LC used for GT was 68,050 +/- 13,990/microliter, and the mean LC volume was 377.4 +/- 79.2 ml (14.82 +/- 3.54 ml/kg). The mean time required to collect the LC used for GT was 232.1 +/- 73.4 minutes. Neutrophils from LC had significantly reduced in vitro stimulated migration to zymosan-activated serum, when compared with peripheral blood neutrophils of the donors (P less than 0.05). Neutrophil phagocytosis and bactericidal capacity were not significantly changed in LC. Mean neutrophil migration indices were not significantly different in foals after GT. Mild depression and transient diarrhea was noticed in 1 foal 30 minutes after the start of the GT. The donor of LC for this foal and 1 other donor experienced depression, piloerection, and muscle tremors during CL, indicating that complement had been activated. Problems were eliminated by the use of new disposable plastic materials for blood processing in each CL procedure. PMID- 3631707 TI - Evaluation of an antigenic fraction of Taenia hydatigena metacestode cyst fluid for immunodiagnosis of bovine cysticercosis. AB - An antigenic fraction (ThFAS) isolated from Taenia hydatigena metacestode cyst fluid was used in an ELISA to detect antibodies to T saginata in experimentally and naturally infected cattle. In 10 calves given 1,000 to 100,000 T saginata eggs (20% to 60% viability), IgG and IgM antibodies were detected in all the calves by post-inoculation week 3. Immunoglobulin G antibody values remained increased until calves were slaughtered at post-inoculation weeks 13 to 26. Six naturally infected calves (determined by postmortem examination) were considered positive, using the ELISA. Shared antigens were demonstrated between ThFAS and T saginata and T crassiceps; there were no shared antigens between ThFAS and Haemonchus contortus or Fasciola hepatica. Specific lectin binding to ThFAS indicated the presence of glycoconjugates. Immunoblot analysis indicated that a low molecular weight polypeptide (10,000 Mr) bears the immunodiagnostic antigen. PMID- 3631708 TI - Concentrations of carnitine in the seminal fluid of normospermic, vasectomized, and castrated dogs. AB - Concentrations of total carnitine (free and esterified) were determined in seminal fluids from 12 normospermic dogs before treatment and from the same 12 dogs after assignment to control, vasectomized, or castrated treatment groups (4 dogs each). Before treatment, the mean concentration (+/- SD) of carnitine in seminal fluid was 946 +/- 345 nmol/ml and was not significantly different (P greater than 0.05) among groups on any seminal collection day. After surgery, mean concentrations of carnitine in seminal fluid from vasectomized and castrated dogs were 49 +/- 9 and 14 +/- 5 nmol/ml, respectively and were lower (P less than 0.001) than the mean concentration in control (sexually intact) dogs. Dogs with obstructive azoospermia may be distinguished from those with aspermatogenesis (secretory azoospermia) by measuring seminal carnitine concentration. Seemingly, the epididymis is the major source of carnitine in canine seminal fluid, because the concentration of carnitine in prostatic fluid was only 58 +/- 53 nmol/ml, whereas the concentration of carnitine in 6 pools of epididymal fluid was 18.8 +/ 3.9 mumol/ml. PMID- 3631709 TI - Compound-action potentials of myelinated fibers in the saphenous nerve of the dog: in situ electrophysiologic and behavioral studies. AB - Compound-action potentials (CAP) were recorded directly from the surface of fascicles of the distal portion of the saphenous nerve (SN) of dogs in situ. Potentials were evoked through needle electrodes and were recorded through bipolar stainless steel electrodes. Stimuli of 10-microseconds duration and of 0.4 +/- 0.15-mA amplitude evoked a monophasic CAP. Sensory conduction velocities of afferent fibers, the action potentials of which contributed to this evoked compound potential, ranged from 62.4 +/- 2.8 m/s for the most rapidly conducting fibers to 30.5 +/- 2.4 m/s for the least rapidly conducting fibers. Stimuli of 25 microseconds duration and of 2.2 +/- 0.8-mA amplitude evoked a second, longer latency CAP in addition to the first CAP. Sensory conduction velocities of afferent fibers, the action potentials of which contributed to this evoked compound potential, ranged from 20.4 +/- 2.9 m/s for the most rapidly conducting fibers to 13.7 +/- 1.0 m/s for the least rapidly conducting fibers. Low amplitude, negative peaks were recorded between the first and second major potentials elicited by the longer duration stimuli. Stimuli of still longer duration and higher currents induced contractions of the caudal part of the sartorius muscle by current spread in 9 of 12 dogs. In 3 dogs, a third monophasic CAP was evoked, having a maximal conduction velocity of 1.7 +/- 0.2 m/s. After section of the distal portion of the SN on one side in each of 2 dogs, an absence of signs of sensory deficit was found on clinical neurologic examination. The area of cutaneous innervation of the cranial branch of the distal portion of the SN was determined electrophysiologically. PMID- 3631710 TI - Thermodilution cardiac output determination in the guinea pig. AB - Thermodilution cardiac output was compared with simultaneously determined aortic flow in 5 guinea pigs during thoracotomy. Total cardiac output was affected by volume expansion, adrenergic stimulation, and the volume of hemorrhage. For the equation y = mx, where y is aortic flow, x is thermodilution cardiac output, and m is the slope of the regression line, m = 0.88 +/- 0.02 (95% confidence interval). The SE of the regression was 27.8 ml/min. Thermodilution may have been overestimated because the aortic flow measurement did not take into account the coronary arterial blood flow, which is approximately 4% of total cardiac output in the guinea pig. Indicator loss (ie, temperature) also may be an important factor in the calculation of cardiac output, as determinations of thermodilution cardiac output were affected by sampling site in the guinea pig. Thermodilution appears to be a useful and reliable means of determining cardiac output in the guinea pig. PMID- 3631711 TI - Seasonal occurrence and distribution of Gasterophilus intestinalis and Gasterophilus nasalis in the stomachs of equids in Texas. AB - Stomachs of 271 horses and ponies from 2 sources were evaluated for the presence of Gasterophilus intestinalis and G nasalis larvae, through 2 overlapping 12 month periods of bot fly activity in southern Texas. Equids (n = 140) from one source had nearly 96% of their stomachs infected, whereas equids (n = 131) from another source had 44% of their stomachs infected by Gasterophilus spp. Seasonal dynamics of the bot infection indicated the highest average number of bot larvae per infected stomach occurred in the winter and spring. The smallest average number of bots per infected stomach occurred in the fall. Higher percentages of early (2nd instar plus young 3rd instar) larvae of G intestinalis were observed in the fall in equids from both sources. The late (more fully developed older 3rd instar) G intestinalis larvae outnumbered the early larvae in the winter, spring, and summer. Seasonal variation in numbers and development status of the larvae was consistent with the largest period of adult bot fly activity occurring during the fall. The 2 species of bots had different predilection sites of attachment. Gasterophilus intestinalis larvae concentrated in the nonglandular portions of the stomach near the margo plicatus on the cranial (parietal) surface of the stomach and in the most dorsal extent of the saccus cecus. Gasterophilus nasalis larvae attached almost exclusively in the first ampulla of the duodenum. Predilection sites for both Gasterophilus spp occurred in dorsally positioned areas in the alimentary tract favoring increased availability of oxygen. PMID- 3631712 TI - Efficacy of dichlorvos, fenbendazole, and ivermectin in swine with induced intestinal nematode infections. AB - Anthelmintic efficacies of dichlorvos, fenbendazole, and ivermectin were compared in specific-pathogen-free crossbred weanling pigs inoculated with Ascaris suum, Trichuris suis, and Oesophagostomum dentatum. On postinoculation day (PID) 50, 24 pigs in each treatment group were treated orally with 43 mg of dichlorvos/kg of body weight, 3 X 3 mg of fenbendazole/kg, or 300 micrograms of ivermectin/kg, SC. Twenty-four pigs were not treated. On posttreatment day 7 (PID 57), 12 pigs from each treatment group (phase I) were slaughtered, and the anthelmintic efficacy of each treatment was determined. Efficacies against A suum, T suis, and O dentatum, respectively, were: dichlorvos, 100%, 99.9%, and 100%; fenbendazole, 100%, 99.8%, and 100%; and ivermectin, 98.7%, 53.9%, and 87.6%. Weight gains and feed conversions of the remaining pigs were monitored until they reached market weight (phase II). The average weight gains (kg) and feed conversions (kg of feed/kg of gain) at posttreatment day 81 (PID 131), respectively, were: 73.6 and 3.44 for nontreated controls, 78.9 and 3.31 for dichlorvos-treated pigs, 72.1 and 3.36 for fenbendazole-treated pigs, and 74 and 3.48 for ivermectin-treated pigs. Differences in average weight gains and feed conversions were not significant (P greater than 0.05). PMID- 3631713 TI - Protection of lambs with a purified metabolite of exsheathed third-stage Haemonchus contortus larvae. AB - Helminth-free lambs (approx 4 months old) were inoculated SC with a purified metabolite of exsheathed third-stage Haemonchus contortus larvae. The metabolite was obtained from in vitro cultivation and was identified as XL3FA1. After 3 periodic XL3FA1 inoculations, lambs were challenge exposed with H contortus. Multiple vaccinations with XL3FA1 did not inhibit the development of worm populations in the lambs; however, worm egg production seemed to be inhibited. PMID- 3631714 TI - Serodiagnosis of postnatally and prenatally induced toxoplasmosis in sheep. AB - Nineteen pregnant (45 to 90 days of gestation) and 9 nonpregnant ewes were inoculated orally with 1,000 or 10,000 oocysts of Toxoplasma gondii. Pregnant ewes were euthanatized at days 14 (2 ewes), 21 (1 ewe), 23 (1 ewe), 28 (2 ewes), 35 to 42 (6 ewes), and 49 to 62 (6 ewes), and antibody titers in fetal and maternal sera were assayed, using the modified agglutination, latex agglutination, indirect hemagglutination, and dye tests. Although all ewes developed antibody titers of greater than or equal to 1,024 within 28 days after inoculation, fetuses were seronegative up to 28 days, using the modified agglutination test. Toxoplasma gondii antibodies were found in fetuses, using the modified agglutination and dye tests 35 days after ewes were inoculated. Latex agglutination and indirect hemagglutination tests were insensitive for detection of T gondii antibodies in ovine fetal sera. Toxoplasma gondii antibody titers in nonpregnant ewes were similar to those in pregnant ewes. Passively acquired T gondii antibodies from the colostrum decreased from 1,024 to less than 16 between 49 and 56 days of age in 1 lamb and between 62 and 106 days in its twin. PMID- 3631715 TI - Pharmacokinetics and interactions of digoxin with phenobarbital in dogs. AB - In one experiment, 5 dogs were administered digoxin (0.022 mg/kg of body weight, IV), were rested for 2 weeks, were then given phenobarbital (13.2 mg/kg orally) for 14 days, and then were given digoxin again (0.022 mg/kg, IV). Comparing prephenobarbital (control) digoxin half-lives of 42.4 +/- 8.8 hours and postphenobarbital digoxin half-lives of 18.0 +/- 2.2 hours, the half-life was significantly (P less than 0.05) decreased after phenobarbital administration. Clearance was increased by 84%, and the volume of distribution given was decreased by 34%. In a second experiment, 5 dogs were given digoxin (0.022 mg/kg, orally) daily for 11 days, and the digoxin kinetics were evaluated after the last dosing. The dogs were then rested and given phenobarbital (13.2 mg/kg, orally) once daily for 14 days and digoxin (0.022 mg/kg) once daily for 11 days, and the pharmacokinetics of digoxin was determined on the last day of dosing. Significant differences in steady-state serum concentrations and the pharmacokinetics of digoxin were not found between the control and phenobarbital phases of the experiment. Mean (+/- SD) half-lives of digoxin were 29.0 +/- 7.2 hours before phenobarbital treatment (control) and were 34.8 +/- 7.2 hours after phenobarbital treatment. In comparing results of the single-dose experiment vs the oral multiple-dose experiment, dogs had shorter half-lives for digoxin after multiple dosing. Therefore, if phenobarbital and digoxin are to be chronically coadministered orally, an adjustment in the digoxin dose is not necessary. PMID- 3631716 TI - Temporal effects of halothane and isoflurane in laterally recumbent ventilated male horses. AB - Cardiopulmonary function was monitored in 6 non-medicated, healthy male horses, anesthetized with halothane or isoflurane in O2 at a constant dose (1.2 times the minimum alveolar concentration). Horses were exposed once to each anesthetic agent, and a minimum of 2 weeks separated anesthetic exposures. All horses were studied in left lateral recumbency, and ventilation was mechanically controlled to induce a PaCO2 of 35 to 45 mm of Hg and an inspiratory peak airway pressure of 18 to 22 cm of H2O. After 1 hour of horse preparation, constant conditions were begun. With duration of anesthesia, cardiac output increased (P less than 0.05) with both anesthetic agents, because of an increase in stroke volume (P less than 0.05). Heart rate did not change from initial values with either agent. Mean arterial blood pressure also increased (P less than 0.05) with both agents. With both anesthetics, respiratory rate (P less than 0.05) was increased progressively to maintain acceptable PaCO2 values. Arterial O2 tension did not change with time. PMID- 3631717 TI - Pharmacokinetics of phenolsulfonphthalein in horse and pony mares. AB - Pharmacokinetics of phenolsulfonphthalein (PSP) in horse and pony mares was determined after injection of 1 mg/kg of body weight, IV. A plasma PSP concentration vs time curve was described adequately in horses and ponies by an open, 2-compartment model. There were significant differences in the elimination phase parameters, apparent volume of distribution at steady state, and apparent volume of distribution of horses and ponies. The harmonic mean elimination half life of PSP in horses was significantly longer (P less than 0.001) than that in the ponies (16.4 and 10.0 minutes, respectively). The mean plasma clearance of PSP in horses was significantly (P less than 0.05) less than that in ponies (0.00554 and 0.00701 L/min/kg, respectively). There was no difference between horses and ponies in the metabolic clearance of PSP. The fraction of the administered dose of PSP excreted in the urine in the first 15 minutes was not significantly different between horses and ponies. PMID- 3631718 TI - Pharmacokinetics of oxytetracycline hydrochloride in rabbits. AB - Pharmacokinetics of oxytetracycline HCl (OTC) was studied in rabbits. After 10 mg of OTC/kg of body weight was administered IV, the distribution half-life was 0.06 hour, terminal half-life was 1.32 hours, volume of distribution area was 0.861 L/kg, and total body clearance was 0.434 L/kg/h. After 10 mg of OTC/kg was given IM, the absorption half-life was 2.09 hours, extent of absorption was 71.4%, and total body clearance of the absorbed fraction was 0.576 L/kg/h. Based on these kinetic data, a dosage of 15 mg of OTC/kg, every 8 hours was developed. This dose given IM for 7 consecutive days resulted in observed steady-state maximum and minimum concentrations (mean +/- SD) of 4.7 +/- 0.3 micrograms/ml and 3.2 +/- 0.6 micrograms/ml, respectively. Twice this dose (30 mg of OTC/kg, every 8 hours) given IM caused anorexia and diarrhea. PMID- 3631719 TI - Canine distemper virus-induced thrombocytopenia. AB - Effects of canine distemper virus (CDV) infection on circulating platelet values were studied in gnotobiotic dogs inoculated with R252-CDV. Thrombocytopenia (less than 200,000 platelets/microliter) was present on postinoculation day (PID) 5 and persisted through PID 15. Peak thrombocytopenia occurred on PID 10 (less than 85,000 platelets/microliter). Thrombocytopenia was accompanied by lymphopenia, neutropenia, and monocytopenia. Platelet membrane-bound CDV antigen and IgG were present from PID 7 onward; neither the third component of complement nor IgM was detected on platelets from CDV-inoculated dogs. The mean number of megakaryocytes per unit of bone marrow surface area was unchanged. Megakaryocyte infection was present in dogs euthanatized on PID 4 (0.33%), increased slightly in dogs euthanatized on PID 8 (3%), and increased sharply in dogs euthanatized on PID 9 and 10 to 17.8% and 8.3%, respectively. Phagocytosis of platelets by stellate reticuloendothelial (Kupffer's) cells in the liver was prominent in dogs euthanatized from PID 5 onward. Seemingly, CDV-induced thrombocytopenia was mediated by virus-antibody immune complexes on platelet membranes. Decreased platelet production after PID 8 resulting from direct viral infection of megakaryocytes was a likely contributing factor and occurred against a background of profound virus-induced dysfunctions of all hematopoietic cellular elements. PMID- 3631720 TI - Peripheral metabolism of thyroid hormones and iodide in healthy and hyperthyroid cats. AB - The metabolic clearance rate, volume of distribution, and fractional clearance rate of thyroxine (T4), triiodothyronine (T3), and iodide were calculated for 6 healthy and 7 hyperthyroid cats, using single-compartmental and noncompartmental methods of analysis. The mean T4 volume of distribution of the hyperthyroid cats was 32.0% less than that of the healthy cats; it was the only variable that was significantly different (P less than 0.05) between these 2 groups of cats. The mean fractional clearance rate of T4 in the hyperthyroid cats was 53.2% greater than that in the healthy cats, but this difference was not significant. Hyperthyroid cats had no significant differences in T3 or iodide kinetic variables when compared with those in healthy cats. Single-compartmental analysis significantly overestimated T4 kinetic variables of healthy cats and T4, T3, and iodide kinetic variables of hyperthyroid cats when compared with the noncompartmental method of analysis. PMID- 3631721 TI - Arterial and venous supply to the bovine jejunum and proximal part of the ileum. AB - The blood vasculature of the bovine jejunum and proximal part of the ileum was studied in 20 mature dairy cows at slaughter. The cranial mesenteric artery and vein supplied the jejunum and ileum, and their major branches were present in all specimens and supplied similar regions of the intestinal tract. Proximal branches of the cranial mesenteric artery were pancreatic arteries, caudal pancreaticoduodenal artery, middle colic artery, and ileocolic artery. A large collateral branch arose from the proximal segment of the cranial mesenteric artery, anastomosing with the continuation of the cranial mesenteric artery distally along the jejunum. Jejunal arteries arose from the continuation of the cranial mesenteric artery, forming a series of anastomosing arches. Straight vessels arising from these arches did not branch or anastomose before entering the serosal layer of the intestine. The proximal part of the ileum was supplied by branches from the continuation of the cranial mesenteric artery; these branches anastomosed with the mesenteric ileal (ilei mesenterialis) artery, a branch of the ileocolic artery. The venous supply paralleled the arterial supply in all specimens. PMID- 3631722 TI - Bovine postparturient hemoglobinemia: hypophosphatemia and metabolic disorder in red blood cells. AB - Mechanism of hemolysis in postparturient hemoglobinemia was studied in 7 cows. Cows 1 to 5 had a history of hemoglobinemia at a previous calving, but hemoglobinemia did not occur during the present parturition. Cow 6, a daughter of cow 4, and cow 7 from another farm, developed postparturient hemoglobinemia and had hemoglobinuria on days 20 and 21 and 10 to 17 after calving, respectively. During the time cows 6 and 7 had hemoglobinuria, both cows had a marked decrease in serum inorganic phosphorus, RBC adenosine 5'-triphosphate (ATP), and reduced glutathione, and a significant (P less than 0.01) increase in methemoglobin concentration. In cow 6, these changes were observed before the onset of hemoglobinuria, indicating metabolic disorder of RBC. After phosphate administration IV, serum inorganic phosphorus was corrected, and RBC ATP was increased above base-line value. During the time cows 6 and 7 had hemoglobinuria, PCV, hemoglobin concentration, and RBC count decreased progressively and reached nadir values, 40% to 50% of baseline values, on day 22 in cow 6 and on day 19 in cow 7. Cows 6 and 7 were anemic, even after serum inorganic phosphorus and RBC ATP values returned to acceptable values. Glycolytic disorder and depletion of ATP, resulting from phosphorus deficiency, appeared to be a primary and essential step leading to hemolysis in postparturient hemoglobinemia in cows 6 and 7. PMID- 3631724 TI - The NIH centennial. Current and prospective funding of biomedical research. A note to Chicken Little: the sky is not falling. PMID- 3631723 TI - Regulation of murine macrophage phagocytosis of sheep erythrocytes by T-2 toxin. AB - The effect of a single oral dose of 4 mg of T-2 toxin/kg of body weight on in vivo phagocytosis of sheep RBC by peritoneal macrophages was evaluated in nonsensitized mice and in mice sensitized with sheep RBC. T-2 toxin treatment had no effect on the viability or phagocytic activity of resident peritoneal macrophages in nonsensitized mice. However, a significant (P less than 0.005) increase in phagocytic activity occurred in cells from mice treated with toxin and subsequently sensitized with sheep RBC. In contrast, phagocytosis of sheep RBC was significantly (P less than 0.05) suppressed in cells from mice treated with toxin after sensitization. Toxin treatment induced necrosis of lymphocytes and significant decreases in thymus and spleen weights. Seemingly, T-2 toxin, administered at a dose that caused marked lymphoid depletion, suppressed or enhanced in vivo macrophage phagocytic activity in antigenically sensitized mice, and enhancement or suppression of phagocytosis was a function of the time of toxin treatment in relation to antigenic stimulation. PMID- 3631725 TI - Influenza prevention--the key to reduction in morbidity and mortality from acute respiratory disease (ARD) PMID- 3631726 TI - What does exercise have to do with "exercise-induced" asthma? PMID- 3631727 TI - Survey of underlying conditions of persons hospitalized with acute respiratory disease during influenza epidemics in Houston, 1978-1981. AB - The peak occurrence of hospitalizations of persons with acute respiratory disease (ARD), usually pneumonia, has coincided with the peak of influenza virus activity each year. The purpose of this study was to examine the diagnoses other than ARD on the discharge record of patients hospitalized with ARD. We were particularly interested in determining the frequency of high-risk conditions for which influenza vaccine is currently recommended. The risk for ARD hospitalization was 19.7 per ten thousand for persons with high-risk conditions and only 9.3 for persons without. Chronic pulmonary disorders were the most common underlying conditions identified, and persons with pulmonary conditions had the greatest risk for ARD hospitalization. The highest rate occurred among persons older than 65 yr of age with pulmonary conditions (87.5 per ten thousand), and the rate was 27.5 for persons 45 to 64 yr of age. Cardiac conditions were the second most frequent group of underlying disorders of patients hospitalized with ARD. Only for persons younger than 20 yr of age was the risk of ARD hospitalization greater for persons with cardiac conditions than for those with pulmonary conditions (22.9 and 14.9 per ten thousand, respectively). Death, however, was more frequent among persons with underlying heart disease. Intensified effort is needed to fully implement recommendations for prophylaxis of influenza in order to reduce these risks. PMID- 3631728 TI - Respiratory syncytial virus infections in adults. AB - In a retrospective 10-year study of 57 adult patients admitted to Orebro Medical Center Hospital, Sweden, with RS virus infections, pneumonia was diagnosed in 36. A primary episode of obstructive airway symptoms was observed in 20% of the patients with pneumonia. Several patients had a long period of fever and a protracted stay in the hospital. No fatal cases or serious complications were registered. Compromised hosts did not appear to be overrepresented in the material, nor did patients with impaired immune responses seem to be more seriously ill. Laboratory findings indicated that the RS virus pneumonia in adults was in some cases due to a mixed bacterial and RS virus infection, but in a few cases it was caused by the RS virus alone. Positive epidemiologic findings were found only in a few cases. The length of the period between the seasonal peak incidences of RS virus infection varied. A tendency to recurrent long and short intervals between the peak incidences was observed. An IgM antibody response to RS virus was common, and IgM detection was found to be a useful complement in the diagnosis of RS virus disease. PMID- 3631729 TI - Protected transbronchial needle aspiration and protected specimen brush in the diagnosis of pneumonia. AB - Protected transbronchial needle aspiration (PTBNA) of pneumonic lung theoretically could bypass dislodged upper respiratory tract flora, a potential source of contamination of protected specimen brush (PSB) cultures. To evaluate the usefulness of PSB and PTBNA in establishing the etiology of pneumonia, we prospectively studied 20 patients with acute bacterial pneumonia not receiving antibiotics. After informed consent, patients had fiberoptic bronchoscopy under fluoroscopy to localize the pneumonia, and specimens were obtained by the PSB. The protective plug of a specially devised needle for PTBNA was pneumatically dislodged and aspiration was performed within the infiltrate under fluoroscopy. Quantitative cultures were plated immediately for aerobes, anaerobes, and Legionella. Greater than 4 X 10(3) organisms/brush or 1 X 10(4) organisms/ml needle aspirate were considered to be consistent with infection. The results using PSB and PTBNA were compared in 15 of 20 patients in whom a definitive diagnosis (positive blood or pleural fluid culture) or presumptive diagnosis (expectorated sputum culture, clinical characteristics, and response to specific therapy) was established. The PSB and PTBNA cultures on uninfected control subjects (n = 5) being bronchoscoped for other reasons were negative. The PSB and PTBNA were each diagnostic in 2 of the 5 patients with definitive diagnoses. In the group with a presumptive diagnosis (n = 10), PSB was diagnostic in 7 of 10 and PTBNA in 9 of 10. The overall (definitive plus presumptive) diagnostic yield was 60% for PSB and 73% for PTBNA. Multiple organisms were isolated in high concentrations in 53% of the patients. The most common organisms recovered in addition to the primary pathogen was alpha hemolytic streptococci.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631730 TI - Tuberculosis in patients with the acquired immunodeficiency syndrome. Clinical features, response to therapy, and survival. AB - Tuberculosis has been reported previously in patients with acquired immunodeficiency syndrome who are at increased risk of prior infection with Mycobacterium tuberculosis. We performed a population-based study of AIDS and tuberculosis in San Francisco using the Tuberculosis and AIDS Registries of the San Francisco Department of Public Health. Of 287 cases of tuberculosis in non Asian-born males 15 to 60 yr of age reported from 1981 through 1985, 35 (12%) also had AIDS, including 23 American-born whites. Patients with tuberculosis and AIDS were more likely to be nonwhite and heterosexual intravenous drug users than were AIDS patients without tuberculosis. Fifty-one percent had tuberculosis diagnosed before AIDS, and 37 percent had AIDS diagnosed at least 1 month prior to the diagnosis of tuberculosis. Although the lungs were the most frequent site of tuberculosis in both AIDS and non-AIDS patients, 60% of the AIDS group had at least 1 extrapulmonary site of disease compared to 28% of the non-AIDS group (p less than 0.001). Nonsignificant tuberculin skin tests were more common in AIDS patients (14 of 23 patients tested) than in non-AIDS patients (12 of 129 patients tested; p less than 0.0001). Chest radiographs in AIDS patients showed predominantly diffuse or miliary infiltrates (60%), whereas non-AIDS patients had predominantly focal infiltrates and/or cavitation (68%). Response to antituberculosis therapy was favorable in AIDS patients, although adverse drug reactions occurred more frequently than in non-AIDS patients (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631731 TI - Exercise intensity determines and climatic conditions modify the severity of exercise-induced asthma. AB - Recent studies have shown some evidence that exercise-induced asthma (EIA) may not be entirely explained by respiratory heat loss (RHL). We investigated the interrelationship between heat exchange, exercise intensity and EIA. In order to differentiate between the effects of RHL and exercise intensity, we arranged for tests to be performed with the same RHL, but with different intensities of exercise and inspired air conditions. Each of 8 asthmatic children exercised twice in random order for 6 min on a cycle ergometer. One test consisted of exercise performed at a greater level of effort while breathing room air, mean (+/- SE) air conditions being 25.0 +/- 0.4 degrees C and 15.7 +/- 0.2 mg H2O/L. The other test was performed at a lesser level of effort while breathing cold (0.0 +/- 0.5 degrees C) and dry air (O mg H2O/L). The mean ratio of minute ventilations in the 2 exercise tests was 1.78 +/- 0.03, but the RHL was similar in both tests. The EIA after the exercise at the greater level was more severe than after the lesser level, the percent fall in FEV2 from baseline being 36 +/- 7% and 21 +/- 5%, respectively (p less than 0.025). We conclude that the exercise level has a major role in determining the severity of EIA and that climatic conditions act as modifying factors. PMID- 3631732 TI - Airflow-induced bronchospasm. Imbalance between airway cooling and airway drying? AB - We used an animal model of airflow-induced bronchospasm (AIB) to examine the role of airway cooling in responses to dry air challenge. A bronchoscope was wedged in situ into perfused lower lobes of anesthetized dogs. Through the bronchoscope, dry air was delivered, resistance to collateral flow (Rcs) was measured, and airway wall temperature (Taw) was monitored. A dry-air challenge through the bronchoscope produced a fall in Taw and a rise in Rcs, presumably related to evaporative heat loss (EHL) and/or an increase in osmolarity. By changing the temperature of blood perfusing the lobe it was possible to lower Taw without affecting either EHL or osmolarity. Four series of experiments were performed. In the first series, Taw was lowered in 2 ways: by increasing dry air flow and by cooling the pulmonary perfusate. After a 2-min challenge with dry air, Rcs rose. After lowering Taw with cooled blood for 2 min, Rcs did not rise. In the second series of studies, Taw was lowered for 15-min periods by reducing the temperature of blood. Neither cooling per se nor rewarming after the 15 min of cooling initiated increases in lung tone. In the third series of experiments, a 2-min dry air challenge was performed while the lobe was perfused with cool blood. Despite greater reductions in Taw during the dry-air challenge, responses after the challenge were virtually abolished. In a final series of experiments in which pulmonary perfusion was stopped during challenge, airway cooling was enhanced, and responses were again significantly attenuated. Thus, cooling actually depressed increases in Rcs produced by dry-air challenge.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631733 TI - Ventilation-perfusion inequality in chronic asthma. AB - The prevalence and variability of ventilation-perfusion (VA/Q) inequality was examined in 26 stable, symptomatic, asthmatic subjects (mean FEV1/FVC, 79% predicted; mean FEF75, 43% predicted) studied once a week for 9 consecutive weeks. We used a recent modification of the multiple inert gas elimination technique allowing frequent serial studies without the need for sampling arterial blood. The VA/Q inequality was expressed as log SD (the second moment) of the distributions of blood flow (Q) and ventilation (V) on a log scale. Log SDQ averaged 0.74, and in every patient log SDQ exceeded the 95% upper limit of normal (0.60) in 2 wk or more. In only 5 patients was mean log SDQ less than 0.6. The ventilation distribution was less abnormal, with mean log SDV exceeding the 95% normal upper limit in only 4 patients. Bimodal blood-flow distributions containing low VA/Q units were observed at some point in 24 of 26 subjects, but occurrence was variable, and in only one third of all measurements was bimodality found. Analysis of variance showed that 70 to 75% of the total variance of log SD was due to intersubject differences, about 20% was due to random changes over time, and the remaining 7 to 9% was not explained by either and was due mostly to experimental error. Arterial PO2 measured 3 times in each subject was inversely related to log SDQ (r = 0.76), but only 60% of the variance in PaO2 was explained by VA/Q mismatch, the rest being due presumably to variation in mixed venous PO2 and similar extrapulmonary factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631734 TI - Reflex decrease of histamine-induced bronchoconstriction after laryngeal stimulation in humans. AB - The aim of this work was to determine whether the nonadrenergic, noncholinergic, inhibitory nervous system can be reflexly activated in humans by laryngeal stimulation. The stimulation was achieved with a cytology brush passed through a bronchoscope previously introduced transnasally and positioned just above the epiglottis. In one series of experiments, subjects were premedicated with beta adrenergic and cholinergic blockers, and bronchoconstriction was induced by histamine inhalation. The results showed that mechanical irritation of the vocal cords with the cytology brush produced a sharp, short-lasting (less than 1 min) decrease in RL from (mean +/- SE) 6.8 +/- 2.1 to 4.8 +/- 1.5 cm H2O.L-1.s, and in the absence of parasympathetic blockade, laryngeal irritation produced a fall in RL from (mean +/- SE) 9.0 +/- 3.7 to 5.4 +/- 2.0 cm H2O.L-1.s (p less than 0.0001) (ANOVA). This decrease in RL was independent of the slight cough produced by laryngeal stimulation and reflects a change in lower and not upper airway resistance. Adequacy of the beta-adrenergic and cholinergic blockade was checked with an intravenous infusion of isoproterenol and inhaled methacholine, respectively. In 2 subjects, the fall in RL was abolished by a block of the superior laryngeal nerves and direct local anesthesia of the vocal cords. We conclude that mechanical irritation of the larynx produces a partial reversal of histamine-induced bronchoconstriction that is mediated through nervous pathways that are neither beta-adrenergic nor cholinergic in origin. We suggest that this decrease in bronchoconstriction is modulated by the nonadrenergic, noncholinergic, inhibitory nervous system. PMID- 3631735 TI - Pharyngeal size and resistance in obstructive sleep apnea. AB - Although anatomic and physiologic abnormalities of the upper airway are thought to be important in the pathogenesis of obstructive sleep apnea (OSA), the relative contributions of these factors have not been elucidated. We therefore measured pharyngeal cross-sectional area (PCSA) and pharyngeal air-flow resistance (Rp) in 12 overweight men with severe symptomatic OSA (mean apnea plus hypopnea index [AHI], 66.9 +/- 6.0 events per hour) and in 17 age- and weight matched control subjects without spontaneous complaints of OSA symptoms (mean AHI, 4.9 +/- 1.6 events per hour). During wakefulness, PCSA was assessed during breath cessation at FRC by computed tomography (CT) and Rp by measuring inspiratory air-flow resistance between the choanae and epiglottis. No measure of PCSA differed significantly between patients and control subjects, and only 1 measure of PCSA, minimal pharyngeal area, correlated with AHI in all subjects (r = -0.38, p less than 0.05). In contrast, Rp was significantly higher (p less than 0.05) in patients (6.9 +/- 1.0 cm H2O/L/s) than in all control subjects (4.2 +/- 0.5 cm H2O/L/s) and correlated significantly with AHI (r = 0.53, p less than 0.01). We conclude that increased inspiratory resistance to air flow in the naso oropharynx is present during wakefulness in overweight men with OSA, when compared with matched control subjects without symptomatic OSA, and is associated with disordered breathing during sleep. This occurs even though computed tomography is unable to demonstrate that pharyngeal size during wakefulness at FRC is significantly different between patients and control subjects. These observations suggest that the ability to dilate the pharynx during inspiration may be defective in patients with OSA. PMID- 3631736 TI - Effect of acute diaphragm paralysis on ventilation in awake and sleeping dogs. AB - The mechanisms responsible for hypoventilation during rapid-eye-movement (REM) sleep in patients with diaphragmatic weakness are not clear. Therefore, we studied the effects of unilateral (UDP) and bilateral (BDP) diaphragmatic paralysis on ventilation during wakefulness (W), slow-wave sleep (SWS), and REM sleep. Studies were performed in 3 trained dogs in which small silicone cuffs had been implanted surgically around the phrenic nerves. Reversible diaphragmatic paralysis was induced during wakefulness or sleep by bathing the phrenic nerves in local anesthetic injected through a catheter attached to the phrenic cuffs. The UDP reduced abdominal expansion and increased rib cage expansion, but had no effect on minute volume of ventilation (VI) or end-tidal PCO2 (PACO2). The BDP produced marked abdominal paradox, but did not reduce VI during W or SWS and had no effect on tidal volume or respiratory frequency. In contrast, during REM sleep, VI was decreased by an average of 21% mainly because of a fall in tidal volume, and PACO2 increased by 2.4 mm Hg compared with that during the intact state. Furthermore, addition of extra dead space to the breathing circuit, which was well tolerated in intact dogs, led to a progressive increase in PACO2 during BDP and to arousal from sleep. The findings indicate that acute BDP does not impair ventilation during quiet W or SWS, but reduces ventilation during REM sleep, supporting the concept that during REM sleep maintenance of ventilation is critically dependent on diaphragmatic compensation for intercostal and accessory muscle inhibition. PMID- 3631737 TI - Physiologic characteristics of subjects exhibiting accelerated deterioration of ventilatory function. AB - From a randomly selected community population sample followed with sequential surveys since 1972, 13 subjects who exhibited a mean annual decline in FEV1 greater than 60 ml/yr were drawn for detailed studies of lung function. These subjects had developed clinically significant airway obstruction during this period of follow-up. Clinical evaluation was not successful in characterizing the nature of the disorder. None of the subjects had alpha-1-antitrypsin deficiency. In a small proportion of subjects, elevated total serum immunoglobulin E may have played a role in the obstructive airway disorder. Some subjects exhibited loss of lung elastic recoil and diminished carbon monoxide diffusing capacity suggestive of developing emphysema. Others appeared to have intrinsic airway disease involving large and/or small airways, which may be fixed in some and responsive to bronchodilator in others. Thus, neither the site nor the nature of the disorder inferred from results of physiologic tests was uniform, illustrating the heterogeneous nature of chronic obstructive lung disease. PMID- 3631738 TI - One hundred percent oxygen lung injury in adult baboons. AB - Healthy adult baboons exposed to 100% oxygen for 5 to 7 days maintained on continuous mechanical ventilation develop severe bilateral noncardiogenic pulmonary edema that resembles in many aspects the human adult respiratory distress syndrome (ARDS). In the present study, we evaluated the effects of hyperoxia for 5 to 6 days in 8 baboons to compare changes in abnormalities in bronchoalveolar lavage fluid (BALF) biochemical markers, hemodynamic measurements, and pulmonary function tests in order to find early predictors of lung injury. All animals had bilateral alveolar infiltrates, severe hypoxemia, and progressive deterioration of pulmonary function tests. Diffuse alveolar damage and mild-moderate pneumonias were found and were associated with low-grade bacterial infection. Total lung capacity, diffusing capacity for carbon monoxide, pulmonary static compliance, and oxygenation were significantly impaired after Day 5; BALF proteins, elastase, and total polymorphonuclear leukocytes increased significantly at least 24 h before (Day 4) any abnormalities in chest radiographs, pulmonary function tests, and hemodynamic measurements were detected. We conclude that exposure to 100% oxygen in this model causes marked gas exchange, hemodynamic, biochemical, cytologic, radiographic, and pathologic changes similar to those noted in patients with ARDS. Bronchoalveolar lavage abnormalities precede hemodynamic and gas exchange abnormalities. PMID- 3631739 TI - Uptake of bloodborne bacteria by pulmonary intravascular macrophages and consequent inflammatory responses in sheep. AB - Bacteria are primarily removed from the bloodstream of most species by mononuclear phagocytic cells in the liver and spleen. We have recently described large numbers of pulmonary intravascular macrophages in several ruminant species that also remove inert particles from the bloodstream. To determine the role of these cells in removal of bacteria from the bloodstream, sheep and rats were injected intravenously with a single dose of Pseudomonas aeruginosa, and kinetics of clearance, relative uptake among organs, and morphologic changes in the lungs and liver 1 h after injection were compared. In rats, bacteria were removed primarily by the liver, and pathologic changes were found in hepatic sinusoids but not in the lungs. However, in sheep, bacteria were removed primarily by the lungs, and pulmonary capillaries became filled with neutrophils, platelets, and fibrin deposits. We propose that uptake of bacteria by pulmonary intravascular macrophages and subsequent release of inflammatory mediators are central to the pathologic changes produced in ruminant models of sepsis-induced adult respiratory distress syndrome. PMID- 3631740 TI - Induction of acute pulmonary inflammation. A differential effect of C5 and the 200,000 molecular weight form of trypsin-activated C5 (C5'). AB - A series of studies was performed in which Syrian golden hamsters were injected intratracheally with 25 to 200 micrograms of highly purified human C5 or the 200,000 molecular weight form of trypsin-activated C5 (C5'). Bronchoalveolar lavage (BAL) was performed 4 h after intratracheal injection, the recovered white cells were counted and differentiated, and the BAL fluid was assayed for in vitro neutrophil chemotactic activity. A significant increase in BAL neutrophils and total BAL cell numbers was evident at 4 h after C5' instillation. In contrast, highly purified native C5 induced no evidence of pulmonary inflammation, even at the highest injection doses studied. Kinetic experiments indicated that hamsters receiving an intratracheal injection of 60 micrograms of C5' per animal demonstrated rapid pulmonary neutrophil infiltration that persisted for 120 to 168 h. Control hamsters receiving intratracheal injections of phosphate-buffered saline (PBS) or 60 micrograms of highly purified C5 did not demonstrate significant neutrophil infiltration. Lung pathology studies revealed neutrophilic alveolitis with intraalveolar and intracapillary neutrophil infiltration in the C5'-treated animals. The BAL fluid obtained from C5'-treated, but not from C5 treated or control hamsters, contained chemotactic factors for neutrophils, which appeared to be unrelated to C5. From these studies we conclude that C5', the 200,000 molecular weight form of protease-activated C5, is capable of mediating an acute inflammatory response in the hamster lung in vivo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631741 TI - Pulmonary vascular structural and functional changes in papain-induced emphysema in dogs. AB - We evaluated the pulmonary circulatory effects of emphysema produced by papain in 6 dogs that received 4 weekly treatments of papain administered by aerosolization. A control group of 6 dogs received saline treatments. Hemodynamic measurements were performed during normoxic and hypoxic (10% oxygen) ventilation approximately 3 and 6 months after treatment. Baseline hemodynamic parameters were comparable in both groups and were unchanged at 6 months in the control group. In the papain-treated group at 6 months, there were significant reductions in PaO2 (95 +/- 4 to 79 +/- 3 mm Hg, p less than 0.005) and increases in mean pulmonary artery pressure (12 +/- 1 to 18 +/- 3 mm Hg, p less than 0.05) and pulmonary vascular resistance (2.0 +/- 0.3 to 6.2 +/- 2.1 units, p less than 0.01). Morphometric evaluation demonstrated increased medial thickness in muscular pulmonary arteries less than 50 mu in size. Morphologic evaluation confirmed the presence of panlobular emphysema with papain administration. We conclude that chronic emphysema produced in dogs by aerosol administration of papain results in elevated pulmonary artery pressure, which is characterized pathologically by medial hypertrophy of small pulmonary arteries. This model appears suitable for further study of the pathogenesis of pulmonary vascular disease associated with chronic lung disease. PMID- 3631742 TI - Passive exhalation technique correlates with esophageal balloon measurements of respiratory mechanics in beagle pups. AB - We correlated respiratory system mechanics measured by passive exhalation technique with pulmonary mechanics assessed by esophageal balloon technique to determine the ability of each to detect histamine-aerosol-induced changes in conductance and compliance. Eight beagle pups were anesthetized with chloralose and mechanically ventilated 6 times over a 2-wk period of an acute canine parainfluenza II infection. Measurements of respiratory mechanics were obtained by both methods after aerosol challenge with 5 breaths of saline and after each of 9 increasing doses of histamine. Pulmonary conductance and static compliance of the lung were measured by the esophageal balloon method. The rate constant of the respiratory system was calculated by computer-assisted analysis of passive exhalation. Static compliance of the respiratory system was measured after 2 s of apnea, and conductance of the respiratory system was calculated as compliance multiplied by rate constant. Paired data were obtained on 349 measurements. As expected, both conductance and compliance decreased significantly (p less than 0.05) after histamine aerosol challenge by both techniques. Rate constant did not change significantly by either method. The 2 techniques were highly correlated (p less than 0.001) for conductance (r = 0.76), compliance (r = 0.94), and rate constant (r = 0.66). We conclude that analysis of respiratory mechanics using the passive exhalation method correlates well with esophageal balloon data. Furthermore, passive exhalation techniques are technically simple and can detect changes in respiratory mechanics associated with histamine challenges. PMID- 3631744 TI - Delirium and pulmonary edema after completing a marathon. AB - Pulmonary edema is a rare complication of distance running. All 4 previously reported cases occurred after triathalons or ultramarathons. We report the first case of pulmonary edema in a healthy but untrained runner after a conventional 42 km marathon race. This is also the first reported case of pulmonary edema complicating distance running in which hemodynamic measurements have been made. The pulmonary capillary wedge pressure was low. The cardiac index was initially depressed, and the arterial-venous oxygen tension difference was high, but the latter abnormalities disappeared after volume infusion. These hemodynamic data suggest that pulmonary edema in this distance runner was predominantly noncardiogenic. The etiology of the edema is uncertain, but concurrent hyponatremia and cerebral edema were present in this patient, as in 2 previously reported cases, suggesting that neurogenic pulmonary edema caused by water intoxication may be a contributing factor in pathogenesis. PMID- 3631743 TI - Comparison of methods of measurement of compliance of the respiratory system in children. AB - Compliance of the respiratory system (Crs) was compared using 2 previously described methods, namely, the passive expiratory flow and multiple occlusion techniques. These 2 methods have the advantage of being totally noninvasive, but both have limitations precluding their use in some circumstances. The results of this study of 10 intubated patients, who varied widely in age (premature newborn to adolescence) and diseases, showed no significant difference between the Crs obtained by the 2 methods. The Crs measurements can therefore be used interchangeably, the choice of technique being dependent on the subjects' clinical state. PMID- 3631746 TI - Lipid mediators in the normal and abnormal pulmonary circulation. Reports from the Second Grover Conference. Deckers, Colorado, September 15-18, 1986. 3. PMID- 3631745 TI - American Thoracic Society. Incoming president's address. PMID- 3631747 TI - Potential role of eicosanoids and PAF in the pathophysiology of bronchopulmonary dysplasia. PMID- 3631748 TI - Prostaglandins and structural changes in pulmonary arteries. PMID- 3631749 TI - Exaggerated titles for scientific articles: a new vogue. PMID- 3631750 TI - The effect of malpractice paranoia on medical practice. PMID- 3631751 TI - How to define asthma and COPD. PMID- 3631752 TI - The diagnosis of nonmalignant diseases related to asbestos. PMID- 3631754 TI - Effects of volume history during spontaneous and acutely induced air-flow obstruction in asthma. PMID- 3631753 TI - Gastroesophageal reflux in children with asthma. PMID- 3631755 TI - Theophylline dosing frequency: principles and practices. PMID- 3631757 TI - Progression of arteriosclerotic disease in the failed infrainguinal bypass. AB - Thirty-three male patients had 34 infrainguinal bypass for ischemic arterial disease that became occluded. The indications for surgery were severe disabling claudication in 22 (65%) legs and rest pain in 12 (35%) legs. Twenty-three (68%) of the bypasses were above the knee and 11 (32%) bypasses were below the knee. Reversed saphenous vein was used in 16 (47%) bypasses and polytetrafluoroethylene (PTFE) in 18 (53%) bypasses. The mean ankle pressure index prior to the bypass was 0.40 and the post-operative mean ankle pressure index was 0.86. The arterial bypasses remained patent from 1 month to 47 months (mean, 17.7 months). The reversed saphenous vein remained patent for a mean period of 21.3 months and the PTFE for a mean period of 10.6 months. This difference was statistically significant (P greater than .01). After occlusion of the bypasses, arteriography was performed. The postocclusion arteriography was compared with the pre-bypass arteriography. There was significant progression of arterial disease to account for the failure of bypasses in the inflow arteries in three (8.8%) patients and in the arteries distal to the bypasses in 23 (67.6%) patients. Eight patients showed no significant changes in the postocclusive arteriography. In this series of 33 patients with 34 infrainguinal bypasses, 76.5 per cent of the patients developed progression of the arterial disease causing failure of the bypasses. The reversed saphenous vein bypasses remained patent twice longer than the PTFE. PMID- 3631756 TI - The effects of aspirin, dipyridamole and warfarin in femorodistal reconstruction: long-term results. AB - This study was done to evaluate the effect of aspirin (ASA), dipyridamole (DIP), and warfarin on 406 patients who had femoropopliteal-tibial operations with saphenous vein (SV), umbilical vein (UV), polytetrafluoroethylene (PTFE) and Dacron (DuPont, Wilmington, DE). Above-knee bypasses were performed in 181 patients: 77 were taking ASA and DIP at the time of operation, 41 were placed on postoperative "low-dose" warfarin, whereas 63 did not receive adjunctive medications. Late patency demonstrated no significant difference among the groups based on graft material used (SV 71%, UV 68%, PTFE 66%, and Dacron 65%) (P less than .25). Below-knee femoro-popliteal bypasses were performed in 183 patients: 82 were taking ASA and DIP at the time of operation, 40 were placed on warfarin postoperatively and no medications were given to 41 patients. Late patency rates (39 months) demonstrated that SV (62%) was superior to UV (51%), PTFE (30%), and Dacron (18%) (P less than .01). Femorotibial-peroneal bypasses were done in 42 patients: 13 patients were taking ASA and DIP at operation, 21 were placed on warfarin postoperatively and 8 received no medication. SV late patency (33 months) was again superior (43%) to UV (31%); no PTFE or Dacron grafts functioned after 24 months. Patients who took warfarin and ASA had the best early (16 months) patency results. Above-knee prosthetic grafts achieved late patency rates similar to SV while reducing operative time, shortening recuperation, and sparing the saphenous vein for use in the coronary or infrapopliteal vessels. In below knee bypasses SV was superior to prosthetic grafts, with or without the use of ASA and DIP or warfarin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631758 TI - Axillary artery aneurysm as an occult source of emboli to the upper extremity. AB - Reported here is a case of axillary artery aneurysm secondary to crutch trauma as a source of emboli to the upper extremity. This patient along with several reported in the literature was initially diagnosed and treated for brachial artery embolism. It is believed that awareness of this entity as a cause of forearm and hand ischemia is important in planning the appropriate surgical therapy. PMID- 3631759 TI - The risk of perioperative stroke in patients with asymptomatic carotid bruits undergoing peripheral vascular surgery. AB - Three hundred patients without neurologic symptoms had 374 elective peripheral vascular procedures and they were screened preoperatively for incidental asymptomatic carotid bruits prior to surgery. The bruits were hemodynamically evaluated with the GEE-OPG. A bruit was considered hemodynamically significant if the OPG test was positive. Seventy-four patients (24.7%, 74/300) were found to have 118 carotid bruits. Twenty-five (22.3%, 25/112) of the 112 bruits with OPG studies were hemodynamically significant. There were three perioperative strokes that occurred for an incidence of 0.8 per cent (3/374). There was no stroke in patients without bruits and with nonhemodynamically significant bruits. The incidence of perioperative stroke in patients with hemodynamically significant bruits was 16 per cent (3/19). There is a subgroup of patients with hemodynamically significant carotid bruits who are at high risk for perioperative stroke. PMID- 3631760 TI - The influence of sepsis and ischemia on the natural history of the diabetic foot. AB - One hundred seventeen diabetic patients with lesions involving 174 extremities were reviewed to evaluate the natural history of the problem and specifically those factors that influence its course both acutely and chronically. The extremities of diabetic patients with foot lesions can be categorized based on severity of infection and presence of ischemia. Half of these patients developed lesions in the contralateral extremity either concurrently (synchronous) (7%) or later (metachronous) (43%). Major amputation was required in 59 of the 174 extremities evaluated (34%). In patients with metachronous lesions, unilateral amputations were required in 28 per cent of patients and bilateral amputations in 26 per cent. Limb salvage by revascularization required 1.4 operations per extremity, carried 2 per cent operative mortality and was successful in 66 per cent. Although 24 per cent of these patients died within 5 years of the initial presentation of their foot lesions, these data suggest that limb salvage attempts are reasonably successful and relatively safe. The combination of extremity sepsis and ischemia in the diabetic adversely effects the survival of both the extremity and the patient. PMID- 3631761 TI - The surgical treatment of complicated peptic esophagitis. AB - Healing of stenosing peptic esophagitis was proved by endoscopy and biopsy in 22 of 27 patients treated by transthoracic Nissen fundoplication and esophageal dilation during a follow-up period extending to 14 years. Four additional patients did not have follow-up endoscopy because three expired from intercurrent disease before endoscopy could be carried out and one refused to have the procedure because of lack of symptoms. Postoperative reflux has not been demonstrated in any patient either endoscopically or by contrast studies. Dysphagia, requiring repeat dilation, occurred in two patients after operation. Transthoracic fundoplication with intraoperative stricture dilation is a reasonable alternative in treating complicated esophagitis. PMID- 3631762 TI - Radiation enteritis. AB - As the population receiving radiation therapy grows, so does the incidence of chronic radiation enteritis. A review of the pathology of chronic radiation enteritis reveals fibrosis, endarteritis, edema, fragility, perforation, and partial obstruction. Conservative management of patients with this disease is common. Because the obstruction is only partial, decompression is easily achieved with nasogastric suction and parenteral support. The patient is then often discharged on a liquid-to-soft diet. This therapeutic strategy does nothing for the underlying pathology. The problem, sooner or later, will return with the patient further depleted by the chronic radiation enteritis. We think surgical intervention is appropriate when the diagnosis of chronic radiation enteritis is assumed. The surgery in relation to this disease is high risk with a 30% mortality and 100% expensive morbidity. Early intervention seems to decrease these figures. All anastomoses, if possible, should be outside the irradiated area. Trapped pelvic loops of intestine should be left in place and a bypass procedure with decompressing enterostomies accomplished. The surgery should be performed by a surgeon with extensive experience with all kinds of bowel obstruction as well as experience in performing surgery in radiated tissue. PMID- 3631763 TI - Optimizing surgical management of symptomatic solitary hepatic cysts. AB - Four men and six women with symptomatic solitary hepatic cysts were encountered over an 11-year period. Average age was 49 years (range, 10 months to 67 years). Most common clinical features included right upper quadrant (RUQ) pain, a palpable RUQ mass and early postprandial satiety. Liver function studies were uniformly normal. Ultrasound and computerized tomography CT were virtually diagnostic alone or in combination. Eight patients had unilocular, simple cysts and two patients had multilocular complex cysts also designated as biliary cystadenomas. Cysts recurred in four patients treated surgically by needle aspiration, incision, and internal drainage or external catheter drainage. All four patients required reoperation, which included hepatic lobectomy in three patients and extensive unroofing in one patient. No cysts have recurred in six patients treated by extensive unroofing or excision of the cyst and none has required reoperation. One patient who underwent hepatic lobectomy for cyst recurrence after an inadequate primary procedure was found to have an unsuspected carcinoma in the cyst wall. The conclusion is that extensive unroofing of unilocular solitary hepatic cysts minimizes the likelihood of cyst recurrence and obviates the need for hepatic resection. Total cyst excision is indicated for all multiloculated cysts to avoid overlooking a biliary cystadenoma or for unilocular cysts if the biopsy specimen of the cyst wall demonstrates an unsuspected neoplasm. PMID- 3631764 TI - Leukopenia secondary to silver sulfadiazine: frequency, characteristics and clinical consequences. AB - Leukopenia associated with silver sulfadiazine (SSD) is a frequent event and may be a risk factor for infectious complications in the burn patient. This study reviews 77 patients with thermal injuries to determine total body surface area (BSA) burned, and white blood cell count (WBC) at time of hospital admission. A subpopulation of 56 patients with serial WBC counts were evaluated to determine lowest WBC count, topical burn therapy, episodes of infection or septic shock and final outcome. There was not a significant incidence of leukopenia on admission. Fifty-six per cent of patients treated with SSD and 12 per cent of silver nitrate treated patients became leukopenic (P less than .05). The leukopenia was higher among SSD-treated patients who had greater than 15 per cent BSA burns (P less than .05). The onset of leukopenia generally occurred the second day after the burn and the WBC count returned to normal with discontinuance of the drug. The leukopenia was due primarily to a marked decrease in the number of mature neutrophils. There was no difference in the incidence of septic complications or opportunistic infections in the treatment groups. There was no significant difference in final outcome. Silver sulfadiazine-induced leukopenia appears to be a self-limited phenomenon that does not increase the incidence of infectious complications nor affect final outcome. PMID- 3631765 TI - A prospective randomized study evaluating periumbilical versus infraumbilical peritoneal lavage: a preliminary report. A combined hospital study. AB - Peritoneal lavage has been proved to be a fairly safe and reliable diagnostic tool in evaluating blunt abdominal trauma. However, the operation is not always a simple procedure. In an attempt to determine the ease and reliability of the procedure, the authors conducted a combined hospital approach, prospectively randomizing the performance of periumbilical and infraumbilical approaches to the peritoneal lavage. To date, 53 lavages have been performed. Reliability of the procedures appears to be equal. The greatest differences in the techniques are with regard to the greater efficacy and performer acceptance of the periumbilical approach. The operative approaches are discussed in detail and literature regarding peritoneal lavage is reviewed. PMID- 3631766 TI - Spontaneous splenic rupture in infectious mononucleosis. AB - Spontaneous splenic rupture occurs in association with infectious mononucleosis. Three cases of serologically proven infectious mononucleosis complicated by spontaneous splenic rupture are described. In two, the diagnosis was confirmed preoperatively by abdominal computerized tomographic (CT) scan. Treatment by splenectomy was curative in all three patients. Infectious mononucleosis patients who have acute abdominal pain must be considered for potential splenic hemorrhage. PMID- 3631767 TI - Scleroderma of the breast: light and electron microscopy study. AB - The initial presentation of scleroderma (systemic sclerosis) with a manifestation involving only the breast has not been reported in the literature. Previous reports document scleroderma occurring after cosmetic mammaplasties. The presumed etiology is related to silicone, which has some adjuvant effect in development of the disease. This report documents a case of scleroderma presenting as a breast problem in a 28-year-old woman without prior exposure to silicone. We also describe the light and electron microscopy findings. PMID- 3631769 TI - Anatomy: how much or how little and taught by whom? PMID- 3631768 TI - Claudication as a rare symptom of recurrent cervical carcinoma. AB - Diagnosis of recurrent cervical cancer can be very difficult in the heavily irradiated pelvis. Sciatica and lymphedema are well-known symptoms of disease recurrent to the side wall. The isolated symptom of claudication is reported as an early sign of recurrence. Two patients are presented in whom claudication was the only early presenting symptom. This symptom in a patient with a history of a gynecologic malignancy should lead to an evaluation for recurrent cancer as well as the routine vascular studies. PMID- 3631770 TI - [Indications for the surgery of gastroesophageal reflux in children]. AB - A retrospective study based upon 100 consecutive antireflux operations performed in children for gastroesophageal reflux (GER) in the last 9 years enables the authors to elaborate on indications and their timing. The clinical pictures, often combined in this series, were vomiting (85%), respiratory disease (50%), failure to thrive (47%), haemorrhage (25%), brain damage (16%), rumination (6%), oesophageal stenosis (4%), torticollis (3%) and cricopharyngeal dysphagia (1%). Five children had been previously operated upon for oesophageal atresia. Hiatal hernia was found in only 10 instances. Only 9 children were operated upon before the age of 12 months. Overall operative age was high (52.5 months) and that of patients with neurologic disease was even higher (81.3 months) probably as a result of delayed diagnosis. This experience underlines the limitations of medical treatment beyond the age of 12 months, the poor reliability of disappearance of vomiting as an index of cure during the first year and the need for facing operative indications without prejudgements based on traditional ideas that do not take into consideration clinical manifestations of GER disease which are currently well established. PMID- 3631771 TI - [Congenital malformations in Sweden]. AB - The thalidomide catastrophy in the early 1960th clearly demonstrated the need of accurate epidemiological data of birth defects. Since 1963 there is in Sweden like in many other countries a continuous registration of congenital malformations in order to provide data for the early detection of changes in frequencies or patterns of defects and thus also to facilitate early identification of new environmental teratogens. During the more than 20 years period the Swedish register has been in operation an increase in the incidence of certain malformations such as omphalocele, hypospadia and Down's syndrome in the offspring of young mothers has been observed. Despite rather extensive studies no explanation for these changes has so far been found. Due to the great concern in the public about the relation between environmental factors and the occurrence of congenital malformations it is of great importance that the register can be used to elucidate the situation when there has been a suspicion of increased teratogenic risks in certain areas of Sweden or when pregnant women have special working conditions. The rate of malformations has been found to be higher among infants born to women coded as laboratory technicians than in the rest of the Swedish population. So far, no specific teratogenic factor has been identified. In Sweden no relation has been found between the incidence of congenital malformations and socioeconomic conditions. The incidence of neural tube defects has been found to be higher than expected in a count in Western Sweden.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631773 TI - [Composition of fatty acids of the adipose tissue in 22 0- to 11-year-old normal children]. AB - Fatty acid composition of subcutaneous cellular tissue in 22 children at different ages was determined. The obtained results served as reference values and as indicators of fatty acid composition change with time. Children below and above 45 days of age were compared. Palmitoleic acid showed the greatest variation in composition change with age in the two first months of life. The results are discussed. PMID- 3631772 TI - [Bronchodilating effect of terbutaline inhaled with and without a tube spacer in asthmatic children]. AB - Eighteen children aged 10.3 +/- 2.4 years who needed regular use of antiasthmatic drugs and showed after abandoning them with the appropriate intervals a FEV1 below 85% of their highest previous value, received in a randomized, double-blind crossover fashion two puffs of terbutaline 1 hour apart on two consecutive days. The drug was administered either with the conventional inhaler or a 10.3 X 2 cm. Forced spirometry, peak flow, flow-volume loops, and whole body plethysmography were performed basally, and 5, 15 and 45 minutes after each puff. The peak increase of the FEV1 was greater with the spacer (41.7% vs 30.4%, p less than 0.05). The increase of FEV1 was higher with the spacer at 5 minutes following the first puff and at 15 and 45 minutes after the second puff. No difference was observed in the other variables measured. Sixteen inhaled the drug "coordinatedly". The spacer offers some advantage in asthmatic children who inhale terbutaline mostly in a coordinated way. PMID- 3631774 TI - [Bronchial provocation test with dermatophagoides in the diagnosis of infantile asthma: sensitivity, specificity and reproducibility]. AB - The purpose of this study has been to prove if the lung is the target organ of an allergen against which a biological hypersensitivity, by means of skin test and RAST, has been found; comparing score Foucard diagnostic with inhalatory test result. At the same time, checking test specificity and reproductibility. Fourty children, both sexes aged between 6 and 14 years diagnosed of bronchial asthma divided in two groups were studied. First group included 31 children with hypersensitivity to dermatophagoides and second group was control group including 9 children. The test with dermatophagoides was performed in both groups according to Cockcroft method. The parameters which indicated test positivity were 20% fall in FEV1 for early response and 40% fall in PERF for late response. The results obtained show 83.9% positive tests with 80.6% early responses and 45.2% positive late response. The specificity and reproductibility were of 100%. PMID- 3631775 TI - [Pediatric AIDS through vertical transmission]. AB - We report here the first paediatric immunodeficiency acquired syndrome (AIDS) in Spain, acquired by vertical-transmission and a second infant case with the same transmission and classified as AIDS related complex. We also mention the incidence and characteristics, of the neonatal population born in the last eighteen months to HIV positive mothers in our geographic area. The AIDS patients, was a female drug addicted parents born to who died at 22 month. Her parents are HIV positive and have ARC. The second patient was a boy, born to a sexual HIV positive partner of a member of a high risk group who died pat 17 month. Review of the literature until September 1986, revealed 369 AIDS paediatric patients, the number is lower 265 (7 Spanish), if only vertical transmitted AIDS is considered. For this reason, we considered pertinent to provide some information about clinical manifestations and laboratory, radiologic and necropsy findings in our patients. PMID- 3631776 TI - [Kawasaki disease. Presentation of 8 cases]. AB - Clinical and laboratory findings in eight children seen in our department in the last seven years with Kawasaki's syndrome are described. Incidence in our area seems to be higher than it is in the whole country. Authors interested in transmitting their experience as general pediatricians, particularly on difficulties found to establish correct diagnosis in early stages of the disease. Therefore, they insist on the time at which signs, symptoms and laboratory data appeared. ECG was abnormal in five of our eight cases (62%). Bidimensional echocardiogram showed abnormalities in half of the patients in whom the procedure was performed. There were no deaths among our children. Bacteriological, serological and other laboratory investigations were not of help to diagnosis. They conclude that periungual descamation and thrombocytosis are the most useful data to confirm initial diagnostic suspicion. PMID- 3631777 TI - [Neonatal lupus erythematosus: complete atrioventricular block and SSA/Ro antibodies]. AB - A newborn boy with complete A-V block and positive anti-SSA/Ro antibodies is reported. Authors comment on pathological findings of neonatal lupus erythematosus. They also review prognosis and clinical course and point out management of these patients before and after birth. PMID- 3631778 TI - [Asphyxiating thoracic dysplasia in 2 dizygotic twins]. AB - Two cases of asphyxiating thoracic dysplasia in a pair of dizygous twin females are described. Both were diagnosed at birth and presented characteristic clinical, radiological and pathological features of this rare entity. PMID- 3631779 TI - [Neonatal myasthenia of persistent course: apropos of 2 cases in siblings]. AB - Authors report 2 siblings with neonatal myasthenia gravis of persistent course. The first of them died at 10 months old probably of bronchial aspiration. His sister aged 3 years continues symptomatic requiring anticholinesterase medication. Comparing their patients with those from literature, they comment clinical, diagnostic, therapeutic and specially, classificatory aspects of this entity. PMID- 3631781 TI - [The pediatrician and oral health]. AB - The pediatrician must know about dental health in order to detect the principal and more frequent problems and send the pediatric patients to stomatologist. PMID- 3631780 TI - [Partial trisomy 18q]. AB - Authors present a new case with partial trisomy for long arms of chromosome 18(q12-qter) resulting from a balanced translocation t(4;18) on her mother. Comparing clinical features of our patient with that of other reported cases with the same trisomic segment, we can deduce that most important characteristics on this syndrome are: psychomotor and grow retardation, congenital heart disease, dolicocephaly, low set and malformed ears, micrognathia, short neck with redundant skin and a longer survival than in total trisomy 18. PMID- 3631782 TI - [Apert's syndrome and intralobar pulmonary sequestration with fatal hemoptysis]. PMID- 3631783 TI - [Craniocerebral injury caused by compressed air shotgun]. PMID- 3631784 TI - 1-Desamino-8-D-arginine vasopressin (desmopressin) decreases operative blood loss in patients having Harrington rod spinal fusion surgery. A randomized, double blinded, controlled trial. AB - To evaluate the effect of 1-desamino-8-D-arginine vasopressin (desmopressin) on blood loss in surgery, we conducted a randomized, double-blind trial of the drug in 35 patients with normal hemostatic function who were having spinal fusion with Harrington rod instrumentation. Seventeen patients were designated to receive 10 micrograms/m2 of desmopressin, and 18, to receive a placebo. Preoperative testing showed that desmopressin increased factor VIII coagulant activity, von Willebrand antigen concentrations, glass bead platelet retention, and prothrombin consumption and decreased the partial thromboplastin and bleeding times (p less than or equal to 0.0003). During surgery, desmopressin reduced blood loss by 32.5% (547 mL; 95% confidence interval [CI], 19 to 1075; p = 0.015) and reduced the need for concentrated erythrocyte transfusions by 25.6% (0.86 units; 95% CI, 0.08 to 1.65; p = 0.022). After surgery, desmopressin reduced the duration of treatment with analgesic agents by 13.1% (34.0 hours; 95% CI, -5.2 to 72.7; p = 0.105), presumably by decreasing bleeding in the surgical wound. When adjusted for the origin of the scoliosis by two-way analysis of variance, this effect was even more evident (p = 0.014). Multiple regression analysis showed that the best three predictors of blood loss in surgery and transfusion requirements were the bleeding time, glass bead platelet retention, and the use of desmopressin. PMID- 3631785 TI - Fulminant hepatic failure after occupational exposure to 2-nitropropane. AB - Two construction workers became ill after applying an epoxy resin coating containing 2-nitropropane in the confined space of an underground concrete vault. One man died 10 days later from fulminant hepatic failure. The second man recovered but has had persistently elevated serum aminotransferase activity. The serum concentration of 2-nitropropane on admission of the man who died was 13 mg/L, and was 8.5 mg/L in his coworker. The acute toxicity of 2-nitropropane has not been widely appreciated despite previous reports of death due to hepatic failure after exposure to the compound in confined spaces. These cases show the importance of effective education and protective work practices. PMID- 3631786 TI - The Neurobehavioral Cognitive Status Examination: a brief but quantitative approach to cognitive assessment. AB - The Neurobehavioral Cognitive Status Examination (NCSE), a screening examination that assesses cognition in a brief but quantitative fashion, uses independent tests to evaluate functioning within five major cognitive ability areas: language, constructions, memory, calculations, and reasoning. The examination separately assesses level of consciousness, orientation, and attention. This instrument quickly identifies intact areas of functioning, yet provides more detailed assessment in areas of dysfunction. Standardization data are provided for 119 healthy adults (age range, 20 to 92 years) and for 30 patients receiving neurosurgical care for brain lesions (range, 25 to 88 years). Cognitive profiles for several common neuropsychiatric conditions illustrate the usefulness of this examination in clinical practice. PMID- 3631787 TI - The Neurobehavioral Cognitive Status Examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. AB - Studies to determine the validity of the Mini-Mental State Examination (MMSE) and the Cognitive Capacity Screening Examination (CCSE) have indicated unacceptably high false-negative rates for these tests. To determine whether a new examination, the Neurobehavioral Cognitive Status Examination (NCSE), is more sensitive in the detection of cognitive dysfunction, we compared the three examinations in 30 patients with documented brain lesions. The CCSE had a false negative rate of 53%; the MMSE, of 43%; and the NCSE, of 7%. The sensitivity of the NCSE is derived from two features of its design: the use of independent tests to assess skills within five major areas of cognitive functioning, and the use of graded tasks within each of these cognitive domains. PMID- 3631788 TI - Effect of rifampin therapy on thyroid function tests in a hypothyroid patient on replacement L-thyroxine. PMID- 3631789 TI - Prevention and control of influenza. Recommendations of the Immunization Practices Advisory Committee. Centers for Disease Control. AB - Unless vigorous measures are used to control influenza in the 1987 to 1988 season, mortality due to this disease may increase because the proportion of elderly persons in the United States is rising, and age and its associated chronic diseases are risk factors for severe influenza illness. Also, the younger populations at high risk for influenza-related complications are increasing for various reasons, including the success of neonatal intensive-care units, better management of diseases such as cystic fibrosis, and better survival rates for organ-transplant recipients. To help control influenza in the upcoming season, information on the influenza strains in the trivalent vaccine is provided, recommendations for vaccination of persons in households with a high-risk person are made, and precautions for the use of amantadine hydrochloride are described. PMID- 3631790 TI - Thromboendarterectomy for chronic, major-vessel thromboembolic pulmonary hypertension. Immediate and long-term results in 42 patients. AB - Since 1970, forty-two patients with pulmonary hypertension due to chronic, thromboembolic obstruction of the major pulmonary arteries have had pulmonary thromboendarterectomy at the University of California, San Diego, and the San Diego Veterans Medical Centers. Duration of symptoms before admission averaged 4.4 years, with many alternative diagnoses having been made. At admission, 29 patients had class IV disease by New York Heart Association criteria, and 12, class III. Immediately after surgery, pulmonary vascular resistance declined significantly (p less than 0.001) from 897 +/- 352 dynes/s.cm-5 to 278 +/- 135 dynes/s.cm-5. Seven patients with class IV disease died in the postoperative period. Of the 35 survivors (mean follow-up, 28 months), 16 had class I disease; 18, class II; and 1, class III. Of the 17 patients who have returned for cardiac catheterization at 4 to 12 months after surgery, a further decline (p less than 0.05) in pulmonary vascular resistance has occurred. This experience indicates that the disorder is commoner than we previously suspected and that thromboendarterectomy is feasible, even in patients with severe and protracted hemodynamic compromise. PMID- 3631791 TI - Pulmonary angiography in severe chronic pulmonary hypertension. AB - We have analyzed the safety of doing pulmonary angiography in 67 consecutive patients with moderate-to-severe primary pulmonary hypertension or hypertension secondary to chronic thromboembolic occlusions of the pulmonary arteries. The average (+/- SD) pulmonary arterial systolic and diastolic pressures were 74 +/- 19 and 34 +/- 10 mm Hg, respectively. Fourteen patients had a right ventricular end-diastolic pressure of 20 mm Hg or more. Selective left and right main pulmonary artery injections were done using ionic contrast agents in 56 patients and nonionic contrast agents in 11. No major rhythm disturbances or systemic hypotension requiring therapy occurred, and there were no deaths. Thrombotic occlusions of the pulmonary arteries were identified in 52 patients and confirmed in all 42 of those who had a thromboendarterectomy. At autopsy, 3 of the 15 patients who had normal angiograms were found not to have had thrombotic occlusions. We conclude that pulmonary angiography can be done safely despite the presence of severe pulmonary hypertension and right ventricular failure, and that the procedure leads to the identification of chronic, major-vessel thromboembolic pulmonary hypertension that may be alleviated by thromboendarterectomy. PMID- 3631793 TI - Screening devices for cognitive capacity. PMID- 3631792 TI - Computerized display of past test results. Effect on outpatient testing. AB - STUDY OBJECTIVE: To determine the effect of displaying previous results of diagnostic tests on the ordering of selected outpatient tests. DESIGN: Sixteen week controlled trial with a 13-week pre-intervention and 8-week post intervention observation periods. Patients were randomly assigned to intervention or control groups so that each physician was his or her own control. Only scheduled visits were included. Randomization occurred before the pre intervention observation period. SETTING: Academic primary care general medicine clinic affiliated with an urban general hospital. SUBJECTS: Pre-intervention period: 111 physicians (97 internal medicine residents, 14 faculty internists), 4683 patients, 5942 scheduled visits. INTERVENTION period: same 111 physicians, 5946 patients, 8148 visits. Post-intervention period: 76 physicians (62 residents, 14 faculty), 2571 patients, 2858 scheduled visits. INTERVENTION: With an order for one of eight selected diagnostic tests through microcomputer workstations, a window was opened on the screen and previous test results were displayed along with the time interval between the first and last result. Tests were ordered for control patients into the same workstations without previous results displayed. MEASUREMENTS AND MAIN RESULTS: Previous results of one or more study tests were available for display for 96% of scheduled patients. Significantly lower results (p less than 0.05 by paired t-test) for the selected tests were found for intervention patient visits than for control visits: charges per visit (mean +/- SE) for intervention patients $12.17 +/- 0.62, compared with $13.99 +/- 0.77 for controls, a 13.0% difference; tests per visit were 0.51 +/- 0.03, compared with 0.56 +/- 0.03, an 8.5% difference. The number of study tests ordered decreased significantly for intervention patients (16.8%) and for controls (10.9%). During the post-intervention period, ordering of study tests increased for both groups, but the increase from the intervention period was not significant. CONCLUSIONS: Presenting physicians with previous test results reduced the ordering of those tests. The actual effect may have been greater than 13%, because there were reductions in study tests ordered for both intervention and control patients during the intervention period when compared with the pre intervention period, and both tended to rise after the intervention, or display, was turned off. PMID- 3631794 TI - A new look at clinical privileges for procedures. PMID- 3631796 TI - Guide for the use of American College of Physicians Statements on Clinical Competence. Health and Public Policy Committee. PMID- 3631795 TI - Syphilis and infection with the human immunodeficiency virus. PMID- 3631797 TI - Clinical competence in the use of flexible sigmoidoscopy for screening purposes. Health and Public Policy Committee. PMID- 3631798 TI - Endoscopic surveillance of patients with Barrett esophagus. PMID- 3631799 TI - Factitious ventricular tachycardia. PMID- 3631800 TI - Treadmill score for predicting prognosis in coronary artery disease. PMID- 3631801 TI - Legionnaire's disease and a whirlpool-spa. PMID- 3631802 TI - Antibiotic therapy and chronic obstructive pulmonary disease. PMID- 3631803 TI - Aggressive treatment of a patient with the acquired immunodeficiency syndrome. PMID- 3631804 TI - Hypotension in infection with the human immunodeficiency virus. PMID- 3631805 TI - Pentoxifylline and diabetic neuropathy. PMID- 3631806 TI - Drug fever and triamterene. PMID- 3631807 TI - Interaction between nalidixic acid and warfarin. PMID- 3631808 TI - Institutional ethics committees. PMID- 3631809 TI - Pediatric cardiology in perspective. PMID- 3631810 TI - Hemodialysis and lupus nephritis in MKSAP VII. PMID- 3631811 TI - Repetitive publication. PMID- 3631812 TI - [Indications for vagotomy in postoperative peptic ulcer]. PMID- 3631813 TI - [Crohn disease and intestinal cancer: clinical considerations]. PMID- 3631814 TI - [Preoperative antibiotic prophylaxis with ceftriaxone in elective appendectomy]. PMID- 3631815 TI - [Short-term drug prophylaxis with ceftriaxone in abdominal surgery]. PMID- 3631816 TI - [The problem of gastroesophageal reflux in the surgical therapy of achalasia of the esophagus]. PMID- 3631817 TI - [Rare pathology of the spleen (description of 3 cases of non-parasitic cysts]. PMID- 3631819 TI - [Experimental model for evaluating the possibility of the surgical treatment of pathologic obesity]. PMID- 3631818 TI - [Conservative treatment of infections of vascular prostheses: considerations on 2 cases]. PMID- 3631820 TI - [Long-term results of surgery of colorectal cancer. Analysis of 350 cases]. PMID- 3631821 TI - [Intestinal lesions caused by seat belts: apropos of a case]. PMID- 3631822 TI - [Circulating anticoagulant of the antiprothrombinase type. Retrospective study of 134 cases]. AB - A retrospective study of 134 cases of circulating "lupus anticoagulant" (LA) observed between 1975 and 1985 in the haemostasis laboratory of Henri Mondor Hospital is reported. In 66 p. 100 of cases the circulating anticoagulant was discovered fortuitously and auto-immune diseases were associated with the inhibitor only in 25 p. 100 of cases (mainly systemic lupus erythematosus). Thrombosis (venous, arterial or both) was found in 26 p. 100 of cases when auto immune diseases were present and in 13.5 p. 100 of cases in the absence of these diseases. Spontaneous abortion was observed in 42 p. 100 of the women when the anticoagulant occurred in the course of an auto-immune disease and in 4 p. 100 when another or no underlying disease were identified. False-positive VDRL and thrombocytopenia were found associated with LA mainly in auto immune diseases. Anticardiolipin antibodies were positive in 37 p. 100 of 32 patients without any difference between auto-immune diseases and other pathologies. These results show that the "lupus anticoagulant" is a frequent coagulation abnormality even when auto-immune diseases are absent. The differences observed between auto-immune diseases and other pathologies in respect to clinical manifestations and biological findings associated with lupus anticoagulant suggest that the so called "lupus anticoagulant" represents a group of antibodies with probably different specificities but which act in a similar manner in "in vitro" coagulation tests. PMID- 3631823 TI - [Analysis of 1,400 blood pressure profiles]. AB - Hypertension may be defined by 3 criteria obtained by indirect, non invasive, automatic measurement of blood pressure using the DINAMAP device analyses the profile obtained over a 12 hour period (one recording every fifteen minutes): percentage of abnormal values (BP greater than 160/95 mm Hg), average values of systolic, diastolic and mean BP, variability (standard deviation of means), The analysis was based on 1,400 profiles recorded from 174 normotensive and 1,226 hypertensive patients. The following observations were made: the largest group was that of patients with predominantly diastolic hypertension under 60 years of age (81.3 p. 100 vs. 18.9 p. 100 systolic hypertension) and predominantly systolic hypertension over 60 years of age (68.9 p. 100 vs. 31.1 p. 100 diastolic hypertension), borderline hypertension (between 1 and 20 p. 100 of pathological values) is observed in 34.5 p. 100 of hypertensive patients under 60 years of age, and 21.8 p. 100 of patients over 60 years of age. This form of hypertension may be managed without drug therapy but requires a control blood pressure profile at least once a year, the other groups of patients were much smaller: pure diastolic hypertension (4.8 p. 100 in the under 60's, 0.6 p. 100 in the over 60's); pure systolic hypertension (1/1,226 cases of hypertension), permanent hypertension (5.7 p. 100 in the under 60's and 4.4 p. 100 in the over 60's), paroxysmal hypertension (2.1 p. 100 in the under 60's and 5.6 p. 100 in the over 60's).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631824 TI - [Panic attacks: a diagnosis to know in internal medicine. Analysis apropos of 11 patients and an attempt at a physiopathological explanation]. AB - The authors report a series of 11 patients who consulted or were admitted to a hospital medical unit for organic symptomatology, especially hypertensive, diagnosed as panic attacks based on the criteria of the DSM III. Cardiovascular symptoms were dominant in 10 out of the 11 patients. In 7 cases, the symptoms were very suggestive of pheochromocytoma. Treatment based on tricyclic antidepressive drugs associated with behavioural therapy in 5 cases, led to the total regression of acute panic attacks in 9 out of 11 patients with a follow-up period ranging from 1 to 2 years. However, it did not prevent 2 of the patients from developing a chronic anxiety state. After reviewing the principal clinical features of panic attacks, the authors discuss their underlying physiopathological mechanisms. The results of catecholamine metabolic studies in 2 out of 3 patients suggest the possible role of an inhibitor of catecho-o-methyl transferase, but this requires confirmation by further studies. Panic attacks are very prevalent in the general population (2 to 5 p. 100). The diagnosis must be born in mind to avoid long and costly investigations, and for specific treatment to be instituted. The main risk is the development of chronic severe morbidity with serious socio-familial consequences. PMID- 3631825 TI - [African histoplasmosis in Mali]. AB - Twenty-four cases of histoplasmosis have been diagnosed since 1945 in native Malians (20 cases) or Europeans living in Mali (4 cases). Seventeen cases have already been published and 7 other cases diagnosed recently in Bamako or Marseille are reported here. Mali is within the African histoplasmosis zone and the Kayes district may be a particularly endemic zone. The disease affected the skin (62 p. 100), lymph nodes (46 p. 100), bones (21 p. 100), gastrointestinal tract (26 p. 100) and lungs (4 p. 100). A rare lesion of the uvula is also reported. Direct fungal and histopathological techniques are the easiest and the most effective diagnostic investigations. All cases were due to Histoplasma duboisii. Amphotericin B was used in over 60 p. 100 of cases for an average period of 3 months. The total recovery rate was 66 p. 100. PMID- 3631826 TI - [Pulmonary manifestations in severe ictero-hemorrhagic leptospirosis]. AB - Eight cases of pulmonary involvement were observed in 17 severe cases of ictero haemorrhagic leptospirosis. Haemoptysis (7 cases) occurred on the 4th day of the infectious syndrome and was associated with other haemorrhagic manifestations in 4 cases. Cough, pain and polypnoea were not constant. Chest X-ray showed diffuse, non-specific changes, such as nodular opacities or infiltrates. Septicaemia was confirmed in all cases with acute renal failure in 7 cases and meningitis in 6 cases. Severe thrombocytopenia was demonstrated in 2 cases. Six patients recovered quickly with regression of the lung changes within 12 days. Two patients died, one of a fulminant haemoptysis related to a disseminated intravascular coagulation syndrome, and the other of acute respiratory failure. All cases were confirmed serologically. Although lung changes in leptospirosis are usually benign and mild, haemoptysis and polypnoea with diffuse radiological changes are poor prognostic factors. The pathological changes were similar to those of haemorrhagic alveolitis. These changes may be either due to the liberation of toxins or to an immunological phenomenon. PMID- 3631827 TI - [Legionnaires' disease in hairy cell leukemia. 2 new cases]. AB - We report the cases of two patients who developed legionnaires' disease during the course of hairy cell leukaemia. The clinical features are described with special emphasis on the severity of illness in one patient and marked jaundice in both. These cases demonstrate the enhanced susceptibility to Legionella pneumophila infections in patients with hairy cell leukaemia. We therefore suggest a reevaluation of empiric antimicrobial treatment of pneumonia in such patients. PMID- 3631828 TI - [Acute respiratory distress syndrome in chickenpox in 3 healthy adults]. AB - Three adults previously in good health developed pulmonary oedema during chickenpox. Severe hypoxemia required mechanical ventilation. All patients recovered without extensive pulmonary sequela on the first month pulmonary functional test. The severity of adult chickenpox requires hospitalization for treatment with Acyclovir. PMID- 3631829 TI - [Migraine manifestations and lymphocyte pleocytosis of the cerebrospinal fluid]. AB - The authors report the case of a 26 year old non-migrainous man who presented over a 5 week period with a cluster of classical migrainous attacks associated with CSF lymphocytosis. The association of this type of CSF response with attacks of migraine is unusual; in migraine the CSF is normal or may show an isolated increase in protein content (with the exception of the very rare familial hemiplegic migraine). In the reported case, other conditions liable to give rise to migraine and CSF lymphocytosis having been excluded (acute DLE, brucellosis...), this association corresponded to a benign and spontaneously regressive condition, possibly a migraine symptomatic of benign acute lymphocytic meningitis. The authors suggest that a primary meningeal inflammation may have been the cause of the cluster of migraine attacks which in this case were more accompanied perhaps because they induced a wave of depression of cortical activity. PMID- 3631830 TI - [Severe pneumopathy and acute renal insufficiency disclosing Chlamydia psittaci infection: resistance to the treatment with erythromycin]. AB - The authors report one case of psittacosis with acute respiratory distress syndrome, acute tubulo-interstitial nephropathy and jaundice. Erythromycin therapy was uneffective but recovery was obtained with minocycline and rifampicin treatment. Early diagnosis of Chlamydia psittaci infection is mandatory in order to prevent severe complications and to institute appropriate antimicrobial therapy. PMID- 3631831 TI - [Cerebral cysticercosis: 4 cases]. AB - Four cases of cerebral cysticercosis are reported, occurring in an immigrant population. Two patients presented with periodic epileptic fits and cerebral calcifications. One patient presented with an acute hemiparesis associated with lymphocytic meningitis and cerebral calcifications; the fourth patient had chronic meningitis with epileptic fits. Three patients were treated with praziquantel: an acute reaction occurred during treatment in two cases with an increase in the titres of the immunological reaction of hydatid cyst disease in one case. The authors suggest classifying this condition in three types: acute (parenchymatous or subarachnoid), chronic (chronic meningitis, hydrocephalus, progressive dementia), and sequelae (epilepsy with or without headaches). This classification seems the most appropriate way of summarizing the variable clinical presentation of this condition which is rarely observed in France. The most valuable diagnostic investigation is CT brain scanning. Immunological reaction to hydatid cyst (CSF and blood) are sometimes negative. Treatment with praziquantel often causes an acute reaction with a rise in antibody titres; this is a clinically benign reaction, and it could be used as a diagnostic test. PMID- 3631832 TI - [Hepatic involvement in measles in adults: 23 cases]. PMID- 3631833 TI - [Subacute meningococcal septicemia and temporary deficiency in complement factor C4 in lupus disease in an outbreak]. PMID- 3631834 TI - [Horton's disease improved by a tonic based on total adrenal cortex extract]. PMID- 3631835 TI - Investigation of contrast sensitivity following radial keratotomy. AB - Radial keratotomy is a surgical procedure for the correction of myopia in which the cornea is flattened by partial-thickness radial incisions. While postoperative visual acuity is usually good, measurements of acuity are of only limited value and do not describe visual performance for a variety of spatial frequencies and contrasts. In the present study, the effect of radial keratotomy on the contrast-sensitivity function was examined. Six spatial frequencies were tested (0.5, 1.0, 3.0, 6.0, 11.4, and 22.8 cycles/degree) using the Nicolet CS 2000 with patients wearing corrective lenses. The results revealed that, at least for the conditions tested, radial keratotomy does not produce a statistically significant decline in contrast sensitivity. PMID- 3631836 TI - Asteroid hyalosis: posterior vitreous detachment and diabetic retinopathy. AB - The vitreoretinal relationship in 59 eyes with asteroid bodies was studied by biomicroscopy with the El Bayadi-Kajiura lens. Complete posterior vitreous detachment (PVD) occurred less often in eyes with asteroid bodies than in control eyes (P less than .05), and partial PVD occurred more often than in control eyes (P less than .01). In eyes with asteroid bodies after the age of 70 years, the prevalence of PVD, either complete or partial, was lower than in age-matched control eyes (P less than .01), and the prevalence of liquefaction (19%) was lower than has been reported in controls. Of eight eyes with proliferative diabetic retinopathy and asteroid bodies, only one showed partial PVD. Patients who were diabetic and who had asteroid bodies were significantly younger than patients without diabetes with asteroid hyalosis (P less than .01). Our data suggest that the presence of asteroid bodies may arrest the process of vitreous collapse or contraction and that diabetes might influence the development of asteroid hyalosis. PMID- 3631837 TI - The use of sodium hyaluronate as a biologic sleeve in strabismus surgery. AB - Strabismus surgery sometimes fails because of the mechanical restriction caused by the development of fibrous adhesions between the operated muscle and the surrounding tissues. Reoperation increases the frequency and severity of mechanical restriction significantly because of additional scar formation. Attempts to isolate the muscle from other tissues using gelatin sponges or Supramid plastic sleeves have been unsuccessful because of the body's reaction to these permanent foreign bodies. We used an ultra-pure fraction of sodium hyaluronate to study whether this nonantigenic, noninflammatory, viscoelastic substance could function as a temporary sleeve to prevent or reduce scarring and mechanical restriction following strabismus surgery. We resected the superior rectus muscle of 14 eyes from seven 5- to 7-pound white rabbits. In one eye, we instilled sodium hyaluronate 1% around the muscle. The other eye served as a control. The rabbits were killed at five, seven, ten, 14, 21, 28, and 42 days. Ante mortem length-tension measurements and post mortem histologic examinations of the operated muscles were performed in a blinded fashion. The results suggested, but did not definitely demonstrate, that sodium hyaluronate may reduce postoperative adhesions. PMID- 3631838 TI - The corneal epithelium basement membrane complexes after alkali burn: an ultrastructural study. AB - Chemical burns were produced using a 4 N NaOH solution in 21 rabbit corneas. The ultrastructural findings were examined under an electron microscope five minutes and 1, 2, 4, 8, 15, and 30 days after the burn. A morphologic disturbance of the basement membrane and its complexes was detected from the first day of the experiment. These findings suggest that the basement membrane plays an important role in the pathogenesis of corneal recurrent erosions and ulcer formation after chemical burns. PMID- 3631839 TI - Histology of vitreous in its gel and fluid forms. AB - Low- and high-power microscopic examination of just-dried (without flame) fresh smears of gel, semi-gel, and fluid human and rabbit vitreous without stain showed that solid gel vitreous is composed of two types of transparent network, i.e., thick fibers in meshes of which there is another fine fibril network and both types of fluid vitreous, the fiber and fibril networks, show stages in transformation to transparent granules; this is why fluid vitreous remains transparent. PMID- 3631840 TI - [Influence of positioning of the newborn infant in ligation of the umbilical cord on bilirubin levels in the blood during the first days of life]. PMID- 3631841 TI - [Blood sialic acid in pregnancy and the puerperium]. PMID- 3631842 TI - [Dosimetry of solar ultraviolet radiation. Daily and monthly changes in Paris]. AB - The intensity of ultraviolet A and B radiations was measured in Paris (48 degrees North) by means of silicon photoelectric cells (Osram Centra dosimeter) from December, 1984 till February, 1986. The results, which must be regarded as approximate, are expressed as physical units (mW/cm2) and biological units (minimal erythema dose/hour). For sunny days two curves are presented separately for UVB and UVA: daily variations in radiation (hourly measurements) and daily variations at 11 hours (solar time) during one year. Maximum irradiation was observed at noon in early July: UVB 0.15 mW/cm2, UVA 5.4 mW/cm2. Between December and July the amount of UVB radiation was multiplied by 14 and that of UVA radiation by 9. For subjects with clear photo-type and when the sun was at its zenith, an MED per hour was obtained from May 1 onwards. Within a day, 30 p. 100 (summer) and 50 p. 100 (winter) of erythema-producing UV intensity were delivered between 11 and 13 hours (solar time). This kind of study has numerous clinical applications: advice regarding exposure to sun rays, dosing of heliotherapy, epidemiological data concerning photodermatitis (circumstances of exposure, UV threshold dose) and photocarcinogenesis (determination of annual MED doses in relation to areas of uncovered skin and occupational exposure to sun rays). Other studies on the French territory will provide a map of UV irradiation. PMID- 3631843 TI - [Stewart-Treves pseudo-syndrome caused by cutaneo-lymphatic metastases of contralateral breast carcinoma]. AB - The pathogenesis of Stewart-Treves syndrome remains controversial: angiosarcoma or epithelial cell metastases from a mammary carcinoma? The case reported here, with clinical signs of Stewart-Treves syndrome on one side and mastectomy for carcinoma on the other side of the body, revives the debate. Case-history. The patient was an 89-year old woman whose left breast had been removed in June, 1981 for carcinoma with lymph node involvement. One year after the operation, multiple lymphadenopathy developed in her right armpit and subclavian region. In December, 1984, her right arm became swollen by lymphoedema, while Kaposi-like and nodular skin lesions appeared on her right upper chest and upper back and on her right shoulder and arm. Radiography of the chest showed right pleural effusion, bronchial lymph node enlargement and a reticulate image in the right lung. In spite of chemotherapy, the patient died in April, 1985. Pathology. Pathological examinations included standard histology (HPS, PAS and Gordon-Sweet staining), immunohistochemistry, using anti-factor VIII, anti-keratin KL1 and anti-EMA antisera, and electron microscopy. Results. Irrespective of the skin area biopsied, the histological images were always the same, showing carcinomatous lymphangitis with a varying degree of invasion of the surrounding dermis. Staining of the reticulum enhanced the vascular basal membranes but did not mark the intraluminal tumoral cell population. Post-mortem examination confirmed that the malignant lymphangitis extended to the lung tissue, the oesophageal wall and the adrenal glands, and that the axillary and subclavian lymph nodes were invaded by metastases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631844 TI - [Cutaneous and visceral sarcoidosis. Apropos of an exceptional form]. AB - We present here an exceptional case of cutaneous and vascular sarcoidosis associated with lesions of the liver, spleen and lymph nodes. The disease began when this male patient was 27 years' old and gradually extended over 35 years, despite long-term systemic corticosteroid therapy. Clinically, the initial cutaneous lesions were atrophic, erythematous and squamous, resembling those of erythroderma; they were located on the skin of the right popliteal fossa, the left arm, the neck, the upper part of the chest and around the waist. Subsequently, they spread slowly to involve almost the entire skin, except for the face, right upper limb, left lower limb, hands and feet. The most ancient of these lesions were distinctly black. The skin was paper thin due to complete disappearance of the subcutaneous tissue. Left temporo-parietal alopecia of the cicatricial type developed towards the end of the patient's life. The nails remained normal throughout, and there were no other cutaneous signs of sarcoidosis. Initially, the venous network was clearly visible beneath the atrophic skin, but later on, the veins became grossly dilated and sacculated in those areas which had first been invaded by skin atrophy. Phlebography of the left upper limb confirmed the venous dilatation, while arteriography of the upper limbs showed multiple sacciform aneurysms of the subclavian, axillary and brachial arteries, with distal thrombosis of the latter vessel. Histology showed typical lesions of sarcoidosis in a vein; no arterial biopsy was performed. The muscles had a nodular and sclerous appearance; amyotrophy developed in the last stages of the disease; tendons and joints were normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631845 TI - [Leg ulcer of the pyoderma gangrenosum type. Manifestation of tertiary cutaneous syphilis]. PMID- 3631846 TI - [The first Moroccan case of Cowden's disease]. PMID- 3631847 TI - [Syringoma of the scalp beneath a seborrheic wart]. PMID- 3631848 TI - [Connective tissue papillae and proliferative epithelial units]. PMID- 3631849 TI - [Cutaneous sarcoidosis: treatment with etretinate]. PMID- 3631850 TI - [Case for diagnosis. Livedo vasculitis]. PMID- 3631851 TI - [Treatment of recurrent buccal aphthosis]. PMID- 3631852 TI - [Cryosurgery of cutaneous carcinoma]. PMID- 3631853 TI - [Analysis of proteins by immunoblotting. Application to dermatology]. PMID- 3631854 TI - Subspecialization in surgery: can it be stopped? PMID- 3631855 TI - Anatomy and development of the pterygopalatomaxillary region, studied in relation to Le Fort osteotomies. AB - An understanding of the anatomy and postnatal development of the pterygomaxillary region is needed as a basis for timing and completion of Le Fort osteotomies. The present study included a macroscopic and microscopic study of human skull and autopsy material, both materials representing different developmental stages. Finally, Le Fort I procedures were completed on adult cadavers and the pterygomaxillary region studied histologically. The skull material demonstrated an increasing association between the palatine bone and adjacent bones. Disarticulation was possible only in the infantile period; in the late juvenile and the adolescent stages, disarticulation was accompanied by fractures of the heavily interdigitated osseous surfaces. The histological studies confirmed the marked complexity of the suture, and our findings suggest that the palatine bone acts as a buffer between these areas with their differing intrinsic growth patterns. The remodeling processes in the area seem to reflect different functional demands of the bony pharynx and the maxillary complex. These findings, in conjunction with the significant variations in the gross anatomy of the pterygomaxillary area combined with the location of the actual osteotomy in simulated Le Fort I procedures, force consideration of placement of the posterior osteotomy through the maxillary sinus rather than through the pterygomaxillary fissure in adults. If Le Fort procedures are to be completed in children, probable interference in facial growth is of major concern. Therefore the timing of Le Fort procedures before adolescence must be reconsidered. PMID- 3631856 TI - Vascularized skull bone grafts in craniofacial surgery. AB - Vascularized skull bone grafts based on a pedicle of temporalis muscle have been used in 30 zygomatic arch and malar reconstructions, 1 mandible reconstruction, and 1 palate reconstruction. The surgical technique, complications, and postoperative results are reviewed. Technetium bone scans obtained within one week of operation confirm blood supply to the transferred bone. After a mean follow-up of 13 months, there is no evidence of bone graft resorption. We have used a team approach and careful surgical technique, and no serious complications have been encountered. PMID- 3631857 TI - Is experimental muscle flap temperature a reliable indicator of its viability? AB - This study was designed to assess the effects of environmental factors on experimental muscle flap temperature and to critically evaluate temperature as a modality for assessing vascular patency. A brief overview of the physiology of tissue heat transfer is presented. The right vertebral head of the biceps femoris muscle was used in albino New Zealand rabbits for monitoring temperature. Temperature was recorded simultaneously by means of thermocouples placed into the tested muscle, the contralateral control biceps femoris muscle, the ipsilateral control thigh compartment, and rectally (core temperature). The muscle flap temperature was recorded as a function of time during the following flap manipulations: steady state, exposed muscle, muscle elevated and then replaced with pedicles intact, and pedicles ligated. In addition, the effects of environmental manipulations on muscle flap temperature were evaluated. The constant findings demonstrated that the dominant aspects of muscle temperature are the temperature of the surrounding tissue, as well as the prevailing environmental conditions. Vascular occlusion did not alter muscle temperature. In 3 patients who underwent successful free-flap transfer, muscle temperatures were monitored and found to be labile, and altered by environmental manipulations. We concluded that temperature is an unreliable, nonreproducible method of assessing the vascular status of a muscle flap, unless all environmental variables are meticulously monitored and controlled. PMID- 3631858 TI - Wound contraction as treatment of dog bite avulsions of the lip. AB - In cases of dog bite avulsion injuries of the lip, allowing the wound to spontaneously close by contraction (without surgical intervention) may often be the treatment of choice and may have the best aesthetic and functional results. PMID- 3631859 TI - The conjunctival approach to the orbital floor and maxilla--advantages and disadvantages. AB - The conjunctival approach to the infraorbital rim and the orbit is discussed. A series of patients is presented with a small number of complications. The technique is described and the important factors in preventing problems are emphasized. PMID- 3631860 TI - Effect of intravenous prostaglandin E1 on experimental flaps. AB - Prostaglandin E1 (PGE1) is a kind of prostaglandin that produces vasodilation of the peripheral vessels and platelet disaggregation, similar to prostacyclin (PGI2). The effects of PGE1 administered intraarterially or intravenously on peripheral vascular disease have been reported by many authors. In this investigation, 2 experiments were designed to assess the effect of intravenous infusion of PGE1 on the experimental skin flaps in rabbits. In the first experiment, the blood flow in the flap was measured before and after the administration of PGE1 by using the technique of clearance of hydrogen gas, which was generated by electrolysis. The result indicated a biphasic effect of PGE1 on the blood flow in the flap. That is, the low dose (3 micrograms per kilogram per hour) increased the blood flow on the critical line of the dye distance, while the high dose (20 micrograms per kilogram per hour) decreased it. The second experiment, in which the survival length was measured, indicated the practical effect of intravenous infusion of PGE1 on flap survival. PMID- 3631861 TI - Results of treatment of recurrent dorsoradial wrist neuromas. AB - Dorsoradial wrist neuromas diagnosed and treated by traditional techniques remain the most difficult for which to achieve satisfactory pain relief. Between 1981 and 1985, 52 patients with dorsoradial wrist neuromas were treated by neuroma resection and implantation of the nerves innervating the neuroma into the brachioradialis muscle. Critical to this treatment schema was preoperative use of nerve blocks to diagnose overlapping patterns of the cutaneous nerves in this region. Of patients for whom this technique was the first surgical treatment of their neuroma (primary group), 100% achieved good to excellent pain relief. Among patients in whom the neuroma had been operated on once previously (first recurrence group), 88% achieved good to excellent pain relief with the technique described in this article. Of patients treated who had had 3 or more previous "neuroma" operations (multiple recurrence group), this technique resulted in excellent pain relief in 56%. Factors contributing to a poorer result in the multiple recurrence group included duration of pain longer than 24 months and the patient's unemployment. The diagnostic and surgical approach detailed in this article has yielded clinical results that recommend this approach not only as the primary treatment of choice but also as the treatment to help patients with pain from recurrent dorsoradial neuromas. The apparent susceptibility of the superficial branch of the radial nerve (SBRN) to form painful neuromas has been well documented. Once established, the neuroma appears particularly resistant to treatment. Based on experimental and cadaveric studies, we have formulated a treatment plan for patients with dorsoradial wrist neuromas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631862 TI - Outcome of mammary capsulotomies. AB - We reviewed the outcome of capsulotomies, both open and closed, in 134 patients with fibrous capsular contractures surrounding mammary implants. The rate of occurrence of fibrous capsules is given, along with other percentages for each type of augmentation. The study shows that the first attempt at a capsulotomy, either closed or open, gives a better result than the following attempts. After the third attempt, successful capsulotomies are either very rare or nonexistent. We therefore advise that after two or at most three unsuccessful closed capsulotomies, one should opt for an open capsulotomy. After two or at most three unsuccessful open capsulotomies, one should change to another approach. PMID- 3631863 TI - Testicular autotransplantation after traumatic castration. AB - Severe genitoperineal trauma with total avulsion of testicles in a 7-year-old boy resulted from a road accident. Soft tissues were reconstructed by local flaps and skin grafts. The only testicle that was found was reimplanted in his biceps muscle in an attempt to restore endocrine function. A human chorionic gonadotropin test showed no response, indicating that the transplanted tissue did not survive. PMID- 3631864 TI - Closure of a palatal fistula by a free tongue composite graft. AB - Postpalatoplasty fistulas were closed by free tongue composite grafts. Based on this experience, sharply dissected, thin hinge flaps and the fixation of the grafts are considered the vital points. If carefully executed, this procedure is safe and produces good results in closing small fistulas of the hard palate. Operative procedures are described and 2 representative cases are discussed. PMID- 3631865 TI - The latissimus dorsi free flap for coverage of sacral radiodermatitis in the ambulatory patient. AB - Ambulatory patients with large sacral ulcers can represent extremely challenging coverage problems. Technical options become fewer when sacral ulcers are coupled with radiation dermatitis. Latissimus dorsi free flap transfer, with direct anastomoses to sacral vessels, is described in 2 patients. PMID- 3631866 TI - Giant cerebriform intradermal nevus. AB - Giant cerebriform intradermal nevus (GCIN) is a form of cutis verticis gyrata and may be associated with a number of systemic diseases. Clinically it manifests itself as a scalp deformity resembling the surface of the brain with cerebriform morphologic characteristics. Degeneration into malignant melanoma has been reported. We herein report 3 cases of GCIN successfully treated by surgical extirpation and scalp flap reconstruction. PMID- 3631867 TI - Use of the paper clip as a hemostatic restraint in experimental end-to-side microvascular anastomosis. PMID- 3631868 TI - Re: Sachs and Bosniak: nonsurgical fat removal. PMID- 3631869 TI - An evaluation of a direct access flexible fibreoptic sigmoidoscopy service. AB - During a 3 year period 146 general practitioners referred 630 patients to a direct access flexible sigmoidoscopy clinic. The yield was 53.3% with significant colonic or rectal pathology in 30%. Twenty six cancers, 4 Dukes' A, and 38 patients with symptomatic adenomatous polyps were detected. Five further cancers were detected by subsequent barium enemas. The service reduced delay in diagnosing colorectal pathology but did not reduce the number of barium enemas requested by general practitioners. It is suggested that where facilities are already available, such a service to investigate rectal bleeding in patients over 40 years is of benefit both to patients and general practitioners. PMID- 3631870 TI - The effects of calcium alginate on wound healing. AB - A non-woven alginate dressing has been used on experimental, full and partial thickness wound models for periods up to 14 days, to assess its effects on wound healing. Histological evaluation has shown that it is an effective haemostat, generally well tolerated by body tissues. Good epidermal healing was seen on all wounds although cellular reactions could be provoked in full thickness wounds without occlusion, if there was an insufficient volume of wound exudate to completely wet the alginate fibres. PMID- 3631872 TI - The value of routine preoperative investigations. AB - In a prospective study of 400 patients admitted for elective surgery, the value of preoperative investigations in identifying the group at high risk of complications was assessed. In order to evaluate methods of reducing the number of investigations a preoperative questionnaire was used and patients were also grouped with regard to age and extent of surgery. Sixteen per cent of the results of the preoperative investigations showed some abnormality but only 0.013% caused a change in management. Abnormal results were significantly associated with complications (P less than 0.05). A positive (abnormal) questionnaire and increased age together defined a group more likely to have abnormal results (P less than 0.05) but age was a more specific indicator. The extent of surgery was not associated with abnormal results other than biochemistry results but was associated with complications (P less than 0.01) and with the need to repeat investigations postoperatively. It was concluded that a preoperative questionnaire might be useful in the assessment of day case patients, where a larger fraction would be expected to fall into the low risk group. A policy for routine preoperative investigation was drawn up. Full blood count should be performed in all patients over 40 years, ECG in all patients over 50 years and CXR and urea and electrolytes in patients over 60 years undergoing major surgery. Asymptomatic patients out with these categories do not require routine investigations. PMID- 3631871 TI - Fine needle aspiration cytology of breast masses: an evaluation of its accuracy and reasons for diagnostic failure. AB - A study of 1458 patients who had undergone breast aspiration cytology was conducted to determine the diagnostic accuracy of the technique. The effect of tumour histology and size on the unsatisfactory aspirate and false negative rate was examined. Seven hundred and thirty one patients (50%) had histological diagnoses. The sensitivity of aspiration cytology for malignancy was 64% for the first aspiration, but was 91% in patients who had had 3 aspirates. The specificity was 56%, this low figure was almost entirely due to inadequate or unsatisfactory cytological preparations. The positive and negative predictive values of aspiration cytology were 99.4% and 85% respectively demonstrating high diagnostic accuracy given a satisfactory aspirate. Invasive lobular carcinoma yielded a significantly higher unsatisfactory rate than invasive ductal carcinoma (P less than 0.001) and fibroadenoma yielded a significantly lower unsatisfactory rate than fibroadenosis (P less than 0.001). Mass size influenced the unsatisfactory rate for invasive ductal carcinoma (P less than 0.05) and fibroadenoma, but not for invasive lobular carcinoma or fibroadenosis. Only 2 of the 32 false negatives were due to misinterpretation, the remainder resulted from the aspiration needle missing the mass. We conclude that aspiration cytology is an accurate preoperative diagnostic procedure for the evaluation of breast masses. Unsatisfactory or negative aspirates should be regarded as 'non-results' if there is clinical or radiological suspicion of malignancy. PMID- 3631873 TI - Colovesical fistula. AB - The experience of 66 cases of colovesical fistula is reported. The most common cause was diverticular disease (71%), the remainder being due to malignancy, Crohn's disease, radiotherapy, appendicitis and trauma. The most sensitive investigation was barium enema, which was abnormal in 98% and actually showed the fistula in 57%. In 32 patients a single stage resection was performed, without mortality or significant morbidity and we would advocate this form of treatment for fistulae which are not complicated by gross sepsis or obstruction. PMID- 3631874 TI - Emergency abdominal re-exploration in a district general hospital. AB - A series of 3600 consecutive patients undergoing laparotomy was studied prospectively. Fifty six patients required a total of 64 urgent re-explorations of the abdomen during the period of hospitalisation after the first operation. The re-exploration rate was 1.7%. Re-laparotomy was most often necessary in the elderly and following gastroduodenal or intestinal operations. The indication for re-operation must in part reflect the nature of surgical practice but in this general surgical unit the most common complications requiring re-laparotomy were sepsis, small bowel obstruction and wound dehiscence. Biliary operations were relatively uncomplicated. Mortality rose with age. Diagnosis depends upon the ability to distinguish the clinical symptoms and signs of developing complication from the clinical features inevitable following abdominal surgery. We believe that the decision to re-operate and the second operation should normally be undertaken by experienced surgical staff. PMID- 3631875 TI - Anaesthesia for major craniofacial surgery: a report of 23 cases in children under four years of age. AB - The problems of anaesthetising infants and small children for major craniofacial surgery are discussed. A series of 23 patients is presented to illustrate the practical difficulties. PMID- 3631876 TI - Splenic conservation and the management of splenic artery aneurysm. AB - We report two patients with splenic artery aneurysm diagnosed by CT, treated by proximal and distal ligation of the splenic artery and followed for two years by CT to assess splenic size and pitted erythrocyte counting to assess function. Literature review shows that excision of the aneurysm and splenectomy is usual but with growing regard for conservation of splenic tissue we suggest that proximal and distal ligation of the artery is a preferable alternative as shown by splenic function tests in these patients. PMID- 3631877 TI - The management of a neck mass: presenting feature of an asymptomatic head and neck primary malignancy? AB - Malignancy of the upper aerodigestive tract is not always associated with obvious localizing symptoms. Presentation may then only be prompted by the appearance of a hard mass in the neck, a metastasis to a cervical lymph node. Neck exploration without a prior diligent search for an occult head and neck primary tumour is to be avoided as it compromises subsequent treatment. The diagnostic investigation of 112 patients complaining solely of a painless and enlarging neck swelling is reviewed. An otolaryngologic examination identified an asymptomatic malignancy of the head and neck in 72 patients (64%). Excision biopsy of the neck mass was required to achieve a diagnosis in only 29 (29%) of those patients who had not already undergone surgery. These results are presented to emphasize the need for a specialist examination of the head and neck prior to embarking on excision of any suspicious neck mass. PMID- 3631878 TI - Auditing perioperative mortality. AB - An audit of mortality following operation was performed over ten years classifying deaths into those that were 'expected' and 'unexpected'. 'Unexpected' deaths were defined as those in which, after careful consideration of the prevailing clinical circumstances at the time of operation, the probability of death following operation was felt to be low. This definition is a more helpful assessment of surgical performance than overall perioperative mortality as it highlights cases where improvements in surgical management might be achieved. In audits involving surgical mortality, the classification of deaths into 'expected' and 'unexpected' is recommended. PMID- 3631879 TI - Complications of T-tube drainage of the common bile duct. PMID- 3631880 TI - Duodenal ulcer perforation: the effect of H2 antagonists? PMID- 3631881 TI - A prospective randomised comparison of healing in Gritti-Stokes and through-knee amputations. PMID- 3631882 TI - Bupivacaine 'squirting'. PMID- 3631883 TI - Hepatic metastases in Hong Kong Chinese: evidence for an East-West difference in gastric cancer. PMID- 3631884 TI - The surgical management of pancreatic abscess. PMID- 3631885 TI - Bringing HELP to the clinical laboratory--use of an expert system to provide automatic interpretation of laboratory data. AB - In domains where the types of data which are to be interpreted are relatively constrained (as in the case of specific laboratory test results), our modular data-driven approach can be very productive and well received by the clinical recipient of the data. The computer rarely surpasses the knowledge of an experts result from lack of communication, imperfect memory, oversight or multiple decision-makers caring for the same patient. In such cases, most of the alerts are immediately recognized as valid, so the need for elaborate explanations is not a high priority. On the other hand, a non-specialist is alerted to the need for additional investigation, tests or collaborative support, by the fact that a reminder or diagnosis that s/he had not previously considered, appears. In other words, for the expert, a data-driven system provides unceasing oversight in high volume low-yielded situations where a small number of mistakes may uncommonly occur for reasons which are not related to the lack of knowledge of the provider. For the non-specialist the system suggests that the patient may have problems in a domain for which the physician needs additional support. In the present state of the art, we do not think that total reliance on the computer-contained knowledge is the ultimate source of this additional support; providing the awareness of the need may be the most important contribution. Once you know that you need help, it is usually obtainable. In a discussion about how computer systems have failed, Friedman and Gustafson made the following observation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3631886 TI - Antitumor activity and toxicity in mice of RA-700, a cyclic hexapeptide. AB - The antitumor activity of RA-700, a cyclic hexapeptide isolated from Rubia Cordifolia, was evaluated in comparison with deoxy-bouvardin and vincristine (VCR). As regards the proliferation of L1210 cultured cells, the cytotoxicity of RA-700 was similar to that of VCR but superior to that of deoxy-bouvardin. The IC50 value of RA-700 was 0.05 mcg/ml under our experimental conditions. RA-700 inhibited the incorporation of 14C-leucine at a concentration at which no effects were observed on the incorporation of 3H-thymidine and 3H-uridine in L1210 culture cells in vitro. The antitumor activity of RA-700 was similar to that of deoxy-bouvardin and VCR against P388 leukemia. Daily treatment with RA-700 at an optimal dose resulted in 118% ILS. As with deoxy-bouvardin and VCR, the therapeutic efficacy of RA-700 depends on the time schedule. RA-700 showed marginal activity against L1210 leukemia (50% ILS), similar to that of deoxy bouvardin but inferior to that of VCR. RA-700 inhibited Lewis tumor growth in the early stage after tumor implantation, whereas deoxy-bouvardin and VCR did not. As regards toxicity, a slight reduction of peripheral WBC counts was observed with the drug, but no reduction of RBC and platelet counts. BUN, creatinine, GPT and GOT levels in plasma did not change with the administration of the drug. PMID- 3631887 TI - Effect of ellipticine on MFO activity in single living 3T3 fibroblasts studied by microspectrofluorimetry. AB - The MFO activity in intact cells was monitored through microspectrofluorimetry study of BaP metabolization. This approach allowed observation of individual cells in a cell population to represent the studied samples through histograms as a function either of rate constants or of "residual BaP". The inhibitory effect of ellipticine was demonstrated on intact living 3T3 fibroblasts. The role of DMF dissolution and cellular localisation of compounds were also studied. PMID- 3631888 TI - Influence of 5-hydroxytryptamine on the combination effect of lonidamine or gossypol and hyperthermia on Ehrlich tumour in vivo. AB - An experiment was conducted using lonidamine and gossypol against Ehrlich tumour in the foot pad of CD-1 mice. These compounds alone were mild antitumour agents, but their cytotoxicity increased when they were combined with hyperthermia. The antitumor effect was further increased by 5-hydroxytryptamine, particularly when combined with lonidamine. PMID- 3631889 TI - Ultrastructural morphometric studies on benign and malignant lung tumours. AB - Premalignant and malignant lesions from human lung tumours have been investigated by ultrastructural stereological methods and compared to normal bronchial tissue. It was possible to develop characteristic quantitative ultrastructural criteria for the different lesions. These criteria are the basic of a data bank system. After verification by further investigations they may be applicable to the development of a diagnosis supporting system. PMID- 3631890 TI - Primary human tumor cells and continuous cell lines differ in clonal growth in soft agar. AB - This study is a sequel in our continuing efforts to improve the colony forming efficiency of the Human Tumor Colony Assay. We have previously reported that the use of culture media supplemented with rat red blood cells and a low oxygen environment resulted in notable improvements in the clonal growth of three different tumor cell lines (colon, breast and melanoma). We now report, however, that the application of these methods to cells from 18 different samples of primary human tumors resulted in no improvements in growth. Our results suggest that caution must be exercised in extrapolating results obtained from the use of homogeneous cell lines to that of cells from human solid tumors. PMID- 3631891 TI - Tumoricidal cells increased by pulsating magnetic field. AB - Repeated applications of pulsed magnetic fields (right-angle waves, 50 Hz = 135 Gauss, 2 Hz = 262 Gauss) significantly enhanced the number and the tumoricidal activity of nonparenchymal liver cells. The transplantable mouse leukemia L1210 used as a tumor model was not significantly influenced, either directly or during Cyclophosphamide treatment. PMID- 3631892 TI - Pretreatment transurethral resection of prostate cancer and disease-free survival. AB - Data from the American College of Surgeons' national survey on prostate cancer were analyzed to determine whether recurrence-free survival differs between those patients diagnosed by transurethral resection of the prostate (TURP) and those diagnosed by needle biopsy. Only patients who received radiation therapy as treatment were included in this analysis. There were 461 patients diagnosed by TURP and 541 patients by needle biopsy. Disease free survival was calculated according to the state and tumor differentiation. Except in stage B1, none of the groups showed a statistically significant difference in recurrence-free survival between the two diagnostic procedures. The results of this analysis suggest that the disease-free survival of patients with radiation-treated prostate cancer diagnosed by TURP and needle biopsy are similar. PMID- 3631893 TI - A multifactorial analysis of different biological and clinical parameters in breast cancer. AB - Different biological and clinical parameters were correlated in a consecutive series of breast cancer patients. Age, tumor size, hormonal receptor status, grading and lymph nodal status (N) were taken into account. A linear logistic regression analysis was performed for 83 patients in whom all parameters were known. Lymph nodal involvement was observed more frequently in tumors with a diameter larger than 2 cm (RR = 3.83; p less than 0.05); it was also more frequently observed in undifferentiated tumors (G2-3), although these data were not significant (RR = 2.75). Neither age nor hormonal receptors were related to lymph nodal involvement. A significant relationship between age and estrogen receptors (ER) was found: younger women had a greater frequency of ER negative tumors (RR = 8.81; p less than 0.005). An opposite tendency was found as regards progesterone receptor status (PgR) (RR = 0.20; p less than 0.05), although these data require further confirmation. No obvious correlation was found between tumor size and hormonal receptor content, although in younger patients tumor size seems to influence ER levels: tumors larger than 2 cm were 1.43 times more often ER negative than tumors smaller than 2 cm. There was no correlation between ER and grading, although G3 tumors were found to be ER negative more frequently than others (RR = 1.71; ns) and showed a tendency to be PgR negative (RR greater than 3). Finally, tumors with lower ER levels were more frequently PgR negative (RR = 11.89; p less than 0.001). PMID- 3631894 TI - Biological characteristics of a newly established human oesophageal carcinoma cell line. AB - An epithelial cell line, EC/CUHKI was established from a human squamous cell carcinoma of the oesophagus. The cells were polygonal in shape with numerous microvilli. Transmission electron microscopy (TEM) revealed the presence of desmosomes and tonofilaments. Karyotypic analysis of cells from the cell line demonstrated an aneuploid human type with a modal chromosome number of 85. Epstein-Barr viral nuclear antigen (EBNA) has not been demonstrated in the cells from the primary culture or subcultures. The tumour cells form colonies in agar and have a plating efficiency of 20%. The cells are highly invasive in vitro and are tumorigenic in nude mouse. PMID- 3631895 TI - Fragile sites and chromosomal structural rearrangements in human leukemia and cancer. AB - Information on chromosomal structural rearrangements in leukemia and solid tumors was retracted from a computerized databank and the literature. A binomial test procedure was used to determine the statistical significance of the observed numbers of breaks. The results showed that breakage occurred preferentially in bands known to contain a fragile site and that some of them were associated with specific chromosomal structural changes in specific types of leukemia and cancer. The hypothesis of a possible relation with proto-oncogenes is also raised. PMID- 3631896 TI - Satellite and in-transit (SIT) metastases from melanoma are more predominant in females than in males. AB - A prospective study was undertaken on 489 patients registered between 1981 and 1983 in order to evaluate the correlation between the sex of the patient and the incidence of satellite and in-transit (SIT) metastases. There were 186 males, 12 of whom (6.5%) showed clinical or histopathological evidence of SIT lesions at the time of diagnosis. Thirty-one out of 303 females (10.2%) had SIT lesions. Moreover, the extent of SIT involvement was greater in females than in males. Five out of 12 males (41.7%) had clinical evidence of SIT lesions, compared to 20 out of 31 females (64.5%). The other patients with SIT lesions had microscopical involvement only. Similarly, only 1 out of 12 males (8.3%) had in-transit lesions (greater than 5 cm from primary), compared to 6 out of 31 females (19.4%). The female preponderance in developing SIT lesions was statistically significant (P less than 0.05, allowing for stage of disease and extent of SIT involvement). It is concluded that the female sex is correlated with an increased risk of developing SIT metastases when compared with males of similar (micro)stage. PMID- 3631897 TI - Improvement of the diagnostic accuracy in pigmented skin lesions by epiluminescent light microscopy. AB - Epiluminescent light microscopy (ELM) represents a technique which permits to examine details of the surface of the skin and also--in by using the oil immersion technique--of the dermal-epidermal junction zone. Criteria are described which allow the distinction of benign from malignant growth patterns of pigmented skin lesions; thus ELM adds considerably to the diagnostic armamentarium of pigmented skin lesions at the clinical level. PMID- 3631898 TI - Two cases of spindle cell tumors studied by light microscopy, electron microscopy and immunohistochemistry. AB - Two cases of spindle cell tumors are presented which by histopathology, histochemistry and electron microscopy were classified as desmoplastic melanoma and neurotropic melanoma, respectively. The striking similarity of these tumors has to be regarded as further evidence of the close histogenetic relationship of desmoplastic and neurotropic melanoma. PMID- 3631899 TI - Brain metastases of an amelanotic melanoma as the primary manifestation in a 15 year old boy. AB - A 15-year old boy was admitted to hospital with an acute left hemiparesis because of a 3.5 cm-diameter-tumor in the right frontoparietal region. In CCT 4 other tumors were to be seen in both hemispheres after giving contrast medium. Upon a diagnostic operation, a hemorrhage into a metastasis of an amelanotic melanoma was found. The boy survived 2.5 months. In the pathological examination the primary tumor was not found, but there were 12 other intracerebral metastases and two metastases in the left lung and the thyroid gland. Histologically it was an amelanotic melanoma. PMID- 3631900 TI - Normothermic isolation perfusion with melphalan for advanced melanoma of the limbs. AB - Eighteen patients with advanced melanoma of the limbs underwent a single isolation perfusion with melphalan under normothermic conditions, i.e. tissue temperatures between 37.0 and 38.0 degrees C. There were no major complications. In 7 patients complete remission was achieved and in 8 the remission was partial, i.e. tumor reduction greater than 50%. No obvious response was seen in the remaining 3 patients. At the time of analysis 4 patients were still in complete remission, 56, 55, 19 and 8 months after perfusion, respectively. One patient died from distant spread, 17 months after perfusion, but without exhibiting new tumor growth in the perfused area. In 2 patients local control was transient with locally recurrent disease 28 and 10 months after perfusion, respectively. In patients with partial remission the duration of remission could not be determined because of supplementary treatment or death. Our results seem to be comparable to those obtained by so-called mild hyperthermic perfusions. PMID- 3631901 TI - Angioocclusive chemotherapy in melanoma: rationale and technical considerations. AB - To date, systemic chemotherapy for melanoma metastases appears to be of only limited benefit since tumoricidal drug concentrations can hardly overcome primary or secondary drug resistance of melanoma cells. Recently, intraarterial infusion techniques with or without regional venous drug hemofiltration have been shown to provide high cytotoxic levels at the target region, thus subsequently using persistent (chemo-embolization) or transient (microspheres, liposomes) blocking techniques may optimize the pharmacological advantage of regional drug delivery. In a pilot series in metastatic liver cancer a significant increase of drug concentration within the target tissue could be achieved while systemic levels were found to be reduced during angio-occlusion. The rationale of angio-occlusive approaches in melanoma offers the possibility of focusing the anti-tumor action directly at the target so that improved response rates can be expected. PMID- 3631903 TI - Incidence of malignant melanoma in Central Hesse, Germany. AB - The incidence of melanoma in Central Hesse, the catchment area of the Dermatological Clinic of the University of Giessen, was 11.1 per 100,000 inhabitants in 1984. The incidences in the different districts are relatively equa, varying only between 9.7 and 12.4 in 5 of 6 districts. In Central Hesse, too, the frequency of melanoma has steadily increased since 1970, the rates for 1984 being fivefold in both men and women. Apart from the real increase, this is probably due to an intensive public and professional melanoma education project and higher public awareness. PMID- 3631902 TI - Intracranial melanoma metastases: surgical treatment and follow-up of 18 patients. AB - Eighteen patients with operated cerebral metastases from malignant melanoma were followed-up. There was no operative death and in general the patients' quality of life was improved. The results suggest that operation of a cerebral metastasis prolongs the survival of the patient if no other cerebral lesions develop. Every operatively accessible recurrence or new metastasis should be operated on, if the general condition of the patient allows it. PMID- 3631904 TI - Combined treatment of advanced malignant melanoma with coumarin and cimetidine. AB - An immunostimulant therapy with coumarin and cimetidine was evaluated in 17 patients with advanced malignant melanoma. Induction therapy with coumarin 100 mg daily was given for 8 weeks, after which cimetidine 1000 mg daily was added. No patients had been previously treated with cytotoxic drugs. All patients had good performance status. Sixteen patients experienced progressive disease, and only one patient showed no change lasting for 30 weeks. It is concluded that treatment with this schedule of coumarin and cimetidine is without effect in advanced malignant melanoma. PMID- 3631905 TI - Acute renal failure following hyperthermic isolation perfusion of the left leg. AB - This is the case report of a 37-year-old female who underwent primary excision of a malignant melanoma on the left foot as well as an inguinal lymphnode dissection in May 1983. In January 1984 a satellitosis on the same foot was treated with an isolation perfusion which had to be repeated in December of the same year due to secondary satellitosis. For the first perfusion, Alkeran 80 mg was used with a temperature of up to 41.4 degrees C, whereas Cis-Platinum 20 mg/l and Eldesine 0.3 mg/l were used for the second perfusion, with a maximum temperature in the tumor area of 39.0 degrees C. On the first postoperative day, significant edema of the left leg accompanied by severe pain was noticed. This was followed by an increase of the serum creatinine to 2.2 mg % two days later. Despite the immediate inducement of a forced diuresis, renal function deteriorated during the following days with serum creatinine going up to 4.8 % and CK to 14800 U/L. After a forced diuresis of two weeks' duration, the laboratory parameters slowly went back to normal. As a consequence of this complication we analyzed the influence of hyperthermic isolation perfusion on five patients with regard to muscular damage and its influence on renal failure. During perfusion we observed myoglobinemia which subsided within 36 hours. This slope was paralleled by CK values. A discrete myoglobinuria which was observed in two patients disappeared within 36 hours after perfusion. No rise of creatinine could be found. The changes described above were not influenced by cytostatic medication (Alkeran versus Cis-Platinum and Eldesine). In addition, none of the cases showed a leakage of over 16%. The case of acute renal failure was apparently caused by increased rhabdomyolysis as a consequence of the second hyperthermic perfusion. PMID- 3631906 TI - Prognostic significance of the receptor for epidermal growth factor in human mammary carcinomas. AB - 125I-EGF binding technique was used to demonstrate high affinity receptor binding for epidermal growth factor (EGF-R) in 72 human mammary carcinomas. 27% of the tumors were EGF-R positive and the presence of this receptor was correlated with receptor levels for estradiol, DNA-pattern, proliferative index, thymidine kinase, tumor size, number of lymph node metastases and 6-year relapse probability. Our results confirm previous reports of an inverse relation between the cellular content of EGF-R and ER. In addition, we could associate EGF-R positivity with an aneuploid DNA-pattern and an increased growth rate, as measured by proliferative index. No correlation was found between EGF-R positivity in the primary tumor and presence of axillary lymph node metastasis at the time of operation. The 6-year relapse rate was somewhat higher for patients whose primary tumors were EGF-R positive. Moreover patients who had lymph node metastases at the time of operation and EGF-R positive tumors experienced a significantly lower 6-year disease free survival rate as compared to those who were node negative and had receptor negative tumors. It remains to be shown whether EGF-R alone can be used as an independent prognostic factor. PMID- 3631907 TI - Signs, symptoms, metastatic spread and metabolic behavior of neuroblastomas treated in Denmark during the period 1943-1980. AB - The clinical manifestations of 253 neuroblastoma cases in childhood, treated in Denmark from 1943 to 1980, were reviewed. Most striking was the vagueness of symptoms in the majority of patients, only a few of whom exhibited the symptoms strongly suggestive of a neuroblastoma (i.e. the Horner syndrome, the watery diarrhoea syndrome, the dancing eye syndrome). The vagueness of the symptoms might have led to fatal procrastination of the diagnosis. The diagnostic delay has, however, no independent prognostic significance for survival in our patients (p = 0.09). The maximal tumour spread was recorded for all 253 patients, and the distribution of metastases was in accordance with the "soil-seed" hypothesis. The tumour spreads with equal frequency by local growth, by lymphatic vessels to distant lymph nodes, and by blood to bone. Only in widely disseminated tumours are metastases to the lungs, the meninges, the brain, and the reproductive organs seen to occur. Eighty-five percent of the patients, for whom data were available, excreted VMA above the normal value for their age, and 43% excreted Norepinephrine + Epinephrine (N + E) above normal levels. The excretion of both VMA and N + E was significantly correlated to stage, and thus to prognosis. Neither the level of VMA excretion nor the level of N + E had any bearing on the survival when age and stage were adjusted for. Serial VMA and N + E determinations show that patients with normal values for these parameters had significantly better prognosis than patients with elevated values during the first, second, third and fourth trimesters after the initiation of treatment. Increasing values in the individual patient were associated with a poor prognosis. We found no correlation between the initial leucocyte count and survival when age and stage were adjusted for. PMID- 3631908 TI - Growth requirements and growth pattern of human urothelial cell lines of different grades of transformation. AB - Human urothelial cell lines propagated in culture have been classified into three grades of transformation (TGr I-III). This classification is unrelated to the histological classification of the original biopsy material. Mortal TGr I cell lines differed from immortal and nontumorigenic TGr II cell lines and tumorigenic TGr III cell lines; they have a lower growth rate, growth fraction, and saturation density, and a higher requirement for Ca2+. Except for one TGr II cell line, TGr II cells differed from TGr III cells by having a higher serum requirement and a lower saturation density. The ability to grow in agar was not correlated with the TGr of the cell lines. PMID- 3631909 TI - Extraction of ER and PgR with molybdate. AB - Extraction of ER and PgR with 10 mM molybdate in TEDG buffer greatly facilitated their solubilization and a much higher receptor value was observed. However, since molybdate also affects the hormone receptor binding reaction, the apparent receptor activity assayed with molybdate is different from the actual receptor activity normally assayed without molybdate. A correction factor obtained by assaying cytosol with and without adding molybdate can be used to convert the apparent value into the actual value. The mathematical evaluation involving two separate effects of molybdate on receptors is illustrated. PMID- 3631911 TI - Spontaneous premature chromosome condensation in metastatic variants of the B16 murine melanoma and human astrocytomas in culture. AB - Spontaneous premature chromosome condensation (PCC) occurs in B16 murine melanoma variants and two human astrocytoma cell lines in the absence of physical fusion of interphase and mitotic cells. There was no apparent relationship between PCC incidence and metastatic ability. PMID- 3631910 TI - The effect of a biological response modifier, PSK, on the intestinal immune system in tumor-bearing mice. AB - We have previously shown that oral administration of PSK not only exerts antitumor activity, but also restores immune response in tumor-bearing mice. In order to analyze the immunomodulative effect of PSK, we investigated the effects of oral PSK on the intestinal immune systems in ICR mice bearing sarcoma 180. Oral administration of PSK increased the number of Peyer's patches that developed relatively well, and led to recovered mitogenic response of lymphocytes from gut associated lymphatic tissue and responsiveness to oral preimmunization with SRBC in tumor-bearing mice. These results suggest that PSK modulates the immunity in intestinal tract of tumor-bearing mice. PMID- 3631912 TI - Increased recovery of estrogen receptor in crude homogenates of breast cancer biopsies. A preliminary report. AB - Crude homogenates and cytosols of 31 breast cancer biopsies were analyzed for estrogen receptor, using the ER-EIA monoclonal assay (ABBOTT Laboratories). The recovery of the receptor was significantly higher in all homogenates than in their corresponding cytosols, in six of which the receptor was below the level of detection. The range of the ratio between homogenate and cytosol concentrations was 0.9-8.1 for 25 positive biopsies. If the recent hypothesis of nuclear localization of the receptor is accepted, the values obtained with crude homogenates would more correctly reflect the true concentration of the receptor in the cells. PMID- 3631913 TI - Flow cytometric studies of colorectal tumors using fine needle aspiration. AB - The results are reported of cytofluorometric DNA analyses of colorectal tumors using cells obtained by mechanical disruption and fine needle aspiration. The latter method does not lower the level of debris or cell aggregates. We found a significantly higher proportion of aneuploid cells by needle aspiration. There was a good correlation between the data obtained by both methods, but for large heterogeneous tumors multiple site aspirations are needed to obtain representative specimens. Fine needle aspiration was found particularly useful for small tumors and polyps. PMID- 3631914 TI - Phagocytosis of the streptococcal preparation OK-432 (picibanil) by non phagocytic human leukemia K 562 cells and its modulation by tumor cell differentiation. AB - OK-432, an inactivated and lyophilized preparation of a low-virulence strain of Streptococcus pyogenes induced a phagocytosis process in human erythroleukemic K 562 cells. This process seems to be specific to the cell line, known however as non-phagocytic, and specific to the bacterial preparation. Transmission and scanning electron microscopy confirmed phagocytosis. Increased lysosomal activity was also demonstrated by cytochemical and biochemical criteria. The induction of phagocytosis required an intact cell surface membrane and sialo-glycoproteins seemed to be implied. The phagocytosis was inversely correlated with the erythroid differentiation of the K 562 cell. Hemin-treated K 562 cells and the markedly erythroid K 562 clone showed a decreased level of phagocytosis. The phagocytosis level in a K 562 clone expressing Fc (IgG) receptors was not altered by OK-432. In addition, a weak erythroid K 562 clone expresses the same level of phagocytosis as the total population. PMID- 3631915 TI - Oculogyric crisis: a syndrome of thought disorder and ocular deviation. AB - In 3 patients who suffered oculogyric crises, mental changes accompanied upward deviation of the eyes. In 1 patient, whom we studied in detail, the mental disturbance consisted of a disorder of attention in which pathological fixation of a thought occurred. During the period of upward eye deviation, all functional types of conjugate eye movements were present in the upper field of gaze, suggesting an imbalance of the vertical gaze-holding mechanism. The eyes could be driven down only by a combined blink and downward saccade. Both the thought disorder and the ocular deviation responded promptly to anticholinergic agents. We propose that the disorders of thought and eye movement in oculogyric crisis are linked by a pharmacological imbalance common to both. PMID- 3631916 TI - Loss of pedunculopontine neurons in progressive supranuclear palsy. AB - In the present study, the number of neurons (greater than 20 microns in diameter) within the lateral part of the pedunculopontine nucleus pars compacta (PPNc) was determined at six rostrocaudal levels in 3 subjects with progressive supranuclear palsy (PSP), in 9 subjects with Alzheimer's disease, and in 6 age-matched control subjects. At each level examined, significantly fewer neurons were present in patients with PSP than in control subjects (49 to 69% reduction). Significant differences in numbers of neurons were not demonstrated between control subjects and patients with Alzheimer's disease. The extent of pathological changes, particularly neurofibrillary tangles, was examined within the PPNc of subjects in these three groups. The average number of neurofibrillary tangles in a 12-microns thick midlevel section of the lateral PPNc was 68.7 in subjects with PSP, 18.3 in those with Alzheimer's disease, and 3.0 in aged control subjects. These abnormalities of PPNc neurons in PSP may play important roles in some of the clinical features characteristic of this disease. PMID- 3631917 TI - To treat early or to treat late? PMID- 3631918 TI - Cholinergic-dependent cognitive deficits in Parkinson's disease. AB - In a double-blind cross-over study, the effects of a subthreshold dose of scopolamine (0.25 mg) on memory were compared in 32 control subjects and 32 parkinsonian patients who were without any sign of intellectual and mnemic impairment. Although the scores of the controls in the memory test battery showed no deterioration after the administration of scopolamine, the same dose resulted in significantly reduced memory performance in parkinsonian patients in two tests which involved the recognition of meaningless drawings. The selective vulnerability of parkinsonian subjects without cognitive impairment to a subthreshold dose of scopolamine suggests the existence of an underlying alteration of central cholinergic transmission. The neuropsychological findings in our study agree with postmortem biochemical data, which showed decreased cortical choline acetyltransferase activity in all parkinsonian patients, suggesting the existence of neuronal compensation in parkinsonian patients who are without cognitive impairment. PMID- 3631919 TI - Factors that influence the occurrence of response variations in Parkinson's disease. AB - Retrospective study of 129 patients treated with dopamine substitution showed that the occurrence of response variations is related to the duration of therapy and not to the nature of the predominant symptom (tremor or hypokinesia and rigidity) or the age of onset of the disease. A relationship was found between the occurrence of response variations and the severity of the disease when levodopa therapy was started. Patients fared worst who were in Hoehn and Yahr stages I and II when levodopa therapy was begun. PMID- 3631920 TI - The role of scanpaths in facial recognition and learning. AB - We carried out a comprehensive assessment of eye movements in 2 subjects with impaired facial learning and recognition to determine if the defect might be associated with abnormal scanning of faces. Standard electroculogram showed that fixation, pursuit, saccades, and scanning of salient features of scenes and faces were normal, indicating that the defect was not due to abnormal scanning. However, study of the transitional properties of scanning revealed that the scanpaths of personally meaningful familiar faces, whether or not they were consciously recognized, were less predictable than those of other faces. This result indicates the existence of an internal and relatively specific schema for familiar faces sufficient to alter the "predictable" scanpath used for nonfamiliar faces. This internal schema is accessed even when conscious recognition fails, i.e., when other pertinent memories related to the possessor of the face are not evoked. The meaning of this finding is comparable to that obtained with autonomic studies of covert recognition in prosopagnosia and suggests that properties of scanning can be used as an index of higher neural processing. PMID- 3631921 TI - Site of penetrating brain lesions causing chronic acquired stuttering. AB - Ten subjects exhibited acquired stuttering that had persisted for 10 to 15 years following penetrating missile wounds sustained during the Vietnam War. None had a history of developmental or chronic adult stuttering. In comparison with other head-injured subjects and normal control subjects, the subjects with acquired stuttering had significant deficits in skilled rapid hand movements and oral and speech movements, suggesting a motor control disorder. The identified brain lesions of the acquired stuttering group were on the right in 5 subjects, on the left in 4, and bilateral in 1. The internal and external capsules, the frontal white matter, and the striatum were more frequently involved in the acquired stuttering group than in other head-injured subjects (p less than or equal to 0.05). This speech rhythm and rate disorder was not associated with evident cortical lesions in either hemisphere but with predominantly unilateral lesions of the subcortical pyramidal and extrapyramidal systems. PMID- 3631922 TI - Does carotid endarterectomy decrease stroke and death in patients with transient ischemic attacks? Committee on Health Care Issues, American Neurological Association. PMID- 3631923 TI - Ataxia after severe head injury: the pathological substrate. AB - Ataxia is a common finding in patients who have recovered from severe head injury. This report delineates the clinical and pathological findings in a patient who recovered from a head injury but was left with ataxia of gait. A lesion of the superior cerebellar peduncle, demonstrated post mortem 2 1/2 years after injury, was the only explanation for the ataxia. This lesion is part of the spectrum of changes seen in diffuse axonal injury thought to be due to shearing forces which tear white matter at the time of the initial injury. PMID- 3631924 TI - Giant axonal neuropathy: correlation of clinical findings with postmortem neuropathology. AB - We report the clinical and postmortem neuropathological findings in a case of long-standing giant axonal neuropathy. The patient, a caucasian male with kinky hair, was first seen at 4 years of age because of increasing unsteadiness of gait. Clinical examination showed nystagmus, cerebellar ataxia, distal sensory loss, and weakness. A sural nerve biopsy at 8 years of age revealed giant axonal neuropathy. The patient became increasingly demented and was incapacitated by weakness and ataxia; he died at 18 years of age. Histological examination of the brain and spinal cord showed numerous Rosenthal fibers, a distal axonopathy that most severely affected the corticospinal tracts, middle cerebellar peduncles, and posterior columns, and olivocerebellar degeneration. PMID- 3631925 TI - Multi-center study of Parkinson mortality with early versus later dopa treatment. AB - Four geographically diverse centers provided data on mortality in 359 patients with Parkinson's disease, the majority of whom began dopa treatment during the early experimental trials of 1968 to 1970. Patients were classified into three groups based on the duration of symptoms prior to starting dopa treatment: Group 1, 1 to 3 years; Group 2, 4 to 6 years; Group 3, 7 to 9 years. After 15 years of treatment and 3,689 person-years of observation, Group 1 had an observed-to expected mortality ratio of 1.43; Group 2, 2.44; and Group 3, 2.95 (p less than 0.05). This result confirmed that increased duration of disease was associated with increased mortality risk. To examine the effect of the time of initiation of dopa treatment, duration of disease was held constant at 17 years for all three groups. Observed-to-expected mortality ratios were 1.43 for Group 1; 2.66 for Group 2; 2.63 for Group 3. This statistically significant advantage for Group 1 (p less than 0.0001) led to the conclusion that early treatment with dopa has a beneficial effect on life expectancy. After 17 years of disease, causes of death in Group 1 were less likely (p = 0.027) to be due to Parkinson's disease than was found in the other groups. PMID- 3631926 TI - Ataxia and paraproteinemic polyneuropathy. PMID- 3631927 TI - Confusing reporting in abetalipoproteinemia. PMID- 3631928 TI - Methylmalonic acid, methanol, metabolic acidosis, and lesions of the basal ganglia. PMID- 3631929 TI - Diagnosing neonatal seizures. PMID- 3631930 TI - Still another cause of monocular oscillopsia. PMID- 3631932 TI - [Comparative antibiotic sensitivity of NAG vibrios]. AB - Six hundred and forty eight NAG vibrio strains isolated at various periods from patients and carriers and from environmental objects such as surface of water reservoirs and sewage were studied with respect to their sensitivity to 14 antibiotics with the method of serial dilutions in solid media. Irrespective of the isolation place, object and time, the NAG vibrios were highly resistant to penicillins and polymyxin M. At the same time they were highly sensitive to gentamicin (MIC 1-2 micrograms/ml), levomycetin (MIC 0.5-1 micrograms/ml) and tetracyclines (MIC 0.25-1 micrograms/ml). Study of the recipient capacity of NAG vibrios with respect to R plasmids showed that they could be recipients of exogenic R plasmids of various incompatibility groups. PMID- 3631931 TI - [Synthesis and antitumor action of 14-N-substituted derivatives of rubomycin and karminomycin]. AB - The reaction of nucleophilic substitution of 14-bromine derivatives of carminomycin and rubomycin with respective nitrogen-containing heterocycles yielded six novel derivatives of carminomycin and rubomycin: 14-N-imidazolyl carminomycin, 14-carminomycyl-N-pyridinium bromide, 14-carminomycyl-N-(3 aminocarbonyl)-pyridinium chloride, 14-rubomycyl-N-(3-amino-carbonyl)-pyridinium chloride, 14-N-succinimidocarminomycin and 14-N-succinimidorubomycin. In vitro and in vivo antitumor activity of the above derivatives and three other derivatives described earlier: 14-rubomycyl-N-pyridinium bromide, 14-N imidazolylrubomycin and 14-N-phthalimidorubomycin was studied. It was shown that in vitro all the 9 semisynthetic derivatives had a lower (by 1.5-6 times) cytostatic action on murine lymphadenosis cells NK/LI as compared to the initial antibiotics. The in vivo experiments on mice revealed that by acute toxicity the rubomycin derivatives administered intravenously were close to rubomycin, whereas the toxicity of the analogous derivatives of carminomycin was 5-17 times lower. The in vivo experiments also showed that seven out of the nine 14-N-substituted derivatives of carminomycin and rubomycin were practically deprived of antitumor activity (strain LIO-1), while 14-carminomycyl-N-pyridinium bromide and 14-N succinimidocarminomycin inhibited the tumor growth by 40-60 per cent. PMID- 3631933 TI - [Seasonal fluctuations in the antibiotic sensitivity of Vibrio cholerae]. AB - Sensitivity of group 01 Vibrio cholerae to 6 antibiotics including tetracycline, ampicillin, benzylpenicillin, polymyxin M, erythromycin and novobiocin was studied during various seasons within 3 years. The antibiotic sensitivity of the cultures was assayed with the method of two-fold dilutions in solid medium AGV. The "clonal sensitivity" of the populations of the same strains was estimated by the original method developed by the authors. There were observed seasonal biorhythms in manifestation of the physiological functions by Vibrio cholerae reflected in altered "clonal sensitivity" of the populations to the antibiotics, altered multiplication intensity during various periods and seasonal dissociation with respect to the cultural and morphological features in the strains with altered properties. PMID- 3631934 TI - [Action of hepatoprotective agents in a tetracycline lesion of the liver]. AB - Comparative efficacy of hepatoprotective agents in tetracycline affection of the liver is discussed. The affection was induced by daily intragastric administration of the antibiotic in a dose of 0.5 g/kg body weight to Wistar albino rats. The level of the hepatocyte affection and the efficacy of the hepatoprotective agents were judged by changes in the biligenic, glycogen producing, antitoxic and absorbing-excretory functions of the liver and the activity of lipid peroxidation (LPO) and serum enzymes. In acute tetracycline intoxication there was observed suppression of cholopoiesis, induction of LPO, increased permeability of hepatocyte membranes, lowered stabilizing activity of bile and decreased detoxicating and absorbing-excretory capacity of the liver. The highest correcting effect of the hepatoprotective agents was shown with respect to cholopoiesis, carbohydrate metabolism and lipoperoxidation of hepatocyte membranes. The efficacy of silibor in tetracycline affection of the liver was close to that of Essentiale and legalon and superior to that of LIV-52. PMID- 3631935 TI - [Microbiological research on the secretion of the normal parotid glands and in acute and chronic non-mumps parotitis in children]. AB - The qualitative and quantitative compositions of the microbial flora of the parotid gland were investigated in 42 children with nonepidemic parotiditis. The pathogenic properties of the microbial flora were the most pronounced in acute purulent and purulent necrotic parotiditis as compared to those in aggravation and remission of chronic parotiditis. In children with acute or chronic recurring parotiditis during its aggravation there was observed a significant increase in the number of the coccal organisms in the mixture of saliva and secretion of the parotid gland. Direct relationship between the aggravation activity and the number of the microbes was noted which testified to lowering of the protective functions of the oral cavity tissues. With an account of the presence of microorganisms in the clinically intact salivary glands it was concluded that the microbial factor was secondary in etiology of parotiditis. Quantitative estimation of bacteria in the mixture of saliva and parotid gland secretion is important for antibacterial therapy of the disease which is advisable when 1 ml of secretion of the affected glands contains 10(5) microorganisms. Their antibiotic sensitivity tests are obligatory. PMID- 3631936 TI - [Microcomputer-based automation of the microbiological analysis of antibiotic activity]. AB - Laboratory informative computer systems (LICS-10 and LICS-11) for microbiological assay of antibiotics were developed. The systems are based on the ISKRA-1256 computer. As compared to the routine method with the use of the well-known V. S. Dmitrieva's Tables the LICSs provide more than a 2-fold decrease in the working hours of the assay. The data on the specific software for the LICSs are presented and the algorithms for the calculations are described. PMID- 3631937 TI - [Vibrio and aeromonad sensitivity to the vibriostatic O 129]. AB - Sensitivity of vibrios and aeromonads to vibriostatic O129 (2,4-diamino-6,7 diisopropyl pteridine) was studied. The vibrios and aeromonads were isolated in the USSR. The tests were performed with disks made in the USSR and Great Britain. The content of the drug in the disks was 10 and 150 micrograms. It was shown that V. cholerae O1 V. cholerae not O1 and V. albensis were highly sensitive to vibriostatic O129 and produced no growth in the presence of either low or high concentrations of the drug. Halophilic vibrios and 26.3 per cent of the aeromonads resistant to low concentrations of the drug were less sensitive to the vibriostatic. The aeromonads and plesiomonads were resistant to the drug. The reaction to vibriostatic O129 was found to be one of the biological features of vibrios and aeromonads which can be used for differentiation of genera Vibrio and Aeromonas and within genus Vibrio as a taxonomic criterion. PMID- 3631938 TI - [Etiological structure and antibiotic sensitivity of the causative agents of puerperal endometritis]. AB - The study revealed the dominating role of aerobic-anaerobic microbial associations and in particular the specific role of anaerobic gram positive cocci in development of puerperal endometritis. The data suggested that a definite level of the uterus cavity contamination with microbes, not lower than 10(4) 10(5) CFU/ml or a large number of bacterial associates, not less than 3 was necessary for endometritis development. It was confirmed that pathogenicity of anaerobes increased in the presence of aerobic bacteria. It is concluded that quantitative methods for detecting the main causative agents of endometritis are needed. A set of antibacterial drugs for rational antibacterial therapy of puerperal endometritis is recommended. PMID- 3631939 TI - [General toxic and organotropic properties of azlocillin in acute and chronic experiments]. AB - The general toxic and organotropic properties of azlocillin were studied in acute and chronic experiments with various animal species. By the body surface area the doses of azlocillin were equivalent to the drug average and maximum course doses for humans. The aim of the study was to determine the drug dose inducing certain side effects. It was found that only in a dose equivalent to the maximum course dose for humans i. e. 300 g the drug induced a transient increase in the blood levels of aspartate aminotransferase and alkaline phosphatase and some increase in the coagulation time. The allergenic properties of the drug were slightly pronounced. Within the tested doses azlocillin did not affect the peripheral blood indices and showed no immunomodulating embryotoxic, teratogenic or mutagenic effect. The experimental data indicated that the range between the drug therapeutic course doses and the doses inducing certain side effects was significant. This is evidence of a sufficiently high level of azlocillin safety. PMID- 3631940 TI - [Antibiotic sensitivity of Staphylococci representative of the normal skin flora of the breasts of healthy women]. AB - Four hundred and forty seven staphylococcal strains isolated from various anatomical areas of the mammary gland skin of healthy women were studied with respect to their sensitivity to benzylpenicillin, methicillin, tetracycline, erythromycin and lincomycin. It was shown that 87.5, 85 and 81.4 per cent of the isolates preserved their high sensitivity to lincomycin, methicillin and erythromycin respectively. Sensitivity to tetracycline and benzylpenicillin was observed in 49.9 and 57.7 per cent of the isolates respectively. No resistant forms were detected among S. intermedius and S. hyicus. The strains of S. aureus were resistant only to tetracycline. 56.52 and 39.61 per cent of the S. epidermidis strains amounting to 46.3 per cent in the species structure of Staphylococcus were resistant to tetracycline and benzylpenicillin respectively. No cultures of S. epidermidis resistant to methicillin were isolated. Among 263 strains resistant to separate antibiotics 42 (16 per cent) were polyresistant. PMID- 3631941 TI - Disposition of moxalactam and N-methyltetrazolethiol in rats and monkeys. AB - The disposition of moxalactam (MOX) and N-methyltetrazolethiol (NMTT) in rats and monkeys after intravenous injection was investigated, focusing on the in vivo liberation of NMTT, by using [NMTT-14C]MOX and [14C]NMTT. After [NMTT-14C]MOX injection, MOX levels in plasma quickly became high in both rats and monkeys and then declined, with half-lives at the beta phase of 18.8 and 67.1 min, respectively. The levels of NMTT liberated from MOX were much lower than those of MOX, but the apparent elimination was significantly slow. The levels of MOX and NMTT in rat liver were almost comparable but lower than those in plasma. With [14C]NMTT administration, the level of NMTT in plasma declined, with half-lives at the beta phase of 21.5 min in rats and 54.0 min in monkeys. After [NMTT 14C]MOX injection, most of the radioactivity was excreted in urine as MOX, with 11% of the dose in rats and 8% of the dose in monkeys eliminated as NMTT until 24 h. Total biliary excretion was 26% of the injected radioactivity in rats, and most of it was due to MOX. In one monkey, the total biliary excretion was only 0.2% of the injected radioactivity. With [14C]NMTT administration, most radioactivity was excreted in the urine as unchanged NMTT in both animals. Oral administration in rats showed that part of the biliary-excreted MOX was degraded to NMTT in the intestine and then absorbed. Repeated administration of [NMTT 14C]MOX to rats did not change the levels of MOX and NMTT in plasma or liver nor did it change the excretion profiles. Thus, accumulation of MOX and NMTT did not occur. PMID- 3631942 TI - Bactericidal activity of ciprofloxacin compared with that of cefotaxime in normal volunteers. AB - We compared ciprofloxacin (200 mg) with cefotaxime (2 g) when each was administered intravenously over a 30-min period to six volunteers in a crossover manner 1 week apart. To integrate the pharmacologic and microbiologic activity, inhibitory and bactericidal activities in serum were obtained for both antibiotics 1 and 6 h after administration against 10 strains of Escherichia coli, 10 strains of Klebsiella pneumoniae, 15 strains of Pseudomonas aeruginosa, and 10 strains each of methicillin-susceptible and -resistant Staphylococcus aureus. Geometric mean bactericidal titers for E. coli 1 h after the infusion were 1:60 for ciprofloxacin and 1:252 for cefotaxime, and for K. pneumoniae they were 1:20 and 1:256, respectively. However, geometric mean titers were poor for both antibiotics against methicillin-susceptible S. aureus (less than 1:2 for ciprofloxacin versus 1:5 for cefotaxime) and methicillin-resistant S. aureus (less than 1:2 for both antibiotics), as well as against P. aeruginosa (1:3 for ciprofloxacin versus 1:2 for cefotaxime). These data suggest that ciprofloxacin may be useful for the treatment of serious infections caused by E. coli and K. pneumoniae. However, caution is suggested when this dose of ciprofloxacin is used in situations in which septicemia is caused by P. aeruginosa or S. aureus and originates outside the urinary tract. PMID- 3631943 TI - Ranking of prophylactic efficacy of poly(ICLC) against Rift Valley fever virus infection in mice by incremental relative risk of death. AB - The prophylactic efficacy of poly(ICLC) (stabilized, synthetic, double-stranded polyriboinosinic-polyribocytidylic acid) against Rift Valley fever virus infection in Swiss-Webster mice was dependent on the treatment schedule. The treatment schedule was optimized by ranking the results of various treatments by the Cox proportional-hazard model based on the incremental relative risk of death. With this ranking procedure, the schedule of choice was three doses of 20 micrograms each given 5 days apart. This regimen yielded a 90% survival rate. Additional parameters were determined, including the timing of the first and second drug dose, the temporal relationship of these treatments to the day of challenge, and the minimal effective dose (1 microgram per mouse). PMID- 3631944 TI - Entry of five antifungal agents into the ovine lung. AB - The passage of antifungal agents into pulmonary parenchyma was studied in normal sheep prepared by cannulation of the right external jugular vein and the efferent duct of the right caudal mediastinal lymph node. Five sheep were given single, sequential, intravenous injections of flucytosine, ketoconazole, BAY n 7133, amphotericin B methyl ester, and amphotericin B. Venous blood plasma and pulmonary lymph were collected before infusion and from 5 min to 24 h postinfusion; the concentrations of the drugs were assayed by a well-agar diffusion method. All drugs appeared promptly in the pulmonary lymph and disappeared at approximately exponential rates from both liquids. The lymph/plasma ratios of the drug concentrations did not differ between flucytosine and the two azoles but were lower for both polyenes. Binding by plasma proteins did not appear to be a determinant of pulmonary entry. PMID- 3631945 TI - Antiherpesvirus activity of 9-(4-hydroxy-3-hydroxy-methylbut-1-yl)guanine (BRL 39123) in cell culture. AB - The activity of 9-(4-hydroxy-3-hydroxymethylbut-1-yl)guanine (BRL 39123) against several herpesviruses was compared with that of acyclovir (ACV). In plaque reduction tests with clinical isolates of herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), and varicella-zoster virus, mean 50% inhibitory concentrations (IC50S) (n = number tested) for BRL 39123 were 0.4 (n = 17), 1.5 (n = 13), and 3.1 (n = 5) micrograms/ml, respectively. Corresponding IC50S for ACV were 0.2, 0.6, and 3.8 micrograms/ml. Cytomegalovirus was relatively resistant to BRL 39123 (IC50, 51 micrograms/ml), but equid herpesvirus 1, bovid herpesvirus 2, and felid herpesvirus 1 were susceptible (IC50S, 1.6, 1.2, and 0.9 micrograms/ml, respectively). BRL 39123 was inactive against an HSV 1 strain which does not express thymidine kinase activity, but a DNA polymerase mutant selected for resistance to ACV was sensitive to BRL 39123 (IC50, 1.5 micrograms/ml). In contrast to the results from plaque reduction tests, BRL 39123 was more active than ACV against HSV-1 and of equal activity against HSV-2 in virus yield reduction assays in MRC-5 cells. After treatment of HSV-infected cultures for short periods, BRL 39123 was considerably more effective than ACV at reducing virus replication, and furthermore, after removal of extracellular BRL 39123, virus replication remained depressed for long periods, whereas such persistent activity was not observed with ACV. Neither compound significantly affected MRC-5 cell replication at 100 micrograms/ml, but at 300 micrograms/ml BRL 39123 was more inhibitory than ACV. PMID- 3631946 TI - Class D tetracycline resistance determinants of R plasmids from the fish pathogens Aeromonas hydrophila, Edwardsiella tarda, and Pasteurella piscicida. AB - Tetracycline resistance determinants of R plasmids from the fish pathogens Aeromonas hydrophila, Edwardsiella tarda, and Pasteurella piscicida were classified as class D by their expression of resistance to tetracycline and minocycline and through their DNA structure. PMID- 3631947 TI - Plasmids and resistance to antimicrobial agents in Aeromonas sobria and Aeromonas hydrophila clinical isolates. AB - The antimicrobial susceptibilities of 75 Aeromonas isolates were determined by agar dilution. Differences in resistance patterns were observed between strains isolated from different geographic locations and between A. sobria and A. hydrophila isolates. Multiple resistance was common; however, only one conjugative plasmid was detected. This 110-megadalton plasmid mediated resistance to eight antibiotics. PMID- 3631948 TI - Praziquantel and clonorchiasis. PMID- 3631949 TI - Food-composition, changes in brain serotonin synthesis and appetite for protein and carbohydrate. PMID- 3631950 TI - A skeptical view of the role of central serotonin in the selection and intake of protein. PMID- 3631951 TI - Recent evidence from human studies linking central serotoninergic function with carbohydrate intake. PMID- 3631952 TI - Influence of noise on gustatory affective ratings and preference for sweet or salt. AB - Ten adult men were exposed to four different conditions of noise--low noise (70 dB), loud noise (90 dB), loud music (90 dB) and a silence control--while they tasted sweet or salty solutions. In the first experiment, they rated the pleasure/displeasure aroused by ten gustatory stimuli (five sucrose and five sodium chloride from 0.15 to 2.35 M/l). The median affective rating for sucrose was significantly higher in loud noise and with loud music. No change was observed for salt. In the second experiment, the subjects were invited to mix solutions in order to obtain the most pleasant concentration of sucrose or sodium chloride. Subjects' preferred concentrations of sucrose or sodium chloride did not vary with auditory conditions. PMID- 3631953 TI - Pyridoxylated polymerized hemoglobin solution processing. Interest of a membrane molecular fractionation step. AB - Glutaraldehyde hemoglobin polymerization gives too many high polymers, resulting in a too viscous solution. We describe here an alternate method leading to superior results, as compared to the classical one. This method includes a molecular fractionation step using a tangential flow ultrafiltration that secondarily lowers the unpolymerized tetramer's content of a mildly polymerized, pyridoxylated hemoglobin solution (Pyr-Poly Hb). This leads to an adequately polymerized product with a lesser high polymer content, implying a lower viscosity. We thus obtain a pyridoxylated, polymerized molecular fractionated solution presenting suitable features as a blood substitute: A 7.5 g% hemoglobin 2 g% albumin solution had a 16% unpolymerized tetramer's ratio, a 1.8 mPas viscosity, a P50 of 2.8 kPa, a Hill coefficient of 2.1, a binding coefficient of 1.3 mL/g, a colloid osmotic pressure of 2.4 kPa, and a methemoglobin concentration of 3% Male-Sprague-Dawley rats undergoing an isovolumic blood exchange with this Pyr-Poly Hb solution, down to a 2% hematocrit, present a mean survival time of 20 h. PMID- 3631954 TI - [Organophosphorus compounds as tools for the pharmaco-histochemical study of cholinesterase in the rat striatum]. AB - A series of organophosphorous compounds (OP) was tested using a pharmacohistochemical method applied in vitro on the rat striatum, the central structure which contains the highest levels of acetylcholine and its metabolic enzymes; the OP showed a great variety of action towards the specific cholinesterase (AChE) and non-specific cholinesterase (BuChE). Except for iso OMPA which is specific for BuChE localized in the microvessels endothelium, all the OP doses used in the present study were more or less potent inhibitors of cholinesterases (ChE). 15 mn after LD 50 doses of OP administered by subcutaneous route, a partial inhibition of the neurophile AChE occurred, revealing some striatal neurons which displayed high residual activity, i.e. the cholinergic interneurons. During the recovery phase following the inhibition of AChE by 1.5 LD 50 doses (the animals being treated with atropine) the AChE reaction product was detected almost simultaneously in some axo-spinous synapses probably non cholinergic. The partial inhibition and the de novo synthesis of AChE also revealed the presence of small and less reactive non-cholinergic neurons. Among all the OP tested, soman was remarkable for its patchy inhibition of AChE in the striatum. The significance of the alternation of reactive and non-reactive areas is discussed. PMID- 3631955 TI - Meiosis-inducing and meiosis-preventing effects of sex steroid hormones on hamster fetal ovaries in organ culture. AB - Day 11 to day 15 p.c. female gonads were cultured for 6-8 days in chemically defined media. In day 11 and day 12 p.c. ovaries grown in a non-hormonal medium, the germ cells were unable to enter meiosis; they were retained at a stage of oogonia or more frequently at a preleptotene stage. Ovaries of the same ages cultured in an estradiol-containing medium showed germ cells progressing through meiotic prophase in a way close to that in ovaries of equivalent age in vivo. That was the case of the germ cells in day 13 to day 15 p.c. ovaries maintained in a non-hormonal medium. In a testosterone-containing medium, the germ cells in day 13 and day 14 p.c. ovaries were prevented from entering meiosis; by contrast, those in day 15 p.c. ovaries underwent meiotic prophase normally. These results indicated that each of both hormones was able to exert its corresponding (meiosis inducing or meiosis-preventing) effect before a definite critical time of ovarian development. The possibility is suggested that the germ cell differentiation in the female and male gonads in vivo would also depend on estrogens or androgens precociously synthesized in the gonads or supplied from other organs via the fetal blood. PMID- 3631956 TI - On the non-equivalence of skeletal muscle satellite cells and embryonic myoblasts. AB - Postnatal satellite cells, isolated from normal or previously denervated skeletal muscles of juvenile quails, were tested as to their capacity to participate in embryonic muscle ontogeny. They were grafted into 2-day chick embryo hosts, in place of a piece of brachial somitic mesoderm. Satellite cell implants were prepared from pellets either of freshly isolated cells or of cells precultured in vitro under proliferative conditions. Myogenic capacity of the implanted cells was attested by their ability to fuse into myotubes when cultured under differentiation conditions. In no case did the implanted satellite cells invade the adjacent wing bud or participate in wing muscle morphogenesis. They did not either give rise to myotubes at the site of implantation, nor did they even survive longer than 3 days in the embryonic environment. These negative results indicate that postnatal satellite cells, unlike embryonic myoblasts, are unable to take part in muscle embryogenesis. Although they derive from the same somitic myogenic cell line as the embryonic myoblasts, they therefore represent a differentiated non-totipotent type of myogenic cell. PMID- 3631957 TI - Course and termination of the pyramidal tract in the pig. AB - To study the pyramidal tract in the pig, the motor cerebral cortex of one side was defined electrophysiologically and subsequently excised. The animals operated were killed after 7, 11 and 14 days, and the cerebral hemisphere of the operated side, brain stem and spinal cord were removed for histological examination. The pyramidal tract proved to run ipsilaterally as far as the oral extremity of the 12th cranial nerve nucleus. The decussation, which exhausted itself almost completely at the level of the rostral extremity of the 1st cervical metamere, started here. After the limit just mentioned only rare isolated fibres were visible. Along its course, the pyramidal tract sent a small number of axons to the ipsilateral and contralateral nucleus of the 7th cranial nerve, while the fibres running from the opposite side to the reticular formation and to the hypoglossal nerve nucleus, cuneatus, gracilis and trigeminal spinal tract nuclei were more numerous. PMID- 3631958 TI - Rat brain hexokinase: amino acid sequence at the substrate hexose binding site is homologous to that of yeast hexokinase. AB - A reactive Glc analog, N-(bromoacetyl)-D-glucosamine (GlcNBrAc), has recently been used (D. M. Schirch and J. E. Wilson (1987) Arch. Biochem. Biophys. 254, 385 396) to label the Glc binding site of rat brain Type I hexokinase. This site has been located in a 40-kDa domain at the C-terminus of the enzyme previously shown to be the location of the substrate ATP binding site (M. Nemat-Gorgani and J. E. Wilson (1986) Arch. Biochem. Biophys. 251, 97-103). In the present study, peptide mapping of hexokinase modified by radiolabeled GlcNBrAc yields three labeled peptides (Peptides I-III). Peptides I and III, as well as catalytic activity, are protected by inclusion of Glc or GlcNAc during reaction with GlcNBrAc. These two peptides show considerable homology to contiguous regions in the sequences of yeast hexokinase isozymes A and B. Peptide III is homologous to a sequence which, based on the X-ray crystallographic work by Steitz and co-workers, is located near the Glc binding site of yeast hexokinase; Peptide I is homologous to an immediately adjacent (toward the C-terminus) region of yeast hexokinase. An essential serine residue implicated in the binding of Glc to the yeast enzyme is also conserved in Peptide III from rat brain hexokinase. These results provide strong support for the view that the "catalytic domain" at the C-terminus of the mammalian Type I hexokinase shares a common ancestry with yeast hexokinase. Peptide II appears to be nonspecifically labeled by GlcNBrAc since labeling is insensitive to the presence of protective ligands such as Glc or GlcNAc; the sequence of Peptide II shows no detectable homology with the yeast isozymes. PMID- 3631959 TI - The experimental basis of some recent hypotheses on the mechanism of the polymerization of actin: a reappraisal. AB - We have studied the effect of sonication on the fluorescence of N-(1 pyrenyl)iodoacetamide-labeled F-actin as well as of native actin-pyrenyl-actin mixed oligomers in which the subunits were covalently attached to each other by phenylenebismaleimide. In both cases the fluorescence of the solution was largely decreased by sonication. We have found that this effect is due (a) to a 20-30% decrease of the specific fluorescence of the polymers. These results question the validity of the novel mechanism for the polymerization of actin recently proposed (D. Pantaloni et al. (1984) J. Biol. Chem. 259, 6274-6283). In these studies, in fact, the implicit assumption was made that the quenching of the fluorescence of the solution under sonication was due exclusively to the conversion of F-actin into G-actin. PMID- 3631960 TI - Identification of the FTBL protein of Sumner and Dounce as a leucine aminopeptidase. AB - The crystalline beef liver protein of Sumner and Dounce (A. L. Dounce, P. Z. Allen, and G. A. Mourtzikos (1978) Arch. Biochem. Biophys. 188, 251-265) termed FTBL (football) protein because of the shape of its crystals, has been identified as a crystalline leucine aminopeptidase (LAP), on the basis of its high specific LAP activity and coincidence of its N terminal amino acid sequence (30 amino acids) with that of beef eye lens LAP. Amino acid analyses of the two proteins are also in reasonable agreement when based on the exact monomer molecular weight of beef eye lens protein obtained by the van Loon group ((1982) J. Biol. Chem. 257, 7077-7081). Our previously published monomer molecular weight of the FTBL protein was 25% too high, leading to the erroneous conclusion that the beef liver FTBL-LAP protein was a tetramer rather than a hexamer, as found by the van Loon group for beef lens LAP. The present report, taken together with our first paper on the FTBL protein establishes that the FTBL-LAP protein has been isolated from beef kidney and beef spleen as well as from beef liver. We now find that the properties of FTBL-LAP protein indicate that it is the same protein as beef eye lens LAP. The cellular and intracellular distributions of the FTBL-LAP protein have been considered in our first publication on the FTBL protein. PMID- 3631961 TI - The kinetic mechanism of acyl-CoA:lysolecithin acyltransferase from rabbit lung. AB - Acyl-CoA:lysolecithin acyltransferase is a key enzyme in the deacylation reacylation pathway of biosynthesis of molecular species of lecithin. However, the mechanism of the reaction has been little studied. In this paper, the kinetic mechanism of acyl-CoA:lysolecithin acyltransferase, partially purified from rabbit lung, is studied. The double-reciprocal plots of initial velocity vs substrate concentration gave two sets of parallel lines which fitted to a ping pong equation with the following parameters: Km (palmitoyl-CoA) = 8.5 +/- 2 microM, Km (lysolecithin) = 61 +/- 16 microM, and V = 18 +/- 4 nmol/min/mg protein. Inhibition studies by substrates, alternate substrates, and products supported the ping-pong mechanism, although some nonclassical behavior was observed. Palmitoyl-CoA did not inhibit even at concentrations of 100 Km. In contrast, lysolecithin was a dead-end inhibitor with a dissociation constant of Ki = 930 +/- 40 microM. Alternate substrates and CoA showed alternate pathways for the reaction due to the formation of ternary complexes. Dipalmitoylphosphatidylcholine inhibition pointed to an isomerization of the free enzyme prior to the start of the reaction. From these results, an iso-ping-pong kinetic mechanism for lysolecithin acyltransferase is proposed. The kinetic steps of the reaction are correlated with previous chemical studies of the enzyme. PMID- 3631962 TI - Inhibition of hexokinase activity by a fructose 2,6-bisphosphate-dependent cytosolic protein from liver. AB - Mammalian and yeast hexokinases were found to be reversibly inhibited by fructose 2,6-bisphosphate, an effect requiring the presence of a cytosolic protein factor. Experimental evidence suggests that this factor (inhibitor) is a regulatory protein, the interactions of which with hexokinases are modulated by fructose 2,6 bisphosphate. The Vmax of hexokinase D was decreased, and no changes on other kinetic parameters were observed. The inhibitor was present in fresh liver cytosol filtered through Sephadex G-25 and was partially isolated by negative absorption on DEAE-cellulose followed by ammonium sulfate fractionation. The inhibitor was also present in brain and kidney, but not in muscle. A molecular mass of 200,000 was determined by gel filtration. The inhibition was dependent on the concentrations of both the inhibitory protein and fructose 2,6-bisphosphate. No delay in fructose 2,6-bisphosphate inhibition was observed. Several other hexose phosphates were tested and were not effective. In the presence of amounts of inhibitor sufficient to produce complete inhibition of hexokinase D, the concentration of fructose 2,6-bisphosphate required to produce 50% inhibition was about 0.5 microM. The inhibitor was unstable and was stabilized by the presence of fructose 2,6-bisphosphate. PMID- 3631963 TI - Reaction of the model thiol 2-mercaptoethanol and glutathione with methylvinylmaleimide, a Michael acceptor with extended conjugation. AB - Many alpha,beta-unsaturated compounds are sufficiently reactive to condense with nucleophiles under physiological conditions and are potentially deleterious to cellular processes. These compounds react with thiols by nucleophilic attack to give 1,4 addition products. We have examined the products formed from the reaction of the model thiols HSCH2CH2OH and glutathione with methylvinylmaleimide, a Michael acceptor with extended conjugation. Glutathione produced exclusively a 1,6 addition product with methylvinylmaleimide. HSCH2CH2OH also formed a 1,6 nucleophilic addition product, as well as a disubstituted product resulting from apparent further 1,4 addition to the 1,6 addition product. Two other novel products which resulted from addition to the maleimide ring and addition at the vinyl carbon proximal to the maleimide ring were observed. PMID- 3631964 TI - A novel purification procedure for chalcone flavanone isomerase from Petunia hybrida and the use of its antibodies to characterize the Po mutation. AB - We have purified chalcone flavanone isomerase (CHI) from flowerbuds of Petunia hybrida to high purity. We made use of an affinity matrix consisting of Sepharose bound Dextran Blue that is known to bind proteins containing the dinucleotide fold [S. T. Thompson, K. H. Cass, and E. Stellwagen (1975) Proc. Natl. Acad. Sci. USA 72, 669-672]. The final step, consisting of preparative elution from a denaturing acrylamide gel, yielded an approximately 2000-fold purified CHI protein. The enzyme is a single polypeptide with Mr = 29,000, and highly specific antiserum was raised against it. Using this antiserum it was shown that corolla and anther tissues express different forms of the enzyme as judged by pI. Furthermore, the absence of immunoreactive CHI was demonstrated in a mutant of P. hybrida (genotype popo) which accumulates 2',4,4',6'-tetrahydroxy-chalcone in anthers as a consequence of lack of enzyme activity. PMID- 3631965 TI - 2-Oxoglutarate dehydrogenase and pyruvate dehydrogenase activities in plant mitochondria: interaction via a common coenzyme a pool. AB - 2-Oxoglutarate (2-OG)-dependent O2 uptake by washed or purified turnip (Brassica rapa L.) and pea (Pisum sativum L. cv. Massey Gem) leaf mitochondria, in the presence of malonate, was inhibited between 65 and 90% by micromolar levels of pyruvate. The inhibition was not observed in the absence of malonate and was reversed by alpha-cyano-4-hydroxycinnamic acid. The inhibition was also reversed by oxaloacetate or by malate, but not by any other tricarboxylic acid cycle intermediates. The stimulation of O2 uptake by oxaloacetate was half maximal at 8 9 microM and was transient, indicating its action was not mediated through the complete metabolic removal of pyruvate. Pyruvate had not effect on 2-OG oxidation under conditions in which pyruvate dehydrogenase was not active, indicating that pyruvate metabolism, rather than pyruvate itself, was responsible for producing the inhibition of 2-OG oxidation. Similar results were obtained with detergent treated mitochondrial extracts with the exception that the inhibition of 2-OG oxidation by pyruvate could also be reversed by coenzyme A. The results suggest that pyruvate inhibits 2-oxoglutarate oxidation, in intact plant mitochondria, by sequestering intramitochondrial CoA as acetyl-CoA and, in the absence of citrate synthase activity, reduces the amount of free coenzyme A available for 2 oxoglutarate dehydrogenase. These results indicate that pyruvate dehydrogenase and 2-oxoglutarate dehydrogenase share a common CoA pool within plant mitochondria and that the turnover of the acyl-CoA product of one enzyme will dramatically influence the activity of the other. PMID- 3631966 TI - [High-risk factors in the development of head and neck cancers]. AB - It is considered that the great majority of head and neck squamous cell cancers are self-inflicted cancers. The main high-risk factor for squamous cell cancers of the oro-airway region is heavy smoking. Well-known habits of smoking include reverse smoking and betel nut chewing in South Asia. Tobacco smoking has distinct carcinogenecity as both an initiator and promoter. Also the risks associated with smoking and alcohol consumption are synergistic. There are many adjuvant carcinogens which act as promoting factors and which are also causes of cancer in the head and neck area. Distinct promotion factors are poor dental hygiene for mouth cancer, vocal abuse in laryngeal cancer, Plummer-Vinson's syndrome in post cricoid cancer and chronic sinusitis in maxillary cancer. High-risk factors for carcinogenesis in the larynx are smoking (Brinkman index, over 600), heavy drinking, being over 50 years of age in males and anyone with a husky voice and abnormal sensation in the throat. In the piriform sinus, main risk factors of carcinogenesis are heavy smoking and drinking in males and in the post-cricoid area, those most at risk are female patients with Plummer-Vinson's syndrome. The prevention of head and neck cancers involves discouragement from smoking, and earlier detection of these cancers is very important. If early detection can be achieved, the highest cure rate among human cancers will be achieved. PMID- 3631967 TI - [High-risk group--lung cancer]. AB - Carcinogenesis of the lung cancer may have possibly many factors because that lung has been always exposed many extrinsic materials. Investigation of risk factor and recognition of high-risk group of lung cancer possess much important meaning, approached not only carcinogenesis of the lung but also clinical diagnosis and treatment of lung cancer. In this report, risk factors that established hitherto, air pollution, occupation, smoking habit and co-existing other lung disease are reviewed as high-risk groups of lung cancer. PMID- 3631968 TI - [High-risk population of gastric cancer patients]. AB - Atrophic gastritis with intestinal metaplasia cannot be regarded as a form of precancerous change, but it is of profound significance in the development of gastric carcinoma. It would be reasonable to infer that those subjects who have atrophic gastritis with intestinal metaplasia to any great extent represent a high-risk population for gastric cancer. Environmental factors, especially dietary habits, are implicated in the etiology of gastric carcinoma. Intake of high concentrations of sodium chloride is assumed to promote the development of carcinoma of the stomach. Cigarette smoking is also one of the risk factors in the pathogenesis of gastric cancer, supposedly acting as an initiator in gastric tumorigenesis. Although a controversy exists as to whether gastric resection for benign ulcers enhances the subsequent development of gastric carcinoma, it appears likely that an increased amount of long-term duodenogastric reflux after partial gastrectomy results in a higher incidence of carcinoma in the stomach remnant. PMID- 3631969 TI - [High-risk group--breast cancer]. AB - Amongst the various elements regarded as risk factors of breast cancer, such as family history of breast cancer, past history of mammary diseases, unmarried status, sterility and first birth at a late age, the most critical is weight and height increase due to a high fat/high protein diet. Only twenty years ago, Japan was one of the countries with the lowest mortality rate due to breast cancer, and the rapid rise seen since then is presumably because of the westernization of food. Our present investigation has proved that breast cancer patients are larger in weight and height in comparison with normal women. The second cause of this increase in breast cancer patients in Japan is the longer period for which women menstruate, due to early menarche and late menopause. This tendency has lately become conspicuous and is considered to have a strong influence on the increase of breast cancer. It has also been noted that the age of occurrence of breast cancer in Japan is gradually advancing, so that the range is shifting from middle aged patients to those in old age, as in Western countries. PMID- 3631970 TI - [Clinical study of a synthetic calcitonin derivative (elcatonin) in patients with metastatic bone tumors]. AB - Forty-three cases of metastatic bone tumor were treated with Elcatonin. The agent was injected intramuscularly to each patient at a dose of 40 units twice daily. Twelve patients (28%) experienced pain relief within 4 days after treatment and after 4 weeks, twenty-eight patients (65%) had palliation of pain. In patients with hypercalcemia (4 cases), a decrease of serum Ca was observed one week after administration of Elcatonin. Improved bone scintigram was observed in 37.5% of cases, and radiographic improvement in 20% of cases. These data indicate that Elcatonin is effective for achieving pain relief and in improving the state of invaded bones when administered in combination with conventional treatment modalities for patients with metastatic bone tumors. PMID- 3631971 TI - [Immunobiological studies of interferon-alpha A/D in comparison with a streptococcal preparation, OK-432]. AB - In order to clarify the characteristics of interferon-alpha A/D (IFN-alpha) as a biological response modifier (BRM), several immunobiological activities were compared with OK-432. 1) Both IFN-alpha and OK-432 inhibited the multiplication of Meth-A cells in vitro. 2) IFN-alpha (2 X 10(5) IU, ip) augmented the NK activity of peritoneal exudate cells (PEC) and spleen cells, and the peak of NK activity was observed 1 day after injection. OK-432 (1 KE, ip) augmented the NK activity of PEC, but not of spleen cells, and the peak was 3 days after. 3) Macrophage activating activity was more potent with OK-432 (1 KE) than IFN-alpha (2 X 10(5) IU). 4) Induction of CTL against alloantigens was augmented by IFN alpha and OK-432. 5) By the combination of IFN-alpha with OK-432, a synergistic antitumor effect was obtained against Meth-A ascites tumor. Immunobiological effects of IFN-alpha seemed to be somewhat different from those of OK-432. Therefore, the combination of the two agents might cause a synergistic antitumor effect. PMID- 3631972 TI - [The synergistic effect of human recombinant TNF in combination with various anti cancer drugs]. AB - The synergistic effect of human recombinant TNF in combination with various anti cancer drugs was examined in vitro. In vitro treatment of L-M cells with TNF and mitomycin C (MMC), adriamycin (ADM), cytosine arabinoside (Ara-C), actinomycin D (ACD), daunorubicin (DM), cisplatin (CDDP), vincristine (VCR), or 5-fluorouracil (5-FU) revealed a synergistic cytotoxicity. However, the combination of TNF with bleomycin (BLM) failed to show such a synergistic effect. PMID- 3631973 TI - [A study of hepatic arterial occlusion by infusion chemotherapy via the left subclavian artery]. AB - Hepatic arterial infusion chemotherapy via the left subclavian artery was performed in 112 patients with primary or metastatic liver tumors, and those cases showing hepatic arterial occlusion were discussed. Hepatic arterial occlusion occurred in 22.3% of cases, and the rates of occurrence in males and females showed no significant difference. Therefore, when the catheter was placed and replaced in the RHA or LHA, the occurrences of arterial occlusion seemed to be relatively high, i.e., 45.5% and 50.0%. The diameter of the hepatic artery, which was measured in 25 patients with hepatic arterial occlusion (occlusion group) and 17 patients in a control group (catheter placed in position for over 150 days) on angiographs was 5.2 +/- 1.42 mm (mean +/- S.D) in the occlusion group and 6.1 +/- 1.77 mm in the control group, but the difference was not significant (p less than 0.05). Clinical symptoms and flow scintigraphy were useful for the diagnosis of hepatic arterial occlusion. However, recently, a frequent check of drug delivery has been necessary. PMID- 3631974 TI - [The effect and CT imaging of FAM hepatic infusion chemotherapy in patients with liver metastasis from colorectal carcinoma]. AB - A study of FAM (5-FU, ADM, MMC) hepatic infusion chemotherapy via the left subclavian artery was performed in 40 patients with liver metastasis from colorectal carcinoma. The response rate was 61.1% (1 CR and 21 PR among 36 evaluable cases), and the 50% survival period was 11.6 months. CT imaging in the 22 responders was discussed. The CT scan images showed no remarkable changes except for tumor size in 10 cases (45.5%), a decrease of marginal density in 4 cases (18.2%), an increase of calcification in 2 cases (9.1%), dimpling sign in 3 cases (13.6%) and fatty liver degeneration and abscess formation in the hepatic duct in 1 case (4.5%). These findings on CT scan were important for evaluating the effects and side effects in patients receiving hepatic infusion chemotherapy, and provided useful information for follow-up. PMID- 3631975 TI - [A case report of inflammatory breast cancer effectively treated with cis platinum]. AB - A 50-year-old woman with bilateral inflammatory breast cancer (T4, N1b, M1, Stage IV) underwent right extended radical mastectomy and left modified radical mastectomy following pre-operative administration of carcinostatics (ADM, 5-FU) and irradiation. However, tumor recurrence was observed at the skin and right pleural cavity after the operation. Adriamycin-containing combination chemotherapy and radiation therapy were performed, but no significant response was obtained. CDDP was then administered intravenously at a daily dose of 62.5 mg/m2 at intervals of 60 days. The pleural effusion disappeared and the extent of skin metastasis was reduced, resulting in partial response which lasted for 90 days. The serum CEA level decreased from 13.1 ng/ml to 2.3 ng/ml. As the side effects of this therapy, slight nausea, vomiting and general fatigue were observed. This result suggested that CDDP is an effective drug for inflammatory breast cancer. PMID- 3631976 TI - [Absorption of 5-FU orally administered in a patient with postoperative gastric cancer under artificial dialysis]. AB - A patient under artificial dialysis due to chronic renal failure suffered from gastric cancer concurrently. This patient underwent subtotal gastrectomy followed by consecutive oral administration of 5-FU (tablets) as a postoperative adjuvant chemotherapy. The 5-FU level in the peripheral blood on oral administration at 50 mg remained at 0.007-0.01 microgram/ml over 2 hours. This feature of 5-FU blood level is not seen in gastric cancer patients with normal renal functions on administration of 5-FU tablets, and it seems to approximate the features of a 5 FU prodrug level in the blood upon oral administration. Neither the influence of dialysis on the absorption of orally administered 5-FU nor side effects caused by 5-FU were observed. The above findings suggest that it may be possible to maintain a certain blood level of 5-FU and to perform adjuvant chemotherapy even in cancer patients under artificial dialysis, as long as the dose is controlled carefully. PMID- 3631978 TI - [Cyclophosphamide]. PMID- 3631977 TI - [Introduction of natural interferon-alpha "Sumiferon"]. AB - Natural interferon-alpha preparation "Sumiferon" was recently developed in Japan. This is a human lymphoblastoid interferon (HLBI) preparation. Like other interferon preparations, this preparation showed both direct and indirect antitumor effect and the toxicities were moderate. The phase I-II studies were carried out in 38 major institutions in Japan. In the phase I study in 5 patients with advanced breast cancer, the maximum tolerated dose (MTD) was found to be 12 X 10(6) units/day given for 1 month. In the phase II study, HLBI was given in at 3 approximately 6 X 10(6) units/day. Out of 391 cases, 280 were evaluable. Complete and partial responses (CR and PR) were observed in 40 (14.3%) out of 280 evaluable cases, including 11 (19.6%) out of 56 renal cell cancer, 14 (19.2%) out of 73 multiple myeloma, and 9 (17.3) out of 52 malignant lymphoma among others. Major side effects observed were: fever (69.8%), gastrointestinal disturbances (31.4%), leukopenia (30.7%), thrombocytopenia (27.8%), hepatotoxicities (23.6%) and general fatigue (22.1%). Sumiferon seemed to be one of useful antitumor drugs effective against renal cancer. PMID- 3631979 TI - Hypopigmentation, vitiligo, and melanoma. New data, more enigmas. PMID- 3631980 TI - The labial melanotic macule. AB - A series of 41 cases of melanotic lesions of the lip from 1980 to 1984 are reported. These lesions occur preponderantly in young white women on the lower lip. The term labial melanotic macule is suggested for these lesions. PMID- 3631981 TI - Hair growth induction by ultraviolet radiation in the marsupial Monodelphis domestica. AB - Hair follicles in the telogen stage of the hair cycle were induced into anagen phase after the skin of the South American opossum, Monodelphis domestica, was exposed to levels of ultraviolet B radiation (280 to 320 nm), which induced desquamation. Post-ultraviolet B exposure to long-wavelength radiation (320 to 400 nm, ultraviolet A) suppressed the induction of edema and desquamation and the induction of hair growth. Hair growth induction was also observed in skin damaged either by mechanical abrasion or by exposure to methoxsalen and ultraviolet A. PMID- 3631982 TI - Management of psoriasis vulgaris with a hydrocolloid occlusive dressing. AB - Because clinical improvement of psoriasis vulgaris was recently observed after the prolonged application of tape, 26 patients with symmetric plaque-type psoriasis were enrolled in a prospective bilateral comparison study evaluating the clinical efficacy of the adhesive hydrocolloid occlusive dressing (HCD). The majority of localized plaques of psoriasis achieved improvement (41%, 14/34) or resolution (47%, 16/34) with the prolonged application of HCD; also, HCD was therapeutically superior to twice-daily applications of fluocinolone acetonide cream, and was comparably effective as erythemogenic ultraviolet B treatment. Although the therapeutic mechanism is not completely understood, occlusive dressings have great potential in the management of limited psoriasis vulgaris. PMID- 3631983 TI - Prognostic significance of hypopigmentation in malignant melanoma. AB - It has been suggested that the presence of cutaneous hypopigmentation favorably influences the prognosis of patients with malignant melanoma (MM). To examine this possibility, we have compared the actual with the predicted survival of 46 patients with MM and hypopigmentation who were among 1130 patients with MM entered in a long-term prospective study of MM at the New York University Medical Center. The actual average five-year survival rate of the patients with MM and hypopigmentation (86.3%) was significantly better than predicted (74.8%) on the basis of the risk factors present in each patient at the time of entry into the study. The findings suggest that hypopigmentation is a factor that beneficially influences the prognosis of MM, and that the mechanisms that inhibit or destroy normal melanocytes in patients with MM may also slow the growth of this cancer. PMID- 3631984 TI - The natural history of dysplastic nevi. A case history illustrating their evolution. AB - A 31-year-old man with familial dysplastic nevus syndrome presented with numerous histologically confirmed dysplastic nevi. Seven years before this, all of his nevi, numbering over 150, had been "prophylactically" removed. Despite the removal of all visible nevi, many new nevocellular nevi and atypical nevi appeared during the subsequent seven years. This case illustrates the natural history of dysplastic nevi and suggests that removal of all nevi to prevent melanoma may be futile. PMID- 3631986 TI - Pruritic, pink, papular eruption. Generalized granuloma annulare (GA). PMID- 3631985 TI - Atypical fibroxanthoma in a patient with xeroderma pigmentosum. AB - A 3-year-old boy with xeroderma pigmentosum developed a papule on the right ala nasi that had the light-microscopic, immunohistochemical, and ultrastructural features of atypical fibroxanthoma. This lesion most commonly arises on the sun exposed skin of older adults. The occurrence of an atypical fibroxanthoma in such a patient adds weight to the concept that this tumor of "fibrohistiocytic" origin is induced by ultraviolet exposure. Mechanisms of tumor formation in a patient with xeroderma pigmentosum may be similar to those occurring in the more typical situation in adults. PMID- 3631987 TI - A child with hair loss. Pili torti, apparently unassociated with other abnormalities. PMID- 3631988 TI - Chronic dermatosis in a young man. Darier's disease. PMID- 3631989 TI - Well-demarcated papules and plaques in sun-exposed areas. Multiple large-cell acanthomas. PMID- 3631990 TI - Skin potions. PMID- 3631991 TI - Squamous cell carcinoma following fluorouracil-responsive 'keratoacanthoma'. PMID- 3631992 TI - Bloom's syndrome with dimorphism of sister chromatid exchanges in phytohemagglutinin-stimulated lymphocytes. PMID- 3631993 TI - Mycosis fungoides treated with high-dose carmustine. PMID- 3631994 TI - Halo scalp ring: a cause of scarring alopecia. PMID- 3631995 TI - Thrips. PMID- 3631996 TI - Positive Nikolsky's and bulla-spread signs in acute bullous lichen planus. PMID- 3631997 TI - An ultrastructural study of the reactive type of elastosis perforans serpiginosa. PMID- 3631998 TI - Toxic epidermal necrolysis. Unmuddying the waters. PMID- 3631999 TI - Treatment of toxic epidermal necrolysis. Creteil's experience. PMID- 3632000 TI - Toxic epidermal necrolysis. Clinical findings and prognosis factors in 87 patients. AB - Eighty-seven patients with toxic epidermal necrolysis were observed at Hopital Henri Mondor in Creteil, France, over the last 12 years. The mean percentage of body surface area involved was 39%. Erosive mucous membrane lesions, identical to those of Stevens-Johnson syndrome, were present in all but three cases. Necrolysis was sometimes generalized within 24 hours but usually spread progressively after a Stevens-Johnson syndrome-like aspect at the onset. Mortality was 25%. Infection, mainly with Staphylococus aureus and Pseudomonas aeruginosa, was the first cause of death, clearly responsible in ten of 20 cases. Age, extension of necrolysis, idiopathic nature of toxic epidermal necrolysis, ingestion of many drugs, elevation of urea, creatinine, and glucose levels, neutropenia, lymphopenia, and thrombocytopenia were statistically linked to a bad prognosis. A multivariant analysis showed that three of these prognosis factors are of paramount importance, namely: age, area of necrolysis, and serum urea level. Pigmentary changes and sicca syndrome were frequently observed sequelae in survivors. PMID- 3632001 TI - The culprit drugs in 87 cases of toxic epidermal necrolysis (Lyell's syndrome). AB - Between 1972 and 1985, 87 patients with toxic epidermal necrolysis (TEN) were admitted to the dermatological intensive care unit at Hopital Henri Mondor, Creteil, France. The culpable drug was determined by standardized criteria. Only three patients had received no drugs before the onset of TEN. Most patients (71 of 87) were receiving more than one drug. Patients had taken an average of 4.4 +/ 3.4 drugs each. A culpable drug was determined in 67 patients (77%). The mean time from first drug administration to onset of TEN was 13.6 +/- 8.4 days. The culprit drugs included the following: sulfonamides, 18 cases, and especially sulfamethoxazole and trimethoprim, 12; anticonvulsants, seven (barbiturates and carbamazepine only); nonsteroidal anti-inflammatory drugs, 29 (especially the phenylbutazone derivative, 16, and oxicam derivatives, 10); allopurinol, three; chlormezanone, three; and others, seven. Aspirin, antipyretics, and antibiotics are infrequently implicated in this series. The pattern of culprit drugs changed with years. The level of sulfonamide-related TEN remained the same, while incidence of nonsteroidal anti-inflammatory drug-induced TEN increased sharply, the introduction of oxicam derivatives being in part responsible. PMID- 3632002 TI - Sequence of reconstitution of seven basement-membrane components following split thickness wound induction in primate skin. AB - Recent studies have shown an orderly sequence of expression of structural antigens within the skin basement-membrane zone of the human fetus. Interestingly, these findings differ from those reported following split thickness would induction in Yorkshire pigs. To readdress this apparent disparity, as well as to further extend such studies to include other basement membrane antigens more recently identified, we produced split-thickness wounds in a primate species and serially examined the wounds by immunofluorescence technique for the expression of seven antigens normally found in intact primate skin basement membrane. By the fourth day following wounding, laminin, type-IV collagen, and fibronectin were all detectable along the dermoepidermal junction. In contrast, bullous pemphigoid antigen, epidermolysis bullosa acquisita antigen, cicatricial pemphigoid antigen, and KF-1 antigen were undetectable until days 6, 8, 10, and 11, respectively. These latter findings are in complete agreement with those previously reported in the developing human fetus. On the basis of the results of this study, we would suggest that primate rather than pig skin may be a more appropriate animal model for wound-healing studies. These data are consistent with previous reports suggesting that the basement-membrane antigens recognized by bullous pemphigoid and cicatricial pemphigold autoantibodies are indeed distinct. Finally, these data bring into question the functional role of bullous pemphigoid antigen during the early phase of wound healing in humans. PMID- 3632003 TI - Membrane attack complex of complement in leukocytoclastic vasculitis of the skin. Presence and possible pathogenetic role. AB - The presence of the membrane attack complex of complement (MAC) was studied by a two-step immunofluorescence method in 15 patients with leukocytoclastic vasculitis of the skin, using an antibody against MAC neoantigen. Perivascular deposits of MAC were present in 13 specimens of lesional skin and only two specimens of clinically uninvolved skin, suggesting a possible pathogenetic role for MAC in the development of a skin lesion. Control studies were performed on the clinically normal skin of 15 individuals (11 patients with various nonbullous skin diseases and four healthy volunteers) and on skin lesions of seven patients with inflammatory skin diseases. In the clinically normal skin of only one patient, perivascular deposits of MAC were detected. This patient had rheumatoid arthritis and a cutaneous eruption due to the administration of aurothioglucose. We conclude that the activation of the terminal components of the complement system may play an important role in the formation of lesions in leukocytoclastic vasculitis of the skin, but is not an indispensable condition. PMID- 3632004 TI - Sclerosing agents in the treatment of telangiectasia. Comparison of the clinical and histologic effects of intravascular polidocanol, sodium tetradecyl sulfate, and hypertonic saline in the dorsal rabbit ear vein model. AB - A 0.25-mL quantity of 0.25%, 0.5%, and 1.0% polidocanol (Aethoxysclerol [France]), 0.5% sodium tetradecyl sulfate (Sotradecol injection), and 23.4% hypertonic saline was injected into the dorsal marginal rabbit ear vein; clinical and histologic thrombosis resulted that lasted between four and eight days. The lowest concentration of polidocanol (0.25%) demonstrated immediate thrombosis; however, no clinical or histologic changes occurred eight days after injection. With all other agents, histologic fibrosis of the vessel correlating with clinical disappearance occurred after eight days. However, 0.5% polidocanol and sodium tetradecyl sulfate developed recanalization through the initially sclerosed vessel between eight and 14 days, with clinical reappearance of the 0.5% polidocanol-injected vessel at 30 days, after injection. Cutaneous necrosis was noted clinically and histologically in three of ten vessels injected with 1.0% polidocanol and in two of ten vessels injected with hypertonic saline. Clinical and histologic evidence of necrosis occurred with and without extravasation of the sclerosants. PMID- 3632005 TI - Synchronization of plasmapheresis and pulse cyclophosphamide therapy in pemphigus vulgaris. AB - Long-lasting and complete remission was obtained in a 48-year-old patient with refractory pemphigus vulgaris by an experimental treatment protocol that tries to synchronize plasmapheresis with subsequent pulse cyclophosphamide therapy. The rationale of the approach tries to utilize the plasmapheresis-induced increased proliferation of pathogenic cell clones for partial deletion of these clones through application of maximum pulse immunosuppression treatment during the period of assumed maximum proliferation and, thus, maximum vulnerability of the antibody-producing cells. The treatment schedule consisted of initial withdrawal of immunosuppressive drug therapy, repeated large-volume plasmaphereses substituted with immunoglobulin-free albumin solutions, subsequent application of high-dose (36 mg/kg of body weight) cyclophosphamide therapy, and low-dose maintenance immunosuppression for several months. As a result, our patient remained disease free over a follow-up period of 40 months without any further immunosuppressive treatment. Stimulation of postexchange antibody production and subsequent application of high-dose cytotoxic drugs might be a valuable tool in the management of refractory pemphigus vulgaris and, possibly, in the management of other autoantibody-mediated diseases. PMID- 3632006 TI - Symptomatic zinc deficiency in a breast-fed, premature infant. AB - Hypozincemia and clinical features of acrodermatitis enteropathica developed in a breast-fed, premature infant at 6 months of age. Maternal breast milk zinc levels were normal at birth and at the time of appearance of zinc deficiency in the infant. Zinc supplementation administered orally resulted in rapid improvement. Seven premature infants with hypozincemia and transient symptomatic zinc deficiency have been previously described. In contrast with this case, the other infants received feedings with low zinc content. PMID- 3632007 TI - Hyperkeratotic papules on the hands and feet. Focal acral hyperkeratosis (FAH). PMID- 3632008 TI - A photodistributed rash. Pellagra. PMID- 3632009 TI - Doctors and nurses in neonatal intensive care: towards integration. PMID- 3632010 TI - Is your grommet really necessary? PMID- 3632011 TI - Should we screen for congenital adrenal hyperplasia? A review of 117 cases. AB - A total of 117 patients with congenital adrenal hyperplasia who were under the care of paediatricians at Birmingham Children's Hospital between 1958 and 1985 were reviewed retrospectively. There were 47 boys (40%) and 70 girls (60%); 30 of the 47 boys (64%) and 38 of the girls (58% of the 66 whose salt state was known) were salt losers. In all salt losers the condition was diagnosed before the age of 6 months, 90% of the diagnoses being made during the first month. The ratio of boys to girls, the distributions of salt losers to non-salt losers, and the age at diagnosis were studied in relation to the year of birth. Early diagnosis was found to be more common in children born after 1970 due partly to the introduction of a method of assaying the concentration of 17 alpha hydroxyprogesterone in serum, partly to an increase in the number of paediatricians in the West Midlands, and partly to the appointment of a paediatric endocrinologist. A neonatal screening programme does not seem to be necessary. PMID- 3632012 TI - Correlation of specific gravity and osmolality of urine in neonates and adults. AB - There is good correlation between the specific gravity and osmolality of urine obtained from neonates and adults, if specimens contain neither protein nor glucose. The regression equations between specific gravity and osmolality, however, differ considerably between the two age groups, maturation to the adult regression occurring within the first 5 years of life. Specifically derived regression equations should therefore be used when predicting urine osmolality from measurement of specific gravity in neonates. PMID- 3632013 TI - Adrenal cortical tumours: epidemiological and familial aspects. AB - Epidemiological data on the 14 cases of adrenal cortical tumour registered with the Manchester Children's Tumour Registry from 1954 and 1985 are presented. The incidence of adrenal cortical carcinomas was 0.3%, mainly in girls, most of whom presented with virilisation. The incidence of neoplastic disease among close relatives was ascertained, but, except in siblings, this was not significantly higher than would be expected. Evidence from extended pedigrees, however, indicates that at least four of the children could be members of families with the SBLA (sarcoma, breast and brain tumour, leukaemia, laryngeal and lung cancer, and adrenal cortical carcinoma) cancer family syndrome, and that other relatives may be at risk of developing such neoplasms. PMID- 3632014 TI - Nosocomial hepatitis A infection in a paediatric intensive care unit. AB - Seven members of staff in a paediatric intensive care unit and two of their relatives developed hepatitis A over a period of five days. A 13 year old boy who was incontinent of faeces prior to his death, was presumed to be the source of infection. Two hundred and sixty seven other members of staff underwent serological testing and were given prophylactic pooled gamma globulin. Twenty three per cent were immune before exposure. Of people born in the United States, those at highest risk of developing the disease are physicians, dentists, nurses and those under the age of 40. Of those born outside the United States, being white and under the age of 30 are the two main risk factors. Data from a questionnaire sent to 19 nurses at risk (six cases, 13 controls) suggested that sharing food with patients or their families, drinking coffee, sharing cigarettes and eating in the nurses' office in the intensive care unit were associated with an increased incidence of hepatitis. Nurses with three or four of these habits were at particular risk. The costs of screening and prophylaxis were US $64.72 per employee, while prophylaxis alone would have cost US $8.42 per employee. Assessing risk factors on the one hand and costs of prophylaxis on the other are important elements in the control of nosocomial infections. PMID- 3632015 TI - Purulent pericarditis. AB - Eleven children under 16 years of age with purulent pericarditis were seen in one hospital in one year. The condition was always secondary to a septic focus elsewhere, usually staphylococcal pneumonia; its incidence after pneumonia was 0.64%, but this may be an underestimate. Clinical diagnosis can be difficult in patients with pneumonia as the heart is not always enlarged. Persistent or progressive liver enlargement was an important diagnostic feature. The presence of excess pericardial fluid was easily confirmed by echocardiography. Early diagnosis and drainage followed by continuous irrigation with 0.1% povidone iodine solution usually resulted in rapid recovery, but two patients died. PMID- 3632016 TI - Sudden and unexpected death between 1 and 5 years. AB - Of a population of 9856 children followed up from birth, 9251 of whom underwent 24 hour tape recordings of electrocardiograms and abdominal wall breathing movements during early infancy, five died suddenly and unexpectedly at home at ages ranging from 16 months to 4 years. Postmortem examination, including full histological and microbiological investigations. failed to identify abnormalities ordinarily associated with death in all five cases. Two of the children were known to have had frequent cyanotic episodes and died during these events. In the three remaining cases there was no previous history of cyanotic or apnoeic episodes. The death of one of these three children was seen by his parents and the clinical features suggested that apnoea rather than a cardiac arrhythmia was the primary mechanism for his death. As in infancy, sudden and unexpected death for which no adequate cause is found at necropsy seems to constitute a major component of mortality between 1 and 5 years. PMID- 3632017 TI - Compliance with gluten free diet in coeliac disease. AB - Fifty two children in whom coeliac disease was confirmed by persistent enteropathy while they were taking gluten were monitored to assess the effects of compliance with a gluten free diet (GFD). Between the ages of 17.8 and 18.5 years height (in 45 patients followed up for a mean of 14.9 years) and weight (in 43 followed up for a mean of 15.2 years) were significantly lower in those complying poorly with a GFD compared with those complying well. Of the 37 patients still attending the clinic after a mean of 25 years, having been followed up for a mean of 18.4 years, 16 who had complied well with the diet had normal or only slightly abnormal mucosal morphology whereas all 10 who had not complied had abnormal morphology. In these 10 lactase, sucrase, and alkaline phosphatase activities were significantly less than values in those who complied well. Mucosal sucrase and alkaline phosphatase activities in those who complied well were no different from those in a control population, whereas lactase activity was significantly lower. It is concluded that failure to comply with a GFD during childhood results in decreased adult stature and in persisting active enteropathy with depressed brush border enzyme activity. PMID- 3632018 TI - Ethnic differences in incidence of very low birthweight and neonatal deaths among normally formed infants. AB - The incidence of very low birthweight babies (less than 1500 g) and neonatal mortalities in this group were analysed for the 15,608 births to mothers of various racial origins at this hospital during the years 1979-82 inclusive. Very low birth weight occurred less commonly in the European (9.1/1000) and Pakistani (10.1/1000) groups and most commonly in the West Indian group (23.2/1000). Neonatal survival in West Indians, however, was better than in any other group. Analysis of the stillbirths weighing less than 1500 g showed a lower rate in the West Indians compared with that of the European, Pakistani, and Indian groups. There was no evidence of a higher incidence of 'light for dates' in very low birthweight West Indian neonates. PMID- 3632019 TI - Severe pre-eclampsia and infants of very low birth weight. AB - The effect of severe pre-eclampsia on the outcome of infants of very low birth weight was studied in a prospective case control study of 35 pairs of infants of comparable gestation. Significantly more infants were delivered before the onset of labour and by caesarean section in the group with pre-eclampsia. These babies tended to be smaller and had a higher incidence of hyaline membrane disease, patent ductus arteriosus, pulmonary air leak, and hypotension. They also required more intensive treatment with oxygen and mechanical ventilation. The significant difference in birth weight was still apparent at 2 years of age. Although the mean psychomotor developmental index and the incidence of specific neurodevelopmental impairments were not significantly different between the two groups, survivors in the group born to pre-eclamptic mothers had a significantly lower mean mental developmental index, and significantly more of these children had one or more impairments compared with the control group at 2 years of age. PMID- 3632020 TI - Epidemiology of facial clefts. AB - Data from the Glasgow Register of Congenital Malformations were used to investigate the epidemiology of congenital facial clefts over the period 1974-85. Facial clefts were registered in 247 infants representing a prevalence of 1.56 per 1000 total births. Cleft palate was more common than cleft lip, with cleft lip and palate occupying an intermediate position. More than half of the infants with facial clefts had associated defects. Males predominated for cleft lip; females for cleft palate. Cleft lip (alone) was more common in babies born to women aged 35 years and over. Sudden declines in registered prevalence were observed in 1978 and 1985. Clefts were more common in socioeconomically deprived areas of the city. In comparison with data from elsewhere, Glasgow seems to have a low rate of cleft lip, a high rate of cleft palate, and a high rate of associated defects. Many of the findings of cleft palate in Glasgow could be explained by the interaction of an unidentified environmental teratogen with a susceptible population. PMID- 3632021 TI - Cardiorespiratory patterns in siblings of babies with sudden infant death syndrome. AB - Clinical data and 24 hour tape recordings of electrocardiogram (ECG) and abdominal breathing movements were collected from 301 infants who had had a sibling who had suffered the sudden infant death syndrome (SIDS). Of these, 261 were referred cases, and 40 were recorded prospectively as part of a population based study; none of the 301 subsequently died. Fifty five of the referred siblings who had been born at full term (greater than or equal to 37 week gestation) were randomly selected for a detailed analysis of heart rate and breathing patterns, as were all siblings born at full term from the prospective study (16 with a previous sibling in whom SIDS had occurred and seven with a sibling born at full term and in whom SIDS had subsequently occurred). The control group consisted of 197 recordings on 170 infants born at full term and matched by postnatal age. The mothers of the siblings smoked and consumed alcohol more often during pregnancy than the mothers of control babies. The siblings had lower Apgar scores and were more often breast fed than controls. There were no significant differences in the number of apnoeic pauses in the quantities of periodic breathing or in the heart and respiratory rates during regular breathing between the siblings and the controls. PMID- 3632022 TI - Duration of antibiotic courses for neonates. AB - A survey of the use of antibiotics in a neonatal unit for two years showed a considerable reduction in the mean duration of courses prescribed without any appreciable change in morbidity. PMID- 3632023 TI - Brain stem glioma presenting as gastro-oesophageal reflux. AB - Brain stem gliomas may present as gastro-oesophageal reflux. In such cases gastro oesophageal reflux presents atypically late, and computed tomography may not detect the presence of the tumour until late in the course of the disease. PMID- 3632024 TI - Prognosis in Guillain-Barre syndrome. AB - Clinical recovery started in 23 children with Guillain-Barre syndrome after a mean time of 19 days and to full recovery in 15 was 6.2 months. Long term follow up indicated that 19 with acute onset had completely recovered clinically and three with subacute onset had a chronic relapsing or protracted course. PMID- 3632025 TI - Aetiology of growth hormone deficiency. AB - A retrospective analysis was performed in an attempt to identify perinatal risk factors for the development of growth hormone deficiency. More of the affected children were boys, and their birth weights were significantly lower than those of the national average; there were also considerably more preterm and post-term deliveries among boys. PMID- 3632026 TI - Neonatal lupus erythematosus, late onset hypocalcaemia, and recurrent seizures. AB - A 6 day old infant had neonatal lupus erythematosus manifested by rash, haemolytic anaemia, and hepatosplenomegaly. His mother was asymptomatic until eight months of pregnancy. Between 7 and 10 weeks he had recurrent seizures with hypocalcaemia. Other causes of convulsions were excluded. By 14 weeks various abnormalities had largely disappeared. PMID- 3632027 TI - Multiple thromboses in systemic lupus erythematosus. AB - A 5 year old girl with systemic lupus erythematosus developed extensive thromboses at multiple sites. Coagulation screen confirmed presence of the lupus anticoagulant. She recovered satisfactorily on high dose steroids without the use of anticoagulant treatment. PMID- 3632028 TI - Swivel walkers in Duchenne muscular dystrophy. AB - Swivel walkers were used to provide low energy ambulation in 11 boys with Duchenne muscular dystrophy in schools for the physically handicapped in South Glamorgan. Our preliminary experience suggests that these walkers improve the quality of life and provide a useful part of the physical treatment of the condition. PMID- 3632029 TI - Annual statistical review. AB - We have given an indication of the range of national data which are available on child health. Paediatricians are familiar with simple demographic, mortality, and morbidity statistics, and it is intended tht trends in these should be updated annually. There is, however, a wealth of data on the use of medical social, and financial services which will be reported in future. Professional interest may help to improve the collection and presentation of national data, and we hope that this series will do this as well as providing a source of data for those who do not otherwise have access to it. PMID- 3632030 TI - Guidance for divorcing parents. PMID- 3632031 TI - The role of neonatal nurse practitioners: a viewpoint. PMID- 3632032 TI - Assessment of child abuse. PMID- 3632033 TI - 'New' fontanometer for estimation of intracranial pressure in the newborn. PMID- 3632034 TI - How linear is growth? PMID- 3632035 TI - Collagen studies in congenital cutis laxa. AB - A case of congenital cutis laxa (CCL) of unclear mode of inheritance associated with multiple pulmonary artery branch stenosis was extensively investigated to assess possible correlations between clinical, ultrastructural, and biochemical features. Light microscopy revealed that elastic fibers were absent in the papillary dermis, while hypoplastic elsewhere. Transmission electron microscopy showed a poor elastin matrix content in some elastic fibers, variable diameters of collagen fibrils, and abundant glycogen granules in most dermal cells. Measurement of collagen fibril diameters, using an image analyzer, was carried out in the patient and two age- and site-matched controls. A bimodal distribution was found in the upper reticular dermis of the patient. In vitro analysis of collagen in skin fibroblast cultures of the patient showed increased collagen synthesis with a balanced production of type I and type III procollagens. Our study confirms that CCL represents a disorder both of collagen and elastic connective tissue. PMID- 3632036 TI - Dermatitis herpetiformis: relation between circulating immune complexes, small intestinal mucosal status, and immunohistopathological findings. AB - Some aspects of humoral immunity and the status of the jejunal mucosa were investigated in 22 patients with classical dermatitis herpetiformis (DH). The mucosal status was characterized on the basis of immuno- and histopathological findings and functional analysis of malabsorption and disaccharidase activity. There was no significant abnormality in the serum immunoglobulins, whereas the IgA and C3 contents of the circulating immune complexes (established by polyethylene glycol precipitation and inverse radial immunodiffusion techniques) were significantly elevated. Polyorgan-specific autoantibodies of IgG type were present in the sera of 95% of the 22 patients. Functional analysis of the gastrointestinal tract revealed some abnormality in all of the 18 cases examined, while direct immunofluorescence studies demonstrated an increased number of subepithelial IgA lymphoid cells in all of the 15 cases examined. These findings did not correlate well with the jejunal mucosal morphology. This study supports the view that IgA deposited in the skin is formed in the gut. PMID- 3632037 TI - In vivo relationship between transepidermal water loss and percutaneous penetration of some organic compounds in man: effect of anatomic site. AB - The relationship between the percutaneous penetration of four chemicals and transepidermal water loss (TEWL) was investigated in vivo in man as a function of anatomic site. The findings showed an appreciable difference in the permeability of the skin from one site to another with regard to both water loss and chemical penetration. In addition, independent of the physicochemical properties of the molecules administered, there was a linear relationship between TEWL and penetration. These data confirm both the importance of anatomic site in the degree of permeability of the cutaneous barrier and the utility of determinations of TEWL and percutaneous absorption in the evaluation of its functional condition. PMID- 3632038 TI - Determination of individual metabolites of aromatic compounds in hydrolyzed bile of English sole (Parophrys vetulus) from polluted sites in Puget Sound, Washington. PMID- 3632039 TI - Relationship of microbial activity and Ceriodaphnia responses to mining impacts on the Clark Fork River, Montana. PMID- 3632041 TI - Tissue distribution of heavy metals and their variations with age, sex, and habitat in Japanese serows (Capricornis crispus). PMID- 3632040 TI - Mutagenic activity of surface waters adjacent to a nuclear fuel processing facility. PMID- 3632042 TI - Biochemical and toxicological effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) congeners in female rats. PMID- 3632043 TI - Bromacil and diuron herbicides: toxicity, uptake, and elimination in freshwater fish. PMID- 3632044 TI - Occupational exposure to fosetyl-Al fungicide during spraying of ornamentals in greenhouses. PMID- 3632045 TI - The effect of aerial application of Zectran on brain cholinesterase activity in forest songbirds. PMID- 3632047 TI - Effects of suspended solids on the water column biotransformation of anthracene. PMID- 3632046 TI - Neurotoxicity of hexachlorophene in mice: implications of altered cerebral amino acid profiles. PMID- 3632048 TI - [Effects of hypothermia on the testicles. I. Structural and morphometric studies]. PMID- 3632049 TI - [Cytochemical and ultrastructural aspects of human seminal vesicles]. PMID- 3632050 TI - [Urinary osmolarity and ureteral dynamics]. PMID- 3632051 TI - [Surgical treatment of plastic induration of the corpora cavernosa]. PMID- 3632052 TI - [Renal oncocytoma]. PMID- 3632053 TI - [Urolithiasis caused by infection]. PMID- 3632054 TI - [Adult type ureterocele. Surgical treatment]. PMID- 3632055 TI - [Correlation between analysis of semen and hormonal concentrations in oligospermia]. PMID- 3632056 TI - [Cutaneous metastasis of bladder cancer]. PMID- 3632057 TI - [Endometrioid carcinoma of the prostatic utricle]. PMID- 3632058 TI - [Renal calculus resistant to shock wave therapy]. PMID- 3632059 TI - [Ureterohydronephrosis following tubal ligation. Spontaneous resolution]. PMID- 3632060 TI - [Anatomo-pathologic diagnosis of syphilitic adenopathies. Apropos of a case]. PMID- 3632061 TI - [Mediastinal schwannoma containing calcosiderotic nodules]. PMID- 3632062 TI - [A peculiar form of osteodysplasia: cherubism. Apropos of 3 cases with histoenzymologic and ultrastructural studies]. PMID- 3632063 TI - [Melanotic schwannoma. Anatomo-clinical study of a case and review of the literature]. PMID- 3632064 TI - [Primary malignant lymphoma of the thyroid. A case report and a review of the literature]. PMID- 3632065 TI - Adenosquamous carcinoma of the stomach. Histochemical and ultrastructural study. PMID- 3632066 TI - Special types of malignant lymphomas limited to intrathoracic sites. PMID- 3632067 TI - Incidence and size of erosions in the wrist and hand of rheumatoid patients: a quantitative microfocal radiographic study. AB - Quantitative macroradiographic examination of a group of early to moderately advanced rheumatoid patients showed the wrist and hand to have an average of 75 (SD 26) erosions out of 142 possible sites. Joint involvement was greatest in the wrist followed by the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints respectively. In the wrist erosion distribution was concentrated in the radiocarpal and medial carpometacarpal complex, in the hand it tended to be located at the second and third MCP and third PIP joints. No difference was observed in erosion number and area between the right and left extremities. The distribution of the lesions is discussed in relation to the intra-articular pressures on normal hand function. The similarity of erosion development, across the joints at the different regions of the hand, suggests the presence of factors other than mechanical pressure. In general, erosions were widespread, and the largest erosions occurred in the larger bones of the wrist and hand. PMID- 3632068 TI - Acute non-infectious arthritis of the hip in patients with rheumatoid arthritis. AB - Five patients with rheumatoid arthritis and no previous hip joint disease developed an acute disabling arthritis in one hip joint. Roentgenograms were negative and synovial fluid from the hip joint was inflammatory, but no crystals were seen and cultures were negative. Four of the five patients responded rapidly to intra-articular corticosteroids, and none of the five has had further hip joint symptoms during a mean follow up period of two years. PMID- 3632069 TI - Rapidly destructive hip disease following ipsilateral hemiparesis: report of two cases. AB - Two patients who developed rapidly destructive arthropathy of the hip following ipsilateral hemiparesis are described. The possible significance of this association is discussed. PMID- 3632070 TI - Pneumococcal septic arthritis in rheumatoid arthritis. AB - Septic arthritis is associated with a definite morbidity which may be related to a delay in diagnosis and hence treatment. The cases of three patients with rheumatoid arthritis and chronic chest disease where the joint sepsis was not the predominant feature are presented. The responsible organism was Streptococcus pneumoniae which had spread after recent chest infections. Minimal joint symptoms or general malaise in association with an unexplained rise in erythrocyte sedimentation rate in these circumstances warrant a search for joint sepsis. PMID- 3632071 TI - Membranous glomerulonephritis in rheumatoid arthritis unassociated with gold or penicillamine treatment. AB - A 16 year old girl with rheumatoid arthritis who had not received gold or penicillamine developed a nephrotic syndrome. Her renal biopsy specimen showed membranous glomerulonephritis by light, electron, and immunofluorescence microscopy. PMID- 3632072 TI - HLA antigens Dw4 and Dw14 in rheumatoid arthritis. PMID- 3632073 TI - Alternatives to allopurinol. PMID- 3632074 TI - [The campaign against AIDS in Africa: a public health priority]. PMID- 3632075 TI - [Immunoenzyme (ELISA) diagnosis of onchocerciasis: use of an antigenic fraction of Ascaris suum]. PMID- 3632076 TI - [Responsibility for tsetse control by rural communities: first trial in 5 Congolese villages]. PMID- 3632077 TI - The use of the card agglutination test (Testryp CATT) for the serodiagnosis of T. evansi infection. PMID- 3632078 TI - A computer simulation of the effect of multidrug therapy on the incidence of leprosy. PMID- 3632079 TI - Flubendazole in-feed preparation for prophylaxis of experimental lymphatic filariasis. PMID- 3632080 TI - [International colloquium: Health and mortality of young children in developing countries. 12-14 December 1985, Antwerp, Belgium. Proceedings]. PMID- 3632081 TI - Childhood mortality. Development of a quantitative planning model for the evaluation of policy choice. PMID- 3632082 TI - The death of Amilcar. A case study from Santo Antao/Cabo Verde. PMID- 3632083 TI - [Child mortality in the Cheraga health sector]. PMID- 3632084 TI - [Health and mortality of young children in developing countries: the lessons of the symposium]. PMID- 3632085 TI - General panorama of mortality at young ages in developing countries: levels, trends, problems of measurement. PMID- 3632086 TI - Theory, analytical frameworks and causal approach in the study of mortality at young ages in developing countries. PMID- 3632087 TI - Problems in the measurement of child mortality where statistical systems are limited. PMID- 3632088 TI - Mortality at young ages as an indicator for evaluation of health programmes in developing countries. PMID- 3632089 TI - Presidential address: the craft of surgery, its changing face. PMID- 3632090 TI - Pigment gallstones form as a composite of bacterial microcolonies and pigment solids. AB - Although previous studies have suggested that bacteria may contribute to pigment gallstone formation, the current experiments provide evidence that bacteria have a central role in this process. The studies included scanning electron microscopy (SEM) of gallstones, measurements of bacterial adherence to gallstones in vitro, and determination of glycocalyx elaboration by biliary bacteria. Gallstones from 85 patients were studied under SEM. Twenty-five (78%) of 32 pigment stones had evidence of bacterial microcolonies throughout the interior of the stones. Bacteria were absent from the interior of all 35 cholesterol stones studied. Composite stones (stones with separate pigment and cholesterol portions) showed evidence of bacteria within the pigment portions in 14 (78%) of 18 cases. Biliary bacteria adhered to the surface of pigment gallstones in vitro in 35 (90%) of 39 cases, compared with three (8%) of 39 cholesterol stones. Glycocalyx was elaborated by bacteria isolated from nine (82%) of 11 patients with either pigment or composite gallstones. One (33%) of three bacterial species from patients with cholesterol gallstone disease produced glycocalyx. These studies indicate that most pigment gallstones obtained from patients in Western cultures form as a composite of bacteria, bacterial glycocalyx, and pigment solids. Bacteria were found in the majority of black as well as brown pigment stones. These findings serve as the basis of a new theory of pigment stone formation in which bacteria and glycocalyx are postulated to be responsible for the precipitation and subsequent agglomeration of bilirubin pigment. These results also suggest that sepsis is more common in pigment gallstone disease because the stones can serve as a sanctuary for bacteria. PMID- 3632091 TI - Results with the Mustard operation in simple transposition of the great arteries 1963-1985. AB - From May 1963 to December 1985, 329 infants and children underwent repair of simple transposition of the great arteries (TGA) using Mustard's technique. To assess improvement, the patients were separated into two groups by date of operation: Group I, May 1963 to December 1973 (N = 106), and Group II, January 1974 to December 1985 (N = 223). The operative mortality was 11 (10.4%) in Group I and two (0.9%) in Group II. The 10-year actuarial survival rate was 73.4% in Group I and 93.7% in Group II. Baffle complications, similar in both groups, were identified in 81 patients; 19 were major, causing death or requiring reoperation. By latest electrocardiogram, 21 of 45 (46.7%) of Group I patients and 129 of 180 (71.7%) of Group II patients were in normal sinus rhythm. Late ambulatory electrocardiography, however, revealed that a majority of patients had sinus node dysfunction or other dysrhythmias. Right ventricular (RV) angiography revealed definite diminution of RV contractility in 14 (11%) of 126 children. At late follow-up, 113 of 148 (76%) children were in New York Heart Association (NYHA) Class I and 35 of 148 (24%) were in NYHA Class II. Thirty-five (21%) patients were on cardiac medication chiefly for dysrhythmia management. There has been significant improvement in the early and late mortality with the Mustard operation, and serious baffle complications are infrequent. Dysrhythmias continue to be a major problem but the surviving patients are clinically well and relatively few have significant RV dysfunction. PMID- 3632092 TI - Evolving strategies for the repair of complex renovascular lesions. AB - Fifty-five patients with 59 complex renovascular lesions required two or more branch artery anastomoses during aortorenal grafting. Forty-five reconstructions involving 112 branches were facilitated using hypothermic ex vivo perfusion preservation, whereas 14 involving 28 branches were repaired in situ. Ex vivo repair was used whenever the kidney was considered unreconstructable by in situ techniques. Fibromuscular dysplasia predominated and the branched internal iliac artery was used for renal artery substitution. There were no deaths and only one kidney (ex vivo) was lost. Branch vessel occlusion occurred in two of 140 anastomoses (1.4%). Ninety-eight per cent (51/52) of the heparinized patients had cure or improvement at mean follow-up of 5 years. No late graft dysfunction occurred in postoperative angiographic follow-up. The branched internal iliac artery is uniquely suited and remains the preference of the authors for the replacement of the diseased renal artery and its branches. The in situ repair is ideally suited for lesions limited to the renal artery bifurcation. Ex vivo repair is reserved for complex or reoperative distal arterial lesions. Unique characteristics in the group include: bilateral lesions (25%), solitary kidney (22%), reoperative lesions (16%), children (9%), and coexisting significant aortic disease (7%). In situ and ex vivo repair meet all the challenges of complex renovascular disease. The strategies outlined will achieve outstanding long-term total and segmental renal salvage in the treatment of hypertension or aneurysmal disease. When ex vivo repair is required, it can be accomplished with only one additional simple maneuver, the reanastomosis of the renal vein. PMID- 3632093 TI - Recognition and treatment of patients with hereditary nonpolyposis colon cancer (Lynch syndromes I and II). AB - Primary genetic factors are etiologic in at least 5-10% of patients with colon cancer. The polyposis syndromes (FPC) are easily identified examples because of the spectacular number of polyps. The hereditary nonpolyposis syndromes (HNPCC), although five times more common than FPC, are usually not recognized because they do not have such a distinctive clinical, premonitory genetic marker. Colorectal cancer expression was surveyed in 10 extended, thoroughly documented HNPCC kindreds. One hundred sixteen patients were found to have 183 colorectal cancers. Despite the striking family history, less than 5% were correctly treated by subtotal colectomy. This provided a unique opportunity to study the natural history. Five findings differed significantly (p less than 0.05) from patients with sporadic colon cancer: (1) mean age of initial colon cancer diagnosed was 45.6 years; (2) 69.1% of first colon cancers were located proximal to the splenic flexure of the colon; (3) 18.1% had synchronous colon cancer; (4) 24.2% had metachronous colon cancer develop with life table analysis showing the risk for a metachronous lesion at 10 years to be 40%; and (5) only 23.3% of cancers were located in the sigmoid colon or rectum. Based on this data, it is recommended that the family history of all patients with a newly diagnosed colon cancer be evaluated for evidence of this syndrome. If an autosomal dominant inheritance pattern emerges, an in-depth genetic investigation is indicated. When HNPCC is confirmed, the following recommendations apply: a subtotal abdominal colectomy is indicated at the time of the initial colon cancer because of the risk of synchronous and metachronous lesions. The rectum should be spared in favor of careful lifetime surveillance because of the proclivity for proximal colon cancer involvement. As yet unaffected members of a newly diagnosed HNPCC kindred who are in the "direct genetic line" should be cautioned that they are at 50% risk and must begin an intensive surveillance program beginning in the third decade with careful attention to the right colon. Patients from newly diagnosed HNPCC families who have had a previous conventional colectomy for colon cancer should, at the very least, enter an intensive surveillance program; a prophylactic completion subtotal colectomy should be considered for patients who are less than totally compliant. PMID- 3632094 TI - The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. AB - Since February 1, 1980, the identical standardized Greenville Gastric Bypass has been performed in 397 morbidly obese patients with an operative mortality rate of 0.8%. The operation effectively controlled weight and maintained satisfactory weight loss even after 6 years (mean weights and ranges: Preoperative: 290 lbs (196-535); 18 months: 175 lbs (110-300); 72 months: 205 lbs (140-320). The gastric bypass favorably affected non-insulin-dependent diabetes (NIDDM), hypertension, physical and role functioning, and several measures of mental health. Rigorous follow-up (97.5% over 6 years) revealed that health problems were common in postoperative patients; there were nine late deaths. Abnormal glucose metabolism was present in 141 (36%) of 397 patients before surgery: NIDDM was present in 88 patients (22%) and 53 patients (14%) were glucose impaired. Of these, all but two became euglycemic within 4 months after surgery without any diabetic medication or special diets. The most recent 42 morbidly obese patients with NIDDM were studied intensively. In that cohort, fasting blood glucose, fasting insulin, and glycosylated hemoglobin returned to normal after surgery; insulin release, insulin resistance, and utilization of glucose improved sharply. The normalization of glucose metabolism after gastric bypass may not be related solely to weight loss and restriction of caloric intake, but may also be due to the bypass of the antrum and duodenum. PMID- 3632095 TI - An access-oriented negotiated fee schedule. The Caterpillar experience. AB - This paper describes the system used by Caterpillar Corporation (CAT) in Peoria, Illinois, to reimburse surgeons. The CAT system assures access for Caterpillar employees and their families to a selection of qualified surgeons, while achieving cost savings through improvements in processing of surgical claims and negotiation of selected fees. CPT-4 codes are recorded for greater accuracy, when indicated, surgical services that have been incorrectly unbundled are rebundled, and the appropriateness of surgical assistant charges is reviewed. A "degree of difficulty" relative value scale (DODRVS) of surgical services is periodically revised as technology changes. The DODRVS multiplied by a regional factor, determined by local market research, establishes the fee that CAT will pay the surgeon. Balance billing is permitted if the patient (1) is informed in advance by the surgeon that the fee will be higher than CAT will pay, and (2) knows that the service can be obtained from other local surgeons who will accept the CAT fee. The goal of the CAT method of surgeon reimbursement is to gain physician support for an access-oriented, market-driven negotiated fee schedule. Compared with a resource-based relative value scale RBRVS) methodology, the CAT system is not formula-driven and depends on physician acceptance. PMID- 3632097 TI - Characterization of Kenyan Leishmania spp. and identification of Mastomys natalensis, Taterillus emini and Aethomys kaiseri as new hosts of Leishmania major. AB - A survey to examine rodents for leishmanias was initiated in the Perkerra Settlement Scheme, Marigat, Baringo District, Kenya, 789 rodents of ten different species were trapped and examined. Leishmanial parasites were isolated from the spleen and liver of 17 animals of five different species: seven from Tatera robusta, five from Arvicanthis niloticus, two from Mastomys natalensis, two from Taterillus emini and one from Aethomys kaiseri. These were identified as L. major by enzyme electrophoresis, using 12 enzymes, and by excreted factor (EF) serotyping. The isolation of L. major from Mastomys natalensis, Taterillus emini and Aethomys kaiseri represent newly recorded hosts of L. major. PMID- 3632098 TI - In vitro and in vivo anti-leishmanial activity of chlorpromazine alone and combined with N-meglumine antimonate. AB - Chlorpromazine (CPZ) was effective in vitro against leishmanial promastigotes and amastigotes. CPZ at 7.5 micrograms ml-1 killed the promastigotes of Leishmania mexicana, L. aethiopica and L. major within 24 hours of exposure. A higher concentration was required to achieve the same effect against L. donovani. N meglumine antimonate (MGA) was only partially effective against the promastigotes of the four strains studied. Even at 1000 micrograms ml-1 total destruction of the parasites did not occur within four days of treatment. Combination chemotherapy of CPZ and MGA generally showed an additive effect against promastigotes. However, a synergistic effect was observed in the case of L. donovani promastigotes and L. major amastigotes in vitro. No significant effect was obtained against the amastigotes of L. major and L. mexicana in vivo, in cutaneous lesions of BALB/c mice. PMID- 3632096 TI - Improved hospital morbidity, mortality, and survival after the Whipple procedure. AB - Between 1969 and 1986, 88 patients had a Whipple resection for adenocarcinoma of the pancreas (N = 50), ampulla (N = 19), distal bile duct (N = 10), and duodenum (N = 9). Forty-nine patients were men, 39 were women, and the mean age was 58 years (range: 34-84 years). The patients were divided into two groups on the basis of two different time periods: those operated on from 1969 to 1980 (N = 41) and those operated on from 1981 to 1986 (N = 47). There were no significant differences between the two groups in terms of mean age, sex distribution, duration of symptoms before presentation, or mean weight loss. Likewise, preoperative laboratory data were similar for both groups of patients. In addition, mean tumor size for patients with pancreatic cancer (3.5 cm vs. 3.2 cm) and patients with nonpancreatic periampullary cancer (1.9 cm vs. 2.2 cm) was similar in both groups, as was the incidence of positive lymph nodes. Among the 41 patients operated on during the first period, hospital morbidity and mortality rates were 59% and 24%, respectively. In contrast, hospital morbidity and mortality rates were 36% and 2%, respectively, among the 47 patients operated on during the recent period. During the recent period, more Whipple procedures were performed each year (7.8 vs. 3.4) and by fewer surgeons (3.4 operations/surgeon vs. 1.9 operations/surgeon). In addition, between 1981 and 1986, there were fewer total pancreatectomies (9% vs. 39%), fewer vagotomies (26% vs. 76%), and more pyloric-preserving procedures (30% vs. 0) performed compared with the earlier period. During the recent period, mean operative time (7.8 vs. 9.0 hours), mean estimated blood loss (1694 vs. 3271 mL), and mean intraoperative blood replacement (3.6 vs. 6.3 units) were all significantly less than in the earlier period. These findings suggest that the recent decline in operative morbidity and mortality may be due to fewer surgeons performing more Whipple resections in less time and with less blood loss. The actuarial 5-year survival rate for the 38 patients with nonpancreatic periampullary cancer was 34%. Surprisingly, the actuarial 5-year survival rate among the 50 patients with pancreatic cancer was 18%. Moreover, in the absence of positive lymph node involvement, the 5-year actuarial survival rate among patients with pancreatic cancer was 48%. No explanation is obvious for the improvement in survival among patients with pancreatic cancer. PMID- 3632099 TI - Hydatidosis in sheep, goats and dromedaries in Morocco. AB - Two thousand two hundred and forty-six sheep, 510 goats and 35 dromedaries were examined for hydatid cysts. The mean prevalence was 0.7% (range 0.4-38.5%) in sheep, 1.4% (range 0.2-7.7%) in goats and 80% in dromedaries. The increase in prevalence with age of the animals was statistically significant in sheep only. In all species examined infection of the lungs was more common and important than that of the livers. The fertility rate of hydatids was 50% in sheep and 67.8% in dromedaries; and degenerative changes were shown by 65.8% of hydatids from dromedaries as compared to 16.3% in sheep. Dromedaries seem to play an important role in the epidemiology of hydatidosis in Morocco. PMID- 3632100 TI - Toxocara canis infection and hyperactivity. AB - An observational study using video recordings and computer assisted data analysis showed that infection with Toxocara canis larvae had a marked effect on five readily and reliably differentiable categories of murine behaviour. The infection was also associated with an increase in the number of shorter bouts of each behavior. These results indicate that infection with T. canis renders mice hyperactive, and would appear to justify a complete reappraisal of the role of this neurotropic parasite as a cause of behavioural abnormalities such as hyperactivity in children. PMID- 3632101 TI - Mansonella perstans microfilaraemia among the Bori community in the Niger Delta area of Nigeria. AB - Night and day blood surveys for filariasis were conducted among inhabitants of Bori Local Government Area in the Niger Delta area of Nigeria between October 1983 and July 1984. Of the 1674 persons examined 47.0% had microfilaraemia. The infections were due to Mansonella perstans only. The prevalence of the infection was higher among males (51.8%) than among females (42.4%), and increased with age in both sexes. Eight persons were found with elephantoid scrotums and all had microfilariae of M. perstans. PMID- 3632102 TI - The immune response to vaccination in undernourished and well-nourished Nigerian children. AB - The immune response of young Nigerian children to a full course of infant immunizations was studied in relation to their nutritional state at the time of vaccination. No significant correlations were found between anthropometric measurements made at the time of vaccination and the antibody response to triple, polio, measles, meningococcal and typhoid vaccines. Significant correlations were found between serum pre-albumin levels and the response to group A meningococcal polysaccharide vaccine and between serum albumin levels and the response to group C meningococcal polysaccharide vaccine. These correlations may reflect the depressive effect of malaria both on serum albumin and pre-albumin levels and on immune responsiveness to meningococcal polysaccharides. No significant correlations were found between nutritional state at the time of BCG vaccination and the development of a positive tuberculin reaction five weeks later. We conclude that under-nutrition has little or no effect on the immune response to vaccines used in routine infant immunization programmes. PMID- 3632104 TI - Penetration of chicken peripheral blood lymphocytes by Eimeria acervulina sporozoites. PMID- 3632103 TI - Prevalence of intestinal parasitic disease agents in stools of people in a rural area of Nigeria. AB - Little is known of the prevalence of intestinal parasites in rural areas of Nigeria because there are few published data and laboratories in these areas are rarely well equipped for parasitological work. During a survey of a Nigerian village, Ascaris and hookworms were found to be the commonest helminths and Entamoeba coli the commonest protozoan. Differences in parasite prevalences between rural and urban areas of Nigeria are related to occupation, cultural patterns, and physical, social and biological environments. PMID- 3632105 TI - Differentiation of the rediae of Fasciola hepatica and Fasciola gigantica. PMID- 3632106 TI - Staging of lung cancer. PMID- 3632107 TI - Management of mediastinal tumors. PMID- 3632108 TI - Standard biplane roentgenography is highly sensitive in documenting mediastinal masses. AB - The records of 30 patients with mediastinal masses were reviewed to evaluate the signs, symptoms, and preoperative tests that were most useful in diagnosing and localizing the masses. Sixteen (53%) of the tumors were benign, and 14 (47%) were malignant. Twenty patients were seen with symptoms. The most common symptoms suggesting malignancy were pain, weight loss, fever, and cough. Four of the 5 patients who were truly asymptomatic had benign lesions. All 4 patients with palpable adenopathy had malignant tumors. Posteroanterior and lateral chest roentgenograms detected the mediastinal mass in 29 (97%) of the 30 patients. All patients were operated on for tissue diagnosis or resection (13, median sternotomy; 8, right thoracotomy; 3, left thoracotomy; 2, low anterior cervical approach). Eight patients underwent mediastinoscopy, which was diagnostic in 6 and obviated the need for operation in 4. It was of particular value for patients with lymphoma, who can be managed without resection. PMID- 3632109 TI - Extracorporeal membrane oxygenation following repair of congenital diaphragmatic hernias. AB - From 1981 through 1986, 8 newborns with congenital diaphragmatic hernia required herniorrhaphy in the first 8 hours of life. Extracorporeal membrane oxygenation (ECMO) was employed in 7 after they met local criteria predictive of 95% mortality. These criteria were an alveolar-postductal arterial oxygen gradient greater than 600 mm Hg for 12 hours or hemodynamic instability. Four of these 7 patients had unremitting hypoxemia after herniorrhaphy (no "honeymoon" period), 3 of whom survived. One additional patient died, producing a mortality of 29%. ECMO used for 68 to 241 hours (mean, 163 hours) provided reliable oxygenation in all. Deaths resulted from disseminated intravascular coagulation and bleeding, and bleeding and pulmonary failure after ligation of a patent ductus arteriosus. Complications occurred in 6 patients and included bleeding (3), hernia recurrence (3), and air embolism (1). Follow-up ranging from 1 year to 6 years after discharge of the 5 survivors shows normal growth and development in 4. The reported mortality without ECMO following congenital diaphragmatic herniorrhaphy in the first 8 hours of life ranges between 60 and 80%. While bleeding may present problems, survival of newborns with refractory hypoxemia after diaphragmatic repair has improved with ECMO. PMID- 3632110 TI - Management of esophageal gunshot wounds. AB - The records of 20 patients with gunshot wounds of the esophagus seen from 1973 through 1985 were reviewed. Nine perforations were cervical, 10 were thoracic, and 1 was abdominal. Because physical findings and plain roentgenograms lack specificity, a high index of suspicion based on the path of the bullet tract is essential for early diagnosis. Esophageal injury should especially be suspected when the bullet wound is transcervical or transmediastinal. Perforation was diagnosed by esophagoscopy in 9 patients, esophagography in 4, and surgical exploration in 7. Mean time from admission to operation was 3.8 hours. Associated injuries occurred frequently. Eighteen patients were treated by primary closure and wide drainage, and 2 were managed by esophageal exclusion. There were 2 perioperative deaths, both in patients with associated aortic injuries, and 1 late death, for an overall mortality of 15%. There was one postoperative leak following a cervical repair. No leaks occurred in patients having a thoracic repair. The findings indicate that esophageal perforation must be sought by a variety of methods. With prompt diagnosis and early operation, primary repair can be safely accomplished. When sepsis from esophageal leak is avoided, mortality and major morbidity are related to associated injuries. PMID- 3632111 TI - Mixed venous oxygen saturation as a predictor of cardiac output in the postoperative cardiac surgical patient. AB - Mixed venous oxygen saturation (SvO2) was measured continuously with a fiberoptic pulmonary artery catheter in 25 patients during the first 24 hours after cardiac surgery and was compared with the thermodilution cardiac index (CI). The mean correlation coefficient between SvO2 and CI was 0.05 +/- 0.42, and was not significantly different from zero. Although the mean correlation coefficient between the change in SvO2 and the change in CI was significant (p less than .05), the magnitude of the coefficient (0.19 +/- 0.44) indicates poor predictive value. The correlation did not improve when adjusted for multiple clinical variables, and the SvO2 was not predictive of a CI less than 2 L/min/m2, a level of cardiac performance that might require intervention. In conclusion, SvO2 was not predictive of CI postoperatively in the cardiac surgical patient. PMID- 3632112 TI - The myocardial contractile responses to protamine sulfate and heparin. AB - The administration of protamine sulfate for the reversal of heparin anticoagulation has been associated with adverse hemodynamic changes including hypotension and decreased cardiac output. The possible direct toxic effect of protamine on human right atrial trabeculae contracting isometrically in vitro was studied. Muscles were stimulated to contract at 1 Hz in Tyrode's solution (maintained at 34 degrees C, pH 7.4) into which protamine was continuously added. Following a polynomial regression analysis, a parabolic dose-response curve resulted. The equation was: y = 95.13 + 38.76x - 278.71x2 where y = relative developed force and x = concentration of protamine (milligrams per milliliters) (r = 0.82). The estimated concentration of protamine resulting in 50% developed force was 0.48 mg/ml. In a second series of experiments, protamine was added to the bath along with a neutralizing amount of heparin. This resulted in a limited reduction in the fall of relative developed force. Thus, protamine in high concentrations alone or in complex with heparin has a direct toxic effect on human myocardial muscle mechanics, and care is warranted in its clinical use. PMID- 3632113 TI - Lingular and right middle lobe biopsy in the assessment of diffuse lung disease. AB - It has been said that the lingula and right middle lobe should be avoided for open-lung biopsy because of nonspecific fibrosis and vascular changes. To determine if the diagnostic yields of lingular or right middle lobe biopsy specimens were unsatisfactory, we reviewed the results of open-lung biopsy in 73 adult patients; 26 were immunocompromised and 47, nonimmunocompromised. We found no evidence to suggest that these two sites were inherently inferior. In 20 of the nonimmunocompromised patients, computed tomography was performed prior to biopsy, and demonstrated no particular tendency for greater involvement of the lingula or right middle lobe. We conclude that lingular and right middle lobe biopsy is useful in the diagnosis of parenchymal lung disease and that these sites should not necessarily be avoided. Computed tomographic scanning prior to biopsy is helpful in guiding the surgeon to the appropriate sites from which to obtain biopsy specimens. PMID- 3632114 TI - Long-term results of emergency surgery for postinfarction ventricular septal defect. AB - This study assesses the long-term results of emergency surgical repair of postinfarction ventricular septal defect (VSD). The cases of 28 patients surviving early operative closure of septal rupture (within 1 day to 20 days of the infarction) were reviewed. Only 1 had concomitant coronary artery bypass grafting. Follow-up ranged from 7 to 16 years with an average of 9 years. Four patients were lost to follow-up. There were 4 late deaths, 2 of which were of cardiac origin. One was due to congestive heart failure and 1 to arrhythmia, 1 and 6 years after operation, respectively. Of the remaining 20 patients, 8 are in New York Heart Association Functional Class I and 12 are in Class II. Two patients underwent reoperation, 1 for a left ventricular false aneurysm 5 years postoperatively and the other for unstable angina 10 years postoperatively. Both had an uneventful postoperative course. Only 2 patients had late coronary events (1, nonfatal myocardial infarction; 1, unstable angina). We conclude that aggressive management of postinfarction VSD is fully justified in view of the long-term survival and functional palliation that can be anticipated for operative survivors. We advocate that preoperative coronary artery angiography and subsequent bypass grafting be performed on a selective rather than routine basis. PMID- 3632115 TI - Free radicals and cardioplegia: allopurinol and oxypurinol reduce myocardial injury following ischemic arrest. AB - Oxygen-derived free radicals generated by xanthine oxidase may represent a major cause of myocardial injury during ischemia and reperfusion. We have used the isolated working rat heart model of cardiopulmonary bypass and ischemic arrest to assess whether allopurinol or oxypurinol, which should prevent free radical formation through their ability to inhibit xanthine oxidase, can improve postischemic myocardial recovery when the drugs are administered either chronically (pretreatment) or acutely (as an addition to the cardioplegic or reperfusion solution). With normothermic ischemic arrest, both drugs, when given either chronically or acutely, significantly improved postischemic recovery of function. However, under hypothermic conditions, allopurinol conferred no protection when given either as pretreatment or during reperfusion, but it was effective when added to the cardioplegic solution. When administered under the appropriate conditions, both allopurinol and oxypurinol enhanced the protective effect afforded by the St. Thomas' Hospital cardioplegic solution, possibly by inhibiting xanthine oxidase activity and preventing the formation of oxygen derived free radicals. PMID- 3632116 TI - Implantation of the Duromedics bileaflet cardiac valve prosthesis in 400 patients. AB - From September, 1983, to April, 1986, 451 Duromedics bileaflet cardiac valve prostheses were implanted in 400 patients at our institution in Vienna. Aortic valve replacement was done in 190 patients, 157 underwent mitral valve replacement (1 patient also underwent tricuspid valve replacement), 52 underwent double valve replacement, and 1 patient underwent isolated reoperation for tricuspid valve replacement. Concomitant procedures were performed in 86 patients (21.5%). Sixty-one patients (15.2%) had undergone previous cardiac surgery; 32 (8%) had undergone earlier valve replacement. The early mortality rate (within 30 days) was 6.25% (25 patients). Follow-up was done on 337 surviving Austrian citizens; this represents 429 patient-years. The late mortality rate was 2.1% per patient-year (9 patients). We observed paravalvular leak in 3 patients (0.7% per patient-year), thromboembolism in 4 (0.9%), prosthetic valve endocarditis in 5 (1.2%), and anticoagulant-related hemorrhage in 10 (2.3%). Valve failure occurred in 8 patients (1.8%). We conclude, therefore, that good clinical results and a low complication rate can be achieved with this new type of valve. PMID- 3632117 TI - Repair of intrapericardial rupture of left sinus of Valsalva aneurysm. AB - A 62-year-old man with no history of preexisting heart disease was seen in cardiogenic shock. Prompt cardiac catheterization and aortography revealed pericardial tamponade and aneurysms of the right and left sinuses of Valsalva. Immediate sternotomy relieved the tamponade, which was secondary to an aneurysm of the left sinus of Valsalva rupturing into the transverse pericardial sinus. Endoaneurysmorrhaphy was performed successfully. PMID- 3632118 TI - Successful management of left ventricular rupture following myocardial revascularization. AB - Left ventricular (LV) rupture is a common cause of death following myocardial infarction, but it is rarely noted following coronary bypass surgery. This is true despite the increasing number of coronary bypass operations performed for postinfarction angina, often following transmural infarction. A 59-year-old woman underwent successful repair of left ventricular free-wall rupture that occurred after coronary surgery performed for postinfarction angina. To our knowledge, this is the first report to establish the feasibility of successful surgical repair of left ventricular free-wall rupture in the postoperative patient with tamponade or intrathoracic bleeding. PMID- 3632119 TI - Dysphagia lusoria associated with an esophageal carcinoma. AB - A patient with dysphagia lusoria associated with an esophageal carcinoma is reported. A review of the literature of this unusual condition is presented. PMID- 3632120 TI - Congenital tracheobiliary fistula. AB - Congenital tracheobiliary fistulas are uncommon and almost always are diagnosed in the first weeks or months of life. Untreated congenital tracheobiliary fistulas cause intractable pneumonia and are revealed by a persistent cough. Medical therapy is not effective, and surgical repair is needed. A 22-year-old woman was treated successfully by resection of a fistula communicating between the tracheobronchial tree and the liver. PMID- 3632121 TI - A simple method of repairing wires fractured during sternotomy closure. AB - A simple method for safely repairing a wire broken during sternal closure is described. This method ensures secure closure when other methods may be hazardous. PMID- 3632122 TI - The skeletonized internal mammary artery. AB - The internal mammary artery increasingly is being used to construct multiple distal anastomoses. By skeletonizing the pedicle, the artery is functionally lengthened and sequential anastomoses are easier to perform. PMID- 3632123 TI - Valve repair for mitral insufficiency. PMID- 3632124 TI - Invagination of antireflux check valve. PMID- 3632125 TI - Cardiac pacing in pericardial tamponade. PMID- 3632126 TI - An antioxidant-induced life table modification and life-span prolongation in Zaprionus paravittiger (Diptera). AB - An antioxidant, sodium hypophosphite (SHP-1 X 10(3) microM), when added to the diet of Zaprionus paravittiger, induces various shifts in the age-related biochemical parameters. It maintains the viability of protein synthesis and normal energy-yielding processes through longer intervals besides decelerating the rate of loss of nucleic acids (Sharma and Wadhwa, 1986). Reduced body weight which indicates the low level of food restriction, and adaptive changes in amino acids and proteins, could be the important factors for the favourable effect of this antioxidant on life span. PMID- 3632127 TI - Biliary excretion of ouabain in aging male and female F-344 rats. AB - The biliary excretion of ouabain was examined in Fischer-344 rats of both sexes and of different ages. The biliary recoveries for the first 10-min period after the intravenous injection of ouabain (0.1 mg/100 g body weight) were nearly 2 fold higher in female than in male rats for all age groups compared (4, 6, 12, 24, 28 months). In both sexes, the biliary recovery showed a gradual decrease with age, and the first 10-min value in 24-months old rats was about one third of those in the youngest rats. The 60-min total recovery values also significantly decreased with age. Some very old (males, 28 months; females, 31 months) rats, however, showed higher 60-min total recovery values than younger rats comparable to the youngest animal values. It was concluded that the biliary excretion of ouabain in rats decreases with age in both sexes which suggests that this is a general phenomenon in this animal species. PMID- 3632128 TI - EEG dysfunction in geropsychiatry. AB - Electro-clinical correlations are reported in 200 elderly patients admitted to a psychiatric ward of a general hospital. Normal EEG characteristics were generally associated with functional psychiatric disorder. Abnormal EEG features correlated with organic brain syndromes (O.B.S.). The diagnostic and pathogenetic considerations and restrictions of EEG foci, intermittent rhythmic delta activity (Irda) and diffuse EEG slowing are discussed. The informative value of EEG dysfunction in geropsychiatry is emphasised. PMID- 3632129 TI - Polymorphism of heterochromatin areas on chromosomes 1, 9, 16 and Y in long-lived subjects and persons of different ages in two regions of the Soviet Union. AB - Variants of chromosome polymorphism were analyzed in long-lived individuals and in subjects aged 40-79 years (170 persons) in two regions of the Soviet Union. The results of this analysis allow the suggestion that there is an association between the individual variants of chromosome polymorphism as regards C heterochromatin and the longevity phenomenon. Large size C segments on the human Y chromosome and the long Y chromosome were found both in the Ukrainian and Abkhasian long-lived males. In the long-lived females the chromosome polymorphism variants were associated with a region of their residence. The long-lived females of Abkhasia had a decreased relative size of C segments on chromosome 1 and an increased absolute and relative size of C segments on chromosome 9, while in their Ukrainian counterparts there was an increased relative size of C segments on chromosome 1 and a decreased one on chromosome 16. PMID- 3632130 TI - Age-related changes in the redox status of the housefly, Musca domestica. AB - The objective of this study was to further test the hypothesis that aging in the housefly is associated with increased oxidative stress. Age-related changes in the concentration of glutathione, NAD and NADP, which undergo oxidation-reduction reactions, and of H2O2, a potent cellular oxidant, were examined in the homogenates of adult male houseflies at 4, 8, 12 and 16 days of age. Sixteen days of age represents the beginning of the dying phase of the population when about 20% mortality usually occurs. Results indicate that the ratios of reduced/oxidized forms decline with age; H2O2 concentration steadily increases with age. Results suggest that the intracellular redox potential of the housefly becomes progressively more pro-oxidizing or less reducing during the aging process. PMID- 3632131 TI - [Institut Pasteur de Madagascar: Annual report 1985]. PMID- 3632132 TI - [Spatial distribution and spatio-temporal fluctuation of the principal groups of insects on a cotton plantation]. AB - The cotton entomofauna consists of various groups of Insects which show a distribution in strata. Except the superfamily of Chalcidoidea which offers a relatively homogeneous distribution, each group of Insects studied prospect a preferential area with particular ecologic conditions. Among these conditions the trophic relations are of the first importance. The Drosophilidae keep close to the organic matter in decomposition at the deep stratum. The phytophagous Insects live on the foliage at the medium strata. They could be hosts of parasites of some Chalcidoidea and Thecostomates or preys of some predators such as Empididae and Syrphidae. The interactions between these different Insects and vegetal are discussed. PMID- 3632133 TI - [Cystic pyelo-ureteritis apropos of 3 cases]. AB - This anatomo-radiologic entity is rare. It presents diagnostic, pathogenic, therapeutic and prognostic problems which are discussed about three personal cases and the review of the literature. PMID- 3632134 TI - [The development of rabies in Tunisia from 1982 to 1986]. AB - The authors describe the epidemiology of rabies disease in Tunisia since 1982, the problem of reservoirs and vectors, the production of vaccine, the diagnosis and the treatment of the disease. They note that this disease is decreasing in the animals that have bitten, nevertheless the canine rabies remains an important problem of public health in the country. PMID- 3632135 TI - [The bacterial pollution of coastal waters of the southern suburbs of Tunis]. AB - The authors present in this paper a study of the bacterian pollution of inshored waters of southern suburbs of Tunis, on the basis of 180 samples collected in 15 different stations, 15 monthly (one for each station). Two districts have been considered: Ez-Zahra and Hammam-Lif. The two districts are submitted to an important bacterian pollution, mainly due to human factor but also to geographical and geomorphological data, to physico-chemical parameters and to some biological characters. PMID- 3632136 TI - [Acanthodactyles of Tunisia: VIII--The southern acanthodactyles from south of Chott el Djerid]. AB - Applied to 135 Acanthodactylus, from eight clusters of collecting sites, a multidimensional analysis of 11 characters, mainly of colouring and scale patterns, providing 35 mathematical variables, reveals a hight intrapopulational variability. Samples dwelling on reg nebkhas and sandy knolls in the river beds are Acanthodactylus inornatus. Some specimens, in the sample from barkhanes and sand dunes areas, are morphologically close to A. longipes. PMID- 3632137 TI - Effect of cooling on ovalbumin-induced contraction of the tracheal muscle isolated from actively sensitized rat. AB - Isolated tracheal strip-chain preparations from actively sensitized rat were used to study the effect of temperature on ovalbumin-induced contraction. The preparations were suspended in an organ bath containing Krebs bicarbonate solution for isometric tension recording. A decrease of the bath temperature from 37 degrees C to 20 degrees C (cooling) had no effect on basal tone but augmented the contractile responses of the trachea caused by ovalbumin (OA, 10 micrograms/ml) and 5-hydroxytryptamine (5-HT 1-30 microM). Both responses of the trachea to OA and 5-HT were almost abolished by pretreatment of the tissue with methysergide (1 microM). The response to 5-HT was also inhibited by about 20% by atropine (1 microM) but not by tetrodotoxin (0.3 microM). On the other hand, 5-HT induced contractile responses of the trachea which was incubated with normal and Ca2+-free Krebs bicarbonate solution containing atropine (1 microM) were both augmented by 20 degrees C. In the presence of atropine (1 microM), diltiazem in a concentration of 10 microM, which almost abolished the potassium chloride (KCl, 20-40 mM) induced contraction, caused partial depression of the contractile response to 5-HT at 20 degrees C but not at 37 degrees C. The present results demonstrate that the cooling-induced augmentation of the sensitized rat trachea to OA is due to the increase of tissue responsiveness to 5-HT which is an important chemical mediator in the anaphylactic response. The major part of the contractile response to 5-HT may be mediated by a direct action on the smooth muscle. The increased responsiveness of the tracheal smooth muscle to 5-HT with lower temperature may involve the acceleration of Ca2+ release from intracellular storage sites and Ca2+ influx through voltage-dependent Ca2+ channels. PMID- 3632138 TI - Electrophysiological study in the dog of the risk of cardiac toxicity of bupivacaine. AB - The risk of toxic effects on the heart of bupivacaine following several kinds of locoregional anaesthesia has been investigated in the dog in situ heart by determining conduction time and effective refractory period in the various parts of the conduction system and the ventricular muscle, as well as the discharge rate of the sinus node. Bupivacaine, i.v. infused at 3 rates, 0.2, 0.3 and 0.4 mg X kg-1 X min-1, proved to have depressant effects on conduction, automatism and excitability. It slows down conduction in all the parts of the myocardium, considerably at high stimulation frequencies, but always much more in the His Purkinje system and the ventricular contractile fibres than in the atrioventricular node, because it tends to block the sodium rather than the calcium or potassium channel. Its effect remain more moderate, indeed, on sinus automatism and atrial and mainly ventricular refractoriness. Its danger lies, therefore, in the inhibition of conduction, with atrioventricular or His bundle branch block, but more frequently reentrant arrhythmias, likely to result in ventricular fibrillation. However: these alterations are observed with very high plasma levels (about 4 to 9 micrograms X ml-1), much higher than usual peak concentrations following spinal anaesthesia (0.10 micrograms X ml-1) or even epidural anaesthesia or brachial plexus block (1.20 micrograms X ml-1); reversal of these alterations occurs rapidly (reduction by 50% within 30 min for instance), when they have not led to ventricular fibrillation or they have not been associated with circulatory collapse. PMID- 3632139 TI - Evidence for a class 4 effect of cibenzoline "in vivo". AB - In anesthetized dogs, it has already been shown that cibenzoline (4 mg/kg i.v.) possesses class 1 anti-arrhythmic properties. In this work, the cardiac electrophysiologic effects of cibenzoline (1 mg/kg i.v.) were studied before and after propranolol (0.2 mg/kg i.v.) treatment. Cibenzoline caused a slight tachycardia, a reduction of conduction velocity in the His-Purkinje system and in the ventricle, but no significant effects in the atria and the atrioventricular node were detected. On the contrary, when dogs were given the beta-adrenoceptor blocking agent propranolol, cibenzoline produced major effects in the slow response structures, especially in the sinus node and the atrioventricular node (bradycardia and depression of the atrioventricular nodal conduction). No further effects were observed on the His-Purkinje system and ventricle as compared to administration of cibenzoline alone. In dogs, cibenzoline given i.v., had no effects on the slow response systems, probably because of sympathetic nervous system intervention since the class 4 effects of cibenzoline appeared after beta adrenoceptor blockade. PMID- 3632140 TI - Effects of coenzyme Q10 on recovery of hypoxia-induced changes in ATP and creatine phosphate contents of sinoatrial nodal cells of the rabbit's heart after reoxygenation. AB - We have studied the effects of reoxygenation on hypoxia-induced changes in contents of high energy phosphate compounds in pacemaker cells of nodal tissues excised from the rabbit heart, and effects of coenzyme Q10 on the electrical activity and metabolite contents in the tissue exposed to hypoxia and then reoxygenated. The contents of ATP and creatine phosphate (CP) in the sinoatrial node tissue were markedly reduced within 15-30 min after exposure to hypoxic Tyrode's solution. Reoxygenation produced almost complete recovery of the tissue ATP, but not of CP. After 60-120 min of hypoxia, the tissue ATP and CP decreased to about 60-30% of the initial value, but were not recovered by reoxygenation. Coenzyme Q10 (CoQ) at concentrations of 10(-6)-10(-5) g/ml did not produce changes in action potential parameters in the normal Tyrode's solution. CoQ (10( 5) g/ml) did not prevent the decreases in tissular ATP and CP in the initial period of hypoxia (30-60 min), but the ATP content at 120 min of hypoxia in the presence of CoQ was higher than the control. CoQ promoted recovery of tissular ATP after reoxygenation. Our results provide direct evidence that generation of action potentials in the sinoatrial nodal cells can be maintained by a small amount of ATP produced by the anaerobic glycolytic pathway. The present results suggest that exogenous CoQ would facilitate resynthesis of ATP in the functionally impaired mitochondria. PMID- 3632141 TI - Species and sex differences in the liver microsomal nitroreductive biotransformation of nifurtimox and benznidazole. AB - Nifurtimox (NFX) and Benznidazole (Bz) are two drugs effective against acute Chagas' disease. Both have considerable toxic side effects related to nitroreductive biotransformation. In this work, we studied the species and sex differences in liver microsomal NFX (NFX-ase) and Bz nitroreductase activity (Bz ase). Animal species tested were rats, mice, hamsters and guinea-pigs. Bz-ase is significantly higher in male rats and hamsters than in females. No significant sex difference was observed in mice or guinea-pigs. Bz-ase in the males is: hamsters greater than mice greater than guinea-pig approximately equal to rat and in females it is: mice approximately equal to guinea-pig approximately equal to hamster greater than rat. NFX-ase is higher in either male rats or female mice than in either female rats or male mice. No sex difference was observed in the other species. In males NFX-ase is: hamsters approximately equal to mice greater than rat approximately equal to guinea-pig, while in females it is mice approximately equal to hamsters greater than guinea-pig approximately equal to rat. Results suggest that hamsters and mice might be the most suitable species to study toxic effects related to their liver microsomal nitroreductive biotransformation. This might be of particular relevance for carcinogenicity studies. PMID- 3632142 TI - Simultaneous evaluation of drug effects on both the spinal cord and the descending pathways in rats. AB - Effects of drugs affecting the central nervous system on the spinal reflexes and the descending modulations of the reflexes were simultaneously evaluated in rats. Mono- and polysynaptic reflexes were, respectively, increased and decreased by conditioning stimulation of the nucleus raphe in the medulla, with a deflection in resting dorsal root potential being evoked by the stimulation. Baclofen exclusively depressed the segmental responses without affecting the descending modulatory systems. On the other hand, KW-6629 (7-chloro-N,N,3 trimethylbenzo[b]furan-2-carboxamide) significantly depressed the descending modulations without affecting the segmental responses which were sensitive to baclofen. Diazepam and suriclone reduced the descending influence without affecting the ventral root reflexes. Tolperisone and chlorphenesin carbamate as well as tizanidine depressed not only the segmental reflexes but also the descending modulations. Thus, sites of drug actions were estimated. PMID- 3632143 TI - Effects of adenosine and theophylline on canine tracheal smooth muscle tone. AB - The postulated mechanisms by which theophylline induces relaxation of airway smooth muscle include, among others, inhibition of cyclic nucleotide phosphodiesterase(s) and antagonism of adenosine-induced contraction. This latter possibility was examined by investigation of the interaction of theophylline and adenosine in canine tracheal smooth muscle preparations. Adenosine did not alter basal tone i.e. there is no evidence of a contractile response. However, when contraction was induced with methacholine, adenosine caused relaxation. It appears that this relaxation occurred as a consequence of the combination of adenosine with a site within the smooth muscle cell. The prior addition of theophylline (10(-6)-10(-3) M) did not alter adenosine-induced relaxation and in the reverse experiment, the prior addition of adenosine (10(-6)-10(-3) M) did not alter the relaxation produced by theophylline. It is concluded that adenosine relaxes canine tracheal smooth muscle by combination with an intracellular site, rather than a receptor on the cell surface. The hypothesis that theophylline relaxes airways smooth muscle by antagonism of adenosine or that adenosine antagonizes theophylline was not supported by our data. PMID- 3632144 TI - N-butyl hyoscine exerts local spasmolytic effect in the small and large bowel of the conscious dog. AB - The spasmolytic activity of N-Butyl Hyoscine (NBH) (1) has been investigated in conscious dogs provided with ileal or colonic Thiry fistulas in which motility was stimulated by intraluminal distension. In ileal motility experiments, phasic motility index (PMI), intestinal tonus, contraction frequency and heart rate were monitored. Intravenous administration of NBH (10 to 100 micrograms/kg) depressed PMI (ED50 35.1 micrograms/kg) and the other motility parameters. Heart rate increases were observed at 100 micrograms/kg. Application of NBH directly into the fistula (300 to 3000 micrograms/kg) caused a long-lasting, potent inhibition (31-72%) of PMI; tonus and contraction frequency were only slightly affected, while heart rate was not altered. When NBH was administered into an ileal fistula adjacent to the one from which motility was recorded, changes of PMI and other parameters were observed only after a massive dose of the drug (10000 micrograms/kg). In colonic fistula experiments, intraluminal NBH administration (300 to 3000 micrograms/kg) depressed colonic motility (39-59%), without affecting heart rate. It is concluded that NBH present in the intestine, although poorly absorbed, exerts local spasmolytic action. PMID- 3632145 TI - Electrophysiologic, antiarrhythmic and hemodynamic effects of transcainide. AB - Transcainide was selected as an antiarrhythmic drug with potential clinical application. In isolated dog, sheep and rabbit Purkinje fibres, in dog and guinea pig trabecular preparations and in the guinea-pig right auricle, transcainide decreases the rate of rise of the transmembrane action potential, with no effect on normal spontaneous activity and calcium-mediated action potentials; it inhibits early after-depolarizations. The effect on the rate of rise is very slow in onset. In vivo a prolongation of QRS duration is observed. In dogs, the drug is effective against post-infarction and ouabain-induced ventricular arrhythmias, and abolishes acetylcholine and aconitine-induced atrial fibrillation; it elevates the threshold of electrically induced ventricular fibrillation. Hemodynamic studies in anaesthetized and unaesthetized dogs indicate that transcainide moderately decreases contractility, while slightly increasing frequency. No major side effects are seen. Preliminary data on the pharmacokinetics suggest that in the dog the observed effects after i.v. infusion are related to the parent drug. Transcainide is an antiarrhythmic of the local anaesthetic type, with very slow kinetics. It is characterized by a good oral absorption and a long duration of action. PMID- 3632146 TI - Ethically permissible. PMID- 3632147 TI - Eosinophilia as a clue to the diagnosis of atheroembolic renal disease. PMID- 3632148 TI - Reversible adsorption (desorption) of aspirin from activated charcoal. AB - The potential desorption of aspirin from activated charcoal was investigated in eight patients in a randomized cross-over study. Despite prebinding of aspirin, systemic absorption did occur. Desorption from activated charcoal was characterized by a peak salicylate concentration that was 16% of control and a time to peak salicylate concentration that was delayed in the study group. Bioavailability of aspirin from activated charcoal described by area under the curve was 19% of control. Elimination half-lives were similar in both groups until 12 hours after ingestion, but after 12 hours the half-life of the study group was prolonged while salicylate concentrations were undetectable in the control group. Fifteen percent to 20% of aspirin prebound to charcoal may desorb leading to systemic absorption. Furthermore, release from activated charcoal is initially delayed then sustained through 30 hours. PMID- 3632149 TI - Impact of a therapeutic drug monitoring program for digoxin. AB - Although numerous utilization reviews of serum digoxin assays have demonstrated the positive impact of therapeutic drug monitoring, to our knowledge, the question of whether the withdrawal of such a program would reverse the effect has not been addressed. The current study employed a prospective, randomized, crossover design to evaluate this question and document the cost savings. There were 196 serum digoxin assays performed in the 207 patients. It was found that a continuous therapeutic drug-monitoring program was warranted since, after its withdrawal, there was a deterioration in audit criteria performance. Reimplementation of the therapeutic drug-monitoring program resulted in a significant decrease in the average number of assays requested per patient (from 1.41 to 0.73) and an improvement in audit criteria performance. PMID- 3632150 TI - Lactic acidosis and insulin resistance associated with epinephrine administration in a patient with non-insulin-dependent diabetes mellitus. AB - Epinephrine raises plasma lactate concentrations when infused intravenously in normal subjects. We studied a patient with non-insulin-dependent diabetes mellitus who developed lactic acidosis and marked insulin resistance when treated with epinephrine after open heart surgery. PMID- 3632151 TI - Faculty development in general internal medicine. Perceptions concerning academic survival. AB - To understand the educational needs of faculty general internists in academic hospital environments, surveys of general internal medicine division chiefs, department of medicine chairmen, and members of the Society for Research and Education in Primary Care Internal Medicine were undertaken. Results indicated considerable interest in faculty development activities among all physicians sampled. Division chiefs and department chairmen viewed such activities as feasible, potentially effective, and were willing to assume considerable responsibility in providing educational opportunities to their faculty. Although some physicians viewed self-learning as a potentially effective educational method, the vast majority preferred learning in a small group taught by an expert. Specific content areas for faculty development were assessed, as were the skills thought to be essential for personal job satisfaction, academic promotion, and organizational effectiveness. PMID- 3632152 TI - Malnutrition among hospitalized patients. A problem of physician awareness. AB - Between 25% and 50% of patients admitted to an acute medical service are malnourished. Physicians are often unaware which patients are admitted at nutritional risk and make no attempt to arrest further nutritional decline until a dramatic deterioration has occurred. We studied all patients admitted to an acute medical ward service before and after their physicians were taught to recognize nutritional deficiency early and to intervene appropriately. During the initial period, the house staff correctly identified two (12.5%) of 16 patients as being malnourished. During the posteducation period, physicians correctly identified all 14 patients admitted at nutritional risk (100%), using a simple screening device that required only routine admission data. In all cases, the appropriate nutritional intervention was subsequently made. Results were further validated using a pretest and posttest, showing a significant improvement in nutritional knowledge. We conclude that physicians are not presently being taught to recognize malnutrition, that such malnutrition is latrogenically worsened in the hospital, and that physician education can effectively correct this problem. PMID- 3632153 TI - Esophagitis and gastroduodenal disorders associated with diabetic gastroparesis. AB - The prevalence of associated gastrointestinal disorders with diabetic gastroparesis was studied retrospectively by reviewing all data on patients with diabetic gastroparesis who were admitted to the Hospital of the University of Pennsylvania, Philadelphia, over a four-year period. Twenty diabetic patients with intractable nausea and vomiting, thought to be secondary to diabetic gastroparesis, underwent upper gastrointestinal tract endoscopy after failure to respond to conventional therapy for gastroparesis within several days. Nine (45%) patients had normal upper endoscopic examination results. Eleven (55%) patients were discovered to have other gastrointestinal tract disorders that could explain their persistent symptoms of nausea and vomiting. Specifically, three patients had Candida esophagitis, four had erosive esophagitis, two had gastric ulcers, one had duodenal erosions, and one had bile reflux gastritis. These 11 patients improved when therapy was altered to treat their additional disorder. Management of diabetic gastroparesis is discussed with emphasis on early upper gastrointestinal tract endoscopy for patients who fail to respond to therapy initially. PMID- 3632154 TI - Metoclopramide-induced neuroleptic malignant syndrome. AB - The neuroleptic malignant syndrome (NMS), an unusual idiosyncratic reaction to neuroleptic medications, may be fatal if unrecognized. Symptoms of NMS include rigidity, hyperpyrexia, altered consciousness, and autonomic instability. This syndrome is generally associated with neuroleptic medications used to treat psychotic and major depressive illnesses. We describe two diabetic patients at our institution who developed NMS in association with antiemetic metoclopramide hydrochloride. PMID- 3632155 TI - Extreme bradycardia during sleep apnea caused by myxedema. AB - A 52-year-old man with myxedema was evaluated for anterior chest pain that was considered to be compatible with myocardial ischemia. The night after admission he developed extreme bradycardia, hypotension, and apneic episodes lasting up to 25 s. Continuous positive airway pressure and administration of medroxyprogesterone acetate prevented further episodes and relieved much of the somnolence and lethargy that had contributed to the evidence for myxedema. Alveolar hypoventilation caused by decreased sensitivity to carbon dioxide, inadequate central neural drive, peripheral muscle force, and obesity all may have contributed to the apnea. Chest pain has not recurred, and results of electrocardiography have remained normal following full thyroid hormone replacement. The early recognition of myxedema causing sleep apnea will allow specific treatment to avoid the cardiovascular risks related to prolonged apnea and will help avoid confusion with other etiologies of cardiovascular abnormalities. PMID- 3632156 TI - Aeromonas hydrophila-associated colitis in a male homosexual. AB - A 37-year-old homosexual man was evaluated for a one-week history of hematochezia. Results of a physical examination were remarkable only for grossly bloody stool. Sigmoidoscopy to 30 cm showed a friable mucosa compatible with an acute colitis, and a rectal biopsy specimen demonstrated an increased plasma cell infiltrate. Stool cultures subsequently yielded Aeromonas hydrophila; serum human T-cell lymphotropic virus type III antibody titer was positive. The patient responded to a course of treatment with sulfamethoxazole and trimethoprim with resolution of his symptoms and restoration of the bowel to a normal sigmoidoscopic appearance. Aeromonas hydrophila infection should be considered in the differential diagnosis of acute proctocolitis, particularly in patients with underlying immunodeficiency states. PMID- 3632158 TI - DVT equals deep venous thrombosis? PMID- 3632157 TI - Neuro-osteoarthropathy (Charcot's joint) in diabetes mellitus following revascularization surgery. Three case reports and a review of the literature. AB - The initial primary defect in the development of neuro-osteoarthropathy is neuropathy. Our case reports and a review of the literature strongly implicate a neurally initiated vascular reflex leading to increased blood flow. This may play a pivotal role in the development of Charcot's joint in the neuropathic limb. Mechanical trauma in an insensitive foot is contributory, but it is probably a secondary mechanism. PMID- 3632159 TI - Ecthyma gangrenosum without bacteremia or necrotic cellulitis: a localized form of septic vasculitis. PMID- 3632160 TI - An eight-year search for Dr Osler. PMID- 3632161 TI - Atypical or nonanginal chest pain. Panic disorder or coronary artery disease? AB - Of 195 patients with atypical or nonanginal chest pain presenting in a cardiology clinic, 104 consented to be evaluated for anxiety disorders using a structured psychiatric interview. Thirty patients had histories of coronary artery disease (CAD). Fifty-nine patients in the sample (16 of those with CAD and 43 of those without CAD) fit diagnostic criteria for panic disorder (PD). Those without CAD and with PD were primarily women (mean age, 43 years) with predominantly nonanginal chest pain. Those patients with both CAD and PD were primarily men (mean age, 54 years) with predominantly atypical angina. Since PD has been shown to be readily responsive to pharmacologic intervention, this diagnosis should be considered in patients with atypical or nonanginal chest pain. PMID- 3632162 TI - The value of serum magnesium determination in hypertensive patients receiving diuretics. AB - Some clinicians contend that hypomagnesemia is a common problem in patients receiving diuretic therapy and that routine serum magnesium determinations may be indicated in such patients. We determined serum magnesium (Mg++) levels in 354 patients with uncomplicated hypertension. No significant difference was observed in the mean Mg++ between the 245 diuretic-treated patients and the 109 patients not receiving diuretics, 0.965 vs 0.97 mmol/L (1.93 vs 1.94 mEq/L). When analyzed by type of diuretic, there were statistically significant differences in the mean serum Mg++ concentrations between those receiving thiazides, 0.94 mmol/L (1.87 mEq/L); those receiving no diuretics, 0.97 mmol/L (1.94 mEq/L); and those receiving triamterene-containing diuretics, 1.01 mmol/L (2.01 mEq/L). These absolute differences, however, were clinically quite small, and hypomagnesemia was uncommon. Neither patient age, the duration of diuretic use, nor the serum potassium level correlated with Mg++. With respect to dose, those receiving 100 mg/d of hydrochlorothiazide had the lowest Mg++ concentrations and the greatest prevalence of hypomagnesemia (12%), defined as Mg++ less than 0.75 mmol/L (1.5 mEq/L). Serum Mg++ need not routinely be determined in patients with uncomplicated hypertension who are receiving triamterene-containing diuretics or low-dose (50 mg/d or less) hydrochlorothiazide. PMID- 3632163 TI - Improving follow-up among hypertensive patients using a health belief model intervention. AB - Seventy-two hypertensive patients visiting an emergency department (ED) were randomized to one of four study groups to test the effect on compliance of a health belief model (HBM) intervention: a control group, a group receiving an HBM clinical intervention in the ED, a group receiving an HBM telephone call two days after the ED visit, and a combination clinical plus telephone intervention. Patients receiving any HBM intervention were 50% more likely to make, and 47% more likely to keep, a follow-up referral appointment than control group patients. PMID- 3632164 TI - Atrial fibrillation: a major contributor to stroke in the elderly. The Framingham Study. AB - Chronic atrial fibrillation without valvular disease has been associated with increased stroke incidence. The impact of atrial fibrillation on the risk of stroke with increasing age was examined in 5184 men and women in the Framingham Heart Study. After 30 years of follow-up, chronic atrial fibrillation appeared in 303 persons. Age-specific incidence rates steadily increased from 0.2 per 1000 for ages 30 to 39 years to 39.0 per 1000 for ages 80 to 89 years. The proportion of strokes associated with this arrhythmia was 14.7%, 68 of the total 462 initial strokes, increasing steadily with age from 6.7% for ages 50 to 59 years to 36.2% for ages 80 to 89 years. In contrast to the impact of cardiac failure, coronary heart disease, and hypertension, which declined with age, atrial fibrillation was a significant contributor to stroke at all ages. PMID- 3632165 TI - Complex partial status epilepticus presenting as fever of unknown origin. AB - A woman experienced multiple attacks of fever, each lasting 24 to 72 hours, over 1 1/2 years. The patient herself could not relate details of most episodes; her husband reported observing extreme prostration and incoherence during some of the episodes. A thorough investigation at three medical centers failed to reveal any of the usual causes of fever of unknown origin. Finally, another family member observed a sudden loss of responsiveness without loss of consciousness, blank staring, and repetitive arm movements. A diagnosis of complex partial status epilepticus was made, and fever was documented in association with repetitive complex partial seizures on two occasions in the hospital. Both the fever and the seizures were controlled by anticonvulsant medication, and both recurred under observation when the medication was discontinued. A review of the charts of adult patients admitted to the hospital for a primary neurologic disorder showed that those with epilepsy were more likely to experience fever within the first 24 hours than those without epilepsy (13 of 29 vs five of 29) especially if multiple seizures occurred. Fever may occur in association with seizures; occasionally it may be a presenting manifestation. PMID- 3632166 TI - Postanginal sepsis following infectious mononucleosis. AB - During a five-year period, three patients were seen with postanginal sepsis occurring within ten days of the onset of infectious mononucleosis. Postanginal sepsis was not diagnosed in other hospitalized patients during this period. These cases demonstrate that postanginal sepsis can be a complication of infectious mononucleosis. PMID- 3632167 TI - High-level aminoglycoside-resistant enterococci. Colonization of nursing home and acute care hospital patients. AB - Enterococci with high-level resistance (HLR) to gentamicin sulfate and other aminoglycosides have emerged as pathogens in recent years. More than half of all current isolates of enterococci at the Ann Arbor (Mich) Veterans Administration (VA) Medical Center are HLR strains. We determined the rate of colonization with HLR enterococci in patients in the acute care hospital, the attached nursing home, and a private nursing home. We also studied the factors related to colonization and the molecular relatedness of strains of HLR enterococci in these settings. In the VA facilities, 47.4% of patients in the nursing home and 36.1% of patients in the acute care hospital were colonized, compared with a 4.3% colonization rate in the private nursing home. Intravenous or Foley catheters and bedridden status were associated with colonization in the acute care setting; the need for advanced nursing care and prior antibiotic therapy were associated with colonization in the nursing home. Environmental surfaces were contaminated with HLR enterococci in both VA settings. Plasmid analysis of HLR strains revealed identity between both patient and environmental strains in the nursing home care unit and the acute care hospital. Nursing home patients, with their high rate of colonization with HLR enterococci and their frequent movement into the acute care hospital, may play a role as a reservoir for subsequent transmission of HLR enterococci. PMID- 3632168 TI - Metoclopramide response in patients with progressive systemic sclerosis. Effect on esophageal and gastric motility abnormalities. AB - Twelve patients with progressive systemic sclerosis (four with CREST [calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia] variant) underwent systematic evaluation to assess the esophagogastric effects of metoclopramide hydrochloride in this patient population. Esophageal manometry, esophageal radionuclide scintigraphy, solid-phase gastric emptying, and 24-hour esophageal pH monitoring were performed in all patients with and without metoclopramide. Metoclopramide improved lower esophageal sphincter pressure and reduced the gastric emptying delay and gastroesophageal reflux in most patients but had a less consistent effect improving esophageal transit or esophageal body pressures. Metoclopramide should be strongly considered in the pharmacologic approach to the gastroesophageal reflux-related complications of this disease. PMID- 3632169 TI - Serum protein electrophoresis patterns in chronic lymphocytic leukemia. Clinical and epidemiologic correlations. AB - Serum protein electrophoresis (SPEP) data obtained at diagnosis were available for 98 of 342 patients with chronic lymphocytic leukemia (CLL) identified in a population-based case-control epidemiologic study. Patients tested with SPEP at diagnosis were significantly younger, more likely to have lymphadenopathy, and more likely to have had their conditions diagnosed at a university hospital than those not tested. Four categories of electrophoretic patterns were identified: normal (N = 56), hypogammaglobulinemia (N = 28), hypergammaglobulinemia (N = 11), and monoclonal gammopathy (N = 3). A higher proportion of those with hypergammaglobulinemia were black, and patients with hypergammaglobulinemia and monoclonal gammopathy were more likely to die within the first year following diagnosis than patients in the other SPEP groups. No association was found, however, between SPEP pattern and a clinical staging classification for CLL. These findings suggest that SPEP may be a useful adjunct in categorizing possible subtypes of CLL and developing future clinical staging classifications. PMID- 3632170 TI - Cancer and resuscitation. Does the diagnosis affect the decision? AB - We asked if physicians are less likely to resuscitate patients with cancer because of the diagnostic label alone. We composed a questionnaire of nine patient vignettes with similar expected mortality rates, identical quality of life, and witnessed cardiopulmonary arrest. Internists and neurologists in a university training program were asked to decide, for each "patient," whether to administer cardiopulmonary resuscitation (CPR) before and after being informed of similar mortality rates. Decisions for CPR were less frequent for cancer vignettes than for vignettes of other chronic medical illnesses before and after mortality information was given. Analysis indicated that decisions varied among physicians according to their subspecialties. Overall, women favored resuscitation less often than did men. The diagnosis of cancer appears to have a negative impact on physicians' CPR decisions over and above that due to inaccurate prognostic assumptions about cancer. A physician's subspecialty and gender may also influence resuscitation decisions for patients in general. PMID- 3632171 TI - Shame and humiliation in the medical encounter. AB - Patients are at high risk for experiencing shame and humiliation in any medical encounter. This is because they commonly perceive diseases as defects, inadequacies, or shortcomings; while the visit to the hospital and the doctor's office requires physical and psychological exposure. Patients respond to the suffering of shame and humiliation by avoiding the physician, withholding information, complaining, and suing. Physicians may also experience shame and humiliation in medical encounters resulting in their counterhumiliation of patients and dissatisfaction with medical practice. A heightened awareness of these issues can help physicians diminish the shame experience in their patients and in themselves. Twelve clinical strategies for the management of shame and humiliation in patients are discussed. PMID- 3632172 TI - Aneurysmal subarachnoid hemorrhage presenting as cardiorespiratory arrest. AB - Three cases of subarachnoid hemorrhage (SAH) due to ruptured developmental (berry) aneurysm are reported. Two patients presented with cardiac arrest and were successfully resuscitated, but the diagnosis of SAH was delayed and this most likely influenced poor final outcome. The third patient presented with irreversible respiratory arrest. The possible mechanisms responsible for SAH triggered cardiac arrhythmia and/or respiratory arrest are discussed. Absence of previous cardiac history, persistent headache, focal neurologic findings (especially papilledema or subhyaloid hemorrhages) should warn the clinician of the possibility of SAH and warrant further neurologic investigation. PMID- 3632173 TI - Salmonella vertebral osteomyelitis treated with cefotaxime. AB - The antimicrobial therapy of systemic salmonella infections is presently limited to ampicillin, chloramphenicol, and sulfamethoxazole and trimethoprim. Infrequently, alternative therapy may be necessary. We report the successful treatment of a case of Salmonella vertebral osteomyelitis with cefotaxime sodium. PMID- 3632174 TI - Infections caused by Pseudomonas maltophilia. Expanding clinical spectrum. AB - Pseudomonas maltophilia (Xanthomonas maltophilia) is a frequently isolated commensal that is gaining increasing recognition as an opportunistic pathogen in debilitated hosts. We report three unusual infections due to P maltophilia that illustrate the ability of the organism to cause life-threatening illness. We describe a case of postoperative meningitis, a case of recurrent bacteremia complicated by ecthyma gangrenosum, and a case of native valve endocarditis in a drug addict. Because of frequent isolation from noninfected sites, the pathogenic potential of P maltophilia may be overlooked. The notable resistance of this organism is commonly used beta-lactam and aminoglycoside antibiotics may complicate therapy. PMID- 3632175 TI - Cutaneous vasculitis associated with propylthiouracil therapy. AB - Cutaneous vasculitis is an uncommon complication of propylthiouracil therapy. Its pathogenesis has been related to the presence of circulating immune complexes. The lesions may be purpuric or bullous hemorrhagic, possibly evolving into necrotic ulcerations. Usually, lesions develop on the extremities and earlobe. The vasculitis has been related to the duration of the treatment and disappears with the withdrawal of the drug, although a fatal case has been reported. Corticosteroid therapy is often prescribed, but its efficacy has not been demonstrated. We describe a patient in whom treatment with propylthiouracil for a year was associated with vasculitic lesions on the lower extremities and earlobe. Discontinuation of the drug was correlated with disappearance of the lesions. PMID- 3632176 TI - Kinetics of transdermal clonidine. PMID- 3632177 TI - Symptomatic hypotension induced by nifedipine. PMID- 3632178 TI - Premedical education: a modest proposal debated. PMID- 3632179 TI - Transverse myelitis secondary to intramuscular administration of benzathine penicillin. PMID- 3632180 TI - Acute allergic bronchoconstriction in the guinea-pig: advantages of intratracheal immunization. PMID- 3632181 TI - Effect of fentanyl and naloxone on early and late components of the auditory evoked potentials. PMID- 3632182 TI - Coerulospinal enhancement of repetitive firing with correlative changes in postspike afterhyperpolarization of cat spinal motoneurons. AB - The present study was aimed at determining if inputs from the locus coeruleus (LC) have any effect on repetitive firing of ventral horn motoneurons in cats. In hindlimb flexor and extensor motoneurons stimulated intrasomatically with current below the threshold for repetitive discharges, added LC-evoked excitatory post synaptic potentials (EPSPs) were consistently found to produce repetitive firing, suggesting a lowering in the repetitive firing threshold attributable to excitatory LC inputs. With those extensor motoneurons showing episodic, self sustained firing, LC-EPSPs introduced during the quiescent period were capable of starting a continuous discharge with rhythmic frequencies higher than the spontaneous activity. In some of these cells, intracellularly applied hyperpolarizing current was able to stop the spontaneous discharges. Subsequently, LC stimuli were found to reinitiate repetitive discharges, thus counteracting the ongoing suppression of the motoneurons. Quantitative analysis of the single-spike afterhyperpolarization (AHP) indicated a consistent reduction in its amplitude and time course (duration, time-to-peak, half-decay time) for flexor and extensor motoneurons in response to LC conditioning stimuli. Present results suggest an excitatory LC action on the repetitive discharges of cat motoneurons accompanied by a concurrent decrease in the amplitude and time course of the single-spike AHPs. PMID- 3632183 TI - Presynaptic facilitatory action of locus coeruleus stimulation upon hindlimb sensory impulse transmission in decerebrate cats. AB - This study sought to delineate the presynaptic role of the locus coeruleus (LC) on hindlimb primary afferent terminals. Changes in presynaptic function in response to LC stimulation were assessed by measuring the dorsal root potential (DRP), interaction of LC- and peripherally-evoked DRPs, and intraspinal afferent terminal excitability. LC stimulation in unanesthetized, decerebrate cats produced a sequence of early and late positive DRPs succeeded by a small-sized negative DRP. Conditioning the negative DRPs elicited from individual hindlimb nerve branches with LC stimuli led to a decrease in test DRPs. Similarly, there was a predominant decrease in excitability in both large muscle and cutaneous afferent terminals. These data suggest a presynaptic role of the LC in augmenting afferent impulse transmission, presumably through inhibition of tonically active interneurons having axoaxonic contacts on primary afferents; functionally, presynaptic facilitation. PMID- 3632184 TI - Convergence of neck and macular vestibular inputs on vestibulospinal neurons projecting to the lumbosacral segments of the spinal cord. AB - The activity of LVN neurons was recorded in decerebrate cats and analyzed during separate stimulation of macular vestibular and neck receptors elicited by sinusoidal rotation about the longitudinal axis at 0.026 Hz, 10 degrees peak amplitude. Of 119 LVN units examined, the great majority, i.e. 106, were vestibulospinal neurons antidromically identified following stimulation of the spinal cord at T12-L1, thus projecting to the lumbosacral segments of the spinal cord (IVS neurons); the remaining 13 units were nonantidromically activated. Among the 119 LVN neurons, 77 (64.7%) responded with a periodic modulation of their firing rate to roll tilt of the animal and 81 (68.1%) responded to neck rotation. Convergence of macular and neck inputs was found in 58/119 (48.7%) lateral vestibular neurons; in these units, the gain as well as the sensitivity of the first harmonic of responses corresponded on the average to 0.58 +/- 0.45, S.D. imp./sec/deg and 4.39 +/- 3.58, S.D.%/deg for the neck responses and 0.52 +/ 0.49, S.D. imp./sec/deg and 3.85 +/- 3.35, S.D.%/deg for the macular responses, respectively. In addition to these convergent units, 19/119 (16.0%) and 23/119 (19.3%) lateral vestibular units responded to selective stimulation either of macular receptors or of neck receptors only. These units, which showed on the average an higher firing rate and a lower conduction velocity of the corresponding vestibulospinal axons than the convergent units, displayed a significantly lower response gain and sensitivity to animal tilt and neck rotation with respect to those obtained from convergent units. Most of the convergent lateral vestibular units were maximally excited by the direction of stimulus orientation, the first harmonic of responses showing an average phase lead of +51.4 degrees with respect to neck position and +21.9 degrees with respect to animal position. Two populations of convergent neurons were observed. The first group of units (53/58, i.e. 91.4%) showed reciprocal ("out-of-phase") responses to the two inputs in that they were mainly excited during side-down animal tilt and side-up neck rotation. The remaining group of units (5/58, i.e. 8.6%) showed parallel ("in phase") responses to the two inputs and they were mainly excited by side-up neck rotation and animal tilt. Interestingly, the former group of units displayed an average gain and sensitivity to the labyrinth and neck inputs which were more than twice higher than the values obtained from the latter group of units.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3632185 TI - Effects of local injection of the alpha 2-adrenergic agonist clonidine into the locus coeruleus complex on the gain of vestibulospinal and cervicospinal reflexes in decerebrate cats. PMID- 3632186 TI - A neuroimmunological challenge: schizophrenia as an autoimmune disease. PMID- 3632187 TI - [Effects of calcium antagonist on ischemic cell injury of the rat brain]. PMID- 3632188 TI - [The origin and developmental mechanism of experimentally induced cerebral aneurysms in rats]. PMID- 3632190 TI - [Selective inhibition of neuronal activities in lateral vestibular nucleus in the rat under cerebral hypoxia]. PMID- 3632189 TI - [Experimental study of sutureless micro-vascular anastomosis using Nd-YAG laser combined with a water-soluble PVA splint]. PMID- 3632191 TI - [Experimental study of the artificial esophagus of the dog: comparison of materials and concerning to the neogenesis of the intima and the occurrence of the stenosis]. PMID- 3632192 TI - [Experimental studies of splenic autotransplantation]. PMID- 3632193 TI - [Nutritional quality of pigeon pea protein, immature and ripe, and its supplementary value for cereals]. AB - The purpose of the present research was to determine the differences which could exist between immature and mature pigeon pea in gross chemical composition and protein quality, raw and cooked, as well as their respective supplementary value to rice, and to mature and immature corn and sorghum. The chemical composition data showed only small differences in proximate composition between the mature and immature grain. The cooking process did not affect chemical composition. Based on the FAO/WHO amino acid reference pattern, immature pigeon pea was more deficient in threonine than mature pigeon pea, which was limiting in valine. Both grains were limiting in sulfur amino acids. The protein quality of the immature grain was higher than that of the mature grain, and both responded positively to cooking, suggesting the presence of antiphysiological substances in both. Amino acid supplementation studies demonstrated that both the immature and mature grain responded to methionine addition, the first limiting amino acid, and to tryptophan, the second limiting amino acid. The effects were more marked when samples were cooked. Both types of grains were good supplements to rice, when added in amounts of 10-20%. Mature pigeon peas supplemented relatively well the proteins of sorghum, immature and mature corn, at the 20, 30 and 20% levels, respectively. The differences found could be explained on the basis of the amino acids limiting cereal grains and pigeon peas protein. PMID- 3632194 TI - [Efficacy of the protein of canned tuna (Thunnus alalunga) in animal growth]. AB - The effect of the manufacturing process on canned tuna (Thunnus alalunga) by the sterilization procedure at 115 degrees C for 60 and 90 minutes on its protein quality was studied. Protein quality was mainly evaluated according to its efficiency for animal growth. Protein from food obtained by the sterilization procedure at 115 degrees C for 60 minutes was similar for animal growth to that from a standard casein-methionine diet. No changes in digestibility and biological values were found between both proteins. Nevertheless, when the sterilization procedure was prolonged up to 90 minutes, the protein suffered modifications. Thus, protein digestibility decreased in spite of the fact that protein digestibility remained unmodified. On the other hand, introduction of the mixed protein into a diet based on flour plus tuna sterilized at 115 degrees C for 90 minutes, was not capable of maintaining the optimum patterns for weight evolution. PMID- 3632195 TI - [Replacement of peanut oil used for the fortification of sugar with vitamin A for other vegetable oils available in Central America]. AB - The objective of this study was to determine the technical feasibility of replacing the peanut oil used in the preparation of the premix to fortify sugar with vitamin A, for other vegetable oils available in Central America. For this purpose, cottonseed, soybean, corn and African Palm oils were tested. Premixes were prepared using each one of the oils and stored for evaluation during a six month period. A premix prepared with peanut oil was used as a control. It was found that the stability of vitamin A was similar in all premixes; less than 10% of the original activity was lost through the duration of the study. The physical characteristics of the premixes were also acceptable, with the exception of the one containing soybean oil which became caked and rancid. The peroxide content of the oils contained in the premixes increased throughout the study period. The lowest level of oxidation occurred in the premix made with African Palm oil. Its peroxide content changed only from 1.4 to 8.8 mEq/kg of oil. In contrast, that containing soybean oil showed the greatest change in peroxide from 2.8 to 130.0 mEq/kg of oil. It was concluded that it is indeed technically feasible to substitute the peanut oil by another vegetable oil, which should be low in peroxides and of high stability. Furthermore, it should not alter significantly the stability of the vitamin A contained in the premix during storage. On this basis, the African Palm oil was the most suitable one. PMID- 3632196 TI - [Silage of huizache (Acacia farnesiana, L. Willdt) as a potential resource in the feeding of goats]. AB - Acacia farnesiana, L. Willd (huizache) is a leguminous plant that, because of its abundance, represents a forage resource for ruminant animals which up to this moment has not been effectively utilized. Bearing this fact in mind, the present research was focussed on investigating the silage method efficiency for conservation and improvement of its nutritive value. Considering the high protein content and low carbohydrate availability which characterize legumes in general, the following chemical additives were submitted to trial: formaldehyde, sodium hydroxide and ammonium hydroxide (3 ml/100 g dry matter); another variable was also introduced: the addition or lack of addition of molasses to the different treatments, both of the silaged and not ensiled forage. The resulting silages were then submitted to proximate chemical analysis, determination of neutral detergent fiber, pH, ammonium, and acetic, propionic, butyric and lactic acids. The dry matter disappearance percentage in situ, as well as nitrogen protein, cell walls and cellular matter contents were also calculated. For the dry matter disappearance trials, four female goats with permanent ruminal fistulas were distributed in four 4 X 4 latin squares. Findings revealed that the high dry matter content of the ensiled forage (73.6%) markedly restricted fermentation. Nevertheless, the silage proved to be of good quality; as expected, a high lactic acid concentration was detected in silages to which molasses were added. In regard to the dry matter disappearance percentage and nitrogen protein, no differences of statistical importance were found among treatments. However, significant results were obtained in regard to disappearance of cell walls and cellular contents. It was concluded that no chemical additives are required to ensile huizache, as the plant by itself makes a good quality forage. PMID- 3632197 TI - [Food and nutrition knowledge of students graduating from basic education in the metropolitan area of Santiago, Chile]. AB - The aim of this study was to evaluate the degree of knowledge on food and nutrition in students graduating from Basic Education in the Metropolitan Area of Santiago, Chile. A random sample of 249 students of both sexes (1:1) from public and non-public schools (1:1) and from high, medium and low socioeconomic level (SEL), was selected. SEL was measured through the Graffar Modified Scale, and the degree of knowledge on food and nutrition was evaluated through a standardized test of 29 multiple choice items, based on the objectives of the curriculum program. The test was divided in two areas: Area 1, which contemplated Food and Requirements and Area 2, Food, Personal and Environmental Hygiene. Data were analyzed by chi-square procedure, comparing students who obtained sufficient knowledge (greater than or equal to 50% of correct answers) with those who obtained insufficient knowledge (less than 50% of correct answers). Results of the study indicated that 39.8% of students registered sufficient knowledge, 31.3% and 65.9% in Area 1 and 2, respectively. According to SEL, 62.1% and 12.3% of students from high and low SEL, respectively, registered sufficient knowledge (p less than 0.001), and the same effect was observed in Areas 1 and 2. In relation to sex, 46.3% of females and 33.3% of males registered sufficient knowledge (p less than 0.05), fact which was confirmed in both areas of the test. No significant differences were registered in the degree of knowledge on food and nutrition of students from public and non-public schools. It is therefore concluded that the degree of knowledge on food and nutrition in students graduating from Basic Education differs significantly according to SEL and, sex. This study represents a basic contribution to the better understanding of factors affecting the degree of knowledge on food and nutrition in students graduating from Basic Education in Santiago, Chile, and may serve as base-line for further studies on the subject. PMID- 3632198 TI - [Effect of mass communication media in food purchasing at the family level]. AB - The main purpose of this study was to determine the effect of mass media advertisement of food products (TV, radio and the press), particularly in pre school and school-age children, as well as the concomitant impact these age groups have on the family food buying patterns. To test the hypothesis that the impact of mass media advertising on foods varied in the different socioeconomic levels of a community, a stratified sample of all children below 13 years of age, who attended the Francisco Fajardo school in the central coast of Venezuela, was drawn. Mass media contact, food and nutrition knowledge and other socioeconomic characteristics were related to the family's food-buying patterns. More specifically, the age, working status and educational level of the mother in regard to beliefs concerning the nutritional value of advertized food products, were related. A semi-structured questionnaire was designed, tested and applied to the housewife or whoever performed this role within the family. Findings revealed that families of low socioeconomic status are prone to be most influenced by mass media food product advertising. This is reflected not only in food purchasing practices but also in food consumption patterns at the family level. Chocolate drinks, cereals, jello, sausages, and ice cream are the most popular products among pre-school and school-aged children, without social class distinction. Furthermore, results revealed that the degree of exposure to mass communication media--television, radio and newspapers--is a determining factor in children's food preferences at all socioeconomic levels, and that television is the media exerting the greatest influence. PMID- 3632199 TI - [Nutritional status and land tenure. A study in adults of the rural area of the northeastern Brazil]. AB - The present study was carried out in the rural areas of four municipalities in the North-East of Brazil as part of a broader survey which covered a sample of families living in the area. A subsample of adults (453 women and 126 men) was obtained from individuals who attended the survey's post for clinical and anthropometric evaluation. According to land tenure, they were stratified into four categories: those with-without land (W.L.); small land owner (S.O.); medium land owners (M.O.); and large land owners (L.O.). Means for anthropometric variables (height, weight, middle arm circumference and skinfold thickness) were calculated for each stratum. The differences between groups were statistically significant (p less than 0.05). Findings revealed that the larger the property, the greater the mean value for height; extreme values attained a difference of 7 and 6 cm in men and women, respectively. Mean weight increased as land ownership grew reaching a difference of 9 and 11 kg in men and women, respectively (p less than 0.01). Skinfold thickness and middle arm circumference showed significant differences between strata. To evaluate their present nutritional status, the adequacy of weight to height was obtained. In spite of the low proportion of individuals who exhibited less than 90%, adequate improvement was detected as land tenure increased. The study discusses the precariousness of criteria and patterns for the nutritional evaluation of adults, and suggests the existence of a relationship between nutritional status and land ownership. PMID- 3632200 TI - [Chemical composition and evaluation of the protein quality of beans in adult humans by the short-term nitrogen balance method]. AB - Three varieties of common beans were chemically analyzed and their protein quality was evaluated in 12 human male adult subjects by the short-term nitrogen balance method. Chemical analyses were performed for both raw and cooked grains. Cooking reduced the trypsin inhibitors in 28 to 73%, hemagglutinins, 100%, tannins as acid tannic equivalents, 9 to 72%, and 55 to 75% as catequin equivalents, and alkali-soluble nitrogen in 65%. Red and black beans contained more residual trypsin inhibitors and tannins than white beans, while the latter contained more alkali-soluble nitrogen. Although cooked colored beans had more antinutritional factors that affect protein digestibility, their protein quality was similar to that of white beans. This could be explained by the fact that the amino acid composition and/or balance of red and black beans absorbed nitrogen is better than that of white beans, so that the final nutritional value will be determined by the sum of interactions between all factors. In this study, each of the three varieties presented at least one protein quality depressor in higher concentration than the other two varieties. Therefore, the overall differences found between treatments and residual effect, were small or non existent, while significant differences (p greater than 0.05) were found between subjects and nitrogen balance periods. A level of 0.65 g of bean protein/kg/day was not enough to maintain nitrogen balance in subjects fed a diet where beans were the only protein source. According to calculations, 0.9-1.0 g of bean protein/kg/day are necessary for nitrogen balance in male adults, and 1.2-1.3 g of protein bean would be the recommendation for a normal population. PMID- 3632201 TI - [Zootechnic measurements and characterization of ducts of the native Salvadorean hog]. AB - A zoometric and yield study of the domestic Salvadorean hog in its three representative types: "chino" or beardless (CH), "negro" or black (N) and "parchado" or patched (P) in the birth-to-sacrifice stages, as well as in the carcasses, was carried out. All live animals were weighed, and shoulder height, perimeter of thorax and length of dorsal arch measurements were taken and daily average gains, evaluated. Comparison between the pure domestic hog and those crossed with specialized breeds is also established in animals studied from birth to 21 days old; crossed hogs proved to be superior to the domestic animals. Weights of the different commercial parts of the animal such as head, ducts, bacon, skin and main organs (entrails) were taken from sacrificed hogs (carcass). Dorsal fat was measured as well, and animals with a control diet and those consuming a free diet are compared. Projections are also made with the daily gains and commercial yields of animals weighing 110, 130, 150, 170 and 190 pounds at sacrifice, and of the mean zootechnic characteristic values. Statistical analysis of data pertaining to animals fed the free diet revealed differences among types (p less than 0.05) in regard to duct weight (CH and N superior to P), fat weight (N inferior to P and CH), head weight (P inferior to CH and N), weight of skin (CH inferior to P and N), length of body (CH superior to N and P) and perimeter of thorax (CH superior to P and N). PMID- 3632202 TI - [Bases for the integration of an Ibero-American program of research in food technology]. PMID- 3632203 TI - Serum cholesterol, triglyceride, and high-density-lipoprotein concentrations in men with different dietary and exercise regimens in Puriscal, Costa Rica. AB - Mean serum cholesterol and triglyceride concentrations were higher for two groups of sedentary middle-aged and elderly men than for a group of physically-active, middle-aged farmers, all from rural Puriscal, Costa Rica. The mean serum cholesterol, triglyceride, and high-density lipoprotein (HDL)-risk factor levels of the three groups were all higher than the comparable US means. Dietary fat and cholesterol intake were also greater for the Puriscal men than for the comparable US counterpart. No correlations were found between dietary fat or cholesterol and the corresponding serum levels. Age was correlated with serum cholesterol and HDL risk factor values. Weight was also correlated with these variables as well as with serum triglyceride concentrations. A high prevalence of obesity was found among the middle-aged sedentary men. PMID- 3632204 TI - Energy supplementation and productivity of Guatemalan sugar-cane cutters: a longitudinal approach. AB - A long-term energy supplementation program was carried out to determine its effect on the productivity of agricultural workers in Guatemala. The program provided, free of charge, a low-energy (24 Kcal) and a high-energy (350 Kcal) bottled, orange-flavored soft drink to two groups of long-term resident sugar cane cutters who worked on the same plantation, located in the Pacific Coast. Previous to, and periodically thereafter during implementation of the program, data relative to energy intake and anthropometry were collected. Through data obtained from payroll lists, a longitudinal series of average productivity (tons of sugar cane cut and loaded per day) covering 48 weeks of pre-supplementation, 90 weeks of supplementation and 21 weeks post-supplementation, was constructed. Control of the supplement consumption was daily observed. Random assignment of workers to the high-energy supplement (HES) and the low-energy (LES) groups, was not possible. Prior to supplementation both groups presented the same characteristics in terms of age, energy intake level, weight, height, tricipital adiposity and daily productivity. Little variation was found throughout the time the supplement was consumed by the HES Group. Energy intake of workers increased significantly in absolute terms in relation to the LES Group, except towards the end of the 28 months' supplementation period. Energy balance was maintained by workers throughout the study period. A time series of the difference in mean productivity of the two supplement groups (Yt) was modeled using the ARIMA techniques. No auto-regressive term was present in the Yt series. The ARIMA (0,0,1) model was fitted and expanded with different intervention components. None of the estimated parameters of the intervention components were statistically significant. It was therefore concluded that no abrupt, or gradual and sustained energy supplementation effect on productivity was present. PMID- 3632205 TI - [Use of the demonstrative method for the quantitative evaluation of food intake]. AB - The demonstrative method can be used to evaluate food intake by permitting interviewed subjects to visualize food samples and to demonstrate the amount consumed of each food using standard kitchen utensils. In the present study, data obtained by the 24-hour recall method were compared to those obtained by the demonstrative method. The data collected by the two methods were then compared to the values obtained by direct weighing of the different foods; they were used as reference values. The study was carried out on 10 women and 10 men admitted to the University Hospital of the School of Medicine of Ribeirao Preto. All patients were adults, had completed at most their elementary education, consumed a hospital common diet, and were selected at random. There were no differences between the two methods tested for evaluation of the amount of rice, beans and milk consumed, regardless of sex. The item salad, however, was poorly evaluated by the 24-hour recall method, but in relation to the demonstrative method, the 24 hour recall permitted a better evaluation of the amount of meat ingested by women. Nevertheless, the demonstrative method allowed a better evaluation of the amount of bread ingested by both men and women. We conclude that the demonstrative method has advantages with respect to some food items when compared to the 24-hour recall method. PMID- 3632206 TI - [Food habits of high school graduates in the metropolitan area of Santiago, Chile]. AB - The purpose of this study was to determine the food habits of Chilean high-school graduates, and measure the effect that socioeconomic level (SEL), type of school (public and private school), sex and age exerts on those habits. A random and stratified sample of 283 schoolers, according to type of school, sex and SEL, measured through the Graffar Modified Scale was selected for the study. Food habits were defined by the frequency of consumption of food, expressed as days per week and were compared with the Model Allowance established by the Ministry of Health of Chile. A food habits questionnaire was administered to students by duly trained interviewers, and were defined by the frequency of consumption of food groups. Data were analyzed by the chi-square procedure, analysis of variance and Student's "t" test. In accordance with the results, the most consumed foods (over 90% of students) were meat, poultry, eggs, potatoes, apples, bread, rice, oil and butter or margarine. On the other hand, the most disliked foods (40% and more of students) were fresh cheese, viscera, radish and chickpeas. The high SEL students showed a significantly greater frequency of consumption of dairy products, and of meat products and eggs (p less than 0.001). No differences were found according to type of school, sex and age of students. We conclude, therefore, that SEL exerts a significant effect on food habits, in spite of which they were adequate according to the Model Allowance. PMID- 3632207 TI - Composition and dietary effects of the fish oil from "mandi" (Pinelodus clarias). AB - A study was carried out to determine the chemical composition and dietary effects of the oil from "mandi" (Pimelodus clarias). Findings revealed that it had a low proportion of essential C18:2 fatty acids and a high percentage of oleic acid (20.93%), as well as polyunsaturated fatty acids with more than 18 carbon atoms. Of the long-chain fatty acids, C22:6 was present in the highest percentage (1.94%). When rats were fed a diet the lipid source of which was the oil of mandi, they showed a reduced growth rate as compared to animals receiving the control diet (corn oil). The fatty acid composition of the liver and heart of rats from the experimental group was modified. The greatest variation occurred in the percentage of C22:6 in the heart muscle, wherein a five-fold increase was observed. Reduction of growth and alteration in the polyunsaturated fatty acids levels may be due to a deficiency in C18:2-w6, or to a possible imbalance between C18:2-w6 and C18:3-w3. PMID- 3632208 TI - [Application of the calculation factor to the analysis of foods of Venezuela]. AB - The direct weighing method was used to determined the Conversion Factor (rate that exists between gross weight and net weight of a food) of tubers, vegetables, fruits, meats, viscerae, cheese and eggs. The amount of food lost by discarding the nonedible portion, was also established. Results from applying the Conversion Factor revealed that values obtained, differed from those reported in the Food Composition Table for Practical Use of the National Institute of Nutrition of Venezuela. PMID- 3632209 TI - [Composition and nutritive value of the Pajimaca sweet corn and Pajimaca Opaque 2, grown in Venezuela]. AB - The chemical composition and nutritive value of the sweet corn variety known as Pajimaca, and of the Pajimaca with the Opaque-2 gen, is herein presented. Evidence revealed that they contained similar levels of vitamins and minerals, with the exception of niacin, which was found to be higher in the latter. Lysine and tryptophan values for the Pajimaca Opaque-2 almost doubled those determined in the normal variety Pajimaca. As expected, compared with common corn, these varieties showed lower amounts of starch and higher amounts of sucrose and of total sugars. Biological evaluation assays in rats demonstrated a higher PER, weight gain and food efficiency index values for the Pajimaca Opaque-2, thus confirming its better protein quality. PMID- 3632210 TI - Chemical constituents, in vitro protein digestibility, and presence of antinutritional substances in amaranth grains. AB - The chemical composition, content of antinutritional factors, and the in vitro protein digestibility of grains of the pseudo-cereal Amaranthus were analyzed. The plants were grown in Brazil (without fertilizer), Puerto Rico (100 kg N/ha), and California (200 kg N/ha). The seed analysis gave the following values (%DM): 14.4 - 16.9 protein (N X 6.25), 4.8 - 6.8 fat, 2.5 - 3.9 ash, and 2.3 - 2.9 crude fiber. The trypsin inhibitors, phenolics and saponine contents were low, and the phytohemagglutinin activity, fairly low. The in vitro protein digestibility was 61 - 76%. Digestibility was not correlated to the analyzed proximal composition nor to the antinutritional factors. The grain composition indicates a food value equivalent to that of conventional food grains. PMID- 3632211 TI - [Lipid composition of the placenta of rats with protein restriction and deficiency of essential fatty acids]. AB - The influence of diet restriction and EFA deficiency during pregnancy in the rat on the lipid and phospholipids composition of the placenta was investigated. Female virgin albino Wistar rats weighing 130 +/- 4 g, were assigned to three equivalent groups. Prior mating and during pregnancy each group of rats received the following regimen: Animals in the Control Group (C) were fed a 25% casein diet in ad libitum quantities; the dietary Restricted Group (D) received the same control diet in amounts calculated to approximate 50% (g/100 g rat) of the intake of group C; the Deficient and Restricted Group (DD) rats were fed a restricted amount of EFA deficient diet. On the 21st day of gestation pregnant animals were sacrificed. The foetuses and placentae obtained by caesarium section were isolated and weighed. A 50% food restriction before and during pregnancy resulted in a significant decrease in phospholipid contents (p less than 0.05); severe EFA deficiency superimposed to 50% food restriction, moreover induced significant changes in the fatty acid pattern of phospholipids, decreasing n3 and n6 fatty acids and increasing eicosatrienoic acid. There was an accumulation of triglycerides in the placenta of rats fed on the EFA deficient diet. In the two restricted groups fetal weight was reduced, but although in the DD group, placental weight was not affected, litter size was dramatically reduced. PMID- 3632212 TI - [Chemical evaluation and determination of the nutritive value of a variety of Opaque-2 corn in the initial diet of broilers]. AB - Chemical and amino acidic composition of Opaque-2 corn, cultivar CIMMYT-TL 81-A (Hungarian compound) locally produced were determined. In addition, the productive performance of broiler chicks fed Opaque-2 corn or normal corn (Pioneer) for the first 28 days of age was evaluated. The chemical and amino acid content results obtained for the Opaque-2 corn studied, compared well ranges previously reported. The productive performance at the end of the experiment was similar between the two treatments assayed. PMID- 3632213 TI - Energy utilization of supplemented cereal diets in human volunteers. AB - Energy utilization was studied in human volunteers using different diets containing wheat flour supplemented by groundnut (Arachis hypogaea), "masur" (Lens culinaris), mung (Phaseolus aureus) and gram (Cicer arietinum) flour. Digestible and metabolizable energies were determined for all the experimental diets. An improved energy digestibility was observed when wheat flour was supplemented with groundnut flour, and groundnut flour plus gram flour, i.e. 93.35 and 89.48%, respectively. Percent digestibility of energy for the other two experimental diets was 81.07% when wheat flour was supplemented with groundnut and "masur" flour. It was further depressed to 77.87% when wheat flour was supplemented with groundnut and mung flour. PMID- 3632214 TI - [Food intake of students graduating from basic education in the metropolitan area of Santiago, Chile]. AB - This study pursued to evaluate the adequacy of the dietary intake of students graduating from Basic Education in the Metropolitan Area of Santiago, Chile. A random sample of 258 students from public and non-public schools (1:1), of both sexes (1:1) and from high, medium and low socioeconomic level (SEL) (1:1:1), was selected. Standard procedures for 24-hr dietary recall individual interviews were used to collect data. The students' dietary intake was then compared with the FAO/WHO 1973 Recommended Dietary Allowances. Results revealed that 53.5% and 62.0% of the sample registered a deficient and excessive intake for energy and protein, respectively. Protein contributed 13.2% of the dietary energy, fat, 27.1%, and carbohydrates, 59.8%. Animal and vegetable protein intake was found in the proportion of 1:1. As findings indicated, the dietary intake of students differed significantly according to SEL. Deficiencies in energy, vitamin A, riboflavin, niacin and calcium intake were observed, in both sexes, besides iron deficiency in the female group. It is considered that results could be useful for food and nutrition planning in school feeding programs. PMID- 3632215 TI - Effect of dietary columbinic acid on the fatty acid composition and physical membrane properties of different tissues of EFA-deficient rats. AB - The effect of columbinic acid (5 trans, 9 cis, 12 cis, octadeca-trienoic acid) supplemented to a fat-free diet on the fatty acid composition and its correlation to the physical properties of several tissues of rats, was studied. The absence of lipids in the diet produced the typical changes in the fatty acid composition characteristic of essential fatty acid (EFA) deficiency, namely a significant increase in the relative percentage of monoenoic fatty acids with a concomitant decrease in linoleic and arachidonic acids and a rise in eicosa-5,8,11-trienoic acid in liver, kidney, lung and spleen homogenates. Columbinic acid supplemented to a fat-free diet for 24 or 48 hr was incorporated into the different tissues and was partially elongated to 7 trans, 11 cis, 14 cis eicosatrienoic acid, but it was not desaturated. It modified the fatty acid spectrum of the lipids in the different tissues returning it to a similar composition of non-EFA deficient animals, except for a decrease of linoleic acid. The absence of lipids in the diet produced an increase in the 1-6 diphenyl-1,3,5-hexatriene (DPH) steady-state fluorescence anisotropy (rs) in liver microsomes, that was corrected by the administration of columbinic acid for 24 hr. It is concluded that columbinic acid produced a change in the pattern of total fatty acid composition of the different tissues studied which induced a favorable effect on the physical properties of the liver microsomal membranes (rs), leading to an improvement on the fatty acid deficiency in those membranes. Besides, columbinic acid would also exert a favorable effect in the short term, but not in the long-term eicosanoids production. PMID- 3632216 TI - [Effect of the quality and quantity of dietary proteins on vitamin A depletion rate, and biological availability of vitamin A precursors]. AB - The effect of quantity and quality of protein from cereal and legume sources on the rate of vitamin A depletion was evaluated through changes in retinol serum levels and liver stores in male and female Wistar strain rats. A total of 64 animals were distributed into four groups and fed ad libitum with diets adequate in all nutrients, except vitamin A. The protein in the diets was derived from 91% common maize (Diet A); 91% Opaque-2 maize (Diet B), 64% common maize plus 27% precooked common black bean flour (Diet C), and 64% Opaque-2 maize with 27% bean flour (Diet D). The total depletion period lasted 60 days and four rats per group were sacrificed at 15, 30 and 60 days. A total of 4 animals were sacrificed at 0 day to count with a basal serum and hepatic retinol concentration value. The 16 depleted remaining rats were used for the carotene bioavailability study with dehydrated carrots. During the first 15 days the greater rate of depletion was observed in animals fed the highest protein quality diet made from Opaque-2 maize and beans (Diet D), which also caused the greatest weight increase. The least depletion rate and lowest weight gain was obtained with the common corn diet (Diet A). Diets B and C caused intermediate depletion rates, with Diet B (Opaque 2 maize) being more effective than Diet C in spite of its lower protein content. At the end of 60 days all groups presented depletion levels not statistically different. Thus, these results confirm that protein quantity and quality from basic staple foods influence mobilization of retinol liver reserves. The 16 remaining depleted rats were then divided into four groups and fed a standard 14% casein diet to which 25, 50 and 75% of the retinol requirements was added to obtain a reference standard biological response. The fourth group was fed with an amount of dehydrated and ground carrot containing 67.1 mg % of total carotenoids. After seven days, serum and hepatic retinol were obtained, from which a regression equation of liver retinol to diet retinol was calculated (microgram % liver retinol per 100 g of rat) = 2.47 + 0.063 (microgram retinol/g diet) (r = 0.585). From this equation the bioavailability of carrot carotenoids was established with a value of 21.8% comparable to the FAO/WHO value previously reported. PMID- 3632217 TI - [Toxicological effects induced by the chronic intake of brominated vegetable oils]. AB - Several biochemical parameters of male Wistar rats fed during 15 weeks with standard laboratory chow, supplemented with 0.1 g of brominated vegetable oil (olive, sunflower) per 100 g of diet, were compared to those of a control group fed a normal diet during the same period of time. The former group showed a significant increase of triglyceride content in both heart and soleus muscle, as well as of total and sterified cholesterol in heart muscle. This increase was accompanied by decreased plasma levels of total and HDL-cholesterol. Some of these abnormalities were similar to those observed in rats fed the same standard laboratory chow, supplemented with 0.5 g of brominated oil per 100 g of diet. The hepatic levels of triglycerides, total proteins and glycogen, as well as the weight gain and caloric intake of the animals which were fed 0.1 g of brominated oil per 100 g diet, were similar to those of the control group. In summary, the toxicologic effects observed during the chronic intake of diets supplemented with relatively low doses of brominated oils, suggest the need to undertake wider and deeper biochemical studies. The authors consider that these are necessary in order to ascertain the maximum tolerance levels for the use of these compounds, to minimize the risk of inducing important biological alterations. PMID- 3632218 TI - [Dietary protein level during pregnancy. Its influence on maternal-fetal exchange of substrates]. AB - It is well known that the dietary protein level influences both the pregnancy process and development of the offspring. Therefore, a study was carried out to determine the effect that different protein percentages: 10%, 4% and 20% in diets administered to rats during pregnancy, had on food efficiency and on the substrates partition between rat dams and their neonates. Experimentation was thus carried out over a period of 21 days (pregnancy) and comparisons were made with well-nourished rats receiving 10% protein (controls) and between one and other group. Moreover, the effect on pregnancy was observed by comparing pregnant rats with non pregnant rats within each dietary situation. Food intake, weight parameters and food efficiency ratio were recorded in adult rats. Weight parameters were also evaluated in newborns. As results revealed, the highest the protein level in the diet, the highest the food efficiency ratio, both in the pregnant group and in the non pregnant group. Weight changes were determined in rat dams and their neonates, as a consequence of the different protein intakes. These also involved alterations in the substrates partition between the mothers and their offspring. Such findings might lead to the retention of substrates by the maternal tissues and, hence, to impairment of neonatal development. PMID- 3632219 TI - [Chemical composition and biological value of tortillas and bread produced on the commercial level in Costa Rica]. AB - A study was conducted to evaluate the nutritive value of tortilla, wheat bread, and tortilla meal. Six types of tortillas, five breads and two tortillas meal were thus studied. Chemical composition of each product was determined, and biological trials in laboratory rats were also carried out with each of them. Results demonstrated that the corn products had a better protein quality than the wheat products. Furthermore, little variability in nutrient content and protein quality (NPR) between the different corn and wheat products was found. The utilizable protein content of the wheat products was higher than that of the corn products, while the gross energy content was similar for both. An economical nutritional analysis revealed that the corn-soybean tortilla meal is the most nutritive and economic product to provide basic nutrients (protein and energy) to the population. PMID- 3632220 TI - Amino acid composition of some Amaranthus sp. grain proteins and of its fractions. AB - This study was carried out to determine the protein content of several Amaranthus sp. grains. Findings revealed this has a high lysine (5.3 to 6.3 of the protein) and sulphur amino acids content (3.4-4.0%), while leucine could well be limiting when those seeds are used as a sole protein source in food. Using the correction for in vitro protein digestibility, the chemical score varied from 50 to 67. The calculated protein efficiency ratios and biological values ranged from 1.39 to 1.80 and 53 to 68, respectively. Considering that amaranth grain is a good supplement to cereal grain, the protein of A. hypochondriacus HH5 (yellow seeds) and A. anclancalius (black seeds) was fractionated into albumin, globulin, prolamin and glutelin. The average proportions between those soluble proteins were 65:17:11:7, respectively. Albumin had the highest lysine content (7.3-8.2%), and globulin the highest methionine (4.1-5.3%) and phenylalanine (6.0-6.1%) content. Prolamin had the highest threonine (4.6-5.4%) and leucine (6.8-6.9%) content, while glutelin had a very low methionine content (0.6-1.0%). Based on the above-mentioned findings, the authors conclude the variation in the amino acid composition of the protein fractions can be used for genetic protein improvement. PMID- 3632221 TI - [Sodium and potassium content of some fresh, frozen and canned vegetables]. AB - Sodium and potassium content was determined in fresh, frozen and canned green peas, corn and green beans, as well as in fresh and canned tomatoes. Flame photometry was the method used for this analysis, as the AOAC recommends. Among the fresh products tested, green beans yielded the lowest sodium and potassium contents, with 2.2 and 150.2 mg/100 g, respectively. The highest sodium content was found in green peas, with 31.8 mg/100 g, and the highest potassium values were determined in tomatoes and green peas, with 271.7 and 271.3 mg/100 g, values which are not statistically different. In regard to frozen products, green beans also presented the lowest values of these cations, with 3.0 mg/100 g sodium, and 111.0 mg/100 g potassium. The highest averages were detected in green peas, with a sodium content of 149.4 mg/100 g, and 145.1 mg/100 g potassium. In general, all canned products tested showed higher sodium and lower potassium values than those found in fresh or frozen products. The highest sodium content (317.3 mg/100 g) was found in canned green peas, and the lowest (127.4 mg/100 g), in canned tomatoes. With respect to potassium, the highest values corresponded to canned tomatoes, with 168.8 mg/100 g, and the lowest to corn, with 7.6 mg/100 g. PMID- 3632222 TI - [Influence of cooking and drying processes at different temperatures on the nutritive value of the protein of mussels (Mytilus edulis)]. AB - The effect of steam cooking (96 degrees C for 15 minutes) and drying at two temperatures, 70 degrees C and 110 degrees C, on nutritive value of mussel protein was studied. The measurements were carried out by nitrogen balance techniques in growing rats, and the nutritional parameters studied were: CD, BV and NPU. The crude digestibility (CD) values were: 87 +/- 1 and 82 +/- 1, and the biological values (BV), 80 +/- 1 and 74 +/- 1 for raw mussels, dried at 70 degrees C and at 110 degrees C respectively. This implies a significant decrease in the protein nutritive values of the mussel dried at a higher temperature. Cooking prior to drying significantly improved the digestibility and the biological value of the mussel's protein. In effect, improvement was so great, that the different drying temperatures did not affect the previously cooked product in a different way; therefore, the CD (94 +/- 1 and 94 +/- 1) and the BV (90 +/- 1 and 90 +/- 2) were the same for the mussel's protein, cooked and dried at 70 degrees C or at 110 degrees C. PMID- 3632223 TI - [Peeling of sorghum by a dry method: continuous and discontinuous methods]. AB - A study was carried out wherein two dry dehulling sorghum grain methods, the continuous and discontinuous types, were quantitatively compared in a laboratory abrasive dehulling device. Reflectance values, expressed as dehulling percentage, the percentage of kernels removed, and of kernel cracking were evaluated. Graphs of the dehulled and removed percentages as function of the contrast time for each method, revealed that the continuous process was the most efficient of both procedures. Analysis of the broken kernels indicated a similar behavior for both methods. The macrocomponent and tannin variations as dehulling advanced, as well as the reflectance values were determined with the continuous method. Findings showed that the greater proportion of tannin, fiber and ashes has been removed at the 85% extraction rate. Thus, abrasion of grains above the 65% extraction rate is not convenient, since an excessive loss of nutrients is produced without any important decrease in polyphenolic pigments and of those imparting color to the sorghum grain milling products. PMID- 3632224 TI - [Processing and evaluation of fish silage from accompanying fauna of shrimps]. AB - Fish silage for animal feed was produced from a mixture of several fish species belonging to the shrimp by catch. All of them were ground and mixed with formic and sulfuric acids, 3.5% w/w at 1:2; 1:3 and 1:4, respectively, and stored at room temperature for 15 days, to complete liquefaction. The pH, exuded liquid, consistency, soluble nitrogen, total volatile bases, trimethylamine, lipid oxidation by thiobarbituric acid test and microbial count were measured during the 60 days of the storage period. Fish silage was dried and used for biological tests in chicken fed a diet with 6% of silage as a substitute of fish meal. Results of proximal analysis, amino acid profile and mineral content, as well as of the biological test with the dried product, indicated the feasibility of using fish silage as a substitute of traditional fish meal for the chicks included in the trial. This fact, coupled to its simple processing technology, make fish silage adequate for utilization as animal feed. PMID- 3632225 TI - Food and nutrition knowledge in Chilean high school graduates. AB - The purpose of this study was to determine the degree of knowledge on food and nutrition in students graduating from high school in the Metropolitan Area of Santiago. The sample included 272 students of both sexes and type of school (public and private) and from high, medium and low socioeconomic level (SEL), measured through the Graffar Modified Scale. The degree of knowledge on food and nutrition was measured through a test of 48 items based on curriculum program objectives. The test covered three areas: Area 1, Food and Requirements; Area 2, Food, Personal and Environmental Hygiene, and Area 3, Nutritional Physiology. Students showed a good achievement of the food and nutrition objectives that are considered essential for obtaining and adequate nutrition and health status. Students from high SEL registered a significantly higher degree of knowledge on food and nutrition than students from other strata (p less than 0.001). However, sex and type of school had no effect on the degree of food and nutrition knowledge. This study is a contribution to the better understanding of factors affecting the food and nutrition knowledge, and provides good foundations for further studies. PMID- 3632226 TI - [The behavior of the perpetrator in cases of missing persons with a hidden or removed cadaver]. PMID- 3632227 TI - [Defensive cadaver dismemberment--a further case of a "transit cadaver"]. PMID- 3632228 TI - [Simulation of a suicide to hide a homicide in a case of autoerotic accident]. PMID- 3632229 TI - [A suicide decision as a motive for murder--an airplane as the murder weapon]. AB - It is supposed that some fatal aviation accidents of "cause unknown" especially of light and private airplanes are possibly intended by a suicidal act. However it is difficult to prove this suggestion. A case of a light aircraft accident is reported in which the medicolegal autopsy and the police investigation revealed, unexpected, a simultaneous homicide and suicide caused by a stabbing attack on the pilot. This paper stresses the importance of autopsies of the victims in aircraft accident investigation and discuss the medicolegal and psychopathological aspects of the case. PMID- 3632230 TI - [An unusual death caused by strangulation]. AB - An accidental case of strangulation is reported in which the victim caught his head in the gap of a wooden shed. Before passing into unconsciousness rescue was attempted. PMID- 3632231 TI - [Erroneous decisions based on false evidence. A criminalistic debate in forensic practice for forensic practice]. PMID- 3632232 TI - Fluoroacetamide resistance mutations in Chlamydomonas reinhardtii. AB - Acetamide, a nitrogen and carbon source for Chlamydomonas reinhardtii, is hydrolyzed by acetamidase to ammonium and acetate. It also induces urea pathway activities. Fluoroacetamide (F-acetamide) is toxic to wildtype through conversion to F-citrate, a respiratory inhibitor. Resistant mutants were selected on plates of F-acetamide plus urea. When tested on acetamide plates two mutant classes were obtained, acm+ (utilized acetamide as sole N source) and acm-. All acm+ isolates had acetamidase activity and were obligate phototrophs (i.e. "dark-diers"). Acm- isolates had either normal urea assimilation (ure+) or lacked all urea pathway activities, namely transport, urea carbooxylase and allophanate hydrolase (ure-). Inheritance patterns for both types indicated single nuclear gene mutations. The acm- ure+ type presumably resulted from a defective acetamidase gene, and the acm ure- strains might be regulatory gene mutants. Temperature conditional F acetamide tolerant mutants were also obtained. Acetamidase extracted from one such strain was more thermolabile than the wildtype enzyme, indicating a mutation in the coding region. The hypothesis that acetamidase is involved in urea assimilation was not supported by the genetic and biochemical evidence. PMID- 3632233 TI - [The photometric determination of sperm concentration--a step toward objectivity in sperm estimation procedures]. PMID- 3632234 TI - [Photometric estimation of sperm motility]. PMID- 3632235 TI - [Effect of UV rays on parasitic arthropods. 2. In vitro studies on the effect of one-time UV-irradiation on the developmental stages of Psoroptes cuniculi (Acaridida: Psoroptidae)]. PMID- 3632236 TI - Prognostic significance of serum/plasma cortisol, cholesterol, lactic dehydrogenase, and hydroxyproline in bovine diaphragmatic hernia. PMID- 3632237 TI - Monthly variations in certain biochemical parameters of buffalo blood. PMID- 3632238 TI - [Preliminary results in the use of a method for determining estrone sulfate in experimental studies on pregnant sows]. PMID- 3632239 TI - [Suitability of laboratory mouse strains for virulence testing of Bordetella bronchiseptica]. PMID- 3632240 TI - [The occurrence of bacterial infections in swamp beavers (Myocastor coypus Molina, 1782). 1. Salmonella infections]. PMID- 3632241 TI - [The effect of chronic ammonia exposure on the histomorphologic structure of the respiratory tract and the clearance capacity of the lungs in rats. 1. Results of mucociliary clearance of Staphylococcus aureus in rat lungs after ammonia loading]. PMID- 3632242 TI - [The occurrence of bacterial infections in swamp beavers (Myocaster coypus Molina, 1782). 2. Erysipelothrix rhusiopathiae infections]. PMID- 3632243 TI - [The effect of differently treated wheat straw on the metabolic parameters of fattening bulls with special reference to urea-preserved moist straw]. PMID- 3632244 TI - [Results of experimental infection of calves with Pasteurella multocida and Pasteurella haemolytica]. PMID- 3632245 TI - Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic whites. AB - Utilization of general medical and mental health services by respondents in the Los Angeles Epidemiologic Catchment Area (ECA) site was compared with that in three ECA sites studied previously (New Haven, Conn, Baltimore, and St Louis). Within the Los Angeles sample, Mexican-American patterns of utilization were compared with those for non-Hispanic whites. Los Angeles respondents were less likely than those at other ECA sites to make ambulatory health care visits and to be hospitalized for physical or mental health reasons. Mexican Americans were less likely than non-Hispanic whites to report ambulatory health care but were as likely to have been hospitalized. Six percent of Los Angeles respondents reported a recent mental-health-care visit as compared with 6% to 7% of respondents at the other ECA sites. However, among respondents with Diagnostic Interview Schedule DSM-III disorders diagnosed within the six months prior to the interview, a lower proportion made a mental health visit in Los Angeles (14%) compared with the other sites (16% to 20%). Of those who made a mental-health-care visit, Los Angeles respondents with a recently diagnosed disorder were more likely than comparable respondents at the other ECA sites to visit a mental health specialist rather than a general medical care provider. Mexican Americans with a recently diagnosed mental disorder were only half as likely as non-Hispanic whites (11% vs 22%, respectively) to have made a mental health visit. However, when Mexican Americans with Diagnostic Interview Schedule/DSM-III did make a mental health visit, they were as likely as non-Hispanic whites to see a mental health specialist. PMID- 3632246 TI - A psychometric analysis of the social-interpersonal and cognitive-perceptual items for the schizotypal personality disorder. AB - Because the social-interpersonal symptoms of schizotypal personality disorder have been more useful than the cognitive-perceptual in identifying the biological relatives of schizophrenics, it has been recommended that the schizotypal DSM-III R (or DSM-IV) criteria be revised to emphasize the social-interpersonal items. This study determined whether the social-interpersonal items would be more efficient than the cognitive-perceptual in diagnosing schizotypal personality disorder in patients presenting to a clinical setting. In contrast to studies conducted in nonclinical samples, we found that the cognitive-perceptual items were equally and at times more important than the social-interpersonal items to the diagnosis of patients with schizotypal personality disorder. We demonstrate that the value of an item depends in part on the particular differential diagnosis at issue. PMID- 3632248 TI - Incompetency to stand trial. Appropriateness and outcome. AB - Of 85 persons (38% of those found incompetent to stand trial in Los Angeles County in 1983), 92% were currently charged with felonies and 62% with crimes of violence. Eighty-seven percent had a history of serious physical violence against persons and 68% had prior felony arrests. This study indicated that in this jurisdiction, incompetency to stand trial is not being used to divert mentally ill persons, charged with minor offenses, into intermediate or long-term psychiatric hospitalization to circumvent obstacles such as restrictive commitment laws and rapid hospital discharge policies. The lack of adequate postrelease planning and follow-up for most of these chronically and severely mentally ill offenders was clear. Neither the criminal justice nor the mental health system is inclined to take responsibility for their care. Mandatory community treatment on release is recommended. PMID- 3632247 TI - Assessing psychiatric disorders in children. Discrepancies between mothers' and children's reports. AB - Results were compared from independent interviews using the Schedule for Affective Disorders and Schizophrenia for School-aged Children-Epidemiologic Version and DSM-III with 220 subjects (ages 6 to 23 years) and their parent informants. In agreement with results from studies using a variety of structured diagnostic interviews or symptom scales, considerable discrepancies were found between parents' and children's reports on the degree and nature of the child's psychopathology. The children reported more illness about themselves than their parents reported about them. The parents' reports were primarily a subset of the children's reports. Various factors that might affect agreement, including demography, parental clinical status, severity of illness, and treatment, were also explored. The findings that parents under-report psychiatric disorders in their children are comparable with those reported in studies of adults when family informants are used to obtain diagnostic information. Until these parent child discrepancies can be resolved by longitudinal, family, and other research, diagnostic assessment of children should include direct interviews with them. An independent assessment of the child's diagnosis based on information from multiple informants, including the child, may be the best estimate. PMID- 3632249 TI - A potential artifact in determining rates of depression. PMID- 3632250 TI - Does the dexamethasone suppression test relate to subtypes, factors, symptoms, or severity? AB - Results of the dexamethasone suppression test (DST) are frequently abnormal in depression but not always. We performed the DST in 95 depressed inpatients to determine whether abnormal DST results were associated with individual symptoms of depression, latent behavioral "factors," melancholia, or severity of depression. Initial insomnia, agitation, loss of sexual interest, and weight loss correlated significantly with nonsuppression. Using multiple regression, these four symptoms contributed independently to the variance in DST results and more closely associated with the DST results than did severity or the diagnosis of melancholia or endogenous subtype. Factor analysis failed to identify a factor that correlated with the DST results more significantly than did the individual symptoms. Our findings and a literature review suggest that DST nonsuppression associates with certain vegetative signs of depression but not with such symptoms as loss of interest or anhedonia nor with "psychological" symptoms such as guilt, worthlessness, helplessness, hopelessness, or suicidal ideation. PMID- 3632252 TI - Neuroendocrine aspects of primary endogenous depression. II. Serum dexamethasone concentrations and hypothalamic-pituitary-adrenal cortical activity as determinants of the dexamethasone suppression test response. AB - To determine the contribution of serum dexamethasone concentrations and hypothalamic-pituitary-adrenal cortical activity before dexamethasone administration to the dexamethasone suppression test (DST) response, a series of stepwise discriminant function analyses were performed for 40 patients with definite endogenous depression and 40 matched normal control subjects. The 24 hour serum cortisol concentration before dexamethasone administration and the serum dexamethasone concentrations at 8, 16, and 24 hours after administration served as the independent variables, and the DST "escaper"/"suppressor" dichotomy served as the dependent variable. While both types of independent variables significantly influenced the DST response, the major factor that contributed to the discrimination of escapers from suppressors was the 24-hour cortisol concentration before dexamethasone administration. Sixteen hours after dexamethasone administration, when the DST had the highest positive predictive value, serum dexamethasone concentrations significantly influenced DST outcome only when they were below a certain threshold level. At this time, hypothalamic pituitary-adrenal cortical hyperactivity before dexamethasone administration accounted for approximately two thirds of the incidence of DST nonsuppression. PMID- 3632251 TI - The effects of dexamethasone on plasma homovanillic acid and 3-methoxy-4 hydroxyphenylglycol. Evidence for abnormal corticosteroid-catecholamine interactions in major depression. AB - We investigated the possible interactions between corticosteroids and catecholamines in depression by studying the effects of the synthetic glucocorticoid dexamethasone on plasma levels of homovanillic acid (HVA) and 3 methoxy-4-hydroxyphenylglycol (MHPG) in a group of depressed patients and normal controls. In comparison with metabolite levels on a control day, normal controls showed a significant dexamethasone-induced increase in the plasma HVA level and a trend toward a decrease in the plasma MHPG level at 4 PM following dexamethasone administration (1 mg orally at 11 PM). Conversely, depressed patients, particularly those with psychotic features, showed a significant dexamethasone induced increase in the plasma MHPG level and a blunting of the plasma HVA response relative to the normal controls. Dexamethasone-induced increases in the plasma MHPG level were directly correlated with the severity of depressive symptoms and with postdexamethasone cortisol levels in the depressed patients. These data suggest abnormal corticosteroid-catecholamine interactions in depression and, specifically, in depressed patients with psychotic features. PMID- 3632253 TI - Dexamethasone suppression test and plasma dexamethasone levels in bulimia. AB - A 1-mg dexamethasone suppression test (DST) was carried out in 66 women with bulimia and in 26 age- and sex-matched controls. Blood samples were obtained at 4 PM on the day following dexamethasone ingestion, and levels of cortisol and of dexamethasone in the plasma were measured. Thirty-two percent of the patients vs only 7% of the controls had plasma cortisol levels of 140 nmol/L (5 micrograms/dL) or greater following the DST (a positive DST). The plasma levels of dexamethasone varied substantially, and there was a significant inverse relationship between the plasma level of cortisol and that of dexamethasone. Patients with positive DST results had lower levels of plasma dexamethasone than did those with negative DST results, and the mean plasma level of dexamethasone was lower in the bulimic group than in the control group. These results suggest that factors other than a disturbance of hypothalamic-pituitary-adrenal activity may contribute to positive DST results in bulimia. PMID- 3632254 TI - Afternoon continuous plasma levels of 3-methoxy-4-hydroxyphenylglycol and age. Distinctive biologic subgroups of endogenous depression? AB - Afternoon continuous plasma levels of 3-methoxy-4-hydroxyphenylglycol (MHPG) were first shown to be a good representation of the mean 24-hour plasma level of MHPG in 18 normal subjects. Then, after the stability of the procedure was tested and retested, the afternoon continuous test for plasma MHPG levels was performed in 57 normal subjects and 42 endogenously depressed patients. A significant correlation between plasma MHPG levels and age was found in normal subjects and depressive patients. When the variable of age was taken into account, a distinct pattern of increasing plasma MHPG levels with age--the "MHPG per age"--was found in the depressed patients, especially the women, who could be divided into high or low MHPG per age groups. There was almost no association between plasma levels of MHPG or MHPG per age values and clinical symptoms, and the two biologic subgroups did not differ clinically. PMID- 3632255 TI - Reliability of DSM-III diagnoses for major depression and generalized anxiety disorder using the structured clinical interview for DSM-III. AB - This study examined the interrater reliability of generalized anxiety disorder (GAD) and major depressive disorder (MDD) diagnoses derived from the Structured Clinical Interview for DSM-III (SCID). Using videotaped interviews, paired raters made independent diagnoses of 75 psychiatric outpatients. The percent agreement of the raters was 82% for MDD and 86% for GAD; the respective kappa values were .72 and .79. The results indicated that the SCID can be employed reliably to differentiate MDD from GAD. The SCID is recommended for further research with these disorders. PMID- 3632256 TI - Further measures of the psychometric properties of the Children's Global Assessment Scale. AB - The Children's Global Assessment Scale (CGAS), a measure of overall severity of disturbance, is an adaptation of the Global Assessment Scale for adults. Data obtained on the CGAS during a pilot study in Puerto Rico demonstrate high interrater reliability and both concurrent and discriminant validity. A discriminant function was generated that highly correlates with other measures of impairment. Use of the CGAS can be of heuristic value to complement other methods of diagnostic categorization. PMID- 3632257 TI - Ontario Child Health Study. I. Methodology. AB - We developed the methodology for a community survey to determine the prevalence of emotional and behavioral disorders among children 4 to 16 years of age in Ontario, Canada. Our discussion includes the objectives of the survey, the measurement of disorder, sampling methods and survey design, and a description of the data collected and instrumentation. Among 2052 households with eligible children, 1869 (91%) participated in the survey. The results can be used to help plan the future allocation of mental health resources in Ontario. PMID- 3632258 TI - Elevation of plasma homovanillic acid level can be detected within four hours after initiation of haloperidol treatment. PMID- 3632259 TI - Quantitative electroencephalography. PMID- 3632260 TI - Circulating immune complexes in uveitis. AB - The occurrence of circulating immune complexes was studied in 28 patients suffering from uveitis. The presence of complexes was found in 18 patients including 6 out of 10 patients with iridocyclitis and in 12 out of 18 patients with chronic total uveitis. PMID- 3632261 TI - Primary cardiac non-Hodgkin's lymphoma. PMID- 3632262 TI - Successful pregnancy in patients with multiple myeloma. PMID- 3632263 TI - Anencephalic phenotype in the 13q-syndrome. PMID- 3632264 TI - The accuracy of frozen section diagnosis. PMID- 3632265 TI - Nomenclature of prostatic carcinoma. PMID- 3632266 TI - The epidemiology and genetics of insulin-dependent diabetes mellitus. AB - The epidemiologic study of insulin-dependent diabetes mellitus (IDDM) has provided evidence for both a genetic and an environmental component in the etiology of the disease. The characteristics of IDDM, such as incidence and prevalence, and the worldwide variations therein, have prompted research into the areas of both environmental and genetic influences. While animal studies have strongly implicated an environmental agent, such as a virus, as the initiator of the disease process, it appears that such an agent needs a genetically susceptible individual in order to be effective. A coexisting approach to the study of the environmental etiology of IDDM involves immunogenetics. Recent technological advances in the study of the human genome have prompted research particularly in the HLA region of chromosome 6, where an IDDM susceptibility gene or genes are thought to lie. The combined knowledge regarding the environmental and genetic roles and their probable interaction will be helpful in understanding the etiology of the disease, if not directly leading to a mode of prevention of the disorder. PMID- 3632267 TI - Idiopathic cardiomyopathies. A review of pathologic studies and mechanisms of pathogenesis. AB - The purpose of this article is to provide a critical review of our current knowledge of the pathogenic mechanisms of human cardiomyopathy in the context of accepted morphologic findings (gross, microscopic, ultrastructural) and the clinical presentation of this disease. It is our intent to emphasize the numerous difficulties encountered in categorizing patients with cardiomyopathy to pursue investigations in the pathogenesis and origins of this puzzling cardiac condition. It is our belief that such difficulties stem primarily from the existing classification of cardiomyopathies, which is mostly empirical and somewhat vague. This is particularly true in regard to the dilated cardiomyopathies that probably encompass multiple entities grouped under the umbrella of cardiomegaly and dilation. The article's objective is to summarize clinical symptoms and signs, modalities of diagnostic investigations, and prognosis for each category of cardiomyopathy. However, the main purpose of this article is to present recent findings on the origins, possible autoimmune basis of the disease, and results of immunologic studies in patients with cardiomyopathy. PMID- 3632268 TI - Amines and the heart. PMID- 3632269 TI - Pathology of the human heart in drowning. AB - Examination of the hearts of ten human drowning victims revealed smooth-muscle contraction banding within the media of the major coronary arteries of eight patients (80%), focal ventricular myocyte hypereosinophilia in eight patients (80%), and ventricular myocyte contraction banding in five patients (50%). These lesions suggest that drowning is associated with a sympathetic storm, which produces both coronary arterial spasm and focal myocyte injury. The lesions may be the first-described positive morphologic markers of drowning in immersed subjects. This study provides further support for the concept that medial smooth muscle contraction bands may be morphologic markers for antemortem coronary arterial spasm. PMID- 3632270 TI - Reversibility of myocyte injury in moderate and severe acute rejection in cyclosporine-treated cardiac transplant patients. AB - Myocyte injury in acute cardiac transplant rejection was studied ultrastructurally in 45 patients. Mild myocyte injury consisted of increased glycogen granules and mitochondria, and condensation and streaming of myofilaments. More severe cell injury was characterized by clumping of Z-band material at the periphery of the cell and loss of sarcomeric units. Cell swelling was not seen, and intramitochondrial dense deposits (indicative of irreversible cell injury) were rarely seen. Restoration of normal myocyte ultrastructure occurred after treatment for rejection. Although the light microscopic appearance of moderate or severe acute rejection may suggest myocyte necrosis, this is rarely observed ultrastructurally. We conclude that the majority of cell injury in acute rejection is potentially reversible. PMID- 3632271 TI - Age and fibroplasia as preconditions for atheronecrosis in human coronary arteries. AB - The first 8 cm of the left circumflex, anterior descending, and right coronary arteries in 173 autopsies of men and women aged 15 to 69 years were examined in hematoxylineosin-stained, paraffin-embedded sections. With increasing age, the intima thickened with fibroproliferative tissue, approaching a threshold of about 150 micron, beyond which atheronecrosis became likely. Compared with the lateral thoracic aorta, the coronaries revealed (1) lower threshold for atheronecrosis, (2) thinner nonnecrotic intima, (3) fewer smooth-muscle cells present at lower densities, (4) less extensive foam cell infiltration in non-atherosclerosis related cause-of-death cases, and (5) a prominent association of foam cell infiltration with atherosclerosis-related causes of death, which was lacking in the aorta. It is suggested that the lower threshold for atheronecrosis in the coronaries compared with the aorta might be related to the relative deficiency of smooth-muscle cells and foam cells. PMID- 3632272 TI - Dissecting cuspal hematomas. A rare form of porcine bioprosthetic valve dysfunction. AB - Large dissecting cuspal hematomas (DCHs) were present in six (3%) of 193 porcine bioprostheses (PBs) explanted at reoperation. In four mitral PBs, the DCHs contributed to valve dysfunction; in one aortic PB, DCH was the only determinant of failure, causing stenosis by cusp thickening and rigidity. In another mitral PB, DCHs were occasionally found in the setting of valve incompetence due to commissural tears. While confirming that DCHs are a potential but infrequent cause of PB failure, these observations demonstrate that they may involve PBs implanted both in mitral and aortic position and might be a complication of anticoagulation. PMID- 3632273 TI - The impact of alanine aminotransferase testing on Hispanic blood donations. AB - The American Association of Blood Banks, Arlington, Va, has required that all blood donors must be tested for serum alanine aminotransferase (ALT), and that donations from donors with ALT levels above a certain cutoff value must be discarded. To assess the impact of this requirement on different ethnic/racial groups, the ALT levels of 1781 blood donors were compared. Hispanic blood donors had significantly higher ALT levels than did black and non-Hispanic white blood donors. No significant difference in ALT was seen between black and non-Hispanic white blood donors. We conclude that there are statistically significant differences in the ALT levels between Hispanic and non-Hispanic blood donors, and that a disproportionate number of Hispanic blood donations (11% to 13%) will be discarded as a result of testing blood donors for ALT. PMID- 3632274 TI - Cardiovascular ochronosis. AB - A 64-year-old man with alkaptonuric ochronosis required aortic valve replacement for severe aortic stenosis and single-vessel aortocoronary artery bypass grafting for a subtotally occluded obtuse marginal branch of the circumflex coronary artery. Operative findings included ochronosis of a partly calcified aortic valve and the aortic intima. The aortic valve and a punch biopsy specimen of the ascending aorta were removed at surgery and were studied with transmission electron microscopy and light microscopy. The ultrastructural studies of the aortic valve revealed intracellular and extracellular deposits of ochronotic pigment. A portion of the extracellular ochronotic pigment represented degenerated cells. Large deposits of extracellular ochronotic pigment were associated with areas of valvular calcification. Electron microscopic study of the aorta disclosed ochronotic pigment in macrophages and smooth-muscle cells. Aggregates of extracellular ochronotic pigment in the intima and media appeared to be in locations of necrotic cells. Light microscopy also showed intracellular and extracellular deposits of ochronotic pigment. Our study suggests that extensive extracellular deposits of ochronotic pigment in the aortic valve may serve as a stimulus for dystrophic calcification. This may play a role in the development of aortic valve calcification and aortic stenosis associated with alkaptonuric ochronosis. To our knowledge, this is the first ultrastructural study of the aortic valve and aorta in alkaptonuric ochronosis. PMID- 3632275 TI - Hamartomatous malformation in the mitral valve's anterior leaflet. AB - We report a previously undescribed (to our knowledge) anomaly of the mitral valve's anterior leaflet: a cystic lesion that protruded from the atrial surface in the midportion near the base. The lesion consisted of large, irregularly shaped, endothelial-lined spaces separated by trabeculae of tissue containing atrial myocardial fibers. The endothelial-lined spaces communicated with the left ventricular cavity through an opening on the ventricular surface of the leaflet. Inasmuch as the anterior mitral leaflet arises embryologically by fusion of the endocardial cushions, the location of the lesion suggests that an anomaly in the fusion process might have been involved. PMID- 3632276 TI - Graduate medical education in pathology revisited. PMID- 3632277 TI - Correlation between hepatitis B core antigen in liver tissue and hepatitis B virus DNA in the serum of HBV-infection chronic carriers. PMID- 3632278 TI - Liver fibrosis in arginase deficiency. PMID- 3632279 TI - National Epidermolysis Bullosa Registry. PMID- 3632280 TI - Drug-specific Fab therapy in drug overdose. AB - The use of digoxin-specific fragments, antigen-binding (Fab) for antidotal therapy of severe digitalis intoxication is rapidly becoming a treatment of choice. Furthermore, studies with this mode of drug-specific therapy using Fab specific for desipramine and for phencyclidine suggest that this treatment may be applicable to a variety of other drugs or drug classes. As Fab technology has advanced, so have laboratory methods for monitoring the efficacy of treatment. PMID- 3632282 TI - The diagnostic value of microscopic examination of human hair. PMID- 3632281 TI - Chromosome analysis in the clinical setting. PMID- 3632283 TI - Four-year experience with rapid bone marrow chromosome analyses in newborns. AB - Decisions surrounding management of the profoundly ill and seriously malformed neonate involve many ethical dilemmas, as well as concern for the family and the quality of the infant's life. The more information available to parents and clinicians the better informed any decision can be regarding surgical intervention, life-support systems, or extraordinary resuscitative efforts. To provide accurate data in an appropriate time frame, a rapid analysis of bone marrow chromosomes can be of value. Over four years, 42 cases were studied by this method, yielding diagnostic information within four hours. Twenty-three neonates had trisomic karyotypes. Only one false-negative test result was recorded, and no false-positive interpretations were made. Recognition of a normal karyotype provided important clinical information for pursuing vigorous therapy and was reassuring to parents. PMID- 3632284 TI - Transient atypical lymphocytosis in patients with emergency medical conditions. AB - Lymphocytosis in older adults is unusual and frequently indicates chronic lymphocytic leukemia or other lymphoproliferative disorder. This report describes 73 patients, aged 43 to 93 years, who presented with emergency medical conditions and who had absolute lymphocytosis, with absolute lymphocyte counts ranging from 4.1 to 12.9 X 10(9)/L (4100 to 12,900/mm3). The lymphocytosis was characterized morphologically by atypical lymphocytes and was transient, followed, in most instances, by a neutrophilia. Most of the patients presented with serious cardiac conditions; the remaining presented with other critical disorders including status epilepticus and traumatic injuries. The mortality rate was high (50%). The lymphocytosis in some patients was probably secondary to the administration of epinephrine. The lymphocytosis in those not receiving epinephrine may have represented a physiologic reaction to severe stress. PMID- 3632285 TI - Predictive value of stool examination in acute diarrhea. AB - We prospectively evaluate the value of fecal blood and fecal leukocytes in predicting whether acute diarrhea in adults is associated with a stool culture positive for a bacterial pathogen. One hundred thirteen patients, aged 19 to 50 years, seen in a two-year period in an urban adult outpatient setting underwent stool culture for the presenting symptom of diarrhea. Heterosexual men represented 48% of the cohort, women represented 17%, and homosexual men represented 35%. Overall, 53 (47%) of the patients had positive stool cultures for enteric pathogens. Campylobacter jejuni was the most common organism in the entire cohort, but Shigella species were most common in homosexual men. The best predictive variables for a stool culture positive for a bacterial pathogen were the presence of both fecal leukocytes and fecal blood in the stool, compared with only one or neither. When both were present, the sensitivity was 81%, the specificity 74%, and the predictive values of a positive and negative test were 81% and 83%, respectively; the likelihood ratio was 4.87. When homosexual men and the rest of the cohort were analyzed separately, the combination of fecal leukocytes and fecal blood remained the best method of predicting a positive stool culture in both. Examination of stool for fecal leukocytes and fecal blood is a rapid, reliable, and inexpensive way to differentiate between bacterial and other causes of acute diarrhea in the adult acute care setting. PMID- 3632286 TI - Multilocular renal cyst. A hamartoma with potential for neoplastic transformation? AB - Multilocular renal cyst is a pathologically distinctive lesion of uncertain pathogenesis that usually presents as a large abdominal mass in male infants or middle-aged women. We performed detailed light and electron microscopic studies of three nephrectomy specimens that contained multilocular cysts and attempted to correlate their morphology with various theories of pathogenesis. In one of our cases, a microscopic focus of clear cells that resembled renal cell adenocarcinoma was observed in the wall of one locule. Although such a finding has been reported previously, the lack of well-documented cases with metastases suggests that the prognosis for patients with this lesion remains uniformly excellent. PMID- 3632287 TI - Cutaneous protothecosis. A clinicopathologic study. AB - In what we believe to be the first case of cutaneous protothecosis identified in Taiwan, a 5-year-old Chinese girl presented with a pruritic erythematous plaque on her right upper eyelid. A clinical diagnosis of eczematous dermatitis was made initially, and sporotrichosis was diagnosed subsequently. Later, histopathologic and cultural studies of the lesion finally led to the diagnosis of protothecosis. The recognition of the characteristic sporangia containing symmetrically arranged endospores is the most important initial diagnostic clue of protothecosis. Biochemical assimilation tests and direct immunofluorescence study using species specific antibodies identified the organism as Prototheca wickerhamii. Systemic ketoconazole treatment proved to be effective for our patient. The in vitro minimal inhibitory concentrations of tetracycline hydrochloride, amphotericin B, and ketoconazole were also determined. PMID- 3632288 TI - Vaginitis emphysematosa. AB - Vaginitis emphysematosa is rare, as only 173 cases, to our knowledge, have been reported in the English literature, the last in 1967. We report three new cases and bring the subject up to date. The ages of our patients ranged from 42 to 65 years; one patient complained of vaginal discharge, and the other two cases were found on routine examination, one at autopsy for breast carcinomatosis. The lesions were described as nodules in the vagina, on occasion producing a "popping sound" that relieved the pressure sensation. Microscopically, variably sized cysts were seen containing pink hyalinlike material and foreign body-type giant cells in the cyst's wall, accompanied by minimal chronic inflammatory cell infiltrate. Vaginitis emphysematosa is an uncommon self-healing disease of unknown cause that produces no sequelae deleterious to the patient. PMID- 3632289 TI - Granulomatous lymphadenitis in children. AB - The spectrum of granulomatous inflammation in peripheral lymph nodes in 85 children over the previous decade was systematically investigated. A variety of histopathologic features were examined and correlated with the epidemiologic, clinical, and microbiologic information, in addition to the long-term outcome. Sixty children had head or neck involvement, with atypical mycobacteria accounting for the vast majority of confirmed causes. It was most frequent in cervical and submandibular glands of children aged between 1 and 10 years (35 of 44 patients), peaking between age 2 and 5 years, and was more common in girls (male:female ratio, 1:3). Mycobacterium avium-intracellulare was the predominant pathogen, accounting for 75% of the mycobacteria that could be characterized. Granulomatous inflammation in other sites (axilla and upper extremity, 16 patients; inguinal, nine patients), or older than age 10 years rarely yielded a cause. Such patients had no recurrent or persistent clinical problems following surgical excision. Histopathologic features were extremely variable, and no consistent patterns were discerned that could reliably be related to either cause or time course. The clinical features and bacteriologic investigations were the most useful for establishing a diagnosis. PMID- 3632290 TI - The uncombable hair syndrome. AB - We report a case of "uncombable hair syndrome" that occurred in a boy who had no other abnormalities. The diagnosis was clinically suspected and confirmed by examination of the scalp hair, which was treated with a bath of gold. Scanning electron microscopy was used for examination. The main defect of the hair was a longitudinal, canalicular depression in one side. The same defect was demonstrated by light microscopy in the transverse cut of the hair embedded in epoxy resin. PMID- 3632291 TI - Transferrin analysis by immunofixation as an aid in the diagnosis of cerebrospinal fluid otorrhea. AB - Laboratory diagnosis of cerebrospinal fluid leakage has been unreliable and has required expensive, labor-intensive radiographic procedures. Recently, using protein electrophoresis and immunofixation, the presence of an isoform of transferrin present only in cerebrospinal fluid has been identified. We describe the value of this simple test in a patient with recurrent meningitis in whom repeated radiographic studies failed to demonstrate a leak. PMID- 3632292 TI - Acanthamoeba keratitis. AB - A 41-year-old woman underwent a corneal transplant in her right eye because of a nonhealing ulcer. The graft failed within weeks of surgery and was eventually removed. Both the primary host cornea and the failed graft contained numerous Acanthamoeba cysts and trophozoites. Awareness of the causes of infectious keratitis should increase the likelihood of establishing the correct diagnosis. PMID- 3632293 TI - Invasion of human embryo by Enterobius vermicularis. AB - Two Enterobius vermicularis organisms invading a macerated embryo 2 cm in length were found in the tissue from an endometrial curettage performed for missed abortion in a pregnant woman. Ova from the helminths were recovered from the vagina and endometrium of the patient. This most unusual case provides further evidence for the invading capacity of E vermicularis. PMID- 3632294 TI - Immature omental teratoma. AB - Immature omental teratomas are extremely rare neoplasms. To our knowledge, only two cases have been reported in the literature. In some anatomic locations, the malignant potential of immature teratomas correlates with the presence and quantity of neuroectoderm within the tumor mass. We describe the first immature omental teratoma with prominent neuroectodermal differentiation. PMID- 3632295 TI - Lipofuscinosis of the human uterus. AB - A case of uterine lipofuscinosis in a patient with Friedreich's ataxia is described. Ultrastructural investigation confirmed the mitochondrial origin of the lipofuscin. Clinically, the patient suffered from brown bowel syndrome. Both the brown bowel syndrome and the uterine lipofuscinosis in the present case may be related to Friedreich's ataxia. PMID- 3632296 TI - The necessity of studying mortality and necropsy data of adults. PMID- 3632297 TI - The effects of heparin on the activated partial thromboplastin time of the College of American Pathologists Survey specimens. Responsiveness, precision, and sample effects. AB - Heparinized survey samples from the College of American Pathologists from 1981 through 1984 were reviewed to assess effects of the various reagents and instrumentation on the performance of the activated partial thromboplastin time (aPTT) in response to heparin. Responsiveness of the aPTT to the concentration of heparin as well as its sensitivity to the detection of heparin in the therapeutic range was most affected by choice of reagents. Precision was most affected by choice of instruments with photo-optical devices being roughly comparable. A previously described effect of calcium vs sodium salts of heparin was not supported by these data. Survey results were compared with results from fresh plasma samples from patients who had received heparin therapeutically and with response curves obtained from specimens heparinized ex vivo. The pattern of reagent dose responsiveness to the heparinized patient samples differed from that seen with survey samples and with the ex vivo heparinized fresh plasma samples. In addition, intrinsic characteristics of the individual specimens exerted substantial effects on the test results for all specimen types. Therefore, one cannot automatically assume that phenomena that hold for one form of plasma preparation are applicable to another. The nature and source of the heparinized plasma specimen must be taken into account when interpreting aPTT results. PMID- 3632298 TI - Histologic typing of ovarian tumors. PMID- 3632299 TI - Evaluation of the reproducibility of the World Health Organization classification of common ovarian cancers. With emphasis on methodology. AB - Seven pathologists independently classified 50 slides of ovarian tumors using category I of the World Health Organization classification (WHO I), each case being seen twice under different random code numbers. Intraobserver reproducibility and interobserver reproducibility, based on consistent interpretations, were both suboptimal. However, scrutiny suggested that no pathologist was a source of excessive variability, nor was suboptimal interobserver reproducibility simply due to intraobserver variability. Neither could excessive variability be attributed to skewing of results by a subgroup of unclassifiable cases. However, clearcut sources of variability were identified among the categories of WHO I, namely, mixed epithelial, unclassified epithelial, and undifferentiated carcinoma. There was also considerable variability in distinguishing serous and endometrioid neoplasms, and in identifying tumors of low malignant potential. These findings should not be misconstrued as implying that pathologists in routine practice cannot diagnose common ovarian cancers reproducibly for patient care purposes. Availability of clinical and macroscopic data, extensive sampling, histochemistry, and consultation combine, in an uncontrolled and highly individualistic fashion, to render routine service work very different from this highly controlled formal exercise. Furthermore, at the current state of the therapeutic art, many of the taxonomic problems identified in this study may have little clinical significance. Nonetheless, this study has strengthened the evidence that there may be important problems in classifying common ovarian cancers reproducibly using WHO I, and that WHO I may require greater clarity to enhance reproducibility. Current emphasis on quality assurance dictates reconsideration of the literature on reproducibility of histopathologic taxonomy, which has tended to inculpate pathologists as sources of variability. Virtually all of this literature is subject to some degree of skepticism due to deficiencies in methodology. Consideration of the question of how to measure reproducibility in anatomic pathology leads us to suggest that the community of pathologists should address the need to decrease ambiguity in classification systems as an important step toward optimizing reproducibility. PMID- 3632300 TI - Neuron-specific enolase expression and neuroendocrine differentiation in carcinomas of the breast. AB - The concentration of neuron-specific enolase (NSE, gamma-subunit of enolase) in tumor extracts of 25 nonargyrophilic and seven argyrophilic carcinomas of the female breast was measured by radioimmunoassay. The mean concentration of NSE in nonargyrophilic carcinomas was 89 ng/mg of protein, (range, 9 to 281 ng/mg), and the mean concentration of NSE in argyrophilic carcinomas was 153 ng/mg of protein (range, 4 to 420 ng/mg). All carcinomas, irrespective of the silver reaction, could be grouped in regular histopathologic terms. Neuron-specific enolase immunoreactivity in sections of the corresponding fixed tumors occurred in both silver-stained and unreactive tumors, although the reaction was more prominent in the argyrophilic tumors. The results indicate that NSE in considerable amounts may be present in both argyrophilic and nonargyrophilic carcinomas of the breast, although higher concentrations are found most often in the former tumor type. PMID- 3632301 TI - Nerve growth factor and the concept of neural-epithelial interactions. Immunohistochemical observations in two cases of vasitis nodosa and six cases of prostatic adenocarcinoma. AB - The so-called perineural invasion is a well-recognized, but poorly understood, phenomenon occurring in vasitis nodosa, a benign epithelial proliferation of the vas deferens; such unusually close epithelial-neural interactions also occur, among others, in benign and malignant conditions of the prostate. In the present study, immunoreactive nerve growth factor was found in the epithelium of these organs. This nerve growth factor is thought to possibly play a role in the process of the so-called perineural invasion. PMID- 3632302 TI - Autopsy legislation and practice in various countries. AB - Information concerning autopsy laws, regulations, rates, and practice was collected from 29 industrialized countries. In many countries, laws have been revised in recent years, introducing more restrictive rules, with consent required from the next-of-kin. With one exception (Finland), introduction of a requirement for consent was followed by a decline in the autopsy rate. Experiences in various countries are discussed. It is apparent that the problem of decreasing autopsy rates is an international one. Efforts to inform and educate the public about the benefits of autopsy are necessary, if the decision whether to perform autopsy is to remain their responsibility. PMID- 3632303 TI - Pathogenesis of vertebral artery occlusion following cervical spine manipulation. AB - Sporadic cases of vertebral artery occlusion following neck manipulation have been reported since 1947. The pathogenesis of occlusion, however, has remained largely speculative. Autopsy examination of the intracranial and extracranial portions of the vertebral arteries in the case presented here clearly demonstrates that intramural hematoma arising within granulation tissue in the tunica media was the acute, occlusive event. Furthermore, prior neck manipulation may have caused asymptomatic development of granulation tissue within the tunica media, thereby predisposing the patient to acute intramural hematoma during subsequent neck manipulation. PMID- 3632304 TI - Basal plate dysplasia presenting as a hamartoma of the pontine tegmentum. AB - A child with an intractable, nonfocal seizure disorder, progressive lethargy, and psychomotor retardation had a malformation involving rhombencephalic structures deriving from the embryonic basal plate. Its principal component was a mature neuroepithelial hamartomatous mass arising from the pontine tegmentum. Diencephalic, metencephalic, and myelencephalic derivatives of the alar plate were remarkably spared. To our knowledge, the morbid anatomy and embryopathology of this central nervous system malformation has not been previously described. PMID- 3632305 TI - Squamous cell carcinoma of the ovary. AB - A 45-year-old woman developed a grade III and stage III squamous cell carcinoma of the left ovary 12 years after a hysterectomy for treatment of endometriosis. Origin from a teratoma or a Brenner tumor was excluded. Despite extensive surgery with additional radiation therapy and chemotherapy, the patient died five months after the malignancy was diagnosed. Squamous cell carcinoma of the ovary, either de novo or arising from endometriosis, has rarely been reported. We describe a case of ovarian squamous cell carcinoma in which endometriosis is strongly favored as the origin, but that remains speculative. PMID- 3632306 TI - Multicentric fibromatosis of familial inheritance. AB - This is an unusual case presentation of a young woman with a clinical history and course simulating juvenile hyaline fibromatosis, but without hyalinization in the stroma. Because of the age of onset, the apparent familial inheritance, the nonaggressive and nonregressive tumor traits, the disease cannot be classified as multicentric fibromatosis. Therefore, we are referring to this case as multicentric fibromatosis with familial inheritance, a previously unreported entity to our knowledge. PMID- 3632307 TI - Estradiol and progesterone receptors in a case of fibromatosis of the breast. AB - A case of fibromatosis of the breast with positive cytosol assays for estradiol and progesterone receptors is described. Estrogen and progesterone receptors in fibromatosis have been only rarely reported in the English literature, and never, to our knowledge, in fibromatosis of the breast. We discuss the implications of these findings and review the literature. PMID- 3632308 TI - Multicentric early adenocarcinoma involving stomach and duodenum. AB - Six separate foci of superficial adenocarcinoma were seen in the first part of the duodenum of a 53-year-old man with a multicentric superficial adenocarcinoma of the stomach. To our knowledge, duodenal involvement in such a tumor has not been reported before. The duodenal foci were partly covered by gastric-type surface epithelium, suggesting that they might have arisen in areas of gastric metaplasia or heterotopia. PMID- 3632309 TI - Regeneration of human tendons after homologous tendon-graft transplantation. A morphological study of 25 cases. AB - The authors examined the regeneration and incorporation of homologous tendon grafts in 25 patients from 10 days to 20 years after tendon grafting. Newly formed collagen fibers in the place of graft are first observed 3 months after transplantation. The reorganization of tendon grafts begins at the end of the first postoperative year and is accomplished within the second year. PMID- 3632310 TI - Ganglion of the hip--an unusual cause of soft tissue swelling of the groin. AB - Soft tissue swellings of the groin can be a problem for diagnosis and treatment. One case of a ganglion connected to the hip joint capsule is presented. PMID- 3632311 TI - Management after application of the Pavlik harness in congenital dislocation of the hip. AB - The Pavlik harness was applied to a group of outpatients to treat CDH (group I), to a group of hospitalized patients (group II), and to a third group who received additional treatment to prevent avascular necrosis of the femoral head, based on the theory that the weight of the lower extremity plays an important role in the successful reduction by the Pavlik harness (group III). The results of the three groups were carefully compared in order to determine the ideal management of infants after application of the harness. No difference was found in the therapeutic results between group I and group III, when the reduction was attempted on the outpatient basis. However, the rates of reduction and anatomical healing were lower in the hospitalized patients of group III than in group II patients, but there was no difference in the incidence of avascular necrosis of the femoral head between the two groups. In the treatment of CDH using the Pavlik harness, application of the harness on the outpatient basis should be the first choice. It is fundamental to let the weight of the lower extremity help in effecting abduction of the hip joint, but the general and local reactions of the infant must be watched constantly, because too much pressure on the hip joint could invite avascular necrosis of the femoral head. If reduction at the outpatient clinic fails, the patient should be regarded as having the treatment resistant type of CDH, and should be treated further with traction of the lower extremity, muscle release, and adjustment of the hip joint angle. PMID- 3632312 TI - Semimembranosus tenosynovitis: operative results. AB - Semimembranosus tenosynovitis is a common knee problem in the over-50 age-group, occurring mainly in women. It affects the reflected portion of the tendon of the semimembranosus muscle as well as the bursa below it. The tendon becomes inflamed as a result of friction at the entrance to the bony canal (semimembranosus groove), especially if osteophytes are present on the edges of the groove. Conservative treatment includes anti-inflammatory drugs, ultrasound, and friction massage. If necessary, nonresponders may be given local injection of 40-80 mg methylprednisolone acetate with 1% Xylocaine. Between 1979 and 1983 we operated on 16 patients who had not obtained relief even after three or four injections. The approach in each case was through a posterior medial oblique incision. The semimembranosus osteofibrotic tunnel was revealed and the fibrous sheath surrounding the tendon was excised. Good results were obtained in eight patients in whom the inflammatory process had been localized to only the semimembranosus insertion area: eight patients in whom the knee joint or the pes anserinus insertion was also involved achieved fair or poor results. The operation is not advised for young athletes because of the important function of the reflected head of the semimembranosus muscle. PMID- 3632313 TI - Distal femoral fixation of the iliotibial tract. AB - The anatomy of the distal femoral fixation of the iliotibial tract was studied in 100 knee joints. A fiber bundle system with three main parts was isolated: (a) the supracondylar bundle oriented from proximal-lateral to distal-medial and fixed to the supracondylar area of the femur; (b) the fibers near to the septum with transverse course between superficial tract and dorsolateral femur; (c) the retrograde tracts which connect Gerdy's tubercle with the dorsolateral femur and form an arc bridging the knee joint. Distance measurements over the range of motion of the knee joint revealed isometric conditions only for the insertion point on the dorsolateral femur. The retrograde fibers are believed to be static stabilizers of the lateral side of the knee, and their insertion point on the dorsolateral femur is the correct site for refixation or reefing of the distal iliotibial tract. PMID- 3632314 TI - Cord compression as the presenting symptom of extradural malignant lymphoma. AB - Six patients with spinal cord compression as the presenting symptom of malignant lymphoma are described. These patients suffered from back pain for several months and were diagnosed after sudden paraparesis appeared. Five patients were treated by operative decompression followed by local irradiation, and all regained their motor function. A sixth patient presented with a more insidious paraparesis. A bone marrow aspiration established the diagnosis of malignant lymphoma, and this patient recovered with radiation and steroids alone. Thus, we recommend considering malignant lymphoma as a possible cause of acute cord compression, attempting to establish the diagnosis on an emergency basis within several hours, and attempting to achieve decompression with local radiotherapy and intravenous dexamethasone. PMID- 3632315 TI - Survival analysis of an uncemented ceramic acetabular component in total hip replacement. AB - Follow-up examinations of 67 implants of cement-free ceramic sockets show the need for an exact definition of failure, to warrant comparable evaluations of results. Statistical survival analysis offers the possibility of presenting both the incidence of failures and the dates of their occurrence. If only revision surgery with removal of the socket is considered to be a failure, our material shows the "survival quota" of the ceramic socket after 8 years to be 96.7% +/- 2.2%. If radiological signs of loosening are included in the evaluation of failures, the "survival quota" of the stable implants is reduced to 81.9% +/- 6.9%. PMID- 3632316 TI - Examinations of the pathology of the rotator cuff. AB - We performed autopsies on 195 shoulder joints in order to check the differing opinions as to the pathogenesis and incidence of tendinopathia calcarea and rupture of the rotator cuff that have been expressed in literature. There was a rupture rate of 11%. Intratendinous calcific deposits could be observed by radiology in 22% of the cases. The simultaneous presence of intratendinous calcification and rotator cuff rupture could be proved in 13 of 22 cases with a rupture of the rotator cuff. On the basis of our results we conclude that tendinopathia calcarea and rupture of the rotator cuff have an identical pathogenesis. PMID- 3632317 TI - Atrophy of the thumb web space in rheumatoid arthritis: clinical and electrodiagnostic studies. AB - One hundred and twenty definite or classical rheumatoid arthritis (RA) patients with an average duration of the disease of 12.1 years were studied. Sixty-two patients had distinct atrophy of the first dorsal interosseous of the hand without definite signs of carpal, cubital, or ulnar tunnel syndrome (group A); 43 patients showed neither distinct atrophy nor sensory disturbance of either hand (group B). Other patients had sensory and/or motor disturbances due to carpal, cubital, or ulnar tunnel syndrome and other neuropathies. Electrodiagnostic examinations revealed that there were differences in the distal latency to the first dorsal interosseous muscle from the wrist between 24 group-A patients and 14 normal controls (P less than 0.05), and between the group-A patients and 12 group-B patients (P less than 0.1). The results of this study indicate that some RA patients with atrophy of the thumb web space may have compression neuropathy of the most distal branches of the ulnar nerve. PMID- 3632318 TI - Dual-photon absorptiometry of the proximal tibia. AB - Dual-photon absorptiometric bone-mineral assay, penetration tests, and axial compression tests of the proximal tibial epiphyses were carried out in 18 human cadaver knees. The reproducibility of bone mineral assay was within +/- 12% (95% tolerance limits). Linear regression analysis with bone-mineral content as the independent variable showed a good correlation to the ultimate force obtained from the compression tests on the medial (r = 0.81) and the lateral (r = 0.90) condyles. The correlation between bone mineral content and an average of three condylar penetration tests was somewhat weaker (medical condyle: r = 0.65, lateral condyle: r = 0.62). It is concluded that dual-photon absorptiometric bone mineral assay may be a suitable noninvasive alternative to bone-strength measurement and thus suitable for monitoring the changes in tibial condylar bone during follow-up studies. PMID- 3632319 TI - The rise of blood sugar as an additional parameter in traumatic shock. AB - Besides the known cardiovascular effects of hemorrhagic shock, regular metabolic consequences can be demonstrated in the rabbit: 1. The rise in blood sugar in hemorrhagic shock increases with the amount of blood withdrawn per unit of time. 2. The characteristic rise in blood sugar lasts longer than the phase of the partial exsanguination. 3. In traumatic shock, the rise in blood sugar indicates the degree of severity of the injury earlier than the fall in blood pressure does. The rise in blood sugar is attributable to a reflex increase in glycogenolysis due to catecholamine secretion elicited via baroreceptors in hemorrhagic shock. For the pronounced rise in blood sugar in traumatic shock, an additional receptor is postulated. Supplementary investigation of the blood sugar may possibly enable the extent of the injury to be diagnosed earlier in traumatic shock, and the negative sequelae may be reduced by timely, adequate therapy. PMID- 3632320 TI - Transposition of coracoacromial ligament to humerus in treatment of vertical shoulder joint instability. Clinical applicability of experimental technique. AB - Treatment of experimental distal subluxation in the shoulder joint was achieved by transposition of the coracoacromial ligament and its bony attachment from the acromion to the lesser tuberosity of the humerus. This transposition also reduced external rotation in the first 40 degrees of abduction. The method, which was applied in two clinical cases of distal subluxation, proves reasonable from a biomechanical point of view and yields satisfactory primary clinical results. PMID- 3632322 TI - Simultaneous fracture of the hamate and the capitate bones. AB - A fracture of both the hamate and capitate bones in a child is described. The literature is reviewed with special attention to the treatment of these rare fractures. PMID- 3632321 TI - Severely comminuted femoral shaft fractures: treatment by bridging-plate osteosynthesis. AB - We report on 71 severely comminuted femoral shaft fractures that were operated on between 1980 and 1984 at the Berufsgenossenschaftliche Unfallklinik Duisburg Buchholz. The method of operative stabilization was plate osteosynthesis in two variations: In one group 39 fractures (ten open) were stabilized by plate osteosynthesis after anatomical reduction of the fractured area. The other group comprised 32 fractures (six open) fixed with a bridging-plate osteosynthesis, without preparation of the fracture zone. The rate of postoperative complications was strikingly diminished after bridging-plate osteosynthesis. Fracture healing occurred within 23 (16-32) weeks after bridging-plate osteosynthesis and within 36 (32-40) weeks after anatomical reduction. No special instrumentation or equipment is necessary to perform a bridging-plate osteosynthesis. The patient rests in a supine position. There is no need for intraoperative image-intensifier control. For operative treatment of severely comminuted femoral fractures we consider the technique of bridging-plate osteosynthesis advantageous, especially in multiply injured patients. PMID- 3632323 TI - Electrodiagnostic characteristics of acute carpal tunnel syndrome. AB - Carpal tunnel syndrome (CTS) exemplifies a cumulative trauma disorder which may occur in industrial settings. Occasionally, industrial workers develop CTS acutely over the course of a few days to a few weeks. We recently performed electrodiagnostic studies on 22 workers at a midwestern automobile manufacturing plant who developed symptoms compatible with CTS. All tests were within eight weeks of symptom onset; 70% were within four weeks. The acute syndrome was manifested by a conduction block of sensory, motor, or both fiber types beneath the carpal ligament. All patients received sensory studies; nine had motor studies as well. Sensory nerve latencies were not prolonged in proportion to the symptoms, which were short in comparison to the low amplitude sensory nerve action potential evoked proximal to the carpal ligament. Sensory nerve action potential amplitude at midpalm averaged 200% of the value obtained proximally. Because of short distance and residual latency, comparison of motor latencies proximal and distal to the carpal ligament was less helpful than the difference in amplitude of the evoked potentials. Amplitude of the distal response increased an average of 32%. Prompt identification of acute CTS was followed by a recommendation for job change which, along with conservative therapy, led to resolution of symptoms in 77% of patients. The diagnosis of acute CTS leading to avoidance of inciting activities is beneficial in the industrial setting. PMID- 3632324 TI - Temperature effect on antidromic and orthodromic sensory nerve action potential latency and amplitude. AB - The measurement of sensory nerve action potential (SNAP) latency and amplitude is often necessary to accurately diagnose disorders of peripheral nerves. The sensory evoked response can be obtained using either the antidromic (AD) or orthodromic (OD) technique. In a previous study we demonstrated that in healthy subjects the AD SNAP distal latency of median and ulnar nerves at 14 cm distance is approximately 0.2 msec slower than the OD SNAP distal latency at 32C. The AD SNAP amplitude was also two times greater than the OD SNAP amplitude. In this study we observed that these differences between the AD and OD SNAP latency and amplitude varied significantly as temperature changed. The AD median nerve SNAP distal latency was delayed by .06 msec/degree with cooling. The OD median nerve SNAP distal latency was delayed by .03 msec/degree with cooling. These values represent less of a slowing per degree centigrade cooling than has been previously noted in the literature. The median nerve SNAP amplitude was found to increase with upper extremity cooling with the AD and OD technique by 3.5 microV and 0.5 microV per degree, respectively. For accurate interpretation of SNAP latency and amplitude, the electromyographer must be familiar with the technique used and the differing effect of the temperature with each technique. PMID- 3632325 TI - Pneumothorax: a complication of needle electromyography of the supraspinatus muscle. AB - A patient developed sudden, severe pleuritic chest pain during needle electromyography (EMG) of the right supraspinatus muscle. Chest x-rays revealed a 10% right pneumothorax. The patient was treated conservatively and there was complete resolution one week later. A review of the pertinent anatomy indicates that the supraspinatus muscle overlies the pleural cavity. Indications for needle EMG of the supraspinatus muscle are reviewed. A new technique that minimizes the risk of pneumothorax when performing needle EMG of the supraspinatus muscle is presented. PMID- 3632326 TI - Pneumatosis cystoides intestinalis in quadriplegia: a case report. AB - Pneumatosis cystoides intestinalis is an uncommon clinical entity with nonspecific symptomatology of the gastrointestinal system. Its diagnosis is made by radiologic demonstration of multiple gas-filled cysts in the submucosa or subserosa of the intestinal tract. There are two major clinical types--idiopathic and secondary. A case report of a spinal cord injured patient with this condition is presented. Since gastrointestinal disturbances are common in spinal cord injured patients, health care professionals should be aware of this condition. Identification of pneumatosis cystoides intestinalis is important since it represents a benign condition and usually requires no treatment. PMID- 3632327 TI - Transient locked-in syndrome and phenobarbital. AB - Locked-in syndrome is a rare syndrome characterized by quadriplegia, intact consciousness, mutism, and communication using vertical eye movements. We report the case history of a patient with transient locked-in syndrome following repeated shunt procedures for idiopathic aqueductal stenosis. Communication was with lateral eye movements. Although she eventually recovered and regained functional independence, high doses of phenobarbital, given to prevent seizures, sedated her and obscured her mental status during her rehabilitation. We urge the careful monitoring of all centrally acting agents in patients with locked-in syndrome. PMID- 3632328 TI - Independently activated talking tracheostomy systems for quadriplegic patients. AB - Patients who require mechanical ventilator support use cuffed tracheostomy tubes to facilitate prolonged, intermittent, positive-pressure ventilation. The air flow provided by these cuffed tracheostomy tubes bypasses the vocal cords, preventing verbal expression by the patient. Specially designed cuffed tracheostomy tubes are available that restore air flow across the vocal cords without compromising a patient's ventilation. These tracheostomy tubes require an air control port to be covered when air flow is needed by the patient to produce speech. Individuals with neuromuscular impairment usually require an attendant to activate the control port. Electromechanical systems have been developed to allow independent activation of the air flow by the patient. Both freestanding and wheelchair-based systems are described. PMID- 3632329 TI - Atypical EMG findings. PMID- 3632330 TI - [Concordance index s(R AvBv). A value in determining the reliability of multivariate qualitative observational data]. PMID- 3632331 TI - [Dimensions of the concept of emotions. A reanalysis based on a random sample of emotional concepts]. PMID- 3632332 TI - [Performance increasing effect of self-caused failure: behavioral effects of attributions]. PMID- 3632333 TI - [Some determinants of persistence and performance]. PMID- 3632334 TI - The first law of concentration. PMID- 3632335 TI - [Are body position-induced changes in heart rate conditionable?]. PMID- 3632336 TI - Papers read before the 13th annual meeting of the New England Society for Vascular Surgery. Dixville Notch, New Hampshire, September 25 to 26, 1986. PMID- 3632337 TI - The management of early in situ saphenous vein bypass occlusions. AB - To determine the causes and optimum management of early in situ bypass occlusions, we reviewed our experience of 13 thromboses occurring within the first 30 postoperative days in 148 in situ saphenous vein reconstructions. All early thrombosed bypasses were performed for limb salvage, with 31% of bypasses to the popliteal level and 69% to infrapopliteal vessels. The median time to occlusion was 24 hours. All patients underwent reoperation. Graft failure was due to retained venous valves in 31% of the procedures, other technical problems in 38%, and inadequate outflow in 31%. Reoperative surgery was individualized. In grafts explored for thrombosis, the one-year graft patency rate was 46%, and the limb salvage rate was 54%. Graft patency did not appear to correlate with the presumed cause of initial graft occlusion. Our results indicate that an aggressive surgical approach is appropriate in early in situ graft thrombosis. PMID- 3632338 TI - Subclavian artery insufficiency. Treatment with axilloaxillary bypass. AB - Twenty patients underwent axilloaxillary bypass at Tufts-New England Medical Center, Boston, between 1973 and 1983, all for tight stenosis or occlusion of the subclavian artery. Review of records was possible for 19 cases. Symptoms included intermittent claudication and numbness of the upper extremity, as well as dizziness, vertigo, and ataxia due to episodes of vertebrobasilar insufficiency. Dacron, reversed saphenous vein, and polytetrafluoroethylene grafts were inserted, with all but one occupying a subcutaneous tunnel across the sternum. There were no operative deaths, and morbidity was minimal. The median follow-up was 83 months. The early patency rate was 94%, with a cumulative patency rate of 89% at ten years of follow-up, as determined by the life-table method. Our experience supports axilloaxillary bypass as a safe and effective treatment for symptomatic subclavian artery insufficiency. PMID- 3632339 TI - Sigmoid intramural pH for prediction of ischemic colitis during aortic surgery. A comparison with risk factors and inferior mesenteric artery stump pressures. AB - We compared intramural pH (pHI) measured through a silicone balloon placed in the lumen of the sigmoid colon with risk factor analysis and inferior mesenteric artery (IMA) stump pressures as predictors of ischemic colitis in 34 patients undergoing elective or emergency operations on the abdominal aorta. All patients had preoperative and postoperative flexible sigmoidoscopy, IMA stump pressure measurements, and serial measurements of pHI. Logistic regression analysis showed that aortic aneurysm, age, and stenosis of the superior mesenteric artery were the only risk factors that bore a statistical relationship to ischemic colitis. Ligation of a patent IMA did not increase the likelihood of ischemic colitis. The IMA stump pressure criteria for predicting ischemic colitis were absent in nine of the ten patients in whom ischemic colitis developed and were present in five of the 24 in whom it did not develop. Intraoperative pHI dropped below 6.86 in all three patients in whom severe ischemic colitis developed. Mild colitis developed in seven patients whose minimum pH was 6.99 +/- 0.12 (mean +/- SD). No colitis developed in the remaining 24, whose minimum pH was 7.21 +/- 0.13. Thus, stump pressure is not a reliable means of predicting ischemic colitis. Aortic aneurysm, age, and superior mesenteric artery stenosis were significant risk factors. The average minimum intraoperative pHI and its duration were the best predictors for the development of ischemic colitis. PMID- 3632340 TI - Thrombolysis in the treatment of peripheral arterial vascular occlusions. AB - The efficacy of thrombolytic agents in the management of peripheral arterial disease remains unclear. We reviewed our experience with 64 consecutive episodes of limb-threatening graft or native vessel occlusions. The overall success rate was 59%, with a major complication/mortality rate of 28%. Thrombolytic therapy in patients with occluded vascular grafts required identification of a causative lesion and subsequent adjunctive management with percutaneous transluminal angioplasty or surgery for sustained patency (64%). In contrast, approximately 70% of native vessel occlusions maintained patency whether a causative lesion was identified and corrected or not. Patients who failed thrombolytic therapy had a worse prognosis overall, with 38% undergoing primary amputation, although patients with reconstructable occlusions still had a 64% salvage rate at six months. The review demonstrated that thrombolytic therapy continues to be a useful adjunct in treating the patient with peripheral vascular occlusion, although a significant risk of major complications persists. Patients with graft occlusions successfully treated with thrombolysis require correction of any precipitating lesions for long-term limb salvage, while careful management of patients failing thrombolysis can still achieve significant limb salvage in selected cases. PMID- 3632341 TI - Resurrection of the amputations of Lisfranc and Chopart for diabetic gangrene. AB - When a patient with neuropathic diabetic gangrene of the foot has sepsis, it is not always necessary to do a below-knee guillotine amputation or a Syme's amputation. In more than six years we have done 18 successful open Lisfranc's and Chopart's amputations. Improved ambulation has been achieved in three months using simple shoe prostheses. All flaps are fashioned immediately and never sutured. No equinus deformities have developed. PMID- 3632342 TI - Reversal of benign intracranial hypertension by surgically induced weight loss. AB - Weight loss is recommended in the treatment of benign intracranial hypertension (BIH) but is difficult to achieve because of the administration of steroids. A 24 year-old morbidly obese woman with BIH presented with headache, a cerebrospinal fluid pressure of 300 mm H2O, enlargement of the blind spot in the right eye, and bilateral papilledema. Treatment with steroids for one year produced an increase in weight with worsening symptoms and visual findings. Gastric exclusion surgery produced a 37-kg weight loss in six months that was associated with cessation of symptoms, reduction in cerebrospinal fluid pressure to 170 mm H2O, marked improvement in visual fields, and resolution of papilledema. This raises the possibility that gastric exclusion surgery may be an effective means to achieve weight loss and ultimately a remission in obese patients with BIH. PMID- 3632343 TI - Femoral hernias in children. An infrequent problem. AB - Femoral hernias in children are uncommon and many surgeons have had little exposure to their clinical manifestations. A ten-year survey of our experience with groin hernias in children showed only six children with this condition, which represents 0.12% of this entire population. Definite preoperative diagnosis was made in only two patients, while in the other patients this condition was suspected during herniorrhaphy. Preoperative diagnosis is possible if the bulge appears in a location inferior and lateral to that of the commonly occurring indirect hernia. Any child with early recurrence of a groin swelling after what seems to be an adequate inguinal herniorrhaphy should be suspected of having a femoral hernia. PMID- 3632344 TI - Radionuclide imaging in the diagnosis of hernias related to peritoneal dialysis. AB - Abdominal hernias are noted with increasing frequency in association with peritoneal dialysis as this mode of dialysis becomes increasingly popular. These hernias often present as localized groin edema, without evidence of a mass, on physical examination. Diagnosis is more difficult when the edema encompasses both groins. Radionuclide imaging peritoneography offers a safe, simple, well tolerated, highly accurate method of localizing peritoneal defects. We used this method to locate and lateralize inguinal hernias in three patients receiving continuous ambulatory peritoneal dialysis who presented with bilateral scrotal edema and who had unrevealing physical examination findings. All three had unilateral, indirect inguinal herniorrhaphies under local anesthesia and have returned successfully to peritoneal dialysis without complication. PMID- 3632345 TI - Mortality of gastrointestinal complication after cardiac surgery. PMID- 3632346 TI - Treatment of caustic sclerosing cholangitis. PMID- 3632347 TI - Observations on the venous structure of a breast. PMID- 3632349 TI - Responsibility of clinical surgeons who write. PMID- 3632348 TI - Ogilvie's syndrome: a true definition. PMID- 3632350 TI - Do the data support the conclusions? PMID- 3632351 TI - Transconjunctival oxygen tension measurements during carotid endarterectomy. PMID- 3632352 TI - Comparison of benzo(a)pyrene metabolism in isolated perfused rat lung and liver. AB - The metabolism of 1 mM benzo(a)pyrene was studied in isolated perfused lung and liver of 5,6-benzoflavone-pretreated rats. Benzo(a)pyrene metabolism by the liver was more rapid than by the lung, but total metabolite formation in the lung at the end of a 120-min perfusion period was comparable to that in the liver. Lung perfusate was characterized by high concentrations of free metabolites, with diols outweighing phenols; in liver perfusate free metabolite concentrations were low, and large quantities of metabolites were found as conjugates in the bile at the end of perfusion. The tissue concentrations of free diols and phenols including the precursors of the main DNA-binding secondary metabolites were higher in the lung than in the liver. These findings explain the similar level of covalent binding in perfused lung and liver previously described (Klaus et al. 1982). PMID- 3632353 TI - Stimulation of DNA repair synthesis of rat thymocytes by novobiocin and nalidixic acid in vitro without detectable DNA damage. AB - Scheduled (SDS) and unscheduled (UDS) DNA synthesis as well as nucleoid sedimentation was investigated in vitro under the influence of novobiocin (NB) and nalidixic acid (NA) using intact thymic (T-cells) and splenic (S-cells) rat cells and cells which were exposed to X-rays, UV irradiation, methyl methanesulfonate (MMS), and DNA polymerase inhibitors. At concentrations of greater than or equal to 56.25 (S-cells) and greater than or equal to 225 micrograms/ml (T-cells), respectively, NB inhibited SDS in a dose-dependent manner. Within a concentration range of greater than or equal to 225-900 micrograms NB/ml, UDS of S-cells decreased to values far below the tracer ([3H methyl]-thymidine) incorporation of control cells, whereas UDS of T-cells increased by at least 200%. Within a concentration range of 450-1800 micrograms/ml, NA enhanced SDS and UDS by about 30% in S-cells and by 100% in T cells. The stimulating activity of NB and/or NA could be eliminated specifically by the DNA polymerase beta inhibitor 2',3'-dideoxythymidine. Enhanced nucleoid sedimentation was observed at NB concentrations greater than or equal to 750 micrograms/ml; S-cells revealed a higher sedimentation rate than T-cells. It is suggested that NB (and NA) influence DNA topology in a rather cell specific manner, stimulating UDS of T-cells by a DNA polymerase beta - dependent repair like mechanism. PMID- 3632354 TI - Metabolic changes following oral exposure to tetrachloroethylene in subtoxic concentrations. AB - Mice were exposed to very small quantities of Per (0.05 and 0.1 mg Per/kg body weight per day) administered orally for 7 weeks. It was shown that Per was transported through the body by two separate mechanisms and was finally stored in the adipose tissue. On the one hand, Per reaches the interior of the membranes of red blood cells, leading to changes in the entire erythropoietic system. The membranes of the red blood cells are destroyed prematurely and its fragments are increasingly phagocytized in the spleen. The result is a high level of Per stored in the spleen. The increase in haemolysis was also demonstrated by showing an increase in LDH activity and the accumulation of haemosiderin in the macrophages in the spleen. Only 8 weeks following discontinuation of Per, these changes were reversible. On the other hand, Per is also transported with the chylomicrons. Since the lipoprotein lipase is inhibited by Per, these molecules are broken down to a lesser degree. The concentration of triglycerides (the major component of the chylomicrons) in the serum was elevated, and the chylomicrons were increasingly integrated into the adipose tissue, Per also reached this depot fat. It took as long as 16 weeks after discontinuation of Per until these changes were fully reversed and the experimental mice no longer differed from those in the control group. PMID- 3632355 TI - Evaluation of paraquat concentrations in paraquat poisoning. AB - The toxicological significance of paraquat concentrations in paraquat poisonings was evaluated by means of multivariate analysis methods. Paraquat could be determined by a newly developed procedure, which involved thin-layer chromatography with flame ionization detector (TLC-FID) and solid-phase extraction with a disposable octadecylsilane cartridge. This new method proved to be simple, rapid and reliable for the analysis of paraquat in our seven cases of suicidal poisoning. The relationship between plasma paraquat concentration (C) and time from ingestion (T) could be best described by the following functions. The regression equation of fatal cases was ln[ln(C X 1000)] = 2.5453 - 0.2114 lnT. The regression equation of survivors was ln[ln(C X 1000)] = 2.1041 - 0.2826 lnT. The discriminant function (D) to separate the fatal and survival cases was D = 1.3114 - 0.1617 lnT - 0.5408 [ln(C X 1000)] (fatal cases: D less than 0, survivors: D greater than 0). The discriminant function was demonstrated to have a high reliability for the toxicological significance in our seven poisoned patients. The significant correlation between plasma paraquat concentration and urine paraquat concentration (C') in our cases was obtained. The regression equation was lnC' = 0.953 lnC + 1.409. This also indicated that urinary concentrations are 3.3 - 4.5 times greater than plasma concentrations. The multiple regression equation among plasma paraquat concentration, time from ingestion, and the ingested volume (V) of Gramoxone (trade name of paraquat), was lnC = 0.009V - 0.232T + 3.612. It is suggested that the determination of paraquat is of great value, and that these data are useful in assessing the severity and predicting the outcome of poisoning for forensic and clinical purposes. PMID- 3632356 TI - Activity of ethylene oxide in the mouse sperm morphology test. AB - Inhaled ethylene oxide induced an increased frequency of abnormal sperm cells in mice when the animals were treated at 200 and 400 ppm (6 h per day; 5 days) in three stages of cell development: spermatozoa, spermatid and preleptotene spermatogonial cells. These results suggest that sperm head morphology changes can be induced by interference of ethylene oxide with spermatogenesis, which, depending on the stage of the treated germ cells, may be correlated with the mutagenic potential of this chemical agent. PMID- 3632357 TI - Lack of effect of diet on benzpyrene metabolism by colonic mucosal homogenates from mice. PMID- 3632358 TI - [Sensitivity of the primordia of various organs to chemical substances]. AB - In the experiments performed in chick embryos, using the chick embryo screening test (CEST)-1 and CEST-2 technique, 100 various classes of chemical substances have been tested for teratogenic activity. Estimation of three morphogenetic systems (caudal part of the body, facial skull and extremities) has demonstrated that some of the substances do not produce any damaging effect, other produce some lesions in selected germs, the third influence two or three germs simultaneously. Similar picture is also specific for the effect of the chemical substances to the rat intrauterine development. Owing to data obtained, we come to the conclusion that for screening of embryotoxicity of various xenobiotics under in vivo and in vitro experimental conditions one should not orient to one single germ. PMID- 3632359 TI - [Changes in the walls of autologous venous grafts after transplantation into arteries]. AB - In 54 dogs 76 operations on plastics of the common carotid arteries with the femoral vein segments have been performed. The animals have been observed for 3 days--1.5 years. The grafts, preserving their permeability, have been studied using a complex of anatomical, histological and micromorphometric techniques. At early stages after the operation (up to 7 days), dystrophic and necrobiotic changes predominate in the wall of the venous graft. As a result of overstretching of the denervated and devascularized vessel, under the effect of a high arterial pressure, nearly total rejection of the endothelial lining takes place, as well as death of some smooth myocytes in the middle tunic; this determines appearance of early thromboses. During 2-6 months after the operation, against the background of a good revascularization of the graft, restorative and adaptive changes develop in its wall. The intima becomes thick at the expense of formation of the obliquely situating layer of myocytes, as well as the result of parietal thromboses organizing on the deendothelized internal surface. These thickenings are especially well seen in the zones of anastomoses. In 6 months- 1.5 years after the transplantation into the artery, as a result of constriction of the vessels feeding the graft and reduction of blood stream along them, atrophic and sclerotic changes increase in the wall. The intimal thickenings often acquire the pattern of fibrous patches, that make the lumen more narrow; this can cause appearance of late occlusions and thromboses of the grafts. PMID- 3632360 TI - [Myocardial damage during immobilization stress and the protective effect of thyroid hormones]. AB - In the experiments performed on 30 white inbred male rats, the stress produces an essential increase of dilated canals in the T-system and sarcoplasmic reticulum, lesions of sarcolemma and nucleolemma, fragmentation and homogenization of mitochondrial cristae; there are many pinocytic vesicles in the capillary walls. Preliminary injection of thyroid hormones in small doses, that do not result in any noticeable influence on the body mass, cardiac contraction rate and thyrotoxin concentration in blood serum, at the stress causes less pronounced changes in ultrastructure of cardiomyocytes, demonstrating as a poor swelling of the T-system elements, preservation of the sarcolemmic integrity at its larger length; besides, large mitochondria with compact arrangement of cristae appear, amount of the sarcoplasmic reticulum elements increases, chromatin margination becomes evident, i. e. a complex of adaptive processes develops. The data presented demonstrate a defensive role of physiological concentrations of the thyroid hormones under the stress. PMID- 3632361 TI - [Age and features of the skeletotopy of the roots of the lungs of newborn infants and children]. AB - In 186 roentgenograms of frontal projections, obtained in children from birth up to 7 years of age, made according to the vital indications (but without any pathology in the thoracic organs), and in 63 isolated preparation of lungs, skeletotopy and size of the lung roots have been studied. The skeletopic difference between superior and inferior margins of the roots near the medial surface of the lung in the newborns during the first day of life has been stated to make in the projection to the frontal thoracic wall 2 ribs, or 2 vertebrae (to the posterior wall), and to the end of the first month of life-3 ribs, or 3 vertebrae, respectively; during the first year-2.5 ribs, or 2 vertebrae, in children of 1-7 years of age-2 ribs, or 2 vertebrae, respectively. The projection borders of the lung roots from birth up to 7 years of age are noted to change in time and with various intensity. PMID- 3632362 TI - [Localization of catecholamines, serotonin and histamine in the cells and mucus of bronchial washings from apparently healthy subjects]. AB - By means of luminescent-histochemical methods localization of catecholamines, serotonin, histamine has been studied in cells and mucus of bronchial washings of 30 practically healthy persons. Cytofluorometry is performed in mucus, pulmonary epithelium, alveolar macrophages, lymphocytes and neutrophils of the bronchial washings. In the alveolar macrophages a high level of the compounds studied is detected. PMID- 3632363 TI - [Ultrastructural organization of the endotheliocytes of human liver sinusoids in the prenatal period]. AB - Structure of endotheliocytes of the human liver sinusoids during 4-5-9 months of intrauterine development has been studied electron microscopically. At early stages of embryogenesis the liver sinusoids are covered with continuous endothelium. As cytodifferentiation progresses, formation of zonality in cytoplasm of endotheliocytes is observed. In the most thinned parts of cytoplasm single fenestrae, situating irregularly appear. As the fetus is growing, the number of diafragmented fenestrae increases their arrangement becomes more regular; together with accidental, claster arrangement of the fenestrae is observed. Open intra- and intercellular fenestrae of endotheliocytes appear in the second half of the intrauterine development. For endotheliocytes of the fetal liver sinusoids presence of transitory migrational pores is specific; they are maximally thinned areas of endotheliocytic cytoplasm, that emerge at the moment of diapedesis of the blood formed elements across the endothelial lining. High tempo of histogenesis is specific for endothelium of the liver sinusoids; the endothelium of a continuous type differentiates into the specialized--sinusoid endothelium. PMID- 3632364 TI - [Ultrastructure and relations between cells in the myometrium and in myomas of the human uterus]. AB - The state of myocytes and their intercellular connections in an unaltered myometrium in the peripheral zone and in the central part of the myoma node has been studied electron microscopically. When analysing the peripheral zone of the uterine myoma, myocytes have resemblence with myometrial cells in the folliculine phase of the menstrual cycle. Simultaneously, certain changes are observed both in the intracellular components and in intercellular interrelations: myocytic nuclei swell, most part of chromatin is decondenced, cell cytoplasmic volume increases, in the prenuclear zone numerous agregates of ribosomes are revealed. The myocytes draw nearer and form specialized junctions, that ensure their cooperation. PMID- 3632365 TI - [Surface features of human ribs in different areas]. AB - By means of light and electron microscopy, internal and external surfaces of the human rib have been studied at the age of 25-85 years. The data are obtained on the relief difference of mineralization of these surfaces both in persons of middle age and under conditions of age osteoporosis. PMID- 3632366 TI - [Structural analysis of the pattern of interphase chromatin of rat hepatocyte nuclei]. PMID- 3632367 TI - [Method of topographoanatomic study of the 3d ventricle in relation to structures of the base and vault of the cranium]. PMID- 3632368 TI - VIth World Congress of the International Society for Artificial Organs and XIVth Congress of the European Society for Artificial Organs. Abstracts. PMID- 3632369 TI - Dietary influences on the antiparkinsonian response to levodopa. AB - The ability of dietary factors to modify the response to levodopa was evaluated in six patients with idiopathic Parkinson's disease who manifested fluctuations in motor performance. The single oral administration of a high-protein formula substantially elevated plasma large neutral amino acid levels, and prematurely terminated the antiparkinsonian response to levodopa/carbidopa. In contrast, during oral or intravenous administration of levodopa, the ingestion of diets meeting the recommended daily allowance (RDA) for protein had no significant effect on plasma levodopa or large neutral amino acid levels or variance, nor on parkinsonian scores or variance. The results suggest that while protein intake in excess of the RDA can diminish the antiparkinsonian response to orally administered levodopa/carbidopa in patients with advanced disease, diets adhering to RDA protein guidelines have no clinically appreciable effect. PMID- 3632370 TI - Plasma levels of amino acids correlate with motor fluctuations in parkinsonism. AB - Seven patients with Parkinson's disease who experienced severe motor fluctuations in response to levodopa were studied in detail with relation to the effect of dietary protein on their motor function. The levodopa dose for each patient was not changed during the period of study, and no other antiparkinsonian drugs were used. Regular and high-protein diets resulted in a marked elevation in the plasma concentrations of large neutral amino acids (LNAAs) that are known to compete with levodopa for transport across the blood-brain barrier. Despite elevated plasma levodopa levels, all patients with elevated LNAA levels experienced parkinsonian symptoms. When the amino acid level dropped while plasma levodopa levels were elevated, patients experienced relief of these symptoms. On a low protein diet, LNAA levels remained low and all patients were consistently dyskinetic throughout the day, even though the mean plasma levodopa levels were somewhat lower than when the patients consumed a high-protein diet. A redistribution diet that is virtually protein free until supper and then unrestricted until bedtime is tolerated by patients because this simple manipulation permits near-normal daytime motor function. PMID- 3632371 TI - Controlled release levodopa-carbidopa (CR-5) in the management of parkinsonian motor fluctuations. AB - Parkinsonian patients receiving long-term levodopa-carbidopa (Sinemet) therapy often develop fluctuations in motor performance. Although maintenance of stable levels of plasma levodopa by means of its continuous intravenous infusion diminishes these fluctuations, practical limitations attending this therapeutic approach have prompted continuing attempts to develop oral controlled release levodopa-carbidopa formulations. In a double-blind, crossover clinical trial, one such preparation, CR-5 (Merck, Sharp & Dohme), produced significantly less plasma levodopa variations and substantially improved motor performance over Sinemet in 15 patients with mild to moderate fluctuations, all but one of whom chose to continue on CR-5 therapy after the study. Eight patients with severe motor fluctuations could not adjust to this preparation during the open phase and consequently withdrew from the study. Subjectively, most patients noted the convenience of less frequent dosing, improved sleep, and the amelioration of early morning akinesia and dystonia. PMID- 3632372 TI - Factor analysis of Parkinson's impairment. An evaluation of the final common pathway. AB - The question of how pathophysiologic mechanisms may combine to yield significant performance impairment in Parkinson's disease was studied by factor analysis of the covariation among behavioral deficits observed during simulated daily living activities. Eighty-four patients with idiopathic Parkinson's disease were videotape-recorded while performing a sequence of nine common tasks of daily living in a standardized format. Acceptable observer reliability was achieved for ten clinical signs that were factor-analyzed to suggest three dimensions of motor performance: ambulation, tremor, and animation. The findings are discussed with respect to traditional concepts of Parkinson's disease and the possible interplay between primary disease mechanisms. PMID- 3632373 TI - Migraine and other diseases in women of reproductive age. The influence of smoking on observed associations. AB - From among the pregnant women in the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, we identified 508 who had migraine, and 3192 who had no history of migraine, of taking headache medication during the previous 12 months, and of headaches during the pregnancy. Migraineurs smoked more heavily and had a longer smoking history than their headache-free peers. Among migraineurs, smokers were not more likely to consume analgesics than nonsmokers. Regardless of smoking classification, more migraineurs consumed tranquilizers, amphetamines, and sleeping pills than headache-free women. Among smokers only, migraine was associated with heart disease, thrombosis/phlebitis, asthma, peptic ulcer, and pneumonia. In nonsmokers, migraine was associated with drug sensitivity and other allergies. PMID- 3632374 TI - Olfactory deficits as a neurologic sign in dementia of the Alzheimer type. AB - Many patients with dementia of the Alzheimer type (DAT) have an abnormal sense of smell. I studied 18 mildly demented subjects with DAT between the ages of 60 and 80 years and found them less able to identify five fragrances compared with 26 healthy elderly controls. The mean (+/- SEM) olfactory identification score for demented subjects was 0.3 +/- 0.2 compared with 2.8 +/- 0.2 for controls. When the subjects were given a multiple-choice list of ten items including the test fragrances and five other odors, performance of both demented and normal subjects improved, with a score of 1.8 +/- 0.4 for subjects with DAT and 4.2 +/- 0.2 for controls. The findings suggest that olfactory deficits are a sensitive, although non-specific, indicator of mild DAT. PMID- 3632375 TI - The GABA-agonist progabide for spasticity in multiple sclerosis. AB - Thirty-two patients with spasticity due to multiple sclerosis were entered into a randomized, double-blinded, placebo-controlled crossover trial of the gamma aminobutyric acid agonist, progabide. Each patient was treated with a maximum of 45 mg/kg of progabide during each of two four-week treatment periods, separated by a two-week washout. Twenty-five participants completed the study; seven failed to complete the study due to adverse events. Progabide was associated with lessened spasticity. There was no loss of motor power associated with progabide. The physician, patients, and study nurse coordinator all declared preferences for progabide for treatment of spasticity. Ten participants (40%) chose to remain on progabide in an open, long-term follow-up protocol. Seven serious adverse events occurred. One consisted of fever and weakness without infection; the other six consisted of elevated aspartate aminotransferase and alanine aminotransferase levels, four of which were asymptomatic. All adverse events resolved entirely when the drug was stopped. Progabide is an effective antispastic agent and its antispastic effect is not accompanied by increased motor weakness. The use of the drug, however, is associated with a high incidence of adverse events, which will likely limit progabide's therapeutic usefulness. PMID- 3632376 TI - Oligoclonal IgG bands in cerebrospinal fluid. Principles for demonstration and interpretation based on findings in 1114 neurological patients. AB - Unconcentrated cerebrospinal fluid (CSF) and serum samples from 1114 consecutive patients were examined for presence of oligoclonal IgG bands (OB) by agarose isoelectric focusing (AIF) followed by protein transfer to nitrocellulose membrane, immunolabeling, and avidinbiotin-peroxidase staining (avidin-biotin AIF). Oligoclonal bands were demonstrated in CSF from all 58 patients with multiple sclerosis (MS), eight of 29 with aseptic nervous system infections, and 9% of 1014 with other neurological disorders (OND) considered as noninflammatory at primary clinical evaluation. Comparative examination of all specimens in another laboratory by conventional AIF after concentration of CSF revealed lower frequencies of OB in all diagnostic groups. In addition to the high sensitivity of avidinbiotin AIF, which enables detection of OB by separation of 5 microL of unconcentrated CSF even when the CSF IgG level is around the lower normal range, the procedure also has optimal specificity since IgG exclusively is detected. Avidin-biotin AIF may be the method preferred for routine examination of CSF for OB. Demonstration of OB in CSF is valuable especially in MS, where, in contrast to diagnostic aids such as evoked potentials and neuro-imaging, it establishes inflammatory type of nervous system involvements. Oligoclonal IgG bands in CSF from patients with OND reflect intrathecal immune response and should lead to investigations of infectious etiology. PMID- 3632377 TI - Does neuroretinitis rule out multiple sclerosis? AB - Neuroretinitis, a form of optic neuritis, is characterized by papillitis and a stellate macular exudate, or "macular star." The star implies the presence of a disc vasculopathy and secondary leakage of lipoproteinaceous material into the macula. Demyelinating optic neuritis would not be expected to produce a secondary macular exudate. We reviewed the literature on the risk of multiple sclerosis developing in a patient after an attack of optic neuritis, and rarely found a comment on the presence of a macular star. We then reviewed two series of 40 patients who had neuroretinitis and added ten patients of our own. Signs of multiple sclerosis had not developed in the 13 patients contacted retrospectively, nor in the patients followed up prospectively. We also noted that in our patients, neuroretinitis may be accompanied by other neurologic manifestations; neuroretinitis may be bilateral and may be staggered; papillitis may present without a macular star, only to have typical exudates develop up to two weeks later; and the macular exudate may take up to 12 months to resolve. We suggest that patients who demonstrate acute papillitis with a normal macula be reevaluated within two weeks for the development of a macular star. Its presence militates strongly against the subsequent development of multiple sclerosis. PMID- 3632378 TI - Rett's syndrome. Correlation of electroencephalographic characteristics with clinical staging. AB - Rett's syndrome is a progressive disorder in female patients, characterized by autistic behavior, dementia, ataxia, loss of purposeful use of the hands, and seizures. The electroencephalographic (EEG) characteristics of 17 patients with Rett's syndrome, studied between the ages of 1 and 16 years, are reported and correlated with a recently proposed system of clinical staging. Although a specific diagnostic EEG pattern was not seen in these patients, we did observe a progressive deterioration in the EEG, characterized by a slowing of EEG activity, a loss of normal sleep EEG characteristics, and the appearance of multifocal epileptiform abnormalities, followed by a pattern of generalized slow spike-wave activity. These characteristics appear to be typically seen in patients with Rett's syndrome and can be correlated with clinical staging. The EEG may be of benefit in identifying variations or subgroups in patients with Rett's syndrome as a complement to the clinical examination. PMID- 3632379 TI - Coexistent Meige's syndrome and myasthenia gravis. A relationship between blinking and extraocular muscle fatigue? AB - We studied five patients with a combination of Meige's syndrome (blepharospasm oromandibular dystonia) and myasthenia gravis. The coexistence of two disorders impairing eyelid opening led to diagnostic confusion and delayed appropriate therapy. Detailed oculographic monitoring of one patient indicated that eye position drifting due to myasthenic oculomotor fatigue was corrected by eye blinks, and that blinks tended to occur with slower saccades. Our observations suggest that fatigue of extraocular muscles may lead to synkinetic blinking and perhaps eventually to autonomous blepharospasm. PMID- 3632380 TI - Pure motor hemiplegia due to meningovascular neurosyphilis. AB - Two young male homosexuals developed prodromal syndrome followed by penicillin responsive meningitis and the acute onset of pure motor hemiplegia. The clinical and laboratory features are consistent with meningovascular neurosyphilis. Basis pontis infarctions were subsequently demonstrated on magnetic resonance imaging scans. To our knowledge, this is the first description of syphilitic arteritis as a pathophysiologic basis for pure motor hemiplegia. PMID- 3632381 TI - Mania after brain injury. A controlled study of causative factors. AB - Eleven patients who developed manic syndromes after brain injury (secondary mania) were studied. Six patients had depressive episodes before mania and five had a definite or possible family history of affective disorder. Eight had lesions involving limbic areas, and nine had right hemisphere involvement. In addition to focal brain injury, mean values for bifrontal and third ventricle/brain ratios of manic patients were significantly increased when compared with non-manic patients who had lesions matched for cause, location, volume, and time since injury. Results indicate that the confluence of either anterior subcortical atrophy and a focal lesion of a limbic or limbic-connected region of the right hemisphere, or genetic loading and a limbic-connected right hemisphere lesion may account for the rare occurrence and specific factors necessary to produce secondary mania. PMID- 3632382 TI - Comparison of magnetic resonance and roentgen ray computed tomography in dementia. AB - To compare the merits of magnetic resonance imaging (MRI) and roentgen ray computed tomography (CT) in assessing patients with dementia, we examined pairs of MR and CT brain images obtained from 26 patients with Alzheimer's disease (AD), eight patients with vascular or mixed dementia, and two patients with Parkinson's disease plus dementia. Magnetic resonance and CT images were independently rated on a qualitative scale of 0 (normal) to 3 (severely abnormal) in 39 separate brain regions. Ratios of anterolateral and third ventricular linear spans to linear skull spans were measured. Abnormalities in subcortical white matter and in hippocampus, enlargement of basal and sylvian cisterns, and ventriculomegaly were more evident on MR than CT scans, but qualitative ratings in all other brain regions were similar. Linear ventricular span ratios based on MR images did not differ significantly from those measured on CT. White matter abnormalities on MR were high signal foci on T2-weighted images whose pathologic substrate was uncertain; in a single case studied pathologically, no abnormalities were detected in brain regions that contained high signal foci. Dementia severity correlated with periventricular white matter abnormalities on both MR and CT images. PMID- 3632383 TI - Retrograde changes in the corticospinal tract of posttraumatic paraplegics. AB - Autopsy material from patients with posttraumatic paraplegia of long duration was examined to determine the extent of survival of corticospinal axons proximal to the injury. Spinal cord sections from sites above a functionally complete spinal cord injury were examined for the presence of axons, myelin, and gliosis. There was a marked depletion of axons from the corticospinal tract close to the region of injury. There appeared to be a gradual increase in the density of axons within the tract at increasing distance from the injury in all patients. Corticospinal axons appear to retract from the spinal cord injury site, but do not show progressive degeneration even years after a spinal cord injury. PMID- 3632384 TI - The importance of carotid artery plaque disruption and hemorrhage. AB - The event or mechanism that causes an asymptomatic atherosclerotic carotid artery to become symptomatic remains uncertain. Analysis of carotid endarterectomy surgical specimens from symptomatic patients has suggested that primary intraplaque hemorrhage is the most important initiating event. Reanalysis of several recent series of carotid endarterectomy specimens demonstrated that plaque disruption (ulceration) occurs as frequently as plaque hemorrhage, and that both processes are significantly more frequent in symptomatic as compared with asymptomatic endarterectomy specimens. A review of the coronary artery pathology literature reveals that plaque disruption is commonly present in patients with acute fatal myocardial infarction. It is widely asserted that coronary artery plaque disruption leads to luminal thrombosis and intraplaque hemorrhage. A similar sequence of events may occur in symptomatic carotid arteries. PMID- 3632385 TI - Treatment of myasthenia gravis with pyridostigmine. PMID- 3632386 TI - Computed tomographic evidence of cerebral focal ischemic lesion in thrombotic thrombocytopenic purpura. PMID- 3632387 TI - Thoracic disk herniation associated with chiropractic spinal manipulation. PMID- 3632388 TI - Hepatic ultrastructural change and liver dysfunction in amyotrophic lateral sclerosis. PMID- 3632389 TI - A cause of episodic neurologic dysfunction. PMID- 3632390 TI - Temporal lobe epilepsy: response to endocrine dysfunction? PMID- 3632391 TI - Neuropsychological features of early and late-onset Alzheimer's disease. PMID- 3632392 TI - Evaluation of an exaggerated somatosensory deficit with symptom validity testing. PMID- 3632393 TI - Clinical investigation of Duchenne muscular dystrophy. Interesting results in a trial of prednisone. AB - We investigated the effect of high-dose prednisone therapy in 33 boys with Duchenne muscular dystrophy. The drug was given daily in doses of 1.5 mg/kg of body weight (to a maximum of 80 mg) for six months. Muscle strength, joint contractures, timed functional tests, functional ability, and pulmonary function were measured at the beginning and end of the treatment period. The trial was designed using natural history controls, and the power of the study was 0.80 to detect a slowing of 50% in the rate of progression. During the period of the trial, muscle strength, functional grades, timed functional tests, and pulmonary function improved. Contractures followed the expected natural history of the illness. PMID- 3632394 TI - Prednisone treatment in Duchenne muscular dystrophy. Long-term benefit. AB - We report the long-term results of a therapeutic trial of prednisone in the treatment of Duchenne muscular dystrophy, comparing the age at which 16 treated patients and 38 controls lost the ability to ambulate. Survival curve analysis and group mean comparisons indicate that ambulation was significantly prolonged, by approximately two years, in the prednisone-treated group compared with the control group. The results of this study indicate that prednisone therapy has a long-term beneficial effect in the treatment of Duchenne muscular dystrophy, in addition to the short-term palliation we previously reported. Further studies are needed to establish optimal treatment schedules using prednisone and to develop improved therapeutic agents. PMID- 3632395 TI - Intracerebral hemorrhage after experimental embolic infarction. Anticoagulation. AB - Embolic stroke was induced in rabbits using autologous blood clot. One hour after stroke, animals received heparin anticoagulation (AC) for five hours (acute AC) or five days (chronic AC). Animals received excessive AC (partial thromboplastin time greater than 3.0 times control), adequate AC (partial thromboplastin time, 1.2 to 2.5 times control), or saline. After the animals were killed, the brains were examined for macroscopic evidence of intracerebral hemorrhage. There was no significant increase over control in the incidence or severity of hemorrhage in any of the four treatment groups. The data suggest that heparin AC does not promote intracerebral hemorrhage after experimental embolic stroke. PMID- 3632396 TI - Left-hemisphere missile injury. A clinical and anatomical case study, with 25 year follow up. AB - A case is reported of left-hemisphere missile injury sustained in 1944. A stable pattern of selective loss (dysphasia, dyslexia, dysgraphia, and verbal memory impairment) and intact abilities (perceptual and spatial skills and nonverbal memory) was followed up for 25 years. No progressive or generalized intellectual deterioration to suggest interaction between this brain injury and normal aging was observed. The clinical and neuropsychological sequelae are related to the detailed postmortem findings. PMID- 3632397 TI - Carbamazepine plasma concentration. Relationship to cognitive impairment. AB - Neuropsychological function was assessed before and after carbamazepine monotherapy in children with newly diagnosed complex partial epilepsy. Simultaneous video-electroencephalographic monitoring examined the influence of subclinical abnormal electrical discharges on performance. Total and unbound plasma carbamazepine concentrations were examined in relation to changes in performance at low (carbamazepine level, less than or equal to 32 mumol/L [less than or equal to 7.5 mg/L]) and moderate (carbamazepine level, greater than 34 mumol/L [greater than 8.0 mg/L]) drug levels. The data suggest a mild beneficial effect of carbamazepine on speeded eye-hand coordination and, at low drug levels, more rapid processing of items in memory. Efficiency of learning new information and memory-scanning rate displayed a concentration-dependent relationship with carbamazepine level, with poor performance significantly associated with higher carbamazepine plasma concentrations. Carbamazepine free levels were equivalent to total levels in predicting cognitive side effects. PMID- 3632398 TI - Migraine-related strokes. Clinical profile and prognosis in 20 patients. AB - We reviewed the records of 4874 patients, aged 50 years and younger, who were seen at the Mayo Clinic, Rochester, Minn, from 1976 to 1980, and had received a diagnosis of migraine, migraine equivalent, or vascular headache. Twenty patients (16 females and four males) who had migraine-associated brain infarctions are described. The areas of infarction and corresponding angiographic abnormalities were most frequently in the distribution of the posterior cerebral artery. During a mean follow-up period of seven years, two patients had a second brain infarction. At last follow-up examination, 18 of the 20 patients had minimal or no functional impairment. For the period 1976 to 1979, we reviewed the available data on cerebral infarction for the Rochester, Minn, population aged 50 years or younger; 25% of all incidence cases of cerebral infarction were migraine associated. PMID- 3632399 TI - Seven-year survival following spinal cord injury. AB - This retrospective study of 5131 persons who sustained a spinal cord injury between 1973 and 1980 sought to determine the overall seven-year survival rate and the effect of several prognostic factors on survival. All study subjects had been treated at one of seven federally designated Model Regional Spinal Cord Injury Care Systems and each had survived at least 24 hours after injury. The cumulative seven-year survival was 86.7%. Advancing age at time of injury and being rendered a neurologically complete quadriplegic were significant prognostic factors. The cumulative seven-year survival among neurologically complete quadriplegics who were at least 50 years of age when injured, was only 22.7%. Spinal cord injury mortality rates ranged from 3.26 to 20.78 times higher than corresponding rates for nonspinal injured persons. Although mortality rates for spinal cord injury patients have declined dramatically since World War II, life expectancies for these patients are still substantially below normal. PMID- 3632400 TI - Access to information by databases. PMID- 3632401 TI - On predicting ocular power changes in refractive keratoplasty. PMID- 3632402 TI - Sphenoid ridge meningioma masquerading as Graves' orbitopathy. PMID- 3632403 TI - Caveat: beware the different indexing systems. PMID- 3632404 TI - Vitreous fluorophotometry in vitreous degeneration. PMID- 3632405 TI - The use of a model eye to gain endophotocoagulation skills. PMID- 3632406 TI - Dendriform lesions of the cornea induced by soft contact lenses. Case report. PMID- 3632407 TI - Delayed, incomplete recovery of macular function after photic retinal damage associated with extracapsular cataract extraction and posterior lens insertion. Case report. PMID- 3632408 TI - Ocular coloboma and hypothalamic hypogonadism. Case report. PMID- 3632409 TI - 20/20 is not enough: psychosocial aspects of patient care. PMID- 3632410 TI - Intraocular lens power calculations. An extra edge or expensive waste? PMID- 3632411 TI - Theoretical vs empirical prediction of aphakic refraction. AB - The aphakic refraction was predicted from preoperative and postoperative keratometry and axial length determinations in 43 patients subjected to cataract extraction without intraocular lens implantation using a theoretical and an empirical (Sanders, Retzlaff, Kraff [SRK]) method of calculation. The error (mean +/- SD; observed value minus expected value) of the theoretical vs the empirical method was 0.02 +/- 0.76 diopters (D) vs 0.66 +/- 0.72 D, respectively, when the preoperative data were used in the calculations, and 0.21 +/- 0.80 D vs 0.84 +/- 0.79 D, respectively, when the postoperative data were used in the calculations. The mean error was significantly different from zero (predicted values were lower than observed values) for the SRK method but not for the theoretical method. The mean error of the SRK method could be eliminated by adjusting the offset constant in the regression formula. PMID- 3632412 TI - Intraocular lens power calculations. A practical evaluation in normal subjects at the Wilmer Institute. AB - The practical value of preoperative intraocular lens power calculations in "normal" eyes with less than 4.50 diopters (D) of myopia or hyperopia was evaluated in a consecutive series of 520 eyes that underwent cataract extraction and lens implantation by four experienced surgeons at The Wilmer Ophthalmological Institute. The observed postoperative results with the lenses selected by the surgeons were compared with results calculated for the measurement-predicted emmetropic power lens and for a standard 20-D lens. The need for postoperative spectacle correction of residual refractive errors was comparable for all three choices of lens. Only two eyes (0.4%) would have developed greater than 4.00 D of refractive error with either the "implanted" or "predicted-emmetropic" lenses, as would 11 eyes (2.1%) with the "standard" 20-D lens. The surgeons' deviation from the calculated emmetropic lens did not reduce postoperative refractive error. PMID- 3632413 TI - Laser photocoagulation in the acute retinal necrosis syndrome. AB - Acute retinal necrosis (ARN) is a syndrome of fulminant necrotizing vaso occlusive retinitis associated with a high incidence of retinal detachment due to retinal breaks and vitreous traction. We performed argon or krypton laser photo coagulation to demarcate areas of active retinitis as prophylaxis against retinal detachment in five patients with ARN. Patients were concomitantly treated with antiviral agents, systemic steroids, and antiplatelet therapy. One patient required multiple additional treatments as retinal necrosis progressed. The retinas remained attached in all five patients over a mean follow-up period of 15 months. By creating a chorioretinal adhesion in areas of potential retinal break formation, laser photocoagulation may be an effective prophylaxis against retinal detachment in ARN. PMID- 3632414 TI - A case-control study of risk factors in open angle glaucoma. AB - In a case-control study using an exploratory health questionnaire, we examined the relationship between primary open angle glaucoma (POAG) and a variety of personal characteristics and potential toxic exposures in patients in a general eye service. There were 83 patients with definite POAG, 121 POAG suspects, and 237 controls. Using multiple logistic regression analysis for simultaneous evaluation of potential risk factors, we found that black race (rate ratio = 6.8; 95% confidence interval [CI] = 2.8 to 16.0) and untreated systolic hypertension (rate ratio = 5.8; 95% CI = 2.2 to 15) were the most important risk factors. Current cigarette smoking was also associated with glaucoma (rate ratio = 2.9; 95% CI = 1.3 to 6.6). Suggestive associations were found with family history of glaucoma, definite or borderline diabetes, and myopia. The effects of many of these personal characteristics and exposures as risk factors were also noted for the glaucoma suspect group, though not as strongly as for the definite glaucoma cases. PMID- 3632415 TI - Self-tonometry to manage patients with glaucoma and apparently controlled intraocular pressure. AB - We tested a self-tonometer than can be used by the patient alone to monitor intraocular pressure (IOP) in a normal environment. The instrument is safely and easily used after training. Normal subjects and patients with glaucoma who had an IOP of 22 mm Hg or less at three consecutive visits were referred for diurnal monitoring. After successful training, they received a self-tonometer and instructions to obtain five measurements daily between awakening and bedtime for three to six days. More than half the patients had one or more readings above 22 mm Hg. About half of the IOP peaks occurred at times outside of normal office hours. Interestingly, more elevated IOP readings were recorded in patients with suspected or documented progression of glaucomatous damage than in patients thought to be stable or in normal subjects. In eyes that have already sustained glaucomatous damage, the progression may be explained by the presence of previously undocumented IOP peaks. Valuable additional clinical information can be gained by diurnal IOP monitoring, and the self-tonometer is a practical tool for its measurement. PMID- 3632416 TI - Preclinical diagnosis of pseudoexfoliation syndrome. AB - Although the diagnosis of pseudoexfoliation syndrome (PXS) is made by observation of pseudoexfoliation material (PXM) deposited on the anterior lens capsule, there are several additional signs related to pigment dispersion that are often present both in eyes with PXS and fellow eyes in unilateral cases. On the basis of the presence of these signs, we have categorized a group of patients as "pseudoexfoliation suspects" who demonstrated no evidence of PXM on the lens capsule in either eye. As PXM has previously been identified in the conjunctiva of affected eyes as well as fellow eyes in unilateral cases, we hypothesized that it could also be present in PXS suspect eyes. Inferior bulbar conjunctival biopsies were performed on four eyes with PXS, five fellow eyes, and 23 PXS suspect eyes, and specimens were examined by transmission electron microscopy. In eight PXS suspect eyes biopsy specimens demonstrated PXM, suggesting that PXS is more prevalent and possibly responsible for a greater proportion of glaucoma than previously suspected. PMID- 3632417 TI - A longitudinal study of the age-adjusted variability of automated visual fields. AB - Twenty-six normal eyes of 26 subjects were tested three times during an 18-month period using the 30-2 program of the Humphrey Visual Field Analyzer (Humphrey Instruments, San Leandro, Calif). For the average eye, the SD of threshold values over time ranged from 1.8 to 5.5 dB, depending on the location in the field. For those subjects under 60 years of age, SDs ranged from 1.2 to 2.8 dB. For those subjects 60 years of age and older, the range was 2.2 to 8.3 dB. Short-term fluctuations contributed 25% of the variability of threshold measurements over time. Short-term and long-term variations were greater in older eyes, but long term variability was more affected by age than was short-term variation. PMID- 3632419 TI - Where is the gray line? AB - The gray line is a well-known surface anatomic landmark used by surgeons in the repair of lacerations involving the lid margin. To the best of our knowledge, no description of any deep or superficial anatomic counterpart of the gray line has been previously reported. We examined block resections of 51 eyelids histologically following localization of the gray line. The visualized gray line was consistently seen to correspond histologically to the most superficial portion of the orbicularis muscle, known as the muscle of Riolan. We comment on changes in gray line morphology with lid movement, and we advance a hypothesis to explain its "gray" color. PMID- 3632418 TI - Neodymium-YAG laser vitreolysis in sickle cell retinopathy. AB - Six patients with proliferative sickle cell retinopathy and vitreous bands were treated with the neodymium-YAG (Nd-YAG) laser to accomplish lysis of avascular traction bands or to clear the media in front of the macula. Transection of bands was possible in five of the six cases but in two of these the effect was only partial. Three cases were satisfactorily treated with the Nd-YAG laser application alone, two eventually required conventional vitreoretinal surgery, and one patient's condition stabilized despite failure of the treatment. Complications from the treatment occurred in three cases and included subretinal (choroidal) hemorrhage, preretinal hemorrhage, microperforation of a retinal vein, and focal areas of damage to the retinal pigment epithelium. Neodymium-YAG vitreolysis may be a useful modality in carefully selected patients with proliferative sickle cell retinopathy, but potentially sight-threatening complications may occur. PMID- 3632420 TI - Ophthalmologic findings in the fragile X syndrome. AB - The fragile X (Fra[X]) syndrome is a commonly encountered X-linked recessive chromosomal disorder associated with mental retardation that primarily affects males. The demonstration of a fragile site in the long arm of the X chromosome (Xq27-28) through special culture techniques confirms the diagnosis. Phenotypic features are often lacking, especially in early life. We studied the ophthalmologic and clinical characteristics of 15 patients (13 male and two female) with the Fra(X) syndrome and reviewed the clinical picture of the disorder. Strabismus was the most prevalent ophthalmologic abnormality and was observed in six patients. The frequent occurrence of strabismus in our series suggests that it is a commonly associated abnormality. It is recommended that the Fra(X) syndrome be added to the list of genetic and dysmorphic disorders with which strabismus is frequently associated. PMID- 3632421 TI - Hemangiopericytoma of the orbit treated with conservative surgery and radiotherapy. AB - A 23-year-old man had two recurrences following local excision of a hemangiopericytoma of the right orbit. A third local excision was followed by a course of postoperative radiation therapy (64.8 Gy [6480 rad] in 36 treatments). Seven and a half years following therapy, the patient is disease free and has experienced no side effects. PMID- 3632422 TI - A new method for vascular occlusion. Photochemical initiation of thrombosis. AB - A new photochemical method has been used to produce focal thrombosis and occlusion of the blood vessels on the surface of the myelin wings of rabbit retinas. Following intravenous injection of rose bengal, the vessels next to the disc on the nasal wing were exposed to filtered light (550 nm, the absorption maximum of rose bengal) for four minutes. As a control, the vessels on the temporal wing of each rabbit eye were exposed to filtered light for four minutes before the injection of rose bengal. Complete vascular occlusion was produced on the nasal wing in all eyes, with no visible alterations on the temporal wing. Progressive reopening of the arteries on the nasal wing was observed at three days, with reopening of the veins visible by seven days. Reperfusion of capillaries had occurred by 21 days. Light and electron microscopic examination of blood vessels on the nasal wing after light exposure with rose bengal showed disrupted endothelial cells in all exposed blood vessels and platelet aggregates in the arteries and arterioles. No morphologic abnormalities were observed in the temporal wings. This method should be useful in studying the effects of vascular occlusion in the retina and could lead to a new treatment modality for subretinal, iris, or corneal neovascularization. PMID- 3632423 TI - Laboratory evaluation of freeze vs nonfreeze lamellar refractive keratoplasty. AB - Four pairs of human eyes were operated on to correct 10 diopters of myopia. One eye underwent standard myopic keratomileusis, and the mate underwent planar lamellar refractive keratoplasty (PLRK). Cryolathing produced morphologic alterations in all layers. Planar lamellar refractive keratoplasty produced a smoother stromal surface in the optic zone. Peripheral triangular surface depressions in the lenticule, corresponding to fixation facets on the PLRK unit, were the only morphologic alterations noted. It appears that PLRK eliminates many adverse features associated with tissue freezing and lyophilization. PMID- 3632424 TI - Unusual retinal tears in an amateur boxer. PMID- 3632425 TI - Obtaining fascia lata. AB - The surgical procedure for obtaining fascia lata can be easily carried out by the ophthalmic surgeon. However, anatomy related to obtaining the tissue, as outlined in standard surgical textbooks, is not entirely accurate and should be clarified. The tissue necessary for strong frontalis slings should come from a thick band of fascia lata referred to as the "iliotibial tract." If one attempts to obtain fascia lata by directing a fascia stripper along an imaginary line directed from the head of the fibula to the anterior iliac spine, as suggested in most textbooks, an inadequate specimen may be obtained. The iliotibial tract of fascia lata actually runs from the lateral tibial condyle to the iliac crest. The fascia stripper, therefore, needs to be directed along an imaginary line from the lateral tibial condyle to the iliac crest to obtain the strongest fascia lata and avoid transecting the longitudinal fibers. PMID- 3632426 TI - Confirmation of Kushner's method for augmented recessions of the medial recti. PMID- 3632427 TI - Photocoagulation for diabetic macular edema. PMID- 3632428 TI - Vitreous changes in retinal branch vein occlusion. PMID- 3632429 TI - Excimer laser lens ablation. PMID- 3632430 TI - Improvement of the blood-retinal barrier induced by bendazac lysine: preliminary clinical observation in insulin-dependent diabetics. PMID- 3632431 TI - Additional comments on the effect of triamcinolone injection. PMID- 3632432 TI - Silicone intraocular lenses during vitrectomy. PMID- 3632433 TI - Betaxolol and restrictive airway disease. Case report. PMID- 3632434 TI - Angioid streaks associated with abetalipoproteinemia. Case report. PMID- 3632435 TI - Edrophonium tonography in suspected ocular myasthenia. Case report. PMID- 3632436 TI - Subretinal fibrosis following cyclocryotherapy. Case report. PMID- 3632437 TI - Quinine-induced thrombocytopenia complicating eyelid surgery. Case report. PMID- 3632438 TI - Open angle glaucoma. Why not a cure? PMID- 3632439 TI - An update on the accreditation of graduate education in ophthalmology. The Residency Review Committee for Ophthalmology. AB - Educational standards for residency training in ophthalmology are established by a nine-member committee whose members represent the American Academy of Ophthalmology, the American Medical Association, and the American Board of Ophthalmology. Residency programs are reviewed to see that they meet these standards and are accredited if they do. Over the past 11 years, the accreditation status of a total of 445 programs was reviewed: 19 programs lost accreditation (nine withdrew voluntarily), 52 programs were placed on probation or were continued on probation, 310 programs were granted full accreditation or continued accreditation, and 15 of 20 applicants were granted provisional accreditation. During this time, the Residency Review Committee for Ophthalmology on two occasions modified the "Special Requirements for Residency Training in Ophthalmology." In addition, an appeals process was instituted by the Accreditation Council for Graduate Medical Education to give program directors the opportunity to appeal adverse accreditation decisions. There is evidence that this system has had an overall beneficial effect on residency training in ophthalmology in the United States. PMID- 3632440 TI - Scleral buckling with intraocular air injection complicated by arcuate retinal folds. AB - Three cases of bullous superior rhegmatogenous retinal detachment were surgically repaired by circumferential scleral buckling and intravitreal air injection. Unusual retinal folds were found postoperatively. Unlike the well-recognized radial retinal folds classically associated with circumferential buckling of bullous retinal detachments, the folds reported herein originated from the "end" of a hard silicone exoplant and traversed an arcuate course corresponding to the lower meniscus of the intravitreal air bubble. Although the macula was involved in all three cases, the retinal break was unaffected. PMID- 3632441 TI - Lack of evidence for aspirin use and prevention of cataracts. AB - A population-based cross-sectional survey of 838 men aged 30 years and over was conducted to examine the effect of aspirin, and other potential risk factors, on the prevalence of cataracts. Lens opacities were graded on clinical examination for location (cortical, nuclear, and posterior or subcapsular) and severity. The results do not support the claim that large doses of aspirin, or frequent use of aspirin, protects against or retards the growth of lens opacities. PMID- 3632442 TI - Macular geographic helicoid choroidopathy. AB - We treated eight patients who had lesions typical of geographic helicoid peripapillary choroidopathy (GHPC) (also called serpiginous choroidopathy or geographic choroiditis) initially affecting the macula. The lesions were similar in funduscopic and fluorescein angiographic appearance to lesions of GHPC, but they were located initially or exclusively in the macular region. The recurrent nature of these lesions (eventually involving the peripapillary retina in two eyes) and their association with GHPC lesions of the fellow eye in four patients suggest that this macular disease is a different manifestation of the same condition that usually starts adjacent to the optic nerve head. The causative agent was not identified. Prompt treatment of initial or recurrent acute disease with corticosteroid medication was associated with remission and preserved vision in all eight eyes so treated. PMID- 3632443 TI - High-speed photography of excimer laser ablation of the cornea. AB - We have used laser-based high-speed photography to investigate excimer laser ablation of the cornea. Photographs of the ablation plume were obtained 500 ns to 150 microseconds after incidence of a 193- or 248-nm excimer laser pulse on the surface of the cornea. Ejection of material from the cornea begins on a time scale of nanoseconds and continues for 5 to 15 microseconds following the excimer pulse. At 193 nm the ablation plume resembles a burst of smoke, and individual particles are too small to be optically resolved with our apparatus. At 248 nm the plume resembles a spray of larger, discrete droplets. Material is ejected from the cornea at supersonic velocity but decelerates rapidly; the velocity for the first 500 ns following the excimer pulse averages 400 m/s at 193 nm. Plume size and velocity increase with increasing fluence. PMID- 3632444 TI - Reduction of enucleation-induced metastasis in intraocular melanoma by periorbital irradiation. AB - The optimum treatment of malignant choroidal melanoma remains controversial. Some authors have hypothesized that enucleation promotes metastatic disease. This hypothesis has been demonstrated in the B16F10 melanoma mouse model. The present study used this model to examine the effect of external beam irradiation as a means of reducing metastases induced by enucleation. The results show a dose dependent reduction in the DNA synthesis of irradiated melanoma cells. Administration of 800 cGy (800 rad) of radiation produced a 90% reduction in DNA synthesis; however, higher levels of radiation failed to produce further depression of cell proliferation. Irradiation of melanoma cells before intravenous injection resulted in a significant dose-dependent reduction in the number of lung metastases. While there was no effect with 100 cGy (100 rad) of radiation, 1000 cGy (1000 rad) produced a 95% reduction in metastases. In the animal model of enucleation-induced metastasis, 2000 cGy (2000 rad) delivered to the orbit either before or after enucleation produced a significant reduction in the number of lung tumors, compared with animals that did not undergo irradiation; 1000 cGy (1000 rad) delivered before enucleation did not have such an effect. These studies provide evidence that periorbital external beam irradiation is useful in reducing metastases following enucleation of a malignant melanoma in this animal model. PMID- 3632445 TI - Experimental doxorubicin myopathy. A permanent treatment for eyelid spasms? AB - Doxorubicin may effect a more permanent chemomyectomy and chemodenervation (by retrograde "suicide transport") of the orbicularis oculi muscle than the chemodenervation produced by botulinum A toxin used for the treatment of blepharospasm. Graded doses (0.4 mg and 1.0 mg) of doxorubicin hydrochloride (2 mg/mL) were injected into the eyelids and antecubital and popliteal skin of rabbits in an attempt to evaluate the drug's efficacy and safety. Histologic changes in the orbicularis oculi muscle included necrosis and decreased mass. The results are promising because the eyelids appear to be more resistant than other skin regions to the development of tissue necrosis. Moreover, doxorubicin might not be excessively toxic in the treatment of eyelid cancer. PMID- 3632446 TI - Effect of silicone oil on experimental traction retinal detachment. AB - The use of silicone oil as a retinal tamponade in the treatment of proliferative vitreoretinopathy is often complicated by membrane reproliferation. We studied the development of traction retinal detachments following the intravitreal injection of 15,000 retinal pigment epithelial cells in silicone-, perfluoropropane-, and fluid-filled rabbit eyes. By 28 days a higher proportion of silicone-filled eyes (83%) had severe proliferative vitreoretinopathy than either the perfluoropropane-filled (30%) or fluid-filled (10%) eyes. An in vitro proliferation assay using the vitreous samples showed that the silicone-filled vitreous had increased mitogenic activity for retinal pigment epithelial cells compared with the gas-filled or fluid-filled vitreous. Silicone oil appears to increase proliferation by stimulating the release of more or different mitogenic factors as well as by concentrating active factors into a smaller volume near the retina. PMID- 3632447 TI - Phorbol ester-induced orbital myositis. AB - A single injection of TPA (12-0-tetradecanoyl-phorbol-13-acetate) into the superior rectus muscle of New Zealand white rabbits produced inflammation and edema, followed by fibrosis and muscle restriction. Strain gauge measurements showed a 60% increase in muscle restriction at 24 hours and an increase greater than 400% at 12 weeks. Clinical and histologic characteristics paralleled those of human idiopathic orbital myositis and thyroid orbital myopathy. The combination of initial muscular inflammation and enlargement, subsequent fibrosis and restricted extraocular motility, and histologic evidence of these changes creates a useful model of orbital myositis. PMID- 3632448 TI - A simple procedure for adjusting eyelid position after aponeurotic ptosis surgery. AB - An aponeurotic approach to ptosis surgery elevates the eyelid without sacrificing the elevating and supporting structures or the tear-producing glands. With this preservation of normal anatomy, reoperation by the technique described herein for the adjustment of overcorrections or undercorrections and contour abnormalities is simple to carry out in the first three weeks after surgery and has yielded good to excellent results in 32 of 34 patients. PMID- 3632449 TI - New instrumentation and technique for epiretinal surgery. AB - A multifunctional probe for vitreous surgery, which combines fiberoptic endoillumination, microforceps, bipolar diathermy, and infusion/aspiration, has allowed the development of an original technique for the peeling of very adherent preretinal membranes. PMID- 3632450 TI - Effects of ethanol, caffeine and nicotine on conflict behavior established under an operant situation in mice. PMID- 3632451 TI - [A study on drinking by young employed men]. PMID- 3632452 TI - [A case of caffeine dependence]. PMID- 3632453 TI - [Research on the drinking pattern of the residents of Old Tokyo City in comparison with the metropolitan area]. PMID- 3632454 TI - [Recent advances in alcoholism treatment in the United States]. PMID- 3632455 TI - [Present status of drug abuse in the United States]. PMID- 3632456 TI - [Characteristics of female alcoholics in T prefecture]. PMID- 3632457 TI - Diabetes mellitus and pregnancy: management simplified by a computer assisted home glucose meter and measurement of glycosylated protein. PMID- 3632458 TI - Fetal heart rate response to scalp stimulation as a test of fetal well-being in labour. PMID- 3632459 TI - Delivery following removal and chemotherapy of ovarian endodermal sinus tumor. PMID- 3632460 TI - The effect of epidural analgesia on labour and delivery in Chinese women: a preliminary experience. PMID- 3632461 TI - Cardiac failure associated with the use of salbutamol for inhibition of premature labour. PMID- 3632462 TI - Variants of 61 cases with gonadal dysgenesis. PMID- 3632463 TI - Catheterization of urinary bladder before major gynaecological surgery. PMID- 3632464 TI - Cystic hygroma presenting as a case of shoulder dystocia in labour. PMID- 3632465 TI - Hydatidiform mole: patient profile and the impact of prophylactic chemotherapy at the Philippine General Hospital, 1975-1983. PMID- 3632466 TI - Pregnancy after intra-uterine insemination of washed motile fraction sperm: a case report. PMID- 3632467 TI - Studies on diagnostic criteria for gestational diabetes mellitus by 75 g glucose tolerance test. PMID- 3632468 TI - A comparative study of intrauterine fetal resuscitation by beta-stimulant and O2 inhalation. PMID- 3632469 TI - Tubal pregnancy following laparoscopic sterilisation. PMID- 3632470 TI - Intrauterine growth retardation: a comparative study of the perinatal outcome. PMID- 3632471 TI - Scanning electron microscopy of the human endometrium in pill users. PMID- 3632472 TI - Properties of ectopic proteins synthesis in vitro by human cervical carcinoma cells. PMID- 3632473 TI - Effect of a calcium antagonist (ICI 109,081) upon follicular steroidogenesis and oocyte maturation in the golden hamster. PMID- 3632474 TI - Catecholamine concentrations of fetal blood and amniotic fluid during labor. PMID- 3632475 TI - Screening tympanometry: criteria for medical referral. AB - Tympanograms were obtained from normal preschool and adult subjects with a prototype hand-held tympanometer to obtain normative values for four tympanometric variables: static admittance, equivalent ear canal volume, tympanometric peak pressure, and gradient. Effects of age group, sex, and pump speed (200 or 400 daPa/s) were determined. The results were incorporated into a four-part screening protocol (history, visual inspection, audiometry, and tympanometry) designed to reduce the excessive error rates associated with screening strategies that rely exclusively on tympanometry. PMID- 3632476 TI - Audiologic diagnosis of central versus eighth nerve and cochlear auditory impairment. AB - 122 subjects divided into four groups according to the site of lesion (cochlea, eighth nerve, brainstem and temporal lobe) were subjected to an audiometric test battery, including pure-tone sensitivity measures, recruitment testing, tone decay, Bekesy audiometry, speech audiometry, stapedius reflex measures and auditory brainstem response (ABR) audiometry. The results were contrasted among the four groups by calculating several measures of test performance, including sensitivity, specificity, efficiency, A' (test performance) and plots on the receiver operating characteristic (ROC) space of pure positives versus false alarms. In the differential diagnosis between eighth nerve and cochlear site, the various measures did not rank the tests in the same order: (a) for efficiency: ABR, Bekesy audiometry; (b) for A' (similarly to the analysis into the ROC space): ABR, recruitment, Bekesy, stapedius reflex, speech audiometry, tone decay. In distinguishing an eighth nerve from a brainstem site, it is important to consider amount of hearing loss, presence of tinnitus, abnormal tone decay and Bekesy audiometry patterns. ABR adds significant diagnostic efficiency only when waves II, III and V are detectable: a prolonged I-II interpeak interval (IPI) and a normal III-V IPI are characteristic of the eighth nerve site. ABR gives good diagnostic support in the intrinsic brainstem lesions by suggesting changes in the generator sites of the component waves. The audiometric diagnosis of temporal lobe lesions involving the auditory cortex still relies upon speech audiometry: tests specifically designed for this purpose by Bocca and Calearo and by Jerger - i.e. the 'sensitized sentences' and the identification of synthetic sentences under ipsi- or contralateral competing message - are commendable for their sensitivity and efficiency in distinguishing brainstem from temporal lobe sites. In brainstem sites, the most affected ear is ipsilateral to the lesion for ABR, but contralateral for speech audiometry. PMID- 3632477 TI - Effects of three contralateral maskers on pure-tone thresholds using manual audiometry. AB - This study investigated how central masking associated with low-level maskers would affect thresholds obtained using a standard clinical technique. Signals included 500, 1,000, 2,000, and 4,000 Hz; maskers, presented at 40 dB SL, consisted of (a) a wideband masker (WBM), (b) a narrow-band masker (NBM) centered about each signal frequency, and (c) a pure-tone masker (PTM) identical to each signal. Only the PTMs caused significant threshold shifts, that is, poorer masked thresholds. The WBM and NBMs caused no shift 60% of the time and a 5-dB threshold improvement 16% of the time. The findings weigh against the clinical use of a central-masking correction when a low-level WMB or NBM is used. PMID- 3632478 TI - Speech recognition in noise and reverberation by school-age children. AB - The present study examined the effects of noise (S/N ratio = +2 and +6 dB) and reverberation time (Rt = 0.0 and 0.8 s) on monaural speech recognition in normal hearing school-age children (aged 8-10 years) using sentence materials. Our data confirm the results of other studies which suggest that the typical acoustic conditions existing in classrooms do not permit adequate speech recognition. The introduction of a typical level of classroom reverberation significantly reduced speech recognition in both levels of noise. These results have implications regarding the clinical assessment of communicative function in hearing-impaired children. PMID- 3632479 TI - Three-channel Lissajous trajectories of auditory brainstem-evoked potentials in patients with neurological lesions affecting the brainstem: preliminary impressions. AB - Three-channel Lissajous trajectories (3CLT), as well as vertex-mastoid records of auditory brainstem-evoked potentials (ABEP) were obtained from 12 patients with neurological lesions localized to the auditory nerve, the medulla, the pons, the pons and midbrain and the midbrain. Patients selected had well-localized lesions at the levels of the presumed generators of ABEP (10 patients), as well as below (1 patient) and above (1 patient) those levels. The 3CLT measures used were trajectory amplitude, peak latency and amplitude, planar segment number, apex latency, duration, orientation in voltage space, as well as size and shape. Latencies and amplitudes of vertex-positive peaks I-V, as well as interpeak latency differences, were determined. Vertex-mastoid ABEP and 3CLT were compared in terms of their sensitivity to the existence of a lesion, the accuracy of lesion localization as well as their specificity to the lesion. 3CLT had an advantage in all three comparisons, with the most prominent advantage in specificity, which was over twice as high as that of single-channel ABEP. The results of this preliminary study indicate that 3CLT affords a sensitive analysis of ABEP, which is superior to single-channel analysis in sensitivity, accuracy and specificity. These results also indicate that the 'contralateral effect' of peak V latency prolongation in cerebellopontine angle tumors may be related to anatomical changes of its generators' orientation, rather than slowed conduction along the upper brainstem. PMID- 3632480 TI - Bilaminar structure of the developing stapedial footplate in the mouse--a histological study using a light microscope. AB - Normal development of the stapes, especially the bilaminar structure of the footplate, in the mouse was investigated histologically. On day 14 of pregnancy, the footplate had an easily distinguishable lamina consisting of two layers. This bilaminar structure was seen clearly as a pale and loose portion composed of mesenchymal cells in the vestibular side adjacent to the original footplate in the stapedial ring. The authors considered this structure to be the same structure as the lamina stapedialis in the developing human stapes. A dualistic theory of the developmental origin of the footplate in the mouse is proposed. PMID- 3632481 TI - Positional nystagmus of benign paroxysmal type (BPPN) due to cerebellar vermis lesions. Pseudo-BPPN. AB - Positioning nystagmus accompanied by severe vertigo had been reported in patients with partial lesions of the inner ear, especially otolith lesions. Typically this type of nystagmus represents a latent period and subsequent fatiguability. We concur with this finding and have constantly emphasized the significance of this phenomenon in clinical diagnosis. Since we started to use CT-scanning, this type of nystagmus has been noted in 20 patients, all of whom had cerebellar vermis lesions. Attention should be focused on this association. A simple coincidence could not be excluded if such a combination were seen in only 1 or 2 patients, it could be attributed to simple coincidence. But its occurrence in as many as 20 patients a causal role of cerebellar vermis lesions. Its mechanism may be explained by incomplete inhibition of the vestibulo-oculomotor system including the cerebellar flocculonodular lobe or vestiburo-cerebellum. PMID- 3632482 TI - The experience of otolaryngological practice on neurological patients. AB - This paper summarizes the experiences of three years of otolaryngological practice at the Tokyo Metropolitan Neurological Hospital. Almost 30% of the patients treated were bedridden, necessitating otolaryngologists' ward visits. Neuro-otological examinations, other otolaryngological examinations and surgical treatments were accomplished. Neurology, neurosurgery and pediatric neurology have different purposes with regard to otolaryngological consultations. This study indicates that those varied demands are a problem in conducting effective otolaryngological practice. The study concluded that otolaryngologists could play a more important role in the diagnosis and treatment of patients with diseases of the central nervous system. PMID- 3632483 TI - The adrenaline contraction test with rhinomanometry. AB - The relationship between the sensation of nasal obstruction as a subjective symptom and nasal resistance was examined, and the adrenaline contraction test combined with rhinomanometry was evaluated. The nasal resistance was determined by the oscillation method using a rhinomanometry. As the sensation of nasal obstruction advanced, the nasal resistance tended to be increased. The group with a (-) sensation of nasal obstruction included patients with a high nasal resistance who corrected their first statement to a (+) sensation as a result of the adrenaline contraction test. The test indicated the sensation of nasal obstruction more accurately. In the 26 patients who underwent septoplasty and conchotomy, the rate of change in BNR by the adrenaline contraction test was 30 40%. The eight patients whose preoperative rate was less than 20% all showed a rate of more than 40% in unilateral rhinomanometry. Indications of reconstructive surgery for nasal obstruction may be present if the rate of change in BNR is 30 40% or the rate of change in unilateral rhinomanometry is more than 40%. Since the test predicted the postoperative nasal resistance, it can also be used in evaluating the results of surgical therapy. PMID- 3632484 TI - Simultaneous pleomorphic adenomas of the right parotid and ipsilateral submandibular glands. AB - A case of simultaneous pleomorphic adenomas of the right parotid and ipsilateral submandibular glands was reported. The patient was a 68-year-old woman who had a ten-year history of an otherwise asymptomatic non-enlarging mass in the parotid gland and a slowly enlarging mass in the submandibular gland. Microscopically, the parotid tumor consisted of predominant spindle-shaped cell proliferations with myxoid stroma in places. The submandibular gland tumor showed tubular and trabecular formations with stroma consisting of hyalinized fibrous connective tissues. Simultaneous pleomorphic adenomas in the salivary glands are so rare that only 23 cases can be found in the literature. Additionally, only five tumors occurring simultaneously in the parotid and submandibular glands are reported in the literature. Our case seems to be the sixth of simultaneous pleomorphic adenomas of the parotid and submandibular glands. PMID- 3632485 TI - Thyroidectomy and neck dissection for the carcinoma of the thyroid gland in children. AB - A peculiarity in thyroid cancer in children is discussed in terms of clinical course and pathology. A case report of well differentiated papillary carcinoma of the thyroid gland in a 6-year-old boy is presented, with emphasis on the clinical course and pathology. The clinical course indicated a slowly growing, firm tumor lateral to the superior cornu of the thyroid cartilage, up to the hyoid bone. As treatment of the tumor and its lymph node metastases, a hemithyroidectomy with simple neck dissection was performed. Thyroid hormone was administered for suppression of endogenous thyroid-stimulating hormone postoperatively, and the patient tolerated this therapy well. An review of the literature dealing with the question of whether or not a radical neck dissection is appropriate in thyroid cancer in children was carried out. PMID- 3632486 TI - Surgical approach to hearing improvement in the radically operated ear. AB - Our method of improving hearing in patients with old radical cavity is presented. Tympanoplasty is generally indicated for cases of persistent aural discharge with no severe tubal dysfunction. A preserved homologous septal cartilage plate was used to reconstruct the aerated tympanic cavity and to hold the columella material. For cases with insufficient opening of the eustachian tube, planned staged operations were performed following reopening of the tube and insertion of the protuberance part of a silicone plate. Functional results were satisfactory in 12 cases followed up for longer than 2 years (success rate in 80% of the modified type III and in 57% of modified type IV procedure). PMID- 3632487 TI - Mycotic abortion in cattle. AB - Placentas and foetuses from 1107 bovine abortions were examined and a fungal infection was diagnosed in 131 instances. Fungi seen in silver impregnated sections of tissues could be placed into 3 categories designated aspergillus, phycomycete and atypical. Culture indicated that the first 2 of these categories were due to Aspergillus sp and Mortierella wolfii respectively. The infections in the atypical category are probably also due to Aspergillus sp. Gross or microscopic examination or culture of the placenta were valuable diagnostically but examination of the foetus was seldom of value as infection in most instances did not involve foetal tissues. Questionnaires indicated that many M. wolfii abortions were associated with the feeding of poorly prepared or stored grass silage. As the majority of cattle are fed hay or silage, no association could be demonstrated between Aspergillus sp abortion and these feeds. Fertility following fungal abortion was apparently unimpaired. PMID- 3632488 TI - Foetal and calf wastage in Bos indicus cross beef genotypes. AB - The prevalence, stages and causes of foetal and calf wastage were determined in Brahman (1/2 B, 3/4 B) and Sahiwal (1/2 Sah, 3/4 Sah) and high grade Sahiwal (HGSah) genotypes over a 12-year period. The mean total loss from pregnancy being first diagnosed to weaning was 13.5% (range 9.4 to 19.0%) and was not influenced by cow age. Across all age groups total losses were significantly lower in 1/2 B (11.8%) and 3/4 B (11.7%) than in 1/2 Sah (16.3%) and 3/4 Sah (19.4%) which were in turn significantly lower than in HG Sah (26.5%). Mean prenatal, perinatal and postnatal losses were 3.5%, 4.4% and 5.6%, respectively. For prenatal losses, 42.4% occurred in early-, 34.8% in mid- and 23.0% in late gestation, the prevalence being influenced only by year effects. Perinatal losses were lowest in 3/4 B (2.9%) and highest in 3/4 Sah (8.3%) with other genotypes intermediate. Postnatal losses were lowest in 1/2 B (4.1%) and 3/4 B (5.0%), intermediate for 1/2 Sah (7.2%) and 3/4 Sah (6.2%) and highest in HG Sah (15.5%). In Brahmans, important causes of perinatal and postnatal losses were from unknown causes, and in Sahiwals from bottle teats, unknown causes and factors influenced by the cow. Bottle teats were mostly in cows older than 2 years with the majority being in Sahiwals. A high proportion (44%) of the postnatal losses occurred by 14 days after birth. PMID- 3632489 TI - Infestation in the dog by the paralysis tick Ixodes holocyclus. 1. Clinical and histological findings. AB - Under laboratory conditions 8 dogs were infested with Ixodes holocyclus and the clinical signs and histological findings were recorded. Seven of the dogs developed clinical signs of the disease, died and were subjected to a post-mortem examination, while the eighth dog remained normal. The clinical signs were consistent between animals and enabled the course of the disease to be subdivided into 5 stages to facilitate analysis of data in future experiments. The most prominent feature of the disease was dysfunction of the efferent motor system although some disturbance of the afferent pathways and involvement of the autonomic nervous system did occur. The period elapsing between attachment of the ticks and onset of signs varied from 5.5 to 7 days, while the mean duration of the disease was 23.3 h. The histopathology demonstrated moderate to severe congestion of the liver, kidney and lungs, and in some lung sections pulmonary oedema was present. PMID- 3632490 TI - Infestation in the dog by the paralysis tick Ixodes holocyclus. 3. Respiratory effects. AB - To assess respiratory function in dogs with tick paralysis, respiratory measurements were recorded on 14 dogs experimentally infested with Ixodes holocyclus. There was a progressive fall in respiratory rate with no change in tidal volume, which resulted in a significant fall in minute respiratory volume in the latter stages of the disease. The fall in respiratory rate was possibly central in origin and was accompanied by an increased alveolar-arterial oxygen tension difference, probably caused by pulmonary congestion and oedema. The "grunting" respiration seen in tick paralysis was due to closure of the vocal cords during expiration and could represent an attempt to re-expand collapsed parts of the lung. PMID- 3632492 TI - Control of the scientific use of animals in Victoria. PMID- 3632491 TI - Dieldrin toxicity in housed merino sheep. AB - An outbreak of nervous disease with deaths and reproductive failure was investigated in a fully housed flock of 640 super fine wool (Sharlea) Merino sheep. During the 4 months after the flock was dipped in dieldrin, 70 adult sheep died and no live lambs were produced by the ewes. The diagnosis of poisoning with dieldrin was based upon the presence of characteristic clinical signs, pathological findings and the detection of residues of dieldrin in tissues. Deficiency of vitamin A was confirmed in 2 sheep and may have contributed to the reproductive failure. PMID- 3632493 TI - Chronic nephritis in a horse. AB - An 11 year old Anglo-Arabian mare was presented with a five month history of gradual weight loss and inappetence. On physical examination the mare was in fair body condition with no localising signs of illness. Persistently elevated blood urea nitrogen and isothenuria indicated the presence of primary renal failure. At necropsy both kidneys were shrunken and contracted. Histopathology revealed lesions consistent with end stage renal disease which were characterised by severe and diffuse interstitial fibrosis. PMID- 3632494 TI - Suppurative splenitis and peritonitis in a horse after gastric ulceration caused by larvae of Gasterophilus intestinalis. AB - A 12-year-old Thoroughbred mare, with a history of anorexia, dramatic weight loss, fluctuating pyrexia and intermittent diarrhoea after an episode of colic, was presented for examination with depression, emaciation and ataxia. Thoracic and abdominal paracenteses yielded copious quantities of inflammatory exudate. Palpation per rectum revealed an enlarged spleen. The primary alterations in haematology included a severe leucocytosis with a left shift, and a hyperproteinaemia characterised by hypoalbuminaemia and hypergammaglobulinaemia. Post-mortem examination revealed a low grade pleurisy and peritonitis with fluid accumulation in both cavities. A suppurative gastritis with full thickness perforations of the stomach wall associated with Gasterophilus intestinalis larvae had extended to the juxtaposed organ initiating an extensive suppurative splenitis. Streptococcus zooepidemicus was cultured. PMID- 3632495 TI - A comparison of a Chinese and an Australian strain of bovine ephemeral fever virus. PMID- 3632496 TI - Treatment of trichomoniasis. PMID- 3632497 TI - An outbreak of mycotic dermatitis in goat kids. PMID- 3632498 TI - Pyrrolizidine alkaloid poisoning of sheep in New South Wales. AB - Pyrrolizidine alkaloid poisoning of sheep in New South Wales was reviewed, based on the records of the New South Wales Department of Agriculture's Regional Veterinary Laboratories. The plant species causing significant mortalities were Echium plantagineum and Heliotropium europaeum. The syndrome of hepatogenous chronic copper poisoning was more frequently diagnosed than primary pyrrolizidine alkaloid poisoning, particularly when grazing E. plantagineum. The data indicated that adult crossbred ewes were the most commonly affected class of sheep. PMID- 3632499 TI - A comparison of nematode control programs for cattle in south western Victoria. AB - Nematodiasis and its subsequent effect on production in Hereford weaner steers in western Victoria was studied during 1983 and 1984. In the first summer, steers were allocated to 2 replicates of 6 treatments--No treatment (Nil); Morantel slow release bolus in March (M1); Morantel bolus in March and June (M2); pour-on levamisole in January, May and July (R3); albendazole in January and July (V2) and albendazole in January, May and July, (V3). In 1984, treatment M2 was discontinued to provide extra replicates for Nil and M1. The replicate paddocks were 5 ha and were stocked with 7 and 8 steers in 1983 and 1984, respectively. Nematode egg counts in faeces, were generally less than 50 epg, indicating low numbers of adult nematodes. Faecal egg counts were highest in autumn and declined during the year. There was a significant (P = 0.02) effect of treatment on mean faecal egg count. Mean egg counts for treatment groups Nil and M1 were 16 and 10 epg above the overall mean (47 epg); those of the other treatments were 6 to 12 epg below the mean. There were no significant (P = 0.8) differences between treatments in the numbers of nematode larvae on pasture, during the experiment. At the end of both years of the experiment most nematodes (92%) were early fourth stage larvae of O. ostertagi. There were no consistent differences in nematode counts between treatments. There were no significant (P = 0.33) differences between treatments in bodyweights at any time during the experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632500 TI - Crystal-associated cholangiohepatopathy and photosensitisation in lambs. AB - Four outbreaks of hepatogenous photosensitisation occurred in weaned lambs in north eastern Victoria during the summers of 1985 and 1986. Attack rates varied between 7% and 43% and case fatality rates between 60% and 71%. Clinical signs included photosensitisation and jaundice. Serum biochemistry suggested hepatobiliary and hepatoparenchymal damage with impaired renal function. At necropsy livers were an ochre colour and kidneys a mottled brown to khaki. Histopathologically, needle-shaped to lenticular clefts were observed in and around bile ducts and in hepatocytes, hepatic sinusoidal macrophages and renal tubules. Optically active rhomboidal crystals were present in bile sediments. Panicum schinzii was identified as a possible cause in 2 of the 4 outbreaks. The clinical disease was reproduced in 2 of 6 lambs grazed on a toxic paddock. The disease was indistinguishable from geeldikkop except for the fact that Tribulus terrestris was not present on any of the 4 farms. PMID- 3632501 TI - Revised post-mortem inspection procedures for cattle and pigs slaughtered at Australian abattoirs. AB - Revised procedures for the post-mortem inspection of cattle and pigs at Australian abattoirs were developed as minimum national requirements. Comparative trials of current and revised procedures were conducted at 3 and 4 Australian abattoirs for pigs and cattle respectively. Residual pathological changes after inspection and removal of lesions from heads, carcases or viscera were recorded by an evaluation team with the data used to determine relative effectiveness. For cattle, there was no significant difference between current and revised procedures. Although it had been proposed to eliminate routine incision of cervical lymph nodes for pigs, it was found necessary to retain this procedure. The data also revealed a significant variation in detection of pathology between abattoirs for both species. Parasitic conditions accounted for the greatest proportion of undetected lesions in both species for both current and revised procedures. These comprised mainly fascioliasis in cattle and ascariasis in pigs. The former was associated with the study being conducted in eastern Australia. Chronic interstitial nephritis was also a common undetected lesion, reinforcing the need for intensified inspection of kidneys. However, such residual pathology was considered to be of only limited significance to human health. The revised procedures and findings are discussed in the context of animal and human health and of the importance of the meat industry to Australian exports. Some attention has been given to specific conditions likely to be affected by the proposals including tuberculosis, bovine cysticercosis, fascioliasis, porcine arthritis and salmonellosis. The role of meat inspection in monitoring for specific diseases is discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632502 TI - Survey of cats for Strongyloides felis. PMID- 3632503 TI - Factors affecting oestrus response and calving rates following 7-day intravaginal progesterone treatment of cattle. PMID- 3632504 TI - Electro-immobilisation. PMID- 3632505 TI - Response of sheep to short term restraint by electro-immobilisation. PMID- 3632506 TI - The physiological concept of stress is useful for assessing welfare. PMID- 3632507 TI - Zygomycosis in a tattoo, caused by Saksenaea vasiformis. PMID- 3632509 TI - Electron microscopic findings in ichthyosis secondary to sarcoidosis. PMID- 3632510 TI - Three cases of hypomelanosis of Ito. PMID- 3632508 TI - Anaphylaxis from topical neomycin and bacitracin. PMID- 3632511 TI - Contact photoallergy to musk ambrette. PMID- 3632512 TI - Allergic contact dermatitis to Helichrysum diosmifolium. PMID- 3632513 TI - Multifocal fibrosclerosis, cutaneous associations. PMID- 3632514 TI - Post steroid panniculitis. PMID- 3632515 TI - Norwegian scabies. PMID- 3632516 TI - Screening for haematinic deficiencies in patients with recurrent aphthous stomatitis. PMID- 3632517 TI - Early breast cancer. Mammography--the state of the art 1986. PMID- 3632518 TI - Early breast cancer--an overview of current and future directions. PMID- 3632519 TI - Conservative surgery and radiation therapy as treatment for patients with early breast cancer: treatment policy at the Harvard Joint Center for Radiation Therapy. PMID- 3632520 TI - Four unusual cases of spinal cord compression. PMID- 3632521 TI - Retropharyngeal calcific tendinitis. PMID- 3632522 TI - Round atelectasis. PMID- 3632523 TI - Evaluation of intracardiac and pericardial tumours with computed tomography. PMID- 3632524 TI - Gastro-oesophageal reflux: the role of imaging in diagnosis and management. PMID- 3632525 TI - Pseudo-tumours of the liver on computed tomographic (CT) scanning caused by adjacent ascitic or pleural fluid. PMID- 3632526 TI - Acute systemic reactions to intravascular contrast media--a planned approach. PMID- 3632528 TI - MRI of multiple limb abscesses in a child. PMID- 3632527 TI - Magnetic resonance imaging of aortic aneurysms with 3-D image reconstruction. PMID- 3632529 TI - Osteosclerotic metastasis from thyroid carcinoma. PMID- 3632530 TI - Specific landmarks on radiographs as diagnostic tools in determining hip diseases in the Cross River State of Nigeria. PMID- 3632531 TI - Large phalangeal exostosis in multiple cartilaginous exostoses (diaphyseal aclasia)--a case report. PMID- 3632532 TI - Retrospective cohort analysis of class A mishaps in aviators evaluated at USAFSAM: 1957-1984. AB - A retrospective analysis of Class A mishaps in all United States Air Force (USAF), Air National Guard (ANG), and Air Force Reserve (AFR) pilots (n = 5088) evaluated at the USAF School of Aerospace Medicine (USAFSAM) from 1957-84 was conducted to test whether the cohort career mishap experience differed significantly from the general USAF, AFR, and ANG pilot population. The analysis involved merging the USAFSAM Cover Sheet computer file with the Aircraft Accident Data System and Flight Record Data System maintained at the Air Force Inspection and Safety Center, Norton AFB, CA. A life table analysis compared observed cohort mishap accumulation over career flight hours with theoretical curves derived from USAF wide aircraft year-specific Class A mishap rates. The cohort experienced significantly fewer (p less than 0.005) mishaps over career flight hours in all major aircraft categories except trainers, in which the cohort experienced significantly more mishaps (p = 0.013). Areas for further analyses based on these preliminary findings are discussed. PMID- 3632533 TI - Scott Emergency Escape Breathing Device evaluation for use by aircraft cabin crew and passengers. AB - The Scott Emergency Escape Breathing Device (EEBD) was evaluated for use in Canadian Forces (CF) transport/passenger aircraft in providing smoke protection during emergencies and in preventing hypoxia during cabin decompression at high altitude. Five human subjects wearing the EEBD were subjected to decompression from 2,438 m (8,000 ft) to 9,753 m (32,000 ft) in approximately 15 s followed by a free fall to 7,010 m (23,000 ft) in a challenge gas atmosphere of 5,000 ppm of carbon monoxide (CO), where they performed moderate exercise (80 W output) on a bicycle ergometer. Very little in-leakage of CO was observed when the neck seal was maintained. Hood atmosphere was measured at 97% oxygen at 7,010 m, which resulted in an arterial oxygen saturation (SaO2) of 97%. Temperature in the hood rose to as high as 45.5 degrees C but the subjects were able to function normally. The EEBD is effective in providing noncockpit aircraft crew with smoke protection, adequate vision, and hypoxia prevention for at least 15 min in the event of a fire, smoke, or decompression emergencies at altitudes up to 7,010 m following a brief exposure to 9,753 m. PMID- 3632534 TI - Effects of hydraulic resistance circuit training on physical fitness components of potential relevance to +Gz tolerance. AB - Recent studies carried out in the United States and Sweden have demonstrated that strength training can improve +Gz acceleration tolerance. Based on these findings, the Canadian Forces have introduced a training program for aircrew of high performance aircraft. This report describes the changes in physical fitness components considered relevant to +Gz tolerance after 12 weeks of training with this program. Prior to beginning training, 45 military personnel were tested, but only 20 completed a minimum of 24 training sessions. The following variables were measured in these 20 subjects before and after training: maximal strength of several large muscle groups during isokinetic contractions, maximal aerobic power and an endurance fitness index, maximal anaerobic power, anthropometric characteristics, and maximal expiratory pressure generated during exhalation. Training involved hydraulic resistance circuit training 2-4 times/week. The circuit consisted of 3 consecutive sets at each of 8 stations using Hydra-Gym equipment. The exercise:rest ratio was 20:40 s for the initial 4 training weeks and was then changed to 30:50. After training the changes in anthropometric measurements suggested that lean body mass was increased. Small, but significant, increases were also measured in muscle strength during bench press, biceps curls, squats, knee extension, and knee flexion. Neither maximal anaerobic power (i.e. muscular endurance) nor maximal expiratory pressure were changed after the training. Indices of endurance fitness were also increased in the present study. The relatively small increases in strength are probably due to the design of the exercise:rest ratio which resulted in improved strength and aerobic fitness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632535 TI - Anaerobic energetics of the simulated aerial combat maneuver (SACM). AB - The role of anaerobic metabolism in +Gz duration tolerance was measured using venous blood lactate concentrations before G exposure and after subjects had been fatigued from exposure to one of several levels of G: low (4.5 G) sustained G (LSG); high (7-9 G) sustained G (HSG); and simulated aerial combat maneuver (SACM) of 4.5/7 G levels. A mean +/- S.E. blood lactate of six subjects fatigued from LSG was 29.8 +/- 4.0 mg%. Four subjects fatigued from HSG had blood lactates of 42.4 +/- 3.2 mg%, and six had blood lactates of 46.7 +/- 7.2 mg% from the SACM. Blood lactates appeared to correlate directly (on a group basis) with maximum heart rates found during G exposures. Six subjects exposed to 8 or 9 G for 10 s or less demonstrated an anaerobic alactate capacity. These G findings were related to fatigue produced with isometric muscle contraction in physiologic studies conducted at 1 G. We concluded that anaerobic metabolism and isometric exercise physiology are directly related to duration tolerances of fatigue at all levels of +Gz. PMID- 3632536 TI - Decrement in postural control during mild hypobaric hypoxia. AB - The effects of mild hypoxia on the postural control system of 39 naive subjects were examined by measuring the postural sway with a Kistler force platform, at ground level and at one of four simulated altitudes: 1,521 m (5,000 ft), 2,438 m (8,000 ft), 3,048 m (10,000 ft), or 3,658 m (12,000 ft). The total sway increased above the ground level controls for the 1,521 m, 2,438 m, and 3,048 m exposures (p less than or equal to 0.005) as did the sway at the lowest measurable frequency (p less than or equal to 0.002), but no change in sway was seen in those subjects exposed to 3,658 m as compared to ground level values. Significant interaction between altitude and exposure was observed at p less than or equal to 0.04, reflecting the definite effect at the lower altitudes and the lack of an effect at the higher altitude. The multiple comparison test indicated no difference between the responses at 1,524 m, 2,438 m, and 3,048 m. Both arterial oxygen saturation, SaO2, and the end-tidal oxygen partial pressure, PetO2, decreased in relation to the test altitudes with a statistically significant interaction between altitude and PetO2 (p less than or equal to 0.02), and SaO2 (p less than or equal to 0.005). There was no significant interaction between altitude and end-tidal carbon dioxide partial pressure (p = 0.4853). The postural control mechanisms, as an intergrative functional unit, are very sensitive to acute mild hypoxia. Arguments are advanced to indicate that intervention of compensatory mechanisms at higher altitudes may explain the recovery of postural stability at 3,658 m. PMID- 3632538 TI - Cigarette smoking, field-dependence and contrast sensitivity. AB - This study examined the separate and combined effects of cigarette smoking and field-dependence on contrast sensitivity. No previous research on these relationships exists; however, all three variables are known to be significantly related to many aspects of human performance. Under carefully controlled conditions, 12 smokers and 16 non-smokers were tested for field-dependence and measured for contrast sensitivity (Nicolet CS 2000 Testing System). No differences in contrast sensitivity of smokers were found when measured immediately after smoking 1 cigarette, as compared with having been deprived of smoking for at least 90 min. Habitual smoking and field-dependence were found to be separately and interactively related to contrast sensitivity. A field independent non-smoker group performed significantly better than a field dependent smoker group at all but the lowest spatial frequency. The results have important implications for many types of performance, particularly aircraft and motor vehicle operation, and may be valuable for use in selection and training. PMID- 3632537 TI - Treatment of severe motion sickness with antimotion sickness drug injections. AB - This report concerns the use of intramuscular injections of scopolamine, promethazine, and dramamine to treat severely motion sick individuals participating in parabolic flight experiments. The findings indicate that a majority of individuals received benefit from 50-mg injections of promethazine or 0.5mg-injections of scopolamine. By contrast, 50-mg injections of dramamine and 25-mg injections of promethazine were nonbeneficial. The use of antimotion drug injections for treating space motion sickness is discussed. PMID- 3632539 TI - Intensity judgments of vibrations in the Y axis, Z axis, and Y-plus-Z axes. AB - Seated subjects matched their perceptions of the intensity of Y-axis, Z-axis, or Y-plus-Z vibrations, by adjusting the intensity of a sinusoidal, 5-Hz, X-axis response vibration. Stimuli were sinusoidal at 3.2, 5, and 8 Hz. For each frequency there were six vibration conditions (Y axis alone, Z axis alone, or both axes together with 0 degrees, 90 degrees, 180 degrees, or 270 degrees phase angles between them) presented at each of two acceleration levels (0.15 and 0.25 G R.M.S.). Results showed that X-axis response accelerations for the dual-axis stimuli were greater than those for either one of their Y-axis or Z-axis components. This occurred for both acceleration levels and for all three frequencies. In addition, response acceleration was nearly constant for the dual axis stimuli regardless of the phase angle between their Y-axis and Z-axis components. Again, this was true for both acceleration levels and all three frequencies. These findings indicate that although dual-axis vibrations are judged to have greater subjective intensity than either of their single-axis components the phase relationship between those components appears to have no appreciable effect. PMID- 3632540 TI - Exercise-enhanced risk factors for coronary heart disease vs. age as criteria for mandatory retirement of healthy pilots. AB - Exercise-enhanced risk assessment for subsequent morbidity and mortality due to coronary heart disease is examined in 4105 asymptomatic healthy men of 15 to 80 years of age (mean of 44.7 years) observed in Seattle community practice. Annual incidence of primary coronary events averages 0.22% in 1792 men (43.6%) without conventional risk factors, and 0.42% in the majority of men (55.3%) with risk factor(s), but less than two abnormal responses to maximal exercise. Among 44 men (1.1%) at high risk defined by any conventional risk factor(s) and two or more abnormal responses to maximal exercise, annual incidence of primary coronary events averages 5.2% (p less than 0.001). The proportion of men of 60-64 years at low risk with a 98% 3-year survival rate is 16 times that of men of 55-59 years at high risk with a 78% survival rate in this asymptomatic population. Of 1718 men under 60 years of age and without conventional risk factors, 117 or 6.8% developed ischemic ST depression with maximal exercise testing, but none reported any coronary event during 5.6 years of follow-up surveillance. PMID- 3632541 TI - Grief in the grounded aviator. AB - Grounding aviators is an important and difficult aspect of being a flight surgeon. The psychological impact that grounding has on a flier may not only represent a serious pathological process in itself, but may also detrimentally affect the flight surgeon's relationships with other crewmembers. Grounding represents a loss to the aviator, the severity of which varies with pre-morbid motivation to fly. As a loss, grounding elicits grief; this must be dealt with effectively by the patient, with the help of the flight surgeon, or an unresolved grief reaction may cripple the ex-flier and hinder the flight surgeon's effectiveness. PMID- 3632542 TI - Civilian air ambulance services in Oregon. AB - To describe and evaluate the status of air ambulance service in Oregon, questionnaires were mailed to Oregon's 18 air ambulance operators; 16 operators responded with data on aircraft type and configuration, medical supplies and equipment aboard the aircraft, and training of inflight attendants. Records of 128 of the 152 patients transported by these services during September, 1985, were reviewed to estimate the extent to which patients had been appropriately selected. Findings were: trauma patients being transported to large specialized medical centers comprised the single largest patient category; failure to obtain an aeromedical assessment of every patient preflight resulted in some inappropriate transports, with airlift definitely contraindicated in at least 2% of the cases; most agencies met advanced life support standards for equipment; inflight documentation was inadequate; numerous aircraft lacked pressurization and adequate doorway size; many attendants received insufficient aeromedical training; and existing state regulations went unenforced. Measures to guide services and to remedy existing deficiencies are recommended. PMID- 3632543 TI - Pilot studies of vapor transfer through breathable outerwear by simulating sweating in the cold. AB - Claims that rainproof films allow the unimpeded evaporation of sweat have been examined by modifying a heat transfer method to include evaporation of water. This physical study simulates a casual hiker (2 mets) in 4 degrees C (40 degrees F) dry weather wearing clothing of 1.5-2.0 clo and sweating at 40 g X h-1. Goose down, wool, polyester, and polyolefin fills were combined with no protective cover, Gore-Tex, and polyurethane covers. No significant differences in insulation between dry (control) and wet (stabilized evaporation) occurred. Neither cover nor fill had significant effects on heat transfer. Total water evaporated (sweat produced) was affected only by the wool filler. A significantly greater amount of water was trapped by the natural fibers and the polyurethane cover. These data indicate that breathable rainwear is likely to have little effect on heat transfer, even though it allowed 89% of sweat to evaporate compared to 51% for the polyurethane raincoat. PMID- 3632544 TI - A computerized system for measuring detection sensitivity over the visual field. AB - A device is described for comprehensively measuring the capability of human operators to detect and react to visual signals occurring at a variety of locations throughout the functional visual field. The system is completely automated and computerized, and provides both documentation files and descriptive graphics of the operator's performance immediately upon completion of testing. Sensitivity of detection can be measured for red, yellow, and green stimulus colors in a testing configuration which mimics commonplace surveillance of the ordinary viewing field. An abbreviated listing of the main operating program software is provided. PMID- 3632545 TI - Cases from the aerospace medicine residents' teaching file. Case #19. An aviator with acute upper gastrointestinal hemorrhage secondary to a duodenal ulcer. PMID- 3632546 TI - Cortisol and behavioral responses to separation in mother and infant guinea pigs. AB - In Experiment 1, lactating guinea pigs 3 days postpartum exhibited an elevation of plasma levels of cortisol when their litters were taken from the home cage and placed out of auditory range for 30 min. If pups were left within auditory range during the period of separation, or if the litter was disturbed but not removed, no increase in plasma cortisol levels was observed. In Experiment 2, 11/12- and 18/19-day-old guinea pig pups placed alone in a novel environment for 30 min displayed levels of plasma cortisol and vocalizations that were greater than those of pups tested in the same environment but with their mother. Pups tested with littermates but not with their mother exhibited plasma cortisol levels that were as great as those of pups tested alone. Pups tested with littermates vocalized much less than pups tested alone but more than pups tested with their mother. These results indicate that brief mother-infant separation can activate the pituitary-adrenal system in mother as well as infant guinea pigs and they provide further evidence for the existence of a reciprocal mother-infant attachment in this species. PMID- 3632547 TI - Differences in learning between hyperprolinemic mice and their congenic controls. AB - These experiments expanded earlier work on hyperprolinemic mice which showed learning deficits. The following behavioral tasks were used: step-through, passive avoidance; T-maze acquisition; shuttlebox acquisition, and radial-arm maze. Mouse species included PRO/Re-bb (genetically hyperprolinemic mice) and PRO/Re-aa (congenic nonhyperprolinemic controls) obtained from the Jackson Breeding Laboratories. Hyperprolinemic mice were impaired in acquiring T-maze and shuttlebox footshock avoidance behavior. One-trial passive avoidance behavior did not clearly differentiate between the groups. Radial maze performance was poor in both groups due possibly to observed acrophobia and lack of exploratory behavior. The results of this study combined with previously published work suggest that high-brain proline in conjunction with other amino acid changes account for the learning deficits. PMID- 3632548 TI - Hypothermia-induced anterograde amnesia: is memory loss attributable to impaired acquisition? AB - The present investigation examined whether the poor test performance observed in studies of anterograde amnesia reflects a memory deficit or is a by-product of weaker initial learning resulting from impaired sensory, motivational, or associative processes. Two experiments were performed which utilized latent extinction (Experiment 1) and delay of punishment (Experiment 2) manipulations in order to assess the nature of original learning in rats trained under either hypothermic (29 degrees C) or normothermic conditions. Results from both experiments provided evidence that hypothermia treatment administered prior to training had relatively little influence on the animal's ability to acquire a passive avoidance response. Therefore, the rapid forgetting observed in hypothermia-induced anterograde amnesia is most likely due to memory deficits rather than an artifact of poorer acquisition. PMID- 3632549 TI - The GM1 ganglioside hastens the reduction of hyperemotionality after septal lesions. AB - The purpose of the present study was to assess the effects of ganglioside treatment on changes in emotional, activity, and avoidance behaviors following septal brain damage. Rats were treated with GM1-gangliosides either before and after septal lesions, or only after septal lesions and tested for emotionality on 10 consecutive days beginning on the second day after surgery. The ganglioside treatment decreased the emotionality of rats with septal damage on the first test day, and enhanced their rate of recovery to control levels of emotionality. Septal rats treated with gangliosides had activity, rearing, and avoidance behaviors equivalent to nontreated septal rats; however, lesioned rats treated with GM1 showed reduced intertrial crossings during avoidance conditioning. These results suggest that the changes in emotional behavior of septal rats treated with GM1 occur shortly after the lesion. PMID- 3632550 TI - Modulation of male mouse sniff, attack, and mount behaviors by estrous cycle dependent urinary cues. AB - Modulation of male urogenital sniff, attack, and mount behaviors by urinary cues from female mice (SJL/J) was assessed in two experiments. Experiment 1 examined the efficacy of urine from ovariectomized and intact females in modulating the behavior of sexually experienced and inexperienced males vis-a-vis the control substance, water. It was found that urine from ovariectomized females showed no behavior-modulating properties, whereas urine from intact females decreased attack but increased sniff and mount behaviors in male mice. These findings are indicative of ovarian-dependent chemosignals contained in the urine of only intact females. Prior sexual experience had no effect on behavior of males when exposed to urine from ovariectomized females. Sniff and mount behaviors were, however, increased when sexually experienced males were exposed to urine from intact females. Using sexually inexperienced males, Experiment 2 assessed the chemosignal activity of urine from females in each of four estrous phases. It was determined that urine from proestrous and estrous females increased sniff and mount behaviors and decreased attack behavior. Urine from metaestrous females was shown to possess only sniff-inducing and mount-reducing chemosignal properties. Urine from females in diestrous lacked attack- and mount-modulating chemocues but may possess a sniff-inducing chemosignal. PMID- 3632551 TI - Scent marking by male dwarf hamsters (Phodopus sungorus campbelli) in response to conspecific odors. AB - Male hamsters (Phodopus sungorus campbelli) scent marked at greater frequencies in the presence of conspecific odor, either male or female, than in clean areas. Marking rates were not different between male and female odor conditions. In contrast, the pattern of investigation in response to conspecific odor did differ between the male and the female odor conditions. When male odors were used as stimuli, investigative sniffing increased at the scent marking sites but when female odors were used as stimuli investigative sniffing increased throughout the arena. Thus, male dwarf hamsters direct their scent marks at both male and female conspecifics, discriminate between male and female odor, and investigate in a different manner areas scent marked by males and females. PMID- 3632552 TI - Evidence for a possible functional interaction between serotonergic and cholinergic mechanisms in memory retrieval. AB - A total of three experiments were conducted. In Experiment 1, the dose-dependent effects of the pretest administration of the serotonergic agonist alaproclate and the selective muscarinic cholinergic agonist oxotremorine, alone and in combination, were assessed in a one-trial inhibitory avoidance task. A clear dose dependent enhancement of performance was demonstrated as a result of all three treatment conditions, which could not be explained in terms of nonspecific effects of the drugs on behavior in general. In addition, the facilitation of retrieval performance produced by the combined treatment of alaproclate and oxotremorine was observed at dose levels well below those observed following administration of either compound alone. In Experiment 2 attempts were made to block the enhancements of retention resulting from the different treatment conditions (alaproclate, oxotremorine, or the combination of alaproclate and oxotremorine) by pretreating the mice with either scopolamine (a muscarinic cholinergic antagonist) or quipazine (a serotonergic agonist). The results of these experiments indicate that (a) quipazine completely blocked the enhancement of retrieval resulting from alaproclate but not that following oxotremorine or oxotremorine in combination with alaproclate, while (b) scopolamine blocked the enhancement of retrieval resulting from oxotremorine alone as well as that resulting from alaproclate plus oxotremorine but failed to block the memory enhancement resulting from alaproclate. The present results lend further support to the view that both serotonin and acetylcholine play important roles in memory retrieval. More importantly, the results of the present series of experiments provide additional support for a functional interaction between the serotonergic and cholinergic nervous systems in the mediation of behavior. PMID- 3632553 TI - Zinc-induced peripheral anosmia and behavioral responses to novelty in mice: a quantitative-genetic analysis. AB - Adult male mice were made anosmic by intranasal flushing with a 5% zinc sulfate solution. Twelve behavioral variables were measured in treated as well as saline irrigated control animals placed in a novel environment. The genetic underpinnings and the genotype-treatment interactions with regard to these behaviors were analyzed in a classical Mendelian cross between the inbred strains C57BL/6 and DBA/2 and in a full 4 X 4 diallel cross, replicated five times, between these strains and strains C3H/St an CPB-K. Based on the hypothesis of an evolutionary history of directional selection for a well-balanced information processing system, one might expect directional dominance for decrease in exploration after anosmization. Although decreases were found for several behavioral phenotypes, only few and relatively unimportant genotype-treatment interactions were present. This absence of any kind of genetic variation for behavioral change after anosmization points to an extremely strong directional selection which has eliminated all less favorable alleles. The findings support the hypothesis of directional selection for an efficient olfactory information processing system. PMID- 3632554 TI - Active avoidance performance in genetically defined mice. AB - It has been concluded by several investigators that active avoidance performance in mice is primarily influenced or even determined by a single gene. The genetically defined strains C57BL/6 and BALB/c have provided evidence that an aberrant development of pyramidal cells and mossy fiber configuration in the hippocampus of BALB/c mice also is determined by a single gene. As a test of the generality of the single gene influence on avoidance learning, and to examine the relationship of the hippocampal defect to avoidance learning, adult male mice of the inbred progenitor strains C57BL/6ByJ and BALB/cByJ and their seven recombinant inbred strains were tested in a variant of the shuttle-box paradigm used in previous studies. BALB/c were found to acquire the avoidance response at a faster rate than C57BL/6, consistent with most earlier reports, but performances of the recombinant inbred strains failed to dichotomize about the progenitor strains. The rank order of performance scores for the recombinant inbred strains was different from that reported in previous studies. Thus the present data failed to support the interpretation of a single major gene influencing active avoidance learning. It is concluded that avoidance learning and performance cannot be considered as unitary variables and that the interaction of genetic with environmental factors, including the conditions of the specific testing situation, are important considerations in any interpretation of genetic effects. No relationship between the hippocampal lamination defect and avoidance performance was demonstrated. PMID- 3632555 TI - Genetic factors and the measurement of exploratory activity. AB - The progenitor strains C57BL/6 and BALB/c and the seven recombinant inbred strains derived from them were used to examine the genetic relationship between two measures of activity and hippocampal lamination defect (Hld). Fifty-three mice (Mus musculus), 9 from each of the progenitor strains and 5 from each recombinant inbred strain, were tested for 16 min in a device which permitted both unobstructed traverse of the length of a runaway and contact with objects which were aligned alongside the runway. The C57BL/6 mice produced significantly more locomotor (runway traversal) activity, whereas the BALB/c showed significantly greater amounts of investigatory (object contact) activity. This reversal of relative position in the distribution of scores was not present for the recombinant strains. There was no dichotomous separation of recombinant strains for either measure. Examination of activity in terms of four consecutive 4-min periods indicates differences among the strains with respect to changes during the test session. The strains may be dichotomized with respect to decrement in activity within the 16-min session, but these groups do not correspond with those reported by others. The inference of a single genetic determinant for activity measured either as locomotor or investigatory responses is not supported by these data, nor is there any apparent relationship between activity and Hld. The critical influence of genetic-environment interactions in determining behavior and the effect of the selection of measurement techniques upon interpretation of data are emphasized by these data. PMID- 3632556 TI - Receptor structures of the immune system. Symposium. Marburg, FRG, September 24 26, 1986. Proceedings. PMID- 3632558 TI - The immunoglobulin receptor. PMID- 3632557 TI - Receptors for anaphylatoxic peptides. PMID- 3632559 TI - The genetic analysis of repeated measures. II. The Karhunen-Loeve expansion. PMID- 3632560 TI - Further evidence for a gene influencing spatial ability. PMID- 3632561 TI - Genotype-environment correlation and IQ. PMID- 3632563 TI - The use of flow cytometry to measure glucocorticoid-induced killing of lymphoid cell lines. AB - A flow cytometer method was developed to measure glucocorticoid-induced death in sensitive lymphoid cells. The murine lymphoma cell lines, R1.1, S49.1 and WEHI 7.1, and the human T-lymphocyte cell line, MOLT-4, were exposed to 10(-8) to 10( 6) mol/L dexamethasone or methylprednisolone. The cytogram for unstained, unfixed cells, produced by plotting the axial light loss versus the right-angle scatter using a He-Ne laser as the light source, showed two clearly separated peaks corresponding to live and dead cells. The ratio of live to dead cells seen in the cytogram correlated with that obtained by trypan blue staining. The flow cytometry method offers a number of advantages: 300 to 500 cells/s can be counted, yielding speed and good counting statistics; unstained, unfixed cells can be used; and the live and dead cells can be sorted for plating or biochemical analysis. S49.1 and R1.1 cells were sensitive to methylprednisolone and dexamethasone in the 10(-6) to 10(-8) mol/L concentration range, while MOLT-4 and WEHI 7.1 cells were less sensitive. After a 48-h exposure to 10(-8) mol/L dexamethasone, S49.1 and R1.1 cell cultures had 30% and 38% dead cells, respectively, while WEHI 7.1 and MOLT-4 cell cultures had less than 5% dead. PMID- 3632562 TI - Intelligence in fathers and sons: familial resemblances and generational differences. PMID- 3632564 TI - Chromosomal and cell kinetic pattern in human transitional cell bladder carcinoma. AB - Cell kinetics in transitional cancer of the bladder was studied in 35 patients by using the in vitro 3H-thymidine labeling index. The proliferative activity was remarkably lower than that observed for other human histotypes. Analysis of the relation between cell kinetics and histologic grading showed a value for grade III tumors two-fold that of grade I and grade II tumors. Cytogenetic analysis was possible in 15 cases, and different chromosome numbers from 40 to 120 and the presence of various structural aberrations were observed. When cytogenetic features were analyzed in relation to cell kinetics, higher proliferative activities were always associated with a loss of chromosome 13 and, except for one case, with a loss of chromosome 22. PMID- 3632565 TI - Some comments on ventricular afterload. AB - In this issue of Basic Research in Cardiology a paper by Timisjarvi et al. is presented in which the problem of afterload, generated by the resistance against which the left ventricle is ejecting, is discussed. These authors have performed experiments in which they examine the role and validity of the so-called mean outflow resistance (MOR) of the left ventricle. In this editorial, the opportunity is taken to present some thoughts on the different possibilities of expressing the interrelation between the heart and the arterial system. It is intended to show how, from the first ideas about ventricular-arterial interaction bei Ph. Broemser (1935; 1) different concepts about simple descriptions of the functioning of the heart, the arterial system and the matching between both have evolved. In particular, the concept by Sunagawa et al. seems worthy of mention. An examination of this, and several other concepts, prove that the peripheral resistance and, particularly, the MOR, are important parameters that determine the influence of the arterial system on the performance of the heart. However, since MOR by definition is closely related to the total peripheral resistance, there is no essential need to introduce this resistance as a new concept of ventricular afterload. Calculations based on this definition of MOR demonstrate an agreement between theory and experimental results. PMID- 3632566 TI - Cardiovascular response to sudden strenuous exercise. AB - Cardiac responses to sudden strenuous exercise were studied in seven dogs instrumented to measure cardiac output (Q), stroke volume (SV), left ventricular (LV) pressure, aortic pressure and circumflex coronary blood flow (CBF). The dogs were run on a treadmill at 12.9 km/h, 20% grade for 15s without prior warm-up. During the first 10s of the run, HR and Q increased rapidly. By 2s, myocardial O2 requirements, as estimated from either the tension time index (TTI) or calculated wall tension, had increased significantly above resting values. Simultaneously, mean CBF fell 13% and stroke CBF fell 49% below resting values at the onset of sudden exercise (2s) and was associated with 17% and 21% decreases in positive and negative LV dP/dt, a 9% decrease in (dP/dt)/P and an 11% decrease in SV. After the initial decrease at 2s, these variables then increased rapidly as the run continued except for stroke CBF which never reached resting levels. HR, Q, and LV dP/dt reached near maximal values for this level of exercise by 10s after the start of exercise. In contrast, mean CBF was still increasing when the run was terminated. These data show that sudden strenuous exercise results in a transient decrease in myocardial O2 delivery at a time when myocardial O2 requirements are rapidly increasing. This imbalance between myocardial O2 supply and demand is due to a transient decrease in coronary blood flow followed by a delay in metabolic regulation of CBF. PMID- 3632567 TI - Calcium repletion-induced arrhythmias after short periods of calcium-free perfusion in the isolated rat heart. AB - The occurrence of arrhythmias was studied in the "calcium-paradox" model in the isolated rat heart. Clear relationships were found between the duration of calcium-free perfusion and (a) the occurrence of calcium-free-induced electrophysiological changes, (b) the incidence and duration of subsequently induced calcium-repletion arrhythmias and (c) mechanical recovery at the end of the repletion period. The first signs of electrophysiological changes (i.e. decreased heart rate, T-wave amplitude and increased PQ-interval) and irreversible loss of myocardial recovery occurred during or after 60-90 s of calcium-free perfusion. The occurrence of calcium-repletion induced ventricular tachycardia parallelled this onset of irreversible cardiac injury. These results suggest that the process of calcium washout and subsequent sudden calcium overloading may play a role as a trigger in the pathogenesis of ventricular arrhythmias. PMID- 3632568 TI - Binding of diltiazem and verapamil to isolated rat heart mitochondria. AB - The occurrence of arrhythmias was studied in the "calcium-paradox" model in the isolated rat heart. Clear relationships were found between the duration of calcium-free perfusion and (a) the occurrence of calcium-free-induced electrophysiological changes, (b) the incidence and duration of subsequently induced calcium-repletion arrhythmias and (c) mechanical recovery at the end of the repletion period. The first signs of electrophysiological changes (i.e. decreased heart rate, T-wave amplitude and increased PQ-interval) and irreversible loss of myocardial recovery occurred during or after 60-90 s of calcium-free perfusion. The occurrence of calcium-repletion induced ventricular tachycardia paralleled this onset of irreversible cardiac injury. These results suggest that the process of calcium washout and subsequent sudden calcium overloading may play a role as a trigger in the pathogenesis of ventricular arrhythmias. PMID- 3632569 TI - Maturation of coronary responsiveness to exogenous adenosine in the rabbit. AB - Previous studies have indicated that some cardiac control systems, such as autonomic innervation, are incomplete in the newborn and undergo postnatal maturation. However, relatively little is known of maturational changes which will affect the ability of the coronary circulation to regulate blood flow during various interventions. We tested the hypothesis that the coronary circulation of the rabbit develops a progressive, age related increase in responsiveness to exogenous adenosine during the first 16 weeks of life. We examined the response of coronary circulation to exogenous adenosine in four age groups (6-10 days, 3-4 weeks, 7-8 weeks, 16 weeks) of rabbits by using an isolated heart preparation. Coronary flow was measured during an control period, during reactive hyperemia (following release of a 2 min coronary flow interruption), and during infusions of exogenous adenosine. All age groups had similar levels of control coronary blood flow, with a large increase in flow observed during reactive hyperemia. The volume of coronary flow was higher during reactive hyperemia (P less than 0.001) in the 6-10-day-old animals than in the other age groups. However, the 6-10-day old age group showed a smaller (P less than 0.01) flow response to exogenous adenosine than the other age groups. In addition, the 6-10-day-old animals required higher adenosine concentrations to produce an initial detectable coronary flow increase and to produce the maximal flow response. Additional studies demonstrated a significant reduction in percentage flow debt repayment after theophylline administration in adult rabbit hearts. However, neonatal rabbit hearts showed no change in flow debt repayment following theophylline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632570 TI - Inhibition of contractility during the early phase of total ischaemia in the working heart. Recovery during reperfusion. AB - Total global ischaemia of the normothermic working rat heart caused an initial positive inotropic response characterized by vigorous contractions. After +/- 15 s this response reached a peak whereafter the isotonic contraction amplitude started to decline. After +/- 3.5 min the heart ceased to beat. The low level of high energy phosphates (HEP), determined 3 min after the onset of ischaemia, indicated that these phases of contractility during ischaemia might play a significant role in depleting HEP. This was substantiated by the observation that inhibition of the contractions during ischaemia by low calcium or high potassium solutions resulted in conservation of myocardial adenosine triphosphate (ATP) and creatine phosphate (CP) stores. It also resulted in the prevention of contracture development during ischaemia and improved mechanical recovery during reperfusion. It was therefore concluded that inhibition of contractility immediately after the onset of total global ischaemia of the normothermic working rat heart is of prime importance in mechanical recovery during reperfusion. PMID- 3632572 TI - A place for theoretical cardiology. PMID- 3632573 TI - [Skeletal changes in sickle cell anemia]. PMID- 3632574 TI - [Treatment concept for Perthes disease--report of clinical experiences of a multicenter prospective study]. PMID- 3632571 TI - Critical early metabolic changes associated with myocardial recovery or failure after total ischaemia in the rat heart. AB - Isolated rat hearts were used to measure tissue levels of the adenine nucleotides plus their degradation products and the 'intracellular' electrolytes after 15 or 25 min of global ischaemia alone and also after 5 or 60 min of reperfusion. Following 15 min of ischaemia, hearts showed near complete recovery of cardiac function (aortic flow rate = 92 +/- 7% of control), but recovery was severely depressed following 25 min of ischaemia (aortic flow rate = 18 +/- 15% of control). Similarly, after 5 min of reperfusion, hearts made ischaemic for 25 min had a reduced tissue content of ATP (10.5 vs 18.9 mumol X g X dry wt), and NAD (4.30 vs 4.75 mumol X g X dry wt) and a 3-4-fold increase in AMP, adenosine and oxypurines, as compared with hearts ischaemic for 15 min. However, the extent of loss of oxypurines during 5 min of reperfusion was essentially similar in both groups (21% vs 18% of total purine pool). After this initial period of reperfusion a significant (p less than 0.01) difference in potassium content was seen between the two groups; hearts which recovered function gained, whilst failing hearts lost, potassium. Changes in the other electrolytes were essentially similar in the two groups of hearts. Extending reperfusion from 5 to 60 min did not change ATP levels in either group but in the functionally depressed group it was associated with a 5-fold increase in calcium and a 30% reduction in potassium, together with a further loss of oxypurines. Thus, loss of nucleotide precursors does not appear to be a critical event in the relatively sudden transition from reversible to irreversible functional injury in ischaemia. There may, however, be a reduction in the activity of the ATP synthesizing processes. PMID- 3632575 TI - [Detection of occult femoral neck fractures by bone scintigraphy]. PMID- 3632576 TI - [Diagnostic and therapeutic problems in suppurative nonspecific coxitis in adulthood]. PMID- 3632577 TI - [Results following surgical treatment of tibial fractures]. PMID- 3632578 TI - [Complete forearm fractures in childhood]. PMID- 3632579 TI - [Occupational stress and degenerative diseases of the locomotor system--study of correlations in clinic patients]. PMID- 3632580 TI - [Reference for 2 successful forms of physical therapy: treading massage and centrifugal massage]. PMID- 3632581 TI - [Intercorporal traction spondylodeses of the lumbar spine--results and experiences]. PMID- 3632582 TI - [Total hip joint replacement with dysplasia prostheses]. PMID- 3632583 TI - [Cemented and cement-free anchoring of total hip joint endoprostheses]. PMID- 3632584 TI - [Compression arthrodesis of the upper ankle joint with a hook plate]. PMID- 3632585 TI - [Negative effect of the pneumatic splint on the development of a compartment syndrome]. PMID- 3632586 TI - [Myopathic changes in Camurati-Engelmann diaphyseal dysplasia]. PMID- 3632587 TI - [Pelizaeus-Merzbacher syndrome (case report)]. PMID- 3632588 TI - [The organization of sexual topics]. PMID- 3632589 TI - [Sexual politics controversies. Results of the 15th scientific meeting of the German Society for Sexual Research. 3-5 October 1985, Hannover. Proceedings]. PMID- 3632590 TI - [What the king can't see]. PMID- 3632591 TI - [Sublimation of sexual aspects in psychoanalysis]. PMID- 3632592 TI - [Social ideology of sexuality]. PMID- 3632593 TI - [Females as the bearers of hope?]. PMID- 3632594 TI - [The difficulty of talking about sexuality]. PMID- 3632595 TI - [Sexuality and feminism--or also: very wrong sex]. PMID- 3632596 TI - [Subjectiveness of the researcher and psychoanalysis of female sexuality]. PMID- 3632597 TI - [Psychological coping with heterologous insemination]. PMID- 3632598 TI - [Individual effects of reproduction technics]. PMID- 3632599 TI - [Significance of nutrition in maintaining the health of domestic animal stocks]. PMID- 3632600 TI - [Bacteriologic status of the muscle tissue of broilers in the fattening phase and following meat removal]. PMID- 3632602 TI - [Arthrodesis of the stifle joint with bolts in the dog and cat]. PMID- 3632601 TI - [High mortality of the Nile tilapia Oreochromis niloticus caused by Providencia rettgeri]. PMID- 3632603 TI - [Microparasitosis (toxoplasmosis) in mountain gazelles (Gazella g. cuvieri)]. PMID- 3632604 TI - Hypertension in the community. Proceedings of the second international symposium. Jerusalem, December 1985. PMID- 3632605 TI - Home monitoring of blood pressure: an alternative to repeated clinic measurement in the initial assessment of hypertension. PMID- 3632606 TI - Role of ambulatory blood pressure monitoring as a decision-making tool in hypertensive pharmacotherapy. PMID- 3632607 TI - Counselling for weight reduction in obese hypertensives in family practice. A three-year experience. PMID- 3632608 TI - Behaviour modification in obese patients with essential hypertension. Group treatment versus health counselling in a general practice setting. PMID- 3632609 TI - Possible determinants of blood pressure during childhood (age 4-16 years). PMID- 3632610 TI - Temperature dependence of lithium efflux in erythrocytes: distribution in a hypertensive family. PMID- 3632611 TI - Cardiovascular hypersensitivity to norepinephrine in normotensive members of hypertensive families: influence of dietary sodium and potassium intake. PMID- 3632613 TI - Management of community programs for the control of hypertension: experience from the international scene. PMID- 3632612 TI - Reducing the dose of antihypertensive medications in controlled hypertensives in family practice. PMID- 3632614 TI - Regional implementation of the Connecticut High Blood Pressure Program. PMID- 3632615 TI - The North Hammersmith Stroke Prevention Project: changes in stroke mortality in the London Health Districts. PMID- 3632616 TI - Struggle for compliance among hypertensive patients in a primary care clinic. PMID- 3632617 TI - Ashkelon hypertension prevention and control program. PMID- 3632618 TI - Prognosis in treated hypertension. PMID- 3632619 TI - Clinical management of hypertension in the elderly. PMID- 3632620 TI - Hypertension in Nepal. PMID- 3632621 TI - Community control of high blood pressure in Portugal. PMID- 3632622 TI - Comparison of blood pressure and prevalence of hypertension in rural and urban Zaire. PMID- 3632623 TI - Evolvement of hypertension in Ethiopian new immigrants. PMID- 3632624 TI - Cations and other environmental variables in normotensive and hypertensive urban Africans and 'coloureds'. PMID- 3632625 TI - Glutathione S-transferases of mouse lung. Selective binding of benzo[a]pyrene metabolites by the subunits which are preferentially induced by t-butylated hydroxyanisole. AB - Six isoenzymes of glutathione S-transferase (GST) present in mouse lung have been purified and characterized. GST I (pI 9.8) is a dimer of Mr-26,500 subunits and GST II is a heterodimer of Mr-26,500 and -22,000 subunits, and GST III (pI 7.9) and IV (pI 6.4) are dimers of Mr-24,500 subunits. GST V (pI 5.7) is a heterodimer of Mr-24,500 and -23,000 subunits, whereas GST VI (pI 4.9) is a dimer of Mr 23,000 subunits. Immunological studies indicate that the Mr-24,500 subunits present in GST III (pI 7.9) are distinct from those present in GST IV (pI 6.4) and V (pI 5.7). Structural and immunological studies provide evidence that at least five distinct types of subunits in their different binary combinations give rise to various GST isoenzymes of mouse lung. These isoenzymes express varying degrees of catalytic activities towards a wide range of electrophilic substrates including benzo[a]pyrene 7,8-oxide and benzo[a]pyrene 4,5-oxide. The dietary antioxidant t-butylated hydroxyanisole (BHA) preferentially induces GST II and III. Also, these two isoenzymes selectively bind benzo[a]pyrene (B[a]P) metabolites, indicating that they play an important physiological role in the detoxification of B[a]P metabolites. The preferential induction of the GST isoenzymes involved in the detoxification of activated B[a]P metabolites indicates that the anti-neoplastic activity of BHA against B[a]P-induced neoplasia in mouse lung [Wattenberg (1973) J. Natl. Cancer Inst. 50, 1541-1544] may be due to the enhanced detoxification of B[a]P metabolites. PMID- 3632626 TI - Interaction of unsaturated fatty acids with anti-oestrogen-binding sites. AB - Specific high-affinity binding sites for non-steroidal anti-oestrogens such as tamoxifen have been identified in many animal and human tissues. The function of these binding sites and the nature of their endogenous ligands are currently unknown. Our laboratory has previously reported that unsaturated fatty acids at micromolar concentrations inhibited [3H]tamoxifen binding to the anti-oestrogen binding sites in rat liver, raising the possibility that fatty acids might represent endogenous ligands for these sites. These studies have now been extended to examine the mechanism by which fatty acids inhibit [3H]tamoxifen binding to the anti-oestrogen-binding site. Saturation analysis revealed that increasing concentrations of oleic acid progressively decreased the apparent binding affinity of these sites for [3H]tamoxifen without decreasing the total number of binding sites; however, the apparent dissociation constant did not vary linearly with the prevailing oleic acid concentration, suggesting that the inhibition of [3H]tamoxifen binding by fatty acid was not competitive in nature. Kinetic studies of [3H]tamoxifen binding showed that oleic acid did not affect the rate of association, but increased the rate of dissociation of [3H]tamoxifen from the anti-oestrogen-binding site; the latter finding would not be expected if oleic acid acted as a competitive inhibitor. Furthermore, incubation of a rat microsomal fraction with [3H]oleic acid in the absence and presence of excess non radioactively labelled tamoxifen also failed to demonstrate direct competition between oleic acid and tamoxifen for the same binding site. It is concluded that oleic acid, and presumably other unsaturated fatty acids, do not compete for the anti-oestrogen-binding site and probably reduce its tamoxifen-binding affinity by some other mechanism, such as perturbation of the lipid environment of the binding site. The biological significance of this interaction of unsaturated fatty acids with the anti-oestrogen-binding site remains to be elucidated. PMID- 3632627 TI - Isolation and characterization of pig enamelins. AB - Enamel proteins were extracted from pig developing enamel by sequential extraction procedures. Two proteins identified as enamelins by slab-gel electrophoresis (Mr 67,000 and 63,000) were separated from amelogenins by gel sieving and ion-exchange chromatography. Their enamelin characteristic was confirmed by hydroxyapatite-binding studies and amino acid analysis. Degradation of extracted enamel proteins was also studied in vitro. The larger of the two enamelins appeared to be resistant to degradation by endogenous enamel proteinases. Hydroxyapatite showed strong binding with the enamelins, but did not prevent the degradation of the Mr-63,000 enamelin. These results indicate that at least one high-Mr enamelin in pig developing enamel is a source of enamelin breakdown products. PMID- 3632628 TI - The use of gel chromatography for the determination of sizes and relative molecular masses of proteins. Interpretation of calibration curves in terms of gel-pore-size distribution. AB - The separation of proteins by gel-exclusion chromatography has been explained in terms of partitioning of the macromolecules within the gel by a distribution of pores of various radii. The assumption that the distribution of pore sizes is Gaussian has led to the prediction of a linear relationship between the molecular Stokes radius (RS) of the protein and the function erf-1 (1-KD), where KD is the partition coefficient [Ackers (1967) J. Biol. Chem. 242, 3237-3238]. Since careful calibrations of classical (agarose and dextran) gels and h.p.l.c. gels have shown that such a linear relationship is not verified experimentally over a wide range of native protein sizes, we have reinvestigated the model of Ackers (above reference). We show that Ackers' (above reference) derivation is not valid except for a particular Gaussian distribution of pore sizes centred at the origin. Relaxation of this restriction to allow for other types of Gaussian distributions cannot account for the non-linear calibration curves that we have obtained. Instead we show that the pore-size distribution can be calculated from the experimentally determined function KD = f(RS) and that this distribution is bimodal (non-Gaussian). One distribution is centred below 2 nm, whereas the mean value of the second one is around 6-8 nm. The minimum in this bimodal distribution corresponds, for some gels, to a region of poor resolution, which needs to be appreciated for the proper use of gel chromatography in the determination of molecular size. PMID- 3632629 TI - Expression of myosin light chains during fetal development of human skeletal muscle. AB - The expression of myosin light chains (MLCs) during the development of human skeletal muscle was investigated by using two different two-dimensional electrophoretic techniques. In both electrophoretic systems the predominant light chain 1 (LC1) expressed during the whole fetal period was found to co-migrate with the adult fast LC1 (LC1F). The main LC2 expressed during the whole fetal period was found to be different from the main fast LC2 (LC2F) and slow LC2 (LC2S) usually present in adult muscle, but co-migrated with a minor component often present in adult muscle. This fetal LC2 was phosphorylatable, and the phosphorylated form co-migrated with the main component of LC2F expressed in the adult. The adult fast LC3 appeared as early as week 20 of gestation, whereas the adult slow light chains (LC1S and LC2S) appeared only during the late fetal period. A minor component of LC1, previously described in humans as an 'embryonic LC' (LCemb.) [Strohman, Micou-Eastwood, Glass & Matsuda (1983) Science 221, 955 957], was only expressed in the early fetal period and was found to co-migrate with atrial LC1 (ALC1). We discuss the expression of these specific developmental forms of MLCs co-existing with immature myosin heavy chains during fetal life. PMID- 3632630 TI - Identification of a liver growth factor as an albumin-bilirubin complex. AB - We have reported the purification and characterization of a protein that behaves as a liver growth factor, showing activity either in vivo or in vitro [Diaz-Gil et al. (1986) Biochem. J. 235, 49-55]. In the present paper, we identify this liver growth factor (LGF) as an albumin-bilirubin complex. This conclusion is supported by the results of chemical and spectroscopic characterization of this protein as well as by experiments in vivo. Incubation of albumin isolated from normal rats with bilirubin/albumin molar ratios (r) resulted (when r = 1 or 2) in a complex with liver DNA synthesis promoter activity identical with that of LGF. The exact amount of bilirubin bound to albumin was assessed by fluorescence and c.d. spectra. This albumin-bilirubin complex showed the same dose-dependence profile as LGF either at low or high dose of protein injected per mouse. Both LGF and albumin-bilirubin complex produced similar increases in the mitotic index of mouse hepatocytes in vivo. A new mechanism for the onset of the hepatic regenerative process is proposed. PMID- 3632631 TI - NADPH-binding component of the superoxide-generating oxidase in unstimulated neutrophils and the neutrophils from the patients with chronic granulomatous disease. AB - The NADPH-binding component of the neutrophil superoxide-generating oxidase was studied in the particulate oxidase fractions obtained from the neutrophils of normal and chronic-granulomatous-disease (CGD) patients. The molecular mass of the NADPH-binding component of the stimulated human neutrophils, which was labelled with the 2',3'-dialdehyde derivative of NADPH and sodium cyanoboro[3H]hydride, was 66 kDa. The 66 kDa component was also labelled in monocytes, but not in red blood cells, platelets and lymphocytes. The particulate oxidase fractions obtained from the patients with CGD had a diminished amount of FAD, whether they contained cytochrome b558 or not. The fractions labelled with the NADPH analogue showed that CGD patients had the NADPH-binding component in the neutrophils. The molecular mass of the component was identical with that of the normal neutrophils. The patients are thought to have an intact NADPH-binding domain of the oxidase in the neutrophils in spite of a diminished amount of FAD in the particulate fractions. The component of the oxidase in the resting neutrophils was also labelled with the analogue. The molecular mass of the component in the resting neutrophils was identical with that of the stimulated neutrophils, and the component was not phosphorylated during the activation process. These results indicate that the NADPH-binding component of the oxidase, which is specific to phagocytes, is present in the resting neutrophils and that the component does not change with respect to molecular mass during the activation process. PMID- 3632632 TI - Determination of arrangement of isoprene units in pig liver dolichol by 13C n.m.r. spectroscopy. AB - The arrangement of isoprene units in pig liver dolichol-18, -19 and -20 was determined by 1H- and 13C-n.m.r. spectroscopies. The alignment of trans and cis isoprene units was found to be in the order: dimethylallyl unit, two trans units, a sequence of 14-16 cis units, and a saturated isoprene unit terminated with a hydroxyl group, which verified the presumed chemical structure of dolichol. The absence of geometric isomers was confirmed. A slight amount of impurity was detected in each reversed-phase h.p.l.c. fraction of dolichol obtained by a conventional method. Detailed assignments of the 13C-n.m.r. spectrum were given for these dolichols by using model compounds and INEPT (insensitive nuclei enhanced by polarization transfer) measurement. The chemical structure of synthetic dolichol-19, which was prepared by the addition of a saturated isoprene unit to the polyprenol-18 isolated from Ginkgo biloba, was confirmed to be identical with that of pig liver dolichol-19. PMID- 3632633 TI - Rapid catabolism of tyrosine-O-sulphated proteins and the formation of free tyrosine O-sulphate as an end product in rat embryo fibroblasts. AB - Rat embryo fibroblasts, line 3Y1, were prelabelled for 24 h with [35S]sulphate and incubated in fresh medium without [35S]sulphate. A rapid efflux of the overall 35S-labelled compounds from the cells into the medium was observed. After 9 h of incubation, about 50% of the total 35S radioactivity appeared in the medium and up to 84.3% did so at the end of a 48 h incubation. Determination of [35S]sulphated macromolecules present in both the cell-associated and the incubation-medium fractions at different time points during incubation indicated that the majority of the 35S-labelled compounds released from the cells were low Mr products derived from digestion of the [35S]sulphated macromolecules. Further analysis for tyrosine-O-[35S]sulphated proteins, which constituted only a small fraction of the overall [35S]sulphated macromolecules, showed that, after 9 h of incubation, there was a 65% decrease in the cell-associated fraction, and only 16.4% remained after 48 h. During that time, an amount equivalent to 20.7% of the cell-associated tyrosine-O-[35S]sulphated proteins originally present was released into the medium. Free tyrosine O-[35S]sulphate was generated in the cells and excreted into the incubation medium. Its rate of increase with time, however, was slow, and could account for only 12.4% of the tyrosine-O [35S]sulphated proteins catabolized at the end of the 48 h incubation. PMID- 3632634 TI - The synthesis of fluorescent chlorotriazinylaminofluorescein-concanavalin A and its use as a glycoprotein stain on sodium dodecyl sulphate/polyacrylamide gels. AB - Concanavalin A, a specific glycoprotein probe, was optimally labelled to a maximum stoichiometry of 0.4 mol of chlorotriazinylaminofluorescein (CTAF)/mol of concanavalin A monomer under mild reaction conditions (pH 8.0, 6 h), and under these conditions the CTAF concanavalin A preparation retains its carbohydrate binding ability and is able to penetrate SDS/7.5-15%-polyacrylamide gradient gels. CTAF-concanavalin A gives fluorescent bands for the glycoproteins transferrin, fetuin and deoxyribonuclease and shows no fluorescent response for the non-glycoproteins bovine serum albumin and soya-bean trypsin inhibitor. The detection limit of sensitivity for CTAF-concanavalin A, which is similar to that of fluorescein isothiocyanate-concanavalin A, is in the range 5-25 micrograms of glycoprotein. CTAF-concanavalin A is a suitable probe for the detection of glycoproteins in higher-percentage (greater than or equal to 10%) SDS/polyacrylamide gels, and will probably have other applications in, for example, fluorescent energy transfer and other structure-function studies. PMID- 3632635 TI - Phospholipid and fatty acid composition in mitochondria from spinach (Spinacia oleracea) leaves and petioles. A comparative study. AB - Essentially chlorophyll-free mitochondria from photosynthetic (leaf) and non photosynthetic tissue (petiole) were isolated from spinach (Spinacia oleracea). Leaf mitochondria were found to contain more phosphatidylcholine than phosphatidylethanolamine compared with petiole mitochondria. Galactolipids were found in small and equal amounts (5 mol of galactolipids/100 mol of galactolipids and phospholipids) in both leaf and petiole mitochondria. Fatty acid composition showed a significant difference in the amounts of C18:2 and C18:3 acids. The C18:2/C18:3 ratio was more than twice as high in all of the phospholipids studied from petiole mitochondria compared with the ratio in leaf mitochondria. More than 50% (mol/100 mol) of the fatty acids in the major lipids (phosphatidylcholine, phosphatidylethanolamine and cardiolipin) in petiole mitochondria were C18:2. In the minor lipids (phosphatidylinositol and phosphatidylglycerol), C16:0 dominated in both leaf and petiole mitochondria. PMID- 3632636 TI - Hydrogen peroxide production in uncoupled mitochondria of the parasitic nematode worm Nippostrongylus brasiliensis. AB - 1. Mitochondria from the parasitic nematode worm Nippostrongylus brasiliensis produce H2O2 in the energized state; higher rates of H2O2 production were observed in the presence of the uncoupler carbonyl cyanide m chlorophenylhydrazone. 2. Antimycin A inhibits respiration and H2O2 production by 70 and 65% respectively; the residual activities can be attributed to alternative electron-transport pathway(s). 3. o-Hydroxydiphenyl and 1,3,5-trihydroxybenzene, inhibitors of alternative electron transport, inhibit respiration by 37% and H2O2 production by 26%. 4. Another inhibitor of alternative electron transport, salicylhydroxamic acid, shows a complex mode of action; low concentrations (less than 0.5 mM) stimulate respiration and H2O2 production, whereas 2 mM salicylhydroxamic acid inhibited respiration by 35% and stopped H2O2 production completely. 5. O2 thresholds were observed for the inhibition of respiration at O2 concentrations greater than 57.7 microM and inhibition of H2O2 production (greater than 20.5 microM-O2); apparent Km values for oxygen were 5.5 microM and 3.0 microM respectively. 6. In the presence of antimycin A the O2-inhibition thresholds and apparent Km values for O2 of respiration and H2O2 production matched closely, suggesting that the alternative oxidase is a likely site of H2O2 production. 7. These results are discussed in relation to O2 toxicity to N. brasiliensis. PMID- 3632637 TI - Cloning and sequencing of the medium-chain S-acyl fatty acid synthetase thioester hydrolase cDNA from rat mammary gland. AB - cDNA clones coding for the medium-chain S-acyl fatty acid synthetase thioester hydrolase (thioesterase II) from rat mammary gland were identified in a bacteriophage lambda gt11 library and their nucleotide sequences were determined. The predicted coding region spans 263 amino acid residues and includes a sequence identical with that of a peptide derived from the enzyme active site. The rat thioesterase II cDNA sequence exhibits homology with that of a thioesterase found in duck uropygial glands. PMID- 3632638 TI - Properties and prenatal ontogeny of beta-D-mannosidase in selected goat tissues. AB - beta-D-Mannosidase activity in selected normal adult, neonatal and foetal goat tissues and in tissues from animals affected with caprine beta-mannosidosis was examined with the use of 4-methylumbelliferyl beta-D-mannopyranoside as substrate. The enzyme in normal adult thyroid, kidney and brain exhibited a sharp unimodal pH optimum at pH 5.0, whereas the enzyme in both normal adult and mutant liver exhibited broad pH ranges of activity (pH 4.5-8.0). No residual enzyme was detectable in mutant kidney or brain; in contrast, residual activity in mutant liver was 52% of that in a neonatal control. Concanavalin A-Sepharose 4B (Con A Sepharose) fractionation of normal adult liver beta-D-mannosidase resolved the enzyme into an unbound (non-lysosomal) from (52%) with a broad pH range of activity (pH 4.5-8.0) and a bound (lysosomal) form (48%) with a sharp pH optimum of 5.5. The enzyme in mutant liver consisted entirely of the unbound (non lysosomal) form. Beta-D-Mannosidase activity in normal adult thyroid, kidney and brain was resolved by chromatofocusing into two major isoenzymes, with pI 5.5 and 5.9, and traces of a minor isoenzyme, with pI 5.0. In normal adult liver the enzyme was also resolved into three isoenzymes with similar pI values; however, that with pI 5.0 predominated. The predominant form of the enzyme in 60-day foetal liver was bound by Con A, exhibited a unimodal pH optimum (5.0) and was resolved into two isoenzymes, with pI 5.4 and 5.8; only traces of an isoenzyme with pI 5.0 were detectable. Total hepatic beta-D-mannosidase activity increased progressively towards adult values during the last 90 days of gestation as a result of increasing non-lysosomal isoenzyme activity (pI 5.0). Lysosomal beta-D mannosidase was shown to occur in all normal goat tissues studied as multiple isoenzymes, which are genetically and developmentally distinct from the non lysosomal isoenzyme occurring predominantly, if not exclusively, in liver. PMID- 3632639 TI - Tyrosine and tyrosinate fluorescence of pig intestinal Ca2+-binding protein. AB - The single tyrosine residue in both pig and cow intestinal Ca2+-binding proteins fluoresces at 303 nm although the crystal structure of the cow protein shows a hydrogen bond between the hydroxy group of the tyrosine and glutamate-38 [Szebenyi & Moffat (1986) J. Biol. Chem. 261, 8761-8777]. The latter interaction suggests that tyrosinate fluorescence should dominate the emission spectra of these proteins. A fluorescence difference spectrum, produced by subtracting the spectrum of free tyrosine from the spectrum of the protein, gives a peak at 334 nm due to ionized tyrosine. That this component of the emission spectrum is not due to a tryptophan-containing contaminant is shown by its elimination when the protein is denatured by guanidine and when glutamate-38 is protonated. We conclude that, in solution, the tyrosine residue in this protein interacts occasionally with glutamate-38 but that a permanent hydrogen bond is not formed. PMID- 3632640 TI - Separation and characterization of pentacarboxylic porphyrinogen isomers by high performance liquid chromatography with electrochemical detection. AB - A reversed-phase h.p.l.c. system is described for the separation of all five naturally occurring pentacarboxylic porphyrinogen isomers. The compounds are detected electrochemically with high sensitivity. The peaks are positively identified by h.p.l.c. analysis of the pentacarboxylic porphyrinogens from reduction of pentacarboxylic porphyrins prepared by partial decarboxylation of hexa- and hepta-carboxylic porphyrin III of known structures. The resolution of pentacarboxylic porphyrinogens is superior to that of the porphyrins and the method is applicable to the small-scale preparative isolation of pure isomers. PMID- 3632641 TI - Does the arterial baroreflex control the initial heart rate response to standing? AB - Following a 6 min period of squatting or sitting the early cardiovascular response to standing up was investigated on a beat to beat basis using noninvasive methods in healthy young subjects. After the active transition the arterial pressure fell immediately, the peak of heart rate response was markedly delayed with respect to the minimum in pulse and mean pressure. It is concluded that arterial barore-flexes can participate in the immediate heart rate increase to standing up from the squatting or sitting position whereas the subsequent phase of the initial heart rate response might be induced rather by other mechanisms. PMID- 3632642 TI - Which information comprise Ca-mediated action potentials in cardiac muscle? AB - Ca-mediated action potentials (CaAP) from guinea pig papillary muscle have been reconstructed by means of a computer simulation. The reconstruction model is based as closely as possible on ionic currents which have been measured by voltage clamp methods. Three currents were formulated in terms of Hodgkin-Huxley type equations: a Ca inward current, a time-independent K outward current ("rectifier" current), and a time dependent slowly activated K outward current ("delayed rectifier" current). The maximum upstroke velocity of CaAP was compared with the Ca inward current. It turned out that the discrepancy between Vmax and maximum Ca current can be tremendous. A non-linearity between Vmax and gCa has been described. Furthermore, a twice peaking of the calcium current during CaAP cannot be excluded. The existence of outward currents in nearly the same size as the Ca current even during the upstroke of CaAP seriously question the use of CaAP as a measure of calcium current properties. PMID- 3632643 TI - Early postnatal development of open field behaviour is changed by single doses of fenfluramine or p-chloroamphetamine. AB - Three groups of 8 male hooded rats were treated with 50 mumol/kg fenfluramine (FF) or 50 mumol/kg p-chloroamphetamine (PCA) or the same amount of vehicle solution (NaCl) i.p. on postnatal day 8. Each rat was exposed to a 60 X 75 X 22 cm open field (OF) for 30 min from the 10th to the 30th postnatal day (pd) at the same time. FF and PCA enhanced the ambulatory activity on 11-14th pd between 200 and 1000%. Several parameters of the exploratory activity and grooming were also significantly increased in this period (p less than 0.01). Habituation to the OF was weakened. The differences disappeared during eye opening. Exploratory activity was significantly diminished in the fourth week. Most of the changes were similar after both drugs, some of them point to different actions of FF and PCA. The timing of the qualitative behavioral development was influenced by both drugs. The results demonstrate the important role of the serotoninergic system in behaviour development. Serotoninergic neurons are postulated to participate in certain forms of response inhibition. Some of the deficits may be compensated during early development. PMID- 3632644 TI - Classification of geniculo-cortical relay cells of albino rat dorsal lateral geniculate nucleus by means of multivariate analysis. AB - It was tested if responses of geniculo-cortical relay (GCR-) cells in rat dorsal lateral geniculate nucleus (dLGN) to diffuse light flashes contain features permitting a separation of the cell population into slow and fast cells like the response latency to stimulation of optic chiasm (OX-latency). The location of neurons within the dLGN found additional consideration. Using hierarchical cluster analysis two clusters were obtained for on- as well as off-like neurons, which reflected to a high degree the classification into slow and fast cells by OX-latency. Two subgroups were detected in the cluster of slow cells. Multivariate discriminance analysis made it possible to separate the cell population into two classes. The latency of primary excitation to flash (primary inhibition for off-cells), the number of impulses in the first excitation peak (duration of inhibitory period) and the location of the cells within the dLGN were suited for this separation differing in 11 up to 17% from that achieved by OX-latency classification. PMID- 3632645 TI - The postnatal development of open field behaviour of the visually deprived rat. AB - The postnatal development of open field (OF) behaviour of two groups of each 8 male hooded rats (Long-Evans strain) was compared after bilateral eye bulb removal on the seventh postnatal day (pd) in one group and sham-operation on the same day in the other group. Ambulatory activity of the deprived group was much increased (p less than 0.01) in all sessions from the 10th to the 30th pd. Their habituation of responses to the OF was stabilized with delay only on the 21st pd. The deprived rats immediately entered central fields whereas sham-operated controls began this on the 23rd pd. Exploratory behaviour as measured by groups of horizontal head and body turnings, sniffing periods, rearings and wall climbings was significantly enhanced in deprived rats during certain phases of the postnatal development. The timing of the phases was rather identical with those of the sham-operated group and with untreated controls. Grooming activity was enhanced, too. The results indicate a rather quantitative than qualitative difference to rats which can develop visually guided behaviour. The changed OF behaviour of visually deprived rats is hardly explainable in terms of changed emotionality or tendencies to reinstate social contact and attempts to evade predation or any other ethological hypothesis of OF behaviour, but may be related to the role of visual input in the development of goal-directed behaviour. PMID- 3632646 TI - Influence of diuretics on renal lithium excretion and tissue distribution of some cations in saline loaded young and adult rats. AB - In 5- and 105-day-old rats the effect of acetazolamide, cyclopenthiazide, and/or a saline load on renal lithium excretion as well as on lithium, sodium and potassium concentrations in serum and in various tissues (kidney, muscle, intestine, liver, brain) was investigated during the first 3 h after ip. administration of lithium. The administration of acetazolamide or saline led to a significant increase in renal lithium elimination in animals of both age groups, which could be stimulated additionally, when both substances were given simultaneously. In principle, increased renal lithium excretion is paralleled by enhanced sodium elimination. There was evidence for an inhibition of renal tubular lithium reabsorption and besides, extrarenal changes were observed in the lithium, sodium, and potassium distribution, which have consequences for lithium elimination as well. Lithium is accumulated to a different extent in each of the tissues investigated. Furthermore, tissue accumulation and efflux rate of lithium strongly depend on age. The influences of the diuretics and/or saline administration on possible mechanisms of renal and extrarenal lithium movements are discussed. PMID- 3632647 TI - Studies on the pharmacokinetics of hirudin. AB - Absorption, distribution and elimination of the naturally occurring thrombin inhibitor hirudin were studied in dogs after intravenous and subcutaneous injection or intraduodenal application using an assay which detects the inhibitor in blood and urine by its antithrombin activity. The plasma concentration time curve after intravenous injection of the pure polypeptide could be best described by an open two-compartment model with first-order kinetics. Dependent on the dose, long-term infusion or subcutaneous injection produced anticoagulantly effective blood levels for a prolonged period of time. The enteral absorption is very low and does not suffice to produce adequate blood levels. Hirudin is distributed into the extracellular space and eliminated through the kidneys by glomerular filtration in active form with a half-time of about 1 h. PMID- 3632649 TI - Transport of p-aminohippurate in renal cortical slices of rats of different ages following treatment with thyroid hormones. AB - Following treatment with thyroid hormones PAH accumulation is increased in renal cortical slices of 5-, 10-, 20-, 30-, 50- and 105-day-old rats. Both thyroid hormones are more effective in young than in adult rats. A single dose of T3 or T4 (20 micrograms/100 g b.m.) administered 24 h before measurement is effective whereas acute effects of T3 or T4 on PAH transport could not be demonstrated. Treatment with thyroid hormones (20 micrograms/100 g b.m., 3 days, once a day) is without any influence on body mass; there is a tendency to an increase of kidney mass following treatment with T3 or T4. Simultaneous administration of an inhibitor of protein biosynthesis (neomycin, 1 or 5 mg/100 g b.m.) reduces the effect of T3 treatment. An additional low dose of T3, 24 h before measurement of PAH transport can restore the effect of T3 treatment which was performed 9 days before. PMID- 3632648 TI - The influence of social isolation, hypoxia and immobilization on potassium stimulated dopamine release from telencephalon slices of mice. AB - Dopamine release from mice telencephalon slices was investigated following immobilization or hypobaric hypoxia exposure during periods of social isolation of different length which itself affects dopamine release in a characteristic manner. Isolation initially results in a decreasing release, which is compensated at the end by adaptive processes. The decrease of dopamine release induced by immobilization is highly dependent on the foregoing isolation. On the other hand, a hypoxia-induced decrease of release always dominates the results. Adaptive processes in consequence of social isolation are supposed to be important in relation to immobilization effects but not to hypoxia-induced changes. PMID- 3632650 TI - Changes in seizure susceptibility in rats following chronic administration of pentylenetetrazol. AB - Repeated administration of pentylenetetrazol (PTZ) once every 48 h in behaviourally active threshold and suprathreshold doses induces a marked enhancement of seizure behaviour (kindling phenomenon). In contrast, PTZ in initially subconvulsive doses failed to elicit convulsions more complex than stage 1 seizures. With 40 mg/kg PTZ i.p. kindled rats show in the fully kindled state a marked shift of the dose-response curve for PTZ-seizures to the left. The mean stage 4 dose of PTZ is 40 mg/kg in kindled and 75 mg/kg in non-kindled rats. PMID- 3632651 TI - Increase of 14C-leucine uptake following stimulation of renal tubular transport processes. AB - Following treatment with cyclopenthiazide, triiodothyronine or dexamethasone the renal excretion of p-aminohippurate (PAH) as well as the accumulation of PAH in renal cortical slices from adult rats and from rats with immature kidney function are increased. There are differences with respect to the age of the rats as well as in dependence on the substance used for treatment. In 10- and 60-day-old rats the [14C]leucine uptake following such a stimulation of kidney function is increased, that means active tubular transport of amino acids can also be stimulated. Furthermore, the [14C]leucine content in the protein fraction of homogenized kidney tissue is increased, indicating a higher degree of incorporation of amino acids in kidney tissue following treatment with cyclopenthiazide, triiodothyronine or dexamethasone. PMID- 3632652 TI - Procoagulant activity of human mononuclear blood cells (MBC). Stimulation by concanavalin A and mixed MBC culture. AB - Human mononuclear blood cells (MBC) express procoagulant activity PCA) upon stimulation in vitro. This thromboplastin activity is generated in monocytes under the influence of T-helper cell-derived signals. The own experiments described here served to establish the methodological basis for human MBC PCA generation in vitro and its measurement. Using Con A as stimulant it was shown that maximum PCA could be detected after 6-8 h of incubation. Incubation of the cells at 37 degrees C resulted in much higher PCA as compared to 40 degrees C. But in most experiments the specific differences between unstimulated controls and the Con A treated cells were more marked at 40 degrees C, because the "spontaneous" activation of controls occurred more slowly. The "spontaneous" activation of controls has been the most troublesome problem throughout the experiments, and was most likely due to traces of endotoxin in the media used. Choosing an incubation temperature of 40 degrees C it was shown that neither glass-adherent (AC) nor non-adherent cells (NAC) responded sufficiently to Con A when incubated separately. Addition of NAC to AC restored the capability to respond to Con A. NAC pulse-stimulated with Con A were able to activate AC. The same has been true for 20 h incubation supernatants of Con A-pulsed NAC. Finally, some two-way MBC mixed culture experiments are described which have been conducted under apparently endotoxin-free conditions. These results clearly show cellular PCA generation to be a sensitive indicator of allogenic recognition. PMID- 3632653 TI - [Effect of a proliferation- stimulating preparation from bovine brain on cultured calf aortic endothelial cells]. AB - A preparation from bovine brain (HS-3) stimulates the proliferation of a calf aortic cell line (BKEz-7) in concentrations between 50-200 micrograms/ml. It is especially effective at low inoculum cell density, it economizes fetal serum and is very efficient as additive for the improvement of inadequate sera. Important questions for the practical use as the properties of the preparation with regard to durability and sterile filtration have been investigated. PMID- 3632655 TI - Human genetics: the molecular challenge. PMID- 3632654 TI - Behaviour-dependent variability of potentials in the somatosensory cortex evoked by stimulation of the trigeminal nuclei in freely moving rats. AB - Nine hooded rats with chronically implanted epidural recording electrodes on the right primary somatosensory cortex, the olfactory bulb and bipolar stimulating electrodes in the left ponto-mesencephalic trigeminal nuclei and parabrachial region were investigated during different patterns of spontaneous behaviour. The early positive-negative component of the TNEP with peak times P5 and NII (ms) appeared about 1 ms earlier than after tooth pulp stimulation. The amplitude P5 N11 was slightly increased during drowsiness, decreased during slow wave sleep and was strongly decreased in behavioural patterns with movements, always compared with relaxed wakefulness. The behaviour-dependent changes of cortical EP to stimulation of trigeminal nuclei (TNEP) were analogous to those after tooth pulp stimulation. PMID- 3632656 TI - The potential of adipokinetic hormone to teach us about neuropeptides. PMID- 3632657 TI - Sodium cotransport systems: cellular, molecular and regulatory aspects. PMID- 3632658 TI - Pharmacogenetics of methyl conjugation and thiopurine drug toxicity. PMID- 3632659 TI - Many a mickle makes a muckle; network maxims may mitigate controversy. PMID- 3632660 TI - Approaching the biochemistry of virus multiplication. PMID- 3632661 TI - Highly frequent detection of transforming genes in acute leukemias by transfection using in vivo selection assays. AB - DNAs from nine out of ten acute leukemia cases that were negative by in vitro focus forming assays exhibited transforming activity tested by in vivo selection assays in nude mice using transfected NIH3T3 cells. Of the nine cases, six cases contained activated N-ras genes, and one case exhibited activation of the c-K-ras gene. None of the ras gene family showed homology with the transforming genes derived from the other two cases. Our observations indicate that in vivo selection assays detect transforming genes including ras oncogenes at high frequency, and that activated N-ras genes are frequently detected in human acute leukemias. PMID- 3632662 TI - Phosphorylation heterogeneity of tryptic phosphopeptides of chicken riboflavin binding protein. AB - The tryptic phosphopeptide of hen egg white riboflavin-binding protein has been found to exist as a mixture of peptides which differ only with respect to the number of covalently bound phosphoryl groups. Anion-exchange chromatography was used to separate homologues of the tryptic phosphopeptide of egg white riboflavin binding protein. Four peptide peaks were obtained and analyzed using plasma desorption mass spectrometry. Molecular ions obtained agree closely with calculated molecular weight values for phosphopeptides with 8, 7 and 5 phosphoryl groups. Amino acid analyses showed that the octa- and hepta-phosphorylated peptides were pure and had the same amino acid compositions. PMID- 3632663 TI - Characterization and cloning of androgen-repressed mRNAs from rat ventral prostate. AB - The involution of the prostate that occurs after castration is thought to be an active process, requiring protein synthesis. A number of "castration-induced" proteins which might be involved in this process have been identified. We recently described a group of "testosterone-repressed" mRNA sequences in the prostate which could code for these proteins. Because of their potential importance in the autophagic response we have cloned these sequences, and we report here the characterization of the most abundant of these sequences (TRPM 2), and the kinetics of the induction of this gene in the prostate after castration. TRPM-2 is induced to a maximum level of approximately 1440 ppm of total RNA six days after castration, by which time the androgen dependent, prostate steroid binding protein (PSBP) mRNA sequences have diminished to undetectable levels. The translation product of TRPM-2 is a protein of approximately 46,000 daltons, with a pI of 5.9-6.3. Since this gene is expressed in other involuting tissues, it may play an important role in the process of tissue regression. PMID- 3632664 TI - Carcinoembryonic antigen (CEA) and two crossreacting antigens of 165 kD and 105 kD isolated from meconium exhibit identical amino terminal sequences. AB - Two antigens of 165 kD and 105 kD crossreacting with the carcinoembryonic antigen (CEA) were isolated from human meconium by perchloric acid extraction, differential immunoaffinity chromatography, and size exclusion HPLC. The sequences of the 30 amino terminal amino acids of both antigens are identical with the corresponding sequence of CEA. PMID- 3632665 TI - The induction of ornithine decarboxylase by the tumor promoter TPA is controlled at the post-transcriptional level in murine Swiss 3T3 fibroblasts. AB - The expression of ornithine decarboxylase (ODC) mRNA after treatment of murine Swiss 3T3 cells with the tumor promoter TPA was studied. The induction of ODC mRNA was detectable after 20-40 min, peaked after 60-120 min and declined within 24 hrs. Using an in vitro nuclear transcription assay, we found that the polymerase II density on the ODC gene is not affected by TPA treatment. Additionally, we were able to detect stable ODC mRNAs in cycloheximide pretreated fibroblasts. These two different experimental approaches lead us to the interpretation that in Swiss 3T3 cells TPA controls ODC expression predominantly at the post transcriptional level by prolonging the half-life of ODC-mRNA. PMID- 3632666 TI - Ontogenically regulated expression of metallothionein and its messenger RNA in chick liver. AB - By electrophoretic and immunological assay the concentration of hepatic metallothionein in new born chick liver was found to be ontogenically modulated, reaching a peak accumulation per gram liver in fourth day of hatching and declining below the detection limit after second week postnatal. The protein was undetectable upto second week of incubation in egg-embryonic stage. The concentration of metallothionein mRNA shows drastic change during first few days after hatching. The greatest accumulation of metallothionein mRNA was detected in the one day new born chicks, which declined rapidly there after, and reduced to a barely detectable level. Metallothionein was also detected in the in vitro translated product of one day neonatal chick hepatic poly(A+) RNA by S-cysteine labelling and immunoprecipitation. The naturally occurring new-born chick liver metallothionein was found to be a zinc-metallothionein and the concentration of hepatic zinc in new-born chick was found to undergo drastic modulation during development, unlike some other chick tissues. Endogenous zinc ion mobilization can thus play a significant role in the developmental regulation of chick metallothionein expression. PMID- 3632667 TI - Substrate-specific stimulation of protein kinase C by polyvalent anion. AB - The activity of protein kinase C (PKC) toward arginine-rich substrates was greatly stimulated by sulfate and phosphate, but not by monovalent anions. This stimulation did not require phospholipid, calcium, or diacylglycerol, and appeared to mimic the stimulation by phospholipid. Anionic proteins such as bovine serum albumin also promoted PKC activity toward certain substrates that were characterized by either high arginine or high lysine content. The mechanism of both of these stimulations appeared to be related to formation of a substrate PKC complex which is essential to phosphorylation by PKC. Polyvalent anions bind the cationic substrate and, together with PKC, form an aggregate which allows phosphorylation. Potential physiological relevance of this stimulation is discussed. PMID- 3632668 TI - Peroxide(s) of vanadium: a novel and potent insulin-mimetic agent which activates the insulin receptor kinase. AB - The actions of insulin, vanadate (V) and hydrogen peroxide (H2O2) on IGF-II binding and insulin receptor tyrosine kinase activity were studied in rat adipocytes. Incubating adipocytes with a combination of V plus H2O2 resulted in a potent synergistic effect on both the increase in IGF-II binding and the activation of the insulin receptor kinase. Catalase, which removes H2O2, abolished this synergism if added at the time of mixing of V plus H2O2 but not if added 10 min. later, suggesting that the formation of peroxide(s) of vanadate generated a potent insulin mimicker. The data support a critical role for the insulin receptor kinase in insulin action. The novel insulin-mimetic compound, a presumed peroxide of vanadate, could prove useful for investigating insulin action and may be valuable for treating insulin resistance. PMID- 3632669 TI - Apparent cathepsin B deficiency in neuronal ceroid lipofuscinosis can be explained by peroxide inhibition. AB - Fibroblasts from patients with various forms of neuronal ceroid lipofuscinosis (NCL or Batten's disease) showed decreasing cathepsin B activity with increasing passage number and time in culture. In contrast, other lysosomal hydrolase activities were largely unaffected. Cathepsin B activity, was found to be associated with the lysosome-enriched fraction following cell disruption and Percoll gradient fractionation. Exposure of fibroblasts to low concentrations (less than 0.1 mM) of hydrogen peroxide either in vivo or in vitro resulted in a dose-dependent loss of cathepsin B activity with no concomitant loss in cathepsin H activity or lysosomal hydrolase activity. These results suggest that a primary defect resulting in accumulation of abnormal peroxides could produce a secondary cathepsin B inhibition in lysosomes and lead to observed peptide and dolichol accumulation in NCL. PMID- 3632671 TI - Conversion of leukotriene C4 to leukotriene D4 by a cell-surface enzyme of rat macrophages. AB - Leukotriene (LT) C4-metabolizing enzyme was studied using rat leukocytes. Neutrophils and lymphocytes hardly metabolized LTC4, whereas macrophages rapidly converted LTC4 to LTD4. The LTC4-metabolizing enzyme of macrophages was present in the membrane fraction but not in the nuclear, granular and cytosol fractions. When macrophages were modified chemically with diazotized sulfanilic acid, a poorly permeant reagent which inactivates cell-surface enzymes selectively, the LTC4-metabolizing activity of macrophages decreased significantly (greater than 90%). These findings suggest that rat macrophages possess the LTC4-metabolizing enzyme which converts LTC4 to LTD4, on the cell surface membrane. PMID- 3632670 TI - High production of type VI collagen in multiple fibromatosis with multiple articular dysplasia. AB - A patient with multiple fibromatosis occurring at the sites of multiple cartilagenous dysplasia was described. Collagen types solubilized with pepsin from the fibromatous tissue were fractionated by a different salt concentration and analyzed by SDS-polyacrylamide gel electrophoresis, which indicated that the tissue produces predominantly "short-chain" collagen. Western blotting of the subunits indicated a cross reaction with antisera of the type VI collagen. The results of rotatory shadowing electron microscopy confirmed the characteristic short-chain structure. PMID- 3632672 TI - Binding of non-histone chromosomal protein HMG1 to histone H3 in nucleosomes detected by photochemical cross-linking. AB - The interaction of non-histone chromosomal protein HMG1 with core histones in nucleosomes was studied via reconstitution and photochemical cross-linking. The results obtained indicated that photoaffinity-labeled HMG1 interacted in nucleosomes with histone H3. Similar experiments with peptides derived from HMG1 by V8 protease digestion allowed to identify N-terminal domain of HMG1 (peptide V3) as a binding region for histone H3 in nucleosomes. PMID- 3632673 TI - Sub-set characteristics of DNA sequences involved in tight DNA/polypeptide complexes and their homology to nuclear matrix DNA. AB - Polypeptides co-isolating with DNA induce the binding of a fraction of native DNA fragments to nitrocellulose filters. Southern analysis reveals a high intensity of self-hybridization of the DNA sequences retained on nitrocellulose filters. Consistently, the DNA fraction passing the filters shows only weak hybridization when probed with DNA retained on filters. This indicates that the DNA/polypeptide complexes reside on a non-random sub-set of DNA sequences. Moreover, a high degree of homology was found between residual nuclear matrix DNA sequences and the DNA sequences retained on nitrocellulose filters. This indicates that the DNA sequences associated with tightly bound polypeptides originate from sites where the genome is salt-stably anchored in the nuclear matrix. PMID- 3632674 TI - Radiolabelling of DNA/polypeptide complexes in isolated bulk DNA and in residual nuclear matrix DNA by nick-translation. AB - Conditions are described that allow 32P-radiolabelling and detection of tight complexes between DNA and polypeptides by nick-translation. Prolonged nick translation of purified bulk DNA results in radiolabelled complexes migrating on SDS-polyacrylamide gels with apparent molecular weights of 68 kd and 54 kd respectively. Residual nuclear matrix DNA which is not accessible to DNase I on the nuclear level becomes accessible to radiolabelling by nick-translation on the nuclear matrix level. In this case the in situ radiolabelled complexes migrate on SDS-polyacrylamide gels with apparent molecular weights of 68 kd and 100 kd. The DNA/polypeptide complexes are stable during treatments with SDS, beta-mercapto ethanol and alkali which points to covalent bonds between the polypeptides and DNA strands. PMID- 3632675 TI - Evidence for the one-electron oxidation of 1-methyl-4-phenyl-2,3 dihydropyridinium (MPDP+). AB - Optical data have shown that the neurotoxin metabolite 1-methyl-4-phenyl-2,3 dihydropyridinium undergoes one-electron oxidation/reduction in the presence of iron chelates. The activation energy for one-electron oxidation of 1-methyl-4 phenyl-2,3-dihydropyridinium is less than that for two-electron oxidation. Horseradish peroxidase catalyzes the oxidation of 1-methyl-4-phenyl-2,3 dihydropyridinium. Reactivity of 1-methyl-4-phenylpyridinyl radical is discussed in relation to the well-known pyridinyl radicals. PMID- 3632676 TI - Immunochemical probing of the N-terminus of the myosin heavy chain. AB - The reactivity of myosin subfragment 1 (S-1) towards site specific polyclonal anti-N-terminus antibodies was examined in competitive ELISA titrations. Tryptic digestion of S-1 and specifically the cleavage at the 25/50K junction greatly increased the accessibility of the N-terminus region to the antibodies. The binding of actin to S-1 did not change significantly the reactivity of either tryptic or intact S-1 towards anti-N-terminus antibodies. These results suggest the interdependence of the N-terminus and 25/50K junction regions on S-1. PMID- 3632677 TI - Inhibition of sodium-dependent transport systems in rat renal brush-border membranes with N,N'-dicyclohexylcarbodiimide. AB - Treatment of rat renal brush-border membrane vesicles with N,N' dicyclohexylcarbodiimide (DCCD) causes irreversible inhibition of the Na+-coupled transport systems for D-glucose, L-phenylalanine, L-glutamate, and sulfate. The DCCD-reactive side groups of these transport systems differ in their sensitivity towards DCCD and protection by substrates. The D-glucose and L-glutamate transporters cannot be protected by their substrates. In contrast, Na+ protects the transport systems for L-phenylalanine and sulfate from inactivation by DCCD. The data suggest covalent modification by DCCD of D-glucose and L-glutamate transporters apart from their substrate binding sites and of L-phenylalanine and sulfate transporters within their Na+-binding regions. PMID- 3632678 TI - A single form of protein kinase C is expressed in bovine adrenocortical tissue, as compared to four chromatographically resolved isozymes in rat brain. AB - Protein kinase C purified to apparent homogeneity from rat brain was resolved into four active moieties following chromatography over a hydroxyapatite high resolution system. By contrast, the same procedure applied to bovine adrenocortical protein kinase C revealed that a single protein kinase C isoform could be detected in this tissue, with a chromatographic behavior identical to that of one of the brain isoenzymes. Although the isolated protein kinase C isozymes were all activated to various degrees in the presence of phospholipids and calcium, quantitative differences were observed in their catalytic properties, especially with regard to their sensitivity to diacylglycerol and TPA and to their relative affinity for different protein substrates. These observations confirmed at the protein level the heterogeneity of protein kinase C predicted on the basis of cDNA cloning studies. They also suggest that the expression of a specific set of protein kinase C isoenzyme(s) in a given cell type deserves further attention, since it may reflect a functional significance with regard to the regulation of specific cellular processes. PMID- 3632679 TI - Erythrocyte membrane heterogeneity studied using 1,6-diphenyl-1,3,5-hexatriene fluorescence lifetime distribution. AB - The fluorescence decay of 1,6-diphenyl-1,3,5-hexatriene has been used to characterize the structural organization of erythrocyte membranes. At 37 degrees C a large fraction of the decay (0.96) is associated with a lifetime value of 11.31 ns, while a minor fraction has a short lifetime of 2.63 ns. The distribution analysis approach has shown that the 11 ns component can be described using a Lorentzian distribution function having a full width at half maximum of 0.27 ns. The width of this component is associated with the membrane structural organization since liposomes from erythrocyte total lipid extract exhibit a narrower width. Moreover the distribution width is sensitive to different treatments of erythrocyte membrane. PMID- 3632680 TI - Evidence that post-transcriptional changes in the expression of mitogen regulated protein accompany immortalization of mouse cells. AB - Primary mouse embryo fibroblasts passed in culture go through a period of declining growth rate and then after a period of minimal proliferation begin to grow again, generating, under appropriate conditions, an immortal 3T3 line. The 3T3 cells, but not the primary mouse embryo fibroblasts, are able to synthesize and to secrete mitogen regulated protein (MRP, also known as proliferin). We report here that the level at which the change in gene expression occurs during this spontaneous immortalization process is post-transcriptional, reflecting a change in either RNA processing or transcript stability. To our knowledge, this is the first report of an alteration at the post-transcriptional level of gene expression that accompanies immortalization. PMID- 3632681 TI - Infrared spectroscopic evidence for a conformational alteration of plant plasma membranes upon exposure to the growth hormone analog, 2,4-dichlorophenoxyacetic acid. AB - Infrared spectroscopy of highly purified fractions of plasma membrane vesicles from hypocotyls of etiolated soybean (Glycine max L.) seedlings revealed changes in bands assigned to proteins and phospholipids upon exposure to the growth hormone analog, 2,4-dichlorophenoxyacetic acid (2,4-D). The changes included a concentration dependent broadening of amide I absorbance and a change in the absorbance ratios of amide I and amide II indicative of a change in protein conformation. Band broadening of amide I was observed at 2,4-D concentrations as low as 10(-8) M, and the optimal 2,4-D concentration to evoke the change was 1 microM whereas the amide peak ratios (amide II/amide I) declined steadily over the range of concentrations (10(-8) to 10(-3)M) tested. An alteration in hydrocarbon chains (CH2 scissoring) was seen only at 1 mM (10(-3) M) 2,4-D. In contrast, the vibrational frequency of the choline stretch declined proportionally over the range 10(-6) to 10(-3). The findings provide evidence for a conformational change in the plasma membrane in response to the hormone demonstrable in a cell-free system. PMID- 3632682 TI - A rapid affinity method for isolation and characterization of sequence specific DNA binding factor. AB - An affinity chromatography technique using avidin monomer and biotin interaction was used for isolating a sequence specific DNA binding factor. This approach was used for purifying a transcription factor that binds to 152 to 160 base pairs upstream of the transcription start site of adenovirus IVa2 promoter. A 432 bp IVa2 promoter fragment was isolated and was incorporated with biotin at the 5' end using Bio-11-dUTP and Klenow fragment of DNA pol I, it was then bound with factor in vitro in reactions containing hela cell extract in optimized conditions. After incubation, reactions were loaded onto an avidin monomer column. Adenovirus IVa2 transcription factor was purified by 0.3M, 0.6M Nacl in binding buffer, band retardation assays demonstrated a 12,000 fold purification of factor was obtained. PMID- 3632683 TI - Stimulation of DNA synthesis in primary cultures of adult rat hepatocytes by sodium butyrate. AB - Replicative DNA synthesis in primary cultures of adult rat hepatocytes is increased by the addition of the histone deacetylase inhibitors, propionate or butyrate. DNA synthesis was increased by the addition of 0.5 or 1.0 mM butyrate; in contrast 5.0 mM butyrate inhibited replicative DNA synthesis. Replicative DNA synthesis was increased only when low levels of butyrate were added as the hepatocytes entered the S phase. The observed apparent increase in replicative DNA synthesis was real, and not owing to changes in the specific activity of the dTTP precursor pool. The effects of butyrate and propionate on DNA synthesis appear to be related to their effects on histone acetylation. PMID- 3632684 TI - Fluoride effects on 31P NMR spectra of macrophages. AB - 31P High resolution nuclear magnetic resonance studies have been carried out on the P388D1 tumoral cell line and the BCG elicited alveolar rabbit macrophages both in sedimented cells and in perfused agarose-embedded cells. When the cells were sufficiently oxygenated, the phosphorylated sugars and ATP concentrations attained high levels. The intensity of the peak representing phosphorylated sugars varied inversely with ATP level when macrophagic cells were treated by NaF. The identities of the phosphorylated sugars were revealed by 1H and 31P NMR studies of the P 388D1 cells perchloric extracts. PMID- 3632685 TI - Isolation and characterization of the alpha and beta chains of human platelet glycoprotein Ib. AB - Human platelet glycoprotein Ib has been purified in milligram amounts from platelets obtained by pheresis of thrombocytotic donors. Purification steps included lectin (wheat germ agglutinin) and immuno (murine monoclonal anti glycoprotein Ib antibody)-affinity chromatography. The disulfide-linked individual alpha and beta chains of GPIb were separated and the amino-terminal amino acid sequence of each chain was determined. Rabbit polyclonal antibody directed against each individual chain was prepared by affinity chromatography and shown to be monospecific by western blot analysis using whole platelet lysate as antigen. These studies outline a useful approach to isolate and characterize the individual chains of GPIb. PMID- 3632686 TI - Analysis by flow cytometry of rat hepatocytes from different acinar zones. AB - Many functional, morphological and biochemical differences among hepatocytes from different acinar zones have been described. Therefore, it will facilitate studies on liver metabolism rapid, non-destructive procedures to isolate hepatocytes from these zones. Flow cytometry is a new powerful tool which, however, has not been used thus far to accomplish the separation of hepatocytes from different acinar zones. We describe here various cytometric parameters which characterize hepatocyte populations, separated by isopycnic centrifugation in Percoll gradients. The intraacinar origin of the different hepatocytes was assessed by enzymatic and morphological measurements. PMID- 3632687 TI - Protective effect of endogenous coenzyme Q on both lipid peroxidation and respiratory chain inactivation induced by an adriamycin-iron complex. AB - Mitochondria from beef heart have been partially depleted of coenzyme Q by pentane extraction. It has been found that lipid peroxidation induced by an adriamycin-iron complex proceeds at a higher rate in this preparation than in coenzyme Q reincorporated mitochondria. Moreover in coenzyme Q depleted mitochondria both NADH and succinate oxidase activities result more affected. These observations indicate that endogenous coenzyme Q can effectively protect mitochondria from membrane lipid oxidative damage induced by adriamycin-iron and can reduce the inactivation of NADH and succinate oxidases. PMID- 3632688 TI - On the relationship between nucleotide hydrolysis and microtubule assembly: studies with a GTP-regenerating system. AB - The assembly of pure tubulin dimer has been studied in two buffer systems (containing low and high glycerol/Mg), using a regeneration system protocol to assess the amount of GDP-tubulin in the assembling polymer. For both assembly systems studied, the GDP content is effectively stoichiometric with tubulin throughout assembly. This indicates a high degree of coupling between assembly and GTP-hydrolysis, giving a hydrolysis rate at least 10-fold faster than previously deduced. The steady state GTP hydrolysis rate is quantitatively consistent with this finding. We conclude that the extent of any GTP-tubulin cap is below the detectable limit, both during elongation and at steady state. PMID- 3632689 TI - Cross-linked polymers in the red cell membranes of a patient with Hb-Koln disease. AB - Membranes isolated from the red cells of a Hb-Koln patient were shown to contain appreciable amounts of N epsilon-(gamma-glutamyl)lysine, the characteristic product of the post-translational cross-linking of proteins by transglutaminase. Such an apparently irreversible fusion of membrane proteins may contribute to the membrane defect in Hb-Koln disease. PMID- 3632690 TI - Alternative splicing model for the synthesis and secretion of the 20 kilodalton form of rat growth hormone. AB - The characterization of a 20 kilodalton (20 kD) variant of rat growth hormone is reported. The 20 kD variant from rat pituitary gland extracts was identified on Western immunoblots of polyacrylamide gels. It was also shown that pituitary tissue maintained in culture secretes the 20 kD form. A rat growth hormone cDNA fragment was used as a probe in S1 nuclease mapping experiments of rat pituitary poly (A) mRNA to detect the presence of two growth hormone mRNAs in the rat pituitary gland. The protected mRNAs correspond to the predicted sizes that would encode the 22 kD and 20 kD forms of growth hormone. The site of variation between the mRNAs maps to a potential alternative 3' splice site in the 5' end of exon 3 of the coding sequence. The results support the hypothesis that the 20 kD variant in rat is the product of an mRNA alternatively spliced in exon 3, as is the case for the human growth hormone. PMID- 3632691 TI - External GSSG enhances intracellular glutathione level in isolated cardiac myocytes. AB - The addition of external GSSG at concentrations in the range 50-500 microM produces in isolated adult rat heart myocytes an increase of GSH level and only a slight increase of GSSG level. On the contrary, external GSH at the above same indicated concentrations did not change the cell glutathione pool. The pretreatment of the cells with diethylamaleate depleted the myocytes of glutathione and enhanced the GSSG-induced replenishment effect on GSH level. On the contrary, the addition of GSH did not increase the concentration of cell glutathione. The level of cell GSH in diethylmaleate-treated myocytes was not increased after 30 min of incubation with cysteine, or acetylcysteine. The GSSG induced-stimulation on GSH level was not inhibited by buthionine sulfoximine, an inhibitor of glutathione synthesis. On the contrary, this stimulatory effect was inhibited by N, N-bis(2-chloroethyl)-N-nitrosourea, an inhibitor of glutathione reductase, or partially, by the remotion of glucose from the incubation medium. These results support the idea that the isolated adult rat heart myocytes are able to utilize external GSSG in order to increase the intracellular glutathione pool, probably through the reduction of the imported GSSG to GSH. PMID- 3632692 TI - Isolation and uptake characteristics of adenovirus transformed cell revertants resistant to the antiproliferative effects of methylglyoxal bis(guanylhydrazone). AB - Four independent variant cell lines resistant to the toxic action of methylglyoxal bis(guanylhydrazone), an anticancer drug and inhibitor of polyamine synthesis, have been isolated by single step selection from an adenovirus type 2 transformed rat brain cell line. Drug-resistance was accompanied by loss of tumorigenic potential in athymic nude mice. MGBG resistance was attributable to decreased drug uptake. PMID- 3632693 TI - Isolation of murine pluripotent hemopoietic stem cells in the Go phase. AB - A method to purify pluripotent hemopoietic stem cells in the Go phase from mouse bone marrow was established. Bone marrow cells from 5-fluorouracil (5-FU)-treated mice were fractionated by Percoll density gradient. The cells with density between 1.063 and 1.075 were further separated into wheat germ agglutinin (WGA) positive and -negative cells using fluorescent-activated cell sorter (FACS) after staining with fluorescein isothiocyanate-conjugated WGA (FITC-WGA). An assay for spleen colony-forming units (CFU-S) revealed that the WGA-positive cells (1 X 10(6)) produced 1380 CFU-S (about 150 times of the number in the original bone marrow cells) on day 12 (but no CFU-S on day 8), whereas the WGA-negative cells produced no CFU-S. Thus, the stem cells in the Go phase are found to be enriched 150 times in 5-FU-treated WGA-positive cells. PMID- 3632694 TI - Increased 13-hydroxyoctadecadienoic acid content in lipopolysaccharide stimulated macrophages. AB - Endotoxin-stimulated mouse peritoneal macrophages were found to contain 13 hydroxyoctadecadienoic acid, which was released upon alkaline hydrolysis of the cells. Compared to untreated cells, incubation with LPS increased the content of 13-hydroxyoctadecadienoic acid in macrophage hydrolysates to about 8-fold. Analysis of the material on chiralphase HPLC revealed that it consisted prevalently of 13(S)-hydroxyoctadecadienoic acid. This indicates its enzymatic origine. PMID- 3632695 TI - TPA-induction of c-fos mRNA during the cell cycle of WI-38 human fibroblasts. AB - A brief exposure of quiescent (Go) WI-38 human fibroblasts to the tumor promoter TPA results in an increase in the mRNA levels of c-fos protooncogene. The same effect is produced by exposing to TPA human diploid fibroblasts WI38 synchronized in S phase by treatment with 2.5 mM hydroxyurea. Induction of c-fos mRNA in response to TPA occurs also during the progression of synchronized WI38 throughout the second and third cell cycle, but it is not associated with measurable changes in the cell cycle progression of these cells. These findings suggest that TPA induction of c-fos mRNA levels in proliferating cells is a stimulus specific rather than a function specific event. PMID- 3632696 TI - Dissociation of recombinant tumor necrosis factor-alpha studied by gel permeation chromatography. AB - The structure of tumor necrosis factor-alpha (TNF-alpha) was studied using gel permeation chromatography. At an initial protein concentration of 0.4 mg/ml, the TNF-alpha exists as a compact trimer with a Stokes radius of 2.3 +/- 0.1 nm. This trimer dissociates as the protein concentration is decreased, and this dissociation is effected by pH. At the lower protein concentrations at pH 6.0 a species with a Stokes radius of 1.9 +/- 0.1 nm, possibly monomer, is evident. This species is not obvious at pH 7.0, but instead a species with a Stokes radius of 2.2 +/- 0.1 nm appears. PMID- 3632697 TI - Near infra-red sensitivity of the eye of the crustacean Mysis relicta? AB - When individuals of the crustacean Mysis relicta are fully dark-adapted and preparations for electroretinogramme recordings are performed in infra-red light of wavelength greater than 730 nm, responses to 300 ms flashes of light can be recorded. Though this is the first time that responses to such long wavelengths have ever been reported for any invertebrate photoreceptor, the authors suggest that near infra-red sensitivity in arthropods could be more widespread, and that because of very long adaptation and sensitivity regeneration times preparations should not be carried out in red light, hitherto deemed invisible to most arthropods, but with the aid of an infra-red image converter and a filter at wavelengths greater than 800 nm. PMID- 3632698 TI - Microheterogeneity of the malate dehydrogenase from several sources. AB - Different homogeneously purified cytosolic malate dehydrogenases gave, on isoelectric focusing, several active bands. The phenomenon could not be assigned to differences in their molecular weights or to alterations in the enzyme preparations during the purification procedure. Resolution of the multiple malate dehydrogenase active bands was achieved by chromatofocusing. The aged isolated subforms always yielded the original electrofocusing pattern. This fact suggests that conformational isomerism is a likely explanation for the charge heterogeneity of the enzymes studied. PMID- 3632699 TI - Phosphorothioated binary complex of eukaryotic initiation factor eIF-2 and GDP inhibits protein synthesis in hemin-supplemented reticulocyte lysates. AB - The rabbit reticulocyte heme-regulated eIF-2 alpha kinase (HRI) utilizes adenosine-5'-0-(3-thiotriphosphate) (ATP-gamma-S) as a substrate for its autophosphorylation and activation, and for the phosphorylation of eIF-2. The phosphorothioated binary complex [eIF-2(alpha-[35S]P) . GDP], interacted with the reticulocyte reversing factor (RF) in in vitro assays, and inhibited the ability of RF to catalyze GDP exchange from (eIF-2 . [3H]GDP) complexes. The phosphorothioate residue in the binary complex was resistant to phosphatase action under protein synthesis conditions. eIF-2(alpha-[35S]P) . GDP inhibited protein synthesis in hemin-supplemented lysates with biphasic kinetics, but had no effect on protein synthesis in heme-deficient lysates. The data reported here indicate that phosphorylation of eIF-2 . GDP alone, through the ability of eIF 2(alpha-P) . GDP to bind and sequester RF, is sufficient to inhibit protein chain initiation in the reticulocyte lysate. PMID- 3632700 TI - Uncoupling of mitochondrial oxidative phosphorylation by hexetidine. AB - To gain further insight into the biochemical properties of the antibacterial hexetidine, isolated rat liver mitochondria were added with this drug and investigation made of certain features related to mitochondrial bioenergetics. Hexetidine was found to cause oxidation of intramitochondrial pyridine nucleotides and stimulate the rate of oxygen uptake caused by respiratory substrates involving three, two and one site(s) of phosphorylation. Reversal of oxygen uptake inhibition by oligomycin was also determined. By investigating hexetidine effect on oxidative phosphorylation, hexetidine was found both to inhibit the rate of ATP synthesis and to cause ATP hydrolysis. Likewise, hexetidine capability to produce acidification of extramitochondrial medium and to collapse delta psi was also observed. The reported findings show that hexetidine exhibits uncoupling properties. PMID- 3632701 TI - Transient induction of ornithine decarboxylase mRNA in rat hepatoma cells treated with 12-O-tetradecanoylphorbol-13-acetate. AB - The contribution of changes in mRNA levels to the induction of ornithine decarboxylase (ODC) by 12-O-tetradecanoylphorbol-13-acetate (TPA) in rat H35 hepatoma cells was analyzed by Northern blot and quantitative dot blot hybridization. ODC mRNA accumulated rapidly in TPA-treated cultures. The increase in message was transient, reaching a peak within about 3 h, then declining to control levels after 18 h. Maximal accumulation of ODC-specific mRNA varied from 3- to 8-fold above control. The TPA dose-response for ODC message accumulation was half-maximal at approximately 0.18 microM TPA. The increase was completely blocked by actinomycin D, suggesting that TPA stimulates the transcription of ODC genes. Inhibition of protein synthesis by cycloheximide (10 micrograms/ml) led to a superinduction of ODC mRNA in the presence of TPA, which suggested that a short lived protein may be responsible for negative control of ODC expression. PMID- 3632702 TI - Monoamine oxidase activities in lymphocytes and granulocytes taken from pig blood. AB - The characterisation of monoamine oxidase activities in lymphocytes and granulocytes was studied using cells prepared from pig blood. The specific activities against beta-phenylethylamine, benzylamine, tyramine and 5 hydroxytryptamine as substrates in granulocytes (G) were approximately twice those found in lymphocytes (L). The absence of the semicarbazide-sensitive amine oxidase (SSAO) was confirmed by insensitivity of the latter to semicarbazide as inhibitor with benzylamine as substrate. MAO activity present in (G) and (L) was selectively inhibited by low deprenyl concentrations; this fact, in addition to the simple sigmoid inhibition curves obtained with increasing concentrations of clorgyline with tyramine as substrate, suggests that the MAO activity present both in (G) and (L) is predominantly of the MAO-B form. The absence of any contamination with plasma amine oxidase (EC 1.4.3.6) was confirmed by the fact that activity towards benzylamine (Bz) was insensitive to KCN-induced inhibition. Kinetic constants were determined for each fraction towards beta-phenylethylamine (PEA) and Bz as substrates. MAO-B was titrated with unlabelled pargyline, deprenyl and [3H]-pargyline; the corresponding Kcat values, turnover number and the active concentrations were then determined. The molecular weight of MAO-B present in both cellular fractions was calculated by SDS-electrophoresis and fluorography, after reaction with [3H]-pargyline. Some of these results are compared with those obtained with human blood leucocytes. PMID- 3632703 TI - Generation of formaldehyde by N-demethylation of antipyrine. Detection of formaldehyde in bile by 13C-NMR spectroscopy. AB - The importance of NMR spectroscopy as a tool to investigate metabolic events in vitro and in vivo becomes more and more evident. Particularly 13C-NMR spectroscopy is able to deliver a wide range of information regarding the chemistry of xenobiotics in vivo. We studied the N-demethylation of N-methyl-13C labelled antipyrine using an isolated perfused rat liver with a fluorocarbon suspension (FC 43) as oxygen carrier. Bile was collected in different fractions during the experiment. On the vascular side metabolite formation was monitored by continuous flow NMR spectroscopy. In bile the metabolic events were detected by standard NMR techniques. The bile spectra exhibit, among others, a signal at 84.2 ppm, indicating formaldehyde hydrate derived from the N-methyl group of antipyrine by an oxidative metabolic pathway. Neither formaldehyde hydrate nor other oxidation products could be detected in the vascular perfusate. The biliary excretion of considerable amounts of formaldehyde during the N-demethylation of antipyrine might have toxicological consequences for the intra- and extrahepatic bile ducts. PMID- 3632704 TI - Warfarin resistance. Vitamin K epoxide reductase of Scottish resistance genes is not irreversibly blocked by warfarin. AB - The dithiothreitol-dependent vitamin K 2,3 epoxide (vitamin KO) reductase activity in liver microsomes of Scottish-derived warfarin-resistant Wistar rats (Tolworth Laboratory) was compared to that of susceptible Wistar rats. Under the test conditions, reductase activities in liver homogenates and in liver microsomes were comparable for both strains. The in vitro i50 of S-warfarin for microsomal reductase activity was 1 to 2 microM in both strains. The effect of in vivo S-warfarin was investigated after single doses, i.e. 0.2 and 1 mg/kg for the susceptible rats, and 1 and 5 mg/kg for the resistant rats. At 20 hr following the warfarin administrations in the susceptible strain, microsomal reductase was suppressed to about 30% of control. Microsomal reductase activity in the resistant strain was not reduced. Tissue and microsomal warfarin concentrations, however, were comparable in both strains. Wash experiments with microsomes which were treated in vitro with S-warfarin showed that vitamin KO reductase of the warfarin-resistant strain was not irreversibly inactivated by warfarin. The reactivation was mediated by DDT. The results suggest the following characteristic of the vitamin KO reductase of the Scottish resistance gene: contrary to the "normal" enzyme, the tight complex between the inhibitor and the resistant enzyme is liable to reactivation by reduction of the disulfide bridge in the active centre of the enzyme. This property explains the resistance for 4 hydroxycoumarin anticlotting activity. PMID- 3632705 TI - Action of carbamoylating agents on the uptake of metabolites in hepatomas and liver. AB - The effects of 2-chloroethylisocyanate, ethylisocyanate and sodium cyanate on the uptake of isotope-labeled thymidine, leucine and H2O were compared in rat liver and hepatomas. The data suggested that carbamoylating agents may have a common property of inhibiting uptake of compounds in hepatomas under conditions in which there is a smaller effect or no action in the liver of tumor-bearing rats. The distinction between tissues may have been mediated, in part, through effects on tumor circulation and was less apparent when isolated cells were studied in vitro. Preferential inhibitory effects of carbamoylating agents on the uptake of leucine and H2O were also observed with a murine hepatoma, but they were not as great as with rat hepatomas. PMID- 3632706 TI - High magnitude hepatic cytochrome P-450 induction by an N-substituted imidazole antimycotic, clotrimazole. AB - A 4-fold induction of hepatic microsomal cytochrome P-450 following 3 days of treatment of rats with clotrimazole (75 mg/kg), a potent monooxygenase inhibitor, greatly exceeded that evident from similar phenobarbital and dexamethasone treatment. The clotrimazole-induced microsomes exhibited a pattern of monooxygenase activities similar to that seen in microsomes from both phenobarbital- and dexamethasone-treated animals. Precautions were necessary to determine both monooxygenase activities and the full amount of cytochrome P-450 present in microsomes because of interference by residual clotrimazole in the microsomes. PMID- 3632707 TI - Kinetic studies on benzene metabolism in rat liver--possible presence of three forms of benzene metabolizing enzymes in the liver. AB - The effects of food deprivation, ethanol consumption and phenobarbital (PB) administration on in vitro benzene metabolism in rat liver were studied by using benzene concentration ranging from 0.0055 to 6.25 mM. The kinetic analysis suggested that the liver of normally-fed rats contained two forms of benzene hydroxylases each with a Km value of 0.01 mM or 0.07 mM. The isozyme with a Km of 0.01 mM disappeared following one-day food deprivation, but the deprivation enhanced the activity of the other isozyme. Ethanol treatment markedly increased the activity of both normally-existing enzymes. On the other hand, PB treatment induced the synthesis of another benzene-metabolizing enzyme with a high Km value of 4.5 mM, the presence of which was indistinct in normal rats. The treatment had no influence on the activity of either of the normally-occurring low-Km isozymes. The combined effects of PB with food deprivation were additive, suggesting that the induction of low- and high-Km isozymes is each independent of the other. PMID- 3632708 TI - Inhibition of leishmanial DNA synthesis by sinefungin. AB - RNA, DNA and protein biosynthesis were studied in Leishmania donovani and L. tropica promastigotes cultured with or without sinefungin. Thymidine incorporation was significantly impaired by this compound. Neither the uptake of thymidine nor its phosphorylation were inhibited. Furthermore the ratios of deoxyribonucleotide to the corresponding ribonucleotide were not significantly affected by sinefungin. Analysis of the DNA indicates that the inhibition of thymidine incorporation affects mostly nuclear DNA, kDNA being less affected by this drug. No such effect on thymidine incorporation was observed in macrophages, the host cells of these parasites. PMID- 3632709 TI - Bromosulfophthalein abolishes glutathione-dependent protection against lipid peroxidation in rat liver mitochondria. AB - The effect of bromosulfophthalein (BSP) on GSH-dependent protection against lipid peroxidation in rat liver mitochondria was examined. Mitochondrial lipid peroxidation induced by ascorbate-Fe2+ was prevented by GSH, and addition of BSP abolished the protective effect of GSH. The effect of BSP was apparently not due to causing disappearance of GSH from the reaction mixture by interacting directly with GSH. BSP strongly inhibited the mitochondrial GSH S-transferase activity rather than the GSH peroxidase activity. Ascorbate-Fe2+-induced lipid peroxidation in mitochondria without addition of GSH was also stimulated to some extent by BSP, and the stimulation seems likely to be due to abolition of the inhibitory effect of endogenous GSH. GSH could not be replaced as an inhibitor of lipid peroxidation by cysteine, beta-mercaptoethanol, or dithiothreitol. The inhibitory effect of GSH on lipid peroxidation was not observed in vitamin E deficient mitochondria. No inhibitory effect of exogenous vitamin E was demonstrated either in vitamin E-deficient mitochondria or in vitamin E sufficient mitochondria in the presence of BSP, whether GSH was added or not. These results indicate that a mitochondrial GSH-dependent factor which inhibits lipid peroxidation requires vitamin E to exert its function. It is suggested that mitochondrial GSH S-transferase(s) may be responsible for GSH-dependent inhibition of lipid peroxidation in mitochondria, probably by scavenging lipid radicals. PMID- 3632710 TI - Inhibition of rat aorta semicarbazide-sensitive amine oxidase by 2-phenyl-3 haloallylamines and related compounds. AB - The inhibition of semicarbazide-sensitive amine oxidase (SSAO) in rat aorta homogenates by some 2-phenyl-3-haloallylamines has been studied. Derivatives containing a fluorine atom were approximately three times more potent than the corresponding 3-chloroallylamines. These halogen-containing compounds were irreversible inhibitors of SSAO after preincubation with aorta homogenates; kinetic evidence for an initial competitive, reversible interaction (Ki around 0.4-0.6 microM) was found with two compounds (MDL 72145 and 72274). A similar Ki (approx. 0.7 microM) was obtained with 2-phenylallylamine (MDL 72200). However, this compound which lacks a halogen atom was a reversible inhibitor, even after preincubation. The use of a spectrophotometric assay to measure H2O2 production from amine metabolism demonstrated that MDL 72200 was a substrate (Km = 1.4 microM) for SSAO, with a Vmax approximately five times smaller than that of benzylamine (Km = 8.1 microM). Of particular interest in this study is the finding that (E)-2-phenyl-3-chloroallylamine (MDL 72274) is highly selective as an inhibitor of SSAO, compared with MAO-A or B activities, and may be a useful compound for investigating the importance of SSAO in animal tissues. PMID- 3632711 TI - On the role of O-methylation in the metabolism of S-adenosylmethionine in rat brain. AB - The effects of tropolone and pyrogallol in areas of the rat brain with a high and low density of catecholaminergic innervation, i.e. the striatum and cortex, on S adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) concentrations were studied and related to the extent of catechol-O-methyltransferase (COMT) inhibition. Moreover, the effects of drugs enhancing dopamine (DA) or noradrenaline (NA) utilization in these areas were also investigated. Pyrogallol reduced the concentrations of SAM in a similar manner in both areas and increased SAH much more in the cortex than in the striatum; these effects corresponded to that on O-methylation in terms of dose-effect relationships, indicating that there is no compartmentation of SAM with respect to the methylation process in which it is used. Tropolone increased SAM and decreased SAH in the striatum only, and these effects occurred at somewhat higher doses than the inhibition of COMT. Together with the data showing that DA antagonists decrease SAM in the striatum, this suggests that a significant proportion of SAM metabolism in this area results from O-methylation of DA (or its deaminated metabolite). A number of antidepressants did not alter the levels of SAM in either area, but some of the drugs increased SAH in the cortex. However, this was not correlated with their effects on the noradrenergic system. Inhibition of the synthesis and decarboxylation of SAM by cycloleucine and methylglyoxal bis(guanylhydrazone) (MGBG), respectively, did not cause the expected pattern of changes, i.e. decreases of both SAM and SAH in the former case and either increase or no change in both parameters in the latter. Instead, both cycloleucine and MGBG increased SAH while decreasing SAM, suggesting an involvement of other properties of these drugs. PMID- 3632712 TI - Dichloro-p-nitroanisole (DPNA)-demethylation not specifically induced by phenobarbitone in mice. PMID- 3632713 TI - Effect of phorbol ester on rat liver regeneration. PMID- 3632714 TI - Inhibition of the mitochondrial NADH-oxidase (NADH-coenzyme Q oxido-reductase) enzyme system by flavonoids: a structure-activity study. PMID- 3632715 TI - Hepatic disposition of clinically useful 5-nitrofurans. PMID- 3632716 TI - N-acetylcysteine and glutathione-dependent protective effect of PZ51 (Ebselen) against diquat-induced cytotoxicity in isolated hepatocytes. AB - The glutathione peroxidase (GSH-Px)-like reduction of H2O2 by the selenoorganic compound 2-phenyl-1,2-benzoisoselenazol-3(H)-one (PZ51: Ebselen) was studied using glutathione (GSH) and the therapeutic agent N-acetylcysteine (NAC) to provide reducing equivalents. In a purely chemical system containing H2O2 and in an enzymatic system of glucose/glucose oxidase-generated H2O2 Ebselen alone did not reduce H2O2. Ebselen in combination with either GSH (1 mM) or NAC (1 mM) was capable of reducing H2O2 in both systems. In these non-cellular systems GSH was a more effective source of reducing equivalents than NAC. The GSH-Px-like activity of Ebselen was further investigated in a cellular system. The redox-cycling bipyridylium compound diquat generates active oxygen species, depletes intracellular glutathione, and is cytotoxic in isolated hepatocytes pretreated with the glutathione reductase inhibitor 1,3-bis(Z-chloro-ethyl)-1-nitrosourea (BCNU). Ebselen alone did not ameliorate diquat cytotoxicity, but in combination with either GSH (1 mM) or NAC (1 mM) it produced a significant delay in diquat induced cytotoxicity. Further additions of either GSH (0.5 mM) or NAC (0.5 mM) at 30 min intervals provided significantly more protection against diquat-induced cytotoxicity and intracellular GSH depletion than the single 1 mM addition. Thus, the combination of Ebselen and NAC may provide an effective antidote in cases of overexposure to bipyridylium herbicides, such as diquat and paraquat. PMID- 3632717 TI - Identification of a human liver cytochrome P-450 exhibiting catalytic and immunochemical similarities to cytochrome P-450 3a of rabbit liver. AB - Immunoblot analysis of liver microsomes from nine patients demonstrated that each contained a cytochrome P-450 that reacted with an antibody directed against the ethanol-inducible rabbit liver cytochrome, P-450 3a. Two of the liver specimens exhibited high concentrations of the immunoreactive protein, high rates of aniline hydroxylation and N-nitrosodimethylamine demethylation, and extensive inhibition of activity in the presence of antibody to P-450 3a. One other liver specimen exhibited a very low rate of aniline hydroxylation with significantly less antibody inhibition. The variability witnessed was independent of the alcohol history of the individual patients, suggesting that the human cytochrome may be under some other environmental, dietary or genetic regulation. Its inducibility by ethanol was not directly studied in this investigation. However, we conclude that there is a cytochrome P-450 present in human liver which is immunochemically and catalytically similar to the ethanol-inducible P-450 of rabbit liver. PMID- 3632718 TI - Intra- and extra-dopamine-synaptosomal localization of monoamine oxidase in striatal homogenates from four species. AB - MAO-A and MAO-B activities within and outside dopaminergic synaptosomes in homogenates of striatal tissue from pig, cat, rat and human brains have been studied by using a specific "low substrate concentration technique" with dopamine. It was found that within the synaptosomes, MAO-A activity predominated in all species. Outside the synaptosomes there were more pronounced differences and only in the rat did MAO-A predominate, while in the other species MAO-B predominated. When estimating MAO-A and -B activities with a conventional method the activity of MAO-B predominated in man, cat and pig. Thus, also in species where the MAO-B activity (as estimated in a conventional way) was dominating, the intrasynaptosomal deamination of dopamine was brought about mainly by MAO-A. The "low substrate concentration technique", more adequately reflects physiological conditions by taking into account the higher concentration of monoamine transmitter substrates within the monoamine neurons. With this technique it was found that in all species (with the possible exception of man) the oxidation rate was higher within than that outside the DA-synaptosomes. In man the unavoidable longer time between death and estimation of the enzyme activity may be the cause of the deviating result. PMID- 3632719 TI - Verapamil interaction with the muscarinic receptor: stereoselectivity at two sites. AB - Verapamil, in addition to blocking calcium channels, exhibits such "non-specific" effects on myocardium as inhibition of sodium and potassium conductances and modifications of muscarinic receptor-ligand interactions. To characterize further the effects of verapamil on the cardiac muscarinic receptor, we examined the abilities of the enantiomers of verapamil to modify the binding of the muscarinic antagonist [3H]quinuclidinyl benzilate ([3H]QNB) to purified canine sarcolemmal vesicles. Membranes were incubated with [3H]QNB and various concentrations of racemic, (+)-, or (-)- verapamil (25 or 37 degrees, pH 7.4), and reactions were terminated by rapid filtration. (-)-Verapamil (Ki of 5.3 +/- 0.2 microM) was twice as potent an inhibitor of equilibrium binding as (+)-verapamil (Ki of 11.4 +/- 0.6 microM), and this effect resulted from the ability of each enantiomer to slow [3H]QNB-receptor association. This degree of stereoselectivity, albeit at nanomolar concentrations, was similar to that observed for each enantiomer to compete for the specific phenylalkylamine site in this preparation. Verapamil also inhibited [3H]QNB-receptor dissociation, but this effect required high concentrations and demonstrated stereoselectivity opposite to that observed for association. These findings support the view that verapamil interacts with two distinct sites, possibly within membrane lipid, each with a different affinity and preference for (+)- and (-)-verapamil, to modify the muscarinic receptor. PMID- 3632720 TI - Characterization of the muscarinic receptor subtype in isolated gastric fundic cells of the rabbit. AB - The characteristics of the muscarinic receptor in isolated gastric fundic cells from rabbit were determined by radioligand binding techniques and functional tests. The dissociation constants (KDS) of selective (hexahydrosiladifenidol and pirenzepine) and non-selective (N-methylscopolamine and atropine) muscarinic receptor antagonists obtained in competition experiments vs [3H]-N methylscopolamine were compared with the pA2 values of the drugs as inhibitors of carbachol-stimulated [14C]-aminopyrine accumulation (an index of acid secretion) in the gastric fundic cells. Good correlations were found between the ability of the drugs to inhibit acid secretion and their affinity for muscarinic receptors in the gastric fundic cells. The rank order of potency in both tests was N methylscopolamine greater than atropine greater than hexahydrosiladifenidol greater than pirenzepine. The character of the muscarinic receptor subtype present on gastric fundic cells was established by comparing the affinity values of the compounds for this receptor with those for the receptors in other rabbit tissues. It was found that only pirenzepine and hexahydrosiladifenidol displayed tissue selectivity in their binding profiles. The KDS for pirenzepine were 13nM for the M1 receptor of the cerebral cortex and about 500 nM for the M2 receptors of the submandibular and gastric glands and heart. Differently from pirenzepine, hexahydrosiladifenidol showed about 10-fold discrimination between the M2 subtype of the gland (KD = 31 nM) and the M2 subtype of the heart (KD = 330 nM). PMID- 3632721 TI - N-hydroxy-N-arylacetamides--IV. Differences in the mechanism of haemoglobin oxidation in vitro between N-hydroxy-N-arylacetamides and arylhydroxylamines. AB - In solutions of purified human haemoglobin N-hydroxy-4-chloroacetanilide (N hydroxy-4ClAA] was one of the most active compounds and N-hydroxy-acetanilide (N hydroxy-AA) was the least active compound among the six N-hydroxy-N arylacetamides tested for ferrihaemoglobin (HbFe3+)-forming activity. Co oxidation of haemoglobin by N-hydroxy-4-chloroacetanilide was compared with that of N-hydroxy-4-chloroaniline(N-hydroxy-4ClA) and found to differ in the kinetics of HbFe2+-oxidation, in the catalytic activity of the two compounds, in the activation energy, and in the product pattern, indicating that the mechanism by which N-hydroxy-N-arylacetamides oxidize oxyhaemoglobin in vitro is different from that of arylhydroxylamines. Attempts have failed to detect by EPR spectroscopy acetyl 4-chlorophenyl nitroxide radical, the postulated catalytically-active oxidation product of N-hydroxy-4-chloroacetanilide. PMID- 3632722 TI - Enhancement of hypoxic liver damage by ethanol. Involvement of xanthine oxidase and the role of glycolysis. AB - Using isolated hemoglobin-free perfused rat livers we investigated the hepatotoxic effects of hypoxia, ethanol or the combination of both. Hypoxia only (90 min) led to a weak toxicity as evidenced by the efflux of the enzymes glutamate-pyruvate-transaminase (GPT) and sorbitol dehydrogenase (SDH). This toxic effect was slightly higher in livers treated with ethanol (3 g/l) under normoxic conditions. Ethanol added under hypoxic conditions, however, showed a strong hepatotoxic effect. Under hypoxic conditions, lactate + pyruvate production was increased fivefold over control, indicating that glycolysis was more effectively undergone as main source of energy. Addition of ethanol suppressed this effect, indicating that ethanol inhibited glycolysis. These results indicate that ethanol potentiates hypoxic liver damage by inhibiting the main metabolic pathway yielding ATP under low oxygen tension resulting in a severe energy deficit. Allopurinol (100 mg/l) inhibited the toxic effects seen with ethanol + hypoxia. Also, the inhibitory action of ethanol on glycolysis was antagonized. Our results are consistent with the following model: hypoxia converts NAD-dependent xanthine dehydrogenase (XD) into the oxygen-dependent xanthine oxidase (XO). Due to hypoxia and ethanol, purine metabolites and acetaldehyde accumulate and are metabolized via XO. This process leads to the production of oxygen radicals which most probably mediate both the inhibition of glycolysis and the direct toxic effects towards liver cells. PMID- 3632723 TI - Induction of peroxisomal fatty acyl-CoA oxidase and microsomal laurate hydroxylase activities by beclobric acid and two metabolites in primary cultures of rat hepatocytes. AB - Beclobrate [2-(4-[(4-chlorophenyl)methyl]phenoxy)-2-methylbutyric acid ethyl ester], a structural analog of clofibrate, is used clinically as a lipid-lowering agent. Although, like clofibrate, beclobrate produces a profound hepatomegalic response in rodents, no studies of this drug on hepatic peroxisome proliferation have appeared. We have examined, relative to clofibric acid (CPIB), the concentration-dependent effects of beclobric acid (Beclo), the activity moiety of beclobrate, and two oxidized metabolites [a carbinol (M2) and a benzophenone (M3)] on peroxisomal fatty acyl-CoA oxidase (FACO) and microsomal laurate hydroxylase (LH) activities in primary cultures of rat hepatocytes. All compounds induced FACO and LH activities in a concentration-dependent manner after a 72 hr incubation with the cultured cells. Beclo was 4.8- and 6.5-fold more potent than CPIB as an inducer of FACO and LH respectively. M2 and M3 were more potent than Beclo as inducers of FACO and LH. Additionally, all compounds produced significant elevations relative to untreated control cultures in cellular lactate dehydrogenase activity (1.6- to 2.2-fold). We conclude that (1) Beclo is more potent than CPIB as an inducer of peroxisome proliferation-associated enzyme activities; (2) two metabolites of Beclo are more potent than the parent molecule as inducers of these activities and (3) these metabolites may contribute to the lipid-lowering and/or hepatomegalic effects of beclobrate in rats. PMID- 3632724 TI - Ontogeny of the chicken cytochrome P-450 enzyme system. Expression and development of responsiveness to phenobarbital induction. AB - The sensitivity of the developing embryo to toxins and drugs is highly dependent on the state of development of the cytochrome P-450 system. Previous work in this laboratory has demonstrated the genotoxicity of aflatoxin B1 (AFB1) to the chicken embryo at 3 days of incubation (DI) and induction of AFB1 genotoxicity by phenobarbital at 7 DI. In this study, the basal and 24-hr phenobarbital (PB) induced levels of aminopyrine-N-demethylase (AMPD) and cytochrome P-450 were assayed in hepatic microsomes from 7 DI to 36 days posthatching (PH) and in microsomes from whole embryos at 5 DI. A dose-response for induction by PB was observed in embryonic hepatic microsomes as early as 7 DI, whereas a low level of cytochrome P-450 was detected in control 7 DI microsomes using the reduced CO vs oxidized CO difference spectrum. Basal levels of AMPD and cytochrome P-450 in hepatic microsomes increased steadily throughout development as did the responsiveness of the embryonic liver to induction with PB. Hepatic microsomes from control and PB-induced chickens had the highest AMPD activities posthatching particularly from 1 to 3 days PH. Maximal induced levels, which were 2- to 3-fold over control throughout development, ranged from 1.22 at 7 DI to 12.72 nmol HCHO/mg protein/min at 2 days PH. The potency of PB as an inducer increased about 1000-fold between 7 DI and hatching. PB induction did not increase the specific activity of AMPD at any period of development. The specific activity of AMPD posthatching increased about 3-fold above embryonic levels, indicating the development of a cytochrome P-450 complex more active toward aminopyrine in the neonatal period. PMID- 3632725 TI - Antipyrine metabolism in cultured rat hepatocytes. PMID- 3632726 TI - The prolongation of the survival times of mice implanted with TLX5 cells by treatment with methotrexate encapsulated in erythrocytes. PMID- 3632727 TI - Effect of succinylacetone administration on brain heme metabolism and behavior in mice. PMID- 3632728 TI - Liver regeneration and hepatic microsomal changes in rats administered cyclosporin A. PMID- 3632729 TI - Influence of the sulphation inhibitor, 2,6-dichloro-4-nitrophenol, on the production and conjugation, of 4-hydroxybiphenyl generated from 4-methoxybiphenyl by rat isolated hepatocytes. PMID- 3632730 TI - Needle enzyme electrodes for biological studies. AB - Needle enzyme electrodes have been produced for measurement of glucose and lactate. They comprise glutaraldehyde-crosslinked oxidases immobilised over less than 1.1 mm od needle-type sensors for H2O2. To obtain selectivity in blood, an underlying polyethersulphone membrane was used which excluded electrochemical interferents from the working (Pt) electrode. Linearity for the systems was extended to cover the clinical range by the use of outer low permeability polyurethane membranes. This type of external membrane also reduced the stirring dependence of electrodes. The glucose needle electrode was used in unstirred whole blood samples and gave an acceptable correlation with the routine spectrophotometric method (y = 0.954x + 0.202, r = 0.991, n = 48). PMID- 3632731 TI - Inhibition of neutrophil-mediated degradation of isolated basement membrane collagen by nonsteroidal antiinflammatory drugs that inhibit degranulation. AB - The ability of nonsteroidal antiinflammatory drugs to inhibit neutrophil-mediated degradation of type IV collagen in an in vitro tissue injury model using glomerular basement membrane (GBM) containing immune complexes was investigated. Auranofin (2.5-10 microM), phenylbutazone (50-250 microM), sulfasalazine (250 1,000 microM), and 4-bromophenacyl bromide (5-20 microM) each inhibited up to 70% of the collagen degradation, in parallel with almost complete inhibition of the release of azurophil and specific granule enzymes. These drugs had much less an effect on gelatinase release. Indomethacin and the antimalarials, which inhibited the neutrophil oxidative burst but not degranulation, had little effect on GBM collagen degradation. Our results do not necessarily imply that inhibition of neutrophil-mediated degradation of connective tissue is relevant to the action of nonsteroidal antiinflammatory drugs in vivo; however, using the GBM model system, we have shown that when a drug inhibits granule enzyme release, there is an associated decrease in collagen degradation, whereas inhibition of the oxidative burst has relatively little effect. PMID- 3632732 TI - The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. AB - To investigate the prevalence of osteoarthritis (OA) of the knee in elderly subjects, we studied the Framingham Heart Study cohort, a population-based group. During the eighteenth biennial examination, we evaluated the cohort members for OA of the knee by use of medical history, physical examination, and anteroposterior (standing) radiograph of the knees. Radiographs were obtained on 1,424 of the 1,805 subjects (79%). Their ages ranged from 63-94 years (mean 73). Radiographs were read by a radiologist who specializes in bone and joint radiology, and were graded 0-4 according to the scale described by Kellgren and Lawrence. OA was defined as grade 2 changes (definite osteophytes), or higher, in either knee. Radiographic evidence of OA increased with age, from 27% in subjects younger than age 70, to 44% in subjects age 80 or older. There was a slightly higher prevalence of radiographic changes of OA in women than in men (34% versus 31%); however, there was a significantly higher proportion of women with symptomatic disease (11% of all women versus 7% of all men; P = 0.003). The age associated increase in OA was almost entirely the result of the marked age associated increase in the incidence of OA in the women studied. This study extends current knowledge about OA of the knee to include elderly subjects, and shows that the prevalence of knee OA increases with age throughout the elderly years. PMID- 3632733 TI - Attributional processes in rheumatoid arthritis patients. AB - In a study of 92 patients with rheumatoid arthritis, we examined patients' beliefs about the causes of their illness, disease flares, and disease remissions, and about the selective incidence of the disease. Numerous self report measures were used to elucidate the patients' attitudes and perceptions; the tendency of patients to present themselves in socially desirable ways was taken into account and was found not to influence the study results. The causes for the illness that were most frequently cited by patients were heredity (34.7%), autoimmune factor (24.4%), personal behaviors (22.8%), and psychological stress (22.8%). Patients who were more actively searching for the causes of the illness and who continued to ask "Why me?" reported greater functional problems and a greater sense of helplessness. The most frequently cited causes for symptom flares were psychological stress (45.5%), changes in weather (34.0%), and excessive physical activity (34.1%). Symptom remissions were most frequently believed to be related to medication changes (49.4%) and the absence of psychological stress (21.0%). Several of these causal beliefs were related to perceptions of helplessness and the illness' predictability and to health care providers' assessments of disease severity and patients' psychosocial adjustment. PMID- 3632734 TI - Medical management of pneumococcal arthritis involving a knee prosthesis. AB - Septic arthritis involving prosthetic joints has been frequently reported, with Staphylococcus species being the pathogen most commonly noted. We report a case of septic arthritis of a prosthetic knee caused by Pneumococcus, a previously unreported pathogen in this condition, which uniquely responded to treatment with antibiotics. PMID- 3632735 TI - Wegener's granulomatosis presenting with erosive arthritis. AB - We describe a patient with Wegener's granulomatosis who presented with erosive arthritis. The patient's multisystem disease responded to cyclophosphamide treatment, and the erosions healed. Our findings suggest that Wegener's granulomatosis should be added to the differential diagnosis of diseases associated with erosive arthritis. PMID- 3632737 TI - Sjogren's syndrome: comments on the proposed criteria for classification. PMID- 3632738 TI - Ankylosing spondylitis in a nonhuman primate: a monkey tale. PMID- 3632736 TI - Transverse myelitis and optic neuritis in systemic lupus erythematosus: a case report with magnetic resonance imaging findings. AB - We describe a patient with systemic lupus erythematosus who developed transverse myelitis and optic neuritis. Magnetic resonance imaging showed the presence of an abnormal signal in a normal-sized spinal cord which corresponded to the patient's neurologic deficit. No abnormality was recognized in either optic nerve. Magnetic resonance may prove to be a useful imaging modality for the diagnosis of a transverse myelopathy in systemic lupus erythematosus. PMID- 3632739 TI - Cyclosporine treatment for intractable polymyositis. PMID- 3632740 TI - Lifestyle factors affecting intrapair differences of serum apoproteins and cholesterol concentrations in adult identical twins. AB - 83 pairs of twins, aged 50-74 years, were studied with respect to their serum apoproteins (A-I, A-II, B, C-II, C-III and E) and cholesterol concentrations. Each of the variables showed a higher intraclass correlation in the MZ twins than in the DZ twins. HDL cholesterol showed the highest intraclass correlation among the variables and indicated strong heritability. In the MZ pairs discordant for alcohol consumption, the higher consumers within the pair showed a significantly higher level of apo A-I and HDL cholesterol, and a lower level of apo B concentration. In the MZ pairs discordant for cigarette smoking, the higher consumers within the pair showed a significantly lower level of apo C-III. In the MZ pairs discordant for obesity, the heavier twins within the pair showed higher levels of non-HDL cholesterol, total cholesterol, apo B, apo C-II and apo C-III. In the MZ pairs discordant, for occupation, the twins of 'heavy work' showed significantly higher levels of apo B, total cholesterol and non-HDL cholesterol than the twins of 'light work'. PMID- 3632741 TI - Effect of long-term clofibric acid treatment on serum and tissue lipid and cholesterol levels in obese Zucker rats. AB - The long-term effects of clofibric acid (200 mg/kg body weight) injected subcutaneously from 6-36 weeks of age were assessed in obese, hyperlipemic Zucker rats. At 18 and 36 weeks of age, treated rats had significantly lower fasted serum cholesterol levels but triacylglycerol levels were not affected. Rats were killed at 36 weeks of age at which time there were no differences in body and kidney weights between control and clofibric acid-treated rats. Liver, spleen and heart weights were lowered by clofibric acid treatment. In liver there was an elevation of lipid/g due to treatment but there were no effects on cholesterol/g or on either total liver lipid or cholesterol levels. In the epididymal fat pad of clofibric acid-treated rats, there was a 21% elevation of cholesterol level on a per pad basis. In the other organs, there were no effects of treatment on lipid or cholesterol levels except for lowered total cholesterol in kidney. Several liver lipogenic enzymes were lowered by treatment but malic enzyme was two times higher. PMID- 3632742 TI - Alterations in molecular species of cholesterol esters formed via plasma lecithin cholesterol acyltransferase in human subjects consuming fish oil. AB - The influence of a dietary supplement of n-3 polyunsaturated fatty acids containing eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) on the molecular species of cholesteryl esters (CE) formed via the plasma lecithin (phosphatidylcholine)-cholesterol acyltransferase (LCAT; EC 2.3.1.43) reaction was evaluated. For this purpose, one group of eight subjects received an encapsulated fish lipid concentrate (MaxEPA) and another group of eight volunteers in the control group received encapsulated olive oil for 22 days. Plasma lipid profiles and fatty acid compositions of plasma phosphatidylcholine (PC) and CE were measured at day 0 and day 22 in all subjects. A decrease in plasma triglyceride (by 34%) and a moderate rise in high density lipoprotein (HDL)-cholesterol (by 13%) was observed in the MaxEPA group. For characterization of the plasma LCAT-derived reaction products formed in vitro, [14C]cholesterol was used as the substrate and the newly formed molecular species of [14C]CE were separated by argentation thin-layer chromatography. Marked shifts were found in the abundance of the various classes of LCAT-derived products in the MaxEPA group whereas no significant changes were observed in the controls. The proportion of the [14C]CE as pentaenoic (EPA) species rose by 9 fold (from 1.5% at day 0 to 14.4% at day 22) as the dienoic (linoleate) species fell (from 50.6 to 39.2%); a moderate rise in the hexaenoic (DHA) species (from 1.7 to 2.4%) with no significant change in the tetraenoic (arachidonate) (AA) species was observed. The LCAT results were in the order of the observed shifts in the fatty acid patterns of the plasma CE.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632743 TI - A study of the lipid transport system in the cat, Felix domesticus. AB - Feline serum lipoproteins were fractionated into four distinct classes by density gradient ultracentrifugation and characterized with respect to physical and chemical properties. The distribution of serum lipids, lipoproteins and apolipoproteins was quite unlike that in man, the cat having five times as much high density lipoproteins (HDL) as low density lipoproteins (LDL). The lipoproteins in the d less than 1.019 g/ml fraction of cats were larger and were richer in triglycerides than their human counterparts and contained a considerable amount of beta-migrating particles. The low density lipoproteins of cats and man had similar chemical composition, but cat LDL had a higher negative charge, were smaller and contained apoprotein A-I. Cat HDL consisted of two distinct subfractions HDL2 and HDL3 with similar density boundaries and particle size as in man. In cat serum and HDL fraction apoprotein A-II was a minor component. Like human serum, fasting cat serum contained only the larger species of apoprotein B, apo B-100, whereas intestinal lymph contained exclusively the smaller apo B-48. Post heparin feline and human plasma possessed both lipoprotein lipase and hepatic lipase. Chylomicrons formed after a fat load in cats were removed from the circulation as rapidly as in man. It is concluded, that the cat is another animal model of potential interest for the study of lipoprotein metabolism. PMID- 3632744 TI - Isolation and characterization of a full-length rabbit apolipoprotein E cDNA. AB - In order to study the primary structure of rabbit apolipoprotein (apo) E and the regulation of levels of liver apo E mRNA by dietary cholesterol, we have cloned and sequenced a full length rabbit apo E cDNA. DNA sequence analyses suggests that rabbit apo E is synthesized with an additional 18 amino acids as the prepeptide. The mature rabbit apo E contains 293 amino acids with a calculated molecular weight of 33,528. It has a 76% amino acid sequence homology with human apo E. Northern blot analyses showed that rabbit apo E mRNA is about 1200 nucleotides in length. Using mRNA dot blot analyses, we found that dietary cholesterol has no effect on the level of apo E mRNA in rabbit liver. We conclude that the elevated levels of plasma apo E in rabbits fed a cholesterol-rich diet is not a result of an increase of levels of apo E mRNA in the liver. PMID- 3632745 TI - Comparison of uptake and degradation of low density lipoproteins by arteries and veins of rabbits. AB - The uptake and degradation of low density lipoproteins were compared in arteries and veins of rabbits in vivo. Rabbits were injected with low density lipoproteins labelled singly with 125I (125I-LDL) or doubly with 131I and with [125I]tyramine cellobiose (TC-LDL) which remains trapped intracellularly. After increasing times up to 24 h the largest vessels were perfused to remove blood, fixed in situ and excised. When the uptake of 125I-LDL by arteries and veins was compared on the basis of luminal surface area, there were no significant differences up to 3.5 h. When degradation rates of double labelled LDL were compared after 24 h on the same basis, the arteries contained significantly more TC label than the veins, but when the comparison was based on dry weights there were no significant differences. These results show that veins, like arteries, take up LDL from the circulating blood; and they suggest that the preferential accumulation of LDL in arteries susceptible to atherosclerosis may be accounted for, at least in part, by more degradation of LDL in arteries than in veins. PMID- 3632746 TI - Enhanced degradation of low density lipoprotein in human monocyte-derived macrophages associated with an increase in its free fatty acid content. AB - Low density lipoprotein (LDL) rich in oleic acid (designated FFA-rich LDL) was produced by the reconstitution technique. FFA-rich LDL, like acetyl LDL, moved faster than native LDL in agarose gel electrophoresis. While FFA-rich LDL was observed to degrade far less than natural LDL in lymphocytes, its degradation in monocyte-derived macrophages was three times higher than that of natural LDL or LDL reconstituted without the addition of oleic acid. A competitive study showed that the catabolism of FFA-rich LDL in macrophages may be influenced by systems other than the acetyl LDL receptor. PMID- 3632747 TI - Detection of human apolipoprotein B polymorphic species with one monoclonal antibody (BIP 45) against low density lipoprotein. Influence of this polymorphism on lipid levels and coronary artery stenosis. AB - The immunoreactivity of apolipoprotein B (apo B) in plasma samples obtained from a variety of subjects was analysed by non-competitive ELISA with a polyclonal and a monoclonal (BIP 45) anti-LDL antibody. Three populations were tested: the first, comprising 244 healthy male volunteers, provided reference values; the second consisted of a population undergoing coronary angiography (n = 88) and was divided into a subgroup with (n = 64) and without (n = 24) coronary artery disease (CAD); the third was made up of 56 patients with heterozygous familial hypercholesterolemia. Total apo B (measured with the polyclonal antibody) was increased in the populations with CAD and in the heterozygous familial hypercholesterolemic subjects compared to the reference population. When monoclonal antibody BIP 45 was used in the non-competitive ELISA, three different patterns emerged in each population, corresponding to weak, intermediate and strong binding of the particles containing apo B to the monoclonal antibody. This may result from genetic polymorphism of apo B, and in the reference population the data fit a model consisting of two co-dominant apo B alleles (BIP(-) and BIP(+]; the 3 subpopulations then correspond to the 2 homozygotes and the heterozygote. The number of patients whose particles bound weakly to monoclonal BIP 45 antibody was low in the CAD population, while intermediate binding was increased in this group. Nevertheless, when the analysis of variance of allele BIP(-) was studied no significant difference between groups was established. This finding indicates that the genetic difference in apo B detected by BIP 45 may not be significant in the development of CAD. Furthermore, the apo B genetic polymorphism detected by BIP 45 is not associated with a particular lipoprotein level in the reference population. PMID- 3632748 TI - Age-related changes in the level of circulating elastin-derived peptides in serum from normal and atherosclerotic subjects. AB - The level of the circulating elastin-derived peptides (CEDP) in the serum is believed to reflect the activity of the degradation of the elastic structures. This paper reports a new method, based on the 'sandwich' version of the enzyme linked immunosorbent assay (ELISA), for the detection and quantification of CEDP in human serum. By this method we investigated the age-related changes in their level among healthy subjects within the age range of 1 and 75 years and among atherosclerotic subjects aged 50 to 75 years. The highest level of CEDP was found in the serum of the atherosclerotic patients, and the lowest, among the healthy subjects between 18 and 50 years of age. PMID- 3632749 TI - Cardiac catheterization in a case of homozygous familial hypercholesterolemia. PMID- 3632751 TI - Coronary angiographic characteristics in Japanese patients with heterozygous familial hypercholesterolemia. AB - Coronary angiographic findings were analyzed in 51 consecutive patients (36 males and 15 females) with heterozygous familial hypercholesterolemia (FH) and 279 consecutive patients (216 males and 63 females) without FH (non-FH). The coronary stenosis index and over 75% stenosis vessel subset were almost three times as high in the FH group. The incidence of myocardial infarction was almost twice as high in the FH group. Levels of total cholesterol and its lipoprotein fractions, except HDL-cholesterol, were almost twice as high in the FH group. In the FH group aged under 50 years, the two parameters of coronary angiogram and the incidence of myocardial infarction were significantly higher in males than in females. However, in the group aged over 50 years, all three parameters were not significantly different between those in males and females. The level of HDL cholesterol was significantly lower in males than in females. A significantly higher incidence (18%) of coronary ectasia was observed in the FH group compared with the incidence (2%) in non-FH. All patients with coronary ectasia were males, except one female with FH. On comparison of the males among the FH patients with those among the non-FH patients matched for total cholesterol, age and other risk factors, the FH patients were associated with a significantly higher degree of coronary atherosclerosis and lower level of HDL-cholesterol. Seven FH patients with a normal coronary angiogram were observed. However, any factors as regards age, total cholesterol, HDL-cholesterol and Achilles tendon thickness failed to distinguish between the FH patients with a normal coronary angiogram and those without.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632750 TI - Platelet aggregability in rats with early atherosclerotic changes induced by parenterally-administered lipid emulsions. AB - The present study is the first work to evaluate thrombin-, ADP-, and collagen induced platelet aggregation in laboratory rats receiving alimentation with the parenterally-administered lipid emulsion, Lipofundin-S, in doses sufficient to induce early atherosclerotic changes in the aorta. The aggregometry parameters of percent maximum aggregation, slope, and b2 or b20 almost uniformly indicate that such lipid treatments result in a statistically significant increased sensitivity of the platelets to ADP and collagen, while no change is noted with thrombin as the aggregating agent. By varying the amounts of ADP and collagen during aggregometry, we also demonstrate that the concentrations of these reagents necessary for equivalent platelet aggregation is substantially lower in lipid infused rats than in controls. We conclude from this study that such lipid infusions can cause increased platelet aggregation, and that these lipids probably act in a synergistic fashion by affecting a variety of components which comprise the atherogenic process and its clinical endpoint. In addition, we believe that this experimental approach is of interest in that infusions of clinically-useful lipid emulsions are easily controlled, while alterations in platelet physiology and aortic structure occur concurrently and rapidly. PMID- 3632752 TI - Characterization of high density lipoproteins from patients with severe hypertriglyceridemia. AB - High density lipoproteins (HDL) were isolated by zonal ultracentrifugation from 6 subjects with severe hypertriglyceridemia. Four subjects had familial endogenous hypertriglyceridemia with fasting chylomicronemia; 2 subjects were non-insulin dependent diabetics. Plasma triglycerides ranged from 920 to 5440 mg/dl and HDL cholesterol from 12 to 23 mg/dl. The major HDL from these hypertriglyceridemic subjects had a peak mean density of 1.153 g/ml as compared to 1.140 g/ml for HDL3 from normal subjects. None of the subjects had significant amounts of HDL corresponding to normal HDL2. The major subpopulation of hypertriglyceridemic HDL had a mean diameter of 8.4 +/- 0.1 nm (range 7.6-9.0 nm). The HDL were enriched in triacylglycerols and depleted in cholesteryl esters and the C apoproteins as compared to control HDL3. The mass ratio of triacylglycerols to cholesteryl esters ranged from 4.00 to 5.22 for the patients versus 0.41 for normal HDL3. The increased content of triacylglycerols partially explains the decreased amount of cholesterol associated with these hypertriglyceridemic HDL. PMID- 3632753 TI - The effect of thermally oxidized soya bean oil on metabolism of chylomicrons. Increased uptake and degradation of oxidized chylomicrons in cultured mouse macrophages. AB - Oral administration of thermally oxidized soya bean oil (TO) increased the level of lipid peroxides in human plasma, mainly in chylomicrons. No changes were observed after fresh oil (FO) intake. Human chylomicrons obtained after TO ingestion were rich in lipid peroxides and degraded more rapidly by cultured mouse macrophages than chylomicrons after FO. The uptake of TO chylomicrons by macrophages occurred via a saturable process and was partially inhibited by beta very low density lipoprotein as well as by acetyl-low density lipoprotein and fucoidin. A 48-h incubation of macrophages with TO chylomicrons caused a 10-fold higher accumulation of cholesterol ester mass in the cells than the incubation with FO chylomicrons. These studies suggest that chylomicrons containing lipid peroxides may be taken up by mouse macrophages by mediation of beta-VLDL receptor as well as by acetyl-LDL receptor, and show a potential pathway by which chylomicrons obtained after ingestion of heated oil could contribute to accumulation of cholesterol esters in macrophages. PMID- 3632754 TI - Failure of foreign serum injections to induce immune vasculitis and to accelerate spontaneous or cholesterol-induced atherosclerosis in swine. AB - Experiments were conducted with domestic swine in an attempt to accelerate and/or modify spontaneous or cholesterol-induced atherosclerosis through immune complex produced changes in the arterial wall. For the purpose of comparison, another experiment was carried out with rabbits. Swine differed completely from rabbits in that various experimental designs failed to produce immune complex arteritis and fibroproliferative arteriosclerosis. In addition, two foreign serum infusions (human plasma and horse serum on the 30th and 60th day, respectively, 350 mg/kg foreign protein/infusion/animal) did not produce a significant effect on spontaneous arteriosclerosis and cholesterol-induced atherosclerosis (4 months atherogenic diet) in the arterial system of swine. In the aortic trifurcation, however, it was found that antigen administration slightly enhanced cholesterol dependent atherogenesis. PMID- 3632755 TI - Mitogenic activity in human atherosclerotic lesions. AB - Focal smooth muscle cell proliferation is a key event in atherogenesis, but the stimulating factors are unknown, and there is little information on the occurrence of growth promoting factors in the arterial wall. We have tested extracts of human aortic intima for stimulation of DNA synthesis, using the chick chorioallantoic membrane (CAM) assay in an attempt to avoid artifacts arising with cultured cells. Consistently high levels of stimulation were obtained with early proliferative (gelatinous) lesions (mean DNA synthesis 188% of control, n = 6) and slightly more advanced transitional lesions (mean 160%, n = 4); results with mature fibrous plaques were variable (range 120-182%, n = 3). Significant stimulation was also given by four of eleven samples of apparently lesion-free intima. Intima contains fibrinogen and a range of fibrinogen and fibrin degradation products (FRA) and preliminary fractionation experiments suggest that activity may reside in the FRA fraction. Serum does not stimulate DNA synthesis in the CAM; extract activity was retained in FRA-containing fractions after removal of most serum proteins by affinity chromatography, but was mainly lost from serum protein-containing fractions after removal of FRA. PMID- 3632756 TI - Autoradiography of endothelium in whole rat aorta by a new method. AB - This report describes a method for studying the arterial endothelial kinetics in the rat by autoradiography of the luminal surface of the endothelium. The procedure involves stripping off the adventitia, sticking the 'whole' artery on a glass slide, and covering the endothelium (with some layers of the media as a support) with the nuclear emulsion. This method gives endothelial autoradiographies with very good optical quality, so that counting the labelled cells is as easy as in the Hautchen preparations. It also eliminates uncertainties due to the occasional lack of endothelium in some areas and the interference of smooth muscle layers, problems which are frequent in the Hautchen techniques used so far. The present method has been tested in rats fed an atherogenic diet for one day and 1, 2, 3 and 4 weeks and in the corresponding controls. PMID- 3632757 TI - Long-term effects of a linoleic acid-enriched diet, changes in body weight and alcohol consumption on serum total and HDL-cholesterol. AB - Investigations on diet, body weight, and lipoproteins were carried out in 28 patients with stable angina pectoris. They consumed a linoleic acid-enriched diet (P/S ratio = 2) for a period of 2 years. The total fat content remained constant before and during intervention, contributing 34% to energy intake. During intervention serum total cholesterol and the total/HDL cholesterol ratio decreased significantly, but HDL cholesterol did not change. Changes in body weight were significantly inversely related to changes in HDL cholesterol and positively to the total/HDL cholesterol ratio. Changes in alcohol intake were significantly positively related to both total and HDL cholesterol but unrelated to the total/HDL cholesterol ratio. From the results of this long-term study it can be concluded that a moderate fat diet with a P/S ratio of 2 can lower total cholesterol effectively without affecting HDL cholesterol. PMID- 3632758 TI - Diets realistic for westernized people significantly effect lipoproteins, calcium, zinc, vitamins C, E, B6 and haematology in vervet monkeys. AB - This report describes measurements of 50 variables in adult, female, reproductively inactive Vervet monkeys during prolonged nutrition realistic for westernized people. Dietary treatments consisted of an atherogenic Western diet (WD) and a prudent Western diet (PD). Ingredients were normal foods for man and no extra cholesterol was added. Fortification of both diets with vitamin C after cooking was necessary to prevent deficiency. Randomised groups of Vervet monkeys received either the PD or WD for 47 months, while a third group was fed WD for 20 months and then PD for 27 months (WD-PD). Before the dietary treatments nourishment was by a high carbohydrate diet (HCD) and baseline and reference values (RV) apply to this nutritional status. Plasma total cholesterol (mg/dl) was increased from 147 (HCD) to 174 (PD) and 376 (WD). Individual cholesterolaemio response ranged from mild to severe and was stable (PD and WD). Dietary reversal (WD-PD) reduced cholesterolaemia promptly. Statistically significant increases in calcium, zinc and vitamin E and decreased vitamin B6 were associated with the WD relative to the PD (in serum and plasma). Two cholesterol metabolising microsomal enzymes in liver were notably increased and one unchanged (WD). There were no dietary effects on triglycerides, vitamin A and glucose in plasma; insulin, glucagon, electrolytes, copper, magnesium or enzymes reflecting liver, muscle or brain cell damage in serum. Red blood cells, platelets and directly associated parameters increased (WD), haemoglobin was the same and haemoglobin per red cell decreased. Bleeding time was not affected. Bivariate correlations across the diets confirmed that Western nutrition promoted inherent individual susceptibility to cholesterolaemia. There were notable differences from RVs in total cholesterol, calcium, packed cell volume and haemoglobin, which emphasise excesses and deficiencies of the WD and PD. PMID- 3632759 TI - Promotion and regression of atherosclerosis in vervet monkeys by diets realistic for westernized people. AB - We have described and measured aortic and arterial atherosclerosis in adult female Vervet monkeys (n = 61) after application of dietary treatments for 47 months. The diets were compounded entirely of normal food items for westernized people, with no extra cholesterol added. A 'Western' diet (WD), known to induce hypercholesterolaemia, was found to be atherogenic in aortas and some arteries. A more 'prudent' diet (PD) induced much less lipid infiltration into aortic intimas and was not associated with serious atherosclerotic changes. However, when this PD was used as a treatment for 27 months, following 20 months of nutrition by the WD, minimal regression of cholesterol crystals and non-lipid components of atherosclerotic plaque was detected. There was no significant coronary artery or myocardial disease in these adult females after 47 months of feeding on the WD whereas males do develop coronary atherosclerosis and myocardial fibrosis. For this model the PD would be more effective in preventing atherosclerosis than treating advanced lesions. We believe this is the first time that the pathology of atherosclerosis promoted by realistic diets has been modelled in adult females of this species. PMID- 3632760 TI - Dietary linoleate increases fluidity and influences chemical composition of plasma low density lipoprotein in adult men. AB - Dietary linoleate was effective to increase LDL fluidity in adult men but did not significantly influence VLDL or HDL fluidities. Lipoproteins were isolated ultracentrifugally from plasma of sixteen healthy, free living male volunteers consuming controlled diets formulated from typical U.S.A. foods to have 35 energy % fat with 10 g (diet L) or 30 g (diet H) linoleate per day, 30-50 g saturated fatty acids/day and the balance mainly monounsaturated fatty acids. Calculated cholesterol intakes were 500 mg/day at each calorie level. Changes in LDL fluidity were detected as differences in diphenylhexatriene (DPH) fluorescence polarization upon crossover between the two controlled diets. Thermotropic measurement of DPH fluorescence anisotropy and compositional analyses indicated that LDL and HDL fluidities were dependent upon phospholipid and triacylglycerol concentrations, respectively, and were modulated by the presence of cholesteryl esters. Fatty acid analyses of the major lipid classes of the isolated lipoproteins indicated that changes, upon diet crossover, in DPH fluorescence anisotropy, were a linear function of the incremental change in LDL phospholipid linoleate. The fluorescent probe described an environment corresponding to the fatty acyl moieties of the phospholipids on the LDL periphery, which composition is apparently under dietary control. It is suggested that the diet induced fluidity changes may affect the conformation of the apoprotein moiety on the LDL surface and thus the potential for LDL interaction with cellular LDL receptors. PMID- 3632761 TI - Metabolism of native and acetylated low density lipoproteins in squirrel monkeys with emphasis on aortas with varying severities of atherosclerosis. AB - We studied the clearance of 131I-labeled native low density lipoproteins (LDL) and 125I-acetyl LDL from the blood of hypercholesterolemic and atherosclerotic squirrel monkeys which had been fed a semipurified diet supplemented with cholesterol for 3 years and from control monkeys which had been fed the same diet without cholesterol. In agreement with previous observations in other species, acetyl LDL left the circulation much more rapidly than native LDL. The cholesterol supplemented monkeys removed native 131I-LDL to the liver, the major site of clearance of both LDL forms, more slowly than controls. The overall clearance of 125I-acetyl LDL was similar for the two groups. The aortic intima plus inner media (AIM) cleared both LDL forms much more slowly than other organs, and the ratio of acetyl LDL to native LDL cleared was quite high. The outer media (OM) showed less selectivity for acetyl LDL than the AIM. While LDL clearance by the OM was not affected by diet, the LDL clearance per g of AIM tissue was increased by 2-fold for both native and acetyl LDL in the cholesterol supplemented monkeys. These monkeys also had a 3-fold increase in AIM weight (due to intimal and subintimal thickening), which resulted in a 6-fold increase in the total LDL cleared by the AIM. The clearance of both LDL forms by the AIM correlated with three indices of atherosclerosis: intimal thickness, AIM weight, and AIM cholesterol concentration. The correlations were higher in the case of acetyl LDL clearance which may be due to the high affinity of the acetylated form for macrophages. PMID- 3632762 TI - Fish oil increases peripheral capillary blood cell velocity in humans. AB - Fish oils containing n-3 fatty acids have been shown in humans to decrease platelet aggregation in vitro, lower plasma triglycerides, and to increase bleeding time. The in vivo effects of fish oils on microcirculatory blood flow in humans has not been studied to date. Twenty-one male subjects were randomly assigned to either olive oil (n = 10) or fish oil (n = 11) supplemented groups to determine the effects of these oils on capillary blood flow velocity (CBV) in the nailfold area. The subjects were given the oils for three weeks (1.5 g oil/10 kg b.wt./day) in a single blind study design. In addition to CBV plasma lipid profiles, blood viscosity, blood pressure and platelet and erythrocyte fatty acids were also determined prior to and after the dietary intervention. Fish oil supplementation significantly increased CBV, by 1.75-fold (0.144 +/- 0.069 to 0.253 +/- 0.147 mm/s). The olive oil group remained unchanged. Increased levels of n-3 fatty acids were noted in platelets and erythrocytes of the fish compared to olive oil-supplemented groups. Blood viscosity was unaltered in both groups, however, blood pressure in the olive oil supplemented group was significantly decreased. Plasma triglycerides were significantly decreased in the fish oil supplemented group. These observations suggest that increases in CBV after fish oil supplementation are due to changes in vascular tone and not to alterations in blood pressure or blood viscosity. PMID- 3632763 TI - HDL clearance and receptor-mediated catabolism of LDL are reduced in hypothyroid rats. AB - Hypercholesterolemia associated with hypothyroidism is due partly to increased plasma LDL and partly to increased HDL cholesterol concentrations. The increase in LDL cholesterol has been shown to be secondary to reduced plasma clearance of LDL. To determine which catabolic route was thyroid dependent, the present study examined the effects of hypothyroidism on the receptor-mediated pathway and the 'receptor-independent' pathway of LDL metabolism. Wistar rats (327 +/- 22 g; mean +/- SD) were made hypothyroid by feeding propylthiouracil (0.1%, w/w) and rat 131I-LDL (rLDL; d = 1.019-1.050) and 125I-methylated-LDL (rLDL-CH3) were simultaneously injected i.v. after which the rates of clearance of labelled LDL in plasma were determined over 0-54 h. Total LDL and 'receptor-independent' clearances were represented by clearance of 131I-rLDL and 125I-rLDL-CH3 respectively and the difference between the two represented high affinity receptor-mediated clearance. The data were analyzed using Matthews' model and the fractional catabolic rates (FCR) were calculated. The FCR of rLDL clearance via the receptor-mediated pathway was 0.1042 +/- 0.0112 pools/h (n = 6) in controls vs. 0.0613 +/- 0.0079 pools/h (n = 6) in hypothyroid animals (P less than 0.01). The FCR via the 'receptor-independent' pathway was 0.0642 +/- 0.0040 pools/h (n = 6) in controls vs. 0.0561 +/- 0.0036 pools/h (n = 6) in hypothyroid animals (not significant). The plasma HDL cholesterol concentration was also increased in hypothyroid rats (70.4 +/- 6.7 mg/dl) compared to control (53.3 +/- 3.1 mg/dl) (P less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632764 TI - [Clinical study of severe hypertension treated by intravenous labetalol]. PMID- 3632765 TI - Reconstitution of molecule images analysed by correspondence analysis: a tool for structural interpretation. AB - Correspondence analysis is gaining increasing importance in the analysis of electron micrographs of macromolecules. Partial or complete reconstitution of images from their factorial representations is introduced as a useful tool in interpreting variational patterns and tracing their physical origin. The value of image reconstitution is demonstrated with two examples, one using a set of model images and the other a set of images of a haemocyanin molecule assembly product. PMID- 3632766 TI - Consequences of accelerated gain and growth hormone administration for lipid metabolism in growing beef steers. AB - Lipid accretion and metabolism during accelerated gain and growth hormone administration were examined in a 29-d trial with 24 beef steers. Treatments in this 2 X 2 factorial design consisted of level of feeding (restricted or ad libitum) and exogenous hormone [pituitary-derived bovine growth hormone (GH) at 38 IU/d or excipient]. Live weight gain was not affected by hormone treatment. Protein content of the 9-10-11th rib section was greatest in steers receiving GH irrespective of feeding level, whereas a reduction of lipid content due to GH was seen only with ad libitum feeding. Restricted-fed steers had the highest plasma concentrations of free fatty acids (FFA), and only at this feeding level did GH treatment result in further elevation of FFA concentrations. In vitro rates of adipose lipogenesis, esterification and lipolysis were greatest in tissue from ad libitum-fed steers. The only effect of GH on in vitro metabolism was a tendency for lower lipolytic rates with ad libitum feeding. GH did not affect adipocyte size. The mechanism for the effect of GH on lipid deposition could not be determined from incubations of adipose slices from chronically treated steers, although enhanced responsiveness to an in vivo lipolytic challenge was observed. By inference, substrate availability appears to determine the productive responses to GH. PMID- 3632767 TI - Factitious pneumothorax. PMID- 3632768 TI - Nutrition priority system: a model for patient care. AB - The criterion for the level of nutrition monitoring used by many hospitals and residential care facilities has traditionally been the patient's diet order. Patients on "regular" diets may receive minimal monitoring (if any) with little discharge instruction, and patients on "modified diets" receive a full assessment with specified routine follow-up by nutrition-care team members and detailed discharge planning. The concentration on the diet rather than the patient gives cause for concern, but in residential care facilities such concerns are magnified. While it is appropriate to monitor a 60-year-old patient with adult onset diabetes whose disease of 20 years' duration is stable, the present diet order system insists that that patient be monitored intensely but ignores his 80 year-old neighbor on a general diet, despite her poor appetite and 87-lb weight. The authors developed a priority system that sets three levels of patient care and materials for teaching the system to treatment team members. The system is based on the patient's needs, not the diet order. Although reduction in staff time would have been an additional welcome result, use of the system does permit the more efficient utilization of the dietitian's and dietetic technician's time. The greatest effect has been individualized, monitored nutrition care for residential psychiatric patients. PMID- 3632769 TI - [Intracavitary electrophysiology in children with loss of consciousness caused by vagotonia]. PMID- 3632770 TI - Intrauterine transfusion: ethical issues involving a Jehovah's Witness mother. PMID- 3632772 TI - Community-based education of health personnel. Report of a WHO study group. PMID- 3632771 TI - [Recommendations for endobronchial laser therapy]. PMID- 3632773 TI - [Early diagnosis of patent ductus arteriosus in preterm infants with contrast echocardiography]. PMID- 3632774 TI - Nurses can do without employers who punish workers for exercising their right to free speech. PMID- 3632775 TI - Medication errors. Don't confuse milligrams with milliliters. PMID- 3632776 TI - What's new in CPR? PMID- 3632777 TI - Finding the right role model. PMID- 3632778 TI - Power: it's changing hands and moving your way. PMID- 3632779 TI - Lessons from the law. Look and look again. PMID- 3632780 TI - Detect phlebitis and infiltration before they harm your patient. PMID- 3632782 TI - 10 ways to help the family of a critically ill patient. PMID- 3632781 TI - The changing universe of nursing. PMID- 3632783 TI - An on-the-spot guide to antihypertensive drugs. PMID- 3632784 TI - Detecting abnormal heart sounds (continuing education credit). PMID- 3632785 TI - You can conquer conflict. PMID- 3632786 TI - Looking back, looking ahead. PMID- 3632787 TI - Involvement of lysophospholipase D in the production of lysophosphatidic acid in rat plasma. AB - A vasoactive lipid present in rat plasma that had been incubated at 37 degrees C for 48 h was identified as lysophosphatidic acid with the following fatty acid composition: palmitic acid (25.2%), stearic acid (8.4%), oleic acid (7.0%), linoleic acid (44.4%) and arachidonic acid (11.9%). The involvement of lysophospholipase D in the production of lysophosphatidic acid was suggested on the basis of extensive analyses of phospholipids in the plasma. Results indicated that lysophospholipase D hydrolyzed polyunsaturated lysophosphatidylcholines preferentially to the saturated species. Exogenously added platelet activating factor was found to be first converted to its lyso derivative by an acetylhydrolase in rat plasma and then degraded by lysophospholipase D to 1 alkyllysophosphatidic acid to a similar extent with exogenously added lyso derivative of platelet activating factor; their percent conversions to lysophosphatidic acid were higher than those of saturated 1 acyllysophosphatidylcholines, but lower than those of polyunsaturated 1 acyllysophosphatidylcholines. PMID- 3632788 TI - In defence of nursing theory. PMID- 3632789 TI - [Living one's menopause]. PMID- 3632790 TI - Healthworks--an adolescent assessment tool. The House. PMID- 3632791 TI - [A communication evaluation guide--C.V.A]. PMID- 3632792 TI - Students experience multiple assignments in community health nursing. PMID- 3632794 TI - How nursing happens in adult day care. PMID- 3632793 TI - Splicing pathways of the chicken apo very low density lipoprotein II (pre)messenger RNA. AB - The precursor-mRNA transcribed from the chicken apo very low density lipoprotein II gene was identified. This gene which is under full estrogen control and only expressed in the liver, possesses three introns. Splicing intermediates were characterized by hybridization with intron-specific probes, and by electron microscopy of R-loops. The introns appear to be excised in a non-obligatory order, but at different rates. PMID- 3632795 TI - Sleep disturbances and what to do about them. PMID- 3632796 TI - Telephone consultation in the care of the older adult. PMID- 3632797 TI - Phantom limb pain. PMID- 3632798 TI - A guide for teaching elders. PMID- 3632800 TI - A simple way to modify behavior. PMID- 3632799 TI - The admission ward concept. PMID- 3632801 TI - Of vitamin D, fish oil, and changing RDAs. PMID- 3632802 TI - Setting nursing hours standards. Part 1. AB - Data were collected and prepared for entry to a computer. Analysis then was done to provide standard hours of care per patient classification level. Further options for use of this data and details on data analysis will be presented in Part 2 (February 1986 issue). PMID- 3632803 TI - Decentralization reduces absenteeism. PMID- 3632804 TI - Perspectives on nursing issues and health care trends. AB - A national survey of nurse administrators from magnet hospitals and faculty directors of graduate programs in nursing administration delineated perspectives on the foremost issues facing professional nurses and the most significant trends in health care policy and delivery. The findings are useful in developing data based nursing curriculums sensitive to an increasingly market-oriented economy, and for resource-conscious nurse executives struggling to prioritize which issues to address and which directions to take when spending is restrained. PMID- 3632805 TI - Time documentation of clinical nurse specialist activities. AB - Evaluating clinical nurse specialists (CNSs) has perplexed both administrators and CNSs. Realizing that a key structural variable of CNSs' role is time use, the authors developed an instrument for examining how CNSs spend their time. The authors discuss the elements of this instrument and its utility as a component of CNS evaluation. PMID- 3632806 TI - Developing relationships with the board of directors. AB - As a nurse administrator, you want to attend, or perhaps have already been invited to attend, meetings of your hospital's board of directors or trustees. What personal and professional strategies can you use, outside the board room, to foster your image as a powerful and competent administrator? Once in the board room, what is appropriate board etiquette? How can you contribute most effectively to board deliberations? The authors present strategies for establishing yourself as an influential, powerful, and valuable contributor to the executive management team as well as the board of directors. PMID- 3632807 TI - Does attitude really influence the writing of nursing care plans? PMID- 3632808 TI - Checking in at the library. PMID- 3632809 TI - Catalyzing educational change. PMID- 3632810 TI - Selecting a nurse researcher. PMID- 3632811 TI - Shared governance: a strategy for transforming organizations. Part 1. AB - In translating this to nursing, shared governance systems can be used to effectively implement transformational philosophies. The process is not easy; it does, however, offer new hope for realizing the maximum potential of nursing services within organizations and for effectively meeting the challenges presented by the complex changes occurring in our world. Part 2 of this series will address specific strategies for operationalizing transforming principles in a nursing organization. PMID- 3632813 TI - Not just a job: God's unique call to nurses. PMID- 3632812 TI - What holistic healers believe. PMID- 3632814 TI - Nursing frontiers. Working through medicine men. New trends in Third-World health care. PMID- 3632815 TI - Spiritual care and the unprepared nurse. PMID- 3632816 TI - Addicted: one nurse's battle with alcohol & drugs. PMID- 3632817 TI - Sick love and sick religion: exposing our dependencies. PMID- 3632818 TI - Effects of protein intake on blood pressure, sodium metabolism, and urinary kallikrein excretion in salt-loaded rats. AB - Fifty-five male Wistar rats were divided into four groups and were fed (1) a control diet, (2) a high-salt low-protein (HSLP) diet, (3) a high-salt standard protein (HSSP) diet, or (4) a high-salt high-protein (HSHP) diet for 17 weeks in order to assess the effects of these diets on blood pressure, sodium metabolism, and urinary kallikrein excretion. Mean blood pressure on the 17th week was 156 +/ (SE)3 mm Hg in the HSLP group, and 152 +/- 3 mm Hg in the HSSP group. These values were significantly higher than 126 +/- 4 mm Hg in the HSHP group. Blood pressure showed reciprocal relationships to both urinary sodium and kallikrein excretion. These results suggest that high protein intake suppresses the rise of blood pressure of salt-loaded rats by facilitating sodium excretion and activating the renal kallikrein-kinin system. PMID- 3632820 TI - A time for self-assessment. Art and science of management. PMID- 3632819 TI - Listen to requests of patients/families. Law for the nurse manager. PMID- 3632821 TI - PCS: one system for both staffing and costing. PMID- 3632822 TI - Zone of indifference: effective decision-making in critical care management. PMID- 3632823 TI - Mastering coronary care skills. PMID- 3632824 TI - The ambulatory surgery center nurse. PMID- 3632825 TI - Tracking productivity: an easy, quick and useful way. PMID- 3632826 TI - Testing validity and reliability in a psychiatric patient classification system. PMID- 3632827 TI - New approaches to theory development. PMID- 3632828 TI - Theory development and nursing practice: a synopsis of a study of the theory practice dialectic. PMID- 3632829 TI - Theory development and domain concepts. PMID- 3632830 TI - Reconceptualizing the environment. PMID- 3632831 TI - Quantitative methods: descriptive and experimental. PMID- 3632832 TI - Qualitative methods: phenomenology. PMID- 3632833 TI - A second look at mentors. PMID- 3632834 TI - Poverty trends: implications for nursing. PMID- 3632835 TI - Decentralization: how it affects nurses. PMID- 3632836 TI - The vulnerability of deans. PMID- 3632837 TI - Unprofessional conduct and licensure revocation. PMID- 3632838 TI - Shifting world views among nurses. PMID- 3632839 TI - Conflicts, satisfactions, and attitudes during transition to the maternal role. AB - A correlational descriptive study of 86 first-time mothers examined the relationships among employment status, role conflict, marital satisfaction, employment role attitude, and ease of transition to the maternal role. Interview and questionnaire data were collected 5 to 18 months after the birth of the first child. No significant differences were observed between employed and unemployed mothers in relation to role conflict. Mothers with careers tended to experience more role conflict between their worker, self, and spouse roles than mothers with jobs. Mothers who experienced more role conflict, regardless of their work status, had more difficulty in making the transition to the maternal role. Marital satisfaction was found to be positively correlated with ease of transition to the maternal role. No significant correlation was observed between employment role attitude and ease of transition to the maternal role. Mothers who reported a more positive attitude toward employment reported significantly less conflict between spouse and parent roles. Mothers who had attended a parent support group, regardless of their work status, experienced more conflict between the parent and self roles; these mothers also tended to have greater difficulty in making the transition to the maternal role. PMID- 3632840 TI - Attitudes, subjective norms, and intentions to engage in health behaviors. AB - The theory of reasoned action was used as the conceptual framework for analyzing the relationships among attitudes, subjective norms, and intentions to exercise regularly, maintain/attain recommended weight, and avoid highly stressful life situations. The sample (N = 377) consisted of adults between the ages of 18 and 66 living in two midwestern communities. Data were collected using a structured questionnaire designed according to guidelines developed by Ajzen and Fishbein (1980). The theory was supported in part by study results. Attitudes were useful in explaining intentions to engage in all three health behaviors studied. Subjective norms contributed only to the explanation of intentions to engage in regular exercise. Three factors, attitudes, subjective norms, and weight, affected intentions to engage in regular exercise, R = .364, p less than .01. Attitudes, weight, and perceived health status were the principle determinants of intention to eat a diet consistent with weight control, R = .428, p less than .001. Of the variables studied, only attitude was associated with intention to manage stress, R = .271, p less than .01. PMID- 3632841 TI - Theoretical model testing to identify personality variables effecting preventive behaviors. AB - To test the preventive behavior model, the impact of perceived barriers and benefits and health value orientations on two health care activities (smoking and exercise) was examined. Data from 76 subjects who had taken part in a health screening program were analyzed using regression analysis. A reduced empirical model for exercise resulted, explaining 46% of the variance. However, only one variable that accounted for 7% of the variance was significant in explaining smoking behavior. Significant personality variables in the exercise model provide clues toward understanding psychological factors that may be operating to influence an individual's participation in health care activities. PMID- 3632842 TI - Arthritis patients' self-reported affective states and their caregivers' perceptions. AB - Differences between arthritis patients' self-reported affective states and caregivers' perceptions of their affective states were assessed. Thirty hospitalized arthritis patients completed the Multiple Affect Adjective Check List (MAACL) and the Marlowe-Crowne Social Desirability Scale, a component of which measures denial, after which an interview assessment of their denial was made. Following this, a caregiver sample, 26 registered nurses who were familiar with at least one of the patient subjects, completed the MAACL as they believed the patient would. T tests revealed that caregivers were generally accurate in their assessment of the patients' affective states. These results are discussed in light of Wright's (1960, 1983) requirement of mourning. Further significant findings of interest were: The caregivers' attribution of anxiety was positively correlated with the patient's socioeconomic status; and, the higher the nursing educational level of the caregivers the more accurate their assessments. PMID- 3632843 TI - A new method to quantitatively describe pain behavior in infants. AB - Photogrammetric techniques were used to record the responses of 10 newborn infants to heelstick procedures at 4 hours of age. The responses consisted of an immediate withdrawal of both the affected and unaffected leg, followed by facial grimacing and crying. The median latency of withdrawal in response to the first heelstick was 0.3 seconds for the unaffected and 0.4 seconds for the affected leg, respectively. The median latency following a second heelstick was 0.2 seconds for both legs. The median latency of cry was 1.8 seconds following the first heelstick and 1.6 seconds following the second heelstick. Other quantitative parameters of the response, velocity of first affected leg movements, number of leg movements, and number of movements directed toward the stimulus, were also measured. This pilot study demonstrated a method by which quantitative data regarding pain responses in infants can be obtained and evaluated. PMID- 3632844 TI - Here come the clones. PMID- 3632845 TI - Acute confusional states in hospitalized elderly: a research dilemma. AB - This article reviews the literature on acute confusional states, including classification, incidence and prevalence, etiology, psychogenetic theories, and implications for nursing. PMID- 3632846 TI - Social support during pregnancy: a unidimensional or multidimensional construct? AB - The purpose of this study was to test empirically a conceptually derived multidimensional formulation of social support. Analyses were based on responses of 313 expectant couples who varied in age, income, and education. A questionnaire, which included the Support Behaviors Inventory (SBI), was given in the latter half of pregnancy. A four-phased analysis was conducted: discriminate validity testing of the multidimensional support structure, further subscale analysis, factor analysis of the structure of the SBI, and reformulation of the SBI based on results of the factor analyses. Results did not demonstrate independence of measurement with items that were developed to represent a priori social support dimensions of emotional, material, informational, and appraisal support. The factor analysis in particular revealed that the scree test by Cattell (1966) demonstrated a large, dramatic discontinuity in eigen-values and suggested that there was only one systematic factor. These results implied a dominant construct of social support in pregnant couples that organizes at the broad level the perceived degree of experienced support during pregnancy. This broader concept was so dominant in the current study, explaining 48% of the variance in partner support and 61% of the variance in others support, that the idea of multidimensionality was not confirmed. These data suggest an ongoing need to scrutinize carefully and validate empirically the hypothesized multiple dimensions of social support proposed in a number of recent support instruments. PMID- 3632847 TI - Development of the Nursing Career Preference Inventory. AB - The Nursing Career Preference Inventory (NCPI) was developed to assist nurses in determining which of the four primary nursing practice areas--clinical, administration, research, or education--are most reflective of their personal work activity interests or preferences, and which of 14 customary hospital nursing role positions most often encompass the preferred work activity patterns. This report describes NCPI development and the reliability and validity of the instrument for VA and non-VA hospital nurse reference groups. Correlations between work activity responses of VA and non-VA nurses in the same positions ranged from .71 to .96, and alpha reliability coefficients for the four practice and activity item subsets ranged from .86 to .93 for the two nurse populations. Although additional work is needed to explore item consistency over time, the NCPI can be a useful tool in career development programs that are designed to assist nurses toward selecting nursing role positions and building career plans that reflect their own personal talents and interests. PMID- 3632849 TI - Re: Patient education in a public hospital. PMID- 3632848 TI - Effect of pushing techniques in birthing chair on length of second stage of labor. PMID- 3632851 TI - Re: Stress in ICU and non-ICU nurses. PMID- 3632850 TI - Continuous monitoring of mixed venous oxygen saturation: an instrument for research. PMID- 3632852 TI - Re: Institutional sources of articles published in 13 nursing journals, 1978 1982. PMID- 3632853 TI - Re: Physiological circadian rhythmicity in preterm infants. PMID- 3632854 TI - Comparison of moisture vapor permeable (MVP) dressings to conventional dressings for management of radiation skin reactions. PMID- 3632855 TI - Pruritus and cancer. PMID- 3632856 TI - Fertility considerations in the gynecologic oncology patient. PMID- 3632857 TI - Health beliefs about testicular cancer and self-examination among professional men. PMID- 3632858 TI - Anticipatory nausea and vomiting associated with cancer chemotherapy. PMID- 3632859 TI - Association of chemotherapy related nausea and vomiting with pretreatment anxiety. PMID- 3632860 TI - Early detection of malignancy: from birth to twenty years. PMID- 3632861 TI - Clinical research in cancer chemotherapy. PMID- 3632862 TI - Bone marrow procedure guide. PMID- 3632863 TI - Administrative Task Force report. PMID- 3632865 TI - Chemotherapy administration precaution. PMID- 3632864 TI - Why a generalist exam in a specialty area? PMID- 3632867 TI - National testing firm designs oncology certification examination. PMID- 3632866 TI - Nursing assessment with cyclosporin A. PMID- 3632868 TI - A conceptual framework for nursing diagnoses: alterations in urinary elimination. PMID- 3632869 TI - A coat of many colors: a program to reduce the incidence of hospital-originated pressure sores. PMID- 3632870 TI - Physical and occupational therapy on a newborn intensive care unit. PMID- 3632871 TI - Publishing an article. PMID- 3632872 TI - Patient compliance: issues and outcome. PMID- 3632873 TI - Compliance: self-care or compromise? PMID- 3632874 TI - Compliance: myths and motivators. PMID- 3632875 TI - Methods for assessing compliance. PMID- 3632876 TI - Strategies for improving compliance. PMID- 3632877 TI - Compliance and health behaviors. PMID- 3632878 TI - Compliance and illness responses. PMID- 3632879 TI - Promoting compliance in rehabilitation of a patient with a myocardial infarction. PMID- 3632880 TI - Using compliance research in clinical practice. PMID- 3632881 TI - Ethical issues in compliance. PMID- 3632882 TI - Nursing research and patients' rights. PMID- 3632883 TI - 'I didn't sleep a wink'. PMID- 3632884 TI - Bile leakage from biliary cath. PMID- 3632885 TI - Cure dry mouth without causing cavities. PMID- 3632886 TI - Filling in the blanks on prescription writing. PMID- 3632887 TI - Giving cancer drugs i.v. Some guidelines. PMID- 3632888 TI - Back to basics. The preop exam. PMID- 3632889 TI - Living with AIDS. A mother's perspective. PMID- 3632890 TI - Living with AIDS. When the system fails. PMID- 3632891 TI - Tough-minded nursing. PMID- 3632892 TI - Stress tag: you're it! PMID- 3632893 TI - Diabetes. Let's stop testing urine. PMID- 3632894 TI - After T-E puncture: relearning to speak. PMID- 3632895 TI - Giving a CPR form new life. PMID- 3632896 TI - A crying need. PMID- 3632897 TI - A toast: to overriding a presidential veto. PMID- 3632898 TI - Congress overrides veto, nursing gets center for research. PMID- 3632899 TI - RNs bring needed view to legislatures. PMID- 3632901 TI - Political action by nurses is vital in 1986 elections. PMID- 3632900 TI - NOLF (Nursing Organization Liaison Forum) leaders discuss issues that unite. PMID- 3632902 TI - As I see it--consumer views social policy statement. PMID- 3632903 TI - Cancer: are support groups meaningful in the workplace? PMID- 3632904 TI - Motivating health & safety. PMID- 3632905 TI - How the OHN can relieve stress to improve employee health. Balancing career and home. PMID- 3632906 TI - AIDS--meeting the challenge in the workplace. PMID- 3632907 TI - Anxiety disorders--America's leading mental health problem. PMID- 3632908 TI - Psychosocial issues in the workplace (continuing education credit). PMID- 3632909 TI - Bridge to recovery--stigmatized and isolated, the impaired nurse needs your help. PMID- 3632910 TI - [Kallikrein as a modulator of serotoninergic and bradykininergic myotropic reactions in the small intestine]. AB - The effect of 0.01 U/ml of kallikrein on serotonin and bradykinin contractile action in the isolated intestinal segment has been described. The character of myotropic reactions was shown to change in accordance with the anatomical localization of the intestinal segment. Sensitivity to serotonin and bradykinin increases in duodenum segments and decreases in jejunum and ileum segments. Kallikrein is supposed to serve as a modulator of intestinal serotonin- and bradykininergic myotropic reactions. PMID- 3632911 TI - Primary dysfunction in aggregation and secretion of SHRSP platelets: not secondary to the circulation of "exhausted" platelets. AB - The thrombin-induced secretion of [14C]-serotonin and adenine nucleotides from stroke-prone spontaneously hypertensive rats (SHRSP) platelets was markedly reduced with the development of hypertension accompanying hypo-aggregability compared with that from age-matched Wistar Kyoto rats (WKY) platelets. Calcium Ionophore A23187-induced secretion and aggregation were also attenuated in SHRSP platelets. Additionally, an enhancement of platelet secretion as well as aggregation by extracellular Ca2+ was less in SHRSP platelets than in WKY platelets. The platelet contents of adenine nucleotides and serotonin were not different between SHRSP and WKY at 5-16 weeks of age whereas they became significantly lower in SHRSP beginning at 22 weeks. The serotonin content in SHRSP platelets at 36 weeks of age was only 55% of that in WKY platelets. It is suggested that the reduced platelet aggregation and secretion observed in SHRSP platelets at ages lower than approximately 20 weeks are not secondary phenomena to the circulation of degranulated platelets, but the primary defect of SHRSP platelets appears to be an impaired function of Ca2+. PMID- 3632912 TI - Teniposide is not effective in chronic lymphocytic leukemia. AB - Teniposide has been evaluated in a phase II clinical trial in chronic lymphocytic leukemia (CLL). Among 16 consecutive patients with CLL entered in the study and treated with Teniposide, 100 mg/m2 weekly, no objective response was observed. Toxicity was generally mild and mainly hematologic. Teniposide at this dosage and schedule is an inactive drug in CLL. PMID- 3632913 TI - Aberrant protein pattern in red cell membranes of a patient with mild hemolytic anemia. AB - A 17-year-old patient with mild hemolytic anemia known since early childhood displayed an aberrant protein pattern of his red cell membranes when analyzed in SDS-polyacrylamide gel electrophoresis (SDS-PAGE). A double protein band in the low molecular weight region (molecular weight of about 33,000) was distinctly reduced or missing in the membranes that were investigated concomitantly with those of controls on two occasions at an interval of 6 months'. The phosphorylation pattern of membrane phosphoproteins, on the other hand, did not seem to differ from that of controls. It is suggested that a causal relationship existed between the observed membrane abnormality and the mild hemolytic anemia. PMID- 3632914 TI - Long-term (5-11 years) follow-up of general immune competence in breast cancer. I. Pre-treatment levels with reference to micrometastasis. AB - General immune competence was measured before treatment in 185 breast cancer patients. They were then followed for 5 to 11 years to determine its relationship to recurrence and its clinical value in predicting prognosis. The tests of immune competence used were immunoglobulins IgG, IgA, IgM, leucocyte counts, percentage and total lymphocyte counts and Mantoux and DNCB skin hypersensitivity tests. None of these tests was strongly predictive of recurrence on an individual basis, a finding similar to our results at 2 years. The longer period of follow-up now reported has provided no findings of unequivocal statistical significance, but suggests a biphasic host response to early tumours. The patients who developed recurrence within 5-11 years due to micrometastasis had higher lymphocyte counts in their preoperative assessment than patients who remained recurrence free. This suggests that small tumour volumes do not stimulate immunity and that large volumes depress it; tumours in between these groups are associated with higher levels. Examination of studies by a number of authors reveal parallel findings which have not been previously noted. It is not possible to confirm the significance of these findings from this study because of the heterogeneity of human breast cancer. However, if they indicate a general principle of a dynamic host-tumour interplay they have important implications for assessing immune competence at any single point of time and for the theory that cancer may arise during an anergic state. We hope that these findings will stimulate other workers to examine host-tumour interaction from this point of view. PMID- 3632915 TI - Relation between the site of primary intracranial tumors and mitogenic responses of blood lymphocytes. AB - The possible relation between the site of primary intracranial tumors and mitogenic responses of blood lymphocytes was analyzed in 115 patients who had not undergone surgery or received any radiation or chemotherapy. Some of the patients had however received corticosteroid treatment. PHA responses were impaired in nonsteroid treated patients with tumors affecting the left cerebral hemisphere. They were normal in patients with tumors affecting the right cerebral hemisphere or central structures of the brain or tumors growing in the posterior fossa of the skull. Lymphocyte responses to PPD were normal in patients with hemispheric or posterior fossa tumors. However, the PPD response was sharply reduced in patients with central tumors. The results could not be explained by different histological tumor types or anticonvulsant medication in the various patient groups. In addition, the capacity of sera to promote mitogen stimulation of lymphocytes did not differ significantly between the patient groups. It is speculated that intracranial tumors may interfere with the function of certain centers in the brain which are involved in the regulation of lymphocyte responses. PMID- 3632916 TI - Development of highly immunogenic variants of a rat fibrosarcoma line during in vitro cultivation. AB - Rat fibrosarcoma KMT-17 cells decreased in tumorigenicity when cultured in vitro. Eight clones derived from cultured KMT-17 cell lines (c-KMT-17) were examined for their tumorigenicity, immunosensitivity, and immunogenicity. All the clones were less or nontumorigenic in normal syngeneic rats than KMT-17 cells maintained in vivo. All eight clones produced tumors in rats immunosuppressed with 600 rad 60Co; differences in degree of tumorigenicity were seen among clones in rats irradiated with 250 rad 60Co. Although immunosensitivity of the eight clones to complement-dependent and cell-mediated cytotoxicity was the same or less than that of KMT-17 cells, al leight clones induced greater transplantation resistance to KMT-17 than KMT-17 itself. Cold target inhibition tests demonstrated new antigens in a highly immunogenic variant in addition to the original tumor associated antigen (TAA). New glycolipids, not observed in KMT-17 cells, were demonstrated in the clones by thin layer chromatography. These results suggest that new antigens appearing during culture of KMT-17 may act as helper antigens for TAA, increasing the immunogenicity and decreasing the tumorigenicity of the cultured cells. PMID- 3632917 TI - Long-term follow-up of general immune competence in breast cancer. II. Sequential pre- and post-treatment levels: a 10 year study. AB - Pre-treatment and sequential post-treatment (at 3 months, 6 months, 1, 2, 3, 4 and 5 years) examination of general immune competence was performed in 185 consecutive breast cancer patients. The patients were followed for 5 to 11 years to monitor the dynamic relationship between host immunity and cancer and to examine the effect of the treatment method. The tests of immune competence used were immunoglobulins IgG, IgA, IgM, leucocyte counts, percentage and total lymphocyte counts and Mantoux and DNCB skin hypersensitivity tests. Serum IgG and IgA showed no change relating to treatment method in recurrence-free patients; but IgG levels were higher when recurrent disease was imminent or established; IgM diminished (P less than 0.001) after treatment and this continued at 5 years in all patient groups. Simple lymphocyte counts showed the most interesting changes. They remained depressed for as long as 60 months following radiotherapy (P less than 0.01). After treatment by surgery, lymphocyte counts rose in patients without recurrence, but fell when systemic recurrence was imminent or established. This effect was not seen in patients with local recurrence only. There was no change in immune competence immediately before recurrence sufficient to be of clinical usefulness, but a low pre-treatment lymphocyte count with a steady rise after surgery carried a good prognosis. Similarly a high initial lymphocyte count with a fall after surgery was indicative of recurrence. Universal and prolonged depression of lymphocyte counts following radiotherapy was confirmed, and the effect was additive to that of tumour load in recurrent disease. Because of the large number of statistical calculations carried out, some of the apparently significant findings may be due to chance. However, the general trends emerging suggest that similar long-term studies, using the more sophisticated measures of lymphocyte function now available, might be rewarding. PMID- 3632920 TI - Environmental and occupational health content in undergraduate nursing educational programs. PMID- 3632918 TI - WEHI 164 sarcoma cells rendered resistant to monocyte-released cytotoxin are also resistant to monocyte-induced cytolysis. AB - WEHI 164 sarcoma cells cultured with monocyte-released cytotoxin (CF) for 4 weeks became resistant to CF-induced cytolysis and were concomitantly rendered resistant to monocyte-induced cytolysis. The resistant cell line (R-WEHI 164) has been stable with respect to resistance to monocyte- and CF-induced lysis for more than 7 months. WEHI 164 and R-WEHI 164 cells adsorbed CF and no significant difference in CF adsorption was observed. The results indicate that CF may be an effector molecule in monocyte-mediated cytolysis. PMID- 3632919 TI - Clinical and immunological evaluation of 20 patients with advanced colorectal cancer treated with high dose recombinant leukocyte interferon-alpha A (rIFN alpha A). AB - A total of 20 patients with advanced colorectal cancer received recombinant leukocyte interferon-alpha A (rIFN alpha A) either chronically (group I: twice a week up to 20 X 10(6) IU/m2 i.m.) or cyclically (group II: 1-4 periods of 8 consecutive days up to 20 X 10(6) IU/m2 i.m. daily at 20-days intervals) over a period of 12 weeks. There was 1 partial response, 1 mixed response and 1 patient with stable disease, whilst 17 patients had progressive disease. Median survival was 15.5 months. Survival was significantly shorter when the extent of hepatic disease was greater than 25% (P = 0.05), extrahepatic disease was extensive (P less than 0.005), alkaline phosphatase level was greater than 2 X normal (P less than 0.02), or performance status was less than 100% (P less than 0.001). Toxicity consisting mainly of fever, fatigue, anorexia and weight loss was serious in group I and minimal in group II. Administration of rIFN alpha A led to a "short lived" augmentation of natural killer (NK) cell activity. In the cyclically treated group this was a recurrent phenomenon whereas a marked lasting depression of NK cell activity was seen in chronically treated patients. Interferon-gamma production capacity was significantly stimulated during rIFN alpha A therapy. The differences in toxicity and immunostimulatory effects between the two schedules may be of importance in the design of further studies. PMID- 3632921 TI - In vitro activity of cefpirome (HR810) against antibiotic-resistant gram-positive and gram-negative bacteria including organisms with inducible resistance. AB - The activity of cefpirome (HR810) was compared with seven beta-lactam antibiotics against selected gram-positive and gram-negative bacteria. Cefpirome was the most active antibiotic tested against all groups of Enterobacteriaceae; 46% of the isolates of Pseudomonas aeruginosa were inhibited by less than or equal to 8 micrograms/ml of cefpirome. Fifty percent of the oxacillin-resistant Staphylococcus aureus isolates and 82% of the Streptococcus faecalis isolates were inhibited by less than or equal to 8 micrograms/ml of cefpirome. All Enterobacteriaceae and two of five P. aeruginosa isolates that were induced to produce beta-lactamase by prior exposure to cefoxitin remained susceptibile to cefpirome. PMID- 3632922 TI - Designing your nursing career. PMID- 3632923 TI - Decreasing side effects of anticonvulsants. PMID- 3632924 TI - New isolation guidelines. Part 1. Critical care applications. PMID- 3632925 TI - New isolation guidelines. Part II. Controversies. PMID- 3632926 TI - Career development. Multiple authorship and professional advancement. PMID- 3632927 TI - Chest X-ray interpretation: implications for nursing intervention (continuing education credit). PMID- 3632928 TI - Isoelectrofocusing in the study of the BfF system: existence of two common subtypes of the BfF allele in a Japanese population. AB - The Bf gene frequencies including BfF' allele and BfF'' allele in a Japanese population were studied by using the PAGIF method. The results showed the Bf gene frequencies: BfF' allele = 0.0778, BfF'' allele = 0.1007 and BfS allele = 0.8215. PMID- 3632929 TI - Dementia: a family problem. PMID- 3632930 TI - The real world of the old-old. Interview by Linda Sheesley and Maureen Osis. PMID- 3632932 TI - "Old Bill.". PMID- 3632931 TI - A program of activities of daily living for the cognitively impaired. PMID- 3632933 TI - Drugs & healthy aging. Sexuality: an interactional perspective. PMID- 3632934 TI - Promoting professional nursing practice in geriatric settings: power and influence of nursing administrators. PMID- 3632935 TI - Significance of the presence of conjugated iopanoic acid in the bowel of patients with abnormal oral cholecystogram. PMID- 3632936 TI - Blood counts in portal hypertension of non-cirrhotic origin: correlation with splenic size and splenic pulp pressure. PMID- 3632937 TI - Gastrointestinal carcinoids. PMID- 3632938 TI - Surgery in pancreatic pseudocysts: a retrospective study. PMID- 3632940 TI - Non-operative treatment of benign esophageal strictures. PMID- 3632939 TI - Calcific enterolithiasis. PMID- 3632941 TI - Chemotherapy of gastric cancer. PMID- 3632942 TI - Choledochoduodenal fistula: an unusual complication of duodenal ulcer disease. PMID- 3632943 TI - Early gastric carcinoma. PMID- 3632944 TI - Primary amyloidosis. PMID- 3632945 TI - Barrett's oesophagus following Heller's myotomy. PMID- 3632946 TI - Phenytoin induced hepatotoxicity. PMID- 3632947 TI - Dieulafoy's ulcer--a rare cause of upper gastrointestinal bleeding. PMID- 3632948 TI - Nursing education in the United Arab Emirates. AB - This paper reviews the development of the nursing manpower situation in the United Arab Emirates, with particular emphasis on the trends and currents that have had an impact on the national school of nursing in Abu Dhabi, in the last decade. Special attention is placed on the design of the nursing curriculum. This is based on a framework of core concepts derived from a philosophy relating to man, health and nursing. A competency-based model, designed for three levels of nursing personnel, each with well defined responsibilities, is presented along with an educational and professional career ladder for nurses in the United Arab Emirates. A phased implementation of the proposed system of nursing education is undertaken, with the first phase nearing completion. Preparations are well underway to initiate the second phase of nursing education, that has been successfully implemented earlier in the state of Bahrain. PMID- 3632949 TI - The development of an observation schedule for measuring nurse-patient touch, using an ergonomic approach. AB - An observation schedule for recording nurse-patient touch was developed, using an ergonomic approach to design. A preliminary study using video-tape analysis and a ward survey indicated that 'instrumental touch' was more frequently employed by nursing staff than 'expressive touch'. Three levels of relevant information relating to touch were recorded: General circumstances (the type of hospital, etc.); Demographic variables (relating to participants in the touch episode); Events specifically relating to the touch episode. The third section of the schedule was tested in an acute geriatric ward, using inter-observer reliability techniques. Reliability was found to be acceptable for those where the criteria for categorization were reasonably objective. It was concluded that an instrument for recording nurse-patient touch has useful applications for both ergonomic and nursing research. PMID- 3632950 TI - Nursing care of the dying: its relationship to selected nurse characteristics. AB - This study examined the relationship between the quality of nursing care given to terminally-ill patients and their families, and selected characteristics of 210 nurses caring for terminally-ill patients. Mailed questionnaires received 90% response from nurses in a two-stage, stratified, proportionate, random sampling plan. Independent variables studied were: death anxiety, educational experience, personal experience and professional experience. Dependent variables studied were three measures of the quality of nursing care: communication, continuity of care and family care. Kendall's tau and parametric partial correlation coefficients were used for data analysis. The study results show that 13 of the 18 statistical tests were significant at 0.05. PMID- 3632952 TI - Replication research in nursing. AB - The importance and contribution of replication research in nursing to the development of nursing science is discussed as well as deterrents which have apparently contributed to a dearth of replication studies in nursing. Various types and examples of replication studies are analyzed and criteria for replication in nursing are proposed. PMID- 3632951 TI - The response of nurses towards the management and teaching of patients on continuous ambulatory peritoneal dialysis (CAPD). AB - The aim of this paper is to shed some light on the way trained nurses responded to the challenge of teaching patients to manage life on Continuous Ambulatory Peritoneal Dialysis (CAPD). This topic is of interest since nursing skills and knowledge are central to the successful management of patients on CAPD. More importantly, the treatment has the potential to keep patients alive who would not previously have been treated. Hence the assumption underpinning this work is that the opinions which nurses hold regarding this form of treatment may in due course influence its future. The data on which this paper is based were collected by means of participant observation over a period of nine months on one male and one female medical ward. Supplementary data were collected during this time at the out-patient clinic and at multidisciplinary CAPD meetings. The findings reported here are impressionistic and hypothesis-generating, but nevertheless they do provide sound insights into the way nurses reacted to patients on this new form of treatment. The type of patient selected for treatment and the ward workload were found to be the most influential factors in the way nurses regarded CAPD patients. It seemed that patients were viewed as 'members' of a collectivity rather than as individuals. Hence the job of the nurse was to rationalize competing demands on her time. Our data suggest that nurses viewed CAPD patients as generating 'extra work' and these patients were more likely to be viewed unfavourably.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632953 TI - Effect of nursing approach in understanding of physicians' directions, by the mothers of sick children in an out-patient clinic. AB - This article discusses whether the mothers of sick children can be helped to increase the level of their understanding of the recommendations by the physicians regarding their childrens' treatment, care and follow-up with an appropriate nursing approach. PMID- 3632954 TI - International nursing: one nurse's experience. AB - Helen McDowell has had extensive experience working in other people's countries and helping them with their nursing organization. Here she provides useful information which should be helpful to anyone contemplating working abroad. PMID- 3632955 TI - Psychosocial aspects of terminal care. A preliminary study of nurses' attitudes and behaviour in a general hospital. AB - American research has shown that dying patients in general hospitals are unpopular with health care personnel who withdraw from them socially while maintaining adequate physical care. Some of the reasons for this may be doctors' control of patient care and their own fears of death or perception of patient death as failure. Most doctors would not permit patients to know of a poor prognosis and this often leads to 'closed awareness' in which both nurse and patient are aware of the eventual outcome, but the nurse is forbidden to discuss this and so cannot encourage 'dangerous' conversation in the patient. This study was designed to replicate some of the American findings and confirmed that nurses are ill-prepared to deal with death, withdraw socially from terminal patients and have no authority to discuss dying. The findings are discussed in terms of nurse education and implications for professional autonomy and responsibility. PMID- 3632956 TI - Nursing education in Mexico. AB - This is a descriptive report on nursing education in selected areas of Mexico. The data could be used to identify some cultural components unique to nursing education in Mexico. The cities of Jalapa and Mexico City were chosen because of recent advances in health care and health education in these cities. Only with knowledge of a system, an open attitude, and an international perspective of caring, can attempts be made to make the north-south relationship between North America and South America a wholesome experience of reality. PMID- 3632957 TI - Violation of human rights and the nursing profession. AB - In this presentation, the focus will be on torture and its after-effects on the individual and the responsibility of the nursing profession in this tragic context. The nursing profession must therefore be as vigilant as possible in combatting this practice which can be characterized as the most evil in the world. PMID- 3632958 TI - The development of a family nurse practitioner programme in Botswana. AB - The Family Nurse Practitioner Programme, offered through the National Health Institute in Botswana, Africa, is the result of a collaborative effort between the Ministry of Health of the Government of Botswana and the United States Agency for International Development. This one-year post-basic nursing programme evolved from a national commitment to expand and upgrade primary health care services. The curriculum, based on service needs and reflecting national development priorities, has been designed to increase the relevance of nursing education to the social and health needs of the people. PMID- 3632959 TI - The intrainstitutional ethics committee: response to a primal scream. PMID- 3632960 TI - A diagnosis of myocardial infarction in the presence of left bundle-branch block. PMID- 3632962 TI - Cardiac output determination by the thermodilution method: comparison of ice temperature injectate versus room temperature injectate contained in prefilled syringes or a closed injectate system. PMID- 3632961 TI - Catecholamines, potassium, and beta-blockade. AB - Stress-induced hypokalemia represents a transient risk factor for malignant arrhythmias in patients with coronary artery disease. The adrenergic nervous system serves as a major control system for the transport of potassium across the cell membrane. Nonselective beta-blockade presents epinephrine-mediated hypokalemia. This helps explain a possible mechanism for the significant improvement in morbidity and mortality rates of patients taking long-term propranolol therapy in the Beta Blocker Heart Attack Trial report. PMID- 3632963 TI - A nurse supervised exercise stress testing laboratory. PMID- 3632964 TI - Deep hypothermic arrest in children undergoing heart surgery. AB - Deep hypothermia with cold cardioplegia is a technique that increases the chances for successful palliative or reparative cardiac surgery for the critically ill infant or child with complex or severe cardiac anomalies. Perioperative nursing care is of vital importance to the child, family, and operative team. Nursing care measures include perioperative teaching as well as preoperative and postoperative physical assessment of the child and psychosocial assessment of the child and family unit. An understanding of the advantages and the potential complications of hypothermic techniques enhances the nurse's ability to carry out these nursing interventions. PMID- 3632965 TI - Torulopsis (Candida) glabrata endocarditis involving a bovine pericardial xenograft heart valve. PMID- 3632966 TI - Writing for the popular press: a professional nursing responsibility. PMID- 3632967 TI - Turning clinical problems into research. AB - The nursing process is well known by practicing nurses. The model for approaching the development of nursing research using this process has been presented. The clinical arena is rich in data and problems worthy of detailed research work. The models provide structure and methods that are familiar to practicing nurses so that they may begin to work with colleagues and other researchers in the clinical setting. A nurse who wants to use this model to begin research efforts needs interested colleagues in nursing, friends with patient ears, superiors who value this type of work, and affable determination. PMID- 3632968 TI - The endotracheal use of emergency drugs. AB - The endotracheal route for medication is useful in emergency situations. Epinephrine, atropine, and naloxone have proved to be effective when administered by this route. Experience with lidocaine is largely anecdotal, but the available information and the drug's chemical properties indicate that endotracheal lidocaine may be considered if necessary. Drugs that should not be given by the endotracheal route include bretylium, diazepam, calcium salts, isoproterenol, norepinephrine, and sodium bicarbonate. PMID- 3632969 TI - Nursing diagnoses, indicators, and interventions in an outpatient cardiac rehabilitation program. AB - This study identified two nursing diagnoses used in an outpatient cardiac rehabilitation program. The indicators and interventions for these diagnoses were also identified. We feel that nurses in cardiac rehabilitation programs will find these diagnostic labels to be clinically useful. The indicators may also help nurses decide when to use the diagnostic labels. The interventions will provide direction on how to treat these nursing diagnoses. The use of nursing diagnoses in this setting helps clarify nursing's unique role in a multidisciplinary team providing services to participants in outpatient cardiac rehabilitation programs. PMID- 3632970 TI - Life situations, health beliefs, and medical regimen adherence of patients with myocardial infarction. AB - One hundred twelve patients with MI were followed over a 6- to 9-month period to investigate their intentions and adherence behavior to a prescribed medical regimen in four life situations. The subjects with MI had strong intentions in the hospital to follow their prescription in all four situations, with the strongest for the home situation and the weakest for work. However, the actual adherence behaviors were less than the original intentions. The findings indicate the need for a review of the content of rehabilitation programs and consideration of the stage of recovery at which instructions are presented to patients rehabilitating from a MI. The intentions and adherence behaviors of subjects with MI were closely related to their perceptions of significant others' expectations. For the health team, this emphasizes the need to include significant others in patient rehabilitation. PMID- 3632971 TI - Multidimensional health locus of control, adherence, and lowered diastolic blood pressure. PMID- 3632972 TI - Levels of pacemaker acceptance by patients. PMID- 3632973 TI - Prekallikrein deficiency in a dog. AB - A 15-year-old male dog with chronic hematuria was found to have prolonged activated partial thromboplastin time. Results of plasma coagulation assays indicated a deficiency of prekallikrein, a plasma protein that modulates the rate of activation of factors XI and XII in the intrinsic clotting system. Patients with prekallikrein deficiency rarely have manifestations of hemorrhage. The hematuria was the result of a renal transitional cell carcinoma. PMID- 3632974 TI - Functional adaptation of diaphragm to chronic hyperinflation in emphysematous hamsters. AB - Costal strips of diaphragmatic muscle obtained from animals with elastase-induced emphysema generate maximum tension at significantly shorter muscle fiber lengths than muscle strips from control animals. The present study examined the consequences of alterations in the length-tension relationship assessed in vitro on the pressure generated by the diaphragm in vivo. Transdiaphragmatic pressure (Pdi) and functional residual capacity (FRC) were measured in 22 emphysematous and 22 control hamsters 4-5 mo after intratracheal injection of pancreatic elastase or saline, respectively. In 12 emphysematous and 12 control hamsters Pdi was also measured during spontaneous contractions against an occluded airway. To allow greater control over muscle excitation, Pdi was measured during bilateral tetanic (50 Hz) electrical stimulation of the phrenic nerves in 10 emphysematous and 10 control hamsters. Mean FRC in the emphysematous hamsters was 183% of the value in control hamsters (P less than 0.01). During spontaneous inspiratory efforts against a closed airway the highest Pdi generated at FRC tended to be greater in control than emphysematous hamsters. When control hamsters were inflated to a lung volume approximating the FRC of emphysematous animals, however, peak Pdi was significantly greater in emphysematous animals (70 +/- 6 and 41 +/- 8 cmH2O; P less than 0.05). With electrophrenic stimulation, the Pdi lung volume curve was shifted toward higher lung volumes in emphysematous hamsters. Pdi at all absolute lung volumes at and above the FRC of emphysematous hamsters was significantly greater in emphysematous compared with control animals. Moreover, Pdi continued to be generated by emphysematous hamsters at levels of lung volume where Pdi of control subjects was zero.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3632978 TI - Some observations on health care by health services or health industries. PMID- 3632976 TI - Interactions between diphtheria toxin entry and anion transport in vero cells. III. Effect on toxin binding and anion transport of tumor-promoting phorbol esters, vanadate, fluoride, and salicylate. AB - When Vero cells were incubated with TPA (12-O-tetradecanoylphorbol 13-acetate) and related tumor promoters, their ability to bind diphtheria toxin in a functional way was rapidly reduced to less than 1% of the normal value. Upon further incubation with TPA, the cells recovered their ability to bind the toxin, apparently because they became resistant to TPA. Treatment with Na3VO4 reduced the ability of the cells to bind diphtheria toxin to approximately the same extent as treatment with TPA, but the reduction required longer time to develop and it persisted upon prolonged incubation with Na3VO4. ATP depletion of the cells prevented the reduction in binding capability. Such treatment also prevented the reduction in toxin binding induced by treatment with salicylate or fluoride. Treatment with TPA, fluoride, vanadate, and salicylate altered the ability of the cells to carry out anion transport and interfered with their ability to regulate the transport. The results indicate that the binding sites for diphtheria toxin on Vero cells are modulated by TPA, Na3VO4, salicylate, and fluoride by a process which requires ATP. The possibility is discussed that the modulation consists in phosphorylation of the toxin binding sites, which may be identical with, or closely linked to, the anion antiporter in the cells. PMID- 3632975 TI - Association of RNA polymerase III with transcription factors in the absence of DNA. AB - The gene for tRNAMet1 from Xenopus oocytes was transcribed in a cell free system with components isolated from a HeLa cell-free extract. It was found that, apart from the established assembly of transcription factors IIIB and IIIC on tRNA genes into stable transcription complexes, these factors can also associate with the enzyme in the absence of DNA to form a functional polymerase III complex. These complexes can be isolated in a highly active form from the bulk of other cellular proteins by mild methods such as gel filtration or density gradient centrifugation. When associated with RNA polymerase III into a functional complex, the transcription factors IIIB and IIIC can clearly be differentiated from free transcription factors, which individually display a much lower relative molecular mass. The polymerase complexes are stable against 1 M KCl, rendering unlikely that they represent fortuitous aggregates including RNA polymerase III and transcription factors IIIB and IIIC. These complexes are sensitive to dilution and, whereas transcription factor IIIC binds to the enzyme more tightly, factor IIIB tends to leak from the complex upon dilution of the protein concentration. From these results it is clear that in addition to their function as DNA-binding protein(s), transcription factors IIIB and IIIC can directly interact with RNA polymerase III without prior binding to the promoter region of the gene to be transcribed. PMID- 3632979 TI - Janforum. Identifying the place of theoretical frameworks in an evolving discipline. PMID- 3632977 TI - In vitro proteolysis of human plasma low density lipoproteins by an elastase released from human blood polymorphonuclear cells. AB - In vitro incubation of human plasma low density lipoproteins (LDL) with human blood polymorphonuclear cells (PMN) for 1 h at 37 degrees C resulted in an increased (2-4-fold) release into the medium of an enzymatic activity which co eluted with LDL by column chromatography at physiological ionic strength but dissociated from it in high salt media in an ultracentrifugal field. The release of this enzymatic activity increased with increasing concentration of LDL in the medium and caused the hydrolysis of the LDL apoprotein B100 as indicated by the appearance of 7-8 low molecular weight bands (immunoreactive with anti-LDL) which were not present in the electropherogram of control LDL. The proteolytic activity was identified as an elastase by the following criteria: 1) capacity to hydrolyze the synthetic substrate methoxysuccinyl-Ala-Ala-Pro-Val-4-methylcoumaryl-7-amide known to be specific for the PMN elastase, 2) pattern of apo-B proteolysis identical to that exhibited by pure PMN elastase, 3) inhibition of the proteolysis by the elastase inhibitor methoxysuccinyl-Ala-Ala-Pro-Val-CH2Cl, 4) identity in molecular weight (28,000-30,000) of this activity with a pure preparation of PMN elastase labeled with [3H]diisopropylfluorophosphate. Based on thiobarbituric acid analyses and the lack of effect by vitamin E, oxidative events appeared to play no detectable role in apo-B proteolysis. Since we previously reported (Byrne, R. E., Polacek, D., Gordon, J. I., and Scanu, A. M. (1984) J. Biol. Chem. 259, 14531-14543) that high density lipoprotein-3 promotes the in vitro release of PMN elastase which cleaves apo-A-II, it is apparent that in vitro, both LDL and high density lipoprotein, two of the major plasma lipoprotein classes, can affect the export from PMN of an elastase which exhibits proteolytic action on apo-B and apo-A-II. PMID- 3632980 TI - Stress and social facilitation: the effects of the presence of an instructor on student nurses' behaviour. AB - This paper analyses, in terms of social facilitation and stress theories, some of the effects of the presence and actions of instructors on student nurses' behaviour. The theories imply the existence of a paradox in the training of nurses. The aim of teaching is to reduce errors. Much of the training is done in the presence of instructors and patients. However, the presence of significant others during learning is hypothesized to increase errors, due to fear of failure and embarrassment. Indeed, the analysis of students' self-reports describing stressful encounters with instructors indicates that the students tended to perceive the instructors as mainly evaluative. One possible solution to this paradox is to distinguish clearly between the instructive and evaluative roles, to de-emphasize evaluation, especially during learning, thus reducing potential sources of anxiety and creating a more supportive learning atmosphere. It is also suggested that both instructors and students may benefit from stress-reduction strategies, such as relaxation training and improved communication. PMID- 3632981 TI - Unity for change? PMID- 3632982 TI - Action and reflection: practice and theory in nursing. AB - There are three issues related to theory and practice in nursing which are continually problematic. These are: the separation of theory from practice; reality vs the ideal; and nursing adherence to a scientific paradigm versus nursing adherence to an arts paradigm. It is suggested that Shotter's 'theory of personal action' (1974, 1975) may form the basis for a resolution of these three issues. Applying Shotter's work, a nursing action may be defined as an action which is deliberately thought out and which has as its goal the benefit of the patient and client. The 'deliberate thought and goal' of the action which is an integral component of it then forms the basis of nursing theory which is concerned with reasons for and reflections on action. This immediately unites theory and practice as two components of nursing action. The use which could be made of the theory of personal action in nursing practice, research and theory building and nurse education is explored. PMID- 3632983 TI - Breast feeding, fertility and child health: a review of international issues. AB - Breast feeding is of central importance to child survival, growth and development, especially in non-industrialized countries. It also protects the mother against further pregnancy. In the light of the increase in the world's population, the implications of the decrease in breast feeding worldwide are serious. There is a direct association between child health and survival and breast feeding. In this paper, the contraceptive effect of breast feeding is reviewed. The emphasis is on families in non-industrialized societies. The importance of suckling frequency and duration, and the timing of introduction of supplementary foods to the baby, are discussed. Limitations of the method, and recommendations to maximize its effectiveness, are given. It is noted that protection of breast feeding both as a means of improving child health and of spacing births will require positive action at local and at governmental levels. PMID- 3632984 TI - The elderly coping at home: a study of continuity of nursing care. AB - Thirty-three elderly clients who had been hospitalized and required continued care at home were studied for 3 months, with 836 visits made. Coping at home was studied in relationship to their certainty/uncertainty scores, perceived level of health, and perceived satisfaction with nursing care services. The relationship between coping and certainty/uncertainty was significant at P less than 0.001 and P less than 0.005 (first and second visits); the relationship between coping and perceived level of health was significant at P less than 0.001 and P less than 0.05 (first and second visits); and the relationship between coping and perception of care was not significant. This study presents significant data to contribute to nursing knowledge in the care of elderly people at home. PMID- 3632985 TI - Appropriate use of drugs by elderly people. AB - The effectiveness and safety of prescribed medication theoretically depends on the patient correctly following the prescriber's instructions. However, patient compliance is often difficult to achieve. This paper discusses reasons for this in relation to elderly people, and attempts to remedy the situation are reviewed. PMID- 3632986 TI - Sleep patterns of aged persons in long-term care facilities. AB - The nursing staff of long-term care facilities are often faced with the decision of whether or not to administer sleep medication when it is ordered 'prn'. This decision should be made on the basis of information contained in the patient's nursing sleep history as well as knowledge regarding the effects of sleep medication. This study was carried out to assess the factors involved in changes in sleep patterns of elderly patients in long-term care facilities and to evaluate the extent of use of the nursing sleep history. The sleep patterns of 102 elderly patients (mean age 78.7 years) in three long-term care facilities were assessed by means of interview questionnaire. Patients' records indicated that 71% were receiving some type of sleep medication on a regular basis. A quantitative analysis of their responses indicated that there were significant shifts in sleep patterns following admission. Only 54% of the patients in this study had a nursing sleep history and this contained only minimal information. The results indicate that the nursing sleep history is under-utilized. A better appreciation of the patient's sleep requirements could lead to a reduction in the amount of sleep medication given and an improvement in the general well-being of the long-term care elderly population. PMID- 3632987 TI - Social dramatics: social skills development for the chronically mentally ill. AB - The purpose of this study was to investigate the use of social dramatics as a clinical tool for teaching social skills to the chronically mentally ill on adult inpatient units of a state hospital. The research tested the hypothesis that patients exposed to social dramatics with videotape feedback would demonstrate greater ability to perform social skills as measured by the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Fifteen schizophrenic adults of both sexes meeting specific criteria were randomly assigned to experimental and control groups. Subjects were exposed over an 8-week period to randomly introduced social dramatic scenarios. The Wilcoxin test for two independent samples was used for testing differences between experimental and control groups. The research findings supported the hypothesis for one positive factor, social competence. The findings did not support any treatment effect on either social interest and personal neatness or irritability, manifest psychosis, and psychotic depression. There were no significant differences on the total score NOSIE-30. Recommendations for psychiatric nursing are made. Limitations of research methodologies and sample size were addressed. PMID- 3632988 TI - Self-esteem, types of attributional style and sensation and distress pain ratings in males. AB - This descriptive study focused on self-esteem and types of attributional style, and their relationship to sensation and distress pain ratings. Negative correlations were hypothesized between self-esteem and each pain rating, between positive internal type of attributional style and each pain rating, and between negative external type of attributional style and each pain rating. One hundred and nine healthy, non-institutionalized males, aged 21-50 years, participated in this study. The Tennessee Self-Concept Scale and revised Attributional Style Questionnaire were administered prior to the cold pressor test, a safe, short duration cold water hand immersion procedure for pain induction. Sensation and distress pain ratings were measured using visual analogue scales, and a pain history was obtained. The predicted relationship between self-esteem and distress pain ratings was supported. All other correlations were not statistically significant. A pain history question, asking subjects to rate their pain tolerance as compared with other people, was significantly related to both pain ratings, the correlations being negative. PMID- 3632989 TI - What 1357 hospital inpatients think about aspects of their stay in British acute hospitals. AB - Following on a long series of interviews and pilot studies a substantial questionnaire was devised for soliciting the reactions of patients to their stay in hospital. With the cooperation of health authorities it was distributed to ex patients in seven acute hospitals. A total of 1357 respondents returned a completed questionnaire. In this paper the responses to some 17% of the questions are presented. Most of these particular questions have been selected because they are concerned with nursing issues but a few others are included on account of their relevance. What comes across very clearly from the pattern of responses are the wide disparities between hospitals. Given that the questions were deliberately intended to be very specific a comparison of the results obtained in one institution with the overall averages does enable attention to be focused on areas where improvements are called for. In fact a number of health authorities, recognizing this feature, have since commissioned studies. PMID- 3632990 TI - Shared governance: a strategy for transforming organizations. Part 2. AB - Nursing leaders know change is not easy: it produces varying degrees of chaos and ambiguity. Maintaining control and traditional structure to minimize either chaos or ambiguity, however, does not achieve the final goal: organizational transformation and effective responses to changes in the environment and the organization. Given our current environment and its demands, we must remember that superficial changes will not address the fundamental problems. Transforming philosophies are relevant and needed in organizations. Transformation requires a shift in our perspectives, our attitudes, and our beliefs. Shared governance is one strategy for assisting in transforming nursing organizations. By sharing power and control with staff, leaders can effectively help to empower the whole and provide leadership that is visionary and creative. The end result of this transformation is meaningful collaboration and a humane, quality nursing system responsive to client needs. PMID- 3632991 TI - Setting nursing hours standards. Part 2. AB - These two articles have described a simple study based on random observations that will allow the nurse manager to establish hours standards for care provided to patients of varying acuity levels. While this study is a quick-and-easy method of obtaining data on standards of current practice, it is an inexpensive method that can be used on a regular basis to track trends in a highly dynamic health care environment. PMID- 3632992 TI - Dealing with premature employee turnover. AB - Premature nurse turnover was a topic of critical concern to nursing managers through the early 1980s. For the past few years, there has been less discussion of such turnover and what had previously been an acute shortage of nurses. A recent Wall Street Journal article suggests why this lack of overt interest in nurse turnover may have arisen: "Economic downturns, paradoxically, often act as apparent cures for existing problems. In the midst of the past recession, for example, few companies [substitute hospitals] paid much attention to a management problem that was pervasive during the prerecession growth period: professional turnover." While the earlier nursing shortage may never reappear as critically as before, it is increasingly clear that understanding the causes of premature nurse turnover is essential if hospitals are to be able to retain their most valued nurse staff members. Thus, there remains a strong interest in the attitudinal precursors of such turnover and how they might help nursing managers avert dysfunctional nurse turnover. PMID- 3632993 TI - Application of nursing theories. PMID- 3632995 TI - Access to research subjects. PMID- 3632994 TI - Getting your research published. PMID- 3632996 TI - Long-term hospitalization of women with high-risk pregnancies. A nurse's viewpoint. AB - The addition of high-risk pregnancy units to perinatal care systems provides a setting for daily maternal-fetal surveillance during complicated pregnancies. These units permit safe prolongation of pregnancy when the fetus is immature and timely delivery when either the mother's or infant's health is in jeopardy. Hospitalization also encourages maternal rest with its beneficial effects during complicated pregnancy. Nursing functions and goals as developed in the High-risk Pregnancy Unit at Parkland Memorial Hospital in Dallas, Texas, are presented. PMID- 3632997 TI - Chorionic villus sampling. AB - Chorionic villus sampling in the first trimester of pregnancy has the potential to become a major tool in the prenatal diagnosis and therapy of genetic disorders. Villus samples can be used for cytogenetic and biochemical studies as well as DNA analysis. However, little is known about the effects of chorionic villus sampling on a continuing pregnancy, or the long-term effects on the subsequently delivered infants. Despite these limitations, chorionic villus sampling appears to be a major breakthrough in prenatal diagnosis. PMID- 3632998 TI - Personal and family impact of premenstrual symptoms. AB - An exploratory study of premenstrual symptomatology, coping strategies, personal and family impact, and alterations in family functioning attributed to premenstrual symptoms was conducted. A sample of 83 women and 32 men completed a questionnaire before an evening lecture on premenstrual syndrome. Women reported a total of 74 different recurrent premenstrual symptoms, with the most frequently reported category being the "tension states." Men used multiple coping techniques to deal with their spouse's symptoms with offering support and expressing anger as the most frequently reported. Recurrent negative family impact themes emerged from the content analysis: increased conflict, decreased family cohesion, and disrupted communication among family members. Nursing implications are discussed. PMID- 3632999 TI - Evaluation of a pectin-based barrier under tape to protect neonatal skin. AB - The use of a pectin-based barrier between tape and skin as a method of minimizing epidermal stripping while keeping monitoring equipment and other devices securely attached to infants was evaluated. From 45 subjects, 199 application/removal procedures were recorded. The pectin-based barrier under tape held appliances securely for an average of 5.5 days (range 1-23 days). In 72% of the observations, the barrier was removed for nonadhesive-related reasons. Skin condition remained grossly normal in 97% of the observations after the barrier removal. A pectin-based barrier under tape provides effective adhesion for certain appliances and protects neonatal skin from damage caused by tape removal. PMID- 3633000 TI - Continuity of care through improved documentation. AB - An 18-month, nursing service-education project studied means to improve the quality of maternity services in satellite clinic settings. Tools, inservice education meetings, and questionnaires were used to guide nurses, other team members, and students in patient education services. Progress in written and verbal communications was made. Ongoing collaboration between the nurse practitioner and nurse educator produced mutual benefits and unanticipated outcomes. PMID- 3633001 TI - Postpartum assessment. The psychological component. AB - The postpartum patient's emotional status plays a significant part in her recovery and her adjustment to her infant. Postpartum hospital stays are very brief, so nurses must make every encounter with the patient meaningful. Developing a systematic method of assessing the patient will save time and allow for quicker identification of patient needs. Assessment guidelines that focus on three aspects of the patient's psychological status are provided patient's reaction to the birth experience, patient's adaptation to the infant, and family's reaction to the infant. PMID- 3633002 TI - Postpartal nursing diagnosis. AB - The responsibility of nurses for postpartal patients has changed greatly in the past few years. No longer is it adequate to assess and manage only those physical problems that occur during the hospital stay. Today, potential psychosocial problems and consequences of parental knowledge deficit are part of nursing's domain of diagnosis and management. A review of the purpose of nursing diagnosis is important. Clarifying the difference between medical diagnosis and nursing diagnosis is also essential if one is to be comfortable with the process. Careful scrutiny of the unique needs of new parents will form the basis for formulating meaningful postpartal nursing diagnosis. PMID- 3633004 TI - Guidelines for drug therapy during lactation. AB - The issues that should be taken into consideration when counseling the lactating mother who requires short-term or long-term drug therapy are reviewed. The process of milk formation, the principles of drug transport, factors affecting the appearance of a drug in breast milk, possible effects on infants of substances ingested through breast milk, evaluation of the safety of a drug for an infant, information available about various classes of drugs, and principles for counseling breastfeeding patients about medications are discussed. PMID- 3633003 TI - Changes in sexual relationships in postpartum couples. AB - To assess perceived changes in intimacy and sexuality in postpartum couples, an Intimate Relationship Scale was developed, tested for reliability (alpha = 0.86), and administered by mail. Sixty-eight, middle-class couples responded at four months postpartum and 126 couples at 12 months postpartum. Data revealed declines in the frequency of and desire for sexual activity, especially for mothers, when compared to sexual activity before the infant's birth. At four months postpartum, most women reported physical discomfort with sexual intercourse, a decline in physical strength, dissatisfaction with bodily appearance, and fatigue which interfered with sex. Strategies and techniques to promote and maintain intimacy and sexuality in postpartum couples are suggested to assist their transition to parenthood and may positively influence parenting behaviors. PMID- 3633005 TI - Appraisal system plans key role in achieving company goals. PMID- 3633006 TI - Transfer anxiety and the MI patient. PMID- 3633007 TI - Implementation of the federal "Baby Doe" administrative regulations in Kentucky. PMID- 3633008 TI - A nurse for all seasons. Interview by Alison Dunn. PMID- 3633009 TI - A fine balance. PMID- 3633010 TI - Protecting your interests. PMID- 3633011 TI - Action stations. PMID- 3633012 TI - Life after Griffiths. PMID- 3633013 TI - The College I know. PMID- 3633014 TI - Scenes from nursing life: Christmas past. PMID- 3633015 TI - A question of standards. PMID- 3633016 TI - How to be a globetrotter. PMID- 3633017 TI - Preliminary report: treatment of type 3 hyperlipoproteinemia with mevinolin. AB - Type 3 hyperlipoproteinemia (HLP) results from the accumulation in plasma of remnants of very low density lipoproteins (VLDL) due to a defect in apolipoprotein E. Current data suggest that VLDL remnants can be removed by the same receptors that remove low density lipoproteins (LDL). Mevinolin has been shown to enhance clearance of LDL by LDL receptors. In this study, mevinolin markedly lowered both VLDL remnants and LDL in a patient with type 3 HLP, presumably by increasing the activity of LDL receptors. PMID- 3633019 TI - Health-care reforms: what can we expect? PMID- 3633018 TI - Evidence that the methylation inhibitor cycloleucine causes accumulation of a discrete ribosomal RNA precursor in hamster mitochondria. AB - A novel RNA fraction, 'Cy RNA,' that accumulates in mitochondria when hamster cells are treated with the methylation inhibitor cycloleucine, has been characterized by high resolution acrylamide gel electrophoresis and DNA-RNA hybridization. Cy RNA ran in gels as a discrete band, with an apparent chain length of 2 600. It hybridized specifically to restriction fragments containing genes for the mitochondrial ribosomal RNAs. We infer that Cy RNA is a discrete polycistronic ribosomal RNA precursor transcript, whose processing is dependent on normal methylation. PMID- 3633020 TI - Effects of prospective pricing on nursing. PMID- 3633021 TI - National Center for Nursing Research: how it came to be. PMID- 3633022 TI - University-based nursing research centers: a strategic investment. PMID- 3633023 TI - Computerized central intake: streamlining community health-care admissions. PMID- 3633024 TI - An economic view of collaboration between nursing service and education. PMID- 3633025 TI - Action pack for RCN members. PMID- 3633026 TI - Royal College of Nursing. Fire in the hold. PMID- 3633027 TI - Together we can go forward and give service. PMID- 3633028 TI - We simply cannot afford to economise any further in nursing manpower. PMID- 3633029 TI - Royal College of Nursing. Caring role. PMID- 3633030 TI - Dispelling nursing myths in the independent sector. PMID- 3633031 TI - Skill mix review. PMID- 3633032 TI - Action pack: bring sanity back to the NHS. PMID- 3633033 TI - Labour of love. PMID- 3633034 TI - Royal College of Nursing. Huge response. No easy way. PMID- 3633035 TI - Good care of elderly is a necessity, not a luxury. PMID- 3633036 TI - We stand firm with our colleagues over the border about Griffiths. PMID- 3633038 TI - Wound dehiscence. PMID- 3633039 TI - When the burden of proof falls on you. PMID- 3633040 TI - Look out for these drug-nutrient interactions. PMID- 3633041 TI - Mr. Gomez had a bad case of "hospital smarts". PMID- 3633042 TI - Practical tips for patients with A.L.S. PMID- 3633043 TI - Why nurses should make "medical" diagnoses. PMID- 3633045 TI - Fever: when to leave it alone. PMID- 3633044 TI - Tailoring your diabetic patient's care plan to fit his life-style. PMID- 3633046 TI - Upgrade your shift reports with the three R's. PMID- 3633047 TI - The turning point. PMID- 3633048 TI - Nursing can do without hospitals that make a mockery of nursing ethics. PMID- 3633049 TI - Professional growth: who's in charge here. PMID- 3633050 TI - Giving your best shot. PMID- 3633051 TI - Code gray: ethical dilemmas in nursing. PMID- 3633052 TI - Avoiding legal risks in the S.P.U.: short procedure unit. PMID- 3633053 TI - 6 steps to building your confidence! PMID- 3633054 TI - Myra complained about everything so we weren't listening. PMID- 3633055 TI - Performing I.V. procedures like an expert: 10 questions about I.V. therapy--and the revealing answers (continuing education credit). PMID- 3633056 TI - Teaching patients after arterial bypass surgery. PMID- 3633057 TI - Hidden hazards on the job. Part IV. Sterilizing agents. PMID- 3633058 TI - I.C.U. it's also the intensive communication unit. PMID- 3633059 TI - Getting your share at tax time. PMID- 3633060 TI - Motivating your staff to do their best. PMID- 3633061 TI - Assessment on trial. PMID- 3633062 TI - Collective bargaining is the answer for the future of nursing. PMID- 3633063 TI - Nursing care plan for an AIDS patient. Nursing care must offer support and corrective measures in all areas--physical, psychological, social. PMID- 3633064 TI - ANA reaffirms position on health care for AIDS patients. PMID- 3633065 TI - Red Cross to public: fight AIDS with facts. PMID- 3633066 TI - Some questions and answers about AIDS. PMID- 3633067 TI - Classical conditioning in neonatal intensive care nurseries. PMID- 3633069 TI - Assessing childhood depression: do parents and children agree? PMID- 3633068 TI - Perceptions of sexual responsibility: do young men and women agree? PMID- 3633070 TI - A multidimensional study of infants' responses to painful stimuli. PMID- 3633071 TI - Counseling strategies for families of children with heart disease. PMID- 3633072 TI - Pediatric home tracheostomy care: a parent's guide. PMID- 3633073 TI - The effects of breast-feeding on toddler health. PMID- 3633074 TI - Handling antineoplastic drugs. PMID- 3633076 TI - Integrating public policy into the curriculum. PMID- 3633075 TI - Survival tactics for newcomers. PMID- 3633077 TI - The importance of policy in the nursing curriculum. PMID- 3633078 TI - Public policy curricula: past and present practices and future directions. PMID- 3633079 TI - Curriculum survey: health policy content in graduate nursing programs. PMID- 3633080 TI - Teaching public policy. PMID- 3633081 TI - Health services research and the formulation of public policy. PMID- 3633082 TI - Policy and politics: implications for curriculum. PMID- 3633083 TI - Resources for teaching public policy. PMID- 3633084 TI - Key concepts in public policy: student workbook. PMID- 3633085 TI - A statistical method for correlating tRNA sequence with amino acid specificity. AB - A statistical method for finding the nucleotide positions in tRNA sequences that correlate with amino acid specificity has been developed. The procedure involves finding the subset of nucleotide positions and groups of positions where the marginal density of one amino acid tRNA class does not overlap that of any other amino acid class. The procedure is an application of a statistical method known as the Expectation Maximization algorithm. PMID- 3633087 TI - Money wise. 4. PMID- 3633086 TI - Structure of two tRNA genes from Dictyostelium discoideum. PMID- 3633088 TI - A radical blueprint. PMID- 3633089 TI - My plans for nursing. Interview by Niall Dickson. PMID- 3633090 TI - Predictions: hubble bubble. PMID- 3633091 TI - A new direction for CPNs. PMID- 3633092 TI - The nursing process at work. PMID- 3633093 TI - Storming the ark. PMID- 3633094 TI - Quantifying quality. PMID- 3633095 TI - A room of their own. PMID- 3633097 TI - Deafness: lip service. PMID- 3633096 TI - Principles for teachers. PMID- 3633098 TI - Behaviour therapy nursing: a new era? PMID- 3633099 TI - Cardiac monitoring at a distance. PMID- 3633100 TI - 'Can't they see I'm me?'. PMID- 3633101 TI - Whose polyp is it, anyway? PMID- 3633103 TI - Benefits: social insecurity. PMID- 3633102 TI - 'Why me?'. PMID- 3633104 TI - Pay claim: all work and no pay? PMID- 3633105 TI - Old people and drugs. PMID- 3633106 TI - An independent mind. PMID- 3633107 TI - Management: targets and trends. PMID- 3633108 TI - Welfare benefits: hidden cuts. PMID- 3633109 TI - Any use for an American import? PMID- 3633110 TI - Hepatitis B--a nursing problem? PMID- 3633111 TI - Hepatitis B--protecting the carers. PMID- 3633112 TI - Systems of life. No 133. Setting up the systems. 33. PMID- 3633113 TI - Putting proposals into practice. PMID- 3633115 TI - Talking to the elderly and its relevance to care. PMID- 3633114 TI - Budgeting for beginners: marginal costs. PMID- 3633116 TI - A fair deal for ENs. PMID- 3633117 TI - Community-acquired bronchitis and pneumonia. Presentation, pathogens, and therapy. AB - Community-acquired bronchitis and pneumonia are common conditions that can be approached in a methodical manner. Knowledge of the patient's epidemiologic history, any underlying conditions, and the clinical presentation should allow the physician to make a rational empirical judgment concerning therapy and the need for hospitalization. Most patients with bronchitis and many with pneumonia can be treated as outpatients if the diagnosis is certain and the patient is compliant and is not severely ill. However, if the diagnosis is in doubt or if other issues surface, strong consideration should be given to early hospitalization. All reasonable efforts should be made to identify a specific pathogen, although in many instances the clinician can make valid empirical choices, obviating invasive and potentially dangerous procedures. If the patient has an adverse drug reaction or otherwise responds unsatisfactorily to treatment, more invasive measures may be necessary. PMID- 3633118 TI - The association of an elastase with amyloid fibrils. AB - The fibrils of all systemic forms of amyloid (primary, AL; secondary, AA; and hereditary, AF) that had been isolated by the water extraction procedure demonstrated elastolytic enzyme activity when examined in a specific assay using tritiated elastin. The source of this fibril-bound enzyme activity was consistent with human neutrophil elastase (HNE), since it was readily extracted by high salt solutions and inhibited by an elastase-specific chloromethyl ketone inhibitor, human alpha-1-protease inhibitor or by an antibody specific for HNE. The presence of an elastase on the amyloid fibril may suggest physiologic mechanisms of amyloid precursor protein degradation. PMID- 3633119 TI - Effect of dietary modifications on anaerobic threshold. PMID- 3633120 TI - Applied physiology of soccer. AB - Soccer is characterised as a high intensity, intermittent non-continuous exercise. Players cover approximately 10 km of ground per game, of which 8 to 18% is at the highest individual speed. In higher levels of competition there is a greater number of tackles and headings plus a greater percentage of the game is performed at maximum speed. The average aerobic energy yield during a national level game is around 80% of the individual maximum. Blood lactate concentration during a game averages 7 to 8 mmol/L. Because of a high energy yield most players have empty muscle glycogen stores at the end of the game, were hypohydrated and also have an increased body temperature. Soccer players of national and international standard have a maximal aerobic power of around 60 to 65 ml/kg/min, an above average anaerobic alactacid power, and a greater buffer capacity and muscle strength compared with untrained controls, yet seem to be less flexible. PMID- 3633121 TI - Value of resistance training for the reduction of sports injuries. AB - Many competitive and recreational athletes perform resistance training as a part of their conditioning programmes. Resistance training in addition to increasing muscular strength and hypertrophy may also aid in the prevention of injuries. Research indicates that resistance training promotes growth and/or increases in the strength of ligaments, tendons, tendon to bone and ligament to bone junction strength, joint cartilage and the connective tissue sheaths within muscle. Studies involving humans and animal models also demonstrate resistance training can cause increased bone mineral content and therefore may aid in prevention of skeletal injuries. Investigations to date suggest resistance training can aid in injury prevention. The incidence of various types of overuse injuries, such as swimmers shoulder and tennis elbow, may be reduced by the performance of sport and/or motion specific resistance training activities. Screening of athletes for agonist and antagonist muscle strength imbalances can be utilised to identify possessing a predisposition for injury. Resistance training may then be performed to correct the imbalance and therefore reduce the incidence of injury. PMID- 3633122 TI - Soccer accidents in the French Rhone-Alpes Soccer Association. AB - The analysis of 6153 accidents reported to the insurance company of the French Rhone-Alpes Soccer Association, for the 1980-81 season was undertaken, providing a survey of acute pathology in French soccer accidents and an estimation of the cost of this pathology to French society. Findings from this study include: injuries--ankle sprain is the most common; fractures prevail in the young players pathology; exposure--the average risk is one accident for 20 matches; the highest risk is for the senior category; collisions with opponents is the main cause of accidents; the first 5 minutes of the second half have a peak of accidents; the players exposure is roughly the same whatever their position on the ground; risk- winter should not increase the risk if the matches are played under good conditions; the risk is unevenly distributed according to the level of practice; cost--the cost for France over 1 year was estimated at US$20,000,000 and the total number of sick leave days at 2000 years; games with several accidents are very common in January and for the adult category. Consequently, tightening up the safety measures would be a very good investment. PMID- 3633123 TI - A prize-winning way to reward your staff. PMID- 3633124 TI - How hospitals hurt old people. PMID- 3633125 TI - Pneumonia: where nursing care really counts (continuing education credit). PMID- 3633126 TI - To Lisa's nurses, with love. PMID- 3633127 TI - Keeping up on arthritis meds. PMID- 3633128 TI - Make mouth care a must for your patients. PMID- 3633129 TI - Simple remedies for postop gas pain. PMID- 3633130 TI - Acute MI: the road to recovery. PMID- 3633131 TI - Legally speaking. When the hospital won't let you tell the truth. PMID- 3633132 TI - Nutritionist on call. Will new dietary regs endanger your patient? PMID- 3633133 TI - Why turn our backs on plastic surgery patients? PMID- 3633134 TI - A new ally for non-union nurses. PMID- 3633135 TI - Human melanoma proteoglycan: expression in hybrids controlled by intrinsic and extrinsic signals. AB - Human malignant melanoma cells express specific chondroitin sulfate proteoglycans (mel-CSPG) on the surface, both in vivo and in vitro. Melanocytes in normal skin show no detectable mel-CSPG but can be induced to express the antigen when cultured in the presence of cholera toxin and the tumor promoter 12-O tetradecanoylphorbol-13-acetate. Most other cell types do not express mel-CSPG either in vivo or in vitro. A study was designed to examine regulatory signals controlling mel-CSPG expression. The gene encoding mel-CSPG was mapped to human chromosome 15, and this chromosome was introduced into rodent cells derived from distinct differentiation lineages. Three types of mel-CSPG--expressing hybrids were found: (i) hybrids derived from human melanomas; (ii) hybrids derived from human cells that do not express mel-CSPG; and (iii) hybrids derived from human cells expressing mel-CSPG that are antigen-negative but that are induced to express mel-CSPG when cultured on extracellular matrix instead of plastic surfaces. Thus, mel-CSPG expression can be controlled both through intrinsic signals, provided by the differentiation program of the rodent fusion partner, and through extrinsic signals, provided by specific cell-matrix interactions. PMID- 3633136 TI - [A joint nursing and health care service]. PMID- 3633138 TI - [The greatest challenges in 1986?]. PMID- 3633137 TI - [The need for nurses in the next 20 years]. PMID- 3633139 TI - [Holidays and leisure time--an alternative possibility?. Interview by Pal Horsle]. PMID- 3633140 TI - [Rogaland puts the facts on the table. A lot of wrong placements in homes for the aged]. PMID- 3633141 TI - [NSF (Norwegian Nurses' Association) together under one roof]. PMID- 3633142 TI - Applications of research findings in the clinical setting. PMID- 3633143 TI - Proposed competencies of graduates of associate degree and baccalaureate degree nursing programs in Texas. PMID- 3633144 TI - Preventing pregnancy with tubal ties. PMID- 3633145 TI - ORBIS: flight for knowledge. PMID- 3633147 TI - Update on scleral buckling: a fight for sight. PMID- 3633146 TI - Standards of care. Part 2. Application. PMID- 3633148 TI - RNA to registered nurse? A study to consider the possibility of granting credit options to registered nursing assistants in a two year program. PMID- 3633149 TI - Advances nursing education has made towards baccalaureate as entry to practice. PMID- 3633150 TI - Quality assurance corner. PMID- 3633151 TI - Nurse educators' perception of clinical competence. PMID- 3633152 TI - The University of Calgary outreach post R.N. degree program: a demonstration project. PMID- 3633153 TI - AIDS: opportunism and opportunity. PMID- 3633154 TI - Color preferences of patients with port-wine stains. PMID- 3633155 TI - Packed cells and normal saline. PMID- 3633156 TI - How courts look at nurse practice acts. PMID- 3633157 TI - What are nurses doing to help PMS patients? PMID- 3633158 TI - If I can do anything.... PMID- 3633159 TI - After the fall--confusion. PMID- 3633160 TI - Death before birth. PMID- 3633161 TI - 'Did we do all we could?'. PMID- 3633163 TI - Arts and flowers: drawing out the patient's best. A growing interest. PMID- 3633162 TI - The continent urostomy. PMID- 3633164 TI - Arts and flowers: drawing out the patients best. The 'we can weekend'. PMID- 3633165 TI - The homebound alcoholic. PMID- 3633166 TI - California: AJN jobfocus. PMID- 3633167 TI - Let's diagnose strengths, not just problems. PMID- 3633168 TI - All this and patients, too! PMID- 3633170 TI - San Francisco nurses provide AIDS care. PMID- 3633171 TI - North Dakota adopts rules, SNAs push for BSN. PMID- 3633169 TI - Effect of aminophylline on lung maturation in preterm rabbit fetuses. AB - Pregnant rabbit does were treated intravenously with aminophylline (6 mg/kg/day) from the twenty-fifth day after the day of mating, and the fetuses were delivered by hysterotomy on the twenty-eighth day. One group of neonates was breathing air, and another group 100% oxygen. Lung mechanics were evaluated in the newborn animals during spontaneous or artificial ventilation, and the lungs were studied histologically with particular reference to the alveolar volume density. In one series of experiments, the lungs were washed and the lavage fluid was analyzed for phosphatidylcholine and phosphatidylglycerol. Aminophylline-treated litters had greater body weights, an improved survival rate, and an increased amount of phosphatidylglycerol in lung lavage fluid. Respiratory frequency was increased in aminophylline-treated animals breathing air, but data on lung compliance showed no significant difference between treated and control animals. In the present model, the beneficial effect of aminophylline can be attributed largely to a combination of accelerated fetal growth and improved postnatal regulation of breathing and less to a specific influence on the biochemical and functional maturation of the lung. PMID- 3633172 TI - Survey shows nurses' support of state political action groups. PMID- 3633173 TI - Membership is major issue at Constituent Forum. PMID- 3633174 TI - Official tells how North Dakota's new rules work. PMID- 3633175 TI - As I see it... Let's remap to avoid educating too many, too few. PMID- 3633176 TI - Nursing is on the road to health, says columnist. PMID- 3633177 TI - ANA board acts to assure competence of nurses. PMID- 3633178 TI - Legislation is focus for Arizona Nurses' Association. PMID- 3633179 TI - The expert nurse witness. AB - The expert nurse witness plays a necessary role in our civil system. Although the prospect of serving as an expert witness may seem onerous, OR nurses should give serious thought to doing so. If practicing OR nurses do not testify, attorneys may have to rely on physicians or non-OR nurses to testify to OR nursing standards. As professionals who want to establish and uphold professional standards, OR nurses should consider serving as expert witnesses to assist the court in establishing the legal standards of OR nursing practice. PMID- 3633180 TI - Team building. Developing a unified staff. PMID- 3633181 TI - Motivation. Creating the environment. PMID- 3633182 TI - Medical students. Orientation to the operating room. AB - Until fairly recently, the orientation was one hour in length and held every two months. With the support of the director of the third-year surgery clerks at our hospital, the time was increased to two hours. The orientation program is evaluated orally. Several weeks after each session, three nurses meet informally with three students to discuss the program. The students have responded positively to the program and have said they feel better about the OR, are not so scared of not knowing anything, and know that the OR nurses are there to help. The nursing staff, too, has indicated its approval. They feel more secure with the students and say the students are communicating better with them, are asking more questions, take their advice, and are friendlier. It is hoped that this brief introduction to the surgical suite is meaningful for the students, and that they feel more relaxed because of the confidence gained from familiarity with the OR. It is also hoped that through this training, they will give better patient care, support the OR nurses, and work efficiently as members of the team. We think this can only lead to mutual professional respect. PMID- 3633183 TI - Perioperative nursing competencies. The process and study. PMID- 3633184 TI - Perioperative nursing competencies. The model. PMID- 3633185 TI - Competency statements in perioperative nursing. PMID- 3633186 TI - Perioperative nursing credentialing model. PMID- 3633187 TI - OR experience for BSN students. Helping educators overcome barriers. PMID- 3633188 TI - Lasers in outpatient surgery offer an alternative to conventional methods. PMID- 3633189 TI - Market yourself as a professional. PMID- 3633191 TI - Workplace health education: work group consensus, priorities and practices. PMID- 3633192 TI - Employee relocation. PMID- 3633190 TI - Vanadate-stimulated NADH oxidation by xanthine oxidase: an intrinsic property. AB - Vanadate-dependent oxidation of NADH by xanthine oxidase does not require the presence of xanthine and therefore is not due to cooxidation. Addition of NADH or xanthine had no effect on the oxidation of the other substrate. Oxidation of NADH was high at acid pH and oxidation of xanthine was high at alkaline pH. The specific activity was relatively very high with NADH. Concentration-dependent oxidation of NADH Concentration-dependent oxidation of NADH was obtained in the presence of the polymeric form of vanadate, but not orthovanadate or metavanadate. Both NADH and NADPH were oxidized, as in the nonenzymatic system. Oxidation of NADH, but not xanthine, was inhibited by KCN, ascorbate, MnCl2, cytochrome c, mannitol, Tris, epinephrine, norepinephrine, and triiodothyronine. Oxidation of NADH was accompanied by uptake of oxygen and generation of H2O2 with a stoichiometry of 1:1:1 for NADH:O2:H2O2. A 240-nm-absorbing species was formed during the reaction which was different from H2O2 or superoxide. A mechanism of NADH oxidation is suggested wherein Vv and O2 receive one electron each successively from NADH followed by VIV giving the second electron to superoxide and reducing it to H2O2. PMID- 3633193 TI - Environmental hazards in the work setting: their effect on women of child-bearing age. PMID- 3633194 TI - Are you reaping the rewards? Understanding your job enhances your self-direction. PMID- 3633195 TI - Sexual harassment. PMID- 3633196 TI - The effects of alcohol consumption during pregnancy. PMID- 3633197 TI - Utilization of nurse practitioners in occupational health: a position description. PMID- 3633198 TI - Premenstrual syndrome: medical puzzle of the '80s. PMID- 3633199 TI - Regulation of cholesterol synthesis and binding of lipoproteins in cultured rat intestinal epithelial cells. AB - The regulation of cholesterol synthesis has been studied using a rat epithelial intestinal cell line (IRD 98) as a cellular model. As observed in other cell types, mevinolin increases the levels of 3-hydroxy-3-methylglutaryl coenzyme A reductase (EC 1.1.1.34) and concomitantly reduces the incorporation of [14C]acetate into cholesterol. Free cholesterol is able to suppress reductase activity. In contrast, when cells are shifted from standard culture medium to lipoprotein-deficient medium, an increase in hydroxymethylglutaryl-CoA reductase specific activity (2-5-fold) is observed. The possible regulatory roles of the different classes of human lipoproteins were thus compared. The effects of a long term exposure to LDL and HDL vary according to cell density. In actively growing cells, VLDL and LDL cause a decrease in the level of hydroxymethylglutaryl-CoA reductase, whereas HDL do not have a significant effect. In contrast, in subconfluent preresting cells, HDL provoke large decreases in hydroxymethylglutaryl-CoA reductase activity as compared to VLDL and LDL. While LDL binding is constant, the maximal binding capacity of HDL in subconfluent cells is seven times that of actively growing cells. Altogether, these results suggest an important role for HDL in the regulation of intestinal cholesterol synthesis. PMID- 3633200 TI - Role of arginine residues in the coagulant activity of high molecular weight kininogen. AB - High molecular weight (HMW) kininogen, the cofactor for activation of the contact system of plasma proteolysis, transports and optimally positions prekallikrein and factor XI on a negatively charged surface, allowing those zymogens to be activated by surface-bound factor XIIa. HMW kininogen circulates in plasma as a procofactor that, after cleavage by kallikrein or factor XIIa, gains ability to bind to the surface. The mechanism responsible for this increased affinity for the surface is unknown. We hypothesized that modification of arginine residues may prevent cleavage of HMW kininogen, since the initial kallikrein-induced cleavage sites on the HMW kininogen molecule are at the NH2 terminal and the COOH terminal of the bradykinin-containing portion of the molecule, each of which contains arginine. We found that modification with butanedione of four arginine residues in the HMW kininogen molecule prevented bradykinin release, which results from cleavage of HMW kininogen. Furthermore, HMW kininogen coagulant activity was lost, in proportion to the degree of arginine modification, until 6.6 residues had been modified. Complex formation with prekallikrein, however, was found to be uneffected by the modification of modified HMW kininogen. To account for the loss of coagulant activity, we also examined the ability of modified HMWKa (active cofactor) to bind to an activating surface. The affinity of modified HMWKa for kaolin was tenfold less than the affinity of unmodified HMWKa. These data suggest that arginine residues play a critical role in the ability of HMW kininogen to function as an activation cofactor, both by preventing the cleavages that produce HMWKa as well as by decreasing the affinity of HMWKa for the surface. PMID- 3633201 TI - Modulating effects of monocytes and autologous serum on natural killer capacity in multiple myeloma patients. PMID- 3633202 TI - Detection of anomalies in cell-surface carbohydrates on thrombasthenic platelets using 125I-labeled lectins. AB - The composition of carbohydrates on the surface of platelets from a patient with Glanzmann's thrombasthenia and from seven normal donors were determined and compared. To this end, binding studies were performed using nine different purified 125I-labeled lectins; Concanavalin A, P-Phytohaemagglutinin, Wheat Germ Agglutinin, Dolichos biflorus, Pisum sativum, Ricinus communis II Agglutinin, Tetragonolobus purpureus, Lens culinaris and Soybean Agglutinin. These studies show that thrombasthenic platelets bear significantly decreased numbers of receptors for Concanavalin A and Lens culinaris, both with a specificity for D mannose, and Ricinus communis II, with specificity for D-galactose. There were no detectable differences in the numbers of other lectin receptors. These results provide further evidence of molecular defects in thrombasthenic platelets. Moreover, the use of 125I-labeled lectins, as shown here, provides a fast and reliable technique for identifying abnormalities in the carbohydrate composition on the surface of platelets in various thrombopathies. PMID- 3633204 TI - Automating a patient classification system: nurse-vendor collaboration. PMID- 3633203 TI - Computer software for nursing: the advantages of a hospital-university liaison. PMID- 3633206 TI - Foodborne illness: the problem that just won't go away. PMID- 3633205 TI - Helping nursing faculty overcome resistance to computer use in the curriculum. PMID- 3633208 TI - The marketing of nursing jargon. PMID- 3633207 TI - Ocular screening for the elderly. PMID- 3633209 TI - Living with Alzheimer's disease. PMID- 3633210 TI - [Demystifying epilepsy]. PMID- 3633211 TI - Changing attitudes in health promotion. PMID- 3633212 TI - Expression by human fetal organs of organ-specific cancer neoantigens as measured by leukocyte adherence inhibition. AB - Human cancers express organ-specific cancer neoantigens (OSN) as determined by in vitro leukocyte responses to extracts of cancers by the tumor host. In this study, we determined whether the OSNs were normal developmental proteins that were expressed by fetal organs and re-expressed with oncogenesis. Fetal extracts, principally of lung and colon but also of liver and kidney, were tested for their ability to induce leukocyte adherence inhibition (LAI) as compared to extracts from adult tissues of the same organ. Leukocytes from lung cancer patients showed positive LAI responses to 13- and 19-week fetal lung tissue. Likewise, leukocytes from colon cancer patients showed positive LAI responses to 14- and 19-week fetal colon tissue, whereas leukocytes from control subjects did not. Neither group responded positively to 21-week fetal organs. Criss-cross experiments showed that the fetal antigen was organ specific. Multiparous pregnant women showed positive LAI responses to cancer extracts but not to extracts from normal tissues of the same organ. The pattern of the LAI response was bell-shaped. Positive LAI responses to lung and breast cancer were detected at 4 to 7 months gestation and peaked at 5 months. To the fetal colon, LAI positive responses were detected at 5 to 8 months gestation, with the peak response at 6 months. The results indicate that OSN of cancers are also expressed by fetal organs and sufficient antigen is shed by fetal organs to sensitize pregnant women. Older fetal organs (21 weeks) and adult organs do not express an immunogenic or antigenic OSN. PMID- 3633213 TI - Effects of orally administered retinol on natural killer cell activity in wild type BALB/c and congenitally athymic BALB/c mice. AB - Retinoids have been shown to inhibit the growth and development of neoplastic cells in many systems. One mechanism of action may be through activation of the immune system, specifically natural killer (NK) cell activity. The effect of retinol on NK cell cytotoxicity was examined in three groups of mice: BALB/c (wild-type), BALB/c nu/nu (athymic), and BALB/c nu/nu previously injected with human tumor cells. In untreated mice, NK activity was highest in athymic mice without tumors and lowest in wild-type mice, although serum and liver retinol concentrations were identical in all three groups. In mice fed graded, nontoxic doses of retinol daily for 3 weeks, serum retinol levels in all three groups exhibited a sharp peak and decline following daily bolus retinol administration. Retinol stores in the livers showed a dose-dependent increase in all treated animals. However, NK cell activity, differed for each group. Athymic mice without tumors exhibited no change in NK activity as a result of retinol treatment. Athymic mice with tumors had NK levels that tended to increase with increasing retinol doses, but these changes were not statistically significant. Wild-type mice, on the other hand, demonstrated significantly higher NK levels after treatment with retinol doses of 300 and 600 micrograms/day. In subsequent time course experiments, there was a peak in NK activity 1 h following bolus retinol administration similar to the peak seen in serum retinol concentrations, suggesting either an acute activation or recruitment of cytotoxic cells. Retinol thus appears to increase NK activity in wild-type BALB/c mice, and this activity may be an important component of its antineoplastic activity. PMID- 3633214 TI - Immunizations against infectious diseases and childhood cancers. AB - A study based upon an unusually large series of childhood cancers and matched controls found a significant deficit of case/control pairs in which the cancer case had fewer immunizations against infectious diseases than the matched control. All types of immunizations and cancers were affected but the case/control differences were more pronounced for older cases with late immunizations than for younger cases with early immunizations, and more pronounced for solid tumours than leukaemia. Therefore there may be immune system responses to immunizations (or simulated infections) which make it difficult for small clones of cancer cells to enlarge and are more successful in preventing localised tumours in adolescents than childhood leukaemias. PMID- 3633216 TI - Large granular lymphocytes, Leu 7 reactivity and natural killer cell function in peripheral blood of patients with Hodgkin's disease. AB - The percentage and absolute number of lymphocytes and Leu 7+ cells were significantly lower in HD even in active stages. There was no significant difference in the percentage of LGL between the three groups (control, active HD, inactive HD), however, because of differences in counts of lymphocytes the absolute number of LGL was significantly lower in HD even in the active group than that in healthy controls. The absolute count of LGL and Leu 7+ cells in patients in remission was significantly higher than that in active HD. Natural cytotoxicity against K-562 cells was also significantly lower in active patients in comparison with controls, while the percentage of cytotoxicity was slightly but not significantly higher in patients in remission than that in the active group. A positive correlation was observed between all the three examined parameters both in controls and in patients with active and inactive HD. PMID- 3633215 TI - Equine sarcoid: BCG immunotherapy compared to cryosurgery in a prospective randomised clinical trial. AB - A total of 30 horses with single or multiple sarcoid tumors of the skin were randomly divided into three treatment groups: (i) cryosurgical treatment, (ii) intralesional immunotherapy with a live BCG vaccine, (iii) intralesional immunotherapy with a BCG cell wall preparation. Complete tumour regression was obtained in all 10 cryosurgically treated horses, in 6 of 10 live BCG treated horses, and in 7 of 10 BCG cell wall treated horses. One live BCG and 2 BCG cell wall treated horses showed partial tumour regression of more than 50% of the tumour area. Eleven horses with sarcoid tumours were not eligible for random allocation in the trial because unfavourable site or size of the tumour precluded cryosurgical treatment. These animals were treated with BCG cell wall vaccine except for 1 animal, which was treated with live BCG. In 4 cases this treatment was combined with cytoreductive surgery of the tumour. In this prognostically unfavourable group 8 animals showed complete tumour regression and 3 animals did not respond. Regression after BCG immunotherapy appeared to correlate with size (larger tumours worse response) and localization of the sarcoid (less favourable results in the limb), and increase in peripheral blood leucocytes after the first injection. Horses with a positive delayed type hypersensitivity reaction to PPD before the start of treatment showed a tendency to more favourable prognosis than PPD negative horses. No correlation was present between regression and single or multiple presence of sarcoids, increase in body temperature after injection of BCG and the formation of specific antibodies to BCG. None of the cured animals have shown tumour recurrence 3 to 40 months following treatment. PMID- 3633217 TI - Elastase 1 levels during oral zinc therapy. PMID- 3633218 TI - Card tables as siderails. PMID- 3633219 TI - Using antiseptics effectively. PMID- 3633220 TI - Lydia Bragger--she makes "old" good. PMID- 3633221 TI - Nutrition. Ten tips for teaching. PMID- 3633222 TI - A three-part system to combat pressure sores. PMID- 3633223 TI - Group psychotherapy with demented patients. PMID- 3633224 TI - Working with the bereaved. PMID- 3633225 TI - Helping the person with an altered self-image. PMID- 3633226 TI - Toward a less restrictive environment. PMID- 3633227 TI - How to reduce falls. PMID- 3633228 TI - Nursing: on becoming a genderless profession. PMID- 3633229 TI - Home health nursing: a rediscovered concept. PMID- 3633230 TI - Marketing a profitable nursng image: recognizing image is power. PMID- 3633231 TI - The image of nursing: Michigan's story. PMID- 3633232 TI - Nursing style: is your image showing? PMID- 3633234 TI - A public relations primer. PMID- 3633235 TI - Up close. Interview by Rita Didrichsons. PMID- 3633233 TI - Once a nurse--always a nurse? PMID- 3633236 TI - Is it academic failure or a learning disability? A personal experience with loss and grief. PMID- 3633238 TI - The significance of fluctuations in infection rates. PMID- 3633237 TI - Complement activation in human lymph: modulation by the contact activation system and by leukocytes. AB - Complement components, their activation and the generation of C3a and C5a peptides were studied in human lymph used as a model of tissue fluid. Both, classical and alternative pathways could be activated by suitable agents such as immune aggregates or zymosan. C3 activation and C3a formation were marked while only 10-15% of the anyway low amount of C5 were converted during complement activation, yielding very low concentrations of C5a. Carboxypeptidase N activity was present in lymph and converted the peptides to their less (C5a) or not at all (C3a) active desArg derivatives. Contact activation of Hageman factor and kallikrein enhanced activation of the classical pathway up to C3 conversion. The search for additional processes apt to create efficient concentrations of C5a (desArg) in lymph led to the discovery that the presence of leukocytes in lymph greatly increases the release of C5a activity upon complement activation. This suggests a physiological role of leukocytes resident in tissues for the induction of inflammatory reactions. PMID- 3633239 TI - Yeast infection in immunocompetent patients: fomenting ferment to foil the fermenter. PMID- 3633240 TI - Candidal suppurative peripheral thrombophlebitis: recognition, prevention, and management. AB - Candida species are seldom considered as a cause of suppurative peripheral thrombophlebitis. During a 15-month period in a 291-bed acute-care hospital, candidal suppurative peripheral thrombophlebitis developed in seven patients. All patients had fever, a tender palpable cord, and Candida species isolated from resected veins and/or pus expressed at the catheter entrance site. Four patients had candidemia. None were neutropenic or recipients of corticosteroids. All had concomitant or preceding bacterial infections, and had received a median of 5 antibiotics (range 3 to 9) for at least 2 weeks. Five of seven had documented preceding candidal colonization associated with broad spectrum antibiotic therapy. Catheter sites had not been routinely rotated and local catheter site care was deficient. Risk factors of antibiotics and duration of hospitalization were fewer in patients with bacterial suppurative thrombophlebitis. Combined segmental venous resection and intravenous amphotericin B appears to be the most rational therapy for this nosocomial fungal infection. PMID- 3633241 TI - Alteration of normal gastric flora in critical care patients receiving antacid and cimetidine therapy. AB - One hundred fifty-three critical care patients with documented cimetidine and antacid use were prospectively studied with serial gastric pH determinations and semiquantitative gastric fluid cultures. This study documents the abnormal gastric colonization of patients with therapeutically altered gastric acidity by hospital acquired gram negative rods (GNR). Three hundred twenty-four gastric fluid cultures from 153 patients revealed 152 (47%) positive cultures for GNR, 78 (24%) sterile specimens, and 94 (29%) positive for mixed oropharyngeal flora. One hundred forty (59%) of the 236 cultures at a pH of 4 or greater were positive for GNR. In contrast, only 12 (14%) of the 88 cultures at a pH of less than 4 were positive for GNR (p less than .001). Forty-six (52%) of 88 cultures at a pH of less than 4 were sterile as compared to only 32 (14%) of 236 sterile cultures at a pH of 4 or greater (p less than .001). At low pH, cultures are predominantly sterile and at a pH of 4 or greater the flora dramatically changes to hospital acquired GNR. This artificially maintained reservoir of gram negative rods in the critically ill patient is a potential reservoir of organisms causing nosocomial bacteremia or pneumonia in this high risk population. PMID- 3633242 TI - Multi-lumen lines. PMID- 3633243 TI - Hepatitis B infection in a vaccinated renal dialysis staff worker. PMID- 3633244 TI - Relationship between the prolonged QTc interval and ventricular fibrillation. PMID- 3633245 TI - Pacemaker malfunction: fact or artifact? AB - In summary, the present examples illustrate how pacemaker malfunction can be simulated by the sources of artifact produced or detected by the monitoring equipment. This form of pseudopacemaker malfunction remains a common cause of mistaken diagnosis of pacemaker malfunction. A thorough understanding of the examples outlined above should help distinguish true pacemaker malfunction from pseudopacemaker malfunction produced by artifact. PMID- 3633246 TI - Nursing care of the immunosuppressed patient in an intensive care unit. AB - In summary, a comprehensive investigation into the etiologies of immunosuppression within a critical care unit has been described. Nursing interventions appropriate for these patients have been detailed. PMID- 3633247 TI - Needs of relatives of critically ill patients: a follow-up. PMID- 3633249 TI - Drug-induced torsade des pointes: case report and implications for the critical care staff. PMID- 3633248 TI - Investigation of selected psychosocial needs of family members of critically ill adult patients. PMID- 3633250 TI - Round atelectasis in an elderly man: the role of thoracotomy. AB - In summary, a case of round atelectasis appearing subsequent to a pleural effusion in an elderly man 6 months after open heart surgery is reported. Although plain roentgenograms and linear and computerized tomography could help the physician make the diagnosis with confidence, a needle biopsy of the lesion at the very least or exploratory thoracotomy may sometimes still be justified for the properly selected patient. PMID- 3633251 TI - Doctoring or nursing under the influence. PMID- 3633252 TI - An electrocardiographic study of viral myocarditis. PMID- 3633254 TI - Ventricular tachycardia and sudden cardiac death. PMID- 3633253 TI - Platelet aggregation and atherosclerosis. AB - The relationship of platelet aggregation to coronary and cerebral ischemic attacks has been well established. A number of clinical trials have shown that the daily use of aspirin 160 to 325 mg daily, dipyridamole 300 to 400 mg daily, or both are effective in preventing platelet aggregation, and results in a statistically significantly reduction in the incidence of coronary events and transient ischemic cerebral attacks. PMID- 3633255 TI - Hyperinflation, hyperventilation and hyperoxygenation before tracheal suctioning in children requiring long term care. PMID- 3633256 TI - Involving physicians in home care. PMID- 3633258 TI - The complex care team: meeting the needs of high-technology nursing at home. PMID- 3633257 TI - "The invited intruders". PMID- 3633259 TI - Safety tips for the community health nurse in urban practice. PMID- 3633260 TI - Shy-Drager syndrome: the nursing challenge of dealing with impaired communication and grief. PMID- 3633261 TI - The legalities of home care. What would you do in the following situations? PMID- 3633262 TI - Meeting your new legislators. PMID- 3633263 TI - The role of loneliness in health and wellness. PMID- 3633264 TI - [Scholarship report. Sexology course]. PMID- 3633265 TI - [Scholarship report. Planning and individual care and quality of care measurements]. PMID- 3633266 TI - [Scholarship report. Report from a study trip to Helsinki]. PMID- 3633267 TI - Novobiocin and rifampicin in combination against methicillin-resistant Staphylococcus aureus: an in-vitro comparison with vancomycin plus rifampicin. AB - Novobiocin and rifampicin were evaluated in vitro as a possible new antibiotic combination against methicillin-resistant Staphylococcus aureus. An evaluation of 20 strains of methicillin-resistant Staph. aureus using microdilution checkerboard techniques at 10(5) cfu/ml showed neither synergy nor antagonism between novobiocin and rifampicin or between vancomycin and rifampicin. Agar surface inoculation of six strains of methicillin-resistant Staph. aureus showed increased synergy with increased inocula (10(6)-10(9) cfu) for novobiocin plus rifampicin compared to vancomycin plus rifampicin. Time-kill curves showed indifference at 6h for all combinations, whereas, at 24 and 48 h, they generally showed indifference, occasionally synergy, but never antagonism. The 'synergy' between novobiocin and rifampicin at higher inocula of methicillin-resistant Staph. aureus appears to be due to prevention of emergence of resistant organisms and may have clinical relevance. The combination of novobiocin-rifampicin merits further investigation. PMID- 3633268 TI - Isoprenoid synthesis in Halobacterium halobium. Modulation of 3-hydroxy-3 methylglutaryl coenzyme a concentration in response to mevalonate availability. AB - Halobacterium halobium was evaluated as a potentially simpler biological model to study the regulation of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity (content) in response to mevalonate availability. H. halobium's HMG-CoA reductase was soluble and required NADPH as its reduced coenzyme. Maximum HMG-CoA reductase activity (4-10 nmol/min/mg of soluble protein) was obtained in buffers which contained 3.5 M KCl. Mevinolin (a) blocked growth of H. halobium, (b) was a competitive inhibitor of HMG-CoA reductase (Ki = 20 nM), (c) did not cause the paradoxical increase in assayable reductase activity, as reported for eukaryotic cells, and (d) caused a rapid (within 30 min) 8-12-fold accumulation of intracellular HMG-CoA. Mevalonate blocked and reversed mevinolin-mediated HMG-CoA accumulation. Although mevinolin-treated cell's growth was restored by mevalonate, HMG-CoA reductase's activity was not. Thus, H. halobium is a unique biological model which allows one to study the regulation of intracellular HMG CoA concentration and not HMG-CoA reductase activity (content) in response to mevalonate availability. PMID- 3633269 TI - Analysis of RNA polymerase III transcription complexes by gel filtration. AB - We studied the in vitro assembly and stability of RNA polymerase III transcription complexes on the 5 S RNA and tRNAMet genes of Xenopus and the VA genes of adenovirus. Complete and partial assemblies were formed on these genes using transcription factor IIIA from Xenopus ovaries and factors IIIB and IIIC from HeLa cells. The complexes were purified away from unbound factors by filtration through Sepharose 4B columns and then assayed for transcription in the presence of Xenopus polymerase III. The 5 S gene complexes were also investigated using a postlabeling DNase I footprinting technique that we devised. The binding of factor IIIA to the 5 S gene facilitated the binding of factor IIIC; this subassembly was required for factor IIIB to bind. On the VA I and tRNA genes, factor IIIC alone bound and allowed IIIB to bind. RNA polymerase bound last to form a preinitiation complex, but it was less stably affixed than any of the factors. The complete factor complexes on the 5 S and VA I genes were strikingly stable to brief exposure to high salt concentrations, and the stability of the factor IIIB interaction was limiting. Two modes of IIIC binding were distinguished that differed in stability and specificity. Assembly of the complexes did not require ATP, and faithful transcription occurred when adenyl-5' yl imidodiphosphate was substituted for ATP. PMID- 3633270 TI - The ET nurse's role in educating patients with open or draining wounds. PMID- 3633271 TI - Challenging stoma placement. PMID- 3633273 TI - Perineal hernia after proctectomy. PMID- 3633272 TI - Air-fluidized therapy as a cost-effective treatment for a "worst case" pressure necrosis. PMID- 3633274 TI - Enterostomal therapy clinic-on-wheels. PMID- 3633276 TI - Malpractice: why you need your own policy. PMID- 3633275 TI - Gastrointestinal surgical procedures. Getting ready for certification. PMID- 3633277 TI - Overcoming fear of cancer chemotherapy: interventions for the ET nurse. PMID- 3633278 TI - We have the responsibility, we are the people: hunger in America. PMID- 3633279 TI - A new perspective on pressure sore prevention. PMID- 3633280 TI - Theoretical foundations for an approach to fecal incontinence. PMID- 3633281 TI - Mental status assessment for the ET nurse: psychologic impact of physical trauma. PMID- 3633282 TI - An overview of dementia. PMID- 3633284 TI - Product ingredients... and their ramifications. PMID- 3633283 TI - Classifications of urinary incontinence. PMID- 3633285 TI - Recognition of psychiatric symptoms in dementia. PMID- 3633286 TI - Aging alcoholics need nursing help. PMID- 3633287 TI - How accurate are stress scales? PMID- 3633288 TI - One black couple's means of coping--preserving integrity. PMID- 3633289 TI - Your patient is older--what leads to job satisfaction? PMID- 3633290 TI - Alcoholism in older adults. PMID- 3633291 TI - The therapy of music. PMID- 3633292 TI - Friendly visitors learn about wellness. PMID- 3633293 TI - Alzheimer's: the need for caring. PMID- 3633294 TI - Bringing home the health care. PMID- 3633295 TI - Drug interactions and the elderly. PMID- 3633296 TI - Increasing your professional networth. PMID- 3633297 TI - To many, Katie was just a silhouette. PMID- 3633298 TI - The benefits of aquatic activity. PMID- 3633299 TI - Anxiety and pain as predictors of distress during a myelography procedure. PMID- 3633300 TI - Assessment of infant pain in clinical settings. PMID- 3633301 TI - Changing the route of administration in children. PMID- 3633302 TI - Behavioral control of symptoms--introduction. PMID- 3633303 TI - Controversy in the management of chronic cancer pain: therapeutic equivalents of IM and PO morphine. PMID- 3633304 TI - Wisconsin initiative for improving cancer pain management: progress report. PMID- 3633305 TI - Psychological control of acute pain in medical settings. PMID- 3633307 TI - Rural maternity services: community health nurse providers. PMID- 3633308 TI - Counseling clients regarding over-the-counter drug use. PMID- 3633306 TI - Obligatory relationship between the sterol biosynthetic pathway and DNA synthesis and cellular proliferation in glial primary cultures. AB - Primary cultures of newborn rat brain, which are composed predominantly of astroglia, were used to examine the relationship between the sterol biosynthetic pathway and DNA synthesis and cellular proliferation. Reduction of the fetal calf serum content of the culture medium from 10 to 0.1% (vol/vol) for an interval of 48 h between days 4 and 6 in culture resulted in a quiescent state characterized by inhibition of DNA synthesis and cellular proliferation. When 10% fetal calf serum was returned to the medium for these quiescent cells, within 24 h DNA synthesis increased markedly. Preceding the rise in DNA synthesis was an increase in sterol synthesis, which occurred within 12 h of the return of the quiescent cells to the 10% fetal calf serum. Exposure of the quiescent cells to mevinolin, a specific inhibitor of sterol synthesis at the 3-hydroxy-3-methylglutaryl-CoA reductase step, completely inhibited the increase in DNA synthesis that followed serum repletion. The increase in total protein synthesis that followed serum repletion was not similarly inhibited by mevinolin. When mevinolin was removed after causing the 24-h inhibition of DNA synthesis, the cultured cells underwent active DNA synthesis and proliferation. Thus, inhibition of the sterol biosynthetic pathway resulted in a specific and reversible inhibition of DNA synthesis and glial proliferation in developing glial cells. These findings establish a valuable system for the examination of glial proliferation, i.e., primary glial cultures subjected to serum depletion and subsequent repletion. Moreover, the data establish an obligatory relationship between the sterol biosynthetic pathway and DNA synthesis and cellular proliferation in developing glia. PMID- 3633309 TI - A model for discharge planning in nursing education. PMID- 3633310 TI - Using participant observation in community-based practice. PMID- 3633311 TI - Length of stay. Significant variables. AB - An analysis of data from medical records of 500 patients discharged from an acute care hospital in 1983 found seven of ten variables studied to be significantly related to length of stay. The results of this correlational study can lead to experimental research to determine the effects of nursing care on length of stay, which greatly affects hospitals' financial survival. PMID- 3633312 TI - The relationship of support, availability, and attitude to research utilization. PMID- 3633313 TI - Are you prepared to meet the media? AB - Nursing administrators are increasingly called upon to participate in media interviews. Because the affects of a single interview can help or hinder the reputation of an individual or an institution, it is vital that one be thoroughly prepared for the interview. This article offers specific suggestions for improving interview skills, including the importance of predetermining the interview objectives and audiences; how to avoid the mistakes that novices frequently make; special considerations for live interviews; what to do if you are misquoted; and how to handle malpractice situations. PMID- 3633314 TI - To profess--to be a professional. PMID- 3633315 TI - Absenteeism. Nursing service's albatross. AB - Absenteeism negatively impacts sick leave benefits, staff hours, overtime pay, salary losses, productivity, employee moral, continuity, and quality of patient care. This paper describes findings from a large study that was conducted for the purpose of identifying variables contributing to absenteeism. Variables identified by the study included child care problems, conflict between the parent and employee roles, staffing and scheduling difficulties, and attitudes toward sick leave. While valuable information was identified by the study, the findings raised some serious questions about productivity, staff attitudes, and work ethics. PMID- 3633317 TI - Ethnic diversity. PMID- 3633316 TI - Gender and nursing leadership. PMID- 3633318 TI - Defining the retinal nerve fiber layer: use monochromatic light to compare photos. PMID- 3633319 TI - Testing monocular vision loss. PMID- 3633320 TI - Update on scleral buckling: a fight for sight. PMID- 3633321 TI - Perspective on contact lenses. Tinted lenses--shades of tomorrow. PMID- 3633322 TI - Using the Amsler grid. PMID- 3633323 TI - Testing single binocular fields. PMID- 3633324 TI - [Systemic thermal therapy of cancer: an interview with Dr. Nobuo Kato, head, Special Therapy Department, Nagoya Memorial Hospital]. PMID- 3633325 TI - [Decision making in nursing. 2. Lack of communication between the physician and nurse causing misunderstanding by the patient]. PMID- 3633327 TI - [Nursing terminology: compliance]. PMID- 3633326 TI - [Nursing theory. 2]. PMID- 3633328 TI - [Difficult patients: encounters at the gyneco-obstetric department]. PMID- 3633329 TI - [Solutions for the problem of dealing with difficult patients: consideration, flexibility, and occasional sternness in the practice of medicine]. PMID- 3633330 TI - [Solutions for the problem of dealing with difficult patients: difficult but lovable patients]. PMID- 3633331 TI - [Introduction of the topic "likeable" and "difficult" patients to classroom teaching: education of nurses with rich personality]. PMID- 3633332 TI - [Personal maturity through interaction with difficult patients]. PMID- 3633333 TI - [When difficult patients cease to be difficult: description of patients on a psychiatric ward]. PMID- 3633334 TI - [For better interprofessional cooperation: expectation on physicians and other professions]. PMID- 3633335 TI - [Report from New York: Beth Israel Medical Center. Miss Hammond in charge of terminal patients]. PMID- 3633336 TI - [Personal account of a cancer patient. 2. Surgery]. PMID- 3633338 TI - [Monologue by a nursing director. Importance of the language]. PMID- 3633337 TI - [Report from a hospice. 13. Care of dying people. Management of hospices]. PMID- 3633339 TI - [The practice of oriental medicine. 2. Traditional Chinese and Oriental drugs]. PMID- 3633340 TI - [Clinical aspects of dementia. 10. Symptoms of dementia (9)]. PMID- 3633341 TI - [Counseling of patients. 13. On listening: counseling methods (1)]. PMID- 3633342 TI - [Nursing homes in New York. 2. Problems of fecal and urinary incontinence]. PMID- 3633343 TI - [Team care and POS. On nursing summaries at discharge of patient]. PMID- 3633344 TI - [Team care and POS. Comprehensive discussion]. PMID- 3633345 TI - [Team care and POS. Practice of POS at the Kinki University]. PMID- 3633346 TI - [Panel discussion: problems in the practice of POS by the medical team. Introduction]. PMID- 3633347 TI - [Panel discussion: problems in the practice of POS by the medical team. A nutritionist's viewpoint]. PMID- 3633348 TI - [Panel discussion: problems in the practice of POS by the medical team. A physician's viewpoint]. PMID- 3633349 TI - [Panel discussion: problems in the practice of POS by the medical team. A physician's viewpoint]. PMID- 3633350 TI - [Panel discussion: problems in the practice of POS by the medical team. A physician's viewpoint--an attempt at standardization of problem lists with team care]. PMID- 3633351 TI - [Panel discussion: problems in the practice of POS by the medical team. Conclusion]. PMID- 3633352 TI - [Team care and POS. Orientation]. PMID- 3633353 TI - Depression in children. AB - Depression among children has received considerable attention from mental health professionals. A knowledge of the major approaches to conceptualizing, diagnosing, and treating childhood depression can assist school health practitioners in treatment. The purpose of this paper is to review research on the prevalence, classification, etiology, assessment, and treatment of childhood depression. PMID- 3633354 TI - Latchkey children: the fastest-growing special interest group in the schools. PMID- 3633356 TI - Cost documentation of school nursing follow-up services. AB - The cost of nursing services was documented as part of a grant to study the effect of school nursing follow-up on the outcome of dental screening. Eleven nurses participated in the study with experimental (n = 287) groups of fifth and sixth grade students from a large West Coast school district who were screened for caries. Stratifiers for the randomized group assignment were school, cavity severity, gender, ethnicity, and insurance coverage. A positive difference occurred for the 11 nurses (p = 0.0046). The cost of telephone follow-up averaged $8.92 for 26.69 minutes and compared favorably with a California state allowance of $11 for a half-hour of similar service. The study offers a beginning analytical formulation for examining field services in school and community health nursing using a naturalistic experimental design. PMID- 3633355 TI - The impact of chlamydia infections on teen mothers and their children. AB - Chlamydia trachomatis recently has emerged as the most frequently diagnosed sexually transmitted disease (STD) agent. An estimated three million cases are diagnosed annually in the United States. Because the infection is not reportable, only estimates can be made. The most common STD, it also is often transmitted to infants through infected mothers. Prevention and treatment of the disease in newborns require different procedures from those for gonorrhea, as do diagnostic and treatment methods for infected adults. Chlamydia also appears to pose a threat to pregnancy. PMID- 3633357 TI - Factors associated with adolescent participation in a cardiovascular risk factor assessment program. AB - A Student Attitude Survey was administered to high school seniors to determine attitudinal and behavioral factors associated with participation in a longitudinal cardiovascular risk factor screening program. Health beliefs, attitudes, and practices were assessed as were altruism, social skills, self concept, conformity, and academic class standing. Male participants showed higher self-concept scores than non participants. Black participants were younger than black nonparticipants and black participants also showed greater perceived control over their health and more optimistic appraisals of the worth of medical research and practice. White male participants tended to be more likely to remain home from school or to see a doctor when ill. These observations suggest that attitudinal and behavioral factors related to participation in a health-related program can be assessed in childhood. PMID- 3633359 TI - Reasons to quit: two antismoking activities for youth. PMID- 3633358 TI - Clove cigarettes: problem or symptom? PMID- 3633360 TI - The Arrowhead Elementary School tornado safety program. PMID- 3633361 TI - The quest for a smoke-free young America by the year 2000. PMID- 3633362 TI - School health education in Canada: an interview with Gordon Mutter. PMID- 3633363 TI - Appropriate use of health risk appraisals with school-age children. AB - Health Risk Appraisals (HRAs) use personal risk assessment as an educational approach to encourage adoption of positive health-related behavior. An individual's behavior and health history are compared to morbidity and mortality tables to estimate a level of personal risk. Current trends suggest HRAs will continue to be popular with school health educators. Appropriate use of HRAs requires an understanding of the assumptions, interpretations, and limitations of these instruments. This article reviews the development, validity, and reliability of HRA methodology. The educational usefulness of HRAs designed for school-age populations is examined. Recommendations are offered to optimize the instructional benefits of HRAs while minimizing potential deficiencies. PMID- 3633364 TI - Education for menarche. AB - Educational programs to prepare young women for menarche potentially can affect their self-view, peer interaction, decision-making, and self-care capabilities. A review of literature on menarche and menarcheal education is presented with implications for program development. References that can assist health educators in developing appropriate content and strategies are identified. PMID- 3633365 TI - A process evaluation study of peer leaders in health education. AB - Peer education is an important part of health education programs. In smoking prevention programs, peer leaders are particularly efficacious. Yet, research on peer leaders' perceptions of these programs is minimal. This study assessed the perceptions of elected peer leaders (N = 207) in one seventh grade smoking prevention program and one chemical abuse prevention program in spring 1984. Peer leaders' assessments of the adequacy of their training, the programs' components, the programs' influence on their behavior and attitudes, and the efficacy of the programs were analyzed. Differences between genders and the level of peer leader enthusiasm also were assessed. Further research with peer leaders is suggested as a way to strengthen ongoing health promotion efforts. PMID- 3633366 TI - The relationship between the sexual attitudes of parents and their college daughters' or sons' sexual attitudes and sexual behavior. AB - This study determined if three selected sexual attitudes of parents were related to similar sexual attitudes of their college daughters or sons and to five sexual behaviors. Only never married, college freshmen (N = 83) with both parents participating were utilized. A self-report questionnaire was administered to students at a large midwestern university and distributed to and returned from parents by mail. The Pearson product-moment correlation and the stepwise and multiple regressions were used to test four hypotheses. Mothers' sexual attitudes had a stronger relationship than fathers' attitudes with offspring sexual attitudes and behaviors, particularly for daughters. Generally, mothers with the most positive attitudes toward sexual-self had daughters who were more responsive relative to personal sexual expression (masturbation frequency and orgasmic experience), but who were not any more involved heterosexually (frequency of coitus and number of coital partners). Fathers' sexual attitudes had little relationship to offspring sexual attitudes and behavior. None of the male students' sexual behaviors were related strongly to parent sexual attitudes. Implications for school and parent sexuality education programs are briefly discussed. PMID- 3633368 TI - Teaching about body image: a technique for improving body satisfaction. PMID- 3633367 TI - When education becomes abuse: a different look at the mental health of children. PMID- 3633369 TI - Low prevalence of the booster phenomenon in nursing-home employees in Maryland. PMID- 3633370 TI - Results of mandatory screening for cervical cancer in a black population. PMID- 3633371 TI - A well doctor's family: the struggle for intimacy. PMID- 3633372 TI - Follow-up of colorectal cancer patients. PMID- 3633373 TI - Five-hour blood pressure check to assess hypertension not responding to conventional therapy. PMID- 3633374 TI - Post-traumatic stress disorders: delayed for a decade. PMID- 3633375 TI - Drug disposition in the neonate. PMID- 3633376 TI - Teratology: a primer. PMID- 3633377 TI - New light on phototherapy: home use. PMID- 3633378 TI - Transitional infant care: a bridge to home for high-risk infants. PMID- 3633379 TI - Congenital adrenal hyperplasia. PMID- 3633380 TI - Guide to lobbying. PMID- 3633382 TI - Power, professions and practice. PMID- 3633381 TI - Detection of familial hypercholesterolemia by assaying functional low-density lipoprotein receptors on lymphocytes. AB - In familial hypercholesterolemia, structural and functional abnormalities of the receptor for low-density lipoprotein (LDL) lead to hypercholesterolemia and premature atherosclerosis. We have developed a simplified method to identify LDL receptor defects in peripheral-blood lymphocytes. When lymphocytes are cultured in lipoprotein-depleted medium and endogenous sterol biosynthesis is suppressed with mevinolin, mitogen-stimulated proliferation of lymphocytes is dependent on an exogenous source of cholesterol. Whereas a small concentration of supplemental LDL cholesterol (3 to 4 micrograms per milliliter) permits a maximal response in normal lymphocytes, even high concentrations (10 to 50 micrograms per milliliter) are unable to support the proliferation of lymphocytes from patients with homozygous familial hypercholesterolemia. Thus, functional LDL receptors are necessary to allow lymphocyte proliferation in these cultures. The response of lymphocytes from patients with hyperlipidemia not caused by defective LDL receptors was like that of normal cells. In contrast, the response of lymphocytes from patients with heterozygous familial hypercholesterolemia was intermediate between that of homozygotes and that of normal or hyperlipidemic controls. Our method can therefore be used to identify persons who are heterozygous for abnormalities of LDL receptors. PMID- 3633383 TI - The psychiatric nurse's failure therapeutically to nurture. PMID- 3633384 TI - Primary nursing. PMID- 3633385 TI - Death: coming to terms with death and dying. PMID- 3633386 TI - Death and dignity. PMID- 3633387 TI - Bereavement. PMID- 3633388 TI - Cruse, a source of on-going support for bereaved families. PMID- 3633389 TI - When a baby dies--a father's view. PMID- 3633390 TI - Pain--an African perspective. PMID- 3633391 TI - Leadership of the multi-disciplinary team in psychiatry--a nursing perspective. PMID- 3633392 TI - The selection of learning activities in continuing education and staff development. PMID- 3633393 TI - Concepts of care: a way of life. PMID- 3633394 TI - Why nursing care does not end at the hospital door. PMID- 3633396 TI - "Do you have any other ideas for improvement?". PMID- 3633395 TI - Beating the blahs: 10 tips to improve the health and well-being of your nurses. PMID- 3633397 TI - A refreshing update on nursing education. PMID- 3633398 TI - Bonus skills for entry-level practice. PMID- 3633399 TI - What is leadership? PMID- 3633400 TI - Staff complaints about patient care should be seen as a professional responsibility. Interview by Phil Cohen. PMID- 3633402 TI - Vital contribution. PMID- 3633401 TI - Royal College of Nursing. Popular support for RCN campaign. PMID- 3633403 TI - Royal College of Nursing. Caring core of the health service. PMID- 3633404 TI - Empathy with patients. PMID- 3633405 TI - Highlighting changing character of hospice care. PMID- 3633406 TI - Drug abusers 'most likely' to spread AIDS virus by needles. PMID- 3633407 TI - Hospital kitchens now subject to Food Act hygiene provisions. College delighted by removal of Crown immunity. PMID- 3633408 TI - Royal College of Nursing. The next step. PMID- 3633409 TI - Institutional care. PMID- 3633410 TI - Making more of a meal out of nutritional needs. PMID- 3633411 TI - Royal College of Nursing. Ill-briefed. PMID- 3633412 TI - Standing up and being counted. PMID- 3633413 TI - The rights of women who have breast cancer, their families and their friends. PMID- 3633414 TI - The three C's of administering chemotherapy: considerations, classifications, complications. PMID- 3633415 TI - Thrombolytic therapy. PMID- 3633416 TI - Comparison of transparent dressing to paper tape dressing over central venous catheter sites. PMID- 3633417 TI - I.v. antibiotics: nursing considerations in the administration of the initial dose. PMID- 3633418 TI - Patient care units: a management productivity tool for i.v. therapy teams. PMID- 3633420 TI - Ten trends to watch. PMID- 3633419 TI - Congress overrides Presidential veto: nurses triumph. PMID- 3633421 TI - School sets sights on bold innovations. PMID- 3633422 TI - A mandate for standards of care. PMID- 3633423 TI - Lessons from a failed consolidation: how two home health agencies never became one. PMID- 3633424 TI - The single purpose road to higher education. PMID- 3633425 TI - The enigma of graduate nursing education: advanced generalist? Specialist? PMID- 3633426 TI - Conceptual perspectives on the organization design task and the quality assurance function. PMID- 3633427 TI - Shedding light on a shifting marketplace: competition in maternity care. PMID- 3633428 TI - The problems and payoffs of setting up a rural health clinic. PMID- 3633429 TI - Tracking down the right degree for the job. PMID- 3633430 TI - The Americanization of Florence: a look at associate degree nurses. PMID- 3633431 TI - Nurses have tough work ahead to hold ground in D.C. PMID- 3633432 TI - Nursing today and tomorrow--the role of NCNIP. PMID- 3633433 TI - A first for the nation: North Dakota and entry into nursing practice. PMID- 3633434 TI - Restricting the RN license to BSN graduates could cloud nursing's future. PMID- 3633435 TI - Decision analysis: a step-by-step guide for making clinical decisions. PMID- 3633436 TI - Practice phone calls hone graduate students' skills. PMID- 3633437 TI - Development, implementation, and utilization of a computerized information system for nursing. PMID- 3633439 TI - Computer technology: its impact on nursing practice. PMID- 3633438 TI - Information access: a basis for strategic planning and control of operations. PMID- 3633440 TI - Implementing an automated scheduling system. PMID- 3633441 TI - Unsigned medical orders: a common problem magnified by automation. PMID- 3633442 TI - Computerized care planning. PMID- 3633443 TI - Educating nurses to work in computerized nursing services. PMID- 3633444 TI - Computerization's impact on nursing services. PMID- 3633445 TI - Using and interpreting item analysis data. PMID- 3633446 TI - Multiple authorship in nursing. PMID- 3633447 TI - Preserving your simulation lab displays. PMID- 3633449 TI - Analysis of decisions to initiate doctoral programs in nursing. PMID- 3633448 TI - Using the humanities in nursing education. PMID- 3633450 TI - Effective clinical behaviors of faculty: a review of the literature. PMID- 3633451 TI - Applying adult learning principles in instructional module design. PMID- 3633452 TI - Why research in nursing education? PMID- 3633453 TI - The "invisible" spouse. PMID- 3633454 TI - Duck-bill prosthesis: words of hope for the laryngectomy patient. PMID- 3633455 TI - Emergency childbirth. PMID- 3633456 TI - Reacting to anaphylaxis (continuing education credit). PMID- 3633457 TI - Keeping your legal balance when it comes to patient falls. PMID- 3633458 TI - Leukocyte studies: what the counts can tell you. PMID- 3633460 TI - Stopping the spread of sexually transmitted diseases. PMID- 3633459 TI - Pep needed someone looking out for him. PMID- 3633462 TI - The ins & outs of measuring cardiac output. PMID- 3633461 TI - Nurses: are we eating our young? PMID- 3633463 TI - Keeping air out of i.v. lines. PMID- 3633465 TI - Code/no code? The question that won't go away. The no-code decision: a doctor's perspective. PMID- 3633464 TI - Code/no code? The question that won't go away. PMID- 3633466 TI - Professional growth. 5 ways to resolve conflict. PMID- 3633467 TI - Treat shock with dopamine. PMID- 3633468 TI - When your patient's depressed--you can make a difference. PMID- 3633469 TI - The most difficult person I've ever worked with--Dr. Grant liked to pull a disappearing act. PMID- 3633470 TI - Avoiding legal risks in pediatrics. PMID- 3633471 TI - Code Gray. Ethical dilemmas in nursing--Part 2. Considering the principle of autonomy. PMID- 3633472 TI - Total hip replacement. Helping your patient avoid complications. PMID- 3633473 TI - Assessing chest pain and intervening efficiently (continuing education credit). PMID- 3633474 TI - What our readers said about refusing to work in an intensive care unit. PMID- 3633475 TI - Nursing Life's guide to hidden hazards on the job. V: Anesthetic gases. PMID- 3633476 TI - Preventing air embolism in patients with central venous catheters. PMID- 3633477 TI - Keeping the gears meshing--five steps for managing the problem employee. PMID- 3633478 TI - Good intentions gone awry. PMID- 3633480 TI - [Emergency at the end of the line... do not cut!]. PMID- 3633479 TI - Right drug, wrong route. PMID- 3633481 TI - [A computer inside the head or at the care unit?]. PMID- 3633482 TI - [Breaking dependency while playing with space]. PMID- 3633483 TI - [Sister Claire Perreault, great humanist. Interview by Nicole Rodrigue]. PMID- 3633485 TI - Law for the nurse manager. Licensure problems. PMID- 3633484 TI - [Professional appraisal--a double-selection mechanism]. PMID- 3633486 TI - The transport case: capitalizing on PCS data. PMID- 3633487 TI - Profit-sharing plans in nonprofit hospitals. PMID- 3633488 TI - A new concept in routine vital signs measurement. PMID- 3633489 TI - A nursing staff designs its own system. PMID- 3633490 TI - Developing a cohesive team in a critical care unit. PMID- 3633491 TI - Problems of post-anesthesia care for ambulatory surgery. PMID- 3633492 TI - Systems management: evaluating nursing departments as a whole. PMID- 3633493 TI - Patient education: progress and problems. PMID- 3633494 TI - The corporate image of a nurse executive. PMID- 3633495 TI - Emotional versatility: a nursing skill. PMID- 3633496 TI - Selling our wares in a not-so-open market. PMID- 3633497 TI - Orthopaedic trauma: pelvic fractures (continuing education credit). PMID- 3633498 TI - Avoid legal pitfalls in charting. PMID- 3633499 TI - Respiratory complications of orthopaedic injuries. PMID- 3633500 TI - Respiratory assessment of the orthopaedic patient. PMID- 3633501 TI - Preoperative patient education: in the home or in the hospital? PMID- 3633502 TI - Translation arrest by oligodeoxynucleotides complementary to mRNA coding sequences yields polypeptides of predetermined length. AB - We investigated the arrest of mRNA translation at predetermined sites by oligodeoxynucleotides complementary to defined coding sequences within a mRNA. An in vitro transcription and a wheat germ cell-free translation system were used for the synthesis of mRNA and protein, respectively. Oligodeoxynucleotides (10-, 15- and 20-mer) arrested polypeptide synthesis in a concentration-dependent manner at the site of their hybridization to the mRNA, as judged by the size of the translation products. A 5-mer oligodeoxynucleotide did not prevent synthesis of the full length protein. Ribosomes arrested by an oligodeoxynucleotide transiently stacked up and eventually disassembled. Upon dissociation of the ribosomes from the blocked site, nascent chains were released as peptidyl-tRNAs which in turn became rapidly converted to free polypeptide chains. None of these results was affected by the position within the reading frame to which the 3' end of the oligodeoxynucleotide hybridized. The general applicability of translation arrest by oligodeoxynucleotides was demonstrated for different mRNAs. Only partial arrest of translation was obtained when oligodeoxynucleotides were used to arrest translation in the reticulocyte cell-free system. PMID- 3633503 TI - Effects of therapeutic touch on tension headache pain. AB - Therapeutic touch (TT) is a modern derivative of the laying on of hands that involves touching with the intent to help or heal. This study investigated the effects of TT on tension headache pain in comparison with a placebo simulation of TT. Sixty volunteer subjects with tension headaches were randomly divided into treatment and placebo groups. The McGill-Melzack Pain Questionnaire was used to measure headache pain levels before each intervention, immediately afterward, and 4 hours later. A Wilcoxon signed rank test for differences indicated that 90% of the subjects exposed to TT experienced a sustained reduction in headache pain, p less than .0001. An average 70% pain reduction was sustained over the 4 hours following TT, which was twice the average pain reduction following the placebo touch. Using a Wilcoxon rank sum test, this was statistically significant, p less than .01. Study results indicated that TT may have potential beyond a placebo effect in the treatment of tension headache pain. PMID- 3633504 TI - Re: 'Handwashing: ring-wearing and number of microorganisms'. PMID- 3633506 TI - Response sets in questionnaire research. PMID- 3633505 TI - Task complexity and nursing expertise as factors in decision making. AB - This study used an information-processing approach and verbal protocol methodology to describe the initial and overall approaches to planning used by six expert and five novice nurses for three patient cases of varying complexity. Subjects did not change their initial approaches significantly across the cases. Most experts consistently used broad initial approaches, but no clear pattern was evident in novices' use of initial approaches. Experts varied their overall approaches as a function of case complexity; novices did not. Most experts used opportunistic overall approaches in the more complex cases; that is, they jumped about, pursuing whatever was opportune at a given point in the planning process. However, they used systematic overall approaches in the least complex case. In contrast, most novices used opportunistic overall approaches in all cases. No relationship was found between overall approaches used and quality of plans developed. The findings support the cognitive model of planning proposed by Hayes Roth and Hayes-Roth (1979) and the conclusion found in information-processing literature that the task itself is a major determinant of decision-making behavior. PMID- 3633507 TI - Maternal role attainment and identity in the postpartum period: stability and change. AB - Stability and change in maternal identity and maternal role attainment were examined in 64 medically normal, middle-class primiparous and 58 multiparous women. Using two semantic differential scales, "Myself as Mother" and "My Baby", for maternal identity and the Pharis (1978) Self-Confidence Scale for role attainment, subjects were tested at 1 to 3 days and 4 to 6 weeks postpartum. Main effects for parity and testing occasions were found for both semantic differential scales. While mothers' attitudes toward themselves became more positive over time, those toward their babies became less positive. Self confidence showed main effects for both time of testing and parity as well as interaction effects. Although attitudes and self-confidence were stable across testing occasions, self-confidence was less related to indicators of maternal identity for multiparas than for primiparas. Sociodemographic variables demonstrated only low correlations with indicators of maternal identity and role attainment. Testing the relationship of maternal identity and role attainment to actual parenting behaviors is needed to determine the empirical and practical import of these two concepts in nursing practice. PMID- 3633508 TI - Social support, stress, and health: a comparison of expectant mothers and fathers. AB - The influence of social support and stress on expectant mothers' and fathers' health was determined by testing and comparing different predictive models. Instruments used were the Support Behaviors Inventory, Stress Amount Checklist, and Health Responses Scale. Regression analyses were performed on data from questionnaires completed by 313 couples in the second half of pregnancy to predict health, using the same independent variables for women and men. The regression analyses began with a model that included the variables of stress, satisfaction with partner support, satisfaction with other persons' support, history of chronic illness, education, age, employment status, military status, and family income. The effects of four variables, satisfaction with partner support, satisfaction with others' support, stress, and chronic illness, were tested separately for men and women. Subsets of these variables were deleted to create a series of nested comparisons. Results indicated that social support and stress were useful in predicting health. Partner support appeared to be the most important variable in understanding expectant fathers' health, but social support for mothers included a larger domain and social networks contributed to their health in the same way as partner support. Both stress and chronic illness were more important explanatory variables for pregnant women's health than for their partners' health. These data suggest that nursing interventions targeted at reducing stress and improving expectant parents' satisfaction with their partner support might enhance their health. PMID- 3633509 TI - Parent coping, a replication. AB - Forty-seven pairs of parents of 2- to 3-month-old infants were asked to respond to a questionnaire to determine parent coping in relation to infant temperament and parent psychological responses. Mothers' and fathers' reports of helpfulness of coping behaviors were similar, but fathers reported more responses of depression and anxiety and focused less on coping by seeking social support and being responsible. Mothers who viewed their infant as of optimal temperament sought social support, maintained family integrity, and reported being religious, thankful, and content. Being responsible was more helpful to fathers who saw their infant as responding positively to soothing techniques and as smiling and laughing frequently, but less helpful to fathers who perceived their infant as being fearful and distressed by limitations. Fathers who perceived their infant as being fearful and distressed also reported more depression. PMID- 3633510 TI - Measure of attitude toward menopause using the semantic differential model. AB - A semantic differential instrument that measures adult women's attitudes toward menopause was constructed and validated. A volunteer sample of 504 women, 18 years or older, completed the pilot instrument of 45 bipolar adjective scales. A principal components factor analysis revealed 20 scales that loaded on one dominant factor; this factor accounted for 60% of the variance for the 20 scales. Cronbach alpha reliability was .96. The revised 20-scale instrument was called the Menopause Attitude Scale (MAS). A second sample of 419 women completed the MAS and one additional instrument for assessment of convergent and discriminant validity. Convergent validity was demonstrated by a correlation of r = .63 for the MAS with the Attitudes Toward Menopause Scale. Discriminant validity was demonstrated by a correlation of r = .42 for the MAS with the Attitudes Toward Old People Scale and a correlation of r = -.04 for the MAS with the Attitudes Toward Women Scale. Factor analysis of MAS scores revealed that one factor accounted for 61.5% of the variance for the 20 scales. The test-retest reliability for 39 subjects was .87. Multiple regression analysis identified age and menopausal status as significant explanatory variables for MAS scores. PMID- 3633511 TI - Leg volume changes with EPIC and posturing in dependent pregnancy edema. AB - This study explored the differential effects of external pneumatic intermittent compression (EPIC) and posturing on leg volume changes in healthy pregnant women with dependent leg edema. Thirty-five healthy pregnant women with severe pedal edema were randomly assigned to one of two treatment groups. The experimental group (n = 17) received EPIC for 30 minutes at 40 torr while in the left lateral recumbent position. Control women (n = 18) were similarly positioned, but received no EPIC. Both groups walked for 10 minutes following left lateral posturing. Circumference measures required for leg volume estimates were made: prior to posturing (Time 1), immediately after posturing (Time 2), and following the ambulation period (Time 3). Volume losses for the experimental group were greater than for the control group at Time 2. Although volume losses for the experimental group had reversed somewhat at Time 3, they remained greater than control group losses, which did not change from Time 2 to Time 3. Analysis of covariance revealed significant mean volume losses for both experimental and control groups, with ponderal index the only significant covariate. PMID- 3633512 TI - Human responses to chronic illness: physiologic and psychosocial adaptation. AB - To identify factors that promote adaptation, physiological and psychosocial responses to chronic illness were studied. The adaptation to chronic illness model (Pollock, 1984a) served as the theoretical framework for integrating the major variables of chronicity, stress, hardiness, and physiological and psychosocial adaptation. The sample (N = 60) consisted of three equal-sized groups of adults who had been diagnosed with diabetes mellitus, essential hypertension, or rheumatoid arthritis for at least one year. Data were collected from all subjects over a 9-month interval to determine their physiological and psychosocial adaptation and if they had the hardiness characteristic. The hypothesis, that presence of the hardiness characteristic was significantly correlated with physiological adaptation, was supported for the diabetic group but not for the hypertensive or rheumatoid arthritic groups. Physiological and psychosocial adaptation were found to be two independent domains in this study. PMID- 3633513 TI - Variables associated with skin dryness in the elderly. AB - This study investigated whether sebum secretion and other external variables were associated with the occurrence of dry skin in the elderly. The sample consisted of 76 elderly white individuals ranging in age from 65 to 97 years who resided in retirement homes. Dry skin was measured through verbal report and verified by observation. Sebum was collected on dacron mesh disks and measured by quantitative thin layer chromatography. Other variables pertinent to the occurrence of dry skin were measured through structured interview. Dry skin was found in 59% of the subjects. Mean sebum secretion rate was .534 mg/10 sq cm/3 hr. Although sebum secretion rate was significantly lower in females than in males, p less than .001, sebum levels did not differ significantly as a function of dry skin for either sex. A significant association was found between severity of skin dryness and age, p less than .02. The findings refute the widely held, though untested belief, that the decreased sebaceous gland activity that accompanies aging is responsible for skin dryness in the elderly. PMID- 3633515 TI - Child abuse: it's OK to say no. PMID- 3633514 TI - Innocent parents. PMID- 3633516 TI - Spanish health: viva Espana? PMID- 3633517 TI - Professional representation: voice in the wilderness; how to make yourself heard. PMID- 3633518 TI - On the edge of the whirlpool. PMID- 3633519 TI - Child health. Learning about hospital. PMID- 3633520 TI - Child health. Programmes for the under-privileged. PMID- 3633521 TI - A happy return. PMID- 3633523 TI - Dangerous smoke signals. PMID- 3633522 TI - Speech impairment after a stroke. PMID- 3633524 TI - A very special birth day. PMID- 3633525 TI - A doleful existence. PMID- 3633526 TI - Management: what they said. PMID- 3633527 TI - Mental Health Nursing. Journal of the Psychiatric Nurses Association. PMID- 3633528 TI - Mental health nursing. Why change? PMID- 3633529 TI - Mental health nursing. Home benefits. PMID- 3633530 TI - Mental health nursing. What is normal? PMID- 3633531 TI - Private and confidential. Interview by Charlotte Alderman. PMID- 3633532 TI - Enrolled nurses: to be an EN, or not? PMID- 3633533 TI - Mental illness: if in doubt. PMID- 3633534 TI - ENs on the transfer list. PMID- 3633535 TI - Planning patient care: from heart failure to independence. PMID- 3633537 TI - Child health: helping them face tomorrow. PMID- 3633536 TI - Ankylosing spondylitis. PMID- 3633538 TI - Health: a universal concern. PMID- 3633539 TI - Training the carers. PMID- 3633541 TI - Developing a management budget. PMID- 3633540 TI - The private sector: the cost of caring. PMID- 3633542 TI - Stoma care. Emergency surgery for ulcerative colitis. PMID- 3633543 TI - Stoma care. Choosing the right appliance. PMID- 3633544 TI - Experience in theatre. PMID- 3633545 TI - Money wise. PMID- 3633546 TI - Nurses' pay: can't pay, won't pay? PMID- 3633547 TI - Voluntary work: teaching in troubled areas. PMID- 3633548 TI - Commons sense--a kick up the coccyx. PMID- 3633549 TI - Family planning. If the cap fits. PMID- 3633550 TI - Family planning. Fertility rights. PMID- 3633551 TI - Family planning. Accurate predictions. PMID- 3633552 TI - Cause and effect. PMID- 3633553 TI - Searching in the dark. PMID- 3633554 TI - Drug and solvent abuse in adolescents. PMID- 3633555 TI - Measuring patient dependency. PMID- 3633556 TI - A clash of characters. PMID- 3633557 TI - Child nutrition. Feeding babies with cleft lip and palate. PMID- 3633558 TI - Child nutrition. Keeping caries at bay. PMID- 3633559 TI - Night duty: when the lights are low. PMID- 3633560 TI - An 'ideal' sister--seven years on. PMID- 3633561 TI - Leading light. Interview by Laurence Dopson. PMID- 3633562 TI - Men's health. PMID- 3633563 TI - Women and mental health. A model for practice. AB - This article has addressed the need to consider multiple sources of stress in women's lives to assist them in determining those areas over which they can increase their sense of control as well as ways of coping with those aspects over which they have limited control. The continuing need to help women define and explore realistic options is stressed. PMID- 3633564 TI - The health of older women. AB - The emerging profile of a healthy older woman in the community is that of an active, independent, and positive person. Data from in-depth interviews are presented to illustrate the value of research in assessing health status. Nurses are encouraged to use research to accurately portray older women and their nursing care requirements. PMID- 3633565 TI - Nursing service administrators. Marginality and the public person. AB - The manner in which nursing executives construct their meanings of management work impacts on power and connectedness between the privatized feminine and clinical worlds and male-dominated public management worlds. It is important that administrative studies examine which actors hold access to administrative knowledge, what knowledge is required, and how social interactions control the administration of proper nursing management. PMID- 3633566 TI - Nursing education administrators: blocked women. AB - In spite of affirmative action legislation, career barriers still exist for women and minorities in higher education. Women deans of nursing are thwarted because they have fewer opportunities to develop appropriate experiences and talents necessary for promotion to university-wide positions of leadership. This article discusses some of the factors which contribute to the blocked career paths of nursing education administrators. PMID- 3633567 TI - Men's work environments and health risks. AB - There are multiple risks to men's health and safety in workplace settings. These include biological, chemical, physical, and mechanical agents. There are biologic and social characteristics of men that may place them at excess risk of exposure and response to these hazards. These exposures may threaten the entire family through secondary exposure in the home or through physical and psychological changes in the male. The key to minimizing or eliminating these hazards lies in the identification of the potential or actual exposures and effective education on protective measures. The nurse's role in this preventive approach is to incorporate occupational health data into each client assessment and to use this information to identify workplace exposures and appropriate worker education. PMID- 3633568 TI - Health concerns of aging men. AB - The older man's significant health concerns have relevant implications for practice. The identification of and discussion about the issues of health, retirement, dependency, and sexuality of the older man represent a good beginning to understanding the health concerns of the aging man; however, it is only a beginning. There still remains a critical need for additional studies to elucidate other sex-related differences in aging as well as to clarify how these differences affect the lifestyles and the health care of both older men and women. PMID- 3633569 TI - Women's health. PMID- 3633570 TI - Selecting a tool for measuring stomatitis. PMID- 3633571 TI - Pediatric Phase I clinical trials: ethical issues and nursing considerations. PMID- 3633572 TI - Family responses to cancer hospitalization. PMID- 3633573 TI - Nurses' attitudes toward sexuality in cancer patients. PMID- 3633574 TI - Nurses and smoking: role modeling and counseling behaviors. PMID- 3633575 TI - Publishing your thesis. I. Guidelines to facilitate publishing. PMID- 3633576 TI - Publishing your thesis. II. A personal experience. PMID- 3633577 TI - Cancer prevention and detection: from twenty to sixty-five years of age. PMID- 3633578 TI - Nephrotoxicity of cancer treatment. PMID- 3633579 TI - A patient's guide to the implanted port. PMID- 3633580 TI - Advising women receiving pelvic irradiation. PMID- 3633581 TI - Sperm banking considerations. PMID- 3633582 TI - Sexuality and the person with cancer. PMID- 3633583 TI - Emergency medicine for the primary care physician. PMID- 3633584 TI - Hypertensive emergencies. AB - This article examines hypertensive crises and urgencies as they relate to the primary care physician. Special attention is given to the treatment of these conditions in the office setting. Conditions discussed include hypertensive encephalopathy, acute aortic dissection, hypertension and pulmonary edema, severe hypertension with angina or myocardial infarction, pheochromocytoma, eclampsia, and food and drug interactions. PMID- 3633585 TI - Infectious disease emergencies. AB - Patient visits to the primary care physician are prompted most often by an infectious disease. The clinician must be aware of the common and serious infections present in the community and must institute proper diagnostic and therapeutic measures. Diagnosis and treatment of streptococcal infections, staphylococcal infections, pneumonia and upper respiratory tract infection, bone and joint infections, sinusitis, clostridial infections, and tetanus are discussed. PMID- 3633586 TI - Management of obstetric and gynecologic office emergencies. AB - Careful telephone triage of women with significant obstetric and gynecologic emergencies is the optimal way to avoid devastating complications in the office. With practical knowledge and some specialized office equipment and medications, most obstetric and gynecologic emergencies can be managed effectively in the office or stabilized while arranging transport to a hospital. Management of the most common complications likely to be encountered is outlined in this article. PMID- 3633587 TI - Orthopedic emergencies. AB - Conditions affecting the musculoskeletal system may be classified as emergencies depending on their magnitude. In this article, such urgent injuries are reviewed to assist the primary care physician in dealing with them in an office setting in the most efficient manner possible. Conditions discussed include open fractures, joint injuries, epiphyseal injuries, septic arthritis, and compartment syndromes. PMID- 3633588 TI - Outpatient management of acute and chronic poisoning. AB - Approximately 70 per cent of all poisonings reported to poison control centers will be referred after home or hospital management to the primary care physician. When a patient presents to the physician's office following a poisoning, the care provider must know when hospitalization is needed, what equipment should be available, and where information about the toxin can be obtained. PMID- 3633589 TI - Acute renal failure in the outpatient setting. AB - With the ever-increasing pressures for outpatient diagnostics and therapeutics, one must be increasingly alert to the occurrence and consequences of acute renal failure. The significance of minor increases in the serum creatinine level must be recognized, so that modifications of drug therapy can be made and correction of possibly life-threatening electrolyte imbalances can be undertaken. The multiple drug-related renal syndromes must be considered when initiating therapy with any medication. Prophy, laxis for acute renal failure with saline solution, mannitol, and/or furosemide should be considered in patients at increased risk. PMID- 3633590 TI - Respiratory emergencies. AB - This article is intended as an overview of emergencies that could and often do present to the physician's office, especially when a hospital emergency department may not be nearby. It is not intended as an in-depth view of every problem but should be considered as a presentation of essential management in the emergency phase of treatment. The reader is directed to the references for more in-depth information on these topics. PMID- 3633591 TI - Shock. AB - Inevitably, a patient in shock will present to your office. The findings may be obvious, or they may show the more subtle changes of mild tachypnea, tachycardia, and/or changes in mental status. In either event, the perfusion pressure either has already decompensated or will do so momentarily. Whether you initiate therapy then and there might well determine whether your patient will survive. Accordingly, each office should have available for the pre-hospital management of shock those items listed in Table 3. As clinicians, you must be prepared to begin treatment in your office. Although the hospital, particularly the intensive or coronary care unit, is the appropriate setting for the management of shock, therapy must be initiated as soon as and wherever the diagnosis is made. In this situation, an ounce of prevention is indeed worth a pound of cure. Shock, whether it develops insidiously or precipitously, is a state of inadequate tissue perfusion that, if misdiagnosed or treated inadequately, will inevitably result in death. PMID- 3633592 TI - Advanced cardiac life support. AB - It is important for all physicians to be familiar with the equipment and medications needed for advanced cardiac life support. The most important aspect in advanced life support is the establishment and maintenance of an airway and ventilation of the patient. Office personnel should be trained in Basic Cardiac Life Support, so that the physician can intubate the patient, start an intravenous line, and administer intravenous medications to support the patient. Appropriate drug dosage tables and defibrillation tables are included in this article. PMID- 3633593 TI - Abdominal pain. AB - In this article, the incidence of acute abdominal pain in primary care practice, its etiology and pathogenesis, and the evaluation of the patient with pain are discussed. Special attention is given to the differential diagnosis of both surgical and nonsurgical diseases that can present with abdominal pain as the major manifestation. PMID- 3633594 TI - Advanced trauma life support. AB - The care of the trauma patient is a complex undertaking involving multiple health care professionals and represents one of the greatest challenges to any physician. There is perhaps no greater opportunity to have a positive impact on patient care than in the care of these patients. By adhering to a systematized and prioritized approach, the chances of the patient's survival with decreased morbidity are dramatically improved. It is the physician's responsibility both to provide the best care he or she is capable of delivering and to oversee the care delivered by other professionals. With proper motivation and experience, the physician's care of trauma patients will continually improve. This will lead to a rewarding experience for the patient and the physician alike. PMID- 3633595 TI - Bronchial asthma. AB - Bronchial asthma is a very common disease afflicting 2 to 3 per cent of the general population. Attacks may be mild or life-threatening. Modern guidelines for diagnosis, therapy, and prognosis are presented in this article. PMID- 3633596 TI - Chest pain. AB - The purpose of this article has been to review the multiple causes of chest pain. Because acute chest pain can be the only presenting symptom of a potentially life threatening illness, it is important that the physician identify these patients rapidly and arrange appropriate hospital care. Likewise, it is also important that the physician recognize the less severe causes of chest pain so that the patient can be appropriately reassured in the office or sent for evaluation of the cause of this pain. Although nearly every patient with acute chest pain views this pain as an emergency, the majority of patients with this type of pain presenting to a physician's office can be evaluated and reassured using only basic office skills. PMID- 3633597 TI - Coma. AB - The preceding discussion is an attempt to stress anatomy in the diagnosis of coma. By localizing the offending lesion, the physician can apply the appropriate diagnostic and therapeutic measures more adeptly. Because physicians are also frequently asked to prognosticate, I have tried to summarize the work of Plum and Posner in their study of the outcome of patients presenting in coma. The primary care physician is encouraged to plan at least for the basics in case he or she is faced with a comatose patient. PMID- 3633598 TI - Congestive heart failure and pulmonary edema. AB - This article provides a brief description of the clinical manifestations and cardiac physiology of congestive heart failure. This is followed by specific treatment options and specific guidelines for treatment of patients with acute pulmonary edema while arrangements are being made for transfer to the hospital setting. PMID- 3633599 TI - Convulsions. AB - Management of seizures requires prompt medical attention to prevent morbidity and mortality and to clarify the etiology of the event so that proper long-range therapy can be planned. This article provides an overview of the diagnosis and treatment of this common medical problem. PMID- 3633600 TI - Premature extubation: death in recovery room. PMID- 3633601 TI - Infiltrating i.v.'s and nurses' negligence. Case in point: Macon-Bibb Hosp. Authority v. Ross (335 E. 2d 633--GA). PMID- 3633602 TI - Dr. sleeps while pt. dies: E.R. nurse sued. Case in point: Anthony v. Hospital Service Dist. No. 1 (477 So. 2d 1180-LA). PMID- 3633603 TI - Nutrition and cancer. Introduction. PMID- 3633604 TI - Methodological issues in the study of cancer and nutrition: alternative designs and lessons learned. PMID- 3633605 TI - Symptom management: a comprehensive approach to increasing nutritional status in the cancer patient. PMID- 3633606 TI - Nutritional interventions: increasing oral intake. PMID- 3633607 TI - Nutrition quackery. PMID- 3633608 TI - [Tracheotomy cannula]. PMID- 3633609 TI - [Trial of a hydrocolloid in occlusive dressings in the treatment of skin wounds, "Duoderm"]. PMID- 3633610 TI - [Food hygiene]. PMID- 3633611 TI - [Integration of midwives of rural areas in family planning]. PMID- 3633612 TI - [Continuing education]. PMID- 3633613 TI - [Medico-surgical nursing. Nursing care to cardiology patients (continuing education)]. PMID- 3633614 TI - [Role of the nurse in the prevention of hospital infections]. PMID- 3633615 TI - [Changing personal experiences in continuing education]. PMID- 3633616 TI - [Proteins and diet (I)]. PMID- 3633617 TI - [Nursing care in hyaline membrane disease with atelectasis]. PMID- 3633618 TI - [Continuing education. Nursing technics. Administration of drugs via intramuscular, intradermal and subcutaneous route]. PMID- 3633619 TI - [Health for all in the year 2000. An unobtainable goal without nursing]. PMID- 3633620 TI - [Proteins and diet (II). Taurine]. PMID- 3633621 TI - [Peter O'Neill: a man and his message]. PMID- 3633622 TI - [Health reforms in Spain]. PMID- 3633623 TI - [The role of nursing in hospital reforms]. PMID- 3633624 TI - [Reforms in nursing and in primary care]. PMID- 3633625 TI - [Nursing and the word]. PMID- 3633626 TI - [Personnel policy and nursing]. PMID- 3633627 TI - [INSALUD's contribution to the education of nursing personnel]. PMID- 3633628 TI - [Proposal for reforms in the study plan of the school of nursing]. PMID- 3633629 TI - [Diet in advanced renal insufficiency]. PMID- 3633630 TI - [The loneliness of the patient]. PMID- 3633631 TI - Symptomatic effect of pancreatic enzyme therapy in patients with chronic pancreatitis. AB - The symptomatic effect of pancreatic enzyme substitution therapy was examined in a 4-week double-blind crossover study. Twenty patients, 11 with and 9 without steatorrhoea, were examined. Pancreatic steatorrhoea was reduced from a median of 24 g/day to 10 g/day by the enzyme therapy (P less than 0.01). No significant pain reduction was found in either of the two groups, although there was a tendency to reduction in pain and analgetic consumption in the patients with steatorrhoea when treated with pancreatic enzymes. It is concluded that pancreatic steatorrhoea is still the only indication for pancreatic enzyme therapy. PMID- 3633632 TI - [University in Bergen--6-year experience with nursing science]. PMID- 3633633 TI - [3 clinical nursing problems: improved birthing aids]. PMID- 3633634 TI - [Fear of a confused old age: is it Monday or December today?]. PMID- 3633635 TI - [Health protection for mentally retarded--a lot of sickness and need for nursing]. PMID- 3633636 TI - [Management of community health services]. PMID- 3633637 TI - [Now we have one!]. PMID- 3633639 TI - [Publicly approved nurses without nursing education?]. PMID- 3633638 TI - [Seminar in Trondheim: 6-hour standard work day in the health sector]. PMID- 3633640 TI - [Personnel and patients ask: how can we organize nursing to deliver the best possible care?]. PMID- 3633641 TI - [New alliance in aged policy: home care nurses and Federal Housing Agency]. PMID- 3633642 TI - [Successful trial in Oslo: nursing care planning in primary health services]. PMID- 3633643 TI - [Action gives results: 4 new nurses' residences in Longyearbyen]. PMID- 3633644 TI - [In a developmental stage: official studies in nursing]. PMID- 3633645 TI - [The bid gap]. PMID- 3633646 TI - [Home or nursing home? Everyone should get a chance to choose]. PMID- 3633647 TI - [Variety is the spice of life--experience with group management of a clinic]. PMID- 3633648 TI - [Nursing home with a new gift: therapy--not just bingo!]. PMID- 3633649 TI - [Pressure sores--occurrence, prevention and treatment]. PMID- 3633650 TI - [Offshore with the Norwegian Nurses' Association. Occupational health nurses on a visit to the continental shelf]. PMID- 3633651 TI - [Patient classification in home care nursing. The number of patients does not decide personnel requirements]. PMID- 3633652 TI - [Cooperative project in Harstad: improved nursing care with new care plans]. PMID- 3633653 TI - [Shortage of nurses in northern Norway. Are they finally listening to the Norwegian Nurses' Association?]. PMID- 3633654 TI - [Put a circle around the public health services]. PMID- 3633655 TI - [Improved nursing homes: out with routines--in with individualized care]. PMID- 3633657 TI - [Nursing shortage and recruitment]. PMID- 3633656 TI - [Healthier hospital environment: crush out smoking! But when and where?]. PMID- 3633658 TI - [Midwives: one in action--yet divided. Interview by Pal Horsle]. PMID- 3633659 TI - [The Swedish education system. Why Swedish nurses cannot get official recognition in Norway]. PMID- 3633660 TI - [Research and practice: we should have a clear basis in our own profession. Interview by Pamela Aasand]. PMID- 3633661 TI - [HVPU (Health Care for Mentally Retarded)--research' stepchild. Standardization- but for what?. Interview by Bjorn Arild Ostby]. PMID- 3633662 TI - [Now is the time for action]. PMID- 3633663 TI - [Nursing and organizational development]. PMID- 3633664 TI - [What are RIAGGs (Regional Institution for Ambulatory Mental Health Care)?]. PMID- 3633665 TI - [Chemotherapy, how can you bear it?]. PMID- 3633666 TI - [The nurse's new clothes]. PMID- 3633667 TI - [When being fat is a problem. Potential role of the nurse]. PMID- 3633668 TI - [Nurses and euthanasia. Roles--tasks--qualifications--responsibilities]. PMID- 3633669 TI - [Care and cost control. Cost control in health care from the nurses' viewpoint]. PMID- 3633670 TI - [Career development, but how?]. PMID- 3633671 TI - [Medical information for nurses. Organ transplantation. I. Vascularized allogenic organ transplants]. PMID- 3633672 TI - [The right to examen and correct and the nursing record]. PMID- 3633673 TI - [Emancipation of the chronic psychiatric patient]. PMID- 3633674 TI - [Inservice education 1986. A synopsis of the most important content changes]. PMID- 3633675 TI - [Acute bacterial meningitis in adults--a therapeutic problem]. AB - Even with reference to the available modern chemotherapeutics the acute bacterial meningitis represents a therapeutic problem. References to indication and dosage of several chemotherapeutics are given on the basis of recent knowledge of liquor metabolism as well as clinical and experimental findings. The used doses in medical practice are mostly situated below the necessary doses and could be the cause for a non-sufficient reaction among other things. PMID- 3633677 TI - How do you manage epicardial wires? PMID- 3633676 TI - A 'home-fashioned' disposable ear irrigation. PMID- 3633678 TI - Too soon to give up?! PMID- 3633679 TI - Autonomic neuropathy. Diabetics' hidden foe. PMID- 3633680 TI - Living wills. Do nurses and physicians have them? PMID- 3633681 TI - Nursing management. Playing to win. PMID- 3633682 TI - Depression. Acute care in the hospital. PMID- 3633683 TI - Depression. A case of anger and alienation. PMID- 3633684 TI - 5 nursing lessons from a patient with T.E.N. PMID- 3633685 TI - Start your own library. PMID- 3633686 TI - Tailoring care plans to nursing diagnoses. PMID- 3633687 TI - City streets--the public health ICU. PMID- 3633688 TI - The ax is about to fall. PMID- 3633689 TI - Staffing: sometimes a no-win situation. PMID- 3633690 TI - RN to BSN: fitting the pieces together. PMID- 3633692 TI - Shock (wave) treatment for kidney stones. PMID- 3633691 TI - The "simple" Valsalva. PMID- 3633693 TI - Exciting external pacemakers. PMID- 3633694 TI - Life/death/life. PMID- 3633695 TI - Nurses' views of NDEs. PMID- 3633696 TI - Studying the NDE phenomenon. PMID- 3633697 TI - Pressure sores in the homebound: one solution. PMID- 3633698 TI - Swept away by technology. PMID- 3633699 TI - Topical vancomycin formulation for methicillin-resistant Staphylococcus epidermidis blepharoconjunctivitis. AB - We successfully treated two patients with severe Staphylococcus epidermidis blepharoconjunctivitis by means of a topical vancomycin hydrochloride solution (50 mg/ml) prepared with sterile water. Aqueous vancomycin preparations, however, cause significant ocular irritation probably because of low pH and osmolality values. Solutions prepared with normal saline (5 mg/ml) and phosphate-buffered artificial tears (5 mg/ml and 50 mg/ml) were significantly less irritating and possessed equivalent in vitro antimicrobial activity. Topical vancomycin should be used only when commercially available antibiotics are inadequate. PMID- 3633700 TI - Inhibition of cycling and noncycling cross bridges in skinned smooth muscle by vanadate. AB - Vanadate (Vi, 3-300 microM) reversibly inhibited force development elicited by micromolar Ca2+ in membrane-skinned fibers of smooth muscle from taenia coli and trachea of guinea pig. When relaxed fibers were preincubated with Vi, the contraction to Ca2+ was characterized by a peak response followed by a lower steady-state phase. The peak phase depended on the rate of contraction and the [Vi]and was absent after Vi incubation during a previous contraction. These observations were consistent with Vi binding to a site that was exposed during the cross-bridge cycle but absent in the relaxed state. The actin X myosin X ADP intermediate formed at the active site during the cross-bridge cycle is suggested as the site of action of Vi. A weak antagonism between Pi and Vi was demonstrated during contractions activated by myosin thiophosphorylation. High concentrations of Pi (6-12 mM) were needed to produce a small inhibition (10%) of maximal Ca2+ activated tension. Skinned fibers relaxed slowly after Ca2+ removal, and the absence of an active state suggested that tension was maintained by noncycling cross bridges. Both Vi and Pi increased the rate of tension loss by 10-fold, but Vi was 5-10 times more potent than Pi. It is suggested that Vi and Pi both act on the active site but that Pi has a more efficacious action on slowly cycling than rapidly cycling cross bridges. PMID- 3633701 TI - Effect of amiloride on urinary and renal kallikrein in the rat. AB - A single intraperitoneal injection of amiloride in the range of 2.7, 5.4, 10.9, and 21 mumol/100 g body wt in female adult rats produced, in the two successive periods of 4 h following its administration, a significant decrease in the urinary excretory rate of kallikrein. Amiloride, 10.9 mumol/100 g body wt, which significantly reduced active kallikrein, also decreased, but less significantly, the trypsin-activated kallikrein in the urine. The fall in the excretory rate of kallikrein cannot be explained by its enzymatic inhibition by amiloride, since the inhibition was only present at higher concentrations. In hyperhydrated rats amiloride did not change the kallikrein excretory rate in the urine collected within 4 h after the injection. Rats simultaneously injected with 7.6 mumol/100 g body wt furosemide and 10.9 mumol/100 g body wt amiloride excreted levels of kallikrein similar to those found in rats injected with furosemide alone. The kidneys of rats removed after 4 h of administration of 10.9 mumol/100 g body wt amiloride showed a significant lowering of the kallikrein activity compared with the respective controls. The decrease of renal kallikrein tended to be similarly pronounced in those rats that received amiloride and furosemide simultaneously. These results confirm the depressive effect of amiloride on kallikrein excretion, which may be explained by an inhibitory action on kallikrein release, activation, and synthesis by the renal cells. PMID- 3633702 TI - Perceptions and beliefs of nursing and medical personnel about needle-handling practices and needlestick injuries. AB - A survey of 1473 nursing and medical personnel employed in two hospitals in a large metropolitan area was conducted to determine perceptions and beliefs about needle-handling practices and needlestick injuries. Additional questions in the survey focused on responsibility for discarding needles and syringes and the correct practice for disposal of needles and syringes in various situations presented. Analyses were based on 488 responses (33%). Nurses at the 437-bed University Hospital handled more needles and experienced more needlestick injuries than did nurses at the 300-bed Community Hospital. Needle-handling and needlestick injuries among medical personnel at the two hospitals were similar, although University Hospital interns and residents and University Hospital fourth year medical students handled more needles than did the medical staff at either hospital. A total of 164 (33.6%) respondents reported receiving one or more needlestick injuries during 1983. A large proportion of respondents in each group reported that they did nothing about the needlestick injuries they experienced. Carelessness was perceived by all groups to be the most common reason for needlestick injuries. Most respondents reported some knowledge of proper needle disposal techniques and perceived lack of knowledge as the least important reason for needlestick injuries. PMID- 3633703 TI - Certification: philosophy, goals, and methods, with application to the discipline of infection control practice. AB - The philosophy, goals, and methods of certification are complex and need to be understood in general before they can be applied to a specific practice discipline. This article is intended to provide background information about certification, summarize the history of credentialing for health occupations, and briefly describe methods for test design and construction. Philosophy, goals, methods, and preparation for certification are then applied to the discipline of infection control practice, with specific reference to the Infection Control Certification Examination, offered for the first time in November 1983 and in each subsequent year. PMID- 3633704 TI - Infection control for the emergency medical technician: developing an educational program. PMID- 3633705 TI - Reagan's 1987 budget eliminates nursing funds. PMID- 3633706 TI - Nurse practitioners show nursing's promise. PMID- 3633707 TI - Laws in 25 states provide for direct pay to nurses. PMID- 3633708 TI - Advanced nursing care is focus of ANA lobbying. PMID- 3633710 TI - Nurse practitioner alliance will benefit nursing. PMID- 3633709 TI - Court rules against key provision of budget law. PMID- 3633711 TI - As I see it... progress, pain are part of NPs' first 20 years. PMID- 3633712 TI - SNA groups provide support for nurse practitioners. PMID- 3633713 TI - The AIDS hysteria: how it began and what nurses can do. PMID- 3633714 TI - Reader questions sinus article. PMID- 3633715 TI - Help for nurses' questions about refusal to follow directives from their employers. PMID- 3633716 TI - Effective criticism. Producing positive changes. PMID- 3633717 TI - Death in the OR: one nurse's perspective. PMID- 3633718 TI - Solving ethical problems. PMID- 3633719 TI - The pioneer spirit in first assisting. AB - Unless RNs are willing to accept this responsibility, less trained people will be more than happy to do so. We have given away many of our technical skills in the past, such as allowing technicians to become firmly entrenched in the scrub role. I hope we don't let this opportunity slip through our hands because we have lost the pioneering spirit of our nursing heritage. Thirty years ago, the issue was whether or not nurses could take blood pressures. More recently, it has been whether nurses could use the defibrillator. Now both are accepted without a thought. Those of us who have chosen to expand our practice must be patient with our colleagues who have not had an opportunity to work through both sides of the issue, and encourage them to do so. There will be those who choose not to function in this role, and I believe that first assisting is not for everyone. But in order to have a choice, the option must be there. PMID- 3633720 TI - Thymectomy. Surgical procedure for myasthenia gravis. PMID- 3633721 TI - Permanent eyeliner. Microsurgical eye enhancement. PMID- 3633722 TI - Customized suture packs. A method for containing costs. PMID- 3633723 TI - Preoperative Testing Center. Central location to evaluate and educate patients. PMID- 3633724 TI - Pregnant nurses should be excused from cases involving radiation. PMID- 3633725 TI - Nurse responsibility once the surgeon is informed of a missing item; leaving one circulator to cover two rooms. PMID- 3633726 TI - [Synthesis of fragments of the D-branch of yeast valine tRNA1 and their analogs]. AB - Nonanucleotide GpUpCpUpApGpDpCpGp corresponding to the fragment 10-18 of the yeast tRNA1Val with pseudouridine-13 replaced by uridine has been synthesized. Dihydrouridine derivatives were studied as substrated of ribonucleases with various specificity and of RNA ligase. PMID- 3633727 TI - Infection prevention and control in the workplace. PMID- 3633728 TI - Infection prevention and control in the workplace (continuing education credit). PMID- 3633729 TI - Clean cuisine: infection control in food services. PMID- 3633730 TI - The best possible condition for nature to act upon host-agent environment relationships. PMID- 3633731 TI - Legionnaires' disease. PMID- 3633732 TI - Sexually transmitted diseases. PMID- 3633733 TI - A worksite behavioral health education program based on operant conditioning. PMID- 3633734 TI - Viruses: genetic parasites--last major hurdle in conquest of infectious diseases. PMID- 3633735 TI - Tuberculosis on increase. PMID- 3633736 TI - Shiftwork: its effect on health performance and well-being. PMID- 3633737 TI - An update on inflammatory bowel disease. PMID- 3633738 TI - Concerns about passive smoking. PMID- 3633739 TI - AAOHN position statements. PMID- 3633740 TI - Warning: smoking cigarettes may reduce your chances for a job. PMID- 3633741 TI - National Center for Nursing Research. PMID- 3633742 TI - Malpractice issues in childbirth: report on a national forum. PMID- 3633743 TI - Spectrin, red cell shape and deformability. I. Membrane curvature in genetic spectrin deficiency. AB - Using novel microscopic techniques for observing individual cells in suspension, the shape and deformability of the erythrocytes of a spectrin-deficient strain of mouse were investigated in vitro (fresh and after fixation) and in vivo (intravital microscopy of the mesenteric capillaries). The animals were identical to those studied by Greenquist et al. [14]; however, in contrast to the descriptions by these authors, in the present study, spherical cells were seen only exceptionally. Instead, sphero-echinocytes, spherules with tethered microvesicles, myelin figures and occasional stomato-spherocytes were observed. This pleomorphy, also seen in scanning electron micrographs, can be explained by the fact that in the majority of these cells the membrane assumes an extremely positive outward curvature. After osmotic dehydration, all cells responded by developing progressive membrane protrusions with a positive curvature. Osmotic inflation led to reincorporation of the membrane tethers. After hypoosmolar lysis, the ghosts of the spectrum-deficient mouse cells also showed a pronounced tendency to assume shapes characterized by a progressively positive outward curvature. In vivo observation of the mouse erythrocytes using high magnification interference contrast optics confirmed this in vitro observation. Thus, it is concluded that spectrin deficiency does not primarily lead to spherocytosis: instead, the equilibrium shapes assumed are associated with membrane evaginations which are easily torn off from the main cell body by mechanical forces. PMID- 3633744 TI - Spectrin, red cell shape and deformability. II. The antagonistic action of spectrin and sialic acid residues in determining membrane curvature in genetic spectrin deficiency in mice. AB - In a companion paper, the shapes of spectrin deficient mouse erythrocytes were described; in contrast to previous assumptions, spherules with tethered microvesicles rather than true "spherocytes" were found. Thence, spectrin deficient mouse erythrocytes are endowed with an excess of surface area for the given volume but the membrane is assuming a highly positive curvature. Observations during and after the action of enzymes cleaving the red cell surface charge (Neuraminidase, Trypsin, Chymotrypsin) showed that the previously positive membrane curvature, as well as the tendency of the membrane to flow into fingerlike protrusions was completely abolished. The erythrocytes of the spectrin deficient, desialylated mouse erythrocytes assumed a variety of shapes, often discocytic or even stomatocytic, i.e. their membrane presented with negative curvature. However, while these desialylated membranes could be easily deformed (elongated) by shear flow they did not recoil elastically into any definitive configuration after removal of the deforming forces. It is concluded from these observations that spectrin (acting on the inner interface between membrane and cytoplasm) and sialic acid residues (acting on the outer interface between membrane and plasma) exert antagonizing effects on membrane curvature and membrane bending elasticity. Sialic acid residues, strongly charged and situated on the outer side of the cell, produce positive membrane curvature; this observation can most readily be explained by assuming that this mechanical effect is caused by repulsive coulombic forces expanding the outer half of the bilayer. To explain the effect of the spectrin-complex in counteracting positive or in producing negative membrane curvature, a similar expansive coulombic force acting between the highly charged residues has been postulated. Thence, a model for explaining the overall elastic behaviour of the normal mammalian red cell is developed which is based on the assumption of elastic interactions of proteinacous membrane components coupled to the lipid bilayer of the membrane. PMID- 3633745 TI - A model of hemopoietic stress in a lactate dehydrogenase mouse mutant with hemolytic anemia. AB - A codominantly inherited mutation of the lactate dehydrogenase (LDH) in the C3H mouse causes a severe hemolytic anemia in homozygous mutants, whereas viability and fertility are close to normal. Investigation of multipotent hemopoietic stem cells (CFU-S), myeloid (GM-CFC) and erythroid progenitors (BFU-E, CFU-E) in femur and spleen indicates a general shift from bone marrow to splenic hemopoiesis. In terms of total body hemopoiesis, however, the BFU-E pool is 1.4- and the CFU-E pool 19-fold enlarged, whereas CFU-S and GM-CFC show little or no deviation from normal. It is concluded that this mouse mutant is an appropriate model of long term hemopoietic stress showing that compensation in this severe hemolytic anemia is achieved primarily by an increase of the number of the most mature erythroid progenitors. PMID- 3633746 TI - Effect of human plasmalipoproteins on erythropoietic progenitor cells in serum free cultures. AB - The purpose of the present study was to investigate the influence of human lipoproteins on CFU-e and BFU-e proliferation from human bone marrow in a serum free system. In our previously described miniaturized agar system the main lipoprotein-density-classes from human plasma, namely very low density lipoproteins (VLDL), intermediate density lipoproteins (IDL), low density lipoproteins (LDL), high density lipoproteins2 (HDL2) and HDL3 and a mixture of all the five lipoproteins were added in rising concentrations (from 1/10 to normal human plasma concentration) to serum-free medium containing delipidated and deionized bovine serum albumin (BSA), iron saturated transferrin and erythropoietin. The results demonstrate that all lipoproteins markedly increased the CFU-e and BFU-e proliferation after 7 and 14 days of incubation, respectively. Moreover, the lipoproteins induced a shift towards a lower threshold concentration of erythropoietin. Serumlike conditions were obtained if LDL and the mixture of lipoproteins were added to serum-free medium. Furthermore, in the serum-free cultures a maturation to the mature erythrocyte could be found. PMID- 3633747 TI - Coronary heart disease and the cardiomyopathies: where are we going? PMID- 3633748 TI - Doppler echocardiography in the evaluation of valvular heart disease. AB - Doppler echocardiography is a relatively new non-invasive technique which provides direct hemodynamic data that is complementary to M-Mode and 2 Dimensional echocardiography. This technique allows measurement of peak flow velocity through a stenotic valve and allows accurate prediction of the pressure gradient across the valve. It is a promising technique for screening patients with suspected pulmonic and aortic stenosis. It allows quantitation of gradient and valve area in patients with mitral stenosis. Doppler techniques are also valuable in detecting and semi-quantitating valvular regurgitation. Pulsed Doppler echocardiography is accurate in evaluating patients with multi-valvular disease. Finally, Doppler techniques are finding an important role in the evaluation of suspected prosthetic valve malfunction. In summary, Doppler echocardiography offers a complementary approach for direct evaluation of intracardiac hemodynamics in patients with valvular heart disease. PMID- 3633749 TI - Effect of hydrocortisone on the hemodynamics and serum CK and MBCK enzymes in acute myocardial infarct in dogs. AB - The effects of hydrocortisone on the hemodynamics and plasma creatine kinase (CK) in dogs with acute myocardial infarction were investigated. Acute myocardial infarction was produced by ligating the anterior descending branch of the left coronary artery and the effects on hemodynamics and plasma CK were observed for two hours. Complete coronary ligation produced a decrease in the cardiac index and left ventricular work index following two hours of coronary ligation. Other hemodynamic parameters (systemic and pulmonary arterial pressure, left ventricular pressure, right atrial pressure, pulmonary arterial wedge pressure, systemic and pulmonary vascular resistance, heart rate, cardiac effort) were essentially unaffected. There was a tendency for an increase in (dp/dt)/IIP but the increase was not significant. In hydrocortisone treated dogs, all the hemodynamic parameters were unaffected except the cardiac index which decreased significantly. Partial coronary ligation produced an increase in the systemic and pulmonary vascular resistance and a decrease in the cardiac index. The other hemodynamic parameters were unaffected. Plasma CK and MBCK increased significantly in dogs with partial or complete ligation of coronary artery. The serum CK was more in partially ligated than in complete coronary ligated dogs. Although hydrocortisone pretreatment decreased the rise of plasma CK it did not change the rise in MBCK observed in coronary ligated dogs without hydrocortisone treatment. These results indicate that hydrocortisone prevents, although not completely, the deleterious effects of ischemia on the plasma CK but has no effect on the increase in plasma MBCK and decrease in the cardiac index. PMID- 3633750 TI - Regional myocardial ischemia: characterization of temporal, transmural and lateral flow interfaces in the porcine heart. AB - The three-dimensional distribution of coronary flow and tissue adenosine triphosphate was characterized in the anaesthetized open pig chest after 10, 15, 30, 45, 60 and 120 min of coronary artery ligation. Radioactive microspheres were given at the onset (153-gadolinium) and end (113-tin) of ischemia. A simultaneous multiple biopsy device was used to obtain 50 contiguous transmural biopsies from each heart over an area (40 mm X 28 mm) of tissue which incorporated the centre of the ischemic zone, a lateral interface of injury and normally perfused tissue. Frozen biopsies were lyophilized, subfractionated into 2 mm transmural sections, and taken for radioactive counting. There was little or no detectable collateral flow in the ischemic zone. There was a sharp lateral flow interface which fell from 2.2 +/- 0.04 mL/min/g in normally perfused tissue to less than 2% of this value over a transition zone of less than 2 mm width. Myocardial adenosine triphosphate content showed a similar sharp interface and was severely depressed throughout the ischemic zone at all the ischemic times studied. During the 2 h ischemic period there was no increase in flow to any part of the ischemic zone and there was no change in the position, or sharpness, of the lateral interface. The absence of either lateral or transmural borderzones of intermediate injury in the pig makes pharmacological infarct size limitation highly improbable in this species. PMID- 3633751 TI - DSS--a meaning behind the BUZZ. PMID- 3633752 TI - "Gearing up" for an automated nurse scheduling system in a decentralized setting. PMID- 3633753 TI - Principles of computerized database management: considerations for the nurse administrator. PMID- 3633754 TI - Nurses' attitudes towards computerization in a Midwestern community hospital. PMID- 3633755 TI - Child abuse and community mental health practice. PMID- 3633756 TI - Challenges and changes in psychiatric nursing. PMID- 3633757 TI - Psychiatric nurses develop their own workload measurement system. PMID- 3633758 TI - AIDS: caring for your patient at home. PMID- 3633759 TI - [Reflections on AIDS]. PMID- 3633760 TI - A question of balance. PMID- 3633761 TI - [Brazil: country of contrasts]. PMID- 3633762 TI - No second chance. PMID- 3633764 TI - No frills patient education. PMID- 3633763 TI - [Towards a more positive mother-child relation]. PMID- 3633765 TI - Ethical dilemmas in the NICU. PMID- 3633766 TI - Caps, masks and boots. PMID- 3633767 TI - Nurses in trouble. PMID- 3633768 TI - [The egg-milk-orange project]. PMID- 3633769 TI - Designing nursing care for patients with peripheral arterial occlusive disease. Part I. Update. PMID- 3633770 TI - Peripheral arterial occlusive disease. Part II. Nursing assessment and standard care plans. PMID- 3633771 TI - Legislative phone tree: how one district initiated a plan to improve communication. PMID- 3633773 TI - Political action in nursing: the role of nursing education. PMID- 3633772 TI - The contact activation system: biochemistry and interactions of these surface mediated defense reactions. AB - This review is intended to be a critical state-of-the-art overview of the activation and inhibition of the proteins (factor XII, prekallikrein, high molecular weight kininogen, and factor XI) of the contact phase of coagulation. Specifically, this review will reconsider the concept of the reciprocal activation of the proteases of the contact phase of coagulation, factor XII, and prekallikrein, in light of much recent evidence indicating that factor XII, itself, autoactivates when associated with negatively charged surfaces. In addition, the mechanisms for amplification of activation of the proteins of the contact phase of coagulation will be discussed from the pivotal role of high molecular weight kininogen, or one of its altered forms, serving as a cofactor to order the activation of the zymogens it is associated with. The role and relative importance of each of the naturally occurring plasma protease inhibitors (C1 inhibitor, alpha-2-macroglobulin, alpha-1-antitrypsin, antithrombin III, and alpha-1-antiplasmin) will be assessed as they relate to the dampening of contact phase activation. Finally, the contact phase of coagulation activation will be discussed not only as a plasma proteolytic mechanism, but also as it interacts with platelets. PMID- 3633774 TI - Nutrition and lung water. AB - Lung water homeostasis and the subsequent prevention of pulmonary edema involve a balance of many forces and safety factors. Malnutrition and its effects on fluid distribution within body compartments and on oncotic pressure gradients can play a crucial role in this balance of forces. These forces are discussed, with emphasis on the complications of superimposed malnutrition. PMID- 3633775 TI - Comparison of antibiotic resistance of gram-negative bacilli with beta-lactam and aminoglycoside antibiotics. AB - In 1981 a comparison of the resistance rates of aminoglycosides, penicillins, cephalosporins, and nalidixic acid was made in species of gram-negative rods between a hospital in Toulouse, France and one in Brooklyn, New York. The results showed similar rates of resistance from both institutions. Both institutions showed high rates of aminoglycoside resistance; high ampicillin resistance among salmonella and Pseudomonas mirabilis in France and shigella in New York City; similar rates of resistance to cephalosporins and finally, markedly different incidences of resistance to naladixic acid. Analysis of medical records over several years indicated a gradual but continuing increase in resistance to aminoglycosides. The majority of such isolates had been isolated from patients in intensive care units. Few differences in the rates of resistance to the cephalosporins were noted between the two institutions, either for the older or newer agents in this group. Further, no increase in resistance was noted to this group of antibiotics in the previous 5 yr. PMID- 3633777 TI - Elderly people. Staying put. PMID- 3633776 TI - Inhibitory effect of carp muscle trypsin inhibitor on mammalian pancreatic proteinases. AB - Carp muscle trypsin inhibitor showed an inhibitory effect on bovine trypsin, bovine alpha-chymotrypsin and porcine elastase in a non-competitive, competitive and competitive manner, respectively. The inhibitor formed a stable complex with the above proteinases which was not dissociated in the presence of 2 mercaptoethanol and SDS. The true target proteinase for carp muscle trypsin inhibitor, as yet unknown, seems to be an alpha-chymotrypsin- or elastase-like enzyme rather than trypsin, judging from the manner of inhibition. PMID- 3633778 TI - Students. Outward bound. PMID- 3633779 TI - A centre for change. PMID- 3633780 TI - Promoting continence. Staying fresh. PMID- 3633781 TI - Enuresis. Dry at night. PMID- 3633782 TI - Health visiting. Parents as partners. PMID- 3633783 TI - Strength through unity. Bard nursing award. PMID- 3633784 TI - Elderly people. The emperor's new clothes. PMID- 3633786 TI - The impaired nurse: whose responsibility? PMID- 3633785 TI - Infant feeding--milking the market. PMID- 3633787 TI - CNA's peer assistance network for nurses. PMID- 3633788 TI - A computer at every bedside: issues and obstacles. PMID- 3633789 TI - IV bolus: effective, but potentially hazardous (continuing education credit). PMID- 3633790 TI - Hemodynamic assessment using the automated physiologic profile. PMID- 3633791 TI - Room temperature injectate and iced injectate for cardiac output: a comparative study. PMID- 3633792 TI - ECG challenge. PMID- 3633793 TI - Nursing care plan. Major thermal injury--the first 48 hours (continuing education credit). PMID- 3633794 TI - Comparison of major stressors perceived by ICU and non-ICU nurses. PMID- 3633795 TI - Specialized nutrition for critical care. PMID- 3633797 TI - Monitoring intra-arterial pressure. PMID- 3633796 TI - Rectal temperatures are as acurrate as oral temperatures in patients receiving oxygen therapy. Nursing rules: fact or facy? PMID- 3633798 TI - Learning labs: critical care. PMID- 3633799 TI - Reducing loneliness in critical care. PMID- 3633800 TI - Preventing complications in continuous arteriovenous hemofiltration. PMID- 3633801 TI - Temporary epicardial electrodes. PMID- 3633802 TI - Invasive pressure monitoring: a modified system for pediatrics. PMID- 3633804 TI - Organ donation. PMID- 3633803 TI - The role of the critical care nurse in developing informed consent (continuing education credit). PMID- 3633805 TI - Gestational diabetes mellitus and diet control. PMID- 3633806 TI - The accuracy of glucose monitoring by diabetic individuals in their home setting. PMID- 3633807 TI - The stability of Chemstrip bG used in conjunction with AccuChek bG. PMID- 3633808 TI - The biggest problem in diabetes. PMID- 3633809 TI - A test of instruction approaches designed to influence food selection. PMID- 3633810 TI - Teaching Braille reading to tactilely impaired, blind adults with diabetes: case report. PMID- 3633811 TI - Evaluating a workshop model for improving diabetes patient education programs: is it really successful? PMID- 3633812 TI - Evaluation of "Life with Diabetes" patient education booklets. PMID- 3633813 TI - CHID: an automated information retrieval system. PMID- 3633814 TI - Streamlining in-hospital diabetes education. PMID- 3633815 TI - Effects of ammonium nitrate aerosol exposure on lung structure of normal and elastase-impaired rats and guinea pigs. AB - Groups of rats and guinea pigs with normal lungs and others with elastase-induced emphysema were exposed to NH4NO3 aerosols of 0.60 mass median aerodynamic diameter at 1 mg/m3 for 6 hr/day, 5 days/week, for 4 weeks. Morphologic and morphometric studies were performed on lungs perfused with cacodylate-buffered 2% glutaraldehyde under 20 cm H2O pressure at necropsy. The tissues were studied for pathologic change by light and electron microscopy; emphysema was evaluated by subgross and microscopic methods, including changes in mean alveolar chord length using scanning electron microscopy techniques. Elastase produced emphysema to a degree quantifiable by all criteria studied; however, it apparently obscured the effects of nitrate inhalation. The NH4NO3 exposure (compared to air alone) tended to increase values for pulmonary parameters in normal animals of both species and to decrease them in elastase-treated animals. The NH4NO3 exposure increased values for lung volume in rats, percentage area affected in elastase-treated rats, and chord length beta in normal animals of both species. The responses to NH4NO3 were slight (P less than 0.10) and were not accompanied by any detectable changes in alveolar structure. Therefore, the effects of NH4NO3 at this exposure level and duration, are regarded as biologically insignificant for rats and guinea pigs. PMID- 3633816 TI - [Organization of the prevention of allergies]. PMID- 3633817 TI - [Measles]. PMID- 3633818 TI - [Differentiation of acute appendicitis from kidney pathology and gynecologic diseases]. PMID- 3633819 TI - [Tuberculosis of the breast]. PMID- 3633820 TI - [Allergy]. PMID- 3633821 TI - [Abscess and gangrene of the lungs]. PMID- 3633822 TI - [Differential diagnosis of the abdominal pain syndrome]. PMID- 3633824 TI - [Use of elastic tubular gauze bandages in surgical practice]. PMID- 3633823 TI - [Injuries to the knee joint]. PMID- 3633825 TI - [Regulations for calculating the continuous work service record of workers and employees in assigning benefits under the State Social Insurance]. PMID- 3633827 TI - Disaster: knowledge is critical. PMID- 3633826 TI - What about spouses? S-O-S! PMID- 3633828 TI - Intravenous fibrinolytic therapy in a community hospital. PMID- 3633829 TI - I was negligent. Will I lose my nursing license? PMID- 3633830 TI - Children's understanding of death and dying. PMID- 3633831 TI - Implications of administering drugs in renal insufficiency. PMID- 3633832 TI - Saudi Arabia: an overview of nursing and health care. PMID- 3633833 TI - Barbara Dossey: practicing what she preaches. PMID- 3633834 TI - Awareness adventurous commitment networking. PMID- 3633835 TI - Cancer: the right to refuse treatment. PMID- 3633836 TI - Home health care oncology nursing. PMID- 3633837 TI - Undergraduate cancer education. PMID- 3633838 TI - Ethical considerations in nursing. PMID- 3633839 TI - Case studies: a practical way to teach bioethics. PMID- 3633840 TI - Ethics in nursing curricula. PMID- 3633841 TI - Formation of Bioethics Council--Florida Nurses Association. PMID- 3633842 TI - Seminar discusses "AIDS: issues in the workplace". PMID- 3633843 TI - Getting to really know nursing. PMID- 3633844 TI - Managing through communication. PMID- 3633845 TI - Care and handling of chemotherapeutic agents. PMID- 3633846 TI - The moral decision-making process. PMID- 3633847 TI - A journalist's holiday--volunteer David Greenawalt writes on FNS subjects. PMID- 3633848 TI - C3 and Bf complement types in chronic renal failure. AB - C3 and BF allele frequencies were studied in 55 patients with idiopathic membranous nephropathy (IMN) and unrelated normal individuals from North-East England. Eighteen of these IMN patients progressed to renal failure and C3*S allele showed a significant increase in these patients. A possible mechanism for this increase is briefly discussed. PMID- 3633849 TI - A nutritional challenge: the elderly patient with dysphagia. PMID- 3633850 TI - Multidisciplinary geriatric interest group: meeting the needs of the elderly in an acute care setting. PMID- 3633851 TI - The grey area of geropsychiatry: pseudodementia. PMID- 3633852 TI - The visibility and health of the aged in Canadian commercials. PMID- 3633853 TI - Out of the jungle and into the zoo: living in a long-term institution. PMID- 3633855 TI - Herbal remedies: food for thought. PMID- 3633854 TI - 7 stories in black & white from left to right. PMID- 3633857 TI - The district nurse and anticipatory care of the elderly in the community. PMID- 3633856 TI - Home care for the highly dependent. PMID- 3633858 TI - 'All her own teeth!'. PMID- 3633859 TI - Give your back a rest and your patients a lift. PMID- 3633860 TI - Hypothermia--an insidious condition. PMID- 3633861 TI - An approach to undergraduate student investigations in clinical settings. PMID- 3633862 TI - A descriptive profile of type B personality. PMID- 3633863 TI - Self-esteem in women: the influence of employment and perception of husband's appraisals. PMID- 3633864 TI - Comparable worth: an issue whose time has come? PMID- 3633865 TI - Ambulatory care centers: a new alternative for nurses. PMID- 3633866 TI - Associate degree nurse: R.N. of course! PMID- 3633867 TI - The entry level into practice--the baccalaureate degree. PMID- 3633868 TI - A diploma educator's view of entry into practice. PMID- 3633869 TI - Report of the Ad Hoc Committee on Titling and Entry into Nursing Practice. PMID- 3633870 TI - Redefining the role of the nurse. PMID- 3633871 TI - Independent study in nursing school: how to make it easier and fun. PMID- 3633872 TI - Empathy. PMID- 3633874 TI - The rehabilitation and nursing care of severely disabled psychiatric patients. AB - The purpose of this paper is to describe an exploratory study of long-term care of mentally ill people in a hospital ward and the factors which may hinder or facilitate their rehabilitation and nursing care. The findings suggest that three aspects appear to be particularly relevant: the peer group support patients experience in long-term care, the level of nurse/patient interaction and the weak accountability of nurses for their patients on an individual basis. PMID- 3633875 TI - Teaching and adaptation of patients with myocardial infarction. AB - The role of teaching in facilitating adaptation were examined in 60 patients with myocardial infarction (MI) of working age (under 65 years). Recovery of three different patient groups were followed for one year at three times: at discharge and three months and one year after it. Data for evaluating the effects of the teaching program on the patients and their close relatives were collected by questionnaires from the patients at discharge and by interviewing the patients three months after discharge. Information on patients' recovery during the first year after MI was collected from patients' records. Impact of teaching was prominent on several outcome measures. Patients' knowledge of illness and care increased, they also perceived having received more information and support. The time devoted to exercise increased after myocardial infarction and amount of butter used on bread decreased in the follow-up state. No impact was observed on the outcome variables measuring patient's use of alcohol and smoking. Some of the impacts at the early stages of the convalescence were not lasting. After one year of MI patients had partly returned to their old life styles, for example some patients had resumed the smoking habit. Teaching of close relatives improved only slightly. PMID- 3633873 TI - Restriction of the alternative pathway of human complement by intact Trypanosoma brucei subsp. gambiense. AB - We studied the interaction of African trypanosomes with human complement. Bloodstream forms of Trypanosoma brucei subsp. gambiense isolated from mice activated the alternative pathway of complement during a 30-min incubation in vitro. In human serum, all cells remained intact and motile during this period. C3 was detected on the surface by a direct binding assay with a monoclonal antibody which recognizes C3b and iC3b. C3 deposition could also be detected by this radioimmunoassay when parasites were incubated with purified C3. Such C3 binding was enhanced by factor B, factor D, and magnesium. Surface deposition of factor B was demonstrated both by flow immunofluorescence analysis and binding of radiolabeled factor B. C3 binding and factor B binding were inhibitable by EDTA but not by ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N' -tetraacetic acid (EGTA). The inhibited binding could be restored by addition of magnesium. No human immunoglobulin G or mouse immunoglobulin was detected on the trypanosome surface. By flow cytometry, neither human C5 nor polymerized C9 was detected on trypanosomes incubated in serum, although this assay was able to detect C5 and C9 on the surface of complement-treated human erythrocytes. Using a radioimmunoassay which measures C5b-9 in serum, we found that there was no generation of SC5b-9 in serum which had been incubated with trypanosomes. We concluded that, although trypanosomes activate the alternative pathway of complement, they are not lysed, because the cascade does not continue beyond the establishment of C3 convertase. PMID- 3633876 TI - An evaluation of the effects of shift rotation on nurses' stress, coping and strain. PMID- 3633877 TI - A conceptual framework to study the use of nursing care plans. AB - Value-expectancy theory proposed by Lewin states that motivation for behaviour is based on the probability that a given action or behaviour will achieve a valued or desired outcome. Becker and Maiman elaborated on this theory and developed a model to study compliance by considering the influence of sociobehavioural determinants in the inter-relationship of motivating and modifying factors which dictate human behaviour. The Becker-Maiman framework was used to determine factors which influence the use of the nursing care plan by staff nurses. From interviews with staff nurses, surveys of nurses attending workshops on NCPs and review of literature a model was developed for use in examining the nursing care planning behaviour of nurses. PMID- 3633878 TI - Health policy opinions of graduate students in nursing. AB - Post-graduate students in a School of Nursing whose curriculum represents a broad view of the problems and improvement strategies of contemporary health were surveyed on issues in health policy at the beginning of their study and two years later. They formed one group in a survey of the training programs of 12 health professions; this was part of a project surveying leadership of the major organizations active in health policy-making in the United States. Nursing students moved significantly toward more progressive positions on all categories of issues. At the end of two years of graduate study, student opinions were consistent with the leadership of the nursing profession. PMID- 3633879 TI - Physiologic and microbiologic changes in skin related to frequent handwashing. AB - Handwashing practices may be adversely influenced by the detrimental effects of handwashing on skin. A protocol was developed to assess the physiologic and microbiologic effects of frequent handwashing. Fifty-two female volunteers washed their hands 24 times per day for 5 days. Five agents were tested: water alone, non-medicated bar soap, a chlorhexidine-containing antiseptic, and two agents containing povidone-iodine (one currently available on the market and one being tested for possible marketing). Some damage to the outer membrane of skin, the stratum corneum, occurred in all groups. There were significant changes in the amount of evaporation water loss (p = .001) and in self assessments of skin condition (p = .005) from pre-to-post test for the entire group. Skin damage was also assessed by visualizing desquamating stratum corneum cells, which are shed in large aggregates when detergents injure skin. Significantly less such shedding occurred in subjects using water alone, bar soap, and the chlorhexidine formulation (p = .02). Greater antimicrobial activity of an agent was not correlated with increased skin trauma. We have quantitated, using objective physiologic parameter, the skin damage that occurs during even a short period of frequent handwashing. We recommend that further studies using the methods described be conducted to quantitate skin damage over longer periods of time, more closely resembling handwashing practices of health care personnel. PMID- 3633880 TI - The prevalence of hepatitis B in employees of small, rural hospitals- implications for vaccine administration. AB - The Centers for Disease Control Advisory Committee on Immunization Practices has based recommendations for hepatitis B vaccine for hospital employees on studies done in large urban hospitals. Data on the prevalence of hepatitis B in employees of small hospitals have been lacking. We measured hepatitis B surface and core antibody in 422 employees of six small, rural hospitals who were exposed to blood. The overall prevalence among those "high-risk" employees was 5.5%. The highest prevalence was found in General Nursing, Intensive Care Nursing, Recovery Room, IV Therapy, Laboratory, and Respiratory Therapy, although differences were seen between hospitals. Results of such testing for individual hospitals may have a major impact on the cost-effectiveness of vaccination programs for their employees. PMID- 3633881 TI - Nosocomial Mycobacterium gordonae pseudoinfection from contaminated ice machines. AB - Thirty-two clinical specimens submitted to the laboratory during a 12-month period from July 1980 to June 1981 were reported to be culture-positive for Mycobacterium gordonae, an organism generally considered to be a slow-growing saprophyte with natural habitats which include soil and water. Only seven similar isolates had been recovered in the preceding 4 1/2 year period. The discordance between clinical findings and the mycobacterial cultures suggested extrinsic contamination of the specimens. Contamination in the laboratory was believed unlikely because: 1) clinical samples obtained in an aseptic manner were never contaminated; 2) various surveillance cultures of reagents and deionized water used in the laboratory were negative; and 3) substitution of deionized water with sterile water did not control the outbreak. Extensive hospital-wide cultures of water sources implicated the use of ice and ice water from contaminated ice machines as the source of this pseudoepidemic. Cleaning of the ice machines resulted in a sharp decrease in the number of M. gordonae isolates. Pseudoinfection by M. gordonae from improperly maintained ice machines has not been reported before. PMID- 3633882 TI - Systemic and topical antimicrobial agents in the prevention of catheter associated bacteriuria and its consequences. PMID- 3633883 TI - The sources of pneumonia in ITU patients. PMID- 3633884 TI - Zero infection rate: an achievable irreducible minimum in clean surgery? PMID- 3633885 TI - Wound infection. PMID- 3633886 TI - Skin as a source for hospital infection. PMID- 3633887 TI - Skin as a source of nosocomial infection: directions for future research. PMID- 3633888 TI - Methicillin-resistant S. aureus and S. epidermidis strains: modern hospital pathogens. PMID- 3633890 TI - Endemic nosocomial filamentous fungal disease: a proposed structure for conceptualizing and studying the environmental hazard. PMID- 3633889 TI - Endemic emergence of cephalosporin-resistant Enterobacter: relation to prior therapy. PMID- 3633891 TI - Other approaches to the prevention of aspergillosis. PMID- 3633892 TI - Infections in hematologic malignancy. PMID- 3633894 TI - Proceedings of the Second ICI/Stuart Workshop. Apache Junction, Arizona, September 26-29, 1985. PMID- 3633893 TI - Nosocomial infection prevalence, risk and control in small community and rural hospitals. PMID- 3633895 TI - Nosocomial infection--the irreducible minimum. PMID- 3633896 TI - Nosocomial bacteriuria: estimating the potential for prevention by closed sterile urinary drainage. PMID- 3633897 TI - Methicillin-susceptible "methicillin-resistant Staphylococcus aureus": a sheep in wolves' clothing. PMID- 3633898 TI - Methicillin-resistant Staphylococcus aureus: how reliable is laboratory reporting? AB - Microbiology laboratories in Oregon were surveyed in 1981 to determine how often methicillin-resistant Staphylococcus aureus (MRSA) was being reported to physicians in the state. Results of this survey were surprising in three respects. First, the mean percent of S. aureus isolates reported by laboratories as methicillin-resistant was 8.3%. Second, a significant inverse correlation was found between the percent of reported MRSA and laboratory size (p = 0.0001). Finally, laboratories which retested initially resistant isolates reported significantly less MRSA (mean 3.3%, median 1%) than those laboratories which accepted initial results (mean 20%, median 12%) (p = 0.0001). Independent testing by the Centers for Disease Control of isolates reported to be MRSA confirmed that some misidentification was occurring. Participating laboratories were notified of our initial findings and their potentially serious clinical ramifications. Laboratories were resurveyed in 1982, and a significant decrease in the reported MRSA to a mean percentage of 3.4% was observed (p = 0.002). It is unlikely that this situation is unique to Oregon, and similar misreporting of MRSA to physicians in other areas of the country may be compromising the safe and effective treatment of S. aureus infections. PMID- 3633899 TI - All-inclusive concurrent antibiotic usage review: a way to reduce misuse without formal controls. AB - During an 11-week period, all antibiotic usage on a 113-bed medical teaching service was reviewed concurrently in weekly sessions between house staff and a review team. Recommendations for change, based on accepted criteria, were communicated by the house officer to the attending physician. In one-half of the patients no change was suggested; in one-third, a recommended change was made; and in only one-sixth was a recommendation not followed. Cost savings were conservatively estimated to approach $10,000 in this pilot study; this extrapolates to almost $300,000 per year for the 714-bed medical center, or more than 18% of the antibiotic expenditures. This program achieves its objective in a nonthreatening, noncontrolling manner, provides continuing education, and contributes to improved patient care. PMID- 3633900 TI - Nosocomial outbreak of hand-foot-and-mouth disease among operating suite personnel. AB - In the fall of 1983 an outbreak of hand-foot-and-mouth disease occurred in a large urban hospital. The outbreak began among surgical nurses confined to one area of the operating suite and appeared to spread by direct contact to personnel working in the other areas. No cases were diagnosed among hospital patients. There was no evidence to support an ongoing community epidemic as only three of 98 physicians surveyed had seen hand-foot-and-mouth disease in their practices, and none occurred among family members of 94 unaffected employees. The outbreak resulted in 82 lost workdays at an estimated cost to the hospital of $5,676. Existing infection control guidelines do not address the issue of transmission of hand-foot-and-mouth disease from hospital personnel to patients; our experience suggests that the risk of transmission, at least in the operating suite environment, may be greater for other personnel than for patients. PMID- 3633901 TI - Microbial adherence and infection--clinical relevance. AB - Adherence mechanisms have been described for some microbes, often in direct association with onset of infection. In other cases, the evidence is vague. This article will summarize modes of attachment, and will focus on each anatomical tract in an effort to outline the relationship between microbial adherence, host cells, foreign bodies, and infection. PMID- 3633902 TI - Waterless agents for decontaminating the hands. PMID- 3633903 TI - CDC guideline for prevention of surgical wound infections, 1985. Supersedes guideline for prevention of surgical wound infections published in 1982. (Originally published in November 1985). Revised. PMID- 3633904 TI - Towards a change in nursing practice. PMID- 3633906 TI - U.S. nurse consultants in the international marketplace. AB - Although a significant number of United States nurses is active in international interactions within sociocultural, economic and political contexts different from this country, little is known about international consultation by these nurses. This study identifies the consultants, the clients, the nature of advice given, and the attitude and beliefs of the consultants. PMID- 3633905 TI - Professional credibility for the psychiatric nurse: a question of survival. PMID- 3633907 TI - Higher nursing education in Bavaria and in Florida. AB - A German programme for nursing administrators and nurse educators in Bavaria is compared with similar programmes in Miami, Florida. The German students are full time students whereas their American counterparts remain full-time employees, part-time students and are frequently heads of households. PMID- 3633908 TI - Familial abuse of the elderly: a look at caregiver potential and prevention. PMID- 3633909 TI - Geriatric falls in the home. PMID- 3633910 TI - Neighborhood resources for the elderly. PMID- 3633911 TI - Use of protocols in home care: an innovative approach to meet today's needs. PMID- 3633912 TI - The legalities of home care. Should a home health nurse carry her own professional liability insurance? PMID- 3633913 TI - Breastfeeding: a preventive approach to health care in infancy. PMID- 3633914 TI - Development of a clinical assessment scale: evaluation of the psychosocial impact of childhood illness on the family. PMID- 3633915 TI - Prevention of childhood obesity. PMID- 3633916 TI - A theoretical framework for standard care plans: a nursing approach for working with chronically ill children and their families. PMID- 3633917 TI - Nonorganic failure to thrive: a pediatric social illness. PMID- 3633918 TI - Practice of the Master's-prepared nurse in pediatrics. PMID- 3633919 TI - Nursing management of the pediatric AIDS patient. PMID- 3633920 TI - Relationship of burnout to personal and job-related variables in acute-care pediatric settings. PMID- 3633921 TI - Practical aspects of toilet training the child with a physical disability. PMID- 3633922 TI - Promoting child development for hard-to-reach high-risk families. PMID- 3633923 TI - Effects of tRNATyr point mutations on the binding of yeast RNA polymerase III transcription factor C. AB - A physical DNA binding assay was employed to analyze the binding of yeast RNA polymerase III transcription factor C (TFIIIC) to tRNA genes. The assay allowed us to measure the equilibrium constants for specific and nonspecific TFIIIC-DNA binding and to assess the effects of tRNATyr-DNA gene promoter mutations on binding. Sequence alterations in the B block element of the promoter greatly affect the equilibrium constant for specific TFIIIC binding (K8). Mutations which decrease tRNATyr homology to the recognized B block consensus sequence drastically reduce K8 (43- to 370-fold), while mutations which increase homology increase K8 (4- to 5-fold). By contrast, point mutations in the A block element of the tRNATyr promoter have less than 2-fold effects on K8; however, total deletion of A block sequences reduces K8 2- to 5-fold. These results indicate that TFIIIC-rTNA gene binding involves interactions with both A block and B block sequences, but B block interactions dominate, and the relative contribution of A block interactions is small. Since A block sequences are absolutely required for active tRNA gene transcription, the binding results suggest that the role of A block sequences in transcription is not confined solely to TFIIIC binding. PMID- 3633924 TI - Evaluation of the AutoMicrobic system Gram-Positive Susceptibility-MIC card for detection of oxacillin-resistant coagulase-negative staphylococci. AB - A total of 398 consecutive clinical staphylococcus isolates, of which 205 were coagulase negative and 193 were coagulase positive, were tested in parallel by using AutoMicrobic system Gram-Positive Susceptibility-MIC cards and modified Mueller-Hinton agar containing 4% NaCl and oxacillin (6 micrograms/ml). The AutoMicrobic system cards correctly detected 103 of 104 (99%) oxacillin-resistant coagulase-negative isolates with no reports of false resistance. PMID- 3633926 TI - Faculty and student perceptions of computer applications in nursing. PMID- 3633925 TI - Human complement protein D catabolism by the rat kidney. AB - Factor D (D) is an essential component of the alternative complement pathway. To determine whether D is catabolized by the kidney and, if so, at what site, we studied the renal handling of human D by in vivo nephron microperfusion and in vitro perfusion of rat kidneys. Human D was purified and labeled with 125I. Individual nephrons were perfused in vivo at varying rates with perfusate that contained 125I-D and [14C]inulin. When nephrons were perfused from proximal sites with perfusate 125I-D in a concentration of 3.0 micrograms/ml, urinary recovery of 125I-D increased (P less than 0.05) from 57.7 +/- 5.0 to 74.4 +/- 2.5% as tubule fluid flow rate was increased from 10 to 40 nl/min; recovery of 125I-D was less than (P less than 0.001) [14C]inulin recovery at all perfusion rates. At 20 nl/min, an increase in perfusate 125I-D concentration from 1.5 to 3.0 micrograms/ml was associated with an increase (P less than 0.001) in urinary 125I D recovery (42.1 +/- 4.0 vs. 65.8 +/- 2.6%). Similarly, the addition of unlabeled D, 30 micrograms/ml, to 125I-D, 3.0 micrograms/ml, increased urinary 125I-D recovery (95.3 +/- 2.1%) at 20 nl/min. When nephrons were perfused from early distal segments at 10 nl/min, 125I-D recovery (91.2 +/- 4.3%) did not differ from [14C]inulin recovery (95.8 +/- 1.3%). In the isolated perfused filtering kidney, the concentration of intact 125I-D in the perfusate declined 60.3 +/- 14.6% over 1 h. 83.4 +/- 6.3% of the decrement in 125I-D was catabolized by the kidney; the remainder was excreted in the urine as intact D. When glomerular filtration was prevented by increasing perfusate albumin concentration to 16 g/dl, perfusate intact (125I-D) remained unchanged over 1 h. These data show that human D is catabolized by the kidney via glomerular filtration and reabsorption by the proximal nephron. Reabsorption of D appears to be a saturable process. PMID- 3633927 TI - Generic baccalaureate nursing student satisfaction regarding professional and personal development prior to graduation and one year post graduation. PMID- 3633928 TI - Enrollment update: comparison of Fall 1984 and 1985 enrollments in American Association of Colleges of Nursing member schools and with trends in higher education enrollments. PMID- 3633929 TI - Reflections on facilitating collaboration between nursing service and nursing education. PMID- 3633930 TI - Nurses in China look to the future. PMID- 3633931 TI - Patient rights: when a patient's "no" had to be the nurse's "yes". PMID- 3633932 TI - The dean deals with faculty responses to curriculum revisions. PMID- 3633933 TI - Holistic nursing practice: an idea whose time has come. PMID- 3633934 TI - Nurse midwives face malpractice insurance crisis. PMID- 3633935 TI - The dean, faculty research, and entrepreneurship. PMID- 3633936 TI - Positive pressure to publish. PMID- 3633937 TI - International dimensions of nursing and health care in baccalaureate and higher degree nursing programs in the United States. PMID- 3633938 TI - Professional education: post-baccalaureate education for professional nursing. PMID- 3633939 TI - NCLEX-RN: predicting the performance of graduates of an integrated baccalaureate nursing program. PMID- 3633940 TI - Burnout among nursing home personnel. PMID- 3633941 TI - Doctoral preparation for gerontological nurses. PMID- 3633942 TI - Withholding treatment: is it ethical? PMID- 3633943 TI - Predicting and preventing confusion in your patients. PMID- 3633944 TI - Possible gastrotoxicity of NSAIDs in the elderly. PMID- 3633945 TI - Skin care for older adults. Nursing diagnosis: potential for impairment in skin integrity. PMID- 3633946 TI - Nurses as advocates. Interview by Judith Paquet. PMID- 3633947 TI - Communicating with the elderly. PMID- 3633948 TI - Effects of sodium and angiotensin II on urinary active and inactive kallikrein in rats. AB - To assess possible relationships between sodium balance, angiotensin II (ANG II), and renal active and inactive kallikrein, we studied the effects of sodium loading with 1% NaCl and chronic ANG II infusion (900 micrograms/kg per day) on the urinary excretion of total and active kallikrein for 6 days in conscious rats. We determined urinary total, active and inactive kallikrein by measuring kallikrein activity using a kininogenase assay before and after treatment with trypsin (200 micrograms/ml). Sodium loading produced a sustained increase in urinary total, active and inactive kallikrein excretion. Chronic infusion of ANG II induced a sustained increase in urinary total, active and inactive kallikrein excretion in rats on a regular diet. In rats loaded with sodium, however, ANG II did not induce any further changes in urinary kallikrein excretion. Thus, the present study suggests that both sodium loading and ANG II infusion might stimulate the synthesis of renal kallikrein. In addition, it is suggested that ANG II infusion might stimulate the synthesis of kallikrein, at least partly, via the same mechanism as sodium loading does. PMID- 3633949 TI - Characterization of monoclonal antibodies against rat glandular kallikrein. AB - Monoclonal antibodies can be produced in large amounts, are homogenous and can be highly purified. A specific monoclonal antibody against glandular kallikrein could be very useful in studies of the kallikrein-kinin system, both in vivo and in vitro. Two monoclonal antibodies against rat glandular kallikrein (rgKK) were produced by immunized mouse spleen and lymph node fusion with myeloma Ag8.653. Both antibodies, named 2E9.8 and 2E9.9, bound active 125I-kallikrein and phenylmethylsulfonyl fluoride (PMSF)-inactivated 125I-kallikrein. A radioimmunoassay (RIA) was developed with each of the antibodies using rabbit anti-mouse gamma globulin to separate bound from free 125I-rgKK. The standard curve (range 10-1000 ng/tube) was curved even when subjected to logit-log transformation. Using 3% polyethylene glycol (PEG) to assist separation of bound from free, the standard curve became straight for 2E9.8 and the RIA was more sensitive, with a binding range of 0.35-2.4 ng/tube. Both antibodies were specific for rgKK since they had negligible cross-reaction with purified proteases from the submandibular gland of the rat (tonin, esterases B and E). They did not cross-react with mouse nerve growth factor, epidermal growth factor, nor with pig pancreatic kallikrein. Antibody 2E9.9 did appear to bind some human kallikrein when tested with high concentrations of this enzyme, while 2E9.8 did not. When preincubated with purified rgKK, both antibodies prevented the enzyme from releasing kinins from semi-purified dog kininogen and from cleaving [3H]-L arginine methyl ester (3H-TAME). These results suggested that both antibodies bind an epitope near to, and maybe including, the active site of the enzyme. Monoclonal antibody 2E9.8 appears to be specific for rgKK, can be used in a sensitive RIA, and is capable of inhibiting the enzymatic activity of kallikrein. It should prove to be useful in vivo for examining the role of kallikrein in physiological processes. PMID- 3633950 TI - [Urinary kallikrein quantity and activity of normal pregnant women and toxemia patients in third trimester]. AB - In this study, urinary kallikrein quantity and activity were measured by the kallikrein direct RIA and kininogenase activity with human low molecular weight kininogen in 32 non pregnant healthy women, 20 normal 3rd trimester pregnant women and 18 3rd trimester hypertension type toxemia patients. There was no significant difference in urinary kallikrein quantity between non pregnant women (n = 32, 64.0 +/- 6.3 micrograms/day, mean +/- SE) and normal pregnant women (n = 20, 68.1 +/- 10.1 micrograms/day). There was a significant difference (p less than 0.001) between non pregnant women and toxemia patients (n = 18, 22.5 +/- 3.3 micrograms/day). There was a significant difference (p less than 0.001) between toxemia patients and normal pregnant women. There was a significant difference (p less than 0.05) in urinary kallikrein activity between non pregnant women (n = 32, 496.2 +/- 57.2 micrograms kinin/day) and normal pregnant women (n = 20, 319.5 +/- 48.1 micrograms kinin/day). There was a significant difference (p less than 0.0001) between non pregnant women and toxemia patients (n = 18, 82.6 +/- 13.6 micrograms kinin/day). There was a significant difference (p less than 0.01) between normal pregnant women and toxemia patients. There were no correlation in both urinary kallikrein quantity and activity between severe type toxemia patients (systolic blood pressure greater than or equal to 160mmHg or diastolic blood pressure greater than or equal to 110mmHg) and mild type toxemia patients (160mmHg greater than systolic blood pressure greater than or equal to 140mmHg and 110mmHg greater than diastolic blood pressure greater than or equal to 90mmHg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3633951 TI - Characterization of a translational inhibitor isolated from rabbit brain following intravenous administration of d-lysergic acid diethylamide. AB - Intravenous administration of d-lysergic acid diethylamide (LSD) to rabbits results in a transient inhibition of brain protein synthesis in vivo and in vitro. A translational inhibitor that appears in the postribosomal supernatant fraction of cerebral hemispheres following LSD administration was partially purified by gel filtration on Sephadex G-150 and precipitation with 60% ammonium sulfate. This inhibitor, which was proteinaceous, reduced the translational capacity of an initiating cell-free protein synthesis system derived from brain. It also inhibited a messenger RNA-dependent reticulocyte lysate programmed with brain polysomes and a globin-synthesizing reticulocyte lysate system. Addition of the partially purified inhibitor to a brain cell-free protein synthesis system resulted in the decreased formation of ternary complexes as well as 40 and 80S initiation complexes, suggesting that the inhibitor affects an early step in the initiation of protein synthesis in brain. PMID- 3633953 TI - A fresh approach to group goal setting. The three-way rotation nomimal group technique. PMID- 3633952 TI - VP-16 plus ifosfamide plus cisplatin as salvage therapy in refractory germ cell cancer. AB - Forty-eight evaluable male patients with germ cell tumors (GCT) failing to be cured with first-line therapy were treated with VP-16 (75 mg/m2), ifosfamide (1.2 g/m2), and cisplatin (20 mg/m2) (VIP), all given daily for 5 consecutive days every 3 weeks. All patients either achieved an unresectable partial remission as their best response to induction chemotherapy (Group A), relapsed from complete remission (CR) less than or equal to 2 months after induction therapy (Group B), or had received cisplatin plus VP-16 as previous salvage therapy (Group C). Nine (19%) had extragonadal GCT, and 37 (77%) had advanced disease. Twenty-three (48%) of the patients had greater than or equal 2 prior treatment regimens. Sixteen of 48 (33%) achieved CR with VIP treatment alone or following surgical excision of residual disease. Six of 22 (27%), three of seven (43%), and seven of 19 (37%) patients from groups A, B, and C, respectively, attained a CR. The median survival time of all patients was 7 months (range 0 to 28+) with seven patients remaining continuously free of disease (four patients greater than 1 year). Myelosuppression was significant with a median WBC nadir of 900/mm2 and platelet nadir of 24,000/mm2. Fourteen (26%) had granulocytopenic fever, and renal insufficiency developed in 15%. VIP combination chemotherapy demonstrates activity in this highly unfavorable population of patients with germ cell tumors. The actual contribution of ifosfamide in this regimen is unclear, but these results compare favorably to our experience with similar patients treated with cisplatin plus VP-16 alone. Further studies with VIP as initial salvage therapy for patients with GCT are planned. PMID- 3633954 TI - A nursing contribution to cost containment. A group preoperative teaching program that shortens hospital stay. PMID- 3633955 TI - Point-counterpoint: certification of nursing staff development educators. The credentialing process. PMID- 3633956 TI - The clinical nurse specialist--an underutilized staff development resource. PMID- 3633958 TI - Improving readability of hospital forms. PMID- 3633957 TI - Preceptor training programs. PMID- 3633959 TI - A new approach to professional development--nurse career counseling. PMID- 3633960 TI - Point: for certification of nursing staff development educators. PMID- 3633961 TI - Counterpoint: against certification of staff development educators. PMID- 3633962 TI - The research role of the clinical nurse specialist. PMID- 3633963 TI - Measurement technology applications in performance appraisal. AB - Every nursing administrator needs a credible performance appraisal system. By using psychometric methods and computer technology, the process of developing such a system can be more efficient and demonstrably successful. This article raises issues that relate to changing the performance appraisal system and gives a clear, step-by-step description of how computerized, statistical procedures were applied in improving nursing performance appraisal. PMID- 3633964 TI - Performance feedback: a question of source credibility. PMID- 3633965 TI - Facilitating change. Choosing the appropriate strategy. AB - The accelerated pace of change demands that managers develop skill in the effectiveness and efficiency with which they accomplish change. Crucial to facilitating change is selecting a strategy that is likely to produce the desired change with minimal time and resistance. This article describes a method of selecting a potentially successful strategy using a combination of two factors: change target and level of change willingness and ability. PMID- 3633966 TI - A comprehensive charge system for unit supplies. AB - Various methods of capturing charges for supplies stocked on nursing units have been devised, such as stickers and charge slips attached to the items. Effectiveness and efficiency were not maximized through these methods. A new system customized for each unit showing daily patient charges per patient provides for an audit of inventory and for lost charges. Items from both pharmacy and central supply are included. Charge capture is maximized with relative ease for the nursing staff. PMID- 3633967 TI - Unit-based research in a service setting. AB - This paper describes a model for involving staff in a service setting in nursing research. The model offers suggestions for organizing nurses into research groups and implementing the research process. Success of this model depends on nursing unit size, composition of the research group, and departmental integration of nursing research. PMID- 3633968 TI - The effects of clinical placements on seeking employment. PMID- 3633969 TI - Evaluating medication errors. AB - What is appropriate disciplinary action for medication errors? Believing the severity of the error is a critical factor in determining disciplinary actions, we developed a tool to assess medication error severity. The El Dorado Medication Error Tool (EDMET) is objective and simple to use. It ensures objectivity, fairness, and clarity of expectations for the staff nurse and ensures consistency of scoring medication errors and disciplinary actions among nurse administrators. PMID- 3633971 TI - Assessing the work environment. PMID- 3633970 TI - The changing environment. PMID- 3633972 TI - Nurse-midwifery education--challenges ahead. PMID- 3633974 TI - Nurse-midwifery peer review at Phoenix Memorial Hospital. PMID- 3633973 TI - Professional attire at delivery--effect on postpartum and neonatal infection. PMID- 3633975 TI - Certified nurse-midwife political involvement--regulatory and licensing board. PMID- 3633976 TI - Burnout experienced by nurse midwives. PMID- 3633977 TI - Sexuality: knowledge and attitudes of student nurse-midwives. PMID- 3633978 TI - Outpatient co-management of the patient receiving oral ritodrine therapy. PMID- 3633979 TI - Hospital privileges. PMID- 3633981 TI - Responding to claims and lawsuits. The lawyer--the deposition--the trial. PMID- 3633980 TI - Use of the labor graph in Malawi. PMID- 3633982 TI - Assessment of one alternative to an essay format certification examination. PMID- 3633983 TI - The medical malpractice insurance crisis: implications for future practice. PMID- 3633984 TI - Auscultated fetal heart rate accelerations. Part I. Accuracy and documentation. PMID- 3633985 TI - Auscultated fetal heart rate accelerations. Part II. An alternative to the nonstress test. PMID- 3633987 TI - Breech delivery--a cooperative nurse-midwifery medical management approach. PMID- 3633986 TI - Association between maternal weight gain and outcome of pregnancy. PMID- 3633988 TI - Code of ethics for nurse-midwives. PMID- 3633989 TI - Medicine--a two-way process. PMID- 3633991 TI - Accentuate the positive. PMID- 3633990 TI - Assessment of adjustment to chronic hemodialysis. PMID- 3633992 TI - Protein restriction in renal disease: how much is enough? PMID- 3633993 TI - Our growing elderly population. PMID- 3633994 TI - "Teaching the elderly ESRD patient.". PMID- 3633995 TI - Lithotripsy: a revolutionary technique with implications for nursing care. PMID- 3633996 TI - The geriatric patient with ESRD: special patients--special needs. PMID- 3633997 TI - Infection control: hepatitis B. PMID- 3633998 TI - Corticosteroids and NSAIDS in rheumatoid arthritis (continuing education credit). PMID- 3633999 TI - The NAPNES perspective: an interview with NAPNES Executive Director Helen Larsen, L.P.N. PMID- 3634000 TI - How LP/VNs can play a role in the prevention of elderly falls. PMID- 3634001 TI - The special needs of partial maxillectomy patients. PMID- 3634002 TI - Scoliosis: causes, treatments and preventive measures for curvature of the spine. PMID- 3634003 TI - Drug interactions--nutrients, vitamins, foods (continuing education credit). PMID- 3634004 TI - The inhibited child. PMID- 3634005 TI - Hispanic utilization of an ethnic mental health clinic. PMID- 3634007 TI - NSGAE. Nursing adaptation evaluation. PMID- 3634006 TI - Depression & dementia. Differential diagnosis. PMID- 3634008 TI - NSGAE useful for all disciplines. PMID- 3634009 TI - Lithium and the thyroid. PMID- 3634010 TI - Biological rhythms and affective illness. PMID- 3634011 TI - Chronic factitious disorders. Helping those who hurt themselves. AB - A chronic factitious disorder is a complex psychiatric illness that generally manifests itself in the medical/surgical setting. The immediate need for psychiatric intervention is generally overshadowed by the need for intense medical treatment. The psychiatric liaison nurse is in a key position to manage emotional nursing care during acute hospitalization. Assisting staff to recognize behavioral manifestations can help to prevent further self-destruction and promote future psychiatric followup. The prevalence of factitious disorders is probably higher than misconceptions about the disorder. The potential to save health care cost as well as needless human misery makes this a professional nursing concern. The high incidence of factitious disorders in the nursing profession may make profession may make it a personal issue for nurses as well. PMID- 3634012 TI - Difficult young adult chronic patients. Re-evaluating short-term clinical management. PMID- 3634013 TI - ECT: exploring myths, examining attitudes. PMID- 3634014 TI - Perspective on contact lenses. Parents and cataract kids. PMID- 3634015 TI - Scleral rupture. PMID- 3634016 TI - Mobile Nd:YAG laser: team roles and management. PMID- 3634018 TI - A micro-computer program package for the computation of intraocular lens powers. PMID- 3634017 TI - Botulinum chemodenervation treatment of strabismus. PMID- 3634019 TI - A controlled study of silver nitrate prophylaxis and the incidence of nasolacrimal duct obstruction. PMID- 3634020 TI - Corneal topography: uses and applications of photokeratoscopes. PMID- 3634021 TI - ALT: argon laser trabeculoplasty following failed trabeculectomy. PMID- 3634022 TI - Office cataract/IOLS. PMID- 3634023 TI - Nitrogen dioxide exposure and development of pulmonary emphysema. AB - This study assessed the relationship between nitrogen dioxide inhalation and the development of pulmonary emphysema and investigated how the severity of preexisting emphysema brought about by protease (elastase) instillation into the lung may be augmented by a subchronic exposure to a relatively high concentration of nitrogen dioxide. Lungs of adult Fischer-344 rats were evaluated for emphysematous changes after (1) a single intratracheal instillation of elastase (E), (2) a 25-d exposure to 35 ppm nitrogen dioxide (NO2), and (3) elastase instillation followed by 25-d exposure to 35 ppm NO2 (E + NO2). Rats instilled with sterile normal saline and subsequently exposed to filtered air served as a control group (NS). Residual volumes (RV) of the NO2 and NS groups were virtually identical, whereas the RV of the E and E + NO2 lungs (2.3 and 2.3 ml, respectively) were significantly greater than those of the NS and NO2 lungs (1.3 and 1.4 ml, respectively). Directionally similar changes in the excised lung volumes and total lung capacities were obtained with the E and E + NO2 groups; NO2 alone, however, did not alter these volumetric parameters. No differences in arterial blood gases and pH values, minute ventilation, or breathing frequencies were found among the experimental groups. The mean linear intercept values (MLI) obtained with the NS and NO2 exposed lungs were essentially identical with average values of approximately 62 micron. This morphometric parameter was substantially increased in the E- and E + NO2-exposed lungs; no significant differences, however, were found between the MLI values obtained with the E and E + NO2 lungs (approximately 95 and approximately 97 micron, respectively). From these data, as well as histologic examinations of lung sections for evidence of emphysema, we conclude that (1) a subchronic, moderately high level of NO2 exposure does not produce an irreversible emphysematous lesion in the rat model and (2) exposure of rats to 35 ppm for 25 d after elastase instillation into the lungs does not potentiate protease-induced emphysema or bring about a progression in preexisting emphysema. PMID- 3634024 TI - [Decision making in nursing. 1. Reevaluation of a negative attitude in nursing]. PMID- 3634025 TI - [Counseling of patients. Clients' responsibility must not be transferred to the counselor: basic attitude expected in counseling. 3]. PMID- 3634027 TI - [Profile of a nurse: Ms. Yukiko Okui who devoted 27 years to occupational health care]. PMID- 3634026 TI - [Nursing homes in New York. 1. Residents of nursing homes]. PMID- 3634028 TI - [Nursing theory. 1. What is nursing theory?]. PMID- 3634029 TI - [On the role of nurses in advocating patients' rights. Declaration of patients' rights as a movement to restore humanity]. PMID- 3634030 TI - [Data on patients' rights: 1. "Your rights as a patient at Beth Israel Hospital, Boston"; 2. Declaration of patients' rights by the American Hospital Association; 3. Physicians' Manual by the Japanese Hospital Association; 4. Declaration of patients' rights by the Japanese Committee for Preparation of Declaration of Patients' Rights (a draft)]. PMID- 3634031 TI - ["Declaration of patients' rights," and nurses' role]. PMID- 3634033 TI - [Social responsibility of nursing personnel in the care of patients: nurses' responsibility concerning decubitus ulcer]. PMID- 3634032 TI - [Patients' rights in daily activities]. PMID- 3634034 TI - [A right to die: nursing of a patient who chose "no Code Blue"]. PMID- 3634035 TI - [Evaluation of the format for nursing records for neurosurgery patients]. PMID- 3634036 TI - [A survey on the use of medical electronic instruments by nurses, and their knowledge]. PMID- 3634037 TI - [Psychological assistance of a patient who was aware of the approaching fatal outcome: interactions with children with progressive muscular dystrophy]. PMID- 3634038 TI - [Diet education of a diabetic patient who takes his meals at restaurants]. PMID- 3634039 TI - [Interactions with children with cerebral palsy through their play]. PMID- 3634040 TI - [New York report: a visit to Beth Israel Medical Center. 1]. PMID- 3634041 TI - [Record by a woman physician suffering from cancer. 1. Process leading to surgery]. PMID- 3634043 TI - [Practice of Oriental medicine. 1. The importance of Chinese medicine]. PMID- 3634042 TI - [Monologue by a nursing director: the era of high technology and nurses]. PMID- 3634044 TI - [Clinical aspects of dementia. Symptoms of dementia. 8]. PMID- 3634045 TI - [POS in nursing. 4. The keyword in data bases: the data base for nursing. 2]. PMID- 3634046 TI - [Decision making in nursing. 4. Responses to various problems concerning patients' frequent use of the buzzer to call nurses]. PMID- 3634047 TI - [Nursing theory. 4. Approach to nursing theory. 2]. PMID- 3634048 TI - [Establishment of a sound relationship between senior and new nurses through training of incoming nurses: introduction of the elder system]. PMID- 3634049 TI - [Training of new nurses at a newly established university hospital: description by a nursing supervisor]. PMID- 3634050 TI - [Active training of new incoming nurses by the senior nursing staff]. PMID- 3634051 TI - [Training of new nurses at a regional nuclear hospital: opinions of the senior and junior nurses]. PMID- 3634052 TI - [Satisfaction in learning through suffering together: training of new nurses at an emergency health service center]. PMID- 3634053 TI - [Challenge at a new work place: transfer from a ward to a home care consulting service]. PMID- 3634054 TI - [My experience as a new nurse]. PMID- 3634056 TI - [Current nursing practice in China]. PMID- 3634055 TI - [Approach to an aphasic patient using an aphasia evaluation table]. PMID- 3634057 TI - [New York report: a visit to Beth Israel Medical Center. 4. Passively addicted infants of drug-addicted mothers]. PMID- 3634058 TI - [Report by a woman physician suffering from cancer. 4. Chemotherapy using antineoplastic agents]. PMID- 3634059 TI - [Monologue by a nursing director. From turmoil to stability: a thought on nursing through observing child rearing by her son]. PMID- 3634060 TI - [Practice of Oriental medicine. 4. On the concepts of air, blood and fluid. 2. Stagnation and reflux of the air]. PMID- 3634061 TI - [POS in nursing. 7. The keyword in data bases: the data base for nursing. 5]. PMID- 3634062 TI - [Counseling of patients. 15. Reframing: a method in counseling]. PMID- 3634063 TI - [Nursing homes in New York. 4. Nurses' aides in nursing homes]. PMID- 3634064 TI - [Profile of a nurse. Ms. Sachiko Itonaga, an organizer of a hospital group studying terminal care]. PMID- 3634065 TI - [The point of intersection of inductive method and deductive method--focus on caregiving by families]. PMID- 3634066 TI - [Support systems around the pregnant woman and nursing mothers]. PMID- 3634067 TI - [A contact of theories and researches--focus on the concept of support (discussion)]. PMID- 3634068 TI - [Social support and the deductive method]. PMID- 3634069 TI - [Social support in nursing--a contact of theories and researches]. PMID- 3634070 TI - [A contact of theories and researches--focus on the concept of support]. PMID- 3634071 TI - [The point of intersection of deductive method and inductive method--focus on social support]. PMID- 3634072 TI - [Caregiving by families--a contact of theories and researches]. PMID- 3634073 TI - [Caregiving by families and the inductive method]. PMID- 3634074 TI - [Survey on the activities of graduates of national medical technology colleges and their opinion on midwifery education]. PMID- 3634075 TI - [Midwifery education in foreign countries]. PMID- 3634077 TI - [Classroom practice of injection technic]. PMID- 3634076 TI - [Study on methods of teaching cleansing in the basic course of nursing: evaluation of classroom teaching of cleansing technology]. PMID- 3634078 TI - [Mechanism and structure of teaching and learning. 7. The school-student relationship]. PMID- 3634079 TI - [International exchange tour of Taiwan]. PMID- 3634080 TI - [A tentative plan for midwifery education (1983)]. PMID- 3634082 TI - [Survey on the curricula of midwifery departments of national medical technology colleges]. PMID- 3634081 TI - [Current status of and keypoints in midwifery education]. PMID- 3634083 TI - [Incorporation of local clinical training of nursing students in the regional program: a significant role of the regional nursing study group. Discussion]. PMID- 3634084 TI - [Local clinical nursing training as an important segment of the regional nursing system--significance in the aging society]. PMID- 3634085 TI - [Roots of nursing in underdeveloped areas. 1. Hokkaido: the starting point in my nursing activity]. PMID- 3634086 TI - [My experience in public health nursing: care of an aged man suffering from mental disturbances]. PMID- 3634088 TI - [Sex-related problems of apoplexy patients and their guidance]. PMID- 3634087 TI - [Education of public health nurses evaluated by the data on their employment immediately following graduation]. PMID- 3634089 TI - [Duties of public health nurses and organization of systems including local residents. Discussion]. PMID- 3634090 TI - [Organization of a system to support the public health activities. Organization at the Sumoto Public Health Office. A discussion by the former and current directors of the office]. PMID- 3634091 TI - [Problems faced by the public health nurses at Sumoto City. Trials and tribulations associated with the work: a concerted approach to the problems as the basis of team work. Discussion]. PMID- 3634092 TI - [Suicides by the aged and the organization of families. (1). A report from a public health office]. PMID- 3634093 TI - [Roots of public health nursing in underdeveloped areas. 2. The depth and extent of the history of reclamation programs in Hokkaido]. PMID- 3634095 TI - The efficacy of a written clinical challenge exam. PMID- 3634094 TI - [Cooperation between the public health offices and the city government. 1. The status of the "public health nursing of aged, bed-ridden patients at home" at Sumoto City]. PMID- 3634096 TI - Computers in nursing practice in Kansas. PMID- 3634097 TI - Spiritual and legal dimensions of emergency health care. PMID- 3634099 TI - Getting ahead financially. PMID- 3634098 TI - Mentoring as facilitator of the developmental process. PMID- 3634100 TI - Preceptorship program in a rural hospital. PMID- 3634101 TI - Standards for continuing education in nursing. PMID- 3634102 TI - An ounce of prevention is worth several pounds of cure. PMID- 3634103 TI - Depression: an occupational hazard for nurses? PMID- 3634105 TI - [The international symposium "Cancer and alternative medicine". Openmindedness in thinking is necessary]. PMID- 3634104 TI - [The nursing staff and AIDS: caution yes--fear no]. PMID- 3634106 TI - [Male nurses are a part of holistic nursing]. PMID- 3634107 TI - [Introduction of preventive medicine into Swiss television. Fun instead of threats]. PMID- 3634108 TI - [Surveillance of the patient with acute pancreatitis]. PMID- 3634109 TI - [7th Swiss Conference of Oncologic Nurses. The information of the patient and its strategies]. PMID- 3634110 TI - [Employment and working conditions: the ILO promotes measures for improvement]. PMID- 3634111 TI - [Oncology. An important report for nurses. The patient's perception of his situation]. PMID- 3634112 TI - [Classical homeopathy (II). There is no sickness on its own, there are only sick people]. PMID- 3634113 TI - [A work document by the International Council of Nurses. Nursing care today and tomorrow: facing the future with imagination and courage]. PMID- 3634114 TI - [Continuing education. Conducting an interview: reflections of a participant. From theory to practice]. PMID- 3634115 TI - [The hospice movement: accompanying to the end of life]. PMID- 3634116 TI - [Overcoming strangeness in nursing. Next to one's own reality to see the reality of the others]. PMID- 3634117 TI - [Memorandum from the Swiss Professional Commission for AIDS Problems on how to deal with AIDS patients and persons with antibodies to LAV/HTLV-III]. PMID- 3634119 TI - [Means for the activation of the elderly. Music for fun]. PMID- 3634118 TI - [Working conference of the administrative psychiatric nursing personnel: holistics as a red thread]. PMID- 3634121 TI - [Origin, effect and hazards of roentgen rays. I]. PMID- 3634120 TI - [Extracorporeal fertilization, cross-pregnancy and genetic counseling. The dignity of developing life]. PMID- 3634122 TI - [What do we mean with psychoanalysis?]. PMID- 3634124 TI - [Surgical procedures in tracheal stenosis]. PMID- 3634123 TI - [Looking masterfully down the nose at Freud]. PMID- 3634126 TI - [The treatment of 'cleft' children]. PMID- 3634127 TI - [Addiction dangers caused by mistakes in early child nutrition]. PMID- 3634125 TI - [Asphyxia syndrome in premature infants]. PMID- 3634128 TI - [Origin, effect and hazards of roentgen rays. II]. PMID- 3634129 TI - Reducing adolescent smoking: a comparison of peer-led, teacher-led, and expert interventions. AB - To test the effectiveness of a psychosocial strategy of smoking deterence on seventh grade students, the School Health Education Development project implemented peer-led, teacher-led, and expert-led interventions in six Vermont schools. Four additional schools served as control groups. The teacher-led approach reduced the rate of smoking onset and the intention to smoke in the future among highly vulnerable females but not among males. The peer-led approach reduced the behavioral intention to smoke for both sexes but did not affect current smoking behavior. The expert-led approach did not produce favorable effects. Both the peer-led and teacher-led interventions had positive, though not significant, effects on student perception of locus of control. In the control schools, females experienced higher levels of smoking onset than males. Generally, the study points toward further development of a teacher-led approach to smoking deterence based on the theory of adolescent psychosocial development and the principle of continuous reinforcement. PMID- 3634130 TI - AIDS: a commentary. PMID- 3634131 TI - Lewin's force field theory applied to behavior change in a college health course. PMID- 3634132 TI - Epidemiology on the elementary school playground. PMID- 3634133 TI - Adolescents who have experienced cesarean sections: hints for the school nurse. PMID- 3634134 TI - Temporomandibular joint dysfunction syndrome in children. AB - Temporomandibular joint (TMJ) dsyfunction is described and a historical perspective of the disorder is presented. A review of research related to symptoms, incidence, correlates, and causes of TMJ dysfunction in children is presented. Factors regarding identification are discussed, and treatment options are outlined. The purpose of this article is to increase the awareness of school health personnel about a condition which traditionally has been considered an adult disorder. PMID- 3634135 TI - Through the art of children: perceptions of alcohol use and abuse. AB - Through analysis of children's art, submitted as alcohol education posters, insight was gained as to what children believe to be the effects of alcohol use. More than 5,000 posters were submitted by children in grades one-13 in two poster contests sponsored by the Addiction Research Foundation of Ontario in 1982 and 1984. Most posters were submitted by students in grades four-eight. The most common messages were "Don't Drink" and slogans about drinking and driving. Other messages included use within the family, use with friends, use and sports, use leading to death, physical effects, and solutions to drinking. The message never to drink was prominent, but few posters advocated drinking in moderation. PMID- 3634136 TI - AIDS: preschool and school issues. AB - This paper reviews the epidemiological, clinical, and public health aspects of Acquired Immunodeficiency Syndrome (AIDS) in the pediatric population. Evidence establishing modes of transmission is emphasized. Guidelines are presented to assist school staff in the educational management of children infected with the AIDS virus. PMID- 3634137 TI - An alcohol attitude scale for teen-agers. AB - A scale was designed to measure the affective, cognitive, and conative components of teen-agers' attitudes toward the use of alcohol. Data collected from a representative sample of about 700 Indiana high school students were subjected to univariate and multivariate statistical analyses to evaluate scale performance and validity. Findings demonstrated that internal and external criteria were met at highly significant levels. Factor analysis identified four factors that describe the dimensionality of teen-agers' alcohol attitudes. Findings of discriminant function analysis of the data supported the results of univariate analyses and revealed one significant function that differentiated between drinker and nondrinker groups in terms of attitudes. The scale was a valid instrument for obtaining measures having dependable inferential value and was useful in analyzing teen-agers' attitudes toward alcohol use. PMID- 3634139 TI - Recommended guidelines for dealing with AIDS in the schools from the National Education Association. PMID- 3634138 TI - Educators question content of role delineation report. PMID- 3634140 TI - Caring for the ill child in day care. AB - Current estimates indicate about 54% of American children have mothers who work outside the home. All children become ill, whether or not their parents are employed. However, for a working mother, even a mild illness can create anxiety, since alternate day care arrangements may be necessary. The problem of caring for the ill child in preschools or day care has received little attention from program planners or policy makers. Most state regulatory policies require exclusion of the ill child from day care. This article discusses recent developments in providing for ill children in day care settings. Four models of providing such care are described and criteria are offered for evaluating ill child care arrangements. PMID- 3634141 TI - AIDS, the schools, and policy issues. AB - Acquired Immunodeficiency Syndrome (AIDS) first was reported in the United States in May 1981. As many as two million Americans may be infected with the AIDS virus and that number could approach five million within five years. This article reviews the discovery of AIDS and describes the biology of the disease. The problem of AIDS among children is discussed and implications for school policy decisions are cited. PMID- 3634142 TI - Report of the 1984 ASHA membership survey. AB - The results of the most recent American School Health Association (ASHA) membership survey, conducted by ASHA to retain its continuing education units provider status granted in 1981 by the American Nurses' Association are reported. Results of the 1984 survey are compared to two previous surveys, conducted in 1980 and 1982. Topics examined include membership demographics, attendance at national meetings, continuing education needs and preferences, maintaining professional competence, professional issues of importance to readers, and options for improving the usefulness of the Journal of School Health. Several membership trends are discussed and implications for future planning are noted. PMID- 3634143 TI - Social disaffection, friendship patterns and adolescent cigarette use: the Muscatine Study. AB - This study was undertaken to determine if adolescent social disaffection with school and family not only would be a significant predictor of cigarette use but would explain a significant amount of the association with friends who smoke. Eleven hundred and eighty ninth-12th grade students in Muscatine, Iowa, were surveyed in Spring 1984. Multiple regression analyses indicated several social disaffection variables were significant predictors of association with friends who smoke, explaining 20% of the variance. The combination of association with friends who smoke and social disaffection variables explained 48% of the variance in adolescent cigarette smoking. Variables related to adolescents' participation in school and related activities suggest prevention programs should recognize the impact of social disaffection on adolescents cigarette use. PMID- 3634144 TI - Allergy, asthma, and school problems. PMID- 3634145 TI - Clarifying concepts of traditional, preventive, and wellness lifestyles. PMID- 3634146 TI - The school nurse as athletic trainer. PMID- 3634147 TI - Developmental studies of the first step of the initiation of brain protein synthesis, role for initiation factor 2. AB - Developmental changes at the level of initiation step of translation in the rat brain were studied. The level of deacylated tRNAimet in rat brain was measured at two stages of postnatal development. Although the amount of tRNA was slightly lower in adult than in young (4 day old) rats, the charging capacity of initiator tRNAimet in vitro was similar at both ages. No differences during development were found in methionyl-tRNA synthetase activity, which throws doubt on its possible participation in regulation of the initiation step. When assayed in the ribosomal salt wash protein fractions, initiation factor 2 activity decreased during brain development, and increased activities were detected in the supernatant of the microsomal fractions. The decrease in eIF-2 activity paralleled the observed decrease in the rat of overall protein synthesis or initiation activity in vitro, suggesting that the regulation of the initiation step of translation during brain development may be tightly linked to changes in initiation factor 2 activity in brain tissue. PMID- 3634148 TI - We are the world--we are the women. PMID- 3634149 TI - [Demyelinating diseases of the nervous system]. PMID- 3634150 TI - [Therapeutic physical exercise in the combined treatment of patients with protracted forms of mental diseases]. PMID- 3634152 TI - [Role of the nurse in carrying out the doctor's orders]. PMID- 3634151 TI - [Clinical sexopathology--a new type of specialized medical care]. PMID- 3634153 TI - [Operating characteristics of the Elektronika Mammography Microfocus X-ray Unit]. PMID- 3634154 TI - [Psychotherapy of postalcoholic cardiophobias]. PMID- 3634155 TI - [Inventory of the drugs and medical supplies in the departments (offices) of Dnepropetrovsk Province hospitals]. PMID- 3634156 TI - [Radon waters]. PMID- 3634157 TI - [Age-related characteristics of alcoholism]. PMID- 3634158 TI - [Role of the nurse in caring for ileostomy patients]. PMID- 3634159 TI - [Use of hydrotherapy and ultraviolet irradiation in the combined treatment of gingivitis]. PMID- 3634160 TI - Medical malpractice--MNA's positions. PMID- 3634161 TI - Medical malpractice--comparing the legislation. PMID- 3634162 TI - Nursing practice in ambulatory care. PMID- 3634163 TI - Nursing's image in the competitive 80's. PMID- 3634164 TI - Modern prenatal management--pattern of care for the future. PMID- 3634165 TI - Community midwifery care project. PMID- 3634166 TI - Family care & the pre-term baby. PMID- 3634167 TI - Neonatal community liaison visiting. PMID- 3634168 TI - Care for families following stillbirth & first-week deaths. PMID- 3634169 TI - Refresher courses: unfulfilled potential? PMID- 3634170 TI - More career advice for midwives. PMID- 3634171 TI - The midwifery examination system--a matter for concern. PMID- 3634172 TI - The 18-month training: what difference has it made? PMID- 3634173 TI - Refresher courses: unfulfilled potential? PMID- 3634174 TI - Doing away with "us and them" parentcraft classes. PMID- 3634175 TI - Cleft lip & palate in perspective. PMID- 3634176 TI - Hair colour & problems in breast feeding. PMID- 3634177 TI - Breast feeding support group in Taunton. PMID- 3634178 TI - Left cerebral hemisphere contributions to tachycardia: evidence and recommendations. AB - Six topics were discussed in which research has shown a stimulus or activity to be independently related to increases in human heart rate and to left cerebral hemisphere functioning: lateralized touching, reasoning, pleasantness, talking, lateralized feedback, and resistance to persuasion. On the basis of this converging evidence, strategies were suggested for altering heart rate by use of the method of induced lateral orientation of attention as a means of selective hemisphere activation. PMID- 3634179 TI - The aetiology of essential hypertension: an hypothesis describing two categories. AB - It is proposed that there are two distinct types of essential hypertension. Type I is of renal origin and results from a decreased glomerular filtration coefficient. Type II is due to arteriosclerosis of the aorta resulting in decreased elasticity. Both types are self perpetuating via positive feedback loops. The two types may occur together. PMID- 3634180 TI - General principle of existence of natural objects. AB - Natural objects, live and inanimate, actively maintain their entities by using their capacities (i.e., properties, internal resources, mechanisms, and experience) adequately to their needs. It is suggested that the principle of adequate function is a law of nature. PMID- 3634181 TI - Surfactant replacement therapy. PMID- 3634182 TI - Update on the treatment of persistent pulmonary hypertension of the newborn. PMID- 3634183 TI - Extracorporeal membrane oxygenation in the neonate. PMID- 3634184 TI - Respiratory distress syndrome in the tiny baby. PMID- 3634185 TI - New advances in respiratory care of the neonate (continuing education credits). PMID- 3634187 TI - Missouri Nurses Association gerontological nursing special interest group: statement on gerontological nursing in Missouri. PMID- 3634186 TI - A nurses guide for the job market. PMID- 3634188 TI - A reexamination of the role of magnesium in the human alternative pathway of complement. AB - The formation of the alternative-pathway C3 convertase has been previously suggested to have an absolute requirement for Mg2+, especially at the level of complex formation between C3b and factor B (B). In the course of defining spectral probes that could be used to monitor the C3b-B interaction (e.g. 1 anilino-8-naphthalene sulfonic acid fluorescence and near-u.v. circular dichroism) we observed that the signal change reporting on this binding was not completely reversed upon addition of excess ethylene-diaminetetraacetic acid (EDTA). Using sucrose gradient ultracentrifugation, we have directly demonstrated a Mg2+-independent C3b-B complex in the fluid phase. B thus bound was not only susceptible to specific proteolytic activation by factor D, but the resulting C3bBb enzyme was able to convert native C3 to C3b. Interestingly, we were unable to detect Mg2+-independent specific binding of 125I-B to C3b which was particle bound. Using a sensitive hemolytic assay, however, we estimated that the functional activity of B with surface-bound C3b is 80-fold greater in the presence of physiological Mg2+ (0.5 mM) than in 2 mM EDTA. In contrast, the fluid phase association is estimated to differ less than three-fold under the same conditions. These data demonstrate that the requirement for Mg2+ in the formation of the fluid-phase alternative-pathway C3 convertase is not absolute. Furthermore, they suggest a difference in the stable functional properties of fluid-phase and surface-bound C3b. PMID- 3634190 TI - Making sense of violence. PMID- 3634189 TI - Operating room practice in Australia. PMID- 3634191 TI - To reuse or not to reuse, that is the question. PMID- 3634192 TI - The Judge Report--the way ahead for nurse education? PMID- 3634193 TI - On-call and standby. PMID- 3634194 TI - Don't look now: the liability crisis isn't improving. PMID- 3634195 TI - Health care: right or privilege? PMID- 3634196 TI - An organizational strategy for empowering nursing. PMID- 3634198 TI - Grantmanship: winning foundation funding. PMID- 3634197 TI - Writing effective federal grant proposals. PMID- 3634199 TI - Justifying costs for continuing nursing education departments. PMID- 3634200 TI - [An epidemic in a hospital caused by a methicillin-resistant strain of Staphylococcus aureus]. PMID- 3634201 TI - Marketing your hospital. PMID- 3634202 TI - The image of nurses in television. PMID- 3634203 TI - Interview: Connie Holleran, RN, MSN, FAAN. PMID- 3634204 TI - Your income taxes. PMID- 3634205 TI - Promoting a professional image through campaigning. PMID- 3634206 TI - Students share a clinical experience. PMID- 3634207 TI - Royal College of Nursing. Breaking point. PMID- 3634208 TI - Learn more about AIDS. PMID- 3634209 TI - Take things to heart. PMID- 3634210 TI - Fowler would welcome Commons Griffith debate. PMID- 3634211 TI - Residential homes for the elderly need reform now. PMID- 3634212 TI - Royal College of Nursing: cause to be proud. PMID- 3634213 TI - Acute poisoning. PMID- 3634214 TI - Exceeding limits. PMID- 3634215 TI - Campaign launch to set up mass screening for breast cancer. PMID- 3634217 TI - Consumerism and nursing. PMID- 3634216 TI - Royal College of Nursing. Must act now. PMID- 3634218 TI - Our unique strength. PMID- 3634219 TI - AIDS precautions for clinical and laboratory staff. PMID- 3634220 TI - Elder abuse. PMID- 3634221 TI - The nurse-physician relationship: conflict to collaboration. PMID- 3634223 TI - Notes on the discipline of nursing. PMID- 3634222 TI - The nurse coordinator in a multidisciplinary geriatric assessment center. PMID- 3634224 TI - Quality nursing research: the key to quality nursing education. PMID- 3634225 TI - The chart critique: a learning activity for nursing students. PMID- 3634226 TI - Moving nurses into the political process. PMID- 3634227 TI - What to do about toxic mentors. PMID- 3634228 TI - Criteria for selecting textbooks. PMID- 3634229 TI - Clinical grades and the grievance process. PMID- 3634230 TI - Increasing accountability through program evaluation. PMID- 3634231 TI - Public/community health nursing: what do these terms mean? PMID- 3634232 TI - Cardiopulmonary assessment--how to do it better in 15 easy steps (continuing education credit). PMID- 3634233 TI - Why we must take care of our own. PMID- 3634234 TI - Spinal anesthesia--as bad as it sounds? PMID- 3634235 TI - 5 lessons you can learn from court decisions. PMID- 3634237 TI - Nursing can do without unnecessary restrictions that drive good nurses out of nursing homes. PMID- 3634236 TI - Easing the pain of bereaved parents. PMID- 3634238 TI - More power to you. PMID- 3634239 TI - A gift from Mrs. Piper. PMID- 3634240 TI - Choosing a natural or an active childbirth. PMID- 3634241 TI - Caesarean section: psychological problems. PMID- 3634243 TI - Bottle feeding. PMID- 3634242 TI - Psychological problems in the puerperium. PMID- 3634244 TI - Breast feeding. PMID- 3634245 TI - Parenthood by design. PMID- 3634246 TI - Becoming a parent. A personal account. PMID- 3634247 TI - Personal cleanliness. PMID- 3634248 TI - How productivity management programs improve patient care and cut costs. PMID- 3634250 TI - Responding to a time of tension. Art & science of management. PMID- 3634249 TI - When can a nurse refuse to give care? PMID- 3634251 TI - Developing nurses' managerial competence. PMID- 3634252 TI - Does management style affect burnout? PMID- 3634253 TI - Ambulatory care in clinics: organizing a staffing pattern. PMID- 3634254 TI - Management team assessment: a learning style inventory. PMID- 3634255 TI - How nursing service administrators view clinical nurse specialists. PMID- 3634256 TI - Job satisfaction: is collective bargaining the answer? PMID- 3634257 TI - On a nursing AIDS task force: the battle for confident care. PMID- 3634258 TI - AIDS: a balance of sorrows. PMID- 3634259 TI - Cutbacks and shrinkages: a means to eliminate the "victim mentality". PMID- 3634260 TI - Who are the survivors: Art and science of management. PMID- 3634261 TI - Law for the nurse manager. Understaffing--Part I. PMID- 3634262 TI - Improving a quality assurance program. PMID- 3634263 TI - The moral and ethical component of nurse-burnout. PMID- 3634264 TI - Communication: learning from the market. PMID- 3634265 TI - The new manager: finding your place--and theirs. PMID- 3634266 TI - In nursing's future: establishing adult day health care centers. PMID- 3634267 TI - Charge nurse: where staff and management meet. PMID- 3634268 TI - Does education affect nursing care? PMID- 3634269 TI - The effect of job satisfaction on retention. PMID- 3634270 TI - Changing roles: from nurse educator to novice executive. PMID- 3634271 TI - FY87: a crisis for compassion. PMID- 3634272 TI - Hospice: the promises and the problems. PMID- 3634274 TI - Paisano. PMID- 3634273 TI - AIDS virus not transmitted through tears, experts say. PMID- 3634275 TI - Implementing nursing diagnosis in the clinical setting. PMID- 3634276 TI - Community health conference group: the benefits of home care. PMID- 3634277 TI - What is a nurse midwife? PMID- 3634279 TI - Malpractice and its impact on nursing. PMID- 3634278 TI - Changing qualifications for professional nursing practice--a nursing educator's perspective. PMID- 3634280 TI - The process and profile of nurses seeking certification. PMID- 3634281 TI - Developing a treatment plan for the chemically-impaired nurse. PMID- 3634282 TI - Caution: alcoholics don't need medications containing alcohol. PMID- 3634283 TI - Red Cross to educate public on AIDS: goal to dispel myths. PMID- 3634284 TI - How does addiction start? One nurse's story. PMID- 3634285 TI - The reality of addiction--what you can do. PMID- 3634286 TI - Job sharing: an employment alternative for nurse practitioners. PMID- 3634287 TI - Family relocation: helping children adjust. PMID- 3634289 TI - Research on adolescent male attitudes about contraceptives. PMID- 3634288 TI - Herpetic gingivostomatitis in children. PMID- 3634290 TI - Health care for Cambodian children: integrating treatment plans. PMID- 3634291 TI - Pediatric management problems (pulled elbow). PMID- 3634292 TI - Topical corticosteroid preparations. PMID- 3634293 TI - Reducing calculation errors in drug dosages: the pediatric critical information sheet. PMID- 3634295 TI - Promoting dental health care in children with congenital heart disease. PMID- 3634294 TI - Autism: recognition and management. PMID- 3634296 TI - Characterization of bovine surfactant for infants with respiratory distress syndrome. AB - Exogenous surfactant treatment of surfactant-deficient disease states is now under study in a number of centers, using a variety of surfactant preparations. We have chosen one preparation because of its current and potential clinical usefulness, and we have characterized it using selected tests and assays that we thought would be necessary (although not necessarily sufficient) to justify extended clinical use. We found its lipid composition to resemble that of other surfactants derived from lung mince. There is little variation among several batches with regard to lipid composition or surface tension-lowering capability. Morphologic heterogeneity occurs in individual samples of pelleted material studied by electron microscopy. Arterial oxygenation is improved when the material is administered to animals depleted of surfactant. A low molecular weight protein was identified that reacted with antibody that specifically binds nonserum surfactant proteins in a number of animal species (including human and cow). The characteristics of this surfactant preparation should be useful for comparison as newer and simpler products become available. PMID- 3634297 TI - Characteristics of a top-ranked school survey: an evaluation instrument for schools of nursing. PMID- 3634298 TI - When the media call. PMID- 3634299 TI - Nurse practitioners in New York state: a case study in institutional licensure? PMID- 3634300 TI - How to evaluate nursing textbooks. PMID- 3634301 TI - Teaching nursing care through poetry. PMID- 3634302 TI - The conflicting roles of nurse and nurse educator. AB - During the socialization process of moving from nurse to nurse educator a number of formerly acquired and practiced key behaviors change. The newly acquired role set may well seem to be the direct antithesis of the former set. Role conflict and confusion in varying degrees can be expected. Conflict resolution and role definition and clarification can be greatly aided through proper preparation and initiation into this role. Preparation should include a clearer differentiation between practice and teaching, increased knowledge and skills related to the subject matter (nursing), familiarity with various teaching and evaluation strategies, and the development of creative approaches to the discovery, use, and transmission of new knowledge. PMID- 3634303 TI - Surviving academia. PMID- 3634304 TI - Rule by the majority. PMID- 3634305 TI - Amputees. The avoidable disability. PMID- 3634306 TI - Elderly. Out in the cold? PMID- 3634307 TI - Consumer relations. Are you being served? PMID- 3634308 TI - Consumer relations. A patient's eye view. PMID- 3634309 TI - One day at a time. PMID- 3634310 TI - Management--how to get value for money. PMID- 3634311 TI - Education--in at the deep end. PMID- 3634312 TI - Pre-natal zinc deficiency. PMID- 3634313 TI - Diverse reports. PMID- 3634314 TI - Living together. PMID- 3634315 TI - Nursing dilemmas. Every which way but.... PMID- 3634316 TI - Alternative rota systems. PMID- 3634318 TI - The Journal of Infection Control Nursing. Too close a shave? PMID- 3634317 TI - A change of course? PMID- 3634320 TI - A cut above the rest? PMID- 3634319 TI - Too close a shave? PMID- 3634321 TI - Taking precautions. PMID- 3634322 TI - Making it the last one. PMID- 3634323 TI - Racism. Second class nurses? PMID- 3634324 TI - Misconduct. Conduct unbecoming. Interview by Lynn Alleway. PMID- 3634325 TI - As others see us. The hospital without any nurses. PMID- 3634327 TI - Ask the family. PMID- 3634326 TI - Why teachers feel degraded. PMID- 3634328 TI - Ethics. Blowing the whistle. PMID- 3634329 TI - Maternity benefits? PMID- 3634330 TI - Child care. It's a wrap. PMID- 3634331 TI - Fatherhood. Focus on fathers. PMID- 3634332 TI - Budgeting for beginners. Clinical costing. PMID- 3634333 TI - Fast food. PMID- 3634334 TI - The magic shop. PMID- 3634335 TI - Theatre nursing. Good relations. PMID- 3634336 TI - Theatre nursing. The Savile Row of prosthetic surgery. PMID- 3634337 TI - Credibility gap. PMID- 3634338 TI - Mothers' advocate. PMID- 3634339 TI - Equal rights: does racial affect care? PMID- 3634340 TI - Griffiths: on the campaign trail. PMID- 3634341 TI - Nursing with honours. Interview by Harriet Gaze. PMID- 3634342 TI - Hospital-acquired infection. Control measures. PMID- 3634344 TI - The withdrawn schizophrenic. PMID- 3634343 TI - Hospital-acquired infection. The Friesen concept--a blueprint for care? PMID- 3634345 TI - Turning over a new leaf. PMID- 3634346 TI - Management of atopic eczema. PMID- 3634347 TI - The constant itch. PMID- 3634348 TI - Models of perfection? PMID- 3634349 TI - Child health: learning from example. PMID- 3634350 TI - Care today, gone tomorrow. PMID- 3634351 TI - Seeking informed consent. PMID- 3634352 TI - Quest. NT's educational supplement. Change for the better. From school to ward teaching. PMID- 3634353 TI - Quest. Who dares wins. PMID- 3634354 TI - Quest. Ours is to reason why. PMID- 3634355 TI - The genital touch. PMID- 3634356 TI - Stanley Royd: errors that led to tragedy. PMID- 3634357 TI - Should midwives train as florists? PMID- 3634358 TI - Introducing change. PMID- 3634360 TI - Word perfect. PMID- 3634359 TI - Is there life after Griffiths? PMID- 3634361 TI - Schizophrenics and the family. PMID- 3634362 TI - Taken over by heroin. PMID- 3634363 TI - Ending it all. PMID- 3634364 TI - Systems of life. No 134. Setting up the systems. 34. Antenatal care. PMID- 3634365 TI - Role models in nursing. PMID- 3634366 TI - Investing in education. PMID- 3634367 TI - What future for mental handicap nursing? PMID- 3634369 TI - Seeing through the smokescreen. PMID- 3634368 TI - Legionnaire's disease: faulty towers. PMID- 3634370 TI - Holistic nursing. Going the whole way. PMID- 3634371 TI - Holistic nursing. All in the mind's eye. PMID- 3634372 TI - Holistic nursing. Taking the strain. PMID- 3634373 TI - Planning patient care: learning to walk safely. PMID- 3634374 TI - Nursing by numbers. PMID- 3634375 TI - Music and movement for the elderly. PMID- 3634376 TI - Education: heat trials. PMID- 3634377 TI - Ethical dilemmas: angels of mercy? PMID- 3634378 TI - Budgeting for beginners: the goodwill factor. PMID- 3634379 TI - Pressure sores. Calculating the risk. PMID- 3634380 TI - Pressure sores. Floating on a bed of beads. PMID- 3634381 TI - Pressure sores. Under pressure. PMID- 3634382 TI - Money wise. PMID- 3634383 TI - Care about food. We're getting there. PMID- 3634384 TI - Care about food. Eat to your heart's content. PMID- 3634385 TI - Childbirth on trial. PMID- 3634386 TI - Missionaries. A mission to heal. PMID- 3634388 TI - Education. A new beginning. PMID- 3634387 TI - Gruel and the Crown. PMID- 3634389 TI - Slipped femoral epiphysis. PMID- 3634390 TI - When the revolving door stops. PMID- 3634392 TI - Midwifery: having trust in the Trust. PMID- 3634391 TI - Health care overseas: lessons from Bombay. PMID- 3634393 TI - Time out. PMID- 3634394 TI - Psychotherapy: swallowing the guilt. Interview by Cathy Watson. PMID- 3634395 TI - Supplement. Occupational health. PMID- 3634396 TI - Occupational health. Worth their weight. PMID- 3634397 TI - Occupational health. Out of sight, but not out of work. PMID- 3634398 TI - A network for safe staffing. PMID- 3634399 TI - Getting in on the Act. Interview by Laurence Dopson. PMID- 3634400 TI - A complementary view of nursing diagnosis. PMID- 3634401 TI - Establishing mutual-help groups for family-member care givers: a new role for community health nurses. PMID- 3634402 TI - The hazards of migrant farm work: an overview for rural public health nurses. PMID- 3634403 TI - Infant weaning patterns and related maternal-infant health outcomes. PMID- 3634405 TI - When a nurse is called to testify. PMID- 3634404 TI - Theory-based nursing: is it real? PMID- 3634406 TI - Nurses have done their part: now it's time the public delivered. PMID- 3634407 TI - Third-party reimbursement: status of legislation. PMID- 3634408 TI - Nurses, doctors and sponge counts: liability. PMID- 3634409 TI - Failing to "Moon River" costs nurse's job. Case in point: Wagenseller v. Scottsdale Mem. Hosp. (710 P. 2d 1025-AZ). PMID- 3634410 TI - Nurse anesthetist lic. suspended. Constitutional issues. Case in point: Mississippi Bd. of Nursing v. Belk (481 So. 2d 826-MS). PMID- 3634411 TI - Can you be terminated at any time? Case in point: Ewing v. Bd. of Trustees of Pulaska Mem. Hosp. (486 N.E.2d 1094-IN). PMID- 3634412 TI - Vaccines and Guillain-Barre syndrome: R.N. liability. Case in point: Samuels v. American Cyanamid Co. (495 N.Y.S. 2d 1006-NY). PMID- 3634413 TI - Home care for children dying of cancer. AB - The feasibility of home care as an alternative to hospitalization for children dying of cancer was studied. The home care system was defined as nurse-directed with a consultant physician and did not entail extensive participation by other health professionals. Of 58 children cared for at home during the 2-year project, 79% died at home and 21% died in the hospital or en route to it. The findings, as shown by interview data, suggest that home care at the end stage of life is a viable alternative for children dying of cancer and for their families. PMID- 3634414 TI - Life change and instrumental support as predictors of illness in mothers of 6 month-olds. AB - The extent to which life change after birth of a baby and instrumental support of parenting predict the occurrence of illness in mothers of 6-month-olds was studied. Mothers (N = 155) were selected from an urban clinic and from the birth records of a suburban hospital. All data were collected with questionnaires and interviews in mothers' homes when infants were 6 months old. Age, race, socioeconomic status, and prior illness were used as control variables in the analyses. Life change and intensity of support were positively related, and size of the support network was negatively related to illness. There was no evidence for the buffering effect of support. Findings confirmed that life change helps predict postpartal illness, and revealed that characteristics of instrumental support differ in their importance as predictors. PMID- 3634415 TI - The relationship of developmental variables to maternal behavior. AB - Developmental differences in self-concept, personality integration, flexibility, empathy, and temperament, and the relationship of these variables to maternal behavior, were investigated using three age groups of first-time mothers. The age groups also were tested for change in self-concept and personality integration from 1 to 3 days postpartum to 8 months postbirth. The longitudinal study included 60 mothers aged 15-19 years, 138 aged 20-29 years, and 90 aged 30-42 years. Self-completed instruments were used to measure the personality variables, and an interviewer-rated instrument measured maternal behavior. Personality integration and flexibility increased significantly and correlated significantly with age indicating that both are developmental constructs. Empathy and temperament traits did not increase with age, although teenage scores were significantly lower in empathy, self-concept, several temperament traits, and maternal behavior. The two older groups' self-concept decreased significantly the first eight months of motherhood. In the teenage group personality integration, empathy, activity level, intensity and threshold to stimulus were significantly correlated with maternal behavior. In the 20-29 year-old group, self-concept, personality integration, flexibility, rhythmicity, adaptability, intensity and mood quality correlated significantly with maternal behavior. In the older group, self-concept, flexibility, approach/withdrawal, adaptability, intensity, and mood quality correlated significantly with maternal behavior. PMID- 3634416 TI - Critical care nurses' intent to stay in their positions. AB - The purpose of this study was to build upon earlier research into the relationships among locus of control, organizational unit structure, job satisfaction, and registered nurses' intentions to remain in their positions. The data were collected by a questionnaire from 214 registered nurses from adult critical care units within 12 hospitals in two Midwestern cities. The best predictor of intent to stay was satisfaction with work activities (R = .43, p less than or equal to .05). Satisfaction with job remuneration, lower level of nursing education, and less intent to continue work toward a advanced degree or to do work-related educational activities also contributed to intent to stay on the job (R = .52, p less than or equal to .05). PMID- 3634417 TI - Religiousness among terminally ill and healthy adults. AB - The purpose of this study was to compare terminally ill with healthy adults for differences in religiousness; sense of well-being also was explored. This study was based upon a conceptualization of dying as a developmental phase of life. It was hypothesized that terminally ill adults report greater religiousness than healthy adults. A terminally ill and a healthy group with 57 adults each were matched on four key variables: age, gender, education, and religious affiliation. All 114 participants completed two questionnaires: the Religious Perspective Scale and the Index of Well-Being. A t-test of differences between the group means supported the hypothesis (t (112) = 3.11, p less than .001). There was no difference between the groups on sense of well-being; both indicated moderately high levels of well-being. A positive relationship between religiousness and well being was found in the healthy group (r = .43, p less than .001), but not in the terminally ill group. PMID- 3634418 TI - Development of a patient satisfaction scale. AB - Three studies to develop and test an instrument to measure hospitalized patients' satisfaction with nursing care are reported. Content validation procedures involved both clinicians and patients (N = 75). An inverse relationship of satisfaction scores to negative mood states demonstrated evidence of construct validity. Factor analytic procedures (N = 664) failed to confirm the existence of the subscales initially conceptualized for this instrument and others in common use. Three new factors were identified: dissatisfaction, interpersonal support, and good impression. The dissatisfaction subscale explained 73.6% of the variance and had a high internal consistency (alpha = .91); the reliability coefficients of the other subscales also were high (alpha = .92 and .89). Reliability coefficients for the total instrument in successive testings were .92 (N = 100) and .95 (N = 533). PMID- 3634419 TI - Vacancy, stability, and turnover of registered nurses in hospitals. AB - The purpose of this study was to determine if organizational, administrative, and practice factors differentiate among hospitals and patient care units as to registered nurse vacancy, stability, and turnover rates. Data from 90 patient care units in 15 hospitals are reported. Results from stepwise multiple regression indicate that 52% of the variability in vacancy, 56% of the variance in registered nurse stability, and 42% of the variance in relative turnover rates were explained by seven variables. Important predictors included nursing workload, characteristics of nurse staffing and practice, as well as job satisfaction. These findings indicate that a combination of organizational attributes and staff attitudes are important for understanding nurse staffing. PMID- 3634420 TI - Ensuring anonymity by use of subject-generated identification codes. AB - The technique of subject-generated identification codes was recently devised to solve the problem of ensuring anonymity in longitudinal research when the researcher needs to connect each set of data with the particular respondent who was the source. An explanation of the technique, an example of a form used by subjects to generate the code, and a report on the use of the technique with a sample of 142 nursing students are provided. PMID- 3634421 TI - The impact of parental life change on the early development of children. AB - The effect of parental life change on children's mental and social development was explored in a longitudinal study of 193 families. Data on life changes, social supports, home environment, child development and interactions were obtained in a series of nine interviews from before the child's birth to 48 months after birth. For the sample as a whole, significant negative correlations were obtained between maternal life change in the first year of the child's life, and the child's IQ and receptive language at 4 years. An examination of subgroups revealed, however, that this relationship was strongest for mothers low in both personal coping resources and in social support. Findings suggest that both direct and indirect effects of maternal life change on the child contribute to the observed relationship. PMID- 3634422 TI - [Cancers of the oral cavity, the facial area and the rhinopharynx. Diagnostic aspects]. PMID- 3634423 TI - [Preparation of the patient for therapy]. PMID- 3634424 TI - [Cervicofacial oncology. Surgery]. PMID- 3634425 TI - [Cervicofacial oncology. Radiotherapy]. PMID- 3634426 TI - [Anatomo-physiological review of the cervico-facial region]. PMID- 3634427 TI - [Cervicofacial oncology. Chemotherapy]. PMID- 3634428 TI - [Bases for therapeutic indications]. PMID- 3634429 TI - [Nursing care during medical treatment]. PMID- 3634430 TI - [Etio-epidemiology and natural history of nasopharyngeal neoplasms]. PMID- 3634431 TI - [Urinary tract infection]. PMID- 3634433 TI - [Is the aging of the skin unavoidable?]. PMID- 3634432 TI - [Apprenticeship in work organization in module 3]. PMID- 3634434 TI - [Dwelling in order to continue to exist]. PMID- 3634435 TI - [Individual dispensing of drugs]. PMID- 3634436 TI - [A consultation ... unlike the others]. PMID- 3634437 TI - [To the rescue! Apropos of suppositories ... precise facts. Sleep]. PMID- 3634438 TI - [Suffering and care of body and mind]. PMID- 3634439 TI - [Mandibular fractures. Clinical and therapeutic general facts]. PMID- 3634440 TI - [Sterilization]. PMID- 3634441 TI - [What to do about an asymptomatic carotid artery stenosis]. PMID- 3634442 TI - [Information for patients about to undergo laryngectomy. Reflections of a hospital nursing team]. PMID- 3634444 TI - [When to stop drugs in elderly patients?]. PMID- 3634443 TI - [Pulmonary embolism]. PMID- 3634445 TI - [The efficacy of nursing care]. PMID- 3634446 TI - [Health: the reason for summoning ethics]. PMID- 3634447 TI - [Public health in the Valley of Jezreel]. PMID- 3634448 TI - [Happening at the day nursery]. PMID- 3634449 TI - [The pleurisies]. PMID- 3634450 TI - [Fecalomas in the elderly]. PMID- 3634451 TI - [Spastic torticollis]. PMID- 3634452 TI - [At Saint-Denis: a pedagogical undertaking for community health]. PMID- 3634453 TI - [The process of care and the nurses aide]. PMID- 3634454 TI - [Efficiency of the norm or the possibilities of the rule?]. PMID- 3634455 TI - [Efficiency and ethics in nursing care]. PMID- 3634456 TI - A club that offers low-cost CE. PMID- 3634457 TI - Why the patient must come first. PMID- 3634458 TI - Use vectors to round out an ECG. PMID- 3634459 TI - Would you have recognized this deadly disease? PMID- 3634460 TI - When there's no treatment left but the truth. PMID- 3634461 TI - The ABCs of pediatric emergencies (continuing education credit). PMID- 3634462 TI - How we streamlined pre-op paperwork. PMID- 3634463 TI - Why patients don't follow instructions. PMID- 3634464 TI - AIDS: an update on what we know now. PMID- 3634465 TI - My first AIDS patient. PMID- 3634467 TI - The write way to earn big bucks. PMID- 3634466 TI - Legally speaking. How an emergency can spell trouble. PMID- 3634468 TI - What lies ahead for nursing? PMID- 3634469 TI - Are you cut out to be a manager? PMID- 3634470 TI - If a patient asks you to pray with him. PMID- 3634471 TI - A crash course in serum drug monitoring (continuing education credit). PMID- 3634472 TI - Never give up on a "hopeless' patient. PMID- 3634473 TI - A delivery room you can set up anywhere. PMID- 3634474 TI - Tips for successful respiratory suctioning. PMID- 3634475 TI - Easing the torment of an irritable bowel. PMID- 3634477 TI - The new drugs you're giving now. PMID- 3634476 TI - Multiple blood samples without multiple sticks. PMID- 3634478 TI - Legally speaking. We teach nurses to chart defensively. PMID- 3634479 TI - Do you know me? I'm a nurse. PMID- 3634481 TI - How times have changed in home care. PMID- 3634480 TI - What you can learn from weighing a patient. PMID- 3634482 TI - Registered Nurses' Association of British Columbia: guidelines for resolving professional practice problems. PMID- 3634483 TI - Cultural relevance in nursing education. Part I. A native Indian model. PMID- 3634484 TI - Defining roles. PMID- 3634486 TI - Changing the Act: proposals for graduate nurses. PMID- 3634485 TI - New law aims to deter drunk driving. PMID- 3634487 TI - Organ procurement: nurses have a vital role to play. PMID- 3634488 TI - Crib safety--an ongoing concern. Child safety. Part I. PMID- 3634489 TI - Home environment clinic--transition from hospital to home. PMID- 3634490 TI - Management of related spinal cord injury problems. PMID- 3634491 TI - SCI home care: transitional rehabilitation as a component of follow-up care. PMID- 3634492 TI - [Humoryl]. PMID- 3634493 TI - [Psychoanalysis, the nursing staff and psychiatry]. PMID- 3634494 TI - [The neurobiologic model. Contribution of drugs]. PMID- 3634496 TI - [Epidemiological methods]. PMID- 3634495 TI - [Phenomenology and existential analysis]. PMID- 3634497 TI - [Psychiatry and the tower of Babel]. PMID- 3634498 TI - [Explanatory models in psychiatry. The genetic explanation]. PMID- 3634499 TI - [The familial and systemic approach]. PMID- 3634500 TI - [Personality structure]. PMID- 3634501 TI - [The drug addict in a psychiatric hospital]. PMID- 3634503 TI - [Classification of psychiatric problems; scope and limits]. PMID- 3634502 TI - [Immigrant families and their cultural practices]. PMID- 3634504 TI - [Aldactazide]. PMID- 3634505 TI - [Acute cardiogenic pulmonary edema]. PMID- 3634506 TI - [Chronic pulmonary heart disease]. PMID- 3634507 TI - [Study of left ventricular function]. PMID- 3634508 TI - [Physiopathology of pulmonary heart disease]. PMID- 3634509 TI - [Therapeutic modalities for pulmonary heart disease]. PMID- 3634510 TI - [Emergency measures and the proper role of the nurse facing acute pulmonary edema. Clinical case]. PMID- 3634511 TI - [Estrogel]. PMID- 3634512 TI - [Sexually transmissible Chlamydia infections]. PMID- 3634513 TI - [Are herpes and the condylomata sexually transmissible diseases?]. PMID- 3634514 TI - [Care of a woman with secondary syphilis]. PMID- 3634515 TI - [Rehabilitation after mastectomy]. PMID- 3634516 TI - [Male and female gonorrhea]. PMID- 3634517 TI - [Care for the seriously ill and dying--let's hope for a good day tomorrow!]. PMID- 3634518 TI - [From a study in Ostfold: respite for patients in home care]. PMID- 3634519 TI - [Will, will not, will ... (closure of Reitgjerdet)]. PMID- 3634520 TI - [Ulleval for example: a night at Station 13]. PMID- 3634521 TI - [Outskirts community Naeroy--we need district midwives!]. PMID- 3634522 TI - [Proposal from the Ministry of Social Affairs: legislation on passive smoking supported by the Norwegian Nurses' Association]. PMID- 3634523 TI - Maternal/child health research applications for the clinical setting. PMID- 3634524 TI - A quiz: are your cut out to entrepreneur? PMID- 3634525 TI - Purification of human factor XII from plasma using zinc chelate affinity chromatography. AB - Human factor XII (Hageman Factor) was isolated from human plasma to apparent homogeneity using a four step procedure with yields up to 30%. The method, which is more rapid than the current conventional procedures, consists of a 25-50% ammonium sulfate fractionation, two affinity chromatography steps using Zinc Chelate Sepharose, followed by gel filtration. The isolated zymogen factor XII was a single protein component when examined by SDS PAGE with a Mr of 80,000. Activation of zymogen factor XII to its active enzymatic forms by kallikrein resulted in factor XIIa and factor XIIf as observed with factor XII purified by other procedures. PMID- 3634526 TI - Plasma prokallikrein and kininogens in burned patients. AB - Using specific immunological (1) and enzymatic (2) methods, we have measured prokallikrein, total, high, and low molecular weight kininogens in 36 severely burned patients. At admission to the intensive care unit, all constituents were significantly decreased when compared to previously defined reference intervals. The values remained low during the three first days after burn. The changes affecting total and low molecular weight kininogens were significantly correlated (p less than 0.05) with the severity of the burn area. Prokallikrein and kininogens levels were also closely related to the concentrations of C3c and C4 complement factors. PMID- 3634527 TI - [Neonatology and the mother-child relationship]. PMID- 3634528 TI - [Euthanasia in nursing practice]. PMID- 3634529 TI - [Euthanasia and the State Supervision of Public Health]. PMID- 3634530 TI - [Continuous arteriovenous hemofiltration]. PMID- 3634531 TI - Stemming the tide of airborne contaminants. PMID- 3634532 TI - Managing detachment with retinal tacks. PMID- 3634534 TI - Streamlining patient care with the 2-pack system. PMID- 3634533 TI - A yearly program for OR nurse retention. PMID- 3634535 TI - Your patient has cancer: post-surgery repairs are needed. PMID- 3634536 TI - Advanced assessment skills. PMID- 3634537 TI - Assessment of the neonate. PMID- 3634538 TI - Assessing the adolescent. PMID- 3634539 TI - A theory-based nursing assessment of the aged. PMID- 3634541 TI - Assessing the client with acute cardiovascular dysfunction. PMID- 3634540 TI - Assessing and identifying the high-risk pregnancy: a holistic approach. PMID- 3634542 TI - The client with aphasia--the nurse's assessment of language abilities. PMID- 3634543 TI - The self-assessment of health among the chronically ill. PMID- 3634544 TI - On masking among clients. PMID- 3634547 TI - [Swedish Laboratory Technicians' Association arranges a world congress in Stockholm. What shall we do about the South African participants?]. PMID- 3634546 TI - [Eva tells about the Philippines: good care for the rich--nothing at all for the poor people. Interview by Jan Thomasson]. PMID- 3634548 TI - [Portrait: Gun Hakansson. Interview by Janne Berglund]. PMID- 3634545 TI - Synergism of azlocillin, mezlocillin, piperacillin in combination with tobramycin against Klebsiella and Pseudomonas. AB - Fifty-three clinical isolates of Klebsiella and fifty-one clinical isolates of Pseudomonas aeruginosa, twenty-six of which were carbenicillin-(CARB) resistant, were tested for susceptibility to mezlocillin (MEZ), azlocillin (AZL), and piperacillin (PIP), both alone and in combination with tobramycin (TOB) using the microtiter broth diluent method and an inoculum density of 10(6) CFU/ml. The Klebsiella were highly resistant to TOB, MEZ, and PIP (MIC90: 8, greater than 256, greater than 128 micrograms/ml, respectively). Synergy was demonstrated in 53 percent (PIP/TOB) and 51 percent (MEZ/TOB). An indifferent response was observed in 47 percent (PIP/TOB) and 49 percent MEZ/TOB of the Klebsiella. PIP, MEZ, and AZL in combination with TOB showed synergism against CARB-resistant Pseudomonas in less than 10 percent of the strains tested. Synergy could be demonstrated against CARB-susceptible Pseudomonas with the combinations PIP/TOB, AZL/TOB, and MEZ/TOB in 12 percent, 12 percent, and 24 percent, respectively, of the twenty-five strains tested. Indifferent effects were observed in 84 percent, 88 percent, and 76 percent, respectively, of these same CARB-susceptible strains. These data suggest that there is no significant difference in the incidence of synergy with these new penicillins and tobramycin against either Pseudomonas or Klebsiella. PMID- 3634549 TI - [Lars is home now after 7 months in war-torn Afghanistan. Interview by Viveka Holmertz]. PMID- 3634550 TI - [Ann-Marie--laboratory assistant with a doctor's title. Interview by Viveka Holmertz]. PMID- 3634551 TI - [Nursing care activities produce special demands]. PMID- 3634552 TI - [Swedish nursing personnel seldom talks about feelings, rather propose remedies]. PMID- 3634553 TI - [Civil Servants International Congress in Venezuela--a well-directed great performance]. PMID- 3634554 TI - [Mob mentality often hides behind "cooperation problems"]. PMID- 3634555 TI - [Marten shows the way to a new kind of care: secure patients and happy staff when care team becomes reality. Interview by Anita Widen]. PMID- 3634556 TI - [Kristina, nurse: "I was shocked about how lonesome nurses are"]. PMID- 3634557 TI - [Profession: nurse--place of work: North Sea. Interview by Berit Blomqvist]. PMID- 3634558 TI - [This is how SHSTF will work internationally]. PMID- 3634559 TI - [Portrait: Gun Greebachs. Interview by Jan Thomasson]. PMID- 3634560 TI - [Better than turning on the light ... many political prisoners' only hope is Amnesty. Interview by Janne Berglund]. PMID- 3634561 TI - [New York has taught me much but not in nursing care]. PMID- 3634562 TI - [Student nurses' spokesperson: equally good education is most important issue. Interview by Janne Berglund]. PMID- 3634563 TI - [Comprehensive care must be raised on a level with the medical problems]. PMID- 3634564 TI - [Verdict in health and nursing care liability Committee. Gave 70 instead of 7 milligram of cytostatic agent. Warning--overlooked abdominal sponges]. PMID- 3634565 TI - [New records legislation a tool for change]. PMID- 3634566 TI - Client education: position statement and guidelines. PMID- 3634567 TI - Clients' perspectives of in-hospital education. PMID- 3634568 TI - A challenge to care. PMID- 3634569 TI - Quality of working life. PMID- 3634570 TI - The stethoscope as talisman: medical technology and loneliness. PMID- 3634572 TI - Hospital RNs feel brunt of budget cuts. PMID- 3634571 TI - The IgE-dependent release of a Hageman factor cleaving factor from human lung. AB - Passively sensitized human lung fragments were shown to release a protease by an IgE-dependent mechanism which can cleave human Hageman factor (Coagulation Factor XII). This enzyme, lung Hageman factor cleaving factor, was partially purified by ion exchange chromatography and gel filtration and was shown to be a serine protease with an apparent molecular weight of 12,000-13,000. This protease appears to be unrelated to any known activator of Hageman factor by molecular weight and inhibition profile and was shown to be distinct from an IgE-dependent prekallikrein activator, as well as the kininogenase activity defined as basophil kallikrein of anaphylaxis. Although it appears marginally capable of activating Hageman factor, it rapidly cleaves and inactivates the activated form so that the net effect is a loss of activatable Hageman factor. The result suggests that diminished levels of Hageman factor that may be seen associated with IgE dependent reactions can be due to digestion and depletion rather than activation, and other criteria for activation of the contact system must be employed. PMID- 3634574 TI - SNAs say cuts threaten wages, staffing, jobs. PMID- 3634573 TI - Balanced budget law slashes health programs. PMID- 3634575 TI - For patient's sake nurses must learn to compete. PMID- 3634576 TI - As I see it ... turbulent era brings change to labor relations. PMID- 3634577 TI - Conferences seek improved access to prenatal care. PMID- 3634578 TI - Nursing homes need stronger regs, says study. PMID- 3634579 TI - Acute effect of smoking on elastaselike esterase activity and immunologic neutrophil elastase levels in bronchoalveolar lavage fluid. AB - In order to determine the acute effect of smoking on elastase in bronchoalveolar lavage fluid (BAL), we obtained BAL from 30 smokers twice, the first before smoking (after 8 h of abstinence) and the second 2 min to 1 h after the subjects had smoked either 2 or 4 cigarettes. Bronchoalveolar lavage was concentrated 100 fold and was assayed for elastaselike activity against succinyl-trialanyl-p nitroanilide (SLAPN) as substrate. Elastolytic activity against insoluble 3H elastin and immunologic neutrophil elastase levels tested with a sensitive enzyme linked immunosorbent assay were determined in some subjects. No activity against insoluble 3H-elastin was detected using a sensitive assay capable of detecting subnanogram quantities of elastase. Total elastaselike activity in BAL against SLAPN was significantly (p less than 0.02) increased in smokers prior to smoking (47.4 +/- SD 20.2 ng human neutrophil elastase (HNE) equivalents) when compared with BAL from 7 nonsmokers (26.3 +/- SD 13.4 ng HNE); however, there was no significant change in enzyme activity in smokers' BAL after smoking. Assays with EDTA and phenyl-methyl-sulfonyl-fluoride as inhibitors suggested that approximately two thirds of elastaselike activity was due to a metalloprotease and that there was negligible serine protease activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3634580 TI - Effects of dosage and timing of administration of a peptide boronic acid inhibitor on lung mechanics and morphometrics in elastase-induced emphysema in hamsters. AB - The peptide boronic acid, MeOSuc-Ala-Ala-Pro-boroVal-pinacol (AAPbV), is an effective inhibitor of both pancreatic and leukocyte elastase. Initial work showed that AAPbV diminishes the effect of emphysema induced by pancreatic elastase. This initial work has been expanded to show that AAPbV provides a high degree of protection against elastase-induced increases in lung volume and mean linear intercept when given intratracheally at 200 mg/kg either 15 min before, simultaneous with, or 15 min after instilling elastase. Intraperitoneal administration, although less effective, is dose dependent and dependent on the time of treatment. We conclude that a reversible protease inhibitor can be used to prevent aberrant proteolysis in vivo. PMID- 3634582 TI - The nursing profession does not need two Federations. PMID- 3634581 TI - A new peptide boronic acid inhibitor of elastase-induced lung injury in hamsters. AB - A highly effective, reversible elastase inhibitor, MeOSuc-Ala-Ala-Pro-boroVal-OH, was tested for its ability to prevent emphysema induced by intratracheally administered elastase in hamsters. Anesthetized hamsters were given elastase intratracheally with or without the inhibitor or were given elastase intratracheally and the inhibitor intraperitoneally. Two weeks after administration, lungs were removed, and static air pressure volume curves were performed followed by intratracheal fixation and morphometric determination of mean linear intercepts. The results indicate significant preservation of structure and function whether the inhibitor is given intratracheally or intraperitoneally and suggest that this inhibitor may be useful in controlling diseases arising from aberrant proteolysis by elastolytic enzymes. PMID- 3634583 TI - Is your OR giving you the blues? It could be color. PMID- 3634584 TI - Using games to learn in the OR. PMID- 3634585 TI - Arthroscopy of the knee. A perioperative nursing challenge. PMID- 3634586 TI - Epinephrine. Use, adverse effects, and dosage calculation. PMID- 3634587 TI - Surgery for reflux esophagitis. Experience with the antireflux prosthesis. PMID- 3634588 TI - Artificial urinary sphincter. Restoring continence. PMID- 3634589 TI - Career development. Steps to achieving your goals. PMID- 3634590 TI - Growing old. Increased surgical risks in the elderly. PMID- 3634591 TI - Infection control survey. Identifying compliance with guidelines. PMID- 3634592 TI - Infection control education. Identifying breaks in aseptic techniques. PMID- 3634593 TI - Perioperative clinical experiences. Opportunities for baccalaureate nursing students. PMID- 3634594 TI - Incorrect counts; surgeon's negligence does not absolve nurses from liability. PMID- 3634595 TI - Hemodialysis orientation using ANNA standards as guidelines. PMID- 3634596 TI - Clinical observations of the use of AN69 dialyzers. PMID- 3634597 TI - Nephrology nursing consult: case study. Authors' guidelines. A dialysis patient with diabetes mellitus and peripheral vascular disease. PMID- 3634598 TI - Reflections on the nurturing of professionalism. PMID- 3634599 TI - Stress and coping in patients on CAPD compared to hemodialysis patients. PMID- 3634600 TI - Sickle cell crisis during hemodialysis. PMID- 3634601 TI - Humanizing the teaching-learning environment for Vietnamese clients with ESRD. PMID- 3634602 TI - Case history of a homosexual male on CAPD. PMID- 3634603 TI - Self-care activities and processes used by hemodialysis patients. PMID- 3634604 TI - Reuse with continuous cyclic peritoneal dialysis. PMID- 3634605 TI - AIDS and the nurse. Part 1. PMID- 3634606 TI - Aids and the nurse. Part 2. PMID- 3634607 TI - AIDS and the nurse. Part 3. PMID- 3634608 TI - Justice--truth in action. PMID- 3634610 TI - AIDS care in the community. PMID- 3634609 TI - Integrating Aboriginal students into the general nursing course. PMID- 3634611 TI - Promoting parental care of high-risk babies. PMID- 3634612 TI - Successful behaviour modification in a CVA patient. PMID- 3634614 TI - Tertiary nursing courses: education or training? PMID- 3634613 TI - The clinical nurse specialist--role, overview and future prospects. PMID- 3634615 TI - Nurse & the law. It speaks for itself. PMID- 3634616 TI - I.V. incompatibilities. PMID- 3634617 TI - Lead poisoning: a complex issue. PMID- 3634618 TI - Stress: the high cost to industry. PMID- 3634619 TI - Role enactment: a model for pre-retirement planning. PMID- 3634620 TI - Breast self-examination: knowledge, attitudes and practice behaviors of working women. PMID- 3634621 TI - Breast cancer screening in a university setting. PMID- 3634622 TI - Quality assurance: a safe working environment for hospital nurses. PMID- 3634623 TI - The availability of primary caregivers: an emerging problem. PMID- 3634624 TI - Hospice patients without caregivers. PMID- 3634625 TI - La Maison Michel Sarrazin. A Canadian community network of care for the dying cancer patient. PMID- 3634626 TI - Hospital utilization of laboratory tests, procedures, and special therapies. PMID- 3634627 TI - Problems and successes in rural hospice development. PMID- 3634628 TI - An old man's tale about a special Inn. PMID- 3634629 TI - [Different sensitivity of cross-bridges in the muscle fiber sarcomere in Ca2+ activation]. AB - The investigation of transient kinetics of force development by glycerinated rabbit m. psoas fibres at consecutive pCa stepwise drops in the presence of 0.1 mM Na3VO4 was carried out. Stationary content of trapped vanadate in the fibres at low levels of Ca2+-activation was deduced to be attained slowly as compared to the initial rate of force development and vanadate trapping. This result is considered an indication of the fact, that not all cross-bridges can be activated by turns at low levels of Ca2+-activation. PMID- 3634630 TI - [Various properties and kinetics of interaction of high and low molecular weight human kininogens with human plasma kallikrein]. AB - A relatively simple procedure for isolation and purification of human blood plasma kallikrein (HPK) by QAE-Sephadex A-50 SP-Sephadex C-50 and affinity chromatography on Sepharose 4B with immobilized soybean trypsin inhibitor with the activity yield of about 40% has been developed. The method allows for simultaneous isolation of low (LMW) and high molecular weight (HMW) kininogens from the same HPK sample. HPK preparations are homogeneous upon 7.5% polyacrylamide gel electrophoresis in the presence of 0.1% SDS; its Mr is 90,000. After treatment with beta-mercaptoethanol, HPK dissociates into two fragments with Mr of 43,000 and 37,000. HPK preparations have high specific activities of esterase (31 microM/min), amidase (78 microM/min), and kininogenase (420 micrograms equiv. bradikinin/min). The high degree of protein purification was demonstrated by titration of active centers with 4-methylumbelliferylguanidine benzoate. The values of equilibrium dissociation constants for the HPK complex with aprotinin (Ki) equal to 1 X 10(-8) M (ethyl ester of N-alpha-benzoyl-L arginine) and 1,5 X 10(-9) M (HMW) were determined. The kinetics of HPK-induced liberation of bradikinin from purified preparations of HMW and LMW was studied. The kinetic parameters (Km, kcat and kcat/Km) of this reaction suggest a high affinity of HPK for HMW, but not for LMW. LMW does not compete with HMW for the enzyme active center. It is assumed that LMW is not a physiological substrate for HPK. PMID- 3634631 TI - Spermine-nucleic acid interactions: a theoretical study. PMID- 3634633 TI - The family in grief. PMID- 3634632 TI - High dosage desferrioxamine therapy in a female patient with acquired aplastic anaemia and transfusion siderosis. AB - A 32 year old woman with severe aplastic anaemia required frequent transfusions and consequently developed hyperferrioxaemia (54 microMol/l) and hyperferritinaemia (1,700 ng/ml). For the treatment of transfusion siderosis she was given 18 high dose courses each comprising 35 g of desferrioxamine. Because of pre-existing thrombocytopenia (platelet count 5 X 10(9)/l) the iron chelating agent was given by continuous intravenous infusion over 3 1/2 days. High dose desferrioxamine had to be abandoned because of severe bone pain. The desferrioxamine infusions achieved a negative iron balance, iron loss after each infusion being 100 to 200 mg in the urine and 400 mg in the faeces. Serum iron and ferritin concentrations fell almost to normal. This report shows that faecal iron excretion must be taken into account in assessing the balance of iron input and output during desferrioxamine treatment. PMID- 3634634 TI - The perfect parent is a myth. PMID- 3634635 TI - Diabetes--the silent disease. PMID- 3634636 TI - Mental retardation. An American approach through Irish eyes. PMID- 3634637 TI - Bi-national nursing in San Francisco. PMID- 3634638 TI - Recognizing health hazards. PMID- 3634639 TI - Care of the pregnant psychotic patient. PMID- 3634640 TI - AIDS: a nurse's responsibility. PMID- 3634642 TI - Clinical management of AIDS patients. PMID- 3634643 TI - San Francisco General Hospital's AIDS/ARC care plan. PMID- 3634641 TI - AIDS: a nurse's responsibility. Nursing's special challenge. PMID- 3634644 TI - Legal issues around the AIDS crisis. PMID- 3634645 TI - AIDS: a nurse's responsibility. Infection precautions in the community. PMID- 3634646 TI - AIDS and the caregiver. PMID- 3634647 TI - AIDS myths. PMID- 3634648 TI - AIDS. Home care hospice program. PMID- 3634649 TI - AIDS: a nurse's responsibility. Care plan for home care. PMID- 3634650 TI - AIDS bills hit legislature. PMID- 3634651 TI - AIDS: a nurse's responsibility. Safe sex guidelines for women. PMID- 3634652 TI - AIDS and politics. PMID- 3634653 TI - High touch nursing in a high tech world. PMID- 3634655 TI - Noise: who says hospitals are quiet places. PMID- 3634654 TI - Applying nursing research: getting started. PMID- 3634656 TI - [To each his "sailboard"]. PMID- 3634657 TI - Letter from Africa. PMID- 3634658 TI - [Reflexology]. PMID- 3634659 TI - Total program approval: a terrific option. PMID- 3634660 TI - Evolution of the CE program in Illinois: a personal perspective. PMID- 3634661 TI - Continuing education in Illinois. PMID- 3634662 TI - ANA revises accreditation system. PMID- 3634663 TI - Current trends in the licensure examination system. PMID- 3634664 TI - Kinetics of enzymes released from polymorphonuclear leucocytes in a skin chamber. AB - Ten healthy volunteers were investigated with a skin chamber technique developed for leucocyte migration studies. Chambers, filled with autologous serum, were harvested at 4, 8, 12, 22, and 30 hours. A marked increase was found both in the concentration of elastase in chamber serum as measured by RIA, and of lysozyme as measured both with lysoplate and electroimmuno assays. The immuno-reactive elastase was shown to consist exclusively of elastase-alpha 1-proteinase inhibitor complexes. During the first 22 hours the concentrations of elastase and lysozyme were roughly proportional to the number of cells in the skin chamber (r = 0.92 and 0.85). At longer incubation times there was a decrease of relative concentration of elastase but not of lysozyme. Lactate dehydrogenase (LDH) was measured as a marker of the lysis of chamber leucocytes. Lysis was less than 1.5% at all incubation times. The present study shows a release of elastase from primary granules and of lysozyme when polymorphonuclear leucocytes migrate into a skin chamber. PMID- 3634666 TI - Graphical reports and displays for complex ICU data: a new, flexible and configurable method. AB - The use of computers for critical care data management may markedly increase the volume of digital numbers presented to the nurse and clinician. Such digital displays and reports may not be optimum for estimating the graded levels of intervention required for specific physiologic problems. We have devised software subsystems which allow for rapid configuration of medically oriented graphical reports and video images, using an English language syntax rather than specific computer code. These subsystems produce graphical reports which resemble previous hand-written charts, and video displays which are useful for hemodynamic patient management. PMID- 3634665 TI - Use of computerized information systems in U.S. health maintenance organizations and hospitals. AB - A comparison was made between the use of data processing in hospitals and Health Maintenance Organizations (HMOs). Findings indicate that the HMO and hospital data processing markets are currently quite distinct. As expected, the functions automated reflect the uses of the different care delivery systems. The hardware and software vendors to these markets are also different. A high percentage (50%) of HMOs are using software they developed in-house. In this respect, current HMO data processing is similar to the hospitals of a decade ago. The hospital market (for hardware and total systems) is highly concentrated. A few firms have a combined market share of over 50% and there are a large number of firms with very small shares. In the HMO market, there is a high concentration ratio for hardware but not for software or systems. HMOs and hospitals are almost uniformly satisfied with their hardware. Satisfaction with most applications is between 80 and 90% but there is a need, at least within HMOs, for improvements in support of the software supplied. PMID- 3634667 TI - Prescription-writing with a PC. AB - We described the development of an automated system to perform writing of prescriptions and associated advice. A prototype computer program has been in operation in a dermatologist's office for three years. All prescriptions are routinely generated using the system. The program, originally developed for a multi-user computer system, now operates in a self-contained personal computer. The program is constructed to use external human-readable files as the drug formulary or data base. Experience with this system and efforts to expand its applicability to another ambulatory care setting (gastroenterology) are described. Rapid access to drug names and related information is achieved using diagnosis-specific subsets contained in the personally defined formulary. This organization supports rapid pruning of the list of drugs. From this point, a prescription of the selected drug is displayed on a video terminal. The base level prescription is easily modified using only five keys organized in a cluster. Preliminary training and performance studies are summarized. PMID- 3634668 TI - Modelling reading aloud and its relevance to acquired dyslexia. AB - The cognitive processes underlying reading aloud are generally believed to involve a dual-route print-to-sound mapping. To test this idea, a parallel activation model of reading aloud is being implemented and subjected to experiments. Spread of activation in the model is based on a theory that competition between cognitive processes for limited neurophysiological resources is a fundamental organizing principle of memory retrieval. This paper briefly describes the dual-route print-to-sound mapping, introduces the competition-based theory being tested, and explains our work's relationship to modelling acquired dyslexia. PMID- 3634669 TI - Wheelchair-based mobile measurement of behavior for pressure sore prevention. AB - A recently developed device which provides continuous, direct monitoring of the pressure relief performance of persons confined to wheelchairs is reported. A custom portable computer records the data, which is transferred for analysis to an Apple IIe. The mobile computer can also signal the patient to relieve pressure on the basis of preset criteria and the patient's performance. Teaching lift-offs to prevent ischial pressure sores is the object. Data collected with the device are used clinically and for research. Examples of such data are presented. The benefits of the device are reviewed. PMID- 3634670 TI - Multilingual translation techniques in the analysis of narrative medical text. AB - The feasibility of computer translation of scientific and medical documents is controversial. This report describes a minicomputer-based translation system (TRANSOFT) that employs word order rearrangement followed by word-for-word translation and resolution of ambiguities based on context. This translation system was applied to an entire medical textbook written in German and to short medical texts written in French, Italian, Spanish and Turkish. Results suggest the versatility of TRANSOFT for narrowly defined translation problems. As foreign language medical documents and medical records become increasingly available in computer readable form through word processing, computerized typesetting and hospital information systems, computer translation methods may provide a rapid and inexpensive means of obtaining draft translations. PMID- 3634671 TI - Studies in artificial aphasia: experiments in processing change. AB - Computational neurolinguistics, an integrated approach to cognitive modelling of neural processes which may subserve natural language performance, attempts to build computational models that model behavior on two levels: at the neural process level and at the human performance level in its normal state and under pathological conditions. HOPE is one example of such a model. It demonstrates how the design and implementation of such models can provide insights into how a brain-like architecture can produce a behavior as complex as natural language. This paper will briefly describe the neurally motivated or 'natural computation' processes which produce the model's observable and verifiable behavioral results. Experiments with artificially induced aphasia on HOPE will then be described, showing that the results of simulation produce hypothesized patient profiles that are unique. These profiles illustrate the suggested contribution of the computational neurolinguistics research approach as a tool for investigating the breakdown of language performance and its potential contribution to understanding brain function. PMID- 3634672 TI - A computerized system for measuring the effect of nursing care activities on the clinical indices of energy expenditure. AB - A computerized system for measuring clinical indices of energy expenditure (heart rate, temperature and activity) was pilot tested on three low-birth-weight infants over a period of 24 hours. The mean heart rate was 163 beats/min and the following mean temperatures were recorded: heel, 34.7 degrees C; abdominal skin, 35.1 degrees C; incubator wall, 29 degrees C; and air, 25.5 degrees C. Activity, determined as the number of baseline crossings of the processed signal from a pressure mattress, was calculated to be 8-9 crossings/min. When compared with an established activity scale based on behavioral observation, a correlation of 0.84 was found. The system described is valid, reliable and interferes minimally with normal nursing activities. PMID- 3634673 TI - Designing information systems for nursing practice: data base and knowledge base requirements of different organizational technologies. AB - One of the major causes of failure of information system design is the failure of developers to take into account the organizational environment, thereby leading to an unusable system. The first step in designing an effective system is to describe the user's view of the system, a view that incorporates how the system will help users to manage information in their particular organizational environment. For nurses involved in designing a nursing information system, a useful way of considering the organizational environment is provided by Perrow. The organizational technologies described by Perrow can be viewed as different models of nursing practice, each with particular requirements for a knowledge base and a data base. Nurses can identify the model that most closely corresponds to actual or desired nursing practice in their agencies and use the model's associated knowledge base and data base requirements as a guide to specifying the information system to be developed. PMID- 3634674 TI - Development and application of a three-dimensional artificial visual system. AB - A three-dimensional artificial visual system has been developed to aid in the analysis of 3-D fluorescence images of smooth muscle cells. The system consists of three sets of 3-D spatial filters that decompose the image to enable a simple recombination algorithm to locate the discrete bodies of protein concentration in a cell, classify the concentration bodies as globular or oval, and determine the 3-D orientation of the oval bodies. A graphic model of the protein concentration is created from the data provided by the artificial visual system. Patterns of organization in the distribution of the protein bodies are investigated using an interactive graphics system. PMID- 3634675 TI - [Psychocybernetics and nursing--in search of more meaningful interactions with patients]. PMID- 3634677 TI - [What I gain from work--methods of self development]. PMID- 3634676 TI - [Values and vicissitudes of the scientist nurse]. PMID- 3634678 TI - [Teaching case studies to nursing students]. PMID- 3634679 TI - [From a diary of a Japanese nurse in Canada]. PMID- 3634680 TI - [Psychiatry--establishment of scientific psychiatry. 4]. PMID- 3634681 TI - Health visiting: twilight zone. PMID- 3634682 TI - Leg ulcers: adsorbing the problem. PMID- 3634684 TI - Community psychiatry: selling skills. PMID- 3634685 TI - A nurse for Europe. PMID- 3634683 TI - Leg ulcers: know your enemy. PMID- 3634686 TI - Respite care: holiday home. PMID- 3634687 TI - The challenge of patient education in critical care. PMID- 3634688 TI - Integrating hemodynamic parameters with clinical decision-making. PMID- 3634689 TI - Monitoring left atrial pressures in the open-heart surgical patient. PMID- 3634690 TI - Ventricular failure: new therapy using the mechanical assist device (continuing education credit). PMID- 3634692 TI - Insulin pump therapy for older adults: case report. PMID- 3634691 TI - AIDS awareness in the emergency department. PMID- 3634693 TI - Problems perceived by adults in adhering to a prescribed diet. PMID- 3634694 TI - Impacts of professional education in diabetes on trainees' reports. PMID- 3634695 TI - Diabetes patient education: a consumer view. PMID- 3634696 TI - Diabetes patient education: a health care provider perspective. PMID- 3634697 TI - Diabetes patient education: nurse specialist approach. PMID- 3634698 TI - A diabetes psychosocial profile. PMID- 3634699 TI - Patient and spouse expectations of and reactions to continuous subcutaneous insulin infusion (CSII) therapy: case report. PMID- 3634700 TI - Is it safe to consume aspartame during pregnancy? A review. Nutrition update. PMID- 3634701 TI - Third-party reimbursement: alphabet medicine and diabetes care. PMID- 3634702 TI - Travel: implications of education for coping with diabetes. PMID- 3634703 TI - Flight attendants speak about travel and diabetes. PMID- 3634704 TI - But I want to motivate you. PMID- 3634705 TI - Retail strategy: for diabetes educators who go into business for themselves. PMID- 3634706 TI - [Carcinogenic action of soot extracts and the composition of the aromatic polycyclic hydrocarbons in emissions of the coke chemical industry]. AB - Carcinogenicity of the extract of "unorganized" emission of coke-oven batteries of the coke and by-product processes, 15 polycyclic hydrocarbons (PAH), solution of 4 carcinogenic PAH and benz(a)pyrene (BP) was studied in longterm experiments on (CBAXC57Bl/6)F1 hybrid mice. 1.5 ml of olive oil containing 1 mg of BP or the respective amount of PAH proportionally to their content in the extract were administered to each mouse. The sarcomas developed in 46.6% of mice which had received injections of the extract and in 95 to 100% of mice which had received injection of PAH and BP solution. Thus, the results demonstrated that besides carcinogenic PAH the emissions contain substances which inhibit the tumour development. Our data confirm a possibility of using BP as an indicator in the evaluation of carcinogenicity of industrial emission discharges of the coke and by-product processes. PMID- 3634707 TI - [Determination of the human requirements for the basic foodstuffs by using nomograms]. PMID- 3634708 TI - [Chronic pneumonia]. PMID- 3634709 TI - [Epicondylitis]. PMID- 3634710 TI - [Congenital and acquired talipes]. PMID- 3634711 TI - [Arthrosis deformans of the knee joint]. PMID- 3634712 TI - [Results and the prospects of development in obstetrical science]. PMID- 3634713 TI - [Intestinal obstruction caused by gallstones]. PMID- 3634714 TI - [Hemoptysis and pulmonary hemorrhage]. PMID- 3634715 TI - [Performance of antiepidemic measures in the case of an elevated level of diphtheria morbidity]. PMID- 3634716 TI - [Work of polyclinic paramedical personnel in prophylactic departments]. PMID- 3634717 TI - Craniocerebral trauma. A review of primary and secondary injury and therapeutic modalities. PMID- 3634718 TI - Early mobilization of uncomplicated myocardial infarct patients. PMID- 3634719 TI - There's more to informed consent than information. PMID- 3634720 TI - General theories of hospital liability for negligence. PMID- 3634722 TI - Professional profile: Margretta Styles--breakthrough thinker. PMID- 3634721 TI - Malignant hyperthermia--a concern for critical care nurses. PMID- 3634723 TI - Impacting change through the legislative process: legislative issues in gerontological nursing. PMID- 3634724 TI - Communicating with your elected representatives: a brief guide to lobbying. PMID- 3634726 TI - Stress/burnout indicators of concern across clinical areas of nursing. PMID- 3634725 TI - The case for clinical nursing research: the why and how of gerontological nursing research. PMID- 3634727 TI - A profile of older Americans. PMID- 3634728 TI - Position paper. Sunset: nursing home rules (Chapter 400). PMID- 3634729 TI - Effect of exercise on plasma kallikrein and muscular phospholipase A2 activity in rats. AB - Many experimental observations show that prolonged physical exercise produces an increase of muscular glucose uptake. Recent findings suggest that the kallikrein kinin-prostaglandin system may be related to this phenomenon, but so far, no direct evidence of quantitative alteration in this system has been observed during exercise. We measured plasma kallikrein and muscular phospholipase A2 activity, respectively the first and the last steps of reactions leading to prostaglandin synthesis. We demonstrated, for the first time, that during exercise plasma kallikrein activity increases in rats. We also observed an increase of muscular phospholipase A2 activity after exercise and a positive correlation between these parameters. Our findings demonstrate, under physiological conditions of enhanced muscular glucose uptake, a concomitant significant increase of plasma kallikrein and muscular phospholipase A2 activity, supporting the hypothesis that activation of the kallikrein-kinin-prostaglandin system may play some part in the enhanced muscular glucose uptake during physical activity. PMID- 3634730 TI - Cancer awareness: "Where there's smoke...". PMID- 3634731 TI - The role of the nurse in cancer prevention. PMID- 3634732 TI - Cancer fears and caring nurses. PMID- 3634733 TI - A home for the dying where quality of life is not the issue. PMID- 3634734 TI - Nurses meet needs of homeless in Savannah. PMID- 3634735 TI - American Cancer Society colorectal health check program. PMID- 3634736 TI - Service & rehabilitation program of the American Cancer Society. PMID- 3634737 TI - [Legal aspects of the legislation for the nursing profession]. PMID- 3634738 TI - [Comparative evaluation of the fibrogenic activity of asbestos cement and hydrated cement dust]. PMID- 3634739 TI - A unit for the acutely ill. PMID- 3634741 TI - A program for the emotionally disturbed. PMID- 3634740 TI - Sheltered freedom--an Alzheimer's unit in an ICF. PMID- 3634742 TI - Plush animals--do they make a difference? PMID- 3634743 TI - Britain's community psychiatric nursing teams. PMID- 3634744 TI - Aging and reactive alcoholism. PMID- 3634745 TI - 70+ and going strong. Doris Schwartz--community health nurse extraordinary. PMID- 3634746 TI - Calcium and the blood pressure connection. PMID- 3634747 TI - Properdin factor B frequencies in four Asian populations. AB - The distribution of Properdin factor B (Bf) phenotypes and their gene frequencies were investigated in four Asian populations (Chinese, Filipino, Thai and Japanese). The frequency of the BfS phenotype in Filipinos (0.717) was significantly lower than that in Chinese (0.900) and Thai (0.889) (p less than 0.01), but not different from the Japanese (0.840). One variant, BfF 0.65 S, was identified in a Japanese subject. Thus, in the Asian populations studied, Bfs frequencies were high and the frequency of variants other than F and S were low. PMID- 3634748 TI - The nature of knowledge and theory in nursing. PMID- 3634749 TI - Exclusion and confirmation: a phenomenology of patients' experiences with caregivers. PMID- 3634751 TI - Can clients understand our instructions? PMID- 3634750 TI - Establishing a collaborative nurse-patient relationship: a distinct focus of nursing action in primary care. PMID- 3634752 TI - A case study of oppressed group behavior in nurses. PMID- 3634753 TI - Top-ranked schools of nursing: network of scholars. PMID- 3634754 TI - Critical care of nursing in Nebraska. PMID- 3634755 TI - Reproductive decisions in adolescence. PMID- 3634756 TI - Partial amino acid sequence of porcine elastase II. Active site and the activation peptide regions. AB - The partial amino acid sequence of porcine elastase II, isolated from crude trypsin Type II, was determined. The enzyme consists of two polypeptide chains, a light chain composed of 11 residues, and a heavy chain (Mr = 23 500) with four intrachain disulfide bridges; the two chains are held together by one interchain disulfide bond. Elastase II was fragmented into several peptides by chemical cleavages with CNBr at the two methionine residues, 99 and 180 (chymotrypsinogen numbering), and with hydroxylamine at the peptide bond following DIP-Ser195. About 50% of the sequence was determined and the positions of 120 amino acids were located, including the light chain residues and most of the active site residues. The partial sequence shows 64% difference between porcine elastase II and elastase I and only 26% difference between porcine elastase II and bovine chymotrypsin B. PMID- 3634757 TI - Tuberculosis surveillance in hospital employees: are we doing too much? PMID- 3634759 TI - Microbial examination of kidney lithotripter tub water and epidural anesthesia catheters. AB - Kidney lithotripsy patients frequently receive epidural anesthesia via indwelling epidural catheters. In our hospital, patients are immersed in a tub of warm, continuously-flowing tap water. The epidural catheter-entry site is covered by a transparent occlusive dressing. To determine the risk of microbial colonization of the epidural catheter during lithotripsy, we performed quantitative cultures of tub water and semiquantitative cultures of catheters in 63 lithotripsy procedures. Most of the tub water organisms were typical tap water and skin flora isolates. Total colony counts were generally low with no significant progression during the course of serial procedures. Forty-two epidural catheters were cultured; 34 (81%) were sterile, 8 (19%) were colonized with small numbers of flavobacteria or coagulase-negative staphylococci. Only four catheters had organisms present on catheter segments covered by the transparent occlusive dressing (in each case there was a single colony forming unit per semiquantitative plate) and these organisms were probable contaminants. We conclude that with our current lithotripsy procedures, the risk for the development of epidural catheter-associated infection seems to be low. PMID- 3634758 TI - The epidemiology and risk factors for nosocomial catheter-associated bacteriuria caused by coagulase-negative staphylococci. AB - Studies of the risk factors for bacteriuria associated with the use of temporary indwelling urinary catheters have focused on gram-negative bacilli and enterococci, the predominant causes of nosocomial urinary tract infection. During a prospective study of 747 catheterized patients, bacteriuria with greater than or equal to 1,000 bacteria/mL were found in 96 patients. Coagulase-negative staphylococci (CNS) accounted for 19% of the episodes of bacteriuria, and S. epidermidis was the most frequent species of CNS. Significant risk factors for bacteriuria were a positive meatal culture for CNS, non-surgical illness, and no antibiotic therapy during catheterization. In contrast to the results of this and earlier studies that females were at greater risk factor for catheter-associated bacteriuria with gram-negative bacilli and enterococci, this was not a risk factor for acquisition of CNS. Possibly this is due to the more similar prevalence of meatal colonization with CNS of males and females compared to the striking difference in prevalence of meatal colonization with gram-negative bacilli and/or enterococci of males and females. PMID- 3634760 TI - Infectious complications of acute myocardial infarction. AB - Four cases of purulent complications in the heart following acute myocardial infarction are described. Fever occurred during the first week after coronary occlusion. In one case thrombophlebitis at an infusion site was followed by purulent pericarditis. One patient had an infected mural thrombus with peripheral septic embolic, and two suffered from streptococcal endocarditis. The association between these infections and recent acute myocardial infarction could be related to tissue necrosis and local thrombosis, but the increasing risk of bacteremia following invasive monitoring procedures in these patients is a risk factor that should not be ignored. PMID- 3634761 TI - The antiseptic efficacy of chlorxylenol-containing vs. chlorhexidine gluconate containing surgical scrub preparations. AB - The studies described here evaluate the efficacy of the chlorxylenol-containing surgical scrub formulations against the chlorhexidine gluconate-containing formulations using the Glove Juice Test, as recommended by the FDA's panel to develop guidelines for the study of antiseptic agents. Similar reports from the literature evaluating the relative efficacies of the iodophor-containing and the hexachlorophene-containing formulations are cited. Results fail to detect any significant differences in the efficacy of these two preparations, each significantly reducing the bacterial flora on the hands as indicated by immediate post-wash colony counts, and each demonstrating the continuing ability to significantly reduce bacterial growth with continued regular use. PMID- 3634762 TI - Acyclovir. PMID- 3634763 TI - Effects of zinc on tumor transplantability. AB - The effects of zinc treatment on the transplantability of tumor cells were investigated in two syngeneic murine tumor systems. A 15-min incubation of tumor cells in 0.1 mM zinc caused a dramatic decrease in intravenous transplantability for melanoma B16 cells, while MCG 101-AA cells were unaffected. The subcutaneous transplantability remained unchanged in both cases. In order to elucidate the mechanism responsible for the effect on B16 cells, a number of factors of possible importance for the intravenous transplantability were investigated. Zinc treatment reduced the activity of extracellular neutral protease, and increased the cell rigidity and fragility in a similar way in both cell lines. However, zinc effects on cell adhesion and cell proliferation were different in the two cell lines. It is possible that zinc reduces the intravenous transplantability of melanoma B16 cells by impairment of cell adhesion. PMID- 3634764 TI - Creativity: survival in turbulent times. PMID- 3634765 TI - Comparative evaluation of intravenous therapy regulating devices. PMID- 3634766 TI - Postdischarge concerns of cardiac patients as presented via a telephone callback system. PMID- 3634767 TI - Training the cardiac arrest support team: the cardiac arrest support team program. PMID- 3634768 TI - Continuous S-vO2 monitoring: a tool for analyzing hemodynamic status. PMID- 3634769 TI - Postoperative shivering after cardiac surgery: a review. PMID- 3634770 TI - NTI (National Teaching Institute) research abstracts. Anaheim, Calif., May 20 to 23, 1986. PMID- 3634771 TI - The role of the clinical ethicist. PMID- 3634773 TI - Symposium on nursing diagnosis in critical care. PMID- 3634772 TI - The use of bolus normal saline instillations in artificial airways: is it useful or necessary? PMID- 3634774 TI - Identification of a modified nucleoside located in the first position of the anticodon of Torulopsis utilis tRNAPro as 5-carbamoylmethyluridine. AB - An unknown nucleoside in the first position of the anticodon of Torulopsis utilis tRNAPro has been isolated. The UV, 1H NMR and secondary ion mass spectra indicated that this nucleoside is a uridine derivative, 5-carbamoylmethyluridine. The structure was completely established by comparison of the instrumental analysis results and chromatographic behavior of the isolated nucleoside with those of a synthetic sample. PMID- 3634775 TI - Studies on the antibacterial activity of dodecylglycerol. Its limited metabolism and inhibition of glycerolipid and lipoteichoic acid biosynthesis in Streptococcus mutans BHT. AB - Growth-inhibitory concentrations of racemic sn-1(3)-dodecylglycerol inhibit the incorporation of [14C] glycerol into lipids and lipoteichoic acid of Streptococcus mutans BHT and alter the per cent composition of the glycerolipids. Increases in phosphatidic acid and diphosphatidylglycerol (at the expense of phosphatidylglycerol) contribute the most to the change in lipid composition. No cellular lysis occurs under these conditions. Radioactive racemic sn-1(3) dodecylglycerol is readily taken up by the cell and is metabolized primarily to lysophosphatidic acid and phosphatidic acid with smaller amounts converted to phosphatidylglycerol and diacylglycerol. The accumulation of phosphatidic acid and the loss of viability respond in parallel to different concentrations of dodecylglycerol. An increase in CTP is also observed which together with the increase in phosphatidic acid suggests a possible impairment in the synthesis of CDP-diacylglycerol. PMID- 3634776 TI - Effects of mevinolin and mevalonate on cell growth in several transformed cell lines. AB - Studies were conducted to explore the effects of mevinolin, a competitive inhibitor of HMG CoA reductase, on the growth and morphology of normal and transformed murine fibroblasts. Mevinolin is known to block DNA synthesis and cell growth in a number of kinds of non-transformed cells. Eight cell lines were studied, including two normal fibroblast cell lines (C3H 10T 1/2 and NIH 3T3) and derivatives of these cell lines transformed by chemical carcinogens, X irradiation or the H-ras oncogene. All of the eight cell lines displayed appreciable growth inhibition by 5 microM mevinolin and marked inhibition by 30 microM mevinolin. Mevinolin also induced a marked rounding in the morphology of all of the cell lines. These effects of mevinolin on cell growth and morphology were blocked or reversed by the addition of mevalonic acid. Thus, both normal and transformed cells require mevalonate, or an as yet unidentified metabolite of mevalonate for their growth, even though some transformed cells have become relatively autonomous of other growth factors. Whereas mevinolin acted primarily as a cytostatic agent for most of the cell lines studied, with the transformed cell line MCA/10T 1/2, which ordinarily grows to a very high cell density, prolonged exposure to mevinolin caused marked cytotoxicity. Thus mevinolin might be useful as an anti-tumor agent for specific tumors. PMID- 3634777 TI - Evaluation of the newly modified AutoMicrobic system gram-positive susceptibility MIC card for detection of methicillin-resistant Staphylococcus aureus. AB - AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) gram-positive susceptibility-MIC (GPS-MIC) cards and GPS cards were compared for their ability to detect methicillin-resistant Staphylococcus aureus (MRSA) in two groups of isolates. MRSA isolates from the first group were detected at rates of 23 and 85%, and MRSA isolates from the second group were detected at rates of 95 and 88% for GPS and GPS-MIC cards, respectively. Detection of MRSA by the AutoMicrobic system lacks sensitivity and remains unsatisfactory unless accompanied by supplemental testing. PMID- 3634778 TI - Comparative evaluation of four systems for determining susceptibility of gram positive organisms. AB - A study was undertaken to compare four commercial systems for testing the antimicrobial susceptibility patterns of gram-positive cocci. The reference method was an agar dilution method. The systems evaluated were the MS-2 system (Abbott Diagnostics Div., Mississauga, Ontario), the AutoMicrobic system (AMS) (Vitek Systems, Inc., Hazelwood, Mo.) with the gram-positive susceptibility (GPS) card, the Sceptor system (BBL Microbiology Systems, distributed by Becton Dickenson, Canada Inc., Mississauga, Ontario), and the Micro-Media system (Beckman Instruments, Inc., Anaheim, Calif.). There was a greater than 98% essential accord (EA) between all test results and the reference method results when testing 134 isolates of Staphylococcus aureus. In testing 79 isolates of coagulase-negative staphylococci the EA was greater than 97% with all systems except the MS-2. In the MS-2 system only, 30% of tests were interrupted by the instrument because of insufficient growth in the control chamber. Excluding the Sceptor system, the EA was greater than 96% on testing 70 isolates of enterococcus. In testing 15 isolates of group B Streptococcus there was 91% EA with the AMS and Sceptor systems and only 71 and 88% EA with the MS-2 and Micro Media systems, respectively. The new AMS GPS MIC card was tested against 29 methicillin-resistant S. aureus, 10 coagulase-negative staphylococci, and 9 enterococci, and it gave more accurate results than the earlier GPS breakpoint card. The Micro-Media and MS-2 systems did not reliably detect marginally methicillin-resistant S. aureus. The MS-2 was the least expensive system to operate on a cost per test basis ($3.59 Can.), whereas the Sceptor was the most expensive system ($5.29 Can.). The AMS ws the least labor intensive (0.9 min per test), and the Sceptor system was the most time consuming (2.9 min per test). PMID- 3634779 TI - Coagulase production by strains of Staphylococcus aureus of differing resistance characters: a comparison of two traditional methods with a latex agglutination system detecting both clumping factor and protein A. AB - Five groups of strains of Staphylococcus aureus (54 in total) were tested by slide and tube coagulase methods with rabbit and human plasma, and the results were compared with a latex test for both clumping factor and Protein A (Staphaurex, Wellcome Foundation). The five groups comprised: epidemic methicillin resistant S aureus (group 1); other methicillin resistant S aureus (group 2); other resistant S aureus (group 3); other S aureus (group 4); and a group of reference strains, not all true S aureus (group 5). Groups 1, 3, and 4 gave consistently strong positive results with the tube test and the latex test and less strong positive results with the slide test. Group 2 strains sometimes gave weak or negative results in slide and latex tests, but tube tests with both types of plasma were strongly positive. Only within group 5 strains were negative results in the tube test found. Group 1 strains showed no diminution in expression of free coagulase or of clumping factor. The latex test was more sensitive than the slide test but less sensitive than the tube test. Doubtful or negative slide test or latex test results, particularly with strains resistant to methicillin, should be checked by a tube coagulase test. PMID- 3634781 TI - Generalized chronic fatigue in the elderly: assessment and intervention. PMID- 3634780 TI - Nutritional evaluation--who needs it? PMID- 3634782 TI - Learning needs of caregivers. PMID- 3634784 TI - Clothing gifts for the nursing home patient. PMID- 3634783 TI - Overlooking the emotional needs of older adults. PMID- 3634785 TI - Becoming involved in health policy formulation. PMID- 3634786 TI - Promoting healthy lifestyles in mature women. PMID- 3634787 TI - Bacteriological characters of strains of Staphylococcus aureus submitted to a reference laboratory related to methicillin resistance. AB - Methicillin-resistant Staphylococcus aureus (MRSA) strains present an increasing clinical problem. Analysis of 2679 strains submitted to a reference laboratory in the first quarter of 1983 and 3050 strains submitted in summer 1984 showed 479 and 593 multi-resistant strains. The proportion of methicillin-resistant strains classified as epidemic rose from 5.9 to 10.2%. Other methicillin-resistant strains continued to occur but other methicillin-sensitive multi-resistant strains appeared to fall. A strain with defined characters could be recognized in the Thames regions. PMID- 3634788 TI - Validating a psychiatric patient classification system. AB - Validation studies are crucial to the establishment of an accurate patient classification system in the psychiatric setting. This paper describes and discusses a validity study done on four forensic psychiatric units. Administrators will find the design applicable to other types of psychiatric units. The recommendations are useful for validating a patient classification system in any setting. PMID- 3634789 TI - Preadmission discharge planning. Organization of a concept. AB - Preadmission testing programs have been developed to recognize and treat medical abnormalities prior to hospitalization, thus reducing preoperative hospital day costs. A preadmission testing program's objectives can be expanded by combining with a discharge planning program. The two programs combined can facilitate discharge planning and patient education prior to hospitalization and coordinate the nursing process. This article will discuss the purposes, organization, and benefits of a preadmission discharge planning program. PMID- 3634790 TI - Sharing responsibility for home care of the indigent. AB - What should you do with indigent patients who are ready for discharge but cannot afford the home care services they need? Should you extend their hospital stay? Discharge them and hope for the best? Search for a community agency that will care for them at no cost? To address this dilemma, one hospital developed a health care consortium for the purpose of guaranteeing home care to indigent patients, regardless of their ability to pay. PMID- 3634791 TI - What do first-line nursing managers do? AB - Appropriate selection and preparation of nursing managers is essential; however, the unclear role descriptions for first-line managers has hindered the selection and preparation process. A specific image of the actual tasks performed by first line nursing managers provides the information necessary to design a clearer role description and an appropriate educational program for the development of managers. PMID- 3634792 TI - Developing a documentation system that works. AB - A documentation system that facilitates accurate and complete recording is needed by every obstetric/neonatal nursing service. Developing an individualized system is a major undertaking. However, specific steps can be taken to ease the process. These steps are described, beginning with the assessment phase and concluding with evaluation. PMID- 3634793 TI - The educational pelvic examination. Women's responses to a new approach. AB - To compare the reactions of women to educational and traditional formats of the pelvic examination, a convenience sample of 213 women with divergent demographic characteristics was selected from the practices of six nurses and physicians. After random assignment to educational or traditional groups, all subjects completed a questionnaire developed by the researchers that assessed preexisting attitudes toward pelvic examination. All subjects were then examined with either the educational or traditional method. Afterwards, all subjects completed a second questionnaire, which assessed their responses to the recent examination. The educational and traditional groups' preexisting attitudes toward pelvic examination did not differ significantly. After experiencing the pelvic examination, however, the educational group demonstrated significantly more positive attitudes toward the examination. PMID- 3634794 TI - The use of homemaker-home health aides' perinatal care of high-risk infants. AB - The Homemaker-Home Health Aide program for high-risk neonates started in late 1982. Funded by a grant from the March of Dimes Birth Defects Foundation, several agencies in Pinellas County, Florida, set up a special training program for the aides in the care of high-risk infants and their families during the difficult transition period after release from the neonatal intensive care unit. PMID- 3634795 TI - Home care of the high-risk newborn. AB - When a newborn at high risk because of prematurity is discharged from the hospital, the family involved faces a time of crisis. Because parents experience increased stress during the transition to home care, both the parents and their infant are vulnerable to the effects of the added stress on the family's health and well-being. Community nursing intervention is a necessary component of care for the family of a high-risk newborn. Nursing strategies that address specific counseling and teaching needs of the family of a high-risk newborn are presented. PMID- 3634796 TI - Relieving parental anxiety in the care-by-parent unit. AB - To determine if maternal anxiety could be reduced by allowing mothers to live in the hospital with their infant before discharge, a study was conducted using 14 mothers who spent 36 to 48 hours in a care-by-parent unit (CBPU) just before the infants' discharge home. The mothers gradually assumed total responsibility for infant care with the support of health-care professionals. Anxiety of mothers was measured before and after their care-by-parent experience. In one situation, which involved potential illness of the infant, maternal anxiety was significantly reduced. If further studies support these results, care-by-parent units for infants who require intensive care should be part of discharge planning in neonatal intensive care units. PMID- 3634797 TI - Anxiety and problem-solving ability in mothers of premature infants. AB - A study was conducted to examine factors associated with anxiety in mothers of premature infants. Demographic information was obtained from 40 mothers of premature infants who were then tested for anxiety and problem-solving ability with the State-Trait Anxiety Inventory and the Means-Ends Problem-Solving Procedure. Neither the mother's past pregnancy outcomes nor her current infant's physical status had an effect on maternal anxiety levels. The difference in the level of anxiety experienced by mothers grouped according to problem-solving ability (t = 2.94; P = 0.0053) was significant. Mothers with good problem-solving ability acknowledged experiencing higher levels of anxiety than did mothers with lower problem-solving abilities. PMID- 3634798 TI - Impact of an infant's premature birth on the grandparents and parents. AB - Although the reactions of a family to the premature birth of an infant have been studied increasingly in recent years, the family examined has been limited almost exclusively to the parents. An exploratory survey examined the feelings, perceptions and experiences of 83 grandparents and 50 parents of premature infants. Results indicated that the impact of a premature birth was intensely felt by parents and grandparents. Both groups experienced similar reactions to the initial appearance of the neonate and neonatal intensive care unit environment and to visiting policies. Parents received most of their information about premature infants directly from nurses, doctors, and the parent support group, whereas grandparents had to rely on the newborn's parents. PMID- 3634799 TI - AIDS in pregnancy. AB - A brief description of AIDS and suggested guidelines for providing nursing care to the parturient AIDS victim are provided. The current literature in defining the syndrome, its course, and its statistics is surveyed. Infection control precautions that need to be adapted when caring for the mother and infant who are affected by AIDS during the perinatal period are described. The possible emotional consequences that AIDS may inflict on its victims are also described. Finally, methods are suggested for setting up a communications system for sharing necessary information about these patients and their care. PMID- 3634800 TI - Breastfeeding as a risk factor for fathers. AB - The case for breastfeeding being a paternal risk factor in respect to the marital relationship, breastfeeding success, and father-infant attachment is presented. Specific interventions that might minimize this risk, centered around communication, father involvement, and nurturance of the marital relationship, are posited. PMID- 3634801 TI - Staphylococcus aureus: biology, mechanisms of virulence, epidemiology. AB - The prominence of Staphylococcus aureus as a cause of serious human infection has prompted extensive studies of the microbiology, pathogenesis, and epidemiology of staphylococci and staphylococcal infections. Staphylococci are of the family Micrococcaceae, although there are diverse genetic and phenotypic differences between them and other members of this family. Of the more than 20 species of staphylococci, only three are clinically significant: S. aureus, S. epidermidis, and S. saprophyticus. These species can be distinguished by coagulase production and novobiocin resistance. Staphylococci produce a variety of structural, enzymatic, and toxic products, which are associated with adherence, invasion, toxicity, and avoidance of host defense mechanisms. In addition, a variety of host characteristics increase susceptibility to staphylococcal infection. Staphylococci are an important cause of infection in hospitals and the community. Following the introduction of antimicrobials, staphylococci rapidly developed resistance. A penicillin-resistant specific phage type, designated 80/81, caused severe outbreaks of nosocomial disease in the 1950s and 1960s. Staphylococci recently acquired resistance to methicillin and other antimicrobials, and persist as important nosocomial pathogens. Although S. aureus is one of the earliest recognized and most studied human pathogens, it is a perplexing, ever-changing, recurring public health problem. PMID- 3634802 TI - Children with sex chromosome variations: implications for pediatric nursing practice. PMID- 3634803 TI - Concomitants of death imagery in stories told by chronically ill children undergoing intrusive procedures: a comparison of four diagnostic groups. PMID- 3634804 TI - Helping hospitalized children and their parents cope with painful procedures. PMID- 3634805 TI - Reestablishing the parental role in a pediatric intensive care unit. PMID- 3634807 TI - Research. A view of what is yet to come. PMID- 3634806 TI - Difficult employees: a management challenge. PMID- 3634808 TI - Legal notes--preview. PMID- 3634809 TI - Equipment. Selecting home monitors. PMID- 3634810 TI - Future time perspective and loneliness: a comparison between adolescents from father-absent and two-parent families. PMID- 3634811 TI - Therapeutic play: work of both child and nurse. PMID- 3634812 TI - Congenital adrenocortical hyperplasia: supportive nursing interventions. PMID- 3634813 TI - Managing innovation in pediatrics. PMID- 3634814 TI - Use of infant seats for gastroesophageal reflux. PMID- 3634815 TI - Documentation. PMID- 3634816 TI - Pediatric cardiac catheterization. PMID- 3634817 TI - Children with short stature. PMID- 3634818 TI - Multimodal stimulation of the premature infant. PMID- 3634819 TI - Promoting healthy family functioning in acute care units. PMID- 3634820 TI - Nightmare in El Salvador: a nursing student's story. PMID- 3634822 TI - Living & learning. Breaking the silence. PMID- 3634821 TI - Spiritual care. How to reach out to refugees. PMID- 3634823 TI - Holistic healers and therapeutic touch. PMID- 3634824 TI - Tampering with truth. PMID- 3634825 TI - Refugee clinic: Los Angeles nurses battle a growing health crisis. PMID- 3634826 TI - Postoperative stress. Do nurses accurately assess their patients? PMID- 3634827 TI - The 24-hour stay. PMID- 3634828 TI - Understanding the impact of illness on the individual and the family. PMID- 3634829 TI - Building better treatment plans. PMID- 3634830 TI - 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors. 4. Side chain ester derivatives of mevinolin. AB - Modification of the 2(S)-methylbutyryl moiety of mevinolin led to a series of side chain ester derivatives. A systematic exploration of the structure-activity relationships showed that the introduction of an additional aliphatic group on the carbon alpha to the carbonyl group increased potency. This observation led to the synthesis of compound 16, which has about 2.5 times the intrinsic inhibitory activity of mevinolin. PMID- 3634832 TI - Writing as a form for professional development and creative expression. PMID- 3634833 TI - The prediction of success using comprehensive examinations. PMID- 3634834 TI - Tomorrow's "IV" catheters. PMID- 3634831 TI - Nucleotide sequence analysis of squirrel monkey retrovirus reveals a novel primer binding site for tRNALys1,2. AB - Nucleotide sequences of a DNA fragment containing the long terminal repeat (LTR) of squirrel monkey retrovirus (SMRV) were determined. Sequence analysis showed that the SMRV LTR is 456 base pairs (bp) long and is bounded by 2-bp inverted repeats. Within the U3 region, there are two 43-bp repeats and two 42-bp repeats which are homologous to each other. These repeats are likely to provide enhancer activities commonly observed in other enhancer sequences. Following the repeats are transcriptional regulatory sequences including a CAT box, a Goldberg-Hogness box, and a polyadenylation signal, all positioned within the U3 region of SMRV LTR. A 22-nucleotide sequence immediately downstream from the LTR was found to be complementary to tRNALys1,2, suggesting that tRNALys1,2 serves as the primer for the reverse transcription of SMRV viral RNA. PMID- 3634836 TI - Writing a chapter. PMID- 3634835 TI - Some thoughts about writing a book. PMID- 3634837 TI - Writer's block. PMID- 3634838 TI - The review process in refereed journals. PMID- 3634839 TI - Independent learning projects of registered nurses. PMID- 3634840 TI - [Professional ethics of female and male nurses. What will make me happy in the professional nursing of sick people?]. PMID- 3634841 TI - [Ethics in everyday nursing? Moral satisfaction from consciously ethically responsible nursing care]. PMID- 3634842 TI - [Imperfection in relation to law and ethics. Law and ethics have the same objectives]. PMID- 3634843 TI - [Bedside ethics--from the viewpoint of a hospital physician. Simple actions that come from the heart]. PMID- 3634844 TI - [Patients describe their experiences: somewhat tough, perhaps ...]. PMID- 3634845 TI - [A hospital diary. The night before, as though nothing had changed ...]. PMID- 3634846 TI - [The nurse-researcher as a participating observer. In the tension field between proximity and distance]. PMID- 3634847 TI - [Ethics and patient's rights. The right to autonomy should be a constant concern of the nurse]. PMID- 3634848 TI - [A patient's experiences: and if ethics were love?]. PMID- 3634849 TI - [Nurses, are you afraid to face pain?]. PMID- 3634850 TI - [Ideology or responsibility? Good-bye, paradoxes]. PMID- 3634851 TI - [Nursing the aged patient. Ethics, a reflection, a choice]. PMID- 3634852 TI - [Deontology and how to teach it. A possible path towards ethics]. PMID- 3634853 TI - [The rights of children with reference to pediatric nursing care. To comply with in any situation--even apparently simple ones]. PMID- 3634854 TI - [Enlivening in medicosocial institutes. An ever more important place]. PMID- 3634855 TI - [Medicosocial institutes today. Quality of life foremost]. PMID- 3634856 TI - [A preoccupation in the Vaud district. Spiritual needs of elderly persons]. PMID- 3634857 TI - [Education: care of elderly persons in the curriculum]. PMID- 3634858 TI - [3d meeting of the Swiss Nurses' Association's research group. What kind of care in response to the needs of elderly persons?]. PMID- 3634859 TI - [A nonagenarian tells about being old and living in an institution. Interview by Marie-Cecil Bersch]. PMID- 3634860 TI - [The role of a nurse consultant in a home for the aged. Observing, collaborating, improving]. PMID- 3634861 TI - [Geriatric nursing: a visit to Vienna. Transitional nursing--as seen in practice]. PMID- 3634863 TI - [Therapeutic education in psychiatric hospitals. Improved quality of life for the mentally handicapped]. PMID- 3634862 TI - [A representative of the World Health Organization in Bern: the European nurses must do some rethinking]. PMID- 3634864 TI - [Special problem: evaluation of nurses in intensive care]. PMID- 3634865 TI - [Clinical aspects and therapy of schizophrenia]. PMID- 3634866 TI - [Abdominal pain in childhood]. PMID- 3634867 TI - [Handling of an intravascular catheter by nursing personnel]. PMID- 3634869 TI - For richer, for poorer. Interview by Alison Dunn. PMID- 3634868 TI - Differential estrogen responsiveness of the vitellogenin and apo very low density lipoprotein II genes in the rooster liver. AB - The primary transcript of the chicken apo Very Low Density Lipoprotein II (apoVLDL-II) gene is formed almost immediately after a first estrogen administration, contrary to the appearance of the vitellogenin primary transcript which has a lag of at least 4 h. However, after a second estrogen administration the vitellogenin gene transcription shows no detectable lag (memory effect). After estrogen withdrawal, the primary transcripts of both genes rapidly decline to undetectably low levels. In the presence of estrogen, the half-lives of the mRNAs of apoVLDL-II and vitellogenin are 15 and at least 70 h, respectively, whereas in the absence of hormone they are only 3.5 and 5.5 h, respectively. Thus estrogen not only controls the transcription of both genes, but also the turnover of their mRNAs. In short, there appears to be a quantitative difference in the response of both genes. PMID- 3634871 TI - Protecting your interests. PMID- 3634870 TI - Where have all the women gone? PMID- 3634872 TI - Scenes from nursing life: on the district. PMID- 3634873 TI - Financial facts of life. PMID- 3634874 TI - Myth, reality, dichotomy. PMID- 3634875 TI - The College I know. PMID- 3634876 TI - Back to nursing with confidence. PMID- 3634877 TI - [Humeroscapular periarthritis. Its treatment by massage]. PMID- 3634878 TI - [Use of the ethyl chloride block in ambulatory practice]. PMID- 3634879 TI - [Combined treatment in adenoids]. PMID- 3634880 TI - [Late results of using magnetotherapy in clinical orthodontics]. PMID- 3634882 TI - [Lichen ruber planus]. PMID- 3634881 TI - [Chronic blepharitis]. PMID- 3634883 TI - [Thrombophlebitis of the surface veins of the lower extremities]. PMID- 3634884 TI - [6-year-old children in school]. PMID- 3634885 TI - [Conditions for teaching 6-year-old children in a general education school]. PMID- 3634886 TI - [Indoor clothing and the thermal comfort of preschool children]. PMID- 3634887 TI - [Swimming pools in preschool institutions]. PMID- 3634888 TI - [Organization of dispensary care for schoolchildren based on a program of screening tests]. PMID- 3634889 TI - [Dispensary care of children with chronic sialadenitis and the participation of paramedical workers]. PMID- 3634890 TI - [Prevention of injuries during the physical education of children]. PMID- 3634891 TI - [The pain syndrome following amputation of an extremity]. PMID- 3634892 TI - [The resuscitation panel--a very simple training simulator for preclinical practice]. PMID- 3634893 TI - [The nurse's compassion today]. PMID- 3634894 TI - Child abuse and neglect: reporting, preparing to testify & maintaining nurse client rapport. PMID- 3634895 TI - Zinc deficiency and the adolescent. PMID- 3634896 TI - Should we leave the third stage to Nature? PMID- 3634897 TI - Nursing the paranoid client. PMID- 3634898 TI - Neonatal problems in the Asian population of Peterborough. PMID- 3634899 TI - Drugs for viral infections. PMID- 3634900 TI - The "Listen-While-You-Iron" tape service. PMID- 3634901 TI - Primary adult lactose intolerance protects against development of inflammatory bowel disease. AB - We have compared the incidence of inflammatory bowel disease (IBD) to the prevalence of lactose malabsorption (LM) in several countries. Our observations indicate that IBD is rare where LM is highly prevalent. The correlation between incidence of Crohn's disease and LM is -0.93, p less than 0.01, the correlation between incidence of ulcerative colitis and LM is -0.89, p less than 0.01. We, therefore, propose that LM results in the formation of volatile fatty acids which may inhibit multiplication of potentially pathogenic organisms. PMID- 3634902 TI - Taking birth trauma seriously. AB - Virtually all mainstream schools of psychology, including biological psychology, reject the idea that people sustain psychological trauma at birth. Their objections are basically those raised by Freud more than 50 years ago: (1) lack of solid evidence that difficult births are related to mental disturbances and (2) a general conviction that the neonatal brain is not sufficiently developed to experience birth psychologically. But recent empirical evidence gathered by Stanislav Grof in over 3500 psychotherapy sessions using psychedelic drugs as a facilitator seems to show that a link does exist between birth trauma memory "matrices" in the unconscious and various mental conditions. And separate research on psychedelic drug effects, subcortical learning mechanisms and the nature of emotional response suggest that birth trauma memories might be explained in a way that circumvents without refuting Freud's basic objections. The following briefly reviews these developments, concluding that birth trauma theories--especially Grof's--deserve more serious consideration by mainstream psychologists and medical researchers. PMID- 3634903 TI - A hypothesis for the mechanism of tumor killing by NG-hydroxymethyl-L-arginines. AB - Arginine reacts with formaldehyde in a spontaneous equilibrium reaction yielding hydroxymethyl derivatives. They seem to have an direct and indirect inhibiting effect on cell proliferation. PMID- 3634904 TI - The mechanism of botulism. AB - Botulism is induced by botulinum toxin and the mechanism of the disease is unknown. In another study, a fatal autoimmune disease was produced in animals by immunization with a fraction of choline acetyltransferase. When these two syndromes are compared, numerous similarities are observed. It is postulated that botulism toxin acts as an initiator for the autoimmune disease by catalyzing in vivo the formation of the pathogenic fraction of choline acetyltransferase. PMID- 3634905 TI - Control of repair in articular tissues and the development of osteoarthritis. AB - Bones from different mammalian species, including man, contain a low molecular weight extractable activity which stimulates proteoglycan synthesis by connective tissue cells in culture ("matrigenin" activity). Partial purification of matrigenin activity has been achieved from bovine bone. The activity shows a strong tendency for reversible physical associations in low ionic strength solutions and binds tightly to collagenous and other bone matrix proteins. It is speculated that the pathophysiological role of matrigenins may be to initiate repair during injury to bone. Chronic repair reactions are more likely to occur at sites of repeated anatomical stress at the ligamentous, tendon and synovial attachments at the ends of bones, in the subchondral bone and in the articular cartilage regions abbuting to subchondral bone. At these sites, repair reactions may be broadly viewed as the development of osteophytes and fibrocartilage and the progression of subchondral bone sclerosis. Repeated anatomical stress leads to the activation of extracellular, small molecular weight factors, which in turn, stimulate the biosynthesis of matrix macromolecules that are an important feature of these repair reactions of osteoarthritis. PMID- 3634906 TI - Resistance to cancer chemotherapy. AB - Human cancers are either refractory to chemotherapy, or acquire resistance to it. Although acquired resistance to chemotherapy is generally ascribed to the drug itself, it may be linked with the nature of neoplasia, since normal tissues e.g. gastrointestinal mucosa or bone marrow, do not seem to acquire resistance and their perpetuating sensitivity even undermines effective treatment. According to the theory presented herewith, chemotherapy ultimately fails since it is based on wrong premises. Cancer is regarded here as a metabolic deficiency, originating in stem cell destruction. Besides serving as tissue progenitors, stem cells are postulated to secrete a vital substance 'A' necessary for proper tissue function. Carcinogens interfere with 'A' production mainly by destroying stem cells, which the organism is incapable of fully replenishing, so that less 'A' is produced. This irreversible 'A' deficiency may be replenished solely by a substitute, or substance 'B', produced by a specialized organ, the neoplasm. Since carcinogens continue depleting additional stem cells, the deficiency worsens. In order to keep up with increasing demand the neoplasm has to proliferate more and more until it reaches a stage of decompensation when the harm inflicted by it outweighs its benefit. Stem cell depletion is regarded here as the common final pathway of carcinogens. The theory predicts that following a supply of 'A' producing stem cells or inactivated 'B' producing neoplastic stem cells, the tumor will regress. Tumor regression is achievable also by diminishing the demand for the missing metabolites, which may be accomplished by chemotherapy. 'A' and 'B' are consumed mainly by transitional cells. Upon their elimination the demand for 'A' declines and the tumor may wane. This is regarded here as the main role of chemotherapy in cancer, while its tumoricidal potency is indicated solely for repairing tumor induced function loss. It is proposed here that the good response to chemotherapy by Hodgkin's disease and seminoma is linked with their being partially infective. Both start as genuine smouldering infections turning later into neoplasms. While chemotherapy is adequate only during the infective phase, it is met with mounting resistance when applied during the neoplastic phase. PMID- 3634907 TI - The relationship between ultraviolet radiation and epithelial cancer. AB - Carcinomas are the most common of human malignancies and occur in epithelial cells both in the skin and throughout the body. The ultraviolet wavelengths in solar radiation are accepted as the predominant cause of the DNA damage which results in skin cancer. These same ultraviolet wavelengths are emitted at all inner epithelial areas during normal bodily functions. It is suggested that DNA damage to epithelial cells caused by the absorption of ultraviolet radiation may be a basic cause of all carcinomas. PMID- 3634908 TI - Milk consumption and multiple sclerosis--an etiological hypothesis. AB - Epidemiological studies of Multiple Sclerosis (MS) in the United States have shown an association with urban living and higher socio-economic groups and a higher incidence and earlier age at onset of symptoms in women. This study is based on the proposition that these trends may be a consequence of differences in exposure to an etiological factor around 15 years of age. As a result of variations in related United States and New Zealand data and other pertinent observations the possibility of a link between high childhood milk intake followed by a large or sudden reduction during the adolescent growth spurt, and the subsequent incidence of MS in young adults is proposed. The possible involvement of calcium and lead metabolism is also discussed. It may be that the elusive environmental variable associated with the incidence of MS is partly a behavioural one related to western social attitudes. PMID- 3634910 TI - NATN guidelines: the nurse as first assistant to the surgeon. PMID- 3634909 TI - [Autolytic degradation of RNA; the effect of various factors on the dynamics of the process]. AB - As found earlier RNA preparations from different eukaryotic tissues followed by thorough deproteinization contain "masked" RNases, that cause autolytic degradation. The present paper indicates that the autolytic degradation of a deproteinized preparation of RNA from Ehrlich's cells by gel electrophoresis under denaturated conditions and ultracentrifugation in sucrose gradient is submitted by definite regularities and is essentially dependent on the concentration change of Mg2+, Na+, K+, NH4+ ions and also GTP and guanosine. It is proposed the activity of "masked" RNases is the manifestation of ribozyme properties of RNA molecules. Similar processes may take place in processing and catabolism of RNA in vivo. PMID- 3634911 TI - In vitro fertilisation. PMID- 3634912 TI - The violent society--this vicious circle. PMID- 3634914 TI - Four steps to success. PMID- 3634913 TI - Nurses' attitudes toward patient education. PMID- 3634915 TI - A women's knowledge of health care. PMID- 3634916 TI - Women in administration. PMID- 3634917 TI - Tools to aid nurses in providing preventive services. PMID- 3634918 TI - Royal College of Nursing. Living in the twilight zone. PMID- 3634920 TI - Royal College of Nursing. For safety's sake. PMID- 3634921 TI - Protect patients rights. PMID- 3634919 TI - Working in the community 'can seriously damage your health'. PMID- 3634922 TI - Surveillance of 'at risk' elderly in the community. PMID- 3634923 TI - Review's report is 'a charter for nursing'. PMID- 3634924 TI - Royal College of Nursing. Master work. PMID- 3634925 TI - RCN President Sheila Quinn's final address to Congress in Blackpool. Forever the nurses' and patients' champion. PMID- 3634926 TI - Review team's chairman discusses its recommendations. The case for neighbourhood nursing. PMID- 3634927 TI - Royal College of Nursing. Fight for ideal. PMID- 3634928 TI - Diverse implementation of grading review. PMID- 3634929 TI - The crisis facing all mental handicap nursing. PMID- 3634930 TI - Developing a role for the family nurse clinician in hospice care. PMID- 3634931 TI - [Effects of elastase on experimentally induced aneurysms in rats]. AB - The purpose is to study the potentiality of Elastase in preventing the development of experimentally induced aneurysms in rats. 64 Sprague-Dawly male rats of 5 months age were used. Unilateral common carotid artery ligation was done to effect hemodynamic changes in intracranial vessels. Posterior renal artery was ligated to induce hypertension which was further augmented by feeding with 1% saline and 0.1% BAPN, separately and in combination. The rats were divided into two equal groups of 32 and 32. The second group was in addition treated with intra-muscular injection of Elastase at a dose of 10 mg/kg/day for 6 days in a week. The rats were sacrificed at the end of 18 weeks to study the development of intracranial aneurysm and the effect of Elastase. There were 5 aneurysms in the first group comparing with 2 aneurysms in second group. The histopathology showed thickening of the intima and breakdown of elastic lamina at the site of the aneurysm. The effect of Elastase on these pathological changes is discussed. PMID- 3634932 TI - A clinical evaluation of the effect of tip integrity of I.V. catheters on phlebitis rates. PMID- 3634933 TI - I.v. team--a unique experience for students. PMID- 3634934 TI - Organizational synergy in changing times. PMID- 3634936 TI - Qualitative research: an approach whose time has come. PMID- 3634935 TI - Home i.v. therapy. Part I. PMID- 3634937 TI - AIDS: clarifying values to close in on ethical questions. PMID- 3634938 TI - Learning to care for clients with AIDS--the practicum controversy. PMID- 3634939 TI - Pinning down the psychosocial dimensions of AIDS. PMID- 3634940 TI - Stratifying research curricula--the logical next step. PMID- 3634941 TI - Simulated encounters prime community health students for practice. PMID- 3634942 TI - On death and dying. PMID- 3634943 TI - On the scene: national symposium at Virginia Mason Medical Center. Nurses and health policy. PMID- 3634944 TI - Traditional medicine: dilemmas in nursing practice. PMID- 3634945 TI - Defining prognosis and therapeutic goals for the critically ill. PMID- 3634946 TI - ICU admission and discharge screening criteria. PMID- 3634947 TI - Pain management for the terminally ill patient. PMID- 3634949 TI - Power-from-within: feminism and the ethical decision-making process in nursing. PMID- 3634948 TI - Infant care review committee and ethical decision making. PMID- 3634950 TI - Health care rationing: ethical reflections. PMID- 3634951 TI - Ethical-moral issues in nursing practice and decision making. PMID- 3634952 TI - Disclosure of information in nursing. PMID- 3634953 TI - Ethical decision making: a response of hospital nurses. PMID- 3634954 TI - Ten legal commandments for nurses who get sued. PMID- 3634955 TI - How you can comfort a grieving family. PMID- 3634956 TI - We called Mrs. Stone "the Ogre". PMID- 3634957 TI - Encouraging compliance with antihypertensive treatment. PMID- 3634958 TI - Helping your patient cope with COPD (continuing education credit). PMID- 3634959 TI - Addicted nurses: how you can lend them a helping hand. PMID- 3634960 TI - Addicted nurses: how you can lend them a helping hand. How managers can help. PMID- 3634961 TI - High-gear nursing: how it can run you down and what you can do about it. PMID- 3634962 TI - Sharpen your leadership skills--even if you aren't a manager. PMID- 3634963 TI - Code gray: ethical dilemmas in nursing. Part 3. PMID- 3634964 TI - Balancing patient care and the bottom line. PMID- 3634965 TI - Two hours of neglect? PMID- 3634966 TI - Understaffing--Part II. Law for the nurse manager. PMID- 3634967 TI - Updating your communication skills. PMID- 3634968 TI - An acute care geriatric unit. PMID- 3634969 TI - A survey of the 12-hour nursing shift in 25 North Carolina hospitals. PMID- 3634971 TI - Guest relations and private obligations. PMID- 3634970 TI - Managing down-staffing. PMID- 3634972 TI - A career for all reasons. PMID- 3634973 TI - Role alienation: staff nurses and powerlessness. PMID- 3634974 TI - The one minute manager is an androgynous manager. PMID- 3634975 TI - Tackling the nursing process, gamely. PMID- 3634976 TI - Changing male/female relationships in organizations. PMID- 3634977 TI - Assessing patients' teaching/learning needs. PMID- 3634978 TI - Appraising performance. PMID- 3634979 TI - An innovative approach to a procedure manual. PMID- 3634981 TI - The clinical nurse specialist as a consultant. PMID- 3634980 TI - A profile of certified nursing administrators. PMID- 3634982 TI - Hiring patterns and the quality of nursing care. PMID- 3634983 TI - Staffing and scheduling alternatives. PMID- 3634984 TI - Advice to a young manager. PMID- 3634985 TI - Evaluation for staff development? PMID- 3634986 TI - Customer-based management: when the patient comes first. PMID- 3634987 TI - Institutional assessment. PMID- 3634988 TI - Courtesy: rescuing patients from the me-generation. PMID- 3634989 TI - An introduction to laser safety. PMID- 3634990 TI - Medical lasers. PMID- 3634991 TI - Laser treatment for lung cancer. PMID- 3634992 TI - Getting the best out of lighting. PMID- 3634993 TI - Foiling flashes. PMID- 3634994 TI - A nurse's dilemma--confidentiality. PMID- 3634996 TI - Noise. Quiet please. PMID- 3634995 TI - Noise. Noise reduction: a political issue. Interview by Michael Bangs. PMID- 3634997 TI - Noise. As far as reasonable priced. PMID- 3634998 TI - Noise. 'Turn it down'! PMID- 3634999 TI - Noise. Looking for protection? PMID- 3635000 TI - Sunlight and the skin. PMID- 3635001 TI - We'll take more care of you. PMID- 3635002 TI - Anyone for tennis elbow? PMID- 3635003 TI - AIDS--still no concensus. PMID- 3635004 TI - Building sickness--all in the mind? PMID- 3635005 TI - Asthma, humidifiers and 'office worker's lung'. PMID- 3635006 TI - Controlling Legionnaires' disease. PMID- 3635007 TI - Occupational stress and VDUs. PMID- 3635008 TI - Audiometry--an occupational hazard. PMID- 3635009 TI - ICU syndrome: a literature review. PMID- 3635010 TI - Meet a nurse-midwife. PMID- 3635011 TI - A most memorable nursing experience--"Marie". PMID- 3635012 TI - [Care of geriatric quadriplegics--what to bear in mind]. PMID- 3635013 TI - [Psychosomatic pediatrics--description of a ward at the Wilhelminehospital- community of Vienna]. PMID- 3635014 TI - [Homeopathy--quackery or science?]. PMID- 3635015 TI - [Health/disease. Facts--subjective findings]. PMID- 3635016 TI - [Pollution and heritage]. PMID- 3635017 TI - [Juridical and ethical questions in the participation in organ transplantations]. PMID- 3635018 TI - [Nursing in osteosynthesis treatment (in children)]. PMID- 3635019 TI - [One-day surgery]. PMID- 3635020 TI - [Safety of patient and personnel in the operating room--from a technical viewpoint]. PMID- 3635021 TI - [SOS Racism]. PMID- 3635022 TI - Acute postoperative pain: cause and control (continuing education credit). PMID- 3635023 TI - The Humerus Joint Commission and buns and bones: Quality Control Circles on orthopaedic surgery divisions. Interview by Steve Turner. PMID- 3635024 TI - Writing about nursing practice. PMID- 3635025 TI - Orthopaedic radiology. PMID- 3635026 TI - Radiology review (metastatic bone neoplasm). PMID- 3635028 TI - Putting nursing in your article on nursing care. PMID- 3635027 TI - The detection of osteoporosis by measuring bone density. PMID- 3635029 TI - Interpretive statement on NLN position in support of two levels of nursing practice. PMID- 3635030 TI - Position statement on scope of NLN accreditation activities. PMID- 3635031 TI - Nursing data review 1985. PMID- 3635032 TI - Power and politics in organizations. PMID- 3635033 TI - Power and effective nursing practice. AB - Underlying the Nursing Knowledge Program were the beliefs that professionals can be prepared to function more effectively in organizations and that organizations can be designed to promote better use of professional skills. The training program, therefore, included both educational and structural solutions for the problems of powerlessness experienced by nurses in the hospital setting. Educationally, the program was designed to empower the participating nurses by teaching them the analytic and interpersonal skills they needed to develop and implement plans for change. Structurally, it established new lines of communication between staff nurses and nurse administrators, linked the nurses to needed resources, and gave the nurses more control over working conditions. Due to the quasi-experimental nature of the research design used in the project, the findings cannot be generalized to all nurses in all hospitals. There is no question, however, that each of the four strategies can be a valuable administrative approach for increasing nursing power. Confirming the strategies and moving groups of nurses through a series of activities specifically designed to use the strategies can bring significant change in the perceptions of nurses about themselves and their profession. For the administrator, the strategies are a way to develop a more effective and satisfied nursing staff, to encourage new leadership, and to create a stronger constituency among staff members. They also create a new source of energy and ideas for resolving the very real problems of professional practice. PMID- 3635034 TI - Entry into practice: competency statements for BSNs and ADNs. PMID- 3635035 TI - Entry skills for BSNs. PMID- 3635036 TI - Institutionalizing faculty practice. PMID- 3635037 TI - Clinical trials: new responsibilities and roles for nurses. PMID- 3635039 TI - Quality of nursing care: how it is affected by public health care delivery systems. PMID- 3635038 TI - Malpractice and standards of care. PMID- 3635040 TI - Interpersonal attraction and nursing needs. PMID- 3635041 TI - Crisis decision making in coronary care: a replication study. PMID- 3635042 TI - Ethics in nursing: theory to practice. PMID- 3635043 TI - [Principal decisional factors relating to contraceptive usage in adolescents]. PMID- 3635044 TI - Program evaluation: a strategy for effective promotion of community health. PMID- 3635045 TI - Food for thought. PMID- 3635046 TI - Validation of infant behavior identified by neonatal nurses. AB - Nurses observe that the behavior of an occasional full-term healthy newborn is "unusual," "different," "funny," or "not like the others." This study was designed to determine whether infants identified by nurses as suspect behaved differently from those identified as normal. Suspect infants scored significantly lower on the Brazelton Neonatal Behavior Assessment Scale than their matched controls. No dysfunction was common across the entire suspect group. Although nurses accurately predicted suspect infant behavior, they did not identify the specific Brazelton dimensions on which infants demonstrated worrisome behavior. The results indicated that nurses are reliable sources of information about infant behavior and can be valuable aids in screening infants in need of further assessment. In addition, the data provided tentative insight into the methods nurses use to make clinical judgments. Finally, the results pointed to the possible limitations of the medical model of infant assessment and demonstrated that nurses' empirical knowledge is amenable to measurement and testing. Additional research is necessary to determine if and under what circumstances infants who behave suspiciously are at risk. PMID- 3635047 TI - Temperament in very low birth weight infants. AB - This project compared the temperament of very low birth weight (VLBW) infants to that of full-term infants at 6 and 12 months of age, assessed patterns of change in temperament from 6 to 12 months, and investigated effects of the neonatal experience on manifestations of temperament in VLBW babies. The subjects were 41 VLBW infants who were free of congenital anomalies and appropriate for gestational age. Instruments included the Infant Temperament Questionnaire (ITQ), Toddler Temperament Questionnaire (TTQ), and the Home Observation for Measurement of the Environment (HOME) Inventory. At 6 months, the VLBW infants were significantly less adaptable and more intense than full-term infants. There were significantly more "difficult" and fewer "easy" infants in the study group. At 12 months, the infants were less persistent than a full-term toddler. Behavioral style clusters of the toddlers did not differ significantly from published data. Multiple regression analyses revealed that the social environment of the VLBW infant plays an important role in the manifestation of childhood temperament as early as 6 months of age. Results suggest that VLBW infants do manifest behavioral styles that are different from full-term infants but are modified during the first year of life. In addition, the nine temperament dimensions were differentially affected by adverse perinatal events and environmental factors. PMID- 3635048 TI - Re: Nursing practice in women's health--concept paper. PMID- 3635049 TI - Re: 'Circadian rhythms: basis for screening for fever'. PMID- 3635050 TI - Father-newborn interaction: effects of social competence and infant state. AB - Indicators of both father and infant social competence were explored as predictors of four types of paternal interaction behavior: touch affection/comfort, talk-affection/comfort, touch-stimulate, and talk-stimulate. Data collected from 114 father-newborn pairs 2 to 4 days after birth included perceived competence as a father, the infant's orientation and range of state scores on the Brazelton Neonatal Behavioral Assessment Scale, and the infant's behavioral state during a structured paternal-infant interaction. Infant state at the time of interaction was the best predictor, particularly of affection/comforting behavior. Infant orientation scores helped predict touch stimulating behavior and range of state scores helped predict touch-affectional behavior. Paternal competence was a predictor of stimulating behavior. Results emphasized the importance of considering state behavior when observing fathers interacting with their newborns. PMID- 3635051 TI - The sensations of pulmonary dyspnea. AB - This study compared recalled physical and emotional sensations during episodes of acute dyspnea across pulmonary disease groups. The convenience sample consisted of 68 subjects with emphysema-bronchitis, asthma, vascular, and restrictive disease. Temporal patterns of physical and emotional sensations before and during episodes of dyspnea were identified. The frequency of sensations was remarkably similar across disease categories with few significant differences identified. Rather than the disease category, the frequency, intensity, and periodicity of the symptom of dyspnea had the greatest effect on the quality and frequency of sensations reported. The intensity of usual dyspnea reported on a visual analog scale varied significantly among groups, p = .026, with asthmatics having the lowest mean score and vascular subjects the highest. Females reported significantly greater usual dyspnea than males, p = .005. The variables of pulmonary disease group, gender, fatigue, and total network of social support were significantly related to usual dyspnea, and pulmonary group, gender, and attendance at Better Breathers classes were significantly related to worst dyspnea. PMID- 3635052 TI - Development and testing of the circumvaginal muscles rating scale. AB - The purpose of this research was to develop an instrument for clinical assessment of the circumvaginal muscles (CVM), to test the reliability of the instrument, and to correlate sample characteristics with this instrument. The 9-point CVM Rating Scale is based on four components: pressure, duration, muscle ribbing, and position of the examiner's finger during examination. Reliability of the CVM Rating Scale was ascertained by use of interrater and test-retest reliability. Interrater reliability was tested on two separate occasions, N = 10, rho = 0.6, p less than .04; N = 10, rho = 0.7, p less than .05. A test-retest sequence was conducted 10 days apart, N = 10, rho = 0.9, p less than .003. Results from these tests indicated that the CVM Rating Scale is a reliable instrument for assessing CVM. A convenience sample of 30 women, aged 18-37, in good general health was tested, using the CVM Rating Scale. Women with a history of pelvic floor reconstructive surgery were excluded. A significant positive correlation between self-reported orgasm and the CVM Rating Scale total scores was found, chi 2 = 7.5, p less than .02. No significant correlations were found between age, race, parity, episiotomy, or self-reported Kegel exercises and the CVM Rating Scale total scores. The scale is a cost-effective, time-efficient, systematic assessment, accessible in clinical settings. PMID- 3635053 TI - Relationship of demographic, life-style, and stress variables to blood pressure in adolescents. AB - The relationship of selected predictor variables to blood pressures of freshman students (N = 323) attending rural, urban, and suburban high schools was examined. Independent variables included 7 anthropometric and demographic factors, 10 life-style factors, and 38 stress factors. Significant predictors of higher systolic pressure in the regression analysis were age, gender, body mass index, and urban residence. Urban subjects also had poorer health habits. Significant predictors of diastolic pressure were body mass index, smoking, and lack of regular exercise. Gender differences in amount and types of stressors were independent of geographic location. Males and females exhibited different dietary and exercise patterns; males exercised more, but had less healthy eating habits. PMID- 3635054 TI - Normal and overweight adults: perceived weight and health behavior characteristics. AB - Perceived weight, perceived health status, health conception, and health behavior choices were studied in 33 normal weight and 26 overweight adults. Data were collected by interview and by weighting the 59 participants (25 men and 34 women). Results indicated that 92% of the overweight and 36% of the normal weight participants perceived themselves to be overweight. The two groups did not differ significantly in perceived health status, health conception, or health behavior choice. Health conception and health behavior choice were significantly related in both groups. Perceived health status was not related to either health conception or health behavior choice in the overweight group but was significantly related to health conception in the normal weight group. Although the overweight participants were aware that they were overweight, they did not perceive themselves to be less healthy than the normal weight group. Further, their health conceptions were as complex and their behavior choices as health promoting as those of the normal weight group. PMID- 3635055 TI - Development of a tool to measure subjective time experience. AB - Although variations in time experience in specific health-illness situations have been documented, the information has not been systematically described. This is due in part to lack of reliable and valid measurement of time experience. This article, which reports the development and testing of Time Experience Scales (TES) in a sample of healthy adults, represents preliminary work in the identification of temporal experience in ill persons. Subjective time experience was defined as thoughts and feelings about the temporal frame in which life events occur. Semantic differential and Likert scale items indicated four conceptual dimensions of subjective time experience. A mail questionnaire was distributed to a purposive sample of community-based healthy adults. Data were analyzed separately for men (n = 587) and women (n = 475). Factor analysis methods resulted in the emergence of six robust empirical factors: meaning, fast tempo, slow tempo, attention to death, future orientation, and past orientation. Product moment correlations between scales (.01 to .45) indicated the validity, and coefficient alpha (.68 to .88) the reliability of measurement, using the factors. Results suggest that at least six distinct temporal experiences help people assign order, rhythm, and meaning to life events, thereby creating a continuing and optimal life story. Further reliability and validity testing is suggested. PMID- 3635056 TI - Perceived susceptibility to breast cancer and practice of breast self examination. PMID- 3635057 TI - Evaluating validity of screening tests. PMID- 3635058 TI - Time-series designs in clinical nursing research: human issues. AB - Prospective time-series research methods require substantially greater commitment and effort from both subjects and investigators compared to designs that involve one-time data collection. Human issues such as retention, confidentiality, burnout, and clinician-researcher role conflict have not been adequately addressed in existing literature on time-series methodology. To maintain the scientific integrity of a time-series design and minimize unnecessary costs associated with subject and staff attrition, these issues should not be overlooked. PMID- 3635059 TI - Closing time. PMID- 3635060 TI - Prisons: within these walls. PMID- 3635061 TI - Filipino nurses: the ones who got away. PMID- 3635062 TI - Training pick-me-up? PMID- 3635063 TI - A crying shame. PMID- 3635064 TI - Coping with death. Death rites. PMID- 3635065 TI - Coping with death. Last offices. PMID- 3635066 TI - Coping with death. The practical reality. PMID- 3635067 TI - American Nursing. State-side story. Interview by Catharine Watson. PMID- 3635068 TI - Neonatal drug addicts. PMID- 3635069 TI - Fatherhood. Is there a father in the house? PMID- 3635070 TI - Planning patient care. Helping a patient understand diabetes. PMID- 3635071 TI - Mental health nursing. A lesson for the learning. PMID- 3635072 TI - Mental health nursing. Home service. PMID- 3635073 TI - Mental health nursing. Troubled waters. Interview by Martin Vousden. PMID- 3635074 TI - End of term report. PMID- 3635075 TI - Transport: when the bus doesn't come. PMID- 3635077 TI - When the projections fail to persuade. PMID- 3635076 TI - Contraception: no longer beyond the Pill. PMID- 3635078 TI - Anatomy of a profession. PMID- 3635079 TI - Anatomy of a profession. Training for a varied career. PMID- 3635080 TI - Anatomy of a profession. Free from the straitjacket. PMID- 3635081 TI - Management--Swiss precision. PMID- 3635083 TI - Talking it out. PMID- 3635082 TI - Fetal alcohol syndrome. PMID- 3635084 TI - Measuring job satisfaction. PMID- 3635085 TI - Coping with cancer: in the shadow of the crab. PMID- 3635086 TI - Computers in Nursing News. PMID- 3635087 TI - Computers in nursing. Private and confidential. PMID- 3635088 TI - Computers in nursing. Bits, bytes and nurses. PMID- 3635089 TI - Staff shortage: planning for a crisis. PMID- 3635090 TI - Elderly: an age-old problem. PMID- 3635091 TI - Objections overruled? PMID- 3635092 TI - Stroke patients. A new way of living. PMID- 3635093 TI - Stroke patients. A model of support. PMID- 3635094 TI - Stroke patients. Looking back with pride. PMID- 3635095 TI - Home is where the help is. PMID- 3635096 TI - Expedition nursing: on thin ice. PMID- 3635097 TI - Indexing by computer. PMID- 3635098 TI - Childhood behavior: 'Can Tiger come, too?'. PMID- 3635099 TI - Putting the community in focus. PMID- 3635100 TI - Care about food. All change. PMID- 3635101 TI - Sexual dysfunction in women. PMID- 3635102 TI - Final knowledge. PMID- 3635103 TI - The key issue in nursing. PMID- 3635105 TI - Budgeting for beginners: checking your budget. PMID- 3635104 TI - Anatomy of a profession: the face of the future? PMID- 3635106 TI - Flying visits. PMID- 3635107 TI - The birth battle. PMID- 3635108 TI - Wall of silence. PMID- 3635109 TI - Coping with pain. Pain relief--a two-way process. PMID- 3635110 TI - Coping with pain. Handling the patient with pain. PMID- 3635111 TI - Machiavellian machinations. PMID- 3635112 TI - Mother's day. PMID- 3635113 TI - Hope for heroin addicts. PMID- 3635115 TI - Quest. Getting the ratio right. PMID- 3635114 TI - Growth retardation: why are pygmies small? PMID- 3635117 TI - Supplement. Association of Continence Advisors. PMID- 3635116 TI - Quest. Think before we link. PMID- 3635118 TI - Continence. Promoting research. PMID- 3635119 TI - A programme for continence. PMID- 3635120 TI - Continence. Steps to regaining pelvic control. PMID- 3635121 TI - Continence. New thoughts on male catheterisation. PMID- 3635122 TI - Continence. A woman's lot? PMID- 3635124 TI - Peripheral vascular dysfunction. PMID- 3635123 TI - Urinary symptoms and sexual difficulties. PMID- 3635125 TI - Health education and the patient with peripheral vascular disease. AB - PVD is a frightening and disabling disease, but health education can make a difference. Changing behavior through health education offers the client some control over the direction in which PVD progresses. This article provides the educator with suggestions for decreasing barriers to change and methods for promoting patient understanding of PVD. PMID- 3635126 TI - Nursing care of the stroke patient. PMID- 3635127 TI - Pharmacologic approach to ischemic stroke management. AB - Currently, pharmacologic intervention is directed toward preventing further spread of damage in the patient with cerebrovascular disease. Anti-platelet agents decrease platelet aggregation responses and anticoagulants decrease formation of the fibrin plug. In addition to the potential clinical benefits of these agents, risks must be considered. Patient education and compliance are major factors for consideration when assessing and monitoring treatment plans. Therefore, it is beneficial to the patient for health care teams to engage in multidisciplinary rounds which foster a consistent approach to treatment and allow each team member to make his unique contribution to the overall care of the patient. PMID- 3635128 TI - Interdisciplinary roles in stroke care. AB - Care of the stroke patient presents a complex challenge to the interdisciplinary stroke team. The physical therapist, occupational therapist, and clinical social worker are important members of that team, each of whom contributes specialized knowledge and interventions in behalf of the patient. The physical therapist focuses on prevention of joint and tissue injury and retraining of lost motor skills. The occupational therapist considers the total patient in his or her environment and assists the patient in regaining or improving function in all areas of daily living. The clinical social worker concentrates on psychosocial assessment and intervention with the patient and family, aiding them in the adjustment process and planning for discharge. The nurse, in addition to playing a unique role in the delivery of nursing care to the stroke patient, is in a position to serve as coordinator of the interdisciplinary team. The nurse can facilitate the work of the physical and occupational therapists and the social worker by providing them with timely referrals, valuable assessment information and insights, and reinforcement of therapeutic activity while the patient is on the nursing unit. The keys to making the interdisciplinary team work for the maximal benefit of the patient are threefold: mutual respect and understanding among team members; ongoing coordination of efforts; and open communication between all team members, the patient, and the family. These elements are interrelated and essential if the interdisciplinary team is to be successful at meeting its ultimate goal: expert care of the total patient to achieve maximal independence. PMID- 3635129 TI - Call for refinement of health for all strategies. PMID- 3635130 TI - The expressive role of a nurse: a study in constraints. PMID- 3635131 TI - An approach to systematic nursing. PMID- 3635132 TI - Quality nursing care: myth or reality? PMID- 3635133 TI - A day in the life of a legislative intern. PMID- 3635134 TI - Selecting a tool for vein assessment. PMID- 3635135 TI - Caring for the elderly patient with cancer. PMID- 3635136 TI - Intrathecal morphine infusion for intractable cancer pain: a new use for implanted pumps. PMID- 3635137 TI - Is heroin needed for cancer pain? PMID- 3635138 TI - Development of the sexual adjustment questionnaire. PMID- 3635139 TI - Do fewer oncology nursing smoke? PMID- 3635140 TI - The role of the nurse in early detection of cancer: population sixty-six years of age and older. PMID- 3635141 TI - Development of an information package for post-mastectomy patients on adjuvant therapy. PMID- 3635142 TI - Certification renewal--task force report and recommendations. PMID- 3635144 TI - ANA surveys state nurses' associations on AIDS. PMID- 3635143 TI - Infective endocarditis in childhood. AB - A total of 37 cases of infective endocarditis, in children aged two days to 13 years, were seen from 1971 to 1983 at the Children's Hospital, Camperdown. Structural heart disease was known to preexist in 95%. Cyanotic congenital heart disease was present in 15 children, of whom 11 had been palliated by a systemic to-pulmonary artery shunt. In five children, there was infection of a prosthetic valve. Identifiable precipitants of infection were rare. In particular, no child had had a preceding dental procedure within three months, while only 19% had had recent cardiac surgery. Organisms were identified by blood culture in 92%, the majority being streptococci (43% of cases) and staphylococci (27% of cases). While 59% of all organisms were penicillin sensitive, six of the seven early postoperative children were infected with organisms not sensitive to antibiotics, given for wound infection prophylaxis in the perioperative period. The overall death rate was 13.5%. Of the children infected with Staphylococcus aureus, 40% died, while no child with Streptococcus viridans endocarditis died. Of the survivors, four needed urgent valve replacement, and three had major central nervous system complications. Using these figures, a current profile of patients with infective endocarditis is presented. PMID- 3635145 TI - Red meat is still your friend. PMID- 3635146 TI - Nurses fail to follow doctors' orders: disaster. PMID- 3635147 TI - The nurse and the recalcitrant patient: dilemma. Case in point: Bennet v. Winthrop Community Hosp. (489 N.E. 2d 1032--MA). PMID- 3635148 TI - Legal case briefs for nurses. MT: license denied: "reciprocity" issue; ND: National Guard nurse: discrimination. PMID- 3635149 TI - Unsupervised patient "escapes": death results. Case in point: Rosemont, Inc. v. Marshall (481 So. 2d 1126--AL). PMID- 3635150 TI - The pathogenesis of renal sodium retention and ascites formation in Laennec's cirrhosis. AB - This chapter critically reviews our current understanding of the pathogenesis, clinical syndrome, and therapy of the disturbances of renal sodium handling, renal perfusion, and glomerular filtration rate that occur in patients with Laennec's cirrhosis. Avid renal sodium reabsorption, a characteristic feature of cirrhosis, occurs independent of moderate changes in renal function and precedes the onset of ascites. The initiation of sodium retention may be a direct consequence of the hepatic disease process and may also result from defective intravascular filling. In the presence of ascites the most important sodium retaining signal is a defective intravascular volume. The principal effectors of renal sodium retention and vasoconstriction are stimulation of the renin angiotensin-aldosterone axis and augmentation of renal sympathetic nerve activity. Deficient production of natriuretic hormone(s) and endogenous renal vasodilators, such as prostaglandins and kinins, also contributes to the sodium retention and renal hypoperfusion seen in cirrhosis. The hepatorenal syndrome is an extreme imbalance in these renal vasoconstrictor and vasodilator forces. In the therapy of ascites in Laennec's cirrhosis, abstention from alcohol, sodium restriction, and cautious diuresis are the principal therapeutic measures. A grave prognosis accompanies the diagnosis of the hepatorenal syndrome although recoveries have been reported. PMID- 3635151 TI - Spousal adjustment to chronic illness. PMID- 3635152 TI - Coital positioning for stroke afflicted couples. PMID- 3635153 TI - Developing a patient classification system (PCS) in a rehabilitation setting using the GRASP system. PMID- 3635155 TI - Nutrition and cancer. PMID- 3635154 TI - Functional gains in CVA patients: a nursing approach. PMID- 3635156 TI - [Upper member of the locomotor system (3). The principal shoulder muscles]. PMID- 3635157 TI - [Complications of femoral neck fractures]. PMID- 3635158 TI - [Anesthesia-resuscitation in femoral neck fractures]. PMID- 3635159 TI - [Role of the circulating nurse during intervention for femoral neck fracture]. PMID- 3635160 TI - [Treatment of fractures of the upper extremity of the femur]. PMID- 3635161 TI - [Femoral neck fracture: 2 case reports]. PMID- 3635162 TI - [Femoral neck fractures: rehabilitation and readaptation]. PMID- 3635163 TI - [Allergic accidents]. PMID- 3635164 TI - [The education of insulin-treated diabetics]. PMID- 3635165 TI - [The role of the nurse in the education of diabetics in a hospital environment]. PMID- 3635166 TI - [Nutrition of diabetics]. PMID- 3635167 TI - [Medico-social problems of the diabetic]. PMID- 3635169 TI - [Treatment of diabetes with an insulin pump: the nurse's role]. PMID- 3635168 TI - [The nurse facing a diabetic patient in coma]. PMID- 3635170 TI - [The physiology of pain (1)]. PMID- 3635171 TI - [Health and communication with migrants]. PMID- 3635172 TI - [Your specialty is there!. Interview by Madeleine Clave]. PMID- 3635173 TI - [Nursing care record: study and utilization]. PMID- 3635174 TI - [Focus on vagrancy]. PMID- 3635175 TI - [AIDS: what newspapers, radio and T.V. unfortunately grimly have to say... (various simple tools to fight against the spread of the virus)]. PMID- 3635176 TI - [With the pockets full...]. PMID- 3635178 TI - [Hodgkin's disease]. PMID- 3635177 TI - [A bag for everything... every thing in its bag]. PMID- 3635179 TI - [Lymphography]. PMID- 3635180 TI - [Principles of monitoring and care of patients with a bladder catheter]. PMID- 3635181 TI - [Therapeutic management of strabismus]. PMID- 3635182 TI - [The eyes of Claire]. PMID- 3635183 TI - [From computers to microcomputers or the hour of its demystification has rung...]. PMID- 3635184 TI - [Thrombopenia due to heparin]. PMID- 3635185 TI - [Biermer's anemia]. PMID- 3635186 TI - [USA-style surgery. Psychological preparation of the patient before his operation]. PMID- 3635188 TI - [Raynaud's phenomenon]. PMID- 3635187 TI - [When the patient becomes a parcel]. PMID- 3635189 TI - [Computerization of nursing care]. PMID- 3635190 TI - [Continuous peridural analgesia at home in the terminal stage of cancer]. PMID- 3635191 TI - [In a medico-educational institution]. PMID- 3635192 TI - [Parents' experience at the time their children become adolescents]. PMID- 3635193 TI - [The patient underneath the cast]. PMID- 3635194 TI - [Usefulness of nocturnal graphic recording in studying male infertility]. PMID- 3635196 TI - [Health information and education to control female genital cancer]. PMID- 3635197 TI - [Let us professionalize management]. PMID- 3635195 TI - [How an education program can be set up]. PMID- 3635198 TI - [The PCC (primary care center). An experience of team work]. PMID- 3635199 TI - [Nourishment and nutrition: the individual and food]. PMID- 3635200 TI - [Rectal balloon probe]. PMID- 3635202 TI - How to call the plays for a nursing team. PMID- 3635201 TI - [Continuing education. 3. Area: pharmacology and nursing. Topic: therapeutics chemotherapy]. PMID- 3635203 TI - When you hand over a patient for home care. PMID- 3635204 TI - Acute MI: the first crucial hours (continuing education credit). PMID- 3635205 TI - Cephalosporins--the third-generation. PMID- 3635206 TI - Taking the terror out of challenge exams. PMID- 3635207 TI - Treating pressure sores stage by stage. PMID- 3635208 TI - More pressure sore treatments--and why they're used. PMID- 3635209 TI - Procedures for stage 4 pressure sores. PMID- 3635210 TI - A flow sheet that saves time and trouble. PMID- 3635211 TI - Why patient teaching fails. PMID- 3635212 TI - Why is this patient unconscious? PMID- 3635214 TI - What really makes nurses angry. PMID- 3635213 TI - When schizophrenia complicates med/surg care. PMID- 3635215 TI - An act of compassion--or a crime? Legally speaking. PMID- 3635216 TI - Longevity deserves royal treatment. PMID- 3635217 TI - How diet helps the skin fight pressure sores. PMID- 3635219 TI - How to fit that management job. PMID- 3635218 TI - A second look at the Minnesota Strike. PMID- 3635220 TI - Are we too quick to use restraints? PMID- 3635221 TI - A buyer's guide to malpractice insurance. PMID- 3635222 TI - Reducing fluid overload without hemodialysis. PMID- 3635223 TI - Stroke: how to contain the damage (continuing education credit). PMID- 3635224 TI - How we prep patients for the ICU. PMID- 3635225 TI - What to tell patients about sterilization. PMID- 3635226 TI - Your rights when you're called on the carpet. PMID- 3635227 TI - Will the real nurse please stand up. PMID- 3635228 TI - Deep in the heart of Texas. PMID- 3635229 TI - Nursing image. PMID- 3635230 TI - How nurses see themselves. PMID- 3635232 TI - Professional conduct review process: protecting you. PMID- 3635233 TI - Transfer of function. PMID- 3635231 TI - Nursing image. The historical perspective. PMID- 3635234 TI - Transplantation is now. PMID- 3635235 TI - Cultural relevance in nursing education. Part II. The Native Health Careers Access Program. PMID- 3635236 TI - [Hibidil]. PMID- 3635237 TI - [Placing an indwelling urinary catheter in a female patient]. PMID- 3635238 TI - [And if it were I...]. PMID- 3635239 TI - [Use of a cooling helmet during chemotherapy]. PMID- 3635241 TI - [Training of nurses in oncologic pluridisciplinary activities]. PMID- 3635240 TI - [High dosage methotrexate--pharmacokinetic surveillance and role of the nursing team]. PMID- 3635242 TI - [AIDS, a new disease. A nurse speaks]. PMID- 3635243 TI - [The cancer patient on chemotherapy. Response of the nursing team to his needs and those of his family]. PMID- 3635244 TI - [The pattern of evaluation of nursing care records]. PMID- 3635245 TI - [Legal aspects of the hospitalization of children]. PMID- 3635246 TI - [Round table conference. Realization and practical applications of the nursing record]. PMID- 3635247 TI - [Thyroid cancer (1). Understanding the people who have it]. PMID- 3635248 TI - [Betadine]. PMID- 3635249 TI - [Muscular dystrophies in human pathology]. PMID- 3635250 TI - [Role of the physical therapist in the rehabilitation of the patient with myopathy]. PMID- 3635251 TI - [Psychological and psychosocial aspects of myopathies]. PMID- 3635252 TI - [The nurse facing myopathies]. PMID- 3635253 TI - [Questions--answers: various technical pamphlets edited by the Association of Myopathic Patients in France]. PMID- 3635254 TI - [Family allowances (4)]. PMID- 3635255 TI - [The patient's sleep--its evaluation in the nursing care record]. PMID- 3635256 TI - [Current research methods and perspectives in neuromuscular diseases]. PMID- 3635257 TI - [The placing of a Cathlon]. PMID- 3635258 TI - [Rigid ureteroscopy in ureteral lithiasis]. PMID- 3635259 TI - [Role of functional rehabilitation in urination disorders in children]. PMID- 3635260 TI - [The problem of pain in persons with terminal-stage cancer]. PMID- 3635261 TI - [Intermittent catheterization in children with neurogenic bladder]. PMID- 3635262 TI - [The choice of site for external urinary derivations]. PMID- 3635263 TI - [Family allowances (5)]. PMID- 3635264 TI - [The educative process in care]. PMID- 3635265 TI - [Percutaneous surgery]. PMID- 3635266 TI - [Ergotamine]. PMID- 3635267 TI - [Death in the soul]. PMID- 3635269 TI - [Psychopathology of the actor: a profile]. PMID- 3635268 TI - [Mourning work in children]. PMID- 3635270 TI - [Visions or hallucinations. Evidence of the Black Elk, "medicine man" of the Sioux]. PMID- 3635271 TI - [Some thoughts on "abandonism"]. PMID- 3635272 TI - [The celebration, psychopathology of the carnival]. PMID- 3635273 TI - [The nurse and the psychiatric patient]. PMID- 3635274 TI - [The child with symptoms or the child-therapist]. PMID- 3635275 TI - [Catapressan]. PMID- 3635276 TI - [Atrioventricular blocks]. PMID- 3635277 TI - [The place of cardiac stimulation in the treatment of bradycardias]. PMID- 3635278 TI - [The bradycardias]. PMID- 3635279 TI - [The nurse's role in the surveillance of a patient with bradycardia]. PMID- 3635280 TI - [Conceptual model of care and myocardial infarct]. PMID- 3635281 TI - [Auricular bradycardias]. PMID- 3635282 TI - [Lassa fever]. PMID- 3635283 TI - [The isolated nurse in the presence of a suspected case of yellow fever. Severe hepato-nephritic form in an African rural area]. PMID- 3635285 TI - [Arbovirus infections]. PMID- 3635284 TI - [Nursing personnel facing laryngo-tracheal involvement in tropical practice (Africa)]. PMID- 3635286 TI - [Yellow fever]. PMID- 3635287 TI - [Blood kinin system and the course of the puerperium in puerperants with a history of nephropathy]. PMID- 3635288 TI - [Diurnal urinary excretion of kallikrein in nephropathy patients]. PMID- 3635289 TI - [Progestogel]. PMID- 3635290 TI - [Complications of childhood diabetes]. PMID- 3635291 TI - [Hypoglycemia]. PMID- 3635293 TI - [Economic and social problems in childhood diabetes. "Help for young diabetics"]. PMID- 3635292 TI - [Elements of surveillance of childhood diabetes]. PMID- 3635294 TI - [Use of nursing records. A daily reality in home nursing service]. PMID- 3635296 TI - Dealing with staff anxiety on a non-psychiatric unit. PMID- 3635295 TI - [Functioning of the day hospital in pediatric surgery]. PMID- 3635297 TI - [Cytostatics on the ward]. PMID- 3635298 TI - [Home care made to measure]. PMID- 3635299 TI - [The examination MDGO-VP (Intermediate Education for Service and Health Care Nursing). Current status of the national MDGO-VP examination commission]. PMID- 3635300 TI - [Technology and patient care]. PMID- 3635301 TI - [Who ensures the patient's rest. A quiet battle between family and nursing]. PMID- 3635302 TI - [Working together, talking together. A positive critical working atmosphere]. PMID- 3635303 TI - [10 years of Reigersdaal: a look back]. PMID- 3635304 TI - [Women's health centers]. PMID- 3635305 TI - Preflighting the operating room: a mental checklist for the circulating nurse. PMID- 3635306 TI - The practical application of lasers: a first-hand account. PMID- 3635307 TI - Perioperative care and advanced technology. PMID- 3635309 TI - Alternative to hysterectomy: endometrial ablation by laser photovaporization. PMID- 3635308 TI - Combatting stress in the OR. 1. PMID- 3635310 TI - Combatting stress in the OR. Part II. PMID- 3635312 TI - Toward a more profitable OR nursing image. PMID- 3635311 TI - Hypothermia: a nursing concern for surgical patients. PMID- 3635313 TI - Introduction to the law--products liability (Part I). PMID- 3635314 TI - [Activation of the components of the kallikrein-kinin system of the blood in critical states and their sorption on activated charcoal]. AB - The authors have demonstrated activation of the Kallikrein-Kinin system in critical states and ways to decrease the level of its components in hemosorption. It was shown in experiments in 15 dogs and 120 rats (in blood loss and endotoxin shock) and in 12 patients (with acute pneumonia, Mendelson syndrome and "shock lung"). PMID- 3635315 TI - Ethical issues in nursing research. PMID- 3635316 TI - Problems in doing nursing research: systems entry. PMID- 3635317 TI - Strategies for teaching nursing research. Preparing master's students to develop clinical trials. PMID- 3635319 TI - Computer use and nursing research. Application of microcomputers in nursing research. PMID- 3635318 TI - Using research in practice. A case for replication in nursing--Part I. PMID- 3635320 TI - Research in cultural diversity: defining diversity. PMID- 3635321 TI - Promoting nursing research. The Center for Nursing Research at the University of Michigan. PMID- 3635322 TI - Research in nursing education and practice: the ecological methods perspective. PMID- 3635323 TI - An exploratory study of the experience of resentment. PMID- 3635324 TI - Editorial: on the patient career. PMID- 3635325 TI - The unification model in nursing: risk-receptivity profiles among deans, tenured, and nontenured faculty in the United States. PMID- 3635326 TI - Health beliefs of pregnant and postpartum Hmong women. PMID- 3635327 TI - Predictors of maternal role attainment at one year postbirth. PMID- 3635328 TI - Universal child immunization by 1990: a realistic goal. PMID- 3635329 TI - [Efficacy of low-intensity laser radiation and its effect on immune complexes, indices of the kallikrein-kinin system and sialic acids during treatment of psoriasis]. PMID- 3635330 TI - The effectiveness of doxapram administration in hastening arousal following general anesthesia in outpatients. PMID- 3635331 TI - The effect of diazepam in the prevention of succinylcholine-induced hyperkalemia. PMID- 3635332 TI - Impact of the CRNA: the specialty and its future. PMID- 3635333 TI - A review of the present status of nitrous oxide. PMID- 3635334 TI - Anesthesia and the patient with alcoholic liver disease. PMID- 3635335 TI - Monitoring in anesthesia: clinical application of monitoring central venous and pulmonary artery pressure (continuing education credit). PMID- 3635336 TI - A technique and clinical study of isoflurane administration in pediatric patients. PMID- 3635337 TI - Microcomputers and anesthesia. PMID- 3635338 TI - Ambulatory surgery: the future is now. PMID- 3635339 TI - Venous air embolism during anesthesia for maxillary sinus irrigation: a case study. PMID- 3635340 TI - The effect of Innovar versus droperidol or fentanyl on the duration of action of succinylcholine. PMID- 3635341 TI - Obstetric anesthesia for the patient with diabetes mellitus: a case study. PMID- 3635342 TI - Post-dural puncture cephalgia. PMID- 3635343 TI - The effects of acidosis on cardiovascular function. PMID- 3635344 TI - Quality assurance: the pieces of the puzzle. 1. (Continuing education credit). PMID- 3635346 TI - Trends in nursing for Alberta male nurses. PMID- 3635345 TI - A look at the Georgia Worthy case. legal Briefs. PMID- 3635348 TI - Quality of working life position paper. PMID- 3635347 TI - The registered nurse in the operating room. PMID- 3635349 TI - Computers in nursing: ergonomics. PMID- 3635350 TI - Quality assurance and nursing diagnosis. PMID- 3635351 TI - What is the action plan? PMID- 3635352 TI - The importance of interpretation of research for nursing practice. PMID- 3635353 TI - Prekallikrein and factor VII as prognostic indexes of liver failure. AB - Normotest, serum albumin, prekallikrein (Prekk), and Factor VII plasma activity were investigated in 64 patients with chronic liver disease--13 with type I chronic active hepatitis (CAH), 10 with type II CAH, 16 with compensated liver cirrhosis (LC), and 25 with decompensated LC--and in 20 matched-for-age healthy individuals. All of these blood parameters were reduced significantly as a result of liver damage. Patients with type II CAH and compensated LC had similar blood coagulation values. Eight decompensated LC patients, who died 30 to 45 days after the last blood coagulation parameter measurements, showed significantly low Prekk and Factor VII values compared with eight matched for sex and age survivors of decompensated LC. Prekk and Factor VII values of nonsurvivors did not overlap those of the survivors. This striking difference was not detected if Prekk and Factor VII were studied 2 to 4 months before death. These data suggest that Prekk and Factor VII are very sensitive to liver damage and could be useful prognostic indexes of liver insufficiency. PMID- 3635354 TI - False susceptible penicillin G MICs for Streptococcus pneumoniae with a commercial microdilution system. AB - A commercial minimal inhibitory concentration (MIC) panel that contains a broth of undisclosed formulation intended to support growth of streptococci unable to grow in Mueller-Hinton broth was found to give false susceptible MIC results for pneumococci. The authors encountered several Streptococcus pneumoniae isolates that showed resistance by the oxacillin disk diffusion test, but showed a susceptible penicillin G MIC when tested in an unsupplemented MIC panel. Seven isolates that showed penicillin G resistance by oxacillin disk diffusion testing were retested for penicillin G susceptibility with oxacillin disk diffusion, commercial MIC panels, Mueller-Hinton with blood agar dilution, and Mueller Hinton with blood broth microdilution. Five of these isolates produced a button of growth in the commercial MIC panel growth control well, but no growth in the penicillin G-containing wells (0.06-4.0 micrograms/mL), suggesting a valid test system and susceptibility to penicillin G. When tested by the three standard methods, these seven isolates showed resistance (R) or relative resistance (I) to penicillin G. These data indicate that frozen MIC panels from this commercial source (American Micro Scan, Campbell, CA) are not reliable for detection of resistance to penicillin G in S. pneumoniae, and if these panels are used, results must be confirmed by another method. PMID- 3635355 TI - Methicillin-resistant Staphylococcus aureus bacteremia linked to intravenous drug abusers using a "shooting gallery". AB - Over a 15-month period, seven intravenous drug abusers had 10 admissions because of bacteremia due to methicillin-resistant Staphylococcus aureus. Seven episodes of probable bacterial endocarditis occurred in four patients; one patient had septic thrombophlebitis and two had soft tissue infections. All seven patients patronized a local "shooting gallery" where paraphernalia were provided and drugs were often administered by a "street doctor." All isolates were phage type 29/77/83A/84/85 and demonstrated resistance only to methicillin, oxacillin, and penicillin. This strain of methicillin-resistant S. aureus has a phage type and antibiogram that is distinct from nosocomial methicillin-resistant S. aureus and was probably acquired by intravenous drug abusers during visits to the "shooting gallery". The "shooting gallery" is an integral part of the drug culture and a likely source for the transmission of antibiotic-resistant organisms. PMID- 3635356 TI - American nurses in Vietnam: stressors and aftereffects. PMID- 3635357 TI - Merital withdrawn by manufacturer. PMID- 3635358 TI - Questions about interstitial cystitis. PMID- 3635359 TI - Undesirable neighbors. PMID- 3635360 TI - After rape: who should examine rape survivors? PMID- 3635361 TI - Assessment: the logic of coma. PMID- 3635362 TI - Brain resuscitation: much ado about nothing? PMID- 3635363 TI - Treating traumatic coma. PMID- 3635364 TI - Change theory. PMID- 3635365 TI - Patients' perceptions of the cardiac crisis. Key to recovery. PMID- 3635367 TI - A compact electrophysiology-studies record. PMID- 3635366 TI - Your patient is scheduled for electrophysiology studies. PMID- 3635368 TI - Alcoholism: ineffective family coping. PMID- 3635369 TI - Are the people who need analgesics getting them? PMID- 3635370 TI - How do you manage peritoneal dialysis? PMID- 3635371 TI - Attacking fuzzy documentation. PMID- 3635372 TI - Tell it like it is. A realistic approach to wound documentation. PMID- 3635373 TI - 'But do you get paid for this?'. PMID- 3635374 TI - Physiologic, microbiologic, and seasonal effects of handwashing on the skin of health care personnel. AB - The handwashing practices of 22 personnel on an oncology unit in an urban medical center were studied for 2 months. During 891 person-hours of observation, 986 handwashes were observed. Subjects washed a mean of 1.1 times an hour for a mean of 13.2 seconds. Reported and observed handwashing behavior was only moderately correlated (p = 0.05 for frequency, 0.30 for duration of handwashing). Physicians washed significantly less often (p less than 0.001), but more thoroughly (p less than 0.001), than did nurses. Nurses washed more often after minimal or no patient contact than did physicians (p less than 0.001). Individuals were very consistent in their handwashing technique. A total of 558 isolates were recovered from 158 hand cultures. The mean log count was 4.88, with no significant difference between physicians and nurses. Coagulase-negative staphylococci isolated from hands of physicians and nurses were significantly more resistant to antimicrobial agents than those of personnel with minimal patient contact (p less than 0.01). Subjects had more skin damage in winter than in summer, as indicated by increased shedding of skin squames (p less than 0.05). We conclude that handwashing practices vary significantly by profession and that reporting of handwashing practices by personnel is inaccurate. PMID- 3635375 TI - Survey of hospital personnel on the understanding of the acquired immunodeficiency syndrome. PMID- 3635376 TI - Effect of remote infections on clean wound infection rates. PMID- 3635377 TI - Training needs of the infection control practitioner: development of practice standards and internship programs. PMID- 3635378 TI - Council affiliates report work scene turbulence. PMID- 3635379 TI - House to act on 15-year plan for nursing. PMID- 3635381 TI - N.Y. hospital opens acute care AIDS unit. PMID- 3635380 TI - NPs, clinical specialists share nursing's cutting edge. PMID- 3635382 TI - Convention will plan for future and honor nurses. PMID- 3635383 TI - As I see it--Councils offer a way to help professional advance. PMID- 3635385 TI - Aminoacylation of rat liver transfer RNA with homologous and heterologous enzyme systems during aging. AB - Total tRNA extracted from livers of young (7 +/- 1 weeks), adult (40 +/- 1 weeks) and old (80 +/- 1 weeks) rats showed quantitative variation with age, being maximal in adults. Young and old animals yielded almost the same level of tRNAs. Quantitative changes in tRNAs were also observed from the study of amino acid acceptor activity using homologous enzyme i.e., aminoacyl-tRNA synthetase preparations from rat liver of the same age group. Quantitative variation followed the trend of qualitative variation. When tRNA was amino-acylated with a heterologous enzyme system, i.e., synthetase preparation from rat liver of another age group, age-related variation in aminoacyl-tRNA did not follow a pattern similar to that in the case of the homologous enzyme system. Young and adult synthetase enzymes showed maximum affinity for their homologous tRNAs but synthetases from old rat liver did not show any specific affinity for "old" tRNAs. This shows that apart from tRNAs, enzyme activity also changes with age. PMID- 3635386 TI - Hysteretic enzyme response induced by inhibitory antibodies against human leukocyte elastase. AB - Polyclonal antibodies raised in rabbits against human leukocyte elastase contained two distinct populations of enzyme-inhibiting immunoglobulins. The enzyme-catalyzed reaction in the presence of antibodies (both IgG or monovalent Fab fragments) showed a transient state lasting up to several minutes depending on the inhibitor and substrate concentrations, which was followed by a linear steady-state. The transient was a concave upward or concave downward lag phase depending on whether the enzyme had been preincubated with the antibodies or not, respectively. The kinetic analysis of reaction progress curves showed that both antibody populations were slow inhibitors, which completely and reversibly excluded the substrate from binding to the enzyme. For both antibody populations, the formation of the enzyme-inhibitor complex was characterized by an initial rapid interaction followed by a slow isomerization to a catalytically inactive complex. The apparent pseudo first-order rate constant of the transient slow phase was a hyperbolic function of the inhibitor concentration for both antibodies, from which relevant kinetic constants and the half times for enzyme inactivation could be calculated. For instance, with a total antibody concentration of 1 mg/ml (as IgG), leukocyte elastase was inactivated with t1/2 = 0.31s and 24.8s by the faster and the slower of the two antibodies, respectively. It is suggested that the hysteretic response of the enzyme to the inhibitory action of its antibodies may be due to a kind of memory of the antibody molecule for a special inactive enzyme conformation resulting from inhibition by proteinase inhibitors during the immunization procedure. In turn, the purified antibodies would be able to reversibly induce a slow transition of the enzyme molecule from an active to a substrate-excluding conformation ("induced misfit"). PMID- 3635384 TI - Resistance to mercury and to cadmium in chromosomally resistant Staphylococcus aureus. AB - Apparently chromosomally located mercury resistance determinants in five methicillin-resistant Staphylococcus aureus strains of different geographical origin were structurally homologous to plasmid-located mercury resistance determinants in S. aureus. These were all located on a 6.3-kilobase (kb) Bg/II fragment, as evident from Southern hybridization experiments with the 6.3-kb Bg/II fragment of plasmid pI258 as the probe. These methicillin-resistant S. aureus strains exhibited similar phage susceptibility patterns and biochemical reactions. They differed, however, in the DNA location of the mercury resistance determinants, as evidenced by neighboring cleavage sites for restriction endonucleases EcoRI, HindIII, and PstI. In an environmental (nonhospital) strain in which mercury resistance was also apparently chromosomally conferred, these determinants were also homologous to pI258 DNA, but they were located on a 6.6-kb Bg/II fragment. Cadmium resistance determinants in the five methicillin-resistant S. aureus strains and the environmental S. aureus strain were not similar to the known plasmid-located determinants cadA and cadB. Cd2+ resistance was based on an efflux mechanism for Cd2+. However, no parallel resistance to zinc was conferred. The 3.2-kb XbaI-Bg/II fragment obtained from plasmid pI258 and used as a cadA specific probe did not hybridize to total DNA digests of the strains with apparently chromosomally determined cadmium resistance. PMID- 3635387 TI - A study of hospice costs for non-Medicare age group. Results show significant savings during last month of life. PMID- 3635388 TI - Helping parents whose child has died. A review of coping strategies and alternatives for support. PMID- 3635389 TI - Maximizing quality of life for the house bound patient. Specialized ramp allows accessibility to outdoors. PMID- 3635390 TI - A British perspective on hospice. The development, planning, and inception of a program. PMID- 3635391 TI - Do hospice nurses differ from non-hospice nurses? Some similarities--and differences. PMID- 3635392 TI - A personal experience with AIDS. Courageous patient shares his ordeal through newspaper. PMID- 3635393 TI - A community approach to AIDS through hospice. Louisiana program promotes high quality of life. PMID- 3635394 TI - Infection control at home. A guideline for caregivers to follow. PMID- 3635395 TI - The lodging of patients with AIDS as your guests: case studies are presented to discuss the role of nurses. PMID- 3635396 TI - Psychosocial aspects of hospice care for AIDS patients. Addressing these issues is a key aspect of treatment. PMID- 3635397 TI - The AIDS home care and hospice program. A multidisciplinary approach to caring for persons with AIDS. PMID- 3635398 TI - Pastoral care and persons with AIDS. A means to alleviate physical, emotional, social, and spiritual suffering. PMID- 3635399 TI - Where can an AIDS patient turn for care? PMID- 3635400 TI - Choosing a home volunteer for AIDS patients. An appropriate match requires sensitivity in judgement and knowledge. PMID- 3635401 TI - Helping AIDS patients through unconditional love. PMID- 3635402 TI - Research on nursing practice. Bereavement. PMID- 3635403 TI - Evaluation of primary nursing. PMID- 3635404 TI - Research on nursing education. Faculty productivity. PMID- 3635405 TI - Nontraditional nursing education. PMID- 3635406 TI - Research on nursing practice. Preschool children. PMID- 3635407 TI - Maternal anxiety in pregnancy: relationship to fetal and newborn health status. PMID- 3635408 TI - Research on nursing practice. Menopause. PMID- 3635409 TI - Aging: gerontological nursing research. PMID- 3635410 TI - NMR study of isoleucine transfer RNA from Thermus thermophilus. AB - An NMR and nuclear Overhauser effect (NOE) analysis of Thermus thermophilus tRNAIle1a is presented. This species contains modifications including s2T54 and s4U8 [Horie, N., Hara-Yokoyama, M., Yokoyama, S., Watanabe, K., Kuchino, Y., Nishimura, S., & Miyazawa, T. (1985) Biochemistry 24, 5711-5715]. All the expected secondary and reverse Hoogsteen AU pairs were identified, with one possible exception. The general geometry of the T psi C loop is the same as the Escherichia coli species, and there is NOE evidence for an A9-UA12 triple. Preliminary measurements of solvent exchange rates of internally hydrogen-bonded bases suggest that this tRNA is more stable than previously studied E. coli and yeast tRNAs. PMID- 3635411 TI - Human high molecular weight kininogen as a thiol proteinase inhibitor: presence of the entire inhibition capacity in the native form of heavy chain. AB - High molecular weight (HMW) kininogen was purified from fresh human plasma by two successive column chromatographies on DEAE-Sephadex A-50 and Zn-chelate Sepharose 4B. The purified HMW kininogen appeared to be a single band on sodium dodecyl sulfate (SDS)-polyacrylamide disc gel electrophoresis in both the presence and absence of beta-mercaptoethanol. However, it gave two bands on nonreduced SDS polyacrylamide slab gel electrophoresis, a major band of dimeric form (Mr 200 000, ca. 95%) and a minor band of monomeric form (Mr 105 000, ca. 5%). Under reduced conditions, the dimeric form was converted stoichiometrically to a monomeric form (Mr 110 000), and the monomeric form observed under nonreduced conditions (Mr 105 000) was converted to a heavy chain (Mr 60 000) and a light chain (Mr 50 000). The formation of a dimer of HMW kininogen was also confirmed by an immunoblotting experiment. This unique property of intact HMW kininogen to form a dimer was further utilized in studies on the kininogens and their derivatives as thiol proteinase inhibitors. The purified HMW kininogen strongly inhibited the caseinolytic activities of calpain I, calpain II, and papain but not those of trypsin, chymotrypsin, and thermolysin, indicating that it was a group-specific inhibitor for thiol proteinases. When HMW kininogen was reduced with 0.14 or 1.4 M beta-mercaptoethanol, its inhibitory activity was partially or mostly inactivated, but on subsequent air oxidation its activity was almost completely recovered. In addition, kinin-free and fragment 1,2 free HMW kininogen showed higher inhibitory activity than the intact HMW kininogen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3635412 TI - Control of respiration and of motility in ejaculated bull spermatozoa. AB - The relations between motility and respiration were studied in ejaculated bull spermatozoa respiring with lactate. Motility was quantitatively evaluated by a turbidimetric procedure as percentage of cells moving per minute from the bottom of the cuvette into the light path. For selective inhibition of ATP-consuming reactions including motility or of mitochondrial respiration, vanadate or cyanide, respectively, were used. Both inhibitors were found to produce proportional changes in motility and respiration. The simultaneous changes in motility and respiration were linked to shifts in the cellular ATP/ADP ratio. Partial uncoupling of respiration in vanadate-inhibited cells gave similar relations between respiration and ATP/ADP ratios as stepwise inhibition of ATP utilizing reactions by vanadate. Presuming saturation kinetics with respect to the ATP/ADP ratio, half maximum constants of 1.7 and 4.7 for the ATP/ADP ratio and maximum values of about 130% and 300% (in comparison to untreated cells) were estimated for motility and respiration, respectively. Respiration showed a much steeper dependence on the ATP/ADP ratio than motility resulting in an apparent cooperativity coefficient of 2.9. From these dependences on the ATP/ADP ratio, the shares in the control of ATP turnover in untreated cells were estimated. At sufficient supply with substrate, more than 80% of control were excreted by motility and other ATP-utilizing reactions, the rest by mitochondrial ATP production, i.e., the reactions of oxidative phosphorylation. PMID- 3635413 TI - Lipid peroxidation in hemoglobin-containing liposomes. Effects of membrane phospholipid composition and cholesterol content. AB - The effects of phospholipid-oxidation state and vesicle composition on lipid peroxidation in hemolysate-containing liposomes (hemosomes) were studied by the thiobarbituric acid assay. Liposomes (hemosomes) were prepared from egg phosphatidylcholine (PC) with either low (PC0.08) or high (PC0.66) oxidation indices reflecting low and high conjugated diene/lipid hydroperoxy contents. Thiobarbituric acid reactivity was negligible over 6 h at 38 degrees C in buffer containing (control) liposomes prepared from PC0.08, whereas it was slightly increased in those prepared from PC0.66. Encapsulated hemolysate had no effect in PC0.08 liposomes, but significantly increased thiobarbituric acid reactivity in those prepared from PC0.66. Inclusion of either phosphatidylethanolamine or phosphatidylinositol in the membrane further increased lipid peroxidation in hemosomes prepared from PC0.66, whereas phosphatidic acid and phosphatidylserine were inhibitory. Inclusion of cholesterol in the membrane had no effect in PC0.66 hemosomes, but significantly inhibited lipid peroxidation in the presence of phosphatidylethanolamine or phosphatidylinositol. The effects of phosphatidic acid and cholesterol were dose-dependent. Co-incorporation of cholesterol and phosphatidic acid or phosphatidylserine in the membrane resulted in almost complete elimination of hemoglobin (Hb)-induced lipid peroxidation. Lysophosphatidic acid had similar effect as phosphatidic acid, whereas lysophosphatidylserine exerted inhibition only in the presence of phosphatidylethanolamine. The rate of lipid peroxidation showed no correlation with the amount of encapsulated Hb, neither with the oxidation indices nor the polyunsaturated fatty acid contents of negatively charged phospholipids. The above findings suggest a possible role for the high cholesterol content and preferential localization of phosphatidylserine in the inner bilayer leaflet of erythrocyte membrane in protecting against Hb-induced lipid peroxidation in the membrane. PMID- 3635414 TI - Sex dimorphism and hormonal regulation of rat tissue kallikrein mRNA. AB - The regulation of rat tissue kallikrein mRNA levels was investigated by RNA filter hybridization using a kallikrein cDNA probe and by in vitro translation of isolated RNA. The synthesis of a 37 kDa polypeptide has been hybrid-arrested by the tissue kallikrein cDNA in cell-free translation assays directed by submandibular mRNA and the quantitation of this protein was used as a measure of translational activity of kallikrein mRNA. In Northern blot analyses, relative kallikrein mRNA levels were found to be 60-fold higher in submandibular gland than in pancreas and 20-fold higher than in kidney. In addition, it was noted that kallikrein mRNA is differentially regulated in tissues from male and female animals. Rat submandibular gland kallikrein mRNA is 2-times more abundant in male animals as in females. This trend is reversed in kidney, where the kallikrein mRNA in females is twice that in male animals. Relative submandibular gland kallikrein mRNA levels were found to be responsive to hormonal manipulation as measured by both Northern blotting and cell-free translation assays. Castration of male animals resulted in a decrease of kallikrein mRNA which could be partially restored by treatment with thyroxine and almost completely restored by testosterone treatment. The submandibular gland kallikrein mRNA in normal female rats was increased up to 30% by administration of testosterone or thyroxine. Adrenalectomized female rats showed a decrease in submandibular kallikrein mRNA which was significantly increased by testosterone, thyroxine, aldosterone and cortisol, with the largest effect being a 2- to 2.4-fold increase in cortisol treated rats. These results indicate that hormones regulate tissue kallikrein synthesis in the rat submandibular gland, at least in part, by altering kallikrein mRNA accumulation. PMID- 3635415 TI - Primary treatment of hairy cell leukemia: should IFN-therapy replace splenectomy? PMID- 3635416 TI - Alpha-interferon induces remission in hairy cell leukemia without enhancement of natural killing. AB - The number of large granular lymphocytes (LGL) and the capacity of peripheral blood mononuclear cells (PBMC) to lyse K 562 target cells in a natural killer (NK)-like fashion was evaluated in seven hairy cell leukemia (HCL) patients undergoing treatment with recombinant interferon-alpha-2 (rIFN-alpha-2). In HCL patients, whose peripheral blood showed high numbers (greater than or equal to 15 X 10(3)/microliters) of leukemic cells the number of LGL and their capacity to lyse K 562 tumor target cells were very low prior to treatment but increased significantly (p less than 0.05) following interferon (IFN) therapy. In patients with low numbers of hairy cells (HC) in their peripheral blood, both these parameters were higher and remained largely unaffected throughout IFN treatment. In vitro, HC proved to be completely insensitive to natural killing when tested against unstimulated and IFN-activated LGL from healthy donors. These results fail to support the concept of IFN-mediated enhancement of host antitumor actions, responsible for the favourable clinical results in HCL. PMID- 3635417 TI - Plasma lactoferrin in patients with neutropenia. AB - This study examines the role of plasma lactoferrin in the assessment of neutropenia. In particular, we have studied lactoferrin as an inhibitor of granulopoiesis and as an indicator of the size of the total blood granulocyte pool (TBGP). Plasma lactoferrin concentration was determined in a heterogeneous group of 30 patients with neutropenia. Serial plasma lactoferrin levels in a patient with cyclic neutropenia correlated with the cycles of the neutrophil count. Patients with splenomegaly had a grossly elevated lactoferrin:neutrophil ratio. Most chronic idiopathic neutropenia patients had no real clinical problems and a normal plasma lactoferrin level. The results provide further evidence to support the concept that plasma lactoferrin indicates the size of the TBGP and the lactoferrin: neutrophil ratio indicates the degree of granulocyte margination. There was no evidence to suggest that lactoferrin acting as a feedback inhibitor of granulopoiesis caused neutropenia in these patients. PMID- 3635418 TI - An unusual sample of irregular anti-A1, probably causing an early delayed transfusion reaction. AB - An unusual case of a 37 degrees C-active irregular anti-A1 is reported. Apparently consisting mainly of IgG, the antibody appeared in an A2B recipient only two days after massive transfusion of A1-cells in absence of previous transfusion. It was associated with severe hemolysis and renal failure which was reversed after exchange transfusion. PMID- 3635419 TI - Identification of monocytic nature in acute undifferentiated leukemia by in vitro marrow culture study. AB - We report a case with acute undifferentiated leukemia whose leukemic blasts lacked morphological, cytochemical and immunological features of lymphoid or myeloid differentiation. The in vitro culture study defined her leukemia as of monocytic origin. Her marrow blasts underwent monocytic differentiation with strong nonspecific esterase activity when cultured in a liquid system with human placental conditioned medium. The semisolid agar culture showed an AML-type growth pattern. The present study indicates that in vitro culture study can be used as a supplement to improve the classification of certain unclassifiable leukemias. PMID- 3635420 TI - Grading angina pectoris: comment on the Canadian system. PMID- 3635421 TI - The value of sum of ST segment depression in 12-lead electrocardiogram in relation to change in heart rate during exercise to predict the extent of coronary artery disease. AB - The present study was planned to investigate whether the sum of ST segment depression in 12-lead electrocardiogram (sigma STD) in relation to change in heart rate (delta HR) during exercise, sigma STD/delta HR index, could be utilized to predict the extent of underlying coronary artery disease. Two hundred and twenty-six consecutive patients were included in this study, 191 men and 35 women, aged 28-74 years (mean 56). Patients were classified into two groups. Group I consisted of 165 patients with either no coronary disease, single or double vessel disease. Group II included 61 patients with triple vessel or left main stem stenosis. It was found that the sigma STD/delta HR index at 25 mm. beat 1 X min. 10(2) provided the best separation between Groups I and II patients. All but 3 of the 61 patients in Group II had a sigma STD/delta HR index greater than 25. In contrast, all but 4 of the 165 patients in Group I had an index less than 25. The sensitivity, specificity and positive predictive value in the identification of Group II patients by using the index were 95%, 98% and 94% respectively. Utilization of ST segment depression of greater than or equal to 2 mm in a VF alone as a test criterion for the recognition of Group II patients had a low sensitivity (41%), specificity (88%) and positive predictive value (56%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3635422 TI - [Thromboses of the right cardiac cavities: echocardiographic diagnosis and therapeutic indications apropos of 2 cases and review of the literature]. AB - Two cases of pulmonary emboli are reported: a thrombus was detected by echocardiography in the right atrium in the first case and in the right ventricle in the second. Following a review of the 28 cases published to date, criteria are given for distinguishing between those thrombi embolizing from the peripheral veins and those arising in the right cavities of the heart. Therapeutic recommendations are also given. PMID- 3635423 TI - Torsades de pointes and sudden death in a patient with a permanent pacemaker. AB - This report describes a patient with a functioning permanent pacemaker who developed torsades de pointes. Although overdrive cardiac pacing has been used to suppress this arrhythmia, cardiac pacing was not protective in this patient. This case also illustrates the difficulty in interpreting Q-T intervals in the presence of paced beats. PMID- 3635425 TI - Nursing information systems: the key to the future? PMID- 3635424 TI - Effect of adrenochrome on adenine nucleotides and mitochondrial oxidative phosphorylation in rat heart. AB - Effects of adrenochrome, an oxidation product of epinephrine, on myocardial energy production were investigated by studying changes in adenine nucleotide content and mitochondrial oxidative phosphorylation activities in the isolated rat heart. Perfusion of the heart with 50 mg/L adrenochrome induced a marked decline in contractile force within 5 min and this was associated with a rapid decline in the myocardial ATP/AMP ratio. A significant decrease in ATP and ATP/ADP ratio as well as a significant increase in ADP and AMP content was observed at 10 min of perfusion with adrenochrome. Furthermore, mitochondrial oxidative phosphorylation activities were unchanged except that an increase in state 4 respiration and a decrease in RCI value were seen in the heart perfused with adrenochrome for 10 min. Autoradiography of the sections from hearts perfused with 14C-adrenochrome revealed the localization of a significant amount of radioactivity on mitochondria. Adrenochrome at concentrations of 20 mg/L or higher was found to inhibit the oxidative phosphorylation activities of heart mitochondria under in vitro conditions. The depressant effects of adrenochrome on mitochondrial oxidative phosphorylation were additive to those seen with calcium. These data suggest that adrenochrome in the presence of excess calcium in the myocardial cell may impair the process of energy production in mitochondria and this may result in contractile failure of hearts exposed to this cardiotoxic metabolite of epinephrine. PMID- 3635426 TI - Computer training for nursing personnel: suggestions for training sessions. PMID- 3635427 TI - Putting the PC to work in continuing education. PMID- 3635428 TI - The NI pyramid--a model for research in nursing informatics. PMID- 3635429 TI - Cancer nursing in the year 2000. PMID- 3635430 TI - Carotid artery rupture: prediction, prevention, and preparation. PMID- 3635431 TI - Glucocorticosteroid-induced depression in the patient with leukemia or lymphoma. PMID- 3635432 TI - The primary caregiver's perception of the dying trajectory. An exploratory study. PMID- 3635433 TI - Alterations in taste appreciation in cancer patients during treatment. PMID- 3635434 TI - A time for reassessment. PMID- 3635435 TI - A comparison of patient and nurse perceptions of patients' self-care deficits associated with cancer chemotherapy. PMID- 3635436 TI - Hospice home care pain management. Four critical variables. PMID- 3635437 TI - Pain: problem for the person with cancer. PMID- 3635438 TI - Attitude of patients living in Switzerland about cancer and its treatment. PMID- 3635439 TI - Cancer nurses' perceptions of caring. PMID- 3635440 TI - New trends in the chemotherapy of staphylococcal infections. AB - The authors evaluated the susceptibility of some antibiotics against several Staphylococci subdivided in lyogroups and different resistance patterns: methicillin-susceptible/penicillin-susceptible (MS/PS), methicillin susceptible/penicillin-resistant (MS/PR), methicillin-resistant/penicillin resistant (MR/PR) and methicillin-resistant/penicillin-susceptible (MR/PS). The antimicrobial agents used were: methicillin, penicillin, rifampin, tetracycline, lincomycin, erythromycin, gentamicin and netilmicin. Netilmicin showed better activity against all Staphylococcus strains tested, particularly against coagulase-negative. PMID- 3635441 TI - Women in politics. PMID- 3635442 TI - Our peer assistance program: its beginnings. PMID- 3635443 TI - Magnetic resonance: indications for imaging and considerations on the other possibilities. Utrecht, April 26, 1985. PMID- 3635444 TI - Description of flow phenomena in magnetic resonance imaging. AB - The magnetic resonance (MR) signal from the hydrogen nuclei of blood is not only determined by the MR parameters T1, T2 and proton density, but is strongly dependent on the movement of the protons. Magnetic resonance imaging (MRI) offers therefore the possibility to visualize the distribution of moving spins, especially blood flow, noninvasively and without contrast agents; moreover, the velocity of the moving spins can be quantified. Flow phenomena in MRI are a pretentious field because the complicated hydrodynamics of the living system is coded in the MR signal; therefore, an understanding of the underlying physical principle of the MR signal is required to interpret and extract flow information from the image. However, rather simple theoretical and experimental models of fluid transport in vessels allow to explain the main features of various effects observed in images. PMID- 3635445 TI - Evaluation of MRI today. AB - After a historical introduction several aspects of clinical MRI are treated: optimal field strength, siting, tissue characterization, examination time and the use of surface coils. In a bird's eye view the major clinical applications and the actual place of MRI in the diagnostic process are discussed. PMID- 3635446 TI - Influence of magnetic field strength on image contrast. AB - In magnetic resonance imaging (MRI) S/N increases with magnetic field strength. The curve, however, flattens out at higher fields, resulting in diminishing gains as the field strength is increased. PMID- 3635447 TI - Interpretation of spinal MR images in relation to tissue parameters. AB - When relaxation parameters of tissues are known, selection of adequate instrumental parameters in magnetic resonance imaging is possible. The signal strength of various tissues is defined by proton density, T1 and T2. The calculation of this signal strength is given. The advantages of multiple echoes and the reason why they are used, are mentioned. PMID- 3635448 TI - MRI of the brain and cervical spine: first choice in the detection of abnormalities. Preliminary study. AB - The preliminary results are presented of a comparative study between MRI and CT in 150 patients from the University Hospital Utrecht. The purpose is through a prospective study to make more definitive assessments about the role and the value of MRI in the region of the brain and cervical spine. If compared with CT, no abnormalities were missed with MRI in 150 cases; MRI detected more lesions than CT, and often more information was provided by MRI. Spin-echo pulse sequence with long multiple echoes and short repetition time proved to be a sensitive detection method with sufficient tissue characterization for diagnosis. In the opinion of the authors, MRI should be the first step in detecting abnormalities of the brain and cervical spine. PMID- 3635449 TI - MRI of the spine. AB - Experience of more than 250 magnetic resonance (MR) examinations of the spinal cord is reported. MR imaging (MRI) using spin echo technique provides an excellent demonstration of the spine and the spinal cord, especially when appropriate surface coils are used. Consequently, MRI appears to be often the optimal imaging modality to be performed in cases of spinal cord tumors, extramedullar intradural tumoral, epidural lesions, syringo-hydromyelia, spinal cord compression by primary or secondary spinal canal stenosis, and traumatic lesions of the spinal cord. PMID- 3635450 TI - Functional analysis of magnetic resonance studies of the heart. AB - To calculate left ventricle volumes and ejection fraction, magnetic resonance images (MRI) were acquired in an oblique position in end-diastole and end systole. The ejection fraction values were compared with results of gated blood pool studies with 99mTc-labelled erythrocytes (correlation coefficient 0.8). Determination of regional wall motion was also possible. A method for acquiring sequences of 16 images per heartbeat was developed. It allows the detection of disturbances of wall motion by using Fourier analysis. PMID- 3635451 TI - Use of surface coils in magnetic resonance imaging of orbit and knee. AB - Surface coils are specially designed radio-frequency receiver coils used for magnetic resonance imaging (MRI) of special anatomical regions, for instance, orbit and knee joint, with a higher spatial resolution than that obtained with conventional MRI techniques. They are designed to fit the anatomical part to be imaged, thus enabling a coil to be placed in close proximity to relevant structures. Surface coils can take these different shapes because they are only used for detecting the MR signal and thus do not need to meet particular design specifications for optimal radio-frequency homogeneity. We report our clinical experience with nearly 100 patients in the first year in the special surface-coil approach of orbit and knee joint. PMID- 3635452 TI - Costs of MRI. A calculation for the Netherlands. AB - A calculation of the costs of magnetic resonance (MR) using a machine with a field strength of 0.5 and 1.5 T is presented for the Netherlands. The costs per patient are 1,000 Dfl. and approximately 1,200 Dfl., respectively. Because the total number of MRI facilities in the Netherlands is strictly limited, also the costs of scientific research in the field of MRI have to be taken into account. It is possible to calculate the hourly costs of research on a time-sharing basis for a 1.5-Tesla machine. Combining patient care and scientific research on one machine has a reciprocal influence on the costs. PMID- 3635454 TI - Algorithms for the detection of events in electrocardiograms. AB - The detection of events in electrocardiograms (ECGs) and vectorcardiograms (VCGs) is an essential processing step in systems for computer-assisted ECG/VCG interpretation. This paper describes various algorithms for the detection of QRS complexes, atrial activity and artefacts. These algorithms have been used in various versions of the TNO Modular ECG/VCG Interpretation System including its latest version, MEANS. Evaluation results are presented. PMID- 3635453 TI - Bactericidal action of nafcillin, vancomycin, and three cephalosporins against nafcillin-susceptible and nafcillin-resistant coagulase-negative staphylococci. AB - Coagulase-negative staphylococci (S. epidermidis, 43 strains; S. warneri, 16 strains; S. haemolyticus, five strains; and others, four strains) were tested by the agar dilution method for nafcillin susceptibility: 53 were susceptible with a minimal inhibitory concentration (MIC) of less than or equal to 2 micrograms/ml; four were of indeterminate susceptibility, MIC = 4-16 micrograms/ml; and 11 were resistant, MIC greater than or equal to 32 micrograms/ml. The bactericidal activities from 0 to 24 hr for nafcillin, vancomycin, cephalothin, cefazolin, and cefamandole, each at 16 micrograms/ml in broth, were determined for all the isolates. The data indicate that a nafcillin agar dilution susceptibility test result of resistance does not consistently predict lack of killing activity by the cephalosporins. It is likely that each cephalosporin would have to be tested against individual coagulase-negative staphylococci in order to determine a suitable therapeutic or prophylactic cephalosporin, if a cephalosporin were to be used. Vancomycin was bactericidal for all the nafcillin-resistant coagulase negative organisms tested. PMID- 3635455 TI - A personal computer program using a 4-component logit for the evaluation of ELISA calibration curves with unknown asymptotic values. AB - A BASIC program is described for the calculation of ELISA calibration curves using a 4-component logit for the linearisation of the sigmoidal shape. The difficulty of estimating the four logit parameters without knowledge of upper and lower asymptotic values is overcome by statistical analysis of the experimental data. The program is run on an IBM-PC and the curves are plotted by a HP7475A plotter. PMID- 3635456 TI - ODDC and MULTIGRAPH: programs for spectrophotometer data collection and manipulation using a microcomputer. AB - A software package is described that collects, graphs, performs peak sensing, and prints data from a spectrophotometer interfaced to an Apple II microcomputer with an ADALAB analog-to-digital converter card. Data collection and storage is performed by an interpreted BASIC program with machine language subroutines. Recalling, graphing, and printout of the data is accomplished by a separate compiled BASIC program. Both of these programs, as well as assisting utility programs, are under control of a menu program. The programs take advantage of all available memory in the 64-K Apple II computer to allow for storage of up to 12 600 data points (7 hours of data collection at a sampling rate of 1 sample every 2 s). As the data collection program provides peak sensing, and the capability of annotating various time points, the programs are ideally suited for use in column chromatography. PMID- 3635457 TI - Real-time detection of ventilatory maneuvers by a microcomputer. AB - The SYTER software system was built around an Apple II microcomputer to automatically process the data yielded by three ventilatory tests: analysis of lung elasticity during an expiratory maneuver, plethysmographic measurement of airway resistance during a panting maneuver, and similar measurements of lung volumes. A volume signal is displayed to the operator throughout each test to help control the maneuver. The various stages of the test are recognized in real time by routines written in assembling language, so that significant data are displayed and stored during the maneuver. This paper describes the algorithms used to perform waveform analysis, and presents illustrative displays obtained in the Lung Function Laboratory. PMID- 3635458 TI - Computerized system for a nutritional support service. AB - The development of a computerized system for the assistance of a nutritional support service (NSS) is described. A cooperative program exists between the NSS and the Department of Laboratory Medicine, whose computer system is used to support the activities of the NSS. A record is maintained on each patient followed by the NSS (15-20 patients per day). Demographic and anthropometric data, nutritional disorder(s), laboratory data, nutritional support therapy, patient response criteria, and concomitant drug therapy are components of the computer program. Computer reports are provided to the NSS for daily rounds. An automated nutritional assessment program has also been developed. Computer assistance has proven to be a valuable tool to support the patient care, education and research program of the NSS. PMID- 3635459 TI - Portable file management system in FORTRAN. II. The input/output routine for free format text. AB - A software tool for inputing and outputing patient data (1/O routine) has been developed. Since this I/O routine is programmed exclusively in FORTRAN77, it will make a powerful tool for constructing a portable database system. Basically the routine manipulates an ASCII-coded text string that consists of lines demarcated by the CR code (13) and is terminated by the null code (0). The editing commands are preceded by one of the following ASCII characters: @, !, ], [, *, and _, and all the strings with an initial character other than these are interpreted as data to be inserted into the text. Since the routine uses two FORTRAN tools already reported, i.e. the subroutines to manipulate key files and the subroutines to manage variable length records, character strings can be stored without any restrictions in format or in size, and can be retrieved either sequentially or in an indexed manner. PMID- 3635460 TI - MODDIS: a microcomputer program for model discrimination. AB - A computer program for a microcomputer (HP 86) is presented to discriminate between different models and to design new experiments for model discrimination. By a non-linear fitting algorithm a set of experimental data is fitted with different models suggested by the user. The parameters characterizing each model are estimated by minimizing the sum of squared residuals; different criteria are used to test the choice between two or more models at different levels of probability and the smallest number of additional experiments required for discrimination is computed. If discrimination is not achieved a direct search method is used to find the local maxima of the divergence (or information for discrimination) over a user-chosen domain of independent variables (x R'''). The x value corresponding to the absolute maximum of the divergence is the best choice to run a new experiment for discrimination. PMID- 3635461 TI - Molecular weight by approach to equilibrium (Archibald) method from ultracentrifuge data: computation on Apple II. PMID- 3635462 TI - Breast feeding: mother's little helper. PMID- 3635463 TI - Fact sheet: breast pumps. PMID- 3635464 TI - District nursing: where the buck stops. PMID- 3635465 TI - Matters for concern: the healing touch. PMID- 3635466 TI - Complement activation in septic shock patients. AB - To evaluate the status of the complement system and to determine the effects of corticosteroids on complement component levels in septic shock, C3, C4, and Factor B were measured in 42 patients with severe late septic shock. Serum levels of C4 and Factor B correlated with C3 levels (r = 0.48 and 0.64, respectively; p less than .01) in patients in shock for more than 4 h, but only Factor B correlated with C3 (r = 0.85; p less than .01) in patients in shock for 4 h or less. C3 and Factor B levels were significantly (p less than .05) lower in patients who died (12,174 +/- 1,524 CH50 U/ml and 14 +/- 1 mg/dl, respectively) than in patients who survived (18,418 +/- 2,833 CH50 U/ml and 21 +/- 2 mg/dl, respectively). Corticosteroids did not alter complement component levels. The alternative pathway appears to be activated early in septic shock, whereas the classical pathway is activated later. C3 and Factor B levels may predict survival of patients in septic shock. In this study, corticosteroids did not change the complement component levels of patients in late severe septic shock. PMID- 3635467 TI - Humor is a serious business. PMID- 3635468 TI - Decreasing tracheal damage due to excessive cuff pressures (continuing education credits). PMID- 3635469 TI - Malignant hyperthermia: a critical care challenge. PMID- 3635470 TI - Acute renal failure of the neonate. PMID- 3635471 TI - Laughter and humor in critical care. PMID- 3635472 TI - Appropriate uses of humor in critical care. PMID- 3635473 TI - Selecting computer software applications in critical care. PMID- 3635474 TI - Nursing diagnosis: potential sexual dysfunction after myocardial infarction. PMID- 3635475 TI - Decreased cardiac output: validation of a nursing diagnosis. PMID- 3635476 TI - Three-dimensional structure of clathrin cages in ice. AB - We have collected tilt series of electron micrographs from unstained clathrin cages embedded in vitreous ice. From these micrographs we have generated three dimensional reconstructions of individual hexagonal barrels, which show details of the internal structure. Four types of preparation have been examined: (i) coated vesicles; (ii) cages reassembled from clathrin heavy and light chains; (iii) reassembled cages treated with elastase to remove the light chains; and (iv) reassembled cages treated with trypsin to remove the light chains and the terminal domains of the clathrin heavy chains. In the intact and elastase-treated cages, the clathrin extends from the vertices into the interior of the polyhedron and forms an inner shell of material. Limited digestion with trypsin removes the inner shell, which indicates that this material corresponds to the terminal domains of the clathrin heavy chains. PMID- 3635477 TI - A tentative model of formation of structural proteins of tick-borne encephalitis virus (flavivirus). AB - The time course of tick-borne encephalitis virus cell-free protein synthesis was studied by using either [35S]-methionine or formyl[35S]methionyl-tRNAMet/f as substrates, and the [35S]methionine-labelled products were compared by fingerprinting tryptic peptides. An intermediate in the protein processing, the polypeptide doublet p36/33, was characterized and a tentative model for flavivirus structural protein synthesis and processing was proposed. PMID- 3635478 TI - Ammonium ion as a possible regulator of the commencement of rRNA synthesis in Xenopus laevis embryogenesis. AB - Recently, we have shown that ammonium salts and amines at an external concentration of 3 mM selectively inhibit rRNA synthesis in Xenopus disaggregated neurula cells. We studied here the change in the amount of ammonia within the embryo and its inhibitory action on the commencement of rRNA synthesis which normally occurs at the blastula stage of development. Ammonia exists at ca. 50 ng/egg (or ca. 3.0 mM at an intra-egg concentration) in the unfertilized egg. This level was maintained during cleavage and then sharply decreased during the blastula stage to the level of ca. 20 ng/embryo (or 1.2 mM) in postblastular stages. Ammonia was extracted from cleavage embryos in a form of ammonium chloride and confirmed to selectively inhibit rRNA synthesis in neurula cells. With authentic ammonium chloride, ammonia was found to be promptly incorporated into cells and to inhibit rRNA synthesis within 1 hr after treatment. In blastula cells, ammonium salts reversibly inhibited the commencement of the synthesis of rRNA, but not hnRNA, 5 S RNA and U1, U2, and U5 snRNAs. The inhibition was at the step of transcription of 40 S pre-rRNA but not the processing or degradation of the processed rRNA. Ammonium salts did not inhibit DNA synthesis, protein synthesis, cell division, and cellular reaggregation. These observations suggest that ammonium ion may be involved in the regulation of the commencement of rRNA synthesis in Xenopus embryogenesis, although it is not yet clear if the ammonium ion exerts its effect directly upon the rDNA transcription system. PMID- 3635479 TI - [Quantitative elastase determination in tear fluid in conjunctivitis]. PMID- 3635481 TI - EMI care--an alternative solution. PMID- 3635480 TI - Silly questions and good sense. PMID- 3635482 TI - The biology of ageing--an introduction. PMID- 3635483 TI - Pressure sores in patients admitted for hip operations. PMID- 3635484 TI - Preventing pressure sores--an evaluation of three products. PMID- 3635485 TI - The elderly make the world go round. PMID- 3635486 TI - A safe and happy refuge. PMID- 3635487 TI - Acting as the patient's advocate. PMID- 3635488 TI - The value of a streamlined surveillance method. PMID- 3635489 TI - Preparation of the skin for surgery. PMID- 3635490 TI - Increasing handwashing in an intensive care unit. AB - The present study provides the first systematic evaluation of strategies for increasing handwashing of hospital staff. Nursing staff on two intensive care units (ICUs) were observed over a 3-month period. After baseline observations, two interventions were implemented on the experimental unit: changing to an emollient handwashing agent, and providing feedback to staff about the frequency of handwashing. Feedback focused on the previous day's handwashing following completed patient contacts, interrupted patient contacts, and critical procedures. No increase in handwashing was observed following introduction of the emollient soap. However, when feedback was provided on the experimental ICU, handwashing following completed patient contacts (the major dependent measure) increased to 92%, and was significantly higher than handwashing on the control unit. Follow-up observations suggested that compliance on the experimental unit appeared to return to baseline levels. PMID- 3635491 TI - Category 1, 2, 3 and 4: a procedure-oriented isolation system. AB - A procedure-oriented isolation system, Category 1,2, 3, and 4, was introduced at a 547-bed, acute and rehabilitative medical center. The system consisted of four categories of isolation which followed a numerical sequence that represented the necessary attire needed to complete the procedure. After 1 year of use, personnel compared the procedure-oriented system with the previously-used system (Strict, Respiratory, Wound and Skin, Enteric, and Limited Barrier). Personnel found the procedure-oriented system easier to understand (84%) and follow (83%). Seventy six percent felt their isolation techniques had improved with the new system. A reduction in the cross-infection rate with methicillin-resistant Staphylococcus aureus did coincide with the use of the new isolation system, however, no causal relationship was established. The Category 1, 2, 3, and 4 isolation system was well received by personnel and was found to be an effective alternative to the previous, more complicated system used in this setting. Further evaluation of this system in other settings would seem warranted. PMID- 3635492 TI - The efficacy of several new handwashing agents for removing non-transient bacterial flora from hands. AB - Forty subjects participated in a study of four handwashing agents evaluated for their efficacy in removing non-transient bacteria: 70% isopropanol, 0.05% stabilized iodine, 4% chlorhexidine gluconate, and 1% para-chloro-meta-xylenol. Each subject performed a non-medicated handwash to remove transient flora. Afterwards, three consecutive experimental handwashes were performed using a 10 second contact time, and a fourth handwash employed a 1-minute contact time. Quantitative post-handwash cultures were obtained using the sterile bag technique incorporating an effective agent neutralizer. Significant mean log10 reductions were documented for chlorhexidine gluconate, but only after the third (P = .05) and fourth (p = .004) handwash; however, the total log10 reduction was less than 1.0 for any single agent. Subsequently, three evaporative handwash agents, including 70% isopropanol, 0.5% chlorhexidine in 70% isopropanol, and a 60% isopropanol formulation containing evaporative retardants, were tested in 14 subjects. Contact time was prolonged to the point of evaporation prior to culturing. Four consecutive post-handwash cultures were obtained after performing a baseline pre-handwash culture. When compared with the other two evaporative agents, the 60% isopropanol formulation demonstrated significant mean log10 reductions for each handwash (p less than or equal to .03), with a total log10 reduction of 2.9 over all four handwashes (p = .0001). The brief contact time incorporated in our handwashing technique reflects clinical usage patterns. The marked bacterial reduction demonstrated by the 60% isopropanol formulation warrants further study. PMID- 3635493 TI - Disposable tracheostomy inner cannula. PMID- 3635494 TI - Can we protect our patients and employees from childhood diseases? PMID- 3635495 TI - Strict versus modified isolation for prevention of nosocomial transmission of methicillin-resistant Staphylococcus aureus. AB - Patients colonized or infected with methicillin-resistant Staphylococcus aureus (MRSA) in a Surgical Intensive Care Unit and Surgical Intermediate Care Unit were placed either in Strict Isolation or cared for with modified isolation precautions. The assignment was determined by the unit in which they were hospitalized. Units were changed from one form of isolation to the other and served as their own controls. Over a 4-month study period, the rate of MRSA transmission did not change when the type of isolation precautions were altered. The ratio of colonized to infected patients also remained constant. Infected patients were usually first detected by clinical specimens, while colonized patients were usually detected by surveillance cultures performed under the study protocol. Following the study, all hospitalized patients with MRSA were placed in modified isolation precautions. Total new acquisitions of MRSA in the hospital have decreased over the subsequent 6-month period. PMID- 3635496 TI - The efficacy of a Florida hospital consortium for infection control: 1975-1982. AB - From 1975 through 1982, the South Florida Hospital Consortium for Infection Control provided consultative and educational services to personnel of 20 community hospitals. To evaluate program efficacy, outbreak frequencies were compared at 11 hospitals with 5 to 8 years of experience through 1982. Annual outbreak rates during the first 4 membership years were compared with those of subsequent years, by service. Each hospital served as its own control. Outbreaks were most frequent in critical care and orthopedic-general surgery patients, and among hospital personnel. Critical care outbreaks occurred more often in hospitals classified as oncology centers (P less than .05); their frequency did not decrease significantly after 4 years of membership. However, surgical outbreak rates did decrease from .36 annually in the first years to .03 thereafter (P less than .01). This was not attributable to a secular decrease and is taken to indicate program efficacy. No change in frequency of hospital personnel outbreaks was evident. PMID- 3635497 TI - Marketing a hepatitis B vaccine program. PMID- 3635498 TI - Defining and differentiating ADN and BSN competencies. PMID- 3635500 TI - Helping parents to help their children comply with treatment regimens for chronic diseases. PMID- 3635499 TI - An analysis of trends in nursing education. PMID- 3635501 TI - Measuring parental participation. Part I. PMID- 3635502 TI - Talking about cystic fibrosis within the family--what parents need to know. PMID- 3635503 TI - Description of a nursing diagnosis: alteration in bowel elimination related to neurogenic bowel in children with myelomeningocele. PMID- 3635504 TI - Learned helplessness in the sexually abused child. PMID- 3635505 TI - A comparison of illness concepts of school age children and adolescents. PMID- 3635506 TI - [Scholarship report from a study visit to California, March 1985]. PMID- 3635507 TI - [Midwife in Cape Verde]. PMID- 3635508 TI - [Teenage mothers' group in Sollentuna]. PMID- 3635509 TI - [Water gymnastics for prospective mothers--a complement]. PMID- 3635510 TI - [Teenage girls in Malmo--study among 200 12-19-year-old girls visiting a Youth Conference in Malmo, Spring of 85]. PMID- 3635511 TI - [Report from the Swedish Midwifery Association on activities from 1 January 1985- 31 December 1985]. PMID- 3635512 TI - [Travel Report: study trip to Austria 1985]. PMID- 3635513 TI - Culture, society and menstruation. PMID- 3635514 TI - Women's social position as menstruating beings. PMID- 3635515 TI - The law and women's bodies: the case of menstruation leave in Japan. PMID- 3635516 TI - Socialization and social context: influence on perimenstrual symptoms, disability, and menstrual attitudes. PMID- 3635517 TI - Toward delineating menstrual symptom groupings: examination of factor analytic results of menstrual symptom instruments. PMID- 3635518 TI - Premenstrual syndrome (PMS) examined through a feminist lens. PMID- 3635519 TI - Menopause as a symbol of anomaly: the case of Japanese women. PMID- 3635520 TI - Premenstrual syndrome: an assessment, education, and treatment model. PMID- 3635521 TI - Peer support, PMS, and stress: a pilot study. PMID- 3635522 TI - Help-seeking for premenstrual symptomatology: a description of women's experiences. PMID- 3635523 TI - Sex role orientation, sex typing, occupational traditionalism, and perimenstrual symptoms. PMID- 3635524 TI - Function and dysfunction: a historical critique of the literature on menstruation and work. PMID- 3635525 TI - Analyzing emergent issues in women's health: the case of the toxic-shock syndrome. PMID- 3635526 TI - Menstruation and menstrual change: women in midlife. PMID- 3635527 TI - Social and menstrual cycles: methodological and substantive findings. PMID- 3635528 TI - Menstrual attitudes, beliefs, and symptom experiences of adolescent females, their peers, and their mothers. PMID- 3635529 TI - Aminopenicillins and superinfection by gram-negative rods. PMID- 3635530 TI - N-terminal amino acid sequence of human urinary prokallikrein. AB - The N-terminal amino acid sequences of human urinary prokallikrein and kallikrein have been determined. Their amino acid sequences are as follows. (Formula; see text) The results showed that prokallikrein comprises an additional seven amino acids at the amino terminus of the kallikrein, of which the sequence is (H2N)Ala Pro-Pro-Ile-Gln-Ser-Arg(COOH). Comparison of the structure of this peptide with those of other proteins revealed extensive sequence identity with the propeptide portions of rat and mouse tissue kallikreins, that were predicted from the preproenzyme-encoded nucleotide sequences. The amino acid sequence of the peptide was also highly homologous to that of the propeptide portion of EGF-binding protein, that was predicted from the nucleotide sequence, and that of the alpha subunit of NGF. The N-terminal amino acid sequence of kallikrein was completely identical to the reported one (Lottspeich, F., et al. (1979) Hoppe-Seyler's Z. Physiol. Chem. 360, 1947-1950) and shows considerable amino acid sequence homology with the porcine and rat pancreatic kallikreins. As far as the present results are concerned, it is strongly indicated that the inactive kallikrein in human urine is a tissue type prokallikrein which is activated on the release of the N-terminal peptide consisting of seven amino acids. PMID- 3635531 TI - Identification of a new kinin in human urine. AB - The types of kinins excreted in fresh urine of dogs, rats, and humans were compared. Urinary kinins were separated by reverse-phase (C18) high performance liquid chromatography and quantitated by radioimmunoassay using an antibody directed against the COOH-terminal region of the peptide. Kinins were found in the following proportions: 53 +/- 3% bradykinin, 23 +/- 4% Lys-bradykinin, and 13 +/- 7% des-Arg1-bradykinin in dog urine; 67 +/- 6% bradykinin, 6 +/- 3% Lys bradykinin, and 10 +/- 3% des-Arg1-bradykinin in rat urine; and 12 +/- 4% bradykinin, 30 +/- 3% Lys-bradykinin, 2 +/- 1% des-Arg1-bradykinin, and 41 +/- 3% unknown kinin in human urine. The unknown kinin was purified from a pool of human urine. Amino acid sequencing revealed a structure similar to Lys-bradykinin except that proline in position 4 was replaced by alanine ([Ala3]Lys-bradykinin). Synthetic and endogenous [Ala3]Lys-bradykinins had similar high performance liquid chromotography elution volumes and both had vasodilator activity and contracted the rat uterus. Human urinary kallikrein incubated with semipurified human low molecular weight kininogen released 76% of the total kinins as Lys bradykinin, 7% as bradykinin, and 17% as [Ala3]Lys-bradykinin. In contrast, rat urinary kallikrein released 86% bradykinin, 18% Lys-bradykinin, and negligible amounts of [Ala3]Lys-bradykinin. The study revealed the presence of a new kinin, [Ala3]Lys-bradykinin, in human urine and it also proves that the types of kinins generated intrarenally are species-dependent. PMID- 3635532 TI - Affinity purification of kallikrein and elastase from hog pancrease powder. AB - The present report describes a method that is efficient for simultaneous isolation of kallikrein and elastase from hog pancrease powder. Both enzymes were separated by successive column chromatography on CM-cellulofine and p aminobenzamidine-Sepharose 4B. Kallikrein was further purified by column chromatography on DEAE-Sephadex and elastase was purified by repeated gel chromatography on Sephadex G-75. The kallikrein obtained was composed of two components, which were separable by sodium dodecyl sulphate polyacrylamide gel electrophoresis, and the elastase had one component. The activity yields of kallikrein and elastase were 49 and 38%, respectively. PMID- 3635533 TI - Evaluation of rapid coagulase methods for the identification of Staphylococcus aureus. AB - Four rapid latex agglutination assays, StaphAurex (Wellcome Diagnostics, Research Triangle Park, N.C.), Bacto Staph (Difco Laboratories, Detroit, Mich.), SeroSTAT (Scott Laboratories, Inc., Fiskeville, R.I.), Veri-Staph (Zeus Technologies, Raritan, N.J.), and two hemagglutination tests, Staphyloslide (BBL Microbiology Systems, Cockeysville, Md.) and Hemastaph (Remel, Lenexa, Kans.), were compared with the conventional slide coagulase, tube coagulase (TC), and thermonuclease (TNase) tests for the identification of Staphylococcus aureus. A total of 118 clinical isolates of S. aureus (52 methicillin resistant), 50 S. epidermidis, 5 S. capitis, 2 S. hominis, 3 S. simulans, 6 S. saprophyticus, and 2 S. warneri were tested. The slide coagulase, TC and TNase tests detected 115 (97.5%), 117 (99.2%), and 118 (100%) of the S. aureus isolates, respectively. All showed 100% specificity. The StaphAurex, Veri-Staph, Staphyloslide, Hemastaph, SeroSTAT, and Bacto Staph assays correctly identified 117 (99.2%), 117 (99.2%), 116 (98.3%), 110 (93.2%), 108 (91.5%), and 107 (90.7%) of the S. aureus isolates, respectively. For methicillin-resistant S. aureus isolates, StaphAurex, Veri Staph, Staphyloslide, Hemastaph, SeroSTAT, and Bacto Staph showed 1 (2%), 1 (2%), 2 (4%), 7 (13.5%), 7 (13.5%), and 8 (15.4%) false-negative results, respectively. All the commercial agglutination assays demonstrated false-positive results with strains of S. capitis, S. saprophyticus and S. warneri. The overall accuracy of the commercial agglutination assays compared with TC and TNase ranged from 90.7 to 99.2%. We recommend that negative reactions with the rapid commercial test kits for methicillin-resistant Staphylococcus isolates be confirmed with the TC or TNase test. PMID- 3635534 TI - Phenotypic characteristics of Aeromonas species isolated from adult humans. AB - The phenotypic characteristics of 89 Aeromonas strains, most of which had been isolated from feces, were examined. Eighty-two percent of the isolates could be placed into one of four groups on the basis of five tests. The relationship of these groups to the three motile species of Aeromonas (Aeromonas caviae, A. hydrophila, and A. sobria) that have been isolated from humans is unclear. Because the means for identification of Aeromonas strains to the species level appear to be imprecise and because the role of each of these species in human diarrhea is unclear at this time, we recommend that identification of enteric Aeromonas isolates to the species level not be done routinely. PMID- 3635535 TI - Theoretical foundations for an approach to urinary incontinence. PMID- 3635536 TI - Publishing the results of clinical research projects. PMID- 3635538 TI - The challenge of home care. PMID- 3635537 TI - The use of flexible catheters for constructing, bridging, and pouching loop ileostomies. PMID- 3635539 TI - The anatomy and physiology of an organization. PMID- 3635540 TI - Pressure relief characteristics of various support surfaces used in prevention and treatment of pressure ulcers. PMID- 3635541 TI - Criterion-based practice for the ET nurse. PMID- 3635542 TI - Indicators of quality in nursing care--an alternative approach. AB - Indicators of quality of nursing care were developed from a conceptual framework for geriatric nursing based on the twin concepts of care and having a positive attitude to the health and welfare of old people. These primary concepts were further developed using structural aids, in particular the theoretical guidelines for practice disciplines propounded by Dickoff et al. From this, a measure, called the Therapeutic Nursing Function (TNF) Indicator, was devised which attempted to identify those ward sisters who provided more patient-centred or therapeutic nursing care from ward sisters who gave routine-centred or non therapeutic nursing care. The TNF Indicator, based on the conceptual framework, comprised a list of statements to which ward sisters responded. The scaling system divided responses into more--or fewer--therapeutic nursing responses. A stratified random sample of 25 ward sisters was used in the study and from this the characteristics of ward sisters in the upper and lower range of the scale were compared. Distinct variations were noted between groups in relation to demographic information, perception of geriatric nursing, use of nursing information, management approach and the ward sisters' concept of rehabilitation. A further instrument, the Therapeutic Nursing Function Matrix, attempted to measure the quality of care patients were receiving on geriatric wards. Nurse patient interaction on a ward where the ward sister had a high TNF Indicator score was compared to a ward where the ward sister had a low score. The results showed that quality of care seemed to be related more to the orientation and perception of the ward sister than to any number of extraneous variables such as medical and paramedical input, ward facilities and ancillary staff support. PMID- 3635543 TI - Twenty-four hour reality orientation: changes for staff and patients. AB - A 24-hour reality orientation programme was initiated in a long-stay geriatric ward. Nursing and occupational therapy routines were changed specifically to meet the needs of the 20 patients participating in the programme. The assessments included the Clifton Assessment Procedures for the Elderly, the Holden Communication Scale, the Holden Orientation Facilities Scale, and the Oberleder Scale (adapted by Holden et al.). These scales were administered before, during and after completion of a study lasting 4 months. The CAPE scales showed no significant results. However, the Holden Communication Scale indicated that there were significant differences for certain groups of patients. Those patients with high scores initially tended to continue to have high scores and showed no real change. However, patients who had scores in the medium range initially, showed improvement. This finding indicated that severity at onset of the experiment was an important variable when considering outcome of treatment. Expectations regarding the future of the very elderly must be realistic, and to anticipate a return to previous vitality and total independence should not be expected. However, to find a means by which functional levels can be maintained, and even slightly improved, is desirable. It would seem that the 24-hour reality orientation programme achieved this goal. PMID- 3635544 TI - Older women: a literature review. AB - Older women need special attention and study in the health care profession, yet this attention has not been forthcoming. Age has a serious impact on women. This paper reports on the state of the literature on older women. This literature review on older women includes specific problem areas, such as caregiving, social networks, and retirement. Nursing will have many opportunities for development and implementation of resources for this vast age group. The literature on older women is examined, including strengths and weaknesses. Recommendations for future research to build knowledge and theory in nursing are identified. PMID- 3635545 TI - Spouse burnout syndrome. AB - In married couples, chronic illness in one partner can result in increased responsibilities for the spouse and lead to spouse burnout. Burnout has been described as a syndrome encompassing both physical and emotional symptoms. The literature has addressed the burnout syndrome experienced by health care professionals but few articles have addressed burnout in spouses of chronically ill persons. During a preliminary study of 30 chronically ill persons and their spouses, the following two questions were raised: Were the manifestations of the spouses similar to the indications of burnout exhibited by health professionals? and What factors in the home where one member was chronically ill contributed to the spouse's burnout? The three stages of burnout were examined. The emotional and physical symptoms of burnout in the first and second stages were very similar to symptoms identified in the spouses of our preliminary study. The spouses in our study did not exhibit signs or symptoms of the third stage. Three home situations were extrapolated from the study group in order to examine in depth specific examples of spouse burnout. Nurses have a responsibility to care for the spouse caregiver as well as the patient. The nurse must recognize behaviour which may be indicative of burnout syndrome. With this knowledge, the nurse is then better prepared to assist the spouse in prevention and/or early recognition and plan interventions accordingly. PMID- 3635546 TI - Professional and lay social support for hysterectomy patients. AB - This paper describes a study of social support for women undergoing hysterectomy, and shows how original research plans had to be modified when early interviews revealed women's need for basic information and their desire to obtain this from the researcher. The modified design allowed comparisons between one group of women receiving information as part of the research interview and a second group receiving no such help. Post-hysterectomy follow-up at 3 months showed significant differences between the 2 groups, with the 'information group' being less hostile but more critical of their hospital treatment. The study also confirms previous findings by the same author of generally high levels of satisfaction, health and resumption of activities after hysterectomy. With regard to social support, it is suggested that full-time housewives are in particular need of support from nurses due to their relative isolation from other sources of support and information. However, all interviewees would have liked more information and support from health care professionals. Despite the acknowledged limitations of the study, some guidelines are offered for nurses attempting to increase levels of lay and professional support for their patients. PMID- 3635548 TI - Nursing research, nursing theory and the nursing process. AB - In recent years, practising nurses and nurse theorists have shown interest in the development of conceptual models of nursing and nursing theory. As yet, however, there exists little agreement concerning the most appropriate methodologies to be employed in such an exercise. This paper identifies a number of strategies which might usefully be adopted for this purpose. In particular, it distinguishes between inductive and hypothetico-deductive approaches to the development of nursing theory. It further attempts a clarification of the relationship between conceptual models of nursing and theories of nursing, and explores the use of the nursing process as a research technique which combines both inductive and hypothetico-deductive commitments. Finally, it argues that the systematic use of the nursing process may identify a set of research procedures with the potential to facilitate the development of nursing theory using insights from both the direct experience of practising nurses and from existing conceptual models of nursing. PMID- 3635547 TI - A comparative analysis of nurse and physician characters in the entertainment media. AB - The results of a large body of research have yielded findings supportive of the view that the mass media have a decisive effect on the formation of public attitudes and behaviours. This study reports the results of a content analysis of 670 nurse and 466 physician characters portrayed in novels, motion pictures and prime-time television series, published or produced from 1920 to 1980. When compared with media physicians, media nurses were consistently found to be less central to the plot, less intelligent, rational, and individualistic, less likely to value scholarliness and achievement and exercise clinical judgement. Moreover in television series nurse characters were depicted as valuing service to others and being helpful to patients less, and as being lower in nurturance and empathy than physician characters. An analysis of these data over time points to a steady and unmistakable decline in the mass media entertainment image of nurses while physician characters have remained consistently high or shown improvement. The implications of this image gap are discussed along with the need for image reshaping efforts which might direct public demand for more collegial and productive 'real world' nurse-physician roles and interprofessional relationships. PMID- 3635549 TI - Planning and evaluating innovations in nursing practice by measuring the ward atmosphere. AB - A controlled evaluation of nurses' and patients' perceptions of the hospital ward atmosphere served to both define problems and evaluate the corrective changes that were implemented in a psychiatric day hospital. The results indicated that nurses and patients held similarly unfavourable views of the ward at a baseline assessment, including low levels of support, involvement, spontaneity and programme clarity. This finding then served as the basis for systematic changes, including staff training, the regrouping of patients, and revising the therapeutic programme. A repeat evaluation then indicated that these changes had significantly improved the ward atmosphere from the perspective of both nurses and patients. It is concluded that this approach holds considerable promise for the implementation of changes in nursing practice. PMID- 3635550 TI - The nursing process: implications for curriculum planning. AB - The focus of this paper is an exploration of the implications for curriculum planning of adopting the nursing process; which, it is suggested, represents the most far-reaching innovation in British nursing of recent years. An examination of the abilities required by nurses in order for them to deliver care in this way shows that to encompass the philosophy of the nursing process, fundamental changes need to be made in the way nurses are prepared in schools of nursing. In particular, to those elements of the curriculum dealing with content and teaching methods. PMID- 3635551 TI - Two faces of nurse faculty: teacher and researcher. AB - The purpose of this paper is to examine three topics related to nurse educators and research productivity. The first section is an analysis and synthesis of what is known about nurse educator involvement in research activities from published studies. The second section is an examination of factors that may enhance or deter nurse educators from engaging in research activities. The focus of the last section is on the relationship between research and teaching quality. Empirical data are examined and recommendations made for nurse faculty. PMID- 3635552 TI - Academization of nursing education: the Israeli experience. PMID- 3635553 TI - Bowel management: a quality assurance approach to upgrading programs. PMID- 3635554 TI - VA study: training the geriatric nurse. PMID- 3635555 TI - Before and after attitudes toward aging in a BSN program. PMID- 3635556 TI - Elderly in Egypt. PMID- 3635557 TI - Stimulating creativity through artistic inspiration. PMID- 3635559 TI - Nurse managers-a blessing? A bother? An endangered species? PMID- 3635558 TI - The black elderly. PMID- 3635560 TI - Mobile coronary care units: the Dundee experience. PMID- 3635561 TI - Electrocardiographic monitoring II--ambulatory monitoring. PMID- 3635562 TI - A survey of continuing educational needs of nurses working in an intensive care unit. PMID- 3635563 TI - Are circadian rhythms important in intensive care? PMID- 3635564 TI - Isolation and characterization of rabbit properdin of the alternative complement pathway. AB - Rabbit factor P, which is involved in stabilizing the labile C3 convertase of the alternative complement pathway, was isolated from rabbit serum by a simple two step procedure: polyethylene glycol precipitation and QAE-Sephadex A-50 column chromatography. The chemical properties, and functional activities of the rabbit P were very similar to those of human P, except that there were slight differences in the SDS-PAGE patterns of limited tryptic digests and in the amino terminal sequences. The molecular weights were estimated to be 58 000 for rabbit P and 59 000 for human P on SDS-PAGE under reducing conditions. The amino terminal 36 residues of rabbit P showed 78% homology to the equivalent region of human P. PMID- 3635565 TI - Relationship between the component and regulatory proteins of the classical pathway C3 convertase. AB - A relationship was found between the sums of the component proteins of the classical pathway C3 convertase (C2 and C4) and their regulators (C4bp and 1) in 184 normal controls. The relationship was maintained in most patients with low levels of individual components resulting from congenital deficiency and urinary losses, as well as in most cord sera. On the other hand, classical pathway activation in membranoproliferative glomerulonephritis type I, systemic lupus erythematosus, hereditary angioneurotic edema, and bacteremia resulted in loss of this relationship. Patients with alternative pathway-mediated complement activation (membranoproliferative glomerulonephritis type II) had a normal relationship between the classical component and regulatory proteins. In situations in which classical pathway activation is suspected, simultaneous examination of C4, C2, C4bp, and I may be helpful. PMID- 3635566 TI - Home care of the client with AIDS. PMID- 3635567 TI - Well woman's clinic: a health promotion program. PMID- 3635568 TI - Health beliefs in compliant and noncompliant hypertensive clients. PMID- 3635569 TI - Staff development: setting up a peer review system. PMID- 3635570 TI - Code syndromes: teaching nurses to cope. PMID- 3635571 TI - Focused data collection for the generation of nursing diagnoses. PMID- 3635572 TI - Use and misuse of algorithms in nursing staff development. PMID- 3635573 TI - Revisiting the preceptor concept--crosstraining nursing staff. PMID- 3635574 TI - Applying Orem's theory of self-care to staff development. PMID- 3635575 TI - Experimental learning in staff development. PMID- 3635576 TI - Continuing nursing education: does it make a difference? PMID- 3635577 TI - A practical approach to nursing grand rounds. PMID- 3635578 TI - The impact of budget-related behaviors on nurse managers' need satisfaction. PMID- 3635579 TI - An economic analysis of comparable worth. AB - Comparable worth has been called the civil rights issue of the 1980s. Nursing is in the forefront of this movement. Although several governmental agencies are implementing salary programs based on comparable worth, establishing such a program in the hospital setting could yield problems for nurse executives. Implementation could be costly and demand a significant investment of resources. This paper discusses how wages are determined in a competitive market and what happens to that process when restrictions and barriers make the market noncompetitive. Of most importance, alternative strategies for increasing nursing salaries are presented. PMID- 3635580 TI - The benefits of preceptorships. PMID- 3635581 TI - Research contributions of clinical nurse specialists. PMID- 3635582 TI - Building excellence through competition. The team concept. AB - To increase staff productivity, an innovative program that provides a monetary incentive was developed. By increasing productivity through competition, the Team Concept Program quantifiably measures nursing documentation, attendance at both work and educational programs, and patient satisfaction. The author describes this program, which is enhancing patient care, demonstrating cost savings, and increasing employee satisfaction. PMID- 3635583 TI - Burnout. PMID- 3635584 TI - Presumptive maternal benefits of routine episiotomy. A literature review. PMID- 3635585 TI - Effect of perineal massage on the incidence of episiotomy and perineal laceration in a nurse-midwifery service. PMID- 3635586 TI - Management of the third stage of labor. A review. PMID- 3635587 TI - Certified nurse-midwives and health promotion and disease prevention. Results of a national survey. PMID- 3635588 TI - The proposed New York State legislation on midwifery. PMID- 3635589 TI - An innovative physical assessment experience for nurse-midwifery students. PMID- 3635590 TI - Maternal positions and pushing techniques in a nonprescriptive environment. AB - An observational study was done on the positions and breathing techniques women will choose for second-stage labor when they are given the freedom and support to choose. In the 50 second stages and births observed, nine different positions were used in conjunction with three variations of expulsive breathing techniques. No adverse outcomes resulted from the nonprescriptive approach to birthing women. All outcome parameters were found to be within the range of normal. These findings support the acceptability of allowing women to respond to their birthing impulses. Further study is recommended to verify the safety of a nondirective approach to birth. PMID- 3635591 TI - Antepartal nursing management of Grave's disease. AB - The signs and symptoms of Grave's disease may be difficult to distinguish from the normal thyroid changes that occur in pregnancy. A brief review of thyroid physiology, thyroid changes during pregnancy, the effect of Grave's disease during pregnancy on the woman and fetus, and an assessment tool for use during the antepartal period is presented. Recommendations of specific areas of need seen in the pregnant Grave's patient during the antepartal period are also outlined. PMID- 3635592 TI - Protocol for tuberculosis screening in pregnancy. AB - Screening for tuberculosis in pregnancy should be considered in clinics where the incidence of the disease is high. With early diagnosis and adequate chemotherapy, available literature suggests that the disease should not adversely affect the outcome of pregnancy. Current research is needed in this area. Much of the literature is dated. Because the disease is still prevalent in many large cities, studies could be initiated to examine the complications of tuberculosis in pregnancy, treatment regimens, and drug resistance, as well as the fetal and neonatal effects of the disease. Nurses involved in providing prenatal care are in a unique position to screen for tuberculosis. Pregnancy may be the first condition for which many young women seek medical attention. Also, prenatal nurses have access to many segments of the population at particular risk for tuberculosis infection: the indigent, people living in crowded urban areas, foreign-born people, and non-white races. In these segments, preventive health care and medical screening may be inaccessible or nonexistent. Therefore, prenatal care provides an excellent opportunity for screening for tuberculosis infection. PMID- 3635593 TI - The psychosocial impact of a high-risk pregnancy on the family. AB - A conceptual model for guiding the nurse in assessing the psychosocial impact of a high-risk pregnancy on and planning care for the family is described. The model depicts four major concepts that the nurse must consider in determining how the family is integrating, interpreting, and adapting to the high-risk pregnancy: health status of the pregnancy, the family's perception of the high-risk pregnancy, support available to the family, and the family's adaptation to a high risk pregnancy are discussed. PMID- 3635594 TI - Sending infants home on low-flow oxygen. AB - A program for sending infants on low-flow oxygen home or to less-specialized hospitals is described. Problems identified in the development of the program are outlined. In establishing the program, its benefits for increasing infant-parent bonding, decreasing hospital costs, and eliminating the risk of nosocomial infection were considered. A comprehensive teaching package was established to ensure that parents were adequately instructed and confident before discharge. Some families had older children, multiple births, or other complicating factors, but most were able to adapt to their infant's needs. Of the 51 infants discharged between April 1979 and June 1982, two had to be readmitted until weaned from oxygen and three died of other causes. PMID- 3635595 TI - Hospital and home care of the infant with congenital bilateral choanal atresia. AB - Congenital bilateral choanal atresia in the newborn presents a nursing challenge in both the hospital and the home setting. Emergency intervention is necessary at birth to ensure the infant's survival. Surgery within the first month is frequently necessary to perforate the blocked nasal passages. After these interventions, the infant requires continued care within the home. This article reviews the hospital and home care of the infant with bilateral choanal atresia, stressing the need for health professionals to support family members in caring for the infant. PMID- 3635596 TI - Health care for women. AB - To provide optimum care to women, nurses need to understand some of the social, historical, and political factors that have influenced women and women's health care. Nurses, as consumers and providers of health care, play a central role in the women's health-care movement by providing education, support, and counseling. Although educational topics are vital, even more important is the way nurses communicate caring, support the woman in decision making, and mobilize available support persons. To provide women's health care, nurses must first do a nursing assessment, which involves gathering physiological, psychosocial, and cognitive data. A sample women's health-care assessment is outlined. PMID- 3635597 TI - The effects of culture on mother-infant interaction. AB - A study was conducted to investigate the influence of culture on infant behavior, maternal attitudes toward child rearing, and maternal-infant interaction in 39 Korean and American mother-infant dyads at two to three days after delivery. Significant findings for the Brazelton Neonatal Behavioral Assessment Scale included more rapid habituation by the Korean infants (P = 0.01) and better state regulation by the American infants (P = 0.01). In addition, on the Cohler's maternal scale, Korean mothers were found to view their infants as more passive and dependent than American mothers did (P less than 0.00). No differences were found in maternal reciprocity (Maternal-Infant Adaptation Scale) or maternal sensitivity (Maternal-Infant Play Interaction Scale). The findings are attributed to a combination of culturally specific differences, differences in the testing situation, and maternal medication during labor. PMID- 3635598 TI - Effects of tactile stimulation on premature infant weight gain. AB - A study was conducted to determine the effect of continuous tactile stimulation on weight gain in premature infants. Thirty infants made up the sample. The experimental group received continuous tactile stimulation by being placed on a pile decubitus pad for a five-day period. Infants in the control group received routine nursery care. Both groups were weighed daily on the same scale. Analysis of covariance was used to analyze the data, which resulted in a failure to reject the hypotheses of no difference. PMID- 3635600 TI - Options, not orders. PMID- 3635599 TI - The effect of music as a conditioning aid in prepared childbirth education. AB - The addition of self-selected music as a conditioning aid during prepared childbirth education and subsequent family performance in labor within a musical environment were examined. Thirty primigravida couples received the same psychoprophylactic instruction, with 15 randomly selected couples receiving the added musical conditioning aid. Medication use remained minimal, without significant difference, for couples who did and couples who did not use music. However, the value of music to both the family and the health care staff is felt to be of enough subjective significance to warrant its use as a normal component of prepared childbirth education. PMID- 3635601 TI - Dialysis nurses coping with stress through a peer support group. PMID- 3635602 TI - Scleroderma--the silent disease. PMID- 3635603 TI - For Mark. PMID- 3635604 TI - A self-care program for hemodialysis patients based on Dorothea Orem's concepts. PMID- 3635605 TI - For dialysis patients only: "Value your lab values". PMID- 3635606 TI - Implementation of a self-care approach in a pediatric interdisciplinary phenylketonuria (PKU) clinic. PMID- 3635607 TI - Obtaining therapeutic antibiotic blood levels in children. PMID- 3635608 TI - The Brazelton neonatal behavioral assessment scale: a tool to enhance parental attachment. PMID- 3635609 TI - The manager's role in downsizing pediatric services. PMID- 3635610 TI - Malpractice suits and child abuse. PMID- 3635612 TI - A translation guide for postanesthesia nurses. PMID- 3635611 TI - Assessing the elderly PACU patient. PMID- 3635613 TI - Reliability and validity of the PAR score: a pilot study. PMID- 3635614 TI - Primary nursing in postanesthesia practice. PMID- 3635615 TI - Practical points in postanesthetic assessment and care following bronchoscopy. PMID- 3635616 TI - Morphine epidural anesthesia. PMID- 3635617 TI - Emergency preparedness in the ambulatory setting: medical emergencies. PMID- 3635618 TI - The CHF patient in PACU. PMID- 3635620 TI - Understanding the fallibility of research. PMID- 3635619 TI - Innovation: the nurse manager's critical skill. Part II: The people process. PMID- 3635621 TI - The voice of nursing. PMID- 3635622 TI - Strategies for surviving stress in the PACU. PMID- 3635623 TI - Pulmonary aspiration in the postanesthetic period. PMID- 3635624 TI - Change: are you a resistor or a creator? PMID- 3635625 TI - Carotid endarterectomy: a comprehensive approach to care. PMID- 3635626 TI - Mobilizing depressed clients. PMID- 3635627 TI - Breaking barriers. PMID- 3635628 TI - Anne J. Davis, PhD, RN, FAAN. PMID- 3635629 TI - Exposure of workers to intense RF electric fields that leak from plastic sealers. AB - This paper presents the results of an environmental investigation in a plastic ware industry using RF sealers. Environmental measurements have demonstrated the presence of strong electric fields the intensity of which: reaches significant levels from the health-protection point of view only in proximity to the applicators; often exceeds the maximal levels allowed by all standards (including the most permissive) for short duration exposures, especially in the region of the hands. Results of a cross-sectional study on the health of 63 female workers are related to the observed RF exposure. A statistically significant correlation was found to exist between RF exposure and some minor health effects--eye irritation, upper limb paresthesias, and vitreous body disorganization. PMID- 3635630 TI - Increasing antigenicity of B16 melanoma cell fraction with microwave hyperthermia. AB - An injection of a fraction of a fraction (C30 mw) obtained by centrifugation at 30 kg of homogenate of B16 melanoma cells, treated with microwave hyperthermia (2450 MHz, CW, 44 degrees C, for 20 minutes), increases the survival time (p less than 0.01) of C57-BL/6J male mice inoculated 26 days later with 10(7) cells (viability greater than 95%) of B16 melanoma. This delay of 26 days between these two injections corresponds to the moment where the synthesis of immunoglobulins is increased in protected mice. The earliest death (p less than 0.001) of animals injected with untreated tumoral cell fraction (C30), and that received a suspension of viable B16 melanoma cells (10(7)) can be explained by an inhibition of humoral immunity system. PMID- 3635631 TI - The development of biomedical approaches and concepts in radiofrequency radiation protection. AB - The approaches and concepts used in the development of radiofrequency radiation (RFR) protection guidelines evolved over the past quarter of a century. The values of exposure limits (EL) proposed by various groups are converging. Early guides specified ELs in incident power density. Recent ELs are based on considerations of the relationship between bioeffects and the magnitude of the whole body average specific absorption rate (WBA-SAR) and current densities induced in the body. Both these quantities may be considered as dosimetric ones. Thresholds for untoward health effects expressed in terms of these quantities were suggested, and may be considered as basic ELs. It is possible to derive a frequency-dependent relationship between incident RFR fields and WBA-SAR and/or induced current densities in the body. ELs specified for the purpose of determining compliance in terms of electric and magnetic field strengths or equivalent plane-wave power density existing at a point where a person could be present, but measured in the absence of the exposed subject, may be considered as derived working limits. The rationales offered for the recommended ELs indicate that the principal consideration in establishing limits for frequencies of 10 MHz and higher is the prevention of thermal injury, thermal being defined as relatable to heating, i.e. an increase in temperature. At lower frequencies, below 100 kHz or 30 kHz, direct effects on membranes of nerve and muscle cells may be the limiting factor. An additional consideration is the hazard of shock and burns from contact with ungrounded large metal objects that are charged by RFR fields. Recent advances in RFR dosimetry led to concerns that exposure to presently accepted derived ELs may result in large local SARs and induced current densities in certain parts of the body. The present review concludes that further refinements to the basis for RFR should be introduced. Threshold for health hazards should be investigated taking into account both direct and thermal bioeffects of RFR. The dose-thermal effects relationships should be quantified using the concepts of SAR, SA and thermal dosage. Several unresolved questions, such as the biological basis for SAR time-averaging, and the limitation of pulse peak power, are briefly discussed. PMID- 3635632 TI - Gem quality blades: the care and handling. PMID- 3635634 TI - Videography in surgery. PMID- 3635633 TI - Ocular side effects of systemic drugs: a physical assessment guide for the ophthalmic medical assistant. PMID- 3635635 TI - Peer profile. PMID- 3635636 TI - ABC's of pediatric ophthalmology: a look at the pediatric exam. PMID- 3635637 TI - Managing detachment with retinal tacks. PMID- 3635638 TI - Automated versus Goldmann perimetry. PMID- 3635639 TI - [Saliva kallikrein activity in diabetics]. PMID- 3635640 TI - [Professional image of the midwife]. PMID- 3635641 TI - [Right to life?]. PMID- 3635642 TI - [The need for sick leave during pregnancy]. PMID- 3635643 TI - Policy making: a nursing role. PMID- 3635644 TI - Legal functions of the Kansas State Board of Nursing ... after the Administrative Procedures Act. PMID- 3635645 TI - [Nursing process. Nursing of a patient with Crohn's enterocolitis in the terminal stage "...it is more than just care, it is human solicitude"]. PMID- 3635646 TI - [Social aspects of the AIDS problem. The best possibility lies in reality oriented actions]. PMID- 3635647 TI - [Parttime work for nursing personnel. Work within 48 hours. Interview by Nelly Haldi]. PMID- 3635648 TI - [Ambulatory chemotherapy by continuous infusion with a portable pump. Ample freedom of movement for the patient]. PMID- 3635649 TI - [Hospital hygiene. AIDS: preventing contamination in the hospital]. PMID- 3635650 TI - [A representative of the WHO in Bern: European nurses will have to change orientation]. PMID- 3635651 TI - [Research forum in nursing care: one year already]. PMID- 3635652 TI - [The elderly. Animation in medico-social facilities. 2. Everybody can cooperate]. PMID- 3635653 TI - [Flavonoids extracted from Ribes nigrum L. and Alchemilla vulgaris L.: 1. In vitro inhibitory activities on elastase, trypsin and chymotrypsin. 2. Angioprotective activities compared in vivo]. AB - In vitro experiments were conducted on the inhibitory properties of extracts from Ribes nigrum L. and Alchemilla vulgaris L. (fractions A1 + A2, A1, A2) on activity of the proteolytic enzymes elastase, trypsin and alpha-chymotrypsin. Extracts from Ribes Nigrum L. and Alchemilla Vulgaris L. (Fraction A1) inhibited 50% of the activity of porcine pancreas elastase at concentrations of 0.56 mg/ml and 0.16 mg/ml, respectively, against a synthetic substrate. Inhibition was less effective on activity of trypsin and alpha-chymotrypsin. Marked in vivo angioprotective properties were shown by the compounds studied, except Fraction A2 of Alchemilla vulgaris L. which had no significant activity. The results suggest a possible role by these inhibitors in the protection of conjunctive and elastic tissues adversely affected by proteolytic enzymes. An additional advantage is their lack of toxicity. PMID- 3635655 TI - L. D. 2061: a recap. PMID- 3635654 TI - Computer aided prediction and evaluation of the tertiary structure for rat elastase II. AB - Predictive methods have been extended to generate a proposed tertiary structure of rat elastase II on the basis of primary amino acid sequence and structural homologies within the family of mammalian serine proteinases. Force field refinement calculations were used to relax the structure. Structurally conserved molecules of solvation were introduced and the structure was again refined by means of force-field calculations. The resulting structure suggests probable substrate cleavage preferences. An independent statistical analysis of the crystallographically refined structures of serine proteinases (0.01-0.13 A, RMS) shows a close similarity to the final predicted model of rat pancreatic elastase II (0.03-0.14 A, RMS). PMID- 3635656 TI - The usefulness of Mahler's phases of the separation-individuation process in providing a theoretical framework for understanding relocation. PMID- 3635657 TI - Reflections on a miscarriage. PMID- 3635658 TI - Neonatal circumcision: a social and medical dilemma. PMID- 3635659 TI - Laypersons' beliefs about the "critical" nature of father-infant bonding: implications for childbirth educators. PMID- 3635660 TI - Effect of visitation upon siblings of hospitalized children. PMID- 3635661 TI - Amoxycillin-resistant streptococci in dental plaque. AB - This investigation was undertaken to study the prevalence of amoxycillin resistant oral streptococci in normal healthy patients and patients with a cardiac condition, susceptible to infective endocarditis. Samples of supragingival dental plaque were collected from two test groups, children with congenital heart disease and adults with a history of rheumatic fever, and two control groups comprising normal healthy children and normal healthy adults. Bacteria from these samples were grown on a medium selective for oral streptococci, as well as on the same medium containing known concentrations of amoxycillin. The results indicate that a high percentage of rheumatic heart patients and children with congenital heart disease harboured amoxycillin resistant oral streptococci. The level of amoxycillin resistance in the plaque of adults with rheumatic heart disease was significantly greater than in that of normal adults. In view of the high percentage of patients at risk harbouring amoxycillin-resistant streptococci, it is important that the individual clinical situation be monitored. Perhaps antibiotic sensitivity tests should be performed to select an appropriate antibiotic for prophylaxis of infective endocarditis. PMID- 3635662 TI - Renal disease and hypertension: the erythrocytosis factor. AB - For some unknown reason, the blood hematocrit will become elevated 50 percent or more in some cases of renal disease where hypertension is a factor. In the absence of other identifiable causes of erythrocytosis, this is believed to result from the formation of erythropoietin stimulating factor (ESF) by the kidney in response to some intrarenal hypoxic stimulus. In this study it could be demonstrated with the help of computer simulations, that the hypertension was caused by excess fluid being retained by the kidneys, whereas, the elevated hematocrit could only be attributed to primary increase in the resistance to blood flow. This suggests that the high hematocrit levels that have been reported probably could not have occurred, except for powerful excess vasoconstrictor activity affecting the whole circulation. PMID- 3635663 TI - Chromosome instability: a biological significance of in vitro hyperdiploidy in heritable single tumors. PMID- 3635664 TI - Is alpha-MSH deficiency the cause of Alzheimer's disease? AB - The hypothesis is that a functional deficiency of alpha-melanotropin (alpha-MSH) is the primary event in the development of Alzheimer's disease. Beginning with the concept that Alzheimer's disease occurs because of a deficiency of a neurotrophic factor specific for central cholinergic neurons data is then presented to support the hypothesis that alpha-MSH is the critical neurotrophic factor. PMID- 3635665 TI - Acupuncture and myofascial pain: treatment failure after administration of tricyclic antidepressants. AB - A 63-year old depressed woman with a 2-year history of chronic pain on the right side of her face in the area of the zygomatic arch and temporomandibular joint received acupuncture before and after the medical treatment of her depression. During her unmedicated state electroacupuncture provided pain relief, while after prolonged intake of doxepin the treatment no longer produced analgesia. The literature fails to provide a mechanism explaining the differential responses to acupuncture with regard to antidepressant medication. Suggestions on further endorphin related research are made with particular emphasis on gonadotropin activity. PMID- 3635666 TI - Theoretical mechanisms for synthesis of carcinogen-induced embryonic proteins: XV. Preliminary generalizations. AB - The term embryonic gene is discussed in which an operational definition is given, namely that it be restricted for those genes which are active during the embryonic state but repressed during differentiation. After generalizing a large variety of different types of carcinogenic agents and their action, which in principle are capable of activating embryonic genes, a preliminary notion of the carcinogenic process was derived. It appears that the bioalkylation pattern can be perturbed by a variety of agents from electromagnetic radiation to ethionine. Specific genes or their corresponding repressors such as an embryonic type phospho-protein kinase would become derepressed because of their methylation status (or by some other analogous alteration, e.g., via a specific mutation of a proto-oncogene that would create an embryonic type kinase, DNA intercalation by planar molecules, or, a hereditary process such as V-type position effect). This would cause competent stem type precursor cells containing easily derepressed or partially repressed arrays of embryonic genes to become activated, producing many features characteristic of a neoplastic cell. PMID- 3635668 TI - Developing instructional objectives for continuing education offerings. PMID- 3635667 TI - Accreditation, standards, and continuing education. PMID- 3635669 TI - [Home nursing by public health nurses and their records--reevaluation of one's own records]. PMID- 3635670 TI - [Responsibility of the nursing profession and the nursing records]. PMID- 3635672 TI - [Innovation and improvement of the format for nursing records--modification of the cardex system and the process of POS introduction]. PMID- 3635671 TI - [Conditions for better nursing records--a thought on reviewing records]. PMID- 3635673 TI - [Effective use of the cardex--use of the improved nursing standard]. PMID- 3635674 TI - [Variable nature of time--in-between time and fulfilling life]. PMID- 3635675 TI - [Notes on preparation of the standard nursing plan and the nursing record- improvement on so-called "alibi records"]. PMID- 3635676 TI - [Relationship among the patient, nurse, and nursing instructor during clinical training at a department of internal medicine where nursing students found the work difficult]. PMID- 3635677 TI - [On the "difficulty" felt by nursing students at clinical training]. PMID- 3635678 TI - Isobel Curry, OBE. Interview by Anna Alexander. PMID- 3635679 TI - Images of theatre nursing. PMID- 3635681 TI - Changing patterns in health benefits design. PMID- 3635680 TI - The AIDS epidemic: dilemmas facing nurse managers. PMID- 3635682 TI - Economic and marketing benefits of an air ambulance program. PMID- 3635683 TI - Industry and nursing research: a compatible couple? PMID- 3635684 TI - Guidelines for collaborative research with industry. PMID- 3635685 TI - Futurist approaches in nursing education. PMID- 3635686 TI - Marketing the clinical nurse specialist. PMID- 3635687 TI - Courting the consumer. PMID- 3635688 TI - Nurses' attitude toward nurse-patient interaction in the patient-teaching situation. PMID- 3635689 TI - Cost containment--whose job is it? PMID- 3635690 TI - MD vs. RN--the role of professional associations in improving working relationship. PMID- 3635691 TI - Standards of care Part 1--Definition. PMID- 3635692 TI - The RN consultant. PMID- 3635694 TI - Royal College of Nursing. Misguided notion. PMID- 3635693 TI - Caring for AIDS patients in a compassionate way. PMID- 3635695 TI - Dental care for elderly. PMID- 3635696 TI - Urgent call to look at training needs of nursing in secure settings. PMID- 3635697 TI - New preparation for practice. PMID- 3635699 TI - Education is catalyst for the profession. PMID- 3635698 TI - Royal College of Nursing. Clearing a path. PMID- 3635700 TI - Time for action. PMID- 3635701 TI - AIDS--challenge nurses cannot fail to meet. PMID- 3635702 TI - Immunisation for all children. PMID- 3635703 TI - Royal College of Nursing. Food for thought; facing reality. PMID- 3635704 TI - Career challenges. PMID- 3635705 TI - Hospital units would widen options open for rape victims. PMID- 3635706 TI - Royal College of Nursing. Recognition. PMID- 3635707 TI - Putting care of the elderly into perspective. PMID- 3635708 TI - Why RRB is both dull and electrifying. PMID- 3635709 TI - Nursing diagnosis. PMID- 3635710 TI - Let's not confuse the issues. PMID- 3635711 TI - RN to BSN: fitting the pieces together. PMID- 3635712 TI - What's happening to insurance? PMID- 3635713 TI - Elastase-type activity in human radial artery in patients with chronic renal failure. AB - To elucidate the nature of the abnormality of elastin metabolism in arteriosclerosis, we determined the elastase-type activity in the human radial artery of patients with chronic renal failure due to glomerular disease and diabetes. Elastase-type activity was determined by HPLC analysis of the hydrolyzed products of succinyl-trialanine-4-nitroanilide, a sensitive synthetic substrate for elastase. Three kinds of hydrolyzed products, (L-Ala)2-NA, L-Ala-NA and NA, were found after incubation of the substrate with human radial artery in the presence of amastatin (an inhibitor of aminopeptidases). We assumed the activity that liberates NA to be an elastase-type activity because purified human aorta elastase liberates NA from the substrate. The pH optima of the human artery and rat aorta activities were 6.0 and 6.8, respectively. The elastase activity in human radial artery and rat aorta was inhibited by diisopropyl phosphofluoridate, a serine protease inhibitor, and by elastatinal, an elastase inhibitor. The elastase-type activity in the radial artery of patients with chronic renal failure was significantly lower than that of the control group, and the decrease was especially marked in the patients with juvenile onset diabetes. These results suggest that the elastin metabolism is abnormal in the radial artery in diseases that tend to cause atherosclerosis. PMID- 3635714 TI - Budget crunch threatens nursing's place in the Federal ledger. PMID- 3635715 TI - On redefining the baccalaureate degree. PMID- 3635716 TI - Defining the product of baccalaureate education. PMID- 3635717 TI - What employers will expect from tomorrow's nurses. PMID- 3635718 TI - Harnassing today's trends to guide nursing's future. PMID- 3635719 TI - Students as research subjects. PMID- 3635720 TI - Reentry women: nursing's challenge. PMID- 3635721 TI - The nursing student was a doctor: a second-degree student's experience. PMID- 3635722 TI - Developmental crises: helping students grow. PMID- 3635723 TI - Effective teaching: a problem-solving paradigm. PMID- 3635724 TI - Personnel issues in academic nurse-managed centers: the pitfalls and the potential. PMID- 3635725 TI - Clinical focus: bridging theory and practice. PMID- 3635726 TI - Test-taking workshops for nursing students. PMID- 3635728 TI - When your ability to give gives out, remind yourself you're not an angel you're a nurse. PMID- 3635727 TI - Coaching the question. PMID- 3635729 TI - Time to say good-bye. PMID- 3635730 TI - Taking the P.V.D. patient's history. PMID- 3635731 TI - Laryngospasm. PMID- 3635733 TI - You can stand up for your principles--and your job. Lessons from the law. PMID- 3635732 TI - Track down the what, where, when, and how of chest pain (continuing education credit). PMID- 3635734 TI - Caring for the patient who makes caring difficult. PMID- 3635735 TI - APTT and PT--the tests of time. PMID- 3635737 TI - Small hopes--care of the patient with head trauma. Nursing grand rounds. PMID- 3635736 TI - Get smart: a proposed response to the impact of PPSs. PMID- 3635738 TI - Make nursing diagnoses work for you ... every day. PMID- 3635739 TI - How to handle postanesthetic hypertension. PMID- 3635741 TI - Coping with complications of diabetes. PMID- 3635740 TI - Embolex: to prevent a double postop danger. PMID- 3635742 TI - Check concentrations of medications ordered for children. PMID- 3635743 TI - Remember the well one, too. PMID- 3635745 TI - Lightning injury. PMID- 3635746 TI - Understanding the final message of the dying. PMID- 3635747 TI - The unseen bridge. PMID- 3635748 TI - Dress codes: fashion statements that insult nursing. PMID- 3635750 TI - What you should know about informed consent. PMID- 3635749 TI - Lessons learned outside the classroom. PMID- 3635751 TI - New drugs. PMID- 3635752 TI - Professional growth: 9 ways to make better decisions. PMID- 3635753 TI - A blade of grass. PMID- 3635754 TI - Education for parenthood. PMID- 3635755 TI - Social and psychological aspects of pregnancy. PMID- 3635756 TI - Normal pregnancy. PMID- 3635757 TI - High risk and complicated pregnancy. PMID- 3635758 TI - Diary of a pregnant woman. PMID- 3635759 TI - Alternative medicine--an introduction. PMID- 3635760 TI - Memories of India. PMID- 3635761 TI - Who's pulling the punches? PMID- 3635762 TI - Paediatric nursing. PMID- 3635763 TI - Urinary tract infection. PMID- 3635765 TI - Sterilization. PMID- 3635764 TI - Disinfection in hospitals. PMID- 3635766 TI - Patient comfort. Additions to the bed. PMID- 3635767 TI - Systems of health care in India. PMID- 3635769 TI - Psychological and physiological effects of isolation. PMID- 3635768 TI - Infection control: an integral part of the nursing process. PMID- 3635770 TI - The surgical wound. PMID- 3635771 TI - Intravenous therapy: peripheral/central lines. PMID- 3635772 TI - Spread of infection: airborne route. PMID- 3635773 TI - Respiratory tuberculosis. PMID- 3635774 TI - Spread of infection: direct contact. PMID- 3635775 TI - Care study: MRSA (multiple-resistant Staphylococcus aureus)--contact spread of infection. PMID- 3635776 TI - Spread of infection: faecal oral route. PMID- 3635777 TI - Care study--Clostridium difficile: enteric spread of infection. PMID- 3635778 TI - Spread of infection via blood. PMID- 3635779 TI - Care study--HTLV III: spread of infection via blood. PMID- 3635780 TI - A guide to immunization. PMID- 3635781 TI - The physiology of wound healing. PMID- 3635783 TI - Post-operative wound infections. PMID- 3635782 TI - Nutrition in wound healing. PMID- 3635784 TI - Burns. PMID- 3635785 TI - Cosmetic camouflage. PMID- 3635786 TI - [Thousands of children to protect]. PMID- 3635787 TI - [Who are you when facing an abused child?]. PMID- 3635788 TI - [Failure of the suicide process]. PMID- 3635789 TI - [The Tuesday clinics and nursing care at the Sherbrooke University Hospital Center. The marriage of care and sciences]. PMID- 3635790 TI - [Collegiate nursing education. 4th year of experimentation with a new program]. PMID- 3635791 TI - [Report of the survey by the Quebec Association of Psychiatric Nurses. Psychiatry is in bad shape]. PMID- 3635792 TI - [The O.I.I.Q. in the domain of mental health and psychiatric services. A permanent commitment]. PMID- 3635794 TI - [Home maintenance: what do you know about the role assumed by family aides in the nursing care team?]. PMID- 3635793 TI - [Burnout among psychiatric nurses]. PMID- 3635795 TI - [The patient with a stoma facing his new body image]. PMID- 3635796 TI - [The health record of the client. Yes, to access without restrictions]. PMID- 3635797 TI - [Education and transformation in psychiatric nursing]. PMID- 3635798 TI - [Nursing Quebec: more than 120,000 regular readers]. PMID- 3635799 TI - [Striking out is sometimes a matter of health]. PMID- 3635801 TI - [From now until the end of 1986 fluoridation everywhere in Quebec]. PMID- 3635800 TI - [The trench of a contradiction?]. PMID- 3635802 TI - [Insurance--professional responsibility. Beyond the crisis, the nursing records]. PMID- 3635804 TI - Health education: identifying priorities. PMID- 3635803 TI - [Standards and criteria of competence in community health--a step toward the future]. PMID- 3635805 TI - Reducing the incidence of eye injuries. PMID- 3635806 TI - Nursing care of the eye. PMID- 3635807 TI - Can VDUs affect your vision? PMID- 3635808 TI - Eye injuries from industrial chemicals. PMID- 3635809 TI - Administrative support for unit managers in psychiatric primary nursing settings. PMID- 3635810 TI - A nursing information system using nursing diagnosis. PMID- 3635811 TI - [Nursing students should start their professional education at a later age]. PMID- 3635812 TI - [Health in Austria "resident-oriented care"]. PMID- 3635813 TI - [Nursing care in traction treatment]. PMID- 3635814 TI - [Positioning of a child with multiple injuries with reference to physiotherapeutic goals]. PMID- 3635815 TI - [Incontinence: suffering which affects about 260,000 Austrians]. PMID- 3635816 TI - [Increase in adolescent smokers alarming]. PMID- 3635817 TI - Nursing in the Emerald Isle. PMID- 3635818 TI - I work in a state mental hospital. PMID- 3635819 TI - Psycho-mental health nursing in the private sector. PMID- 3635820 TI - Family therapy. PMID- 3635821 TI - May is high blood pressure month: treat yourself for life. PMID- 3635822 TI - Helping parents select day-care centers. PMID- 3635823 TI - Selecting a caliper for measuring triceps skinfold thickness. PMID- 3635824 TI - Siblings of chronically ill children: helping them cope. PMID- 3635825 TI - Health concepts of preschool children. PMID- 3635826 TI - Self-destructive behavior in school-age children: a hidden problem? PMID- 3635828 TI - Rett syndrome: what do we know about it? PMID- 3635827 TI - Reflections on direct reimbursement for nurses. PMID- 3635829 TI - Adoption as a positive option. PMID- 3635830 TI - NAPNAP report: curriculum development project in preventive medicine. PMID- 3635831 TI - Pediatric management problems (quadriplegia). PMID- 3635832 TI - Using insect repellents effectively. PMID- 3635833 TI - Avoiding spontaneous extubation of nasotracheal or oral tracheal tubes. PMID- 3635834 TI - Nursing intervention studies: the tale of the elephant and the ant. PMID- 3635835 TI - Nursing contracts: essential elements. PMID- 3635836 TI - Pediatric home tracheostomy care alternatives. PMID- 3635838 TI - Gerontology in the professional nursing curriculum. PMID- 3635837 TI - NAPNAP: 1985 membership attitude survey. PMID- 3635839 TI - Gerontological nursing: a critical element in professional nursing curricula. PMID- 3635840 TI - Gerontological content for basic professional nursing preparation. PMID- 3635841 TI - Curriculum models for gerontological nursing. PMID- 3635842 TI - Techniques for teaching gerontological nursing. PMID- 3635843 TI - Key concepts in public policy. PMID- 3635844 TI - A potential primer for reverse transcription of mdg3, a Drosophila copia-like element, is a leucine tRNA lacking its 3' terminal 5 bases. PMID- 3635845 TI - Teaching nurses. 1. Are you fit to teach? PMID- 3635846 TI - How to pass the screen test. PMID- 3635848 TI - Bad old days. PMID- 3635847 TI - General managers: there's no place like it. PMID- 3635849 TI - Radiotherapy. What do patients need to know? PMID- 3635850 TI - Radiotherapy. Planning nutritional support. PMID- 3635851 TI - Korner in the community. PMID- 3635852 TI - In sickness, health--and in between. PMID- 3635853 TI - A life of rejection. PMID- 3635854 TI - Systems of life. No 136. Senior systems. 1. Ageing. PMID- 3635855 TI - Coping with pain: strategies for relief. PMID- 3635856 TI - Pressure sores: a policy for prevention. PMID- 3635857 TI - What is distance learning? PMID- 3635858 TI - Focus on urinalysis. Part 1. PMID- 3635859 TI - Noises off. PMID- 3635860 TI - RCN finances: the price of success. PMID- 3635861 TI - Holism: going all the way. PMID- 3635862 TI - Retirement: late departure. PMID- 3635863 TI - A word in your ear. PMID- 3635864 TI - Planning for terminal care. PMID- 3635865 TI - Management. Counting the sick notes. PMID- 3635866 TI - Acute gastroenteritis in infants. PMID- 3635867 TI - Nutritional needs of medical patients. PMID- 3635868 TI - Picking up the pieces. PMID- 3635869 TI - Aiding recovery from a stroke. PMID- 3635870 TI - Ploughing back the profits. PMID- 3635871 TI - Pregnancy: inside story. PMID- 3635872 TI - Nursing in Lebanon: caught in the crossfire. PMID- 3635873 TI - Radiotherapy: expectations of recovery. PMID- 3635875 TI - How the College changed its image. The selling of the RCN. PMID- 3635874 TI - Using the census. PMID- 3635876 TI - RCN supplement. The college goes commercial. PMID- 3635877 TI - RCN supplement. Front runner. Interview by Caroline Howie. PMID- 3635878 TI - RCN supplement. Blackpool's open door. PMID- 3635879 TI - RCN supplement. Cumberlege: the primary issue. PMID- 3635880 TI - When children cry alone. PMID- 3635881 TI - Cumberlege report: the radical solution ... or the safe option? PMID- 3635882 TI - Primary health review: the radical solution ... or the safe option? PMID- 3635883 TI - Digging for victory. PMID- 3635884 TI - Back to nursing. Regaining the knowledge. PMID- 3635885 TI - Back to nursing. A quick reminder. PMID- 3635886 TI - Back to nursing. Starting all over again. PMID- 3635887 TI - Impaling injury. PMID- 3635888 TI - The mobile accident team: when the music stopped. PMID- 3635889 TI - Making progress with Makaton. PMID- 3635890 TI - Creative therapy: every picture tells a story. PMID- 3635891 TI - Fare's fair? PMID- 3635892 TI - Radiotherapy: after the treatment's over. PMID- 3635893 TI - Nursing practice. Probing the practice. PMID- 3635894 TI - Nursing practice. Why there are no accidents in Thika. PMID- 3635895 TI - Nursing practice. Taking time to talk. PMID- 3635897 TI - Husband and wife team. Interview by Laurence Dopson. PMID- 3635896 TI - Nursing practice. Monitoring blood glucose levels. PMID- 3635898 TI - Hospitals and institutions in Himachal Pradesh. PMID- 3635899 TI - Nurses as a social force. PMID- 3635900 TI - Attention and treatment in ocular emergencies. PMID- 3635901 TI - Understanding aggressive behaviour: role of a nurse. PMID- 3635902 TI - Rheumatology: a challenging speciality for nurses. PMID- 3635903 TI - Quality nursing care: myth or reality? PMID- 3635904 TI - [Criteria of the activity of nonspecific endobronchitis in patients with pulmonary tuberculosis treated surgically]. PMID- 3635905 TI - Trends in ambulatory surgery: office based surgery. PMID- 3635907 TI - A trip to China. PMID- 3635906 TI - New techniques in head and neck reconstruction--new nursing challenges. PMID- 3635908 TI - Characteristics and functional outcomes of elderly rehabilitation patients. PMID- 3635910 TI - Nursing education dilemma. PMID- 3635909 TI - Hemophilia: the person, family, and nurse. PMID- 3635911 TI - Appraising the need for altered sexuality information. PMID- 3635912 TI - The adolescent with cancer. Compliance with treatment regimens. PMID- 3635913 TI - Treatment refusal in adolescents. PMID- 3635914 TI - Helping adolescents with cancer cope with their disease. PMID- 3635915 TI - Educational needs of the adolescent with cancer and his family. PMID- 3635916 TI - Late effects in adolescent survivors of childhood cancer. PMID- 3635917 TI - Helping adolescents whose parents have cancer. PMID- 3635918 TI - Future perspectives in adolescent oncology. PMID- 3635919 TI - The adolescent with cancer. Introduction. PMID- 3635920 TI - Growing up differently: and adolescent's perspectives. PMID- 3635921 TI - Adolescent oncology unit: an attempt at normalcy. PMID- 3635922 TI - Care of the adolescent cancer patient on an adult medical oncology unit. PMID- 3635923 TI - Exercise prescription for cardiac patients. Reasons for concern. PMID- 3635925 TI - [Intensive medicine. Calculating the nursing staff]. PMID- 3635926 TI - [Case of the patient subjected to ionizing radiation]. PMID- 3635924 TI - Anterior shoulder dislocations in sports. AB - Anterior shoulder dislocations, primary and recurrent, are among the most disabling injuries to the shoulder that can plague the athlete. The diagnosis is easily made by the following: the physical appearance of the shoulder; loss of capability by the athlete to internally and externally rotate the shoulder with the elbow at his side; by evaluating the mechanism of injury; and x-rays. Anterior shoulder dislocations should be reduced as soon as possible after diagnosis, to minimise the stretching effect on the neurovascular structures while the humeral head is dislocated. The reduction is not done to allow the athlete to return immediately to sport. Use of a simple traction method in the first 10 to 15 minutes following the injury will result in a successful reduction in the vast majority of dislocations. Reduction of the humeral head can be confirmed by the athlete regaining the capability to internally and externally rotate his shoulder with his elbow at his side. Following reduction, the athlete should begin a treatment regimen which includes a restrengthening programme emphasising the muscles of internal rotation and adduction plus rigid restrictions of activities until the goals of the rehabilitation programme are satisfied. The author's experience with this treatment regimen with athletes at the United States Naval Academy, has shown a decrease of the recurrence rate of primary anterior shoulder dislocations to 25% versus the 80% recurrence rate we have become familiar with from studies done which did not stress specific rehabilitation programmes. The athlete should also be instructed in a self performed traction method for reduction should a redislocation occur, to minimise the stretching effect on the neurovascular structures and allow relief from discomfort. Surgery for primary and recurrent anterior dislocations should only be considered when the athlete fails to achieve the desired goals after participating in a specific, progressive, adequate rehabilitation programme. PMID- 3635927 TI - [Nutrition and cancer]. PMID- 3635928 TI - [Women and health]. PMID- 3635929 TI - [Analysis of the problems in the nurse-patient relationship in the ICU]. PMID- 3635930 TI - [Family planning within primary health care]. PMID- 3635931 TI - [The arterial catheter]. PMID- 3635932 TI - [Continuing education. 4. Subject: emergency nursing. Topic: the nurse facing acute pulmonary edema of cardiac origin]. PMID- 3635933 TI - How to keep your poise under pressure. PMID- 3635934 TI - Do we have too much power over our patients? PMID- 3635935 TI - A fresh start for Tommy--and for me. PMID- 3635936 TI - Why didn't somebody think of this sooner! PMID- 3635937 TI - Job security: will things get any worse? PMID- 3635938 TI - Safe needle disposal: a timely reminder. PMID- 3635939 TI - Helping your patient through eye surgery. PMID- 3635940 TI - Eyedrops: more side effects than meet the eye. PMID- 3635942 TI - If you want to stop treating a patient. PMID- 3635941 TI - Stroke: what to say about sex. PMID- 3635943 TI - Are nurses professionals or patsies? PMID- 3635944 TI - When your patient is eating for two. PMID- 3635945 TI - What's happening to diploma education? PMID- 3635946 TI - Wife assault. PMID- 3635947 TI - [Release of granulocytic elastase and plasma protein changes in traumatic hemorrhagic shock]. PMID- 3635948 TI - [Hospital-connected home care--alternative for seriously ill patients]. PMID- 3635949 TI - [Relatives cooperate in care of cancer patients]. PMID- 3635950 TI - [Handling of cytostatic agents--how can we protect ourselves?]. PMID- 3635951 TI - [New method of handling cytostatic agents]. PMID- 3635952 TI - [Care during cytostatic treatment]. PMID- 3635954 TI - [2 geriatric hospitals in London]. PMID- 3635953 TI - [Problems with care for aged chronic patients at home]. PMID- 3635956 TI - [Pain groups as a resource in oncology]. PMID- 3635955 TI - [To have cancer and get cytostatics]. PMID- 3635957 TI - [Tofranil]. PMID- 3635958 TI - [Levels of education in psychophysical technics]. PMID- 3635959 TI - [Voice, word and body or psychoanalysis and psychophysical therapy]. PMID- 3635960 TI - [The new psychophysical therapies]. PMID- 3635961 TI - [Emotions as intermediary behavior]. PMID- 3635962 TI - [Observations on education in psychophysical therapies]. PMID- 3635964 TI - [Professional attitude of the psychiatric nurse. Demarcation from the analysis of the limits in the nurse-patient relations]. PMID- 3635963 TI - [Listening which helps the anxious patient]. PMID- 3635965 TI - [Observations on schizophrenia]. PMID- 3635966 TI - [Project of nursing education]. PMID- 3635967 TI - [With or without words, the body speaks. Learning to feel it, see it, live it]. PMID- 3635968 TI - [Fever and intercurrent diseases in the cardiac patient]. PMID- 3635969 TI - [Fever following cardiac surgery]. PMID- 3635970 TI - [Fever and cardiovascular disorders. The role of the nurse]. PMID- 3635971 TI - [Patient hospitalized for infectious endocarditis. Case report]. PMID- 3635972 TI - [Fever and cardiovascular diseases]. PMID- 3635973 TI - State nursing legislation. PMID- 3635975 TI - [The diabetic child and his nutrition]. PMID- 3635976 TI - [Education of the diabetic patient]. PMID- 3635974 TI - [Adepal]. PMID- 3635977 TI - [2 observations of diabetic children]. PMID- 3635978 TI - [Recall of indispensable elements in obstetrics]. PMID- 3635979 TI - [Breech presentation in childbirth]. PMID- 3635980 TI - [Childbirth in twin pregnancy]. PMID- 3635981 TI - [Presentation of the face]. PMID- 3635983 TI - [Difficult crown presentations]. PMID- 3635982 TI - [Presentation of the front]. PMID- 3635984 TI - [Admission of a newborn infant at the end of a "difficult childbirth". Role of the midwife]. PMID- 3635985 TI - [Use of the insulin pump in diabetic children]. PMID- 3635986 TI - [Wide support and much sympathy]. PMID- 3635987 TI - [Norwegian Nurses' Association's need for adjustment negotiations--full support in counter-legal procedures against government]. PMID- 3635988 TI - [NIS (Norwegian Institute for Hospital Research) is 15 years old: great challenges are waiting]. PMID- 3635989 TI - [Sheltered unit in Nordland's nursing home: small changes--big effects]. PMID- 3635990 TI - [Organization of ward plans: which nursing model works best?]. PMID- 3635991 TI - [This century's catastrophe? (4). No isolation of AIDS patients in the hospital]. PMID- 3635992 TI - [Newly graduated nurses--how will they work and where will they work?]. PMID- 3635994 TI - [From day to day: government provokes a week-long strike]. PMID- 3635993 TI - [Government inspection of health services--distant control or stimulation toward cooperation?]. PMID- 3635995 TI - [Traveling exhibit in Hedmark: health station with a campaign against children's accidents]. PMID- 3635997 TI - [Current methods and procedures for the isolation of a patient with an infectious disease]. PMID- 3635996 TI - [Visiting oncology nurses: greater continuity with cancer nursing at home]. PMID- 3635998 TI - [A treatment trial: combination of physical training and group psychotherapy]. PMID- 3635999 TI - [Common goal for nursing services--new forms of team work in Aker Hospital. Interview by Bjorn Arild Ostby]. PMID- 3636000 TI - [Nurses' salary conditions--escape from the nursing profession?]. PMID- 3636001 TI - [Patients and information: important for treatment or democratic right?]. PMID- 3636002 TI - [Questionnaire study among relatives: how satisfied are the elderly in the nursing home?]. PMID- 3636003 TI - [Nursing and care of victims of incest]. PMID- 3636004 TI - [This century's catastrophe? (5). Fear of meeting AIDS patients]. PMID- 3636006 TI - [Basic education and educational capacity]. PMID- 3636005 TI - [General meeting of midwives--professional resources should be mobilized]. PMID- 3636007 TI - [Fooling around with numbers: functional analysis of Norwegian Society of Nursing Assistants]. PMID- 3636008 TI - [Swedish comments: the Swedish educational system]. PMID- 3636010 TI - [Children and cancer: "Tumor is a lump with angry cells"]. PMID- 3636009 TI - [Norwegian Nurses' Association's answer: no downgrading of Swedish nurses]. PMID- 3636011 TI - [Aggression in health care]. PMID- 3636012 TI - [What is aggression: social psychology theories and viewpoints]. PMID- 3636013 TI - [Aggression in the general hospital]. PMID- 3636014 TI - [Nurses on aggression]. PMID- 3636015 TI - [Beating or stroking: on the use of aggression in psychotherapy]. PMID- 3636016 TI - [The severely behavior-disordered and/or aggressive patient]. PMID- 3636017 TI - [When does therapy become abuse?]. PMID- 3636018 TI - [Accountable and competent. Accountability and liability of nurses according to Dutch justice]. PMID- 3636019 TI - [Inspector and advisor. Interview with Mrs. C.J.M. Nieland by Han Kock and Jan Roessink]. PMID- 3636020 TI - [Carrying hands: physical contact with children elucidated from the viewpoint of haptonomy]. PMID- 3636021 TI - [Tuning of the nursing care between district and hospital]. PMID- 3636022 TI - Managing an operating room schedule. PMID- 3636023 TI - Preparation of the skin for surgery. PMID- 3636024 TI - PMS: how does it affect the OR nurse? PMID- 3636025 TI - The living will: its execution and application. PMID- 3636026 TI - The role of the OR nurse in reconstructive/plastic surgery. PMID- 3636028 TI - Sports-related injuries. PMID- 3636027 TI - Introduction to the law--products liability (Part 2). PMID- 3636029 TI - Caring. PMID- 3636030 TI - Care facilitation and resistance factors in the culture of nursing. PMID- 3636031 TI - Caring for low birth weight infants beyond the intensive care nursery: developing public policy. PMID- 3636032 TI - Noncaring and caring in the clinical setting; patients' descriptions. PMID- 3636033 TI - Caring in the instance of unexpected early pregnancy loss. PMID- 3636034 TI - Pastoral care in the hospital: uniqueness and contribution. PMID- 3636035 TI - The experience of care: patient perspectives. PMID- 3636036 TI - Cancer patients' and families' perceptions of nurse caring behaviors. PMID- 3636037 TI - A caring concept: providing information to make decisions. PMID- 3636038 TI - Evaluating caring competencies in nursing practice. PMID- 3636039 TI - The caring concept and nurse identified caring behaviors. PMID- 3636041 TI - [Proposal to do away with education for psychiatric nursing. "This can have disastrous results for patients"]. PMID- 3636040 TI - Evidence for environmental familiality of kallikrein excretion in Utah kindreds. AB - In investigating the role of urinary kallikrein in the pathophysiology of hypertension, we measured 12-hour kallikrein excretion in 1,100 persons in 68 Utah kindreds. The kallikrein excretion was statistically adjusted to account for variations in body size and urine output. Adjusted kallikrein excretion was greater in youths than in adults and correlated with potassium excretion and sodium excretion in persons with normal blood pressure. It was decreased in normotensive subjects with strong family histories of stroke and hypertension, but was not significantly different in adults with hypertension. Adjusted kallikrein excretion was correlated between pairs of siblings, parent-offspring pairs and spouses. Our results indicate that kallikrein excretion is a familial variable, with the familiality due more to shared environmental than genetic factors. PMID- 3636042 TI - [Preservation of professional competence and identity]. PMID- 3636043 TI - [How will health care look in about 25 years? We take a look at the year 2010]. PMID- 3636044 TI - [Among refugees in Trelleborg: a nurse's job with a difference]. PMID- 3636045 TI - [Licensure question nearing a solution]. PMID- 3636046 TI - [Lab assistants from all over the world in Sweden]. PMID- 3636047 TI - [Relations between caregivers and patients must improve. Interview by Jan Thomasson]. PMID- 3636048 TI - [Nurses trained as "surgeons"]. PMID- 3636049 TI - [Now we are really tired!]. PMID- 3636050 TI - [Are hospitals dangerous? 7 nurses had malformed children]. PMID- 3636051 TI - [Dialysis accident and Vardfacket]. PMID- 3636052 TI - [Professional honor or battle for prestige--answer to Ake Oberg and Ulf Bostrom]. PMID- 3636053 TI - [Anna-Karin, nurse in the service of the UN--she works for 6th time in a developing country. Interview by Mikael Dolfe]. PMID- 3636054 TI - Implementation of an automated student information system Foothills Hospital- School of Nursing. PMID- 3636056 TI - Quality assurance in nursing: an interpretation definitions, beliefs, assumptions. PMID- 3636055 TI - Nursing and primary health care. PMID- 3636057 TI - A case for single subject research in nursing. PMID- 3636058 TI - Nursing: a rewarding career for men? PMID- 3636059 TI - "To be--or not to be"--a unit supervisor in the operating room. PMID- 3636060 TI - Efficacy of single-agent therapy with azlocillin, ticarcillin, and amikacin and beta-lactam/amikacin combinations for treatment of Pseudomonas aeruginosa bacteremia in granulocytopenic rats. AB - The efficacy of azlocillin, ticarcillin, and amikacin as single agents and the penicillin/amikacin combinations for treatment of Pseudomonas aeruginosa bacteremia during cyclophosphamide-induced severe neutropenia in a rat model were assessed. Equivalent antibiotic dosing was based on the time rat serum antibiotic levels were above the minimal bactericidal concentration for the challenge organism. Antibiotic therapy was administered for 62 hours after bacterial challenge. Antimicrobial efficacy was based on the rate of bacteremia, the emergence of resistant organisms during therapy, life-table survival analysis, and rat survival seventy-two hours after bacterial challenge. For infection with a P. aeruginosa strain susceptible to all study antibiotics, therapy with azlocillin and ticarcillin (given so as to be equipotent) were equivalent, as judged by bacteremia rates or rat survival. However, combination therapy prevented the emergence of organisms resistant to azlocillin, but not to ticarcillin. Amikacin-containing combinations were more effective than single agent regimens. PMID- 3636061 TI - The hazards of magnetic resonance imaging. PMID- 3636062 TI - Reporting child abuse. PMID- 3636063 TI - Navigating neuroleptic malignant syndrome. PMID- 3636064 TI - Working smart. PMID- 3636065 TI - Spotlight on support for impaired nurses. PMID- 3636066 TI - Rhode Island's contract for employee assistance. PMID- 3636067 TI - Distinguishing dementias. PMID- 3636068 TI - Diagnostics. The struggle to classify our diagnoses. PMID- 3636069 TI - An empty promise. PMID- 3636070 TI - Decision by committee. PMID- 3636071 TI - When lightning strikes. PMID- 3636072 TI - Kangaroo care for premature infants. PMID- 3636073 TI - Giardia lamblia--day care diarrhea. PMID- 3636074 TI - Torsade de pointes--malignant arrhythmia. PMID- 3636075 TI - Giving intrathecal drugs. PMID- 3636076 TI - Starting from scratch. PMID- 3636078 TI - RN shortage suddenly surfaces in many states; hospitals scramble to hire critical care nurses. PMID- 3636077 TI - Games nurses play. Part 1. Merry-go-round and catch. PMID- 3636079 TI - With liberty and nursing for all. PMID- 3636080 TI - Community-based nursing services: innovative models. PMID- 3636081 TI - Students aid Cambodian refugees. PMID- 3636082 TI - Downtown Hotel clinical rotation. PMID- 3636083 TI - Atlanta's homeless find health care. PMID- 3636085 TI - Discontinue care? Nurses say no. PMID- 3636086 TI - Nurse promote health in Appalachia. PMID- 3636084 TI - Marketing skin cancer prevention to farmers. PMID- 3636087 TI - Prevention of prematurity. PMID- 3636088 TI - An aid to assess parents' learning interests. PMID- 3636089 TI - Community collaboration: a model for success. PMID- 3636090 TI - Wellness clinic serves neighborhood. PMID- 3636091 TI - Alternative sites for service, education, and research. PMID- 3636092 TI - Adolescents relate health risks to heart disease. PMID- 3636093 TI - Health promotion in the school. PMID- 3636094 TI - Idaho network supports families. PMID- 3636095 TI - Center benefits students, faculty, clients. PMID- 3636096 TI - Alliance provides hospice care at home. PMID- 3636097 TI - Programs serves the elderly living alone. PMID- 3636098 TI - Proposals bring major issues to House. PMID- 3636099 TI - NLRB says two all-RN units are not appropriate. PMID- 3636100 TI - Implementation project creates process for change. Interview by Patricia McCarty. PMID- 3636101 TI - ANA minority interns learn about legislative arena. PMID- 3636103 TI - Public policy meeting draws 200 RNs. PMID- 3636102 TI - U.S., Chinese nurses share, compare at China meeting. PMID- 3636104 TI - Cole reflects on four years of achievements and change. Interview by Terry L. Selby. PMID- 3636105 TI - Report to delegates will address crisis in liability insurance. PMID- 3636107 TI - As I see it... All-RN unit best represents nurses, benefits patients. PMID- 3636106 TI - ANA marks 40 years of action for equity, security. PMID- 3636108 TI - Nurses House offers assistance to nurses in need. PMID- 3636109 TI - Comparative in vitro susceptibilities of eight Enterobacter species, with special reference to Enterobacter sakazakii. AB - An agar dilution method was used to measure the MICs of 29 antimicrobial agents against Enterobacter sakazakii, E. cloacae, E. aerogenes, E. agglomerans, E. amnigenus, E. gergoviae, E. intermedium, and E. taylorae (formerly Enteric Group 19). E. sakazakii was the most susceptible species. Results showing resistance to ampicillin are likely to exclude E. sakazakii. PMID- 3636110 TI - Mentoring experiences: much can be gained if we are aware of their potential. PMID- 3636111 TI - One nurse's goal can become ours if we lend support. PMID- 3636112 TI - Laser recommended practices clarified. PMID- 3636113 TI - Natural disaster. Personal preparedness. PMID- 3636114 TI - Disaster nursing. Preparedness in the OR. PMID- 3636115 TI - Operating room design. Accommodating lasers. PMID- 3636116 TI - Flash sterilization. Evaluating biological indicators. PMID- 3636117 TI - Identifying discharge concerns. A study. AB - This study demonstrated that patients who underwent a cholecystectomy or herniorrhaphy were able to identify concerns about discharge before going home. Knowing patients' discharge concerns may help the nurse plan their discharge education which in turn might help them cope with postoperative problems at home. Because a nonprobability small sample was used, the application of this study is limited; nevertheless, there is a great need to explore patients' discharge concerns. With the increased incidence of ambulatory surgery, there is limited time for discharge planning, making it even more critical to research patients' perceptions of discharge. PMID- 3636118 TI - Cost accountability in the OR. A case for custom-designed, procedure-ready packs. PMID- 3636119 TI - Skill acquisition. Students in the OR. PMID- 3636120 TI - RN staffing, accreditation problems highlight ambulatory surgery meeting. PMID- 3636121 TI - Biocompatibility: bioengineering aspects. AB - Bioengineers have contributed to biocompatibility research. Many materials have been designed, synthesized, and characterized by use of various analytical instruments. The blood compatibility of materials has been studied by focusing on the blood-material interfacial reactions. Although much information has been accumulated regarding such local reactions, understanding of biocompatibility is still limited. A more global approach to study is needed. A new approach to understanding biocompatibility is proposed and discussed. Three points are stressed: interaction within body's defense system and its effect on blood material reactions; induction of a systemic reaction by a local reaction, which then affects the blood-material interaction; the time sequence of such interactions between local and systemic reactions. To establish a logical approach to study biocompatibility is most important at this moment for the future progress in biocompatibility research. PMID- 3636123 TI - Planning clinical objectives for nursing students. PMID- 3636122 TI - Influence of sex and age on kallikrein excretion in stimulated human parotid saliva. AB - We determined the activity of parotid salivary kallikrein in 65 healthy males and females. We then formed two groups of probands by age. The mean age in the first group (n = 35) was 24.5 +/- 1.7 years, whereas the mean age in the second group (n = 30) was 58.1 +/- 10.5 years. The activity of the glandular kallikrein was measured with a chromogenic substrate. The salivary kallikrein excretion in the younger females was higher when compared with that in the younger males. No sex differences concerning salivary kallikrein activity could be observed in the second group. A possible influence of female sex hormone on salivary kallikrein excretion is discussed. PMID- 3636125 TI - Midwifery care in remote areas. PMID- 3636124 TI - Nursing Trivia: a game for fun and learning. PMID- 3636126 TI - Product comparison: absorbent draw-sheets. PMID- 3636127 TI - Nurse & the law. Valuable hints about valuables. PMID- 3636128 TI - Treatment of gout. PMID- 3636129 TI - The role of N-6-isopentenyl adenine in tumor cell growth. AB - When cell extracts from Ehrlich ascites tumor cells were assayed for isopentenyl adenine content and correlation with cell growth stage by radioimmunoassay, concentrations of low statistical significance were obtained. High performance liquid chromatographic analysis of cell extracts showed undetectable levels of isopentenyl adenine or 8-hydroxy-isopentenyl adenine, a known metabolite. Thus these substances do not seem to be required for cell division in Ehrlich ascites tumor cells. PMID- 3636130 TI - Hazard communication. Workers' right to know--nurses' need to know. PMID- 3636131 TI - Hazard communication and right-to-know: passion, progress, practice. PMID- 3636132 TI - Pre-employment screening--its use and usefulness. PMID- 3636133 TI - Health promotion--the university: a unique setting. PMID- 3636134 TI - Chronic occupational lead exposure: the potential effect on sexual function and reproductive ability in male workers. PMID- 3636135 TI - Health care cost containment--a nursing issue. PMID- 3636136 TI - Sound sleep--alcohol not an ingredient. PMID- 3636137 TI - Primary prevention and the occupational health nurse. PMID- 3636138 TI - The family nurse practitioner in industry. PMID- 3636140 TI - Nurse practitioners and HMOs in occupational health. PMID- 3636139 TI - Cholesterol & smoking education programs--application to the workplace. PMID- 3636141 TI - Some thoughts on doing research. PMID- 3636142 TI - Health care in the 21st century. PMID- 3636143 TI - Postpartum 'missing pieces': sequela of a passing obstetrical era? PMID- 3636144 TI - A study of mothers' breastfeeding concerns. PMID- 3636145 TI - A proposed alliance of midwives and family practitioners in the care of low-risk pregnant women. PMID- 3636146 TI - Commentary: physician--CNM partnership. How likely are they in practice? A certified nurse-midwife's perspective. PMID- 3636147 TI - Surgery on the paralyzed, unanesthetized newborn. PMID- 3636148 TI - How can we translate good science into good perinatal care? PMID- 3636149 TI - Differences among Oregon WIC recipients planning home births. PMID- 3636150 TI - Compliance with childbirth education classes in second stage labor. PMID- 3636151 TI - Degree graduates: reflections one year on. PMID- 3636152 TI - Measles immunization: ignorance or apathy? PMID- 3636153 TI - Mastery learning for midwifery: a college-based course. PMID- 3636154 TI - tRNAfMet-induced conformational transition at the intersubunit domain of fluorescent-labeled methionyl-tRNA synthetase. AB - Conformational transition in methionyl-tRNA synthetase upon binding of tRNAfMet, whose binding shows strong negative cooporativity, was analyzed by fluorescence spectroscopy. The fluorescent probe N-[[(iodoacetyl)amino]ethyl]-5-naphthylamine 1-sulfonic acid (1,5-I-AEDANS) reacts with native methionyl-tRNA synthetase in a nearly stoichiometric amount (2 per dimer) without affecting enzyme activity. The probe is shown by controlled trypsinization to be located in a 130 amino acid fragment at the C-terminus joining the subunits. The emission and excitation spectra, rotational freedom, and solvent accessibility of the fluorophore in AEDANS-methionyl-tRNA synthetase are analyzed. The results suggest that the probe is localized in a nonpolar environment, nearly immobile relative to methionyl tRNA synthetase yet fully accessible to the solvent. Upon binding of tRNAfMet, the fluorescence intensity in AEDANS-methionyl-tRNA synthetase was appreciably reduced without a shift in the emission or excitation spectra. Lifetime measurement shows that a static mechanism accounts for the observed quenching. Furthermore, the remaining emitting AEDANS becomes effectively shielded from solvent molecules. These results suggest an unsymmetric conformational transition at the intersubunit domains of the two subunits in methionyl-tRNA synthetase upon binding one molecule of tRNAfMet. PMID- 3636155 TI - Amino acid sequence of human factor XI, a blood coagulation factor with four tandem repeats that are highly homologous with plasma prekallikrein. AB - A lambda gtll cDNA library prepared from human liver poly(A) RNA has been screened with affinity-purified antibody to human factor XI, a blood coagulation factor composed of two identical polypeptide chains linked by a disulfide bond(s). A cDNA insert coding for factor XI was isolated and shown to contain 2097 nucleotides, including 54 nucleotides coding for a leader peptide of 18 amino acids and 1821 nucleotides coding for 607 amino acids that are present in each of the 2 chains of the mature protein. The cDNA for factor XI also contained a stop codon (TGA), a potential polyadenylation or processing sequence (AACAAA), and a poly(A) tail at the 3' end. Five potential N-glycosylation sites were found in each of the two chains of factor XI. The cleavage site for the activation of factor XI by factor XIIa was identified as an internal peptide bond between Arg 369 and Ile-370 in each polypeptide chain. This was based upon the amino acid sequence predicted by the cDNA and the amino acid sequence previously reported for the amino-terminal portion of the light chain of factor XI. Each heavy chain of factor XIa (369 amino acids) was found to contain 4 tandem repeats of 90 (or 91) amino acids plus a short connecting peptide. Each repeat probably forms a separate domain containing three internal disulfide bonds. The light chains of factor XIa (each 238 amino acids) contain the catalytic portion of the enzyme with sequences that are typical of the trypsin family of serine proteases. The amino acid sequence of factor XI shows 58% identity with human plasma prekallikrein. PMID- 3636156 TI - Study of the interaction between uncharged yeast tRNAPhe and elongation factor Tu from Bacillus stearothermophilis. AB - Proton NMR studies are presented on the interaction of nonaminoacylated yeast tRNAPhe and elongation factor Tu X GTP from Bacillus stearothermophilis. From experiments in which transfer of magnetization is observed between proton spins of tRNA and the protein, it is concluded that complex formation takes place. Amino acid residues of the protein come into close contact with the base pair A5U68 and/or U52A62 of the acceptor T psi C limb of the tRNA molecule. From the line broadening of tRNA resonances, associated with complex formation, an association constant of 10(3)-10(4) M-1 is estimated. The NMR experiments do not monitor a significant conformational change of the tRNA molecule upon interaction with the protein. However, at times long after the onset of complex formation, spectral changes indicate that the upper part of the acceptor helix becomes distorted. PMID- 3636157 TI - Effects of mevinolin in rat liver: evidence for a lack of coupling between synthesis of hydroxymethylglutaryl-CoA reductase and cholesterol 7 alpha hydroxylase activity. AB - The effect of treatment of rats with the hydroxymethylglutaryl-CoA reductase inhibitor, mevinolin, on 7 alpha-hydroxylation of cholesterol was studied. Treatment with 0.1% mevinolin in diet for 3 days was found to have an inhibitory effect on 7 alpha-hydroxylation of cholesterol (about 35%). Treatment with cholestyramine increased 7 alpha-hydroxylation of both exogenously added and endogenous microsomal cholesterol 3-4-fold. Combined treatment with both cholestyramine and mevinolin decreased this stimulation to 2-2.5-fold. Treatment with 2% cholesterol in diet increased 7 alpha-hydroxylation of exogenous cholesterol about 2-fold and 7 alpha-hydroxylation of endogenous cholesterol about 3.5-fold. The stimulatory effect of cholesterol was reduced or abolished when 0.1% mevinolin was added to the cholesterol-containing diet. With the exception of the experiments with cholesterol in the diet, all experiments including mevinolin gave a marked stimulation (up to 60-fold) of the hydroxymethylglutaryl-CoA reductase activity under the in vitro conditions employed. The concentration of free cholesterol in the liver microsomes was not significantly changed in any of these experiments. It is concluded that there is no coupling between induction of synthesis of hydroxymethylglutaryl-CoA reductase protein and cholesterol 7 alpha-hydroxylase activity. The inhibitory effect of mevinolin on cholesterol 7 alpha-hydroxylase activity under experimental conditions where most of the effect of mevinolin on hydroxymethylglutaryl-CoA reductase was abolished by treatment with cholesterol suggest that the effect of mevinolin on the cholesterol 7 alpha-hydroxylase may be independent of its effect on cholesterol synthesis. The over-all results do not favour the hypothesis that cholesterol synthesis and cholesterol availability are the most important determinants for the regulation of the cholesterol 7 alpha-hydroxylase. PMID- 3636159 TI - Staphylococcal infections in hospital. AB - Staphylococcus aureus is a major cause of surgical sepsis and septicaemia. The prevention and control of outbreaks of hospital infection caused by methicillin resistant strains has become increasingly important in recent years. Staph. epidermidis has also emerged as a "problem organism" often causing serious infection in patients with prosthetic implants. PMID- 3636158 TI - CS-514, a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase: tissue-selective inhibition of sterol synthesis and hypolipidemic effect on various animal species. AB - CS-514 is a tissue-selective inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, a key enzyme in cholesterol synthesis. For the microsomal enzyme from rat liver, the mode of inhibition is competitive with respect to hydroxymethylglutaryl-CoA, and the Ki value is 2.3 X 10(-9) M. CS-514 also strongly inhibited the sterol synthesis from [14C]acetate in cell-free enzyme systems from rat liver and in freshly isolated rat hepatocytes; the concentrations required for 50% inhibition were 0.8 ng/ml and 2.2 ng/ml, respectively. On the other hand, the inhibition by CS-514 was much less in the cells from nonhepatic tissues such as freshly isolated rat spleen cells, and cultured mouse L cells and human skin fibroblasts. In addition, the cellular uptake of 14C-labeled CS-514 by isolated rat spleen cells or mouse L cells was less than one-tenth of that by isolated hepatocytes. These differences between hepatic and nonhepatic cells were further confirmed by the fact that CS-514 orally administered to rats inhibited sterol synthesis selectively in liver and intestine, the major sites of cholesterogenesis. CS-514 markedly reduced serum cholesterol levels in dogs, monkeys and rabbits, including Watanabe heritable hyperlipidemic (WHHL) rabbits, an animal model for familial hypercholesterolemia in man, but did not reduce those in rats and mice. In the former case, preferential lowering of atherogenic lipoproteins was observed in all of the animals tested. The biliary neutral sterols significantly decreased, whereas the amount of biliary bile acids was not affected by administration of the drug to dogs. PMID- 3636160 TI - Primary nursing and all that--is this the way to treat a patient? PMID- 3636161 TI - Should men cry? PMID- 3636162 TI - "Hidden handicap". PMID- 3636163 TI - Avoiding the coalition trap: recognizing the centricity and vulnerability of the psychiatric nurse in the realm of family treatment. PMID- 3636164 TI - Sexuality and the psychiatric patient. PMID- 3636165 TI - A sexuality workshop: increasing sexual self awareness. PMID- 3636166 TI - Schizophrenia: current concepts. PMID- 3636167 TI - Assault: just part of the job? PMID- 3636168 TI - [Aggression in a psychiatric setting]. PMID- 3636169 TI - [Ethical vocabulary]. PMID- 3636170 TI - Better off dead? PMID- 3636171 TI - Facing the future: one hospital's approach to nursing the elderly. PMID- 3636172 TI - Utilization of hospice/home care in pediatric oncology. A national survey. PMID- 3636173 TI - Evaluation of burnout in oncology nurses. PMID- 3636174 TI - A nurturing work environment--in philosophy and practice. PMID- 3636176 TI - Enabling hope. PMID- 3636175 TI - Cancer-induced hypercalcemia. PMID- 3636177 TI - Difficulties encountered in implementing guidelines for handling antineoplastics in the physician's office. PMID- 3636178 TI - INA Board acts on AIDS recommendations. PMID- 3636179 TI - Meeting the AIDS challenge in Illinois. PMID- 3636180 TI - Psych nursing care of AIDS victims. PMID- 3636181 TI - Acquired immune deficiency syndrome (AIDS): precautions for clinical staff. PMID- 3636182 TI - [Care of psychiatric patients exhibiting manipulative behavior]. PMID- 3636183 TI - [Changes in skin temperature after toe transplantation in thumb injuries]. PMID- 3636184 TI - [Systematic nursing of pre-school children in the treatment of dental diseases]. PMID- 3636185 TI - [Psychological care of psychiatric children]. PMID- 3636186 TI - [Traditional Chinese medicine in inspecting psychotic patients]. PMID- 3636187 TI - [Postoperative nursing in bone lengthening]. PMID- 3636188 TI - [Nursing in operations on patients with WPW syndrome]. PMID- 3636190 TI - [Nursing care in the first stage of labor]. PMID- 3636189 TI - [Postoperative care of patients with pheochromocytoma of the bladder]. PMID- 3636191 TI - [Diet therapy of hemorrhoid patients in the postoperative period]. PMID- 3636192 TI - [Psychological care to improve the attention process]. PMID- 3636193 TI - [Current status and trends in the development of nursing education in Japan]. PMID- 3636194 TI - [Psychological qualification of nurses in the department of psychiatry]. PMID- 3636195 TI - [ECG in intensive care of patients with WPW syndrome after surgery]. PMID- 3636196 TI - Induction of neutrophil enzyme release by rheumatoid factors: evidence for differences based on molecular characteristics. AB - Cathepsin G and elastase are two neutrophil proteases capable of degrading the major structural macromolecules of the joint. Evaluation of factors capable of inducing the release of these enzymes is crucial to the understanding of neutrophil-mediated tissue destruction. We have evaluated the effects of IgM rheumatoid factor (RF), as well as monomeric and polymeric forms of IgA RF, on the release of neutrophil elastase, cathepsin G, and the specific granule protein lactoferrin. None of these rheumatoid factors alone was able to induce more lysosomal protein release than media controls. Under conditions used in this study, aggregated human IgG was able to induce slightly more release than media controls. The addition of IgM RF or polymeric IgA RF to the aggregated IgG resulted in release of significantly more lysosomal proteins than aggregates alone. In contrast, monomeric IgA RF, even in the presence of aggregated IgG, was unable to augment enzyme release. These results suggest that differences in the molecular characteristics of RF found in synovial fluid may significantly influence the contribution of RF to tissue injury in rheumatoid arthritis. PMID- 3636197 TI - Percutaneous transhepatic biliary drainage. Series with a technical note. AB - Barium duodenography was performed simultaneously with percutaneous transhepatic cholangiography in 11 patients with failed transhepatic visualisation of the duodenum prior to percutaneous transhepatic biliary drainage (PTHBD). The advantages of this modification, not only to guide PTHBD but also in percutaneous tumour biopsy and coeliac gangliolysis, are discussed with particular reference to developing economies, where newer cross-sectional imaging modalities are not available. There were no complications related to the duodenography. PMID- 3636198 TI - Calcified enteroliths in regional enteritis. AB - A case of enterolith formation in a dilated pre-stenotic segment of the ileum in a patient with long existing regional enteritis is presented. Recognition of abdominal calculi as enteroliths may represent the diagnostic clue to the presence of chronic stenosing disease of the lower intestinal tract. PMID- 3636199 TI - A secondary vaginal stone. A case report. AB - A case is presented of a large calculus that was formed in the vagina of a 44 year-old woman within less than 4 months. Urinary salts from a vesico-vaginal fistula deposited around an inadvertently unremoved medical gauze. PMID- 3636200 TI - CT demonstration of calcified post-thrombotic inferior vena cava. AB - A calcified thrombus in the inferior vena cava is imaged and exactly located by computed tomography in an adult presenting with acute phlebitis complicating deep venous thrombosis. It is the purpose of this case report to discuss the rare finding of inferior vena caval (IVC) calcification and to demonstrate the computed tomographic (CT) findings of a calcified post-thrombotic inferior vena cava. PMID- 3636201 TI - Gastroduodenal intussusception due to the prolapse of a gastric adenoma. A case report. AB - A case of gastroduodenal intussusception due to the prolaps of a gastric adenoma is presented. The radiographic findings are discussed and illustrated. The clinical features and therapy are briefly dealt with. PMID- 3636202 TI - Pneumonia caused by a relatively resistant strain of Streptococcus pneumoniae. AB - A patient with pneumonia caused by a relatively resistant strain of Streptococcus pneumoniae that did not respond to prolonged therapy with intravenous ampicillin is described, and general principles of treatment for such cases are reviewed. The patient was a 16-month-old, 10-kg girl who was admitted to a hospital for treatment of severe smoke inhalation and burns. The patient was intubated immediately, but her respiratory status remained unstable. Chest roentgenograms showed numerous episodes of pneumonia; the organism was later identified as Strep. pneumoniae. Despite empiric therapy with ampicillin and tobramycin followed by a prolonged course of ampicillin and subsequent treatment with cefazolin, the patient's respiratory status did not improve, and she continued to have elevated temperatures. Strep. pneumoniae isolated from her blood was identified as relatively resistant to penicillin but sensitive to chloramphenicol. After a seven-day course of chloramphenicol, the patient recovered and was later discharged. Relatively resistant Strep. pneumoniae (RRSP) infections often occur at sites where high antibiotic concentrations are not achieved, such as in the CNS. Prior antibiotic therapy may increase or have no effect on the incidence of RRSP. The mechanism for RRSP is unknown, and these infections often are not detected until a patient has failed to respond to conventional therapy. Also, the incidence of RRSP has not been determined because many hospitals do not perform susceptibility tests for pneumococcal isolates routinely. Vancomycin or chloramphenicol may be alternates to penicillin for the treatment of RRSP, but antibiotic sensitivities should be determined for each isolate to ensure susceptibility. PMID- 3636203 TI - Terminal care: a better way to die. PMID- 3636204 TI - Cumberlege--at a glance. PMID- 3636205 TI - Life on the receiving end. PMID- 3636206 TI - Pressure area care: float like a butterfly. PMID- 3636207 TI - Taking the right tablets. PMID- 3636208 TI - A book at bedtime. PMID- 3636209 TI - Stoma care. Seals of approval. PMID- 3636210 TI - Infant feeding. Satisfaction guaranteed? PMID- 3636211 TI - The cost of a battle won. PMID- 3636212 TI - Continuing my education. PMID- 3636213 TI - AIDS: a risk for diabetes educators? PMID- 3636214 TI - AIDS: a reminder on preventing the spread of blood-borne viruses while teaching blood glucose self-monitoring. PMID- 3636215 TI - Diabetes Research and Training Centers in the 1990s: national needs and future directions. PMID- 3636216 TI - The role of the Diabetes Research and Training Centers in relation to diabetes educators. PMID- 3636217 TI - A view from the National Institutes of Health. PMID- 3636218 TI - The Diabetes Research and Training Centers--a decade of progress in diabetes education. PMID- 3636219 TI - Innovations in professional education: the model demonstration unit. PMID- 3636220 TI - The development of a competency-based interdisciplinary clinical training program in diabetes. PMID- 3636221 TI - Training health professionals to improve the effectiveness of patient education programs. PMID- 3636222 TI - Professional education in diabetes care: beyond the physician and back. PMID- 3636223 TI - Future directions in continuing education. PMID- 3636224 TI - The role of the clinical environment in the translation of research into practice. PMID- 3636225 TI - The activated patient: a force for change in diabetes health care and education. PMID- 3636226 TI - The background needed by registered dietitians working in the field of diabetes management. PMID- 3636227 TI - Professional education--fostering a team approach? PMID- 3636228 TI - Effect of the novel synthetic protease inhibitor furoyl saccharin on elastase induced emphysema in rabbits and hamsters. AB - Furoyl saccharin, a novel heterocyclic acylating agent which has been previously found to possess a potent inhibitory capacity in vitro for elastase and other serine proteases, has been investigated in vivo in two acute animal models of emphysema. In hamsters, intratracheal (i.tr.) administration of 0.1 mg porcine pancreatic elastase resulted seven days later, in a 42% increase of the mean linear intercept (Lm). Addition of 0.3 mg to 0.3 mg furoyl saccharin to elastase exhibited a partial, not dose-related, but statistically significant inhibition of the increase of LM. Addition of 1 mg furoyl saccharin (equivalent to a dose of 12.5 mg/kg) completely abolished the increase in Lm. In the rabbit i.tr. instillation of 3.7 mg porcine pancreatic elastase induced within seven days, a 48% increase of the Lm, a 27% decrease of the internal surface area (ISA) of the lungs and a 33% decrease of the ISA corrected to an arbitrary total lung volume of 70 ml (ISA70). Furoyl saccharin given i.tr. 15 min prior to elastase at the doses 3, 10 and 20 mg prevented significantly in a dose-related manner, the changes in Lm, ISA and ISA70. The highest furoyl saccharin dose (equivalent to a dose of 10.8 mg/kg) completely protected against the emphysematous lesion. Additionally furoyl saccharin (20 mg i.tr.) prevented in the rabbit model the depletion in lung insoluble elastin and the increase in salt soluble collagen induced by the elastase administration. These results show that furoyl saccharin also in vivo has a marked antielastase activity. PMID- 3636229 TI - The inactive subunit of ruminant procarboxypeptidase A-S6 complexes. Structural basis of inactivity and physiological role. AB - Subunit III has so far been found only in the pancreas of ruminants in a non covalent association (procarboxypeptidase A-S6) with two different proteins: the procarboxypeptidase A itself (subunit I) and a C-type chymotrypsinogen (subunit II). In contrast with these latter two proteins, which are zymogens of pancreatic proteases, subunit III seems to be devoid of any activity towards specific substrates of pancreatic proteases. However, it possesses a weakly functional active site which allows it to hydrolyze a non-specific ester, p-nitrophenyl acetate, and to react with several active-site titrants. The binding of proflavin to subunit III shows that this protein owns a non-polar binding site with a very high Kd compared to that of chymotrypsin. The comparison of the amino acid sequences of subunit III and some serine proteases showed that subunit III is closely related to an elastase. Models of the tertiary structure of subunit III suggest a conformational modification that affects the substrate binding and could explain the lack of specific enzymatic activity. The presence of subunit III in the ternary complex is not related to an enzymatic function. This protein does not participate in the activation process of subunit I but prevents the denaturation of this subunit at low pH. This may represent its biological role in the acidic environment of the duodenum in ruminants. PMID- 3636231 TI - Critical care nursing--a brief view of practice in Austria, Hungary, Greece, and Yugoslavia. PMID- 3636230 TI - [Effect of vicasol and protamine sulfate on the indices of the blood kallikrein kinin system and of aortic carbohydrate metabolism in nicotine poisoning]. AB - The experiments on rats showed that 6-day nicotine intoxication was followed by an increase of the initial esterase activity (IEA) of the blood, a decrease of oxygen uptake by the aorta tissue. Vicasol produced an activation of kininogenesis in control rats and a reduction of IEA in animals under nicotine intoxication; irrespective of the background, the drug stimulated the aorta tissue respiration. Acute administration of protamine sulfate increased IEA and against the background of nicotine intoxication it increased oxygen uptake by the vessel tissue. PMID- 3636232 TI - Sexual counseling of the patient with chronic lung disease. PMID- 3636233 TI - Sudden cardiac death. PMID- 3636234 TI - Legal issues in nursing. But I was just the supervisor. PMID- 3636235 TI - Nomograms shortcuts to accuracy. PMID- 3636237 TI - Professional profile--Xiao Xing Jiang: implementing change in China. PMID- 3636236 TI - Should patients with acute myocardial infarctions receive back massage? PMID- 3636238 TI - AACN recertification. PMID- 3636239 TI - Baccalaureate education for nursing research. PMID- 3636241 TI - The relevance of clinical research. PMID- 3636240 TI - Facilitating staff involvement in research. PMID- 3636242 TI - Strategies for research in practice. PMID- 3636243 TI - Faculty participation in FNA. PMID- 3636244 TI - Challenges in serving the elderly American Indian. PMID- 3636245 TI - Seat belt law enacted with FNA support. PMID- 3636247 TI - The future of nursing: developing a team spirit. PMID- 3636246 TI - Developing a protocol for child health assessments in a pre-school child care center. PMID- 3636249 TI - The joys of pediatric nursing. PMID- 3636248 TI - Clinical experience with intravenous Augmentin in the treatment of paediatric infections. AB - The clinical efficacy of intravenous Augmentin (a formulation containing amoxycillin plus clavulanic acid) was investigated in an open study in fifty eight children with a mean age of 6 years (range 1-15 years). The normal dosage was in the range 100-200 mg/kg/day Augmentin, administered parenterally by short i.v. infusion in 3 or 4 divided doses. Most patients were hospitalised for lower respiratory tract infections. Complete clinical cure or distinct clinical improvement was achieved in all assessable cases. Bacteriological success was obtained in 92% of the assessable cases. In two patients, mild, transient exanthema was noted after i.v. Augmentin was replaced by oral Augmentin. No additional therapeutic measures were required. PMID- 3636250 TI - Support for parents of hyperactive children. PMID- 3636251 TI - Child abuse in Georgia. PMID- 3636253 TI - Tort law and liability chaos. PMID- 3636252 TI - Child mental health. PMID- 3636254 TI - Drama for children? Drama for you--a nurse? PMID- 3636255 TI - First steps toward preventing child abuse. PMID- 3636257 TI - Two human tyrosine tRNA genes contain introns. AB - A human lambda-phage recombinant which contains at least four tRNA genes, has been isolated. Two DNA fragments were subcloned to give the recombinant plasmids pM6 and pM6128. Nucleotide sequence analysis showed that each plasmid contained a different tyrosine acceptor tRNA (tRNATyr) gene. Both tRNATyr genes are interrupted by 21-bp introns. These recombinant plasmids have been shown to direct the in vitro synthesis of tRNA-sized products in a HeLa cell transcription system. PMID- 3636256 TI - Sino-American Nursing Conference: "Care for the sick and peace for the world". PMID- 3636258 TI - [Lung biopsy findings in pneumoconiosis caused by dust from construction materials]. PMID- 3636259 TI - Ensuring effective care. PMID- 3636261 TI - Whose goals determine care? PMID- 3636260 TI - Measuring improvement in patients with dementia. PMID- 3636262 TI - The enhancement project: a program to improve the quality of residents' life. PMID- 3636263 TI - Nursing assistants learn through the competency-based approach. PMID- 3636264 TI - Six months after hip fracture. PMID- 3636265 TI - 70+ and going strong. Margaret Gamper: a pioneer in childbirth education. PMID- 3636266 TI - Drugs and the elderly. When the risks outweigh the benefits. PMID- 3636267 TI - New congenital deficiency of high molecular weight kininogen and prekallikrein (Fitzgerald trait). Study of response to DDAVP and venous occlusion. AB - The prolonged partial thromboplastin time observed in the plasma of a 36 year old asymptomatic man was related to the reduced prekallikrein activities (coagulant; antigenic; and amidolytic) and the absence of coagulant and immunologic activities of high molecular weight kininogen (HMWKg). The patient's plasma also exhibited impaired surface-mediated fibrinolysis and impaired generation of kallikrein. The coagulation defect was identified as the "Fitzgerald trait". The levels of CH50, C2, C4 and C-1 inactivator were normal. Venous occlusion in the patient gave rise to a normal release of extrinsic plasminogen activator from the vascular endothelium. The administration of DDAVP led to a FVIII/VWF response which was similar to that obtained in healthy subjects. No alteration could be observed in the contact phase proteins after DDAVP administration. PMID- 3636268 TI - Humor and healing: therapeutic effects in geriatrics. PMID- 3636270 TI - A seniors home--designs for independent living. PMID- 3636269 TI - The campus of care: Baycrest Centre for Geriatric Care. PMID- 3636271 TI - Understanding incontinence: a urodynamic perspective. PMID- 3636272 TI - Profile of Liz Lyons: age is a state of mind. PMID- 3636273 TI - Insomnia in the elderly: sleeping pills or warm milk. PMID- 3636275 TI - 'Don't shout, nurse'! PMID- 3636274 TI - 'Sharing caring'--by geriatric and psychiatric nurses. PMID- 3636276 TI - The biology of ageing: maintenance of homeostasis. PMID- 3636277 TI - Protecting patients with chronic mental illness. PMID- 3636278 TI - Reality orientation: a nursing approach. PMID- 3636279 TI - Towards safer drug administration. PMID- 3636280 TI - Geriatric nursing comes of age. PMID- 3636281 TI - Histologic and ultrastructural changes in human endometriotic implants treated with the antiprogesterone steroid ethylnorgestrienone (gestrinone) during 2 months. AB - In 20 infertile patients, the laparoscopic, histologic, and ultrastructural characteristics of endometriotic implants were studied before and after a 2-month course of therapy using 1.25 mg of the antiprogesterone steroid ethylnorgestrienone daily. Before treatment, well-differentiated endometriotic foci were seen only in implants with a rich microvascular supply. It is postulated that the degree of microvascular development may determine the differentiation of ectopic endometrium. After therapy, well-differentiated endometriotic tissues were recovered in only one patient. In all other patients, the foci remained undifferentiated, while in 11 patients striking epithelial involutionary changes were seen, such as nuclear pyknosis, extrusion of nuclear remnants, enhanced lysosomal autophagy, abortive secretion, and focal epithelial erosion. These histologic and ultrastructural changes reflect a progesterone withdrawal effect in endometriotic implants. It is thus concluded that ethylnorgestrienone induces inactivity in most endometriotic implants, while marked involution is observed in many foci. However, this subcellular involution does not result in a change of the extent of the disease according to the American Fertility Society classification system. Preliminary data concerning the pregnancy rate reveal that five patients conceived during a mean follow-up period of 6 months. PMID- 3636282 TI - World economy: its impact on the delivery of health care. PMID- 3636283 TI - A short course in research methods. AB - In May 1985, the Coordinator for Nursing Affairs of the West African College of Nursing requested the author to organize a short course in applied research methods for senior nurse from the West African Health Community. This paper reports the first such effort in West Africa, with particular reference to health services research in primary health care. PMID- 3636284 TI - Nursing education in Kenya: trends and innovations. AB - The nursing profession in Kenya plays a very fundamental role in the society and provides employment to a good number of young men and women at an important part of their lives. The education of the nurse therefore forms a significant part of the overall educational system of the society. Thus the nursing curriculum reflects the educational philosophy of the society as a whole, Kenya's philosophy of health, the society's concept of the nurse and at the same time endeavouring to maintain the world standard of professional nursing. This paper was presented at the ICN Congress in Tel Aviv, June 1985. PMID- 3636285 TI - Basic steps in the review of Nepal's nursing curriculum. AB - Since the efforts made in Nepal to improve health care delivery had little impact, it was decided to introduce the primary health care concept in nursing education so that nurses could reach and care for the people at all levels. PMID- 3636286 TI - Incidence of infanticide in America: public and professional attitudes. PMID- 3636287 TI - The legal response to Babies Doe: an analytical prognosis. PMID- 3636288 TI - The "Uniform Rights of the Terminally Ill Act": a critical analysis. PMID- 3636289 TI - Mental health nursing clinical specialization: extinction or adaptation? PMID- 3636290 TI - Establishing the mental health clinical specialist role in the medical setting. PMID- 3636291 TI - Creative accommodation: role satisfaction for psychiatric staff nurses. PMID- 3636292 TI - Behavioral management training for families of emotionally handicapped and/or developmentally delayed children. PMID- 3636293 TI - Considerations of power by graduate student nurse psychotherapists: a pilot study. PMID- 3636295 TI - How to deal with overt aggression. PMID- 3636294 TI - Perceptions of stress, coping, and recovery one and three years after a natural disaster. PMID- 3636296 TI - Secondary pulmonary hypertension: clinical features. PMID- 3636297 TI - Activities of daily living in women after myocardial infarction. PMID- 3636298 TI - Preparation for cardiac catheterization: tailoring the content of instruction to coping style. PMID- 3636300 TI - Kaposi's sarcoma presenting with endobronchial lesions. PMID- 3636299 TI - Hemolysis, elevated liver enzymes, and low platelet count syndrome: nursing care of the critically ill obstetric patient. AB - Although patients with severe preeclampsia and eclampsia are infrequently admitted to critical care areas, it is important that the critical care nurse be aware of the HELLP syndrome. The case presentations demonstrated hemolysis, liver dysfunction, and abnormal platelet consumption. Knowledge of the clinical and laboratory findings will assist in nursing assessment and intervention for these critically ill obstetric patients. PMID- 3636301 TI - Tain't cricket: ethical comments on patient informedness. PMID- 3636302 TI - The cardiomyopathies. PMID- 3636303 TI - Saying no and other ethical dilemmas. PMID- 3636304 TI - The effect of an advanced cardiac life support course on advanced cardiac life support ability. PMID- 3636305 TI - Constraints on nursing practice today. PMID- 3636306 TI - The educational needs of home health nurses. PMID- 3636307 TI - Occupational stress of the home health nurse. PMID- 3636308 TI - Use of a data base system by a home health care agency: an illustrative example. PMID- 3636309 TI - Should we initiate a hospice program? A study of relevant factors. PMID- 3636310 TI - Incident reports in home health agencies. PMID- 3636311 TI - Hepatitis B: an urban epidemic. PMID- 3636312 TI - The dialysis patient, the family, and the home health nurse. PMID- 3636313 TI - Respite care: what nurses need to know. PMID- 3636314 TI - The federal budget: its impact on home health agencies. PMID- 3636315 TI - Cancer support groups: what do they do? PMID- 3636316 TI - The care and feeding of manuscripts: how following instructions can help. PMID- 3636317 TI - Physical, psychosocial, menstrual changes/risks and addiction in the female marathon runner. PMID- 3636318 TI - Sources of support of elderly Acadian widow. PMID- 3636319 TI - Changes in responsibility in women's families after the diagnosis of cancer. PMID- 3636320 TI - A comparison of anxiety levels in midlife women (aged 35-65) who are military spouses and a group of non-military-affiliated women. PMID- 3636321 TI - Factors affecting the measurement of antibiotic resistance in bacteria isolated from lake water. AB - It is more difficult to obtain a reliable assessment of antibiotic resistance in populations of aquatic bacteria than in those populations which are well characterized (e.g. bacteria of medical and veterinary significance). Factors which influence the results include the bacterial taxa involved, their site of origin and the methods and media used to isolate and subculture the bacteria, and to perform the sensitivity tests. Examples of these effects are provided. The resistance profiles obtained with populations of aquatic pseudomonads depend on the species composition of the population. Resistance patterns in aquatic bacteria varied with the site from which they were isolated; a higher incidence of resistance was recorded along shorelines and in sheltered bays than in the open water. The inclusion of antibiotics in the media employed for primary isolation increased the number of individual and multiple resistances recorded. A similar effect was observed with increased inoculum size in the sensitivity disc method but this could be reversed by raising the incubation temperature. The medium used to conduct the test also affected the results and many aquatic bacteria failed to grow on media such as Iso-Sensitest Agar. It is recommended that the sensitivity disc method is adopted for aquatic bacteria because it permits interpretation of a wider range of response. Comparison of the incidence of antibiotic resistance in different habitats will remain meaningless, however, until comprehensive methods for the identification of bacteria are developed and the techniques used for sensitivity testing are standardized. PMID- 3636322 TI - Probable chromosomal mutation to resistance to all aminoglycosides in Staphylococcus aureus selected by the therapeutic use of gentamicin: a preliminary report. AB - A patient suffering from burns was treated with gentamicin: subsequently, a 'methicillin-resistant' strain of Staphylococcus aureus (B27), was isolated which was highly resistant to this antibiotic and all other aminoglycosides. In all other respects this isolate resembled the gentamicin-sensitive 'methicillin resistant' S. aureus prevalent on the Yorkshire Regional Burns Unit. Subsequently, fusidic acid treatment was substituted for gentamicin therapy, and a fusidic acid-resistant variant was isolated from the same patient. This article reports a preliminary characterization of these isolates. PMID- 3636323 TI - Comparative bactericidal activity of penicillin-netilmicin and penicillin gentamicin against enterococci. AB - The synergistic bactericidal activity of netilmicin in combination with penicillins was compared with that of gentamicin and streptomycin against 16 clinical isolates of enterococci. In a macrodilution chessboard assay against multiple combinations of penicillin, gentamicin and netilmicin, bactericidal activity uniformly occurred at two- to four-fold lower concentrations of penicillin + netilmicin than with penicillin + gentamicin. With four strains, penicillin + netilmicin produced up to ten-fold greater killing than penicillin + gentamicin after 6 h of incubation. With one strain, 3 X log10 greater killing occurred with netilmicin after 24 h. Netilmicin was two- to four-fold more active than gentamicin when combined with penicillinase-resistant penicillins. The bactericidal activity of netilmicin against enterococci is equal to or greater than that of gentamicin, either alone or when combined with penicillins. PMID- 3636325 TI - In-vitro activity of ticarcillin with and without clavulanic acid against clinical isolates of gram-positive and gram-negative bacteria. AB - The in-vitro activity of ticarcillin with and without clavulanic acid was investigated against 285 freshly isolated clinical strains of Gram-positive and Gram-negative bacteria by the agar-dilution technique on Mueller-Hinton-agar. Clavulanic acid had an excellent or moderate potentiating effect on the in-vitro activity of ticarcillin against staphylococci, Escherichia coli, Klebsiella spp., Enterobacter aerogenes, Proteus mirabilis, Citrobacter spp., Acinetobacter, Haemophilus influenzae and Bacteroides spp. No effect was seen against enterococci, indole-positive Proteus spp., Ent. cloacae, Serratia marcescens and Pseudomonas aeruginosa. The effect of clavulanic acid was dose- and inoculum dependent. PMID- 3636324 TI - In-vitro activity of amoxycillin and ticarcillin in combination with clavulanic acid compared with that of new beta-lactam agents against species of the Bacteroides fragilis group. AB - One hundred and one isolates representing five species of the Bacteroides fragilis group were examined for their susceptibility to amoxycillin and ticarcillin alone or in combination with clavulanic acid, as well as to cefoxitin, latamoxef (moxalactam), ceftizoxime, imipenem, chloramphenicol, clindamycin and metronidazole by the proposed NCCLS agar dilution method. Bactericidal activity of amoxycillin, ticarcillin, combinations of amoxycillin clavulanic acid and ticarcillin-clavulanic acid, cefoxitin and latamoxef against 54 strains was further assessed by a dilution test in broth. The most active agents were imipenem and the combinations of amoxycillin-clavulanic acid and ticarcillin-clavulanic acid. MIC results indicated that Bacteroides fragilis and B. vulgatus were more susceptible to beta-lactams than were B. distasonis, B. ovatus and B. thetaiotaomicron. Clavulanic acid greatly potentiated the activity of amoxycillin and ticarcillin against the 94 beta-lactamase positive strains but had no effect on the seven B. distasonis isolates that were beta-lactamase negative. Synergistic bactericidal activities could be observed by the amoxycillin-clavulanic and ticarcillin-clavulanic combinations. PMID- 3636326 TI - Timentin in the treatment of nosocomial bronchopulmonary infections in intensive care units. AB - A clinical trial with Timentin (ticarcillin plus clavulanic acid) was undertaken in patients with hospital-acquired lower respiratory tract infections. Two formulations, 3.2 and 5.2 g consisting of 200 mg clavulanic acid and 3 or 5 g ticarcillin, respectively were usually given three times daily. Eighty-one patients were evaluable for clinical efficacy and 89 for tolerance. The clinical cure rate was 96% of the assessable cases even though all patients had severe concurrent or underlying diseases. The pronounced synergism between ticarcillin and clavulanic acid resulted in a bacteriological elimination rate of 94%. Adverse effects were very rare and of a mild nature, and restricted to those usually seen with the well-tolerated penicillins. No toxicological abnormalities could be detected in extensive laboratory screening. Timentin is a highly effective broad-spectrum antibiotic with good tolerance. Its potentiated action in comparison to other penicillins against beta-lactamase-producing strains, could reduce the usage of aminoglycosides in the future. PMID- 3636327 TI - Timentin in the treatment of invasive burn wound infection with sepsis. AB - Twenty-one patients with infected burns were treated with 5.2 g Timentin (ticarcillin 5 g + potassium clavulanate 200 mg) three times a day for an average of 8.3 days. Staphylococcus aureus was the commonest pathogen, there being ten cases of septicaemia with this organism and all were cured. Three patients with Pseudomonas aeruginosa septicaemia and infections with methicillin-resistant S. aureus failed. No drug related side effects were noted. PMID- 3636328 TI - Clinical experience with Timentin in severe hospital infections. AB - Sixty-four severe infections in hospitalized patients were treated with intravenous Timentin. Most patients (mean age: 50.5 years, range 18-85) had serious underlying conditions such as agranulocytosis, heart failure, cancer, diabetes mellitus, chronic alcoholism or other functional or anatomical abnormalities. Forty-three episodes were bacteriologically proved, and bacteraemia was diagnosed in 18. The sites of infection were: lower respiratory tract (10), upper respiratory tract (10), soft tissues (9), urinary tract (7), bones (6), peritoneal cavity (3), meninges (1) and pelvis (1). In addition, 13 episodes of fever and four of septicaemia in patients with agranulocytosis were treated with Timentin plus amikacin. Overall, 59% of the episodes were cured, 14% improved and 17% failed to respond. In 9% of cases the efficacy of the Timentin was unassessable mainly because of concurrent administration of other antimicrobials. Failure appeared to be more frequent in soft tissue and intra abdominal infections, in patients infected with bacteria susceptible to Timentin but resistant to ticarcillin and in patients superinfected with Timentin resistant strains. Major side effects were haemorrhagic diathesis with platelet dysfunction (1), severe water sodium overload (1), and possibly pancreatitis (1). Other side effects were mild: catheter-related phlebitis, and abnormal but clinically insignificant laboratory test results. Timentin appears to be an effective and safe broad-spectrum combination which compares favourably with third-generation cephalosporins in the treatment of severe hospital infections. More experience is needed to decide whether the somewhat lower response rate in patients infected with ticarcillin-resistant strains is significant. PMID- 3636329 TI - The efficacy of the combination of Timentin and tobramycin in the treatment of patients with bacteraemia. AB - Twenty-eight patients with bacteraemia were treated with Timentin, a combination of ticarcillin and clavulanic acid, and tobramycin. According to a simple physiological classification scheme 20 patients were moderately and eight severely ill. Clinical cure was achieved in 15 of 20 moderately ill and in four of eight severely ill patients. The nine therapeutic failures were due to non removable foreign material (2 cases), abscesses that were not effectively evacuated (5 cases), urolithiasis (1 case), and decubitus ulcer (1 case). One of these cases was complicated by infection with a Klebsiella strain with Timentin and tobramycin MICs of 64 mg/l. Thirteen of 31 bacterial isolates from blood were resistant to greater than or equal to 128 mg/l of ticarcillin of which 11 were susceptible to less than or equal to 64 mg/l of Timentin. The addition of Timentin to tobramycin offered a better coverage in vitro than ticarcillin combined with tobramycin against the strains isolated from the blood of the patients included in this study. PMID- 3636331 TI - An open study of Timentin for the initial treatment of serious infections. AB - Fifty patients were treated for suspected serious bacterial infection with Timentin 3.2 g 6-8-hourly. Three patients did not complete a minimum of 48 h treatment. Pathogens were isolated from 28 of the remaining 47 patients; 13 were resistant to ticarcillin but fully sensitive to Timentin; six of these isolates were Staphylococcus aureus. Five of the patients with Timentin-sensitive organisms or no significant growth failed to respond or relapsed after Timentin but also failed on subsequent therapy. An additional patient relapsed because of inadequate duration of treatment and one patient, with salmonella enteritis, became an asymptomatic carrier. The Timentin-resistant organisms were a Pseudomonas aeruginosa which responded to ceftazidime, a Klebsiella pneumoniae which was of doubtful clinical significance and an Escherichia coli which caused a relapse of pyelonephritis 16 days after apparently successful treatment with Timentin. No serious adverse reactions were seen. Timentin was effective against ticarcillin-resistant organisms but its final role will depend on the prevalence and significance of in-vitro resistance to the combination amongst Enterobacteriaceae and pseudomonads. PMID- 3636330 TI - Timentin in the antimicrobial treatment of nosocomial and polymicrobial infections. AB - The combination of ticarcillin and clavulanic acid (Timentin) was used in a nonrandomized open study in 28 patients with severe nosocomial infections. The infections were polymicrobial in 19 cases. Ten patients were bacteraemic and all were severely ill, receiving mechanical ventilation and with at least one organ system failure. Seventeen patients were treated with Timentin alone, 11 with a combination of Timentin and aminoglycosides. Timentin was used empirically, before identification of the bacteria in 14 patients (group I) and after identification of all the micro-organisms in 14 patients (group II). In group I, the empirical choice of Timentin was wrong in four cases, because at least one micro-organism was resistant to this drug. In the remaining 24 evaluable patients 12 patients were definitively cured. A relapse of the infection occurred in two cases. Five patients were initially improved but a secondary failure occurred due to a residual abscess in one case and to the underlying disease in four cases. Five initial failures due to the underlying disease in three cases were noted. The antimicrobial spectrum of Timentin is valuable in the management of nosocomial and polymicrobial infection, especially intra-abdominal infections and this study confirms a good clinical efficacy. However, combination with aminoglycosides seems mandatory, at least until the identification of all the micro-organisms involved in the infection. PMID- 3636332 TI - Ticarcillin and clavulanic acid in serious infections. AB - In an open, non-comparative study 40 patients with severe, often life-threatening infections, were treated with Timentin 5.2 g (5 g ticarcillin plus 200 mg potassium clavulanate) by iv infusion every 6 or 8 h. They were suffering from septicaemia (9), obstructed UTI (8), non-obstructed urinary tract infection (10), respiratory tract infection (6), infected burns (4) or malignant otitis externa (3). Many patients had important aggravating factors such as renal transplantation, peritoneal or haemodialysis, leukaemia, extensive burns, renal stones, tracheostomy and diabetes. Pathogens included Pseudomonas aeruginosa (21), Escherichia coli (7), and other Enterobacteriaceae (6). Twenty-four pathogens (13 P. aeruginosa) were ticarcillin-resistant. Thirty-six patients were clinically cured including all cases of malignant otitis externa, infected burns and non-obstructed urinary tract infection. Three patients improved and one patient with obstructed urinary tract infection failed. In 32 patients the pathogen was eradicated, in one patient it persisted and in seven it reappeared. In particular, 11 of 13 patients with infections due to ticarcillin-resistant P. aeruginosa were cured and two improved. There was, however, bacteriological relapse in five. There were no side-effects or evidence of toxicity in any of the patients. In an in-vitro study a synergistic effect between ticarcillin and clavulanate was noted against Enterobacteriaceae but only a slight synergistic effect against P. aeruginosa. Studies in patients with normal liver and kidney function showed pharmacokinetic compatibility of the two agents. Timentin can be recommended for the initial treatment of serious infections. PMID- 3636333 TI - Timentin in the treatment of post-operative infections. AB - In an open study 50 patients were treated for a variety of infections with 3.2 g Timentin 6, 8- or 12-hourly for a mean period of six days. Timentin was clinically successful in 87% of patients assessed at the end of treatment of whom 95% remained cured or improved at a later follow-up. Bacteriologically Timentin was successful against 92% of organisms, including all 11 which were ticarcillin or ampicillin resistant. Side effects were reported in seven patients, the majority of which were minor local reactions at the site of infusion. This open study shows Timentin to be a safe and effective antibiotic for the treatment of infection. PMID- 3636334 TI - Empirical antimicrobial therapy with Timentin plus amikacin in febrile granulocytopenic cancer patients. AB - Timentin (ticarcillin plus clavulanic acid) plus amikacin was administered as an empirical regimen to 52 febrile granulocytopenic patients with cancer and appeared as effective as the other commonly recommended combinations of antimicrobial agents. A favourable response was observed in 61% of episodes with bacteraemia and in 83% of the episodes without bacteraemia. However, the efficacy in Gram-positive bacteraemia was suboptimal and the emergence of superinfections caused by Gram-positive cocci may represent a clinical challenge. PMID- 3636335 TI - A prospective randomized study comparing the efficacy of Timentin alone or in combination with amikacin in the treatment of febrile neutropenic patients. AB - One hundred febrile episodes in neutropenic (PMN less than 500/mm3) patients were treated with Timentin alone or in combination with amikacin. The overall response rate in 87 episodes was 82.9% with Timentin alone and 84.5% with the combination. Eleven out of 15 patients with septicaemia were cured by Timentin alone and 12 out of 13 by the combination, a response rate of 73.3% and 92.4% respectively (not-statistically significant P = 1.307). The rates of superinfection were low. Few side effects occurred. Timentin is a useful antibiotic in the treatment of febrile neutropenic patients and was, in this study, as effective alone as in combination with an aminoglycoside in the initial therapy. PMID- 3636336 TI - Timentin in combination with tobramycin as empirical therapy in febrile neutropenic patients with haematological malignancies. AB - Timentin (5.2 g tds) and tobramycin (40 mg tds) were administered to 51 patients (22 male, 29 female, age range 17-72, mean age 40.4) with acute leukaemia, chronic myeloid leukaemia in blastic crisis, severe aplastic anaemia and acute agranulocytopenia. All patients had neutropenia (PMN less than 1000/mm3) and fever (greater than 38 degrees C). Febrile episodes consisted of 22 proved septicaemias due to Gram-positive organisms (Staphylococcus aureus, S. epidermidis, enterococcus) in 11 cases and to Gram-negative organisms (Escherichia coli, Pseudomonas aeruginosa, Alkaligenes faecalis, Serratia marcescens, Klebsiella pneumoniae) in 10 cases. One patient had a polymicrobial infection (P. aeruginosa, S. aureus, non-haemolytic streptococcus). Twenty-nine infections were diagnosed only clinically. The mean duration of treatment was 11.1 days (range 4-20 days). Eighty-seven per cent of evaluable febrile episodes improved. Among 11 infections due to Gram-positive cocci, eight (72%) resolved, and in nine (90%) of ten cases due to Gram-negative bacilli success was obtained. The polymicrobial infection also resolved. In only four patients were mild side effects seen, e.g. exanthema, pruritus, phlebitis: renal toxicity was not observed. These data suggest that the combination of Timentin and tobramycin is an effective and safe empirical antibiotic regimen in febrile neutropenic patients. PMID- 3636337 TI - The activity of ticarcillin in combination with clavulanic acid against Bacteroides species: an in-vitro comparison with other antibiotics. AB - The in-vitro activity of ticarcillin alone and with 4 and 8 mg/l of clavulanic acid, has been studied on 100 strains of Bacteroides (66 Bacteroides fragilis, 13 B. ovatus, 11 B. vulgatus, 6 B. distasonis, 4 B. thetaiotaomicron) by an agar dilution method and compared to that of latamoxef cefoxitin, cefotaxime, ceftizoxime, ceftriaxone, cefmenoxime, ceftazidime and metronidazole. All the strains tested were susceptible to the combination of ticarcillin-clavulanic acid (MIC less than or equal to 8 mg/l), to metronidazole (MIC less than or equal to 4 mg/l), and to cefoxitin (MIC less than or equal to 32 mg/l). The combination of ticarcillin and clavulanic acid has an activity superior to that of ticarcillin alone. The MIC90 was 32 mg/l for ticarcillin alone, 1 and 0.5 mg/l for ticarcillin combined with 4 and 8 mg/l of clavulanic acid respectively. Against all the tested strains, cefoxitin was the most active of the cephalosporins, followed by latamoxef (3% of all strains with an MIC greater than 32 mg/l), cefotaxime (5%), ceftizoxime (9%), ceftriaxone (13%), cefmenoxime (17%) and ceftazidime (33%). Differences in sensitivity to cephalosporins were observed within species; the B. ovatus was clearly more resistant than B. fragilis and B. vulgatus. In all species, the combination of ticarcillin and clavulanic acid was always highly active, with MICs less than or equal to 0.01-8 mg/l. PMID- 3636338 TI - Susceptibility of ticarcillin-resistant gram-negative bacilli to different combinations of ticarcillin and clavulanic acid. AB - The susceptibility of ticarcillin-resistant and of ticarcillin-susceptible Gram negative bacilli to different combinations of ticarcillin and clavulanic acid has been investigated. Susceptibility to ticarcillin has been restored in ticarcillin resistant isolates in proportion to the amount of clavulanic acid in the combination and depending upon the species. The decrease in the MICs of ticarcillin was excellent to good in Proteus, Morganella, Providencia, Escherichia coli and Klebsiella, moderate in Enterobacter, Citrobacter and Serratia, but poor in Pseudomonas aeruginosa. An unfavourable effect of clavulanic acid on the MICs of ticarcillin was observed in some isolates belonging to species with inducible beta-lactamases. PMID- 3636339 TI - Efficacy and pharmacokinetics of Timentin in paediatric infections. AB - Twenty-four children, ten of whom had an infection due to ticarcillin-resistant, Timentin-sensitive bacteria, were treated with Timentin. A full clinical success was obtained in sixteen cases (13 pyelonephritis, nine of them due to ticarcillin resistant, Timentin-sensitive Escherichia coli, two neonatal infections and one pneumonia). Four children were improved (1 bronchiectasis, 3 leukaemias), three were unassessable and one failure occurred with a staphylococcal urinary tract infection. A pharmacokinetic study was performed in three newborns (under three months) and ten children (mean age 3 years). Timentin was administered as four daily 30-min iv infusions. The mean dosage used in patients under three months was 225 mg/kg/d ticarcillin and 9 mg/kg/d clavulanic acid. In infants older than three months of age the mean dosage was 250 mg/kg/d ticarcillin and 16 mg/kg/d clavulanic acid. The pharmacokinetic results demonstrated similar serum concentrations of ticarcillin to those in earlier studies, and serum concentrations of clavulanic acid of 3.1 +/- 0.63 mg/l and 2.18 +/- 0.17 mg/l at 1 h and 2 h respectively after infusion in newborns. For children, at the same times, the serum levels were respectively 2.3 +/- 0.9 mg/l and 1.4 +/- 0.9 mg/l. The peak serum concentrations of clavulanic acid were the same in the two groups of dosages (4.7 mg/l), but the half-lives of clavulanic acid were 1.1 h in children older than three months and 1.8 h in infants younger than 3 months. The tolerance was good. Timentin may be useful as a first line antibiotic in infections in hospitalized children in the dosage described, as three or four injections daily, according to the age and the severity of the disease. PMID- 3636341 TI - Clinical evaluation of Timentin in complicated urinary tract infections. AB - Timentin proved to be highly effective in the treatment of 70 urological patients suffering from complicated urinary tract infections. There were few adverse effects, and development of resistance was not observed. Surgical treatment was possible in each case, without any septic complications. The results show that Timentin is a very useful drug for the urologist who often treats complicated urinary tract infections, especially because of its low re- and super-infection rate and the absence of development of resistance. PMID- 3636340 TI - Timentin versus piperacillin in the treatment of hospitalized patients with urinary tract infections. AB - The efficacy and safety of Timentin (ticarcillin plus potassium clavulanate) and piperacillin were compared in a clinical trial of 78 hospitalized patients with urinary tract infections. There were 37 evaluable patients in the Timentin treated group and 39 in the piperacillin-treated group. The 43 infection sites in each group were primarily complicated pyelonephritis or complicated cystitis; six patients in the Timentin-treated group and four in the piperacillin-treated group also had septicaemia. Both ticarcillin (3 g) plus potassium clavulanate (200 mg) and piperacillin (125-200 mg/kg per day) were administered intravenously. The 43 most common pathogens in each treatment group were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa from the urinary tract and E. coli from the blood. Nine pathogens in the Timentin-treated group and 11 in the piperacillin-treated group were resistant to ticarcillin in vitro. Eradication was achieved for 39 of the 43 (91%) pathogens in the Timentin group, including all six organisms isolated from the blood, and eight (89%) of the ticarcillin resistant pathogens. In the piperacillin-treated group, 33 of the 43 (77%) pathogens were eradicated, including three of the four blood isolates, but only eight (73%) of the ticarcillin-resistant pathogens. Clinical cure or improvement occurred in 97% of the patients in each group. Mild and transient increases in levels of liver enzymes or eosinophils were reported for 11 patients in the Timentin group and seven in the piperacillin group. In one patient in the Timentin group, a drug-related rash and nausea developed, and treatment was discontinued.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3636343 TI - Reactivation of euglenoid movement and flagellar beating in detergent-extracted cells of Astasia longa: different mechanisms of force generation are involved. AB - Detergent-extracted cell models of the euglenoid flagellate, Astasia longa, were obtained that rounded-up on addition of calcium. Treatment with 4% Triton X-100 and Nonidet P-40 removed the flagellar membrane, all membranous structures inside the cell body and the plasma membrane at groove regions of the cell surface. Maximum rounding-up was induced when the concentration of free calcium was raised to greater than or equal to 10(-7) M, and ATP strongly enhanced this response. The ionic requirements and sensitivity to vanadate were different from those for the reactivation of flagellar movement. The results suggest that the mechanism of force generation is different from the dynein-based system of the flagellum and that a rise in cytoplasmic free Ca2+ concentration might cause euglenoid movement in vivo. The mechanism of euglenoid movement is discussed in relation to other protozoan motile systems. PMID- 3636342 TI - Purification and characterization of a protein synthesis inhibitor associated with vaccinia virus. AB - A protein synthesis inhibitor, solubilized from vaccinia virus (Ben-Hamida, F., Person, A., and Beaud, G. (1983) J. Virol. 45, 452-455), has been purified to homogeneity, yielding a basic protein with molecular mass of 11 kDa. This purified protein migrates as a single spot in two-dimensional gel analysis (isoelectric point above 8.6). It is phosphorylated by the vaccinia-associated protein kinase, and it aggregates in the absence of reducing agents. This 11-kDa protein inhibits protein synthesis when added to a reticulocyte lysate at a stoichiometric ratio of approximately one protein molecule/ribosome, and it associates with the ribosome fraction after incubation in reticulocyte lysates or in Ehrlich ascites tumor cell lysates. As previously described for the inhibitor associated with vaccinia cores, the purified inhibitor inhibits the formation of the 40 S ribosomal subunit X Met-tRNAi ribosomal initiation complex. It has no detectable effect on the formation of the ternary complex (Met-tRNAi X GTP X eucaryotic initiation factor 2). This inhibitor associated with vaccinia virus particles may be involved in the shutoff of host protein synthesis and may also be responsible for the absence of virus replication in some cell-virus systems. PMID- 3636344 TI - Being well read ... or reading well. PMID- 3636345 TI - The 1987 Reagan budget and the Gramm-Rudman-Hollings Act. PMID- 3636346 TI - Use of the Norton Pressure Sore Risk Assessment Scoring System with elderly patients in acute care. PMID- 3636347 TI - Nursing management: the continent urostomy. PMID- 3636348 TI - Sexual rehabilitation of the cancer patient undergoing ostomy surgery. PMID- 3636349 TI - Rehabilitation philosophy: a means of fostering a positive attitude toward cancer. PMID- 3636350 TI - Drug therapy and the ostomy patient. PMID- 3636351 TI - Management of long-term percutaneous catheters. PMID- 3636352 TI - Nurses as a social force. AB - Nurses in every continent engage in social action. This, the author argues, has been a fact throughout the ages. The major social issues which contribute to health today are economic, energy, environmental and social welfare problems. Other major issues affecting health are population growth, poverty, education, clean water supply, and family planning. The author shows how individual nurses and nurses' associations can, and should, exercise their influence and power in promoting health at local, national and international levels, making primary health care a priority. By using their levers of power, together with technology and communications, nurses can help create a new world health order, the author concludes. PMID- 3636353 TI - The nurse as advocate for vulnerable persons. AB - This paper discusses the following issues. Advocacy: in planning and implementing nursing care; in primary care; in terminal care; in nursing research; and in health promotion/disease prevention. That which comprises a vulnerable population. Continuum of vulnerability: the potentially vulnerable; the circumstantially vulnerable; the temporarily vulnerable; the episodically vulnerable; the permanently vulnerable; and the inevitably vulnerable. Damaging one's humanity and self-image: loss of independence; barriers to the ability to make choices; the absences and presence of that which is needed; and the loss of individuality. Types of advocacy: human advocacy; animal advocacy; political advocacy; moral-ethical advocacy; legal advocacy; spiritual advocacy; and individual system advocacy. Advocacy concomitants: risk; heat; and prevention. PMID- 3636354 TI - Communication patterns between nursing staff and the ethnic elderly in a long term care facility. AB - The purpose of this study was to examine verbal communication interactions between nursing staff and the elderly residents in a long-term care facility. Three groups of elderly were studied and compared. These were immigrant, Canadian born, and Anglo-born elderly. Non-participant observation and tape recordings were the methods by which data were collected. Findings were transcribed and quantified under headings of 'words spoken', 'commands given', 'statements made', and 'questions asked and answered'. Significant differences in the observed interaction were found between groups. The findings indicate the need for nurses to be aware of the implications of ethnicity in caring for the elderly, and also for further communication studies in this area. PMID- 3636355 TI - Interpersonal support amongst nurses at work. AB - The needs for support of staff in human services work are often stated, but less often is the nature of such support clearly specified. This study attempts to clarify the nature of effective support from a superior, as perceived by qualified nursing staff working in psychiatric, mental handicap and medical settings. 'Personal respect', 'empathic attention' and 'absence of interpersonal defensiveness' appeared to be important components to such support. Staff on the same ward showed a high degree of agreement in judgements of their superior's personal respect and empathic attention, but perceived interpersonal defensiveness appeared more specific to perceptions or interactions between particular staff. Greater degrees of 'personal respect' experienced by staff were associated with reduced role ambiguity and reduced emotional exhaustion ('burnout'). The empathic attention reported as given by ward charge nurses was highly correlated with the personal respect they reported receiving from their own superior. These results support approaches which see respect, empathy and genuineness as important ingredients in helping relationships. PMID- 3636357 TI - The development of a nursing centre on a college campus: implications for the curriculum. AB - The development of nurse-managed centres for health is receiving increased attention in the United States of America. Nursing centres serve a variety of clients and exhibit multiple management designs. This article describes the development of The Nursing and Health Information Centre (NHIC) at Herbert H. Lehman College of the City University of New York, USA. The NHIC is unique in that it is managed by the Department of Nursing and serves as a site for implementing the clinical objectives of the nursing programme. PMID- 3636356 TI - The previous training and present training needs of nurses in charge of alcohol treatment units and community alcohol teams. AB - The aim of the study was to collect information on the educational needs of nurses in charge of alcohol treatment units and community alcohol teams. The sample of all such nurses in England and Wales was asked to complete a postal questionnaire and give information on the training and education they had already received, what further training they needed and brief details about their background and future plans. It was expected that a small proportion of the respondents would have had specialized training and this expectation was borne out. The results do provide evidence of considerable dissatisfaction amongst the group as to the training they receive. It is shown that these nurses wish to develop behavioural and psychotherapeutic skills and that training provided so far has not met these needs. Suggestions are made as to the content of future training events for nurses. PMID- 3636358 TI - Social class, underprivileged areas and psychiatric disorder in the city of Stoke on-Trent. AB - A survey of psychiatric disorder, based on hospital inpatient records, was conducted in the City of Stoke-on-Trent, England for the year 1983. This was used to test the hypothesis that areas of lower social class and greatest underprivilege would display higher rates of inpatient admissions for psychiatric disorder than the more privileged areas of the city. The results confirmed a significant positive correlation between extent of underprivilege of an area and rates of inpatient admissions. The link between lower social class and mental disorder was not directly demonstrated. PMID- 3636359 TI - Nursing students' perceptions of a child: influence of information on family structure. AB - Sixty-eight undergraduate nursing students from a large university in the mid western United States volunteered to participate in a study to determine nursing students' perceptions of a preschool-aged child when information about his family structure was presented. Subjects viewed a videotape of a 4-year-old male. Half of the subjects received written information that the child was from a two-parent family; the other half received written information that the child was a member of a single-parent family. Two instruments, the First Impressions Semantic Differential and the Predicted Behaviour of a Hospitalized Child Questionnaire, and a demographic data sheet, were completed by each subject. In general, a child believed to be from a two-parent family tended to be perceived more positively than a child believed to be from a single-parent family structure. However, when viewed as a potential patient on a hospital unit, no significant differences in perceived behaviours were reported. PMID- 3636360 TI - Broad-based clinical learning experiences: some curricular issues. PMID- 3636361 TI - 'In-basket' research: an education for educators. PMID- 3636362 TI - Sharing expertise with other countries. PMID- 3636363 TI - Clinical contractual agreements: liability or blessing? PMID- 3636365 TI - Evolutions and revolutions in practice: so what's new? PMID- 3636364 TI - The nurse executive. Deaning and the numbers game. PMID- 3636366 TI - Research mentoring. PMID- 3636367 TI - Programs that internationalize nursing curricula in baccalaureate schools of nursing in the United States. PMID- 3636368 TI - Service and education: similar perspectives of the performance of the new baccalaureate graduate. PMID- 3636369 TI - Faculty practice: a view of its development, current benefits, and barriers. PMID- 3636370 TI - Dynamics and dilemmas of the associate and assistant dean roles. PMID- 3636371 TI - Development of an instrument to measure self-reported leadership behaviors of nurse practitioners. PMID- 3636372 TI - Student choice of baccalaureate nursing programs, their perceived level of growth and development, career plans, and transition into practice: a replication. PMID- 3636373 TI - The value of the nursing student loan program. PMID- 3636374 TI - Assessing health needs: the well elderly. PMID- 3636375 TI - GNP and LTC team. PMID- 3636376 TI - ANA speaks out. PMID- 3636377 TI - Diverse learning experiences from a nursing home clinical. PMID- 3636378 TI - Bladder retraining: program for elderly patients with post-indwelling catheterization. PMID- 3636379 TI - Our clients are our best teachers. PMID- 3636380 TI - Sexuality and aging. PMID- 3636381 TI - Doctors, nurses and others in ICU--'drains' or 'radiators'. PMID- 3636382 TI - Continuous ultrafiltration with periods of dialysis. PMID- 3636383 TI - The junior doctor on the intensive care unit. PMID- 3636384 TI - The nurse on the intensive care unit. PMID- 3636385 TI - Neonatal intensive care (provisions and costs). PMID- 3636386 TI - Just coping or burnt-out? PMID- 3636387 TI - Methicillin-resistant Staphylococcus aureus (MRSA) in the German Democratic Republic. Incidence and strain-characteristics. AB - In GDR methicillin-resistance strains of S. Aureus only occur in connection with nosocomial infections with a comparably low incidence (about 2%). They are not found in outpatients. For the detection of MRSA the test on nutrient medium L4 with addition of 5% NaCl has proved successful. All of the MRSA exhibit a rather unique pattern of strain-characteristics; they are nontypable by the basic-set phages and show a reaction with the experimental phage A 994. The MRSA are multiple drug-resistant (generally penicillins, cephalosporins, isoxyzolylpenicillins, oxytetracycline, minocycline, streptomycin, erythromycin, lincomycin and additionally chloramphenicol and gentamycin, kanamycin, tobramycin). The genetical characterization and the plasmid-pattern analysis has shown that only resistance to chloramphenicol and in one case also to macrolides are determined by plasmids (MW 2.0 and 1.8 Megadalton). The determinants for the other resistance-characters are obviously located on the chromosome. Altogether these data indicate that the MRSA described are derivatives of a single-strain clone. PMID- 3636388 TI - After the crash. A school nurse helps Concord students grieve. PMID- 3636389 TI - Burned out: should a battle-weary nurse endure--or find another job? PMID- 3636390 TI - Burned out: should a battle-weary nurse endure--or find another job? A psychologist responds: weigh occupational hazards. PMID- 3636391 TI - Burned out: should a battle-weary nurse endure--or find another job? An ICU nurse responds: accept your limitations. PMID- 3636393 TI - Burned out: should a battle-weary nurse endure--or find another job? The nurse responds: knowing when to quit. PMID- 3636392 TI - Burned out: should a battle-weary nurse endure--or find another job? A pastor responds: expect what God expects. PMID- 3636394 TI - A risk taken, a life changed. The day one nurse shared her faith in the ICU. PMID- 3636395 TI - Holistic health and psychic healers. PMID- 3636396 TI - Healing of memories. What is it? Is it biblical? PMID- 3636398 TI - Infection control. Hepatitis A. PMID- 3636397 TI - Segmental nephron function in rats treated with aprotinin, an inhibitor of kallikrein. AB - The effects on kidney function of aprotinin, an inhibitor of kallikrein and other serine proteinases, were investigated in rats made diuretic by infusion of 0.9% saline. Late proximal, early distal and late distal tubular fluid samples were collected before and after aprotinin administration (20,000 kallikrein I.U./kg b.wt. i.v.). Glomerular filtration rate and urinary excretion of solute and water were assessed simultaneously. Aprotinin did not alter blood pressure or glomerular filtration rate, but reduced urine flow from 23.8 +/- 4.5 to 16.4 +/- 3.4 microliter min-1 100 g-1 (P less than .05) and urinary kinin excretion from 23.5 +/- 3.2 to 10.8 +/- 1.9 pg min-1 100 g-1 (P less than .01). Aprotinin increased the tubular fluid to plasma inulin concentration ratio at late distal tubule puncture site, but not at late proximal or early distal tubule collection sites. Estimates of fluid reabsorption in the distal convoluted tubule, expressed as a percentage of glomerular filtration rate, as a percentage of delivery to this nephron segment or as net volume transported, increased after the administration of aprotinin by 22, 24 and 23% (P less than .05), respectively. In contrast, aprotinin did not alter the estimates of fluid reabsorption in the proximal convoluted tubule, the loop of Henle or the collecting tubule. We conclude that the antidiuretic effect of aprotinin in saline-expanded rats is related to selective augmentation of fluid reabsorption in the distal convoluted tubule. This effect of aprotinin may be the expression of reduced renal kinin levels, inhibition of serine proteases other than kallikrein or other unrecognized properties of the agent. PMID- 3636399 TI - The law and your profession. PMID- 3636400 TI - Your CE topic this month (No. 15). Therapy for Parkinson's disease. PMID- 3636401 TI - It's vital! PMID- 3636402 TI - Quality vs. quantity: which type of nursing do you practice? PMID- 3636403 TI - Care plans--they work for you and your patient. PMID- 3636404 TI - Evelyn was unorganized until she received some good advice on organizational skills (maybe it can help you too!). PMID- 3636405 TI - The impaired nurse. PMID- 3636406 TI - Corrections and mental health. PMID- 3636407 TI - Psychiatric nursing: 1986. PMID- 3636408 TI - "Tea with Demons". PMID- 3636409 TI - Managing manipulation. PMID- 3636410 TI - Acanthamoeba keratitis in soft contact lens wearers. PMID- 3636411 TI - Care of an artificial eye after enucleation--with comments from the author's personal experience. PMID- 3636412 TI - Cobalt plaque therapy--a conservative approach to posterior uveal melanoma. PMID- 3636413 TI - The ophthalmic writer. PMID- 3636414 TI - Confrontation visual field testing. PMID- 3636416 TI - [My professional activities as a midwife in the past 10 years]. PMID- 3636415 TI - [Achievement by midwives in the past 10 years]. PMID- 3636417 TI - [Discussion: changes in women's status over the past 10 years]. PMID- 3636418 TI - [Society based on nature and with emphasis on human lives-transformation from the past materialism and the practice of role assignment according to sex]. PMID- 3636419 TI - [Observation on childbirth and infant care in Copenhagen and Paris]. PMID- 3636420 TI - [Achievements by 4 midwives in the past 10 years]. PMID- 3636421 TI - [Guidance of patients at discharge following gynecologic surgery]. PMID- 3636422 TI - [Changes in the midwifery profession. 11. The process leading to dissolution of the Japanese Society of Midwifery (1948)]. PMID- 3636423 TI - [On puerperal home nursing]. PMID- 3636424 TI - [Circulatory physiology of the newborn infant. (2)]. PMID- 3636425 TI - [Childbirth and child rearing. 10. Sex during pregnancy]. PMID- 3636426 TI - [Difficulties associated with BBT]. PMID- 3636427 TI - [Educational evaluation: on correlation. 1]. PMID- 3636429 TI - [Counseling by medical social workers]. PMID- 3636428 TI - [Planning nutritional guidance for pregnant women. (1)]. PMID- 3636430 TI - [Simple detection of fetal membrane rupture]. PMID- 3636431 TI - [Thyroid diseases and physiopathology in pregnancy, delivery, and puerperium]. PMID- 3636432 TI - [Management of patients with pregnancy complicated with thyroid diseases]. PMID- 3636433 TI - [Nursing standard for pregnant and puerperal patients with thyroid diseases]. PMID- 3636434 TI - [Prognosis of the mother and infant following pregnancy complicated with thyroid diseases]. PMID- 3636435 TI - [Case report: management of a patient with hyperthyroidism complicating severe pregnancy toxemia]. PMID- 3636436 TI - [Creation of a midwifery ambulatory service: a suggestion by an obstetrician]. PMID- 3636437 TI - [Disseminated intravascular coagulation and pregnancy]. PMID- 3636438 TI - [Life and health of mothers and children in a farming community in Java]. PMID- 3636439 TI - [Nursing of a dying patient]. PMID- 3636440 TI - [Body temperature adjustment and heat generation by the newborn infant]. PMID- 3636441 TI - [Evaluation of nursing technology in clinical training in obstetrics: clinical records by the students and a survey on their self-evaluation]. PMID- 3636442 TI - [Nursing of a patient with repeated placental separation at the normal position]. PMID- 3636443 TI - [On childbirth and child rearing. 11. On psychological effects on the fetus in utero]. PMID- 3636444 TI - [Mean remaining years for individuals and life expectancy]. PMID- 3636445 TI - [Educational evaluation. On correlation 2. Correlation coefficient]. PMID- 3636446 TI - [Planning nutritional guidance for pregnant women (2)]. PMID- 3636447 TI - [Start of a new life and the involvement of a social worker]. PMID- 3636448 TI - [Anemia in pregnancy and fetal development]. PMID- 3636449 TI - [Congenital abnormalities-understanding and the role of medicine]. PMID- 3636450 TI - [Basis of assistance for parents who have infants with congenital abnormalities]. PMID- 3636451 TI - [Congenital abnormalities encountered frequently in plastic surgery]. PMID- 3636452 TI - [The role of genetic counseling]. PMID- 3636453 TI - [Sex and childbirth]. PMID- 3636454 TI - [Survey on continued nursing in midwifery education: evaluation by students, clinical midwives, and patients]. PMID- 3636455 TI - [The tear in the doctor's eyes after a difficult but successful childbirth]. PMID- 3636456 TI - [On childbirth and child rearing. 12. Sites of childbirth]. PMID- 3636457 TI - [Body temperature regulation and heat generation by the newborn (2)]. PMID- 3636458 TI - [Asymptomatic placenta praevia during the mid-term of pregnancy]. PMID- 3636460 TI - [Education on food habits]. PMID- 3636459 TI - [Educational evaluation: on correlation-3: on correlation coefficients]. PMID- 3636461 TI - [Lack of responsible attitude in men in unwanted pregnancy]. PMID- 3636462 TI - [Chorionic villi sampling]. PMID- 3636463 TI - [Clinical tests in obstetrics. 16. Diagnosis of placenta praevia, uterine myoma, and ovarian cysts]. PMID- 3636464 TI - [Aging and physiology of pregnancy]. PMID- 3636465 TI - [Pregnancy, delivery and puerperal care of aged primigravida]. PMID- 3636466 TI - [Nursing assistance for aged primigravida]. PMID- 3636467 TI - [Management and health guidance of aged primigravida]. PMID- 3636468 TI - [Lamaze method as the basis of nursing in term pregnancy]. PMID- 3636470 TI - [Observation of extra-uterine adaptation phenomena of newborn infants within 2 hours of birth]. PMID- 3636469 TI - [Case report: massive hemoperitoneum in a pregnant woman who suffered injuries in a traffic accident]. PMID- 3636471 TI - [My experience in obstetrical nursing]. PMID- 3636472 TI - [Psychosocial factors in pregnant and puerperal women]. PMID- 3636473 TI - [Growth and development of the fetus and newborn infants]. PMID- 3636475 TI - [Pregnant women and alcoholic beverages]. PMID- 3636474 TI - [Childbirth and child rearing. 13. Methods of childbirth, with special reference to postures]. PMID- 3636476 TI - [Educational measurement: on the criteria of evaluation]. PMID- 3636477 TI - [Use of data on pregnancy and delivery in the medical social service]. PMID- 3636478 TI - [Injection of a physiological saline into the amniotic cavity during delivery]. PMID- 3636479 TI - [Clinical tests in obstetrics. 17. Diagnosis of cephalopelvic disproportion]. PMID- 3636480 TI - [Encounter with childbirth. A discussion]. PMID- 3636481 TI - [Rediscovery of self through childbirth]. PMID- 3636482 TI - [Unexpected difficulty in labor: my experience in delivery]. PMID- 3636483 TI - [My experience in childbirth and study in sociology]. PMID- 3636484 TI - [A survey on clinical training of male nursing students in obstetrics]. PMID- 3636485 TI - [Nursing of a patient with moya-moya disease throughout pregnancy and delivery]. PMID- 3636486 TI - [Questions and answers on breast feeding: management of depressed nipples]. PMID- 3636487 TI - [Lessons from predecessors in midwifery. 5. Ms. Iyo Katsuragawa. Interview by F. Ogawa]. PMID- 3636488 TI - [Memory of my mother who was an experienced midwife]. PMID- 3636489 TI - [Childbirth and child rearing. 14. Religious practice concerning safe childbirth]. PMID- 3636491 TI - [Neonatal jaundice (1)]. PMID- 3636490 TI - [Perinatal nursing of mothers and infants: a psychosocial approach. 2. Nursing of pregnant patients under stress]. PMID- 3636492 TI - [Fetal tobacco syndrome]. PMID- 3636493 TI - [On educational evaluation. The use of evaluation criteria]. PMID- 3636494 TI - [Marriage and registration of minors]. PMID- 3636495 TI - [Women with renal insufficiency and their pregnancy and delivery]. PMID- 3636496 TI - [Decubitus ulcer]. PMID- 3636497 TI - [The mechanism of development of decubitus ulcer and its clinical treatment]. PMID- 3636498 TI - [Basic nursing technics for prevention of decubitus ulcer]. PMID- 3636499 TI - [Trends in nursing research on decubitus ulcer]. PMID- 3636500 TI - [Causes for the development of decubitus ulcer: work analysis at a neurosurgical ward]. PMID- 3636501 TI - [Causes for the development of decubitus ulcer: work analysis at an orthopedic ward]. PMID- 3636502 TI - [Innovation in intraoperative posture and prevention of decubitus ulcer]. PMID- 3636503 TI - [Prevention of decubitus ulcer in patients with consciousness disorders]. PMID- 3636504 TI - [Prevention of decubitus ulcer in stroke patients]. PMID- 3636505 TI - [Prevention of decubitus ulcer in patients with spinal cord injuries]. PMID- 3636506 TI - [Prevention of decubitus ulcer in patients with severe mental disorders]. PMID- 3636507 TI - [Various innovations in the management of decubitus ulcer]. PMID- 3636508 TI - [Health instruction given to patients and their families for the prevention of decubitus ulcer]. PMID- 3636509 TI - [Efforts for total eradication of decubitus ulcer]. PMID- 3636510 TI - [Treatment of head injuries]. PMID- 3636511 TI - [Nursing of patients with head injuries]. PMID- 3636512 TI - [Prevention and treatment of decubitus ulcer at a geriatric ward]. PMID- 3636513 TI - [Nursing of an aged patient with enterostomy]. PMID- 3636514 TI - [New bedside nursing technology. Interactions with patients through their acceptance (listening)]. PMID- 3636515 TI - [New clinical tests. 4. RI diagnosis]. PMID- 3636516 TI - [Information on new drugs. 4. Drugs used for the treatment of gastric and duodenal ulcer]. PMID- 3636517 TI - [Nursing technics in home care. 4. Symptoms common among aged patients and their nursing (1). Care of decubitus ulcer]. PMID- 3636518 TI - [Nursing and medico-legal problems. 4. Accidents at hospitals]. PMID- 3636519 TI - [On the "expression" used in nursing records. Conditions for records which can be understood--ABC of recording]. PMID- 3636521 TI - [The quality of information and the patient-nurse relationship--language and conversation in accepting the patient as an individual]. PMID- 3636520 TI - [On the "expression" used in nursing records. Records which transmit the intention of the recorder]. PMID- 3636522 TI - [Nursing records and language. Concern of the observer and the language used in records--evaluation and utilization of the records]. PMID- 3636523 TI - [Nursing records and language. Nursing records and the problem of the language]. PMID- 3636524 TI - [Nursing records and language. Abbreviations used in nursing records--a re evaluation of a trial in the use of abbreviations at an ICU]. PMID- 3636526 TI - [A need for a "simplified record" and the comprehensive description of the patient]. PMID- 3636525 TI - [Nursing records as a method of communication. The nursing record and the attitude of nurses--nursing attitude necessary in the introduction of the SOAP record in POS]. PMID- 3636527 TI - [Individual description of the patient and formats for the nursing record]. PMID- 3636528 TI - [Nursing records as a form of communication. Judgment by the recorder and the resultant record]. PMID- 3636529 TI - [Nursing records as a form of communication. Continuation of the care and the nursing record]. PMID- 3636530 TI - [Nursing records as a form of communication. Records for information exchange in team nursing and methods of expression]. PMID- 3636531 TI - [Nursing records as a form of communication. A nursing record for a patient hospitalized for an extended period]. PMID- 3636532 TI - [Nursing records as a form of communication. Use of the nursing record at the initial admission--evaluation of the record of a patient who was hospitalized for the second time]. PMID- 3636533 TI - [Nursing records as a form of communication. A study of the nursing record of a patient who attempted suicide]. PMID- 3636534 TI - [Nursing records as a form of communication. A nursing record of an emergency patient--an innovation in preparing a record which is useful in continued care]. PMID- 3636535 TI - [Nursing records as a form of communication. Nursing records for children who have difficulty in expressing themselves--a case of cerebral palsy]. PMID- 3636536 TI - [Innovation and expressions used in the nursing record needed at patient transfer between departments or hospitals]. PMID- 3636537 TI - [Nursing records for communication between health facilities and regional health services]. PMID- 3636538 TI - [Nursing records used in home nursing--expressions used in the nursing records]. PMID- 3636539 TI - [Science of sleep in man. Discussion]. PMID- 3636540 TI - Volunteerism and community health nurses. PMID- 3636542 TI - Volunteerism, the community and the nursing professional. PMID- 3636541 TI - Volunteering for wellness in Southeast Kansas. PMID- 3636543 TI - After retirement, then what? PMID- 3636544 TI - 1985: Christmas with the homeless. PMID- 3636545 TI - Organ transplantation: the Pandora's box of issues. PMID- 3636546 TI - Computer corner. PMID- 3636548 TI - [Diet therapy in chronic gastritis]. PMID- 3636547 TI - Cracking the code: professional dilemmas for nurses. PMID- 3636549 TI - [Diet therapy in peptic ulcer (diets Nos. 1a, 1b and 1)]. PMID- 3636550 TI - [Diet therapy in constipation]. PMID- 3636551 TI - [Diet therapy in ischemic heart disease]. PMID- 3636552 TI - [Diet therapy in gout]. PMID- 3636553 TI - [Diet therapy in obesity]. PMID- 3636554 TI - [Propagandizing knowledge of harmful habits among patients]. PMID- 3636555 TI - [Work of the charge nurse in the oncology ward]. PMID- 3636557 TI - [Rectal administration of antibacterial preparations]. PMID- 3636556 TI - [Dietotherapy in liver and biliary tract diseases]. PMID- 3636559 TI - [Work in universal dispensary care at the Smela City Hospital]. PMID- 3636558 TI - [Doctor-teacher observations of the physical education lesson in school]. PMID- 3636560 TI - [Characteristics of the immune status of newborn and infants in the 1st year of life]. PMID- 3636561 TI - [Therapeutic massage in infantile cerebral palsy]. PMID- 3636562 TI - [Mastocytosis in children]. PMID- 3636563 TI - [Chemotherapy of malignant neoplasms in children]. PMID- 3636564 TI - [Organization and work of milk kitchens today]. PMID- 3636566 TI - [Alopecia]. PMID- 3636565 TI - [Use of mefenamine sodium salt in the combined therapy of periodontal diseases]. PMID- 3636567 TI - [Deontological aspects of the relationships between medical personnel and the patient]. PMID- 3636568 TI - [Diet therapy in pancreatic diseases]. PMID- 3636569 TI - [The Communist Party's concern for public health]. PMID- 3636570 TI - "Right to know" as a provider--as an employee. PMID- 3636571 TI - The death of the USS Hornet. PMID- 3636573 TI - A study in nipple care. PMID- 3636572 TI - Disposables versus Terries. PMID- 3636574 TI - Breast care during lactation--ancient or modern? PMID- 3636575 TI - Odontogenic polarity and Butler's field theory. AB - Tooth shape potential resides in those ectomesenchymal cells that colonise the presumptive jaws prior to the commencement of odontogenesis. Support for Butler's field theory as applied to the human dentition hinges on the observation that distal teeth within each morphogenic class are the most variable. This variability, it has been argued, reflects a decrease in the concentration of field substance with increased distance from the polar teeth. In contrast to the above, it is suggested here that tooth size variability should be related to the length of time spent in the soft tissue stage prior to calcification. It is argued that a long soft tissue stage will result in a variable phenotype and vice versa. Odontometric variability of distal teeth is thus unrelated to morphogenetic field concentrations and hence fails to support Butler's field theory. PMID- 3636576 TI - Dual neuroendocrine glands: sensitivity of the pineal gland to hormonal feedback. AB - Numerous studies have tried to determine whether alterations in the hormonal content of the plasma would modify pineal function. Recent evidence has indicated that the pineal is relatively insensitive to alterations in plasma hormone concentration, as contrasted with the neuroendocrine hypothalamus which is very responsive to hormonal feedback. Therefore, two types of neuroendocrine glands appear to exist based on their ability to respond to hormonal feedback. The first type of neuroendocrine gland, exemplified by the neuroendocrine portion of the hypothalamus, is extremely sensitive to hormonal modulation and is concerned with maintaining the endogenous balance of plasma hormones. The second type of neuroendocrine gland, exemplified by the pineal gland, is principally responsible for converting its neural input, usually a environmental stimulus, into a hormonal messenger, irrespective of plasma hormone levels. These two types of neuroendocrine glands would act in synchrony to maintain homeostasis throughout a variety of external conditions. PMID- 3636577 TI - Cancer resistance, carcinogenesis and ground substance viscosity. AB - Tumor host resistance and promotion are multiple complex simultaneous phenomena. This paper relates only to the effect of ground substance viscosity on tumor host interaction. Tar, anthralin, ultraviolet light, x-ray and arsenic have been widely used to treat inflammatory skin disorders such as psoriasis. They are also well known carcinogens. It is proposed that both the anti-inflammatory effect and part of the carcinogenic effect could occur by decreasing ground substance viscosity and suppressing fibroblasts. Streptococcal infections, chloroquine and pyridoxine deficiency increase inflammatory skin disorders and are known to be beneficial to tumor resistance. It is proposed that both effects could occur because of their effect of increasing ground substance viscosity and, at least with streptococcal infections, by stimulating fibroblasts. Within certain limits, vitamin C has a stimulant effect on fibroblast and ground substance viscosity. Beta carotene is active in stimulating wound healing. Localized edema of the dermal papillae precedes granulocytic inflammation in disorders like psoriasis. Anything that decreases ground substance viscosity will prevent dilution of tissue fluids by decreasing localized edema and thus decrease formation of some mediators of inflammation. Anything that increases ground substance and its viscosity will promote local dilution of tissue fluid. Increasing dilution of tissue fluids promotes the formation of some mediators of inflammation. Tumors commonly secrete hyaluronidase. It is proposed that substances that decrease ground substance viscosity (hyaluronidase-like activity) encourage tumors and substances that increase ground substance viscosity (anti-hyaluronidase-like effect) increase resistance to tumors. PMID- 3636578 TI - A re-evaluation of nutritional goals--not just deficiency counts. AB - There is considerable controversy about the soundness and relevance of so-called "megavitamin" therapy for various illnesses. In this article it is suggested that this disagreement is caused to a large extent by the use of two very different approaches to nutrition, which are referred to here as the "nutritional need" and "optimal intake" approaches. It is clear that a re-evaluation of the goals of nutrition is required, as nutritional recommendations deal mainly with the prevention of deficiency diseases and are not concerned with optimal levels of intake. PMID- 3636579 TI - Lung cancer: is fluoride in cigarette smoke an etiological factor? PMID- 3636580 TI - Period and cohort trends in mortality from cancers of the uterus in England and Wales. A new theory of changing gene frequencies. AB - Analysis of the age distribution of cancers of the uterus reveals three clearly distinctive types: early- and late-onset cancers of the cervix and one form of cancer of the corpus. England and Wales mortality data are available for the three types combined from 1911; cancers of the cervix and corpus have been listed separately from 1951. In the highest age groups, 60-64 yr and above, death rates fell fairly steadily from 1921-25 to 1981-82 whereas cigarette smoking - an alleged cause of cervical cancer - rose over much of that period. In the younger age groups, 55-59 yr and below, the more complicated temporal trends include two marked cohort dips. The first dip affected cohorts born around 1911; this was followed by a rise up to the 1921 central cohort, then a steep fall to the 1936 central cohort and, finally, a further rise up to the 1946 cohort (at least). The period trends are probably caused by a decline in the impact of one or more precipitators of cervical cancer, such as the papilloma virus. Cohort shifts are attributed to autoaggressive attacks on parental germ cells, the zygote, or early stage embryo that induce gene change to affect the frequency of women genetically predisposed to early-onset cervical cancer. Attacks are also triggered by one or more precipitating agents with a temporal, and possibly a seasonal, dependence. Implications of this hypothesis of cohort shifts are discussed. PMID- 3636581 TI - Left ventricular dysfunction and altered autonomic activity: a possible link to sudden cardiac death. AB - There is now a growing body of clinical evidence that suggests a strong association between left ventricular dysfunction and sudden cardiac death in patients recovering from myocardial infarction. The mechanisms underlying this association remain to be determined. Alterations within the autonomic nervous system may represent one factor that links an impairment in cardiac function to an increased mortality. Since ventricular dysfunction would tend to reduce stroke volume, an increased sympathetic and/or decreased parasympathetic efferent activity may compensate for this fall in stroke volume by increasing heart rate and/or the force of contraction (inotropic state) in an attempt to maintain a more normal cardiac output. Similar changes in autonomic activity are, in fact, known to increase the vulnerability to ventricular fibrillation. Therefore, I propose that myocardial infarction induces changes in cardiac function which in turn elicits autonomic efferent changes. As a consequence of these compensatory reflex changes the heart becomes less electrically stable and thereby more prone to lethal arrhythmias. PMID- 3636582 TI - Differences in human serum copper and zinc levels in healthy and patient populations. AB - This report is designed to re-examine the use of our presently accepted normal laboratory levels for human serum zinc and copper and to suggest a technique, previously unreported in the literature, to more precisely understand the relationship of serum zinc and copper in health and disease. Data from a patient population of 95 and a healthy population of 115 who met certain criteria are compared. PMID- 3636583 TI - Bone marrow in boneless fish: lessons of evolution. AB - The existence of marrow tissue in cartilaginous ganoid fish, before the evolutionary development of bone, implies that the marrow and bone are two independent organs, developed separately and merged together by evolutionary pressure. Their relation is, therefore, matrimonial and not patrimonial. This should form a frame of reference for studying the interrelationship of bone and marrow. Some of the possible physiologic consequences of this merger are discussed. Evolutionary aspects of hemopoiesis have a potential for yielding information that may not otherwise be possible. PMID- 3636584 TI - Systemic lupus erythematosus: a role for anti-receptor antibodies? AB - Systemic lupus erythematosus (SLE) is considered by many to represent the best example of human disease where immune complexes play a primary role in the pathogenesis. SLE is thought to have an autoimmune basis; a conclusion based largely upon the propensity of these patients to form antibodies to cell nuclear components. The etiology of SLE remains unknown, as does the mechanism by which nuclear components are rendered autoantigenic. Here we present an argument for considering SLE as an antireceptor autoimmune disease, analogous to Graves' disease or myasthenia gravis. The proposed target of autoimmune attack, the estrogen receptor (ER), is normally resident in the nucleus, physiologically more active in women, and shed from hormonally responsive tissues during the course of the menstrual cycle. Autoantigenicity of ER is enhanced in SLE patients owing to a biochemical abnormality of estrogen metabolism which favors ligand occupancy of the receptor. The spectrum of anti-nuclear antibodies characteristic of SLE arises via normally functioning immune network regulatory mechanisms. PMID- 3636585 TI - Using learning contracts to support change in nursing organisations. PMID- 3636586 TI - A case study in developing an ENB pilot scheme in general student nurse education. PMID- 3636587 TI - Learning about groups. PMID- 3636588 TI - The emergence of sick children's nursing. Part 2. PMID- 3636590 TI - Supporting parents in the NICU. PMID- 3636589 TI - The caring profession. PMID- 3636591 TI - Promoting normal growth and development in the hospital environment. PMID- 3636592 TI - Retrolental fibroplasia: what we know and what we don't know (continuing education credit). PMID- 3636593 TI - Percutaneous nephrostomy tubes in the neonate with obstructive uropathy. PMID- 3636594 TI - Jeff's story: a unique approach to the care of an infant with esophageal atresia and a cervical esophagostomy. PMID- 3636596 TI - Watch the pennies and the pounds will look after themselves: a study of stock control in the operating theatre. PMID- 3636597 TI - On-call and stand-by questionnaire. PMID- 3636595 TI - Structural relationship between tRNALys2 and tRNALys4 from mouse lymphoma cells. AB - Mouse lymphoma cells have three major isoaccepting lysine tRNAs. Two of these isoacceptors, tRNALys2 and tRNALys4, were sequenced by rapid gel or chromatogram readout methods. They have the same primary sequence but differ in two modified nucleotides. tRNALys4 has an unmodified uridine replacing one dihydrouridine and an unidentified nucleotide, t6A*, replacing t6A. This unidentified nucleotide is not a hypomodified form of t6A. Thus, tRNALys4 is not a simple precursor of tRNALys2. Both tRNAs have an unidentified nucleotide, U**, in the third position of the anticodon. Also, partial sequences of minor homologs of tRNALys2 and tRNALys4 were obtained. The distinctions between tRNALys2 and tRNALys4 may be part of significant cellular roles as illustrated by the differential effects of these isoacceptors on the synthesis by lysyl-tRNA synthetase of diadenosine 5',5'''-P1,P4-tetraphosphate, a putative signal in DNA replication. PMID- 3636598 TI - Mechanism of recognition of the 5' splice site in self-splicing group I introns. AB - Group I introns include many mitochondrial ribosomal RNA and messenger RNA introns and the nuclear rRNA introns of Tetrahymena and Physarum. The splicing of precursor RNAs containing these introns is a two-step reaction. Cleavage at the 5' splice site precedes cleavage at the 3' splice site, the latter cleavage being coupled with exon ligation. Following the first cleavage, the 5' exon must somehow be held in place for ligation. We have now tested the reactivity of two self-splicing group I RNAs, the Tetrahymena pre-rRNA and the intron 1 portion of the Neurospora mitochondrial cytochrome b (cob) pre-mRNA, in the intermolecular exon ligation reaction (splicing in trans) described by Inoue et al. The different sequence specificity of the reactions supports the idea that the nucleotides immediately upstream from the 5' splice site are base-paired to an internal, 5' exon-binding site, in agreement with RNA structure models proposed by Davies and co-workers and others. The internal binding site is proposed to be involved in the formation of a structure that specifies the 5' splice site and, following the first step of splicing, to hold the 5' exon in place for exon ligation. PMID- 3636599 TI - Cephalosporin antibiotics can be modified to inhibit human leukocyte elastase. AB - Several laboratories, including our own have reported the synthesis and activity of certain low relative molecular mass inhibitors of mammalian serine proteases, especially human leukocyte elastase (HLE, EC 3.4.21.37), an enzyme whose degradative activity on lung elastin has been implicated as a major causative factor in the induction of pulmonary emphysema, and which is present in the azurophil granules of human polymorphonuclear leukocytes (PMN). Normally, these granules fuse with phagosomes containing engulfed foreign material (such as bacteria), and HLE, in combination with other lysosomal enzymes, catabolizes the particles. Under certain pathological conditions, however, PMN become attached to host protein (elastin fibres, basement membrane, connective tissue, immune complexes), and in response to this adherence, the granules may fuse with the PMN outer membrane and release their contents, including HLE, directly onto the tissue. Besides emphysema, HLE may also contribute to the pathogenesis of disease states such as adult respiratory distress syndrome, and its potential involvement in rheumatoid arthritis makes HLE inhibitors of considerable interest. It is known that cephalosporin antibiotics (for example, cephalothin (compound I, Table 2)) are acylating inhibitors of bacterial serine proteases which help synthesize the cell wall by performing a transpeptidation reaction on a peptidyl substrate bearing a D-Ala-D-Ala terminus. We now report that neutral cephalosporins (that is, compounds not bearing a free carboxyl at position C-4) can be modified to become potent time-dependent inhibitors of HLE. PMID- 3636600 TI - Clinical teachers and teaching. PMID- 3636601 TI - Nursing in Israel. PMID- 3636603 TI - Clinical nurse specialists. PMID- 3636602 TI - Nursing models: a personal view. PMID- 3636604 TI - The clinical nurse specialist. PMID- 3636605 TI - Nurse specialisation--an alternative route? PMID- 3636606 TI - The clinical nurse specialist in critical care. PMID- 3636607 TI - Conflict and co-operation between doctors and nurses in primary health care. PMID- 3636608 TI - The nursing instructor and clinical teaching. PMID- 3636609 TI - The changing concept of dependence--in the drug and alcohol field. PMID- 3636610 TI - An investigation of the diagnostic skills of nurses on an acute medical unit relating to the identification of risk of pressure sore development in patients. PMID- 3636611 TI - Core plans: nursing models and the nursing process in action. PMID- 3636612 TI - Shaping nursing process. PMID- 3636613 TI - Achieving wellness. PMID- 3636614 TI - Facing ethical dilemmas. PMID- 3636616 TI - Outward bound. PMID- 3636615 TI - Who's the boss? Power struggles. PMID- 3636618 TI - Concerns about passive smoking. PMID- 3636617 TI - ICU sensory deprivation. PMID- 3636619 TI - What do you say?--when you can't say normal. PMID- 3636620 TI - Standards of care (Part 2)--Application. PMID- 3636621 TI - Real images. Nurses respond to NBC over "accurate portrayals". PMID- 3636623 TI - Good starting point. PMID- 3636622 TI - Royal College of Nursing. Momentum. PMID- 3636624 TI - Making a difference. PMID- 3636625 TI - Babies saved from chills by quick thinking nurses. PMID- 3636627 TI - Future success of RRB effectiveness is in the hands of the membership. PMID- 3636626 TI - Royal College of Nursing. The basics. PMID- 3636628 TI - Coping with cancer. PMID- 3636629 TI - Royal College of Nursing. Vital cooperation. PMID- 3636630 TI - Egyptian examples. PMID- 3636632 TI - Royal College of Nursing. Career choice. PMID- 3636631 TI - Pursue the project. PMID- 3636633 TI - Membership unity. PMID- 3636634 TI - Working with CESP. PMID- 3636635 TI - From the President. The need for nurses to become involved in marketing. PMID- 3636636 TI - Susan Yates, R.N. PMID- 3636637 TI - Home i.v. therapy. Part II. PMID- 3636638 TI - Home blood component therapy--an alternative. PMID- 3636639 TI - Internal jugular vein thrombosis. A rare complication of long-term indwelling subclavian vein catheters. PMID- 3636641 TI - Nursing research at the baccalaureate level. PMID- 3636640 TI - Virus: a concern in transfusion therapy. PMID- 3636642 TI - Strong efforts still needed to survive lean times. PMID- 3636643 TI - Blending key ingredients to assure quality in home health care. PMID- 3636644 TI - Guiding patients through the labyrinth of home health care services. PMID- 3636645 TI - Program under siege: the politics of defense. PMID- 3636646 TI - Sharpening nursing's focus by focusing on health. PMID- 3636647 TI - Nursing diagnoses and interventions: new tools to define nursing's unique role. PMID- 3636648 TI - Nursing education: statistics you can use. PMID- 3636649 TI - Accidental poisoning. PMID- 3636650 TI - Anatomy of a murmur (continuing education credit). PMID- 3636652 TI - Donor cards: a matter of death--and life. PMID- 3636653 TI - Take a look at nursing now--and tomorrow. PMID- 3636651 TI - Don't keep packaging problems under wraps. PMID- 3636654 TI - Problems in paradise. PMID- 3636655 TI - The fine art of measuring tracheal cuff pressure. PMID- 3636656 TI - Home care for the elderly in three-part harmony. PMID- 3636657 TI - Giving pediatric code drugs: no longer a calculated risk. PMID- 3636658 TI - Professional growth. TPR (theory, practice and research): nursing's vital signs. PMID- 3636659 TI - A good sales job. PMID- 3636660 TI - Renacidin irrigation for struvite stones. PMID- 3636661 TI - Nursing can do without ... St. Elsewhere. PMID- 3636662 TI - Cardiac tamponade. Action stat! PMID- 3636663 TI - Drug interactions--another good reason for checking and rechecking before you administer medications (continuing education credit). PMID- 3636664 TI - Preventing drug interactions--it starts with you. PMID- 3636665 TI - Look beyond your state for your standards of care. PMID- 3636666 TI - Managing the patient with testicular cancer. Nursing grand rounds. PMID- 3636667 TI - Take a reading on your blood pressure techniques. PMID- 3636668 TI - Winning hearts and minds: let's hold on to our own in professional turf battles. PMID- 3636669 TI - No code--helping the family understand what it means. PMID- 3636670 TI - Artificial airways = real risks. PMID- 3636671 TI - Adult day care--a new ambulatory care alternative. PMID- 3636672 TI - 20 rules for good charting. PMID- 3636673 TI - Interpreting blood glucose studies. PMID- 3636674 TI - Just be a friend. PMID- 3636676 TI - Hug a patient, p.r.n. PMID- 3636675 TI - Get out of nursing, traitors. Nursing has its share of Benedict Arnolds--and they're hurting the profession. PMID- 3636677 TI - Scars: formation and effects. PMID- 3636678 TI - The treatment of leg ulcers. PMID- 3636679 TI - Wound care in the community. PMID- 3636680 TI - Pressure sores: causes and prevention. PMID- 3636682 TI - Self-inflicted wounds. PMID- 3636681 TI - Care and management of pressure sores. PMID- 3636683 TI - Zone therapy. PMID- 3636684 TI - Fundamentals of nutrition. PMID- 3636685 TI - Slimming safely. PMID- 3636686 TI - Wound healing: a nutritional perspective. PMID- 3636687 TI - Determinant of food intake. PMID- 3636688 TI - Eating and drinking. PMID- 3636689 TI - Changing our eating habits. PMID- 3636690 TI - The Griffiths Report: what might it mean to nursing? PMID- 3636691 TI - How to survive the coming changes in nursing: 5 things you can do. PMID- 3636692 TI - Communicating better with the elderly: how to break down the barriers. PMID- 3636693 TI - Recognizing the many faces of fear. PMID- 3636694 TI - Getting organized: how to finish on time when everything goes wrong. PMID- 3636695 TI - How to fine-tune your assessment of breath and heart sounds (continuing education credit). PMID- 3636696 TI - How to handle criticism. PMID- 3636697 TI - How to shorten your patient's hospital stay safely. PMID- 3636698 TI - Best ideas from NursingLife. PMID- 3636699 TI - How to avoid lawsuits. PMID- 3636700 TI - Critical care nursing--Part I. PMID- 3636701 TI - Unexplained equipment failures. PMID- 3636702 TI - Equipment fair. PMID- 3636703 TI - Job-sharing: an alternative work pattern for nurses. PMID- 3636704 TI - Nursing productivity: from data to definition. PMID- 3636705 TI - Decentralization: cardiac care as a case in point. PMID- 3636706 TI - Monday to Friday: a short stay surgical unit. PMID- 3636707 TI - Equipment trials make sense. PMID- 3636708 TI - A strategic plan for the management of patients with AIDS. PMID- 3636709 TI - Designing a forms management program. PMID- 3636710 TI - ICON: a model of nursing practice for the future. PMID- 3636711 TI - Problem employees. PMID- 3636712 TI - Post-mortem blues: evaluating educational program failures. PMID- 3636713 TI - Education and cancer screening. PMID- 3636714 TI - Staff development for the night shift. PMID- 3636715 TI - Accent the positive. PMID- 3636716 TI - Decentralizing nursing management. PMID- 3636717 TI - Effective management training. PMID- 3636718 TI - Nursing in the year 2000: learning from the future. PMID- 3636719 TI - Job enrichment: putting motivators to work. PMID- 3636720 TI - Multi-disciplinary patient care planning. PMID- 3636722 TI - Professional authority: defeating the "My Girls" syndrome. PMID- 3636721 TI - The self in the organization. PMID- 3636723 TI - A practical "Welcome Back" for inactive RNs. PMID- 3636724 TI - Art and science of management. A contract of commitment. PMID- 3636725 TI - Critical care nursing--Part II. Law for the nurse manager. PMID- 3636726 TI - Computers: integrating information-world into nursing. PMID- 3636727 TI - Management information systems: determining nurse manager requirements. PMID- 3636728 TI - Managing nursing care with a personal computer. PMID- 3636730 TI - Keeping your balance in a stressful work culture. PMID- 3636729 TI - Computerized nurse staffing systems: you'd better shop around! PMID- 3636731 TI - Defending a capital budget item: an approach that works. PMID- 3636732 TI - Powernomics: a concept every nurse should know! PMID- 3636733 TI - "Right stuff" clinical services leaders. PMID- 3636734 TI - Nurse trustee: getting power over policy. PMID- 3636735 TI - Communication aids. PMID- 3636736 TI - Consultation: using the expert in all of us. PMID- 3636737 TI - Eight steps to better staff selection. PMID- 3636738 TI - Profiling nurses as managers. PMID- 3636739 TI - Clinical ladders: back to the drawing board. PMID- 3636740 TI - Learning to lead. PMID- 3636741 TI - Planning to promote self-care. PMID- 3636742 TI - Nursing standards: models of expectations, guardians of the profession. PMID- 3636743 TI - The case of the reluctant role model: from health to heresy. PMID- 3636744 TI - The telephone: an excellent source for communicating with foreign patients. PMID- 3636745 TI - The challenge of AIDS. PMID- 3636746 TI - Initiating group work in nursing. PMID- 3636747 TI - Application of nursing diagnosis in the clinical setting. PMID- 3636748 TI - Nursing--an academic discipline? Reflections on the past, images for the future. PMID- 3636749 TI - [Changes in the nasal and pharyngeal mucosa in persons exposed to cement dust]. PMID- 3636750 TI - Child safety seat misuse. PMID- 3636751 TI - Malpractice insurance update. PMID- 3636752 TI - How to write an article for publication. PMID- 3636753 TI - Nurses care: buckle up. PMID- 3636754 TI - Care occupant safety--a national priority. PMID- 3636756 TI - Caring for the child in a spica cast: a parent's perspective. PMID- 3636755 TI - Practical considerations in caring for a child in a hip spica cast: an evaluation using parental input. PMID- 3636757 TI - The adolescent in a spica cast. PMID- 3636758 TI - Time management: the time is now (continuing education credit). PMID- 3636759 TI - Guide to lateral ankle sprain management. PMID- 3636760 TI - Professional development for orthopaedic nurses through patient care conferences. PMID- 3636761 TI - Radiology review (femoral fractures in children). PMID- 3636762 TI - Nursing home reform: on being part of the problem. PMID- 3636764 TI - Case studies in nursing theory. PMID- 3636763 TI - The legal role regarding medications. Part II. PMID- 3636765 TI - Case studies in nursing theory. Orlando's theory. PMID- 3636766 TI - Case studies in nursing theory. The Roy adaptation model. PMID- 3636767 TI - The Neuman systems model: description and application. PMID- 3636768 TI - Case studies in nursing theory. Humanistic nursing: the phenomenological theory of Paterson and Zderad. PMID- 3636769 TI - Case studies in nursing theory. King's theory of goal attainment. PMID- 3636770 TI - Pattern as methodology for assessing family health: Newman's theory of health. PMID- 3636771 TI - Orem's general theory of nursing. PMID- 3636772 TI - Case studies in nursing theory. Rogers's conceptual model. PMID- 3636773 TI - Patterns in specialization: challenge to the curriculum. PMID- 3636774 TI - The specialist in the marketplace: analysis of supply and demand. PMID- 3636775 TI - Specialization at the master's level: orthopaedic nursing. PMID- 3636776 TI - Specialization and the graduate curriculum: where does it fit? PMID- 3636777 TI - The process of curriculum design. PMID- 3636778 TI - Education for ethical decision making. PMID- 3636779 TI - Specialty core curriculum: competencies in maternal-infant nursing. PMID- 3636780 TI - Ethical issues in advanced nursing practice. PMID- 3636781 TI - Infection control nursing: challenge to the curriculum. PMID- 3636782 TI - Rituals without reason: updating the curriculum in infection control. PMID- 3636784 TI - Teaching the teacher: preparing the educator of specialists. PMID- 3636783 TI - Patterns of preparation: the nurse executive. PMID- 3636785 TI - The cost of preparing a nurse specialist: who should pay? PMID- 3636786 TI - Costs of preparing the specialist: nurse practitioners and nurse-midwives. PMID- 3636787 TI - Master's prepared caregivers in line positions: a case study. PMID- 3636788 TI - The clinical nurse specialist in a staff position. PMID- 3636789 TI - Specialization without walls: community-based nursing. PMID- 3636790 TI - Challenging the curriculum: the future of specialization. PMID- 3636791 TI - Specialization and fragmentation: the enterostomal therapist. PMID- 3636793 TI - Regulating advanced nursing practice: state regulatory boards. PMID- 3636792 TI - Accreditation: the state of the art. PMID- 3636794 TI - Nurse practice acts: the advanced practitioner. PMID- 3636795 TI - Promoting partnership: education, service, and specialization. PMID- 3636796 TI - Certification: self-regulation for specialty practice. PMID- 3636797 TI - Specialization in the undergraduate curriculum: does it fit? PMID- 3636799 TI - Understanding the academic role: a handbook for new faculty. PMID- 3636798 TI - Specialization at the baccalaureate level: occupational health nursing. PMID- 3636800 TI - An institutional perspective of higher education. PMID- 3636802 TI - Understanding the academic role. Faculty rights. PMID- 3636801 TI - Developing a career in academia. PMID- 3636803 TI - Faculty roles in higher education: teaching, service, and scholarship. PMID- 3636804 TI - Nursing student census with policy implications 1985. PMID- 3636805 TI - The hospice concept. PMID- 3636806 TI - Home health services: organizational dilemmas. PMID- 3636808 TI - Health care and nutrition services. PMID- 3636807 TI - Housing for elderly persons: its implications for nursing. PMID- 3636809 TI - Professional and public education initiatives: addressing health and related needs of elderly persons. PMID- 3636810 TI - Congregate living and the institutional campus. PMID- 3636811 TI - Talking points. PMID- 3636813 TI - Nurses meet the needs of grieving families through legislative action. PMID- 3636812 TI - The sequence of a cDNA clone coding for a novel kallikrein from mouse submaxillary gland. AB - Mouse submaxillary gland contains many proteolytic enzymes, the most widely studied of which are the kallikreins. This gland also contains high levels of nerve growth factor (NGF), which is isolated as a complex of three subunits, alpha, beta, and gamma. We report here the cloning and sequence analysis of a novel kallikrein from mouse submaxillary gland. Antibodies directed against the alpha subunit precipitate the product of this clone, but do not precipitate the homologous gamma subunit. This new kallikrein is therefore closely related to alpha NGF, yet in contrast to the alpha subunit, its sequence suggests it has proteolytic activity. PMID- 3636814 TI - The National Center for Nursing Research becomes a reality. PMID- 3636815 TI - Leadership development in public policy. PMID- 3636817 TI - An instrument to assess the dynamic characteristics of the circumvaginal musculature. AB - This report describes an intravaginal balloon device (IVBD) and an improved method for measuring the dynamic characteristics of circumvaginal muscle (CVM) contractions. The IVBD measurement system may be used in research on women's health problems related to the pelvic floor musculature. The system is independent of examiner judgment and variability, and measurement conditions are carefully controlled. In an initial trial using the device with 20 volunteers, aged 22 to 58 years, the maximal pressure developed during strong CVM contractions was measured with the subjects supine. Subjects were asked to repeat the contraction while they contracted abdominal muscles. The length of time a submaximal contraction could be held was also measured. Test-retest reliability, determined by repeating each experiment, revealed significant correlations in maximal pressure attained, r = .85, p less than .03. A t test demonstrated no significant difference between the variables with and without the use of abdominal muscles, indicating the contraction of abdominal muscles did not affect intravaginal pressure when assessed with the IVBD. A weak correlation between length of time a submaximal contraction could be held and age of subject was found, r = -.44, p less than .06, but no pressure variable was correlated with age or parity, a possible effect of the small sample in this study. PMID- 3636816 TI - Chemically dependent nurses: the trajectory toward self-annihilation. AB - Interviews and participant observation were used to generate a substantive grounded theory that explains the process of nurses becoming chemically dependent. Data collection included: reading 10 case histories of nurses who had appeared before the Board of Nursing because of a problem with chemical dependency; interviewing 20 nurses who admitted their dependence on drugs and/or alcohol and who were in the process of recovery; interviewing representatives of the Board of Nursing, Department of Professional Regulation, and nurse investigators; attending Board of Nursing hearings and meetings concerning nurses who violated the Nurse Practice Act; accompanying a nurse investigator on her rounds to do urine checks on chemically dependent nurses presently on probation; and observing meetings of a chemically dependent nurses' self-help group for a period of 1 year. Findings revealed that as a result of physical and/or psychological pain nurses who became chemically dependent embarked on a trajectory of self-annihilation. The stages and phases of the self-annihilation process are discussed. PMID- 3636818 TI - Comparison of intramuscular injection techniques to reduce site discomfort and lesions. AB - The Z-track intramuscular injection technique was compared with the standard injection technique for incidence and severity of discomfort and lesions at the injection site. Fifty subjects received injections of meperidine hydrochloride alone or in combination with promethazine hydrochloride every 3 to 4 hours for a total of two to eight injections. Subjects served as their own controls by receiving both techniques. They were evaluated for the presence and severity of discomfort on a 4-point Likert scale. Injection site lesions were determined by visualization and palpation. The Z-track technique significantly decreased incidence of selected descriptors of discomfort and lesions at selected time intervals, severity of discomfort at selected time intervals, and severity of lesions at all time intervals postinjection. PMID- 3636819 TI - Effect of tachypnea on oral temperature estimation: a replication. AB - The effect of tachypnea on oral temperature measurement was examined in 53 patients in a medical intensive care unit. This study was a replication of Tandberg and Sklar's (1983) study. The effect on rectal/oral temperature difference exerted by normal respiratory rate (20 or less respirations per minute) versus tachypnea (greater than 20 respirations per minute) was studied. A t test demonstrated that mean rectal/oral temperature difference between the groups was significantly different, t = -3.26, df = 49.45, p less than .01, supporting Tandberg and Sklar's findings. The present study found a positive relationship between the variables, r = .33, p less than .05, as did the previous study, r = .49, p less than .001. PMID- 3636820 TI - Patient falls in the acute care setting: identifying risk factors. AB - A retrospective comparative chart audit was conducted to identify patient characteristics associated with falls in the acute care setting, to examine the extent to which the significant characteristics explained if falls occurred, and to test the ability of variables believed to be risk factors to predict falls. Patients aged 60 and older who fell during hospitalization (n = 331) were compared with a random sample of patients aged 60 and older who were hospitalized during the same time period but did not fall (n = 300). Two days of documentation were sampled: admission day and day preceding the fall for the fall group, and admission day and a random day of hospital stay for the no-fall group. Findings supported the idea that fall-prone patients can be identified and that significant differences between those who do and do not fall are evident at hospital admission. The findings also suggested an alteration in the constellation of characteristics nurses use to identify fall-prone patients. Of 11 variables representing standard risk factors, only 6 were significantly related to fall status; 5 entered the regression equation as significantly contributing to the 22% explained variance. When potential predictor variables were expanded to include additional patient characteristics, the explained variances for fall status were 31% from the admission day data and 34.5% from the fall/random day data. PMID- 3636821 TI - Spouses' body image changes during and after pregnancy: a replication and extension. AB - This longitudinal study replicated and extended an investigation of the relation between spouses' strength of identification and similarities in their patterns of change in body image components during and after pregnancy. The sample included 54 married couples. The results did not duplicate previous study findings of similarity in spouses' patterns of change in perceived body space. There were statistically significant changes in wives' perceived body space scores from the third month of pregnancy to the second postpartal month, but no changes in the husbands' perceived body space scores. Results upheld previous study findings of no relationship between spouses' strength of identification and similarities in their patterns of change in perceived body space. No changes were detected in either wives' or husbands' global body attitude scores, nor was there evidence of a relationship between spouses' strength of identification and similarity in their patterns of change in global body attitude. PMID- 3636822 TI - Toward a theory of nursing action: skills and competency in nurse-patient interaction. AB - Existing models of nursing require expansion and refinement to link theory, research, and clinical practice more closely. To accomplish this goal, conceptual models need to integrate a theoretically motivated and clinically useful account of nursing action. One way to do this is to view nursing action as a process of social interaction. Effecting positive changes in patients' health care status depends on nurse-patient interaction that promotes consensus. Consensus is arrived at through the process of negotiation and depends on the nurse's level of interpersonal competence. This article discusses core assumptions about the nature and function of nursing action as viewed through an interactional lens and identifies interpersonal skills suggested by this perspective, which are likely to account for competent nursing action. PMID- 3636823 TI - The structure of problem solving in simulations. AB - This study was a secondary analysis of an existing data set. The purpose was to explore the problem-solving cognitive structure that nurse practitioners (NPs) used in their assessment and management of a patient with acute pneumonia superimposed over chronic bronchitis, as measured by a patient management problem with 296 items. Results of a factor analysis suggested that the activity of patient education was different from assessment and medical management functions. A discriminant analysis was used to explore which variables correlated with high and low performance on the simulation. Laboratory proficiency scores were the first, patient education management the second best discriminating variables. Routes through the simulation were labeled typical, suggesting the usual sequence of history, physical, laboratory tests, and management, and atypical, suggesting variations on this route. The typical group performed significantly better than the atypical group. At the end of each section within the simulations, subjects were asked to list potential problems and possible medical diagnosis. Subjects were able, with a minimal amount of data, to list correct problems and diagnosis and appeared to proceed through the simulation attempting to confirm or deny those hunches. These findings support the concept that there appears to be a nursing focus within NPs' performance on a clinical simulation. PMID- 3636824 TI - Re: 'Stress in ICU and non-ICU nurses'. PMID- 3636825 TI - Nurse practitioner-patient interactional analyses during well-child visits. PMID- 3636826 TI - On 'toward a theory of nursing action: skills and competency in nurse-patient interaction'. PMID- 3636827 TI - Three estimates of interrater reliability for nominal data. PMID- 3636828 TI - Return of the lost experts. PMID- 3636829 TI - Regrading: when the salaries don't add up. PMID- 3636830 TI - Communications gap. PMID- 3636831 TI - Occupational health--in working order? PMID- 3636832 TI - Occupational health--a primary concern. PMID- 3636833 TI - Nutritional needs of surgical patients. PMID- 3636834 TI - The falling sickness. PMID- 3636835 TI - Litigation: maternity care at a premium? PMID- 3636836 TI - Freezing skin. PMID- 3636838 TI - Alcoholism--setting limits. PMID- 3636837 TI - Learning management at a distance. PMID- 3636839 TI - Assessing and reducing the stress and strain of psychiatric nursing. PMID- 3636840 TI - Don't forget the patient. PMID- 3636841 TI - Focus on urinalysis. Part 2. PMID- 3636842 TI - The project has landed. PMID- 3636843 TI - A different face each time. PMID- 3636844 TI - Giving the patient control. PMID- 3636845 TI - A computerised duty rota. PMID- 3636847 TI - Not just the baby blues. PMID- 3636846 TI - Coming back to life. PMID- 3636848 TI - Care about food. In for a lean time? PMID- 3636849 TI - Care about food. Does the end justify the means? PMID- 3636850 TI - Education: personality or performance? PMID- 3636851 TI - Please write soon. PMID- 3636852 TI - Watch my lips. PMID- 3636853 TI - Accident & Emergency. Management of head injuries. PMID- 3636854 TI - Accident and Emergency. A&E courses: on the right track? PMID- 3636855 TI - Accident and Emergency. The chaos controller. PMID- 3636856 TI - Teaching nurses. 2. Teaching resources--of the human kind. PMID- 3636858 TI - Chernobyl: something in the air. PMID- 3636857 TI - A friend in need. PMID- 3636859 TI - Informed consent. Tell me honestly. PMID- 3636860 TI - Informed consent. Dangerous territory. PMID- 3636861 TI - Short hospital breaks. PMID- 3636862 TI - Community nursing: Cumberlege on Cumberlege. Interview by Ruth Devlin. PMID- 3636863 TI - Why do people die from cancer? PMID- 3636865 TI - Recording patient dependency. PMID- 3636864 TI - The Greenfield vena cava filter. PMID- 3636866 TI - Systems of life. No 137. Senior systems. 2. PMID- 3636867 TI - The social ulcer. PMID- 3636868 TI - Mental Health Nursing. Journal of the Psychiatric Nurses Association. PMID- 3636869 TI - Mental Health Nursing. Behaviour therapy: mainstream or slipstream? PMID- 3636871 TI - Mental Health Nursing. American dream or nightmare? PMID- 3636870 TI - Mental Health Nursing. When sex becomes a problem. PMID- 3636872 TI - Visibility good. PMID- 3636873 TI - Mental handicap. What's in a name? PMID- 3636874 TI - Alternative therapy. Fringe benefits. PMID- 3636875 TI - Blowing hot and cold. PMID- 3636876 TI - After Chernobyl. PMID- 3636877 TI - When the relative is the nurse. PMID- 3636878 TI - Hunt the accident form. PMID- 3636879 TI - Leg ulcers. Treating chronic venous ulcers. PMID- 3636880 TI - Leg ulcers. Overcoming loneliness. PMID- 3636881 TI - Leg ulcers. Antiseptics and their effect on healing tissue. PMID- 3636882 TI - Management: change without cash. PMID- 3636883 TI - Helping a handicapped child improve her walking. PMID- 3636884 TI - Psychological effects of chronic renal failure. PMID- 3636885 TI - Death of a dear friend. PMID- 3636886 TI - Midwives' Journal. Caesarean section: the unkindest cut? PMID- 3636887 TI - Midwives' Journal. Changing attitudes to intervention. PMID- 3636888 TI - Midwives' Journal. Emotional effects of a caesarean. PMID- 3636889 TI - Midwives' Journal. An image restored. PMID- 3636890 TI - Midwives' Journal. When the midwife misses out. PMID- 3636892 TI - Teaching nurses. 3. A positive learning environment. PMID- 3636891 TI - The fig-leaf bureaucracy. PMID- 3636893 TI - Skoal bandits. Something to chew on. PMID- 3636894 TI - Nursing in China. East meets West. Interview by Andrew Cole. PMID- 3636895 TI - Reviewing the review body. PMID- 3636896 TI - Cervical cancer. Falling through the net. PMID- 3636897 TI - Cervical cancer. What price silence? PMID- 3636898 TI - Cervical cancer. Connections and causes. PMID- 3636899 TI - Diary of an anxious student. PMID- 3636900 TI - The making of a home. PMID- 3636901 TI - Systems of life. No 138. Senior systems. 3. PMID- 3636902 TI - Patient-centred handovers. PMID- 3636903 TI - Quest: NT's educational supplement. Getting the house in order. PMID- 3636904 TI - Putting the house in order. PMID- 3636905 TI - Thematic learning. PMID- 3636906 TI - Networks and coalitions: tools for strength. PMID- 3636907 TI - The research process versus related processes. PMID- 3636908 TI - Reaffirming catheter placement and patency. PMID- 3636909 TI - Cancer education: how nurses can help. PMID- 3636910 TI - To teach or not to teach? Overcoming barriers to patient education in geriatric oncology. PMID- 3636911 TI - Health promotion behaviors in ambulatory cancer patients: facts or fiction? PMID- 3636912 TI - Living with melanoma: content analysis of interviews. PMID- 3636913 TI - The needs of family members of cancer patients. PMID- 3636914 TI - Publishing your speech. I. Preparing a speech for publication. PMID- 3636915 TI - Publishing your speech. II. A personal experience. PMID- 3636916 TI - Cancer prevention and early detection: reported activities of nurses. PMID- 3636918 TI - Continuous subcutaneous infusion of morphine. PMID- 3636917 TI - Vaginal dilatation post pelvic irradiation: a patient education tool. PMID- 3636919 TI - Educating rural home health care nurses in respiratory assessment: an evaluation study. PMID- 3636920 TI - Assessment of clinical nursing practice in a rural decentralized case-management system. PMID- 3636921 TI - Health services in day-care centers: a public health nursing design. PMID- 3636922 TI - Nuclear freeze and disarmament: a mandate for community health nursing. PMID- 3636923 TI - Public health nursing: a study of role implementation. PMID- 3636924 TI - Health behavior: evolution of two paradigms. PMID- 3636925 TI - Like good packing material--safety belts protect delicate contents. PMID- 3636927 TI - Biomedical ethics. PMID- 3636926 TI - Prospective payment systems and their implications for nursing. PMID- 3636928 TI - Ethics in primary care: setting aside common misunderstandings. AB - Ethics, as generally defined, tries to answer the question, "What ought to be done in a given situation, all things considered?" Answering this question in primary care is hampered by some common and recurring misunderstandings--some arising from physicians' misunderstanding of ethical concepts and vocabulary and some arising from ethicists' misplaced emphasis and ignorance of medical settings. Examination and clarification of these misunderstandings illuminate the nature of primary care ethics and the role of the practicing physician. PMID- 3636929 TI - The ethics of in vitro fertilization. AB - Advances in medicine's ability to assist reproduction in those afflicted with infertility raise numerous ethical questions both for potential recipients of the techniques and for society as a whole. Society must decide what level of resources should be committed to the treatment of infertility in light of the fact that many children are not readily placed in adoptive or foster homes and the increasing competition that exists for scarce health care resources. The ethical uncertainty about the moral status of embryos and the moral acceptability of nonstandard techniques of in vitro fertilization raise further troubling questions about the adequacy of consent, committee review, and other protections for the welfare of families. Although it may not yet be appropriate to call for legislation or regulation in this area, there is a very real need to increase professional and public discussion of the ethical and policy questions raised by assisted reproduction. PMID- 3636930 TI - Faith dimensions in medical practice. AB - In this article, two cases are presented that illustrate that the principles underlying medical practice and religious scruples are often the same. The author argues, therefore, that better understanding of religious traditions that inform patients' views might diminish seeming conflicts in the provision of medical care. PMID- 3636931 TI - Parents as decision makers for children. AB - The continuing high incidence of abuse and neglect requires limits to parental authority over children. Although most parents believe they act in the interests of their children, that alone would not justify interference with a child's liberty. In the area of health care, allowing children some independence from parental control serves three functions: physical protection; respect for autonomy; and protection of public health interests. Despite all that, parents need and deserve to be left alone within broad limits of tolerance, for their sake as well as that of their children. PMID- 3636932 TI - Ethical issues in caring for elderly residents of nursing homes. AB - Good decision making is important, especially with patients who are disadvantaged in the ways common to long-term care institutions. Few decisions are as important as where to live and where to receive medical care for chronic illnesses, and these decisions deserve careful consideration by providers. Dying is common in long-term care facilities but is commonly managed poorly. Physicians could help this situation by encouraging advance directives, better educating patients, knowing more adequate symptom control measures, and understanding moral and legal considerations better. Pressures for cost containment are forcing physicians to re-examine and defend their role as patient advocate and to defend reasonable expenditures even on patients who are close to death. PMID- 3636933 TI - The role of the courts, legislatures, and lawyers in treatment decisions. AB - During the past 10 years, the issues surrounding the right to refuse various forms of treatment have remained complex, and the development of appropriate societal responses has become more elusive. This article considers the role that the judiciary, the legislature, and the legal profession have played in the resolution of these medical, legal, and ethical dilemmas. The courts, legislatures, and lawyers will never be removed completely from involvement in these matters, nor should they be. Yet, a continuation of the medical profession's responsible approach to these issues will insure that their involvement will be kept to a minimum. PMID- 3636934 TI - Developing issues in medical decision making: the durable power of attorney and institutional ethics committees. AB - Legal doctrines clearly place the responsibility of medical decision making on the individual, but the physician must assume the responsibility for medical care and treatment decisions and must always strive to do so in ways that promote the rights and interests of his or her patients. In this article, the legal basis for patients' rights in health care decision making is explored, and advance directives for health care decisions (living wills and durable powers of attorney) and the development of institutional ethics committees are discussed. PMID- 3636935 TI - Biomedical ethics committees. AB - As a consequence of rapidly increasing and complex ethical dilemmas in medicine, health care institutions are responding by forming biomedical ethics committees. In this article, the authors review the origins, functions, and potential drawbacks of these committees and also make suggestions on starting these committees. PMID- 3636936 TI - Aspiration & anesthesia death: nurse liability. PMID- 3636937 TI - Head nurse "resigns": discrimination charged. Case in point: Glymph v. Spartanburg General Hosp. (783 F. 2d 476-SC). PMID- 3636938 TI - Legal case briefs for nurses. N.Y.: nurse charts "afebrile": temp. and complications; N.Y.: nurse brings malpractice claim v. doctor. PMID- 3636939 TI - Failing to chart can cost you your job! Case in point: Alexander v. Dept. of Health & Human Resources (484 So. 2d 722-LA). PMID- 3636940 TI - Nurse rejects heart attack victim: liability. PMID- 3636941 TI - Unattended patients drowns in tub: liability issue. Case in point: Kanter v. Metropolitan Medical Center (284 N.W. 2d 914-MN). PMID- 3636942 TI - "Spiritual" nursing care: liability issue. Case in point: Baumgartner v. First Church of Christ (490 N.E.2d 1319-IL). PMID- 3636943 TI - Development of a health conception scale. AB - Described in this paper are the development, reliability, and validity of an instrument, the Laffrey Health Conception Scale to measure individual perceptions of the meaning of health. The instrument measures four dimensions of health conception: clinical, functional/role performance, adaptive, and eudaimonistic. A score is obtained for each dimension as well as a total score for the four dimensions. The high levels of reliability and validity in preliminary testing indicate that the instrument warrants further development and use with different populations. PMID- 3636944 TI - Primary prevention behaviors: the female-headed, one-parent family. AB - The purpose of this study was to describe the primary prevention behaviors of 59 female-headed, one-parent families and the barriers which deter their practice. Two interviews, a health diary, and a card sort were used for data collection. Descriptive statistics and content analysis were used to analyze the qualitative data. Nutrition was the behavior the families felt was most important for maintaining health. Time was the major barrier to primary prevention practices. A relationship was found between the family's ability to change and grow and their practice of primary prevention behaviors. Families that consciously risked lifestyle changes also were willing to try to incorporate primary prevention behaviors. On the contrary, families with stagnant lifestyles expressed the desire to change their primary prevention behaviors but made no visible attempt to do so. PMID- 3636945 TI - The relationship of movement and time to older adults' functional health. AB - The relationship of movement (measured by walking cadence) and time (measured by perceived duration) to functional health was investigated in a sample of community-based, white, older women (N = 114). Significant relationships were found between health and movement, and between movement and time. Speed, inherent in both movement and time, may be an important qualitative dimension of functional health. Walking cadence shows the most promise for use as an inexpensive, noninvasive, easy-to-use clinical measure of health. PMID- 3636946 TI - Prevalence of nurse smokers and variables identified with successful and unsuccessful smoking cessation. AB - A mailed survey of 823 randomly selected registered nurses, constituting an 82% return rate, was conducted to determine the prevalence and quit rate of smoking related behaviors. Variables identified with successful quitters and continuing smokers also were investigated. The findings revealed that nurses have a decreased proportion of current smokers, an increased proportion of never smokers, and an increased quit smoking rate. The smoking cessation method used most frequently by successful quitters was "cold turkey". PMID- 3636947 TI - Attitudes of patients with schizophrenia toward taking medication. AB - The attitude of 50 hospitalized persons with schizophrenia toward taking their medication was examined. Both open-ended and fixed-response estimates of attitude were made. Insight also was measured, and the relationships between insight and attitude and between hallucinations and insight were analyzed. Patients were able to provide information about beliefs and feelings about taking medication and about insight toward illness and treatment. Attitudes varied, and both strongly positive and strongly negative beliefs about taking medication were held simultaneously. Some of the implications for nursing are explained. PMID- 3636948 TI - Burnout among intensive care nurses. AB - The purpose of this study was to examine the relationship between intensive-care nurse burnout and demographic variables. The Maslach Burnout Inventory measured six components of burnout; emotional exhaustion frequency and intensity, depersonalization frequency and intensity, and personal accomplishment frequency and intensity. The sample (N = 89) was drawn from an army medical center. The variables, nursing, age, sex, military status, level of education, and length of time in nursing correlated with more than one aspect of burnout (p less than .05). Older age, less than a baccalaureate degree, female, and civilian status described the intensive care nurse who was less prone to burnout. Further study of the relationship between nurses and burnout is required. PMID- 3636949 TI - Planning by expert and novice nurses in cases of varying complexity. AB - The question addressed in this study was: what are the relationships among task complexity and nursing expertise and the planning processes of generating, evaluating, and choosing alternative actions? Eleven hospice nurses, six experts, and five novices were asked to think aloud as they developed drug administration plans to control patients' pain in three hypothetical cases of varying complexity. The results indicated that subjects varied the number of alternative actions generated and their approaches to alternative evaluation as functions of task complexity. Experts generated more drug alternative actions, were more specific in evaluating alternative actions, and developed better plans than did novices. PMID- 3636951 TI - Color vision tests to identify elevated digoxin levels. AB - The purpose of this study was to determine the usefulness of color vision screening in identifying patients with elevated digoxin levels (greater than or equal to 2.0 ng/ml). Test-retest color vision measurements were obtained on 56 subjects with elevated digoxin levels and 93 non-digoxin subjects. Two tests, the Ishihara and Sahlgren's Saturation Test (SST), identified digoxin levels of 2.9 ng/ml or more. These tests also yielded a high percentage of improved retest scores among subjects with elevated digoxin levels (greater than or equal to 2.7 ng/ml) of more than 4-days duration and a low percentage of improved retest scores among the non-digoxin group. The Ishihara, SST, and other bedside color vision tests may prove useful in the routine monitoring of patients on digoxin therapy, especially those with a high risk for toxicity. PMID- 3636950 TI - Emotionally triggered asthma as a predictor of airway response to suggestion. AB - Twenty-nine male and female adults with asthma were tested to determine the relationship between perceived response to emotional triggers of asthma and bronchoconstrictive suggestion. Subjects were told that they were inhaling a bronchoconstricting agent in four increasingly potent concentrations, when in fact the solution the subjects inhaled was nebulized isotonic saline. Ten subjects responded to suggestion with a greater than 20% increase in specific airway resistance, but this response could not be predicted by the report of perceived emotional triggers of asthma. The finding that perception of asthmatic response to emotional arousal does not predict airway response to bronchoconstrictive suggestion may mean that suggestion is an invalid proxy variable for studying the role of psychological factors in provocation of asthma. PMID- 3636952 TI - Factors influencing career success in nursing. AB - The purpose of this descriptive study was to examine educational preparation, personal characteristics, and significant others in the career success of women in nursing. The sample was a random selection of 194 doctorally prepared female nurses who reported some degree of career success. The factor, personal characteristics, was ranked as the most important in facilitating career success, educational preparations was ranked second, and significant others was ranked third. Among significant others ranked as influential were teachers, peer/colleagues, and supervisors. PMID- 3636953 TI - Introverted research. PMID- 3636954 TI - Cesarean birth outside the natural childbirth culture. AB - The meaning of cesarean birth to women who are not typical members of the natural childbirth culture was examined. Fifty women who received obstetric care in a public inner-city hospital serving the medically indigent and who sought minimal preparation for childbirth were interviewed. The findings suggest that the women used distancing behaviors prenatally and postdelivery to cope with the idea and reality of cesarean birth. In addition, the women did not display the psychic wounding following cesarean birth reported by natural childbirth followers. PMID- 3636955 TI - Clinical and cost-saving effects of psychoeducational interventions with surgical patients: a meta-analysis. AB - Meta-analysis of 102 studies was conducted to examine how psychoeducational interventions influence recovery, pain, psychological well-being, and satisfaction with care among hospitalized adult surgery patients. Statistically reliable and positive effects were found on each of these four classes of outcome. Further analyses showed that the effects could not be attributed to biases associated with the decision to publish, low internal validity, measurement subjectively, or a Hawthorne effect. Analyses of the subset of outcomes with most direct cost implications showed that positive, cost-relevant effects were obtained across a wide range of patients, treatment providers, hospital settings, and historic periods. PMID- 3636956 TI - Personal characteristics important to back injury. PMID- 3636957 TI - Body image in older adults: a review of the literature. PMID- 3636959 TI - [Locomotor system: upper limbs (4). The arm, elbow articulation]. PMID- 3636958 TI - The Barthel Index and other indices of functional ability. PMID- 3636960 TI - [Electronic infusion pumps (1)]. PMID- 3636962 TI - [Bladder tumors. Therapeutic methods]. PMID- 3636961 TI - [Bladder tumors. Diagnostic studies]. PMID- 3636963 TI - [Bladder tumors]. PMID- 3636965 TI - [Bladder tumors. En bloc endoscopic resection]. PMID- 3636964 TI - [Bladder tumors. Therapeutic indications and results]. PMID- 3636966 TI - [Endoscopic resection of bladder tumors]. PMID- 3636967 TI - [Bladder tumors. Epidemiology and etiological factors]. PMID- 3636968 TI - [Total cystectomy. Special aspects. Intestine and Bricker]. PMID- 3636969 TI - [Total cystectomy. Special aspects]. PMID- 3636970 TI - [Total cystectomy. Special aspects. Bacteriological follow-up of the patient with a Bricker procedure]. PMID- 3636971 TI - [A case of total cystectomy with Bricker procedure]. PMID- 3636972 TI - [Histological classification of bladder tumors. Anatomical staging]. PMID- 3636974 TI - [Locomotor apparatus--upper limbs (5). The elbow: flexion-extension]. PMID- 3636973 TI - [Bladder tumors. Anatomopathological study]. PMID- 3636975 TI - [Electric infusion pump (2)]. PMID- 3636976 TI - [Chronic appendicitis and mesenteric adenolymphitis]. PMID- 3636977 TI - [Meckel's and appendicular peritonitis]. PMID- 3636978 TI - [Tumors of the appendix]. PMID- 3636980 TI - [Indications for appendicectomy]. PMID- 3636979 TI - [Surgery in appendicitis and Meckel's diverticulum]. PMID- 3636981 TI - [Complications of appendectomy]. PMID- 3636982 TI - [Ordinary acute appendicitis]. PMID- 3636984 TI - [Role of the circulating nurse in appendectomy]. PMID- 3636983 TI - [Viewpoint of the resuscitation anesthetist]. PMID- 3636985 TI - [Acute gangrenous appendicitis. Case report]. PMID- 3636986 TI - [Complicated acute appendicitis]. PMID- 3636988 TI - [A review for nurses' aides ... some impressions in the confusion]. PMID- 3636989 TI - [Is obesity a disease?]. PMID- 3636987 TI - Bacteremia in narcotic addicts at the Detroit Medical Center. I. Microbiology, epidemiology, risk factors, and empiric therapy. AB - The changing microbiology of bacteremia among narcotic addicts in Detroit raised concerns about current presumptive antimicrobial therapy. In a one-year study of incidence, microbiology, sites, and risk factors, 180 bacteremic addicts (15% of addict-related admissions) were followed prospectively. Cases of bacteremia were caused by methicillin-sensitive Staphylococcus aureus (33%), methicillin resistant S. aureus (MRSA, 24%), streptococci (20%), mixed organisms (11%), Pseudomonas aeruginosa (9%), and miscellaneous other single organisms (3%). Endocarditis (41%) and abscess or cellulitis (34%) were usually found. Multivariate analysis of host factors and addiction habits yielded results predictive of bacterial species but not of infection sites. Previous hospitalization, long-term addiction, and nonprescribed antibiotic use were associated with MRSA acquisition (odds ratio, 8.6:1). All addicts with polymicrobial or P. aeruginosa bacteremia abused pentazocine and tripelennamine (P = .05). Many of the addicts with streptococcal bacteremia were women who did not abuse antibiotics (odds ratio, 20.7:1). Physicians inappropriately prescribed empiric antibiotics for 67 of 72 addicts with MRSA, P. aeruginosa, or polymicrobial infection. The results of regression analysis suggest that, guided by the patient's history, the physician can prescribe appropriate empiric antimicrobial therapy for bacteremia in the febrile addict in Detroit. PMID- 3636990 TI - [Bony tumors in children]. PMID- 3636991 TI - [A nurse in the dynamics of a business enterprise. Interview by Madeleine Clave]. PMID- 3636992 TI - [Nurse in Australia]. PMID- 3636993 TI - [Being well-footed. My feet hurt!]. PMID- 3636994 TI - How to handle a patient's complaint. PMID- 3636995 TI - You hold a key to your patient's recovery. PMID- 3636996 TI - How to care for an AIDS patient. PMID- 3636997 TI - Tips on drawing blood through a heparin lock. PMID- 3636998 TI - What you can learn from pulmonary function tests. PMID- 3636999 TI - When the kidneys fail (continuing education credit). PMID- 3637001 TI - When actions speak louder than words. PMID- 3637000 TI - Clearing up infusion pump problems. PMID- 3637002 TI - The special needs of the special patient. PMID- 3637003 TI - Why I let the nurse off the hook. PMID- 3637004 TI - "Why won't they let us help deliver babies?". PMID- 3637005 TI - Can diet control the urge to drink? PMID- 3637006 TI - The war over home health care. PMID- 3637007 TI - An examination of variables in spinal cord injury patients with pressure sores. PMID- 3637008 TI - A solution to self-catheterization in the female with upper extremity weakness. PMID- 3637009 TI - Patient rights vs. nursing responsibility. PMID- 3637010 TI - [Urine collection for cytobacteriological studies in children]. PMID- 3637011 TI - [Ankylosing spondylitis or rheumatoid pelvic spondylitis]. PMID- 3637012 TI - [Rheumatoid polyarthritis]. PMID- 3637013 TI - [Chronic satellite inflammatory rheumatism of rheumatoid polyarthritis]. PMID- 3637014 TI - [Chronic inflammatory rheumatism. Case report]. PMID- 3637016 TI - [Psoriatic rheumatism]. PMID- 3637015 TI - [Chronic juvenile arthritis]. PMID- 3637017 TI - [Paraclinical evaluation of a vascular acrosyndrome]. PMID- 3637018 TI - [The various vascular acrosyndromes]. PMID- 3637019 TI - [Causes of Raynaud's phenomenon]. PMID- 3637020 TI - [Raynaud's disease, syndrome or phenomenon?]. PMID- 3637021 TI - [Raynaud's disease]. PMID- 3637022 TI - [Clinical study of a vascular acrosyndrome]. PMID- 3637023 TI - [Management of Raynaud's phenomenon]. PMID- 3637024 TI - [Consultation-hospitalization in Raynaud's phenomenon. Case reports]. PMID- 3637025 TI - [Anatomophysiology of the microcirculatory unit]. PMID- 3637026 TI - [Physiopathology of Raynaud's phenomenon]. PMID- 3637027 TI - [Orthopedic treatment of fractures in children]. PMID- 3637028 TI - [Surgical treatment of fractures in children]. PMID- 3637029 TI - [Christophe's femoral fracture. Case report]. PMID- 3637030 TI - [Family planning]. PMID- 3637031 TI - [Fractures in children. Anatomical and psychological characteristics of children]. PMID- 3637032 TI - [The sophrological preparation for motherhood]. PMID- 3637033 TI - [Different type of fractures encountered in children and their development]. PMID- 3637034 TI - Characteristics of advanced nurse practitioners. PMID- 3637036 TI - Reality shock for new OR nurses. PMID- 3637035 TI - Median sternotomy for bilateral pulmonary lesions. PMID- 3637037 TI - A preoperative teaching booklet for pediatric patients. PMID- 3637038 TI - Same day surgery: two perspectives. PMID- 3637039 TI - The evolution of surgical lasers. PMID- 3637041 TI - [Lab assistants at AIDS symposium]. PMID- 3637040 TI - [Activity of the kallikrein-kinin system of the blood in patients with chronic ischemic heart disease]. PMID- 3637042 TI - [Supervisors in critique of medical superintendents are subjected to reprisals]. PMID- 3637043 TI - [SHSTF's association lawyer: employers don't accept their responsibility. Interview by Jan Thomasson]. PMID- 3637044 TI - [National Social Welfare Board: never wrong to turn to us. Interview by Jan Thomasson]. PMID- 3637046 TI - [Every patient has his own nurse]. PMID- 3637045 TI - [Government says yes to licensure of assistants]. PMID- 3637047 TI - [Parliament is in agreement with apartheid]. PMID- 3637048 TI - [Why doesn't anybody say anything when somebody drinks on the job?. Interview by Viveka Holmertz]. PMID- 3637049 TI - [An altogether ordinary workweek in a school nurse's life]. PMID- 3637050 TI - Inhibitors of trypsin, chymotrypsin and elastase in human uterine fluid. AB - Pure uterine fluid, obtained from 18 women in the luteal phase, was pooled and gel filtered. Inhibitory activity against trypsin, chymotrypsin and elastase was present in fractions containing alpha 2-macroglobulin, alpha 1-antitrypsin, alpha 1-antichymotrypsin and antileukoprotease. After solid-phase adsorption with antibodies to these inhibitors, no inhibitory activity remained. It was concluded that the entire inhibitory capacity of the proteinases studied was attributable to inhibitors derived from serum and antileukoprotease. These proteinase inhibitors which are present in uterine fluid during the luteal phase might be of significance during the implantation process. PMID- 3637051 TI - Lipoprotein fractions and receptors: a role for probucol? AB - Cholesterol transport in the plasma involves several lipoprotein families. The process is remarkably ordered and is driven vectorily by apolipoproteins, which activate appropriate enzymes or serve as recognition sites for lipoprotein receptors. Of the lipoproteins in plasma, low density lipoprotein (LDL) contains most of the cholesterol and has the greatest atherogenic potential. Its plasma concentration is determined by LDL receptor activity, which serves to regulate intracellular cholesterol concentrations. LDL receptor activity in the body is not fixed, but can be stimulated by drugs that affect hepatic cholesterol content, such as inhibitors of HMG-CoA reductase or bile acid sequestrants. By stimulating LDL receptor activity, these drugs increase the fractional catabolic rate of apoLDL. HMG-CoA reductase inhibitors also appear to reduce the apoLDL synthetic rate. As a consequence, LDL cholesterol levels are reduced while high density lipoprotein (HDL) cholesterol levels remain stable or increase. Probucol is a drug that lowers both LDL and HDL cholesterol levels. It appears to lower LDL cholesterol levels by affecting LDL structure rather than by stimulating LDL receptor activity. It has no consistent effect on LDL synthetic rates. Probucol lowers plasma HDL cholesterol levels by decreasing the synthetic rates of the major HDL apolipoproteins. The biologic significance of these probucol-induced changes in HDL metabolism is unknown. PMID- 3637052 TI - Strategies in aminoglycoside use and impact upon resistance. AB - Assessment of amikacin resistance over a 10-year period at our institution revealed that the number of resistant strains remained stable. Qualitatively, amikacin-resistant Enterobacteriaceae and Pseudomonas were fairly stable. There was a slight increase in amikacin-resistant Acinetobacter and staphylococci. Different factors influencing the emergence and spread of resistant hospital bacteria have been studied at different periods and compared with similar data on gentamicin-resistant strains. Transmissible plasmids, multiple mechanisms of resistance, and high levels of resistance were more frequent in gentamicin resistant strains. In the amikacin-resistant strains, the level of resistance was 16 to 32 mg/liter with few autotransferable plasmids. A synergistic or additive effect with cephalosporins, which may be a factor in decreasing the risk of selection of the resistant strains since there is no plasmid-mediated resistance to cephalosporins, was demonstrated in Enterobacteriaceae. To control the development of aminoglycoside resistance in hospitals, it may be necessary to restrict the use of more than the one drug to which resistance is developing; to use the antibiotic at the right dosage and, when necessary, in a combination that may prevent the emergence of resistant organisms and plasmids; and to develop measures to control bacterial and R factor transmission. PMID- 3637053 TI - Guide to test item development. PMID- 3637054 TI - Cultural diversity in the nursing curriculum: a guide for implementation. PMID- 3637055 TI - Clinical nurse specialists: distribution and utilization. PMID- 3637056 TI - Psychiatric and mental health clinical nurse specialists: distribution and utilization. PMID- 3637057 TI - Ultrastructural changes in hamster lung 15 min to 3 hr after exposure to pancreatic elastase. AB - A single endotracheal instillation of porcine pancreatic elastase into hamster lungs induces morphological changes that can be detected as early as 15 min after the instillation of enzyme. Lung tissue from animals sacrificed at six time points between 15 min and 3 hr after enzyme instillation was examined for ultrastructural alterations. There were few of these alterations and they were highly focal, but they included damaged epithelial cells and partially digested elastic fibers that occurred both in the parenchyma and the pleura. A cytochemical technique employing N-t-Boc-L-alanine-p-nitrothiophenyl ester as a substrate for elastase-like enzymes was also used in an effort to locate pancreatic elastase shortly after instillation into the lungs. Reaction product was observed on the alveolar surface and in pinocytotic vesicles of alveolar type I cells, in connective tissue areas, in fibroblasts, and in pinocytotic vesicles of capillary endothelial cells. The location of reaction product coupled with ultrastructural alterations in the tissue suggests that pancreatic elastase instilled into the trachea may reach the interstitium in two ways: First, transport may take place across intact alveolar type I cells via pinocytotic vesicles, and second, a small amount of enzyme may gain access to the connective tissue after the disruption of epithelium in a few highly focal areas. PMID- 3637058 TI - Structure and research activities of pediatric infection control programs in the United States and Canada. AB - Although this survey was not intended to evaluate all aspects of pediatric infection control programs, we hoped to learn about such programs as reflected by the placement and classification of the practitioner and the infection control program in the hospital administrative hierarchy, by salary, and by research priorities and activities. Perhaps our informal survey may prompt pediatric institutions to evaluate the goals of their infection control programs and to explore possibilities for growth and development of the program as well as the practitioner. PMID- 3637059 TI - Influenza roulette: did data demonstrate vaccine efficacy? PMID- 3637060 TI - ANA House adopts goals to guide nursing's future. PMID- 3637061 TI - Supreme Court strikes down 'Baby Doe' regs. PMID- 3637062 TI - ANA opposes draft registration for RNs. PMID- 3637063 TI - Together we can negotiate progress, improve care. PMID- 3637064 TI - What was most important about the 1986 House? PMID- 3637065 TI - An improved method for isolating type II cells in high yield and purity. AB - A method has been developed for isolating alveolar type II cells by digesting lung tissue with elastase and "panning" the resultant cell suspension on plates coated with IgG. This method provides both high yield and purity of type II cells. In 50 experiments with rats, we obtained 35 +/- 11 X 10(6) cells/rat, 89 +/- 4% of which were type II cells (mean +/- SD). Type II cells isolated by "panning" adhered more rapidly and completely in tissue culture than did cells isolated by centrifugation over discontinuous density gradients of metrizamide. The "panning" method is superior to other methods for isolating type II cells in that it provides a population of type II cells of both high yield and high purity. The method is fast, reproducible, and easily adaptable to isolating type II cells from species other than rats. PMID- 3637067 TI - Infection control. AORN recommended practices in ambulatory surgery. PMID- 3637068 TI - Ambulatory surgery scheduling. Assuring a smooth patient flow. AB - Managing the surgical schedule and facilitating patient flow through the ambulatory surgery unit is an administrative challenge. Each area is dependent on the other, making good communication among staff members essential. This communication begins in the physician's office when the surgical procedure is scheduled and continues with the patient and family through the entire perioperative experience. PMID- 3637066 TI - Clinical comparative study on the activity of cefamandole in the treatment of serious staphylococcal infections caused by methicillin-susceptible and methicillin-resistant strains. AB - Ninety-two microbiologically documented staphylococcal infections were treated with cefamandole in an open comparative study on the clinical efficacy of this cephalosporin in the therapy of infections caused by both methicillin-susceptible and methicillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus spp. The majority of the episodes (86 of 92) were treated with cefamandole alone, and six were treated with cefamandole in association with other antibiotics. In the evaluable S. aureus infections, 34 of 46 (73.9%) due to methicillin-susceptible strains and 12 of 16 (75%) due to methicillin-resistant strains responded to therapy. In particular, among the patients infected by methicillin-susceptible S. aureus 6 of 9 cases of septicemia, 0 of 2 cases of endocarditis, 2 of 2 cases of pneumonia, 2 of 3 osteoarticular infections, 8 of 12 cases of peritonitis in patients with chronic renal failure in continuous ambulatory peritoneal dialysis (CAPD), 13 of 15 skin-soft tissue infections, and 3 of 3 urinary tract infections responded to therapy. Among those due to methicillin-resistant strains, cure was achieved in 2 of 4 cases of septicemia, 0 of 1 case of endocarditis, 9 of 10 skin-soft tissue infections, and 1 of 1 urinary tract infection. In the evaluable infections caused by coagulase-negative staphylococci, 9 of 11 (81.8%) due to methicillin-susceptible and 15 of 17 (88.2%) due to methicillin-resistant strains responded to therapy. In particular, among patients infected by methicillin-susceptible, coagulase-negative staphylococci, 4 of 4 cases of septicemia, 0 of 1 case of endocarditis, 1 of 1 case of pneumonia, 1 of 1 case of peritonitis in CAPD, 2 of 3 infections of skin soft tissue, and 1 of 1 urinary tract infection responded to therapy. Among patients infected by methicillin-resistant, coagulase-negative staphylococci were cured 5 of 6 cases os septicemia, 6 of 6 cases of peritonitis (in CAPD), 4 of 4 infections of skin-soft tissue, and 0 of 1 urinary tract infection. PMID- 3637069 TI - Gastric bypass with Roux en Y. Surgical treatment for morbid obesity. PMID- 3637070 TI - Overcoming fear. A review of research on patient, family instruction. PMID- 3637071 TI - Medical anti-shock trousers. Nursing implications. PMID- 3637072 TI - Liposuction. Redefining body proportions. PMID- 3637073 TI - Genetic screening; medical progress prompts ethical questions. PMID- 3637074 TI - Preclotting of grafts. PMID- 3637075 TI - Nurse educators needed to keep student OR rotations in nursing school curriculum. PMID- 3637076 TI - Use of AORN recommended practices. Applications in ambulatory surgery. PMID- 3637077 TI - Uvulopalatopharyngoplasty. Alternative surgery for obstructive sleep apnea. PMID- 3637078 TI - A personal perspective. Working with families who donate organs and tissues. PMID- 3637079 TI - Small joint replacements. An alternative for victims of arthritis. PMID- 3637080 TI - Inadvertent hypothermia. Etiology, effects, and prevention. PMID- 3637081 TI - Nurses on ethical teams--expanding their decision-making role. PMID- 3637083 TI - Continuous arterio-venous hemofiltration: a nursing perspective. PMID- 3637082 TI - The elderly hemodialysis patient (continuing education credit). PMID- 3637084 TI - Continuous arterio-venous hemofiltration program implementation. PMID- 3637085 TI - Developing audio-visual programs for patient education. PMID- 3637086 TI - Nursing diagnoses most frequently used by renal staff nurses. PMID- 3637087 TI - Nursing diagnosis most frequently used by renal staff nurses. Research critique. PMID- 3637088 TI - Systemic lupus erythematosus and renal insufficiency. PMID- 3637089 TI - Clinical faculty appointments. PMID- 3637090 TI - Aged abuse: who cares? PMID- 3637091 TI - Dissatisfied with your roster? Self rostering--a viable alternative. PMID- 3637093 TI - Developing a nursing audit. PMID- 3637092 TI - Computer literacy for clinical nurses. PMID- 3637094 TI - Career structure in the U.S.A. PMID- 3637095 TI - Music therapy in geriatric care. PMID- 3637096 TI - The play's the thing! PMID- 3637097 TI - Nurse & the law. What is informed consent? PMID- 3637098 TI - Acyclovir--antiviral agent.the Royal Melbourne Hospital Pharmacy Department. PMID- 3637099 TI - Scission of human apolipoprotein B-100 by kallikrein: characterization of the cleavage site. AB - Low density lipoprotein (LDL) from human plasma was digested with the specific endoprotease, kallikrein. Apolipoprotein B-100, the protein moiety of LDL, was cleaved by kallikrein into two fragments (K1 and K2) which we have compared to the naturally occurring fragments, B-74 and B-26. We have found that K1 and K2 precisely match B-74 and B-26 with respect to molecular weight, stoichiometry, and amino terminal amino acid sequence. These findings provide strong evidence that kallikrein is the agent responsible for the formation of B-74 and B-26 in human LDL. PMID- 3637100 TI - Pulmonary function testing procedures. A preliminary study of local occupational health clinics. PMID- 3637101 TI - Application of the Heart at Work module to a worksite health promotion program. PMID- 3637102 TI - Utilizing health education strategies in infection control: implications for nursing. PMID- 3637103 TI - Motivations and satisfactions of the Hospice of Wichita volunteer. Implications for marketing volunteerism. PMID- 3637105 TI - Touching a patient through music. Volunteer develops special relationship with her songs. PMID- 3637104 TI - Informed consent in the hospice setting. A discussion of the legal doctrine and its impact on hospice programs. PMID- 3637106 TI - Hospice care and children. An overview of the benefits for kids. PMID- 3637107 TI - When it's one of us. A hospice team deals with a team member's illness. PMID- 3637108 TI - The dying process: a psychological continuum. A refinement of Kubler-Ross' five stage theory. PMID- 3637109 TI - The skills of listening. A review of helpful communication techniques. PMID- 3637110 TI - Humor and death: you've got to be kidding. Analyzing a special communication tool. PMID- 3637111 TI - Performance and biocompatibility of a new hemodialysis membrane. AB - Performance studies and investigations of the biocompatibility of a new hemodialysis membrane were conducted in patients being chronically hemodialyzed. The investigated polycarbonate membrane revealed a very satisfying performance with regard to clearance values and the ultrafiltration rate. The biocompatibility studies showed a significant leukopenia and an increase of C5a, platelet factor 4 and granulocyte elastase. Thrombocytes and C3d remained unchanged. Long-term studies have to confirm whether or not the new membrane is more biocompatible, a suggestion which could be advanced, as no febrile episodes were observed during any treatment, a finding which is not typical for Cuprophan hemodialysis. PMID- 3637112 TI - Cement workers and cancer: epidemiology at work? PMID- 3637113 TI - Mortality among masons in Iceland. AB - An investigation was carried out to determine the cause of death among 450 masons in Iceland who had been exposed to hexavalent chromium, a trace element in cement. The cohort was defined as all men born between 1905 and 1945 who had, according to the Register of Masons and Stone-cutters, finished vocational training as masons. For deaths occurring between 1951 and 1982 information was obtained from the Statistical Bureau of Iceland. Expected death rates were calculated, based on the national rates for men in the corresponding age groups. The total number of deaths from all causes was less than expected for the whole study period (81 v 85.86) but, with a 20 year latent period, 58 deaths were found against 50.57 expected; with a 30 year latent period, 38 deaths were found against 27.82 expected, which may, to a large extent, be accounted for by an excess of deaths from lung cancer. Nine deaths from lung cancer were found in the cohort, eight with 20 and 30 year latent periods compared with expected rates of 2.87, 2.19, and 1.28 respectively. The results seem to indicate that the increased number of deaths from lung cancer among the masons has a causal relation to occupational exposure. PMID- 3637114 TI - Mortality from stomach cancer in United States cement plant and quarry workers, 1950-80. AB - In 1978 a study of the mortality of United States cement plant and quarry workers was initiated. The vital status of a cohort of 5292 men who had been employed for at least five years in a cement plant between 1950 and 1980 was traced to 1 January 1980. The mortality experience was evaluated for 4231 white men for whom complete work histories and demographic information were available. Deaths from stomach cancer were significantly increased during 1965-9 but not over the entire follow up period (1950-80). Additionally, stomach cancer mortality was not significantly associated with tenure under separate control for age at follow up, latency, nativity, or year of birth. Evidence from this and other epidemiological studies has not confirmed an association between the constituents of cement plant dust exposure and death from stomach cancer. PMID- 3637115 TI - Elastase digestion and biochemical analysis of the elastin from an elastofibroma. AB - Elastin from both elastofibroma and control skin samples was analyzed by means of pancreatic elastase digestion and subsequent biochemical studies, such as for elastin content and amino acid composition. Elastin of elastofibroma was more resistant to elastase digestion than that of controls. Elastin content was increased almost twice (wet weight) or three times (dry weight) in elastofibroma. The amino acid composition had the characteristics of elastin; however, the cross linking amino acids such as desmosine, isodesmosine, and lysinonorleucine were increased in elastofibroma when compared with controls. An electron microscopic study showed that the interspersed cells had prominent intermediate filaments without any periodicity, pinocytotic vesicles, rough endoplasmic reticulum, and other organelles. These cells were considered to be fibroblasts not myofibroblasts. Therefore, it could be supposed that fibroblasts newly form an elastin that has a slightly different amino acid composition from that of controls. PMID- 3637116 TI - Men in nursing. PMID- 3637117 TI - PE: pulmonary embolism. PMID- 3637118 TI - [A perspective on Nicaragua]. PMID- 3637119 TI - [Expectations of parents]. PMID- 3637120 TI - What is a nurse? PMID- 3637121 TI - Eukaryotic pre-tRNA 5' processing nuclease: copurification with a complex cylindrical particle. AB - In eukaryotes pre-tRNA species are processed at the 5' end by an endonuclease. Here we describe the first characterization of the structure of a eukaryotic pre tRNA 5' processing endonuclease. The 5' pre-tRNAase, isolated from X. laevis ovaries, copurifies with a 16S macromolecular complex consisting of at least 14 polypeptides ranging in MW from about 20,000 to 32,000. These polypeptides comprise a cylindrical particle, apparently organized as a stack of four rings, similar or identical to a ubiquitous eukaryotic subcellular particle described in the literature over the past 15 years. Similar copurification is observed for the enzyme from HeLa cells, suggesting that the X. laevis enzyme is representative of a general class of eukaryotic pre-tRNA 5' processing nuclease. PMID- 3637122 TI - Real-time acquisition and data analysis of skeletal muscle contraction in a multi user environment. AB - A data acquisition system is described which acquires data from contracting skeletal muscle. The system is designed to run in a multi-user environment while acquiring contractile data in real-time. Time dedicated solely to laboratory experiments is thus eliminated. A menu-driver is included to allow users to enter experimental commands with or without command arguments. Error monitoring functions prevent operator errors from causing data loss. Data storage in both ASCII and binary formats maximizes file flexibility, readability and accessibility. Finally, an on-line tutorial and help facility is provided for user training. The system developed is applicable to any experimental environment involving data acquisition, storage and analysis. PMID- 3637123 TI - A computerized system for rapid retrieval and compilation of critical or interesting patient data. AB - The timely availability and presentation of critical and interesting patient data is essential to ensure quality patient care as well as ease of recognition and, secondarily, to provide material for teaching and research. The ability to accomplish these goals expeditiously in a complex and busy clinical laboratory may be difficult to acquire. An on-line, computerized system has been developed which automatically searches each patient record for up to 600 different laboratory tests, compares each result against individually established limits, and then formats pertinent test results for maximum discrimination. The report format also includes patient and specimen collection data, diagnosis, attending physician's name, and other desired associated test results. An additional feature of the system is that selected critical or interesting results for each laboratory division may be displayed on video display terminals located throughout the laboratory and at nursing stations. The system was written using the FORTRAN programming language and runs on a Control Data Cyber 18 computer. PMID- 3637124 TI - Computer-assisted predictive mathematical relationship among metrazol dose and time and mortality in mice. AB - A microcomputer program in BASIC for predicting mortality in mice administered metrazol is designed. A formula published by the author to express the mathematical relationship among the drug dose, the time after administration, and the biological response was used in this program. Analysis of the actual and the computer-assisted predicted mortalities has shown that the program is fairly accurate and reliable in expressing tolerance of mice as a function of the dose and the time. PMID- 3637125 TI - A C-language program for the computation of power spectra on a laboratory microcomputer. AB - A computer program is described which performs power-spectral analyses on time domain data. The program is written in the C language and incorporates an algorithm for the fast Fourier transform translated from BASIC into C. Sequential segments of time-domain data are accessed by the program, transformed to the frequency domain, and ensemble-averaged to generate smoothed spectra. Specific application of the program to the detection of high-frequency oscillations in the phrenic neurogram of the cat is addressed. Thus, 100 successive 512-point fast Fourier transforms were found to accurately reveal the relative strength (power) and frequency position (spectrum) of multiple peaks in this respiratory motor pathway. Because C language programs are very transportable, this program should run on machines other than our LSI 11/23, provided a C-compiler is available. PMID- 3637126 TI - The Complete Stoichiometer. AB - The Complete Stoichiometer, a computer program used in solving stoichiometric problems in chemical, biochemical or metabolic systems, is described. The program contains general facilities for handling the stoichiometric and real matrices used in chemical network problems. The program contains a number of utility and application subprograms. The utility programs provide for input of matrices in both standard form and symbolic equation form, editing and combination of matrices; storing and retrieving stoichiometric matrices from the disk; printing of reports; a BlackBoard subprogram which allows stoichiometric matrices to be manipulated on the screen with a command-driven language. The application programs are: standard processing of network stoichiometry to obtain reaction trees and reaction loops, the independent driving potentials, and the conserved moieties; the standard processing of an atomic composition matrix to obtain the set of independent reactions interconnecting the reactants, and a possible moiety structure; factoring of an atomic composition matrix to obtain the structure of reactants in terms of moieties and of moieties in terms of atoms; generation of reduced equivalent networks when some reactions are in rapid equilibrium and some reactants are in steady-state; a robust mass action chemical equilibrium solver. PMID- 3637127 TI - The maintenance, distribution and development of biomedical computer software: an exercise in software engineering. AB - The growing reliance of biomedical investigations on computer software in almost all facets of their work places considerable emphasis on the need for the integrated management of the software. In order to efficiently develop, distribute, and maintain the software, tools are required which not only automate these tasks but also, wherever possible, 'semi-intelligently', alert their user to irregular situation. We describe an assortment of such tools routinely used in the management of the SAAM/CONSAM biokinetic software and illustrate their application. Furthermore, using these techniques we have presented some comparative performances of numerical integrators and of computer processors. PMID- 3637128 TI - Development and evaluation of digitally processed Z-contrast imaging: a technological advance in medical imaging. AB - For the first time in the field of medical imaging, harmonious use of Z-contrast imaging and digital image processing was developed as an analytical imaging tool and demonstrated in studying human and rabbit spermatozoa. The biological information generated is unique to the science of medical imaging. The versatility of its applications is wide as this advance in imaging technology can be applied to any area of medicine involving tissue analysis. Tissue analysis plays a vital role in both medical research and diagnostic patient care. Imaging in the Z-contrast mode of the scanning-transmission electron microscope affords biologists the capability to image tissue in its natural state such that heavy metal fixatives and stains are not used. The digitally processed Z-contrast image is not only devoid of artifacts caused by fluctuating mass-density, topography variations, and the addition of heavy metal contrast agents but also offers a biological blueprint of the atomic weight distribution in the tissue. The varying gray level intensities assigned to each pixel in the resulting image are specific to the average atomic weight differences inherent in the tissue. The advent of complementary Z-contrast imaging and digital image processing and their concomitant research possibilities offers areas of medical care and medical research an invaluable imaging tool. PMID- 3637129 TI - Infant feeding: the weighting game. PMID- 3637130 TI - Asthma: finger on the trigger. PMID- 3637131 TI - Asthma: breathing more easily. PMID- 3637132 TI - Asthma: anxiety attacks. PMID- 3637133 TI - Health visiting: doctor in the house. PMID- 3637134 TI - Power of the prescription pad. PMID- 3637135 TI - Doing the legwork. PMID- 3637136 TI - Reader survey report: effects of cost-cutting measures on critical care nursing. PMID- 3637137 TI - Computers in critical care. Computation of cardiorespiratory variables using a hand-held computer. PMID- 3637138 TI - ECG challenge. Sinus pause. PMID- 3637139 TI - Antiarrhythmic medications classified by their autonomic properties. PMID- 3637140 TI - A simple formula for monitoring parenteral infusion. PMID- 3637141 TI - The Glasgow Coma Scale: ten years after (continuing education credit). PMID- 3637142 TI - Arrhythmia quiz. PMID- 3637143 TI - The trial of a medical malpractice case. PMID- 3637144 TI - Secretion clearance: state of the art from a nursing perspective (continuing education credit). PMID- 3637145 TI - Management problems in unilateral lung disease with emphasis on differential lung ventilation. PMID- 3637146 TI - Hidden chest trauma in the head-injured patient (continuing education credit) PMID- 3637147 TI - AIDS: getting past the diagnosis and on to discharge planning. PMID- 3637148 TI - I.v. medication compatibility chart. PMID- 3637149 TI - Meeting the challenge of fetal surgery. PMID- 3637150 TI - Cardiac tamponade after nonpenetrating cardiac trauma. PMID- 3637151 TI - Life-threatening heat-related emergencies (continuing education credit). PMID- 3637152 TI - DINAMAP monitor versus direct blood pressure measurements. PMID- 3637153 TI - Point-counterpoint technique in assessing hidden agendas. PMID- 3637155 TI - Pediatric trauma nursing: a career option. PMID- 3637154 TI - Cardiovascular responses to communication during catheterization. PMID- 3637156 TI - The Mr-50 000 polypeptide of mammalian pyruvate dehydrogenase complex participates in the acetylation reactions. AB - The mammalian pyruvate dehydrogenase complex, Mr 8.5 X 10(6), contains an additional tightly bound 50 000-Mr polypeptide, component X, which copurifies with the intact assembly. Small amounts of the individual E2 and X polypeptides were obtained by elution of the protein bands from SDS/polyacrylamide gels. One dimensional peptide mapping studies with 125I-labelled lipoyl acetyltransferase (E2) and component X subunits indicate that these two proteins are structurally distinct entities. Similar analysis of purified subunits, initially radiolabelled in the intact complex in the presence of [2-14C]pyruvate and N-ethyl-[2,3 14C]maleimide confirm that distinct 14C-labelled peptides are generated from these two species. These protein-chemical data supplement recent immunological findings, which demonstrate that component X is not a proteolytic fragment of the larger lipoyl acetyltransferase (Mr 70 000) subunit. Incubation of the native PDC in the presence of [2-14C]pyruvate leads to rapid uptake of radiolabel, presumably as acetyl groups, into both E2 and protein X. Specific incorporation of acetyl groups declines to a similar extent on both polypeptides after inhibiting pyruvate dehydrogenase (E1) activity by phosphorylation or omitting thiamine diphosphate (TPP) from the assay mixture. Addition of CoASH promotes the parallel deacetylation of both lipoyl acetyltransferase and protein X in a reaction which displays sensitivity to N-ethylmaleimide. PMID- 3637158 TI - Nurse manpower: the problems ahead. PMID- 3637157 TI - [Disorders of the coagulating, fibrinolytic and kallikrein-kinin systems and microembolization of the lesser circulation vessels in chronic kidney failure patients treated by hemodialysis]. PMID- 3637159 TI - Recent manpower trends in Northern Ireland. PMID- 3637160 TI - The merging of participatory and analytical approaches to evaluation: implications for nurses in primary health care programs. AB - This paper addresses the need to make evaluation part of the nurse's expanded role within the Primary Health Care system. In a social policy and decision making context, the nurse is an intermediary between political authorities and community groups. This requires diverse, but complementary, evaluation skills. The author proposes a dual method of evaluation for community health programs. The approach incorporates an objective-stance Logical Framework Analysis Model, to meet agencies' needs for program effectiveness and impact data, and a Participatory Evaluation approach, to recognize the ability of communities to judge whether health services are responsive to their needs. The nature and application of both methods within an International Primary Health Care context are explored. The paper concludes that access to a wide spectrum of evaluation data places the nursing profession in a challenging position to influence policy decisions related to health services. PMID- 3637161 TI - A study of changes in the information routines in a neurological ward. AB - The purpose of this study was to investigate whether changes in the method of organizing medical and nursing care in the neurological ward would affect the patients' satisfaction with information during their stay in the ward. The changes consisted of systematic information routines, systematic follow-up and feedback of information which was provided by a 'mentor' system and systematic routines for written communication between informants and 'mentors' about the patients' need for information. A general improvement of the information to the patients occurred. General information was judged almost completely adequate with the aid of the new routines. The effect of the organizational changes upon the patients' satisfaction with medical information could not be fully studied. The physicians continued to give information about diagnosis, prognosis and after care very late during the patients' hospital stay and this information was not followed up at all during the experimental period. PMID- 3637162 TI - Resident parents during paediatric admissions. AB - During a 9-month study period, 20% of parents (usually mothers) of children admitted to an acute medical paediatric ward opted to live in the hospital. We compared 34 resident parents with 23 from within the visiting group; the children were group-matched for age and sex. Our findings suggest that a number of resident parents perceive their children as temperamentally vulnerable and that they are in special need of reassurance and explanation. Thought needs to be given to how the hospital can respond optimally to them. PMID- 3637163 TI - Parental weight and its relation to infant feeding patterns and infant obesity. AB - Mother-infant feeding behaviour as a possible determinant of obesity was studied. Seventy-eight healthy primiparous couples and their newborn children were divided into three groups according to parents' weight status (normal weight parents; one overweight and one normal weight parent; both parents overweight). Infants' weight and length measurements were obtained at birth and at 6 months of age. Mother-infant dyads were observed during feeding sessions at 55-77 hr after birth, at 2 weeks, 1, 2, 4 and 6 months postpartum. Feeding behaviour of mother and infant did not differ, nor did mother-infant interaction differ between the three groups throughout the observation period. However, infant weight status, although not different at birth, differed significantly at 6 months of age. Bartholomew's test showed the proportion of infants greater than or equal to 90%il increased significantly from infants of normal weight parents to infants of one overweight and one normal weight parent, to infants both parents of whom were overweight (chi 2 = 6.904, c = 0.44, P less than or equal to 0.01). While data of this study do not show any behavioural differences between overweight and normal weight parents and their offspring, they confirm results reported by other researchers showing children of overweight parents at risk of becoming overweight at 6 months of age as well. PMID- 3637164 TI - Life satisfaction of the elderly American Indian. AB - This study examined the life satisfaction of 58 elderly American Indians and its relationship to selected external and internal environmental factors. Elderly Indians were 51-85 years of age and resided on two midwestern reservations. Data were collected through use of the Life Satisfaction Index Z-scale (LSI-Z), the Oars Multi-dimensional Functional Assessment Questionnaire (OARS) and a semi structured interview schedule. Findings indicated that life satisfaction tended to be high. Six internal environmental variables explained 40% of the variance in life satisfaction scores. A higher correlation was found between self-perception of life satisfaction and mental health than objective ratings on these two variables. This study suggests that variables associated with the internal environment may be useful as indicators of life satisfaction in elderly reservation American Indians and that subjective measures of life satisfaction may be more predictive of mental health than objective measures. PMID- 3637166 TI - Application of plasmid analysis to infection control. PMID- 3637165 TI - Toxic shock in a hospital employee due to methicillin-resistant Staphylococcus aureus. PMID- 3637167 TI - Dissemination of a plasmid determining multiple antibiotic resistance between two Veterans Administration Medical Centers. AB - The endemic R-plasmids mediating resistance to gentamicin and multiple other antibiotics among many species of Enterobacteriaceae from the Minneapolis and Cleveland Veterans Administration Medical Centers were compared by restriction endonuclease digestion profiling and by phenotype expressed in sensitive E. coli recipients. Southern hybridizations were also performed. Our data indicate that these plasmids demonstrate some microheterogeneity, but are very closely related. Both are self-transferable and mediate resistance to ampicillin, carbenicillin, chloramphenicol, gentamicin, tobramycin, neomycin and kanamycin. These results suggest the dissemination of a conjugal R-plasmid or of Enterobacteriaceae bearing the plasmid between two midwestern Veterans Administration Medical Centers. The most likely mechanism of transmission may be the frequent transfer of patients between midwestern Veterans Administration Medical Centers. PMID- 3637168 TI - Hepatitis B vaccine in healthy hospital employees. AB - A low rate of seroconversion to hepatitis B vaccine is reported. This occurred in healthy hospital employees from two separate institutions. A total of 236 individuals were evaluated in this study and only 53% or 124 persons developed protective levels of antibody to hepatitis B surface antigen following a complete vaccine series. In one hospital, 30% of the vaccine recipients developed antibody but not to a protective level. Employees who received the entire series in the arm or in the arm and buttock (mixed) had a significantly greater number of responders than employees who received the entire series in the buttock (P less than .05). Recipients aged 50 to 59 years had a significantly lower response rate to the vaccine (P less than .05). There was no correlation with the vaccinee's sex or the timing of the second injection. Vaccine was noted to have frozen in one hospital and accounted for some loss of antigenicity. This failure to respond to the vaccine has necessitated the use of booster injections of vaccine and continued antibody monitoring. PMID- 3637169 TI - Viability of staphylococci in various diluents. AB - Standardized suspensions of 78 staphylococci and micrococci were stored in different diluents and tested periodically for 3 weeks to determine their ability to maintain viability. In 92% of the tests, diluent suspensions yielded viable organisms for at least 21 days. Organism survival was maintained in the following order, from best to worst: skim milk, tap water, 0.9% NaCl, deionized water, Dianeal (peritoneal dialysis) fluid, 0.2% bovine serum albumin and 5% glycerol. In 81% of the instances, oxacillin-susceptible staphylococci survived better than oxacillin-resistant staphylococci. PMID- 3637170 TI - Herpes simplex virus. PMID- 3637171 TI - North Dakota rule changes require associate, baccalaureate education. PMID- 3637172 TI - South Dakota statewide project for nursing and nursing education. PMID- 3637173 TI - An LPN looks at the developing LPN role. PMID- 3637174 TI - An analysis of trends in the role of the licensed practical nurse. PMID- 3637175 TI - Incorporating a deliberative nursing care approach with breastfeeding mothers. PMID- 3637176 TI - Breastfeeding adoption by low-income black women. PMID- 3637177 TI - A project for facilitating maternal adaptation with Chinese adolescent mothers in Taiwan. PMID- 3637178 TI - Physiological determination of methicillin resistance in Staphylococcus aureus: comparison of clinical and genetically derived isolates. AB - The expression of methicillin resistance in 10 clinical and 5 genetically constructed strains of Staphylococcus aureus has been measured in relation to temperature of incubation (37 degrees C versus 30 degrees C), the presence of additional sodium chloride in the medium (5.5% vs. 0.5%), and pH (7.4 vs. 5.4). Resistance was quantitatively measured by disc diffusion and agar dilution assays. In disc assays of methicillin resistance, all but one clinical isolate and both transduced strains displayed increased the resistance at the lower temperature. Increased salt had little effect, or decreased the resistance of these strains. At pH 5.4 resistance decreased substantially. Methicillin resistance in three step-selected strains, by contrast, was variably affected by changes in temperature or salt concentration, though the effects were never great. The most distinctive feature of these strains was that pH change did not affect their resistance. In agar dilution assays, where surviving fractions within the population were measured as a function of antibiotic concentration, the temperature and salt effects seen in disc assays of resistance were again evident for the two clinical isolates tested, but not for the transduced strains, where added salt increased resistance at the higher concentrations of methicillin tested. For two step-selected strains, the effects of lowering temperature and increasing salt on resistance were variable. By contrast with the disc assays, these strains were less resistant at the lower pH, though not to the same relative extent as that shown by the clinical isolates and transduced strains. Resistance heterogeneity was not significantly affected by higher salt and lower incubation temperature in the two clinical strains tested, but elevated salt consistently increased heterogeneity in transduced and step-selected strains at the higher concentrations of methicillin tested. In the absence of salt, step selected strains exhibited little heterogeneity, unlike the clinical and transduced strains. We conclude that the similarities and differences seen in clinical isolates and laboratory strains favour the idea that methicillin resistance arises clinically in S. aureus as a result of transduction (or other genetic transfer) of existing gene(s) determining resistance, rather than as a result of selection of mutants among sensitive or less resistant strains. Our findings also indicate that inclusion of salt in media containing methicillin may attenuate resistance to the antibiotic and thus decrease the sensitivity of detection of marginally resistant strains of S. aureus. PMID- 3637179 TI - Increased resistance to penicillin of oral viridans streptococci in dental students. AB - Salivary samples were taken annually in October from 48 dental students as they progressed from pre-clinical studies to final year. The MICs of penicillin for the viridans streptococci were determined. Over the three years these organisms became progressively more resistant but not to a level of clinical significance. The findings were confirmed by a cross-sectional study of 57 pre-clinical and 37 final year students. The increase in resistance might have been related to age, but a further study of 20 postgraduate chemistry students of the same age as the final year dental students showed that the former had a population of streptococci similar to that found in the pre-clinical students. Whether the increase in resistance is a result of the dental students working in the clinic or having penicillin more frequently prescribed for them personally is a matter for speculation. PMID- 3637180 TI - Application of the stoichiometric displacement model of retention to anion exchange chromatography of nucleic acids. AB - The stoichiometric displacement model has been refined in its application to anion-exchange chromatography. The revised stoichiometric displacement model has been shown to be valid for anion-exchange chromatography with respect to all particulars of the model tested. It has been shown that the use of displacing agent activity is not a necessary condition for valid application of the stoichiometric displacement model to anion-exchange chromatography. While the cation of the displacing salt can influence anion-exchange chromatography, the data indicate that the displacing anion is of primary importance. It has been shown that solutes with three-dimensional structure have Zn value to solute charge ratios less than unity, and that the stoichiometric displacement model may be useful as a probe of solute three-dimensional structure. PMID- 3637181 TI - Bandwagons nursing has jumped on--or off: a satire on some of the events in the history of nursing education. PMID- 3637182 TI - Preparation of a curriculum vitae. PMID- 3637183 TI - "You mean fund-raising is in my job description"? PMID- 3637184 TI - Primary health care in four countries. PMID- 3637185 TI - Freedom to decide--yours, mine, or theirs.... PMID- 3637186 TI - The changing of the guard. PMID- 3637187 TI - The politics of interdisciplinary collaboration in professional practice. PMID- 3637188 TI - The Gramm-Rudman-Hollings Budget Deficit Control Act. PMID- 3637189 TI - Regional research networking: a stimulus to research collaboration and research productivity. PMID- 3637190 TI - Trends in master's education in nursing. PMID- 3637191 TI - Health care delivery in Sweden and Finland: a challenge to the American system. PMID- 3637192 TI - Burnout in nurse faculty: relationships with management style, collegial support, and work load in collegiate programs. PMID- 3637193 TI - Future of health care delivery. PMID- 3637194 TI - Investigating the problem of pressure sores. PMID- 3637195 TI - Assessment protocols for acute medical conditions. PMID- 3637196 TI - Sensory loss simulation use in nursing education. PMID- 3637197 TI - Delivering home health care to the elderly in Zuni Pueblo. PMID- 3637198 TI - The path of the past shaping the future. PMID- 3637199 TI - Late life depression: a guide for assessment. PMID- 3637200 TI - In vitro and in vivo study of fosfomycin in methicillin-resistant Staphylococcus aureus septicaemia. AB - Five hundred strains of methicillin-resistant Staphylococcus aureus were tested against various anti-staphylococcal agents. Vancomycin, fusidic acid and fosfomycin were found to be the most effective. Only 1 strain out of 500 was resistant to fosfomycin. Three patients with methicillin-resistant Staphylococcus aureus septicaemia were successfully treated by fosfomycin. We conclude that fosfomycin could be the drug of choice for methicillin-resistant Staphylococcus aureus infection. PMID- 3637201 TI - Concentrations of glandular kallikrein in human nasal secretions increase during experimentally induced allergic rhinitis. AB - We have previously demonstrated that a mixture of bradykinin and lysylbradykinin is generated in nasal secretions during the immediate allergic response to allergen. The present studies were performed to determine whether glandular kallikrein plays a role in kinin formation during the allergic reaction. Allergic individuals (n = 7) and nonallergic controls (n = 7) were challenged intranasally with appropriate allergen, and nasal lavages obtained before and after challenge were assayed for immunoreactive glandular kallikrein as well as for histamine, kinins, and N-alpha-tosyl-L-arginine methyl esterase (TAME-esterase) activity. The increase in postchallenge immunoreactive glandular kallikrein levels above baseline was significantly greater (p less than 0.01) for the allergic group (16.3 +/- 14 ng/ml; means +/- SD) than for the nonallergic controls (1.0 +/- 1.9 ng/ml). Increased levels of immunoreactive glandular kallikrein correlated with increases in kinins, histamine, and TAME-esterase activity and with the onset of clinical symptoms. Characterization of immunoreactive glandular kallikrein purified from postchallenge lavages by immunoaffinity chromatography confirmed the identity of this material as an authentic glandular kallikrein on the basis of its inhibition by protease inhibitors and by monospecific antibody to tissue kallikrein, its chromatographic behavior on gel filtration, and its ability to generate lysylbradykinin from highly purified human low m.w. kininogen. The specific activity of this purified material, in terms of kinin generation from kininogen, was very similar to that for authentic glandular kallikrein, suggesting that most if not all of the immunoreactive material purified from nasal lavages represented active enzyme. Inhibition studies by using pooled postchallenge lavages suggest that the majority of the kinin generating activity in these samples was due to glandular kallikrein. We conclude, therefore, that glandular kallikrein is secreted during the allergic response and can contribute to the formation of the lysylbradykinin produced during the allergic reaction. PMID- 3637203 TI - Kinin-prekallikrein system in Mediterranean spotted fever. PMID- 3637202 TI - Mechanism of penicillin-streptomycin synergy for clinical isolates of viridans streptococci. PMID- 3637204 TI - Exchange and mass efflux of cholesterol in macrophages. Evidence for a common mechanism and a role for plasma membrane proteins. AB - Exchange and net mass efflux of cholesterol were investigated in [3H]cholesterol labeled or cholesteryl ester-loaded murine peritoneal macrophages, respectively. Macrophages were subjected to mild proteolysis prior to measurements of mass efflux or exchange to assess whether plasma membrane proteins participated in either process. Cholesterol exchange and mass efflux were inhibited up to 70% following trypsinization. The inhibitory effect was reversible as cells regained normal efflux and exchange 6-8 hr following treatment. Incubation of trypsinized cells with cycloheximide prevented recovery, indicating that protein synthesis was necessary for restoration of normal cholesterol efflux. Studies with peptide and nonpeptide inhibitors of proteolysis suggested that active catalytic activity of trypsin was necessary for the inhibitory effect to be expressed. The degree of inhibition for both cholesterol exchange and mass efflux was dependent in a quantitatively similar manner on the time of incubation and the concentration of trypsin, suggesting that the mechanism of cholesterol exchange and mass efflux were similar at the level of the plasma membrane. Two other serine-proteases, thrombin and elastase, were also capable of inhibiting cholesterol removal in a similar manner. No cell death was observed by altered morphology, detachment, changes in DNA or protein content, or trypan blue exclusion even under the most severe proteolytic conditions. These studies suggest that protease-sensitive plasma membrane proteins play a role in cholesterol efflux in macrophages. PMID- 3637205 TI - Sleep and bedtime routines of non-institutionalized aged women. PMID- 3637206 TI - Application of Orem's theory of self-care: a case study. PMID- 3637207 TI - Hospice: concept and implementation in the black community. PMID- 3637208 TI - Nurse practitioners in a crowded marketplace: 1965-1985. PMID- 3637210 TI - Validity and reliability of teacher-made tests. PMID- 3637209 TI - Teaching child health-care concepts to Khmer mothers. PMID- 3637211 TI - Clinical evaluation of a nursing orientation program. PMID- 3637213 TI - A new approach to the care-plan problem. PMID- 3637212 TI - A paradigm for thinking about death. Implications for the development of nursing practice. PMID- 3637215 TI - Competency-based orientation proved effective. PMID- 3637214 TI - Bridging the gap between research and practice: teaching the research process. PMID- 3637216 TI - Nursing staff development--critical times, critical issues. PMID- 3637217 TI - Marketing strategies to increase participation in continuing education. PMID- 3637218 TI - The corporate nurse consultant. AB - With the increase in for-profit, multi-hospital, corporate systems, a new nursing role has evolved: that of corporate nurse consultant. This article discusses how the role and functions of this consultant differ from those of an independent consultant. It also describes the corporate nurse consultant's responses to integrating corporate imperatives with the needs of individual institutions. Suggestions are offered for enhancing the relationship between the corporate nurse consultant and an institution's nurse executive. PMID- 3637219 TI - The human resource consultant in nursing. AB - The authors have developed a role that supports nurse managers in developing their management skills and effectiveness. Nursing administrators will find the role useful because it provides a different avenue for the strategic planning of change. The role and examples of its use in the support of nursing are described. Considerations in operationalizing this role in a nursing organization also are discussed. PMID- 3637220 TI - Journal usage by nurse executives and staff. PMID- 3637221 TI - Staff nurse performance. Effects of goal-setting and performance feedback. AB - Goal-setting and performance feedback have motivated improved performance in various occupational groups for over 30 years. During the current time of staffing cutbacks and increased patient acuity, the nurse administrator has growing concern for the morale of the nursing staff. In this study, goal-setting and performance feedback, used in conjunction with a performance appraisal session, were successful in improving the performance of staff nurses. The author outlines the implications for head nurse training. PMID- 3637222 TI - Rational product evaluation. AB - This article describes a systematic method for planning and implementing a program for product evaluation. Steps for the planning process include appointing a centralized, decision-making group, developing an evaluation plan, implementing mechanisms to introduce new products, defining follow-up methods, and developing methods to identify product needs. Steps in the implementation process include initiating product requests, exploring options, evaluating options, and summarizing findings on which to base a final product decision. A tool for product evaluation is presented. PMID- 3637223 TI - Nursing administration in small rural hospitals. AB - Most of the world's population is rural and 45% of all United States hospitals are small or located outside of urban centers. The interdependence of rapidly changing rural communities and hospitals is described in this study of nursing directors' jobs. Findings provide needed information about the challenges and demands of nursing administration in small organizations useful for development of curriculums sensitive to values, politics, and economies; and for all nurse executives eager to understand the complexity of decisions and actions, whether in small organizations or in large multi-institutional systems comprising hospitals of varying sizes. PMID- 3637224 TI - A displacement orientation program. Effects on transferred nurses. AB - When nursing administrators make a decision to close nursing units and displace staff nurses, nursing staff respond with feelings of anger and demoralization. Instituting a Displacement Orientation Program (DOP) can positively affect the staff nurses' level of anger, independence, innovation, self-confidence, and productivity. This article presents a research based DOP used to minimize staff reactions and maximize staff adjustments to displacement. PMID- 3637225 TI - Stress among head nurses: where's the evidence? PMID- 3637226 TI - The nurse executive as risk taker. PMID- 3637227 TI - Anti-inflammatory effect of a selective inhibitor of elastase, cathepsin G and chymotrypsin on carrageenin-induced inflammation in rats. AB - The anti-inflammatory activity of a proteinase inhibitor on carrageenin-induced inflammation was studied by using N-(2,4-dinitrophenyl)-benzisothiazolinone-1,1 dioxide, a selective inhibitor of elastase, cathepsin G and chymotrypsin. The selective inhibitor suppressed leukocyte chemotaxis in vivo and in vitro, vascular permeability and development of granulation tissue. These results suggest that a selective inhibitor of elastase, cathepsin G and chymotrypsin is an effective agent for suppression of induction and development of carrageenin induced inflammation in rats. PMID- 3637228 TI - Factors influencing survival of patients on chronic hemodialysis: implications for nursing. PMID- 3637229 TI - Quality care for the hospitalized CAPD patient on a general medical unit. PMID- 3637230 TI - A patient's opinion. PMID- 3637231 TI - Abnormalities in cardiac rhythm: sinus and atrial dysrhythmias. PMID- 3637232 TI - Preparation of children for hospitalization and surgery: a review of the literature. PMID- 3637233 TI - Nonorganic failure to thrive: identification and intervention. PMID- 3637234 TI - Psychological factors, childbearing, and black female adolescents. PMID- 3637235 TI - Merely child's play? Developmental work and playthings. PMID- 3637236 TI - Delegation strategies for the pediatric nurse. PMID- 3637237 TI - Mothers' reactions to their children's hospitalizations. PMID- 3637238 TI - "At will" employment. PMID- 3637240 TI - Research problems in clinical practice. PMID- 3637239 TI - Home phototherapy. PMID- 3637241 TI - The use of dextroamphetamine to counteract sedation for patients on a morphine drip. PMID- 3637242 TI - Share and Care family support weekend. PMID- 3637244 TI - Mental health acuity system. The measure of nursing practice. AB - As the mental health unit continues working with the acuity system, areas within the system can be improved, such as simplifying the number of behavioral emergencies and decreasing any overlap of behavioral categories. As the supervisor anticipates "fine-tuning" the system, the process of obtaining feedback from the majority of nursing staff on the unit and involving the senior staff nurses as a group in any revisions will be repeated. The sense of the mental health acuity system at St. Francis Hospital is that it reflects all the intricacies of the work that the mental health staff perform. This validity needs to be maintained throughout any revisions because it is integral to continuing the excellence of the system. The mental health staff knows best the work that they perform daily and this acuity system validates the quality and quantity of the care. PMID- 3637243 TI - Androgyny, sexual satisfaction, and women. PMID- 3637245 TI - Sexual abuse. PMID- 3637246 TI - Expressed emotion and life events in schizophrenia and depression. PMID- 3637247 TI - Peptidyl carbamates incorporating amino acid isosteres as novel elastase inhibitors. AB - The design and synthesis of 13 novel peptidyl carbamates are described. When tested for inhibitory activity toward porcine pancreatic elastase, trypsin, and chymotrypsin, six compounds were found to specifically inhibit elastase without affecting the other two serine proteases. All the active inhibitors had an amino acid isostere at the P1 position. Kinetic studies indicated that the inhibition was competitive with Ki values ranging from 4.23 X 10(-5) to 2.4 X 10(-6) M. The degree of inhibition was found to be dependent on the specificity of the peptide chain for the extended subsites on the enzyme as well as on the nature of P1'. Preliminary work on one inhibitor indicates that the inhibition is reversible and proceeds via the rapid formation of a strong enzyme-inhibitor complex, followed by slow acylation of the serine residue on the active site of the enzyme. Peptidyl carbamates represent a novel class of elastase inhibitors. PMID- 3637248 TI - Stereochemical analysis of ribosomal transpeptidation. Conformation of nascent peptide. AB - Transpeptidation performed by the ribosome is considered as a nucleophilic Sn2 substitution reaction, passing through a tetrahedral intermediate. A stereochemically universal mechanism of the reaction is assumed to exist for all 20 amino acid residues, both in the attacked (donor) and in the attacking (acceptor) substrates. The angles of internal rotation around the bonds of the attacked carbonyl carbon and around the neighbouring bonds in the tetrahedral intermediate, as well as the stereoconfiguration of the intermediate, have been varied. All 54 combinations of the sterically allowed rotational isomers determined by the five torsional angles have been analysed by using Corey-Pauling Koltun models and by direct calculations permitting the "extreme limits" in interatomic distances and +/- 7 degrees deviations in bond angles. Only one combination, i.e. one unique conformation of the tetrahedral intermediate, is found to be sterically compatible with all 400 possible pairs of the reacting amino acid residues and at the same time to be capable of cleaving into a planar trans-peptide group. The torsion angles phi and psi of this universally allowed intermediate and the peptide product resulting from its cleavage are similar to those in an alpha-helix. It is suggested that the ribosome generates the alpha helical confirmation at the C-end of the nascent peptide. PMID- 3637249 TI - Disallowed conformations of the tetrahedral intermediate. PMID- 3637250 TI - [Clinical examination in obstetrics. 18. Examination of anemia among pregnant women]. PMID- 3637251 TI - [Evaluation of neonatal care based on fluctuations in body temperature pattern]. PMID- 3637252 TI - [Emotional response as the starting point in neonatal nursing]. PMID- 3637253 TI - [Opportunity for ambitious midwives at Yusuhara-cho, Kochi Prefecture]. PMID- 3637254 TI - [Neonatal jaundice. 2]. PMID- 3637255 TI - [Perinatal nursing: psycho-social approaches. 3. Stress suffered by the expectant mothers and the nursing approach]. PMID- 3637256 TI - [Thoughts on childbirth and child care. 15. Birth assistants (midwives): in search of the source of their role]. PMID- 3637257 TI - [Pioneers in natural childbirth]. PMID- 3637259 TI - [Uterine rupture observed in modern obstetric practice]. PMID- 3637258 TI - [Educational evaluation: test problems]. PMID- 3637260 TI - [Decision making in nursing. 3. Genital cleansing and patients' hesitation in voicing complaints]. PMID- 3637261 TI - [Nursing theory. 3. Approach to the theory (1)]. PMID- 3637262 TI - [Experience in ambulatory care and counseling]. PMID- 3637263 TI - [Nursing problems in ambulatory practice of internal medicine and the role of nurses]. PMID- 3637264 TI - [Studying to improve emergency nursing and the result of the effort]. PMID- 3637265 TI - [On the practice of ambulatory nursing: a survey]. PMID- 3637266 TI - [Current status and future problems in ambulatory nursing based on work analysis]. PMID- 3637267 TI - [A nursing student's concept of the nurse at an outpatient clinic]. PMID- 3637269 TI - [Bedside nursing. Introduction of gardening and painting to the activities of psychiatric patients]. PMID- 3637268 TI - [Learning through interactions with a terminal cancer patient]. PMID- 3637270 TI - [Current status of sex behavior of stroke patients and health instructions]. PMID- 3637271 TI - [A report from New York. 3. Social workers at Beth Israel Medical Center: the importance of a sense of humor]. PMID- 3637272 TI - [A physician's personal account on the experience with cancer. 3. The result of the pathological diagnosis]. PMID- 3637274 TI - [A comment by a nursing director at a commencement ceremony]. PMID- 3637273 TI - [Medical and nursing activities in Ethiopia: an emergency report. 2. High mortality from diarrhea after rain]. PMID- 3637275 TI - [On Chinese medicine. 3. "Air, blood, and water" (1): On air]. PMID- 3637276 TI - [Clinical description of dementia. 11. Various types of dementia. (1) Senile dementia and dementia caused by cerebrovascular disorders]. PMID- 3637277 TI - [Introduction of POS to nursing. 6. Passwords: "data bases for nursing." 4]. PMID- 3637278 TI - [Counseling of patients. 14. A skill of listening: methods of counseling]. PMID- 3637279 TI - [Reports on nursing homes in New York. 3. Care of dying patients]. PMID- 3637280 TI - [Profile of a nurse: Ms. Tomoko Shimada who completed a nursing manual based on Oriental medicine]. PMID- 3637281 TI - [Decision making in nursing. 5. Nursing of pain]. PMID- 3637282 TI - [On nursing theory. 5. Dr. Parse and her nursing theory]. PMID- 3637283 TI - [Social rehabilitation of aged patients following stroke]. PMID- 3637284 TI - [Health instruction following discharge with consideration toward personal relationship between the patient and the person in charge of nursing at home]. PMID- 3637285 TI - [Assistance toward independence of the patient and preparation by the family to accept him]. PMID- 3637286 TI - [Planning early social rehabilitation of an apoplexy patient using an ambulation table]. PMID- 3637287 TI - [A thought on family education for smoother return of apoplexy patients to home]. PMID- 3637288 TI - [Training of a hemiplegic patient with muscular atrophy from disuse for unaided sitting and locomotion in a sitting position]. PMID- 3637289 TI - [Bedside nursing. Encouragement of an isolated, extended care patient toward socialization with other patients]. PMID- 3637290 TI - [Experience in establishing a health counselling service for overseas Japanese]. PMID- 3637291 TI - [The effect of classroom health education of diabetic patients]. PMID- 3637292 TI - [A report from New York. A visit at the Beth Israel Medical Center. 5. Patient representatives]. PMID- 3637293 TI - [A physician's personal account on the experience with cancer. 5. Life at the hospital]. PMID- 3637295 TI - [On Chinese medicine. 5. "Air, blood, and water". (3). On the "blood"]. PMID- 3637294 TI - [A comment by a nursing director. The importance of a smile in nursing]. PMID- 3637297 TI - [Introduction of POS to nursing. 8. Further study for accurate localization of problems]. PMID- 3637296 TI - [Clinical description of dementia. 13. Various types of dementia. (3). Subdural hematoma, hypothyroidism, anterior pituitary hypofunction, carbon monoxide poisoning, and pseudodementia]. PMID- 3637298 TI - [Counseling of patients. 16. Reframing as a method in counseling. (4)]. PMID- 3637299 TI - [Nursing homes in New York. 5. Nurses at nursing homes]. PMID- 3637300 TI - [Profile of a nurse. Ms. Akemi Irisa who acts as a free health consultant for the poor at Kamagasaki, Osaka]. PMID- 3637301 TI - [Decision making in nursing. 6. Predictability of sudden death]. PMID- 3637302 TI - [Nursing theory. 6. Parse's nursing theory: a unique theory based on human science]. PMID- 3637303 TI - [Assistance in deglutition actions]. PMID- 3637304 TI - [Assistance in oral intake by patients with deglutition disorders: nursing at an acute care facility]. PMID- 3637305 TI - [Oral nutrition as an important ingredient in living: oral intake as a nursing goal in a patient with deglutition disorder due to pseudobulbar palsy]. PMID- 3637306 TI - [Assistance in oral feeding of home patients with refractory neurologic diseases]. PMID- 3637307 TI - [A thought on meals, memory of a daughter who suffered from congenital muscular dystrophy and deglutition disorder]. PMID- 3637308 TI - [Rehabilitation of swallowing after stroke]. PMID- 3637309 TI - [Needs of expectant patients who require bed rest]. PMID- 3637310 TI - [Use of medication by the aged and their psychological analysis]. PMID- 3637311 TI - [A report from New York. A visit to the Beth Israel Medical Center. 6. Mrs. Rose Muscatine Hauer, the head nurse]. PMID- 3637312 TI - [A physician's personal account on the experience with cancer. 6. A visit to a church]. PMID- 3637313 TI - [A comment by a nursing director. Activities in the field of nursing]. PMID- 3637314 TI - [On Chinese medicine. 6. "Air, blood, and water". (4): Circulatory disturbances]. PMID- 3637315 TI - [Clinical description of dementia. 14. Treatment of dementia]. PMID- 3637316 TI - [Introduction of POS to nursing. 9. Further study for accurate localization of problems. 2]. PMID- 3637317 TI - [Counseling of patients. 17. Close observation of the patient, a method in counseling. 5]. PMID- 3637318 TI - [Nursing homes in New York. 6. Will to live among the demented patients]. PMID- 3637319 TI - [Profile of a nurse. Ms. Mikiko Ehira who published a book describing cancer patients]. PMID- 3637321 TI - [Surgery of senile cataract and pre and postoperative management]. PMID- 3637320 TI - [Surgery in the aged and related problems--with special reference to abdominal surgery]. PMID- 3637322 TI - [Surgery of esophageal cancer and postoperative management of aged patients]. PMID- 3637323 TI - [Surgery of femoral neck fracture and postoperative management]. PMID- 3637324 TI - [Emergency surgery in aged patients: problems in postoperative care and their solutions]. PMID- 3637325 TI - [Pre and postoperative care of aged patients with metabolic or endocrine disorders]. PMID- 3637326 TI - [Pre and postoperative management of aged patients with cerebrovascular disorders]. PMID- 3637327 TI - [Pre and postoperative care of aged patients with liver cirrhosis]. PMID- 3637328 TI - [Pre and postoperative care of aged patients with pulmonary complications]. PMID- 3637329 TI - [Improvement of personal environment and mental care of aged patients undergoing surgery]. PMID- 3637330 TI - [Postoperative nutritional care and diet instructions for aged patients]. PMID- 3637331 TI - [Pre and postoperative care to prevent prolonged inactivity--a case of femoral neck fracture]. PMID- 3637332 TI - [Postoperative care of aged patients and instructions on self care--a case of colonic cancer with creation of a colostomy]. PMID- 3637333 TI - [Pre and postoperative programs for a patient undergoing total hip joint replacement and designing of an abduction pillow for the affected leg]. PMID- 3637334 TI - [Nursing of apoplexy patients with urination disorders--effects of intermittent catheterization, behavior therapy, and chemotherapy]. PMID- 3637335 TI - [Behaviors of patients at the development of acute myocardial infarction and the need for patient education]. PMID- 3637336 TI - [Social rehabilitation after an extended stay at a hospital--education of psychiatric patients and team approach at the hospital]. PMID- 3637338 TI - [Myocardial infarct]. PMID- 3637337 TI - [The "balance sheet" of human capability: a view on modern medicine. 27. A discussion]. PMID- 3637339 TI - [Emergency care of patients with myocardial infarction]. PMID- 3637340 TI - [Prevention and treatment of severe arrhythmia associated with acute myocardial infarction]. PMID- 3637341 TI - [Diagnosis and treatment of heart failure associated with acute myocardial infarction]. PMID- 3637342 TI - [Prevention and treatment of cardiogenic shock associated with acute myocardial infarct]. PMID- 3637343 TI - [Items to be observed in patients with myocardial infarction and management of sudden exacerbation]. PMID- 3637344 TI - [Nursing actions in easing the apprehension of patients in the CCU and their families]. PMID- 3637345 TI - [Nursing of a patient with myocardial infarction and cardiogenic shock]. PMID- 3637346 TI - [Exercise therapy for patients with myocardial infarction--timing and methods]. PMID- 3637347 TI - [Treatment of facial injuries]. PMID- 3637348 TI - [Nursing of patients with facial injuries]. PMID- 3637349 TI - [Ambulatory care of patients with myocardial infarction--examination for signs of recurrence and an innovation in health education]. PMID- 3637350 TI - [Nursing of a patient with extensive myocardial infarction associated with low cardiac output]. PMID- 3637351 TI - [Progress in cancer therapy. 5. Lung cancer]. PMID- 3637352 TI - [New clinical tests. 5. Radioimmunoassay (RIA)]. PMID- 3637353 TI - [Drug information. 5. Therapeutic agents for hepatic and pancreatic diseases]. PMID- 3637354 TI - [Nursing technology for home care. 5. Symptoms common among aged being cared for at home and their nursing (2)]. PMID- 3637355 TI - [Nursing and medico-legal problems. 5. Accidents related to nursing actions]. PMID- 3637356 TI - [Treatment of spinal injuries]. PMID- 3637357 TI - [Nursing of patients with spinal injuries]. PMID- 3637358 TI - [Urethro-rectal anastomosis for urinary diversion]. PMID- 3637359 TI - [Evaluation of brushing at hip joint replacement]. PMID- 3637360 TI - [Progress in cancer therapy. 6. Uterine cancer]. PMID- 3637361 TI - [New antidiabetic agents]. PMID- 3637362 TI - [Symptoms common among the aged and their care (3): care of demented patients]. PMID- 3637363 TI - [Nursing profession and medical disputes. 6. Accidents associated with nursing. 2]. PMID- 3637364 TI - [Urination disorders and neurologic diseases]. PMID- 3637365 TI - [Care planning in urination disorders following colostomy]. PMID- 3637366 TI - [Physiology of urination disorders]. PMID- 3637367 TI - [Urination disorder due to urethral injury and its management]. PMID- 3637368 TI - [Urination disorders due to neurogenic bladder and its management]. PMID- 3637369 TI - [Methods in urination training in nursing]. PMID- 3637370 TI - [Management of an indwelling catheter and prevention of infection--with special reference to the care of ambulatory patients]. PMID- 3637371 TI - [Patient education in intermittent urinary catheterization as part of self care]. PMID- 3637372 TI - [Key points in patient education on stoma care]. PMID- 3637373 TI - [Urination disorders of aged patients and their nursing care]. PMID- 3637374 TI - [Urination disorders in postoperative patients and their nursing--patient care following surgery of the digestive system]. PMID- 3637375 TI - [Urination disorders of patients with spinal cord injuries and their nursing care]. PMID- 3637376 TI - [Assistance in urinary control by apoplexy patients--a case of cerebral hemorrhage]. PMID- 3637377 TI - [Urination disorder following extensive hysterectomy and associated nursing care]. PMID- 3637378 TI - [Self care following ileostomy]. PMID- 3637379 TI - [Esophageal cancer]. PMID- 3637380 TI - [Metastasis of cancer of the thoracic esophagus and prognosis of patients with esophageal cancer]. PMID- 3637381 TI - [Esophagectomy, esophagoplasty, and postoperative care]. PMID- 3637382 TI - [Multimodal treatment of esophageal cancer]. PMID- 3637383 TI - [Preoperative care of patients with esophageal cancer--with special reference to the assistance in easing apprehension and prevention of pulmonary complications]. PMID- 3637384 TI - [Nursing of a patient following subtotal esophagectomy--with special reference to the care associated with intubation]. PMID- 3637385 TI - [Nursing of a patient with esophageal cancer and loss of voice]. PMID- 3637386 TI - [Nursing of a patient in the terminal stage of esophageal cancer and assistance to the family]. PMID- 3637387 TI - [Treatment of patients with thoracic injuries]. PMID- 3637388 TI - [Nursing of patients with thoracic injuries]. PMID- 3637389 TI - [Urinary tract infection in patients with urinary diversion]. PMID- 3637391 TI - [Personalities in postwar Japanese nursing: Ms. Aya Maeda]. PMID- 3637390 TI - [Vocalization training of alaryngeal patients--preliminary training and actual speech training]. PMID- 3637392 TI - [Progress in cancer therapy. 7. Breast cancer]. PMID- 3637393 TI - [Current clinical tests. 7. Electron microscopic histiocytology]. PMID- 3637394 TI - [Current pharmacological agents. 7. Therapeutic agents used for the treatment of hyperlipemia and hyperuricemia (gout)]. PMID- 3637396 TI - [Nursing actions and medical disputes. 7. Accidents related to nursing. (3). Incidents related to blood transfusion and medical instrumentation]. PMID- 3637395 TI - [Nursing technology applied to home care. 7. Therapeutic involvement--with special reference to medication and therapeutic actions performed by visiting nurses]. PMID- 3637397 TI - [Nursing experience at delivery and resultant emotional maturity]. PMID- 3637398 TI - ["Death" and nursing education. Clinical training in dealing with dying patients and their families and responses to nursing students]. PMID- 3637399 TI - [Staged learning in nursing of terminal patients]. PMID- 3637400 TI - [Ogai Mori's philosophy concerning life and death]. PMID- 3637401 TI - [On apprehension of student nurses in giving injections: analysis of the mental state by a Japanese version of the State-Trait Anxiety Inventory and reliability and validity of results]. PMID- 3637402 TI - [Study of home nursing in nursing education]. PMID- 3637403 TI - [Classroom training in oral medication]. PMID- 3637404 TI - [On punishment in the field of education]. PMID- 3637405 TI - [From my teaching records in clinical training]. PMID- 3637406 TI - [A plan on standardization of the number of teaching personnel in nursing education. (2): A study on time assigned to clinical training with emphasis on the nursing process]. PMID- 3637407 TI - [A study on clinical training: involvement of the teacher in self evaluation]. PMID- 3637408 TI - [Emotional tendencies of nursing personnel associated with nursing practice and the ideal format of clinical training: a comparison of nurses and nursing students based on a survey of emotional experiences]. PMID- 3637409 TI - [Evaluation of teaching plans in clinical practice using the standard nursing plans and specific examples of nursing planning]. PMID- 3637410 TI - [A trial in clinical training at an obstetric clinic]. PMID- 3637411 TI - [Introduction of an encounter group into nursing education: my involvement with encounter groups]. PMID- 3637412 TI - [Significance of the cleansing actions in the development of a relationship between the student and the patient]. PMID- 3637413 TI - [Structure and effects of education and learning. 9. On educational contents]. PMID- 3637414 TI - [Classroom training in technology in nutritional support]. PMID- 3637415 TI - [True nursing study and the theory on happiness]. PMID- 3637416 TI - [A tentative revision of nursing curricula proposed by the Japanese Council of Nursing Schools]. PMID- 3637417 TI - [The second version of the nursing curriculum at Medical Technology Colleges of National Universities: a proposal by the Project Section of the New Curriculum Research Committee]. PMID- 3637418 TI - [Structure of the curriculum in the adult nursing course and extraction of its contents]. PMID- 3637419 TI - [Study on the educational contents in training of nursing instructors: comprehension of teaching methods by instructors and introduction of methods in teaching]. PMID- 3637420 TI - [A study on future training in nursing technology: evaluation of the training in blood specimen collection by venipuncture]. PMID- 3637421 TI - [Case studies in classroom practice]. PMID- 3637422 TI - [Structure and effects of education and learning. 10. Educational methodology]. PMID- 3637423 TI - [Problems in and overview of private nursing colleges]. PMID- 3637424 TI - [Problems in and overview of nursing education in private schools]. PMID- 3637425 TI - [Problems in student guidance at 2-year nursing colleges]. PMID- 3637426 TI - [Current status and problems at the St. Luke's Nursing College in relation to the expression of the founding philosophy]. PMID- 3637427 TI - [Problems in and overview of nursing education in private schools]. PMID- 3637428 TI - [Newly established advanced nursing education in China]. PMID- 3637429 TI - [Purpose of training in clinical cases at our school]. PMID- 3637430 TI - [A study on clinical training of male nursing students in obstetrical nursing: a survey on patients' attitudes]. PMID- 3637431 TI - [Structure and effects of education and learning. 11. Educational evaluation]. PMID- 3637432 TI - [Clinical training in pediatric nursing: interactions between students and children]. PMID- 3637433 TI - [Status of computer-related study subjects such as information processing technology: a survey on the status of teaching and the attitudes of the administration at nursing educational facilities]. PMID- 3637434 TI - [The First Teaching Hospital ward system and computer utilization in nursing education at the Fujita Gakuen Health and Hygiene College]. PMID- 3637436 TI - [Structure and effects of education and learning. 12. On teaching personnel]. PMID- 3637435 TI - [Computer evaluation and analysis of nursing records in clinical training]. PMID- 3637437 TI - [Reflection on the National Health Insurance system and the activities of public health nursing: achievement by the public health nurses under the National Health Insurance system. A discussion]. PMID- 3637438 TI - [Importance of understanding the client's psychology in public health nursing]. PMID- 3637439 TI - [Development of public health activities as a cooperative action with municipal governments: an impression of a research meeting on geriatric health held at Higashi-Uwa, Ehime Prefecture]. PMID- 3637440 TI - [Public health nurses and health planning: return to grass-roots activities. A discussion]. PMID- 3637441 TI - [Public health nursing and health planning: return to grass-roots activities. Local support of the aged residents; our attempt at a meeting to evaluate the care of the aged]. PMID- 3637442 TI - [Public health nurses and health planning: return to grass-roots activities. Support of the local alcoholic patients and their families: public health nurses and the regional mental heath council]. PMID- 3637443 TI - [Severe cold in the winter in Hokkaido: the roots of public health nursing in the Wilderness of Hokkaido. 3]. PMID- 3637444 TI - [Daily activities of a public health nurse: life-saving ambulance service]. PMID- 3637445 TI - [Suicide by the aged and family structure (2). Reports from public health offices]. PMID- 3637446 TI - [Studies on instructions on reduced salt intake (1): on taste sensation and salt intake]. PMID- 3637447 TI - [Areawide public health activities and public health nursing stations]. PMID- 3637448 TI - [Study on the effective management of regional health care centering around the public health nursing stations]. PMID- 3637449 TI - [Physical examination designed for individual inhabitants. Example; 1. Examination for adult diseases as part of health objective of area citizens]. PMID- 3637451 TI - [The roots of public health nursing in the wilderness of Hokkaido. 4. Mass screening scene suggestive of a mobile public health clinic]. PMID- 3637450 TI - [Physical examination designed for individual inhabitants. Example; 2. Activities of "Ichi-no-Kai" (a group composed of borderline hypertension patients of the Kami-Oshima area)]. PMID- 3637452 TI - [Suicide in the aged and family structure. (3). Reports from public health offices]. PMID- 3637453 TI - [A study on the relationship between mothers' child-rearing experiences and their child-rearing behavior--a comparison between mothers' attitudes in dealing with their first and second children]. PMID- 3637454 TI - [Relationship between obesity with and without hyperlipemia and diseases]. PMID- 3637455 TI - [A memorable experience with Mrs. S.: a public health nurse's account of an unforgettable patient in a brief encounter of 2 years and 7 months]. PMID- 3637456 TI - [Nursing actions on the use of housing. (1): The housing problems which describe the health status of patients]. PMID- 3637457 TI - [Roots of nursing in public health nursing in the wilderness of Hokkaido. 5. Residents and public health nurses sharing community living]. PMID- 3637458 TI - [Regional care of patients with refractory diseases: practice at Mitaka-Shi. A panel discussion]. PMID- 3637459 TI - [Cooperation among specialized health care agencies, regional health services, a patients' organization, and a special school for the regional care of children with muscular dystrophy]. PMID- 3637461 TI - [Seminars on nursing administration. Budgeting for nursing department]. PMID- 3637460 TI - Modified vein allograft for small arterial reconstruction in dogs. AB - The ideal graft for peripheral arterial reconstruction has yet to be developed. We evaluated on the effectiveness of porosity to intimization of the graft. Modified vein allografts newly constructed through digestion of vein allografts with elastase, glutaraldehyde tanning and lyophilization were implanted in thirty nine canine femoral arteries. These grafts had a higher porosity than conventional vein allografts and the overall patency rate was 70 per cent at 6 months after implantation. Microscopic examination showed that graft interstitial healing and subsequent intimization were completed by ingrowth of connective tissue from outside through the graft wall at 3 weeks and later. Aneurysmal change of the modified vein allografts was never evident. These results indicated that porosity of the graft is indeed an important factor for intimization and durability of grafts, even in bioderivative substitutes. PMID- 3637462 TI - [Issue analysis of the expanded role of nursing]. PMID- 3637463 TI - [Expanding role of maternity nursing]. PMID- 3637464 TI - [Pediatric nurse practitioners]. PMID- 3637465 TI - [Alzheimer's disease inpatient care]. PMID- 3637466 TI - [An analytical study on the degree of job satisfaction of school nurses in school health services]. PMID- 3637467 TI - [Seminars on nursing administration. Budgeting]. PMID- 3637468 TI - [Seminar on nursing administration. Group dynamics and its application to effective meeting]. PMID- 3637469 TI - [A study of the attitudes of the health team towards a hospital-based community health nursing service]. PMID- 3637470 TI - [Should everything be sacrificed to health?]. PMID- 3637471 TI - [Nutrition and health: what profits?]. PMID- 3637472 TI - [Nutrition education or the role of prevention]. PMID- 3637473 TI - [Degenerative diseases and immunity]. PMID- 3637474 TI - [Nutrition education in the primary school. An experience in Geneva]. PMID- 3637475 TI - [After the move to Aarau. An interview with Ruth Quenzer]. PMID- 3637476 TI - [Hemodialysis technic. Dialysis with adjusted sodium concentration in the dialysate]. PMID- 3637477 TI - [After the move from Zurich to Aarau. In nursing of the future the professional tasks go beyond the hospital. Interview by Nelly Haldi]. PMID- 3637478 TI - [Inaugural celebration: Swiss Red Cross president for Federal Support and Equal Opportunity]. PMID- 3637479 TI - [The oncologic nurse in the stress area between school and alternative medicine. Remaining independently in the middle]. PMID- 3637480 TI - [A visit to the Rheinfelden paint group. Painting as a way to freedom]. PMID- 3637481 TI - [10th continuing education conference of nurse anesthetists. Anesthesia and blood circulation]. PMID- 3637482 TI - [Psychiatric nursing. A concept for inservice training. Continuing education for everyone]. PMID- 3637483 TI - [1st educational course for diabetes nurses. A necessary supplement to basic knowledge]. PMID- 3637484 TI - [Professional nurse]. PMID- 3637485 TI - [Nursing process: which change? A demonstration of professionalism]. PMID- 3637486 TI - [The nursing process: teaching, working, communication tool]. PMID- 3637487 TI - [Health and professional ethics]. PMID- 3637489 TI - [Study of the "nursing process" in basic nursing education--the weight of the topic in the curriculum and curriculum formulation]. PMID- 3637488 TI - [Teaching of the "nursing process": the "nursing process" in relation to the theory and practice]. PMID- 3637490 TI - [Problems associated with the "nursing process" in the early stage of nursing study and their solution--at the stage of nursing information collection]. PMID- 3637491 TI - [In search of effective methods of teaching the "nursing process"]. PMID- 3637493 TI - [The family. 4. Working wives: a feminist's viewpoint]. PMID- 3637492 TI - [Analysis of nursing students' attitude toward bioethics (3). Attitude toward induced abortion]. PMID- 3637494 TI - [Clinical ladder: its application to nursing administration at the St. Luke's International Hospital. Future prospect and development]. PMID- 3637495 TI - [Factors in adult nursing training which motivate students in their study--an experience with a 5-day clinical training]. PMID- 3637496 TI - [Planning of teaching the subject of nursing history]. PMID- 3637497 TI - [Innovation in daily lives based on the nursing process. 1. Innovation in clothing for patients]. PMID- 3637498 TI - [Mentality and health of the aged population in sparsely populated mountainous areas. A medico-social study at three communities at Totsukawa Mura, Yoshino-Gun, Nara Prefecture. 2]. PMID- 3637499 TI - [Reality shock in nursing-a view from mental health]. PMID- 3637500 TI - [Reality shock among new nursing graduates]. PMID- 3637501 TI - [The involvement of nursing education in the problem of reality shock]. PMID- 3637502 TI - [Reality shock--psychological support of new nursing graduates]. PMID- 3637503 TI - [Preceptorship as a method to prevent reality shock among new nursing graduates]. PMID- 3637504 TI - [An interview with Faye G. Abdellah. Interview by S Senno]. PMID- 3637505 TI - [Factor analysis of the image of death and related elements--a survey among nursing students]. PMID- 3637506 TI - [The family. 5. Transfer of husbands, resultant separation, and family relationship]. PMID- 3637507 TI - [Satisfaction in assisting the birth process. 30-year clinical practice in midwifery. A discussion]. PMID- 3637508 TI - [Designing of a hospital information system using a computer--systematization of prescriptions at wards]. PMID- 3637509 TI - [Perception of the patient by students in clinical training in psychiatry: guidance of the students for the improvement of their attitudes]. PMID- 3637510 TI - [Educational methods in nurturing proper attitudes in clinical training]. PMID- 3637511 TI - [Nursing actions in daily lives based on the nursing process. 2. Clothing care and design]. PMID- 3637512 TI - [Motivating the clinical instructors as "leaders"]. PMID- 3637513 TI - [Close coordination between the site of clinical practice and the educational facilities for clinical training]. PMID- 3637514 TI - [Coordination of "knowledge, technology, and attitude" in clinical training and instructions]. PMID- 3637515 TI - [Involvement of the clinical instructors in the preparation of clinical training records and the evaluation of the training]. PMID- 3637516 TI - [The hospital as the site of clinical training--requirements for the educational environment]. PMID- 3637517 TI - [Conference with world nursing leaders: an impression on the World Nursing Leader's Conference organized by WHO]. PMID- 3637518 TI - [Analysis of nursing students' awareness of bioethics. (4). On making a decision on life and death]. PMID- 3637519 TI - [Empathic nursing: realization of a human capacity]. PMID- 3637520 TI - [The family. 6. Modern trends in divorce]. PMID- 3637521 TI - [Satisfaction in assisting the birth process. 6. 30 years of clinical practice in midwifery]. PMID- 3637522 TI - [Nursing scoring and proper allocation of nurses]. PMID- 3637523 TI - [Attempt at an effective nursing training--development of a nursing process from a description of a case]. PMID- 3637524 TI - [Assistance in maintaining personal hygiene]. PMID- 3637525 TI - [Job rotation and career development. Work experience = education and rotation]. PMID- 3637526 TI - [The structure of the nursing system and personnel assignment plans]. PMID- 3637527 TI - [Training of nursing specialists and the system of rotation]. PMID- 3637529 TI - [Nursing organization and rotation plans. Adjustment of nursing capability and training of nursing personnel]. PMID- 3637530 TI - [Nursing organization and rotation plans. Rotation plans to meet individual desires]. PMID- 3637528 TI - [Nursing organization and rotation plans. Rotation within major nursing specialties caused by nursing reorganization]. PMID- 3637531 TI - [Problems seen at the early learning stage of the "nursing process" and their solutions--at the stage of nursing diagnosis]. PMID- 3637532 TI - [The family. 7. Modern sex and life structures--in search of ideal relationship between man and women]. PMID- 3637533 TI - [Observation of changes in American nursing education. Discussion. 1]. PMID- 3637534 TI - [Group dynamics in clinical training--human relationship and training results]. PMID- 3637536 TI - [Patient assistance according to the nursing process. 4. Assistance in maintaining personal hygiene (2)]. PMID- 3637535 TI - [A teaching method in the analysis of the information concerning the assigned patient]. PMID- 3637537 TI - [Assistance in excretion by patients with spinal cord diseases]. PMID- 3637538 TI - [Emergency nursing. Carbon monoxide poisoning]. PMID- 3637539 TI - [Physiopathology of subarachnoid hemorrhage and activities and prognosis of the patients]. PMID- 3637540 TI - [Diagnostic and therapeutic processes for patients with subarachnoid hemorrhage]. PMID- 3637541 TI - [Nursing of patients with subarachnoid hemorrhage. Keypoints in the observation of patients with subarachnoid hemorrhage]. PMID- 3637542 TI - [Nursing plans for patients with subarachnoid hemorrhage]. PMID- 3637543 TI - [Nursing of patients with subarachnoid hemorrhage. Pre- and Post-operative care of patients with subarachnoid hemorrhage--a case with recovery from various postoperative complications and eventual discharge from the hospital]. PMID- 3637544 TI - [Nursing of patients with subarachnoid hemorrhage. Re-evaluation and analysis of the deficiencies in nursing]. PMID- 3637545 TI - [A nursing view which determines the nursing process]. PMID- 3637546 TI - [Easing of pain in a patient with pharyngeal cancer metastasizing to the neck region]. PMID- 3637547 TI - [An observation on respiration training of a patient with chronic obstructive lung disease]. PMID- 3637548 TI - [Test yourself. Pre- and post-operative nursing of a patient with rectal cancer]. PMID- 3637550 TI - [Significance of having one's own nursing philosophy]. PMID- 3637549 TI - [A case of fracture in a demented patient and an observation on geriatric nursing]. PMID- 3637551 TI - [Experiences contributing to the development of my nursing philosophy]. PMID- 3637553 TI - [My nursing philosophy nurtured in the past 6 years]. PMID- 3637552 TI - [Nursing philosophy tested at the clinical scene]. PMID- 3637554 TI - [Psychological processes of cancer patients. (4). A physician's experiences]. PMID- 3637555 TI - [Nursing actions in cleansing of ICU patients]. PMID- 3637556 TI - [Emergency nursing. Drowning]. PMID- 3637557 TI - [Physiopathology of liver cirrhosis]. PMID- 3637558 TI - [Diagnostic and therapeutic processes for patients with liver cirrhosis]. PMID- 3637559 TI - [Keypoints in the observation of patients with liver cirrhosis]. PMID- 3637560 TI - [Nursing plans for patients with liver cirrhosis]. PMID- 3637561 TI - [Nursing of a liver cirrhosis patient with refractory complications and personal problems at home]. PMID- 3637562 TI - [Nursing of patients with liver cirrhosis: possibilities in nursing and guidance of patients without support from family members]. PMID- 3637563 TI - [Experience in nursing of a patient with malignant rheumatoid arthritis]. PMID- 3637564 TI - [Nursing approach using transactional analysis to a schizophrenic patient lacking a sense of cleanliness]. PMID- 3637566 TI - [Actions toward schizophrenic patients with behavior problems]. PMID- 3637565 TI - [Test yourself. Nursing of a patient with intrahepatic biliary calculi]. PMID- 3637567 TI - [Reflection on the transitions in my nursing philosophy since the student days]. PMID- 3637568 TI - [Importance of retaining a fresh approach in spite or routine duties]. PMID- 3637569 TI - [My personal changes as a nurse]. PMID- 3637570 TI - [Reflections on my attitude 7 years ago]. PMID- 3637571 TI - [Psychological processes of cancer patients. (5)]. PMID- 3637572 TI - [Prevention of decubitus ulcer in patients with apoplexy]. PMID- 3637573 TI - [Severe arrhythmia]. PMID- 3637574 TI - [Physiopathology and symptoms of cholelithiasis]. PMID- 3637575 TI - [Diagnostic and therapeutic processes for patients with cholelithiasis]. PMID- 3637576 TI - [Keypoints in comprehensive observation of patients with cholelithiasis]. PMID- 3637577 TI - [A nursing plan for a patient with cholelithiasis--a case with complications]. PMID- 3637578 TI - [Nursing of a patient with cholelithiasis at a ward of internal medicine--a case complicated with diabetes mellitus and subsequent development of mistrust toward medical care]. PMID- 3637579 TI - [Evaluation of nursing of patients with cholelithiasis; inadequacy in expressing "nursing problems"]. PMID- 3637580 TI - [Sorting information and utilizing knowledge]. PMID- 3637581 TI - [Nursing of a patient with amyotrophic lateral sclerosis--attempts at assistance at meal time and communication]. PMID- 3637582 TI - [Significance of training in maintaining sitting postures in nursing of aged neurosurgical patients]. PMID- 3637583 TI - [Test yourself: nursing keypoints. Nursing of a patient with femoral neck fracture]. PMID- 3637584 TI - [Psychiatric counseling of a mother with apprehension toward child rearing]. PMID- 3637585 TI - [The roles of the nurse and families in the care of hospitalized patients]. PMID- 3637586 TI - [Nursing of terminal patients and interactions with their families]. PMID- 3637587 TI - [Lessons from the families through the care of hospitalized patients]. PMID- 3637588 TI - [The presence of family members as a hindrance in nursing of hospitalized patients]. PMID- 3637589 TI - [Psychology of cancer patients. 7]. PMID- 3637590 TI - Do-not-resuscitate orders for the incompetent patient in the absence of family consent. PMID- 3637591 TI - Prevention of patient falls through perceived control and other techniques. PMID- 3637593 TI - Project 2000. PMID- 3637592 TI - Intrauterine devices: malpractice and product liability. PMID- 3637594 TI - Power to the people. Interview by Valerie O'Connor. PMID- 3637595 TI - Are we leading you a merry dance? PMID- 3637596 TI - Who's ever heard of nursing ethics? PMID- 3637597 TI - Fit to nurse? PMID- 3637598 TI - The fat connection. Part 2. PMID- 3637599 TI - Health visiting and child abuse: lessons from the Jasmine Beckford inquiry. PMID- 3637600 TI - Allergies and infant feeding. PMID- 3637601 TI - The 'Know Your Midwife' scheme. PMID- 3637602 TI - When your patients ask about alcohol in pregnancy. PMID- 3637603 TI - School non-attenders and long-term problems. Aspects of child psychiatry. PMID- 3637604 TI - On demand breastfeeding. PMID- 3637605 TI - Screening for hearing impairment in the first year of life. PMID- 3637606 TI - Midwifery care on trial? PMID- 3637607 TI - Labour ward aspects in the care of the drug-addicted mother. PMID- 3637608 TI - Project 2000: a new preparation for practice. UKCC's major review of nurse education & training. PMID- 3637609 TI - Heroin addiction in pregnancy. PMID- 3637610 TI - The use of pethidine in labour. PMID- 3637611 TI - Use of meptazinol in routine obstetric practice in a district hospital. PMID- 3637612 TI - Project 2000: a new preparation for practice: the future preparation of the midwife. PMID- 3637613 TI - Ulcerative colitis: the result of an altered bacterial metabolism of bile acids or cholesterol. AB - It is proposed that in genetically susceptible individuals ulcerative colitis is caused by a bacterial metabolite of bile acids or cholesterol and that this substance is similar or identical to the bacterial metabolites implicated in the development of colon cancer. Since the responsible bacterial reactions may be dependent on vitamin K as an electron acceptor it is suggested that poorly absorbed vitamin K antagonists, specifically alpha-tocopherylquinone, may be capable of inhibiting these reactions and may therefore prove effective in treating ulcerative colitis and in preventing the development of colon cancer. PMID- 3637614 TI - The history of the herring and with its decline the significance to health. AB - For centuries Europe seems to have partaken of the herring. With the coming of steam drifters in 1900 trawling for white fish became easier and they substituted for the herring and the taste for herring has been lost. Illnesses thrombotic, immune and inflammatory seem to be associated with the dietary change and modern biochemical science is busy showing that certain essential fatty acids present in vegetable oils and oily fish can give rise to essences obviating the need to revert to diets that may now be difficult to resume. PMID- 3637615 TI - Lead levels in the hair of bipolar patients and normal controls. AB - The analysis of hair samples taken from ten symptomatic bipolar patients and from ten normal controls matched for age, sex and race suggest that a relatively high body burden of lead may be associated with episodes of bipolar illness. PMID- 3637616 TI - Why do patients with essential hypertension experience sleep apnea syndrome? AB - Augmented drive from the arterial chemoreceptors has been found in essential hypertension. We hypothesize that overactivity of the chemoreflex is responsible for frequent episodes of sleep apnea in hypertensive patients. PMID- 3637617 TI - On the role of 2,3-butanediol in the metabolism of ethanol. AB - A new mechanism is proposed for the enzymatic formation of 2,3-butanediol. It could be related to the elimination of ethanol and acetaldehyde in chronic alcoholic subjects. PMID- 3637618 TI - The unique merits of a low-fat diet for weight control. AB - The virtual freedom from obesity enjoyed by many primitive societies may be traceable to the low fat content of their traditional diets. Recent studies indicate that humans have a very limited capacity for de novo lipogenesis from dietary carbohydrate; this implies that it should be easy to achieve negative fat balance if dietary fat intake is kept low and fat oxidation is promoted by regular exercise. Overfeeding with carbohydrate--but not with fat--provokes an insulin-mediated thermogenesis which acts to retard weight gain. Low-fat starchy foods have a relatively low caloric density, resulting in lower caloric consumption with meals. Once absorbed, carbohydrate has greater satiety value than fat. These considerations suggest that avoidance of dietary fat may be a more successful approach to weight control than "calorie counting". The efficacy of low-fat diets may be promoted by supplementary carnitine, which stimulates fat oxidation, and by chromium, which aids insulin-mediated thermogenesis. An unrefined low-fat diet, eaten to satiety and accompanied by regular exercise, may be the ideal means of maintaining a trim figure throughout life while minimizing one's risk for "Western" degenerative diseases. PMID- 3637619 TI - Thought pathology in The Waste Land. AB - An examination of T.S. Eliot's supreme puzzle poem, The Waste Land reveals complex pathological thought processes and perceptual derangements. Written during a time of deep psychic distress, The Waste Land is a unique illustration of psychopathology in a poetic message. PMID- 3637620 TI - The intravaginal absorption of male generated hormones and their possible effect on female behaviour. AB - In this paper I hypothesize that a woman through her vagina absorbs sufficient quantities of the prostaglandins from her partner's semen, to affect her mood. The vagina appears to have an active transport mechanism which readily absorbs the hormones found in seminal plasma. The seminal secretions include estrogens, F.S.H., LH, testosterone, and at least 13 prostaglandins. Prostaglandins have a modulating effect on neurotransmitters. Evening Primrose Oil (E.P.O., Efamol) may improve depressed mood by facilitating the production of prostaglandins. I have described a depressed, child abusing mother who was possibly getting insufficient exogenous prostaglandins post-partum to maintain her pre-partum mood state because she was avoiding intercourse with her husband. When her mood improved on E.P.O., she began enjoying her husband and her child. If these observations and deductions are correct, regular amounts of seminal plasma may be important in maintaining a woman's affective health and E.P.O. may be useful in treating depressed abusing mothers. PMID- 3637621 TI - Cystic fibrosis: a casualty of "detoxification"? AB - It is proposed that excessive and/or aberrant function of cytochromes P450, due to a combination of genetic and environmental influences, is the basic defect in cystic fibrosis. Organs that are involved in oxidative detoxification reactions in foetal life are thus at risk: tissue damage is initiated by excessive production of oxygen free radicals which deplete cellular antioxidants and provoke the secretion of mucus. PMID- 3637622 TI - Decisions concerning the care of very low birthweight infants. PMID- 3637623 TI - Attitudes/beliefs/feelings held by neonatal nurses toward the care and management of fetal-infants. PMID- 3637624 TI - An anticipatory support program for high-risk parents. PMID- 3637625 TI - Axillary and rectal temperatures of full-term neonates: are they different? PMID- 3637626 TI - Transilluminator assistance in neonatal venipuncture. PMID- 3637627 TI - Obstetrical decision making in the delivery of the extremely premature infant. PMID- 3637628 TI - Tourniquets and nosocomial methicillin-resistant Staphylococcus aureus infections. PMID- 3637629 TI - [The last days of Ms. Tome: a home visiting nurse's account of an old lady living alone]. PMID- 3637630 TI - [The importance of preserving the natural form of living--effort toward medical and nursing care of terminal patients at home]. PMID- 3637631 TI - [A peaceful end of a housewife--home nursing of a cancer patient who spent the terminal stage at home with her family]. PMID- 3637632 TI - [Nursing action and peaceful death at home--professional conference at the hospital and home nursing]. PMID- 3637633 TI - [My spiritual support in dealing with terminal care--prayer and hope]. PMID- 3637634 TI - [On meeting the dying patient's wish--terminal care at home and attitude and experience of the nursing personnel]. PMID- 3637635 TI - [Daily problems of adult hemodialysis patients at various life stages and their nursing--clinical studies]. PMID- 3637636 TI - [Review and discussion of current Japanese novels]. PMID- 3637637 TI - The RNA required in the first step of chlorophyll biosynthesis is a chloroplast glutamate tRNA. AB - A molecule of chlorophyll is synthesized from eight molecules of delta aminolevulinate (DALA), the universal precursor of porphyrins. The light regulated conversion of glutamate to delta-aminolevulinate in the stroma of greening plastids involves the reduction of glutamate to glutamate-1-semialdehyde and its subsequent transamination. The components performing this conversion have been isolated from barley and Chlamydomonas and separated into three fractions by serial affinity chromatography on Blue Sepharose and haem- or chlorophyllin Sepharose. The complete reaction can be performed in vitro in a reconstituted assay by combining all three fractions. An RNA is the essential component of the chlorophyllin-Sepharose-bound fraction. By nucleotide sequence analysis, we have now identified this RNA as a chloroplast glutamate acceptor RNA. Glutamate attached by an aminoacyl bond to the 3'-terminal adenosine of this RNA is a substrate for the enzyme(s) which perform the subsequent reactions. This reaction represents a novel role for transfer RNA: participation in the metabolic conversion of its cognate amino acid into another metabolite of low relative molecular mass which subsequently is not used in peptide bond synthesis. PMID- 3637638 TI - Putting a stop to the nursing brain drain. PMID- 3637639 TI - Moral values and ethical decisions in a constrained economic environment. PMID- 3637640 TI - Ethical conflicts in a prospective payment home health environment. PMID- 3637641 TI - Documentation: meeting requirements while maximizing productivity. PMID- 3637642 TI - Cost savings of retaining chemically dependent nurses. PMID- 3637643 TI - Increases in married nurses' incomes: 1982-84. PMID- 3637644 TI - Long-term care nursing: how satisfying is it? PMID- 3637645 TI - Doing things differently and better. PMID- 3637646 TI - Subjective time orientation. PMID- 3637647 TI - Building business relationships. PMID- 3637649 TI - Self-care model: an assessment tool based on Orem's theory. PMID- 3637648 TI - A pre-school health fair. PMID- 3637650 TI - A visit to China. PMID- 3637651 TI - Royal College of Nursing. Manifesto. PMID- 3637652 TI - Recognise the needs of children in hospital. PMID- 3637653 TI - Timely and welcome. PMID- 3637654 TI - Royal College of Nursing. Stem the flow. PMID- 3637655 TI - Challenge facing us all in skill mix review. PMID- 3637657 TI - 'Concern' for care of mentally handicapped. PMID- 3637656 TI - Recommendations of Project 2000 must not be allowed to gather dust. PMID- 3637658 TI - Call to expand role for nurses in UK prisons. PMID- 3637659 TI - College opposed to compulsory measles immunisation for children. PMID- 3637660 TI - Royal College of Nursing. Caring in prison; a high profile. PMID- 3637662 TI - Project report as it affects mental handicap. PMID- 3637661 TI - A visionary report which can provide professional unity. PMID- 3637663 TI - Evidence on Green Paper. PMID- 3637664 TI - Royal College of Nursing--a good practice. PMID- 3637665 TI - Adding insult to injury. PMID- 3637666 TI - Can elderly people ever hope for a Bob Geldof to promote their interests? PMID- 3637667 TI - Leeds Conference speaker endorses Project 200. 'Welcome erosion' of doctor dominance. PMID- 3637668 TI - Royal College of Nursing. Survey support; the next stage. PMID- 3637669 TI - Comberlege Report is a gift to the profession. PMID- 3637670 TI - Royal College of Nursing. Right message. PMID- 3637671 TI - New forum within ANM (Association of Nursing Management). PMID- 3637672 TI - Unite to achieve more than second best. PMID- 3637673 TI - Infertility services remain haphazard. PMID- 3637674 TI - Dopaminergic regulation of glandular kallikrein in the intermediate lobe of the rat pituitary. AB - The intermediate lobe of the rat pituitary contains a trypsin-like protease closely related or identical to glandular kallikrein. This study examined whether glandular kallikrein in the intermediate lobe is under inhibitory control by dopaminergic systems. Male rats were treated for 4-6 days with various doses of the following drugs, alone or in combination: haloperidol (a dopamine receptor blocker), reserpine (a catecholamine depleting agent), and bromocriptine (a dopamine receptor agonist). Neurointermediate lobe (NIL) homogenates were prepared. Following activation of latent enzymes with trypsin, glandular kallikrein was measured using two chromogenic peptide substrates. Haloperidol doubled NIL glandular kallikrein activity. Dissection of the NIL revealed that haloperidol specifically increased glandular kallikrein in the intermediate lobe and had no effect on the small amount of activity in the neural lobe. Reserpine also doubled NIL glandular kallikrein and haloperidol did not produce further increases. The reserpine-induced increase in NIL glandular kallikrein was completely blocked by concurrent administration of bromocriptine: this effect was blocked by haloperidol. The results demonstrate that intermediate lobe glandular kallikrein is under inhibitory control by dopaminergic systems. This parallels the regulation of proopiomelanocortin (POMC) synthesis in the intermediate lobe and suggests that glandular kallikrein should be evaluated as a POMC-processing enzyme. PMID- 3637675 TI - Presidential address (risk management). PMID- 3637676 TI - Spartanburg General Hospital policy book on i.v. therapy administration--Part I. PMID- 3637677 TI - Autologous transfusion--present practice and future trends. PMID- 3637678 TI - Hypercalcemia of malignancy--nursing responsibilities. PMID- 3637679 TI - Factors enhancing the success of consultation. PMID- 3637680 TI - Considerations on corporate consulting. PMID- 3637681 TI - On the scene: corporate nursing and consulting. Corporate consultation: the opportunities and the challenges. PMID- 3637682 TI - Environmental factors impacting consultation. PMID- 3637683 TI - Consultation: a key role for the corporate nurse in a multihospital system. PMID- 3637684 TI - The impact of consultation in a multihospital system. PMID- 3637685 TI - International nursing consultation. PMID- 3637687 TI - Preparing for the consultant: making the right choices. PMID- 3637688 TI - Opportunities for consulting: the Intracorporate Nurse Consultant Roster. PMID- 3637686 TI - The vice president of patient care services visits China. PMID- 3637689 TI - The clinical nurse specialist: a valued consultant. PMID- 3637690 TI - Forging a dual role: administrator/consultant. PMID- 3637691 TI - For-profit health care institutions: nursing implications. PMID- 3637692 TI - Consulting focus: process management. PMID- 3637693 TI - The consultant role for clinical nurse specialists. PMID- 3637694 TI - The consultant's role in enhancing practice skills. PMID- 3637695 TI - Clinical nurse consultants: utilizing internal resources. PMID- 3637696 TI - A health planning simulation game. PMID- 3637697 TI - Setting the stage for change: using elective courses to create social and political awareness. PMID- 3637698 TI - Developing evaluation tools. PMID- 3637699 TI - Correspondence courses: an alternative instructional method. PMID- 3637701 TI - The nursing care plan as a teaching method: reason or ritual? PMID- 3637700 TI - Displaced persons in nursing. PMID- 3637702 TI - Nursing as a profession in Nigeria. PMID- 3637703 TI - The effect of Nigerian value system on nursing education and practice. PMID- 3637704 TI - Utilizing the expertise of a clinical nurse specialist in a developing nation: Nigeria. PMID- 3637705 TI - The genesis of primary health care in Nigeria. PMID- 3637706 TI - The phenomenology of leadership in student unionism. PMID- 3637708 TI - The human rights of family planning. PMID- 3637707 TI - Offering an alternative to illegal abortion in Nigeria. PMID- 3637709 TI - Traditional structures clash with new imperatives. PMID- 3637710 TI - Weighing risks against benefits in contraceptive safety. PMID- 3637712 TI - War against indiscipline as related to professional nursing ethics. PMID- 3637711 TI - Exclusion of males in midwifery. PMID- 3637713 TI - The professionalization of nursing: a challenge to our leaders. PMID- 3637714 TI - [Humanism in the discipline of nursing]. PMID- 3637715 TI - [Health promotion. 1. Adopting a common language]. PMID- 3637716 TI - [The client in gynecology: better care through education]. PMID- 3637717 TI - [Will computerization of care bypass the nurse?]. PMID- 3637718 TI - [The deontological code--a commitment in practice]. PMID- 3637719 TI - [Planning to survive cancer--a social emergency]. PMID- 3637720 TI - Informed consent: the right to know and the right to choose. PMID- 3637721 TI - Retrenchment: weathering the crisis. PMID- 3637722 TI - Evaluating the stressors in your life. Art and science of management. PMID- 3637723 TI - The maintenance of life: 1983-1985--Part I. PMID- 3637724 TI - LDRP: staffing a single care maternity system. PMID- 3637725 TI - Rewarding bedside nursing. PMID- 3637726 TI - Leadership: getting leverage on group power. PMID- 3637727 TI - Utilization: does this patient belong in CCU? PMID- 3637728 TI - Evaluating clinical competency in nursing. PMID- 3637729 TI - Intravenous antibiotic therapy: hospital to home. PMID- 3637730 TI - Discipline: establishing just cause for correction. PMID- 3637731 TI - Growth and change: a nursing organization case study. PMID- 3637732 TI - Health care options: down the yellow brick road. PMID- 3637733 TI - New nurses: overcoming "Trial by Decision". PMID- 3637734 TI - Managing cultural differences. PMID- 3637735 TI - What satisfies ... and doesn't? PMID- 3637736 TI - Marketing: getting in the public eye. PMID- 3637738 TI - Role theory: living up to expectations. PMID- 3637737 TI - Combining management education with an assessment center. PMID- 3637739 TI - Psychiatric nursing in a crisis center: standards and practice. PMID- 3637740 TI - Nursing in the Orient: in the People's Republic of China. PMID- 3637742 TI - Ergonomics and personal protection. PMID- 3637741 TI - Metal fume fever. PMID- 3637743 TI - Compatibility in PPE (personal protective equipment). PMID- 3637744 TI - How OH nurses keep informed. PMID- 3637745 TI - Cytotoxic drugs and the risk to health care staff. PMID- 3637746 TI - Into the depth. PMID- 3637747 TI - Testing the water. Interview by Michael Bangs. PMID- 3637748 TI - Going it alone. Interview by Michael Bangs. PMID- 3637749 TI - The changing face of OH? PMID- 3637751 TI - Visual acuity. PMID- 3637750 TI - The introduction of a nurse-based OH service for a county council. PMID- 3637752 TI - A hypertension pilot scheme. PMID- 3637753 TI - Occupational liver disease. PMID- 3637754 TI - Computers. Need an OH computer? Which system? PMID- 3637755 TI - Are you computer friendly? PMID- 3637756 TI - Understanding computers. PMID- 3637757 TI - Computers. Identifying the users. PMID- 3637758 TI - Protecting policemen against hepatitis B. PMID- 3637759 TI - Geriatric/gerontological nurse practitioners. PMID- 3637760 TI - [Working and living conditions of nursing personnel]. PMID- 3637761 TI - [Vorarlberg model--pediatric nurse in primary health care]. PMID- 3637762 TI - [Psychological aspects in the rehabilitation following craniocerebral injuries in children]. PMID- 3637763 TI - [Psychohygiene of living--the child's environment]. PMID- 3637764 TI - East-West scientific and cultural contacts--implications for nursing: USA-USSR health exchange program. PMID- 3637765 TI - Taking children home where they belong. PMID- 3637766 TI - Home apnea monitoring. PMID- 3637767 TI - Motor development in premature infants with intracranial hemorrhage. PMID- 3637768 TI - Considering pediatric nurse practitioner certification. PMID- 3637769 TI - Adolescent fathers: often forgotten parents. PMID- 3637770 TI - A survey of parents' perceptions regarding latchkey children. PMID- 3637771 TI - Genetic counseling in pediatric nursing care. PMID- 3637772 TI - Counseling adolescents about environmental teratogens. PMID- 3637773 TI - Asbestos in schools: reducing pediatric risk factors. PMID- 3637774 TI - Pediatric management problems (neonatal jaundice). PMID- 3637776 TI - How to develop the consultant role. PMID- 3637775 TI - Growth hormone. PMID- 3637778 TI - Clarification on the North Dakota action. PMID- 3637777 TI - The nucleotide sequence of a human tRNALeu gene. PMID- 3637779 TI - A matter of life or death. PMID- 3637780 TI - Unsafe student practice: policy and procedures. PMID- 3637781 TI - No code orders: guidelines for policy. PMID- 3637782 TI - Modified contractual grading. PMID- 3637783 TI - Faculty peer review in a group setting. PMID- 3637784 TI - Developing a CE program in trauma/disaster care. PMID- 3637785 TI - Needed: nurse engineers to link theory and practice. PMID- 3637786 TI - BSN faculty workload: its impact on research. PMID- 3637787 TI - A question of civil rights. PMID- 3637788 TI - Decoding your student evaluations. PMID- 3637789 TI - Learning group process skills. PMID- 3637790 TI - [Evaluation of the relevance of program objectives: an appropriate methodology]. PMID- 3637791 TI - The women's value orientation questionnaire: an instrument revision study. PMID- 3637792 TI - Determinants of perceived life satisfaction in the institutionalized elderly. PMID- 3637794 TI - Analysis of Pender's health-promotion behaviour model. PMID- 3637793 TI - Video--a teaching strategy for learning group process. PMID- 3637795 TI - Adolescent communication: understanding it's dynamics and fostering it's development. PMID- 3637796 TI - Focus on urinalysis. Part 3. PMID- 3637797 TI - Motorbike madness. PMID- 3637798 TI - He who laughs, lasts. PMID- 3637799 TI - Working mothers. Is a mother's place in the home? PMID- 3637800 TI - Working mothers. Jobs for the girls? PMID- 3637801 TI - Working mothers. Bridging the gap. PMID- 3637802 TI - Working mothers. Going solo. PMID- 3637803 TI - Provision of breast prostheses. PMID- 3637804 TI - The sound of silence. PMID- 3637806 TI - Dramatherapy for psychiatric patients. PMID- 3637805 TI - Hidden problems after a hysterectomy. PMID- 3637807 TI - Diabetes at dawn. PMID- 3637808 TI - In someone else's shoes. PMID- 3637810 TI - The Journal of Infection Control Nursing. PMID- 3637809 TI - The intuitive method of patient dependency. PMID- 3637811 TI - Journal of Infection Control Nursing. Thinking prevention. PMID- 3637812 TI - Journal of Infection Control Nursing. Catheter toilet and urinary tract infections. PMID- 3637813 TI - After the revolution. PMID- 3637814 TI - The voice of pragmatism. Interview by Martin Vousden. PMID- 3637815 TI - When no one's to blame. PMID- 3637817 TI - Mental health. Participating in change. PMID- 3637816 TI - Mental health. An identity crisis perpetuated. PMID- 3637818 TI - Management of the head-injured patient. PMID- 3637819 TI - Famine--the politics of feeding. PMID- 3637820 TI - Management. Computer speak. PMID- 3637822 TI - First aid. Glamour, champagne ... and heart disease. PMID- 3637821 TI - Complications of measles. PMID- 3637823 TI - Planning patient care. Aiding recovery from a lobectomy. PMID- 3637824 TI - Patients' views on cardiac monitoring. PMID- 3637825 TI - Effects of short-term catheterisation. PMID- 3637827 TI - Active service. PMID- 3637826 TI - Percutaneous nephrolithotripsy. PMID- 3637828 TI - Focus on urinalysis. Part 4. PMID- 3637829 TI - Mix and match. Interview by Niall Dickson. PMID- 3637830 TI - The poacher turns gamekeeper. Interview by Pauline Chudley. PMID- 3637831 TI - Cumberlege--cracks in the community. PMID- 3637833 TI - Assertiveness--speak your mind. PMID- 3637834 TI - Assertiveness--time for a change. PMID- 3637832 TI - Commons sense. Twisting the knife. PMID- 3637835 TI - Just how assertive are you? PMID- 3637836 TI - Management--shifting the system. PMID- 3637837 TI - How safe is the 'safe' period? PMID- 3637838 TI - Education. A late return to the classroom. PMID- 3637840 TI - The midwifery road-show. PMID- 3637839 TI - Compression fractures of the thoracic vertebrae. PMID- 3637841 TI - Funeral arrangements: time to bury the past. PMID- 3637842 TI - Mental health: skills in family therapy. PMID- 3637843 TI - Mental health: agents of change, or care-givers? PMID- 3637844 TI - Spotlight on children. It's the quality that counts. PMID- 3637845 TI - Spotlight on children. A blueprint for child care. PMID- 3637846 TI - Why Mr Paige couldn't manage. PMID- 3637847 TI - Griffiths: Scots mix a new broth. PMID- 3637848 TI - Midwives rules--straight rules. PMID- 3637849 TI - Is there no alternative? PMID- 3637850 TI - Into business--going it alone. Interview by Pamela Holmes. PMID- 3637851 TI - Into business--a home of your own. PMID- 3637852 TI - One step at a time. PMID- 3637853 TI - Management. Measuring quality in district nursing. PMID- 3637854 TI - Patient evaluation of a rheumatology nursing clinic. PMID- 3637855 TI - Epidural and spinal anaesthetics. PMID- 3637856 TI - Controlling the demon. PMID- 3637857 TI - Assertiveness--believe in yourself. PMID- 3637858 TI - Lessons from the health service ombudsman's reports. PMID- 3637859 TI - Tell them before they tell us. PMID- 3637860 TI - Newcastle blues. PMID- 3637861 TI - Nurse management: being your own boss. PMID- 3637862 TI - Unemployment: who should pick up the pieces? PMID- 3637864 TI - Waste not, want not? PMID- 3637863 TI - Strange bedfellows. PMID- 3637866 TI - Costing flexible working patterns. PMID- 3637865 TI - Undervalued and misunderstood. PMID- 3637867 TI - Into business in a spirit of co-operation. PMID- 3637869 TI - Systems of life. No 139. Senior systems. 4. PMID- 3637868 TI - Pumping in pain relief. PMID- 3637870 TI - Liberal studies. PMID- 3637871 TI - Part of the team? PMID- 3637872 TI - RCM Supplement. The parting of the ways? PMID- 3637873 TI - RCM Supplement. Begging to differ. Interview by Niall Dickson. PMID- 3637874 TI - RCM Supplement. 'You can always try for another'. Interview by Gill Crabbe. PMID- 3637875 TI - RCM Supplement. Image consciousness. PMID- 3637876 TI - RCM Supplement. Taking on the transfer list. PMID- 3637877 TI - Focus on Urinalysis. Part 5. PMID- 3637878 TI - Psychiatric nursing: votes of confidence. PMID- 3637879 TI - Project 2000: hopes and fears. PMID- 3637880 TI - Heatwave: some don't like it hot. PMID- 3637881 TI - Project 2000: the disappearing nurses. PMID- 3637882 TI - Project 2000: a college education? PMID- 3637883 TI - Project 2000: whose helping hand? PMID- 3637884 TI - Keep counting the cost. PMID- 3637885 TI - Action speaks louder than words. PMID- 3637886 TI - Care about food. One child's poison. PMID- 3637887 TI - Questions on quality. PMID- 3637889 TI - Women smokers: hiding behind the smokescreen. PMID- 3637888 TI - Politics in the fast lane. PMID- 3637890 TI - Mental Health Nursing. Journal of the Psychiatric Nurses Association. PMID- 3637891 TI - Mental Health Nursing. Turning a blind eye to Griffiths. Interview by Martin Vousden. PMID- 3637892 TI - Mental Health Nursing. Not waving, but drowning? PMID- 3637893 TI - Mental Health Nursing. That sinking feeling. PMID- 3637894 TI - Mental Health Nursing. Sheila's hat-trick. Interview by Martin Vousden. PMID- 3637895 TI - Altered body image in anorexia nervosa. PMID- 3637896 TI - Radiotherapy: minimising the side effects. PMID- 3637897 TI - Communicating with children. PMID- 3637898 TI - How safe is sunbathing? PMID- 3637899 TI - Nursing as a therapy. PMID- 3637900 TI - Taking temperatures. PMID- 3637901 TI - How the law affects nursing. PMID- 3637902 TI - Failure to treat & communicate: death results. PMID- 3637903 TI - R.N. searches patient-death results: criminal charges. Case in point: people v. Coe (501 N.Y.S. 2d 997-NY). PMID- 3637904 TI - Legal case briefs for nurses. NE: E.R. patient unattended: liability. LA: agency placements: fee dispute. PMID- 3637906 TI - [Locomotor apparatus--upper limbs. (6). The elbow: pronation-supination]. PMID- 3637905 TI - Misuse of fetal monitor: brain damage results. Case in point: McGee v. Corometrics Medical Systems, Inc. (487 So. 2d 886-AL). PMID- 3637907 TI - [Central venous routes (1)]. PMID- 3637908 TI - [Ligament lesions of the knee. Clinical and radiological studies]. PMID- 3637909 TI - [Ligament lesions of the knee. Anesthesia]. PMID- 3637911 TI - [Ligament lesions of the knee. Surgical intervention]. PMID- 3637910 TI - [Severe sprains of the knee. Role of the circulating nurse and of the instrument nurse]. PMID- 3637912 TI - [Recent severe ligament injuries of the knee]. PMID- 3637913 TI - [Nursing care of a severe sprain of the knee]. PMID- 3637914 TI - [Rehabilitation of severe sprains of the knee]. PMID- 3637915 TI - [Ligament injuries of the knee. Anatomical review]. PMID- 3637916 TI - [Recent severe ligament injuries of the knee. Conclusion]. PMID- 3637917 TI - [Ligament injuries of the knee. Physiological review]. PMID- 3637918 TI - [Care of wounds. Conditions of adapted nursing care in the local treatment of wounds]. PMID- 3637920 TI - [Implantable defibrillators]. PMID- 3637919 TI - [Computerized angiography--principles and indications]. PMID- 3637921 TI - [Management of hematuria]. PMID- 3637922 TI - [Intravenous urography]. PMID- 3637923 TI - [Management of arterial hypertension]. PMID- 3637925 TI - [Surgery of bone metastases]. PMID- 3637924 TI - [Eruptive fever in children]. PMID- 3637926 TI - [Beating infection]. PMID- 3637927 TI - [Internship in visceral and vascular surgery: need for a structured specialization]. PMID- 3637928 TI - [A microcomputer in the intensive care unit]. PMID- 3637929 TI - [Hospital infection: a report for the benefit of hospital personnel]. PMID- 3637930 TI - [The media in the service of health?]. PMID- 3637931 TI - [Surface abscess: influence of skin preparation]. PMID- 3637932 TI - [Who will take care of me?]. PMID- 3637933 TI - [Dysmenorrhea in adolescence]. PMID- 3637934 TI - [The nursing care process in a neonatal unit]. PMID- 3637935 TI - [Knowledge and desire for information of cancer patients]. PMID- 3637936 TI - [Diaper use and expenditure in a neonatal unit]. PMID- 3637938 TI - [Nursing consultations]. PMID- 3637937 TI - [Nursing care for the patient confined to bed]. PMID- 3637939 TI - [Monitors]. PMID- 3637941 TI - [The nurse midwife in the EEC. European Economic Community]. PMID- 3637940 TI - [Antinutritive substances]. PMID- 3637942 TI - [Continuing education. 5. Subjects: nursing technics. Topic: bladder catheterization]. PMID- 3637943 TI - [Thoracic drainage]. PMID- 3637945 TI - [Nutrition during the holidays (I)]. PMID- 3637944 TI - [Postponed death]. PMID- 3637946 TI - [Public health practice by alumnae of diploma nurses and primary health care centers]. PMID- 3637947 TI - [Extra-hospital emergencies]. PMID- 3637948 TI - [The adolescent facing contraception: methods]. PMID- 3637949 TI - [Placenta praevia]. PMID- 3637950 TI - [The humane quality of nursing in the care of seriously ill patients]. PMID- 3637951 TI - [Continuing education. 6. Field: pharmacology and nursing. Subject: antibiotic therapy]. PMID- 3637952 TI - OLI's refresher program: a self-directed approach to learning. PMID- 3637953 TI - Nurse trends. PMID- 3637954 TI - Nursing image: reflections of an evolution. PMID- 3637956 TI - Refusing an assignment. PMID- 3637955 TI - Pride in being a nurse. PMID- 3637957 TI - [Nolvadex]. PMID- 3637958 TI - [Clinical aspects and complications of biliary lithiasis]. PMID- 3637959 TI - [Surgical treatment of biliary lithiasis]. PMID- 3637960 TI - [Biliary lithiasis. General aspects]. PMID- 3637961 TI - [Cholelithiasis. Conclusion--which therapeutic choice, by whom?]. PMID- 3637962 TI - [Realization and initial evaluation of a nursing records (round-table discussion)]. PMID- 3637963 TI - [S.O.S. phantom nurses]. PMID- 3637964 TI - [Part-time work and the right to work (1)]. PMID- 3637965 TI - [Cholelithiasis. Case report]. PMID- 3637966 TI - [Music therapy, psychotherapy and the helping institution: impossible marriage?]. PMID- 3637967 TI - [Music and perspectives of care]. PMID- 3637968 TI - [The role of music for the equilibrium and adaptation of the individual. From therapy to culture]. PMID- 3637969 TI - [The history of Nicolas or the impossible creativity]. PMID- 3637970 TI - [Music plus therapy equals music therapy?]. PMID- 3637971 TI - [Therapy by music: Mireille's voice]. PMID- 3637972 TI - [Education in music therapy...]. PMID- 3637973 TI - [Relationship between care giver and patient in the face of distress]. PMID- 3637974 TI - [What is music therapy?]. PMID- 3637975 TI - Legislation affecting nursing practice. Legislation affecting occupational allied health groups. Legislation related to acquired immune deficiency syndrome. PMID- 3637976 TI - [Pain treatment in the USA: hospital with its own pain department]. PMID- 3637977 TI - [Stoma therapy as a specialty]. PMID- 3637978 TI - [Who owns patient records?]. PMID- 3637979 TI - [A new attitude toward the nursing profession?]. PMID- 3637980 TI - [New technology--new morals? Ethical problems in current midwifery practice]. PMID- 3637981 TI - [AIDS-solution: a difficult fight against prejudice]. PMID- 3637982 TI - [Secret trial with LSD--does physicians' infallibility outweigh patients' rights?]. PMID- 3637983 TI - [Endurance test--while arbitration continues]. PMID- 3637984 TI - [Medication routine in the nursing homes: use of weekly dosage containers saves work and time]. PMID- 3637985 TI - [Experience in Gaustad: recruitment and personnel policy]. PMID- 3637986 TI - [This century's catastrophe? (6). World's first AIDS unit]. PMID- 3637987 TI - [Who shall have the responsibility? Substance abusers and community health services]. PMID- 3637988 TI - [Medicine B 9--District Hospital Trondheim: 6-hour day? No, that way we don't have time for this!]. PMID- 3637989 TI - [A challenge to nurses: bridge over troubled waters]. PMID- 3637991 TI - [Fruitful team work in a joint task]. PMID- 3637990 TI - [Offshore occupational health nurse: perspectives in health services on the open sea]. PMID- 3637992 TI - [Apropos the series: threatening advice on AIDS?]. PMID- 3637993 TI - [Nursing workload measurement. (1). Control of workload--possibility or illusion?]. PMID- 3637994 TI - [ADP in nursing--health policy's reality and "actual nursing care"]. PMID- 3637995 TI - [Something better? Developments came from Inderoy. Interview by Albert H. Collett]. PMID- 3637996 TI - [Spotlight on education. (1). Painful unlearning--necessary for change]. PMID- 3637997 TI - [AIDS debate: must we wait until all answers are at hand?]. PMID- 3637998 TI - [Nursing workload measurement. (2). Standardized registration of nursing workload]. PMID- 3637999 TI - [I want to smile--a life with facial paralysis]. PMID- 3638000 TI - [Nurse Anita and the "Wage Committee Monster"]. PMID- 3638002 TI - [Congress 86. Better possibilities to participate in spokesperson course]. PMID- 3638001 TI - [While we wait for the State Wage Committees--8000 on strike]. PMID- 3638003 TI - [Congress 86. EEC developments are followed very closely]. PMID- 3638004 TI - [Unemployment Fund. Payments from Unemployment Fund concern mostly back wages]. PMID- 3638005 TI - [Irreconcilable debate in Parliament about hospital problems]. PMID- 3638006 TI - [Drug information. Medication pump with programmed intravenous administration]. PMID- 3638007 TI - [Education. We need WHO's 5 stages in teaching]. PMID- 3638008 TI - [Around-the-clock home care. Nursing assistants is one group too many in around the-clock home care for the aged]. PMID- 3638009 TI - [Coordination and management of information on AIDS]. PMID- 3638010 TI - [Cross-occupational care and treatment of hemiparesis]. PMID- 3638011 TI - [Congress 86. Nurses' shortages reduces education and causes mental stress]. PMID- 3638012 TI - [Congress 86. There is nothing too small to be discussed]. PMID- 3638013 TI - [Congress 86. Strong desire for influence on new technology]. PMID- 3638014 TI - [Congress 86. Objective and usable argumentation from periodicals]. PMID- 3638015 TI - [Co-influence but only few know to take part in progressive discussion]. PMID- 3638016 TI - [Activities which call for engagement during the holidays also]. PMID- 3638017 TI - [Educational curriculum with a strongly professional slant]. PMID- 3638018 TI - [Congress 86. Bubbling fantasy and engagement in the development of the health system]. PMID- 3638019 TI - [Executive Board. Nurses: we are slow in cutting off district politicians]. PMID- 3638020 TI - [Psychotic youth can be helped to be competent citizens]. PMID- 3638022 TI - [Congress 86. Congress doesn't want to go along with the changing of Paragraph 35]. PMID- 3638021 TI - [Congress 86. We must show ourselves and attend congresses]. PMID- 3638023 TI - [Wrong yardstick for judging of Middelfart Report]. PMID- 3638024 TI - [Summer's thrills are upon us]. PMID- 3638025 TI - [WHO--partners in team work for health]. PMID- 3638026 TI - [Conditions of the elderly. Do the aged have the possibility of choice in the housing area?]. PMID- 3638027 TI - [Health policy. District politicians: the hospital domain cannot be pressured more]. PMID- 3638028 TI - [Truth can present itself with many faces]. PMID- 3638029 TI - [Trauma care. First aid casualty ward is a success at large sports meets]. PMID- 3638030 TI - [Pension. We shall work to avoid reduced pensions]. PMID- 3638031 TI - [Care for the aged. Mental stimulation can provide a better life for patients with senile dementia]. PMID- 3638032 TI - Recent evolutionary divergence of plasma prekallikrein and factor XI. AB - The evolution in mammals of the zymogens of the contact activation system of coagulation (factor XII, prekallikrein and factor XI) has been investigated. The NH2-terminal sequences of human plasma prekallikrein and the heavy and light chains of kallikrein have been determined and compared with those of bovine prekallikrein and of human and bovine factors XII and XI. The human and bovine NH2-terminal sequences of the light chains (catalytic polypeptide) show striking similarities both among themselves and with those of the catalytic polypeptide chains of other coagulation and digestive proteases, indicating a common origin. Comparison of the NH2-terminal sequences of human prekallikrein with those of the bovine prekallikrein and human bovine factors XIa and XIIa indicates a common origin of the heavy chain of kallikrein and factor XIa, different from that of either factor XIIa or other known amino acid sequences. Ancestral sequences for human and bovine prekallikrein and factor XI, deduced by genetic analysis of the minimum number of base changes indicate that the NH2-terminus of prekallikrein and factor XI have evolved at about the same rate. The estimated time for the gene duplication was about 124 million years ago, a value consistent with the age of the mammals. PMID- 3638033 TI - [Sister Modal and her education. I. Continuing education in nursing]. PMID- 3638034 TI - [Relief Fund Health Care for Refugees. Unfortunately a necessity]. PMID- 3638035 TI - [Day care as an alternative to hospital treatment]. PMID- 3638036 TI - [The rise and fall of the Institute for Nursing Science]. PMID- 3638037 TI - [Hospital Audit: our joint responsibility]. PMID- 3638038 TI - [Assertiveness, a matter of 'a mouth' and 'an ear'. Ensuring the rights of the hospital patient]. PMID- 3638039 TI - [What is a flow-directed catheter? The Swan-Ganz catheter, action and function]. PMID- 3638040 TI - [Sister Modal as specialist. II. Specialization in nursing]. PMID- 3638041 TI - [Not deeds, only words. My experience in being nursed for cancer as a nursing instructor]. PMID- 3638042 TI - [Is the patient a critical consumer? Quality and care]. PMID- 3638043 TI - [Effect of glucocorticosteroids on behavior. Unintentioned side effects]. PMID- 3638044 TI - [Nurses and the FONAK-Committee (errors, accidents, near-accidents and complaints). Experiences in a hospital]. PMID- 3638045 TI - [Children of addicts. Report on the symposium 'Child and Addiction']. PMID- 3638046 TI - Help for the impaired OR nurse: substance abuse programs. PMID- 3638047 TI - Coping with death in the OR. PMID- 3638048 TI - Is the patient getting better? PMID- 3638050 TI - The ambulatory surgery facility: from conception to birth and beyond. PMID- 3638049 TI - Surveying and controlling waste gases in the OR. PMID- 3638051 TI - Informed consent: a confusing concept. PMID- 3638052 TI - Sit down, you're rocking the boat. PMID- 3638053 TI - Vox non pop. PMID- 3638054 TI - Trauma (geriatric ward). PMID- 3638055 TI - Protecting patients or telling tales. PMID- 3638056 TI - [Nursing diagnosis applied to eating problems in patients with cerebrovascular diseases]. PMID- 3638057 TI - I want to smile. How do individuals with facial paralysis resulting from surgical removal of an acoustic neuroma cope with daily living? PMID- 3638058 TI - [Handling of cytostatic agents--a work environment problem?]. PMID- 3638059 TI - [Nursing in relation to developments in health and medical services]. PMID- 3638060 TI - The patient's perspective. PMID- 3638061 TI - Heuristic heresy: application of reliability and validity criteria to products of grounded theory. PMID- 3638062 TI - Meta-analyses of nursing interventions: the codebook as a research instrument. PMID- 3638063 TI - Reliability and validity of the Phaneuf Nursing Audit. PMID- 3638064 TI - The Basic Knowledge Assessment Tool (BKAT)--validity and reliability: a national study of critical care nursing knowledge. PMID- 3638065 TI - Stimulating research: a sensory model. PMID- 3638066 TI - Health heritage project: a research proposal submitted to the division of nursing. PMID- 3638067 TI - The "Pink Sheet": review and recommendations by a special review committee of the division of nursing. PMID- 3638068 TI - Measurement error in clinical research. PMID- 3638069 TI - Strategies for teaching nursing research. Small group games for teaching nursing research. PMID- 3638070 TI - Computer use and nursing research. Computerized nursing management data--a challenge and opportunity for research. PMID- 3638071 TI - Researchmanship: the University of Arizona environment--productivity versus resources. PMID- 3638072 TI - Using research in practice: a case for replication in nursing--Part two. PMID- 3638073 TI - [Vardfacket's language school. School nurse]. PMID- 3638074 TI - [District continuous chief for school health care. This is how it went until County Organization forced it to retreat]. PMID- 3638075 TI - [Treatment home for alcoholics discontinued. "That will be the death for many"]. PMID- 3638076 TI - [Nursing College in Ornskoldsvik: here students know what they want]. PMID- 3638077 TI - [Health care in the year 2010. Readers' survey about the future]. PMID- 3638078 TI - [Straight from the heart. To be sick in the mind]. PMID- 3638079 TI - [TCO, LO and Saco/SR agree: more women must be at the top in trade unions]. PMID- 3638080 TI - [Portrait: Stig Kvarnstrom. Interview by Jan Thomasson]. PMID- 3638081 TI - [Difficult life for hospital administrator. Interview by Inger Lernevall]. PMID- 3638083 TI - [Assistants received certification]. PMID- 3638082 TI - [Summer problem: special proposition to help members]. PMID- 3638084 TI - [Liability case. Verdict in health and nursing care liability committee. Adrenaline mistaken for saline]. PMID- 3638085 TI - [Better supervisors in 17 weeks]. PMID- 3638086 TI - [District nurses in Karlskoga: this is how "doctors' strike" affects our work]. PMID- 3638087 TI - [Therapeutic community: prepare food and tell about emotions]. PMID- 3638088 TI - [Acupuncture and massage important elements in Chinese medicine]. PMID- 3638090 TI - [Health care legislation breaks with top-controlled care. Interview by Anita Widen]. PMID- 3638089 TI - [From words to action--women can change working conditions. Interview by Anita Widen]. PMID- 3638091 TI - [Recommendation from teachers and students--all those with basic education should seek continuing education]. PMID- 3638092 TI - [Some look towards the new year: quota system on the way out]. PMID- 3638093 TI - [Scandinavian cooperation in centrum of Swedish Nurses' Association's representatives' meeting]. PMID- 3638094 TI - [Talk instead of psychopharmaceutical drugs in the modern prison system. Interview by Viveka Holmertz]. PMID- 3638095 TI - [Monica leads project on mental health. Interview by Jan Thomasson]. PMID- 3638096 TI - [Last days of the strike--long-suffering patients wait for 10 hours]. PMID- 3638097 TI - [Acupuncture for pain control. Future field for nurses. Interview by Jan Thomasson]. PMID- 3638098 TI - [Dialysis lawsuit--many experts support nurse]. PMID- 3638100 TI - [Empilisweni--a place to get healed]. PMID- 3638099 TI - ["Health Care in Vara": unusual project for health education. Interview by Anne Sorman]. PMID- 3638101 TI - [Ingrid, Swedish physician: we fight starvation here. Interview by Stefan Karlsson]. PMID- 3638102 TI - [Project about ward managers--their situation must improve. Interview by Jan Thomasson]. PMID- 3638103 TI - [Committee says yes to test-tube babies. Interview by Inger Lernevall]. PMID- 3638104 TI - [Interest in everything which reinforces father's role]. PMID- 3638105 TI - [Valuable conference on operating room nursing]. PMID- 3638106 TI - [ILO--oldest of UN organizations. Interview by Jan Thomasson]. PMID- 3638107 TI - [Need for more nurses in sports medicine]. PMID- 3638108 TI - [Summer 1986 remains problematic--"insufficient interest in solving problems". Interview by Jan Thomasson]. PMID- 3638109 TI - [County Council promised serious investigation--doubtful it will provide any results. Interview by Jan Thomasson]. PMID- 3638110 TI - [That was a childbirth which wouldn't wait...]. PMID- 3638111 TI - [6 months among the bare mountains]. PMID- 3638112 TI - [Hospital infections cost money and suffering]. PMID- 3638113 TI - [Vardfacket's language school. Dialysis nurse]. PMID- 3638114 TI - [There is a great demand for Lena's knowledge. Interview by Janne Berglund]. PMID- 3638115 TI - [Better information--calmer patients. Interview by Viveka Holmertz]. PMID- 3638116 TI - [All-important to know self defense but disagreement about best technic]. PMID- 3638117 TI - A direct action of kallikrein on spermatozoal motility? AB - Semen samples from infertile normozoospermic and slight to moderate asthenozoospermic subjects were tested in parallel with and without kallikrein (dry substance) by Kremer's capillary tube test. Penetration in human midcycle cervical mucus and AB Rh+ (RH+) serum was evaluated. Kallikrein increased spermatozoal penetration into cervical mucus after 3 hrs incubation (p less than 0.01 in normozoospermic subjects). PMID- 3638118 TI - The senator and the nurses. PMID- 3638119 TI - Drug errors can be bitter pills. PMID- 3638120 TI - For want of lactase.... PMID- 3638121 TI - Battering during pregnancy. PMID- 3638122 TI - Where do women turn? PMID- 3638123 TI - Sulfite sensitivity. PMID- 3638124 TI - Come here, nurse! PMID- 3638125 TI - The weakness of steroids. PMID- 3638126 TI - Sexual healing after pelvic irradiation. PMID- 3638127 TI - Wound care forum: Readers' remedies for pressure sores. PMID- 3638128 TI - Washington. A prestigious practice: AJN jobfocus. PMID- 3638130 TI - Games nurses play. Part 2. Pass to a higher authority and trivial pursuit. PMID- 3638129 TI - Clarification or obfuscation? PMID- 3638131 TI - Diabetes from an early age. PMID- 3638132 TI - AIDS: what precautions do you take in the hospital? PMID- 3638133 TI - With ICUs filling up, hospitals are searching high and low for more critical care nurses. PMID- 3638134 TI - The more things change... PMID- 3638135 TI - Enhanced specificity of immunoblotting using radiolabeled antigen overlay: studies of blood coagulation factor XII and prekallikrein in plasma. AB - Immunoblotting of blood coagulation Factor XII and plasma prekallikrein in whole plasma was performed using radiolabeled antigen for detection. After sodium dodecyl sulfate-polyacrylamide gel electrophoresis of plasma and transfer to nitrocellulose sheets, the blots were first reacted with polyclonal goat anti Factor XII or anti-prekallikrein antisera and then with 125I-Factor XII or 125I prekallikrein, respectively. A major advantage of using radiolabeled antigen rather than radiolabeled secondary antibody was enhanced specificity of immunodetection of these antigens in plasma. This procedure was sensitive to approximately 0.3 ng of either Factor XII or prekallikrein antigen and was useful for detection of Factor XII cleavage fragments in contact activated plasma. Radiolabeled antigen overlay may improve the specificity of immunoblotting of trace antigens in any complex mixtures. PMID- 3638136 TI - Is antioxidant deficiency related to chronic obstructive pulmonary disease? AB - This report describes an assay with the capability of detecting antioxidant activity of plasma and of purified proteins. The method is based on the enzymatic oxidation of plasma elastase inhibitory capacity of enzyme(s) in extracts of human lysosomes in the presence of hydrogen peroxide, chloride, and magnesium ions. Using this method we measured the antioxidant activity of the plasma of 59 subjects. We detected a strong relationship between a deficiency in the antioxidant activity of plasma and the presence of a family history of lung disease (p less than 0.005), and an abnormal mean FEV1/FVC ratio (p less than 0.005). PMID- 3638137 TI - In vitro inhibition of the classical pathway of human complement by a natural microbial product, colistin sulphate. AB - Colistin sulphate was found to be an inhibitor of the classical pathway of the complement system. The main sites of inhibition were the interaction of EAC14 with C2 and EAC142 with C3. It also inhibited EAC14 formation from EA and C2 deficient serum, EAC1-7 formation from EAC1-3, C5, C6 and C7 and the interaction of EAC1-7 with C8 and C9, though less efficiently. It did not inhibit formation of C3/C5 convertase of the alternative pathway. The inhibition of the classical pathway was reversible since hemolytic activity was completely restored after dialysis. PMID- 3638138 TI - About one-fourth of the Fortune 500 companies now screen applicants for drugs. PMID- 3638139 TI - Motivating youths to conserve hearing: a unit plan. PMID- 3638140 TI - The illiteracy crisis: implications for the occupational health nurse. PMID- 3638141 TI - Reducing the risk of acquiring AIDS. PMID- 3638143 TI - Critical health issues in the workplace. PMID- 3638142 TI - The mental health training needs of occupational health nurses. PMID- 3638144 TI - Smoking and cancer. PMID- 3638145 TI - Properties of a membrane-bound tyrosine kinase phosphorylating the cytosolic fragment of the red cell membrane band 3 protein. AB - Band 3 protein of human erythrocyte membrane is phosphorylated on a tyrosine residue located near the NH2 terminal by an endogenous tyrosine kinase activity (Dekowski, S., Rybicki, A. and Drickamer, K. (1983) J. Biol. Chem. 258, 2750 2753). A tyrosine kinase phosphorylating the band 3 protein in situ has been extracted from ghosts by non-ionic detergent and partially characterized (Phan Dinh-Tuy, F., Henry, J. and Kahn, A. (1985) Biochem. Biophys. Res. Commun. 126, 304-312). We have studied the properties of the tyrosine kinase activity which remains bound to the ghosts after detergent extraction using the 43 kDa fragment of protein 3 as substrate. This activity, solubilized from the detergent resistant material at 0.25 M NaCl and concentrated by phosphocellulose and tyrosine-agarose chromatographies, remains linked to high molecular weight complexes. It is specific for tyrosine. Assayed with the purified 43 kDa fragment it requires the presence of Mn2+ which cannot be replaced by Mg2+. Its affinity for 43 kDa fragment is very high with a Km of 3.3 microM. ATP acts as a phosphoryl donor with a Km of 0.55 microM. The tyrosine kinase activity was not modified by insulin, DMSO, phorbol ester and epidermal growth factor, vanadate and xanthine derivatives. Polyamines spermidine and the polylysine are inhibitors in the presence of Mn2+ but not in the presence of Mg2+. Heparin is a competitive inhibitor of ATP. 2,3-Diphosphoglycerate is an inhibitor at physiological concentrations (Ki = 2 mM). Purified red cell actin is not phosphorylated by the tyrosine kinase. These properties distinguish the red cell membrane-bound tyrosine kinase from other tyrosine kinases extracted from normal cells. PMID- 3638146 TI - ATP-dependent calcium pump and Na+-Ca2+ exchange in plasma membrane vesicles from squid optic nerve. AB - Purified plasma membrane vesicles from the optic nerve of the squid Sepiotheutis sepioidea accumulate calcium in the presence of Mg2+ and ATP. Addition of the Ca2+ ionophore A23187 to vesicles which have reached a steady state of calcium active uptake induces complete discharge of the accumulated cation. Kinetic analysis of the data indicates that the apparent Km for free Ca2+ and ATP are 0.2 muM and 21 muM, respectively. The average Vmax is 1 nmol Ca2+/min per mg protein at 25 degrees C. This active transport is inhibited by orthovanadate in the micromolar range. An Na+-Ca2+ exchange mechanism is also present in the squid optic nerve membrane. When an outwardly directed Na+ gradient is imposed on the vesicles, they accumulate calcium in the absence of Mg2+ and/or ATP. This ability to accumulate Ca2+ is absolutely dependent on the Na+ gradient: replacement of Na+ by K+, or passive dissipation of the Na+ gradient, abolishes transport activity. The apparent Km for Ca2+ of the Na+-Ca2+ exchange is more than 10-fold higher than that of the ATP-driven pump (app. Km=7.5 muM). While the apparent Km for Na+ is 74 mM, the Vmax of the exchanger is 27 nmol Ca2+/min per mg protein at 25 degrees C. These characteristics are comparable to those displayed by the uncoupled Ca pump and Na+-Ca2+ exchange previously described in dialyzed squid axons. PMID- 3638147 TI - New antimicrobials. AB - Two groups of compounds, the beta-lactams and the quinolones, account for the main developments in antimicrobials in the last 5 years. Efforts to overcome emerging problems of resistance and to broaden further the spectrum of similar existing agents have been the main impetus to the pharmaceutical industry, though some compounds have also been developed with a narrow spectrum intended for specific pathogens. This article reviews antibiotics that have recently become available in the UK and also discusses compounds that are undergoing clinical trials at present. PMID- 3638148 TI - Urinary kallikrein excretion during inhibition of endogenous angiotensin II in the pig. AB - This study was performed to assess the possible contribution of endogenous angiotensin II (AII) to the regulation of urinary kallikrein excretion. The AII antagonist saralasin or the saline vehicle was infused into the aorta above the renal arteries of pigs under halothane-O2/N2O anaesthesia. Systemic and renal functional parameters were followed for 140 min and during stimulation of the reninangiotensin system by haemorrhage. Urinary kallikrein excretion, determined as kininogenase activity, was increased immediately upon both initiation and termination of the 2 h saralasin infusion into pigs not subjected to haemorrhage. Renal cortical blood flow (RCBF) was maintained, in both saline and saralasin treated animals at blood pressures as low as 70 mm Hg, while glomerular filtration rate was dissociated during saralasin infusion. As long as RCBF was maintained, urinary kallikrein excretion rate was elevated during the progressive hypotension in both saline and saralasin-treated animals. These findings confirm a close relationship between the maintenance of RCBF and increased activity of the kallikrein-kinin system whether or not AII is antagonized, and indicate that during haemorrhage the kallikrein-kinin system is stimulated by a mechanism not involving AII. PMID- 3638149 TI - The Alzheimer caregiver: prisoner of love. PMID- 3638150 TI - Health-related, but not nursing--is this the education for you? PMID- 3638151 TI - Ethical advocacy with style. PMID- 3638153 TI - Putting theory to clinical use. PMID- 3638152 TI - The Black nurse as advocate. PMID- 3638154 TI - A nursing family assessment program. PMID- 3638155 TI - Skill sharing for success '86. PMID- 3638156 TI - Support for psychiatric nurses in the workplace. PMID- 3638157 TI - [Ethical considerations in maternity]. PMID- 3638158 TI - Changing patterns in maternity care. PMID- 3638159 TI - Artist in the nursery. PMID- 3638160 TI - How to survive the death of your child. PMID- 3638161 TI - [Preeclampsia. Would not a series of home visits suffice for patients with light preeclampsia]. PMID- 3638162 TI - Effects of vanadate on the assembly and disassembly of purified tubulin. AB - Sodium-orthovanadate (100-700 microM) added to purified pig brain microtubule protein (molar ratios 13-90 moles vanadate/mole tubulin) inhibits to a considerable extent the assembly (up to 65%) and the disassembly rates (up to 60%) of microtubules, as determined by turbidimetry. Vanadate added to preformed microtubules did not appreciably alter the turbidity level of the samples, however, the disassembly rates were decreased in the same manner as when vanadate was added prior to polymerization. Microtubule protein kept on ice for 3-6 hours became more susceptible to vanadate than freshly prepared protein. The effect of vanadate was independent of the GTP concentration at which the polymerization assays were performed (0.025 to 1 mM GTP). In the presence of taxol, which increases the rate and extent of microtubule formation, vanadate had no effect on assembly rates. Disassembly was inhibited, however, much less than in the presence of vanadate alone. Electron microscopy and polyacrylamide gel electrophoresis did not reveal differences between microtubules prepared in the presence or in the absence of vanadate. This is consistent with the notion that vanadate does not interfere with the interaction between tubulin and the high molecular weight microtubule-associated proteins. Apparently vanadate brings about an allosteric change of the microtubule protein(s) resulting in the abnormal polymerization kinetics of tubulin found in our study. The above results may be relevant for studies where the effects of vanadate on intracellular motility are interpreted as being solely due to a specific inhibition of ATPases. PMID- 3638163 TI - RN employment: the latest trends. PMID- 3638164 TI - Networking through INA. PMID- 3638166 TI - [Nursing care of patients undergoing extracorporeal shock wave lithotripsy]. PMID- 3638165 TI - [Prevention of bedsores by using cereal seed pads]. PMID- 3638168 TI - [Insufficiency of blood volume after the surgery of children with Fallot's syndrome: treatment and nursing care]. PMID- 3638167 TI - [Electrohydraulic shock wave lithotripsy: patient care]. PMID- 3638169 TI - [Experiences in admitting of psychotic patients]. PMID- 3638170 TI - [Management of clean air in the operating theater]. PMID- 3638171 TI - [Estimation of nitrogen and electrolyte loss in the early period after abdominal operations]. PMID- 3638172 TI - [Beautification and management of wards]. PMID- 3638173 TI - [Current status and future of research in traditional Chinese medicine nursing]. PMID- 3638174 TI - [Traditional Chinese medicine nursing of patients with fever, cough and parotitis]. PMID- 3638175 TI - [Traditional Chinese medicine care of patients with stomatitis]. PMID- 3638176 TI - [Nursing care of patients with disseminated pneumorrhagic leptospirosis]. PMID- 3638177 TI - [Triage in hospital emergency units]. PMID- 3638178 TI - [Problems on parenteral infusions for neurosurgical patients]. PMID- 3638179 TI - [Controlled hypotensive anesthesia with sodium nitroprusside]. PMID- 3638180 TI - The nursing student loan program: its history and present status. PMID- 3638181 TI - Comparative efficacy of once versus twice daily mevinolin in the therapy of familial hypercholesterolemia. AB - Mevinolin, a competitive inhibitor of the rate-limiting enzyme in cholesterol biosynthesis, is an effective hypocholesterolemic agent in patients with primary hypercholesterolemia when given in a twice-daily regimen. The present study compares the hypocholesterolemic effects of mevinolin given in a twice-daily dosage regimen with the same total dosage given either once in the morning or once in the evening in 12 patients with heterozygous familial hypercholesterolemia. Ten patients took a total daily dose of 40 mg of mevinolin and two took 20 mg. On the twice-daily dosage regimen, plasma concentrations of total cholesterol decreased 29.5% and 35.9% as compared with 21.4% and 26.9% with mevinolin given once in the morning and 27% and 32.2% with the drug given once in the evening. These values are all significantly different from baseline, but differences between the three treatment regimens do not reach statistical significance (P = 0.07 for the twice-daily versus once-in-the-morning dosage regimens). We conclude that once-daily administration of mevinolin, particularly in the evening, is an effective hypocholesterolemic regimen in patients with familial hypercholesterolemia. PMID- 3638182 TI - Computer-aided measuring of motor functions using pursuit tracking. AB - The necessity of evaluating motor functions objectively and quantitatively is discussed. Tracking tasks and their appropriateness in assessing motor performance is reviewed. Motor performance can be effectively assessed by means of tracking tasks. A simple tracking device is presented which allows the measurement of motor performance in different conditions. It is pointed out that computers are well suited for driving the stimulus in tracking tasks as well as recording the performance in experiments based on tracking tasks. Differences between open and closed loop conditions, compensatory tracking, pursuit tracking, preview tracking and cognitive tracking are discussed. A flexible computer controlled device is presented with which diverse experiments based on tracking tasks can be performed and their results recorded. A complete description of the user-oriented, interactive programs with which the experiments can be controlled and the relevant performance data can be recorded is given. An example of their application on measuring the effects of levodopa therapy on the motor symptoms of Parkinson's disease is presented. PMID- 3638183 TI - Simulation of the spatial distribution of muscle fibres in human muscles. AB - A composite muscle cross section model was simulated on a VAX 780 computer. The various motor unit territories in the cross section area were circular, partially overlapping each other. The radii of the territories of the motor units, their centres, and the number of muscle fibres in each motor unit were treated as random variables. Two different models were generated, one with a uniform distribution of the fibres in the motor unit territories, and the other with a normal distribution of the fibres. An algorithm for simulation of fibre density measurements was written, and the effects of varying the parameters of the model on fibre density measurements were investigated. The results of the computer simulation were in agreement with analytical and laboratory findings. PMID- 3638184 TI - PROLIF: a computer program for calculation and comparison of cultured lymphocyte proliferation. AB - A computer program which expedites the quantitation and comparison of cultured lymphocyte proliferative responses is described. The program, entitled PROLIF, is written in VAX BASIC and computes this in vitro activity by collating and reducing radioactive count data obtained from tritiated-thymidine incorporation studies. The report generated by this program includes descriptive statistics such as the mean, percentage change from control and t-test probability. Special program features allow for flexibility in experimental protocol design, user defined default program options, and automatic result storage on disk for subsequent archiving purposes. PMID- 3638185 TI - ADOXI-PLOT: a computer program for plotting pedigrees illustrating autosomal dominant and X-linked inheritance. AB - A FORTRAN program ADOXI-PLOT (Autosomal Dominant Or X-linked Inheritance Plot) has been developed. Different symbols are used to characterize individual family members. Depending on the size of the kindred, the pedigree automatically obtains a rectangular or circular appearance. The program can be used alone, or be connected to a register of families from which the input information for the plot program is obtained. PMID- 3638186 TI - BMDP program for piecewise linear regression. AB - Piecewise linear regression has potentially broad applications in medical data analysis as well as other types of regression. Various kinds of algorithms have been proposed for finding optimum piecewise linear regressions. This paper presents a BMDP program for obtaining near optimum piecewise linear regression equations. An idea intrinsic to the method is that restricting parameter space to a discrete set makes the difficult problems become standard problems. Any software having the variable selection feature in the multiple linear regression can be used to apply the method. PMID- 3638187 TI - Kruskal-Wallis test: BASIC computer program to perform nonparametric one-way analysis of variance and multiple comparisons on ranks of several independent samples. AB - Multiple t tests at a fixed p level are frequently used to analyse biomedical data where analysis of variance followed by multiple comparisons or the adjustment of the p values according to Bonferroni would be more appropriate. The Kruskal-Wallis test is a nonparametric 'analysis of variance' which may be used to compare several independent samples. The present program is written in an elementary subset of BASIC and will perform Kruskal-Wallis test followed by multiple comparisons between the groups on practically any computer programmable in BASIC. PMID- 3638188 TI - [Guidance of students conducting case studies. (4)]. PMID- 3638189 TI - [Restoration of medicine--definition of medicine and medical care]. PMID- 3638191 TI - [Nursing study and dietetics--re-evaluation of nursing study based on the concept of diet. (1)]. PMID- 3638190 TI - [Lessons from work--my method of self-enlightenment (2)]. PMID- 3638192 TI - [Lessons in sharing experiences: recreation of nursing scenes by using process records]. PMID- 3638193 TI - [Nursing records as an information system--as part of information system to support nursing (1)]. PMID- 3638194 TI - [Psychocybernation and nursing--for more meaningful encounters with patients. (6)]. PMID- 3638195 TI - Sold on Cumberlege. Interview by Ruth Devlin. PMID- 3638196 TI - School nursing: helping children to grieve. PMID- 3638197 TI - Wound care: body builders. PMID- 3638198 TI - Health visiting: models for care. PMID- 3638199 TI - Cement burns of the heels. PMID- 3638200 TI - Transcutaneous oxygen monitoring: assessment techniques. PMID- 3638201 TI - Preventing radiation exposure in critical care. PMID- 3638202 TI - Withdrawing mechanical support from the brain-damaged neonate. PMID- 3638203 TI - Increasing productivity through computer communications. PMID- 3638204 TI - Providing patient opportunities to increase control. PMID- 3638205 TI - Developing an IABP education program (continuing education credit). PMID- 3638206 TI - Panic disorder and agoraphobia. PMID- 3638207 TI - Multiple sclerosis. PMID- 3638208 TI - Pregnancy and insulin-dependent diabetes. PMID- 3638209 TI - Diabetes patient education in hospital settings. PMID- 3638210 TI - Diabetes patient education in the office setting. PMID- 3638211 TI - National standards and review criteria for diabetes patient education programs: quality assurance for diabetes patient education. National Diabetes Advisory Board. PMID- 3638212 TI - National standards for diabetes patient education programs: pilot study results and implementation plan. A report by the National Standards Steering Committee of the National Diabetes Advisory Board. PMID- 3638213 TI - Diabetes-related continuing education needs of pharmacists. PMID- 3638214 TI - [Prevention of food poisoning]. PMID- 3638215 TI - [Criteria of individual adaptability to different work regimens depending on the human chronobiological type]. PMID- 3638216 TI - [Spinal injury in the diver]. PMID- 3638217 TI - [Wounds and injuries to the extremities]. PMID- 3638218 TI - [Dispensary care for young infants in the country]. PMID- 3638220 TI - [Kalanchoe]. PMID- 3638219 TI - [Alcoholism and progeny]. PMID- 3638221 TI - [Popularization of contraception]. PMID- 3638223 TI - [Health-education reference bulletins in health propaganda]. PMID- 3638222 TI - [Propaganda on hardiness training (material for discussions)]. PMID- 3638224 TI - [Rapid method for detecting growth disorders in children]. PMID- 3638225 TI - [Prevention of industrial injuries and the organization of traumatology care for miners]. PMID- 3638226 TI - [Effect of the weather on human health]. PMID- 3638227 TI - [Placental insufficiency]. PMID- 3638228 TI - [Humeroscapular periarthritis]. PMID- 3638229 TI - [Itsenko-Cushing disease in children (diagnosis and treatment)]. PMID- 3638230 TI - [Lymphadenitis]. PMID- 3638231 TI - [Hemochromatosis]. PMID- 3638232 TI - [Demography and health]. PMID- 3638233 TI - [Organization of medical care for children in natural disasters and catastrophes]. PMID- 3638234 TI - [Emergency care in injuries to the orbit and adnexa oculi]. PMID- 3638235 TI - [Sobriety--a way of life (material for discussions)]. PMID- 3638236 TI - [Anti-tobacco hygiene education of youth]. PMID- 3638237 TI - [Prevention of tuberculosis infections from animals]. PMID- 3638238 TI - [Prophylactic examinations of female workers in greenhouse farming]. PMID- 3638239 TI - [Diphtheria in adults]. PMID- 3638240 TI - Health cost "containment" measures are placing insurmountable burdens on the elderly. PMID- 3638241 TI - Proteolytic activity of arginine esterase from dog seminal plasma towards actin and other structural proteins. Comparison with trypsin and kallikrein. AB - At equimolar ratio of enzyme/substrate, actin, tropomyosin, fibronectin and myosin were extensively hydrolyzed during an incubation of one hour at 37 degrees C. Dog serum albumin, ovalbumin, bovine gamma-globulin and human prostatic acid phosphatase were not hydrolyzed. The activity of arginine esterase towards actin at pHs 6.5, 7.1 and 7.6 was respectively 60, 74 and 84% of the one found at optimum pH 8.2. The cleavage products of actin by arginine esterase and trypsin were similar although trypsin activity was 5000-fold higher. Kallikrein produced a major fragment of actin not observed with arginine esterase and trypsin. It is concluded that arginine esterase has a low trypsin-like activity towards structural proteins and that this activity may have a physiological significance. PMID- 3638242 TI - Real change is becoming better. Interview by Donna Waddell. PMID- 3638243 TI - Brothers and sisters love, "my new baby". PMID- 3638244 TI - [Central sterilization--from theory to practice]. PMID- 3638245 TI - Oral health and aging. PMID- 3638246 TI - Mouth care--basic and essential. PMID- 3638247 TI - Renewing the commitment to oral hygiene. PMID- 3638248 TI - A dental program for nursing home residents. PMID- 3638249 TI - A guide for oral assessment. PMID- 3638250 TI - Enabling clients to manage dentures. PMID- 3638251 TI - Patients suffering from memory loss can be taught self-care. PMID- 3638252 TI - Drugs and the elderly. Update: cardiac emergency drugs. PMID- 3638253 TI - 70+ and going strong. Arthur Merrill, renaissance man. Interview by Joan Sanger. PMID- 3638254 TI - Vitamin C--a miracle cure? PMID- 3638255 TI - Research challenges in hospice nursing. PMID- 3638256 TI - Child and family teaching: special needs and approaches. PMID- 3638257 TI - Agendas for quality of life. PMID- 3638258 TI - The experience of terminal illness on adult family members. PMID- 3638259 TI - How can nurses improve the quality of life of the hospice client and family?: an exploratory study. PMID- 3638260 TI - Patterns of hospice care--the RN role. PMID- 3638261 TI - Needs of old people prominent in nursing research. PMID- 3638262 TI - The team concept in care of the elderly. PMID- 3638263 TI - Stroke: first the mind and then the body. PMID- 3638265 TI - The right to die. PMID- 3638264 TI - The biology of ageing: body temperature regulation. PMID- 3638266 TI - Alzheimer's disease: 'We didn't know the half'! PMID- 3638267 TI - Providing an information service. PMID- 3638268 TI - The 'Age Well' Show. PMID- 3638269 TI - What it takes to be an auxiliary. PMID- 3638270 TI - Battered women: an important nursing issue. PMID- 3638271 TI - Parent and child health nursing: exciting career opportunities. PMID- 3638272 TI - Communicating with difficult patients. PMID- 3638273 TI - The nurse-physician "team": realities and relationships. PMID- 3638274 TI - Want to get your message across? Write about it! PMID- 3638276 TI - Observations on the consortium method of infection control. PMID- 3638275 TI - PDR: your reference for academic success. PMID- 3638277 TI - Increasing handwashing compliance with more accessible sinks. AB - The frequency of handwashing in two intensive care units (ICUs) was observed. Handwashing after direct contact with patients or their support equipment was recorded. The ratio of beds to sinks was 1:1 in the medical ICU and 4:1 in the surgical ICU. Surveillance of physicians, nurses, and other personnel demonstrated a greater frequency of handwashing by nurses (63%) compared with physicians (19%) and other personnel (25%). The nurses in the unit with one sink per bed had a significantly greater number of handwashes (76%) than those in the unit with fewer sinks (51%). PMID- 3638278 TI - Traditional maternity care within a bio-social framework. AB - This study, using quantitative and qualitative methodologies attempts to draw a profile of traditional midwives in Botswana through describing their demographic characteristics, the patterns of communication between midwives and patients, their knowledge and practices and their cooperation with the modern maternity care sector. From the case study emerges a profile of a traditional midwife who: is socially and culturally integrated in the local community; represents a highly valuable source of information on cultural conceptions of crucial importance to childbearing Botswana women; demonstrates the value of a close personal interaction and communication with the pregnant and delivering woman; realizes the limitations of her own capability in birthing situations; and maintains a close communication with the local hospital to which she refers patients when required. The traditional midwife described in this case study is probably not a prototype of the contemporary Motswana traditional midwife. However, she does represent many of the valuable characteristics of the traditional approach which we in the modern sector might benefit from studying in order to improve the human quality of our own care. On the basis of this and other studies, it is recommended that cooperation be developed between modern and traditional midwives, not with the intention of controlling or regulating, but to respect the unique character of each. It appears that an open-minded cooperation between two independent sectors providing health care to the childbearing population is the optimal choice for the country at the present time. A policy for the structured cooperation between the two sectors might include the following: Regional education seminars for both modern and traditional midwives.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3638279 TI - Nursing in a changing world. AB - This paper describes some of the societal trends which affect nursing and the mutual impact of these trends on nursing education, practice, research and organization. It was presented at the seminar "Talking about the Future", Escola Universitaria d'Infermeria Santa Madona, Barcelona. PMID- 3638280 TI - AIDS in the workplace. How to prevent the transmission of the infection. U.S. Department of Health and Human Services. AB - The following recommendations have been developed by the Public Health Service of the U.S. Department of Health and Human Services who granted International Nursing Review the authorization to reproduce them. Since AIDS knows no frontier, we believe that these guidelines could be useful to health care personnel the world over. PMID- 3638281 TI - Nuclear accident. World Health Organization. AB - After the nuclear accident in Chernobyl (U.S.S.R.) at the end of April, the Regional Office for Europe of the World Health Organization issued a statement about the precautions to be taken in Europe, the effects and the possible treatment. PMID- 3638282 TI - Mexico earthquake. PMID- 3638283 TI - Modulation by vanadate of the adrenergic characteristics of the iris, ileum, and vas deferens. AB - The influence of vanadate upon the adrenergic response of the rabbit iris (dilation) was examined in vivo, while the effects of vanadate upon adrenergic responses of the rabbit ileum and guinea pig vas deferens were investigated in vitro. Intravenously administered vanadate (2 mg/Kg) sensitized the iris to topically administered epinephrine; a small quantity of epinephrine, that elicited no change of pupil size following topical administration to the eye in the normal rabbit, produced a marked pupillary dilation in animals treated systemically with vanadate. The response of the isolated ileum to vanadate (1-10 micrograms) was identical to that elicited by norepinephrine or epinephrine. Brief exposure of the ileum to vanadate, norepinephrine, or epinephrine resulted in a transient cessation of rhythmic activity and reduction of mean tension. When the ileum was superfused continuously with solutions containing vanadate (10 micrograms/ml; 5.4 X 10(-5) M), the rhythmic activity and mean tension returned to control values within several minutes, suggesting tachyphylaxis. Exposure of the guinea pig vas deferens to vanadate did not elicit a contractile response. However, when the vas deferens was superfused continuously (greater than 60 min) with vanadate (5.4 X 10(-5) M), both the amplitude and duration of the contraction elicited by epinephrine were increased. Consistent with the above findings is the hypothesis that vanadate might inhibit the mechanisms responsible for the removal of epinephrine or norepinephrine from the site of action within a tissue. PMID- 3638284 TI - Holistic care--a topic of profound importance. PMID- 3638285 TI - Pastoral concern of the Church. PMID- 3638286 TI - Legal services and medical treatment for poor people: a need for advocacy. PMID- 3638287 TI - Bouvia v. Superior Court. PMID- 3638289 TI - Regulating the nursing practice of chemically addicted nurses. PMID- 3638288 TI - In the matter of Nancy Ellen Jobes. PMID- 3638290 TI - An analysis of trends in society. PMID- 3638291 TI - Parental anxiety related to the care of a child with apnea. PMID- 3638292 TI - Continued help in lending direction: a proposed nurse to nurse communication system. PMID- 3638293 TI - Measuring parental participation: Part II. PMID- 3638294 TI - Primiparas' attitudes toward mothering. PMID- 3638295 TI - Effects of infant colic on the family: implications for practice. PMID- 3638296 TI - [Student project from the College for Health Occupations, Stockholm concerning time of care, medical safety and attitudes to discharge after delivery]. PMID- 3638297 TI - [Discharge after childbirth]. PMID- 3638298 TI - [Study on sphincter rupture]. PMID- 3638299 TI - [Early discharge--what is the midwife's position?]. PMID- 3638300 TI - [Travel report]. PMID- 3638301 TI - [Genital infections in girls--from the RFSU's youth meeting's Open House with special reference to Chlamydia trachomatis]. PMID- 3638302 TI - [Ancient wisdom or contemporary revolution?]. PMID- 3638303 TI - [Breast feeding--how do we really treat it?]. PMID- 3638304 TI - Molecular cloning of the gene of a penicillin-binding protein supposed to cause high resistance to beta-lactam antibiotics in Staphylococcus aureus. AB - A novel penicillin-binding protein, PBP-2' (Mr about 75,000), is known to be induced in excessively large amount by most beta-lactam compounds in cells of a clinically isolated strain of Staphylococcus aureus, TK784, that is highly resistant to beta-lactams and also most other antibiotics. This protein has very low affinities to most beta-lactam compounds and has been supposed to be the cause of the resistance of the cells to beta-lactams. A 14-kilobase DNA fragment was isolated from the cells that carried the gene encoding this penicillin binding protein and also a genetically linked marker that is responsible for the resistance to tobramycin. This DNA was cloned on plasmid pACYC184 and was shown to cause both production of PBP-2' and resistance to tobramycin in Escherichia coli cells. However, the formation of PBP-2' in E. coli was only moderate and was independent of normal inducer beta-lactams. The PBP-2' formed in the E. coli cells showed slow kinetics of binding to beta-lactams similar to that of PBP-2' formed in the original S. aureus cells and gave a similar pattern of peptides to the latter when digested with the proteolytic V8 enzyme of S. aureus. PMID- 3638305 TI - Transcription unit of the chicken histone H5 gene and mapping of H5 pre-mRNA sequences. AB - We have analyzed the transcription unit of the gene coding for the erythrocyte specific histone H5. RNA transcripts elongated in vitro by permeabilized immature cells hybridized to the template strand of the structural gene as well as to 3' flanking sequences. Approximately 90% of the engaged RNA polymerase II molecules terminate transcription within a region of about 500 base pairs immediately downstream of the polyadenylation site. S1 nuclease protection experiments indicated that the downstream sequences are also transcribed in vivo, their relative amounts reflecting the distribution of RNA polymerases observed in vitro. RNA molecules extending up to 1.14 kilobase pairs downstream of the polyadenylation site were detected, but no unique site of termination was found. The sequence of the transcription termination region shows no obvious homology to those of other RNA polymerase II termination regions. The possible involvement of altered DNA and/or chromatin structures in the transcription termination process is discussed. PMID- 3638306 TI - The mechanism and regulation of dolichyl phosphate biosynthesis in rat liver. AB - Rat liver slices were pulse labeled for 6 min with [3H]mevalonolactone and then chased for 90 min with unlabeled mevalonolactone in order to study the mechanism of dolichyl phosphate biosynthesis. The cholesterol pathway was also monitored and served to verify the pulse-chase. Under conditions in which radioactivity in the methyl sterol fraction chased to cholesterol, radioactivity in alpha unsaturated polyprenyl (pyro)-phosphate chased almost exclusively into dolichyl (pyro)phosphate. Lesser amounts of radioactivity appeared in alpha-unsaturated polyprenol and dolichol, and neither exhibited significant decline after 90 min of incubation. The relative rates of cholesterol versus dolichyl phosphate biosynthesis were studied in rat liver under four different nutritional conditions using labeled acetate, while the absolute rates of cholesterol synthesis were determined using 3H2O. From these determinations, the absolute rates of dolichyl phosphate synthesis were calculated. The absolute rates of cholesterol synthesis were found to vary 42-fold while the absolute rates of dolichyl phosphate synthesis were unchanged. To determine the basis for this effect, the rates of synthesis of cholesterol and dolichyl phosphate were quantitated as a function of [3H]mevalonolactone concentration. Plots of nanomoles incorporated into the two lipids were nearly parallel, yielding Km values on the order of 1 mM. In addition, increasing concentrations of mevinolin yielded parallel inhibition of incorporation of [3H]acetate into cholesterol and dolichyl phosphate. The specific activity of squalene synthase in liver microsomes from rats having the highest rate of cholesterol synthesis was only 2 fold greater than in microsomes from rats having the lowest rate. Taken together, the results suggest that the maintenance of constant dolichyl phosphate synthesis under conditions of enhanced cholesterogenesis is not due to saturation of the dolichyl phosphate pathway by either farnesyl pyrophosphate or isopentenyl pyrophosphate but coordinate regulation of hydroxymethylglutaryl-CoA reductase and a reaction on the pathway from farnesyl pyrophosphate to cholesterol. PMID- 3638307 TI - 15N-labeled tRNA. Identification of 4-thiouridine in Escherichia coli tRNASer1 and tRNATyr2 by 1H-15N two-dimensional NMR spectroscopy. AB - Uridine is uniquely conserved at position 8 in elongator tRNAs and binds to A14 to form a reversed Hoogsteen base pair which folds the dihydrouridine loop back into the core of the L-shaped molecule. On the basis of 1H NMR studies, Hurd and co-workers (Hurd, R. E., Robillard, G. T., and Reid, B. R. (1977) Biochemistry 16, 2095-2100) concluded that the interaction between positions 8 and 14 is absent in Escherichia coli tRNAs with only 3 base pairs in the dihydrouridine stem. We have taken advantage of the unique 15N chemical shift of N3 in thiouridine to identify 1H and 15N resonances for the imino units of S4U8 and s4U9 in E. coli tRNASer1 and tRNATyr2. Model studies with chloroform-soluble derivatives of uridine and 4-thiouridine show that the chemical shifts of the protons in the imino moieties move downfield from 7.9 to 14.4 ppm and from 9.1 to 15.7 ppm, respectively; whereas, the corresponding 15N chemical shifts move downfield from 157.5 to 162.5 ppm and from 175.5 to 180.1 ppm upon hydrogen bonding to 5'-O-acetyl-2',3'-isopropylidene adenosine. The large difference in 15N chemical shifts for U and s4U allows one to unambiguously identify s4U imino resonances by 15N NMR spectroscopy. E. coli tRNASer1 and tRNATyr2 were selectively enriched with 15N at N3 of all uridines and modified uridines. Two dimensional 1H-15N chemical shift correlation NMR spectroscopy revealed that both tRNAs have resonances with 1H and 15N chemical shifts characteristic of s4UA pairs. The 1H shift is approximately 1 ppm upfield from the typical s4U8 resonance at 14.8 ppm, presumably as a result of local diamagnetic anisotropies. An additional s4U resonance with 1H and 15N shifts typical of interaction of a bound water or a sugar hydroxyl group with s4U9 was discovered in the spectrum of tRNATyr2. Our NMR results for tRNAs with 3-base pair dihydrouridine stems suggest that these molecules have an U8A14 tertiary interaction similar to that found in tRNAs with 4-base pair dihydrouridine stems. PMID- 3638309 TI - Sports injuries--a growing phenomenon. PMID- 3638308 TI - Comparative evaluation of identification systems for testing methicillin resistant strains of Staphylococcus aureus. AB - Several commercial systems are available to distinguish between Staphylococcus aureus and the coagulase-negative species of the Micrococcaceae family. Four latex agglutination systems (Accu-Staph, SeroSTAT, Staphaurex, and Staphylatex) and two hemagglutination systems (Hemastaph and Staphyloslide) were compared for their performance in the rapid identification of 232 isolates of staphylococci, including 114 of methicillin-resistant S. aureus. Accu-Staph, Staphaurex, and Staphyloslide correctly identified 100% of the methicillin-resistant S. aureus isolates; Hemastaph and Staphylatex, 99.1%; and SeroSTAT, 94.7%. Most reactions were easy to interpret, although 15% of the SeroSTAT reactions were weak. Autoagglutination occurred only with isolates of coagulase-negative staphylococci. False-positive reactions were rare and occurred only with systems which did not detect autoagglutination. Five of these six systems appear to be adequate for the rapid identification of S. aureus, including methicillin resistant isolates. PMID- 3638310 TI - Nursing the aged with brain failure. AB - Nurses are the major caregivers for the aged with brain failure. The patients' needs and resources must be continually reassessed and care adjusted to the changing situation whether the patient is at home, attending a community ambulatory clinic, or in a hospital or a long-term institution. The nursing role includes humanistic concern, physical care, scientific/technological interventions, organization of care and contributing to the limited body of knowledge. The most complex area of care of brain-failure patients is communication, which has an important impact on both psychosocial and physical well-being. Often neglected aspects of care are ambulation and regulating body temperature. Nurses can make maximum use of resources through good organization of the environment. The nurse must continually update her knowledge and use a problem-solving approach in her work. She should record, analyse and share her experiences with others, thus helping to develop more humanistic and scientific modes of care. PMID- 3638311 TI - Morning care of patients with Alzheimer-type dementia. A theoretical model based on direct observations. AB - Five hospitalized patients in different stages of Alzheimer-type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self-care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance. PMID- 3638312 TI - The influence of elderly patients' mental impairment on nurse-patient interaction. AB - The study investigates nurse-patient interaction on a geriatric ward. The Clifton Assessment Procedure for the Elderly was used to measure cognitive and behavioural functioning and the 23 subjects studied were divided into three groups: lucid; slightly confused; and confused or demented. Information relating to the subjects' activities and interactions with nursing staff was gained from time sampling by direct observation. One hundred and eighteen nurses also completed a questionnaire to elicit their priorities in care. The results reveal very low levels of staff-patient communication. Nurses interact significantly less with confused than lucid patients. Patients spent only 9.7% of observed time in self-care activities, and 5.9% eating and drinking; the remaining time they were inactive. Nursing staff, however, regarded their care priority as physical care rather than psychosocial interaction or restorative activities. PMID- 3638313 TI - Pressure sore prevention and treatment: an example of nurses' failure to implement research findings. AB - For more than 20 years pressure sore prevention and the treatment of established pressure sores have continued to generate research by nurses and those in allied disciplines. Pressure sore aetiology is established and much is known about the healing of chronic wounds, but little impact has been made on clinical nursing practice. The failure of nurses to implement research findings in this sphere is examined according to the framework suggested by Hunt (1981). One of the main reasons may be the failure of nurse educationalists to incorporate relevant material into basic and post-basic teaching programmes. PMID- 3638314 TI - The significance of secondary school education for education and training of nurses in South Africa. AB - This paper examines current basic nursing education in South Africa and suggests that problems in the secondary school education of Black recruits affect their later training potential as professional nurses. It reports the move towards the transfer of nurse training into higher education from 1986 in South Africa. Black nurses' learning and studying difficulties are considered in the light of their high failure rate in the South African Nursing Council qualifying examinations. It is agreed that in order to prepare the high number of qualified Black nurses required by South Africa within the tertiary education sector from 1986, special attention would need to be paid to secondary education provision for Blacks. PMID- 3638315 TI - Children's pain vocabulary. AB - This paper will address children's pain vocabulary, that is, the self-reported words provided by the children, in a descriptive study carried out to examine how a group of school-age children view their pain. This was an initial step to demonstrate that children can describe pain and do possess a pain vocabulary. Our aim was to determine the feasibility of achieving a meaningful grouping of children's pain words and the pain intensity implied by the words. A sample of 40 school-age children were the subjects for this study. All the pain word descriptors used by the children in response to the question 'Can you think of words to describe what pain feels like?' were categorized on the basis of the Melzack classification. PMID- 3638316 TI - Comparison of two theorists on care: Orem and Leininger. AB - Dorothea Orem and Madeleine Leininger are two nursing scholars who are contributing significantly to the body of nursing knowledge. This paper contrasts their backgrounds, the origins of their theories, their views of the nature of nursing, use of theory development strategies, and contributions to nursing science. The concepts of Leininger's care and Orem's self-care will be compared as these relate to their theories with the examination of similarities and differences. PMID- 3638317 TI - Game playing: a way to look at nursing models. AB - This paper deals with macrotheories of nursing and a new way of looking at them. It also shows through the use of a board game why the discipline of nursing would be greatly hindered in its development by the acceptance of only one of the nursing macrotheories available today. The board game shows that macrotheorists of nursing do not discuss death and dying as a part of their conceptual models. Since death is not incorporated into the concepts, then they are not describing or explaining all the aspects dealt with in the discipline of nursing. This is not to say that theory is not necessary but that the acceptance of only one nursing macrotheory (model) is limiting and inhibiting. It denies nursing the ability to create and use intuition. PMID- 3638318 TI - Hope, morale and adaptation in patients with chronic heart failure. AB - Clinical observation of a population of patients with chronic heart failure suggested that some patients adapt to their disease more effectively than others. This difference in response appeared to be more related to psychosocial variables, including a positive future orientation, than to variation in severity of disease. The purpose of this study was to investigate the relationship among the psychosocial variables of hope and morale, the level of function of the individual, and the physiological status of that individual. The sample for this descriptive study was patients who met inclusion criteria and who attended the Heart Failure Clinic at St Joseph's Hospital, Hamilton, Ontario, Canada (n = 23). Data were collected at one point in time. Population characteristics were obtained by chart extraction and patient interview. The Beck Hopelessness Scale, the Philadelphia Geriatric Centre Morale Scale, and an adapted version of the McMaster Health Status Index were administered. Physiological status was determined by clinical signs and symptoms in accordance with a scale devised by Lee. Patients who scored higher on the scales assessing hope and morale also scored higher on social function. There was very little relationship between these psychosocial variables and the physical variables of physiological status and physical function. These findings suggest that patients who are more hopeful maintain their involvement in life regardless of physical limitations imposed by their heart failure. Nursing interventions must continue to include the enhancement of hope for the future and active participation with others. PMID- 3638319 TI - An introduction to the use of repertory grid technique as a research method and clinical tool for psychiatric nurses. AB - This paper outlines a technique, the repertory grid technique, which offers the opportunity for psychiatric nurses to document information gained in an interview setting. The method, which consists of structured and systematic questioning, allows exploration of individual's systems of meanings. Data collection is separated from inference, hence the criticism that the nursing data is impressionistic and opinionated is avoided. The controlled conversational format of the technique provides an enhanced awareness of receiving information and interpreting it, and the primary data is clearly presented and available for discussion about conclusions. These data can be subjected to qualitative and quantitative analysis and the method is to be recommended as a research technique which could be of value to psychiatric nurses at the clinical level. PMID- 3638320 TI - Nurse education and adult education: a question of the person. PMID- 3638321 TI - Summary report of Working Group on Training for Quality Assurance. World Health Organization, Regional Office for Europe. Meeting held in Udine, Italy, 25-28 June 1985. PMID- 3638322 TI - Explore life care possibilities. PMID- 3638323 TI - Letters from a life care community. PMID- 3638324 TI - Studying the language of time. PMID- 3638325 TI - Teach the elderly to prevent falls. PMID- 3638326 TI - Telephone contacts in the decision-making process. PMID- 3638327 TI - Measures to rid sleeplessness. 10 points to enhance sleep. PMID- 3638328 TI - Human needs and holistic nursing practice. PMID- 3638329 TI - A holistic approach to pain management. PMID- 3638330 TI - A comparison of age and health perceptions between diabetics and non-diabetics. PMID- 3638331 TI - Teaching the art of holistic nursing care. PMID- 3638332 TI - A wellness program for student nurses: studying its effects on health values, health locus of control, and self-care agency. PMID- 3638333 TI - The exceptional cancer patient support group: coping with cancer. PMID- 3638334 TI - Admission: the consumer's first impression. AB - In today's changing healthcare economy, it's critical for a hospital to attract and retain a client base. The healthcare consumer's choice of hospital is based on their perception of the quality of care. Although virtually all hospitals espouse excellence in care, the consumer's perception must agree or they will go elsewhere. First impression of the hospital begins with admission. This article describes the interactive approach taken by Northside Hospital in Atlanta, Georgia to solve admission/discharge problems. PMID- 3638335 TI - Patient controlled analgesia: traditional versus mechanical. PMID- 3638336 TI - Communication: key contributor to effectiveness--the research. AB - This field study of 327 professional nurses at an east coast teaching hospital investigated the effects of nurses' satisfaction with different facets of organizational communication on their job satisfaction and job performance. The author found that certain aspects of communication (e.g., communication with supervisor, communication climate, personal feedback, and communication with top level executives) are influential contributors to nurses' job satisfaction and, to a lesser extent, to nurses' job performance. The author suggests a number of ways nurse executives can increase the communication effectiveness of their nursing staffs. PMID- 3638337 TI - Communication: key contributor to effectiveness--a nurse executive responds. PMID- 3638338 TI - Nursing care and nursing products: revenue or expenses? AB - Top level nursing administrators must clearly conceptualize professional nursing activities in a corporate context. The accounting and marketing practices utilized in established corporate entities provide a model for interpreting nursing activities. Definition of product and determination of nursing as revenue or expense centers are explored with an established non-nursing corporation as a source for comparison. PMID- 3638339 TI - Practical approaches to marketing. AB - Marketing in health care is the process of developing, promoting, and administrating health care services to a client for the benefit of both. The success of a nurse executive in the area of marketing is dependent on the appropriate application of marketing principles, including assessment and/or awareness of needs, development of new services, promotion of current and new services, and target market development. The author discusses how the nurse executive can aggressively promote services based on consumer demand states and effectively use advertising, publicity, and personal promotion strategies. PMID- 3638340 TI - Money as a motivator. PMID- 3638341 TI - Improving nurses' cooperation with clinical research. PMID- 3638342 TI - How well are we practicing primary nursing? AB - Primary nurses in the Intensive Care Unit of Maryland Institute for Emergency Medical Services Systems' Shock Trauma Center have developed a unique, cost effective, time-efficient tool for evaluating and recording primary nursing activities. The discussion of methods and procedures used in developing this tool constitutes a guide for developing a similar program in any facility. PMID- 3638343 TI - Support groups for infertile patients. AB - Support groups offer infertile couples an opportunity to share feelings and concerns in a confidential, nonjudgmental setting--an alternative to coping with the crisis alone. Nurse involvement in organizing and maintaining a support group is described. The nurse can be a valuable asset to the support group in the role of patient liaison, small-group counselor, or community resource person. PMID- 3638344 TI - Intrauterine treatment of fetal tachycardia. AB - The presence of sustained tachycardia in a fetus can result in congestive heart failure, hydrops, and eventual fetal death. With the increased use of advanced technology in routine obstetric practice, fetal tachycardias are being diagnosed with greater frequency. Recently, administration of antiarrhythmic medications to the mother has been successful in slowing the fetal heart rate and preventing or reversing potentially lethal complications in the fetus. The medications that have been used to treat fetal tachycardia and their potential effects on the mother are discussed. A case study and nursing protocol are presented. PMID- 3638345 TI - Support for the woman with an ectopic pregnancy. AB - Increased knowledge and awareness among health-care providers as well as technologic advances have decreased the risk of death from ectopic pregnancies. More sensitive pregnancy tests and improved diagnostic procedures have contributed to earlier and more rapid diagnosis of ectopic pregnancy. Also, women in the childbearing years have become more aware of ectopic pregnancy. This has probably contributed to earlier diagnoses and interventions; however, data are not available to substantiate this hypothesis. Research is needed in this area, particularly to study trends in number, causes, and characteristics of women with ectopic pregnancy among reproductive age women (15 to 45 years of age). PMID- 3638346 TI - Self-assessment: a personalized approach to nursing during pregnancy. AB - A Prenatal Self-Assessment questionnaire was developed to aid in personalizing nursing care in a large medical center prenatal clinic. The questionnaire complements the standard prenatal record, which is intended primarily to document medical findings and treatment. The tool was used with more than 100 mothers who were receptive to this approach. The women's responses to questions about their feelings and thoughts concerning their pregnancies facilitated identification of potential problems and provided a basis for individualized and comprehensive care. PMID- 3638347 TI - Neonatal hypoglycemia in response to maternal glucose infusion before delivery. AB - An ex post facto study was designed to determine the occurrence of neonatal hypoglycemia in correlation to maternal glucose infusions. The sample consisted of 62 normal mother-infant pairs. Forty-three percent of term normal newborns studied had Dextrostix values less than 40 mg%. Data revealed that duration of maternal glucose infusion was statistically the most significant parameter in correlation with lowered newborn serum blood glucose. Also, multiple linear regression revealed that all three parameters of maternal intravenous glucose therapy duration, total amount of glucose received, and rate of glucose per hour significantly correlated with lowered newborn Dextrostix. PMID- 3638348 TI - Percutaneous central venous catheters in neonates. AB - Fifty-six percutaneous central venous catheters were inserted over a six-month period in 41 term and preterm infants who required long-term venous access. The mean birth weight and gestational age for the study population was 1,281 g and 30.5 weeks, respectively. A cross-case analysis of data revealed information concerning duration of percutaneous central venous catheter therapy, weight gain or loss during therapy, and incidence of catheter-related complications. No complications were observed in 52% of the subjects; the remaining 48% of infants experienced problems with clotting, leaking fluids, and peripheral edema. There was one positive blood culture. As the insertion procedure and nursing management plan became standardized with experience over time, the incidence of complications sharply decreased. The use of percutaneous central venous catheter therapy in neonatal care promises to be a cost-effective nursing technique that will be advantageous for care providers, sick infants, and their parents. PMID- 3638349 TI - Minimal breastfeeding. AB - Current advice to breastfeeding mothers is that breasts must be emptied regularly and frequently to help maintain lactation. A method of maintaining lactation, minimal breastfeeding, in which mothers nurse once or twice a day without expressing the breast between breastfeedings was investigated. A convenience sample of 30 mothers using minimal breastfeeding was interviewed monthly until weaning. These mothers used minimal breastfeeding as a method of slow weaning, a way to combine breastfeeding and work, and a means of comfort-nursing older infants. In all cases, weaning occurred because the mother or the infant chose to wean, not because of insufficient milk. The authors conclude that for working mothers who cannot express between feeds, breastfeeding can still be maintained, and that minimal breastfeeding is an important alternative to weaning. PMID- 3638350 TI - Automobile seat belt practices of pregnant women. AB - Despite the fact that seat belts have been proved effective in reducing deaths and serious injuries, many pregnant women do not wear seat belts. A study was conducted to examine the seat belt practices of pregnant women. Of the 87 women who were interviewed, 40 reported using seat belts regularly during pregnancy. However, almost one-third of them did not adjust the belts properly for maximum protection. Older women and those with more education were more likely to use their seat belts routinely. Only 20 women recalled receiving information about seat belts during their pregnancies, but 48 women would have liked to receive more information. PMID- 3638351 TI - Female patients and male nursing students. AB - Male nursing students, just like their female counterparts, are expected to give quality, professional nursing care to all patients. The sex of the patient assignment should not prevent learning opportunities. Cultural attitudes, however, perceive nursing to be a female profession. Role confusion occurs when a female patient and a male nurse are paired. Because of this stereotypical behavior, men in nursing sometimes face barriers in providing quality care to female patients. The cause and possible solutions to this issue are addressed. PMID- 3638352 TI - Managing the seven As. PMID- 3638353 TI - Hypertensive crisis in the postanesthesia care unit. PMID- 3638354 TI - The role of continuous passive motion in the recovery and rehabilitation of the total knee prosthesis recipient. PMID- 3638355 TI - The forgotten: families of your surgical patients. PMID- 3638356 TI - Practical points in the postanesthesia assessment and care of the patient having a thyroidectomy. PMID- 3638358 TI - Ambulatory surgery in Phoenix. PMID- 3638357 TI - Embolex. PMID- 3638359 TI - Hospital-based ambulatory surgery: history, marketing, staffing, and remodeling. PMID- 3638360 TI - The principles of conducting ethical research. PMID- 3638361 TI - Shattered silence. PMID- 3638362 TI - Patient care and lawsuits: it could happen to you. PMID- 3638363 TI - Suicide attempts. The search for meaning. PMID- 3638364 TI - Peplau's theory. An application to short-term individual therapy. PMID- 3638365 TI - Pilipino and Vietnamese clients: utilizing an Asian mental health center. PMID- 3638366 TI - Nursing diagnosis of depression. AB - To summarize, based on a sample of six subjects who were depressed, 12 nursing diagnoses were identified. Five of the 12 diagnoses occurred in more than one subject. Criteria for making a diagnosis were specified, and the diagnoses and their defining characteristics were examined for principles of classification. PMID- 3638367 TI - Synthesis of complement components (C3, C2, B and C1-inhibitor) and lysozyme by human monocytes and macrophages. AB - The synthesis of C3, C2, factor B (B) C1-inhibitor and lysozyme has been studied in monocytes and macrophages isolated from the synovial fluids of patients with rheumatoid arthritis. Concentrations of all 5 proteins in culture supernatants were measured by the sandwich ELISA technique. Kinetic studies showed that only lysozyme and C3 could be detected in monocyte culture supernatants on the first day of culture, whereas C2, B and C1-inhibitor were not present until the third day. In contrast all 5 proteins could be detected in the supernatants of macrophage cultures on day 1. In both monocyte and macrophage cultures synthesis of lysozyme and C1-inhibitor continued throughout the culture period, whereas synthesis of C2, B and C3 appeared to be reduced after the fifth day in culture. Quantitative studies showed that the secretion rates of lysozyme (4,700 X 10(3) molecules/cell/hr) was similar in monocytes and macrophages. Synthesis rates for all 4 complement components in monocyte cultures were less than 0.2% of that for lysozyme. Although the synthetic rates were higher in macrophages, even then they constituted less than 2% of the rate for lysozyme. Synthetic rates for complement components, but not lysozyme, were increased by BSA-anti-BSA antigen-antibody complexes and reduced by serum-treated complexes. Although the functional activity of monocyte B was similar to that for serum, the activity of monocyte C2 was 5 times that of serum C2. As C42 formed with monocyte C2 had a half-life of 13.5 min at 30 degrees C, compared with 4.5 min for the enzyme formed with serum C2, it is probable that monocyte C2 is oxidized by the oxygen products of these cells. PMID- 3638369 TI - [Nursing theory. 7. A thought on Parser's nursing theory (3). Invitation to re evaluation of the basis of nursing]. PMID- 3638368 TI - [Decision making in nursing: dealing with family members facing sudden death. 7]. PMID- 3638370 TI - [Definition of a good nurse. Return of the nurse to bedside: a viewpoint by a physician who has an experience as a patient]. PMID- 3638371 TI - [Definition of a good nurse: a view held by a nursing instructor and a family member of a patient]. PMID- 3638372 TI - [Definition of a good nurse. Concern in the illness and individual patient: expectation by patients]. PMID- 3638374 TI - [Patients as a mirror to reflect nursing practice: an advice from a head nurse]. PMID- 3638373 TI - [Professionalism in nursing: an advice to nursing graduates after 3 months of clinical practice]. PMID- 3638375 TI - [Awareness as self-disciplined professional: a condition required in the primary nurse]. PMID- 3638376 TI - [Psychological advice to cancer patients and their families]. PMID- 3638377 TI - [Improvement of nursing records of cancer patients undergoing chemotherapy: through preparation of a pamphlet and attending a seminar on nursing records]. PMID- 3638378 TI - [Sudden death]. PMID- 3638379 TI - [Self-help group]. PMID- 3638380 TI - [Record by a woman physician suffering from cancer. 7. Home care and baptism at a Christian church]. PMID- 3638381 TI - [Monologue by a nursing director: the importance of a positive attitude]. PMID- 3638382 TI - [Practice of Oriental medicine. 7. "Air", "blood", and "body water". (5). Body water and fluid balance]. PMID- 3638383 TI - [Clinical description of dementia. 15. Nursing of demented patients: the basic attitude in dealing with aged demented patients]. PMID- 3638384 TI - [POS in nursing. 10. Further study for accurate location of the problem. 3]. PMID- 3638385 TI - [Counseling of patients. 18. Positive use of "sensitivity" of patients: a method in counseling. 6]. PMID- 3638386 TI - [Nursing homes in New York City. 7. Description of patients with senile dementia cared for at a special ward]. PMID- 3638387 TI - [Defining the work of public health nursing in the modern society--legislative changes and citizens' lives]. PMID- 3638388 TI - [Social conditions surrounding public health nurses and future problems in public health nursing]. PMID- 3638389 TI - [Consolidation and closure of national hospitals and regional movements]. PMID- 3638390 TI - [Approaches to living conditions and health problems: sensitivities to public needs. A discussion]. PMID- 3638391 TI - [Basis of epidemiology]. PMID- 3638392 TI - [Management of schizophrenic patients. Discussion]. PMID- 3638393 TI - [Leg us record the achievements of public health nurses]. PMID- 3638394 TI - [Physical examination of infants and young children and revision of maternal and child health laws]. PMID- 3638395 TI - [Management of adult diseases to meet the regional needs]. PMID- 3638396 TI - [Management of active public health clinics--a force to withstand the trends for consolidation and closure of clinics]. PMID- 3638397 TI - [Public health nursing activities and organization of citizens' groups--basis of health-related citizens' groups]. PMID- 3638398 TI - [Lives of the working class]. PMID- 3638399 TI - The nurse as artist. PMID- 3638400 TI - The art of nursing. PMID- 3638401 TI - Appreciation of beauty through the arts. PMID- 3638402 TI - Into the hospital through the stage door. PMID- 3638403 TI - Fiction and the art of nursing. PMID- 3638404 TI - Tapping into your alpha rhythm. PMID- 3638405 TI - Music--vital for my life. PMID- 3638406 TI - Three Kansas nurses serve over 100 Indian tribes. PMID- 3638407 TI - [Perceptions and interpretations of cancer patients. How does the patient experience his illness?]. PMID- 3638408 TI - [Revision of Swiss Red Cross guidelines: Swiss Nurses Association presents basic position paper]. PMID- 3638409 TI - [Nurse in an Italian hospital. Fantasy and improvisation]. PMID- 3638410 TI - [Speaking of tenderness]. PMID- 3638411 TI - [Experience at the hospital: man, father, old and sick]. PMID- 3638413 TI - [Responsibility for one's own body in the lower social strata]. PMID- 3638414 TI - [Urinary continence: a conscious process]. PMID- 3638412 TI - [Notes on the attitude of mastectomized patients. Breast reconstruction]. PMID- 3638415 TI - [Can human rights be taught?]. PMID- 3638416 TI - [New possibility in education: clinical nurse--clinical male nurse]. PMID- 3638417 TI - [Speaking of tenderness (2)]. PMID- 3638419 TI - [Life in an old age home: new chance for living or resignation? Nice and friendly is not enough]. PMID- 3638418 TI - [The situation of the hospitalized patient: the only means to counteract isolation: intensified contacts between patients and personnel]. PMID- 3638420 TI - [A decision by the Swiss insurance court: instead of home nursing rates compensation for work according to the tariff]. PMID- 3638421 TI - [Diagnosis and therapy by means of medical technics]. PMID- 3638422 TI - [Clinical aspects and therapy of atopic dermatitis]. PMID- 3638423 TI - [Clinical aspects and therapy of osteomyelitis]. PMID- 3638424 TI - [Urinary drainage--possibilities in nursing. Urinary tract infection caused by indwelling catheters, suprapubic bladder fistula, percutaneous renal fistula]. PMID- 3638425 TI - [How dangerous is AIDS?]. PMID- 3638427 TI - [Cosmetic surgery and outsider methods]. PMID- 3638426 TI - [Clinical aspects and therapy of candidiasis]. PMID- 3638428 TI - [Emphasis in the nursing of patients with Guillain-Barre syndrome]. PMID- 3638429 TI - [Defined criteria in the evaluation sheet for the members of the nursing service]. PMID- 3638430 TI - [Physical therapy of arthrosis]. PMID- 3638431 TI - [Becoming a mother--at any price?]. PMID- 3638432 TI - [Incidence of AIDS cases in the Federal Republic of Germany and in Munich]. PMID- 3638433 TI - [Problems in the admission of children to the hospital]. PMID- 3638434 TI - [Hysteria in children and adolescents--are there any therapeutic rules for hospital treatment?]. PMID- 3638436 TI - [The use of closed systems of sterile water in hospitals]. PMID- 3638435 TI - [Outpatient therapy in ulcer patients]. PMID- 3638437 TI - [The treatment of venous leg ulcer with compression dressing and soft foam compresses]. PMID- 3638438 TI - [The significance of psychosomatic disorders for the origin and therapy of ulcer disease]. PMID- 3638439 TI - Enhancing the health competence of school-age children through behavioral self management skills. AB - School health education programs are based on the assumption that health status is influenced by personal health practices. Health instruction cannot have a favorable impact on all factors influencing personal health behavior, so an effort must be made to determine which skills enhance health behavior for most individuals. Self-management skills can help individuals make behavioral changes consistent with their health-related decisions. This article describes several self-management skills and offers suggestions for teaching behavioral self management. PMID- 3638440 TI - Cognitive development and the dynamics of decision-making among adolescents. AB - Cognitive development was examined in relation to the amount of time students would deliberate before making a decision, the effect of perceived emotional stress on decision making, and identification of all possible decisions that would have to be made. Subjects were 94 eighth-11th grade students in New Mexico and Montana. Results indicated abstract thinkers had a better decision-making process than concrete thinkers and made more health promoting decisions. Health educators are challenged to create educational strategies that enhance abstract development and teach classic steps of decision-making, thus improving the decision-making ability of youth. PMID- 3638442 TI - How to estimate practical significance in health education research. PMID- 3638441 TI - San Diego family health project: reaching families through the schools. AB - This project tests the effectiveness of a family-based health behavior change intervention in two ethnic groups. The aim is to help family members initiate and maintain dietary and physical activity behaviors believed to be linked to risk factors for cardiovascular disease. This paper describes the project and the baseline results. Twelve San Diego elementary schools were randomly assigned to intervention or control conditions. Hispanic and Anglo families with a fifth or sixth grade child were recruited to participate in a two-year study. The intervention emphasizes enjoyable experiences designed to transmit knowledge and skills required for long-term changes in diet and physical activity habits. Groups of families met at schools for 12 weekly sessions and six maintenance sessions distributed throughout the following nine months. Outcome behavioral and physiologic measures will be collected at baseline, three months, 12 months, and 24 months. Differences between Anglo and Mexican-American subjects justify targeted activities specific to these groups. PMID- 3638443 TI - YouthScene Theater: health education comes alive in rural Maryland. PMID- 3638444 TI - Hypertension programs in schools. PMID- 3638446 TI - Community health nursing of aggregates: what is it? PMID- 3638445 TI - "Potential marketing strategies for a professional organization". PMID- 3638447 TI - The changing nature of continuing education. PMID- 3638448 TI - [Clinical application of basic nursing technic. Hygienic care of patients who have difficulties in changing posture]. PMID- 3638449 TI - [Physiopathology, diagnosis, and treatment of acute myocardial infarction]. PMID- 3638450 TI - [Physiopathology of burns and daily activities and prognosis of the affected patients]. PMID- 3638451 TI - [The diagnostic and therapeutic processes for patients with severe burns]. PMID- 3638452 TI - [Keypoints in comprehensive observation of patients with severe burns]. PMID- 3638453 TI - [Nursing plans for patients with severe burns]. PMID- 3638454 TI - [Nursing of a patient with severe burns complicated with acute respiratory insufficiency following shock]. PMID- 3638455 TI - [Conference on nursing of patients with severe burns: contribution of feedback to patients in recovery]. PMID- 3638456 TI - [Understanding of the basic needs of a patient with difficulty in communication and his nursing care]. PMID- 3638457 TI - [Test yourself. Nursing of a schizophrenic patient]. PMID- 3638458 TI - [Case report: nursing of a patient with bilateral coxarthrosis]. PMID- 3638459 TI - [Significance of the patient's desire for recovery]. PMID- 3638460 TI - [Various forms of expressions by patients for recovery and nursing actions]. PMID- 3638461 TI - [Knowledge of poor prognosis and desire for recovery]. PMID- 3638462 TI - [Psychological support of patients]. PMID- 3638463 TI - [Psychology of cancer patients. 6. Autopsy]. PMID- 3638464 TI - Entering into the profession of nursing. PMID- 3638465 TI - [Encephalitis (primary and secondary)]. PMID- 3638466 TI - [Parkinson disease (paralysis agitans)]. PMID- 3638467 TI - [Work organization for the nurse in the preschool institution]. PMID- 3638468 TI - [Evaluation of the physical development of children and adolescents]. PMID- 3638469 TI - [Organization of the work of nurses in municipal polyclinics]. PMID- 3638470 TI - [Increased efficiency in utilizing the work time of nurses in nephrology departments]. PMID- 3638471 TI - [Excessive hairiness in women (hirsutism)]. PMID- 3638472 TI - [Role of the surgical office of a pediatric polyclinic in preventing injuries in children]. PMID- 3638473 TI - [Thrombocytopenic purpura in children]. PMID- 3638474 TI - Raiding for fun and profit. PMID- 3638475 TI - The lethal "cot-death syndrome" fallacy. AB - The ammonia factor theory of infant death causation shows how the known, deadly properties of this respiratory poison, potentially present at every infant's cot, are compatible with the known causative relationships found with "cot-death syndrome" infants. It also predicted and demonstrated that a causal relationship existed between cot-death infants and most other post neo-natal infant deaths. The ammonia factor theory is quite incompatible with the medical profession's "cot-death syndrome" model. A critical evaluation of the medical profession's "cot-death syndrome" model shows that it provides no predictive, causative, diagnostic, or preventative dimensions and is used by some of the medical profession as a tool of fear to extract research monies and by others in the profession to placate parents. The "cot-death syndrome" model is a definition of a non-reality and the antithesis of a scientific model. As a mathematical model it is impossible and is supported by statistical gerrymandering. It places diagnosed "cot-death syndrome" parents in legal jeopardy. Its correlation with the reality of infant death is staggeringly improbable. These features are in stark contrast with the ammonia factor theory of infant death causation. The ammonia factor theory shows that the overall infant death rate is preventable through a programme of welfare, as well as through educational, social and environmental improvements. The medically centred "cot-death syndrome" model is a useless, lethal fallacy. It is politically obstructive. It must be discarded. PMID- 3638476 TI - Draft of a general stochastic theory of cancer and its possible experimental verification with monoclonal multiplication of repairing and immunological systems. AB - A general stochastic theory of cancer is outlined by applying to cancer the laws of quantum mechanics instead of the laws of traditional physics, especially with regard to the concept of cause. This theory is combined with the evolutionary theory on the one hand and the mutation theory of aging/death of multicellular beings consisting of somatic cells on the other. The cancer theory centers around the phenomenon of DNA mutating randomly by quantal steps. Because of mutations in the DNA in general as well as in the special DNA which codes for the DNA repairing systems the body is permeated in the course of time - via increasing losses of information in the DNA - with increasingly altered proteins which is observed as aging process. From this process of entropy the concept of the cancer cell is deduced: When the losses of information in a certain cell and also in the repairing and immunological systems have random concordances, cancer as a type of antigens comes into existence. Here the concept of CONCORDANCE OF "BLURRING" is introduced. This CONCORDANCE OF "BLURRING" occurs randomly approximately once among three times 60 000 billion cells, i.e. three human beings. The so-called "oncogenes" are integrated into this theory. It is proposed to test this theory using monozygotic twins both suffering from cancer: By injecting monoclonally multiplied immunological systems, eventually also repair-systems, from the respective other twin, the proposition is that the cancer would be cured in both twins. If this critical experiment is successful, one can cure human beings suffering from cancer by the same procedure, using those systems of their relatives. This treatment would cure the cancer to the extent to which there is a genetic correspondence in the sections of genes coding for these systems. PMID- 3638477 TI - Multiple sclerosis, latitude and dietary fat: is pork the missing link? AB - The relationship between prevalence rates of multiple sclerosis (MS) in several countries and the corresponding per capita consumption of fat, beef and pork was investigated. A significant correlation was obtained between prevalence of multiple sclerosis and fat intake (r = 0.63, p less than 0.01), total meat intake (r = 0.61, p less than 0.01) and pork consumption (r = 0.87, p less than 0.001). There was no significant correlation with beef consumption. The mechanism by which pork intake may increase the risk of developing MS is unknown and deserves further study. PMID- 3638478 TI - Mechanism of tumor growth and metastasis; an alternate hypothesis. AB - The author proposes that malignant tumors increase in size not only by cell division, but also by transforming neighboring normal cells into malignant ones. Further, tumor metastasis may occur by humoral mechanisms, in addition to, physical migration of malignant cells. PMID- 3638479 TI - Possible relation of small pox vaccination to multiple sclerosis-like disease. A personal note. AB - My multiple sclerosis-like disease seemed to be an allergy to small pox vaccination. Repeated small pox vaccinations apparently arrested the disease. PMID- 3638480 TI - The education connection: the higher education provision for nursing. PMID- 3638481 TI - A literature search into the continuing education undertaken in nursing. PMID- 3638482 TI - Education and training for sisters. PMID- 3638483 TI - Steps in evaluating a programme of nurse education. PMID- 3638484 TI - Sight and sound--any use for video found? Part 1. Video--a technology spurned. PMID- 3638485 TI - Links between nurses and cigarette smoking? PMID- 3638486 TI - Treating the impaired nurse. PMID- 3638487 TI - Treating the impaired nurse: another perspective. PMID- 3638488 TI - Co-dependency. PMID- 3638490 TI - Teaching & training. Teaching methods. PMID- 3638491 TI - Teaching & training. PMID- 3638489 TI - Perspective on impairment. PMID- 3638492 TI - Teaching & training. Seventeen months on! Where are we now? (Student nurse training in theatre). PMID- 3638493 TI - Teaching & training. Teaching aids. PMID- 3638494 TI - Teaching & training. Master of six chairs. PMID- 3638496 TI - The importance of gown and drape barriers in the reduction of the incidence of post-operative wound infection. PMID- 3638495 TI - Teaching & training. Surgical investigations? Teaching research to E.N.B. theatre nursing course students. PMID- 3638497 TI - Is the theatre nurse in jeopardy? PMID- 3638498 TI - Post-anaesthetic recovery facilities. PMID- 3638499 TI - Pre-operative information and visits promote recovery of patients. PMID- 3638501 TI - Seven steps from idea to print. PMID- 3638500 TI - Synthetic peptides as nuclear localization signals. AB - The nuclear envelope defines a compartment boundary which is penetrated by pores that mediate a remarkable transport process. Precursor RNAs are retained in the nucleus, while processed messenger RNA, transfer RNA and ribosomal subunits are transported to the cytoplasm. Proteins destined for the nucleus become localized soon after synthesis and again following mitosis, while cytoplasmic proteins are excluded. The process is highly specific: a single base change in vertebrate initiator tRNAMet (tRNAiMet) reduces the rate of export 20-fold; a point mutation within the simian virus 40 (SV40) large-T antigen, converting Lys 128 to Thr or Asn, prevents import. Lys 128 lies within a short 'signal' sequence which, when fused to large non-nuclear proteins, causes their accumulation in nuclei. Regions of other eukaryotic proteins also seem to contain nuclear localization signals, although a single consensus sequence has not emerged. We report here that a synthetic peptide containing 10 residues of large-T antigen sequence serves as a nuclear localization signal when cross-linked to bovine serum albumin (BSA) or immunoglobulin G (IgG) and microinjected in Xenopus oocytes. Substitution of Thr at the position of Lys 128 in this peptide renders it six- to sevenfold less effective. The uptake of peptide-linked BSA is saturable, and the rate is diminished by co-injection of free peptide. These findings are indicative of a receptor-mediated uptake process. With the use of anti-peptide antibodies, a family of proteins is revealed in nuclear but not cytoplasmic extracts of human lymphocytes which contain large-T antigen-like sequences. PMID- 3638502 TI - Adding assertiveness to the nursing profession. PMID- 3638503 TI - Evaluating staff nurse floating. PMID- 3638504 TI - Control the pain dilemma. PMID- 3638506 TI - Study calls for urgent restructuring of students' experience in geriatric nursing. PMID- 3638505 TI - Vision quest: qualities for nurse leaders. PMID- 3638507 TI - Royal College of Nursing. At the ready. PMID- 3638508 TI - Make it your business to read Project 2000. PMID- 3638509 TI - Mental handicap nurses--we are here to stay. PMID- 3638510 TI - Royal College of Nursing. Time's running out. PMID- 3638511 TI - Performance indicators in nurse education. PMID- 3638512 TI - Sister's role must be imbued with authority. PMID- 3638513 TI - A manifesto for nursing. PMID- 3638514 TI - Royal College of Nursing. A politician's dream. PMID- 3638515 TI - Little is known about the pain experience of children. PMID- 3638516 TI - Stark facts of child sex abuse. PMID- 3638517 TI - Royal College of Nursing. Need for a boost. PMID- 3638518 TI - Think before you speak. PMID- 3638519 TI - Time to prove them right. PMID- 3638520 TI - A model for integration of the i.v. nurse into the nursing care team. PMID- 3638521 TI - Making the NITA standards work for you. PMID- 3638522 TI - Research in nursing education: renaissance or regression? PMID- 3638523 TI - Nursing innovations help reach traditional goals. PMID- 3638524 TI - Consumers look to nurses for affordable quality care. PMID- 3638525 TI - Nursing college fights for life--and wins. PMID- 3638526 TI - Community care practicums ready RN students for new levels of practice. PMID- 3638528 TI - Action stat! Malignant hyperthermia. PMID- 3638527 TI - Standing by her man. PMID- 3638529 TI - Home care for the A.I.D.S. patient: safety first. PMID- 3638531 TI - A new CPR form you can use. PMID- 3638530 TI - Our first home care A.I.D.S. patient: Maria. PMID- 3638532 TI - Thora-Drain III: closed chest drainage made simpler and safer. PMID- 3638533 TI - Helping the abused women. PMID- 3638534 TI - 9 ways a computer can make your work easier. PMID- 3638535 TI - You have the right to protect your civil rights. PMID- 3638536 TI - Interpreting ABGs in four easy steps (continuing education credit). PMID- 3638538 TI - Professional growth: get ready for your next evaluation. PMID- 3638537 TI - Amnion dressings--a natural for wounds. PMID- 3638539 TI - Psychophysiology of sleep. PMID- 3638540 TI - The functions of sleep. PMID- 3638541 TI - The chronology of sleep. PMID- 3638543 TI - Narcolepsy. PMID- 3638544 TI - Comfort. PMID- 3638542 TI - Disorders of sleep. PMID- 3638545 TI - Aspects of comfort for the elderly person. PMID- 3638546 TI - Sleep and comfort during pregnancy. PMID- 3638547 TI - Nosocomial infections: every patient is a target. Part I. The problem. PMID- 3638549 TI - What our readers said about resuscitating a patient with A.I.D.S. PMID- 3638548 TI - Nosocomial infections. A growing problem in nursing homes. PMID- 3638551 TI - Helping your patient recover from a lumbar laminectomy. PMID- 3638550 TI - Code gray: ethical dilemmas in nursing. Part 4. PMID- 3638552 TI - Coordinating your efforts to manage multiple trauma (continuing education credit). PMID- 3638553 TI - Jackie had creative ideas--but some of them created problems. PMID- 3638554 TI - Living wills: the spectrum of new possibilities. PMID- 3638555 TI - Pain management: are your biases showing? PMID- 3638556 TI - Medication administration: avoiding the latest legal pitfalls. PMID- 3638557 TI - The case of the missing assessment. PMID- 3638558 TI - The maintenance of life: 1983-1985--Part II. PMID- 3638559 TI - Satisfying hours of care for eye patients. PMID- 3638560 TI - Filling the gaps in health care: a hospital-based skilled nursing facility. PMID- 3638561 TI - Nursing patients 75 years and older. PMID- 3638562 TI - Making practical use of the DMS 1 form. PMID- 3638563 TI - Coronary care documentation: incentives for improvement. PMID- 3638564 TI - Effective feedback improves job satisfaction. PMID- 3638565 TI - Meeting the needs of the hospitalized elderly. PMID- 3638566 TI - Using a coordinator in a nursing home. PMID- 3638567 TI - Motivating groups. PMID- 3638568 TI - Philosophy of nursing service as a control system. PMID- 3638569 TI - The nursing care plan as a management tool. PMID- 3638570 TI - Preparing the new graduate. PMID- 3638571 TI - Quality assurance from a process audit approach. PMID- 3638573 TI - A new look at (of all things) team nursing care. PMID- 3638572 TI - Mock codes improve emergency performance. PMID- 3638574 TI - Organ transplants: givings and misgivings. PMID- 3638575 TI - Nursing--an academic discipline? Reflections on the past images for the future. Part two. PMID- 3638576 TI - Managing disturbed behavior. PMID- 3638577 TI - Starting your own research. PMID- 3638578 TI - Sub HB 315, nursing, medicine, and power. PMID- 3638579 TI - The nature of PN education today. PMID- 3638580 TI - [Primary health care--a challenge to nursing?]. PMID- 3638581 TI - [Disposal of hospital waste. I]. PMID- 3638582 TI - [Immunization of all children by 1990]. PMID- 3638583 TI - [Exposure prevention in travel to warm countries]. PMID- 3638584 TI - [Intervention study for the reduction of risk of myocardial infarct]. PMID- 3638585 TI - In sickness and in health--think nursing. PMID- 3638586 TI - Today's legislation: how to impact on future legislation to secure tomorrow's practice. PMID- 3638589 TI - Idiopathic radial tunnel syndrome. PMID- 3638588 TI - Arthroscopy of the shoulder. PMID- 3638587 TI - Rotator cuff tears (continuing education credit). PMID- 3638590 TI - Carpal tunnel syndrome. PMID- 3638592 TI - Curriculum revisited: an update of curriculum design. PMID- 3638591 TI - Radiologic review: unicameral bone cyst with humeral fracture. PMID- 3638594 TI - The essential ingredient in curriculum design: the organizing framework. PMID- 3638593 TI - The philosophy and its effect on curriculum development. PMID- 3638595 TI - Reality in the curriculum. PMID- 3638596 TI - The integrated curriculum: a 15-year perspective. PMID- 3638597 TI - Criteria for the evaluation of practical nursing programs. PMID- 3638598 TI - Plant mitochondria and chloroplast tRNAsTrp do not suppress the UGA stop codon. PMID- 3638599 TI - Shadows on the image. PMID- 3638600 TI - Community-as-client: a model for practice. PMID- 3638601 TI - Nurses who publish journal articles. PMID- 3638602 TI - The new nurse influentials. AB - The current group of nursing leaders strongly resembles Vance's group in geographic setting, travel, mentor connections, support systems, political activity and sources of influence. However, there are substantially more academic/educational positions, publications and research among the current group. PMID- 3638603 TI - Teaching humane care for dying patients. PMID- 3638604 TI - Home health care: changing legal perspectives. PMID- 3638605 TI - Infant crying during aircraft descent. AB - The phenomenon of infant crying during aircraft descent is described, based on in flight observations of 37 infant-mother pairs and mother interviews. The hallmark was crying during descent that was not alleviated by mothers' strategies that had been effective prior to descent. A significant relationship was found between bottle feeding and crying during descent; 18 (78%) of nonfeeding infants cried, compared with 4 (29%) of the bottle feeders. All infants with colds cried during descent, and descent crying always occurred more than 9 minutes after adults perceived the need to clear their ears. Only 4 of the 22 mothers (18%) with crying infants attributed the crying to ear pain, yet the findings support the explanation of otalgia due to inadequate middle ear ventilation. Developmental factors that put airborne infants at risk for otic barotrauma, educational implications, and directions for future research are discussed. PMID- 3638606 TI - Effect of preoperative instruction on postoperative outcomes: a meta-analysis. AB - A meta-analysis was performed on 68 studies to examine the effect of preoperative instruction on postoperative outcomes. The 68 studies represented 2,413 experimental subjects and 1,605 control group subjects and yielded 423 individual effect sizes. The 423 individual effect sizes had a mean effect size of 0.44 and a variance of 2.43. The mean effect size indicated that, in terms of postoperative outcomes, an average patient who received preoperative instruction was at the 66th percentile of a similar group of patients who did not receive preoperative instruction. The accompanying large variance indicated this finding was not consistent across subject-studies. Substantive characteristics of subject studies used to categorize effect size were: type of content, method of organization, type of presentation, level of patients' fear/anxiety, and types of outcomes measured. All categories analyzed had positive effect sizes. Within categories of content, psychological and mixed forms of content produced the lowest variances. Categories of organization and presentation did not produce data to demonstrate a clear difference in the levels analyzed. Categories of patient fear/anxiety indicated that the greatest effects were achieved with patients who had high levels of fear/anxiety, followed by moderate levels and low levels. The most consistent results were found with moderate levels of fear/anxiety. When categorized by types of outcomes measured, all effect sizes remained positive. The variances accompanying each effect size remained relatively substantial at all levels of aggregation, with small variances found only at the greatest level of specificity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3638607 TI - Informational needs of recently diagnosed cancer patients. AB - Informational needs of 60 recently diagnosed cancer patients were assessed in relation to their disease, personal, family, and social concerns. The theoretical framework underlying the study was constructed from theories of coping, appraisal, information seeking, needs, and hierarchy of needs. Categories of analysis were derived from these theories and from findings of previous research. The Derdiarian Informational Needs Assessment was used to gather data. Patients' informational needs were described in relation to harms, threats, and resources and to their importance values associated with the major categories of disease, personal, family, and social concerns. Comparisons of informational needs and their importance values among patients stratified by person- or situation-related variables indicated few differences by gender, age, and stage of cancer. The findings imply that informational needs may be universal and warrant research on their relationship to these variables. PMID- 3638608 TI - Effect of role clarity and empathy on support role performance and anxiety. AB - The purpose of this study was to examine wives' anxiety in response to their husbands' first myocardial infarction from the perspective of perceptions and interpretations of their support roles, their husbands' experience, their abilities to act supportively, and how these and other factors contributed to their degree of anxiety. Major study variables were: role clarity (measured by an instrument developed for the study), empathy (measured by the Barrett-Lennard [1978] Relationship Inventory), support role performance (measured by an instrument developed for the study), and anxiety (measured by the State-Trait Anxiety Inventory Form A [Spielberger, Gorsuch, & Lushene, 1970]). Four exogenous variables, husband's condition, previous experience in the support role, self esteem, and trait anxiety, were used to test alternate hypotheses. Subjects were 82 wives of men admitted to three cardiac care units. Data were collected prior to the husband's hospital discharge and at 3 weeks postdischarge. Data were analyzed with path analysis procedures. Study findings supported two hypotheses, that support role performance has a direct negative effect on anxiety and trait anxiety has a direct positive effect on anxiety. Descriptive data obtained during the postdischarge interview provided documentation of uncertainty as another source of anxiety. PMID- 3638609 TI - Expectant fathers at risk for couvade. AB - A repeated measures survey design was used to monitor the physical and emotional health of 81 expectant fathers at lunar month intervals throughout their partners' pregnancy and the early postpartum period. The data set consisted of 515 repeated measures. The backward elimination regression procedure was used to identify six factors that partially explained health events experienced by expectant fathers: affective involvement in pregnancy, number of previous children, income, ethnic identity, perceived stress, and recent health prior to expectant fatherhood. PMID- 3638611 TI - The circumvaginal musculature: correlation between pressure and physical assessment. AB - This study assessed two recently developed techniques to assess the circumvaginal musculature (CVM), the CVM Rating Scale and the pressure sensitive intravaginal balloon device (IVBD), and correlated results of the two methods. Thirty women volunteers, aged 20 to 42, were studied. CVM Rating Scale total scores and IVBD maximal contraction variables were measured for resting pressure, rate of rise, maximal pressure, rate of return, and time that a submaximal contraction could be sustained (endurance contraction). Age, parity, self-reported orgasm, self reported Kegel exercises, and self-reported physical exercise were separately correlated with CVM Rating Scale total scores and IVBD maximal pressure results. A positive significant correlation was found between the CVM Rating Scale total scores and the IVBD maximal contraction results for the variables rate of rise, r = .50, p less than .01, maximum pressure, r = .82, p less than .01, and rate of return, r = .44, p less than .01. Self-reported orgasm had a positive significant correlation to the CVM Rating Scale total scores, rho = .34, p less than .05, and to the IVBD maximal pressure results, r = .52, p less than .01. A positive correlation was found between self-reported physical exercise and the CVM Rating Scale total scores, rho = .31, p less than .05. IBVD maximal pressure results were negatively correlated with age, r = -.34, p less than .05, and parity, r = .34, p less than .05. PMID- 3638610 TI - Initial handling of newborn infants by vaginally and cesarean-delivered mothers. AB - The pattern of newborn handling by 36 cesarean-delivered women and 36 vaginally delivered women was studied during their infants' first postpartum bedside visit. The research hypothesis predicted that the initial pattern of handling newborn infants would be different for the two groups of mothers. However, the pattern was found to be similar for the time it took both groups to initiate using their fingers, palms, arms, and trunks, as well as the sequence of use of these body parts, although neither group followed the sequence of handling reported in the bonding literature. The two groups did differ in the frequency and amount of handling of the infants: the cesarean mothers handled their infants significantly less, possibly due to the effects of fatigue and discomfort. In addition, the presence of the infant's father in the cesarean group had a significant effect of decreasing the frequency and amount of maternal handling. No such effect was found in the vaginally delivered group. PMID- 3638612 TI - Time-series analysis in nursing research: ARIMA modeling. PMID- 3638613 TI - The race to stay fit. PMID- 3638614 TI - Waiting lists: waiting games. PMID- 3638615 TI - Skill mix: skills on trial. PMID- 3638616 TI - Homes fit for heroes? PMID- 3638617 TI - Covering up for the doctor. PMID- 3638618 TI - Sobering thoughts. PMID- 3638619 TI - Safe intravenous practice. PMID- 3638620 TI - Management. All one family. PMID- 3638621 TI - Holism: the whole works. PMID- 3638622 TI - Project 2000. Out in the field. PMID- 3638623 TI - Finding what is best for baby. PMID- 3638624 TI - Time of the month. PMID- 3638625 TI - Passing the buck? PMID- 3638626 TI - Assessing nurses. 1. Stress in assessment. PMID- 3638627 TI - Mapping cancer trends. PMID- 3638628 TI - Tooting Bec: trouble at Tooting. PMID- 3638630 TI - What, minister? PMID- 3638629 TI - Honours: a mission to serve. Interview by Laurence Dopson. PMID- 3638631 TI - Stress. Reading the danger signs. PMID- 3638632 TI - Stress. Burn-out at senior level. PMID- 3638633 TI - Controlling the cost of care. PMID- 3638634 TI - Second sight. PMID- 3638635 TI - Candidates for conversion. PMID- 3638636 TI - Minding the quality. PMID- 3638637 TI - The swollen limb. PMID- 3638638 TI - Curbing routine and ritual. PMID- 3638639 TI - Project 2000. Branching out. PMID- 3638640 TI - Care about food. Vitamins, glorious vitamins. PMID- 3638641 TI - Opportunity knocks. PMID- 3638642 TI - Monitoring the nature of a paediatric clinical experience. PMID- 3638643 TI - Vive la difference!. Interview by Laurence Dopson. PMID- 3638644 TI - Focus on urinalysis. Part 6. PMID- 3638645 TI - Maternity care: mothers' lament. PMID- 3638647 TI - Misconceptions in the wake of the Wendy Savage affair. Interview by Harriet Gaze. PMID- 3638646 TI - Farming: death on the farm. PMID- 3638648 TI - An NHS knightmare? PMID- 3638649 TI - Supporting the family. A family snapshot. PMID- 3638650 TI - Supporting the family. Trouble and strife. PMID- 3638651 TI - Supporting the family. Heading off a breakdown. PMID- 3638652 TI - Time and patience. PMID- 3638653 TI - Pressure sores. Does anyone read research? PMID- 3638654 TI - Hiring and firing: the ins and outs. PMID- 3638656 TI - When the going gets hot. PMID- 3638655 TI - Project 2000. Disputed territory. PMID- 3638657 TI - Lights out. PMID- 3638658 TI - Stress: lowering the tension. PMID- 3638659 TI - Pressure sores. An eradication campaign. PMID- 3638660 TI - Pressure sores. A sore point with nurses. PMID- 3638661 TI - Pressure sores. Airwaves take the pressure. PMID- 3638662 TI - Who needs an advocate? PMID- 3638663 TI - The decline of public health. PMID- 3638664 TI - Prisons: care in custody. PMID- 3638665 TI - Occupational mortality: risky business. PMID- 3638666 TI - Putting on a public face. PMID- 3638667 TI - Talking to patients. Making contact. PMID- 3638668 TI - Talking to patients. Human interest. PMID- 3638669 TI - An holistic approach to intensive care. PMID- 3638670 TI - Communication breakdown. PMID- 3638671 TI - The changing face of Rampton. PMID- 3638672 TI - How to be a better sister. PMID- 3638673 TI - Project 2000. Future tense. PMID- 3638674 TI - Systems of life. No 140. Senior systems. 5. PMID- 3638677 TI - Ghosts from the past. PMID- 3638676 TI - A measure of care. PMID- 3638675 TI - Stress on operating days. PMID- 3638678 TI - Facing up to disfigurement. Interview by Pamela Holmes. PMID- 3638679 TI - Blindness: blind spot. PMID- 3638680 TI - Health education: the advertising myth. PMID- 3638681 TI - Royal Society of Health: message of health. PMID- 3638682 TI - Mother's little helper. PMID- 3638683 TI - Immunisation: why we're missing the point. PMID- 3638684 TI - Immunisation. Vaccination booster. PMID- 3638685 TI - Immunisation. Strong arm of the law. PMID- 3638686 TI - Talking to patients: mind your language. PMID- 3638687 TI - Planning patient care: assisting a mother to establish breastfeeding. PMID- 3638688 TI - Project 2000. The staffing equation. PMID- 3638689 TI - Taking midwifery off the conveyor belt. PMID- 3638691 TI - Join the professionals, see the world. PMID- 3638690 TI - The ward moves out. PMID- 3638692 TI - The thought-police. PMID- 3638693 TI - Quest. NT's educational supplement. PMID- 3638694 TI - Quest. Linked for success. PMID- 3638696 TI - Psychiatric/mental health nursing. PMID- 3638695 TI - Quest. Two's company. PMID- 3638697 TI - Psychiatric emergency evaluation. AB - This article is designed to assist the psychiatric clinical nurse specialist in the Emergency Department by defining psychiatric emergency; reviewing crisis intervention theory; exploring various nursing roles in the ED: delineating the assessment process; and outlining a decision-making process for determining client follow-up. PMID- 3638698 TI - Acute depression: treatment and nursing strategies for this affective disorder. AB - Depression is a major affective disorder characterized by feelings of loss, worthlessness, fatigue, and a general decrease in interest in the usual activities of daily living. This complex disorder is the most common mental health problem in the United States, more common in women, adults over 60 years of age, and those of lower socioeconomic status. According to the DSM III, the major subclassifications related to depression are major depression and bipolar disorder. An integrated causation theory is useful in describing the etiology of this disorder. Generally, signs and symptoms involve changes in affect, cognition, behavior, and physical functioning. Depression may be treated with antidepressant psychotropic medications (tricyclics and MAO inhibitors), lithium carbonate (for bipolar disorder), electroconvulsive therapy, and a variety of psychotherapies. Careful monitoring of the drugs via blood level values must be ongoing. Nursing care of hospitalized depressed persons involves careful monitoring of clients' status and the effectiveness of treatments. Nursing care focuses on three areas of need. Immediate needs are those related to critical and safety issues. Short-term needs are concerned with identifying and reducing or eliminating obvious problem areas which hamper return to community living. Long term needs are issues related to maintenance of persons in the least depressive state for as long as possible. To provide a sound basis for planning and implementing such care, nurses must understand the dynamics of depression, the issues which dictate selected treatment methods, and the issues which are likely to shape and change the treatment of depression in the future. Nursing must accept the responsibility of acting in a responsible, professional manner to ensure the best possible treatment for clients within the restraints imposed by policy decisions. PMID- 3638699 TI - The challenge of working with patients diagnosed as having a borderline personality disorder. AB - Patients with a borderline personality disorder evoke unique problems and treatment dilemmas among members of an inpatient treatment team. This article explores the essential interplay of various treatment modalities during the course of intensive inpatient hospitalization and also describes guidelines, approaches, and therapeutic interventions aimed at reducing destructive influences and maximizing treatment outcome. PMID- 3638700 TI - Assisting adolescents toward mental health. AB - The developmental stage of adolescence may be so turbulent as to require psychiatric intervention. The adaptive difficulties experienced by Offer's tumultuous group of adolescents were once considered normal problems for that age group. Now they are considered to be a precursor to more serious psychosocial problems and require entry into the mental health care system. The adolescent psychiatric patient may experience adaptive difficulties, such as delinquency, substance abuse, and sexual acting out, or a diagnosed psychiatric disorder. The level of care an adolescent requires depends upon the type and severity of his dysfunction. Early detection and prevention is largely accomplished through education. Assessment and crisis intervention require the structure of an acute care inpatient setting. Long-term treatment may be necessary to provide a corrective emotional experience for the severely dysfunctional adolescent. Research endeavors should be directed toward further exploration of the relationship between adaptive difficulties and adult psychiatric disorder. Outcome studies would be helpful in evaluating the success of psychiatric nursing intervention at multiple levels of complexity. PMID- 3638701 TI - Partial hospitalization. An alternative to inpatient psychiatric hospitalization. AB - Partial hospitalization programs provide alternatives to traditional inpatient hospitalization. The initial optimism generated by the development of partial hospital programs has been moderated by the realization that it is quite difficult to make changes in mental health care, even though the effectiveness of traditional approaches has not been demonstrated. Research findings about partial hospital programs have provided information that many persons formerly treated as inpatients can be treated in partial hospital programs, probably at an economic savings. Several conceptual models are briefly reviewed for providing direction and rationale to guide thinking, planning, and decision making regarding client care. Continual effort must be given to the development and expansion of useful models and sets of interventions for care directed not only at symptom reduction but toward facilitation of health induction. Partial hospitalization programs have the potential to provide the settings and services to meet this need. Changing times offer nurses new opportunities to consider alternatives for providing psychiatric care. It is a challenge which nurses are well prepared to accept. To ignore the current situation and the needs of clients, families, and communities for these services would be to lose an opportunity for nurses to share a significant role in providing services to psychiatric clients. PMID- 3638702 TI - Family therapy. One role of the clinical specialist in psychiatric nursing. AB - This article is a discussion of the role of the clinical specialist as family therapist. Application of the Bowen Theory to families with a depressed member is emphasized. PMID- 3638703 TI - Interventions with alcoholics and their families. AB - Different types of alcoholism seem to exist, but all alcoholics progress through predictable stages. At any stage, interventions can be made by the nurse. The most effective, though unorthodox, interventions include the use of reversals (encouraging more of the same behavior) and the use of leverage (requiring treatment). These interventions focus upon the alcoholic. Family intervention, however, is a necessary condition for the complete recovery of the alcoholic and his family. The family system is a more powerful force than the addiction itself and has great potential for overcoming or sustaining the alcoholism. Using Bowen's family systems theory, the alcoholic family system was explained along with appropriate interventions for it. The major interventions included coaching the co-alcoholic to differentiate a self in the family system, to modify the habitual overfunctioner and pursuer roles, to bridge cutoffs, and to de-triangle oneself as the anxiety and tension rise in the family system. This article focuses on the alcoholic and the family system during the period of active alcoholism. Work on the family system is equally necessary and rewarding to family members once abstinence and sobriety are established. Families with alcoholism require several years of such work before the family system reaches an optimal level of functioning. Family systems work is a powerful, therapeutic adjunct to alcoholism treatment for the alcoholic and the participation of family members in Alcoholics Anonymous, Al-Anon, Ala-Teen, and Adult Children of Alcoholics is quite useful. Work with the alcoholic family system introduces a note of optimism for the future. As high levels of anxiety are reduced, opportunities are provided for differentiating a self in the family system, and triangling in of children becomes less necessary. The transmission of alcoholism and its effects are thereby lessened for future generations of children of alcoholics. PMID- 3638704 TI - Group psychotherapy. AB - Group psychotherapy is a treatment modality used to assist patients in learning how they are perceived, what interactions and communication styles are effective, and which behaviors are acceptable. Emphasis is placed on self-knowledge and growth by using constructive feedback and support from others to make changes. Different types of groups can be classified broadly as open or closed. All group psychotherapists follow a theoretical framework and derive their interventions from this orientation. Groups follow the developmental stages of orientation, working relationship, and termination, and each phase has characteristic issues. Nurses make excellent group psychotherapists when they have received the additional education and supervision necessary to work with this modality. The education may be formal--via a master's degree in psychiatric nursing or specific courses on group psychotherapy--or it may be more informal--via seminars and workshops. Supervision is obtained concurrently while the new nurse group therapist is conducting clinical groups. PMID- 3638705 TI - Nursing and the voluntary association. Origin, development and collaboration. AB - This article identifies the mutual help group as a mechanism to enhance support services in the community. This type of voluntary association should be used as referral sources for patients and family members. It is through promoting the collaborative efforts of professionals patients, family, and friends that the nurse can contribute to the mental health needs of the community. PMID- 3638706 TI - Expanded practice in psychiatric nursing. AB - This article discusses consultation, liaison, and private practice as the three major expanded roles in psychiatric nursing. The qualifications and expectations of each role are described. Knowledge areas needed to practice within the guidelines of each expanded role are delineated. PMID- 3638707 TI - The future of psychiatric/mental health nursing. AB - The future of psychiatric/mental health nursing will reflect expansion of services to the elderly and chronic mentally ill. Providers of services and their reimbursement will also expand. If the specialty is to survive, changes in the undergraduate nursing curriculum must be addressed so that a larger cohort of nurses select graduate education in psychiatric/mental health nursing. PMID- 3638709 TI - Tips on superficial reflexes. PMID- 3638708 TI - Nutrition knowledge of student nurses: an exercise in evaluation. PMID- 3638710 TI - Healthy living: everyone a winner. PMID- 3638711 TI - Tasks before student nurses. PMID- 3638712 TI - Health education for tuberculosis drug defaulters. PMID- 3638713 TI - Closed circuit television and primary health care. PMID- 3638714 TI - Urinary tract infection: a problem solving approach. PMID- 3638715 TI - Lung cancer and dyspnea: the patient's perception. PMID- 3638716 TI - Dyspnea: a distressing sensation in lung cancer. PMID- 3638717 TI - Nursing management of intraperitoneal therapy. PMID- 3638718 TI - Breast self-examination: hospital-based nurses aren't assessing their clients. PMID- 3638719 TI - Stress and cancer: elusive connections. PMID- 3638720 TI - Cerebellar toxicities associated with cytosine arabinoside: a nursing perspective. PMID- 3638721 TI - Care of the family with a child with cancer: diagnosis and early stages of treatment. PMID- 3638722 TI - Your guide to intraperitoneal chemotherapy. PMID- 3638723 TI - Long-term continuing education programs in cancer nursing. PMID- 3638724 TI - Reflections and reactions to nursing's image in the media. PMID- 3638725 TI - Neighbourhood nursing. PMID- 3638726 TI - Hospital induced malnutrition: a cause for concern. PMID- 3638727 TI - Care of the urinary incontinent patient. PMID- 3638728 TI - Compliance: a shared responsibility. PMID- 3638729 TI - Old age abuse by carers. PMID- 3638730 TI - Aromatherapy. PMID- 3638731 TI - People power--implications for nurses. PMID- 3638732 TI - Health syndrome of unemployment. PMID- 3638733 TI - Commissioned to care. PMID- 3638734 TI - Anesthetic considerations in prolonged reconstructive surgeries. PMID- 3638735 TI - Nursing aspects of microvascular surgery. PMID- 3638737 TI - The operating microscope. PMID- 3638738 TI - Patient education with tissue expanders. PMID- 3638736 TI - Replantation technique. PMID- 3638739 TI - Trends in ambulatory surgery--office based surgery. PMID- 3638740 TI - The Nurse Practice Act & deplorable nursing care. PMID- 3638741 TI - Are you held to the standard of a nurse specialist? Case in point: Northern Trust Co. v. Louis A. Weiss Mem. Hosp. (493 N.E. 2d 5 - IL). PMID- 3638742 TI - Legal case briefs for nurses: GA: patient jumps out window--death; NC: male nurse rapes intensive care patient. PMID- 3638743 TI - Failure to follow doctors' orders and documentation. Case in point: Hurlock v. Park Lane Medical Center (709 S.W.2d 872 - MO.). PMID- 3638744 TI - Stroke in the family: theoretical considerations. PMID- 3638745 TI - Relationship of routine assessment of temperature and febrile illness. PMID- 3638746 TI - Strategies for sexual counseling. PMID- 3638747 TI - A model of wellness seeking behavior in traumatic spinal cord injury victims. PMID- 3638748 TI - Development of educational programs in rehabilitation nursing. PMID- 3638750 TI - Cancer prevention and early detection. PMID- 3638749 TI - [Pathogenesis of pulmonary emphysema]. PMID- 3638751 TI - Epidemiologic approaches to cancer research. PMID- 3638753 TI - Host-susceptibility factors in cancer etiology. PMID- 3638752 TI - Environmental factors in cancer etiology. PMID- 3638754 TI - Cancer risk assessment. PMID- 3638756 TI - Behavioral dimensions in cancer prevention and detection. PMID- 3638755 TI - The role of the nurse in cancer detection and screening. PMID- 3638757 TI - The role of the American Cancer Society in cancer public education. PMID- 3638758 TI - [Do you like the Revue de l'Infirmiere?]. PMID- 3638759 TI - [Hemodialysis: a new access way to the blood vessels]. PMID- 3638760 TI - [Radioactivity in the environment and health]. PMID- 3638761 TI - [Radiation accidents: principles and basis for intervention]. PMID- 3638763 TI - [Influence and tasks of the nurse in dietetics and diet therapy]. PMID- 3638762 TI - [Chernobyl nuclear reactor: information by WHO]. PMID- 3638764 TI - [Nursing, an independent profession]. PMID- 3638765 TI - [The importance of handwashing in the prevention of hospital infection]. PMID- 3638766 TI - [Intra-aortic balloon counterpulsation]. PMID- 3638767 TI - [Nutrition during the holidays (II)]. PMID- 3638768 TI - [The Cuban model of primary health care]. PMID- 3638769 TI - [Venous catheters]. PMID- 3638770 TI - [Characteristics of the home visiting service (I)]. PMID- 3638772 TI - How to survive a shift at the top. PMID- 3638771 TI - [Continuing education. 7. Field: medical-surgical. Subject: the diabetic patient]. PMID- 3638773 TI - When a patient doesn't complain enough. PMID- 3638774 TI - Close-up on cancer care. Colorectal cancer: when a polyp is more than a polyp [continuing education credit]. PMID- 3638775 TI - How radiation complicates stoma care. PMID- 3638777 TI - The patient who can't remember to take her meds. PMID- 3638776 TI - Helping an elderly patient live with CHF. PMID- 3638779 TI - Take the work out of range-of-motion exercises. PMID- 3638778 TI - Bringing a patient through ICU psychosis. PMID- 3638780 TI - How to teach patients better and faster. PMID- 3638781 TI - All we could do was help him live with dignity. PMID- 3638782 TI - How to beat an attorney at his own game. PMID- 3638783 TI - When a nurse and patient battle for control. PMID- 3638784 TI - Would you miss these clues to a vitamin C deficiency? PMID- 3638785 TI - Why hospitals like contented nurses. PMID- 3638786 TI - The never-ending search for a cure has resulted in some new treatments for cancer. PMID- 3638788 TI - Rural nursing. PMID- 3638787 TI - Wrongful dismissal. PMID- 3638789 TI - Take charge of your future. PMID- 3638790 TI - The real cost of hunger. PMID- 3638791 TI - Oncology nursing. PMID- 3638792 TI - Affinity chromatography of splicing complexes: U2, U5, and U4 + U6 small nuclear ribonucleoprotein particles in the spliceosome. AB - The splicing process, which removes intervening sequences from messenger RNA (mRNA) precursors is essential to gene expression in eukaryotic cells. This site specific process requires precise sequence recognition at the boundaries of an intervening sequence, but the mechanism of this recognition is not understood. The splicing of mRNA precursors occurs in a multicomponent complex termed the spliceosome. Such an assembly of components is likely to play a key role in specifying those sequences to be spliced. In order to analyze spliceosome structure, a stringent approach was developed to obtain splicing complexes free of cellular contaminants. This approach is a form of affinity chromatography based on the high specificity of the biotin-streptavidin interaction. A minimum of three subunits: U2, U5, and U4 + U6 small nuclear ribonucleoprotein particles were identified in the 35S spliceosome structure, which also contains the bipartite RNA intermediate of splicing. A 25S presplicing complex contained only the U2 particle. The multiple subunit structure of the spliceosome has implications for the regulation of a splicing event and for its possible catalysis by ribozyme or ribozymes. PMID- 3638793 TI - [Kenacort retard]. PMID- 3638794 TI - [Treatment of Parkinson's disease]. PMID- 3638795 TI - [Monitoring of antiparkinson treatment]. PMID- 3638796 TI - [Kinesitherapeutic approach in Parkinson's disease]. PMID- 3638798 TI - [There once was a parkinsonian patient and ... his spouse]. PMID- 3638797 TI - [The nursing team facing Parkinsonism]. PMID- 3638799 TI - [Life style of the parkinsonian patient. Attitude facing this disease]. PMID- 3638800 TI - [Bedsores: a method of monitoring for bedsores]. PMID- 3638801 TI - [The future of home support and its financing. The complementarity of actions- home care support services]. PMID- 3638802 TI - [Etiology of Parkinson's disease]. PMID- 3638804 TI - [Graph for the evaluation of the patient's autonomy]. PMID- 3638803 TI - [Clinical aspects of Parkinson's disease]. PMID- 3638805 TI - [The old man]. PMID- 3638806 TI - [Analysis of the experience of the nursing team with patients in chemotherapy]. PMID- 3638807 TI - [Study of an educational project for adult asthma patients]. PMID- 3638808 TI - [An experience in continuing education]. PMID- 3638809 TI - [Educational project for patients]. PMID- 3638810 TI - [Perspectives in the study of nursing care]. PMID- 3638811 TI - [Study of oppositional behavior in the nurse-patient relation]. PMID- 3638812 TI - [Part-time work in workmen's legislation]. PMID- 3638813 TI - [Interview with the patient relating to his care]. PMID- 3638814 TI - [Working with the unconscious in the body]. PMID- 3638815 TI - [And outside psychoanalytic therapy?]. PMID- 3638816 TI - [Psychopathological aspects of children's play]. PMID- 3638817 TI - [Play and the Rorschach test]. PMID- 3638818 TI - [Bodily expression and dramatic play in psychotic children]. PMID- 3638819 TI - [After the fifth year: home nursing--stagnation or development]. PMID- 3638820 TI - [Nurses' working environment. Elimination of cytostatic agents--focus on protection effort]. PMID- 3638821 TI - [Focus on education (3). Do nursing colleges create negative professional roles?]. PMID- 3638822 TI - [Education discussion: advance understanding--necessary for learning]. PMID- 3638823 TI - [Sleep disturbances can be prevented--hurrah, children asleep!]. PMID- 3638824 TI - [Something to learn? New initiatives in Danish care for the aged]. PMID- 3638825 TI - [But otherwise it's a good idea]. PMID- 3638826 TI - [Standards for nursing services]. PMID- 3638827 TI - [Stroke units in Aker. Stroke patients--treatment in the acute stage]. PMID- 3638828 TI - [Focus on education (4). Occupational health nursing--where are they, where are they going?]. PMID- 3638829 TI - [Education discussion. Why don't we learn that it is fantastic to be a nurse]. PMID- 3638830 TI - [Kari Martinsen--first nurse with a Norwegian doctorate degree. Interview by Hanne Mai Svaboe]. PMID- 3638831 TI - [Now member positions have priority]. PMID- 3638832 TI - [Difficult but not impossible: nursing in Afghanistan]. PMID- 3638833 TI - [Education of nursing assistants ripe for revision?]. PMID- 3638834 TI - [Future care for the aged: if we should take the most infirm seriously?]. PMID- 3638835 TI - [Care for the aged. This is how a senile demented patient is helped by mental stimulation]. PMID- 3638836 TI - [Choice confirmed desire for more noticeable attitude]. PMID- 3638838 TI - [Lesser increase in the number of student nurses]. PMID- 3638837 TI - [Psychiatry--Italy. The best prevention is the closing of psychiatric hospitals]. PMID- 3638839 TI - [Alternative treatment. Man's opinions in East and West]. PMID- 3638840 TI - [Working in ambulances is also nursing]. PMID- 3638841 TI - [Work environment. Work Inspection has rejected criticism of cytostatics report]. PMID- 3638843 TI - [Ambulance system--Helsingborg. 5-months report on prehospital contribution by nurse anesthetists]. PMID- 3638842 TI - [Ambulance system--Helsingborg. We should introduce a system like in Helsingborg]. PMID- 3638844 TI - [Talking with patients about sexuality]. PMID- 3638845 TI - [Better information needed about treatment with radioactive substances]. PMID- 3638846 TI - [Home nursing. Personal assistance should be more need-oriented]. PMID- 3638847 TI - [They like possibility for active life on their own]. PMID- 3638848 TI - [AIDS--thorough information is never wasted]. PMID- 3638849 TI - [An initiative which is beginning to bear fruit]. PMID- 3638850 TI - [Accidents among hospitalized patients in Sweden]. PMID- 3638851 TI - [Key number will read it and use it correctly]. PMID- 3638852 TI - [Cutbacks. Parents themselves must watch their sick children]. PMID- 3638853 TI - [Psychiatry. Mobilize patients' self-esteem]. PMID- 3638854 TI - Understanding the professional liability insurance crisis. PMID- 3638855 TI - A primer on the liability crisis. PMID- 3638856 TI - Delegating nursing tasks today. PMID- 3638858 TI - [Providing assistance from a concept. Man as a provider of meaning to his existence]. PMID- 3638857 TI - Possible risk of thrombosis in human subjects administered pancreatic elastase. PMID- 3638859 TI - [The career of Nurse Modal. Conclusion: on work distribution and proliferation]. PMID- 3638860 TI - [More with less. Increase in productivity in general nursing. I]. PMID- 3638861 TI - [Referral and transfer of the patient. Attention points for nurses]. PMID- 3638862 TI - [Medical information for nurses. Epilepsy and pregnancy]. PMID- 3638863 TI - [Limitations for nurses in health care]. PMID- 3638864 TI - [This is how nurses can feel ... musings]. PMID- 3638865 TI - [Special care for the aged in De Bijster]. PMID- 3638866 TI - [Progress and care. Increase in productivity in general nursing. II]. PMID- 3638868 TI - [Management attention for education. What priority should patient education receive in nursing management?]. PMID- 3638867 TI - [Doctor's degree candidates at the bedside? Interview with Professor Johanna Roode]. PMID- 3638869 TI - [Tuberculosis]. PMID- 3638870 TI - [The Therapeutic Intervention Scoring System. An automatized system used by intensive care nurses]. PMID- 3638871 TI - Serving as an expert nurse witness. PMID- 3638872 TI - Developing a laser program. PMID- 3638873 TI - Traumas to the eye. PMID- 3638874 TI - Skill-sharpening methods in conducting patient interviews. PMID- 3638875 TI - Stages of successful litigation (Part 1). PMID- 3638877 TI - Monitoring OR quality assurance. PMID- 3638876 TI - Preparing OB nurses to assist with cesarean sections. PMID- 3638878 TI - Marketing your hospital. PMID- 3638879 TI - Tax reform: where is it taking us? PMID- 3638880 TI - [Activation of the blood kallikrein-kinin system as a cause of hemodynamic disorders during traumatic surgery of the liver and bile ducts]. AB - Experimental and clinical studies have shown that surgical procedures on the liver and biliary tracts particularly accompanied by compression of the hepatoduodenal ligament in order to perform temporal hemostasis are followed by activation of kinin-formation. In most traumatic operations it exceeds the limits of regulatory mechanisms and is a cause of hemodynamic disturbances. Protease inhibitors are recommended to prevent such complications. PMID- 3638881 TI - [Differentiation between acute myocardial infarction and acute myocardial infarction with cardiogenic shock using parameters of the kallikrein-kinin systems]. PMID- 3638882 TI - [Nursing education in Stockholm. Agreement reached]. PMID- 3638883 TI - [My son is dead]. PMID- 3638884 TI - [Vardfacket's language school. Free clinic]. PMID- 3638885 TI - [Fight about education a ministerial problem]. PMID- 3638886 TI - [Health care organization is an obstacle for change]. PMID- 3638887 TI - [Vidar Hospital has prevailing harmony. Interview by Viveka Holmertz]. PMID- 3638888 TI - [The concept of death and transplantation possibilities]. PMID- 3638889 TI - [20,000 demonstrate for proper wages and the right to time off]. PMID- 3638890 TI - [New pamphlet provides information and advice on medical technology]. PMID- 3638891 TI - [Umea: investigation cannot explain abnormalities]. PMID- 3638892 TI - [Portrait: Kerstin Lind. Interview by Jan Thomasson]. PMID- 3638893 TI - [Scandinavian cooperation can crack--Swedish nurses challenge Norwegian quality of care]. PMID- 3638894 TI - [20 nurses resign in protest against medical superintendent. Interview by Jan Thomasson]. PMID- 3638895 TI - [Pretentions talk gives wage results. Interview by Viveka Holmertz]. PMID- 3638896 TI - [Hoping for more support from the SHSTF. Interview by Anne Sorman]. PMID- 3638898 TI - Training nurses for the North: which nurses? What program? PMID- 3638897 TI - [Developing public health is the most important]. PMID- 3638899 TI - Therapeutic touch. PMID- 3638901 TI - Confidentiality and security of automated health information. PMID- 3638900 TI - The little people--and the operating room. PMID- 3638902 TI - The image of nursing--reflections from the written media. PMID- 3638903 TI - Introspection. PMID- 3638904 TI - Midwifery in Alberta. PMID- 3638905 TI - Relations between nucleolar morphometric parameters and pre-rRNA synthesis in animal and plant cells. AB - In order to study if there are differences between cells of the same tissue with one and two nucleoli, nuclear and nucleolar volume, density of tritiated uridine incorporation, amount of DNA per nucleus and intensity of cytoplasmic basophilia were measured in mononucleolated and binucleolated rat epithelial endometrial cells, in onion root meristematic cells and in chick embryo matrix cells of the central nervous system, neuroblasts and neurons. No significant differences in nuclear volume, density of tritiated uridine incorporation and amount of DNA per nucleus were found between cells of the same type with diverse numbers of nucleoli. Binucleolated endometrial cells, matrix cells, and root meristematic cells have biphasic distributions of nucleolar volumes. One peak of this distribution roughly coincides with the nucleolar volume of mononucleolated cells, the other peak corresponds almost to double the volume. As the density of uridine incorporation is the same irrespective of the nucleolar number and volume, the cells with larger nucleolar volumes have higher pre-rRNA synthesis. These cells also have higher amounts of ribosomes in the cytoplasm, as revealed by the photometric study of basophilia. It is concluded that in this population of cells the ribosomal production is regulated to a higher steady equilibrium than in the general population. This difference is not due to polyploidism or to the increased DNA content of G2 phase cells. Binucleolated neuroblasts and neurons have nucleolar volumes similar to those of mononucleolated ones. PMID- 3638907 TI - AGA preemies can be Kangaroo infants too. PMID- 3638908 TI - The automatic implantable cardioverter defibrillator: a lifesaving device. PMID- 3638906 TI - Evidence for a role of the plasma kallikrein-kinin system in acute inflammation: reduced exudation during carrageenin- and kaolin-pleurisies in kininogen deficient rats. AB - Experimental pleurisy was induced by intrapleural injection of carrageenin or kaolin in three strains of rat: Brown Norway-Katholiek (B/N-Ka), Brown Norway Kitasato (B/N-Ki) and Sprague-Dawley (SD). B/N-Ka rats (kininogen-deficient) showed significantly less pleural fluid accumulation and exudation rate than SD rats or than B/N-Ki rats (normal). The result indicates the involvement of the plasma kallikrein-kinin system in these pleurisies and a role of high-molecular weight kininogen is suggested. PMID- 3638909 TI - Making the diabetes connection. PMID- 3638910 TI - . . . and don't send her back! PMID- 3638911 TI - AIDS beyond the hospital. 1. A home care plan for AIDS. PMID- 3638912 TI - Reading the fine print. PMID- 3638913 TI - Quackery. A thoroughly modern problem. PMID- 3638914 TI - Soothing the ragged edge of pain. Bring back the dream lady... PMID- 3638915 TI - Soothing the ragged edge of pain. Bring on the music... PMID- 3638916 TI - Games nurses play. Part 3. Monopoly and make a wish. PMID- 3638917 TI - Spinal relief of cancer pain. PMID- 3638918 TI - Would you put a Foley in the rectum? PMID- 3638919 TI - Wait and see. PMID- 3638920 TI - Wring 'em dry mismanagement. PMID- 3638921 TI - Mother's helper. PMID- 3638922 TI - Operating room surveillance: a new approach in reducing hip and knee prosthetic wound infections. AB - A prospective study of surgical wound infections (SWI) in hip prosthesis surgery and total hip and knee replacements at two community hospitals with common surgical staffs was begun in May 1982. The rates of SWI during the first 7 months for four orthopedic surgeons were 9% (3/32) for hip prosthesis surgery and 16.7% (3/18) for total hip and knee replacement, with 12% (6/50) overall. To reduce infections, each orthopedic surgeon agreed to intraoperative surveillance (IOS) of two procedures (hip prosthesis or total hip or knee replacement) by the infection control nurse at each hospital. Significant IOS findings were too many persons in the operating room (five to nine persons), operating room doors opened frequently (25 to 50 times), inconsistent use of prophylactic antibiotics, and excessive conversation. In January 1984, IOS data and recommendations were shared with each orthopedic surgeon, the operating room staff, and the anesthesia personnel. Subsequently, a statistically significant drop in SWI was realized for total hip and knee replacement (1/36 versus 5/36, p = 0.05) and overall (3/73 versus 14/116, p = 0.05). The drop in SWI for hip prosthesis surgery was not statistically significant (2/37 versus 9/80, p greater than 0.10). IOS and individualized communication were effective in reducing SWI. PMID- 3638923 TI - Infection control in the Netherlands. AB - A survey was made by the Dutch association of infection control practitioners (VHIG) concerning the organization of infection control in Dutch hospitals and the activities of its members. The results are reported and compared with recent American studies. A comparison is made between a group of infection control technicians (ICTs) who were not nurses and a group of nurses (ICNs), working in infection control. Although the ICT has significantly more daily contacts with the hospital microbiologist and is more often secretary to the infection control committee and the ICN visits the outpatient department significantly more often, the other activities in their practice are essentially the same. From this study we conclude that either an ICT or an ICN can adequately function as an infection control practitioner in the Netherlands. PMID- 3638924 TI - Outbreak of bacterial endophthalmitis after cataract surgery and lens implantation: lack of direct evidence for exogenous contributing factors. PMID- 3638925 TI - The infection control practitioner and an expanding responsibility. PMID- 3638926 TI - ICU patient's life depends on how well RNs, MDs get along. PMID- 3638927 TI - Nurses support congressional candidates. PMID- 3638928 TI - Nurse-managed care meets needs of the homebound. PMID- 3638929 TI - As I see it... Two bills before Congress are vital to families. PMID- 3638930 TI - Preventive therapy of emphysema. Lessons from the elastase model. PMID- 3638931 TI - Interaction between rifampin and fusidic acid against methicillin-resistant coagulase-positive and -negative staphylococci. AB - We studied the interaction between rifampin and fusidic acid against a group of staphylococci. Of the 20 coagulase-positive strains studied, checkerboard studies revealed synergy in 3 and indifference in 17; time-kill studies revealed synergy in 18 of 19 coagulase-positive strains at both 24 and 48 h. Of the 19 coagulase negative strains, checkerboard studies revealed synergy in 6 and indifference in 13; time-kill studies revealed synergy in 6 of 18 coagulase-negative strains at 24 h and in 17 of 18 coagulase-negative strains at 48 h. The combination of rifampin and fusidic acid warrants further evaluation in the therapy of staphylococcal disease. PMID- 3638933 TI - With or without regulations, the responsibility of OR nurses is clear. PMID- 3638932 TI - Alterations in kinetic properties of penicillin-binding proteins of penicillin resistant Streptococcus pneumoniae. AB - Earlier studies have shown that the highly penicillin-resistant South African Strains of pneumococci contain altered penicillin-binding proteins (PBPs) (S. Zighelboim and A. Tomasz, Antimicrob. Agents Chemother. 17:434-442, 1980). We now describe a detailed quantitative characterization of the reaction of radioactively labeled penicillin with the PBPs of the penicillin-susceptible and penicillin-resistant pneumococci and several intermediate-resistance-level genetic transformants as well. The altered binding of the antibiotic by the PBPs of resistant cells appears to be due to a combination of two factors: lower drug affinity and change in the cellular amounts of PBPs. No alteration in the rates of deacylation of the penicilloyl-PBPs of the resistant cells was detected. PMID- 3638934 TI - Nurses must use power in legislative arena to affect health care and professional issues. PMID- 3638935 TI - A patient classification system for the OR. AB - Changes are still occurring as we continue to refine the tool. We have now determined that not all OR nurses need to learn to use the tool. The head nurse or assistant head nurse can do it quickly. We are continuing to gather data and hope to have input from other hospitals interested in testing the tool. PMID- 3638936 TI - Quality assurance in the OR. Getting a program started. PMID- 3638937 TI - Time management. Cashing in on both brains. PMID- 3638938 TI - Patient teaching. Understanding the needs of the adult learner. PMID- 3638939 TI - Temporary transcutaneous pacing. New indications for an old technique. PMID- 3638940 TI - Nursing students in the OR. Clinical opportunities. PMID- 3638942 TI - Scheduling employees for weekend and on-call work. PMID- 3638941 TI - Surgery in School. Preoperative pediatric education. PMID- 3638943 TI - Selecting and educating perioperative nurses for an ambulatory surgery setting. AB - A decision was made that review of technical skills for the perioperative and postanesthesia nurses hired from within the hospital was not necessary because they all had experience in their specialty areas. Those hired from other areas of the hospital will spend one month with a preceptor in the postanesthesia care area, one month in our short stay unit with a preceptor, and one month either in class or OR observation. All will have formal classes on anesthesia, fluid and electrolytes, and the philosophy of ambulatory surgery. These employees were released from their previous positions three months before the projected opening date of the new unit to allow them to learn the new skills. The patient care manager assigned responsibilities to the perioperative nurses hired from the main OR. They were asked to research needed equipment and supplies for various procedures in the different specialty areas. The patient care manager felt this would help them make a smooth transition to the new unit by making them feel like members of the team. My original hypothesis that perioperative nurses will not only rise to the occasion, but will far exceed our expectations will be tested when we move to the new ambulatory surgery unit. Although our opening date has been delayed, I am confident that our forethought and preparation will result in a smooth transition and an efficient staff. PMID- 3638944 TI - Consulting with industry: an entrepreneurial opportunity. PMID- 3638945 TI - Radiocontrast media induced nephropathy. PMID- 3638946 TI - Complex immunosuppressive protocols increase the need for patient education. PMID- 3638947 TI - Deferoxamine use in aluminum toxicity. PMID- 3638948 TI - Reduction of peritonitis with patient education and the Travenol CAPD Germicidal Exchange Device. PMID- 3638949 TI - An ethical dilemma for ESRD: preserving human values. PMID- 3638950 TI - Charity begins at home. PMID- 3638951 TI - Parkinsonism defused. The diagnosis of Parkinson's disease. PMID- 3638952 TI - Parkinsonism defused. Nursing parkinsonism. PMID- 3638953 TI - The computer caper. PMID- 3638954 TI - Paediatric hospitals in Canada. PMID- 3638955 TI - Nurse & the law. Fruitful lessons from 'sterile' arguments. PMID- 3638956 TI - The third age: Hurst at large. PMID- 3638957 TI - My wings are free. PMID- 3638958 TI - From neophyte to expert. Part two. PMID- 3638959 TI - Preceptoring. PMID- 3638960 TI - Interpersonal skills: learning the importance of listening. PMID- 3638961 TI - Regulations of nursing: an emerging responsibility for the profession. PMID- 3638962 TI - Nurse & the law. The anatomy of conscience. PMID- 3638963 TI - Effects of glucocorticoid and cycloheximide on the activity and amount of RNA polymerase I in nuclei of rat liver. AB - The activity of the template-engaged form of RNA polymerase I from livers of adrenalectomized rats was about 50-60% of that of normal control rats, and increased about 2-fold at 6 h after the administration of dexamethasone. However, no change was found in the activity of the 'free' form of RNA polymerase I or the template-engaged form of RNA polymerase II. Immunochemical studies using guinea pig anti-(RNA polymerase I) serum disclosed that the total number of RNA polymerase I molecules did not vary during the treatment with dexamethasone. Cycloheximide caused a rapid decrease in the template-engaged form of RNA polymerase I activity in normal rats and in dexamethasone-treated (6 h) adrenalectomized rats, to the value in adrenalectomized rats, but affected it only slightly in adrenalectomized rats. The elongation rate of rRNA-precursor synthesis in liver nuclei was not affected by a change in the concentration of circulating dexamethasone. From these results, it is concluded that about half the rRNA-precursor synthesis in rat liver is regulated by glucocorticoids, probably through the synthesis of short-lived protein(s) which may play a role in conversion of the 'dormant' form of RNA polymerase I into the 'engaged' form. PMID- 3638965 TI - Nucleotide ligands protect the inter-domain regions of the multifunctional polypeptide CAD against limited proteolysis, and also stabilize the thermolabile part-reactions of the carbamoyl-phosphate synthase II domains within the CAD polypeptide. AB - Improved methodologies are described which allow the measurement of the part reactions, with glutamine or ammonia as nitrogen donor, of mammalian carbamoyl phosphate synthase II (EC 6.3.5.5) through the incorporation of [14C]bicarbonate into either carbamoyl phosphate or carbamoylaspartate. The enzyme is part of the multifunctional polypeptide (CAD) which also comprises the pyrimidine biosynthetic enzymes aspartate transcarbamoylase (EC 2.1.3.2) and dihydro-orotase (EC 3.5.2.3). The conformational stability of the carbamoyl-phosphate synthase was investigated through the inactivation of the part-reactions which occurred during incubation at 37 degrees C. The domain involved in the removal of the amide N from glutamine was more thermolabile than the ammonia-dependent synthase moiety. The former activity was stabilized in the presence of sodium aspartate or MgATP, whereas the latter was stabilized by MgATP and MgUTP. Binding of MgUTP and MgATP to CAD restricted the initial proteolysis by trypsin and elastase of one or both regions linking the carbamoyl-phosphate synthase domain to the other major domains. A model is described to account for both aspects of nucleotide binding to CAD; these stabilizing effects may be important in the cell, where similar concentrations of nucleotides are found. PMID- 3638967 TI - Computing in occupational health. The computer as a tool for occupational health nurses. PMID- 3638964 TI - The C3 convertase of the alternative pathway of human complement. Enzymic properties of the bimolecular proteinase. AB - The association of Factor B with C3b (the major fragment of complement component C3) in the presence of Mg2+ results in the formation of a bimolecular zymogen, C3b,B, which is activated by the serine proteinase Factor D, generating the C3 convertase, C3b,Bb (EC 3.4.21.47). Cleavage of native C3 by the C3 convertase was monitored by recording the increase in fluorescence associated with C3b formation in the presence of the fluorescent probe 8-anilinonaphthalene-1-sulphonate. Measurements of initial rates of C3b formation at various C3 concentrations were analysed in accordance with the Michaelis-Menten equation, yielding kcat. = 1.78 +/- 0.08 s-1, Km = 5.86 X 10(-6) M and turnover number = 107 min-1. The assay was used to measure the Ki values of a variety of proteinase inhibitors. The C3 convertase has a short half-life, owing to spontaneous dissociation of the complex. The t1/2 and kcat./Km of the enzyme were determined by fitting an equation modelling both the kinetic reaction and enzyme decay to the fluorimetrically measured progress curve. The enzyme, C3b,Bb, exhibited a t1/2 of 90 +/- 2 s and a kcat./Km of 31.1 X 10(4) +/- 0.8 X 10(4) M-1 X s-1 at physiological pH, ionic strength and temperature. The enzyme that initiates activation of the alternative pathway, C3(H2O),Bb, was also examined. It was slightly less stable (t1/2 = 77 +/- 3 s) and exhibited only half the activity of C3b,Bb (kcat./Km = 16.3 X 10(4) +/- 1.0 X 10(4) M-1 X s-1). PMID- 3638966 TI - The nucleotide sequence of a cytoplasmic tRNAPhe from Scenedesmus obliquus and comparison with a tRNATyr species. AB - The nucleotide sequence of a cytoplasmic tRNAPhe from the eukaryotic green alga Scenedesmus obliquus was determined as: pG-G-C-U-U-G-A-U-A-m2G-C-U-C-A-G-C-D-Gm-G G-A-G-A-G-C-m22G-p si-psi-A-G-A-Cm-U-G - A-A-m1G-A-psi-C-U-A-C-A-G-m7G-N-m5C-C-C C-A-G-T-psi-C-G-m1A-U-m5C-Cm-U-G -G-G-U- C A-G-G-C-C-A-C-C-A-OH. The structure has some notable features. Unlike other tRNAPhe species from plant sources, it has an unmodified G as the first residue of the anticodon and m1G rather than a Y derivative as the residue following the anticodon. The sequence m5C(60)-Cm(61) is unique to this tRNA. The sequence of S. obliquus tRNAPhe shows close homology with S. obliquus tRNATyr. PMID- 3638968 TI - Research trends in the health promotion of well adults. PMID- 3638969 TI - The New Orleans Police Department hypertension project. PMID- 3638970 TI - Alcoholism: the illness. The occupational health nurse as a link to survival. PMID- 3638971 TI - Legal issues--organ transplants: nursing considerations. PMID- 3638972 TI - Nutritional questions--the nurse's answers. PMID- 3638973 TI - Blood alcohol concentration: a critical factor for producing fetal alcohol effects. AB - A dose of 6.6 g/kg of alcohol, delivered in 12 equally-spaced fractions each 24 hours via an artificial rearing procedure during postnatal days 4-10, produced mean blood alcohol concentrations (BACs) that were low (46.6 mg/dl), but stable with time. This relatively constant alcohol exposure did not limit brain growth in neonatal rats when measured on postnatal day 10. The same daily dose concentrated into 6 fractions over 12 hours (with 6 alcohol-free fractions the remaining 12 hours) resulted in cyclic BACs having high peaks (270.2 mg/dl). The cyclic regimen produced a significant reduction in brain growth. Thus, the peak blood alcohol concentration is a critical factor in determining the minimum dose for producing microencephaly and must be considered when estimating the relative teratogenic risks of alcohol intake during pregnancy. PMID- 3638975 TI - Midwifery: a case of misleading packaging? PMID- 3638974 TI - How the study of literature develops perceptive, sensitive nurses. PMID- 3638976 TI - A conceptual framework for nursing practice. PMID- 3638977 TI - Job satisfaction, role conflict and role ambiguity--a study of hospital nurses. PMID- 3638978 TI - Not free to be moral. PMID- 3638979 TI - Cancer prevention education in a hospice program. Counseling during bereavement: how effective is it? PMID- 3638980 TI - The hospice garden. Addressing the patients needs through landscape. PMID- 3638981 TI - Group experience for the recently widowed. A bereavement follow-up study. PMID- 3638982 TI - When the cancer patient presents intractable pain. A new method for managing the chronic/acute pain complex. PMID- 3638984 TI - Political prescription: more nurses. Interview by Audrey Cochran. PMID- 3638983 TI - Development of a hospice support group. The need for a staff support group. PMID- 3638985 TI - Nurse-physician collaboration. PMID- 3638986 TI - Child care: a working solution. PMID- 3638987 TI - Writing for publication: an invitation and advice from the new editor. PMID- 3638988 TI - HTLV-III expression and production involve complex regulation at the levels of splicing and translation of viral RNA. AB - The African green monkey nonlymphoid cell line cos-1 produces infectious HTLV-III virus following transfection with biologically active molecular clones of HTLV III. Transfected cos-1 cells produce large amounts of viral RNA and protein. We have used this rapid transfection system to study the regulatory functions and synthetic capacity of the HTLV-III genome, as well as mutants derived from it. Analysis of transfected lymphoid and nonlymphoid cell lines suggests that tat-III mediated trans-activation of viral gene expression is operative predominantly, if not exclusively, at a posttranscriptional level. We have also identified an additional HTLV-III-encoded gene that controls viral gene expression through regulation of the relative proportions of the various viral RNA transcripts and is required for viral replication. PMID- 3638989 TI - PNPA update: concerns and attitudes of Illinois nurses following the 1985 forums. PMID- 3638990 TI - Dispelling the misinformation about PNPA. PMID- 3638991 TI - Less is more: writing an abstract of nursing research. PMID- 3638992 TI - Purification and characterization of pancreatic secretory trypsin inhibitor in human gastric mucosa. AB - Immunoreactive pancreatic secretory trypsin inhibitor (PSTI) was purified to homogeneity from human gastric mucosa by gel chromatography, ion-exchange chromatography, and repeated reverse-phase high-performance liquid chromatography (HPLC). The molecular weight of the purified immunoreactive PSTI in human gastric mucosa was estimated to be 6000. The electrophoretical mobility of purified PSTI was identical with that of the main component of PSTI in human pancreatic juice. It consisted of 56 amino acids and had the same amino acid composition as PSTI in pancreatic juice. It inhibited bovine pancreatic trypsin stoichiometrically, and did not inhibit porcine pancreatic kallikrein or elastase. Heat treatment of immunoreactive PSTI in gastric mucosa showed the same inactivation curve of immunoreactivity as that of pancreatic juice PSTI. PMID- 3638993 TI - Comparison of microbiologic characteristics of pathogenic and saprophytic coagulase-negative staphylococci from patients on continuous ambulatory peritoneal dialysis. AB - Twenty-one microbiologically documented episodes of coagulase-negative staphylococcal peritonitis occurred in 21 continuous ambulatory peritoneal dialysis patients. All strains involved in these infections were tested for antimicrobial susceptibility and in vitro adherence assays. Twenty of the strains were species identified using two commercially available systems. For comparison, 20 saprophytic strains of coagulase-negative staphylococci obtained from the nares and axillae of 10 uninfected, peritoneal dialysis patients were included for in vitro characterization. Staphylococcus epidermidis was the species most often identified for both clinical and saprophytic strains. Eighteen of the 21 (86%) clinical strains were resistant to penicillin G. Methicillin resistance, which was present in five clinical strains, was not found in saprophytic strains. Adherence assay determinations showed marked differences between clinical versus colonization strains, with the clinical isolates significantly more adherent (p less than 0.025) than colonization strains. Electron microscopic examination of silastic catheter segments incubated with a strain of S. epidermidis in used and unused dialysis fluids demonstrated marked differences in attachment of bacteria to catheter material. PMID- 3638994 TI - Susceptibility testing of methicillin-resistant Staphylococcus aureus with three commercial microdilution systems. AB - The antimicrobial susceptibilities of 100 methicillin-resistant Staphylococcus aureus isolates were determined concurrently by API Uniscept KB, Micro-Media, MicroScan, standardized disk diffusion, and reference broth microdilution to evaluate whether these commercial microdilution systems would reliably defect methicillin-resistant S. aureus. The methicillin minimal inhibitory concentration for all isolates was greater than or equal to 16 micrograms/ml as determined by the reference minimal inhibitory concentration panels containing 2% NaCl supplemented Mueller-Hinton broth. Using the breakpoints established by the National Committee for Clinical Laboratory Standards for reporting susceptible and resistant methicillin results, there was 100% agreement between the reference methods and API Uniscept KB at 24 hr. The Micro-Media and MicroScan systems had 47% and 8% very major discrepancies at 24 hr, respectively. At 48 hr, these two systems exhibited 15% and 0% very major discrepancies. Micro-Media and MicroScan were in agreement with the reference microdilution method (+/- 1 log2 dilution) for 62% and 68% of the strains at 24 hr, respectively and 88% and 85% of the isolates at 48 hr, respectively. The results of this study indicate that API Uniscept KB would provide a practical and reliable method for the detection of methicillin-resistant S. aureus. PMID- 3638995 TI - School nursing: helping children to grieve. PMID- 3638996 TI - 'You're not in the NHS now'. PMID- 3638997 TI - Which catheter? PMID- 3638998 TI - Alcoholism: a context for drinking. PMID- 3638999 TI - Promoting continence: pelvic power. PMID- 3639000 TI - Teamwork: reinventing the wheel. PMID- 3639001 TI - Developmental screening: baby, can you hear me? PMID- 3639002 TI - The great Copyright caper of 1986. PMID- 3639003 TI - Dual-chamber cardiac pacing: an overview (continuing education credit). PMID- 3639004 TI - Mediscus Low Air-Loss Beds and the prevention of decubitus ulcers. PMID- 3639005 TI - Fundamentals of chest x-ray interpretation (continuing education credit). PMID- 3639006 TI - Troubleshooting ventilator- and patient-related problems--Part 2. PMID- 3639007 TI - Mystery arrhythmia. PMID- 3639008 TI - Documenting care in the medical intensive care unit: change theory in action. PMID- 3639009 TI - Antidiuretic hormone. PMID- 3639010 TI - Neurologic aspects of critical care. Brain tumor basics. PMID- 3639011 TI - Effects of kallidinogenase on urinary kallikrein excretion and plasma prostanoid concentrations in patients with essential hypertension. AB - The effects of kallidinogenase on urinary kallikrein excretion, plasma immunoreactive prostanoids and platelet aggregation were investigated in patients with essential hypertension. Urinary kallikrein excretion and plasma 6-keto PGF1 alpha concentration were significantly decreased in these patients. Significant decreases in blood pressure, as well as significant increases of urinary kallikrein excretion and plasma 6-keto PGF1 alpha concentration after kallidinogenase administration were also observed. PMID- 3639012 TI - [Effect of diuretics on the activity of the blood kallikrein-kinin system in experimental inflammation]. AB - Experimental inflammatory edema induced by subplantar administration of dextran was shown to activate the blood kallikrein-kinin system in rats. Furosemide, dichlothiazide and ethacyrnic acid (50 mg/kg) prevented this effect. Ethacrynic acid exerted the most pronounced action. PMID- 3639013 TI - Uncharged tRNA error damping model. AB - Uncharged tRNA is known to bind to the ribosome in a codon-specific fashion. In this way, cognate uncharged tRNA competes with non-cognate aminoacyl-tRNA. If uncharged tRNA can be aminoacylated while on the ribosome, this will damp errors due to aminoacyl-tRNA imbalance. Kinetic analysis shows that this scheme reduces errors at 'hungry' codons considerably more effectively than J. Ninio's accuracy tuner model; for example, a 10-fold decrease in cognate aminoacyl-tRNA elicits only a 10% increase in the error frequency. PMID- 3639014 TI - [Differential diagnosis of pediatric infectious diseases accompanied by macular rashes]. PMID- 3639015 TI - [Additional electrocardiographic leads]. PMID- 3639016 TI - [Dermatoglyphics]. PMID- 3639017 TI - [Emergency care in eye injuries]. PMID- 3639018 TI - [Transportation of patients with multiple injuries and alcoholic intoxication]. PMID- 3639019 TI - [Vaccinal prophylaxis in controlling infections]. PMID- 3639020 TI - [Pseudoacute abdomen in patients with rib fractures]. PMID- 3639021 TI - [Arrest of the psychotic states in alcoholic patients suffering from somatic diseases]. PMID- 3639023 TI - [Organization of an evening for the health of youth]. PMID- 3639022 TI - [Hemostatic agents]. PMID- 3639024 TI - [Sex education of girls (materials for a talk with adolescent girls and young women)]. PMID- 3639025 TI - [Advice for women in controlling drunkenness (materials for talks)]. PMID- 3639026 TI - [Medical leeches]. PMID- 3639027 TI - [Treatment of the complications of acute appendicitis]. PMID- 3639028 TI - [Prolonged soft-tissue crush syndrome]. PMID- 3639029 TI - [Detection of diabetes mellitus in pregnant women]. PMID- 3639031 TI - [Angina]. PMID- 3639030 TI - [Management of pregnancy and labor in diabetes mellitus]. PMID- 3639032 TI - [Stein-Leventhal syndrome]. PMID- 3639033 TI - [Meteorotropic reactions in children]. PMID- 3639034 TI - [Diet therapy in obesity]. PMID- 3639035 TI - [Industrial hygiene in the manufacture and use of feeds in modern animal husbandry]. PMID- 3639036 TI - [Paronychia]. PMID- 3639037 TI - [Hypotensive agents]. PMID- 3639038 TI - [Promotion of self-control in physical education and sports exercises]. PMID- 3639039 TI - [Tetanus (epidemiology, etiology and prevention)]. PMID- 3639040 TI - [Fostering interest in a future profession]. PMID- 3639042 TI - Duane D. Walker--striving for excellence. PMID- 3639043 TI - Minimizing the complications of tracheal suctioning. PMID- 3639041 TI - A nurse educator's view of employing new graduates in critical care settings. PMID- 3639044 TI - Using interactive video to supplement student experience in critical care nursing. PMID- 3639045 TI - Clinical implications of deep and shallow suctioning in neonatal patients. PMID- 3639046 TI - AIDS: a challenge for contemporary nursing. Part II: Clinical aids. PMID- 3639047 TI - Atherosclerosis as a complication of diabetes. Implications for cardiovascular nursing. PMID- 3639048 TI - A silk impression of nursing in China. PMID- 3639049 TI - Legal limitations on the political activities of public employees. PMID- 3639050 TI - Federal regulation of the professionals. PMID- 3639051 TI - Community project enhances student education: Valencia and UF involve students in summer youth sports program. PMID- 3639052 TI - Antibody response to sheep red blood cells in four substrains of BB rats, some other strains and interstrain F2 hybrids. AB - Primary and secondary antibody responses to SRBC were assayed in three substrains of dp BB rats, one strain of ndp BB rats, in their parental WOK rats, in highly inbred LEW rats, in two RT1 congenic strains LEW.1A and LEW.1W, and in the recombinant LEW.1WR2 strain. Furthermore, interstrain F1 and F2 hybrids of two dp BB substrains with congenic animals were tested. A significant lowering of the primary antibody response was found in two dp BB substrains and in the recombinant LEW.1WR2 strain. A transient lowering was shown in ndp BB rats. The third dp BB substrain responded well. The observed differences among three dp BB substrains only indicate that the level of antibody response to SRBC cannot be taken as a further marker, besides the RT1uv haplotype, for spontaneous development of the IDDM in BB rats. The observed decrease in the primary antibody response in the RT1 recombinant LEW.1WR2 rats and in one group of interstrain F2 hybrids typing as homozygous RT1uv may have another meaning. They could indicate some immunoregulatory effects of the RT1 haplotype on the supposedly multigenic response to SRBC in rats. No significant differences were found in the secondary antibody responses to SRBC. PMID- 3639053 TI - "Health system clerkship"--FNS and UK join in a program of field work for health students. PMID- 3639054 TI - FNS Director David M. Hatfield delivers "State of FNS" address at annual meeting. PMID- 3639055 TI - LAV-like viral particles in lymph node germinal centers in patients with the persistent lymphadenopathy syndrome and the acquired immunodeficiency syndrome related complex: an ultrastructural study of 30 cases. AB - The detection of LAV- or HTLV III-type viral particles in lymph node germinal centers from patients with the persistent lymphadenopathy syndrome (LAS) or the acquired immunodeficiency syndrome (AIDS)-related complex (ARC) is an important diagnostic factor in the prodromal stages of AIDS. These particles, the morphology of which is defined, are situated solely in the extracellular spaces delimited by cytoplasmic extensions of the dendritic reticular cells. Often few in number, they were found in 26 of the 30 lymph nodes studied, selected uniquely on the basis of light microscopic criteria (predominantly follicular lymphoid hyperplasia). The four negative nodes contained no, or fewer than two, germinal centers in the samples taken for ultrastructural study. The diagnosis of the LAS or the ARC was always confirmed clinically and biologically. Thus, lymph node biopsy and the corresponding ultrastructural study are important steps in the diagnosis of AIDS. PMID- 3639056 TI - Pathologic features of long-standing "healed" bronchopulmonary dysplasia: a study of 28 3- to 40-month-old infants. AB - Alveolar septal fibrosis, the main residual feature in the "healed" stage of bronchopulmonary dysplasia (BPD), was the consistent finding in 28 infants who died at 3 to 40 months of age, all having had moderate to severe BPD in the neonatal period. The cause of death in 68 per cent of the cases was progressive respiratory failure related directly to the residual changes. An additional 18 pe cent of the infants died of pneumonia superimposed on the long-standing healed bronchopulmonary dysplasia. Cardiomegaly was present in 84 per cent of the cases; biventricular hypertrophy was present in 29 per cent of the cases, right ventricular hypertrophy alone in 21 per cent, and left ventricular hypertrophy alone in 21 per cent. Evidence of pulmonary hypertensive vascular disease was found in 68 per cent of the cases. The pulmonary changes of alveolar septal fibrosis are strikingly variable within individual infants, with moderate or severe fibrosis in one area and normally inflated or hyperinflated lung in the adjacent sublobule or lobe. It is postulated that this variability may be related to a protective effect of necrotizing bronchiolitis (a prominent feature of the acute stages of BPD), whereby the occlusion of the bronchioles shields the distal sublobule from the high oxygen tensions and ventilatory pressures used in treating BPD. PMID- 3639057 TI - Studies of HLA, factor B (Bf), complement C2 and C4 haplotypes in type 1 diabetic and control families from northern Sweden. AB - The HLA-A,-B,-C,-DR antigens and the complement factors C2, C4 and Bf were determined in 30 insulin-dependent diabetes mellitus (IDDM) patients and 30 healthy controls from northern Sweden. Family studies allowed the deduction of extended haplotypes in the HLA and complement systems. Phenotype studies revealed significant associations between IDDM and HLA-DR4 (p less than 0.001), HLA-DR3 (p less than 0.05), HLA-DR3/4 (p less than 0.025), C4-B3 (p less than 0.001) and Bf S (p less than 0.025). Haplotype studies showed that the extended haplotype [HLA B15, C2-1, C4-A3B3, Bf-S, HLA-DR4] had a particularly strong association to IDDM. This haplotype was found in 10 out of 30 IDDM probands but in none of 30 control children and accounts for practically all the C4-B3 allotypes among the 30 IDDM probands. The C4-B3 gene therefore seems to be a valuable marker for IDDM. No haplotype containing HLA-DR3 was increased in frequency among the IDDM probands. The extended haplotype [HLA-B7, C2-1, C4-A3B1, Bf-S, HLA-DR2] present among the controls was absent in the IDDM probands. The frequency of the extended haplotype [HLA-B15, C2-1, C4-A3B3, Bf-S, HLA-DR4] was increased also among the parents to the IDDM probands compared to those of the control parents, whereas the frequency of [HLA-B7, C2-1, C4-A3B1, Bf-S, HLA-DR2] was decreased. The extended haplotype [HLA-B8, C2-1, C4-B1, Bf-S, HLA-DR3] was more common among the males (p less than 0.05) compared to the females in the total material. The family analysis showed that 3 out of 5 affected sibs shared both haplotypes with their IDDM proband. This was the case for only 3 out of 35 unaffected sibs. PMID- 3639058 TI - Human MHC class III genes, Bf and C4. Polymorphism, complotypes and association with MHC class I genes in the Finnish population. AB - Electrophoretically detected genetic polymorphism of human MHC class III genes, factor B (Bf) and complement C4A and C4B, was studied in the Finnish population. Bf alleles were determined in a panel of sera from 70 unrelated individuals. The common Bf alleles, Bf*S and Bf*F, had frequencies of 73% and 26%, respectively. Only in 1 individual was another allele, Bf*F1, detected. The frequencies of the C4A and C4B alleles were based on studies of 254 unrelated individuals. In this panel, five different alleles were detected at the C4A locus and four at the C4B locus. At both loci an allele without a gene product, i.e. a 'null' allele, was observed with high frequency, 11% for C4A 'null' and 17% for C4B 'null'. The association of complotypes to HLA haplotypes was analyzed in 70 chromosomes. The most common combination, defined by class I and class III alleles, was HLA-B7-S31 (13%), followed by HLA-B35-F20 (8.4%) and HLA-B8-S03 (7.1%). Some HLA-B specificities, for example B15, B27 and B40, were associated with a variety of complotypes. The importance of complotyping in HLA genetics is discussed. PMID- 3639059 TI - Distribution of C3 and Bf allotypes in Tuscany (Italy). AB - The C3 and Bf polymorphisms were studied in 1,000 unrelated Italians. The gene frequencies were calculated and compared with other districts of Italy. PMID- 3639060 TI - A new BF variant (F025). AB - A rare variant of Factor B exhibiting a mobility intermediate between BF F and BF S was described. After comparison with the mobilities of BF F and F075, this variant was designated BF F025. The allele was transmitted together with C2*C, C4A*3, and C4B*1. PMID- 3639062 TI - Do nurses need mentors? PMID- 3639061 TI - Reducing uncertainty: self-diagnosis of pregnancy. PMID- 3639063 TI - Developing and implementing a model for evaluating teaching effectiveness. PMID- 3639064 TI - Informing the public about nursing research. PMID- 3639065 TI - The National Center for Nursing Research. PMID- 3639066 TI - A comprehensive school health initiative. PMID- 3639067 TI - Hospice policy and patterns of care. PMID- 3639068 TI - Cultural values and the decision to circumcise. PMID- 3639069 TI - Wound infection after cesarean section. AB - A prospective multicenter study of 1,032 cesarean sections was performed to identify risk factors for postoperative wound infection. The overall rate of wound infection was 6.6% (3.8% in elective cases and 7.5% following nonelective operations), with considerable interhospital variation. Obesity was recognized as a patient-related risk factor, while risk factors inherent to the obstetric situation were duration of ruptured membranes prior to operation, fetal and labor monitoring by intrauterine devices, and omission of the use of plastic draping and redisinfection of the skin before closure. Logistic regression analysis was used to estimate the influence of these factors on the probability of wound infection. Certain risk factors associated with and over-represented in nonelective operations would explain the increased infection rates in these, and the observed interhospital variations did not differ from the expected rates when the distribution of other risk factors was considered. PMID- 3639070 TI - The JK diphtheroids. PMID- 3639071 TI - Diagnosis of secondary pulmonary hypertension: invasive techniques. PMID- 3639072 TI - Lung biopsy findings in secondary pulmonary hypertension. PMID- 3639073 TI - Therapy of secondary pulmonary hypertension. AB - Secondary pulmonary hypertension is seen in disorders that either interfere with gas exchange within the lung or in which large portions of the pulmonary vasculature are obliterated. Because the causes are diverse, there is no uniform approach to therapy. The approach to treatment should be methodic, but aggressive and primarily directed at improving the underlying disease process. Other forms of therapy, which are more controversial, should be reserved for patients with refractory cor pulmonale and should be instituted cautiously and their effects monitored closely. PMID- 3639074 TI - Hypoxic pulmonary hypertension: acute and chronic. PMID- 3639075 TI - Diagnostic monitoring and drive system management of patients with total artificial heart. PMID- 3639076 TI - The initial surgical intensive care unit nursing experience with the permanent total artificial heart. AB - The Utah experience with implantation of the Jarvik-7 demonstrated that this TAH can be implanted successfully within the confines of the adult human mediastinum. The device has proven its capacity to sustain the patient's life without causing the patient pain. There is no immunologic rejection of the heart, and in fact most other organ systems appear to accommodate well to the artificial pump. As is the nature of any experiment, problems were encountered and questions raised. Laboratory investigation is underway to test the durability of various prosthetic valves in the Jarvik-7. Subsequent recipients of the Jarvik-7 implant have experienced embolic episodes. The quick connects are being scrutinized closely for a predilection for thrombi accumulation. The significance of reperfusing persons who have adapted to chronic states of low cardiac output is still not completely understood. The ramifications of rapidly reperfusing cellular and organ systems is currently being studied. Ethical considerations as described by Woolley are being discussed at length. Protocols are being established with flexible guidelines for management of the TAH patient. Some of these protocols include infection control, anticoagulation, and hematological guidelines; nutritional support, physical therapy, and rehabilitation programs. More extensive preoperative evaluation and testing protocols are being developed. Further clarifications of the nurses' responsibility in maintaining the TAH equipment are being made. Certification methods are being developed to ensure the nurse's competency. Data collection methods are being refined by adapting information flow charts and computer hard copies specifically to the TAH patient. The Utah experience with TAH implantation in humans is still in its infancy. Twenty years of animal research provided a strong base from which to approach the first human subject. However, "there are limitations in extrapolating information from the best animal models and relating it to the critically ill human being." Animals used in the research were young and healthy; human candidates who meet the criteria for implant are generally extremely debilitated. This, coupled with the absence of human historical perspective or precedent, left many unknowns for the first TAH recipient. Our patient expired on March 23, 1982 of pseudomembranous colitis. Despite his death after 112 days of life sustained on the mechanical heart, he participated in a successful pioneering scientific experiment. PMID- 3639077 TI - Psychophysiologic effects of caregiver touch on incidence of cardiac dysrhythmia. PMID- 3639078 TI - Autonomy and the critically ill patient: the legal issues. PMID- 3639079 TI - Networking and working with a mentor: keys to eliciting support for clinical research as a staff nurse. PMID- 3639080 TI - Ethics without virtue. PMID- 3639081 TI - The value of the previous 12-lead electrocardiogram. PMID- 3639083 TI - Pathophysiology and clinical sequelae of cardiopulmonary bypass. PMID- 3639082 TI - Brain resuscitation. PMID- 3639084 TI - Use of pulmonary hydrogen gas excretion to detect carbohydrate malabsorption in dogs. AB - Pulmonary H2 excretion was measured in 10 healthy dogs, in 6 dogs with pancreatic exocrine insufficiency, and in 6 dogs with chronic small intestinal disease. Concentration of expired H2 in fasted healthy dogs was 0.9 +/- 0.1 ppm (mean +/- SEM) and peak H2 concentration of 1.4 +/- 0.2 ppm was detected up to 8 hours after feeding. Dogs with pancreatic exocrine insufficiency had fasting expired H2 concentrations of 3.3 +/- 0.9 ppm, which increased to a mean peak H2 concentration of 28.8 +/- 2.0 ppm 6.5 hours after feeding. Following xylose administration, expired H2 concentrations increased from fasting concentrations of 3.6 +/- 0.9 ppm to peak at 19.0 +/- 2.0 ppm in 1.5 hours. Blood xylose concentrations were diagnostic for carbohydrate malabsorption in 4 of 6 dogs with pancreatic exocrine insufficiency. Plasma p-aminobenzoic acid concentration identified bentiromide maldigestion in all dogs with pancreatic exocrine insufficiency. In 3 pancreatic exocrine insufficient dogs tested, pancreatic enzyme replacement therapy partially corrected carbohydrate malabsorption. Fasting expired H2 concentration was 5.3 +/- 1.3 ppm in dogs with chronic small intestinal disease and increased to a peak H2 of 72.2 +/- 18.0 ppm 7 hours after feeding. Following administration of xylose to dogs with chronic small intestinal disease, fasting expired H2 concentration increased from 3.0 +/- 1.0 ppm to a peak of 35.5 +/- 7.2 ppm at 2 hours. Blood xylose concentration was abnormal in only 2 of 6 dogs with chronic small intestinal disease. Results of these studies indicate that expired H2 analysis can identify carbohydrate malabsorption in dogs with pancreatic exocrine insufficiency or chronic small intestinal disease, and that pulmonary H2 testing is more sensitive than xylose absorption testing for the identification of carbohydrate malabsorption. PMID- 3639085 TI - The effect of a single large dose of amoxycillin on oral streptococci. AB - Salivary samples were examined for a period three weeks before, and three weeks after the administration of 3 g of amoxycillin in ten volunteers. There was a marked drop in the concentration of streptococci in all subjects in the first 4 h but most had substantially recovered within 48 h. All had recovered at seven days. No strains were resistant to 1 mg/l amoxycillin in the pre-treatment control series, and no resistant streptococci emerged. PMID- 3639086 TI - In-vitro activity of coumermycin against methicillin-resistant staphylococci: a comparison with six other agents. AB - The in-vitro activity of coumermycin was compared with that of vancomycin, rifampicin, fusidic acid, trimethoprim-sulphamethoxazole, norfloxacin and cefamandole against seven isolates of methicillin-resistant Staphylococcus aureus and 97 isolates of methicillin-resistant coagulase negative staphylococci. Apart from one strain of methicillin-resistant S. aureus all isolates were inhibited by less than or equal to 0.06 mg/l of coumermycin. Cefamandole was more active against strains of S. epidermidis than against other coagulase negative staphylococci. PMID- 3639087 TI - Detection of methicillin-resistant Staphylococcus epidermidis. AB - To determine whether methods suggested for detecting methicillin-resistant Staphylococcus aureus apply equally to methicillin-resistant Staphylococcus epidermidis, 135 S. epidermidis isolates were tested by the Vitek AMS gram positive susceptibility card (Vitek Systems, Inc., Hazelwood, Mo.) and by modifications of agar screen, disk diffusion, and microdilution methods. Modifications included 24- versus 48-h incubation, unsupplemented versus 2% NaCl supplemented broth, and standard versus direct inoculum. At 24 h, the highest number of resistant strains, 59, was detected by oxacillin (1 microgram) disk diffusion. At 48 h, three additional strains were judged resistant. With one exception, results for oxacillin disk diffusion and agar screen were equivalent at 24 and 48 h. Vitek detected 50 resistant strains. Significantly fewer resistant strains were detected at 24 h by methicillin disk diffusion (5 micrograms) and methicillin microdilution with 2% NaCl. For oxacillin microdilution, neither 2% NaCl supplementation nor the method of inoculum preparation significantly affected the results. Oxacillin microdilution with cation- rather than non-cation-supplemented broth detected significantly fewer (n = 33) resistant strains at 24 h; 51 were resistant at 48 h. To detect methicillin resistant S. epidermidis, a direct inoculum with either 24-h oxacillin disk diffusion and reincubation of intermediate strains for an additional 24 h or 24-h oxacillin agar screen and reincubation of strains with no growth for a total of 48 h is recommended. PMID- 3639089 TI - An integrated approach to risk assessment. PMID- 3639088 TI - Hageman factor, high molecular weight kininogen, and prekallikrein in chronic liver disease. AB - The activities of Hageman factor, high molecular weight kininogen (HMWK), and prekallikrein were studied in patients who had chronic active hepatitis and cirrhosis. Serum HMWK and prekallikrein activities were decreased in chronic active hepatitis and cirrhosis, but Hageman factor activity was low in cirrhosis only. The reduction of prekallikrein, HMWK, and Hageman factor was dependent on the degree of liver failure. Similar prekallikrein values were found in serum samples, activated or not, with an excess of Hageman factor and HMWK, which suggests that the decrease of prekallikrein in liver disease is not influenced by the simultaneous decrease of Hageman factor and HMWK. PMID- 3639090 TI - Product labeling: a marketing perspective. PMID- 3639091 TI - Product labeling: the ET nurse's responsibility. PMID- 3639093 TI - Industry response to patient safety concerns. PMID- 3639092 TI - Product labeling: the FDA perspective. PMID- 3639094 TI - Professional effectiveness through responsible communication. PMID- 3639095 TI - Understanding quantitative descriptive data analysis. PMID- 3639096 TI - Cancer of the colon: ruminations on the past and future. PMID- 3639097 TI - Role play as a teaching strategy. PMID- 3639098 TI - The future of disease and treatment. Changing health conditions, changing behaviors, and new medical technology. PMID- 3639099 TI - Nursing in the 21st century. Proceedings of the American Association of Colleges of Nursing (AACN) and the American Organization of Nurse Executives (AONE) Conference, Aspen, Colorado July 9-11, 1985. PMID- 3639100 TI - Nursing in the 21st century: an introduction. PMID- 3639101 TI - Health care providers: the future marketplace and regulations. PMID- 3639102 TI - Educational remapping for a responsible future. PMID- 3639103 TI - Nursing in the 21st century: conclusion. PMID- 3639104 TI - The vulnerable elderly. PMID- 3639105 TI - Investigating tools to aid in restorative care for Alzheimer's patients. PMID- 3639106 TI - Effects of biofeedback and urinary stress incontinence in older women. PMID- 3639107 TI - Visiting the hospitalized elderly. PMID- 3639108 TI - Reducing risks for seniors (a nurse's role). PMID- 3639109 TI - Conquering a Red Sea experience. PMID- 3639110 TI - Do indwelling cannulae on coronary care units need a heparin flush? PMID- 3639111 TI - Confidence not courage. PMID- 3639112 TI - Critical care nursing in Australia. PMID- 3639113 TI - Management of a patient in respiratory failure due to chronic bronchitis. PMID- 3639114 TI - Sleep and breathing. 'To sleep, perchance to breathe' (with apologies to the bard). PMID- 3639115 TI - Sensitive assay for neutralizing antibodies against AIDS-related viruses (HTLV III/LAV). AB - A sensitive assay for neutralizing antibodies (NA) against AIDS-related viruses (HTLV-III and LAV) was developed, using human T-cell lymphotropic virus type-I (HTLV-I)-bearing and HTLV-III-susceptible MT-4 cells. NA to HTLV-III in 21 patients with acquired immune deficiency syndrome (AIDS), 10 individuals with AIDS-related complex (ARC), 20 healthy male homosexuals, and 10 healthy male controls were titrated. Antibodies to HTLV-III were also detected by indirect immunofluorescence (IF). The assay was sensitive up to a dilution of 1:10 000. Sera from patients with AIDS showed a geometric mean titer (GMT) of NA of 1:475, whereas much higher GMTs (1:1318 and 1:1009) were observed in patients with ARC and healthy male homosexuals, respectively. Moreover, titers of NA significantly correlated with the levels of anti-HTLV-III antibodies detected by IF. PMID- 3639116 TI - Humoral and cellular immunologic aspects of adjuvant and collagen arthritis in rats. AB - Systemic and local immunological responses of rats sensitized with either M. butyricum or native type II collagen have been evaluated. In rats exhibiting adjuvant-induced arthritis no antibodies to collagen could be detected. In animals exhibiting collagen-induced arthritis, high antibody titers developed by day 14, and could be correlated with the severity of the arthritis. Delayed type hypersensitivity (DTH) responses were measured by a 5-iodo-2'-deoxyuridine 125-I (125-IUdR) uptake assay. Arthritic scores in rats immunized with collagen were not accompanied by a positive DTH response, whereas adjuvant arthritic rats showed a positive response. T-lymphocyte cellular responses in both adjuvant- and collagen-induced arthritic rats were measured. In neither syndrome were major alterations observed in T-lymphocyte subpopulations. These results provide evidence that adjuvant-induced arthritis and type II collagen-induced arthritis are distinct entities, and that they may be discriminated by the nature of the humoral response. PMID- 3639117 TI - Effect of smoking on plasma neutrophil elastase levels. AB - Plasma elastase is considered to indicate neutrophil elastase that has been released in vivo and has complexed with plasma inhibitors. Because smoking may play a pathogenetic role in emphysema by inducing elastase release in the lung, which may be reflected in the plasma elastase level, we evaluated the effect of smoking on plasma elastase in healthy men by using an enzyme-linked immunosorbent assay. No significant difference was found in plasma elastase levels between 30 smokers and 29 nonsmokers (103 +/- 23 [SD] ng/ml vs. 97 +/- 23 ng/ml). We found no significant change in plasma elastase level in eight heavy smokers when we compared morning with afternoon plasma samples taken about 7 hours later, while the subjects continued to smoke ad libitum in the interval. However, we found a significant rise in plasma elastase level in 12 healthy smokers who were tested after 8 hours of abstinence from smoking and then immediately and 1/2, 1, and 2 hours after intense smoking (eight cigarettes smoked over a period of 2 hours). Neutrophil count increased from a baseline of 3.8 +/- 0.7 X 10(3)/mm3 to 8.0 +/- 2.5 X 10(3)/mm3 at 1 hour, and 8.8 +/- 3.1 X 10(3)/mm3 at 2 hours. Plasma elastase level increased significantly (P less than 0.02) from a baseline of 111 +/- 30 ng/ml to 141 +/- 24 ng/ml at 1 hour after completion of smoking, but was not significantly different from baseline 2 hours after smoking (130 +/- 34 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3639118 TI - Analysis of prostatic bud induction by brief androgen treatment in the fetal rat urogenital sinus. AB - The androgen dependency of prostatic bud formation in fetal rat urogenital sinuses was studied using brief treatments with androgen, and the incorporation of androgens by the sinus mesenchyme was followed by steroid autoradiography. Urogenital sinuses from 16.5-day fetuses of both sexes were grown in organ culture and treated with androgens for periods ranging from 4 to 72 h and then transferred to control medium. A minimum treatment of 24 h was required to induce prostatic buds in male sinuses and of 36 h in all female sinuses. This difference in response disappeared after more prolonged treatment. In both sexes the number of prostatic buds increased with the time of exposure to androgens. Prostatic bud formation continued for 24-36 h after transfer to control medium. Steroid autoradiographic analysis showed that the labelled androgen was concentrated in the mesenchymal nuclei. The rate of incorporation rose steeply during the first 12 h and then more slowly. After transfer to control medium the amount of labelled androgen decreased rapidly to half within 12 h and then decreased more slowly. In the competition experiments a 200-fold excess of unlabelled testosterone or dihydrotestosterone in the labelling medium greatly reduced the nuclear labelling with [3H]testosterone. PMID- 3639119 TI - Induction of hair follicles in mouse skin by rat vibrissa dermal papillae. AB - Rat vibrissa dermal papillae were transplanted between the epidermis and dermis of isolated embryonic mouse skin and then grafted onto nude mice. The papillae induced the formation of hair follicles which were larger than those of the host skin but smaller than vibrissa follicles. The potential of isolated dermal papillae to induce follicles with characteristics of those from which the papillae originated is discussed. One of the major factors affecting the sizes of induced follicles may have been related to the splitting of the papilla mass and dispersal of the cells by invading cords of epidermal cells from the host skin during induction. PMID- 3639120 TI - A management blueprint for nursing staff development. PMID- 3639121 TI - Developing a leadership program for charge nurses. PMID- 3639122 TI - Developing an instructional program for ESRD patients. A team approach. PMID- 3639123 TI - Contracting: a collaborative approach. PMID- 3639124 TI - Teaching communication skills. PMID- 3639125 TI - O-CHR pursuit of trivia: an orientation game. PMID- 3639126 TI - Bridging the gap: a new graduate nurse program that works. PMID- 3639127 TI - Perspectives on research. Research--front and center. PMID- 3639128 TI - Diminishing liability: laws and regulations. PMID- 3639129 TI - Organizational culture: how important is it? PMID- 3639130 TI - The multiple dimensions of staff nurse role conception. AB - Role expectations among staff nurses in hospitals have been linked to turnover and attrition from the profession and may be associated with phenomena such as absenteeism and burnout. A study was conducted in eight Midwestern hospitals to obtain an empirically based model of staff nurse role conception. Seven major components of the construct were identified, which included 12 different dimensions. Data from the study provided helpful information for nurse administrators in understanding the dynamics of the hospital work environment for staff nurses. Potential sources of role conflict are discussed. PMID- 3639132 TI - The role of the clinical nurse specialist: problems and solutions. AB - The clinical nurse specialist (CNS) is a generally untapped resource for the nurse executive. Although seen as an asset, the CNS may be considered an expensive and nonessential part of the department of nursing. The role is threatened with extinction not only because it is seen as dispensable in a time of cost restraint, but also because of problems in role implementation. We believe the CNS role is vital to the advancement of nursing practice and that the impact of the CNS on nursing practice has not reached its full potential. This paper summarizes the major problems inhibiting role development in the hospital setting and suggests solutions to the nurse executive for maximizing the role potential of the CNS. PMID- 3639131 TI - Professional behavior in collaborative practice. AB - Cost containment, increased severity of illness, earlier patient discharge, and high staff turnover are causing nurse executives to implement new systems of health care delivery. One such delivery system, collaborative practice, strives to maximize efficient and effective use of staff, to improve nurse retention, and to enhance patient care. The authors present one approach to implementing collaborative practice and the empirical findings related to the system's impact on physician-nurse professionalism. PMID- 3639133 TI - Orientation of nurse executives. AB - How were you oriented to your current position? If you're like 58% of the nurse executives who answered this survey, you had no formal, planned orientation to your new job. Realizing how critical the first few months in a new position are in shaping attitudes and values, the author discusses how a random sample of nurse executives felt about their orientation. The author makes suggestions, to both relocating nurse executives and the employers of a top level nurse administrator, for structuring an effective orientation program. PMID- 3639134 TI - The effect of primary nursing on nursing quality assurance. PMID- 3639135 TI - Computerized care plans help nurses achieve quality patient care. AB - Well-conceived patient care plans are a crucial component of high quality nursing care. Writing care plans, however, can often be a difficult and time-consuming task. Computerization can significantly enhance the speed, quality, comprehensiveness, and effectiveness of creating patient-specific care plans. The benefits to nursing administrators include more efficient use of nursing resources, more effective use of nursing skills and expertise, and improved patient management. PMID- 3639136 TI - Using nursing models to guide nursing practice: key questions. PMID- 3639137 TI - RNs may cost less than you think. PMID- 3639138 TI - Alternative staffing plans. PMID- 3639139 TI - Building a case for decision making. PMID- 3639140 TI - Research and the staff nurse: troublesome issues. PMID- 3639141 TI - Promoting intrepreneurship in the acute care setting. AB - Seeking ways to generate revenue for both the institution and the nursing department, as well as to attract, retain, and motivate creative, bright nurse managers, the author developed a unique for-profit nurse consulting business venture. While providing new services, thus generating revenue, the consulting program also focuses on the wants and needs of the nursing staff. The author discusses program development and profit-sharing methodologies as well as some of the innovative projects marketed by her nurse managers. PMID- 3639143 TI - The health care team: a physician's perspective. PMID- 3639142 TI - National survey of factors contributing to and hindering the successful practice of nurse-midwifery. Summary of the American College of Nurse-Midwives Foundation Study. PMID- 3639144 TI - Midwifery and medicine in America. The struggle for justice in infant health. PMID- 3639145 TI - Maternity care: an international perspective. PMID- 3639146 TI - Special issues in nurse-midwifery: a look at the past and future. PMID- 3639147 TI - Euthanasia: drawing new distinctions. PMID- 3639148 TI - Grandmother's final decision. PMID- 3639149 TI - "God talk" is it healthy or unhealthy? PMID- 3639150 TI - Destination: Ethiopia: an ordinary nurse confronts extraordinary needs. PMID- 3639151 TI - Effect of wealth on approach to patient care. PMID- 3639152 TI - Normalizing the return to school of the child with cancer. PMID- 3639153 TI - Clinical problem: reward system for patients. PMID- 3639154 TI - Body image changes in amputee children: how nursing theory can make the difference. PMID- 3639155 TI - [Decrease in urinary excretion of active kallikrein in conscious young and adult spontaneously hypertensive rats]. AB - Urinary excretion of active kallikrein was determined every day (amidolytic assay) in 6 male Okamoto-Aoki spontaneously hypertensive rats (SHR) and 6 male normotensive Wistar-Kyoto rats (WKY) from ages 4 to 7 weeks and from 12 to 15 weeks. The rats were housed in individual metabolic cages and were allowed free access to food having normal sodium content and to tap water. Urinary kallikrein excretion was lower in 4-week-old SHR than in age-matched WKY (7.8 +/- 1.4 vs. 15.5 +/- 2.3 nkat/24 h respectively, P less than 0.01) at a moment when systolic blood pressure (BP) in SHR was already higher than in WKY. The slope of the increase in active kallikrein excretion from week 4 to 7 was not different for SHR and WKY (6.34 +/- 1.05 vs. 7.50 +/- 1.02 nkat/24 h-1 . wk-1 respectively). In contrast, from week 12 to 15, this slope was not significant for SHR (1.67 +/- 2.55 nkat/24 h-1 . wk-1) while it remained positive in WKY (7.36 +/- 3,44 nkat/24 h-1 . wk-1). In both SHR and WKY, urinary kallikrein excretion was directly related to BP from week 4 to 7 but the slope of the regression line was less for SHR than for WKY (0.19 +/- 0.05 vs. 0.48 +/- 0.12 nkat/24 h-1 . mm Hg respectively). From ages 12 to 15 weeks, kallikrein excretion was still related to pressure in WKY (y = 1.92 x - 180.8; r = 0.93) but not in SHR (y = 0.71 x - 81.48; r = 0.52).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3639157 TI - Patient selection and preparation techniques. Avoiding early dropouts. PMID- 3639156 TI - To bedlam and back. PMID- 3639158 TI - Present issues and future perspectives of psychosocial nursing. Theory and research. PMID- 3639159 TI - Interpersonal dimensions of illness. PMID- 3639160 TI - Endocytotic activity in the endometrium during conceptus attachment in the cow. AB - The uptake of horseradish peroxidase tracer injected into the uterine lumen of the cow was studied during the period of conceptus attachment (Days 18-21; Day 0 = oestrus) and also in cyclic animals. Endocytosis occurred in pregnant and non pregnant cows but was especially marked when circulating progesterone concentrations were high. By 20 min after injection, the tracer was located in apical endocytotic vesicles and in organelles of the lysosomal system. In addition, some of the horseradish peroxidase-containing vesicles were associated with the lateral membranes of the cells and the tracer was also present in the intercellular spaces and beneath the basal membrane, especially in pregnant animals by the time of conceptus attachment. There was no evidence that pinopod like functions could be attributed to large cytoplasmic protrusions from endometrial cells. Rather, the protrusions seemed to be involved in secretory processes. The presence of clear vesicles among the endocytotic vesicles suggested a coupled secretory-endocytotic activity of the cells, the significance of which remains to be determined. PMID- 3639161 TI - Nursing grand rounds: hyphema. PMID- 3639162 TI - Nursing grand rounds: von Hippel-Lindau disease. PMID- 3639163 TI - New instruments in the operating room. PMID- 3639164 TI - The "Schocket" procedure: anterior chamber tube shunt to an encircling band. PMID- 3639165 TI - Perspective on contact lenses. Dealing with rigid gas permeable problems. PMID- 3639166 TI - Preventing the spread of AIDS. PMID- 3639167 TI - [Decision making in nursing. 8. Afterthought on terminal care]. PMID- 3639168 TI - [Nursing theory. 8. Nursing theory by Parse (4): The meaning of the theory of a "life with emphasis on health"]. PMID- 3639169 TI - [The nurse and iatrogenic incidents: a court case concerning decubitus ulcer]. PMID- 3639170 TI - [An iatrogenic incident concerning decubitus ulcer: an appeal by the plaintiff. Interview by T. Yoshimi]. PMID- 3639171 TI - [An iatrogenic incident concerning decubitus ulcer: responsibility of nurses, an interview with Ms. Sachiko Ujiie, a witness for the plaintiff. Interview by T Yoshimi]. PMID- 3639172 TI - [An iatrogenic incident concerning decubitus ulcer. Hindrance to the development of the nursing profession: a review of the case]. PMID- 3639173 TI - [An iatrogenic incident concerning decubitus ulcer and standard nursing: problems involving current nursing practice]. PMID- 3639174 TI - [An iatrogenic incident concerning decubitus ulcer. Decubitus ulcer encountered at clinical scenes: a discussion]. PMID- 3639175 TI - [Reflection on interactions with clinical patients: the attitude in accepting and sympathizing with patients]. PMID- 3639176 TI - [Self help groups. 2. Alcoholism and an organization of former alcoholics]. PMID- 3639177 TI - [Record by a woman physician suffering from cancer. 8. Efforts to restore normal daily activity]. PMID- 3639179 TI - [Practice of Oriental medicine. 8. Etiology and internal and external symptoms]. PMID- 3639178 TI - [A monologue by a nursing director. Efforts for sincere human interactions]. PMID- 3639180 TI - [Clinical description of senile dementia. 16. Senile dementia and society]. PMID- 3639181 TI - [Introduction of POS to nursing. 11. Completion of a problem list and application of POS to each problem]. PMID- 3639182 TI - [Counseling of patients. 19. Bioenergetics: counseling methodology. 7]. PMID- 3639183 TI - [Nursing homes in New York. 8. Demanding and undemanding patients]. PMID- 3639184 TI - [Profile of a nurse. Ms. Reiko Kiryu who assists an organization of enterostomy patients]. PMID- 3639185 TI - [Night duties and clinical cases: difficulties encountered at each department]. PMID- 3639186 TI - [Night shifts, a test of nursing skill. Night shifts at the department of ophthalmology]. PMID- 3639187 TI - [Night shifts, a test of nursing skill. Night shifts and hospitalized children]. PMID- 3639188 TI - [Night shifts, a test of nursing skill. Experience in clinical training through night duties]. PMID- 3639189 TI - [Ward management during night shifts: a viewpoint of a nursing supervisor on duty]. PMID- 3639190 TI - [Hardship and enjoyment of night shifts. A discussion]. PMID- 3639191 TI - [Self-help groups. 3. An organization of patients with rheumatoid arthritis]. PMID- 3639193 TI - [A monologue by a nursing director. On love]. PMID- 3639194 TI - [Practice of Oriental medicine. 9. Positivity vs. negativity: deficiency vs. fullness; and cold vs. fever]. PMID- 3639195 TI - [Welfare and medical care in a graying society. 1. The concept of the aging society]. PMID- 3639192 TI - [A record by a woman physician suffering from cancer. 9. Development of intestinal obstruction and discovery of rectal cancer]. PMID- 3639196 TI - [Introduction of POS to nursing. 12. Division of the initial plan into 3 parts and starting with the therapeutic planning (care planning)]. PMID- 3639198 TI - [Nursing homes in New York. 9. Plain diet of the home]. PMID- 3639197 TI - [Counseling of patients. 20. Practice of bioenergetics. Counseling methodology. 8]. PMID- 3639199 TI - [Profile of a nurse: Ms. Kathleen Ann Paton of Australia, a supervisor of the operating room at Manly Hospital]. PMID- 3639200 TI - [Decision making in nursing. 9. Demand by a patient's family member outside the practice of nursing and perplexity experienced by a nurse]. PMID- 3639201 TI - [Nursing theory. 9. "Man-living-health", a theory by Parse. 5]. PMID- 3639202 TI - [Night shifts, a test of nursing skill. On standardization of night rounds]. PMID- 3639203 TI - [Night shifts, a test of nursing skill. A lesson in night duties at the department of internal medicine]. PMID- 3639204 TI - [Night shifts, a test of nursing skill. Night duties and new nursing graduates: nurturing a professional attitude at clinical scenes]. PMID- 3639205 TI - [Nursing issues in 1986. Be prepared for the 21st Century]. PMID- 3639206 TI - [Nurses in clinical setting: feeling helpless working with leper house]. PMID- 3639207 TI - [Feminism and nursing--can nursing afford to remain aloof from the women's movement?]. PMID- 3639208 TI - [Scholarship--a woman's perspective]. PMID- 3639210 TI - [Problems observed with ovarian cancer patients]. PMID- 3639209 TI - [Assessment of nursing administration by systematic thinking]. PMID- 3639211 TI - [Nursing issues in 1986. Nursing in health administration]. PMID- 3639212 TI - [Nursing issues in 1986. Standard nursing care in hospitals]. PMID- 3639213 TI - [Greetings at the beginning of 1986]. PMID- 3639214 TI - [Nursing issues in 1986. Issues in nursing education today]. PMID- 3639216 TI - [Nursing issues in 1986. Nursing research--analysis and creativity]. PMID- 3639215 TI - [Nursing issues in 1986. Coordination with other health professionals]. PMID- 3639217 TI - [Nursing issues in 1986. Status of nursing profession in health care system]. PMID- 3639219 TI - [Nursing issues in 1986. Public expectation of nurses]. PMID- 3639218 TI - [Nursing issues in 1986. Health education for community people]. PMID- 3639220 TI - [Verbs in our life--shame]. PMID- 3639221 TI - [Nursing and counseling]. PMID- 3639222 TI - [Bed sores--duty and responsibility of nurses]. PMID- 3639224 TI - [Care of the elderly in New York City]. PMID- 3639223 TI - [Medical topics: Prolactinemia in chronic uremia; Paget's disease of the bone]. PMID- 3639225 TI - [Nurses in clinical setting--patient's safety and alleviation of pain]. PMID- 3639226 TI - [Woman leaders--modern day heroines or social deviants]. PMID- 3639227 TI - [Clinical tests--are they all necessary ones: role of the nurse in alleviating patient's anxiety and pain toward tests]. PMID- 3639229 TI - [Nursing and way of living of women in a society with increased aged population]. PMID- 3639228 TI - [Nurses acts and trends in nurse practitioners' movement in U.S.A]. PMID- 3639230 TI - [Clinical tests--are they all necessary ones: nurses working with patients undergoing tests]. PMID- 3639231 TI - [A writer's self-diagnosis]. PMID- 3639232 TI - [Clinical tests--are they all necessary ones? Meaning of tests in dialysis nursing]. PMID- 3639233 TI - [Clinical tests--are they all necessary ones? Meaning of tests for terminal patients]. PMID- 3639234 TI - [Clinical tests--are they all necessary ones? Tests and ethics of medicine]. PMID- 3639235 TI - [Clinical tests--are they all necessary ones: are we conducting too many tests on patients?]. PMID- 3639236 TI - [Terminal care and depression]. PMID- 3639238 TI - [Verbs in our life--exclaim]. PMID- 3639237 TI - [Assessment of nursing administration by systematic thinking]. PMID- 3639239 TI - [Nursing and counseling]. PMID- 3639240 TI - [Medical topics: X-ray during pregnancy and neonate cancer; cotton dust and cancer]. PMID- 3639241 TI - [10 days in Bogota to care for disaster victims]. PMID- 3639242 TI - [Assessment of nursing administration by systematic thinking]. PMID- 3639243 TI - [Data processing in nursing. Planning nursing care by personal computer]. PMID- 3639244 TI - [On creativity in nursing]. PMID- 3639245 TI - [Nurse-patient relationship]. PMID- 3639246 TI - [Data processing in nursing. On-line support system for nurse work scheduling]. PMID- 3639247 TI - [Data processing in nursing. Injection ordering system]. PMID- 3639248 TI - [Data processing in nursing. Nursing service and computers]. PMID- 3639249 TI - [Data processing in nursing. Information system for hospitalized patients]. PMID- 3639250 TI - [Data processing in nursing. Personal computer in central sterilized supply]. PMID- 3639252 TI - [Nurses in clinical setting. Relating to psychiatric patients]. PMID- 3639253 TI - [Verbs in our life--the sun rises, the sun sets]. PMID- 3639251 TI - [Data processing in nursing. Data processing in ICU]. PMID- 3639254 TI - [A letter from Miss Virginia Henderson]. PMID- 3639255 TI - [Medical topics: non-steroid anti-inflammatory drugs; cowpox infection from cats]. PMID- 3639256 TI - [Components of the blood kallikrein-kinin system in patients with uncomplicated and complicated myocardial infarct]. PMID- 3639257 TI - [PMN elastase determination in tear fluid in corneal ulcer]. AB - The PMN-Elastase concentration in tear fluid was determined in 87 persons without eye disease and compared with the PMN-elastase values of 28 patients with ulcus corneae. A significant increase in the PMN-elastase concentration was found in patients with ulcus corneae (means = 1196 micrograms/l) in comparison with the control group (means = 73 micrograms/l). The lapse control shows that the PMN elastase values in the tear fluid of patients with ulcus corneae are elevated for a number of weeks, even though there are clinical signs of healing of the ulcer. The determination of PMN-elastase in tear fluid represents a new parameter indicating the real end of the inflammatory processes in the eye. PMID- 3639258 TI - [Inactivation of HTLV-III/LAV by UV irradiation and chemical disinfection]. AB - The principle and technical design of a simple UV sterilization device for applanation tonometer bodies is described. Time-dose relations effective against HTLV-III-LAV are given. PMID- 3639259 TI - [Ultrastructural manifestations of intravascular coagulation and the role of the kallikrein-kinin system in the pathogenesis of cardiogenic pulmonary edema]. PMID- 3639260 TI - [Status of the kallikrein-kinin system of the blood in patients with angina pectoris]. PMID- 3639261 TI - [Ethical dilemma in nursing (1). A basic stock of ethical perceptions]. PMID- 3639262 TI - [Within the framework of an AFS-program in Spain: impressions from the Catalan capital]. PMID- 3639263 TI - [Considerations on nursing education on the university level]. PMID- 3639264 TI - [Unicef-project: the Swiss Nursing Association appeals to its members: fight against the most dangerous communicable diseases. Interview by Nelly Haldi]. PMID- 3639265 TI - [New technics in oncology. The implantable chamber or indwelling catheter]. PMID- 3639266 TI - [The portable pump for continuous perfusion]. PMID- 3639267 TI - [Patient isolators]. PMID- 3639268 TI - [A decision by the Federal Tribunal of Insurances. Indemnification according to rate schedule rather than lump sum for "home care"]. PMID- 3639269 TI - [Care outside the hospital. The health visit. Evaluation and perspectives]. PMID- 3639270 TI - [Swiss Cystic Fibrosis (mucoviscidosis) Association. 20 years of existence]. PMID- 3639271 TI - Long term management of pregnancy in a comatose patient. PMID- 3639272 TI - Nissen fundoplication for gastroesophageal reflux in infants. AB - Some degree of gastroesophageal reflux is very common in infants and tends to reverse with time. Therefore, the indications for an antireflux operation are not well defined. Furthermore, the complication rate and the ability of the fundoplication to grow remain to be determined. To answer these questions, we reviewed the records of patients 6 months of age or younger who underwent a Nissen fundoplication with gastrostomy tube placement between 1979 and 1985. There were 45 patients (25 boys and 20 girls) with birth weights of 0.65 to 4.3 kg. The consequences of gastroesophageal reflux were more varied than in older children. Severe respiratory problems were common, including recurrent aspiration or bronchopulmonary dysplasia in 60% and frequent apneic and bradycardiac spells in 17%. Failure to gain weight was present in 20% and intractable vomiting in 2.0%. As expected, 78% of these patients had congenital anomalies or acquired problems which, in many cases, were important to the prognosis. The diagnosis was confirmed by barium swallow in all but one patient in whom gross reflux during feedings was present. Initially, medical management was tried for 3 to 4 weeks. In one patient, however, the severity of the respiratory problems precluded trial beyond 12 days. The recommendation for operation was based only on the severity of symptoms attributed to gastroesophageal reflux. All patients underwent Nissen fundoplication with gastrostomy tube placement at 2 weeks to 6 months of age and weighing 1.02 to 6.95 kg. The only surgical complication was one gastrostomy leak. Prematurity or preexisting anomalies led to a 20% incidence of late unrelated deaths between 2 weeks and 23 months postoperatively. Improvement in symptoms occurred in our survivors with follow-up of 5 to 72 months. We conclude: Significant gastroesophageal reflux in infancy most frequently produces respiratory problems that can be life threatening. Nissen fundoplication can be a safe and effective procedure in infants 6 months of age or younger. Fundoplication appears to have good growth potential, and no late complications or feeding problems have occurred. Consequently, surgical correction can be recommended for infants not responding to conservative medical therapy. PMID- 3639273 TI - Fourth-party audit organizations: practical and legal considerations. PMID- 3639274 TI - Corporate restructuring of tax-exempt hospitals: the bastardization of the tax exempt concept. PMID- 3639275 TI - Legal views of the malpractice crisis. In search of the "lawsuit crisis". PMID- 3639276 TI - Legal views of the malpractice crisis. Tort reform from within. PMID- 3639278 TI - Money matters. PMID- 3639277 TI - A small injection of capital. PMID- 3639279 TI - Complementary therapies. PMID- 3639280 TI - Assessment of the use of Bengali health aides. PMID- 3639281 TI - The constantly crying child. PMID- 3639282 TI - Understanding Asian women in pregnancy and confinement. PMID- 3639283 TI - Vitamin A deficiency and connective tissues: a new etiological approach. AB - A unifying concept, that the impairment of connectives tissue, owing to the effect of immigrant cells, is at the basis of the pathogenesis of Vitamin A deficiency has been considered. Changes in various tissues and organs have been reviewed in the light of the recent discoveries in the field of histology (1). An effort has been made to link the various symptoms of Vitamin A deficiency to those related to other pathologies where connective tissues are involved, and to suggest a plan for research to be undertaken to achieve a better knowledge of the etiology of Vitamin A deficiency. PMID- 3639284 TI - Stomach cancer in Japan: relationship to a common folk remedy? PMID- 3639285 TI - The use of sodium and potassium to reduce toxicity and toxic side effects from lithium. AB - Studies in rats find that the animals develop toxic side effects at serum levels which are therapeutic for man. Most of the toxic effects were prevented by feeding sodium and potassium. The rats must ingest and excrete comparatively higher amounts of lithium than humans to maintain these levels. Sodium used alone has been shown to reduce side effects in man, but was found to reduce therapeutic effectiveness at fixed lithium dosages. Evidence is presented to suggest that therapeutic effectiveness can be maintained and toxic side effects and risk of toxicity reduced, by using both sodium and potassium, and by modestly raising the dosage of lithium. PMID- 3639286 TI - Toward a unified theory of disease: understanding the aging process. AB - Medicine is complex and multi-disciplined with each speciality trying to cure specific illness in their fields of interest. Research would be more productive if there was a common denominator applicable to all medical specialties--i.e., a unified theory of disease. Of the seventy-two leading causes of death in the United States in 1980, there was a direct relationship with age, after age four, for virtually all causes of death per 100,000 population. Understanding the genetics of the aging process and developing capacities to manipulate such factors could revolutionize medicine by giving it a working unified theory applicable to all its disciplines. PMID- 3639287 TI - A unified hypothesis for the histogenesis of the soft tissue sarcomas of unknown origin. AB - At the present time there is still a group of soft tissue sarcomas with an unknown origin. These occur most frequently in the extremities and include the following sarcomas: clear cell, alveolar, synovial, epithelioid, chordoid and small round cell. Most of the studies directed to find their histogenesis are based on finding similarities between normal embryonic or mature tissues of the tenosynovial region and these tumors at the ultrastructural and immunohistochemical level searching for specific markers. In this sense, the results are confusing and the common or different cells responsible for these sarcomas have not yet been isolated. In the present hypothesis it is proposed that the common progenitor of these malignancies is an ectomesenchymal derived tissue related to the tendons, aponeuroses, synovia and menisci called chondroid tissue or pseudocartilage; the evolutionary reasons that support this hypothesis are also discussed here. This also emphasizes the possibility that these sarcomas originate in phylogenetic mature remains and not in the reactivation of embryological cellular groups (Cohnheim's theory). PMID- 3639288 TI - Inflammation spurts: the role of ground substance viscosity. AB - A cyclical phenomenon of spurting polymorphonuclear leukocytes occurs in a number of skin diseases. The phenomenon is easy to observe because the polymorphonuclear leukocytes move into the epidermis and away from the vascular area. It is proposed that repeated spurting of polymorphonuclear leukocytes may be a broad biologic phenomenon. Edema appears essential to initiate the phenomenon by diluting the tissue fluids. The chemicals released by inflammation decrease ground substance viscosity and therefore interfere with dilution of tissue fluids. This stops the mediation of inflammation. The polymorphonuclear leukocytes also release connective tissue activating peptides which lead to increased glycosaminoglycans production and stimulate fibroblast to proliferate. The tissue activating peptides thus restore the viscosity of the ground substance and the cycle can be repeated. What we interpret as chronic inflammation could be the result of this repeated spurting phenomenon. PMID- 3639289 TI - Experimental design for vaccine preparations against human malignant tumors. AB - The cancer cell is immunoresponsive and indirectly immunocompetent cell inserting itself in an extremely delicate system of natural antibodies and their respective anti-idiotypes. In regulatory sense it mimicks--in the Richter's model of immune system function--second order of response by antigenic cell surface product of malignant transformation, acting functionally as incomplete anti-idiotypic antibody (homobody) with exteriorized tumor antigen. It successfully competes with the natural anti-idiotypic antibodies replacing their repressive function by inducive one, and by doing so, changing natural antibody response by two orders of magnitude. The proposed experimental design would hybridize in separate experiments in one molecule: anti-HLA and anti-tumor xenogeneic antibodies obtained from animals and used for passive immunization; unaltered tumor antigen with organ-specific histocompatibility antigen having a preserved capacity of associative recognition. The latter process of humoral exteriorization of antigens would be elicited in animals and these immunoglobulin molecules (homobodies) would be used in humans for active immunization or in isogeneic animals for a production of antisera for passive immunization. Both these types of immunization would revert deranged immunological response in the cancer patient back to its normal order. Appropriate absorptions at critical steps would assure high specificity of the antisera. PMID- 3639290 TI - Human immunodeficiency virus in Minnesota: statewide risk reduction and disease prevention plan. PMID- 3639291 TI - Patient education: a unit-based programme. PMID- 3639292 TI - Sister/staff nurse and the nurse learner. PMID- 3639293 TI - Learning theories and the ward tutorial. PMID- 3639294 TI - Assessing the development of clinical nursing skills. PMID- 3639295 TI - Nursing research in Britain: the state of the art. PMID- 3639296 TI - The professional standing of nurse teaching: a review of the literature. PMID- 3639297 TI - Do conferences serve a useful purpose? PMID- 3639298 TI - Midwifery training: the views of newly qualified midwives. PMID- 3639299 TI - The impact of the nursing process on the role and function of the clinical teacher. PMID- 3639300 TI - Writing a research article. PMID- 3639301 TI - Issues raised by the use of nursing models in psychiatry. PMID- 3639302 TI - Ethnography: a tool for learning. PMID- 3639303 TI - Music in the classroom. PMID- 3639304 TI - Preventing possible HTLV-III contamination from EEG electrodes. PMID- 3639305 TI - Acute geriatric problems--medical. PMID- 3639306 TI - Medication: guidelines for health professionals. PMID- 3639307 TI - Guidelines to research in nursing: an introduction to sampling and statistical concepts. PMID- 3639309 TI - Family planning and sexuality. PMID- 3639310 TI - The sun--friend or foe? PMID- 3639308 TI - [Nursing assessment: physical examination--examination technics]. PMID- 3639311 TI - Post-operative pain control. PMID- 3639312 TI - Nursing intervention during the life-cycle. PMID- 3639313 TI - [Psychological reactions and aspects of disasters]. PMID- 3639314 TI - Introducing supplemental foods into a baby's diet. PMID- 3639315 TI - Staff development--whose responsibility? PMID- 3639316 TI - Educating the educators. PMID- 3639317 TI - Lasker prizes. Threesome gain AIDS award. PMID- 3639318 TI - Human immunodeficiency virus: an unacceptable term. PMID- 3639319 TI - Pricing the nursing product: charging for nursing care. PMID- 3639320 TI - Serving as an expert witness. PMID- 3639321 TI - Dispelling myths about for-profit health care. PMID- 3639322 TI - Opportunities for nurses in utilization review. PMID- 3639323 TI - Patient classification in ambulatory care. PMID- 3639324 TI - [AIDS in the Netherlands in 1986]. PMID- 3639325 TI - Unacceptable for nurses to refuse to care for AIDS patients. PMID- 3639326 TI - Royal College of Nursing. Plunging morale. PMID- 3639327 TI - Change outdated and biased attitudes to care of elderly. PMID- 3639328 TI - Political big time. PMID- 3639329 TI - Helping hospitalized diabetic patients. PMID- 3639330 TI - Decreased cardiac output from Valsalva maneuver. PMID- 3639331 TI - The latest protocols for blood transfusions (continuing education credit). The Committee on Transfusion Practices. PMID- 3639332 TI - Avoid the perils of "misinformed" consent. PMID- 3639333 TI - The family loved Sammy but hated each other. PMID- 3639334 TI - Tracking your outpatient's E.K.G. with a Holter monitor. PMID- 3639335 TI - Drug compliance: going beyond the facts. PMID- 3639336 TI - CPR: breathing life back into a child. PMID- 3639337 TI - Some pointers on needle safety. PMID- 3639338 TI - Does specialty certification merit a salary differential? PMID- 3639339 TI - Careful, they might hear you. PMID- 3639340 TI - Wrongful discharge: how to avoid it. PMID- 3639341 TI - Letting go. PMID- 3639342 TI - Food intolerance: fact or fallacy? PMID- 3639343 TI - Food additives. PMID- 3639344 TI - The nurses' role in nutrition education. PMID- 3639345 TI - Nutrition in health and illness. PMID- 3639346 TI - Law for the nurse manager. Informed consent. PMID- 3639347 TI - Outcome and accountability: getting into the consumer dimension. PMID- 3639348 TI - The cost of supervisory services. PMID- 3639350 TI - Discipline: facing up to imposing sanctions. PMID- 3639349 TI - Staff participation in nursing quality assurance. PMID- 3639351 TI - A 13-hour shift. PMID- 3639352 TI - Patient classification: cutting the margin of human error. PMID- 3639354 TI - Nurse retention: adjusting to the job revolution. PMID- 3639353 TI - Indirect hours of care per patient per day in a Midwest extended care facility. PMID- 3639356 TI - Clinical ladder: it's skill--not degrees--that count. PMID- 3639355 TI - Orientation: off toward a nurse's "personal best". PMID- 3639357 TI - Peer review assures quality care. PMID- 3639358 TI - Work designs: nurse-managed hypertension care. PMID- 3639359 TI - First-line managers: training on the cutting edge. PMID- 3639360 TI - Sister Angelique "blows the whistle".... PMID- 3639362 TI - Night shift: an associate coordinator for staff development. PMID- 3639361 TI - Documentation: designing forms that serve you. PMID- 3639364 TI - The role of nursing and midwifery personnel in the strategy for health for all. Progress report by the Director-General. PMID- 3639363 TI - Nursing supervision: a contemporary model. PMID- 3639365 TI - [The pharmacist facing bioethics. International Federation of Catholic Pharmacists]. PMID- 3639366 TI - Human artificial procreation. PMID- 3639367 TI - First aid at work under review. PMID- 3639369 TI - Selling OH. Selling your OH service. PMID- 3639368 TI - Fluorosis in welders? PMID- 3639370 TI - Selling OH. Management's needs. PMID- 3639371 TI - Selling OH. Costing an OH service. PMID- 3639372 TI - Lifting advice on videotape. PMID- 3639373 TI - Clinical supervision in psychiatric nursing. PMID- 3639374 TI - Who's staffing Ohio nursing homes? A challenge for gerontological nursing. PMID- 3639375 TI - [How well informed are patients at the time of their discharge?]. PMID- 3639376 TI - [Disposal of hospital refuse]. PMID- 3639377 TI - [Peace and charity]. PMID- 3639378 TI - [Pediatric nursing in Great Britain]. PMID- 3639379 TI - Financially speaking. Developing a net worth statement. PMID- 3639380 TI - A home discharge program for ventilator-assisted children. PMID- 3639381 TI - PNPs: case managers for technology-dependent children. PMID- 3639382 TI - Nursing care plan: home management of children with BPD. PMID- 3639384 TI - Pediatric abdominal assessment. PMID- 3639383 TI - Sleep patterns of breast-fed and nonbreast-fed infants. PMID- 3639385 TI - School-based adolescent health-care programs. PMID- 3639386 TI - Pediatric management problems (torticollis). PMID- 3639387 TI - New guidelines for pediatric & neonatal cardiopulmonary resuscitation & advanced life support. Part I: Basic CPR for adults & children. PMID- 3639388 TI - Calcium channel blockers. PMID- 3639389 TI - Hospitals & home care: inseparable in the '80s. PMID- 3639390 TI - Practice management. Establishing specialized programs. PMID- 3639392 TI - Faculty-curriculum development. Curriculum design by nursing faculty. PMID- 3639391 TI - [Functional state of the thyroid in premature children with early anemia]. PMID- 3639393 TI - The "what," "why" and "when" of evaluation. PMID- 3639394 TI - Curriculum process--problems and concerns. PMID- 3639395 TI - The need for and concerns relating to curriculum evaluation. PMID- 3639396 TI - Curriculum evaluation for today and tomorrow. PMID- 3639397 TI - Curriculum evaluation--methods and tools. PMID- 3639398 TI - The "who" in curriculum evaluation. PMID- 3639399 TI - Accreditation and the evaluation process. PMID- 3639400 TI - The meaning, and functions of concepts and theories within education and nursing. PMID- 3639401 TI - Composite of program and/or terminal behavior objectives of baccalaureate nursing programs. PMID- 3639402 TI - Education trends which influenced the development of the conceptual framework within the curriculum. PMID- 3639403 TI - Today's conceptual frameworks within baccalaureate nursing programs. PMID- 3639404 TI - The conceptual framework and its influence on learning experiences. PMID- 3639405 TI - The conceptual framework as a component of curriculum development. PMID- 3639406 TI - The conceptual framework as part of the curriculum process. PMID- 3639407 TI - Identifying changes and priorities in social and health care needs. PMID- 3639408 TI - Education trends and the integrated curriculum approach in nursing. PMID- 3639409 TI - The integrated curriculum and nursing education. PMID- 3639411 TI - Implications for evaluation in an integrated curriculum. PMID- 3639410 TI - Curriculum process and the integrated curriculum. PMID- 3639412 TI - The integrated curriculum--problems and concerns in the world of specialization. PMID- 3639414 TI - Changes in nursing service that affect baccalaureate nursing programs. PMID- 3639413 TI - Three factors of significance to baccalaureate nursing education. PMID- 3639415 TI - Changes in community nursing service that affect baccalaureate nursing programs. PMID- 3639416 TI - Curriculum implications of the changing role of the professional nurse. PMID- 3639417 TI - Offering learning experiences that reflect the changing role of the professional nurse. PMID- 3639418 TI - Curriculum development process. PMID- 3639419 TI - Curriculum revision--the what, when, why, and who. PMID- 3639420 TI - The philosophy as part of the total curriculum process. PMID- 3639422 TI - The conceptual framework in nursing education. PMID- 3639421 TI - Comments on identifying changes and priorities in social and health care needs. PMID- 3639423 TI - The development of behavioral objectives through curriculum strands. PMID- 3639424 TI - Curriculum design and approaches to nursing courses and content. PMID- 3639425 TI - Learning experiences within and outside the classroom. PMID- 3639426 TI - Some components of curriculum evaluation. PMID- 3639427 TI - The implications for curriculum of changes in the health care system. PMID- 3639428 TI - The evolution of curriculum planning. PMID- 3639429 TI - Higher education and curriculum issues. PMID- 3639430 TI - Model for the utilization of the curriculum process. PMID- 3639431 TI - Patients and purse strings. Patient classification and cost management. PMID- 3639432 TI - Identifying orthopaedic nursing costs. PMID- 3639433 TI - A patient classification system for rehabilitation nursing. PMID- 3639434 TI - A patient classification tool for maternity services. PMID- 3639435 TI - Pitfalls of using patient classification systems for costing nursing care. PMID- 3639436 TI - Developing cost awareness in nursing students. PMID- 3639437 TI - Development of a patient classification system for home health nursing. PMID- 3639438 TI - Developing a patient classification system: a case study. PMID- 3639439 TI - Cost management through caseload/workload analysis. PMID- 3639440 TI - Ser-tRNAs from bovine mitochondrion form ternary complexes with bacterial elongation factor Tu and GTP. AB - Transfer ribonucleic acids were isolated from mitochondria of bovine heart and aminoacylated in vitro by a crude mitochondrial enzyme. Ser-tRNASerUCN and Ser tRNASerAGY were isolated and characterized by partial sequencing. Although these tRNAs possess unique structural features not found in any bacterial tRNA, they form a ternary complex with elongation factor from the extreme thermophilic bacterium Thermus thermophilus and GTP. PMID- 3639441 TI - A methionine tRNA gene from lupine mitochondria. PMID- 3639442 TI - Assessing nurses. 2. Assessing nursing competencies. PMID- 3639443 TI - South Africa: nursing on the frontline. PMID- 3639444 TI - South Africa: broken links. PMID- 3639446 TI - Going, going, gone? PMID- 3639445 TI - Meningitis: on the track of a killer. PMID- 3639447 TI - Quality assurance. Rest assured. PMID- 3639448 TI - Quality assurance. The methods of measuring quality. PMID- 3639449 TI - Terminal illness: love and death. PMID- 3639450 TI - A question of ethics. PMID- 3639451 TI - Tailor made for the job? PMID- 3639452 TI - Danger: men at work. PMID- 3639453 TI - Project 2000. The Scottish experience. PMID- 3639455 TI - Child care. Changing nappies. PMID- 3639454 TI - Child care. Open hours. PMID- 3639456 TI - Generating confidence. PMID- 3639457 TI - Australia: Bondi bound. PMID- 3639458 TI - Israeli nurses: out in force. PMID- 3639459 TI - Man's best friends. PMID- 3639461 TI - Cancer nursing. A special friend. PMID- 3639460 TI - Cancer nursing. One day at a time. PMID- 3639462 TI - Extra hands or extra problems? PMID- 3639463 TI - Lending an ear. PMID- 3639464 TI - Calculating drug dosages. PMID- 3639465 TI - Splinting materials: getting plastered. PMID- 3639466 TI - Secrets of the group. PMID- 3639467 TI - Quality assurance: taking action. PMID- 3639468 TI - Project 2000. Supporting the aged. PMID- 3639469 TI - CINNews. Computers in Nursing News. PMID- 3639470 TI - Computers in nursing. Spreading the load. PMID- 3639471 TI - Computers in nursing. If you want something done.... PMID- 3639472 TI - Labour of love. Interview by Laurence Dopson. PMID- 3639473 TI - No place to die. PMID- 3639474 TI - Recruitment: London calling. PMID- 3639475 TI - Invisible mending. PMID- 3639476 TI - Wound care. Charting wound healing. PMID- 3639477 TI - Look after yourself. PMID- 3639478 TI - Psychogeriatric nursing in 2005. PMID- 3639479 TI - Nursing in Africa. Rosemary and Robbie. PMID- 3639480 TI - Performance indicators. PMID- 3639481 TI - Guarding the perineum. PMID- 3639482 TI - A word in your ear. PMID- 3639483 TI - On the frontline. PMID- 3639485 TI - Midwives' Journal. PMID- 3639486 TI - Midwives' Journal. Dispelling the myths on direct entry training. PMID- 3639484 TI - Project 2000. The Project's handicap. PMID- 3639488 TI - Midwives' Journal. A document of the past. PMID- 3639489 TI - Midwives' Journal. Getting closer to the 'Vision'. PMID- 3639487 TI - Midwives' Journal. Refresher courses from experience. PMID- 3639491 TI - HTLV-III infection. A clinical approach to diagnosis and treatment of the 'AIDS virus'. AB - The retrovirus human T cell lymphotropic virus type III (HTLV-III) can cause no symptoms at all, a syndrome of vague symptoms such as fever and fatigue, or full blown acquired immune deficiency syndrome (AIDS). Serologic tests for antibodies to HTLV-III are available for identifying the virus; tests for T lymphocyte subset numbers and function and white cell count are also helpful. Management of patients with the virus depends on clinical presentation: Patients who are asymptomatic carriers need only reassurance and follow-up, patients with mild illness need symptomatic treatment and monitoring, and patients with full-blown AIDS need increasing levels of physical and emotional supportive care. Through early diagnosis, treatment when needed, and patient education, primary care physicians can be instrumental in curtailing the spread of HTLV-III infection. PMID- 3639490 TI - Antibiotic-resistant pneumococcal disease in children at Baragwanath Hospital, Johannesburg. AB - Seventeen of 60 cases of pneumococcal bacteremia in children at Baragwanath Hospital in 1983 were caused by strains not fully susceptible to penicillin G. Eight strains had minimal inhibitory concentrations of greater than 1 microgram/ml and five were resistant to four or more antimicrobial agents. Only three isolates were resistant to chloramphenicol. Antibiotic-resistant strains occurred in younger children with a mean age of 13.1 months compared with a mean age of 31.6 months in children with susceptible strains (P less than 0.01). Underlying conditions, including nutritional status, did not correlate with antibiotic resistance of isolates from blood. Some of the resistant strains were apparently community-acquired. Of 3379 nasopharyngeal swabs taken from hospitalized children 829 yielded pneumococci and 408 of these carrier strains were either relatively or fully resistant to penicillin while 241 were resistant to four or more antibiotics. Multiply resistant strains from patients and carriers belonged to serovars 6A, 6B and 19A. PMID- 3639492 TI - Practicing autonomously: a comparison of nurses. PMID- 3639493 TI - Comparison of the clinical practice of a geriatric nurse practitioner and two internists. PMID- 3639494 TI - Identifying needs and community resources in arthritis care. PMID- 3639495 TI - An evaluation of consistency in baccalaureate public health nursing education. PMID- 3639496 TI - Health promotion in Zaire: time perspective and cerebral hemispheric dominance as relevant factors. PMID- 3639498 TI - Stream analysis: a method for planning and directing change (continuing education credit). PMID- 3639497 TI - [Effect of prodectin on the activity of the blood kallikrein-kinin system in diffuse toxic goiter]. AB - Elevated activity of the blood kallikrein-kinin system with the predominance of kinin formation over inactivation was recorded in 65 patients with diffuse toxic goiter. The use of prodectin (pyridinolcarbamat), kinin antagonist, caused a decrease in the activities of the kallikrein-kinin system and improved the clinical course of the disease. The results obtained give evidence in favour of this preparation being included into the multiple modality treatment of diffuse toxic goiter. PMID- 3639500 TI - Developing an educational exchange program. PMID- 3639499 TI - An administrative preceptorship in the operating room: one student's experience. PMID- 3639501 TI - Strategic service units: a collaborative model for cost containment. PMID- 3639502 TI - A profile of operating room nurse managers. PMID- 3639503 TI - An application of Levine's conceptual model. PMID- 3639504 TI - Professional survival tips: a guide to administering investigational drugs. PMID- 3639505 TI - Research: theory development in nursing. PMID- 3639506 TI - Ethical inquiry in nursing: the definition and method of biomedical ethics (continuing education credit). PMID- 3639507 TI - Ethical issues in perioperative nursing practice. PMID- 3639508 TI - Using ethical reasoning to guide clinical decision making. PMID- 3639509 TI - Communicating about ethical issues. PMID- 3639510 TI - The ethics of refusal: nurses' rights and responsibilities. PMID- 3639511 TI - Creating a nursing ethics committee: content and process (continuing education credit). PMID- 3639512 TI - Professional survival tips: basing your practice decisions on research. PMID- 3639513 TI - Research: why knowledge about sampling is important. PMID- 3639514 TI - The role of values in health care. PMID- 3639515 TI - Kallikrein-kinin system and prostaglandins interactions: relevant to hypertension. PMID- 3639516 TI - [Emotional disturbances in children]. PMID- 3639517 TI - [Information in the department]. PMID- 3639518 TI - [The infant in the nursery]. PMID- 3639519 TI - [At summer camps]. PMID- 3639520 TI - [Calendar of prophylactic inoculations]. PMID- 3639521 TI - [Breast feeding]. PMID- 3639522 TI - [The child with diabetes]. PMID- 3639523 TI - [Informing patients]. PMID- 3639524 TI - [Not settling for a zloty coin...]. PMID- 3639526 TI - [The specialization of nurse midwives]. PMID- 3639525 TI - [Among our Swedish colleagues]. PMID- 3639527 TI - [Ankylosing inflammation of the vertebral articulations]. PMID- 3639528 TI - [How to reduce the personnel shortage]. PMID- 3639529 TI - [The charge nurse as manager of the team]. PMID- 3639530 TI - When nurse says "stop calling": disaster. PMID- 3639531 TI - Unresponsive staff: liability for injury. Case in point: Keeton v. Maury County Hospital (713 S.W. 2d 314--TN). PMID- 3639532 TI - Legal case briefs for nurses. MN: Narcotics taken: license suspension. MO: patient commits suicide: liability. PMID- 3639534 TI - The case study: a viable approach to clinical research. AB - The case study, although associated with several misconceptions which compromise its effective utilization, is especially appropriate for investigation of clinical nursing problems. A literature review of the application of this research approach in other practice-based disciplines was completed. Results indicate that the case study permits focusing upon the individual in an intensive, longitudinal perspective, and facilitates bridging of the research practice gap. Internal and external validity, considered especially problematic in case studies, can be maximized by a variety of techniques. PMID- 3639533 TI - Psychiatric patients: voluntary & involuntary admissions. Case in point: in the matter of Tyrone Blair (510 A. 2d 1048--DC). PMID- 3639535 TI - Use of water pillows in reducing head shape distortion in preterm infants. AB - The purpose of this study was to determine the effectiveness of a water-pillow treatment in reducing bilateral head flattening of preterm infants. The subjects were 21 healthy infants of less than 36 weeks gestational+ age. Care of the experimental babies included supporting the head on a small water pillow and supporting the torso at the same level to avoid flexion or curvature of the spine; the control group received customary care. The ratios of the anterior posterior diameter to the biparietal diameter were significantly different for the two groups (p less than .0005). The heads of the control infants became flattened on both sides, while those of the experimental babies maintained the round shape they had at admission to the unit. The findings support the use of a small water pillow, in combination with support for the torso, as a means of alleviating bilateral head flattening in preterm infants. PMID- 3639536 TI - Effect of early postpartum teaching on primiparas' knowledge of infant behavior and degree of confidence. AB - The purpose of this experimental study was to determine the effectiveness of teaching primiparous mothers about infant behavior. Experimental mothers (n = 17) received a teaching intervention representative of the Brazelton Neonatal Behavioral Assessment Scale when their infants were 2 weeks old; contrast mothers (n = 16) completed a Newborn Information Checklist about infant behavior at home two weeks postnatally; control mothers (n = 13) received neither teaching nor a checklist. At a 4-week postnatal office visit, experimental mothers had more knowledge about infant behavior than either the contrast or control mothers. There was no difference among the groups regarding maternal confidence in interpreting behavioral cues of their own infant. Contrast mothers reported wanting information about topics included in the teaching intervention. PMID- 3639537 TI - Effects of health teaching in the workplace on women's knowledge, beliefs, and practices regarding breast self-examination. AB - This study had two primary purposes: to examine the effects of group and individual teaching by nurses in the workplace on 140 female office employees' health knowledge, beliefs, and practices regarding breast self-examination and to identify factors associated with frequency of practice. Skill in technique, confidence in the skill, and frequency of breast self-examination increased significantly with both teaching formats, but there were areas of technique that needed further improvement. Perceived susceptibility to breast cancer and perceived benefits of breast self-examination increased significantly only with individual teaching; knowledge was not increased with either teaching format. PMID- 3639538 TI - Response time and health care learning of elderly patients. AB - The purpose of this study was to determine if elderly patients perform better in health care learning when provided slower or self-paced response conditions. The sample consisted of 105 institutionalized elderly people randomly assigned to three response groups: fast-paced, slow-paced, and self-paced. After nutrition instruction, learning performances of each of the three groups were measured. Learning performances under the fast- and slow-paced conditions did not differ; learning performances under the self-paced condition was superior to the two experimenter-paced conditions. Findings of this study document that a self-paced response condition is advantageous for elderly patients. PMID- 3639539 TI - Maternal anxiety and sensitive mothering behavior in diabetic and nondiabetic women. AB - To evaluate the effects of a high-risk pregnancy on development of the maternal infant relationship, the differences in anxiety, sensitive maternal behavior, and maternal separation anxiety in diabetic and nondiabetic mothers were examined. The findings imply that a high-risk pregnancy may not always be accompanied by increased anxiety or disturbances in sensitive maternal behavior. Questions are raised regarding the influences of demographic factors on maternal behavior and the differences that chronic versus sudden onset high-risk pregnancy factors might have on maternal anxiety and behavior. The findings also reinforce the influence of supportive medical and nursing care throughout a high-risk pregnancy. PMID- 3639540 TI - Personal control and coping effectiveness in spinal cord injured persons. AB - The relationship between personal control and coping effectiveness was studied in a convenience sample of 104 hospitalized spinal cord injured males. Control was conceptualized as participants' preference to control, their generalized expectation for control, and their perception of options to control. Depression was used as an indicator of level of coping effectiveness. Demographic data and participants' trait anxiety were included as possible correlates of the variables of interest. For those who preferred to control, perceived options to do so were negatively related to levels of depression regardless of locus of control orientation. Depression scores were unrelated to expected or perceived control for those without such a preference. Findings indicate that the significance of having control is an individualized matter. Detailed assessments may need to be devised if patients are to obtain maximum benefit from participating in their own care. PMID- 3639541 TI - [Multi-resistant Staphylococcus aureus]. PMID- 3639542 TI - The cultural impact of the 'AIDS' test: the American experience. AB - In March 1985 an ELISA test for serum antibodies to human T-cell leukemia/lymphotropic virus type III (HTLV-III) was licensed for use in screening commercial blood products. Controversy over the appropriate use and interpretation of this test continues, and some public health officials in the United States have advocated different counselling strategies for high and low risk individuals with the same test results. The response to AIDS illustrates that contagion has a social definition, even in the context of Western scientific medicine. PMID- 3639543 TI - [Ventolin--measured aerosol]. PMID- 3639544 TI - [The principal diuretics and their presentation]. PMID- 3639545 TI - [The nurses blaze the trail]. PMID- 3639546 TI - [Ways and points of impact of the effect of diuretics]. PMID- 3639547 TI - [Diuretics in heart failure]. PMID- 3639548 TI - [Use of diuretics in the treatment of arterial hypertension]. PMID- 3639549 TI - [Adverse effects of diuretics. Monitoring of treatment]. PMID- 3639550 TI - [Indications for diuretics in nephrology]. PMID- 3639551 TI - [Diuretics outside edema and hypertension]. PMID- 3639552 TI - [Acute pulmonary edema. Clinical case]. PMID- 3639553 TI - [The diuretics]. PMID- 3639554 TI - [Arterial hypertension with hypokalemia. Clinical case]. PMID- 3639555 TI - [Clinical observation of a case of nephrotic syndrome]. PMID- 3639556 TI - [Clinical study of a case of idiopathic edema]. PMID- 3639557 TI - [Those examinations which cause anxiety]. PMID- 3639558 TI - [Renal regulation of the excretion of water and mineral salts]. PMID- 3639559 TI - [The tramps. Health and life style]. PMID- 3639560 TI - [Physiopathology of edema]. PMID- 3639561 TI - [Cholestyramine]. PMID- 3639562 TI - [Antiseptic handwashing]. PMID- 3639564 TI - [Follow-up of infections in a hepatologic resuscitation unit]. PMID- 3639563 TI - [Sclerosing of esophageal varices. Technics, indications, results and the nurse's role]. PMID- 3639565 TI - [Liver diseases specific for the last trimester of pregnancy]. PMID- 3639566 TI - [Infection of ascitic fluid in cirrhosis patients]. PMID- 3639567 TI - [A weekday hospital unit in hepatology]. PMID- 3639568 TI - [The thyroid gland and excess of iodine]. PMID- 3639569 TI - [Diagnosis of hyperthyroidism]. PMID- 3639570 TI - [The heart and hyperthyroidism]. PMID- 3639572 TI - [Neurologic manifestations of bilharziasis]. PMID- 3639571 TI - [Hyperthyroidism--case report]. PMID- 3639573 TI - [Neurologic manifestations of hemoglobinopathies]. PMID- 3639574 TI - [Salt-free diet and fluid restriction in the ascitic cirrhosis patient. The role of the nurse and of the dietitian]. PMID- 3639575 TI - [Project of a medico-surgical service in hepato-gastroenterology within the framework of departmentalization]. PMID- 3639576 TI - [Velbe : indications, methods of use]. PMID- 3639577 TI - [Sinus lavage and sinus instillations]. PMID- 3639578 TI - [Pathology of digestive tract infections in the aged]. PMID- 3639579 TI - [Respiratory infections in the aged]. PMID- 3639580 TI - [Influenza]. PMID- 3639582 TI - [Therapy with antibiotics in the aged]. PMID- 3639581 TI - [Urinary tract infections]. PMID- 3639583 TI - [Vaccinations in the aged]. PMID- 3639584 TI - [Taking care of an aged patient with a febrile episode. The nurse's role]. PMID- 3639585 TI - [Physiology of the thyroid hormones]. PMID- 3639586 TI - [The aged person in the presence of infection]. PMID- 3639587 TI - [Diagnosis and treatment of hypothyroidism in adults]. PMID- 3639588 TI - [The heart and thyroid insufficiency]. PMID- 3639589 TI - [Hypothyroidism. Case report]. PMID- 3639590 TI - [Continuing nursing education at the hospital]. PMID- 3639591 TI - [Leave for economic, social and work-related education]. PMID- 3639592 TI - [Emergency management in the presence of a septicemic syndrome]. PMID- 3639593 TI - [Infectious endocarditis]. PMID- 3639594 TI - [Rohypnol]. PMID- 3639595 TI - [Does the psychiatric hospital still have its place in the care of the aged?]. PMID- 3639596 TI - [Urban and rural psycho-geriatric experience]. PMID- 3639597 TI - [Emotional life and senile dementia]. PMID- 3639598 TI - [Geronto-psychiatry]. PMID- 3639599 TI - [The nurse's role in a day hospital for the aged]. PMID- 3639601 TI - [The role of the physical therapist in a day hospital for the aged]. PMID- 3639602 TI - [Aging from a demographic viewpoint and its medico-socio-economic implications]. PMID- 3639600 TI - [The psychologist's role in a day hospital for the aged]. PMID- 3639603 TI - [Protocol for the fight against pain with elixir of morphine]. PMID- 3639604 TI - [To be or to turn psychotic in prison]. PMID- 3639605 TI - [Psychiatric care or manifold]. PMID- 3639606 TI - [Clamoxyl (or amoxicillin)]. PMID- 3639607 TI - [Non-hormonal female contraception]. PMID- 3639608 TI - [Male contraception]. PMID- 3639609 TI - [Sterilization of couples]. PMID- 3639610 TI - [The nurse and social gynecology]. PMID- 3639611 TI - [Psychological aspects of contraception]. PMID- 3639612 TI - [The intervening third party, the couple, the contraceptive project]. PMID- 3639613 TI - [Female hormonal contraception]. PMID- 3639614 TI - [Continued professional education of the personnel of the city of Paris taking care of children from 2 months to 4 years]. PMID- 3639615 TI - [A change in the manner of care]. PMID- 3639616 TI - [Leaving nursing after barely 4 years. Interview by Helle Kastholm Hansen]. PMID- 3639617 TI - [Drug information. A permanently implanted access to the blood-vessel]. PMID- 3639618 TI - [Professional policy priorities high in our county board]. PMID- 3639619 TI - [Health care in India: a many-sided job]. PMID- 3639620 TI - [Danish Nursing Council invites applications to research fund]. PMID- 3639621 TI - [Great need for a new psychological counseling center. Interview by Vibeke Ostbirk]. PMID- 3639622 TI - [Who's to be blamed for the nursing shortage?]. PMID- 3639623 TI - [Hospital administration. New organizational plans create nervousness among nurses]. PMID- 3639624 TI - [Hospital administration. Administration and politicians dismiss apprehension about cutdowns]. PMID- 3639625 TI - [Development project. The entire population must be involved in the increase to health promotion]. PMID- 3639627 TI - [Health for all by the year 2000 after Chernobyl]. PMID- 3639626 TI - [Research. Concept clarification of the many new nursing terms]. PMID- 3639628 TI - [WHO: intensification of information exchange after Chernobyl]. PMID- 3639629 TI - [Death criterion. Brain death ought to be the criterion for transplantation]. PMID- 3639630 TI - [Development project. The nursing home is closed down in Skaevinge. Interview by Ulla Danielsen]. PMID- 3639631 TI - [Health services' responsibility for health conditions in the local area- including prevention, organization and coordination]. PMID- 3639632 TI - [Greenland. District president: there is not profit in professional visions. Interview by Soren Palsbo]. PMID- 3639633 TI - [Research. Nurses satisfied with chosen systems]. PMID- 3639634 TI - [Catastrophic developments for nursing homes]. PMID- 3639635 TI - [Drug information. A perspiration-inhibiting deodorizing anticholinergic agent]. PMID- 3639636 TI - [Danish Council of Nurses. We have cooperated in the change-over from professional evaluation]. PMID- 3639637 TI - [Executive Board. Change-overs are also in force for organizations and its members]. PMID- 3639638 TI - [Poor quality in report on cytostatic agents]. PMID- 3639639 TI - [Nursing. Unreasonable conditions makes health-promoting activities impossible]. PMID- 3639640 TI - [Students demand participation in education]. PMID- 3639641 TI - [Greenland. Nurses leave without any replacements. Interview by Soren Palsbo]. PMID- 3639642 TI - [Danish Council of Nurses' legislation]. PMID- 3639643 TI - [Health care. Immigrant children are in a squeeze--how can we help them?]. PMID- 3639644 TI - [The Executive Board should define what professional policy is]. PMID- 3639647 TI - [Executive Board looks at possibilities for wage reform for public employees]. PMID- 3639646 TI - [Executive Board. Brakes on new educational burdens for nurses]. PMID- 3639645 TI - [Drug information. This is how hormonal contraceptives act]. PMID- 3639648 TI - [Change-over and nursing education]. PMID- 3639649 TI - [Evaluation should give student a feeling of being somebody]. PMID- 3639650 TI - [Illness as a signal and as a symbol for health]. PMID- 3639651 TI - [Home helpers grossly downgraded by Preben Rudiengaard]. PMID- 3639652 TI - [Ardent discussion about how to meet the need for nurses]. PMID- 3639653 TI - [Education. Useful knowledge from practice in primary health care]. PMID- 3639654 TI - [Principle considerations contain many good intentions]. PMID- 3639655 TI - [Alternative medicine. Relevant knowledge for the "authorized" health system]. PMID- 3639656 TI - [SSN (Nurses' Cooperation of Scandinavia) discussed visibility of nursing]. PMID- 3639657 TI - [Nursing. Communication devices for the deaf must be kept in good repair--the same for the hearing handicapped]. PMID- 3639658 TI - [Technology. Disagreement about equipment: less independence or a good assistant]. PMID- 3639659 TI - [Technology. Freedom to exercise influence over purchase and use]. PMID- 3639660 TI - [Technology. The Danish Council of Nurses follows developments centrally and locally]. PMID- 3639661 TI - [Acknowledged that there is also nursing care in an operating room]. PMID- 3639662 TI - [Health care. Invisible contribution of health visitors must become visible]. PMID- 3639663 TI - [New technology as consumers evaluate it]. PMID- 3639664 TI - [Widespread mistrust of Copenhagen's data wage system]. PMID- 3639665 TI - [Technology. Mapping out of working conditions in an intensive care unit]. PMID- 3639666 TI - [Alternative medicine. Is it time to take the biological medicine seriously?]. PMID- 3639667 TI - [Technology. In the future there will be an ADP-terminal at every bedside]. PMID- 3639668 TI - Mini-plasminogen-like fragments of plasminogen in synovial fluid in acute inflammatory arthritis. AB - Neutrophil elastase digests plasminogen to yield a fragment, mini-plasminogen, which is activatable to a mini-plasmin capable of escaping the action of the primary plasmin inhibitor. Such a molecule may play a role in joint destruction, either directly or by activation of procollagenase to collagenase. Synovial fluid samples from 34 acute joint effusions were examined by lysine-Sepharose chromatography and fibrinolytic assay of the fall-through (non-lysine-binding) fractions in presence of urokinase. Fragments similar to mini-plasminogen were found in 20 of 23 inflammatory effusions (cell count greater than 0.5 X 10(3)/microliter) and in none of 11 non-inflammatory (traumatic and osteoarthritic) effusions (cell count less than 0.5 X 10(3)/microliter) (p less than 0.001). Analysis of four inflammatory fluids by gel filtration on Bio-Gel P 100 and enzyme-linked immunoassay for plasminogen antigen revealed plasminogen fragments with molecular weight similar to mini-plasminogen (34,000 daltons) in three, and larger plasminogen fragments (or complexes of mini-plasminogen with other synovial fluid macromolecules) in all four. Fibrinolytic activity was demonstrable in fractions containing plasminogen fragments after treatment with tissue type plasminogen activator. In contrast with non-inflammatory effusions, inflammatory joint fluids contain plasminogen fragments with the properties of mini-plasminogen, suggesting their possible role in inflammatory joint destruction. PMID- 3639669 TI - Tumor promoter, TPA, enhances replication of HTLV-III/LAV. AB - The incubation of Molt-4/HTLV-III cells, human T-lymphotropic virus type III (HTLV-III)/lymphadenopathy-associated virus (LAV)-producer cell line, with more than 0.5 ng/ml of 12-O-tetradecanoylphorbol-13-acetate (TPA) for 2 to 4 days stimulated virus-induced cell killing which resulted in a high production of HTLV III/LAV. TPA significantly increased the number of plaque-forming viruses released from the cultures as well as viral RNA content. Interestingly, MT-4 cells freshly infected with HTLV-III/LAV treated for 4 days with 0.125 to 2.0 ng/ml of TPA were found to retain the capacity to grow, because TPA inhibited the induction of the virus-specific antigens and cytopathic effects. In contrast to the situation in infected MT-4 cells in liquid cultures, the addition of 0.125 and 0.25 ng/ml of TPA into agarose medium induced large plaques, suggesting that TPA basically enhanced the production of the virus from one infected MT-4 cell. Taken together, the data suggest that TPA enhances the replication of HTLV/III/LAV. These assay systems are shown to be useful for analyzing the induction or suppression of a virus infection by many drugs and other factors in vitro. PMID- 3639670 TI - [Elastolytic activity in eye tissues and serum antiproteases in corneal burns]. AB - Within the first week after deep thermic burns of rabbit cornea elastolytic activity was increased in the impaired zone of cornea, in the cornea zones surrounding the burns as well as in ciliary body, iris of the eye and in chamber humor, whereas the antitryptic activity was increased in eye tissues. Both elastolytic and antitryptic activities were decreased within two weeks after the burns. In circulating blood alterations in content of alpha 1-antitrypsin and alpha 2-macroglobulin were directed against the proteolytic enzymes, which were activated after the cornea burns. Instillation of the antiprotease drug hordox within the first ten days after the burns led to a decrease in the elastolytic activity detected in the cornea zone with burns as well as to more favourable development of postburn inflammation. PMID- 3639671 TI - Growth-support intervention for the treatment of depression in women of middle years. PMID- 3639672 TI - Strategies patients use to manage the sensation of dyspnea. PMID- 3639673 TI - Teaching nurses priority setting for patients with pain of acute myocardial infarction. PMID- 3639674 TI - Approaches to studying patient assault. PMID- 3639675 TI - The effects of undergraduate nursing education on empathy. PMID- 3639676 TI - Projecting the number of professional nurses required for in-hospital, direct care of older people, 1970-2050. PMID- 3639677 TI - Interpersonal distance of hospital staff. PMID- 3639678 TI - A FLU system to equalize faculty assignments in a school of nursing. PMID- 3639679 TI - Strategies for teaching nursing research: participant observation. PMID- 3639680 TI - Ethical issues in nursing research. PMID- 3639681 TI - Computer use and nursing research: interfacing microcomputers and nursing research--I. Management and analysis of research data. PMID- 3639682 TI - Family finance. PMID- 3639683 TI - Basic nursing education in Ireland--why not a single basic training? PMID- 3639684 TI - Who works for WHO? PMID- 3639685 TI - [A 3-year prospective study of infection with HIV (=LAV/HTLV III) in homosexuals]. PMID- 3639686 TI - [Variations in perinatal mortality according to the hour of birth in Switzerland]. AB - In Switzerland like in most developed countries, the number of births is strongly related to the hour of the day and the day of the week: this pattern is very probably related to the current practice in obstetrics. Less expected is the fact that the perinatal mortality shows a striking circadian rhythm according to the hour of birth. The paper presents this pattern and comments some related issues. PMID- 3639687 TI - [Periventricular fatty metamorphosis in neuroglia--a morphologic substrate in SIDS]. AB - In 7 of 15 cases of sudden infant death syndrome (SIDS), distinct periventricular fatty metamorphosis of the neuroglia could be demonstrated by a histological staining technique. None of the six children (under 1 year of age) used as a control group whose cause of death was not SIDS showed this morphological change. Thin-layer chromatographic analysis of the lipids accumulated in the glial cells in SIDS established a high amount of esterified cholesterol whereas the content of esterified cholesterol in the control group was low. We presume that fatty metamorphosis of the neuroglia represents the morphological substrate of a metabolic disorder of the sensitive, immature glia of the periventricular white cerebral matter caused by various kinds of damage. PMID- 3639688 TI - The professional conduct process: AARN. PMID- 3639689 TI - Dr. Thelma Wells. Urinary incontinence research. An interview--by Eve Henderson. PMID- 3639690 TI - Quality assurance of professional nursing practice. The operating room. PMID- 3639691 TI - Where are all the nurses going? PMID- 3639693 TI - Perioperative nursing: an evolving specialty. PMID- 3639692 TI - Shock and the Trendelenburg position. PMID- 3639694 TI - Scientific review process: Alberta Foundation for Nursing Research. PMID- 3639695 TI - Establishment of a post-basic degree program at the University of Lethbridge (Part two). PMID- 3639697 TI - Games nurses play. Part 4. Pin the tail on the donkey and war. PMID- 3639696 TI - Selling a career that starts with care. PMID- 3639698 TI - Who transcribed that order? PMID- 3639699 TI - Continuous motion for post-traumatic arthritis. PMID- 3639700 TI - Managing assault. PMID- 3639701 TI - When in seclusion. PMID- 3639702 TI - Healing under pressure. PMID- 3639703 TI - Living with a Foley. PMID- 3639704 TI - Are we dying for nuclear weapons? PMID- 3639705 TI - AIDS beyond the hospital. 2. Children with AIDS. PMID- 3639707 TI - Sham feeding: another kind of nourishment. PMID- 3639706 TI - Why me? Second trimester abortion. PMID- 3639708 TI - Chicago by the sea: AJN JobFocus. PMID- 3639709 TI - Using analogies in patient teaching. PMID- 3639710 TI - A common thread. PMID- 3639711 TI - Clinical and economic considerations associated with testing for fetal lung maturity. AB - Performing multiple tests of fetal lung maturity on amniotic fluid samples may not use the individual test results and laboratory personnel most effectively. To determine the best strategy for fetal lung maturity testing, we analyzed our experience with use of a variety of procedures. Clinical usefulness was assessed according to sensitivity, specificity, predictive values, and efficiency. Economic and technical aspects analyzed included time and personnel requirements, availability of tests, and expense of each procedure. Several testing sequence approaches were compared for efficiency and cost. In our laboratory the foam stability index proved to be the most useful initial test of fetal lung maturity, reserving more expensive and time-consuming tests for instances in which the foam stability index is immature. Routine multiple testing did not enhance clinical usefulness and greatly increased costs. Development of a testing strategy using a rapid, inexpensive, and widely available test such as the foam stability index would promote clinical and economic efficiency. PMID- 3639712 TI - Enforcement of the Nursing Practice Act. PMID- 3639713 TI - Minnesota, Tuskegee, Yale: each excels. PMID- 3639714 TI - ANA Councils offer avenues for professional growth. PMID- 3639715 TI - Bill would increase access to nursing services. PMID- 3639716 TI - Patient care attracts students to nursing profession. PMID- 3639717 TI - Nurses must share in resolving health care crisis. PMID- 3639718 TI - In the spotlight, we need each other. PMID- 3639719 TI - What advice would you give to a beginning nurse? PMID- 3639720 TI - Cerebral granulomatous angiitis associated with isolation of human T-lymphotropic virus type III from the central nervous system. AB - A 42-year-old homosexual man without evidence of immune deficiency developed cerebral granulomatous angiitis in association with the isolation of human T lymphotropic virus type III (HTLV-III) from brain tissue and cerebrospinal fluid. This syndrome may be an additional neurological sequela of HTLV-III infection. PMID- 3639721 TI - Withdrawal of life support in a competent patient. PMID- 3639722 TI - Parathyroid autotransplantation. Indications and techniques. PMID- 3639723 TI - Developing OR management skills. Advice from OR managers. PMID- 3639724 TI - Time management. Part II. Rewriting obsolete work rules. PMID- 3639725 TI - Trauma center and the OR. A cooperative approach to caring for the massively injured. AB - Communication must be established between the operating room and trauma center. At SNJRTC, perioperative nurses rotate through the trauma center and are part of nursing grand rounds on trauma patients. This system has improved interdepartmental relations, educational development, and most importantly, established a system in which patients have the best chance of survival as a result of the cooperative approach to the care of the massively injured. PMID- 3639726 TI - Juvenile rheumatoid arthritis. Diagnosis and medical management. PMID- 3639727 TI - Juvenile rheumatoid arthritis. Anesthetic and surgical considerations. PMID- 3639728 TI - Isolation and partial characterization of rat elastolytic enzymes from various cells and tissues. AB - Different elastolytic enzymes were isolated from rat aorta and platelets, as well as from granulocyte and pancreatic extracts. The active fractions were purified to electrophoretic apparent homogeneity by precipitation with ammonium sulfate, sequential batch fractionation on DEAE-Sephadex A-50, and finally by isoelectric focusing (IF) on Sephadex G-75 Superfine. The molecular weight and the isoelectric point of the isolated enzymes were estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and by analytical IF, respectively. All the enzymes have elastolytic activity as well as activity toward Suc-(Ala)3-NA. The inhibition profile of the different isolated enzymes toward various inhibitors indicates that aortic, pancreatic, and granulocyte enzymes all belong to the group of serine proteinases, unlike the platelet elastase which is a metalloproteinase. PMID- 3639730 TI - [Rare forms of criminal administration of poisons. I]. PMID- 3639731 TI - [Activation of kallikreinogens in blood plasma after experimental endotoxin poisoning in juvenile pigs]. PMID- 3639729 TI - Carbohydrate derived energy and gross energy absorption in preterm infants fed human milk or formula. AB - Significant production of breath hydrogen has been shown in premature infants, suggesting limited intestinal capacity for digestion of carbohydrate. To evaluate net absorption of carbohydrate 24 three day balance studies were carried out in seven preterm infants fed pasteurised banked human milk and in 17 preterm infants fed a formula containing 75% lactose and 25% glucose polymers. Because carbohydrate reaching the colon may be converted to organic acids by bacterial flora, carbohydrate net absorption was determined by quantitating the faecal excretion of energy derived from carbohydrate. The carbohydrate derived energy content of milk and stools was calculated as the difference between the measured gross energy and the sum of energy related to nitrogen and fat. Faecal loss of carbohydrate derived energy was lower in the group fed formula (1.9 (SD 1.2) kcal/kg/day) than in the group fed human milk (4.0 (SD 1.8) kcal/kg/day). Net absorption of carbohydrate derived energy was 97.0 (SD 1.9)% as opposed to 92.6 (SD 3.9)%, respectively. Within each group there was no significant relation between carbohydrate energy absorption and fat, nitrogen, or gross energy absorption. Thus, although less complete with human milk than with formula, apparent absorption of energy derived from carbohydrate seemed quite satisfactory in these preterm infants. PMID- 3639732 TI - [Degradation and excretion of 32P-methamidophos after oral administration in lactating cattle]. PMID- 3639733 TI - Multinucleated cells in the lymph nodes of HTLV-III seropositive intravenous drug abusers with generalized lymphadenopathy. PMID- 3639734 TI - [Evaluation of 15N marked urea in the laying hen. 4. Incorporation of 15N in blood, its fractions and follicles in various developmental stages]. AB - In order to study the utilization of urea in poultry, 3 colostomized laying hybrids were orally supplied with a traditional ration supplemented with 1% 15N' labelled urea with a 15N excess (15N') of 96.06 atom-% over a period of 6 days. After another 2 days on which the hens received the same ration with unlabelled urea, they were butchered. The atom-% 15N' of the blood on an average of the 3 hens was 0.64, of the plasma 1.40 and of the corpuscles 0.47. The TCA-soluble fraction of the blood had an average 15N' of 1.14 atom-%; the 15N amount is 9.7% of the total amount of 15N in the blood. The amount of 15N' in the urea in the blood was 6.8 atom-%. This shows that the absorbed urea is decomposed very slowly. The quota of 15N' in the basic amino acids from the total 15N' of the blood plasma is only 0.3% and that of the corpuscles 2.2%. The average 15N' of the mature follicles is 2.39 atom-% whereas the smallest and the remaining ovary contain 1.12 atom-%. The labelling level of lysine in mature egg cells was, in contrast to this, only 0.08 atom-% 15N' and in infantile follicles 0.04 atom-% 15N'. 1% of the 15N' quota is in the follicles and the remaining ovary. Of the basic amino acids, histidine is most strongly labelled. The as a whole lower incorporation of the 15N from urea into the basic amino acids shows that the nitrogen of this compound can be used for the synthesis of the essential amino acids to a low degree only. PMID- 3639736 TI - The third age. PMID- 3639735 TI - Your income tax. PMID- 3639737 TI - Nursing school of the air. PMID- 3639738 TI - Reaching remote area nurses. PMID- 3639739 TI - A human auto-immune antibody specifically recognizing initiator methionine tRNA from yeast and higher eucaryotes. AB - Analysis of sera from 168 patients with autoimmune disorders revealed that one patient with Sjogren's syndrome produced antibodies against deproteinized initiator methionine tRNA in addition to those against La protein. This anti tRNAimet recognizes also tRNAimet from yeast but not from Phaseolus vulgaris chloroplasts (bean) or E. coli. It appears therefore that the epitope could be located in the TF loop in which an A residue in position 60 and the AUCG sequence are the only common features in yeast and human tRNAimet. PMID- 3639740 TI - Human urinary prokallikrein: rapid purification and model activation by trypsin. AB - With only a three-step chromatographic procedure, human urinary prokallikrein has been purified completely. The active kallikrein also could be purified in the process of this purification. The prokallikrein was very rapidly activated by trypsin, followed thereafter by a very slow increase in the kallikrein activity. In the rapidly activated state, the molecular weight and the values of Km and Vmax were very similar to those of the purified active kallikrein. Only the slow increase in the activity was observed by tryptic digestion of the active kallikrein. The results suggest that the initial rapid activation is due to release of the propeptide and the slow reaction is due to a limited hydrolysis of the activated prokallikrein at sites which are not directly related to the active site. PMID- 3639741 TI - Ribozyme inhibitors: deoxyguanosine and dideoxyguanosine are competitive inhibitors of self-splicing of the Tetrahymena ribosomal ribonucleic acid precursor. AB - The intervening sequence (IVS) of the Tetrahymena rRNA precursor catalyzes its own splicing. During splicing the 3'-hydroxyl of guanosine is ligated to the 5' terminus of the IVS. One catalytic strategy of the IVS RNA is to specifically bind its guanosine substrate. Deoxyguanosine (dG) and dideoxyguanosine (ddG) are found to be competitive inhibitors of self-splicing. Comparison of the kinetic parameters (Ki = 1.1 mM for dG; Ki = 5.4 mM for ddG; Km = 0.032 mM for guanosine) indicates that the ribose hydroxyls are necessary for optimal binding of guanosine to the RNA. dG is not a substrate for the reaction even at very high concentrations. Thus, in addition to aiding in binding, the 2'-hydroxyl is necessary for reaction of the 3'-hydroxyl. A second catalytic strategy of the IVS RNA is to enhance the reactivity of specific bonds. For example, the phosphodiester bond at the 3' splice site is extremely labile to hydrolysis. We find that dG and ddG, as well as 2'-O-methylguanosine and 3'-O-methylguanosine, reduce hydrolysis at the 3' splice site. These data are consistent with an RNA structure that brings the 5' and 3' splice sites proximal to the guanosine binding site. PMID- 3639744 TI - Neonates receive specialized care on the road. PMID- 3639743 TI - Coping with the time trap. PMID- 3639742 TI - Localization of noncovalently bound ethidium in free and methionyl-tRNA synthetase bound tRNAfMet by singlet-singlet energy transfer. AB - Ethidium binds tRNAfMet with 17-fold enhancement in the emission intensity at 600 nm. Fluorescence titration of tRNAfMet with ethidium indicates a single high affinity site in tRNAfMet with a dissociation constant of 5 microM. Ethidium is apparently rigidly bound to tRNAfMet and effectively shielded from solvent. tRNAfMet(8-13), tRNAfMet(3'-Flc), and tRNAfMet(D-PF) with fluorophores at thiouridine, the 3'-terminus, and dihydrouridine, respectively, are prepared, and the singlet-singlet energy-transfer efficiencies between these fluorophores and noncovalently bound ethidium are determined. The transfer efficiency between bound ethidium and the fluorophore in tRNAfMet(8-13) determined by donor quenching and sensitized emission is the same, strongly suggesting that there is only one bound ethidium per tRNAfMet molecule. The apparent distances between ethidium and various fluorophores including 3'-fluorescein, the 8-13 photo-cross link, and D-proflavin are 41, 19, and 30 A, respectively, assuming random orientation between the donor and the acceptor. The results suggest that noncovalently bound ethidium is intercalated in the amino acid acceptor stem. In the complex of tRNAfMet and methionyl-tRNA synthetase, the transfer efficiencies for the tRNAfMet(8-13), tRNAfMet(3'-Flc), and tRNAfMet(D-PF) are reduced, enhanced, and little changed, respectively. These methionyl-tRNA synthetase induced changes suggest changes in the conformation of the 3'-terminal unpaired bases and the relative orientation or location between tRNAfMet and ethidium upon binding of methionyl-tRNA synthetase. PMID- 3639745 TI - Case comment: Pike v. Peace Arch District Hospital. PMID- 3639746 TI - Nurse specialization in an evolutionary environment. PMID- 3639747 TI - Suction assisted lipectomy. PMID- 3639748 TI - Developing a positive learning environment between O.R. nurses and ward nurses. PMID- 3639749 TI - Pre-operative teaching. Reducing pre-surgical anxiety. PMID- 3639751 TI - Laser safety: using the CO2, argon and Nd:YAG lasers. PMID- 3639750 TI - Can the nursing profession govern itself? PMID- 3639752 TI - The laser: lethal weapon, but still a marvellous device. PMID- 3639753 TI - Legal problems facing nurses. PMID- 3639754 TI - Nurse specialization in an evolutionary environment. PMID- 3639755 TI - [Repair and reconstruction of the anterior cruciate ligament]. PMID- 3639756 TI - Post-op nosocomial infections. The real issue! PMID- 3639757 TI - Electrosurgical safety and management. PMID- 3639758 TI - Consent and marital status--the legalities. PMID- 3639759 TI - [Transplantation of an hemipelvis. The nurse's viewpoint]. PMID- 3639760 TI - Recognition and treatment of burn wound infection. PMID- 3639762 TI - Nurses under legal attack. PMID- 3639761 TI - Repair of the acutely injured anterior cruciate ligament. PMID- 3639763 TI - Infection control strategies in the operating room. PMID- 3639764 TI - Health care industry to feel impact of laser technology. PMID- 3639765 TI - The clinical nurse specialist. PMID- 3639766 TI - A new style of nursing leadership. PMID- 3639767 TI - Mycosis fungoides. PMID- 3639768 TI - [Music therapy]. PMID- 3639769 TI - Lakehead University's RN baccalaureate program. Years in the making. PMID- 3639770 TI - [Ultrastructural changes on the alveolar surface in experimental respiratory distress syndrome with emphasis on the detection of surfactants]. AB - The lung lesions induced by herbicide paraquat lead to certain structural changes which have some features in common with those known in the idiopathic respiratory distress syndrome. It has been therefore suggested and proved that "paraquat lung" might serve as a convenient model of this disease in infants. In both the lesions lack of surfactant was supposed and revealed mostly by physical and biochemical methods. The study concerns the morphological demonstration of alveolar lining layer by various methods (the Callas' agar fixation technique, the Shea's alcian blue method, the Dermer's tricomplex fixation) in the rat lung in normal and experimental conditions and demonstrates its deficiency in the latter. PMID- 3639771 TI - [Advances in the care of patients with burns]. PMID- 3639772 TI - [Reform of nursing education]. PMID- 3639773 TI - [A teaching method for basic nursing]. PMID- 3639774 TI - [Students appraisals of teachers]. PMID- 3639775 TI - [Nursing care of patients with supportive traction using a halo-cast and halo hoop]. PMID- 3639776 TI - [Cultivation of nursing ability through professional training]. PMID- 3639777 TI - [Using psychological knowledge in the training of nurses]. PMID- 3639778 TI - [Nursing care of patients with biliary tract drainage using a transhepatic U tube]. PMID- 3639779 TI - [A general duty head nurse system]. PMID- 3639780 TI - [Advances in nursing in the last thirty years]. PMID- 3639781 TI - [Overview of the health care system in the United States]. PMID- 3639782 TI - [Nursing care of patients with a simple bending-shaped compressive fracture of the thoracic and lumbar vertebra]. PMID- 3639783 TI - [Selection of tubes for angiography]. PMID- 3639784 TI - [Emergency nursing care of the patient with acute isoniazid poisoning]. PMID- 3639785 TI - [Nursing care of the tumor patient during radiation therapy]. PMID- 3639786 TI - [Setting up the ICU]. PMID- 3639787 TI - [Nursing care of children with esophageal stenosis caused by injury]. PMID- 3639788 TI - [Preventive inoculation against rabies]. PMID- 3639789 TI - [Side-effects caused by the combined use of traditional Chinese and Western drugs]. PMID- 3639790 TI - [Research: using nursing observations to improve patient care]. PMID- 3639791 TI - [Nursing care in the home medical service]. PMID- 3639793 TI - [Types of fever in the puerperium after cesarean section]. PMID- 3639792 TI - [Leadership and support in nursing work]. PMID- 3639794 TI - [Comparative study of lidocaine effects on artificial abortion]. PMID- 3639795 TI - [Nursing care of patients with middle and late stage cervical cancer treated by arterial catheterization]. PMID- 3639796 TI - [Delivery control]. PMID- 3639797 TI - [In-service training: the credit system]. PMID- 3639798 TI - [Nursing care of patients with skeletal fluorosis]. PMID- 3639799 TI - [Instructions for patients in self-care after laryngectomy]. PMID- 3639800 TI - [Cooperation between nurses and anesthetists during operations]. PMID- 3639801 TI - Intradermal testing with multiple recall antigens for identification of cell mediated immune deficiency in homosexual men. AB - In a health screening project for gay men in Stockholm, delayed cutaneous hypersensitivity was tested in 710 men by a commercial kit (Multitest, Merieux) containing seven recall antigens and related to past hepatitis B virus (HBV) infection, various life style factors, the lymphadenopathy syndrome (LAS), and antibodies to human T-lymphotropic virus type III (HTLV-III). The multiscore (MS: the sum of all positive reactions) was significantly decreased in men with the following characteristics: HBV markers, greater than 50 yearly sexual partners, regular practice of receptive rectal intercourse, regular sex in gay bathhouses, recent sexual encounters in the US, greater than 50 lifetime exposures to inhaled nitrates, LAS, and positive HTLV-III serology. Anergy to tuberculin (TU) but not to any other antigen was more common in men with greater than 20 yearly partners, regular practice of receptive rectal intercourse, exposure to inhalant nitrates, LAS as well as lesser degree of lymphadenopathy, and HTLV-III seropositivity. HTLV-III antibodies were demonstrated in 61 of 416 (14.7%) men. During the 2-year follow-up four men have developed acquired immune deficiency syndrome. All four had MS less than 10 mm and TU anergy. In a BCG-immunized population Multitest only adds marginal information as compared to intradermal testing solely with TU, but may yield prognostic information in evaluating HTLV-III positive individuals with respect to development of manifest AIDS. PMID- 3639802 TI - Computed tomography with multiplanar reconstruction of acetabular fractures. AB - Computed tomography of acetabular fractures, using 3 mm thick continuous slices, was routinely supplemented with reformatted images in the coronal and sagittal plane. We have found this to be helpful in the preoperative evaluation of our cases for insight into these often complex fractures. Three representative case reports are presented. PMID- 3639803 TI - Radiation exposure and image quality in computed tomography for hip joint measurements in children. AB - Computed tomography (CT) is considered a useful modality in the diagnosis of hip abnormalities in children. In this article a procedure is described, using low dose CT with thick slices and integration of different images, in which radiation exposure is in ranges equal to the conventional methods. This makes CT the method of choice for routine examination. PMID- 3639804 TI - Hypertrophic osteoarthropathy in childhood malignancy. AB - A case of hypertrophic osteoarthropathy associated with carcinoma of the nasopharynx in a child is presented. Peculiar findings were the minor changes on the chest film, and the absence of periosteal reactions in the radii. PMID- 3639805 TI - Arteries of the hand in patients with scleroderma. AB - The arteriographic features of the arteries of the hand in 12 patients with biopsy proven scleroderma are discussed. The lesions were primarily observed in the proper digital arteries and less frequently in the ulnar artery, the superficial arch and the common digital arteries. In this series the radial artery and the deep palmar arch were never affected. PMID- 3639806 TI - The contused kidney, an angiographic picture. AB - Problems in the interpretation of an angiogram of a contused kidney are reported. The angiogram showed signs of avascularity and tumor vessels and a malignancy was considered. However, on operation the kidney appeared to be contused but otherwise normal. One should be aware of the possibility of pitfalls arising in early angiograms of contused kidneys. PMID- 3639807 TI - Westermark's sign demonstrated by a peripherally wedged Swan-Ganz catheter. A case report. PMID- 3639808 TI - De novo calcification in lymph node metastasis. AB - Calcification in malignant lymphoma or in lymph node metastases from a malignant tumor are most often encountered after radiotherapy or chemotherapy. De novo calcifications in malignant lymphoma however, are very rare. As far as we know, de novo calcification in retroperitoneal lymph node metastases from carcinoma have not been described before. A case is presented and the literature is reviewed. PMID- 3639809 TI - Urinary kallikrein response to repeated frusemide injections in rats: effect of adrenalectomy and deoxycorticosterone acetate treatment. AB - The effect of repeated intravenous injections of frusemide (0.17 mg/kg) on the urinary kallikrein excretion of normal, adrenalectomized and deoxycorticosterone acetate (DOCA)-treated adrenalectomized rats was studied. Adrenalectomy decreased baseline urinary kallikrein excretion, while DOCA treatment restored it to normal. Frusemide injections repeatedly increased urinary kallikrein excretion in the three groups of rats studied. Compared with control and DOCA-treated animals, adrenalectomized rats were less responsive. The excretion of urinary kallikrein was positively correlated with urine volume and with the excretion of sodium and potassium in all groups. The regression lines were shifted to the left in DOCA treated adrenalectomized rats showing that mineralocorticoids enhance the effect of frusemide on urinary kallikrein excretion. The regression lines between urinary kallikrein excretion and the measured variables in adrenalectomized rats did not differ from those of control animals. We conclude that the response of urinary kallikrein to frusemide is influenced by the level of mineralocorticoid activity. The effect of frusemide on urinary kallikrein excretion does not appear to be a 'wash-out' of the enzyme since its influence did not subside after repeated injections. PMID- 3639811 TI - [Instructions on case studies by students. (5)]. PMID- 3639810 TI - [Survey on the "sound" which is unpleasant to patients]. PMID- 3639812 TI - [Learning from work--my approach to self-enlightenment]. PMID- 3639813 TI - [Nursing study and dietetics--renewed understanding of nursing based on the concept of nutrition]. PMID- 3639814 TI - [Research report. Part 1. Interactions with a patient often assuming frozen postures due to persecution complex]. PMID- 3639815 TI - [Comment on a research report. A support for the mentally ill]. PMID- 3639816 TI - [Discussion of a student's report: on the "interactions with a patient often assuming frozen postures due to persecution complex"]. PMID- 3639817 TI - [Nursing in Canada--from the diary of a Japanese nurse in Canada. 2]. PMID- 3639818 TI - [Nursing record as an information system--part of the information system to support nursing (2)]. PMID- 3639819 TI - Hemodynamic abnormalities in acute myocardial infarction. AB - Great strides have been made in the management of patients with acute myocardial infarction since the advent of coronary care units. However, congestive heart failure continues to be the major cause of in-hospital mortality. The accurate diagnosis and classification of hemodynamic abnormalities allow the application of specific therapies for each patient. Because clinicians can now routinely measure left and right ventricular preload, systemic and pulmonary vascular resistance, cardiac output, and arteriovenous oxygen difference, pharmacologic and surgical interventions can be applied in a scientific manner. In addition, mechanical complications can be promptly recognized and aggressively treated. Although the mortality rate for patients with severe left ventricular dysfunction after myocardial infarction remains high, expert management offers an improved prognosis for many patients. PMID- 3639820 TI - Elastase-producing microorganisms in horse lungs: their possible role in the pathogenesis of chronic pulmonary disease in the horse. AB - Seventeen out of 21 horses had pulmonary microbial organisms which reached considerable numbers in seven cases. Elastase-producing microorganisms from the environment (Streptomyces species and to a lesser extent Bacillus species) constituted 22 per cent to 99 per cent (mean 79 per cent) of the total growth. There was a considerable number of microorganisms with in vitro-produced elastases which were not or only slightly affected by horse serum. There was no correlation between numbers of organisms and pulmonary histopathological findings thus the significance of these microorganisms in the pathogenesis of alveolar emphysema is unknown. The growth of a strain of Streptomyces collinus/diastatochromogus isolated from the lungs was suppressed by fresh horse serum but not by decomplemented horse serum. Complement activation in response to this organism could contribute to airway inflammation through the production of mediators. PMID- 3639821 TI - Elastase effect on the extracellular matrix of rat aortic smooth muscle cells in culture. AB - The effect of elastase on the extracellular matrix of neonatal rat aortic smooth muscle cell cultures was monitored both chemically and ultrastructurally. Porcine pancreatic elastase was shown to decrease the elastin content in these cultures. Although chemically no distinction could be made between the elastin remaining in the culture matrix after elastase when compared to that in the nontreated cultures, the elastin was dramatically altered morphologically. The elastin assumed a "mottled" appearance after elastase treatment similar to that seen in vivo in emphysema models. A highly sensitive immunogold staining technique was used to detect elastin at the earliest stages of accumulation. Pulse experiments demonstrated an increase in protein synthesis by the cells 20 hr after elastase exposure. The culture system described here provides a model for probing in vivo elastase effects on elastin-containing tissues. PMID- 3639822 TI - [Effect of leukocyte interferon and its inducers on the prekallikrein-kallikrein system of the blood serum in children with acute respiratory viral infections]. AB - In 50 patients aged from 6 months to 7 years with severe forms of acute respiratory infections against background of basis-therapy with aerosols of leukocytic interferon as well as contrykal the blood kallikrein content was decreased and prekallikrein content was increased. PMID- 3639823 TI - Critical care nursing in Paris. PMID- 3639824 TI - Torsade des pointes--etiology and treatment. PMID- 3639825 TI - Nursing management of continuous arteriovenous hemofiltration for acute renal failure. PMID- 3639826 TI - Faye G. Abdellah--working to enrich the profession. PMID- 3639827 TI - Using Neuman's model in the acute phase of spinal cord injury. PMID- 3639829 TI - SI units: the new international language. PMID- 3639828 TI - Detecting compartmental syndrome using continuous pressure monitoring. PMID- 3639830 TI - Elastinolytic activity of horse leukocyte proteinases. Comparison with elastases from human leukocytes and porcine pancreas. AB - Three proteinases from the azurophilic granules of horse leucocytes are typical elastases degrading elastin at neutral pH. Both proteinases: 1 and 2A exhibit similar elastinolytic activity, comparable with human leucocyte elastase (HLE). In relation to human enzyme, elastase 2B shows several-fold higher activity, which is comparable to the porcine pancreatic elastase activity (PPE). Similarly to HLE elastinolytic activity of the horse proteinases increases at higher ionic strength: twofold in case of 1 or 2A and fivefold for 2B. Significant activity observed during degradation of homologous lung elastin, implies the possible role of these enzymes during pathological injury of connective tissue in the lower respiratory tract and suggests similar pathogenesis of horse and human pulmonary emphysema. PMID- 3639831 TI - Comparison of specificity of human and horse leucocyte proteinases with synthetic peptide substrates. AB - Highly purified horse leucocyte proteinases 1, 2A and 2B hydrolyze synthetic substrates which are decomposed also by human leucocyte elastase but they are unable to hydrolyze typical substrates of cathepsin G. Thus in distinction to other mammalian species horse leucocytes are devoid of cathepsin G and contain only elastases. PMID- 3639832 TI - Taking risks: nurses in business. PMID- 3639833 TI - Born again: an experience in shared governance for nursing. PMID- 3639834 TI - Truth in sexual advertising. PMID- 3639835 TI - [Exocrine pancreatic insufficiency. Comparison of substitution therapy with a non acid resistant and an acid resistant enzyme preparation]. PMID- 3639836 TI - [A classification system for HTLV-III infected patients]. PMID- 3639837 TI - Health for all in Montrouis, Haiti. AB - "Health for all by the year 2000" ... everyone's discussing it... in meetings, workshops and conferences. But are we any closer to it now than we were in 1978 when the concept was born at Alma Ata or are we still just discussing it? The author believes that in Montrouis, Haiti, they are closer as the concept has become action in the community health programme of Clinique St. Paul. PMID- 3639838 TI - Nursing intervention in a disaster. AB - In October 1985, Puerto Rico was struck by disaster. Two of the nurses who were part of the health team wrote about their experience and what they learned. PMID- 3639839 TI - Job satisfaction among Jordanian registered nurses. AB - In a nationwide survey, factors contributing to job satisfaction and dissatisfaction among Jordanian nurses were examined. Questionnaires were completed by 312 Jordanian staff nurses working in army, government, and private hospitals. The results revealed the Jordanian staff nurses were somewhat satisfied with their social and safety rewards and incentives but somewhat dissatisfied with their psychological rewards and incentives as offered to them by their hospital work settings. PMID- 3639841 TI - The ethical standards for withholding/withdrawing nutrition and hydration. PMID- 3639840 TI - Multicultural nursing. AB - Are nurses taking into account the cultural differences when caring for immigrant patients? The author presents here her personal views and experiences in multicultural nursing. PMID- 3639842 TI - An ABC of alternative medicine: Bach flower remedies. PMID- 3639843 TI - Know your organisations: the Cancer Help Centre. PMID- 3639844 TI - Breast examination: who is doing it? PMID- 3639846 TI - The role of health clubs in health education. PMID- 3639845 TI - A shared approach to screening and well woman clinics. PMID- 3639847 TI - Meeting the needs of the mentally handicapped. PMID- 3639848 TI - Running an obesity clinic. PMID- 3639849 TI - Teaching and evaluating breast self-examination: interaction between a research unit and health visitors. PMID- 3639850 TI - Cholesterol knowledge, avoidance, and monitoring among the American public. PMID- 3639852 TI - Diagnosis of right ventricular infarction with right precordial ECG leads. PMID- 3639851 TI - Organ donation: the supply/demand discrepancy. PMID- 3639853 TI - Visitation needs reported by patients with cardiac disease and their families. AB - Results suggest some factors that nurses in an MICU might consider to create an environment better adapted to the persons in residence in that environment. While there are areas of agreement between patients and family about visitation, the nurse may need to respond to family member and patient needs and preferences that are sometimes agonistic. Nurses can play a pivotal role in advocating and supporting visitation practices individualized to patients' and family members' needs. PMID- 3639854 TI - Wives' experiences in the support role after husbands' first myocardial infarction. PMID- 3639855 TI - Arm blood pressure gradients in young adults: impact of induced hypotension. PMID- 3639856 TI - Systemic blood pressure in various lateral recumbent positions: a pilot study. PMID- 3639857 TI - Psychologic and physiologic factors related to dyspnea in subjects with chronic obstructive pulmonary disease. PMID- 3639858 TI - The effect of chest tube manipulation on mediastinal drainage. PMID- 3639860 TI - Orthostatic heart rates and blood pressures in healthy young women and men. AB - Orthostatic heart rate, systolic and diastolic blood pressure responses to standing were measured in 50 young healthy men and women. The responses of the men and women were the same. Heart rate stabilized after 45 seconds of standing, systolic blood pressure after 2 minutes, and diastolic blood pressure immediately on standing. There was considerable variability in the responses of these normal subjects, raising concerns about the validity of commonly accepted normal values. PMID- 3639859 TI - Effect of sidelying positions on pulmonary artery pressures. PMID- 3639861 TI - Reproducibility of thermodilution cardiac output measurements. AB - The findings of this study provide preliminary evidence to suggest that the first in a series of three thermodilution cardiac output measurements is statistically significantly higher than the second and third measurements when 10 ml of iced 5% dextrose is used as the injectate. The repeated measures analysis of variance was highly significant (p = 0.00001) for the sample (N = 61) and for a subset of patients (N = 34) with concurrent central infusions of 1 to 25 ml/hr (p = 0.004). The first measurement was the highest reading in the series more frequently than expected (54% of the sample). However 23% of the subjects had the second measurement as the highest reading and 22% had the third reading as the highest measurement in the series. The effect of the concurrent central infusions on this set of data is not known. The mean difference between sequential measurements was smallest between the second and third measurements (0.33 L/min) but the mean difference between the first and second measurement (0.38 L/min) and the first and third measurement (0.44 L/min) was of similar magnitude. The first measurement differed from the average of the second and third measurements by more than 10% or by greater than 0.5 L/min in 26% (N = 16) of the readings for the entire sample; this figure was 38% (N = 13) in the subset of patients with concurrent central infusions of 1 to 25 ml/hr. It is important that the measurement protocol be consistent and that triplicate measurements be done so that trends in a patient's hemodynamics can be accurately assessed and the effects of therapeutic interventions evaluated. Data should be cautiously interpreted if the first measurement is significantly higher than the second and third measurements because hemodynamically compromised patients could be adversely affected by this type of technical error. PMID- 3639862 TI - Comparison of coagulation values obtained by traditional venipuncture and intra arterial line methods. PMID- 3639863 TI - Monitoring systemic arterial blood pressure: strip chart recording versus digital display. PMID- 3639864 TI - Care of the patient with superior vena cava syndrome. PMID- 3639865 TI - Wide complex tachycardia: diagnosis and treatment. AB - A wide QRS complex tachycardia that cannot be immediately identified, and which on clinical grounds requires prompt treatment, should be converted electrically. Drug management can be time consuming, and agents that block AV transmission, that is, verapamil and propranolol, may be life-threatening. PMID- 3639866 TI - The role of the clinical ethicist. PMID- 3639867 TI - The effect of hyperinflation, inspiratory hold, and oxygenation on cardiopulmonary status during suctioning in a lung-injured model. PMID- 3639868 TI - Person-environment interaction as a determinant of labor length variables. PMID- 3639869 TI - A meta-analytic study of the effect of childbirth education on the parent-infant relationship. PMID- 3639870 TI - An exploratory study of the miscarriage experience. PMID- 3639871 TI - Artificial insemination by donor: problems and issues. PMID- 3639872 TI - The mechanism of methicillin resistance. PMID- 3639873 TI - Cell-bound and extracellular autolytic activity of a tolerant and a nontolerant Staphylococcus aureus strain exposed to methicillin. AB - Cell-bound and extracellular autolytic activity was studied in a tolerant and a non-tolerant Staphylococcus aureus strain after exposure to low (10 mg/l) and high (80 mg/l) concentrations of methicillin. Tolerance was defined as survival after 24 h of over 2% of the inoculum after exposure to high concentrations of methicillin (greater than or equal to 64 mg/l). The nontolerant strain showed an increased cell-bound autolytic activity after exposure to both low and high concentrations of methicillin. The tolerant strain on the other hand selectively showed a reduced cell-bound autolytic activity after exposure to 80 mg/l of methicillin. In both types of strains extracellular activity was less after exposure to a high concentration of methicillin than after exposure to a low concentration. This phenomenon was caused by the release of an inhibitor of the autolysins under the influence of the high concentration of methicillin. PMID- 3639874 TI - Study of the effect of high molecular weight kininogen upon the fluid-phase inactivation of kallikrein by C1 inhibitor. AB - Plasma kallikrein and factor XIa circulate bound to high molecular weight kininogen, and such binding has been reported to protect these enzymes from inactivation by their respective inhibitors. However, this observation is controversial, and the effect of high molecular weight kininogen upon the interaction between kallikrein and C1 inhibitor (C1-INH) has been questioned. We have re-evaluated this reaction and studied the rate of inhibition of kallikrein by C1-INH in the presence and absence of high molecular weight kininogen. The second-order rate constant of inhibition of kallikrein by C1-INH was unaffected by saturating concentrations of high molecular weight kininogen. Our results suggest that although high molecular weight kininogen clearly augments the rate of formation of kallikrein and other enzymes of the contact activation pathway, it has no effect on the rate of enzyme inhibition by C1-INH. PMID- 3639875 TI - Progress in the characterization of an immunosuppressive glycopeptide (SAP) from patients with major thermal injuries. PMID- 3639876 TI - Influence of membrane dressings on wound contraction. PMID- 3639877 TI - Chemical burns. PMID- 3639879 TI - Comparison of burn size estimates between prehospital reports and burn center evaluations. PMID- 3639878 TI - Pseudomonas maltophilia: an unusual burn wound pathogen. PMID- 3639880 TI - Pain on the burn unit: patient vs nurse perceptions. PMID- 3639881 TI - Silver sulfadiazine-impregnated biologic membranes as burn wound covers. PMID- 3639882 TI - Burn care protocols--nursing care of burned patients with mouth, chin, and neck revisions. PMID- 3639883 TI - Roles and functions of occupational therapy in burn care delivery. PMID- 3639884 TI - Camp Celebrate: a therapeutic weekend camping program for pediatric burn patients. PMID- 3639885 TI - A novel microtubule-associated protein from mammalian nerve shows ATP-sensitive binding to microtubules. AB - We report the isolation of a protein from mammalian nerve which shows ATP sensitive binding to microtubules and ATPase activity. This protein, which we have designated HMW4, was prepared from bovine spinal nerve roots by microtubule affinity and ATP-induced release, and was further purified by sucrose density gradient centrifugation. It is a high molecular weight protein with a denatured Mr of 315,000, a Stokes radius of 90 A, and a sedimentation value of approximately 19S. It can be resolved electrophoretically from the well characterized bovine brain microtubule-associated proteins (MAPs) and also appears to be distinct from MAP 1C. HMW4 has a vanadate-sensitive and azide insensitive ATPase activity which averages 20 nmol Pi/min per mg protein and is different from dynein and myosin ATPases. HMW4 prepared on sucrose gradients exhibits binding to MAP-free microtubules in the absence of ATP which is reduced by ATP addition. Assayed by darkfield microscopy, HMW4 causes bundling of MAP free microtubules which is reversed by ATP addition. PMID- 3639886 TI - o-Nitrophenyl-beta-D-galactopyranoside-urease-indole broth, a new composite tube medium for Salmonella screening. AB - A new composite broth medium combining o-nitrophenyl-beta-D-galactopyranoside (ONPG) and urease and indole tests in a single tube is described. High-level agreement with individual conventional tests was recorded in comparative studies with 2,412 cultures of members of the family Enterobacteriaceae, i.e., 100% agreement with the exception of Hafnia spp. (96.3% agreement) for the ONPG test and Citrobacter, Enterobacter, and Hafnia spp. (75, 86.4, and 98.2% agreement, respectively) for the urease test. The new medium seems especially promising as a screen for Salmonella subgroup I which encompasses most pathogenic Salmonella species other than the Arizona subgroup. PMID- 3639887 TI - Evaluation of laboratory tests for detection of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. AB - Few studies evaluating susceptibility testing of methicillin-resistant staphylococci have included isolates of Staphylococcus epidermidis, a known pathogen in many types of serious infections. We tested 175 S. epidermidis and 95 Staphylococcus aureus isolates to determine the most sensitive procedures for detecting methicillin-resistant staphylococci. Reference procedures included agar dilution with methicillin and 4% NaCl in the agar and broth microdilution with methicillin and 2% NaCl in cation-supplemented Mueller-Hinton broth. After 24 h of incubation, the results from both methods correlated well and were within 1 log2 dilution for all isolates tested. Only one-half of all resistant isolates (92 of 183) were detected at 18 h by using the standard disk diffusion technique with 5-micrograms methicillin disks, and even fewer were detected with 10 micrograms methicillin disks and newly recommended zone-size criteria. However, the standard disk diffusion method with 4% NaCl in the agar increased the sensitivity and specificity for identification of the proper phenotype to greater than 92%. The spread plate and new spot techniques, both using agar with 4% NaCl, were also sensitive methods. Of 47 S. epidermidis isolates tested against oxacillin, 6 (13%) were oxacillin susceptible but methicillin resistant. Two automated systems, the Automicrobic system (Vitek Systems) and MicroScan (American MicroScan), as well as two broth screening systems available from Remel and Austin Biological Laboratories, failed to detect several resistant isolates, depending on the species. PMID- 3639888 TI - Early identification of infants at risk for institutional care. AB - The neonatal health and family situation of infants admitted for institutional care were evaluated retrospectively. Based on the criteria for admission they were classified into four groups: handicapped infants; infants of mothers with psychiatric illness or mental retardation; infants of alcoholic or drug-addicted mothers; and infants of mothers with various social dysfunctions. Mentally disturbed and addicted mothers were to a large extent multiparae. One-fourth of them already had children in foster care. The mentally disturbed mothers had a raised frequency of pregnancy and delivery complications. Compared to the general population, the gestational age and birth weight were significantly lower in all groups, and the number of preterm babies was twice as high. The majority of infants at risk for parental failure due to mental disturbance or addiction can be identified in the maternity ward. Deficient maternal behaviour in the maternity ward and the occurrence of previous children in foster care are important risk factors in predicting maternal incapability for parenting. PMID- 3639890 TI - Nursing science: more promise than threat. AB - This paper considers the issue of nursing science. Nursing, as an art, has long been accepted as integral to nursing. Nursing, as a science, however, is a more recent concept. Nursing science is viewed as a threat to the profession by its opponents, while the proponents of nursing science see it as a promise for advancement of the discipline. This paper examines the issue of nursing science by looking at its history and development, the definition of science, and five factors critical to the nursing science issue. The author concludes that nursing science is, in varying respects, both a threat and a promise. It is clear that the preponderance of evidence favours the promise nursing science holds for the profession of nursing. It is not a matter of choosing either art or science, but rather skillfully blending both for the betterment of nursing. Both art and science are necessary in nursing--neither, however, is sufficient. PMID- 3639889 TI - How nurse therapists assess and contribute to the management of alcohol and sedative drug use among anxious patients. AB - Fourteen nurse therapists completed self-administered questionnaires on their assessment of and input to management of alcohol and sedative drug use among 110 anxious patients referred to them for behaviour therapy. Information on use and on case management is summarized. The therapists play an active, extended role in assessing, communicating about and in some cases advising on reduction of these substances. Policies on use in the context of behaviour therapy are formed in training, and implications for training and the need for awareness of the relevant literature are discussed. PMID- 3639891 TI - Teaching practice experience: linking theory to practice. AB - This paper analyses the relationship between the theory and practice of the art of teaching as experienced by the author during a period of teaching practice in a school of nursing. It examines such concepts as 'aims', 'objectives', 'scheme of work' and 'lesson plans' and sets these in the context of practical classroom teaching. PMID- 3639892 TI - Re-inventing the wheel: a case study of nursing curriculum innovation. AB - This paper reviews the literature concerned with active learning methods in British nurse education. A case study is presented describing the introduction of assisted independent learning to a cohort of student nurses in a district general hospital school of nursing in England. The implications, advantages and problems associated with such curriculum innovation are discussed and some areas for further study are identified. PMID- 3639893 TI - The nurse-client relationship: a mutual learning experience. AB - The nurse-client relationship is a mutual learning experience and a corrective emotional experience for the client. The terms 'learning' and 'corrective' imply a change in the participants' behaviour. Because the prospect of change is threatening, the skillful nurse provides a climate for the client that is conducive to expressing feelings at every step in the course of the nurse-client relationship. Both positive and negative feelings are appreciated; both are put into the service of the problem-solving venture other than being allowed to impede it. To the extent that this occurs, the nurse-client collaborative efforts further the experience of each participant. PMID- 3639894 TI - A comparison of mercury and digital clinical thermometers. AB - A primarily clinical trial has been undertaken to investigate and compare the use of mercury and digital thermometers in a ward situation. Both laboratory and clinical studies show that there is no significant difference in the average accuracy of the two types of thermometers, however there is a greater fluctuation of readings of temperature when using electronic thermometers. In clinical studies between 9 and 23% of repeated measurements using an electronic thermometer differ by 0.5 degrees C or more whilst the corresponding range for mercury thermometers is 0.6%. It is also shown that when making clinical measurements with mercury thermometers there is no clinical advantage in using a measurement time longer than 3 minutes. PMID- 3639895 TI - Binge eaters: a comparison of eating patterns of those who admit to binging and those who do not. AB - The purpose of the study was to assess the prevalence of undiagnosed bulimic or pre-bulimic behaviours in a normal, but high risk population. A questionnaire eliciting information about eating habits and potential binge episodes, demographic background, and information about height and weight was completed by 479 college students. Subjects were designated as a non-binger, a non-labelled binger, or labelled binger according to their responses. Consistent with previous literature, findings showed a high prevalence of bulimia in the young, female, middle income population. Findings also revealed a group of students who described frequent binge episodes but did not consider themselves to have an eating disorder in that they did not label themselves as 'binge eaters' (the non labelled binge group). PMID- 3639896 TI - Relearning to eat late after a stroke by systematic nursing intervention: a case report. AB - Using a training programme developed by Heimlich, we have attempted to train swallowing in a 78-year-old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and, during a follow-up of 1 year, the patient was eating normal food. The training process is analysed as a two-level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of 'eight stages of man'. PMID- 3639897 TI - Nurses' attitudes to care of the elderly. AB - There are problems recruiting nurses to the geriatric wards in Leicester. Using a Likert attitude scale, attitudes of training and trained nurses to the care of the elderly were assessed. Although the trained staff had a significantly more positive attitude than the nurse learners, the latter felt that the attitudes of the trained staff were poor. Possible explanations for this contraindication are discussed. PMID- 3639898 TI - Elucidation and measurement of clinical learning opportunity. AB - Competence in nursing derives from the actual practice of the craft. The authors describe ways of assessing the variety and extent of opportunities for clinical learning available to student nurses. Cohorts of students from each of three different types of hospital (72 students in all) were followed from the beginning to the end of training. From interviews with ward sisters, observation on the wards, and examination of nursing notes the pattern of clinical conditions characteristic of each training ward is established and hence, by aggregation, the pattern for each of the three training schemes. However, it is argued that only by investigating the learning careers of individuals can one gain knowledge and insight in sufficient detail to act as a guide to reform. Information on allocation to training wards is used to construct individual profiles of clinical opportunity, one for each student. Clinical conditions are grouped into 13 categories and it is shown how, for some categories, there are large differences between the experiences of individuals within a cohort, especially in one hospital. Finally the authors explain how, with a minimum of effort, these methods and findings could be adapted to improve and facilitate training; the procedures could be used to monitor each developing profile and, by judiciously modifying the continuing process of allocation, tutors would be able to achieve equality of clinical opportunity for their students. PMID- 3639899 TI - The influence of a positive environment on the attitudes of student nurses towards the nursing process. AB - The attitudes of 67 student nurses towards the nursing process were studied by means of a questionnaire. Attitudes became more favourable over the 8-week study period. The results indicate that a positive environment is influential in changing the attitudes of student nurses towards the nursing process. These findings lend further support to our original work. PMID- 3639900 TI - Paradigms and practices: the organization of the delivery of nursing care. AB - The patient allocation paradigm of nursing care is slowly superseding the task allocation paradigm. A research study reported here upon the introduction of patient allocation in a maternity hospital found that patients experienced few significant changes in their satisfaction; similar to previous studies this research found that the nurses reported significant gains in satisfaction. Following analysis of the 'medical model' assumptions inherent in the two paradigms and the methods used in the studies, it is suggested that a third paradigm of nursing care is emerging, 'patient centred'--a paradigm within which the patient is a participating individual. PMID- 3639901 TI - AIDS: a review and guide for infection control. AB - The Acquired Immune Deficiency Syndrome (AIDS) has been aptly termed the plague of the 80s. Over 19,000 people in less than five years have contracted this incurable viral disease. We have reviewed and summarized the literature in regards to characteristics and epidemiology of the virus, ocular and systemic manifestations, and guidelines for infection control. PMID- 3639902 TI - Across the age boundaries. PMID- 3639903 TI - Recognize gerontological content. PMID- 3639904 TI - Identifying the characteristics of pseudodementia. PMID- 3639905 TI - Nursing diagnosis: actual impairment of skin integrity. PMID- 3639906 TI - A home is a home. PMID- 3639907 TI - Expression of the renal kallikrein gene in mineralocorticoid-treated and genetically hypertensive rats. AB - On the basis of both clinical observations and experimental studies it has been proposed that renal kallikrein is a mineralocorticoid regulated protein. In other studies, changes in renal kallikrein activity have been implicated in the genesis of, and/or response to, hypertension. Using a cloned complementary DNA (cDNA) to rat pancreatic kallikrein (pcXP39) for hybridization histochemistry, and both Northern and dot blot analysis, we studied expression of the kallikrein gene in steroid-treated control animals, and in three strains of genetically hypertensive rats. No differences in renal kallikrein messenger RNA (mRNA) levels were found between adrenalectomized rats and those treated for 5-14 days with 9 alpha fludrocortisone, corticosterone or dexamethasone, or between hypertensive rats and their appropriate controls. Since mRNA levels appear essentially invariant under such circumstances, the change in renal kallikrein activity/immunoreactivity after chronic mineralocorticoid elevation, or in hypertensive rats, presumably reflects modulation at the post-transcriptional level. PMID- 3639908 TI - In vitro generation of an HTLV-III variant by neutralizing antibody. AB - Transmission and culture of "parental" virus (HTLV-III) from H9 cells transfected with the cloned isolate (lambda HXB-2D) in human serum possessing HTLV-III neutralizing antibody selected for a "variant" that was not neutralized by the selecting serum but was neutralized by another antibody-positive serum "Control" virus, selected in serum lacking neutralizing antibody, and the variant showed highly similar tryptic peptide maps of the major envelope glycoprotein, and no changes in restriction enzyme patterns of viral DNA. These findings show that HTLV-III type-specific neutralizing antibodies occur, can influence the propagation of variant viruses that may arise, and presumably result from minor changes in the eliciting antigen. The extent to which such type-specific neutralizing antibodies influence immune surveillance against HTLV-III infection in vivo, a question with relevance to future vaccination attempts, remains to be determined. Nucleotide sequencing of the control and variant envelope genes may elucidate a region important for virus neutralization and vaccine development. PMID- 3639909 TI - Microneurography/microstimulation. PMID- 3639910 TI - Wisconsin Initiative for improving cancer pain management: progress report. PMID- 3639911 TI - Pain facility report: Memorial Sloan-Kettering Cancer Center. PMID- 3639912 TI - Neurolytic nerve block for cancer pain. PMID- 3639913 TI - Itch. PMID- 3639914 TI - The management of acute pain evoked by medical procedures in children with cancer. PMID- 3639915 TI - The availability of narcotics and attitudes towards their use. PMID- 3639916 TI - How to treat a "construct". PMID- 3639917 TI - Report on the NIH Consensus Development Conference on Pain. PMID- 3639918 TI - Wisconsin Initiative for improving cancer pain management: progress report. PMID- 3639919 TI - Thrombolytic therapy: an overview. PMID- 3639920 TI - Trends in cardiovascular nursing research: an analysis. PMID- 3639921 TI - Lasers in cardiovascular diseases. PMID- 3639922 TI - Nursing research. PMID- 3639923 TI - EFM and the nursing role. PMID- 3639924 TI - Nurse-midwifery care in an academic health center. AB - A study of 1,966 women who registered in a certified nurse-midwife (CNM) program for pregnancy and delivery at an academic health center is reported. Eleven percent either were medically disqualified or voluntarily transferred out of the program. Of the 1,852 women who entered labor, 46.5% required MD consultation most often for dysfunctional labor patterns. The primary cesarean section rate was 10.4%. The corrected perinatal mortality rate was 3.80/1,000 births. CNM care is a safe, cost-effective, and sought-after alternative to MD-only care for low risk women within a tertiary care setting. PMID- 3639925 TI - Fatigue during the first trimester of pregnancy. AB - Fatigue is accepted as an early symptom of pregnancy. Fatigue may be due to energy depletion resulting from the physiologic and psychological changes occurring during the first trimester. The following changes are considered: oxygen consumption; fetal growth and development; cardiovascular, respiratory, urinary tract, metabolic, and psychological processes. The goals of nursing therapy for first-trimester fatigue are to help the woman cope with the distress caused by the fatigue and to help minimize or alleviate the fatigue to the degree that is possible. The nursing therapy should include sharing information about the nature of the fatigue, developing an activity-rest program, and sharing information aimed at alleviation of psychological stresses. PMID- 3639926 TI - Changes in bladder function in the woman undergoing radical hysterectomy for cervical cancer. AB - Radical hysterectomy, a procedure used in the treatment of women with cervical cancer, is frequently a cause of either temporary or permanent bladder dysfunction in the postoperative period. Four major types of dysfunction are seen: hypertonus of the bladder muscle, loss of sensation of bladder fullness, difficulty initiating micturition, and bladder hypotonia. Nursing interventions can affect adaptation to some of these problems and prevention of others. A review of rehabilitative literature is used to develop a rationale for nursing care using Levine's Conservation Principles as a conceptual framework. PMID- 3639927 TI - Nursing implementation of single-room maternity care. AB - For five generations, infants were born at St. Mary's Hospital in Minneapolis, Minnesota, in a conventional setting. Mothers labored in one room, delivered in another, recovered in yet another, and spent the remainder of the hospital stay in a postpartum room. Five generations of nurses were taught and practiced in the compartmentalized manner that the physical structure of this traditional unit mandated. In March 1984, tradition gave way to a new era with the opening of an 18-bed, single-room maternity care system--The Birthplace. With the opening of this new unit, the changes in nursing care delivery were dramatic. New roles were developed for nursing staff. The transition to this contemporary practice was not without its labor pains. PMID- 3639928 TI - The use of daily fetal movement records in a clinical setting. AB - A variety of biochemical and biophysical techniques are used for the assessment of fetal well-being in high-risk pregnancy. Based on clinical experience, the daily fetal movement record has been found to be an inexpensive, non-invasive, simple tool that may be used for the continuous assessment of the fetus by the mother. The daily fetal movement record may predict fetal distress occurring in the interim between other assessments. Patients are instructed to count the number of fetal movements perceived in a 30-minute period, three times per day. The daily fetal movement record is a screening tool that may signal the need for further fetal well-being assessment. The tool promotes the mother's active participation in assessment of her high-risk fetus and may encourage maternal fetal attachment. PMID- 3639929 TI - Unique aspects of Korean-American mothers. AB - A descriptive study was conducted to explore Korean beliefs and attitudes toward pregnancy, birth, and postpartum practices. In addition, overall characteristics of Korean mother-infant interactions are described. The sample consisted of 21 healthy Korean mothers and their term infants. The study revealed that Korean mothers in the United States continued Korean cultural practices related to pregnancy, birth, and postpartum behaviors. One alteration from traditional birth practices was related to infant feeding. Although many of the mothers believed that breastfeeding was better for the infants, the mothers chose to bottle-feed. Nurses need to use knowledge of the value systems of culturally different patients to plan relevant nursing care. PMID- 3639930 TI - The effect of infant formula samples on breastfeeding practice. AB - To determine whether infant formula samples affect breastfeeding practice, 95 breastfeeding mothers were randomly assigned to receive or not receive formula samples on discharge from a postpartum unit. Unaware of the specific nature of the study, these mothers were interviewed by telephone six to seven weeks postpartum by an investigator blind to the randomization status. Although more women who had discontinued breastfeeding were among the group who had received samples than those who had not received samples, the difference was not statistically significant. Significant differences were not found in three subgroups hypothesized to be more vulnerable to the samples: less educated women, primiparas, and women who were ill postpartum. PMID- 3639931 TI - Menstrual perceptions and preparation among female adolescents. AB - Seventy-four 8th- and 10th-grade students attending a private girls' school in Hawaii were queried about their perceptions of and preparation for menstruation using a questionnaire administered in a health education class. Eighty percent had already started menstruating. The most frequently cited perceptions by the respondents referred to both the inconveniences and the normalcy of menstruation. Many were first informed about menstruation by their mothers and stated that they also first informed their mothers when they started menstruating. Surprise, fear, and embarrassment were common initial reactions, while strong negative or positive emotions were more rare. Only 35% wanted boys and girls together during class discussion, but 89% stated that boys needed to be informed about menstruation. The most frequent reasons cited for noncoed settings were the girls' concern about their comfort in openly discussing menstruation. Thirty eight percent thought parents should inform other siblings when they started menstruation, although almost half gave specific conditions the parents should consider. The majority thought the fifth to sixth grades were the best times to introduce menstruation content. PMID- 3639932 TI - The role of the nurse in labor and delivery as perceived by nurses and patients. AB - A study was conducted to examine the role of the labor and delivery room nurse as perceived by expectant mothers trained in the Lamaze method of preparation for childbirth (L/RC), expectant mothers not trained in the Lamaze method (RC), and labor and delivery room nurses. All expectant mothers received baseline prenatal education by attending Red Cross Preparation for Parenthood. Perceptions were measured through a Q-sort of 50 items constructed for this study. Each item described a nursing behavior in labor and delivery. Differences between Q-sorts of expectant mothers and labor and delivery room nurses were insignificant. The collected data showed that labor and delivery room nurses were meeting the expectations of expectant mothers, both trained and not trained in the Lamaze method. Perceptions of the nurse's role in labor and delivery differed slightly so that individualization of care is important. PMID- 3639934 TI - Public speaking and nursing: an avenue for professionalism. PMID- 3639933 TI - Promoting informed consent of women in labor. AB - Laboring women are increasingly being asked to participate in perinatal research. These women should be considered captive or special subjects who deserve greater protection of their rights. Essential elements of informed consent are reviewed. Specific guidelines are suggested for promoting informed consent for women in labor participating in clinical research. PMID- 3639935 TI - Adolescents' perception of stressful events during hospitalization. PMID- 3639936 TI - Pediatric nurses' assessments of pain in children. PMID- 3639937 TI - A comprehensive exercise program for persons with cystic fibrosis. PMID- 3639938 TI - Environmental variables and acute asthmatic attacks in children. PMID- 3639939 TI - Managing a pediatric service in a general hospital. PMID- 3639940 TI - Children have rights too. PMID- 3639941 TI - Employer preventive practices. PMID- 3639942 TI - Esophageal pH monitoring. PMID- 3639943 TI - Infection control. Nutritional assessment. PMID- 3639944 TI - The law and your profession. PMID- 3639945 TI - Your ce topic this month (No. 17). Quantitative evaluation of vitamin safety. PMID- 3639946 TI - The left-handed patient: is there a difference? PMID- 3639947 TI - Burnout! PMID- 3639949 TI - Your CE topic this month (No. 18). Common childhood acute illnesses. PMID- 3639948 TI - International nursing: a cure for burnout. PMID- 3639950 TI - AIDS virus infection. PMID- 3639951 TI - Effects of pulsed microwave radiation on the contractile rate of isolated frog hearts. AB - Hearts from 81 frogs were divided into 10 groups and placed individually in a temperature-controlled waveguide filled with Ringer's solution. Hearts of Group A served as controls. Hearts of the other nine groups were treated with pulsed microwaves (2450 MHz, 10 microseconds, 100 pps) that ranged from a specific absorption rate (SAR) of 2 to 200 W/kg. In several groups, an electrocardiogram was used to synchronize microwave irradiation with the heartbeat. In one group of frog hearts exposed at 200 W/kg, the heart rate slowed down sharply 25 minutes after irradiation, by which time the temperature of the Ringer's solution had risen by 7 degrees C. In another group exposed at 200 W/kg but under constant temperature, the heartbeat almost paralleled that of the control group. Other groups, including exposures of frog hearts to 16 Hz modulated CW or pulsed fields at SARs from 3 mW/kg to 8.55 W/kg, showed no effects of pulsed microwave irradiation on heartbeats; no brachycardia or tachycardia were found at constant temperatures. PMID- 3639952 TI - Detection of HTLV-III RNA in lungs of patients with AIDS and pulmonary involvement. AB - A majority of pediatric patients and rare adult patients with the acquired immunodeficiency syndrome (AIDS) develop a chronic respiratory disorder referred to as "lymphocytic interstitial pneumonitis" (LIP). Efforts to identify an infectious agent responsible for this process so far have failed. In this study, frozen sections of lungs from patients with AIDS and pulmonary disease were tested by in situ molecular hybridization for the presence of cells infected with human T-cell lymphotropic virus type III (HTLV-III) and expressing viral RNA. In the case of an infant with LIP, a relatively high frequency (0.1%) of cells in the lung were found to be positive for HTLV-III RNA. This number is the lower limit of total cells infected since the in situ hybridization technique as applied in this study depends on expression of HTLV-III genes, and previous evidence indicates that a proportion of cells infected with HTLV-III may not express viral RNA. Moreover, this degree of infection of the lung is likely limited to LIP, since in ten patients with AIDS and pulmonary diseases other than LIP, only 0% to 0.002% of cells in lung were positive for viral RNA expression. Thus, HTLV-III may play a direct causal role in the development of LIP in infected patients, implicating its involvement in yet another of the diverse clinical diseases associated with this virus. PMID- 3639954 TI - HTLV-III/LAV and the monocyte/macrophage. PMID- 3639953 TI - Human T-cell lymphotropic virus type III infection of the central nervous system. A preliminary in situ analysis. AB - Patients with the acquired immunodeficiency syndrome (AIDS) are subject to a spectrum of central nervous system (CNS) disorders. Recent evidence implicates the human T-cell lymphotropic virus type III (HTLV-III) in the pathogenesis of some of these illnesses, although, the cells infected by the virus have yet to be identified. Using in situ hybridization, we examined brain tissue from two patients with AIDS encephalopathy for the presence of HTLV-III RNA. In both cases, viral RNA was detected and concentrated in, though not limited to, the white matter. The CNS cells most frequently infected included macrophages, pleomorphic microglia, and multinucleated giant cells. Less frequently, cells morphologically consistent with astrocytes, oligodendroglia, and rarely neurons were also infected. The findings strengthen the association of HTLV-III with the pathogenesis of AIDS encephalopathy. In situ hybridization can be applied to routinely prepared biopsy tissue in the diagnosis of HTLV-III infection of the CNS. PMID- 3639955 TI - [Diagnostic tests in clinical obstetrics. 19. Diagnostic tests for pregnancy toxemias]. PMID- 3639956 TI - [Nursing process for mothers and infants]. PMID- 3639957 TI - [Nursing process for pregnant patients: management of pregnant patients on ambulatory basis]. PMID- 3639958 TI - [Nursing process for pregnant and puerperal patients]. PMID- 3639959 TI - [Nursing process for newborn infants: nursing of an infant with Pierre-Robin syndrome and cleft palate]. PMID- 3639960 TI - [The role of midwives at the ambulatory gyneco-obstetrical service. An impression on the "creation of ambulatory gyneco-obstetrical service" published in the February issue of the journal]. PMID- 3639961 TI - [Current childbirth education practiced in the United States. An interview with Ms. Susan McKay]. PMID- 3639962 TI - [Basis of nursing in midwifery. Extraction of the keypoints in the analysis of the nursing process during delivery]. PMID- 3639963 TI - [Questions and answers in breast feeding. Management of the pain due to congestion of the breast]. PMID- 3639964 TI - [Training of home helpers]. PMID- 3639965 TI - [A survey on the "attitude toward delivery and breast feeding" conducted by Yanase Waichi]. PMID- 3639966 TI - [Traditions in childbirth and child rearing. 16. Husbands' assistance at delivery]. PMID- 3639967 TI - [Perinatal nursing: a psychosocial approach. 4. A "psychological loss" associated with pregnancy and nursing assistance for the adjustment]. PMID- 3639968 TI - [Changes in midwifery function. 14. Uninvolvement of Dr. Seki of the Department of Health and Welfare in legislation of the Eugenic Act of 1941]. PMID- 3639969 TI - [The nervous system and reflexes of the newborn]. PMID- 3639970 TI - [Maternity blues]. PMID- 3639971 TI - [Preparation and use of an objective test]. PMID- 3639972 TI - [Pregnancy threatening family life]. PMID- 3639973 TI - [Progress in intrauterine fetal transfusion]. PMID- 3639974 TI - [Diagnostic tests in clinical obstetrics. 20. Tests for heart diseases in pregnancy]. PMID- 3639975 TI - [Attitude of midwives toward the presence of husbands at delivery]. PMID- 3639976 TI - [The "new type of childbirth" and the role of husbands]. PMID- 3639977 TI - [Childbirth and the modern trend]. PMID- 3639978 TI - [Discussion. Husbands' experiences in attending their wives' delivery]. PMID- 3639979 TI - [Presence of husbands at childbirth and their psychological support]. PMID- 3639981 TI - [The work conditions of the instructors at midwifery schools in Japan]. PMID- 3639982 TI - [Importance of freer teacher-student relationship in midwifery education]. PMID- 3639980 TI - [Survey among the couples following childbirth attended by husbands]. PMID- 3639983 TI - [Immunity and infection of newborn infants]. PMID- 3639984 TI - [Questions and answers in breast feeding. Management of stagnation mastitis]. PMID- 3639985 TI - [Perinatal care of the mother and infant: psycho-social approach. 5. Nursing during delivery--attitude to the patient experiencing labor pain]. PMID- 3639986 TI - [Changes in midwifery functions. 15. Dr. Mitsuo Seki of the Ministry of Health and Welfare and the establishment of the system of pregnancy registration. Interview by M. Obayashi]. PMID- 3639987 TI - [Traditions of childbirth and child rearing. 17. Childbirth--recognition by the local community]. PMID- 3639988 TI - [The concept of high risk pregnancy]. PMID- 3639989 TI - [Preparation of an essay test]. PMID- 3639990 TI - [Medical social service: understanding the others]. PMID- 3639991 TI - [Shoulder dystocia (1)]. PMID- 3639992 TI - [Diagnostic tests in clinical obstetrics. 21. Obstetrical shock and diagnosis of DIC]. PMID- 3639993 TI - [Exercises for pregnant women to nurture a positive attitude toward pregnancy]. PMID- 3639994 TI - [Theories behind exercise therapy and exercises during and following pregnancy]. PMID- 3639995 TI - [A counseling service for breast feeding. Discussion]. PMID- 3639996 TI - [Recommendation of breast feeding (1). Advantages of breast feeding]. PMID- 3639997 TI - [Re-evaluation of the obstetrical care by reviewing a process record]. PMID- 3639998 TI - [Menstruation and a modern view on associated hygienic behaviors: a survey among nursing students]. PMID- 3639999 TI - [Natural childbirth described in "The Good Earth" by Pearl Buck]. PMID- 3640000 TI - [Customs concerning childbirth and child care. 18. Changes in the attitude to pregnancy]. PMID- 3640001 TI - [Questions and answers on breast feeding: management of mastitis]. PMID- 3640002 TI - [Introduction to perinatology. 18. Congenital abnormalities and heredity]. PMID- 3640003 TI - [Perinatal nursing of the mother and infant: psychosocial approaches. 6. A review of the birth process--assistance in assuming a new role of a mother]. PMID- 3640004 TI - [Timing of birth]. PMID- 3640005 TI - [Encouragement of students to engage in research (1)]. PMID- 3640006 TI - [Medical social services. Support of a pregnant patient by her family members]. PMID- 3640007 TI - [Shoulder dystocia]. PMID- 3640008 TI - [Chronic effect of sodium and angiotensin II on the synthesis or activation of renal kallikrein in rats]. PMID- 3640009 TI - [Decision making in nursing. 10. Indifference of nurses in spite of a slogan, "patient-oriented nursing"]. PMID- 3640010 TI - [Nursing theory. 10. A need for a theory in facing a difficulty in nursing]. PMID- 3640011 TI - [Understanding of a patient at crisis and the role of nursing. A loss and grief- a crisis process and nursing actions]. PMID- 3640012 TI - [Understanding of a patient at crisis and the role of nursing. The reaction of a mother at the death of her child: grief reaction and the recovery process seen in the family]. PMID- 3640014 TI - [Understanding of a patient at crisis and the role of nursing. Care of a patient who refuses to acknowledge the illness]. PMID- 3640013 TI - [Understanding of a patient at crisis and the role of nursing. Patients with renal failure at finding out the nature of their illness: understanding of unspoken anguish]. PMID- 3640015 TI - [Understanding of a patient at crisis and the role of nursing. Postoperative discovery of a loss of the esophagus: nursing of a patient in a crisis state following surgery]. PMID- 3640016 TI - [Understanding of a patient at crisis and the role of nursing. A patient with hemiplegia and aphagia: the role of nursing in the process of acceptance of disability by a stroke patient]. PMID- 3640017 TI - [Bedside nursing. Nursing of a patient in crisis and the process of his recovery from despair]. PMID- 3640018 TI - [Listening to a schizophrenic patient through nursing interactions]. PMID- 3640019 TI - [Self-help groups. 4. An organization of asthmatic patients]. PMID- 3640021 TI - [A monologue of a nursing director. Human touch in modern nursing]. PMID- 3640020 TI - [A record of woman-physician suffering from cancer. 10. Resumption of antineoplastic chemotherapy]. PMID- 3640022 TI - [Practice of Oriental medicine. 10. Treatment at the development of the overt symptoms of cold]. PMID- 3640023 TI - [Welfare and medical care in the aging society. 2. Definition of the aged]. PMID- 3640024 TI - [Introduction of POS to nursing. 13. Examples of formats for initial planning]. PMID- 3640025 TI - [Counseling of patients. 21. The Gestalt therapy: counseling methodology. 9]. PMID- 3640026 TI - [Nursing homes in New York. 10. Nursing conferences to improve the quality of care]. PMID- 3640027 TI - [Liver cirrhosis]. PMID- 3640028 TI - [Diagnosis of liver cirrhosis and determination of its severity]. PMID- 3640029 TI - [Prognosis in liver cirrhosis]. PMID- 3640030 TI - [Bed rest and diet of patients with liver cirrhosis]. PMID- 3640031 TI - [Establishment of the criteria for bed rest for patients with liver cirrhosis]. PMID- 3640032 TI - [Health education of patients with alcoholic liver cirrhosis]. PMID- 3640034 TI - [Nursing of patients with non-compensatory liver cirrhosis. Chemotherapy and nursing support]. PMID- 3640033 TI - [Early detection of factors responsible for acute exacerbation and the care of patients with liver cirrhosis]. PMID- 3640035 TI - [Nursing of patients with non-compensatory liver cirrhosis. Nursing of patients with liver cirrhosis and ascites]. PMID- 3640036 TI - [Nursing of patients with non-compensatory liver cirrhosis during exacerbation]. PMID- 3640037 TI - [Management of a patient with liver cirrhosis complicated by liver cancer before and after hepatectomy]. PMID- 3640038 TI - [Surgery of the digestive system in patients with a complication of liver cirrhosis]. PMID- 3640040 TI - [Nursing of patients with abdominal injuries]. PMID- 3640039 TI - [Treatment of abdominal injuries]. PMID- 3640041 TI - [New nursing technology. A prosthetic urinary bladder]. PMID- 3640042 TI - [Psychological effects of extended bedrest and advantages of early ambulation--a case of spinal surgery]. PMID- 3640043 TI - [Cleaning and sterilization of the upper gastrointestinal endoscope]. PMID- 3640044 TI - [Progress in cancer therapy. 8. Brain tumors]. PMID- 3640045 TI - [Modern clinical tests. 8. Automated blood analyzers]. PMID- 3640047 TI - [Nursing technology in home care. 8. Rehabilitation by home nursing]. PMID- 3640046 TI - [Pharmacological information. 8. Therapeutic agents for hemophilia and leukemia]. PMID- 3640048 TI - [Nursing practice and accidents. 8. Accidents involving hospitalized patients]. PMID- 3640049 TI - [To live a fulfilled life: discussion]. PMID- 3640050 TI - [Attitudes of health personnel toward terminal care and their education]. PMID- 3640051 TI - [What is expected in the terminal care]. PMID- 3640052 TI - [Terminal care and the attitude of health personnel: life, death, and medical care]. PMID- 3640053 TI - [Limitations in terminal care at hospitals and in home care]. PMID- 3640054 TI - [On a "more desirable dying process" by Dr. Ishikawa]. PMID- 3640056 TI - [Futility of terminal care]. PMID- 3640055 TI - [A comment by the attending physician of a dying patient]. PMID- 3640057 TI - [Consideration for the remaining time of dying patients]. PMID- 3640058 TI - ["Habituation" with death in nursing]. PMID- 3640059 TI - [Death encountered in home nursing]. PMID- 3640061 TI - [Terminal care as the scene for the practice of humane nursing]. PMID- 3640060 TI - [Preparation for the final stage of dying patients]. PMID- 3640062 TI - [Home as an ideal place for dying]. PMID- 3640063 TI - [Management and training of the terminal care team]. PMID- 3640064 TI - [Understanding dying patients]. PMID- 3640066 TI - [Grief education and nurses]. PMID- 3640065 TI - [A terminal care training program at the Hospice Unit of Yodogawa Christian Hospital]. PMID- 3640067 TI - [Nurses' dilemma]. PMID- 3640068 TI - [New bedside nursing technology. Nursing and patients with vertigo]. PMID- 3640069 TI - [Pre-surgical psychological adjustment--nursing of a patient who was scheduled for amputation of the left leg but was unable to accept the circumstances]. PMID- 3640070 TI - [The relationship of the quantity of dust particles with bacterial count or with the volume of traffic in a ward of internal medicine]. PMID- 3640071 TI - [Attempt at improving sequential nursing records of patients in serious conditions]. PMID- 3640072 TI - [Focus on modern medical services. 28. Overview on geriatric care]. PMID- 3640073 TI - [Pre- and post-operative nursing of a patient with lumbar vertebral disk herniation]. PMID- 3640074 TI - [Treatment of peripheral vascular injuries]. PMID- 3640075 TI - [Nursing of patients with peripheral vascular injuries]. PMID- 3640076 TI - [Keypoints in th observation of patients with acute myocardial infarction at the CCU]. PMID- 3640078 TI - [Witnesses of postwar nursing in Japan. Nursing as a learning experience with patients]. PMID- 3640079 TI - [Progress in cancer therapy. 10. Pharyngeal cancer]. PMID- 3640077 TI - [Preparation and the use of formats for communication between nursing shifts]. PMID- 3640080 TI - [Important pharmacological information. 10. Pharmacological agents used for the treatment of allergic diseases]. PMID- 3640081 TI - [Nursing technology practiced in home care. 10. Understanding and support of patients' families]. PMID- 3640083 TI - [A study on empathy among nursing students]. PMID- 3640082 TI - [Nursing practice in iatrogenic incidents. 10. Accidents related to guidance and observation of patients]. PMID- 3640084 TI - [A study on empathy among nursing students. Discussion]. PMID- 3640085 TI - [Impressions of a foreign student (5). Response to conflict and scientific belief]. PMID- 3640086 TI - [Parse's nursing theory and I]. PMID- 3640087 TI - [The goal of nursing education--student-centered nursing education]. PMID- 3640088 TI - [Preparation of a guidance outline for clinical training]. PMID- 3640089 TI - [A study on acquisition of basic nursing technics at a two-year college of medical technology]. PMID- 3640090 TI - [Structure and functions of education and study. 13. On life-time learning]. PMID- 3640091 TI - [Clinical training: psychological processes seen in students' records]. PMID- 3640093 TI - [Interpersonal relationship of nursing students: with special reference to their problems]. PMID- 3640092 TI - [Structuralization of the nursing theory and its background. Discussion]. PMID- 3640094 TI - [Specific goals in assistance in daily activities--with special reference to assistance at mealtime]. PMID- 3640095 TI - [Educational innovation]. PMID- 3640096 TI - [The current focus on Sawauchi-Mura, Iwate Prefecture: municipal effort to maintain the public health standard]. PMID- 3640097 TI - [Changes in the public health nursing activities at local public health clinics. Discussion]. PMID- 3640098 TI - [Maternal and child health care at a public health clinic]. PMID- 3640099 TI - [Hardship at the settlement project in Hokkaido: in search of the roots of nursing in public activities in the wilderness]. PMID- 3640100 TI - [Public health nursing action in the improvement of the housing environment. (2). Varied responses to varied living conditions]. PMID- 3640101 TI - [Health improvement campaign closely related to daily lives: achievement in public health nursing in the past 10 years]. PMID- 3640102 TI - [The role and function of the public health nurse in social therapy of alcoholic patients (2)--With special reference to assistance in their social rehabilitation]. PMID- 3640104 TI - [Assessment and assistance for families in crisis: crisis triggered by health problems of family members having varied roles]. PMID- 3640103 TI - [Study on the method of regional nursing education (2)--The effects of clinical training in school health in the curriculum of public health nursing]. PMID- 3640105 TI - [Medical cost and public health. Public health activities at Sawauchi Village, Iwate Prefecture (4). People who created and supported the activities]. PMID- 3640106 TI - [Public health activities at Nerima Ward, Tokyo: an appeal by a member of a citizens' organization]. PMID- 3640107 TI - [Group rehabilitation training to expand the daily activities--a legislative response to the aging society]. PMID- 3640108 TI - [Rehabilitation training program implemented by the legislation for welfare of the aged]. PMID- 3640109 TI - [Public health services and maternal and child health care. 2. Efforts to raise healthy children]. PMID- 3640110 TI - [Nursing roots in the remote reclamation areas of Hokkaido. 7. Appreciation of the public health nursing system]. PMID- 3640111 TI - [Regional public health activities. Focusing on a model area as a starting point in preventive health services]. PMID- 3640112 TI - [Nursing input to the housing arrangement (3). Housing situations and prevention of recurrence of mental disorders]. PMID- 3640114 TI - [Educational methods in teaching of home nursing technics]. PMID- 3640113 TI - [Study on the professional nature and specificity of public health nursing. A study of enuresis. I. Helping functions and analytical framework of enuresis]. PMID- 3640115 TI - [Soft medicine. Science of structure according to function. Ethiopathy, a true difference?]. PMID- 3640116 TI - [Ethical conflicts: how to approach them? (2)]. PMID- 3640117 TI - [Complementary education for nursing assistants]. PMID- 3640118 TI - [Teaching anatomy and physiology. Using conceptual frameworks]. PMID- 3640119 TI - [Catastrophic nursing care: from now on an integral part of nursing education]. PMID- 3640120 TI - [A new group of common interests has arisen in the Swiss Nurses' Association: continuing and complementary inservice training]. PMID- 3640121 TI - [Nursing care in case of catastrophies, integrated into basic education]. PMID- 3640122 TI - [Ergonomic considerations according to the Brugger-concept. A pathway towards good posture]. PMID- 3640123 TI - [Developments in nursing (1). What is a concept?]. PMID- 3640124 TI - [The ethical dilemma in nursing (2). 2 models of ethical argumentation]. PMID- 3640125 TI - Health problems and sexual activity of selected inner city, middle school students. AB - Physical examinations were performed and health and sexual histories were taken on 496 12-14-year-old, inner city, middle school students participating in extracurricular activities. Health problems were identified in 9.5% of students. Twenty-one percent of a subgroup of 276 students reported sexual activity; males were three times as likely as females to report intercourse. More than one-half of a smaller subgroup named their parents as their primary source of information on sex. The value of the screening exam is discussed, and suggestions are offered on the content of preventive health and sex education curricula for this age group. PMID- 3640126 TI - Transferring a clinic-based health education program for children with asthma to a school setting. AB - Open Airways is a clinic-based health education program for low income, inner city families of children with asthma. The program was transferred to the public schools to test it in a setting more representative of school-age children with asthma, and to provide health education for families not receiving medical care for asthma. During the transfer, the program changed from placing primary responsibility for management on parents to a child-centered program independent of direct parental involvement. Children's attendance increased greatly and a significant number of families not receiving regular medical care for asthma enrolled. Preliminary analysis showed the child-centered program improved children's school performance and asthma management skills. The findings of this study suggest health education programs designed for medical care settings can be adapted successfully for use in the schools and reach new populations of children with chronic diseases. PMID- 3640127 TI - Evaluation of nursing practice in schools. AB - Evaluation of school nursing often focuses more on programmatic concerns than on performance. More emphasis is placed on program components than on quality of nursing performance. In addition, many such evaluations are conducted by non nurses who do not possess the theoretical or clinical knowledge to evaluate practice accurately. Considerations in planning meaningful evaluations of school nursing practice are described. Types of objectives are identified, and suggestions for designing an evaluation are offered. The importance of standardizing an evaluation is discussed, including reference to some major evaluation resources. PMID- 3640128 TI - School-based drug education in North America: what is wrong? What can be done? AB - This article reviews experimental literature concerning the impact of drug (including alcohol and tobacco) education. Major weaknesses are identified with respect to planning, development, implementation, and evaluation of programs. Of special significance are inadequate identification of program objectives and target groups, failure to appreciate the dynamics of effective influence, lack of attention to program dissemination and utilization, and lack of concern with establishing the impact of programs through careful evaluation. PMID- 3640129 TI - Blood pressure of low income, Mexican-American children. AB - Blood pressure (BP) readings were obtained for 1,680 low income Mexican-American (MA) children, ages ten-14 years, to determine distributions among this ethnic group. Analysis of data indicated mean BP increased with age, with boys exhibiting slightly higher systolic and diastolic blood pressures than girls. Comparison of MA subjects with National Institutes of Health percentile norms revealed significantly lower BP levels (p less than .001) among study subjects at all age groups. PMID- 3640130 TI - Comprehensive school-based health clinics: a growing movement to improve adolescent health and reduce teen-age pregnancy. PMID- 3640132 TI - Recurrent physical symptoms: a collaborative biopsychosocial approach to evaluation and management. PMID- 3640133 TI - Promoting positive attitudes toward aging among children. PMID- 3640131 TI - The Newport News, Virginia, Dental Health Fair. PMID- 3640134 TI - The structure of children's beliefs about health and illness. AB - This study examined the structure of causal beliefs in children, concentrating on attributions by children about "staying well" vs. "getting sick." Eighty-two children in grades one, three, five, and seven-eight participated in the study. Children were asked pairwise to compare five causes of health and five causes of illness. Self-controlled or self-initiated actions were the most highly ranked causes of health. As a cause of illness, self-initiated behaviors were ranked second to germs and bad weather. Health and illness seemed to be understood as reciprocal aspects of the concept "health" by older but not by younger children. Results are discussed in relation to attributions made at different age levels. PMID- 3640136 TI - Negative health messages in schools. PMID- 3640135 TI - Future Fit: a cardiovascular health education and fitness project in an after school setting. AB - Future Fit was developed to provide a low cost, heart health education and fitness program that could be incorporated readily into existing after-school programs with minimal teacher training and nominal expenditures for equipment and supplies. Participants in the 12-week demonstration project were 55 third and fourth grade students enrolled in after-school programs at four sites, randomly assigned to experimental and control conditions. Results indicated significant knowledge gains and changes in knowledge, attitude, and behavior at home. These outcomes suggest health and fitness programming in the after-school setting can be an effective complement to the education provided within the school setting. PMID- 3640137 TI - A Toblacko Belt in Karate: classroom theater on the hazards of smoking. PMID- 3640138 TI - The elementary school health fair: a process involving the whole school in health education. PMID- 3640139 TI - [A need to nurture a professional attitude in health personnel]. PMID- 3640140 TI - [Training of nursing students to develop a professional attitude--the significance and practice of training]. PMID- 3640141 TI - [Current status of and problems in the evaluation of the emotional aspects of nursing]. PMID- 3640142 TI - [Changes in nursing students' attitudes during clinical training in psychiatry]. PMID- 3640143 TI - [The attitude of nursing students observed by a ward nurse]. PMID- 3640144 TI - [Development of professional attitude through group training--use of a camp experience in organization]. PMID- 3640145 TI - [Changes in pressure distribution by the angle of the bed and their significance in the prevention of bedsores]. PMID- 3640146 TI - [The family. 10. Single persons in the modern society]. PMID- 3640147 TI - [Discussion: life activities through nursing. 10. Creation of an ideal home for the aged utilizing the nursing experience]. PMID- 3640148 TI - [The role of hospital nurses in primary nursing care. 2. The educational system for diabetic patients and the role of nurses]. PMID- 3640149 TI - [Learning the fundamentals of nursing through clinical training]. PMID- 3640150 TI - [Teaching plan for geriatric psychology--on responses to an aged patient who misunderstood fasting before diagnostic tests]. PMID- 3640151 TI - [Nursing associated with activities of daily living. 7. Nursing actions related to excretion (1)]. PMID- 3640152 TI - [Giving a shampoo to patients who require bed rest]. PMID- 3640153 TI - [Epidemiology and prognosis of pancreatitis]. PMID- 3640154 TI - [Symptoms, diagnosis and treatment of pancreatitis]. PMID- 3640155 TI - [Keypoints in comprehending the overall condition of patients with pancreatitis (with a surgical indication)]. PMID- 3640157 TI - [Nursing of patients with acute pancreatitis requiring emergency surgery]. PMID- 3640156 TI - [Nursing plan for a pancreatitis patient (with a surgical indication)]. PMID- 3640158 TI - [Nursing of pancreatitis patients: evaluation of case studies. Were the approach to the families and psychological aid to the patients appropriate?]. PMID- 3640159 TI - [Assistance in rehabilitation training of a patient with open fracture of the leg and evaluation of the results of the training]. PMID- 3640160 TI - [Nursing during abdominal hysterectomy under spinal anesthesia]. PMID- 3640162 TI - [To enter the world of patients with senile dementia]. PMID- 3640161 TI - [Nursing of a patient with tongue cancer during radiotherapy. A case report]. PMID- 3640163 TI - [Understanding of senile patients. Understanding through abnormal behaviors]. PMID- 3640164 TI - [Understanding of senile patients. Communication through the residual memory of the patient]. PMID- 3640165 TI - [Impressions on a film, "the World of Aged Demented Patients."]. PMID- 3640166 TI - [Care of children with cerebral palsy. 1. Attempts at creating a closer relationship between mothers and institutionalized children]. PMID- 3640167 TI - [Emergency nursing. Multiple injuries]. PMID- 3640168 TI - [Physiopathology and prognosis of breast cancer]. PMID- 3640169 TI - [Diagnosis and treatment of breast cancer]. PMID- 3640170 TI - [Keypoints in observation of patients with breast cancer]. PMID- 3640171 TI - [Nursing planning for patients with breast cancer]. PMID- 3640172 TI - [Nursing of a patient with bilateral breast cancer developing at different times and followed by repeated recurrences and metastases]. PMID- 3640173 TI - [Nursing of patients with breast cancer. Discussion: a possible lack of nursing effort to encourage patients to express anxiety]. PMID- 3640174 TI - [A study on storage of patients' personal belongings at a hospital environment]. PMID- 3640175 TI - [Meal-time assistance of a patient with chorea-acanthocytosis]. PMID- 3640176 TI - [Test yourself. Nursing of a patient with acute type A hepatitis]. PMID- 3640177 TI - [Case report. An innovation in the meal-time assistance of a patient with sequelae of a stroke]. PMID- 3640178 TI - [Excessive nursing actions and independence of the patient]. PMID- 3640179 TI - [A gap between the intended nursing action and the expectations by the patient]. PMID- 3640180 TI - [Experience in hospitalization as an opportunity to understand the needs of patients]. PMID- 3640181 TI - [Discovery of the real profile and needs of the patient]. PMID- 3640182 TI - [Psychology of cancer patients. 8. Prayers]. PMID- 3640183 TI - Expectations and coping of women undergoing in vitro fertilization. AB - Approximately 15% of childbearing couples in America experience infertility. While dramatic progress has been achieved in relation to the diagnosis and treatment of the organic components of infertility, less attention has been paid to the emotional dimensions of this life crisis. Descriptive data were gathered from interviews with three women who completed an in vitro fertilization cycle at a large midwestern university hospital. Open-ended interview questions elicited information about each woman's in vitro experience with regard to the realization of her expectations, her coping mechanisms, and suggestions for what would have helped. Differences in the perception of the difficulty of the experience are suggested depending on pregnancy success. Health team strategies for supporting women undergoing in vitro fertilization are discussed. PMID- 3640184 TI - Monitoring an apneic infant: impact on the infant's mother. AB - Selected findings from a study of mothers of apneic infants who were enrolled in a monitoring program are presented. Stresses reported by the mothers included the need for constant watchfulness, feelings of confinement, lack of personal time, and limited time with other children in the family. PMID- 3640185 TI - Infant feeding practices of Haitian mothers in south Florida: cultural beliefs and acculturation. AB - The practice of breast feeding is declining among immigrant groups in the U.S. This study explores the socioeconomic and cultural factors affecting the decision of infant feeding preference among Haitian mothers in Florida. Thirty Haitian immigrant mothers were interviewed in their homes by two Haitian, Creole speaking health care providers. A 110-item, predominantly open-ended questionnaire developed from the Field Guide for a Study of Socialization was utilized. Descriptive data gathered from the interviews revealed that while most of the Haitian women believe that breast feeding is a better feeding choice, only one woman chose to breast feed her U.S.-born infant. Factors cited for the decision to bottle feed included: need for employment, lack of support, influence of other people, and a wish to acculturate to the perceived norm of infant feeding in the U.S. Haitian ethnomedical beliefs about breast milk, beliefs about bottle feeding, and implications for health teaching by health care professionals are discussed. The author stresses that the reasons for a woman's feeding preference must be evaluated before health care professionals advocate a specific feeding choice, so that the functional significance of the woman's choice is not lost and the stresses of acculturation are not increased. PMID- 3640186 TI - Maternal-fetal attachment in relation to self-concept and anxiety. AB - This study investigates the association that maternal-fetal attachment has with self-concept, state anxiety, and trait anxiety. One hundred third trimester pregnant women attending prenatal classes were studied. Data were collected by using three psychometric instruments: Maternal-Fetal Attachment Scale, the Tennessee Self-Concept Scale, and the State-Trait Anxiety Inventory. The findings do not show a significant relationship between the overall level of maternal fetal attachment and self-concept. The findings do show significant inverse correlations between state (temporary) anxiety and the overall Maternal-Fetal Attachment Scale. An inverse but non-significant relationship between maternal fetal attachment and overall scores representing trait (long-term) anxiety was found. The study failed to demonstrate the strong association between anxiety and maternal-fetal attachment described by other theorists. The author speculates that the chosen instrument does not adequately differentiate between the mother's anxieties regarding self and those related to the fetus. PMID- 3640187 TI - Genetic expression of complement factors and alpha 1-acid glycoprotein by liver tissue during senescence. AB - The effect of age on several messenger RNAs coding for non-specific immune factors were determined in liver RNA isolated from 6-, 12-, 24-, 29- and 37-month old male Fischer Rats. The levels of complement factors C3 and C4, complement protein factor B, and alpha 1-acid glycoprotein were determined by dot blot hybridization using cDNA probes. All four mRNAs increased slightly between 6 and 29 months of age. Only the mRNAs coding for complement factors C3 and C4 decreased significantly after 29 months of age. In addition, Northern blot analysis of the RNA preparations showed that the size of the four mRNA species did not change with increasing age. There was no evidence for age-related changes in the post-transcriptional processing or degradation of the mRNA species coding for complement factors C3 and C4, complement protein factor B, and alpha 1-acid glycoprotein. PMID- 3640188 TI - Nurse Practice Act: overview of "grandfather" clauses. PMID- 3640189 TI - Politics and public policy making. PMID- 3640190 TI - Behavioural approaches to sleep problems in young children. PMID- 3640191 TI - When your patients ask about teenage pregnancy. PMID- 3640192 TI - The computer in health visiting. PMID- 3640193 TI - The fat connection. PMID- 3640194 TI - Miscarriage and its implication. PMID- 3640195 TI - Current drug problems in London. PMID- 3640196 TI - Second International Conference on the acquired immune deficiency syndrome. PMID- 3640197 TI - Helping families deal with perinatal loss. PMID- 3640198 TI - A case study in death with dignity. PMID- 3640199 TI - Optimizing care for the infant with a tracheostomy. PMID- 3640201 TI - [From study to research: improvement in the capability in clinical nursing and research publication]. PMID- 3640200 TI - Perinatal grief and loss: an overview. PMID- 3640202 TI - [Passion for nursing practice and research]. PMID- 3640203 TI - [Nursing supervisors' experience in research: a 2-year experience by a study group]. PMID- 3640204 TI - [Impression on "nursing supervisors' experience in research": an example shown by supervisors in their attitude to research]. PMID- 3640205 TI - [The nursing supervisor's involvement in research conducted at work]. PMID- 3640206 TI - [Terminal care in pediatrics: on research and the attitude of Dr. Martinson]. PMID- 3640207 TI - [An attempt at stimulation of group activities: effects on the organization of small self-started groups]. PMID- 3640208 TI - [Evaluation of learning and education of nursing personnel: application of pre- and post-training tests for the improvement of learning activities]. PMID- 3640209 TI - [Reflection on the activities of the "Safety Committee" in the past 5 years]. PMID- 3640210 TI - ["Play" and "work"]. PMID- 3640211 TI - The dynamics of speech. PMID- 3640212 TI - From job satisfaction emerges new leadership. How to meet healthcare demands. PMID- 3640213 TI - Taking a tip from big business. PMID- 3640214 TI - Older women and care giving. PMID- 3640215 TI - Facing the challenge of marketing & advertising. PMID- 3640216 TI - Royal College of Nursing. Vulnerable; problem remains. PMID- 3640217 TI - A soft option--or an informed choice? PMID- 3640218 TI - Nursing the adolescent. PMID- 3640219 TI - A haunting tale to tell. PMID- 3640220 TI - Royal College of Nursing. Face to face. PMID- 3640221 TI - All in favour of accountability. PMID- 3640222 TI - Budget holds familiar promise of jam tomorrow. PMID- 3640223 TI - Birth of new group paves the way for progress in community care. PMID- 3640225 TI - NHS--a cause for concern? PMID- 3640224 TI - Prevention and the primary health care team. PMID- 3640226 TI - Royal College of Nursing. Powerhouse. PMID- 3640227 TI - Agenda for health. PMID- 3640228 TI - Ethos of custodial care lingers on. PMID- 3640229 TI - Nurses should be masters of health care. PMID- 3640230 TI - Royal College of Nursing. Irrevocable trend. PMID- 3640231 TI - Accountability. PMID- 3640233 TI - Royal College of Nursing. In the spotlight. PMID- 3640232 TI - Leading the way. PMID- 3640234 TI - Flexibility or futility? PMID- 3640235 TI - Should society educate or legislate for health? PMID- 3640236 TI - Position statement on ensuring quality in home health care. A statement approved by the Board of Directors National League for Nursing, February 1986. PMID- 3640237 TI - Health care brokering--a career option for changing times. PMID- 3640238 TI - Priming students to read research critically. PMID- 3640239 TI - Toward shared governance: one school's experience. PMID- 3640241 TI - Teamwork training polishes students' home care skills. PMID- 3640240 TI - Professional schools team students to improve oncology care. PMID- 3640242 TI - Washington focus. Now is the time to push the nursing solution. PMID- 3640244 TI - Systems theory facilitates student practice in self-directed learning courses. PMID- 3640243 TI - Managing your academic career. The rocky road to tenure. PMID- 3640245 TI - Student participation in curriculum evaluation. PMID- 3640246 TI - Evaluating colleagues' classroom teaching effectiveness. PMID- 3640247 TI - Validating credentials in the faculty appointment process. PMID- 3640248 TI - Mock Hospital: a preclinical laboratory experience. PMID- 3640251 TI - Clinical nurse specialist: not every graduate nursing student qualifies. PMID- 3640250 TI - Anatomy of a site visit. PMID- 3640249 TI - Registered nurses and nursing students learn together in a cancer nursing course. PMID- 3640252 TI - Winning with games. PMID- 3640254 TI - The structure of therapeutic self. PMID- 3640253 TI - Essay exams: increasing scoring objectivity. PMID- 3640255 TI - Prediction of success on the nurse licensure exam. PMID- 3640256 TI - Tape recorded evaluations of nursing care plans. PMID- 3640257 TI - Generating researchable problems. PMID- 3640258 TI - Take charge of change. PMID- 3640259 TI - Action stat! Epistaxis. PMID- 3640260 TI - Detecting dysrhythmias (continuing education credit). PMID- 3640261 TI - Don't overlook discharge teaching about drugs. Lessons from the law. PMID- 3640262 TI - Crisis intervention. Stopping push before it comes to shove. PMID- 3640263 TI - Reporting faulty medical devices. PMID- 3640264 TI - An update on BCLS Standards. PMID- 3640266 TI - An ambulation assessment system you can count on. PMID- 3640265 TI - What's happened to the essence of nursing: patient care? PMID- 3640267 TI - Effective problem solving: you gotta believe. PMID- 3640268 TI - Alzheimer's disease--helping the patient's family. PMID- 3640269 TI - Cardiac therapy: digitalis glycosides, diuretics, antianginals, and anti arrhythmics. PMID- 3640270 TI - Unspoken thoughts. PMID- 3640271 TI - Pain: an introduction. PMID- 3640272 TI - Psychophysiological pain theories. PMID- 3640273 TI - Neurophysiological pain theories. PMID- 3640274 TI - Acute pain: a personal experience. PMID- 3640275 TI - The nurse's response to postoperative pain. PMID- 3640276 TI - Pain: a summary. PMID- 3640277 TI - Fundamentals of drug action administration and absorption: an overview. PMID- 3640278 TI - Incontinence and the individual. PMID- 3640279 TI - Incontinence: a personal account. PMID- 3640281 TI - Incontinence: prevent, treat or ignore? PMID- 3640280 TI - Continence promotion. My three D's. PMID- 3640282 TI - Avoiding incontinence--health education and preventative care for women. PMID- 3640283 TI - The continence adviser: a key role in the team. PMID- 3640284 TI - "The most difficult person I've ever worked with." Dr. Remmington had the biggest ego we'd ever seen. PMID- 3640285 TI - Irrigating peripheral i.v.s: sensible or foolhardy? PMID- 3640286 TI - 5 common legal risks--could these stories have happened to you? PMID- 3640287 TI - Ensuring safe, effective drug therapy (continuing education credit). PMID- 3640288 TI - Test your knowledge of nursing liability. PMID- 3640289 TI - Nosocomial infections--every patient is a target. Part II: Fighting the problem. PMID- 3640290 TI - Nosocomial infections--can you be sued? PMID- 3640291 TI - What to do when your staff won't follow your lead. PMID- 3640292 TI - Some golden rules of everyday nursing. PMID- 3640293 TI - Should you help when a patient wants to die. 6 questions to ask yourself. PMID- 3640294 TI - Who's expert on nursing practice? PMID- 3640296 TI - [Application of a code of deontology--a minimal standard]. PMID- 3640295 TI - [Health promotion. 2. Our turn to play]. PMID- 3640297 TI - [Quality of life of the elderly--the pills that fool]. PMID- 3640298 TI - [Geriatric centers--family prohibited...?]. PMID- 3640299 TI - [Innovations in community health: parent-child workshops]. PMID- 3640300 TI - [Survey: alternative nursing and treatment practices]. PMID- 3640301 TI - [I have a minor ailment, but I take care of it]. PMID- 3640302 TI - [Professional inspection: the realization of a general surveillance]. PMID- 3640303 TI - Legal aspects of AIDS--Part I. Law for the nurse manager. PMID- 3640304 TI - Patient care centers keep nurses close to bedsides. PMID- 3640305 TI - Nursing personnel budgets: a step-by-step guide. PMID- 3640306 TI - Work designs: extended shifts balance workloads--and budgets, too! PMID- 3640307 TI - Taking disciplinary action in the OR. PMID- 3640308 TI - Open hospital beds open new opportunities. PMID- 3640309 TI - Refreshing one's practice: a regional co-op for critical care nurses. PMID- 3640310 TI - Introducing family-centered care for mothers and newborns. PMID- 3640311 TI - MIS software brings "Hi-Tech" care home. PMID- 3640312 TI - Monitoring: controlling the QA agenda. PMID- 3640314 TI - Persuasion: the power is in the art. PMID- 3640315 TI - Nurse recruitment: the "fair" way. PMID- 3640313 TI - Education and practice: reframing our perspectives. PMID- 3640316 TI - Patient acuity systems: taking the measure of nursing care. PMID- 3640317 TI - Nursing in the Orient: in Japan. PMID- 3640319 TI - Successful writing: yes, you can. PMID- 3640318 TI - Core curricula: ten steps to assuring on-the-job competence. PMID- 3640320 TI - A professional and public trust... PMID- 3640321 TI - Inhalation of iodine in the operating theatre. PMID- 3640322 TI - Current approaches to stress at work. PMID- 3640323 TI - Stress in OH nursing? PMID- 3640324 TI - Educating for hearing conservation. PMID- 3640326 TI - Research: the crossroad of nursing practice and education. PMID- 3640325 TI - Health care needs of homeless people. PMID- 3640327 TI - Caring for the client with anorexia nervosa. PMID- 3640328 TI - The psychomotor development of full term infants whose mothers were treated with glucocorticosteroids during pregnancy. AB - The Development Quotient (D.Q.) was tested in 48 full term infants at the ages of 12-24 months who had been treated antenatally with Betamethasone to hasten pulmonary maturity. The results were compared with a control group of 100 normal full term infants of the same age. Although the two groups differed with respect to gestational age, there were no differences in birth weight, Apgar score and method of delivery between them. The results of the D.Q. evaluation showed no significant difference between the two groups. The assumption is made, therefore, that antenatal treatment with Glucocorticosteroids in the second and third trimester does not adversely affect the infant's psychological and motor development. PMID- 3640329 TI - Infections following orthopaedic injury (continuing education credit). PMID- 3640330 TI - Cardiac pacing: implications for management of orthopaedic patients. PMID- 3640331 TI - Cardiovascular assessment. PMID- 3640332 TI - Radiology review (low back pain). PMID- 3640333 TI - Interrogatories. Incident reports: hindrance or help? PMID- 3640334 TI - An option for the patient with chronic osteomyelitis: home intravenous antibiotic therapy. PMID- 3640335 TI - Serum thyroglobulin levels in preterm infants with and without respiratory distress syndrome. II. A longitudinal study during the first 3 weeks of life. AB - Serum thyroglobulin (Tg) and thyroid-stimulating hormone (TSH) levels were measured in 182 preterm and term infants. Samples were taken from cord blood, and at 1, 3, 7, 14, and 21 days after birth. The infants were divided into groups according to their perinatal characteristics: infants who were appropriate for gestational age, infants who were small for gestational age, and preterm infants who developed respiratory distress syndrome. These groups were subdivided according to gestation age. Tg serum levels showed a significant increase in the 1st day in all groups, and decreased significantly after about 1 wk. The highest Tg levels were found in the 1st wk of life in respiratory distress syndrome infants, and in infants with the lowest gestation ages. TSH levels increased at day 1 but only in appropriate and small for gestational age infants of more than 30 wk of gestation. TSH levels at day 1 in the groups with gestation ages of less than 30 wk and in respiratory distress syndrome infants of more than 30 wk were low, reflecting a low TSH surge. We conclude that the neonatal increase of Tg is not merely caused by the TSH surge. We suggest that the Tg increase is due to an impaired degradation of Tg, and/or to hemoconcentration, which are more pronounced in respiratory distress syndrome infants compared with appropriate for gestational age infants. PMID- 3640336 TI - Serum thyroglobulin levels in preterm infants with and without the respiratory distress syndrome. I. Cord blood study. AB - Cord serum levels of thyroglobulin (Tg) and thyroid stimulating hormone (TSH) in 147 term and preterm infants were related to gestation age, birth weight, respiratory distress syndrome (RDS), and several perinatal factors by means of multiple linear regression analysis. None of the perinatal factors influenced Tg and TSH cord serum levels. However, in infants who developed RDS, Tg and TSH cord serum levels differed significantly from values in infants who did not develop this syndrome. In RDS infants, significantly higher Tg values were found. Tg cord serum levels increased with birth weight in the "average" RDS infant (i.e. infants with birth weights according to the 50th percentile of the growth chart for their gestation age), while these levels decreased in the "average" non-RDS infant. In RDS infants TSH cord serum levels increased with increasing birth weight, while these levels did not vary in non-RDS infants. Although Tg and TSH cord serum levels in RDS infants increased during gestation, no correlation between Tg and TSH cord serum levels could be demonstrated. There was no correlation between Tg and TSH cord serum levels in non-RDS infants. Since we found a clear correlation between Tg cord serum levels and gestation age, but no correlation between Tg and TSH cord serum levels, we suggest that other phenomena are responsible for the high Tg levels such as organ immaturity. PMID- 3640337 TI - In vitro processing of a plant pre-mRNA in a HeLa cell nuclear extract. AB - In order to determine whether there is a general difference in the splicing mechanism of animal and plant pre-mRNAs, we cloned part of the gene for the small subunit of the ribulose 1,5-bisphosphate carboxylase containing both introns into the SP64 vector. RNA was synthesized with SP6 polymerase and used as substrate for in vitro processing in a HeLa cell nuclear splicing extract. Analyses of the processed RNA demonstrate that both introns of the plant pre-mRNA are efficiently removed in an ordered fashion yielding a faithfully ligated mRNA. Two branch points were identified for intron A and three for intron B. The branched nucleotides are adenosine residues in all cases and are located within a distance from the 3' splice site found to be crucial for lariat formation in animal pre mRNAs. The implications of these results are discussed in light of our previous observation, that a functional pre-mRNA of the human growth hormone gene was not processed in plant tissue in vivo. PMID- 3640338 TI - Isolation and sequence of a human gene encoding a potent inhibitor of leukocyte proteases. AB - We report the isolation of the human gene encoding an inhibitor of neutrophil elastase and cathepsin G. We have sequenced the gene and a cDNA clone isolated from human parotid tissue. The protein encoded by this gene appears to contain two functional domains, one having a trypsin inhibitory site and the other an elastase inhibitory site. The two-domain structure of the protein is reflected in the organization of the gene, with each domain represented by a separate exon. We have also noted that the intervening sequence separating the trypsin-inhibitor exon and the elastase-inhibitor-exon is flanked by eleven base-pair direct repeats, suggesting that this intron may have been generated by a transposition type event. PMID- 3640340 TI - The bigger picture. PMID- 3640339 TI - Institutionalizing nursing practice. PMID- 3640341 TI - The coming of age of nursing research. PMID- 3640342 TI - Nursing doctorates: is there a difference? PMID- 3640343 TI - Opening a doctoral program in nursing: factors to consider. AB - As nursing education has evolved from hospital-based training schools to the college campus, the need for doctoral nursing faculty and other leaders has increased. The greatest needs are for nurses capable of conducting research in nursing and for faculty to teach in baccalaureate and master's nursing programs. Therefore, schools of nursing across the country are considering initiation of new doctoral programs. This decision is a complex one that depends on numerous factors related mostly to resources. Ideally, new programs will develop only after the necessary resources have been identified and secured. Another critical decision is the type of doctoral program a school chooses to offer. Nursing should make an attempt to determine whether there actually are substantial differences between the present professional and research degree programs. In addition, the roles that doctorally prepared nurses will be expected to fulfill in the health care system should be defined. Overall, in spite of the documented need for many more doctorally prepared nurses and the inability of existing doctoral nursing programs to meet that need, new programs should be initiated with utmost caution. Thorough, extensive data gathering should provide information about available alternatives. The positive and negative consequences of each alternative should be identified and carefully weighed. Finally, once a school has decided to initiate a program, it should plan carefully for implementation. Thorough preparation will assure that the program selected is well matched to the resources available to support it. PMID- 3640344 TI - Survival skills for the acting dean. PMID- 3640345 TI - Preparing for student grievances. PMID- 3640347 TI - Re: 'Toward a theory of nursing: skills and competency in nurse-patient interaction'. PMID- 3640346 TI - Homogeneity of potassium chloride in small volume intravenous containers. AB - The purpose of this investigation was to determine whether potassium chloride as an additive is distributed homogeneously throughout small volume parenteral solutions and whether the pattern of electrolyte distribution is identical for two types of delivery systems. The effect of purposeful mixing after addition of potassium chloride was also studied. Thirty-one registered nurses prepared two supplementary intravenous solutions consisting of 10mEq potassium chloride in 50ml of 5% dextrose solution. One solution was prepared in a soft polyvinyl chloride minibag (Viaflex, Baxter-Travenol), the other in a semirigid plastic burette (Buretrol, Baxter-Travenol). The solutions were discharged through a volumetric pump (IMED) and four aliquots were taken at regular intervals. Samples were chemically analyzed by flame photometry to determine the potassium concentration in each solution layer of the container. For each container type, there were significant differences in the potassium concentrations among the layers of solution. The pattern of distribution also differed significantly between the two containers. The strata in the minibag showed smaller variations in potassium concentration than did corresponding layers in the burette. Some single sample concentrations from burettes exceeded the expected concentration of 200mEq/L by 105mEq. Nurses manipulated the two types of containers differently. Thirty of 31 minibags were mechanically mixed, but only 11 of 31 burettes were treated in this way. When the effect of mixing was considered, solutions in mixed containers were essentially no different from those not agitated after addition of the electrolyte. PMID- 3640348 TI - Relationship between percent body fat and menstrual patterns in athletes and nonathletes. AB - The relationship between body fat percentage and menstrual patterns was examined in a longitudinal study of 25 collegiate athletes and 41 college-aged nonathletic control subjects. The athletes were training in gymnastics, figure skating, synchronized swimming, volleyball, or track. Data were collected each month concerning cycle, flow length, weight, and skinfold thicknesses (iliac crest, triceps, and subscapular). Height was determined once. Body fat percentage was estimated using the Sloan and Weir (1970) nomogram. Total energy expenditure was estimated for athletes according to sport. Mean body fat percentages of controls and athletes differed significantly, t = 4.4, p less than .01, but no significant difference was found in cycle length, F = 3.3, p = .078. Multiple regression analysis revealed no clear relationship between length of menstrual cycle and height, weight, skinfold thickness, or total energy expenditure. No significant relationship existed between body fat percentage and menstrual cycle length as tested with the Pearson correlation coefficient. This study confirmed that menstrual phenomena cannot be defined as normal or pathologic by rhythmic occurrence alone. Rather, an individual's menstrual cycle length may be more suitably evaluated according to a multivariable continuum of menstrual patterns. PMID- 3640349 TI - Self-esteem, social support, and positive health practices. AB - The purpose of this study was to identify relationships among perceived social support, self-esteem, and positive health practices among adults living in a south-western metropolitan area. The sample (N = 98) of convenience was selected from an adult apartment complex and the variables were measured using three self report questionnaires (Personal Resource Questionnaire, Coopersmith Self-Esteem Inventory, and Personal Life-style Activities Questionnaire). Initially, a positive association among the variables, self-esteem, social support, and life style, was determined using a simple correlation matrix. To further explicate the relationships among the variables, a theoretical causal model was developed and tested. Using path analytic techniques, both the direct and the indirect effects of various independent variables on life-style were determined; 28% of the variance, p less than .0001, was accounted for by this model. The study suggests that both self-esteem and social support are positive indicators of life-style. Further, social support was found to exert influence indirectly through its direct effect on self-esteem. PMID- 3640351 TI - Relating mothers' anxiety and perception to infant satiety, anxiety, and feeding behavior. AB - The purpose of this study was to explore early psychophysiologic mother-infant interaction using the tenderness and anxiety theorems of Harry Stack Sullivan. Maternal anxiety and perception were assessed and related to changes in infant satiety, anxiety, and feeding behavior. Sixty-five healthy post-partum, bottle feeding mothers completed the Blank Infant Tenderness Scale and the State-Trait Anxiety Inventory. Blood samples were obtained from the infants just before and 60 minutes after feeding for determination of glucose and cortisol. Formula consumption was also noted. Multivariate analysis of variance demonstrated that maternal state-trait anxiety was related to infant glucose, cortisol, and formula consumption. In particular, mild maternal prefeed state anxiety was associated with lower infant cortisol difference scores, and extremely low maternal prefeed state anxiety was associated with higher infant cortisol difference scores. Mild maternal feed state anxiety, in turn, was associated with greater infant formula consumption, and extremely low maternal feed state anxiety was associated with lower formula consumption. Pearson correlations indicated a significant direct relationship between infant prefeed cortisol and postfeed glucose, but not between infant formula consumption and postfeed glucose. PMID- 3640350 TI - Theoretical models for studying the effect of antepartum stress on the family. AB - Three models are proposed to predict the effect of antepartum stress on the family. These models consider external and internal family environments and individual characteristics as they influence an individual family member's health status, dyadic relationships within the family, and the family's functioning as a unit. Research to date validates the complex interrelationships between antepartum stress, social support, self-esteem, sense of mastery, anxiety, depression, and their effect on health status, dyadic relationships, and family functioning. The theoretical models presented identify relationships between these important variables that can guide much-needed research on the effects of antepartum stress on the childbearing family. PMID- 3640352 TI - Mothering behavior and maternal role attainment during the postpartum period. AB - Relationships among subjective and behavioral components of maternal role attainment were investigated separately for 64 primiparous and 60 multiparous mothers. The influence of contextual variables on maternal behavior was also examined. Subjects were medically low risk with normal infants. Attitudes toward themselves and their infants and feelings of self-confidence were measured at 1 to 2 days and 4 to 6 weeks after delivery. At 4 to 6 weeks mothers were also videotaped performing an infant feeding at home. Tapes were rated for maternal sensitivity and responsivity. For primiparas, self-confidence was related to maternal feeding behavior as were maternal age, education, and socioeconomic class. For multiparas, only initial attitude toward self was related to maternal behavior; however, maternal age and infant size were contextual factors related to behavior. Distinctions proposed among subjective and behavioral components are in part supported by the findings of the study. PMID- 3640353 TI - Adult attention to infants in a newborn nursery. AB - Six 3-hour observations of adult attention to infants in a newborn nursery were conducted to describe the amount and type of attention received by the infants and to determine if individual differences among infants were related to this attention. Most infants spent the majority of the observation time between feedings in the nursery and received attention from an adult in the nursery an average of 5.5% of the time. More infant crying was associated with longer adult attention, although this effect was largely attributable to a small group of particularly irritable infants in which circumcised males were overrepresented. A number of infant characteristics, including age, sex, race, physical attractiveness, degree of prematurity, crying, and eye opening, were associated with the content of the interaction between nurses' aides and newborns. These observations are discussed with respect to hospital practices concerning care of newborns and the potential effects on newborns of rooming-in with their mothers. PMID- 3640354 TI - Effect of the birth chair on duration of second stage labor and maternal outcome. AB - The effect of delivering in a birth chair on duration of second stage labor, perineal swelling, incidence of episiotomies, lacerations, hemorrhoids, and maternal blood loss was examined in a prospective quasi-experimental study. The sample consisted of 55 primiparous women, 37 to 41 weeks gestation, with normal pregnancy and labor; 22 delivered on a traditional delivery table (DT) and 33 in a birth chair (BC). Comparisons were made between groups for mean duration of second stage labor, mean time bearing down in the delivery room, mean maternal blood loss, frequency of instrument-assisted deliveries, frequency of episiotomies and lacerations, and frequency of perineal swelling and hemorrhoids. The two groups were statistically similar for weight of infant. No significant difference was found between groups for mean duration of second stage labor (BC M = 55 minutes, DT M = 43 minutes) or mean time bearing down (BC M = 60 minutes, DT M = 53 minutes). No difference was found in the amount of blood loss between the two groups as measured by the mean difference in the pre- and postdelivery hemoglobin (BC M change = 1.4 Gms, DT M change = 1.8 Gms). The lack of significant differences in blood loss may be due to the fact that the angle of the birth chair was lowered during or after delivery in 88% of the cases. The incidence of instrument-assisted deliveries (BC = 7, DT = 6), episiotomies (BC = 27, DT = 20), lacerations (BC = 17, DT = 5), and hemorrhoids (BC = 14, DT = 4) was similar between groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3640356 TI - The D-L test of agreement: a stronger measure of interrater reliability. AB - This article examines the theoretical underpinnings and the procedures of the Derdiarian-Lewis (D-L) test of proportion of complete agreement to determine reliability among raters. The D-L test yielded data produced by three raters who rated an average of 253 units of verbal content for each of six patients. The test is supported as a stronger measure of interrater reliability than the conventionally used percent agreement method. PMID- 3640355 TI - Developmental resources and depression in the elderly. AB - A longitudinal study was carried out with 28 clinically depressed and 28 mentally healthy older adults, matched on age, sex, and years of education. Developmental resources and depression were measured on three occasions using the Developmental Resources of Later Adulthood and the Center for Epidemiological Studies Depression scales. A 2 X (3) repeated measures factorial analysis of variance indicated that the depressed group had significantly lower developmental scores across all three time periods. Results of cross-lagged panel correlation analyses suggested that the direction of the relationship between developmental resources and depressive symptoms differed markedly between the two groups. The mentally healthy group showed a significant causal tendency for developmental resources to influence level of depression; a reverse trend was noted in the depressed group. PMID- 3640357 TI - Randomized experiments in nursing: the quality of reporting. PMID- 3640358 TI - Determination and quantification of content validity. PMID- 3640359 TI - All change. PMID- 3640360 TI - Parenting: family matters. PMID- 3640361 TI - Safe in whose hands? PMID- 3640363 TI - Nursing homes. A dual responsibility. PMID- 3640362 TI - Nursing homes. Home hunting. PMID- 3640364 TI - Nursing homes. An independent outlook. PMID- 3640365 TI - Attitudes to mental illness: a child's view. PMID- 3640366 TI - On-line nursing. PMID- 3640367 TI - Reassuring a young girl after a drug overdose. PMID- 3640368 TI - Project 2000. Who's helping whom? PMID- 3640369 TI - Geriatric nursing: attitudes make a difference. PMID- 3640370 TI - Systems of life. No 141. Senior systems. 6. PMID- 3640371 TI - Family planning: taking precautions. PMID- 3640372 TI - Counting the bruises. PMID- 3640373 TI - Matron and manager. Interview by Laurence Dopson. PMID- 3640374 TI - The Journal of Infection Control Nursing. PMID- 3640375 TI - Journal of Infection Control Nursing. Nursing the isolated patient: Lassa fever. PMID- 3640376 TI - Journal of Infection Control Nursing. Handling infection. PMID- 3640377 TI - Journal of Infection Control Nursing. What's it like on Mount Olympus?. Interview by Charlotte Alderman. PMID- 3640378 TI - Journal of Infection Control Nursing. A drain on resources. PMID- 3640379 TI - Journal of Infection Control Nursing. Preventive measures. PMID- 3640380 TI - Journal of Infection Control Nursing. Building standards. PMID- 3640381 TI - Assessing nurses. 3--Self assessment. PMID- 3640383 TI - RCN president--the race for the presidency. PMID- 3640382 TI - Nothing ventured, nothing gained. PMID- 3640384 TI - Commons sense: the odd couple. PMID- 3640385 TI - Body image. When the face doesn't fit. PMID- 3640386 TI - Body image--mirror, mirror, on the wall... PMID- 3640387 TI - Management: staffing a children's unit. PMID- 3640388 TI - Aperients can be deceptive. PMID- 3640389 TI - Nurses' management of patients' self-care. PMID- 3640390 TI - Hazardous cures. PMID- 3640392 TI - Mental health nursing. Journal of the Psychiatric Nursing Association. Skills available: see within. PMID- 3640391 TI - Time to work together. PMID- 3640393 TI - Mental health nursing. Mechanical faults. PMID- 3640394 TI - Mental health nursing. Open to interpretation. PMID- 3640395 TI - Mental health nursing. The voice of realism. Interview by Martin Vousden. PMID- 3640396 TI - How to catch the CAB. PMID- 3640398 TI - Board chief. Scots' broth. Interview by Laurence Dopson. PMID- 3640397 TI - Registration fees. Cash for the register. PMID- 3640399 TI - Care plan or talisman? PMID- 3640400 TI - Nursing Aid--where does your money go? PMID- 3640401 TI - Nursing Aid. A healthy chain reaction. PMID- 3640403 TI - Discharge planning. Going home. PMID- 3640402 TI - Handle with care. PMID- 3640404 TI - Management: the flexitime solution. PMID- 3640405 TI - A friend in need... PMID- 3640406 TI - Professional standards--afraid to tell. PMID- 3640408 TI - Project 2000. A view from the sidelines. PMID- 3640407 TI - The nervous system. Reflex action. PMID- 3640409 TI - Body image. Keeping up appearances. PMID- 3640410 TI - Students' lament. PMID- 3640411 TI - Theatre nursing. Lasers in the theatre. PMID- 3640412 TI - Theatre nursing. Beaming in on ENT. PMID- 3640413 TI - Theatre nursing. Do put your daughter in the theatre. Interview by Laurence Dopson. PMID- 3640414 TI - Theatre nursing. Safety first. PMID- 3640415 TI - Theatre nursing. Can my friend go with me? PMID- 3640416 TI - The manifesto mystery. PMID- 3640417 TI - Diet and health. Should Mrs Currie eat her words? PMID- 3640418 TI - Psychiatric Congresses. Follow the leaders. PMID- 3640419 TI - Political poll. Who will win your vote? PMID- 3640420 TI - Political poll. Floating voters. PMID- 3640421 TI - Political poll. Personal politics. PMID- 3640422 TI - Professional standards. Rough justice. PMID- 3640423 TI - Management--is there room at the top? PMID- 3640424 TI - It's child's play. PMID- 3640426 TI - Nursing practice. The journal for the development of clinical nursing. PMID- 3640427 TI - Measuring blood glucose levels. PMID- 3640425 TI - The nervous system. Parts of the brain. PMID- 3640428 TI - Nursing practice. Last but not least. PMID- 3640429 TI - Nursing practice. Escaping from the ivory tower. PMID- 3640430 TI - Worried sick. PMID- 3640431 TI - Paramedical personnel in National Tuberculosis Programme. PMID- 3640432 TI - Arthroscopy for arthritis: role of nurses. PMID- 3640434 TI - Hospitals and institutions in Himachal Pradesh. PMID- 3640433 TI - Are we ready for computers? PMID- 3640435 TI - Gynecological concerns in young and adolescent physically active girls. AB - Young girls should be advised to develop the regular exercise habit and to maintain it throughout life. Prepubertal athletes are more likely than their sedentary friends to experience menarcheal delay. Postmenarcheal athletes have increased susceptibility to oligomenorrhea and amenorrhea. Athletes with delayed puberty deserve examination and possibly further evaluation. Adolescent athletes with oligomenorrhea or amenorrhea deserve examination and hormonal evaluation. Hormonal replacement therapy is unnecessary prior to age 16, is optional between ages 16 and 18, and is recommended after age 18. PMID- 3640436 TI - Ethical considerations: the participation of children in elite sports. AB - In a way, children involved in elite sports can be considered participants in an uncontrolled mass experiment with human beings. Sports have many benefits for children, especially when this activity is compared with the sedentary life styles of too many children all over the world. However, training in such sports is progressively becoming more prevalent in an earlier age in childhood, and potential risks of musculoskeletal disorders or diseases, social isolation to a restricted group with similar interests, and the psychologic stress of repetitive and monotonous sports activities for several hours each day, are concerning physicians. Added to these concerns are the dangers associated with hormonal and dietary manipulations practiced by athletes in elite sports. Ethics committees to control training procedures of gifted children and to propose higher age limits for participants, especially in international sports events, seem to be needed. Long-term effects of elite sports activities beginning in early childhood should be studied using appropriate epidemiologic methods. The basic ethical consideration is not to harm or alienate children by using them as objects for sports organizations, spectators or nationalists. PMID- 3640437 TI - Integrated cardiopulmonary approach to exercise testing in pediatrics. AB - In the pediatric age groups exercise evaluation of cardiac and pulmonary disease has had a lesser impact on clinical care than in adults. Exercise evaluation complements clinical information, echocardiography, hemodynamics and lung function studies at rest to provide reproducible, quantitative information to answer questions of capacity for physical work, employment, insurability and participation in recreation and sports. To ensure serial studies in children measurements should be noninvasive and minimize demands of patient cooperation. Exercise evaluation should include evaluation of lung function at rest to exclude pulmonary limitations of exercise. Because of the close link of cardiovascular and pulmonary responses to exercise, assessment of ventilation and pulmonary gas exchange should be an integral part of exercise evaluation. Computerized systems can enhance the accuracy and precision of such measurements and can provide a data base for evaluation of individual patients and the natural history of treated congenital cardiac defects and pulmonary disease. PMID- 3640438 TI - Antimicrobial treatment of pancreatin. PMID- 3640439 TI - [Nutrition for pregnant women]. PMID- 3640440 TI - [The child with a digestive tract disease]. PMID- 3640441 TI - [Understanding]. PMID- 3640442 TI - [Nursing personnel in Poland]. PMID- 3640443 TI - [We nurse the tetanus patient]. PMID- 3640444 TI - [Free Saturdays]. PMID- 3640445 TI - [With me in the hospital]. PMID- 3640446 TI - [Into the world we bear our warm hearts]. PMID- 3640447 TI - [How to educate nurses]. PMID- 3640448 TI - [Tuberculin diagnosis]. PMID- 3640449 TI - [Our tasks]. PMID- 3640450 TI - [Psychosomatic ailments in tuberculosis]. PMID- 3640451 TI - [Zinc in nutrition]. PMID- 3640452 TI - [Therapeutic contact]. PMID- 3640453 TI - [Scientific research in nursing]. PMID- 3640454 TI - [Nursing personnel]. PMID- 3640455 TI - [The usefulness of studies]. PMID- 3640456 TI - [Preparation for work in the cardiac intensive care unit]. PMID- 3640457 TI - [To deal with society as with one's own. Interview by Maria Lesnikowska]. PMID- 3640458 TI - [Hygiene]. PMID- 3640459 TI - [BCG vaccination]. PMID- 3640460 TI - [The patient's self-protection]. PMID- 3640461 TI - [In order to avoid the mistakes]. PMID- 3640462 TI - [The mistake: a transgression]. PMID- 3640464 TI - [The character of the profession]. PMID- 3640463 TI - [Leadership in work]. PMID- 3640465 TI - [The nurse midwife in the occupational health service]. PMID- 3640466 TI - [Rheumatoid arthritis]. PMID- 3640467 TI - [Iatrogenic situations]. PMID- 3640468 TI - [The goals of academic education and the development of nursing]. PMID- 3640469 TI - [The nurse in the cardiac intensive care unit]. PMID- 3640470 TI - [Work time balance]. PMID- 3640471 TI - [Information for the patient]. PMID- 3640472 TI - [Privilege and honor. Interview by Krystyna Serafin]. PMID- 3640473 TI - [The boss' help is needed .... Interview by Maria Lesnikowska]. PMID- 3640474 TI - [Where is nursing headed?!]. PMID- 3640475 TI - [Tuberculosis: detection and treatment]. PMID- 3640476 TI - [Amniotic fluid embolism]. PMID- 3640477 TI - [Attitudes toward work]. PMID- 3640478 TI - [What we are doing]. PMID- 3640479 TI - [Organization of the control of tuberculosis in Poland]. PMID- 3640480 TI - [Organizational and essential supervision in basic health care]. PMID- 3640481 TI - [Planning of services and the flow of information]. PMID- 3640482 TI - [Work time utilization by community health nurses]. PMID- 3640483 TI - [Work in the wider community]. PMID- 3640484 TI - [Economic aspects of the functioning of health protection and public health care in the Polish People's Republic]. PMID- 3640485 TI - [Community health nursing care in diseases of the circulatory system]. PMID- 3640486 TI - [Training of community health nurses in caring for patients with disease of the circulatory system]. PMID- 3640487 TI - [Final address]. PMID- 3640488 TI - [My activities in the service of nursing]. PMID- 3640490 TI - [Nurse administrator. Interview by Krysyna Serafin]. PMID- 3640489 TI - [Nursing is surviving the crisis. Interview by Maria Lesnikowska]. PMID- 3640491 TI - [Health for everyone by the year 2000]. PMID- 3640492 TI - [With our Swedish colleagues]. PMID- 3640493 TI - [Considerations on the subjects of dying and death]. PMID- 3640494 TI - [Basic health care. The systems programming of services]. PMID- 3640495 TI - [Information system on a countrywide scale]. PMID- 3640496 TI - [Supervision of the activities of nurses and midwives]. PMID- 3640497 TI - [Directions in the development of basic care in the immediate years to come]. PMID- 3640498 TI - Psychological aspects of the lipoplasty patient. PMID- 3640499 TI - When the nurse suspects drug abuse. PMID- 3640500 TI - "Instructions for after your surgery"--a patient teaching tool. PMID- 3640501 TI - Facial fractures. PMID- 3640502 TI - Breast reconstruction using abdominal tissue. PMID- 3640503 TI - Efficacy of mevinolin as adjuvant therapy for refractory familial hypercholesterolaemia. AB - Mevinolin, a potent inhibitor of cholesterol synthesis, was used as a therapeutic adjuvant in patients with refractory familial hypercholesterolaemia for an average period of 13 months. Sustained decreases in serum cholesterol of 23 and 31 per cent were achieved by doses of 20 mg and 40 mg/day respectively in 13 heterozygotes already on cholestyramine or after partial ileal bypass. Administration of 80 mg/day to three patients undergoing plasma exchange reduced peak serum cholesterol levels by 11.5 per cent in two homozygotes and by 17 per cent in a double heterozygote for familial hypercholesterolaemia and type III hyperlipoproteinaemia. The decrease in cholesterol was largely confined to low density lipoprotein and no significant changes occurred in serum triglyceride or high-density lipoprotein cholesterol. Mevinolin was well-tolerated except in one patient who developed myositic symptoms; asymptomatic, transient elevations of serum enzymes were observed in five others. Short and long Synacthen tests showed no evidence that the drug impaired adrenocortical response to ACTH. These results indicate that mevinolin provides a safe and highly effective means of reducing LDL levels in patients with heterozygous familial hypercholesterolaemia refractory to conventional treatment but is less useful in homozygotes. PMID- 3640504 TI - [The locomotor apparatus: upper extremity. (7). The wrist: articular mechanics. Pouteau-Colles fracture]. PMID- 3640505 TI - [The central venous routes. (2). Incidents, accidents, surveillance]. PMID- 3640506 TI - [Face lifting]. PMID- 3640507 TI - [Blepharoplasty]. PMID- 3640508 TI - [Role of the circulating nurse in the surgery for sticking-out ears]. PMID- 3640509 TI - [Problems facing the anesthetist during plastic surface surgery]. PMID- 3640510 TI - [Plastic surgery. Psychological aspects]. PMID- 3640511 TI - [The desired illness or rhinoplasty in plastic surgery]. PMID- 3640512 TI - [Intervention for sticking out ears]. PMID- 3640513 TI - [The microbiologist and problems in hospital hygiene]. PMID- 3640514 TI - [Study of the risk of infection in intensive care units. Apropos of 539 patients]. PMID- 3640515 TI - [Wounds and scars of the face]. PMID- 3640516 TI - [Nursing students are needed]. PMID- 3640517 TI - [Ethics and informed consent]. PMID- 3640518 TI - [Non-woven operating drapes]. PMID- 3640519 TI - [Acid-base imbalance]. PMID- 3640520 TI - [Diaper rash in infants]. PMID- 3640522 TI - [Nursing care. Thinking and acting before the year 2000]. PMID- 3640521 TI - [Treatment of cardiac insufficiency in adults]. PMID- 3640523 TI - [Can nursing be computerized?]. PMID- 3640525 TI - [The Swan-Ganz catheter]. PMID- 3640524 TI - [Evaluation of the Home Visits Service (II)]. PMID- 3640526 TI - [Acute gastroenteritis: the role of nursing]. PMID- 3640527 TI - [Health. A psychosocial study]. PMID- 3640528 TI - [Abused children: detection systems]. PMID- 3640530 TI - [Continuing education. 8. Field: Medical-surgical. Topic: The hemiplegic patient: mobilization and care]. PMID- 3640529 TI - [Food surveys]. PMID- 3640531 TI - [The perception of one's self and one's role]. PMID- 3640532 TI - [How to face up to conflicts]. PMID- 3640533 TI - [Tension or stress in the operating room]. PMID- 3640534 TI - Your duty when doctors brow-beat a patient. PMID- 3640535 TI - Osteoporosis: how to avoid its crippling effects. PMID- 3640536 TI - PCA: a new way to spell pain relief. PMID- 3640537 TI - Dealing with a wound that drains 1.5 liters a day. PMID- 3640538 TI - When that dying patient calls you Mommy. PMID- 3640540 TI - If a friend asks you for medical advice. PMID- 3640539 TI - Stopping CHF while there's still time (continuing education credit). PMID- 3640541 TI - Does renal failure mean sexual failure? PMID- 3640542 TI - Why we work side by side with student nurses. PMID- 3640543 TI - Avoiding the legal pitfalls of home care. PMID- 3640544 TI - When your patient needs extra calcium. PMID- 3640545 TI - Nurses vs. infection: the battle continues. PMID- 3640546 TI - How rounds improved our nursing care. PMID- 3640547 TI - Subcellular localization of platelet elastase and its retention during the release reaction. PMID- 3640548 TI - [Velbe (2). Surveillance]. PMID- 3640549 TI - [Change of the cannula in a patient with tracheostomy]. PMID- 3640550 TI - [Chemotherapy protocol for the treatment of acute leukemias in children. The Fralle protocol]. PMID- 3640551 TI - [Randomization: apropos of controlled prospective studies in chemotherapy]. PMID- 3640552 TI - [Percutaneous central venous catheters. Organization and management in ambulatory hematology patients]. PMID- 3640553 TI - [The professional secret at a public hospital]. PMID- 3640554 TI - [Thorax injuries]. PMID- 3640555 TI - [Pre and postoperative resuscitation in emergency heart surgery]. PMID- 3640556 TI - [The filariases]. PMID- 3640557 TI - [Malaria and bilharziasis]. PMID- 3640558 TI - [Reflexotherapy of bronchial asthma]. PMID- 3640559 TI - [Which way are we going? Interview with Dr. H.B. van Aller]. PMID- 3640560 TI - [Informatics: automatic data processing in health care a fact!]. PMID- 3640561 TI - [Medical information for nurses. In vitro fertilization and embryo transfer]. PMID- 3640562 TI - [Nurses and the legislative bill BIG (professional practice in individual health care). Part I: Significance of the BIG Bill and licensure]. PMID- 3640563 TI - [Psychiatric nurse also competent without certificate]. PMID- 3640564 TI - [I'm afraid because I don't know what's going to happen. Reduction of fear in children and their parents in diagnostic tests]. PMID- 3640565 TI - [Continuity of care]. PMID- 3640566 TI - [Medical information for nurses. Muscle relaxation during general anesthesia]. PMID- 3640567 TI - [Wanted: one hundred thousand]. PMID- 3640568 TI - [AIDS: role for nurses]. PMID- 3640569 TI - [Team nursing in the nursing home]. PMID- 3640570 TI - [Nurses in the legislative bill BIG (professional practice in individual health care). Part II: Responsibility and quality]. PMID- 3640571 TI - [Activity of the prekallikrein-kallikrein system and characteristics of its regulation in various allergies]. AB - Activity of kallikrein and content of prekallikrein were estimated in blood serum of 34 patients with atopy and of 17 patients with urticaria by means of the chromatographic procedure. In these patients activity of alpha 1-proteolytic inhibitor (alpha 1-PI) and alpha 2-macroglobulin (alpha 2-MG) was studied. At the acute period of pollinosis activation of the kallikrein-kinin system was found, which correlated with the disease aggravation. During specific immunotherapy of the patients with atopy activation of the kallikrein-kinin system occurred, which depended on the total concentration of allergen administered. At the same time, activation of the kallikrein-kinin system, observed under conditions of urticaria, was most distinct in the patients with chronic relapsing urticaria and was related to the degree of the disease aggravation. Preparations of proteinase inhibitors analogous to contrical were only short-term effective in chronic relapsing urticaria. In the patients with distinct aggravation of pollinosis inhibitory activity of alpha 2-MG was markedly increased which occurred apparently as a result of blood pachyemia simultaneously with activation of the kallikrein-kinin system. Distinct increase in the alpha 1-PI activity was not found in the patients with pollinosis and urticaria even at the step of pronounced aggravation. Phenotyping of the inhibitor in 10 patients with a marked decrease in its activity enabled to find 6 persons exhibiting the heterozygous genotype with a defect allele. PMID- 3640573 TI - Computer technology and the nurse educator's role. PMID- 3640572 TI - [Arterial pressure in female spinners in woolen manufacture]. PMID- 3640574 TI - The master of nursing degree: a student's perspective. PMID- 3640575 TI - New concepts in nursing education delivery. PMID- 3640576 TI - How do nurses learn about quality assurance? PMID- 3640577 TI - Professional conduct. Part II. Reporting a complaint. PMID- 3640578 TI - The "in vitro" susceptibility of urinary tract pathogens to mecillinam, compared with nine other antimicrobial agents. A multicenter study. PMID- 3640579 TI - Non-Hodgkin's lymphoma, HTLV-III/LAV, and HTLV-III/LAV antibody in the wife of a man with transfusion-acquired AIDS. AB - Non-Hodgkin's lymphoma of the small intestine developed in a 66-year-old woman who was the wife of a man with transfusion-related acquired immune deficiency syndrome (AIDS). Antibody to the human T lymphotrophic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) was present in her serum, and the virus was isolated from her peripheral lymphocytes. The possibility that the non-Hodgkin's lymphoma in this patient was a manifestation of HTLV-III/LAV infection is discussed. This is believed to be the first reported case of lymphoma occurring in a patient with documented HTLV-III/LAV infection outside the male homosexual risk group. PMID- 3640580 TI - Horrible Harry. PMID- 3640581 TI - Pressure sores need professional treatment. PMID- 3640582 TI - How to recognize hostility and what to do about it. PMID- 3640583 TI - Diabetes: controlling the insulin balance. Contrasting type I and type II diabetes. PMID- 3640584 TI - How painful are postop incisions? PMID- 3640585 TI - When is "confusion" translocation syndrome? PMID- 3640586 TI - Nursing the patient, not the machines. PMID- 3640587 TI - [Cases with difficulties in the diagnosis of acute abdomen in obstetrics]. PMID- 3640588 TI - Elastase inhibitors for treatment of emphysema. Approaches to synthesis and biological evaluation. PMID- 3640589 TI - Testing for human immunodeficiency virus. PMID- 3640590 TI - Efficacy of ciprofloxacin for experimental endocarditis caused by methicillin susceptible or -resistant strains of Staphylococcus aureus. AB - The efficacy of ciprofloxacin for experimental aortic valve endocarditis in rabbits infected by either a methicillin-susceptible or a methicillin-resistant strain of Staphylococcus aureus was compared with standard therapy of nafcillin or vancomycin, respectively. After 4 days of therapy, ciprofloxacin reduced the counts of organisms in aortic valve vegetations as effectively as the standard regimen for both susceptible and resistant strains. Mean concentrations of ciprofloxacin in serum achieved 1 h after a dose exceeded the MBC for each strain by twofold or less. In these experiments ciprofloxacin was as efficacious as standard regimens currently used to treat staphylococcal infections in humans. PMID- 3640592 TI - Craniofacial reconstruction. Perioperative care of the craniosynostosis patient. PMID- 3640591 TI - Antibiotic-resistant bacteria in surveillance stool cultures of patients with prolonged neutropenia. AB - The value of stool surveillance for antibiotic-resistant gram-negative bacteria was analyzed in 86 neutropenic bone marrow transplant patients. Twice-weekly specimens were inoculated onto culture medium containing gentamicin plus carbenicillin. The recovered organisms were identified to the species level and tested for antibiotic susceptibility. Forty-eight resistant organisms were recovered from 35 patients. Thirteen isolates persistently colonized patients. Escherichia coli (29%) and Pseudomonas aeruginosa (19%) were the most frequently recovered organisms. Although most organisms were recovered while patients were on antibiotics, 15 isolates, including eight of nine resistant P. aeruginosa, were detected before antibiotics were initiated. The duration of antibiotic use was longer for patients persistently colonized than for those not colonized (P = 0.03). Of the 15 resistant organisms which caused infection, 12 were detected in the surveillance cultures. Infections by antibiotic-resistant organisms occurred more frequently in patients colonized than in those not colonized (P = 0.006) and more frequently in patients persistently colonized than in those colonized only once (P = 0.01). The absence of colonization or persistent colonization correlated well with the absence of infection (negative predictive values of 94 and 91%, respectively). PMID- 3640593 TI - Perioperative teaching plan. Craniofacial reconstruction. PMID- 3640594 TI - Intraoperative nursing care plan. Craniofacial reconstruction. PMID- 3640596 TI - Time management. Part III: Making time for joy. PMID- 3640595 TI - Abdominoplasty. Indications and technique. PMID- 3640597 TI - Proposed recommended practices. Aseptic barrier materials for surgical gowns and drapes. PMID- 3640598 TI - Planning, publicizing OR Nurse Day: a personal experience. PMID- 3640599 TI - A perioperative program in ambulatory surgery for senior nursing students. PMID- 3640600 TI - Fatigue in the renal patient. PMID- 3640601 TI - A model for patient education. PMID- 3640602 TI - Regional citrate anticoagulation: a viable alternative? PMID- 3640603 TI - Independence vs. dependence: whose decision? PMID- 3640604 TI - Speaking out: professional issues. Nursing and the legal maze. PMID- 3640605 TI - Studies on the direct compression of pharmaceuticals, XXIII. Pancreatin, 1) Effect of lubricants on enzyme activity after storage. PMID- 3640606 TI - Goetteman's legal guidelines. PMID- 3640607 TI - Lung surfactant apoprotein and phosphatidylglycerol in amniotic fluid for prediction of respiratory distress syndrome. PMID- 3640608 TI - Women in unions. PMID- 3640609 TI - Substantiation--new income tax rules. PMID- 3640610 TI - Care of the caregivers. PMID- 3640611 TI - A program for career structure: a vision becomes reality. Part Two. PMID- 3640612 TI - Preceptoring: a link between theory and practice. PMID- 3640613 TI - Management of narcotic dependent pregnancy. PMID- 3640614 TI - Nursing quality assurance: a review. PMID- 3640615 TI - Nurses and other people. PMID- 3640616 TI - Nurse & the law. Hypotheticals. Merely documenting is not enough. PMID- 3640617 TI - Confronting child abuse. PMID- 3640618 TI - A program for career structure: the process of implementation. Part Three. PMID- 3640619 TI - Aged care reality. PMID- 3640620 TI - Nurses' stress: research directions. PMID- 3640622 TI - A student nurse speaks up. PMID- 3640621 TI - Long shifts: a trial evaluated. PMID- 3640623 TI - Nurse & the law. Foresight v. hindsight. Every incident not actionable. PMID- 3640624 TI - Poisoning: prevention and first aid. Royal Melbourne Hospital Pharmacy Department. PMID- 3640625 TI - Anti-viral activity of amphotericin B methyl ester: inhibition of HTLV-III replication in cell culture. PMID- 3640627 TI - Toxicology in the workplace (continuing education credit). PMID- 3640626 TI - Toxic-related health effects. PMID- 3640628 TI - Toxicology--an overview. PMID- 3640629 TI - Antineoplastic agents--action and toxicities. PMID- 3640630 TI - Mercury toxicity--an overview. PMID- 3640631 TI - Obesity: a weighty factor in the risk of diabetes. PMID- 3640633 TI - Disaster planning. Medical response: organization and preparation. PMID- 3640632 TI - Pre-retirement planning--a nursing role. PMID- 3640634 TI - Workplace smoking policy--an occupational health nurse's perspective. PMID- 3640635 TI - The effectiveness of peer recognition on motivation. PMID- 3640637 TI - When perinatal caregivers enter the insurance business. PMID- 3640636 TI - The science of chronobiology. PMID- 3640638 TI - Minimizing harm and maximizing benefit during innovation in health care: controlled or uncontrolled experimentation? PMID- 3640639 TI - Neonatal intensive care: parents' role in ethical decision making. PMID- 3640640 TI - Ethical decision making in neonatal intensive care. Commentary. Communicating with parents. PMID- 3640641 TI - Touch in labor: a comparison of cultures and eras. PMID- 3640642 TI - Behaviorally functional opioid systems in infant rats: II. Evidence for pharmacological, physiological, and psychological mediation of pain and stress. AB - In order to determine the behavioral characteristics of the neonatal opioid system during distressful situations, a modification of the hot-plate paw-lick test used on adults was developed for infant rats. Ten-day-old pups were analgesic to heat following morphine administration. Pretreatment with an opioid antagonist prevented the analgesia. Morphine analgesia was significantly greater in pups group isolated from the dam. Saline control pups group isolated from the dam exhibited longer latencies than their nest-housed siblings. Individual isolation for 5 min increased paw-withdrawal latency markedly. This was also naltrexone reversible. This analgesia was not seen when pups were tested directly from the nest or when grouped with other pups for the 5 min. It is suggested that the opioid system(s) for stress and pain are functional in Day 10 rats and short term isolation from the dam is a probable natural stressor that is modulated by endogenous opioid release. PMID- 3640643 TI - Learning nursing research: a preliminary survey. PMID- 3640644 TI - Care of the dying child at home: a unique cooperative relationship. PMID- 3640645 TI - Joint appointment: an Australian study illuminates world views. PMID- 3640646 TI - Breast self examination: nurses' personal and professional practice. PMID- 3640647 TI - Adult learning theory: its applications to the education of midwives. PMID- 3640648 TI - Recruiting black volunteers for a hospice setting: understanding the community and your role in it. PMID- 3640649 TI - The use of multiple group therapy in support groups for grieving families: a model of bereavement support for a hospice program. PMID- 3640650 TI - The hospice garden: addressing the patients' needs through landscape. 2. PMID- 3640651 TI - The Hospice of St. Francis in Havering-Atte-Bower. PMID- 3640652 TI - Maintenance treatment of erectile impotence by cavernosal unstriated muscle relaxant injection. AB - Intracavernosal injection of phenoxybenzamine or papaverine has been tried on 127 men suffering from erectile impotence. In 113 of them it caused an erection which should have sufficed for coitus. Seventy-three men have used such injections, given at home by themselves or their wives, fortnightly or less often, to make coitus possible after each injection; 54 of them still do so. PMID- 3640653 TI - Alterations in mice dopamine receptor characteristics after early exposure to phenobarbital. AB - The present experiment was designed to study the sensitivity of dopamine (DA) receptors after early (pre- and neonatal) administration of phenobarbital (PhB). These receptors have been implicated in some of the behaviors which are altered by early barbiturate exposure. Pregnant HS mice were exposed to PhB (3 g/kg milled food) from the 9th to the 18th day of gestation. Their offspring were the subjects of the prenatal studies. The neonatal treatment consisted of daily injections of PhB to pups from ages 2 to 21 days (50 mg/kg PhB). Striata of treated animals and controls from both treatments, prenatal (PreB) and neonatal (NeoB) were removed at 22 or 50 days for DA receptor binding assay. Using Scatchard plot analysis of [3H]spiroperidol specific binding, long-term increase from control level in DA receptor number (Bmax) was found in the PreB mice, while NeoB mice had decreased Bmax (P less than 0.001). No differences were found in the respective KD values. In parallel psychopharmacological studies, PreB mice had increased apomorphine-induced climbing behavior response, and in previous studies we showed that NeoB had decreased apomorphine induced-climbing behavior response. The long-term alterations in DA receptor number may possibly mediate the changes in brain sensitivity to barbiturate and alcohol found in our previous studies. PMID- 3640654 TI - Selective attention and place navigation in rats treated prenatally with methylazoxymethanol. AB - Prenatal treatment of rats on gestation day 15 with methylazoxymethanol (MAM) caused forebrain microencephaly. The behavioral analyses included measures of spontaneous motor activity and tests for cognitive deficits, and were performed when the rats had reached adult age. Female MAM-treated rats failed to demonstrate contextual control of latent inhibition, which confirms earlier findings with male rats. Male MAM-treated rats demonstrated a notable impairment of place navigation in a swim-maze, but showed as strong sensory preconditioning as the control animals. Biochemical analyses indicated considerable increases in catecholamine levels in the cerebral cortex, hippocampus and striatum. The cognitive deficits, characterised by the various conditioning (taste-aversion) and instrumental learning (swim-maze) tasks, suggested that the MAM rats are deficient in their capacity to attend selectively to the relevant stimulus in complex arrangements of the stimulus situation. PMID- 3640655 TI - Clinical problems in cardiology pericarditis. PMID- 3640656 TI - Why some patients do not sue. PMID- 3640657 TI - Organ donations: the role of hospital staff. PMID- 3640658 TI - Obtaining disclosure of domestic violence. PMID- 3640659 TI - Family involvement in patient care. PMID- 3640660 TI - Late paraphrenia. PMID- 3640661 TI - The perception of stress in the operating room. A research study. PMID- 3640662 TI - The role of the nurse: informed surgical consent. PMID- 3640663 TI - Surge in ophthalmic surgery predicted. PMID- 3640665 TI - Non-surgical disc therapy passes clinical trials. PMID- 3640664 TI - Gastroplasty--the ethical dilemmas. PMID- 3640666 TI - Computer case cart system. A simple solution. PMID- 3640667 TI - When sleep won't come: helping our elderly clients. PMID- 3640668 TI - Depression in the elderly. PMID- 3640669 TI - [Tobacco and oral contraceptives, that's war]. PMID- 3640670 TI - [Steinert's disease]. PMID- 3640671 TI - Cancer care for the elderly. A need for emphasis. PMID- 3640672 TI - Influence of cultural background on nurses' attitudes and care of the oncology patient. PMID- 3640673 TI - How well informed? PMID- 3640674 TI - Nurses' prognosis for oncology and coronary heart disease patients. PMID- 3640675 TI - Sexual and reproductive issues for women with Hodgkin's disease. II. Application of PLISSIT model. PMID- 3640676 TI - Information-seeking and adaptational outcomes in women receiving chemotherapy for breast cancer. PMID- 3640677 TI - Muscarinic binding sites in newborn brain from intrauterine growth-retarded rabbits. AB - Intrauterine growth retardation (IUGR) was induced in rabbits by means of vascular ligation in utero 4-6 days prior to birth. The vascular-restricted living newborns and controls from the unligated uterine horns were killed at birth and the level of the muscarinic cholinergic receptors in cerebral and cerebellar homogenates measured using the potent antagonist 3H-QNB. No significant difference in the binding sites of the cerebellum and the cerebral cortex was found between restricted and control animals. It is speculated that the ineffectiveness of the vascular insult to affect specifically muscarinic binding sites could partially be explained by the specificity of the receptors and the timing of the ischemic insult in relation to the stage of the developing brain. Other cholinergic markers should also be assessed. PMID- 3640678 TI - Nursing diagnosis: the pivotal point of the nursing process in cardiovascular nursing. PMID- 3640679 TI - Binding and cleavage of pre-tRNA by the Xenopus splicing endonuclease: two separable steps of the intron excision reaction. AB - We have constructed three base-substitution mutants of the yeast tRNALeu3 gene. In two of them the ability to form an extended anticodon stem is lost. In the first mutant the bases encoding the anticodon change from TTG to GAC (positions 37, 36, 35); in the second, the nucleotides encoding the region of the intron that base-pair with the anticodon change from CAA to GTC (positions 48, 47, 46). The third is a double mutant characterized by both substitutions described above so that its ability to form an extended anticodon stem is restored. The precursors derived from the two single mutants are accurately spliced in the X. laevis germinal vesicles (GV) extract: pairing of the anticodon with the intron, therefore, is not required for the splicing reaction. The precursor derived from the double mutant is not spliced, indicating that the new extended anticodon stem exerts an inhibitory action. Since the double mutant precursor binds to the purified splicing endonuclease, binding and cleavage occur as two separable steps in the intron excision reaction. PMID- 3640680 TI - GAIN Project helps disadvantaged nursing students achieve academic success. PMID- 3640682 TI - MINMOD: a computer program to calculate insulin sensitivity and pancreatic responsivity from the frequently sampled intravenous glucose tolerance test. AB - Insulin sensitivity and pancreatic responsivity are the two main factors controlling glucose tolerance. We have proposed a method for measuring these two factors, using computer analysis of a frequently-sampled intravenous glucose tolerance test (FSIGT). This 'minimal modelling approach' fits two mathematical models with FSIGT glucose and insulin data: one of glucose disappearance and one of insulin kinetics. MINMOD is the computer program which identifies the model parameters for each individual. A nonlinear least squares estimation technique is used, employing a gradient-type of estimation algorithm, and the first derivatives (not known analytically) are computed according to the 'sensitivity approach'. The program yields the parameter estimates and the precision of their estimation. From the model parameters, it is possible to extract four indices: SG, the ability of glucose per se to enhance its own disappearance at basal insulin, SI, the tissue insulin sensitivity index, phi 1, first phase pancreatic responsivity, and phi 2, second phase pancreatic responsivity. These four characteristic parameters have been shown to represent an integrated metabolic portrait of a single individual. PMID- 3640683 TI - A program for analysing single neuron activity by methods based on estimation of a change-point. AB - A program for analysing the sequences of discharge of a single neuron is presented. This program performs the following tasks: it tests if there is a neuronal response after a stimulus, it estimates the response latency and, in the case of an experiment with a conditioned movement, it estimates the onset of the movement and gives indications about the functional role of the neuron by analysing the variances of the stimulus-response and response-movement times. The methods used have been developed by the authors and are based on the estimation of a change point. The basic methods are published elsewhere but some novelties are presented here, in particular a robust estimator of a variance ratio. PMID- 3640681 TI - Computerized pattern recognition used for grain counting in high resolution autoradiographs with low grain densities. AB - Using a video-image system coupled to a minicomputer with commercial image handling software, autoradiographic grains displayed in dark-field are counted with a fast (ca. 3.5 min for 120,000 microns 2) and reliable (false scores less than 5%) grain-recognizing FORTRAN program executed in the users memory. The grain counts are printed in a raster of adjustable size overlying a bright-field image, so that the counts can be related directly to the underlying histological structures. PMID- 3640684 TI - Alveolar flooding: a computer simulation. AB - A validated computer simulation of pulmonary microvascular exchange (J.L. Bert and K.L. Pinder, Microvasc. Res., 27 (1984) 51-70) has been extended to include exchange with the air space (alveoli). Equations which hypothetically describe characteristics associated with this additional compartment and the exchange of both fluid and plasma proteins between the lung tissue and the alveolar space are presented. These are incorporated into the simulation which has been used to predict the behavior of the pulmonary microvascular exchange system including alveolar flooding. The predicted trends associated with alveolar flooding are reasonable. However, due to the lack of specific experimental or clinical findings, the simulation remains essentially unvalidated. The effect on alveolar flooding and interstitial edema of the parameters associated with the additional relationships is presented and discussed. Primarily, results for perturbations in circulatory pressure are presented. Additionally, changes in permeability characteristics are shown and discussed. PMID- 3640685 TI - Preventing hypothermia. Antifreezers. PMID- 3640686 TI - Keeping warm this winter. PMID- 3640687 TI - Preventing hypothermia. Catching the cold ones. PMID- 3640688 TI - Development screenings: baby talk. PMID- 3640689 TI - Carry on learning. PMID- 3640690 TI - Cumberlege: breaking tribal barriers. PMID- 3640691 TI - Computers in critical care nursing: yet another technology? PMID- 3640692 TI - Care of the patient with coronary artery spasm (continuing education credit). PMID- 3640693 TI - Sleep pattern disturbance. PMID- 3640694 TI - Effectively managing a major media event. PMID- 3640695 TI - Burn unit experience for nursing students. PMID- 3640696 TI - Trauma resuscitation nursing: a career development option for the experienced critical care nurse. PMID- 3640697 TI - Transgenic progeny inherit tissue-specific expression of rat elastase I genes. AB - Six different lines of transgenic mice bearing rat elastase I genes stably inherit both the high-level pancreatic expression and low-level nonpancreatic expression characteristic of each original founding mouse. The high pancreatic expression of the introduced rat genes is transcriptionally determined. In response to high rat elastase I mRNA content in the pancreas, rat elastase I protein is synthesized and secreted at high levels. The stable inheritance of expression of the foreign rat elastase I genes in transgenic mice allows the development of animal lines that synthesize and secrete high levels of foreign protein by the pancreas. PMID- 3640698 TI - Diabetes and sexual health. PMID- 3640699 TI - How clinician communication patterns affect patients' comprehension and satisfaction. PMID- 3640700 TI - Building a helpful relationship: the foundation of effective patient education. PMID- 3640701 TI - Wide, wide world of diabetes mellitus. PMID- 3640702 TI - Problems of diabetes education in different cultures. PMID- 3640703 TI - Diabetes education--a universal need. PMID- 3640704 TI - Humulin BR, a new insulin for use in external insulin pumps. PMID- 3640705 TI - Cyclosporine therapy in type I diabetes mellitus. PMID- 3640706 TI - Diabetes health care, nutrition, and diabetes education in diabetes centers in India. PMID- 3640707 TI - Elevated glandular kallikrein in estrogen-induced pituitary tumors. AB - Anterior pituitary tumors were induced in F344 rats by implants of diethylstilbesterol (DES) for 8 weeks. DES-induced tumors contained 250 times more glandular kallikrein than anterior pituitaries from rats not exposed to estrogen, and 6.6 times more glandular kallikrein than anterior pituitaries from rats exposed to large doses of estrogen for 10 days. DES-induced anterior pituitary tumors in F344 rats arise from lactotroph proliferation. Thus, the results suggest that anterior pituitary glandular kallikrein is associated with lactotrophs. PMID- 3640708 TI - Young hamsters are more resistant than adults to endotracheally instilled porcine pancreatic elastase. AB - We measured the physiologic and stereologic response to 0.1, 0.2, and 0.4 microgram of porcine pancreatic elastase instilled in a volume of 0.25 ml 0.9% NaCl/100 g body weight into the trachea of groups of young and adult hamsters. The young hamsters averaged 50 g and the adult hamsters 116 g in initial body weight. Twenty-one days after administration of elastase, lung volumes, static lung compliance, maximum expiratory flow, the whole section mean linear intercepts (MLI) were measured. The degree of emphysema increased in all animals as a function of dose. Examination of the lung volume and compliance dose response characteristics indicated that young hamsters developed less physiologic change with increasing elastase dose than did adult hamsters. Maximum expiratory flow and whole section MLI dose-response were similar in the young and adult elastase-treated groups. However, the MLI in young hamsters treated with the 0.4 microgram elastase dose was decreased in the outer third of the lung compared to adult emphysematous hamsters. Also, mean airspace density relative to saline control values in young hamsters was double that found in adult hamsters treated with the 0.4 microgram elastase dose. Although serum alpha 1-globulin levels were equivalent in both young and adult normal hamsters, values normalized for lung elastin content were significantly increased in young animals. We conclude that young hamsters show less change in lung function as a function of elastase dose twenty-one days after elastase instillation. Possible reasons for this include an increased ratio of lung alpha 1-globulin/lung elastin in young hamsters, their continued ability to grow new alveoli, and age related differences in airway size favoring a central distribution of enzyme. PMID- 3640709 TI - X-ray crystal structure of the complex of human leukocyte elastase (PMN elastase) and the third domain of the turkey ovomucoid inhibitor. AB - Orthorhombic crystals diffracting beyond 1.7 A resolution, have been grown from the stoichiometric complex formed between human leukocyte elastase (HLE) and the third domain of turkey ovomucoid inhibitor (OMTKY3). The crystal and molecular structure has been determined with the multiple isomorphous replacement technique. The complex has been modeled using the known structure of OMTKY3 and partial sequence information for HLE, and has been refined. The current crystallographic R-value is 0.21 for reflections from 25 to 1.8 A resolution. HLE shows the characteristic polypeptide fold of trypsin-like serine proteinases and consists of 218 amino acid residues. However, several loop segments, mainly arranged around the substrate binding site, have unique conformations. The largest deviations from the other vertebrate proteinases of known spatial structure are around Cys168. The specificity pocket is constricted by Val190, Val216 and Asp226 to preferentially accommodate medium sized hydrophobic amino acids at P1. Seven residues of the OMTKY3-binding segment are in specific contact with HLE. This interaction and geometry around the reactive site are similar as observed in other complexes. It is the first serine proteinase glycoprotein analysed, having two sugar chains attached to Asn159 and to residue 109. PMID- 3640711 TI - LAV/HTLV-III and sperm antibodies. PMID- 3640712 TI - Graham unveils health care platform at Convention. PMID- 3640710 TI - Alternative processing of H-2Dd pre-mRNAs results in membrane expression of differentially phosphorylated protein products. AB - Two distinct mRNA species encoding the mouse major histocompatibility antigen H 2Dd have been identified in BALB/c spleen cells as well as in cultured cell lines expressing this cell surface glycoprotein. The alternate transcripts of H-2Dd arise from either removal or inclusion of exon VII (encoding I2) during pre-mRNA processing. The relative levels of each kind of H-2Dd transcript varied considerably between different cell types, and in all cells examined both forms of alloantigen were expressed on the cell membrane. Antigen derived from both types of transcript reacted with H-2Dd-specific monoclonal antibodies, whereas only protein lacking the 13 amino acids of I2 reacted with a specific antiserum raised against a predicted exon VI/VIII fusion peptide. Those H-2Dd proteins translated from full length, but not smaller, transcripts were phosphorylated in resting and phorbol myristate acetate-stimulated BALB/c spleen cells, suggesting that the major site of in vivo phosphorylation is within the highly conserved sequence encoded by exon VII. Thus alternative splicing of pre-mRNA transcripts is a mechanism which leads to membrane expression of two forms of H-2Dd, one of which lacks a major site of phosphorylation. PMID- 3640713 TI - Nursing: is survival an issue. A nursing executive's perspective. PMID- 3640714 TI - Nursing diagnoses in psychiatric nursing. PMID- 3640715 TI - Behaviour and fertility of albino Swiss mice after the administration of MTX. PMID- 3640716 TI - [ATP and DNA in the ejaculate of subfertile males]. PMID- 3640717 TI - A dietitian's perspective on food/drug interactions. PMID- 3640719 TI - The future of geriatric medicine in Canada. PMID- 3640718 TI - Well seniors' perceptions of their health and well-being. How's your health? PMID- 3640720 TI - From anger to empathy. PMID- 3640721 TI - The Patent Act: a matter of refinement. PMID- 3640722 TI - Scheduling drug administration: drug and food interactions. PMID- 3640723 TI - The biology of ageing: digestion and nutrition in the elderly. PMID- 3640725 TI - 'A tale told by an idiot'. PMID- 3640724 TI - Planning menus for the elderly. PMID- 3640726 TI - Anamnesis in dementia: restoring a personal history. PMID- 3640727 TI - Moderate dementia and multiple disabilities. PMID- 3640728 TI - Geriatric care in South Africa. PMID- 3640730 TI - Job satisfaction and organizational change in a maternity hospital. PMID- 3640729 TI - Nursing in Australia comes of age! PMID- 3640731 TI - Communication and decision-making in a study of a multidisciplinary team conference with the registered nurse as conference chairman. AB - It was decided that the medical and nursing staff had to communicate verbally concerning the patient's need for information and to make decisions concerning steps to be taken when satisfying the patient's need for information. The aim of this study was, accordingly, to investigate if a training programme for registered nurses as chairperson of the multidisciplinary team conference (MTC) changed the communication and decision pattern during the neurological ward conference. The training material provided instructions and a scheme for the chairperson of the MTC. The training was carried through with the help of patient case reports and role play. Data were collected through tape recordings of the communication at ten MTCs before the training and ten MTCs after the training. The strictly medical communication was less illuminated, while the patient's psychological needs, especially concerning the patient's need for information, were better illuminated than before the training. After the training 42 information problems were reported and two before. For half of them, decisions were made on the steps to be taken in order to fulfil the patient's need. For the other half, the discussion concerning the patient's need for information was communicated between the staff. Only the decision-making was missed. PMID- 3640732 TI - Socio-demographic characteristics and opinions of basic and post-basic nursing students in Nigeria. AB - In attempting to describe the socio-demographic characteristics and opinions of Nigerian nurses, a random selection of 293 students was made in three schools offering basic and post-basic programmes. Most of the students were from the lower socio-economic background; they entered nursing to 'help' people, and were enthusiastic about their training and exposure to new experiences. For most basic students, first job expectation was bedside nursing after graduation; it was administrative and/or teaching duties for those in the post-basic programme. The students showed similarities with their counterparts elsewhere. PMID- 3640733 TI - Implications of architectural and structural characteristics of institutions for the aged in Israel. PMID- 3640734 TI - Concerning the report on chloroxylenol-containing antiseptic: queries and response. PMID- 3640735 TI - Old wine in new bottles. PMID- 3640736 TI - Outbreak of staphylococcal infection in two hospital nurseries traced to a single nasal carrier. AB - In late January and early February 1983, an outbreak of skin infections (7 of 145 infants) caused by a penicillin/erythromycin resistant strain of Staphylococcus aureus (SA), phage type 3A/3C, occurred in our newborn nursery. A week following the first cluster of infections, another nursery outbreak due to SA with the same antibiogram occurred in a nearby community hospital (11 of 114 infants). Subsequently, a second cluster of infections with the same SA was identified at our nursery. The epidemic strain was carried in the anterior nares of a single nurse who worked at both hospital nurseries on alternate weeks. Investigation revealed that the nurse had an upper respiratory tract infection during each of these outbreaks--simulating "a cloud baby." No further infections have occurred since this nurse was treated and her SA nasal carrier state eliminated. PMID- 3640737 TI - The nosocomial colonization of T. Bear. AB - A national effort to reduce nosocomial infections includes a program developed at the National Institutes of Health to encourage handwashing in hospitals and day care centers. The program promotes a symbolic teddy bear (T. Bear) with slogans to remind hospital personnel and patients to practice handwashing. One of the items used is a stuffed toy T. Bear to be dispensed to the hospitalized child. Considering the manner in which children handle stuffed toys, we suspected the T. Bear might serve as a "fomite" for transmission of nosocomial microbes. A prospective study of 39 sterilized T. Bears revealed that all became colonized with bacteria, fungi, or both within 1 week of hospitalization. Hospital acquired organisms cultured from the T. Bear included Staphylococcus epidermidis, Staphylococcus aureus, alpha streptococci, Corynebacterium acnes, Micrococcus sp, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Bacillus sp, and species of Candida, Cryptococcus, Trichosporon, Aspergillus and others. Concomitant cultures of the patients revealed similar isolates. Although the T. Bear handwashing campaign should not be discredited, the promotional toy may pose an unnecessary expense and hazard and should not be used in hospitals or day care centers. PMID- 3640738 TI - Effects of ultra high speed floor burnishing on air quality in health care facilities. AB - Effects of ultra high speed (UHS) floor burnishing upon air quality in health care facilities were evaluated. A 2,000-rpm burnisher can disseminate high velocity (190 km/hr) dust and microbial particles. A UHS burnisher used with either inadequate or no air restraint produced significant increases (P less than 0.05) in the levels of airborne dust particles and microorganisms. A UHS burnisher equipped with an air restraint assembly specifically designed for use in health care facilities produced no significant increase (P greater than 0.05) in the levels of airborne dust particles or microorganisms when compared to ambient air levels. The types and distribution of airborne microorganisms isolated from microbial air samples were not unusual nor were they directly influenced by the floor burnishing processes. Furthermore, the UHS floor burnishing process produced a significant reduction (P less than 0.05) in microbial floor contaminants (96%). When the use of UHS floor burnishing is contemplated for productivity improvement and esthetic enhancement, the possible adverse effects on air quality should also be considered. PMID- 3640739 TI - Reuse of disposable medical devices: historical and current aspects. AB - The "plastics revolution" of the last quarter century disrupted a hospital tradition. Since the 1890s, hospitals processed, packaged, and sterilized most of the medical-surgical items they needed in their own sterile supply departments--a "cottage industry" developed specifically for recycling. Only those consumable items that were too difficult, expensive, or inconvenient to reprocess were purchased from outside manufacturers as presterilized, single-use "disposables." Since the plastics revolution, however, the "disposables" started to displace the "reusables," and while claiming to be an economical innovation, have become a significant item in the budget. Some hospitals feel that if disposables save money, reusing the disposable several times will save more. The practice is spreading. The manufacturers, in turn, claim that hospitals do not have adequate quality assurance programs or skills to reprocess their items properly. The debate is further complicated by legal and ethical ramifications, as well as commercial and economic arguments. PMID- 3640740 TI - Report on chloroxylenol-containing antiseptic: reference correction. PMID- 3640741 TI - Does irrigation prevent catheter-associated UTI? PMID- 3640742 TI - The susceptibility of health care workers to varicella-zoster virus. PMID- 3640743 TI - Double-bagging of items from isolation rooms is unnecessary as an infection control measure: a comparative study of surface contamination with single- and double-bagging. AB - In many hospitals, waste materials and used linens from the rooms of patients in isolation or the clinical laboratories are routinely double-bagged to reduce contamination of the external surface of the bag that could be transmitted to hospital personnel subsequently handling them. No studies have prospectively examined the value, if any, of double-bagging. We randomly assigned waste and linens from the rooms of 42 patients in contact isolation to be transported in single bags or double bags. Shortly after a single (or double) bag had been set outside the patient's room, the surface was cultured quantitatively in two locations near the knot; over 2 months, 209 bags were cultured. Surface contamination by Staphylococcus aureus (3% to 5%), enteric gram-negative bacilli (6% to 7%), or either (9% to 12%) was infrequent and comparable in both groups; moreover, quantitative levels of contamination in the two groups were almost identical (mean, 27 and 29 colony forming units [cfu] per bag). These data suggest that there is no advantage, as regards asepsis, to double-bagging potentially contaminated items from isolation rooms or clinical laboratories as compared with using a single bag. The use of a single-bag system with a heavy duty bag, as compared with double-bagging, saved our hospital $9,400 in 1985. PMID- 3640744 TI - Selective screening of hospitalized patients for the presence of asymptomatic hepatitis B virus carriage: predictability based on census tract data. AB - Review of all hepatitis B surface antigen-positive patients reported to the county health department over the past 3 years showed that 60% of patients had been diagnosed at our hospital, which serves an inner city, predominantly black, indigent population. Sera from 524 adult patients admitted to the hospital were prospectively collected and tested for hepatitis B surface antigen, eight (1.5%) of which were antigen-positive. Census tract data allowed us to perform selective screening of sera from 95 other patients who were subsequently hospitalized and deemed "high risk" for hepatitis B infection. Nine of 95 (9.5%) selectively screened samples were positive for hepatitis B surface antigen, which represented a significantly higher rate of antigen carriage (P less than 0.0001) in hospitalized patients from "high risk" areas than that found in the general population screen. The methodology presented herein may be useful in providing a means of identifying hepatitis B surface antigen-positive patients from adult, urban, indigent care populations. PMID- 3640745 TI - Influence of country of origin on prevalence of hepatitis B markers among employees in a small suburban hospital. AB - Hepatitis risk in a small suburban hospital was evaluated by laboratory screening of all hospital employees for hepatitis immunologic markers. Excluding four U.S. born subjects who had received hepatitis vaccination, the laboratory screening revealed 21% of those tested had some hepatitis B antigen or antibody. Positive markers were found in 46% of foreign-born compared to 10% of native-born (P less than 0.001). Foreign-born participants accounted for 68% of the positive marker cases while representing only 31% of the employee population. The country of origin appeared to have a statistically significant greater importance as a determinant of hepatitis B status than occupational area in this particular hospital setting. PMID- 3640746 TI - The Streptococcus milleri group. AB - The Streptococcus milleri group is newly recognized as a cause of pyogenic infection. It is important that microbiologists and physicians become aware of these organisms. The heterogeneous nature of this group of streptococci does mean that laboratories will have to use a combination of antigenic, physiologic, and hemolytic characteristics to identify these pathogenic streptococci. Physicians need to recognize that these microorganisms as a group are able to cause serious infections that may require prolonged treatment and/or surgical drainage of abscesses. PMID- 3640747 TI - Guidelines for the reuse of disposable medical devices. The American Society for Hospital Central Service Personnel. AB - Decisions about the reuse of single-use-only (disposable) medical devices should not be made "on-the-spot." Consistency of practice in all areas of the institution is of utmost concern. Practice should conform to the reuse policies established. Unless an institution can demonstrate and document that patient safety, correct processing, and device effectiveness are not compromised by reprocessing a single-use-only (disposable) medical device, reprocessing is not recommended. PMID- 3640748 TI - Protective ribs for connectors. PMID- 3640749 TI - Assessment of screening as a preventive technology: the example of HTLV-III/LAV antibody testing. AB - Screening for disease control can be defined as a preventive technology that is used to examine asymptomatic people in order to classify them as likely or unlikely to have the disease that is the object of screening. Screening may consist of routine physical examinations, radiologic procedures, semi-invasive procedures such as endoscopy, or serologic tests. In this paper, a new serologic test is considered. Acquired immunodeficiency syndrome (AIDS) is a devastating disease with high mortality, recently shown to be caused by a retrovirus named human T-lymphotropic virus Type III (HTLV-III) or lymphadenopathy-associated virus HTLV-III antibody in serum specimens. Performance characteristics are excellent with high sensitivity and specificity when reactive serum specimens are checked for consistency of response by enzyme immunoassay (EIA). This test is now part of the screening protocol for all blood donation centers to decrease the risk of HTLV-III transmission via blood or blood products. About 0.2% (1 in 400) of blood donors have repeatedly reactive EIA tests to HTLV-III antibody. Approximately one-third of these donors have other laboratory evidence of infection. Screening for HTLV-III is a new technology that illustrates virtually all of the factors that need consideration in an assessment of disease screening. This paper explores these technical, epidemiologic, economic, legal, social, and ethical factors. PMID- 3640750 TI - Functional assessment: measurement with the Barthel Index and PULSES profile. PMID- 3640751 TI - Recovery of coping: a case study. PMID- 3640752 TI - Nurse-owned agency offers management training for nursing students. PMID- 3640753 TI - The psychosocial clinical nurse specialist: an untapped resource for home care. PMID- 3640754 TI - Rehabilitation nursing. PMID- 3640755 TI - Growing pains. Hospice care. PMID- 3640756 TI - National Home Care Week: your opportunity to educate and inform. PMID- 3640758 TI - [Midwives' outward-directed activities on the subject of sexuality and living together]. PMID- 3640757 TI - Health insurance: a summary of basic types. PMID- 3640759 TI - [Scholarship report. Report from the National Association of Childbearing Centers (NACC) congress in Orlando, Florida 9-12 April 1986]. PMID- 3640760 TI - [Open letter to all who have to make decisions on the future of maternal-child care in Lidkoping]. PMID- 3640761 TI - Effect of compression pressure on forced expiratory flow in infants. AB - The effect of the force of compression on expiratory flow was evaluated in 19 infants (2-13 mo of age) with respiratory illnesses of varying severity. An inflatable cuff was used to compress the chest and abdomen. Expiratory flow and volume, airway occlusion pressure, cuff pressure (Pc), and functional residual capacity were measured. Transmission of pressure from cuff to pleural space was assessed by a noninvasive occlusion technique. Close correlations (P less than 0.001) were found between Pc and the change in pleural pressure with cuff inflation (delta Ppl,c). Pressure transmission was found to vary between two cuffs of different design and between infants. Several forced expirations were then performed on each infant at various levels of delta Ppl,c. Infants with low maximal expiratory flows at low lung volumes required relatively gentle compression to achieve flow limitation and showed decreased flow for firmer compressions. Flow-volume curves in each infant tended to become more concave as delta Ppl,c increased. These findings underline the importance of knowledge of delta Ppl,c in interpreting expiratory flow-volume curves in infants. PMID- 3640762 TI - Changes in chest wall structure and elasticity in elastase-induced emphysema. AB - The present study examined the effects of elastase-induced emphysema on the structure and elasticity of the chest wall. Specifically, we examined the passive pressure-volume relationship of the intact chest wall in anesthetized animals and the stress-strain relationship of the isolated rib cage devoid of respiratory musculature. The structure of the isolated rib cage was assessed by measuring its circumferential, anterior-posterior, and transverse dimensions, the angles of articulation of the ribs at the costovertebral and sternochondral joints, and the length of the sternum and individual ribs. Studies were performed in 10 Syrian Golden hamsters, 26-27 wk after intratracheal injection of elastase, and 9 saline injected hamsters that served as controls. Mean functional residual capacity of emphysematous animals was 239% of the value obtained in control animals. In emphysematous animals, the pressure-volume curve of the chest wall was shifted parallel and to the left of the curve obtained in controls. That is, at any given esophageal pressure, lung volume was significantly greater in emphysematous animals compared with controls, but the slope of the pressure-volume relationship was similar in the two groups. In the relaxed position, the circumference, anterior-posterior, transverse, and rostral-caudal dimensions of the thorax were significantly greater in emphysematous than control animals. Although the length of the thoracic spinal column was the same in both groups, the length of the ribs and sternum were greater in emphysematous animals and the angles of articulation of the ribs with the vertebrae and sternum were altered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3640763 TI - Structural organization of apolipoprotein B-100 of human plasma low density lipoproteins. Comparison to B-48 of chylomicrons and very low density lipoproteins. AB - The present study characterizes the substructural organization of apolipoprotein B-100 (B-100) of human plasma low density lipoproteins (LDL) and its relation to B-74 and B-26 of LDL and B-48 of chylomicrons and very low density lipoproteins. LDL were digested with human kallikrein and thrombin to yield two major fragments: K1 (Mr 410,000) and K2 (Mr 145,000) and T1 (Mr 385,000) and T2 (Mr 170,000), respectively. The antigenic sequences, Mr, and amino acid compositions of K1 and K2 were identical to those of plasma B-74 and B-26; B-26 and K2 had identical NH2-terminal sequences and correspond to the NH2-terminal region of B 100. K1 was further degraded by kallikrein to give K3 (Mr 235,000) and K4 (Mr 170,000); these peptides correspond immunochemically to two newly discovered plasma LDL peptides B-44 and B-30 and are assigned as complementary fragments of B-74. The thrombin cleavage fragments, T1 and T2, did not correspond to B-74 and B-26. Neither kallikrein nor thrombin generated a fragment from B-100 corresponding to B-48 in chylomicrons. However, B-48 showed antigenic homology with B-26 and to the of B-74 adjoining B-26, indicating that its structure is represented in the NH2-terminal half of B-100. The structural studies further clarify the relatedness among the B-100, B-74, B-26, and B-48 polypeptides and should now make possible the delineation of the functional domains mediating the interactions of apolipoprotein B in the circulation and arterial wall. PMID- 3640765 TI - Integrating cost analyses in quality assurance. PMID- 3640764 TI - Use of narrow-bore high-performance liquid chromatography for microanalysis of protein structure. AB - We report here systematic approaches to microanalysis of protein structures using narrow-bone high-performance liquid chromatography of protein, peptide and derivatized [phenylthiocarbamyl (PTC-) and phenylthiohydantoinyl (PTH-)] amino acids. The utilization of columns with small diameters (2 mm or less) has improved resolution and sensitivity and enabled protein structure analysis at the low pmol level. Preparative isolation of proteins and peptides of pmol quantity is achieved and separation and identification of PTC- and PTH-amino acids can be routinized at the low pmol to subpmol level. The use of diode-array detection enables simultaneous multiple-wavelength monitoring and spectral retreat, which greatly enhances flexibility and usefulness of the present methods. In combination with protein microsequencing techniques, these narrow-bore high performance liquid chromatographic procedures can facilitate structural analysis of minutely available proteins of biochemical and physiological significance. PMID- 3640766 TI - Downsizing: measuring its effects on quality of care. PMID- 3640767 TI - Ethics, economics, and quality. PMID- 3640768 TI - A quality and cost control model for managing nursing utilization. PMID- 3640769 TI - Cost and quality: balancing the issues through management. PMID- 3640770 TI - Communicating quality assurance. PMID- 3640771 TI - Using the QA process for departmentwide problems. PMID- 3640772 TI - The incidence of skin breakdown in a surgical intensive care unit. PMID- 3640773 TI - Reliability of latex agglutination tests for identification of Staphylococcus aureus resistant to oxacillin. AB - Commercial latex agglutination tests (LATs) for the simultaneous detection of clumping factor and protein A are gaining increased acceptance as a means of identifying Staphylococcus aureus. We evaluated two LATs (Accu-Staph; Carr Scarborough, Decatur, Ga.; Staphaurex; Wellcome, Dartford, England) with particular emphasis on their ability to correctly identify oxacillin-resistant S. aureus. We tested 59 oxacillin-resistant S. aureus, 136 oxacillin-susceptible S. aureus, and 92 coagulase-negative staphylococcal strains with the two LATs and with thermonuclease, slide clumping factor, tube coagulase, and protein A hemagglutination tests. Clumping factor and protein A were present in 96.9 and 82.1% of our S. aureus strains, respectively. Accu-Staph correctly identified 92.8% and Staphaurex correctly identified 91.3% of S. aureus strains. No significant difference in LAT positivity rates, presence of clumping factor, or presence of protein A was found between oxacillin-resistant and -susceptible S. aureus. Overall, there were 31 false-negative LATs for 20 S. aureus strains, 14 with Accu-Staph and 17 with Staphaurex. Ninety-five percent of these strains possessed either clumping factor or protein A or both when these factors were determined independently. There were five false-positive LATs for four strains of coagulase-negative staphylococci (three Staphylococcus epidermidis and one Staphylococcus warneri), four with Accu-Staph and one with Staphaurex. Clumping factor was present in one S. warneri strain. Thus, the specificities of Accu Staph, Staphaurex, and the clumping factor test were 95.6, 98.9, and 98.9%, respectively. Our results indicated that LATs identify oxacillin-resistant and susceptible S. aureus equally well; however, they offer no greater sensitivity or specificity than the clumping factor test for identification of S. aureus. PMID- 3640774 TI - Elastolytic activity among staphylococci. AB - A total of 161 isolates of the genus Staphylococcus were evaluated for the ability to produce elastase. Elastase activity was detected only in S. epidermidis strains (sensu stricto), being absent in S. aureus isolates and other coagulase-negative staphylococci tested. The elastase elaborated by S. epidermidis isolates appeared to be an inducible enzyme whose synthesis was medium dependent. PMID- 3640775 TI - The season of giving: kickbacks and ET nursing. PMID- 3640776 TI - Comprehensive wound management with a starch-based copolymer dressing. PMID- 3640777 TI - Interventions of the ET nurse with the continent urinary Kock pouch patient. PMID- 3640778 TI - The ET nurse as researcher: governing our practice. PMID- 3640779 TI - The development of a comprehensive instructional package for teaching intermittent self-catheterization. PMID- 3640780 TI - Gastrointestinal diagnostic tests (getting ready for certification). PMID- 3640781 TI - Care of the percutaneous nephrostomy tube. PMID- 3640782 TI - Acquired C1 esterase-inhibitor deficiency: case report with emphasis on complement and kallikrein activation during two patterns of clinical manifestations. AB - A case of severe angioedema with several episodes of life-threatening attacks during a follow-up of 7 years is presented. Although the biologic profile is that of an acquired C1 INH deficiency, no lymphoproliferative malignancy or immune complex disease could be proven until now. However, the patient has had a small monoclonal IgG lambda-gammopathy for 4 years. During the last 4 years, edematous manifestations have stopped. The patient now suffers at regular intervals of about a week from short-lasting attacks with digestive and vasomotor symptoms. This clinical evolution is accompanied by a worsening in the complement abnormalities. The digestive and vasomotor attacks were found to be correlated with sudden prekallikrein and high-molecular-weight kininogen consumption. These findings demonstrate that prekallikrein is activated during acquired C1 INH deficiency and that the products of this pathway such as bradykinin are probably responsible for a part of the clinical manifestations associated with this disorder. PMID- 3640783 TI - A community health center responds to the aging of Japan. PMID- 3640784 TI - Elderly clients as educators. PMID- 3640785 TI - On loneliness and the elderly. PMID- 3640786 TI - Nurses can learn from wives of impaired spouses. PMID- 3640787 TI - Who will care for the elderly? PMID- 3640788 TI - Wandering behavior. PMID- 3640789 TI - Measuring blood pressure via sensory detection. PMID- 3640790 TI - Methicillin-resistant Staphylococcus aureus: a 6-month survey in a Lisbon paediatric hospital. AB - The prevalence of nasal colonization and infection with methicillin-resistant Staphylococcus aureus (MRSA) among patients and staff was studied in a section of a Paediatric Surgical Unit in Lisbon between February and July 1985. Nasal colonization was demonstrated in 41% of burned patients, 5% of non-burned patients and 35% of the nurses. Infection by MRSA occurred in 30% of the burns. The isolates had identical serological patterns, slight differences on phage typing and were resistant to methicillin, cephalosporins, tetracycline, erythromycin and aminoglycosides. A chloramphenicol resistance plasmid of 3 Md was present in those isolates which were chloramphenicol resistant and a small plasmid of 1.7 Md which coded for constitutive erythromycin resistance was present in many isolates. Gentamicin, tetracycline and inducible erythromycin resistance were chromosomal. Several reasons for the apparent low virulence of the isolates are discussed. Attempts to control the outbreak by the discharge of colonized or infected patients, improvement of nursing practices and treatment with temporary removal from work of the colonized nurses did not eliminate the organism from the unit. PMID- 3640791 TI - Effect of beta-propiolactone--an inhibitor of HTLV III/LAV activity--on immunological analyses. AB - beta-Propiolactone (BPL) inactivates LAV/HTLV III, the retrovirus associated with acquired immune deficiency syndrome (AIDS). Addition to specimens from patients with suspected AIDS or antibodies to LAV/HTLV III could reduce any occupational risk to laboratory staff. This study demonstrates that BPL treatment does not significantly affect the immunological analyses commonly required on these patients, namely measurements of serum immunoglobulins, complement components C3 and C4 and other serum proteins, detection of autoantibodies and estimations of T lymphocyte subpopulations. PMID- 3640792 TI - In vitro suppression of HTLV-III/LAV infectivity by a combination of acyclovir and suramin. PMID- 3640793 TI - The nature and nurture of pain control. PMID- 3640794 TI - A model for the treatment of cancer pain. PMID- 3640795 TI - A troubleshooting guide to the subcutaneous epidural implantable reservoir. PMID- 3640796 TI - Continuous infusion of opioid drugs in the treatment of cancer pain: guidelines for use. PMID- 3640797 TI - The use and availability of rectal narcotics. PMID- 3640798 TI - Acupuncture treatment: a perspective. PMID- 3640799 TI - Effects of an antiserum to rat growth hormone on lactation in the rat. AB - A highly specific antiserum to rat GH (anti-rGH) was used to assess the role of GH in lactation in the rat. When administered alone, anti-rGH had no effect on litter weight gain, whereas bromocriptine reduced serum prolactin concentrations and litter weight gain for up to 7 days when given on day 4 of lactation. When bromocriptine and anti-rGH were given in combination, however, litter weight gain declined even more dramatically so that pups were receiving virtually no milk 2-3 days after treatment. Daily litter exchange failed to prevent this effect. Concurrent injections of highly purified GH (prolactin contamination undetectable) prevented the dramatic decline in litter weight gain induced by combined bromocriptine and anti-rGH treatment, so that these litters grew as well as those receiving bromocriptine alone. Growth hormone did not act by influencing serum prolactin concentrations, which remained low during GH therapy. Direct effects of anti-rGH or GH on the pups (transferred through the milk) were ruled out since virtually identical results were obtained when milk yield was estimated during a 30-min suckling period after a 3-h separation of mother and pups. Lactation had virtually ceased 3 days after treatment with both bromocriptine and anti-rGH, but it could be reinitiated by a single injection of prolactin or GH, and subsequent recovery was virtually complete. The results of this study show that prolactin can maintain a full milk yield in the absence of GH, milk yield is reduced by approximately 50% in the absence of prolactin and milk yield is totally stopped in the absence of prolactin and GH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3640801 TI - Nursing center: from concept to reality. PMID- 3640802 TI - Over-the-counter medications: quicksand for the elderly. PMID- 3640800 TI - Role of envelope glycoprotein carbohydrate in human immunodeficiency virus (HIV) infectivity and virus-induced cell fusion. AB - Human immunodeficiency virus (HIV) envelope glycoprotein interactions with cell surface CD4 are involved in both virion infectivity and virally mediated cell fusion. D-mannose-specific lectins such as Con A specifically blocked virion infectivity and cell fusion. Studies with a recombinant vaccinia virus containing the HIV envelope gene demonstrated that Con A-mediated inhibition of HIV-induced fusion involved lectin binding to the viral envelope glycoprotein. These results indicate the importance of envelope glycosylation in the pathobiology of HIV infection, and suggest potential mechanisms for interfering with HIV infectivity and cytopathology. PMID- 3640803 TI - A community health approach to AIDS: caring for the patient and educating the public. PMID- 3640804 TI - Meeting health needs in a crisis shelter: a challenge to nurses in the community. PMID- 3640805 TI - Use of physician consultation by nurse practitioners in community health and ambulatory clinic settings. PMID- 3640806 TI - Influence of eating on blood pressure readings in older adults. PMID- 3640807 TI - Hypotensive and natriuretic effects of nifedipine in essential hypertension. Role of renal kallikrein-kinin-prostaglandin and renin-angiotensin-aldosterone systems. AB - To assess the role of renal kallikrein-kinin-prostaglandin and renin-angiotensin aldosterone systems in the diuretic and natriuretic actions of nifedipine, a calcium-channel blocker, 20 mg of nifedipine was administered orally to 15 patients with essential hypertension. Nifedipine promptly induced a hypotensive effect and an increase in pulse rate. Urine volume, urinary sodium excretion, and creatinine clearance were significantly increased after the administration of nifedipine by 63.5%, 48.5% and 12.4%, respectively. Urinary excretion of kallikrein and prostaglandin E were also significantly increased after the administration of nifedipine by 29.4% and 50.0%, respectively. The change in urinary kallikrein excretion was significantly correlated with that in urine volume (r = 0.70, p less than 0.01) or that in urinary sodium excretion (r = 0.86, p less than 0.01). In addition, the change in urinary prostaglandin E excretion was also significantly correlated with that in urine volume (r = 0.72, p less than 0.01) or that in urinary sodium excretion (r = 0.53, p less than 0.05). Plasma aldosterone concentration did not change despite of the marked increase in plasma renin activity, and plasma aldosterone concentration/plasma renin activity ratio decreased after the administration of nifedipine. These results suggest that the augmented renal kallikrein-kinin-prostaglandin system and the suppressed secretion of aldosterone may be associated with the diuretic and natiuretic action of nifedipine and may contribute to the reduction in blood pressure that is caused mainly by its vasodilatory action. PMID- 3640809 TI - Managing organizational stress in nursing. AB - The strategic management of a nursing organization in a changing health care market creates pressure on nursing administrators and on their organizations. The effective management of organizational stress potentiates quality nursing care and reduces the costs related to stress and burnout. This article describes a two tiered program designed to manage organizational stress. The first component focuses on educating nursing leadership about the nature and impact of organizational stress and how to minimize it. The second component is the instrument used to measure the perceived effectiveness of our interventions. PMID- 3640808 TI - Costing nursing services using RVUs. AB - Keeping track of nursing resources consumed by each hospital inpatient does not have to be a cumbersome process. The authors present an inexpensive, straightforward approach to generate management information on nursing acuity by DRG, payor, hospital service, or physician. PMID- 3640810 TI - Recognizing clinical excellence. AB - Questioning the effectiveness of clinical ladders in recognizing excellence in practice, nursing administration developed a program in which staff nurses receive monetary and professional recognition. By completing a number of performance criteria over the course of 1 year, participants demonstrate self growth in leadership, teaching, and role modeling. The authors explain their recognition program and how staff, administration, and patient care benefited. PMID- 3640811 TI - Nursing diagnoses in a professional model of nursing: keystone for effective nursing administration. AB - While the benefits of nursing diagnoses in clinical practice have been well documented, reports of the advantages from a nursing administration viewpoint are scant. In this article, the author highlights how nursing diagnoses can be used as a leadership strategy to achieve a professional model of practice and to increase organizational effectiveness. PMID- 3640812 TI - The MS in nursing/MBA program. PMID- 3640813 TI - Negotiations: getting what you want. PMID- 3640814 TI - Essential skills for nurse managers. PMID- 3640815 TI - School re-entry program for oncology patients. PMID- 3640816 TI - Children as decision makers. PMID- 3640817 TI - Clinical problem: mucositis. PMID- 3640818 TI - President's pen (overview of APON activities). PMID- 3640819 TI - Distribution and elimination of vanadium in mice following a four weeks intraperitoneal administration of sodium orthovanadate. PMID- 3640820 TI - Psychiatric ward atmosphere. PMID- 3640821 TI - Stress & coping in psychiatric nursing. PMID- 3640822 TI - The abused elderly. PMID- 3640823 TI - Mutual expectations. How family members view the social role of the mental health center client. PMID- 3640824 TI - ECT myths. PMID- 3640825 TI - Involuntary commitment and the right to refuse medication. PMID- 3640826 TI - Body searches and the right to privacy. PMID- 3640827 TI - Seclusion: organizing safe and effective care. PMID- 3640828 TI - Providing for the rights and safety of patients. PMID- 3640829 TI - Ethical perspectives. PMID- 3640830 TI - Violence and behavior control. PMID- 3640831 TI - Structure of the product complex of acetyl-Ala-Pro-Ala with porcine pancreatic elastase at 1.65 A resolution. AB - A single crystal of porcine pancreatic elastase was mounted in a thin-walled capillary and allowed to react with acetyl-Ala-Pro-Ala-paranitroanalide. Diffraction data to 1.65 A resolution were measured and the isomorphous structure was solved from the difference Fourier map. The structure contains two surprises. Two molecules of the product: acetyl-Ala-Pro-Ala molecule are bound in the extended binding site. Both molecules are bound backwards with respect to the established mode of peptide binding. PMID- 3640832 TI - Productive, persistent infection of human colorectal cell lines with human immunodeficiency virus. AB - Thirteen adherent human non-lymphocyte cell lines were tested for their susceptibility to infection by human immunodeficiency virus. Productive infection could be demonstrated in three of five colorectal carcinoma cell lines examined; the other eight human non-lymphocyte cell lines were uninfectible. A susceptible colon carcinoma cell line (HT29), as well as normal colonic mucosa, was shown to contain a 3.0-kilobase species of poly(A)+ CD4 RNA, whereas uninfectible colon carcinoma and rhabdomyosarcoma cell lines synthesized no detectable T4 RNA. A persistently infected colon carcinoma cell line was established that continued to produce progeny human immunodeficiency virus for more than 10 weeks postinfection. PMID- 3640833 TI - [Transmission of AIDS in Japan via blood component transfusion]. PMID- 3640834 TI - [Deglutition disorders]. PMID- 3640835 TI - [Evaluation of deglutition disorder and care planning by video radiographic examination]. PMID- 3640838 TI - [Deglutition disorders and pain associated with swallowing]. PMID- 3640837 TI - [Diseases in the background of deglutition disorders and deglutition pain]. PMID- 3640836 TI - [Physiology and neural control of the deglutition action]. PMID- 3640839 TI - [Nursing of patients with deglutition disorders: methods and actual practice of deglutition training]. PMID- 3640841 TI - [Assistance of a patient with oral diseases and resultant difficulty in deglutition at independent oral feeding]. PMID- 3640840 TI - [Nursing of patients with deglutition disorders: special consideration to the diet at independent oral feeding]. PMID- 3640843 TI - [Nursing of patients with difficulties in deglutition. Assistance at independent oral feeding by a patient with difficulty in swallowing due to esophageal disease -nursing of an aged patient following surgery of esophageal cancer]. PMID- 3640845 TI - [Deglutition disorders of the aged and their nursing]. PMID- 3640842 TI - [Nursing of patients with difficulties in deglutition. Meal time assistance for patients after surgery of tumors of the tongue and mouth floor]. PMID- 3640846 TI - [Clinical effects of oral cleansing with an amphotericin B syrup in bedridden patients in hospital]. PMID- 3640844 TI - [Nursing of patients with difficulties in deglutition. Nursing of a patient with Parkinson's disease complicated with aspiration pneumonia]. PMID- 3640848 TI - [Nursing of patients with severe pelvic fractures]. PMID- 3640847 TI - [Initial treatment of patients with pelvic fractures]. PMID- 3640849 TI - [Urinary stoma care. On sexual dysfunction]. PMID- 3640850 TI - [Problems of the urinary indwelling catheter for an extended period and its management in refractory neuromuscular diseases]. PMID- 3640851 TI - [Current clinical tests. 9. Autoanalyzers for multiple test items]. PMID- 3640852 TI - [Current information on pharmacology. 9. Therapeutic agents used in neurologic symptoms]. PMID- 3640853 TI - [Nursing technology in home care. 9. Terminal care in home nursing]. PMID- 3640854 TI - [Nursing practice and iatrogenic incidents. 9. accidents at hospitals]. PMID- 3640855 TI - [Asthma]. PMID- 3640856 TI - [Asthma and exercise training]. PMID- 3640857 TI - [Factors and the mechanism in the development of asthma]. PMID- 3640859 TI - [Symptoms and attacks of asthma]. PMID- 3640860 TI - [Progress in the treatment of bronchial asthma]. PMID- 3640858 TI - [Psychosomatic view of asthma]. PMID- 3640861 TI - [Severity of asthmatic attacks and nursing standards]. PMID- 3640862 TI - [Prevention of asthmatic attacks associated with daily activities and improvement of the living environment]. PMID- 3640863 TI - [Nursing responses at asthmatic crises]. PMID- 3640864 TI - [Asthmatic complications and nursing actions for their prevention]. PMID- 3640865 TI - [Rehabilitation of asthmatic patients--types and application of various methods]. PMID- 3640866 TI - [Management of oxygen inhalation therapy of asthma practiced at home--the current status and future problems at our hospital]. PMID- 3640867 TI - [Nursing of a patient with severe and refractory asthma]. PMID- 3640868 TI - [Nursing of patients with psychogenic asthma--keypoints in nursing associated with psychotherapy]. PMID- 3640869 TI - [Nursing of an asthmatic patient exercising a self control: a case study]. PMID- 3640870 TI - [Treatment of patients with multiple injuries]. PMID- 3640871 TI - [Nursing of patients with multiple injuries]. PMID- 3640872 TI - [Assistance to a patient with chronic respiratory disease who is scheduled to be discharged]. PMID- 3640874 TI - [Evaluation of surgical schedules--the use of a weekly surgical schedule]. PMID- 3640873 TI - [Evaluation of the peak flow value and assistance in daily activities of asthmatic patients]. PMID- 3640875 TI - [Progress in cancer therapy. 11. Progress in the treatment of bladder cancer]. PMID- 3640876 TI - [The current clinical diagnosis. 11. Automatic drug sensitivity detecting devices]. PMID- 3640878 TI - [Nursing technics related to home care. 11. Utilization of social resources]. PMID- 3640877 TI - [Drug information. 11. Antineoplastic agents]. PMID- 3640879 TI - [Nursing practice and medical dispute. 11. Keypoints in prevention of basic medical accidents]. PMID- 3640880 TI - [The present and future of medical services]. PMID- 3640881 TI - [On the system of nursing education to comply with social changes--a special course leading to a nursing degree for nursing school graduates]. PMID- 3640882 TI - [Nursing research and theoretical models: analysis of nursing activities and structure of nursing theories]. PMID- 3640883 TI - [Structuralization of nursing theories. 2. Nojima's model and its structural formula]. PMID- 3640884 TI - [Response to structuralization of nursing theories: possibilities of the application of the structures to nursing education]. PMID- 3640885 TI - [Environment for clinical training for the enjoyment of the sense of fulfillment by members of the nursing team. Evaluation of the training records and comments by 24 nursing students]. PMID- 3640887 TI - [Systematization of nursing education. 1. Establishment of a course of nursing education and the status of nursing education in Japan]. PMID- 3640886 TI - [Motor functions of fingers and toes of nursing students and training in nursing technics]. PMID- 3640888 TI - [Changes in feeding routines in the infant ward]. PMID- 3640889 TI - [Naturalness and humanity in childbirth. Current international developments]. PMID- 3640890 TI - [As a matter of fact. Interview by Sirkka Aberg]. PMID- 3640891 TI - [Indications for and complications of cesarean section]. PMID- 3640892 TI - [The influence of perinatal risk factors on subsequent child development]. PMID- 3640893 TI - [The change in drug utilization during pregnancy]. PMID- 3640894 TI - [Revision of mid-level education applauded by Midwifery Association]. PMID- 3640895 TI - [Pregnancy in health care personnel handling cancer medications]. PMID- 3640896 TI - [Breast feeding--how do we really manage it?]. PMID- 3640897 TI - A survey: positions available for registered nurses in Kansas hospitals. PMID- 3640898 TI - Nurse recruiter: interview skills that get the job. PMID- 3640899 TI - Re-entry into practice of the recovering nurse: an issue confronting nursing practice. PMID- 3640900 TI - [Personnel management of health manpower and hospital nursing service]. PMID- 3640901 TI - [Personnel management of health manpower and community health nursing service]. PMID- 3640902 TI - [KNA activities on personnel management of health manpower]. PMID- 3640903 TI - [Role expansion of nurse--cardiovascular nurse specialist]. PMID- 3640904 TI - [Extended role of nurses in adult nursing]. PMID- 3640905 TI - [A study on the job analysis of nurse's position]. PMID- 3640906 TI - [A survey on nursing service administration, education & Q.A. of clinical nursing]. PMID- 3640907 TI - [Analysis of the nutritional health status of school children]. PMID- 3640908 TI - [Personnel management of health manpower]. PMID- 3640909 TI - [No fear of the computer?]. PMID- 3640910 TI - [Data processing is nothing new]. PMID- 3640911 TI - [Electronic data processing in the nursing field. The nursing personnel must cooperate]. PMID- 3640913 TI - [Computer rejection--computer euphoria: how sane is the world of computers?]. PMID- 3640912 TI - [Potential for utilization in the nursing service. Electronic data processing can bring real improvement]. PMID- 3640914 TI - [Are you ready?]. PMID- 3640915 TI - [Geneva: use of a hospital information system. Experience of the nursing staff]. PMID- 3640916 TI - [A psychosociologist's viewpoint--computers and resistance to change]. PMID- 3640917 TI - [Individualized care and the binary system--an art to be promoted, a technic to be exploited]. PMID- 3640918 TI - [Interviews: what they think of it]. PMID- 3640919 TI - [Protection of computer data about real people. The laws and their applications]. PMID- 3640920 TI - [Physiology of digestion]. PMID- 3640921 TI - [Pathophysiology of digestion]. PMID- 3640922 TI - [Anatomy and histology of the digestive tract]. PMID- 3640923 TI - Preventing drug abuse in the United States: integrating the efforts of schools, communities, and science. PMID- 3640924 TI - Drug abuse prevention--the sponsoring foundations' perspective. PMID- 3640925 TI - Community-wide health promotion and drug abuse prevention. AB - This paper reviews the rationale for a community-wide approach to drug abuse prevention. Four arguments are outlined. The question of how to conceptualize community-wide strategies is then addressed. Three background frameworks, psychosocial theory, the appropriate intervention targets, and the timing or readiness of the community, are reviewed. Examples of each from ongoing research are presented. The usefulness of each framework to the design of specific strategies for drug abuse prevention is provided. PMID- 3640926 TI - Objectives of community programs to prevent drug abuse. PMID- 3640927 TI - Dissemination of community health promotion programs: the Fargo-Moorhead Heart Health Program. AB - Dissemination often is the neglected phase of the development and distribution cycle. While attention has focused on developing and testing new health education and health promotion programs, relatively little effort has been placed on studying how the programs can be disseminated. This paper reviews the dissemination process, identifies factors critical to successful dissemination, uses examples from a community-based heart disease prevention study to illustrate how health promotion programs can be disseminated across a community, and suggests ways these methods might be applied to a community-based approach to adolescent drug use prevention. PMID- 3640928 TI - Community organization and school liaisons: how to get programs started. AB - This paper briefly reviews four intervention models, Rothman's community organization, Green's system-centered education, Rogers' innovation-decision process, and Watzlawick's planned change, for their applicability to help initiate community-based programs for drug abuse prevention and health promotion in youth. An expanded model is described, including preprogram assessment of the target population, community, and drug use problem, and continuous evaluation of program process and product. School liaisons are emphasized as a key factor in early adoption and demonstration of a community-based program for youth. The expanded model, including school liaisons, is applied to a comprehensive community drug abuse prevention project being implemented in the Greater Kansas City area. The model--and the project--suggest methods for organizing communities for long-term drug prevention, initially at the level of school and school district, and later to the family, mass media, and community organizations in a proximal-to-distal sequence of programming. PMID- 3640929 TI - Balancing program and research integrity in community drug abuse prevention: project STAR approach. AB - This paper focuses on the process of community-based drug prevention programming using an ongoing, multiple community project (Project STAR) as an illustration. Particular attention is paid to problems and strategies for balancing program and research integrity over the long-term. Specific strategies are discussed for obtaining and sustaining support for the program, quality control throughout program delivery, and accommodation of both research and program objectives. PMID- 3640930 TI - Community-based chemical use problem prevention. PMID- 3640931 TI - Two sides to the prevention equation--demand reduction vs. supply reduction. PMID- 3640932 TI - [A process for nursing students to understand patients with senile dementia and assistance by instructors]. PMID- 3640933 TI - [Application by unqualified personnel to the seminars for clinical training instructors of Fukuoka Prefecture and the reason for the problem--Report on the Seminars for Clinical Instructors at Fukuoka]. PMID- 3640934 TI - [Assistance in activities of daily living in accordance with the nursing process. 6. Assistance at meal time]. PMID- 3640935 TI - [Mental health required in health service personnel]. PMID- 3640937 TI - [Stress factors in the medical service environment and mental health of nurses]. PMID- 3640936 TI - [Stress factors in the medical service environment and mental health of physicians]. PMID- 3640938 TI - [Stress factors in the medical service environment and mental health of social workers]. PMID- 3640939 TI - [Increase in the incidence of suicide among physicians]. PMID- 3640940 TI - [Mental health status of physicians and nurses]. PMID- 3640941 TI - [Mental health of health service personnel: nurses and burnout syndrome. Case discussion]. PMID- 3640942 TI - [The family. 9. The aged and the family]. PMID- 3640943 TI - [A life of a nurse. 9. Creation of an ideal home for the aged using the nursing experience (1).. Interview by F. Otani]. PMID- 3640944 TI - [Role of nursing at the Ambulatory Department of Internal Medicine, Juntendo Urayasu Hospital--with special reference to a regional analysis and a survey on patients]. PMID- 3640945 TI - [Nursing system at medium and small hospitals. Discussion: a need for more flexible nursing systems at medium and small hospitals]. PMID- 3640946 TI - [Difficulties and innovation in establishing a nursing system at medium and small hospitals. Reduction of the rate of nursing turnover--an example at Daido Hospital]. PMID- 3640947 TI - [Nursing system at medium and small hospitals. Adherence to the basic philosophy of the nursing system--an example at Kawaguchi Kogyo General Hospital]. PMID- 3640948 TI - [Nursing system at medium and small hospitals. A nursing system at the dialysis unit--an example at Kosei General Hospital]. PMID- 3640949 TI - [Nursing system at medium and small hospitals. Training of personnel in preparation for the establishment of a system--an example at the Yamaga-machi National Hospital]. PMID- 3640950 TI - [Nursing system at medium and small hospitals. A need for more efforts for active training and studies]. PMID- 3640951 TI - [Nursing problems at medium and small hospitals. Problem of uneven distribution of nurses]. PMID- 3640952 TI - [Nursing problems at medium and small hospitals. Private medical services and nursing--nursing to meet the local needs]. PMID- 3640953 TI - [Current problems concerning nursing education]. PMID- 3640954 TI - [Maturity of nurses observed in the egogram]. PMID- 3640955 TI - [Responses to patients using the results of the Rorschach test]. PMID- 3640957 TI - [A life of a nurse. 8. Observation of changes in American nursing education. (2)]. PMID- 3640956 TI - [The family. 8. Family life after retirement]. PMID- 3640958 TI - [Active involvement in nursing problems--on-the-job study group activities for individual and group development on counseling of patients with chronic dis]. PMID- 3640959 TI - [Training to nurture the attitude necessary in nursing--through analysis of 3 examples from scenes in clinical training]. PMID- 3640960 TI - [Health education based on the nursing process. 5. Nutritional assistance]. PMID- 3640961 TI - [Materials to cover the surgical wounds and safety of showering by patients before the removal of sutures following abdominal surgery]. PMID- 3640962 TI - [Test yourself: nursing of an aged patient with congestive heart failure]. PMID- 3640963 TI - [Psychological support for terminal patients]. PMID- 3640964 TI - [The patients who accidentally learned the nature of their illnesses]. PMID- 3640965 TI - [Sudden outburst of distrust of the hospital personnel by a patient after his discovery of true diagnosis]. PMID- 3640966 TI - [Patients' discovery of the true diagnosis of their illness: exposure of the patients' personality]. PMID- 3640967 TI - [Patients' discovery of the true diagnosis of their illness: psychological suffering by the patients]. PMID- 3640968 TI - [Psychology of cancer patients]. PMID- 3640969 TI - [Posture changes of patients following abdominal surgery]. PMID- 3640970 TI - [Etiological factors and physiological characteristics of infants with low birth weights]. PMID- 3640971 TI - [Diagnostic and therapeutic processes for diseases of infants with low birth weights]. PMID- 3640972 TI - [Keypoints in comprehensive observation of infants with low birth weights]. PMID- 3640973 TI - [Nursing plans for infants with low birth weights]. PMID- 3640974 TI - [Nursing of an extremely premature infant with various diseases associated with prematurity]. PMID- 3640975 TI - [Nursing of infants with low birth weights: innovation in information exchange at patient transfer]. PMID- 3640977 TI - Long term care. Home health care. PMID- 3640976 TI - [Nursing of a patient with a language barrier--communication in nursing]. PMID- 3640978 TI - Voluntary Service Overseas. PMID- 3640979 TI - V.S.O. in Gambia. PMID- 3640980 TI - A programme for more effective ante-natal health education in a small rural clinic in Ghana. PMID- 3640981 TI - Career intentions of newly qualified midwives. PMID- 3640982 TI - The practices of birth attendants and the safety of birth. PMID- 3640983 TI - Similarities and differences between women who breastfeed for short and long duration. PMID- 3640984 TI - The use of role play in midwifery education. PMID- 3640985 TI - Midwifery and childcare in China: report of a study tour. PMID- 3640986 TI - Creating change in midwifery: integrating theory & practice through practice based research groups. PMID- 3640987 TI - Breech presentation: a review of current practice. PMID- 3640988 TI - Drinking in pregnancy and fetal harm: results from a Scottish prospective study. PMID- 3640989 TI - Do breast-feeding mothers know how hungry their babies are? PMID- 3640990 TI - Gestational diabetes--are the right women being screened? PMID- 3640991 TI - Having a baby in Europe. PMID- 3640992 TI - Intranatal care in a rural community in Haryana, North India. PMID- 3640993 TI - Apprenticeship into midwifery: an American example. PMID- 3640994 TI - The humanizing of childbirth: the response of medical institutions to women's demand for change. PMID- 3640995 TI - Maternal characteristics associated with the duration of breast-feeding. PMID- 3640996 TI - Breast feeding of infants diagnosed as having congenital hip joint dislocation and treated in the von Rosen splint. PMID- 3640998 TI - What exactly is the 'team approach'? PMID- 3640997 TI - The role of the community midwife in society. PMID- 3640999 TI - Is it safe to have sex following heart disease? Aspects of counselling. PMID- 3641000 TI - Under the common types of discolouration of teeth. PMID- 3641001 TI - Treating and preventing tooth decay. PMID- 3641002 TI - Management of coeliac disease. PMID- 3641003 TI - Asian children and dental health. PMID- 3641005 TI - Infectious disease control. PMID- 3641004 TI - The Education Act of 1981. PMID- 3641006 TI - When your patients ask about heart attacks in women. PMID- 3641007 TI - The Child Development Programme. PMID- 3641008 TI - Baby drinks. PMID- 3641009 TI - Smoking and health. PMID- 3641011 TI - Dietary treatment of childhood migraine. PMID- 3641010 TI - Exercise and sport in pregnancy. PMID- 3641012 TI - A behavioral approach to temper tantrums in young children. PMID- 3641013 TI - Satellite clinics in maternity care. PMID- 3641014 TI - Midwifery training in Scotland: an opinion survey. PMID- 3641015 TI - What are we training midwives for? PMID- 3641016 TI - MACIT is reversed to TICAM--a useful guide for marking scripts. PMID- 3641018 TI - Project 2000: the way forward for midwives. PMID- 3641017 TI - Untangling the midwifery process with COMB--care of mothers & babies. PMID- 3641019 TI - Project 2000 & midwifery's future: grasping the nettle. PMID- 3641020 TI - Rheumatoid arthritis & pregnancy: helping women to meet their needs. PMID- 3641021 TI - Screening for congenital dislocation of the hip (CDH): professional guidelines. PMID- 3641022 TI - Maternity care in the Netherlands. PMID- 3641023 TI - The origin and evolution of vertebrate pattern and form--a theory of vertebrate development by preformation based on the genetic molecular shape. AB - A new hypothesis is presented to explain the origin of vertebrate form and the guiding mechanism by which embryological development occurs. The hypothesis is based on the observation which is demonstrated, that both vertebrate form and embryological development follow a pattern which correlates with the shapes formed by a spiral as it unfolds. The fact that the DNA molecule which carries the genetic information for embryological development, also has a helical structure, has suggested the hypothesis, that vertebrate form and its development are related to the molecular shape of the genetic material. A theoretical vertebrate genetic molecular structure is proposed and it is demonstrated how this structure by "unfolding", as growth occurs, (the mechanism for which is suggested) provides an accurate prepattern and a template for vertebrate embryological development and vertebrate form. Evolutionary implications follow, which question the Neo-Darwinian synthesis. These are firstly, that the vertebrate pattern is not the result of random genetic variations and natural selection, but owes its origin to a spiral pattern, possibly that of DNA. Secondly, that progressive changes occurring in the shape of the genetic molecule provide an explanation and a mechanism for the evolution of species; a concept which is demonstrated. PMID- 3641024 TI - Cancer is a metabolic deficiency. AB - Cancer is regarded here as a metabolic deficiency originating in stem cell destruction. Tissue stem cells are postulated to secrete a vital substance 'A' necessary for proper tissue function. Carcinogens interfere with 'A' production mainly by destroying stem cells which the organism is incapable of fully replenishing so that less 'A' is produced. This irreversible 'A' deficiency may be compensated by a substitute, or substance 'B', produced by a specialized organ, the neoplasm. Since carcinogens continue depleting more and more stem cells, the deficiency worsens. In order to meet the increasing demand, the neoplasm proliferates more and more until reaching a stage of decompensation when the harm inflicted by it outweighs its benefit. Stem cell depletion is regarded here as the final common pathway for carcinogen action. The theory predicts that following a supply of 'A' producing stem cells or inactivated 'B' producing neoplastic stem cells, the tumor will regress. PMID- 3641025 TI - The packing of spheres in embryogenesis and carcinogenesis. AB - Fertilization of the mammalian ova results in the formation of a compact ball of cells, the morula, which then transforms into a hollow sphere of cells, the blastula. The formation of these structures is considered to be dependent on the number and shape of the cells present and approximates to the problem of maximal sphere packing. Similarly, the shape of organs, to some degree, is considered to be dependent upon the shape of the constituent cells which predetermines their maximal packing densities. Implicit in this concept is that like-cells divide until they reach their maximal packing density and are then inhibited from further replication by three dimensional contact inhibition. In this context, tumour cells may be considered as pleomorphic relative to the tissue in which they arise and form a benign tumour, whereas malignant tumours display pleomorphism within the tumour mass. PMID- 3641026 TI - Double blind: double talk or are there ways to do better research. AB - In an attempt to counteract placebo effects, scientists studying the effectiveness of medication often use the 'double blind' trial. Unfortunately, in less than 5% of the studies reported in major medical and psychiatric journals was there a check to determine whether patients and observers were blind. Between 1972 and 1983 there was increasing reliance on active placebos which attempt to mimic the effects of the medication. It is unlikely however, that patients are not aware of significantly different physiologic changes within them resulting from the different chemicals. Whenever a physician informs a subject that they may be on placebo or active treatment medication, they will spend much time in trying to guess when they are taking which. In these situations Philip's paradox will apply. This states that the more potent a therapeutic variable the less likely its efficacy can be 'proven' in a double-blind study. One can only 'prove' that medication is no more effective than placebo. To have a truly blind procedure, the active placebo must have identical physiological effects to those of the medication being studied. We are now using the patient's and the observer's awareness of changes as useful information to obtain: a guess factor, the percentage of correct guesses whether the patient is on medication or placebo; a direction factor, whether the patient considers the change beneficial or detrimental; an attributional factor, whether the change is considered to result from medication or other intervening variables. This information is usually reliable and can be analyzed with the usual statistical procedures. PMID- 3641027 TI - Damaging venous reflux into the skull or spine: relevance to multiple sclerosis. AB - Unequal propagation of central venous excess pressure into the different cerebral and spinal venous drainage systems is the rule rather than the exception. The intensity of the forces thus to be exerted on vulnerable cerebrospinal structures by the resulting pressure-gradients in the craniovertebral space is unknown. There is a need to consider the various conditions which may cause individual proneness to heavier reflux into particular cerebral as well as epi- and subdural spinal venous compartments. An attempt is made to indicate eventual consequences of excessive retrograde dilatation especially of internal cerebral veins. The importance of elucidating the neuropathological and clinical implications of undue reflux into the skull or spine is deduced from the probability of relations between localized backflow into the craniovertebral space and unexplicated cerebrospinal diseases. In this regard the features of multiple sclerosis are discussed. PMID- 3641028 TI - Hypothetical synaptic ultrastructure. PMID- 3641029 TI - The uniqueness of human learning. AB - It is proposed that humans are capable of a unique type of learning. All other animals are limited to contiguous learning (not more than 60 seconds separating the two events). Only humans are capable of "separated" or scientific learning (learning a connection between two or more events separated by more than 60 seconds). Science itself is a generalized type of non-contiguous learning. It is also proposed that humans' capacity for separated learning is dependent upon the unique ability to hypothesize (to propose a connection or relationship between two or more events separated by time). As a result of separated learning, humans are the only animals capable of "separated foresight" (anticipating which events are likely to occur more than one minute into the future). PMID- 3641030 TI - The function of the gallbladder as a lesser biliary circulation. AB - The function of the gallbladder is questioned in a hypothesis postulating that all bile which enters this reservoir is totally absorbed to the liver and none of it flows back to the cystic duct and duodenum. Cholecystokinesis is believed to increase and maintain a gradient of intravesical pressure which increases the filtration pressure necessary for the absorption of bile to the liver. The absorption is through the tributaries of the cystic veins, the ducts of Luschka and Rokitansky-Aschoff sinuses. Although the hypothesis lacks experimental support, it is based on a number of anatomical, histological, physiological, radiological and surgical observations. PMID- 3641031 TI - Familial peritoneal ovarian carcinomatosis: a new clinical entity? AB - A familial form of ovarian carcinoma is now widely recognized. There are at least several ovarian cancer-prone genotypes, consistent with genetic heterogeneity. Prophylactic oophorectomy has been employed for women who were judged to be at 50% risk for this disease by virtue of their position in the pedigree. However, recent evidence has disclosed that a fraction of such patients who underwent prophylactic oophorectomy and who had ovaries which appeared to be histologically normal at surgical resection, subsequently developed intraabdominal carcinomatosis with histologic findings showing the lesions to be indistinguishable from ovarian carcinoma. Given the embryologic derivatives of the ovary, which comprise gonadal ridges composed of mesodermal cells covered by coelomic epithelium, we postulate that patients with hereditary predisposition to ovarian carcinoma harbor the first germinal hit in both the epithelial cells of the ovary as well as their derivatives in the coelomic mesothelium. These patients may then be inordinately susceptible to carcinogenesis from the second (somatic) hit in these same tissues. PMID- 3641032 TI - DNA hole: a hypothesis for carcinogenesis. AB - Transformation of a normal cell to a cancer cell involves a stable secondary inheritable change in the nucleus. The initial event in carcinogenesis is the splitting of the base pairs in the DNA double helix. A hole in the duplex DNA results, a deformity in the secondary structure of DNA. The cellular event in carcinogenesis is the continuous replication of the duplex DNA hole from one cell to the next. PMID- 3641034 TI - Circulations, including the hemic with and without cardiac peristalsis. AB - Vigorous human life precedes facilitates and ultimately requires the development and addition of the heart to the red circulation. Asymptomatic athletic activity sometimes continues although the heart is gravely diseased. The relative importance of the various vascular motors, including the cardiac components, requires individual evaluation because circulatory function and/or arrest does not always match the cardiac condition. PMID- 3641035 TI - Can some cases of pre-eclampsia be corrected surgically? PMID- 3641033 TI - The role of oxygen deficiency and cytosolic reactions in cell growth. AB - It has been suggested that a decrease in the availability of oxygen to certain tissues may lead to increased metabolism of glucose through the hexose monophosphate shunt pathway and to increased synthesis of polyols, in particular myoinositol. It is further suggested that these "cytosolic reactions" result in stimulation of the phosphatidylinositol cycle by increasing substrate availability (i.e. phosphatidate, diglyceride and inositol). A relative decrease in local oxygen availability may therefore play a role in cell proliferation and differentiation and in the etiology of cancer, diabetic sequelae and obesity. PMID- 3641036 TI - Is maternal serum heat stable alkaline phosphatase an index of fetal maturity? AB - A cross sectional estimation of serum heat stable alkaline phosphatase (HSAP) levels in 145 women with uncomplicated pregnancies between 24-41 weeks gestation showed increasing levels with advancing gestation and a steep rise at about 34 weeks gestation from a mean level of 17.3 +/- 6.5 micrograms/ml to a mean level of 36.1 +/- 1.5 micrograms/ml (t = 7.4 p less than .001) at about 37 weeks gestation. Ninety-three point seven percent (93.7%) and 24.4% of women between 31 35 weeks gestation and 27-34 weeks gestation respectively had levels equal to or exceeding 20 micrograms/ml. It is postulated that serum HSAP represent stages of fetal maturity rather than gestational age per se and that there is a possible relationship between serum HSAP and amniotic fluid lecithin viewed against a background of a similar rise of amniotic fluid lecithin levels at about 33 weeks gestation and the common role of steroid receptor sites in the formation of both HSAP and Lecithin. PMID- 3641037 TI - [Effect of an acid protected, micro-encapsulated pancreatin preparation on pancreatogenic steatorrhea]. PMID- 3641039 TI - Aspects of research methodology. PMID- 3641038 TI - [Perinatal hypoxia in the newborn infant]. PMID- 3641040 TI - Testing times? PMID- 3641041 TI - Clinical evaluation of student nurses: syllabus needs for nursing instructors. PMID- 3641042 TI - Psychiatric nurse education: a question of balance? PMID- 3641043 TI - Integrated self-awareness training: a holistic model. PMID- 3641044 TI - Sight and sound--any use for video found? Part 2. A potential still untapped. PMID- 3641045 TI - Images of nursing in Missouri: a test of Kalisch's and Kalisch's typology. PMID- 3641046 TI - The cocaine epidemic: proof of the poison. PMID- 3641047 TI - No free lunches. PMID- 3641048 TI - Liability insurance coverage: a must for nurses. PMID- 3641049 TI - Modulation of transcriptional activity and stable complex formation by 5' flanking regions of mouse tRNAHis genes. AB - We determined the nucleotide sequences of three mouse tRNAHis genes and a tRNAGly gene present in two different lambda clones. One lambda clone contained two tRNAHis genes 600 base pairs (bp) apart in opposite orientations. The other clone contained a tRNAHis and a tRNAGly gene 569 bp apart in the same orientation. The coding regions of the three tRNAHis genes were identical to sequenced mammalian tRNAHis if posttranscriptional modifications are not considered. Notably, the three tRNAHis genes and a fourth gene previously sequenced by us contained within the flanking regions, various amounts of short, conserved 5' leader sequences and 3' trailer sequences directly abutting the coding regions. Otherwise the flanking regions were not homologous. Deletion mutants of one of the tRNAHis genes were constructed which contained 228, 99, 9, and 3 bp of the wild-type 5'-flanking region, respectively. Deletion of 5'-flanking sequences from positions -9 to -4 reduced transcriptional activity substantially (ca. fivefold) in a HeLa cell S 100 lysate. This effect was independent of the vector sequences in the deletion clone, implying that the region from -4 to -9 of the intact gene contains a positive modulatory element for transcription in vitro. The deletion mutant containing 3 bp of wild-type 5'-flanking sequence also had a greatly reduced ability to inhibit the transcription of a second tRNA gene in a competition assay. Thus, the normal 5'-flanking region influences the ability of the gene to form stable complexes with transcription factors. These data further indicate that a mammalian transcription extract is sensitive to 5'-flanking-region effects if a suitable tRNA gene is assayed. PMID- 3641050 TI - Ventricular assist devices. PMID- 3641051 TI - Consignment stock control. PMID- 3641052 TI - What did he say nurse? PMID- 3641053 TI - Quality assurance tool for the operating department. PMID- 3641054 TI - Post-basic course: where do we go from here? PMID- 3641055 TI - Medical emergencies at sea. PMID- 3641056 TI - Acute prolapsed intervertebral disc. A case for individualised nursing care in the operating theatre. PMID- 3641057 TI - How sterile is sterile? PMID- 3641058 TI - Champagne or coffee? NATN Theatre Mastermind visit to the Netherlands. PMID- 3641059 TI - Not painful, but a nuisance: excision of an epididymal cyst. Patient care in theatre. PMID- 3641060 TI - The essential light chains constitute part of the active site of smooth muscle myosin. AB - Myosin, a major contractile protein, characteristically possesses a long coiled coil alpha-helical tail and two heads. Each head contains both an actin binding site and an ATPase site and is formed from the NH2-terminal half of one of the two heavy chains (relative molecular mass, Mr, 200,000) and a pair of light chains; the so-called regulatory and essential light chains of approximately Mr 20,000 each. Recently we have identified Trp 130 of the myosin heavy chain from rabbit skeletal muscle as an active-site amino-acid residue after labelling with a new photoaffinity analogue of ADP, N-(4-azido-2-nitrophenyl)-2-aminoethyl diphosphate (NANDP). Nonspecific labelling was eliminated by first trapping NANDP at the active site with thiol crosslinking agents. Exclusive labelling of the heavy chains with no labelling of the light chains agreed with previous findings that the heavy chains alone contain the actin-activated Mg-ATPase activity of rabbit skeletal myosin. Here we report similar photolabelling experiments with smooth muscle myosin (chicken gizzard) in which 3H-NANDP is trapped at the active site with vanadate and which show that both the heavy chains and the essential light chains are labelled. The results indicate that both chains contribute to the ATP binding site and represent the first direct evidence for participation of the essential light chains in the active site of any type of myosin. PMID- 3641061 TI - What can AIDS virus codon usage tell us? PMID- 3641063 TI - 10 years on the Hill with Sheila Burke. Interview by Karen Mitchell. PMID- 3641062 TI - Effect of mutations at the lariat branch acceptor site on beta-globin pre-mRNA splicing in vitro. AB - Introns are excised from full-length transcripts (pre-messenger RNAs) of eukaryotic genes in two steps. First, the pre-mRNA is cleaved at the 5' splice site and a branched (lariat) intermediate is formed. Then, cleavage at the 3' splice site and ligation of the two exons leads to the release of the lariat intron. The intron sequence which accepts the 5' end to form the lariat branch is strictly conserved in yeast, but shows more variation in eukaryotes. To investigate the requirements for branch formation in eukaryotes further, we have studied in vitro splicing of a rabbit globin gene intron with mutations of the normal branch-accepting adenosine nucleotide. We conclude that all four nucleotides can serve as branch acceptors, but that A and C are preferred to G and U in lariat formation. Mutation of the normal A to G or U can lead to an A residue one nucleotide upstream of the normal branch site being used instead. Only branches to A or C participate efficiently in the second splicing step. PMID- 3641064 TI - Assuring quality through a professional practice approach. PMID- 3641065 TI - Implementation of direct third party reimbursement legislation for nursing services. PMID- 3641066 TI - Issues in nursing resource management: past and present. PMID- 3641067 TI - Survey regarding factors influencing nursing hours. PMID- 3641068 TI - Consumer rights in health care. PMID- 3641069 TI - Health policy forecast for '87. PMID- 3641070 TI - Success stories. A useful approach to emergency department charges. PMID- 3641071 TI - Implementing nursing diagnosis in clinical settings: strategies to ensure a professional practice change. PMID- 3641072 TI - Nurse anesthesia: a clinical specialty. PMID- 3641074 TI - Organizational resume. PMID- 3641073 TI - Back to school & a commuter marriage. PMID- 3641075 TI - Role transition. PMID- 3641076 TI - High tech/high touch. PMID- 3641077 TI - Unifying nursing. PMID- 3641078 TI - The Pygmalion effect: nursing managers have the ability to stimulate performance. PMID- 3641080 TI - Myth or reality: autonomy of RNs. PMID- 3641079 TI - Recognize the bulimic (what educators need to know about the binge-purge syndrome). PMID- 3641081 TI - The longest journey--a recovering professional tells her story. PMID- 3641082 TI - Nurses are best placed to take leadership role in primary care. PMID- 3641083 TI - Royal College of Nursing. Lead the way. PMID- 3641084 TI - Coping with the stress of change. PMID- 3641086 TI - Royal College of Nursing. Vital resource. PMID- 3641085 TI - Mental handicap nurses must band together and fight. PMID- 3641087 TI - Nursing staff must do more for patients dying in hospital. PMID- 3641089 TI - UGMs shouldn't investigate complaints by patients. PMID- 3641088 TI - The profession will continue to have an authoritative voice. PMID- 3641090 TI - Royal College of Nursing. Grand design. PMID- 3641091 TI - Framework for quality. PMID- 3641092 TI - Royal College of Nursing. Face reality. PMID- 3641093 TI - Abhorrent, unethical and impractical for nurses to refuse to care for AIDS patients. PMID- 3641094 TI - Spotlight on A and E nursing. PMID- 3641095 TI - Nursing facing change. PMID- 3641096 TI - Royal College of Nursing. Welcome start. PMID- 3641098 TI - Morale is political. PMID- 3641097 TI - Dangers nurses face. PMID- 3641100 TI - In right direction. PMID- 3641099 TI - Royal College of Nursing. Key members. PMID- 3641102 TI - Royal College of Nursing. Unique cause. PMID- 3641101 TI - Striking the balance. PMID- 3641103 TI - Management skills. PMID- 3641104 TI - Raising nurses awareness levels on AIDS. PMID- 3641105 TI - Lesson to learn. PMID- 3641106 TI - No one acceptable way to determine apt mix of staff. PMID- 3641107 TI - Lessons learned setting up day centre. PMID- 3641108 TI - Exercising nurses' right to fight for clinical privileges. PMID- 3641109 TI - Nursing and professionalization: on the road to recovery. PMID- 3641110 TI - A nurse-managed clinical practice unit. Part II. The problems. PMID- 3641111 TI - Education and service: a collaborative model to improve patient care. PMID- 3641113 TI - Administrative research. PMID- 3641112 TI - Educating nurse administrators: one program's answer. PMID- 3641114 TI - Concept development in nursing research. PMID- 3641115 TI - Nursing supervision: a new look at an old role. PMID- 3641116 TI - On the scene: research as a component of graduate study in nursing administration at the University of Washington School of Nursing. PMID- 3641117 TI - Research: a vital part of administrative practice. PMID- 3641118 TI - Subordinate choice of conflict-handling modes. PMID- 3641119 TI - Staff nurses' perceptions of head nurses' leadership styles. PMID- 3641120 TI - Nursing research in the practice setting. PMID- 3641121 TI - RNs' job involvement and need for achievement in primary and team nursing settings. PMID- 3641122 TI - Role ambiguity among hospital head nurses. PMID- 3641123 TI - Job satisfaction of nursing leaders with mentor relationships. PMID- 3641124 TI - The nurse executive role: research relevant to managing. PMID- 3641125 TI - Role ambiguity and job satisfaction of clinical nurse specialists in a cost conscious environment. PMID- 3641126 TI - New organization theories for future nursing administration research. PMID- 3641127 TI - Research in nursing administration. PMID- 3641128 TI - Use of nurses from supplemental services: implications for hospitals. PMID- 3641130 TI - A very special bequest. PMID- 3641129 TI - Public health implications of HIV infection. AB - Acquired immunodeficiency syndrome is the most extreme of a range of immune abnormalities that have been linked to infection with a recently described retrovirus. From a public health viewpoint, the most important advance to date has been the development of serum tests that detect exposure to this virus. Serologic screening has greatly reduced the risk of infection for transfusion recipients and facilitated surveillance studies and research. False negative tests clearly occur, and prognostic implications of positive antibody tests are not yet well-described. Primary care providers have a major role to play in public education for prevention of this new and frightening epidemic. PMID- 3641131 TI - Pulmonary edema. Action stat! PMID- 3641132 TI - The ins and outs of chest drainage systems (continuing education credit). PMID- 3641133 TI - Your colleague is incompetent? Speak up. PMID- 3641134 TI - 10 steps for preventing medication errors. PMID- 3641135 TI - How to clear catheter clots with urokinase. PMID- 3641136 TI - Administering i.v. antibiotics to children. PMID- 3641137 TI - Working in a long-term care facility. PMID- 3641139 TI - Nursing can do without... too much controversy, too much change. PMID- 3641138 TI - Your ventilator patient can go home again. PMID- 3641140 TI - Problems with your supervisor? Here's a way to work together. PMID- 3641141 TI - [Protection of persons who had occupational accidents]. PMID- 3641142 TI - [Stress]. PMID- 3641143 TI - [Subcutaneous vascular access]. PMID- 3641144 TI - [Mental disease and its taboos]. PMID- 3641145 TI - [Complete medical records on a computer card: dream or reality?]. PMID- 3641146 TI - [Depression: a feminine disease]. PMID- 3641147 TI - [Evaluation of staff nurses: towards greater responsibility]. PMID- 3641148 TI - [Is your professional secret safe?]. PMID- 3641149 TI - [Returning the power to the clients]. PMID- 3641150 TI - Legal aspects of AIDS--Part II. PMID- 3641151 TI - Same day surgery: coordinating the admission process. PMID- 3641152 TI - Outpatient nursing: getting ready for a growing field. PMID- 3641153 TI - Intensive caring: orienting ICU families through AV media. PMID- 3641154 TI - Pre-admission testing and teaching: more satisfaction at less cost. PMID- 3641155 TI - Can we educate outpatients effectively? Certainly. A busy VA clinic proves it. PMID- 3641156 TI - Continuity of care: from hospital unit into home. PMID- 3641157 TI - The effects of shift rotation on the quality of nursing care and the well-being of nurses. PMID- 3641158 TI - Acute psychiatric units need staffing standards, too. PMID- 3641159 TI - Distinguishing voluntary from involuntary nurse turnover. PMID- 3641160 TI - Is there life after nursing care plans? PMID- 3641161 TI - Anecdotal records improve evaluations. PMID- 3641163 TI - PCS and QA set the standard. PMID- 3641162 TI - Care plans: competence and forms "find the time". PMID- 3641164 TI - A nurse for the nurses: designing support for your hospital. PMID- 3641165 TI - Throwaway people? PMID- 3641166 TI - OH as a component of primary health care. PMID- 3641167 TI - Poland's labour laws take a step back in time. PMID- 3641168 TI - Self-induced skin disorders. PMID- 3641169 TI - The story of a clean sheet. PMID- 3641170 TI - [Health as a condition of patient-oriented nursing]. PMID- 3641171 TI - [A healthy life, gain for all]. PMID- 3641172 TI - [Recommendations for the prevention of urinary tract infections caused by catheters]. PMID- 3641173 TI - [Where does nursing lead us?]. PMID- 3641174 TI - Credit card offers--are they all the same? PMID- 3641175 TI - Empowerment of nurses. PMID- 3641176 TI - Smoking behavior of nurses is health issue. PMID- 3641177 TI - The Great American Smokeout. Smoking & nurses--and other health professionals. PMID- 3641178 TI - David Elkind discusses parental pressures. PMID- 3641179 TI - Changing concepts of childhood in society. PMID- 3641181 TI - Children with ostomies: comprehensive care planning. PMID- 3641180 TI - Factors influencing weight change in preterm infants. PMID- 3641182 TI - Assessing parent's knowledge of pediatric dental disease. PMID- 3641183 TI - Establishing a community-based sick child center. PMID- 3641185 TI - Insurance reimbursement of pediatric home care. PMID- 3641184 TI - New guidelines for pediatric & neonatal cardiopulmonary resuscitation & advanced life support. Part II: Pediatric advanced life support. PMID- 3641186 TI - Drug use in sports. PMID- 3641187 TI - Pediatric management problems. PMID- 3641188 TI - Innovations in nursing service. PMID- 3641190 TI - A mutant tRNA-Met gene in the mitochondrial genome of Schizosaccharomyces pombe. PMID- 3641189 TI - Sequence organisation and transcriptional regulation of the mouse elastase II and trypsin genes. AB - Elastase II and trypsin mRNAs were cloned in form of their cDNAs from pancreas of strain A/J mice, and their complete nucleotide sequences were determined. The elastase II mRNA is 912 nucleotides long and encodes a protein of 271 amino acids. The cloned trypsin mRNA species is 814 nucleotides long and encodes a protein of 246 amino acids. The elastase II gene, which exists as a single copy in the haploid mouse genome, measures 11.2 kb from cap to poly(A) site and is interrupted by at least seven introns. Between 5 and 10 trypsin genes exist in the mouse genome. Five different trypsin genes, two of which are closely linked in a tail-to-tail manner, were studied in detail. They vary in size between 3.4 and 4.0kb, and all are interrupted by four introns. DNA sequence comparison of the elastase II, trypsin and Amy-2a alpha-amylase genes reveals a conserved 13 nucleotide motif in their 5'-flanking regions. The differential accumulation of the elastase II and trypsin mRNAs in the cytoplasm of the acinar pancreatic cell is regulated predominantly at the transcriptional level. PMID- 3641191 TI - The 3' non-coding region of the mouse brain B creatine kinase mRNA: a sequence with exceptional homology among species. PMID- 3641192 TI - A gene for the major cytoplasmic tRNATyr from Nicotiana rustica contains a 13 nucleotides long intron. PMID- 3641193 TI - Team research etiquette: making the rules explicit. PMID- 3641194 TI - Client perceptions of nursing practice. PMID- 3641195 TI - Identification of health risk factors among undergraduate university students. Stage 3: Development of a holistic health assessment tool. PMID- 3641196 TI - [Attitudes and behavior of Quebec nurses with regard to holistic health]. PMID- 3641197 TI - Influences of age and gender on self-perceived components of health, health concerns, and health ratings. PMID- 3641198 TI - The incorporation of cultural concepts into basic nursing texts. PMID- 3641200 TI - Family centered community health nursing and the Betty Neuman systems model. PMID- 3641199 TI - Academic advising in a university school of nursing: problems and solutions. PMID- 3641201 TI - Life preservers. PMID- 3641202 TI - Breast cancer: a woman's right to choose. PMID- 3641203 TI - Consultancy: stepping out. Interview by Patricia Slack. PMID- 3641204 TI - Who will meet the challenge? PMID- 3641205 TI - Accident and emergency. The waiting game. PMID- 3641206 TI - Accident and emergency. Behind the times. PMID- 3641207 TI - Room for improvement. PMID- 3641208 TI - Learning your tables. PMID- 3641209 TI - Working out the problem. PMID- 3641210 TI - Planning patient care. Rehabilitation after a myocardial infarction. PMID- 3641211 TI - Whose turn to break the silence? PMID- 3641213 TI - Political poll. Professional issues. PMID- 3641212 TI - Systems of life. No 142. Senior systems. 7. PMID- 3641214 TI - Political poll. Thoughts on the Project. PMID- 3641215 TI - Education. Welcoming developments. PMID- 3641216 TI - Health visiting. Supplement. PMID- 3641217 TI - Health visiting. Looking the gift horse in the mouth. PMID- 3641218 TI - Health visiting. A new face in the chair. Interview by Ruth Devlin. PMID- 3641219 TI - Health visiting. Let them eat cake. PMID- 3641220 TI - Health visiting. Time to value the golden age. PMID- 3641222 TI - Corridors of learning. PMID- 3641221 TI - The state of the art? PMID- 3641223 TI - Reshuffle: management takeover. PMID- 3641224 TI - Paddy Henry: one man's battle. Interview by Harriet Gaze. PMID- 3641225 TI - The hinge that squeaks loudest. PMID- 3641226 TI - Care of the dying. The last refuge. PMID- 3641227 TI - Care of the dying. A family concern. PMID- 3641228 TI - Care of the dying. Patients' coping strategies. PMID- 3641230 TI - Assenting to change. PMID- 3641229 TI - Eastern eyes. PMID- 3641231 TI - Nursing a library back to health. PMID- 3641232 TI - Political poll: feelings of frustration. PMID- 3641234 TI - Spotlight on Children. PMID- 3641233 TI - Project 2000. Winding up the roadshow. PMID- 3641235 TI - Spotlight on Children. Is no news good news? PMID- 3641236 TI - Spotlight on Children. Scaling down a model. PMID- 3641237 TI - Back to the drawing board. PMID- 3641238 TI - Family care: ask the family. PMID- 3641239 TI - Psychiatric nursing: role models. PMID- 3641240 TI - Lighting the Blue touch-paper. PMID- 3641241 TI - In vitro fertilisation. A way of hope. PMID- 3641242 TI - In vitro fertilisation. The birth of Michael. PMID- 3641243 TI - In vitro fertilisation. Whatever happened to Warnock? PMID- 3641244 TI - Diabetic heart disease. PMID- 3641245 TI - Dirty linen. PMID- 3641246 TI - Model developments. PMID- 3641247 TI - Care of the dying: easing emotional distress. PMID- 3641248 TI - The great divide. PMID- 3641249 TI - Quest. NT's educational supplement. PMID- 3641250 TI - Quest. Coping with copyright. PMID- 3641251 TI - Quest. Data protection. PMID- 3641252 TI - Issues in the prevention of neurotrauma. AB - Over one half of all neurotrauma occurs in or by motor vehicles. The other causes of neurotrauma are falls, violent assaults, sports and recreation, and firearms. The victims who survive are left with paralysis, disfigurement, loss of sight and hearing, seizures, epilepsy, psychiatric disorders, amnesia--in short, significant and often permanent impairment. To permanently prevent this annual human destruction, the prevention agenda should include advocating for air bags in all cars, helmet use for all motorcyclists, the elimination of handguns, and the regionalization of all trauma care. After this is accomplished, we can continue working on preventing other neurotrauma problems. PMID- 3641253 TI - Neurotrauma. PMID- 3641254 TI - Acute management of the head-injured adult. AB - Acute nursing management of the head-injured adult is both complex and challenging. Knowledge of the underlying pathophysiology and understanding the goals of medical and nursing management allow the nurse to organize and evaluate appropriate nursing interventions. PMID- 3641255 TI - Rehabilitation of the adult with head trauma. AB - The changes incurred as a result of brain injury are often devastating. The approaches outlined in this article merely scratch the surface because the list of possible deficits is inexhaustible. The behavioral and cognitive capacity during the various phases of recovery dictate the intervention method that will be appropriate and successful, with concepts and tasks progressing from the simple to the more complex. When confusion, agitation, and inappropriate behavior are evident, safety is a prime concern. Some individuals do not progress beyond this stage. Placement and appropriate future planning are major issues in this situation. When behavior becomes more appropriate, inpatient rehabilitation efforts will be most beneficial and successful, with the focus on helping the individual regain functional skills. Improvement may be rather dramatic during this time, especially when compared with previous stages. Recovery beyond this point, with intact memory, goal-directed behavior, adequate socialization skills, and vocational rehabilitation, occurs over an extended period of time, perhaps years. With discharge, new concerns for the individual and family emerge as the reality of the situation becomes clearer. Health care providers in the community setting must recognize the effects of injury on the individual and the resulting psychosocial stresses and strains on the individual and family. Adequate neuromedical and neuropsychological follow-up are essential during the outpatient recovery phase to monitor progress and provide input for future plans. PMID- 3641256 TI - Acute phase management of persons with spinal cord injury: a nursing diagnosis perspective. AB - The focus of this article is to provide the reader with a greater understanding of acute spinal cord injury from the nursing diagnosis perspective. Nurses have a significant role to play in the acute care phase, which will have an even greater and long-lasting impact on the quality of life for persons with spinal cord injury. PMID- 3641257 TI - Maxillofacial trauma. AB - Maxillofacial trauma runs the full gamut from minor discomfort to life threatening injuries. Principles of airway management, adequate breathing, and circulation are paramount in the initial management. Health care professionals must anticipate problems based on a knowledge of anatomy and the pathophysiology of facial trauma and initiate treatment measures that decrease morbidity and mortality. Creative nursing approaches, based on a knowledge of physiologic needs and pathophysiologic consequences of facial trauma, are the keys in the convalescent phase as the patients struggle with alterated anatomy, sensory losses, and fear. PMID- 3641258 TI - Psychological impact of neurotrauma in the acute care setting. AB - Meeting the psychological needs of neurotrauma patients in the acute care setting is a challenging experience. Nurses must be aware of and cope with their own emotional responses to devastating losses experienced by the spinal cord injured and head trauma patients. Specific interventions for neurology patients can be designed to minimize the psychological trauma imposed by intensive care units. Assisting the patient through the initial crisis period and establishing short term, realistic goals is crucial. The acute care setting and the successful management of psychological needs are the foundation the neurotrauma patient builds on as he begins the long, arduous journey through the rehabilitation process. PMID- 3641260 TI - Emergency nursing. PMID- 3641261 TI - Indices of injury. Development and status. AB - Each of the indices of injury provides a systematic method by which to collect and report data about the trauma victim. Since the 1960s, researchers and physicians have tried to develop predictive tools which are capable of evaluating the current status of the victim as well as determining morbidity and mortality. This article traces the development of indices of injury and provides their current status. PMID- 3641259 TI - Family-centered care for the neurotrauma patient. AB - Nursing management of the family of the neurotrauma patient is a challenging experience. Whether the family is first encountered during their initial days of crisis or following discharge to the home, they require individualized, thoughtful nursing care. Indeed, according to Bond, the pattern of stresses the family encounters changes with time, with one of the most significant points being in the first days after discharge from the hospital when they realize and accept the full extent of the victim's deficits. It is to this end that nursing intervention throughout hospitalization is geared, and it is during this time that we cannot forget that nursing management may still be required. In the case of neurotrauma, the patient and family are not "cured" when they leave the hospital, for many their problems are just beginning. Let us develop mechanisms through which continued professional support can be made available to the families of neurologically impaired patients both during and following hospitalization. PMID- 3641262 TI - Role of the trauma nurse coordinator. AB - Trauma center designation paved the way for an exciting, expanded nursing role, the Trauma Nurse Coordinator. This position has evolved to include, not only the in-hospital role, but also a role in government. This article focuses on the role of the trauma nurse coordinator in the health care system. PMID- 3641263 TI - Nursing assessment of blunt cardiac trauma. AB - Cardiac injuries due to blunt trauma are common and contribute to the overall mortality of the trauma victim. Such injuries may be difficult to detect, and the clinician must maintain a high degree of suspicion for their presence. Clinical findings are nonspecific, but the nurse should focus on assessing the adequacy of cardiac output and tissue perfusion. Initial management of the patient with blunt cardiac trauma is the same as for any trauma patient: stabilization of airway, breathing, and circulation. Intravascular volume replacement is an important aspect of the resuscitation. Injuries such as aortic transection or ventricular rupture lead to exsanguination and the need for rapid infusion of large volumes of blood. On the other hand, cardiac function may be severely depressed with myocardial contusion and septal or valvular rupture; volume replacement must proceed cautiously. PMID- 3641264 TI - Thoracic trauma. Nursing assessment and management. AB - The importance of the respiratory system to total body functioning cannot be overemphasized. It is imperative that the nurse realize that the first priority in trauma care is to maintain and support the respiratory system. The nurse must be able to rapidly and effectively perform a primary survey, recognize the clinical manifestations of life-threatening thoracic injuries, and intervene in the care of the patient to help stabilize and maintain the patient's respiratory function. The nurse must not only be able to asses, but must also be able to technically intervene rapidly and effectively. Other potential life-threatening injuries must remain uppermost in the nurse's mind. Continual, ongoing monitoring of the patient's status must be an integral part of the nurse's actions. If these activities are judiciously employed, perhaps the mortality rate will decrease and the thoracic trauma victim will survive, capable of leading a full and productive life in our society. This is quality patient care. PMID- 3641265 TI - Resuscitation of patients with central nervous system trauma. AB - The care patients with spinal cord or head injury receive in the acute phase of their injury is critical to outcome. The basics of trauma care are of primary importance to the patient with central nervous system trauma. In the SCI patient, extreme care must be used in establishing an airway. The focus in the head injured patient is to provide adequate oxygenation and ventilation sufficient to cause hypocarbia. Proper immobilization of the neck is a priority concomitant to establishing an airway in the SCI patient, while control of ICP is a challenge in the head-injured patient. Paramedics, nurses, and physicians who are aware of these important factors in caring for the neurotrauma patient will ensure the patient every chance of functional recovery. PMID- 3641266 TI - Trauma in pregnancy. AB - The pregnant woman is exposed to the same risks as the non-pregnant woman for sustaining a traumatic injury, but because of the multiple physiologic changes that occur during pregnancy, the assessment and treatment of such patients must be adapted accordingly. This article discusses these normal physiologic changes, their effect on response to trauma, and the comprehensive care of the patient using the nursing process. PMID- 3641267 TI - Early assessment and management of musculoskeletal injuries. AB - Permanent disability following musculoskeletal injury can often be prevented with prompt recognition and appropriate temporary or definitive management. This article has highlighted some specific injuries and guidelines for emergency treatment. PMID- 3641268 TI - Emotional impact of trauma. AB - The psychosocial care of trauma patients is a serious responsibility and a gratifying aspect of trauma nursing. Intervention with patients facing the threat of their own death is a challenging one. Many studies and theories guide us in meeting the challenge and suggest that there is more to the emotional impact of trauma than most realize, and that interventions should be more than just automatic responses based on popular wisdom. PMID- 3641269 TI - Transport of the critically ill trauma patient. AB - Nurses play an important role in the transport of critically ill trauma patients. The special problems one encounters in ground and/or air transfers must be anticipated. The patient should be prepared both physically and emotionally for this process, and all nurses involved in the transport should work together to insure positive patient outcome. PMID- 3641270 TI - The nurse and her role as a family planning practitioner. PMID- 3641271 TI - Training health professionals about breastfeeding. PMID- 3641272 TI - Child's nutritional needs: nature's wonderful formula. PMID- 3641274 TI - Techniques and technology. PMID- 3641273 TI - [Use of andekalin in treating diabetic microangiopathies]. AB - A combined study of the state of the blood kinin, coagulation and fibrinolytic systems and microcirculation in the peripheral microvessels of 19 patients with diabetic microangiopathies has shown a diverse nature of disorders of kininogenesis (the enhancement or weakening of the process) and corresponding to it hypo- and hypertonic stages of changes of microcirculation in the microvessels of the eyeball and I toe nail matrix. Activation of blood coagulation, Phase I, revealed both in weakened and enhanced kininogenesis, was more noticeable in the phase of hypokininemia. The administration of andekalin at a single dose of 0.6 units per 1 kg of body mass against a background of sugar reducing therapy in both types of disorders of the activity of the kinin system was accompanied by an insignificant increase in the activity of plasma callicrein but resulted in a marked increase in the initially lowered kinin destroying blood enzymes. The improvement of some indices of microcirculation was noted but in patients with microangiopathies against a background of the weakening of kininogenesis. The administration of andekalin with an enhanced process resulted in some cases in the deterioration of the condition and development of perivascular edema. Insufficient therapeutic efficacy of commonly used doses of andekalin was determined by the presence of andekalin agents in commercial samples and admixtures of a considerable amount of kininases of tissue origin. Proceeding from the earlier experiments and ongoing clinical trials it was proposed that andekalin should be administered to patients with suppressed activity of the blood kinin system only at doses which would not practically contain kininases and would correspond to 0.004-0.005 units per 1 kg of body mass a day. PMID- 3641275 TI - A nurse equipment specialist: innovative addition to the perioperative team. PMID- 3641276 TI - Managing charges for operating room supplies. PMID- 3641277 TI - Total ear reconstruction: procedure and implications (continuing education credit). PMID- 3641278 TI - Tips and techniques for balancing work, home, and personal responsibilities. PMID- 3641280 TI - Discharge instructions for ambulatory surgery patients. PMID- 3641279 TI - A patient relations program: bridge between high technology and sensitive patient care. PMID- 3641281 TI - Abortion by hysterotomy--an ethical dilemma. PMID- 3641282 TI - Professional survival tips: essential steps in effective negotiations. PMID- 3641283 TI - Research: the levels of research framework (continuing education credit). PMID- 3641284 TI - Cochlear implants: the second generation (continuing education credit). PMID- 3641285 TI - Hospital induced malnutrition: prevention and treatment. PMID- 3641286 TI - Treatment of leg ulcers. PMID- 3641288 TI - Successful breastfeeding. PMID- 3641287 TI - Living with incontinence. PMID- 3641289 TI - Encouraging compliance. PMID- 3641290 TI - Central clearance for nursing applicants. PMID- 3641291 TI - Ensuring dignity and self esteem for patients and clients. PMID- 3641292 TI - Nursing the unconscious patient. PMID- 3641293 TI - Writing accident reports. PMID- 3641294 TI - Prevention of venous ulcers. PMID- 3641295 TI - How to care for your legs. PMID- 3641296 TI - Communicating with elderly people. PMID- 3641298 TI - Implications for management. PMID- 3641297 TI - Project 2000: a nurse educator's view. PMID- 3641299 TI - Blood glucose monitoring: a tool in diabetic control. PMID- 3641300 TI - [Arthritis in the course of gout]. PMID- 3641301 TI - [The toughest health problems of Polish society]. PMID- 3641302 TI - [Diagnosis in nursing care]. PMID- 3641303 TI - [Documentation of the nursing process]. PMID- 3641304 TI - [Care of the child and its family]. PMID- 3641305 TI - [Aspects of geriatric nursing in Belgium]. PMID- 3641306 TI - [The tasks of the medical education system]. PMID- 3641307 TI - [The sexual reaction of women--the orgasm]. PMID- 3641308 TI - [The development of classification in nursing]. PMID- 3641309 TI - [Evaluation of nursing care]. PMID- 3641310 TI - [Informing the patients]. PMID- 3641311 TI - [I love the work. Interview by Krystyna Serafin]. PMID- 3641312 TI - [There where the Polish pole of cold weather is. Interview by Krystyna Serafin]. PMID- 3641313 TI - [The example of the hospital in Eskilstuna]. PMID- 3641314 TI - [Nursing in Belgium]. PMID- 3641316 TI - [The Polish Society of Nursing in Szczytno]. PMID- 3641315 TI - [The education system]. PMID- 3641317 TI - [Private practice]. PMID- 3641318 TI - [Intrahepatic cholestasis in pregnant women. I]. PMID- 3641320 TI - [Potential of nursing and midwife personnel]. PMID- 3641319 TI - [Profile of nursing care]. PMID- 3641322 TI - Office surgery. PMID- 3641321 TI - [The adult respiratory distress syndrome in surgical patients]. PMID- 3641323 TI - Flexible sigmoidoscopy in the primary care setting. AB - Flexible sigmoidoscopy has been universally endorsed for use by primary care physicians for early diagnosis of colorectal cancer. Patient selection, preparation, and procedure are discussed in this article. PMID- 3641324 TI - Fine-needle aspiration biopsy of thyroid, neck masses and lymph nodes, and breast masses. AB - Fine-needle aspiration biopsy is a relatively simple procedure that is becoming increasingly popular among physicians in the United States. It has provided significant advancement in the diagnosis of a number of pathologic conditions of the head and neck as well as other areas, especially those presenting as palpable masses or nodes. At present, many situations that previously would have required open biopsy or surgical removal of a mass lesion for diagnosis can now be diagnosed safely and accurately with fine-needle aspiration biopsy. The speed, safety, patient acceptability, low cost, and accuracy of fine-needle aspiration biopsy make it a valuable addition to any diagnostic armamentarium. PMID- 3641325 TI - [Anti-HTLV III antibodies in the personnel of a hospital in the Campania region]. AB - The authors have effected an epidemiological research on 417 employees of the "Centro Traumatologico Ortopedico" (CTO) Hospital of Naples (Italy) in order to locate the anti-HTLV III antibodies. The obtained result alloweds to point out the low percentage of positivity (0.2%), therefore the authors concluded that the professional risk of infection with HTLV III is very low among the hospital employees. PMID- 3641326 TI - Doctors, nurses and "sponge counts". PMID- 3641327 TI - Doctor's verbal orders and license revocation. Case in point: Montgomery v. Dept. of Registration & Education (486 N.E. 2d 1100 = IL). PMID- 3641328 TI - The nurse entrepreneur: patient solicitation. Case in point: Prentice Medical Corp. V. Todd (495 N.E. 23 1044 = IL). PMID- 3641329 TI - [Structure and function of alternative pathway components of complement]. PMID- 3641330 TI - [Nutrition for 0-1-year old infants. From theory to nutritional reality]. PMID- 3641331 TI - [Homes for the aged--an evaluation]. PMID- 3641332 TI - [Nurse's role in hemodynamic studies]. PMID- 3641333 TI - [Leisure activities for the elderly in old age homes]. PMID- 3641334 TI - [Nurses and their place in the organization]. PMID- 3641335 TI - [Role of the nursing team caring for cases of heart failure in a small hospital]. PMID- 3641336 TI - [A psychiatric hospital as a center for the promotion of mental health]. PMID- 3641337 TI - [Directions for nurses: perceptions of auxiliary nursing personnel in medico surgical units in a teaching hospital]. PMID- 3641338 TI - [Psychomotor education in preschool children: favorable effects on neurological, psychological and social maturation processes]. PMID- 3641339 TI - Ostomy surgery: an overview of historical, current, and future perspectives. PMID- 3641341 TI - Colorectal cancer: etiology and pathophysiology. PMID- 3641340 TI - The ostomy: colorectal, urinary, and gynecological surgery. PMID- 3641342 TI - Treatment modalities for colorectal cancer. PMID- 3641343 TI - Nursing considerations for the patient undergoing colostomy surgery. PMID- 3641344 TI - Bladder cancer: etiology and pathophysiology. PMID- 3641345 TI - Treatment modalities for bladder cancer. PMID- 3641346 TI - Nursing management of a patient with a urinary diversion. PMID- 3641347 TI - Gynecological cancers: etiology and pathophysiology. PMID- 3641348 TI - Treatment modalities for gynecological cancers. PMID- 3641349 TI - Nursing management of a patient following pelvic exenteration. PMID- 3641350 TI - Fistula management. PMID- 3641351 TI - [Disorders of plantar stability in children]. PMID- 3641352 TI - [A resuscitation unit in a neurology service: For whom? What for?]. PMID- 3641353 TI - [The nurse's educational role, a role on its way... to apprenticeship]. PMID- 3641355 TI - [Global strategy for breast cancer]. PMID- 3641354 TI - [Puncture-drainage and lavage of the maxillary sinuses]. PMID- 3641356 TI - [Burns and emergency care]. PMID- 3641357 TI - [Nursing care: an initiative that joins everyone's efforts and wishes]. PMID- 3641358 TI - [International colloquium in Lyons: Competence and cohesion in the nursing service]. PMID- 3641359 TI - [Considered autonomy: assured discharge]. PMID- 3641360 TI - [Complications in abdominal surgery]. PMID- 3641361 TI - [Extraperitoneal septic complications after digestive system surgery]. PMID- 3641362 TI - [Complications in digestive surgery]. PMID- 3641363 TI - [Parietal infections after abdominal surgery]. PMID- 3641364 TI - [Disorders of peristalsis in adults in intensive care units]. PMID- 3641365 TI - [Independence in the aged. When care comes to a home for the aged]. PMID- 3641366 TI - [School health... and we...?]. PMID- 3641367 TI - [Ear noises or acouphenes]. PMID- 3641368 TI - [Delegation of work. An example of organization in a surgical service]. PMID- 3641369 TI - [Hypoglycemia in adults]. PMID- 3641370 TI - [Health education during basic nurses training]. PMID- 3641371 TI - [Causes of error in the use of pressurized cartridges]. PMID- 3641372 TI - [Current trends in nursing]. PMID- 3641373 TI - [Leprosy still exists in Spain]. PMID- 3641374 TI - [Hansen's disease]. PMID- 3641375 TI - [Health in constant revision]. PMID- 3641376 TI - [Smoking, a harmful habit]. PMID- 3641377 TI - [The psychiatric hospital]. PMID- 3641378 TI - [Study of the Wechsler adult intelligence scale in Santiago nursing students]. PMID- 3641379 TI - [Continuing education. Field: basic nursing care. Topic: hygiene of the hospitalized patient]. PMID- 3641380 TI - Taking charge. When you have the job for only a day. PMID- 3641381 TI - Patient's advocate. Why patients need more than a "no code" order. PMID- 3641382 TI - Bringing your patient through gallbladder surgery (continuing education credit). PMID- 3641384 TI - What's different about this MI? PMID- 3641383 TI - Do you know child abuse when you see it? PMID- 3641385 TI - The special problems of childhood leukemia. PMID- 3641386 TI - Psychiatric interventions you can use in an emergency. PMID- 3641387 TI - Sex questions a cardiac patient may be too scared to ask. PMID- 3641388 TI - The good news about breast reconstruction. PMID- 3641389 TI - Why it's harder to defend nurses now. Legally speaking. PMID- 3641390 TI - Our job is to care for patients, not judge them. PMID- 3641391 TI - Could you spot the "other" anemia? PMID- 3641392 TI - A different approach to traditional nursing goals. PMID- 3641394 TI - Light up for safety. PMID- 3641393 TI - Combatting the invisible shortage. PMID- 3641395 TI - Health, wholeness and harmony. PMID- 3641396 TI - Visual identity. Part II. Birth of a symbol. PMID- 3641397 TI - The pros and cons of nursing models. No: model mania. PMID- 3641398 TI - The pros and cons of nursing models. Yes: nursing models can help. PMID- 3641399 TI - Nursing with a difference. PMID- 3641400 TI - Nurse in the witness box. PMID- 3641401 TI - Houston VA spinal cord injury program: initiating a spinal cord injury program. PMID- 3641402 TI - Facilitating change. PMID- 3641403 TI - [Fraxiparine]. PMID- 3641404 TI - [Pharyngitis in the adult]. PMID- 3641405 TI - [Deafness in the adult]. PMID- 3641406 TI - [Rhinitis in the adult]. PMID- 3641407 TI - [Sintrom]. PMID- 3641408 TI - [Treatment of leg ulcers]. PMID- 3641409 TI - [Qualitative approach to the care of wounds]. PMID- 3641410 TI - [Salary and accounting slip]. PMID- 3641411 TI - [Sinusitis in the adult]. PMID- 3641412 TI - [Laurylated mercryl]. PMID- 3641413 TI - [Dysmenorrheas]. PMID- 3641414 TI - [Metrorrhagia--menorrhagia]. PMID- 3641415 TI - [The menstrual cycle]. PMID- 3641416 TI - [Premenstrual syndrome]. PMID- 3641417 TI - [Maternity, psychoprophylactic period]. PMID- 3641418 TI - [The admission to prenatal consultation]. PMID- 3641419 TI - [Disorders of ovulation]. PMID- 3641420 TI - [Econazole]. PMID- 3641421 TI - [Psychological aspects of scoliosis treatment]. PMID- 3641423 TI - [Scoliosis. Technics of orthopedic and surgical treatments]. PMID- 3641422 TI - [Role of the nursing team and the environment]. PMID- 3641424 TI - [Anesthesia-intensive care for the surgical treatment of scoliosis in children]. PMID- 3641425 TI - [Roles of circulating nurses and operating room nurses]. PMID- 3641426 TI - [Treatment of scoliosis in children]. PMID- 3641427 TI - [The place of exercise therapy in the treatment of idiopathic scoliosis]. PMID- 3641428 TI - [Pre- and postoperative nursing care in Harrington grafts]. PMID- 3641429 TI - [Description of the normal back and of scoliosis. Clinical examination, causes, spontaneous evolution, consequences and justification for treatment]. PMID- 3641430 TI - [Posterior vertebral arthrodesis. Case report]. PMID- 3641431 TI - [Psycho-social aspects of premenopause]. PMID- 3641432 TI - [News from central management: HVPU (Health Care for Mentally Retarded) institutions should be liquidated]. PMID- 3641433 TI - [Nursing workload measurement (3). Practical short system with variation possibilities]. PMID- 3641434 TI - [Focus on education (2). No desire to practice in old-age institutions?. Interview by Bjorn Arild Ostby]. PMID- 3641436 TI - [Comment on wage settlement: a long step in the right direction says vice president Anne Karin Brokhaug. Interview by Pal Horsle]. PMID- 3641435 TI - [Report from Tromso on the strike: we both will and can!]. PMID- 3641437 TI - [Vice-president of the Oslo district, Anne Herseth: Oslo is ignored in wage settlement]. PMID- 3641438 TI - [AIDS--not merely a case for the dedicated]. PMID- 3641439 TI - [Do you want to get a Ph.D.? 1,000,000 krone in scholarships from the Norwegian Nurses' Association]. PMID- 3641440 TI - [Still many things lopsided]. PMID- 3641441 TI - [This century's catastrophe? (7) AIDS epidemic cannot go on a waiting list]. PMID- 3641442 TI - [Granli psychiatric nursing home--new proposition for senile demented]. PMID- 3641443 TI - [Lack of knowledge or lack of professional pride in geriatric care?]. PMID- 3641444 TI - [Norwegian Nurses' Association's wage policy: should nursing have its own professional advancement ladder?]. PMID- 3641445 TI - [Leadership development in the hospital: capable leaders provide better health services. Interview by Jofrid Bjorkvik]. PMID- 3641447 TI - [WENR's (Workgroup of European Nurse Researchers) 3d conference: nurse researchers from 24 countries meet in Finland]. PMID- 3641446 TI - [Guidelines from the Norwegian Nurses' Association: nursing records and nurses' responsibility]. PMID- 3641448 TI - [Radium hospital goes in new directions: primary nursing care the outpatient clinic]. PMID- 3641450 TI - [Focus on education (5). Education in terminal care in the university]. PMID- 3641449 TI - [Project in Sunnaas hospital: nursing workload measurement and frequency study]. PMID- 3641451 TI - [Why does clinical practice remain a shock for students?]. PMID- 3641452 TI - [This century's catastrophe? (8). AIDS--threat and challenge]. PMID- 3641454 TI - [Norwegian Nurses' Association's wage policy (2): Do we need more member positions?]. PMID- 3641453 TI - [Station 4 in St. Hans Home: senile demented get professional stimulation]. PMID- 3641455 TI - [Mireille Kingma, ICN's secretariat: Norwegian Nurses' Association guidepost in international cooperation?. Interview by Bjorn Arild Ostby]. PMID- 3641456 TI - [Take care of the elected representative!]. PMID- 3641457 TI - [Our new man in the group: Rolf Schjolberg--Norwegian Nurses' Association's new negotiations manager]. PMID- 3641458 TI - [Home nursing in Oslo: patients and nurses best served with a public general physician]. PMID- 3641459 TI - [Working days' spring. Is it right to stick with it--in spite of everything?]. PMID- 3641460 TI - [The local adjustment proceedings]. PMID- 3641461 TI - [Culture collision: difficult to be an immigrant-patient]. PMID- 3641462 TI - [Challenge to nurses: postpartum women know but little about breast feeding]. PMID- 3641463 TI - [Do we need continuing education in pediatrics?]. PMID- 3641464 TI - [Gerontologic nursing--special continuing education?]. PMID- 3641465 TI - [Fisher harbor Batsfjord--have: modern health center--seek: nurses. Interview by Bjorn Arild Ostby]. PMID- 3641466 TI - [Technology in nursing: ADP--friend or enemy?]. PMID- 3641467 TI - [Readers' survey 1986: yes, we read your periodical!]. PMID- 3641468 TI - [This century's catastrophe? (3) AIDS--a challenge for home care nursing]. PMID- 3641469 TI - [Norwegian Nurses' Association on the new social legislation: nursing homes must not become social storehouses]. PMID- 3641470 TI - [Experiences with a new project: incontinence can be treated]. PMID- 3641471 TI - [Annual congress demands: quality in nursing services]. PMID- 3641472 TI - [Government declined negotiations--hence, strike]. PMID- 3641473 TI - [Discrimination against women in the public health service]. PMID- 3641475 TI - The Texas peer assistance program: the legal ins-and-outs. PMID- 3641474 TI - [Vensmoen's HVPU (Health Care for Mentally Retarded)-institution--rapid development with a poor basis]. PMID- 3641476 TI - Chemical dependency among nurses: we must solve this problem together. PMID- 3641477 TI - The nurse, the addict. PMID- 3641478 TI - Association between HLA-A9 and rapidly progressive periodontitis. AB - HLA-A, B, C, DR antigen frequencies and Properdin factor B (Bf) allotypes were studied in a group of 44 patients with rapidly progressive periodontitis. HLA-A9 (A24) was the only antigen with a frequency statistically significantly different from the control population. An increased frequency of HLA-A9 was previously reported in periodontal diseases. Our results in a well characterised group of patients adds to the evidence that HLA-A9 plays a role in the susceptibility to severe periodontitis. PMID- 3641479 TI - HLA and narcolepsy in a German population. AB - In this paper the first MHC data including HLA-A, B, C, DR, DQ and complement BF, C4A, C4B determinants in German narcoleptics are presented together with the first family studies in European Caucasoids. 57 out of 58 unrelated patients (98.3%) were positive for DR2 and DQw1, respectively. In contrast to all other reports, one patient with typical signs of narcolepsy was found to be DR2/DQw1 negative. Data showing significant increase in the frequency of B7, and normal frequencies of B35 were discordant with data from Japanese patients. Definition of the extended DR2 linked haplotypes, deduced from 6 families, revealed that 5 out of 12 were DQw1, DR2, BFS, C4B1, C4A3, B7 (Cw7), while 11/12 had DR2, DQw1, BFS, C4A3, C4B1 in common. In one multiple case family two genotypically different DR2 haplotypes were identified in affected siblings. Results from the family study were concordant with a dominant mode of inheritance with incomplete penetrance of a hypothetical disease susceptibility gene. PMID- 3641480 TI - HLA antigens and complement types in patients with intracranial saccular aneurysms. AB - The occurrence of HLA-A, -B, -C antigens and the HLA controlled complement factors (Bf, C2, C4) was investigated in an unselected group of 116 consecutively admitted patients with intracranial saccular aneurysms, and compared to that of healthy controls (blood donors). When multiplying the p-values with the number of comparisons made, none remained significant. However, a rather high etiologic fraction of the BfS gene (0.59) was obtained. Moreover, for HLA -B7 a significant deviation from the Hardy-Weinberg equilibrium with an increase of homozygotes was found. Due to linkage disequilibria this could indicate a strong association between HLA-DR2 and saccular aneurysms. The presence of HLA-DR2 was therefore investigated in a series of 15 aneurysm patients used as cadaver kidney donors and not included among the 116 consecutively admitted patients. In this group the HLA-DR2 antigen frequency was significantly increased (66.7% vs. 29.7%, p less than 0.01). The present study thus demonstrates an association of saccular aneurysm and the major histocompatibility complex and shows the existence of a genetic predisposition to saccular aneurysm. PMID- 3641481 TI - [Making a virtue of necessity? On the competent unqualified nurse. I. Economic crisis and health care]. PMID- 3641482 TI - [Practice supervision in hospitals. Task distribution, organization and evaluation]. PMID- 3641483 TI - [Department-related quality assurance. Practical experience of more than 1 year]. PMID- 3641484 TI - [Integrated Cancer Centers. Cooperative organization in cancer control]. PMID- 3641485 TI - [Medical information for nurses. Adult respiratory distress syndrome and multiple organ failure]. PMID- 3641486 TI - [Continuing Education Professional Innovation: an education for many functions]. PMID- 3641487 TI - [Making a virtue of necessity. II. 'Extended arm' in international perspective]. PMID- 3641488 TI - [The resolution for medical assistance to the aged]. PMID- 3641490 TI - [This is how patients can feel...]. PMID- 3641489 TI - [Patient education, why and how?]. PMID- 3641491 TI - Laser safety. Part 3. PMID- 3641492 TI - Postoperative flatulence: causes and remedies. PMID- 3641493 TI - Documenting perioperative care. PMID- 3641494 TI - The nurse liaison. PMID- 3641496 TI - A continent ileal reservoir for urine. PMID- 3641495 TI - Stages of successful litigation (Part 2). PMID- 3641497 TI - Building business relationships. PMID- 3641498 TI - Interview. The longest journey: a recovering professional tells her story. PMID- 3641499 TI - New instruments in ophthalmic surgery. PMID- 3641500 TI - Prevalence of HTLV-III antibody among New Mexico residents with hemophilia. AB - Persons with hemophilia who have received therapy since 1978 are at risk for the acquired immunodeficiency syndrome. Plasma and serum specimens collected from 1980 to 1985 from 73 New Mexico residents with hemophilia were tested by enzyme immunoassay for antibody to human T-cell lymphotropic virus type III (HTLV-III), and positive results were confirmed by Western blot. Antibody to HTLV-III was first detected in New Mexico residents with hemophilia in 1981. Among 49 persons tested in 1984-1985, seropositivity was found in 35%. Of these, 17 of 32 (53%) commercial concentrate versus 0 of 17 cryoprecipitate users were seropositive (P = .002). Of the 7 with hemophilia B, 3 (43%) were seropositive versus 14 of 42 (33%) with hemophilia A. Of 17 Albuquerque residents with hemophilia, 2(12%) were seropositive as compared with 15 of 32 (47%) persons with hemophilia who resided outside the city (P = .02). Compared with patients with hemophilia outside of Albuquerque, those living in Albuquerque tended to have milder disease and to use cryoprecipitate rather than commercial concentrate. Less frequent treatment (mild disease) and use of cryoprecipitate were associated with a decreased risk of HTLV III infection. PMID- 3641501 TI - AIDS: acquired immune deficiency syndrome. 2. PMID- 3641502 TI - Continuous assessment. PMID- 3641503 TI - Research in cancer nursing. PMID- 3641505 TI - INO Nursing Association for the Elderly. PMID- 3641504 TI - Red Cross in Ethiopia. PMID- 3641506 TI - Testicular survival after neonatal torsion. AB - Ten newborn patients with an extravaginal testicular torsion are presented. All were operated on with an emergency orchiopexy. At follow-up, two to 15 years after the operation, no significant difference was noted in the volumes of the operated and the contralateral testis in eight of the ten patients. The results show the importance of an emergency orchiopexy in order to ensure testicular survival after neonatal torsion. PMID- 3641507 TI - [Recurring meningitis caused by Streptococcus pneumoniae during preventive penicillin therapy]. AB - It is generally accepted, that Streptococcus pneumoniae is very sensitive to penicillin G; minimal inhibitory concentration (MIC) is normally about less than = 0.01 microgram/ml. Some years ago strains relatively resistant to penicillin (MIC 0.1 to 1.0 microgram/ml) were reported on. In 1977 strains isolated from blood and cerebrospinal fluid in South-Africa were found to have a higher resistance to penicillin (MIC 0.5-4 micrograms/ml). We report on an 6-year-old girl with septicemia and meningitis caused by a strain of S. pneumoniae relatively resistant to penicillin (MIC 0.5 microgram/ml). Aged 5 years the girl had a first meningitis caused by S. pneumoniae. The girl was then treated with penicillin (450,000 IU/d) to prevent a new infection. During this time the second meningitis caused by S. pneumoniae took place. In the agarose gel electrophoresis a plasmid was found (4.2 X 10(6) Dalton). No beta-lactamase-activity was detected (nitrocefin-test and acidimetric measurement). It is unlikely that there is a plasmid-dependent resistance to penicillin. PMID- 3641508 TI - [Analysis of specificity in the serodiagnosis of acquired immunodeficiency syndrome]. AB - Analysis of serum samples for the presence of antibody to AIDS-inducing virus was carried out with the use of the Virognostika diagnosticum manufactured by Organon (the Netherlands). As a result, 6.1% of sera from patients with hematologic diseases, 5.7% of sera from oncologic patients, and 9.2% of sera from hepatitis B patients proved to be "positive" according to the criteria of the manufacturer. However the positively reacting sera could be neutralized by sorption on human red cells, groups AB and 0 and by treatment with the lysate of human lymphocyte culture, which was indicative of the fact that false positive reactions were probably due to the contamination of the antigenic preparation by components of the producer-cell membrane. PMID- 3641509 TI - Relevance of plasma, glandular and urinary kallikrein in renal hypertrophy in streptozotocin-diabetic rats. AB - The relevance of plasma, glandular and renal kallikrein as an intrarenal hemodynamic regulator, in renal hypertrophy, in 1-5 weeks streptozotocin diabetic rats has been investigated. The fasting plasma glandular kallikrein level significantly decreased with increasing duration of diabetes (p less than 0.05). Glandular kallikrein correlated negatively with kidney weight (r = 0.76, p = 0.05). The 24 hour urinary kallikrein excretion significantly increased with increasing duration of diabetes (p less than 0.05), but this level was not correlated with glucose level, nor with kidney weight. Aprotinin (a kallikrein inhibitor) injected (10 X 10(3) KIU/kg) twice daily for 2 weeks in diabetic rats, significantly decreased plasma glucose levels by 28%, 24 hour urinary kallikrein by 37% (p less than 0.05) and kidney weight by 6%. These results suggest that plasma, glandular and renal kallikrein did not play an important role in the renal hypertrophy observed in streptozotocin diabetic rats. PMID- 3641510 TI - Hospital regulations: potential evidence of negligence. PMID- 3641511 TI - Use of fentanyl markedly increases nausea and vomiting in gynecological short stay patients. PMID- 3641513 TI - Nitrous oxide as an adjunct to local anesthesia: a study. PMID- 3641512 TI - Anesthetic implications in sickle cell anemia. PMID- 3641514 TI - Prevention and management of anesthetic mishaps (continuing education credit). PMID- 3641516 TI - Nurses creating their future. PMID- 3641515 TI - Nurse anesthetists' well-being: Part I. PMID- 3641517 TI - Patient abuse. PMID- 3641518 TI - How do nurses learn about quality assurance? PMID- 3641519 TI - Effective death education for nursing students. PMID- 3641521 TI - Career mobility: or how to get that job you've always wanted! PMID- 3641520 TI - Operating room nursing program--results of a needs survey. PMID- 3641522 TI - Code of Ethics for Nursing, Canadian Nurses Association February 1985. PMID- 3641523 TI - Kallikrein effect on the acquisition and extinction of conditioned reflexes in rats. AB - The effect of kallikrein was studied on the acquisition and extinction of conditioned reactions in rats. It was demonstrated that kallikrein in doses of 50 and 100 mu/kg i.p. accelerated the process of learning in these animals. The observed effect might be connected with a rise in the activity of kininogenic enzymes in the central nervous system. PMID- 3641525 TI - Will that IM needle reach the muscle? PMID- 3641524 TI - AIDS and addiction in New York City. AB - The association between AIDS and intravenous drug abuse is emerging as a critical component of the AIDS epidemic due to several factors: the high rate of infection of this group with the HTLV-III virus-approximately 50%; the risk of infection to others through shared needles, sexual contact, and intrauterine transmission to the fetus; and the impact of large numbers of new cases of AIDS among addicts on the health care services of a few urban areas. This paper outlines the projected dimensions of the AIDS epidemic among intravenous drug abusers in New York City and its implications for hospital utilization and local health care expenditures. These considerations indicate the urgent need for a rapid expansion of addiction treatment services and modification of treatment objectives to deal with this new problem. PMID- 3641526 TI - Who says prisoners have a right to health care? PMID- 3641527 TI - Inaccurate technique displayed on September cover? PMID- 3641528 TI - Potassium is not a treatment for constipation. PMID- 3641529 TI - And to all a good night. PMID- 3641531 TI - Discharge score for surgical outpatients. PMID- 3641530 TI - The Orange Blossom special. PMID- 3641532 TI - ACLS guidelines. What nurses are saying about the drug changes. PMID- 3641533 TI - Could this be delirium? PMID- 3641534 TI - Working with people. Evaluation of the clinical nurse specialist. PMID- 3641535 TI - Children at risk for depression. PMID- 3641536 TI - How to evaluate staffing software. PMID- 3641537 TI - 21 new diagnoses and a taxonomy. The North American Nursing Diagnosis Association. PMID- 3641538 TI - Orthopaedic nursing practice: process and outcome criteria for selected diagnoses. PMID- 3641539 TI - Standards of rehabilitation nursing practice. PMID- 3641540 TI - AIDS and anaesthesia. AB - The Acquired Immune Deficiency Syndrome (AIDS) is a group of conditions which is reaching epidemic proportions. It is caused by a virus new to man, with an as yet poorly understood natural history, ominous prognosis and no known cure. Anaesthetists should be aware of the implications of dealing with increasing numbers of both diagnosed and undiagnosed AIDS patients and asymptomatic carriers in the fields of resuscitation, intensive therapy and theatre anaesthesia. The misunderstanding of AIDS is as extensive as the literature on the subject and a review of the current knowledge of the disease relevant to the anaesthetist is pertinent. PMID- 3641541 TI - Postanesthetic apnea and periodic breathing in infants. PMID- 3641542 TI - Poor seroconversion rate after hepatitis B vaccination in high-risk institutionalized mentally retarded patients. AB - We studied the rate of seroconversion to positivity for antibody to hepatitis B surface antigen (anti-HBs) after immunization with hepatitis B vaccine in a group of mentally retarded institutionalized patients. Eight hundred sixty-eight individuals were screened for seromarkers of hepatitis B infection (hepatitis B surface antigen and anti-HBs), and 287 seronegative patients were vaccinated with the recommended schedule of hepatitis B virus vaccine (20 micrograms IM at 0, 1, and 6 months). Overall, 59% of patients responded to vaccination with detectable anti-HBs. We found a high correlation of lack of response with both intragluteal injection and increasing age (p less than 0.0008), although the design of the study did not allow these factors to be analyzed separately. We conclude that buttock injection and advancing age may be risk factors for poor immunogenicity of the hepatitis B vaccine in mentally retarded populations. PMID- 3641544 TI - Pseudomeningitis caused by Sporobolomyces salmonicolor. PMID- 3641543 TI - Are health care workers at risk for infection during an outbreak of nosocomial Legionnaires' disease? AB - We studied data from 500 health care workers to answer the question: Are health care workers at risk for infection during an outbreak of nosocomial Legionnaires' disease? These workers were employed at a hospital where eight cases of nosocomial Legionella pneumophila serogroup 1 pneumonia occurred over a 4-week period. The source was potable water. Acute-phase blood samples were collected on the day the water supply was decontaminated, convalescent samples were collected 4 to 6 weeks later from 373 subjects, and a single serum sample was obtained from an additional 127 subjects. Antibody titers to L. pneumophila were determined by an indirect immunofluorescent antibody (IFA) technique and by a microagglutination assay with the epidemic strain as the test antigen. Subjects who had an IFA titer of greater than or equal to 1:256 were retested with an anti human IgM conjugate. None of the 373 health care workers had a fourfold rise in antibody titer. The geometric mean antibody titer of 73.8 for the 500 health care workers was significantly higher than that of 68.1 for 976 blood donors (p less than 0.01). Only 2.4% had recent infection as evidenced by a microagglutination test, despite the fact that 84% were susceptible. We conclude that in the setting of a short-term outbreak of Legionnaires' disease caused by contaminated potable water the risk of infection among health care workers is low: 2.4% or less. PMID- 3641545 TI - The infection control practitioner in Canadian hospitals with more than 200 beds. PMID- 3641546 TI - Infection control: consultation provides new frontier. PMID- 3641547 TI - Review of infection control literature 1973 through 1981. AB - A total of 446 manuscripts published between 1973 and 1981 were selected for analysis in this review of the literature. More than half of these articles used research designs, with presentations of epidemic outbreaks the single greatest category. The overall category of surveillance was addressed in some way in almost three fourths of all manuscripts reviewed. Some aspect of ICP role components was the topic of about 10% (n = 55) of the total sample. Physicians were credited as first authors in 56.7% of the articles. It was not possible to determine the exact extent of ICP authorship because credentials varied widely. Finally, a cursory effort was undertaken to quantify numbers of articles that might have met study criteria for inclusion in years after 1981. That effort confirmed the investigators' suspicion that the yearly total of published manuscripts continued to escalate, as did the number of specialty journals in infection control. PMID- 3641548 TI - Environmental and occupational health hazards in hospitals: the realm of the institutional epidemiologist. PMID- 3641549 TI - Appropriate needle disposal: implementing change to reduce injury and lessen risk. PMID- 3641550 TI - Infectious disease update: "The successful cephs ...". PMID- 3641551 TI - Prekallikrein deficiency in a family of miniature horses. AB - Two sibling miniature horses, a male and a female, had a normal 1-stage prothrombin time and a prolonged activated-partial thromboplastin time (APTT). The addition of as little as 5% of a normal equine plasma pool to the plasma samples of both horses shortened their prolonged APTT to within normal limits. Coagulation factor analysis revealed deficiencies in factor XII (12 and 13 U/dl, control population 77 to 128 U/dl), when determined with a feline factor XII deficient plasma substrate, but normal concentrations (119 and 96 U/dl) when a human factor XII-deficient plasma substrate was used. Deficiencies of another factor, prekallikrein, were detected with a human prekallikrein-deficient plasma substrate (16 and 6 U/dl, control population 70 to 173 U/dl). Other intrinsic coagulation factors were present in normal concentrations. The APTT was measured with plasma from the 2 horses after various incubation periods (1 to 15 minutes) with a contact activator before the addition of Ca ions. With incubation times of greater than or equal to 10 minutes, the APTT of both horses were essentially the same as that of the normal equine plasma pool. Several family members of the 2 prekallikrein-deficient miniature horses appeared to be heterozygous carriers of the prekallikrein deficiency. PMID- 3641552 TI - Research in medical education 1986. Proceedings of the twenty-fifth annual conference. In conjunction with the 97th annual meeting of the Association of American Medical Colleges. October 25-30, 1986, New Orleans, Louisiana. PMID- 3641553 TI - Characteristics of students recruited in different types of medical schools. PMID- 3641554 TI - Career choices of men and women in medicine: a study of a cohort of recent medical graduates. PMID- 3641555 TI - Exploring the relationship of entry and performance data to NBME Part I examination scores for use in decision making. PMID- 3641556 TI - Training resident physicians to use clinical prediction rules. PMID- 3641557 TI - An approach to teaching and evaluating diagnostic reasoning. PMID- 3641558 TI - The impact of clinical appearance on pediatric residents' assessment of the febrile infant. PMID- 3641559 TI - The effects of continuing medical education upon family physician performance in the office management of hypertension. A randomized controlled study. PMID- 3641560 TI - The role of the consultation process in physician learning. PMID- 3641561 TI - A review of family medicine faculty development fellowship programs, their alumni and recommendations for future programs. PMID- 3641562 TI - The relationship of clinical exposure to examination performance on a surgical clerkship. PMID- 3641563 TI - Practical experience in the pre-registration year in relation to undergraduate preparation. PMID- 3641564 TI - The influence of prior experience and confidence on physician preferences for information sources and continuity of care. PMID- 3641565 TI - Some cognitive characteristics of medical students with and without diagnostic reasoning difficulties. PMID- 3641566 TI - Clinical decision making: a study to define educational objectives for resident physicians. PMID- 3641567 TI - Decision making of internists and family physicians in the Netherlands. PMID- 3641568 TI - Harvey: the impact of a cardiovascular teaching simulator on student skill acquisition. PMID- 3641569 TI - Defining the content of board certification examinations. PMID- 3641570 TI - "Something old, something new": the certification examination of the United Kingdom Royal College of General Practitioners. PMID- 3641571 TI - Utilization of in-training examinations for curriculum evaluation: a model from the surgical residency. PMID- 3641572 TI - Formative evaluation of a structured data base as an educational strategy in medical microbiology. PMID- 3641573 TI - A program of microcomputer use in a junior internal medicine clerkship. PMID- 3641574 TI - A re-evaluation of the projected physician surplus in the United States. PMID- 3641575 TI - The organizational, professional and clinical characteristics of general practitioners and family physicians' medical practice. PMID- 3641576 TI - Effective attending physician teaching: the correlation of observed instructional activities and learner ratings of teaching effectiveness. PMID- 3641577 TI - Perceived performance and clinical experiences: a comparative evaluation across five clerkships. PMID- 3641579 TI - Distress and attitudes toward the learning environment: effects of a curriculum innovation. PMID- 3641578 TI - The effect of a monitoring system on clinical training. PMID- 3641580 TI - Learning and teaching the process of informed consent. PMID- 3641581 TI - Empirical observations on the stability and attitudinal correlates of warmth and caring in medical students. PMID- 3641582 TI - Reliability and validity of the Medical Helping Relationship Inventory. PMID- 3641583 TI - Change in medical student learning styles: a four year prospective study. PMID- 3641585 TI - Symposium: Self-directed learning and physicians' practice changes: concepts, research and implications for CME. PMID- 3641584 TI - Symposium: Medical education and health services delivery--forging research links. PMID- 3641586 TI - Symposium: Development of the oral examination as part of specialist certification examinations--an international perspective. PMID- 3641587 TI - Symposium: The use of health care data in medical education. PMID- 3641588 TI - Symposium: Parallel innovative tracks: are they an effective vehicle for changing traditional medical education? PMID- 3641589 TI - Medical students perceptions of pre-clinical medical ethics teaching. PMID- 3641590 TI - Symposium: The use of site visits to evaluate clinical clerkships. PMID- 3641591 TI - Symposium: Dilemmas in the evaluation of residents. PMID- 3641592 TI - Teaching interviewing skills to first year medical students: do they learn? PMID- 3641593 TI - The ideal physician: an analysis from two perspectives. PMID- 3641594 TI - Evaluating clinical competence in anesthesia: using faculty comments to develop criteria. PMID- 3641595 TI - Comparing self and supervisor evaluations: a different view. PMID- 3641596 TI - An evaluation of the construct validity of four alternative theories of clinical competence. PMID- 3641597 TI - New directions for organizing structural curriculum reform. PMID- 3641598 TI - Long term effects of breast exam teaching unit in physical diagnosis on medical students' practices. PMID- 3641599 TI - Influential literature in medical education. PMID- 3641600 TI - Factors influencing experiential learning of medical students on third year family medicine clerkships. PMID- 3641601 TI - Programmatic and institutional quality analysis: the perspective of the alumni. PMID- 3641602 TI - Urinary kallikrein excretion in normal and hypertensive pregnancy at term. AB - To study the urinary kallikrein excretion before the delivery of term pregnancy we measured its excretion preterm (between 32-36 gestational week) in 13 patients with normotensive pregnancy and 17 patients with pregnancy-induced hypertension and one to five days before the delivery at term in 18 and 22 patients, respectively. In normotensive pregnancy urinary kallikrein excretion remained unchanged during the late third trimester until delivery (12.6 +/- 1.7 ncat in 24 hours in preterm, 10.8 +/- 1.2 before delivery). In pregnancy-induced hypertension and particularly in pre-eclampsia urinary kallikrein excretion was lower than in normotensive pregnancy and the decrease became more marked as the time of delivery approached (respective values: in pregnancy induced hypertension 9.2 +/- 1.2 and 7.0 +/- 0.7; in pre-eclampsia 7.6 +/- 1.3 and 7.3 +/- 0.9). The decrease in urinary kallikrein excretion suggests progressive disturbances in the interactions of renal vasoactive systems (the kallikrein-kinin system, the renin angiotensin system and prostaglandins) with resultant changes in renal hemodynamics. PMID- 3641603 TI - Networking can lead to success. PMID- 3641604 TI - Your signature is valuable; watch where you put it. PMID- 3641605 TI - Wolff-Parkinson-White syndrome. Cryosurgical ablation of accessory pathways. PMID- 3641606 TI - Surgical intervention for pheochromocytoma. AB - Between 1964 and 1983 at Rush-Presbyterian-St Luke's Medical Center, 30 surgical procedures on 28 patients were performed for pheochromocytoma. In two cases, the tumors were nonresectable. Three patients had malignant pheochromocytomas, and of these, all had recurrences by eight years after surgery. Although the prognosis for patients with malignant pheochromocytomas is not good, the majority of patients have benign tumors and are cured of their disease. PMID- 3641607 TI - Tonsillectomy. Procedure and nursing care. PMID- 3641608 TI - Inadvertent hypothermia. Clinical nursing research. PMID- 3641609 TI - Perioperative elective. Developing a successful course. AB - The rapid advances in medical technology have increased the number of potential learning experiences. For example, when the elective was originally planned, laser surgery was not available in the community. Now, a perioperative nurse offers continuing education courses on laser surgery. Freestanding surgical centers have their own specialties (eg, eye clinics), and perioperative nurses specialize within these fields. Ambulatory surgical centers are creating another specialty, such as home health care within the first 24 hours of surgery. Baccalaureate nursing programs need to offer electives for students to explore their interests. Thorough planning of the perioperative elective can ensure its successful implementation. At ASU, the curriculum committee approved the proposed course with few questions, and the hospitals and freestanding clinics readily accepted the students. A perioperative elective is a satisfying experience for instructors who like to teach surgical nursing and work with registered nurses and motivated students. PMID- 3641610 TI - Simulation games. Playing to win and to learn. PMID- 3641611 TI - Time management. Part IV: Decontaminating work and play time. PMID- 3641612 TI - Restructuring the OR. Evaluating change. PMID- 3641613 TI - Perioperative nursing diagnoses. What, why, and how. AB - Nursing diagnoses are important to perioperative nursing practice because they promote quality care and the growth of nursing as a profession. The development of nursing diagnoses is still in its infancy, and some perioperative patient problems cannot be delineated by the current list. For nursing diagnoses to be clinically useful to practicing nurses, they must be derived from data collected, compiled, and analyzed by practicing nurses. The North American Nursing Diagnosis Association has prepared guidelines for submitting diagnoses. A copy can be obtained by writing to NANDA, St Louis University School of Nursing, 3525 Caroline St, St Louis, MO 64104. PMID- 3641614 TI - Monitoring patients for local cases. Nursing responsibilities. PMID- 3641615 TI - Performance of routine OR nursing activities can be the deciding factor in determining negligence. PMID- 3641616 TI - Developing a documentation form for surgeons' intraoperative verbal orders. PMID- 3641617 TI - Proposed recommended practices: care of instruments, scopes, and powered surgical instruments. PMID- 3641618 TI - When patient OR records are missing. PMID- 3641619 TI - Conducting a feasibility analysis for freestanding ambulatory surgery centers. PMID- 3641620 TI - Flash sterilization article creates controversy. PMID- 3641621 TI - Should a pillow be placed under the scapulae for intubation? PMID- 3641623 TI - Multi-organ donor procurement. Preparation and procedures. PMID- 3641622 TI - Cardiac myxomas. Diagnosis, surgical excision, and nursing care. AB - Diagnosis of cardiac myxoma is rare, but one that prompts expeditious action by the cardiac surgical service. It is one form of acquired heart disease for which surgical intervention can result in a cure. Perioperative nursing care plays an important part in helping the patient and family cope with this urgent situation. PMID- 3641624 TI - Organizational politics. Learning to play the corporate game. PMID- 3641625 TI - Outpatient hemorrhoidectomy. Laser treatment and case results. PMID- 3641626 TI - Time management. Part V: Energy engineering. PMID- 3641627 TI - Resume writing. An effective way to market yourself. AB - You cannot be modest on a resume--you have to state skills, abilities, energies, interests, aptitudes, dedication, motivation, and willingness to make contributions. Discovering what makes you special is part of the resume development process. Professional resume consultants are available to help you with this process. Focus on what you are and what you can be; do not focus on what you are not. Do not pigeonhole your professional self by identifying yourself only by your job title--that only reflects basic skills. Focus instead on the specific skills that you developed through application of those basic skills. Know your interests, demonstrate your qualities, and identify your accomplishments. PMID- 3641628 TI - Employee evaluations. Shifting the emphasis. PMID- 3641629 TI - [The thyroid gland and adrenal cortex in the large fetus and their role in the development of macrosomia]. AB - In a morphological study of thyroid glands and adrenal cortex of large fetuses compared to the controls the authors revealed a significant increase of the thyroid gland functional activity, as well as of glomerular and fascicular zones of adrenal cortex. The functional tension of the thyroid gland appeared to be reduced in large fetuses with obesity. Hyperfunction of all zones of the adrenal cortex was also revealed in them. In medium height fetuses with obesity hypofunction of the thyroid gland, as well as hyperfunction of the fascicular and fetal adrenal cortex zones were present. Correlation-regression analysis has revealed close interrelations between the functional state of the thyroid gland, adrenal cortex and fetal mass. PMID- 3641631 TI - Homelessness: one city's response. PMID- 3641630 TI - [Benzoyl-kallikrein: kallikrein activity and kinin generation in plasma]. AB - The inactive acyl-derivative benzoyl-kallikrein was prepared from porcine pancreatic kallikrein. By deacylation the enzymatically active kallikrein was generated in plasma from benzoyl-kallikrein demonstrated by means of its amidolytic activity. Benzoyl-kallikrein was protected from being inactivated by plasma inhibitors. Therefore, the kallikrein activity in plasma was higher following incubation of benzoyl-kallikrein than following incubation of the free enzyme. A comparatively high kinin activity was found in rabbit plasma. In human plasma, this effect was prevented by rapid degradation of kinin. PMID- 3641632 TI - Experiences of a nursing student on an oncology unit. PMID- 3641633 TI - Dolichol and dolichyl phosphate in human tissues. AB - The content of dolichol and dolichyl phosphate in various human organs was analysed using autopsy samples. The reliability of these measurements was demonstrated by comparison with values for fresh biopsy material. Dolichol was present in all tissues investigated and the content was highest in the adrenal gland, pancreas, pituitary gland, testis and thyroid gland, ranging between 1.5 and 7.1 mg/g tissue. Dolichyl-P was detected in the various organs in highly variable amounts, ranging between 1 and 9% of the total dolichol content. While the main pattern of isoprene composition for dolichol and dolichyl-P was similar in individual organs, some variation was observed between tissues. Dolichol represents the largest lipid component in the pituitary gland, exceeding the total phospholipid content. The high concentrations of dolichol and dolichyl-P in human organs indicate that these lipids may play important roles in physiological and pathological cellular functions. PMID- 3641635 TI - What's in a name? The Research and Resource Centre, Obelisk Park. PMID- 3641634 TI - Topographic modeling of free and methionyl-tRNA synthetase bound tRNAfMet by singlet-singlet energy transfer: bending of the 3'-terminal arm in tRNAfMet. AB - Conformations of tRNAfMet, free and methionyl-tRNA synthetase bound forms, are analyzed by using singlet-singlet energy transfer as a spectroscopic ruler. tRNAfMet(8-13,3'-Flc), tRNAfMet(8-13,D-Etd), and tRNAfMet(3'-Flc,D-Etd) are prepared by sequential chemical modifications. The methionyl-tRNA synthetase binding affinity of these double-labeled tRNAfMets is similar to those of unmodified tRNAfMet. The fluorescence properties of the individual fluorophore in these tRNAs, including emission spectra, anisotropy, and quenching by methionyl tRNA synthetase, are similar to those of single-labeled tRNAfMet. The transfer efficiencies of double-labeled tRNAfMets, as determined by both donor quenching and sensitized emission, showed efficient energy transfer in all cases. Random orientation being assumed, the apparent distances are 25 A between 8-13 and D20, 44 A between 8-13 and the 3'-terminus, and 49 A between the 3'-terminus and D20, respectively, in free tRNAfMet. Upon binding of methionyl-tRNA synthetase, the apparent distances are 25 A between 8-13 and D20, 45 A between 8-13 and the 3' terminus, and 54 A between the 3'-terminus and D20, respectively. These results provide topographic models of these specific locations in free and methionyl-tRNA synthetase bound tRNAfMet and suggest that the immobilized 3'-terminal arm in the amino acid acceptor stem bends toward the inner loop of the L-shaped tRNA upon binding of methionyl-tRNA synthetase. PMID- 3641636 TI - Educating Martha. PMID- 3641637 TI - Young people in employment. The unseen benefits. PMID- 3641638 TI - Collective bargaining turns 40. PMID- 3641639 TI - Plan your way to prosperity. PMID- 3641640 TI - How the IRSC-NP works. PMID- 3641641 TI - A tale of three teachers. PMID- 3641642 TI - Beyond the power of logic. PMID- 3641643 TI - Professional performance: committees can make a difference. PMID- 3641645 TI - Future issues theme of clinical sessions. PMID- 3641644 TI - Bringing order to moral chaos. PMID- 3641646 TI - Optical scanning and computer technology in nursing research. PMID- 3641648 TI - Implementing change in the O.R. setting. PMID- 3641647 TI - The role of centralized computer services in faculty evaluation. PMID- 3641649 TI - Intra-operative nursing care of the geriatric patient. PMID- 3641650 TI - Time management: teaching strategies to prevent the White Rabbit syndrome. PMID- 3641651 TI - What it takes to be a preceptor. PMID- 3641652 TI - Vulnerable and valuable: the spouse's role. PMID- 3641653 TI - The rainbow to wellness. PMID- 3641654 TI - [Information systems at the time of choice]. PMID- 3641655 TI - Smokeless tobacco. PMID- 3641657 TI - Helping the hard core smoker. PMID- 3641656 TI - Smokeless tobacco: a northern perspective. PMID- 3641658 TI - Rehabilitation following a Van Nes rotation arthroplasty. PMID- 3641659 TI - [From ethics to bioethics: a nursing perspective]. PMID- 3641660 TI - [I stopped smoking without suffering. Interview by France Metivier]. PMID- 3641661 TI - Terminology issues in nursing diagnosis: focus on cardiovascular nursing. PMID- 3641662 TI - The congruence between in-labor and postpartum self-report of parturition pain as measured by the McGill Pain Questionnaire. PMID- 3641663 TI - Sexuality expectations and outcomes in women having hysterectomies. PMID- 3641664 TI - Studies on lincosamide antibiotic resistance in methicillin-susceptible and resistant staphylococci. AB - Lincomycin and clindamycin are still effective against anaerobic bacteria, and their antibacterial activity has also been indicated against gram-positive aerobic cocci, chiefly Staphylococcus aureus. The present emergency due to epidemiological circulation of Staphylococci, especially coagulase-negative, methicillin-resistant, and the question of the current validity of the lincosamides, induced us to study the activity of lincomycin and clindamycin against staphylococci belonging to different lyogroups in comparison to erythromycin. Clindamycin showed good antibacterial activity while methicillan resistant strains showed an increase in resistance to erythromycin and lincomycin. PMID- 3641666 TI - [Advances in nursing care in microsurgery]. PMID- 3641665 TI - [Nursing practice in America]. PMID- 3641667 TI - [Training of nursing personnel to enhance the quality of the nursing team]. PMID- 3641668 TI - [Monitoring of patients with arrhythmia after heart surgery]. PMID- 3641669 TI - [Monitoring of patients with 3d degree AV-block after operations on heart ventricular septal defects]. PMID- 3641670 TI - [Changes in body temperature in patients with hyperthyroidism]. PMID- 3641671 TI - [Patients without a nasogastric tube after esophago-gastrostomy]. PMID- 3641672 TI - [Accidents and risks in trans-urethral electric cauterization]. PMID- 3641673 TI - [Nursing care of patients treated with medication administered through the internal carotid artery]. PMID- 3641674 TI - [Resin hemoperfusion in the treatment of severe hypnotic intoxication]. PMID- 3641675 TI - [Clinical significance of observations on changes in the pupils]. PMID- 3641676 TI - [Report on U.S. research in nursing education]. PMID- 3641677 TI - The role of the nursing service administrator in nursing personnel administration in hospitals. PMID- 3641679 TI - Priority areas for nursing research. PMID- 3641678 TI - [Student counseling]. PMID- 3641680 TI - Accompaniment of students by nurse teachers--a brief didactic study. PMID- 3641681 TI - Implications of the education system for Blacks in nursing education. PMID- 3641682 TI - [A study is needed of the service parameters and training needs of auxiliary hospital personnel]. PMID- 3641683 TI - Casting light on nurses: their opinions of the South African Nursing Association and their morale. PMID- 3641684 TI - [Are Community Nursing Services justified for the person with a cleft facial deformity?]. PMID- 3641685 TI - Today's nursing for tomorrow's health. PMID- 3641686 TI - [The picture of the nurse in television dramas]. PMID- 3641687 TI - Evaluation tools and techniques: the development of a structured critical factor assessment tool at Carinus Nursing College. PMID- 3641688 TI - [Profile of the white student nurse in Transvaal nursing schools]. PMID- 3641689 TI - An alternative programme for nursing administration practica offered by the Department of Nursing Science, University of South Africa. PMID- 3641690 TI - Obstetrical services in South Africa. PMID- 3641691 TI - Perceptions of health and illness, and related practices among the urban black population of Mangaung (Bloemfontein). PMID- 3641692 TI - Criticism and the growth of nursing science. PMID- 3641694 TI - Effect of nephritic factor on C3 and on the terminal pathway of complement in vivo and in vitro. AB - Plasma samples from patients with nephritic factor (NeF) were examined for their C3 converting activity. C3, C3dg, C5 and the fluid phase terminal complement complex (TCC) were quantified. All patients had evidence of C3 activation with low plasma C3 and high C3dg. Some patients had normal C5 and normal TCC levels, and thus no evidence of terminal pathway activation in vivo; others, with slower C3 conversion in vitro, had low C5 levels with TCC either elevated or in the upper normal range, suggesting in vivo activation of the terminal pathway. These observations were confirmed by in vitro experiments using purified NeFs. It is concluded that considerable activation of C3 may occur in vivo without a simultaneous activation of the terminal pathway, and that NeF is heterogeneous with regard to its ability to activate complement. PMID- 3641693 TI - A comparison of the effects of danazol and gestrinone on testosterone binding to sex hormone binding globulin in vitro and in vivo. AB - Danazol and gestrinone are both effective agents in the treatment of endometriosis. Their mechanism of action is unknown but may be related to their androgenic activity, which is at least partly dependent on increases in the proportion of testosterone which circulates unbound to plasma protein. We have quantified these increases in patients on treatment, and by experimentation in vitro have demonstrated the relative importance of the reduction of sex hormone binding globulin (SHBG) binding capacity and competition with testosterone for SHBG binding sites by the drugs and some of their metabolites. The mean SHBG binding capacity in patients treated with danazol (400 mg/d, n = 7) and gestrinone (5 mg/week, n = 7) fell from 66.9 and 56.4 nmol/l to 36.1 and 28.1 nmol/l, after 1 week's treatment and to 11.1 and 7.1 nmol/l after 4 weeks respectively. Despite the similarity between the falls in SHBG binding capacity there was a significantly greater increase in % free testosterone in plasma samples from patients treated with danazol than in those from patients treated with gestrinone at 1 week. Experiments in vitro suggest that this was largely due to ethisterone (a major metabolite of danazol) competing with testosterone for SHBG binding sites. After 4 weeks on treatment there was a similar, near maximal reduction in SHBG binding of testosterone in both treatment groups. At the low levels of SHBG binding capacity reached by this time the extra effect of any competition for binding sites was much reduced. PMID- 3641696 TI - Survival guide for deans and faculty. PMID- 3641695 TI - C3 nephritic factor (C3NeF): dissociation of cell-bound and fluid phase stabilization of alternative pathway C3 convertase. AB - Fluid phase C3 conversion by C3 nephritic factor (C3NeF) is usually easily detectable and forms the basis of the C3NeF screening test. We have described a group of patients with membranoproliferative glomerulonephritis or partial lipodystrophy and hypocomplementaemia who have an unusual C3NeF which stabilizes cell-bound C3 convertase of the alternative pathway (C3bBb) but causes such weak fluid phase C3 conversion that a C3NeF screening test is negative. These patients have low concentrations of C5 in serum. PMID- 3641697 TI - Adjunctive and therapeutic progestins in endometrial cancer. AB - With the arrival of progestin therapy for advanced, metastatic and recurrent endometrial cancer a quarter of a century ago, came the discovery that approximately one-third of all these tumors would show a clinical response. Probably no more than half of this group will survive more than 5 years. Identification of the type of patient who is most likely to respond has proven difficult. Both clinical and histopathological characteristics act only as an unreliable guide. The site of metastasis and the time for a recurrence to appear are the most constant of these factors. It is hoped that the steroid receptor content of the tumor will prove to be as valuable as it has been in the case of breast cancer. At the moment this is under investigation with numerous ongoing studies. Type, dosage and mode of administration of progestin do not appear to be critical factors in tumor response, nor does the type of synthetic agent used. However, medroxyprogesterone has been the subject of numerous symposia and is the best researched. It also offers the opportunity of being administered orally and in large doses. All agents are virtually free of toxic effects and cessation on this basis is unusual. For patients with tumors that either do not respond to progestin, or else have a temporary response, other agents--antiestrogens and cytotoxic--may well prove to be of value either simultaneously or sequentially. These possibilities are under current investigation. The definitive therapy of primary 'nonadvanced' disease is not established and is at this point unproven in any significant published randomized study. Orthodox proven methods of treatment, i.e. surgery and irradiation, must form the initial component in every patient's therapy, whatever the stage of the disease. It is hoped that prospective studies will elucidate the place of progestins in an adjunctive primary setting. However, it must be emphasized that such studies must concentrate on 'high-risk' patients. The probability of proof in any group of 'good prognosis' patients--whatever the numbers entered--appears to be very low. PMID- 3641699 TI - Primary health care: a nursing voice. PMID- 3641698 TI - The acquired immune deficiency syndrome--1985. PMID- 3641700 TI - Inner city care: French connection. PMID- 3641701 TI - Nutrition: get fit, stay slim. PMID- 3641702 TI - The superfamily myth. PMID- 3641703 TI - Oxygen transport. PMID- 3641705 TI - Sexual counseling of the patient following myocardial infarction (continuing education credit). PMID- 3641704 TI - Amiodarone. PMID- 3641706 TI - Arab-Americans' perceptions of and responses to pain. PMID- 3641707 TI - Assessment of coping strategies of ICU nurses in response to stress. PMID- 3641708 TI - Nurses' assumptions about patients' perceived needs in the PACU. PMID- 3641709 TI - Holiday blues: theirs and ours. PMID- 3641710 TI - Sleep-disordered breathing: a common problem in chronic obstructive pulmonary disease. PMID- 3641711 TI - Tension pyothorax and acute empyema. PMID- 3641712 TI - Cross-training programs in critical care. PMID- 3641713 TI - Lemon-glycerine swabs should be used for routine oral care. PMID- 3641714 TI - Alerting an infant in a brightly lit room. PMID- 3641715 TI - Management of oral and genital herpes simplex virus infections: diagnosis and treatment. PMID- 3641716 TI - [Elastin diseases of the skin]. PMID- 3641718 TI - Tetracycline can inhibit tRNA binding to the ribosomal P site as well as to the A site. AB - A and P sites of Escherichia coli ribosomes were titrated with AcPhe-tRNAPhe, in the absence or presence of tetracycline. The P-site location of the bound AcPhe tRNA was assessed by means of a quantitative puromycin reaction. The results demonstrate that, in agreement with the generally held view, tetracycline exclusively inhibits the A-site binding, if the statistical number of bound acyl tRNA molecules per ribosome does not exceed about 0.5. However, above this value the P site becomes sensitive to tetracycline as well. It follows that the tightly coupled 70S ribosomes used in functional studies appear to be functionally heterogeneous, i.e. those P sites which cannot be affected by tetracycline are preferentially occupied by AcPhe-tRNA, whereas higher concentrations of this tRNA species are required to fill tetracycline-sensitive P sites. Furthermore, the results imply that under tRNA saturation conditions the tetracycline inhibition cannot be used as an indicator for the site location of bound tRNA. PMID- 3641719 TI - Scanning electron microscopy of epithelial lesions induced by artificial ventilation of the immature neonatal lung; the prophylactic effect of surfactant replacement. AB - Immature newborn rabbits, delivered on day 27 of gestation were ventilated artificially for 5-10 min with a peak insufflation pressure of about 35 cm H2O, with or without previous treatment with natural surfactant via the airways. The alveolar expansion pattern and the surface structure of the airways were then examined by scanning and transmission electron microscopy. Animals not receiving surfactant had very irregular alveolar expansion and showed prominent desquamation of the bronchiolar epithelium with a strikingly ragged appearance of the mucosa in the scanning electron microscopic images. Litter mates treated with surfactant had improved alveolar expansion and a flattened but otherwise nearly intact bronchiolar epithelium. The findings confirm the beneficial effect of surfactant replacement on the immature neonatal lung. PMID- 3641720 TI - [Allergic diseases in children]. PMID- 3641717 TI - Characterization of the elongation factors from calf brain. 2. Functional properties of EF-1 alpha, the action of physiological ligands and kirromycin. AB - The properties of EF-1 alpha from calf brain have been investigated and compared with those of EF-Tu. EF-1 alpha binds GDP and GTP in a 1:1 stoichiometry, showing the same affinity for both nucleotides (K'd = 2-4 microM). EF-1 beta strongly enhances the dissociation rate of the EF-1 alpha X GDP complex and to a lesser extent of the EF-1 alpha X GTP complex. Aminoacyl-tRNA (aa-tRNA) stabilized EF-1 alpha X GTP much less efficiently than the EF-Tu X GTP complex. Unlike EF-Tu, EF 1 alpha sustains the binding of aa-tRNA to the ribosome also in the presence of GDP or in the absence of any nucleotide, though to a lesser degree than with GTP. Kirromycin enhances the dissociation rate of both EF-1 alpha X GTP and EF-1 alpha X GDP but especially that of the latter. This effect results in an increase of the exchange rate of the EF-1 alpha-bound nucleotide with free nucleotides. Although in this regard the effect of kirromycin mimics that of EF-1 beta, the antibiotic is incapable of increasing the EF-1 alpha X GDP/GTP exchange rate when aa-tRNA and ribosomes are present. Therefore, unlike EF-1 beta, kirromycin cannot enhance the rate of poly(Phe) synthesis. On the other hand, the failure of kirromycin to induce a GTP-like conformation of EF-1 alpha X GDP, as in the case of EF-Tu X GDP, explains its inability to inhibit peptide bond formation in the eukaryotic system. PMID- 3641721 TI - [Hypothalamic syndrome]. PMID- 3641723 TI - [Neurocirculatory dystonia]. PMID- 3641722 TI - [Inflammatory diseases of the salivary glands]. PMID- 3641724 TI - [Blepharitis]. PMID- 3641725 TI - [Etiology, pathogenesis and clinical aspects of myopia]. PMID- 3641726 TI - [Acute alcoholic intoxication]. PMID- 3641727 TI - [Health education work of the drug abuse offices in industrial enterprises]. PMID- 3641728 TI - [Primary medical and health care and health protection for the rural population in countries of the Middle East]. PMID- 3641730 TI - [Prevention of diseases in the workers in poultry plants]. PMID- 3641729 TI - [Organizational work of an instructor in health education]. PMID- 3641731 TI - [Anatomically and clinically narrow pelvis, cesarean section]. PMID- 3641732 TI - [Spontaneous pneumothorax]. PMID- 3641733 TI - [Suspected cancer of the corpus uteri]. PMID- 3641734 TI - [Acute and chronic nonspecific lymphadenitis in children]. PMID- 3641735 TI - [Prevention of occupational diseases in women engaged in animal husbandry and poultry raising]. PMID- 3641736 TI - [Ascariasis]. PMID- 3641737 TI - [Traumatic injuries to the growth areas of the extremities in children]. PMID- 3641738 TI - [Characteristics of the nursing care of newborn infants delivered by cesarean section]. PMID- 3641739 TI - [Diseases of the lymphatic vessels in children (lymphangioma, hemolymphangioma, lymphangitis)]. PMID- 3641740 TI - [Epidemiology and prevention of staphylococcal diseases]. PMID- 3641741 TI - [Treatment of osteoarthritis deformans]. PMID- 3641742 TI - [Effect of smoking on the cardiovascular system]. PMID- 3641743 TI - [Urological diseases in chronic alcoholism]. PMID- 3641744 TI - [Each woman should know about the hazards of abortion]. PMID- 3641745 TI - [New forms of sanitary work]. PMID- 3641746 TI - [Cosmetics and medicinal plants]. PMID- 3641747 TI - [Combined toxicosis in pregnant women (nephropathy against a background of pyelonephritis)]. PMID- 3641748 TI - [Preinfarct state]. PMID- 3641749 TI - [Premature sexual development]. PMID- 3641750 TI - [Sodoku and Haverhill fever]. PMID- 3641751 TI - Caught in the middle--practice and ethical issues. PMID- 3641752 TI - The stress-carative model of nursing practice. A contemporary holistic health modality for critical care nursing practice. PMID- 3641753 TI - Challenging concerns for patients with Automatic Implantable Cardioverter Defibrillators. PMID- 3641754 TI - Retrograde medication administration--a predictable and simple system for pediatric drug delivery. PMID- 3641755 TI - Professional profile: Carrie Lenburg--changing the complexion of nursing education. PMID- 3641756 TI - Plans underway for a commission on the future of nursing in Florida. PMID- 3641757 TI - Florida's children in sunshine and shadows. PMID- 3641759 TI - ANA update on use of safety seats for children. PMID- 3641758 TI - A nurse's understanding of trials in oncology. PMID- 3641761 TI - Florida school health services: an overview. PMID- 3641760 TI - Culture: a challenge to optimal nursing care. PMID- 3641762 TI - rDNA transcription and pre-rRNA processing during the differentiation of a mouse myoblast cell line. AB - The rates of formation and processing of rRNA and transcription of rDNA were examined during the differentiation of MM14DZ mouse myoblasts into muscle fibers. Analyses of the incorporation of [3H]uridine into 18 and 28 S rRNAs and the UTP precursor pool indicate that the rate of rRNA formation is 2.3-fold higher in myoblasts as compared to muscle fibers. To determine if the rate of rRNA formation is regulated at the level of pre-rRNA processing, the labeling kinetics and steady state levels of pre-rRNAs were measured in myoblasts and fibers. These experiments suggest that the time required for and the efficiency of pre-rRNA processing are the same in myoblasts and fibers, but that the steady state levels of all pre-rRNAs detected (32, 34, 37, 41, and three 45 S subspecies) are reduced 2.5- to 3.0-fold in fibers. This suggests that the reduced rate of rRNA formation in fibers is not regulated at the level of pre-rRNA processing but is due to a decrease in the rate of rDNA transcription. The transcriptional rates for rRNA in myoblasts and fibers were calculated from measurements of the total rate of transcription and from hybridization analyses of radioactive rRNA formed in isolated nuclei or in short pulses of cultured cells. These experiments indicate that the rates of 18 and 28 S rDNA and 5 S rDNA transcription are reduced 2.5 to 3.0-fold in fibers. Thus, a coordinate change in the rate of rDNA transcription is the primary mechanism regulating the formation of rRNA during the differentiation of this myoblast line. This decreased transcription in fibers appears to be due to modulation of the activity of the known mouse rDNA promoter, as S1 nuclease mapping experiments indicate that rDNA transcription initiates at the same location in both myoblasts and fibers. PMID- 3641763 TI - Preventing excess disability in patients with Alzheimer's disease. PMID- 3641764 TI - Restlessness: a disturbance in rhythmicity. PMID- 3641765 TI - The magic of Mandrake. PMID- 3641766 TI - Carers learn to cope. PMID- 3641767 TI - The growth of a senior group. PMID- 3641768 TI - Chinese and Hispanic elders and OTC drugs. PMID- 3641769 TI - Bridging the cultural gap between residents and staff. PMID- 3641770 TI - Let the feast begin ... with caution. PMID- 3641771 TI - Is tampering detectable? PMID- 3641772 TI - Frontier nurses brave wilderness to reach rural Kentucky patients. PMID- 3641773 TI - A story about my life. To my children and friends for their benefit. PMID- 3641774 TI - Genetic variants of factor B in a population of Jordan. AB - BF phenotyping was performed in a population of Jordan. The observed allele frequencies were as follows: BF*S = 0.5457, BF*F = 0.3744, BF*SO7 = 0.0763, BF*F1 = 0.0075. These values are in agreement with the geographic position and the ethnic composition of Jordan. PMID- 3641775 TI - Critical analysis of NANDA nursing diagnosis taxonomy I. PMID- 3641776 TI - Women's experiences of infertility. PMID- 3641778 TI - Authorship: yours, mine, or ours? PMID- 3641779 TI - The effect of didactic teaching on spiritual attitudes. PMID- 3641777 TI - Understanding patients' agendas. PMID- 3641780 TI - Chronic fatigue. PMID- 3641781 TI - Family study and nursing research. PMID- 3641782 TI - The day I felt most like a nurse. PMID- 3641783 TI - Worried about boards? 10 tips for success. PMID- 3641784 TI - Countdown to your career. PMID- 3641785 TI - Orthovanadate inhibition of rat epididymal neutral alpha-mannosidase isoenzymes. PMID- 3641786 TI - Failure of guinea pig plasma kallikrein to cause neutrophil migration. AB - Guinea pig plasma kallikrein was apparently chemotactic for guinea pig neutrophils when assayed in Boyden's chamber. However, it was concluded that this phenomenon was artificial due to the following reasons: Kallikrein was only chemotactic in the presence of bovine serum albumin (BSA) in the chamber but not when BSA was substituted by guinea pig serum albumin or egg albumin. Kallikrein injection failed to cause dermal tissue leukocytosis. Kallikrein did not polarize neutrophils. A chemoattractant(s) seemed to be generated from BSA preparation time dependently. Although this generation required the enzymatic activity of kallikrein, the chemotactic activity once generated was resistant to a kallikrein inhibitor (diisopropylfluorophosphate) and antiprekallikrein antibody. PMID- 3641789 TI - Nosocomial dermatophytosis caused by Microsporum canis in a newborn department. AB - Seven nurses working in a newborn unit were infested by Microsporum canis, involving the skin of the left forearm. One infant who was treated in the same unit suffered from a similar lesion on the occipital region. Transmission during bottle feeding was suspected. After the introduction of long sleeves for all nurses, no further cases occurred. Data collected on the nurses in the unit suggested that infection correlated with direct exposure to infants. PMID- 3641787 TI - Fosfomycin-ampicillin versus gentamicin-ampicillin in the treatment of critically ill patients with pneumonia. AB - Thirty-two patients with severe pneumonia (22 on assisted ventilation) were entered into a prospective randomised trial, in which fosfomycin plus ampicillin (17 patients) was compared with gentamicin plus ampicillin (15 patients). Treatment was either 4 g fosfomycin or 80 mg gentamicin every 8 h and 1 g ampicillin every 6 h. Complete or partial clinical success was attained in 94% (16/17) in the fosfomycin group and in 80% (12/15) in the gentamicin group. Bacteriological success was 87.5% with fosfomycin-ampicillin and 90% with gentamicin-ampicillin. An intermediary sensitive Klebsiella pneumoniae strain developed complete resistance in the fosfomycin group, and an in vitro sensitive Pseudomonas aeruginosa strain was resistant in vivo in the gentamicin group. Two of three patients in the fosfomycin group receiving the infusion through a peripheral vein developed thrombophlebitis. No other side-effects were observed. We conclude that fosfomycin is at least as effective as gentamicin. Since fosfomycin is widely atoxic and may be given in large doses, irrespective of kidney function, it is considered to have advantages over gentamicin in the combined therapy of pneumonia. PMID- 3641788 TI - Management of inflammation: the parametrical system, its practical and methodological position. AB - Since individual cases of inflammation differ one from another, and it is necessary to distinguish between adequate and inadequate inflammatory responses, the proper Management of Inflammation demands the simultaneous assessment of the various component processes. The parameters chosen for such diagnosis should be of broad specificity and show unequivocal and consistent changes wherever the inflammatory response is inadequate. Our long-term studies of carrageenin-induced inflammation in variously conditioned rats have led to a singling out of a set of parameters which satisfy the above three conditions, some fully and some partly: lipid peroxide, proamidase and lysosomal enzymes in exudate, sialoglycoproteins in serum and alkaline phosphatase, elastase in granuloma pouch tissue. Use of this system affords a broad reliable observation of inflammatory processes which an interpretation of isolated components alone could not provide, and determines the position and significance of other components in the inflammatory system. Moreover, it permits the discovery of correlations which would hardly be realized if single mechanisms were considered, and helps to form new hypotheses and to outline fields for further study. PMID- 3641790 TI - High incidence of subclavian dialysis catheter-related bacteremias. AB - This retrospective cohort study reviews the incidence of bacteremia in 48 patients undergoing hemodialysis using subclavian vein dialysis catheters (SDC) as temporary vascular access. Twelve (25%) of these patients had catheter-related bacteremia, and the most frequently isolated organisms were coagulase-negative staphylococci. Three patients developed right-sided endocarditis and one of them died due to pulmonary embolism. The presence of possible risk factors for SDC related bacteremia, including duration of catheterization and number of hemodialysis procedures, were not statistically different when patients with and without bacteremia were compared, with the exception of a significantly lower incidence of bacteremia among those patients receiving antibiotic therapy at the time of catheter insertion. The use of resterilized catheters was not a risk factor. Specific guidelines for SDC insertion and care were established and followed, after which the infection frequency was reduced to 7.5% (1 episode per 45.5 patient-weeks of catheter use) in this high-risk population. PMID- 3641792 TI - Legal and professional responsibilities in the regulation of nursing practice. PMID- 3641791 TI - Withholding fluids and nutrition: identifying the populations at risk. PMID- 3641793 TI - Debate: regulatory vs. professional approaches to continued competence. PMID- 3641794 TI - Continuing competency--regulatory alternatives. PMID- 3641795 TI - A code of practice to protect and promote breast feeding. PMID- 3641796 TI - Effective health visiting for elderly people. PMID- 3641797 TI - A study of the elderly clients of the Beech House General Practice. PMID- 3641798 TI - The needs of retired people. PMID- 3641799 TI - Screening the elderly. PMID- 3641801 TI - Health promotion for the elderly. PMID- 3641800 TI - The value of a preventive care service for the elderly. PMID- 3641802 TI - Screening the elderly: a neglected aspect of health visiting. PMID- 3641803 TI - An ABC of alternative medicine: chiropractic. PMID- 3641804 TI - The experience of unemployment and its effects on family life. PMID- 3641805 TI - HVA code of practice for health visitors in relation to the international code of marketing of breastmilk substitutes. PMID- 3641806 TI - Homelessness from a health visitor's viewpoint. PMID- 3641808 TI - Health visiting homeless families. PMID- 3641807 TI - An approach to the neighbourhood study. PMID- 3641810 TI - Preparation for retirement. PMID- 3641809 TI - The health of pre-school children and the response to illness of single-parent families. PMID- 3641811 TI - Health visitors and homeless families. PMID- 3641812 TI - Do immunisation defaulters know enough about immunisation? PMID- 3641813 TI - Travelling families in Northumberland. PMID- 3641814 TI - An ABC of alternative medicine. Healing. PMID- 3641816 TI - What do school nurses do? PMID- 3641815 TI - Case study of Helen and Clare. PMID- 3641817 TI - Brush and comb won't let them roam. PMID- 3641818 TI - Effect of chest tube management on drainage after cardiac surgery. PMID- 3641819 TI - Research-based practice: the need for, use, and reporting of instrument reliability and validity. PMID- 3641820 TI - Ethical issues in critical care. Voluntariness. PMID- 3641821 TI - Problem solving for complications with the AICD. PMID- 3641822 TI - Comparative evaluation of intravenous therapy regulating devices. PMID- 3641823 TI - Coagulation studies and the indwelling heparinized catheter. PMID- 3641824 TI - Effect of progressive muscle relaxation on the objective symptoms and subjective responses associated with asthma. AB - Our findings suggest that PMR can increase an asthmatic's ability to cope with asthma, by enabling him or her to exert greater control over the symptoms associated with the disease. Findings of this study also offer insight into patient responses and give direction to the approaches needed in the individual treatment and education of asthmatics. Findings of this study also suggest that proper patient selection may be of importance when using self-management or behavior modification techniques in asthma. Maximum profit from future use of PMR in the behavioral treatment of asthma might be achieved by identifying patients who are characterized as moderate or high in panic-fear. They will receive the greatest benefit from this treatment modality. PMID- 3641825 TI - Treatment of tuberculosis in a nurse-managed clinic. AB - From July 1982 to January 1986, we saw 86 patients in the tuberculosis clinic; 77 (90%) were alcoholics; all were males, 71 (83%) were black, 14 (16%) were white, and one (1%) was hispanic. Of these, 10 patients (12%) failed to complete therapy and were referred to the Chicago Board of Health. Nine patients (10%) were dropped from the clinic: three moved from the state of Illinois, three died of nontuberculosis causes, and three were transferred to the Chest Clinic for other medical problems. Therefore, 67 patients (78%) successfully completed therapy. Our high rate of success is attributed to constant, high-intensity contact and consistent supervision of these potentially noncompliant patients. PMID- 3641826 TI - Differences in postsuctioning arterial blood oxygen concentration values using two postoxygenation methods. PMID- 3641827 TI - A clinical evaluation of an oxygen insufflation/suction catheter. PMID- 3641828 TI - Successful medical management of esophagopericardial fistula. AB - Esophagopericardial fistula is a rare condition, usually presenting with cardiac tamponade, and is invariably fatal in the adult patient. In our patient the disorder resulted from fistulization secondary to a malignant tumor. Immediate decompression of resultant tense pneumopericardium can be accomplished safely through percutaneous pericardiocentesis without the need for surgery. Rarely, as in the present case, spontaneous closure of esophagopericardial fistula is encountered. PMID- 3641829 TI - Complete atrioventricular block with a 22-month history of ocular sarcoidosis: a case report. AB - A 52-year-old woman with acute uveitis associated with ocular sarcoidosis developed complete atrioventricular block 22 months after the initial diagnosis was made. Cardiac sarcoidosis is a serious and, not infrequently, a fatal disease. Although it is difficult to establish the clinical diagnosis of cardiac sarcoidosis, a serial ECG is considered necessary in patients with any kind of sarcoidosis. PMID- 3641830 TI - The coping responses of female spouses of patients with myocardial infarction. PMID- 3641831 TI - Effect of an education-orientation program on family members who visit their significant other in the intensive care unit. AB - An education-orientation program given to family members may be an effective initial intervention technique for alleviating familial stress. The findings suggest that the intervention program had a positive effect on the experimental group. A comprehensive, ongoing program is needed to ensure that each family is given the attention they require to promote and maintain family function and integrity during the hospitalization crisis. Future research is needed to identify stressors perceived by family members and to identify effective nursing interventions that would decrease familial stress and promote and maintain the family integrity during the hospitalization crisis. Future research should be time-sequenced to examine the effect of an intervention program as initial coping mechanisms begin to diminish. Finally, research is needed to determine whether family intervention alleviates stress in the stricken family member. PMID- 3641832 TI - [Asphyxia in newborn infants--zinc treatment during pregnancy. 1-year study in Soderhamm's health district]. PMID- 3641833 TI - [Delivery of primipari under the influence of epidural analgesia; need for labor stimulation]. PMID- 3641834 TI - [Study trip to Denmark 1986]. PMID- 3641835 TI - [Social Welfare Department's general advice on prevention, diagnosis and treatment of eye infections in newborn infants]. PMID- 3641836 TI - [Together and separate in the same hour]. PMID- 3641837 TI - Battered women: why do they stay? PMID- 3641838 TI - Dimensions of health in violent families. PMID- 3641840 TI - Sophie's choice: a metaphor for infertility. PMID- 3641839 TI - Nurses' and physicians' attitudes about women abuse: the effects of gender and professional role. PMID- 3641842 TI - Sacred cows in nursing. PMID- 3641841 TI - Femininity, image, feminism and a decision to seek treatment in obese women. PMID- 3641843 TI - Nursing theory: evolution of a sacred cow. PMID- 3641844 TI - Nursing process: musings on the method. PMID- 3641845 TI - Nurses' work: the sacred and the profane. PMID- 3641847 TI - Professional loyalties. PMID- 3641846 TI - Advocacy in nursing: perils and possibilities. PMID- 3641848 TI - Nursing research: sacred cow or fatted calf? PMID- 3641849 TI - Performance of four slide agglutination methods for identification of Staphylococcus aureus when testing methicillin-resistant staphylococci. AB - Four commercially available slide agglutination systems for identifying Staphylococcus aureus were compared with the conventional slide (clumping factor) and tube coagulase tests. The systems evaluated included Bacto Staph Latex (Difco Laboratories, Detroit, Mich.), Staphyloslide (BBL Microbiology Systems, Cockeysville, Md.), Mini ID Accu-Staph (Carr-Scarborough Microbiologicals, Inc., Decatur, Ga.), and Staphaurex (Wellcome Diagnostics, Research Triangle Park, N.C.). A total of 338 clinical isolates, including methicillin-resistant S. aureus (n = 149), methicillin-susceptible S. aureus (n = 78), methicillin resistant, coagulase-negative staphylococci (n = 45), and methicillin susceptible, coagulase-negative staphylococci (n = 66), were tested by each method. The slide test for clumping factor, the 4-h tube coagulase test, Bacto Staph Latex, Staphyloslide, Mini ID Accu-Staph, and Staphaurex detected 212 (93.4%), 218 (96%), 223 (98.2%), 223 (98.2%), 221 (97.4%), and 224 (98.7%) of the S. aureus (44% methicillin-resistant) isolates, respectively. There were no false positive results with any of the methods when the 111 strains of coagulase negative staphylococci were tested. The results of this evaluation suggest that the four slide identification methods tested can provide rapid and accurate identification of methicillin-resistant S. aureus strains. PMID- 3641850 TI - Welcome proposals for a revolution in the education and training of British nurses, midwives and health visitors. PMID- 3641851 TI - The experience of suffering: conceptual clarification and theoretical definition. AB - This paper is concerned with the phenomenon of human suffering and is an attempt to justify and begin theoretical development of this phenomenon for nursing science. The paper is divided into three sections. The first section describes the interest of nursing science in the phenomenon and critically examines relevant literature in order to further conceptualize development and clarification. This section concludes with a theoretical definition of suffering derived from this critique. Suffering is defined as an individual's experience of threat to self and is a meaning given to events such as pain or loss. The second section elaborates on this definition and examines how it can inform theoretical discussion in two areas with import for nursing--the patient's experience of suffering and the nurse's experience of patient suffering. The final section briefly considers some implications for clinical research. PMID- 3641852 TI - Burnout and professional depression: related concepts? AB - In 1978 Oswin documented a process of 'professional depression' affecting some nursing staff in long-stay hospitals. This study tested the hypothesis that 'professional depression' in long-stay nursing and 'emotional exhaustion' as a component of burnout describe a similar phenomenon. This hypothesis was supported. The results are consistent with Cherniss' characterization of burnout, which appears to show considerable similarities to the concept of depression. In this study professional depression demonstrated a substantial correlation with depressed mood. Personality demonstrated significant relationships with burnout variables, extrapunitive hostility correlating with hardening toward others, intropunitiveness with avoidance as a coping response. These findings, although confined to hospital nurses, support the usefulness of approaches stressing the interaction between the work environment and the individual. PMID- 3641853 TI - The human needs model of nursing. AB - Nurses in the United Kingdom spend much time attempting to fit British nursing practice into the theoretical framework of American nursing models. This is often a manipulative process in that it seeks to establish positive links with a care delivery system totally unlike our own. In the present paper the authors detail the process of establishing a new nursing model which integrates nursing curricula, education and practice to meet the needs of patients, staff and students within their own health district. An over-emphasis on lower levels of human need is common within nursing practice, which, although often blamed upon lack of human and financial resources, is also due to practitioners' misconceptions. The latter are invariably the result of a lack of an adequate or overt, practice orientated, conceptual framework. The Human Needs Model of Nursing adapts Maslow's concept of human needs to create such a conceptual framework for practice. It places equal emphasis on those patient problems which arise as the result of unmet needs at higher levels as well as those at lower levels, thereby acknowledging the holistic and dynamic nature of man. PMID- 3641854 TI - Health care students' attitudes towards, and intention to work with, patients suffering from senile dementia. AB - Health care students' attitudes towards and intention to care for patients suffering from senile dementia were measured by questionnaire during the last week of their education. The relationship between curriculum content and attitudes and other variables which affect student training is discussed. It was noted that education on dementia lagged behind the needs of students. Factorial analysis of the respondents' answers on the attitudinal items indicates generally negative attitudes to demented patients. Few female, and none of the male, students stated an intention to work with demented patients. Fear of death and experiences of patients dying are described, and are seen as crucial factors in the care of demented patients. PMID- 3641855 TI - Is a science of caring possible? AB - After some exploration of caring as a socio-historical construct, the author examines the changing conception of caring in nursing between Florence Nightingale's day and our own. The place of the older and emergent meanings in the work of some of the recognized nursing theorists is critically examined. A distinction is drawn between a science for caring and a science of caring and some of the problems of conceptualizing and developing a science of caring are explored. It is argued that a science of caring may need to take a hermeneutical form, as, for example, in the work of Patricia Benner. The recognition of nursing skills, knowledge and values as exemplified in nursing caring is linked to the broader struggle for recognition of the ways in which women function intelligently in the world, as thinking, as well as feeling, beings. A link is thus made between nursing's attempts to establish itself as an academic discipline and the academic arm of the feminist movement, particularly where it insists that women's traditional knowledge and concerns be taken as seriously as those of men. PMID- 3641856 TI - Curriculum models: product versus process. AB - At the beginning of this article there is a brief outline of the nature of the curriculum and models. This leads into a discussion of curriculum models in which 'product' and 'process' models are set out and discussed. The strengths and weaknesses of both approaches to the curriculum are outlined and issues relating to the choice of model are advanced. PMID- 3641857 TI - Numerical measures of integration. AB - In a previous article the authors showed how, by following the clinical careers of individual student nurses, one could paint a coherent and illuminating picture of opportunities for clinical learning on the wards. By observing and counting, and using only the simplest methods of calculation, numerical measures of comparison were constructed. Here the authors turn to the question of the integration of classroom and ward. Indices of integration between theory and practice were devised and computed for three sets of students in three different training schools (72 students in all). The results were used to answer the following questions. Within each training school what was the degree of equality of educational opportunity? For each hospital what is the maximum level of integration which the organization of training makes possible, and what was the actual level achieved? What is the connection between the achieved levels of integration and the type of training scheme (modular, block, etc)? PMID- 3641858 TI - Implementing faculty practice: a question of human and financial resources. AB - Two issues confronting nursing education are: improving the relationship between nursing service and nursing education, and achieving status as an academic discipline. The concept of faculty practice addresses both of these problems. By definition faculty practice requires demonstration of clinical competence through practice, and scholarly outcomes of practice which satisfy the research requirement of the nursing faculty role. While scholarly practice by nursing faculty members may benefit the nursing service-education relationship, it is a myth that nursing faculty members were more effective teachers prior to nursing education's move into institutions of higher education. While few argue against the need for clinical competence of nursing faculty members for effective teaching, the need to attain educational preparation for effective teaching must not be overlooked. The vast majority of nursing faculty members hold master's degree as their highest earned credential. To establish itself as an equal in academe and to increase teaching effectiveness, nursing education needs faculty prepared at the doctoral level. If nursing faculty members add faculty practice and doctoral study to the standard faculty role requirements of teaching, research and service, chronic overload will result. Nursing faculty members cannot solve all the problems confronting nursing education by continuously increasing their workload. Nursing programmes need to assess their resources and priorities. For all of its merits, faculty practice should not be implemented until a programme has adequate resources to support it. PMID- 3641859 TI - Hospital admission for depression. AB - Fifty depressed patients in a psychiatric unit were asked in an open-ended and a forced-choice question: 'When you're feeling depressed what sorts of things can make you feel worse in hospital and at home?'. The responses were analysed and compared with a study where non-depressed subjects were asked the same question. Implications of the results of this study for the admission of clinically depressed people to hospital are discussed. PMID- 3641860 TI - Preparing for change: an investigation into the attitudes of assessors to ward based assessments as a preliminary to continuing clinical assessments. AB - A sample of ward-based assessors from the Gwynedd School of Nursing demonstrated unfavourable attitudes to the current system of practical examinations as measured by a scale produced by the author. He suggests that this information could be a desirable adjunct to the unhindered introduction of continuing clinical assessment. PMID- 3641861 TI - The changing nature of fatherhood: the nurse and social policy. AB - Fathers, fathering and fatherhood are topics which receive little attention throughout the world's professional literature. Only recently has there been increased interest and research on the changing roles of men with particular emphasis on nurturing and parenting. A body of knowledge has started to accumulate which investigates the role of fathers with their families. The purpose of this article is to summarize the research literature about fatherhood in the United States of America today and to discuss the implications of this research for the practice of nursing. This analysis synthesizes the literature using two different perspectives. The developmental perspective traces the role of fathers from family planning through the family life cycle to grandfatherhood. The social contextual perspective summarizes the literature related to fathers for three common variations in society today: single custodial fathers, fathers in dual earner families, and adolescent fathers. Lastly, implications for nursing practice and social policy are discussed. PMID- 3641862 TI - Sickle cell disease: implications for nursing care. AB - Abnormal haemoglobins produce a variety of anaemias which range in effect from being very mild to lethal. The most common of these are the sickle cell disorders and thalassaemias. In London, thalassaemia affects 3.5% of the Maltese population, 2.5% of the Italian population and 1.5% of the West Indian population respectively. Seventeen per cent of the Cypriot population carry a thalassaemia gene. Sickle cell disease occurs in 500:100,000 people in Britain's black population but is not exclusive to people of Afro-Caribbean origin. The gene is carried by 1 in 10 people. Sickle cell disease is statistically more prevalent among the host population than is phenylketonuria (10-12:100,000), hypothyroidism (20:100,000) and cystic fibrosis (62-63:100,000) in the general population. Although these diseases are routinely screened for at birth, there is no general strategy among district health authorities for sickle cell screening. It has been shown that of 76 health districts with a 3+% ethnic minority population, 30 of which have an ethnic minority population of 'over 10%', only 6 have a comprehensive health care policy for people with sickle cell disease. PMID- 3641863 TI - Factors affecting perioperative body temperature. AB - Factors affecting body temperature in the perioperative period were investigated in two groups of surgical patients (cholecystectomy and repair of fractured femur). Core, toe skin and thigh skin temperatures were assessed pre and postoperatively for all subjects. A control group showed a significant fall in toe skin temperature only during exposure to theatre conditions, whereas all of the surgical patients underwent falls in core temperature. The fractured femur patients sustained significantly greater reductions in core temperature than the cholecystectomy patients. Age and ambient theatre temperature were found to be the most influential factors affecting this fall in core temperature. Body composition had less of an influence than these two variables, but it was found that the patients with the greatest body fat contents had the smallest reductions in core temperature. Seven of the 31 patients returned to the ward with core temperatures below 35 degrees C, and only one of these seven received assistance in rewarming. Four of the 31 patients developed significantly higher core temperatures than the remaining 27 during the immediate postoperative period, and these four subsequently developed respiratory tract infections. Standard monitoring of temperature on the wards during the immediate postoperative period failed to identify postoperative hypothermia or pyrexia in the majority of cases. PMID- 3641864 TI - The National Center for Nursing Research. PMID- 3641865 TI - Inappropriate silence. PMID- 3641866 TI - Legal and ethical aspects of informed consent: a nursing research perspective. PMID- 3641867 TI - An exploratory study of schools of nursing that assume patient care responsibilities. PMID- 3641868 TI - Evaluation of the doctor of nursing (ND) program: preliminary findings. PMID- 3641869 TI - Faculty perceptions of organizational climate and expressed job satisfaction in selected baccalaureate schools of nursing. PMID- 3641870 TI - Live as on a mountain--leadership, the great potential. PMID- 3641871 TI - Education for excellent care. PMID- 3641872 TI - Nursing management of the infant requiring respiratory support. PMID- 3641873 TI - Caring touch and anxiety in myocardial infarction patients in the intermediate cardiac care unit. PMID- 3641874 TI - Patients, relatives and nurses in a technological environment. PMID- 3641875 TI - The importance of sleep and the sensory environment to critically ill patients. PMID- 3641877 TI - The Israeli system of training in critical care nursing. PMID- 3641876 TI - The management of acute renal failure in intensive care units. PMID- 3641878 TI - Chimaerism of primordial germ cells in the early postimplantation mouse embryo following microsurgical grafting of posterior primitive streak cells in vitro. AB - A microsurgical grafting technique has been used to introduce primordial germ cell (PGC) precursors into intact primitive-streak-stage mouse embryos in vitro. Operated embryos were cultured for 36-40 h and then analysed by a combined histochemical and autoradiographic method. PGC chimaerism occurred in embryos that received grafts of caudal primitive streak cells but not adjacent embryonic endoderm or anterolateral ectoderm/mesoderm cells. Graft-derived PGCs were found to be migrating through the gut endoderm alongside host-derived PGCs in approximately half of the chimaeric embryos whereas in the other 50% of cases PGCs remained at the site of grafting in association with graft-derived somatic cells. A similar pattern of somatic chimaerism was produced by primitive streak and anterolateral ectoderm/mesoderm grafts: the allantois was colonized predominantly, with, in addition, formation of amnion, surface ectoderm and caudal mesoderm in a few embryos. The majority of embryonic endoderm grafts failed to incorporate into host embryos and formed yolk-sac-like vesicles. The findings of this study indicate that PGCs originate from the embryonic ectoderm via the primitive streak during development of the mouse embryo, and anterolateral ectoderm and mesoderm cells are unable to form PGCs after heterotopic grafting to the posterior primitive streak site. The combined microsurgical and embryo culture methods provide an experimental system for the analysis of PGC development in intact mouse embryos. PMID- 3641879 TI - Phenotypic switching to long cilia effected by various proteases: results with Dendraster excentricus and Stronglyocentrotus purpuratus blastulae. AB - Incubation in trypsin effects a phenotypic switch from short to long cilia (greater than 30 micron) in hatched blastulae of the sea urchin, Arbacia punctulata. To determine how trypsin causes such a switch we tested whether the phenomenon was unique to the species, Arbacia, and to the protease, trypsin. With two other echinoderm species, the sand dollar, Dendraster excentricus, and the sea urchin, Strongylocentrotus purpuratus, trypsin incubation increased the percentage of long cilia. During incubation of D. excentricus in trypsin, the percentage of long cilia increased progressively from the normal 10% long cilia of the apical tuft to 45-50% long cilia covering 1/2-3/4 of the embryo. With S. purpuratus blastulae, however, the percentage of long cilia was lower (32-40%) and the results were more variable. Of the additional proteases tested with D. excentricus, elastase was more effective than trypsin in terms of the percentage of long cilia (58%), the mean length, and the broad distribution of lengths formed. Thermolysin was about as effective as trypsin but chymotrypsin was much less so. Thus, increases in ciliary length were not unique to a particular echinoderm species or to incubation in trypsin. The magnitude of the change in length distribution, however, was species- and enzyme-dependent. An extracellular or membrane component with differential susceptibility to various proteases may, therefore, be involved in altering ciliary length. PMID- 3641880 TI - Documenting nurse-midwifery outcomes. The need for a national database. PMID- 3641881 TI - Hydration in labor--is routine intravenous hydration necessary? PMID- 3641882 TI - Postpartum weight loss in a nurse-midwifery practice. PMID- 3641883 TI - Women's health care and the workplace in the People's Republic of China. PMID- 3641884 TI - Acquired immunodeficiency syndrome. PMID- 3641885 TI - Adverse childbirth outcomes. A midwifery dilemma. PMID- 3641886 TI - Aerobic exercise, maternal self-esteem, and physical discomforts during pregnancy. PMID- 3641887 TI - Teen Pregnancy Service. An interdisciplinary health care delivery system utilizing certified nurse-midwives. PMID- 3641889 TI - Barriers to nurse-midwifery. Is the enemy us? PMID- 3641888 TI - The experience of touch received during labor. Postpartum perceptions of therapeutic value. PMID- 3641890 TI - Analysis of research reports. PMID- 3641891 TI - Transcultural midwifery. Adapting to Hmong birthing customs in California. PMID- 3641892 TI - Peer review in an American College of Nurse-Midwives' local chapter. PMID- 3641893 TI - Early detection of preterm labor: ambulatory home monitoring of uterine activity. AB - Most women who experience preterm labor cannot receive long-term tocolysis mainly because of belated diagnosis. To detect excessive uterine contractions, an ambulatory tocodynamometer was developed. Sixty-two women, at high risk for preterm labor, monitored uterine activity between 20 and 36 weeks' gestation daily for a total of 200 minutes per day. Twenty-nine women (47%) had episodes of preterm labor. All the episodes were diagnosed by the device, and tocolysis was begun. The mean gestational age at which diagnosis was made was 28 +/- 2 (mean +/ SD) weeks, and the mean time gained in utero was 7.5 +/- 2.6 weeks. The data indicate that ambulatory home monitoring may represent a new and effective means for accurate and early diagnosis of preterm labor. PMID- 3641894 TI - Weight gain in pregnancy. AB - The amount of weight that women are advised to gain during pregnancy has changed significantly in the past few decades. In the past, recommendations were aimed at curtailing weight gain because of problems surrounding delivery (i.e., cephalopelvic disproportion or toxemia). More recently, concern for development of maternal obesity has been used to justify curtailed weight gain. Factors that should be considered for determining the appropriate gain for an individual woman are discussed. PMID- 3641895 TI - Expecting in prison: preparing for birth under conditions of stress. AB - When a pregnant woman is separated from her customary support system and placed in a high-stress environment, she experiences concurrent developmental and situational crises. A unique example of this is the incarcerated pregnant woman. A prenatal program developed to decrease the stress of being pregnant in prison is presented. The needs and concerns of the women are described. Nursing strategies are presented, with emphasis on practical interventions. Problems in implementation and ways to alleviate those problems are discussed. PMID- 3641896 TI - More on male nurses. PMID- 3641897 TI - The nipple stimulation contraction stress test. AB - The nipple stimulation contraction stress test is finding increasing favor as an alternative or adjunct to the nonstress test as an assessment of fetal well being. The nipple stimulation contraction stress test has been found to be an effective, convenient alternative to the costly, time-consuming oxytocin challenge test. Current literature and protocols are reviewed to compare effectiveness, predictive value for perinatal outcomes, and current recommendations concerning the safe and effective use of the nipple stimulation contraction stress test for antepartum testing. A protocol provides clear guidelines for antepartum testing with the nipple stimulation contraction stress test. PMID- 3641898 TI - Neonatal circumcision: is it needed? AB - Current changes in attitudes regarding infant circumcision have placed the nurse in a position of being asked for a professional opinion. However, little information concerning the topic is to be found in nursing literature. The pros and cons of circumcision are explored along with descriptions of current methods of circumcision. Also, alternative practices are discussed, as the American Academy of Pediatricians is advocating the demise of routine circumcisions. PMID- 3641899 TI - Discordant microform cleft lip in a dizygotic female twin. AB - Details are given regarding a pair of dizygotic twins, discordant for microform cleft lip. The maternal history is reviewed, indicating three environmental factors as relevant to the origin of the cleft, using the multifactoral threshold model. Nurses are encouraged to survey and report cases concerning microform cleft lip. PMID- 3641900 TI - A comparison of cold and warm sitz baths for relief of postpartum perineal pain. AB - The effect of cold sitz baths for relieving perineal pain in the postpartum period after an episiotomy was evaluated. Forty patients took both cold and warm sitz baths with random assignment of the initial bath. Patients rated the degree of perineal pain before and after each sitz bath and at half-hour and one-hour intervals after each bath. A pain scale using 0-5, 0 representing no pain and 5 representing extreme pain, was used. Analysis of pain scale scores using a two way analysis of variance with replications showed that cold sitz baths were significantly more effective in relieving perineal pain. The greatest amount of pain relief was experienced immediately after the cold sitz baths. PMID- 3641901 TI - Marital support during pregnancy. AB - To describe and compare women's and men's experiences of partner support during pregnancy, a questionnaire that included the Support Behavior Inventory was given to 313 expectant couples in the latter half of pregnancy. Study findings revealed no difference between men and women in the mean partner support satisfaction score. A significant difference occurred in the variability of expectant mothers' and fathers' partner support scores. The specific support behaviors that elicited the greatest satisfaction and dissatisfaction in men and women are described. PMID- 3641902 TI - The influence of selected variables on the experience of menstrual distress in alcoholic and nonalcoholic women. AB - Studies indicate that some alcoholic women relate their drinking to their menstrual cycle. Studies also indicate that the menses can serve as a situational stressor for certain alcoholic women. A study of 100 alcoholic and 100 nonalcoholic women was designed to investigate factors that influence menstrual distress. The factors of age, education, income, occupational status, and menstrual distress were investigated. None of the predictor variables accounted for significant amounts of variance in the criterion variable (menstrual distress). Alcoholic women were found to have a higher degree of menstrual distress than nonalcoholic women. The relationship of race to menstrual distress deserves further investigation. Nursing implications are presented. PMID- 3641903 TI - International family-planning training for nurse practitioners. AB - Since the mid-1970s, the Margaret Sanger Center of Planned Parenthood of New York City has prepared nurses and nurse midwives from less developed countries to be family-planning nurse practitioners. These nurse practitioners then provide services to patients, train other staff, and manage integrated family-planning clinics. More than 120 nurses and nurse midwives have arrived in groups of 10 at the Sanger Center, with 72 attending since 1981. Each course lasts 10 weeks. The core curriculum provides trainees with skills in women's health care including contraception, in training and advocacy, and in management of clinics. Whether, in the current period of scarce resources, cross-cultural training programs of this type remain a worthwhile investment, and if so, which of their components are most important to this success, is assessed. PMID- 3641905 TI - The nurse's legal duty to report changes in patient status. PMID- 3641904 TI - Pulmonary follow-up of moderately low birth weight infants with and without respiratory distress syndrome. AB - Pulmonary function was measured in 18 children aged 6 to 9 years who had been born prematurely (mean birth weight 1760 +/- 555 g) and who had each received greater than 100 hours (mean 177 +/- 74 hours) of mechanical ventilation for respiratory distress syndrome (RDS). We used as controls 26 children aged 6 to 7 years who had been born prematurely (mean birth weight 1636 +/- 554 g) but who had required no treatment for pulmonary disease. Results for total lung capacity, FEV1, ratios of functional residual capacity and residual volume to total lung capacity, specific airway conductance, and alveolar plateau slope did not differ in the RDS and control groups. Eight of the 18 children in the RDS group had had radiologic evidence of bronchopulmonary dysplasia at 30 days and oxygen dependence at 30 days, but did not differ from the control group for any of the indices of pulmonary function. However, FEV1 and specific airway conductance were significantly reduced in the premature control group compared with children born at term. Therefore, factors associated with prematurity rather than combined effects of RDS and its treatment determined pulmonary function at age 6 to 9 years. PMID- 3641906 TI - Care of the burned patient with herpes simplex. PMID- 3641907 TI - Content validity of an instrument to measure young children's perceptions of the intensity of their pain. PMID- 3641908 TI - Case study of a child with meningococcemia. PMID- 3641909 TI - Administrative aspects of pediatric nursing: the child's family. PMID- 3641911 TI - Whose patient is that? PMID- 3641910 TI - The cardiovascular effects of vasopressin after haemorrhage in anaesthetized rats. AB - The cardiovascular effects of an acute haemorrhage (2% of the body weight) were studied over a 60 min period in three groups of rats: (a) Brattleboro rats with hereditary hypothalamic diabetes insipidus (b.d.i.) lacking circulating vasopressin, (b) control rats of the parent Long Evans (l.e.) strain, and (c) l.e. rats treated with an antagonist of the vascular action of vasopressin. Prior to the haemorrhage there were no significant differences between the three groups of rats with respect to mean arterial blood pressure, cardiac output, stroke volume or total peripheral resistance. Following the haemorrhage cardiac output and stroke volume were severely reduced in all three groups of rats. Total peripheral resistance was relatively unaffected in antagonist-treated l.e. rats and b.d.i. rats, but rose substantially in response to the loss of blood in the control l.e. group. Both total peripheral resistance and mean arterial blood pressure were markedly greater in the untreated l.e. control rats than in the other two groups of animals during the first 20 min after haemorrhage. The mean heart rate measured in Brattleboro rats was elevated compared with that of control l.e. rats throughout the experiment and, in addition, significantly greater than that of antagonist-treated l.e. rats during the first 40 min after the haemorrhage. Survival rate for the b.d.i. rats following the 2% haemorrhage was lower than that for l.e. control rats and antagonist-treated l.e. rats. The results indicate that the recovery of the blood pressure following an acute arterial haemorrhage is significantly influenced by vasopressin, particularly during the first 20 min, and that the predominant effect of the hormone is to increase the total peripheral resistance. The higher mortality associated with volume depletion in the b.d.i. rats is unlikely to be directly related to the absence of the vascular action of vasopressin, since administration of the vasopressin antagonist to normal l.e. rats does not reduce their survival rate. PMID- 3641912 TI - Nursing diagnosis and the syndrome of inappropriate antidiuretic hormone. PMID- 3641913 TI - Put some roar in your pediatric program. PMID- 3641914 TI - Post-spinal anesthesia headache and the epidural blood patch. PMID- 3641915 TI - Staffing options in the postanesthesia care unit. PMID- 3641916 TI - Practical points in the postanesthesia assessment and care of the patient undergoing thoracic surgery. PMID- 3641917 TI - Pharmacological intervention for the obstetrical patient in the PACU. PMID- 3641918 TI - PACU vignette: what would you do in this situation? PMID- 3641920 TI - Nurses can be writers, too! PMID- 3641919 TI - Personal computers in the PACU. PMID- 3641923 TI - Disinfection protocol. Health maintenance in an eye clinic. PMID- 3641922 TI - Stereochemistry of binding of the tetrapeptide acetyl-Pro-Ala-Pro-Tyr-NH2 to porcine pancreatic elastase. Combined use of two-dimensional transferred nuclear Overhauser enhancement measurements, restrained molecular dynamics, X-ray crystallography and molecular modelling. AB - A nuclear magnetic resonance study of the conformation of the tetrapeptide acetyl Pro-Ala-Pro-Tyr-NH2 bound to porcine pancreatic elastase is presented. From two dimensional transferred nuclear Overhauser enhancement measurements, a set of 23 approximate distance restraints between pairs of bound ligand protons, indicative of an extended type structure, is derived. The structure of the bound tetrapeptide is then refined from two different starting structures (an extended beta-strand and a polyproline helix) by restrained molecular dynamics, in which the interproton distances are incorporated into the total energy of the system in the form of effective potentials. Convergence to essentially the same average restrained dynamics structures is achieved. The refined structures are then modelled into the active site of elastase by interactive molecular graphics. The determination of the anchor point of the bound tetrapeptide on the enzyme was aided by a simultaneous crystallographic study which, despite the fact that only electron density for a Pro-X dipeptide fragment was visible, enabled both the approximate position and orientation of binding to be determined. It is found that the tetrapeptide is bound in the S' binding site in the reverse orientation found in other serine protease-inhibitor complexes and is stabilized both by hydrogen-bonding and by van der Waals' interactions. PMID- 3641921 TI - Maximum likelihood alignment of DNA sequences. AB - The optimal alignment problem for pairs of molecular sequences under a probabilistic model of evolutionary change is equivalent to the problem of estimating the maximum likelihood time required to transform one sequence to the other. When this time has been estimated, various alignments of high posterior probability may be written down. A simple model with two parameters is presented and a method is described by which the likelihood may be computed. Maximum likelihood estimates for some pairs of tRNA genes illustrate the method and allow us to obtain the best alignments under the model. PMID- 3641924 TI - Model eye for teaching applanation tonometry. PMID- 3641925 TI - Assessment tool for low vision patients. PMID- 3641926 TI - Telephone triage in the ambulatory care setting. PMID- 3641927 TI - Office patient safety. PMID- 3641928 TI - Fluorescein angiogram processing. PMID- 3641929 TI - Tattooing of eyelids: magnetic resonance imaging artifacts. PMID- 3641930 TI - Bifocal contact lenses: are they coming of age? PMID- 3641931 TI - Fetal alcohol syndrome and myasthenia gravis. AB - Alcohol is increasingly being described in the literature as a teratogenic agent producing dysmorphism and multisystem problems. The child described herein demonstrates the occurrence of myasthenia gravis and mitral incompetence with fetal alcohol syndrome. The association of myasthenia gravis in this case is unique, and could be suggestive of an immunological component to this syndrome. PMID- 3641932 TI - [AIDS]. PMID- 3641933 TI - [Clinical diagnosis in obstetrics. 22. Diagnosis of gestational diabetes mellitus]. PMID- 3641934 TI - [Keypoints in maternal health care of working women and the new labor standard]. PMID- 3641935 TI - [Life activities and health education of working expectant mothers]. PMID- 3641936 TI - [Support of working mothers with young infants]. PMID- 3641938 TI - [Experience in breast feeding by working mothers]. PMID- 3641939 TI - [Recommendation of breast feeding (2): Instructions on nursing]. PMID- 3641937 TI - [Assistance in breast feeding by working mothers--elimination of problem in breast feeding by working mothers]. PMID- 3641940 TI - [A practicing midwife in the countryside]. PMID- 3641941 TI - [Questions and answers on breast feeding]. PMID- 3641942 TI - [Perinatal nursing: psychosocial approaches. 7. Worries of mothers following delivery]. PMID- 3641943 TI - [Theories and the use of instruments used in the care of newborn infants]. PMID- 3641944 TI - [Traditions concerning childbirth and child care. 19. The umbilical cord and placenta]. PMID- 3641945 TI - [Changes and overview on midwifery education]. PMID- 3641946 TI - [Progress in monitoring technique during delivery and expectation on nursing]. PMID- 3641947 TI - [Thresholds: tolerance and labor pain]. PMID- 3641948 TI - [Educational evaluation. Research methods (2)]. PMID- 3641949 TI - [Medical social work. Behavior of an adolescent mother]. PMID- 3641950 TI - [The amniotic band]. PMID- 3641951 TI - [Seminar on child care counseling by telephone]. PMID- 3641952 TI - [Recommendation of the use of pessaries for the prevention of unwanted pregnancy by teenagers]. PMID- 3641953 TI - [Traditions concerning childbirth and child care. 20. Bathing of the newborn]. PMID- 3641954 TI - [Questions and answers on breast feeding. Management of excessive milk secretion]. PMID- 3641955 TI - [Nutrition of the newborn]. PMID- 3641956 TI - [Perinatal nursing: a psychosocial approach. 8. The process of the acquisition of maternal attitude by new mothers and their nursing assistance]. PMID- 3641957 TI - [Educational evaluation. Research methods. (3)]. PMID- 3641958 TI - [Medical social services: problems of nuclear families]. PMID- 3641959 TI - [The FAS-TEST (a non-stress test for fetal cardiac monitoring)]. PMID- 3641960 TI - [Clinical examinations in obstetrics. 23. Diagnosis of SLE and thyroid disorders]. PMID- 3641961 TI - [The future of obstetric care]. PMID- 3641962 TI - [Midwifery activities at an obstetric clinic]. PMID- 3641964 TI - [Midwifery practice at a local hospital: a nursing supervisor's reflections on the past 10 years]. PMID- 3641963 TI - [Cooperation between midwives and physicians under the open system in obstetrics]. PMID- 3641965 TI - [Achievement of the health counseling service at a private clinic in the past 12 years]. PMID- 3641966 TI - [A new diagnostic test of cancer: an SCM (structure of cytoplasmic matrix) test]. PMID- 3641967 TI - [The "ideal birth process" envisioned by women: an impression on "the birth process witnessed by husbands" published in the August issue]. PMID- 3641968 TI - [Study on the development and transformation of the maternal attitude. (1): Acquisition of maternal psychology through pregnancy, delivery, and child rearing]. PMID- 3641969 TI - [Family involvement in childbirth: experiences at my clinic]. PMID- 3641970 TI - [Decision making in nursing. 11. The effect of inadequacy of the medical service reflected on patients]. PMID- 3641971 TI - [Roger's nursing theory. 1]. PMID- 3641972 TI - [A husband-wife team in a struggle against cancer: reflection on the past 3 years with my wife]. PMID- 3641974 TI - [A nurse caring for her father with gastric cancer]. PMID- 3641973 TI - [Hope for tomorrow: a life with my husband who suffered from cancer]. PMID- 3641975 TI - [Interview with Mrs. Reiko Wagatsuma on the death of her husband who succumbed to esophageal cancer]. PMID- 3641976 TI - [Notes by a nurse hospitalized as a patient]. PMID- 3641977 TI - [Note on the nursing process for social rehabilitation of patients]. PMID- 3641978 TI - [Apprehension of the patient overlooked in nursing efforts to promote his comfort]. PMID- 3641979 TI - [Self-help groups. Efforts by Mr. Kiyoshi Kuroda who organized a group for people suffering from stuttering]. PMID- 3641980 TI - [Struggle with cancer. 11. The most trying period]. PMID- 3641981 TI - [A monologue by a nursing supervisor. Importance of an occasional diversion away from work]. PMID- 3641982 TI - [Practice of Oriental medicine. 11. Treatment of the "Shoyo" illness]. PMID- 3641983 TI - [Welfare and medical care in the aging society. 3. The home for the aged as a place of living]. PMID- 3641984 TI - [Introduction of POS to nursing. 14. Difficulty in implementing nursing plans]. PMID- 3641985 TI - [Counseling of patients. 22. Practice of the Gestalt therapy: methodology in counseling]. PMID- 3641986 TI - [Nursing homes in New York. 11. Orientation procedures for the residents and nursing staff]. PMID- 3641987 TI - [Decision making in nursing. 12. Distinction between assistance and forcing: rehabilitation nursing to nurture patients' independence]. PMID- 3641989 TI - [Systems dealing with disasters at large hospitals: a description by a nursing manager]. PMID- 3641988 TI - [Nursing theory. 12. Uniqueness of Rogers' theory]. PMID- 3641990 TI - [Fire prevention system organized by nurses: a recommendation by a fire department]. PMID- 3641991 TI - [Disasters at hospitals and associated problems: an experience at the earthquake originating at the sea off the coast of Miyagi Prefecture]. PMID- 3641992 TI - [Use of past experience and constant preparedness against disasters: an experience at the earthquake of the mid Japan Sea Coast]. PMID- 3641993 TI - [No ending in disaster planning: an experience at flooding at Nagasaki]. PMID- 3641994 TI - [Equipment for quick transport of newborn infants during a disaster]. PMID- 3641995 TI - [Protection of patients from news reporters: experience by Tano General Hospital in caring for miraculous survivors of the Japan Airline disaster]. PMID- 3641996 TI - [Bedside nursing. Expansion of thoughts of a schizophrenic patient seen through expressions in short poetry (Tanka)]. PMID- 3641997 TI - [Self-help groups. Parents as members of a therapist team: a partnership between parents and other team members of "Shingonkai"]. PMID- 3641998 TI - [Monologue by a nursing director: difficulties and blessings of the occupation]. PMID- 3641999 TI - [Practice of the Oriental medicine. 12. Treatment of "Yomeibyo"]. PMID- 3642001 TI - [Counselling of patients. 23. Psychosynthesis]. PMID- 3642000 TI - [Welfare and medical care in the aging society. 4. Homes for the aged as a place of living (2)]. PMID- 3642002 TI - [Nursing homes in New York. 12. Leisure activities and the reason for living]. PMID- 3642003 TI - [Profile of a nurse. Mr. Kazumi Suzuki, a considerate male nurse planning improvement in psychiatric nursing]. PMID- 3642005 TI - [Conceptual framework in nursing research]. PMID- 3642004 TI - [About the necessity of a conceptual framework in nursing research]. PMID- 3642006 TI - [The conceptual framework in my research]. PMID- 3642007 TI - [Sensory information, behavioral instructions and coping with sensory alteration surgery]. PMID- 3642008 TI - [Hysterectomy: a study in coping with recovery]. PMID- 3642009 TI - [The elderly coping at home: a study of continuity of nursing care]. PMID- 3642010 TI - [Discussion: the significance of framework in research. Discussion about 3 materials]. PMID- 3642011 TI - [Framing and testing of the questionnaire on "Amea" Network--Part 2]. PMID- 3642013 TI - [The approach to English monographs. Analysis of experimental data]. PMID- 3642012 TI - ["Amea"--dependency and intimacy]. PMID- 3642014 TI - [For beginners of nursing research--discussion on this column for 5 years]. PMID- 3642015 TI - [Lessons from nursing students: turning points in students who lost self confidence and were at a dead end in nursing studies]. PMID- 3642016 TI - [A view on the current basic nursing education and future prospects]. PMID- 3642017 TI - [Nursing education compatible with the area inhabitants in the era of an aging society]. PMID- 3642018 TI - [Impression on receiving new nursing graduates]. PMID- 3642019 TI - [Sophisticated nursing education and training comparable to medical education]. PMID- 3642020 TI - [Characteristics of individual nursing students and instruction on bed making]. PMID- 3642021 TI - [Systematization of nursing education. 2. A theory on the system of nursing education. 1]. PMID- 3642022 TI - [Facilities for the aged in Scandinavia: in search of the definition of aging]. PMID- 3642023 TI - [Objectives in midwifery education: report by Subcommittee, Committee on Midwifery Education, Japanese Council of Midwifery Schools]. PMID- 3642024 TI - [Proposed plan for midwifery education system: 1983 plan by the Japanese Council of Midwifery Schools]. PMID- 3642025 TI - [Revised midwifery curriculum for the Midwifery Department, National Medical Technology College]. PMID- 3642026 TI - [Definition of the position of midwifery education when basic nursing education is upgraded to a 4-year university level]. PMID- 3642027 TI - [Study of nursing technology: evaluation of basic nursing technic. (5). Assistance at mealtime]. PMID- 3642028 TI - [Systematization of nursing education. 4. Theories on the system of nursing education. 3]. PMID- 3642029 TI - [A friend who expressed uselessness of public health nursing: a suggestion by a practicing public health nurse]. PMID- 3642030 TI - [The public health nursing administrator as the key personnel in public health service dealing with the public]. PMID- 3642031 TI - [Maternal and child health services and the public health clinic. 3. Child rearing based on the cultural tradition of the area]. PMID- 3642032 TI - [The life of a public health nurse. Cooperation between area public health nurses and the public health clinic]. PMID- 3642033 TI - [Nursing roots found in public health nursing in the wilderness. 8. In support of the life of the pioneers]. PMID- 3642034 TI - [Assistance in the housing situation (4). The housing conditions threatening maternal and child health: maintenance of minimum essential space and acquisition of social and physical environments]. PMID- 3642035 TI - [Explanation of special focus on specific areas in regional public health nursing planning: a lesson from routine activities (1)]. PMID- 3642036 TI - [Study on the professional and intrinsic qualities of the actions by public health nurses: a study of nocturnal enuresis. 11. Individual factors in the affected children and the attitudes of the mothers]. PMID- 3642037 TI - [Care of patients with refractory diseases--a group of exercises for patients with parkinsonism]. PMID- 3642038 TI - [Public health nursing activities in a mass incidence of pediculosis of the head in children of an isolated village--treatment and prevention]. PMID- 3642039 TI - [Status of patients with refractory diseases in the islands off Tokyo and state of their assistance]. PMID- 3642040 TI - [Aging society and home care of the aged. A conference on patients requiring home care]. PMID- 3642041 TI - [Aging society and home care of the aged. Examples of effective operation of the home care system]. PMID- 3642042 TI - [The home nursing system of the Yokosuka City Government]. PMID- 3642043 TI - [Aging society and home care of the aged. Observation of the aged population through physical rehabilitation programs]. PMID- 3642044 TI - [Conditions of bedridden patients in Yokohama at the initial home visits and description of cases]. PMID- 3642045 TI - [Comments on the 5 reports on home nursing of the aged: a thought on conditions requiring home care]. PMID- 3642046 TI - [Maternal and infant health services and the public health clinic]. PMID- 3642047 TI - [Nursing roots in pioneering public health nursing. The prisoners who engaged in the reclamation of the wilderness of Hokkaido]. PMID- 3642048 TI - [The significance in focusing public health nursing effort to a certain area. A lesson in routine activities (11)]. PMID- 3642049 TI - [Cardiac symptoms of newborn and young infants: keypoints in detecting congenital heart defects]. PMID- 3642050 TI - [Specialty and uniqueness of nursing by public health nurses. On a study of enuresis. 11. Relationship among enuresis, life environment, and past history of family members]. PMID- 3642051 TI - [On review of the literature on public health nursing activities. On the postwar achievements of public health nurses]. PMID- 3642052 TI - [Anxiety of the aged and their environment]. PMID- 3642053 TI - [Pregnancy in diabetes]. PMID- 3642054 TI - [Monitoring of a pregnant diabetic patient]. PMID- 3642055 TI - [Educational reform at the intermediate level and the midwife as a woman's nurse]. PMID- 3642056 TI - [The midwife's outward-bound activities in the subject of sexuality and living together]. PMID- 3642057 TI - [Snoring; harm of coffee]. PMID- 3642058 TI - [Clinical nurse at the pediatric ward]. PMID- 3642060 TI - [Underevaluated nurses]. PMID- 3642059 TI - [Incontinent elderly]. PMID- 3642061 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Researcher's point of view on health institutions for the elderly]. PMID- 3642062 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Home health service provided by hospitals]. PMID- 3642063 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Nurses should be the principal care-givers at the newly proposed intermediate facilities]. PMID- 3642064 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Round-table talk: nursing point of view on intermediate facilities]. PMID- 3642065 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing professions. Visitors to our small private day hospital]. PMID- 3642066 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Proposed intermediate facilities should support home health services]. PMID- 3642067 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Home health services as health and welfare policy]. PMID- 3642068 TI - [Health institutions for the elderly (intermediate facilities)--propositions from the nursing profession. Health institutions for the elderly from the point of health economics]. PMID- 3642069 TI - [Fundamental principles of the proposed revision of the law concerning the health for the aged in order to incorporate the provision for the health institutions for the aged (intermediate facilities)]. PMID- 3642070 TI - [Interim Report of the Intermediate Facilities Consulting Committee appointed by the Ministry of Health and Welfare]. PMID- 3642071 TI - [JNA statement on intermediate facilities]. PMID- 3642073 TI - Research: a process to a better way. PMID- 3642072 TI - [Health services management--basic understanding]. PMID- 3642074 TI - Future scope of practice of graduates of associate degree and baccalaureate degree nursing programs: report on the 1986 KSNA opinion survey. PMID- 3642075 TI - In search of a scientific base for nursing practice. PMID- 3642076 TI - The pilot study: one key to research success. PMID- 3642078 TI - [Bioinstrumentation and nursing. Normal EKG]. PMID- 3642077 TI - Staff nurses as researchers. PMID- 3642079 TI - [Bioinstrumentation and nursing. Cardiac dysrhythmias]. PMID- 3642080 TI - [Bioinstrumentation and nursing. Nursing intervention for the patient with an artificial cardiac pacemaker]. PMID- 3642081 TI - [Continuing education. Education program and perspectives of psychiatric clinical specialist]. PMID- 3642082 TI - [Continuing education. Child psychiatric clinical nurse specialist]. PMID- 3642083 TI - [Continuing education. The psychiatric clinical specialist in the emergency room and a model for advanced nursing preparation in chronic psychiatric care]. PMID- 3642084 TI - [Keeping air out of i.v. lines]. PMID- 3642085 TI - [A case study of patient with femur fracture]. PMID- 3642086 TI - [Health care of the elderly: social welfare services in Korea]. PMID- 3642087 TI - Nursing management--based on the role of head nurse. PMID- 3642088 TI - [Bioinstrumentation and nursing. Use and effect of bioinstrumentation in nursing]. PMID- 3642089 TI - [Getting rid of one's anxieties or: to be reborn through breathing]. PMID- 3642090 TI - [The rights of psychiatric patients. The asylum seen through the other end of the opera glasses]. PMID- 3642091 TI - [Should the clinical training be reconsidered?]. PMID- 3642092 TI - [Evaluation of the quality of nursing: an annotated bibliography]. PMID- 3642093 TI - [Nursing-quality control in the hospital. Searching for suitable methods]. PMID- 3642094 TI - [11th congress for continuing education of anesthesia nurses. Special methods in radiology and urology and their importance for anesthesia]. PMID- 3642096 TI - [Alternative medicine. The 1986 Basle Psi days. Deep impressions and open questions]. PMID- 3642095 TI - [Continuing education course "Nursing of Tumor Patients". A positive balance]. PMID- 3642097 TI - [Role playing: as close as possible to real life]. PMID- 3642098 TI - [7th National Student Meeting. Students want to be considered]. PMID- 3642099 TI - [Registration with the Swiss Red Cross. An important service for the hospital and for those who work there]. PMID- 3642100 TI - [Peer interest. In praise of encouragement]. PMID- 3642101 TI - [The task of the ward nurse in a Protestant hospital in East Germany]. PMID- 3642102 TI - [Man as an expanded object]. PMID- 3642103 TI - [Nursing diabetic patients in the intensive care unit]. PMID- 3642104 TI - [When children experience death. Reactions to the loss of close persons. Clarification and the chance of mourning]. PMID- 3642105 TI - [Cesarean section--clinical aspects, indications and results]. PMID- 3642106 TI - [What is meant by specific hyposensitization?]. PMID- 3642107 TI - [Artistic movement as physical therapy]. PMID- 3642108 TI - [The concern of the care giver. Empathy--what is it?]. PMID- 3642109 TI - School phobia: the importance of prompt intervention. AB - School nurses, teachers, administrators, and child study team members annually are confronted with the recurring problem of how to help school phobic children cope with and resolve the fears and anxieties that beset them. In their efforts to aid the phobic child, school personnel must communicate with concerned parents who oftentimes view the school as the primary source of the problems evidenced by their child. Because of the dearth of literature on school phobia, school personnel frequently are uncertain of the proper approach in dealing with the phobic child and the family. The importance of prompt treatment, and the need for good communication among those concerned with the phobic child, are addressed in this article. The manifestation of this disorder is described and theories and intervention methods are reviewed. PMID- 3642110 TI - A California school nurse credential survey. AB - This survey determined which required competencies currently employed California school nurses rated as adequate in their basic preparation for entry into school nursing practice. A questionnaire was sent to 2,861 California school nurses; 1,534 (54%) were returned and 1,227 were used in the analysis. The questionnaire listed 24 competencies required for school nursing by the California Commission on Teacher Credentialing. Demographic factors were solicited to develop a profile of the candidates who responded. Survey results indicated most nurses believed 11 of the required competencies were met in their bachelor's degree program. Many respondents did not consider their preservice training adequate in some competencies. These results could be useful to universities that are considering establishing a certificate program for school nursing. PMID- 3642112 TI - Children of alcoholics: breaking the cycle. PMID- 3642113 TI - Celebrate life! A learning style-based mental health curriculum. PMID- 3642111 TI - Two noninvasive methods to measure female maturation. AB - Data from a sample (n = 278) of female subjects, ages seven-13, from a cross sectional study were used to compare two methods of measuring maturation. The methods were self-assessment of secondary sex characteristics and prediction of adult height. Breast and pubic hair assessments were correlated significantly (r = 0.615 and r = 0.696, p less than 0.001) with predicted adult height estimates, indicating the practical use of either method. Assessment of maturation in childhood is strongly recommended to further understanding of the timing and sequence of physical, physiological, social, and behavioral characteristics of children during growth and maturation. PMID- 3642114 TI - "Mouse Calls:" a storytelling approach to teaching first aid skills to young children. PMID- 3642115 TI - Enhance your school nursing practice: join a study group. PMID- 3642116 TI - Professional profile. W. Micki Wilder. PMID- 3642118 TI - [The criteria for professional practice and responsibility of the nurse in future. An interview with Ms. Masako Yano]. PMID- 3642117 TI - Rational-emotive therapy--transactional analysis: similarities and differences of two approaches to group therapy. PMID- 3642119 TI - [The criteria for professional practice of nursing: a survey among medical and nursing specialists]. PMID- 3642120 TI - [The extent of participation by nurses in emergency medical care. A symposium]. PMID- 3642121 TI - [The criteria for professional practice and responsibility of the nurse: the nurse practitioner and physician]. PMID- 3642122 TI - [The attitudes toward continued nursing expressed by graduates of the nursing department of a junior college of medical technology--a 12-year survey among graduates of various nursing specialties]. PMID- 3642123 TI - [Problems encountered at the early stage of the study of the "nursing process" and their management--stages in nursing planning]. PMID- 3642124 TI - [The family. 11. Illness in the family]. PMID- 3642125 TI - [Life of a nurse. 11. Nursing in Okinawa (1). An interview with Ms. Nobu Madamubashi]. PMID- 3642126 TI - [The role of hospital nursing in primary health care (3). The educational effect of the class for diabetics--a survey result]. PMID- 3642127 TI - [Clinical training in nursing: observation on training in the attitude in pediatric nursing--an interaction with students who do not like children]. PMID- 3642128 TI - [Assistance in life activities in accordance with the nursing process. 8. Assistance at defecation and urination. (2)]. PMID- 3642129 TI - [Nursing action at bathing of a premature infant]. PMID- 3642130 TI - [Bronchial asthma]. PMID- 3642132 TI - [Diagnostic and therapeutic processes for pneumonia]. PMID- 3642131 TI - [Epidemiology and prognosis of pneumonia]. PMID- 3642133 TI - [Keypoints in observation of pneumonia patients]. PMID- 3642134 TI - [Nursing plan for pneumonia patients]. PMID- 3642135 TI - [Nursing of a patient with progressive muscular dystrophy complicated by pneumonia]. PMID- 3642136 TI - [Nursing process for pneumonia patients. Planning suitable for individual patients]. PMID- 3642137 TI - [Trends in the food habits of non-insulin-dependent diabetic patients--a study by factor analysis]. PMID- 3642139 TI - [Test yourself: nursing of a patient with manic-depressive disorder developing in adolescence]. PMID- 3642138 TI - [Experience in meal-related nursing actions for a patient with terminal cancer- terminal care specially designed for individuals]. PMID- 3642140 TI - [Nursing of a patient with diabetes mellitus undergoing physical therapy following cerebral hemorrhage]. PMID- 3642141 TI - [Patients' refusal of nursing actions]. PMID- 3642142 TI - [Refusal by the patient as a starting point in nursing]. PMID- 3642143 TI - [Nurse-patient relationship and the reason for the patient's refusal]. PMID- 3642145 TI - [Life at a home for children with cerebral palsy. 2. Wonderful appreciation of simple pleasures of living]. PMID- 3642144 TI - [A child's refusal of nursing actions and responses by nurses]. PMID- 3642146 TI - Living will legislation. PMID- 3642147 TI - Nurse Strength. PMID- 3642148 TI - A framework for the nature and development of health beliefs in children. AB - The framework uses the social cognitive perspective that health is personally defined in relation to an object of emotional attachment. Thought related to this person/object parallels, but is distinct from, the process of cognitive development. The framework suggests that cognitive operations will vary according to situational differences. PMID- 3642149 TI - The rapprochement subphase of the separation-individuation process. AB - The dynamics of the rapprochement subphase of the separation-individuation process are examined. Individual solutions to rapprochement as well as the mother's role in promoting a successful outcome of this process are discussed. PMID- 3642150 TI - Stress and later-life childbearing: important implications for nursing. AB - Scientific literature which links advanced maternal age to pregnancy outcome was critically appraised. Little evidence was found to support the pessimistic advice offered to older expectant mothers. Evidence is accumulating which suggests that emotional stress has a deleterious effect on obstetrical outcome, although the manner in which the deleterious effects are produced remains unclear. PMID- 3642151 TI - Third trimester fantasies of first-time expectant fathers. AB - Results of an exploratory study of fantasies of first-time expectant fathers and non-expectant males are presented. Data collection instruments included the Imaginal Processes Inventory, the Sex Role Inventory, and the Affectional Relationship Inventory. The fantasy pattern of expectant fathers differed minimally from that of non-expectant males. Fantasy pattern of the expectant fathers appeared to be influenced by their sex role orientations and involvement in the pregnancy. PMID- 3642152 TI - Sibling preparation classes for preschool children. AB - The purpose of this study was to evaluate the effect of sibling preparation classes on the behavior of firstborn children following the birth of the family's second child. The maternal perceptions of the preschool child behaviors of two groups of mothers, one group of 17 mothers whose children attended sibling preparation classes and one group of 16 mothers whose children did not attend classes, were determined prior to and after the birth of the second child using the Maternal Perception of Preschool Child Behavior (Knicely, 1981). It was hypothesized that prenatal perceptions of child behavior would differ from postnatal perceptions for both groups. No significant difference between the two groups was found. Although the value of the classes may not have been clearly supported by the study, there are theoretical indications that the classes are valuable. Further study needs to be done on the effectiveness of sibling preparation classes. Several aspects of this research can be strengthened and the research repeated. Implications for further research are indicated. PMID- 3642153 TI - Illnesses and children in a preschool center. AB - The illnesses experienced by children in a preschool center over a 9-month period were analyzed from the records kept by a Headstart health coordinator. These records included a description of both the illness and the care given. Comments made by children such as "feeling funny" or "something hurts," as well as changes in function or behavior were described by the teachers. Ninety-five children out of a total sample of 241 developed 161 illnesses. The most common illnesses were respiratory infections, fevers, gastrointestinal symptoms, and skin changes. In 73 of these illnesses children were sent home, sent for medical care, or excluded from class. Factors which affected decisions about the care of children's illnesses were their well-being, risk to others in the school or public health considerations, and perceived need for medical evaluation. Ill-child care has been one part of the health coordinator role developed by Headstart; in its many functions this role might be adopted by pediatric nurses as a valuable role for providing general health care to young families. PMID- 3642155 TI - Superannuation and the 'roll-over' system. PMID- 3642154 TI - Effect of promethazine on double tetracycline bone labeling in old mice. AB - Twenty-five-month-old female B6AF1 mice were injected intramuscularly (i.m.) with declomycin (75 mg/kg) 50 days and 2 days, or 20 days and 2 days, before sacrifice, and cross-sections of their femoral shafts were examined quantitatively for areas of tetracycline fluorescence. Two groups of mice received promethazine HCl in their drinking water (12 mg/dl) for 1 year, and the control groups were untreated. It was found that: the number of discrete areas of cortical and endosteal tetracycline deposition was increased slightly in the groups given promethazine; the length of the endosteal and cortical tetracycline deposits were 2-3 times greater, respectively, in the promethazine treated groups; and the distance between the cortical tetracycline deposits and the endosteum was 2.5 times greater in the promethazine groups. These results support the view that net bone deposition in osteopenic old mice is enhanced by promethazine. PMID- 3642156 TI - Mental Health Advocacy Service. PMID- 3642158 TI - [Care of patients with Korsakoff's syndrome]. PMID- 3642157 TI - Anterior cricoid split: the Chicago experience with an alternative to tracheotomy. AB - Twenty-six infants and children underwent anterior cricoid split (ACS) in an attempt to avoid tracheotomy. Twenty (77%) were extubated successfully without tracheotomy;six (23%) failed and required tracheotomy. Our experience corroborates that reported in the literature. To date, 106 (77%) of 138 patients who have undergone ACS have been extubated successfully without tracheotomy. These results substantiate the validity of the operation when done for the proper indications. Substantive glottic and tracheal pathology indicate a high likelihood of failure of ACS. PMID- 3642159 TI - [Prevention of postinjection complications]. PMID- 3642160 TI - [Longevity]. PMID- 3642161 TI - [Arteriosclerosis obliterans of the vessels of the lower extremities]. PMID- 3642162 TI - [Hepatocerebral dystrophy]. PMID- 3642163 TI - [Polycystic kidneys]. PMID- 3642164 TI - [Uterine myoma]. PMID- 3642166 TI - [Pruritus vulvae]. PMID- 3642165 TI - [Basic principles of the observation and care of neurosurgical patients]. PMID- 3642167 TI - [Hysteria]. PMID- 3642168 TI - [Use of ultraviolet rays in the combined therapy of periodontal diseases]. PMID- 3642170 TI - [Our experience in raising the qualifications of paramedical workers]. PMID- 3642169 TI - [Device for dissolving drugs]. PMID- 3642171 TI - [Care of patients with senile psychoses]. PMID- 3642172 TI - [Health education work among young parents to prevent injuries to infants]. PMID- 3642173 TI - [Medical supervision of the organization of the vocational training of schoolchildren in workshops]. PMID- 3642174 TI - [Medicinal plants in the combined treatment of patients with alopecia areata]. PMID- 3642175 TI - [Experience in using clinical tasks for exercises in pediatric diseases]. PMID- 3642176 TI - [Health and hygiene supervision in children's preschool institutions]. PMID- 3642177 TI - [Neuropsychic disorders in multiple myeloma]. PMID- 3642179 TI - [Staphylococcus epidermidis and its role in the occurrence of an infectious process]. PMID- 3642178 TI - [Conservative treatment of patients with chronic suppurative otitis media]. PMID- 3642180 TI - [Combined treatment of patients with discogenic lumbosacral radiculitis and other manifestations of osteochondrosis of the lumbar spine]. PMID- 3642181 TI - [Computerization problems in public health]. PMID- 3642182 TI - [Changes in the nervous system in alcoholism]. PMID- 3642183 TI - [Poisoned milk]. PMID- 3642184 TI - [The major risk factor]. PMID- 3642185 TI - [The health certificate in the school class log]. PMID- 3642186 TI - [Puncture catheterization of the internal jugular vein in resuscitation practice]. PMID- 3642187 TI - [Nursing manipulations of patients with ocular tuberculosis]. PMID- 3642188 TI - [Characteristics of the puncture of the peripheral veins]. PMID- 3642189 TI - [Massage in the central spastic paralysis syndrome]. PMID- 3642190 TI - [Acute disseminated encephalomyelitis]. PMID- 3642191 TI - [The registration office--a structural subdivision of outpatient polyclinic institutions]. PMID- 3642192 TI - Nursing and the developmentally disabled. PMID- 3642193 TI - Decisions for life--offer the opportunity. PMID- 3642194 TI - The grandfather concept: a simple process. PMID- 3642195 TI - Hypothalamic hypothyroidism with end-organ resistance--further personal observations. AB - Further personal observations are made of the case of hypothalamic hypothyroidism with end organ resistance described in an earlier report. The course of the disorder on replacement therapy appears to be a relapsing one, with relapses provoked by seasonal changes and physical stresses. The relapses remit with increased doses of thyroid replacement. There is some evidence of increased levels of reverse T3 prior to T3 replacement and also evidence suggestive of a parallel hypothalamic hypoadrenal deficit. PMID- 3642196 TI - The presence of trans unsaturated fatty acids in ruminant meat and milk is unnatural. AB - It is proposed that the presence of large quantities of trans unsaturated fatty acid isomers as final metabolic products of the rumen bacteria and their consequent presence in ruminant tissues and milk is completely unnatural. This results from excessive feeding of domestic ruminants and the consequent passage of bacteria containing partially hydrogenated trans fatty acids into the small intestine. Digestion of such bacteria and the subsequent absorption of the released trans fatty acids could account for their unnatural presence in ruminant tissues and secretion in milk. It is also proposed that the feeding of ruminants, poultry and pigs with unsaturated fatty acid-containing concentrates, could also be a source of trans fatty acids which occur in their tissues. PMID- 3642197 TI - The AIDS virus as an opportunistic organism inducing a state of chronic relative cortisol excess: therapeutic implications. AB - The AIDS virus is an opportunistic organism which requires a previously immunocompromised host for successful replication. We propose that the primary and as yet unlocalized lesion caused by the AIDS virus involves disruption of physiologically balanced responses to stressors, effectively creating a state of chronic relative cortisol excess. Such a state inhibits successful anti-pathogen strategies including those directed against the AIDS virus itself and leads to a self-sustaining downhill clinical course. Therapies based on this model are discussed. PMID- 3642198 TI - Free radicals in immunological killing: the case of tumor necrotising factor (TNF). AB - There is now considerable evidence that in many circumstances free radical activity constitutes not only an early but also an essential event in the causation of cell death in vivo. It is proposed that the cytotoxic effect of TNF against tumours may be exerted in like manner, by stimulating the generation of hydroxyl radicals which leads in turn to an upset of energy metabolism, and hence to cell death. Simple experimental protocols are indicated for testing the proposal at various stages. PMID- 3642199 TI - Sleep apnea syndrome: is it a contributing factor to the sex differential in mortality? AB - Sleep apnea syndrome is a relatively common disease, with an overwhelmingly male predominance. The female:male ratio is about 1:15-20, depending on the specific age group. In light of findings linking sleep apnea syndrome to essential hypertension, it is hypothesized that the syndrome may contribute to the sex differential in mortality. In most of the developed countries women have longer life expectancy than men even after adjustment for various lifestyles and biologica variables Mortality from heart disease accounts for 40% of the total sex differential. The fact that the 2-5 fold sex differential for heart disease mortality is reduced to much lesser extent by multivariate adjustment than the sex differential for mortality from all causes, and that it is minimally affected by the exclusion of all persons with a history of chronic diseases, indicates that other risk factors should be sought. I propose the hypothesis that Sleep Apnea Syndrome (SAS), which almost exclusively affects males, contributes to the sex differential in mortality from coronary heart disease. Sleep Apnea Syndrome is a relatively common disease. It is the most preponderant finding among patients referred to diagnostic sleep laboratories, particularly among patients complaining of excessive daytime sleepiness. Its incidence among the adult male population (age greater than 21 years) was estimated to be at least 1-1.5%. It is considerably higher than that, at least 5 to 7 fold, in the 40 to 60 years age group, and in specific high-risk populations such as the morbidly obese. The female:male ratio is about 1:15-20, depending on the specific age group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3642200 TI - Human knowledge, scientific research and dreaming. PMID- 3642201 TI - Atherogenesis. An epidemiological model based on the presence of unnatural trans and cis isomers of unsaturated fatty acids in the maternal diet and in mothers milk. AB - The hypothesis that the presence of unnatural trans and cis isomers of unsaturated fatty acids in the maternal diet and in human mothers milk could be responsible for initiating atherosclerosis in utero or in infants is proposed. It is suggested that the key etiological factor involved in the formation of atherosclerotic plaques could be uncontrolled division of smooth muscle cells of the intima resulting from the intracellular excess of linoleic acid and deficiency of its metabolites gamma-linolenic acid and dihomogamma-linolenic acid. This imbalance is brought about by competitive inhibition of the enzyme delta-6-desaturase by unnatural trans and cis unsaturated fatty acids. Delta-6 desaturase is the enzyme responsible for converting linoleic acid to dihomogamma linolenic acid. The cellular presence of unnatural trans and cis isomers of unsaturated fatty acids would therefore enhance increased levels of linoleic acid and deficiency of its metabolites gamma-linolenic acid and dihomogamma-linolenic acid. It is proposed that prophylaxis against the effects of delta-6-desaturase inhibition could be achieved by the adoption of an Eskimo-like diet containing the essential fatty acid metabolites gamma-linolenic acid and/or dihomogamma linolenic acid and eicosapentaenoic acid per se in high concentrations. PMID- 3642202 TI - Relapsing fever/Lyme disease. Multiple sclerosis. AB - Lyme Disease and Relapsing Fever caused by Borrelia burdorferi and Borrelia hermsii, respectively, have been generally considered curable if diagnosed early. However, it is becoming apparent that when these diseases are left undiagnosed and untreated they may cause severe problems for some people. They, in fact, may be one of the major causes of Multiple Sclerosis. These two Borrelia infections, when left untreated, are now known to be capable of causing neurological problems, cardiac problems, relapses as much as ten years later, increased IgG/albumin ratio and increased lymphocytes. These same things hold true for Multiple Sclerosis patients. This paper discusses the Borrelia spirochetes which cause Lyme Disease and Relapsing Fever and what correlation that may have with Multiple Sclerosis. PMID- 3642203 TI - Reorganization of contemporary medical practice. AB - A research project now in development at Rutgers University is discussed. Its aim is to elaborate a comprehensive program for the physician which he or she could use for a continuous individualized treatment of a healthy person with the aim of preventing development of a chronic disease. PMID- 3642204 TI - Is fluorosis an etiological factor in overuse injuries (RSI)? PMID- 3642205 TI - Fetal ripening. AB - Babies do not manifest complications of organ immaturity such as hyaline membrane disease when they are born from a hormone milieu dominated by estrogen as shown by vaginal cytology. Those who are delivered from a progesterone-influenced environment are at risk for developing the problems of immaturity. A fetus probably 'ripens' in late pregnancy under the control of estrogen. PMID- 3642207 TI - Vitamin C and immunosuppression. AB - Large daily doses of vitamin C resulted in severe lymphocytopenia in stressed mice. A characteristic biochemical expression of stress is an abrupt increase in adrenal corticosteroids in blood plasma which is always preceeded by a release of vitamin C by the adrenals. It is hypothesized that large doses of vitamin C maintain high levels of plasma corticosteroids which inturn may reduce the organism's immune response when stress is present. PMID- 3642206 TI - The pathogenesis of vascular headaches in patients with hypertension; the role of the ammonia-potassium axis. AB - Headaches may occur in as many as 25% of hypertensive patients and generally bears little relationship to level of diastolic blood pressure. Previous observations, in normotensive patients, suggested that abnormalities in both potassium and ammonia metabolism might be related to the pathogenesis of these headaches. The present study was undertaken to see whether these factors also occurred in hypertensive patients with headaches. The present observations were made in thirteen hypertensive patients with vascular headaches. The major findings include potassium levels of 3.45 +/- 0.25 mEq/L; CO2, 29.85 +/- 1.21 mEq/L; blood ammonia, 41 +/- 8.40 U mol/L and an alkaline pH of the urine. The blood ammonia levels, when factored by the BUN, yielded elevated ammonia to BUN ratios (3.81 +/- 1.82). These findings are similar to those previously observed in normotensive patients with vascular headaches. The profile of hypokalemia and/or alkalosis, increased blood ammonia to BUN ratios and a relatively alkaline urine appears to be a commonly observed pattern in patients with vascular headaches. These data suggest that a biochemical basis exists for the genesis of vascular headaches in patients with hypertension. PMID- 3642208 TI - The Eskimo diet. Prophylactic effects ascribed to the balanced presence of natural cis unsaturated fatty acids and to the absence of unnatural trans and cis isomers of unsaturated fatty acids. AB - In addition to the well recognised roles of eicosapentaenoic acid and possibly docosahexaenoic acid, there are two other major important, but unrecognised, features of the traditional Eskimo staple diet namely that it contains the unsaturated fatty acids (UFA) cis oleic, cis linoleic and cis alpha-linolenic as well as their respective C20 and C22 metabolites in physiologically optimal concentrations and, it is virtually totally devoid of unnatural and potentially hazardous trans and cis isomers of these fatty acids. Large quantities of unnatural trans and cis isomers of UFA are found in the Western diet as partially hydrogenated UFA in many foods. These isomers are formed during the manufacture of margarines and related compounds, as food contaminants during excessive heating of cooking oils for deep-frying and other excessive heat-requiring mass food preparation procedures and it is suggested, as the result of excessive feeding with an unnatural diet of ruminants and non-ruminants for increased meat and/or milk production and of poultry for increased egg and/or meat production. These isomers have been shown to display potentially hazardous metabolic effects which include the competitive inhibition of UFA metabolism at various steps and have been causally implicated in the etiology of ischemic heart disease and cancer. It is suggested that the myth of the safety of trans fatty acids arises from misinterpretation of the observation that increasing dietary cis linoleic acid reduces the toxic effects of trans UFA. It is suggested that the decrease of 20% in the ischemic heart disease mortality in the USA during the past two decades is directly related to a shift in the dietary ratio of unnatural trans and cis UFA isomers: cis linoleic acid in favour of the latter. It is predicted that this ratio will be found to correlate with ischemic heart disease patterns in other countries. Eskimos consume the bulk of their food frozen, raw or dried, seldom boiled, but never deep-fried or after exposure to excessive heat. Moreover the proportionality of cis UFA and their metabolites in their traditional staple diet would render gross tissue UFA utilization relatively independent of desaturase enzyme activity. In the Eskimo tissues these enzymes would function to make the minute, critical UFA metabolic adjustments required to ensure the presence of structural UFA in membranes in functionally optimal quantities and, ensure the synthesis of eicosanoids from dihomogamma-linolenic acid, arachidonic acid and eicosapentaenoic acid in balanced, optimal physiological concentrations for the genetic make-up of Eskimos.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3642209 TI - The prediction of lung cancer in Australia 1939-1981. AB - Lung cancer is shown to be predicted from petrol consumption figures for a period of 42 years. The mean time for the disease to develop is discussed and the difference in the mortality rate for male and females is explained. PMID- 3642210 TI - Unmasking AIDS: chemical immunosuppression and seronegative syphilis. AB - In both African AIDS populations and homosexual populations outside of Africa, a high incidence of syphilis and multiple exposures to infectious diseases results in frequent, often abusive use of antibiotics. Epidemiological evidence exists for chemical immunosuppression resulting from antibiotics and other prescribed and recreational drugs prior to the current AIDS crisis. Analysis and review of literature is given on the effects of subcurative doses of antibiotics masking and distorting the expression of secondary and tertiary syphilis. A high incidence of seronegative syphilis is found in Africa and compares with Western reports of seronegativity and persistence of treponemes despite adequate antibiotic therapies. Late latent and tertiary syphilis produce symptoms and immunosuppression comparable to that seen in the current AIDS crisis. Screening procedures instituted for a group of gay men with AIDS and AIDS related conditions is revealing evidence of chemically immunosuppressed syphilis as a factor in AIDS. Key words: AIDS, immunosuppression, syphilis, chemical immunosuppression, seronegativity, immunosuppressive sera, etiology of AIDS. PMID- 3642211 TI - The multifactorial nature of osteoporosis: the potential of corticosteroid binding globulin as a unifying regulator. AB - Accelerated bone loss often accompanies the menopause, and may also affect a significant proportion of ageing women. This osteoporosis can also be an accompaniment of several other pathological manifestations. It is difficult to imagine that each process alters bone resorption and renewal by a separate mechanism; in all probability a common mechanism may operate in some of the instances where osteoporosis is observed. It is proposed that chronic alterations in the levels of circulating physiologically-active cortisol could account for some of the osteoporoses. These alterations need not necessarily affect total plasma cortisol values, but rather affect the relationship of cortisol to its plasma carrier protein, transcortin, since changes in this relationship are a common occurrence in many of the conditions associated with osteoporosis. PMID- 3642212 TI - Blood-letting, iron homeostasis, and human health. PMID- 3642213 TI - Medicine in the long-living society. AB - Contemporary medicine is faced with a new objective--control over chronic diseases. In order to achieve it, new approaches in theory and practice should be explored. PMID- 3642214 TI - Beyond the birth of a defective child. PMID- 3642215 TI - Extended nursing care after a perinatal loss: theoretical implications. PMID- 3642216 TI - Unresolved grief. PMID- 3642217 TI - AIDS and the neonatal ICU. PMID- 3642218 TI - Interhospital perinatal nursing transport conferences. PMID- 3642219 TI - Iatrogenic burn in the newborn. PMID- 3642220 TI - Grief: the traditional process. PMID- 3642221 TI - Challenges and choices in membership development. PMID- 3642222 TI - The Code for Nurses: Statements 1 & 2--revisited. PMID- 3642223 TI - Effects of pre- and postnatal cholecystokinin treatment on brain development in rats. PMID- 3642224 TI - [Neurotrauma]. PMID- 3642225 TI - The primary health care nurse--is she a mini doctor? PMID- 3642226 TI - Trauma in sport. PMID- 3642227 TI - [Dilemmas in practice. To resuscitate or not]. PMID- 3642228 TI - [30 years of degree education in S.A]. PMID- 3642230 TI - The nursing crisis: quantitative or qualitative. Part 1. PMID- 3642229 TI - 1986: the year of change. PMID- 3642231 TI - Implant eases treatment for chemotherapy patients. PMID- 3642233 TI - Sorting out triage in urban disasters. PMID- 3642232 TI - The South African nurse and family planning. PMID- 3642234 TI - Intervention during the life cycle. PMID- 3642235 TI - Nursing and research--an introductory overview. PMID- 3642236 TI - The teaching role of the postnatal ward sister. PMID- 3642237 TI - Teenage pregnancy. PMID- 3642238 TI - Nursing education: unwanted pregnancy? The new four-year course. PMID- 3642239 TI - Margaretha van Huyssteen retires as president of SANA and is succeeded by Odelia Muller. Interview by Julian Craft. PMID- 3642240 TI - Guidelines to research in nursing. PMID- 3642241 TI - [Nursing assessment: the data collection interview--I]. PMID- 3642242 TI - Primary health care or primitive health care? PMID- 3642243 TI - The pain sister. PMID- 3642244 TI - Creative nursing management. PMID- 3642245 TI - The traditional healer in primary health care--yes or no? PMID- 3642246 TI - Handling of cytotoxic agents: a practical approach. PMID- 3642247 TI - [Primary health care: the homeless of Edinburgh]. PMID- 3642248 TI - The nursing crisis: an exercise in labour economics. PMID- 3642249 TI - Adolescent sexual health care. PMID- 3642250 TI - How well do our rural clinics function? PMID- 3642251 TI - Community care of the neonate: neonatal examination--II. PMID- 3642252 TI - Problem solving. PMID- 3642253 TI - Primary health care. Empowering learners, empowering people. PMID- 3642254 TI - The image of nurses in the media. PMID- 3642256 TI - Nursing and research: an introduction to methods of data collection. PMID- 3642255 TI - [Nursing assessment: physical examination of the ear]. PMID- 3642257 TI - Psychosocial aspects of contraceptive use. PMID- 3642258 TI - Health in education--quo vadis? PMID- 3642259 TI - Nurses on stamps. PMID- 3642260 TI - [Stress!]. PMID- 3642261 TI - Reflections on the National Society of Oncology Nurses' Congress: April 1986. PMID- 3642262 TI - On being a patient. PMID- 3642263 TI - The dilemma of being a woman! PMID- 3642264 TI - Interpreting Regulation R2598 of Nursing Act 50 of 1978 as amended. PMID- 3642265 TI - Guidelines to research in nursing. PMID- 3642266 TI - Clinical nurse specialists in ambulatory tertiary health care. PMID- 3642267 TI - The relationship of family planning nurse and client. PMID- 3642268 TI - [Nursing assessment: physical examination of the lips, mouth and throat]. PMID- 3642270 TI - [Guidelines for the drafting of a nursing service schedule]. PMID- 3642269 TI - Community nursing. Adolescents in perspective. PMID- 3642271 TI - Should we tell the patient? PMID- 3642272 TI - The role of the private nurse practitioner: a family practitioner's viewpoint. PMID- 3642273 TI - I understand the words, but what do they mean? What is all this computer talk? PMID- 3642274 TI - The what, the why and the how of regional anaesthesia. PMID- 3642275 TI - Private practice. Practical guidelines for the nurse practitioner. PMID- 3642276 TI - Can I provide adequate maternal and child care? PMID- 3642277 TI - Maternal and child health services through the mother and child's eyes. PMID- 3642279 TI - Professional associations versus trade unions. PMID- 3642278 TI - The dilemma of being a woman--a male nurse hits back. PMID- 3642280 TI - Guidelines to research in nursing. PMID- 3642281 TI - Carcinoma and the stomatherapist. PMID- 3642282 TI - The nurse's role during regional anaesthesia. PMID- 3642283 TI - Clinical pulse oximetry. PMID- 3642284 TI - Nurses in unions spells conflict. PMID- 3642286 TI - [Nursing assessment: blood pressure determination]. PMID- 3642285 TI - Counselling in family planning. PMID- 3642287 TI - A new look at breast cancer. PMID- 3642288 TI - Adolescent sexuality--are we opting out? Community nursing intervention during the life cycle. PMID- 3642289 TI - Tragic neglect. PMID- 3642290 TI - Change and the advent of unionism in hospitals. PMID- 3642291 TI - Maternal health--a missed opportunity? PMID- 3642292 TI - Primary health care. Maternal and child health services. A nurse's perspective. PMID- 3642293 TI - Communication with the dying. A Christian perspective. PMID- 3642294 TI - The Jewish concept of dying. PMID- 3642295 TI - The emotional stages of dying. PMID- 3642296 TI - The dying child. PMID- 3642297 TI - A family affair--care of the dying patient and his family. PMID- 3642298 TI - The care of the dying patient in Islam. PMID- 3642300 TI - [Nursing assessment: examination of hair and nails]. PMID- 3642299 TI - Understanding the terminally ill. PMID- 3642301 TI - Guidelines to research in nursing. PMID- 3642302 TI - The choice is yours! Part one: Choosing your software. PMID- 3642303 TI - 'We feel secure'. The story of St Luke's Hospice. PMID- 3642304 TI - Highway Hospice--Durban. PMID- 3642305 TI - The design and implementation of a pilot exchange cart system for the new Groote Schuur Hospital. PMID- 3642306 TI - Professor Penny Prophit. Interview by Libby Campbell. PMID- 3642307 TI - Comments on Project 2000 consultative document. PMID- 3642308 TI - Media mustn't treat AIDS as soap opera. PMID- 3642310 TI - Royal College of Nursing. Be prepared. PMID- 3642309 TI - Misconceptions about hepatitis. PMID- 3642311 TI - Co-operation between nurses and social workers is crucial. PMID- 3642312 TI - Join me in my New Year's resolution. PMID- 3642313 TI - OH nurse role in care of patients with AIDS. PMID- 3642315 TI - Doctors versus nurses. PMID- 3642314 TI - Royal College of Nursing. In same boat. PMID- 3642316 TI - Do they know it's Christmas: forgotten children. PMID- 3642317 TI - RCN welcomes major review of community care policies. PMID- 3642319 TI - Royal College of Nursing. Resolution. PMID- 3642318 TI - Survey highlights violence problem. PMID- 3642320 TI - Annual report highlights recruitment difficulties. PMID- 3642321 TI - Royal College of Nursing. Grand impetus. PMID- 3642322 TI - Qualifying statement. PMID- 3642323 TI - Warming to idea. PMID- 3642324 TI - Personalized system of instruction for i.v. therapy orientation. PMID- 3642325 TI - A CRNI's role in pediatric chemotherapy administration. PMID- 3642326 TI - Writing for publication. PMID- 3642327 TI - The family of Ringer's solutions. PMID- 3642329 TI - The limits of medicine spell opportunities for nursing. PMID- 3642328 TI - Reading the amount of fluid in polyvinyl chloride i.v. bags. PMID- 3642330 TI - Stepping up to new challenges in public health nursing. PMID- 3642332 TI - Expanding our sights to include social networks. PMID- 3642331 TI - Nurse leadership: a vital ingredient in urgent care delivery. PMID- 3642333 TI - Words can sway perceptions of nursing. PMID- 3642334 TI - Nursing education update: enrollments and admissions trends. PMID- 3642335 TI - Communication skill performance and needs of deans. PMID- 3642336 TI - Facilitating classroom learning: the Ausubel model. PMID- 3642337 TI - A model for teaching critical thinking. PMID- 3642338 TI - Teaching the research process through participatory learning. PMID- 3642339 TI - Systematic instructional strategies in clinical teaching: outcomes in student charting. PMID- 3642340 TI - The nontraditional doctorate: an asset or liability in nursing education? PMID- 3642341 TI - Teaching nurses to care. PMID- 3642342 TI - Views on research: choosing a methodology. PMID- 3642343 TI - Academic governance: you must get involved. PMID- 3642344 TI - Too late. PMID- 3642345 TI - Medication errors. Violating protocol; Failing to label syringes. PMID- 3642346 TI - A love-hate relationship. PMID- 3642347 TI - Blood transfusion reaction. PMID- 3642348 TI - Diabetes: new names, new test, new diet (continuing education credit). PMID- 3642349 TI - What you don't know can hurt you. PMID- 3642350 TI - Magnetic resonance imaging: the latest in diagnostic technology. PMID- 3642351 TI - How the write stuff can go wrong. PMID- 3642352 TI - Helping David meant having great expectations. PMID- 3642353 TI - Prospective changes in drug administration. PMID- 3642355 TI - When caring is the only cure: managing the chronically ill patient. PMID- 3642354 TI - Toward rational drug therapy: when less is more. PMID- 3642356 TI - Teaching the ABCs of C.O.P.D. PMID- 3642357 TI - Are you ready for State Boards? PMID- 3642358 TI - Professional growth: 5 ways to prevent malpractice claims. PMID- 3642359 TI - Pain relief: pharmacological interventions. PMID- 3642360 TI - Cognitive development and the experience of pain. PMID- 3642361 TI - Towards understanding pain, and planning for relief. PMID- 3642363 TI - A care study of acute distress: Joe the rugby player. PMID- 3642362 TI - Use of the London Hospital pain observation chart. PMID- 3642364 TI - Prenatal influences on fetal development. PMID- 3642365 TI - Influences on normal growth and development during infancy. PMID- 3642366 TI - The concept of childhood and theories of development. PMID- 3642367 TI - The first year of life experiencing, communicating, perceiving. PMID- 3642368 TI - Infant nutrition. PMID- 3642369 TI - The first year: a mother's view. PMID- 3642370 TI - Home safety and accident prevention. PMID- 3642371 TI - Alternative medicine: bridging the gap. PMID- 3642372 TI - Fundamentals of drug action: drug elimination. PMID- 3642373 TI - Doing the "professional" thing. PMID- 3642374 TI - Portrait of a nurse: Ruth Noble, RN, Staff Nurse II, Children's Hospital, Boston. Interview by tony DeCrosta. PMID- 3642375 TI - Preventing patient injury: what you don't do can land you in court. PMID- 3642376 TI - Overwhelmed? You can cope. PMID- 3642377 TI - Hypoglycemia: physiology, signs, and symptoms (continuing education credit). PMID- 3642378 TI - Margaret should have been charged with disorderly conduct. PMID- 3642379 TI - Turn worry into wisdom: proven strategies for the new nurse-manager. PMID- 3642380 TI - Are A.I.D.S. patients getting good nursing care? PMID- 3642381 TI - How to sell your ideas. PMID- 3642383 TI - About nurses: perceptions--and misperceptions. PMID- 3642382 TI - Informed consents: whose responsibility, anyway? PMID- 3642384 TI - Night supervisors: breaking through the clouds of stress. PMID- 3642385 TI - Eight steps to recruiting the right manager. PMID- 3642386 TI - Accountability standards balance quality and efficiency. PMID- 3642387 TI - Assertiveness: phone-calls, memos, and I messages. PMID- 3642388 TI - Nursing peer review: a development process. PMID- 3642389 TI - OR marketing: come to the fair! PMID- 3642390 TI - Controlling overtime costs. PMID- 3642391 TI - A humanistic approach to management. PMID- 3642392 TI - CPR: will videotaping mock drills improve performance? PMID- 3642393 TI - Management retreats: keys to effective planning. PMID- 3642394 TI - Nursing and the nuclear threat. PMID- 3642395 TI - Head nurses: clinicians or managers? PMID- 3642396 TI - Patient profile: Munchausen's syndrome. PMID- 3642397 TI - Teaching skills: three modes enhance learning. PMID- 3642398 TI - Adjusting new graduates to practice. PMID- 3642399 TI - Standards of care: fitting the pieces together. PMID- 3642400 TI - Confidentiality under question. PMID- 3642401 TI - Radiation and Sellafield. PMID- 3642402 TI - Ionising radiation and its biological effects. PMID- 3642403 TI - Individual monitoring of radiation workers. PMID- 3642404 TI - Ionising radiation: a guide to the regulations. PMID- 3642405 TI - Keeping abreast of gynaecomastia. PMID- 3642406 TI - Counselling. A problem of identity. 1. PMID- 3642407 TI - Problems in use of nursing diagnoses. PMID- 3642408 TI - Unleash your power! PMID- 3642410 TI - Perspective of a nurse administrator. Nursing: a social policy statement. PMID- 3642409 TI - In celebration. PMID- 3642411 TI - New age nursing. PMID- 3642412 TI - Nursing: health care's best resource--fulfilling the commitment. PMID- 3642413 TI - Anticipatory guidance: preventive care for stepfamilies. PMID- 3642414 TI - Physical exercise in coronary artery disease. PMID- 3642416 TI - [Life after Chernobyl]. PMID- 3642415 TI - [Delegating physician's functions to certified nursing personnel]. PMID- 3642417 TI - [Trip to Edinburgh for graduate nurses]. PMID- 3642418 TI - Air Force nursing has more to offer today than when Cherry Ames was a flight nurse. PMID- 3642419 TI - Nurses speak out: terminal care. PMID- 3642420 TI - Planning a continuum of gerontological care: the hospital-based skilled nursing facility. PMID- 3642421 TI - Orthopaedic nursing--1986 the need for communication. PMID- 3642422 TI - Nursing implications for post-polio sequelae. PMID- 3642423 TI - Documentation of discharge teaching of patients who have had hip surgery. PMID- 3642424 TI - Voiding dysfunction in geriatric patients with hip fracture: prevalence rate and tentative nursing interventions. PMID- 3642425 TI - Osteoporosis: cause, treatment, prevention. National Institute of Arthritis and Musculoskeletal and Skin Diseases. PMID- 3642426 TI - Radiology review--elbow injury. PMID- 3642427 TI - The investigation of nursing problems and orthopaedic nursing. PMID- 3642428 TI - Surfactant quantity and composition during recovery from hyaline membrane disease. AB - The appearance of phosphatidylglycerol in the tracheal wash of infants with hyaline membrane disease (HMD) has been reported to be associated with clinical signs of recovery. We analyzed lung tissue and bronchoalveolar lavage surfactant in an animal model of HMD to determine whether phosphatidylglycerol or some other component is necessary for recovery. The amount and composition of phospholipid (PL) was determined in the premature Macaca nemestrina monkey (140 days' gestation) during an acute stage of HMD, and in two stages of recovery. These changes were compared to observations made in healthy premature controls (140 days), gestational age-matched fetuses (140 days), and fetuses of 150 days' gestation (term = 168 days). The amount of PL and its surfactant composition in lung homogenates of the right lower lobe and in lavage of the excised left lung was determined. Compared to 140-day fetuses, the healthy controls had a several fold increase in lavage PL and disaturated phosphatidylcholine (DSPC) during the first few days of life (p less than 0.05). Prior to recovery, animals with HMD had no such increase in lavage PL or DSPC and demonstrated poor deflation stability. Recovery was associated with increased tissue and lavage PL (p less than 0.05) and increased fractions of phosphatidylinositol and DSPC (p less than 0.05), but not phosphatidylglycerol. The tissue compositional changes observed during recovery reflected maturational changes observed in the fetal animals studied at 10 days' greater gestational age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3642429 TI - Chronic vascular pulmonary dysplasia associated with neonatal hyperoxia exposure in the rat. AB - Chronic sequelae of neonatal hyperoxia was studied in male rats exposed to 0.96 1.0 FiO2 for the first 8 days of life. At 58 days of age functional and morphologic cardiopulmonary changes were compared with controls. Right ventricular systolic pressure was measured percutaneously under anesthesia and was increased in the O2 group (29.5 mm Hg +/- 3.1 versus 23.2 mm Hg +/- 3.5, p less than 0.001). Lung and heart weights were similar between groups. Right ventricular weights however were increased in the O2 group (0.197 g +/- 0.023 versus 0.175 g +/- 0.020, p less than 0.001). Air pressure-volume curves were similar but in the O2 rats saline deflation curves were shifted left and maximal fluid lung volumes were greater (14.1 +/- 1.2 versus 12.0 +/- 0.7 ml, p less than 0.001). Pulmonary arteries were perfused at 100 cm H2O with a barium-gel mixture and lungs were fixed at 25 cm H2O with formalin. Microscopic examination of lungs revealed dysplastic changes of alveolar architecture which included irregularly enlarged alveoli and incomplete alveolar septation. Morphometric studies of the lungs showed that the O2 rats had an increased volume proportion of parenchyma (0.865 +/- 0.020 versus 0.850 +/- 0.019, p less than 0.05), increased mean linear intercept (72.3 microns +/- 9.5 versus 53.6 microns +/- 5.0, p less than 0.001), decreased number of alveoli per mm2 (207 +/- 34 versus 319 +/- 39, p less than 0.001) and fewer small arteries (20-200 microns) per mm2 (8.7 +/- 1.3 versus 14.9 +/- 2.4, p less than 0.001). The number of small arteries/100 alveoli was similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3642430 TI - Transfusion-associated acquired immunodeficiency syndrome--what is the risk? PMID- 3642432 TI - Review of research in nursing education. Volume I. PMID- 3642433 TI - Research on clinical judgment. PMID- 3642431 TI - Comparison of four surfactants: in vitro surface properties and responses of preterm lambs to treatment at birth. AB - Natural sheep surfactant, rabbit surfactant, human surfactant, and surfactant TA were compared for in vitro surface properties and for responses of preterm lambs to treatment. Equivalent amounts of sheep, rabbit, and human surfactants were needed to lower the surface tension to less than 10 dynes/cm, whereas four times less surfactant TA similarly lowered the surface tension. Surface-spreading rates were similar for the surfactants. The surface adsorption of the batch of human surfactant tested was much slower than was adsorption of the other surfactants. Ventilation was significantly improved in all surfactant-treated lambs relative to the control lambs, indicating the general efficacy of the surfactant treatments. Overall, surfactant TA had the best in vitro characteristics, yet the preterm lambs treated at birth with surfactant TA had lower PO2 values and higher ventilatory requirements than did the sheep surfactant-treated lambs. The in vivo responses to rabbit surfactant were intermediate between the responses to sheep surfactant and to surfactant TA. Human surfactant resulted in the least effective clinical response. More of the phosphatidylcholine associated with human surfactant and surfactant TA was lost from the alveoli and lung tissue after four hours of ventilation than was lost from sheep or rabbit surfactant-treated lambs. More intravascular radiolabeled albumin leaked into the alveoli of the surfactant TA-treated lambs than sheep or rabbit surfactant-treated lambs. The four surfactants also had different sensitivities to the effects on minimum surface tensions of the soluble proteins present in alveolar washes. The study demonstrates that the range of clinical responses was not predictable based on the in vitro surface properties that we measured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3642434 TI - Stress of the returning RN student. PMID- 3642435 TI - Stress and critical care nursing. PMID- 3642436 TI - Research studies in hospital staff development. PMID- 3642437 TI - The clinical nurse specialist. PMID- 3642439 TI - Research on clinical teaching. PMID- 3642438 TI - Professional socialization of the registered nurse. PMID- 3642440 TI - Predicting academic success. PMID- 3642441 TI - NLN guide to success on nursing examinations. PMID- 3642442 TI - The community health nursing supervisor: a handbook for community/home care managers. PMID- 3642444 TI - Looking beyond the entry issue: implications for education and service. PMID- 3642443 TI - Competencies of the associate degree nurse: valid definers of entry-level nursing practice. PMID- 3642445 TI - Organizational positions on titling and entry into practice: a chronology. PMID- 3642446 TI - State positions on titling and licensure. PMID- 3642447 TI - A sociological perspective on professions: other entry dilemmas. PMID- 3642448 TI - Competencies of associate and professional nurses. PMID- 3642450 TI - Transforming the patterns of nursing education. PMID- 3642449 TI - Mobility programs for students and faculty. PMID- 3642451 TI - Issues affecting nursing and the delivery of health care. PMID- 3642452 TI - Nursing practice in the health care organization of the future. PMID- 3642453 TI - The nucleotide sequences of two glycine tRNAs from Lupinus luteus seeds. PMID- 3642454 TI - Real lives. PMID- 3642455 TI - Unionisation: a matter for the unions. PMID- 3642456 TI - Hospital closures: the big move. PMID- 3642457 TI - A stand on apartheid. PMID- 3642458 TI - Oral thrush in hospice patients. PMID- 3642459 TI - Monitor: definition or measurement? PMID- 3642460 TI - Monitor: a pointer to quality. PMID- 3642461 TI - Nursing Aid. Broadening the pyramid base. PMID- 3642462 TI - Nursing Aid. 'Nice' girls don't. Interview by Pamela Holmes. PMID- 3642463 TI - Nursing Aid. Let's dance! PMID- 3642464 TI - A mini-clinic for diabetics. PMID- 3642465 TI - The case for combination casts. PMID- 3642466 TI - Project 2000. The future with confidence. PMID- 3642467 TI - Home care. No place like home. PMID- 3642468 TI - Home care. Opening the communication line. PMID- 3642469 TI - Locally organised antenatal classes and their effectiveness. PMID- 3642470 TI - Views on health visitors. PMID- 3642471 TI - Management: the missing guest at the feast. PMID- 3642472 TI - Community care: bridging a widening gap. PMID- 3642473 TI - Second opinions, second thoughts? PMID- 3642474 TI - Ward management. What future for the ward sister? PMID- 3642476 TI - A record of violence. PMID- 3642475 TI - Ward management. More than just managing. PMID- 3642477 TI - Mothers' reaction to a perinatal death. PMID- 3642478 TI - Winner takes all?. Interview by Patricia Slack. PMID- 3642479 TI - A home of their own. PMID- 3642480 TI - Down under and back. Interview by Laurence Dopson. PMID- 3642481 TI - Tough on the streets. PMID- 3642482 TI - Hector Mackenzie: COHSE's changing face. Interview by Harriet Gaze. PMID- 3642483 TI - Mental handicap: under new management. PMID- 3642484 TI - AIDS and the moral majority. PMID- 3642485 TI - Therapeutic touch. The human connection. PMID- 3642486 TI - Therapeutic touch. Joining forces. PMID- 3642487 TI - Relieving pain for a patient with breast cancer. PMID- 3642488 TI - Systems of life. No 143. Senior systems. 8. PMID- 3642489 TI - Slow stroke back massage for cancer patients. PMID- 3642490 TI - Mental health Nursing. Journal of the Psychiatric Nurses Association. PMID- 3642491 TI - Mental Health Nursing. Are you legal? PMID- 3642492 TI - Mental Health Nursing. Informal patients. PMID- 3642493 TI - Mental Health Nursing. Nobody's fool. Interview by Martin Vousden. PMID- 3642494 TI - The forgotten children. PMID- 3642495 TI - MIND conference: removing labels. PMID- 3642497 TI - Therapeutic touch: getting the massage. PMID- 3642496 TI - AIDS: too little, too late? PMID- 3642498 TI - Skill mix. All mixed up. PMID- 3642499 TI - Skill Mix. Plan of action. PMID- 3642500 TI - An unwelcome companion. PMID- 3642501 TI - Down on the farm. PMID- 3642502 TI - The spiritual dimension. PMID- 3642503 TI - Midwives' Journal. PMID- 3642504 TI - Midwives' Journal. When it all gets too much. PMID- 3642505 TI - Midwives' Journal. Knowing when to leave well alone. PMID- 3642506 TI - Midwives' Journal. Troubled water. PMID- 3642507 TI - Midwives' Journal. I'm not racist, but. PMID- 3642508 TI - Continence. PMID- 3642509 TI - Continence. Managing faecal incontinence. PMID- 3642511 TI - Continence. When the sheets were changed. PMID- 3642510 TI - Continence. Checking catheter care. PMID- 3642513 TI - Continence. Calling in the experts. PMID- 3642512 TI - Continence. Setting up an advisory service. PMID- 3642514 TI - Shock to the system. Interview by Laurence Dopson. PMID- 3642515 TI - Teaching AIDS. PMID- 3642516 TI - Saudi Arabia: culture clash. PMID- 3642517 TI - Do they know it's Christmas? PMID- 3642519 TI - Nursing aid. Hospitals for health. PMID- 3642518 TI - Nursing aid. Feeding for the future. PMID- 3642520 TI - Nursing aid. Developing infection control. PMID- 3642521 TI - Teaching patients and clients. 1. Teaching, learning or both? PMID- 3642522 TI - Hydatidiform mole and choriocarcinoma. PMID- 3642523 TI - Communication. Towers of Babel? PMID- 3642524 TI - Management. Shared information. PMID- 3642525 TI - Squint. Early management of strabismus. PMID- 3642526 TI - Squint. The ugly duckling. PMID- 3642527 TI - Just a little jab? PMID- 3642528 TI - Mothers' meeting. PMID- 3642529 TI - Hyperventilation. PMID- 3642530 TI - Therapeutic touch. Knowledge at one's fingertips. PMID- 3642531 TI - The Journal of Infection Control Nursing. PMID- 3642532 TI - Journal of Infection Control Nursing. Practice versus procedure. PMID- 3642533 TI - A move for the Duchess. PMID- 3642534 TI - Health education: ignoring the health warnings. PMID- 3642535 TI - Casualty: making a drama out of a crisis. PMID- 3642536 TI - Feeding election fever. PMID- 3642537 TI - Patients' notes. On the record. PMID- 3642538 TI - Patients' notes. Information retrieval. PMID- 3642539 TI - Structural faults. PMID- 3642540 TI - Falling asleep. PMID- 3642542 TI - Quest: NT's educational supplement. PMID- 3642541 TI - Treatment schedules for hydatidiform mole and choriocarcinoma. PMID- 3642543 TI - Quest. The challenge of open learning. PMID- 3642544 TI - Quest. Testing skills. PMID- 3642545 TI - Crisis of faith. PMID- 3642547 TI - Eve Bendall: all about Eve. Interview by John Webb. PMID- 3642548 TI - Who dares wins. PMID- 3642546 TI - When the violence spills over. PMID- 3642549 TI - Coming in from the cold. PMID- 3642550 TI - The key to the future. PMID- 3642551 TI - Learned helplessness. PMID- 3642552 TI - Parental prerogatives. PMID- 3642554 TI - [Should we give information about the student to clinical teachers and head nurses before the clinical experience?]. PMID- 3642553 TI - Climb every crossroads. PMID- 3642555 TI - [Utilization of private nursing agencies in staffing general hospitals]. PMID- 3642556 TI - [Structural standards for the nursing unit. Committee on Nursing Standards, Division of Nursing, Ministry of Health, Jerusalem]. PMID- 3642557 TI - [Delayed rehabilitation due to decubitus ulcer]. PMID- 3642558 TI - Nursing at the threshold of 21st Century. PMID- 3642559 TI - AIDS: from West to East? PMID- 3642560 TI - An Indian psychiatric nurse in the United States: a personal experience. PMID- 3642561 TI - Your hands: lethal or life saving? PMID- 3642562 TI - A day hospital for cancer patients: clinical and economic feasibility. PMID- 3642563 TI - Protective measures used by oncologic office nurses handling parenteral antineoplastic agents. PMID- 3642564 TI - Characterization of the pain experience in a sample of cancer outpatients. PMID- 3642565 TI - Nonanalgesic methods of pain control used by cancer outpatients. PMID- 3642566 TI - Family care when a child has late stage cancer: a research review. PMID- 3642567 TI - Vulvar cancer: patient information booklet. PMID- 3642569 TI - Living wills. PMID- 3642568 TI - A view of women in higher ed. PMID- 3642570 TI - An introduction to computer technology (continuing education credit). PMID- 3642572 TI - Using a project management approach to install an automated order processing system. PMID- 3642573 TI - A computerized operating room scheduling and utilization system: one manager's experience. PMID- 3642571 TI - Justifying, proposing, and planning an operating room computerized information system. PMID- 3642574 TI - Computer applications in clinical anesthesia: present and future trends. PMID- 3642575 TI - Making the most of your computer. PMID- 3642576 TI - Future innovations in computer technology for operating room services. PMID- 3642577 TI - Pain management with intraspinal morphine sulfate injection. PMID- 3642578 TI - Professional survival tips: how to be a valuable employee (continuing education credit). PMID- 3642579 TI - Research: selecting an instrument. PMID- 3642580 TI - What is primary nursing? PMID- 3642581 TI - Mental handicap: human rights and relationships. PMID- 3642583 TI - Defining quality assurance. PMID- 3642582 TI - Action of cancer chemotherapy. PMID- 3642584 TI - Terminal care: their death in your hands. PMID- 3642586 TI - Intermittent self-catheterisation. PMID- 3642587 TI - [The health problems of nurses]. PMID- 3642585 TI - Blood glucose monitoring: teaching effective techniques. PMID- 3642588 TI - [Cognitive reflection of disease]. PMID- 3642589 TI - [Role of the nurse in school]. PMID- 3642590 TI - [How graduates work]. PMID- 3642592 TI - [Difficult, pressing tasks. Interview by Krystyna Serafin]. PMID- 3642591 TI - [Students and teachers]. PMID- 3642594 TI - [Partnership in marriage. II]. PMID- 3642593 TI - [Let us learn to have fun]. PMID- 3642595 TI - [The puerperium]. PMID- 3642596 TI - [Working conditions]. PMID- 3642597 TI - [Degenerative disease of the locomotor system]. PMID- 3642598 TI - [Higher nursing studies and personnel requirements]. PMID- 3642599 TI - [Effect of disease on personality]. PMID- 3642600 TI - [New status and tasks of the school nurse]. PMID- 3642601 TI - [Model of the teacher of the practical science of the profession]. PMID- 3642602 TI - [Experiences and attitudes]. PMID- 3642603 TI - [The return to health. Interview by Maria Lesnikowska]. PMID- 3642604 TI - [Students and graduates]. PMID- 3642605 TI - [Barriers to partnership in marriage. I]. PMID- 3642606 TI - [Intrahepatic cholestasis in pregnant women. II]. PMID- 3642607 TI - [In concern for the health of society]. PMID- 3642608 TI - [For the good of the nursing personnel and the patient]. PMID- 3642610 TI - Office laboratory testing. PMID- 3642609 TI - Painless office laboratory regulation. AB - In summary, the attention focused on the work performed in the physicians' office laboratories need not create any apprehension on the part of the physician directors. If the physician's office laboratory is subject to government regulations, be assured that the only objective is to provide assistance in accomplishing a mutual objective of quality work. The approach is one of a cooperative effort between professionals, and the physician's office laboratory should take advantage of the services, both consultation and training, offered by the regulatory agency. If the physician's office laboratory is not subject to regulations, the physician-director should personally direct the operation of his or her laboratory and keep abreast of the latest developments in laboratory medicine applicable to the specific areas of testing performed. The simplest way to do this is to take advantage of the voluntary certification programs being developed and any state or federal guidelines readily available. PMID- 3642611 TI - Performance audit in the selection and management of personnel in the physician's office laboratory. AB - The performance audit does not contain any startling news about human performance. It does, however, provide a unique perspective from which to view human performance. It asks the user to relate systematically each part to the whole, to test a hypothesis against actual data, and to formulate solutions based on a strong rationale. We have of necessity described this process very briefly, suggesting how specific tools may be derived for immediate use in the office laboratory. We conclude with a reminder that much useful information in the performance audit can be captured by constructing three tables with the following headings: 1. Job Description, Requirements, Standards; 2. Requirements, Standards, Deficiencies, Potential Impact; 3. Deficiencies, Possible Causes, Possible Solutions. Thus, the performance audit can provide useful information in regard to selecting personnel (item 1), monitoring the performance of laboratory personnel (item 2), and trouble-shooting specific problems (item 3). PMID- 3642612 TI - The role of the office laboratory in the diagnosis of vaginitis. AB - In this article, a standardized approach to the evaluation of a patient with vaginitis is presented. The article includes detailed descriptions of specimen collection techniques, slide preparation, and the microscopic examination. In addition, a series of case histories is presented demonstrating how laboratory findings can be interwoven with history and physical findings to provide the correct diagnosis. PMID- 3642613 TI - Clinical uses of the leukocyte esterase test. AB - In summary, there are many current and potential uses of the leukocyte esterase dipstick. However, the studies in the literature supporting these uses have several methodologic problems that should make one cautious about relying on the test too heavily. Its use in the symptomatic patient should be secondary to a urinalysis, especially in those who as a group have significant sequelae from urinary tract infections. These include pregnant patients, diabetics, and geriatric patients who may be lacking signs and symptoms of infection. The dipstick is not meant as a replacement for the microscopic examination of the urine sediment; it should be used to direct one to examine urine specimens that would not normally be analyzed microscopically. Further studies controlling for symptoms and gender are needed to make the leukocyte esterase test more useful to the primary care physician. PMID- 3642614 TI - What to expect from a laboratory industry representative. AB - The role of the laboratory industry representative is changing. Today, industry representatives must play a much stronger role in providing the products, service, and information that physicians need to run their practices more effectively. They must not only continue to offer high-quality products that are accurate, reliable, and cost-efficient but also provide the product knowledge and services that enable their customers to use those products effectively. They must also be able to advise their customers on new legislation and changes in the market. PMID- 3642615 TI - Assessing an office chemistry instrument. AB - Selection of appropriate testing systems depends on the characteristics and needs of the office. Clinical practice needs, work flow needs, and the analyst's ability must be balanced against the level of system complexity, automation, quality characteristics, and cost. PMID- 3642616 TI - Office glucose analysis. AB - The advent of dry chemistry techniques has made inexpensive glucose testing equipment available to physicians and their patients. The ability to measure blood glucose concentration quickly, in almost any setting, has eliminated urinary glucose monitoring as the parameter of choice for managing diabetic patients. Blood glucose monitoring has allowed improved control of diabetic patients who avail themselves of one of the techniques. The physician choosing to offer blood glucose testing in the office laboratory has a variety of test equipment from which to choose. Most physicians will want to own and operate an inexpensive, dedicated glucose reflectometer to test glucose samples in the office and to use in patient education. Machines used by both patients and physicians are about the same price. They are easy to learn to use. Office personnel must be trained to perform the procedure, teach it to patients, maintain the machine, and keep adequate quality control records. PMID- 3642617 TI - Office therapeutic drug monitoring. AB - Considerations necessary for appropriate therapeutic drug monitoring in the office practice setting have been presented. Practical issues focusing on clinical pharmacokinetics as well as serum drug concentration evaluation methods and techniques have been reviewed, with emphasis on orally administered medications. PMID- 3642618 TI - Nurse murders pediatric patient. PMID- 3642619 TI - Drug distribution "authorized": nurse convicted. Case in point: United States v. Vamos (797 F. 2nd 1146--NY). PMID- 3642620 TI - When doctor is "on call": disaster. Case in point: Boyd v. Lynch (493 So. 2d 1315 -MS). PMID- 3642621 TI - Nurse refuses to "float": sunk. PMID- 3642622 TI - Do you really have professional liability insurance? Case in point: William M. Mercer, Inc. v. Woods (717 S.W. 2d 391 - TX). PMID- 3642623 TI - Lethal lidocaine overdose: death. Case in point: Brooks v. Memphis & Shelby County Hosp. Author. (717 S.W. 2d 292 - TN). PMID- 3642624 TI - [Student-centered education: beginning evolution of the pediatric nursing course- graduate level]. PMID- 3642625 TI - [Study of nurses performance evaluation--theoretic references (I)]. PMID- 3642626 TI - [Retrospective analysis of research in intensive care nursing: 1975-1984]. PMID- 3642627 TI - [Social relations between the nursing team and parents of hospitalized children]. PMID- 3642628 TI - [Evaluation of the assistance given in an nursing assistance center]. PMID- 3642629 TI - Autonomic arousal and fear in the spinal cord injured. PMID- 3642630 TI - The use of art in stroke group therapy. PMID- 3642631 TI - The implementation of a mental health nursing clinical course in a rehabilitation setting. PMID- 3642632 TI - Wheelchair selection from a nursing perspective. PMID- 3642633 TI - A proactive approach to accrediting standards. PMID- 3642634 TI - [Locomotor apparatus: upper extremity (8). The wrist: carpal tunnel, median nerve, carpal tunnel syndrome]. PMID- 3642635 TI - [Central venous catheters (3)]. PMID- 3642636 TI - [Bronchial cancers: physiological basis]. PMID- 3642638 TI - [Bronchial endoscopy]. PMID- 3642637 TI - [Diagnosis of broncho-pulmonary cancers]. PMID- 3642639 TI - [Bronchial cancers: evaluation of loco-regional and general spread]. PMID- 3642641 TI - [Bronchial cancers]. PMID- 3642640 TI - [General principles of pulmonary neoplasm exeresis]. PMID- 3642642 TI - [Anesthesiologic and surgical technics in surgery of broncho-pulmonary cancers]. PMID- 3642643 TI - [Broncho-pulmonary cancers. 2 case reports]. PMID- 3642644 TI - ["Critical care nurse... who are you?"]. PMID- 3642645 TI - [Epidemiology of primary bronchial cancer and bronchial carcinogenesis]. PMID- 3642646 TI - [The nursing team facing a surgical decision: definitive colostomy]. PMID- 3642647 TI - [Review of thorax anatomy]. PMID- 3642648 TI - [Locomotor apparatus: upper extremity (9). The thumb: the bony column, muscles, scaphoid fracture]. PMID- 3642649 TI - [Central venous pressure (1)]. PMID- 3642650 TI - [Hemorrhoids and fissures: indications for surgery]. PMID- 3642651 TI - [Proctology. Surgical technics]. PMID- 3642653 TI - [Anesthesia-resuscitation in proctology. Viewpoint of the anesthetist]. PMID- 3642652 TI - [Status asthmaticus]. PMID- 3642654 TI - [Surgery in proctology]. PMID- 3642655 TI - [Surgery in proctology. Pre- and postoperative care: the nurse's role]. PMID- 3642656 TI - [Surgery in proctology. Postoperative complications]. PMID- 3642657 TI - [Role of the circulating nurse and the instrument nurse in proctologic surgery]. PMID- 3642658 TI - [Anatomy of the anal region]. PMID- 3642659 TI - [Economics and advanced technical performance in heart surgery]. PMID- 3642660 TI - [Physiological overview of ano-rectal movements]. PMID- 3642661 TI - [AIDS--even the general practitioner is involved]. PMID- 3642663 TI - [The HIV-antibody positive patient in general practice. Guidelines for rational diagnosis and treatment]. PMID- 3642664 TI - [Practical consequences of a positive HIV-antibody test in clinically healthy subjects]. PMID- 3642665 TI - [Viral hepatitis: thoughts on virology and serology]. PMID- 3642662 TI - [HIV-associated encephalopathy]. PMID- 3642666 TI - [Viral hepatitis from the physician's point of view]. PMID- 3642667 TI - [Suggestions for the prevention of viral hepatitis]. PMID- 3642668 TI - [Vaccination against hepatitis B: a study at the General Hospital Center at Flers]. PMID- 3642670 TI - [Puncture-biopsy of the liver]. PMID- 3642669 TI - [Development of nursing care for patients with AIDS]. PMID- 3642671 TI - Developing tests to measure nursing abilities. PMID- 3642672 TI - So you think you want to be a head nurse. PMID- 3642673 TI - The healing power of the human voice. PMID- 3642674 TI - Why deep vein thrombosis is so dangerous. PMID- 3642675 TI - Why do I always misdiagnose the patient I know best? PMID- 3642677 TI - When your patient faces jaw reconstruction. PMID- 3642676 TI - Close-up on cancer care. Multiple myeloma: controlling pain, prolonging survival. PMID- 3642678 TI - What you need to know about neurological testing. PMID- 3642679 TI - How to get your hospital on the right track. PMID- 3642680 TI - The challenge of caring for a patient at home. PMID- 3642681 TI - How the nursing process can turn you into a writer. PMID- 3642682 TI - Patient's advocate. Why do we stereotype our elderly patients? PMID- 3642683 TI - What you can do to stop the AIDS panic. PMID- 3642685 TI - Commonsense nursing care for the patient with poor vision. PMID- 3642684 TI - When the patient's problem is really poor vision. PMID- 3642686 TI - Breast cancer: the risks and the options (continuing education credit). PMID- 3642687 TI - If your patient must undergo fine-needle biopsy. PMID- 3642688 TI - When a vascular access site complicates care. PMID- 3642689 TI - Mr. Cameron proved I could make it in a man's world. PMID- 3642690 TI - Test your skill at troubleshooting chest tubes. PMID- 3642691 TI - Sexual harassment: how the victim pays the price. PMID- 3642692 TI - Stopping sexual harassment: the experts tell you how. PMID- 3642693 TI - Our patients still need tender loving care. PMID- 3642694 TI - We found a new setting for primary care. PMID- 3642695 TI - When your patient must depend on a machine. PMID- 3642696 TI - Why every patient needs a good night's sleep. PMID- 3642697 TI - Winning the battle against Hodgkin's disease. PMID- 3642698 TI - When cancer treatment causes hair loss. PMID- 3642699 TI - Saving the suicidal patient from himself. PMID- 3642700 TI - Two ways to sharpen your charting skills. Key words show what's important. PMID- 3642701 TI - Hypovolemia: when to suspect it; how to stop it (continuing education credit). PMID- 3642702 TI - When pregnancy threatens mother and child. PMID- 3642703 TI - Legal risks when the patient has emotional problems. PMID- 3642704 TI - Why some patients can't afford to go home. PMID- 3642705 TI - Medication errors: reducing the risks. PMID- 3642707 TI - Home care nursing. PMID- 3642706 TI - Breaking the habit: eight tips to help you quit smoking. PMID- 3642708 TI - Why nurses get in trouble. Part 1. Substance abuse. PMID- 3642709 TI - The impaired nurse: one person's story. PMID- 3642710 TI - Changing the Act: will I qualify? PMID- 3642712 TI - I can't hear you: caring for deaf patients. PMID- 3642711 TI - This too is nursing. PMID- 3642714 TI - Skin necrosis as a complication of improperly administered subcutaneous heparin. PMID- 3642713 TI - Degradation of solubilized [3H]elastin by intact human monocytes stimulated by immune complexes in vitro. AB - A simple assay is described that permits determination of elastolytic activity released from human monocytes. The substrate, solubilized [3H]elastin, is coated onto cell culture dishes. Blood monocytes are allowed to adhere, and during subsequent serum-free culture, radioactive degradation products of elastolysis are released into the culture medium. Using this assay we have demonstrated an elastolytic activity by normal human monocytes of 20 +/- 2 ng elastin/hour/3 X 10(6) mononuclear cells. Contaminating granulocytes and lymphocytes do not cause any significant elastolysis. On stimulation with immune complexes in vitro, the monocytes respond with an enzymatic burst that is 3.6 times the basic enzyme activity. This assay could be a useful tool in the evaluation of elastolytic activity of cells from other sources as well as from human monocytes. PMID- 3642716 TI - [Documentation in health care in Finland]. PMID- 3642715 TI - [Time to aim for home plan]. PMID- 3642717 TI - [To succeed with IVP (individual care planning)]. PMID- 3642718 TI - [A pensioners' club grows]. PMID- 3642719 TI - [Relationship between demented patients and their caregivers--a theory]. PMID- 3642720 TI - [Cleaning and disinfection of a room]. PMID- 3642721 TI - [AIDS and the digestive tract]. PMID- 3642722 TI - [Neurologic manifestations of AIDS]. PMID- 3642723 TI - [Kaposi's sarcoma associated with AIDS]. PMID- 3642724 TI - [Mr. B. has AIDS. Viewpoint of the neurological nurse]. PMID- 3642726 TI - [Proposed preventive hygienic measures against the AIDS virus. Proposals of the work group of the Committee to combat hospital infections of the Intercommunal Hospital Center of Montfermeil]. PMID- 3642725 TI - [AIDS]. PMID- 3642727 TI - [Components of the salary]. PMID- 3642728 TI - [Victan]. PMID- 3642729 TI - [Permanent education of psychiatric nurses]. PMID- 3642730 TI - [Viewpoints on specific activities of nurses of the psychiatric sector]. PMID- 3642731 TI - [The place of the psychiatric nurse in the new care policies in mental health]. PMID- 3642732 TI - ["For an effective place for the psychiatric nurse"]. PMID- 3642733 TI - [The IXth plan: the second revolution of the section]. PMID- 3642734 TI - [Psychiatric education and the function of the educational environment]. PMID- 3642735 TI - [The objectives of the French National Association of Psychiatric Male and Female Nurses]. PMID- 3642736 TI - [The nurse and the depressed adult in psychiatry]. PMID- 3642737 TI - [Basic education of psychiatric nurses. Current problems]. PMID- 3642738 TI - [Medico-legal aspects of acting out]. PMID- 3642739 TI - [Acting out within the institution]. PMID- 3642740 TI - [Passage a l'acte, "acting out", "agieren"]. PMID- 3642741 TI - [Acting out in children]. PMID- 3642742 TI - [Children, victims of aggression. A case report of acting out within the family]. PMID- 3642743 TI - [Slight mental handicap and procreation. Knowledge and practice in 15 slightly mentally handicapped women]. PMID- 3642744 TI - [Acting out]. PMID- 3642745 TI - [A theater workshop in psychiatry]. PMID- 3642746 TI - [Acting out in psychiatric nosography]. PMID- 3642747 TI - [Breakdown and violence. Acting out against others]. PMID- 3642748 TI - [Partnership in nursing: an analysis of verbal communication between expectant mothers and public health nurses]. PMID- 3642749 TI - [The effect of intensive physiotherapy teaching 1-2 weeks prior to hospitalization on the recovery of patients undergoing gallbladder surgery]. PMID- 3642750 TI - [Subjective experiences of patients' adaptation to breast cancer]. PMID- 3642751 TI - [Leadership styles of nursing directors]. PMID- 3642752 TI - [Model curriculum for quality assurance training: report on WHO/EURO's meeting in Udine, Italy, 25-28 June 1985]. PMID- 3642753 TI - [Model of a care plan for a cardiac patient. Report of a thesis]. PMID- 3642754 TI - [The nursing process from an interpretative viewpoint]. PMID- 3642755 TI - [Assessing the quality of nursing care: analysis of documents dealing with the assessment of quality of nursing care]. PMID- 3642756 TI - [Nurses' role in an outpatient clinic]. PMID- 3642757 TI - [Primary nursing: experiences evaluated by nursing staff and patients]. PMID- 3642758 TI - [What are the stage, level and possibilities of nursing science? A philosophical approach to nursing science]. PMID- 3642759 TI - Legislation regulating allied health occupations. PMID- 3642760 TI - [Abridged "nursing" education. Are we setting the clock back?]. PMID- 3642761 TI - [Abridged "nurses" education: an assault on the entire health system. Principle comments from members in other societies]. PMID- 3642762 TI - [Abridged "nurses" education. Nursing assistants' warning]. PMID- 3642763 TI - [District leader. Initiative as a counter]. PMID- 3642764 TI - [Another side of things: nurses' legal responsibility]. PMID- 3642765 TI - [When the starting point is craziest...]. PMID- 3642766 TI - [Offshore nursing: Norwegian Nurses' Association on a solid base]. PMID- 3642767 TI - [Health for all by the year 2000 (I): Nurses' role in international cooperation]. PMID- 3642768 TI - [Alma Ata Declaration]. PMID- 3642769 TI - [No to abridged "nurses" education, Norwegian Nurses' Association documents and comments]. PMID- 3642770 TI - [Help for the caregivers--pills or a course of burnout?]. PMID- 3642771 TI - [Finnmark in front: experiences from work with victims of incest]. PMID- 3642772 TI - [Norwegian Nurses' Association's wage policy (3): Scale agreement for all members?]. PMID- 3642773 TI - [Food advisory committee in Trondheim's Regional Hospital has studied: patients' opinion of hospital food]. PMID- 3642774 TI - [Health for all by the year 2000 (II): we hold this against challenges]. PMID- 3642775 TI - [In case confidence fails: few profitable savings]. PMID- 3642776 TI - [Health station no island. Improved pregnancy monitoring with cross-professional team work]. PMID- 3642777 TI - [A contribution to new thinking: creative activities in a psychiatric day care department]. PMID- 3642779 TI - [Everyday ethics--on use and misuse of trust and confidence]. PMID- 3642778 TI - [The least you should know: multiple sclerosis and patients]. PMID- 3642780 TI - [Successful arrangement: home visits to 4-year-olds]. PMID- 3642781 TI - [Risk of perinatal infection--women, infants and AIDS]. PMID- 3642782 TI - [Norwegian Nurses' Association's study indicates: increased shortage of nurses but professional activities on steady increase]. PMID- 3642783 TI - [Negotiations department informs: shorter work time for some after new year]. PMID- 3642784 TI - [Karasjok Health Center--a flagship in health--Finnmark]. PMID- 3642786 TI - [Don't be afraid of private discussions]. PMID- 3642785 TI - [A professional miscarriage of justice under discussion]. PMID- 3642787 TI - [Death and dying. Patients need to be free of pain]. PMID- 3642788 TI - [A short road between the individual and the organization]. PMID- 3642789 TI - [District directors are co-responsible for the organizational profile. Interview by Ulla Danielsen]. PMID- 3642790 TI - [Health visitors displayed important matters]. PMID- 3642791 TI - [Psychiatry. Community living for mental patients promotes a better adaptation]. PMID- 3642792 TI - [Too little known about consequences and problems of urinary incontinence]. PMID- 3642793 TI - [Drug information. Plasma substitutes]. PMID- 3642794 TI - [PSI (Public Services International). Public employment with neglect of professional rights]. PMID- 3642795 TI - [Planning and organization in ambulatory facility based on improved documentation]. PMID- 3642796 TI - [Mozambique. Health care effort threatened by war, starvation and natural disasters]. PMID- 3642797 TI - [Psychiatry. Fountain House--a model for resocialization of psychiatric patients]. PMID- 3642798 TI - [Institution--or home]. PMID- 3642799 TI - [Will basic education again be linked to the hospital?]. PMID- 3642800 TI - [Drug information. Statement of measurement specially for many small amounts]. PMID- 3642801 TI - [Report from a group of mothers of twins]. PMID- 3642802 TI - [Parents of twins have a specially high divorce rate]. PMID- 3642803 TI - [Increased awareness of work-induced disorders]. PMID- 3642804 TI - [Reductions. Foreseeable deaths among patients on waiting list]. PMID- 3642805 TI - [We must not allow ourselves to be cowed by the politicians]. PMID- 3642806 TI - [Round-the-clock home nursing should not lead to isolation of the elderly. Interview by Ulla Holtegaard]. PMID- 3642807 TI - [Alternative treatment. Medical art and health services in a time of conflict]. PMID- 3642808 TI - [Clear answer from the nurses to the politicians]. PMID- 3642809 TI - [Danish Nursing Council. 1986 Congress]. PMID- 3642810 TI - [Kolding Hospital: a working place on the verge of conflict]. PMID- 3642812 TI - [District psychiatry. Future health care system must function at the patient's premises]. PMID- 3642811 TI - [Education. We must work on burnout syndrome and student frustration]. PMID- 3642813 TI - [Danish Nursing Council. Congress 86]. PMID- 3642814 TI - [Middelfart. This is how the report gets used, to fire troublesome critics]. PMID- 3642815 TI - [Alternative treatment and nursing]. PMID- 3642816 TI - [Criteria of death. Heart death or brain death--is it the same death?]. PMID- 3642817 TI - [Observations on transplantation statement]. PMID- 3642818 TI - [Still an important choice for all nurses]. PMID- 3642819 TI - [Criteria of death. If should be studies whether people want a change in death criteria]. PMID- 3642821 TI - [Executive Board. Initiative about change-overs in the health care system]. PMID- 3642820 TI - [Danish Nursing Council: Congress 86]. PMID- 3642823 TI - [Nurses' working environment is not always healthy]. PMID- 3642822 TI - [Denmark's nursing university. The adjusted 2d part continuing education is a necessity]. PMID- 3642824 TI - [Nurses' shortage. Establish some more education places for student nurses]. PMID- 3642825 TI - [Income tax return. Tax orientation toward income tax return for the fiscal year 1985]. PMID- 3642826 TI - [WHO: on the way with health for all]. PMID- 3642827 TI - [Nursing. From idea to practice with an open patient kardex system]. PMID- 3642828 TI - [The significance of pregnancy and childbirth for the mother/child/father relationship]. PMID- 3642830 TI - [A conference important for the health care system]. PMID- 3642829 TI - [Why are nursing students frustrated?]. PMID- 3642831 TI - [Nursing under discussion. WHO's medium-term programs starts in self-critical reflection]. PMID- 3642832 TI - [Nursing in work inspection]. PMID- 3642833 TI - [One keeps stressing technology in nursing without an adequate introduction. Interview by Helle Kastholm Hansen]. PMID- 3642835 TI - [Danish Nursing Council establishes blockade against Medscand Recruitment]. PMID- 3642834 TI - [Monitoring with technology can cause strange doings]. PMID- 3642836 TI - [Greenland. Better conditions as long as the law makes it possible]. PMID- 3642837 TI - [Patients' needs determine course of activities in pioneer stoma clinic]. PMID- 3642838 TI - [Human rights in a peace year]. PMID- 3642839 TI - [The aged don't just want to be retired]. PMID- 3642840 TI - [Nurses' shortage should be evaluated from a general economic viewpoint. Interview by Helle Kastholm Hansen]. PMID- 3642841 TI - [Health department's reputation threatened by internal discussions. Interview by Peter Hjorth and Ulla Danielsen]. PMID- 3642842 TI - [Nursing research. Renewed cooperation with WHO following successful project]. PMID- 3642843 TI - [Dialysis. Patient information and personnel training are particularly effective]. PMID- 3642844 TI - [Executive Board. New technology connects Danish Nurses' Council centrally and locally]. PMID- 3642845 TI - [Executive Board. Hvidovre's affairs are a symptom of working conditions]. PMID- 3642846 TI - [New legislation gives patients the right to read their records]. PMID- 3642847 TI - [We can and we want primary nursing also in the future]. PMID- 3642848 TI - [Head nurse: salary is unreasonable in relation to responsibility. Interview by Lars Peter Bergqvist]. PMID- 3642849 TI - [Nurses went on strike and got more in wages]. PMID- 3642850 TI - [We consider changing jobs if ward education doesn't improve]. PMID- 3642851 TI - [Education. Importance of the educational background to nursing students]. PMID- 3642852 TI - [Cross-professional team work. Educational project on treatment of alcohol abuse]. PMID- 3642854 TI - [Need for expressive nursing care during regional analgesia]. PMID- 3642853 TI - [Nursing's knowledge base--dimension, content, level]. PMID- 3642855 TI - [Inferior care if physicians take over anesthetists' positions]. PMID- 3642857 TI - [New nursing plans inspire better nursing care. Interview by Ulla Holtegaard]. PMID- 3642856 TI - [We give nursing care to people--not to diseases]. PMID- 3642858 TI - [Psychiatry. Milieu where young psychiatric patients can develop]. PMID- 3642859 TI - [We must be more open to confront crisis reactions after accidents and violence]. PMID- 3642860 TI - [Saint Hans: they make far too few demands on patients. Interview by Jesper Jespersen]. PMID- 3642861 TI - [Saint Hans: an extra guard who can be summoned must replace belt fixtures. Interview by Jesper Jespersen]. PMID- 3642862 TI - [Saint Hans: quality of care is not proportional to the appropriation. Interview by Jesper Jespersen]. PMID- 3642864 TI - [Expanded information on change-overs in the health care system]. PMID- 3642863 TI - [Drug information. Potassium important in the right dosage]. PMID- 3642865 TI - [We are both caregivers and prisoners]. PMID- 3642866 TI - [Change-over requires a showdown with habits and traditions]. PMID- 3642867 TI - [Saint Hans: it is psychologically charged with identity-threatening working situation]. PMID- 3642868 TI - [Let the dying go in peace]. PMID- 3642869 TI - [We are not being heard say Copenhagen's home care nurses. Interview by Nina Engen]. PMID- 3642870 TI - [Public auditing report covers only quantitative dimensions]. PMID- 3642871 TI - [Danish Council of Nurses invites applications for research fund]. PMID- 3642872 TI - [Cooperation with WHO over Greenlanders' health?]. PMID- 3642873 TI - [Responsibility for the sick and inform must not be impaired]. PMID- 3642874 TI - [Nursing research. Patients do not always know side effects of their medications]. PMID- 3642875 TI - [Greenland. Nurses will imagine the extra step]. PMID- 3642876 TI - [Health services must be based on prevention]. PMID- 3642877 TI - [We encounter clients' loneliness especially in the evening shift]. PMID- 3642878 TI - [Executive Board. Shortage of nurses is a scandal]. PMID- 3642879 TI - [Documentation of nurses' shortage in dry figures]. PMID- 3642881 TI - [Difficult to have eyes for something else but sympathy. Greenland. Interview by Soren Palsbo]. PMID- 3642880 TI - [Greenland's conflict between dependency and independence]. PMID- 3642882 TI - [If anything, one should get money for the work]. PMID- 3642884 TI - [Prevention and recovery should go hand in hand]. PMID- 3642883 TI - [Ombudsman annual course--growth in work quantity must be documented]. PMID- 3642885 TI - [We're not lacking ideas for change-overs]. PMID- 3642886 TI - [Back injuries and care of patients]. PMID- 3642887 TI - [Drug information. Sublingual synthetic morphine preparations]. PMID- 3642888 TI - [Patients with psoriasis have an alternative]. PMID- 3642889 TI - [A great many communities over the entire country have no health visitors]. PMID- 3642890 TI - [How can one come to work as a nurse in New York]. PMID- 3642891 TI - [Greenland: fruitful discussion about Greenland's health care system. Interview by Soren Palsbo]. PMID- 3642892 TI - [Nurses in Greenland should be able to clarify what they prefer. Interview by Soren Plasbo]. PMID- 3642893 TI - [Valedictory interview. This makes us strongly think new thoughts and try new ways]. PMID- 3642894 TI - [Urinary incontinence--difficult to learn to live with urinary incontinence]. PMID- 3642895 TI - [Problems with urinary incontinence can be lessened]. PMID- 3642896 TI - [Greenland. At pioneer post in home care nursing for the second time. Interview by Soren Palsbo]. PMID- 3642897 TI - [New work area waiting in Greenland's home for the aged. Interview by Soren Palsbo]. PMID- 3642898 TI - [Greenland's nurse-peqqissaasoq]. PMID- 3642899 TI - [Greenland. The status of nursing in a small piece of USA]. PMID- 3642900 TI - [Station nurse--a job of maturity. Interview by Soren Palsbo]. PMID- 3642901 TI - [Administration of nursing. Nursing's role in an administrative model]. PMID- 3642902 TI - [Danish nurses' Unemployment Fund]. PMID- 3642903 TI - The business of nursing is--caring first. PMID- 3642905 TI - Can nurses, nursing influence legislators? The nurse as seen by politicians. PMID- 3642904 TI - Can nurses, nursing influence legislators? Legislators' perceptions of nursing and nursing's input into health care legislation. PMID- 3642906 TI - [Making a virtue of necessity. III. How qualified is a competent 'lengthened arm'?]. PMID- 3642907 TI - [Between management and patient bedside]. PMID- 3642909 TI - [With a map through the maze. A model of the nursing process]. PMID- 3642908 TI - [Snapshot in Ethiopia. Relief Action, 1985]. PMID- 3642910 TI - [Medical information for nurses. Wegener's disease]. PMID- 3642911 TI - [Nursing--interview with Professor A.H.M. van den Bergh-Braam]. PMID- 3642912 TI - [Automation of the nursing record. Marginal notes with a development]. PMID- 3642913 TI - [Children of drug-addicted parents. An inventory and literature review]. PMID- 3642914 TI - Hepatotoxicity of metals in glutathione-depleted mice. AB - Sublethal doses of cadmium chloride (CdCl2; 3 mg/kg i.v.), mercuric chloride (HgCl2; 2 mg/kg i.v.) and sodium vanadate (6 mg/kg i.v.) were administered to normal and glutathione (GSH)-depleted mice (phorone, 250 mg/kg i.p.). In normal mice serum sorbitol dehydrogenase (SDH) activity as a measure of hepatotoxicity was elevated 24 h after treatment with CdCl2 and HgCl2. Following GSH depletion more pronounced increments of SDH activities were observed only after CdCl2 treatment. No difference was seen in the exhalation of ethane by normal and GSH depleted animals, neither in metal-treated nor in control mice, indicating that lipid peroxidation is not involved in their hepatotoxicity. PMID- 3642915 TI - Nursing--a discipline between social and medical sciences. PMID- 3642917 TI - [A proposal for the classification of nursing situations in extramural care. A Nursing Dependency Scale]. PMID- 3642916 TI - [Nurses' perception of their own role and its practical realization]. PMID- 3642918 TI - [Election preparations report: Inger becomes SHSTF's association's new spokesperson. Interview by Jan Thomasson]. PMID- 3642919 TI - [A comparison between Arvika and Linkoping]. PMID- 3642920 TI - [SHSTF's delegates agreement: in principle, yes to new wage system]. PMID- 3642921 TI - [We want to create as homelike an atmosphere as possible. Interview by Jan Thomasson]. PMID- 3642922 TI - [Health University in Beersheba, Israel: not only the grades decide here- admission interview is important]. PMID- 3642923 TI - [IAMLT's (International Association of Laboratory Technologists) 17th congress: a show of strength of Swedish laboratory assistants]. PMID- 3642924 TI - [South Africa a hot potato for IAMLT (International Association of Medical Laboratory Technologists)]. PMID- 3642925 TI - [Wage earners agree: a poor bargaining offer]. PMID- 3642926 TI - [Are computers more human than physicians?. Interview by Viveka Holmertz]. PMID- 3642927 TI - [What are nurses' dreams in 1986?]. PMID- 3642929 TI - [Government puts negotiations systems out of the running]. PMID- 3642928 TI - [Judy Mansell--nurse in the Australian outback]. PMID- 3642930 TI - [Vardfacket's Language School: having children]. PMID- 3642931 TI - [Questions from Soder Hospital in Stockholm: must I watch every single step continuing education students take?]. PMID- 3642932 TI - [SHSTF investigates instructor's responsibility]. PMID- 3642933 TI - [Deficient special education in pediatric nursing--a threat against future care. Interview by Jan Thomasson]. PMID- 3642934 TI - [More professional articles in Vardfacket]. PMID- 3642935 TI - [Start for health university: here prospective doctors and nurses train as a team]. PMID- 3642936 TI - [Misery is the worst sickness]. PMID- 3642937 TI - [Massive protests over cutbacks]. PMID- 3642938 TI - [SHSTF (Swedish Association for Health Care and Nursing Employees) in conflict]. PMID- 3642939 TI - [Association's board says 'yes' to David's motion on rationing of alcohol. Interview by Viveka Holmertz]. PMID- 3642940 TI - [AIDS in Africa]. PMID- 3642941 TI - [The future psychiatric nurse--psychotherapist or physician's assistant?]. PMID- 3642942 TI - [England. New system after 3 years--profession doesn't negotiate about wages. Interview by Jan Thomasson]. PMID- 3642943 TI - [SHSTF in conflict]. PMID- 3642944 TI - [This is how to handle over-occupation: open a new ward]. PMID- 3642945 TI - [ICN conference on "Health for All"]. PMID- 3642946 TI - [Expectation in Mora: working as a nursing team provides better care]. PMID- 3642947 TI - [We take a peek in Marianne's photo album]. PMID- 3642948 TI - [Vardfacket's Language School: nursing school and jobs]. PMID- 3642949 TI - [Nursing home with a license]. PMID- 3642950 TI - [SHSTF (Swedish Association for Health Care and Nursing Employees) in conflict)]. PMID- 3642951 TI - [Preparations finished--congress can start. Interview by Jan Thomasson]. PMID- 3642952 TI - [Everybody says 'yes'--but not everybody is clear]. PMID- 3642953 TI - [Jeanette is the youngest. Interview by Viveka Holmertz]. PMID- 3642954 TI - [Economy and working environment behind need--employers should agree on service car]. PMID- 3642956 TI - [England. Neil is responsible for Rcn's political activities. Interview by Jan Thomasson]. PMID- 3642955 TI - [England. Rcn carried out "Contract 86 campaign". Interview by Jan Thomasson]. PMID- 3642957 TI - [Women who cry blood]. PMID- 3642958 TI - [Flying Doctors--saviors in emergencies]. PMID- 3642959 TI - The addicted professional--after recovery. PMID- 3642960 TI - A surgeon's liability for the anesthesia administrator: the law according to Dr. Modell. PMID- 3642961 TI - Quality assurance. Part IV: The law (continuing education credit). PMID- 3642962 TI - Obesity; a review. Part I. PMID- 3642963 TI - An analysis of the subjective pungencies of inhalational anesthetics. PMID- 3642964 TI - Epidural anesthesia for cesarean section and tubal ligation in an achondroplastic dwarf. PMID- 3642966 TI - The AANA code of ethics. PMID- 3642965 TI - Nurse anesthetists' well-being: Part II. PMID- 3642967 TI - CRNA direct reimbursement bill enacted. PMID- 3642968 TI - Anesthetic implications of the acquired immunodeficiency syndrome (AIDS): Part II. PMID- 3642969 TI - The effects of a warming vest and cap during lower extremity orthopedic surgical procedures under general anesthesia. PMID- 3642970 TI - Medical malpractice: the need for documentation/communication (continuing education credit). PMID- 3642971 TI - Obesity: a review. Part II. PMID- 3642972 TI - Acute AIDS viral infection. PMID- 3642973 TI - Detection of human immunosuppressive virus in salivary lymphocytes from dental patients with AIDS. PMID- 3642974 TI - In search of the excellent one-minute megatrend...or how to tolerate the five minute burden. PMID- 3642975 TI - Flu alert: adult epiglottitis. PMID- 3642976 TI - Touching you, touching me. PMID- 3642977 TI - Strike: more than two sides. PMID- 3642978 TI - Radiation therapy not to blame for all symptoms. PMID- 3642980 TI - Is it safe to reuse disposables? PMID- 3642979 TI - Clinical judgment: how expert nurses use intuition. PMID- 3642981 TI - Airway management for the critically ill patient. PMID- 3642982 TI - Imprisoned within ourselves. PMID- 3642983 TI - The secret to life in a spica. PMID- 3642984 TI - The hospital racket: how noisy is your unit? PMID- 3642985 TI - Troubleshooting intraspinal narcotic delivery systems. PMID- 3642986 TI - The liver: to know it is to love it. PMID- 3642988 TI - Standards of home health nursing practice. PMID- 3642987 TI - HTLV-III expression in infected lymph nodes and relevance to pathogenesis of lymphadenopathy. AB - In situ hybridization with a 35S-labeled probe of cryosections from 14 lymph nodes of HTLV-III/LAV-seropositive individuals with lymphadenopathy showed the presence of rare cells containing HTLV-III RNA at levels consistent with virus replication. Positive cells were observed at a frequency of only 1-10 per section. In all lymph nodes studied, including those showing follicular hyperplasia or involution, most of the cells expressing viral RNA were present in the follicular areas. Only a minority of such cells were found outside the follicles. The nature of the follicular, virus-replicating cells was not evident from the processed cryosections. After prolonged autoradiography, another pattern of hybridization was observed, suggesting low levels of viral RNA diffusely distributed throughout most, but not all, follicles. This may represent extracellular virus and/or virus-antibody complexes, but was not consistent with intracellular viral RNA or phagocytosed virus particles. Comparison of hybridization levels in relation to histology suggested a decrease in both the number of HTLV-III replicating cells as well as in the diffusely distributed viral RNA with progression of follicular involution. Our observations indicate that in HTLV-III-infected subjects, lymph node follicles are an important site of virus replication and trapping, suggesting a decisive role of the virus in the characteristic reactive and cytopathogenic changes of HTLV-III-associated lymphadenopathy. PMID- 3642989 TI - Standards of college health nursing practice. PMID- 3642990 TI - Pay equity: what it means and how it affects nurses. PMID- 3642991 TI - Gerontological nursing curriculum: survey analysis and recommendations. PMID- 3642992 TI - Gerontological nurses in clinical settings: survey analysis. PMID- 3642993 TI - The role of the clinical nurse specialist. PMID- 3642994 TI - Change and infection control. PMID- 3642995 TI - Education of the adult learner: a practical approach for the infection control practitioner. AB - Infection control practitioners (ICPs) are expected to be educators in their role, yet few have had formal training in preparing, presenting, and evaluating education programs for personnel from different disciplines. This article presents guidance from several sources specific to "andragogy"--the art and science of helping adults learn--to assist the ICP in the role of educator. PMID- 3642996 TI - Meeting the challenge: minimum authority, maximum responsibility. Seventh annual Carole DeMille lecture. PMID- 3642997 TI - Recapping needles safely using a recapping adapter. PMID- 3642998 TI - ANA contracts for new RN liability insurance program. PMID- 3642999 TI - Project charts transition for education. PMID- 3643000 TI - Demand surges for specialty nurses. PMID- 3643001 TI - Reports on AIDS call for strong action. PMID- 3643002 TI - Teamwork needed for hospitals, nursing to thrive. PMID- 3643003 TI - Two points to ponder about the shortage. PMID- 3643004 TI - As I see it--nurses face new challenges when hospitals merge. PMID- 3643005 TI - Forum considers nursing scope statement. PMID- 3643007 TI - Health groups discuss radiation emergencies. PMID- 3643006 TI - Academy looks at nursing's preferred future. PMID- 3643008 TI - Liaison Forum seeks ways to promote action. PMID- 3643009 TI - From crisis to coalescence. PMID- 3643010 TI - As I see it--nursing centers make nursing care accessible. PMID- 3643011 TI - ANA statements focus on nursing home issues. PMID- 3643013 TI - The ethics of health care. PMID- 3643012 TI - Elastase activity in capillary and aortic endothelial cells. AB - Tissue cultured bovine capillary and aortic endothelial cells were examined for cellular and secreted proteinase activity. Cell-lysates from both sources showed significant elastase activity but differed in the level of activity and the pH optimum and inhibition profile. Secretion of elastase was only detected using aortic cells. Tumour angiogenesis factor (TAF), heparin or 12-0-tetradecanoyl phorbol-acetate (TPA) had no effect on the levels of cell-associated or secreted elastase. PMID- 3643014 TI - Ethical problems in organ procurement and transplantation. PMID- 3643015 TI - Ethics in nephrology: a regional approach. PMID- 3643016 TI - Patient and staff involvement in decisions for ESRD treatment. PMID- 3643017 TI - Patient and staff involvement in decisions for ESRD treatment. PMID- 3643018 TI - Death with dignity: supporting a patient's decision. PMID- 3643019 TI - Can nurses be involved in making ethical decisions? PMID- 3643020 TI - Complement does not facilitate in vitro invasion of bovine erythrocytes by Babesia bovis. PMID- 3643021 TI - The nucleotide sequence of Scenedesmus obliquus chloroplast elongator methionine accepting tRNA. AB - The chloroplast elongator methionine-accepting tRNA from the green alga Scenedesmus obliquus was purified and and its nucleotide sequence determined. The sequence does not bear close homology to higher-plant chloroplast tRNAMetm species, nor to the chloroplast tRNAMetm species from Euglena gracilis. This tRNA is unique among all tRNAs in having pseudouridine at position 8, and this has implications with regard to the proposed interaction of aminoacyl-tRNA synthetases with their cognate tRNAs at this position. The primary sequence of the tRNA is: pG-C-C-U-G-C-U-psi-A-G-C-U-C-A-G-U-D-Gm- G-C-C-A-G-A-G-C-A-U-C-C-G psi-psi-U-C-A-U-m2A-C-G-C-G-G-A-A-A- m7G-D-C-A-C-U-A-G-T-psi-C-G-A-A-U-C-U-A-G-U A-G-C-A-G-G-C-A-C-C-A-OH. PMID- 3643023 TI - Cotranslational attachment of fatty acids to nascent peptides in gastric mucus glycoprotein. AB - Using gastric mucous cells which are involved exclusively in the synthesis of secretory O-glycosidic glycoprotein (mucin), the relationship between protein core synthesis and its acylation with fatty acids was investigated. Labeling of the cells with [3H]palmitic acid and [35S]methionine followed by isolation of peptidyl-tRNA and release of nascent peptides, indicated that these peptides contain covalently bound fatty acids. The high performance thin layer chromatography, SDS-gel electrophoresis, and radioactivity scanning revealed that the preparation contained three fractions labeled with palmitate (Mr 15,000 3,600) and two (Mr 1,500 and less) without this label. Based on these data and the nascent peptides amino acid analysis, we conclude that the protein core of the O-glycosidic glycoprotein is acylated with fatty acids during translation, when the peptide chain is longer than 21 amino acid residues. PMID- 3643022 TI - Dinitrophenyl glutathione efflux from human erythrocytes is primary active ATP dependent transport. AB - Dinitrophenyl S-glutathione is accumulated by inside-out vesicles made from human erythrocytes in a process totally dependent on ATP and Mg2+. The vesicles were shown to accumulate dinitrophenyl S-glutathione against a concentration gradient. The vesicles were able to concentrate this glutathione derivative even in the absence of membrane potential. This indicated that the ATP-dependent uptake of dinitrophenyl S-glutathione by inside-out vesicles represented an active transport process. Neither extravesicular EGTA nor intravesicular ouabain inhibited the transport process, indicating that neither the Ca2+-ATPase nor the Na+, K+-ATPase were involved. These results indicated that dinitrophenyl S glutathione uptake by inside-out vesicles probably represented primary active transport. The uptake of dinitrophenyl S-glutathione was a linear function of time (up to 5 h) and vesicle protein. The rate of uptake was optimal between pH 7.0 and 8.0 and at 37 degrees C. The Km values determined for dinitrophenyl S glutathione and ATP were 0.29 mM and 1 mM, respectively. The transport process was completely inhibited by vanadate and by p-hydroxymercuribenzene sulphonate and inhibited to a lesser extent by N-ethylmaleimide. GTP could efficiently substitute for ATP as an energy source for the transport process, but CTP and UTP were comparatively much less effective. PMID- 3643024 TI - Effect of elastin peptides on human monocytes: Ca2+ mobilization, stimulation of respiratory burst and enzyme secretion. AB - The effect of elastin peptides (Kappa-elastin) was investigated on human monocytes. The data presented here indicate that elastin peptides increase the intracellular Ca2+ level measured by Quin 2 fluorescence and mediate the release of beta glucuronidase and elastase. The O2 consumption and H2O2 release were stimulated in a dose-dependent manner. The early rise of cAMP was followed by a return to the original level at 30 min and by a concomitant increase of cGMP level. The action of elastin peptides on intracellular calcium level and cGMP levels may well be related to its previously demonstrated chemotactic activity. These activities may well play a role in the modifications of the extracellular matrix following elastin degradation as observed in atherosclerosis, emphysema and aging. PMID- 3643025 TI - The Lossen rearrangement in biological systems. Inactivation of leukocyte elastase and alpha-chymotrypsin by (dl)-3-benzyl-N-(methanesulfonyloxy) succinimide. AB - (dl)-3-Benzyl-N-(methanesulfonyloxy) succinimide 5 has been found to inactivate human leukocyte elastase and alpha-chymotrypsin efficiently and irreversibly. The kobsd/[I] values were 1170 and 9000 M-1 s-1 respectively. Porcine pancreatic elastase was not inhibited by 5. Compound 5 may constitute the first example of a mechanism-based inhibitor of a serine proteinase that appears to exert its effect via an unprecedented enzyme-induced Lossen rearrangement. PMID- 3643026 TI - Ca2+ and Mg2+ protection against thermal denaturation of pancreatic elastase. AB - Thermal denaturation of porcine pancreatic elastase was studied by difference spectrophotometry. At 293 nm, and pH 8.0, the thermal transition of elastase occurs with a midpoint temperature (Tm) of (58.0 +/- 0.5) degrees C. Mg2+ and Ca2+ stabilize the native form in increasing the midpoint temperature of the transition, Ca2+ being more effective than Mg2+ in the 0-0.02 M concentration range. Furthermore, Ca2+ protects pancreatic elastase against the destabilizing effect of Cu2+. Whatever be the temperature between 40 degrees C and 55 degrees C, Ca2+ protects pancreatic elastase against loss of enzymatic activity. PMID- 3643027 TI - [Determination of phosphate residues participating in the formation of the spatial structure of tRNA- Leu IAG from cow mammary glands]. AB - The phosphates of the tRNA-Leu IAG from cow mammary gland (tRNA which has a long variable loop) participating in the formation of three-dimensional structure were studied by alkylation with ethylnitrosourea and methylnitrosourea. A low degree of modification was observed for the phosphates of the following nucleotides: 7, 8, 9, 10 (at the bend site between the acceptor and D-stem); 18, 19, 20A and 21 in the D-loop; 47H and 49 at the joint of variable and T-stem; 57, 58 and 59 in the T-loop. PMID- 3643028 TI - Rheumatoid arthritis and human T cell lymphotropic retroviruses. PMID- 3643029 TI - Alzheimer's disease and hospice care. PMID- 3643030 TI - The Talbot Hospice Foundation bereavement program: a history. PMID- 3643031 TI - Leadership behavior of nurse managers and job satisfaction of registered nurses in a hospice-home care setting: study finds great need for strong leadership in nurse management. PMID- 3643032 TI - For it is in giving that we receive. Nurses provide care to a dying colleague. PMID- 3643034 TI - A Christian response to AIDS issues. PMID- 3643033 TI - Analysis of a hospital-based hospice program for terminally ill cancer patients: detailing patient needs to understand complex programs. PMID- 3643036 TI - China visit. PMID- 3643035 TI - Expanding the nursing role: innovating an activities program for geriatric patients on a psychiatric ward in Austria. PMID- 3643037 TI - Further studies on elastase and trypsin inhibitory activities in mammalian lenses. AB - Elastase and trypsin inhibitory capacities increased significantly on heat treatment of the lens extract for 15 min at 60 degrees C in human infant (mean increase 290 and 335%), human adult (130 and 245%), ovine (90 and 140%), and bovine (70 and 90%) lenses. No increase was observed in human cataractous lenses. Preincubation with target enzymes in the absence of substrate abolished the antitryptic activity in lenses whereas antielastase activity was more resistant. No decrease in antielastase activity in human adult and cataractous lenses was observed on 15-min preincubation whereas about 50% of activity was abolished in human infant lenses. The differences were attributed to the changes in the levels of endogenous proteinases and proenzymes during cataractogenesis and aging. PMID- 3643038 TI - ADNs at George Wallace Community College: experience geriatric nursing care. PMID- 3643039 TI - Nursing process how-to's. PMID- 3643040 TI - Drugs and computers--they are compatible! PMID- 3643041 TI - No one can imagine. PMID- 3643043 TI - Care of the Alzheimer patient in the community. PMID- 3643042 TI - Just one of the family [continuing education credit]. PMID- 3643044 TI - Coping with chronic pain. PMID- 3643045 TI - Nursing diagnoses and the neuro patient. PMID- 3643046 TI - Neurological complications in acquired immune deficiency syndrome. PMID- 3643047 TI - Comparisons of data from regional perinatal mortality surveys. AB - The standard format in which NHS regions are invited to submit data from their perinatal mortality surveys for comparative analysis in the British Journal of Obstetrics and Gynaecology is described. Some examples of the way these data can and will be used to compare regional differences in mortality patterns are given and possible future developments are discussed. Although the term perinatal mortality is used in the title, it is hoped that surveys will cover stillbirths and neonatal deaths and also, where possible, late fetal deaths of less than 28 weeks gestation. PMID- 3643048 TI - Commentary on current World Health Organization definitions used in perinatal statistics. PMID- 3643049 TI - Kinetic evidence for half-of-the-sites reactivity in tRNATrp aminoacylation by tryptophanyl-tRNA synthetase from beef pancreas. AB - The aminoacylation reaction catalyzed by the dimeric tryptophanyl-tRNA synthetase from beef pancreas was studied under pre-steady-state conditions by the quenched flow method. The transfer of tryptophan to tRNATrp was monitored by using preformed enzyme-bis(tryptophanyl adenylate) complex. Combinations of either unlabeled or L-[14C]tryptophan-labeled tryptophanyl adenylate and of aminoacylation incubation mixtures containing either unlabeled tryptophan or L [14C]tryptophan were used. We measured either the formation of a single labeled aminoacyl-tRNATrp per enzyme subunit or the turnover of labeled aminoacyl-tRNATrp synthesis. Four models were proposed to analyze the experimental data: (A) two independent and nonequivalent subunits; (B) a single active subunit (subunits presenting absolute "half-of-the-sites reactivity"); (C) alternate functioning of the subunits (flip-flop mechanism); (D) random functioning of the subunits with half-of-the-sites reactivity. The equations corresponding to the formation of labeled tryptophanyl-tRNATrp under each labeling condition were derived for each model. By use of least-squares criteria, the experimental curves were fitted with the four models, and it was possible to disregard models B and C as likely mechanisms. Complementary experiments, in which there was no significant excess of ATP-Mg over the enzyme-adenylate complex, emphasized an activator effect of free L-tryptophan on the rate of aminoacylation. This result disfavored model A. Model D was in agreement with all data. The analyses showed that the transfer step was not the major limiting reaction in the overall aminoacylation process. PMID- 3643050 TI - AIDS "Train the Trainer" program underway. PMID- 3643051 TI - A lesson from Tony. PMID- 3643052 TI - What nurses need to know about ionizing radiation. PMID- 3643053 TI - Visible means of support. PMID- 3643054 TI - Role performance issues for oncology clinical nurse specialists. PMID- 3643055 TI - Rectal infections in acute leukemia. PMID- 3643056 TI - Cancer knowledge among elderly individuals. PMID- 3643057 TI - Living with cancer. A patient education program. PMID- 3643058 TI - Patient symptoms and family coping. Predictors of hospice utilization patterns. PMID- 3643059 TI - Professional friends. The inclusion of the personal into the professional. PMID- 3643060 TI - Intervention raises risks and rewards. PMID- 3643062 TI - Costing out nursing services: what are we learning? PMID- 3643063 TI - Third-party reimbursement for nurse psychotherapists. PMID- 3643061 TI - Cell-specific expression of the human complement protein factor B gene: evidence for the role of two distinct 5'-flanking elements. AB - The human complement protein Factor B is encoded by a single gene in the major histocompatibility complex and is closely linked to the gene encoding the second component of complement C2. DNA sequencing, S1 mapping, and primer extension experiments have established that the transcription initiation site of the Factor B gene lies only 421 bp from the poly(A) site of the C2 gene. Deletion analysis of the Factor B 5'-flanking region has suggested the presence of cis-acting DNA elements that are essential for the cell-specific expression of the Factor B gene. These sequences extend into the 3' region of the C2 gene. We have defined an enhancer element in the 5'-flanking region in addition to the promoter element. Our results suggest that the cell-specific expression of the Factor B gene is dependent upon the combinatorial effect of both the promoter and the enhancer elements. PMID- 3643064 TI - Women's coping with a spontaneous abortion occurring in early pregnancy. PMID- 3643065 TI - [Experience in the management of nursing care]. PMID- 3643066 TI - [Treatment of fetal asphyxia with crystalline urea-hydrogen peroxide]. PMID- 3643067 TI - [Sterilization of a dental turbine handpiece]. PMID- 3643068 TI - [Nursing service in the traditional Chinese medicine ward]. PMID- 3643069 TI - [Nursing care of cancers treated by hematoporphyrin laser therapy]. PMID- 3643070 TI - [Care of severely burned patients with nasal feeding]. PMID- 3643071 TI - [Nursing of patients with thromboangiitis obliterans treated by free omentum transplants]. PMID- 3643072 TI - [Nursing care of critical patients in the waiting room]. PMID- 3643073 TI - [Problems in the practice of primary nursing]. PMID- 3643074 TI - [Present status and trends in the development of ICU nursing in Japan]. PMID- 3643075 TI - [Clinical and biological consequences of human immunodeficiency virus (LAV) infection in 15 Congolese subjects]. AB - We report 15 cases of symptomatic HIV infection seen in Paris between June 1983 and June 1985 in Congolese patients. The first signs were diarrhea, weight loss, fever, pruritus. Disseminated lymphadenopathy was frequent. Twelve patients had AIDS, and the opportunistic infections were: isosporosis, oesophageal candidiasis, cerebral toxoplasmosis, Kaposi's sarcoma, CNS' cryptococcosis, cutaneo-mucosal. PMID- 3643076 TI - [Human immunodeficiency virus infection and AIDS]. PMID- 3643077 TI - Anti-HTLV-III/LAV in pooled sera. PMID- 3643078 TI - Guidelines for HIV antibody testing and post-test counseling. Colorado Department of Health. PMID- 3643080 TI - [Definition of psychiatry--establishment of scientific psychiatry (5)]. PMID- 3643081 TI - [Survey on the effects of wives' experiences at the terminal scenes of their husbands in their later lives]. PMID- 3643079 TI - Site-specific activation of the alternative pathway of complement. Synthesis of a hybrid molecule consisting of antibody and cobra venom factor. AB - Cobra venom factor (CoF) is an analog of the activated third component of human complement (C3b). Unlike C3b, CoF is completely resistant to inactivation by factors H and I, the endogenous control proteins of the alternative pathway of complement. This property makes CoF a useful reagent when unrestricted activation of complement is desired. CoF was covalently conjugated to the IgG fraction of rabbit antihuman erythrocyte antiserum, and the ability of the hybrid molecules to initiate activation of the alternative pathway at a specific site was tested. The hybrid molecules were heterogeneous polymers (CoFn-IgGn, where n is an integer greater than 1 for at least one of the components), and both components retained their individual functional activities. The alternative-pathway C3/C5 convertase complex was formed by adding purified factors B and D to the hybrid in the presence of magnesium. This complex (antibody-CoFBb) was able to bind to erythrocytes and activate both C3 and C5. Activation of C5 initiated formation of the potentially cytolytic membrane attack complex of complement on the surface of the cell. When used in combination with rabbit serum, the hybrid molecule was a potent mediator of complement-induced hemolysis. The decay kinetics of the hybrid C3/C5 convertase complex when bound to normal human erythrocytes were not first order, but 40% of the activity remained after 3.5 h at 37 degrees C. Conjugation of CoF to specific antibodies will permit investigation of the consequences of alternative-pathway activation at selective sites. These hybrids may also have therapeutic potential. PMID- 3643082 TI - [Nursing record as an information system--part of an information system to support nursing (3)]. PMID- 3643083 TI - [Explanation on the "Notes on Nursing" (7)]. PMID- 3643084 TI - [Essay on nursing: from a diary of a Japanese nurse in Canada]. PMID- 3643085 TI - [Instruction on nursing students conducting case studies (6)]. PMID- 3643086 TI - [Psychocybernetics and nursing--for more meaningful encounter with patients]. PMID- 3643087 TI - [What I gain from my work--my method of self-enlightenment (4)]. PMID- 3643088 TI - Wound healing under the microscopy. PMID- 3643089 TI - Diabetes: testing, testing. PMID- 3643090 TI - Family feeling. PMID- 3643091 TI - [Changes in pulmonary and cerebral blood flow and the relation between the changes and pulmonary edema in the early phase of respiratory distress syndrome induced by oleic acid in rabbits]. PMID- 3643092 TI - [Experimental observation on protease-antiprotease balance in rats exposed to hyperoxia]. PMID- 3643093 TI - Education for continuous subcutaneous insulin infusion pump users. PMID- 3643094 TI - Differences between ADA and NACOR recognition programs. PMID- 3643095 TI - Meeting the standards: the participants in planning. PMID- 3643096 TI - Diabetic peripheral neuropathy. Part I. Sensorimotor neuropathy (continuing education credit). PMID- 3643097 TI - The relationship of information exchange during medical visits to patient satisfaction: a review. PMID- 3643098 TI - Cultural challenges in nutrition education among American Indians. PMID- 3643099 TI - A team approach to the child with diabetes who is having academic difficulties. PMID- 3643100 TI - A new look for the Exchange Lists for Meal Planning. PMID- 3643102 TI - [Permissibility of routine HIV serology]. PMID- 3643101 TI - [Follow-up studies of donors and recipients of HIV antibody-positive blood products]. AB - In a retrospective study the rate of HIV (LAV/HTLV-III)-infected recipients of blood units (excluding haemophiliacs) issued before HIV antibody testing became routine in 1985 was investigated. Screening of 200,000 donations yielded 24 seropositive blood donors. Of these 17 were homo- or bisexual, one subsequently known to take drugs by i.v. injection, one had received donor blood, and in five there was no information concerning sexual preference. Ten seropositive multiple blood donors (mean of 17.6 donations) and the 42 potentially infected units donated between 1982 and 1985 were examined in detail. Blood donations from infected first-time donors were discarded. Nine recipients were found to be seropositive (one case of transfusion-associated AIDS), five were seronegative. Both groups were evaluated clinically and immunologically. Ten recipients had died in the intervening time, and in 15 cases it proved impossible to determine whether the donated and incriminated blood had in fact been transfused. It is likely that there will be an increase in transfusion-associated AIDS over the next 3-5 years, before preventive measures of HIV antibody screening and voluntary exclusion of donors at risk will prove to be effective. PMID- 3643104 TI - Effects of estrogen and vanadate on the proliferation of newly established transformed mouse Leydig cell line in vitro. AB - A permanent cell line (B-1-A-2) derived from an estrogen-responsive mouse Leydig cell tumor (T 124958-R) was established in culture. Although this cell line showed estrogen-induced enhancement of cell proliferation in vitro, a moderately high concentration (10(-8) M) of estradiol was required to stimulate maximum growth. A whole cell binding assay revealed that the B-1-A-2 cells contained estrogen receptors with relatively low affinity for estradiol (Kd, 10(-9)-10(-8) M). This estrogen receptor was found to have a mol wt of 65,000. In addition, incubation of the cells with [32P]orthophosphate and subsequent purification revealed that the estrogen receptor is phosphorylated. This finding prompted us to study the effect of phosphatase inhibitors on cell proliferation. The inclusion of vanadate (25 microM) in the culture medium resulted in a significant increase in estrogen sensitivity, showing a maximal growth stimulatory effect of estradiol at concentrations of 10(-10)-10(-9) M. Simultaneously, the conversion of the low affinity to the high affinity receptor (Kd, 10(-10)-10(-9) M) was induced by treatment of cells with vanadate. These data suggest that estrogen directly stimulates the growth of B-1-A-2 cells in culture, and that the sensitivity to estrogen can be altered by modulating the estrogen receptor possibly via a phosphorylation-dephosphorylation mechanism. PMID- 3643103 TI - Tissue kallikrein in rat brain and pituitary: regional distribution and estrogen induction in the anterior pituitary. AB - We have detected tissue kallikrein and kallikrein mRNA in various brain regions with a kallikrein direct RIA and with nucleic acid hybridization using a kallikrein cDNA probe. In the direct RIA, rat urinary kallikrein-like activity was found in the pituitary and pineal glands, hypothalamus, cerebral cortex, cerebellum, and brain stem. Pituitary and pineal gland kallikrein concentrations were significantly higher than those in other regions. Only in pituitary was there a significant difference in tissue kallikrein concentration according to sex, with glands from female rats showing levels 4-fold higher than those from male rats. Kallikrein mRNAs were detected in all of the regions and were about 4 fold higher in female than in male pituitary gland. Northern blot analyses show sex dimorphism of pituitary kallikrein mRNA, similar in size to submandibular gland and kidney mRNA. In castrated male rats, whole pituitary kallikrein content was reduced to 50% of the control value and increased 1.7-fold with testosterone replacement and 18-fold with 17 beta-estradiol treatment. Neither T4 nor cortisol affected whole pituitary kallikrein levels in the castrated male rat, but testosterone decreased pituitary kallikrein in normal female rats by 35%. When anterior pituitary or neurointermediate lobe extracts were separately examined, immunoreactive kallikrein was 10.2- and 1.3-fold higher respectively, in female than in male rat lobes. Estradiol benzoate (30 micrograms/kg) administration increased kallikrein levels 90- and 22-fold, respectively, in the anterior pituitary of gonadectomized male and female rats, while it increased by only 40 50% kallikrein levels in the male and female neurointermediate lobe. In dot blot analysis, kallikrein mRNA levels were increased 5-fold by 17 beta-estradiol in the whole pituitary of castrated male rats. In the cytoplasmic dot hybridization analysis, estradiol benzoate treatment increased kallikrein mRNA levels 54-fold in the anterior pituitary of ovariectomized rats. The data show that a tissue kallikrein indistinguishable thus far from a urinary kallikrein is widely distributed in brain and pituitary and that levels of enzyme and mRNA are comparable in certain central sites. Kallikrein levels in the anterior and neurointermediate pituitaries are differentially regulated by estrogen. PMID- 3643105 TI - Vancomycin for treatment of infections with methicillin-resistant Staphylococcus aureus: are there alternatives? PMID- 3643107 TI - Methicillin susceptibility testing of Staphylococcus aureus on media containing five percent sodium chloride. PMID- 3643106 TI - Strategies for typing and properties of epidemic methicillin-resistant Staphylococcus aureus. AB - Isolates of 17 strains of epidemic methicillin-resistant Staphylococcus aureus from outbreaks in ten hospitals in the UK were investigated with a variety of techniques both to explore their properties and to type them in order to confirm or refute known or suspected epidemiology. The techniques consisted of a biotyping system, peptidoglycan analysis, testing of antibiotic sensitivity to 21 agents, various phage-typing methods including heat shock, plasmid pattern analysis, and heat cure derivation of plasmid-less isogenic strains. All strains resembled those originally isolated in Australia, being in the possession of a large number of chromosomal resistance factors, pigmentation, ability to produce lipase and large molecular weight plasmids (c.15 Md to c.23 Md) which conferred resistance to gentamicin, propamidine, ethidium bromide, cetrimide and chlorhexidine. Some strains also had a c.3 Md plasmid conferring chloramphenicol resistance and others a c.1 Md cryptic plasmid. A large percentage of the population was resistant to 25 mg/l methicillin at 37 degrees C, an unusual feature. All the strategies, with the exception of peptidoglycan analysis, contributed to typing of the strains. PMID- 3643109 TI - [Diabetes mellitus (its diagnosis, clinical picture and prevention)]. PMID- 3643108 TI - [Diseases of the lymphatic vessels in children (elephantiasis and lymphangiectasis)]. PMID- 3643110 TI - [Wounds (their pathogenesis and clinical picture)]. PMID- 3643111 TI - [Foreign bodies in the respiratory tracts]. PMID- 3643112 TI - [Equipment of makeshift agricultural airfields (helipads) and the organization of technical aviation operations]. PMID- 3643113 TI - [Effect of alcohol on the nervous system]. PMID- 3643114 TI - [Alcohol and vision]. PMID- 3643115 TI - [The teaching of physics in medical schools]. PMID- 3643116 TI - [Placental presentation and transverse lie]. PMID- 3643117 TI - [Hypoglycemic coma]. PMID- 3643118 TI - [Dysfunctional uterine hemorrhage]. PMID- 3643119 TI - [Bronchospasm]. PMID- 3643120 TI - [Felinosis (cat scratch disease)]. PMID- 3643122 TI - [Nutrition for women during pregnancy and labor]. PMID- 3643121 TI - [Clinical aspects and treatment of peritonitis following cesarean section]. PMID- 3643123 TI - [Differential diagnosis in jaundice]. PMID- 3643124 TI - [Hemophilia]. PMID- 3643125 TI - [Soviet public health in the 11th Five-Year Plan]. PMID- 3643126 TI - [Elephantiasis]. PMID- 3643127 TI - [Phytotherapy of eczema and neurodermatitis patients]. PMID- 3643128 TI - [Antacid agents]. PMID- 3643129 TI - [Anti-alcohol propaganda aimed at youthful audiences]. PMID- 3643130 TI - [Medical and atheistic propaganda]. PMID- 3643131 TI - [Comprehensive plans for health education work]. PMID- 3643132 TI - [Prolonged pregnancy]. PMID- 3643133 TI - [Hemorrhage into the brain]. PMID- 3643135 TI - Modern management theory: an adaptation for nursing administrators. PMID- 3643134 TI - [Puerperal hypophyseal insufficiency (Sheehan's syndrome)]. PMID- 3643136 TI - A thumbnail sketch of the evolution of the Drug Issuance Act. PMID- 3643137 TI - Promoting nurses' image: Nursefare '86. PMID- 3643138 TI - Implications of product-line management for nurse managers. PMID- 3643139 TI - The birthday suite: an idea whose idea has come. PMID- 3643140 TI - [Afterloading short-term irradiation of the vagina following radical surgery of uterine cancer]. AB - A report is given of results and complications following postoperative irradiation in endometrial carcinoma via monitored high-dose afterloading therapy (iridium 192). Intravaginal irradiation was performed in all operated cases. In advanced cases or in cases with poor prognosis (deep infiltration of the myometrium, tumour grading 1-2) percutaneous irradiation (cobalt 60) was employed additionally. 327 patients with endometrial carcinoma were treated by postoperative irradiation between 1981 to 1985 and could then be followed up for at least 12 months to 5 years. Evaluation was done with regard to recurrence-free survival rate and side effects. With the postoperative afterloading iridium 192 technique, the 3-year recurrence-free rates were 91% in stage I and 78% in advanced stages. All of the patients in stage I with a control time of 5 years survived. The incidence of radiation side effects in the overall group was: cystitis 4%, proctitis 7% and fistulas 0.6%. No further severe complications occurred with the optimal intravaginal fraction dose of 700 cGy (twice). The afterloading therapy with high dose rates and remote control monitoring reduces the risk of radiation exposure of the medical staff and also places less strain on the patients because of the short-term irradiation. Intravaginal applications were performed without anaesthesia or any drugs, and treatment on an outpatient basis was possible in almost all of the cases. PMID- 3643141 TI - Meeting of the International Continence Society. PMID- 3643142 TI - Primary health care: an agenda for discussion. PMID- 3643143 TI - Nursing the elderly at night. PMID- 3643144 TI - The biology of ageing: the ageing brain. PMID- 3643145 TI - Problems with eating. PMID- 3643147 TI - Dental problems in old age: extracts from an Age Concern Fact Sheet. PMID- 3643146 TI - The dental problems of elderly people. PMID- 3643148 TI - Geriatric nursing in 'tomorrow's world'. PMID- 3643149 TI - Understanding adult acquired megacolon. PMID- 3643150 TI - When the care plan says restrain. PMID- 3643151 TI - Dustin, the youngest resident. PMID- 3643152 TI - The Heimlich Maneuver: mandatory for nursing home employees. PMID- 3643153 TI - Cultivating positive attitudes in nursing home staff. PMID- 3643154 TI - Food allergy facts. PMID- 3643155 TI - Use heparin safely. PMID- 3643156 TI - 70+ and going strong. Mary Bianchini makes a difference. PMID- 3643157 TI - A.D. characterized by familial incidence? PMID- 3643158 TI - Update on "sheltered freedom". PMID- 3643159 TI - Ovarian sarcoma. AB - A 30-year review of primary ovarian sarcomas seen at The University of Iowa Hospitals and Clinics and a review of the literature are presented. Stage at presentation and resectability were the most significant prognostic indicators. Most recurrences appeared outside the pelvis, indicating a need for systemic chemotherapy. With aggressive treatment, patients with early stage disease can have long term survival. A plea is made for multicenter protocols to develop effective programs of treatment. PMID- 3643161 TI - Discharge risks fraud, antitrust. PMID- 3643160 TI - The influence of HTLV-III infection on the natural history of hepatitis B virus infection in male homosexual HBsAg carriers. AB - The presence of antibodies to HTLV-III and markers of active hepatitis B virus replication was examined in a longitudinal study of 33 consecutive male homosexual HBsAg carriers. The mean follow-up time was 37 months (range = 4 to 109 months). All patients were initially hepatitis B virus DNA-positive and HBeAg positive. Antibodies to HTLV-III were detectable in eight patients while they were positive for both of these markers. One of them cleared hepatitis B virus DNA and seroconverted from HBeAg to anti-HBe. This corresponds to an annual clearance/seroconversion rate of 4% (95% confidence limits = 0 to 15%). In two patients, antibodies to HTLV-III appeared after clearance of hepatitis B virus DNA and HBeAg, and in one of them, hepatitis B virus DNA reappeared. Among the 25 patients negative for HTLV-III antibodies, the annual hepatitis B virus DNA clearance rate was 20% and HBeAg to anti-HBe seroconversion rate was 11% (95% confidence limits = 11 to 31% and 4 to 20% respectively). The observed hepatitis B virus DNA clearance rates in the two groups were significantly different (p less than 0.05). Disease activity, as determined by transaminase levels, was significantly lower in HTLV-III-infected individuals as compared to individuals without HTLV-III infection (p less than 0.05). Infection with HTLV-III may extend the period of active viral replication or even reactivate hepatitis B virus replication and seems to diminish inflammatory disease activity in chronic HBsAg carriers. PMID- 3643162 TI - Modification of hepatitis B virus infection by recombinant leukocyte alpha A interferon. AB - A defect in alpha interferon production in patients with chronic type B hepatitis offers a rationale principle for treating this disease with interferon. Two trials with interferon in chronic type B hepatitis indicate that this therapy achieves an elimination of HBsAg and HBeAg significantly higher than spontaneous. Our study and that of others indicate, however, that the response to interferon therapy is dependent on many variables including: the type of interferon, the interferon dose, duration of interferon treatment, sex, sexual preference in men and coinfection with other viruses. As of the multiple modes of action of interferon, a better understanding of viral replication, of the antiviral action of interferon in hepatitis B virus (HBV) infection and of the immunomodulatory action of interferon in HBV infection will help to improve the treatment of chronic HBV infection with interferon. PMID- 3643163 TI - Four antigens expressed on most ovine cell types. AB - Monoclonal antibodies have been produced that bind to four different antigens expressed on the surface of ovine lymphocytes as well as to a variety of other ovine cell types. These antigens have been characterized with respect to their tissue distribution and immunochemistry. The timing of appearance of these antigens within the ovine embryo is reported. PMID- 3643164 TI - Hospital-based data on perinatal and neonatal mortality in India. PMID- 3643165 TI - Assuming the control of change. Auxiliary nurses may write their own history. PMID- 3643166 TI - [Professional education for male and female auxiliary nurses in Quebec]. PMID- 3643167 TI - [To become a counselor in natural therapy. Institute for Psychosomatics, Aurocor Inc]. PMID- 3643168 TI - [Professional services redefined. The future path for the profession]. PMID- 3643169 TI - Diethylstilbestrol-associated vaginal adenosis followed by clear cell adenocarcinoma. AB - A young woman was examined because of a history of in utero exposure to diethylstilbestrol and was identified as having vaginal adenosis. Fourteen months later, on routine follow-up, a small vaginal clear cell adenocarcinoma was recognized. She refused any therapy other than wide local excision. She was seen intermittently for several years with no recurrence. Five and one-half years after initial diagnosis she was found to have multiple sites of clear cell adenocarcinoma in the upper third of the lateral and anterior vaginal walls. Cases of vaginal adenosis followed later by the development of clear cell adenocarcinoma (metachronous cases) are distinctly unusual. The authors have collected the other recorded cases in the literature or in the Registry for Research on Hormonal Transplacental Carcinogenesis and have attempted to compare these cases with the larger group of patients who present with clear cell adenocarcinoma and have associated vaginal adenosis (synchronous cases). The authors have found few differences between the two groups. Most of the differences can be accounted for by the close follow-up of patients with known vaginal adenosis. However, it has been noted that the location of the clear cell adenocarcinoma is apparently different in the two groups. The reasons for this apparent difference are briefly discussed. PMID- 3643170 TI - Getting into the act: a Canadian nurse's experience. AB - The Canada Health Act became law in April 1984 after years of debate and negotiations. The Canadian Nurse's Association (CNA) with a membership of 169,000 took a leading role in the lobby to influence that act, the guiding legislation for Canada's national health insurance system. The CNA lobbied for changes in the Canada Health Act that implied fundamental reforms in the health care delivery system. This paper will chronicle the political activity of CNA and its twelve member associations as they sought to influence the design of the new legislation. PMID- 3643172 TI - Nurses must look towards the future. An interview with Dr Amelia Mangay Maglacas. PMID- 3643171 TI - Assertiveness: believe in yourself. AB - To be assertive, nurses need to realise they are worthy of respect. By discussing real situations, the author highlights assertiveness techniques and shows how they can benefit every nurse. PMID- 3643173 TI - New approaches and emerging issues in negotiation. AB - This article is a brief summary of recent events in Australia and how the Royal Australian Nursing Federation (RANF) has attempted with some success to solve the problems of nurses in our country. This paper was presented at the ICN SEW Resource Group meeting in Geneva. PMID- 3643175 TI - Occupation and suicide among women. PMID- 3643174 TI - Sickness absence of nurses and female doctors in Poland. AB - The demographic-occupational determinants and causes of sickness absenteeism of nurses and female doctors were analysed in a large health service unit in Krakow, Poland. PMID- 3643176 TI - The influence of social, demographic, employment, and health factors on the psychological well-being of employed women. PMID- 3643177 TI - Dealing with delusional patients: discovering the distorted truth. PMID- 3643178 TI - Profile of chronically mentally ill psychotic patients in four community mental health centers. PMID- 3643179 TI - Survivor guilt: one way to understand a reaction to the space shuttle explosion. PMID- 3643180 TI - Victims of international terrorism. PMID- 3643181 TI - Working with abusing families: a specialised service. PMID- 3643182 TI - Incontinence and childbirth. PMID- 3643183 TI - Drinking choices: alcohol education and training for health professionals. PMID- 3643184 TI - Preventing child abuse: an evaluation of two video programmes. PMID- 3643185 TI - The health visiting process is not enough: bring in the auditors! PMID- 3643186 TI - An ABC of alternative medicine: herbalism. PMID- 3643187 TI - Health for all by the year 2000: the role of the health visitor. PMID- 3643188 TI - It's a jumble--no; it's a maze--no; it's your client's medication shelf. PMID- 3643189 TI - Home parenteral antibiotic therapy, Part II: Drug prescription and administration considerations. PMID- 3643190 TI - Biohazards of working with antineoplastics. PMID- 3643191 TI - Home remedies: a cultural study. PMID- 3643192 TI - Activities of daily living. Let's coordinate. PMID- 3643193 TI - Successful client teaching--what makes the difference? PMID- 3643194 TI - Filling the family fuel tank. PMID- 3643195 TI - Home care provisions of the 1987 budget. PMID- 3643196 TI - Intensive care at home: establishing a program in Washington State. PMID- 3643197 TI - Transient regional wall motion abnormality and increased wall thickness of the left ventricle in acute myopericarditis occurring in the puerperium. PMID- 3643198 TI - The plight of a female adolescent--anorexia or bulimia: an overview. PMID- 3643199 TI - Seizures and societal attitudes: a teaching tool for children, siblings, classmates, parents, and classroom teachers. PMID- 3643200 TI - International networking: an experience of American and Chinese pediatric nurses. PMID- 3643201 TI - Setting up a maternal child health center: organizational and marketing strategies. PMID- 3643203 TI - Integration of the Brazelton Neonatal Behavioral Assessment Scale into routine neonatal nursing care. PMID- 3643202 TI - Assessment of functional wellness behaviors in adolescents who are mentally retarded. PMID- 3643204 TI - Sexually transmitted diseases. PMID- 3643205 TI - The female AIDS patient. PMID- 3643206 TI - Chlamydia: the most prevalent cause of sexually transmitted disease. PMID- 3643207 TI - The impact of sexually transmitted diseases on human fertility. PMID- 3643208 TI - Herpes: a dilemma for client and clinician. PMID- 3643209 TI - Management of herpes during pregnancy. PMID- 3643210 TI - A model for sexual assessment and intervention. PMID- 3643211 TI - O2 metabolites and neutrophil elastase synergistically cause edematous injury in isolated rat lungs. AB - Addition of glucose oxidase (GO) increased H2O2 concentrations and decreased antielastolytic activities of beta-D-glucose containing perfusates of isolated rat lungs. Pretreatment with GO also caused acute edematous injury (increased lung weight gains, increased recovery of Ficoll in lung lavages, and increased pulmonary arterial pressures) in isolated lungs perfused with purified human neutrophil elastase (NE). Acute edematous injury in isolated lungs pretreated with GO and then NE exceeded levels found in lungs following addition of GO or NE alone or NE before GO. Simultaneous addition of catalase (an H2O2 scavenger) or methoxy-succinyl-L-alanyl-L-alanyl-prolyl-L-valine-chloromethyl ketone (an NE inhibitor, but not aminotriazole-inactivated catalase, N-tosyl-L-phenyl-alanine chloromethyl ketone (a chymotrypsin inhibitor) or N-alpha-p-tosyl-L-lysine chloromethyl ketone (a trypsin inhibitor), prevented acute edematous injury in isolated lungs perfused with both GO and NE. This observation indicated that injury was dependent on both H2O2 and NE, especially since the relative inactivating specificities of the inhibitors for H2O2 or NE, respectively, were confirmed under similar conditions in vitro. The synergistic nature of the interaction between H2O2 and NE-mediated injury was further clarified when GO- and NE-induced lung injury was prevented by addition of an oxidant-resistant NE inhibitor (Eglin-C), but not an oxidant-sensitive NE inhibitor (human alpha 1 protease inhibitor, alpha 1PI). Moreover, treatment with H2O2 also decreased the ability of alpha 1PI but not Eglin-C to decrease NE activity in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3643212 TI - Biochemical research on oogenesis. Binding of tRNA to the nucleoprotein particles of Xenopus laevis previtellogenic oocytes. AB - In previtellogenic oocytes of Xenopus laevis, nearly all tRNA is included in nucleoprotein particles (thesaurisomes) sedimenting at 42 S. We evaluate the possibility of a tRNA exchange between the particles and the ribosomes during protein synthesis. We find that the particles take up tRNA after a very short incubation in vitro. In the absence of ATP, the particles preferentially bind charged tRNA. In the presence of ATP, more tRNA binds to the particles, and the sedimentation coefficient of the integrated tRNA is displaced to 45 S. When added to nonfractionated homogenates of oocytes together with ATP, poly(U) strongly stimulates the incorporation of radioactive phenylalanine into tRNA and protein. The labeled protein (polyphenylalanine) cosediments with the ribosomes, whereas most of phenylalanyl tRNA cosediments with the thesaurisomes. These data suggest that the thesaurisomes participate to some extent in protein synthesis. They release charged tRNA, thereby supplying the ribosomes with activated amino acids. Discharged tRNA is then taken up, reacylated, and stored in the particles until the next round of peptide bond formation. The aminoacylation and storage functions are probably carried out by two very unequal populations of particles. The main subclass of particles (42 S) binds and stores tRNA in an ATP-independent manner. A much smaller subclass of particles (45 S) is responsible for reacylation of discharged tRNA. PMID- 3643213 TI - Alternative complement pathway activation fragment Ba binds to C3b. Evidence that formation of the factor B-C3b complex involves two discrete points of contact. AB - Alternative complement pathway C3 convertase formation involves the cleavage of C3b-associated factor B into fragments Ba and Bb. Whereas Bb, in complex with C3b, has proteolytic specificity toward native C3, the function of the Ba moiety in the formation and/or decay of alternative complement pathway C3 convertase is uncertain. Therefore, we have examined the effect of purified Ba fragment on both fluid-phase and surface-bound enzymatic activity and showed that whereas Ba could inhibit the rate of C3 convertase formation, the rate of intrinsic decay remained unaffected. A specific, metal ion-independent interaction between Ba and C3b was subsequently demonstrated by use of the cross-linking reagent dithiobis(succinimidyl propionate). When cell-associated 125I-B was activated by D, the dissociation of Bb fragment displayed simple first-order kinetics with a half-time of 2.4 min, this value being in reasonable agreement with the hemolytically determined decay rate of 1.8 min. In contrast, most of the Ba fragment undergoes rapid dissociation, but there is also evidence to suggest the establishment of a new equilibrium due to the ability of Ba to rebind to C3b. Cumulatively, these data are consistent with a model in which the attachment of intact B to C3b is mediated by two points of contact, one being in the Ba domain and the other in the Bb domain. Due to avidity effects, each of these interactions could be of relatively low intrinsic affinity, and the characteristic unidirectionality of alternative complement pathway C3 convertase decay may simply result from the low intrinsic association of "univalent" Bb for the C3b subunit. PMID- 3643214 TI - Control of muscle differentiation in BC3H1 cells by fibroblast growth factor and vanadate. AB - We have examined the control of actin isoform synthesis by pituitary-derived fibroblast growth factor and serum in BC3H1 cells, a tumor-derived nonfusing muscle cell line. Under differentiating conditions in BC3H1 cells, the synthesis of beta- and gamma-actin ceases, and the rate of alpha-actin synthesis is increased concomitant with cessation of cell growth. Addition of fetal calf serum to differentiated cells reverses the process, whereas the addition of pituitary derived fibroblast growth factor inhibits synthesis of alpha-actin but fails to induce the synthesis of beta- and gamma-actin. Analysis of RNA from differentiated BC3H1 cells after the addition of fetal calf serum indicated that the serum-induced increase in beta- and gamma-actin synthesis reflected an increase in their mRNA levels. In contrast, the repression of alpha-actin synthesis by fetal calf serum or fibroblast growth factor appears to reflect the translation efficiency of alpha-actin mRNA. Fibroblast growth factor is a competence factor for BC3H1 cells which allows them to progress from G0 4 h into the G1 phase of the cell cycle. In order to understand the nature of the intracellular signals responsible for the effect of fibroblast growth factor, we treated cells with vanadate, a known inhibitor of tyrosine-specific protein phosphatases. Vanadate fully mimics the action of fibroblast growth on actin synthesis and creatine phosphokinase synthesis and causes BC3H1 cells to exit the G0 portion of the cell cycle, as demonstrated by the induction of the c-fos proto oncogene following addition of serum, vanadate, or bovine pituitary-derived fibroblast growth factor to these cells. We conclude that repression of alpha actin synthesis and induction of the synthesis of beta- and gamma-actin are under independent control and that the induction of beta- and gamma-nonmuscle actin synthesis following serum addition is independent from movement into the cell cycle, and dependent on as yet unidentified serum components. The rate of synthesis of alpha-actin can be controlled by a defined mitogenic polypeptide fibroblast growth factor, which in short term experiments primarily affects the rate of translation of alpha-actin mRNA. The repression by fibroblast growth factor is most likely due to activation of a tyrosine specific protein kinase(s). PMID- 3643215 TI - Direct probing of the interaction between the signal sequence of nascent preprolactin and the signal recognition particle by specific cross-linking. AB - We have studied the interaction between the signal sequence of nascent preprolactin and the signal recognition particle (SRP) during the initial events in protein translocation across the endoplasmic reticulum membrane. A new method of affinity labeling was used, whereby lysine residues, carrying the photoreactive group 4-(3-trifluoromethyldiazirino) benzoic acid in their side chains, are incorporated into a protein by means of modified lysyl-tRNA, and cross-linking to the interacting component is induced by irradiation. SRP interacts through its Mr 54,000 polypeptide component with the signal sequences of nascent preprolactin chains containing about 70 residues, and with decreasing affinity with longer chains as well; it causes inhibition of elongation. Binding of SRP is reversible and requires the nascent chain to be bound to a functional ribosome. SRP cross-linked to the signal sequence still inhibits elongation but does not prevent it completely. We conclude that SRP does not block the exit site of the polypeptide chain on the ribosome. The SRP receptor of the endoplasmic reticulum membrane displaces the signal sequence from SRP and, even if SRP is cross-linked, releases elongation arrest. PMID- 3643217 TI - Binding sites for elastase on cultured human fibroblasts that do not mediate internalization. AB - The proteolytic actions of elastases have been implicated in extracellular matrix damage, which is characteristic of a variety of pathological conditions including emphysema and rheumatoid arthritis. In order to elucidate the molecular events involved in elastase interaction with connective tissue cells, the present study was designed to investigate the association of elastase with human fibroblasts at 4 degrees C. Elastase bound saturably to binding sites that were present on the surface of these cells. Analysis of cell-bound elastase by sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed the presence of a high molecular weight complex (Mr 54,000) that was not formed with elastase whose catalytic site serine was derivatized with a diisopropylphosphate group. The complex did not represent elastase bound to either protease nexin or contaminating serum. The cellular component with which elastase formed a complex could not be detected in the cell culture medium. Unexpectedly, elastase that had been pre-bound at 4 degrees C was not internalized after cells were warmed to 37 degrees C. The elastase binding site described in this report is therefore distinct from high affinity binding sites involved in receptor-mediated endocytosis and intracellular degradation. PMID- 3643218 TI - Attitudinal abuse toward the pregnant woman. PMID- 3643219 TI - Human abuse. PMID- 3643216 TI - Effect of vanadate on cartilage-matrix proteoglycan synthesis in rabbit costal chondrocyte cultures. AB - The effect of vanadate on proteoglycan synthesis by cultured rabbit costal chondrocytes was examined. Rabbit chondrocytes were seeded at low densities and grown to confluency in medium supplemented with 10% fetal bovine serum, and then the serum concentration was reduced to 0.3%. At the low serum concentration, chondrocytes adopted a fibroblastic morphology. Addition of 4 microM vanadate to the culture medium induced a morphologic differentiation of the fibroblastic cells to spherical chondrocytes, and increased by two- to threefold incorporation of [35S]sulfate and [3H]glucosamine into large, chondroitin sulfate proteoglycans. The stimulation of incorporation of labeled precursors reflected real increases in proteoglycan synthesis, in that chemical analyses showed increases in the accumulation of macromolecules containing hexuronic acid and hexosamine in vanadate-maintained cultures. However, vanadate had only a marginal effect on [35S]sulfate incorporation into small proteoglycans and [3H]glucosamine incorporation into hyaluronic acid and chondroitinase AC-resistant material. These results provide evidence that vanadate selectively stimulates the synthesis of proteoglycans characteristically found in cartilage by rabbit costal chondrocyte cultures. PMID- 3643220 TI - Child abuse: a multidimensional phenomenon. PMID- 3643222 TI - Group therapy for men who batter women: some promising developments. PMID- 3643221 TI - Battered women: the shadow side of families. PMID- 3643223 TI - The least restrictive alternative: is it humane treatment or human abuse? PMID- 3643224 TI - Caregiver perceptions of human abuse in health care settings. PMID- 3643225 TI - Medicolegal role in detection and prevention of human abuse. PMID- 3643226 TI - "Staphaurex" negative, methicillin resistant Staphylococcus aureus. PMID- 3643227 TI - The executive working session: a review. PMID- 3643228 TI - Seeing the handwriting on the wall. PMID- 3643229 TI - Urinary incontinence: an overview of causes and treatment. PMID- 3643230 TI - Facilitating psychosocial adaptation. PMID- 3643231 TI - ET goes home. PMID- 3643232 TI - A pharmacist's point of view. PMID- 3643234 TI - Wellness center. PMID- 3643233 TI - Pressure sores: nursing management. PMID- 3643235 TI - The audioscope: a valuable hearing assessment tool. PMID- 3643236 TI - The right to know the right to be taught. PMID- 3643237 TI - Aging and movement therapy: essential interventions for the immobile elderly. PMID- 3643238 TI - Assessing delivery of nursing care. PMID- 3643239 TI - Cross-cultural observations. PMID- 3643240 TI - Joint efforts between education and the community. PMID- 3643241 TI - Stressed nurses dealing with incontinent patients. PMID- 3643242 TI - Organic illness mimicking psychiatric episodes. PMID- 3643243 TI - The educational experiment: a teaching nursing home. PMID- 3643244 TI - Nursing Home Without Walls. PMID- 3643245 TI - Recapping needles safely. PMID- 3643246 TI - Canadian Nosocomial Infection Surveillance Program. PMID- 3643247 TI - Pet therapy and infection control. PMID- 3643248 TI - Carcinoma of the prostate. Is radiation therapy an alternative to radical prostatectomy? PMID- 3643249 TI - Emergence of resistance to cephalothin and gentamicin during combination therapy for methicillin-resistant Staphylococcus aureus endocarditis in rabbits. PMID- 3643250 TI - In-vitro binding of gonadotrophin to fish ovary. AB - Binding of piscine and mammalian gonadotrophin to plasma membranes from the ovaries of a fish, the murrel (Channa punctatus), clearly suggests that the fish ovary possesses distinct and specific binding sites for both piscine and mammalian gonadotrophins. Maximum specific binding of 125I-labelled human chorionic gonadotrophin (125I-hCG) and 125I-labelled silver carp gonadotrophin (125I-scG) was obtained at 30 degrees C and pH 7.5 during 2 h of incubation. In competitive binding studies, binding of radiolabelled scG was effectively inhibited by piscine gonadotrophins while LH and hCG had less effect and FSH showed no inhibition. By using plasma membrane preparations from kidney, skeletal muscle, brain and ovary it could be shown that specific binding of radiolabelled gonadotrophins was restricted to ovarian tissue. Binding characteristics of both 125I-scG and 125I-hCG to a preparation of murrel ovarian plasma membranes showed saturability with high affinity and low capacity. Scatchard plot analysis gave a higher dissociation constant for hCG (Kd = 235 pmol/l) than for scG (Kd = 127 pmol/l). Maximum binding capacity of scG was about twofold higher (6.27 fmol/mg protein) than that of hCG (3.76 fmol/mg protein). An increase in gonadotrophin binding resulted in a greater formation of pregnenolone from cholesterol, indicating functional relevance. At a concentration of 8 mmol/l, Ca2+ markedly inhibited the binding of gonadotrophin. The physiological importance of this inhibition is discussed. PMID- 3643251 TI - Detection of an integrated tetracycline resistance plasmid in the chromosome of methicillin-resistant Staphylococcus aureus. AB - The majority of multiresistant Staphylococcus aureus strains isolated in Australian hospitals since 1970 carry a chromosomally-encoded minocycline and tetracycline resistance determinant. By using DNA-DNA hybridization, some of these multiresistant strains were shown to possess also a tetracycline resistance plasmid, equivalent to pT181, integrated into a unique site in the chromosome. By relating the hybridization data to the map of pT181, the site of integration on this plasmid was established to be between the genes for replication and tetracycline resistance. PMID- 3643252 TI - Managing complexity in health care settings. AB - Health care settings are becoming ever more complex. With this increased complexity, however, people often become less clear about their responsibilities and accountability. In this article, the authors discuss the process of responsibility charting and illustrate how it can be used to clarify the roles of the many different people whose work may be affected by the implementation of new programs and procedures. Responsibility charting is a structured process for establishing sound patterns of communications and collaboration over time. PMID- 3643253 TI - Language, leadership, and power. AB - Analysis of language people use at work is an important way of making sense of what goes on in organizations. Words captivate and compel, or hobble and bag. Recognizing the variety, distribution, and relevance of language can help nurse executives understand the subtleties of leadership, varying dimensions of power, and paradoxes of organizational life. PMID- 3643254 TI - Collecting a reliable urine specimen for drug analysis. PMID- 3643255 TI - A system for unit-based monitors of quality of nursing care. AB - A system of unit-based monitors designed to assess selected factors in quality of nursing care specific to an individual nursing unit is described. The advantages of unit monitors as a means of involving staff nurses in improving quality of care are discussed. These include greater involvement and commitment in problem solving as staff nurses participate in designing and implementing a monitor specific to their unit. PMID- 3643256 TI - Instituting a clinical privileging process for nurses. AB - Following the Joint Commission on Accreditation of Hospital's emphasis on clinical privileging for professionals other than physicians, Saint Elizabeths Hospital implemented a criteria-based system for granting privileges to nurses. Current literature does not provide much, if any, guidance for the nursing administrator facing the task of developing such a system. This article describes the development and implementation of a successful system, as well as results of evaluation of the system 18 months after implementation, and recommendations for change. PMID- 3643257 TI - Promoting an image of professionalism in nursing. PMID- 3643258 TI - Clinical research by master's students. PMID- 3643259 TI - Preventive legal maintenance. PMID- 3643260 TI - Editorial; promoting visibility. PMID- 3643261 TI - Helping children deal with procedures in a clinic setting: a developmental approach. PMID- 3643262 TI - Research and treatment: ethical distinctions related to the care of children. PMID- 3643263 TI - Health care preferences of rural adolescents: types of service and companion choices. PMID- 3643264 TI - Temperament: assessing individual differences in hospitalized children. PMID- 3643265 TI - Nursing assessment of infant feeding problems. PMID- 3643266 TI - Munchausen syndrome by proxy. PMID- 3643267 TI - Managing upward. PMID- 3643268 TI - Nurses and chemical dependency: policy considerations. PMID- 3643269 TI - Noninvasive oxygen monitoring. PMID- 3643271 TI - The law and your profession. PMID- 3643270 TI - Infection control: the aminoglycoside antibiotics. PMID- 3643272 TI - Your CE topic this month (No. 19). Chemotherapy-induced nausea and vomiting. PMID- 3643275 TI - Living with lupus. PMID- 3643274 TI - Managing the assaultive patient. PMID- 3643273 TI - What's the best way to handle a sexually aggressive patient? PMID- 3643276 TI - Living wills "Death with Dignity". PMID- 3643277 TI - Your CE topic this month (No. 20). Antiepileptic pharmacotherapy. PMID- 3643278 TI - Induction and persistence of pituitary and ovarian activity in the out-of-season lactating dairy goat after a treatment combining a skeleton photoperiod, melatonin and the male effect. AB - Thirty-two out-of-season Saanen dairy goats were involved in a 2 X 2 factorial experiment using (1) extra-light treatment (equivalent to long days) from 18 January to 19 March, at the end of gestation and the onset of lactation and (2) daily melatonin injections (equivalent to short days) from 20 March to 30 June. Hence, there were 4 groups of 8 goats each: CC (control-control), EC (extra-light control), CM (control-melatonin) and EM (extra-light-melatonin). In each group teasers (males and androgenized females) were introduced on 30 May. Serial blood samples were taken for measurement of LH pulsatility on 30 April and 30 May. Ovarian activity was followed by plasma progesterone assay and laparoscopy. Oestrous behaviour was checked daily from 30 May to 15 July. The number of LH pulses was not modified by the treatments (extra light or melatonin). Melatonin treatment increased the basal concentration of LH (Groups CC + EC = 0.30 ng/ml; Groups CM + EM = 0.38 ng/ml; P less than 0.02) and the amplitude of pulses (Groups CC + EC = 1.24; Groups CM + EM = 2.44 ng/ml; P less than 0.02); the highest amplitude was observed for females in Group EM. Melatonin-treated females ovulated earlier after introduction of teasers than did untreated goats (Groups CM + EM = 2.3 days; Groups CC + EC = 6.1 days; P less than 0.001), but treatments did not modify ovulation rate (mean 2.1) or percentage of goats experiencing a short luteal phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3643279 TI - Ano-genital distance as a factor in determining puberty acceleration in mice. AB - The daily exposure of newly born female mice to the urine of lactating mice with a small ano-genital distance accelerated the onset of first oestrus while the urine from donors with a large ano-genital distance was without effect in advancing puberty. The rate of growth of the mice exposed to the urine of lactating mothers was greater than that of a control sample but it was only those mice exposed to the urine of lactating females with a small ano-genital distance which continued to grow, after the cessation of treatment at 21 days of age, at a faster rate. There was no difference in the mass of the uterus when the mice were killed when adult but there were significant age-dependent differences in the mass of the ovaries and adrenal glands. The mice exposed to the urine from lactating mothers (with both large and small ano-genital indices) had smaller ovaries than the control mice while the adrenal glands of mice exposed to the urine of lactating mothers with a large ano-genital index were of greater mass than those of the control mice and mice exposed to mothers with a small ano genital distance. Exposure to the urine of lactating mothers had no effect on the subsequent activity of the mice when tested in an automated activity recorder. The results confirm that urine from lactating mothers accelerates the onset of puberty and suggests that the effects are restricted to the urine from mothers with a small ano-genital index. PMID- 3643280 TI - Application of a Poisson-gamma model to study the influence of gamete concentration on sperm-oocyte fusion in the zona-free hamster egg penetration test. AB - A Poisson-gamma distribution model has been developed for studying sperm-oocyte interaction in the zona-free hamster egg penetration test. With the aid of this model we have analysed the relationship between the penetration results achieved with semen of normal fertile men and the concentration of spermatozoa and oocytes used in the assay. From this analysis we have drawn up reference tables estimating the number of spermatozoa and oocytes which must be present in the assay for the result to represent a significant (P less than 0.05) decline in sperm function relative to the normal fertile population. Since there is, as yet, no fixed protocol for the penetration assay, these tables have been constructed to fit a range of methodologies varying with respect to the nature of the preincubation phase and including (a) a 7-h preincubation in Medium BWW, (b) a 3 h preincubation in hyperosmotic Medium BWW or (c) a 3-h preincubation in the presence of A23187. PMID- 3643281 TI - Spacing of conceptuses in the uterine horn and local effects on fetal and placental weights throughout gestation in the rat. AB - Longitudinal growth of the uterine horn and distances between implantation sites and the extremities of the horn were measured in 30 albino Wistar rats at Days 7, 10, 13, 16 or 22 of gestation. Growth of the uterus was most rapid over Days 13 16 but continued over Days 16-22. Distances between implantation sites and between the extremities of the uterine horn and neighbouring implantation sites were relatively even in that the coefficients of variation of these distances were 28, 32, 19, 35 and 35% at Days 7, 10, 13, 16 and 22, respectively. This indicates that an active mechanism promotes even spacing since the expected coefficients of variation given completely random spacing of conceptuses was calculated to be about 100%. Local crowding of fetuses in the uterine horn did not appear to affect fetal or placental growth except at Day 22 when there was a weak but significant correlation (r = 0.3) between fetal weight and the harmonic mean distance to neighbouring implantations. PMID- 3643282 TI - Effects of reciprocal ovary transplantation on reproductive performance of lethal yellow mice (Ay/a; C57BL/6J). AB - This study was conducted to determine whether reproductive failures in ageing, obese lethal yellow (Ay/a) females are due primarily to defects within Ay/a ovaries or to systemic defects which may operate outside the ovaries. Reciprocal ovary transplantation between control (a/a) and lethal yellow (Ay/a) females provided an experimental system to test the reproductive potential of not only Ay/a ovaries in control (a/a) females but also control (a/a) ovaries in mutant (Ay/a) females. Results on reproductive performance of all four combinations of grafts between Ay/a and a/a mice proved that Ay-induced reproductive failures are not due to intrinsic ovarian lesions but rather to defects operating extrinsically to the ovary. The hypothalamo-pituitary axis is a likely site for this reproductive lesion. PMID- 3643283 TI - Inactivation of leukocyte elastase by aryl azolides and sulfonate salts. Structure-activity relationship studies. AB - The inhibitory activity of a series of aryl azolides and sulfonate salts toward human leukocyte elastase is reported. Several of the compounds were found to be potent inhibitors of the enzyme. Active compounds were obtained only when the specificity group and the reactive moiety were separated by a two-carbon chain. The introduction of hydrophobic groups enhanced the inhibitory activity of these compounds, with the exception of the sulfonate salts. The nature of the leaving group had a profound effect on inhibitory activity, with compounds 23 and 26 being the most active (kobsd/[I] = 11,722 and 13,500 M-1 s-1, respectively). PMID- 3643285 TI - [Midecamycin acetate-susceptibility of clinical isolates from dental and oral surgical infections]. AB - To investigate the clinical and bacteriological usefulness of orally administered midecamycin acetate (MOM), the susceptibility of clinical isolates to MOM, Mb-12 (the main metabolite of MOM), josamycin (JM), ampicillin (ABPC) and cephalexin (CEX) was determined. The results are summarized as follows. Antibacterial activities of MOM against aerobic Gram-positive cocci, B. catarrhalis, and anaerobic bacteria were inferior to those of JM by 2-fold, but superior to those of CEX. Activities of MOM against S. aureus, Bacteroides spp., Fusobacterium spp., Veillonella spp. were superior to those of ABPC and CEX. Since serum and tissue concentrations of Mb-12 after 200 mg administration in humans have been reported to be 1-2 micrograms/ml, it can be presumed that the causative bacteria would be eradicated by a usual dosage of MOM used in the present study. From these considerations, it is speculated that MOM may be successfully used in the treatment of dental and oral surgical infections. PMID- 3643284 TI - Synthesis and antiviral activity of various 3'-azido, 3'-amino, 2',3' unsaturated, and 2',3'-dideoxy analogues of pyrimidine deoxyribonucleosides against retroviruses. AB - Various 3'-azido, 3'-amino, 2',3'-unsaturated, 2',3'-dideoxy, and 5-substituted analogues of pyrimidine deoxyribonucleosides have been prepared and tested against Moloney-murine leukemia virus (M-MULV), a mammalian T-lymphotropic retrovirus in vitro. Among these compounds, the 3'-azido analogues of thymidine, 2'-deoxy-5-bromouridine, and 2'-deoxy-5-iodouridine, the 2',3'-unsaturated analogue of thymidine and and 2'-deoxycytidine, and 2',3'-dideoxycytidine were found to be most active, with ED50 values of 0.02, 1.5, 3.0, 2.5, 3.7, and 4.0 microM, respectively. These active compounds were nontoxic to the host SC-1 cells up to 100 microM concentration. The 3'-azido analogues of thymidine and 2'-deoxy 5-bromouridine were also tested in vitro against HTLV-III/LAV/AAV ("AIDS" virus) and found to be significantly active, with ED50 values of 0.23 and 2.3 microM, respectively. The structure-activity relationships are discussed. PMID- 3643286 TI - [Clinical diagnosis in obstetrics. Diagnosis preceding birth]. PMID- 3643287 TI - [Significance of current regional practice of midwifery]. PMID- 3643289 TI - [Practical aspect of local midwifery practice]. PMID- 3643288 TI - [Stimulation of regional midwifery activities]. PMID- 3643290 TI - [Proposal of establishment of a local network of midwives]. PMID- 3643291 TI - [Activities and opinion of a practicing midwife]. PMID- 3643292 TI - [My experience as a practicing midwife]. PMID- 3643293 TI - [Discussion: our image of midwifery practice]. PMID- 3643294 TI - [Maternal and child care of the 21st century. (A prize-winning essay)]. PMID- 3643295 TI - [Maternal and child health care of the 21st century: on childbirth as a joint experience by the husband and wife. (A prize-winning essay)]. PMID- 3643296 TI - [The society in the 21st century and the mother-child relations. (A prize-winning essay)]. PMID- 3643297 TI - [Maternal and child health care of the 21st century: thoughts on future health care activities for mothers and children. (A prize-winning essay)]. PMID- 3643298 TI - [Discussion. Maternal and child health care of the 21st century]. PMID- 3643299 TI - [Water-electrolyte balance of the newborn and developmental physiology of the kidney]. PMID- 3643300 TI - [Perinatal nursing of mothers and infants: psychosocial approach. 9. Response to the basic needs of the expectant mothers and the process of acquisition of the maternal role]. PMID- 3643301 TI - [Essay on nursing: a nurse as a mother and a daughter]. PMID- 3643302 TI - [On childbirth and child rearing. 21. Re-evaluation of breast feeding]. PMID- 3643303 TI - [Questions and answers on breast feeding: weaning]. PMID- 3643304 TI - [Year-end thought on childbirth]. PMID- 3643305 TI - [Educational evaluation: on research methodology. (4): Preparation of questionnaires]. PMID- 3643306 TI - [Loopholes in the law of equal employment opportunity for men and women]. PMID- 3643307 TI - [Fetal myocardial infarct]. PMID- 3643308 TI - [Maternal and child health care and the public health clinic. 5. An opportunity to utilize public health care function of the clinic]. PMID- 3643309 TI - [Housing problems and public health education]. PMID- 3643310 TI - [Public health nursing activities at several selected areas and involvement of public health clinic nurses--experiences acquired by young nurses through their activities]. PMID- 3643311 TI - [A visit by a young man who underwent heart surgery 20 years ago. Job satisfaction of a public health nurse]. PMID- 3643312 TI - [Professional nature and uniqueness of the service by public health nurses. Study on nocturnal enuresis. IV. Children with nocturnal enuresis and family orientation of their parents]. PMID- 3643313 TI - [Survey of the status of patients with senile dementia and their relationship to local public health services]. PMID- 3643314 TI - [On the problem of revision of the nursing system. A new plan proposed by the Japanese Nursing Association signifying negation of public health]. PMID- 3643316 TI - [On maternal and child health--examples of child care and public health nursing]. PMID- 3643315 TI - [Planning a nation-wide on-line system for surveillance of tuberculosis and infections]. PMID- 3643317 TI - [Diagnosis and management of area inhabitants--the intended users of the public health clinic]. PMID- 3643318 TI - [Child welfare in Finland]. PMID- 3643319 TI - [Nurses in clinical setting--nursing administration in hospital]. PMID- 3643320 TI - [Excellence in nursing]. PMID- 3643321 TI - [Standardized nursing system as provided for in the regulation: current issues]. PMID- 3643322 TI - [Incontinent elderly. (2). How they deal with it at home]. PMID- 3643323 TI - [Nursing home--review and perspective]. PMID- 3643324 TI - [American traits in nursing in Japan]. PMID- 3643325 TI - [Standardized nursing system as provided for in regulation: efforts for better nursing care in current system]. PMID- 3643326 TI - [Standardized nursing system as provided for in the regulation: review and proposition]. PMID- 3643327 TI - [Standardized nursing system as provided for in the regulation: efforts made at Saiseikai Central Hospital]. PMID- 3643328 TI - [Standardized nursing system as provided for in the regulation: an urgent need for revision of the regulation]. PMID- 3643329 TI - [Standardized nursing system as provided for in the regulation: problems and suggestion for change]. PMID- 3643330 TI - [Standardized nursing system as provided for in regulation: big gap between principle and reality]. PMID- 3643331 TI - [American language: helping and support]. PMID- 3643332 TI - [Health service and management: quality of health care as controlled by the insurance policy]. PMID- 3643333 TI - [Interview with Nelly Garzon, Marie Colliere, and Muriel Skeet]. PMID- 3643334 TI - [Nurses in clinical setting: as head nurse in a hospital]. PMID- 3643335 TI - [Volunteers in health care. Volunteers at St. Luke's International Hospital]. PMID- 3643336 TI - [Leadership patterns]. PMID- 3643337 TI - [Volunteers in health care. Hospice volunteers]. PMID- 3643338 TI - [Volunteers in health care. I started a hospital volunteer group]. PMID- 3643340 TI - [Volunteers in health care. Volunteers in hospitals]. PMID- 3643339 TI - [Volunteers in health care. Volunteering as a part of life--as I saw it in a hospital in Idaho]. PMID- 3643341 TI - [Volunteers in health care. Volunteerism and the Japanese people]. PMID- 3643342 TI - [Health policy should be given top priority--role of nursing leadership]. PMID- 3643343 TI - [WHO meeting on nursing leadership in PHC for HFA]. PMID- 3643344 TI - [American language: self-help and independence]. PMID- 3643345 TI - [Health service and management: economics of standardized nursing]. PMID- 3643346 TI - A vehicle for political socialization. PMID- 3643347 TI - Lobbying for better health care: a "natural" for a nurse. PMID- 3643348 TI - Reflections of a political nurse. Interview by Susan Tannenwald-Miringoff. PMID- 3643350 TI - National school health day in Tunisia. AB - Through combined efforts of the Ministry of Public Health and the Ministry of National Education, a National School Health Day has been observed for the past several years in Tunisia. Held the third Tuesday in February, features of the day include selecting a theme, conducting a poster contest, preparing instructional material for teachers, and providing information for a national media campaign. National and provincial officials support the day by visits to schools. PMID- 3643349 TI - Diagnostic and prognostic value of serum elastase 1 in acute pancreatitis. AB - Serum elastase 1 was determined in the serum of 38 patients with acute pancreatitis, using specific radioimmunoassay technique. Serving as controls were 36 healthy people, 33 patients with chronic pancreatitis, 49 patients with various GI-tract diseases, and 6 patients with pancreatic carcinoma. Sensitivity of elastase 1 for the diagnosis "acute pancreatitis" was 97% after admission to the hospital and 100% within 48 h after onset of acute pancreatitis. The determination of elastase 1 is clearly superior to that of trypsin, pancreatic lipase, or pancreatic amylase, if diagnosis has to be made more than 48 h after the onset of the disease. The specificity is restricted, because there are some cases with chronic pancreatitis and GI-diseases with raised values. There is no possibility to estimate the severity of acute pancreatitis by measuring serum elastase 1. PMID- 3643351 TI - School-based, short-term group treatment for behaviorally disturbed young adolescent males: a pilot intervention. AB - Behaviorally maladjusted students represent a serious problem for schools. A short-term group counseling program was initiated as an alternative to out-of school suspensions for male students in a middle school (grades six-eight). Thirteen adolescents were identified for group treatment. All received a standard psychiatric interview, and standard measures of self-concept, anxiety, cognitive complexity, and sexual maturity. Eleven students referred to the program had conduct disorders supported by Devereux Behavior profiles. Compared to 48 males of similar age (m = 12.5 years) without behavior problems, no significant differences were noted in self-concept or anxiety. Boys with behavior problems were less cognitively mature (p = .02) and were significantly (p = .001) more advanced in Tanner sexual maturity rating than the comparison group. A behavior management system using group rewards and consequences for individual behavior was utilized. Disciplinary problems decreased in the classroom during treatment but no long-term changes were noted following cessation of treatment. The data raises the question whether early sexual maturation modifies an adolescent's risk for psychological problems. Short-term group treatment may be effective in improving classroom behavior of behaviorally disturbed adolescent males. PMID- 3643352 TI - Cardiovascular health knowledge of children and school personnel in Louisiana public schools. AB - Questionnaires describing educational and administrative practices and cardiovascular health knowledge tests for fourth, sixth, and 12th grade students, teachers, and principals were used to evaluate cardiovascular health knowledge in a carefully matched, representative sample in Louisiana public schools. Data indicated cardiovascular health knowledge of both professionals and students was low, with several correlations between knowledge and educational or administrative practices. Recommendations for improvements in school health education programs are offered. PMID- 3643353 TI - Entry-level competencies and the generic health educator. PMID- 3643355 TI - A checklist for evaluating health information. PMID- 3643354 TI - The influence of peers and parents on the smoking behavior of schoolchildren. PMID- 3643356 TI - Nutrition review: a participation game. PMID- 3643357 TI - Computer competence for school nurses. PMID- 3643359 TI - All is well down on the farm. PMID- 3643358 TI - Ethical issues and concerns of Kentucky nurses: a survey report. PMID- 3643360 TI - Computer corner. PMID- 3643361 TI - [A new principle tested in the treatment of AIDS. A peptide can block cell receptor for HIV]. PMID- 3643362 TI - [Ultrastructural morphology of Kaposi sarcoma of the head and neck in acquired immunodeficiency syndrome (AIDS)]. AB - The ultrastructural morphology of Kaposi's sarcoma in the skin and mucous membranes of the head and neck regions of patients with acquired immune deficiency syndrome (AIDS) was examined electron microscopically. It was found that the tumour consisted of neoplastic spindle cell aggregates, vascular endothelial cell proliferations and an inflammatory infiltrate of lymphocytes and plasma cells. Not only abnormal blood vessel endothelial proliferations, but also irregular lymphatic luminal formations were observed. Moreover, tubuloreticular structures, helical polysomes, giant multivesicular bodies as well as test-tube and ring-shaped forms were found in the tumour cells. Erythrophagocytosis in various stages including ultimately the production of siderosomes was also seen. There was also some mitotic activity in the tumour cells. Retroviruses of 100-120 nm, morphologically identical to HTLV-III, were budding from the plasma membrane of some of the Kaposi's sarcoma cells. As these retroviruses are able to replicate in Kaposi's sarcoma cells without having a clear relation to the tumourogenesis, the characterisation as well as quantification of the virus producing cells may well prove highly relevant. PMID- 3643363 TI - Burns, abortions and dying declarations. PMID- 3643364 TI - [Oxygen therapy in clinical practice]. PMID- 3643365 TI - [Hypervitaminosis]. PMID- 3643366 TI - [Changes in the fundus oculi in diabetes mellitus]. PMID- 3643367 TI - [Physical methods in the combined therapy of pneumonia in premature infants]. PMID- 3643368 TI - [Parasitic diseases of the eyelids and eyelashes]. PMID- 3643369 TI - [Postinjection complications and their prevention]. PMID- 3643370 TI - [Therapeutic physical exercise and massage in scoliosis and flatfoot in schoolchildren]. PMID- 3643371 TI - [Modification of a bandage for the scrotum]. PMID- 3643372 TI - [Methodological bases for anti-alcohol propaganda]. PMID- 3643373 TI - [Deontological aspects in a pediatric ENT hospital]. PMID- 3643374 TI - [Official responsibilities and the professional duty of the nurse]. PMID- 3643375 TI - [Universal device for opening ampules and flasks]. PMID- 3643376 TI - [Apparatus for the sterilization and disinfection of medical articles]. PMID- 3643377 TI - [Duties of the nurse in a viral hepatitis ward]. PMID- 3643378 TI - [One nurse about another. 5000 lives saved. Interview by T. D. Petrovskaia]. PMID- 3643379 TI - [Role of the nurse in performing balneotherapy at the Mine Builder Sanatorium Preventorium]. PMID- 3643380 TI - [Raising the qualifications of paramedical and pharmaceutical personnel in Kemerovo Province]. PMID- 3643381 TI - [Psychological rehabilitation of children with chronic diseases of the digestive system]. PMID- 3643382 TI - [Medical gymnastics following dermatomyoplasty]. PMID- 3643383 TI - [Regimen of facial muscle motor activity in traumatic jaw injuries]. PMID- 3643384 TI - [Treatment of osteoarticular tuberculosis in children]. PMID- 3643385 TI - [Spinal tuberculosis and its surgical treatment]. PMID- 3643386 TI - [School reform in the decisions of the 27th Congress of the CPSU and the role of paramedical personnel in pediatric institutions in its realization]. PMID- 3643387 TI - [Diagnosis and treatment of diaphragmatic dysfunction]. PMID- 3643388 TI - [Alcohol and progeny]. PMID- 3643389 TI - [Work experience of the nurse in the surgical department for spinal tuberculosis]. PMID- 3643390 TI - [Deontology in the pediatric oncology department]. PMID- 3643391 TI - [Hygienic problems of the modern village]. PMID- 3643392 TI - [Organization of preventive medical care for paramedical workers]. PMID- 3643393 TI - [New form of prolonged-action pilocarpine]. PMID- 3643394 TI - [The intestinal douche--its therapeutic use, equipment and setup]. PMID- 3643395 TI - [Medical gymnastics for pulmonary tuberculosis patients]. PMID- 3643397 TI - The 'anatomy' of infant sucking. PMID- 3643396 TI - [Clinical aspects of AIDS and related syndromes in Pointe-Noire (Peoples' Republic of Congo). Apropos of 73 cases detected in 6 months]. AB - A.I.D.S. is a true public health problem in Central Africa since its "appearance" in 1983. Several authors have described its clinical manifestations, as well as the absence of groups at risk and a sex ratio near to 1. The present study, carried out in Pointe-Noire hospital (Popular Republic of Congo) tries to select in connexion with sex and age, one or several clinical symptoms which should indicate the necessity of requesting a HIV serology test. Four groups have been isolated: a) patients with very important loss of weight and chronic or intermittent diarrhea, b) fever with loss of weight and pulmonary X-Ray anomalies, c) polyadenopathies, d) associated opportunistic infections and Kaposi sarcoma. In Africa, A.I.D.S. strikes all age groups and both sex. There is one group at risk: transfused patients, particularly the sickle-cell anemia homozygotes. PMID- 3643398 TI - Aetiology of sore nipples. PMID- 3643399 TI - Treatment of umbilical cords: a randomised trial to assess the effect of treatment methods on the work of midwives. PMID- 3643400 TI - Postnatal blues: a bio-social phenomenon? PMID- 3643401 TI - Postpartum sleep patterns of mother-baby pairs. PMID- 3643402 TI - Fetal home telemetry. PMID- 3643403 TI - A college's experiment with evening clinical rotations in CHN. PMID- 3643404 TI - Evidence to the Review Body for Nursing Staff, Midwives, Health Visitors and Professions Allied to Medicine for 1987. The Royal College of Midwives. PMID- 3643406 TI - The discharge of mothers by midwives. PMID- 3643405 TI - Whispers in the sluice. PMID- 3643407 TI - Nurses and smoking education--a literature review. PMID- 3643408 TI - Problems encountered in setting up support groups in nursing. PMID- 3643409 TI - Health education in basic nursing curriculum. PMID- 3643410 TI - Nurse education: learner-centred or teacher-centred? PMID- 3643411 TI - Curriculum development in action. PMID- 3643412 TI - Formal teaching about death and dying in UK nursing schools. PMID- 3643413 TI - Complete congenital heart block: a case study. PMID- 3643414 TI - Primary nursing in the NICU: a parent's perspective. PMID- 3643415 TI - Sibling grief. PMID- 3643416 TI - Axillary and rectal temperatures of full term neonates: are they different? PMID- 3643417 TI - Anterior cricoid split: an alternative to tracheostomies in infants with subglottic stenosis. PMID- 3643418 TI - How the individual nurse can have an impact on the Federal scene. PMID- 3643419 TI - The Code for Nurses: Statement #3 and #4. PMID- 3643420 TI - The choice is yours! Part two: Choosing your computer. PMID- 3643421 TI - [Nursing assessment. Examination of nose, sinuses and neck]. PMID- 3643422 TI - Can cancer be avoided? PMID- 3643423 TI - Providing contraceptive services. PMID- 3643424 TI - Community nursing. Keeping the aged where they belong. PMID- 3643425 TI - Sexual concerns of the cancer patient. The nurse's role. PMID- 3643426 TI - Maternal and child health care: innovations. PMID- 3643427 TI - Advancing the specialty of cancer nursing through professional organizations. PMID- 3643428 TI - The problem of establishing early cancer detection programmes in developing countries. PMID- 3643429 TI - Copying and copyright. PMID- 3643430 TI - Surgical needles. PMID- 3643432 TI - Postoperative bowel gas. Some simple remedies. PMID- 3643431 TI - [Nursing assessment. Examination of the eye]. PMID- 3643433 TI - Men and family planning. PMID- 3643435 TI - Maternal and child health care. How to use a planning cycle. PMID- 3643434 TI - Compromised patients: potential infection control problems. PMID- 3643436 TI - Surgical sex changes: myths or miracles? PMID- 3643437 TI - Community participation: the heart of community health. PMID- 3643438 TI - Professional education in a university context. PMID- 3643439 TI - Anaesthetics: how they work. PMID- 3643440 TI - Stomatherapy aspects of radiation sequelae. PMID- 3643441 TI - The great generic substitution debate. PMID- 3643442 TI - Middle-age crisis: a self-fulfilling prophecy? PMID- 3643443 TI - [Surgical positions]. PMID- 3643444 TI - Surgery--its effects on the elderly. PMID- 3643445 TI - NATN evidence on the staffing of operating theatres for Joint Meeting at the DHSS in July. PMID- 3643447 TI - Computers in nursing: applications for ambulatory care. PMID- 3643446 TI - Exceptional executive leadership shapes nursing's future. PMID- 3643449 TI - The power and resources of nursing schools within university settings. PMID- 3643448 TI - Treatment decisions with the terminally ill incompetent patient. PMID- 3643450 TI - A cost-effective percutaneous nephrolithotomy program. PMID- 3643451 TI - Evaluating automated information systems. PMID- 3643452 TI - [LAV/HTLV-III infection among homosexual men; prevalence, incidence and possible co-factors]. PMID- 3643453 TI - The educational accountability model. PMID- 3643454 TI - Primary care works! PMID- 3643455 TI - Educating the educators on alcoholism. PMID- 3643456 TI - Control the media with power. PMID- 3643457 TI - Don't say no to success. PMID- 3643458 TI - Dealing with leadership changes. PMID- 3643459 TI - Blocks to nursing success. PMID- 3643460 TI - Getting into law school: a primer for nurses. PMID- 3643461 TI - College calls for legal establishment of nursing formulary. PMID- 3643462 TI - Royal College of Nursing. True triumph. PMID- 3643463 TI - The challenges that Cumberlege presents profession. PMID- 3643464 TI - Development of services to people with mental handicap. PMID- 3643465 TI - Royal College of Nursing. Falling short. PMID- 3643466 TI - Crucial OH role. PMID- 3643467 TI - The student voice. PMID- 3643468 TI - Fears for the future of nursing. PMID- 3643469 TI - AIDS--caring in the community. PMID- 3643470 TI - Royal College of Nursing. Need for change. PMID- 3643471 TI - Fight silent approval. PMID- 3643472 TI - Will I join the exodus? PMID- 3643474 TI - A question of ethics. PMID- 3643473 TI - Royal College of Nursing. Note concern. PMID- 3643476 TI - Marketing can enrich the repertoire of nursing. PMID- 3643475 TI - Neurofibroma: an unusual cause of massive retroperitoneal bleeding. PMID- 3643477 TI - Counseling clears the way for return-to-school decisions. PMID- 3643478 TI - Investor-owned hospitals offer nurses a number of advantages. PMID- 3643479 TI - A brave new world for nurses. PMID- 3643480 TI - Septic shock. PMID- 3643481 TI - Wound care: what's clear, what's not. PMID- 3643483 TI - Lessons from the law: a question of restraints. PMID- 3643482 TI - Reaching Julie--with a gentle touch. PMID- 3643484 TI - Assessing the failing state of the heart (continuing education credit). PMID- 3643485 TI - Let's stop calling ourselves 'patient advocates'. PMID- 3643486 TI - Unveiling the mysteries of anesthesia. PMID- 3643487 TI - Lab tests you can't overlook. Part I. PMID- 3643488 TI - 4 tips to take the fear out of floating. PMID- 3643489 TI - When your patient is acutely ill: how to comfort and guide the family. PMID- 3643490 TI - Balloon embolotherapy for varicocele. PMID- 3643491 TI - Finding the key to problem behavior. PMID- 3643492 TI - Our heart is gone. PMID- 3643493 TI - Common problems of infancy. PMID- 3643494 TI - Anxiety: an integral part of the first year of parenthood. PMID- 3643495 TI - Care of the premature infant. PMID- 3643496 TI - Sudden infant death syndrome. PMID- 3643497 TI - Congenital abnormalities. PMID- 3643498 TI - Care of the neonate undergoing surgery. PMID- 3643499 TI - "He's not my baby any more". Care of the critically ill infant and family support. PMID- 3643500 TI - Beds. PMID- 3643501 TI - A celebration of nurses. PMID- 3643502 TI - HTLV-III in the tears of AIDS patients. AB - The human T-cell leukemia/lymphotropic virus type III (HTLV-III), the causative agent of the acquired immunodeficiency syndrome (AIDS), has been isolated from the tears of five AIDS patients. When combined with data from our previous study, 5 of 16 samples from patients with AIDS or AIDS-related complex (ARC) showed positive isolates for HTLV-III from the tears. Normal control tears were negative for HTLV-III. Based upon these findings, the Centers for Disease Control (CDC) has issued precautions to prevent any possible spread of the virus by this route. Although there is no evidence to suggest transmission of HTLV-III by contact with the tears, until more is known about the possible transmissibility and infectious dose of this virus, such precautions should be taken during ophthalmic examination. PMID- 3643503 TI - A living will insure that your wishes will be followed. PMID- 3643504 TI - IRAs--can you still participate? PMID- 3643505 TI - Has the liability insurance crisis affected nursing? You bet! PMID- 3643506 TI - Understanding the professional liability insurance crisis. PMID- 3643507 TI - A comparison of pneumogram recordings in infants in the hospital and at home. AB - It is not known how environment affects the ventilatory pattern of infants during sleep. Pneumogram recordings of ventilatory pattern and electrocardiograms are performed both in the hospital and at home. However, it is not known if the data obtained in these two settings are comparable. Therefore, 12-hour overnight PNGs were recorded in the hospital and at home within 10 days on 64 infants in three diagnostic categories: apnea of infancy, apnea of prematurity, and siblings of victims of sudden infant death syndrome. Pneumograms were quantitated for total sleep time (TST in minutes), longest apnea (in seconds), periodic breathing, and the total duration of apneas lasting 6 seconds or longer. TST was longer at home for the total group (p less than 0.001) and for the apnea of infancy group (p less than 0.005). No other differences were found between hospital and home recordings for any parameter. There was no difference in the number of abnormal pneumograms recorded in the hospital and at home. Therefore, hospital and home pneumogram recordings are equally sensitive and accurate. PMID- 3643508 TI - [Esophageal pH measurements in newborn infants. Value and indications]. AB - Esophageal pH monitoring is now the most reliable test in the diagnosis of gastroesophageal reflux (GER) in infants and children. A 18-24 hr esophageal pH monitoring is undertaken in 26 newborns to validate this test for this age group where GER is frequent with fair correlation of clinical presentation. In 19 infants with suspicion of GER, this test give a positive diagnosis in 12 of them. Seven out of these 12 infants have another investigations (barium- esophagram - scintigraphy - esophagoscopy) with only a positive diagnosis of GER in 4 cases. Esophageal pH monitoring in 7 control infants show that the percent of monitoring time with pH below 4.0 is one of the best discriminative values (upper limit: 4.2%) for the diagnosis of GER. Unusual symptoms of GER in the neonatal period as apneic spells, dyspnea, cyanosis or neurological signs are indications for esophageal pH monitoring. PMID- 3643509 TI - [Epidemiology of infection by LAV/HTLV-III virus in hemophiliacs multitransfused in France. Results of a survey conducted by 28 hemophilia centers]. AB - In order to determine the contamination level of French hemophiliacs with the retrovirus LAV/HTLVIII, a national investigation of 1,670 hemophiliacs was performed. Results demonstrated that 49% were seropositive for LAV/HTLVIII antibodies. Of these 12.4% had clinical and/or biological symptoms of immunodeficiency. Regional differences with regard to the origin of blood used for plasma fractionation clearly appeared. PMID- 3643510 TI - The professional status of nursing: a view from the courts. AB - The judicial system regards nursing as an occupation that, for the most part, possesses a body of knowledge that is not known to lay persons. However, according to the courts, nursing does not possess a monopoly on that knowledge, since physicians also possess nursing knowledge. Until recently the courts implied that physicians not only possessed nursing knowledge, but possessed it to a superior degree. The ability of the physician to testify to nursing knowledge is rarely questioned and even when questioned, it has been allowed. Courts are confused about the relative independence of nurses from physicians and are reluctant to find nurses liable when they are following physicians' orders. However, courts do expect nurses to exercise independent judgment in the implementation of those orders. Recently, trial level courts have demanded that nurses take affirmative steps to protect patients from the negligent acts of physicians and have found nurses liable for failure to do so. This is true despite the clear statutory mandate that nurses are not competent to diagnose and treat medical conditions. When nurse practitioners engage in acts that could be construed as diagnosis, one state supreme court found they are entitled to be held to a standard of care separate from that of a physician. In so doing, the court recognized nursing as a distinct profession, entitled to its own standard of care, even when performing traditional medical acts. PMID- 3643511 TI - Satisfactions and dissatisfactions of part-time faculty. PMID- 3643512 TI - Role perceptions of part-time BSN faculty. PMID- 3643513 TI - Educating community health nurses for international practice. PMID- 3643514 TI - An experiment in nursing revisited. PMID- 3643515 TI - Determining two levels of nursing competency. PMID- 3643516 TI - An educators' consortium. PMID- 3643517 TI - ADN faculty and NLN accreditation: are the new criteria being met? PMID- 3643518 TI - Substance abuse: nursing has failed to care for its own. PMID- 3643519 TI - A duty to warn. PMID- 3643520 TI - Disclosure or silence on impaired practice? PMID- 3643521 TI - Thoughts on the nature of history. PMID- 3643522 TI - Clio and caring: an agenda for American historians and nursing. PMID- 3643523 TI - Paradise postponed (again): a review of the past 12 months in nursing. PMID- 3643524 TI - Nurse recruitment. When the tap runs dry. PMID- 3643525 TI - Nurse recruitment. The drop-out factor. PMID- 3643526 TI - Nursing recruitment. Late starters. PMID- 3643527 TI - Occupational health: let your fingers. PMID- 3643528 TI - Preventing suicide in hospital. PMID- 3643529 TI - Great expectations? PMID- 3643530 TI - A message for the teacher. PMID- 3643531 TI - Nursing practice. PMID- 3643532 TI - Nursing practice. The diabetic child in Kenya. PMID- 3643533 TI - Nursing practice. Standards of care in psychiatric nursing. PMID- 3643534 TI - Nursing practice. Who's for research? PMID- 3643535 TI - Whatever happened to the class of '83? PMID- 3643536 TI - Community care: community care-less. PMID- 3643537 TI - Whose patient is it, anyway? PMID- 3643538 TI - Psychiatric skills. Light in the darkness. PMID- 3643539 TI - Psychiatric skills. Tomorrow's world. PMID- 3643540 TI - Oral temperature measurement. PMID- 3643541 TI - Nurse recruitment. Best foot forward. PMID- 3643542 TI - Processing clients and colleagues. PMID- 3643543 TI - Visiting time. PMID- 3643544 TI - Spotlight on children. PMID- 3643545 TI - Spotlight on children. Pictures of health. PMID- 3643546 TI - Spotlight on children. Third World first. PMID- 3643547 TI - An aide or a hindrance? PMID- 3643548 TI - All at sea on pay? PMID- 3643549 TI - Two cheers for democracy. PMID- 3643551 TI - In the balance. Periodic registration: the case for. PMID- 3643550 TI - In the balance. Ticket for life. PMID- 3643552 TI - In the balance. Periodic registration: the case against. PMID- 3643553 TI - Two pink and one blue. PMID- 3643554 TI - The telephone never rings. PMID- 3643556 TI - Odd man out. PMID- 3643557 TI - Nurse recruitment: the school-leaver's dream. PMID- 3643555 TI - Systems of life. No 145. Senior systems. 10. PMID- 3643558 TI - Nursing aid. Feeding troubles. PMID- 3643559 TI - The road to conversion. PMID- 3643561 TI - Mental health nursing. Freezing and thawing behaviour. PMID- 3643560 TI - Mental health nursing. PMID- 3643562 TI - Mental health nursing. Skills in supervision. PMID- 3643563 TI - Mental health nursing. Working together. PMID- 3643564 TI - The deadly stigma. PMID- 3643566 TI - David Jones: David's day. Interview by Andrew Cole. PMID- 3643565 TI - Community nursing: pit stop for the roadshow. PMID- 3643567 TI - Prevention not punishment. PMID- 3643569 TI - Everyday ethics for nurses. To lie or not to lie. PMID- 3643568 TI - Everyday ethics for nurses. PMID- 3643570 TI - Restoring function to the arthritic hand. PMID- 3643571 TI - Nursing recruitment. Managing the career-break. PMID- 3643573 TI - Apply sparingly. PMID- 3643572 TI - Psychiatric skills: ask the family. PMID- 3643574 TI - Infant feeding. The young vegetarian. PMID- 3643575 TI - Infant feeding. Breast-feeding practices. PMID- 3643576 TI - Infant feeding. Fussy eaters. PMID- 3643577 TI - Teaching patients and clients. 2. Encouraging participation. PMID- 3643579 TI - Desirable needs of a nurse: a survey. PMID- 3643578 TI - An orientation programme for new staff nurses in an institution. PMID- 3643580 TI - Therapeutic milieu for psychiatric patients. PMID- 3643581 TI - Some suggestions to nurses. PMID- 3643583 TI - The nursing college library. PMID- 3643582 TI - Legal aspects in nursing. PMID- 3643584 TI - Horticulture therapy: an attempt at Indianisation of psychiatric nursing. PMID- 3643585 TI - Towards better health and family happiness. PMID- 3643586 TI - Importance of health education during pregnancy. PMID- 3643587 TI - Volunteer qualities: a survey of hospice volunteers. PMID- 3643588 TI - Evaluation of dimethyl sulfoxide and local cooling as antidotes for doxorubicin extravasation in a pig model. PMID- 3643590 TI - Undergraduate independent study in cancer nursing. PMID- 3643589 TI - Measuring oncology nursing practice: results from one graduate program. PMID- 3643591 TI - Malignant complications of AIDS. PMID- 3643592 TI - AIDS and ethics: concerns and considerations. PMID- 3643594 TI - Research: determining feasibility in a clinical setting. PMID- 3643593 TI - Making a choice: the vein access method you prefer. PMID- 3643595 TI - Living with a diabetic diet. PMID- 3643596 TI - How to administer chemotherapy. PMID- 3643597 TI - Informed consent: a patient's right? PMID- 3643598 TI - Raised intracranial pressure. PMID- 3643600 TI - Sticking plaster removal: a painless technique. PMID- 3643599 TI - Measuring product performance. PMID- 3643601 TI - The nurse as an inventor. PMID- 3643602 TI - Nurses' notes: worth their weight in gold. PMID- 3643603 TI - Head nurse demoted: employment rights. Case in point: Bimbo v. Burdette Tomlin Mem. Hosp. (644 F. Supp. 1033-NJ). PMID- 3643604 TI - Legal case briefs for nurses. MN.: unemployment benefits: timely appeal; N.Y.: staff shortage: negligence or malpractice? PMID- 3643605 TI - Activating clinical inferences: a component of diagnostic reasoning in nursing. AB - In this exploratory study, nursing inferences were examined within a framework of information processing theory. Verbal responses to a patient simulation by 28 nursing students and 15 practicing nurses were used as data. Six different categories of inferences were identified. Inferences most frequently activated across educational levels were those about immediate situational concerns. Practicing nurses activated significantly more complex inferences than the student groups. In each group, the majority of inferences were activated during the first half of the encounter. These results of this preliminary analysis support the proposition that inference activation is an important component of the diagnostic reasoning process used by both nurses and nursing students. PMID- 3643606 TI - Perceived stress and symptom patterns in early adolescents: the role of mediating variables. AB - The relationship between perceived stress and symptom patterns was investigated in 136 seventh and eighth grade boys and girls. Affective-oriented coping and social support, two variables hypothesized as mediators of this relationship, were examined also. Participants completed the Modified Adolescent Life Change Events Questionnaire, the Jalowiec Coping Scale, the PRQ-A Social Support System, and the Symptom Pattern Scale. As predicted, the positive relationship between perceived stress and symptom patterns decreased when controlling for affective oriented coping, while it increased when controlling for social support. Implications for nursing practice and further theory development are discussed. PMID- 3643607 TI - Healthy nursing doctoral programs: relationship between perceptions of the academic environment and productivity of faculty and alumni. AB - Indicators of the environment of doctoral programs in nursing were examined in relationship to productivity. Student and faculty perceptions of the academic program environment were correlated with outcome measures of productivity for both faculty and alumni. Twenty-five of the 29 eligible doctoral programs in nursing participated in the study; results are based on the responses of 326 faculty, 659 students, and 296 alumni. Environmental and productivity indicators were primarily measured by the Graduate Program Self-Assessment (GPSA) instruments developed by Educational Testing Service (ETS) for studying dimensions of quality in doctoral education. Significant relationships were found between faculty perceptions of the environment's scholarly excellence, available resources, and student commitment and motivation and faculty productivity. Students consistently viewed the environment more positively when greater percentages of the faculty were at the associate, rather than the assistant, professor level. There was minimal relationship between faculty and student perceptions of the environment and alumni productivity. PMID- 3643608 TI - An instrument to measure coping responses in employed mothers: preliminary results. AB - The purpose of this study was to develop a survey instrument to measure coping responses in working mothers. Coping responses were defined as efforts to prevent, avoid, or control emotional distress. Based on interviews, literature review, and a survey of existing instruments, items were developed to measure these three functions of coping behaviors. The instrument was distributed to 133 married mothers who worked at least 15 hours per week outside the home; response rate was 93%. Nine subscales to measure coping responses in working mothers were identified. Alpha reliability coefficients for the subscales range from .65-.90. Construct validity of the subscales was investigated by examining specified relationships between subscale scores and role strain measures. All but one of the subscales were significantly correlated in the predicted direction with at least one of the role strain measures. The final instrument, the Coping Responses Inventory (CRI), is comprised of 59 Likert format items from which nine subscale scores can be calculated. Some aspects of the reliability and validity of this instrument have been investigated, but confirmation of the findings await further study. Potential uses of the CRI are as an instrument in survey research and as an exploratory tool in counseling interventions with employed women with children. PMID- 3643609 TI - The hale elderly: health behavior and its correlates. AB - The purposes of this study were to describe health behavior of the elderly and to explore the determinants and health consequences of that behavior, using survey data from 386 respondents (138 men, 248 women), 55 years of age and older. These elderly persons engaged in a wide variety of activities to protect their health, the most important of which were eating properly, obtaining adequate rest, and exercising. By multiple regression analysis, age, sex, socioeconomic status, and marital status explained only 7.2% of the variance in health protective behavior. Of those variables, sex had the greatest association with health protective behavior and age the least. Married men, but not married women, practiced more health behaviors than their unmarried counterparts. Health protective behavior was not related to overall health status, but was weakly related to perceived health. The lack of association between health protective behavior and health status is interpreted in terms of the nature of the population examined. PMID- 3643610 TI - Status of natural disaster victims' health and recovery 1 and 3 years later. AB - Bereaved, property loss, and control groups (N = 155) studied 11 months following the 1980 volcanic eruption of Mt. St. Helens were recontacted 35 months postdisaster to test the hypotheses that the greater the loss experienced, the higher the stress, and the poorer the health. In general, the hypotheses were supported. Even though mental distress decreased between the two data collection periods, the mental health of the bereaved group remained poorer than both the property loss and control groups. At 3 years postdisaster, only 4% of the study participants reported complete recovery from disaster loss. Findings are compared with those of other recent disasters and clinical and theoretical implications are discussed. PMID- 3643611 TI - Expansion exercises: modifying contracture of the augmented breast. AB - Capsular contracture, the condition wherein fibrous tissue encapsulates the implanted silastic gel prosthesis used in breast augmentation, remains the most frequent complication in surgical enlargement of the small breast. Since the condition is a natural, wound-healing response to an implanted foreign body, management of the problem must be geared to the modification of this response. Expansion exercises, manual manipulation of the affected breast tissue for controlling capsule formation, was evaluated. Results showed that subjects who did not use expansion exercises had a higher incidence of capsular contracture than the subjects who did. PMID- 3643612 TI - Self-care attitude changes of nursing students enrolled in a self-care curriculum -a longitudinal study. AB - The purpose of this 3-year longitudinal study was to determine if nursing students' self-care attitudes change after being socialized through a curriculum based on Orem's Self-Care Deficit Theory. The sample consisted of 40 baccalaureate nursing students and 71 general university students who served as a control group. Pretest-posttest design was used employing the Linn-Lewis Self Care Attitude Scale. On initial testing, nursing students had more positive attitudes toward self-care than the general university students, but the results were not significant. At the completion of the nursing curriculum, analysis of covariance on posttest mean scores indicated nursing students had significantly higher self-care scores (p less than .001). PMID- 3643613 TI - [A concept of antibiotic prevention in orthopedic surgery. Methodology and results based on 6 years' experience]. PMID- 3643614 TI - Health beliefs and compliance with a skin care regimen. PMID- 3643615 TI - Dermal ulcers: simplifying a complex problem. PMID- 3643616 TI - A program design to reduce chronic readmissions for pressure sores. PMID- 3643617 TI - Prediction of marital adjustment among spinal cord injured persons. PMID- 3643618 TI - Mock Harvey teams: an approach to clinical experience. PMID- 3643619 TI - Wellness: a theme for an elective course in rehabilitation nursing. PMID- 3643620 TI - A conceptual schema for the study of the etiology of pressure sores. PMID- 3643621 TI - Comparison of five methods of analyzing respiratory pressure-volume curves. AB - Five methods of analyzing the deflation limb of respiratory pressure-volume (PV) curves obtained from seven groups of rats that had undergone various treatments were compared. The five methods utilized measurements of: y intercept and slope with simple exponential curve fitting; area under the curve; volumes at fixed pressures; shape constant, k, of the sigmoid curve described by Paiva et al. (Respir. Physiol. 23:317, 1975); and quasi-static compliance. The seven groups of rats were treated as follows: control (n = 10); high tar/nicotine cigarette smoke exposure (n = 10); low tar/nicotine cigarette smoke exposure (n = 9); intratracheal elastase (n = 10); intratracheal elastase plus sham smoke exposure (n = 10); intratracheal elastase plus high tar/nicotine cigarette smoke exposure (n = 9); and intratracheal elastase plus low tar/nicotine cigarette smoke exposure (n = 10). Elastase treatment caused a leftward and upward shift of the PV curve and this shift was augmented by exposure to either high tar/nicotine or low tar/nicotine cigarette smoke. Using Duncan's multiple range test, we found that the y-intercept measurement of method 1, the area under the curve, volumes at fixed pressures, and quasi-static compliance methods were better able to differentiate PV curves between groups than were the slope measurement of method 1 and the shape constant measurement of method 4. PMID- 3643622 TI - [Controlled emptying in ostomized patients]. PMID- 3643624 TI - [Economy, politics and health administration]. PMID- 3643623 TI - [Sugar and the sugars]. PMID- 3643625 TI - [Anti-ulcer matresses]. PMID- 3643626 TI - [Continuing education, 10. Field: Nursing technology. Theme: Administration of medication via oral and intravenous route]. PMID- 3643628 TI - [Professional organization in nursing, its leadership]. PMID- 3643627 TI - [The hospital: 2 separate viewpoints for 30 years]. PMID- 3643629 TI - [Research, a tool for the forging of a profession]. PMID- 3643630 TI - [Sociology, concern for nursing and health]. PMID- 3643631 TI - [Nursing in the university 10 years from now]. PMID- 3643633 TI - [Nursing consultations in primary care]. PMID- 3643632 TI - [Why are we nurses different to you?]. PMID- 3643634 TI - A care plan to nurse your unit back to health. PMID- 3643635 TI - How you can ease a family's grief. PMID- 3643636 TI - Why don't they pay us what we're really worth? PMID- 3643637 TI - Correcting electrolyte imbalance (continuing education credit). PMID- 3643638 TI - Testicular cancer: the worst disease at the worst time. PMID- 3643639 TI - Why sickness can be a laughing matter. PMID- 3643640 TI - No cause, no cure--but he's still in pain. PMID- 3643641 TI - Troubleshooting pulmonary artery catheters. PMID- 3643642 TI - Which weight-loss diet really works? PMID- 3643643 TI - Making your patient safe at home. PMID- 3643644 TI - Do psych patients really need those drugs? PMID- 3643645 TI - Access to legal counsel. PMID- 3643646 TI - Leadership at the bedside. PMID- 3643647 TI - The effect of some thymic extracts on antibody formation in rats and mice. AB - The influence of some thymic extracts TP1 and TP2 on the number of hemolytic plaque-forming cells (PFC) in the mouse spleen, on the titre of serum antibodies, S-typhy antiflagelar agglutinins and anti-influenza antibodies, was investigated. The results have shown that the hemolytic plaque-forming cells in the mouse spleen increase significantly, 2.3 times under the influence of the TP2 thymic extract in RAP mice inoculated with sheep red cells. In Wistar rats, inoculated with a formol-inactivated suspension of S. typhy and treated with TP2, the antibody titre increases 3.3 times at most. The increase is in relation to the dose of extract and the thymus batch from which the extract was prepared. TP1 also stimulates serum antibody formation in Wistar rats inoculated with A2 influenza vaccine. The antiinfluenza antibody titre increases 2.7 times under the influence of the thymic extract. The results also depend on the dose of extract and the thymus batch. In irradiated animals, the thymic extract had a protective effect. X-ray exposure of Wistar rats caused a 2.5 times decrease in the antiinfluenza antibodies titre. Under the influence of the TP1 thymus extract, the antibody titre increases 2.9 times as against the irradiated controls. PMID- 3643648 TI - The effectiveness of a short perioperative course with pivampicillin/pivmecillinam in transurethral prostatic resection: bacteriological results. AB - We analysed the bacteriological findings in 261 patients undergoing transurethral prostatic resection (TUR) and receiving either an oral course of pivampicillin/pivmecillinam (PAPM) or parenteral cefotaxime (CFT) in a randomized clinical trial. 123/261 patients had bacteriuria before TUR; 80% of the bacteria were gram-negative strains and 20% gram-positive. 88% of the strains were sensitive to PAPM and 93% to CFT but only 58% to ampicillin. The sensitivity of recurring bacteria was not influenced by the short course of PAPM or CFT. The faecal flora was influenced by the treatment with PAPM in terms of growth of Pseudomonas aeruginosa and fungi in some patients, but no resistant strains of Enterobacteriaceae were observed. The peak serum concentrations of ampicillin and mecillinam were obtained 2 hours after intake of the drug and were 4.5 micrograms/ml and 1.7 micrograms/ml respectively. The prostate tissue concentration of ampicillin and mecillinam (AM) was low. PMID- 3643649 TI - New database for AIDS research. PMID- 3643650 TI - Isolation of a T-lymphotropic virus from domestic cats with an immunodeficiency like syndrome. AB - A highly T-lymphotropic virus was isolated from cats in a cattery in which all the animals were seronegative for feline leukemia virus. A number of cats in one pen had died and several had an immunodeficiency-like syndrome. Only 1 of 18 normal cats in the cattery showed serologic evidence of infection with this new virus, whereas 10 of 25 cats with signs of ill health were seropositive for the virus. Tentatively designated feline T-lymphotropic lentivirus, this new feline retrovirus appears to be antigenically distinct from human immunodeficiency virus. There is no evidence for cat-to-human transmission of the agent. Kittens experimentally infected by way of blood or plasma from naturally infected animals developed generalized lymphadenopathy several weeks later, became transiently febrile and leukopenic, and continued to show a generalized lymphadenopathy 5 months after infection. PMID- 3643651 TI - An experimental study on prevention of postlaminectomy scar formation by the use of new materials. AB - An experimental study was performed to investigate the prevention of scar formation after lumbar laminectomy, using Elastase and the new polylactic acid (PLA) membrane containing Elastase. The experimental animals consisted of four groups: control group, E group (using intravenous administration of Elastase), P group (covering the laminectomy defect with PLA membrane), and P-E group (covering the laminectomy defect with "PLA" + Elastase" membrane). The animals were killed at varying intervals (2-12 weeks) and changes in the lumbar spines were evaluated histologically. Scar formation was suppressed most significantly in the P-E group, followed in order by the E group, the P group, and the controls. PMID- 3643652 TI - [Claforan]. PMID- 3643653 TI - [Peritoneal dialysis at home]. PMID- 3643654 TI - [Plasma exchange. Technological aspects, complications and indications]. PMID- 3643655 TI - [The nurses role in plasma exchange]. PMID- 3643657 TI - [Pediatric nephrology, medical specialty]. PMID- 3643656 TI - [Nutrition and renal insufficiency]. PMID- 3643658 TI - [Technic and supervision of hemodialysis in a child]. PMID- 3643659 TI - [Peritoneal dialysis]. PMID- 3643660 TI - Nursing's role: the prevention & treatment of osteoporosis. Shatter those myths with osteoporosis facts. PMID- 3643661 TI - Nursing's role: the prevention and treatment of osteoporosis. Setting up an osteoporosis center: nurse involvement. PMID- 3643662 TI - Nursing's role: the prevention and treatment of osteoporosis. How to do a bone assessment. PMID- 3643663 TI - Direct analysis of plasma fibrinogen-derived fibrinopeptides by high performance liquid chromatography: investigation of A alpha-chain N-terminal heterogeneity. AB - Fibrinopeptide A (FPA), released from the fibrinogen A alpha-chain by thrombin, can be resolved by high-performance liquid chromatography (HPLC) into three forms, the intact peptide (A), a modified peptide phosphorylated at the serine in position 3 (AP), and an N-terminally degraded form (AY). A new method has been developed, using HPLC, that allows direct measurement of the proportions of AP, A, and AY released by thrombin from fibrinogen in plasma samples of 200 ul or less. The method was used to examine variations in the proportions of AP and AY expressed as a % of total FPA in a number of patient and control groups. The mean percentages of AP and AY of plasma fibrinogen were found to be 21.7 and 14.2%, respectively, in normal laboratory controls. In older, apparently normal, individuals these figures were 27.0 and 15.5%, respectively. Cord plasma exhibited very high AP and slightly reduced AY levels (41.6 and 12.4%, respectively) compared with normal adults. Patients with liver failure had low AP levels and high AY levels (11.6 and 21.1%, respectively). Patients recovering from major surgery or acute thrombotic stroke showed an acute-phase rise in fibrinogen level that was accompanied by an increase in AP and variable reduction in AY. Incubation of heparinized whole blood for 8 days in vitro demonstrated a gradual decrease in the proportion of AP and increase in AY of plasma fibrinogen. These results provide some support for the idea that an increased "aging" of fibrinogen in the circulation may result in a decrease in the AP content of fibrinogen accompanied by a more variable increase in AY. PMID- 3643664 TI - Advancements in internal surgical stapling. PMID- 3643665 TI - Nurse anesthesia: patient-centered nursing. PMID- 3643666 TI - The OR then and now: a personal perspective. PMID- 3643667 TI - Stages of successful litigation (Part 3). PMID- 3643668 TI - Controlling smoke evacuation and odor during laser surgery. PMID- 3643669 TI - Informed consent: an ethical dilemma. PMID- 3643670 TI - The nurse in court. PMID- 3643671 TI - Creative image building for nurse managers. PMID- 3643673 TI - Individual retirement accounts. PMID- 3643672 TI - Seven steps from idea to print. PMID- 3643674 TI - Use of multiple immunoassay systems to determine antibodies directed against the human immunodeficiency virus. PMID- 3643675 TI - Safety of immunoglobulin preparations with respect to transmission of human immunodeficiency virus. PMID- 3643676 TI - HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus. PMID- 3643677 TI - Hepatitis B core antibody (anti-HBc) in blood donors in the United States: implications for surrogate testing programs. AB - In order to evaluate the operational implications of excluding donated blood with antibody to hepatitis B core antigen (anti-HBc), the American Red Cross tested 107,473 voluntary blood donations for anti-HBc in 72 test sites during a 1-week period. The system-wide prevalence of anti-HBc was 2.60 percent, with a range of 0.55 to 6.38 percent, depending on geographic region. For the American Red Cross, which collects approximately one-half of the blood supply in the United States, excluding donated blood with anti-HBc would result in a loss of approximately 159,500 units during the first year. PMID- 3643678 TI - Fine structure of human immunodeficiency virus (HIV) and immunolocalization of structural proteins. AB - Ultrathin section and surface replica electron microscopy were applied in combination with immunoelectron microscopy to elucidate the fine structure of HIV. The shell of the tubular core shows p24 antigenicity, while p17 is located at the inner leaflet of the lipid membrane. The virus particle is studded with 70 80 protrusions. These knobs have a diameter of 15 nm, a height of 9 nm, and are probably arranged in a T = 7 I symmetry. The major envelope protein gp120 is spontaneously shed from the viral surface. A possible role of released gp120 in pathogenesis is discussed. PMID- 3643679 TI - Thermal inactivation of human immunodeficiency virus in lyophilised blood products evaluated by ID50 titrations. AB - Inactivation of human immunodeficiency virus (HIV) in lyophilised small pool cryoprecipitate, factor VIII concentrate, prothrombin complex and C1-esterase inhibitor concentrate by prolonged heat treatment (72 h, 60 degrees C) was studied. Plasma products, inoculated prior to lyophilisation, had infectious titres ranging from 10(7) to 10(10.5). Residual infectivity (TCID50) was assessed by multiple titrations on H9 cells in a macro system and subsequent detection of virus replication by determining reverse transcriptase activity. Kinetics of inactivation showed a biphasic pattern: during the first 8 h a variable TCID50 reduction up to 10(4.3) was observed, followed by an additional loss of 10(1) 10(2.7) during the next 64 h. Heat treatment for 72 h resulted in a mean TCID50 reduction of 10(5). It is concluded that prolonged heat treatment may lead to the adequate prevention of HIV transmission by lyophilised plasma products. PMID- 3643680 TI - Conceptual models of nursing, nursing diagnosis, and nursing theory development. PMID- 3643681 TI - Competencies and skills required by nurses working in forensic areas. PMID- 3643682 TI - Clinical specialty preparation and nurses' interpretation of client situations. PMID- 3643683 TI - Transcultural Nursing Council Award. Ethnicity--an important factor for nurses to consider in caring for hypertensive individuals. PMID- 3643684 TI - Ethical issue in nursing research. A shorter catechism for nursing. PMID- 3643685 TI - Exploratory data analysis--introduction. PMID- 3643686 TI - Research in cultural diversity. Unidimensional measures of ethnicity. PMID- 3643687 TI - Strategies for teaching nursing research. Integration of research in a graduate clinical course. PMID- 3643688 TI - Computer use and nursing research. Interfacing microcomputers and nursing research--II. Dissemination of research findings and project management. PMID- 3643689 TI - [Possibilities of vaccine prevention and virostatic therapy in HTLV-III/LAV infection]. PMID- 3643690 TI - Aged maltreatment: a definition dilemma. PMID- 3643691 TI - Self-care for the side effects in cancer chemotherapy and radiation therapy: interview--Dr. Marylin Dodd. Interview by Eve Henderson. PMID- 3643693 TI - Without trust there can be no communication. PMID- 3643692 TI - Problems, approaches and priorities in oncology nursing research. PMID- 3643694 TI - Nursing distance education in Alberta: a preliminary history. Part 2 of 2. PMID- 3643695 TI - Canadian Nurses Association: collaboration between nurse educators in the use of nursing education resources for the year 2000. Part II (of II). PMID- 3643696 TI - The covering letter in the job search process. PMID- 3643698 TI - Kinins IV. Part A. Proceedings of the Fourth International Kinin Congress. October 21-25, 1984, Savannah, Georgia. PMID- 3643697 TI - Alkylating antitumor agents reduce histone acetyl-transferase activity. AB - N-Mustard depresses the acetylation of histones in Ehrlich ascites and Walker carcinoma cells. It is demonstrated that this effect is not caused by an accelerated deacetylation but is due to an inhibition of the acetyl-transferase reaction. Employing 4-sulphonatoethylthio-cyclophosphamide it is demonstrated that the alkylating agent affects predominantly the acetylation of a chromatin fraction which is soluble in 0.1M NaCl after digestion with micrococcal nuclease. After removal of the alkylating agent, the recovery of histone acetylation is relatively slow and--in contrast to the repair of DNA cross-links--characterized by a 4-hr lag period. The reduction of histone acetylation by N-mustard is much less expressed in cells which are resistant to the drug than in the sensitive parental lines. This is in contrast to DNA-interstrand cross-links in Walker cells where both N-mustard sensitive and resistant cells inhibit the same cross link frequency and identical repair rates. Based on these data it is concluded that the inhibition of histone acetylation may be an important part of the mechanism by which alkylating agents inhibit tumor growth. PMID- 3643699 TI - The varied localization and functional significance of kallikrein-like enzymes in salivary glands, pancreas, colon, sex glands and spermatozoa, including evidence for the presence of nerve growth factor (NGF) in bull sperm acrosome. PMID- 3643700 TI - Kininogenase from rat vascular tissue. AB - A kininogenase resembling glandular kallikrein was partially purified from vascular tissue and characterized. Saline perfused rat tail arteries and veins were homogenized in 0.25 M sucrose containing 10 mM Tris-HCl (pH 7.4). The homogenate was centrifuged at 105,000 X g for 60 min and a vascular kininogenase was purified from the supernatant by chromatofocusing, affinity chromatography on immobilized antibodies against rat urinary kallikrein, and gel filtration on Sephadex G-100. The inhibitory effects of antibodies against rat urinary kallikrein were tested using equivalent kinin-forming concentrations of rat urinary kallikrein and vascular kininogenase. Kininogenase activities of both enzymes were similarly inhibited by urinary kallikrein antibodies. Aprotinin (1,000 KIU) completely inhibited vascular kininogenase activity while soybean trypsin inhibitor (100 micrograms) did not modify its kinin-forming activity. Vascular kininogenase and rat urinary kallikrein had the same elution volume when chromatographed on a Sephadex G-100 column and had similar mobilities in 10% polyacrylamide gel electrophoresis. Kinins released by vascular kininogenase were identified as bradykinin by reverse-phase high performance liquid chromatography. Rat vascular kininogenase appears to be similar to glandular kallikrein. Kinins released locally by vascular kininogenase may contribute to the regulation of vascular tone. PMID- 3643701 TI - Hydrolysis of rat high molecular weight kininogen by purified rat urinary kallikrein: identification of bradykinin as the kinin formed. AB - We have previously reported that, although human urinary kallikrein, like glandular kallikreins for other species, releases lysyl-bradykinin from homologous and heterologous substrates, rat urinary kallikrein released a kinin which migrated like bradykinin in CM-cellulose chromatography and polyacrylamide gel electrophoresis (BBA677, 471, 1981). In the study we definitively established the nature of the kinin produced by rat urinary kallikrein by using purified enzyme and substrate, HPLC, radioimmunoassay and N-terminal analysis. Rat urinary kallikrein was purified to apparent homogeneity by a procedure which included affinity chromatography on aprotinin agarose. The kinin produced by rat urinary kallikrein acting on either pure rat high molecular weight kininogen or rat plasma or semipurified bovine and dog plasma was identified as bradykinin. This observation provides the evidence of species differences in the specificity of glandular kallikreins acting on kininogens. PMID- 3643702 TI - Hemodynamics of the isolated perfused rat kidney in the absence and presence of kallikrein substrate. AB - Rat kidneys were isolated and perfused for 120 minutes at 80 mm Hg with Krebs Henseleit buffer containing 7 gm% bovine albumin fraction V. Analysis of the bovine albumin revealed the presence of a contaminating kallikrein substrate which exhibited a MW of 55,000 upon gel-filtration on Sephadex G-200, similar to the reported MW of bovine low molecular weight kininogen. The mean values for renal perfusate flow rate (RPF) and glomerular filtration rate (GFR) in kidneys perfused with this bovine albumin depleted of the kallikrein substrate were significantly lower when compared to standard perfusions. In two other groups of isolated kidneys perfused with kallikrein substrate depleted bovine albumin, purified bovine low molecular weight kininogen (bLMWK, 8.5 micrograms protein in 50 microliters per minute) or synthetic bradykinin (Bk, 1 ng in 10 microliters per minute) were infused after the first 30 minute clearance period into the renal artery. The induced hemodynamic changes were similar in that RPF and GFR significantly increased. These studies show that depletion of bovine albumin from kallikrein substrate results in a concomitant decrease of RPF and GFR, while overall renal function is unaffected. Infusion of both bLMWK or BK to kallikrein substrate depleted bovine albumin has similar effects resulting in a simultaneous increase in RPF and GFR. This suggests that endogenous kallikrein from the perfused kidney releases kinin from infused bLMWK and indicates that kinin primarily affects the afferent arterioles. PMID- 3643703 TI - Characterization of rat kallikrein-like multigene family and its expression in the submandibular gland. AB - A cDNA clone encoding rat tissue kallikrein was isolated from a submandibular cDNA library. The kallikrein cDNA clone was used as a probe to analyze the complexity of the kallikrein-like gene family and its expression. The results indicate that rat kallikrein-like genes identified with this probe belong to a very large and highly homologous multigene family. A number of these genes, perhaps as many as a dozen or so, are expressed in the submandibular gland. PMID- 3643704 TI - Intracellular and intercellular distributions of acid kininogenases in spleen. AB - Intracellular distributions of acid kininogenases were investigated following the subcellular fractionation of bovine and rat spleens. Acid kininogenases as well as other acid hydrolases were observed to be distributed in several fractions. Relatively high kinin forming activity was found in two fractions which were considered to contain lysosomes from reticulum cells and from lymphocytes respectively. The latter fraction had shown the higher sensitivity to thiol compound for its activation. These findings led us to the separation of the free cells existing in spleen each other. We adopted the techniques such as Ficoll Isopaque centrifugation, plastic dish treatment and iron carbonyl treatment for this purpose. Lymphocyte from rat thymus was also examined and proved to have acid kininogenase activity as well. PMID- 3643705 TI - Processing of apolipoprotein B-100 of human plasma low density lipoproteins by tissue and plasma kallikreins. AB - Human plasma low density lipoproteins (LDL) are the major carriers of cholesterol and cholesteryl esters in the circulation. Their increased levels correlate positively with increased risk of coronary artery disease. LDL contain a single major apolipoprotein of apparent molecular weight (Mr) = 550,000, designated apolipoprotein B-100 (apoB-100), and in some LDL preparations, minor components termed apoB-74 (410,000) and apoB-26 (145,000). The structural relationship of the apoB-74 and -26 proteins to the apoB-100 has remained obscure and their roles in cholesterol metabolism are unknown. In the present study, we show that the addition of kaolin to plasma anticoagulated with EDTA induces the proteolytic cleavage of apoB-100. As a result, two apoB peptides are produced with Mr indistinguishable from plasma apoB-74 and -26. The specific cleavage of apoB-100 was mimicked in vitro by purified human plasma and tissue kallikreins. In contrast, thrombin, factor Xa, plasmin, trypsin, and chymotrypsin did not produce these peptides when incubated with LDL. The findings of the study suggest that apoB-74 and -26 are proteolytic fragments of apoB-100 and that the endogenous protease has a kallikrein-like specificity for DLD-apoB-100. The role of plasma and tissue kallikreins in cholesterol metabolism remains to be determined. PMID- 3643706 TI - Transporting epithelia as targets for kinin effects. PMID- 3643707 TI - Purification and partial characterization of cat colon and submandibular gland kallikreins. AB - Kallikreins from cat colon and submandibular gland have been purified by acetone fractionation of tissue extracts, DEAE-Sephacel ion-exchange chromatography, rho aminobenzamidine Sepharose 4B affinity chromatography and gel filtration on Sephadex G-75. They were of similar M.W., approximately 40,000, and each comprised five forms by isoelectric-focusing (pI 4.1-4.8). Both enzymes were potent kininogenases and exhibited similar specificities with synthetic ester and amide substrates. They were susceptible to a range of protease inhibitors. Surprisingly, neither was sensitive to aprotinin yet both were partially inhibited by soya-bean trypsin inhibitor. They were indistinguishable in our immunological tests. An acidic esterase (pI 2.2-3.5) of M.W. 120,000 was isolated from cat stomach by the same procedure. While it exhibited weak immunologic similarity to cat submandibular gland kallikrein, it had negligible kininogenase activity and different substrate and inhibitor specificities to the two kallikreins. It is concluded that similar tissue kallikreins are present in the colon and submandibular gland of the cat but are distinct from this cat stomach esterase. PMID- 3643708 TI - The liver is the main organ to clear plasma and tissue kallikreins from rat plasma, in vivo. AB - We report observations regarding the in vivo distribution of labelled kallikreins in plasma, liver and some other organs, twenty minutes following their intravenous injection in the rat. The kallikreins used were: tritiated homogeneous human plasma (HuPK) and horse urinary (HoUK) as well as highly purified iodinated rat plasma kallikrein (RPK). The main findings were: the liver cleared 15% of HuPK, 38% of RPK and 69% HoUK; with both types (plasma and tissue) of native kallikreins the liver was the main clearing organ. PMID- 3643709 TI - Receptor-mediated clearance of tissue kallikreins by rat liver. AB - The exsanguinated, isolated and perfused rat liver clears from the perfusate, at comparable rates, some native tissue kallikreins: human and horse urinary as well as hog pancreatic; the clearance rates were dependent on the initial enzyme concentration in the perfusing fluid. Contrary-wise, rat urinary kallikrein was cleared at negligible rates. Neuraminidase pretreatment of these four kallikreins did not alter their clearance rates. Horse urinary kallikrein binding to isolated prefixed hepatocytes was calcium-dependent and inhibited by asialofetuin (but not by fetuin) and some sugars; these characteristics are compatible with the interpretation that this native tissue kallikrein is recognized by the hepatocyte asialoglycoprotein-receptor. It was calculated that there are about 300,000 receptor sites per cell either using perfusion experiments at 4 degrees C or isolated hepatocytes. PMID- 3643710 TI - Tissue kallikreins and related enzymes: characterization by model oligopeptides. AB - The first purpose of this work was to obtain direct evidence that tissue kallikreins cleave arginyl bonds when the leaving group is Arg-Val, and on the contrary, do not split them when it is Arg-Pro; the second aim was to ascertain whether this specificity could be used as a criterion, for characterizing tissue kallikreins. Two tetrapeptides Ac-Phe-Arg-Arg-Val-NH2 and Ac-Phe-Arg-Arg-Pro-NH2 were synthesized by the solid phase method and purified to homogeneity. They were used as substrates for homogeneous preparations of tissue and plasma kallikreins, as well as for some related serine proteases. Products identification and kinetic analyses were made by HPLC. PMID- 3643711 TI - Effect of sodium restriction and corticosteroids on glandular kallikrein in plasma and in the submandibular gland. AB - We investigated whether sodium restriction or mineralocorticoid influence the release of submandibular kallikrein into the blood and/or the concentration of kallikrein in glandular tissue. For this we measured submandibular gland blood flow, arterial and submandibular gland venous kallikrein, and kallikrein in glandular homogenates of male Sprague-Dawley rats after one week of either low sodium or deoxycorticosterone acetate (DOCA) treatment. We also studied the effect of dexamethasone on the concentration of kallikrein in gland tissue and peripheral plasma. Kallikrein in plasma and in homogenates was measured by radioimmunoassay. Blood flow was determined by timed collections of venous outflow. Kallikrein release was calculated as the arteriovenous difference in kallikrein times the rate of submandibular gland plasma flow. The concentration of kallikrein in arterial plasma, the basal submandibular kallikrein release into blood, and the concentration of kallikrein in submandibular gland tissue were all higher during low sodium than during normal sodium intake (20.1 +/- 3.6 ng/ml vs 10.7 +/- 0.5, p less than 0.05; 0.40 +/- 0.09 ng/min/100 g bw vs 0.18 +/- 0.02, p less than 0.05, and 81.6 +/- 5.5 micrograms/mg protein vs 65.1 +/- 4.0, p less than 0.05, respectively). In contrast, DOCA treatment did not affect the concentration of kallikrein in arterial plasma, the basal release of kallikrein from the submandibular gland into blood, or the concentration of kallikrein in the gland. Dexamethasone in doses that did not affect the normal growth of the animals had no significant effect on the concentration of kallikrein either in submandibular gland tissue or in peripheral plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3643712 TI - Individual reaction steps in the release of kallidin from kininogen by tissue kallikrein. AB - At low pH values (around 6), porcine pancreatic beta-kallikrein B attacks at first the C-terminal ARg bond of the kinin moiety in bovine HMW kininogen. Arg cleaved kininogen accumulates as an intermediate in the solution. Kallidin is released by cleavage of the aminoterminal Met-Lys bond in a second step. At pH values between 7.6 and 9, however, Arg-cleaved kininogen does not occur as a free intermediate. The participation as a (free, not only enzyme-bound) intermediate of Arg-cleaved kininogen in a short-lived especially reactive conformation or of Met-cleaved kininogen is also unlikely. Probably, both the Met and the Arg bonds are hydrolyzed in one enzyme-substrate complex which does not dissociate between these two events. Kinetic constants for the release of kallidin from native single-chain HMW kininogen and from Arg-cleaved kininogen (even if this Arg residue is removed) remarkably have the same values. Evidently, the rate of the reaction is determined by steps leading to the hydrolysis of the Met bond. As the state of the C-terminal Arg residue has no influence, the efficient cleavage of the Met bond by tissue kallikrein is probably not due to some strain in the kininogen molecule in the region of this bond. As modification of Arg residues of kininogen prevents cleavage also of the Met bond, some Arg residue(s) appear(s) to play a crucial role in this process. kcat/Km (1.4 x 10(6) M-1 sex-1 at pH 9, 25 degrees C) is very high for a proteolytic reaction, mainly because of the low value of Km (0.6 microM).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3643713 TI - The tissue kallikrein-kinin system in human seminal plasma--biochemical and functional aspects. AB - At least three species of tissue kallikrein-like antigens are present in human seminal plasma which differ in their molecular masses and enzymatic activities. At least one of these species is a genuine tissue kallikrein as judged by the criteria of molecular mass, immunoreactivity, inhibition by aprotinin and non inhibition by soybean trypsin inhibitor, and the ability to release kallidin from kininogen. The prostatic gland was identified as the origin of the seminal fluid tissue kallikrein first by indirect studies and then by demonstrating the presence of immunoreactive tissue kallikrein both in prostatic tissue and secretion. PMID- 3643714 TI - Plasma half-life and organ uptake ratio of radiolabeled glandular kallikrein in control and nephrectomized rats. AB - The purified rat urinary kallikrein was radiolabeled by lactoperoxidase method and by chloramine T method. Plasma half-life of radiolabeled kallikrein was 5.06 +/- 0.59 (n = 5) min in control rats and 5.24 +/- 0.42 (n = 5) min in nephrectomized rats. There was no difference between two groups. From autoradiogram, main metabolic organs of radiolabeled kallikrein were liver, kidney and spleen. Total uptake of radiolabeled kallikrein in ech organ was the highest in liver (73.2%). The uptake per g tissue of radiolabeled kallikrein in each organ was high in liver (33.0%), kidney (31.4%) and spleen (21.1%). These results suggest that the active kallikrein is metabolized mainly in the liver, and kidney is not so an important organ to metabolize or to eliminate the active kallikrein in plasma. In order to clarify the mode of existence of active kallikrein in plasma, the following experiment was done by using disc gel electrophoresis. Radioactive profile of radiolabeled kallikrein showed one peak (Rf = 1.0), but radiolabeled kallikrein mixed with rat plasma showed two peaks, that is small peak (Rf = 1.0), and main peak (RF = 0.5). The most of radiolabeled kallikrein was bound to plasma protein and only five per cent was in free form. Furthermore, the binding of radiolabeled kallikrein to plasma protein was interfered by the addition of active kallikrein. These results suggest the possibility of existence of kallikrein binding protein in plasma. PMID- 3643715 TI - A comparative study of prokallikreins and kallikreins from rat pancreatic tissue and juice. AB - Two zymogens, designated prokallikreins A and B, were isolated from homogenates of rat pancreatic tissue. The two forms of prokallikrein were found to be very similar in size and charge properties. They gave rise to very similar kallikreins on activation with exogenous trypsin. Differences in carbohydrate content of the two zymogens were probably responsible for differences seen in their behaviour on ion-exchange chromatography and immunoelectrophoresis. In contrast, only one form of prokallikrein was isolated from rat pancreatic juice. It showed almost identical behaviour on ion-exchange chromatography and identical mobility on electrophoresis to prokallikrein A. Thus it can be tentatively suggested that it is prokallikrein A which is secreted into the pancreatic juice and represents the physiologically important zymogen. PMID- 3643716 TI - Analytical study of kallikrein and kallikrein-like esterase activity in subfractions from rat kidney cortex microsomes and isolated subcellular membranes. AB - Heavy and light microsomal fractions were subfractioned using high performance zonal rotors, and assayed for apoprotenin sensitive kallikrein-like amidolytic activity (pH 8.2). The activity profiles for the various substrates assayed show rather complex distribution pattern demonstrating kallikrein-like amidolytic activity in plasma membranes, basolateral membranes, rough endoplasmic reticulum and membranes derived from the Golgi complex. PMID- 3643717 TI - Endogenous kallikrein inhibitor in rat kidney cortex-effect of glucocorticoid administration. AB - Kallikrein inhibiting proteins with two different molecular weight (6-8 X 10(4), 8-9 X 10(4) respectively) were observed in adrenalectomized rat kidney cortical soluble fraction. The larger one was observed in the kidneys of the adrenalectomized rats only when they had received chronic administration of excess amount of dexamethasone, and its kallikrein inhibitory activity was not lost with treatment with trypsin. This protein appears to be induced by chronic administration of glucocorticoid and might participate in the process of glucocorticoid regulating renal kallikrein kinin system. PMID- 3643718 TI - Bile acids and the intestinal kallikrein-kinin system. AB - We have measured concentrations of tissue kallikrein-like amidase (TKLA) in blood free rat gastrointestinal tissue. TKLA was present in the gut wall from the stomach to the rectum with concentration peaks in the duodenum and caecum. When rats, fasted for 24 hr were compared with normally fed animals, the mean fasted TKLA levels rose significantly in the duodenum and proximal and distal colons and fell in the caecum. No other tissues showed concentration changes. Sodium chenodeoxycholate and other bile acids have biological actions on the rat intestinal wall which are similar to those produced by the kallikrein-kinin system. We have previously reported that bile acids released TKLA from the rat colon wall. This TKLA was totally inhibited by aprotinin. We now report that intraluminal sodium chenodeoxycholate (30 mM) increases both colonic motility and colonic mucosal leakage. These increases are largely blocked by aprotinin. The ability of intraluminal sodium taurochenodeoxycholate to increase vascular leakage in the rat stomach and colon was parallelled by its ability to release TKLA from these issues. Our results are compatible with the mediation of these biological actions of the tested bile acids via activation of a serine proteinase, possibly tissue kallikrein. PMID- 3643719 TI - Amino acid sequence of the light chain of human high molecular mass kininogen. AB - The light chain of human high molecular mass kininogen consists of 255 amino acid residues. The half-cystine residue which forms the single disulfide bridge to the heavy chain is located in position 225. The light chain contains 9 O glycosidically linked carbohydrate side chains. A comparison of the human high molecular mass kininogen light chain with the bovine high molecular mass kininogen light chain reveals a pronounced homology. However, in position 88 of the human sequence an insertion of 22 amino acid residues was found. This insertion and an amino acid exchange in position 131 may explain the different behaviour of human and bovine high molecular mass kininogen during plasma kallikrein digestion. PMID- 3643720 TI - Limited proteolysis of HMW kininogen by plasma kallikrein in man--evidence for a processing mechanism different from the bovine system. AB - The limited proteolysis of human HMW kininogen by plasma kallikrein has been studied. Kallikrein liberated bradykinin from HMW kininogen (Mr 114 kDa) and generated a two-chain molecule with a heavy chain of Mr 63 kDa and a light chain of Mr 58 kDa interconnected via a single disulfide bridge. As proteolysis proceeded, a step-wise processing of the initially formed light chain occurred giving rise to modified light chains of Mr 45 and 41 kDa. Sequence analysis indicated that two polypeptides had been cleaved from the amino- and carboxy terminal parts of the 58 kDa light chain. Major part of the histidine-rich peptide which is critical to surface binding of HMW kininogen was kept in the shortened light chains. These findings are consistent with the observation that trimming of the human HMW kininogen does not abolish its procoagulant activity. By contrast, the bovine HMW kininogen is inactivated due to removal of the entire histidine-rich peptide. Hence, the proteolytic processing mechanisms for HMW kininogen are distinct in the human and the bovine contact phase activation systems. PMID- 3643721 TI - Regulation of the plasma-kallikrein-kininogen system. PMID- 3643722 TI - Kinins IV. Part B. Proceedings of the Fourth International Kinin Conference. October 21-25, 1984, Savannah, Georgia. PMID- 3643723 TI - The renal kallikrein-kinin system: a look at the controversies. PMID- 3643724 TI - Mechanism of urinary kallikrein excretion and its action on water excretion. AB - In male Wistar rats urinary kallikrein excretion was positively correlated with urinary flow and glomerular filtration rate and negatively with urinary osmolality and with TcH2O. The mechanism of urinary kallikrein excretion is interpreted as a wash-out effect of renal kallikrein. The renal kallikrein regulates the water excretion decreasing the reabsorption of water in the distal nephron. PMID- 3643725 TI - The two mechanisms involved in the control of urinary kallikrein excretion. AB - The relation between sodium and kallikrein excretion is biphasic. Increased kallikrein excretion is produced by increased arterial pressure or arterial infusion of vasodilators. It is antagonised by prostaglandin synthesis inhibition or by arterial noradrenaline infusion. Angiotensin in hypertensive doses increases kallikrein excretion and this effect is pressure dependent. Decreasing sodium intake, or producing natriuresis with diuretics, causes a rise in kallikrein excretion by stimulation of the renin/angiotensin/prostaglandin/kallikrein chain. It can be mimicked by infusing 50 micrograms/min of angiotensin II into one renal artery with a clamp to prevent elevation of renal arterial pressure. PMID- 3643726 TI - Urinary and plasma kallikrein-kinin system in ureteral obstruction in man. PMID- 3643727 TI - Change in cortical active kallikrein during the onset of Goldblatt hypertension in the rat. AB - In two-kidney, one clip hypertensive rats renal cortical kallikrein was studied one and two weeks following induction of the hypertension in comparison with sham time controls. Cortical active kallikrein was lower in hypertensive rats only at week 2, although blood pressure was significantly higher one week after clipping. Total cortical kallikrein was however never different in sham control and in hypertensive rats. This results provide evidence for a change in the activation of prekallikrein during the onset of Goldblatt hypertension. PMID- 3643728 TI - Urinary kallikrein activity in pregnant hypertensive rats. AB - Goldblatt one-kidney one-clip (G1K-1C) hypertensive rats were studied to determine the changes of blood pressure (BP) and urinary kallikrein (UK) excretion throughout pregnancy. Uninephrectomized rats (Unx) were used as controls. Both groups showed a significant decrease in BP on day 21 of pregnancy, although G1K-1C rats had higher values. UK activity was markedly stimulated in both groups, reaching its highest level on day 21. This increment in UK was due to greater delivery and/or synthesis of the enzyme, since no change was observed in the active fraction. We postulate that the highly activated kallikrein-kinin system might be contributing to the hypotensive effect of pregnancy. PMID- 3643729 TI - Kallikrein-kinin system in severe experimental hypertension. AB - Plasma levels of low and high molecular weight kininogens, prokallikrein and active kallikrein were determined in four models of experimental hypertension and in genetically hypertensive rats. The high molecular weight kininogen remained essentially unaltered in all groups, whereas the low molecular weight kininogen was decreased in the renovascular groups. In the glucocorticoid hypertensive rats low molecular weight kininogen increased, but rats with hypertension induced both by renovascular and glucocorticoid mechanisms had normal kininogen. Genetically hypertensive rats had levels of low molecular weight kininogen similar to the ones observed in control group. The data presented reinforce the hypothesis of a participation of the kallikrein-kinin system in the etiopathogenesis of hypertension, indicating an implication of the low molecular weight kininogen in some types of severe experimental hypertension. PMID- 3643731 TI - The method of urinary total kallikrein and prekallikrein measurement, and their urinary excretions in the patients with essential hypertension. AB - The method of measurement for urinary total kallikrein (KAL) and preKAL in human was developed, and daily excretions of urinary total KAL, KAL and preKAL were investigated in patients with essential hypertension. Forty microliter of urine samples were incubated with or without 120 micrograms of chymotrypsin-free trypsin for total KAL or KAL, respectively. KAL was measured with direct radioimmunoassay and kininogenase assay. PreKAL was calculated by the subtraction of KAL from total KAL. The subjects of this study included 7 normotensives (NT) and 8 essential hypertensives (EHT). Daily excretions of total KAL, KAL and preKAL were significantly lower in EHT than those in NT. KAL/total KAL ratio, which reflects the conversion rate from preKAL to KAL in the kidney, was not significantly different between EHT and NT. From these results, it is suggested that decreased urinary KAL excretion in EHT is mainly caused by reduced preKAL production rather than the impaired conversion from preKAL to KAL in the kidney. It is emphasized that this method of measurement for urinary total KAL and preKAL may be a very useful tool for research of the renal kallikrein-kinin system. PMID- 3643730 TI - The role of renal kallikrein-kinin system and prostaglandins in diuresis and natriuresis following saline infusion in normotensives and essential hypertensives. AB - In order to clarify the significance of the renal kallikrein(KAL)-kinin(KIN) system and prostaglandins (PG) in exaggerated natriuresis in essential hypertensives, the effect of acute sodium load on urinary KAL, KIN, PG, and renal water and sodium handling were investigated in normotensives (NT) and patients with essential hypertension (EHT). Nine NT and seven EHT were studied following acute physiological saline infusion (1000 ml/2 hrs). Urine volume (UV), urinary sodium excretion (UNaV), fractional excretion of sodium (FENa), and fractional excretion of inorganic phosphorus (FEP) were measured by the clearance method. Urinary KAL and KIN were determined by direct-RIA. Urinary kininase (total, I and II) activities were measured by the kinin destroying capacity. Urinary PGE was measured by RIA. Following saline infusion, UV, UNaV, FEP, KAL, KIN and PGE significantly increased in both NT and EHT. The increases of UV, UNaV, FENa, FEP and KAL were remarkably greater in EHT than each in NT, while no significant difference was found in the increment of PGE between NT and EHT. Significantly positive correlations were observed between PGE and KAL or KIN in NT (r = 0.889, p less than 0.005; r = 0.574, p less than 0.05, respectively), but not in EHT. From these results, it was concluded that the exaggerated natriuresis observed in EHT following infusion may be significantly related to the augmentation of renal KAL-KIN system, but was not directly related to PGE. PMID- 3643732 TI - A comparative study of the measurement of urinary kallikrein by various methods in patients with essential hypertension and patients with proteinuria. AB - In order to investigate the validity of urinary kallikrein (KAL) measurement, comparative studies were performed among the values obtained by various methods of urinary KAL measurements. Daily urine samples were collected from 37 hospitalized normal subjects (NS, 21 essential hypertensives without complications (EHT) and 20 patients with renal diseases associated with proteinuria (PU). Urinary KAL excretions were determined by direct radioimmunoassay (RIA), kininogenase assay (K-genase), TAMe esterase assay (TAMe), and PPA-MCA (MCA) and PPA-NE amidase assay (NE). By the desalting procedure, urinary KAL levels showed significant changes in TAMe, MCA and NE, but not in d-RIA and K-genase in all three groups. In TAMe, MCA and NE, the recovery of added KAL in urine was significantly lower in non-desalted samples in both EHT and PU, but not in NS. Impaired recovery and correlations between d-RIA or K genase and TAMe, MCA or NE in non-desalted samples were improved by desalting. Although good correlations were observed between d-RIA or K-genase and TAMe, MCA or NE in desalted samples, the slopes of curves were steeper in EHT and PU than in NS, suggesting that the synthetic substrate methods still have some problems in the KAL measurement in these pathological states, KAL inhibitor, aprotinin and gabezate mesilate did not suppress the esterclytic and amidolytic activities completely, but suppressed K-genase activity completely in PU urine samples, suggesting that certain kinds of non-KAL esterases might remain in PU urine samples. Thus, d-RIA and K-genase appear to be the most reliable methods in the measurement of urinary KAL quantity and activity, respectively. PMID- 3643733 TI - A study of glandular kallikrein in experimental diabetes. AB - Very high blood glucose concentrations were seen in rats one day after injection with alloxan or streptozotocin. Those levels fell (compared to day one, p less than 0.005) by the third day after injection and subsequently rose again during the ensuing days. In contrast, no significant differences between treated and control rats in concentrations of submandibular kallikrein were recorded until the tenth day after the initial injection. At that time the submandibular kallikrein concentrations in the alloxanized and streptozotocinized rats were less (p less than 0.01) than those of the untreated rats. A further fall (compared to day ten, p less than 0.005) took place over the next four days. Thus submandibular kallikrein would not seem to have been involved in the early stages of the experimental diabetes. In agreement with that conclusion were the results of a related series of experiments in which exogenous porcine pancreatic kallikrein was administered to alloxanized rats. The kallikrein did not bring about a reduction in the high blood glucose levels. PMID- 3643734 TI - A synovial amidase acting on tissue kallikrein-selective substrate in clinical and experimental arthritis. AB - Increased levels of amidase acting on a tissue-kallikrein selective substrate, Val.Leu.Arg.pNA, with an activity optimum at pH9, were detected in blood-free inflamed tissues from adjuvant arthritic rats (p less than 0.01). The component of this activity resistant to inhibition by soybean trypsin inhibitor (SBTI) also greatly increased (p less than 0.05). Both the SBTI-sensitive and SBTI-resistant components were inhibited by aprotinin (93% and 72% respectively). Kallikrein like amidase also increased in inflamed synovia from seropositive rheumatoid, and osteoarthritic dogs when compared with healthy canine synovia. This increase was parallelled by an increase in kinin-forming enzyme which was also measured in rheumatoid and healthy animals and this activity was inhibited 72% by aprotinin. Total kallikrein-like amidase also increased 989% (p less than 0.05) in synovia from seropositive rheumatoid human patients, compared with healthy synovial tissue. Evidence is presented indicating that the origin of this enzymic activity may be plasma kallikrein. PMID- 3643735 TI - Plasma prekallikrein, functional kallikrein inhibition, antithrombin III, plasminogen, kallikrein activity and proenzyme functional inhibition index in 172 acute ill surgical patients on admission. AB - The present study was performed in order to study disturbances in plasma proteolysis in acute ill surgical patients on admission. The paper describes the distribution of values for plasma PKK, KKI, AT III, Plg, KK and PFI-index. In early stages of the disease process rather minimal information can be obtained by these data in addition to clinical examination. The study indicates that chromogenic peptide substrate assays should be reserved for surgical patients treated in the intensive care unit. PMID- 3643736 TI - Kallikrein and kininase activities excretion in newborns affected by jaundice. AB - In a homogeneous group of 30 newborns, aging between 10 hours--10 days, and affected by jaundice, urinary kallikrein and kininase activities were determined. The variable considered were: sex, time of life, weight and gestational age. Urinary samples were taken at the beginning and at the end of phototherapy. PMID- 3643737 TI - Kallikrein and kininase excretion in football players after psychophysical stress. AB - In eleven football players and in four football-reserve players urinary kallikrein and kininase activities were determined before and after an official match. The results showed a significant reduction of kallikrein after the match in football players when the football-reserve players were used for comparison (p less than 0.01). Kininase activity appears increased in football players after the match, but not significantly. The Kininase/Kallikrein ratio after the match resulted significantly increased in football players (p less than 0.05) and very significantly compared to the football-reserve players (p less than 0.01). PMID- 3643738 TI - An improved method for the measurement of rat tissue kallikrein using a monoclonal antibody which recognizes only active enzyme. AB - We have used a monoclonal antibody which recognizes active kallikrein to develop a method for measurement of inactive and active kallikrein in rat urine. The inactive kallikrein levels were calculated from the difference between values before and after trypsin pretreatment in the kallikrein direct radioimmunoassay. In this assay, the final dilution of ascitic fluid containing monoclonal antibody was 1:1.6 X 10(7) which gave 35% specific binding to 125I-labelled kallikrein, and the minimal detectable amount was 0.08 ng/tube. When inactive kallikrein was assessed by this method and a kininogenase assay in 23 randomly collected urines, a significant correlation was observed between the values obtained from the two assays (p less than 0.01). The regression line for this relation was similar to that observed between purified active kallikrein concentration and kininogenase activity. The active and inactive kallikrein excretion rates and the inactive/total kallikrein ratio in rats on normal sodium diet were 74.0 +/- 17.3 micrograms/day (m +/- SD), 82.8 +/- 14.4 micrograms/day and 53.1 +/- 7.1%, respectively. This method can now be applied to studies of prokallikrein activation. PMID- 3643740 TI - Studies on synthetic peptide substrates for F XII enzymes. AB - Screening of chromogenic peptide substrates have shown that FXIIa readily splits substrates of D-Pro-Phe-Arg-pNA (S-2302) and -Gly-Arg-pNA (e.g. S-2222) types. The latter type is preferred in a system where kallikrein is present. By using the substrate S-2222 a method for the determination of beta FXIIa inhibitors has been designed. Chromatography data show that C1-esterase inhibitor is the major inhibitor of beta FXIIa in plasma. Preliminary studies have also been performed on the assay of FXII in human plasma. The procedure to obtain a complete activation of FXII has still to be studied. PMID- 3643739 TI - Purification of human low molecular weight kininogen and its application for a simple ND sensitive method for determination of human urinary kallikrein activity. AB - Human plasma low molecular weight kininogen was purified with ammonium sulfate fractionation, DEAE-cellulose, CM-Sephadex C-50 and aprotinin-agarose affinity column chromatography, after which this was further purified with Sephadex G-150 and DEAE-Sephadex A-50 column chromatographies. Kallikrein activity was measured as the kininogenase activity reflecting the kinin-producing capacity from kininogen. The purification factor from crude plasma to purified substrate was 44 fold, and the recovery was 18%. The purified human substrate did not contain kinin-generating or destroying enzymes which would interfere with kininogenase activity, and showed a cross-reactivity of less than 0.1% against kinin antiserum. In the kininogenase assay, all kininogen was removed by adding ethanol to terminate the enzyme reaction. Because of the high sensitivity of kinin radioimmunoassay, the kinin levels in urine could be determined in very small amounts of samples (0.5 to 2.0 nl of the original urine). These findings indicated that kinin levels in incubation solution could be measured directly, and the control tubes are unnecessary in this assay procedure. In a comparison among human, dog and bovine low molecular weight kininogen as the substrate for human urinary kallikrein, the enzyme activity was 5 and 80 fold higher in the human low molecular weight kininogen, respectively, suggesting that a human substrate is the best for human enzymes. This simple, specific, sensitive and homologous kininogenase assay system seems to be very useful investigating the physiological or pathophysiological role of the renal kallikrein-kinin system in hypertensive and renal diseases. PMID- 3643741 TI - Effect of high and low molecular weight heparin preparations on chromogenic substrate assays for components of the kallikrein-kinin system. PMID- 3643742 TI - Description and evaluation of a new chromogenic substrate assay kit for the determination of prekallikrein in human plasma. AB - Because of an increasing interest in the determination of prekallikrein a kit was made for the determination of this plasma proenzyme. The kit consists of 1) a prekallikrein activator of the cephalin-ellagic acid type containing Factor XII and HMW-kininogen to ensure a total activation of the prekallikrein even in pathological plasmas, 2) a buffer which is optimal for both activation and substrate hydrolysis and 3) the chromogenic substrate S-2302. A control plasma is also included. This kit was evaluated by thirteen research groups as well as by ourselves. Both normal and patient plasmas were analyzed. Good correlations were obtained for prekallikrein levels in plasma samples between the kit method and two other methods (immunochemical and functional). As well as in deficiency states the prekallikrein level was low in pancreatitis (n = 20), cancer (n = 16), early pregnancy with gestosis (n = 15), cirrhosis (n = 9) and cases with thromboembolic disorders (n = 5). The prekallikrein level was high in late pregnancy (n = 4). PMID- 3643743 TI - Human urinary kallikrein (HUK): large-scale purification and direct solid-phase radioimmunoassay (RIA). AB - HUK was purified from 1,000 liters of fresh urine by the following procedures: silica gel adsorption, gel filtration on Sephadex G-75, DEAE-Sephadex chromatography, bentonite treatment, affinity chromatography on aprotinin Sepharose 4B, and rapid gel filtration on a TSK Gel G-3000 SWG column. Seventeen mg of HUK being found to be pure by means of various analyses was obtained. The pI values of the heterogeneous components of HUK were 3.5, 3.8, and 4.1, while the corresponding molecular weights of these components were 5.4 X 10(4), 4.9 X 10(4), and 4.4 X 10(4), respectively. The antigens (125I- and non-labeled HUK) were incubated for 4 hrs at 37 degrees C in polystyrene test tubes to which anti HUK rabbit IgG had been immobilized. The quantitative range of the standard curve was 1-128 ng. This Ria principally recognized active form of HUK. Therefore, total and inactive HUK also could be determined by the combination of the RIA with trypsin treatment of the urine sample. The RIA correlated closely with both S-2266 amidolytic assay and kininogenase assay. PMID- 3643744 TI - Measurement of plasma prokallikrein independent of inhibitors and interfering enzymes. AB - A new method to determine plasmaprokallikrein independently of its inhibitors is described. By ion exchange chromatography with DEAE-A-50 Sephadex plasmaprokallikrein can be separated from its inhibitors Cl-esterase inhibitor, alpha 2-macroglobulin, alpha 1-antitrypsin (protease inhibitor) and antithrombin III as well as from other enzymes like plasmin, Hagemann factor and glandular kallikrein, which can interfere with the chromogenic substrate of the amidolytic assay (S 2302) used to determine plasmakallikrein activity. Furthermore, this method also allows the measurement of plasmaprokallikrein in heparinized plasma, since heparin was separated by this chromatography technique from plasmaprokallikrein too. The enzymatic activity of activated plasmakallikrein was not changed by the ion exchange chromatography. Normal values of the plasmaprokallikrein content in plasma were in the range of 2.57 +/- 0.12 U/ml of plasma (n:42; X +/- SEM). No influence on plasmaprokallikrein activity of age and sex was found. PMID- 3643745 TI - Crossed desensitization between plasma kallikrein and trypsin. AB - The addition of rat plasma kallikrein or trypsin to the bath containing rat uterus caused contraction. On repetition, the same amount of the enzyme, after 4 5 additions, elicited desensitization. When a double dose of the enzyme was used the contraction again occurred. However, after desensitization to kallikrein the response for trypsin remained in altered, but after the desensitization for trypsin the uterus did not respond to kallikrein. Chymotrypsin, in spite of did not cause contraction, became the uterus insensitive to kallikrein and trypsin. It seems that bradykinin is not involved in the mechanism of contraction. The desensitization may be due to the release of inhibitors specific for kallikrein or trypsin; the effect of chymotrypsin may also be due to release of similar inhibitors. PMID- 3643746 TI - Antibody to human immunodeficiency virus in factor-deficient plasma. Effect of heat treatment on lyophilized plasma. AB - The prevalence of antibody to human immunodeficiency virus (HIV) was determined in various commercial substrate plasmas used in clotting factor assays, and viral isolation was attempted from both seropositive and seronegative samples. Antibody to HIV was detected in 13 of 13 plasma substrates used for Factor VIII assays and in 2 of 3 plasma substrates used for Factor IX assays. Antibodies were not detected in any of the other factor-specific substrates. Virus could not be isolated from any of the seropositive samples after 28 days in culture. Heat treatment of the samples under conditions known to inactivate HIV in plasma products indicated that heating the lyophilized substrate plasmas at 60 degrees C for up to eight hours had little effect on factor substrates and factor assays. Progressive loss of Factor V in the deficient plasmas was the most serious effect produced by heat treatment. PMID- 3643747 TI - AIDS in the transfused patient. PMID- 3643748 TI - Medical screening of former asbestos cement workers in Israel: a pilot program. AB - A pilot screening program for the evaluation of former asbestos-cement workers was carried out in the Chest Disease Clinic of the Acco Public Health Office (Ministry of Health), Israel. A total of 184 subjects were evaluated using medical and occupational questionnaires, clinical examinations, and pulmonary function tests (forced expiratory volume, forced vital capacity). Thirty percent of individuals with more than 1 year of work experience had symptoms of breathlessness or cough. Individuals with 10 years or more of work experience showed a high prevalence of rales and reduced pulmonary function, as compared to those with shorter work histories. These findings indicate the urgent need for active follow-up of Israeli ex-asbestos workers. A proposed screening and surveillance program for this high-risk group is discussed with emphasis on follow-up, health education, and smoking cessation. PMID- 3643749 TI - Review of the Israeli Technical Committee for Asbestos. AB - The concern of the Israeli public regarding health hazards arising from asbestos use led to the formation of a governmental body responsible for finding solutions to these problems. This body was formed in 1983 as a National Medical Committee and included representatives from governmental and nongovernmental bodies. The Israeli Technical Committee for Asbestos, which serves as a subsidiary of the National Medical Committee, is concerned with the technical aspects associated with health hazards associated with asbestos and other harmful dusts. This report describes the major activities of the Technical Committee during the last 2 years. PMID- 3643750 TI - Dust levels in an asbestos-cement factory: problem solving. AB - Isasbest Ltd., an asbestos-cement factory in Israel, has established dust preventive measures, maintained high ecological and medical standards, and assisted afflicted workers suffering from asbestos-related diseases. The problems of the handling of asbestos and its relationship to health should be approached according to the conditions in each specific workplace so that reasonable solutions can be found for proper control. PMID- 3643751 TI - Protesting your assignment. PMID- 3643752 TI - How and when do you use pulse oximetry? PMID- 3643754 TI - Does a Foley belong in the rectum? PMID- 3643753 TI - Nurses have rights, too. PMID- 3643755 TI - The path to addiction--and recovery. PMID- 3643756 TI - Techniques that cut costs, not care. PMID- 3643757 TI - Moving from "the gas station" to a nurse-managed psych clinic. PMID- 3643758 TI - The new look in diabetic diets. PMID- 3643759 TI - Spotting the borderline personality. PMID- 3643760 TI - Knock, knock. PMID- 3643761 TI - AJN JobFocus: California dreamin'. PMID- 3643762 TI - How do we define our diagnoses? PMID- 3643764 TI - Taming a tyrant. PMID- 3643763 TI - Software review: Power Pack for the IBM PC. PMID- 3643765 TI - The hunt for the really bad nurse. PMID- 3643766 TI - AIDS antibody tests on inpatient psychiatric units. AB - An antibody test for the causative virus of the acquired immune deficiency syndrome (AIDS) became commercially available in 1985. The author discusses the use of the AIDS antibody test on inpatient psychiatric units. She reviews the controversial legal and ethical questions related to its use, addressing such questions as Who should be tested for the AIDS antibody? When and to whom should the results of the test be disclosed? and How should the doctrine of "right to privacy" be balanced with the "duty to warn"? PMID- 3643767 TI - [Multiple stress of the lung: the emphysema model induced by elastase]. PMID- 3643768 TI - Complement activity in normal rabbit bronchoalveolar fluid. Description of an inhibitor of C3 activation. AB - Hemolytically active C4, C3, C5, and C6, and trace amounts of C1, were present in bronchoalveolar lavage fluid from healthy adult rabbits. Both the alternative and classical pathways were functionally intact through C5. Complement depletion by intravascularly administered cobra venom factor caused a parallel decrease in lavageable C5 from the rabbit's lungs. Whereas BALF C5 had specific activity comparable to serum C5, that of BALF C3 was lower than predicted. This was found to be due to the action of a substance that selectively blocked C3 activation. The inhibitor did not cause irreversible inactivation of C3, and it had no effect on C5 activity. It blocked the formation of EAC423 from EAC42 + C3, but not the lysis of preformed EAC423 + C5-9 or EAC423 rosetting with rabbit neutrophils. Hydrophobic chromatography of BALF separated the activity of the inhibitor from that of C3. Further chromatography showed that it had a net negative charge at physiologic pH, and molecular weight between 14 and 30 kilodaltons. The presence of an inhibitor of C3 activation in the airways would provide control of complement activation in an environment that is constantly exposed to bacteria, dust, and other potential inflammatory stimuli. PMID- 3643769 TI - Isolation patterns of the human immunodeficiency virus from cervical secretions during the menstrual cycle of women at risk for the acquired immunodeficiency syndrome. AB - Human immunodeficiency virus (HIV) has been isolated from both male and female genital secretions. We evaluated the pattern of female genital carriage during the menstrual cycle, and its relationship to HIV viremia. Seven menstruating seropositive women and one seronegative control had cervical secretions and venous blood samples cultured at weekly intervals during a single menstrual cycle. The virus was isolated from cervical secretions in four of seven women. No specific cycle pattern was seen, and positivity for HIV at one site (blood or cervical) did not correlate with positivity at another site. Blood cultures generally, but not always, became positive earlier than cultures from cervical specimens, suggesting higher titers of virus in blood. Thus, HIV secretion may be intermittent. These findings, together with earlier reports, suggest that seropositive women may transmit HIV at any time during the menstrual cycle. PMID- 3643770 TI - [Action of combinations of ampiox and a quinoline derivative on penicillin resistant staphylococcal strains]. AB - The effect of ampiox combination with a quinoline derivative (QD) on penicillin resistant strains of Staphylococcus was studied. Combination of ampiox and QD had in vitro a synergistic action. It was shown that the combined use of ampiox in a dose of 5 mg/kg and QD in a dose of 10 mg/kg had a pronounced therapeutic effect in staphylococcal septicemia of albino mice: 95 per cent prevention of death in the experimental animals and lower contamination of the animal internal organs. It was noted that ampiox and QD had different mechanisms of action on the bacterial cell. Therefore, their combination may be used for increasing antistaphylococcal activity of the antibiotic drug. PMID- 3643771 TI - Comparison of in vitro activity of quinolone antibiotics and vancomycin against gentamicin- and methicillin-resistant Staphylococcus aureus by time-kill kinetic studies. AB - Quinolone antibiotics have been proposed as possible alternatives to vancomycin for methicillin-resistant Staphylococcus aureus infections. We investigated the activities of amifloxacin, ciprofloxacin, norfloxacin, and vancomycin by time kill kinetic studies. Antibiotic concentrations of 0, 1.0, and 4.0 times the MIC were used against four strains of gentamicin- and methicillin-resistant S. aureus. Staphylococci were plated onto ciprofloxacin-containing agar at all time points, in repeat time-kill kinetic studies. Macrobroth dilution MICs and MBCs were determined. Ciprofloxacin levels were measured by bioassay. Replica plating was performed from the original susceptible inoculum (MIC, 0.125 micrograms/ml) onto ciprofloxacin-supplemented agar. At 4.0 times the MIC, only with ciprofloxacin was there regrowth at 24 and 48 h. All four strains of staphylococci grew on agar supplemented with 1 microgram of ciprofloxacin per ml; three of four grew on agar supplemented with 2 micrograms of ciprofloxacin per ml. MICs and MBCs for these resistant clones ranged from 8 to 32 micrograms/ml. No degradation in activity or amount of ciprofloxacin could be detected in the bioassay. Replica-plated staphylococci grew on agar containing 1 microgram/ml but not higher concentrations of ciprofloxacin at 48 h. Amifloxacin and norfloxacin sustained bactericidal activity comparable to that of vancomycin. We conclude that heteroresistant subpopulations of gentamicin- and methicillin-resistant S. aureus can emerge under antibiotic selection pressure. Such resistant clones may then mutate in the presence of subinhibitory concentrations of antibiotic to higher levels of ciprofloxacin resistance. PMID- 3643773 TI - Money management. Steps to financial independence. AB - Lack of knowledge about money leads to the seven money mistakes. To become financially independent, one must become educated about money, avoid those mistakes, and pay yourself first. This formula is simple. Some people insist that it is too simple to work and will ignore it. Those people will probably be no better off in the future than they are today. However, those who follow it can make their financial future secure. PMID- 3643772 TI - In vitro studies simultaneously examining effect of oxacillin on uptake of radiolabeled streptomycin and on associated bacterial lethality in Staphylococcus aureus. AB - We studied the effects of various concentrations of oxacillin on streptomycin uptake and killing for several strains of Staphylococcus aureus. When streptomycin was present in concentrations below the MIC, addition of oxacillin at concentrations greater than or equal to the MIC was associated with both significantly increased aminoglycoside uptake and killing. In contrast, when streptomycin was present in concentrations above the MIC, no increase of streptomycin uptake was noted with the addition of oxacillin, and killing was no greater than what would have been expected with a simply additive effect. Similar studies in a strain of S. aureus selected for high-level streptomycin resistance also demonstrated increased streptomycin uptake in the presence of concentrations of oxacillin above the MIC; however, killing was no greater than that seen with oxacillin alone. These studies provide data which are potentially important in designing a rational approach to clinical use of combination antibiotic therapy. PMID- 3643774 TI - Customers versus patients. A marketing perspective on health care. AB - The thrust of health care "solutions" in the press and in Congress focus on the infirm. In fact, it is the only segment where all of the various economic models fit well. Considerable marketing planning and implementation techniques must be brought to bear on solutions for the healthy, the worried, and the early sick segments in the near future. PMID- 3643775 TI - Mortality rates measure number of deaths and nothing more. PMID- 3643776 TI - Teaching non-OR nurses. Marketing education programs to hospitals. PMID- 3643777 TI - A circulator's thoughts during the day. PMID- 3643778 TI - Using a rapidly identifiable access code system in the OR. AB - To ensure that this system works, each staff member makes an entry into the computer or on the master chart when an item is taken from the supply area. He or she is also expected to check for outdated instrumentation and proper placement on the shelf. The coding system has increased the staff's organization and productivity. It has been successful because it uses a numerical system instead of a memory-based system, and because all instrumentation are categorized and stored according to specialty. The simplicity of the system that allows for quicker access to instrumentation also makes it inexpensive to implement. PMID- 3643779 TI - Patient selection criteria for 1987. AB - Patient selection criteria provides an effective means for assessing the appropriateness of patients for surgery in an outpatient setting. Thorough evaluation in each of the five criteria areas helps ensure the acceptability of each patient for ambulatory surgery. Regardless of the development of new procedures, anesthetic agents, and equipment, the use of patient selection criteria is still one of the most important factors in determining the overall outcome and success of the patient's ambulatory surgery experience. PMID- 3643780 TI - In situ artery bypass. Surgery for leg salvage. PMID- 3643781 TI - Radical retropubic prostatectomy. Campbell and Walsh techniques. PMID- 3643782 TI - Preparing for the nursing shortage. PMID- 3643783 TI - Supplemental staffing. An employment alternative for OR nurses. PMID- 3643784 TI - OR technical and professional staff. A study of California acute care hospitals. PMID- 3643785 TI - Methicillin resistant Staphylococcus aureus in milk. AB - Three separate outbreaks of gentamicin and methicillin resistant Staphylococcus aureus in a special care baby unit are described. The outbreaks ceased only after a milk bank worker was identified as a carrier of the strain. It is postulated that the infant milk feeds served as a vehicle of spread. PMID- 3643786 TI - A program for career structure: nurses speak. Part Four. PMID- 3643787 TI - Getting the message across: nurses and the media. PMID- 3643789 TI - Nursing diagnosis: defining the goal of care. PMID- 3643788 TI - Regression: a nursing response. PMID- 3643790 TI - Coma arousal: is there a need? PMID- 3643791 TI - Nurse & the law. Reasonable risk--reasonable care. PMID- 3643792 TI - Poisoning: prevention and first aid. Part Two. The Royal Melbourne Hospital Pharmacy Department. PMID- 3643794 TI - In vivo processing of rat aldolase B mRNA precursor. AB - Processed intermediates of aldolase B mRNA precursor in nuclei were analysed by hybridization with cDNA or intron-specific DNAs. The results indicated that there is, in part, a preferred order in the removal of eight introns from the primary transcript. The largest intron (IVS 1) may be selectively eliminated at an earlier step during the processing, while others (IVS 2 and IVS 7) are not. In addition, the data suggest that the removal of four to five introns from the precursor occurs rapidly after transcription, and that the resulting partially processed molecules persist rather stably before being completely processed. PMID- 3643793 TI - Identification of a new tissue-kallikrein-binding protein. AB - We have identified a tissue-kallikrein-binding protein in human serum and in the serum-free culture media from human lung fibroblasts (WI-38) and rodent neuroblastoma X glioma hybrid cells (NG108-15). Purified and 125I-labelled tissue kallikrein and human serum form an approximately 92,000-Mr SDS-stable complex. The relative quantity of this complex-formation is measured by densitometric scanning of autoradiograms. Complex-formation between tissue kallikrein and the serum binding protein was time-dependent and detectable after 5 min incubation at 37 degrees C, with half-maximal binding at 28 min. Binding of 125I-kallikrein to kallikrein-binding protein is temperature-dependent and can be inhibited by heparin or excess unlabelled tissue kallikrein but not by plasma kallikrein, collagenase, thrombin, urokinase, alpha 1-antitrypsin or kininogens. The kallikrein-binding protein is acid- and heat-labile, as pretreatment of sera at pH 3.0 or at 60 degrees C for 30 min diminishes complex-formation. However, the formed complexes are stable to acid or 1 M-hydroxylamine treatment and can only be partially dissociated with 10 mM-NaOH. When kallikrein was inhibited by the active-site-labelling reagents phenylmethanesulphonyl fluoride or D-Phe-D-Phe-L Arg-CH2Cl no complex-formation was observed. An endogenous approximately 92,000 Mr kallikrein-kallikrein-binding protein complex was isolated from normal human serum by using a human tissue kallikrein-agarose affinity column. These complexes were recognized by anti-(human tissue kallikrein) antibodies, but not by anti alpha 1-antitrypsin serum, in Western-blot analyses. The results show that the kallikrein-binding protein is distinct from alpha 1-antitrypsin and is not identifiable with any of the well-characterized plasma proteinase inhibitors such as alpha 2-macroglobulin, inter-alpha-trypsin inhibitor, C1-inactivator or antithrombin III. The functional role of this kallikrein-binding protein and its impact on kallikrein activity or metabolism in vivo remain to be investigated. PMID- 3643795 TI - Aminoacyl-tRNA(anticodon): codon adaptation in human and rabbit reticulocytes. AB - A highly significant correlation was observed between the relative abundances of isoacceptor aminoacyl-tRNAs in human and rabbit reticulocytes and the frequency of their cognate codons in alpha and beta globin mRNAs from the respective tissue. The correlation coefficient (r value) for human reticulocytes was 0.78 and for rabbit reticulocytes was 0.88. These results provide strong evidence that the amounts of most isoacceptors in human and rabbit reticulocytes are adapted to requirements for translating their cognate codons in globin mRNA, i.e., there is an aa-tRNA(anticodon): codon adaptation in these tissues. PMID- 3643797 TI - AIDS: from immunity to infection to autoimmunity. A comprehensive hypothesis of the pathogenesis of the disease. PMID- 3643796 TI - Transplacental transmission of HTLV-III virus. PMID- 3643799 TI - Stress, pain, and catecholamines in labor: Part 2. Stress associated with childbirth events: a pilot survey of new mothers. PMID- 3643798 TI - Nausea and pregnancy outcome. PMID- 3643800 TI - The relationship between sibling jealousy and presence at a sibling's birth. PMID- 3643801 TI - The effect of ovarian steroidogenesis on ovulation and fertilizability in the in vitro perfused rabbit ovary. AB - The effects of aminoglutethimide phosphate (AGP) on ovulation, ovum maturation, fertilizability, and steroid production were studied with the use of an isolated perfused rabbit ovary preparation. AGP (10(-3) or 10(-4) M) was added to the perfusate of one ovary. The contralateral control ovary was perfused in medium alone. Thirty minutes later human chorionic gonadotropin (hCG) (50 IU) was added to the perfusate of all ovaries. No difference was observed in time of ovulation or ovulatory efficiency between controls and AGP-treated ovaries. The degree of ovum maturity and degeneration was also comparable in the two groups. Progesterone and estradiol production were significantly reduced by AGP treatment. A second experiment examined fertilizability of ova ovulated in vitro after perfusion with 10(-3) M AGP. AGP significantly reduced the rate of normal fertilization as observed 12 h after insemination. The percentage of inseminated ova with evidence of degeneration was greater in ova from AGP-treated ovaries than in those from controls, however, this difference was not significant. The study indicates that AGP affects neither hCG-induced ovulation nor meiotic resumption; however, fertilizability of ova from ovaries treated with AGP is impaired. These data suggest that the intrafollicular steroid environment may participate in cytoplasmic maturation of ovulated ova. PMID- 3643802 TI - LAV/HTLV-III antibody status and immunological abnormalities in haemophiliac patients. PMID- 3643803 TI - Planned Change: the development of a program for the management of self induced water intoxication. PMID- 3643804 TI - Meeting the mental health needs of victims of crime. PMID- 3643805 TI - The victimization of older persons. PMID- 3643806 TI - Between parent & child. PMID- 3643807 TI - Nursing education moves to the North. PMID- 3643808 TI - The new regime. PMID- 3643809 TI - Surviving assault from within. PMID- 3643810 TI - [A nurse in retirement]. PMID- 3643811 TI - From burned out to turned on. PMID- 3643812 TI - Why nurses leave nursing. PMID- 3643813 TI - The age drain. PMID- 3643814 TI - [Primary health care and community health]. PMID- 3643815 TI - After hours. PMID- 3643817 TI - [Nursing's priorities for the year 2000: priorities for the American Nurses' Association]. PMID- 3643816 TI - Regulation of mRNA accumulation by a human immunodeficiency virus trans-activator protein. AB - HIV LTR-directed expression is markedly stimulated in trans by coexpression of a region of the HIV genome encoding a portion of the tat reading frame. Transient expression assay analysis reveals that trans-activation of LTR-directed expression results primarily from an increase in mRNA accumulation. Deletion analysis of the LTR indicates that upstream promoter and enhancer elements are dispensible for trans-activation, while sequences 3' of the RNA start site displaying strict orientation and position dependence are required. These sequences, contained in the 5' leader of all HIV transcripts, form a stable stem loop structure with twofold symmetry in the cognate mRNA. Analysis of mutations in the trans-acting region demonstrates that the trans-activator is the protein product of the tat gene, identified biochemically in HIV-infected and transfected cells as an Mr 15,000 polypeptide. We discuss possible mechanisms whereby the interaction of p15tat with the dyad element promotes the accumulation of LTR directed mRNA. PMID- 3643818 TI - [Discussion on education for postgraduate nurses]. PMID- 3643819 TI - [Postoperative care of children with contracture of the gluteal muscles]. PMID- 3643820 TI - [Postoperative care of low-birth-weight infants]. PMID- 3643821 TI - [Pre and postoperative care of children detected by right cardiac catheterization]. PMID- 3643822 TI - [Care in neonatal polycythemia children treated by partial exchange transfusion therapy]. PMID- 3643823 TI - [Coordination of the redressment of the single cardioventricle]. PMID- 3643825 TI - [Nursing service for relieving the suffering of cancer patients]. PMID- 3643824 TI - [Nursing of patients after the redressment of the single cardioventricle]. PMID- 3643826 TI - [Nursing care in extracapsular extraction of cataract and intraocular lens implantation]. PMID- 3643827 TI - Study of elastase-type activity in blister fluids of recessive dystrophic epidermolysis bullosa. AB - Recessive dystrophic epidermolysis bullosa (RDEB) is characterized clinically by blister formation due to minor trauma and ultrastructurally by a progressive disappearance of anchoring fibrils at the dermoepidermal junction and of the oxytalan-type fibers which belong to the elastic fiber system. In this study, we determined the elastase-type activity in blister fluid obtained from 8 patients suffering from RDEB as compared to the suction fluid of experimental blisters in a healthy person and to the blister fluid of a patient suffering from epidermolysis bullosa simplex. One patient with dominant dystrophic epidermolysis of the albopapuloid type was also studied. Seven of the eight children with RDEB showed highly elevated values. The eighth child, treated with etretinate, as well as the patient suffering from dominant epidermolysis bullosa had moderately increased values. The determination of elastase-type activity in the blister fluid could therefore be useful to establish the differential diagnosis of recessive dystrophic epidermolysis bullosa. PMID- 3643828 TI - Rounded atelectasis: considerations on its radiological diagnosis. AB - Rounded atelectasis is a particular form of peripheral lung collapse, adjacent to the pleura and causing a pulmonary opacity, often resembling a neoplastic mass. Its early identification avoids further investigations with more invasive techniques, especially unnecessary thoracotomy. The aim of this report is to contribute some case studies to the body of information which characterizes this radiographic and tomodensitometric entity; aspiration biopsy can possibly be performed to resolve diagnostic uncertainties. PMID- 3643830 TI - Peripheral veno-lymphatic communications. AB - Though there have been a number of articles on lympho-venous anastomoses, there have been no reports of the opposite situation, namely veno-lymphatic communication. A case of veno-lymphatic communication is presented, and possible explanations for this finding are described. PMID- 3643829 TI - Retrograde ureteral stenosis in two patients with a uretero-ileal anastomosis. AB - In the case of ureter stenosis, the common treatment is dilatation. In patients with a uretero-ileal anastomosis retrograde placing of a ureter stent over an antegradely inserted guide wire is an elegant way to garantee urine output without inconvenience for the patient. Two patients are described. PMID- 3643831 TI - Myelography using iohexol (Omnipaque). AB - Myelography was performed in 30 patients using iohexol (Omnipaque) 240 mg I/ml for lateral C1C2 injections, or iohexol 300 mg I/ml for lumbar injections. The dose varied from 3 to 10 ml. The patients were observed for 48 h for possible adverse reactions. A complete neurological examination was repeated 24h after the investigation, and EEG recordings 3-24h after the investigation. Adverse reactions occurred in 4 patients, minor EEG changes occurred in 1 patient, and slight changes in the neurological status were seen in 2 patients. PMID- 3643832 TI - Genetically significant diagnostic X-ray dose in The Netherlands. AB - An updated genetically significant X-ray dose (GSD) for The Netherlands is presented. A comparison is made between sets of gonadal doses from The Netherlands, France, Sweden and the USA. A 1980 (Dutch) frequency distribution of diagnostic X-ray examinations served to calculate the GSD with these four sets of doses yielding 0.23, 0.10, 0.20 and 0.09 mSv, respectively. A reduction of the Dutch GSD appears possible. PMID- 3643833 TI - Inventory of medical X-ray equipment in Dutch hospitals. AB - The results of an inventory of medical X-ray apparatus in Dutch hospitals are presented and discussed. An inquiry covering a total of 226 hospitals yielded a response of 92%. The questionnaires contained preprinted data from an earlier inventory of registered X-ray apparatus at the Ministry of Physical Planning, Housing and the Environment. At present the total number of X-ray apparatus in Dutch hospitals is 3,008, of which 2.820 are of the diagnostic X-ray type. The accumulated data show that approximately 8 million X-ray examinations were performed in hospitals during the year 1984, corresponding to 0.56 X-ray examinations per inhabitant per year. PMID- 3643835 TI - Early detection of bone metastases of Ewing's sarcoma by magnetic resonance imaging. AB - Bone metastases of an Ewing's sarcoma were detected by magnetic resonance imaging (MRI), when bone scan, CT and plain films were still normal. This is due to the ability of MRI to detect intramedullary metastases before involvement of the cortex. PMID- 3643834 TI - Left partial absence of the pericardium. AB - A case of left partial absence of the pericardium in a young patient is presented. Plain roentgenographic findings were suggestive, and 2-D echocardiography was useful only to rule out associated cardiac abnormalities. Computerized tomography led to the diagnosis permitting to define some typical features. PMID- 3643836 TI - A case of a gigantic ameloblastoma. PMID- 3643837 TI - Apnea vs. SIDS. Interview by Joan Luethmers. PMID- 3643838 TI - Changing patients in chromate allergy. PMID- 3643839 TI - [A method of rapid mixing and pulsed photo-affinity labeling for the study of the dynamics of ribosome functioning]. PMID- 3643840 TI - [Neuroretinitis leading to blindness in a patient with Kaposi's sarcoma]. PMID- 3643841 TI - Non-specificity of HTLV-III reactivity in sera from rural Kenya and eastern Zaire. PMID- 3643842 TI - Nursing in a changing environment. PMID- 3643843 TI - The nature of changing. PMID- 3643844 TI - Bridging the gap: hospital to home in a changing health care environment. PMID- 3643845 TI - Accountability in primary nursing. PMID- 3643847 TI - Selection criteria as predictors of academic success in women's health care nurse practitioners. PMID- 3643846 TI - Networking in a special interest group. PMID- 3643848 TI - Effects of secondary interactions on the kinetics of peptide and peptide ester hydrolysis by tissue kallikrein and trypsin. AB - Kinetic constants for the hydrolysis by porcine tissue beta-kallikrein B and by bovine trypsin of a number of peptides related to the sequence of kininogen (also one containing a P2 glycine residue instead of phenylalanine) and of a series of corresponding arginyl peptide esters with various apolar P2 residues have been determined under strictly comparative conditions. kcat and kcat/Km values for the hydrolysis of the Arg-Ser bonds of the peptides by trypsin are conspicuously high. kcat for the best of the peptide substrates, Ac-Phe-Arg-Ser-Val-NH2, even reaches kcat for the corresponding methyl ester, indicating rate-limiting deacylation also in the hydrolysis of a peptide bond by this enzyme. kcat/Km for the hydrolysis of the peptide esters with different nonpolar L-amino acids in P2 is remarkably constant (range 1.7), as it is for the pair of the above pentapeptides with P2 glycine or phenylalanine. kcat for the ester substrates varies fivefold, however, being greatest for the P2 glycine compounds. Obviously, an increased potential of a P2 residue for interactions with the enzyme lowers the rate of deacylation. In contrast to results obtained with chymotrypsin and pancreatic elastase, trypsin is well able to tolerate a P3 proline residue. In the hydrolysis of peptide esters, tissue kallikrein is definitely superior to trypsin. Conversely, peptide bonds are hydrolyzed less efficiently by tissue kallikrein and the acylation reaction is rate-limiting. The influence of the length of peptide substrates is similar in both enzymes and indicates an extension of the substrate recognition site from subsite S3 to at least S'3 of tissue kallikrein and the importance of a hydrogen bond between the P3 carbonyl group and Gly-216 of the enzymes. Tissue kallikrein also tolerates a P3 proline residue well. In sharp contrast to the behaviour of trypsin is the very strong influence of the P2 residue in tissue-kallikrein-catalyzed reactions. kcat/Km varies 75-fold in the series of the dipeptide esters with nonpolar L-amino acid residues in P2, a P2 glycine residue furnishing the worst and phenylalanine the best substrate, whereas this exchange in the pentapeptides changes kcat/Km as much as 730-fold. This behaviour, together with the high value of kcat/Km for Ac Phe-Arg-OMe of 3.75 X 10(7) M-1 s-1, suggests rate-limiting binding (k1) in the hydrolysis of the best ester substrates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3643849 TI - Pharmacokinetics of high dose etoposide (VP 16-213). AB - This paper describes the pharmacokinetics of etoposide in cancer patients after high dose administration (up to 3.5 g/m2). High performance liquid chromatography with electrochemical detection was used to determine etoposide, cis etoposide and the glucuronide of etoposide in plasma, bile, cerebro-spinal fluid, urine, saliva and ascites, the detection limit being 2 ng etoposide/ml plasma. The plasma concentration time curve shows a tri-phasic decay. The terminal phase is very slow. It was concluded that etoposide is strongly bound in the peripheral compartment. The volume of the central compartment varied from 7.4 to 20.1 l and the steady state volume of distribution from 3.1 to 7.8 l/m2. Relatively high concentrations of etoposide were found in saliva, bile, ascites and urine and low concentrations in cerebro-spinal fluid. The total body clearance varied from 12.0 to 26.8 ml/min/m2, and 26.2 to 53.4% was excreted as unchanged etoposide into the urine and 8.3 to 17.3% as glucuronide into the urine. Very low amounts of the trans hydroxy acid of etoposide and the cis etoposide were detected in the urine. Glucuronides were found in urine and duodenal fluid but not in plasma. PMID- 3643850 TI - Pharmacokinetics of naproxen in elderly patients. AB - The pharmacokinetics of naproxen have been examined in 13 elderly patients (mean age 84.2 years) and in 9 younger patients (mean age 53.9 years) at the end of a 21 day course of therapy with naproxen 500 mg b.d. The mean pre-dose concentration on days 19, 20 and 21 was significantly higher in the elderly patients than in the controls (60.1 vs. 43.3 micrograms X ml-1). The AUC (0-24) was significantly higher in the elderly subjects only when normalized for body weight (9.1 vs. 5.4 micrograms X ml-1 X h kg-1 p less than or equal to 0.02). The AUC was significantly higher in the elderly group compared to the control group also in the normalized form. The apparent clearance of naproxen was reduced in the elderly compared to the control patients (315 vs. 628 ml X h-1). The percentage protein binding of naproxen was the same in both groups (99.8%) but the free concentration of naproxen was significantly higher in the elderly patients than in the control patients (141 vs. 89.8 ng X ml-1). Although there was no excess of side effects in the elderly patients it is suggested that when naproxen is given to elderly patients, therapy should be started at the lower end of the dosage range. PMID- 3643852 TI - Transcutaneous pacing: meeting the challenge. PMID- 3643851 TI - Antibody used to identify penicillin-binding protein 2' in methicillin-resistant strains of Staphylococcus aureus (MRSA). AB - Polyclonal antibodies were raised against the membrane-bound penicillin-binding protein (PBP 2') present in methicillin-resistant strains of Staphylococcus aureus (MRSA) and were used to detect its presence in membranes from strains grown under varying conditions for the expression of resistance. The antibody preparation reacted with another membrane protein from methicillin-sensitive S. aureus (MSSA) which migrated to the same position as PBP 2' on SDS gel electrophoresis. Pretreatment of the antisera with membranes of sensitive strains removed antibodies recognising high-Mr proteins common to both MRSA and MSSA: the residual antibody then reacted specifically with PBP 2'. Antisera pretreated in this manner can be used as a probe for the definitive identification of MRSA strains. PMID- 3643854 TI - CPR by blitz--an intense campaign for annual recertification. PMID- 3643853 TI - Spinning your wheels? Tips on establishing a chapter research committee. PMID- 3643855 TI - Concepts in the assessment of oxygenation. PMID- 3643856 TI - Nursing boards and disciplinary proceedings. PMID- 3643857 TI - Teaching and retention of cardiopulmonary resuscitation skills for families of high-risk patients with cardiac disease. PMID- 3643858 TI - Contributing to the nurturing of other nurses. PMID- 3643859 TI - Leucospermia and the fertilizing capacity of spermatozoa. AB - Ejaculates obtained from men attending an in vitro fertilization (IVF) program were analyzed to determine the effect of the presence of leucocytes in semen on the ability of sperm in that semen to fertilize oocytes. The mean (+/- S.E.) concentration of leucocytes in 103 ejaculates was 0.62 X 10(6)/ml (+/- 0.09) with a range of 0.1 X 10(6) or less per ml to 7.0 X 10(6)/ml. The leucocyte concentration demonstrated a significant (p less than 0.05) but inverse relationship with the fertilizing capacity of spermatozoa. Though not statistically significant, the leucocyte concentration also demonstrated an inverse relationship to sperm motility and normal morphology. These results suggest that the presence of leucocytes in an ejaculate cannot be used as the sole indicator of the fertilizing capacity of spermatozoa in that ejaculate. PMID- 3643861 TI - Assessing incontinence in the elderly. PMID- 3643860 TI - [Effect of adrenaline on the state and relation between various indices of enzymatic components of the blood coagulation system]. PMID- 3643862 TI - The biology of ageing: muscles, bones, and joints. PMID- 3643863 TI - Functions of the elderly in the field of health. PMID- 3643865 TI - The nursing process evaluated. PMID- 3643864 TI - Difficult people. PMID- 3643866 TI - AIDS and women at risk. AB - Because acquired immune deficiency syndrome (AIDS) has often been perceived as a disease of gay men, little attention has been given to the increasing number of women exposed to AIDS. An overview of the disease reveals that its victims confront both physical and psychosocial problems of great complexity and that social workers have much to contribute to meet the needs of men and women who are affected. PMID- 3643867 TI - A critical test of specific hospice objectives for family caregivers. PMID- 3643868 TI - Developing effective hospice staff support groups: pilot test of an innovative training program. PMID- 3643869 TI - The hospice administrator as counselor. PMID- 3643871 TI - Spiritual elements of hospice care. PMID- 3643870 TI - Depression in geriatric cancer patients: guide to assessment and treatment. PMID- 3643872 TI - Patient and family satisfaction with care for the terminally ill. PMID- 3643873 TI - Assessing patient outcomes in hospice: what to measure? PMID- 3643874 TI - Lessons from hospice evaluations. PMID- 3643875 TI - Biopsychosocial assessment of cancer patients: methods and suggestions. PMID- 3643876 TI - Assessing pain among oncology and terminally ill patients: psychometric considerations. PMID- 3643877 TI - Assessment of acute pain and anxiety and chemotherapy-related nausea and vomiting in children and adolescents. PMID- 3643878 TI - Lessons from hospice evaluations: counterpoint. PMID- 3643879 TI - Assessment of cognitive function in cancer patients. PMID- 3643880 TI - Brachioproctic eroticism and transmission of retrovirus associated with acquired immune deficiency syndrome (AIDS). AB - A case of transmission of the acquired immune deficiency syndrome (AIDS) associated retrovirus (ARV) by brachioproctic eroticism is described. PMID- 3643881 TI - Immunotherapeutic effect of lactobacillus vaccine, SolcoTrichovac. PMID- 3643882 TI - NSNA's position on education: exploding the myths. PMID- 3643883 TI - A career in military service. PMID- 3643884 TI - Vietnam. PMID- 3643885 TI - Commitment to nursing. PMID- 3643887 TI - Successful treatment of experimental neonatal respiratory failure using extracorporeal membrane lung assist. AB - A total of 44 preterm fetal lambs at great risk of developing respiratory failure were delivered by Cesarean section, and were then managed on conventional mechanical pulmonary ventilation. Fifteen animals initially fared well, and 14 of these were long term survivors. Twenty-nine other lambs showed a progressive deterioration in arterial blood gases within 30 minutes of delivery, of which 10 lambs were continued on mechanical pulmonary ventilation (20% survival), while the remaining 19 lambs were placed on an extracorporeal membrane lung respiratory assist (79% survival). Extracorporeal membrane lung bypass rapidly corrected arterial blood gas values, and permitted the use of high levels of CPAP instead of the continuation of mechanical pulmonary ventilation at high peak airway pressures. Improvement in lung function was gradual, and predictable. Early institution of extracorporeal respiratory assist using a membrane artificial lung rapidly corrected arterial blood gas values and significantly improved on neonate survival. PMID- 3643886 TI - Extracellular release of antimicrobial defensins by human polymorphonuclear leukocytes. AB - Human polymorphonuclear leukocytes (PMN) contain three antimicrobial and cytotoxic peptides which belong to a family of mammalian granulocyte peptides named defensins. To determine their potential availability for extracellular microbicidal or cytotoxic events, we quantified the extracellular release of defensins after stimulation of human PMN with phorbol myristate acetate and opsonized zymosan. As determined by enzyme immunoassay and confirmed by polyacrylamide gel electrophoresis and densitometry, 10(6) human PMN contained 4 to 5 micrograms of defensins. After stimulation with a high concentration of phorbol myristate acetate (1 microgram/ml), about 8% of PMN defensins were found in the media. Release of defensins correlated best with the release of azurophil granule marker beta-glucuronidase or elastase and poorly with the release of either the specific granule marker lactoferrin or cytoplasmic lactate dehydrogenase. Phagocytosis of opsonized zymosan resulted in the extracellular release of less than 3% of PMN defensins. The factors responsible for less release of defensins into media relative to the release of other azurophil granule proteins may include heterogeneity of azurophil granules and the affinity of defensins for cellular surfaces and opsonized particles. In vivo, defensins are most likely to reach effective microbicidal or cytotoxic concentrations in PMN-rich exudates (pus), in confined environments of the phagolysosomes, or in intercellular clefts between PMN and their targets. PMID- 3643888 TI - Outbreak due to methicillin- and rifampin-resistant Staphylococcus aureus: epidemiology and eradication of the resistant strain from the hospital. AB - A methicillin- and rifampin-resistant strain of Staphylococcus aureus was introduced into a university hospital by interstate transfer of an infected surgical patient. An outbreak occurred, and 17 patients became infected or colonized with the epidemic strain. Reservoirs appeared to be patients who were infected or colonized with the resistant S aureus and possibly two nurses who were nasal carriers. The outbreak isolate was likely spread by contact with contaminated hands of personnel. A retrospective case-control study identified tracheostomy, debridement, and irrigation of wounds by power spray and prolonged nasogastric intubation as risk factors for acquisition of the epidemic strain. Analysis of factors by groups indicated that surgical procedures, wound care procedures and instrumentation of the respiratory tract were significantly associated with cases. The nasal carrier state was eradicated in two nurses by topical application of 5% vancomycin. The epidemic strain was eradicated from the hospital 8 months after it was introduced. PMID- 3643890 TI - Staphylococcus aureus colonization and infection after discharge from a term newborn nursery. AB - During a 6-month period, term infants underwent nasal and umbilical swabbing within 96 hours of delivery and again at 1 to 18 (mean 3.8) weeks after discharge. Swabs were inoculated onto horse blood agar and all S aureus isolates were phage typed. Two hundred three infants were enrolled and follow-up was obtained for 181 (89%). Thirty-two of 181 (17.6%) were initially colonized, of whom 12 (37.5%) were colonized on follow-up. Thirty-two of 181 became colonized subsequent to hospital discharge. No single phage type predominated. Twenty-five patients were diagnosed to have clinical illness--omphalitis (11), conjunctivitis (10), and pustulosis (5). Six of these were colonized with S aureus initially, although organisms of the same phage type were not recovered from cultures obtained at the time of clinical illness. There was no significant difference in the rate of infections in colonized (19%) versus non-colonized (12%) infants. In five patients where S aureus was recovered at the time of symptoms, all organisms were acquired subsequent to discharge. We conclude that nursery colonization with S aureus did not lead to clinical illness, and clinical illnesses previously ascribed to S aureus frequently occur in the absence of these bacteria. PMID- 3643889 TI - Methicillin-resistant Staphylococcus aureus in a nursing home. AB - During a 13-month period, 25 residents of a nursing home were found to have positive cultures for methicillin-resistant Staphylococcus aureus (MRSA), including 17 with clinically significant infections. The outbreak came to attention in February 1985 when pneumonia was diagnosed in five residents during a 10-day period, and sputum cultures from all five were positive for MRSA. A survey revealed that nine (12%) of a sample of 74 residents and nine (7%) of 130 personnel had positive cultures for MRSA. Six of nine residents with MRSA detected in the culture survey had not been hospitalized for 6 or more months before the survey, suggesting acquisition of MRSA in the nursing home. Implementation of control measures was associated with a decreased occurrence but not complete elimination of new cases. MRSA in nursing homes is of concern because these institutions might serve as reservoirs for MRSA in the community. Further studies are required to define the magnitude of the problem, as well as optimal control measures. PMID- 3643891 TI - "The coccus-conscious" or "the conscious careful". PMID- 3643892 TI - Use of the innovative decision-making process in primary health care. AB - In an effort to provide accessible and affordable health care to the populations of the world, governments and non-governmental organizations have turned to primary health care. The Maua Methodist Hospital in the community health Maua Via Meru, Kenya, gives us an example of such efforts. PMID- 3643893 TI - Health for all and nursing in Turkey. AB - The implementation of primary health care must take into consideration the existing health system and stimulates a study of the role, function of health personnel, and their interrelationships. PMID- 3643895 TI - Settlement of labour disputes. AB - The International Labour Organization (ILO) sponsored a meeting on the Settlement of Labour Disputes in the Public Service which was held in Geneva on 6-10 October 1986. The International Council of Nurses (ICN) participated in the discussions and was able to voice the concerns of nurses employed in the public service. The ICN statement was well received by the delegates and appears below in its entirety. PMID- 3643894 TI - Response of nursing education to primary health care: the training and practice of post basic community health nurses in Botswana. AB - Manpower resources in Botswana are one of the most important constraints on the development of its health services. In the 1970s nurses were sent to India, Ghana and Kenya for specialized training in public health. PMID- 3643896 TI - The Norwegian Nurses Association (NSF)--goals and progress. AB - The Norwegian Nurses' Association was created as an independent organization addressing the professional and socio-economic concerns of nurses. The Association has slowly established a supportive network through cooperation with other similarly oriented organizations. PMID- 3643897 TI - Does professional accountability and effectiveness extend to child health clinics? PMID- 3643898 TI - Management budgeting in the community. PMID- 3643899 TI - An infant crying clinic. PMID- 3643900 TI - Screening babies' hearing: evaluating the Body Spek 2000. PMID- 3643901 TI - A philosophy of health. PMID- 3643902 TI - The refresher course. PMID- 3643903 TI - Cultural value awareness: glimpses into a Punjabi mother's world. PMID- 3643904 TI - Assessing the value of professional development for health visitors and their clients. PMID- 3643905 TI - Stress in the first year of health visiting practice. PMID- 3643906 TI - Pilot study for a sleep clinic. PMID- 3643907 TI - Health visitor involvement in a family centre. PMID- 3643909 TI - An ABC of alternative medicine: homoeopathy. PMID- 3643908 TI - Insight into management. PMID- 3643910 TI - Professional coping. PMID- 3643911 TI - Burnt out cases? PMID- 3643912 TI - Coping with sleeping problems. PMID- 3643913 TI - Pulmonary tissue perfusion altered: emboli. PMID- 3643914 TI - Evaluation of two methods used to stabilize oral endotracheal tubes. AB - This study examined the effects of using an oral endotracheal tube holder versus conventional taping for stabilization of oral endotracheal tubes. Twenty-five patients were studied for 4 days, while 5 remained in the study 3 days. Each of the 30 patients had each of the two methods of stabilization in place for at least 1 day. The oral endotracheal tube holder significantly (p less than 0.0001) decreased both internal and external movement of the tube. Although self extubation did occur in two instances, it was evaluated as less likely to occur when the tube holder was used to secure the endotracheal tube. Skin breakdown was also observed less frequently with the tube holder. Overall, nursing staff had a higher level of acceptance of the tube holder as the method of choice for stabilization of an oral endotracheal tube. Patient perceptions of the system were not evaluated because of the degree of illness of the patients. PMID- 3643915 TI - Pulmonary microemboli presenting as an acute infectious process. PMID- 3643916 TI - Sexual counseling of women with coronary heart disease. PMID- 3643917 TI - Effects of caffeine ingestion on heart rate, blood pressure, myocardial oxygen consumption, and cardiac rhythm in acute myocardial infarction patients. PMID- 3643918 TI - Physiologic effects of cocaine with particular reference to the cardiovascular system. PMID- 3643919 TI - Intrathoracic endometriosis: a women's health issue. PMID- 3643920 TI - Comparison of cancer patients' and professional nurses' perceptions of important nurse caring behaviors. PMID- 3643921 TI - Pitfalls of computer use in acute care medicine. PMID- 3643922 TI - Current facts on pacemaker electromagnetic interference and their application to clinical care. PMID- 3643923 TI - Entry into practice: the continuing saga. PMID- 3643924 TI - Haemophilus parainfluenzae endocarditis. PMID- 3643925 TI - Expression of specific high capacity mevalonate transport in a Chinese hamster cell variant. AB - A variant of a low density lipoprotein receptor-negative Chinese hamster ovary (CHO) cell mutant was isolated using a nutritional selection called MeLoCo. The variant, designated met-18b-2, internalized and metabolized mevalonate at rates 10-40 times greater than the progenitor cells from which they were derived. The extent of incorporation of radioactivity from [3H]mevalonate into steroidal and nonsteroidal mevalonate derivatives, including modified proteins, was much greater in met-18b-2 cells than in their progenitors. Much of the internalized [3H]mevalonate was converted to nonpolar lipids. Unlike wild type CHO cells or the receptor-negative progenitors, met-18b-2 cells were killed by high concentrations of mevalonate (greater than 6 mM) in the culture medium. Regulation of 3-hydroxy-3-methylglutaryl-CoA reductase activity and cholesterol esterification was dramatically more sensitive to mevalonate in met-18b-2 cells than in progenitor cells. In cell extracts, both the rates of conversion of [3H]mevalonate to cholesterol and mevalonate kinase activities were similar for met-18b-2 and progenitor cells. In contrast to progenitor cells, met-18b-2 cells internalized [3H]mevalonate with high capacity (Km approximately 0.3 mM) kinetics. The increased uptake of [3H]mevalonate was temperature dependent and highly specific. These results suggest that met-18b-2 cells express a mevalonate transport activity that is not normally expressed by CHO cells. This activity may be due to a specific mevalonate transporter that is differentially expressed in specialized tissues. Because intracellular mevalonate in met-18b-2 cells can be labeled to high specific activity, these cells should prove very useful in further characterizing the structures of mevalonate derivatives and their metabolism. PMID- 3643926 TI - Effects of chemical modifications on the surface- and protein-binding properties of the light chain of human high molecular weight kininogen. AB - The light chain of kallikrein-cleaved human high molecular weight kininogen is solely responsible for its cofactor activity in blood clotting. Sequencing of the NH2-terminal region of the light chain reported herein identified the third kallikrein cleavage site of high molecular weight kininogen as Arg-437. The co factor activity of high molecular weight kininogen consists of the capacity to bind to negatively charged surfaces and to factor XI or prekallikrein. Chemical modification of the histidines by either photooxidation or ethoxyformic anhydride affected the equivalent of 14-16 of 23 histidines available and resulted in over 90% loss in procoagulant activity. The modified protein had drastically reduced surface- and zinc-binding capacity, but it bound successfully to either factor XI or prekallikrein. In contrast, modification of two carboxyl groups, which led to approximately 80-90% loss of procoagulant activity, seriously compromised protein binding but left surface binding unaffected. All 3 tryptophans were modified at pH 4.0 with N-bromosuccinimide with a 70% reduction in procoagulant activity, but only 1 tryptophan was available for reaction at pH 7.35, resulting in a 50% loss in activity. Tryptophan modification at acidic pH affected protein binding but did not modify surface or zinc binding. Modification of both available tyrosine and 9 of 18 available lysine residues did not have a significant effect on the procoagulant activity of the light chain. These studies indicate that histidines participate in surface binding and that free carboxyl groups and tryptophan side chains are involved in binding of high molecular weight kininogen to other clotting factors. PMID- 3643929 TI - Heteroresistant and nonheteroresistant methicillin-resistant Staphylococcus aureus. PMID- 3643928 TI - Detection of intrinsically resistant (heteroresistant) Staphylococcus aureus with the Sceptor and AutoMicrobic systems. AB - Modified procedures for the Sceptor Gram-Positive MIC Panel and the Vitek AutoMicrobic System GPS-M Card were evaluated for their ability to detect methicillin-resistant (heteroresistant) Staphylococcus aureus. A total of 398 clinical isolates (including 222 methicillin-resistant S. aureus) obtained from 10 hospitals were tested. Both systems had 2% NaCl in the oxacillin wells. Sceptor MIC panels were inoculated with an organism suspension prepared from an 18- to 24-h blood agar plate and were inoculated for a full 24 h at 35 degrees C before MICs were read. All methicillin-resistant S. aureus isolates were detected as resistant to oxacillin at greater than or equal to 8 micrograms/ml by the Sceptor method and at greater than 2 micrograms/ml by the Vitek method. All 176 oxacillin-susceptible, methicillin-susceptible S. aureus isolates were correctly distinguished from methicillin-resistant S. aureus isolates by Sceptor. However, with the Vitek system 29 methicillin-susceptible S. aureus isolates tested as falsely resistant to oxacillin and four isolates tested as falsely resistant to vancomycin. The modified testing procedure with the Sceptor system can be used reliably for accurate susceptibility testing of methicillin-resistant and methicillin-susceptible S. aureus. The Vitek GPS-M card does not accurately discriminate between methicillin-resistant and methicillin-susceptible S. aureus with an oxacillin breakpoint of greater than 2 micrograms/ml. PMID- 3643927 TI - Monoclonal antibodies in the analysis of fibronectin isoforms generated by alternative splicing of mRNA precursors in normal and transformed human cells. AB - Recent results showing that a single fibronectin gene can give rise to several different mRNAs by alternative splicing have offered an explanation for fibronectin polymorphism. Here we report on monoclonal antibodies that show specificity for a fibronectin segment (ED) that can be included or omitted from the molecule depending on the pattern of splicing of the mRNA precursors. Using these monoclonals, we have quantitatively analyzed the expression of the ED sequence in human fibronectin from different sources. The results demonstrated that, at the protein level, the ED segment is not expressed in plasma fibronectin and that, in fibronectin from the tissue culture medium of tumor-derived or simian virus-40-transformed human cells, the percentage of fibronectin molecules containing the ED segment is about 10 times higher than in fibronectin from normal human fibroblasts. These results suggest that in malignant cells the mechanisms that regulate the splicing of mRNA precursors are altered. PMID- 3643930 TI - Treatment of cerebrospinal fluid with formalin from patients infected with human immunodeficiency virus before diagnostic microscopy. PMID- 3643931 TI - Targets for health for all: implications for nurses, midwives and health visitors. PMID- 3643932 TI - The process of translating research findings into nursing practice. AB - Action research studies are described which involved nurse teachers, ward sisters and nurse managers in the processes of: nursing practice problem identification and the search for relevant research literature; the evaluation and synthesis of the collected literature; the identification of the need to change practice and the translation of the research synthesis into practice if warranted. The processes engaged in by the groups in each of the three phases in relation to the management of mouth care and preoperative fasting are analysed. The findings suggest that the demands of these processes are beyond the capacity of any one individual nurse and require systematic organizational approaches such as that proposed by quality assurance programmes. The need is emphasized for as much status and resources to be expended on the utilization of existing information as is given to the generation of new knowledge. PMID- 3643933 TI - Smoking behaviour of student nurses enrolled in diploma, associate degree and undergraduate nursing programmes. AB - Because the literature shows that cigarette smoking is a major causative factor in the occurrence of chronic illness, lung cancer is becoming more common in women than breast cancer, nurses smoke more than any other group of health care providers and studies have not examined differences of smoking among the associate degree, undergraduate and diploma levels of nursing, this study was designed to examine selected health behaviours and their relationship to cigarette use among Alabama senior student nurses, and to determine smoking prevalence by level of educational preparation. A sample of senior associate degree, undergraduate and diploma student nurses in Alabama responded to an 87 item questionnaire which was personally administered by the investigator in a classroom setting. Twenty-two of the 87 items were used to compile the demographics, prevalences and health behaviours reported here. The remaining items were used to develop a sequence of information required to test Ajzen and Fishbein's Theory of Reasoned Action and are beyond the scope of this article. Though there was no significant difference of smoking prevalence among educational levels, there was a trend for increased smoking from undergraduate to diploma level with prevalences of: total sample, 26.2%; diploma, 30%; associate degree, 26%; and undergraduate, 24%. Health behaviours which were significantly different between smoking and non-smoking student nurses were breakfast frequency and coffee consumption. Having a regular exercise routine was not significant. Males smoked significantly more than females. More older nurses (over 40 years) smoked than younger nurses. The findings reported here are useful to the development of health education strategies designed to reduce and prevent cigarette use among student nurses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3643934 TI - The journal publication process: the perspective of the nurse author. AB - This study's purpose was to describe the journal publication process from the perspective of the nurse author. A survey was mailed to 226 nurses who had published an article during the 1-year period. A variety of clinical, research, educational and administrative nursing journals were used to select the sample. Results suggested that authors: find communicating with editors helpful; think time from acceptance to publishing is too lengthy; publish to share their information and contribute to the body of nursing knowledge rather than for career advancement; generally do not use enquiry letters; and many did not know if the journal to which they submitted was referred. Further research on the views of authors who have had manuscripts rejected would clarify whether this process is similar for all authors. PMID- 3643935 TI - Testicular self-examination: teaching, learning and practice by nurses. AB - Testicular cancer is increasing in incidence, is now the commonest solid tumour in men aged 20-34 years and has a better prognosis when detected and treated early. Testicular self-examination is an effective self-screening procedure that is easily taught, learnt and practised. The aim of this study was to discover the extent of the teaching, learning and practice of this procedure by nurses. The data were collected by means of a questionnaire which was sent out to 60 nurses of various grades in one Sussex hospital. Nurses' knowledge of testicular self examination was found to be better amongst men than women, although over a half of female nurses did know of it. Their knowledge of groups at high risk of testicular cancer was incomplete. Whilst two-thirds of nurses saw the teaching of testicular self-examination as part of their role as health educators, very few had in fact taught it. It appeared that most male nurses do self-examine on a regular basis. The results indicate that nurses need to accept their responsibilities as health educators. Testicular self-examination should become an integral part of nurse training. Facilities and materials should be made available to assist nurses in disseminating such information. PMID- 3643936 TI - Attitudes and perceptions of nursing students toward preparation for interdisciplinary health care teams. AB - Using a modification of the Snyder's Health Care Team Questionnaire, the author conducted a study pertaining to attitudes of undergraduate nursing students toward health care teams, and perception of curriculum content on health care teams. The study design involved a random sample of 126 associate degree programmes and 122 baccalaureate degree programmes representing 14 southern states; 588 senior nursing students responded to the questionnaire. Analysis of the data collected suggested differences in attitudes of students. In addition, the data indicated that differences did exist between programmes on specific health care team concepts taught and settings chosen for clinical experiences. Differences were also detected between programmes in perception of readiness of the students to participate as health care team members, and the number of courses taught on health care teams. Data from an Interdisciplinary Health Care Team Questionnaire were analysed using univariate analysis of variance (ANOVA) with the total scale representing attitude as the dependent variable. The statistical design was a mixed model ANOVA with the type of nursing programme as the fixed factor with two levels: 'Associate Degree' and 'Baccalaureate Degree'. The School of Nursing was the random factor nested within programme type. PMID- 3643937 TI - Identification of older adults' perceptions of their health, feelings toward their future and factors affecting these feelings. AB - Controversy exists as to whether older adults living in the community perceive their health status positively or negatively. It is also not known how the elderly perceive their future. In 1982, the Halifax Social Planning Department conducted a survey to assess the health needs of 889 adults ranging in age between 50 and over 85 years and living in eight separate urban public housing accommodations. This descriptive study uses the responses to selected questions from this data bank to describe the subject's perceived health status, feelings about their future and factors affecting these feelings. Perceived health status was found to be the principal contributor to variance in scores of feelings about the future. The majority of respondents perceived their health to be good or excellent and 58% reported positive feelings about their future. PMID- 3643938 TI - The relationship between burnout and job satisfaction in nurses. AB - Nursing is a stressful occupation. This study, carried out on two groups of nurses, confirms the thesis that job satisfaction as measured by the Job Satisfaction Questionnaire designed for this study was a reliable indicator of burnout. It was expected that an inverse relationship between job satisfaction and burnout would be found. The hypothesis was that high job satisfaction would be associated with low burnout. It was found that a relationship exists between job satisfaction as measured by the Job Satisfaction Questionnaire and burnout as measured by the Maslach Burnout Inventory. PMID- 3643939 TI - Developing self-care skills and reducing institutionalized behaviour in a long stay psychiatric population: the role of the nurse in behaviour modification. AB - This paper examines the potential for behaviour modification in the rehabilitation of chronic, long-stay psychiatric patients and the impact such procedures may have on the work role of ward-based nursing staff. Through the use of five case histories the effectiveness of behavioural analysis and modification in encouraging self-help skills and constructive activity is identified. In addition to a critical examination of the clinical and organizational factors involved in patient improvement, it is argued that behaviour modification develops the therapeutic potential of nurses. The development of the patient teaching dimension of the nursing role not only fosters greater clinical responsibility, but also promotes both professional independence and institutional power. This is not to imply that the use of behavioural methods cannot be combined with customary nursing practices, for in many ways they provide nurses with an appropriate technology to achieve established therapeutic goals. In conclusion, it is noted that clinical success is not sufficient to ensure the acceptance of ward-based behavioural programmes. The critical issues concern conventional hospital and staff practices and institutional rigidity, not the commitment of nursing staff or patient improvement. PMID- 3643940 TI - Student and qualified midwives' attitudes to aspects of obstetric practice. AB - Midwife groups qualified for less than 5 years, 5-10 years and more than 10 years, and a group of student midwives, expressed degrees of agreement/disagreement with statements relating to aspects of obstetric practice. Responses were factor analysed and six interpretable rotated factors were obtained. Factors 1 to 3 represented 'patient-centred' attitudes to obstetric issues of increasing technicality. Factor 1 could be construed as a broad attitude to women's rights, factor 2 as an attitude to pregnant women's preferences being the main determinant of obstetric decisions of a relatively non technical nature and factor 3 as an attitude to pregnant women exercising control in relation to obstetric decisions where technical expertise may be a major consideration. Different patterns of factor score differences between the four length of qualification groups and between student nationality subgroups were found for these factors. Implications of these distinctive patterns for the training of midwives are discussed. PMID- 3643941 TI - Multi-dimensional approach: a task for curriculum development. AB - Curriculum development is an issue of continuing concern to nurse educators. For the planning model to be effective, it must be compatible with, and actually facilitate, the implementation of the particular programme or practice that is to be used. In nursing, the process of curriculum construction is predominantly influenced by the linear approach. This planning model which has taken over nursing education at all levels and in all content areas seems neutral, but it is not. It carries with it a particular value position on human nature. This paper examines the value position of the linear model and its limitation, and proposes a multi-dimensional model as a possible alternative. PMID- 3643942 TI - Nursing theory development: successes and challenges. AB - Central to this paper is the belief that developing nursing theory is fundamental to establishing nursing's scientific foundation. Therefore, the paper examines successes and challenges in nursing theory development. This is achieved by evaluating both the present status of nursing theory as well as ideas for future directions. Within present status, the author considers three areas--those in which there is agreement, those in which both opinions differ and the prescribed course of relationships has not yet been achieved, and those which may serve as catalysts for future progress. A tripartite framework is also used to contemplate future directions by evaluating how nursing's knowledge has developed, what improvements and refinements might take place, and how the domains of nursing might be expanded. The author concludes that satisfaction and pride in current successes are not only justified but may motivate future pursuits; pursuits that are necessary to advancing the discipline of nursing. PMID- 3643943 TI - Discharge planning: an exploratory study of the process of discharge planning on geriatric wards. AB - The elderly are a vulnerable group of people who are high users of hospital and community services. The transition from hospital to home is a crucial time for them. This paper reports the findings of an exploratory study into the process of discharge planning in four geriatric wards. It is suggested that discharge planning is not seen as a priority by ward nurses and doctors and that the present methods of communicating with patients in hospital need to be supplemented by written information. PMID- 3643944 TI - Evaluation of a nursing aides scheme for elderly people. AB - The need to provide appropriate domiciliary schemes to enable elderly people to remain in the community is of growing importance and while schemes have been initiated by health authorities, the majority of schemes have so far originated in social services departments. An evaluation of a nursing aides scheme is presented. The study examines the success of the scheme in maintaining elderly people in the community and the views and opinions of patients who have been in the scheme. On the basis of the available evidence it is likely that the intervention of the scheme enabled some elderly people to remain in the community and the majority (70%) of respondents believed that the nursing aides scheme had enabled them to stay at home. PMID- 3643945 TI - Recent advances in the care of children with acute diarrhoea: giving responsibility to the nurse and parents. AB - Five hundred million attacks of diarrhoea occur each year in children under 5 years of age, throughout the world, and acute gastroenteritis remains a frequent cause of admission to hospital in the United Kingdom. Current practice in the treatment of diarrhoeal dehydration in the UK is focused upon intravenous rehydration. Drugs (eg antibiotics, anti-emetics, anti-diarrhoeal agents and absorbents) are commonly prescribed, and 'therapeutic' starvation, followed by cautious reintroduction of diet, is recommended. Studies conducted by health workers in developing countries have challenged these dogma. Whilst intravenous rehydration is occasionally required (eg. in shock, ileus or coma) the majority of episodes of dehydration can be treated orally. Oral rehydration is less unpleasant than intravenous infusion, safer, quicker, cheaper and readily administered by parents with nursing supervision. Recovery may be hastened by continuing to breast feed and offer normal diet, and weight loss is minimized. These principles are being applied in pilot studies at The Children's Hospital, Birmingham. Outpatient treatment is largely supervised by trained paediatric nurses, after initial medical assessment of the child. Nurses are becoming more confident in the technique of oral rehydration, coupled with early reintroduction of food. This is reflected in less discomfort and weight loss for the child, less parental anxiety, decreased length of hospital stay, and financial savings. PMID- 3643946 TI - Emotional impact of possession loss. PMID- 3643947 TI - Relaxation Rx: slow stroke back rub. PMID- 3643948 TI - A study of differences in social support. PMID- 3643949 TI - Facets of dementia. Questions for the next decade. PMID- 3643950 TI - Identifying interest in gerontology. PMID- 3643951 TI - A review of the discharge preparation and initial community support given to families of neonates after surgical intensive care. PMID- 3643952 TI - Videotape modelling of communication skills in a coronary care unit. PMID- 3643953 TI - In need of intensive care--a personal perspective. PMID- 3643954 TI - Guillain-Barre syndrome--patients' and nurses' perspectives. PMID- 3643955 TI - The nursing care of patients receiving paralysing agents. PMID- 3643956 TI - Sharing resources in nursing. PMID- 3643957 TI - AIDS: the Georgia perspective. PMID- 3643958 TI - Dissociation between the ovarian factors controlling sexual receptivity and preovulatory secretion of LH in cyclic female rats. AB - Ovariectomy and treatment with oestradiol benzoate (10 micrograms OB) on the day before behavioural oestrus eliminated the preovulatory surge of LH and reduced the level of sexual receptivity on the following day. Sexual behaviour, but not the LH surge, was restored by progesterone (0.5 mg) given 18 h later. Injection of OB on the day after behavioural oestrus induced a small release of LH and normal sexual behaviour on the following day. Ovariectomy on the day after behavioural oestrus reduced the stimulatory effect of OB on sexual behaviour and eliminated its weakly stimulatory effect on LH release. Sexual behaviour, but not the small LH surge, was restored in these animals by progesterone (0.5 mg) given 18 h later. Treatment of rats ovariectomized 2 days before the day of the LH surge with implants containing oestradiol or injections of oestradiol (1 microgram) induced LH surges but the amplitudes of these LH surges were much smaller than those of the normal LH surge. Treatment of intact rats with OB increased serum progesterone levels 24 h later, an effect which was eliminated by ovariectomy. Injections of LH (20 micrograms) into intact rats on the day after behavioural oestrus also increased serum progesterone concentrations but failed to stimulate sexual behaviour. It is suggested that OB treatment of intact rats on the day after behavioural oestrus stimulates sexual behaviour by inducing a surge of LH secretion which activates ovarian secretion of progesterone. Thus, oestrogen and progesterone but not the LH surge are essential for sexual behaviour.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3643959 TI - The morphology of human immunodeficiency virus particles by negative staining electron microscopy. AB - Negative staining electron microscopy was used to examine culture fluids from the H9/HTLV-III cell line after concentration by centrifugation. Characteristic retrovirus-like particles bearing distinctive envelope projections were seen. The virion envelope was frequently extended in the form of a bleb or a tail. These particles were morphologically virtually indistinguishable from similar preparations of Friend murine leukaemia virus. H9/HTLV-III culture fluids contained, in addition, numerous comet-shaped particles with a dense head and flared tail. These particles were clumped by the addition of anti-HTLV-III positive serum suggesting that they may represent intermediate forms of the virus. PMID- 3643960 TI - A new look at the community: functional health pattern assessment. PMID- 3643962 TI - Beverly C. Flynn: 1986 Community Health Nurse of the Year. Interview by Arlene Cairns and Alice Schroeder. PMID- 3643961 TI - Client satisfaction with nursing center services. PMID- 3643963 TI - Pediculosis corporis and the homeless. PMID- 3643964 TI - Students do make a difference. PMID- 3643965 TI - Anorexia nervosa: case finding of families at risk. PMID- 3643966 TI - Marketing nursing programs: a revenue-sharing approach. PMID- 3643967 TI - Reducing staff turnover: the preceptor connection. PMID- 3643968 TI - A model linking education and practice. PMID- 3643969 TI - Trends in the evaluation of nursing inservice education programs. PMID- 3643970 TI - Toxic substances in the hospital environment. PMID- 3643971 TI - Teaching spiritual care of patients. PMID- 3643972 TI - Comprehensive staff development evaluation; the need to combine models. PMID- 3643973 TI - The human care perspective in nursing administration. AB - Current environmental and economic forces in health care delivery systems have dramatically influenced the practice of nursing administration. The concept of human care is presented as a basis for nursing leadership and management. Philosophical trends that impact the role of the nurse administrator are explored, with specific reference to the evolution of the concept of care as a central domain in nursing practice. Nursing administrators are urged to maintain and enhance the human caring values inherent in professional nursing practice. PMID- 3643974 TI - When is the recovering impaired nurse ready to work? A job interview guide. AB - A nurse administrator, interviewing a recovering nurse addict, needs a method to determine if the nurse is ready to return to work. Understanding the four phases of recovery (premotivation, breakthrough, early recovery, and extended recovery) is helpful in assessing the nurse's readiness. Believing recovering nurses are not ready for the demands of most nursing jobs until they reach the last phase of recovery, the author presents an interview guide to assist nurse administrators to make an assessment. PMID- 3643975 TI - A monitored treatment program for impaired health care professionals. AB - Employees who are motivated to seek treatment, return to the work place as productive employees in 85%-90% of the cases. The Monitored Treatment Program and contract between the employee and employer provide an objective data base for re entry. The program is multifaceted, approaching re-entry with active participation and involvement by all members of the rehabilitation team. Such a program can protect the institution from liability, while providing an appropriate response to impaired staff during the re-entry process. PMID- 3643976 TI - Variability in nurse staffing research. AB - Variability in nurse staffing research has existed and still exists in two major areas: the method of data collection and analysis, and the method of reporting. The authors take a broad look at these two areas of variability and consider the implications for future nurse staffing research. It has become imperative that nurses take responsibility for the determination of what constitutes nursing work and who should perform that work. PMID- 3643977 TI - When bad things happen to good nursing departments: how to stay hopeful in tough times. AB - How does a crisis impact a hospital? And how should nursing executives manage the crisis so that productivity and morale remain high? The purpose of this article is to trace an organizational crisis from its inception to its resolution. Every crisis has predictable components that if recognized will enable an administrator to diminish interpersonal hostility and conflict. Key strategies for resolving a crisis include sending objective messages to staff concerning the magnitude of the crisis, enlisting staff support in resolving problems contributing to the crisis, and projecting an optimistic vision of the future. PMID- 3643978 TI - Management education for nurses: a co-op graduate experience. PMID- 3643979 TI - Assessing staff competency. AB - In the absence of a national credentialing center for nursing and in the interest of ensuring competencies, Forbes Regional Health Center has developed a framework for internal credentialing. This framework, while initiated in a specialty area, has application to all areas of acute care including the medical-surgical areas. Program development within this framework provides a consistent, structured method of documenting selected clinical proficiencies and facilitates the achievement of individual learning needs. PMID- 3643980 TI - Being a proactive leader. PMID- 3643981 TI - Operationalizing a nursing philosophy. AB - A traditional philosophy statement can be transformed into a positioning statement that articulates a "vision" for a department of nursing and provides a framework when planning to thrive rather than merely survive in today's changing and competitive health care environment. Internal and external forces appropriately assessed enable nurse executives to empower staff to respond proactively to change and prepare for the future. PMID- 3643982 TI - Nursing and the corporate world. AB - As large corporations increasingly dominate the American economy, nurses are finding they need to know how they can influence corporate decision making. Nurses may interact with corporations in several ways: as an employee of a corporation, as a consumer of services or products of the corporation, as a beneficiary of corporate funds through grants or gifts to individual nurses, or to nursing groups or to community projects sponsored by nurses and others. This article discusses how nurses can interact with corporations on behalf of nursing and the general public. PMID- 3643983 TI - Hospital nursing education. Dispelling the doomsday prophesies. AB - Productivity is uppermost in the minds of most nurse executives. To protect patient caregivers, nurse educator and clinical specialist positions are being cut. Thus, for hospital nursing educational departments to survive, it is essential that the educational process be defined and include the expectations of the organization and employee as well as the means by which these outcomes can be measured. This article briefly analyzes the factors that have helped to create the current crisis, and then reviews the methods by which nurse administrators can provide some solutions without decimating their educational support services. PMID- 3643985 TI - Standards for clinically based nursing research. PMID- 3643984 TI - Formulating a restraint use policy. AB - When the federal government notified Canadian hospital administrators that several deaths had resulted from improper application of physical restraints, we decided to examine our nursing practice in relation to restraint use. The government communique indicated that at any one time, up to 10% of a hospital's patient population may be using some form of restraint. A hospital-wide survey indicated that 13.2% of our patients were managed with physical restraints and that insufficient documentation occurred. This was interpreted as a significant clinical-administrative problem and we recognized the need for a formal policy. Other adult care facilities can benefit from our experience in solving this dilemma. PMID- 3643986 TI - Nursing research methods to evaluate a change in practice. PMID- 3643987 TI - Nursing department purpose, philosophy, and objectives: their use and effectiveness. AB - The managerial structure provided by the documents of Purpose, Philosophy and Objectives is said to promote efficient and effective management. Since the delivery of cost-effective nursing care is particularly important in the current climate of cost containment, the use and effectiveness of this structure was investigated. References to desired nursing care from these documents were identified and tracked for evidence of implementation in 27 nursing departments. PMID- 3643988 TI - Chlamydia and condylomata acuminata: an update for the nurse practitioner. AB - The number of cases of the sexually transmitted diseases chlamydia and condylomata acuminata continues to increase. An overview of the diagnosis, treatment, possible disease sequelae, and patient education is presented as an update for the nurse practitioner. PMID- 3643989 TI - Nursing management of the infant with an intraoral appliance. AB - A recently developed intraoral device is being used for infants who require orotracheal and orogastric intubation. The purpose of the appliance is to prevent complications associated with long-term intubation, such as palatal groove formation, acquired cleft palate, defective primary dentition, and chronic irritation of the airway. The nursing care required for an infant with this intraoral appliance is described. The procedure for daily removal of the appliance, oral hygiene, and assessment of the oral cavity is presented. Other nursing interventions addressed include provision of non-nutritive sucking, initiation of oral feedings, and parent teaching and support. PMID- 3643991 TI - A conceptual framework for infertility. AB - Infertility is a life crisis situation for the couple who desires children. A conceptual framework for viewing the life crisis effects of infertility is presented. King's conceptual framework for nursing serves as the organizational scheme. The personal system, interpersonal system, and social system effects of infertility are described. PMID- 3643990 TI - Expectant grandparents class. AB - An expectant grandparents class was initiated in an attempt to bridge the communication gap observed between new parents and grandparents. Rather than focus on "how to grandparent," the goal of the class was to acquaint grandparents with changes in maternity and pediatric practices so that the grandparents might understand the parenting framework from which their daughter or son operated. Thus, tension might be reduced between the generations and support encouraged. More than 200 grandparents attended. A description of class content and grandparent response, which can be used as a guide for establishing classes, is provided. PMID- 3643992 TI - Ectopic pregnancy. AB - One out of every 100 to 300 pregnancies is ectopic, and the prevalence is increasing. The classic triad of symptoms; amenorrhea, abdominal pain, and abnormal bleeding, varies greatly among individuals, and ectopic pregnancies frequently are confused with other conditions, such as ovarian cyst, pelvic inflammatory disease, and spontaneous abortion. Ruptured ectopic pregnancies cause hemorrhage and shock and are the leading cause of maternal mortality in the first trimester. Although conservation surgery and tuboplasty have improved the fertility outlook of the ectopic patient, only one-third of such women will be delivered of a live baby. In this overview of ectopic pregnancy, the etiology, symptoms, physical findings, and management/treatment are presented. PMID- 3643993 TI - Newborn circumcision. AB - Newborn circumcision is the most common surgical procedure in the United States today. The decision to circumcise is deeply rooted in historical, psychosocial, and medical fact and fiction. Many parents are uninformed about the risks of circumcision, think circumcision is required by law, and receive inaccurate or insufficient instruction on the care of the uncircumcised child. Nurses need to present accurate information to parents and to help them sort through beliefs and feelings on circumcision. The nurse then needs to support the parents' decision. PMID- 3643995 TI - Antenatal education for cesarean birth: extension of a field test. AB - An exploratory study was conducted to compare responses of vaginally delivered and cesarean-delivered parents to an antenatal educational program of cesarean birth information and to determine the feasibility of incorporating the educational program into Lamaze childbirth preparation classes. Fifty-eight pregnant women and 57 male partners received the educational program. Mailed questionnaires were returned by 44 women and 42 men, representing 13 of the 15 cesarean deliveries and 31 of the 43 vaginal deliveries experienced by class participants. Findings indicated that the educational program met most of the parents' information needs, regardless of method of delivery. Study results suggest that childbirth educators must continue to seek ways to prepare expectant parents for unanticipated cesarean birth without causing undue distress. PMID- 3643996 TI - Exogenous surfactant therapy to prevent respiratory distress syndrome. PMID- 3643994 TI - A descriptive analysis of involuntary bearing-down efforts during the expulsive phase of labor. AB - A series of descriptive studies was carried out to characterize maternal respiration, type of bearing-down efforts, vocalization, and behavior; describe the obstetric conditions and intrauterine pressure associated with the bearing down reflex; and describe the duration of second stage, fetal heart rate, and neonatal outcomes when women bear down spontaneously. Thirty-one healthy nulliparous women who had received no formal childbirth education were neither directed nor instructed to bear down with contractions. The women were supported in their involuntary bearing-down efforts throughout the second stage of their labors while the above features of their labor were recorded. The findings suggest that labor progress is adequate and fetal outcome is good when the management of the expulsion phase of labor encourages maternal pushing that is complementary with the involuntary bearing-down reflex rather than sustained breath-holding. These findings support the necessity for further research regarding the bearing-down techniques used during labor. PMID- 3643997 TI - Interferon. PMID- 3643998 TI - Local anesthesia: not always benign. PMID- 3644000 TI - Paired for success: the nurse researcher and the statistician. PMID- 3643999 TI - Seeing eye to eye on physostigmine. PMID- 3644001 TI - Vacation with ease. PMID- 3644002 TI - AIDS. Psychosocial implications. PMID- 3644003 TI - Ego function. Enhancement through social interaction. PMID- 3644004 TI - Patient classification. Illness acuity and nursing care needs. PMID- 3644005 TI - Survivors of suicide. PMID- 3644006 TI - More on ECT. PMID- 3644008 TI - Development retardation in cultured preimplantation rabbit embryos. AB - Day 3 to Day 5 preimplantation rabbit embryos were cultured for 24 h in chemically defined media which are widely used in early embryo culture (BSM II and Ham's F-10) supplemented with BSA or homologous serum. For the next 24 h, the embryos were left in the same culture medium, placed in freshly made medium, or cultured in medium which was supplemented with uterine flushings. In addition, 24 h cultured embryos were transferred into uteri of synchronous recipients for 1 day. After culture or transfer, development was assessed by cell proliferation evaluated by incorporation of tritiated thymidine. In comparison to non-cultured controls, thymidine incorporation demonstrated a considerably impaired cell proliferation after culture in defined media irrespective of medium, supplement, or replenishment with fresh medium. For Day 3 embryos, there was a developmental retardation amounting to about 1 day after 2 days in culture. Compared to Day 3 embryos, delay was clearly more pronounced in Day 4 and Day 5 blastocysts, i.e. in stages which had been retrieved from the uterus before culture. Supplementation with uterine flushings markedly promoted blastocyst cell proliferation (P less than 0.001). Incorporation data examined after transfer showed that impairment of cell proliferation caused by 1 day in culture had been compensated for to a large extent within 1 day in utero. PMID- 3644007 TI - Sex roles and depression. PMID- 3644009 TI - Effect of glycerol on the penetrating ability of fresh ram spermatozoa with zona free hamster eggs. AB - The presence of 10% glycerol in diluted semen for 30-90 min before preincubation stimulated sperm penetration of zona-free eggs. Prolongation of semen storage in medium with glycerol did not further improve penetration ability. The penetrating activity of spermatozoa depended on the concentration of glycerol and incubation time. These results indicate that the presence of glycerol accelerates induction of the acrosome reaction which could be one of the causes of lower conception rate after insemination with deep-frozen ram semen. PMID- 3644010 TI - Exposure survey of civilian airport radar workers in Australia. AB - An exposure survey of civilian airport radar workers within Australia has been carried out over a two year period beginning late 1983. This paper describes the survey equipment, measurement procedures, radar characteristics and survey results. It was found that, unless working on open waveguide and/or components utilizing waveguide slots, or within transmitter cabinets when high voltage arcing was occurring, personnel were, in general, not exposed to levels of radiation exceeding the specified limits in the recently published Australian radiofrequency exposure standard. Recommended changes to work procedures as a result of the survey are also discussed. PMID- 3644011 TI - Automated microwave oven survey systems: evaluation criteria and procedures. AB - Criteria and evaluation procedures have been established to assess the measurement accuracy of Automated Microwave Oven Leakage Survey Systems. These criteria and procedures are based upon analytical characterizations of the oven leakage fields, measurement data and statistical analysis and experience gained from evaluation of hand-held oven survey instruments. Results of our evaluation of a typical survey system are presented. PMID- 3644012 TI - A macroscopic model of lungs and a material simulating their properties at radio and microwave frequencies. AB - Dielectric mixture theory was applied to develop an analytical expression describing the dielectric constant and conductivity of human lungs. The model consists of air spheres suspended in simulated whole blood in a 30:70 ratio (by volume). Material simulating these properties was tested in the frequency range from 100 MHz to 2 GHz showing a satisfactory agreement with the predicted values. PMID- 3644013 TI - Up- and downshoot in Duane's retraction syndrome. PMID- 3644014 TI - Results of overminus lens therapy on postoperative exodeviations. PMID- 3644015 TI - Bacterial flora of the conjunctiva at birth. PMID- 3644016 TI - Photographic artifacts. Make the diagnosis and correct the problem. PMID- 3644017 TI - Classifications of refractive errors. PMID- 3644019 TI - Augmentation of elastase-induced emphysema by cigarette smoke: effects of reducing tar and nicotine content. AB - The effects of reducing the tar and nicotine concentration of cigarette smoke were examined in a rat model of smoke-augmented, porcine pancreatic elastase- (PPE-) induced, pulmonary emphysema. Sixty-eight female Long-Evans rats were divided approximately evenly into seven groups: control, PPE, PPE plus sham smoke, high-tar/nicotine cigarette smoke (2R1; 38.8 mg total particulate matter and 2.2 mg nicotine per cigarette), low-tar/nicotine cigarette smoke (1R4F; 10.8 mg total particulate matter and 0.8 mg nicotine per cigarette), PPE + 2R1, and PPE + 1R4F. Three days after intratracheal administration of PPE (400 IU/kg), animals in the smoke-treated groups were exposed to 8-10 puffs of cigarette smoke daily, 7 d/wk for 12 wk. Sham-treated animals received room air in place of cigarette smoke. At the conclusion of the exposures, pulmonary function tests were performed under general anesthesia. Cigarette-smoke exposure alone did not produce significant changes in pulmonary function. Elastase-treated groups demonstrated significant increases in total lung capacity, functional residual capacity, and dynamic and static compliance, as well as significant decreases in carbon monoxide (CO) diffusing capacity and CO diffusion coefficient. Morphometric measurements of mean linear intercept demonstrated a loss of alveolar fine structure with enlargement of distal airspaces in PPE-treated rats. Exposure to either 2R1 or 1R4F cigarette smoke significantly enhanced many of the emphysematous changes produced by PPE, but there were no significant differences between the effects of the two smokes. These data indicate that reducing the tar and nicotine concentration of cigarette smoke does not lessen its ability to augment PPE-induced pulmonary emphysema in the rat. PMID- 3644018 TI - Comparison of the succinylcholine induced ocular position and the postoperative alignment in strabismus. PMID- 3644020 TI - Infection of brain-derived cells with the human immunodeficiency virus. AB - A malignant glioma cell line was infected with the human T-lymphotropic virus type IIIB isolate of the human immunodeficiency virus. Infection appeared to be latent rather than productive. Through contact with monocytic or lymphoid cells, the virus present in the glioma cells could be transmitted and gave rise to a fully productive infection. PMID- 3644021 TI - Recovery of human immunodeficiency virus from serum. PMID- 3644022 TI - Inhibitors of cholesterol synthesis and cataracts. PMID- 3644023 TI - [Recent status of the international epidemiology of AIDS]. PMID- 3644024 TI - [Definition of "maternity" based on the socio-ethnic structure of man]. PMID- 3644025 TI - [Historical changes in the maternal attitude]. PMID- 3644027 TI - [Social problems faced by modern mothers]. PMID- 3644026 TI - [Clinical aspects of the maternal attitude]. PMID- 3644028 TI - [In search of the structure of maternal psychology. A discussion]. PMID- 3644029 TI - [Women challenging natural childbirth]. PMID- 3644030 TI - [Attitudes of nursing personnel and the response of the obstetric patients: study on delivery at maternity facilities through questionnaires]. PMID- 3644031 TI - [Questions and answers on breast feeding. Management of lactation after fetal death or miscarriage]. PMID- 3644032 TI - [Customs concerning childbirth and child care. 22. Ceremonies for newborn infants]. PMID- 3644033 TI - [Perinatal nursing of mothers and infants: psycho-social approach. 10. Development of the maternal awareness of expectant mothers and their assistance: in relation to the process of acquisition of the maternal role]. PMID- 3644034 TI - [Drug metabolism by newborn infants]. PMID- 3644036 TI - [Educational evaluation (5). On cross computation]. PMID- 3644035 TI - [Description of childbirth by old farm women of Yuzurihara]. PMID- 3644037 TI - [Independence by a divorced mother with 3 children]. PMID- 3644039 TI - [Arrhythmia]. PMID- 3644038 TI - [Prolongation of stage 2 of labor]. PMID- 3644041 TI - [Classification of arrhythmia--clinical signs and symptoms]. PMID- 3644040 TI - [Assistance in self care of patients with implanted pacemakers]. PMID- 3644042 TI - [Diagnosis and care of arrhythmia. Interpretation of electrocardiographic patterns--normal sinus rhythm ECG]. PMID- 3644043 TI - [Tachyarrhythmia]. PMID- 3644044 TI - [Diagnosis of bradycardia]. PMID- 3644045 TI - [Diagnosis of arrhythmia. Fascicular block]. PMID- 3644046 TI - [Syndromes related to arrhythmia]. PMID- 3644047 TI - [Arrhythmia and cardiac pacing]. PMID- 3644048 TI - [Response to sudden changes in the clinical condition of patients with arrhythmia -nursing during an Adams-Stokes attack]. PMID- 3644049 TI - [Prevention and care of severe arrhythmia associated with acute myocardial infarction]. PMID- 3644050 TI - [Nursing keypoints in cardiac rehabilitation]. PMID- 3644051 TI - [Digitalis intoxication and arrhythmia--prevention and care]. PMID- 3644052 TI - [Electrolyte imbalance and arrhythmia]. PMID- 3644053 TI - [Arrhythmia in heart diseases and nursing keypoints]. PMID- 3644054 TI - [Care of patients with severe burns]. PMID- 3644055 TI - [Nursing of a patient with severe burns]. PMID- 3644057 TI - [Progress in cancer therapy. 12. Prostatic cancer]. PMID- 3644056 TI - [Evaluation of a mini-blood sedimentation test]. PMID- 3644058 TI - [Current clinical tests. 12. Simple reagents and instrumentation]. PMID- 3644059 TI - [Current information on pharmacology. 12. Anesthetics and analgesics]. PMID- 3644060 TI - [Current status and future problems of home nursing]. PMID- 3644061 TI - [Nursing duty and medicolegal problems. 12. Prevention of accidents]. PMID- 3644063 TI - [Selection of research methodology. Nursing philosophy and nursing research: in apposition or opposition?]. PMID- 3644062 TI - [Selection of research methodology. On the selection of methodology in nursing research]. PMID- 3644064 TI - [Selection of research methodology. Single subject research]. PMID- 3644066 TI - [Selection of research methodology. The phenomenological approach in nursing research]. PMID- 3644065 TI - [Selection of research methodology. Qualitative vs. quantitative research or qualitative and quantitative research?]. PMID- 3644067 TI - [Care function for old patients at home]. PMID- 3644068 TI - [Care function for old patients at home. Discussion]. PMID- 3644069 TI - [Depression in women: the challenge of treatment and prevention]. PMID- 3644070 TI - [The approach to the English monograph]. PMID- 3644071 TI - [Care of children with psychosomatic disorders in the home]. PMID- 3644072 TI - [Learning from the area: an attempt by Obihiro Nursing School Department of Public Health: seminars on health care theory and public health nursing]. PMID- 3644073 TI - [Learning from the area: discovery of health problems at Memuro-Machi--examples in the problems of water quality and tooth decay]. PMID- 3644074 TI - [Learning from the area. More extensive study through group work: difficult but gainful experience in the health care seminar. A discussion]. PMID- 3644076 TI - [Nursing in daily activities. 1. Eating and feeding]. PMID- 3644075 TI - [Learning from the area. Educational effects which cannot be duplicated in the classroom. A comment by an instructor]. PMID- 3644077 TI - [Nursing roots in pioneer public health nursing. 11. A strong tie with the inhabitants]. PMID- 3644078 TI - [Public health nursing with emphasis on selected areas. 6. From haphazard, independent activities to more coordinated joint activities]. PMID- 3644079 TI - [Housing and mental health]. PMID- 3644080 TI - [Home nursing within the framework of welfare. An example in an aged patient and her family]. PMID- 3644081 TI - [Professional nature and uniqueness of public health nursing: with special reference to a study on enuresis. V. Planning of public health nursing assistance -a preliminary statistical study]. PMID- 3644082 TI - Two is 100% more than one, but one is only 50% less than two. PMID- 3644083 TI - Impression from a Soviet-American educational tour. AB - During summer 1986, the author served as education leader for a professional tour of the Union of Soviet Socialist Republics. In this article, she recounts the group's experiences including a description of a polyclinic near Moscow and a sanatorium for children with rheumatic fever at Sochi. She shares her impressions of Soviet education and medicine from the perspective of a child health professional. PMID- 3644084 TI - Self-concept, stress symptomatology, and tobacco use. AB - This study examined psychosocial variables associated with cigarette use while controlling for developmental aspects of adolescence. The variables examined included self-esteem, home-esteem, peer-esteem, and adolescent symptomatology of stress. Nine hundred thirty-four students in grades four-12 from 12 schools in two southeastern Ohio counties participated in the study. Data were collected using the Hare Self-Concept Scale, the Adolescent Stress Symptomatology Scale, and a self-report tobacco use instrument. Multiple analyses of covariance were used and, if significant multivariate differences existed, univariate analyses were conducted. Results suggest adolescent cigarette use and intervention strategies should be viewed from a psychosocial and developmental perspective. PMID- 3644085 TI - Cancer knowledge and acceptance of children with cancer. AB - In this study, a Cancer Knowledge Questionnaire (CKQ) for elementary schoolchildren was developed and the relationship of cancer knowledge to attitudinal predispositions to accept and interact with children with cancer was assessed. CKQ includes 21 yes-no items that assess general cancer knowledge and knowledge of cancer's effects on social and emotional functioning. A sample of 478 children, ages six-12, completed CKQ, and a separate sample of 41 children completed it on two occasions separated by a one-week interval. Adequate internal consistency and test-retest reliability were obtained. Children's knowledge of cancer increased with age but generally was limited across all age groups. Knowledge of cancer was associated positively with previous experiences with cancer, lower fear of cancer, less worry about children with cancer, and attitudinal predispositions to accept and interact with children having cancer. PMID- 3644086 TI - Smokeless tobacco use by middle school males: a preliminary test of the reasoned action theory. AB - This study identified psychosocial variables associated with smokeless tobacco use within the context of the reasoned action theory. One hundred twelve male students, ages ten-14, completed a questionnaire that operationalized components of the theoretical model. Multiple regression analyses revealed intention to use smokeless tobacco correlated significantly with attitude toward the behavior and perceived social pressure. As predicted by the theory, significant differences between those who intended to use smokeless tobacco and those who did not were found on several outcome and normative beliefs. The data support the utility of the theory as a means of explaining smokeless tobacco use. Future research recommendations are offered. PMID- 3644087 TI - Advocating for school health education in New York. PMID- 3644088 TI - The silent gift: a project for spiritual health. PMID- 3644089 TI - [The meaning of "illness"--its mystery]. PMID- 3644090 TI - [The world of the patient and the world of the health personnel]. PMID- 3644091 TI - [Questions concerning illness seen in literature--on pathography]. PMID- 3644092 TI - [My experience with illness]. PMID- 3644094 TI - [Psychological impact of illness]. PMID- 3644093 TI - [My experience with central retinopathy and significance of nursing by family members]. PMID- 3644095 TI - [My experience with asthma]. PMID- 3644096 TI - [My encounter with illness--a lesson given by a blind person]. PMID- 3644097 TI - [Problems faced at the early learning stage in the course of "nursing process" and management of these problems--practice and evaluation stages]. PMID- 3644099 TI - [The family. 12. The problems of family members around the patient and their interference with nursing]. PMID- 3644098 TI - [Changes in sanitary napkins in Japan expressed by price fluctuations--from the initial marketing of disposable paper products to the present]. PMID- 3644100 TI - [Re-evaluation of white as an environmental color of a sick room--traditional responses of Japanese to colors]. PMID- 3644101 TI - [Attitudes of nursing students to daily lives and learning--a gap in the approaches by teachers and students]. PMID- 3644102 TI - [Nursing technology for nursing students in the degree-granting nursing course- effects of educational backgrounds on changes in learning]. PMID- 3644103 TI - [A focal point to nurture patient-nursing student interactions--through a process record by students in nursing training in clinical psychiatry]. PMID- 3644104 TI - [Prevention of urinary tract infections in patients with spinal cord injuries]. PMID- 3644105 TI - [Acute pneumonia]. PMID- 3644106 TI - [Physiopathology of brain tumors and prognosis of patients]. PMID- 3644107 TI - [Diagnosis and therapeutic processes for patients with brain tumors]. PMID- 3644108 TI - [Keypoints in nursing observation of patients with brain tumors]. PMID- 3644109 TI - [Nursing plan for patients with brain tumors]. PMID- 3644110 TI - [Nursing process. Nursing of a patient with acoustic neuroma: deficiency in understanding anxiety of the uncomplaining patient]. PMID- 3644111 TI - [Recreational activities of inpatients--planning of a Christmas party]. PMID- 3644112 TI - [The problem of diet in the interactions with a diabetic patient]. PMID- 3644113 TI - [Test yourself: keypoints in nursing. Nursing of a patient undergoing surgery of sigmoid cancer]. PMID- 3644114 TI - [Nursing of a hospitalized child with Kawasaki disease--nursing actions for a child at the age when daily life activities are established]. PMID- 3644115 TI - [The nursing process and patients. Disposition of the information collected from patients]. PMID- 3644116 TI - [Images of patients distorted by expressions used in problems in nursing]. PMID- 3644117 TI - [Recording and evaluation of nursing of patients without "problems"]. PMID- 3644118 TI - [The "nursing process" to meet the needs of patients]. PMID- 3644119 TI - Unity for education. PMID- 3644120 TI - In defence of mental handicap nursing. PMID- 3644121 TI - Project 2000. PMID- 3644122 TI - Lets be friends. PMID- 3644123 TI - Only the cleaner. PMID- 3644125 TI - The intensive care unit. PMID- 3644124 TI - Are animal tests justified. PMID- 3644126 TI - AIDS and its impact on cancer nursing. PMID- 3644127 TI - [Prevalence of anti-HTLV-III antibodies in volunteer blood donors in Guipuzcoa]. PMID- 3644128 TI - [Absence of antibodies of acquired immunodeficiency syndrome virus in patients with collagenosis]. PMID- 3644129 TI - The emotional impact of multiple pregnancy--the midwife's role in support of the family. PMID- 3644130 TI - Case study: congenital hypertrophic pyloric stenosis in twins. PMID- 3644131 TI - Case study: cryptosporidiosis complicating pregnancy and the puerperium. PMID- 3644132 TI - [Comprehensive care of patients with respiratory insufficiency]. PMID- 3644133 TI - [Regional oxygen inhalation care system--an experience at Denver, Colorado]. PMID- 3644134 TI - [Home nursing of patients dependent on oxygen inhalation therapy at home- significance and possibility of home nursing]. PMID- 3644135 TI - [Quality of life and nursing of patients with respiratory insufficiency]. PMID- 3644136 TI - [Importance of respiratory rehabilitation--a viewpoint of a physical therapist]. PMID- 3644137 TI - [Regional nursing and quality of life of patients with respiratory insufficiency: creation of a system of support. A discussion]. PMID- 3644138 TI - [Support of a nursing system for patients requiring respiratory care: regional nursing and quality of life of patients with respiratory insufficiency]. PMID- 3644139 TI - [Projection of intra-operative complications based on pre-operative information- preparation of a list of important data]. PMID- 3644141 TI - [The structure of trust]. PMID- 3644140 TI - [Guide in terminal care: a learning experience from the attitude of a former nurse who was admitted as a patient with lung cancer]. PMID- 3644142 TI - AIDS and illiberal measures. PMID- 3644143 TI - The hidden dangers of AIDS vaccination. PMID- 3644144 TI - Extra MRC funds earmarked for AIDS research in Britain. PMID- 3644145 TI - Immunization against AIDS in humans. PMID- 3644146 TI - [Study on antibodies against human immunodeficiency virus in Amsterdam and Rotterdam]. PMID- 3644147 TI - [Synopsis of the 3d Public Health Council recommendation concerning AIDS: guidelines for group screening and recommendations for prevention]. PMID- 3644148 TI - Royal College of Nursing. Echoes the needs. PMID- 3644150 TI - Golden opportunity to redress the past. PMID- 3644149 TI - Extended role versus accountability. PMID- 3644151 TI - A good performance. PMID- 3644152 TI - Royal College of Nursing. Crystal clear. PMID- 3644154 TI - Who dares wins? PMID- 3644153 TI - Strong co-operation. PMID- 3644155 TI - Responding to the AIDS crisis. PMID- 3644156 TI - New England Deaconess guidelines for the administration of i.v. drugs. PMID- 3644157 TI - The syringe infusion pump system--its effect on phlebitis rates. PMID- 3644158 TI - Evaluation of implanted infusion devices. PMID- 3644159 TI - Evaluating and selecting i.v. equipment. PMID- 3644160 TI - Community education program helps clients help themselves. PMID- 3644162 TI - Specialization and graduate curricula: finding the fit. PMID- 3644161 TI - Instrument credentialing: assessing measurement instruments. PMID- 3644163 TI - Nursing's diverse master's programs: the state of the art. PMID- 3644164 TI - Attuning staff nurses to clinical research. PMID- 3644165 TI - Home health aide program hits the mark. PMID- 3644166 TI - Primaxin: an antibiotic for (nearly) all bacterial infections. PMID- 3644167 TI - Why jessie can't rest. PMID- 3644168 TI - Preterm labor. PMID- 3644169 TI - The three degrees of burn care [continuing education credit]. PMID- 3644170 TI - Don't overlook "routine" orders. PMID- 3644171 TI - 7 ways to win your patient's trust. PMID- 3644172 TI - Practice may make perfect but research makes a difference. PMID- 3644173 TI - Lab tests you can't overlook. Part II. PMID- 3644174 TI - Suppressing the risks of bone marrow suppression. PMID- 3644175 TI - Should you irrigate an occluded i.v. line? PMID- 3644176 TI - 3 fast steps to better patient care plans. PMID- 3644177 TI - Pete's story. PMID- 3644178 TI - The UKCC code of conduct. PMID- 3644180 TI - The extended role of the nurse. PMID- 3644179 TI - The UKCC code of conduct: accountability and implications. PMID- 3644181 TI - Contemporary ethics. PMID- 3644182 TI - Data protection. PMID- 3644183 TI - Documentation. PMID- 3644184 TI - Employment law and nurses. PMID- 3644185 TI - Negligence. PMID- 3644186 TI - The UK legal system. PMID- 3644187 TI - Tools of the trade. PMID- 3644188 TI - The ups and downs of nursing. PMID- 3644189 TI - What's it like to be an occupational health nurse? PMID- 3644190 TI - In business--how one nurse turned a small investment into a small fortune.. Interview by Rose G. Foltz. PMID- 3644191 TI - Are you a winner? PMID- 3644193 TI - Prospective payment: the crunch continues. PMID- 3644192 TI - Discharging patients: do you know all your legal risks? PMID- 3644194 TI - Responding to the violent patient. PMID- 3644195 TI - Recognizing a patient's potential for violence. PMID- 3644196 TI - When you supervise more-experienced colleagues. PMID- 3644198 TI - For this nurse, action was the answer. Interview by Dorothy A. Barash. PMID- 3644197 TI - Medication errors--what happens afterward? PMID- 3644199 TI - Louise needed support--and we almost let her down. PMID- 3644200 TI - Constructive criticism: building blocks to improved performance. PMID- 3644201 TI - What you can do to prevent increased I.C.P. [continuing education credit]. PMID- 3644202 TI - A subtle difference. PMID- 3644204 TI - [The nurse and drug dependence--a reality]. PMID- 3644203 TI - [The shock of mastectomy]. PMID- 3644205 TI - [At home alone ... "latchkey children"]. PMID- 3644206 TI - [The nurses of rehabilitation centers will at last be visited]. PMID- 3644207 TI - [A new image for a new reality]. PMID- 3644208 TI - [Denise Lalancette, a born leader. Interview by Nicole Rodrigue]. PMID- 3644209 TI - What professional image do we want to reflect? PMID- 3644210 TI - [Mildred N. Charlton or the voice of the forgotten. Interview by Nicole Rodrigue]. PMID- 3644211 TI - [The role of nursing in rehabilitation]. PMID- 3644212 TI - [Cytostatic drugs as health risks]. PMID- 3644213 TI - [Clinical studies--a first report on experiences]. PMID- 3644214 TI - [Nursing practice in foreign countries]. PMID- 3644215 TI - [Emancipation from the female role--prerequisite for emancipation from the professional role of the nurse. I. Image of woman, image of the nurse]. PMID- 3644216 TI - Q.U.E.S.T.: a process of pain assessment in children (continuing education credit). PMID- 3644217 TI - Interactive aspects of pain assessment. PMID- 3644218 TI - Total hip replacement. PMID- 3644219 TI - Patient-controlled oral analgesia. PMID- 3644220 TI - Radiology review (slipped capital femoral epiphysis). PMID- 3644221 TI - The legal aspects of medications. PMID- 3644222 TI - Nursing: exerting influence for the future. PMID- 3644223 TI - [Pathology of HTLV III/LAV virus infection]. PMID- 3644224 TI - Marketing the PNP to day-care centers. PMID- 3644225 TI - Assessing jaundice in full-term newborns. PMID- 3644226 TI - Concerns of parents with diabetic children. PMID- 3644227 TI - Chronic childhood illnesses: developmental issues. PMID- 3644228 TI - Family adaptation to cystic fibrosis. PMID- 3644229 TI - Misdiagnosed child abuse and metabolic diseases. PMID- 3644230 TI - Pediatric management problems (tinea capitis). PMID- 3644231 TI - Drug interactions with carbamazepine. PMID- 3644232 TI - Hypothesis testing: scientific roulette. Will the application of topical lidocaine reduce the pain of circumcision? PMID- 3644233 TI - New guidelines for pediatric & neonatal cardiopulmonary resuscitation & advanced life support. Part III: Neonatal advanced life support. PMID- 3644234 TI - Location and sequence of the maize chloroplast gene for tRNAser (GCU); a third serine isoaccepting tRNA. PMID- 3644236 TI - Nucleotide sequence of the pea chloroplast tRNA-Thr(GGU) gene and flanking regions. Comparison to the Vicia faba sequence. PMID- 3644235 TI - Human glutamate tRNA forms stable hybrids in vitro with 28S ribosomal RNA. AB - A human glutamate tRNA has been shown to form stable hybrids with 28S ribosomal RNA. This tRNA was purified from HeLa cell cytoplasmic RNA by RNA-RNA solution hybridization followed by the isolation of tRNA-28S rRNA complexes by hybridization-selection with ribosomal DNA or by recovery of the 28S peak from formamide-sucrose gradients. The single hybridizing tRNA species was identified as tRNAGluCUC by sequencing: pU-C-C-C-U-G-G-U-G-m2G-U-C-phi-A-G-U-G-G-D-phi-A-G-G A-U-U- C-G-G-C-G-C-U-C-U-C-A-C-C-G-C-G-G-C-m5C-m5C-G-G-G-Tm-phi-C-G-A- U-U-C-C-C G-G-U-C-A-G-G-G-A-A-C-C-AOH. Computer analysis located a nucleotide sequence near the middle of human 28S rRNA which is complementary to 15-26 nucleotides between residues 20 and 50 of this tRNA. An interaction between this tRNA and 28S rRNA suggests that tRNAGluCUC may have functions in the cell in addition to translation. PMID- 3644238 TI - The nucleotide sequence of a valine accepting tRNA from Lupinus luteus (lupin) seeds. PMID- 3644237 TI - Regulated expression of chimaeric genes containing the 5'-flanking regions of human growth hormone-related genes in transiently transfected rat anterior pituitary tumor cells. AB - The expression and hormonal regulation of chimaeric genes containing the 5' flanking regions of the normal human growth hormone (hGH-1), the variant hGH (hGH 2) and chorionic somatomammotropin (hCS-1) genes fused to the chloramphenicol acetyl transferase (CAT) gene has been examined after transient transfection into cultured rat pituitary (GC), and non-pituitary (HeLa and Rat 2) tumor cells. As assessed by levels of CAT activity, the hGH-1 and hCS-1 gene hybrids were expressed at 5- to 25-fold higher levels in GC cells than in HeLa or Rat 2 cells. The hGH-2 gene hybrid was expressed at very low levels in all 3 cell types. Triiodothyronine treatment of transiently transfected GC cells had little effect on CAT activity from the hGH-1 gene hybrid but increased CAT activity from the hCS-1 gene hybrid. A slight but significant increase in CAT expression was detected with both genes after dexamethasone treatment. The data indicate that elements present on the hGH-1 and hCS-1 genes' 5'-flanking DNA are required for the efficient expression of these genes in GC cells. PMID- 3644239 TI - Assembly of pre-mRNA splicing complex is cap dependent. AB - To study the influence of the ubiquitous cap structure of nuclear pre-mRNAs on the assembly of a functional splicing complex, the in vitro splicing of a truncated human metallothionein pre-mRNA was examined in the presence of the cap analogue m7GTP. Significant inhibition of splicing was observed at a concentration as low as 5 microM m7GTP. Analysis of the splicing reaction on glycerol density gradients showed two complexes sedimenting at 45S and 22S. When the reaction was carried out in presence of m7GTP a marked decrease of the material sedimenting at 45S, representing the active splicing complex, was observed. When capped pre-mRNA was replaced by uncapped pre-mRNA, complex formation was significantly reduced. These data indicate that the cap structure plays an important yet unknown role in the assembly of spliceosomes. PMID- 3644240 TI - Acting as an expert witness: a professional responsibility. PMID- 3644241 TI - State board criteria for licensure and disciplinary procedures regarding impaired nurses. PMID- 3644242 TI - Developing a focused research effort. PMID- 3644243 TI - Effective responses to sexual harassment. AB - Sexual harassment is a frequent problem for visiting nurses and other community health workers. The Sexual Harassment Intervention Model is offered as a preliminary method for organizing data for assessment and designing intervention strategies. PMID- 3644244 TI - An approach to nursing curriculum evaluation. PMID- 3644245 TI - Instructional objectives in patient education. PMID- 3644246 TI - Student evaluation of teaching: potential and limitations. PMID- 3644247 TI - Teaching students observational skills. AB - Students need to learn to observe specific details about patients and patients' environments in order to make accurate assessments and give quality nursing care. However, nursing faculty cannot expect students to be able to master observational skills without specific assistance in learning how to observe as well as what to observe. PMID- 3644248 TI - Public health nursing requires grassroots activism. PMID- 3644249 TI - Perceptions of staff nurses' perinatal continuing education needs. PMID- 3644250 TI - How parents cope with a child with cystic fibrosis. PMID- 3644251 TI - Articulation and baccalaureate entry to practice: the Canadian context. PMID- 3644252 TI - Learning projects of mothers of preterm and low birth weight infants. PMID- 3644253 TI - Perceptual and behavioural effects of immobility and social isolation in hospitalized orthopedic patients. PMID- 3644254 TI - Profile of the well-controlled, well-adjusted hypertensive patient. AB - The study purpose was to identify discriminant predictors of blood pressure control and adjustment to chronic illness in 450 hypertensive patients. Hypertension control was determined by physician judgment, and adjustment was assessed by Derogatis' (1977) Psychosocial Adjustment to Illness Scale. Potential predictors of the outcome variables were measured by structured interview, formal instruments, and chart review. Well-controlled hypertensive patients had better health adjustment scores, reported more illness-related job problems and less illness-related sexual problems, were more satisfied with health care, knew what to do about medication side effects, were on medications longer, and had lower blood pressure readings on chart review. Well-adjusted hypertensive patients had fewer hypertension-related problems; had their blood pressure under control; were less likely to eat, smoke, or use drugs to handle tension; had no recent weight gain; knew what to do about medication side effects and that there is no cure for hypertension; were less pessimistic and less likely to worry; rated their stress level lower and their quality of life higher; felt that their health was under their own control; tried to problem solve when coping with stress; were on hypertensive medications a shorter time and on fewer medications overall; did not like to be alone when feeling stressed; and ate fewer high sodium foods. PMID- 3644256 TI - Re: 'Off with their heads!'. PMID- 3644255 TI - Doctoral education in nursing: an assessment of quality, 1979-1984. AB - The growth and change in the quality of doctoral education from 1979 to 1984 was assessed using a repeated-measures design. Data were analyzed from 14 nursing doctoral programs that participated in both a 1979 and a 1984 study using Educational Testing Service Graduate Program Self-Assessment questionnaires. Findings suggest that doctoral programs experienced a significant growth and maintained a quality environment. Faculty demonstrated an increased commitment to scholarly activities as evidenced by an increase in publications, presentations, and perceptions of time spent on such projects. Students admitted in 1984 had higher entrance grade point averages than students admitted in 1979; more pursued their graduate education on a part-time basis. The evidence documents a growing scholarly maturity in nursing doctoral programs. PMID- 3644257 TI - Factors related to women's practice of breast self-examination. AB - Factors related to women's practice of breast self-examination (BSE) were studied in a sample of upper-middle-class women attending meetings of voluntary women's groups. Factors found to relate directly to frequency of BSE practice were high perceived benefits of BSE, low perceived barriers to BSE, and high self-concept. Correlations with perceived susceptibility/seriousness of breast cancer, age, perceived level of social support, and social network properties were not significant. A multiple regression analysis was done with BSE frequency as criterion variable: perceived threat (susceptibility/seriousness) and perceived benefits minus perceived barriers were entered hierarchically; age, self-concept, and total social support were entered as a group. Perceived benefits minus barriers was the only significant predictor variable, R2 = .27. These findings underline the importance of assessing detective behaviors such as BSE as potentially different from preventive behaviors. PMID- 3644258 TI - Taking sides: a response to Goodwin and Goodwin. PMID- 3644259 TI - Testing linear model assumptions: residual analysis. PMID- 3644260 TI - Multiple regression analysis with small samples: cautions and suggestions. PMID- 3644261 TI - Re: 'Stress in ICU and non-ICU nurses'. PMID- 3644262 TI - The Health-Promoting Lifestyle Profile: development and psychometric characteristics. AB - This article describes the development and initial psychometric evaluation of an instrument to measure health-promoting life-style. Based on responses from 952 adults in midwestern communities, the Health-Promoting Lifestyle Profile was evaluated using item analysis, factor analysis, and reliability measures. Factor analysis isolated six dimensions: Self-Actualization, Health Responsibility, Exercise, Nutrition, Interpersonal Support, and Stress Management. These six factors accounted for 47.1% of the variance in the 48-item measure. Second-order factor analysis yielded a single factor, interpreted as Health-Promoting Lifestyle. The alpha reliability coefficient for the total scale is .922; alpha coefficients for the subscales range from .702 to .904. Further evaluation of the measure with different populations appears warranted. This instrument will enable researchers to investigate patterns and determinants of health-promoting life style, as well as the effects of interventions to alter life-style. PMID- 3644263 TI - Development of the Scale of Humanistic Nursing Behaviors. AB - The purpose of this study was to develop a reliable and theoretically based scale to measure the degree of humanistic health care in hospital settings as perceived by nursing personnel. Howard's (1975) theoretical model of dimensions pertinent to the domain of humanistic care was used to structure the scale. The dimensions are irreplaceability, holistic selves, freedom of action, status equality, shared decision making and responsibility, empathy, and positive affect. A 163-item scale reflective of Howard's dimensions was developed and distributed to 316 nursing personnel employed in four hospitals which included public, private, community, and university-affiliated health care facilities. Rigorous application of reliability and validity indexes yielded a final scale of 70 items measuring four dimensions: shared decision making and responsibility, holistic selves, status equality, and empathy. The Scale of Humanistic Nursing Behaviors can be used both as a diagnostic aid and as an instructional device. PMID- 3644264 TI - On the prevalence of causal search in illness situations. AB - The prevalence of causal search was examined in two samples, one of chronically ill patients, the other of acutely ill patients. In contrast to the assumption that causal search occurs in important or unexpected life events, the results indicated that such a search was reported by only about half of 296 long-term diabetic, hypertensive, and arthritic patients and 83 newly diagnosed myocardial infarction patients. Moreover, in both samples, affect and expectancies for the future were better for those who had not engaged in causal search. Further research to examine the questions used to elicit causal responses and to test the assumption that causal thinking takes place is suggested. PMID- 3644266 TI - Project 2000. Ready for lift-off? PMID- 3644265 TI - Analyses of coping responses and adjustment: stability of conclusions. AB - This study was conducted to determine the stability of conclusions derived from analyses of different ways of scoring coping responses in relation to the adjustment of subjects who had survived a burn injury. As part of a larger study of adjustment to burn injury, 260 adults who had sustained a burn injury over a 12-year period consented to complete the Billings and Moos Coping Responses Scale (CRS; Moos, Cronkite, Billings, & Finney, 1984) and the Psychosocial Adjustment to Illness Scale (PAIS; Deragotis & Lopez, 1983). A clinician made a global assessment of each subject's adjustment. Three ways of scoring the CRS were used for analyses: Method and Foci of coping (Indices of Coping Responses), as suggested by Moos et al. (1984), new factor analysis, and separate responses. Stepwise multiple regression analysis of each of these with three different outcomes of adjustment (PAIS, global clinical judgment scores, and the PAIS psychological distress component) gave consistent results. The more adjusted burn survivors used more problem-solving coping responses and fewer avoidance responses. The two responses in the individual multiple regression analysis gave a higher correlation than the factor or index descriptors. These two responses correlated well with all three adjustment outcomes, r = .49, .37, and .47. The relationship between coping behavior and adjustment to illness was not sensitive to the different ways of scoring the CRS. PMID- 3644267 TI - Hypothermia: the cold that kills. PMID- 3644268 TI - An attack of conscience? PMID- 3644269 TI - Nurses and doctors. Your disobedient servant. PMID- 3644270 TI - Nurses and doctors. The burden of history. PMID- 3644271 TI - Nurses and doctors. Redefining roles. PMID- 3644272 TI - Cannulation of arteriovenous fistulae. PMID- 3644273 TI - Interview technique. PMID- 3644274 TI - Psychiatric skills: preventive measures. PMID- 3644275 TI - Nurse recruitment. A shared future. PMID- 3644276 TI - Nursing aid. Saving lives in the Sudan. PMID- 3644277 TI - Stress: who cares? PMID- 3644278 TI - Supplement: stoma care. Down to basics. PMID- 3644279 TI - Supplement: stoma care. Restorative proctocolectomy to avoid a stoma. PMID- 3644280 TI - Ritual pursuits. PMID- 3644281 TI - I. Cardiac monitoring. PMID- 3644282 TI - Continuous EKG monitoring systems. AB - This article discusses the employment of continuous electrocardiographic (EKG) monitoring as a tool utilized by the nurse to augment his/her expert assessment skills. The components of the EKG monitoring system and their specific functions are addressed with special emphasis on the importance of proper lead attachment, alarm settings, and documentation of the rhythm strips. Specific techniques for preventing and/or trouble-shooting monitoring problems are also presented. PMID- 3644283 TI - Noninvasive cardiac monitoring. AB - Several noninvasive techniques are currently utilized to safely assess cardiac function beyond the limits of the physical examination and EKG. These studies can accurately document rhythm and valvular abnormalities as well as the heart's ability to withstand stress. Results of these tests provide a solid base on which to decide if invasive diagnostic or therapeutic modalities may be required. PMID- 3644284 TI - II. Ineffective breathing patterns and airway clearance. PMID- 3644285 TI - Ineffective airway clearance and ineffective breathing patterns: theoretical and research base for nursing diagnosis. AB - This article addresses the conceptual approach to nursing diagnosis in general and the theoretical and research base for these two nursing diagnoses. Pertinent issues concerning the use of nursing diagnoses in clinical practice are presented within the framework of the nursing process. This is followed by a review of mechanisms of airway clearance and normal breathing patterns which form the theoretical basis for the subsequent articles on alterations in airway clearance and breathing patterns. PMID- 3644286 TI - Monitoring the patient with acute myocardial infarction. AB - Cardiac monitoring is a vital component in the management of the patient with AMI. Knowledge of the age, location, and extent of an MI and effective use of continuous cardiac monitoring will aid the nurse in anticipating, identifying, and treating potential complications. PMID- 3644287 TI - Ineffective airway clearance related to neuromuscular dysfunction. AB - Individuals with neuromuscular dysfunction are at increased risk for secretion retention. Their underlying disease process compromises or prevents ability to cough effectively. Although their lung function may remain normal, neuromuscular disease predisposes to breathing at low lung volumes and to elimination of sighing respirations, a breathing pattern which predisposes to development of airway and alveolar collapse. As ventilatory reserve decreases, risk of progressive atelectasis and secretion retention is increased. Prompt recognition of the signs and symptoms of this nursing diagnosis can prevent or reverse problems relating to ineffective airway clearance. Nursing management thus becomes the cornerstone of the individual's regimen of care. PMID- 3644288 TI - Ineffective breathing pattern related to decreased lung expansion. AB - This article reviews the general pathophysiology of restrictive processes that cause decreased lung expansion. It describes their clinical features and illustrates how these restrictive disorders lead to an altered breathing pattern related to decreased lung expansion. It also shows how nurses intervene and manage the manifestations of the decreased lung expansion. PMID- 3644289 TI - Ineffective breathing pattern related to malnutrition. AB - This article has highlighted the problem of malnutrition in the stable COPD patient and the critically ill, hypercatabolic patient, and has reviewed resultant mechanisms which influence the alteration of breathing pattern. These complex patients present a challenge for the nurse. Table 1 briefly summarizes the manifestations of malnutrition, goals, interventions and expected outcomes of the nursing diagnosis, ineffective breathing pattern related to malnutrition. The goal of the interventions is to modify the cause (malnutrition) of the nursing diagnosis (altered breathing pattern). The success of the interventions will lead to the achievement of expected outcome As expected outcomes are achieved, relief of signs and symptoms related to the nursing diagnosis will occur. The nurse caring for the patient with actual or potential malnutrition must be knowledgeable about the physiology of malnutrition and effect on breathing pattern. It is essential that the nurse assess and provide appropriate nutritional support and evaluate progress toward expected outcomes. In the event that expected outcomes are not achieved, reassessment with modification of interventions is necessary. Nurses play a key role in the total health care delivery to these complex patients. Further study will strengthen the research base of nursing interventions. PMID- 3644290 TI - Monitoring the patient with conduction disturbances and blocks. AB - Intracardiac block can occur anywhere from the sinus node to the far reaches of the ventricular conduction system. A common site is in the AV junctional area. Block in this region ranges from simply an increased conduction time across the AV junction (first-degree block) through occasionally blocked conduction of supraventricular impulses (second-degree block) to selective block in the ventricular conduction system (BBB and hemiblocks) and finally to complete block of impulses between the atria and the ventricles. When complete block occurs, the heart is stimulated by two separate pacemakers, one above the AV node, usually the sinus node, and one below the block, either an intrinsic pacemaker or an implanted electronic device. For block to be recognized in monitored patients, the EKG lead chosen must be one in which both atrial and ventricular electrical activity can be clearly identified. PMID- 3644291 TI - Monitoring the patient with supraventricular dysrhythmias. AB - Supraventricular dysrhythmias are abnormalities in the rhythm of the heart caused by ectopic impulses originating from the SA node, atria, and AV junction. Certain electrocardiographic characteristics facilitate identification of these dysrhythmias. Supraventricular dysrhythmias are not as dangerous as ventricular dysrhythmias, but they may affect the patient's cardiovascular function significantly. The effects of supraventricular dysrhythmias on the patient are physiologic--those relating to changes in cardiac output and cardiac workload- and psychological--those relating to the patient's perception of the sensations associated with the dysrhythmia. The nurse plays an important role in the care of patients with supraventricular dysrhythmias. Nursing functions include prompt identification and appropriate management consistent with the medical and nursing plans, alleviation of anxiety, and patient education. PMID- 3644292 TI - Essentials of monitoring the electrocardiogram. AB - The electrocardiogram is a useful noninvasive source of information on the various functions and dysfunctions of the heart. With it we can easily detect dysrhythmias and conduction abnormalities, anatomic orientation of the heart, hypertrophy of individual chambers, ischemia or infarction, electrolyte and chemical abnormalities, and drug toxicity. Since each abnormality produces distinctive tracings on the electrocardiogram, the nurse must be able to evaluate the patient's cardiac function when presented with clinical signs and symptoms. The ability to systematically and critically interpret electrocardiographic function should be paramount in the nurse's store of knowledge. Utilization of the electrocardiogram in conjunction with other standard and hemodynamic assessment tools will enable the nurse to perceive cardiac dysfunction, and accurately determine the clinical disorder. PMID- 3644293 TI - Introduction to hemodynamic monitoring. AB - This article discusses nursing care of the patient who requires hemodynamic monitoring. This will include care of the patient who requires intra-arterial pressure monitoring, central venous pressure (CVP) monitoring, left atrial pressure (LAP) monitoring, and monitoring of left heart pressures, cardiac output, and systemic vascular resistance using a pulmonary artery (PA) catheter. PMID- 3644294 TI - Accuracy of activated partial thromboplastin time drawn through central venous catheters. PMID- 3644295 TI - A nursing form for gynecology patient assessment. PMID- 3644296 TI - Litigation involving oncology nurses. PMID- 3644297 TI - The relationship between hopelessness and selected variables in women receiving chemotherapy for breast cancer. PMID- 3644298 TI - Patients' spiritual coping strategies: a study of nurse and patient perspectives. PMID- 3644299 TI - Endocrine mechanisms and obesity: influences in breast cancer. PMID- 3644300 TI - Nursing research using animal subjects: practical and ethical considerations. PMID- 3644301 TI - Collaboration: the key to research feasibility. PMID- 3644302 TI - Determining examination cut scores. PMID- 3644303 TI - Reaching new heights. Oncology Nursing Society. Twelfth Annual Congress, Denver, Colorado, May 6-9, 1987. PMID- 3644304 TI - Quantitative evaluation of neonatal lung expansion with automated image analysis. AB - Lung sections from artificially ventilated premature newborn rabbits, some treated with natural surfactant, were examined microscopically with an IBAS image analyzer connected to a television camera. The "stereological profile" of the alveoli was determined by automatical evaluation of the following parameters: volume density (VV), and its coefficient of variation (CV(VV), surface density (SV), average mean integral surface curvature (K), and a "shape factor" (SF) measuring the "circularity" of sectioned alveoli. Data from image analysis were closely correlated to those obtained with conventional morphometrical techniques (e.g., r = 0.92 for VV). Alveolar expansion was significantly improved after treatment with surfactant, especially in animals ventilated with prolonged inspiration phase. We suggest that image analysis is a useful method for evaluating alveolar expansion patterns in the neonatal lung. PMID- 3644305 TI - Perinatal hypoxic/ischemic spinal cord injury. AB - We have reviewed our experience in 900 consecutive necropsies performed on infants who died in the first 4 weeks of life. The neuropathologic characteristics of acute hypoxic/ischemic spinal cord injury are described in 21 infants who expired in the perinatal period. Several distinct patterns of spinal cord injury were apparent in asphyxiated neonates. Cord infarction, rare in older age groups, was the commonest lesion and was associated with prematurity and with documented episodes of systemic hypotension. Lumbosacral cord segments were more severely affected, and at affected levels central cord parenchyma was completely necrotic with relative sparing of the periphery. Diffuse neuronal necrosis was more typical of infants delivered at or after term. In these neonates ventromedial neurons were most profoundly injured. Hematomyelia dissecting into spinal cord parenchyma was a consequence of germinal matrix hemorrhage in very premature infants. "Watershed zones" in the cord appear to be most severely affected in these infants. The patterns of spinal cord infarction and the association of this lesion with prematurity and systemic hypotension suggest that the absence or failure of spinal cord blood flow autoregulation may play a role in the etiopathogenesis of perinatal hypoxic/ischemic spinal cord injury. PMID- 3644306 TI - Narrowing the reward gap between research and practice. PMID- 3644307 TI - A comparison of family characteristics and attitudes toward after-school care for latchkey children. PMID- 3644309 TI - Modular curriculum development in community health nursing. PMID- 3644308 TI - Life with a new baby: stressors, supports, and maternal experience. PMID- 3644311 TI - Helping people to stop smoking. PMID- 3644310 TI - Nurses' beliefs about nuclear war avoidance. PMID- 3644312 TI - What is quality assurance? PMID- 3644313 TI - Maternity benefits. PMID- 3644314 TI - The essential anatomy and physiology of a stoma. PMID- 3644315 TI - Testicular self-examination. PMID- 3644317 TI - Hypothermia: one of winter's threats to the elderly. PMID- 3644316 TI - From student nurse to DNS. Interview by Di Manthorpe. PMID- 3644318 TI - Caring for mentally handicapped people: the community and the church. PMID- 3644319 TI - Pain relief unit techniques 1: Neural blockade. PMID- 3644320 TI - The choice of dressing for wound healing. PMID- 3644321 TI - Stop smoking! Practical ideas for nurses and patients. PMID- 3644322 TI - Practice check: the patient's visual environment. PMID- 3644323 TI - On becoming a staff nurse. PMID- 3644324 TI - Administering heparin with syringe pumps. PMID- 3644325 TI - Managing psychiatric stigma. PMID- 3644326 TI - Eating for a healthier heart. PMID- 3644327 TI - Contraception: methods and counselling. PMID- 3644328 TI - Minimising the risk of surgery for cerebral ischaemia. PMID- 3644329 TI - Anatomy and physiology of urinary continence: the bladder. PMID- 3644330 TI - Mobility problems of the new stroke victim: supporting the carer. PMID- 3644332 TI - Donor cards. PMID- 3644331 TI - Lymphoedema: management of patients with advanced cancer. PMID- 3644333 TI - How do we set nursing standards? PMID- 3644334 TI - Giving reassurance to anxious patients. PMID- 3644335 TI - Childhood continence problems. PMID- 3644336 TI - [Sex education]. PMID- 3644337 TI - [Care of the dying patient and of the grief-stricken]. PMID- 3644338 TI - [The nurse facing the dying patient]. PMID- 3644339 TI - [The child and death]. PMID- 3644340 TI - [The nurse facing the death of a child]. PMID- 3644342 TI - [Role of the newspaper in school]. PMID- 3644341 TI - [Better to prevent than to treat!. Interview by Maria Lesnikowska]. PMID- 3644343 TI - [The operating room]. PMID- 3644345 TI - [Rupture of the fetal membranes in incomplete pregnancy]. PMID- 3644346 TI - [Penal code responsibility of the nurse]. PMID- 3644344 TI - [40 years of service. Interview by Bogdan Nowak]. PMID- 3644347 TI - [Radiation--the invisible threat]. PMID- 3644349 TI - [Terminal care]. PMID- 3644348 TI - [The reaction of denying disease]. PMID- 3644350 TI - [Allergy]. PMID- 3644351 TI - [Psychotherapy and somatic disease]. PMID- 3644352 TI - [Visits to the gynecologist]. PMID- 3644353 TI - [Bronchial asthma]. PMID- 3644354 TI - [Sick leave of physicians and nurses]. PMID- 3644355 TI - [What has an effect on our work?]. PMID- 3644356 TI - [Prevention and treatment of allergy in the USSR]. PMID- 3644357 TI - [May nurses wear jewelry at work?]. PMID- 3644358 TI - [Diagnosis of allergic diseases]. PMID- 3644359 TI - [Sex education at puberty]. PMID- 3644360 TI - [Nursing care and its status]. PMID- 3644361 TI - A case for generic education. PMID- 3644362 TI - Self-imposed isolation as a factor in depression following cosmetic surgery. PMID- 3644363 TI - The role of the nurse in the plastic surgery office. PMID- 3644364 TI - Demonstration of a "capsule" and subsequent external decompression. PMID- 3644365 TI - Sample selections in nursing research. PMID- 3644366 TI - Integrative reviews of nursing research. AB - Integrative reviews of research are a valuable part of the process of creating and organizing a body of literature. It has been argued that integrative reviews should be held to the same standards of clarity, rigor, and replication as primary research. In this paper methods for conducting an integrative review are discussed. Seventeen reviews from nursing journals were examined and compared with a proposed set of criteria for reviews. The results indicated that the majority of integrative reviews in nursing fell short of primary research standards. Guidelines for conducting more rigorous reviews are presented. PMID- 3644367 TI - Choice and predictability in the preparation for barium enemas: a person-by situation approach. AB - The effects of choice and predictability information regarding preparation for a barium enema procedure was investigated for patients differing in desire for control (DFC) and in experience with the barium enema exam. One-third of the patients, randomly assigned to the choice condition, were selected from three equally effective preparations. For these patients, choice and predictability information are confounded. Patients in the instruction only and information conditions were yoked to choice patients to control for type of preparation. Patients in the information condition were given the same sensation information about their specific preparation as those in choice. Instruction only was effective for low DFC patients, but contrary to prediction the choice was problematic for high DFC patients. It was suggested that the limited choice created reactance for these patients. The differential effectiveness of health care interventions in relation to patient predispositions was stressed. PMID- 3644368 TI - Locus of control among alcoholics, recovering alcoholics, and non-alcoholics. AB - An alcoholic's relapse to drinking is thought to be related to various interpersonal and intrapersonal factors. Drinking-Related Locus of Control (DRIE) scores among alcoholics, recovering alcoholics, and non-alcoholics were compared in this investigation. Each group consisted of 22 males similar in age and other socioeconomic factors. Results indicated significant differences among the three groups. The non-alcoholic group scored more internally than the alcoholic or recovering alcoholic groups; the recovering alcoholic group scored more internally than the alcoholic group. The findings suggest that assessment of the alcoholic's DRIE scores may be useful in planning and monitoring the treatment of this disease. PMID- 3644369 TI - The health of conjugally bereaved older widows: the role of appraisal, coping and resources. AB - Relationships between bereavement, coping, resources, and health dysfunction were investigated in 100 older women (M age = 71.3 years) widowed from 1 to 12 months prior to the interview. Differences in coping for those who appraised their bereavement as either (a) harmful loss, but without major accompanying losses, (b) harmful loss with other anticipated threats, or (c) a challenge were hypothesized. Data collection included use of the Ways of Coping Checklist, Sickness Impact Profile, and appraisal of bereavement and resources. The appraisal groups differed significantly in overall problem-focused coping, wishful thinking, help seeking/avoidance, self blame, and growth-oriented coping. There was no difference in use of emotion-focused coping and ways to minimize threat and seek social support. Social support, strong religious beliefs, practice of rituals, belief in control over bereavement, and good prior mental health were related to less psychosocial and/or physical dysfunction. Greater numbers of resources, but not greater numbers of coping strategies, also were related to less psychosocial and/or physical dysfunction. PMID- 3644370 TI - Stereotyping by nurses and nursing students: a critical review of research. AB - Thirty-eight empirical studies of stereotyping by nurses and nursing students were critically examined and discussed. The review was conducted and reported as though it were primary research. Subjects were the studies examined, methods were the reviewing procedure, data were attributes of the studies, and results were the conclusions drawn. The research on nurses' stereotypes has been characterized by: the use of one method of data collection, usually questionnaires; the measurement of the presence or absence of specific stereotypes; and nonprobability sampling techniques. There is some evidence that nurses stereotype other people based on age, sex, attractiveness, personality, diagnosis, social class, and family structure. Suggestions for adding to this body of knowledge are made. PMID- 3644372 TI - [The locomotor apparatus: the upper limbs (10). The digital flexion-extension apparatus, phlegmon of the sheaths]. PMID- 3644371 TI - Effect of human urinary trypsin inhibitor on granulocyte elastase activity. AB - A human urinary trypsin inhibitor preparation, MR-20, strongly inhibited granulocyte elastase activity. The concentration of MR-20 causing 50% inhibition of the hydrolysis of Suc(Ala) 3pNA by granulocyte elastase was estimated to be 6.4 X 10(-8) M (11 U/ml). PMID- 3644373 TI - [The central venous pressure (CVP) (2)]. PMID- 3644374 TI - [Injuries of the cervical vertebrae. Role of the orthopedic surgeon and the OR circulating nurse]. PMID- 3644375 TI - [Injuries of the cervical vertebrae. The nurses' role]. PMID- 3644376 TI - [Injuries of the cervical vertebrae. Role of the rehabilitation center]. PMID- 3644377 TI - [Injuries of the dorsolumbar vertebrae. Anatomy, physiology, clinical aspects]. PMID- 3644378 TI - [Injuries of the dorsolumbar vertebrae. Role of the Emergency Medical Services and the critical care team]. PMID- 3644379 TI - [Injuries of the dorsolumbar vertebrae. The nurses' role]. PMID- 3644380 TI - [Pelvic injuries. Anatomy, physiology, clinical aspects]. PMID- 3644381 TI - [Pelvic injuries. Role of the Emergency Medical Services and the critical care team]. PMID- 3644382 TI - [Pelvic injuries. Role of the orthopedic surgeon and the circulating nurse]. PMID- 3644383 TI - [Pelvic injuries. The nurses' role]. PMID- 3644384 TI - [A study of manpower distribution in a surgical critical care unit]. PMID- 3644385 TI - [Injuries of the cervical vertebrae. Anatomy, physiology, clinical aspects]. PMID- 3644386 TI - [Injuries of the cervical vertebrae. Role of the Emergency Medical Services and the critical care team]. PMID- 3644387 TI - [The migrant woman and problems of pregnancy]. PMID- 3644388 TI - [Waiting]. PMID- 3644389 TI - [Septicemia]. PMID- 3644390 TI - [The general nurses of Nantes]. PMID- 3644391 TI - [Crystal ball and coffee grounds ... The editorial council is asking itself]. PMID- 3644392 TI - [Meeting of onco-hematologic nurses of the Hopital Saint-Louis; in Paris on 26 and 27 September 1986. Development of nursing between 1970 and 1986]. PMID- 3644393 TI - [Save them from your smoke!]. PMID- 3644394 TI - [Our proper role: a challenge for today's nursing care]. PMID- 3644395 TI - [Public health nurses]. PMID- 3644396 TI - [Cerebral tumors in adults]. PMID- 3644397 TI - [There were three ... meningiomas]. PMID- 3644398 TI - [Hemodynamic surveillance by means of monitoring]. PMID- 3644399 TI - [Acute osteomyelitis]. PMID- 3644400 TI - [Fractures of the long bones]. PMID- 3644401 TI - [He who has been drinking ... shall stop]. PMID- 3644402 TI - [Ionizing radiation]. PMID- 3644403 TI - [Treatment of wounds and ulcers with crystallized sugar. Technical aspects and results]. PMID- 3644404 TI - [First aid on a motorcycle? Why not? Apropos of various sports displays on the road (races: pedestrians, bicyclists, motorcyclists)]. PMID- 3644405 TI - [Drugs: health professionals are the first movers for prevention]. PMID- 3644406 TI - [At the heart of preventive medicine in a small enterprise. The medico-technical assistant to the factory physician]. PMID- 3644407 TI - [Preparation for delivery. Visits by pediatric nurses from Maternal and Child Protection in conjunction with the PMI midwife]. PMID- 3644409 TI - [Health services and other ways of influencing health]. PMID- 3644408 TI - [Nurse for the "Boat People"]. PMID- 3644411 TI - [Methodology in nursing: a necessary goal]. PMID- 3644410 TI - [Prevalence of obesity in a population of infants and juveniles]. PMID- 3644412 TI - [Psychological and educational considerations for hospitalized children]. PMID- 3644413 TI - [The fear of individuality]. PMID- 3644414 TI - [Relationship between the consumption of sugars and health]. PMID- 3644415 TI - [Endotracheal tubes]. PMID- 3644417 TI - [Progress as a tradition]. PMID- 3644418 TI - Why we ought to go back to dress codes. PMID- 3644416 TI - [Continuing education. 11. Field: health policy. Topic: plan for humanizing hospital care]. PMID- 3644419 TI - Who says an inservice has to be humdrum? PMID- 3644420 TI - My wish for Willie. PMID- 3644421 TI - Managing complications after abdominal surgery. PMID- 3644422 TI - More arterial blood sampling tricks. PMID- 3644423 TI - When the patient has hypokalemia (continuing education credit). PMID- 3644425 TI - A guide to external pacing. PMID- 3644424 TI - What you need to know about today's pacemakers. PMID- 3644426 TI - How to help patients get through chemotherapy. PMID- 3644427 TI - The high cost of not paying attention. PMID- 3644429 TI - Helping your patient get his strength back. PMID- 3644428 TI - CAD: cutting back on cholesterol isn't enough. PMID- 3644430 TI - Is it legal? PMID- 3644431 TI - ALS. Cleaning up the confusion about this paralytic disease can lead to better care of the patient. PMID- 3644432 TI - ALS. Support groups can help. PMID- 3644433 TI - ALS. A case study: caring for ALS patients. PMID- 3644434 TI - Help is available to nurses involved in inquests and trials. PMID- 3644435 TI - P.O.R.T. Organ retrieval program started in B.C. PMID- 3644436 TI - Defining the role of the nurse in adult day care: a day in the life of an adult day care centre. PMID- 3644437 TI - Why nurses get into trouble. Part 2. Nursing incompetence. PMID- 3644438 TI - Spinning our wheels. PMID- 3644439 TI - [Placement of a patient on a water mattress (Cliniplot)]. PMID- 3644440 TI - [Computerization of patient movement within a nursing unit]. PMID- 3644441 TI - [Computerized administration at the level of a nursing unit]. PMID- 3644442 TI - [Centralized or departmental computers. Which choice for the user in the hospital?]. PMID- 3644443 TI - [The health card]. PMID- 3644444 TI - [Severe pulmonary embolisms and their treatment. Viewpoint]. PMID- 3644445 TI - [The incognito computer in patient care]. PMID- 3644447 TI - [Traumatic rupture of the isthmus of the thoracic aorta]. PMID- 3644446 TI - [Current cardiac surgery in infants and neonates. Emergency measures]. PMID- 3644448 TI - [Aortic dissections. Indications for surgery and technics used]. PMID- 3644449 TI - [Aortic dissection as an emergency. Pre- and postoperative care]. PMID- 3644450 TI - [Assessments and withholdings from the salary]. PMID- 3644452 TI - [Desernil-Sandoz]. PMID- 3644451 TI - [Programs of computerized calculations in the nursing unit]. PMID- 3644453 TI - [Anorexia nervosa. Clinical syndrome and psychopathological aspects]. PMID- 3644454 TI - [Addictive behavior in adolescents. Alcohol, drugs, psychotropic agents]. PMID- 3644455 TI - [Disorders in feeding behavior]. PMID- 3644456 TI - [A case history of anorexia nervosa]. PMID- 3644457 TI - [Attempt at systematic psychotherapy. Repetiition and change in behavior]. PMID- 3644459 TI - [Ombudsmen's number has increased from 900 to 1200 in 10 years time. Interview by Ulla Danielsen]. PMID- 3644458 TI - [Diet fads, diet and bulimia]. PMID- 3644460 TI - [Refugees--0.5 nurses for every 100 asylum seekers]. PMID- 3644461 TI - [Refugees are people in crisis]. PMID- 3644462 TI - [Colifoam--hydrocortisone rectal foam]. PMID- 3644463 TI - [Social developments change collaboration in trade movements]. PMID- 3644464 TI - [Executive Board. Collective ideas for the health system's reorganization process]. PMID- 3644465 TI - [Reward for positive involvement]. PMID- 3644466 TI - [Ombudsman annual course. Decentralization but not down to ward level]. PMID- 3644467 TI - [Alternative medicine can be a new medical specialty. Interview by Helle Kastholm Hansen]. PMID- 3644468 TI - [People will learn to see themselves as a whole. Interview by Helle Kastholm Hansen]. PMID- 3644469 TI - [Psychiatry. Clinical nursing care lacks dynamics and inspiration]. PMID- 3644470 TI - [Continuing education must be available to all nurses]. PMID- 3644471 TI - [Drug information. Patients get a clean wound with Varidase]. PMID- 3644472 TI - [Danish Nursing Council gets right to negotiate for nurses]. PMID- 3644473 TI - [Student activities. Cut-downs and reorganizations reduce education. Interview by Ulla Danielsen]. PMID- 3644474 TI - [What can we do locally for WHO's health strategy?]. PMID- 3644476 TI - [Alternative treatment. Nurses and doctors gather together in alternative medicine]. PMID- 3644475 TI - [Aid to developing countries. Human rights violated in Denmark's principle collaborating countries]. PMID- 3644477 TI - [Alternative treatment. Public movement will change people's approach to illness. Interview by Helle Kastholm Hansen]. PMID- 3644478 TI - [Alternative treatment. Causes of disease should go before treatment benefits. Interview by Helle Kastholm Hansen]. PMID- 3644479 TI - [Danish Nursing Council. Congress hears every month. Interview by Soren Palsbo]. PMID- 3644480 TI - [Danish Nursing Council. Unless decentralization is exaggerated we drop everything on the floor. Interview by Soren Plasbo]. PMID- 3644481 TI - [Danish Nursing Council. It was our good luck that we renewed the structure in time. Interview by Ulla Danielsen]. PMID- 3644482 TI - [Danish Nursing Council. Weekdays for a county board in the Danish Nursing council]. PMID- 3644483 TI - [Danish Nursing Council. The last 10 years membership increased by 26 percent]. PMID- 3644484 TI - [Health system. Danish health is good--but not everything is rose-colored]. PMID- 3644486 TI - [Especially the public employees bear the brunt]. PMID- 3644485 TI - [The public employees have received enough now]. PMID- 3644487 TI - [Health strategy. Many organizations cooperate with WHO's strategy goals]. PMID- 3644488 TI - [Nurses shortage. An indefensible situation with 1500 unfilled nursing posts]. PMID- 3644489 TI - [Psychological support of relatives following death at home]. PMID- 3644490 TI - [Cause of pressure sores is pressure and only pressure]. PMID- 3644491 TI - [Emergency aid in Ethiopia changes character]. PMID- 3644492 TI - [Guidelines on blood transfusions and intravenous injections]. PMID- 3644493 TI - [Requirement is that they will account for money on the table]. PMID- 3644495 TI - [Executive Board. Catalog of ideas from nurses to the Minister of the Interior]. PMID- 3644494 TI - [Nurses are overtaken in wages by private sector]. PMID- 3644496 TI - [Members' rights. Danish Nursing Council is in need of a broad membership discussion]. PMID- 3644497 TI - [Technology. Utilization responsibility added to education on personal use]. PMID- 3644498 TI - [Danish Nursing Council hosts management meeting for SSN (Scandinavian Nursing Cooperative)]. PMID- 3644499 TI - [SSN (Scandinavian Nursing Cooperative). Lack of professional ethics guidelines for nursing in Denmark]. PMID- 3644500 TI - [Psychiatry. That is why we protested firing]. PMID- 3644501 TI - [Is the position abused to ensure firing?]. PMID- 3644502 TI - [Health visiting. Goal is to add life to years not just years to life]. PMID- 3644503 TI - [Will Danish Nursing Council allow itself to be outwitted?]. PMID- 3644504 TI - [Vice president election. Nurses are exposed to miserable treatment]. PMID- 3644505 TI - [Vice president election. Our effectiveness depends on broad solidarity]. PMID- 3644506 TI - [Vice president election. Consequences of cuts will be made probable]. PMID- 3644508 TI - [Consumer organization. For 20 Krone you can get discounts on a large number of merchandise]. PMID- 3644507 TI - [Support which is a pat on the shoulder for freedom of speech]. PMID- 3644509 TI - [Wages an expression of the devaluation of public employees]. PMID- 3644510 TI - [Cross-professional discussion. Where is Health System's interest for the socially-burdened patient?. Interview by Ulla Danielsen]. PMID- 3644511 TI - [General Assembly. Representatives should support various improved working conditions]. PMID- 3644512 TI - [AIDS: Behavior regulations for health visitors with AIDS patients]. PMID- 3644513 TI - [Psychiatry. Was getting criticism confirmed by Health Administration--but was fired by county]. PMID- 3644514 TI - [Nursing education--a professional and personal development]. PMID- 3644515 TI - [Human rights and peace are among United Nation Organization's tasks. Interview by Helle Kastholm Hansen]. PMID- 3644516 TI - [Better marketing of Danish Nursing Council's activities]. PMID- 3644517 TI - [Unclear political signals prior to negotiations]. PMID- 3644518 TI - [Pensions. Savings for pensions added to social growth]. PMID- 3644519 TI - [Education. Proposal from Fyns County is a breach of the education agreement. Interview by Lars Peter Bergqvist]. PMID- 3644520 TI - [Population course in health and care for nurses]. PMID- 3644521 TI - [A human right to say no to treatment without prospects]. PMID- 3644522 TI - [Budget adjustment mixed up with other considerations]. PMID- 3644523 TI - [How much are nurses' organizations infiltrated by the DKP (Danish Communist Party)?]. PMID- 3644524 TI - [Readers should not swallow all my viewpoints whole. Interview by Lars Peter Bergqvist]. PMID- 3644526 TI - [Congress 86]. PMID- 3644527 TI - [UNICEF. The future is a matter for the children. Interview by Ulla Holtegaard]. PMID- 3644525 TI - [Technology. The invisible work in nursing is not picked up by ADP]. PMID- 3644528 TI - [Firing with the help of a report which consists purely of assumptions]. PMID- 3644529 TI - [Switch-over capabilities and the will to renew]. PMID- 3644530 TI - [Undisguised lack of occupational policy in the capital]. PMID- 3644531 TI - [Inger Rasmussen--future president's material]. PMID- 3644532 TI - [Open letter to nurses in Slesvig]. PMID- 3644533 TI - [Danish Nursing Council and collective bargaining 1987]. PMID- 3644534 TI - [Patient's total condition concern of hospital]. PMID- 3644537 TI - [We have omitted to use our rights and duties long enough]. PMID- 3644535 TI - [Trade guidelines to nurses must extend knowledge]. PMID- 3644536 TI - [Guidelines on drug administration in nursing homes]. PMID- 3644538 TI - [There is talk about gross throwing suspicion on without providing proof]. PMID- 3644539 TI - [Leadership education. A proposal for development of nurse leaders]. PMID- 3644540 TI - [Year of peace. We express our sympathy with UN's main purpose. Interview by Ulla Danielsen]. PMID- 3644541 TI - [Children in the hospital. Improved contact in new mother-infant section in Sonderborg]. PMID- 3644542 TI - [International cooperation. The world's wealth should be distributed more justly]. PMID- 3644543 TI - [Congress in May could be a turning point]. PMID- 3644544 TI - [Nursing process, ICN's moral code and professional policy]. PMID- 3644545 TI - [Too small a catheter is worse than too large a one]. PMID- 3644546 TI - [Executive Board. Signals about inferior education conditions for student nurses]. PMID- 3644547 TI - [Prevention: team work contrary to occupational boundaries]. PMID- 3644548 TI - [Ambulance system--they lack legislation for ambulance system]. PMID- 3644549 TI - [Death and dying. Nurses ought to know their position on passive terminal care]. PMID- 3644550 TI - [Rolfing--man is and reacts as a whole. Alternative treatment. Interview by Lene S. Garden]. PMID- 3644551 TI - [Student nurses and health: do we want to--can we?]. PMID- 3644553 TI - [England: study trip to health center was exciting]. PMID- 3644552 TI - [Misleading information about conditions at Hvidovre Hospital]. PMID- 3644554 TI - [Japan--unique knowledge to take care of atom-bomb victims. Interview by Helle Kastholm Hansen]. PMID- 3644555 TI - [Education cannot be the object of cost control if health goals are to be reached]. PMID- 3644556 TI - [Law on working environment grossly violated every single day]. PMID- 3644557 TI - [Death and dying. Terminal care should be based on a holistic viewpoint]. PMID- 3644558 TI - [Social policy. Every fifth in the age group 18-66 year receives social assistance]. PMID- 3644559 TI - [Politicians should contribute to change-overs themselves]. PMID- 3644560 TI - [Improved management with formal competence to 2 occupational groups]. PMID- 3644561 TI - [We can start improved cooperation within the health team]. PMID- 3644562 TI - [Who can help will help]. PMID- 3644563 TI - [There will be a broad membership discussion before we change structure]. PMID- 3644564 TI - [Criticism will prevent exclusion]. PMID- 3644565 TI - [An unparalleled step backwards for members]. PMID- 3644566 TI - [Observations on force in psychiatry]. PMID- 3644567 TI - [Working environment. We must stand together to improve the environment in departments]. PMID- 3644568 TI - [Sooner a step ahead than backward in development]. PMID- 3644569 TI - [Nurses all through the country sick of stress and discouragement]. PMID- 3644570 TI - [We must reinforce mutual cooperation]. PMID- 3644571 TI - [Influence presupposes flexibility]. PMID- 3644572 TI - [Tobacco smoking. How long can nurses ignore the facts?]. PMID- 3644573 TI - [Drug information. "Angle cream", especially good for the very small]. PMID- 3644574 TI - [Alternative medicine. Life style should change under holistic therapy]. PMID- 3644575 TI - [Spiritual resources will contribute to promotion of health. Interview by Grete Scharfe]. PMID- 3644577 TI - [Clear announcement from nurses: wages must go up]. PMID- 3644576 TI - [Health Administration. Statement on anesthesiology in small hospitals]. PMID- 3644578 TI - HIV antibody screening in a low-risk population (blood donors) PMID- 3644579 TI - Pretransplant blood transfusions in patients with previous pregnancies. PMID- 3644580 TI - Professional liability insurance: nurses take note. PMID- 3644582 TI - Evaluation and measurement in nurse education: the need for multiple criteria. PMID- 3644581 TI - The misuse of physical restraints in the confused patient. PMID- 3644583 TI - Changing health policy. PMID- 3644584 TI - [Analysis of the annual volumes from 1950-1959 and 1970-1979 of the "Zentralblatt fur Gynakologie" with reference to changes in pathogens]. AB - In order to analyse the germ change there have been analysed by way of comparison original articles from the "Zentralblatt fur Gynakologie" of the periods from 1950 to 1959 and 1970 to 1979. In the period from 1970 to 1979 the frequency of demonstrated anaerobic germs increased (12fold), of gram-negative germs as well (from 28% to 32%); in particular that applies to representatives of Enterobacteriaceae (especially E. coli). On the other hand the frequency of the demonstrated Mycobacterium tuberculosis decreased from 35% to 4%. At the same time a change of the character of the infections, partly with serious septic shock conditions, became evident. Information on the attack of Saccharomyces are almost exclusively available in the period from 1970 to 1979. Candida albicans dominates with 23% in the total evidence of mycobacterials. Their are mainly verbal information on an increase of the resistance of germs. PMID- 3644585 TI - Thyroid hormone profile in dairy cattle acclimated to cold or hot environmental temperatures. AB - Milk yields and the circulating profile of T4, T3 and rT3 were assessed during three different seasons of the year, in first trimester lactating (L) and in dry (D) multiparous holstein cows acclimated to distinct weather conditions. Within the thermoneutral zone (18-28 degrees C; 40-60% RH) and regardless of their geographical location, the thyroid hormone profile in all L-cows (n = 50) resembled the so-called euthyroid sick syndrome (T4, 43.7 +/- 7.7 nmol/l; T3, 1.31 +/- 0.10 nmol/l and rT3, 0.52 +/- 0.08 nmol/l). In both groups of animals the T3/T4 molar ratio was similar within the entire range of climates encompassed in the study. However, both groups exhibited a significant shift in the T3/rT3 molar ratio during cold (10 degrees C; 50%) or hot-dry (34 degrees C; 40%) weather conditions. This shift reaches maximum values (L, 6.5 +/- 1.2; D, 7.9 +/- 1.0 nmoles/l) under hot-humid conditions (28-42 degrees C; 60-90%). The relative increase of T3 levels from comfortable to cold or hot environmental temperatures, was significantly higher in L and D animals (30 vs 12%, respectively). Furthermore, only L-cows exhibited a significant decrease in the rT3/T4 molar ratio during either type of thermoregulatory demands, as well as a significant increase of T4 values under heat-acclimation. These results suggest that heat acclimation in dairy cattle does not depress thyroid gland activity, and lend further support to the notion that adaptive thermoregulatory mechanisms in homeothermic vertebrates, involve adjustments in the peripheral monodeiodinative pathways of thyroid hormones. PMID- 3644586 TI - Granulocytes in bronchial lavage fluid after major vascular surgery. AB - Increased numbers of polymorphonuclear granulocytes (PMN) in the airways, as measured by PMN content in bronchial lavage fluid (P less than 0.01), were found 3 h postoperatively in ten patients undergoing surgery for lumbar aortic aneurysms. An increase in plasma levels of the complement split product C3dg from 6 (0-19) AU/ml preoperatively to 20 (13-50) AU/ml 3 h after surgery (P less than 0.01), indicates an activation of the complement cascade. These changes were not accompanied by increased elastase activity in the bronchial lavage fluid or by major changes in pulmonary blood gas exchange or vascular resistance, indicating that massive PMN activation, analogous to that proposed in adult respiratory distress syndrome (ARDS) had not taken place. In conclusion, complement system activation and migration of PMN into the airways, as seen in connection with major vascular surgery, does not seem to contribute to ARDS-type pulmonary dysfunction. PMID- 3644587 TI - Adolescent unwed prospective fathers: readiness for fatherhood and behaviors toward the mother and the expected infant. AB - Despite the increased emphasis on assessing and meeting the needs of unmarried pregnant adolescents, less than adequate attention has been directed toward understanding unwed adolescent prospective fathers who frequently are the mates of pregnant teenagers. As part of a prenatal education intervention study, 28 unmarried adolescent fathers responded to a questionnaire containing items about their readiness for fatherhood, antepartal behavioral interactions, and projected postpartal behaviors with their pregnant adolescent partners, as well as their projected behaviors with their infants. The adolescent males reported that initially they either were definitely unready for paternity (75%) or were undecided about readiness for fatherhood (21%). However, as pregnancy advanced beyond the second trimester, only 57% of the respondents did not want to become fathers. To a significant extent, those who did not were least likely to engage in behaviors supportive of their mate's health antepartally, or to indicate a desire to care for and interact with their expected infant. In addition, they tended to project lower levels of postnatal involvement with the adolescent mothers of their children as compared to those males who were more accepting of their pending fatherhood. Moreover, males who had maintained long prepregnancy relationships with their mates tended to be more supportive of them prenatally, and to perceive themselves as maintaining close relationships with both the mothers and infants after delivery. Finally, 86% of the adolescent fathers planned to work to contribute to the support of their infants. The data demonstrate that unreadiness for fatherhood may be associated with responsible as well as irresponsible behaviors. Accordingly, these data are interpreted as having implications for the establishment of programs and policies which focus on the adolescent male population in order to interdict the high rate of unwed adolescent pregnancy. PMID- 3644588 TI - Comparison of six pharmacologic regimens for hypercholesterolemia. AB - Six sequential clinical trials were conducted over 5 years to evaluate the safety and efficacy of different treatment regimens for hypercholesterolemia. Of all the study participants, 11 patients were evaluated in all 6 clinical trials using the following regimens: neomycin, neomycin/niacin, cholestyramine, cholestyramine/neomycin, lovastatin and lovastatin/neomycin. All 6 regimens significantly (p less than 0.05) reduced both total and low-density lipoprotein cholesterol concentrations by 25 to 42% from baseline levels. Only neomycin/niacin, cholestyramine and lovastatin significantly increased the high density lipoprotein (HDL) cholesterol concentration, reducing the total cholesterol/high-density lipoprotein cholesterol ratio to less than 4.7. Thus, all 6 tested regimens were effective in modifying the plasma lipoprotein concentrations in type II hyperlipoproteinemia, but neomycin/niacin, cholestyramine and lovastatin had the most favorable impact. Only lovastatin treatment was free of adverse effects. PMID- 3644590 TI - Steadying the hand that feeds. PMID- 3644589 TI - Detection of HTLV-III/LAV-specific IgG and antigen in bronchoalveolar lavage fluid from two patients with lymphocytic interstitial pneumonitis associated with AIDS-related complex. AB - Lymphocytic interstitial pneumonitis, a disorder of unknown cause, has been described in association with infection by the retrovirus human T lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV). This report describes the isolation of HTLV-III/LAV in bronchoalveolar lavage fluid and the quantitation of antibodies directed against HTLV-III/LAV in bronchoalveolar lavage fluid and peripheral blood of two patients with lymphocytic interstitial pneumonitis associated with acquired immune deficiency syndrome-related complex. The ratio of the concentrations of HTLV-III/LAV-specific IgG to total IgG in the bronchoalveolar lavage fluid of both patients was higher than that of the peripheral blood. These findings are consistent with the hypothesis that lymphocytic interstitial pneumonitis is sometimes associated with HTLV-III/LAV infection of pulmonary tissue that evokes a specific humoral immune response locally in the lung. PMID- 3644591 TI - Instill ET tube drugs only with lock-on needle. PMID- 3644592 TI - Preventing UTIs: what works? PMID- 3644593 TI - Immediate postop prosthesis. PMID- 3644594 TI - I'm not letting you go. PMID- 3644595 TI - Learning to swallow again. PMID- 3644596 TI - When wishing won't make it so. PMID- 3644597 TI - Sjogren's syndrome. A dry-eyed diary. PMID- 3644598 TI - Sjogren's syndrome. Adding moisture to your life. PMID- 3644599 TI - Symptoms as clues to calcium levels. PMID- 3644600 TI - Trying to explain nausea in advanced cancer. PMID- 3644601 TI - How to set limits when a patient demands too much. PMID- 3644602 TI - Any monkey could... PMID- 3644603 TI - Selection of study patients with premature rupture of membranes. PMID- 3644604 TI - Immunologic abnormalities and antibodies to HTLV-III in asymptomatic drug addicts. PMID- 3644605 TI - Increased salivary elastase precedes gram-negative bacillary colonization in postoperative patients. AB - The upper airway epithelium is coated with fibronectin, a glycoprotein that covers receptor sites for gram-negative bacteria and prevents them from colonizing the oropharynx. We investigated the identity of salivary proteolytic enzymes capable of degrading fibronectin in a group of 16 patients who had elective cardiac surgery. Six patients became colonized with gram-negative bacteria (Group C) and 10 did not (Group NC). Salivary elastase activity was low in both groups preoperatively. Twenty-four hours after surgery, salivary elastase activity increased in Group C, and it remained elevated at 48 and at 72 h. Fibronectin digestive activity of the saliva of patients in Group C was also increased within 24 h of surgery, and salivary elastase and fibronectin digestive activity were highly correlated (r = 0.86, p less than 0.001). Enzyme inhibition experiments showed that most of the fibronectin digestive activity was due to elastase from polymorphonuclear cells (PMN), and the molecular weight of the salivary enzyme digesting fibronectin was 30,000 daltons (similar to the molecular weight of elastase). Levels of antileukoprotease, the major elastase inhibitor in saliva, were normal in patients with increased elastase activity. We conclude that salivary elastase is of PMN origin, increases prior to gram negative bacillary colonization of the pharynx, and is responsible for most of the fibronectin digestive activity of the saliva. PMID- 3644606 TI - Effect of the elastase inhibitor, eglin-c, on antibacterial mechanisms in experimental pneumonia. Description of a system to quantitate phagocytic and bactericidal activity of resident murine alveolar macrophages in vivo. AB - To evaluate the influence of the elastase inhibitor, eglin-c, on lung host defense, normal CD-1 mice were challenged intratracheally with type 3 Streptococcus pneumoniae suspended in phosphate-buffered saline alone or containing 10 mg/ml eglin-c. After infection with 5 X 10(3) colony-forming units (cfu), animals given eglin-c demonstrated a significant enhancement in their capacity to clear viable pneumococci from the lungs at 24 h after challenge; the augmented pulmonary clearance was associated with an increased influx of granulocytes at 6 and 24 h. After challenge with higher inocula (5 X 10(4) and 5 X 10(5) cfu), animals treated with eglin-c exhibited a significant impairment in pulmonary clearance at 6 h; however, in the presence of larger numbers of granulocytes within the bronchoalveolar spaces, the attenuation in pulmonary clearance resolved between 6 and 24 h. Changes in the kinetics of pulmonary clearance that were similar to those noted after infection with high pneumococcal inocula were also observed after challenge with 1 X 10(6) cfu Staphylococcus aureus. In addition, although it did not influence the in vivo phagocytic capacity of resident alveolar against S. aureus, eglin-c depressed the bactericidal activity of these cells. We conclude that in the mouse, high doses of eglin-c alter pulmonary antimicrobial mechanisms important for preventing and eradicating bacterial infection of the lower respiratory tract. PMID- 3644608 TI - People's right to health. PMID- 3644607 TI - Obviating the effects of heat treatment of serum to inactivate AIDS virus on measured calcium and phosphate concentrations. PMID- 3644609 TI - The collaborative functions of nursing administrators in selected health agencies. PMID- 3644610 TI - The philosophical basis of nursing. PMID- 3644611 TI - People's Health Manifesto. PMID- 3644612 TI - Preferences for fertility--regulating methods and personnel in a free choice rural situation. PMID- 3644613 TI - Safeguard integrity of the professions, improve system of board examinations. PMID- 3644614 TI - Retirement and role discontinuities. PMID- 3644615 TI - Traditional medicine. PMID- 3644616 TI - A comparison of three methods of temperature control. PMID- 3644617 TI - The effects of amputation and factors influencing response to rehabilitation. PMID- 3644618 TI - Travel survival versus depression. How travel affects behavior. PMID- 3644619 TI - Air embolism: a potentially lethal surgical complication. PMID- 3644620 TI - The pregnant OR employee. Part I: Ensuring maternal health. AB - By following these guidelines, a pregnant woman working in the OR can maintain her health despite an erratic schedule, constant periods of standing, and exposure to radiation. Part II of this article will focus on infectious diseases and chemicals, what could happen with maternal exposure, and preventative measures. PMID- 3644621 TI - Project Alpha: initiation, implementation, evaluation. PMID- 3644622 TI - New managers: establishing a niche with former peers. AB - Being a well-prepared manager involves having managerial and interpersonal skills. Establishing a proper distance with subordinates is one of the interpersonal skills that gives a new manager the most difficulty. Following the guidelines in this article for establishing healthy interpersonal distancing can benefit all managers--experienced, new, and would-be. PMID- 3644624 TI - Recommended practices: sterilization and disinfection. PMID- 3644623 TI - New product ideas: from the mind to the market. AB - If you have an idea for a new product, consider the following steps. Carefully research your product idea before looking for a company or research office to market it. You will save yourself a considerable amount of time and effort if you find that the same or a similar device is already on the market. Check to see if you signed a patent policy when you were hired. Some employers claim rights to discoveries made on the job. Obtain legal advice. A lawyer can provide information about nondisclosure agreements, patents, and other forms of protection for the inventor. Most major cities have a lawyer referral service offered through the bar association. They will answer some questions and will provide names of lawyers who specialize in that area of law. Before submitting your product idea to a company for evaluation, evaluate the company. Make sure they are a reputable medical supply company. Find out such things as how they plan to research your idea, and what your share as the inventor will be. Take notes when surveying professionals from other hospitals about your idea. The information gathered can be used when writing your product proposal. Submitting a list of hospitals experiencing problems that your device could solve is a good selling point. Keep records of all phone conversations and copies of all written correspondence between the inventor and the company or research office. Always try to get commitments in writing, and keep the lines of communication open. Major cities offer different sources that the inventor can turn to for help. Check around. Do not be afraid to ask questions. If you have carefully researched your product idea and really believe it will improve patient care, go for it! It might be a long hard road, and despite all your efforts, the device may never make it to the market. But if it does, seeing your device used to enhance patient care makes it all worthwhile. PMID- 3644625 TI - Competency-based education. Its implementation in the OR. AB - Because the amount of time that an educator can spend educating staff is slowly being taken away in the name of cost containment, the time that is left is valuable. For many educators, this may be only a few minutes a day or week. Making the most effective use of that time is essential. Devising programs that meet the need-to-know rather than nice-to-know learning needs of staff members contributes to staff competency and thereby to quality patient care, and does so in a cost-effective manner. PMID- 3644626 TI - Patient education for the ambulatory surgery patient. PMID- 3644627 TI - Cot deaths, stillbirths, and the probation service: a potentially recognisable at risk group. AB - Families of clients under the care of the probation service are at significantly higher risk of experiencing a cot death or a stillbirth than the general public. Pregnant women in the immediate families of clients under the care of the probation service should be identified to health service personnel involved in their antenatal and postnatal care in an effort to avert unnecessary deaths. PMID- 3644628 TI - Use of decisional control to combat powerlessness. PMID- 3644630 TI - 12-hour shifts in the dialysis unit. PMID- 3644629 TI - Quality assurance: you can do it, too. PMID- 3644631 TI - A tool for nursing evaluation of the peritoneal dialysis catheter exit site. PMID- 3644632 TI - Nephrology nursing consult: case study. Managing a medically complicated colostomy patient on CAPD. PMID- 3644633 TI - Outcome criteria and nursing diagnosis in ESRD patient care planning. Section I: conservative management. PMID- 3644634 TI - People nurses vs. paper nurses. PMID- 3644635 TI - HIV seroincidence in a hospital worker population: Kinshasa, Zaire. PMID- 3644636 TI - Sperm banking at Groote Schuur Hospital. PMID- 3644637 TI - A program for career structure: nursing evaluation of the trial. Part Six. PMID- 3644638 TI - Adolescents with cancer. PMID- 3644639 TI - AIDS: Australia's response. PMID- 3644640 TI - Nurse & the law. Accountability and reality. PMID- 3644641 TI - Cough medicines. The Royal Melbourne Hospital Pharmacy Department. PMID- 3644643 TI - Inhibition of free and elastin-bound human pancreatic elastase by human bronchial inhibitor. PMID- 3644642 TI - Effect of vanadate of PHA-induced proliferation of human lymphocytes from young and old subjects. AB - The effect of sodium orthovanadate on mitogen-induced proliferation of lymphocytes from young and old human subjects is reported. We found that vanadate is not mitogenic per se; it has an inhibitory effect during the first 3 days of culture, when both differentiation and proliferation take place; it enhances DNA synthesis, acting as a co-mitogen, in the following days of culture, when proliferation prevails. In spite of the fact that lymphocytes from the two groups differ in their responsiveness to PHA and in the activity of (Na+,K+)ATPase, no difference was found as for the effects of vanadate. PMID- 3644644 TI - The effect of the glycosaminoglycan chain removal on some properties of the human urinary trypsin inhibitor. AB - The major urinary trypsin inhibitor UTI I is a proteoglycan. UTI c (Mr 26,000), produced by chrondroitin lyase digestion of UTI I, was isolated and characterized. About 90% of the glycosaminoglycan chain was removed by this treatment without proteolytic modification, as assessed by amino-acid composition and N-terminal sequence of UTI c. Its electrophoretic mobilities on alkaline and SDS-PAGE are identical with those of UTI II which occurs in urine during storage. To study the role of the glycosaminoglycan chain on the inhibitory properties of UTI I, UTI I and UTI c were compared using different proteinases as target enzymes. The inhibitory activity towards bovine trypsin and chymotrypsin as well as human granulocytic cathepsin G did not differ significantly. However, towards human granulocytic elastase, the equilibrium dissociation constant (Ki) is 5 times higher for UTI c than for UTI I. Weak inhibitory activities were measured on human plasmin, UTI c being more efficient than UTI I. The acid-stability of UTI I is not modified after chrondroitin lyase treatment. UTI I and UTI c are equally sensitive to trypsinolysis indicating that the covalently bound glycosaminoglycan chain does not play an important role for the stability of UTI I. PMID- 3644645 TI - Pethidine late in labour: to give or not to give? PMID- 3644646 TI - Hypothermia: the cold facts of surgery. PMID- 3644647 TI - Vocation, career or both? Politicization of Australian nurses, Victoria 1984 1986. PMID- 3644648 TI - An advocacy role for the critical care nurse. PMID- 3644649 TI - Lactation suppression: a pilot study. PMID- 3644650 TI - Nursing diagnosis: in the beginning. PMID- 3644651 TI - Suicide and the hospice patient. Procedures to work with right-to-die wishes. PMID- 3644652 TI - Pressure ulcer prevention for the hospice patient. Strategies for care to increase comfort. PMID- 3644653 TI - Volunteer involvement in a hospice care program. An examination of motives, activities. PMID- 3644654 TI - The medical model of hospice care. Why it cannot work in America. PMID- 3644656 TI - Interview. Dr. David Ponitz. PMID- 3644655 TI - Management of malignant intestinal obstruction. Commentary on contemporary care of patients with advanced cancer. PMID- 3644657 TI - Problem solving (and teaching) toward objectives. PMID- 3644658 TI - Nurse specialist in forensic psychiatry. Outstanding ADN--Barbara Morrow. PMID- 3644659 TI - Six steps to patient rapport. PMID- 3644660 TI - Sexual assault--the nurse's role. PMID- 3644661 TI - Innocent victims. PMID- 3644662 TI - LPN to ADN. PMID- 3644663 TI - Nursing diagnosis in critical care. PMID- 3644664 TI - Monitoring cardiac rhythms. Part I. (continuing education credit). PMID- 3644665 TI - A longitudinal study on seroconversion of HTLV-III/LAV in Japanese haemophiliacs. PMID- 3644666 TI - Caring--not curing. PMID- 3644667 TI - Cerebral aneurysms & subarachnoid hemorrhage--an overview. PMID- 3644668 TI - Carotid endarterectomy: indications and complications. PMID- 3644669 TI - [Neurogenic bladder and multiple sclerosis]. PMID- 3644670 TI - Closure of severe vesico-vagino-rectal fistulas using Lehoczky's island flap. AB - Thirty large vesico-vaginal and vesico-vagino-rectal fistulas developing after severe radiation injury were closed using Lehoczky's island flap. The pedicle flap of skin and adipose tissue was taken from the area bordered by the greater lip of the pudendum, the perineum and the thigh. It received its blood supply from the internal pudendal artery. Urinary or faecal diversion was not performed. Healing was satisfactory in all 30 patients and there was no recurrence of the fistula. PMID- 3644671 TI - New initiatives for integration--a catalyst for change. PMID- 3644672 TI - Social work in a psychiatric hospital. PMID- 3644673 TI - T.B. isn't dead (Part 2). PMID- 3644674 TI - Choices and chances in later life. PMID- 3644675 TI - Boxing--brain damage. PMID- 3644676 TI - Psychiatric day hospital. PMID- 3644677 TI - Life or death? This was my choice. PMID- 3644678 TI - AIDS. PMID- 3644679 TI - Detach yourself from annoyance. PMID- 3644680 TI - Young people and their sexuality. PMID- 3644681 TI - Hospitaller under the microscope. Interview by Donatus Forkan. PMID- 3644682 TI - Domestic violence: when do you need help? PMID- 3644683 TI - Developing cultural sensitivity. PMID- 3644684 TI - The psychiatric/mental health nurse. PMID- 3644685 TI - An automated staff scheduling system that minimizes payroll costs and maximizes nurse satisfaction. PMID- 3644686 TI - Development of a hospital-based computer users' course for student nurses. PMID- 3644687 TI - Training nursing staff in the use of a computerized hospital information system. PMID- 3644688 TI - Occupational risks in the O.R.: current concepts and a review of who's at risk. PMID- 3644689 TI - Why patients seldom sue nurses. PMID- 3644690 TI - The eyes have it. PMID- 3644691 TI - Wound closure and infection control. PMID- 3644692 TI - Resilient bacteria making our antibiotics ineffective. PMID- 3644693 TI - HIV seroconversion and homosexual men. PMID- 3644695 TI - Myelodysplastic syndromes. A preleukemic disorder. PMID- 3644694 TI - Oral complications in children during cancer therapy. PMID- 3644696 TI - Nursing diagnosis for oncology nursing practice. PMID- 3644697 TI - Chemotherapy administration. PMID- 3644698 TI - Continuous monitoring of mixed venous oxygen saturation (SvO2): a new assessment tool in critical care nursing. Part I. PMID- 3644699 TI - Nursing shortage results from changes in health care system. PMID- 3644700 TI - Porcine pancreatic prokallikrein. IV. N-terminal amino acid sequences of prokallikrein B and the kallikrein generated from it by the action of trypsin. PMID- 3644702 TI - Liability insurance coverage: a must for nurses. PMID- 3644701 TI - Chemical dependency: the disease concept. PMID- 3644703 TI - From Tokyo to inner Mongolia: a look at nursing organizations in the Orient. PMID- 3644704 TI - The effect of assay conditions on the measurement of anti-elastase function in lung secretions. AB - We have determined the effect of altering assay conditions on the observed neutrophil elastase inhibitory capacity in lung secretions from emphysematous patients with normal serum alpha 1 PI. alpha 1 PI, ALP and alpha 2-macroglobulin were detected in all samples. Measurement at low enzyme concentration (less than 33.6 nmol/l) caused a 43% reduction in observed neutrophil elastase inhibitory capacity of sputum sol-phase, while inhibition by secretions in buffer without added NaCl was 20% greater than in the presence of 0.2 mol/l NaCl. Increasing the concentration of the synthetic substrate Suc-[Ala]3-pNA in the assay from 0.45 mmol/l to 7.2 mmol/l reduced the observed inhibitory capacity by 53% and the use of elastin-fluorescein gave lower results for inhibitory capacity than the Suc [Ala]3-pNA (median 0.26 mol neutrophil elastase/mol measured inhibitors (range 0 0.72) with elastin; 1.40 mol neutrophil elastase/mol measured inhibitors (0.80 3.21) with Suc-[Ala]3-pNA). Assay conditions therefore greatly influence the results. In addition these findings suggest the presence of an additional inhibitor of neutrophil elastase in these secretions. PMID- 3644705 TI - Improvement of dialyzer compatibility by reduction of membrane surface area. AB - The present study was devised to investigate, whether reduction of membrane surface area would contribute to enhanced dialyzer membrane compatibility. Therefore, 10 hemodialysis patients were dialyzed with three different cuprophan dialyzers, displaying membrane surface areas of 0.9 m2, 1.2 m2, and 1.8 m2. As an index of biocompatibility release of granulocyte elastase and secretion of granulocyte lactoferrin were determined by enzyme-linked immunoassays. With the three cuprophan membranes, marked leukopenia occurred 15 min after the start of hemodialysis, without significant distinction between the different membranes. On the other hand, the release of leukocyte elastase was strictly dependent on the membrane surface area. Thus, at the end of dialysis, plasma levels of elastase were as follows: 0.9 m2: 255 +/- 51; 1.2 m2: 356 +/- 65; 1.8 m2: 471 +/- 56 ng/ml. The magnitude of secretion of leukocytic lactoferrin was also dependent on membrane surface area. Therefore, the increment during dialysis was 300% with the 1.2 m2 membrane compared to 650% using a 1.8 m2 dialyzer. Based upon these data, we concluded that, using measurements of granulocyte degranulation as an index of biocompatibility, reduction of membrane area resulted in a marked improvement of membrane compatibility. PMID- 3644706 TI - Amiloride inhibits the rise of urinary kallikrein excretion induced by frusemide administration in the rat. AB - The effect of amiloride administration on the urinary kallikrein response to the injection or continuous infusion of frusemide in normal Sprague-Dawley rats was investigated. Injections of frusemide induced repeatedly an increase in urinary kallikrein excretion. This effect was suppressed by amiloride. Amiloride also blocked the response to mannitol injection. A continuous infusion of frusemide lasting 100 min also induced an increase in urinary kallikrein excretion which persisted throughout the experiment. This response was completely blocked by the injection of amiloride. Urinary kallikrein excretion was directly and positively related to urine volume and urinary sodium excretion before and after amiloride injection. The regression lines had markedly decreased slopes after amiloride administration. The urinary kallikrein excretion was also positively related to the urine volume and urinary sodium excretion when frusemide was continuously infused. However, these relationships were abolished after amiloride injection. In both the injection and the infusion experiments, there was a direct relationship of urinary kallikrein excretion to urinary potassium excretion. Although this relationship persisted after amiloride injection, the regression line was shifted to the left. The suppression of the kallikrein stimulating effect of frusemide by the sodium channel blocker amiloride indicates that distal tubule sodium reabsorption is the triggering factor in urinary kallikrein excretion. The study suggests that the mechanism involved in the release of kallikrein by the distal tubular cells is linked to the renal mechanism affected by amiloride. PMID- 3644707 TI - Diabetes: the best test. PMID- 3644708 TI - Primary health care: learning from each other. PMID- 3644709 TI - Male incontinence. PMID- 3644710 TI - Incontinence. Chris's story. PMID- 3644711 TI - Incontinence. Men's problems. PMID- 3644712 TI - Pregnancy care: eating for two. PMID- 3644713 TI - Dementia is a family affair. PMID- 3644714 TI - The preceptor's bill of rights. PMID- 3644715 TI - Preparing for the job interview. PMID- 3644716 TI - Mystery arrhythmia. PMID- 3644717 TI - Acetaminophen overdose (continuing education credit). PMID- 3644718 TI - Type-II toxic epidermal necrolysis. PMID- 3644720 TI - Botulism: coping with an epidemic. PMID- 3644719 TI - Neuroleptic malignant syndrome. PMID- 3644721 TI - Care and management of long-term right atrial catheters. PMID- 3644722 TI - Implantable venous access devices. PMID- 3644723 TI - Thyroid disorder. PMID- 3644724 TI - Holter monitoring and electrophysiologic study. PMID- 3644725 TI - Self-learning packages in critical care. PMID- 3644726 TI - Closed-system suctioning. PMID- 3644727 TI - Case study in hemodynamic monitoring. PMID- 3644728 TI - Type-II toxic epidermal necrolysis. PMID- 3644729 TI - Infective endocarditis: a serious and changing disease. PMID- 3644730 TI - Infective endocarditis: nursing considerations. PMID- 3644731 TI - The electrophysiology study: a nursing concern (continuing education credit). PMID- 3644732 TI - Assessment and care of the patient with myocardial contusion (continuing education credit). PMID- 3644733 TI - Nursing elderly cardiac clients (continuing education credit). PMID- 3644734 TI - Prinzmetal's angina: current perceptions and treatments. PMID- 3644735 TI - [Use of various surgical procedures in rectal cancer]. AB - In a consecutive personal series of rectal carcinoma treated for locoregional cure (n = 125) various surgical procedures were employed. 21 patients with a pT1 tumour remained without recurrence with local excision in 17, and with a major restorative excision in the remainder patients. Though only 7 (20%) of the pT2 tumours were selected for local excision, secondary amputation became necessary in 3 instances for nodal involvement. Nodal staging was successful in one third of the local excisions performed. Extension of low anterior (n = 54) to abdominotranssphincteric (n = 11) and abdominotransanal (n = 16) resections was useful for preservation of continence and for performing a major procedure instead of local excision, with satisfying results of locoregional cure. Abdominoperineal excision was the treatment of choice for large tumours lying below 6 cm (n = 15) or in patients with a patulous anus (n = 5). PMID- 3644736 TI - Preventing cardiovascular complications following AAA surgery (continuing education credit). PMID- 3644737 TI - Intraventricular hemorrhage in the premature. PMID- 3644738 TI - Information channels for critical care nurses. PMID- 3644740 TI - Using a market survey for ICU programs. PMID- 3644739 TI - Critical care orientation examinations: a basis for employment? PMID- 3644741 TI - Verifying clinical competence in critical care (continuing education credit). PMID- 3644743 TI - Preparing for the CCRN examination. Part 4: Interviews: personal advice on preparing for the CCRN examination. PMID- 3644742 TI - Preparing for the CCRN examination. Part 1: The seminar approach. PMID- 3644744 TI - Nursing's role in the sexual counseling of critical care patients. PMID- 3644745 TI - Sexual dysfunction in the COPD patient. PMID- 3644746 TI - Nurses' attitudes towards sexual counseling. PMID- 3644747 TI - Preventing long QT syndrome. PMID- 3644748 TI - C3 convertase of the human alternative pathway of complement: modulation of enzyme activity and stability by mouse monoclonal antibodies to Bb. AB - To further characterize functional sites on C3b,Bb, and C3 convertase of the alternative pathway of complement, we examined the effect of four monoclonal antibodies on its activity and stability. These antibodies recognized antigenic epitopes on human Bb which were not fully exposed in intact factor B. Three of the monoclonal antibodies inhibited lysis of rabbit erythrocytes by normal human serum in the presence of Mg2+ and EGTA. Two of these antibodies markedly inhibited the activity of purified C3b,Bb deposited on rabbit erythrocytes. However, all four monoclonal antibodies increased the half-life of the C3 convertase. Thus, these results demonstrate that binding of antibodies to Bb may concomitantly stabilize C3b,Bb and abate its activity. It is likely that such antibodies induce in Bb conformational changes which increase the C3b,Bb complex stability but may also hinder its catalytic site. PMID- 3644749 TI - Facilitation of milk ejection-related activation of oxytocin-secreting neurones by osmotic stimulation in the rat. AB - Extracellular recordings were made from antidromically identified neurosecretory cells in the paraventricular nucleus of the hypothalamus in urethane-anesthetized lactating rats. Sixty-six percent of the rats tested (n = 80) showed reflex milk ejections during suckling. Oxytocin neurones could be distinguished from other neurosecretory neurones by a characteristic high-frequency burst of spikes displayed before a reflex milk ejection. Twenty-three of the oxytocin neurones recorded from twenty-three individual animals were tested for the effect of intraperitoneal injection of 1.5 M NaCl (1 ml), which raised the plasma osmotic pressure from 299.3 +/- 2.4 (SE) mosmole/kg to 313.0 +/- 2.4 mosmole/kg. The injection significantly increased not only the firing rate of the oxytocin neurones (from 1.7 +/- 0.3 spikes/s to 4.9 +/- 0.6 spikes/s) but also the number of spikes per burst (from 53.6 +/- 7.4 to 75.5 +/- 7.5) and burst duration (from 3.38 +/- 0.22 s to 3.80 +/- 0.18 s). The amplitude of reflex milk ejection was also increased to 1.9 times. However, the injection did not change the interval between bursts. On the other hand, intraperitoneal injection of 0.15 M NaCl affected neither these parameters of oxytocin neurones nor the amplitude of milk ejection. Some of the antidromically identified neurones recorded in the rats which showed no detectable reflex milk ejection during suckling displayed intermittent bursts of action potentials. Ten of these neurones in ten individual rats were tested for the effect of 1.5 M NaCl. The number of spikes per burst was significantly increased and reflex milk ejection was induced by the injection in eight of these rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3644750 TI - Human specific immunoglobulin protects against infection with common Staphylococcus in mice. AB - Mice infected with non-capsulated Staphylococcus aureus strains highly resistant to methicillin survived after the administration of specific immunoglobulin extracted from pooled human sera by using homologous capsular type strains, but no protective effect was shown with a conventional immunoglobulin preparation and methicillin, even with high doses. PMID- 3644751 TI - Chemical dependency and nursing: emerging issues and nursing roles. PMID- 3644752 TI - How does a researcher find grant funding for nursing studies? PMID- 3644753 TI - Are hospital ethics committees alive and well in Florida? PMID- 3644755 TI - How we can assist our colleagues who may be impaired to seek treatment for chemical dependency. PMID- 3644754 TI - Nursing shortage symptomatic of changes in health care. PMID- 3644756 TI - The impaired nurse--the employer's role. PMID- 3644757 TI - Neonatal nightmare: devastating effects of cocaine. PMID- 3644758 TI - Crack-cocaine. PMID- 3644759 TI - [Nursing personnel employed in hospitals]. PMID- 3644760 TI - [Information on research in nursing]. PMID- 3644761 TI - [Economics for home care nurses]. PMID- 3644762 TI - [Belgian Society of Intensive Care--Siz Nursing]. PMID- 3644763 TI - [Account of a visit and voluntary probation in an Agrigento hospital (Sicily), Italy]. PMID- 3644764 TI - [Supervision of nursing activities in a nursing unit (1). A method of quality evaluation and promotion]. PMID- 3644765 TI - [Approach to euthanasia, therapeutic tenacity and death]. PMID- 3644766 TI - Ontogenetic steroidogenesis by testes, ovary, and adrenals of embryonic and postembryonic chickens (Gallus domesticus). AB - To elucidate the relationship between steroidogenesis and sex differentiation in the chicken, pituitary and plasma LH, plasma, testicular, ovarian, and adrenal testosterone, estradiol-17 beta, estrone, and progesterone; and plasma and adrenal corticosterone and cortisol concentrations from 8-, 10-, 12-, 14-, 16-, 18-, and 20-day-old embryonic and 1-, 3-, 7-, and 14-day-old chicks were determined by radioimmunoassay. The plasma LH level was high in 10- to 12-day-old embryos and decreased with advancing age. No sex difference was observed in plasma, testicular, and ovarian testosterone concentrations at embryonic ages. After hatching, a higher testosterone level was observed in the testes than in the ovary, while a similar testosterone level was observed in the plasma of both sexes. Both plasma estradiol-17 beta and estrone concentrations were significantly higher in the female embryo than in the male embryo. Higher values of the two estrogens were observed in the left ovary of the female embryo than in the testes of the male embryo, and the estradiol concentration in the female embryonic ovary was much higher than the testosterone concentration in the male embryonic testes. No sex difference was observed in plasma progesterone, corticosterone, or cortisol. Both plasma and adrenal corticosterone concentrations reached peaks at hatching time. These results indicate that the chicken embryonic ovary is much more active in production and secretion of sex hormones with special reference to estrogenic hormones than are the embryonic testes. It is strongly suggested that the sex of the avian species is basically male, having homozygosity of sex chromosomes (ZZ), and that the estrogens secreted by the embryonic ovary have important roles in female sex differentiation. PMID- 3644767 TI - Hearing aids and their care. PMID- 3644768 TI - The biology of ageing: the special senses. PMID- 3644769 TI - The multidisciplinary team--myths and antipathies. PMID- 3644770 TI - Attitudes to the elderly: a student nurse's view. PMID- 3644771 TI - The shortage: can we prevent it? PMID- 3644772 TI - Problems of impaired hearing. PMID- 3644773 TI - Gall bladder emptying in normal subjects--a data base for clinical cholescintigraphy. AB - Biliary excretion scintigraphy with a cholagogic test meal may be used to assess patients with suspected disorders of gall bladder motility. The interpretation of results is frustrated, however, by the lack of information about the range of normal responses in a form suitable for comparative analysis. We present the results of 41 gall bladder emptying studies on 32 normal healthy subjects (14 men, 18 women) 30 minutes after intravenous injection of 74 MBq 99Tcm-EHIDA. Gall bladder emptying was provoked by the ingestion of 300 ml milk. Gamma camera scintigraphy was used to plot gall bladder activity against time. Gall bladder emptying occurred within 10 minutes in all men and 12/18 women (p = 0.02). Gall bladder ejection fractions were significantly greater in women (p less than 0.05). Duplicate studies in nine subjects showed good reproducibility (r = 0.959). A plot of mean and (m + 2 SD) values of gall bladder activity against time has been derived. The data provide an estimate of normal gall bladder emptying response, which may be used to aid interpretation of clinical studies. PMID- 3644774 TI - An urban physician finds rural medicine a rewarding and personal experience. PMID- 3644775 TI - A traditional Navajo medicine woman ... a modern nurse-midwife ... healing in harmony. PMID- 3644776 TI - Pain and coping. PMID- 3644778 TI - Cognitive maturity of nursing students. PMID- 3644777 TI - Satisfaction, commitment and professionalism of newly employed nurses. PMID- 3644779 TI - In defense of empiricism. PMID- 3644780 TI - A historical overview of the phenomenologic movement. PMID- 3644781 TI - Stress: implications for nursing research. PMID- 3644782 TI - Developing a women's mental health research agenda. PMID- 3644783 TI - Stress research: some theoretical and methodological issues. PMID- 3644784 TI - Nurses' notes. Voices passive and active. PMID- 3644785 TI - Using images of the future in grief work. PMID- 3644786 TI - Why not choose nursing! PMID- 3644787 TI - Nursing in the Bureau of Prisons. PMID- 3644788 TI - AIDS: no easy answers. PMID- 3644789 TI - School's almost out! PMID- 3644790 TI - Leadership and the caring role. PMID- 3644791 TI - Leadership in practice. PMID- 3644792 TI - NSNA: path to professional identity. PMID- 3644793 TI - So you're graduating--now what? PMID- 3644794 TI - Issues on death and dying. PMID- 3644795 TI - Standardisation of methods for the estimation of thiocyanate and iodine in foodstuff. AB - Thiocyanate content in vegetables has been estimated by passing the water extract of vegetables through an alumina column. The thiocyanate content in the eluate has been measured according to Johnston and Jones. Iodine content in the vegetables has been estimated according to a modified method of Acland. The results show the primarily the Cruciferae family vegetables contain higher concentration of thiocyanate. PMID- 3644796 TI - Nurse hours per patient: a method for monitoring and explaining staffing levels. PMID- 3644797 TI - The quality of life: design and evaluation of a self-assessment instrument for use with cancer patients. AB - An attempt was made to define the concept of 'quality of life' and outline the development of a self-assessment instrument for detecting the changes in life as a whole which result from the presence and treatment of malignant disease. A comparison was made between three different scoring systems, familiar in psychometric assessment, although less familiar in nursing. The items selected for inclusion in the measurement instrument were based on an existing symptom distress scale and on the previously identified concerns of cancer patients. The relationship between such symptoms and the activities of daily living was explored. Each item, and the instrument as a whole, appeared to be reliable and to represent a valid means of assessing the impact of the disease on patient well being. It was simple to use and straightforward to score and appeared accurately to reflect the patients' general condition. PMID- 3644798 TI - The clinical nurse researcher: institutionalizing the role. AB - The role of the clinical nurse researcher is central to the conduct of clinically relevant research and the integration of research findings into nursing practice, particularly within inpatient settings. Interviews with clinical nurse researchers revealed that implementation of the role occured under four major models: nursing research unit, dual roles, collaborative roles, and functional role division. Organizational and colleague support were critical to the visibility and viability of the clinical nurse researcher role. PMID- 3644799 TI - Nursing research centers: a survey of their prevalence, functions and school characteristics. AB - A survey of all 124 NLN accredited schools of nursing with graduate programs in 1984 identified 50 nursing research centers. Their functions focused on research support, unlike most university research centers that focus on performing externally financed research. Secondary analysis of characteristics associated with research support and research productivity was done comparing schools with and without nursing research centers. Schools with research centers were significantly more likely to be large, have a history of an early commitment to research development, grant more graduate degrees, have more doctorally prepared faculty, and be more research productive than schools without. Nursing research centers seem to contribute to research productivity within the profession. PMID- 3644800 TI - Staff turnover in nursing homes for the aged: a review and research proposal. PMID- 3644802 TI - Metronidazole: reference correction. PMID- 3644801 TI - Physical and emotional responses of expectant fathers throughout pregnancy and the early postpartum period. AB - A comparative, repeated measures survey design was used to monitor the physical and emotional health of 81 expectant fathers and 66 non-expectant men over the course of a year at monthly intervals. A total of 877 monthly data collection episodes were completed. Compared to non-expectant men, expectant fathers were found to experience relatively similar patterns of both physical and emotional symptoms throughout the three trimesters of pregnancy. However, expectant fathers' health was found to differ significantly from that of non-expectant men during the immediate postpartum period with a greater incidence of emotional discomforts as well as total number of symptoms, their duration and perceived seriousness. Included are recommendations for anticipatory health counseling to promote health in expectant fathers. PMID- 3644803 TI - A view from the cutting edge. PMID- 3644804 TI - Effect of changing needle disposal systems on needle puncture injuries. AB - Accidental needle puncture injuries continue to pose a hazard to hospital workers. In order to reduce the number of such injuries in our hospital, needle disposal procedures were revised to discourage recapping and prevent bending or clipping of needles before discard. Collapsible cardboard boxes were replaced with impervious containers. An educational program accompanied these changes. We compared reports of needlestick injuries before and after the change of procedure, for three parallel 9-month periods. During the 27-month study, injuries occurred during administration of medication (22%), or recapping of used needles (16%), from needles protruding through (10%) or out of the "mouth" (9%) of the container, from needles left in the patient's environment (10%), or those left on procedure trays (7%). Seven percent were the result of being stuck by someone else, usually in the operating room. The mechanism of injury for 19% was not described. Altering the disposal procedures did not change the number or anatomic site of injuries, nor the risk of injury among the various job categories. A reduction in the rate of sticks from needles protruding through the container (1.3 vs 0.3/mo, p less than or equal to 0.005) was the only difference observed. Changing the needle receptacle changed the type but not the overall number of injuries. The education program had little effect on the number and types of injuries. These data point to the need for developing innovative approaches for eliciting changes in behavior of health care personnel. PMID- 3644805 TI - Operative related infection rates for ventriculoperitoneal shunt procedures in a children's hospital. AB - We determined the operative related cerebrospinal fluid (CSF) shunt infection rates for our institution over a 3-year period (1982 to 1984) using strictly defined numerator and denominator data. The minimum post-operative follow-up period was 12 months. The average surgical infection risk for a CSF shunt procedure at our institution during the study period was 13.3%. Annual infection rates were relatively constant (13.8%, 13.2% and 12.9%), however both quarterly (5.7% to 23.3%) and surgeon-specific (5.7% to 22.8%) rates varied widely. Infection rates calculated by using "traditional" numerator and denominator data were considerably lower (6.5% to 9.2%). Operative related CSF shunt infection rates should be determined by utilizing strictly defined numerator and denominator values in order to allow valid comparisons of published rates. PMID- 3644806 TI - The plight of the last friend: legal issues for physicians and nurses in providing nutrition and hydration. PMID- 3644807 TI - Psychosocial implications of providing nutrition and hydration to patients. PMID- 3644808 TI - AIDS and a duty to protect. PMID- 3644809 TI - AIDS: holistic home care. PMID- 3644810 TI - Oncology alert for the home care nurse: spinal cord compression. PMID- 3644812 TI - Assessment and the nurse. PMID- 3644811 TI - Paget's disease: implications for home nursing. PMID- 3644814 TI - Marketing. PMID- 3644813 TI - Preventing caregiver depression. PMID- 3644815 TI - The personal touch. PMID- 3644816 TI - Continuity of client education. PMID- 3644817 TI - Can you meet the national standard of care in home health nursing? PMID- 3644818 TI - Home care quality assurance: dollars and sense or dollars and cents? PMID- 3644819 TI - The Ca2+ activity of cochlear endolymph of the guinea pig and the effect of inhibitors. AB - The Ca2+ concentrations in cochlear perilymph and endolymph of the guinea pig were measured with double-barreled Ca2+-selective microelectrodes and showed 1.76 +/- 0.74 X 10(-3) M and 2.20 +/- 0.19 X 10(-5) M, respectively. The electrochemical potential gradient for Ca2+ between perilymph and endolymph was 23.2 mV and the existence of an active transport mechanism from the former to the latter was suggested. Vanadate given perilymphatically decreased the Ca2+ concentration in endolymph with a slight elevation of the endocochlear potential and was suspected of blocking the active transport. The Ca2+ concentration in endolymph was abruptly increased by anoxia or the intravenous administration of 60 mg/kg furosemide and was slightly increased by the intravenous administration of 30 mg/kg furosemide or 100 mg/kg acetazolamide. The endolymphatic pH measured with pH-microelectrodes under various conditions indicates that the mechanism of increase in the Ca2+ concentration is attributed not to the liberation of Ca2+ from the surrounding tissues caused by a fall in pH but to the increased influx of Ca2+ from perilymph due to the depression of the endocochlear potential. PMID- 3644821 TI - Risk of AIDS-related virus (human immunodeficiency virus) transmission through apheresis procedures. AB - Since exposure to blood products occurs on a daily basis during hemapheresis, the acquired immunodeficiency syndrome (AIDS) epidemic has a serious impact both for patients undergoing apheresis procedures as well as for health professionals working in the field. We studied serum samples from 110 patients who underwent therapeutic plasmapheresis for a variety of diseases not related to AIDS for the presence of antibodies to human immunodeficiency virus (HIV). Exchange fluids used in the majority of the patients were plasma protein fraction and 5% human albumin. Four patients received only fresh-frozen plasma. Fifty-five patients also received IV gammaglobulin. The follow-up period exceeded 24 months. All patients who did not belong to any known high-risk group for AIDS were negative for HIV antibodies prior to treatment and remained negative at last follow-up. Seven patients were homosexual men. All seven were seropositive prior to plasmapheresis and remained so throughout the treatment period. Seven health professional working in a busy haemapheresis unit were followed for 2 1/2 years. All remain HIV seronegative with normal immune function. These data indicate that transmission of HIV is unlikely through haemapheresis procedures. PMID- 3644820 TI - Length-tension relationship of abdominal expiratory muscles: effect of emphysema. AB - The present study examined the active and passive length-tension relationship of the abdominal expiratory muscles in vitro during electrically stimulated contractions. Studies were performed on isolated strips of transverse abdominis and external oblique muscle from nine adult hamsters with normal lung function. The effect of chronic hyperinflation on the two muscles was assessed in eight hamsters with elastase-induced emphysema. In normal animals the maximal active tension per cross-sectional area (Po) was equal in the two muscles. The absolute muscle fiber length at which Po occurred (Lo) was less for the external oblique than the transverse abdominis and the length-tension curve operated at shorter fiber lengths. However, the change in tension produced by an increase or decrease in muscle length expressed in relative terms (i.e., as %Lo) was greater for the transverse abdominis than the external oblique. Mean total lung capacity of emphysematous animals was 198% of control. Po of the transverse abdominis and external oblique were the same in emphysematous and control animals. However, Lo and the length-tension curve of the transverse abdominis occurred at shorter fiber lengths in emphysematous animals because of a reduction in the number of sarcomeres in series along the fiber. The length-tension curve and the number of sarcomeres in the external oblique was the same in emphysematous and control animals. These results in normal animals indicate that the magnitude of the change in active and passive tension produced by a change in muscle length differs in the transverse abdominis and external oblique. Moreover, chronic hyperinflation of the thorax produced by elastase injection alters the length tension relationships of some but not all the expiratory muscles. PMID- 3644822 TI - Expression of the aminoacyl-tRNA synthetase complex in cultured Chinese hamster ovary cells. Specific depression of the methionyl-tRNA synthetase component upon methionine restriction. AB - Cultured Chinese hamster ovary cells were subjected to amino acid restriction to examine its effects on the level of expression of the nine aminoacyl-tRNA synthetase components of the multienzyme complex which was previously characterized (Mirande, M., Le Corre, D., and Waller, J.-P. (1985) Eur. J. Biochem. 147, 281-289). Lowering the methionine concentration in the medium from 100 to 1 microM led to growth arrest, rapid deacylation of tRNAMet, and progressive 2-fold elevation of the methionyl-tRNA synthetase level, as assessed by specific activity measurements and immunotitration. The levels of the other eight aminoacyl-tRNA synthetases were not affected. Total methionine deprivation led to the additional derepression of the leucyl- and isoleucyl-tRNA synthetase components, whereas the corresponding tRNAs remained fully acylated. These pleiotropic responses to total methionine restriction were abolished in the presence of 2 mM methioninol, suggesting that amino acid transport systems may play a role in the regulation of aminoacyl-tRNA synthetase expression. The effect of total deprivation of arginine, glutamine, isoleucine, leucine, lysine, or proline from the culture medium on the level of expression of the corresponding aminoacyl-tRNA synthetases was also examined. In all cases, no elevation of the level of the corresponding synthetase was observed. The behavior of methionyl tRNA synthetase from Chinese hamster ovary cells displaying a 2-fold increased level of the enzyme due to methionine restriction was examined in detail. Failure to detect a free form of the enzyme by gel filtration, as well as the finding that the isolated complex displayed twice the amount of methionyl-tRNA synthetase relative to the other components, indicates that this multienzyme structure can accommodate at least one additional copy of one of its components. PMID- 3644823 TI - Growth-promoting activity in serum-free medium of kallikreinlike arginylesteropeptidases from rat submaxillary gland. AB - The characterization and purification of the growth-promoting activity present in rat submaxillary gland extracts, known to be required for the proliferation of adipose precursor cells in serum-free medium, have been undertaken. Fractionation of the extracts by ion-exchange chromatography, gel filtration, and affinity chromatography on immobilized benzamidine allowed the copurification of the mitogenic activity with two distinct arginylesteropeptidases of apparent molecular weight 25,000; one of these enzymes has been purified to homogeneity and shown to be immunologically related to tonin, a well-characterized kallikreinlike protease from submaxillary gland. The specificity of both enzymes was similar to that of plasma and glandular kallikreins, as indicated by the relative rates of hydrolysis of peptide p-nitroanilide substrates. Prior treatment of the kallikreinlike proteases with phenylmethylsulfonylfluoride or aprotinin abolished completely both mitogenic and arginylesteropeptidase activities, indicating that enzymatic activity was essential for the manifestation of their growth-promoting ability. The kallikreinlike proteases from rat submaxillary gland were able to replace thrombin to support the proliferation of Chinese hamster lung fibroblasts in serum-free medium. These results underline the role of proteases in controlling cell growth and are discussed in light of adipose tissue development. PMID- 3644824 TI - Determination of mevinolin and mevinolinic acid in plasma and bile by reversed phase high-performance liquid chromatography. PMID- 3644825 TI - Direct radioimmunoassay of rat urinary kallikrein: its application to the determination of active and inactive kallikrein concentration after HPLC analysis. AB - Rat urinary kallikrein (RUK) was purified to apparent homogeneity by a three-step procedure and antibodies were raised in rabbits. Renal kallikrein exists as an active and an inactive form. A specific radioimmunoassay (RIA) was developed to measure directly the total kallikrein. The antibody used in this radioimmunoassay recognized both forms. No cross reactivity was detected with trypsin, esterase A or human urine. When iodinated rat urinary kallikrein was used, the detection range was between 0.125 and 16 ng with 6.5% intraassay variation and 8.1% between assay variation. Intrarenal kallikrein was measured in renal tissue after homogeneisation and solubilisation. Correlations between this RIA and the kininogenase activity or the amidolytic activity were highly significant. Since kallikrein exists as an inactive precursor the direct measurement of the total immunoreactive protein differs from activities determinations. An HPLC ion exchange system has been developed to separate active and inactive forms directly from urine, with a recovery of 79 +/- 11%. This procedure permits measurement of inactive forms. Rat urine contains as much inactive kallikrein as active kallikrein. PMID- 3644826 TI - From cliche to contract: a systematic approach to an independent ET practice. PMID- 3644827 TI - Taking a ride on the Reading Railroad: achieving autonomy through independent nursing practice. PMID- 3644828 TI - A dollars-and-sense look at ET nursing. PMID- 3644829 TI - Enuresis. PMID- 3644830 TI - Quality assurance: implications for the ET nurse. PMID- 3644831 TI - Inflammatory bowel disease in childhood. PMID- 3644832 TI - Teaching the illiterate patient. PMID- 3644833 TI - Acute respiratory distress syndrome. PMID- 3644834 TI - Reflections on altruism and the practice of nursing. PMID- 3644835 TI - Leaving the deanship: why, when, and how? PMID- 3644836 TI - Mechanisms for evaluating a nursing research center: resource use, costs, and research productivity. PMID- 3644837 TI - Nursing deans in small, liberal arts colleges and universities: roles, challenges, and opportunities. PMID- 3644838 TI - Collaboration in clinical research: binational projects shed new light on old issues. PMID- 3644839 TI - Negotiating new roles with physicians. PMID- 3644840 TI - Academic fraud: prevalence, practices, and reasons. PMID- 3644842 TI - Substance abuse and the nurse: a legal and ethical dilemma. PMID- 3644841 TI - The togetherness factor of the academic health center: is it real? Does it matter? PMID- 3644843 TI - Essentials of college and university education for professional nursing. Report to the membership of AACN, October 1986. PMID- 3644844 TI - Indicators of quality in doctoral programs in nursing. American Association of Colleges of Nursing. PMID- 3644845 TI - Sharpen skills in hospital settings. PMID- 3644847 TI - Legal implications of increased autonomy. PMID- 3644846 TI - Retaining rights of impaired elderly. PMID- 3644848 TI - A probate judge's view. Interview by Dolores M. Alford. PMID- 3644849 TI - Respect basic human rights. PMID- 3644850 TI - Guidelines for decision making. PMID- 3644851 TI - Adding to the educational agenda. PMID- 3644852 TI - Human immunodeficiency virus in brain biopsies of patients with AIDS and progressive encephalopathy. AB - Human immunodeficiency virus (HIV) has been identified in patients with AIDS in their circulating and tissue lymphocytes and in their monocyte-macrophages, an arm of the cell-mediated immune system. We report our findings of HIV in brain biopsies. Virus was detected in oligodendroglial and astroglial cells. Virus was also present in the brain capillaries, both in lumens and at the endothelial gaps. Virus was also found in extracellular spaces. Budding forms of the developing virus and bar-shaped nucleoids of mature virus, the diagnostic hallmark of the HIV retrovirus, were identified in brain tissue of five of seven patients with AIDS studied. We believe that HIV may enter the the brain via the vascular capillaries (through the endothelial gaps), bind to brain cells containing T4 receptors, enter the cells, and replicate. There follows a reactive hyperplasia and degeneration of oligodendroglial and astroglial cells. The oligodendroglial cells are the myelin-forming cells, and thus, the result is myelin degeneration. PMID- 3644853 TI - High-level aminoglycoside resistance mediated by aminoglycoside-modifying enzymes among viridans streptococci: implications for the therapy for endocarditis. AB - Two strains of Streptococcus mitis with high-level resistance to streptomycin and kanamycin were identified from a collection of multiple-resistant streptococci. The strains were resistant to penicillin-streptomycin and penicillin-kanamycin synergy but were synergistically killed by penicillin-gentamicin. Both strains adenylylated streptomycin at the 3'' position. Neither strain could be cured of its streptomycin resistance by novobiocin, acridine orange, or ethidium bromide. Attempts to pass the resistance into two recipients were unsuccessful. Agarose gel electrophoresis and cesium chloride gradients failed to reveal plasmid bands. This is the first report of high-level streptomycin resistance mediated by modifying enzymes among viridans streptococci. It is possible that endemic streptomycin resistance among viridans streptococci will develop. PMID- 3644854 TI - In vitro and in vivo studies of streptomycin-resistant, penicillin-susceptible streptococci from patients with infective endocarditis. AB - The combination of penicillin and streptomycin did not act synergistically in vitro against three streptomycin-resistant strains (MIC, greater than or equal to 1,000 micrograms of streptomycin/ml) of penicillin-susceptible streptococci. Using a model of experimental infective endocarditis, we infected rabbits with a control streptomycin-susceptible strain, with an intermediately streptomycin resistant strain (MIC, 1,000 micrograms/ml), and with a highly streptomycin resistant strain (MIC, greater than 32,000 micrograms/ml). Treating animals with a combination of procaine penicillin and streptomycin was more effective (P less than .01) than treating them with procaine penicillin alone only for those animals infected with the control streptomycin-susceptible strain. Treatment with procaine penicillin plus gentamicin was more effective (P less than .01) than treatment with procaine penicillin alone for all three treatment groups and was more effective (P less than .01) than treatment with procaine penicillin and streptomycin for those animals infected with an intermediately or highly streptomycin-resistant strain of streptococci. PMID- 3644856 TI - Pain perception in burn patients with stress disorders. PMID- 3644855 TI - Pain assessment index: evaluation following multidisciplinary pain treatment. PMID- 3644857 TI - The integrated approach to the management of pain. NIH Consensus Development Conference. PMID- 3644858 TI - Neuroadenolysis of the pituitary: description of a modified technique. PMID- 3644859 TI - Managing undesirable side effects and changes in pain severity. PMID- 3644860 TI - Promising initiatives in pain management. PMID- 3644861 TI - [Quantitative nitroblue tetrazolium reduction test of peripheral blood polymorphonuclear leukocytes in women in pregnancy and labor]. AB - We performed the quantitative nitroblue tetrazolium (NBT) test for normal peripheral blood polymorphonuclear leukocytes (PMNs) to investigate the functions of PMNs during pregnancy and labor. The results were as follows. With regard to the spontaneous NBT test, the ability of PMNs to reduce NBT in pregnant and parturient women was significantly greater than to reduce NBT in non-pregnant women. The greatest ability was observed in PMNs in parturient women. With regard to the PMA-stimulated NBT test, the ability of PMNs to reduce NBT in pregnant and parturient women was significantly greater than to reduce NBT in non-pregnant women. Stimulation of NBT reduction was observed when PMNs were exposed to kallikrein. These results suggest that PMNs are so much affected by pregnancy that their functions are accelerated in pregnancy and labor, and that PMNs may have favorable effects on pregnancy and labor not only in the aspect of defense mechanisms but also in the aspect of the ripening of the uterine cervix, and that PMNs may be affected by kallikrein during labor. PMID- 3644862 TI - Mammary resistance: a possible controlling factor in milk ejection. AB - At 8 and 13 days post partum, rats have the same total milk availability; yet, in response to suckling they release a greater amount of milk on day 13 than on day 8. Increased sensitivity to suckling in the more advanced lactators may result from a greater release of oxytocin or from changes in the mammary glands as lactation advances. The present study explores this latter possibility in anaesthetized dams at 8-9 and 13-15 days of lactation. Milk release and intramammary pressure were measured in anaesthetized dams in response to various doses of oxytoxin. Milk release was determined from the body weight gain of pups which had been fasted for 5 h before suckling on dams which had been isolated for 5 h. This parameter was significantly greater in 13- to 15-day lactators than in 8- to 9-day lactators over the range of oxytocin doses examined. In contrast, intramammary peak pressure and its dissipation time were significantly larger in the 8- to 9-day lactators than in the 13- to 15-day lactators. The compliance of the mammary glands was indirectly assessed at the two stages of lactation. When a constant pressure pulse was introduced into a cannulated gland, the resulting pressure peak was significantly greater in 8-day than in 13-day lactators, indicating a greater resistance in the former. Taken together, these results indicate that when endogenous oxytocin is inhibited (by anaesthesia) the greater milk release observed at the later stage of lactation in response to various doses of oxytocin may be due to a decline in mammary resistance as lactation progresses. PMID- 3644863 TI - Closing the gap. PMID- 3644864 TI - Aging signs and symptoms and perceptions of aging in middle-aged black women. PMID- 3644865 TI - Social policy and school food programs: impact on black school children. PMID- 3644866 TI - A prison health setting as a clinical laboratory for undergraduate nursing students. PMID- 3644867 TI - Marital status, gender role attitude, and black women's report of depression. PMID- 3644868 TI - Detection of cyanosis in the person with dark skin. PMID- 3644869 TI - The economic status of black men and its affect on the black family structure. PMID- 3644870 TI - A troubled black community. PMID- 3644871 TI - Measuring quality in ambulatory care nursing. AB - Ambulatory care is a rapidly growing sector of health care that presents both a challenge and an opportunity for nursing administration. This article presents a quality assurance model that can be used to define and measure quality in ambulatory nursing services. Evaluation factors, tools, and methods are described. This program was designed and could be replicated by a nurse manager and staff at the unit level. PMID- 3644872 TI - Thinly disguised contempt: a barrier to excellence. AB - Many elements in contemporary leadership and management convey contempt for employees. "Thinly disguised contempt," a concept introduced by Peters and Austin in A Passion For Excellence, explains many barriers to the achievement of excellence in corporations across disciplines. Health care executives and managers can learn from the errors of corporate management and avoid replicating these errors in the health care industry. PMID- 3644873 TI - Ethics and administrative decision making. AB - Ethical issues in administrative decision making pose a critical problem for nurse executives in a changing health care environment. A study of all the acute care hospitals in one state reveals an identified ethical component to nursing administrative practice. A description of the study findings includes a discussion of the resources nurse executives use to resolve ethical dilemmas and the implications for practice. PMID- 3644874 TI - Career paths of nurses: when is a nurse no longer a nurse? AB - When is a nurse no longer a nurse? Lillian Wald established the first settlement house. Elizabeth Kinney founded the discipline of physical medicine. These nurses saw a need and used their nursing knowledge and experience to fill that need. Did these innovations make them ex-nurses? Florence Nightingale did not stop considering herself a nurse when she began the discipline of biostatistics. Modern nurse pioneers will not only define but expand the boundaries of nursing. You can take the nurse out of the profession, but it seems unlikely that you can take the profession out of the nurse. PMID- 3644875 TI - Theory development in a non-university service setting. AB - What is the role of the non-university service setting in theory development research? The authors discuss the importance of nursing theory to professional survival, economic necessity, and the generation of a knowledge base for practice. Motivational and contextual characteristics of the non-university setting that enhance or inhibit the conduct of research are identified. Common problems that arise from differing needs and goals of clinical nursing personnel and theoretical researchers are explicated. Specific strategies to facilitate theoretical research in a service setting are proposed. PMID- 3644876 TI - Designing tomorrow. PMID- 3644877 TI - Management development: a needs analysis for nurse executives and managers. AB - Clearly, both the nurse executive and nurse manager roles are becoming more complex. I feel an enthusiasm by the professionals in those positions to pursue development activities that will help them do their jobs better and with less discomfort. Nurse executives obviously know the power of combining knowledge with experience. How do the different leadership and management development needs identified by these NE fit with your organization's needs? What is the content in your leadership and management development programs? Are your programs meeting the real needs of your executive and management-level staff? One way to find out is to do a simple survey. Today, nurse executives are responsible and accountable for challenges we never considered possible, even a few years ago. But along with the new challenges came the flexibility and positive attitudes of NEs to respond to changes and acquire new skills such as cost accounting, computers, or marketing. It's this type of proactive thinking that helps nurse leaders turn problems into opportunities and their situations into success stories. PMID- 3644878 TI - The expansiveness of liability to third parties. PMID- 3644879 TI - Nurse-midwifery education. Issues for survival and growth. PMID- 3644880 TI - Conceptual models in nurse-midwifery. PMID- 3644881 TI - Demystifying the nurse-midwifery management process. PMID- 3644882 TI - The medical malpractice insurance crisis. An overview of the issues. PMID- 3644883 TI - Vaginal birth after cesarean section. Nurse-midwifery management. PMID- 3644884 TI - Will the role of the midwife disappear from Taiwan, Republic of China? PMID- 3644885 TI - Childbirth in the eighties: what next? PMID- 3644886 TI - Nurturance: old friend, new word. PMID- 3644887 TI - Melatonin lowers plasma prolactin levels in female red deer (Cervus elaphus). AB - The aim of the study was to determine the effect of exogenous melatonin treatment on circulating prolactin levels in red deer. Melatonin was administered from 12 June 1984 (day 1) to lactating and non-lactating hinds in the feed daily at 1600 h, and to non-lactating hinds by a subcutaneous implant. Average concentrations (ng/ml) of prolactin in plasma taken serially over 15-h periods were significantly higher for untreated hinds than for melatonin-treated animals on day 15 whether lactating (66-133 v. 23-28, P less than 0.05) or non-lactating (28 174 v. 8-13, P less than 0.01), remained higher on day 36 (lactating: 41-152 v. 15-21, P less than 0.05; non-lactating: 21-50 v. 1-7, P less than 0.001) but had decreased to similar levels on day 72 (lactating: 5-24 v. 7-17; non-lactating: 2 9 v. 0-4). The advanced reduction in plasma prolactin for all melatonin-treated hinds was associated with an advanced onset of seasonal breeding activity. PMID- 3644889 TI - Developmental assessment with the Denver Developmental Screening Test: an effective approach for clinical instruction and performance evaluation. PMID- 3644888 TI - Pinealocyte dense-cored vesicles and synaptic ribbons: a correlative ultrastructural-biochemical investigation in rats and mice. AB - Dense-cored vesicles (DCV) and synaptic ribbons (SR) were quantified in the pineal gland of the rat (Sprague-Dawley) and mouse (Sasco/ICR strain), and day/night differences in frequency of these organelles correlated with levels of indoles determined by high performance liquid chromatography (HPLC). There were significant day/night differences in levels of serotonin (5HT), 5-hydroxyindole acetic acid (5HIAA), N-acetyl-5HT, and melatonin in the rat gland. Melatonin and N-acetyl-5HT were not detectable in the mouse gland sampled every 4 h over the light:dark cycle. The concentrations of 5HT and 5HIAA (ng/microgram protein) were similar in light-adapted rats and mice, but these indoles did not exhibit a circadian rhythm in the mouse gland. Correlative ultrastructural/biochemical results suggest that DCV do not contain physiologically important stores of 5HT since 1) the mouse gland contains the same number of DCV as the rat during the daytime, but only one-tenth the levels of 5HT, 2) day/night 5HT levels do not vary in the mouse gland, but there is a significant nocturnal decline in DCV numbers, and 3) 5HT levels in the rat gland decline at night when DCV numbers increase. Numbers of SR were significantly elevated at night in the rat and mouse, and the frequency of this organelle was similar in both species. However, ribbon-type SR predominated in rat pinealocytes, whereas SR in the mouse were almost exclusively spherical in shape. Day/night differences in SR numbers in the mouse gland suggest that cellular mechanisms regulating the frequency of this organelle do not involve factors related to indole metabolism. Because of the lack of photoperiodic effects on indole metabolism in the mouse pineal gland, this species is a potentially important model to study the functional relationship of pinealocyte organelles to cyclical changes in pineal products other than indoles (e.g., peptide/protein factors). PMID- 3644890 TI - Cognitive screening for adolescent health education. PMID- 3644892 TI - The importance of managerial credibility. PMID- 3644891 TI - The motorized tricycle: an accident waiting to happen. PMID- 3644893 TI - Personal and vicarious liability. PMID- 3644894 TI - Chest physiotherapy and mechanical vibration. PMID- 3644895 TI - Development of a research and publication council in a clinical setting. PMID- 3644896 TI - Volunteerism in pediatric nursing: a conceptual model and practical applications. PMID- 3644897 TI - Has God forsaken the emergency department? PMID- 3644899 TI - Is there a formula for spiritual care? PMID- 3644898 TI - Creative spiritual care for the elderly. PMID- 3644900 TI - Is anybody listening? PMID- 3644901 TI - Miracle on Times Square. PMID- 3644902 TI - When parents refuse treatment for their children. PMID- 3644903 TI - When parents refuse treatment for their children. A home health nurse responds: seek understanding. PMID- 3644904 TI - When parents refuse treatment for their children. A cult expert responds: resist false teaching. PMID- 3644905 TI - When parents refuse treatment for their children. A faculty nurse responds: identify the issues. PMID- 3644906 TI - Rosy Williamson: a one-nurse relief agency. Interview by Melodee Yohe. PMID- 3644907 TI - Coming home to die. PMID- 3644909 TI - The lady in 415. PMID- 3644908 TI - Are AIDS patients uneducable? PMID- 3644910 TI - We let our son die: the tragic story of Rita and Doug Swan. PMID- 3644911 TI - The law should protect all children. PMID- 3644913 TI - Clinical problem: maintaining clear, timely clinic records. PMID- 3644912 TI - Use of a continuous intravenous morphine infusion for pain control in an infant with terminal malignancy. PMID- 3644914 TI - Review of the research process. PMID- 3644915 TI - The role of the pediatric oncology nurse specialist in a follow-up clinic for long-term survivors of childhood cancer. PMID- 3644916 TI - Infection control. The prevention of pressure sores. PMID- 3644918 TI - The nursing diagnosis: the foundation of quality nursing care. PMID- 3644917 TI - The myocardial infarction patient from hospital to home. PMID- 3644919 TI - The nurse's role in obtaining organ donations. PMID- 3644920 TI - Easing the way. PMID- 3644921 TI - Your CE topic this month (No. 22). Hypertension control in the acute care setting. PMID- 3644922 TI - The Maginnis report. PMID- 3644923 TI - Characteristics of restrictiveness. PMID- 3644924 TI - Substance abuse and mental illness. Double trouble. PMID- 3644925 TI - Adult survivors of childhood incest. PMID- 3644926 TI - Community care of the chronically mentally ill. PMID- 3644927 TI - Detecting statistically in psychiatric nursing research. PMID- 3644928 TI - Hopelessness. PMID- 3644929 TI - Constructing a conceptual framework for psychosocial nursing. PMID- 3644930 TI - Understanding Italian American cultural norms. AB - The components of Italian American culture in many ways provide a striking contrast to current American beliefs, values, and living habits. The challenge to the psychiatric nurse lies in maximizing the strengths of this culture to enhance the individual's ability to be what he or she can and chooses to be within the Italian culture and within the broader context of contemporary American society. By being culturally well informed and sensitive, and sharing goals and expectations with clients (Louie), the psychiatric nurse will be accepted and trusted to provide the kind of high quality care that will ultimately have a positive impact on the mental health status of Italian Americans. PMID- 3644931 TI - The therapeutic relationship with abused women. PMID- 3644932 TI - Day-care cataract surgery. The patient's perspective. PMID- 3644933 TI - Congenital nasolacrimal duct obstruction. PMID- 3644934 TI - Becoming real. The nursing factor in chronic illness. PMID- 3644935 TI - Contact lens care products. Uses and actions of ingredients. PMID- 3644936 TI - Model eye for teaching keratometry. PMID- 3644937 TI - Nasal-oropharyngoscopy: a simple test to evaluate lacrimal duct function in children. PMID- 3644939 TI - [Midwives and progress in instrumentation in medical electronics]. PMID- 3644938 TI - Genetic polymorphism of properdin factor B (BF) in Chinese patients with two types of diabetes mellitus. PMID- 3644940 TI - [Use of medical electronics in monitoring during delivery]. PMID- 3644941 TI - [Basis and clinical presentation of monitoring during delivery]. PMID- 3644943 TI - [Medical electronics instrumentation and nursing in the NICU (newborn intensive care unit)]. PMID- 3644942 TI - [Medical electronics instrumentation and nursing in the delivery room: patients' viewpoint]. PMID- 3644944 TI - [Handling of medical electronics instruments for the perinatal period]. PMID- 3644946 TI - [Questions and answers on breast feeding: the quality of human milk]. PMID- 3644945 TI - [Vaginal birth after cesarean section]. PMID- 3644947 TI - [A letter from a graduate of a midwifery school]. PMID- 3644948 TI - [Perinatal nursing of mothers and infants: a psychosocial approach. Nursing of expectant mothers during psychological crises]. PMID- 3644950 TI - [Changes in the midwifery functions. 21. Evaluation of midwifery education by Ms. Mathison]. PMID- 3644949 TI - [Thoughts on childbirth and child rearing. 23. Toward a child's independence- from the end of confinement to the celebration of birth]. PMID- 3644951 TI - [Ontogeny to understand the development of abnormalities]. PMID- 3644952 TI - [Guideline in assistance of menopausal women at various stages]. PMID- 3644953 TI - [Educational evaluation. Evaluation of the emotional aspect]. PMID- 3644954 TI - [Acute leukemia and pregnancy]. PMID- 3644955 TI - [Nursing theory. 13. On Roger's Nursing Theory. (3): Explanation of an expression, "the scene of energy"]. PMID- 3644956 TI - [Understanding of "self help". Encounter with the parties involved: search for the relationship between self-help and nursing]. PMID- 3644958 TI - [Progress in Japanese medicine. Oxygen therapy at home: an interview with Dr. Tatsuo Arai, Director, KDD Health Center]. PMID- 3644957 TI - [Supporting self-help]. PMID- 3644959 TI - [Function and role of self-help groups: from the First Self-Help Group Seminar]. PMID- 3644960 TI - [Research materials used at the First Self-Help Group Seminar]. PMID- 3644962 TI - [Current status and future prospect for Japanese involvement in international emergency medical care]. PMID- 3644961 TI - [Profile of a nurse: Ms. Kazuko Adachi who organized a traditional Japanese puppet show group for social rehabilitation of the mentally disturbed]. PMID- 3644963 TI - [A record by a practicing physician and a nursing instructor at Takamatsu]. PMID- 3644964 TI - [Practice of Oriental medicine. 16. Treatment of "Tai-in byo"]. PMID- 3644965 TI - [On welfare and care in the aging society. 5. Re-evaluation of ADL]. PMID- 3644966 TI - [Introduction of POS to nurses. 13. Significance of "modification" as a prerequisite for auditing conducted at the bedside]. PMID- 3644967 TI - [A record of a wife who experienced a loss of her husband with esophageal cancer: a peaceful final moment]. PMID- 3644968 TI - [Rehabilitation of patients after laryngectomy: a self-help organization of patients]. PMID- 3644969 TI - [Overseas study by a nurse: a prologue of a study in England]. PMID- 3644970 TI - [Real time Doppler echocardiotomography: an interview with Dr. Sinichi Takagi, the First Department of Surgery, Saitama Medical College]. PMID- 3644971 TI - [Decision making in nursing: a dilemma in informing the patient of the result of diagnosis]. PMID- 3644972 TI - [Interpretation of nursing theories. 14. Roger's nursing theory. 4. An expression, the "universe of the open system"]. PMID- 3644973 TI - [The concept of the "fixed team nursing": its introduction to primary nursing]. PMID- 3644974 TI - [Fixed team nursing: a physician's view]. PMID- 3644975 TI - [Training of team leaders: the fixed team nursing system at Itami City Hospital]. PMID- 3644976 TI - [A lesson in the practice of fixed team nursing: a view of the nursing staff]. PMID- 3644977 TI - [Problems and overview on the operation of fixed team nursing: in the development of team activities]. PMID- 3644978 TI - [Profile of a nurse: Ms. Linda Kawamoto, a Canadian nurse and a member of the regional mental health service]. PMID- 3644979 TI - [Self-motivated search for opportunities for self-enlightenment by modern nursing students: "on comprehensive medical care", the 4th Summer Workshop of 1986 held in Kyoto]. PMID- 3644980 TI - [An essay by a physician: an optimum relationship with nursing students]. PMID- 3644981 TI - [Practice of Oriental medicine. 14. Treatment of "sho-in-byo" and "kecchin byo"]. PMID- 3644982 TI - [Welfare and medical care of the aging society. 6. The raison d'etre for the aged]. PMID- 3644984 TI - [A record by a wife who lost her husband to esophageal cancer. 2]. PMID- 3644983 TI - [Introduction of POS to nursing. 17. Importance of the user (the patient) in bedside auditing]. PMID- 3644985 TI - [Self-help theories. Lectures by patients at universities. 1. Responses by students]. PMID- 3644986 TI - [Overseas studies by a nurse. 2. England]. PMID- 3644987 TI - [Introduction to the theoretical basis of nursing theory. 15. Rogers' nursing theory. 5: The 4th dimensional time and space]. PMID- 3644988 TI - [The part of me acting as a head nurse: a comment by a head nurse]. PMID- 3644989 TI - [Selection of a head nurse and description of her activities: Okayama University Hospital]. PMID- 3644990 TI - [Selection of a head nurse and description of her activities: National Yokohama University]. PMID- 3644991 TI - [Selection of a head nurse and description of her activities: Suwa Red Cross Hospital]. PMID- 3644992 TI - [Selection of a head nurse and description of her activities: Yodogawa Christian Hospital]. PMID- 3644993 TI - [Selection of a head nurse and description of her activities: Shakai Hoken Tonan General Hospital]. PMID- 3644994 TI - [Selection of a head nurse and description of her activities: Sekigoshi Hospital]. PMID- 3644995 TI - [My experience with an examination for a head nurse]. PMID- 3644997 TI - [Survey on nurses' opinions on their head nurse]. PMID- 3644996 TI - [My experience with an examination for a head nurse]. PMID- 3644998 TI - [Psychology of head nurses and the nursing staff: a discussion by head nurses]. PMID- 3644999 TI - [A special interview with Dr. Sekihara, Public Relations Committee Chairman, the 22nd General Meeting of the Japanese Medical Association: Active participation by medical personnel being sought]. PMID- 3645000 TI - [Profile of a nurse: Ms. Ikuko Oda in charge of dietary education of diabetic patients]. PMID- 3645001 TI - [Geriatric care in aging societies (Denmark and Sweden)]. PMID- 3645002 TI - [A record of a hospital-affiliated physician. Relationship with the head nurse]. PMID- 3645003 TI - [Clinical practice of Oriental medicine. 15. Application to diagnosis (1): observation of the patient]. PMID- 3645004 TI - [Welfare and medical care in the aging society. 7. Quality of life for the aged]. PMID- 3645005 TI - [Record of a wife who lost her husband to esophageal cancer]. PMID- 3645006 TI - [Self-help theory: learning from self-help groups. 9. Lectures given by members of the group. 2. Reports by the lecturers]. PMID- 3645008 TI - [Structure and mechanism of the brain. 1. Cognition disorders (1): pathogenesis of cognition disorders]. PMID- 3645007 TI - [Overseas study by a nurse. England. 3]. PMID- 3645009 TI - [Organization of a home care volunteer team]. PMID- 3645010 TI - [Nursing theory. 16. Orem's nursing theory. 1: Definition of self care in nursing]. PMID- 3645011 TI - [Technological and economic approach to standard nursing: Patient's view on reevaluation of the standard nursing system]. PMID- 3645012 TI - [Evaluation of nursing care based on "comfort" of the patient: approach by a standard nursing study group of the Tokyo Nursing Seminar]. PMID- 3645013 TI - [Death of a native Tokyoite: care of an aged person who lived alone and the problem of its cost]. PMID- 3645014 TI - [Computation of the nursing cost in a case of an aged person who lived alone]. PMID- 3645015 TI - [Current expectation on nursing: a revision of mental health legislation]. PMID- 3645016 TI - [An essay by a physician: an ordeal of new nursing graduates]. PMID- 3645018 TI - [Welfare and medical care in the aging society. 8. The aged and independence]. PMID- 3645017 TI - [Practice of Oriental medicine. 16. Diagnosis through auditory and olfactory senses and through touch]. PMID- 3645019 TI - [A record by a wife who lost her husband to esophageal cancer. 4]. PMID- 3645020 TI - [Profile of a nurse: Patricia N. Murray, a school nurse at the Sacred Heart International School of Tokyo]. PMID- 3645021 TI - [Nursing students and teaching of "self-help groups"]. PMID- 3645022 TI - [Overseas study by a nurse. 4. England]. PMID- 3645023 TI - [Behavioral characteristics and psychological state of patients with myocardial infarction]. PMID- 3645024 TI - [Revision of the law concerning health care of the aged]. PMID- 3645025 TI - [Dependence of aged men on their wives and independence of aged women]. PMID- 3645026 TI - [Blind spot in the basic care of patients with cerebrovascular disorders]. PMID- 3645028 TI - [Need of nursing during stage 2 of myocardial rehabilitation]. PMID- 3645027 TI - [Keypoints in geriatric nursing. 1. Evaluation at hospital admission]. PMID- 3645029 TI - [Postoperative rehabilitation and problems of aged patients with myocardial infarction]. PMID- 3645030 TI - [Physiological factors causing interruption of the rehabilitation program for patients with acute myocardial infarction]. PMID- 3645031 TI - [Counseling technic to ease the anxiety of patients with myocardial infarct]. PMID- 3645032 TI - [Response to myocardial infarct patients expressing anxiety concerning cessation of medication]. PMID- 3645033 TI - [Effects of exercise therapy by patients with myocardial infarction--with special reference to evaluation of various age groups]. PMID- 3645034 TI - [Nursing of patients with myocardial infarction complicated with other functional disorders]. PMID- 3645035 TI - [Keypoints in progression of myocardial rehabilitation--for safety and efficacy of the rehabilitation program]. PMID- 3645036 TI - [Keypoints in the diagnosis and therapy of right ventricular infarction]. PMID- 3645037 TI - [Exercise and nursing of patients with myocardial infarction--for the preparation of better nursing records]. PMID- 3645038 TI - [Psychiatric symptoms seen at the ICU]. PMID- 3645039 TI - [Prevention of ischemic heart diseases initiated during childhood]. PMID- 3645041 TI - [Keypoints in emergency care. 1. Triage]. PMID- 3645040 TI - [Designing of a disposable plastic tube for blood sedimentation and its efficacy]. PMID- 3645042 TI - [Triage and keypoints in nursing observation]. PMID- 3645043 TI - [Normal electrocardiograms]. PMID- 3645044 TI - [Abnormalities of the P wave]. PMID- 3645045 TI - [Abnormalities of the QRS wave]. PMID- 3645046 TI - [Abnormalities of the ST-T wave]. PMID- 3645047 TI - [Abnormalities of the U wave]. PMID- 3645049 TI - [New electrocardiographic guidance. Angina pectoris]. PMID- 3645048 TI - [New electrocardiographic guidance. Myocardial infarction]. PMID- 3645050 TI - [New electrocardiographic guidance. Heart valve diseases]. PMID- 3645051 TI - [New electrocardiographic guidance. Hypertensive heart diseases]. PMID- 3645052 TI - [New electrocardiographic guidance. Pulmonary heart disease]. PMID- 3645053 TI - [New electrocardiographic guidance. Electrolyte imbalance]. PMID- 3645054 TI - [New electrocardiographic guidance. Digitalis intoxication]. PMID- 3645055 TI - [Electrocardiographic monitoring]. PMID- 3645057 TI - [Vector cardiogram]. PMID- 3645056 TI - [Holter electrocardiogram]. PMID- 3645058 TI - [Exercise electrocardiographic test]. PMID- 3645059 TI - [His bundle electrocardiogram]. PMID- 3645060 TI - [Esophageal lead electrocardiogram]. PMID- 3645061 TI - [Family dynamics and health]. PMID- 3645062 TI - [Creation of theoretical framework]. PMID- 3645063 TI - [Analysis of parents' care for emotional confusion of 2-year-old children caused by hospitalization]. PMID- 3645064 TI - [Research based on Roger's conceptual model]. PMID- 3645065 TI - [To improve the quality of nursing research--role of theories and conceptual framework in research]. PMID- 3645066 TI - [Nursing theories and nursing research]. PMID- 3645067 TI - [Role theory and nursing research]. PMID- 3645068 TI - [Role transition and health]. PMID- 3645069 TI - [Family systems theory and nursing research]. PMID- 3645070 TI - [The purpose of POS (problem-oriented system)]. PMID- 3645071 TI - [Preliminary introduction of POS]. PMID- 3645072 TI - [POS and medical systems. Introduction]. PMID- 3645073 TI - [Experimental introduction of POS and evaluation of the nursing contents]. PMID- 3645074 TI - [Evaluation of the nursing record by POS]. PMID- 3645075 TI - [Introduction of the nursing assignment system and POS: a trial to approach the philosophy of POS]. PMID- 3645076 TI - [Problems which can be solved by a patient care team--handling of nursing problems]. PMID- 3645077 TI - [Preparation of a nursing record by POS: on the future trend in nursing records]. PMID- 3645078 TI - [Use of POS in the ambulatory service]. PMID- 3645079 TI - [POS as a revolutionary concept opposing the conventional DOS (disease or doctor oriented system)]. PMID- 3645080 TI - [POS and education. Introduction]. PMID- 3645081 TI - [POS-based education of dietetic students in hospital training]. PMID- 3645082 TI - [Problems with the introduction of POS to the entire hospital system]. PMID- 3645084 TI - [Nursing service control (auditing) using discharge summaries]. PMID- 3645083 TI - [Problems associated with POS in the education in internal medicine]. PMID- 3645085 TI - [Therapy of a patient as a whole, training in team care, and POS]. PMID- 3645086 TI - [POS and education. Conclusion]. PMID- 3645087 TI - [POS and future medicine. Introduction]. PMID- 3645088 TI - [POS for communication]. PMID- 3645089 TI - [POS to improve the quality of patient care]. PMID- 3645090 TI - [Communication with the succeeding shift and POS]. PMID- 3645091 TI - [POS at the ambulatory service]. PMID- 3645092 TI - [Advanced workshop for the improvement of POS]. PMID- 3645094 TI - [An interview with nursing faculty: Mrs. Sachiko Hosokoshi of the Morioka Red Cross Nursing School]. PMID- 3645095 TI - [Interpersonal relationship between patients and nursing students and educational interpretation of the problem of gifts from patients]. PMID- 3645093 TI - [From DOS to POS]. PMID- 3645096 TI - [Study on the inherent motivation toward study in clinical training]. PMID- 3645097 TI - [Evaluation of a teaching method to nurture motivation for studies: encouraging self-evaluation using a check list]. PMID- 3645098 TI - [Approach to a student having both psychological and physical problems--a case of a student at a 2-year nursing college]. PMID- 3645099 TI - [Technical instruction in nursing related to excretion]. PMID- 3645100 TI - [Systematization of nursing education. 5. Theories of nursing education]. PMID- 3645101 TI - [Nursing education and cultural basis]. PMID- 3645102 TI - [Creation of images of pregnant women in the process of learning through experience]. PMID- 3645103 TI - [Nursing assistance in maintaining cleanliness]. PMID- 3645104 TI - [Curriculum organization in basic nursing education courses]. PMID- 3645105 TI - [An interview with a nursing instructor: Prof. Yoko Sotozaki, President, Tenshi Women's Junior College]. PMID- 3645106 TI - [The role of philosophy in nursing education]. PMID- 3645107 TI - [Concepts necessary in the basic philosophy of the nursing education curriculum]. PMID- 3645108 TI - [Ethical viewpoint necessary in nursing education curricula]. PMID- 3645109 TI - [Educational policy based on the founding philosophy of the St. Maria College and its curriculum characteristics]. PMID- 3645110 TI - [On the basic courses at nursing schools]. PMID- 3645111 TI - [Maternal and child health care in the future]. PMID- 3645112 TI - [Nursing in everyday life. 2. Feeding of patients (2)]. PMID- 3645113 TI - [Nursing roots in public health service in the wilderness. Service for the residents without financial compensation]. PMID- 3645114 TI - [Survey on the status of aged dementia patients at home and their families at Tokorozawa, Saitama Prefecture (1)]. PMID- 3645115 TI - [Comprehensive public health nursing activities at Shimane Prefecture: the goal of focal regional activities]. PMID- 3645116 TI - [Study on professional and unique characteristics of public health nursing activities. A study of enuresis as an example. VI. Background of the development of enuresis and nursing activities for clinical cases]. PMID- 3645117 TI - [Effects of health counseling and nutritional education of diabetic patients at a health center]. PMID- 3645119 TI - [For lively activities: experience with social rehabilitation of patients with mental disorders]. PMID- 3645118 TI - [Trends in public health nursing studies: studies conducted in a 5-year-period from 1980 to 1984]. PMID- 3645120 TI - [Reevaluation of prenatal education of expectant mothers: the format and keypoints of teaching. A panel discussion]. PMID- 3645121 TI - [Regional differences in bronchial injuries due to nitrogen dioxide and elastase]. PMID- 3645122 TI - Looking back: the nurse historian. PMID- 3645123 TI - Why should I belong to my professional organization. PMID- 3645124 TI - Educating nurse educators. PMID- 3645125 TI - Nurse as change agent: Eula Benton. Interview by Karen Smith. PMID- 3645126 TI - Learning to be change makers. PMID- 3645127 TI - Media coverage: a primary facilitator of community research. PMID- 3645128 TI - The impact of television on the public image of nursing. PMID- 3645129 TI - [Characteristics of changes in the kallikrein-kinin system of blood in hypertension]. PMID- 3645130 TI - [The chronically ill patient in an acute hospital--a descriptive study. "His care was truly satisfying..."]. PMID- 3645131 TI - [3d International Congress for Psychiatric Nursing. Encouragement for psychiatric nursing personnel]. PMID- 3645132 TI - [42-hour week: when? how?]. PMID- 3645133 TI - [4th International Congress on Oncologic Nursing. A worldwide view on oncologic nursing]. PMID- 3645134 TI - [Developments in nursing (2). Concepts, theories, models--where lies the difference?]. PMID- 3645135 TI - [European meeting in Norway. The European Nursing Student Group needs new impulses]. PMID- 3645136 TI - [Regarding Italian nursing education. The search for professional identity]. PMID- 3645137 TI - [Humor. Open letter to patients whose nurses are too serious]. PMID- 3645138 TI - [AIDS: fantasies and realities]. PMID- 3645139 TI - [3 years later: the cycle of intensification in nursing care at the Vaud University Hospital Center]. PMID- 3645140 TI - [Considerations on the pain experience of a nursed nurse: talking about it]. PMID- 3645141 TI - [Forum Naissance--Geneva, 21-23 November 1986. Being born today: another look]. PMID- 3645142 TI - [Modern technics: amniocentesis]. PMID- 3645143 TI - [Research paper: children's cries]. PMID- 3645144 TI - [Steiner School, a different school. The anthroposophic view of the young child]. PMID- 3645145 TI - [An application of the nursing process in pediatrics: the obese child]. PMID- 3645146 TI - [Artificial procreation: where do we stop?]. PMID- 3645148 TI - [Perceptions and interpretations on the part of cancer patients. How does the patient experience his illness?]. PMID- 3645147 TI - [Meeting of maternal-infant nurses on 6 December 1986 in Berne. "You have something to offer!]. PMID- 3645149 TI - [Effects on the development of mother-child relations. Separation after delivery impedes synchronization]. PMID- 3645151 TI - [Development of independence in children during the 1st and 2nd year. Symbiosis- bonding--relationship]. PMID- 3645150 TI - [Development of the father-child relationship. A frequently underestimated element]. PMID- 3645152 TI - [The development of infantile perception. The key to communication]. PMID- 3645153 TI - [AIDS patients in the hospital: nursing responsibly and without fear]. PMID- 3645154 TI - [Aspects of interdisciplinary cooperation. Knowledge and competence to be exchanged and appreciated]. PMID- 3645155 TI - [Interdisciplinary team. A practical example in a nursing home. Team work for encouragement and cheering on]. PMID- 3645156 TI - [Meeting of the Swiss Nursing Association 1987. How can the quality of care be measured?]. PMID- 3645157 TI - [Nursing in case of catastrophe as a preparation for war?]. PMID- 3645158 TI - [Interdisciplinary team. Experiences at the Sierre regional health center. Good intentions are not enough!]. PMID- 3645159 TI - [Collaboration in non-hospital care. Interdisciplinary activities: why and how?]. PMID- 3645160 TI - [Counselor in diabetology and partner in interdisciplinary collaboration. The evaluation is positive]. PMID- 3645161 TI - [A theoretical approach. Interdisciplinary collaboration: necessity and limits]. PMID- 3645162 TI - [Potentials, risks and ethical problems of prenatal diagnosis]. PMID- 3645164 TI - [What are the tasks of Balint groups?]. PMID- 3645163 TI - [Breast cancer--diagnosis and therapy]. PMID- 3645165 TI - [Atropine]. PMID- 3645166 TI - [Health for 100 franks]. PMID- 3645167 TI - [Sex and pregnancy guidance at the deaconess relief organization in Bavaria. The possibilities of counseling]. PMID- 3645168 TI - [Abortion and the preservation of life]. PMID- 3645169 TI - [Hygienic foundations of urinary catheterization for the prevention of infections and complications]. PMID- 3645170 TI - [Clinical aspects and therapy of non-Hodgkin lymphomas]. PMID- 3645171 TI - [Diagnosis of immediate hypersensitivity]. PMID- 3645173 TI - [Diagnosis of personality disorders]. PMID- 3645172 TI - [Digitoxin]. PMID- 3645174 TI - [The interplay of primary nursing, therapeutic nursing and contact nursing within the framework of comprehensive nursing care for patients]. PMID- 3645175 TI - Prenatal education for pregnant adolescents. AB - Providing services to pregnant adolescents poses a unique challenge for health professionals. Several programs have emerged tailored specifically to this special population. Prenatal education is an integral component of these programs. This paper describes prenatal education classes offered at Teen Pregnancy Service, including special modifications required to meet the learning needs of participants. Outcome data provided for 66 pregnant teens show significant changes in prenatal knowledge following the class series. Information is included about the teens' backgrounds, their perceptions regarding potential problems infants may experience, and how they remembered being reared by their parents. PMID- 3645176 TI - A three-year study of obesity and its relationship to high blood pressure in adolescents. AB - A sample of 356 matched cases were tracked for three years during high school. Measures taken included self-reported behavior and clinical measures of height, weight, skinfold, blood pressure, and body mass index. Data were analyzed by ethnic group, age, and sex groups. Three year (1981-1982 to 1984-1985) trends for students who were overfat, overweight, and obese revealed: a relatively greater proportion of female to male students were overfat as seniors; overweight trends for each of the four groups (ethnic group and gender) were stable over the study period; a sharp increase of obesity trends among black females was observed; and significant positive relationships existed between Percent Ideal Body Weight, skinfold thickness, Body Mass Index, and blood pressure among females of both ethnic groups. The hypothesis that the early onset of obesity is an indicator of obesity in older adolescents was supported. Students classified at risk as freshmen are more likely to remain at risk as seniors. PMID- 3645177 TI - Self-care motivation: a model for primary preventive oral health behavior change. AB - Attempts to promote compliance of children with preventive health practices are most successful when strategies for motivating self-care behavior change address the physical, cognitive, and affective components of individuals. This study evaluated the effectiveness of using a Self-Care Motivation Model and curriculum to promote oral health and hygiene behavior change among 92 third grade students randomly selected according to homeroom assignments in five Gloucester, Mass., public schools. Student gingival health and oral hygiene measures were obtained two weeks prior to, and two weeks, three months, and one year after educational sessions. Group one, comprised of mid-high socioeconomic status family students, served as an oral examination control. Groups two-five received educational sessions designed to teach students various aspects of oral health. Significant improvements (p less than .001) in gingival health and dental plaque scores were observed in all experimental groups for up to three months. During a period of three months to one year, mean group scores returned to baseline and worsened for all groups except group five, the lowest socioeconomic family status group and the only group receiving the full series of self-care motivation curriculum sessions. Experimental group teachers reported that most children responded favorably to the program, and specific attitude and behavior changes were observed in many children. Further research evaluating the efficacy of using this self-care motivation model in primary preventive health education programs is indicated. PMID- 3645178 TI - Qualitative evaluation issues in funded school health projects. PMID- 3645179 TI - Nutrition education: from the lunchroom to the classroom. PMID- 3645180 TI - Enriching professional preparation of school nurses through a health assessment course. PMID- 3645181 TI - FDA seeks help to reduce adolescent x-ray exposure. PMID- 3645182 TI - Implementation of "Heart Smart:" a cardiovascular school health promotion program. AB - The Bogalusa Heart Study, an investigation of 8,000 children, has compiled a large data bank on cardiovascular (CV) risk factors in children during the past 12 years. Precursors of heart disease begin at a young age, with many children already possessing one or more known clinical risk factors--hypertension, obesity, and adverse lipoprotein changes. Having obtained data examining the determinants, distributions, interrelationships and trends over time for CV risk factors, a foundation was provided to address additional questions directed toward intervention strategies. "Heart Smart" is a comprehensive, research-based CV health promotion program testing differential effects of a population (public health) strategy versus a high-risk approach within four elementary schools. The major goal of "Heart Smart" is to reduce CV risk factors in children with an intervention to facilitate the adoption of healthful lifestyles. Objectives, intervention modalities, and design and evaluation procedures for children and adults in a total school environment (K-6) are described. PMID- 3645183 TI - [Home nursing system: organization of the system which required several years]. PMID- 3645184 TI - [English language training at a 2-year nursing school]. PMID- 3645185 TI - [Complaint by a patient on clinical training of nursing students]. PMID- 3645186 TI - [Problematic attitude of nursing students]. PMID- 3645187 TI - [On nursing standards]. PMID- 3645188 TI - [Advantages and problems in the use of nursing standards]. PMID- 3645189 TI - [The standard care plan and its utilization]. PMID- 3645190 TI - [In search of standard nursing criteria based on nursing processes--through a nursing example in (surgical) gastroenterology]. PMID- 3645192 TI - [Music and the brain]. PMID- 3645193 TI - [Re-evaluation of white in the color environment of a sick room (2). A survey on the color environments of 300 hospitals (and other health facilities) in Japan]. PMID- 3645191 TI - [Effects of complications on the recovery process]. PMID- 3645194 TI - [Leadership required in the head nurse. Responsibility of personnel management by the nursing director]. PMID- 3645195 TI - [Human engineering study of nursing shifts. 1. Interrelationship between seasonal temperature and humidity changes and fatigue indices]. PMID- 3645196 TI - [Accreditation of hospitals]. PMID- 3645197 TI - [Effective classroom practice in nursing. (2). Introduction of role playing in the practice of interactions with geriatric patients]. PMID- 3645198 TI - [Humane nursing]. PMID- 3645199 TI - [A day of a home-visiting nurse]. PMID- 3645200 TI - [Physiopathology, life activities, and prognosis of children with congenital heart diseases]. PMID- 3645201 TI - [Diagnostic and therapeutic processes for children with congenital heart diseases]. PMID- 3645202 TI - [Keypoints in comprehensive observation of children with congenital heart diseases]. PMID- 3645204 TI - [Nursing of an infant with transposition of great vessels following radical surgery]. PMID- 3645203 TI - [Nursing plan for children with congenital heart diseases]. PMID- 3645205 TI - [Oral care of vegetative patients]. PMID- 3645206 TI - [Nursing process: nursing of children with congenital heart diseases. Excessively abstract expression of specific plans to achieve the goal]. PMID- 3645207 TI - [Nursing for the expansion of the ADL of a patient with chronic rheumatoid arthritis]. PMID- 3645208 TI - [Embarrassment experienced by nursing students at sex-related clinical scenes]. PMID- 3645209 TI - [Test yourself. Nursing of a patient with chronic rheumatoid arthritis]. PMID- 3645210 TI - [A lesson in nursing of a puerperal patient during recovery from severe pregnancy toxemia--education of the patient with little knowledge of illness at the time of discharge from the hospital]. PMID- 3645211 TI - [Convulsions in infants]. PMID- 3645212 TI - [Empathy expressed by words alone]. PMID- 3645213 TI - [Tears shed by nurses at clinical scenes: tears shed or held back by nurses]. PMID- 3645215 TI - [Tears shed by nurses and improvement in nursing practice]. PMID- 3645214 TI - [A tendency of a nursing student to avoid contact with distressed terminal patients]. PMID- 3645216 TI - A view from the Clapham omnibus. PMID- 3645217 TI - Medical technology and new frontiers of family law. PMID- 3645218 TI - New law for laboratory life. PMID- 3645219 TI - Experimenting and the new biology: "a consummation devoutly to be wished". PMID- 3645221 TI - The ethics of embryo research. PMID- 3645220 TI - The legal status of the embryo in vivo and in vitro: research on and the medical treatment of embryos. PMID- 3645222 TI - The ethics of embryo research: not as easy as it sounds. PMID- 3645223 TI - Legal and ethical problems in decisions for death. PMID- 3645224 TI - The case for active voluntary euthanasia. PMID- 3645225 TI - Against infanticide. PMID- 3645226 TI - "Should the grandparents die?": allocation of medical resources with an aging population. PMID- 3645227 TI - Made in the U.S.A.: legal and ethical issues in artificial heart experimentation. PMID- 3645228 TI - Bentham in a box: technology assessment and health care allocation. PMID- 3645229 TI - The medical malpraxis position in the United Kingdom. PMID- 3645230 TI - The Mental Health Act 1983 (England and Wales): legal safeguards in limbo. PMID- 3645231 TI - The impact of the Canadian Charter of Rights and Freedoms upon Canadian mental health law: the dawn of a new era or business as usual? PMID- 3645232 TI - A right to choose death: the judicial trilogy of Brophy, Bouvia, and Conroy. PMID- 3645233 TI - Preschool children's conceptions of health and health behaviors. AB - Conceptions of health and health related behaviors of 41 four and five year olds were explored, using a picture-interview guide. Areas of interest included feeling tone associated with health, identification of children who are healthy, health promotion behaviors, behaviors deleterious to health, and individuals who help children stay healthy. Subjects' responses to selected questions were scored; choices from groups of pictures concerned with health promotion behaviors and persons who help in maintaining health were ranked, depending on order of selection. Most subjects were able to make the correct association between feeling tone and health status, and determine health status of depicted children. Health promotion behaviors selected--in descending order of mean ranking--were eating, visiting the doctor, brushing teeth, sleeping, running, and washing hands. Most subjects could correctly identify behaviors hazardous to health. Chi square revealed no significant differences in scores or rankings by age or sex. Subjects in the lowest of the three family income groups tended to have lower scores. PMID- 3645234 TI - [Treatment with mevinolin in a patient with pseudo-homozygous hypercholesterolemia]. PMID- 3645236 TI - [Work of the nurse in the radionuclide diagnosis department (laboratory)]. PMID- 3645235 TI - Update on HIV infection. HIV antibody testing. PMID- 3645237 TI - [Joint advanced training of hospital head nurses and head physicians]. PMID- 3645238 TI - [Participation of nurses in the annual dispensary care for the rural population]. PMID- 3645239 TI - [Changes in the eye during aging]. PMID- 3645240 TI - [Retinoblastoma in children]. PMID- 3645241 TI - [Care for children with eye pathology in the hospital]. PMID- 3645242 TI - [Characteristics of the work of the head nurse in the drug abuse department of an industrial enterprise]. PMID- 3645243 TI - [Sand baths]. PMID- 3645244 TI - [Endonasal lithium electrophoresis in the treatment of patients with neurocirculatory asthenia]. PMID- 3645245 TI - [Postinjection abscesses]. PMID- 3645246 TI - [The ethics of interrelationships in a medical collective]. PMID- 3645247 TI - [The ethics of caring for middle-aged and elderly patients]. PMID- 3645248 TI - [Ethics and deontology in the work of a hospital pediatric department]. PMID- 3645249 TI - [Medical emblem: the cup with the snake]. PMID- 3645250 TI - [Neuralgia of the nasociliary nerve--Charlin's syndrome]. PMID- 3645251 TI - Admitting--a weakness or a strength? Routine admission of a woman in labour. PMID- 3645252 TI - The policy and practice in midwifery study: introduction and methods. PMID- 3645253 TI - An update on acquired immune deficiency syndrome (AIDS)--report on the international conference. PMID- 3645254 TI - Nursing shortage: why? Recruiters report shortage is back. PMID- 3645256 TI - Nurses and chemical dependency. The Board of Nursing's disciplinary role. PMID- 3645255 TI - Nursing in the Pacific. PMID- 3645257 TI - Nurses and chemical dependency. PMID- 3645258 TI - Nurses and chemical dependency. My race with addiction. PMID- 3645259 TI - Nurses and chemical dependency. Facts about nurses and chemical dependency. PMID- 3645260 TI - Nurses and chemical dependency. Reporting suspected drug abuse or diversion. PMID- 3645261 TI - Marketing of infant formulae--time for some commonsense. Interview by Pat Scowen. PMID- 3645262 TI - Learning through play. PMID- 3645263 TI - Emotional aspects of experiencing a multiple birth. PMID- 3645264 TI - Results of the Asian mother and baby campaign. PMID- 3645265 TI - Pre-pregnancy counselling in diabetes mellitus. PMID- 3645266 TI - Diabetic pregnancy. PMID- 3645267 TI - Prenatal maternal behaviour. PMID- 3645269 TI - Epigenetic canalization and phenotypic change: a minimax model. AB - A selectionist model of phylogenic behaviour is presented in which epigenetic canalization fulfills the pivotal role. It is shown that directional selection will result in stress induce creodal destabilization and in genetic unmasking. Both processes will in turn result in a rapid increase in phenotypic variance for natural selection to act on, and hence a sudden increase in the rate of phylogenic change. Acting on the epigenome via internal selection and on phenotypic peripherals via stabilizing selection, natural selection will also assure phenotypic stasis by means of increased genetic concealment, deepened canalization and developmental constraints. The latter two factors allow for the application of a minimax rule of phenotypic change: that part of an organism with the minimum potential for phenotypic change (hence the maximum canalization) will govern the direction of the maximum phenotypic change of the other parts. The hierarchialization of phenotypic change predicted by the minimax rule explains the coexistence of gradualistic and punctuational changes within lineages of the same species. PMID- 3645268 TI - Hypoglycaemia of the newborn. PMID- 3645270 TI - Nucleophilic targets in carcinogenesis, mutagenesis and chemotherapy of cancer. AB - A hypothesis is suggested, which emphasizes the role in carcinogenesis of the attack on low molecular nucleophilic substances (LMN) by electrophilic agents - chemical carcinogens, phisical factors, and antitumor alkylating agents. The significance of the degree of nucleophilicity (electronic charge, order of bonds, index of valence) as a locus minoris resistentiae of the LMN in the electrophilic attack on the latter is emphasized as well as the probable role of the hydrogenated pteridines in influencing carcinogenesis by means of ascorbate, tocopherol, SH-containing compounds etc. In support of this hypothesis the preference of electrophilic agents (derivatives of nitrogen mustard and nitrosoureas) for the places with highest degree of nucleophilicity as targets, in experiments in vitro with nucleic bases and pteridines is emphasized. PMID- 3645271 TI - The significance of proto-oncogenes in carcinogenesis. AB - A survey of the literature on activated proto-oncogenes shows that they are involved in the development of cancer but apparently not in the initiation process. The review of Klein and Klein comes to conclusions in opposition to the review of Duesberg. I favor the latter here. Active proto-oncogenes may be part of the developmental process of carcinogenesis but are not initiators of carcinogenesis. PMID- 3645273 TI - [Classification of LAV/HTLV-III associated diseases]. PMID- 3645272 TI - General mechanism of chronic diseases. AB - In a human, the cells function adequately to the needs of the organism, and to their own needs. Consequently, adequate cell function is comprised of the organism-oriented, and cell-oriented functions. It is suggested that an independent stage in the pathogenesis of a chronic disease exists which so far has not been considered. This is the disturbance of the cell-oriented function of the cells involved. This initial stage may last for years and decades, whereas function of the organ remains preserved. Organism-oriented cellular function appears to become involved in the pathologic process long after the disease has actually started. At this time the cells themselves are severely impaired, and as a result a disease acquires its progressive, irreversible course. Pathogenesis of atherosclerosis is considered as an example of the above-mentioned developments. PMID- 3645274 TI - Why higher education for nurses? Issues and developments. PMID- 3645276 TI - Competition and collaboration in higher education for health care. PMID- 3645275 TI - The university contribution to professional education. PMID- 3645277 TI - Graduate nurses in the United Kingdom: myth and reality. PMID- 3645278 TI - Higher education and the nursing profession. PMID- 3645279 TI - The need for nurse graduates in Scotland: a view from the Scottish Home and Health Department. PMID- 3645280 TI - The role of nurse graduates in the health service in the year 2000. PMID- 3645281 TI - Some issues discussed. PMID- 3645282 TI - Is education for a nursing elite? Some highlights in nursing education in Europe and North America. PMID- 3645283 TI - Postnatal cranial molding and infant attractiveness: implications for nursing. PMID- 3645284 TI - Sequelae of perinatal asphyxia. PMID- 3645285 TI - AIDS virus in breast milk: a new threat to neonates and donor breast milk banks. PMID- 3645286 TI - Air leak syndromes. PMID- 3645287 TI - Application of an ostomy pouch to a preterm infant. PMID- 3645289 TI - Psychiatric disturbance in children. PMID- 3645288 TI - Siblings in the NICU. PMID- 3645291 TI - Sexuality and the developmentally disabled. PMID- 3645290 TI - Pregnant again? PMID- 3645292 TI - Disfiguring surgery: is there a place for it? PMID- 3645294 TI - Wound care in casualty. PMID- 3645293 TI - [The heart]. PMID- 3645295 TI - [Group therapy]. PMID- 3645296 TI - On the road to recovery: the repair of a right inguinal hernia--a theatre nursing care study. PMID- 3645297 TI - Everything you wanted to know about a theatre course (but were afraid to ask)! PMID- 3645298 TI - A visit to Australia. PMID- 3645299 TI - Forward united--unity. PMID- 3645300 TI - In the hot seat?. Interview by Josephine Jones. PMID- 3645301 TI - Prevention of airborne infection in operating rooms. PMID- 3645302 TI - Difficulties facing the nurse educator. PMID- 3645303 TI - Stirring things up! PMID- 3645304 TI - Theatre design and behaviour of staff determining the number of bacteria during surgery. PMID- 3645305 TI - AIDS agreement. PMID- 3645307 TI - Settling the AIDS virus dispute. PMID- 3645306 TI - The sombre view of AIDS. AB - Extrapolation from short-term data is risky, but the development of AIDS among those infected with HIV by blood transfusions, if properly described by a normal distribution, suggests a 15-year mean incubation and a high incidence of disease among carriers of the virus. PMID- 3645308 TI - Reassessing chiefs and Indians. PMID- 3645309 TI - Nursing's role in the AHA: an interview with Connie Curran. Interview by Karen Mitchell. PMID- 3645310 TI - Product evaluation: a key to controlling costs. PMID- 3645311 TI - Empowering nursing in multihospital systems. PMID- 3645312 TI - Labor force participation of registered nurses. PMID- 3645313 TI - Nursing PPOs for corporate clients. PMID- 3645314 TI - An experiment in job sharing for the clinical nurse specialist. PMID- 3645316 TI - Royal College of Nursing. Political acumen. PMID- 3645315 TI - Leeds conference reaction to YTS proposal to aid health service manpower. PMID- 3645317 TI - Changing society's negative attitudes towards the elderly. PMID- 3645318 TI - Exciting times ahead. PMID- 3645320 TI - Commit ourselves to directing change. PMID- 3645319 TI - Royal College of Nursing. Much to gain. PMID- 3645321 TI - Should take off the armour of uniforms. PMID- 3645322 TI - Major study into the teaching of ethics in nursing. PMID- 3645323 TI - Royal College of Nursing. Watch and wait. PMID- 3645324 TI - Our poor lot is due to inactivity. PMID- 3645325 TI - The student voice must continue to be heard. PMID- 3645326 TI - ENB told 'no more cash' for EN conversion courses. PMID- 3645327 TI - Royal College of Nursing. Finding the will. PMID- 3645328 TI - Choice of hours. PMID- 3645330 TI - New government initiatives to combat AIDS. PMID- 3645329 TI - YTS students in NHS. PMID- 3645331 TI - Report reveals 'desperate' nurse shortages in London. PMID- 3645332 TI - Royal College of Nursing. Falling short. PMID- 3645334 TI - Royal College of Nursing. Key to future. PMID- 3645333 TI - Nursing education: fact or fiction, now and in the future? PMID- 3645335 TI - The political point. PMID- 3645336 TI - The rights of patients. PMID- 3645337 TI - Power and politics. PMID- 3645338 TI - [Aminoacylation of tRNA in the pt rabbit brain. II. Amino acyl tRNA level in the pt rabbit brain in vivo]. PMID- 3645339 TI - Infection risks in i.v. therapy. PMID- 3645340 TI - Research, standards, and infection control: the impact on i.v. nursing. PMID- 3645341 TI - Tumor lysis syndrome: a serious complication of chemotherapy. Implications for the i.v. nurse. PMID- 3645342 TI - Continuous heparin infusion in the home-bound ambulatory patient using the Travenol Infusor: a descriptive report. PMID- 3645343 TI - New England Deaconess guidelines for the administration of i.v. drugs. PMID- 3645344 TI - I.v. team management of patient-controlled analgesia. PMID- 3645345 TI - The association of potassium chloride and particulate matter with the development of phlebitis. PMID- 3645346 TI - Expanding the role of the i.v. nurse in infection control. PMID- 3645347 TI - Making the most of today's economic climate. PMID- 3645348 TI - The economics of change: associate degree education today and tomorrow. PMID- 3645349 TI - Faculty development: three programs make the grade. PMID- 3645350 TI - Linking psychiatric nursing care to patient classification codes. PMID- 3645351 TI - Home health agencies and hospices--stronger together or alone? PMID- 3645352 TI - Refocused family study program sharpens students' assessment skills. PMID- 3645353 TI - Again so soon? Thoughts on the nurse shortage. PMID- 3645354 TI - Dimensions of quality in nursing education. PMID- 3645355 TI - Standards of quality: the path to excellence? PMID- 3645356 TI - Harmful to our health: the language of nursing education. PMID- 3645357 TI - Sampling nursing time pinpoints staffing needs. PMID- 3645358 TI - Alcohol use and burnout among student nurses. PMID- 3645359 TI - [Declaration of the ICN on nursing research]. PMID- 3645360 TI - [Preventive measures by health personnel for avoiding AIDS]. PMID- 3645361 TI - [Nursing has made much progress]. PMID- 3645362 TI - [Function of nursing personnel and midwives in the strategy of health for all. 2]. PMID- 3645363 TI - [Recognition of the title and the free circulation of nursing professionals]. PMID- 3645364 TI - [A center for continuing education in nursing is going to be created]. PMID- 3645365 TI - [The functioning and services of the General Council are to be improved]. PMID- 3645366 TI - [We are going to put the profession in 1st place]. PMID- 3645367 TI - [The function of nursing personnel and midwives in the health strategy for all. 3]. PMID- 3645368 TI - [Nursing is at a difficult stage of transition]. PMID- 3645369 TI - The future of the nursing profession. PMID- 3645370 TI - Professional nurses in the year 2,000: committed, conscious colleagues. PMID- 3645371 TI - Believe and achieve: the standard shall be excellence. PMID- 3645372 TI - An administrator's view: ten years later. PMID- 3645373 TI - A multihospital corporation's perspective. PMID- 3645375 TI - Economic responsibility and viability of the nursing department in the prospective pay environment. PMID- 3645374 TI - Uncompensated health care: a legislative briefing paper. PMID- 3645376 TI - HCA's information systems: current products and future strategy. Hospital Corporation of America. PMID- 3645377 TI - Future trends in perioperative nursing and technology. PMID- 3645378 TI - Nurse executives' opportunity to shape a revolution. PMID- 3645379 TI - Challenges in information management for nursing practice. PMID- 3645380 TI - Professional stewardship: a model economic responsibility. PMID- 3645381 TI - Nursing in the 1990s: expanding opportunities. PMID- 3645382 TI - New frontiers in patient care assessment. PMID- 3645383 TI - Future of nursing care delivery. PMID- 3645384 TI - Objective sabbatical: a time for self-renewal. PMID- 3645385 TI - Managing your academic career: managing the boss. PMID- 3645386 TI - A textbook selection process. PMID- 3645387 TI - Film modeling: reducing student anxiety. PMID- 3645388 TI - Using a game to teach students about cost containment. PMID- 3645389 TI - Trivia games: stimulating student learning. PMID- 3645390 TI - Evaluating students' communication skills: tape recording. PMID- 3645391 TI - Integrating growth and development content into practice: a nursing process framework. PMID- 3645392 TI - Stress management: core curriculum in a graduate program. PMID- 3645393 TI - Managing faculty conflict. PMID- 3645394 TI - Self-help groups as a teaching strategy. PMID- 3645396 TI - The master's thesis: process, scope, and outcome. PMID- 3645395 TI - Promoting scholarly work among graduate students. PMID- 3645397 TI - Have a problem employee? Use this plan. PMID- 3645399 TI - Systemic origins of chest pain. PMID- 3645398 TI - Partners. PMID- 3645400 TI - Occluded trach tube. PMID- 3645401 TI - Slow-teaching the C.O.P.D. patient (continuing education credit). PMID- 3645402 TI - How well do you know the legal aspects of nursing? PMID- 3645403 TI - AIDS: coping with the fear. PMID- 3645404 TI - H.O.B. up or H.O.B. down? A guide to postop positioning of neurosurgical patients. PMID- 3645405 TI - Home-team strategies for treating pressure sores. PMID- 3645406 TI - What you can do for the confused elderly. PMID- 3645407 TI - Sharing death. PMID- 3645408 TI - Take time to laugh. PMID- 3645409 TI - [Dignity in death. Educational program]. PMID- 3645410 TI - [Mutual maternal aid or supported maternity]. PMID- 3645411 TI - [Mutual maternal aid or supported maternity. Comments by Louise Migneron]. PMID- 3645412 TI - [The professional inspection visit. What happens afterwards?]. PMID- 3645413 TI - [Intervention program in institutions. Violence towards the aged]. PMID- 3645414 TI - [Hiring unqualified personnel can be expensive]. PMID- 3645415 TI - [The "baby blues" or post-partum depression]. PMID- 3645416 TI - [Let us talk about competence in community health]. PMID- 3645418 TI - Nurse manager: between "us" and "them". PMID- 3645417 TI - [The international system of units in the field of health]. PMID- 3645419 TI - Legal implications of home health care. PMID- 3645420 TI - Closing patient units temporarily. PMID- 3645421 TI - Microcomputers: turning the database into unit management information. PMID- 3645422 TI - Psychogeriatric care: a specialty within a specialty. PMID- 3645423 TI - An expanding universe: professional career opportunities. PMID- 3645424 TI - Contracting for critical care: a new model. PMID- 3645425 TI - Who do you promote? PMID- 3645426 TI - A model for employee development. PMID- 3645427 TI - Six steps to managing unit costs. PMID- 3645429 TI - It's great to have a caring nurse, if.... PMID- 3645428 TI - Distributing scope of practice: between RNs and LPNs. PMID- 3645430 TI - Collaboration: clinical education and hospital orientation. PMID- 3645431 TI - The decisive factor in promotion. PMID- 3645432 TI - Safety fair. PMID- 3645433 TI - Incentives for retention: the psychological dimension. PMID- 3645435 TI - Change agents: a code committee at work. PMID- 3645434 TI - Quality, safety and the healthy hospital. PMID- 3645436 TI - From team nursing to primary nursing.... PMID- 3645437 TI - Integrating psychiatric patient care and staff development. PMID- 3645438 TI - Responsibility: the Greek ideal in nursing practice. PMID- 3645439 TI - Networks: the fabric of social power. PMID- 3645440 TI - Management styles: be eclectic. PMID- 3645441 TI - Marketing nursing positions. PMID- 3645442 TI - Creative staffing fills vacancies. PMID- 3645443 TI - Intern and re-entry programs: two concepts, one coordinator. PMID- 3645444 TI - A little night musing. PMID- 3645445 TI - Decision-making: the multi-attribute model. PMID- 3645446 TI - Developing a powerful and acceptable nurse staffing system. PMID- 3645447 TI - A systems look at infection control. PMID- 3645448 TI - Criterion referenced performance appraisal system: a blueprint. PMID- 3645449 TI - Managing the stress of primary nursing. PMID- 3645450 TI - Levels of practice and retention of staff nurses. PMID- 3645451 TI - Decentralization of OR management. PMID- 3645452 TI - Behaviorally anchored rating scales: pinpointing levels of performance. PMID- 3645453 TI - Problem solving in the ED. PMID- 3645454 TI - The "employment" of autonomy. PMID- 3645455 TI - Change process: a case example. PMID- 3645456 TI - Legal implications of policy and procedure manual--Part I. PMID- 3645457 TI - Analyzing acute care nursing staff productivity. PMID- 3645458 TI - Building a multicultural work environment. PMID- 3645459 TI - Organizing the psychosocial care of hospice patients. PMID- 3645460 TI - Discharge planning: home caregivers need your support, too. PMID- 3645461 TI - Adapting theory Z to nursing management. PMID- 3645462 TI - Contract learning: a leadership experience for the RN student in a BSN program. PMID- 3645463 TI - Networks: forming "old girl' connections among nurses. PMID- 3645464 TI - Job design: matching jobs to staff nurses' interests. PMID- 3645465 TI - The trauma nurse coordinator in a regionalized system of trauma care. PMID- 3645466 TI - CPR for your nursing career. PMID- 3645467 TI - Accountability: the supervisors and the system. PMID- 3645468 TI - Committee work broadens nurses' perspective. PMID- 3645469 TI - Competency-based orientation. PMID- 3645470 TI - Nursing administration by nursing council. PMID- 3645471 TI - Rehabilitation: a team for managing stroke patients. PMID- 3645472 TI - Whatever happened to theory Z? PMID- 3645473 TI - White uniform theft. PMID- 3645475 TI - The human side of organization. PMID- 3645474 TI - Professionalization: power and powerlessness. PMID- 3645476 TI - Introducing nursing diagnosis throughout the hospital. PMID- 3645478 TI - [The right to associate oneself--right to belong to a union]. PMID- 3645477 TI - CPR in small community hospitals. PMID- 3645479 TI - The right to security in the exercise of one's own profession. PMID- 3645481 TI - Changing in the world and human rights. PMID- 3645480 TI - Too old to dream? Nursing in Europe, 1986. PMID- 3645482 TI - [Human rights: commitment for the Church]. PMID- 3645483 TI - [Human rights: current questions for the health professionals]. PMID- 3645485 TI - [Right to life and its quality]. PMID- 3645484 TI - [Human rights: action and commitment]. PMID- 3645486 TI - [Right to life and to the quality of life]. PMID- 3645488 TI - The family. PMID- 3645487 TI - [The right to produce life]. PMID- 3645489 TI - The child and its own rights. PMID- 3645490 TI - Right to health. PMID- 3645492 TI - [The right to care until death]. PMID- 3645491 TI - [The rights of the patient and his family]. PMID- 3645493 TI - [Infringement upon mental dignity and upon physical integrity, upon individual freedom]. PMID- 3645494 TI - [The professional nurse facing her responsibilities]. PMID- 3645496 TI - Rights of health personnel. PMID- 3645495 TI - [2 basic presuppositions]. PMID- 3645497 TI - Right to professional education. PMID- 3645498 TI - Right to fair conditions of work. PMID- 3645499 TI - Right to the objection of conscience. PMID- 3645500 TI - Health and dismissal. PMID- 3645501 TI - The law on health and dismissal. PMID- 3645502 TI - Health and dismissal. Objective and impartial? PMID- 3645503 TI - Health and dismissal. A return on investment. PMID- 3645504 TI - Health and dismissal. A clear purpose. PMID- 3645505 TI - Construction workers cope with AIDS threat. PMID- 3645506 TI - Counselling. A problem of identity--2. PMID- 3645507 TI - How to raise your political awareness. PMID- 3645508 TI - Local government and OH. PMID- 3645509 TI - The AIDS challenge. PMID- 3645510 TI - Occupational hygiene and the OH nurse. PMID- 3645511 TI - First aid. When casualties are critical. PMID- 3645512 TI - OH law. You must be joking! PMID- 3645513 TI - Health promotion Belfast style. PMID- 3645514 TI - Hepatitis B. Mental homes: a special risk? PMID- 3645515 TI - Practice makes perfect. PMID- 3645516 TI - Shiftwork. No proper time of day. PMID- 3645517 TI - The rights and wrongs of rubber gloves. PMID- 3645518 TI - Clinical nurse specialist for substance abuse. PMID- 3645520 TI - Seeking organ donations: required request legislation. PMID- 3645519 TI - Environmental risk appraisal. PMID- 3645521 TI - Research funding: state sources. PMID- 3645522 TI - [Health for all in the year 2000. Targets of "Health for All": Implications for nursing and midwifery]. PMID- 3645523 TI - [Intravascular catheters and infusion therapy--microbiological and hygienic aspects]. PMID- 3645524 TI - [Successful relations with others--from the author's rich store of experiences]. PMID- 3645525 TI - [Successful relations with others--from the viewpoint of an administrative manager]. PMID- 3645527 TI - [Care of the aged--nurse's fate or a chosen calling? Discussion]. PMID- 3645526 TI - [Health for all in the year 2000]. PMID- 3645528 TI - Buckle up campaign--a sign of life. PMID- 3645529 TI - Orthopaedic nursing practice. Process and outcome criteria for selected diagnoses. American Nurses' Association and National Association of Orthopaedic Nurses. PMID- 3645530 TI - History and development of the orthopaedic standards. PMID- 3645531 TI - Using standards of care in the practice setting. PMID- 3645533 TI - Certification and the standards of care. PMID- 3645532 TI - Utilization of the orthopaedic nursing standards in a curriculum. PMID- 3645534 TI - Outpatient anesthesia for orthopaedic procedures (continuing education credit). PMID- 3645535 TI - Fractured femur with internal fixation. PMID- 3645536 TI - A postgraduate course in orthopaedic nursing: one prototype. PMID- 3645537 TI - Falls in the elderly: causes and prevention. PMID- 3645538 TI - Case 7--follow-up (slipped capital femoral epiphyses). PMID- 3645539 TI - Standards of care. PMID- 3645540 TI - [Metabolic lung function with regard to kinins in staphylococcal lesions]. PMID- 3645541 TI - Nursing student census with policy implications 1986. PMID- 3645542 TI - Accreditation criteria, standards, and substantiating evidence: Accreditation Division for Home Care and Community Health. PMID- 3645543 TI - Characterization of an authentic intermediate in the self-splicing process of ribosomal precursor RNA in macronuclei of Tetrahymena thermophila. AB - We have characterized a 1.5 kb RNA species in T. thermophila macronuclei previously found in vivo and including intron sequences linked to the 3' exon. This IVS-3' exon RNA could be detected in gels as a discrete molecule only after denaturation of nuclear RNA. After addition of 32P-GTP, as splicing cofactor in a nuclear in vitro system, the IVS-3' exon RNA was labeled at its 5' terminus, as was the by-product of splicing, the excised IVS RNA. The time course of labeling indicates that the IVS-3' exon RNA acts like a reaction intermediate and specifically a kinetic precursor to IVS RNA. Partial nuclease digestions showed that the IVS-3' exon RNA and the IVS RNA have the same 5' terminal sequence. In addition the IVS-3' exon RNA can release the 15-mer oligonucleotide cleaved off during circularization of IVS RNA under conditions of high temperature. Taken together, the structural, functional, and kinetic properties of the IVS-3' exon RNA strongly suggest that it represents a previously postulated in vivo intermediate in the splicing pathway. PMID- 3645544 TI - Transcription of eucaryotic tRNA1met and 5SRNA genes by RNA polymerase III is blocked by base mismatches in the intragenic control regions. AB - We have constructed duplex DNAs containing single G-T or A-C mismatches in the X. laevis tRNA1met gene. Mismatches within regions of this gene which are bound by transcription factor TFIIIC prevent transcription by RNA polymerase III. Homoduplexes with G-C----A-T mutations at some of the same sites, however, are transcribed efficiently in oocytes. Mismatches outside of the tRNA1met gene have no effect upon transcription. A survey of several point mutants in the Syrian hamster 5SRNA gene indicates that mismatches outside the internal control region somewhat reduce transcription, but a mismatch within the internal control region blocks transcription. Thus, the presence of mismatched bases in the region of DNA which interacts with RNA polymerase III transcription factors blocks transcription, perhaps by interfering with DNA renaturation following transit of the RNA polymerase. PMID- 3645546 TI - Enzymatic synthesis of chimeric tRNAs with unusual numbers of base pairs in the anticodon stem; their structure and properties. AB - Chimeric tRNATyr molecules have been constructed by enzymatic procedures in vitro from the 5'-half fragment of T. utilis tRNATyr and the 3'-half fragment of yeast tRNATyr, and vice versa. These chimeric tRNAs contain base-mismatching(s) in the anticodon stem and, therefore, have only 3 or 4 base pairs in the stem. Although the Tm of these chimeras are largely decreased, there seems to be no gross difference between the structure of native and chimeric tRNATyrs at physiological temperatures in the presence of 10 mM MgCl2. Aminoacylation assays also revealed that the tyrosine-acceptance of the chimeras are fully comparable to that of native tRNATyrs. However, the possibility remains that the properties of the chimeras are considerably different from those of native ones at lower Mg++ concentrations. PMID- 3645545 TI - tRNA-like properties of tobacco rattle virus RNA. AB - The 3' terminal forty nucleotides of tobraviral RNAs readily fold into a tertiary structure, resembling that of tymo- and tobamoviral RNAs. The latter RNAs possess a tRNA-like structure at their 3' end that is recognized by a number of tRNA specific enzymes (Rietveld et al. (1984), EMBO J. 3, 2613-2619). Characteristic for their aminoacyl acceptor arm is the presence of a so-called pseudoknot which we now also find in a corresponding position at the 3' terminus of TRV RNA2 (PSG strain). The nucleotide sequences of all tobraviral RNAs analysed so far indicate that they all possess a similar 3' terminal structure. A domain resembling the anticodon arm of canonical tRNA is not readily recognizable. TRV RNA2 can be adenylated with CTP, ATP; tRNA nucleotidyl transferase and ATP. It is unable, however, to accept any of the twenty common amino acids when incubated with ATP and aminoacyl-tRNA synthetases from wheat germ or yeast. We conclude that TRV RNA contains a tRNA-like structure, which, in contrast to the tymo- and tobamoviral tRNA-like structures, cannot be aminoacylated. It is unlikely therefore, that aminoacylation of plant viral RNAs with a tRNA-like structure is a prerequisite for viral RNA replication. PMID- 3645547 TI - Opal suppressor phosphoseryl-tRNA is not a substrate of phosphoserine aminotransferase. AB - A proposal of the role of animal opal suppressor phosphoseryl (Ps)-tRNA is that Ps-tRNA plays a role as an intermediate in the metabolic pathway from 3 phosphoglycerate to glycine. The labeled [32P]phospho[3H]seryl-tRNA was prepared and used as a substrate in the reaction of bovine brain Ps aminotransferase (EC 2.6.1.52) in the presence of alpha-ketoglutarate. By analysis of the reaction product, no amount of 3-phosphohydroxypyruvate was found, even though phosphohydroxypyruvate was noted in the control experiment by use of Ps and alpha ketoglutarate. These results showed that Ps-tRNA was not a substrate of Ps aminotransferase. PMID- 3645548 TI - Studies on the synthesis of the hypermodified base isolated from rat liver phenylalanine transfer ribonucleic acid. AB - Oxidation of methyl (S,E)-4-[4,9-dihydro-4,6-dimethyl-9-oxo-1- (phenylmethyl)-1H imidazo[1,2-alpha]purine-7-yl]-2-[(methoxycarbonyl) amino]-3-butenoate (3) with osmium tetroxide/N-methylmorpholine N-oxide provided a mixture of diastereomers 4 and 7. Hydrogenolysis of the major dihydroxy compound 4 over Pd-C gave beta hydroxywybutine [[R-(R*,S*)]-1]. The minor isomer 7 was transformed into [S (R*,R*)]-1 through the cyclic carbonate 8. PMID- 3645550 TI - Nurses' pay: making the grade. PMID- 3645549 TI - Japanese take-away?. Interview by Gill Crabbe. PMID- 3645551 TI - Abortion: how late is too late? PMID- 3645552 TI - Death is part of the process. PMID- 3645553 TI - The support worker. Nurse's little helper? PMID- 3645555 TI - The support worker. The auxiliary's tale. PMID- 3645554 TI - The support worker. A special kind of person. PMID- 3645556 TI - Aid to Africa: war on waste. PMID- 3645557 TI - Nursing aid. M.O.T. for humans. PMID- 3645558 TI - Back to nursing: the bank nurse's bonus. PMID- 3645559 TI - A question of personality. PMID- 3645560 TI - Nursing practice. PMID- 3645561 TI - Nursing Practice. Core care plans. PMID- 3645562 TI - Nursing Practice. Not a job for juniors. PMID- 3645563 TI - Nursing Practice. Responding to breast cancer. PMID- 3645565 TI - Circulating the blood. PMID- 3645564 TI - Up from the valleys. Interview by Laurence Dopson. PMID- 3645566 TI - Breast cancer screening: progress and pitfalls. PMID- 3645567 TI - Mental handicap nursing: 'We won't be missed until we're gone'. PMID- 3645568 TI - Retracing our cultural roots. PMID- 3645569 TI - Re-using equipment. Too good to throw away? PMID- 3645570 TI - Re-using equipment. The case for re-use. PMID- 3645571 TI - Re-using equipment. Is re-use worth the risk? PMID- 3645572 TI - Preparing for exams. PMID- 3645573 TI - Spiritual experiences: all in good faith. PMID- 3645574 TI - Nursing aid. The importance of being educated. Interview by Caroline Howie. PMID- 3645575 TI - Organ transplants. Multi-organ donation. PMID- 3645576 TI - Mental health nursing. PMID- 3645577 TI - Mental health nursing. Hidden dangers. PMID- 3645578 TI - Mental health nursing. Hannah's family. PMID- 3645580 TI - Breaking down the barriers. Interview by Joanna Lyall. PMID- 3645579 TI - Mental health nursing. Our man from the ministry. Interview by Martin Vousden. PMID- 3645581 TI - Exams: final curtains? PMID- 3645582 TI - Conflicting allegiances. PMID- 3645583 TI - Family affairs. No need to panic. PMID- 3645584 TI - Family affairs. The neglected sex. PMID- 3645585 TI - Family affairs. The right to reject care. PMID- 3645586 TI - Seclusion: inside looking out. PMID- 3645587 TI - Helping the aged. Nursing Aid. PMID- 3645588 TI - Surgical dressing after nail surgery. PMID- 3645589 TI - First impressions of grief. PMID- 3645590 TI - Nurse staffing in geriatric wards. PMID- 3645591 TI - Fashionable blood suckers. PMID- 3645592 TI - Nutritional assessment of children in hospital. PMID- 3645594 TI - Nurse recruitment: know your market. PMID- 3645593 TI - Final demands. PMID- 3645596 TI - No room for the rebels. PMID- 3645597 TI - The healing art. PMID- 3645595 TI - Nurses and doctors. Doing the right thing. PMID- 3645598 TI - Medical alarms: ringing the changes. PMID- 3645599 TI - Baby milk: is breast second best? PMID- 3645601 TI - Helping hands. Leaving presents. PMID- 3645600 TI - Diary of a nobody. PMID- 3645602 TI - Helping hands. Coping with physical change. PMID- 3645603 TI - Improving appearance. PMID- 3645604 TI - How to run a meeting. PMID- 3645605 TI - Treating yourself. PMID- 3645606 TI - For her own good? PMID- 3645607 TI - Systems of life. No 146. Senior systems. 11. PMID- 3645608 TI - Breaking the pain barrier. PMID- 3645609 TI - Preparing for management. PMID- 3645610 TI - Quest. NT's educational supplement. PMID- 3645611 TI - Quest. Training for health. PMID- 3645612 TI - Quest. The Norwegian experience. PMID- 3645613 TI - Quest. Student profiling. PMID- 3645614 TI - Open sesame. PMID- 3645615 TI - AIDS: innocent victims. PMID- 3645617 TI - How much are you worth? PMID- 3645616 TI - Social trends: trendsetters. PMID- 3645618 TI - Organ transplants. Donors welcome. PMID- 3645619 TI - Organ transplants. A part to play. PMID- 3645620 TI - Making meals a pleasure. PMID- 3645621 TI - Psychiatric skills. Well supported. PMID- 3645622 TI - Time to play. PMID- 3645623 TI - Management made easier. PMID- 3645624 TI - Nursing Aid. In rural isolation. PMID- 3645625 TI - Back to the drawing board. PMID- 3645626 TI - Management. A meeting of minds. PMID- 3645627 TI - Midwives' Journal. PMID- 3645628 TI - Midwives' Journal. The consequences of fetal rights. PMID- 3645629 TI - Midwives' Journal. Midwifery in Nicaragua. PMID- 3645631 TI - Pressure sores. Putting risk calculators in their place. PMID- 3645630 TI - Midwives' Journal. Sexuality in pregnancy. PMID- 3645632 TI - Pressure sores. A quality circle investigation. PMID- 3645633 TI - Pressure sores. An expensive epidemic. PMID- 3645634 TI - When the care collapses. Interview by Martin Vousden. PMID- 3645635 TI - Australian nursing: caught in the crossfire. PMID- 3645637 TI - Non-stick plaster? PMID- 3645636 TI - Exercise: a question of sport? PMID- 3645638 TI - Professional misconduct. When nightmare becomes reality. PMID- 3645639 TI - Professional misconduct. Reviewing the evidence. PMID- 3645640 TI - Professional misconduct. Conduct unbecoming. PMID- 3645641 TI - Recruitment worries. PMID- 3645642 TI - Midwifery on the margins. PMID- 3645643 TI - Nursing Aid. An experience in Third World South Africa. PMID- 3645644 TI - Organ transplants. Brain stem death. PMID- 3645645 TI - Organ transplants. Coping mechanisms. PMID- 3645646 TI - Everyday ethics for nurses: measuring freedom. PMID- 3645647 TI - Choice aids recovery. PMID- 3645648 TI - Computers in Nursing News. PMID- 3645649 TI - Computers in Nursing News. Are programs intelligent? PMID- 3645650 TI - Back to basics. PMID- 3645651 TI - Nurses important in community health care. Interview by Jaiwanti P. Dhaulta. PMID- 3645652 TI - A safe environment for clinical experiences. PMID- 3645653 TI - The quest for autonomy. PMID- 3645654 TI - Employee satisfaction: a key to patient satisfaction. PMID- 3645655 TI - Bringing the operating room to the public: nurse marketing in action. PMID- 3645656 TI - Ceiling art in the surgical holding area: a twofold treasure. PMID- 3645657 TI - Professional survival tips: defensive tactics for dealing with the uncooperative patient. PMID- 3645658 TI - Research: designs. PMID- 3645659 TI - The effect of music on anxiety in the surgical patient. PMID- 3645660 TI - Lipase synthesis in the rat pancreas is regulated by secretin. AB - Conscious rats were infused with optimal doses of secretin (16 clinical units [CU]/kg/h), cerulein (0.25 microgram/kg/h), and both for varying periods of time over 24 h. The presence of zymogen granules in acinar cells and the tissue content of enzymes showed progressive decreases over 3 and 12 h for cerulein and secretin stimulation, respectively. Stimulation with either hormone resulted in a two-fold increase in protein synthesis at 6 and 12 h. Kinetically, the increases observed in protein synthesis were not directly coupled to the observed decreases in tissue content of enzymes. Cerulein stimulation selectively increased the synthesis of anionic trypsinogen forms 1 and 2 and chymotrypsinogen forms 1 (anionic) and 2 (cationic) and decreased the synthesis of amylase. Secretin stimulation selectively promoted the synthesis of lipase and proelastase 2. Lipase synthesis was increased 2.8-, 5.8-, and 4.8-fold at 6, 12, and 24 h, respectively. Proelastase 2 synthesis was increased 2.3-, 3.0-, and 3.4-fold at the same time points. In combination, secretin and cerulein stimulation resulted largely in competitive effects, suggesting that the two hormones exert effects on protein synthesis through different mechanisms. The findings suggest that the anticoordinate changes observed in the synthesis of functional groups of pancreatic enzymes by nutritional substrates in the diet are modulated by specific hormones. Synthesis of the majority of protease zymogens but not cationic trypsinogen or proelastase 2 is modulated by cholecystokinin and its peptide analogs. In contrast, the synthesis of pancreatic lipase and proelastase 2 is regulated by secretin. The findings indicate for the first time that secretin regulates the synthesis of specific proteins in the exocrine pancreas. PMID- 3645661 TI - Effective use of health education skills. PMID- 3645662 TI - Negligence: defining responsibility. PMID- 3645664 TI - The therapeutic community movement. PMID- 3645663 TI - AIDS: informing patients and clients. PMID- 3645666 TI - Project 2000: a major achievement. PMID- 3645665 TI - Skin hygiene. PMID- 3645667 TI - Ethical decisions in nursing. PMID- 3645668 TI - Living with asthma. PMID- 3645669 TI - The five second flow test in urinary assessment. PMID- 3645670 TI - After thoracic surgery: aspects of care. PMID- 3645672 TI - Adverse food reactions. PMID- 3645671 TI - Helping clients to come to terms with loss. PMID- 3645673 TI - Quality assurance: methods of measurement. PMID- 3645674 TI - Rationalizing drug policies in the Philippines. PMID- 3645675 TI - Ensuring Filipino workers' health and safety. PMID- 3645677 TI - Adolescent medicine. PMID- 3645678 TI - Adolescent contraception. AB - Many adolescents are at risk for unplanned pregnancy. Health professionals who care for adolescents should be familiar with the various contraceptive methods and their suitability for teenagers. Each method, with its pros and cons, is described in this article. Ultimately, the health care provider is advised to tailor contraception to fit the needs of the individual patient. PMID- 3645676 TI - Physical growth and development: current concepts. AB - The process we call puberty is complex and still poorly understood. Some of the hormonal effects have been discussed, but much work remains before the specific mechanisms are defined. Genetic and nutritional influences affect puberty and further complicate the study of this population. Knowledge of the developmental sequence and SMR scale is useful in clinical practice. Understanding the changes that an adolescent is experiencing will help in the early diagnosis of abnormalities in growth and development. This knowledge will also serve as a guide in providing useful anticipatory guidance. PMID- 3645679 TI - Adolescent psychosocial growth and development. AB - This discussion has dealt with the nature of adolescence in the context of our culture. The stages of early adolescence (10 to 13 years), middle adolescence (14 to 17 years), and late adolescence (over 17 years) were examined separately and in some detail. Other characteristics of adolescence in general were examined, as were some of the factors influencing adult-adolescent interactions as well as the relationship between the adolescent and the society. Lastly, some of the ways in which this knowledge can be useful clinically were discussed, along with approaches to working successfully with teenagers and making their care a most enjoyable and rewarding part of clinical practice. PMID- 3645680 TI - Routine screening tests for the adolescent. AB - Routine preventive health examinations for adolescents should be conducted annually, and screening tests are an important part of such periodic evaluations. This article outlines the recommended screening tests for all teenagers, and defines the additional screening tests necessary for high risk youth. Annual health screening interventions serve to encourage the development of health promoting behaviors and preventive health awareness among adolescents. PMID- 3645681 TI - Seeing adolescent patients in private practice. AB - Seeing adolescent patients in private practice can be a challenging experience. Practical suggestions concerning the office setting scheduling, staffing, and billing are outlined. Physician attributes seen from an adolescent viewpoint are also enumerated. Finally, indications for pelvic examinations in this age group, interviewing, and confidentiality are discussed. PMID- 3645682 TI - Caring for an adolescent with a chronic illness. AB - Although early, mid, and late adolescence are transient psychological periods, the teenager must master these three phases to complete the psychological stages and tasks of adolescence. Because chronic disease delays or alters these phases, it becomes imperative for the primary care physician to reassess psychological development periodically for appropriate and intensive counseling. With the advantage of continuous contact with the family and the understanding of the family's structure and interpersonal relationships, the primary care physician may be able to: alleviate struggles for control that may seriously impede care, encourage the teenager to accomplish the psychological tasks of adolescence, both during hospitalization and in follow-up outpatient care visits, promote the adolescent's participation in his or her own health care, and ultimately enhance both the family's and the teenager's adaptation to a chronic illness. Finally, during the terminal phase of an illness, the primary care physician will be able to help the adolescent find meaning in his or her short life, provide the support to help the teenager to disengage from life with dignity, and provide a supportive relationship to the parents and siblings. PMID- 3645683 TI - Cross cultural issues in adolescent medicine. AB - This article provides general guidelines and principles for physicians caring for adolescent patients from various cultural backgrounds. Suggestions are offered for managing the special problems presented by new immigrants. Case vignettes are liberally used to illustrate health care issues. PMID- 3645684 TI - Uninsured patient bled to death: nursing dilemma. PMID- 3645685 TI - Inexperienced supervisor hired and fired. Case in point: Euclid Manor Nursing Home v. Board of Review (501 N.E. 2d 635--OH). PMID- 3645687 TI - "Call Dr. after crowning": $8.3 million award. Case in point: Boyd v. Bulala (647 F. Supp. 781--VA). PMID- 3645686 TI - Legal case briefs for nurses. FL.: nurse midwife: license suspension; N.Y.: "ad damnum" prohibited: malpractice. PMID- 3645688 TI - Family assessment and counseling by the rehabilitation nurse. PMID- 3645689 TI - Family participation in the rehabilitation process: te rehabilitators' perspective. PMID- 3645690 TI - Falls in a rehabilitation center: a retrospective and comparative analysis. PMID- 3645691 TI - IBD: implications for patients, challenges for nurses. PMID- 3645693 TI - Brachytherapy: nursing challenges. PMID- 3645692 TI - Spiritual dimensions of the rehabilitation journey. PMID- 3645694 TI - Brachytherapy sources and applicators. PMID- 3645696 TI - Radiobiologic basis of brachytherapy. PMID- 3645695 TI - Principles of radiation safety and protection. PMID- 3645697 TI - Head and neck implants. PMID- 3645698 TI - The gynecological implant patient. PMID- 3645699 TI - Brachytherapy physics and dosimetry. PMID- 3645700 TI - Future directions of brachytherapy. PMID- 3645701 TI - Outpatient and office administration of cisplatin. PMID- 3645702 TI - Practical considerations for administration of cisplatin (Platinol) in the outpatient setting. PMID- 3645703 TI - Considerations in the outpatient and office administration of cisplatin. PMID- 3645704 TI - Cisplatin: outpatient and office hydration regimen. PMID- 3645705 TI - [Comparison of fosfomycin-penicillin M and penicillin M-gentamycin. Apropos of 35 severe infections caused by methicillin-sensitive Staphylococcus aureus]. AB - Two combined antibiotic treatments were compared in 35 cases of methicillin sensitive Staph. aureus infection. Eighteen patients (including 17 with septicaemia) received penicillin M (methicillin or oxacillin) and gentamicin daily for a mean period of 11 days. Clinical and bacteriological cure was obtained in 14 cases; 2 of these 14 patients developed superinfection with gentamicin-resistant enterobacteria, 1 relapsed and 2 had renal impairment. Seventeen patients (including 15 with septicaemia) were given fosfomycin and penicillin M for a mean period of 17 days. Clinical and bacteriological cure was obtained in 16 patients; the patient with clinical and bacteriological failure died. There was no superinfection or relapse; 3 patients had hypokalaemia and 1 had renal damage caused by methicillin. The clinical and bacteriological results, therefore, were in favour of the fosfomycin-methicillin combination, but the only statistically significant difference between the two groups concerned the complications. PMID- 3645706 TI - [The locomotor apparatus: lower extremity (1). General osteology, principal fractures and luxations]. PMID- 3645707 TI - [Pleural drains (1)]. PMID- 3645708 TI - [Clinical aspects and complementary studies of uncomplicated gastroduodenal ulcers]. PMID- 3645709 TI - [Developing complications of gastric and duodenal ulcers]. PMID- 3645710 TI - [Medical treatment of gastric and duodenal ulcers]. PMID- 3645711 TI - [Indications for surgery in duodenal ulcers]. PMID- 3645712 TI - [Uncomplicated gastroduodenal ulcer. Surgical treatment]. PMID- 3645713 TI - [Immediate and long-term surveillance of a patient operated for gastroduodenal ulcer]. PMID- 3645714 TI - [Case report: Mr. G. treated by supraselective vagotomy]. PMID- 3645715 TI - [The life of the Emergency Medical Services and of their nurses]. PMID- 3645716 TI - [Anatomy and physiology of the normal stomach]. PMID- 3645717 TI - [The anesthesiology nurse. Special education for what kind of future?]. PMID- 3645718 TI - [Pathogenesis and physiopathology of gastroduodenal ulcers]. PMID- 3645719 TI - [Locomotor apparatus: lower limbs (2). The bony pelvis, the upper channel in obstetrics]. PMID- 3645720 TI - [The pleural drain (2)]. PMID- 3645721 TI - [Complications of enterostomies]. PMID- 3645722 TI - [Enterostomies in children. Digestive derivations and apparatus in pediatric surgery]. PMID- 3645723 TI - [Enterostomies: equipment and its indications]. PMID- 3645724 TI - [Care of enterostomies]. PMID- 3645725 TI - [Dietetics for enterostomies]. PMID- 3645726 TI - [Urostomies]. PMID- 3645727 TI - [Care and equipment specific for urostomies]. PMID- 3645728 TI - [Indications for enterostomies]. PMID- 3645729 TI - [Technics for enterostomies]. PMID- 3645730 TI - [First thoughts of a young registered nurse]. PMID- 3645731 TI - [General supervisory nurse. Definition of her functions at the Avicenna Hospital]. PMID- 3645732 TI - [Non-sterile self catheterization]. PMID- 3645734 TI - [Pyelonephritis]. PMID- 3645733 TI - [Hyperthyroidism]. PMID- 3645735 TI - [Everything will (possibly?) change]. PMID- 3645736 TI - [The rounds of medicine]. PMID- 3645737 TI - [Phlebitis of the lower extremities]. PMID- 3645738 TI - [Cancer of the uterine cervix]. PMID- 3645739 TI - [Cancer of the uterine cervix. "This is my first operation ..."]. PMID- 3645740 TI - [Acyclovir (antiviral)]. PMID- 3645741 TI - [The nurse in circulatory service]. PMID- 3645742 TI - [Eye injuries]. PMID- 3645744 TI - [A disease which spreads terror "disease which heaven, in its furor, invented to punish the crimes of the world"]. PMID- 3645743 TI - [Hemochromatosis]. PMID- 3645745 TI - [Hereditary metabolic diseases]. PMID- 3645746 TI - [Nurses are changing: what are their plans?]. PMID- 3645747 TI - [Emotional expression: new "art" of being "with it"]. PMID- 3645749 TI - [Operating room nurse, who am I?]. PMID- 3645748 TI - [Treatment of hypertrophic and keloid-like scars by continuous compression]. PMID- 3645750 TI - [Prevention of hemorrhoids is possible]. PMID- 3645751 TI - [Dietetic approach to acute diarrheas in pediatrics]. PMID- 3645752 TI - [France and its immigrants]. PMID- 3645753 TI - [From nursing process to nursing record]. PMID- 3645754 TI - [The campaign for the prevention of colorectal cancer and the nursing students]. PMID- 3645755 TI - [A graph of autonomy in a service for intermediate length of stay]. PMID- 3645756 TI - [For children the royal way, the oral way]. PMID- 3645757 TI - [Carbon monoxide poisoning]. PMID- 3645759 TI - [Problems confronting the families of patients admitted to an intensive care unit]. PMID- 3645758 TI - [Formaldehyde allergies]. PMID- 3645760 TI - [Nursing experience in health education in schools]. PMID- 3645762 TI - [Human rights and nursing]. PMID- 3645761 TI - [Hepatic encephalopathy, an unwelcome patient]. PMID- 3645763 TI - [Nursing personnel in dialysis units]. PMID- 3645764 TI - [Nutritional concepts: quantities of micronutrients present in food (vitamins, minerals, fatty acids...)]. PMID- 3645765 TI - [Continuing nursing education. 12. Field: maternal-child health. Topic: internal monitoring technic during labor]. PMID- 3645767 TI - Why hospice nurses are a breed apart. PMID- 3645766 TI - Nursing practice, intravenous medications. PMID- 3645768 TI - Does your patient seem too cheerful? PMID- 3645769 TI - When emergency care is up to you. PMID- 3645770 TI - So many patients, so little time. PMID- 3645771 TI - When the patient has hyperkalemia (continuing education credit). PMID- 3645772 TI - The cancer that can cost a patient his voice. PMID- 3645773 TI - What to teach the patient who's had a total laryngectomy. PMID- 3645774 TI - I learned about life from Harry's death. PMID- 3645775 TI - An update on new drug breakthroughs. PMID- 3645776 TI - A hostile doctor? Don't lose your cool. PMID- 3645777 TI - How to tie up the discharge plan. PMID- 3645778 TI - When food and drugs collide. PMID- 3645779 TI - Getting involved. PMID- 3645780 TI - AIDS patent dispute settled. PMID- 3645781 TI - The AIDS virus--well known but a mystery. PMID- 3645782 TI - [Distalgesic]. PMID- 3645783 TI - [Removal of a Redon drain]. PMID- 3645784 TI - [BCG]. PMID- 3645785 TI - [The primary tuberculosis infection]. PMID- 3645786 TI - [Diagnosis of common pulmonary tuberculosis]. PMID- 3645787 TI - [Epidemiology of tuberculosis]. PMID- 3645788 TI - [Outlook for a treated tuberculosis patient]. PMID- 3645789 TI - [A case report of pulmonary tuberculosis with effusion]. PMID- 3645791 TI - [Protocol of care and prevention of decubitus ulcers]. PMID- 3645790 TI - [The harvesting of organs]. PMID- 3645792 TI - [Cerebral localization of cysticercosis]. PMID- 3645793 TI - [Management of cardiogenic shock]. PMID- 3645794 TI - [Management of arterial hypertension]. PMID- 3645795 TI - [Psychomotor retardation]. PMID- 3645796 TI - [The impossible adult]. PMID- 3645797 TI - [Retardation in juvenile delinquents]. PMID- 3645798 TI - [The psychiatric asylum: the case of Annie...]. PMID- 3645799 TI - [20 years later: a part of Mrs. B.'s life]. PMID- 3645800 TI - [Retardation and psychosis in children]. PMID- 3645801 TI - [The nurses functions in mental health. A student paper]. PMID- 3645802 TI - [Group dynamics]. PMID- 3645803 TI - [Language retardation]. PMID- 3645804 TI - [Serum elastase, proelastase and free hydroxyproline in acute pneumonia]. PMID- 3645806 TI - Prevalence of antibody to HTLV-III/LAV in a population attending a sexually transmitted diseases clinic. AB - To determine whether HTLV-III/LAV is transmitted to men by heterosexual contact and whether contact with prostitutes plays a role in such transmission, a serosurvey was conducted in clinics for sexually transmitted diseases in New York City. Two hundred ninety-five male heterosexual nonusers of intravenous drugs were studied. Antibody to HTLV-III/LAV was found in sera from ten men (3.4%); this rate is approximately 15 times the prevalence found in healthy blood donors. Seropositivity was associated with serologic evidence of syphilis (odds ratio, 11.2; 95% confidence interval, 2.1-52) and hepatitis B infection (odds ratio, 9.1; 95% confidence interval, 2.0-55). Antibody to HTLV-III/LAV was not associated with self-reported exposure to prostitutes (odds ratio, 0.8; 95% confidence interval, 0.08-4.2). These findings suggest heterosexual transmission of HTLV-III/LAV to men but fail to implicate contact with prostitutes as a mode of such transmission. PMID- 3645805 TI - Relationship between antibody to LAV/HTLV-III and the natural course of subclinical cellular immune dysfunction in homosexual men. AB - To assess the epidemiology and natural history of persistent generalized lymphadenopathy (PGL) and subclinical immunodeficiency in relation to serologic evidence of lymphadenopathy-associated virus/human T-lymphotropic virus type III (LAV/HTLV-III) infection, 109 homosexual men with PGL, 47 homosexual men without lymphadenopathy who attended a sexually transmitted disease (STD) clinic, 25 homosexual male university students, and 26 heterosexual men who attended the STD clinic were studied. In 1982-1983 antibody to LAV/HTLV-III was present in 97%, 35%, 21%, and 4% of the four groups, respectively (P less than .001). Subclinical immunodeficiency was more closely associated with LAV/HTLV-III seropositivity than with lymphadenopathy. Cohorts of 78 homosexual subjects with PGL, 35 homosexual subjects from STD clinic, and 15 homosexual university students were followed for median periods of 13.5, 20, and 14.5 months, respectively. The seroconversion rate was 23% per year among seronegative subjects, and 4% of seropositive subjects developed overt acquired immunodeficiency syndrome (AIDS). Among seronegative subjects, there was significant improvement in T4:T8 ratios (P = .001), whereas most seropositive subjects continued to have subnormal total counts of T4 lymphocytes and low T4:T8 ratios. Some cases of subclinical cellular immunodeficiency apparently are unrelated to LAV/HTLV-III infection, and the presence of antibody to this virus is associated with an unfavorable immunologic prognosis. PMID- 3645807 TI - [Biocidan collyrium]. PMID- 3645808 TI - [Hypertension during pregnancy]. PMID- 3645809 TI - [Blood pressure measurement in pregnant women. Technic and precautions]. PMID- 3645810 TI - [Consequences of pregnancy hypertension for the child]. PMID- 3645811 TI - [Indications for fetal extraction in women with cardiovascular and renal pregnancy complications]. PMID- 3645812 TI - [The hypotrophic newborn infants. Problems during the neonatal period. Prognosis]. PMID- 3645813 TI - [Taking care of children with hearing loss]. PMID- 3645814 TI - [International classification and standards]. PMID- 3645815 TI - [The collective creche: educational structure]. PMID- 3645816 TI - [Health of mothers and children in developing countries]. PMID- 3645817 TI - [Clinical monitoring of a hypertensive patient during pregnancy]. PMID- 3645818 TI - [Imodium]. PMID- 3645819 TI - [Management of siblings (sudden infant death)]. PMID- 3645820 TI - [Infant with gastroesophageal reflux in the hospital. Care by the nurse]. PMID- 3645821 TI - [Sudden unexplained infant death and sleep disorders]. PMID- 3645822 TI - [Menopause]. PMID- 3645823 TI - [3 women seeking voluntary interruption of pregnancy have come to consult ... a female psychiatrist. Analytic considerations on the wish for no children]. PMID- 3645824 TI - [Sudden infant death]. PMID- 3645825 TI - [Etiology of sudden infant death]. PMID- 3645826 TI - [Nurses working environment--the helpers also need help]. PMID- 3645827 TI - [Children on pain: "splinter in the stomach and heat in the bones"]. PMID- 3645828 TI - [Warm election promises--but cold reality in Vardo]. PMID- 3645829 TI - [Marie Ronning--Norwegian Nurses' Association's new leader?]. PMID- 3645830 TI - [Candidates for the new vice president of the Norwegian Nurses' Association]. PMID- 3645832 TI - [The healthy and strong in daily society]. PMID- 3645831 TI - [Norwegian Society for Hygiene Nurses: should every 13th patient get sick in the hospital?]. PMID- 3645833 TI - [Kirkenes' hospital--gateway to Barentshavet]. PMID- 3645834 TI - [Equal opportunity positions: nurse administrators' salaries are against the law]. PMID- 3645835 TI - [Special education in geriatric care for nursing aides]. PMID- 3645836 TI - [Future policy on the elderly]. PMID- 3645837 TI - [A rare anomaly: esophageal atresia in infants]. PMID- 3645838 TI - [Wage discrimination--not just a matter for Oslo]. PMID- 3645839 TI - [Immigrant women at the health center. Monitoring of pregnancy and contraception]. PMID- 3645840 TI - [Instead of rehabilitation--doomed to be a bedridden patient?]. PMID- 3645841 TI - [Information from the hospital. After a heart infarct]. PMID- 3645842 TI - [Psychiatric nursing--high work activity, a lot of draft]. PMID- 3645843 TI - [OSG (Independent Management Group) for ADP (automatic data processing): forum for team work in ADP in the health sector]. PMID- 3645844 TI - [Private hospital]. PMID- 3645845 TI - [Current challenges in health education]. PMID- 3645846 TI - [Occupational health nurse for 1700. To be a factor of well-being in dust and noise. Interview by Jofrid Bjorkvik]. PMID- 3645847 TI - [New county and district structure in 1988?]. PMID- 3645848 TI - [For the first time: nurse in the Central Rescue Service. Interview by Bjorn Arild Ostby]. PMID- 3645850 TI - [Report from Eritrea. Meaningful nursing in a war-torn country]. PMID- 3645851 TI - [Priority problems in the health sector]. PMID- 3645849 TI - [Biofeedback--a new type of pain treatment]. PMID- 3645852 TI - [Patients' needs in the center. Quality assurance--a way toward improved nursing care]. PMID- 3645853 TI - [Representatives' activities. Not everyone knows their rights as a nurse]. PMID- 3645854 TI - [Cut-backs. Pressure on permanent personnel cruel]. PMID- 3645856 TI - [Psoriasis. Few Copenhagers are granted climate treatment]. PMID- 3645855 TI - [Travel letter. To be a nurse is considered inferior in Egypt]. PMID- 3645857 TI - [Alternative medicine. Explaining homeopathy with energy]. PMID- 3645859 TI - [Empathy--a tool for greater challenge and better understanding]. PMID- 3645858 TI - [Toward a more friendly hospital policy for children]. PMID- 3645860 TI - [Representatives' activities. We have the expertise and also want to have political influence]. PMID- 3645861 TI - [Nursing home residents also have a right to a sexual life]. PMID- 3645862 TI - [Drastic reduction in capacity in Godthab's Hospital]. PMID- 3645863 TI - [Alternative treatment. Swedes' attitude is more open]. PMID- 3645864 TI - [Questionnaire research. Nurses' driving expenditures will be mapped out]. PMID- 3645865 TI - [Executive Board. Clear instructions on nurses' negotiations]. PMID- 3645866 TI - [Freedom of speech. This is something hospital directors have misunderstood]. PMID- 3645867 TI - [Cut-backs. Nothing has improved in the children's department of Arhus Hospital]. PMID- 3645868 TI - [Nursing. Too little time for patient information causes distrust]. PMID- 3645869 TI - [Drug information. Bones, liver and muscles contain the element magnesium]. PMID- 3645870 TI - [Alternative treatment. The need for an explanation on ginseng]. PMID- 3645871 TI - [Foot care. Foot therapist can prevent that nails must be torn off]. PMID- 3645872 TI - [Professional arbitration. Rates tightened considerably]. PMID- 3645873 TI - [Danish nurse part of crew of flying eye hospital. Interview by Ulla Danielsen]. PMID- 3645874 TI - [Now the nursing shortage will be cured]. PMID- 3645875 TI - [Advertisement campaign has caused strong repercussions in the press]. PMID- 3645876 TI - [English and Swedish nurses in a campaign for their profession]. PMID- 3645877 TI - [Psychiatry. Those subdued will protect against force]. PMID- 3645878 TI - [Prevention. Trial which will inspire to a better effort for the aged]. PMID- 3645879 TI - [Cross-professional course in nursing care and treatment of stoma patients]. PMID- 3645880 TI - [Alternative treatment. Soil should supply minerals]. PMID- 3645881 TI - [Home nursing. I am speechless about the dictatorial personnel policy]. PMID- 3645882 TI - [Cut-backs. Many groups of patients have received this poorly]. PMID- 3645883 TI - [Parliament. Save the small hospital. Interview by Hans Geisler]. PMID- 3645884 TI - [Campaign. "Now nice girls want to strike too"]. PMID- 3645885 TI - [Campaign. Nursing home director in letter to politicians: I cannot save. Interview by Lars-Peter Bergqvist]. PMID- 3645886 TI - [Hospitals--structure--management]. PMID- 3645887 TI - [Ambulance physicians ensure prehospital treatment according to the international plan]. PMID- 3645889 TI - [Alternative treatment. Anthroposophical medicine would create "balance"]. PMID- 3645888 TI - [We have strengthened our arguments through additional knowledge]. PMID- 3645890 TI - [Spelling. Danish teachers will continuously need a red pencil]. PMID- 3645891 TI - [Parliament. New proposal for a combined health policy]. PMID- 3645892 TI - [Relief of trauma when taboo breaks down around incest]. PMID- 3645893 TI - [City Hospital for multi-problem patients in great numbers]. PMID- 3645894 TI - [An allergy can cause consequences many years from now]. PMID- 3645895 TI - [Delegates' annual workshop. Low wages are nurses' biggest problem]. PMID- 3645896 TI - [Students want a better framework for Scandinavian team work]. PMID- 3645897 TI - [Executive Board. Organization's resources must reach further]. PMID- 3645898 TI - [Campaign. Home visitors at last salary grade feel themselves trapped. Interview by Lars Peter Bergqvist]. PMID- 3645899 TI - [Work with refugees. First station in asylum processing is called Sandholm]. PMID- 3645900 TI - [Work with refugees. Psychological reactions among asylum seekers during the waiting period]. PMID- 3645901 TI - [Work with refugees. Sick asylum seekers visit Concorde in Valby]. PMID- 3645902 TI - [Work with refugees. Children too are stressed by asylum life]. PMID- 3645903 TI - [Hospitals should face the new challenges. Interview by Ulla Danielsen]. PMID- 3645904 TI - [Asylum seekers need much but have much to give]. PMID- 3645905 TI - [Work with refugees. Isolation in a life without identity]. PMID- 3645906 TI - [Spinal cord injury. An underdiagnosed complication of delivery?]. PMID- 3645907 TI - [Nurses and professional secret]. PMID- 3645908 TI - [The nurse--a means or a measure?]. PMID- 3645909 TI - [Troubles without ailment--various observations on psychosomatics]. PMID- 3645910 TI - [Cardiac cripple--treatment of patients with unmanageable arrhythmias]. PMID- 3645912 TI - [Basic health care nursing, a new specialty?]. PMID- 3645911 TI - [Recognition of alternative medical methods. Viewpoint of the Medical Chief Inspection of Public Health concerning alternative treatment methods and regular medicine]. PMID- 3645913 TI - [The ideal, leadership-providing nurse. The role of the nurse in management in intramural health care]. PMID- 3645914 TI - [Patient, physician and nurse--a judgment]. PMID- 3645915 TI - [On the way to self care in a general hospital]. PMID- 3645916 TI - [Nursing care, demand and supply. An exploration of the demand side]. PMID- 3645917 TI - [This is how patients can feel]. PMID- 3645919 TI - [Medical information for nurses. Lupus erythematosus]. PMID- 3645918 TI - [Burnout in health care workers. II: Prevention of burnout in oneself]. PMID- 3645920 TI - [The paradox between emancipation and chronic institutionalization]. PMID- 3645921 TI - [Assistance to women by the foundation 'De Maan']. PMID- 3645922 TI - [The ulcer patient in dermatology]. PMID- 3645923 TI - [Medical information for nurses. Developmental disorders due to chemical agents]. PMID- 3645924 TI - [The preparedness for action of nurses]. PMID- 3645925 TI - [The health care and nursing needs of homeless persons]. PMID- 3645926 TI - [Dealing with aggression and acutely violent situations]. PMID- 3645927 TI - [Angels of death? Nursing and euthanasia]. PMID- 3645928 TI - [Prevention is better--mouth care in children with cancer treated with chemotherapy and/or radiotherapy]. PMID- 3645929 TI - [From intuition to nursing methods. Report of a research process]. PMID- 3645930 TI - [Safety and accountability in the nursing department]. PMID- 3645931 TI - [Functionally elderly mentally handicapped. Characteristics and need of care]. PMID- 3645932 TI - Legal aspects of laser surgery. PMID- 3645933 TI - Breast self-examination. PMID- 3645934 TI - Stages of successful litigation (Part 4). PMID- 3645935 TI - Standing ovation. PMID- 3645936 TI - What image are nurses projecting? PMID- 3645938 TI - Operating room nursing: a rewarding profession. PMID- 3645937 TI - Organ procurement: a matter of life and death. PMID- 3645939 TI - Surgical wound infections. PMID- 3645940 TI - Developing a nurse preceptor training program. PMID- 3645941 TI - Reduction in force: coping with staff layoffs. PMID- 3645942 TI - Who cares for the caregivers? The first year of the VSNA Task Force on the impaired nurse. PMID- 3645943 TI - [Etiology of chronic bronchitis]. AB - From a synopsis of the large number of epidemiological studies of the recent 20 years it is know, that inhalation of cigarette smoke is the most important factor that generates chronic bronchitis. Other noxious agents about which there are still controversial opinions, are air pollution and occupational inhalants. Although hypersecretion of mucus is the primary symptom of chronic bronchitis, it seems to have no particular prognostic meaning. Whether severe airflow obstruction develops, apparently depends upon predisposing factors such as disturbances of humoral immunity manifested by marked hypogammaglobulinemia or a defect of mucociliary clearance. In recent time increased serum IgE-levels in mom atopic smokers with bronchial obstructions were reported. Frequent recurrent bronchial infections alone seem to be no serious risk factor. The molecular mechanisms that lead to structural damage are clarified. Activated alveolar macrophages attract polymorphonuclear leucocytes by chemotaxis. These cells set free proteolytic enzymes such as elastases. In addition certain oxidants inhibit the protection system of proteinase inhibitors. PMID- 3645944 TI - The role of the public health nurse in the primary health care team. PMID- 3645945 TI - The role of the nurse in health care management at policy-making level. PMID- 3645946 TI - Evidence that exteroceptive stimuli other than suckling have no major effect on plasma prolactin in lactating rats. AB - The ability of exteroceptive stimuli from pups to increase plasma prolactin in lactating dams was investigated. Prolactin profiles were measured during 30 min of suckling followed by complete or partial separation from pups. Prolactin profiles were also measured subsequent to complete or partial isolation from pups in dams which had been with pups permanently before the experiment. In addition, plasma prolactin was measured in dams which after a night of isolation were partially united with pups. Finally, the effect of ether stress on prolactin profiles after interruption of suckling by pups was determined. Vigorous suckling after a period of isolation induced a sharp increase of plasma prolactin. Subsequent to pup removal, either partial or complete, prolactin profiles showed a widespread variation. Also dams which before experimentation were kept permanently with pups, showed a great variation in prolactin profiles subsequent to either complete or partial separation from pups. Plasma prolactin either decreased rapidly or gradually. In several dams a rapid or a gradual decline of plasma prolactin was interrupted by one or more episodes of prolactin release. Partial reunion with pups after a night of isolation, either in mid-lactation or in late lactation, did not induce a rise of plasma prolactin. It is concluded that exteroceptive stimuli from pups are not effective as prolactin releasing signal. Because ether stress did not induce a steep rise of plasma prolactin, we conclude that the episodic rises of plasma prolactin in dams, subsequent to partial or complete removal of pups, are due to spontaneous activity of the hypothalamo-pituitary system. PMID- 3645948 TI - Nurse anesthetists' well-being: Part II. PMID- 3645947 TI - The doctrine of Res Ipsa Loquitur. PMID- 3645949 TI - Pharmacology of local anesthetics. PMID- 3645950 TI - Hepatitis: risks confronting nurse anesthetists. PMID- 3645951 TI - FDA approval and surveillance of medical devices. PMID- 3645952 TI - A case study: the use of trans-tracheal guide for a patient with a large protruding oral myxoma. PMID- 3645953 TI - The evolution of a scholarly journal: of readers, writers and gatekeepers. PMID- 3645956 TI - How safe are generic drugs? PMID- 3645955 TI - Effect of anticoagulation on plasma levels of granulocyte elastase during hemodialysis. PMID- 3645954 TI - AIDS in two African infants born in Belgium. AB - Two African infants born in Belgium, dying from the acquired immune deficiency syndrome are reported. The first patient was a premature baby girl born to healthy parents. However, her asymptomatic mother was found to have polyclonal hypergammaglobulinaemia, a reversed T-helper/T-suppressor ratio and a decreased lymphocyte response to mitogens. The second patient's mother was treated for pneumocystis carinii pneumonia during the fourth month of gestation and was subsequently diagnosed with AIDS. The rapid clinical evolution of the acquired immunodeficiency syndrome in infancy suggests that the incubation period is shorter than in adults. PMID- 3645957 TI - Million-dollar errors. PMID- 3645958 TI - Who needs nurses? PMID- 3645959 TI - How the immune system works. PMID- 3645960 TI - Biological response modifiers. PMID- 3645962 TI - Transferring the past to the present. PMID- 3645961 TI - Monoclonal antibodies. PMID- 3645964 TI - Katie's legacy. PMID- 3645963 TI - Cruising with COPD. PMID- 3645965 TI - Nursing in the Big Apple: AJN JobFocus. PMID- 3645966 TI - Getting ahead in the corporate culture. PMID- 3645967 TI - Applying to graduate school. PMID- 3645968 TI - My first jump start. PMID- 3645969 TI - The AIDS virus and the CNS. PMID- 3645970 TI - [Types of cranial bone overlapping during configuration of the head and cerebral circulatory disorders in fetuses and newborn infants]. PMID- 3645971 TI - Hepatitis B "e" antigen in individuals infected with the AIDS virus. PMID- 3645972 TI - Staphylococcus aureus bacteremia caused by infected intravenous catheters. AB - A prospective study of all cases of Staphylococcus aureus bacteremia (SAB) has been ongoing at our institution since April 1983. Data collected as of December 1984 reveal that of 79 episodes of SAB identified, 28 (35%) were caused by infected intravenous catheters; 14 of these were peripheral catheters and 14 were subclavian catheters. Endocarditis or metastatic infection was not recognized; two patients, one with a prosthetic heart valve and the other with recurrent SAB, did not meet the criteria for these complications but the clinical circumstances were strongly suggestive. Six of the 28 patients (21%) died of their infection, and local complications (inflammation or purulent drainage at the insertion site) were common. Only four of 22 patients who recovered were administered antibiotics for greater than 14 days. We conclude that patients with SAB caused by an infected intravenous catheter have a low risk of endocarditis or metastatic infection when the infected catheter is promptly removed and no risk factors (valvular heart disease or a prosthetic valve) are present that favor development of endocarditis. The duration of antimicrobial therapy need not exceed 2 weeks in this situation. The mortality related to SAB, however, was high and emphasizes the need to develop methods to prevent this infection. PMID- 3645973 TI - Accuracy of patient recall for date of peripheral intravenous catheter insertion. PMID- 3645974 TI - Oxacillin-resistant coagulase-negative staphylococcal carriage rates in neonatal intensive care nurses and non-patient care hospital personnel. PMID- 3645975 TI - South Florida Hospital Consortium for Infection Control: structure and function. PMID- 3645976 TI - Infections and electronic pain control devices. PMID- 3645977 TI - Trends in infections and antibiotic usage in a community hospital. AB - The results of a physician-performed prevalence survey of infections and antibiotic use at the Salt Lake City LDS Hospital in 1984 were compared with results of surveys done in 1971 and 1979. The hospital census and length of stay declined in successive surveys, contributing to the changes observed. Community acquired infections were more prevalent in 1984 than in the previous surveys, whereas hospital-acquired infections were seen with similar frequencies. Among hospital-acquired infections, lower respiratory tract and soft-tissue infections were more prevalent in 1984. Gram-negative bacilli accounted for 34% of hospital acquired infections in 1984 versus rates of 60% or more found in the 1970s. Although the overall prevalences of antibiotic use were similar in the three surveys, the proportion attributed to cephalosporins increased from 17.5% (1971) to 49.2% (1979) and 59.1% (1984). Antibiotic prophylaxis was less frequent in 1984 (14.4%) than in 1979 (24.1%) and reversed the trend found after 1971 (11.0%). Despite extensive educational efforts since the prevalence survey of 1979, perioperative antibiotics were used for durations longer than 48 hours after surgery in 43% of the patients receiving such prophylaxis in 1984. The LDS Hospital has adopted a restrictive antibiotic formulary in part as a result of the present survey. PMID- 3645979 TI - Like Florence Nightingale, we use the political system. PMID- 3645978 TI - OTA (Office of Technology Assessment) discusses quality, costs of care. PMID- 3645980 TI - ANA office is link, conscience, lightning rod. PMID- 3645981 TI - Politics of caring is a stark reality. PMID- 3645982 TI - RN shortage threatens quality of care. PMID- 3645983 TI - ANA mission grows, board sees need for dues increase. PMID- 3645984 TI - Tort reform could bring fairness to system--in favor. PMID- 3645985 TI - Tort reform doesn't end liability crisis--opposed. PMID- 3645986 TI - 1986 Tax Reform Act brings changes to tax system. PMID- 3645987 TI - Reagan submits plan for catastrophic coverage. PMID- 3645989 TI - ANA, others sponsor efforts to shape nursing's future. PMID- 3645988 TI - How can nurses prepare for year 2000? PMID- 3645990 TI - Staff nurse is the heart, head and soul of nursing. PMID- 3645991 TI - How can we encourage nursing's voyagers to soar? PMID- 3645992 TI - Nurses add human touch to technology. PMID- 3645993 TI - Date set shows what nurses do in computer era. PMID- 3645994 TI - Nurses begin internships in Washington. PMID- 3645995 TI - In high-tech care, the challenge remains: to nurse. PMID- 3645996 TI - As I see it. What happens to patient autonomy in high-tech care? PMID- 3645997 TI - Advanced nursing practitioners discuss common destiny. PMID- 3645998 TI - Technology produces occupational hazards for nurses. PMID- 3645999 TI - Human T-cell lymphotropic virus-III (HTLV-III) seropositivity and related disease among 71 consecutive patients in whom tuberculosis was diagnosed. A prospective study. AB - The incidence of tuberculosis has recently risen in Southeast Florida. In order to determine the number and proportion of tuberculosis cases and the characteristics of tuberculosis that might be related to human T-cell lymphotrophic virus-III (HTLV-III) infection, all patients seen by the Dade County Florida Public Health Department-Tuberculosis Clinic during a 6-month period were medically evaluated and screened for HTLV-III antibody by an enzyme linked immunosorbent assay. Of 71 consecutive patients confirmed to have tuberculosis (70 by culture) during the study period, 22 (31%) were seropositive and 49 (69%) were seronegative for HTLV-III antibody. The seropositive group had a significantly higher proportion of patients who were black, Haitian, and within the age group of 25 to 44 yr. The seropositive group also had a significantly higher rate of mild-to-moderate serum aspartate transaminase elevations (less than or equal to 5 times normal), tuberculin skin test false negativity, extrapulmonary tuberculosis (especially lymphatic), and pulmonary tuberculosis with an atypical radiographic picture. The seropositive group had a significantly lower proportion of patients with sputum cultures positive for M. tuberculosis. There was no significant difference between the groups with respect to the proportion of patients with positive sputum smears when sputum cultures were positive, serious antituberculosis drug reactions (requiring discontinuation of therapy), or percent of home contacts who were tuberculin skin tested and found to be positive. At the time of the diagnosis of tuberculosis, only 6 (27%) of the seropositive patients with tuberculosis had clinical evidence of AIDS or AIDS related complex (unexplained thrush).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3646000 TI - Sequence of inflammatory cell migration into lung during recovery from hyaline membrane disease in premature newborn monkeys. AB - The appearance of polymorphonuclear leukocytes (PMN) and macrophages (MAC) in lung during the development of hyaline membrane disease (HMD) may be important in lung injury and repair. These inflammatory cells may cause additional lung injury during recovery from HMD and contribute to the development of bronchopulmonary dysplasia (BPD). By morphometric methods, we compared the proportion of PMN and MAC in lung tissue of premature M. nemestrina monkeys with HMD to the proportion of these cells in the lungs of healthy control animals of a similar postnatal age and to fetuses of the same gestational age. Expressed as a fraction of all lung cells, healthy premature control monkeys have the same %PMN and %MAC in lung tissue as fetal animals. However, during the development of acute HMD, there is an increase in %PMN (p less than 0.05), but not in %MAC, compared to fetal animals. During recovery, there is a greater than 10-fold increase in %MAC (p less than 0.02), but no significant additional increase in %PMN compared to animals with acute HMD. We conclude that the sequence of inflammatory cell migration into the premature lung injured during HMD is first a polymorphonuclear one, followed by entry of macrophages. Control of this inflammatory response during recovery from HMD may play a role in the pathogenesis of BPD. PMID- 3646001 TI - Neurologic abnormalities and recovery of human immunodeficiency virus from cerebrospinal fluid. AB - Infectious human immunodeficiency virus (HIV) was recovered from 30 of 48 cerebrospinal fluid specimens from seropositive persons with and without neurologic symptoms or disease. Of 16 patients with only neurologic problems or other HIV-related conditions, but not the acquired immunodeficiency syndrome (AIDS), 11 had virus recovered; over half of those with AIDS also had virus isolated. Patients with headache or altered mental status had the highest recovery rate of HIV from cerebrospinal fluid. Although virus was primarily found in patients with detectable neurologic disease, it was also isolated from 5 of 8 patients with normal neurologic examinations. Two of these patients had fever alone. The presence of virus in cerebrospinal fluid did not necessarily correlate with isolation of virus from the serum. These findings suggest that HIV may at times replicate preferentially in the brain and that its presence may not immediately cause neurologic signs or symptoms. PMID- 3646003 TI - RN first assistants deserve third-party reimbursement, whether it be direct or indirect. PMID- 3646002 TI - Cephalosporin susceptibility of methicillin-resistant, coagulase-negative staphylococci. AB - Coagulase-negative staphylococci were tested for susceptibility to methicillin, cephradine, ceftriaxone, cephalothin, and cefamandole by standard broth microdilution. Most of the 26 methicillin-resistant isolates were susceptible to cephalothin and cefamandole, but very few were susceptible to ceftriaxone, and none was susceptible to cephradine. The proportion of bacterial cells that grew in the presence of 128 micrograms of methicillin per ml was calculated for each methicillin-resistant isolate. Those with every cell or 1 in 10 cells resistant to 128 micrograms of methicillin per ml included the isolates that were most resistant to the cephalosporins and highly resistant to methicillin. Those with 1 cell resistant in 10(5) or 10(6) cells were the isolates most susceptible to the cephalosporins, and their methicillin MICs were lower. When cells resistant to 128 micrograms of methicillin per ml were used as inocula for broth microdilution tests, resistance to cephradine remained the same, but resistance to ceftriaxone, cephalothin, and cefamandole increased significantly. Cefamandole was the only cephalosporin which retained antibacterial activity against some methicillin resistant isolates (12 of 26). Cephradine, ceftriaxone, cephalothin, and cefamandole resistance appeared to be expressed by the same cells that expressed methicillin resistance. In this way, cross resistance was demonstrated between methicillin and the cephalosporins. PMID- 3646004 TI - Surgical rotations: a must for nursing education. AB - Although more documentation is needed, the belief exists among educators that an all-RN staff in the operating room results in more productivity and quality of care. The professional nurse is seen as invaluable in the OR because of his or her flexibility in meeting the varied requirements of scrubbing and circulating. Registered nurses bring with them a broader range of skills, a lessening of costly supervision, and a decrease in ideologic conflicts about care of the surgical patient. It has been suggested that the RN, despite receiving a higher salary, is far more cost-effective than an aide or technician when compared with such factors as percentage of time ancillary staff actually work (estimated at 65%), the amount of supervision they require, and subsequent overtime frequently asked of RNs in understaffed environments. Professional nursing education should include the opportunity to learn perioperative nursing. I believe professional nurses should staff the surgical suite in both scrub and circulating positions in order to promote cost-effective operating room management and maintain quality patient care. PMID- 3646005 TI - Moving the operating room to a new hospital. PMID- 3646006 TI - Local anesthesia. Implications for the perioperative nurse. PMID- 3646007 TI - Cardiac arrest in ambulatory surgery. The management perspective. AB - Preventing cardiac arrests requires constant vigilance on the part of the entire perioperative team. In the preoperative phase, physicians must make careful patient selections based on the patients' risk factors, and cancel the cases or admit the patients if problems are found. In the intraoperative phase, the anesthesia personnel must carefully monitor vital signs, observe tissue perfusion, replace fluids, position the patient to maximize vital functions, and carefully select the anesthetic agents. In the postoperative phase, nurses must carefully observe and monitor the patient, especially high-risk patients, and take any necessary precautions. They must also explain instructions to the patient regarding complications after discharge. Although a manager may establish careful patient selection criteria, the day may come when the staff members must respond to a cardiac arrest in the ambulatory surgery unit. When it does, management of the patient must be the first priority. The staff members must correctly diagnose the problem, send for assistance, perform CPR, mobilize equipment, oxygen, and medications, control traffic, document interventions, and record patient responses. In an ambulatory setting, there is a high probability that family members or friends will be with the patient. A nurse should be delegated to take them to a quiet area away from the immediate crisis, and provide information and emotional support. Frequent reports will help them cope with the crisis. Public awareness and knowledge about CPR has greatly increased since it was first used in 1960. By 1977, some 12 million Americans had been CPR trained and some 53 million more were awaiting training.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3646008 TI - Extracorporeal membrane oxygenation. Its use in neonatal respiratory failure. PMID- 3646010 TI - Management by objectives. Applications for OR nursing. PMID- 3646009 TI - Pregnancy in the OR. Part II: Ensuring fetal health. AB - A pregnant employee must decide for herself on whether to keep working in the OR. Several factors (ie, constant standing/sitting, high-stress situations, exposure to infectious diseases and noxious chemicals) can be detrimental to a pregnant employee and her unborn infant, yet if precautions are taken, the OR can be a safe environment. PMID- 3646012 TI - Documentation of perioperative nursing care. AORN Recommended Practices Subcommittee. PMID- 3646011 TI - Isthmus flap aortoplasty. A new approach to long-segment coarctation repair. AB - While not the answer for every patient with coarctation, isthmus flap aortoplasty offers excellent results for infants with long-isthmus segment defects that are the most difficult to repair by end-to-end or subclavian flap techniques. Isthmus flap aortoplasty has been used in six patients with long-isthmus segment coarctations. The surgical approach to coarctation depends on the local anatomical features in each infant. The standard subclavian flap technique seems to be quite adequate for most infants with short-isthmus coarctation. The decision about which technique to use, however, is made by the surgeon at the OR bed. The isthmus flap technique has been quite useful for this group of infants with coarctation and has given excellent results. The technique eliminates most, if not all, of the limitations of the subclavian flap technique and belongs in the armamentarium of a pediatric surgeon for difficult-to-manage patients. PMID- 3646013 TI - Basic aseptic technic. AORN Recommended Practices Subcommittee. PMID- 3646014 TI - American Nurses' Association considers endorsing presidential candidate in 1988 election. AB - Political action committees are a means for individuals to join together so they have some clout in the political process, Symons said. The most important function of ANA-PAC is that it "builds a perception of nurses being politically powerful," Symons said. "And that is more important than a single piece of legislation that ANA-PAC has been involved with." All funds used to contribute to political campaigns come from voluntary donations to ANA-PAC from members of state nurses' associations. Federal law prohibits ANA-PAC from soliciting funds from outside the state nurses' associations. PMID- 3646015 TI - Use of antitrust laws by health care providers. PMID- 3646016 TI - Cross-cultural nursing. A perioperative experience in Kenya. PMID- 3646017 TI - Exceptions to the right to refuse treatment. PMID- 3646018 TI - Unification of a double uterus. Surgical procedures and patient care. PMID- 3646019 TI - Orientation made easy. Using preceptors and skills checklists. AB - Historically, it has been difficult to list skills that accurately reflect the responsibilities of the perioperative nurse and provide guidance in his or her training. Too often, learning was haphazard, which created inconsistent results and undue stress for new employees. With a preceptor program, the instructor or nurse manager will find improved staff morale and better retention of new employees. Today, ORs are even busier and have more technical equipment than in the past. Uncoordinated teaching efforts by staff and the good intentions of new employees are not enough. Learners must be given every opportunity to be successful. An orientation program that uses adult learning principles, preceptors, and a competency skills list can help new employees quickly become skillful team members. PMID- 3646020 TI - Adult learning principles. Applications for preceptor programs. PMID- 3646021 TI - Pulse oximetry. Monitoring arterial hemoglobin oxygen saturation. AB - The pulse oximeter gives the nurse in the operating room the ability to provide optimum care for the patient having local anesthesia. With the use of this new monitoring device, the nurse can intervene with oxygen therapy before a hypoxic episode occurs. PMID- 3646022 TI - Self-image. Characteristics of operating room nurses. PMID- 3646023 TI - Productive employee interviewing. Methods for choosing OR staff. AB - The hiring interview is a widely used method of identifying qualified applicants to fill the needs of an organization. Careful planning and organizing before the applicant arrives can minimize the risks of gaps in information and poor impressions of the institution. One-to-one or panel interviewing can be conducted, but using structured questions and scoring in a consistent manner are essential for validity. Questions should be job-related and standardized. Scoring the responses to questions provides a mechanism for evaluation and comparison. To enhance the interview process, attention should be given to the overall environment and initial greeting of the applicant. Listening to implicit as well as explicit messages helps the interviewer develop opinions and impressions that can be explored by further discussion or additional questions. Assessment of skills, knowledge, motivation, and personality traits provides a composite of applicant potential and suitability. Although it may not offer a 100% guarantee of success, interviewing can be a rewarding experience for both you and the applicant. PMID- 3646024 TI - Students to perioperative nurses. A hospital work-study program. PMID- 3646025 TI - Purification and characterization of human bronchial proteinase inhibitor. AB - We describe a purification procedure for the human bronchial proteinase inhibitor which involves trichloroacetic acid precipitation of sputum followed by ion exchange and gel filtration chromatography. The inhibitor shows a major band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, but exhibits microheterogeneity on high-resolution chromatography. It has a molecular mass of 15.5-16 kDa as determined by electrophoresis and gel filtration and is 90% active against leukocyte elastase. The amino acid sequence of the N-terminal portion of the inhibitor was determined and was found to be identical (through 29 amino acids) to that recently reported for the human seminal plasma proteinase inhibitor I (Seemuller et al. (1986) FEBS Lett. 199, 43-48). PMID- 3646026 TI - The inter-regional epidemiological study of childhood cancer (IRESCC): a case control study of aetiological factors in leukaemia and lymphoma. AB - The inter-regional epidemiological study of childhood cancer analysed data on 234 children diagnosed with leukaemia or lymphoma and 468 controls matched for age and sex. A wide range of potential risk factors was examined, including prenatal exposure to x rays, maternal drug ingestion and smoking, child's medical history, and parental medical conditions and occupation. Calculations were completed for leukaemia or lymphoma and diagnostic subgroups, as defined by laboratory confirmed cell type. In utero exposure to narcotic analgesics was weakly associated with leukaemia or lymphoma but no other antenatal factors gave significant risks. New associations were identified for skin diseases in both parents and congenital abnormalities in the mothers of children with leukaemia. For past medical conditions in the child, viral disease occurring under 6 months of age increased the risk for acute lymphoblastic leukaemia. Fewer children in the leukaemia or lymphoma group had been immunised compared with the control groups. Case children diagnosed over the age of 9 years were more likely than controls to have had four or more previous episodes of illness. Overall, these results indicate that prenatal factors may be less important than postnatal or genetic influences in the development of leukaemia or lymphoma in children. PMID- 3646028 TI - Development of a classification system for psychiatric/mental health nursing: individual response class. PMID- 3646027 TI - Renal and cerebral necrosis in survivor after in utero death of co-twin. AB - A newborn with bilateral renal cortical necrosis and severe cerebral damage in association with a macerated stillborn twin is reported. The alterations in the kidneys and brain of the twin born alive suggest that the primary event took place before birth. Thromboplastic material and embolizing particles derived from the dead fetus may have passed the monoamnionic-monochorionic twin placenta and caused disseminated intravascular coagulation in the living twin, followed by infarction in other organ systems. PMID- 3646029 TI - The development roots of loneliness. PMID- 3646030 TI - Nursing, madness, and mental health. PMID- 3646031 TI - Art and group work: interventions for multiple victims of child molestation (Part II). PMID- 3646032 TI - Multiple sclerosis and the family. PMID- 3646033 TI - Evaluation of the impact of the clinical nurse specialist in a state psychiatric hospital. PMID- 3646034 TI - The choice of therapist self-disclosure in psychotherapy groups: contextual considerations. PMID- 3646035 TI - Transitional day treatment: an individualized goal-oriented approach. PMID- 3646036 TI - Short-term group treatment of depressed women: a replication study in Great Britain. PMID- 3646037 TI - Update on psychiatric-mental health nursing education at the Federal level. PMID- 3646038 TI - Countertransference in couples therapy. PMID- 3646039 TI - Psychiatric consultation liaison nursing and psychiatric consultation liaison doctoring: similarities and differences. PMID- 3646040 TI - Families of unemployed workers: need for nursing intervention and prevention. PMID- 3646042 TI - Bedtime ceremonials: a focus for nursing. PMID- 3646041 TI - The effects of family training and support on child behavior and parent satisfaction. PMID- 3646043 TI - [Morphofunctional changes in the long tubular bones of animals which have developed while readapting after physical loads]. AB - The investigation has been performed on 120 white male rats of Wistar line. By means of the morphometry, electron microscopy and chemical methods dynamics of readaptive changes have been studied in long tubular bones during the period, when the effect of physical loadings both of dynamic and static character and of various intensity has been stopped, up to the old periods of the animals' life. Readaptation after moderate dynamic and static loadings is occurring for a long time and steadily. The changes caused by static loadings are nearly completely restored in a year. Morphofunctional rearrangements of the long tubular bones in the readaptation process after moderate dynamic loadings is characterized by residual manifestations. Prolonged readaptation after intensive physical loadings does not result in a complete restoration of all the parameters studied concerning growth and skeletal development. An intensive dynamic loading produces more stable changes, that are not subjected to a complete correction even after a passive readaptation for a year. Readaptation morphofunctional rearrangements of the long tubular skeletal bones depend on conditions of the previous regimen of the motor activity. PMID- 3646044 TI - ESWL follow-up studies: rich source of information for improving patient care. PMID- 3646045 TI - A Kock Pouch teaching protocol. PMID- 3646046 TI - Pediatric reflux and extravesical ureteral advancement surgery. PMID- 3646047 TI - Writing for publication. PMID- 3646049 TI - Entering the ethics arena. PMID- 3646048 TI - Exchange visit a success. PMID- 3646050 TI - Answers to some questions about HMOs. PMID- 3646051 TI - Paediatric fractured femur: an innovative treatment. PMID- 3646052 TI - Nurse & the law. The importance of confidentiality. PMID- 3646053 TI - Oral anticoagulants--advice to patients. The Royal Melbourne Hospital Pharmacy Department. PMID- 3646054 TI - A program for career structure. Part 5. Designated nurses. PMID- 3646055 TI - Primary health care: a new focus and challenge for nursing. PMID- 3646056 TI - Self responsibility: the key to change. PMID- 3646058 TI - Nicotine chewing tablets. PMID- 3646057 TI - Nurse & the law. Who decides for those who can't? PMID- 3646059 TI - Co-factors and HIV: what determines the pathogenesis of AIDS? PMID- 3646060 TI - Effect of mevinolin on cholesterol metabolism in obese and lean Zucker rats. AB - Mevinolin is a potent competitive inhibitor of HMG-CoA reductase, the enzyme catalyzing the major rate-limiting step in cholesterol synthesis. In this study the drug was administered as an intragastric dose at 2.5 mg/kg/day to 10 to 12 week-old lean and obese Zucker female rats over a 5-day period. Mevinolin showed no effect on plasma cholesterol levels in the lean rat; however, in the obese rat there was a significant decrease in plasma cholesterol (about a 40% decrease from initial levels). Although there was a difference in effect on plasma cholesterol levels in obese and lean rats, hepatocytes isolated from both fed lean and obese rats incubated with various concentrations of mevinolin exhibited similar levels of inhibition of cholesterol synthesis and showed no effects on the other metabolic processes studied. These results indicate that the drug was effective acutely on cholesterol synthesis in hepatocytes isolated from both lean and obese rats, but on a chronic treatment basis the hypocholesterolemic effect was observed only in the obese Zucker rat. This study supports the idea that the naturally occurring hypercholesterolemic obese Zucker rat may be a good model for testing potential new cholesterol lowering agents. PMID- 3646061 TI - The effect of elastase on chickens with endogenous hyperlipidemia. AB - Elastase has been reported to have a multiplicity of activities which may be protective against atherosclerosis. The data reported here support those reports and show a clear antiatherosclerotic effect in hyperlipidemic chickens. We have shown here that a reduction in calcium and lipid accumulation in aortic tissue and possibly a plasma cholesterol lowering effect can be seen in the chicken when treated with elastase. The most important effect in this animal is probably to aid removal of lipid bound to elastin in the intima. This was achieved at a dose of only 600 U elastase while reductions in tissue calcium required 1800 U elastase. PMID- 3646062 TI - Primary osteoporosis: new thinking on an old problem. PMID- 3646063 TI - The dreaded Mrs. Scott. PMID- 3646065 TI - When it's time for change. PMID- 3646066 TI - A comparison of State Board Examination scores and clinical performance of generic and LPN-admission Associate Degree Nursing students. PMID- 3646064 TI - Monitoring cardiac rhythms, Part II. (continuing education credit). PMID- 3646067 TI - An ADN in Ecuador. PMID- 3646069 TI - AIDS and confidentiality. PMID- 3646070 TI - Catalysis by human leukocyte elastase: mechanistic insights into specificity requirements. AB - Steady-state kinetic parameters were determined for the human leukocyte elastase catalyzed hydrolysis of a series of peptide-based thiobenzyl esters and p nitroanilides. The peptide units are MeOSuc-Val, MeOSuc-Alan-Pro-Val (n = 0-2), and MeOSuc-Alan-Pro-Ala (n = 1 or 2). The results of this study suggest five important mechanistic features for HLE. Few important remote subsite contacts are established in the Michaelis complex. Full recognition and tight binding of the substrate occurs in the transition state for acylation. The P3-S3 interaction is critical during acylation. Subsite contacts are unimportant in deacylation. P1 specificity is regulated by peptide length. An important steady-state kinetic consequence of this specificity is that the rate-limiting step of kc for p nitroanilide hydrolysis changes from acylation to deacylation as the peptide chain is lengthened. PMID- 3646071 TI - Confidence limits to the risk ratio. AB - For the problem of obtaining confidence limits to the risk ratio, or the ratio of two binomial probabilities, Katz et al. (1978, Biometrics 34, 469-474) proposed a method based on the logarithm of the observed ratio and using Fieller's result. We propose a method based on a power of the observed ratio, the power being chosen to minimize the skewness of the pivotal random variable. The method is simple to use and more stable than that of Katz et al. A continuity correction is suggested if a conservative interval is desired. PMID- 3646072 TI - Loop formation in polynucleotide chains. II. Flexibility of the anticodon loop of tRNAPhe. PMID- 3646073 TI - US Surgeon General praises state and CNA. PMID- 3646074 TI - Moving Hispanics into nurses. PMID- 3646075 TI - Working with translators. PMID- 3646076 TI - Nursing care of the patient receiving cyclosporine therapy. PMID- 3646077 TI - Computers in nursing. PMID- 3646078 TI - Developing national standards for critical care nurses. PMID- 3646079 TI - Self scheduling in C.C.U. PMID- 3646080 TI - Controlling anaesthetic gas exposure in PACU. PMID- 3646081 TI - The problem of patient awareness during surgery. PMID- 3646082 TI - The operating room nurse, AIDS, and the law. PMID- 3646083 TI - Tracheoplasty--reconstructing a new airway. PMID- 3646084 TI - Affording higher education. PMID- 3646085 TI - Strained relations: degree and diploma nurses in the workplace. PMID- 3646086 TI - Teleconferencing. PMID- 3646087 TI - The pros and cons of doctorate education. PMID- 3646088 TI - Care of the uncomplicated burn. PMID- 3646089 TI - [Courses on holistic approach to health at the college level: an innovation]. PMID- 3646090 TI - [My mental health]. PMID- 3646091 TI - Levels of alkaline phosphatase isozymes in human seminoma tissue. AB - The three human isozymes of alkaline phosphatases were quantitatively determined in normal testis and seminoma tissues. The highly selective assays were based on isozyme specific monoclonal antibodies. In the normal testis approximately 90% of the catalytic activity originates from the tissue unspecific alkaline phosphatase, and the remaining activity was due to trace expression of both intestinal (approximately 5%) and placental alkaline phosphatase (PLAP) or PLAP like isozyme (approximately 5%). In homogenates of seminoma tissues, highly increased levels of all three isozymes were identified. Both the tissue unspecific alkaline phosphatase and PLAP-like enzymes displayed relative increases of 10- to 100-fold and intestinal alkaline phosphatase 2- to 10-fold compared with normal testis. This finding indicates that the entire genome coding for alkaline phosphatases may be activated in seminomas. The PLAP-like enzyme from seminoma cells comprises a heterogenous population of molecules demonstrating partial heat sensitivity and microheterogeneity upon starch gel electrophoresis in contrast to the pregnancy related PLAP. These findings have implications for the different PLAP assays used in the clinical monitoring of seminoma patients. PMID- 3646092 TI - Peptide T[4-8]: a pentapeptide sequence in the AIDS virus envelope which blocks infectivity is essentially conserved across nine isolates. PMID- 3646093 TI - The positive you. PMID- 3646095 TI - Advanced psychiatric nursing practice in traditional settings. PMID- 3646094 TI - The genome organization of STLV-3 is similar to that of the AIDS virus except for a truncated transmembrane protein. AB - Nucleotide sequence analysis of the 3' portion of the genome of simian T lymphotropic virus type 3 from African green monkeys (STLV-3agm) reveals that it has the same general genome structure as the human immunodeficiency virus (HIV 1), the etiologic agent of AIDS. Short segments of strong amino acid homology and similar predicted protein structure characterize the tat and art/trs open reading frames (orf) of both viruses. Strong conservation of 3' orf and of another, cs orf, for which no protein product has been identified suggests that they both encode proteins important to the life cycle of these viruses. The extracellular glycoproteins of STLV-3 and HIV-1 share a similar backbone structure and 50%-55% amino acid homology in constant domains of the HIV-1 protein. The most evident departure in structural organization is truncation of the transmembrane glycoproteins in two STLV-3agm clones and a biologically active, noncytopathic clone of HTLV-4. PMID- 3646096 TI - Learning to play: fun and games. PMID- 3646097 TI - Pregnancy care: supporting city mothers. PMID- 3646098 TI - Learning to play: child's play. PMID- 3646099 TI - Leg ulcers: in support of stockings. PMID- 3646100 TI - Wound care: antiseptic solutions. PMID- 3646101 TI - Leg ulcers: treatments on trial. PMID- 3646102 TI - Mental handicap nursing: a changing face. PMID- 3646103 TI - Comparison of gastrointestinal pH in cystic fibrosis and healthy subjects. AB - The primary objective of this study was to define the pH conditions under which supplemental pancreatic enzyme preparations must function in the upper gastrointestinal tract. The hypothesis was that normal or greater acid output in patients with cystic fibrosis (CF), combined with low pancreatic bicarbonate output, results in an acidic duodenal pH, compromising both dosage-form performance and enzyme activity. Gastrointestinal pH profiles were obtained in 10 CF and 10 healthy volunteers under fasting and postprandial conditions. A radiotelemetric monitoring method, the Heidelberg capsule, was used to continuously monitor pH. Postprandial duodenal pH was lower in CF than in healthy subjects, especially in the first postprandial hour (mean time greater than pH 6 was 5 min in CF, 11 min in healthy subjects, P less than 0.05). Based on the dissolution pH profiles of current enteric-coated pancreatic enzyme products, the duodenal postprandial pH in CF subjects may be too acidic to permit rapid dissolution of current enteric-coated dosage forms. However, the pH was above 4 more than 90% of the time on the average, suggesting that irreversible lipase inactivation in the duodenum is not likely to be a significant limitation to enzyme efficacy. Overall results suggest that slow dissolution of pH-sensitive coatings, rather than enzyme inactivation, may contribute to the failure of enteric-coated enzyme supplements to normalize fat absorption. PMID- 3646104 TI - An emphysema model in rats treated intratracheally with elastase. AB - Pulmonary functions, morphology, and morphometry were examined in rats at 3, 7, and 10 weeks after a single intratracheal administration of 6.5 units of porcine pancreatic elastase in order to obtain a model of pulmonary emphysema which would be suitable for studying the responses of emphysematous lungs to atmospheric pollutants. Functional residual capacity and residual volume of the elastase treated rats increased at all the times studied, but their total lung capacity increased only at 7 and 10 weeks compared with those of the saline-treated control rats. The increase in static lung compliance and the decrease in peak flow and maximum flow at 50% of total lung capacity during forced expiration were also observed in all except the 3-week elastase animals. The elastase-treated lungs showed morphological changes characteristic of emphysematous lesions. The increase in mean linear intercept length and the decrease in total alveolar surface area were demonstrated by these elastase-treated lungs. Based on these results, we conclude that an adequate and suitable model of pulmonary emphysema could be obtained in rats 7-10 weeks after treatment with the present dose of elastase. PMID- 3646106 TI - [Clinical picture, treatment and prevention of food poisoning]. PMID- 3646105 TI - Limited proteolysis reveals low-affinity binding of N-acetyl-L-glutamate to rat liver carbamoyl-phosphate synthetase (ammonia). AB - Carbamoyl-phosphate synthetase was inactivated by elastase with first-order kinetics, and N-acetyl-L-glutamate speeded inactivation. From the dependence of the t1/2 value for inactivation on the concentration of acetylglutamate we estimate a Kd value for binding of the activator of 0.365 mM, which is approximately 600 times greater than in the presence of ATP, HCO3-, K+ and Mg2+. K+ and Mg2+ are not required for binding with low affinity, and in the absence of ATP they do not appear to increase the affinity for acetylglutamate. In the presence of acetylglutamate, mixtures of ATP, K+ and Mg2+ protect the enzyme from inactivation. ADP or AdoPP[NH]P partly replaced ATP in protecting the enzyme and thus binding of the nucleotide without further reaction is enough for protection. Two partial activities of the enzyme were inactivated by elastase to the same extent as the overall reaction, and thus elastase affects some property of the enzyme which is essential for catalysis. With other proteinases tested, inactivation was also accelerated by acetylglutamate and was slowed by mixtures of ATP, K+, Mg2+ and acetylglutamate, suggesting that changes in the accessibility of susceptible bonds are responsible for the changes in the degree of inactivation. It is concluded that elastase attacks at or close to the binding sites for ATP, and that exposure of the binding site for the ATP molecule that yields Pi (ATPA) upon binding of acetylglutamate causes the acceleration of the proteolytic inactivation. PMID- 3646107 TI - [Specific lymphadenitis of viral origin in children]. PMID- 3646108 TI - [Characteristics of the course of viral hepatitis in pregnant women and its effect on the fetus and the subsequent development of newborn infants]. PMID- 3646109 TI - [Treatment of infected wounds]. PMID- 3646110 TI - [Role of public health during the accelerated socioeconomic development of the USSR]. PMID- 3646111 TI - [Symptomatic characteristics of obstructive calculous pyelonephritis in children]. PMID- 3646112 TI - [Clinical and pharmacological aspects of atherosclerosis in middle and old age]. PMID- 3646113 TI - [Acute attack of glaucoma]. PMID- 3646114 TI - [Characteristics of the development of the family among medical workers]. PMID- 3646115 TI - [Spinal injuries]. PMID- 3646116 TI - [Work experience in anti-alcohol propaganda]. PMID- 3646117 TI - [Optimizing the hygiene education of younger schoolchildren]. PMID- 3646118 TI - [Premature rupture of the fetal membranes and chorioamnionitis]. PMID- 3646119 TI - [Myocardial infarct complicated by paroxysmal tachycardia]. PMID- 3646120 TI - [Fibrocystic mastopathy in a patient with a uterine myoma]. PMID- 3646121 TI - [Ways to improve epidemiological surveillance]. PMID- 3646122 TI - [Chronic leukemia]. PMID- 3646123 TI - [Wound complications]. PMID- 3646124 TI - [Thromboembolism of the pulmonary artery]. PMID- 3646125 TI - [Pathological drunkenness]. PMID- 3646126 TI - [Problems in propagandizing a healthy life style]. PMID- 3646127 TI - [The ethics of interrelationships in small medical collectives]. PMID- 3646128 TI - [Work experience of laboratory hematology offices]. PMID- 3646129 TI - [Puerperal endometritis]. PMID- 3646130 TI - [Asthmatic variant of myocardial infarct]. PMID- 3646131 TI - [Trichinelliasis]. PMID- 3646132 TI - [Acute cervicitis and erosion of the cervix uteri]. PMID- 3646133 TI - [Cervical pregnancy]. PMID- 3646135 TI - [Pyelonephritis in women]. PMID- 3646134 TI - [Atherosclerosis]. PMID- 3646136 TI - [Cancer of the ovary]. PMID- 3646137 TI - [Tuberculosis of the peripheral lymph nodes in children]. PMID- 3646138 TI - [Scientific medical information and its role in the activities of paramedical workers]. PMID- 3646139 TI - [Diagnosis of arrhythmias]. PMID- 3646140 TI - [Alcohol and the child-bearing function]. PMID- 3646141 TI - [Work experience in health education]. PMID- 3646143 TI - [Epidemic parotitis in children]. PMID- 3646142 TI - [Relief of the migraine pain attack by using the Lenar apparatus]. PMID- 3646144 TI - Close to the bull's horns. PMID- 3646146 TI - Transfer stress in patients after myocardial infarction. PMID- 3646145 TI - Nursing management of peripheral intravenous sites. PMID- 3646147 TI - A case of nursing malpractice. PMID- 3646148 TI - Cardiac rehabilitation prescription format for an inpatient program. PMID- 3646149 TI - Electroretinographic examination and definition of serum zinc levels in patients with chronic pancreatitis. AB - The authors have verified that retina dysfunction in patients suffering from chronic pancreatitis could be demonstrated by the help of electroretinography and eliminated or significantly corrected by administration of pancreas enzyme preparations. The retinograph may be applied successfully in the diagnosis of chronic pancreatitis and also in evaluation of the efficacy of the substitution treatment. The insufficiency of zinc absorption may play a definite role in the development of these functional disturbances. It has also been established that lower zinc values parallel with the decrease of the stool fat contents in patients suffering from chronic pancreatitis and can be significantly improved by enzyme preparations. PMID- 3646151 TI - The side-effects and interactions of drugs in elderly patients. PMID- 3646150 TI - Health visitors: partnerships in care. PMID- 3646152 TI - Home from hospital--an experiment in group care. PMID- 3646153 TI - A plea for active euthanasia. PMID- 3646154 TI - A step in the right direction--towards sharing. PMID- 3646155 TI - Dying with dignity--the great dilemma. PMID- 3646157 TI - Continence and the older person. PMID- 3646156 TI - Euthanasia and the nurse. PMID- 3646158 TI - [Embryotoxic action of inhaled potassium ferricyanide]. PMID- 3646159 TI - A closer look at institutional accidents. PMID- 3646160 TI - Profile of a director of nursing service in long-term care. PMID- 3646161 TI - Caretakers-take care! PMID- 3646162 TI - How does crime affect the elderly? PMID- 3646163 TI - Nutrition. Lean, "lite," and low. PMID- 3646164 TI - Drugs and the elderly. Cigarettes and caffeine in drug interactions. PMID- 3646165 TI - H.I.V. antibody testing in lymphoma patients. PMID- 3646167 TI - Hospice care: art and science evaluating primary caregiver perceptions. PMID- 3646166 TI - Hospice volunteers: the impact of personality characteristics on retention and job performance. PMID- 3646168 TI - Quality assurance monitor review of symptom management. PMID- 3646169 TI - Teaching adult patients and their families who are receiving hospice care. PMID- 3646170 TI - Is hospice care least expensive for the terminally ill? PMID- 3646171 TI - The staffing game: playing to win with workload measurement systems. PMID- 3646172 TI - Still chuckin' and drivin'. Interview by Joanne Rudrick. PMID- 3646173 TI - Alcohol: a drug. PMID- 3646174 TI - A geriatric psychiatry nurse rating scale: preliminary findings. PMID- 3646176 TI - Do supplements treat the patient or the practitioner? PMID- 3646175 TI - Drugs and vision: unexplained symptoms--are they due to eye meds? PMID- 3646177 TI - A committee that works. PMID- 3646178 TI - [Professional accreditation: a contribution to the quality of services]. PMID- 3646179 TI - [Perspectives: one profession--one organization]. PMID- 3646180 TI - The elimination of gentamicin-resistant gram-negative bacteria in a newborn intensive care unit. AB - The aminoglycosides play a central role in the treatment of infectious diseases caused by gram-negative bacteria. During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grew Enterobacter cloacae; 41 of them were gentamicin resistant. One neonate developed septicemia. The routine antibiotic protocol was then changed from gentamicin ampicillin to amikacin-ampicillin for a period of six months. During this period the resistance to gentamicin declined to a minimum. Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin. The gentamicin resistant E. cloacae vanished. No isolate was resistant to amikacin. The gentamicin-ampicillin regimen was then reintroduced. PMID- 3646182 TI - Intravenous tubing containing burettes can be safely changed at 72 hour intervals. AB - No studies testing the safety of changing intravenous systems containing in-line burettes at 72 hours in an intensive care setting have been performed. Patients entering a medical or surgical intensive care unit were alternatively assigned to have any line with an in-line burette changed at either 48 hour (105 patients) or 72 hour (65 patients) intervals. Daily quantitative cultures with a 2 ml aliquot of burette fluid were obtained. Contaminated burette fluid was detected in 60 of 1181 (5.0%, 95% confidence interval, 3.7% to 6.3%) samples from the burettes changed at 48 hour intervals, and in 40 of 901 (4.4%, 95% confidence interval, 3.0% to 5.8%) samples from 72 hour interval burettes. Significant bacterial contamination of burette fluid, defined as ten or more colonies per milliliter, occurred in only seven (0.6%) cultures from patients in the 48 hour interval group compared with only three (0.3%) cultures in the 72 hour group. None of the contaminated burette fluids was associated with a primary bacteremia. Change of in-line burettes in patients in intensive care at 72-hour intervals is safe and should result in substantial cost savings to hospitals. PMID- 3646181 TI - Emergence of coagulase negative staphylococci as major nosocomial bloodstream pathogens. AB - Over an eight year period, 1975 to 1982, 1,843 nosocomial bloodstream infections were identified by routine prospective surveillance at the University of Virginia Hospital (106/10,000 admissions). Despite a decline in overall bloodstream infection rates during the study period (P = .085), bloodstream infections due to gram positive organisms increased from 29 (1975-1978) to 43/10,000 (1979-1982), (P less than 0.001). Notably, rates for coagulase negative staphylococci increased from 5.2 (1975-1978) to 12.4/10,000 (1979-1982), (P less than 0.001). In 1982, coagulase negative staphylococci accounted for 17% of all bloodstream infections and were the most frequently isolated pathogens. Sixty-four percent of patients with coagulase negative staphylococci were in critical care units versus 41% with other bloodstream infections (P less than .05). The recognition of coagulase negative staphylococci as significant bloodstream pathogens markedly alters the clinician's approach to nosocomial septicemia. PMID- 3646183 TI - Recreational infections. PMID- 3646184 TI - Protective precautions for the patient with AIDS. PMID- 3646185 TI - Proper handling of dirty linen. PMID- 3646186 TI - The role of epidemiology in medical education. PMID- 3646187 TI - Tuberculosis in hospital personnel. AB - Tuberculosis (TB) skin testing practices and the prevalence and inherent risk of TB infection among hospital employees in 167 North Carolina (NC) hospitals were determined from a 79% (132/167) response to a tuberculosis screening questionnaire. Preemployment TB skin testing was performed by 98% of responding hospitals, primarily (87%) by the Mantoux method. TB skin test reactions of greater than or equal to 10 mm were interpreted as significant by 72% and at the appropriate time interval of 48 to 72 hours after administration by 80%. The booster test was routinely performed in 12% of the hospitals. TB infection prevalence among new employees during 1983 was 6.3% (260/4137) in 30 hospitals supplying these data. A positive correlation was noted between employee infection prevalence and county TB case rates (P = .014). Skin test conversion data from 56 hospitals across the state revealed a five year mean conversion rate of 1.14% among 71,253 personnel. There was an association between the incidence of TB in the general population and the frequency of conversions among hospital employees in corresponding geographical regions. Similarly, the incidence of TB among approximately 100,000 NC hospital employees in 1983 and 1984 was less than the incidence in the general population. These associations suggest that the incidence of TB infection among hospital personnel may reflect the prevalence of tuberculosis in the community rather than an occupational hazard. Annual TB skin testing of hospital employees may be justified in eastern North Carolina where the incidence of tuberculosis (22-30 cases/100,000) is greater than the national average and where the risk of new TB infection among hospital employees is relatively common (greater than or equal to 1.5%). PMID- 3646188 TI - The development of cancer nursing as a speciality. AB - This article describes some of the major events that have shaped the direction of cancer nursing internationally over the past 15 years in terms of the role and function of the cancer nurse. PMID- 3646189 TI - Toxic New World: what nurses can do to cope with a polluted environment. AB - Nurses are increasingly finding themselves in the role of concerned health care givers in a toxic environment. Some of the effects of pollution on our environment are briefly discussed and guidelines offered for those who want to combat this pressing problem. PMID- 3646190 TI - Cross-cultural comparison of images of nurses and physicians. AB - This study investigates attitudes related to the image of nurses and physicians across 30 cultures, using six concepts. Significant differences were found between physician and nurse with respect to power. Moreover, although the physician was highly correlated with knowledge and independence the nurse was correlated with kindness. Nurses' ability to influence health care decision making may be limited if they are viewed as powerless, and they must address this deficit in their public image. PMID- 3646191 TI - Nursing in foreign countries as described in the professional journals of national nurses' associations. AB - This paper discusses the extent of the coverage accorded by national nurses' association journals to the important subject of nursing in other countries. With one exception, the journals sampled showed that dissemination of such information is diminishing. What are the reasons for this? PMID- 3646192 TI - Computer administered testing for California's psychiatric technicians. PMID- 3646193 TI - Computer testing for the National Council. PMID- 3646194 TI - Community living specialist. PMID- 3646195 TI - Constitutional issues related to grandfather clauses. PMID- 3646196 TI - Report of Montana Supreme Court decision--denial of licensure by endorsement as a practical nurse. PMID- 3646197 TI - Statewide committees on nursing education/manpower. PMID- 3646198 TI - Managing minor illness in the under fives. PMID- 3646199 TI - Factors affecting follow up of paediatric referrals. PMID- 3646200 TI - Sudden infant death: parents' views of professional help. PMID- 3646201 TI - But what do we tell the parents? PMID- 3646202 TI - When to contact the doctor. PMID- 3646203 TI - Measuring the need for, and the value of, routine health visiting: 2. PMID- 3646204 TI - Images of fatherhood in antenatal literature: 2. PMID- 3646205 TI - Guidelines for minimum health visitor contact. PMID- 3646206 TI - Quality in the community. PMID- 3646208 TI - Northern Ireland reports on nursing care in the community. PMID- 3646207 TI - An ABC of alternative medicine. Iridology. PMID- 3646209 TI - Warning: Government control may damage health promotion. PMID- 3646211 TI - Critical care nursing stress: another look. PMID- 3646210 TI - Quality: from imperatives to innovations. AB - I have outlined the quality issues facing critical care nurses today and have also presented some challenges for the future. Critical care nurses must now enter a new era characterized by unification, collaboration and involvement, increased professional autonomy, and caring to meet the customer's expectations for quality in fact and quality in perception. Through innovation, critical care nurses can control the pace of change and influence quality in critical care. Recall the kaleidoscope and remember that its intent is to make the whole seem more than the sum of its parts. The image on the horizon is a dynamic and powerful nursing profession as a whole, with critical care nurses assuming an essential and more important role. In fact, the image on the horizon looks bright to me. PMID- 3646212 TI - Intensive care staff stressors and life event changes across multiple settings and work units. PMID- 3646213 TI - Thermodilution cardiac outputs using room and ice temperature injectate: comparison with the Fick method. PMID- 3646214 TI - The effect of a cardiac teaching program on patient rehabilitation. PMID- 3646215 TI - Suppurative thrombophlebitis caused by intravenous line sepsis. PMID- 3646216 TI - Consider an alternative. PMID- 3646217 TI - Gray areas: informed consent in pediatric and comatose adult patients. PMID- 3646218 TI - NTI (National Teaching Institute) research abstracts. New Orleans, La., May 4 to 7, 1987. PMID- 3646219 TI - Networking and working with a mentor: keys to eliciting support for clinical research as a staff nurse. PMID- 3646220 TI - The use of bolus normal saline instillations in artificial airways: is it useful or necessary? PMID- 3646221 TI - Cholesterol knowledge, avoidance, and monitoring among the American public. PMID- 3646222 TI - Providing health care to Vietnamese in America: what practitioners need to know. PMID- 3646223 TI - The health care beliefs and values of Mexican-Americans. PMID- 3646224 TI - The health-seeking process of Mexican-American migrant farmworkers. PMID- 3646225 TI - Transcultural nursing in a migrant school. PMID- 3646226 TI - Public policy, politics, and home health care. PMID- 3646227 TI - Burn injuries: Part I. PMID- 3646228 TI - Relationship between knowledge of burn prevention and emergency treatment and risk-taking attitudes in 11-15 year olds. PMID- 3646230 TI - High voltage electrical injuries. PMID- 3646229 TI - Suicide by burning: emotional needs of the suicidal adolescent on the burn unit. PMID- 3646231 TI - Participation versus diversion during dressing change: can nurses' attitudes change? PMID- 3646232 TI - Pain in the pediatric burn patient: nursing assessment and perception. PMID- 3646233 TI - Interaction of RNA with transformed glucocorticoid receptor. II. Identification of the RNA as transfer RNA. AB - An endogenous RNA (designated as PIVB RNA), which is capable of associating with the 4 S glucocorticoid receptor (GR) to generate the 6 S form, has been purified from AtT-20 cells (Ali, M., and Vedeckis, W. V. (1987) J. Biol. Chem., 262, 6771 6777). We describe here the physiochemical properties, GR-RNA interaction characteristics, and the chemical identification of PIVB RNA. 32P-Labeled PIVB RNA was similar to transfer RNA (tRNA) in its sedimentation coefficient (4 S) on sucrose gradients, electrophoretic mobility on formaldehyde-agarose gels, and receptor binding characteristics. The amino acid acceptor activity of PIVB RNA displayed a typical tRNA-dependent saturation curve and was 2-3-fold higher than that of homologous rabbit liver tRNA when tested using rabbit liver aminoacyl tRNA synthetase. The purified [3H] aminoacyl-PIVB complex was also capable of binding to the 4 S GR to generate the 6 S form. The analysis of PIVB RNA on an acrylamide-urea sequencing gel revealed that it contained a major tRNA of 76 nucleotides and other minor tRNA species of 74 and 78 nucleotides. The identity of the tRNA present in the PIVB RNA was indirectly deduced by analyzing the 3H amino acids, liberated from the [3H]aminoacyl-PIVB RNA (tRNA) complex, and subsequent analysis on an amino acid analyzer. PIVB RNA mainly contained tRNAArg (51.8%), tRNALys (17.1%), and tRNAHis (9.2%) which together accounted for 78% of the total PIVB tRNA. The remaining 22% of tRNA was contributed by threonine, valine, aspartic acid, alanine, and phenylalanine tRNAs. The GR displayed no species specificity, and tRNA samples from mouse, cow, rabbit, yeast, and Escherichia coli can bind to the mouse 4 S GR to generate the 6 S form. However, PIVB RNA did not affect the sedimentation profiles of albumin, chymotrypsinogen, and histone, indicating that PIVB RNA does not bind to all proteins. Thus, there may exist some specificity both at the level of protein (GR) and the selection of RNA (tRNA). The GR binding to PIVB RNA occurred at low (nM) receptor concentration, and PIVB RNA showed limited capacity to shift 4 S GR to the 6 S form. 22.4 X 10(-11) mol of PIVB RNA can completely shift 4.8 X 10(-13) mol of 4 S GR to 6 S. That is, PIVB RNA has to be in a 500-600-fold excess over the amounts of GR to observe a stable 6 S GR X RNA complex on sucrose gradients. These results conclusively demonstrate that the transformed GR specifically binds to endogenous tRNA. PMID- 3646235 TI - Burn clinical nurse specialist/nurse clinician roles and role development. PMID- 3646234 TI - Evidence that phosphorylation of eIF-2(alpha) prevents the eIF-2B-mediated dissociation of eIF-2 X GDP from the 60 S subunit of complete initiation complexes. AB - Recent observations have indicated that eukaryotic initiation factor (eIF)-2 and GTP or GDP normally bind to 60 S ribosomal subunits in rabbit reticulocyte lysate and that when eIF-2 alpha is phosphorylated and polypeptide chain initiation is inhibited, eIF-2 X GDP accumulates on 60 S subunits due to impaired dissociation that is normally mediated by the reversing factor (eIF-2B). Current findings now indicate that inhibition due to phosphorylation of eIF-2 alpha is mediated, at least in part, by the inability to dissociate eIF-2 X GDP from the 60 S subunit of complete initiation complexes. At the onset of inhibition, there is an accumulation of Met-tRNA(f) and eIF-2 on the polysomes, despite a marked reduction in Met-tRNA(f) bound to 40 S subunits and Met-peptidyl-tRNA bound to the polysomes. This initial effect is not associated with the formation of "half mers" (polysomes containing an extra unpaired 40 S subunit), and the 40 S X Met tRNA(f) complexes, though reduced, still sediment at 43 S. When inhibition is maximal and the polysomes are largely disaggregated, there is an accumulation of 48 S complexes consisting of a 40 S subunit and Met-tRNA(f) bound to globin mRNA as well as small polysomal half-mers, such that residual protein synthesis occurs to about the same degree on "1 1/2"s and "2 1/2"s as on mono-, di-, and triribosomes. Exogenous eIF-2B increases protein synthesis on mono-, di-, and triribosomes and decreases that on half-mers. This is associated with reduced binding of Met-tRNA(f) and eIF-2 to ribosomal particles sedimenting at 80 S and greater and a shift from 48 S to 43 S complexes. These results suggest that eIF 2B must normally promote dissociation of eIF-2 X GDP from the 60 S subunit of complete initiation complexes before they can elongate but cannot when eIF-2 alpha is phosphorylated, resulting in the accumulation of these complexes, some of which dissociate into Met-tRNA(f) X 40 S X mRNA and 60 S X eIF-2 X GDP. PMID- 3646237 TI - Patterns of infection over the past ten years. PMID- 3646236 TI - Patterns of infection over the past ten years. Historical patterns. PMID- 3646238 TI - Patterns of infection over the past ten years. Resistance patterns. PMID- 3646239 TI - Patterns of infection over the past ten years. Infection patterns, 1982-1984. PMID- 3646240 TI - Patterns of infection over the past ten years. Emerging patterns. PMID- 3646241 TI - Patterns of infection over the past ten years. Blood culture patterns. PMID- 3646242 TI - Patterns of infection over the past ten years. Biopsy patterns. PMID- 3646243 TI - Patterns of infection over the past ten years. Topical therapy for infection control. PMID- 3646244 TI - Patterns of infection over the past ten years. Mortality patterns. PMID- 3646245 TI - University of Chicago Burn Center: physical therapists care for wounds. PMID- 3646246 TI - Prevention of tap water scald burns. PMID- 3646247 TI - Need a gift? Burn prevention forum. PMID- 3646248 TI - Burn care protocols--infection control in the burn unit. Introduction. PMID- 3646249 TI - Burn care protocols--infection control in the burn unit. PMID- 3646250 TI - Burn care protocols--infection control in the burn unit. University of Miami/Jackson Memorial Hospital Burn Center. PMID- 3646251 TI - Burn care protocols--infection control in the burn unit. Review of infection control procedure at Jackson Memorial Hospital Burn Center, from Parkland Memorial Hospital, Dallas. PMID- 3646253 TI - Nursing process. PMID- 3646252 TI - Burn care protocols--infection control in burn unit. Review of infection control procedure at Jackson Memorial Hospital Burn Center, From Harborview Hospital, Seattle. PMID- 3646254 TI - The promise of nursing process: an evaluation. PMID- 3646255 TI - Neuman nursing process: a model of holistic care. PMID- 3646256 TI - Holistic nursing and nursing process. PMID- 3646257 TI - Nursing interventions: what they are and how to choose them. PMID- 3646258 TI - Using intuitive knowledge in the neonatal intensive care nursery. PMID- 3646259 TI - Intuition and nursing process. PMID- 3646260 TI - Perception in nursing: the value of intuition. PMID- 3646261 TI - Nursing process--a critique. PMID- 3646262 TI - Time and nursing process. PMID- 3646263 TI - AIDS, HIV and women--the next five years. AB - Acquired immune deficiency syndrome (AIDS) is caused by an RNA retrovirus (HIV-1) and is readily transmitted heterosexually. The viral receptor is a differentiation antigen on the surface of a class of immunologically active cells including T 'helper' lymphocytes, some macrophages and antigen presenting cells. HIV may be transmitted vertically and viral antigens have been demonstrated in the placenta. Infants of infected mothers have at least a 60% probability of acquiring HIV in utero. The normal latent period after infection is between 2 and 5 years, and it is estimated that for every case of AIDS, 50-100 people may be infected. Extrapolation of these estimates suggest 1,000,000 may already be infected and the established risk group for AIDS may not reflect the pattern of present infection. In Central and East Africa there now appears to be an epidemic of enormous proportions. Oocytes and spermatozoa are not attacked by the HIV virus but associated lymphocytes or monocytes may be infected. Screening for HIV for semen donation is mandatory and precautions for infection with HIV should follow procedures adopted for hepatitis B virus. PMID- 3646265 TI - A message from Mother Frances Dominica, founder of Helen House Hospice for Children. PMID- 3646264 TI - Mechanism of killing of Giardia lamblia trophozoites by complement. AB - Only antibodies of the IgM class support the lytic effect of complement on Giardia lamblia (GL). We sensitized GL trophozoites (SGL) at 4 degrees C with serum containing anti-GL antibodies or IgM purified from this serum, and either normal human serum (NHS), complement 2-deficient human serum (C2d-HS), or C4 deficient guinea pig serum was used as source of complement. SGL were killed by NHS (86%) and by the deficient sera (50 and 40%, respectively), suggesting activation of the alternative pathway. However, the reaction was inhibited by Mg EGTA. These observations led to studies of the role of C1. The lytic effect of NHS and C2d-HS on SGL was abolished by immunochemically depleting C1 from these sera, and reconstituted by adding purified C1q plus C1r and C1s. Factor B depleted C2d-HS also lost its capacity to mediate killing, but reconstitution with factor B led to a dose-dependent increase in the killing of SGL. We next investigated the participation of the membrane attack complex in this system. SGL carrying C5b to C7 were lysed when incubated with C8 alone (56%); the addition of C9 further increased killing (98%), while C9 in the absence of C8 had no effect. We concluded that although activation of the classical pathway produces lysis of SGL, lysis may also proceed through a unique pathway of complement activation that requires C1 and factor B, but is independent of C4 and C2. Lysis of SGL can be accomplished by C5b to C8 in the absence of C9. PMID- 3646266 TI - The World Health Organization's regions of the eastern Mediterranean and Europe: ageing of the population and nursing care. AB - This paper discusses the context and implications of nursing as a social force in regard to quality of care for the aged. The demographic transformations and its consequences in the WHO regions of the Eastern Mediterranean and Europe are discussed in their relation to socio-political, economic and educational developments and epidemiological changes. It is postulated that nursing has the choice of becoming a social force through raising its awareness of the new reality of a sizeable dependent population with chronic diseases. Nursing knowledge and research, the sharpening of political skills and the refinement of caring skills have the potential for influencing health care policy and long-term care services toward quality health care for the aged. Special attention is given to the use and misuse of concepts as self-care and appropriate technology. The final proof of nursing's willingness and ability to act as a social force will be in the allocation of efforts and resources in different countries. The value of nursing's contribution to the actual care of the aged will depend upon careful ethical considerations, as much as upon knowledge and influence. PMID- 3646267 TI - Planning and evaluation of cross-cultural health education activities. AB - This paper was written to assist health professionals who are or who are planning to undertake health education activities with people of a different culture. The focus is on the educative function of health promotion. A short summary of relevant learning theory is presented. Some obstacles (pitfalls) encountered in cross-cultural transfer of information, knowledge and skills are presented and the effects of this learning process on the learner and teacher are explored. Examples of possible conflict situations drawn from the author's experiences and research are presented. Variables which influence planning and implementation of health education in cross-cultural settings are examined. A cyclical model which identifies critical questions to be asked and decisions to be made in a four phased process of assessment, planning, implementation and evaluation is described for the use of health educators in transcultural settings. The need for systematic cultural assessment prior to planning is stressed to ensure relevancy, acceptance and positive outcome of programmes. Cooperative efforts of health educators with existing systems and traditional teachers and involvement of clients during all phases of the decision making process are suggested. PMID- 3646268 TI - Perceptions of self-care in East Germany: a cross-cultural empirical investigation. AB - The purpose of this empirical investigation was replication for comparing self care phenomena in a cross-cultural setting. Two self-reporting inventories were employed to measure perceptual dimensions of self-care agency and self-concept. Both inventories were translated into German and administered to a convenience sample of 17 adults living in an agricultural collective in East Germany. One research concern was the usability of American-constructed nursing assessment tools in another culture. Other research questions for cross-cultural comparisons of means were formulated. Self-care and self-concept were related in the East German sample. Self-care agency means for the East German sample were lower than for an American student sample. Study limitations are identified and cross cultural implications of the findings for nursing are discussed. PMID- 3646269 TI - The prevalence of pressure sores within an area health authority. AB - A point prevalence survey carried out to determine the number of pressure sores within the Nottingham Health Authority revealed that 5.3% patients were affected (132 patients out of 2513). The majority of patients were elderly (80.3% aged over 65), female (76.5%), and either categorized as immobile or having very limited mobility (77.2%). There were 233 pressure sores, 54.9% of which were on the buttocks or sacrum, and 24.9% of which were on or near the heels and ankles. Nine different cleansing agents were in use, 31 different preparations were applied to the sores and nine types of dressings were employed, with little standardization of use. The most popular aids used for the relief of pressure areas included synthetic sheepskin pads (supplied to 46.2% of the affected patients) and ripple mattresses (supplied to 28.8% of the affected patients). The prevalence of pressure sores within the health authority is indicated. These findings are similar to those of a previous study and may be applicable to other health areas. PMID- 3646270 TI - Towards an epistemological basis for experiential learning in nurse education. AB - Experiential learning methods have been recommended for teaching psychiatric nursing students. What has been lacking to date, however, is a sound theory of knowledge to underpin the concepts involved in this relatively new approach to learning. This paper offers an epistemological theory divided into three domains: propositional knowledge, practical knowledge and experiential knowledge, as a basis for a theory of experiential learning. After a description of the theory, experiential learning is redefined and the practical issues relating to the theory are discussed. The paper closes with some thoughts on the problems of research in the field of experiential knowledge. PMID- 3646271 TI - An individualized teaching programme following primary uncomplicated myocardial infarction. AB - This paper describes the planning and implementation of an individualized teaching programme for patients and their families following primary uncomplicated myocardial infarction. This preliminary study was designed and implemented by a senior nurse while working in the clinical area. Patients were randomly allocated to a control or study group. Both groups of patients were interviewed on the fourth day following admission to hospital and again at 2 and 6 months after discharge. Nurse intervention in the form of individually planned consecutive teaching sessions achieved a reduction in anxiety and modification of identifiable risk factors (smoking, obesity, diet, exercise) in the patients included in the teaching programme. PMID- 3646272 TI - Implementing contract learning in a senior nursing practicum. AB - The use of learning contracts with undergraduates and graduate nursing students, as well as in staff inservice and continuing nursing education, has been promoted in North America as a teaching/learning strategy to individualize learning, promote independence, promote habits of lifelong learning and teach nurses how to cope with change. The purpose of this article is to describe the implementation of contract learning in a required clinical nursing course at the undergraduate level in a Canadian university and to describe retrospectively perceived benefits and difficulties. The process of peer consultation and student evaluation used in modifying contract learning is described. Recommendations for nurse educators considering implementing contract learning are presented. PMID- 3646273 TI - Respiratory teaching of patients: how effective is it? AB - In order to evaluate the effectiveness of a structured respiratory teaching programme, clients with chronic obstructive pulmonary disease who were hospitalized in a 13-month period both prior to and following the implementation of the programme were compared on several parameters to assess changes in their ability to manage their disabilities. The study demonstrated that clients who participated in the teaching sessions had fewer hospital admissions, shorter lengths of hospital stay, and longer stays in the community. A sub-group of clients who were or had been in at-risk occupations was identified as representing the 'revolving door' client with shorter hospital and community stays. The teaching programme is described as well as specific elements that can be used for a shorter teaching experience to respond to time constraints when necessary. PMID- 3646274 TI - Community psychiatric nursing intervention in an accident and emergency department: a clinical pilot study. AB - In a pilot study, 99 patients referred from a general hospital accident and emergency department were seen by a community psychiatric nurse (CPN) using a time series design. They were categorized into those patients having a previous psychiatric history and those with none. The level of service use for the 6 months immediately prior to CPN intervention, 6 months following referral, and 6 months of follow-up indicated a very high level of psychiatric and general medical service use by this group. Referral to the CPN was associated with substantial reduction in the demands on other services made by the group with previous psychiatric history. The group with no previous history showed a decrease in total service usage at follow-up. PMID- 3646275 TI - Staff sickness and its relationships to violent incidents on a regional secure psychiatric unit. AB - This study aimed to examine the relationship between absenteeism in nurses and disturbed and/or violent incidents in patients. It was conducted in the Interim Secure Psychiatric Unit at the Bethlem Royal Hospital, London (which later transferred to the Denis Hill Unit) during 1985. Data was gathered from sickness figures recorded on the ward and in the nursing administration office. Violence records were collected from incident reports made by all grades of nursing staff. The hypothesis to be tested was that as violence increased then staff sickness would decrease. Results indicate that such a correlation is not present. However, staff sickness was significantly concentrated around days off. Some considerations for future research are given. PMID- 3646276 TI - Justification of closed intermittent urinary catheter irrigation/instillation: a review of current research and practice. AB - Urinary tract infections secondary to urinary instrumentation continue to affect over 400,000 patients per year in the USA. While the debate continues over the effectiveness of catheter/bladder irrigation or instillation, these procedures continue to be indicated for certain conditions. Inconsistencies in how these procedures are carried out often depend on the type of catheter used, frequency of the procedure, and equipment available. This review article looks at the available literature on pathogenesis of urinary tract infections and specific literature on irrigation techniques and outcomes. This information is summarized and recommendations are made for adoption of a well-supported procedure, which also provides more cost-effective care. Proposals are made for further research involving use of this procedure. PMID- 3646277 TI - Instilling eyedrops: difficulties experienced by patients following cataract surgery. AB - It was hypothesized that patients instilling their own drops following cataract extraction would experience difficulties with this, due to age-related factors, the nature of the operation itself and the fact that studies in other areas have shown compliance to be less than predicted. Ten patients who intended to instil their own drops were each interviewed on the ward before discharge and again 2 weeks later at home. They were asked about previous experience of using drops, general health, knowledge of their treatment regime, practice received on the ward and their feelings about how they were coping. The majority had inappropriate expectations of what compliance with treatment would involve. Six had used drops before and this was the major factor influencing their decision on this occasion. Supervised practice emerged as the recommended method for teaching drop instillation but this was not carried out often enough on the wards. It was concluded that if more time was devoted to developing and improving the teaching of drop instillation this would result in increased compliance with treatment. However, it may not be possible to achieve all the goals of a teaching programme on the wards and the teaching role may need to be extended into the community. PMID- 3646278 TI - Concept of the person: introduction to the health professionals' curriculum. AB - This paper deals with the concept of the person and its necessity in health care and health curricula. Specifically it looks at aspects of both the biological and social sciences. Further, there is some suggestion that for caring professionals in particular the concept of the person requires more analysis than purely a 'common sense' everyday meaning and use, and that there is some requirement for sorting out and understanding the difference and the interconnections of the two terms 'human' and 'person'. This first proposal will be followed by a further paper that discusses in more detail the distinction between the two terms and the moral issues that derive from the centrality of use of the concept of the person by the health professions. PMID- 3646279 TI - Necessity and methods of HTLV-III inactivation in contact lens practice. AB - This paper reviews and analyzes the sensitivity of HTLV-III to various agents. The finding of HTLV-III in tears, the conjunctiva, and the cornea indicates the remote possibility that acquired immunodeficiency syndrome (AIDS) can be spread by instruments in contact with the eye, specifically trial contact lenses. Common contact lens disinfection systems are compared to agents known to inactivate HTLV III. Recent studies reveal that heat disinfection may not be adequate, thereby, leaving only H2O2 systems as a potentially effective method of inactivating large titers of the virus. Other possible disinfection methods are proposed based on known sensitivity of HTLV-III but are awaiting further investigation. PMID- 3646280 TI - Are we sensitive enough? PMID- 3646281 TI - Reminiscing: the life review therapy. PMID- 3646283 TI - The value of intergenerational relationships. PMID- 3646282 TI - Drug reviews. PMID- 3646284 TI - Assessing a widow's grief--a short index. PMID- 3646285 TI - Curbing incontinence. PMID- 3646286 TI - Self-esteem and the mental health of older adults. PMID- 3646287 TI - Evaluation of a microassay for human plasma prekallikrein. AB - Current methods for determining plasma prekallikrein, one of three zymogens of the contact phase of plasma proteolysis, are laborious and impractical for general use in a clinical laboratory. Therefore, we have developed a simple, reliable assay using commercially available reagents. By use of the substrate H-D Pro-Phe-Arg-p-nitroanilide-HCI (S-2302), a functional assay, performed in a 96 well microplate, was designed to measure prekallikrein in plasma. Measures were taken to destroy the naturally occurring plasma protease inhibitors of kallikrein without affecting the integrity of the plasma prekallikrein, which allowed complete activation of the zymogen to virtually 100% of predicted activity when compared with that of purified kallikrein. Besides permitting full activation, the use of low pH to destroy critical plasma protease inhibitors allowed the conversion of prekallikrein to kallikrein in as many as 44 plasma samples at one time without the tedious individual timing step usually required to activate each sample. An excellent correlation was found (r = 0.92) when this functional microassay was compared with a functional spectrophotometric assay performed in three subject populations: normal individuals, women receiving oral contraceptives (who frequently exhibit high plasma prekallikrein concentrations), and patients with liver disease (who manifest low plasma prekallikrein levels). This plasma prekallikrein microassay should facilitate the increased determination of plasma prekallikrein in pathophysiologic conditions as well as the monitoring of the progression of various diseases in which contact activation occurs. PMID- 3646288 TI - Susceptibility of human peripheral blood dendritic cells to infection by human immunodeficiency virus. AB - Preparations of human peripheral blood dendritic cells have been infected with human immunodeficiency virus (HIV). After 5 days in culture they were examined by electron microscopy. Virus was observed budding from the plasma membrane of dendritic cells and mature virions were observed on the cell surface. In addition, a second cell type, similar in morphology to 'classical' dendritic cells but containing numerous cytoplasmic granules, was also found to support replication of the virus. We speculate that the growth of HIV in dendritic cells could cause immunosuppression by impairing antigen presentation. PMID- 3646289 TI - Peripheral vascular disease. PMID- 3646290 TI - An overview of arterial disease. PMID- 3646291 TI - Acute aortic dissection. PMID- 3646293 TI - Exercise therapy and smoking cessation for intermittent claudication. PMID- 3646292 TI - Arterial reconstruction for atherosclerotic occlusive disease. PMID- 3646294 TI - Thrombolytic therapy. PMID- 3646295 TI - Pharmacologic treatment of intermittent claudication with special emphasis on pentoxifylline. PMID- 3646296 TI - Computer technology and its application to cardiovascular nursing. PMID- 3646297 TI - Valvular heart disease in the elderly. PMID- 3646298 TI - Nursing research. PMID- 3646299 TI - Valvular heart disease. PMID- 3646300 TI - Physiologic dynamics of acquired valvular heart disease. PMID- 3646301 TI - Congenital valvular heart disease. PMID- 3646302 TI - Surgery for acquired valvular heart disease. PMID- 3646303 TI - Mitral valve prolapse: a diagnosis for primary nursing intervention. PMID- 3646304 TI - Rehabilitation of the patient with valvular heart disease. PMID- 3646305 TI - Use of antithrombotic agents in valvular heart disease. PMID- 3646306 TI - Aortic and mitral valvuloplasty. PMID- 3646307 TI - Qualitative theory generation to quantitative theory testing. PMID- 3646308 TI - Relocation: the impact on staff nurses. AB - To stay competitive in the marketplace, many hospitals are renovating their physical plants to a more hotel-like appearance. Others are downsizing their units, reflecting the decreased demand for acute care beds. As these changes are made, patients and nurses are temporarily relocated to other places in the institution. How does this relocation of nurses impact their professional functioning and self-esteem? Based on their study of four groups of nurses who were relocated, the authors discuss their recommendations for making relocation a positive experience. PMID- 3646309 TI - Administrator decisions: data are better than opinions. AB - Nurse executives, in the current economic climate, may be requested to make decisions about resuming tasks that historically had been in the nursing domain but presently are done by other disciplines. Since these decisions shape nursing services in a variety of ways, support by non-nursing colleagues is important. This study reports a decision-making strategy that enhanced receptivity throughout the corporation. The strategy used a data base and involved non nursing leadership persons in examining the issue. PMID- 3646310 TI - An innovative method of job interviewing. AB - When the right candidate is hired for the right position, both the institution and the individual benefit. The individual has increased job satisfaction, is more likely to remain in the position longer, and is more productive. The author describes a method of job interviewing that objectively measures the abilities of candidates so that the best candidate for the position can be hired. PMID- 3646311 TI - Male nurses: do they belong in obstetrics? PMID- 3646313 TI - An organizational checklist. PMID- 3646312 TI - An analysis of professional nurse burnout in two selected nursing care settings. PMID- 3646314 TI - Credentialing: a pathway to quality. PMID- 3646315 TI - Clinical ladders: do they serve their purpose? AB - Clinical ladders may benefit the needs of hospitals and occasionally the needs of individual nurses, but do they meet our professional need to recognize clinical excellence in nursing? Analysis of this issue and its impact on nursing is presented through review of pertinent literature. Conceptual and structural frameworks currently used in clinical ladder programs are discussed. The author then presents a promotional model more appropriate to the needs of nurses and nursing. PMID- 3646316 TI - Midwifery work exchange project in Nicaragua. PMID- 3646317 TI - Toward a professional ethic. PMID- 3646318 TI - Tuberculosis. A persistent health care problem. PMID- 3646319 TI - Detection and management of gestational diabetes in an out-of-hospital birth center. PMID- 3646321 TI - Chemical dependency in the health professions. PMID- 3646320 TI - A survey of nutrition, caffeine, cigarette and alcohol intake in early pregnancy in an urban clinic population. PMID- 3646322 TI - Nurse-midwifery practice and undergraduate nursing education: a unique model. PMID- 3646323 TI - Use of breast stimulation for contraction stress tests. AB - A breast stimulation technique is currently being used for stimulation of uterine contractions when a contraction stress test is indicated for antepartal fetal evaluation. The breast stimulation stress test is considered a practical alternative to the intravenous oxytocin stress test and may be as effective in producing contractions adequate for evaluation of fetal reserve as reflected in a fetal heart rate tracing. Along with a review of related research findings and the purpose of using the breast stimulation stress test indications for use and a step-by-step protocol are provided. In addition, the problem of hyperstimulation of uterine contractions and psychological considerations for the pregnant patient requiring a breast stimulation stress test are included. PMID- 3646324 TI - Nursing support in labor. AB - A retrospective survey was conducted to identify the helpfulness of nursing support behaviors as perceived by women in labor. Behaviors were classified as providing affect, affirmation, or aid support. A convenience sample of 78 women completed two data collection instruments: a demographic questionnaire and the Nursing Support in Labor Questionnaire (NSILQ). All 20 of the nursing support behaviors identified on the NSILQ were perceived as helpful by the study sample. No major differences were found between the perceived helpfulness of affective, affirmation, or aid support. PMID- 3646325 TI - Infant formula samples and breastfeeding. PMID- 3646326 TI - Minimal breastfeeding; a cautionary note. PMID- 3646327 TI - Adolescent pregnancy and incest: the nurse's role as counselor. AB - The incidence, victim symptoms, and characteristics of incestuous families are highlighted. A case history of incest that led to an adolescent pregnancy is presented. Nursing implications and specific intervention strategies that successfully establish patient trust, build rapport, and lay foundations for further interactions are described. PMID- 3646328 TI - Lidocaine hydrochloride: first-line therapy for ventricular dysrhythmias. PMID- 3646329 TI - Surviving the white water phase. PMID- 3646331 TI - The changing professional nurse: questions without answers. PMID- 3646330 TI - Solo staffing: safety or compliance? PMID- 3646332 TI - New grads in critical care? PMID- 3646333 TI - Thermodilution cardiac output (continuing education credit). PMID- 3646334 TI - Ethics: a question fo wrongs and rights. PMID- 3646335 TI - The successful interview. PMID- 3646336 TI - Cardiorespiratory assessment and care of the pediatric patient: are the little ones different? PMID- 3646337 TI - Resident in the postanesthesia care unit: agonist or antagonist? PMID- 3646338 TI - Prolonged receptivity to the male and the fate of spermatozoa in the female black mastiff bat, Molossus ater. AB - Observations were made on the reproductive biology of black mastiff bats maintained in a laboratory colony. Many of the females were inseminated within 24 h after the introduction of the males, and most exhibited a period of 10-50 days during which spermatozoa were present in their vaginal smears almost every day. The frequency of sperm-positive smears began to fall off around the time of implantation, but some smears taken much later in pregnancy were positive. The extent to which spermatozoa in the smears came from reservoirs in the female tract could not be thoroughly investigated, but evidence was obtained that the females have more than a limited period of oestrus. Female courtship behaviour and new copulations were sometimes observed many days after the start of the breeding activity. Also, histological studies of the reproductive tracts of females which had recently mated revealed that many were not in a periovulatory condition. Intact spermatozoa were usually found in the uterine horns and distal oviducts of preovulatory bats and those carrying tubal ova. Spermatozoa were absent from the oviducts of animals bearing early uterine embryos, and were much less abundant in the uterine horns after the start of implantation. Many of the excess spermatozoa appeared to have been expelled into the upper cervix where phagocytic leucocytes were commonly observed in the lumen. Some sperm components were also taken up by epithelial cells in the oviducts and uterine horns. PMID- 3646339 TI - Structure and function of the spermatheca in a snail host of schistosomiasis, Biomphalaria glabrata. AB - The histochemistry and ultrastructure (SEM and TEM) of the spermatheca of Biomphalaria glabrata was investigated to elucidate the function of this organ and to compare its structure and function to similar organs found in other species. The spermatheca has a debris-filled lumen surrounded by a thin wall of tissue. The cells adjacent to the lumen are of three columnar epithelial cell types. Two cell types have abundant microvilli and mammalian cell-like organelle distribution and morphology. The above cell types differ in the electron density of their cytoplasms, nuclear morphologies, and organelle content. The third cell type differs from the other two in its cytoplasmic makeup. However, the most distinctive difference is the presence of large numbers of cilia at the apical surface with no evidence of microvilli. These columnar cells rest on a basal lamina adjacent to a two to three cell thick muscle layer. The entire organ is surrounded by an adventitia of unusual morphology. Histochemical investigation demonstrated that DNAase, RNAase, and protease are present in the lumen, alkaline phosphatase is associated primarily with the microvilli, small amounts of acid phosphatase are concentrated in the midcell area of the columnar epithelium, and ATPase activity is localized in the muscle cells and just below the absorptive surface of the microvillous cells. The luminal contents and adventitial areas are Sudan Black B positive, all areas of the lumen and organ wall are PAS positive, the cell nuclei and amorphous masses in the lumen showed Feulgen staining, and large vesicles in the columnar cells were Oil Red O positive. Apparently, the spermatheca of B. glabrata is both a digestive and absorptive structure. Although this organ shares functional similarities with those found in opisthobranchs and terrestrial pulmonates, the epithelia of the spermatheca differ dramatically in these groups. PMID- 3646340 TI - Inactivation of HIV by povidone-iodine. PMID- 3646341 TI - [Early discovery of various functional disorders of diabetes mellitus]. PMID- 3646342 TI - [Disruption of self-control by diabetic patients and the development of complications]. PMID- 3646343 TI - [Nursing of diabetic patients with various functional complications. Knowledge of the illness and the problems of self-control by the patient]. PMID- 3646344 TI - [Nursing of diabetic patients with various functional complications. Clinical actions to steer the patient toward compliance-positive actions for the elimination of complications]. PMID- 3646345 TI - [Quantification of anxiety of patients by their expression and complaints- innovation in nursing of patients with vision disorders caused by diabetes mellitus]. PMID- 3646347 TI - [Management of diabetic nephropathies starting at the early stage of illness--the current status of management and nursing care]. PMID- 3646346 TI - [Approach to a diabetic patient with autonomic nervous system dysfunction]. PMID- 3646348 TI - [Nursing of a diabetic patient with myocardial infarct]. PMID- 3646349 TI - [Control of the blood sugar level in patients with diabetic nephropathy undergoing CAPD]. PMID- 3646350 TI - [Nursing of diabetic patients with functional disorders. Wonders of blood sugar levels]. PMID- 3646351 TI - [Artificial pancreas and its future prospects]. PMID- 3646352 TI - [Education of diabetic patients and the role of nurses]. PMID- 3646354 TI - [Keypoints in maintenance of the airway]. PMID- 3646353 TI - [Changes in the attitude of nursing students toward acquired blindness after clinical training in the visual system]. PMID- 3646356 TI - [Establishment of patient's rights--a memo by the Mental Health Section, Public Health Conference at revision of the Mental Health Act]. PMID- 3646355 TI - [Nursing during maintenance of the airways]. PMID- 3646357 TI - [Blind spots in the care of patients with gastrointestinal disorders]. PMID- 3646358 TI - [Keypoints in geriatric nursing. 2. Rehabilitation and the role of nurses]. PMID- 3646359 TI - [Airway injury in rats induced by intraperitoneal injection of porcine pancreatic elastase]. PMID- 3646360 TI - Effects of changing salt and water balance on renal kallikrein, kininogen and kinin. AB - The kallikrein-kininogen-kinin system (KKK) has been implicated in the renal sodium excretion response to changes in dietary sodium. However, both increases and decreases in the activity of this system have been observed when urinary sodium excretion is augmented by a variety of maneuvers. To further evaluate the potential physiologic role of this system, we measured three components of the KKK system in urine. Total kallikrein, intact kininogen, and kinin were measured twice in normal individuals during balance on both a high (250 mEq/day) or low (10 mEq/day) sodium intake. A consistent and significant reduction in the activity of all three components of the KKK system was noted during the high salt intake. Furthermore, during the high sodium intake, further acute reductions in components of this system were observed when an acute saline but not water load was administered. The consistent response of the various components of the KKK system to both acute and chronic sodium loading suggests that the system is physiologically linked to the regulation of sodium balance. However, the directional changes argue against a primary natriuretic effect of this system. PMID- 3646362 TI - [Bioinstrumentation and the nurse. III. Electroencephalography]. PMID- 3646361 TI - [Epidural anesthesia in abdominal surgery]. PMID- 3646363 TI - [Bioinstrumentation and the nurse. III. Nursing care of patients with abnormal EEG]. PMID- 3646364 TI - [Survey report on nursing education, 1986]. PMID- 3646366 TI - [Clinical report on nursing diagnosis]. PMID- 3646365 TI - [Nursing diagnosis: a case study]. PMID- 3646367 TI - [Squatting in childbirth]. PMID- 3646368 TI - [A case study of a patient with cerebral infarction]. PMID- 3646369 TI - [Nursing administration for effectiveness of quality care]. PMID- 3646371 TI - [Bioinstrumentation and the nurse. III. Normal encephalography]. PMID- 3646370 TI - [A study on the analysis of the factors affecting junior high school girls' practice of health care]. PMID- 3646372 TI - [A study on comparison of self-care style among clients in nursing according to cultural background]. PMID- 3646373 TI - [Study on the comparison of home environmental elements with self-concept & mental health in adolescence]. PMID- 3646374 TI - [Death revisited. Dying is just a little leaving....]. PMID- 3646375 TI - [Before the entrance of the Secretary General of the Swiss Nursing Association: "We should keep our nursing personnel active for a longer time". Interview by Nelly Haldi]. PMID- 3646376 TI - [A new program in gerontologic specialization (geriatrics-psychogeriatrics). To respond better to the needs of aged patients]. PMID- 3646377 TI - [Help in catastrophies--to be more comfortable helping]. PMID- 3646378 TI - [Performance sheets were tested in the canton of Berne. Dialogue has to supplement statistics]. PMID- 3646380 TI - [The situation in oral examinations. To standardize--but also to differentiate]. PMID- 3646379 TI - [The St. Gall Symposium: "Supportive measures for cancer patients. A singular challenge]. PMID- 3646381 TI - [Day of the patient 1987. The delicate problem of patient information]. PMID- 3646382 TI - The declining status of school nurses in New York. AB - Several organizational factors impeding development of school nursing in New York are identified, including educational preparation, the primary care role, administration of school nursing, professional allegiances, and state legislation. Statistics reveal attrition of more highly educated certified nurses and a rapid influx of noncertified diploma nurses, while employment of other personnel in schools--health educators, school psychologists, and social workers- remains stable or increases. Two national movements in school health nursing have been incorporated in New York: state certification of school nurses and implementation of school nurse practitioners at selected sites. However, the status of school nursing has not improved. School nurses have not been socialized through education to deal with organizational impediments to their role development. Consequently, changes they promoted have proven ineffective. PMID- 3646383 TI - School promotion of healthful diet and exercise behavior: an integration of organizational change and social learning theory interventions. AB - In the Go For Health project, interventions based on organizational change and social learning theory facilitate changes in diet and exercise behavior by elementary school children. Baseline data documented the need for behavior change. Based on chemical analyses, average per meal amounts of total fat and sodium were higher than national recommendations: total fat was 29.3% higher than U.S. Dietary Goals; sodium was 107.4% greater than recommended levels. Observations of students in physical education class revealed children moved through space 50.1% of the time and moved continuously an average of 2.2 minutes per class period. These findings suggest the need for policy and practice changes in the school environment to enable children to engage in more healthful diet and exercise behavior. PMID- 3646384 TI - The school nurse's role in school-based clinics. PMID- 3646385 TI - Enhancing self-esteem through mutual self-disclosure. PMID- 3646387 TI - [Current need for leadership in nursing]. PMID- 3646386 TI - The law of informed consent. PMID- 3646388 TI - [Our future role indicated at the World Conference for Nursing Leaders]. PMID- 3646390 TI - [The role of nurses as a driving force in social change]. PMID- 3646389 TI - [Impression on the World Conference for Nursing Leaders: the significance of nurturing nursing leaders]. PMID- 3646391 TI - [The importance of nurses' participation in politics]. PMID- 3646392 TI - [The significance of nurses' participation in politics]. PMID- 3646393 TI - [The social environment to be created by the year 2000]. PMID- 3646394 TI - [The Alma Ata Declaration]. PMID- 3646395 TI - [Current health problems and innovations to be made--factors which promote or inhibit the changes]. PMID- 3646396 TI - [Nurses as leaders in the improvement of the current status]. PMID- 3646397 TI - [Factors hindering the establishment of leadership in nursing--a feminist's view]. PMID- 3646398 TI - [The concept of "care" as a new starting point in nursing]. PMID- 3646399 TI - [Practice model of nursing for "Health for All"]. PMID- 3646400 TI - [Nurse practitioner as a practice model of health for all]. PMID- 3646401 TI - [Focal points in the creation of a practice model of health for all: a viewpoint in behavioral science for health services]. PMID- 3646402 TI - [Focal points in the creation of a practice model of health for all: a comprehensive network theory and its application]. PMID- 3646403 TI - [Nurses lead the way: an international perspective]. PMID- 3646404 TI - [An objective evaluation of leadership and a design for leadership training]. PMID- 3646405 TI - [Training of nursing leaders: the question of when, where and by whom]. PMID- 3646407 TI - [Dynamism of policy making and methods of participation]. PMID- 3646406 TI - [A need for participation by the nursing profession in policy making]. PMID- 3646408 TI - [Formation of a network among the nursing profession, other professions and local citizen's organizations]. PMID- 3646409 TI - [Regional health promotion and nursing leadership: awakening the latent capability of the area to change the social condition]. PMID- 3646410 TI - [The role of nursing and leadership in fulfillment of regional health care]. PMID- 3646411 TI - [Regional health promotion and nursing leadership: volunteer activities for regional care]. PMID- 3646412 TI - [Health promotion for local residents: a discussion]. PMID- 3646413 TI - [Revision of the law on health care of the aged and involvement of nursing]. PMID- 3646414 TI - [Home nursing practiced at the Saka General Hospital]. PMID- 3646415 TI - [Questions and answers on the management of nursing schools. The problem of absenteeism not due to illness among students: a need for organizations for student guidance]. PMID- 3646416 TI - [Questions and answers in clinical training. Improvement of the training effects by innovation: abundance of hints of small innovations]. PMID- 3646418 TI - [The use of educational material in nursing education--the importance of the caring attitude in training]. PMID- 3646417 TI - [Questions and answers in clinical training. Requirement for care beyond the level taught at schools: re-evaluation of the learning process]. PMID- 3646419 TI - [The use of educational materials in nursing education. VTR introduction to classroom training--educational effects and keypoints in teaching schedules]. PMID- 3646420 TI - [The use of educational materials in nursing education. Educational equipment used in teaching of comprehensive nursing theory]. PMID- 3646421 TI - [The use of educational materials in nursing education. Efficacy of VTR in the teaching of nursing processes]. PMID- 3646423 TI - [On man and nursing: music. 2. Physiological effects of music]. PMID- 3646422 TI - [Application and evaluation of Roy's nursing theory--an observation at a U. S. institution where the theory is practiced]. PMID- 3646425 TI - [Training in assistance for daily activities and its evaluation--in assistance in diet]. PMID- 3646426 TI - [Assistance in independent elimination actions with enterostomy]. PMID- 3646424 TI - [Human engineering study on nursing schedules: in search of better work schedules. 2. Monthly statistics on fatigue and contrast between adaptation to work and fatigue of new employees]. PMID- 3646427 TI - [Emergency nursing: fractures and dislocations]. PMID- 3646428 TI - [Epidemiology and prognosis of esophageal cancer]. PMID- 3646429 TI - [Diagnostic and therapeutic processes for patients with esophageal cancer]. PMID- 3646430 TI - [Keypoints in comprehensive observation of patients with esophageal cancer]. PMID- 3646431 TI - [Nursing plan for a patient with esophageal cancer]. PMID- 3646432 TI - [Nursing of an aged patient with esophageal cancer and a postoperative pulmonary complication]. PMID- 3646433 TI - [Nursing of patients with esophageal cancer: evaluation of individualized nursing actions]. PMID- 3646434 TI - [Instructions on the diet of a patient following resection of 2/3 of the pylorus- reevaluation of diet instructions as part of pre-discharge patient education]. PMID- 3646435 TI - [Pulmonary physiotherapy applied to a patient with chronic obstructive lung disease and a complaint of a respiratory difficulty]. PMID- 3646436 TI - [Nursing keypoints. Nursing of a patient with liver cirrhosis]. PMID- 3646438 TI - [Creative nursing by self-starting nurses]. PMID- 3646437 TI - [Case report. Psychological support of an aged bedridden patient]. PMID- 3646439 TI - [Busy schedule of nursing and the ideal of nursing]. PMID- 3646440 TI - [Individuality in nursing reflected in the goal of team nursing]. PMID- 3646441 TI - [Innovations generated in interactions with patients]. PMID- 3646442 TI - [Preference of home care by patients]. PMID- 3646443 TI - [Stenocardia]. PMID- 3646444 TI - [Catheterization of the subclavian vein]. PMID- 3646445 TI - [Ways to decrease the psychotraumatic effect of diagnostic and therapeutic procedures with painful sensation in the pediatric clinic]. PMID- 3646446 TI - [Physical fitness training measures in preschool institutions]. PMID- 3646447 TI - [Care of children with congenital cataract at a pediatric hospital]. PMID- 3646448 TI - [Participation of the nurse in endoscopic studies]. PMID- 3646449 TI - [The tasks of the drug abuse service in light of the decisions of the Communist Party and government on overcoming drunkeness and alcoholism]. PMID- 3646450 TI - [Endoscopic study of the upper gastrointestinal tract]. PMID- 3646451 TI - [Characteristics of the work of the x-ray laboratory assistant in operating special x-ray equipment]. PMID- 3646453 TI - [First aid in toxico-allergic reactions to wasp venom]. PMID- 3646452 TI - [Characteristics of the work of the x-ray laboratory assistant using mobile x-ray diagnostic apparatus]. PMID- 3646454 TI - [Cardiac rhythm disorders in myocardial infarct]. PMID- 3646456 TI - Specific application of single nutrients as a basic treatment in immunostimulating therapy. AB - Many results of biochemical and animal experiments as well as clinical trials provide justification for the administration of essential fatty acids (EFAs) as a supplementary therapy in rheumatic diseases, atopic disorders and chronic infections. Defective regulation of inflammatory responses or disordered immune mechanisms are probably central to the pathologic processes encountered in chronic inflammatory diseases and immunologic disorders. Epidemiologic studies indicate that vitamins and trace elements are often provided at levels much below the currently accepted minimum requirement and therefore other factors, namely zinc, selenium, niacin, pyridoxine, vitamin A, E and folic acid must also be considered in substitution. In order to optimize immunostimulating therapy the negative influence of suboptimal levels of EFAs, vitamins and trace elements should always be taken into account. PMID- 3646455 TI - Isolation of HTLV III/LAV from drug addicts in Palermo. AB - The new human retroviruses HTLV III/LAV, implicated as the causative agent of AIDS, have been isolated from peripheral blood lymphocytes of 5 of 13 drugs abusers with acquired immunodeficiency syndrome-related complex (ARC). In one patient the virus was also found in cell-free plasma. No HTLV III/LAV was detected in or isolated from 5 clinically healthy drug abusers. The lymphocytes were cultured with interleukin 2 and expressed either a transcriptase reverse activity or HTLV III/LAV antigens within 2-3 weeks of cultivation. The viruses were also transmitted into normal lymphocytes from cord blood of human newborns. At the present state of development, virological investigation, other than seroepidemiological survey, seems a suitable marker for human retroviruses tracing in epidemiological studies. PMID- 3646457 TI - Epidemiological evidence on Balkan nephropathy as a viral disease. AB - Balkan nephropathy is a chronic kidney disease of a completely unknown etiology. Most epidemiologists believe that the disease has been caused by viruses, though all attempts to prove such a relationship have been fruitless. A common feature of most of the clues offered for elucidating the role of the viruses, is that they interfere with the epidemiological evidence on BN. Therefore, a hypothesis is put forward that the disease has been caused by slow viruses transmitted by rodents which contaminate food and articles in the house. Such an explanation fits most of the existing epidemiological data. PMID- 3646458 TI - Juvenile periodontitis--a new perspective. AB - Juvenile periodontitis (JP) is a severe disease of the periodontium in adolescents. It is usually localized to the first permanent molars and (less commonly) the central incisors. The bacteria Actinobacillus actinomycetemcomitans (Aa) is currently implicated in the aetiology of JP since its numbers are high in JP pockets and low in subjects with healthy periodontal conditions or with adult periodontitis. However, Aa harvested from JP pockets and transferred to healthy sites in the same mouth are unable to colonize these areas or initiate disease (17). The conflicting evidence implicating intrinsic or induced impairment of host defence is reviewed. It is hypothesised that JP lesions are primarily of endodontic origin. By-products of an inflammatory process in the pulp enter the periodontium via dentinal tubules, lateral or furcation canals and drain through the periodontium into the mouth. The environmental conditions of the sinus select for bacteria such as Aa which secondarily infect the site and exacerbate the clinical situation by their potent virulence factors. Localized deep defects involving only one side of an interproximal space in an otherwise periodontally healthy mouth result. Studies of the pulpal status of JP teeth are indicated. PMID- 3646459 TI - A conceptual model of cell division in neoplasia. AB - A model of cell division as it occurs in the neoplastic cell is presented. The two basic features of the model are that firstly cell division is autonomous and secondly it is incomplete because not all of the processes which take place during normal division occur in the disordered division of neoplasia. As a result cellular structures may not be replicated along with the rest of the cell and they are therefore deficient. The deficiency of particular structures is then used to explain certain observations made of neoplastic cells eg. disturbances of metabolism and morphology, heterogeneity of the cell population, malignancy and immortalisation. Oncogenes are then introduced into the model in an attempt to understand their role in the development of cancer. PMID- 3646460 TI - Fluoride versus bone tumors. PMID- 3646461 TI - Hypothesis: common bacterial toxins are a possible cause of the sudden infant death syndrome. AB - It is hypothesised that common toxins produced by bacteria growing in the respiratory tract following a viral infection are a cause of SIDS. This hypothesis is consistent with evidence that viral infections pre-dispose to SIDS, minimal morphological change at autopsy, maximum incidence during sleep and the age incidence of this disease. We present evidence of nasopharyngeal bacterial overgrowth in victims of SIDS and have developed a mathematical model based on the hypothesis which closely predicts the age distribution. The model predicts other age distribution patterns for less common toxins and these may apply to other diseases of childhood. The hypothesis can be tested and if sustained would offer hope of prevention. PMID- 3646462 TI - Screening testing for anti-HIV in Australian blood banks in 1986. PMID- 3646463 TI - Changes in health care trigger nursing shortages. PMID- 3646464 TI - The Code for Nurses: Statement #5 and #6. PMID- 3646465 TI - [Problems in hospital nursing in Japan]. PMID- 3646466 TI - [Comments on the article by Ichijo--a comparison with nursing in Japan and in the United States]. PMID- 3646467 TI - [Comments on the article by Ichijo--problems to be faced and solved]. PMID- 3646468 TI - [Comments on the article by Ichijo--efforts toward the expected nursing service]. PMID- 3646469 TI - [Comments on the article by Ichijo--efforts toward establishment of a uniformly high standard in nursing]. PMID- 3646470 TI - [Comments on the article by Ichijo--a need for a full utilization of potentials possessed by the nursing profession]. PMID- 3646471 TI - [Nursing management: the current problems to be faced--upon reflection on the progress over the past 40 years since the end of the Second World War. A discussion]. PMID- 3646472 TI - [The present and future of the study of nursing management]. PMID- 3646473 TI - [Nurturing management concepts during education of basic nursing]. PMID- 3646474 TI - [The current status of on-the-job training (in nursing management)--needs to attend the course and purposes of planning the course]. PMID- 3646475 TI - [Proposals to head nurses who find difficulties in management--a need to gain strength to focus on their own weakness]. PMID- 3646476 TI - [On the mechanism of management]. PMID- 3646477 TI - [Creation of a standard nursing plan for a patient with restricted activities- use of a self-care model]. PMID- 3646479 TI - [Personal observation on regional nursing activities in Sweden]. PMID- 3646478 TI - [Notes left by patients undergoing artificial respiration for extended periods]. PMID- 3646480 TI - Unusual codon usage of HIV. PMID- 3646481 TI - Crystallographic study of a beta-lactam inhibitor complex with elastase at 1.84 A resolution. AB - The continuing discovery and development of beta-lactams as antibiotics has had an unparalleled impact on the overall health and well-being of society. Recently, appropriately substituted cephalosporins were shown to be potent inhibitors of elastase, suggesting a novel therapeutic role for the beta-lactams in the control of emphysema and other degenerative diseases. We have now solved and partially refined at atomic resolution the structure of a complex of porcine pancreatic elastase with the time-dependent irreversible inhibitor 3-acetoxymethyl-7-alpha chloro-3-cephem-4-carboxylate-1,1-dioxide tert-butyl ester (I), the most potent of the beta-lactam elastase inhibitors yet reported. (Porcine pancreatic elastase is a close relative of the desired drug target, human polymorphonuclear leukocyte elastase.) A mechanism of action is presented, based on the structure and on biochemical evidence (T.-Y.L. et al., in preparation), which clarifies the operational similarities and differences between beta-lactam elastase inhibitors and antibiotics. Features of the reaction include the expulsion of a leaving group at the cephalosporin 3' position and the formation of two covalent bonds with the active site of porcine pancreatic elastase at residues Ser 195 and His 57. PMID- 3646483 TI - Nursing ignorance of hepatitis B infection. PMID- 3646482 TI - AIDS vaccine strategies. PMID- 3646484 TI - What is hepatitis B? PMID- 3646485 TI - Psychiatric hospitals and the mentally handicapped--a special case. PMID- 3646486 TI - Royal College of Nursing. Come of age. PMID- 3646488 TI - Reflections on RRB. PMID- 3646487 TI - Nursing students can only hope that Project 2000 goes ahead. PMID- 3646489 TI - Nursing's role in the advancement of wellness promotion. PMID- 3646491 TI - On the scene: Section I--Hartford Hospital. Wellness promotion. PMID- 3646490 TI - Health promotion and disease prevention for the hospitalized patient's family. PMID- 3646492 TI - Nursing leads wellness promotion: overview. PMID- 3646493 TI - The wellness frontier: the community. PMID- 3646494 TI - Contributions by nurse practitioners in primary care to prevention and management of illness. PMID- 3646495 TI - Wellness approached from a different perspective: staff wellness promotes patient wellness. PMID- 3646496 TI - Diabetes: a wellness perspective. PMID- 3646497 TI - Health and life styles: employee wellness. PMID- 3646498 TI - On the scene: Section II--Northwestern Memorial Hospital. Wellness promotion. PMID- 3646499 TI - Wellness promotion in women's health care. PMID- 3646501 TI - Promoting wellness in the pregnant diabetic to improve fetal outcome. PMID- 3646500 TI - Wellness promotion in women's ambulatory care. PMID- 3646502 TI - Promoting health and wellness in the elderly. PMID- 3646503 TI - Wellness promotion and elderly outreach. PMID- 3646504 TI - The "Taking cooking to heart" program. PMID- 3646505 TI - Health education. PMID- 3646506 TI - The Health Learning Center: an integral partner in wellness at Northwestern. PMID- 3646507 TI - Promoting wellness through nutrition. PMID- 3646508 TI - Wellness promotion through education. PMID- 3646509 TI - Nursing the nurse: psychosocial rounds on a gynecology/oncology unit. PMID- 3646510 TI - Promoting wellness in nurses in a hospital setting. PMID- 3646511 TI - Utilizing the resources of a tertiary medical center to provide occupational health services. PMID- 3646512 TI - Nursing staff at St. Paul takes the lead in wellness and health promotion. PMID- 3646513 TI - Locus of decision making in patient and family education: its effect on promoting wellness. PMID- 3646514 TI - The role of the nurse practitioner in developing wellness promotion programs for employees in acute care hospital settings. PMID- 3646515 TI - Health promotion within the nursing work environment. PMID- 3646516 TI - Managing your academic career: have you considered administration? PMID- 3646518 TI - Motivations, barriers, and support systems of ADN students. PMID- 3646517 TI - Critical thinking, creativity, clinical performance, and achievement in RN students. PMID- 3646519 TI - Conflict: insights before intervention. PMID- 3646520 TI - Program evaluation in nursing. PMID- 3646521 TI - Options for clinical nursing research experiences. PMID- 3646523 TI - Clinical evaluation assessment form. PMID- 3646522 TI - Textbook adoption decisions: beyond the objective. PMID- 3646524 TI - Management theory at work in the curriculum. PMID- 3646525 TI - Visions of nursing. PMID- 3646527 TI - E.P.S.: sophisticated dysrhythmia detector. PMID- 3646526 TI - Evaluating measuring instruments. PMID- 3646528 TI - E.S.W.I.: a shocking blow to kidney stones. PMID- 3646529 TI - Medication errors. Improperly mixed i.v. additives. PMID- 3646530 TI - Networking made easy. PMID- 3646532 TI - 19 questions about drug/alcohol abuse. PMID- 3646533 TI - Open fracture. PMID- 3646531 TI - King Richard. PMID- 3646534 TI - Don't let ARDS catch you off guard. PMID- 3646535 TI - Are you prepared to perform arterial punctures? PMID- 3646536 TI - Helping Fran do it her way. PMID- 3646537 TI - Shield yourself from liability. PMID- 3646538 TI - Planning letter-perfect postpartum care. PMID- 3646539 TI - A model approach to pain assessment [continuing education credit]. PMID- 3646541 TI - Join the fight against oral cancer. PMID- 3646540 TI - Color them special: a sensible, sensitive guide to caring for elderly patients. PMID- 3646542 TI - Make the most of your charting time. PMID- 3646543 TI - Two entry levels only? Another point of view. PMID- 3646544 TI - Learning from mistakes: medication errors to avoid. PMID- 3646545 TI - The intensive care unit. PMID- 3646546 TI - Infection control in ITU. PMID- 3646548 TI - The development of care plans for the critically ill patient. PMID- 3646547 TI - The stress of working in intensive care: a look at the research. PMID- 3646549 TI - Communication in critical care areas: competing for attention. PMID- 3646550 TI - Training for management: future possibilities. PMID- 3646551 TI - Management of the intensive care unit. PMID- 3646552 TI - Transplantation and organ donation. PMID- 3646553 TI - Intensive care nursing education. PMID- 3646554 TI - Maintaining sensory balance for the critically ill patient. PMID- 3646555 TI - Self poisoning. PMID- 3646556 TI - The child in the intensive care unit. PMID- 3646557 TI - Elimination. PMID- 3646558 TI - International conference on obesity. PMID- 3646560 TI - Assessment: getting the patient's point of view--early. PMID- 3646559 TI - Legal implications of policy and procedure manual--Part II. PMID- 3646561 TI - Whistleblowing: disclosure and its consequences for the professional nurse and management. PMID- 3646562 TI - Using a factored patient classification system in psychiatry. PMID- 3646563 TI - Toward a comprehensive personnel system: job description development--Part I. PMID- 3646564 TI - Quality assurance: monitoring individual compliance with standards of nursing care. PMID- 3646565 TI - Retention: sound communications keep a critical care staff together. PMID- 3646567 TI - The nursing consultant role. PMID- 3646566 TI - Creative tension: problem solving in conflict. PMID- 3646568 TI - The jury decides: are registered nurses legally liable for their job-related actions? PMID- 3646569 TI - Establishing predictive validity of a patient classification system. PMID- 3646570 TI - Orientation: a resident nurse class reduces stress. PMID- 3646571 TI - A eulogy for the nursing profession--before it's too late! PMID- 3646572 TI - Articulating nursing practice: putting care plans into action. PMID- 3646573 TI - Education and licensure: once more into the breach. PMID- 3646574 TI - Recruiting nurses with an extern program. PMID- 3646575 TI - Quality circles: tapping people power. PMID- 3646577 TI - Alcohol. Working with alcohol. PMID- 3646576 TI - Alcohol. Recovery programmes for problem drinkers. PMID- 3646578 TI - Alcohol. The Good Booze Guide. PMID- 3646579 TI - Alcohol. Identifying and helping problem drinkers. PMID- 3646580 TI - Alcohol. Alcohol and the law. PMID- 3646581 TI - MASTA looks after travellers' health. PMID- 3646582 TI - Selection of OH nurses. PMID- 3646583 TI - Legionella experience. PMID- 3646584 TI - [Histologic changes in the nasopharyngeal mucosa in experimental animals exposed to cement dust]. PMID- 3646585 TI - Nursing shortage surfaces nationally--in Pennsylvania the shortage appears to range from manageable to severe. PMID- 3646586 TI - Changing population structure requires health care providers to be knowledgeable of ethnic-related diseases. PMID- 3646587 TI - The North Dakota decision on entry into practice; how it happened--what it means in Pennsylvania. PMID- 3646588 TI - As a nurse, can I? Guidelines for determining scope of nursing practice issues. PMID- 3646589 TI - [Graft versus host reaction following materno-fetal transfusion. Apropos of 1 case]. AB - After GVHR by probable maternal-foetal in utero transfusion, a male infant carrying a serious combined immune deficit (DICS) has presented a second post transfusional GVHR. On the occasion of this observation, the authors recall the main signs which permit to evoke this rare diagnosis as early as possible, as well as some main preventive measures that can be applied in current practice. PMID- 3646590 TI - Characteristics of baccalaureate education in nursing. PMID- 3646591 TI - Patterns in nursing: strategic planning for nursing education. PMID- 3646592 TI - Analyzing competition: identifying and using the competitive edge. PMID- 3646593 TI - Recruitment planning in light of changing student profiles. PMID- 3646594 TI - Creating change: a survival strategy. PMID- 3646595 TI - Strategic planning: an organizing framework for nursing education. PMID- 3646596 TI - Innovation as a survival strategy. PMID- 3646597 TI - Future view: nontraditional education as the norm. PMID- 3646598 TI - The dream curriculum. PMID- 3646599 TI - Nurse faculty socioeconomic trends 1986. PMID- 3646600 TI - Policies and procedures. PMID- 3646601 TI - Nucleotide sequence of the spinach chloroplast tRNA(CAALeu) gene and its flanking regions. PMID- 3646602 TI - Nursing's preferred future. PMID- 3646603 TI - Making nursing's vision a reality. PMID- 3646604 TI - Shaping nursing's preferred future. PMID- 3646605 TI - Obstacles to nursing's preferred future. PMID- 3646606 TI - Who should be the future SNA member? PMID- 3646607 TI - Who should be the future SNA member? PMID- 3646608 TI - NP education: observations from a national perspective. AB - During the past decade (1976-1986), both the number of nurse practitioner programs and the federal funding of those programs peaked. The majority of programs now offer a master's rather than a certificate and the orientation of the curriculum changed from treatment of disease to health promotion. PMID- 3646610 TI - Judicial perspectives on nursing. PMID- 3646609 TI - Opinions about the professional doctorate in nursing. PMID- 3646611 TI - Scholarly business cards. PMID- 3646612 TI - Comparison of neonatal nighttime sleep-wake patterns in nursery versus rooming-in environments. AB - A two-group design was used to compare the state behavior of newborns who roomed in with their mothers at night with those who were cared for by the traditional nursery-at-night method. Twenty-one full-term, low-risk newborns comprised the study sample. Data were collected using a sleep monitor bassinet for two consecutive nights after delivery. Comparison of the nursery environment with the mother's postpartum room at night revealed greater light and sound levels in the nursery setting. Regarding caregiving practices, rooming-in infants received more contact with the caregiver and care that was more often related to their state behavior. Infants in the mother's room had significantly, p less than .001, more quiet sleep (33% vs. 25.4%), less indeterminate (4.8% vs. 11.2%), and less crying (0.6% vs. 7.5%) states than infants who remained in the nursery. PMID- 3646614 TI - Dimensions of client control. AB - The purposes of this study were to identify activities that give patients a sense of control during their hospitalization and to characterize the kinds of people who find control in various ways. Bandura's (1977) social learning theory and the relationship between control and stress formed the theoretical framework; Q methodology was central to implementation and replication of the descriptive design. Consistent with Q methodology, major and replication samples were purposively selected, each consisting of 30 medical-surgical inpatients of both sexes, ranging from 24 to 75 years of age. Instruments used were the Client Control Q Set, Health Opinion Survey (HOS), a demographic data form, and a semi structured interview. Q factor analysis and the construction of factor arrays resulted in three dimensions of client control in the original data set which replicated and were supported by interview and HOS data. These orthogonal dimensions were: knowing and fulfilling the patient role, being involved in making decisions, and directing interpersonal and environmental components. A theme common to all dimensions was the importance patients attached to having cognitive control over diagnostic tests, surgery, and treatment and to understanding concomitant life-style implications. Identification of the kinds of people who find control in various ways remains elusive, although patients hospitalized for diagnosis and/or treatment of cancer were predominant among those who wanted to be involved in making decisions. PMID- 3646613 TI - Patient management of pain medication after cardiac surgery. AB - The purpose of this study was to investigate the effects of a personal control intervention in the form of self-administered versus nurse-administered pain medication after cardiac surgery, and its interaction with patients' desire for control, patients' perception of pain intensity, disruption in daily activities, emotional responses, and use of pain medication over time. Subjects were 64 adults undergoing coronary artery bypass or valve replacement surgery. Instruments included the Krantz Health Opinion Survey; a 7-point measure of discomfort scale to assess pain intensity, disruption in daily activities due to pain, and emotional upset due to pain; a shortened form of the Sickness Impact Profile; and the Bi-polar Profile of Mood States. No main effects were found between experimental and control groups on any of the dependent measures nor were interaction effects found between individuals' measured desire for control and the personal control intervention. A time by group interaction was found in reports of pain intensity, p less than .05, with subjects in the experimental group reporting higher levels of pain intensity than subjects in the control group in the early postoperative period. PMID- 3646615 TI - Aggressiveness of nursing care for older patients and those with do-not resuscitate orders. AB - Age and do-not-resuscitate (DNR) orders were experimentally manipulated with a 2 X 2 factorial design using four vignettes which were randomly assigned to 95 staff nurses from four sites in a mid-Atlantic metropolitan area. Attitudes toward aggressiveness of nursing care were measured using the same 13-item 6 point Likert scale with all vignettes. Two replications with 183 nursing students and 86 intensive care nurses from six sites followed. Both increased age and DNR orders significantly, p less than .05 and .01, reduced aggressiveness of nursing care attitudes in all three studies. However, attitudes toward care still remained in the moderately aggressive range, which is more aggressive than current patient classification systems describe for DNR patient care. PMID- 3646616 TI - Children's preoperative coping: replication and extension. AB - This study examined the ways 42 children coped with surgery in relation to their locus of control beliefs, age, and the amount of preoperative information given them by their parent(s) and surgeon. Lazarus' (1966) cognitive appraisal perspective of stress and coping provided the theoretical framework for the study. From this perspective, a person's appraisal or evaluation of stress and one's coping modes are determined by both personal and situational factors specific to the individual. Children were interviewed preoperatively and rated as using avoidance modes, active modes, or a combination of avoidance-active coping. Results showed that all three independent variables related to children's adopted coping strategy. The results also replicated findings of previous research that showed locus of control and parent-doctor information were associated with particular coping behaviors. PMID- 3646617 TI - Differences in stress and coping findings: a reflection of social realities or methodologies? AB - A comparison of findings in a qualitative study (N = 22) and a quantitative study (N = 130) of work-related stress suggested that the divergence may be due to differences in methodology rather than in social realities. Important differences were noted in two areas: major sources of stress and coping patterns which reduce stress. The quantitative study identified discrete events as sources of stress; the qualitative study described processes over time. Linkages between stress and coping evident in the qualitative study were not identifiable in the quantitative study. The differences in findings reflect the strengths of the respective methodologies. PMID- 3646618 TI - Serum indirect bilirubin levels and meconium passage in early fed normal newborns. AB - The purpose of this study was to investigate the effect of early feeding of the normal newborn with formula and sterile water on: time of initial meconium passage, serum indirect bilirubin levels at 48 hours of life (HOL), observed jaundice at 48 HOL, and percentage of weight change at 48 HOL. Thirty normal, term newborns were sequentially assigned to one of three treatment groups: a control group given the routine hospital feeding of up to 30 ml of sterile water at 4 HOL and up to 30 ml of formula at 8 HOL; a water-fed group given up to 30 ml of sterile water at each feeding at 1, 2, and 3 HOL; and a third group fed formula at the same times and in the same amounts as the water-fed group. The time of initial meconium passage was significantly earlier in both groups of early fed infants than in the control group, F = 4.202, p = .026. The difference between the water-fed and the formula-fed groups was not statistically significant, but the mean time of passage was earlier in formula-fed infants. Serum indirect bilirubin levels at 48 HOL did not differ significantly, F = 0.412, p = .666, although the mean for the formula-fed group was lower. The correlation between the time of initial meconium passage and serum indirect bilirubin levels at 48 HOL was r = .3271, p = .083. Nine infants in the control group were jaundiced, compared to six in the water-fed group and six in the formula-fed group, a difference that was statistically significant, chi 2 = 6.79, p = .034.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3646619 TI - Predictors of dyspnea intensity in asthma. AB - Predictors of dyspnea were studied during induced airflow obstruction or cough in an attempt to increase understanding of factors related to observed variability in the descriptions of the experience of dyspnea. Thirty-one adult subjects with asthma participated in a 2-day protocol using a laboratory analog of asthma. Air flow obstruction and dyspnea were induced on Day 1 with inhalations of methacholine in doubling concentrations from 0.063 to 2.0 mg/ml. Cough was induced on Day 2 with inhalations of 3% sodium gluconate solution. Dyspnea was assessed on both days by a visual analog technique. The magnitude of dyspnea was not related to airway caliber. There was a significant negative relationship between age and magnitude of dyspnea and between cigarette pack years and dyspnea intensity. Dyspnea at baseline was positively related to dyspnea intensity during induced bronchoconstriction. Dyspnea during cough was not related to airway caliber, but there was a significant difference between males and females in the intensity of dyspnea at cough threshold. These findings may explain some of the variability observed in the experience of dyspnea in asthma. PMID- 3646620 TI - The occurrence of symptoms in expectant fathers. AB - A longitudinal study of 91 expectant fathers was done during early, middle, and late pregnancy to determine (a) which fathers were most likely to experience symptoms and (b) the relationship of the symptoms to emotional state. Men who were working-class, black, or who reported that pregnancy was not planned experienced more symptoms during pregnancy. White expectant fathers reported an increase in somatic symptoms as pregnancy progressed; black expectant fathers indicated a decrease. However, black expectant fathers consistently reported more symptoms than white expectant fathers. Symptom manifestation in expectant fathers was positively associated with anxiety. PMID- 3646622 TI - A triangulation of methods and paradigms to study nurse-given wellness care. PMID- 3646621 TI - Replicated testing of the Nursing Technology Model. AB - The purpose of this study was to replicate the testing of a model to explain complexity of nursing care in the ambulatory care setting. The Nursing Technology Model (Verran & Shaw, 1986) has as its theoretical base a sociological perspective of organizational analysis in which technology is viewed as the antecedent to organizational structure. The model includes materials technology as the nature of the ambulatory care client and knowledge technology as the principal type of activities pertinent to nursing care delivery. The characteristics of these technology types were organized into causal paths to explain complexity of care. Two ambulatory care sites were sampled to obtain a client sample of 610 rating sets. Results were essentially similar to earlier research with R2s for complexity indexes at the same level of .34. Only one regression equation evidenced instability in regression coefficients and the R2. Analysis of findings indicated that other variables, such as some aspects of structure, may need to be further specified in the model in order to increase its explanatory power. PMID- 3646623 TI - Long live the Queen's! PMID- 3646624 TI - The budget: not a lot to drink to. PMID- 3646625 TI - Health education: health hazards. PMID- 3646626 TI - The ward sister. Ever ready or burnt out? PMID- 3646627 TI - The ward sister. Developing the potential of sisters. PMID- 3646629 TI - Hidden loss. PMID- 3646628 TI - The ward sister. The trouble with being boss. PMID- 3646630 TI - Standing up to assessment. PMID- 3646631 TI - Nursing Aid. Home comforts? PMID- 3646632 TI - A new life for Emily. PMID- 3646633 TI - Management. Mixed blessing. PMID- 3646635 TI - Raising the alarm. PMID- 3646634 TI - Hospital or community? The case for. PMID- 3646636 TI - Leg ulcers. Pointers to management. PMID- 3646637 TI - Leg ulcers. Guides to information. PMID- 3646638 TI - Leg ulcers. Trial of a dressing for non-healing ulcers. PMID- 3646639 TI - Male models. PMID- 3646640 TI - Hospitals for sale: the thin green line. PMID- 3646641 TI - Maternity leave: confined to the home? PMID- 3646642 TI - Health advice: can I help you? PMID- 3646643 TI - A lesson for the teachers. PMID- 3646644 TI - The student dilemma. In a class of their own. PMID- 3646645 TI - The student dilemma. Stirrings at the grassroots. PMID- 3646646 TI - The student dilemma. Too little, too late? PMID- 3646647 TI - Setting up a vulval clinic. PMID- 3646648 TI - Management. Squatters' rights. PMID- 3646650 TI - Planning change: Sister Vision's dream. PMID- 3646649 TI - Getting to know you. PMID- 3646651 TI - Rehabilitating heart patients. PMID- 3646652 TI - Everyday ethics for nurses. Cruel to be kind? PMID- 3646653 TI - Assessing the training gap. PMID- 3646654 TI - Looking back in anger. PMID- 3646655 TI - Sharing the grief. PMID- 3646656 TI - Training the district nurse. PMID- 3646657 TI - No job too small. PMID- 3646658 TI - The patient with an ileostomy. Nursing management and patient education. AB - The person who is undergoing surgery for the creation of an ileostomy may have had extensive and unsuccessful medical management but should have a successful surgical outcome. A well-constructed and sited stoma accompanied by diligent, competent, and compassionate nursing management and education will insure this outcome. Information is vital in all stages of the process. Preoperative information needs to center around the nature of the surgery and the expected post-operative course. Once the information needs are met, the nurse can concentrate on the emotional support required. Preoperatively, the patient becomes dependent on health care providers to meet all of his needs. He requires patience, understanding, and repeated explanations to allay his apprehension and anxiety. Postoperatively, the patient needs information on self-care techniques and emotional support to adjust to his new method of toileting. He needs assistance to "accept" the new arrangement and incorporate it into his self-image and lifestyle. Long-term, the patient needs information about possible complications, the need for lifelong medical monitoring, and the availability of support services in his community. By physically preparing the patient for self care and discharge, the nurse can gently ease him onto the road to independence and a new lease on life. PMID- 3646659 TI - The patient with a urinary stoma. Nursing management and patient education. PMID- 3646660 TI - Colostomy. AB - The colostomy is the most commonly performed diversion of the fecal stream in the surgical management of colorectal carcinoma, diverticular disease, congenital birth defects, and trauma. The evolution of the colostomy has resulted in improved surgical techniques and a better quality of life for the patient. The clinician should be familiar with the indications for colostomy surgery, the different types of colostomies, preoperative and postoperative care, complications related to colostomy, and special diagnostic procedures required for follow-up care. PMID- 3646661 TI - Psychosocial issues: the person with an ostomy. AB - Rehabilitation of a person with an ostomy is a complex process that requires the comprehensive, concerted efforts of not only the health care team but family, friends, and the community as well. Competence in the physical aspects of ostomy care enhances psychologic adjustment. Advance planning ensures that nurses will address those issues that foster rehabilitation. Physical, emotional, and interpersonal problems must be closely scrutinized so that appropriate therapeutic interventions can be initiated at the earliest possible moment. Informed, assertive nurses who appreciate the complexity of adaptation to an ostomy, and who are committed to providing comprehensive care in a therapeutic manner, increase the rehabilitation potential of all of their patients. PMID- 3646662 TI - Sexual function following ostomy surgery. AB - This article provides a brief examination of normal sexual function as well as sexual problems associated with ostomy surgery. It also discusses the means by which nurses can intervene effectively to minimize problems through counseling. PMID- 3646663 TI - Ostomies: the art of pouching. AB - Excellent ostomy management is the goal for each new ostomate. Nurses are in pivotal positions to assist in selection and use of a variety of ostomy appliances and products. Individuals with ileostomies, transverse colostomies, sigmoid colostomies, or urostomies have unique management needs. Equipment recommendations and pouching procedures are detailed for each ostomy type. Access to proper instruction will enable the new ostomate to remain socially and physically active. PMID- 3646664 TI - Peristomal skin integrity. AB - The primary goal of skin care for the person with a stoma is prevention of skin breakdown. The first step is careful maintenance of the skin from the time of surgery forward. The patient and family should be taught every step of protecting the skin and recognizing early signs and symptoms of potential breakdown. The loss of peristomal skin integrity affects the person's entire well-being. Pouches will not adhere as well and accidental leaks occur. The impact on psychologic well-being is difficult to measure, but can be assumed to be significant. A circular effect can begin in which the skin irritation leads to accidents, which further compromise the skin integrity. Time may be lost from work or school. Damaged skin is also painful. The cost of treating peristomal skin breakdown can be high. The products used in ostomy care are relatively expensive. A single skin barrier may range from $3 to $5. Frequent changes will be necessary to assess and treat the lesions adding to the cost. Prevention is in the realm of effective nursing care and will include assessment of the skin, selection and application of appropriate pouches and skin barriers, patient and family teaching programs, and follow-up evaluations after hospitalization. PMID- 3646665 TI - Life span changes: implications for ostomy care. AB - Ostomy surgery is performed in patients of all ages from the infant to the elderly, bed-ridden patient. The total patient, not just the ostomy, should be the focus of the nursing care plan. Each age group of patient has its own special characteristics, although there are commonalities. The unique needs of infants, young children, adolescents, and geriatric patients are presented. PMID- 3646666 TI - Nutritional implications in the patient with pressure sores. AB - The relationship between wound healing and nutritional depletion is well accepted, although more specific aspects of repair remain to be established. Additional speculation surrounds the validity of assessment parameters as well as the constituents of replacement therapy. Even in view of this controversy the fact of the matter remains clear; adequate nutriture is one of the most fundamental of patient needs. Hence, the goal of nursing care should focus on the early recognition and intervention of nutritional deficits. Correction of potential and actual deficiency states promotes tissue restoration and reduces associated wound complications. PMID- 3646667 TI - Age-specific characteristics of patients who develop pressure ulcers in the tertiary-care setting. AB - This article explores whether age-specific characteristics of patients who develop pressure ulcers in the tertiary-care setting are present at hospital admission. Characteristics of interest were prescribed activity, diet, and oxygen therapy; weight change in the last 30 days; midarm muscle circumference; triceps skin fold; and total protein, serum albumin, white blood cell count, hematocrit, and hemoglobin. The sample was composed of 67 subjects who developed pressure ulcers when hospitalized electively and admitted to the cardiovascular or neurosurgical services of a tertiary-care hospital. Chi square and analysis of variance were used to analyze the data and showed no significant difference in the characteristics of the two groups. Data did indicate that length of hospitalization and severity of illness are more important determinants of ulcer development than age-specific characteristics in this sample. PMID- 3646668 TI - Assessment and evaluation of pressure sores. AB - Pressure sore prevention is the desired goal to maintain skin integrity. It is a challenging nursing responsibility. The process of pressure sore prevention requires skilled nursing assessment of the integumentary system and knowledge of risk factors, as well as an ongoing evaluation plan to monitor incidence and the efficacy of nursing care. Pressure sore assessment is greatly aided by the availability of several research-based instruments. Assessment instruments grounded in research are rather unique because few nursing problems, other than pressure sores, have such instruments available. Further testing of the predictive validity of risk factors is needed even though instruments have already proved valuable in delineating high-risk patients. Well-designed programs of process and outcome evaluation can result in lower incidence rates and reduced severity of pressure sores. Assessment and evaluation are essential to quality nursing care. PMID- 3646669 TI - Surgical management of pressure ulcers. AB - Prior to closure of pressure ulcers, the patient's wound must be clean, and he must be in a stable condition. Closure involves rotating flaps of muscle and skin into the wound. Maintaining adequate blood supply to the flap and teaching the patient how to prevent new ulcers are the foci of post-operative care. PMID- 3646670 TI - Healing of physical wounds. AB - The sequence of events in the process of wound healing follows a predictable pattern when all components to support the process are present. Healing cannot be accelerated beyond its normal time span; however, there are factors that may negatively influence the rate of wound healing. Among these are malnutrition, infection, trauma, and concomitant medical diagnoses. Nursing functions required when there is an infection complicating the healing process or when wounds have had a surgical repair are usually determined by the physician's plan of care. Correction of malnourished states, control of diabetes, and improvement of anemia and subsequent tissue perfusion contribute to optimal states for wound healing to occur. Independent nursing functions regarding wound management include vigilance, protection from intrinsic and extrinsic factors that may impede healing, and support of those factors that promote optimum environment for the healing to occur. PMID- 3646671 TI - Equipment and products used in management and treatment of pressure ulcers. AB - The new generation of products to put on pressure sores and equipment to put beneath the patient have caused health care professionals to reevaluate how they manage the high-risk patient with pressure sores. Those who use the new products and equipment must appreciate the principles on which they are based. These supportive interventions complement and augment, but do not replace, competent nursing care. Nurses must continue to assess the patient, products and equipment used; monitor the effectiveness of the management protocol; and evaluate the patient's progress. PMID- 3646673 TI - Pressure ulcers: unpublished research 1976-1986. Process to outcome. PMID- 3646672 TI - Patient/family education for the patient with a pressure necrosis. AB - In conclusion, it has been the purpose of this article to discuss patient, family, or significant other teaching for the patient with a pressure necrosis. Teaching content has been presented in tabular form, and the reader has reviewed a number of principles related to learning. Although we have seen that the nurse has certain motives for providing a patient education program, it is the learner who takes the responsibility for using available resources to acquire new knowledge leading to a behavioral skill. Finally, one must recognize that the problem of pressure necrosis care remains one of the most complex and challenging areas to be found in nursing. It is vital to remember that, although difficult, this is a hopefully preventable, treatable, and solvable management problem. PMID- 3646674 TI - Computerized monitoring systems. AB - Computerized monitoring systems facilitate the acquisition, storage, and retrieval of multiple vital parameters, which allow for rapid clinical decision making and more timely patient management. However, computerized monitoring systems can only augment, not replace, direct patient observations and care by nursing personnel. To provide the most effective care for patients, nurses must become proficient in the use of the advanced technology of computerized monitoring systems but also retain the humanistic "caring" quality. PMID- 3646675 TI - Monitoring patients with permanent cardiac pacemakers. AB - Patients requiring cardiac pacing are predominantly older citizens with multiple problems, demanding highly skilled monitoring as well as a holistic approach to their care. Pacemaker therapy, though widely accepted, currently is being scrutinized to determine its impact on cost as well as quality. To this end, a Joint American College of Cardiology/American Heart Association Task Force established a subcommittee on pacemaker implantation to define current indications for permanent cardiac pacemakers. The indications have been grouped into three classifications. Class I: conditions for which there is general agreement that permanent pacemakers should be implanted. Class II: conditions for which permanent pacemakers are frequently used but for which there is divergence of opinion with respect to the necessity of their insertion. Class III: conditions for which there is general agreement that pacemakers are unnecessary. It behooves the nurse in clinical practice to review the reference related to the foregoing classification system and to be knowledgeable of the conditions that fall within each group. PMID- 3646676 TI - Transmitting goals between generations. PMID- 3646677 TI - Role of women in population education. PMID- 3646678 TI - ICN guidelines on occupational health. PMID- 3646679 TI - Merits and demerits of the outreach services. PMID- 3646680 TI - Studies on personality profile with special reference to nursing. PMID- 3646681 TI - AIDS incidence prompts new policy at University of Maryland Cancer Center. PMID- 3646682 TI - Adjuvant radiotherapy to the colorectum: nursing implications. PMID- 3646683 TI - Self protective practices of nurses handling antineoplastic drugs. PMID- 3646684 TI - Anticipatory nausea and emotional distress in patients receiving cisplatin-based chemotherapy. PMID- 3646685 TI - Parents of long-term survivors of childhood cancer: a preliminary survey to characterize concerns and needs. PMID- 3646686 TI - Oncology nurses' versus cancer patients' perceptions of nurse caring behaviors: a replication study. PMID- 3646687 TI - Cultural and ethnic dimensions of cancer nursing care. PMID- 3646688 TI - Cultural and ethnic dimensions of cancer nursing care. Introduction. PMID- 3646689 TI - Ethnic perspectives of cancer nursing: Hispanics and Japanese-Americans. PMID- 3646691 TI - Ethnic perspectives of cancer nursing: the American Indian. PMID- 3646690 TI - Ethnic perspective of cancer nursing: the Black American. PMID- 3646692 TI - Questions on colon and rectum radiation therapy. PMID- 3646694 TI - Ethics of safeguarding client health and safety. PMID- 3646693 TI - Rural Clinical Nurse Placement Center alternative. PMID- 3646695 TI - What do I teach when I teach nursing? PMID- 3646696 TI - Temporal adjustments in sympathoadrenal activity in rats with obesity-producing hypothalamic knife cuts. AB - Sympathoadrenal activity was assessed in adult rats with obesity-producing hypothalamic knife cuts prior to and after the onset of gross obesity by measuring urinary excretion of norepinephrine and epinephrine and by determining rates of norepinephrine turnover in selected organs. Urinary excretion of norepinephrine, as an index of overall sympathetic nervous system activity, was approximately doubled throughout the 4-week study in knife-cut rats, as was intake of the high-fat diet. Three days after knife-cut surgery (before the onset of gross obesity) rates of norepinephrine turnover (ng X organ-1 X hr-1) were 23 33% lower in three of the four organs examined than in the corresponding organs of control rats; rates of norepinephrine turnover were depressed in pancreas, interscapular brown adipose tissue, and abdominal white adipose tissue and unchanged in hearts. Four weeks after surgery when gross obesity was evident, rates of norepinephrine turnover were accelerated in heart (+82%) and pancreas (+63%), but remained low in interscapular brown adipose tissue (-27%) and abdominal white adipose tissue (-28%). Adrenal medullary activity, assessed by urinary excretion of epinephrine, was suppressed within the 1st day after knife cut surgery and remained suppressed for several weeks. Brown adipose tissue and white adipose tissue appear to be selectively excluded from the generalized activation of the sympathetic nervous system in adult hyperphagic rats with obesity-producing hypothalamic knife cuts. Activation of the sympathetic nervous system was associated with reciprocal suppression of adrenal medullary responses in knife-cut rats. PMID- 3646697 TI - Towards the year 2000. PMID- 3646698 TI - Catheter care. PMID- 3646699 TI - Leg ulcers: a disease affecting all ages. PMID- 3646701 TI - The patient's auditory environment. PMID- 3646700 TI - The epidemiology of leg ulcers. PMID- 3646702 TI - Gluten-free diets--helping patients to cope. PMID- 3646704 TI - Evaluation of Project 2000: a new preparation for practice. PMID- 3646703 TI - Living with a gluten-free diet. PMID- 3646705 TI - Management of pain: good communication. PMID- 3646706 TI - Leg ulcers: the nursing assessment. PMID- 3646707 TI - Draining the pleural cavity. PMID- 3646708 TI - Acquired immune deficiency syndrome (AIDS). PMID- 3646709 TI - Preparing children for hospital. PMID- 3646711 TI - Ward sister: teacher and practitioner? The significance of including ward sisters in the course. PMID- 3646710 TI - Ward sister: teacher and practitioner? PMID- 3646712 TI - A preliminary study on the anti-emphysema drug, 2-trifluoro acetamidobenzenesulfonyl fluoride in CF1 mice. AB - 2-Trifluoroacetamidobenzenesulfonyl fluoride was shown to be a potent inhibitor of porcine pancreatic elastase activity with an ID50-30.3 microM. When this enzyme was infused I.V. in mice inducing higher elastase activity in the blood, the agent at 20 mg/kg for 5 days suppressed elastase activity significantly below the value observed in normal mice. The drug was absorbed better by the I.P. route than the P.O. route. A more consistent and higher blood level of the drug was achieved by the I.P. route as opposed to the I.V. or oral routes. The drug distributed rapidly to all tissues concentrating in the skin and carcass. Approximately 56% of the drug was eliminated within 48 hr. The majority of the eliminated drug and its metabolites was via the urine. Whereas the LD50 value was greater than 350 mg/kg I.P. there was elevation in serum alkaline phosphotase activity; cholesterol and triglyceride levels were reduced, and the organ weight of the reproductive organs was markedly reduced. Further evaluation of this drug is necessary to determine if the observed acute toxicity findings are restrictive for the use of this agent in the treatment of emphysema. PMID- 3646714 TI - Pre operative preparation: the key to success in out-patient surgery. PMID- 3646713 TI - Bilateral breast reduction from the nurse as a patient perspective. PMID- 3646715 TI - General anesthesia: an overview. PMID- 3646716 TI - Effects of assertion training and first aid instruction on children's autonomy and self-care agency. AB - Strategies for promoting autonomy and a self-care agency in children were investigated in this study. Ninety-two fifth grade students were randomly assigned to one of four learning groups: assertion training; first aid instruction; assertion/first aid; and control. Results showed mixed support for autonomy being higher where either or both assertion training and first aid instruction had occurred, and support for self-care agency being higher where first aid instruction had occurred. PMID- 3646717 TI - Predictors of life outlook of older single women. AB - The purpose of this study was to examine whether personal and social factors differentiate between widowed, divorced or separated, and never married older women, and predict the life outlook of older single women. A secondary analysis of data from a subsample of the older single women (n = 816) in the 1975 National Survey of the Aged was undertaken. Significant differences between groups were found: never married women were better educated, healthier, less lonely, and had a more positive life outlook than widows. The model predicted 29% of the variance in life outlook. Health and loneliness had the strongest effects on life outlook when predictors were compared. PMID- 3646718 TI - Marathon running: comparison of physical and psychosocial risks for men and women. AB - Physical and psychosocial risks of running and addiction were compared in a sample of female (n = 112) and male (n = 108) marathon runners. While female runners reported more pain in the knee, shin, hip, and heel, and more stress fractures, than the men, no injuries were significantly higher in women. Over 40% of both male and female subjects reported knee injury, making it the most common running injury reported. There were no significant differences in level of self esteem, anxiety, or running addiction between the two groups. There was, however, a significant relationship between level of negative addiction scores and two injuries: torn ligaments X2 (2,202) = 8.45, p less than .02, and hematuria X2 (2,202) = 11.31, p less than .005. PMID- 3646719 TI - The use of lie scales in psychometric measures of children. AB - The appropriateness of lie scales commonly used in psychometric tools for health research with children was investigated. A convenience sample of 74 children was used to test the hypothesis that children at a less mature stage of cognitive development would score higher on a lie scale than would children at a more mature stage. Each child was tested using the Cartoon Conservation Scale to assess the Piagetian cognitive level and the nine-item lie scale for the "How I Think and Feel Test". The findings supported the hypothesis; a two-way analysis of variance showed a significant main effect of cognitive level (F = 13.274; p less than 0.001). A stepwise multiple regression indicated that age and cognitive level accounted for 53% of the variance in lie scale scores. PMID- 3646720 TI - Job stress and health: the role of social support at work. AB - Data are presented on the use of social resources to reduce the negative effects of perceived job stress on the health of 26 psychiatric technicians who cared for severely and profoundly retarded residents of a state institution. Data were collected by participant observation, semistructured interviews, and the self administered Cornell Medical Index. Sources of job stress were found to stem not from problems associated with the care of the retarded but rather from staff members' inability to control other critical aspects of their work. Staff with supportive work-based social networks reported significantly better health (as measured by the Cornell Medical Index) than those without such networks. PMID- 3646721 TI - Ambulatory infusion pumps: a practical view at an alternative approach. PMID- 3646722 TI - Concepts in intraperitoneal chemotherapy. PMID- 3646723 TI - Cancer chemotherapy in children: nursing issues and approaches. PMID- 3646724 TI - Extravasation management. PMID- 3646725 TI - Issues in cytotoxic drug handling safety. PMID- 3646726 TI - Current and future nursing issues in the home administration of chemotherapy. PMID- 3646727 TI - Reflections on the oncology nurse's role in cancer therapy: future challenges. PMID- 3646728 TI - Current concepts in chemotherapy administration. PMID- 3646729 TI - Small gauge central venous catheters and right atrial catheters. PMID- 3646730 TI - Implantable devices for chemotherapy: access and delivery. PMID- 3646731 TI - [Wellcozyme: a new kit for the detection of anti-HIV antibodies. Considerations apropos of the initial trials]. AB - We tested the Wellcozyme anti-HTLV III kit on: 600 blood donors fresh sera, simultaneously tested by Elavia (Diagnostics Pasteur) or Vironostika (Organon); 20 plasmas, known to be anti-HIV negative; 22 sera, already labelled, and a panel of 10 specimens from the "Retrovirus" study group of the French National Society of Blood Transfusion, also tested by Elavia, Vironostika, Abbott HTLV III EIA and by two confirmatory tests: Immuno-blot (Diagnostics Pasteur) and Abbott confirmatory test. The Wellcome kit is, at present, the only one to use a competitive Elisa method and not to require any sample predilution. The method is easy to perform, rapid (results in 1 h 30 time) and it tests as well serum as plasma. No interferences have been observed from high lipid concentrations or strong hemolysis on the Elisa reaction. The performances of the Wellcozyme test are satisfactory. We did not find any "false positive" result. But the study shows that this kit is not sensitive enough for the detection of anti-P25 antibodies, which appear on the beginning of seroconversion, unless the "grey range" is extended: the Wellcome Laboratories have just made this recommendation. PMID- 3646732 TI - [Economics, health and health economics]. PMID- 3646733 TI - [Levels of patient dependence in a traumatology service]. PMID- 3646734 TI - [Femoral neck fractures in the aged]. PMID- 3646735 TI - [Goiter: a current problem and a program of control]. PMID- 3646736 TI - [Celiac disease]. PMID- 3646737 TI - [Doppler stethoscopy (ultrasonocardiography)]. PMID- 3646738 TI - [Continuing education. 13. Field: emergency nursing. Subject: actions by the nurse in charge of a polytraumatized patient]. PMID- 3646740 TI - We made our skin care problems disappear. PMID- 3646739 TI - [The almighty physician]. PMID- 3646741 TI - How to say "I care" when you have no time to talk. PMID- 3646742 TI - When you suspect your patient is a battered wife. PMID- 3646743 TI - The right way to do chest physiotherapy. PMID- 3646744 TI - When the problem involves magnesium, calcium, or phosphate [continuing education credit]. PMID- 3646745 TI - Jay's alive. Do we owe him an apology? PMID- 3646746 TI - Cardiac assessment: what to do; how to do it. PMID- 3646747 TI - Gynecologic cancer: cervical, vulvar, and vaginal malignancies. PMID- 3646748 TI - Can you refuse to assist in abortions? PMID- 3646749 TI - Helping your patients enjoy sex again. PMID- 3646750 TI - What every diabetic patient needs to know. PMID- 3646751 TI - Dual infection of the central nervous system by AIDS viruses with distinct cellular tropisms. AB - Human immunodeficiency virus (HIV) is the causative agent of the acquired immune deficiency syndrome (AIDS). A large number of AIDS patients show evidence of neurologic involvement, known as AIDS-related subacute encephalopathy, which has been correlated with the presence of HIV in the brain. In this study, two genetically distinct but related viruses were isolated from one patient from two different sources in the central nervous system: brain tissue and cerebrospinal fluid. Both viruses were found to replicate in peripheral blood lymphocytes, but only virus from brain tissue will efficiently infect macrophage/monocytes. The viruses also differ in their ability to infect a brain glioma explant culture. This infection of the brain-derived cells in vitro is generally nonproductive, and appears to be some form of persistent or latent infection. These results indicate that genetic variation of HIV in vivo may result in altered cell tropisms and possibly implicate strains of HIV with glial cell tropism in the pathogenesis of some neurologic disorders of AIDS. PMID- 3646752 TI - [Sanmigran]. PMID- 3646753 TI - [To be a psychologist in an adult psychiatric service]. PMID- 3646754 TI - [Night hospitalization--why?]. PMID- 3646755 TI - [Psychomotor therapy. A body-centered practice]. PMID- 3646757 TI - [Community psychiatry]. PMID- 3646756 TI - [The place of the outpatient department in community psychiatry. Function and role]. PMID- 3646758 TI - [Bringing together to separate. Considerations apropos of family psychotherapy with psychoanalytic inspiration]. PMID- 3646759 TI - [Sheltered workshops and reintroduction]. PMID- 3646760 TI - [Nursing records at the psychiatric hospital center]. PMID- 3646761 TI - [The function of community psychiatry. General presentation]. PMID- 3646762 TI - [The day hospital. For a transitional time]. PMID- 3646763 TI - [Augmentin]. PMID- 3646764 TI - [Puberty in boys]. PMID- 3646765 TI - [Puberty in girls]. PMID- 3646766 TI - [Clinical assessment methods of stages of puberty]. PMID- 3646767 TI - [Examination methods in puberty and its abnormalities]. PMID- 3646768 TI - [Puberty]. PMID- 3646769 TI - [Delayed puberty and absence of puberty]. PMID- 3646770 TI - [Precocious puberty]. PMID- 3646771 TI - [Physiology of normal puberty]. PMID- 3646772 TI - [Puberty and adolescence. Psychological and psychopathological aspects]. PMID- 3646774 TI - [Reorganization of Norwegian Nurses' Association's counties and district]. PMID- 3646773 TI - [Norwegian Nurses' Association's wage scale policy--need for rethinking]. PMID- 3646775 TI - [This concerns everybody: AIDS nursing care in the Rikshospitalet. Interview by Gunnar Bolstad]. PMID- 3646776 TI - [District manager takes the initiative--care for the seriously ill and dying]. PMID- 3646777 TI - [Welcome to Central Hospital. Professional goals and means at admission]. PMID- 3646778 TI - [Research in a nursing home: manager training as a group project]. PMID- 3646780 TI - [Closure of Reitgjerdet Hospital]. PMID- 3646779 TI - [Many roads lead away from a rut]. PMID- 3646781 TI - [Mental health protection--and challenge]. PMID- 3646782 TI - [Where do we stand? Pension regulations and nurses]. PMID- 3646783 TI - [Nurses and doctors as healers]. PMID- 3646784 TI - [Turkish women have miserable conditions on Danish maternity wards]. PMID- 3646785 TI - [Inferior evaluation of students without written objectives]. PMID- 3646786 TI - [That is clear language to politicians]. PMID- 3646787 TI - [Nurses in the entire country need better wages. Interview by Ulla Danielsen]. PMID- 3646789 TI - [The Finance Minister's arithmetic concerning wages doesn't fit together]. PMID- 3646788 TI - [Interrelationship between wages and productivity in the health care system. Interview by Helle Kastholm Hansen]. PMID- 3646790 TI - [A few more angels among nurses than in other professions. Interview by Anne-Lise Molvig]. PMID- 3646791 TI - [Thinking about greater frankness is nothing new for nurses]. PMID- 3646792 TI - [Timely beginning for difficult negotiations]. PMID- 3646793 TI - [Apathy can be remedied when it is considered as a stress reaction]. PMID- 3646794 TI - [Acute crisis with high anxiety level causes stress]. PMID- 3646795 TI - Your career: opportunities for advancement. Pulling yourself up: the career credential. PMID- 3646796 TI - Your career: opportunities for advancement. Mastering the job interview. PMID- 3646797 TI - Your career: opportunities for advancement. Back to school for a BSN. PMID- 3646798 TI - [Occurrence of antibodies against HIV. Largely among heterosexual persons in the Oslo region]. PMID- 3646799 TI - [2-year experiment integrated nursing]. PMID- 3646800 TI - [Nursing care of AIDS patients in San Francisco]. PMID- 3646801 TI - [Safety of nurses in psychiatry. Dread(ful) our safety!]. PMID- 3646802 TI - [Hazards of and prevention in radioactive irradiation disasters]. PMID- 3646803 TI - [Medical information for nurses. The kidney lithotriptor]. PMID- 3646804 TI - [Isolation--intensive care nursing in psychiatry]. PMID- 3646805 TI - [Basic education in nursing. From chaos to cohesion in the education picture]. PMID- 3646806 TI - [University study in nursing in Utrecht!]. PMID- 3646807 TI - [The nursing management department in the general hospital]. PMID- 3646808 TI - [Patient classification in a pediatric hospital]. PMID- 3646809 TI - [This is how nurses can feel ... for heaven's sake]. PMID- 3646810 TI - [Basic nursing education financed from general funds]. PMID- 3646811 TI - [The nursing supervisor in patient-oriented nursing systems]. PMID- 3646813 TI - [Choosing for self care: a bad choice]. PMID- 3646812 TI - [District nurse in Nicaragua]. PMID- 3646814 TI - [Treating through negotiating]. PMID- 3646815 TI - Methyl mercury-induced nonselective blocking of phosphorylation processes as a possible cause of protein synthesis inhibition in vitro and in vivo. AB - Inhibition of protein synthesis by methyl mercury occurring in a reticulocyte lysate cell-free translation system can be substantially reduced by addition of excess ATP and inorganic phosphate to the incubation medium. It was established in in vivo experiments that intraperitoneal (i.p.) administration of sodium orthophosphate buffer to a considerable degree prevents the development of certain biochemical effects exerted by an i.p. injection of 1/3 LD50 methyl mercury. Inhibition of protein and ATP synthesis as well as protein phosphorylation in mouse brain and liver tissue was much less severe in phosphate pretreated animals. Administration of orthophosphate in the absence of poison does not alter the rate of the biochemical processes studied. Orthophosphate proved to be less effective in correcting already induced metabolic disorders than in preventing the development of such disorders. PMID- 3646816 TI - [The state of the blood kallikrein-kinin system in acute lung diseases]. AB - Role of lungs in regulation of blood kallikrein-kinin system was studied under conditions of massive hemorrhage in dogs as well as in heavy lung impairments of patients--acute pneumonia, shock of lungs. These stressor effects were shown to correlate with the rate of loss in lung regulating activity towards the blood kallikrein-kinin system. PMID- 3646817 TI - [Use of cholestyramine by patients with chronic ischemic heart disease]. PMID- 3646819 TI - Nursing in a nuclear age. PMID- 3646818 TI - Absence of HIV antibody among dental professionals exposed to infected patients. AB - Dental professionals have relatively frequent skin contact with saliva and small amounts of blood of patients infected with the human immunodeficiency virus (HIV). Despite this exposure, none of 255 dentists, hygienists and chairside assistants had the antibody to HIV following an estimated 189 or more exposures. These data provide further evidence that casual contact with the saliva of HIV infected persons, such as may occur in households, the workplace or in public places, is unlikely to result in transmission of HIV to uninfected persons. Because of the small sample size in this study, however, and the relatively high frequency of exposure of HIV-infected patients that we found, we recommend that dental care professionals increase their use of disposable gloves and adhere to the Centers for Disease Control's guidelines for infection control practices for dentistry until more is known about the transmission of this virus. PMID- 3646820 TI - AIDS: an international perspective. PMID- 3646821 TI - Sudden infant death syndrome. PMID- 3646824 TI - History of off-campus programs and distance education at the University of Alberta. PMID- 3646823 TI - Planning your nursing career for the year 2000. PMID- 3646822 TI - Nocturnal enuresis in children. PMID- 3646825 TI - Sources of stress in third year baccalaureate nursing students. PMID- 3646826 TI - The alternative complement pathway in chickens. Purification of factor B and production of a monospecific antibody against it. AB - Restoring the haemolytic activity of heat-treated chicken serum was used to monitor an initial purification of chicken complement component factor B of the alternative complement pathway. The partially purified factor B was used to prepare a monospecific rabbit antiserum against factor B, and this antiserum was now used to monitor and establish a purification scheme for chicken factor B which could be used for large-scale purifications. The final purification involved precipitation with polyethyleneglycol, ion exchange chromatography on CM 52-cellulose, gel-filtration on Sephadex G 200, elution from a Con A-Sepharose column, and finally ion exchange chromatography on a DE 52-cellulose column. 2.8 mg of factor B was purified from 100 ml of chicken plasma with a yield of 28%. Purity was high as judged from crossed immunoelectrophoresis, SDS-PAGE, and from immunizations of rabbits with the factor B preparation. The purification gave preliminary indications that chicken factor B is a glycoprotein with beta mobility and with a molecular weight around 95 Kd. PMID- 3646827 TI - Raised fecal fat concentration is not a valid indicator of pancreatic steatorrhea. AB - The hypothesis that fecal fat concentration (FFC; g fat/100 g wet stool weight) should be higher in pancreatic steatorrhea than in steatorrhea due to gastrointestinal disease was investigated. Fecal weight and fat excretion were measured in 59 patients with pancreatic steatorrhea and in 53 patients with nonpancreatic steatorrhea. A further 42 patients were studied who had normal fecal fat excretion but exocrine pancreatic insufficiency proven by a secretin pancreozymin test along with 31 patients with well-defined gastrointestinal disease but without steatorrhea. The control group consisted of 184 subjects without evidence for malabsorption. FFC was significantly higher in patients with pancreatic compared to those with nonpancreatic steatorrhea. However, because of the almost identical concentrations in patients with steatorrhea due to celiac sprue (FFC 10.5 +/- 4.3%, mean +/- SD) and those with pancreatic steatorrhea (FFC 11.5 +/- 4.7%), FFC was of no value for the differential diagnosis between pancreatic and nonpancreatic steatorrhea. PMID- 3646828 TI - Risk factors for AIDS and HIV seropositivity in homosexual men. AB - The authors compared cases of acquired immunodeficiency syndrome (AIDS) diagnosed in San Francisco, California, during 1983-1984 with human immuno-deficiency virus (HIV) antibody-negative neighborhood and clinic controls, looking for risk factors for clinical AIDS. They also compared antibody-positive with antibody negative neighborhood and clinic controls for risk factors for HIV infection. Odds ratios were 52.0 for AIDs and 7.8 for seropositivity for more than 100 sexual partners versus 0-5 partners when antibody-negative neighborhood controls were compared with cases and with antibody-positive neighborhood controls, respectively. Odds ratios were only 2.9 and 3.4 when antibody-negative clinic controls were compared with cases and with antibody-positive clinic controls, respectively. Odds ratios of 4.6-7.3 for rectal receptivity with most or all partners versus none or one partner were statistically significant, independent of the number of partners. Douching before sex was independently associated with odds ratios of 2.2-2.8. There was no evidence for oral-genital, oral-anal, or other sexual transmission of AIDS. In multivariate analysis, independent odds ratios of 2.4-6.0 for prior syphilis and 10.8-27.9 for prior giardiasis were statistically significant or marginally significant in all comparisons. There was a moderate association with nitrite use. No other drugs were consistently associated with clinical AIDS or HIV seropositivity. Odds ratios associated with AIDS and seropositivity were closely comparable except for number of partners. PMID- 3646829 TI - Overview of preclinical studies with ciprofloxacin. AB - Ciprofloxacin is a new 6-fluoro-7-piperazino-4-quinolone that is highly active against a broad array of microbial pathogens. Minimal inhibitory concentrations (MICs) of ciprofloxacin are generally below 0.5 micrograms/ml for Hemophilus, Neisseria, and Enterobacteriaceae and are 1.0 microgram/ml or less for many non fermentative gram-negative bacteria. Most staphylococci, including strains resistant to methicillin, are inhibited by 1.0 microgram/ml or less of ciprofloxacin, whereas streptococci are somewhat less susceptible. Obligate anaerobes are generally not susceptible to ciprofloxacin at concentrations below 1.0 microgram/ml. The antimicrobial potency of ciprofloxacin is twofold to fourfold greater than that of norfloxacin and is considerably greater than that of cephalosporins and aminoglycosides in tests with most gram-negative bacteria. Factors diminishing the in vitro activity of ciprofloxacin include acidic pH, high levels of magnesium ions, and an inoculum size of 10(7) colony-forming units/ml or greater. Ciprofloxacin is bactericidal at concentrations near its MIC for most bacteria. In vivo tests with experimentally induced infections in animals confirm the potency of ciprofloxacin. Doses required to protect 50 percent of animals from death are generally less than 2.0 mg/kg for gram-negative infections and range from 0.7 to 7.0 mg/kg for staphylococcal infections. The antimicrobial spectrum and potency of ciprofloxacin demonstrated in these preclinical studies make this quinolone a promising new antimicrobial agent. PMID- 3646830 TI - Malignant melanoma in a homosexual man with HTLV-III/LAV exposure. AB - An HTLV-III/LAV antibody-positive homosexual man in whom disseminated malignant melanoma developed is described. Immunologic analysis revealed an increase in suppressor/cytotoxic phenotype (Leu-2-positive) T cells, depressed proliferative response to mitogens, decreased proportions of T cells with interleukin-2 receptors but normal production of both interleukin-2 and interleukin-1, cutaneous anergy, elevated levels of serum IgG and IgA, and presence of autoantibodies against smooth muscle and parietal cells of the stomach. This case stresses the need for reporting all types of neoplasms associated with exposure to HTLV-III/LAV so that their true incidence in the population "at risk" for the acquired immune deficiency syndrome can be determined. PMID- 3646831 TI - When is AV sequential pacing used? PMID- 3646832 TI - The fragile survivor. PMID- 3646833 TI - A word of caution on implantable delivery systems. PMID- 3646834 TI - California nurses unite to fight AIDS. PMID- 3646835 TI - Clarification on the reuse of disposables. PMID- 3646837 TI - Easing the transfer from CCU. PMID- 3646836 TI - Crack. PMID- 3646838 TI - Managing manic behavior. PMID- 3646839 TI - The inventive nurse. PMID- 3646840 TI - Cataract care made plain. PMID- 3646841 TI - A celebration. PMID- 3646842 TI - Teaching your patients to assert their rights. PMID- 3646843 TI - AJN JobFocus: scoop on the Southeast. PMID- 3646844 TI - Pain perception vs. pain response in burn patients. PMID- 3646845 TI - Whose ICU is this, anyway? PMID- 3646846 TI - Let's create diagnoses psych nurses can use. PMID- 3646847 TI - Crushed corsages and muffled thanks. PMID- 3646850 TI - Credentialing in nursing: contemporary developments and trends. The 1979 study of credentialing in nursing recommendations: where are we now? PMID- 3646848 TI - The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86. AB - The prevalence and incidence of infection by the human immunodeficiency virus (HIV) has been under study in a cohort of 1,034 single men recruited by area probability sampling from a six kilometer square area of San Francisco where the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Prevalence of infection among homosexual/bisexual study subjects increased from an estimated 22.8 per cent during the last half of 1982 to 48.6 per cent during the period July through December 1984. During three subsequent six-month periods, prevalence remained stable at approximately 50 per cent. Annual infection rates, measured by seroconversion among seronegative study subjects, decreased from an estimated 18.4 per cent per year from 1982 to 1984, to 5.4 and 3.1 per cent during the first and second halves of 1985, and to 4.2 per cent during the first six months of 1986. These declines were associated with reductions of 60 per cent or more in the prevalence of high-risk sexual practices associated with both acquiring and disseminating infection by the human immunodeficiency virus. PMID- 3646849 TI - [PMN elastase in extracorporeal circulation procedures]. AB - Proteolytic enzymes released by polymorphonuclear neutrophils are assumed to be important mediators in the development of shock-induced and sepsis-induced organ failure, especially of ARDS. The most remarkable of these enzymes is elastase because of its relatively high intracellular concentration and low substrate specificity. The release of elastase can be monitored by measuring the plasma concentration of elastase-proteinase inhibitor complex. In this study, the elastase concentration pointed towards side effects of methods of extracorporeal circulation. The elastase concentration rose more than sixfold in 20 patients during membrane oxygenation (mean time 124 min) and 15 patients during bubble oxygenation (mean time 77 min). We found that the elastase concentration was affected by the kind of foreign material surface, the time of perfusion and the perfusion volume. The comparison of in-vitro and in-vivo circulation underlines the importance of the terminal capillary bed (in the lung) and of a pre-existent activation of leukocytes, since elastase levels rose only insignificantly during in-vitro recirculation. These results confirm that extracorporeal circulation seems to be able to induce harmful disturbances of the ARDS type. This fact should be taken into consideration when using methods of extracorporeal gas exchange. PMID- 3646851 TI - Access to prenatal care: key to preventing low birthweight. PMID- 3646852 TI - Affinophoresis in two-dimensional agarose gel electrophoresis: specific separation of biomolecules by a moving affinity ligand. AB - Affinophoresis is an electrophoretic separation technique for biomolecules which uses an affinophore. An affinophore is a macromolecular polyelectrolyte bearing affinity ligands. It migrates rapidly in an electric field, and consequently the electrophoretic mobility of molecules having affinity for the ligand is specifically changed. This technique has now been incorporated in two-dimensional agarose gel electrophoresis in a procedure which utilizes normal electrophoresis in the first dimension and affinophoresis in the second dimension. Proteins which do not have affinity for the ligand migrate to locations along a diagonal line passing through the origin, whereas proteins which have affinity are carried away from the line by the affinophore. Accordingly, molecules having affinity for the ligand can be readily assigned. Trypsins contained in Pronase and pancreatin were separated by this procedure using an affinophore bearing a competitive inhibitor for trypsin, benzamidine, on a polyanionic molecule (a polyacrylic acid derivative). PMID- 3646853 TI - Effect of the anticodon loop size of yeast alanyl tRNA on its biological activity. AB - Three analogs of yeast alanyl tRNA with anticodon loops of different sizes, tRNA75 (no G35 and 5'-terminal phosphate), tRNA77 (one more C between G35 and C36, no 5'-terminal phosphate), and ptRNA79 (with Cm1I psi between G35 and C36), were synthesized. In comparison with the reconstituted natural yeast tRNA, the charging activities of the three analogs were 90% (tRNA75), 94.7% (tRNA77), and 104% (ptRNA79). These results supported the conclusion (Yang De-ping and Wang De bao (T. P. Wang) (1983) Acta Biochim. Biophys. Sin. 15, 83-90) that the anticodon loop of yeast alanyl tRNA was not involved in the interaction between alanyl-tRNA synthetase from rat liver and yeast alanyl tRNA. In contrast, in the rabbit reticulocyte lysate system, the incorporation of alanine in the charged analogs was 0% (tRNA75 and ptRNA79) and 100% (tRNA77). There were significant differences between the incorporation activities of analogs and those of the reconstituted molecule. The reason for these differences is discussed. PMID- 3646854 TI - Purification of individual tRNAs using a monoclonal anti-AMP antibody affinity column. AB - A murine monoclonal anti-AMP antibody affinity matrix was used for isolation of individual species of amino acid transfer nucleic acids (tRNAs). The antibodies had been prepared using 5'-AMP covalently attached to bovine serum albumin as antigen and exhibited high affinity for 5'-AMP but greatly reduced affinity for 3'-AMP. Native uncharged tRNAs that terminate in a 5'-AMP group on the amino acid acceptor arm of the molecule bind tightly to the anti-AMP affinity matrix, whereas aminoacylated tRNAs are not retained. This allows separation of a particular tRNA species as its aminoacyl derivative from a complex mixture of uncharged tRNAs under very mild conditions. PMID- 3646855 TI - Prevention of infection during major construction and renovation in the surgery department of a large hospital. PMID- 3646856 TI - Routine surveillance for infections in nursing homes: experience at two facilities. AB - Because the feasibility and usefulness of routine surveillance for infections in nursing homes has been questioned, we reviewed the elements of infection surveillance programs developed by two nursing homes using existing personnel. Although infection definitions and data collection methods differed between the two homes, both homes identified urinary and respiratory tract infections as the major endemic problems at their institutions and demonstrated important clusters of gastrointestinal tract and eye infections. Surveillance data were used to identify individual patients who required follow-up by physicians, to justify special infection control measures for clusters of gastrointestinal tract and eye infections, and to provide the basis for in-service education in infection control. Routine surveillance for infections is both feasible and an integral and valuable part of overall infection control programs at two large Maryland nursing homes. PMID- 3646857 TI - Surgical wound infections documented after hospital discharge. AB - Shorter lengths of hospitalization may result in more surgical wound infections being documented after hospital discharge. The current investigation analyzed 1644 surgical procedures performed over a 3-month period, and documented surgical wound infections both before and for 1 month after hospital discharge. Physician and patient questionnaires were used. One hundred eight infections were noted, of which 50 (46%) were seen after hospital discharge by either the patient or the surgeon. Rates of infection were 5.2%, 7.5%, and 7.5% for clean, clean contaminated, and contaminated-dirty categories, respectively. Had postdischarge surveillance not been used, rates would have appeared to be 2.5%, 6.5%, and 6.8% for the same surgical classes. Infections following clean and clean-contaminated procedures were more likely to be noticed after hospital discharge. Excluding those that were patient-documented, wound infection rates would have been 4.2% (clean), 6.3% (clean-contaminated) and 6.8% (contaminated-dirty). Postdischarge surveillance is imperative to meaningfully document true rates of surgical wound infection, inasmuch as increasing numbers are likely to occur only after patients leave the hospital. PMID- 3646858 TI - Airborne contamination associated with in-use air-fluidized beds: a descriptive study. PMID- 3646859 TI - Pseudoepidemic of salmonellosis in a nursery: importance of isolate serotyping. PMID- 3646861 TI - Standards needed to improve home care quality. PMID- 3646862 TI - Leaders converse about SNA membership question. PMID- 3646860 TI - Nurse practitioners to lose liability insurance coverage. PMID- 3646863 TI - Parish nurses meet health, spiritual needs in Chicago. PMID- 3646864 TI - Will ANA Federation move from mission to action? PMID- 3646865 TI - La dolce volce. PMID- 3646866 TI - As I see it--officials say dues proposal is 'survival strategy'. PMID- 3646867 TI - Neutrophil recruitment and degranulation during induction of emphysema in the rat by nitrogen dioxide. AB - Rats exposed to 30 ppm NO2 continuously for 3 to 6 wk developed mild centriacinar air-space enlargement and mild interstitial fibrosis. The emphysematous changes did not become more severe after 6 wk with continued NO2 exposure for as long as 14 additional weeks. Elastase inhibitory capacity (EIC) and the total protein concentration increased acutely in lung lavage fluid, consistent with the histologic evidence of pulmonary edema, then subsided but remained above control levels for the entire exposure period. The ratio of EIC to total protein remained unchanged relative to that in control animals. Neutrophils accumulated in the lung and were recoverable by lavage with the same relative concentration profile as observed for total protein. The average elastase activity per neutrophil in cells recovered from the air space by lung lavage was 60% less than in cells recovered from peripheral blood. This was true for control or NO2-exposed rats. Thus, emphysematous changes in the NO2-exposed rat were accompanied by a marked neutrophil recruitment concomitant with an increased neutrophil elastase burden in the lung, which may have directly contributed to lesion development. PMID- 3646868 TI - Isolation of the human immunodeficiency virus from cervical secretions during menses. PMID- 3646869 TI - Inactivation of human T-lymphotropic virus type III/lymphadenopathy-associated virus by formaldehyde-based reagents. AB - Neutral buffered Formalin, a fixative used in most pathology laboratories, was found to inactivate human T-lymphotropic virus type III/lymphadenopathy associated virus. Preparations containing this virus with infectivity titers of greater than 10(5) were treated with 1% or greater neutral buffered Formalin; after treatment, virus was undetectable (titer, less than 10(1)). In addition, when infected phytohemagglutinin-stimulated lymphocytes were treated with paraformaldehyde, transmission of the virus to other such lymphocytes was eliminated. PMID- 3646870 TI - Properties of the enzymes catalyzing the biosynthesis of lysophosphatidate and its ether analog in cultured fibroblasts from Zellweger syndrome patients and normal controls. AB - The activities, properties, and steady-state kinetics of the five enzymes catalyzing the synthesis of 1-acyl- and 1-alkyl-sn-glycerol 3-phosphate in the cultured skin fibroblasts from Zellweger syndrome patients and normal controls were studied in detail. Judging from their Km and Vmax values, glycerol phosphate acyltransferase (EC 2.3.1.15), acyl/alkyl dihydroxyacetone phosphate reductase (EC 1.1.1.101), and acyl coenzyme A reductase (long-chain alcohol forming), appear to be affected only slightly by the absence of peroxisomes characteristic of the Zellweger syndrome. Glycerophosphate acyltransferase also showed no differences in N-ethylmaleimide sensitivity nor in inhibition by dihydroxyacetone phosphate between these cell types. Dihydroxyacetone phosphate acyltransferase (EC 2.3.1.42) and alkyl dihydroxyacetone phosphate synthase (EC 2.5.1.26) have altered activity and kinetic constants in homogenates from Zellweger syndrome fibroblasts. Dihydroxyacetone phosphate acyltransferase has similar Km (DHAP) values in both control and Zellweger syndrome cells; however, the value for the Vmax in Zellweger syndrome cells is only 6% of that found in the controls. This is interpreted as indicating that this enzyme is not defective in this disease but is simply present at a depressed level. Also, this enzyme activity has a maximum rate at pH 7.0-7.5 in the mutant cells as opposed to pH 5.4 in the controls. Acylation of dihydroxyacetone phosphate by control cell homogenate was stimulated by N-ethylmaleimide at both pH 5.7 and 7.5 whereas this activity from Zellweger syndrome cells was slightly inhibited at pH 5.7 and strongly inhibited at pH 7.5. In the absence of detergent, dihydroxyacetone phosphate acyltransferase in the Zellweger syndrome cells was much more labile to trypsin than in the control cells. Alkyl dihydroxyacetone phosphate synthase had a slightly higher Km (33 vs 17 microM) for palmitoyl dihydroxyacetone phosphate and a lower Vmax (0.07 vs 0.24 mU/mg protein) in the Zellweger syndrome cells as compared to controls. Although this is a substantial decrease in activity, it probably contributes little to the decreased rate of ether lipid synthesis in these cells. The major problem in this respect is apparently the loss of dihydroxyacetone phosphate acyltransferase activity. All of these enzymes, in both control and Zellweger syndrome cell homogenates, are sedimentable by centrifugation at 100,000g. Also, with the exception of dihydroxyacetone phosphate acyltransferase they had similar patterns of inactivation by heat in both cell types. PMID- 3646872 TI - Adaptations for the Dornier ESWL support system. PMID- 3646871 TI - Nursing care of the infant with bladder exstrophy. PMID- 3646873 TI - Positioning the patient for bilateral extracorporeal shock wave lithotripsy. PMID- 3646874 TI - The ABUAHP: what is it? Who is it? What is it all about. PMID- 3646876 TI - Yag:Nd 8000 laser--effective methods of storage and disinfection. PMID- 3646875 TI - Genital infections with Chlamydia trachomatis. PMID- 3646878 TI - Physical examination program: an expanded role of the occupational health nurse at Raytheon Company. PMID- 3646877 TI - Substance abuse testing in the workplace: a review. PMID- 3646879 TI - Health promotion: an overview for the workplace (continuing education credit). PMID- 3646880 TI - Ethical issues in health promotion and health education (continuing education credit). PMID- 3646881 TI - Problems in worksite health promotion: the perspective of small business (continuing education credit). PMID- 3646883 TI - The female worker and physically demanding work. PMID- 3646882 TI - Return to Jamaica. PMID- 3646884 TI - Blindness prevention. PMID- 3646885 TI - Health promotion in a single-nurse unit (continuing education credit). PMID- 3646886 TI - Pregnancy and birth after cesarean section: a survey based on the Swedish birth register. PMID- 3646887 TI - Outcomes and procedures in low risk birth: a comparison of hospital and birth center settings. PMID- 3646888 TI - Infant formula: a mass, uncontrolled trial in perinatal care. PMID- 3646889 TI - The hut and the hospital: information, power, and symbolism in the artifacts of birth. PMID- 3646891 TI - Hospice in the mainstream: integrating hospice into the health care delivery system. PMID- 3646890 TI - A comparison of the effectiveness of two methods of nipple care. PMID- 3646893 TI - Hospice at the crossroads: the physician director. PMID- 3646892 TI - The acquired immunodeficiency syndrome (AIDS). PMID- 3646894 TI - Views of the deepening shade: psychological aspects of life-threatening illness. PMID- 3646895 TI - Xerostomia in the oncologic patient: combating complications of treatment. PMID- 3646896 TI - Organizational and operational characteristics of hospice programs in Iowa: considering the future with a look at the present. PMID- 3646897 TI - Is hospice care in conflict with Jewish values? Finding a common ground for the Jewish community. PMID- 3646898 TI - Parental coping with a child with myelomeningocele. PMID- 3646900 TI - Patient and family education; a key component of neuroscience nursing. PMID- 3646899 TI - Neurological complications in acquired immune deficiency syndrome. PMID- 3646901 TI - [Mechano-chemical properties of actomyosin-ADP complexes in rabbit psoas muscle fibers]. AB - The relaxing effect of vanadate on active contractile system is found to be completely absent from rigor skinned fibres with ADP even on their stretching up to the forces comparable with the active ones, though vanadate is likely to bind not very firmly with crossbridges not containing inorganic phosphate. Probable reasons of such distinction are considered. The complex actomyosin-ADP in the rigor fibres is supposed to have significantly lower free energy independently of its deformation than the one of the same composition in the active ones. Possible role of different actomyosin-ADP states in the mechanochemical cycle of crossbridge is discussed. PMID- 3646902 TI - Enhancement of lung conditioning by acetylcholine in the prevention of respiratory distress syndrome in the preterm fetal lamb. AB - We exposed 128- to 130-day-gestation fetal lambs by cesarean section leaving the umbilical cord and placenta undisturbed, and we then treated the lungs with pulmonary conditioning (i.e., repeated prolonged inflations to 35 cm H2O, followed by a continuous positive airway pressure of 15 cm H2O). To investigate the added effect of pulmonary vasodilation upon the increase of total compliance and pulmonary oxygen uptake, we also administered acetylcholine intravenously at a rate of 80 micrograms min-1. Eleven of 13 lambs met the endpoint criteria of either compliance (0.5 ml [cm H2O]-1 kg-1; 1 animal), or pulmonary oxygen uptake (6 ml kg-1 min-1; 6 animals), or both (4 animals), and were delivered within 0.6 +/- 0.3 h. This time was significantly (p less than 0.05) shorter than previously seen in similar studies without the infusion of a vasodilator; all animals so delivered survived 24 h of mechanical ventilation in excellent health. We suggest that pharmacologic pulmonary vasodilation, in addition to deep sustained pulmonary insufflation and distension, is an effective and rapid means of transforming stiff immature lungs into lungs that can sustain normal ventilation and gas exchange. PMID- 3646904 TI - Managing computer resistance. PMID- 3646903 TI - The Venice Hospital forms construction program. PMID- 3646905 TI - Lotus 1-2-3. A quality assurance application for nursing practice, administration, and staff development. PMID- 3646906 TI - Continuing education and computerization. Experience of a State Board of Nursing. PMID- 3646907 TI - Coordinating continuing education via computer. PMID- 3646908 TI - Hours of direct nursing care. Assessing baseline data for an automated system. PMID- 3646909 TI - The clinically focused descriptive study. A method of graphic summary of complex observational data. PMID- 3646910 TI - Guidelines for creating test question banks. PMID- 3646911 TI - A day in the life of a computer-using nursing instructor: 1990. PMID- 3646912 TI - Conflicting convictions: nurses in forensic settings. PMID- 3646913 TI - Psychiatric treatment programs for adolescents. PMID- 3646914 TI - Primary prevention in a Northern Ontario boomtown--the ripple effect. PMID- 3646915 TI - The breast physical examination. Its value in early cancer detection. PMID- 3646916 TI - Informational needs of recently diagnosed cancer patients. A theoretical framework. Part I. PMID- 3646917 TI - Hickman catheter care. Developing organized teaching strategies. PMID- 3646918 TI - Incidence and characteristics of pain in a sample of hospitalized cancer patients. PMID- 3646919 TI - Indoor tanning. The nurse's role in preventing skin damage. PMID- 3646920 TI - [Nursing care of patients with hemorrhagic necrotizing pancreatitis treated by the "dish-opening" procedure]. PMID- 3646921 TI - [Care of reinfusing blood in patients after traumatic hemothorax]. PMID- 3646922 TI - [Care of patients with tibia and fibula fractures treated with the external reduction fixator]. PMID- 3646924 TI - [Care of patients with cardiopulmonary diseases treated by isovolume blood dilution therapy]. PMID- 3646923 TI - [Nursing care of patients with polyp electrocautery]. PMID- 3646925 TI - [Dietary nursing for post-operative patients]. PMID- 3646927 TI - [Hepatic artery embolization and its nursing care]. PMID- 3646926 TI - [Observations and nursing of diphtheria patients]. PMID- 3646928 TI - [Measurement of evaporation in burn wounds]. PMID- 3646929 TI - [Management of primary nursing care and nursing morality]. PMID- 3646930 TI - [Superiority of primary nursing--experiences in nursing care of 120 patients with coma combined with paraplegia]. PMID- 3646931 TI - [Nursing of patients in a pressurized cabin]. PMID- 3646932 TI - [Care of patients undergoing transplantation of the greater omentum pedicle to the spinal cord]. PMID- 3646933 TI - [Care of patients with cicatricial stricture of the pharynx and esophagus treated by pharyngo-gastro anastomosis]. PMID- 3646934 TI - [Care of patients with lithotomy via the renal parenchyma by transpelvic cold irrigation]. PMID- 3646935 TI - [Experience in training teachers of traditional Chinese medicine in nursing]. PMID- 3646936 TI - [Definition of psychiatry--establishment of scientific psychiatry]. PMID- 3646938 TI - [Psychocybernetics and nursing--in search of a more meaningful encounter with patients (8)]. PMID- 3646937 TI - [Conditions for channeling actions into nursing--a proposal of a new model]. PMID- 3646939 TI - [Learning from work--my method of self-enlightenment (5)]. PMID- 3646940 TI - [Scenes of interactions with a male patient with a spinal cord injury and paralysis of the lower half of the body: use of student's report in nursing studies]. PMID- 3646941 TI - Dilemmas in infectious diseases. PMID- 3646942 TI - Measurement of lung density by x-ray computed tomography. Relation to lung mechanics in workers exposed to asbestos cement. AB - We measured lung density by means of x-ray computed tomography and lung mechanics in 33 workers exposed to asbestos cement and in 39 normal subjects. The exposed group showed evidence of lung fibrosis with reduced static lung volumes and lung compliance, although only three subjects had signs of interstitial fibrosis at standard chest radiography. Lung density was significantly increased in the exposed workers compared to control subjects, with greater differences between nonsmokers than between smokers. Lung density correlated inversely with static lung volumes. There was no appreciable difference in the regional distribution of lung density between exposed workers and control subjects. We conclude that lung density is often increased in workers with mild asbestosis, even in the presence of a normal chest radiograph. Measurement of lung density may be of value in the evaluation of asbestos-exposed workers for assessment of the extent of parenchymal disease. PMID- 3646943 TI - Characterization of pancreatic elastase II cDNAs: two elastase II mRNAs are expressed in human pancreas. AB - The primary structures of porcine and human pancreatic elastase II precursors were elucidated by molecular cloning and cDNA sequence analysis. The sequences of the cDNAs cloned from a human pancreatic cDNA library indicate that at least two elastases II are expressed in this tissue. These two human elastases II have been designated elastases IIA and IIB. All the cDNA sequences obtained, including porcine elastase II cDNA, reveal that elastase II is synthesized as a preproenzyme of 269 amino acids, including a predicted signal peptide of 16 amino acids and a predicted activation peptide of 12 amino acids. Human elastase IIA contains the published amino-terminal sequence (16 residues) for human pancreatic proelastase II, whereas elastase IIB shares 50% homology with the published 16 residue sequence. However, there is 90% homology between the overall amino acid sequences of elastases IIA and IIB. Blot hybridization analysis of the poly adenylated RNAs isolated from various human tissues demonstrates that the human elastase II mRNAs are specifically detected in the pancreas. PMID- 3646944 TI - Diabetic peripheral neuropathy. Part II. Autonomic neuropathies (continuing education credit). PMID- 3646945 TI - Increasing the utilization of outpatient diabetes education programs. PMID- 3646946 TI - Diabetological education in Latin America. PMID- 3646947 TI - Nurses' expectations and the realities of multidisciplinary education. PMID- 3646948 TI - The prevention of plantar ulceration in the diabetic foot through the use of running shoes. PMID- 3646949 TI - Filling the gaps between patients and professionals. PMID- 3646951 TI - Diabetes nutritional management: a need for meal planning alternatives. PMID- 3646950 TI - The research process. PMID- 3646952 TI - A team approach: coping with neuropathy, the forgotten complication. PMID- 3646954 TI - Certification: questions and concerns. PMID- 3646953 TI - The New Zealand pharmacist. PMID- 3646955 TI - Nutrient intake of young adult women with diabetes mellitus. PMID- 3646956 TI - Certification: progress and prospects for diabetes educators. The National Certification Board for Diabetes Educators. PMID- 3646957 TI - Resource manual to help your program meet the national standards. PMID- 3646958 TI - Computer-assisted management of weight, diet, and exercise in the treatment of Type II diabetes. PMID- 3646959 TI - [Psychiatric manifestations and HIV infection. Apropos of a case]. AB - Psychiatric symptoms in AIDS have been noted in the literature. The case report of a young man with HIV showing psychotic features is presented. The course of the illness points to a possible schizophrenia incipiens. This raises two issues: the neurotropic potential of the virus and its involvement in the occurrence of these psychiatric troubles. PMID- 3646960 TI - Effect of low-level NO2 chronic exposure on elastase-induced emphysema. AB - The effect of chronic exposure to 2 ppm nitrogen dioxide (NO2) for 8 hr a day, 5 days a week, for 8 weeks was assessed in normal and emphysematous hamsters by measuring (1) lung morphometry (mean linear intercept [Lm] and internal surface area [ISA]), (2) lung mechanics (lung volume, compliance and coefficient of static deflation, pressure-volume curve fitted to an exponential equation), and (3) serum elastolytic activity and protease inhibitor capacity. Emphysema was induced by a single intratracheal injection of 6 IU porcine pancreatic elastase. Four groups of animals were used; Control, NO2-exposed, elastase-treated, and NO2 exposed postelastase. Our results show that NO2 exposure alone induced mild emphysematous lesions whose degree of severity estimated by morphometry increase in Lm and decrease in ISA. P less than 0.01) was of the same order as that of the lesions induced by 6 IU elastase. Exposure to 2 ppm NO2 enhanced elastase-induced emphysema (further increased Lm and further reduced ISA. P less than 0.01). By contrast, study of lung mechanics revealed no difference between the control and NO2-exposed groups or between the elastase-treated animals exposed to NO2 and those not so exposed. This apparent discrepancy between results of morphometry and lung mechanics may be due to the lower sensitivity of lung mechanics parameters and their consequent inability to reflect changes in the emphysematous lesions induced by elastase injection or 2 ppm NO2 inhalation. In vivo, serum elastolytic activity and protease inhibitor capacity were not modified in any group, indicating that either serum does not reflect the degree of protease inhibitor capacity in the alveolar spaces or chronic inhalation of low concentrations of NO2 is not sufficient to cause elastase/antielastase imbalance. Lastly, our results suggest that chronic exposure to 2 ppm NO2 may cause individuals with inherited or acquired emphysematous lesions to develop more severe emphysema. PMID- 3646961 TI - [Epidemiology and prevention of tularemia]. PMID- 3646962 TI - [The biological mechanism of labor]. PMID- 3646963 TI - [Clinical picture and diagnosis of hypertension]. PMID- 3646964 TI - [Hypertension in elderly people]. PMID- 3646965 TI - [Poisoning by organophosphorus compounds]. PMID- 3646966 TI - [The alcoholism problem in World Health Organization publications]. PMID- 3646967 TI - [Health education on the 70th anniversary of the Great October Revolution]. PMID- 3646968 TI - [First aid in fractures of the extremities (materials for a talk)]. PMID- 3646969 TI - [Role of Chlamydia in diseases of the urogenital organs]. PMID- 3646970 TI - [Iodine-bromine baths]. PMID- 3646971 TI - [Diagnosis of blood coagulation disorders]. PMID- 3646972 TI - [First aid in injuries by poisonous animals. 2]. PMID- 3646975 TI - Baths, bowels, and books. PMID- 3646974 TI - [Function of the kallikrein-kinin system and of the blood antiproteinase activity in rats exposed to a weak low-frequency magnetic field]. PMID- 3646973 TI - [Acquired immunodeficiency syndrome]. PMID- 3646976 TI - Bridging the information gap. PMID- 3646977 TI - Bill--a care study in dementia. PMID- 3646979 TI - Discharge planning--whose responsibility? PMID- 3646978 TI - Assessing incontinence. PMID- 3646980 TI - Developing services of excellence. PMID- 3646981 TI - CLINITRON Therapy: is it effective? PMID- 3646982 TI - Preparation of geriatric aides for patient care and certification. PMID- 3646983 TI - Diet and diabetes. One nursing home's approach. PMID- 3646984 TI - The camera as a nursing tool. PMID- 3646985 TI - Translating a nursing theory into a nursing system. PMID- 3646986 TI - Exercise and chronic heart disease? PMID- 3646987 TI - Breakfast: off to a good start. PMID- 3646988 TI - 70+ and going strong. Frederick O'Neal--a pioneer in American theatre. PMID- 3646989 TI - The placebo effect. Real or imaginary? PMID- 3646990 TI - AIDS and prevalence of antibody to human immunodeficiency virus (HIV) in high risk groups in Thailand. AB - Since September 1984, six cases of acquired immune deficiency syndrome (AIDS) and 11 cases of AIDS related complex (ARC) have been reported in Thailand. All people with AIDS were homosexual or bisexual men; two were Thai and the rest were European or American. Nine of the 11 people with ARC were homosexual or bisexual men, one was the female sexual partner of a man with AIDS, and one was a Thai man who had lived in the United States of America for several years, but denied having had any homosexual contact. Nine of the 11 people with ARC were Thai. In a survey in April 1985 at a resort area near Bangkok, antibodies to human immunodeficiency virus (HIV) (confirmed by western blot) were detected in 2.4% of 127 homosexual men and none of 77 female prostitutes. In a more extensive survey in October 1985, antibodies were detected in 0.8% of 720 homosexual men, but none of 2880 female prostitutes or 309 sexually active heterosexual men. HIV has been introduced into Thailand primarily by homosexual transmission. The public health policy of Thailand concerning AIDS is discussed. PMID- 3646992 TI - Differential chromosomal radiosensitivity between male and female following X irradiation at G2. PMID- 3646991 TI - Effect of histamine on the gene expression and biosynthesis of complement components C2, factor B and C3 in mouse peritoneal macrophages. AB - The gene expression and biosynthesis of C2, factor B and C3 have been investigated in vitro in mouse resident peritoneal macrophages after incubation with histamine. C2- and factor B-specific mRNA and the amount of the immunoprecipitated C2 and factor B were decreased by 10(-4) M and 10(-8) M histamine. These effects can be abrogated by the H2 antagonist cimetidine and mimicked by the H2 agonists impromidine and 4-methylhistamine. Since the H1 antagonist chlorpheniramine and the H1 agonists PEA and 2-methylhistamine have little effect on C2 and are ineffective on factor B, a strong H2 receptor dependence of the inhibition of C2 and factor B gene expression and biosynthesis is suggested. Conversely, the C3 gene expression and biosynthesis can be influenced through both H1 and H2 receptors, e.g. elevated by histamine + cimetidine, PEA and 2-methylhistamine through H1 receptors, and inhibited by histamine + chlorpheniramine, impromidine and 4-methylhistamine through H2 receptors. The data obtained by quantification of C2, factor B and C3 mRNA concentration of peritoneal macrophages suggest that the regulation of biosynthesis of these complement components by histamine in mouse peritoneal macrophages is under pretranslational control. PMID- 3646993 TI - In vitro effects of ampicillin and streptomycin combination against ampicillin resistant bacteria. PMID- 3646994 TI - Effect of feeding induced milk on body growth of immature mice. PMID- 3646995 TI - Epidemiologic methods in acute respiratory infections. PMID- 3646997 TI - The newly hired hospital staff nurse's professionalism, satisfaction and alienation. AB - In a previously reported panel study [Speedling et al. (1981). Int. J. Nurs. Stud. 18, 217-225], 180 Registered Nurses, three-quarters new graduates, were given questionnaires at time of hire and a year later. Using the panel study data, relationships among bureaucratic-professional role conception, actual situation and role discrepancy, and importance of job factors, job satisfaction and alienation, as well as age and length of stay at termination for time of hire only, are explored in this follow-up report. Mean bureaucratic actual situation (t = -5.18, P less than 0.001), bureaucratic role discrepancy (t = -2.77, P less than 0.01) and alienation (t = -2.36, P less than 0.05) increased, while professional actual situation (t = 3.39, P less than 0.01) and importance of job factors (t = 2.33, P less than 0.05) decreased during this first year of employment. In correlational analysis, at the time of hiring relationships were found between numerous variables, including: bureaucratic role conception with alienation (r = 0.17, P less than 0.05); bureaucratic actual situation with alienation (r = 0.19, P less than 0.05); professional role conception with alienation (r = -0.20, P less than 0.05) and with job satisfaction (r = -0.35, P less than 0.001); professional actual situation with job satisfaction (r = -0.19, P less than 0.05); and professional role discrepancy with job satisfaction (r = 0.23, P less than 0.01). A year after hiring, many relationships were found, including professional actual situation with job satisfaction (r = 0.26, P less than 0.05) and alienation with job satisfaction (r = -0.33, P less than 0.01). In stepwise regression analysis, age accounted for 8% of the variance in the importance of job factors (P less than 0.05), professional role conception for 28% of the variance in job satisfaction (P less than 0.001) at time of hire. A year after hiring, alienation and job satisfaction accounted for 12% of the variance in each other (P less than 0.01). As in the correlational analysis, there were many relationships among the bureaucratic-professional variables. Professional socialization theory was utilized in this study, helping to clarify the relationships among staff nurse professionalism, satisfaction and alienation. PMID- 3646996 TI - New bacterial vaccines for acute respiratory infections. PMID- 3646998 TI - Nursing the immobile: a preliminary study. AB - Permanent loss of mobility has profound physical and mental consequences for both sufferers and carers, and is a major challenge to the National Health Service. A recent study has shown that 42% of beds in departments of Geriatric Medicine are occupied by people with longstanding immobility. These people are highly dependent on nursing staff for their daily activities and quality of life. The assessment of mobility, as a single parameter of dependency, and the measurement of allocated nursing hours are both rapidly and easily performed on geriatric wards. It is felt that a simple correlation of these two variables might highlight areas where more detailed audit is desirable. This study demonstrates that the more immobile patients on a ward, the less the hours allocated to Registered and Learner grade nurses. Some possible reasons for this are suggested and the effects of this deployment on nursing practice and staff recruitment are discussed. It is felt that provision of appropriate nursing care to the most dependent patients in continuing care areas is essential, and that high levels of trained staff are needed to ensure this. PMID- 3646999 TI - Some determinants of stress in psychiatric nurses. AB - This paper reports the results of an empirical study of psychological stress in nurses employed in a large Special Hospital and caring for mentally disturbed patients who may be a danger to themselves or to others. Such an environment would appear to be dangerous and stressful and the findings of this study show that this sample of nurses do indeed report relatively high levels of stress when compared to some other employed samples. Relationships between psychological distress, anxiety and depression and aspects of their jobs, such as job demands, supports and constraints, are discussed. Individual differences in experiences of stress are also considered. PMID- 3647000 TI - Caregivers' attitudes to and interpretations of the behaviour of severely demented patients during feeding in a patient assignment care system. AB - The feeding of six severely demented patients was changed from a task assignment to a patient assignment care system. Four caregivers participated in the study. Each caregiver fed her patient during 14 meals. Interviews with the caregivers after meal Nos 1, 7 and 14 revealed that this system made them feel more certain about how to interpret the eating behaviour of the patients. They also experienced a more positive attitude to the patient as well as more satisfaction with their work as feeders. PMID- 3647001 TI - A comparative analysis of lay-caring and professional (nursing) caring relationships. AB - Acceptable definitions of the terms care and nursing have yet to be reached. Some may feel that lack of agreement on the meaning of these concepts is a rather esoteric or academic point: the argument put forward in this paper is that until a clearer perception of the concepts of care and nursing is arrived at, the profession will be limited in its ability to develop its expertise or to set standards related to the quality of care. The paper outlines the extent to which these concepts have been explored and details the developments and some of the limitations of present modes of thought. An alternative perspective is offered, based on a comparative analysis of the professional (nursing care) and lay-caring relationships. By this means, a set of characteristics similar in both relationships, has been identified. Quality of care in the professional caring relationship is thought to relate to the extent to which aspects of caring activities implicit in the lay-caring relationship are carried into the professional nurse-patient relationship and made explicit. The ability of the nurse to do this emerges as one aspect of her therapeutic nursing function. PMID- 3647002 TI - Re: The response of nurses towards the management and teaching of patients on continuous ambulatory peritoneal dialysis (CAPD) PMID- 3647003 TI - Assessment of thirst among severely demented patients in the terminal phase of life. Exploratory interviews with ward sisters and enrolled nurses. AB - The dying patients' experience of thirst is an important aspect of his quality of life. The ward sister and an experienced enrolled nurse at 30 geriatric wards in the Southern Health Care Region of Sweden were interviewed about their methods of assessing thirst among severely demented patients in the terminal stage of life. The answers could be classified into six categories: a priori opinion; intuition; identification with the patient; amounts of fluids received; the patient's behaviour; and state of hydration. All the reported methods are problematic. There is a need of development of more valid methods. PMID- 3647005 TI - Infection control in hospitals. PMID- 3647004 TI - Achieving self-care in the ventilator-dependent patient: a critical analysis of a case study. AB - After a 4 month hospitalization, a 41-yr-old woman with multiple sclerosis was discharged to her home with a mechanical ventilator and 24 hr nursing care. The relevance of Orem's Self-Care theory and nursing diagnosis to successful discharge are clearly illustrated through the presentation and analysis of a case study. The compatibility of self-care theory and nursing diagnosis are also discussed. Advancing medical technology and societal mandates for cost containment increasingly confront families with the need to provide sophisticated health care in home settings. Case study analysis not only provides opportunities for clarification and refinement of nursing's role in this developing challenge but also demonstrates the uniqueness and suitability of the nursing discipline for leadership in complex home care management. PMID- 3647006 TI - Confound it! PMID- 3647007 TI - Variation in methicillin-resistant Staphylococcus aureus occurrence by geographic location and hospital characteristics. AB - A survey of 162 Veterans Administration Medical Center (VAMC) laboratories performing antimicrobial susceptibility testing was performed to determine variation in reported rates of methicillin-resistant Staphylococcus aureus (MRSA) isolation by geographic location and hospital characteristics. Of the 162 VAMC laboratories surveyed, 136 (84%) provided usable data. The percentage of S aureus isolates reported as resistant to methicillin ranged from 0% to 52% with a mean value of 10% among the 136 survey respondents. MRSA were isolated in every VA Medical District and 96% of all respondent laboratories reported isolating at least one MRSA isolate during the preceding year. These data are considered an underestimate of the time MRSA rate in the VA system due to the fact that many laboratories failed to follow key methodologic guidelines for optimal detection of MRSA. A positive correlation was found between MRSA isolation rate and several measures of hospital size and activity including total beds, total admissions, and total antimicrobial susceptibility tests performed. Geographic clustering of MRSA isolation was observed with distinct areas of very high and very low percentages of S aureus isolates reported as MRSA. The data suggest that the geographic distribution of MRSA within the VA system should be monitored closely for evidence of spread from areas with high-MRSA rates to areas of mid- or low MRSA rates. Evidence of increased MRSA isolation within these areas may necessitate increased caution in patient referral and transfer patterns within the VA system. PMID- 3647008 TI - AIDS--a perspective of care. AB - As a result of the AIDS epidemic the nursing profession and especially oncology nurses are facing challenges never before encountered, including the need to rethink a number of values and concepts. Nursing has a unique opportunity to prove its worth as a caring profession by successfully meeting these challenges. PMID- 3647009 TI - Principles of transnational co-operation in nursing. AB - Four principles are integral to the successful development and implementation of co-operative transnational nursing projects: adaptation of the project to local and national contexts; operating through the counterpart concept; donor group commitment to the project; and recipient group commitment to the project. The major elements affecting adherence to these principles are described and discussed. PMID- 3647010 TI - Nursing studies at university level in Czechoslovakia. PMID- 3647011 TI - Curricular design and the Betty Neuman Systems Model: a new approach to learning. AB - This paper explores the selection and application of the Betty Neuman Systems Model for the fourth and final year of a generic baccalaureate programme of nursing. Its articulation with content and process, the teaching strategies and learning outcomes for both students and faculty are discussed. PMID- 3647012 TI - Night nursing for trainees: living up to the image. AB - Student nurses working a night shift in a hospital in the north of England were interviewed regarding their experience. While professional gains clearly occurred, personal stresses were more prominent. The problem of idealized image of the night nurse was a major issue. It is suggested that psychological preparation and support of trainees would help them to cope with the adjustments required. PMID- 3647013 TI - Evaluation fo accents amongst health visitor students. PMID- 3647015 TI - Measuring the need for, and the value of, routine health visiting: 1. PMID- 3647014 TI - Professional support and the role of support groups. PMID- 3647016 TI - HVA comments on the discussion document: primary health care--an agenda for discussion. PMID- 3647017 TI - Know your organisations: the National Association for Pastoral Care in Education. PMID- 3647018 TI - Health survey of 13 year olds in Royston. PMID- 3647019 TI - Treatment of the juvenile sex offender. PMID- 3647020 TI - A change in approach. PMID- 3647021 TI - The role of community health nurses in cardiac rehabilitation. PMID- 3647023 TI - Changes in family patterns after a myocardial infarction. PMID- 3647024 TI - Documentation of the side effects of medication. PMID- 3647022 TI - Do MI patients have the information they need for the recovery phase at home? PMID- 3647025 TI - Step write into publishing, Part I. PMID- 3647026 TI - National accreditation: will the home care industry be permitted to regulate itself? PMID- 3647028 TI - The loss that shapes the image. PMID- 3647027 TI - Communication disorders: speech therapy in the home. PMID- 3647029 TI - Preparing for the AIDS patient. PMID- 3647030 TI - Teaching time: the MI client's readiness to learn. PMID- 3647031 TI - The legalities of home care. Suggestions to witnesses. PMID- 3647033 TI - The use of tissue expansion in burn scar reconstruction. PMID- 3647032 TI - The use of tissue expansion in pediatric scalp burn reconstruction. PMID- 3647034 TI - A simple moisture chamber for the early treatment of corneal exposure in patients with facial burns. PMID- 3647035 TI - Development of a patient classification system for burn units--a case study. PMID- 3647036 TI - The price of a beautiful tan: a case report. PMID- 3647037 TI - The possible role of mast cells (allergy) in the production of keloid and hypertrophic scarring. PMID- 3647038 TI - Children should be seen--not hurt. PMID- 3647040 TI - Halo neck splint. PMID- 3647041 TI - Home exercise kit for the shoulder. PMID- 3647039 TI - Elevated/window splint for the burned lower extremity. PMID- 3647042 TI - Burn care protocols: administration of ketamine. Ketamine pharmacology and therapeutics. PMID- 3647043 TI - Burn care protocols: administration of ketamine. PMID- 3647044 TI - Burn care protocols: administration of ketamine. Feature protocol San Francisco General Hospital, San Francisco, California. PMID- 3647045 TI - Burn care protocols: administration of ketamine. Review of feature protocol Shriners Hospital for Crippled Children Burns Institute, Galveston, Texas. PMID- 3647046 TI - Will burn center hospitals survive PPS? PMID- 3647047 TI - Clinical evaluation of Abbott and Wellcome enzyme linked immunosorbent assays for detection of serum antibodies to human immunodeficiency virus (HIV). AB - Abbott and Wellcome enzyme linked immunosorbent assays (ELISAs) for detection of antibodies to human immunodeficiency virus (HIV) were compared in tests on 932 sera collected predominantly from male homosexuals attending a sexually transmitted disease (STD) clinic in central London. Two hundred and twenty three sera had HIV antibodies detected by both types of assay, with confirmation of the results by further tests carried out at the Virus Reference Laboratory (VRL) in Colindale. There was a 97.3% correlation between the results obtained by the two commercial ELISA assays on the tests carried out on unheated sera. The Abbott ELISA gave significantly more false positive results than the Wellcome test when the manufacturer's instructions for cut off values were followed. There was one false negative Abbott results: it failed to react to repeated Abbott ELISA but was positive by Wellcome and confirmatory assays. Of 283 heat treated sera 14.8% gave falsely reactive results with the Abbott assay whereas there were no differences between heated and unheated sera with the Wellcome assay. VRL or Western blot confirmatory assays, or both, confirmed all the 235 positive results obtained with the Wellcome assay. PMID- 3647048 TI - Intracavernous self-injection of papaverine in the treatment of erectile impotence after major pelvic surgery. PMID- 3647050 TI - Pseudomembranous colitis. PMID- 3647049 TI - Chronic venous insufficiency of the legs: pathogenesis of venous ulcers. PMID- 3647051 TI - The Ostomy Outreach Program. PMID- 3647052 TI - Impotence: a current understanding and approach. Getting ready for certification. PMID- 3647053 TI - Maintaining percutaneous nephrostomy catheters and the management of intractable leakage at the insertion site. PMID- 3647054 TI - Variables influencing administrative evaluation of nursing deans and directors in public and private institutions. PMID- 3647055 TI - A case study in collaboration. PMID- 3647056 TI - Endowed research chairs: perceptions from other disciplines and implications for the nursing scientific community. PMID- 3647057 TI - Critical thinking and selected correlates among baccalaureate nursing students. PMID- 3647058 TI - Shortage fallout. PMID- 3647059 TI - Common problems--different strategies. PMID- 3647060 TI - Is nursing ready for the future? PMID- 3647061 TI - Consent and unequal power relationships. PMID- 3647062 TI - Collaborative research: a commentary. PMID- 3647063 TI - Multidisciplinary pain policy model: the Wisconsin initiative. PMID- 3647064 TI - Research facilitation in academic and practice settings. PMID- 3647066 TI - Have you ever thought about writing? PMID- 3647067 TI - The process of change in intensive care nursing. PMID- 3647065 TI - [HIV seropositivity and pregnancy. Apropos of 48 cases (how should they be managed at the present time?)]. AB - We describe the gynaecological and obstetrical management of 48 HIV seropositive, pregnant women and review the literature. We did not find that pregnancy aggravated the development of the condition from the asymptomatic anti-HIV related complex (ARC) and AIDS. It seemed that fetal malformations, especially of the face, occurred most frequently in babies born to HIV seropositive mothers. Materno-fetal transmission of HIV was found in the uterus in 50% of our cases. In conclusion, we recommend safe contraception to prevent pregnancies in anti HIV seropositive women. If that fails, induced first trimester abortion is medically indicated and should be carried out if possible, as should strict medical control post-partum of both mother and child if the pregnancy is carried to term. PMID- 3647068 TI - Developing a care plan for intensive care. PMID- 3647069 TI - Visiting acutely ill patients: a literature review. PMID- 3647070 TI - Writing for publication--an open letter from an editor to future authors. PMID- 3647071 TI - A study of the psychological effects of intensive care with particular emphasis on patients in isolation. PMID- 3647072 TI - Technology and machines--bad masters but good servants. PMID- 3647073 TI - A review of stress in the intensive care unit. PMID- 3647074 TI - Caring can damage your health. PMID- 3647075 TI - Computer control of arterial blood pressure following cardiac surgery. PMID- 3647076 TI - Acute circulatory failure in intensive care--basic physiology, monitoring and therapeutic techniques. PMID- 3647077 TI - Patient-controlled analgesia. PMID- 3647078 TI - Cancer pain syndromes. PMID- 3647079 TI - Nonpharmacological management of cancer pain. PMID- 3647081 TI - Semiautomatic pump for analgesic infusion. PMID- 3647080 TI - Wisconsin initiative for improving cancer pain management: progress report. PMID- 3647082 TI - Pain facility certification standards. PMID- 3647083 TI - A retrospective study on the use of oral morphine in cancer pain. PMID- 3647084 TI - Cancer pain control with a combination of methadone, amitriptyline, and non narcotic analgesic therapy: a case series analysis. PMID- 3647085 TI - Pain in chronic multiple sclerosis. PMID- 3647086 TI - The challenge to black nurses. PMID- 3647087 TI - Highlights from the Department of Health and Human Services Task Force on Black and Minority Health. PMID- 3647088 TI - The National Black Nurses' Association's response to the Secretary's Task Force Report. PMID- 3647089 TI - From deinstitutionalization to penal incarceration: impact on the black community. PMID- 3647090 TI - Doctorally prepared nurses in mental health. PMID- 3647092 TI - Selected dimensions of coping behavior in black female college freshmen. PMID- 3647091 TI - Psychological stress and blood pressure levels in black women. PMID- 3647093 TI - Has affirmative action in nursing been successful in North Carolina? PMID- 3647094 TI - Haiti: a cause for concern. PMID- 3647095 TI - Correctional facilities: a viable community health practice site for students. PMID- 3647096 TI - Access to health care and the future of nursing. PMID- 3647097 TI - Measles and rubella: old problems in a new generation. PMID- 3647098 TI - Rx for care givers: respite care. PMID- 3647099 TI - Respite care: a community needs survey. PMID- 3647100 TI - Volunteers providing in-home respite care for the homebound elderly. PMID- 3647101 TI - Perceived stressful situations and coping strategies utilized by the elderly. PMID- 3647102 TI - Contracting. PMID- 3647103 TI - Hiring nurse educators. PMID- 3647104 TI - A motivational preceptorship program. PMID- 3647105 TI - Using Montessori's concepts on a transitional orientation nursing unit. PMID- 3647106 TI - CPR program update: revisions and improvements. PMID- 3647108 TI - Preparing oncology nurses as unit preceptors. PMID- 3647107 TI - Teaching CPR as a motor skill. PMID- 3647109 TI - Mandatory educational programs: a decentralized approach. PMID- 3647110 TI - If nothing else--research-based practice. PMID- 3647111 TI - Nursing care costs for stroke patients in a rehabilitation setting. AB - Many nursing departments have developed methods for identifying the cost of acute nursing care services. Assuming that rehabilitation services will soon be reimbursed on a prospective basis as well, the nursing costs of those services will also need to be ascertained. In a study of one rehabilitation service, it was found that nursing care costs accounted for a greater proportion of hospital charges in rehabilitation than is true in acute care and that length of stay was the best predictor of the cost of care. PMID- 3647112 TI - Establishing a dedicated AIDS unit. AB - In November 1985, St. Clare's Hospital in New York City became the first hospital on the East Coast (the second in the country) to open a separate dedicated unit for AIDS patients. Staff succeeded despite some seemingly impossible contradictions: John Cardinal O'Connor of the Archdiocese of New York, who has been opposed to the life-styles of most of the people who would use the unit (gays and IV abusers) urged the creation of the unit; St. Clare's had been bankrupt and virtually dismantled just a few years earlier; and the hospital did not have the financial resources, facilities, or AIDS patient caseload of the larger, well-known New York medical institutions. Through the perseverance of many individuals, stumbling blocks were overcome. The lessons learned at St. Clare's can be applied anywhere. PMID- 3647114 TI - Job motivators: a ranking of eight variables. PMID- 3647113 TI - Clinical nurse specialists: an institutional process for determining priorities. AB - This article describes a four-step process designed by a midwest teaching hospital to identify priorities for the appointment and use of clinical nurse specialists. In an era of cost containment where the outcomes and effectiveness of staff positions are continually questioned, such a process enhances the objectivity and quality of administrative decision making. PMID- 3647115 TI - In search of: equanimity and imperturbability. PMID- 3647116 TI - Innovative retention strategies for nursing staff. AB - The creation of innovative retention strategies will be a major focus for nursing administration as a shortage of nurses recurs and turnover of staff becomes a problem. A recent study provides information on which to formulate retention strategies. The findings suggest that retention strategies, to be effective, need to be targeted specifically to particular conditions of the nursing staff, e.g., educational preparation and the clinical service on which staff are functioning. The authors outline their research findings and the innovative strategies that have been constructed. PMID- 3647117 TI - What is a nurse-midwife? PMID- 3647118 TI - Factors associated with perineal outcome during childbirth. PMID- 3647119 TI - Disclosure practices of certified nurse-midwives relative to methods of childbirth pain management. PMID- 3647120 TI - Collaborative management of twins. Two case studies. PMID- 3647122 TI - Supplemental report on nurse-midwifery legislation. PMID- 3647123 TI - Perineal massage. Effect on the incidence of episiotomy and laceration in a nulliparous population. PMID- 3647121 TI - Beliefs and practices among Haitian American women in relation to childbearing. PMID- 3647124 TI - Isolation of human immunodeficiency virus and detection of HIV DNA sequences in the brain of an ELISA antibody-negative child with acquired immune deficiency syndrome and progressive encephalopathy. PMID- 3647125 TI - Administration of bovine superoxide dismutase fails to prevent chronic pulmonary sequelae of neonatal oxygen exposure in the rat. AB - Using a rat model, we assessed the efficacy of varying doses of superoxide dismutase of (SOD) to affect plasma and tissue SOD concentrations and to attenuate dysplastic changes of lung and pulmonary vascular growth, which are chronic sequelae of neonatal oxygen exposure. One hundred forty-three 1-day-old Sprague-Dawley rats were divided into two groups and exposed to hyperoxia (0.96 to 1.0 Fio2) or room air for 8 postnatal days. Each group was subdivided into five treatment groups, which received 6, 20, 100, or 200 mg/kg/d SOD or a placebo, intramuscularly every 12 hours. All rats were then placed in room air; 52 were killed, and lung tissue and blood samples were obtained for measurement of bovine SOD concentration. The remaining rats received routine care until 58 to 60 days of age, when functional and morphologic cardiopulmonary changes were assessed. Bovine SOD concentration of pooled plasma samples increased 26-fold, from 2 to 50 micrograms/mL, between the 6 and 200 mg/kg/d SOD groups, but mean tissue concentration increased only six-fold, from 0.34 to 2.1 micrograms/lung. Cardiovascular and pulmonary changes found in each oxygen group, regardless of SOD dosage, included elevated right ventricular pressure, increased right ventricular weight, decreased number of small pulmonary arteries/mm2, decreased number of alveoli/mm2, and increased volume proportion of lung parenchyma. Thus, high plasma concentrations of bovine SOD failed to prevent the chronic cardiovascular and pulmonary sequelae of neonatal oxygen exposure in the rat, possibly because SOD did not reach the intracellular sites of action. PMID- 3647126 TI - Developing a therapeutic alliance with the anorexia nervosa client. PMID- 3647127 TI - Irrational beliefs and intervention. PMID- 3647128 TI - Psychoeducational program evaluation. One practical method. PMID- 3647129 TI - Religion and psychiatry. Cognitive dissonance in nursing students. PMID- 3647130 TI - Vietnam nurses. PMID- 3647131 TI - Social support in suicidal inpatients. PMID- 3647132 TI - Helper secrets: internal stressors in nursing. PMID- 3647133 TI - Should baccalaureate psychiatric nursing students have full access to patient charts? PMID- 3647134 TI - Marital adjustment of headache sufferers and their spouses. PMID- 3647135 TI - Somatopsychology and AIDS victims. PMID- 3647136 TI - The ideal. What role does nursing opinion play in psychiatric hospital image programming? PMID- 3647137 TI - Not fade away. Are psych nurses an endangered species? PMID- 3647138 TI - How to meet your clients' spiritual needs. PMID- 3647139 TI - Inhibition of human sputum elastase by substituted 2-pyrones. AB - Nineteen 4-hydroxy- and 4-methoxy-2-pyrones related to elasnin (I) have been assayed for in vitro inhibition of human sputum elastase (HSE), porcine pancreatic elastase, alpha-chymotrypsin, and trypsin. Inhibition is reported as Ki and Ki'; percentage inhibition was dependent on [S] in a number of cases, making it unsuitable as a measure of relative inhibition. The 3-(1-oxoalkyl)-4 hydroxy-6-alkyl-2-pyrones were found to be most effective, the octyl homologue 11 being the most potent inhibitor (Ki = 4.6 microM, 30 times better than the lead compound). A further reduction in inhibition was observed when the hitherto hydrophobic 6-substituent was substituted by a branched functionality of hydrophilic nature. Conversely, methylation of the 4-hydroxy group of the 6-alkyl 2-pyrones increased inhibitory activity. The mechanism of inhibition varied from pure noncompetitive to mixed type to uncompetitive and was found to be dependent on the pattern of substitution. We believe that the 4-hydroxy-2-pyrone binds to the S4 subsite, with the 6-substituent extending across the S4-S1 subsites and the 3-substituent occupying the S5 subsite. The length of the inhibitor binding region was calculated to be approximately 24 A. None of the hydrophobic compounds were found to have any appreciable inhibition (less than 10%) with porcine pancreatic elastase, bovine alpha-chymotrypsin, and bovine trypsin when tested at the limit of their solubility. The hydrophilic compounds were nonspecific, inhibiting all four enzymes. Dialysis was used to show that the interaction is fully reversible. PMID- 3647141 TI - [Professional attitude of midwives and its relationship to their work environment]. PMID- 3647142 TI - [Expectation on midwives: respect for the life and support for the chief player of the life drama]. PMID- 3647140 TI - [Acquired immune deficiency syndrome in hemophiliac subjects]. PMID- 3647143 TI - [Overcoming the dilemma in midwifery: self-examination of the motive for choosing the profession]. PMID- 3647145 TI - [Experience by a midwife outside the maternity ward: comments by a former midwife acting as a nursing director]. PMID- 3647144 TI - [My image of a midwife]. PMID- 3647146 TI - [Identity of a midwife: a discussion]. PMID- 3647147 TI - [The use and assistance given by the "Shufu-no-Tomo" Breast Feeding Counseling Service]. PMID- 3647148 TI - [Present and future of computer utilization in perinatal care]. PMID- 3647150 TI - [Perinatal nursing of the mother and infant: psychosocial approach. 12. Total assistance of the patient and responses to her family]. PMID- 3647149 TI - [Customs of childbearing and child rearing. A discussion: application of knowledge to practice]. PMID- 3647151 TI - [Questions and answers on breast feeding. Insufficient lactation and its care]. PMID- 3647152 TI - [Coexistence of generations of nurses in spite of superficial differences in personal attitudes]. PMID- 3647153 TI - [Basic scientific knowledge of the mother-child relationship]. PMID- 3647155 TI - [Educational evaluation. Re-defining educational evaluation]. PMID- 3647154 TI - [The third generation of women and their attitude to childbirth]. PMID- 3647156 TI - [Medical social service: assistance for preservation of individuality]. PMID- 3647157 TI - [Trans-vaginal or trans-rectal ultrasonic tomography]. PMID- 3647158 TI - [Role of kallikrein-kinin system and sodium metabolism in the development of hypertension in spontaneously hypertensive rats]. PMID- 3647159 TI - [The system of nursing schools and admission of their graduates to universities]. PMID- 3647160 TI - [Terminal care--mutual understanding among the physicians, nurses, and families concerning their roles]. PMID- 3647161 TI - [A study on clinical training at a nursery school]. PMID- 3647162 TI - [Teaching schedules in the study of the outline of nursing theories]. PMID- 3647163 TI - [Study on personality characteristics of nursing students (1). A comparison of student groups of various nursing courses at the time of school admission]. PMID- 3647164 TI - [Study through camping activities: study of the basis of life activities]. PMID- 3647165 TI - [Curriculum construction at basic nursing education. 2]. PMID- 3647166 TI - [Assistance for young pregnant patients and new mothers--activities of public health nurses to promote independence by young mothers, a discussion by public health nurses of Moriguchi Clinic, Osaka]. PMID- 3647167 TI - [Finding the importance of support in daily lives: activities by the Moriguchi Public Health Clinic to assist young pregnant patients and new mothers. A discussion]. PMID- 3647168 TI - [Nursing and daily life activities. 3. "Eating" and "feeding" (3); individual pace of eating]. PMID- 3647170 TI - [Public health nurses of the Santama area (7). Ms. Natsuko Tominago and her activities for local residents]. PMID- 3647169 TI - [Starting point in public health nursing: nursing roots in public health nursing at land reclamation projects]. PMID- 3647171 TI - [Public health nursing activities with a focus on specific areas. 8. Comprehensive public health nursing activities at Shimane Prefecture: conditions facing the regional activities]. PMID- 3647172 TI - [Health status of the aged judged from their reported difficulties in daily lives -an example in health surveys conducted at the Yanagimot area, Tenri-shi, Nara Prefecture]. PMID- 3647173 TI - Plasma kallikrein elevation in cattle induced with hepatic abscess. PMID- 3647174 TI - Much to know. PMID- 3647175 TI - [The treatment in hospital of gerontopsychiatric patients. A challenging task for the treatment team]. PMID- 3647176 TI - [Successful geriatric psychiatry is possible only within the interdisciplinary team]. PMID- 3647177 TI - [Developments in Great Britain. Specialization: how far should it go?]. PMID- 3647178 TI - [A patient for 20 years. "I want you to have hope with us"]. PMID- 3647179 TI - [Nursing students interview patients: too often in the administration room?]. PMID- 3647180 TI - [Nursing research in Switzerland and its effect on care. Encouraging beginnings and noticeable changes]. PMID- 3647181 TI - [Hospitalized alcoholics and drug addicts. Hints on therapeutic relationships]. PMID- 3647182 TI - [The experience of community psychiatry. Development of the therapeutic role of the nurse]. PMID- 3647183 TI - [Specialization of nurses in mental health and psychiatry. A program adapted to current psychiatry]. PMID- 3647184 TI - [Psychiatric organization in the East Vaud sector. A personalized concept of care]. PMID- 3647185 TI - [The rights of women at work. Women yesterday, today and tomorrow]. PMID- 3647186 TI - Aging education in schools. AB - Aging is a natural and lifelong process that begins at the moment of conception. If Americans are to adapt successfully to their own and others aging, they need to be educated to do so. Schools are the logical place for aging education to begin. Aging education has the potential for an exciting and rewarding future as it can increase the quality of life not only for future elderly, but for today's elderly as well. Education professionals need to be aware of the need for aging education and to advocate its integration into school curricula. In this article, the author presents an overview of aging education and identifies resources to help implement aging education in schools. PMID- 3647187 TI - Health education and sensitivity to cultural, religious, and ethnic beliefs. AB - Health education at times can conflict with the cultural, religious, and ethnic backgrounds of students. This article examines the dilemma by using the religious teachings of Judaism to illustrate conflicts that can arise. Other cultures, religions, and ethnic origins are discussed, and some dilemmas health educators face with these groups are described. Suggestions for health educators are offered to prevent health instruction from leading to conflict between home and school concerning cultural, religious, and ethnic values. PMID- 3647188 TI - The ultimate rejection: helping the survivors of teen suicide victims. AB - Each year, teens who commit suicide leave behind more than 25,000 survivors. In addition to feelings of depression, anger, and guilt, the survivors must cope with societal attitudes toward suicide. Few resources are available to deal with the problem. This paper discusses the impact of teen suicide on survivors, and outlines educational and administrative postincident intervention guidelines for schools. PMID- 3647189 TI - Application of the role delineation project "Framework" to a professional preparation program. AB - Using the Framework for the Development of Competency-based Curricula for Entry Level Health Educators, the health education faculty at the University of Alabama at Birmingham reviewed and modified their undergraduate health education professional preparation program. Efforts focused on the five steps of preparation and study, review and organization of Framework subcompetencies, organization of Framework subcompetencies into potential courses, placement of objectives for courses, and revision of schedule and sequence for professional preparation courses. The process produced seven core courses to be required of all health education majors. A master list of subcompetencies and objectives also was developed. Faculty perceived several benefits from participating in the project. PMID- 3647190 TI - School problems and teacher responsibilities in juvenile rheumatoid arthritis. AB - Juvenile rheumatoid arthritis (JRA) may cause a variety of school problems. Twenty-four children with JRA, 24 of their parents, and 14 of their teachers completed questionnaires regarding the frequency of 40 potential school problems and the extent of the teacher's responsibility in helping children deal with 28 medical, academic, or social issues. Though respondents viewed school problems as occurring infrequently, parents and children more frequently than teachers noted that problems occurred (p less than .05). Children felt problems with self concept and peer relationships occurred most frequently, while parents and teachers emphasized physical health and activity-related problems. Children's ratings regarding extent of teacher's responsibility were lower than those of parents' or teachers' ratings (p less than .05). While parents and teachers viewed the teacher as responsible for helping children deal with psychosocial issues, children felt that teachers should deal primarily with academic areas. Children viewed teachers as being responsible for withholding information about arthritis from their classmates, and did not want their teacher to encourage peer interaction. Results indicate major differences exist between perceptions of children with JRA, and their parents and teachers, regarding frequency of problems and extent of the teacher's responsibility. Since children may resist assistance from teachers in psychosocial areas, their views should be considered before planning interventions to resolve such problems. PMID- 3647192 TI - Promoting self-responsibility: using the school nurse in a health awareness program for primary students. PMID- 3647191 TI - Resources for smokeless tobacco education. PMID- 3647193 TI - Helping the eye-patched child. PMID- 3647194 TI - Professional profile: Michael Schaffer. PMID- 3647195 TI - [HIV in homosexuals in Barcelona: epidemiology and prevalence]. PMID- 3647196 TI - [Determination of lactate and granulocyte elastase can be useful in the diagnosis of pleuritis]. PMID- 3647197 TI - [Nonspecific ulcerative colitis]. PMID- 3647198 TI - [Rehabilitation of myocardial infarct patients]. PMID- 3647199 TI - [Rehabilitative treatment of patients who have undergone stomach operations for peptic ulcer using health resort and physiotherapeutic factors]. PMID- 3647200 TI - [Drip and intravenous infusions in psychiatric practice]. PMID- 3647201 TI - [Health education. The tasks and course to reconstruction]. PMID- 3647202 TI - [Role of the nurse in preventing childhood traumatism]. PMID- 3647203 TI - [Criteria for the diagnosis of intrauterine growth retardation in newborn infants]. PMID- 3647204 TI - [Characteristics of the rearing of low-weight premature infants]. PMID- 3647205 TI - [Physical methods of treating chronic pneumonias in children]. PMID- 3647206 TI - [Endoscopic studies in pediatrics]. PMID- 3647207 TI - [Role of the nurse in the early detection and treatment of children with nystagmus]. PMID- 3647208 TI - [Deontological aspects of the interrelationships of the nurse and the physician]. PMID- 3647209 TI - [The oxygen cocktail]. PMID- 3647210 TI - [Painful states in human beings caused by flour mites]. PMID- 3647211 TI - [Cardiogenic shock]. PMID- 3647213 TI - UKCC--Project 2000: a new preparation for practice. Comments of the Royal College of Midwives. PMID- 3647212 TI - Human immunodeficiency virus (HIV): an ultrastructural study. AB - H-9 cells producing HIV were examined by electron microscopy to value the virus host cell relationships. HIV fine structure was also studied. HIV induces little cellular damages and it can penetrate into the cytoplasm by phagocytosis. Phagocytosis of the virus could play an important role in the mechanism of cellular infection. PMID- 3647214 TI - VOLMAT. A midwife's view. PMID- 3647215 TI - Preparing tomorrow's mother. PMID- 3647216 TI - VOLMAT. An obstetrician's view. PMID- 3647217 TI - VOLMAT. VOLunteers MATernity unit. PMID- 3647218 TI - Farewell to St Mary's--1918 to 1985. PMID- 3647219 TI - Thymic "atrophy" at puberty is a myth. PMID- 3647220 TI - Sudden infant death syndrome. The role of putrefactive toxins in respiratory paralysis and cerebral coma. AB - The Sudden Infant Death Syndrome (SIDS) is responsible for the death of 10,000 infants annually in the U.S.A. The cause of these deaths is not known; all SIDS infants studied died during sleep in a silent fashion and there are no specific lesions observable post mortem. It may be of significance, however, that nearly half of SIDS infants had a respiratory tract infection in the last two weeks of life while forty percent had bloody froth over their mouths when found, presumably pulmonary oedema fluid. It is hypothesis that improper feeding or diarrhoea may likewise be involved in SIDS and that enterotoxins from putrefactive products are the precipitating event in this syndrome. PMID- 3647221 TI - Calcium-channel blockers and the hepatorenal syndrome. AB - It is suggested that calcium-channel blockers may be the agents of choice for treating the renal dysfunction associated with the hepatorenal syndrome because these agents may be effective in reversing the episodic renal vasospasm which characterizes this disorder. PMID- 3647222 TI - Melanoma of the skin is not caused by ultraviolet radiation but by a chemical xenobiotic. AB - The putative ultraviolet (u.v.) carcinogenesis of cutaneous melanoma bears sufficient inconsistencies as to seriously challenge this theory. A more attractive hypothesis is the incrimination of a hitherto unknown chemical xenobiotic. This hypothesis explains the dramatic increase in incidence rates in most affluent countries during the last two or three decades. It also explains the particular risk of populations of high socio-economic status and the increased risk of indoor workers. It finally explains the urban-rural and coastal inland trends observed in many countries with high incidence rates. PMID- 3647223 TI - The sudden infant death syndrome induced by "the fear paralysis reflex'? AB - The sudden infant death syndrome (SIDS) is the greatest single cause of death between one month and one year of age in industrial countries. Its etiology still remains a mystery despite extensive research during the past decades. The outstanding problem is to define the trigger mechanism leading to death. Most theories have dealt with bodily malfunctions, infections and toxic agents, and only minor attention has been paid to a possible psychical trigger mechanism. The hypothesis is advanced that the so-called 'fear paralysis reflex' (for other terms, see below), an atavistic reflex present in the entire animal kingdom, may be a major trigger mechanism for SIDS. The reflex is evoked by fear resulting from any threatening event which is perceived as a danger, and with which the organism is unable to cope, typically in a predator confrontation. Important threatening stimuli in animals, and which may be of particular importance in human infants, are restraint of movement, sudden and unfamiliar noises, separation from the mother and companions, and sudden exposure to an unfamiliar environment. The main response characteristics are an immediate motor 'paralysis' (prolonged and generalized immobility), unresponsiveness, and abrupt and profound bradycardia. The latter may proceed to asystole and fatal cardiac arrythmias. Any hypothesis attempting to explain the cause of SIDS must account for the unique age distribution of SIDS' victims with a peak age incidence at 2-4 months, its frequent occurrence in REM sleep, and the observation that most deaths are silent. Further, it must be consistent with previously established risk factors (genetic determination, opiate-addicted mothers and cigarette smoking). The fear paralysis hypothesis is in accordance with all these facts, and it suggests new and potentially hazardous triggering mechanisms which, one recognized, possibly can be avoided. As a central reflex, it does not leave any trace in the organism, which explains the negative postmortem findings. Suggestions for testing the hypothesis are given, and possible preventive measures are presented. PMID- 3647224 TI - Pathogenesis of port wine stains. A new hypothesis. AB - Port wine stains have been shown to be lesions formed by the progressive dilatation of vessels within the superficial cutaneous vascular plexus. Previous investigators have been unable to define abnormalities of vessel structure or perivascular stromal tissues. We, however, have demonstrated morphologically that port wine stains are lacking proper innervation, and have shown them to behave differently than normal skin, physiologically. Dermal vessels are under the control of sympathetic nerves which course through the dermis and cause vasoconstriction without a parasympathetic system for counterregulation. We, therefore, propose that continued blood flow in the absence of tonic modulation is the basis for the vascular ectasia that characterizes the port wine stain. PMID- 3647225 TI - Psoriasis specific chromosomal proteins, antibodies against them and disease activity. AB - It has been demonstrated recently that the lymphoid cells of patients with psoriasis have antibodies directed against the psoriasis specific non-histone proteins. A conceptual hypothesis for the role of these antibodies in the pathogenesis of psoriasis presented in this communication, is as follows. Perhaps the psoriasis specific non-histone proteins following phosphorylation bind to histone which keeps psoriasis gene(s) repressed. This may result in the displacement of histone from the DNA. Antibodies against psoriasis specific non histone proteins may facilitate the displacement of histone. DNA set free, possibly containing psoriasis gene(s), can then be transcribed into RNA causing a shift of the resting pool of keratinocytes in the symptom-free skin of psoriasis patients to the proliferating pool of keratinocytes in the psoriasis lesions. PMID- 3647226 TI - Kaposi's sarcoma: a trifactorial model. AB - To explain the epidemiology of Kaposi's sarcoma, including its predominance in men, I present a theory based on three concurrent factors: immunodeficiency, exposure to a specific viral agent, and a recessive, highly prevalent X-linked regulatory gene. The X-linked locus is inferred from comparing the aberrant lymphaticovenous nature of immature lesions with absence of lymphaticovenous connections in XO karyotypes. The theory predicts that for heterosexual populations without sex differences in viral exposure or degree of immunodeficiency, the male-to-female ratio of Kaposi's sarcoma will equal the inverse of the lesion's frequency causative virus. In addition, an increased incidence of Kaposi's sarcoma is expected outside of the context of the acquired immunodeficiency syndrome as the causative virus is transmitted separately from the human immunodeficiency virus. PMID- 3647227 TI - A hypothesis: sudden infant death syndrome is a disorder of entrainment. AB - A hypothesis is presented that explains Sudden Infant Death Syndrome (SIDS) as a disorder of entrainment. This hypothesis fits the known characteristics of SIDS i.e., age at death, sleep-related, natural death and absence of a lethal lesion. The spectrum from reversible hypoxia (near-miss SIDS) to irreversible hypoxia (SIDS) can be explained by the presence or absence of brainstem lesions in infants with a disorder of entrainment. PMID- 3647229 TI - The time for change. PMID- 3647228 TI - Prevalence of antibody to HTLV-III in homosexual men in Melbourne. PMID- 3647230 TI - Lifelong education and its relevance to nursing. PMID- 3647231 TI - Project 2000: the midwifery options. PMID- 3647232 TI - The importance of behaviour modification for the nursing process in mental handicap. PMID- 3647233 TI - Helping nurses develop their health education role: a framework for training. PMID- 3647234 TI - The role of formal staff appraisal in nurse education. PMID- 3647235 TI - Nurses' knowledge and attitudes about sexuality in health care--a review of the literature. PMID- 3647236 TI - Objective: social continence. Understanding continence. PMID- 3647237 TI - Tissue damage and repair. PMID- 3647238 TI - What do they really need? Adapting the nursing process for community-based nursing. PMID- 3647239 TI - [Examination of thorax and lungs]. PMID- 3647241 TI - Great job satisfaction. The services provided by the advanced paediatric clinical nurse at Paarl East Hospital. PMID- 3647240 TI - Opportunities to teach. The counselling role of the genetic nurse. PMID- 3647242 TI - A critical factor. PMID- 3647244 TI - Diarrhoeal disease and its management. PMID- 3647243 TI - Aids to social continence available in SA. PMID- 3647245 TI - Practical and effective. The expansion of the course in paediatric primary care. PMID- 3647246 TI - The national childbirth education, and parenting association (NCEPA). PMID- 3647248 TI - [Frightening story from America! The trade union and the nurse]. PMID- 3647247 TI - Burns and the burn patient. PMID- 3647249 TI - A neglected cause of death. Pneumonia in children. PMID- 3647250 TI - Abused children: a follow-up report indicates a 'surprisingly' good outcome. PMID- 3647251 TI - [Nursing assessment. Physical examination of the breast and axillas]. PMID- 3647252 TI - Children in detention. PMID- 3647253 TI - Drug abuse. Recent trends in South Africa. PMID- 3647254 TI - Drug dependence. A practical guide to the signs and symptoms. PMID- 3647255 TI - [Phoenix House]. PMID- 3647256 TI - Objective: social continence. Catheter challenges. PMID- 3647257 TI - Ulcers. PMID- 3647258 TI - The hospice concept. PMID- 3647260 TI - [Nursing assessment. Examination of the abdomen]. PMID- 3647259 TI - Neonatal tetanus: an under-reported scourge. PMID- 3647261 TI - The foetal alcohol syndrome. PMID- 3647262 TI - Chemical impairment in nursing. PMID- 3647263 TI - Can Mummy come too? PMID- 3647264 TI - Surgical safari. Interview by Anne Alexander. PMID- 3647265 TI - A theatre nurse on holiday. PMID- 3647267 TI - Royal College of Nursing. All together. PMID- 3647268 TI - Compulsory treatment in the community. PMID- 3647266 TI - Catalysis of splicing-related reactions between dinucleotides by a ribozyme. AB - Certain intervening sequence (IVS) RNAs catalyse their own excision from a primary transcript to yield mature RNA in a reaction termed self-splicing. These Group I IVS RNAs contain several conserved sequences and possess a common secondary structure. The Tetrahymena precursor ribosomal RNA possesses an IVS of this group that is known to self-splice in vitro. The nature of this IVS is of great interest to both biology and chemistry, because understanding its catalytic activity should shed new light on the function of RNA in biological systems and the evolution of RNA which might be relevant to the early stages of life on Earth. We have analysed the minimum requirement for this reaction as one approach to understanding the mechanism of this RNA catalysis. We now show that a fragment of the IVS RNA of Tetrahymena can mediate a simple transesterification reaction between the substrate GpN (where N is A, C, G or U) and the nucleophile CpU. This newly discovered reaction and its reverse reaction represent the fundamental catalytic activity of the self-splicing Group I IVSs. PMID- 3647269 TI - Manpower crisis. PMID- 3647270 TI - Education in the 21st century. PMID- 3647271 TI - Royal College of Nursing. The time is now. PMID- 3647272 TI - Progress of OH nursing. PMID- 3647273 TI - How job-sharing could help the manpower crisis. PMID- 3647274 TI - Royal College of Nursing. The right stuff. PMID- 3647275 TI - Pay credit to sincere motivated workforce. PMID- 3647276 TI - Regional pay rates--a recipe for chaos? PMID- 3647277 TI - Royal College of Nursing. Getting it right. PMID- 3647279 TI - Women need to turn the tide in the NHS. PMID- 3647278 TI - Hope to preserve my dignity in old age. PMID- 3647280 TI - Pharmacological characteristics and anatomical distribution of [3H]oxytocin binding sites in the Wistar rat brain studied by autoradiography. AB - Oxytocin-binding sites were detected by autoradiography on rat brain sections incubated in the presence of the [3H]oxytocin. These sites were characterized pharmacologically using quantitative autoradiography. High pressure liquid chromatography controls of the incubation media indicated that labelling was due to the intact [3H]oxytocin molecule. Pharmacological analysis of different locations (central amygdaloid nucleus, ventral subiculum and ventromedial hypothalamic nucleus) showed that the sites detected had a high affinity for oxytocin and also for arginine-vasopressin. In contrast, some areas known to bind vasopressin intensely, such as suprachiasmatic and lateral septum nuclei, had little or no affinity for oxytocin. Autoradiographs revealed [3H]oxytocin-binding sites in already known brain areas (olfactory centres, ventral subiculum, central amygdaloid nucleus, bed nucleus of the stria terminalis) albeit with more extensive labelling of some of these formations, in particular, the amygdaloid complex. In addition, specific [3H]oxytocin-binding sites were found in areas not yet reported to bind oxytocin, such as the paraventricular thalamic and caudate nuclei. In the hypothalamus, specific binding sites were not detected in the supraoptic and paraventricular nuclei: the only structure labelled was the ventrolateral part of the ventromedial nucleus. Discrepancies between the concentrations of [3H]oxytocin-binding sites, the known distribution of oxytocin containing endings and electrophysiological data indicate that autoradiography, under our conditions, apparently only reveals some of the oxytocin receptors in the brain. Thus, in the hypothalamus, no relationship can be established between the known effect of oxytocin on oxytocinergic magnocellular neurons and detection of specific [3H]oxytocin-binding sites. Autoradiography may reveal mainly oxytocin-binding sites in areas receiving diverse "parasynaptic" information, where oxytocin might play a modulatory role rather than exerting rapid, short term effects of the neurotransmitter type. PMID- 3647281 TI - Histamine H2-receptors participate in the formation of brain edema induced by kainic acid in rat thalamus. AB - At 4 h after the intraperitoneal administration of kainic acid in a dose of 12 mg/kg, Evans blue extravasation was observed preferentially in the thalamus, accompanied by increases in the water and sodium contents and by a decrease in the potassium content. Subcutaneous pretreatment with a histamine H2-receptor blocking agent, ranitidine, in a dose of 5 mg/kg given 2 h before and at the time of kainic acid injection, partially decreased the edema formation in the thalamus. It is assumed that repetitive discharges evoked by the kainic acid result in the thalamus in an excessive release of histamine from internal (mast cell and neuronal) sources and that this leads to the activation of H2-receptor coupled adenylate cyclase in the brain microvessels and to the induction of brain edema. PMID- 3647282 TI - A new generation of nurses discover transcultural nursing. PMID- 3647283 TI - Keying in on the unique care needs of Asian clients. PMID- 3647285 TI - Nursing education in crisis--a look at recruitment and retention. PMID- 3647284 TI - Nursing education comes into its own in Saudi Arabia. PMID- 3647286 TI - Workload management system highlights staffing needs. PMID- 3647287 TI - Who's responsible for staff development? PMID- 3647288 TI - More than a garden. PMID- 3647289 TI - Snakebite. Action stat! PMID- 3647290 TI - Assessing your patient for increased I.C.P. (continuing education credit). PMID- 3647291 TI - Adequate staffing--whose problem is it? PMID- 3647293 TI - Tips for improving your venipuncture techniques. PMID- 3647292 TI - Dying patients--caring makes the difference. PMID- 3647294 TI - New drugs. PMID- 3647295 TI - How to spot melanoma. PMID- 3647296 TI - Are blood transfusions really safe? PMID- 3647297 TI - Helping the family through a crisis. PMID- 3647299 TI - Getting to know you. PMID- 3647298 TI - Expert advice on becoming an expert witness. PMID- 3647300 TI - Are there opportunities in your own backyard? PMID- 3647301 TI - Resettlement of mentally ill people into the community: management and political issues. PMID- 3647302 TI - Schizophrenia: implications for community care. PMID- 3647303 TI - Care of a child with reflux nephropathy. PMID- 3647304 TI - Case history of a patient with sudden onset ESRF. PMID- 3647305 TI - Psychosocial aspects of end stage renal disease. PMID- 3647306 TI - Dialysis fact sheet. PMID- 3647307 TI - Safety in numbers. PMID- 3647309 TI - 10 questions recruiters will ask and how you should respond. PMID- 3647308 TI - What's it like to be a rehabilitation clinical nurse specialist? PMID- 3647310 TI - Creating a new role: Mary Lou O'Grady--nurse-inventor. Interview by Nancy Van Leuven. PMID- 3647311 TI - How to defend yourself against lawyers' attacks. PMID- 3647312 TI - "Oh, no. Another suicide". PMID- 3647313 TI - Special care for special babies. Interview by Esther Love. PMID- 3647314 TI - Portrait of a nurse: Debi Koczen-Doyle, Rn, MSN. Clinical specialist Presbyterian University of Pennsylvania Medical Center, Philadelphia. Interview by Tony DeCrosta. PMID- 3647316 TI - Would you encourage your child to be a nurse? PMID- 3647315 TI - Test yourself: can you meet your patients' psychosocial needs? PMID- 3647317 TI - Nobody wanted to mess with Holly. PMID- 3647319 TI - Death & dying. PMID- 3647318 TI - Fundamentals of fluid resuscitation (continuing education credit). PMID- 3647320 TI - A case of dispensing drugs. PMID- 3647322 TI - [Waiting for the outstanding report]. PMID- 3647321 TI - From the other side of the side rails. PMID- 3647324 TI - [Integrated care]. PMID- 3647323 TI - [What is integrated care?]. PMID- 3647325 TI - [The head nurse and integrated care]. PMID- 3647327 TI - The study. What do the nurses think? PMID- 3647326 TI - [Decentralization]. PMID- 3647328 TI - The relationship of knowledge to primary nursing systems. PMID- 3647329 TI - [Step by step. The introduction of integrated care]. PMID- 3647330 TI - [Testimonial: 8 years after its introduction]. PMID- 3647331 TI - [Work in a team plus integrated care--a possible marriage]. PMID- 3647332 TI - [Accreditation visit. An enriching experience]. PMID- 3647334 TI - [Health and treatments. Has the time of choice arrived?]. PMID- 3647333 TI - [A tool for professional development: general surveillance in community health service]. PMID- 3647335 TI - [Nurses facing adolescent abortion]. PMID- 3647336 TI - [Aids--a challenge for nursing]. PMID- 3647337 TI - [Many parents' problem: preparation of a child for a stay in hospital]. PMID- 3647338 TI - Networking for nurses. PMID- 3647339 TI - Meeting the psychosocial needs of patients with rheumatoid arthritis (continuing education credit). PMID- 3647340 TI - Developing an exercise program for the elderly with osteoarthritis. PMID- 3647341 TI - Reflex sympathetic dystrophy syndrome: a nursing challenge. PMID- 3647342 TI - Disorders of the knee: genu valgum and chondromalacia patellae. PMID- 3647343 TI - Congenital hip dysplasia. PMID- 3647344 TI - The nurse and the deposition. PMID- 3647345 TI - Father involvement with first-born infants: interpersonal and situational factors. PMID- 3647346 TI - High school suicide prevention programs. PMID- 3647347 TI - Nursing care of the child with a pulmonary artery catheter. PMID- 3647348 TI - Pediatric management problems (erythema infectiosum). PMID- 3647349 TI - Inactive ingredients in the pediatric population. PMID- 3647350 TI - Long-term results of an elementary sexuality program. PMID- 3647351 TI - Strategies for maintaining continuing education in private practice. PMID- 3647352 TI - Pediatric nursing involvement in public and private developmental disabilities services. Public sector perspective: potential nursing services in mental retardation. PMID- 3647353 TI - Becoming a woman: the girl who is mentally retarded. PMID- 3647354 TI - Parent participation with a family health focus: nurses' attitudes. PMID- 3647355 TI - Parenting of hospitalized infants by adolescent mothers. PMID- 3647356 TI - Exhalation time effects on arterial and venous blood oxygen content and arterial PCO2 during high frequency jet ventilation of surfactant-depleted cats. AB - Since high frequency jet ventilation (HFJV) relies on lung mechanics for the passive removal of expiratory gas, one would predict that the time allowed for exhalation would have serious effects on cardiopulmonary function. To document these effects we lavaged the lungs of ten cats with 30 ml/kg of saline six times, then sampled arterial and venous blood while the animals were ventilated conventionally at 30 BPM and then with HFJV at 600 BPM, varying inspiratory/expiratory ratios (I/E) from 1:1 to 1:5. The animals breathed 100% O2 throughout the study, and the mean airway pressure was held constant for each animal when the I/E was varied during HFJV. Decreasing the I/E from 1:1 to 1:5 during HFJV resulted in an increase of arterial oxygen content (Cao2) from 11.3 +/- 1.2S E to 13.6 +/- 1.2 ml O2/100 ml blood (P less than 0.01), a decrease of PaCO2 from 43 +/- 6 to 27 +/- 4 mm Hg, and an increase of alveolar to arterial oxygen gradient from 351 +/- 49 to 377 +/- 49 mm Hg. The ratio of systemic blood flow to oxygen consumption (Q/VO2) was similar during conventional ventilation and with HFJV at I/E of 1:1 (18.9 +/- 3.7 vs 18.0 +/- 2.9) but decreased when I/E was reduced to 1:5 during HFJV (13.9 +/- 2.1). The ratio of the product of CaO2 and Q (systemic oxygen availability) to VO2 (SO2 T/VO2) remained unchanged during all modes of ventilation (1.75 +/- 0.15). The increase in CaO2 observed when I/E was reduced from 1:1 to 1:5 during HFJV was counterbalanced by a decrease in Q/VO2 such that SO2 T/VO2 remained relatively constant. PMID- 3647357 TI - [From HIV infection to AIDS]. AB - HIV is the causative agent of AIDS. It is a retrovirus of the Lentiviridae family whose known biological properties may account for the diversity of the pathology it causes. HIV displays selective tropism for CD4+ lymphocytes and for cells of the macrophage lineage, the cellular receptor involving the CD4 molecule itself. Its latent integration in its targets' genome and its restricted replication explain the observed frequency of asymptomatic carriers and of prolonged incubation periods. Its strong cytopathic effect and the direct activity of some of its soluble proteins is certainly the cause of the immune abnormalities that may follow infection. Altogether, most of the clinical disorders noted after HIV infection appear to result from the interaction between these viral properties and host-dependent factors such as a particular genetic background or immunologic "terrain". PMID- 3647358 TI - Natural point mutations within rat rDNA transcription terminator elements reveal the functional importance of single bases for factor binding and termination. AB - The rat rDNA transcription unit extends 560-565 bp into the spacer downstream of the 28S rRNA coding region. The site of 3' end formation is located in front of a conserved 18 bp sequence element which is repeated eight times in the 3' spacer between nucleotides +582 and +1767 relative to the 3' terminus of 28S rRNA. These sequence motifs are almost identical to the RNA polymerase I transcription termination signal (the Sal I box) that has previously been identified in the 3' terminal spacer of mouse rDNA. Interestingly, each of the single rat elements contains one or more base substitutions as compared to the murine Sal I box. Individual rat Sal I boxes were cloned and tested for their ability to interact with the murine termination factor and to direct transcription termination. It is shown that five of the eight boxes represent genuine transcription terminators, while three elements contain certain point mutations which are not recognized by the nuclear Sal I box-binding protein and therefore are functionally inactive.Images PMID- 3647359 TI - Teaching styles: is the modular method more effective? PMID- 3647361 TI - General education in nursing: current practices and faculty attitudes. PMID- 3647360 TI - Clinical practice: a dilemma for nurse educators. PMID- 3647362 TI - The relationship of shift work to nurses' satisfaction and perceived work performance. PMID- 3647363 TI - Teaching primary health nursing in the University of New Brunswick screening clinic. PMID- 3647364 TI - Project 2000: calling in the bets. PMID- 3647365 TI - Painful choices. PMID- 3647366 TI - Congenital talipes equinovarus. PMID- 3647367 TI - Performance indicators in the care of the elderly. PMID- 3647368 TI - Frightened of fear. PMID- 3647369 TI - Nursing Aid. Trained for success? PMID- 3647370 TI - When the chips are down. PMID- 3647371 TI - Mr Gardner's notebook. PMID- 3647372 TI - Assessing knowledge. PMID- 3647373 TI - Organ transplants: concerns of the family. PMID- 3647374 TI - Quest. Experiential learning. PMID- 3647375 TI - Quest. Learning by doing. PMID- 3647377 TI - Supplement: Royal College of Nursing's annual congress and exhibition in Glasgow, Apr 6-10. PMID- 3647376 TI - Quest. Playing the game. PMID- 3647378 TI - An idea that blossomed. PMID- 3647379 TI - Recruitment: creche barriers. PMID- 3647380 TI - Mental handicap: doing what seems best. PMID- 3647381 TI - Never mind the quality. PMID- 3647382 TI - Heart disease. Controlling a killer. PMID- 3647383 TI - Heart disease. Passports to health. PMID- 3647385 TI - Part of the family. PMID- 3647384 TI - Management. Acting on information. PMID- 3647386 TI - Learning to lift. PMID- 3647387 TI - The search for professionalism. PMID- 3647388 TI - The uniform question: the case for; the case against. PMID- 3647389 TI - A saint for six weeks. PMID- 3647390 TI - Listen to mothers. PMID- 3647391 TI - Nursing Aid. An underground movement. PMID- 3647392 TI - A sorry saga. PMID- 3647393 TI - Continence. ACA 1966-1987: coming of age. PMID- 3647395 TI - Continence. Spreading the word. PMID- 3647396 TI - Continence. Managing supplies. PMID- 3647394 TI - Continence. Coming of age. PMID- 3647397 TI - Continence. Can we help you? PMID- 3647399 TI - Continence. Finding the right medium. PMID- 3647398 TI - Continence. Diagnosing incontinence type. PMID- 3647401 TI - RCN congress: consensus conference. PMID- 3647400 TI - Smoking: a killer cloud. PMID- 3647402 TI - Mental handicap: a word of advice. Interview by Martin Vousden. PMID- 3647403 TI - AIDS perspectives. PMID- 3647404 TI - Tug of love troubles. PMID- 3647405 TI - Child abuse. Behind closed doors. PMID- 3647406 TI - Child abuse. A family affair. PMID- 3647407 TI - The value of vitamins. Interview by Pamela Holmes. PMID- 3647409 TI - Trials, tribulations and triumph. PMID- 3647408 TI - Heart disease: Wales paves the way to heart health. PMID- 3647410 TI - Peritoneal dialysis. PMID- 3647411 TI - Helping hands. Prisoners of care. PMID- 3647412 TI - Battle of the bottle. PMID- 3647413 TI - Systems of life. No 148. Senior systems. 13. PMID- 3647414 TI - Frontline revolt. PMID- 3647416 TI - Euthanasia: last rights. PMID- 3647415 TI - Divided we fall. PMID- 3647417 TI - Beirut: siege mentality. Interview by Mark Pownall. PMID- 3647418 TI - How does Maggie's garden grow? PMID- 3647420 TI - Practice nurses. The future role. PMID- 3647419 TI - Practice nurses. Practice makes perfect? PMID- 3647421 TI - Practice nurses: a GP employee? The case for; the case against. PMID- 3647422 TI - Lessons from the hospice. PMID- 3647423 TI - A home guide. PMID- 3647424 TI - Nursing Aid. Simple solution. PMID- 3647425 TI - Heart disease. Promoting health by example. PMID- 3647426 TI - Walking tall. PMID- 3647427 TI - Child abuse. Probing the power struggle. PMID- 3647429 TI - Spotlight on children. Journal of the Association of British Paediatric Nurses. PMID- 3647428 TI - Child abuse. A parental prerogative? PMID- 3647430 TI - Spotlight on children. Learning to lose fear. PMID- 3647431 TI - Spotlight on children. Steering a united course. PMID- 3647432 TI - The Chinese connection. PMID- 3647434 TI - Agency nurses: agency for change. PMID- 3647433 TI - AIDS: nurse, heal thyself. PMID- 3647435 TI - No surrender. PMID- 3647436 TI - Project 2000: an outside perspective. Make or break? PMID- 3647437 TI - Project 2000: an outside perspective. A welcome attempt at reform. PMID- 3647438 TI - Project 2000: an outside perspective. A top priority. PMID- 3647439 TI - Project 2000: an outside perspective. An unreal brave new world? PMID- 3647440 TI - Preparing for life after a stoma. PMID- 3647441 TI - Chipping away at granite. Interview by Charlotte Alderman. PMID- 3647442 TI - Nursing Times guide to care planning: nurse's little helper. PMID- 3647443 TI - Getting the message across. PMID- 3647445 TI - Too much, too soon? PMID- 3647444 TI - Heart disease: heart health gets the hard sell. PMID- 3647446 TI - Nursing Aid. Lifting the curse. PMID- 3647447 TI - Child abuse. Visiting rights. PMID- 3647448 TI - Mental health nursing journal of the Psychiatric Nurses Association. PMID- 3647450 TI - Mental health nursing. All for one and one for all. PMID- 3647449 TI - Mental health nursing. Your own worst enemy. PMID- 3647452 TI - Epidemic typhoid among nurses. PMID- 3647451 TI - Mental health nursing. The family way. PMID- 3647453 TI - Plea for a better deal to nurses: memoranda on recommendations of Fourth Central Pay Commission. PMID- 3647454 TI - Student Nurses' Association: an introduction. PMID- 3647455 TI - Community health nursing: a challenge within professional nursing. PMID- 3647456 TI - Role of a good teacher. PMID- 3647457 TI - Patient education: major aspect of health and nursing process. PMID- 3647458 TI - Exposing nursing students to vital tasks. PMID- 3647459 TI - Nurses' role in health care policies. PMID- 3647460 TI - Strengthening others with sympathy. PMID- 3647461 TI - Nursing outreach for healthy living. PMID- 3647462 TI - Nursing as a career: a socio-economic study. PMID- 3647463 TI - The multiple role of a head nurse. PMID- 3647464 TI - Behaviour problems among children: role of parents. PMID- 3647465 TI - Using nursing models for nursing practice. PMID- 3647466 TI - The role of the physician in home care. PMID- 3647468 TI - Nurses as agents for change in teaching breast self-examination. PMID- 3647467 TI - Migrant farm workers' perceptions of support persons in a descriptive community survey. PMID- 3647469 TI - The health of teenagers: a focused ethnographic study. PMID- 3647470 TI - The home health agency and the ivory tower. PMID- 3647471 TI - Appointments for adolescent pregnancy and family planning: the effects of delays in providing services. PMID- 3647472 TI - Human-environment interaction: a modification of the Neuman systems model for aggregates, families, and the community. PMID- 3647473 TI - The need for graduate education in community health nursing: a survey. PMID- 3647474 TI - Perspective on home care. PMID- 3647475 TI - Assessment of maternal postpartum adaptation. PMID- 3647476 TI - Primary mitral valve prolapse: the needs of symptomatic patients. PMID- 3647477 TI - Prognosis of patients with persistent ventricular arrhythmias following myocardial infarction. PMID- 3647478 TI - Self-efficacy: new perspectives in caring for patients recovering from myocardial infarction. PMID- 3647479 TI - Creative financing for nursing research. PMID- 3647480 TI - Creatine kinase enzyme determination: implications for cardiovascular nursing. PMID- 3647481 TI - Cardiovascular effects of cocaine use. PMID- 3647482 TI - Pregnancy in women with congenital heart disease. PMID- 3647483 TI - The future of continuing professional education. PMID- 3647484 TI - Syringe drivers in pain control. PMID- 3647486 TI - Antenatal screening. PMID- 3647485 TI - Compression bandaging for venous ulcers. PMID- 3647487 TI - Questioning skills: investigating a disputed incident. PMID- 3647488 TI - Management of male incontinence using a sheath. PMID- 3647489 TI - Nurses power in Albay. PMID- 3647490 TI - [Sex. Woman and man]. PMID- 3647492 TI - [Role of the nurse in preparing patients for surgery]. PMID- 3647491 TI - [A calling or a profession?]. PMID- 3647493 TI - [Clinical significance of atrial fibrillation]. PMID- 3647495 TI - [Ewa Heizer, nurse administrator in Bielsko-Biala, talks more throughly about the ward attendant and nurse. Interview by Maria Lesnikowska]. PMID- 3647494 TI - [Sick leave of nurses and midwives]. PMID- 3647496 TI - [Her mother's disease became the stimulus. Interview by Bogdan Nowak]. PMID- 3647497 TI - [The head nurse of Gostyn District. Interview by Bogdan Nowak]. PMID- 3647498 TI - [Cooperation]. PMID- 3647499 TI - [Cardiotocography]. PMID- 3647500 TI - [The main tasks of nursing care in 1987 (a proposal)]. PMID- 3647501 TI - [AIDS. The acquired immunodeficiency syndrome]. PMID- 3647502 TI - [The social expectations in relation to nurses]. PMID- 3647503 TI - [The work culture of nurses]. PMID- 3647504 TI - [Health for all in Europe by the year 2000. The regional goals]. PMID- 3647505 TI - [Moulding a professional and work culture]. PMID- 3647506 TI - [From a recumbent position]. PMID- 3647507 TI - [The Red Cross is our symbol]. PMID- 3647508 TI - [Sex. Beliefs and myths]. PMID- 3647509 TI - [Pregnancy--the importance of a cardiotocography]. PMID- 3647510 TI - [The health model and nursing. A voice in the discussion]. PMID- 3647511 TI - [Amputation of the lower extremities]. PMID- 3647512 TI - [Emotional reactions towards disease]. PMID- 3647513 TI - [Role of the nurse in the rehabilitation process]. PMID- 3647514 TI - [The sick person after the event--the patient of special concern]. PMID- 3647515 TI - [Plaster casts in orthopedics and traumatology]. PMID- 3647516 TI - [Arthroscopy, the knee joint without secrets]. PMID- 3647517 TI - [Meniscal injuries--only in soccer?]. PMID- 3647518 TI - [Physical therapy of certain diseases and injuries of the locomotor apparatus]. PMID- 3647519 TI - [A few words on tennis elbow]. PMID- 3647520 TI - [Pregnancy. The importance of cardiotocography. 3]. PMID- 3647522 TI - [Sex. From myth to science]. PMID- 3647521 TI - [Nurses as lecturers in the military studies of colleges]. PMID- 3647523 TI - [Those little bits which we can do, we do with a full heart (a voice in the discussion)]. PMID- 3647524 TI - [Health for all by the year 2000. Recommendations for nurses and midwives]. PMID- 3647525 TI - Court upholds mandatory degree for R.N.'s. PMID- 3647526 TI - AIDS victim seeks identity of blood donors. Case in point: Rasmussen v. South Florida Blood Serv. (500 So. 2d 533-FL). PMID- 3647527 TI - When doctors ignore nurses' advice: disaster. Case in point: Tabor v. Doctors Memorial Hosp. (520 So. 2d 243-LA). PMID- 3647528 TI - When nurses should blow the whistle. PMID- 3647529 TI - Obese nursing student expelled: education. Case in point: Russell v. Salve Regina College (649 F. Supp. 391-RI). PMID- 3647530 TI - Legal case briefs for nurses. IL: agency is not employer: discrimination LA: lap sponge left: liability issue. PMID- 3647531 TI - Are you under doctor's supervision and control? Case in point: Holloway v. Robertson (500 So. 2d 1056-AL). PMID- 3647532 TI - Doctoral preparation of qualified nurse researchers. PMID- 3647533 TI - Sensitivity to infant development and behavior: a comparison of adolescent and adult single mothers. AB - The relationship of adolescent mothers' knowledge of infant development and perceptions of infant behavior to stress experienced during pregnancy were examined using a comparison group of adults of similar marital status. Relationships with maternal age across groups also were examined. Adolescents underestimated developmental rate and perceived some infant behaviors less optimally, but did not differ in levels of stress. Stress was related to several parenting subscores. Some support for a linear relationship with maternal age was found. Results suggest the need for further research to determine how level of maturity affects translation of knowledge into maternal action. PMID- 3647534 TI - Measures of mother-child interaction: a comparison of three methods. AB - Three methods of recording mother-child interaction were compared in a sample of 136 adolescent mothers with children ranging in age from 8 to 27 months. Mother child interaction was rated during in-home observations using Barnard's Teaching Scale, Schaefer's Attachment Inventory, and Clarke-Stewart's Rating Scales. The results indicate that each measure complements the other two, and that their interrelationships support the validity of the dimensions each describes. Yet, analyses indicate that they do not share common underlying factors. The findings suggest that each measure contributes to a more complete description of mother child interaction. PMID- 3647535 TI - Patient participation in alternative perinatal care: impact on satisfaction and health locus of control. AB - Women's degree of participation, satisfaction, and change in health locus of control after giving birth in an alternative birthing unit was examined. A quasiexperimental two-group design of convenience samples (N = 99) was used to compare differences and evaluate the care given. An alternative birthing experience increased women's sense of participation and related to women's satisfaction, but did not change internal scores on the Multidimensional Health Locus of Control Scales. Women's reliance on powerful others increased post delivery. Complications were negatively related to selected aspects of women's satisfaction in labor and delivery, but positively related to satisfaction with antepartal care. PMID- 3647536 TI - Nurses and physicians must interact for valid clinical research. AB - The results of clinical research provide information for improving patient care. Seldom can one profession conduct research in the clinical setting without communicating with other professionals affected by the research protocol. When informed consent is obtained from the patient, an investigator may think that sufficient communication to all parties affected by a study has occurred. To conceptualize interactions observed between two professions, (i.e., nursing and medicine), five patterns are proposed: blocking research, hidden research, dumping research, negotiated research, and collaborative research. The patterns are associated with various amounts or types of communication about research. Each description of a pattern contains an example of the interactions possible in that model, a set of assumptions that underlie those interactions, and a number of potential outcomes. The interactions described are real occurrences with some details changed to prevent identification of individuals or institutions. These examples of research interactions occurred at several institutions. The outcomes listed are not all possible at the same time, but are a compilation of a number of outcomes that could occur. PMID- 3647537 TI - Instrumentation to describe subjective sleep characteristics in healthy subjects. AB - The purpose of this study was to develop and test the Verran and Snyder-Halpern (VSH) Sleep Scale, an instrument to subjectively measure sleep characteristics. Four major sleep factors and their associated characteristics were proposed for the Sleep Scale. Subjects completed three randomly ordered sleep questionnaires on three consecutive weekday mornings within the first two hours after arising. Scales included the VSH Sleep Scale, a sleep questionnaire and a sleep log. The VSH Sleep Scale had a reliability coefficient of .82 (theta). Construct validity was examined by factor analysis and correlations between Sleep Scale items and corresponding items on the two other study instruments. Scale validity also was assessed by the known groups method. Beginning support for the validity of the VSH Sleep Scale is provided. PMID- 3647538 TI - The derivation and validation of six Multidimensional Health Locus of Control Scale clusters. AB - The purpose of this research was twofold. First, to determine if eight Multidimensional Health Locus of Control types hypothesized by Wallston and Wallston (1982) existed. Second, to assess the reliability, validity, and clinical utility of the control types. Two investigations were conducted based on research procedures designed for the discovery of clusters. The first study involved the derivation and replication of MHLC clusters with a sample of 400 healthy undergraduate men and women. The results of Study 1 suggested the existence of six MHLC clusters: pure internal; double external; pure chance; yea sayer; nay sayer, and believer in control. The sample for Study 2 consisted of 90 female undergraduate and graduate students. The six-cluster solution was replicated in this second cross-validation study. Furthermore, construct validity of the clusters was established through computer simulation. Finally, relationships between clusters and the Krantz Health Opinion Survey suggested the clusters have a theoretical as well as a empirical foundation. The implications of these findings for clinical practice, for the development of the health locus of control construct, and for future research on the MHLC Scale are discussed. PMID- 3647539 TI - Power orientations and communication style of managers and nonmanagers. AB - The purpose of this study was to compare nurse managers and nonmanagers in their orientations to power and in their communication styles. A complementary purpose was to examine the relationship between six orientations to power and social style. Forty-seven hospitals were randomly selected with 43 used for analysis. The director of nursing and a staff nurse from each hospital were asked to complete the Power Orientation Scale and to obtain ratings from others on their social style. Nurse administrators held more positive orientations to three of the six power orientations, and were perceived to communicate more assertively than staff nurses. Negative correlations were found between four of the power orientations and two dimensions of social style. PMID- 3647541 TI - [Visceral leishmaniasis associated with positive anti-HTLV III antibody]. PMID- 3647540 TI - [Urinary excretion of kallikrein in newborn infants]. PMID- 3647542 TI - [Prevalence of human immunodeficiency virus antibodies in inmates and officials of penitentiaries]. PMID- 3647543 TI - [The nurse's work correlated with the family physician. Lawton Polyclinic. Initial experiences]. PMID- 3647544 TI - [Nursing care for pregnant women with heart disease]. PMID- 3647545 TI - [Nursing care for patients wearing RALCA model external fixation devices]. PMID- 3647546 TI - [Development of models of study plans in nursing education]. PMID- 3647547 TI - [Experiences in the use of respiratory exercise therapy]. PMID- 3647548 TI - [Use of oral rehydration in the Gastroenteritis Service at the Matanzas Pediatric Hospital]. PMID- 3647549 TI - [Results of follow-up in a group of patients with severe hemorrhagic dengue]. PMID- 3647550 TI - [BCG coverage in students of the 7th grade at the La Maya health area]. PMID- 3647551 TI - [Prenatal factors and their relationship to low Apgar scores]. PMID- 3647552 TI - [Significance of serum levels of elastase 1 and pancreatic isoamylase in acute and chronic recurrent pancreatitis]. PMID- 3647553 TI - Coma recovery program. PMID- 3647554 TI - Rehabilitation outcomes in children with brain injury. PMID- 3647556 TI - Head injury and the family: related literature. PMID- 3647555 TI - MI patient expectations and health status. PMID- 3647557 TI - Rehabilitation in head injury: a case study. PMID- 3647558 TI - Ambulation aids. PMID- 3647559 TI - [Locomotor apparatus: lower extremity (3). Physiology of the hip joint]. PMID- 3647560 TI - [Pleural drainage (3)]. PMID- 3647561 TI - [Radiology of the normal foot]. PMID- 3647562 TI - [Hallux valgus]. PMID- 3647563 TI - [Algoneurodystrophy of the foot]. PMID- 3647565 TI - [Flatfoot, hollow foot and vertebral posture]. PMID- 3647564 TI - [Congenital club foot in children]. PMID- 3647566 TI - [How to protect the feet?]. PMID- 3647567 TI - [The feet of the aged]. PMID- 3647568 TI - [Lymphocytic meningitis]. PMID- 3647569 TI - [Lumbar puncture]. PMID- 3647570 TI - [The cataracts]. PMID- 3647571 TI - [Bacterial endocarditis and dental infections]. PMID- 3647572 TI - [Hepatic coma]. PMID- 3647573 TI - [A death from hepatorenal syndrome. History of a resuscitation]. PMID- 3647574 TI - [Placebo effect]. PMID- 3647575 TI - [Arteritis of the lower extremities. Care of patients with trophic disorders]. PMID- 3647576 TI - [Accidental hypothermia]. PMID- 3647577 TI - [Digitalis glycosides]. PMID- 3647578 TI - [Tetanus in 15 questions]. PMID- 3647579 TI - [Tools of public health. 1. Understanding statistics]. PMID- 3647580 TI - [Nursing and reflex therapy]. PMID- 3647581 TI - [Women, health and development]. PMID- 3647582 TI - [Health and health services from an economic perspective]. PMID- 3647583 TI - [Systems of aspiration]. PMID- 3647584 TI - Report: how to say it all in a few words. PMID- 3647585 TI - What I learned from my hospital bed. PMID- 3647586 TI - Calling a code: your role in helping a family decide. PMID- 3647587 TI - The slow code dilemma. PMID- 3647588 TI - The right way to prevent medication errors. PMID- 3647589 TI - My little yellow wonder pill. PMID- 3647590 TI - When a dressing won't do the job. PMID- 3647591 TI - A form that makes wound assessment easier. PMID- 3647592 TI - Dyspnea: finding the cause; treating the symptoms (continuing education credit). PMID- 3647593 TI - Callous nurses, a bewildered mother, a brain-damaged baby. PMID- 3647594 TI - Gynecologic cancer: uterine and ovarian malignancies. PMID- 3647595 TI - How your employee handbook protects you. PMID- 3647597 TI - What a dying patient needs from you. PMID- 3647596 TI - Can a low-fat diet prevent breast cancer? PMID- 3647598 TI - An open letter to staff nurses. PMID- 3647599 TI - Probing the AIDS virus and its relatives. PMID- 3647600 TI - [Potassium-preserving diuretics]. PMID- 3647601 TI - [Handwashing. Everyday technic (1)]. PMID- 3647602 TI - [The diabetic foot]. PMID- 3647603 TI - [The diabetic foot. Theoretical aspects]. PMID- 3647604 TI - [Prevention of the diabetic food and its complications]. PMID- 3647605 TI - [A protocol of care for the diabetic foot]. PMID- 3647606 TI - [Prevention and treatment of the diabetic foot. Survey in the northern region]. PMID- 3647607 TI - [The resolving wounds. An original approach to the treatment of diabetic foot]. PMID- 3647608 TI - [Office hours for diabetic foot]. PMID- 3647609 TI - [Nudity in the hospital. Appearance for the patient--vehicle for a relationship]. PMID- 3647610 TI - [Dietetics in diabetes]. PMID- 3647611 TI - [Simple and complex sugars]. PMID- 3647612 TI - [Patient information in a public hospital]. PMID- 3647614 TI - [A light meal for the insulin-dependent diabetic. Comparative study between 15 g of sugar consumed as fruit or as bread and cheese]. PMID- 3647613 TI - [Carbohydrate allowance and blood sugar equilibrium in the insulin-dependent diabetic]. PMID- 3647616 TI - [The story of Guy]. PMID- 3647615 TI - [Cledial]. PMID- 3647617 TI - [An experience of placing a psychotic adolescent girl with a foster family]. PMID- 3647618 TI - [Psychotic adolescents facing reality. Within the framework of a therapeutic term in an industrial workshop]. PMID- 3647619 TI - [Sound therapy for a girl with an obsessional neurosis refusing school]. PMID- 3647620 TI - [Therapeutic role of the painting studio]. PMID- 3647621 TI - [The nursing staff. Diversity of its function in a child psychiatry service]. PMID- 3647622 TI - [Nurses talk about their experiences]. PMID- 3647623 TI - [The nurse facing the psychiatric patient]. PMID- 3647624 TI - [A workshop in a child psychiatric environment. Caring for adolescents]. PMID- 3647625 TI - [Nutritional needs of children from birth to 18 months]. PMID- 3647627 TI - [Parasitic infections and pregnancy]. PMID- 3647626 TI - [Bacterial infections (and pregnancy)]. PMID- 3647628 TI - [Management of fever following childbirth]. PMID- 3647629 TI - [Detection of fever in a pregnancy woman]. PMID- 3647630 TI - [Musical expression in the collective nurseries of the city of Paris]. PMID- 3647631 TI - [Infections and pregnancy]. PMID- 3647632 TI - [Physiopathology of infections during pregnancy]. PMID- 3647633 TI - [Viral infections and pregnancy]. PMID- 3647634 TI - [Tax orientation for income tax return for the fiscal year 1986]. PMID- 3647635 TI - [Executive Board. Inadequate information about insight into records]. PMID- 3647636 TI - [Wage-related backward slide continues 1984-86]. PMID- 3647637 TI - [Education will be built up through mutual responsibility]. PMID- 3647638 TI - [Working environment. Mapped-out environmental problems at the place of work. Interview by Soren Palsbo]. PMID- 3647639 TI - [Working environment. The private home as a place of work. Interview by Lars Peter Bergqvist]. PMID- 3647640 TI - [Working environment. One has to create one's own credibilities and know where they can be used. Interview by Helle Kastholm Hansen]. PMID- 3647641 TI - [Working environment. How it is perceived by occupational health services]. PMID- 3647642 TI - [Large-savings--both in economics and humans]. PMID- 3647643 TI - [Working environment. Intermediaries are often caught--like a louse between two hard nails]. PMID- 3647644 TI - [Working environment. If we had democracy nobody would become worn out from work. Interview by Ulla Danielsen]. PMID- 3647645 TI - [Working environment. Information about work inspection helps nursing staff. Interview by Ulla Holtegaard]. PMID- 3647647 TI - [Working environment. Cancer incurred at work a more frequent cause of death than traffic]. PMID- 3647646 TI - [Working environment. Activities in the balance weight apparently more than the estimated health. Interview by Helle Kastholm Hansen]. PMID- 3647648 TI - [Working environment. Focus on ergonomics in 1987]. PMID- 3647649 TI - [Access to documents. Now patients have the right to see their own records]. PMID- 3647650 TI - [Danish Nursing Council. Is membership in professional organizations registered correctly?]. PMID- 3647651 TI - [Health policy. Communities can cooperate in the promotion of prevention]. PMID- 3647652 TI - [Poster competition. Danish Nursing Council received many fine designs for posters]. PMID- 3647653 TI - [Freedom of speech. Constitutionally guaranteed right passed in theory by Aarhus' County Council]. PMID- 3647655 TI - [It is snobbery that nurses want to be academicians]. PMID- 3647656 TI - [Students: pay should not be tampered with]. PMID- 3647654 TI - [Nursing models are preliminary studies for nursing science]. PMID- 3647657 TI - [Health visitors' dilemma: she is best when she is "invisible". Interview by Lars Peter Bergqvist]. PMID- 3647658 TI - [Research. Assessments of nursing's contribution should be done scientifically]. PMID- 3647659 TI - [Nurses, politicians and social power]. PMID- 3647660 TI - [There should be a relationship between purpose and philosophy]. PMID- 3647661 TI - [Modernization of psychiatric service from several viewpoints]. PMID- 3647662 TI - [Rethinking and fewer prejudices against integration of somatic medicine and psychiatry]. PMID- 3647663 TI - [Nursing. A challenge to decentralize the anesthesia department]. PMID- 3647664 TI - [Executive Board. Nursing in primary care in international and national development]. PMID- 3647665 TI - [Parliament. Uncertain politicians hesitantly accept criteria for brain death]. PMID- 3647666 TI - [Parliament. The important points in the new law on criteria for brain death]. PMID- 3647667 TI - [Working environment. Safety in the sterilization of equipment]. PMID- 3647668 TI - [Children's health. New series of articles on children and their conditions then and now]. PMID- 3647670 TI - [Working environment. Eyes must be protected with use of lasers]. PMID- 3647669 TI - [Like selling my soul and forsaking my profession. Interview by Lars Peter Bergqvist]. PMID- 3647671 TI - [Greenland. Thrust in education plans with the taking over of the health system]. PMID- 3647673 TI - [Increasing academic education of nurses--snobbery or development]. PMID- 3647672 TI - [Parliament. Growing political demand for a joint health ministry]. PMID- 3647674 TI - [Negotiations 1987. Kirsten Stallknecht: I don't belief in better results with conflict]. PMID- 3647675 TI - [Negotiations 1987. Health visitors are now uppermost on the priority list]. PMID- 3647676 TI - [Women's life. Assertive technics used in hierarchy]. PMID- 3647677 TI - Platelet aggregation induced by ether-linked phospholipids. 1. Inhibitory actions of bovine serum albumin and structural analogues of platelet activating factor. AB - Ether-linked lysophosphatidic acid was able to induce aggregation of platelets from various animals. Feline platelets were the most sensitive followed in decreasing order by human, bovine and rabbit platelets. ONO-6240 and CV-3988, which are antagonists of platelet activating factor, did not inhibit aggregation of feline platelets induced by ether-linked lysophosphatidic acid, indicating that the aggregation induced by the lysophosphatidic acid did not involve receptors for platelet activating factor. An addition of bovine serum albumin caused dose-dependent inhibitions on the aggregation of platelets by both ether linked lysophosphatidic acid and platelet activating factor. Moreover, 0.5% bovine serum albumin reversed platelet aggregation by the active phospholipid before this aggregation reached a maximum. These results suggest that the lysophosphatidic acid exerts its stimulatory action extracellularly, probably by interacting with specific sites on the surface of platelet. PMID- 3647678 TI - Malignant hyperthermia. PMID- 3647680 TI - Marketing your laser program. PMID- 3647679 TI - Could you serve on a professional association board? PMID- 3647681 TI - Your own malpractice insurance: is it necessary? PMID- 3647682 TI - Computerizing an OR. PMID- 3647684 TI - The RN assistant in hand surgery. PMID- 3647683 TI - Acquire and use power effectively. PMID- 3647685 TI - Money misconceptions. PMID- 3647686 TI - Stress management in OR nursing. PMID- 3647687 TI - [Panel discussion: child health and immunization]. PMID- 3647688 TI - [Nursing research and examples]. PMID- 3647689 TI - [Nursing and its occupational diseases. I. Varicose veins]. PMID- 3647690 TI - [Nursing and its occupational diseases. II. Sleeping problems]. PMID- 3647691 TI - [Nursing and its occupational diseases. III. Infectious diseases]. PMID- 3647692 TI - [Nursing and its occupational diseases. IV. Radiation]. PMID- 3647693 TI - [Panel discussion: family planning]. PMID- 3647694 TI - [Women and female health issues. I. Internal genital cancers of women]. PMID- 3647695 TI - [Women and female health issues. II. Infections unique to women]. PMID- 3647696 TI - [Women's place in society. I. Women's place in Turkish society]. PMID- 3647697 TI - [Women's place in society. II. Working life and women]. PMID- 3647698 TI - [Opening speech of the President of the Turkish Nursing Association: Activity Report of the Turkish Nurses Association]. PMID- 3647699 TI - [Role of the blood kallikrein-kinin system in the pathogenesis of functional cardiomyopathy in chronic tonsillitis patients]. PMID- 3647700 TI - Nurse self-esteem and collaboration with physicians. PMID- 3647701 TI - Patients' perceptions of support. PMID- 3647702 TI - Strategies for teaching nursing research. Teaching statistical analysis--a computer application activity. PMID- 3647703 TI - Computer use and nursing research. Statistical packages for microcomputers. PMID- 3647704 TI - Exploratory data analysis--examining single distributions. PMID- 3647705 TI - Social support and the constructive-developmental model. PMID- 3647706 TI - Social support and coping with lung cancer. PMID- 3647707 TI - Uncertainty. A mediator between support and adjustment. PMID- 3647708 TI - Self-efficacy and social support. Mediators of stress on mental health following a natural disaster. PMID- 3647710 TI - Cost and conflict. The darker side of social support. PMID- 3647709 TI - The elderly market for nurse practitioner services. PMID- 3647711 TI - Prevalence of antibody to human immunodeficiency virus and client characteristics in the Wisconsin Alternate Site Testing and Counseling Program, 1985-1986. PMID- 3647712 TI - Biomonitoring of industrial dusts on animals. II. Bioindication on alveolar macrophages. AB - Rats and rabbits were exposed through the respiratory system to industrial dusts (magnesite emissions, solid wastes from nickel refinery dump, cement emissions) at biomonitory stations or in experimental chamber. Following exposure the animals were killed, the alveolar macrophages isolated and acid phosphatase and beta-glucuronidase estimated in the isolated cells. The activity of both enzymes was enhanced in the exposed animals in all cases. The enhancement was dependent on the length of exposure and amount of inhaled particles. PMID- 3647713 TI - Biomonitoring of industrial dusts on animals. I. Bioaccumulation of dust components. AB - The bioaccumulation of industrial dust components in laboratory animals exposed by inhalation was studied under environmental conditions. Three types of industrial emissions were investigated: magnesite emissions, wastes from nickel refinery and cement emissions, respectively. The findings revealed that the chemical components of the industrial dust particles inhaled by animals are accumulated not only in the lungs, but also in the other organs, bone and hair of the exposed animals. In addition, the dust components were found in the organs of the F1 generation as well. This suggests a new aspect for the assessment of the biohazard of industrial dust particles in the environment. PMID- 3647715 TI - Appeals and advice on pension matters. PMID- 3647714 TI - Prevention of relapse with treatment of depression in alcoholic patients: an exploratory study. PMID- 3647716 TI - Access to post-basic baccalaureate education in nursing. PMID- 3647717 TI - A.A.R.N. nursing research grants awarded. PMID- 3647718 TI - The prevalent cohort study and the acquired immunodeficiency syndrome. AB - The acquired immunodeficiency syndrome (AIDS) is caused by a retrovirus, the human immunodeficiency virus (HIV). A rapid and convenient method to identify additional cofactors or risk modifiers and markers of disease progression is to study a cohort prevalent with HIV antibody. However, because the time of viral infection is usually unknown in the cohort, there are several potential sources of bias. Three sources of bias in a prevalent cohort study are identified assuming a proportional hazards model: onset confounding, differential length biased sampling, and frailty selection. A number of problems in the interpretation of results on markers from a prevalent cohort also are considered. It is concluded that risk estimates derived from a prevalent cohort are not directly comparable to risk estimates derived from an incident cohort. PMID- 3647719 TI - What they don't teach you in nursing school. PMID- 3647720 TI - How do you manage pancreatic sump tubes? PMID- 3647721 TI - When the courts define nursing: what it is, what it does. PMID- 3647722 TI - Profiles in excellence. PMID- 3647723 TI - The case for the heparin flush. PMID- 3647724 TI - The case for the saline flush. PMID- 3647726 TI - What keeps nurses in nursing? PMID- 3647725 TI - Starting right after stroke. PMID- 3647727 TI - Time for Texas. PMID- 3647729 TI - The paper-free chart. PMID- 3647728 TI - Maternal-infant core competencies in BSN curricula. PMID- 3647730 TI - Combining care plan and Kardex. PMID- 3647731 TI - Battling the awfulistic, absolutist 'shoulds'. PMID- 3647732 TI - The progression of morphologic changes in bronchopulmonary dysplasia. AB - Review of published reports shows confusion regarding the pathologic sequelae of neonatal respiratory distress. To examine this problem the authors studied histologic slides of lung from 46 patients so diagnosed listed in the autopsy files of The Johns Hopkins Hospital. Two distinct morphologic patterns emerged. In 26 patients (Group 1) there were varying sized areas of interstitial fibrosis with associated distortion of air spaces. The process was nonspecific and closely resembled the interstitial fibrosis of varying etiologies found in adults. This lesion appears to correspond to most descriptions of bronchopulmonary dysplasia. A second process predominated in 10 patients (Group 3). There were normal conducting bronchi, marked uniform enlargement of distal air spaces, and little or no interstitial fibrosis. In 10 patients (Group 2) both lesions coexisted. To gain further insight into the morphology of these disorders, the authors reconstructed serial histologic sections of lung from three infants of varying sizes with normal lungs and infants of varying ages with bronchopulmonary dysplasia. The results confirmed the observations made on routine histologic sections by showing interstitial fibrosis in the early stages of bronchopulmonary dysplasia and a reduced number of very large terminal air spaces without interstitial fibrosis in the late stages. There were no obvious differences in the clinical courses of infants with the different morphologic stages; but Group 1 patients averaged 39 days of age, Group 2 lived 142 days, and Group 3 survived 277 days. It seems probable that early bronchopulmonary dysplasia is simply the healing of alveolar wall injury of whatever cause, most commonly hyaline membrane disease of the newborn; and that in the later phases of repair, with continuing growth, there is a thinning of airway walls, but a failure of alveolar development. Recognition of these two pathologically different patterns is important for further studies of the pathogenesis of bronchopulmonary dysplasia. PMID- 3647733 TI - Reduced urinary kallikrein activity in rats developing spontaneous hypertension. AB - Urinary kallikrein activity, intake, and excretion of sodium and water were measured in metabolic balance studies on spontaneously hypertensive rats (SHR) of the Okamoto-Aoki strain and normotensive Wistar-Kyoto rats (WKY) on a normal sodium diet from 4 through 15 wk of age. Urinary excretion of active and total kallikrein was significantly lower in SHR at all ages examined and represented a stable percentage of the values in age-matched WKY throughout development, on the average 69.5 and 67.4%, respectively. SHR exhibited a lower urinary excretion of sodium and water than WKY, a higher cumulative sodium balance at all ages studied, and a higher cumulative water balance only at ages 7 and 8 wk. The slopes of the regression lines correlating urinary kallikrein to systolic arterial pressure and to urinary excretion and cumulative balance of sodium and water were always significantly less in SHR than in WKY. The results of the present study indicate that SHR developing hypertension exhibit a precocious and stable abnormality in renal excretion of kallikrein activity. PMID- 3647734 TI - Credentialing in nursing: contemporary developments and trends. Methodological considerations in certification and licensure testing. PMID- 3647735 TI - Surgeon General's Report on acquired immune deficiency syndrome. PMID- 3647736 TI - Catastrophic health insurance: who should pay? PMID- 3647737 TI - Managing problem performance. A supervisor's responsibility. AB - Following the suggestions in this paper will not guarantee that you will never have discipline problems or that you will deal with them effectively every time they arise. But the OR supervisor who provides good orientation, sets clear goals and standards, and who consistently motivates employees through foresight, praise, and encouragement should have fewer discipline problems. And if the supervisor develops the self-knowledge, communication skills, and administrative capabilities described in this paper, he or she should be able to cope with unavoidable problems more effectively. PMID- 3647738 TI - Patient positioning. Applying the nursing process. PMID- 3647739 TI - Thoracotomy for esophageal leiomyomas. Preoperative, intraoperative, and postoperative care. PMID- 3647740 TI - A college without walls. Learning first assistant skills. AB - This course for expanded perioperative role assumption as an RNFA intends to prepare nurses who eventually can become individually responsible for comprehensive care of the patient undergoing surgical intervention, and help them establish collegial relationships with other nursing colleagues, surgeons, and health care providers. The RNFA is concerned about the intraoperative safety of the patient and is involved in patient assessment and patient and family education. The RNFA collaborates with the physician to provide patient care in a complementary, collegial partnership. Within a framework of communication, trust, and mutual respect, the perioperative nurse prepared to first assist emerges as a renewed patient advocate, confident of her or his contribution to patient care, and committed to responsibility and accountability for the quality of that care. PMID- 3647741 TI - The preoperative interview. Its effect on perioperative nurses' empathy. AB - Further studies need to be done to determine the impact preoperative visits have on the perioperative nurse's empathy level. The results of this study could be confirmed, or refuted, if a study with more subjects was conducted over a longer period of time. Also, subjects in both the control and experimental groups should be chosen randomly and should be from the same institution. To measure the long term effect of preoperative visits on empathy levels, a study could be conducted that measures the levels at various times (eg, six months to a year following the first study). Other evaluations of empathy levels, such as observer rating and patient rating, could be used to supplement nurses self-rating scores to avoid using one standard instrument and rating scale. Few conclusions can be drawn from this limited study, but it does help nurses realize that preoperative interviews can help the nurse become more aware of the surgical patient as a human being. This increased awareness may help the nurse function more effectively and efficiently in helping the patient during intraoperative care. PMID- 3647742 TI - Monitoring nitrous oxide in the OR. A research study. PMID- 3647743 TI - Teaching perioperative nursing. A proposed design for a curriculum. PMID- 3647744 TI - Understanding cultural differences is the key to transcultural nursing. PMID- 3647745 TI - Dealing with other cultures and religions emphasized at recent ethics conference. PMID- 3647746 TI - Deciphering fact from fallacy about entry-into-practice requirements is every nurse's responsibility. PMID- 3647747 TI - Petroleum products and lasers do not mix. PMID- 3647748 TI - Location of ethylene oxide vents questioned. PMID- 3647749 TI - Esophageal atresia. Corrective procedures and nursing care. PMID- 3647750 TI - Temporomandibular joint arthroscopy. A new treatment alternative. PMID- 3647751 TI - Cricoid pressure. How, when, and why. PMID- 3647752 TI - A quality assurance program. Operating room/postanesthesia care unit. PMID- 3647753 TI - The computer in the OR. An implementation experience. PMID- 3647754 TI - Interhospital transportation. Monitoring sterility of instrument packs. AB - The Minneapolis-St Paul area is currently experiencing an increase in health care mergers among hospitals. As new facilities are acquired, whether through merger or the building of satellite hospitals, economic considerations often instigate the consolidation of certain departments and services. Thus, hospitals are confronted with a new set of management problems. One such problem might be determining if the probability of contamination increases when a sterile pack is transported from the central sterile supply department of one hospital to the operating room of another hospital. This study indicates that interhospital transport of surgical packs, using a specially designed transfer system, can be accomplished without compromising the sterile status to a significantly greater degree than that associated with transport within a hospital. Many more samples would have to be assayed before these results could be considered conclusive. This study proposes a simple, reproducible, microbiologically sensitive and statistically satisfactory test to monitor the sterile integrity of surgical packs. In the past, different sterility monitoring methods proposed have required either special equipment, specially trained personnel, or complicated procedures. The assay method described here can be easily used by central sterile supply department personnel to monitor the sterile status of transported or stored surgical packs. PMID- 3647755 TI - Touch. Research findings and use in preoperative care. PMID- 3647756 TI - Having fun with cost containment. PMID- 3647757 TI - Vanadate-dependent oxidation of pyridine nucleotides in rat liver microsomal membranes. AB - An enzymatic Na3VO4-dependent system for the oxidation of reduced pyridine nucleotides in purified rat liver microsomes was characterized. The system has a pH optimum of 6.5, and appears to be specific for vanadate, since activity in the presence of a related transition metal, molybdate, was not detected. Vanadate dependent oxidation occurred with a concomitant consumption of O2 and, contrary to previous reports, preferred NADPH over NADH. At pH 6.5, the NADPH/NADH oxidase activity ratio was greater than 2:1. Sodium vanadate-dependent oxidation of NADH was inhibited by rotenone, antimycin A, NaN3, and NaCN. Conversely, Na3VO4 dependent NADPH oxidation was slightly affected by rotenone, but was insensitive to antimycin A, NaN3, NaCN, or quinacrine. Vanadate-dependent oxidation of either pyridine nucleotide was inhibited by the addition of either superoxide dismutase or catalase, indicating that both superoxide and hydrogen peroxide may be intermediates in the process. Linear sucrose gradient purification of the microsomes showed that the vanadate-dependent system for NADPH oxidation resides primarily in the endoplasmic reticulum. These studies indicate the existence of separate and distinct enzymatic systems for vanadate-stimulated oxidation of NADPH and NADH in mammalian microsomal membranes, and argue against an exclusive role of endogenous superoxide in the process. PMID- 3647758 TI - Therapeutic plasma exchange in a dialysis unit. PMID- 3647759 TI - Nurses' knowledge of CAPD. PMID- 3647760 TI - Diagnosis and treatment of thyroid cancer in a hemodialysis patient. PMID- 3647761 TI - Outcome criteria and nursing diagnosis in ESRD patient care planning. Section II: Peritoneal dialysis. PMID- 3647762 TI - An endangered species: the general floor nurse. PMID- 3647763 TI - [Changes in lysyl-tRNA associated with the encystment of Entamoeba invadens]. PMID- 3647764 TI - Reversible, slow, tight-binding inhibition of human leukocyte elastase. AB - CBz-Ala-Ala-Pro-ambo-Val-CF3 (1) was synthesized. The compound inhibits human Leucocyte elastase with Ki = 1.0 x 10(-9) M. This inhibitor is reversible, slow, tight-binding inhibitor with k on = 2 x 10(4) M-1 s-1 k off = 1.9 x 10(-5) s-1. For the solubilization of elastin by HLE by 1 I.C. 50 = 110 nM. This inhibitor is the most effective aldehyde or ketone inhibitor of a serine proteinase yet described. PMID- 3647765 TI - Thymosin alpha 1: amino acid homology with peptide T from the human immunodeficiency virus envelope. AB - Thymosin alpha 1 has many effects on immune function and its absence in primary immunodeficiency states produce a clinical presentation similar to the one encountered in acquired immune deficiency syndrome (AIDS). Human immunodeficiency virus (HIV), the etiologic agent of AIDS, binds to T4 helper/inducer lymphocytes through specific surface receptors which include the CD4 glycoprotein. Octapeptide T, a component of the HIV envelope, mediates the binding of HIV to its receptor. In this report, we draw attention to the similarity between the amino acid sequence of thymosin alpha 1 and peptide T and its analogues. This similarity can produce a cross-reactivity between thymosin alpha 1 and HIV and may be a factor in the pathophysiology of the acquired immuno-deficiency syndrome. PMID- 3647766 TI - Activation mechanism of human urinary prokallikrein using trypsin as a model activator. AB - Rapid release of a small peptide from human urinary prokallikrein by trypsin resulted in activation of the prokallikrein. The peptide was identified as the propeptide of the kallikrein from its amino acid sequence. Two large disulfide linked peptides were also produced very slowly, which accompanied the increase in kallikrein activity. The molecular weights of the two peptides were roughly estimated to be 18,000 and 25,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). N-Terminal amino acid sequences were determined as Ile-Val-Gly-Gly-Trp-Glu-Cys-Glu-Gln-His for the Mr 18,000 peptide and Gln-Ala-Asp Glu-Asp-Tyr-Ser-His-Asp-Leu for the Mr 25,000 peptide. The N-terminal sequence of the Mr 18,000 peptide was identical to that of the kallikrein. Both peptides contained carbohydrate side chains as judged by staining with periodic acid Schiff's base. The results indicate strongly that trypsin hydrolyses two specific bonds of human urinary prokallikrein selectively, which are cleaved upon physiological activation to yield the two-chain kallikrein. PMID- 3647767 TI - Hospital-based occupational health programs. PMID- 3647768 TI - Self-care guide for hypertension risk reduction. PMID- 3647769 TI - Hypertension: prevention and control programs for hospital employees. PMID- 3647770 TI - Calcium entry blockers: actions, use and nursing implications. PMID- 3647772 TI - Noise-induced hearing loss: prevention in the work environment. PMID- 3647771 TI - Snakebite: understanding and avoiding this occupational hazard. PMID- 3647773 TI - Diabetic workers. Coping strategies: a qualitative study. PMID- 3647775 TI - Terrorism: an added stressor to employee travel. PMID- 3647774 TI - Nurse practitioners in an occupational setting: utilizing patterns for the delivery of primary care. PMID- 3647776 TI - Steroids. PMID- 3647777 TI - Lost-time injuries. An analysis of differences between lost-time and non-lost time work-related injuries. PMID- 3647778 TI - Video display terminals--How they affect the health of clerical workers. PMID- 3647779 TI - Employed & non-employed women. Daily hassles and uplifts. PMID- 3647780 TI - Single parent in the workplace. Health care needs. PMID- 3647782 TI - Is the research project feasible? PMID- 3647781 TI - AAOHN membership profile. PMID- 3647783 TI - Feminism and the professionalization of nursing. PMID- 3647784 TI - An integrated biophysical science curriculum: design and development. PMID- 3647785 TI - Attempted suicide: a personal construct psychology exploration. PMID- 3647786 TI - Dementia: a community care perspective. PMID- 3647787 TI - Utilizing nursing diagnosis in nursing education. PMID- 3647788 TI - A personal perspective: working with families who donate organs and tissues. PMID- 3647790 TI - Students teaching students. PMID- 3647789 TI - Nutrition & nursing--teaming up for success. PMID- 3647791 TI - Speaking to nursing's future. PMID- 3647792 TI - Enhancing faculty job satisfaction: a do it yourself approach. PMID- 3647793 TI - Avoiding the evaluation blues. PMID- 3647794 TI - New career direction for nurses. PMID- 3647795 TI - Death is different now: organ & tissue donation is the essence of continuing care. PMID- 3647796 TI - A preferential role for lysyl-tRNA4 in the synthesis of diadenosine 5',5'''-P1,P4 tetraphosphate by an arginyl-tRNA synthetase-lysyl-tRNA synthetase complex from rat liver. AB - The synthesis of diadenosine 5',5'''-P1,P4-tetraphosphate (Ap4A) can be catalyzed in vitro by a tetrameric tRNA synthetase complex from rat liver containing two lysyl-tRNA synthetase and two arginyl-tRNA synthetase subunits. This reaction required ATP, AMP, 50-100 microM zinc, and inorganic pyrophosphatase. We show here that AMP can be omitted from the reaction and that the zinc levels can be markedly reduced provided catalytic amounts of tRNA(Lys) are added to the reaction mixture. Ap4A synthesis with purified tRNA(Lys) isoacceptors showed that the minor species, tRNA(4Lys), was 3-fold more active than either of the two major tRNA(Lys) species, tRNA(2Lys) and tRNA(5Lys). No activity could be demonstrated with tRNA(Lys) from Escherichia coli or with tRNA(Lys) or tRNA(Phe) from yeast. Aminoacylation of tRNA(4Lys) was strictly required as determined by the fact that Ap4A synthesis was not observed until aminoacylation was nearly complete, inhibitors of aminoacylation blocked Ap4A synthesis, and there was a strict requirement for added lysine. None of the above observations could be demonstrated, however, when lysyl-tRNA(Lys) was directly supplied to the reaction mixture. Optimum Ap4A synthesis was obtained by the addition of 1 mol of tRNA(Lys)/mol of the synthetase complex. This reaction is unique because it does not require the prior formation of an aminoacyl-AMP intermediate and because it can actively synthesize Ap4A at physiological zinc concentrations. The preferential role for tRNA(4Lys) in Ap4A synthesis is consistent with its prior implication in cell division. PMID- 3647798 TI - [Formation of classical C3 convertase during the alternative pathway of human complement activation]. AB - The fluid phase C3 convertase of the alternative pathway of human complement activation has been constructed from the isolated C3 component and from purified factors B and D. The enzyme was able to activate the isolated components C4 and C2 in the presence of C4 but had no effect on C2 in the absence of C4. The C4 and C2 activation was monitored by the loss of their hemolytic activity during the incubation with the alternative fluid phase C3 convertase. The activation of C4 and C2 components by the membrane-bound alternative C3 convertase formed on red cells (EC3bBb) was followed by the formation of C3 convertase of the classic pathway--EC4b2a. This resulted in the enhancement of hemolysis. PMID- 3647797 TI - Stimulatory effect of mevinolin on rat liver phosphatidic acid phosphatase. AB - The activity of the soluble form of phosphatidic acid phosphatase in rat liver was stimulated about 2.5-fold by inclusion of mevinolin, a competitive hydroxymethylglutaryl-CoA reductase inhibitor, in the diet (0.1%). The stimulatory effect of mevinolin was present also after dietary addition of cholestyramine (5%) or intraperitoneal administration of ethanol. Addition of cholesterol (2%) to the diet totally abolished the stimulation by mevinolin on phosphatidic acid phosphatase. The results support a correlation between the synthesis of the rate-limiting enzyme in cholesterol biosynthesis and the activity of the apparent rate-limiting enzyme in triacylglycerol biosynthesis. PMID- 3647800 TI - Intensity and anisotropy decays of the Wye base of yeast tRNA(Phe) as measured by frequency-domain fluorometry. AB - The intensity and anisotropy decays of Wye base fluorescence from yeast tRNA(Phe) were determined by frequency-domain fluorometry. The intensity decay is at least a double exponential in the presence and absence of Mg2+, but the multi exponential character of the decay is more pronounced in the absence of Mg2+. The anisotropy decay displays components due to overall tRNA rotational diffusion and to local torsional motions. The amplitude of the local motion is decreased 2-fold by the presence of Mg2+. The results are broadly consistent with a more homogeneous environment for the Wye base in the presence of Mg2+. PMID- 3647799 TI - Hemodynamic and ventilatory effects of high-frequency jet and conventional ventilation in piglets with lung lavage. AB - The cardiovascular and ventilatory effects of high-frequency jet ventilation (HFJV) and conventional ventilation (CV) were evaluated in a saline lung lavage model in piglets. After saline lavage and stabilization on CV, animals were randomized to either mode of ventilation for 4 h. Arterial blood gases, cardiac output, mean pulmonary and arterial blood pressures, and pulmonary and systemic vascular resistances were compared between groups. Alveolar-arterial oxygen gradient (AaDO2) was lower in the HFJV than in the CV group after 3 h of ventilation (p less than 0.04). The peak inspiratory pressure necessary to maintain PaCO2 within the normal range was approximately half as much in the HFJV group as in the CV group (p less than 0.005) throughout the entire study period. Mean airway pressure, cardiac output, mean pulmonary and arterial blood pressures as well as pulmonary and systemic vascular resistances were not statistically different between groups. These results suggest that in this model, HFJV produces better oxygenation with lower peak airway pressures compared to CV without producing hemodynamic compromise. PMID- 3647801 TI - Withholding or withdrawing life-sustaining treatment. PMID- 3647802 TI - Removing the barriers to practice. PMID- 3647803 TI - Politics '88--women's roles. PMID- 3647804 TI - The role of the operating room nurse in organ retrieval surgery and transplantations. PMID- 3647805 TI - The effective use of ORNAC recommended standards. PMID- 3647806 TI - Floats and casuals in the OR. The legal issues. PMID- 3647807 TI - The relationship of specialization and certification to entry to practice. PMID- 3647808 TI - The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 87 cases of primary HIV infection. AB - In an ongoing prospective study of homosexual men conducted in Vancouver since November 1982, 87 cases of human immunodeficiency virus (HIV) seroconversion have been documented to date. Comparison of laboratory results obtained a mean of 4.9 months before and 5.4 months after the estimated date of seroconversion revealed that a significant increase in the serum IgG level (from 1149 to 1335 mg/dl on average) and in C1q binding (from 8.8% to 14.2% on average) was associated with early HIV infection (p less than 0.001). A marginally significant decrease in the ratio of helper to suppressor (CD4 to CD8) cells (from 1.55 to 1.29 on average) was also noted (p = 0.025). A marked decrease in absolute number of CD4 cells was not seen with seroconversion, which suggests that profound loss of these cells may be a long-term effect of HIV infection. The occurrence of symptoms (including fatigue, fever, night sweats, unintentional weight loss, diarrhea, joint pains, cough unrelated to smoking, shortness of breath, oral thrush, herpes zoster and rash) did not increase with seroconversion. This finding suggests that most cases of HIV seroconversion may be asymptomatic or associated with relatively minor symptoms. On the other hand, generalized lymphadenopathy was found to develop after HIV seroconversion in about 50% of cases. PMID- 3647809 TI - Co-worker's perceptions of the clinical nurse specialist role. PMID- 3647810 TI - The education role of the clinical nurse specialist. PMID- 3647812 TI - Developing the motivation to write for publication. PMID- 3647811 TI - Socialization of newborn intensive care unit nurses through the use of mentorship. PMID- 3647813 TI - The executive role of the clinical nurse specialist. PMID- 3647814 TI - Time management and the clinical nurse specialist. PMID- 3647815 TI - Clinical nurse specialist: line or staff using Lewin's field theory to resolve the issue. PMID- 3647816 TI - The consultant role of the clinical nurse specialist. PMID- 3647817 TI - Internal consultation as a framework for clinical nurse specialist practice. PMID- 3647818 TI - Clinical nurse specialists in action. PMID- 3647820 TI - Clinical nursing research: the needed link for unifying professional nursing. PMID- 3647821 TI - Planning clinical nursing research with a geriatric population. PMID- 3647819 TI - The research role of the clinical nurse specialist. PMID- 3647822 TI - Clinical nurse specialists in collaborative practice. PMID- 3647823 TI - Collaboration as a means to achieving the clinical nurse specialist research role expectations. PMID- 3647824 TI - Education. PMID- 3647826 TI - Executive practice. PMID- 3647825 TI - Habilitation: application of a concept. PMID- 3647827 TI - Role theory in relation to roles of the clinical nurse specialist. PMID- 3647828 TI - Consultation. PMID- 3647829 TI - Consultation: doing it and doing it well. PMID- 3647831 TI - [Fight on all fronts against AIDS]. PMID- 3647830 TI - AIDS: new considerations in caring. PMID- 3647832 TI - AIDS and the nurse. PMID- 3647833 TI - The staff nurse as leader. PMID- 3647834 TI - Leg ulcers: frustration or challenge? PMID- 3647835 TI - Wound healing. PMID- 3647836 TI - [Computers and future nursing care]. PMID- 3647837 TI - A fish out of water. PMID- 3647838 TI - The Christian nurse as patient advocate. PMID- 3647839 TI - Life after cancer. PMID- 3647840 TI - Life and death questions in an intensive care unit. PMID- 3647842 TI - Tampering with the truth. PMID- 3647841 TI - Everyday ethics--just a naso-gastric tube? PMID- 3647843 TI - Rural nursing: easing the tradition. PMID- 3647844 TI - 5' cleavage site in eukaryotic pre-mRNA splicing is determined by the overall 5' splice region, not by the conserved 5' GU. AB - We have generated all possible single point mutations of the invariant 5' GT of the large beta-globin intron and determined their effect on splicing in vitro. None of the mutants prevented cleavage in the 5' splice region, but many reduced or abolished exon joining. The mutations GT----TT and GT----CT resulted in a shift of the 5' cleavage site on nucleotide upstream; in the case of the mutation GT----TT, this shift was reverted by a second site mutation within the 5' splice region. Our results suggest that the 5' cleavage site is determined not by the conserved GU sequence but by the 5' splice region as a whole, most probably via base-pairing to the 5' end of the U1 snRNA. PMID- 3647846 TI - Nursing diagnosis: where we've been and where we're going. PMID- 3647847 TI - An idea whose time has come: nursing diagnosis in nursing education. PMID- 3647845 TI - Effects of glucocorticoids and cycloheximide upon transcription of ribosomal RNA gene in rat liver: application of quantitative S1 nuclease mapping analysis. AB - The change in the amount of pre-rRNA synthesized in rat liver was examined by S1 nuclease mapping analysis using the probe containing the 5' end of the rat 45S rRNA gene. It was found that the amount of pre-rRNA of adrenalectomized rats, which was about half of the normal level, was increased after administration of dexamethasone attaining to the normal level at 12 h, and that the hormone-induced pre-rRNA synthesis was completely abolished within 1 h after injection of cycloheximide. These results indicate that the glucocorticoids-stimulated initiation of rRNA transcription is mediated by the hormone-dependent short-lived protein(s). PMID- 3647848 TI - Psychiatric nursing: the diagnostic dilemma. PMID- 3647849 TI - Standardizing nursing education: Illinois' challenge. PMID- 3647850 TI - Evaluation of the minimal bactericidal time (MBT) of sulbenicillin against multiresistant pathogens. AB - The in vitro antibacterial activity of sulbenicillin was evaluated against multiresistant strains isolated from in-patients and compared with that of carbenicillin and piperacillin. Sulbenicillin resulted in being as active as the other drugs against the strains tested, both at different pH, and at different bacterial inocula. In the time-kill tests sulbenicillin demonstrated bactericidal activity similar to that of piperacillin, and a higher killing rate when compared with that of carbenicillin. PMID- 3647851 TI - Lung water and vascular permeability-surface area in premature newborn lambs with hyaline membrane disease. AB - Extravascular lung water and vascular permeability-surface area products were measured with a multiple indicator dilution method in 6 premature lambs with hyaline membrane disease 1-5 hours following delivery by cesarean section. The indicators used were 51Cr-labelled erythrocytes, 125I-albumin, 3H-water, and 14C urea. Results were compared with previously obtained data in newborn lambs without hyaline membrane disease also delivered by cesarean section. Extravascular lung water was significantly higher in lambs with hyaline membrane disease [23.2 +/- 1.0 (SEM) vs. 10.7 +/- 1.4 ml/kg body wt]. Vascular permeability-surface area products for 14C-urea were significantly lower in lambs with hyaline membrane disease (0.30 +/- 0.10 vs 0.78 +/- 0.11 ml/s per kg). It is concluded that extravascular lung water is high in lambs with hyaline membrane disease. Permeability-surface area products for 14C-urea is low in lambs with hyaline membrane disease, which probably indicates a decrease in detectable surface area for exchange due to derecruitment or hypoperfusion of pulmonary exchange vessels in edematous and hypoxic areas of the lungs. PMID- 3647852 TI - Infant home apnea monitoring. A five-year assessment. AB - Home apnea/bradycardia monitoring is commonly utilized in the management of infants who have had apnea episodes. Little is established, however, regarding appropriate decision-making guidelines and efficacy. The 5-year experience of the Western Massachusetts Apnea Evaluation Program was reviewed to examine patient outcome and to identify prognostic clinical features. Significant recurrent sleep apnea occurred in 7 of 110 infants in the combined awake and asleep group, and in 2 of 45 siblings of babies dying of SIDS. Unclear histories, normal laboratory tests, and uncertain diagnoses made it impossible to identify features that would indicate infants at risk for recurrence of apnea. Our data indicate that home apnea monitoring lacks specificity but is probably effective in reducing morbidity and mortality. It currently appears to be the most optimal means of managing infantile apnea. PMID- 3647853 TI - [Learning from work--my method of self-enlightenment]. PMID- 3647854 TI - [Psychocybernetics and nursing. (9)]. PMID- 3647855 TI - [Thoughts on nursing--from a diary of a Japanese nurse in Canada]. PMID- 3647856 TI - [Definition of psychiatry--establishment of scientific psychiatry]. PMID- 3647857 TI - [Compliance of schizophrenic patients with medication following discharge and their social background]. PMID- 3647858 TI - Traveller health care: trailer bound. PMID- 3647859 TI - Traveller health care: stopped in their tracks. PMID- 3647860 TI - Stoma care: the appliance of science. PMID- 3647861 TI - Mastectomy: a lot of living to do. PMID- 3647862 TI - Participatory management: the critical care nurse's role in the 21st Century. PMID- 3647863 TI - Pediatric digoxin administration (continuing education credit). PMID- 3647864 TI - Stressors affecting older versus younger AMI patients. PMID- 3647865 TI - Osteoporosis: implications for critical care. PMID- 3647866 TI - Technological caring: a new model in critical care. PMID- 3647867 TI - Remote cardiac monitoring: nursing collaboration is the key. PMID- 3647869 TI - Developing an orientation advisory committee. PMID- 3647868 TI - Staff participation in critical care scheduling. PMID- 3647870 TI - [The packaging of hospital materials: important points to be observed]. PMID- 3647871 TI - [Professional attitude of the surgery center nurse]. PMID- 3647872 TI - [The role of the nurse in treating and preventing AIDS]. PMID- 3647873 TI - [Unicamp Clinical Hospital]. PMID- 3647874 TI - [The activities of the surgical center nurse in pre- and postoperative visits]. PMID- 3647875 TI - Isolation of a thiol-activated T-kininogenase from the rat submandibular gland. AB - T-kininogenase (T-kgnase) activity has been investigated in tissues of the rat and submandibular glands of the rat, mouse and guinea pig. Both rat and mouse submandibular homogenates showed high T-kgnase activity. The enzyme has been purified 360-fold from rat submandibular gland homogenate supernatant fluid. The enzyme has an apparent molecular mass of 28 kDa and a pH optimum of 8.0 toward T kininogen. It cleaved T-kininogen in catalytic quantities to release T-kinin (Ile Ser-bradykinin) and small quantities of bradykinin and an unknown kinin. The activity of the enzyme was increased 10-fold in the presence of thiol groups (dithiothreitol) and inhibited by leupeptin (90%) and to a lesser extent by aprotinin (49%), TLCK (46%) and soybean trypsin inhibitor (27%). Pepstatin and PMSF did not inhibit the enzyme. Studies on substrate specificity, pH optimum and agents which inhibit T-kgnase activity demonstrate that this enzyme is different from plasma and tissue kallikreins, cathepsin D, esterase A and esterase B (other known kininogenases). It is the first thiol-activated kininogenase to be reported. PMID- 3647876 TI - [Acute mastitis]. PMID- 3647877 TI - [Active detection of diabetics]. PMID- 3647878 TI - [First aid in maxillofacial injuries]. PMID- 3647879 TI - [Natural foci infections]. PMID- 3647880 TI - [Sobriety--the requirement of life (material for talks)]. PMID- 3647881 TI - [Characteristics of the use of drugs with middle-aged and elderly patients]. PMID- 3647882 TI - [Phytotherapy in geriatrics]. PMID- 3647883 TI - [Use of diuretics with middle-aged and elderly patients]. PMID- 3647884 TI - [Broncholytic agents]. PMID- 3647885 TI - [Effect of taking food on the pharmacokinetics and pharmacodynamics of drugs]. PMID- 3647886 TI - [Vocational rehabilitation of pulmonary tuberculosis patients in rural locality]. PMID- 3647887 TI - [Work experience of the Museum of History of the Kamenets-Podol'skii Medical School]. PMID- 3647888 TI - [Teaching of ethics, psychology and hygiene of family life in the medical school]. PMID- 3647889 TI - [Tasks of the midwife in preventing injuries during labor]. PMID- 3647890 TI - A case study of atrial fibrillation and mitral stenosis. PMID- 3647891 TI - Caring in a technological age: education for adaptation. PMID- 3647892 TI - Computers, clinical applications, and the CCU nurse. PMID- 3647893 TI - Evaluation of telemetry monitoring: an observational study. PMID- 3647894 TI - Floating: a reality and a problem? PMID- 3647895 TI - Nursing and politics: a dichotomy? PMID- 3647896 TI - Integrating political education into nursing curriculum. PMID- 3647897 TI - Lobbying as a professional role of nurses. PMID- 3647898 TI - The doctor-nurse relationship: insight into factors affecting the balance. Part I. PMID- 3647899 TI - The effect of infant pain treatment methods: the need for multidimensional studies. PMID- 3647900 TI - Financial support for nursing research. PMID- 3647901 TI - Standards of care: linking research and practice. PMID- 3647902 TI - The CURN Project: utilization in rehabilitation. Conduct and Utilization of Research in Nursing. PMID- 3647903 TI - Nursing caught in liability insurance crunch: nurse practitioners to lose liability coverage. PMID- 3647904 TI - Who'll nurse the nurses? PMID- 3647905 TI - Women's health: where do we go from here? PMID- 3647906 TI - The doctor-nurse relationship: insight into factors affecting the balance. Part II. PMID- 3647908 TI - Pregnancy: a time of many changes. PMID- 3647907 TI - Women's Health Council: 'diverse all-encompassing, political'. PMID- 3647909 TI - A cobra venom factor (CVF)-induced C3 convertase activity in the hemolymph of Galleria mellonella. AB - A cobra venom factor (CVF)-induced C3 convertase has been generated from the hemolymph of Galleria mellonella. CVF was immobilized on Sepharose 4B and treated with cell-free hemolymph obtained from either unvaccinated G. mellonella larvae or larvae immunized with formalized Pseudomonas aeruginosa. The C3-cleaving activity was detected by the ability to cleave the alpha-chain of bovine C3 in a manner analogous to the CVF-induced mammalian C3 convertase, CVF,Bb. The insect derived C3 convertase formed at 28 degrees C but not at 37 degrees C, then once formed was active at both 28 degrees C and 37 degrees C. EDTA did not inhibit the formation and action of the insect derived C3 cleaving activity. PMID- 3647910 TI - eIF-2B and the exchange of guanine nucleotides bound to eIF-2. AB - Available data for the formation of the ternary complex eIF-2 X GTP X methionyl tRNAi involved in eukaryotic initiation and of the inhibition of ternary complex formation by GDP have been examined with a view to determining the mechanism by which eIF-2B facilitates nucleotide exchange. Two mechanisms have been considered -first a displacement reaction in which eIF-2B displaces GDP and GTP in a manner analogous to a "ping-pong" enzyme mechanism, and secondly the possibility that binding of eIF-2B to eIF-2 nucleotide complexes enhances the rate of nucleotide exchange without itself inducing nucleotide displacement. Comparison has been made between the properties of eIF-2 and eIF-2B and of the bacterial elongation factors Tu and Ts. It seems most probable that, as previously suggested by others for Ts, eIF-2B effectively catalyses an exchange reaction through a "ping-pong" type mechanism. Possible explanations of data suggesting otherwise are put forward. Both eIF-2 and bacterial Tu are complex allosteric proteins subject to a variety of influences which in the case of eIF-2 include phosphorylation of the alpha subunit. This phosphorylation appears to change the equilibria in the reaction mechanism such that the transferred entity (eIF-2) becomes firmly bound to the catalyst (eIF-2B). Minimum rate constants for the formation of eIF-2 X eIF 2B from eIF-2 X GDP and eIF-2 X GTP and reverse reactions are derived. These values suggest that the initiation factors are likely to have to operate in a restricted environment if rates of protein synthesis seen in vivo are to be sustained. PMID- 3647912 TI - The uniform farce. PMID- 3647913 TI - Urodynamic and medical investigations of urinary incontinence. PMID- 3647911 TI - Acceleration of the rate of processing of 40 S pre-rRNA during Xenopus laevis embryogenesis. AB - Processing of 40 S pre-rRNA into 18 and 28 S mature rRNAs was studied in Xenopus embryonic cells by pulse-chase experiments using actinomycin D as a transcription inhibitor. Gel electrophoretic analyses revealed that the rate of processing was accelerated due to a shortening of the half-life of 40 S pre-rRNA from 19 min at the gastrula stage to 9 min at and after the neurula stage. The step under developmental control appeared to be the cleavage of 40 S pre-rRNA into 18 S rRNA and the 34 S rRNA intermediate, since the time interval between the first detection of labeled 40 S pre-rRNA and 18 S rRNA was significantly shortened as development proceeded. PMID- 3647914 TI - Innovation in nursing care. PMID- 3647915 TI - 'A step in the right direction'--the liaison nurse. PMID- 3647916 TI - Crossing the great divide--from NHS to private care. PMID- 3647918 TI - The conceptualization and assessment of family dynamics in terminal care. PMID- 3647917 TI - Erica Goodman addresses FNS gathering in Cleveland. PMID- 3647919 TI - The measurement of grief: bereaved versus non-bereaved. PMID- 3647920 TI - Meaning and purpose in life: assessment techniques of logotherapy. PMID- 3647921 TI - Measurement of denial in the terminally ill: a critical review. PMID- 3647922 TI - Assessment of patient satisfaction and hospice: a review and an investigation. PMID- 3647924 TI - He remembered my name: symmetry. PMID- 3647923 TI - Anesthesia in the geriatric patient. PMID- 3647926 TI - Drugs & geriatric surgery. Implications for pre-operative and post-operative care. PMID- 3647925 TI - The prevalence of common foot disorders in patients admitted to a geriatric assessment unit. PMID- 3647927 TI - Clinical decision making of staff nurses. PMID- 3647929 TI - Coping in later years: the reconciliation of opposites. PMID- 3647928 TI - Personality hardiness and burnout in female staff nurses. PMID- 3647930 TI - The color gray: ambiguity and infertility. PMID- 3647931 TI - Studying and using conceptual models of nursing. PMID- 3647932 TI - The research process in baccalaureate nursing education: a ten-year review. PMID- 3647933 TI - Hardiness: its development and relevance to nursing. PMID- 3647934 TI - Food for thought. PMID- 3647935 TI - [Use and abuse of drugs: a social phenomenon of our age]. PMID- 3647936 TI - The acquired immunodeficiency syndrome: general overview. PMID- 3647937 TI - Improvements following an easy and inexpensive quality assurance program on the usage of antibiotics in the emergency room setting. PMID- 3647938 TI - Methicillin-resistant Staphylococcus aureus infections: it's time to get tough. PMID- 3647940 TI - Isolation usage in a pediatric hospital. AB - In a prospective 12-month study at a university-affiliated pediatric hospital, isolation usage was quantitated by ward/service, season, isolation category and type of infection (community-acquired vs nosocomial). Such information may be helpful in designing hospitals, recognizing time utilization of the pediatric infection control nurse, and defining educational and isolation needs. Hospitals with multiple bed rooms and inadequate numbers of single rooms may be unable to meet current federal isolation guidelines. The mean number of isolation days was 153 per 1000 patient days or 15.3% of bed days used. This ranged from 18.5% on the infant/toddler/preschool medical ward to 2.8% on child/teenage orthopedic surgery. Isolation requirements vary seasonally and rose to 32% in winter on one ward. Proportional frequencies of isolation category included enteric--29%, protective--28%, strict--16%, barrier (contact)--10%, multiply resistant organism (MRO)--8%, wound--5%, pregnant women (careful handwashing)--3%, blood and body fluid precautions--1%. Isolation of patients with and contacts of nosocomial infections account for 32% of isolation usage. During one third of the 365-day year, the hospital is unable to provide adequate numbers of single rooms for one to 20 patients. PMID- 3647939 TI - Methicillin-resistant Staphylococcus aureus in Veterans Administration Medical Centers. AB - To determine the frequency of isolation of methicillin-resistant Staphylococcus aureus (MRSA) at Veterans Administration Medical Centers, 163 hospitals were surveyed; 137 responded. Between 1975 and 1984, the number of Veterans Administration Medical Centers with known MRSA increased from 3 to 111. This increase was geographically widespread and occurred in hospitals of all sizes. In Veterans Administration Medical Centers, isolation policies for MRSA-infected patients were (% of hospitals using): strict (19%), contact (52%), site-related (28%), no isolation (1%). For patients colonized with MRSA policies were: strict (15%), contact (44%), site-related (35%), and no isolation (6%). Only 41% of Veterans Administration Medical Centers reported discharging known MRSA-colonized patients to nursing homes. Most attempts to eradicate MRSA carriage used trimethoprim-sulfamethoxazole plus rifampin with or without bacitracin ointment; success rates were low. MRSA incidence is increasing at Veterans Administration Medical Centers across the United States. Improved regimens to eliminate MRSA carriage are needed. PMID- 3647941 TI - Bacterial colonization in humidifying cascade reservoirs after 24 and 48 hours of continuous mechanical ventilation. AB - We evaluated levels of bacterial colonization in the humidifying cascade reservoirs of 466 mechanical ventilators; 326 reservoirs were cultured after 24 hours and 140 were cultured after 48 hours of continuous mechanical ventilation. Bacterial colonization was absent in 284 (87.1%) of the humidifier reservoirs sampled at 24 hours and 125 (89.3%) of the reservoirs cultured at 48 hours. Levels of bacterial colonization in the remaining humidifiers were low (less than 100 organisms/mL). The median temperature recorded in the reservoir fluid of 30 different ventilators was 50 degrees C (range 40 degrees to 60 degrees C). In vitro seeding of reservoir fluid at 50 degrees C with 10(6) organisms/mL of four different species of nosocomial gram-negative bacilli and Staphylococcus aureus demonstrated rapid killing of all five strains over a 6-hour incubation period, and no significant bacterial aerosols were detected. Rates and levels of bacteria in heated humidifier reservoirs are low and nosocomial pathogens survive poorly at the median reservoir temperature of 50 degrees C. We conclude that the heated humidifier reservoir on a mechanical ventilator is an unlikely source of colonization or bacterial aerosols, and therefore it can be changed every 48 hours with the ventilator tubing. PMID- 3647942 TI - Effect of water temperature on bacterial killing in laundry. AB - The increasing cost of energy directed our attention to testing the feasibility of low temperature washing. Hospital laundries use formulated chemicals at high temperature wash waters of 66 degrees C. Wash water effluents and fabric bacterial counts of heavily soiled linen were correlated with alkalinity and temperature measurements to investigate the bacterial killing action of hot and cold wash formulas. Terry towels were found to be contaminated with 10(7) to 10(9) organisms per 100 cm2 at the beginning of the washing process. The most common gram-negative rods found were Klebsiella, Enterobacter and Serratia species. Staphylococci were the predominant gram-positives. Both cold and hot water washing including the bleach cycle reduced bacterial counts in fabric by 3 log10. Similarly wash water cfu/mL mL declined 3 to 4 log10. A further 0.5 to 1.0 log10 reduction was effected in the 93.3 degrees C drying cycle. Low temperature wash formulas were comparable to high temperature laundry with respect to bacterial counts and species. Cold water formulas at 31.1 degrees C offer an alternative method to reduce energy consumption and maintain bacteriological and esthetic linen quality. PMID- 3647943 TI - The management of health care workers' accidental parenteral exposures to biological specimens of HIV seropositive individuals. AB - Health care workers can reduce risks associated with caring for HIV seropositive individuals by strict adherence to routine infection control procedures. Educating personnel in infection control should be increasingly stressed in all health-related settings. When accidents occur, however, the health care industry must respond with appropriate care and follow-up of their employees. The outlined approach for the management of health care workers with needlestick injuries from HIV-contaminated biological specimens provides increased follow-up for workers at higher risk (those who develop illness in the months following an exposure) than current CDC guidelines; and less but sufficient follow-up of those who have a lower risk (no illness) of acquiring HIV infection. Overall, this protocol will provide a more economical, practical, and medically adequate method for follow-up of exposed health care personnel. PMID- 3647944 TI - Intravenous filters. PMID- 3647945 TI - The "opiate epidemic" in Dublin: are we over the worst? PMID- 3647946 TI - Trends in anti-HIV positivity in Dublin. PMID- 3647947 TI - AIDS: a killer disease--will it be the end of us? PMID- 3647948 TI - Health: the wider dimension. PMID- 3647949 TI - World Health Organisation--targets for health for all. PMID- 3647950 TI - Trinity Medical Center vs. North Dakota Board of Nursing. PMID- 3647951 TI - Debate: legal vs. professional regulation of nurses. The need for legal authority. PMID- 3647952 TI - Focus on individual responsibility. PMID- 3647953 TI - Social exchanges of infertile women. PMID- 3647954 TI - Coping, thinking, and mental health nursing: cognitions and their application to psychosocial intervention. PMID- 3647955 TI - Care of the chronically mentally ill: a continuing challenge to nursing. PMID- 3647956 TI - Structural family therapy with chronic pain patients. PMID- 3647957 TI - A compliance protocol: psychiatric emergency services and brief encounters. PMID- 3647958 TI - The psychiatric emergency room: staff subculture. PMID- 3647959 TI - Suicide intervention and prevention with Indian adolescent populations. PMID- 3647960 TI - Consumer attitudes to child health clinics. PMID- 3647961 TI - The walk-in clinic: a community approach to emotional problems. PMID- 3647962 TI - All the fun of the fair. PMID- 3647963 TI - Assessing the health needs of pre-retirement groups. PMID- 3647964 TI - Post-natal depression and other myths. PMID- 3647965 TI - Attendance and mobility allowance. PMID- 3647966 TI - Running a post-natal exercise group. PMID- 3647968 TI - An ABC of alternative medicine. Massage. PMID- 3647967 TI - Well woman clinics in Bexley. PMID- 3647969 TI - Medical truths in historical perspective. PMID- 3647970 TI - Importance of basic physiologic research in nursing science. PMID- 3647971 TI - Prospective evaluation of infections associated with pacing catheters for electrophysiologic testing. PMID- 3647972 TI - Comparative study of adjustment patterns of chronic obstructive pulmonary disease patients and peripheral vascular disease patients. PMID- 3647973 TI - Physiologic responses of coronary care patients to selected music. PMID- 3647974 TI - Comparison of measurements of cardiac output from the side port versus the proximal lumen of the Swan-Ganz catheter: follow-up study. PMID- 3647975 TI - Nursing care of the patient with a total artificial heart. PMID- 3647976 TI - White clot syndrome associated with heparin-induced thrombocytopenia: a review of 23 cases. PMID- 3647977 TI - Current standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care. American Heart Association. PMID- 3647978 TI - Evaluating research for use in practice: guidelines for the clinician. AB - Research in nursing has the potential to contribute substantially to the quality of patient care. However, this potential can be realized only if the research base is critically evaluated and used appropriately as a basis for practice. At best, research will always be only a guide for practice. The astute clinician will combine his or her practical wisdom, derived from experience, with an understanding of the individual patient's situation and with knowledge derived from research to make a clinical judgement thought to be of benefit to the patient. PMID- 3647979 TI - Qualitative research designs in the critical care setting: review and application. PMID- 3647980 TI - Vasospastic angina with hyperthyroidism. PMID- 3647981 TI - Medication administration errors in an adult intensive care unit. PMID- 3647982 TI - Unendurable illness. PMID- 3647983 TI - The Miami Vices in the CCU. Part I. Cardiac manifestations of cocaine use. AB - There is a widespread misconception that the social use of cocaine is not associated with serious medical complications. It is therefore necessary to reemphasize that cocaine use can precipitate life-threatening cardiac events even in the absence of underlying heart disease. PMID- 3647984 TI - U waves that mimic T waves. PMID- 3647985 TI - Wide complex tachycardia: diagnosis and treatment. PMID- 3647986 TI - Supply/demand discrepancy of organ donation. PMID- 3647987 TI - Which mothers of newborns are most in need of home health follow-up? PMID- 3647988 TI - Developmental abnormalities in the chemically dependent newborn. PMID- 3647989 TI - Congenital heart disease: assessment and case-finding by community health nurses. PMID- 3647991 TI - Step write into publishing, Part II. PMID- 3647990 TI - M = EC2: a formula every home health nurse should know. PMID- 3647992 TI - Development and utilization of the eyedropper adaptation device: an example of interdisciplinary cooperation. PMID- 3647993 TI - Another view of Alzheimer's disease. PMID- 3647994 TI - AIDS: issues for hospices to consider. PMID- 3647995 TI - Teaching kids. PMID- 3647996 TI - Acquired immune deficiency syndrome and the home health care nurse: selected legal concerns. PMID- 3647997 TI - Designing a market plan. PMID- 3647998 TI - Do nurses know and teach burn prevention and safety in practice? PMID- 3647999 TI - Inhalation injury in children: nursing care. PMID- 3648000 TI - Management of the burn unit. PMID- 3648001 TI - What can nurses learn from structured observations of mother-infant interactions? PMID- 3648002 TI - [Scholarship report]. PMID- 3648003 TI - [Research connection and developments in care--exemplified by a practical application in maternal-infant care]. PMID- 3648004 TI - [Midwives' role in school teaching of living together]. PMID- 3648005 TI - [Midwifery conference in Paris]. PMID- 3648006 TI - [Wrong conclusion in epidural research]. PMID- 3648007 TI - [Report from the conference "Comprehensive birth care" held in Madrid, Spain, 16 18 June 1987]. PMID- 3648008 TI - [Answer to wondering parents, submitted in Jordemodern No. 12 1986]. PMID- 3648009 TI - [Breast feeding and WHO's infant food code]. PMID- 3648010 TI - [Breast feeding in developing countries--our challenge]. PMID- 3648011 TI - [Study trip to Ystad's birth clinic 12 September 1986]. PMID- 3648012 TI - [Study trip to Midwifery Education in the National Hospital in Copenhagen]. PMID- 3648013 TI - [Scholarship report: visit to USA]. PMID- 3648014 TI - [Education as an instrument for developments in care]. PMID- 3648015 TI - Women's work, families and health. The balancing act. PMID- 3648016 TI - Overview of the balancing act: having it all. PMID- 3648017 TI - Women's lives: pressure and pleasure, conflict and support. PMID- 3648018 TI - Childbearing choices of professional women. PMID- 3648019 TI - Differences in network structure, social support, and parental adaptation associated with maternal employment status. PMID- 3648020 TI - Employment during pregnancy: influences on women's health and social support. PMID- 3648021 TI - Work and family roles of women: sources of stress and coping strategies. PMID- 3648022 TI - Infertility and its influence on women's career identities. PMID- 3648023 TI - Cationic neutrophil proteins increase transendothelial albumin movement. AB - Neutrophils play a role in the development of pulmonary edema in many models of the adult respiratory distress syndrome, but the mechanism of their action is not completely understood. We asked whether two neutrophil secretory products, human neutrophil cationic protein (NCP) and human neutrophil elastase (HNE), would nonenzymatically alter the movement of albumin across a cultured endothelial monolayer. Both enzymes were inactivated by heating before use. HNE was additionally enzymatically inactivated with a chloromethylketone oligopeptide (CMK) inhibitor and with alpha 1-proteinase inhibitor (alpha 1-PI). Heated NCP, heated HNE, and CMK-complexed HNE all increased transendothelial albumin transfer. The cation protamine also increased albumin transfer across the endothelium and this increase was blocked by heparin. Alpha 1-PI and fetal bovine serum also prevented the cationic proteins from increasing albumin transfer. Using the release of lactate dehydrogenase as a marker of cytotoxicity, heated HNE was toxic to endothelial cells, heated NCP had only minimal toxicity, and protamine had no toxicity. Changes in endothelial cell shape with gap formation was seen after exposure to both heated HNE and heated NCP. Both the cytotoxicity associated with heated HNE and the cell shape changes associated with heated NCP and heated HNE could be blocked by heparin. These results suggest that in addition to neutrophil proteases and reactive O2 molecules, neutrophil-derived cationic proteins can directly and nonenzymatically contribute to edema formation during acute inflammation. PMID- 3648024 TI - Characterization of a silent gene for human pancreatic elastase I: structure of the 5'-flanking region. AB - A cDNA for porcine pancreatic elastase I has been cloned and used as a probe for blot hybridization analysis. Southern blot analysis of total DNA demonstrated that the elastase I gene is conserved among the porcine, rat, calf, and human genomes. Northern blot analysis, however, indicated that the elastase I gene is not expressed in the human adult pancreas, even though abundant expression is observed in the rat and porcine pancreas. Sequence analysis of the cloned human elastase I gene revealed that the proximal 5'-flanking region from -1 to -200 shows 78% identity with that of the actively transcribed rat elastase I gene, and contains a consensus TATA box and a putative tissue specific enhancer sequence. The transcriptional activity of the human elastase I gene appears to be suppressed in the human adult pancreas. PMID- 3648025 TI - Effective management of cultured epithelial cells--two case reports. PMID- 3648026 TI - Treatment of experimental hydrofluoric acid burns. PMID- 3648027 TI - An improved bed canopy. PMID- 3648028 TI - Effects of immobilization and mobilization on cartilaginous, bony, and soft tissue structure: review of the literature. PMID- 3648029 TI - Burn care protocols. PMID- 3648030 TI - Perception of sleep following burn injury. PMID- 3648031 TI - Synchronized ventilatory support as a therapeutic means of reducing hypercarbia in a pediatric burn unit. PMID- 3648032 TI - Lymphoproliferative response to phytohemagglutinin in the burn patient--no paradigm in vitro. PMID- 3648033 TI - Production of chemotactic factors and lung cell changes following smoke inhalation in a sheep model. PMID- 3648034 TI - Use of naloxone in septic shock: a case report and review of current literature. PMID- 3648035 TI - A coordinated approach to the discharge of burned children. PMID- 3648036 TI - Arm hammock for elevation of the thermally injured upper extremity. PMID- 3648037 TI - A leg support for circumferential exposure of donor sites. PMID- 3648038 TI - Use of the Dynasplint to correct elbow flexion burn contracture: a case report. PMID- 3648039 TI - Postgraduate course: respiratory injury. Part I: Incidence, mortality, pathogenesis and treatment of pulmonary injury. PMID- 3648040 TI - Postgraduate course: Respiratory injury. Part II: A synopsis of respiratory function. PMID- 3648041 TI - A simulation analysis of plasma water dynamics and treatment in acute burn resuscitation. PMID- 3648042 TI - Biologic, biosynthetic, and synthetic dressings as temporary wound covers: a biochemical comparison. PMID- 3648043 TI - Maintaining quality: our present challenge--1986 Presidential Address to the American Burn Association. PMID- 3648044 TI - Plasma exchange for failure of early resuscitation in thermal injuries. PMID- 3648045 TI - Synergism, antagonism, topical antimicrobial combinations: an in vitro analysis. PMID- 3648046 TI - The management of burned children in a general hospital burn unit. PMID- 3648047 TI - The social competence of children following burn injury: a study of resilience. PMID- 3648048 TI - The development of a program for juvenile fire offenders. PMID- 3648049 TI - Harborview: a view of a rehabilitation team. PMID- 3648050 TI - Burn care protocols--documenting nursing in the burn intensive care unit. PMID- 3648051 TI - Postgraduate course: respiratory injury. Part III: Pulmonary dysfunction in the burn patient. PMID- 3648052 TI - Holistic sexuality. PMID- 3648053 TI - Toward a holistic perspective of human sexuality: alterations in sexual health and nursing diagnoses. PMID- 3648054 TI - Cultural aspects of sexuality. PMID- 3648055 TI - Sexual identity and human diversity: implications for nursing practice. PMID- 3648056 TI - Sex, AIDS, and gay American men. PMID- 3648058 TI - Men's sexuality during the childbearing year: implications of recent research findings. PMID- 3648057 TI - The nursing diagnosis of body image disturbance in adolescents dissatisfied with their physical characteristics. PMID- 3648059 TI - The dilemma of the perimenopausal female: a sexual/physical health issue. PMID- 3648060 TI - A holistic view of sexuality and the aged. PMID- 3648061 TI - Attitudes on sexuality in nursing texts today and yesterday. PMID- 3648062 TI - Force-velocity relation and rate of ATP hydrolysis in osmotically compressed skinned smooth muscle of the guinea pig. AB - Chemically skinned guinea pig taenia coli fibre bundles showed a concentration dependent decrease in width when incubated in media containing Dextran T500 (0 0.2 g ml-1). The maximal reduction in width, observed at 0.2 g ml-1 dextran, was 32%. The effect was reversible upon removal of dextran. Isometric force was slightly increased (about 10%) at the lowest dextran concentration (0.025 g ml-1) but decreased at higher concentrations (40% decrease at 0.2 g/ml-1). The energetic tension cost (ATP turnover/force) was decreased by about 40% after dextran addition. Force development and relaxation were markedly slower in 0.1 g ml-1 and absent in 0.2 g ml-1 dextran. In isotonic quick-release experiments 0.025 g ml-1 dextran did not influence maximal shortening velocity (Vmax) and relative stiffness, whereas 0.1 g ml-1 markedly increased stiffness and decreased Vmax to about 27%. Vanadate induced relaxation in the activated muscle (pCa 4.5) both in the absence and presence (0.1 g ml-1) of dextran and increased the rate of relaxation (pCa 9) at 0.1 g ml-1 dextran. The isometric rate of crossbridge turnover, as reflected by the energetic tension cost and the rate of relaxation, was decreased at all degrees of osmotic compression. Crossbridge turnover rate during shortening (Vmax) was unaffected at an osmotic compression of 12% (width) but was decreased at higher compression (32%). PMID- 3648063 TI - ET nursing education--a perspective. PMID- 3648064 TI - The effects of a short-term counseling skills workshop on the therapeutic effectiveness of ET nurses. PMID- 3648065 TI - Patient perception of the ostomy experience. PMID- 3648066 TI - The effects of ET nursing assessment on the incidence of hospital-acquired pressure ulcers. PMID- 3648067 TI - Stomal pain--a reply. PMID- 3648068 TI - Calcium supplement--a reply. PMID- 3648069 TI - The life sciences in nursing: development of a theoretical model. AB - This paper explores the relationship between the life sciences of anatomy, physiology, microbiology and pharmacology and the teaching/learning problems of their application in nursing. A theoretical model is proposed derived from a conceptual consideration of nursing tasks and of nursing actions developed to account for a direct link between these sciences and nursing. It is argued that a 'bio-nursing' approach to the use of the life sciences in nursing is comparable to that of a 'bio-medical' approach in medical education and practice. The paper suggests that an appropriate examination of the contributions of the life sciences to nursing education will provide a more concentrated and illuminating exercise with regard to making possible the identification of a body of knowledge of direct relevance to nursing practice. The teaching/learning implications for nurse education and the development of a distinctive knowledge base derived from these sciences are discussed. PMID- 3648070 TI - Foundational studies in nursing. AB - The essential nature of foundational studies in nursing, which are usually called meta-theories or conceptual frameworks, is explored. There are three approaches to this type of study, namely foundationalism, language critique and philosophical analysis. The work of Orem, King and Rogers is briefly analysed as an example of each of these approaches. PMID- 3648071 TI - Communication training in nursing may damage your health and enthusiasm: some warnings. AB - The purpose of this paper is to outline and discuss some of the fundamental theoretical and practical considerations bearing on the teaching of communications skills to nurses. Although evidence exists that communications training is needed, and welcomed by both nurses and nurse managers, implementation of training schemes without consideration of a number of critical issues is likely to result in only partial success, or even complete failure. The issues identified and discussed in this paper are the need for accurate assessment and evaluation, the need to understand and take into account resistance to change at the level of both the individual and the organization, and most pervasively, the need for a clear relationship between theory and practice. PMID- 3648072 TI - The nurse's role in patient education: incongruent perceptions among nurses and patients. AB - The purpose of this study was to describe the amount of congruence in the perceptions of 38 matched nurse-patient dyads concerning the nurse's role in patient education. The perceptions of nurses and patients from two hospital settings were measured with two complementary sets of questions, developed for this study; t-tests were used to compare the mean responses of nurses and patients within and between the two settings to each set of complementary questions. The results indicated that incongruencies existed between nurses' and patients' perceptions of the nurse's role in patient education. Patients identified a general teaching function for nurses. When asked who they preferred to have teach them the specific information related to their condition, patients most frequently chose a physician. Nurses most frequently chose a nurse as the current and most desired patient teacher. Nurses incorrectly assumed that the desires of their patients for patient education were similar to their own. The results suggest that nurses need to develop a clear definition of their role in patient education, to validate patients' desires for teaching, and to examine organizational factors influencing their performance of the patient teaching role. PMID- 3648073 TI - Preventing chemotherapy-induced alopecia in cancer patients: is scalp cooling worthwhile? AB - Alopecia (hair loss) is often singled out as the most distressing side-effect of cancer chemotherapy treatment. This paper provides a comprehensive and critical review of the research literature on scalp cooling, a procedure introduced to prevent chemotherapy-induced alopecia. In spite of a considerable amount of research (both nursing and medical) over a 15-year period, the evidence on scalp cooling is inconclusive. Although concerned with a specialist issue, this paper may interest the general reader as it illustrates the value of a literature review in raising questions about current practice and in identifying issues for future research. PMID- 3648074 TI - An innovative training programme for ward sisters. AB - The need for the preparation and professional development of ward sisters is now well recognised, and recent actual and proposed changes affecting nursing and nursing education have served to highlight its role and the need further. The London Postgraduate Teaching Hospitals have responded by establishing a training scheme for their sisters. This aims to develop the knowledge and skills of sisters who are relatively new or inexperienced and combines periods of theoretical study with observation of work on wards and/or consolidation of learning in the sister's own clinical setting. The features of the scheme include a course with a comprehensive curriculum related to most, if not all, of the aspects of the sister's role, the extensive use of experimental learning methods, the use of facilitators to create links between the course itself, course members and the workplace, formal and informal evaluation, particularly during the pilot period, and a specifically appointed project director. The evaluation of this innovation has indicated positive outcomes, both in terms of improvements in individuals and beneficial effects in the hospitals. As a result of the relative success of the first 2 years, the scheme has now been incorporated into a programme of provision for trained nursing staff, and has stimulated the development of other initiatives for other grades of staff. PMID- 3648075 TI - Raising standards of clinical practice--the fundamental issue of effective nursing practice. AB - The proposition put forward in this paper is that standards of nursing practice can only be assured if the profession is able to find ways of responding to the intuitions and gut reactions of its practitioners. Rather than deny them, nurses have to know how to test and thus legitimize them. Such a validation process demands more clinically based nursing research projects and the proliferation of arrangements such as clinical nursing practice units. It is further argued that by linking the intuitive and rational aspects of nursing in this way the profession is in a better position not only to fulfil its societal obligations but also to build up its own knowledge and skills. PMID- 3648076 TI - Characteristics of 'best' and 'worst' clinical teachers as perceived by university nursing faculty and students. AB - This study identified and compared characteristics of 'best' and 'worst' clinical teachers as perceived by university nursing faculty and students. The Nursing Clinical Teacher Effectiveness Inventory (NCTEI) was distributed to 201 volunteer subjects. This survey instrument, developed by the authors, contains 48 clinical teacher characteristics grouped into five categories. Each participant was asked to rate, using the NCTEI, the 'best' and them the 'worst' clinical teacher from past observations. Results showed both groups perceived that being a good role model was the highest rated characteristic for 'best' teachers and the 'lowest' rated characteristic for 'worst' teachers. Faculty and students' perceptions were fairly similar as to highest rated characteristics of 'best' clinical teachers. Less agreement was noted about the characteristics of 'worst' clinical teachers. When categories of clinical teacher characteristics were compared, there were significant differences between the ratings of faculty and students for 'best' clinical teachers, but none for 'worst' clinical teachers. PMID- 3648077 TI - Stigma and psychiatric day care. AB - Comparatively little is known about the stigma which attaches to psychiatric day care, as opposed to in-patient care. This study uses grounded theory to analyse the views of 21 clients of a psychiatric day unit. The results suggest that clients have difficulty in interpreting their reasons for continuing to attend the unit, and that these difficulties are connected with a fear of being labelled 'mad'. The issue of stigma management was important to the clients, and some thought that the move to a locally-based service would exacerbate problems by reducing the number of available stigma management strategies. PMID- 3648078 TI - Analysing managerial responses in face-to-face contacts. AB - Executive nurse managers, as well as other nurse managers, spend much time responding verbally to people. Whether or not their responses are effective in these situations remains an unexplored area in nursing administration. The author describes a research-based framework to analyse managerial actions. Five types of actions, three non-exploratory and two exploratory, were identified through previous research using Orlando's theory as the framework. Subsequent research suggests nurses prefer that their managers use exploratory action. The article contains discussion on how specific types of actions facilitate or thwart problem identification. PMID- 3648079 TI - An investigation into the factors influencing variation in the growth of community psychiatric nursing services. AB - During the last 30 years community psychiatric nursing (CPN) services have become an established feature of mental health provision throughout the United Kingdom. The creation of new services peaked in the mid 1970s; however, the rate of individual service growth during the last 5 years has been variable. In 1980, the first national survey of community psychiatric nurses was carried out; 5 years later, in 1985, the survey was repeated by the author. A comparative analysis of the manpower data reveals interesting regional differences and these findings are presented. Using quantitative methods, five district health authorities were identified as extreme examples of variability in CPN team growth. The CPN service managers in these five health authorities were interviewed in depth using a semi structured interview guide. The data produced help to illuminate factors that are involved in the widely differing rates of growth in CPN teams. PMID- 3648080 TI - Spiritual distress and the nursing response: theoretical considerations and counselling skills. AB - Spiritual distress may be described as the failure to invest life with meaning. It is a condition that may be met by nurses in a variety of settings. This paper examines some of the issues and some of the practical skills involved in counselling those who experience such distress. Considerable reference is made to the literature on this vast topic in order that the issues under discussion may be followed up. PMID- 3648081 TI - Persons and humans. AB - This paper examines the concept of a person, in particular in terms of its relationship with the concept of human. It discusses the function of person as a concept and the purpose of making a distinction between human and person and allocating all the value connotations of the two terms to person. An examination of possible definitions of person follows, divided into those dealing mainly in intrinsic features, centrally rationality and self consciousness, and those dealing with the concept as it functions as a relation in terms of role or status. Finally, possible accounts of the relation between human and person are considered and 'potential' is identified as a way of linking the two. PMID- 3648083 TI - The respite care alternative. PMID- 3648082 TI - Effects of air & water mattresses on thermoregulation. PMID- 3648084 TI - Tapping a wealth of data. PMID- 3648085 TI - Alcohol use among bereaved and nonbereaved older persons. PMID- 3648086 TI - Perceptions of learned helplessness. PMID- 3648087 TI - Loneliness in the elderly. PMID- 3648088 TI - Interventions to facilitate personal control. PMID- 3648089 TI - Labeling of confusion in the elderly. PMID- 3648091 TI - Three points of view. PMID- 3648090 TI - Facets of dementia. Using mental status tests. PMID- 3648092 TI - Older adults' sexuality and remarriage. PMID- 3648094 TI - Heterosexuals and the acquired immunodeficiency syndrome: estimating the prevalence of seropositivity among Florida females. PMID- 3648093 TI - Specific inhibitor of complement (C5)-derived chemotactic activity in systemic lupus erythematosus related antigenically to the Bb fragment of human factor B. AB - Serum and plasma from patients with active systemic lupus erythematosus contain a specific inhibitor of complement (C5)-derived chemotactic activity. We found that the inhibitor is antigenically related to the Bb fragment of complement factor B. Lupus plasma and purified inhibitor significantly reduced the chemotactic activity of zymosan-treated normal serum, an effect that was abolished by antibodies to factor B. Similar results were obtained when purified Bb was used. Neither purified inhibitor nor Bb inhibited the chemotactic activity of purified human C5a or C5a des Arg. As reported previously, the chemotactic activity of C5a des Arg was enhanced significantly by the addition of an anionic polypeptide (cochemotaxin) present in normal serum and plasma. Interestingly, both purified lupus inhibitor and Bb inhibited the chemotactic activity exhibited by mixtures of C5a des Arg and its cochemotaxin. This effect was due, most likely, to their ability to neutralize the enhancing effect of the cochemotaxin on the chemotactic activity of C5a des Arg. Immunoelectrophoresis and western blots revealed that the purified inhibitor reacted with anti-factor B and exhibited a similar charge and molecular weight as purified Bb. PMID- 3648095 TI - Cell cycle-specific requirement for mevalonate, but not for cholesterol, for DNA synthesis in glial primary cultures. AB - The requirement for the sterol biosynthetic pathway for the occurrence of DNA synthesis in glial cells and, in particular, the relative roles of cholesterol and of mevalonate have been studied. Primary cultures of developing glial cells were synchronized by reducing the content of fetal calf serum (FCS) in the culture medium from 10% to 0.1% (vol/vol) for 48 h between days 4 and 6 in culture. Reversal of the resulting quiescent state by the return of the cultures to 10% serum caused after 24 h a marked increase in DNA synthesis, and this increase was prevented by the simultaneous addition of mevinolin, a specific inhibitor of the sterol biosynthetic pathway at the 3-hydroxy-3-methylglutaryl coenzyme A reductase step, at the time of serum repletion. A dose-dependent reversal of the mevinolin inhibition of DNA synthesis occurred with simultaneous addition of mevalonate to the culture medium. The induction of DNA synthesis by serum repletion, its inhibition by mevinolin, and the reversal of the inhibition by mevalonate were unaffected by a 95% reduction in exogenous cholesterol produced by utilization of lipoprotein-poor serum (LPPS) rather than FCS. Similarly, return of quiescent cultures to 10% LPPS containing mevinolin and sufficient low-density lipoprotein (LDL) to raise the cholesterol concentration 80-fold failed to restore DNA synthesis. In addition, reversal of the mevinolin inhibition of DNA synthesis by mevalonate occurred despite the continuous presence of mevinolin if mevalonate was added as late as 12 h after serum repletion, but not if added after 16 h or more.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3648096 TI - Ultrastructural morphology and intracellular production of human immunodeficiency virus (HIV) in brain. AB - This is a comparative ultrastructural study of human immunodeficiency virus (HIV) particles in infected H9 lymphocyte cultures and in the brain of a six-year-old boy with acquired immunodeficiency syndrome (AIDS) encephalopathy. Viral particles in the cultures and the brain were of various sizes and shapes; particles ranged from 70 to over 160 nm in diameter, with a variable position of dense nucleoids and less dense core shells. In the brain, viral particles were located free in the cytoplasm of both multinucleated giant cells and mononuclear macrophage-like cells. There was intracellular budding of HIV particles from unidentified membranes, yielding intracellular immature or recently budded particles, with crescentic densities. By contrast, HIV particles in the infected H9 lymphocytes were not free in the cytoplasm but were instead located either extracellularly or in intracellular vacuoles. A small percentage of cells in the cultures were surrounded by immature particles only. Production (replication) of HIV occurred within infected macrophage-like cells in the brain of the child. PMID- 3648097 TI - Prevention of coronary artery disease. PMID- 3648098 TI - Prevention of coronary artery disease. PMID- 3648099 TI - Nonpharmacologic treatment of hypertension: a multiple-risk-factor approach. PMID- 3648101 TI - Exercise in the prevention of coronary artery disease. PMID- 3648100 TI - Physiology, diagnosis, and life-style modifications for hyperlipidemia. PMID- 3648103 TI - Theory generation through methodologic flexibility. PMID- 3648102 TI - Risk-factor modification in the prevention of coronary heart disease. PMID- 3648104 TI - Nursing's social history: new insights, new solutions. PMID- 3648105 TI - Recruiting for nursing: whose responsibility? PMID- 3648106 TI - Circumcision article criticism. PMID- 3648107 TI - Preventive gynecologic nursing in an inpatient setting. AB - A nurse-managed screening program that offers gynecologic examinations and health teaching/counseling to female patients is described. The philosophy of the program includes emphasis on individualized care, health promotion, illness prevention, and fostering of self-care practices. Each physical examination includes a breast and pelvic examination, pap test, and health teaching/counseling in areas of women's health. PMID- 3648108 TI - The pregnant smoker: nursing implications. AB - Evidence documents that smoking is especially detrimental to the unborn fetus and to the developing child. The reproductive risks associated with smoking are reviewed, and implications for nurses caring for the pregnant smoker are discussed. Strategies to assist patient smoking cessation efforts are outlined. Nurses must consider cigarette smoking in pregnancy to be as serious a risk factor to maternal and infant health as drugs and infectious diseases. PMID- 3648109 TI - The effect of a support group on self-esteem of women with premenstrual syndrome. AB - A two-group, descriptive, comparative design was used to explore the effect of a support group on the self-esteem of women with premenstrual syndrome. A Mann Whitney U test failed to show a significant difference between the support group and nonsupport group participants at the inception of the group or eight weeks later with a pretest-posttest technique. The small study sample may have contributed to the results. All support group participants reported receiving benefits from the group. PMID- 3648110 TI - Maternal prenatal attachment in normal and high-risk pregnancies. AB - The purposes of this study were to compare maternal-fetal attachment in normal and high-risk pregnancies and to identify variables affecting the maternal attachment process during pregnancy. Fifty-three women experiencing normal pregnancies and thirty-two women with high-risk pregnancies completed Cranley's prenatal attachment tool and a questionnaire providing data specific to the current pregnancy during the third trimester. The results of a two-tailed, pooled t-test indicated no significant differences (at p less than or equal to .05) in the scores of the normal and high-risk groups on prenatal attachment. No significant correlations (at p less than or equal to .05) were found between the attachment scores and educational level, age, race, whether the pregnancy was planned, whether the women had a sonogram, or the ordinal position of the infant. PMID- 3648111 TI - Postpartum mothers' perceptions of competence for infant care. AB - A descriptive study was undertaken to examine the relationship between mothers' early postpartum experiences and their perceptions of competence for infant feeding and care. A sample of 140 primiparous and multiparous mothers completed a 68-item, self-administered questionnaire before discharge from a midwestern hospital's family-centered unit. The mothers' perceptions of competence for infant feeding and care were associated with in-hospital preparation for bottle feeding mothers and amount of perceived rest for breastfeeding mothers. The findings suggest the need for early assessment of bottle-feeding mothers' perceived competence for infant feeding and care, and adequate provision of rest during the postpartum period for breastfeeding mothers. PMID- 3648112 TI - Concerns of multiparas during the second postpartum week. AB - A study was conducted to identify concerns of multiparas during the early postpartum period. Twenty multiparas were interviewed at home 10 to 14 days postpartum. Family, mother, and baby items were sorted into three categories; worry, interest, and no concern. Meeting the needs of everyone at home and other family items were most frequently sorted as a concern. Feeding method, mother's educational level, yearly household income, sex of the newborn, and childbirth preparation were related to the number of concerns. PMID- 3648113 TI - Nursing--time to bring the pride back. PMID- 3648114 TI - Cocaine: a maternal, fetal, and neonatal risk. PMID- 3648115 TI - There is no such thing as a good tan. PMID- 3648116 TI - First-time camper fear index. PMID- 3648117 TI - From disclosure to court: the facets of sexual abuse. PMID- 3648118 TI - The adolescent gynecologic examination: an overview. PMID- 3648119 TI - FirstTemp. PMID- 3648120 TI - Speech-language development. PMID- 3648121 TI - Pain in children: theoretical, research, and practice dilemmas. PMID- 3648122 TI - Camp nursing: a way to season your summer? PMID- 3648123 TI - Implantable infusion devices in the pediatric patient: a viable alternative. PMID- 3648124 TI - The care of a ventilator-dependent child on a general pediatric unit. PMID- 3648125 TI - Perspectives on adolescent parenting: effect of adolescent egocentrism on the maternal-child interaction. PMID- 3648126 TI - The participative pediatric nurse manager. PMID- 3648127 TI - Toward more credibility in nursing research: researcher-subject collaboration. PMID- 3648128 TI - The new immigration law. PMID- 3648129 TI - New technology for safety and research. PMID- 3648130 TI - My babies died: a mother's plea for understanding. PMID- 3648131 TI - Poetry: Maggie Jones. PMID- 3648132 TI - Ethical dilemmas & packed schedules. How has Nurses Christian Fellowship helped you survive nursing school? PMID- 3648133 TI - How can I explain why God lets patients suffer? PMID- 3648134 TI - How can I explain why God lets patients suffer? A psychologist responds: listening opens doors. PMID- 3648135 TI - How can I explain why God lets patients suffer? A pastor responds: God works through suffering. PMID- 3648136 TI - How can I explain why God lets patients suffer? A pediatrician responds: give comfort before answers. PMID- 3648137 TI - How can I explain why God lets patients suffer? The nurse responds: focus on God's character. PMID- 3648138 TI - Infection control. Fever of unknown origin in the adult. PMID- 3648139 TI - Your CE topic this mont (no. 23). Intestinal parasitic infections: update and review. PMID- 3648141 TI - Vigilant: LPN's knee saves patient. PMID- 3648140 TI - Vocal: LP/VNs fight entry-level proposals. PMID- 3648142 TI - Building a better place to practice for the LP/VN. PMID- 3648143 TI - Compassionate nursing care. Is it a lost art? (Or, how to put the care back in nursing). PMID- 3648144 TI - The LP/VN's role in bioethical decision making. PMID- 3648145 TI - Predictors of success in LPN/RNA programs. PMID- 3648146 TI - Your CE topic this month (No. 24). An update on diabetes. PMID- 3648147 TI - A computerized analysis of astigmatism after cataract surgery. PMID- 3648148 TI - Video display terminals: alleviating visual and physical stress. PMID- 3648149 TI - Cooperation is the watchword in this operating room. PMID- 3648150 TI - Management of superior oblique palsy after surgery for true Brown's syndrome. PMID- 3648151 TI - Contact lenses in the adult aphake. PMID- 3648152 TI - The equation: a photo essay acquainting the diabetic patient with the goals of pars plana vitrectomy for proliferative diabetic retinopathy. PMID- 3648153 TI - [Antibacterial activities of arbekacin, a new aminoglycoside antibiotic, against methicillin-cephem-resistant Staphylococcus aureus]. AB - The in vitro and in vivo antibacterial activities of a new aminoglycoside antibiotic, arbekacin (HBK), against methicillin-cephem-resistant Staphylococcus aureus (MRSA) were compared with those of gentamicin (GM), netilmicin (NTL) and amikacin (AMK). The results obtained were summarized as follows: Compared to other aminoglycoside antibiotics, HBK had the highest antibacterial activities against clinically isolated MRSA (46 strains). Therapeutic effects of HBK against experimental systemic infections with MRSA in mice, were superior to those of GM, NTL and AMK. The ED50's of GM, NTL and AMK were more than 2 mg/mouse. Therapeutic effects of HBK against experimental subcutaneous infections with MRSA in mice were also superior to those of GM, NTL and AMK. PMID- 3648154 TI - [AIDS: new distinction and a disease of discrimination]. PMID- 3648155 TI - [Maternal and child health care in the age of small families]. PMID- 3648156 TI - [The age of small families and health education concerning childbirth]. PMID- 3648157 TI - [Direction in midwifery services in the age of small families. Creation of conditions for continuing nursing]. PMID- 3648158 TI - [Direction in midwifery services in the age of small families. Midwifery ambulatory service where midwives take initiative in the operation]. PMID- 3648159 TI - [Direction in midwifery services in the age of small families. Creation of new regional maternal and child health services]. PMID- 3648160 TI - [Expectation on midwifery activities--an advice to midwifery students]. PMID- 3648161 TI - [Effective professional education. 1. Trust as the starting point in education]. PMID- 3648162 TI - [Working expectant mothers observed at obstetrical clinics: a need for individualized health education]. PMID- 3648163 TI - [Obstetrical immunology. 1]. PMID- 3648164 TI - [My personal process in choosing nursing and then midwifery as a profession]. PMID- 3648165 TI - [Midwifery technics by Ms. Aiko Aoki, a traditional Ainu midwife]. PMID- 3648166 TI - [Use of personal computers in medical services]. PMID- 3648167 TI - [Questions and answers on breast feeding. Breast care during pregnancy]. PMID- 3648168 TI - [Innovation in prevention of premature labor]. PMID- 3648170 TI - [Midwifery assistance in the birth process actively carried out by the patient]. PMID- 3648169 TI - [Cerebral activities in childbirth]. PMID- 3648171 TI - [Childbirth process planned and controlled by the mother: 2 experiences of at home delivery]. PMID- 3648172 TI - [Methods of delivery with the patient in a standing position: the role of medical personnel]. PMID- 3648173 TI - [An experience in childbirth in water]. PMID- 3648174 TI - [Childbirth in water: the origin of the childbirth]. PMID- 3648175 TI - [A report from Hawaii: a report on birth educators and their classes]. PMID- 3648176 TI - [Questions and answers on breast feeding: prevention of the development of fissures at the nipple]. PMID- 3648177 TI - [Attractiveness of midwifery practice. 2. My motivation in becoming a nurse and midwife]. PMID- 3648178 TI - [Obstetrical immunology. 2. Changes in the maternal immunological system during pregnancy]. PMID- 3648179 TI - [Midwifery technics of Ainu. 2]. PMID- 3648180 TI - [Introduction of a personal computer to perinatal care. 2. Preparation of graphs using a personal computer]. PMID- 3648181 TI - [Changes in the midwifery profession. 23. A process leading to legislation of family planning]. PMID- 3648182 TI - [Education based on trust (2)]. PMID- 3648183 TI - [Prenatal diagnosis and screening of congenital heart defects]. PMID- 3648185 TI - [Nursing theories. 17. On Orem's nursing theory. 2. For logical analysis of nursing]. PMID- 3648184 TI - [Preparation for home nursing. 2. Instructions to be given to the patient's family prior to discharge]. PMID- 3648186 TI - [A list of 99 books recommended for reading by new nurses. On possibilities of the human mind: writings by Norman Cousins]. PMID- 3648187 TI - [My learning process through experiences: a physician's re-evaluation of nursing based on his personal experience as a patient]. PMID- 3648188 TI - [AIDS report from Hawaii. 1. The threat of AIDS: STD (sexually transmitted diseases) and KAP (knowledge, attitude and practice)]. PMID- 3648189 TI - [A thought by a hospital physician. 5. Examination of the ambulatory service]. PMID- 3648190 TI - [Practice of Oriental medicine. 17. The diagnostic methods (3). Examination of the abdominal region]. PMID- 3648191 TI - [Welfare and medical care of the aging society. 9. On the bedridden elderly (1). Definition and localization of the bedridden elderly]. PMID- 3648192 TI - [Profile of a nurse: Ms. Fusako Iseri, an i.v. nurse at a California hospital]. PMID- 3648193 TI - [A record by a wife of a cancer patient. 5. Love]. PMID- 3648194 TI - [Self-help groups organized within hospitals and their activities]. PMID- 3648195 TI - [A nursing report from England. 5. Identity crises]. PMID- 3648196 TI - [Mechanics and function of the brain based on symptoms. 3. Cerebral hernia (1): the mechanism of the development of cerebral hernia]. PMID- 3648197 TI - [Preparation for home nursing. 3. Discharge from the hospital]. PMID- 3648198 TI - [Nurses' experiences as patients: my personal experience as an inpatient]. PMID- 3648199 TI - [Nurses' experiences as patients: my 21 days as an inpatient]. PMID- 3648200 TI - [Nurses' experiences as patients: my experience on 3 occasions of hospitalization]. PMID- 3648201 TI - [Nurses' experiences as patients: better understanding of patients through personal experience as a patient]. PMID- 3648202 TI - [Nurses' experiences as patients: a painful experience and its contribution to the understanding of patients]. PMID- 3648203 TI - [Nurses' experience as patients: an experience as a cancer patient]. PMID- 3648204 TI - [Prevention of dermatitis associated with radiotherapy: pre-irradiation application of a steroid ointment]. PMID- 3648206 TI - [Profile: Dr. Yoshihira Hikita, a physician practicing preventive medicine in rural areas through unique activities]. PMID- 3648205 TI - [AIDS report from Hawaii: basic information and latest data]. PMID- 3648207 TI - [A thought by a hospital physician. 9. Death of a patient]. PMID- 3648208 TI - [Practice of Oriental Medicine. 18. On "sho" (final diagnosis)]. PMID- 3648209 TI - [Welfare and medical services in the aging society. 10. On the bedridden elderly (2): minimization and maximization of patient transfer]. PMID- 3648211 TI - [Self-help theories: learning from the activities of self-help groups. An experience by a leprosy patient]. PMID- 3648210 TI - [A record by a wife of a cancer patient. 6. Awareness of the disease process and acceptance of death]. PMID- 3648212 TI - [A nursing report from England. 6. Foreigners' view of the Japanese]. PMID- 3648213 TI - [Home nursing: 4. Continuous troubles with patient care]. PMID- 3648214 TI - [Nursing theory. 18. Study of Orem's nursing theory. 3: From "why" to practice]. PMID- 3648215 TI - [AIDS: from its etiology to therapy]. PMID- 3648216 TI - [Lessons from AIDS. A discussion]. PMID- 3648217 TI - [AIDS nursing standards at the Komagome Hospital in Tokyo]. PMID- 3648218 TI - [Questions and answers on AIDS]. PMID- 3648219 TI - [Hemophilia patients and the AIDS problem]. PMID- 3648220 TI - [Report on AIDS from Hawaii: prevention of AIDS]. PMID- 3648221 TI - [Profile: Mr. Kunio Miyake, representative of an organization of families caring for senile dementia patients]. PMID- 3648222 TI - [A diary of a physician at a hospital: activities in wards in the evening]. PMID- 3648223 TI - [Social welfare and medical care in the aging society. 11. On the aged, bed ridden patients. 3. Stimulation of their minds]. PMID- 3648225 TI - [When health services personnel submit themselves to health services: a discussion of their experiences]. PMID- 3648224 TI - [A record by a wife of a cancer patient. Acceptance of "death" by the family]. PMID- 3648226 TI - [AIDS in England]. PMID- 3648229 TI - [Fluid infusion in patients with traumatic shock]. PMID- 3648228 TI - [Prevention of complications in shock and the role of nurses]. PMID- 3648227 TI - [Management and observation of shock patients at the emergency department]. PMID- 3648230 TI - [Protection of the wound sites in patients with traumatic shock]. PMID- 3648232 TI - [Management of patients in shock and related nursing training]. PMID- 3648231 TI - [Monitoring of shock patients and management of the monitoring instruments]. PMID- 3648233 TI - [Nursing of patients in shock due to multiple injuries]. PMID- 3648234 TI - [Nursing of a patient with severe pelvic fractures associated with shock]. PMID- 3648235 TI - [Nursing of a patient who developed acute renal failure from rhabdomyolysis]. PMID- 3648236 TI - [Nursing of a patient who developed MOF (multiple organ failure) from traumatic shock]. PMID- 3648237 TI - [Diagnosis of traumatic shock and description of diagnostic methods]. PMID- 3648238 TI - [Actions of nurses toward shock patients when physicians are unavailable]. PMID- 3648239 TI - [Quality of life in postgastrectomy patients--a survey on the effectiveness of nutritional education at the hospital on life following discharge]. PMID- 3648240 TI - [Efficacy of phlegm removal by abdominal breathing during asthmatic attacks]. PMID- 3648242 TI - [Heart massage--theories and practice]. PMID- 3648241 TI - [Efficacy of education on daily activities of patients who have been subjected vascular reconstruction using blood vessel prosthesis]. PMID- 3648243 TI - [Nursing associated with heart massage]. PMID- 3648244 TI - [A meeting to discuss sex and death of the aged--at the Horie Center for Welfare of the aged, Nakano Ward]. PMID- 3648245 TI - [Problems of the cemetery: conflicts within families]. PMID- 3648246 TI - [Teaching anatomy to nursing students]. PMID- 3648247 TI - [Blind spots in the care of patients with chronic renal failure]. PMID- 3648248 TI - [Move from the bed--assistance in independent actions in elimination by patients]. PMID- 3648249 TI - [Impression on the Kusatsu Seminar for International Nursing Education]. PMID- 3648250 TI - [The outline of the First International Nursing Education Seminar at Kusatsu]. PMID- 3648251 TI - [The First International Nursing Education Seminar at Kusatsu. The first session: the ideal of nursing]. PMID- 3648252 TI - [The First International Nursing Education Seminar at Kusatsu. The second session: the system of nursing practice and nursing research]. PMID- 3648253 TI - [The First International Nursing Education Seminar at Kusatsu. The third session: nursing education]. PMID- 3648254 TI - [The First International Nursing Education Seminar at Kusatsu. The fourth session: the areas of nursing services]. PMID- 3648255 TI - [Evaluation of case studies and clinical training]. PMID- 3648256 TI - [Training in aseptic technics]. PMID- 3648257 TI - [Systematization of nursing education. 8. Methodology in nursing education]. PMID- 3648258 TI - [Changes in the planning of the curriculum of clinical training in the classroom]. PMID- 3648259 TI - [Stepwise training and evaluation of clinical training in obstetrical nursing in a classroom: understanding of the object in obstetrical nursing--the first stage in clinical training (the 2d half of the 1st year)]. PMID- 3648260 TI - [Stepwise training and evaluation of clinical training in obstetrical nursing in a classroom: acquisition of nursing technics and its application to the object- the second stage in clinical training (the 1st half of the 2d year)]. PMID- 3648261 TI - [Stepwise training and evaluation of clinical training in obstetrical nursing in a classroom: obstetrical nursing--on nursing of mothers by women. The third stage in clinical training (the 2d half of the 2d year)]. PMID- 3648262 TI - [Stepwise training and evaluation of clinical training in obstetrical nursing in a classroom: evaluation of stepwise training based on the practical results]. PMID- 3648263 TI - [Instructions and classroom training in obstetrical nursing]. PMID- 3648264 TI - [Instructions on blood pressure determination]. PMID- 3648265 TI - [Systematization of nursing education. 9. Methodology in nursing education. 2]. PMID- 3648266 TI - [Joint activities of inhabitants and public health nurses: organizational activities at Nerima Ward, Tokyo]. PMID- 3648267 TI - [Public health nursing activities and approaches in joint organization with citizens: achievement at Nerima Ward, Tokyo]. PMID- 3648268 TI - [Public health nursing activities at Matsukawa-cho and findings through interactions with the citizens]. PMID- 3648269 TI - [Public health nursing to assist the activities initiated by citizens: in support of the examples at Matsukawa-cho. Discussion]. PMID- 3648270 TI - [Eating and feeding. 4]. PMID- 3648271 TI - [A survey on aged, demented patients at home and their families at Tokorozawa shi, Saitama prefecture (2)]. PMID- 3648272 TI - [Comprehensive public health activities at Shimane Prefecture: a question on services at the focal areas]. PMID- 3648273 TI - [Problems in public health nursing education (4). Evaluation of educational methodology based on the status of the new graduates during the initial one year]. PMID- 3648274 TI - [Multiple pregnancy: labor management]. PMID- 3648275 TI - [Midwives extracurricular activities in the subject of sexuality and living together]. PMID- 3648276 TI - [AIDS as a problem of occupational safety in nursing services--subject of a meeting on 9-10-1986]. PMID- 3648277 TI - [Urinary incontinence]. PMID- 3648278 TI - [New Professor in obstetrics and gynecology at Turku University, Matti Gronroos. Interview by Maija Kennovaara]. PMID- 3648279 TI - [Course of labor in a primipara under the effect of epidural analgesia; the need for labor stimulation]. PMID- 3648280 TI - [Training as a tool for nursing development]. PMID- 3648281 TI - [The birth of a child should be a real birthday!]. PMID- 3648282 TI - [National Board of Health 1811-1986--175 years of public health administration in Finland]. PMID- 3648283 TI - [Finland's "Health for All by the Year 2000"-program has been finished]. PMID- 3648284 TI - [Rooming-in as experienced by the nursing staff]. PMID- 3648285 TI - Use of multi-family therapy groups in nursing. PMID- 3648286 TI - Spotting the spot. PMID- 3648287 TI - Access to prenatal care in Kansas. PMID- 3648288 TI - Medical-surgical nurses are achievers. PMID- 3648290 TI - The nurse as an information manager. PMID- 3648289 TI - The nurse's role in risk management. PMID- 3648291 TI - The nurse a manager of patient care. PMID- 3648292 TI - Clinical evaluation of continuing education effectiveness. PMID- 3648293 TI - Cadet nurses seek help from KSNA. PMID- 3648294 TI - The rural hospital--a challenge for nursing and nursing education. PMID- 3648295 TI - There's no place like rural home care. PMID- 3648296 TI - Identifying characteristics of the fall-prone medical-surgical patient. PMID- 3648297 TI - Experiences of public health nurse in AIDS crisis. PMID- 3648299 TI - [An experience in Neuchabel. Drugs on the screen]. PMID- 3648298 TI - [Nursing care and computers. Geneva, 29-30 April 1987. A challenge to take up]. PMID- 3648300 TI - [Evaluation of the quality of nursing care at the CHUV (Vaud University Hospital Center). At the basis: adapted tools and measures]. PMID- 3648301 TI - [Congress of male and female operating room nurses of the Swiss Nursing Association. Between requirements of quality and economic considerations]. PMID- 3648302 TI - [Education of the educators: "never to forget to educate oneself"]. PMID- 3648303 TI - [Knowing what one is talking about]. PMID- 3648304 TI - [12th IASP meeting for continuing education (Interest Group of Nurse Anesthetists). Anesthesia in children]. PMID- 3648305 TI - [Coordinated medical service exercise "Foehn storm in the Bernese Oberland". 70 patients to be cared for within 5 hours]. PMID- 3648306 TI - [The tension field between nursing school and hospital. "See what you can do!"]. PMID- 3648307 TI - [A valuable course experience: guidance groups for parents]. PMID- 3648308 TI - [Nursing research and its effects on care. Encouraging applications and visible changes]. PMID- 3648309 TI - [Clinical aspects and therapy of vertigo and disorders of equilibrium]. PMID- 3648310 TI - [The interplay of basic nursing, therapeutic nursing and contact nursing within the framework of comprehensive nursing and care of patients. 2]. PMID- 3648312 TI - [Bibliotherapy: literature as a therapeutic agent]. PMID- 3648311 TI - [Furosemide]. PMID- 3648313 TI - [Profession and vocation]. PMID- 3648314 TI - [AIDS--watching or acting? A memorandum by the physicians in charge of the Center for Internal Medicine, the Essen University Hospital]. PMID- 3648315 TI - [Diagnosis and therapy of congenital heart defects]. PMID- 3648316 TI - [Disorders of lipid metabolism: pathophysiology, diagnosis, pathogenesis and therapy]. PMID- 3648318 TI - [Verapamil]. PMID- 3648317 TI - [Problems of mechanical irrigation of urinary catheters and drains in the urological and general medical fields]. PMID- 3648319 TI - [The nursing process--a new challenge in nursing]. PMID- 3648320 TI - [Lidocaine]. PMID- 3648322 TI - [Special features of various total knee endoprostheses]. PMID- 3648321 TI - [Prevention of thrombosis in surgical medicine]. PMID- 3648323 TI - ["The people's opiate"?]. PMID- 3648324 TI - [A mobile library of talking books at the bedside. A cultural set-up by the Heidenheim/Brenz protestant chaplaincy service]. PMID- 3648325 TI - [The nursing process--a new challenge in nursing? 2]. PMID- 3648326 TI - Types of consent. PMID- 3648327 TI - Nursing caught in liability insurance crunch. PMID- 3648328 TI - Family crisis: personal tragedy. PMID- 3648329 TI - [On possibilities in nursing]. PMID- 3648330 TI - [Questions and answers on nursing administration: a problem of a nurse who often reports to work late or takes unauthorized leave]. PMID- 3648331 TI - [Policies on social rehabilitation of psychiatric patients]. PMID- 3648332 TI - [Home nursing system initiated by a hospital director]. PMID- 3648333 TI - [Questions and answers: approaches to the newly appointed teaching staff concerning the teaching methods at a nursing school]. PMID- 3648334 TI - [Questions and answers: apprehension of instructors concerning clinical training in nursing]. PMID- 3648335 TI - [Questions and answers: a problem of an excessive eagerness of an instructor overwhelming nursing students]. PMID- 3648336 TI - [Creation of a better hospital environment. Discussion]. PMID- 3648337 TI - [On hospital environment under a PPC (progressive patient care) system]. PMID- 3648338 TI - [Environmental improvement at the pediatric ward (excluding the ward for newborn and premature infants)]. PMID- 3648339 TI - [Environmental improvement at the gynecological ward]. PMID- 3648340 TI - [Environmental improvement at the psychiatric ward]. PMID- 3648341 TI - [Environmental improvement at a ward (ophthalmology) predominated by aged patients]. PMID- 3648342 TI - [Environmental improvement at terminal care facilities]. PMID- 3648343 TI - [Improvement of the hospital environment: the concept of privacy of modern men and the space in the patients' room]. PMID- 3648344 TI - [Improvement of the hospital environment: basic study on the hospital environment -the current status and future prospect of the study]. PMID- 3648345 TI - [Application and evaluation of Roy's theory of nursing--observation of the facilities where the theory is applied in the United States]. PMID- 3648346 TI - [On man and nursing. Social and ethnological aspects of human musicality]. PMID- 3648347 TI - [Fatigue among nurses--incidences of subjective fatigue symptoms reported and the composition of the syndromes]. PMID- 3648349 TI - [Study on a program teaching bandaging. 2. A check list for bandaging]. PMID- 3648348 TI - [Human engineering in personnel scheduling: for better work schedules. 3. A comparison of work patterns at night and continual day schedules at a ward of internal medicine--a comparison of the extent of fatigue associated with EEDD and DDEE and fatigue at a day schedule in a continuing 6 days]. PMID- 3648350 TI - [Alteration in the concept of geriatric nursing]. PMID- 3648351 TI - [Questions and answers on nursing administration: on reassignment of nurses in a hospital]. PMID- 3648352 TI - [Training in nursing-related professions and its effect on nursing]. PMID- 3648353 TI - [Achievement of the home health service section of our hospital in the past 5 years--the third function of the hospital]. PMID- 3648354 TI - [Questions and answers: a problem of an overly eager instructor who exceeds the alloted time for lectures]. PMID- 3648355 TI - [Questions and answers: a problem of nursing students in clinical training who disagree with practice in primary nursing]. PMID- 3648356 TI - [Questions and answers: a lack of expected results in student conferences]. PMID- 3648357 TI - [The significance of the nurses' station]. PMID- 3648358 TI - [The character of the ward determined by the nurses' station]. PMID- 3648360 TI - [A nurses' station adopting an eye-contact format]. PMID- 3648359 TI - [A nurses' station designed for the benefit of patients]. PMID- 3648362 TI - [The nurses' station as the basis and liaison point in nursing]. PMID- 3648361 TI - [The major force operating the nurses' station]. PMID- 3648363 TI - [The nurses' station not to be interpreted as a business office for nurses]. PMID- 3648364 TI - [The pediatric surgery ward and the nurses' station]. PMID- 3648366 TI - [Operation of a nurses' station which is open to all]. PMID- 3648365 TI - [Nurses' concept of the nurses' station]. PMID- 3648367 TI - [The nurses' station as a place to practice lively art of nursing]. PMID- 3648368 TI - [A question on the need of a nurses' station--a nurses' corner created at the Koseiren Shinoi General Hospital]. PMID- 3648369 TI - [Possibility of dismantling the nurses' station: a discussion]. PMID- 3648371 TI - [Man and nursing. Music. 4. Child development and music--the meaning of a "new lullaby"]. PMID- 3648370 TI - [A survey on breast feeding of infants in the newborn stage following cesarean section]. PMID- 3648372 TI - [A seminar on "case studies and leadership"--methodology and evaluation of the seminar]. PMID- 3648373 TI - [Human engineering in nursing schedules: for the improvement in work schedules. 4. A trial at continuous night duty at a pediatric (internal medicine) ward and observations of the result]. PMID- 3648374 TI - [Evaluation of teaching methods in nursing history]. PMID- 3648375 TI - [Experiences as a nursing student in the United States--in the 4th year (1)]. PMID- 3648376 TI - [Clinical application of basic nursing. Prevention of bedsores during surgery]. PMID- 3648377 TI - [Emergency nursing. Consciousness disturbances]. PMID- 3648378 TI - [Nursing process: transmission, onset and management of pulmonary tuberculosis]. PMID- 3648380 TI - [Nursing process: keypoints in observing patients with pulmonary tuberculosis]. PMID- 3648379 TI - [Nursing process: symptoms and processes of diagnosis and treatment of pulmonary tuberculosis]. PMID- 3648381 TI - [Nursing process: nursing plans for patients with pulmonary tuberculosis]. PMID- 3648382 TI - [Nursing process: nursing of a patient with pulmonary tuberculosis who has been treated at the departments of internal medicine and surgery]. PMID- 3648383 TI - [Nursing with understanding of the mental process of a patient undergoing extended care]. PMID- 3648384 TI - [An experience in nursing of a patient with malignant rheumatoid arthritis--a process leading to discharge from the hospital]. PMID- 3648385 TI - [A survey on the attitude toward cancer--a comparison between nursing and other students]. PMID- 3648386 TI - [Test yourself. Nursing of a patient with cerebral infarction]. PMID- 3648387 TI - [Analysis and evaluation of case reports by students and a discussion on focal points in the preparation of the reports--comments on the reports presented at the past 14 issues]. PMID- 3648388 TI - [Apprehension of a new nurse: initial fear and hesitation]. PMID- 3648389 TI - [Apprehension of a new nurse: gravity of the responsibility of the night duty]. PMID- 3648390 TI - [Apprehension of a new nurse: responsibility to the patient and the importance of team work]. PMID- 3648392 TI - [Nursing of patients being cared for at home: satisfaction in helping patients and their families]. PMID- 3648393 TI - [Nursing process: physiopathology, diagnosis, and treatment of uterine cancer]. PMID- 3648391 TI - [Apprehension of a new nurse: the initial tension and confusion]. PMID- 3648394 TI - [Nursing process: data collection and assessment of patients with uterine cancer]. PMID- 3648395 TI - [Nursing process: nursing of a patient who experienced a normal clinical course following simple total hysterectomy]. PMID- 3648396 TI - [Illustrated nursing technology related to uterine cancer]. PMID- 3648397 TI - [Effects of cleansing of oral cavity using cotton swabs--failure to clean the front teeth and molars]. PMID- 3648398 TI - [Attempt at weight reduction in obese patients at the department of psychiatry]. PMID- 3648399 TI - [Nursing of a patient at the terminal stage of cancer who also suffered from psychological turmoil]. PMID- 3648401 TI - [Problems encountered in nursing: patients' cooperation in information gathering and the use of a bed pan]. PMID- 3648400 TI - [Nursing of patients with respiratory diseases]. PMID- 3648402 TI - [Ideal nurses's images in various nursing scenes]. PMID- 3648403 TI - [In search of a nurse's image]. PMID- 3648404 TI - [The existing image of a nurse and its improvement]. PMID- 3648406 TI - [A former internist suffering from terminal cancer]. PMID- 3648405 TI - [Menstrual irregularities and menstrual discomfort]. PMID- 3648407 TI - [A patient's real thought not expressed in words]. PMID- 3648408 TI - [Headache suffered by inhabitants of Micronesia]. PMID- 3648409 TI - [Nursing process: nursing plan for a patient with cervix cancer undergoing simple total hysterectomy]. PMID- 3648411 TI - Combating AIDS in Uganda. PMID- 3648412 TI - Continence advisers. PMID- 3648410 TI - In good hands. PMID- 3648413 TI - Teaching and learning to communicate. PMID- 3648414 TI - Hepatitis B: the facts made simple. PMID- 3648415 TI - Saturdays are special. PMID- 3648416 TI - Are animal tests justified? PMID- 3648418 TI - Nurses' malpractice crisis mushrooms. PMID- 3648417 TI - Scenes from nursing life: the inspector calls. PMID- 3648419 TI - Nursing research at Johns Hopkins University School of Nursing. PMID- 3648420 TI - Back injury--so you haven't had one--yet. PMID- 3648422 TI - [Use of computer technology in the system for training and retraining the paramedical team]. PMID- 3648421 TI - Phospholipid studies of marine organisms: 14. Ether lipids of the sponge Tethya aurantia. AB - The novel unesterified alkyl glycerol monoethers, (2S)-1-(hexadecyloxy)-2,3 propanediol (1), (2S)-1-(16-methylheptadecyloxy)-2,3-propanediol (2) and (2S)-1 (15-methylheptadecyloxy)-2,3-propanediol (3) were isolated from the marine sponge Tethya aurantia and were characterized by spectroscopic methods. These three saturated ethers as well as a series of alk-1'-enyl glycerol monoethers were also encountered in the phospholipids of the same sponge after reduction with LiAlH4. Incorporation experiments with dissociated cells of T. aurantia indicated that [1 14C]-hexadecanol was incorporated into the unesterified alkyl glycerol monoethers. PMID- 3648423 TI - [The role of sociological research in raising the quality of medical care for the population]. PMID- 3648424 TI - [The importance of educational work with younger children in treatment in a hospital]. PMID- 3648425 TI - [Intestinal dysbacteriosis and its clinical importance]. PMID- 3648426 TI - [Injuries to the ENT organs of children]. PMID- 3648427 TI - [Cerebrospinal rhinorrhea and otorrhea in children]. PMID- 3648428 TI - [Anesthesiological support of bronchological methods for diagnosis and treatment]. PMID- 3648429 TI - [Medical demographic problems in light of the decisions of the 27th Congress of the CPSU]. PMID- 3648430 TI - [Role of the nurse in performing and fulfilling the physician's instructions for patients after trephination puncture]. PMID- 3648431 TI - [Cholelithiasis. The rehabilitation of patients after cholecystectomy]. PMID- 3648432 TI - [Diet therapy in stomatological diseases at the Shakhtostroitel' Sanatorium Preventorium]. PMID- 3648433 TI - [Ethics and deontology in the dispensary care of the population]. PMID- 3648434 TI - [Emergency medical care for the mentally ill with the appearance of toxic allergic reactions]. PMID- 3648435 TI - [Emergency prehospital care in acute coronary insufficiency in the mentally ill]. PMID- 3648437 TI - [Black currant]. PMID- 3648436 TI - [Plantain]. PMID- 3648439 TI - National Nurses Society on Alcoholism: nurses focusing on chemical dependency. PMID- 3648438 TI - Enzyme studies at subzero temperatures using immobilized substrates. PMID- 3648440 TI - Nurse practitioners to lose malpractice coverage. PMID- 3648441 TI - Nurse practitioner fact sheet. PMID- 3648442 TI - DIS task force tackles provider education. PMID- 3648444 TI - Hospital kitchen hygiene. PMID- 3648443 TI - Family therapy and the out-of-control teenager. PMID- 3648445 TI - Prospects for further approximation of infant formulae to human milk. PMID- 3648446 TI - Pregnancy in the woman with a stoma. PMID- 3648447 TI - Special report on mothers' attitudes to infant feeding. PMID- 3648448 TI - Coping with the death of a twin. PMID- 3648449 TI - Midwifery training & practice in The Gambia. PMID- 3648450 TI - Breast feeding in South Africa. PMID- 3648451 TI - Two maternity units in South Africa. PMID- 3648453 TI - Osteogenesis imperfecta congenita. PMID- 3648452 TI - Some aspects of midwifery practice in Malawi. PMID- 3648454 TI - Unexpected death--sudden infant death syndrome. PMID- 3648455 TI - It's still a baby! PMID- 3648456 TI - Nursing--is it "the caring profession"? PMID- 3648457 TI - Suddenly, at home. PMID- 3648458 TI - Can midwives deliver? PMID- 3648459 TI - Learning for change: developing the 'teaching' role of the ward sister. PMID- 3648461 TI - Reliability of grading essay papers in a baccalaureate nursing programme. PMID- 3648460 TI - Application of nursing models to a curriculum: some considerations. PMID- 3648462 TI - A nursing conference: an exercise in self-directed learning. PMID- 3648463 TI - Literature searching for starters. PMID- 3648464 TI - Professional development programmes for newly registered nurses. PMID- 3648465 TI - Promoting scholarship for graduate education. PMID- 3648466 TI - Newborn temperature control. PMID- 3648467 TI - Neonatal axillary temperatures: increases in readings over time. PMID- 3648468 TI - Care of the family following the birth of a child with a cleft lip and/or palate. PMID- 3648469 TI - Candida sepsis in the very low birthweight infant. PMID- 3648470 TI - Therapeutic touch. PMID- 3648471 TI - Neonatal nursing ethics: toward a consensus. PMID- 3648472 TI - The Code for Nurses: Statement No 7 and No 8. PMID- 3648473 TI - Social Policy Statement: defining professional nursing. PMID- 3648474 TI - Ethics Committee questionnaire. PMID- 3648475 TI - Application of a philosophy for continuing education. PMID- 3648476 TI - The anti-HTLV-III (anti-HIV) and cytotoxic activity of 2',3'-didehydro-2',3' dideoxyribonucleosides: a comparison with their parental 2',3' dideoxyribonucleosides. AB - A series of 2',3'-didehydro-2',3'-dideoxyribonucleosides (ddeNs) [i.e., 2',3' dideoxythymidinene (ddeThd), 2',3'-dideoxyuridinene (ddeUrd), 2',3' dideoxycytidinene (ddeCyd), and 2',3'-dideoxyadenosinene (ddeAdo)] has been synthesized and the individual members compared in terms of their in vitro antiviral, antimetabolic, and cytostatic properties to their 2',3'-saturated counterparts (ddNs) (i.e., ddThd, ddUrd, ddCyd and ddAdo). All ddeNs except ddeUrd are potent and/or selective inhibitors of human immunodeficiency virus (HIV) in vitro, ddeCyd being the most potent (MIC50, 0.30 microM). The inhibitory effect of ddeCyd on ATH8 cell proliferation and HIV-induced cytopathogenicity is comparable to that of ddCyd. ddeThd is a more potent anti-HIV agent than ddThd (MIC50, 3.4 microM and 84 microM, respectively), but also more cytostatic (ID50, 172 microM and greater than 2000 microM, respectively). However, its in vitro chemotherapeutic index is higher than that of 3'-azido-2',3'-dideoxythymidine, a drug which has recently proven effective in the treatment of acquired immunodeficiency syndrome. ddeAdo has a weaker anti-HIV and a stronger cytostatic effect than ddAdo. Neither ddeUrd nor ddUrd shows significant anti-retroviral activity at 500 microM. In contrast to their anti-retroviral activity, both ddNs and ddeNs lack any appreciable inhibitory activity against a series of nononcogenic RNA and DNA viruses, pointing to their selectivity as anti retroviral agents. All ddeNs show a progressive loss of anti-retroviral effect upon prolonged incubation with virus-infected cells. This phenomenon is most likely due to the chemical instability of these compounds, and not to a preferential enzymatic phosphorolytic cleavage of the ddeNs. Evidence is presented that ddeCyd and ddCyd, and ddeThd and ddThd are phosphorylated by cellular dCyd kinase and dThd kinase, respectively. However, the Ki values as alternate substrate inhibitors for their respective kinases are high (greater than 500 microM), indicating poor substrate activity and, thus, poor anabolism in ATH8 cells. PMID- 3648477 TI - Characterization of wheat germ initiation factor eIF-2. AB - The initiation factor eIF-2 that specifically binds Met-tRNAf and GTP in ternary complex (eIF-2. GTP. Met-tRNAf) has been purified to apparent homogeneity from wheat germ ribosomal salt wash. The purified factor exhibits a sedimentation coefficient of 5 X 5S and an aggregate molecular weight of 122,000-daltons for the native protein. PMID- 3648479 TI - Right total knee replacement. A theatre nursing care study. PMID- 3648480 TI - Consciousness during surgery. PMID- 3648478 TI - Induction of a rapidly responsive hepatic gene product by thyroid hormone requires ongoing protein synthesis. AB - The regulation of a gene, designated spot 14, which is rapidly induced in rat liver in response to 3,5,3'-triiodo-L-thyronine (T3) was studied as a model for exploring the molecular basis of thyroid hormone action. The time course of induction of the nuclear precursor to spot 14 mRNA after intramuscular injection of T3 displayed a very short lag period of between 10 and 20 min. The rapidity of this effect suggests that the induction in gene expression occurs as a primary response to the hormone-receptor interaction. The protein synthesis inhibitor cycloheximide injected 15 min before T3 completely blocked the accumulation of nuclear precursor RNA 30 min after T3 treatment. Emetine, an inhibitor of protein synthesis which acts by a different mechanism than cycloheximide, also blocked the induction of the spot 14 nuclear precursor RNA. The increased rate of spot 14 gene transcription observed after T3 treatment, as measured by nuclear run-on assay, was similarly completely abolished in the presence of cycloheximide. In addition, ongoing protein synthesis was required for maintaining spot 14 nuclear precursor RNA at induced levels in animals previously treated with T3. On the other hand, cycloheximide had no effect on T3 uptake or binding to the nuclear receptor during the 45-min time frame studied. The paradox of the rapid kinetics of induction and the requirement of ongoing protein synthesis may be explained by a protein with an extremely short half-life which is necessary for T3 induction of the spot 14 gene. PMID- 3648481 TI - NATN evidence to the Nurses Pay Review Body. PMID- 3648482 TI - The gift of life. PMID- 3648483 TI - French AIDS research plan launched. PMID- 3648484 TI - An interview with Margretta M. Styles: nursing today and a vision for the future. Interview by Beth Ulrich. PMID- 3648485 TI - A review of cost-accounting methods for nursing services. PMID- 3648486 TI - Market research and nursing's dwindling applicant pool. PMID- 3648487 TI - Royal College of Nursing. United spirit. PMID- 3648488 TI - Enemy is complacency. PMID- 3648490 TI - Royal College of Nursing. Double triumph. PMID- 3648489 TI - Have same basic rights. PMID- 3648491 TI - The helper dilemma. PMID- 3648492 TI - Use of volunteers. PMID- 3648493 TI - Party leaders address the profession. PMID- 3648494 TI - Royal College of Nursing. Rich rewards. PMID- 3648495 TI - Achieving unity. PMID- 3648496 TI - Ensure 'Jeanette' case doesn't set a precedent. PMID- 3648497 TI - Definite role for enrolled nurse. PMID- 3648498 TI - Royal College of Nursing. Equality for all. PMID- 3648499 TI - Poor equality records. PMID- 3648500 TI - Reflections on SWING (South Wales Interest Nursing Group). PMID- 3648501 TI - Royal College of Nursing. A watershed. PMID- 3648502 TI - Rights of students. PMID- 3648503 TI - Proposal on AIDS confidentiality criticised by RCN. PMID- 3648504 TI - Royal College of Nursing. A hard sell. PMID- 3648505 TI - Complex problem with simple solution. PMID- 3648506 TI - We must build a smooth career path. PMID- 3648507 TI - The care of children with cancer. PMID- 3648509 TI - Let's take it slowly. PMID- 3648508 TI - Royal College of Nursing. Must be aware. PMID- 3648510 TI - Royal College of Nursing. Must be united. PMID- 3648511 TI - A violation of trust. PMID- 3648512 TI - Significant events for mental handicap. PMID- 3648513 TI - Nurse education--the Australian experience. PMID- 3648514 TI - Retrovirus like particles produced by human embryonal cells and cell lines derived from human malignancies. II. Protein structure. AB - Very small amounts of retrovirus-like particles were isolated from tissue culture media of various types of human cell lines derived from malignant as well as normal cells. The aim of the present study is the characterization of protein profiles of these isolates. The comparison of protein profiles of isolated human virus-like particles with the profiles of well characterized animal as well as human exogenous (LAV/HTLV-III) retroviruses revealed a 25k protein (p25) to be a major protein or at least one of the protein components of human retrovirus-like particles. PMID- 3648515 TI - Risk management of medication errors. PMID- 3648516 TI - Drug delivery by retrograde intravenous infusions. Implications for therapy. PMID- 3648517 TI - The gray areas of antineoplastic therapy. PMID- 3648518 TI - A proposed model for a clinical ladders program in i.v. therapy. PMID- 3648519 TI - New England Deaconess guidelines for the administration of i.v. drugs. PMID- 3648520 TI - Accreditation: the quality solution for home care. PMID- 3648521 TI - The nature of the nursing shortage: will crisis become structure? PMID- 3648522 TI - Going for the win in home health care. Interview by Kevin L. Morissey. PMID- 3648523 TI - Replacing a failing old pattern with a vital new paradigm: home care. PMID- 3648524 TI - Housing conditions and health: a crucial link. PMID- 3648525 TI - Student outreach program closes the gap in community services. PMID- 3648526 TI - Mastering distractions that mar home visits. PMID- 3648527 TI - Quantitative and qualitative research: antagonistic or complementary? PMID- 3648528 TI - The critical case for continued funding of nursing programs. PMID- 3648529 TI - Managing your academic career: preparing for a job change. PMID- 3648530 TI - Creative permission: an unrecognized need. PMID- 3648531 TI - Professionalization: a comparison among generic baccalaureate, ADN, and RN/BSN nurses. PMID- 3648532 TI - Toward the socialization of scholars and scientists. PMID- 3648533 TI - Invitational education: a model for nursing. PMID- 3648534 TI - Using computers to promote health behavior of nursing students. PMID- 3648535 TI - Placement of pathophysiology in the curriculum. PMID- 3648536 TI - Can't tell facts from inferences? Ask Van Gogh. PMID- 3648537 TI - Offering emotional support to families in hospital waiting rooms: an excellent learning experience. PMID- 3648538 TI - Registered nurses and nursing students learn together in a cancer nursing course. PMID- 3648540 TI - Another language. PMID- 3648539 TI - The cookie experiment: a creative teaching strategy. PMID- 3648541 TI - The nursing shortage: how bad is it? Reader survey. PMID- 3648542 TI - Postthyroidectomy respiratory distress. PMID- 3648543 TI - Meeting the challenge of intestinal obstruction (continuing education credit). PMID- 3648544 TI - Nursing intuition: too powerful--and too valuable--to ignore. PMID- 3648545 TI - Play it safe: don't use these abbreviations. PMID- 3648546 TI - Let your patient control his analgesia. PMID- 3648547 TI - Life changes: can they cause disease? PMID- 3648548 TI - Blood samples made simple: using special i.v. lines at home. PMID- 3648550 TI - Harriet and her family: a portrait of courage and grief. PMID- 3648549 TI - Think before you search. PMID- 3648551 TI - Helping the emergency colostomy patient through reality shock. PMID- 3648552 TI - Patient teaching: it's the law. PMID- 3648553 TI - Nursing can do without nurse impostors. PMID- 3648554 TI - Adoptive immunotherapy. PMID- 3648555 TI - Keeping your patients happy: your role in hospital marketing. PMID- 3648556 TI - Jim's new world. PMID- 3648557 TI - Beliefs and behaviour in health and illness. PMID- 3648558 TI - Idealism and reality in nursing. PMID- 3648559 TI - Beliefs and behaviour: a personal account. PMID- 3648560 TI - Resolution of conflicts and organizational change. PMID- 3648561 TI - Beliefs and behaviour: why is it so hard to change? PMID- 3648562 TI - Media image of nursing. PMID- 3648563 TI - Redefining targets. PMID- 3648564 TI - Beliefs and behaviour in health education. PMID- 3648565 TI - Healthy practice. PMID- 3648566 TI - Chiropractic. PMID- 3648567 TI - Lonely at the top. PMID- 3648568 TI - Personal power--your key to success. PMID- 3648569 TI - In business: starting an unusual day-care center. PMID- 3648570 TI - How secure is your hospital? PMID- 3648571 TI - We thought it couldn't happen here. PMID- 3648572 TI - Jo's care was cold as ice. PMID- 3648573 TI - Other options: great opportunities outside the hospital. PMID- 3648574 TI - You too can be an expert witness. PMID- 3648576 TI - The superwoman syndrome: are you trying too hard to please? PMID- 3648575 TI - My toughest nursing decisions. PMID- 3648577 TI - Managing chronic cancer pain effectively. Part 1. What you need to know (continuing education credit). PMID- 3648578 TI - Death & dying. PMID- 3648580 TI - Sexual harassment: legal implications--Part I. PMID- 3648579 TI - Whistle-blowing: at what price? PMID- 3648581 TI - Innovative geriatric care. PMID- 3648582 TI - Multidisciplinary geriatric care in a small community hospital setting. PMID- 3648583 TI - Toward a comprehensive personnel system: personnel selection--Part II. PMID- 3648584 TI - Professional practice: the head nurse sets the climate. PMID- 3648585 TI - Care for the caregivers. PMID- 3648586 TI - BSNs and ADNs: what competencies can we expect of new graduates? Nursing Research Consortium of Long Island. PMID- 3648587 TI - Controlling nursing turnover. PMID- 3648588 TI - Nursing management problem-solving committees help build teams. PMID- 3648589 TI - Have nursing service directors abdicated their leadership role? PMID- 3648590 TI - The nursing process for the very stubborn. PMID- 3648591 TI - Participative management becomes shared management. PMID- 3648592 TI - Managing a critical matter. PMID- 3648593 TI - Sexual harassment: legal implications--Part II, Nursing. PMID- 3648594 TI - Installing the first operational bedside nursing computer system. PMID- 3648595 TI - General-purpose microcomputer software: new tools for nursing professionals. PMID- 3648596 TI - Patient satisfaction: an indicator of nursing care quality? PMID- 3648598 TI - Toward a comprehensive personnel system: staff development Part III. PMID- 3648597 TI - Implementation of a hospital information system: the use of a nursing task force. PMID- 3648599 TI - A guide to writing effective patient education materials. PMID- 3648600 TI - Throw-away nurses? PMID- 3648601 TI - New beginning: ICU nursing shortage eliminated internally. PMID- 3648602 TI - Are you going stale? PMID- 3648603 TI - Competency-based career ladders. PMID- 3648605 TI - Negotiation through justification. PMID- 3648604 TI - Why nurses stay: a positive approach to the nursing shortage. PMID- 3648606 TI - Temporary staffing: a positive approach. PMID- 3648607 TI - Patterned staffing: the personal touch? PMID- 3648608 TI - Treating the job-hopping syndrome. PMID- 3648609 TI - Toxicologic evaluation--from mice to man. PMID- 3648610 TI - Smoking at work. PMID- 3648611 TI - No smoke without fire. PMID- 3648612 TI - Smoking. Legal judgments abroad. PMID- 3648613 TI - Introducing a non-smoking policy. PMID- 3648614 TI - Women and smoking. PMID- 3648615 TI - Interactive video: a new approach to training. PMID- 3648616 TI - Recall of first aid knowledge and skills. PMID- 3648617 TI - Medical negligence. PMID- 3648619 TI - Too tired to drive? PMID- 3648618 TI - Looking after London's transport. Interview by David Mossman. PMID- 3648620 TI - Just spare a thought for the driver. PMID- 3648621 TI - Group services: Hodgson's choice. Interview by Michael Bangs. PMID- 3648622 TI - Post-mortem hazards. PMID- 3648623 TI - Exercise--the stressor that reduces stress? PMID- 3648624 TI - Consultation in acute care. PMID- 3648625 TI - An overview of nurse anesthesia education. PMID- 3648626 TI - About community health: hazards at work and home. PMID- 3648627 TI - Who needs continuing education? PMID- 3648628 TI - Nutritional assessment of the older adult client. PMID- 3648629 TI - Ethics, nursing and politics. PMID- 3648630 TI - Nursing and AIDS: prevention and patient care. PMID- 3648631 TI - Nursing: revolution or death. PMID- 3648632 TI - [Food contamination from the environment--a danger to humans?]. PMID- 3648633 TI - [The oncologic nurse in the tension field between regular and alternative medicine. Staying independently halfway in between]. PMID- 3648634 TI - [Nutrition for healthy and obese children]. PMID- 3648635 TI - [Development aid in the Cameroon. Interview by Paul Morwald]. PMID- 3648636 TI - PA's Secretary of Health assesses state's health. PMID- 3648638 TI - Nursing malpractice insurance to undergo major changes. PMID- 3648637 TI - As computer technology invades health care settings, nursing educators need to focus on computer literacy. PMID- 3648639 TI - Why corporate restructuring? PMID- 3648640 TI - Statement regarding nurse practitioners. PMID- 3648641 TI - Toxic waste--finding acceptable solutions. PMID- 3648642 TI - Let's face it about day care. PMID- 3648644 TI - AIDS from a school health perspective. PMID- 3648646 TI - Sudden infant death syndrome and families at risk. PMID- 3648645 TI - Oral soft tissue abnormalities in children. PMID- 3648643 TI - Accident reports: survey of high school injuries. PMID- 3648647 TI - Treating acute diarrhea and dehydration with an oral rehydration solution. PMID- 3648648 TI - Therapeutic storytelling: helping children learn and cope. PMID- 3648649 TI - Strategies used by nurse practitioners to adjust to workplace encroachment. PMID- 3648650 TI - Selecting a pediatric home care program. PMID- 3648651 TI - Parent questionnaires: a useful tool to pediatric practice. PMID- 3648652 TI - Pediatric management problems (chlamydial infections). PMID- 3648653 TI - Sunscreen agents. PMID- 3648654 TI - The school nurse and freedom of speech. PMID- 3648655 TI - Noncompliance with PKU treatment recommendations may be medical neglect in some states. PMID- 3648657 TI - Changing patterns in nursing education. PMID- 3648658 TI - The significance and role of research in nursing. PMID- 3648656 TI - Applying classical management theory to create a new pediatric intensive care unit. PMID- 3648659 TI - Nursing research in the Netherlands. PMID- 3648660 TI - Clinical nursing research. PMID- 3648661 TI - Nurse researchers on the issue of AIDS. PMID- 3648662 TI - Nursing research in the future. PMID- 3648663 TI - Linking health care and information technology: the future of computer applications in nursing. PMID- 3648664 TI - The scope and trends of international nursing education. PMID- 3648665 TI - Professional identity of nurses in the United States. PMID- 3648666 TI - How to build a professional nursing organization. PMID- 3648667 TI - Accreditation and quality. PMID- 3648668 TI - The Dutch university's ability to contribute to changing patterns in nursing education. PMID- 3648669 TI - Strategies for change in the health care delivery system of the Netherlands. PMID- 3648670 TI - Curriculum building in the United States: 1980s and 1990s. PMID- 3648672 TI - Satellite programs in nursing education. PMID- 3648671 TI - The clinical nurse specialist: graduate preparation for advanced nursing practice. PMID- 3648673 TI - A comparison between Dutch and American nursing education. PMID- 3648674 TI - Problems in changing the pattern of nursing education in Finland. PMID- 3648675 TI - Changing patterns in nursing education: change by evolution: the Israeli experience. PMID- 3648676 TI - Clinical teaching of parent/child nursing. PMID- 3648677 TI - Mental health education. PMID- 3648678 TI - Maximizing resource utilization in community and institutional care of the aged. PMID- 3648679 TI - Nursing education and nursing research in the Netherlands. PMID- 3648680 TI - The nucleotide sequence of a human serine tRNA gene. PMID- 3648681 TI - A nuclear Nicotiana DNA sequence homologous to the 5' half of tRNATyr may have derived from reverse transcription of a pre-tRNA splicing intermediate. PMID- 3648682 TI - State Board members' perceptions of impaired nurses. PMID- 3648683 TI - State Boards of Nursing. PMID- 3648684 TI - Faculty practice: new definitions, new opportunities. PMID- 3648685 TI - Faculty practice in clinical specialties. PMID- 3648686 TI - Nurse midwives and liability insurance. PMID- 3648687 TI - The politics of faculty practice: the dean's role. PMID- 3648688 TI - The new health care economy: opportunities for nurse entrepreneurs. PMID- 3648689 TI - Separate or integrated pharmacology content? PMID- 3648691 TI - Making time for writing. PMID- 3648690 TI - Nursing theory for undergraduates. PMID- 3648693 TI - Re: "On 'Toward a theory of nursing action: skills and competency in nurse patient interaction"'. PMID- 3648692 TI - Controlled supplemental oxygenation during tracheobronchial hygiene. AB - The effect of controlled supplemental oxygenation without bag ventilation on transcutaneous partial pressure of oxygen (TcPO2) measurements during tracheobronchial hygiene was evaluated. Procedure A, no supplemental oxygenation, was compared to Procedure B, in which controlled supplemental oxygenation was used. For controlled supplemental oxygenation, the FiO2 was increased until TcPO2 measurements rose to levels between 90 and 100 torr. Sixteen premature infants who required mechanical ventilation were studied in the neonatal center. Both procedures were performed on each patient in random order. In both procedures, a precipitous decrease in TcPO2 was observed during chest vibration, and further decrease in TcPO2 was noted with endotracheal suctioning. Except for baseline readings, throughout the tracheobronchial hygiene TcPO2 measurements were significantly higher and more subjects maintained TcPO2 values greater than 40 torr in Procedure B. In Procedure A corresponding TcPO2 measurements were 40 torr or less. Mean recovery time was shorter in Procedure B, 2.1 +/- 2.3 minutes, than in Procedure A, 4.9 +/- 2.8 minutes, p less than .003. Thus, in most patients, controlled supplemental oxygenation without manual bag ventilation seems sufficient to prevent hypoxia during tracheobronchial hygiene; it also shortens recovery time from hypoxemia as a result of the bronchopulmonary hygiene procedure. PMID- 3648694 TI - Re: 'Spouses' body image changes during and after pregnancy: a replication and extension'. PMID- 3648695 TI - Adjustment of patients and husbands to the initial impact of breast cancer. AB - This study compared the psychosocial adjustment of 50 newly diagnosed breast cancer patients and their husbands at two points in time. Time 1 interviews were conducted approximately 3 days after surgery; Time 2 interviews were conducted 30 days later. Psychosocial adjustment was measured as a multidimensional construct using the Affects Balance Scale, the Brief Symptom Inventory, and the Psychosocial Adjustment to Illness Scale. Repeated measures analysis indicated that husbands' scores did not differ significantly from patients' scores on the adjustment measures that assessed level of mood and amount of symptom distress. Both patients and husbands reported levels of distress significantly above the level reported for the normal population. Patients and husbands differed only on the adjustment measure that assessed problems in carrying out various psychosocial roles, with patients reporting more role adjustment problems than husbands. Although both patients and husbands reported dramatic improvement in their levels of mood from Time 1 to Time 2, no significant change occurred in their levels of distress. Medical and demographic factors had little relationship to subjects' levels of adjustments at either time. PMID- 3648696 TI - Mexican American, nurse practitioner, and lay control group beliefs about cause and treatment of chest pain. AB - This study compared the health beliefs of Mexican Americans concerning the specific symptom of chest pain to beliefs of a group of predominant culture nurse practitioners and a lay predominant culture control group. Two hypotheses were examined; The health beliefs of groups differ significantly with culture and the health beliefs of groups differ significantly with professional education. A 43 item structured questionnaire was developed, based on literature review and unstructured interviews with Mexican American respondents. the questionnaire was administered to three nonprobability samples of 30 subjects each: Mexican Americans, nurse practitioners, and lay controls. Significant differences were found between Mexican Americans and the predominant culture groups of nurse practitioners and lay controls on folk beliefs regarding chest pain. On some items significant differences between nurse practitioners and the lay groups of Mexican Americans and predominant culture controls were based on professional education. PMID- 3648697 TI - Psychiatric inpatients' perception of the seclusion-room experience. AB - In a study of psychiatric inpatients' perceptions of the seclusion-room experience, 52 voluntarily admitted adult patients in a state hospital were interviewed within 3 days of the experience. An 88-item semistructured interview schedule was used to obtain information on six research questions. Subjects' perceptions of the reasons for their seclusions varied greatly from perceptions of staff members. Findings implied that for some patients seclusion may have been unnecessary, but for others it was beneficial. Subjects who reported out-of control impulses or pathological intensity of relationships prior to seclusion and who showed positive change in mood, behavior, or thinking toward staff and/or other patients during or after seclusion seem to have benefited from the experience. PMID- 3648698 TI - Spousal differences in marital satisfaction during transition to parenthood. AB - Ninety-six couples were assessed to determine the contributions of sex role attitudes, marital equity, perceived father involvement, and infant temperament to satisfaction during transition to parenthood. Both parents reported a significant decline in marital satisfaction from 3 months prebirth to 3 months postbirth. Mothers' evaluations of their postbirth marital relationships were positively influenced by more nontraditional sex role attitudes and greater father involvement in infant care, and negatively influenced by marital inequity and a more temperamentally active infant. Fathers' postbirth marital satisfaction was more negatively influenced by marital inequity than mothers'. Other factors did not contribute to fathers' marital assessment. Results suggest that a mother's perception of marital satisfaction after parenthood is more complex than a father's, and that equity is a greater consideration for men than for women during the transition to parenthood. PMID- 3648699 TI - An instrument for the measurement of infant-adult synchrony. AB - The Dyadic Mini Code (DMC) is designed to measure levels of synchrony in early infant-adult interaction. Based on important components of synchronous interaction reported in the literature, the instrument consists of six items, a total score, and a summary rating. Videotapes of 38 term and preterm mother infant pairs were studied to establish reliability and validity of the tool. Interrater reliability was determined using Cohen's kappa and percent of agreement; kappa was .86 for the total score and ranged from .63 to .92 for each of the six items. A discrimination index, applied to each item, indicated that four items are good predictors of the final rating and two require further testing. Dyadic Mini Code summary ratings compared to mean coherence values computed from Monadic Phase Scale (Tronick, Als, & Brazelton, 1980) scores on the same data yielded moderate concurrent validity; point bi-serial analysis, rpb = .488, p less than .01; and chi 2 = 4.878, df = 1, Fisher's exact test (1-tail) = p less than .05. Construct validity was demonstrated by finding that the instrument discriminated between preterm and term dyads according to expected differences, chi 2 = 4.071, df = 1, Fisher's exact test (1-tail) = p less than .05. Further refinement of the DMC is indicated. PMID- 3648700 TI - Research activities of clinical nurse researchers. AB - A nationwide telephone survey was carried out on 34 nurses employed as researchers in clinical settings (CNRs). CNRs reported current involvement in over 200 projects with a range from 1 to 29 projects. Projects were categorized into the following types: clinical practice, nursing administration, evaluation, education, or methodology. Almost half (47%) of the projects were in clinical practice. Type of involvement in research was used as a basis for conceptualizing the CNR's role as traditional scientist, associate, or facilitator. Results are discussed regarding the variations found in how the CNR role is enacted across settings and the focus of the research in which CNRs are engaged. PMID- 3648701 TI - Private sector support of nursing research. AB - Members of the American Nurses' Association Council of Nurse Researchers were surveyed for information about their nursing research funding activity within the private sector: their submission of proposals to private organizations, the outcomes, and effective funding strategies. Results indicated that 51% of applications submitted to private organizations and 78% of intramural applications were funded. However, 65% of proposals funded by private organizations and 59% of intramurally supported projects were for $3,000 or less. A variety of strategies led to private sector support of successful nursing research proposals. These included making direct, personal contact with funding agencies, matching proposals with the needs and interests of the funding agency, networking with other professionals to obtain funding information, and submitting well-written proposals consistent with agency guidelines. PMID- 3648702 TI - Discriminant analysis. PMID- 3648703 TI - Approaches to avoiding errors in data sets: a technical note. PMID- 3648704 TI - On the move. PMID- 3648705 TI - Massage is the message. PMID- 3648706 TI - The pay-off that palls. PMID- 3648707 TI - Private boom, public constraint. PMID- 3648708 TI - Counselling is not discipline. PMID- 3648709 TI - Specialist delivery of care. PMID- 3648710 TI - Support for the silent sufferers. PMID- 3648711 TI - Making CPNs part of the team. PMID- 3648712 TI - Home nursing for parents. PMID- 3648713 TI - Preventive treatment for bone loss. PMID- 3648714 TI - Heart disease. Good hearted Glasgow. PMID- 3648715 TI - The practice of seclusion. PMID- 3648716 TI - A student of life. Interview by Laurence Dopson. PMID- 3648717 TI - Prisoners of conscience. Interview by Peter Morris. PMID- 3648718 TI - Issues of conscience: end of an affair. PMID- 3648719 TI - Enrolled nurses: rocky roll. PMID- 3648721 TI - Men in nursing. Man appeal. PMID- 3648720 TI - A word of advice. PMID- 3648722 TI - Men in nursing. Putting men in the picture. PMID- 3648723 TI - Men in nursing. Boys' talk. PMID- 3648724 TI - Evaluating specialist skills. PMID- 3648725 TI - Sexuality and the renal patient. PMID- 3648727 TI - Meaningful dialogue. PMID- 3648726 TI - Into the outside. PMID- 3648728 TI - Nursing Aid. What about the women? PMID- 3648729 TI - Helping hands. A dignified death. PMID- 3648731 TI - Midwives' journal. Facing up to antenatal care. PMID- 3648730 TI - Midwives' journal. PMID- 3648732 TI - Midwives' journal. Who needs advertising? PMID- 3648733 TI - Midwives' journal. When technology takes over. PMID- 3648734 TI - Training for a takeover? PMID- 3648735 TI - Radical nurses: dissenting voices. PMID- 3648736 TI - Health divide: an unequal battle. PMID- 3648737 TI - Promises, promises. PMID- 3648738 TI - How drugs act. Drugs and the heart. PMID- 3648740 TI - Is there anyone else out there? PMID- 3648739 TI - Diet and the cancer patient. PMID- 3648741 TI - Room for change. PMID- 3648742 TI - Men in nursing: the male model. PMID- 3648743 TI - Parasuicide. PMID- 3648744 TI - Everyday ethics for nurses: whose morals are they, anyway? PMID- 3648745 TI - Burn-injured children. PMID- 3648746 TI - Systems of life. No 149. Senior systems. 14. The acute abdomen in elderly patients. PMID- 3648747 TI - Stress in nursing. 1. What does stress mean to you? PMID- 3648748 TI - Learned practice. PMID- 3648749 TI - House of horrors. PMID- 3648751 TI - No longer the nit lady. PMID- 3648750 TI - Foot-care for diabetics. PMID- 3648752 TI - Who's in charge? PMID- 3648753 TI - What price standards? PMID- 3648754 TI - Call in the flying squad. PMID- 3648755 TI - Ray treatment for food. PMID- 3648756 TI - Men in nursing: unequal opportunity. PMID- 3648757 TI - How drugs act. Drugs in angina and myocardial infarction. PMID- 3648758 TI - Not daft, not deaf, just old. PMID- 3648759 TI - The journal of infection control nursing. Through the maze--tracking down the source of infection. PMID- 3648760 TI - The journal of infection control nursing. The passage of infection. PMID- 3648761 TI - The other side of smack. PMID- 3648762 TI - Family-self-care: towards health for all. PMID- 3648763 TI - Priority to simple basic care. PMID- 3648764 TI - Convey your enthusiasm to patients. PMID- 3648765 TI - 'U' and 'I' can do a lot for healthy living. PMID- 3648766 TI - The process of preparing a grant: Part I. PMID- 3648767 TI - Humor, life and death. PMID- 3648768 TI - Authenticity, belonging, emotional closeness, and self representation. Mara Mogensen Flaherty Memorial lecture. PMID- 3648769 TI - Making mountains manageable: maximizing quality of life through crisis intervention. PMID- 3648770 TI - Patterns of nausea, vomiting, and distress in patients receiving antineoplastic drug protocols. PMID- 3648771 TI - Experience with a totally implanted venous access device in children with malignant disease. PMID- 3648772 TI - Collaborative practice: a tool for change. PMID- 3648773 TI - Pain descriptors used by patients with cancer. PMID- 3648774 TI - Your child and children with AIDS: a parent information booklet. PMID- 3648775 TI - Networking: when use borders abuse. PMID- 3648776 TI - Chemotherapy teaching and informed consent. PMID- 3648777 TI - Is training, education, and development in your operating room? PMID- 3648778 TI - Who is your same-day surgery learner? PMID- 3648780 TI - Perioperative nursing care of the elderly outpatient. PMID- 3648779 TI - Increasing productivity in the operating room with participative management. PMID- 3648781 TI - Nurse preceptorship in the operating room. PMID- 3648782 TI - Perioperative family nurse clinician: an expanded role. PMID- 3648783 TI - Hunter Allen Nursing Associates: continuing education for the perioperative nurse. PMID- 3648784 TI - Perioperative grand rounds. PMID- 3648785 TI - Nursing care plan for the head and neck cancer patient. PMID- 3648786 TI - An evaluation of a preoperative assessment program. PMID- 3648787 TI - Professional survival tips: getting the job you want. PMID- 3648788 TI - Research: getting funding. PMID- 3648790 TI - Confidentiality. PMID- 3648789 TI - Preoperative teaching for surgical patients. PMID- 3648791 TI - Problems in i.v. therapy: 1. The flow slows or stops. PMID- 3648792 TI - Reaching the year 2000: manpower planning. PMID- 3648793 TI - Maternity benefits. PMID- 3648794 TI - Constipation and faecal incontinence. PMID- 3648795 TI - The psychiatric community meeting. PMID- 3648796 TI - Counselling: basic principles in nursing. PMID- 3648797 TI - Staph aureus: resistance to antibiotics. PMID- 3648798 TI - Radiation: sources, units and biological effects. PMID- 3648799 TI - Intercostal drains. PMID- 3648800 TI - Chronic respiratory disease: educating patients at home. PMID- 3648801 TI - Preventing delayed wound healing. PMID- 3648802 TI - Mobilizing nurses power for health unity & national development. PMID- 3648803 TI - Manifesto for people's health. PMID- 3648804 TI - Issues and concerns of health workers on their quality of work life--implications for social policy. PMID- 3648805 TI - Costing nursing services. PMID- 3648806 TI - Relationship among health professionals--professional, ethical & legal. PMID- 3648807 TI - [Health for all in the year 2000. Recommendations for nurses and midwives]. PMID- 3648808 TI - [Instruction in psychiatric nursing]. PMID- 3648809 TI - [Today's psychiatric nurse]. PMID- 3648810 TI - [Nursing care of patients with a dementia syndrome]. PMID- 3648811 TI - [How many people undergo treatment with a psychiatrist?]. PMID- 3648812 TI - [Community model of psychiatric care]. PMID- 3648813 TI - [Symptoms of mental disorders]. PMID- 3648814 TI - [Nursing care and electroshock]. PMID- 3648815 TI - [The entrance examination]. PMID- 3648816 TI - [My happiest day. Interview by Alina Ozimek]. PMID- 3648818 TI - [The training of nurses in Canada]. PMID- 3648817 TI - [Life spared me the choice--says Wieslawa Baruk. Interview by Maria Lesnikowska]. PMID- 3648819 TI - [We want to serve the idea of humanism]. PMID- 3648820 TI - [The role of tradition]. PMID- 3648821 TI - [Sex. The scientific concept]. PMID- 3648822 TI - [The endocrinology of pregnancy]. PMID- 3648823 TI - [To be conscious of the goal (a voice in the discussion)]. PMID- 3648824 TI - [The status of the head nurse]. PMID- 3648826 TI - Employee handbooks: your legal rights. Case in point: Duldulao v. St. Mary of Nazareth Hosp. (505 N.E. 2d 314-IL). PMID- 3648825 TI - Nurse reviewers: a new dimension. PMID- 3648827 TI - Legal case briefs for nurses. AL.: Dr. assaults nurse: punitive damages; IN.: practicing pharmacy without a license. PMID- 3648828 TI - Watch those Apgar scores: evidence. Case in point: Gaalaas by Gaalaas v. Morrison (353 S.E.2d 899-VA). PMID- 3648829 TI - Dilemma: your conscience or your job? PMID- 3648830 TI - Caveat for nurse-inventors: legal issues. Case in point: Tate v. Scanlan International, Inc. (402 N.W. 2d 66-MN). PMID- 3648831 TI - Legal case briefs for nurses. FL.: permanent license revocation barred; MA.: nurse midwife; license suspension. PMID- 3648832 TI - Nurses fail to communicate: death results. Case in point: Hodges v. Effingham County Hosp. Auth. (355 S.E. 2d 104-GA). PMID- 3648833 TI - [Education of nursing students and their assignment as nurses in a program of child welfare]. PMID- 3648834 TI - [Participation of public health nurses in family health]. PMID- 3648835 TI - [Transcription of medical prescriptions and nursing care]. PMID- 3648836 TI - [The nurse in community development--her role as educator]. PMID- 3648837 TI - [Problems of a nursing service. Experiences in the planning of a work program]. PMID- 3648838 TI - [Treatment of decubitus ulcers with propolis]. PMID- 3648839 TI - [Evaluation of the assistance given by the nursing students in a general INAMPS hospital in the city of Recife--patients' opinion]. PMID- 3648840 TI - [Development of planned psychiatric nursing]. PMID- 3648841 TI - [Reactive choices of nursing students facing the therapeutic bath for severely burned patients]. PMID- 3648842 TI - [Evaluation of educational activities in the nursing of diabetics; Experiment in docent-assistant integration in the University Hospital--UFC, Fortaleza-CE]. PMID- 3648844 TI - [Role of nursing in matters close to young students--2nd part]. PMID- 3648843 TI - [A theory of self-care and its applicability within the rooming-in system]. PMID- 3648845 TI - [A group of patients with heart surgery--report of experiences]. PMID- 3648846 TI - [Evaluation of professional nurses' performance in hospital units]. PMID- 3648847 TI - [Nursing routine for the evaluation of eye lesions in Hansen's disease]. PMID- 3648848 TI - [Nursing care for the mentally defective: levels of prevention]. PMID- 3648849 TI - [Teaching of therapeutic relationships in psychiatric nursing. Problems and perspectives]. PMID- 3648850 TI - [Student-centered teaching: orientation in pediatric nursing--graduate level]. PMID- 3648851 TI - [Food consumption by female university students]. PMID- 3648852 TI - [Considerations on the conjugal relations of pregnant women]. PMID- 3648853 TI - [Study on the performance evaluation of nurses. Methods used and results achieved. II]. PMID- 3648854 TI - [Instruction in therapeutic communication technics between nurses and patients. I]. PMID- 3648855 TI - [Isolation in communicable diseases: concepts in nursing]. PMID- 3648857 TI - [Acquired immunodeficiency syndrome (AIDS) (1)]. PMID- 3648856 TI - [Immunological profile of drug addicts: HTLV-III negative, HTLV-III positive and those with lymphadenopathy syndrome-AIDS related complex]. PMID- 3648858 TI - Response: ReVision and passion. PMID- 3648859 TI - Response: Early morning musings on the passion for substance. PMID- 3648860 TI - Needs of spouses of surgical patients: a conceptualization within the Roy adaptation model. PMID- 3648861 TI - Response to "Needs of spouses of surgical patients: a conceptualization within the Roy adaptation model". PMID- 3648862 TI - ReVisions in knowledge development: a passion for substance. PMID- 3648863 TI - Mothers' perceptions of children's temperament and mother-child attachment. PMID- 3648864 TI - Response to "Mothers' perceptions of children's temperament and mother-child attachment". PMID- 3648865 TI - Dyspnea: a clinical perspective. PMID- 3648866 TI - Response to "Dyspnea: a clinical perspective". PMID- 3648867 TI - Response to "Structuring the nursing knowledge system: a typology of four domains". PMID- 3648868 TI - The effect on bonding behavior of giving a mother her premature baby's picture. PMID- 3648869 TI - Response to "The effect on bonding behavior of giving a mother her premature baby's picture". PMID- 3648870 TI - Toward holistic inquiry in nursing: a proposal for synthesis of patterns and methods. PMID- 3648871 TI - Response to "Toward holistic inquiry in nursing: a proposal for synthesis of patterns and methods". PMID- 3648872 TI - Infant feeding practices of Vietnamese immigrants to the Northwest United States. PMID- 3648873 TI - Response to "Infant feeding practices of Vietnamese immigrants to the Northwest United States". PMID- 3648874 TI - Structuring the nursing knowledge system: a typology of four domains. PMID- 3648875 TI - [Mother presents resistance]. PMID- 3648876 TI - [Did you say: "nurse researcher"?]. PMID- 3648877 TI - [Nurses' aides: conscientious teachers]. PMID- 3648878 TI - [At the hospital, residences for parents]. PMID- 3648879 TI - [Arranging a stay at Burkina-Faso or how a small provincial school enlarged its horizon]. PMID- 3648882 TI - [A profession: the nurses' aide--what the nurses' aides have to say about it]. PMID- 3648881 TI - [Traveling. Advice on adaptation to the climate]. PMID- 3648880 TI - [Children facing a disabling disease in their parents]. PMID- 3648883 TI - [Not just stickers]. PMID- 3648884 TI - [Protocols of nursing care: approach to the evaluation of the quality of care]. PMID- 3648885 TI - [Crises in adolescence]. PMID- 3648886 TI - [Sects and mental health]. PMID- 3648887 TI - [Urinary catheters, identification tags]. PMID- 3648888 TI - [Children's accidents. I]. PMID- 3648889 TI - [Being the head of a dispensary]. PMID- 3648890 TI - [Project of introducing nurses visits for tracheotomized patients with respiratory insufficiency, ventilated at home]. PMID- 3648891 TI - [To become a nurse in 1987. Interview by Nadine Wehrlin]. PMID- 3648892 TI - [A femoral neck fracture]. PMID- 3648893 TI - [AIDS and the gynecologist-obstetrician]. PMID- 3648894 TI - [Cardiac stimulators]. PMID- 3648895 TI - [Adrenal gland tumors]. PMID- 3648897 TI - [Monitoring the surgical patient: landmarks]. PMID- 3648896 TI - [Physiology of the adrenal glands (excluding the sex steroids)]. PMID- 3648898 TI - [Technics for the mobilization and transport of patients]. PMID- 3648899 TI - [Efficiency in medical care]. PMID- 3648900 TI - [Oncologic chemotherapy in gynecology. Tolerance and side effects]. PMID- 3648901 TI - [Plan of hospital reorganization in Catalonia]. PMID- 3648902 TI - [Nocturnal enuresis and its treatment]. PMID- 3648903 TI - [Nebulizers]. PMID- 3648904 TI - [Continuing education. 15. Field: fundamentals of nursing. Topic: the Virginia Henderson model of nursing care]. PMID- 3648905 TI - [Fat, fashion and slimness]. PMID- 3648906 TI - [AIDS: prevention within the hospital environment]. PMID- 3648907 TI - [Economic evaluation of health care]. PMID- 3648908 TI - [Gynecologic cytology: technic of specimen collecting and execution]. PMID- 3648909 TI - [Development of postoperative rectal temperature after surgery using extracorporeal circulation]. PMID- 3648910 TI - [Antiseptics and disinfectants]. PMID- 3648911 TI - [Etiology and prevention of cancer]. PMID- 3648913 TI - [The visit]. PMID- 3648912 TI - [Common discomforts during pregnancy]. PMID- 3648914 TI - [Continuing education. 16. Field: Maternal-child nursing. Topic: Nursing care during the period of dilatation]. PMID- 3648915 TI - A better way to evaluate job performance. PMID- 3648916 TI - When a child needs his parents most. PMID- 3648917 TI - The risks of oxygen therapy (continuing education credit). PMID- 3648918 TI - How to survive a mugging. PMID- 3648919 TI - The pros and cons of circumcision. PMID- 3648921 TI - Which of your patients is starving to death? PMID- 3648920 TI - How to do your best on a certification exam. PMID- 3648922 TI - How nursing looks the second time around. PMID- 3648923 TI - The skin cancer success story. PMID- 3648924 TI - Melanoma: the most lethal skin cancer. PMID- 3648925 TI - When you have to get tough with a doctor. PMID- 3648926 TI - A dietary remedy for irritable bowel syndrome. PMID- 3648927 TI - Preventing pressure sores is a family affair. PMID- 3648928 TI - An open letter to staff nurses. PMID- 3648929 TI - B.C.'s Drug and Poison Information Centre. PMID- 3648930 TI - Poison information nurse. PMID- 3648931 TI - Do not resuscitate orders. PMID- 3648932 TI - Are we at the breaking point again? PMID- 3648933 TI - The mountains we are climbing. PMID- 3648935 TI - Unethical conduct. Part III. Why nurses get into trouble. PMID- 3648934 TI - Walk-in clinics: new opportunities for nurses. PMID- 3648936 TI - [Individual information before a distressing ward procedure--a help to the patient?]. PMID- 3648937 TI - [Information for children prior to diagnostic and therapeutic procedures]. PMID- 3648938 TI - [Aphasia as a nursing care problem can be prevented]. PMID- 3648939 TI - [Interactions between patients with Parkinson disease and senile dementia and their caregivers]. PMID- 3648940 TI - [Communication in nursing care]. PMID- 3648941 TI - [Information to the patient with porphyria]. PMID- 3648942 TI - [Tuberculosis nurse--the first nurse in Sweden with continuous education]. PMID- 3648943 TI - [Clergy, physicians and the whole person]. PMID- 3648944 TI - [Communication in health and nursing care]. PMID- 3648945 TI - [Communication between infants and caregivers in the hospital]. PMID- 3648946 TI - [Glucophage-retard]. PMID- 3648947 TI - [Aseptic urine collection by an independent patient]. PMID- 3648948 TI - [Treatment of urinary tract infections]. PMID- 3648949 TI - [Digestive tract endoscopy: utilization, technic and current development]. PMID- 3648950 TI - [Digestive tract endoscopy for therapeutic purposes]. PMID- 3648951 TI - [The nurse's role in upper fibroscopy. Digestive hemorrhages as an example]. PMID- 3648952 TI - [Clinical aspects of urinary tract infections]. PMID- 3648953 TI - [Nurses facing technologic innovation. Summary of the questionnaires]. PMID- 3648954 TI - [The nurse's professional responsibility. Penal and civil responsibility]. PMID- 3648955 TI - [Nurses facing technological innovations. Considerations from the viewpoint of a burn center]. PMID- 3648956 TI - [The formation of a data bank]. PMID- 3648957 TI - [The aged patient and the hospital]. PMID- 3648958 TI - Tobramycin and ticarcillin as empiric therapy for febrile patients with granulocytopenia: a reevaluation. AB - The combination of tobramycin and ticarcillin is an established regimen used to empirically treat patients with granulocytopenia and fever. However, the clinician now has a plethora of newer alternative antibiotic combinations from which to choose. In this retrospective study of 25 granulocytopenic patients recently treated with tobramycin and ticarcillin, a combined favorable or partial response rate of 78% was achieved, without loss of efficacy over time as a result of emerging resistance of organisms. Our reevaluation of this antibiotic regimen emphasizes that it continues to be as efficacious and safe as newer antibiotic combinations, and supports its continued use until a newer regimen is shown to have significant advantages. This study also emphasizes the significance of staphylococci as pathogens in granulocytopenia, and suggests the need to add specific antistaphylococcal coverage whenever catheter-related infection is suspected. PMID- 3648959 TI - [Milk feeding in the first 3 months. Breast feeding. (1)]. PMID- 3648960 TI - [Biological symptoms of chronic juvenile arthritis]. PMID- 3648961 TI - [Chronic juvenile arthritis: study of a case]. PMID- 3648962 TI - [Treatment of chronic juvenile arthritis]. PMID- 3648963 TI - [Acute rheumatoid arthritis]. PMID- 3648964 TI - [Ankylosing spondylitis]. PMID- 3648965 TI - [Joint diseases other than rheumatic diseases]. PMID- 3648966 TI - [They call me FIVETE. Fertilization in vitro and embryo transfer]. PMID- 3648967 TI - [Chronic juvenile arthritis]. PMID- 3648968 TI - [The Moslem woman and her contraception]. PMID- 3648969 TI - [Voluntary abortion. Nursing care]. PMID- 3648970 TI - [Clinical aspects of chronic juvenile arthritis]. PMID- 3648971 TI - [Dietetic milk foods for the youngest infants]. PMID- 3648972 TI - [Diagnosis and treatment of acute dehydration in infants]. PMID- 3648973 TI - [Acute dehydration of an infant. Case report]. PMID- 3648974 TI - [Of love and milk]. PMID- 3648975 TI - [Water metabolism in children]. PMID- 3648976 TI - [Male contraception]. PMID- 3648977 TI - [Vocal exchanges between babies and adults in the environment of a day nursery]. PMID- 3648978 TI - [Etiology and physiopathology of acute dehydration in children]. PMID- 3648979 TI - [While we wait for clarification]. PMID- 3648980 TI - [Taking off on preventive activities: pregnancy and smoking]. PMID- 3648981 TI - [Late shift on oncology]. PMID- 3648982 TI - [Nursing education in the North (2): Education one--requirements two]. PMID- 3648983 TI - [4 with various experiences and expectations]. PMID- 3648984 TI - [SYSBARN again (System for Child Preventive Health Care and Vaccination)]. PMID- 3648985 TI - [With a final crossroads]. PMID- 3648986 TI - [Responsibility in the place of work. Good nursing leadership--who and how]. PMID- 3648987 TI - [Aud Blankholm's address at the opening. National congress 1987]. PMID- 3648988 TI - [Experiences from Hedmark: SYSBARN (System for Child Preventive Health Care and Vaccination) as a tool in prevention activities]. PMID- 3648990 TI - [Archipelago idyl and central location are not enough]. PMID- 3648989 TI - [College plans in Stavanger: nurses and social workers in the same school]. PMID- 3648991 TI - [Research in Nordland: reduce parttime employment--abolish nursing shortage?]. PMID- 3648992 TI - [We all are residents' most important service contacts]. PMID- 3648993 TI - [An entire continent menaced: AIDS in Africa today. Interview by Gunnar Bolstad]. PMID- 3648994 TI - [Red Cross refugee activities: cooperation between Western and Asiatic medicine]. PMID- 3648995 TI - [Light in the dark tunnel]. PMID- 3648996 TI - [Alternative dues calculation]. PMID- 3648997 TI - [AIDS: current aspects]. PMID- 3648998 TI - [The Norwegian Nurses' Association is enough unto itself]. PMID- 3648999 TI - [SYSBARN--a good system for health centers (System for Child Preventive Health Care and Vaccination)]. PMID- 3649000 TI - [Is the Florence Nightingale spirit dead?]. PMID- 3649001 TI - [Tromso regional hospital: best in class but poor mark for behavior]. PMID- 3649002 TI - [Lindeberg aged and nursing home: 6-hour day best for both staff and patients]. PMID- 3649003 TI - [Shortened education--we have to go against it]. PMID- 3649004 TI - [Nursing education in the North (1): First with decentralized nursing education?]. PMID- 3649005 TI - [Practical nursing: wounds--healing process and care]. PMID- 3649006 TI - [SYSBARN--a good system (System for CHild Preventive Health Care and Vaccination)]. PMID- 3649007 TI - [New nursing legislation?]. PMID- 3649008 TI - [Working environment. Difficult for the employee to get an asbestos certificate. Interview by Lars Peter Bergqvist]. PMID- 3649009 TI - [Why haven't we introduced play as therapy?]. PMID- 3649010 TI - [Patients, relatives and personnel are happy with the assigned care]. PMID- 3649011 TI - [Amnesty. You can help a sick prisoner by virtue of your job]. PMID- 3649012 TI - [Retirement interview. The reinforced self-esteem among nurses. Interview by Peter Skeel Hjorth]. PMID- 3649013 TI - [Executive Board. Political considerations concerning education's capacity and place]. PMID- 3649014 TI - [Prehospital treatment in other countries and in Denmark]. PMID- 3649015 TI - [Trial with ambulance physician is certainly a step forward]. PMID- 3649016 TI - [Leadership structure. Line functions ensure that resources will fit the demand. Interview by Ulla Danielsen]. PMID- 3649017 TI - [Parliament. Bertel Haarder: the Danish Nursing Council is picking on me]. PMID- 3649018 TI - [Nursing care plan should be entered into the hospital record]. PMID- 3649019 TI - [Health policy. Horsens--a nucleus in WHO project]. PMID- 3649021 TI - [A new periodical with in-depth description of nursing's nature]. PMID- 3649020 TI - [New university attracts many nurses]. PMID- 3649022 TI - [Investing in nursing's future]. PMID- 3649023 TI - [New food service as a part of the therapeutic environment]. PMID- 3649024 TI - [Health care. Adoption is a social and psychological process]. PMID- 3649025 TI - [A desired goal is reached in home health nursing]. PMID- 3649026 TI - [Health visiting. We must keep the little ones alive, help tired mothers and kill lice and mites]. PMID- 3649027 TI - [Health visiting. Continuous shortages since 1937]. PMID- 3649028 TI - [Health visiting. Health visitors have a special status among school students. Interview by Ulla Danielsen]. PMID- 3649029 TI - [Messages which are always valid]. PMID- 3649031 TI - [Health visiting. Most of all I would like to throw out the scales]. PMID- 3649030 TI - [Health visiting. Health visitors create new contacts in big-city suburbs]. PMID- 3649032 TI - [Health visiting. Children are society's thermometer. Interview by Ulla Danielsen]. PMID- 3649034 TI - [Health visiting. Increasing interest for health education activities]. PMID- 3649033 TI - [Health visiting. Does the track follow health visitors' guidance and support?]. PMID- 3649035 TI - [Parliament. Possibilities for a child advocacy institute. Interview by Hans Geisler]. PMID- 3649036 TI - [Health visiting. Family Denmark will be helped away from the sofa groups. Interview by Ulla Danielsen]. PMID- 3649037 TI - [Network activities provide an idea of gypsy culture]. PMID- 3649038 TI - [No wrecked timber--it's a story about new jobs]. PMID- 3649039 TI - [Cross-ministerial committee will put focus on children]. PMID- 3649040 TI - [Children's health. 8. We should keep the finger on the pulse in relation to children's situation]. PMID- 3649041 TI - [Nursing's paradigms]. PMID- 3649043 TI - [Executive Board. The well-known principles and professional policy goals assembled in one document]. PMID- 3649042 TI - [The nursing profession doesn't have sufficient educational possibilities]. PMID- 3649044 TI - [A growing problem for which there can be only one possible solution]. PMID- 3649045 TI - [Hospital hygiene. Fewer postoperative infections with current ADP monitoring]. PMID- 3649046 TI - [Health care. Women's day when Copenhagen opened health week]. PMID- 3649047 TI - [Important SSN (Nurses' Cooperation in Scandinavia) discussion about documentation of and in nursing]. PMID- 3649048 TI - [Documentation--one of the ways toward better nursing]. PMID- 3649050 TI - [Without documentation nursing stands out like an illusion]. PMID- 3649049 TI - [We have both a "duty and the right" to documentation of and in nursing]. PMID- 3649051 TI - [What is really the purpose with this bringing to attention of student matters?]. PMID- 3649052 TI - [Children's health. 10. Children, love sexuality and body awareness]. PMID- 3649053 TI - [Prehospital treatment. Nurses' role in a future health-based ambulance service]. PMID- 3649055 TI - [Alternative treatment. Many feel they're being helped by shrewd men and women]. PMID- 3649054 TI - [Burns--a lot of openness and high-class development]. PMID- 3649056 TI - [Negotiations 1987. Specialists' line of action strains their credibility]. PMID- 3649057 TI - [Children's health. 12. Myths and realities about sexual abuse of girls and boys]. PMID- 3649058 TI - [Children's health. 15. Kangaroo method returns children to mothers]. PMID- 3649059 TI - [Children's health. 16. Kangaroo method used in practice at Sonderborg Hospital]. PMID- 3649060 TI - [Development in nursing. Much interest for support groups for heart patients. Interview by Annelise Molvig]. PMID- 3649061 TI - [Health policy. Nurses in a preventive health system]. PMID- 3649062 TI - [Political majority pro voluntariness in AIDS control]. PMID- 3649063 TI - [Alternative treatment. Acupuncture technic seeks to reduce pain]. PMID- 3649064 TI - [Student nurses' Collaborative Council 1987 wants to ensure a broad recruitment for basic education]. PMID- 3649065 TI - Collaborative clinical research. PMID- 3649066 TI - Tips for getting your research published. PMID- 3649068 TI - Research in the clinical setting: perspectives from a non-research institution. PMID- 3649067 TI - An administrator's perspective: research in a private non-teaching hospital. PMID- 3649069 TI - Women in white. PMID- 3649070 TI - [Burn-out in health personnel. I: External factors]. PMID- 3649071 TI - [Measurement of the load of work, better do it]. PMID- 3649072 TI - [Nursing sciences in a Dutch perspective]. PMID- 3649073 TI - [Inspiration and strategy of Integrated Nursing toward psychiatry]. PMID- 3649074 TI - [Is an occupational health nurse still a nurse?]. PMID- 3649075 TI - [Industrial hygiene and working conditions in the general hospital]. PMID- 3649076 TI - [Occupational health care in hospitals]. PMID- 3649077 TI - [You're choosing a job]. PMID- 3649078 TI - [Fear and uncertainty in cancer]. PMID- 3649079 TI - [From mentally handicapped to mentally deficient. Interview by Jos Tenholter]. PMID- 3649080 TI - [Tuning in on health services needs and demand. Quality, costs and budgeting]. PMID- 3649081 TI - [We're looking for an administrator for the nursing service]. PMID- 3649082 TI - [BISON-Project (Counseling Inservice Training)--support restructuring of inservice education. Interview by J. J. Jamin and J. C. Timmer]. PMID- 3649083 TI - [We'll transfer your child tomorrow]. PMID- 3649084 TI - [Medical information for nurses. Epidemic of a special staphylococcus in a general hospital]. PMID- 3649085 TI - [Are there still nurses working in psychiatry? An invitation to a discussion]. PMID- 3649087 TI - [This is how patients can feel.... Six pair of feet]. PMID- 3649086 TI - [Integrated nursing at the ambulatory care level]. PMID- 3649088 TI - [Relationship with demented persons]. PMID- 3649089 TI - [Losing weight and improving: 2 different operations?]. PMID- 3649090 TI - [The Fourth World. Health and social discrimination]. PMID- 3649091 TI - [Medical information for nurses. Pain and pain treatment]. PMID- 3649093 TI - Overcoming barriers to publication. PMID- 3649094 TI - Straight talk--the image of nursing. PMID- 3649092 TI - Inhibition of bradykinin- and kallikrein-induced cerebral arteriolar dilation by a specific bradykinin antagonist. AB - We have previously shown that topical brain application of kallikrein, an enzyme which converts kininogen to bradykinin, induces rabbit pial arteriole dilation. The purpose of the present investigation was to utilize a newly developed competitive kinin receptor antagonist to test the hypothesis that kallikrein induced dilation was due to the conversion of brain kininogen to vasoactive kinins. As in our previous study, we measured rabbit pial arteriole diameter with a microscope using the closed cranial window technique. The kinin antagonist (6 microM) reduced the dose-dependent dilation produced by bradykinin and blocked the dilation induced by kallikrein. In addition, the kinin antagonist was specific since it did not alter the cerebral arteriole dilation produced by adenosine, acetylcholine, or vasoactive intestinal polypeptide. These experiments provide further evidence for a possible role of the endogenous brain kallikrein kinin system in the modulation of the cerebral circulation and provide the necessary pharmacologic foundation for future use of this antagonist in testing the role of kinins in the normal or altered cerebral circulation. PMID- 3649095 TI - Understanding and handling personal conflicts. PMID- 3649096 TI - Photodynamic therapy of malignant tumors. PMID- 3649097 TI - Chloramphenicol-resistant Salmonella typhi in Durban, South Africa. AB - A retrospective survey was undertaken to determine the incidence of chloramphenicol-resistant Salmonella typhi in Durban, South Africa. Of the 3313 strains tested over a 7 year period 20 (0.6%) showed intermediate resistance to chloramphenicol and 19 (0.6%) were fully resistant. Resistance to chloramphenicol was found to fluctuate over the period studied (0-2%). Resistance to ampicillin/amoxycillin was encountered less frequently (0-0.9%). For the present we would still recommend chloramphenicol or amoxycillin for the initial treatment of typhoid fever in this region. PMID- 3649098 TI - [Study of the variables which determine the way nursing is projected in the 5 daily newspapers of Turkey]. PMID- 3649099 TI - [Study to determine the difficulties student nurses face with patients on their first day of clinical practice]. PMID- 3649100 TI - [Having leprosy doesn't mean the end of life!]. PMID- 3649101 TI - [Effect of positioning on discomfort from intramuscular injections in the dorso gluteal site]. PMID- 3649104 TI - [Developments in organ transplantation and its place and importance for medical deontology]. PMID- 3649102 TI - [A child with tetanus]. PMID- 3649103 TI - [Lice: ancient pest with new resistance]. PMID- 3649105 TI - [Assessment of the rectus abdominus muscle and the trunk extensor muscles in healthy 3-to-5-year-old girls and boys]. PMID- 3649106 TI - [Nursing leaders of our country]. PMID- 3649107 TI - [Theoretical functions of professional associations]. PMID- 3649108 TI - [Vaccinations that are systematically applied during childhood]. PMID- 3649109 TI - [Physiological effect of breast care on lactation]. PMID- 3649110 TI - [Estrogen receptors in human breast cancer]. PMID- 3649111 TI - [The difficulties faced by the researchers in the university who completed research for the fulfillment of the requirement for master of science and doctor of philosophy in nursing]. PMID- 3649112 TI - [The place of nursing in Turkey]. PMID- 3649113 TI - [Organizations of the midwife/nursing services in the primary health care national workshops; Turkish Nurses Association Organization Committee]. PMID- 3649115 TI - [World wide child immunization]. PMID- 3649114 TI - [Family planning]. PMID- 3649116 TI - [Interpersonal relations and nursing]. PMID- 3649118 TI - [Admitted decisions in First National Nursing Education Assoc]. PMID- 3649117 TI - [Hospital infections]. PMID- 3649119 TI - [Yesterday and today for nursing]. PMID- 3649120 TI - [Supervisory nurse in the home care nursing field--leaders without insight!]. PMID- 3649121 TI - [Nurses' reaction to forced medication viewed from a double-bind theory]. PMID- 3649122 TI - [Study of a new form for clinical practice testing in nursing colleges]. PMID- 3649123 TI - [Accidents in children in Umea. Epidemiological survey, consequences and preventive strategy]. PMID- 3649124 TI - On reliability and validity in qualitative research. PMID- 3649125 TI - Health locus of control and preventive health behavior. PMID- 3649126 TI - Adolescents' perceptions of pregnancy. A cross-cultural perspective. PMID- 3649127 TI - Women's important relationships during pregnancy and the preterm labor event. PMID- 3649128 TI - Self-care responses to respiratory illnesses among Vietnamese. PMID- 3649129 TI - Tensions in the brokerage role. Nurses in Botswana. PMID- 3649130 TI - Folk health beliefs of health professionals. PMID- 3649131 TI - Ethical issues in nursing research. PMID- 3649132 TI - Research in cultural diversity. Microcomputer applications in cross-cultural qualitative research. PMID- 3649134 TI - Targets for Health for All by the Year 2000. PMID- 3649133 TI - Zimbabwe: a nursing story. PMID- 3649135 TI - [1986 SHSTF Congress. New, ever broader work tasks. Interview by Monika Trozell]. PMID- 3649136 TI - [Patient equal partner in health care legislation. Interview by Monika Trozell]. PMID- 3649137 TI - [1986 SHSTF Congress. I venture before and take initiative]. PMID- 3649138 TI - [1986 SHSTF Congress. Independent work functions are not recognized. Interview by Viveka Holmertz]. PMID- 3649139 TI - [1986 SHSTF Congress. Greater stake in information]. PMID- 3649140 TI - [1986 SHSTF Congress. Unequal sex distribution]. PMID- 3649141 TI - [After the strike--comfortably at work again]. PMID- 3649142 TI - [Alice Lindstrom Honorary Doctor. Interview by Eva Hellung-Strohl]. PMID- 3649143 TI - [1986 SHSTF Congress. Prime Minister: we will have an open mind toward the profession]. PMID- 3649144 TI - [Continuing shortage of personnel in Langbro. Insecurity nourishes violence]. PMID- 3649145 TI - [San Francisco General Hospital--here AIDS patients get the best care]. PMID- 3649147 TI - Vardfacket's language school. US health care. PMID- 3649146 TI - [Overloaded Danderyd Hospital. New freedom of choice worries midwives]. PMID- 3649148 TI - [England--80 percent of all care is carried out by unqualified staff. Interview by Jan Thomasson]. PMID- 3649149 TI - [This hardly needed a vote. Yes--but under protest. Negotiations 86]. PMID- 3649150 TI - [Activities are not directed in correct manner--county department directs severe criticism at Parliament]. PMID- 3649151 TI - [Study shows "Full-time an advantage"]. PMID- 3649152 TI - [A stream of war-injured in the Red Cross Hospital in Pakistan. Interview by Brita Asbrink]. PMID- 3649153 TI - An examination of professional relationships between CRNAs and other health care professionals. PMID- 3649154 TI - Midazolam: a new benzodiazepine. PMID- 3649155 TI - Hemodynamic parameters during a perioperative vancomycin reaction. PMID- 3649156 TI - Closed circuit anesthesia: a practical alternative. PMID- 3649157 TI - Congruence of student, faculty and graduate perceptions of positive and negative learning experiences. PMID- 3649158 TI - AANA Journal course no. 6: examination information. Quality assurance (continuing education credit). PMID- 3649159 TI - AANA Journal course: advanced scientific concepts: update for nurse anesthetists. Part I. The cardiovascular system (continuing education credit). PMID- 3649160 TI - Anesthesia: a practice of nursing. PMID- 3649161 TI - Occupational health nursing, now and in the future. PMID- 3649163 TI - Audit and quality assurance. PMID- 3649162 TI - Funding sources available to nurse researchers. PMID- 3649164 TI - The post-basic baccalaureate degree: the value and the process. PMID- 3649165 TI - Change: challenge and/or crisis. PMID- 3649166 TI - Activation of factor B of the alternative pathway of complement. Assessment by rocket immunoelectrophoresis. AB - During activation of the alternative pathway of complement, Factor B is cleaved into a smaller fragment Ba and a larger fragment Bb. The Ba in plasma was quantitated by one-dimensional rocket immunoelectrophoresis after precipitating plasma B and Bb with 21% polyethyleneglycol. This method was much more sensitive and faster than other technics with which it was compared. Fragment Ba was detected in 22 of 28 rheumatoid arthritis plasma samples and in 12 of 15 systemic lupus erythematous samples but in only 8 of 68 samples obtained from healthy volunteers. The traditional approach of measuring total Factor B for the assessment of activation of the alternative pathway showed values that were even higher than normal in these diseases. The measurement of plasma Ba promises to be a valuable means of assessment of the activation of Factor B and the alternative pathway of complement in clinical disorders. PMID- 3649167 TI - Rectal impaction following enema with concrete mix. AB - This article describes an unusual rectal foreign body resulting from homosexual anal erotic activities. The patient had used an enema containing a concrete mix which became impacted and required surgical removal. The use, abuse, and complications of enemas are reviewed. PMID- 3649168 TI - If it's AIDS, please don't tell. PMID- 3649169 TI - More on automatic implantable cardioverter defibrillators. PMID- 3649170 TI - A disaster with few survivors. PMID- 3649171 TI - Chlamydia. An unheralded epidemic. PMID- 3649172 TI - Moving to shared governance. PMID- 3649174 TI - Speaking out. While the world waits. PMID- 3649173 TI - Into the Sudan. PMID- 3649175 TI - Dialyzable drugs. PMID- 3649176 TI - A protocol for pediatric IV meds. PMID- 3649178 TI - Orthopaedic surgery: what patients need to know. PMID- 3649177 TI - Surviving a child's suicide. PMID- 3649179 TI - Pain in multiple sclerosis. PMID- 3649180 TI - At the carousel. PMID- 3649181 TI - Finally--the nation takes notice. PMID- 3649182 TI - Mouth-to-mouth resuscitation--is there a safe, effective alternative? PMID- 3649183 TI - Keeping watch. PMID- 3649184 TI - Building a better bookshelf. PMID- 3649185 TI - One way to cure postpartum charting blues. PMID- 3649186 TI - Looking good after your mastectomy. PMID- 3649187 TI - The total artificial heart. PMID- 3649188 TI - Heart to heart. PMID- 3649189 TI - Washington, DC--a capital practice: AJN jobfocus. PMID- 3649190 TI - If you're married to a nurse... PMID- 3649191 TI - Isolation of acquired immunodeficiency syndrome virus from the placenta. AB - The etiologic agent of the acquired immunodeficiency syndrome is human immunodeficiency virus. We report here a case of the culturing of this agent from the placenta and suggest the clinical implications. PMID- 3649193 TI - HTLV-III is now HIV. PMID- 3649192 TI - Emphysema alters the deposition pattern of inhaled particles in hamsters. AB - How does pulmonary emphysema affect aerosol deposition? Groups of awake hamsters with emphysema (intratracheal elastase, 0.2 mg/100 g body wt) and age-matched controls (intratracheal saline) were exposed for 30 minutes to an insoluble radioactive aerosol (0.45 mu aerodynamic diameter) at 30, 60, or 90 days after instillation. Immediately after exposure, the animals were sacrificed. The lungs were excised, dried at total lung capacity, and sliced into 1-mm thick sections. Each slice was cut into pieces, which were counted for radioactivity and weighed. Then a measure of the uniformity of deposition, the evenness index (EI), was calculated. With perfect uniformity, all EIs would be one. We found fewer particles in the emphysematous, as compared with the control, lungs at 60 or 90 days after elastase instillation. The deposited particles were distributed less uniformly throughout the emphysematous lungs than in the control lungs. In controls, the standard deviation (SD) of the EI distribution (mean 1.0) averaged 0.33 for the three times studied. In elastase animals, the SD increased to 0.48 at 30 days, and at 60 days and 90 days the distributions were no longer normally distributed. This increased heterogeneity of deposition was also manifested as a loss of the normal apex-base gradient observed in control animals, an increase in the amount of nonventilated parenchyma, enhanced airway deposition, and an altered lobar deposition pattern. Morphometric analysis showed an increase in the mean linear intercept (MLI) of emphysematous lungs as compared with control lungs. However, the author found no correlation between MLI, a measure of emphysema, and EI, a measure of deposition, quantified in the same lung pieces. It is concluded that the emphysematous lesions produced by elastase markedly alter the deposition of an inhaled submicrometric aerosol. Factors that may contribute to these changes include airway obstruction and differences in breathing pattern in emphysematous as compared with control animals. PMID- 3649195 TI - Nurses identify reasonable costs of care. PMID- 3649194 TI - Preoperative testing for human immunodeficiency virus infection. PMID- 3649197 TI - Some hospitals offer higher salaries to attract RNs. PMID- 3649196 TI - National media coverage puts nursing in the news. PMID- 3649198 TI - Report to House outlines scope of nursing practice. PMID- 3649199 TI - Competition, tax changes sweep hospital industry. PMID- 3649200 TI - As I see it. Changes offer opportunities, pose risks for nurses. PMID- 3649201 TI - Effect of heat treatment for inactivation of HTLV III virus on serum immunoreactive prolactin. PMID- 3649203 TI - Susceptibility to five antimicrobial agents of strains of the Bacteroides fragilis group isolated in Brazil. AB - The in vitro activity of metronidazole, chloramphenicol, clindamycin, cefoxitin, and carbenicillin was tested by an agar dilution method against 228 strains of the Bacteroides fragilis group isolated from human intestinal microbiota during 1981 and 1982. All the strains were susceptible to metronidazole. Resistance rates for chloramphenicol, clindamycin, cefoxitin, and carbenicillin were 2, 37, 21, and 13%, respectively. PMID- 3649202 TI - Ciprofloxacin versus vancomycin in the therapy of experimental methicillin resistant Staphylococcus aureus endocarditis. AB - We compared the efficacy of ciprofloxacin with that of vancomycin by using the rabbit model of methicillin-resistant Staphylococcus aureus endocarditis. Endocarditis was treated with ciprofloxacin (25 mg/kg [body weight] intravenously every 8 h) or vancomycin (17.5 mg/kg intravenously every 6 h) for 3 days. Vancomycin and ciprofloxacin were equally efficacious in clearing bacteremia. Both reduced vegetation bacterial counts by 5 log10 CFU/g and renal and splenic bacterial counts by more than 3 log10 CFU/g as compared with untreated control rabbits after 26 h of infection (P less than 0.001). Both antimicrobial agents were able to eradicate the infectious process in an equivalent proportion of animals. No methicillin-resistant S. aureus that was recovered from ciprofloxacin treated rabbits developed resistance to ciprofloxacin during therapy. Peak concentrations of ciprofloxacin in the sera of rabbits with endocarditis were significantly higher than those predicted by single-dose studies in uninfected rabbits. This finding was likely due to changes in the pharmacokinetics of the drug with multiple dosing and in infected versus uninfected rabbits. This study demonstrated that intravenously administered ciprofloxacin is as efficacious as vancomycin is in an in vivo model of a serious systemic methicillin-resistant S. aureus infection. PMID- 3649204 TI - A case of malignant melanoma in AIDS-related complex. PMID- 3649205 TI - The issue of prevention in psychiatric nursing. PMID- 3649206 TI - The evolution of subspecialties in psychiatric and mental health nursing. PMID- 3649207 TI - Research in psychiatric and mental health nursing: the emergence of scientific rigor. PMID- 3649208 TI - Anorexia, bulimia, and sexuality: case study of an adolescent inpatient group. PMID- 3649209 TI - The borderline patient: systemic versus psychoanalytic approach. Part I: Description of the patient. PMID- 3649210 TI - The borderline patient: systemic versus psychoanalytic approach. PMID- 3649211 TI - The borderline patient: systemic versus psychoanalytic approach. Part II: The case of the compassionate canary: the systemic perspective. PMID- 3649212 TI - The borderline patient: systemic versus psychoanalytic approach. Part III: The psychoanalytic approach. PMID- 3649213 TI - Strategies of persistence in a professional bureaucracy: a field study of a psychiatric hospital. PMID- 3649214 TI - A descriptive study of nurses recovering from chemical dependency. PMID- 3649215 TI - Measuring attitudes of clients with schizophrenia using Fishbein's expectancy value model. PMID- 3649216 TI - Sexual knowledge of nephrology personnel. PMID- 3649217 TI - Sexual dysfunction in the female ESRD patient. 1. (continuing education credit). PMID- 3649218 TI - Sexual concerns of the female patient: research study and analysis. 3. PMID- 3649219 TI - Outcome criteria and nursing diagnosis in ESRD patient care planning. Section IV: Hemodialysis. PMID- 3649220 TI - Treatment of theophylline overdose using hemoperfusion. PMID- 3649221 TI - Towards independence: an alternative technique for drawing up Sandimmune. PMID- 3649222 TI - Papaverine--the medical implant. PMID- 3649223 TI - Instruction for papaverine self-injection program. PMID- 3649224 TI - A urological resource room. PMID- 3649225 TI - American Board of Urologic Allied Health Professionals: recollections. PMID- 3649226 TI - How to formulate a research question. PMID- 3649227 TI - Bacteriuria in elderly males with spinal cord injury. PMID- 3649229 TI - Branched RNA. PMID- 3649228 TI - Compartmentalization of proline pools and apparent rates of collagen and non collagen protein synthesis in arterial smooth muscle cells in culture. AB - Rates of collagen and non-collagen protein synthesis in rabbit arterial smooth muscle cells (SMC) were determined by using the specific (radio)activity of [3H]proline in the extracellular, intracellular, and prolyl-tRNA pools. The intracellular free proline specific activity was only 25% of the extracellular value in cultures incubated for 12 h in 0.25 mM-proline. The specific activity of prolyl-tRNA was less than 10% of the extracellular specific activity. Increasing the extracellular proline concentration 10-fold (to 2.5 mM), while keeping the extracellular specific activity of proline constant, resulted in equilibration of the specific activities of intracellular and extracellular free proline, but the specific activity of prolyl-tRNA remained at less than 10% of the extracellular specific activity. Therefore, calculated rates of collagen and non-collagen protein synthesis were greatly underestimated using the intracellular or extracellular specific activity of proline. SMC were also incubated with 0.1 mM [14C]ornithine in 0.25 nM or 2.5 mM non-labelled proline to examine synthesis de novo of proline and prolyl-tRNA from ornithine. In SMC cultures containing 0.25 mM unlabelled proline, the specific activity of intracellular ornithine was approx. 45% of the extracellular specific activity, due to the production of unlabelled ornithine. The specific activity of ornithine-derived intracellular free proline in SMC incubated with 2.5 mM-proline was significantly lower than in SMC incubated in 0.25 mM-proline, due to the influx of unlabelled proline. However, a corresponding difference in the specific activity of [14C]prolyl-tRNA between SMC in 0.25 mM- or 2.5 mM-proline was not observed. Ornithine-derived [14C]proline was incorporated into proteins in a manner different from that of exogenously added radiolabelled proline. A much higher proportion of the proline synthesized de novo was channelled into collagen synthesis relative to total protein synthesis. Together, these results show that intracellular proline pools are highly compartmentalized in arterial SMC. They also suggest that proline synthesized from ornithine may enter a prolyl-tRNA pool separate from that of proline entering from the extracellular medium. PMID- 3649230 TI - Selective inhibition of human immunodeficiency virus (HIV) by 3'-azido-2', 3' dideoxyguanosine in vitro. AB - 3'-Azido-2',3'-dideoxyguanosine (AzddGuo) is a potent and selective inhibitor of human immunodeficiency virus (HIV) in vitro. AzddGuo completely inhibits HIV induced cytopathogenicity and viral antigen expression in MT-4 cells at a concentration of 5.0 microM. Its 50% effective dose for inhibiting HIV-induced cytopathogenicity is 1.4 microM, as compared to 6.4 microM for 2',3' dideoxyadenosine (ddAdo). Thus, AzddGuo is approximately 4.6-fold more potent as an anti-HIV agent than ddAdo, one of the most promising compounds for the treatment of AIDS. However, AzddGuo is about 4.7 times more cytotoxic than ddAdo, so that its selectivity index, as based on the ratio of the 50% cytotoxic dose to the 50% antiviral effective dose, is almost the same as that of ddAdo (136 and 139, respectively). PMID- 3649231 TI - Protein synthesis in rabbit reticulocytes: Mg2+-inhibition of ternary complex (Met-tRNA(f).eIF-2.GTP) formation by reticulocyte eIF-2. AB - There are conflicting reports regarding Mg2+-inhibition of ternary complex formation by reticulocyte eIF-2. Several laboratories have reported that eIF-2 is isolated as eIF-2.GDP and Mg2+ inhibits ternary complex formation, as in the presence of Mg2+, GDP remains tightly bound to eIF-2 and prevents ternary complex formation. A protein factor, GEF is necessary for GDP displacement and subsequent ternary complex formation. Other laboratories have reported that Mg2+ has no effect on eIF-2 activity and eIF-2 forms near stoichiometric amount of ternary complex in the presence of Mg2+. In this paper, we provide evidence which suggests that the Mg2+-insensitive eIF-2 activity as reported by several laboratories might have been the result of the use of high Met-tRNA(f) concentrations in their assays as the nucleotides in excess tRNA bound Mg2+ in the reaction mixture and there was no free Mg2+ available to inhibit eIF-2 activity. Our data will show that the addition of excess tRNA promotes non enzymatic GDP displacement from eIF-2.GDP and relieves Mg2+ inhibition. PMID- 3649232 TI - Evaluation of PAF antagonists using human neutrophils in a microtiter plate assay. AB - This paper describes a testing model for the detection and evaluation of PAF antagonists, based on the inhibition of PAF-elicited elastase release by human neutrophils. Incubations are performed in microtiter plates in the presence of a specific fluorogenic elastase substrate allowing direct measurement of the exocytosis response by means of a 96-well fluorescence reader. Determinations of the IC50 values for five established PAF antagonists, Ro 19-3704, BN 52021, CV 3988, 48740 RP and kadsurenone, showed that the new model is comparable in sensitivity and discriminative capacity to other in vitro assays. From the effect of antagonists on the PAF concentration-response curve pA2 values could be calculated and information on the type of antagonism obtained. BN 52021 was found to behave as a competitive antagonist while Ro 19-3704 showed a more complex type of inhibition. As a one-plate system, the test is simple to handle and highly reproducible, and appears therefore particularly useful for large drug screening programs. PMID- 3649233 TI - [Primary structure of tRNAAsn of bacteriophage T5]. AB - Unformly 32P-labelled phage-specific tRNAAsn was isolated from bacteriophage T5 infected E. coli cells its oligonucleotide fragments were fractionated by thin layer chromatography on cellulose and the tRNA's primary structure was determined as follows: (formula; see text). Main features of the structure are: displacement of the constant residue A14 by U; absence of G27 X A43 and U30 X psi40 pairing in the anticodon stem; possibility of additional pairing in D-loop. Comparison of T5 tRNAAsn with other asparagine tRNAs is presented. PMID- 3649234 TI - [Primary structure of proline tRNA of bacteriophage T5]. AB - The uniformly 32P-labeled bacteriophage T5 proline tRNA has been isolated from phage-infected E. coli cells by two-dimensional PAGE. Its nucleotide sequence has been determined by conventional techniques (using TLC on cellulose for oligonucleotide fractionation) as follows: (Formula: see text). The tRNA has the anticodon sequence UGG, which can presumably recognize the four proline-specific codons (CCN). It has 70% homology with phage T4 tRNA(Pro). PMID- 3649235 TI - Lyme meningoencephalitis: report of a severe, penicillin-resistant case. AB - Although Lyme disease frequently attacks the central nervous system, this involvement is rarely severe, and high-dose intravenous penicillin usually is adequate treatment. The patient we describe developed severe Lyme meningoencephalitis despite receiving a full course of penicillin, and his condition continued to deteriorate after reinstitution of this treatment. Intravenous chloramphenicol was used successfully and resulted in a substantial improvement. PMID- 3649237 TI - Developing a workplace smoking policy. PMID- 3649238 TI - Self nurturing--a concept analysis. PMID- 3649236 TI - Elastin degradation in abdominal aortic aneurysms. AB - Histological sections through the walls of abdominal aortic aneurysms showed scarce and disrupted elastic tissue. The elastin content of the aneurysmal aortic media was only 8.1 +/- 3.2% dry defatted weight (n = 11). The elastin content of grossly normal age and anatomically matched aortic media was 35.0 +/- 3.2% dry weight (n = 4) and the elastin content of severely atherosclerotic, stenosed infrarenal aortic media was 22.0 +/- 7.2% dry weight (n = 6). There was an inverse correlation of elastin content with the elastinolytic activity of aortic media homogenates, r = -0.78. Elastase activity, measured by the hydrolysis of [3H]elastin, was highest in aneurysmal aortic homogenates, 92.1 +/- 43.7 U/mg protein (n = 18), falling to 46.9 +/- 13.3 U/mg protein (n = 13) in severely stenosed atherosclerotic aortic homogenates and 35.5 +/- 11.9 U/mg (n = 6) in grossly normal aortic homogenates. The elastinolytic activity of stenotic aorta contained leukocyte elastase as an important component. In aneurysmal homogenates leukocyte elastase was also found but the increased elastase activity resulted from a protease(s) (Mr 95,000) extracted in 2 M urea, having minimal specificity for alanyl bonds and no immunological cross-reactivity with leukocyte elastase. PMID- 3649239 TI - Philosophical and ethical issues of occupational health nursing practice. PMID- 3649240 TI - Analyses of wrist injuries in workers engaged in repetitive tasks. PMID- 3649241 TI - Occupational injury at a midwestern health science center and teaching hospital. PMID- 3649242 TI - Kinetic studies on the interaction of eglin c with human leukocyte elastase and cathepsin G. AB - We have investigated the inhibition of human leukocyte elastase and cathepsin G by recombinant Eglin c under near physiological conditions. The association rate constants k on of Eglin c for elastase and cathepsin G were 1.3 X 10(7) M-1 s-1 and 2 X 10(6) M-1 s-1, respectively. Under identical conditions, the k on for the association of human plasma alpha 1-proteinase inhibitor with the two leukocproteinases were 2.4 X 10(7) M-1 s-1 and 10(6) M-1 s-1, respectively. The consistency of these data could be verified using a set of competition experiments. The elastase-Eglin c interaction was studied in greater detail. The dissociation rate constant k off was determined by trapping of free elastase from an equilibrium mixture of elastase and Eglin c with alpha 1-proteinase inhibitor or alpha 2-macroglobulin. The rate of dissociation was very low (k off = 3.5 X 10(-5) s-1). The calculated equilibrium dissociation constant of the complex, Ki(calc) = k off/k on, was found to be 2.7 X 10(-12) M. Ki was also measured by adding elastase to mixtures of Eglin c and substrate and determining the steady state rates of substrate hydrolysis. The Ki determined from these experiments (7.5 X 10(-11) M) was significantly higher than Ki(calc). This discrepancy might be explained by assuming that the interaction of Eglin c with elastase involves two steps: a fast binding reaction followed by a slow isomerization step. From the above kinetic constants it may be inferred that at a therapeutic concentration of 5 X 10(-7) M, Eglin c will inhibit leukocyte elastase in one second and will bind this enzyme in a "pseudo-irreversible" manner. PMID- 3649244 TI - Problems with intravenous fluids at the end of life. PMID- 3649243 TI - Synthetic inhibitors of human leukocyte elastase, Part 3. Peptides with alkyl groups at the N- or C-terminus. Non-toxic competitive inhibitors of human leukocyte elastase. AB - A series of carboxy-alkylamidated and N-acetylated amino acids and peptides were synthesized and examined for their ability to inhibit human leukocyte elastase. The Boc-amino acid alkylamides were found to be potent specific and competitive inhibitors of this enzyme. They were found not to or only poorly inhibit several other serine proteinases such as bovine trypsin, alpha-chymotrypsin, porcine pancreatic elastase and human leukocyte cathepsin G at concentrations less than 10(-4) M. Specificity and maximum inhibition of human leukocyte elastase were achieved when the N-terminus of the amino acid was protected by a t-butyloxy carbonyl (Boc) group, the oligopeptide fragment consisted of valine residues and when the alkyl chain was between 10 and 12 carbon atoms in length and attached to the C-terminus of the peptide fragment. Highest inhibition was obtained with the compound Boc-[Val]3-NH[CH2]11--CH3 (Ki = 0.21 microM). These specific inhibitors were also found to be non-toxic after oral administration to mice and rats (LD50 greater than 3.0 g/kg body weight). PMID- 3649245 TI - Management of nausea and vomiting. PMID- 3649246 TI - A support program for the hospitalized terminally ill. Extensive volunteered staff time is key. PMID- 3649247 TI - Stomatitis and specific oral infections of the oncologic patient. Complete care needed to address the symptoms. PMID- 3649248 TI - Holding onto ideals in the face of reality. Rekindling the hospice nurse. PMID- 3649249 TI - Should fluid and nutritional support be withheld from terminally ill patients? Another opinion. PMID- 3649250 TI - Teaching family therapy concepts to the hospice team. PMID- 3649251 TI - Mechanism of slow-binding inhibition of human leukocyte elastase by trifluoromethyl ketones. AB - Kinetics of inhibition have been determined for the interaction of human leukocyte elastase (HLE) with two series of peptide trifluoromethyl ketones (TFMKs): X-Val-CF3,X-Pro-Val-CF3,X-Val-Pro-Val-CF3, and X-Lys(Z)-Val-Pro-Val-CF3, where X is MeOSuc or Z. These compounds are "slow-binding" inhibitors of HLE and, thus, allow the determination of Ki, the dissociation constant for the stable complex of inhibitor and enzyme, as well as kon and koff, the rate constants for formation and decomposition of this complex. Maximal potency is reached with Z Lys(Z)-Val-Pro-Val-CF3, which displays a Ki less than 0.1 nM. Upon binding to HLE, these compounds undergo addition by the hydroxyl of the active site serine to form a hemiketal. The evidence supporting a hemiketal intermediate includes Ki values of 1.6 and 80,000 nM for Z-Val-Pro-Val-CF3 and its alcohol analogue, linear free energy correlations between inhibitory potency and catalytic efficiency for structurally related TFMKs and substrates, and the pH dependence of kon for the inhibition of HLE by Z-Val-Pro-Val-CF3, which is sigmoidal and displays a pKa of 6.9. Hemiketal formation is probably not rate limiting, however. Kinetic solvent isotope effects of unity suggest that kon cannot be rate limited by a reaction step, like hemiketal formation, that is subject to protolytic catalysis. A general mechanism that is consistent with these results is one in which formation of the hemiketal is rapid and is followed or preceded by a slow step that rate limits kon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3649252 TI - Family stress in the eighties. PMID- 3649253 TI - Independent living--or almost. PMID- 3649254 TI - Sterilisation of the mentally handicapped. PMID- 3649256 TI - Research group charts nursing's future. PMID- 3649255 TI - Can caring be taught? PMID- 3649257 TI - Right bundle branch block (RBBB). PMID- 3649258 TI - The design, organization and evaluation of a support group for parents of critically neonates. PMID- 3649259 TI - Nursing in the I. C. U.: Stress without distress? PMID- 3649260 TI - Algorithm for the emergency nursing management of spontaneous carotid artery rupture. PMID- 3649261 TI - Nursing recruitment. Application of a corporate perspective. PMID- 3649262 TI - Should nurses be involved in consent? PMID- 3649263 TI - Developing decision support systems for nursing. Theoretical bases for advanced computer systems. PMID- 3649265 TI - Privacy, confidentiality, and security of computerized systems. The nursing responsibility. PMID- 3649264 TI - Decisions and dilemmas in the development of a Nursing Information System. PMID- 3649266 TI - Depression in women. PMID- 3649267 TI - Student identified factors which facilitated learning in a six week psychiatric nursing rotation. PMID- 3649268 TI - Aids patients--the new nursing challenge. PMID- 3649269 TI - Continuing education by community TV. PMID- 3649270 TI - Demystifying menopause. PMID- 3649271 TI - Stranger in a strange bed. PMID- 3649272 TI - Expo 86. PMID- 3649274 TI - Why should nurses bother about ethics? PMID- 3649273 TI - Nursing through the eyes of a child. PMID- 3649275 TI - Life after cancer. PMID- 3649276 TI - Nutritional and pharmacologic approaches to hypercholesterolemia. PMID- 3649277 TI - Cell lineage ablation in transgenic mice by cell-specific expression of a toxin gene. AB - A method of deleting specific cell lineages has been developed that entails microinjection into fertilized eggs of a chimeric gene in which a cell-specific enhancer/promoter is used to drive the expression of a toxic gene product. We show that microinjection of a construct in which the elastase I promoter/enhancer is fused to a gene for diphtheria toxin A polypeptide results in birth of mice lacking a normal pancreas because of expression of the toxin in pancreatic acinar cells. A small pancreatic rudiment, containing islet and duct-like cells, was observed in some of the transgenic mice. This method provides a new approach for studying cell-lineage relationships and for analyzing cellular interactions during development. PMID- 3649278 TI - Antibiotic resistance monitoring, with particular reference to methicillin resistant Staphylococcus aureus. AB - Two surveys of antibiotic resistance in hospital pathogens are described. The first is a long-term, multi-center, laboratory based investigation in which antibiotic resistance data from laboratories with computerized reporting is collected. The difficulties of this type of investigation are discussed and some solutions suggested. In the second investigation reports of the isolation of methicillin-resistant Staphylococcus aureus (MRSA) were collected from microbiological laboratories on a nation-wide basis. The results were useful in monitoring the spread of the organism and in its control. PMID- 3649279 TI - Sperm-egg penetration of human spermatozoa treated with various rabbit antisera to human sperm antigens. AB - The effect of rabbit antisera to human whole spermatozoa, to human lactate dehydrogenase (LDH-X) and to human protamine 1 (HP1) and protamine 2 (HP2), was tested in the hamster zona-free egg penetration assay with human spermatozoa. The human spermatozoa were incubated with TEST yolk buffer washed and incubated with the antisera before penetration assay. Only antiserum to whole spermatozoa could inhibit the penetration capacity of treated human spermatozoa. The significance of the results as well as the advantage of the method used by us are discussed. PMID- 3649280 TI - Characterization of the third component of complement (C3) after activation by cigarette smoke. AB - Activation of lung complement by tobacco smoke may be an important pathogenetic factor in the development of pulmonary emphysema in smokers. We previously showed that cigarette smoke can modify C3 and activate the alternative pathway of complement in vitro. However, the mechanism of C3 activation was not fully delineated in these earlier studies. In the present report, we show that smoke treated C3 induces cleavage of the alternative pathway protein, Factor B, when added to serum containing Mg-EGTA. This effect of cigarette smoke is specific for C3 since smoke-treated C4, when added to Mg-EGTA-treated serum, fails to activate the alternative pathway and fails to induce Factor B cleavage. Smoke-modified C3 no longer binds significant amounts of [14C]methylamine (as does native C3), and relatively little [14C]methylamine is incorporated into its alpha-chain. Thus, prior internal thiolester bond cleavage appears to have occurred in C3 activated by cigarette smoke. Cigarette smoke components also induce formation of noncovalently associated, soluble C3 multimers, with a Mr ranging from 1 to 10 million. However, prior cleavage of the thiolester bond in C3 with methylamine prevents the subsequent formation of these smoke-induced aggregates. These data indicate that cigarette smoke activates the alternative pathway of complement by specifically modifying C3 and that these modifications include cleavage of the thiolester bond in C3 and formation of noncovalently linked C3 multimers. PMID- 3649281 TI - Food poisoning: health needs hygiene. PMID- 3649282 TI - Assessment and choice. PMID- 3649284 TI - Pressure sores: a sore point. PMID- 3649283 TI - Meningitis: ousting the organism. PMID- 3649285 TI - Cumberlege: one year on. PMID- 3649286 TI - Pressure sores: under pressure. PMID- 3649287 TI - Cumberlege: a sentimental notion? PMID- 3649288 TI - Postnatal depression: 'She just listened'. PMID- 3649289 TI - Perineal care: 'confused, battered, and unwanted'. PMID- 3649290 TI - Cellular basis for the differential response of mouse kallikrein genes to hormonal induction. AB - The expression of many mouse kallikrein genes in the salivary gland is sexually dimorphic and inducible in females by administration of testosterone or thyroxine. Induction is slow (3-7 days) and is accompanied by the non-uniform differentiation of the cell type expressing these genes from striated duct (SD) cells (female) to granular convoluted tubule (GCT) cells (male). One kallikrein gene, mGK-6, is expressed at an apparently constant total level in male and female and is not induced by either hormone. In situ hybridization histochemistry shows that all kallikrein genes analyzed exhibit uniform cellular distribution of expression in the SD cells of the female. The hormonally mediated differentiation of some, but not all, of these cells has different effects on kallikrein gene expression--mGK-6 is repressed while other kallikreins are induced--leading to non-uniform distribution of expression. PMID- 3649291 TI - Two spliceosomes can form simultaneously and independently on synthetic double intron messenger RNA precursors. AB - We have investigated the formation of splicing complexes in vitro on mRNA precursors (pre-mRNAs) containing two introns. Sucrose gradient sedimentation analysis revealed that the double-intron substrate becomes associated with 60S structures, which are larger than the 50S splicing complexes we previously observed with single-intron pre-mRNA precursors. We have demonstrated that the 60S complex represents the assembly of two single splicing complexes on the individual introns by conversion of the 60S double splicing complexes into single 50S spliceosomes by oligodeoxynucleotide directed RNase H cleavage of the double intron pre-mRNAs within the middle exon. In addition, we have observed by native gel electrophoresis a transient double 'pre-splicing' complex analogous to the 35S 'pre-splicing' complex previously found with single-intron pre-mRNAs. Our results indicate that splicing complexes can form independently and simultaneously on the individual introns of multi-intron pre-mRNAs and that the assembly of these multiple spliceosomes proceeds with the same stepwise pathway observed for single-intron RNAs. PMID- 3649293 TI - Urinary kallikrein and non-kallikrein arginine esterase activities in beagle dogs. AB - The activity of urinary kallikrein and non-kallikrein arginine esterase was measured in the 16hrs urine of 16 beagle dogs. Enzyme activity was assayed using D-valyl-L-leucyl-L-arginine-p-nitroanilide as a substrate at 30 degrees C, pH 8.0, and the unit of measurement was defined as the activity which catalyzes the hydrolysis of 1 mumol of the substrate per minute. Kallikrein activity ranged from 3.87 to 48.92 (28.48 average) mU/ml of urine, or from 1.05 to 12.51 (4.56 average) U/16 hrs; whereas that of non-kallikrein arginine esterase ranged from 0.06 to 24.28 (7.11 average) mU/ml, or from 0.01 to 9.78 (1.43 average) U/16 hrs. The ratio between the activity of these two enzymes was 1: 0.002-1: 2.98 (1: 0.42 average). Male dogs had a tendency to show a higher enzyme activity than females for urinary kallikrein and non-kallikrein arginine esterase. PMID- 3649295 TI - [Opisthorchiasis]. PMID- 3649292 TI - Nuclear pre-mRNA splicing in the fission yeast Schizosaccharomyces pombe strictly requires an intron-contained, conserved sequence element. AB - It has recently been argued that pre-mRNA splicing in the fission yeast Schizosaccharomyces pombe may be more similar to splicing in metazoan species than in the budding yeast Saccharomyces cerevisiae. In this report we show that, contrary to this assumption, the conserved sequence element 5'-CTPu APy-3' found in all S. pombe introns 6-18 nucleotides upstream of the 3' splice site is, like the TACTAAC box in S. cerevisiae, indispensable for efficient splicing. The conserved adenine residue of this sequence is used for branch formation and point mutations introduced into the CTPuAPy sequence abolish splicing and seem not to result in the recruitment of cryptic branch sites. We also show that an S. cerevisiae intron is correctly excised in S. pombe whereby the TACTAAC box is used in branch formation. PMID- 3649294 TI - Elastin and elastase-like enzyme change in aorta of rat with malignant hypertension. AB - In order to study the role of elastin in arteries with respect to hypertension and hypertensive arterial disease, aortic elastin content and elastase-like enzyme activity were examined and compared in stroke-prone spontaneously hypertensive rats (SHRSP), which show malignant hypertension, and Wistar-Kyoto normotensive rats (WKY). The elastin content was lower, whereas the elastase-like activity was higher at 20 weeks of age in SHRSP than in WKY, so that the aortic elastin/enzyme ratio of SHRSP was lower than that in WKY. These differences were not found at 6 weeks of age (prehypertensive stage). For SHRSP anti-hypertensive treatment resulted in lowering the elastase-like activity and in increasing the elastin content in comparison to untreated animals. The subcellular distribution of the elastase-like activity closely correlated with that of 5'-nucleotidase activity, a plasma membrane marker enzyme. The results indicate involvement of a smooth muscle plasmalemmal elastase-like enzyme in vascular connective tissue metabolism in health and possibly also its participation in hypertensive arterial diseases. PMID- 3649296 TI - [Treatment and prevention of hypertension]. PMID- 3649297 TI - [Lung cancer]. PMID- 3649298 TI - [Refraction and accommodation of the human eye]. PMID- 3649299 TI - [Vasomotor rhinitis in children]. PMID- 3649300 TI - [Herpetic stomatitis]. PMID- 3649301 TI - [Water--the health-strengthening and therapeutic factor (material for talks)]. PMID- 3649302 TI - [Diagnosis of emergency states in young children]. PMID- 3649304 TI - [Alcoholic lesion of the liver]. PMID- 3649303 TI - [Emergency care in arrhythmia]. PMID- 3649305 TI - [Portable case for transporting reagents]. PMID- 3649306 TI - [Health education in the secondary prevention of hypertension]. PMID- 3649307 TI - [Nutrition in the most frequently encountered pathology of old age]. PMID- 3649308 TI - [Prophylactic examinations of adolescents in railroad transportation]. PMID- 3649309 TI - [Admitting a child to the hospital]. PMID- 3649310 TI - [Cancer of the head and neck: therapeutic approach and nursing care. Nursing care in maxillofacial surgery]. PMID- 3649311 TI - [Study of part-time work in the viewpoint of developments in the concept nursing]. PMID- 3649312 TI - [Water-electrolyte disorders in the elderly]. PMID- 3649313 TI - [The nurse in microsurgery]. PMID- 3649314 TI - [The Minimal Nursing Summary: tomorrow--the Care Record: today]. PMID- 3649315 TI - [Lifting of patients]. PMID- 3649316 TI - Virus safety of beta-propiolactone treated plasma preparations. Clinical experiences. AB - Sterilization of human plasma with beta-propiolactone and UV-irradiation (cold sterilization) has been shown to be effective for a number of common pathogenic viruses. We have published data on the hepatitis safety of cold sterilized factor IX concentrates (PPSB) in healthy volunteers. This study has now been extended to include 6 virgin hemophilia B patients, who have been treated with cold sterilized PPSB for a period of up to 5 years. None of these volunteers or patients exhibited clinical symptoms or laboratory data indicating the transmission of either viral hepatitis (B or NANB) or acquired immunodeficiency syndrome (AIDS). Hyperimmunoglobulin (HIg) preparations from cold sterilized plasma, offering protection against hepatitis B and NANB are also safe regarding HTLV-III virus transmission, even though these preparations may contain HTLV-III antibody titers up to 1:1000. PMID- 3649317 TI - A nursing development unit. PMID- 3649318 TI - Memory clinics. PMID- 3649319 TI - Leg ulcers--establishing the facts. PMID- 3649320 TI - The very frail elderly--the Abbeyfield Society's solution. PMID- 3649321 TI - Improving bladder function. PMID- 3649322 TI - Caring for the care-takers. PMID- 3649323 TI - Different effects of elastase on dermal elastic fibers with age. Ultrastructural studies with the conventional and tannic acid stain. AB - The effect of elastase on dermal elastic fibers from three age groups (children, young and old adults) has been investigated using ultrathin sections embedded in Epon. There were significant differences in the effect of elastase among the age groups; younger elastin was more rapidly digested by elastase than older elastin. In children and young adults, digested areas by elastase were first recognized as tiny round holes scattered in the amorphous material of the elastic fiber, extending to the large part of the fiber except for microfibrils. In old adults, digested areas were limited to the only small part of the elastic fiber. PMID- 3649324 TI - Let the sun shine in. PMID- 3649325 TI - Nature hikes for nursing home residents. PMID- 3649326 TI - Toward a better understanding of Parkinson's disease. PMID- 3649327 TI - An exercise program for those with Parkinson's disease. PMID- 3649328 TI - Group work with the frail ethnic elderly. PMID- 3649329 TI - Satellite clinics for elder health care. PMID- 3649331 TI - The spiritual well-being of the elderly. PMID- 3649330 TI - Reading: the ageless activity. PMID- 3649332 TI - Depression and antidepressants. PMID- 3649333 TI - Nutrient nostrums. PMID- 3649334 TI - [Oxacillin-resistant staphylococci in routine diagnosis]. AB - Methicillin resistance is usually not detected by routine laboratory methods. With the aid of a method that facilitates in vitro detection of methicillin resistance 8.6% of our Staph. aureus strains and 42% of the coagulase-negative staphylococci proved to be resistant towards this antibiotic. PMID- 3649335 TI - Activation of the plasma kallikrein-kinin system by Vibrio vulnificus protease. AB - Vibrio vulnificus protease enhanced hypodermic vascular permeability when injected into the dorsal skin of a guinea pig. Enhancement of permeability was observed within 2 min, and the permeability-enhancing reaction terminated at about 10 min postinjection. The permeability-enhancing reaction was greatly augmented by simultaneous injection of a kininase II inhibitor, whereas the reaction was inhibited by soybean trypsin inhibitor, a well-known inhibitor of plasma kallikrein. Furthermore, in vitro activation of plasma prekallikrein to kallikrein by V. vulnificus protease was observed. These results indicate that V. vulnificus protease enhances vascular permeability through activation of the plasma kallikrein-kinin system which generates bradykinin, factor in edema formation. PMID- 3649336 TI - [Travel report from Ecuador]. PMID- 3649337 TI - [Travel report from Womens Hospital, USC, Los Angeles California]. PMID- 3649338 TI - [Sex education and attitude to sex among youth in Tensta]. PMID- 3649339 TI - Contractile properties of expiratory abdominal muscles: effect of elastase induced emphysema. AB - The present study examined the intrinsic contractile properties and endurance of the transverse abdominis and external oblique abdominal expiratory muscles in adult hamsters and compared their performance with the diaphragm. Experiments were performed in vitro on isolated bundles of muscle stimulated electrically. In control animals peak twitch tension was similar in the two muscles. In contrast, the twitch contraction time and one-half relaxation time of the transverse abdominis were significantly greater than that of the external oblique. The isometric tension generated over a range of stimulus frequencies (i.e., the force frequency relationship) was a greater percent of the maximum value in response to subtetanizing frequencies (10-40 Hz) in the transverse abdominis than in the external oblique. For both abdominal muscles, however, the tension generated over this range of stimulus frequencies was less than that of the diaphragm. The endurance of the transverse abdominis during repeated contractions was significantly greater than that of the external oblique but similar to the diaphragm. The effect of chronic hyperinflation produced by elastase-induced emphysema on the contractile function of the two muscles was assessed in a second group of adult hamsters. In emphysematous animals peak twitch tension, contraction time, and one-half relaxation time of the twitch and force-frequency curves of muscles from emphysematous animals were similar to values obtained in control animals for both the external oblique and transverse abdominis. However, the endurance of both the transverse abdominis and external oblique muscles was greater in emphysematous than control animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3649340 TI - Minimal exon sequence requirements for efficient in vitro splicing of mono intronic nuclear pre-mRNA. AB - Measurements of the in vitro splicing efficiency of deletion mutant RNA precursors containing the small intron of the rabbit beta-globin gene, which are truncated in the first or in the second exon, revealed that no more than approximately 20 nucleotides of either exon are necessary for efficient splicing. At least for the second exon, this minimal length requirement is globin sequence independent. Reduction of the exon-2 length to 14 nucleotides resulted in very inefficient splicing, whereas further reduction to 5 nucleotides apparently abolished the second splicing step (3' cutting and ligation), whereas the first step (5' cutting and branching) still occurred. The splicing efficiency of a double-mutant substrate retaining approximately 20 nucleotides of each exon was reduced to 50%. A kinetic study indicated that in the reaction of this double mutant substrate the second, but not the first, splicing step was delayed, in contrast to the reaction of the wild-type precursor. Duplication or triplication of the entire sequence of exon-1 did not affect the splicing efficiency, whereas elongation of this exon with approximately 100 nucleotides of 5'-flanking (nontranscribed) beta-globin sequence diminished the level of correct splicing with the simultaneous appearance of aberrant lariat forms. We conclude that for mono-intronic precursors in which there is only one choice of splice sites, most of the exon sequences are not mechanistically involved in the splicing process. PMID- 3649341 TI - A strategy for testing established human plasma protein manufacturing procedures for their ability to inactivate or eliminate human immunodeficiency virus. AB - The manufacturing procedures used for the preparation of human plasma proteins that were established before AIDS was first described may reasonably be expected to provide AIDS safe products. Such manufacturing procedures are heat treatment at 60 degrees C in solution for ten hours, described as pasteurization, preparation of human immunoglobulins by ethanol precipitation, pepsin treatment, and sulfonation. To test whether these methods effectively inactivated and/or eliminated the AIDS causing human immunodeficiency virus (HIV), nine volumes or more of plasma or a plasma fraction taken from a production lot were spiked with HIV using one volume of a HIV concentrate and were then subjected to exactly the same procedure as that specified for the manufacturing process. HIV infectivity titres of the initial HIV/plasma protein mixtures and of the resulting products after treatment were determined by the H9 cell assay. In all cases studied complete inactivation/elimination of the added HIV was achieved. We therefore conclude that pasteurization of human plasma proteins or the manufacturing procedure used for the isolation of immunoglobulins from plasma pools result in final products which do not contain any infectious HIV and which are thus safe in that they cannot be vehicles for the transmission of AIDS. PMID- 3649342 TI - Auditory brainstem response in auditory assessment of acute severely burned children. AB - The burn population often requires ototoxic drugs in the treatment of infection. Previous investigations indicate that cochlear damage and auditory impairment may result from this medical therapy. In recent years, the auditory brainstem response (ABR) has assumed an important role in pediatric auditory assessment. We describe a test protocol for ABR assessment in the severely burned child. In a series of 69 acute severely burned children, 13% showed evidence of auditory deficit by the ABR. Based on our experiences, we recommend the inclusion of routine auditory evaluations, including ABR, in the diagnosis and rehabilitation of these children. PMID- 3649343 TI - Scald injury of the respiratory tract: an unusual occurrence. AB - An unusual case of tracheobronchial scald associated with head and neck scald is reported. A five-month-old infant, lying on his back with his face under the hot water tap, not only sustained head and neck scalds, but also swallowed and aspirated hot water. Burns of the mouth, pharynx, trachea, major bronchi, and bronchides ensued. PMID- 3649344 TI - Follow-up report on burned hands, treatment plans. AB - A patient initially seen more than a decade ago with deep second-degree burns on both hands returns for long-term follow-up to determine the extent of damage present after regeneration of the dermal-epidermal elements. At the time of his burns, the patient had undergone a nonsurgical treatment program designed to prevent deformity and to protect the unburned and regenerating epithelium. Multiple biopsies done during the follow-up examination demonstrated that the regenerated skin could not be differentiated, on gross histologic examination, from normal skin. PMID- 3649345 TI - Fatal hydrofluoric acid cutaneous exposure with refractory ventricular fibrillation. AB - A patient with hydrofluoric acid burns involving only 8% of his body surface area died from intractable cardiac arrhythmia secondary to the depletion of ionized calcium by fluoride ion. For burns of this type, immediate subcutaneous injection of 10% calcium gluconate into the burn wound is recommended and the dose given should be titrated to the relief of local pain. Immediate debridgement of the burn wound also can decrease the treacherous aspect of the circulating fluoride ion, which binds to calcium to form an insoluble salt, effectively removing the calcium ion from any physiologic interaction. PMID- 3649347 TI - Anchoring endotracheal tubes on patients with facial burns Medical Center Hospital of Vermont. PMID- 3649346 TI - Influence of gender and age on the behind-the-back reach test. AB - The behind-the-back reach test is a reproducible and reliable physical fitness test for musculoskeletal extensibility of the upper extremities, shoulder girdles, and upper back. Requiring only a rigid ruler and marking pen, administration of this test can be learned easily both by medical and nonmedical personnel. Normative data derived from a study of healthy subjects of different ages demonstrated that extensibility decreases with age. Moreover, musculoskeletal extensibility for women was significantly greater than that for men. The test results were not influenced significantly by anthropometric measurements. PMID- 3649349 TI - Anchoring endotracheal tubes on patients with facial burns. Review from Harborview Hospital Seattle, Washington. PMID- 3649348 TI - Anchoring endotracheal tubes on patients with facial burns. Review from Shriners Burns Institute, Cincinnati, Ohio. PMID- 3649350 TI - Anchoring endotracheal tubes on patients with facial burns. Review from Shriners Burns Institute, Galveston, Texas. PMID- 3649351 TI - Anchoring endotracheal tubes on patients with facial burns. Review from US Army Institute of Surgical Research Fort Sam Houston San Antonio, Texas. PMID- 3649352 TI - Technical resource: a possible answer? PMID- 3649353 TI - What is a standard of practice? PMID- 3649354 TI - Standards of practice: nursing values made visible. PMID- 3649355 TI - Writing institutional criteria sets for nursing diagnosis: from idea to implementation. PMID- 3649356 TI - A method to implement nursing standards in home health care. PMID- 3649357 TI - Development and use of standards in an intensive care unit. PMID- 3649358 TI - Compliance with standards of nursing practice: use of a peer review system. PMID- 3649359 TI - The Marker model: a hierarchy for nursing standards. PMID- 3649360 TI - Standards of nursing practice assessed through the application of the nursing process. PMID- 3649361 TI - The benefits of staff nurse involvement in monitoring the quality of patient care. PMID- 3649363 TI - Monitoring is only the beginning. PMID- 3649362 TI - Tracking quality assurance activities: development of an administrative model. PMID- 3649364 TI - The Slater Scale: a viable method for monitoring care quality in home health. PMID- 3649365 TI - Monitoring systems: establishing the database that has impact. PMID- 3649366 TI - Patient care quality monitoring system: one hospital's experiences. PMID- 3649367 TI - The Marker Umbrella model for quality assurance: monitoring and evaluating professional practice. PMID- 3649368 TI - Methods of monitoring quality in a psychiatric setting. PMID- 3649369 TI - Monitoring practice: simplifying and strengthening the process. PMID- 3649370 TI - Monitoring standards instead of problems. PMID- 3649371 TI - Process through collaboration. PMID- 3649372 TI - The nursing shortage: a potentially unifying challenge. PMID- 3649373 TI - Public policy and the conservatives, traditionals, and influentials. PMID- 3649374 TI - Research utilization: a special challenge for nursing faculty. PMID- 3649375 TI - Resolution of issues: an imperative for creating nursing's future. PMID- 3649376 TI - Research in nursing education administration: state of the art. PMID- 3649377 TI - The development of graduate programs in nursing at small private colleges. PMID- 3649378 TI - The relationship between professionalization of nursing faculty, leadership styles of deans, and faculty scholarly productivity. PMID- 3649379 TI - Clinical teaching associate model: implementation in a community hospital setting. PMID- 3649380 TI - Cost model for baccalaureate nursing education. PMID- 3649381 TI - Gerontologic education: in search of a core curriculum. PMID- 3649382 TI - Incontinence stress index: measuring psychological impact. PMID- 3649383 TI - Atrophy and exercise. PMID- 3649385 TI - Nursing process in injury prevention. PMID- 3649384 TI - Health care of the elderly in Appalachia. PMID- 3649387 TI - Availability and use of opioids for cancer pain patients in Italy. PMID- 3649386 TI - Compared effects of a low and a high sodium diet on the renal and urinary concentration and activity of kallikrein in normal rats. AB - Different sodium intakes may affect or alter the urinary excretion of renal kallikrein. We have compared the renal and the urinary effects of sodium depletion and sodium loading with 1% NaCl on total kallikrein, using a direct radio-immunoassay against immunoreactive kallikrein and on active kallikrein assessed by a kininogenase assay with a kinin radio-immunoassay. Sodium depletion resulted in an increase in renal and urinary excretion of both the immunoreactive kallikrein and the kininogenase activity. Sodium loading resulted in a slight but significant decrease in renal tissue immunoreactive kallikrein content without any change in the kininogenase activity, while the urinary excretion of the kininogenase activity was greatly increased and the urinary immunoreactive kallikrein remained steady. This sodium depletion induces consistent effects at the renal and urinary level, resulting probably from a stimulation of biosynthesis. However, during sodium loading, renal and urinary measurements of kallikrein are dissociated. Furthermore, kininogenase activity and immunoreactive kallikrein are not correlated in either of the two studied compartments. Thus sodium loading seems to induce independent effects at the renal and urinary levels, possibly resulting from different mechanisms. PMID- 3649388 TI - Changing pattern in the treatment of pain and other symptoms in advanced cancer patients. PMID- 3649389 TI - Follow-up study of a multidisciplinary pain center. PMID- 3649390 TI - Challenges in pain management. Part 1. Diagnosis and treatment of temporomandibular joint disorders. PMID- 3649391 TI - A simplified approach to the subcutaneous placement of epidural catheters for long-term administration of morphine. PMID- 3649392 TI - The use of continuous subcutaneous infusions of narcotics in chronic cancer pain. PMID- 3649393 TI - Hyperprolactinemia and reduction in plasma titers of Hageman factor, prekallikrein, and high molecular weight kininogen in patients with acute myocardial infarction. AB - Hemostatic changes and hyperestrogenemia have been reported in men during myocardial ischemia and acute myocardial infarction. Because marked augmentation of Hageman factor (factor XII) titer is induced by estrogen intake in humans, we studied the factors participating in the surface-mediated reactions of clotting in patients with documented acute myocardial infarction. We report lower coagulant titers of Hageman factor, prekallikrein, high molecular weight kininogen, and plasma thromboplastin antecedent (factor XI) in the plasma samples of patients with acute myocardial infarction than in control samples. Further, the plasma estradiol titers of patients with acute myocardial infarction were not significantly different from those of controls. In contrast, the prolactin concentration of patients with acute myocardial infarction was elevated. These data suggest that other nonhormonal factors such as excessive consumption may influence the observed reduction in the titers of surface-mediated clotting factors in acute myocardial infarction. PMID- 3649395 TI - AIDS and professional responsibility. PMID- 3649394 TI - Experience with renal failure during extracorporeal membrane oxygenation: treatment with continuous hemofiltration. AB - We use extracorporeal membrane oxygenation (ECMO) to treat respiratory and cardiac failure in children who are unresponsive to standard ventilator and pharmacologic management. All patients have cardiac and abdominal ultrasonography prior to ECMO to identify major structural anomalies and anatomically normal kidneys. Despite this, oliguric renal failure is seen in a number of patients. Acute renal failure (ARF) developed in two of the first 20 patients we placed on ECMO and both of these patients died. Six of the last 27 patients (22%) also developed ARF and were treated with continuous hemofiltration (CH) placed in-line with the extracorporeal circuit. The technique of CH removes plasma water and dissolved solutes while retaining proteins and cellular components of the intravascular space. The duration of CH ranged from 9 to 112 hours (mean 57.5 hours). Indications for CH were hypervolemia, hyperkalemia, and azotemia. The mean serum potassium prior to CH was 5.6 (range 4.3 to 7.0) compared with 4.5 after filtration. We filtered 5 to 10 mL/kg/h and replaced it with crystalloid chosen on the basis of serum and filtrate electrolytes. These six patients had a 33% mean weight gain prior to CH. We were able to remove as much as 2,200 g in the most edematous patient with significant improvement in cardiopulmonary status. Four of the patients on CH died of their primary pulmonary or cardiac disease without specific problems related to ARF. The other two patients were successfully weaned from ECMO, extubated, and have not needed further therapy for renal failure. We conclude that CH is useful in managing the complications of oliguric renal failure during ECMO. PMID- 3649396 TI - Tracking infants at risk: Washington State's high priority infant tracking system. PMID- 3649397 TI - Car seats: helping parents do it right! PMID- 3649398 TI - Identification and management of the early anorectic child. PMID- 3649399 TI - AIDS in children. PMID- 3649400 TI - Obesity in infants and toddlers. PMID- 3649401 TI - The long-term effects of sibling death on self-concept. PMID- 3649402 TI - The application of locus of control to diabetes education in school-aged children. PMID- 3649403 TI - Anticipatory guidance for parents of hospitalized children. PMID- 3649404 TI - Nurses' and geneticists' role expectations for the genetics nurse clinician. PMID- 3649405 TI - Marketing pediatric nursing services. PMID- 3649406 TI - Pediatric nurse practitioner-patient interactions: a study of the process. PMID- 3649407 TI - Continuous EEG monitoring in the PICU. PMID- 3649409 TI - Role playing: a tool for the prevention and acceptance of mental illness. PMID- 3649408 TI - Case management with the chronically mentally ill. PMID- 3649410 TI - Psychiatric hospital admissions. Assessing patients' perceptions. PMID- 3649411 TI - Italian-Americans. PMID- 3649412 TI - Denial. PMID- 3649413 TI - Need for donor organs and tissues. PMID- 3649414 TI - The dry eye. PMID- 3649415 TI - Transitions--coping with a new job. PMID- 3649416 TI - Basic tools for educating primary eye care providers in developing countries: an interdisciplinary approach. PMID- 3649418 TI - ABCs of cataract surgery preparation. PMID- 3649417 TI - Pharmacology of ophthalmic drugs. Part I: Anesthetics, mydriatics & cycloplegics and ocular hypotensives. PMID- 3649419 TI - Genetic polymorphism of properdin factor B (BF) in a Chinese population: existence of two rare variants. PMID- 3649421 TI - [Public's understanding of their own living conditions: analysis of an example of classroom activities--from the 5th national meeting for organizational activity research held at Yokohama]. PMID- 3649420 TI - [Quality rather than quantity: an observation on group activities organized by public health nurses for the improvement of living conditions]. PMID- 3649422 TI - [Public's understanding of their own living conditions: changes in public health nurses and residents--a report from the first meeting for organizational activity research held at Awajishima]. PMID- 3649423 TI - [Feeding of patients (5)]. PMID- 3649424 TI - [Nursing roots in public health activities at reclamation projects in Hokkaido. 15. Establishment of a women's group and an elementary school]. PMID- 3649426 TI - [Planning area public health activities. 10. Selection of focal areas]. PMID- 3649425 TI - [Public health nurse in assisting a child with a heart defect adjusting to public school schedules]. PMID- 3649427 TI - [A survey on the status of patients with senile dementia being cared for at home and their families in Tokorozawa-shi, Saltama Prefecture]. PMID- 3649428 TI - [Evaluation of the ADL of aged patients and its relationship to their personal hygiene]. PMID- 3649429 TI - [Infections complicating pregnancy and delivery, their diagnosis and treatment]. PMID- 3649431 TI - ["As a job to help"--health care fair in Pori]. PMID- 3649430 TI - [Delivery at home or in the hospital?]. PMID- 3649432 TI - [The fair of Tehy]. PMID- 3649433 TI - [Operation of breast milk centers in Finland]. PMID- 3649435 TI - [Nurses in clinical setting: as a clinical instructor]. PMID- 3649436 TI - [Study visit to UK: first day at RCN]. PMID- 3649434 TI - [Health care and management: health institutions for the aged]. PMID- 3649437 TI - [Training of verbal expression of feeling]. PMID- 3649438 TI - [Acceptance of death]. PMID- 3649440 TI - [Writing on the job. Why publish?]. PMID- 3649439 TI - [Report on JNA-sponsored UCLA summer seminar on nursing theory]. PMID- 3649441 TI - [Writing on the job. Ability to write]. PMID- 3649442 TI - [Writing on the job. Reading and thinking lead to writing]. PMID- 3649444 TI - [Writing on the job. Writing doctoral theses]. PMID- 3649443 TI - [Writing on the job. Write in order to develop oneself]. PMID- 3649445 TI - [Writing on the job. From students' reports on seminars]. PMID- 3649446 TI - [Writing on the job. Why nurses write or do not write]. PMID- 3649447 TI - [Why write? Why publish?]. PMID- 3649448 TI - [American language: communication]. PMID- 3649449 TI - [Medical topics: blood vessel formation by laser beam myelography]. PMID- 3649450 TI - [Health administration--continuing education]. PMID- 3649452 TI - [Study visit in U.K.--RCN nursing abroad programme]. PMID- 3649451 TI - [Expression of one's feelings--verbal expression]. PMID- 3649453 TI - [Nurses in clinical settings--rehabilitation nursing]. PMID- 3649454 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Current situation in psychiatric hospitals and role of nursing personnel]. PMID- 3649455 TI - [Why write? Why publish?]. PMID- 3649456 TI - [Report on a summer seminar on nursing theory at UCLA]. PMID- 3649457 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Nurse staffing at psychiatric hospitals]. PMID- 3649458 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Social rehabilitation and the role of the public health nurse]. PMID- 3649459 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Individualized health care and community psychiatric health]. PMID- 3649460 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Networks for emergency care]. PMID- 3649461 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Changes taking place at psychiatric hospitals: anticipated reform in mental health legislation]. PMID- 3649462 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Psychiatric nursing education--issues and prospects]. PMID- 3649463 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Helping patients' independence--a physician's view]. PMID- 3649464 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Issues for nursing--review of the proposed amendments]. PMID- 3649465 TI - [Discussion on the mental health law--proposed amendment of the law to promote patients' independence. Amendment of the mental health law to facilitate social rehabilitation]. PMID- 3649466 TI - [Thoughts on tender loving touch]. PMID- 3649467 TI - [American language--empathy]. PMID- 3649468 TI - [Medical topics: treatment of hyperpituitarism; stomach cancer after gastric resection]. PMID- 3649469 TI - [Nursing management--experiences of nurses in management positions. Management is interpersonal relationship]. PMID- 3649470 TI - [Why publish?]. PMID- 3649471 TI - [Hospital-based visiting nursing service]. PMID- 3649472 TI - [Nursing management--experiences of nurses in management positions. Supplies management]. PMID- 3649473 TI - [JNA information: public relations activities]. PMID- 3649474 TI - [Nursing management--experiences of nurses in management positions. Managing together]. PMID- 3649475 TI - [Nursing management--experiences of nurses in management positions. Labor management and staff development]. PMID- 3649476 TI - [Nursing management--experiences of nurses in management positions. Emergency department]. PMID- 3649477 TI - [Nursing management--experiences of nurses in management positions. Personnel management]. PMID- 3649478 TI - [Nursing management--experiences of nurses in management positions. What I learned as director of nursing]. PMID- 3649479 TI - [Nursing management--experiences of nurses in management positions. Health instruction at OB/GYN ward]. PMID- 3649480 TI - [JNA annual general convention]. PMID- 3649481 TI - [Nurses in clinical setting: theory and practice]. PMID- 3649482 TI - [American language--individualism]. PMID- 3649483 TI - [Health service and management: aged society and health costs]. PMID- 3649484 TI - Reflections of a nurse entrepreneur. PMID- 3649485 TI - Catalyst of continuing education. PMID- 3649486 TI - From dream to reality. PMID- 3649487 TI - Concept of entrepreneurship. PMID- 3649488 TI - The nurse manager in quality assurance for ambulatory/out-patient care. PMID- 3649489 TI - Effect of vitamin E on the response of lung antioxidant enzymes in young rats exposed to hyperoxia. PMID- 3649490 TI - [Bioinstrumentation and the nurse. IV. The technical aspects in hemodialysis]. PMID- 3649492 TI - [Nursing care of the leukemic child]. PMID- 3649491 TI - [Application of the nursing process in clinical practice: a case study]. PMID- 3649493 TI - [Case study on a congenital hypertrophic pyloric stenosis patient]. PMID- 3649494 TI - [A study of the marital status of clinical nurses]. PMID- 3649495 TI - [A study for investigating compliance in health behavior--centered on rural community people]. PMID- 3649496 TI - [Bioinstrumentation and the nurse. IV. Maintenance of homeostasis and principles of dialysis]. PMID- 3649497 TI - [Nursing attitude]. PMID- 3649498 TI - [Physiopathology, diagnosis, and treatment of malignant lymphoma]. PMID- 3649499 TI - [Data collection and assessment of patients with malignant lymphoma]. PMID- 3649500 TI - [Nursing plan for patients with malignant lymphoma]. PMID- 3649501 TI - [Nursing of patients with non-Hodgkin's lymphoma]. PMID- 3649502 TI - [Psychological nursing of patients with lung cancer]. PMID- 3649503 TI - [Nursing planning with emphasis on cleanliness]. PMID- 3649504 TI - [Nursing of patients with collagen diseases and nephropathies]. PMID- 3649505 TI - [Errors in your nursing method. Pre-operative training of patients]. PMID- 3649506 TI - [Introduction of medical electronics equipment. 2. The infusion pump]. PMID- 3649507 TI - [Enlarging one's own world. Breaking away from the "safe" zone to discover new possibilities]. PMID- 3649508 TI - [Enlarging one's own world. Curiosity as a motivating factor in joining the "Ship of Youths" (on-board cultural activities for Asian youths)]. PMID- 3649509 TI - [Enlarging one's own world. Volunteer activities--more to gain than to give]. PMID- 3649510 TI - [Enlarging one's own world. Scuba diving with your friends]. PMID- 3649512 TI - [Death of a patient with gastric cancer]. PMID- 3649511 TI - [Oral contraceptive agents]. PMID- 3649513 TI - [Nursing hints obtained from patients]. PMID- 3649514 TI - [Do not ignore constipation]. PMID- 3649515 TI - AIDS--science and epidemiology. PMID- 3649516 TI - The genesis of fear: AIDS and the public's response to science. PMID- 3649517 TI - The epidemiology of the human immunodeficiency virus infection. PMID- 3649518 TI - The clinical challenges of AIDS and HIV infection. PMID- 3649519 TI - Worldwide strategies for HIV control: WHO's special programme on AIDS. PMID- 3649520 TI - Religious doctrines and medical procedures in infertility. PMID- 3649521 TI - Adolescent pregnancy and loss. AB - Adolescents have a perinatal and infant mortality rate two times as high as that found in the adult population, and yet few have investigated the characteristics of adolescent grief over pregnancy loss. The mourning response of adolescents appears to differ from that of older females: adult signs of depression are either nonexistent or fleeting. Adolescents who are having difficulties moving away from dependence on their mothers may become pregnant in order to demonstrate a semblance of adulthood and also to circumvent the depression common to this phase of development. When reproductive loss occurs, two outcomes often are seen: mother-daughter conflict concerning independence accelerates, which, in turn, provides the impetus for re-impregnation soon afterward. Since pregnancy interferes with mourning, the adolescent may not be able to bond with subsequent children, thus continuing the mother-child conflict into another generation. PMID- 3649522 TI - Caring for parents of critically ill neonates during hospitalization: strategies for health care professionals. AB - Birth of a child who is critically ill because of prematurity, perinatal problems, or congenital defects precipitates a crisis for the parents. Three major issues which parents must resolve in order to adapt successfully to the crisis are identified and discussed. Phases of the adaptive process are delineated; strategies which health care professionals can utilize to facilitate the parents' adaptation are proposed. PMID- 3649523 TI - Patterns of interaction between mothers and their chronically ill infants. AB - This study describes the general style of interaction between mothers and their chronically ill infants using a dialogic states model. The mother's and infant's vocal and visual behaviors are defined as "communicative acts" and are regarded as the elements of a behavioral dialogue between the pair. Interaction is viewed as a series of four possible dyadic states: quiescent, infant alone, mother alone, and coacting. The flow of interaction was analyzed sequentially and described with transition probabilities. All the observations were carried out in the home. The data on 5 mother-infant dyads suggest some atypical patterns of interaction are present. Non-contingent responses were likely to occur. The mothers also engaged in controlling or interruptive behavior patterns. The infants frequently broke off an interaction with the mother. Patterns of maternal conceptual set development are also described. PMID- 3649524 TI - Determining the relationship of autonomy to self-care agency or locus of control in school-age children. AB - The purpose of this study was to determine whether there is a relationship between autonomy and either self-care agency or locus of control in a sample of school-age children. It was hypothesized that there would be a positive relationship between autonomy and both self-care agency and internal locus of control, and that increases in autonomy would be accompanied by increases in the other two variables. A sample of 92 fifth grade subjects was pretested and randomly assigned to one of four groups. Subjects then participated in six 1-hour learning sessions, followed by posttesting. Results demonstrated a positive relationship between autonomy and self-care agency and mixed findings for autonomy and internal locus of control in children. Additionally, as children's autonomy increased, their self-care agency increased; however, their internal locus of control did not. It was concluded that the methods used in this study to promote children's autonomy promoted their self-care agency but not their internal locus of control. PMID- 3649525 TI - Grandmother functions in multigenerational families: an exploratory study of black adolescent mothers and their infants. AB - This qualitative study explores the functions of 19 Black grandmothers who are engaged in the care of their adolescent daughters' infants. Interviews with grandmothers revealed seven functions related to this role: managing, caretaking, coaching, assessing, nurturing, assigning, patrolling. Suggestions for future research with Black grandmothers are given. PMID- 3649526 TI - Adolescents and rooming-in. AB - This study was designed to investigate the relationship of two different types of postpartum care (one with rooming-in and one without) in terms of: the infant care instruction received by adolescent mothers, the adolescent mother's perception of her infant, the adolescent mother's comfort in infant caretaking skills, and the adolescent mother's satisfaction with nursing care. Sixty-four postpartum adolescents were interviewed at 2 days and 4 weeks postpartum using six measurement instruments. When compared to adolescents who did not experience rooming-in, adolescent mothers who had rooming-in received more teaching related to cord care (p less than .01). Mothers with rooming-in perceived the average infant as crying less at both 2 days and 4 weeks postpartum (p less than .05). In addition, rooming-in mothers were significantly more satisfied with nursing care (p less than .001). Findings suggest that there may be advantages to rooming-in for adolescents and indicate directions for future study. PMID- 3649527 TI - [Research on antiviral antibodies of human immunodeficiency and markers of hepatitis B in polytransfused renal patients subjected to chronic hemodialysis]. PMID- 3649528 TI - Public hospital nurses (state) award--guidelines for clinical nurse specialist classification. PMID- 3649529 TI - How to use the new grading committee. PMID- 3649530 TI - This mystery tour is not magical--it's downright tragic. PMID- 3649531 TI - Introducing computer usage into the basic nursing course at Mitchell College. PMID- 3649532 TI - [Work of nurses in the office of dispensary care registration in a city polyclinic]. PMID- 3649533 TI - [Atherosclerosis and ischemic heart disease]. PMID- 3649534 TI - [Heart aneurysm]. PMID- 3649536 TI - [Role of the educator in preparing the young child for an examination]. PMID- 3649535 TI - [Diagnosis and treatment of primary subacute infectious endocarditis]. PMID- 3649538 TI - [Foreign bodies in the nasal cavity and external auditory canal of children]. PMID- 3649537 TI - [Work safety for the nurse in the radiation therapy department]. PMID- 3649539 TI - [Use of lithium salts for treating mental patients]. PMID- 3649540 TI - [The properties of prolonged-action psychotropic preparations and their use in psychiatric practice]. PMID- 3649541 TI - [The series UZT-100 apparatus for ultrasonic therapy]. PMID- 3649542 TI - [Fractional study of the gastric juice]. PMID- 3649543 TI - [Hygiene of the oral cavity]. PMID- 3649544 TI - We might hold the key but we do not control the lock. PMID- 3649545 TI - Change in employment plans. PMID- 3649546 TI - Ethics and midwifery. PMID- 3649547 TI - Birth positions. PMID- 3649548 TI - Who are maternity services kind to? What is kindness? PMID- 3649550 TI - Predicting success in professional training courses. PMID- 3649549 TI - The Royal College of Midwives replies to Project 2000. PMID- 3649551 TI - Double exposure--coping with newborn twins at home. PMID- 3649552 TI - Obstetric aspects of preterm labour. PMID- 3649553 TI - Measles and the measles vaccine. PMID- 3649554 TI - Sickle cell disease and health education. PMID- 3649555 TI - The growth of twins. PMID- 3649556 TI - Fetal cardiography by telemetry--the benefits of technology brought to the home. PMID- 3649558 TI - The midwife & high-risk pregnancies: experience in an obstetric medical clinic. PMID- 3649557 TI - Impact of intensive care. PMID- 3649559 TI - AIDS & midwifery practice. PMID- 3649560 TI - Obstetric anaesthesia in the Yorkshire region: aspects of interest to midwives. PMID- 3649562 TI - The Code for Nurses: Statements No. 9, No. 10, & No. 11. PMID- 3649561 TI - Butylated hydroxytoluene, lipid-enveloped viruses, and AIDS. AB - Butylated hydroxytoluene (BHT) is a potent inactivator of lipid-enveloped viruses. The viral envelope structure is physically disturbed by BHT, thereby interfering with viral adsorption to host cells. Since the virus responsible for AIDS (HTLV III) contains a lipid envelope, BHT warrants investigation as a potential antiviral agent against the AIDS virus. PMID- 3649564 TI - [Transmission and receipt of information in communication]. PMID- 3649563 TI - Evolutionary changes of sequences and factors that direct transcription termination of human and mouse ribsomal genes. AB - We have analyzed the sequences required for termination of human rDNA transcription. The human ribosomal transcription unit is shown to extend about 350 nucleotides into the 3'-terminal spacer and ends immediately upstream of a region with a distinct sequence heterogeneity. This heterogeneous region contains a cluster of conserved 10-base pair sequence elements which exert a striking homology to the proximal part of the 18-base pair murine rDNA transcription termination signal sequence, termed SalI box. Exonuclease III protection assays and in vitro transcription experiments with both homologous and heterologous human-mouse minigene constructs, and extracts from HeLa or Ehrlich ascites cells, reveal a functional analogy of the human sequence to the mouse SalI box. It mediates binding of a nuclear protein which functions as a transcription termination factor. The murine signal sequence is recognized by the human factor but not vice versa. The different sequence specificities and electrophoretic properties of the functionally equivalent protein factors suggest that a molecular coevolution has taken place between the termination signal sequences and the genes coding for the termination factors. PMID- 3649565 TI - [Basic structure of communication in nursing]. PMID- 3649566 TI - [Nursing actions in response to the slightest expressions by vegetative patients- bedside experiences]. PMID- 3649568 TI - [Communication between nurses and patients]. PMID- 3649567 TI - [Revelation of information intended or unintended for transmission-a method to identify self]. PMID- 3649569 TI - [Advantages and disadvantages of communication methods specific to the Japanese culture]. PMID- 3649570 TI - [Active nursing actions toward a patient with prolonged cognition disturbance due to a traffic accident--silent responses to the patient's desire to live]. PMID- 3649571 TI - [Establishment of a system to hold newborn infants while feeding--nurses acting as substitute mothers]. PMID- 3649572 TI - [A weekly record of clinical training as a method of communication between the instructor and students]. PMID- 3649573 TI - [Criticism on the background of the reproduction technology. A discussion]. PMID- 3649574 TI - [Evaluation of deglutition training of a patient with a brain stem lesion- clinical success in oral feeding initiated by salivary swallowing training which led to the recovery of deglutition reflex]. PMID- 3649575 TI - [Impression of the 1986 International Conference on Health Law and Ethics at Sydney and observation of Australian hospices]. PMID- 3649576 TI - Sequence of simian immunodeficiency virus from macaque and its relationship to other human and simian retroviruses. AB - Because of the growing incidence of AIDS (acquired immune deficiency syndrome), the need for studies on animal models is urgent. Infection of chimpanzees with the retroviral agent of human AIDS, the human immunodeficiency virus (HIV), will have only limited usefulness because chimpanzees are in short supply and do not develop the disease. Among non-human primates, both type D retroviruses and lentiviruses can be responsible for immune deficiencies. The D-type retroviruses, although important pathogens in macaque monkey colonies, are not satisfactory as a model because they differ in genetic structure and pathophysiological properties from the human AIDS viruses. The simian lentivirus, previously referred to as simian T-cell lymphotropic virus type III (STLV-III), now termed simian immunodeficiency virus (SIV) is related to HIV by the antigenicity of its proteins and in its main biological properties, such as cytopathic effect and tropism for CD4-bearing cells. Most importantly, SIV induces a disease with remarkable similarity to human AIDS in the common rhesus macaques, which therefore constitute the best animal model currently available. Natural or experimental infection of other monkeys such as African green monkeys or sooty mangabeys has not yet been associated with disease. Molecular approaches of the SIV system will be needed for biological studies and development of vaccines that could be tested in animals. We have cloned and sequenced the complete genome of SIV isolated from a naturally infected macaque that died of AIDS. This SIVMAC appears genetically close to the agent of AIDS in West Africa, HIV-2, but the divergence of the sequences of SIV and HIV-2 is greater than that previously observed between HIV-1 isolates. PMID- 3649577 TI - New York launches test programme for AIDS virus. PMID- 3649578 TI - An ethical dilemma. PMID- 3649579 TI - Active sliding between cytoplasmic microtubules. AB - Microtubules are versatile cellular polymers that play a role in cell shape determination and mediate various motile processes such as ciliary and flagellar bending, chromosome movements and organelle transport. That a sliding microtubule mechanism can generate force has been demonstrated in highly ordered structures such as axonemes, and microtubule-based force generation almost certainly contributes to the function of mitotic and meiotic spindles. Most cytoplasmic microtubule arrays, however, do not exhibit the structural regularity of axonemes and some spindles, and often appear disorganized. Yet many cellular activities (such as shape changes during morphogenesis, axonal extension and spindle assembly) involve highly coordinated microtubule behaviour and possibly require force generated by an intermicrotubule sliding mechanism, or perhaps use sliding to move microtubules rapidly into a protrusion for stabilization. Here we show that active sliding between cytoplasmic microtubules can occur in microtubule bundles of the amoeba Reticulomyxa. A force-producing mechanism of this sort could be used by this organism to facilitate the extension of cell processes and to generate the dynamic movements of the cytoplasmic network. PMID- 3649581 TI - Royal College of Nursing. Seek solutions. PMID- 3649580 TI - All NHS staff are in danger. Has (Health Authority) must act now to combat violence. PMID- 3649582 TI - Night nursing. PMID- 3649583 TI - Royal College of Nursing. Be positive. PMID- 3649584 TI - Need for more humility. PMID- 3649585 TI - Royal College of Nursing. The real world. PMID- 3649586 TI - Nurse specialist or special nurse? PMID- 3649587 TI - Implications for nursing administration of the relationship of technology and structure to quality of care. PMID- 3649588 TI - Shaping the environment for professional nursing practice. PMID- 3649589 TI - Shaping the nursing environment. Section I--Riverview Medical Center. PMID- 3649590 TI - Participative management. PMID- 3649591 TI - Management development. PMID- 3649592 TI - Creating an autonomous practice environment. PMID- 3649593 TI - Staffing and budgetary controls. PMID- 3649594 TI - Shaping a collaborative practice environment. PMID- 3649595 TI - Collaborative practice: a physician's perspective. PMID- 3649596 TI - Nursing research: alive and well in a community medical center. PMID- 3649598 TI - Research perspectives of a staff nurse. PMID- 3649597 TI - Formation of an orthopedic collaborative practice committee. PMID- 3649599 TI - Marketing. PMID- 3649600 TI - Professional affiliations. PMID- 3649601 TI - The effects of decentralization on nurses' job attendance behaviors. PMID- 3649602 TI - Organizational structure and philosophy. PMID- 3649603 TI - Shaping the nursing environment. Section II--University of California, San Francisco. PMID- 3649604 TI - Collaborative practice. PMID- 3649605 TI - Role of the clinical nurse specialist. PMID- 3649607 TI - Role of the clinical nurse III. PMID- 3649606 TI - Role of the divisional director. PMID- 3649608 TI - Social support: a way to a climate of caring. PMID- 3649609 TI - Analyzing and evaluating a baccalaureate nursing curriculum framework. PMID- 3649610 TI - Health care on wheels: a community health experience. PMID- 3649611 TI - Teaching conflict resolution. PMID- 3649612 TI - Educational mobility in nursing: LPN to RN. PMID- 3649613 TI - Reviewing faculty practice: an administrative approach. PMID- 3649615 TI - Teaching students how to chart. PMID- 3649616 TI - Liberal arts and professional nursing education: integrating knowledge and wisdom. PMID- 3649614 TI - Faculty evaluation: the process and the tool. PMID- 3649617 TI - The coordinated course: efficient and effective. PMID- 3649618 TI - Qualitative study of nursing adult learners: summary. PMID- 3649619 TI - The Code for Nurses: an area for collaboration. PMID- 3649620 TI - Taking a sabbatical? Consider doing research. PMID- 3649621 TI - Learning to behave: lessons from the corporate world. PMID- 3649622 TI - Share the good. PMID- 3649623 TI - Autonomic dysreflexia. PMID- 3649624 TI - The many signs of renal failure [continuing education credit]. PMID- 3649625 TI - How to talk to dying patients. PMID- 3649626 TI - Helping the I.B.D. patient cope with the unpredictable. PMID- 3649627 TI - Has nursing outgrown the nursing process? PMID- 3649628 TI - Against all odds: the story of an amazing appliance--and an even more amazing relationship. Nursing grand rounds. PMID- 3649629 TI - A practical "postable" chart of equianalgesic doses. PMID- 3649630 TI - An expert's guide to using a defibrillator. PMID- 3649631 TI - Nurses with A.I.D.S.--on the firing line? PMID- 3649632 TI - Think twice about falls. PMID- 3649633 TI - Platelet pheresis. PMID- 3649634 TI - 6 questions about malpractice insurance. PMID- 3649635 TI - Intraperitoneal chemotherapy. PMID- 3649636 TI - Going through channels and getting results. PMID- 3649637 TI - Worth the pain. PMID- 3649638 TI - Accidental drug overdose. Action stat! PMID- 3649639 TI - Understanding immune system dysfunction (continuing education credit). PMID- 3649640 TI - Filling in charting gaps... in court. PMID- 3649641 TI - Left vs right: what a difference the side makes in stroke. PMID- 3649642 TI - How to measure jugular venous distention. PMID- 3649643 TI - Incentive spirometry--inspiring your patient to breathe deeply. PMID- 3649644 TI - Controlling violent patients before they control you. Advice on keeping your cool when your patient is losing his. PMID- 3649645 TI - Calculating i.v. medications with confidence. PMID- 3649646 TI - Meeting the needs of geriatric patients on an acute care unit. PMID- 3649648 TI - 50 ways to save time and improve your nursing practice. PMID- 3649647 TI - Diuretics for mild hypertension: still the best choice? PMID- 3649649 TI - Putting Peggy back in the driver's seat. Nursing grand rounds. PMID- 3649650 TI - Think twice about diarrhea. PMID- 3649651 TI - Continuing education--how do we make it work? PMID- 3649652 TI - More about floating. Law for the nurse manager. PMID- 3649653 TI - Intrapreneurship in nursing. PMID- 3649654 TI - Management of pressure sores with occlusive dressings in a select population. PMID- 3649655 TI - The passive-aggressive nurse. PMID- 3649656 TI - New dimensions of regulating the practice of professional nursing. PMID- 3649657 TI - Toward a comprehensive personnel system: performance appraisal--Part IV. PMID- 3649658 TI - Caring, courtesy, understanding in critical care units. PMID- 3649659 TI - Controlling O.R. inventory with notebook computers: a case study. PMID- 3649661 TI - A quality assurance model for nursing. PMID- 3649660 TI - A nursing executive committee. PMID- 3649662 TI - Nursing administration: the problem or the solution? PMID- 3649663 TI - Watch your language ... PMID- 3649664 TI - COSHH regulations. PMID- 3649665 TI - Tackling dermatitis. PMID- 3649666 TI - Dermatitis: identifying the culprit. PMID- 3649667 TI - Noise and the law. PMID- 3649668 TI - Wound management. 1. PMID- 3649670 TI - Deaf juror makes justice listen. PMID- 3649669 TI - [Nursing today and on its way to a new century]. PMID- 3649671 TI - Death pronouncement by R.N.S needed in community health nursing. PMID- 3649672 TI - Traction: a review with nursing diagnoses and interventions (continuing education credit). PMID- 3649673 TI - Discharging the patient in skeletal traction. PMID- 3649674 TI - Pressure sores: prevention is the challenge. PMID- 3649675 TI - Case study 2-87. Total knee replacement. PMID- 3649676 TI - The nursing-therapy connection: bedside treatment. PMID- 3649677 TI - Preventing peroneal nerve damage. PMID- 3649678 TI - Radiology review: hip fracture. PMID- 3649679 TI - Patient safety. PMID- 3649680 TI - Total hip replacement. PMID- 3649681 TI - Power of the "purse string" with case management. PMID- 3649682 TI - Bringing together the young and old with intergenerational day care. PMID- 3649683 TI - If the shoe fits ... wear it. PMID- 3649684 TI - Adolescent cognitive and contraceptive behaviors. PMID- 3649686 TI - Young fathers' support group. PMID- 3649685 TI - "Cured!" ... Now what? PMID- 3649687 TI - Pediatric management problems (epiglottitis). PMID- 3649688 TI - Methods of improving critical care expertise of the general pediatric nurse. PMID- 3649689 TI - Part-time practice: a creative alternative for nurse specialists. PMID- 3649690 TI - Multidisciplinary treatment of feeding disorders in the home. PMID- 3649692 TI - Outcome of teaching clean vs. terminal methods of formula preparation. PMID- 3649691 TI - Incidence data should be viewed with caution. PMID- 3649693 TI - Characteristics of master's education in nursing. PMID- 3649694 TI - Violence: who cares? PMID- 3649695 TI - Ethics: a question of morality. PMID- 3649696 TI - International health: romantics or realists? PMID- 3649697 TI - The politics of the plaster. PMID- 3649698 TI - Part of the institution. PMID- 3649700 TI - Aiming for the top. PMID- 3649699 TI - Institutionalisation. Busy doing nothing. PMID- 3649701 TI - Designing a resuscitation trolley. PMID- 3649702 TI - Nursing Aid. On the front-line. PMID- 3649703 TI - Helping hands. When ignorance is hell. PMID- 3649704 TI - Psychotherapy in special care baby units. PMID- 3649705 TI - How drugs act. Diuretic agents. PMID- 3649706 TI - Quest. NT's educational supplement. PMID- 3649707 TI - Quest. Using the objectives model. PMID- 3649708 TI - Quest. Competent and confident. PMID- 3649710 TI - Colin Ralph: man with a mission. Interview by Janet Snell. PMID- 3649709 TI - Success story. Interview by Laurence Dopson. PMID- 3649711 TI - Drugs: an injection of common sense. PMID- 3649712 TI - Home service. PMID- 3649713 TI - Racism. The great divide. PMID- 3649714 TI - Racism. Sorry, wrong colour. PMID- 3649715 TI - Racism. Limited access. PMID- 3649716 TI - Racism. One step forward? PMID- 3649717 TI - Head injury: face to face with trauma. PMID- 3649718 TI - How drugs act. Drugs and the parasympathetic nervous system. PMID- 3649719 TI - In the balance. An all-qualified workforce: the case for; the case against. PMID- 3649720 TI - Nursing practice. The journal for the development of clinical nursing. PMID- 3649721 TI - Nursing practice. Different expectations. PMID- 3649722 TI - Nursing practice. Getting to the core of the matter. PMID- 3649723 TI - Nursing practice. Patterns of speech. PMID- 3649724 TI - Nursing practice. Coronary fears. PMID- 3649725 TI - When trad is bad. PMID- 3649726 TI - Growth factors: potential for growth. PMID- 3649728 TI - A change of face. PMID- 3649727 TI - Midwives: suspicious intent? PMID- 3649729 TI - Into the community. Haven of care--or sick joke? PMID- 3649730 TI - Into the community. What will the neighbours say? PMID- 3649731 TI - Into the community. Workshop on distress. PMID- 3649732 TI - The alternative patient. PMID- 3649733 TI - A word in your ear. PMID- 3649734 TI - How drugs act. Drugs and the eye. PMID- 3649735 TI - Systems of life. No 150. Senior systems. 15. Nutrition and the elderly. 1. PMID- 3649736 TI - Focus on disability: information gap. PMID- 3649737 TI - Critical care. The physiology of cardiac massage. PMID- 3649738 TI - Critical care. Portrait study. PMID- 3649739 TI - A plea for play. PMID- 3649740 TI - Child abuse: a place of safety. PMID- 3649741 TI - AIDS--a woman's concern. PMID- 3649742 TI - Let nurses run a health service. PMID- 3649744 TI - Security. Lock it or lose it. PMID- 3649743 TI - Security. Are you safe? PMID- 3649745 TI - Who needs midwifery? PMID- 3649746 TI - Surgical intervention in malignant ascites. PMID- 3649748 TI - Critical care: external chest compression--the new skills. PMID- 3649747 TI - Patch work. PMID- 3649749 TI - Prophylactic treatment for venous ulcers. PMID- 3649750 TI - Into the community. Planning blight? PMID- 3649751 TI - How drugs act. Drugs and the gastrointestinal tract. PMID- 3649753 TI - Bring back the Care Bear. PMID- 3649752 TI - Systems of life. No 141. Senior systems. 16. Nutrition and the elderly. 2. PMID- 3649754 TI - 'Is my child dying, nurse?'. PMID- 3649755 TI - Recruitment: why I don't want to nurse. PMID- 3649756 TI - Midwifery: unity of diversity? PMID- 3649757 TI - That one-to-one relationship. PMID- 3649758 TI - Nurse wastage. Waste not, want not. PMID- 3649760 TI - Nurse wastage. Confronting stress. PMID- 3649759 TI - Nurse wastage. A picture of pressure. PMID- 3649761 TI - Surgical treatment for syringomyelia. PMID- 3649762 TI - Nursing Aid. Feeding troubles. PMID- 3649764 TI - Facing the fear. PMID- 3649763 TI - Fournier's gangrene. PMID- 3649765 TI - Nursing Aid. Eye care in India. PMID- 3649766 TI - Why choose midwifery. PMID- 3649767 TI - Who's a pretty girl, then? PMID- 3649769 TI - Nursing the Christian spirit. Interview by Laurence Dopson. PMID- 3649770 TI - Defusing the time bomb. Interview by Harriet Gaze. PMID- 3649768 TI - Sharing the caring. PMID- 3649771 TI - Hospital hygiene: out of the frying pan.... PMID- 3649772 TI - Ain't misbehaving? PMID- 3649775 TI - AIDS. Blazing the trail. Interview by Charlotte Alderman. PMID- 3649774 TI - AIDS. The politics of prejudice. PMID- 3649773 TI - AIDS. Facing the facts. PMID- 3649776 TI - Prevention is better than cure. PMID- 3649777 TI - Help in the home. PMID- 3649778 TI - Midwives' judgement. PMID- 3649779 TI - Management. Winds of change. PMID- 3649780 TI - Psychiatric skills: Spike's progress. PMID- 3649781 TI - Nursing Aid. A growing concern. PMID- 3649782 TI - Organ transplants. The role of the transplant co-ordinator. PMID- 3649783 TI - Teaching patients and clients. 3. The benefits of communicating. PMID- 3649784 TI - The Journal of Infection Control Nursing. PMID- 3649785 TI - Journal of Infection Control Nursing. A policy for community practice. PMID- 3649786 TI - Journal of Infection Control Nursing. To clean or not to clean? PMID- 3649787 TI - Psychosocial impacts created by chronic illness. AB - One can ascertain, from this brief overview, that chronic illness can and does abuse an afflicted person's psychologic well-being, body image, sexuality, social identity, and occupational role. However, the alterations imposed on the chronically ill person by the disease can be dealt with in an effective manner. Health care providers need to examine with each patient what alterations are occurring, what changes might occur, and how the patient might effectively contend with and control each of these alterations. Although chronic illness is intrusive, it can be dealt with in an effective manner so that the afflicted person can lead a productive life. PMID- 3649788 TI - Adaptation to chronic illness. PMID- 3649789 TI - Factors influencing one's ability to adapt to chronic illness. AB - The disease course in chronic illness may be subtle and accompanied by irreversible changes that have to be managed. Once the immediacy of the illness has been dealt with, the patient may face a future full of uncertainties related to illness recurrence, further disease progression, and perhaps even death. Thus the long-term implications of chronic illness necessitate multiple accommodations on the part of the patient, the family, and society. To aid in one's ability to deal with a chronic illness such factors as care, technology, family relationships, developmental level, cultural values and beliefs, communication, and economics need to be considered. An understanding of how each of these factors affects chronic illness can facilitate the appropriate development and initiation of options for adaptation to the illness. PMID- 3649790 TI - Coping strategies of the chronically ill. AB - Coping with chronic illness is both a challenging and threatening process for patients. Health care professionals need to be aware of situations when a patient's usual strategies are no longer adequate for effective coping. At those times health care professionals are in a primary position to assist patients in managing their illness by discovering coping strategies not previously used, designing ways of controlling new stressors, and using resources not needed before. Coping strategies when effectively used are powerful methods for influencing functioning and well-being. Understanding the processes patients go through when confronted with chronic illness can make health care professionals better able to help patients manage their illness effectively. PMID- 3649791 TI - Coping with rheumatoid arthritis. AB - Rheumatoid arthritis, a chronic systemic connective tissue disorder that affects women three times more often than men, that is of unknown cause, and that involves inflammatory changes primarily in the small peripheral joints of the hands and feet, afflicts approximately 8 million people in the United States. In its mildest form, rheumatoid arthritis causes little interference with normal activity. However, in its severest form, it can render the afflicted person bound to a wheelchair, house, or even a bed. As a result of its crippling effects, simply accomplishing the tasks of daily living can be a feat for some people. Coping with the existence of pain, disabling effects, and/or deformities brought on by rheumatoid arthritis is not an easy task for the afflicted person. To cope with the physical aspects of the disease, the afflicted person is likely to use the coping mechanisms of information seeking, direct action, inhibition of action, intrapsychic processes, and social support. Which coping mechanisms are used, how the mechanisms are used, and how effective the mechanisms are, must be determined by the nurse so that appropriate psychosocial interventions can be planned and implemented. PMID- 3649792 TI - Coping with diabetes mellitus. A full-time job. AB - The coping demands of diabetes may be insurmountable to the unprepared and unwary. The psychosocial, self-management, and knowledge/skill demands of diabetes can affect every aspect of a person's life. Planning ways to cope with this unique circumstance may help a diabetic person adjust to a complex and difficult lifelong problem. Viewing the client, family and friends, nurse, physician, dietitian, and relevant other team members as a full corporate partnership, with individual and shared responsibility, also lays the groundwork for realistic problem-solving and coping by all concerned. PMID- 3649793 TI - The chronically ill patient's adaptation to hospitalization. AB - The focus of caring for the chronically ill patient while hospitalized centers on encouraging the patient to maintain as much control of his or her treatment as possible. Nursing personnel needs to involve patients in all aspects of their care and foster independence when feasible. To be effective, discharge planning must begin at the time of admission. PMID- 3649794 TI - Responding to the spiritual needs of the chronically ill. AB - The steps of the nursing process apply to needs of the spirit as well as body and mind. Several nurses have provided guidelines for assessing spiritual needs. Stoll, for example, considers four areas of concern: the person's concept of God; source of strength and hope; significance of religious practices and rituals; and perceived relationship between spiritual beliefs and state of health. In approaching the patient about these four areas, it is important for the nurse to clearly articulate the purpose in seeking such information. For instance, a nurse might explain to a patient that research has demonstrated the positive relationship of spiritual concerns to a patient's ability to cope with chronic illness. Because the nurse is interested in assisting the patient to identify, strengthen, and develop a variety of coping strategies, spiritually related data are relevant to the patient's care. Having collected data from the patients, a nursing diagnosis can be made. Spiritual concerns, spiritual distress, and spiritual despair have been included in the accepted classification system. Meeting the spiritual needs of patients can be uncomfortable for the nurse. Several reasons for such discomfort include embarrassment, the belief that it is not the nurse's role, lack of training, and the lack of own spiritual resources. Experience with an elective course in spirituality for undergraduate nursing students would support the value of offering training. Discussing God-related issues can assist a health care professional to clarify a personal spiritual position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3649795 TI - Social support and the chronically ill individual. AB - Nurses caring for the chronically ill need to be alert for the problems of social isolation and social impairment. Families often respond initially to serious illness by becoming over-protective and fostering dependence and a sense of impaired competence in the ill person. As the illness continues, families often experience exhaustion because of the demands of new roles, depleted finances, and other aspects of a changed lifestyle. Feelings of anger, guilt, and helplessness occur in the network, often leading to withdrawal of support--especially as the ill person's ability to reciprocate support is impaired. Nursing interventions in situations of social isolation focus on reducing isolation by promoting social interaction as appropriate, and by directly or indirectly mobilizing or expanding the social network. The problem of impaired social interaction may occur secondary to the personality changes that often accompany chronic illnesses, or as a function of the chronic illness or disability itself, as in the case of mental illnesses. Social impairment is an appropriate nursing diagnosis in abusive families. Nursing interventions range from educational programs for social skill development to reduction of the amount of contact within the network to involvement of protective and psychotherapy services. Chronic illness has profound effects on social support and the social network of both the ill person and his or her family. As both long-term illnesses and family involvement in care giving increase, nursing care in situations of chronic illness must include attention to issues of social support. Nursing diagnosis provides a framework for nurses to include social support in their care of the chronically ill patient. Social isolation and social impairment can be reduced by nursing interventions. PMID- 3649796 TI - Pain control. PMID- 3649798 TI - Hypnosis as an intervention for pain control. AB - The use of formal hypnosis and/or positive, comforting suggestions to patients for control of pain, fear, and anxiety is simple and effective. In addition, it is easy to learn and teach to patients. Spiegel states that hypnosis, a group of techniques long associated with fantasies of loss of control, is ironically very helpful in actually enhancing patients' sense of control. The clinicians daring to become proficient in the use of hypnotic trance must begin with a conscious effort to abandon all negative suggestions such as "Do you have pain?"; "How much do you hurt?"; and "Move your bad leg." Simultaneously, a conscious effort is made to increase the use of the following positive suggestions: "How comfortable are you going to be tonight?" "Your hand feels so soft and warm"; "It is important to move this leg." These communication skills are best learned from clinicians skilled in hypnotherapeutic techniques. Simultaneously, it is important to become familiar with the works of Erikson and Barber. The American Society of Clinical Hypnosis will provide information about the national organizations and state hypnosis societies that offer approved workshops, conferences, and training opportunities. Hypnosis as analgesia surely provides rest, relaxation, and comfort for patients without the negative side effects of other analgesics. In addition, the ultimate benefit of hypnotic analgesia lies in enabling patients to potentiate their inner strength, resulting in improved self esteem and self-control. PMID- 3649797 TI - Ethical issues related to pain control. AB - Two fundamental ethical questions involved in all health care decisions: what attitudes and practices enhance human values and what attitudes and practices diminish human values? Specifically, in the area of pain control, the ethical dilemma of balancing therapeutic relief with toxic side-effects is complicated by two salient factors. First is the need for an understanding of ethics that recognizes pain control as a crucial ethical issue. Second is the need to examine myths, attitudes, and behaviors in clinical practice that result in restrictive, insensitive, and inappropriate rationing of pain relief. PMID- 3649799 TI - New delivery systems in pain management. AB - Technologic innovations have led to the development of new delivery systems in pain management. Prolonged-release morphine, implanted reservoirs, and external and internal infusion pumps are now employed to improve pain management techniques. These advances have allowed entry to previously inaccessible or difficult-to-enter sites such as the intravenous, subcutaneous, epidural, intrathecal, and intraventricular routes. The role of the nurse is paramount in applying these new technologies to pain control. The nurse must employ sound pain management principles when choosing the route and delivery system that will meet the patient's needs. Nurses are responsible for implementation of the therapy, patient education, ongoing assessment, management of side effects, and evaluation of the effectiveness of the technique. Future innovations will lead to further advances in pain management techniques. As integral members of the health care team, nurses must be involved in the clinical research and evaluation of these new therapies. Advanced technology and supportive nursing care can then be united to ensure optimal pain control for our patients. PMID- 3649800 TI - Health personnel as a united team: a Swedish experience. PMID- 3649801 TI - Myth or reality? Is mental illness incurable? PMID- 3649802 TI - Fathers in the labour room. PMID- 3649804 TI - Nursing education: community involvement and outreach programme. Report on a panel discussion. PMID- 3649803 TI - First trimester: the most important period of pregnancy. PMID- 3649805 TI - The evil of drug dependence. PMID- 3649806 TI - Open university: an alternative approach in nursing advancement. PMID- 3649807 TI - Immunization: a chance for every child. PMID- 3649808 TI - Position paper on nursing education in India. PMID- 3649809 TI - A health-awareness program for elementary school teachers. PMID- 3649810 TI - Use of the public health nursing bag reexamined. PMID- 3649811 TI - Urinary incontinence in women. PMID- 3649812 TI - Recollections of nursing and health care in the Soviet Union. PMID- 3649813 TI - Family as the focus of nursing care. PMID- 3649814 TI - The future role of the physician in home health care. PMID- 3649815 TI - Views on home care--nurses respond. The practice of home care nursing. PMID- 3649816 TI - Views on home care--nurses respond. Home care--what's needed. PMID- 3649817 TI - Construct validity of a clinical-performance-evaluation tool in community health nursing. PMID- 3649818 TI - Public health nursing model for contact follow-up of patients with pulmonary tuberculosis. PMID- 3649819 TI - Effect of elevated C1-esterase inhibitor levels on elastase release in vitro--a proposed model of shock (ECC). PMID- 3649820 TI - Hemodynamics and proteolysis in experimental trypsin induced shock. PMID- 3649821 TI - Reaction pattern of alveolar cells in the posttraumatic lung failure. PMID- 3649822 TI - Neutrophil protease enzymes and oxygen free radicals as mediators of pulmonary membrane damage. PMID- 3649823 TI - Biochemical monitoring of the lung during and after extracorporeal circulation. AB - The activity of NAG, lysozyme and PMN-elastase has been investigated in the superior vena caval and left atrium blood collected from patients who underwent open heart surgery. The effect of various types of respiration on the enzyme release has been also documented. Concentration gradients between v. cava sup. and left atrium has been used as an index for pulmonary damage post operatively. We found a time dependent increase of all enzymes during extracorporeal circulation. However, only the release of NAG and lysozyme is characteristic for pulmonary damage. We observed significant higher enzyme release from the lung after Apnea ventilation compared with the PEEP and low frequency ventilation group. Also significant higher NAG and lysozyme activity was found in patients who needed longer respiration post-operatively. PMN-elastase seems to be not suitable for diagnosis of post perfusion lung because the main amount of elastase released by mechanical destroy of the granulocytes. PMID- 3649825 TI - Health enshrined in new charter. PMID- 3649824 TI - The parent enhancement program for the high-risk elderly gravid clients in relation to the process and outcome of parturition. PMID- 3649827 TI - The perspectives of human immunodeficiency virus infections in 1987. PMID- 3649826 TI - 1987 International Nurses' Day: International Council of Nurses. Health in the workplace. PMID- 3649828 TI - Deplorable nursing care: technical defenses. PMID- 3649829 TI - Nurse's notes save the day. Case in point: Coleman v. Touro Infirmary of New Orleans (506 So. 2d 571-LA). PMID- 3649830 TI - [Prevalence of antibodies against HTLV-III in the at risk population in Madrid. Clinical study and incidence of virologic markers]. PMID- 3649831 TI - [Importance of the nurse's work in administering drugs by the unit dosage]. PMID- 3649832 TI - [Nursing care in acute myocardial infarct. 10 years of work in an intensive care unit]. PMID- 3649833 TI - [Epidemiological study of the low birth-weight newborn infant]. PMID- 3649834 TI - [The social environment and health status of the population]. PMID- 3649835 TI - [Model course study plan for students in the baccalaureate specialty in nursing]. PMID- 3649836 TI - [Study of the life habits of a sample of ischemic heart disease patients as an element for the direction of health education]. PMID- 3649837 TI - [Complications of acute appendicitis in children. A study of 202 cases during a 2 year period]. PMID- 3649838 TI - [Role of the nurse in the geriatric psychosocial aspects of the Pinar del Rio Old Age Home]. PMID- 3649839 TI - [Hypoglycemia in the newborn infant]. PMID- 3649840 TI - [Economic indicators in intensive care units]. PMID- 3649841 TI - [Nursing care in coma]. PMID- 3649842 TI - [Importance of research in nursing teaching and care]. PMID- 3649843 TI - [The computerized teaching system. An educational evaluation]. PMID- 3649844 TI - [Effect of respiratory physiotherapy on the pressure and pulse of the surgical patient]. PMID- 3649846 TI - [Primary care: vaccination. An example of convincing economic savings]. PMID- 3649845 TI - [Effectiveness of health education for puerperae]. PMID- 3649847 TI - [Administrative work of the nurse in a mixed work center (1984)]. PMID- 3649848 TI - [Nursing care facing a new century. Its future setting]. PMID- 3649849 TI - [Nursing care of patients with acute myocardial infarct complicated by heart failure]. PMID- 3649850 TI - [Time devoted to other activities not inherent in nursing]. PMID- 3649851 TI - [Mortality from congenital malformations in the 1980-1984 quinquennium at the South Pediatric Teaching Hospital]. PMID- 3649852 TI - [The essential bases for systematically guiding nursing actions into the year 2000]. PMID- 3649853 TI - [Systematic orientation of the hypertension patient undergoing outpatient treatment]. PMID- 3649854 TI - [Reduction of the anxiety state through group dynamics]. PMID- 3649855 TI - [Specialization in psychiatric nursing]. PMID- 3649856 TI - [The national state of affairs and the situation of the nurse]. PMID- 3649857 TI - [Floods and human leptospirosis in the municipality of Sao Paulo]. PMID- 3649858 TI - [Evaluation of nurse performance: the results found and conclusions--III]. PMID- 3649860 TI - Nursing care of the patient with lung cancer. PMID- 3649859 TI - [Nursing: a conceptual approach]. PMID- 3649861 TI - Confessions of a cancer nurse. PMID- 3649862 TI - The epidemiology of lung cancer: an overview. PMID- 3649863 TI - Nursing management of toxicities associated with chemotherapy for lung cancer. PMID- 3649864 TI - Superior vena cava syndrome: an oncologic complication. PMID- 3649865 TI - Home care of the patient with advanced lung cancer. PMID- 3649866 TI - Lung cancer: psychosocial implications. PMID- 3649867 TI - The key to prevention of lung cancer: stop smoking. PMID- 3649869 TI - Measuring cardiac health knowledge. PMID- 3649868 TI - Methodological problems of clinical trials in nursing illustrated by a study of post-partum care. PMID- 3649870 TI - Caring sciences in Denmark. PMID- 3649872 TI - [Locomotor apparatus; lower limb (4). Femoral neck fractures]. PMID- 3649871 TI - Changes in physical functional capacity from 71 to 78 years of age for a population living at home. Data from a prospective study of an age cohort. PMID- 3649873 TI - [Electrocardiography (1)]. PMID- 3649874 TI - [Preparation and setting up of the operating room. Role of the nurse anesthetist]. PMID- 3649875 TI - [Preparation of the operating room. Role of the circulating nurse and the instrument nurse]. PMID- 3649876 TI - [General anesthesia for mitral valve insufficiency. Induction and monitoring]. PMID- 3649877 TI - [Mitral valve replacement by bioprosthesis. Course of the intervention]. PMID- 3649878 TI - [Anesthesia and surgery for mitral insufficiency]. PMID- 3649879 TI - [Weaning from extracorporeal circulation]. PMID- 3649880 TI - [Reception of the surgical patient, postoperative care and monitoring]. PMID- 3649881 TI - [Fundamental needs and human knowledge]. PMID- 3649882 TI - [Studies of mitral valve insufficiency and indications for surgery]. PMID- 3649883 TI - [Preanesthetic visit before surgical intervention using extracorporeal circulation]. PMID- 3649884 TI - [Locomotor apparatus: lower extremity (5). Gluteal region: course of the great sciatic nerve]. PMID- 3649885 TI - [The electrocardiograph (2). Material maintenance]. PMID- 3649886 TI - [Endoscopy of the lower urinary tract]. PMID- 3649887 TI - [Endoscopy of the upper urinary tract. Endo-urology]. PMID- 3649888 TI - [A case of percutaneous nephrolithotomy]. PMID- 3649890 TI - [Suction lipolysis]. PMID- 3649889 TI - [The use of powdered sugar in infected wounds as exemplified by a case report]. PMID- 3649891 TI - [Recall of urologic anatomy and physiology]. PMID- 3649892 TI - [General facts about urinary endoscopy]. PMID- 3649893 TI - [Results of the first 9 months of testing for anti-HIV antibodies in blood donors in France]. AB - An inquiry conducted in all the French blood transfusion centres from the 1st of July, 1985 to the 31st of March, 1986 in respect of blood donations confirmed to be positive for anti-HIV antibodies has given the following results: prevalence of 0.59 per thousand (1661/2,809,744); significant difference between first-time and regular blood donors (2.04% and 0.39% respectively); predominance of males (85%); 65% are less than 30 years old; the main risk factors are homosexuality (49%) and the use of I.V. drugs (28%). PMID- 3649894 TI - [Detection of anti-HIV antibodies on Reunion. Initial evaluation]. AB - 24,982 detections of HIV-antibodies were performed between 1st October 1985 and 31 October 1986, on Reunion Island (550,000 inhabitants) and also on three groups of population: blood donors (23,413), in-patients (505) out-patients (974). 17 tests Pasteurs Elevia confirmed by Western-blotting were found positives. These safe-carriers were essentially detected in homosexual population, some drug people (intravenous injections) and hemodialyzed patients. Virus was recently introduced in island. No AIDS case has been observed to day. PMID- 3649895 TI - [A study of infectious accidents related to central venous catheters]. PMID- 3649896 TI - [Macromolecular solutes]. PMID- 3649897 TI - [The tools of public health. Understanding demography]. PMID- 3649898 TI - Facing down the fear of ventilator patients. PMID- 3649899 TI - What we do for patients can make a difference! PMID- 3649900 TI - Safe and easy ways to secure breathing tubes. PMID- 3649901 TI - When your patient's baby dies before birth. PMID- 3649902 TI - Helping the parents after a baby's death. PMID- 3649903 TI - What tomorrow holds for cancer nursing. PMID- 3649904 TI - Active specific immunotherapy: turning cancer cells into anticancer agents. PMID- 3649905 TI - Whole body hyperthermia: making things too hot for cancer. PMID- 3649906 TI - Alpha interferon: reinforcing the body's anticancer arsenal. PMID- 3649908 TI - Photodynamic therapy: flashing a red light at cancer. PMID- 3649907 TI - Intraoperative radiation: taking a clear shot at cancer. PMID- 3649909 TI - Current cancer information for you and your patients. PMID- 3649910 TI - If only all doctors felt this way. PMID- 3649911 TI - When your job is just one of your worries. PMID- 3649912 TI - Try these time-saving tips. PMID- 3649913 TI - Will the law let you keep a patient's secrets? PMID- 3649914 TI - Helping food addicts kick the habit. PMID- 3649915 TI - How we give blood transfusions at home. PMID- 3649916 TI - Unionism and professionalism. PMID- 3649917 TI - Leadership in nursing: RNAO and collective bargaining. PMID- 3649918 TI - The effect of heat upon the interaction between aminoglycosides and semi synthetic penicillins in human serum: a consideration for HIV infectious serum. AB - We conducted 2 experiments to study the effect of heat on the interaction between aminoglycosides and semi-synthetic penicillins in human serum. In one experiment, human serum spiked with either gentamicin or tobramycin at a concentration of 4.7 mg/l plus carbenicillin, ticarcillin, piperacillin, mezlocillin, or azlocillin at concentrations of either 50 mg/l or 150 mg/l was subjected to a 30-min, 56 degrees C waterbath incubation. In the second experiment, randomly selected sera from patients receiving either gentamicin or tobramycin were also heat-treated. Two methods, the Abbott TDx and the Syva Emit, were used for each aminoglycoside assay. The difference between pre- and post-heat treatment aminoglycoside concentration was less than 10% in approximately 92% of the patient sera and in 93% of the spiked sera containing an aminoglycoside plus a semi-synthetic penicillin at 50 mg/l. For sera spiked with an aminoglycoside plus a semi synthetic penicillin at 150 mg/l, post-heat treatment concentrations were 5-19% lower than pre-heat treatment concentrations. In most instances, heat treatment of sera does not alter aminoglycoside concentrations to any clinically significant degree. PMID- 3649920 TI - Implications of aging in spinal cord injury. PMID- 3649919 TI - [Antibiotic resistance and serotypes of Streptococcus pneumoniae in Zurich (1984 1985)]. AB - We have investigated the serotypes and sensitivity of 133 pneumococci against 11 antimicrobial agents in the agar dilution test. The strains had been isolated from clinical specimens sent to the Department of Medical Microbiology of the University of Zurich during 1984 and 1985. - Three strains (2.3%) had reduced sensitivity to penicillin G. 23 strains (17.3%) showed resistance or reduced susceptibility to tetracycline, one strain each (0.8%) to amoxycillin and cefaclor, and two strains each (1.5%) to erythromycin and sulfamethoxazole/trimethoprim. All pneumococcal strains investigated were susceptible to ceftazidime, ceftriaxone, chloramphenicol, vancomycin and ciprofloxacin. In view of this situation, routine testing of all clinically significant pneumococci is to be recommended. However, in the agar diffusion test the use of a penicillin G disk is unreliable and may give results with false sensitivity. Therefore, the susceptibility test should be performed with a disk containing oxacillin. - The prevalent capsular serotypes were - in descending order - types 3, 6, 23, 19, 14, 7, 8, 9, 1, and 17. 90.2% of the isolated pneumococci belonged to serotypes which are contained in the new vaccine "Pneumovax-23". PMID- 3649922 TI - [Dressing of a drainage apparatus]. PMID- 3649921 TI - Heparin promotes the inactivation of antithrombin by neutrophil elastase. AB - Heparin is an acceleratory cofactor for antithrombin, a circulating inhibitor of blood coagulation enzymes. The presence of heparin on blood vessel walls is believed to contribute to the nonthrombogenic properties of those surfaces. In apparent opposition to this function, heparin was found to greatly accelerate the in vitro inactivation of antithrombin by neutrophil elastase. Inactivation rates in solution were potentiated several hundredfold by specific heparin fractions with anticoagulant activity. Although the data suggest that a heparin antithrombin complex is essential for the inactivation by elastase to occur, the enzyme itself interacts tightly with heparin. These results suggest a mechanism which, if operating in vivo, could lead to a localized neutralization of the anticoagulant function of heparin at the endothelial surface. PMID- 3649923 TI - [How does dementia start? A concrete case]. PMID- 3649924 TI - [Those called "demented"]. PMID- 3649925 TI - [Integration of disoriented persons into group activities]. PMID- 3649926 TI - [Living with dementia in geriatrics]. PMID- 3649927 TI - [Training of a health care team daily facing demented patients]. PMID- 3649928 TI - [Mental confusions and pseudo-dementias]. PMID- 3649929 TI - [Health for all by the year 2000]. PMID- 3649930 TI - [Evaluation and appreciation]. PMID- 3649931 TI - [Pivalone neomycin suspension (for endo-sinusal administration)]. PMID- 3649933 TI - [Potassium salts]. PMID- 3649932 TI - [Senile dementia]. PMID- 3649934 TI - [Errors not to commit during change of dressings]. PMID- 3649935 TI - [From an administrative to a managerial nursing plan]. PMID- 3649936 TI - [Quality circles in a pediatric ward]. PMID- 3649937 TI - [Organization for the study of medical records and installation of a cycle for the collection of laboratory tests]. PMID- 3649938 TI - [Nurses in the year 2000. Interview with Mme. Danielle Vailland]. PMID- 3649939 TI - [The quality of life of cancer patients. Responses by the nursing teams]. PMID- 3649940 TI - [A grain of philosophy... an opportunity for nursing care]. PMID- 3649941 TI - [Maternity leave. Natural and adoptive maternity]. PMID- 3649942 TI - [Quality circles. Participation in the execution of nursing care and in the quality of performance]. PMID- 3649943 TI - [Quality circles]. PMID- 3649944 TI - [General principles of quality circles. What are they and what do they imply?]. PMID- 3649945 TI - [Problems arising in young deaf-blind children]. PMID- 3649946 TI - [The logopedist and the multiply handicapped child]. PMID- 3649947 TI - [Sign language and the methods of its introduction. Importance for children with multiple handicaps]. PMID- 3649948 TI - [Mentally handicapped children "educational progressions"]. PMID- 3649949 TI - [Audioprosthetic apparatus. Case report of a multiply handicapped child with personality disorders associated with its deafness]. PMID- 3649950 TI - [Parents of deaf children with other handicaps]. PMID- 3649951 TI - [Quality of psychiatric care]. PMID- 3649952 TI - [Psychologic and psychiatric disorders in deaf children]. PMID- 3649953 TI - [The primary ear]. PMID- 3649954 TI - [Sismotherapy]. PMID- 3649955 TI - [Agoraphobia. Diagnosis and group treatment by behavior therapy]. PMID- 3649956 TI - [Behavioral treatment of a phobic-obsessional patient. Delaying, then preventing the response]. PMID- 3649957 TI - [Self esteem]. PMID- 3649958 TI - [Development of behavioral therapies]. PMID- 3649959 TI - [Cognitive therapies and depression]. PMID- 3649960 TI - [Observation and evaluation in behavior therapy]. PMID- 3649961 TI - [Behavior therapies. Precision and effectiveness]. PMID- 3649962 TI - Persistence of high-risk sexual activity among homosexual men in an area of low incidence of the acquired immunodeficiency syndrome. AB - Before 1985 only five cases of the acquired immunodeficiency syndrome (AIDS) had been diagnosed in New Mexico, and there was no information regarding prevalence of antibody to the human immunodeficiency virus (HIV). Of 166 gay and bisexual men tested in 1985 in New Mexico, 20% were found to have antibody to HIV. Of 153 responding participants, 107 (70%) reported practicing receptive anal intercourse in the last 12 months, and only 13% of the 107 reported the regular use of condoms. High-risk sexual activity may have persisted in part because of underestimation of the local risk of acquiring HIV infection. Voluntary serologic testing and education of members of high-risk groups should be stressed in areas where the incidences of AIDS and of seropositivity to HIV are low but where high risk sexual activity may still be prevalent. PMID- 3649964 TI - [ADP and the nursing process. Interview by Pal Horsle]. PMID- 3649963 TI - Nonresponse to hepatitis B vaccine in homosexual men. AB - Of 479 homosexual men immunized with three 20-microgram doses of the hepatitis B vaccine, approximately 15% failed to develop protective titers of antibody to the surface antigen of hepatitis B virus (greater than 10 sample ratio units [SRU]). We revaccinated 34 nonresponders with an additional three doses of vaccine and compared their immunologic status with that of 14 control men who had responded to initial vaccination. Most men (15 of 19) who had measurable antibody to hepatitis B surface antigen (SRU, 2.1-9.9) after initial vaccination responded to revaccination, whereas ten of the remaining 15 nonresponders (SRU, less than 2.1) did not. No single immunologic measure distinguished ultimate responders from nonresponders; however, the initial responders differed from delayed responders and nonresponders by having higher numbers of total lymphocytes, B, T, and T helper and suppressor cells. PMID- 3649965 TI - [Treatment of stroke patients: nurses' role in cross-professional groups]. PMID- 3649966 TI - [A step ahead--whenever the power strikes]. PMID- 3649967 TI - [When children are hospitalized--health visitor: liaison between family and hospital]. PMID- 3649968 TI - [Report from Haukeland. Country's only special unit for burns]. PMID- 3649969 TI - [Pilot project in Langerud: development of leadership in the nursing home]. PMID- 3649970 TI - [Organization leaders: why don't we come to an end with problems in priority setting]. PMID- 3649971 TI - [How can the Norwegian Nurses' Association use professional resources better?]. PMID- 3649972 TI - [He is sick and tired of it, is he: now the numbers magician will have to take over!]. PMID- 3649973 TI - [The Guru speaks]. PMID- 3649974 TI - [We must respect each other's professional boundaries]. PMID- 3649975 TI - [After the new community health legislation--community health nursing and health visiting services in transition]. PMID- 3649976 TI - [Health visitors' visiting activities in families with young children]. PMID- 3649977 TI - [It was an advantage that the Frederiksberg Community Nursing Society Committee was locally recognized. Interview by Ulla Danielsen]. PMID- 3649978 TI - [Future challenge for home nursing is steadily developing]. PMID- 3649979 TI - [Research. Overall care takes time and this can be demonstrated]. PMID- 3649980 TI - [Another example of nurses' contribution to developments]. PMID- 3649982 TI - [We should cooperate instead of striking down what will benefit all]. PMID- 3649981 TI - [Children's health. 19. "Child health" 1987: 9-year-old sat alone in the park on Christmas Eve]. PMID- 3649983 TI - [Drug information. Polyunsaturated fatty acids from fish oils and coronary disease]. PMID- 3649984 TI - [Primary health service. Team work in relation to improving the health of preschool children's families]. PMID- 3649985 TI - [Home nursing. Relatives get paid for taking care of the dying in their own home]. PMID- 3649986 TI - [Criteria of brain death. Brain death discussion without time-table]. PMID- 3649987 TI - [Children's health. 21. Children and youth are Denmark's best raw material]. PMID- 3649988 TI - [Minister of Social Affairs shows disrespect about the elderly with failing health]. PMID- 3649989 TI - [A common front in the campaign against AIDS from ICN and WHO]. PMID- 3649990 TI - [Executive Board. County board questions members: why have you quit the profession?]. PMID- 3649991 TI - [Education. My greatest wish is a 4-year basic education]. PMID- 3649992 TI - [Our dying father crawled around in the hospital basement]. PMID- 3649993 TI - [County burgomaster: mental condition behind complications]. PMID- 3649994 TI - [Absurd that I cannot get support for rehabilitation]. PMID- 3649995 TI - [Children's health. 23. Everyday life and identity among older school children]. PMID- 3649996 TI - [AIDS must be controlled in prostitution and drug addict environments. Interview by Ulla Danielsen]. PMID- 3649997 TI - [Questions about the debate introduction to hospital structure]. PMID- 3649998 TI - [Good experiences with home nurses connected with the hospital]. PMID- 3649999 TI - [Health visitors and artists or nature people search]. PMID- 3650000 TI - [No reserve among passive nurses]. PMID- 3650001 TI - [Nurses' reviews. Reviews must be a source of professional inspiration]. PMID- 3650002 TI - [Children's health. 24. Many children and youth expect a nuclear war in their own lifetime]. PMID- 3650003 TI - [Difficult to help parents with a crib death]. PMID- 3650005 TI - Getting involved in politics. PMID- 3650004 TI - [Incest. We must become better with treating incest victims]. PMID- 3650006 TI - From registered nurse to state legislator: a conversation with Nancy McDonald, RN. Interview by Claire Budgen. PMID- 3650008 TI - [Summer in Sweden. Osterlen: "Call it angels' fields or heavenly grounds if you want..."]. PMID- 3650007 TI - Human immunodeficiency virus infection of the developing human nervous system. AB - Human immunodeficiency virus (HIV), the etiologic agent of acquired immune deficiency syndrome (AIDS) and AIDS-related complex, has recently been implicated as a factor in the development of AIDS-related neurologic dysfunction and may be responsible for an increasing number of neonatal immunologic and neurologic disorders. However, as yet there is no model system available to investigate the interaction of HIV with the developing human nervous system in vitro. To approximate the intracellular events associated with HIV infection of the human fetus nervous system we infected cells obtained by enzymatic dissociation of aborted human fetus dorsal root ganglia and their attached spinal roots and nerves. The expression of the HIV gag gene protein products (p17 and p24) was detected in a subpopulation of cells with a nonneuronal morphology, reaching a maximum within 3 days. Although 70% of the nonneuronal cells were p17- and p24 positive 3 days after infection, a majority of the cell population survived acute HIV infection, with the expression of p17 and p24 decreasing below the limit of detection by 12 days postinfection. This system may prove useful for examining the neuropathology and neurobiology of acute, persistent, or latent HIV infection of the developing human nervous system. PMID- 3650009 TI - [Convicted for miscalculation]. PMID- 3650010 TI - [National Social Welfare Board on the dialysis accident. Physicians and technicians get strong criticism]. PMID- 3650011 TI - [Everyone has a right to 4 weeks of vacation but...]. PMID- 3650012 TI - [Summer in Sweden. Varberg gives you a cure]. PMID- 3650013 TI - Let's talk primary health care: just what is this concept? PMID- 3650014 TI - Clinical medical research coordinators: a new nursing role. PMID- 3650015 TI - Quality assurance data: the audit process. PMID- 3650016 TI - Emergency nurses' attitudes toward the rape victim. PMID- 3650018 TI - Trauma: 'pick up and delivery'. PMID- 3650017 TI - Images. PMID- 3650019 TI - A problem we as nurses face. PMID- 3650020 TI - HTLV-III-like particles within a cell process surrounded by a myelin sheath in an AIDS brain. AB - HTLV-III-like particles were observed within a cell process surrounded by a myelin sheath, in the brain of a 4-year-old boy with AIDS encephalopathy. Similar particles were also observed in the mononuclear macrophage-like cells. PMID- 3650021 TI - Effect of estradiol on the protein synthesis in the female rat liver in vitro. AB - The incorporation of 14C-leucine in protein, as well as in aminoacyl adenylate and aminoacyl-tRNA (AA-tRNA) from the liver of mature female rats (controls, ovariectomized and treated after the ovariectomy with daily doses of 20 micrograms 17, beta-estradiol-dipropionate/100 g body weight for 11 days), was investigated under conditions of a cell-free protein-synthesizing system containing isolated microsomes and cytosol. The ovariectomy causes reduced incorporation of the label in protein and in AA-tRNA, while hormonal treatment compensates this decrease either partially or completely. Data are presented which suggest that the hormone probably increases the supply of macroergic components and free amino acids to the hepatocytes, and that it also increases the sensitivity to cycloheximide and tetracycline. It is assumed that estradiol participates in the regulation of the protein synthesis in the hepatocytes at the level of AA-tRNA synthesis. PMID- 3650022 TI - Correlation of enzyme-linked immunosorbent assays for serum human immunodeficiency virus antigen and antibodies to recombinant viral proteins with subsequent clinical outcomes in a cohort of asymptomatic homosexual men. AB - A cohort of asymptomatic homosexual men at a Boston community health center was screened for the presence of human immunodeficiency virus (HIV) serum antigen and antibodies to recombinant proteins containing portions of the envelope and the gag (core) gene products. Of 196 asymptomatic men screened, 149 were antigen negative/antibody-negative, 41 were antigen-negative/antibody-positive, and six were antigen-positive/antibody-positive. All three men in whom the acquired immune deficiency syndrome (AIDS) developed over the next year were antigen positive at enrollment. Although a larger portion of the men who were antigen positive and did not demonstrate progression to AIDS after one year had thrush, zoster, or generalized lymphadenopathy, the associations were not statistically significant. Whereas all of the seropositive men had antibody to viral envelope antigens, about a quarter did not have detectable antibodies to recombinant core antigens. However, all of these men had detectable antibody to core antigens by Western blot. Titers to recombinant core and envelope antigens tended to be lower in the men with AIDS. HIV-infected persons who are more likely to have enhanced immuno-compromise may be identified by these newer tests, but further longitudinal studies will be necessary to fully understand their prognostic value. PMID- 3650023 TI - Acid secretion in isolated guinea pig colon. AB - Isolated guinea pig distal colons secreted acid into the mucosal bathing solution at a rate of 1.0-1.5 mumol X cm-2 X h-1 when the preparations were mounted in Ussing chambers and bathed with HCO3(-)-CO2-free solution. The rates of the acidification and alkalinization of the solutions were measured by a pH stat system or calculated from changes in the pH of the solution. The acid secretion was localized in the middle and distal parts of the colon but absent in the proximal part of the colon and the cecum. The mucosal acidification was accompanied by serosal alkalinization, the rate of the latter being approximately 60% of the former. A carbonic anhydrase inhibitor, methazolamide (10(-4) M), reduced both the mucosal acidification and serosal alkalinization rates by a similar magnitude. The mucosal acidification was completely abolished by mucosal K+-free conditions but unaffected by mucosal Na+-free conditions. Ouabain added to the mucosal solution promptly inhibited the acid secretion. Dose dependency of the inhibition conformed to the Michaelis-Menten equation with a half-maximal effect at 4 X 10(-6) M. When the pH of the mucosal solution was reduced to 4.3, the rate of the mucosal acidification remained essentially the same as that at pH = 7.4. Vanadate (10(-4) M) added to both the mucosal and serosal solutions significantly reduced the mucosal acidification rate. These results suggest that CO2 derived from the epithelial metabolism is hydrated by carbonic anhydrase in the cell and released H+ enters the mucosal solution while HCO3- enters the serosal solution. H+ exit across the mucosal membrane may be mediated by H+ ATPase that is sensitive to ouabain. PMID- 3650024 TI - Isolation of complement protein D from urine of patients with Fanconi's syndrome. AB - Complement protein D is the least abundant of all complement proteins and, thus, one of the most difficult to purify. We report a new method for obtaining pure D from urine of patients with Fanconi's syndrome. The method is simple and allows the purification of milligram amounts of D within a few days. It involves three chromatographic steps using Bio-Rex 70, hydroxylapatite HPLC, and reverse-phase HPLC. Protein D purified by this method is suitable for both functional and structural studies. PMID- 3650025 TI - Mobile high-containment isolation: a unique patient care modality. PMID- 3650026 TI - Product recalls--what to do. PMID- 3650027 TI - Scabies. PMID- 3650029 TI - Consensus conference on nosocomial infections in long-term care facilities. AB - In May 1986, a group of individuals with experience in the field of infection control in long-term care met to discuss several aspects of infection prevention and control in nursing homes. This article provides background information, along with points of general consensus among the group. The consensus items are also intended to stimulate further discussion and research in the field of infection prevention and control in long-term care facilities. PMID- 3650028 TI - Rubella: one hospital's experience. PMID- 3650031 TI - Public is served when nurses prescribe. PMID- 3650030 TI - House acts on shortage, AIDS, liability. PMID- 3650032 TI - New liability insurance program to cover most NPs. PMID- 3650033 TI - Nurses play critical role in care of AIDS patients. PMID- 3650034 TI - Speak for nursing as a convention delegate. PMID- 3650035 TI - ANA in forefront of AIDS policy making. PMID- 3650037 TI - Building a better umbrella. PMID- 3650036 TI - Control over practice was the issue in Oregon. PMID- 3650038 TI - As I see it: newly elected Board members discuss challenges. PMID- 3650039 TI - Nurses get ready for role in Presidential election. PMID- 3650040 TI - SNAs develop programs, tactics to address shortage. PMID- 3650041 TI - Current concepts in the virology of infection with human immunodeficiency virus (HIV). A view from the III International Conference on AIDS. PMID- 3650042 TI - Preventing a successful malpractice claim. AB - All of these strategies combine to make it less likely that a suit will be filed. But the strategies of complying with the standard of care and accurately documenting that care also combine to make it less likely that a suit will be successful. Injury is just one element of a successful malpractice suit. The plaintiff's attorney must also convince the judge or jury that the defendant failed to meet the standard of care and that failure caused the patient's injury. By complying with the standards of care and documenting that care, the nurse makes it easier for his or her attorney to counter arguments that the standard of care was not met. Accurate documentation can also fortify arguments that the nurse's actions did not cause the injury. There is nothing magical about these five strategies. Nurses will recognize each as actions good nurses perform in the course of their practice. Providing good nursing care also provides the best legal protection. PMID- 3650043 TI - Using principles of beneficence, autonomy to resolve ethical dilemmas in perioperative nursing. PMID- 3650044 TI - Dealing with the nursing shortage--again. PMID- 3650045 TI - Learning RN first-assistant skills. PMID- 3650046 TI - Arteriovenous malformations of the brain. PMID- 3650047 TI - Spinal stabilization. An introduction to Cotrel-DuBousset instrumentation. PMID- 3650048 TI - Caring for the radiation accident victim. PMID- 3650049 TI - Perioperative nursing documentation. Developing the record and using care plans. PMID- 3650051 TI - Scrubbing and circulating: both are essential for professional perioperative nursing practice. PMID- 3650050 TI - Patient shame. Implications for perioperative nursing. PMID- 3650052 TI - Surgery for achondroplasia. Perioperative challenges of dwarfism. AB - We have presented the salient points of managing achondroplastic dwarfs in the operating room. In presenting our experience in dealing with this group of patients we hope that we will make the tasks of those who care for these patients easier and help focus their attention on those problems that are more likely to occur. PMID- 3650053 TI - Comparative specificity of porcine pancreatic kallikrein and bovine pancreatic trypsin. Importance of interactions N-terminal to the scissible bond. AB - Hydrolyses catalyzed by bovine pancreatic trypsin and porcine pancreatic kallikrein were studied using synthetic peptide substrates of the type E chi-L chi 2-L chi 1 decreases Y and E chi-L chi 3-L chi 2-L chi 1 decreases Y with L chi 1 = Arg defining the hydrolysis position (indicated by the arrow). The leaving moiety Y was -OCH3, -NH-C6H4-p-NO2 and -Ala-NH2. Insight into interactions occurring between the active site of the enzymes and the acyl moiety of the substrates was gained by studying the influence on hydrolysis rate of structural variation of residues L chi 2 and L chi 3. Parallel analyses of the hydrolyses of the ester, anilide, and peptide substrates having the same acyl moiety considerably facilitated the interpretation of the kinetic data. Trypsin, but not kallikrein, displayed high reactivity even with relatively short substrates. Ac-Ala-Arg-Ala-NH2, for example, was a better substrate for trypsin than for kallikrein by a factor of 1.3 X 10(4) in terms of kcat and 5.9 X 10(4) in terms of kcat/Km. Reactivity differences of such magnitude were related to two main differences in enzyme-substrate interactions: the interaction of the arginine side chain of the substrate with the specificity pocket of the enzyme is optimal for trypsin but poor for kallikrein and the number of hydrogen bonds formed by the enzyme with the backbone section of the substrate on both sides of the specific residue is larger in the case of trypsin. The latter difference is found to be related to the structure of amino-acid residue 192 which is glutamine in trypsin and methionine in kallikrein. PMID- 3650054 TI - The psychotherapist nurse as clinical researcher. PMID- 3650055 TI - Neuroendocrine factors in affective disorders. PMID- 3650056 TI - Shedding light on "SAD"ness. PMID- 3650057 TI - Impact of circadian rhythm research on approaches to affective illness. PMID- 3650058 TI - A comparative study of widows' and widowers' perceived social support during the first year of bereavement. PMID- 3650059 TI - Nurses' knowledge of the impact of parental alcoholism on children. PMID- 3650060 TI - Psychiatric-mental health assessment: a new look at the concept. PMID- 3650061 TI - Fantasy: it's more than just a nice thought. PMID- 3650062 TI - The relationship of the severity of assault to blame placement for assault. PMID- 3650063 TI - Staff roles and responsibilities in incidents of patient violence. PMID- 3650064 TI - How patients view recovery: what helps, what hinders. PMID- 3650065 TI - [Bacteriological study of acute otitis media in children. Therapeutic consequences]. AB - One hundred children presenting with acute otitis media underwent a bacteriological study of otitis exudate over a 18 month period. The bacteria found were as follows: Streptococcus pneumoniae (24), Haemophilus influenzae (19), Staphylococcus aureus (12), Streptococcus pyogenes (7), Branhamella catarrhalis (3), and 18 Gram negative bacilli (including 7 Pseudomonas aeruginosa and 11 enterobacteriaceae). One pathogenic bacterium was isolated in 56 cases, 2 or more in 12 cases and none in 32 cases. In the age categories 0-1 year (47 cases) and 1-3 years (31 cases), S. pneumoniae and H. influenzae were the main organisms found, followed by S. pyogenes in children older than 3 years (22 cases). With respect to the antibiotics used for treating otitis, 5/22 S. pneumoniae and 4/17 H. influenzae were erythromycin resistant (9/17 had an intermediate susceptibility) and 7/19 H. influenzae and 1/17 S. pneumoniae were cotrimoxazole resistant. None of the S. pneumoniae and 2/19 H. influenzae were ampicillin resistant. These 2 H. influenzae and 2/3 B. catarrhalis were beta lactamase producers. They were sensitive to the combination of amoxicillin with clavulanic acid. PMID- 3650066 TI - Stomal therapy: an unusual case study. PMID- 3650067 TI - Primary health care by Aboriginals for Aboriginals. PMID- 3650069 TI - Nurse & the law. Coroner's Court: purpose and jurisdiction. PMID- 3650068 TI - Making deinstitutionalization work. PMID- 3650070 TI - The elderly patient: a medication problem. PMID- 3650071 TI - Industrial relations bill reforms. PMID- 3650072 TI - Sharing research ideas. PMID- 3650073 TI - Physical assessment skills for RNs? PMID- 3650074 TI - Health: a struggle for survival. PMID- 3650075 TI - Jumping hurdles in geriatric rehabilitation. PMID- 3650076 TI - Nurse & the law. Shifting ground in public policy. PMID- 3650077 TI - Turnover rates of HMG-CoA reductase mRNA: role of pituitary and thyroid hormones. AB - When normal or hypophysectomized rats maintained on a diet containing mevinolin and colestipol were switched to a normal chow diet, HMG-CoA reductase mRNA fell rapidly with a half-life of 3 hrs. After a 90 min lag period, reductase activity and immunoreactive protein fell in parallel with the mRNA in normal rats. In hypophysectomized rats, reductase activity and protein required 10 and 18 hrs, respectively to fall to 50% of their original levels. Administration of thyroid hormones to hypophysectomized rats resulted in a 3 to 4 fold stabilization of reductase mRNA suggesting that the increased mRNA levels are due in part to a posttranscriptional regulatory effect of thyroid hormones. PMID- 3650078 TI - Building better workers. PMID- 3650079 TI - On-the-job accommodation. An OHN commitment. PMID- 3650080 TI - Support for workers with AIDS. Workplace discrimination as perceived by gay men with AIDS or ARC. PMID- 3650082 TI - Health education in the workplace. PMID- 3650081 TI - Noise-induced tinnitus. PMID- 3650083 TI - The new tax law. How it affects nurses. PMID- 3650084 TI - The role of the cytosolic fraction and of initiation factor eIF-2 for changes of the rate of protein synthesis during liver regeneration. AB - The protein synthesis-stimulating activity of the cytosolic fraction from regenerating rat liver was tested in a cell-free system using washed polysomes from normal rat liver. This activity undergoes significant changes during liver regeneration after partial hepatectomy (p.h.). An initial decrease until 16 h after p.h. is followed by a significant increase until 24 h after p.h. Beyond 32 h after p.h. the activity begins to decline again. Evidence is presented that these changes of the cytosolic activity may not be due to alterations in the distribution of protein synthesis-stimulating factors between the microsomal and the cytosolic fraction. The Met-tRNAf-binding activity of the cytosolic fraction changes during liver regeneration analogously to the protein synthesis stimulating activity measured in the polysomal assay. This indicates that initiation factor eIF-2 is involved in the observed changes of the cytosolic activity. This conclusion could be confirmed by addition of purified eIF-2 to the polysomal assay system. Addition of eIF-2 to cytosolic fractions of low endogenous protein synthesis-stimulating activity (16 h after p.h.) enhances amino-acid incorporation to a significantly higher extent than addition to highly active cytosolic fractions (24 h and 32 h after p.h.). From these results it is concluded that changes in eIF-2 plays an essential role in the described alterations of the cytosolic activities during liver regeneration. PMID- 3650085 TI - Kallikrein (kininogenase) in the mouse nephron: effect of dietary potassium. AB - Kininogenase activity of kallikrein was measured in microdissected mouse nephron segments using kininogen from dog plasma and a radioimmunoassay for bradykinin. When single nephron segments were examined, results showed a large scatter. This was found to be due to heterogeneity of distal convoluted tubules (DCT) from different nephrons, since replicate measurements in pools of DCT structures did not show this degree of variation. Nearly 20% of activity was accessible to extracellular substrate when freshly dissected segments were incubated in isoosmotic media. Freezing and thawing which markedly releases activity of intracellular enzymes, did not significantly elevate kininogenase activity. On the other hand deoxycholate and trypsin treatment increased tubular kininogenase activity in an additive fashion. A detailed analysis of microdissected tubule fragments revealed that kallikrein is concentrated in late distal convoluted tubule before entering a branching point (connecting tubule). In contrast initial portions of distal convoluted tubules and cortical collecting tubules contained only little kallikrein activity. Potassium rich diet increased basal and total activity 5-fold, when compared to a potassium poor diet. PMID- 3650087 TI - Theory development in nursing: Australian nurses advance global debate. PMID- 3650086 TI - Professional ethics in nursing: a philosophical analysis. PMID- 3650088 TI - Distance education: an option for gerontic nurses. PMID- 3650089 TI - Nursing diagnosis: what is it? PMID- 3650090 TI - Part-time, mixed mode study: flexibility in a nursing degree course. PMID- 3650091 TI - Intermittent subcutaneous injection. A new look at an old problem. PMID- 3650092 TI - An approach to hospice program evaluation. The use of Donabedian theory to measure success. PMID- 3650093 TI - The spiritual moment of death. Preparing everyone for a patient's death. PMID- 3650094 TI - Oral thrush in the oncologic patient. Therapy must be tailored. PMID- 3650095 TI - Acadia house. Sanctuary for hope. PMID- 3650096 TI - Compassion, conviction, commitment. Creed for quality hospice care, core of hospice burnout. PMID- 3650097 TI - [Demonstration of methicillin-resistant Staphylococci using the broth microdilution method]. AB - The increasing incidence of methicillin resistant staphylococci rendered more important the problem of their detection, by the susceptibility tests, particularly by the broth microdilution methods. The effects of the addition of 2% NaCl to the Cation Supplemented Mueller Hinton Broth (CSMHB) on the MICs of penicillinase resistant penicillins (PRP) and of other antibiotics have been studied on 100 strains of staphylococci isolated by pathological materials. In 13% of the studied strains the MIC of oxacillin in CSMHB plus 2% NaCl was at least 4 times greater than the value found in the absence of NaCl. In the same experimental conditions a ratio between MICs equal or greater than 4 dilutions resulted in 69% of the strains for the gentamicin and in 93% of the strains for the amikacin. Such variation in the value of MIC determined a change in the category of susceptibility (from sensitive to intermediate or resistant and from intermediate to resistant) in 10% of the strains for the oxacillin, in 28% for the gentamicin and 41% for the amikacin. To improve detection of methicillin resistant staphylococci without altering the MICs of other antibiotics (aminoglycosides), it is necessary to perform the broth microdilution tests with CSMHB and with CSMHB plus 2% NaCl. CSMHB plus 2% NaCl will be used for testing PPR and cephalosporin, while CSMHB for the other antibiotics. PMID- 3650098 TI - Examination of HTLV-III. PMID- 3650099 TI - Lack of endemic HIV infection in Venezuela. PMID- 3650100 TI - Neutralizing antibodies and the course of HIV-induced disease. AB - The capacity to neutralize the human immunodeficiency virus (HIV) in vitro was examined in 52 sera obtained from 23 seropositive individuals in addition to 7 negative control sera. Neutralization was measured as the activity of a serum to protect MT-4 cells against the cytopathic effect of HTLV-IIIB. Virus neutralization depended on HIV antibodies. Some sera had HIV neutralizing antibody titers of several thousands. All serum samples had been titrated in two ELISAs based either on disrupted HTLV-IIIB or on a bacterially synthesized polypeptide (ENV-80) of gp41 as a test antigen. The correlation of neutralizing activity of the sera with ELISA titers was low. A correlation of serum neutralizing titers with the stage of the disease could not be observed. However, in a longitudinal study with 6 patients over up to 22 months an increase in neutralizing antibodies seemed to protect against progression of the disease. The implications of these findings for antibody treatment and vaccine development are discussed. PMID- 3650101 TI - Structure of the long terminal repeat of simian lymphotropic virus type III (African green monkey) and its relatedness to that of HIV. AB - The simian T-lymphotropic virus type III (STLV-III[AGM]) is a retrovirus in wild African green monkeys which is serologically related to the human T-lymphotropic virus type III (HTLV-III/LAV-1/HIV) and other related human retroviruses. The long terminal repeats (LTR) contained in clones of viral DNA of (STLV-III[AGM]) were subcloned in M13 and their DNA sequence was determined and compared with that of HIV (HTLV-III[BH10]). The STLV-III(AGM) LTR is considerably larger than that of HTLV-III(BH10) (800 bp vs 634 bp) and contains a 498 bp U3 region, a 176 bp R region, and a 126 bp U5 region. These two LTR sequences share regions of significant homology. Regions of greatest homology include the 5' portion of U3, a core enhancer sequence in U3, sequences including and surrounding the TATAA promoter box in U3 and the AATAAA polyadenylation/termination signal in R, and the 3'-most region of U5. The relatively larger size of the STLV-III LTR is due to the presence in all three parts of the LTR of sequences which have no apparent homolog in the HIV LTR. Overall, the two LTRs are 47% homologous. Even greater homology (75%) is evident with a 300 bp segment including R and some of U3 from the LTR of another human retrovirus, HIV-2/LAV-2. The STLV-III LTR contains an imperfect 28 bp direct repeat in the R region which is not present in HIV. There are no obvious direct repeats in U3 homologous to the 10 bp repeat in the U3 of HTLV-III.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3650102 TI - Extracorporeal shock wave lithotripsy (ESWL): patient education & nursing care. PMID- 3650103 TI - Nursing math--no problem! PMID- 3650104 TI - Outstanding ADN student: Doi Thiminh Nguyen. PMID- 3650105 TI - Battered women--the nurse's role. PMID- 3650106 TI - This epidemic of family violence. PMID- 3650108 TI - Care of long hair. PMID- 3650107 TI - Options: life as a ship's nurse. PMID- 3650109 TI - Catalysis by human leukocyte elastase. Aminolysis of acyl-enzymes by amino acid amides and peptides. AB - Acyl-enzymes of human leukocyte elastase (HLE) were generated in situ during the hydrolysis of peptide thiobenzyl esters and served as substrates for aminolysis by a variety of amino acid amides and short peptide nucleophiles. For amino acid amides, there is a positive correlation between nucleophilic reactivity toward N methoxysuccinyl (MeOSuc)-Ala-Ala-Pro-Val-HLE and the hydrophobicity of the side chain. For peptides, nucleophilicity toward MeOSuc-Ala-Ala-Pro-Val-HLE decreases dramatically with increasing chain length. Combined, these results suggest that substrate specificity for the P1' residue may be more dependent on side chain hydrophobicity than on specific, structural features of the side chain and there may be no important binding interactions available past S1'. Kinetic parameters were also determined for the nucleophilic reactions of PheNH2 and TyrNH2 with MeOSuc-Pro-Val-HLE, MeOSuc-Ala-Pro-Val-HLE, MeOSuc-Ala-Ala-Pro-Val-HLE, and MeOSuc-Ala-Ala-Pro-Ala-HLE. Reactivity of these acyl-enzymes toward nucleophilic attack displays no dependence on peptide chain length but does increase significantly for the substrate with Ala at P1. This same correlation between reactivity and acyl-enzyme structure is also seen for nucleophilic attack by water. PMID- 3650110 TI - The biological properties of bovine parathyroid hormone (1-41), a fragment generated from the native hormone by human leukocytes. AB - Native bovine parathyroid hormone (bPTH) was found to be readily cleaved with human leukocyte elastase to yield the fragments bPTH(1-41) and bPTH(42-84). These were then isolated by reverse-phase HPLC and characterised by gas-phase sequencing and amino acid analysis. The biological activities of these fragments were assessed in an adenylate cyclase bioassay using the rat osteosarcoma cell line UMR106. bPTH(1-41) was found to have approximately twice the molar potency of the native hormone from which it was derived. bPTH(42-84) had no biological activity and did not modulate the adenylate cyclase response to these cells to the native hormone. The possible physiological significance of these observations is discussed. PMID- 3650111 TI - HIV-specific antibody among voluntary blood donors in Lower Saxony (FRG). AB - Anti-HIV test results of the Red Cross Blood Transfusion Service of Lower Saxony from 1 June 1985 to 31 July 1986 inclusive were analysed retrospectively. Nine out of 70,936 donors who had not donated blood before 1 June 1985 (first-time donors) and 9 out of 261,231 donors who had donated blood before this date (repeating donors) were found anti-HIV confirmed positive at the time of the first blood donation during the study period. The prevalence of HIV antibody in first-time donors was significantly higher than in repeating donors (p less than 0.01). It was concluded that some members of risk groups used blood donation to obtain an anti-HIV test result. One out of 30,300 blood donations was confirmed anti-HIV positive. The results of this study justify the transfusion of blood donations that are reactive only in the initial ELISA test. PMID- 3650112 TI - Managing change effectively. PMID- 3650114 TI - The father's involvement in the cesarean birth experience. PMID- 3650113 TI - Moving to the U.S.A. The implications and the price you might have to pay. PMID- 3650115 TI - Reappraising cesarean births. PMID- 3650116 TI - PHC: primary health care in perspective. PMID- 3650117 TI - Primary health care and Canada's indigenous people. PMID- 3650118 TI - Nurses and traditional healers: now is the time to speak. PMID- 3650120 TI - Preparing to work in a multicultural society. PMID- 3650119 TI - Native adolescents in crisis. PMID- 3650121 TI - David. PMID- 3650122 TI - Working together for quality care. PMID- 3650123 TI - [Care of the mouth]. PMID- 3650124 TI - [Elizabeth Kubler-Ross and her philosophy of dying]. PMID- 3650125 TI - Nonpharmacologic management of high blood pressure. PMID- 3650127 TI - NPs to lose insurance coverage. PMID- 3650126 TI - Birth alternatives for consumers. PMID- 3650128 TI - Quality care for nursing home residents. PMID- 3650129 TI - The nurse is in. PMID- 3650130 TI - Speaking of mental status, with less confusion. PMID- 3650132 TI - [Proper determination of nursing problems (nursing diagnosis)]. PMID- 3650131 TI - Restorative nursing in a long term care facility. PMID- 3650133 TI - [Care of patients with adrenal medulla tissue implanted into the caudate nucleus]. PMID- 3650134 TI - [Analysis of mediastinopericardial fluid drainage after open-heart surgery]. PMID- 3650135 TI - [Pre-operative preparation of the intestinal tract with Chinese materia medica]. PMID- 3650136 TI - [Care of patients with acute urinary tract infection treated by Chinese herbal drugs]. PMID- 3650137 TI - [Use of computers in the administration of nursing work in hospitals]. PMID- 3650138 TI - [Computer-aided nursing]. PMID- 3650139 TI - [Clinical uses of the concentration-temperature relationship curve of alcohol]. PMID- 3650140 TI - [Spasm and asphyxia occurring after ketamine or gamma-sodium hydroxybutyrate anesthesia. Report of 2 cases]. PMID- 3650141 TI - [Method of writing a nursing plan]. PMID- 3650142 TI - Evaluating conceptual models for use in critical care nursing practice. PMID- 3650143 TI - Conceptual models of nursing: application to critical care nursing practice (continuing education credit). PMID- 3650144 TI - Roy Adaptation Model: ICU application. PMID- 3650145 TI - Interviews: opinions and conceptual models from other critical care nurses. PMID- 3650146 TI - Amiodarone therapy: reducing the side effects. PMID- 3650147 TI - Your new critical care unit: coping with construction. PMID- 3650148 TI - Nursing care delivery: into the 1990s. PMID- 3650150 TI - Altered cardiac output: an assessment tool. PMID- 3650151 TI - The family nurse system: a variation in primary nursing. PMID- 3650149 TI - Naphthalene poisoning: critical care nursing techniques. PMID- 3650152 TI - Teaching interviewing skills: a three function model [continuing education credit]. PMID- 3650153 TI - Grid analysis for stress management. PMID- 3650155 TI - [The respiratory distress syndrome in newborn infants]. PMID- 3650154 TI - Cytochalasin B selectively releases ovalbumin mRNA precursors but not the mature ovalbumin mRNA from hen oviduct nuclear matrix. AB - Hen oviduct nuclear matrix-bound mature ovalbumin mRNA is released from the matrix in the presence of ATP, while the ovalbumin mRNA precursors remain bound to this structure. Detachment of the mature mRNA from the matrix by ATP as well as ATP-dependent efflux of mRNA from isolated nuclei were found to be inhibited by cytochalasin B. On the other hand, in the absence of ATP, cytochalasin B exclusively caused the release (and nucleocytoplasmic efflux) of the ovalbumin messenger precursors, but not of the mature mRNA. After cytochalasin B treatment, actin could be detected in the matrix supernatant. Phalloidin which stabilizes actin filaments did not cause RNA liberation in the absence of ATP, but inhibited the ATP-induced detachment of mature mRNA. RNA release was also achieved with a monoclonal antibody against actin but not with monoclonal antibodies against tubulin and intermediate filaments. These results suggest that actin-containing filaments are involved in the restriction of immature messengers to the cell nucleus. PMID- 3650157 TI - [Kidney involvement in injuries]. PMID- 3650156 TI - [Vertebrogenic cardialgia in people of different ages]. PMID- 3650158 TI - [Adenoma of the prostate]. PMID- 3650159 TI - [Resuscitation in heart arrest]. PMID- 3650160 TI - [The immunoprophylaxis of infectious diseases as a means of achieving health for all]. PMID- 3650161 TI - [Diagnosis of myocardial infarct]. PMID- 3650162 TI - [Method for propagandizing rational nutrition]. PMID- 3650163 TI - [Situation-simulating games in the teaching of obstetrics]. PMID- 3650164 TI - [Prevention of traumatism and its sequelae in agricultural production]. PMID- 3650165 TI - [Therapeutic use of saline waters]. PMID- 3650166 TI - [Abortions. Their causes and the methods of examination]. PMID- 3650167 TI - Cardiac tamponade in the oncology patient. PMID- 3650168 TI - Postoperative nursing care of the patient who has undergone the Fontan procedure. PMID- 3650169 TI - Techniques for measurement of sleep in critical care. PMID- 3650170 TI - Possible long-term effects of high technology on the child and family. PMID- 3650171 TI - Implications of refusing an employer's directives. PMID- 3650172 TI - Intensive care nursing in Scandinavia. PMID- 3650173 TI - Vacation victims: when unexpected illness strikes away from home. PMID- 3650175 TI - Wellness for nurses. PMID- 3650174 TI - Employment of new graduates: implications for critical care nursing practice. PMID- 3650176 TI - How should the nurse clinician approach application of findings from research reports? PMID- 3650177 TI - Childhood suicide: a national tragedy. PMID- 3650178 TI - Leadership in the wellness movement: a new role for nurses. PMID- 3650179 TI - Can nurses market wellness? PMID- 3650180 TI - The "wellness canary" exercise. PMID- 3650181 TI - Leucocyte elastase in chronic inflammatory bowel diseases: a marker of inflammatory activity? AB - Leucocyte elastase is a neutral proteinase which plays an important role in the pathogenesis of inflammatory disorders. Infiltration of bowel mucosa by neutrophil and eosinophilic granulocytes is a characteristic feature of chronic inflammatory bowel diseases. We studied plasma elastase in 44 patients suffering from Crohn's disease or ulcerative colitis. Plasma levels were significantly higher in these patients compared to 7 patients with non-inflammatory bowel diseases or 53 healthy controls. Elevated plasma levels were more often found in patients with active inflammation than in those with inactive disease. Elastase did neither correlate with leucocyte counts, serum albumin, ESR, alpha 1 proteinase inhibitor and orosomucoid nor with clinical indices or the faecal excretion of 111In-labelled granulocytes. In serial studies of 15 patients, elastase did not always run parallel to the disease activity. We conclude that plasma elastase does not reliably indicate the inflammatory activity in chronic inflammatory bowel diseases. PMID- 3650182 TI - Enzyme substitution in pancreatic disease. AB - Pancreatic enzyme substitution may principally be used in few indications, whereof most of them are only relative. The most obvious indication is malabsorption in chronic pancreatic insufficiency, which is always associated with an advanced form of the disease. Only when the exocrine secretory capacity of the pancreas is 2% or less does the patient exhibit diarrhea with a daily excretion of 25 g of fat or more on a normal diet. There are also strong indications that pain can be controlled in some patients with chronic pancreatitis, and the mechanism for this can be given a plausible explanation. As the pancreatic enzymes (with a few interesting exceptions) are resistant to the hydrochloric acid of the stomach, the galenic preparation must be given attention, and means of reducing the amount of acid in the stomach can be considered. However, the patients' compliance is just as important; the dosage must be individualized. The enzyme preparations must be easy to handle and all patients on regular medication must be given full information of the goals of the therapy. The socio-psychological side effects of the chronic disease should also be considered to get an optimal effect of the enzyme substitution in pancreatic disease. PMID- 3650183 TI - Conservative treatment of chronic pancreatitis. AB - Pain relief and compensatory therapy of exocrine and endocrine pancreatic insufficiency is the aim of conservative treatment of chronic pancreatitis. Pain relief may be achieved by analgetics, dietary restrictions, alcohol abstinence, enzyme substitution, and operative procedures. Decompensated exocrine pancreatic insufficiency, i.e. steatorrhea, is a late complication of chronic pancreatitis. It requires diet, vitamin, and enzyme replacement. Failure of the latter may be due to inactivation of the enzymes by gastric acid. Finally, diabetes mellitus, secondary to chronic pancreatitis, is managed with diet and insulin. Pancreatogenic diabetes responds only for a short period, if at all, to oral antidiabetics. PMID- 3650184 TI - Nursing research on acute confusional states in the elderly. PMID- 3650185 TI - [Chronic fetomaternal macrotransfusion]. AB - A case of massive chronic fetomaternal transfusion with a loss of 500 ml blood is reported. A review of 24 cases covering the last 10 years shows that chronic fetomaternal transfusions do not lead to intrauterine dystrophy. During birth there is a danger of acute decompensation, which led to an irreversible shock and death in five of the 24 children. Hepatomegaly (7/24) often accompanies cardial insufficiency. The histories of the pregnancies are usually normal. In 5 of 17 women fetal distress was only indicated by antepartal cardiotocography; premature delivery was induced in these cases. PMID- 3650186 TI - [The blood plasma kinin system in rabbits at the early stages of postnatal ontogenesis]. PMID- 3650187 TI - The components of a comprehensive district health service for elderly people--a personal view. PMID- 3650188 TI - Caring for older adults in a nursing wellness centre. PMID- 3650189 TI - An ageing Britain--what is its future? PMID- 3650190 TI - Maintaining continence. PMID- 3650191 TI - Pet therapy on a hospital ward. PMID- 3650193 TI - Aspects of catheter care. PMID- 3650192 TI - Leg ulcers--setting standards of care. PMID- 3650194 TI - Care in the community. PMID- 3650195 TI - A district health service for elderly people--2. PMID- 3650196 TI - [A study on the therapy of leptospirosis with gentamycin]. PMID- 3650197 TI - Stress and the I.C.U. Is it for you? PMID- 3650198 TI - Nurses in the closet: is nursing open and receptive to gay and lesbian nurses? PMID- 3650199 TI - Fear of surviving nursing. PMID- 3650200 TI - Visiting nurse. PMID- 3650202 TI - A "difficult" patient? PMID- 3650201 TI - A conflict born of insecurity. PMID- 3650203 TI - Colonization resistance: a guide to antibiotic policy in the ICU. PMID- 3650204 TI - Surgical wound infections: prospective study of 4,468 clean wounds. AB - A prospective four-year study on the infection rate of clean operative wounds is presented. From January 1982 to June 1985, a nurse epidemiologist and a medical team assessed 4,468 operative procedures, from the day of surgery to the patients' discharge from the hospital. The infection rate was 3.2%. A higher incidence of wound infection was detected in patients requiring emergency operations (5.1%), in drained wounds (5.4%), and in patients with conditions thought to predispose to infection, such as advanced cancer, hepatic cirrhosis, diabetes, nephrotic syndrome, previous splenectomy, and treatment with immunosuppressive drugs (7.8%). Age over 65 did not influence infection rates. There were up to tenfold differences in infection indices between surgeons performing the same clean procedures. The continued monitoring of clean wound infection rates allowed the early detection and control of infection outbreaks. Providing periodic information on infection rates to the different surgical services was associated with decreasing infection rates over time. PMID- 3650205 TI - The analysis of the impact of a mild, low-iodine, lotion soap on the reduction of nosocomial methicillin-resistant Staphylococcus aureus: a new opportunity for surveillance by objectives. AB - A significant unremitting increase in the incidence of nosocomial methicillin resistant Staphylococcus aureus (MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA--the intensive care unit, and a medical division. Over a two year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two year period. From year to year, the nosocomial MRSA rate decreased 80% (t test, P = 0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitive Staphylococcus aureus (MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine handsoap permanently at all sinks within the hospital. PMID- 3650206 TI - Effect of long-term storage on sterile status of devices in surgical packs. AB - We investigated the effect of the following on the sterile integrity of surgical packs: four wrapping materials (two-ply reusable, nonbarrier wovens, both new and previously used; disposable, barrier nonwovens; and polypropylene peel pouches), dustcovers, two storage locations, and storage times ranging from 2 to 50 weeks. Two hundred sixty-three packs containing stainless steel coupons were prepared, wrapped, sterilized, and stored. Half of the packs were dustcovered prior to storage. At monthly intervals for a year, packs of each type were opened in a laminar flow hood, and the coupons inoculated into trypticase soy broth. The coupon contamination probabilities were 0.019 for reusable, woven packs; 0.017 for disposable, nonwoven packs; and 0.016 for peel pouches. These differences were not significant. The probability of finding a contaminated coupon in any pack after 50 weeks was 0.018. No trend toward increased probability of contamination over time was observed for any of the pack types studied. PMID- 3650207 TI - Unifying the strategies of primary health care and nursing education. AB - Nurses prepared to work co-operatively with the world's peoples in achieving "Health for All" have a vital role in primary health care. At the University of Illinois, Nursing in Primary Health Care is offered through the Collaborative Baccalaureate Project, a basic instructional system which can be adapted to different educational settings. It is presented here as an example of an original approach for effective delivery of primary health care content. PMID- 3650208 TI - Student competence profile: the Wollongong approach. AB - The difficulty in developing clinical assessment tools for the clinical evaluation of nursing students which will motivate the students is a problem faced by all nurse educators. At the University of Wollongong, New South Wales, the lecturing staff in the new Diploma of Applied Science (Nursing) programmes have formulated a Student Competence Profile (SCP) for the clinical evaluation of students. This SCP, which they describe here, has been organized to reflect the objectives of the course curriculum. PMID- 3650209 TI - The safe motherhood initiative: a call to action. Concluding statement of the International Safe Motherhood Conference. (Nairobi, 10-13 February 1987). PMID- 3650210 TI - Nursing education in Japan and its future trends. AB - As its title indicates, this article describes the development of Japanese nursing education over several decades, the stage it has reached today, the aspirations of the nursing profession for the future upgrading of nursing education, and the trends which are evolving in this direction. PMID- 3650211 TI - Moving from the general to the particular. PMID- 3650212 TI - "Autonomy" and the "quality of life": the dismantling of moral terms. PMID- 3650214 TI - Truth in testing for the professions. PMID- 3650215 TI - Confidentiality: duty or danger? PMID- 3650216 TI - Influencing immunisation uptake in pre-school children. PMID- 3650213 TI - Voluntary organizational activities to address impaired nursing practice. PMID- 3650217 TI - Health visitors' views on immunisation. PMID- 3650218 TI - Increasing health visitor involvement in child health surveillance. PMID- 3650219 TI - Campaign for a measles-free zone. PMID- 3650220 TI - An ABC of alternative medicine. Osteopathy. PMID- 3650221 TI - Improving vaccination levels. PMID- 3650222 TI - Approaches to behaviour patterns in school age children. PMID- 3650223 TI - The gifted child: problem or privilege. PMID- 3650224 TI - Child health profile. PMID- 3650225 TI - Childhood enuresis. PMID- 3650226 TI - Visual disability and associated factors in the elderly. PMID- 3650227 TI - A personal view of alcoholism. PMID- 3650228 TI - Growing old, not unhealthy. PMID- 3650229 TI - The needs of the elderly: a case study. PMID- 3650230 TI - Assessing the counselling of HIV positive clients. PMID- 3650231 TI - Counselling workshops. PMID- 3650232 TI - The needs of the well elderly. PMID- 3650233 TI - The health visitor as counsellor: a framework for interpersonal skills. PMID- 3650234 TI - One year working with the Travellers. PMID- 3650235 TI - Evaluating the health visiting process using a model of nursing. PMID- 3650236 TI - Health education for a Traveller community. PMID- 3650237 TI - Health needs in Uganda. PMID- 3650238 TI - A sleep problems information leaflet. PMID- 3650239 TI - Development of caseload and community profiles. PMID- 3650240 TI - Developments in fieldwork teaching. PMID- 3650241 TI - A review of health visitor establishment at a health centre and a GP practice. PMID- 3650242 TI - Violence against staff: an increasing risk. PMID- 3650243 TI - People, not paper. PMID- 3650244 TI - Effective teaching of home i.v. therapy. PMID- 3650245 TI - Meeting the challenge of alcohol and drug abuse in the older adult. PMID- 3650246 TI - Falls: a challenge to home health aides. PMID- 3650247 TI - Multiple sclerosis: the inner world. PMID- 3650248 TI - Entombment of spirit. PMID- 3650250 TI - Management of contractures. PMID- 3650249 TI - Neuroleptic malignant syndrome. PMID- 3650252 TI - Promotion. PMID- 3650251 TI - Our nation's walking wounded: the chronically ill. PMID- 3650253 TI - How will Congress define "catastrophe"? PMID- 3650254 TI - Obesity in children. PMID- 3650255 TI - Nursing of families with an infant who requires home apnea monitoring. PMID- 3650256 TI - School-age children's fears of medical experiences. PMID- 3650257 TI - Nursing care plan for adolescents and young adults with advanced cystic fibrosis. PMID- 3650258 TI - Diabetic camping: effect on knowledge, attitude, and self-concept. PMID- 3650259 TI - Inhibition of infectivity of human immunodeficiency virus by oxetanocin. PMID- 3650260 TI - Women in transition: being versus becoming or being and becoming. PMID- 3650262 TI - World agricultural policy and its effect on women's health. PMID- 3650261 TI - Role of women as a motivative and collective force in international development. PMID- 3650263 TI - Effects of educated professionals on the health and care of women in Tanzania. PMID- 3650264 TI - Healthy women and the future. PMID- 3650265 TI - Social support among Filipino pregnant women in an atmosphere of socioeconomic political uncertainty. PMID- 3650266 TI - New reproductive technologies and women's rights: framing the ethical questions. PMID- 3650267 TI - Framing the ethical issues in new reproductive technologies. PMID- 3650268 TI - Concluding remarks: a feminist perspective. PMID- 3650269 TI - Primary structure requirements for the binding of human high molecular weight kininogen to plasma prekallikrein and factor XI. AB - We recently identified residues 185-224 of the light chain of human high molecular weight kininogen (HMWK) as the binding site for plasma prekallikrein (Tait, J.F., and Fujikawa, K. (1986) J. Biol. Chem. 261, 15396-15401). In the present study, we have further defined the primary structure requirements for binding of HMWK to factor XI and prekallikrein. In a competitive fluorescence polarization binding assay, a 31-residue synthetic peptide (residues 194-224 of the HMWK light chain) bound to prekallikrein with a Kd of 20 +/- 6 nM, indistinguishable from the previously determined value of 18 +/- 5 nM for the light chain. We also prepared three shorter synthetic peptides corresponding to different portions of the 31-residue peptide (residues 205-224, 212-224, and 194 211), but these peptides bound to prekallikrein more than 100-fold more weakly. Factor XI also bound to the same region of the HMWK light chain, but at least 58 residues (185-242) were required for optimal binding (Kd = 69 +/- 4 nM for the light chain; Kd = 130 +/- 50 nM for residues 185-242). The four synthetic peptides inhibited kaolin-activated clotting of blood plasma with potencies paralleling their affinities for prekallikrein and factor XI. Peptide 194-224 can also be used for rapid affinity purification of prekallikrein and factor XI from plasma. PMID- 3650271 TI - Reality orientation research. PMID- 3650270 TI - Bacteremia caused by a lactose-fermenting, multiply resistant Salmonella typhi strain in a patient recovering from typhoid fever. AB - A female patient suffered a typical attack of typhoid fever due to a lactose negative, fully susceptible Salmonella typhi strain. During convalescence she became febrile, and a lactose-fermenting S. typhi strain resistant to ampicillin, chloramphenicol, tetracycline, and trimethoprim was isolated from blood culture. This isolated was shown to harbor a plasmid which cotransferred lactose fermentation and antibiotic resistance. PMID- 3650272 TI - Health habits of elderly widows. PMID- 3650273 TI - Minority wellness promotion: a behavioral self-management approach. PMID- 3650275 TI - Assessing suicidal intent. PMID- 3650274 TI - Coping strategies of widows. PMID- 3650276 TI - Multiple losses in older adults. PMID- 3650277 TI - Metatheoretical issues: development of new theory. PMID- 3650278 TI - Aging as increasing complexity. PMID- 3650279 TI - Nursing model & research compatibility: concerns and possibilities. PMID- 3650280 TI - Funding for conceptual model building. PMID- 3650281 TI - Nursing model development. PMID- 3650282 TI - Conceptual model directions. PMID- 3650283 TI - Use of existing nursing models. PMID- 3650284 TI - Reflections--in the eyes of others. PMID- 3650285 TI - Hypnosis and pain control on an English burns unit. PMID- 3650286 TI - Stress management. PMID- 3650287 TI - Body image--a problem for intensive care patients (Part 1). PMID- 3650288 TI - The needs of relatives of patients admitted to the coronary care unit. PMID- 3650289 TI - Communicating with children in the intensive care unit. PMID- 3650290 TI - Alleviating the effects of care on the intracranial pressure (ICP) of head injured patients by manipulating nursing care activities. PMID- 3650291 TI - Equipment standards in the ITU. PMID- 3650292 TI - Community health nursing in workplace health programs: rationale and ethics. PMID- 3650293 TI - Identifying compliance incentives for screening and treatment of tuberculosis. PMID- 3650294 TI - Reentry of the head-injured survivor into the educational system: first steps. PMID- 3650295 TI - Substance abuse prevention with preschool children. PMID- 3650296 TI - Development of an in-service education program by school nurses. PMID- 3650297 TI - The effect of PROs on staff development. PMID- 3650298 TI - Getting started. Making the most of continuing education: a framework for developing programs. PMID- 3650299 TI - Closed circuit TV: an alternative teaching strategy. PMID- 3650300 TI - Quality circles: an approach adapted to health care. PMID- 3650302 TI - Designing a teaching program for outpatient antibiotic therapy. PMID- 3650301 TI - Developing a mock code training program with the nursing process. PMID- 3650303 TI - Student nurse internship program. PMID- 3650304 TI - An innovative strategy for management training. PMID- 3650305 TI - Comparing the effectiveness of two teaching methods for neurological assessment. PMID- 3650306 TI - Research utilization in a practice setting. PMID- 3650308 TI - Research challenges and programs for practice settings. AB - Several types of research programs can be developed in service settings. These can be categorized according to whether research is conducted, utilized, or facilitated. The challenges of integrating research into the clinical setting threads through each type of program. Several of the major challenges and strategies will be considered in this article. In addition, several types of research programs will be discussed, especially in terms of their policy implications. PMID- 3650307 TI - Reducing the costs of patient transfers. AB - This study examined the potential cost savings of a new patient transfer device that uses air pressure to assist in the movement of patients. The analysis for a single hospital indicates that this new technology is no less expensive than traditional patient transfer methods if only the direct costs of staff utilization are considered. However, reductions are projected for indirect costs associated with work-related back injuries. A methodology is recommended for conducting similar evaluations at other institutions. PMID- 3650309 TI - CEO succession and its relationship to CNO tenure. AB - Executive turnover and termination are complex organizational issues. In this study, Chief Executive Officer (CEO) succession and its relationship to Chief Nursing Officer (CNO) termination was explored; 12.2% of newly appointed CEOs terminated their CNO counterparts within 1 year of their appointment. Although some CNO terminations are related to CEO succession, complex organizational factors such as organizational context, contingencies, uncertainties, and life cycle must be explored to fully understand the phenomena of CNO and CEO tenure and turnover. PMID- 3650310 TI - What's in a name--or shape? AB - What does your organization chart look like? What titles do your various managers hold? For all of you who have spent so many serious hours developing organizational structures and lines of authority, the author asks you to sit back, relax, and take a break. PMID- 3650311 TI - Patterns of preparation. The nurse executive. AB - The contemporary nurse executive is a hybrid--a blend of nurse and businessperson. The type, nature, and quality of educational preparation will determine the effectiveness of the nurse executive and the influence and impact that person will have on the organization. In this article, the author highlights the scope of responsibility of the nurse executive, models for conceptualizing the role, and the essential skills. The need for quality graduate programs in Nursing Administration, closely articulated with business and management schools, is forwarded as essential to nursing's ability to prepare its own leaders. PMID- 3650312 TI - The consultation you don't want: taking charge. PMID- 3650313 TI - The exit interview technique. PMID- 3650314 TI - Continuing competency assurance. An attainable goal. PMID- 3650315 TI - Are outcomes compromised when mothers are assigned to birth centers for care? PMID- 3650316 TI - A retrospective comparison of certified nurse-midwife and physician management of low risk births. A pilot study. PMID- 3650317 TI - The use of herbs in midwifery. PMID- 3650318 TI - The use of herbs in nurse-midwifery practice. PMID- 3650319 TI - Nurse-midwifery education. PMID- 3650320 TI - Adolescent pregnancy and incest. PMID- 3650321 TI - Early discharge: outcomes of primiparas and their infants. AB - The effects of early hospital discharge on maternal and infant outcomes were studied by interviewing 21 primiparas choosing early discharge and 21 primiparas with hospital stays longer than 24 hours. Other than supervision of infants for jaundice, conditions requiring medical intervention were not linked to time of discharge. No significant differences occurred in intensity of concerns at one week postpartum. The most intense concerns of primiparas, regardless of length of stay, focused on maternal body image, infant care and behavior, and recognition of signs of illness. Women choosing early discharge had more social support at home following discharge. These findings support the need for greater nursing intervention during the puerperal period and for further research evaluating early discharge programs. PMID- 3650322 TI - Maternal-child health in Brazil. AB - An overview of the social and economic climates and the healthcare delivery systems of Brazil is presented. The Brazilian healthcare system is discussed, with particular attention directed to the status of nursing and to the perinatal health-care delivery system. Examples of Brazilian perinatal health-care practices are provided. PMID- 3650323 TI - Obstetric vacuum extraction. AB - A brief historical review of vacuum extraction, indications for use, safety considerations, mode of action, delivery technique, and discussion of nursing implications is presented. Safety and effectiveness of vacuum extraction are supported by the results of a comparative study done at Mount Sinai Medical Center in which 256 vacuum extractions and 300 randomly selected forceps deliveries were performed. Indications for use, clinical status before application, maternal complications, and immediate neonatal complications are analyzed and discussed. PMID- 3650324 TI - Electronic fetal heart rate monitoring with intrauterine fetal demise. AB - Management of patients during labor is often based upon interpretation of electronic fetal heart rate tracings. Misdiagnoses of these records can lead to inappropriate actions, including cesarean delivery for presumed fetal distress. This case study, using a heart rate tracing from a patient with intrauterine fetal death, describes the findings, reviews the origin of the electronic signal, and outlines the means to distinguish the fetal and maternal cardiac impulses. PMID- 3650326 TI - The effect of social and care environments on the disclosure practices of nurse midwives relative to methods of pain management in childbirth. AB - A multivariable model of characteristics in the nurse-patient relationship that influence the disclosure practices of nurses was developed to investigate the effects that characteristics of the nurse midwife, the patient, and the setting have on the disclosure practices reported by nurse midwives. Data were collected by a mailed questionnaire using multiple-choice questions and patient case studies. The questionnaire was sent to a random sample of 500 certified nurse midwives. No association occurred between variations in patient characteristics and the content disclosed by nurse midwives. Many of the patient demographic characteristics were observed to be significantly related to the method and time of disclosure. Results of the study suggested that the social as well as the immediate health-care environment influenced the disclosure of information. PMID- 3650325 TI - A randomized study comparing two methods of performing the breast stimulation stress test. AB - Breast stimulation has been used as a method for inducing uterine activity during testing for fetal well-being. Practitioners using the breast stimulation stress test have employed a variety of methods to stimulate the breast, yet no one has determined the effectiveness of one method over another. A study was undertaken to test the efficacy and safety of two methods of breast stimulation: manual rolling of the nipple and application of moist, hot pads to the breast before stimulation. Fifty-four high-risk patients were randomly assigned to one of two study groups. Group 1 included patients who stimulated one bare nipple intermittently. Group 2 included patients who had moist, warm washcloths applied to the breasts for five minutes before breast stimulation. No differences, in terms of efficacy and safety, were found between the two methods of breast stimulation. PMID- 3650327 TI - Age as a variable in an exercise program for the treatment of simple urinary stress incontinence. AB - This study compared the effectiveness of biofeedback on pubococcygeal muscle strengthening and simple urinary stress incontinence in older and younger women. Women aged 55 years and older and women younger than 55 years of age were taught Kegel exercises, using biofeedback, for the treatment of simple urinary stress incontinence. Eighty percent of the younger group and 67% of the older group eliminated stress incontinence. Also, the younger women required less pubococcygeal strength than the older women to control incontinence. PMID- 3650328 TI - Laser bronchoscopy. PMID- 3650329 TI - Same-day outpatient surgery: Cedars-Sinai Medical Center. PMID- 3650330 TI - The patient with essential hypertension. PMID- 3650332 TI - The nursing process: a tool for writing. PMID- 3650331 TI - Calculation of dosage and infusion rate in continuous intravenous medications (continuing education credit). PMID- 3650336 TI - Trauma in tourist towns. PMID- 3650333 TI - Purification and characterization of an elastase inhibitor derived from hyaline cartilage. AB - Articular cartilage has the ability to retard the invasiveness of inflammatory cells such as leucocytes. This resistance is in part due to the avascular nature, organization, and composition of the extracellular matrix. Extractable components (anti-invasion factors, [AIF]) within the matrix have been shown to be responsible for protecting the tissue against proteases produced by invading leucocytes. In the present study, AIF is examined for leucocyte elastase inhibitory activity using both analytical and preparative electrophoretic and chromatographic techniques. A specific leucocyte elastase inhibitor was isolated and identified as a 15,000 dalton protein on SDS-PAGE. The inhibitor is distinct from aprotinin (Trasylol) in size, electrophoretic pattern, and comparative peptide maps. The inhibitor exhibited a highly cationic (pI greater than 9.5) as well as a strong hydrophobic character. These properties of primary structure were confirmed by amino acid composition and sequence of the amino-terminal residues. The amino-terminal sequence showed no homologies to other proteins or known protease inhibitors. This matrix-derived protease inhibitor may be an important mediator in the regulation of and protection against cartilage destruction. PMID- 3650338 TI - Vignettes from a rural practice. PMID- 3650340 TI - HIV vaccine approved for clinical trials. PMID- 3650339 TI - Suramin therapy in AIDS and related disorders. Report of the US Suramin Working Group. AB - Suramin sodium is a reverse transcriptase inhibitor with in vitro activity against the human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS). Ninety-eight patients with AIDS manifest as opportunistic infections (n = 38), AIDS with Kaposi's sarcoma (n = 38), AIDS related complex (n = 20), or AIDS-associated non-Hodgkin's lymphoma (NHL) (n = 2) were treated with suramin sodium at 0.5, 1.0, or 1.5 g/wk for six weeks followed by maintenance therapy with 0.5 or 1.0 g/wk. Of 72 patients who were HIV culture positive before therapy and were assessable for subsequent HIV culture 40% became culture negative during treatment, with no apparent correlation between virus recovery and serum suramin concentration. No immunologic improvement was noted. One complete clinical remission was noted in a patient with Kaposi's sarcoma and stage IV NHL. Seven minor clinical responses were also noted. Toxic reactions were generally reversible, and included fever (78%), rash (48%), malaise (43%), nausea (34%), neurologic symptoms (33%), and vomiting (20%). Suramin-induced neutropenia was noted in 26%, thrombocytopenia in 12%, a serum creatinine level of 180 mumol/L or higher (greater than or equal to 2.1 mg/dL) in 12%, liver dysfunction in 14%, and clinical and/or laboratory evidence of adrenal insufficiency in 23%. Sixteen patients died while receiving suramin or within three weeks of discontinuation of drug therapy due to infection (n = 6), hepatic failure (n = 3), pulmonary Kaposi's sarcoma (n = 2), AIDS encephalitis (n = 2), AIDS-associated NHL (n = 1), iatrogenic hemo-pneumothorax (n = 1), or pulmonary disease of uncertain etiology. Suramin as currently administered cannot be recommended as effective therapy for AIDS. PMID- 3650341 TI - [A new profession called "surrogate motherhood"]. PMID- 3650342 TI - [Trends in obstetrical infections]. PMID- 3650343 TI - [The effects of infections during pregnancy on the mother and fetus]. PMID- 3650344 TI - [Prevention of infections during pregnancy, delivery, and puerperium]. PMID- 3650345 TI - [Nursing standards for pregnant and puerperal patients suffering from infections]. PMID- 3650346 TI - [A case report. Nursing of a patient with fetal death and puerperal fever due to uterine myoma]. PMID- 3650347 TI - [A weekly record of a practicing midwife. 3. Varied local midwifery needs]. PMID- 3650348 TI - [Effective professional education. 3. Methodology in human understanding]. PMID- 3650349 TI - [Nursing of patients with hyperemesis gravidarum]. PMID- 3650350 TI - [Gynecologic immunology. 3. Immunity in perinatal infection (1): the development of infections and the anti-infective defense system]. PMID- 3650351 TI - [Study on pregnancy, delivery, and nutritional education of obese patients]. PMID- 3650352 TI - [Anxiety and pregnant and puerperal women and their maternal awareness]. PMID- 3650353 TI - [Introduction of a personal computer to perinatology. 3. Compilation of data on tables using a personal computer]. PMID- 3650355 TI - [An essay by a midwife. 38. The result of the efforts of 9 months]. PMID- 3650354 TI - [Midwifery practice by Ainu. The texture of the uterine muscle and the outcome of delivery]. PMID- 3650356 TI - [Questions and answers on breast feeding. Apprehension of a patient who has had surgery performed on mastitis]. PMID- 3650357 TI - [Vitamin K deficiency and intracranial hemorrhage]. PMID- 3650358 TI - [The purpose of patient education at discharge from a maternity ward]. PMID- 3650359 TI - [My method in patient education at discharge from a maternity ward]. PMID- 3650361 TI - [A study of patient education at discharge from a maternity ward through psychodrama]. PMID- 3650360 TI - [Patient education for progression toward satisfactory motherhood: midwifery keypoints]. PMID- 3650362 TI - [Study on the development and changes in the maternal attitude (2). Affinity toward children and its relationship with the development of maternal attitude]. PMID- 3650363 TI - [Midwifery practice of Ainu. 4. Narrow pelvis and protection of the perineal region]. PMID- 3650364 TI - [Function of a midwife in fetal death and associated obstetrical consequences]. PMID- 3650365 TI - [Questions and answers on breast feeding. Advisability of surgery on the frenum linguae of the infant]. PMID- 3650366 TI - [A weekly record by a midwife. 4. Midwifery, a necessary profession]. PMID- 3650368 TI - [Gynecologic immunology. 4. Immunity to infections in the perinatal period (2): Infections to be noted during pregnancy (1)]. PMID- 3650367 TI - [An essay by a midwife. 39. Retracing one's mother's achievement]. PMID- 3650369 TI - [Effective professional education. 4. Methodology in human understanding (2)]. PMID- 3650370 TI - [Introduction of a personal computer to perinatology. 4. The use of data bases with a personal computer]. PMID- 3650371 TI - [Sinusoidal patterns in newborn infants]. PMID- 3650373 TI - [Comfort and psychological support of the patient having a drainage line]. PMID- 3650372 TI - [Keypoints in prevention of complications associated with the care of the drainage line]. PMID- 3650374 TI - [A catheter for cerebral angiography]. PMID- 3650375 TI - [A catheter for cardiac catheterization]. PMID- 3650376 TI - [Cerebral ventricular drainage]. PMID- 3650377 TI - [A line for the determination of intracranial pressure]. PMID- 3650378 TI - [Intratracheal intubation]. PMID- 3650379 TI - [Cannula for tracheotomy]. PMID- 3650380 TI - [Thoracic drainage, with special reference to drainage following pulmonary surgery]. PMID- 3650382 TI - [A pacemaker]. PMID- 3650381 TI - [IABP (intra-aortic balloon pumping)]. PMID- 3650383 TI - [Swan-Ganz catheter]. PMID- 3650384 TI - [Central venous catheter]. PMID- 3650385 TI - [An arterial line for hemodynamic recording]. PMID- 3650386 TI - [Fogarty catheter]. PMID- 3650387 TI - [A tubing for gastric intubation]. PMID- 3650388 TI - [Percutaneous transhepatic cholangiography with drainage (PTC-D)]. PMID- 3650389 TI - [T tube for biliary drainage]. PMID- 3650391 TI - [Catheter in hemodialysis]. PMID- 3650390 TI - [A catheter for urinary catheterization]. PMID- 3650392 TI - [Peritoneal dialysis with special reference to CAPD]. PMID- 3650393 TI - [Patient education in CAPD]. PMID- 3650395 TI - [Information gathering and observation of patients with acute respiratory insufficiency]. PMID- 3650394 TI - [Etiology of acute respiratory insufficiency]. PMID- 3650396 TI - [Problems likely to develop in nursing of patients with acute respiratory insufficiency]. PMID- 3650397 TI - [Nursing actions to ease anxiety and pain associated with acute respiratory insufficiency]. PMID- 3650398 TI - [Nursing to prevent acute respiratory insufficiency--re-evaluation of the methods]. PMID- 3650399 TI - [Nursing of a patient with acute respiratory insufficiency associated with shock]. PMID- 3650400 TI - [Nursing of a patient with acute respiratory insufficiency developing after thoracic injuries]. PMID- 3650401 TI - [Nursing of a patient with postoperative acute respiratory insufficiency]. PMID- 3650402 TI - [Nursing of a patient with refractory nervous system disease during acute respiratory insufficiency]. PMID- 3650403 TI - [Progress and indications for ventilation]. PMID- 3650404 TI - [Keypoints in artificial respiration]. PMID- 3650405 TI - [Management of patients with acute respiratory insufficiency and training of personnel in the ICU--a trial in the use of a teaching plan]. PMID- 3650406 TI - [A trial in individualized training in exercise therapy designed for diabetic patients--determination of the optimum exercise intensity and various conditions affecting the intensity]. PMID- 3650407 TI - [Fluid infusion and blood transfusion therapy]. PMID- 3650408 TI - [Nursing associated with fluid infusion and blood transfusion]. PMID- 3650409 TI - [An interim report from the Headquarters for Comprehensive National Health Planning]. PMID- 3650411 TI - [Nursing of aged, confused patients]. PMID- 3650410 TI - [Blind spots in the care of patients with musculo-skeletal system diseases]. PMID- 3650412 TI - [Nursing of patients with postoperative urination difficulties. Problems concerning organic urination disorders]. PMID- 3650413 TI - [Nursing of patients with postoperative urination difficulties. Problems concerning neurogenic urination disorders]. PMID- 3650414 TI - [Pre-operative self-care training of patients scheduled for ileostomy]. PMID- 3650415 TI - [Nursing of patients with postoperative urination disorders. Risk of urinary tract infection at each postoperative stage and its prevention]. PMID- 3650416 TI - [Nursing of patients with postoperative urination disorders. Nursing technics in sustained urinary catheterization--re-evaluation of methods to prevent infection]. PMID- 3650417 TI - [Nursing of patients with postoperative urination disorders. Keypoints in patient education in intermittent self-catheterization]. PMID- 3650418 TI - [Nursing of patients with postoperative urination disorders. Early stoma care following urinary diversion]. PMID- 3650419 TI - [Nursing of patients with postoperative urination disorders. Assistance in social rehabilitation of patients following urinary diversion]. PMID- 3650420 TI - [Nursing of patients with postoperative urination disorders. A nursing process for a patient with the development of urination disorder following total excision of intrapelvic organs]. PMID- 3650421 TI - [Nursing of patients with postoperative urination disorders. Nursing of a patient with postoperative urination disorder complicated by a urinary tract infection]. PMID- 3650422 TI - [Nursing of patients with postoperative urination disorders. Guidance of a patient incapable of self-care of the stoma--assistance in the care of skin lesion in a patient with a psychiatric disorder]. PMID- 3650423 TI - [Nursing of patients with postoperative urination disorders. Bladder training in a child with urination disorders]. PMID- 3650424 TI - [Nursing of patients with postoperative urination disorders. Postoperative urinary tract infections--with special reference to prevention of iatrogenic urinary tract infection]. PMID- 3650425 TI - [New methods for urinary diversion]. PMID- 3650426 TI - [Antifungal effects of various antiseptics on fungi]. PMID- 3650427 TI - [Hemodynamic changes in patients with acute myocardial infarction while undergoing bathing motions]. PMID- 3650428 TI - [Nursing of patients during induction of hemodialysis]. PMID- 3650429 TI - [The initial treatment of shock]. PMID- 3650430 TI - [Nursing during shock]. PMID- 3650431 TI - [Homes for the aged in Mexico]. PMID- 3650432 TI - [Blind spot in the care of patients in gynecology]. PMID- 3650433 TI - [Assistance of aged patients at meal time]. PMID- 3650434 TI - [Trends and future topics in the study of social support]. PMID- 3650436 TI - [An interview with Dr. Norbeck: trends in the research of social support]. PMID- 3650435 TI - [International nursing research in social support: background concepts and methodological issues]. PMID- 3650437 TI - [Issues of conceptualization and measurement of social support in the construction of nursing theory]. PMID- 3650438 TI - [Research on social support in the field of social welfare]. PMID- 3650439 TI - [Effects of stresses at home and work and social support on the burnout phenomenon in nurses]. PMID- 3650440 TI - [Approach to English monographs. Methodology (2)]. PMID- 3650441 TI - [Society's reactions to the outcome of student's research: the effect of a survey on sex behaviors of high school girls]. PMID- 3650442 TI - [The scope of teaching in clinical training and attitude of school authorities and clinical administrators: for better definition of the scope of teaching]. PMID- 3650443 TI - [Results and subsequent observation on the survey on the establishment of the scope of teaching in clinical nursing training]. PMID- 3650444 TI - [Status and survey on the scope of teaching in clinical nursing training. 3. Evaluation of the response expressed in the comment columns of the survey]. PMID- 3650445 TI - [Current and future problems of the scope of teaching in clinical training: description of the problems expressed by the survey]. PMID- 3650446 TI - [Effective planning in clinical training in emergency nursing: incorporation of classroom teaching and ICU training]. PMID- 3650447 TI - [Instruction on blood specimen collection]. PMID- 3650448 TI - [For systematization of nursing studies. 1]. PMID- 3650449 TI - [Nurses in clinical setting: an encounter with a schizophrenic patient]. PMID- 3650450 TI - [Interview with Ms. June F. Cochrane, President of Australia Academy of Nursing. Interview by Kazuo Hawakawa]. PMID- 3650451 TI - [Acceptance of death]. PMID- 3650453 TI - [Visit to a hospital home health service in New York]. PMID- 3650452 TI - [Tender loving care]. PMID- 3650454 TI - [JNA information: a movement to ament the Labor Standards Act]. PMID- 3650455 TI - [When I chose to be a nurse. Stoma care nurse]. PMID- 3650456 TI - [When I chose to be a nurse. Work at mentally retarded women's home as a Christian nurse]. PMID- 3650457 TI - [When I chose to be a nurse. Restart as a nurse consultant]. PMID- 3650459 TI - [When I chose to be a nurse. From pedagogy to nursing]. PMID- 3650458 TI - [When I chose to be a nurse. From psychology to nursing]. PMID- 3650460 TI - [When I chose to be a nurse. As a male psychiatric nurse]. PMID- 3650461 TI - [When I chose to be a nurse. Nursing in death as a Christian nurse]. PMID- 3650463 TI - [A study on volunteer workers for community care]. PMID- 3650462 TI - [When I chose to be a nurse. As a mother and nurse]. PMID- 3650464 TI - [American language: others and significant others]. PMID- 3650465 TI - [Medical topics: Clostridium difficile diarrhea of patients with chronic disease; rounded blood cells of runners]. PMID- 3650466 TI - [When I chose to be a nurse. Sudden death of my father]. PMID- 3650467 TI - [Health service and management: provision of service and its reimbursement]. PMID- 3650469 TI - [Learning from poetry--expression of feeling in nursing practice (supplementary comments)]. PMID- 3650468 TI - [Nurses and stress. Converting stress into energy for tomorrow]. PMID- 3650470 TI - [Acceptance of death]. PMID- 3650471 TI - [Consideration on expansion of nursing service]. PMID- 3650472 TI - [JNA information: JNA position on proposed amendment of psychiatric health law]. PMID- 3650473 TI - [Nurses and stress. Exploring relief from tension]. PMID- 3650474 TI - [Nurses and stress. Stress at HCU]. PMID- 3650475 TI - [Nurses and stress. Stress can stimulate personal development]. PMID- 3650477 TI - [Nurses and stress. Prevention of reality shock and preceptor programs for new nurses]. PMID- 3650476 TI - [Nurses and stress. In an educational setting]. PMID- 3650478 TI - [Nursing and stress]. PMID- 3650480 TI - [Nurses in clinical setting: visiting nursing]. PMID- 3650479 TI - [Nurses and stress. Relationship with family members--an experience of the visiting nursing service]. PMID- 3650481 TI - [Care of dying patients at home]. PMID- 3650482 TI - [American language--self]. PMID- 3650483 TI - [Health service and management--health service management in U.S.A. and Canada]. PMID- 3650485 TI - [Nursing system--for whose benefit? Round-table talk: nursing should be more sensitive to the changes in society]. PMID- 3650484 TI - [Medical topics: impotence; low blood pressure after heparin injection]. PMID- 3650486 TI - [Health administration--hospitals are changing]. PMID- 3650487 TI - [Study visit in U.K.--RCN nursing abroad program for a midwife]. PMID- 3650488 TI - [Expression of one's feelings--impact of words]. PMID- 3650489 TI - [Nurses in clinical setting--good peer relationships]. PMID- 3650490 TI - [Haiki (Japanese poetry) therapy for a group of psychiatric patients]. PMID- 3650491 TI - [Nursing system--for whose benefit? Reformation of nursing systems--JNA proposals and the outcome of Nursing System Deliberative Council, Ministry of Health and Welfare]. PMID- 3650492 TI - [Nursing system--for whose benefit? Need for baccalaureate programs in nursing education]. PMID- 3650494 TI - [Nursing system--for whose benefit? Assistant nurse system--should it be abolished?]. PMID- 3650493 TI - [Nursing system--for whose benefit? Nursing as a profession]. PMID- 3650495 TI - [Nursing system--for whose benefit? All RN (with degree) staffing in a ward]. PMID- 3650496 TI - [Invisible care and invisible women as health-care providers]. PMID- 3650497 TI - [American language--empathy]. PMID- 3650499 TI - [Nurses in clinical setting--elderly and care]. PMID- 3650498 TI - [Medical topics: calcium intake and blood pressure pills and breast cancer]. PMID- 3650500 TI - [Expression of feeling by writing--find out what to write]. PMID- 3650501 TI - [Maternity service in United Kingdom--study visit arranged by ICN nursing abroad program]. PMID- 3650502 TI - [Home care for diabetic patients deprived of eyesight]. PMID- 3650503 TI - [Prevention of German measles--study at a nursing school]. PMID- 3650504 TI - [Academic assemblies for nursing profession. Japanese Academy of Nursing Science]. PMID- 3650505 TI - [Academic assemblies of nursing profession. Academic assembly--how it should be]. PMID- 3650506 TI - [Academic assemblies for nursing profession. What we expect from academic assembly]. PMID- 3650507 TI - [Invisible care and invisible women as health care providers]. PMID- 3650508 TI - [Academic assemblies for nursing profession. JNA Academic Assembly on Nursing]. PMID- 3650509 TI - [American language--conflict]. PMID- 3650510 TI - [Health administration--health institutions for the elderly]. PMID- 3650511 TI - [American language--problem solving]. PMID- 3650512 TI - [Medical topics: acute gastralgia/menstruation and suicide]. PMID- 3650513 TI - [Health management--health budget curtailment]. PMID- 3650514 TI - [Male nurses in the developing country]. PMID- 3650515 TI - [Nurse as a clinician--as a ward supervisor]. PMID- 3650516 TI - [Expressing oneself--effective writing through close observation]. PMID- 3650517 TI - [Study visit to U.K. on midwifery service]. PMID- 3650518 TI - [Invisible care and invisible women as health care providers]. PMID- 3650519 TI - [Care of discharged patients at home]. PMID- 3650520 TI - [Nurses follow up discharged patients]. PMID- 3650522 TI - [Where is the best place for "vegetables"]. PMID- 3650521 TI - [Problems of elderly patients discharged to home]. PMID- 3650523 TI - [Where do they want to go?]. PMID- 3650524 TI - [Information for continuity of nursing care]. PMID- 3650525 TI - [Care of elderly in hospitals--their conditions when they are transferred to our nursing home]. PMID- 3650527 TI - [Perception and attitudes of nursing personnel in Hokkaido toward the nursing system]. PMID- 3650526 TI - [Medical social workers with discharge plan]. PMID- 3650528 TI - [Health administration: administrative work-delegation of responsibility]. PMID- 3650529 TI - [Fighting against my cancer]. PMID- 3650530 TI - [Nurse as a clinician: 27 years as a male nurse]. PMID- 3650531 TI - [Sweet memories of nurse]. PMID- 3650532 TI - [Care for the elderly in Europe: nursing home in the Netherlands]. PMID- 3650533 TI - [A perspective for effective cooperation]. PMID- 3650534 TI - [Expressing oneself--polishing the style]. PMID- 3650535 TI - [Professional and non-professional nursing in hospitals where attendance service is required]. PMID- 3650536 TI - [Visiting nursing service and problems with home health service]. PMID- 3650537 TI - [Nursing in homes for the aged where most part of work is done by home health aides]. PMID- 3650538 TI - [Working as a home aide in home for sick elderly]. PMID- 3650539 TI - [Expertness in nursing]. PMID- 3650540 TI - [Workshop on the role of nursing in primary health care]. PMID- 3650541 TI - [American language: problem solving, Part 2]. PMID- 3650543 TI - [Health administration: management in changing society and in age of definition]. PMID- 3650542 TI - [Medical topics: survival of dialysis patients trachoma]. PMID- 3650544 TI - [Experteness in nursing: nurse practitioners' activities]. PMID- 3650545 TI - [Expressing oneself: description and perspective]. PMID- 3650547 TI - [Living in imagination]. PMID- 3650546 TI - [Care for the elderly in Europe: Denmark (Part 1)]. PMID- 3650548 TI - [We can make the conference effective]. PMID- 3650549 TI - [Organization of the conference]. PMID- 3650550 TI - [Supervisors conference in our hospital]. PMID- 3650552 TI - [Supervisors conference is a learning place]. PMID- 3650551 TI - [Attending the conference as director of nursing]. PMID- 3650553 TI - [On manual for the evaluation of hospital nursing service]. PMID- 3650554 TI - [Nurse as a clinician: dilemma and excitement in ICU]. PMID- 3650555 TI - [Director of home for the sick elderly reports on: Care and home health service in my home "Sharome"]. PMID- 3650556 TI - Micropuncture localization of kallikrein secretion in the rat nephron. AB - We have used free-flow micropuncture to study the tubular locus at which kallikrein enters the urine. Kallikrein was measured by a newly developed, very sensitive assay for kininogenase activity; active kallikrein was measured directly by this assay and total kallikrein after activation of inactive kallikrein. Kallikrein was readily detected in all of 17, late distal tubular fluid-samples. In contrast, kallikrein was too low to detect in 15 of 17 proximal or in 11 of 14 early distal tubular fluid samples. Calculations indicate that less than 10% of urinary kallikrein could have derived from filtration or from proximal secretion of kallikrein. We conclude that urinary kallikrein enters the urine via secretion in the distal tubule. Filtration or proximal secretion of kallikrein does not contribute significantly to urinary kallikrein excretion. PMID- 3650557 TI - [Importance of the kallikrein-kinin system in the early differential diagnosis of mechanical jaundice and viral hepatitis]. PMID- 3650558 TI - [Rushing after lingering]. PMID- 3650559 TI - [Extensive shortage of nursing personnel: uncontrolled departure]. PMID- 3650561 TI - [Shortage of nursing personnel: is reinstatement a solution?]. PMID- 3650560 TI - [A comprehensive, holistic health service needs self-confident nursing as a partner]. PMID- 3650562 TI - [In many federal Swiss hospitals repeat courses are offered: please enter]. PMID- 3650563 TI - [Possibilities for continuing education for licensed nursing personnel at universities: longer working time?]. PMID- 3650564 TI - [The public health nurse--between demand and reality]. PMID- 3650565 TI - [Congress of the Swiss Nursing Association in Montreux: if interdisciplinary cooperation is not only a slogan but a serious concern, it demands an honest effort from everyone involved]. PMID- 3650566 TI - [Annual congress, Montreux, 30 May 1987. Interdisciplinary activities: from theory to practice]. PMID- 3650567 TI - [The social psychiatry team--a long-winded occupation]. PMID- 3650568 TI - [Considerations on interdisciplinary non-collaboration. Whose fault?]. PMID- 3650569 TI - [Readaptation in geriatrics: rethinking the organization of care]. PMID- 3650570 TI - [Nutrition and health. Look out for additives]. PMID- 3650571 TI - [Therapeutic touch: a form of human interaction]. PMID- 3650572 TI - [The school nurse today. From control of hygiene to health education]. PMID- 3650573 TI - [The nurse in the preschool sector]. PMID- 3650574 TI - [Infant and primary school nursing]. PMID- 3650575 TI - [A week in an unusual school]. PMID- 3650576 TI - [Sex education. Teaching the history of life]. PMID- 3650577 TI - [A health pilot-study at the orientation circle]. PMID- 3650578 TI - [Apprentices]. PMID- 3650580 TI - [Nurses facing adolescents and their health]. PMID- 3650581 TI - [Working with hospitalized adolescents. It all depends on trust]. PMID- 3650579 TI - [Tobacco or health? It's up to you]. PMID- 3650582 TI - [Sexuality and nursing. Routine touching]. PMID- 3650584 TI - [Nursing experts]. PMID- 3650583 TI - [Without a compass. the elderly in hospital]. PMID- 3650585 TI - [A lack of ambition]. PMID- 3650587 TI - [Daily life]. PMID- 3650586 TI - [Interdisciplinarity examined]. PMID- 3650588 TI - [Self realization as a rule of life]. PMID- 3650589 TI - [On the track of manic-depressive psychosis?]. PMID- 3650590 TI - [What may be the reason for pain in the eye?]. PMID- 3650591 TI - [Acquired immunodeficiency syndrome syndrome AIDS in nursing]. PMID- 3650593 TI - Planners need to apply Eberst's Cube Model to sexuality education. PMID- 3650592 TI - [Ampicillin]. PMID- 3650594 TI - Lyme disease: an increasing health risk for school-age children. AB - Lyme disease, a bacterial infection with noticeable short-term and serious long term consequences, is the most common tick-borne disease. First described in 1977, Lyme disease poses a significant health threat to school-age children exposed to the tick vector primarily in three specific regions of the United States. This article describes Lyme disease and its clinical signs and symptoms, and discusses the school nurse's role in identification, management, and prevention of this new health risk. PMID- 3650595 TI - Planning and evaluating a school health project. AB - School health projects allow school nurses to respond to requests from clients, to test new program components, and to address short-term health needs. This article discusses details of planning and evaluating projects in the school setting. Aspects of planning a project are discussed including facilitating and blocking forces, and considerations in evaluating a project are presented including types of evaluation and choosing the appropriate evaluation for a project. PMID- 3650596 TI - An evaluation of side effects associated with participation in a child sexual abuse prevention program. AB - Parents of children who participated in a school-based sexual abuse prevention program were surveyed regarding their children's reactions to the program. In addition, children were asked to rate their fears of various people and situations both before and after participating in the program. No increases in fear ratings were observed, and parents reported no increased frequency of problematic behaviors. Fathers reported a significant decrease in total frequency of problem behaviors after the program. No parent reported the program had an overall negative effect on their child. Instead, the program stimulated discussion in the home regarding sexual abuse. This exchange of information was important, as results indicated more than one-half the parents had not discussed the topic with their child before the program. The results suggest sexual abuse prevention programs can be implemented effectively in schools without harming the children. PMID- 3650597 TI - Effects of the bogus-pipeline on enhancing validity of self-reported adolescent drug use measures. AB - This study examined effects of a bogus objective measure (bogus-pipeline) on self reports of experimentation, frequency, intentions, beliefs, and attitudes related to alcohol, tobacco, and other drug use. One hundred ninety-one adolescents (means age = 11.74 years) were assigned randomly to one of three conditions: a bogus-pipeline with saliva collection, a bogus-pipeline only, or a questionnaire only control. A significantly greater percentage of participants in the questionnaire only condition (28%) reported having experimented with alcohol, compared to those in the bogus-pipeline only condition (22%), and the bogus pipeline with saliva condition (21%). No differences were found across conditions for subject experimentation with other drugs, frequency of drug use, intentions to use drugs, and beliefs and attitudes related to drug use (p greater than .05). The discrepancy among studies suggesting a validity enhancing effect due to bogus pipeline procedures and those indicating no effect may be accounted for by variables including age, experimental setting, population under study, and drug types. The broad, unquestioned application of the bogus-pipeline in tobacco, alcohol, and other drug use prevention programs, or epidemiological studies of drug use, cannot be recommended at present. PMID- 3650598 TI - School bus safety: focus on the danger zone. PMID- 3650599 TI - Exposing sexual exploitation through values voting. PMID- 3650600 TI - Providing a live "death" experience. PMID- 3650601 TI - Nurse perceptions of problems in meeting the health needs of youth. PMID- 3650602 TI - Immunochemical comparison of mutant glucocorticoid receptors and wild type receptor fragments produced by neutrophil elastase and chymotrypsin. AB - We characterized the glucocorticoid receptor fragments produced by neutrophil elastase and compared these receptor fragments to nuclear transfer increased (nti) mutant receptors. Neutrophil elastase and chymotrypsin digested [3H]dexamethasone 21-mesylate labeled receptors at different sites to produce 52 kDa and 42 kDa fragments respectively. Both the 52 kDa elastolytic receptor fragments and 42 kDa chymotryptic receptor fragments bound to DNA-cellulose and were immunoadsorbed by anti-glucocorticoid receptor monoclonal antibodies (BUGR2). More extensive digestion of labeled receptors by neutrophil elastase produced 29 kDa receptor fragments that did not bind to DNA-cellulose and did not react with BUGR2 antibodies. The size of nti mutant receptors from S49 mouse lymphoma cell variants is intermediate between that of the 52 kDa elastolytic receptor fragments and 42 kDa chymotryptic receptor fragments. The nti receptors bound to DNA-cellulose with the same affinity as the 52 kDa elastolytic receptor fragments. However, the nti receptors were not immunoadsorbed by BUGR2 antibodies and did not react with these antibodies on Western blot analysis of denatured cellular proteins. The results indicate that 52 kDa elastolytic receptor fragments, 42 kDa chymotryptic receptor fragments and nti mutant receptors correspond to the same region of the receptor molecule. The failure of nti receptors to react with BUGR2 antibodies suggests that the nti receptors may have an altered sequence compared to the corresponding region of normal receptors. PMID- 3650603 TI - [Questions and answers on nursing management. A problem of older nursing staff not complying with the directives by a new head nurse]. PMID- 3650604 TI - [Physicians' function in primary health care]. PMID- 3650605 TI - [Home care based on regional life activities]. PMID- 3650606 TI - [Questions and answers on nursing school management. Contents and procurement of facilities for clinical training in obstetrical nursing]. PMID- 3650607 TI - [Questions and answers on clinical training. Discrepancies in evaluation of students by the head nurse and the instructor]. PMID- 3650608 TI - [Questions and answers on clinical training: students' attitudes in shaving of patients]. PMID- 3650609 TI - [Clinical training with emphasis on practice: educational technology for effective clinical training]. PMID- 3650610 TI - [Clinical training with emphasis on practice: from abstract nursing planning to the starting point in clinical training]. PMID- 3650611 TI - [Clinical training with emphasis on practice. Students' psychological growth and development through clinical training--beyond the prescribed nursing processes]. PMID- 3650612 TI - [Clinical training with emphasis on practice. Start of the training when a nursing plan goes astray--support and guidance of students]. PMID- 3650613 TI - [Clinical training with emphasis on practice. Training with learning through practice]. PMID- 3650614 TI - [Quantitative analysis of internalization of nursing through basic clinical training--a trial in the observation of the emotional aspect]. PMID- 3650615 TI - [Music therapy in senile dementia]. PMID- 3650616 TI - [A comparison of amounts of dust generated in wearing and removing gowns made of cotton and non-woven fabrics--including the data through repeated uses]. PMID- 3650617 TI - [Human engineering in nursing shifts: for better work patterns. 7. On the basis of technically balanced pairs--a relationship between the ages and fatigue of nurses]. PMID- 3650618 TI - [Meetings to present nursing experiences and their educational effects]. PMID- 3650619 TI - [Research methods. 1. On scientific observation]. PMID- 3650620 TI - [For understanding of the nursing network. 1. From the cognitive stage to practice in interactive comprehensive nursing]. PMID- 3650621 TI - [Relationship between nursing and welfare]. PMID- 3650622 TI - [Questions and answers on nursing management. Nurses who do not get along with each other: a need for honest discussions to pinpoint the problem]. PMID- 3650623 TI - [Creation of the categories of professional social and nursing welfare workers]. PMID- 3650624 TI - [Home nursing at Mizushima Kyoto Hospital: a start with a slogan, "protection of our health by ourselves"]. PMID- 3650625 TI - [Questions and answers on management of nursing schools. Student evaluation in a class taught by multiple instructors: the GPA (grade point average) system as a fair evaluation system corresponding to the number of lecture hours]. PMID- 3650626 TI - [Questions and answers on clinical training. A student nurse who failed in shaving and upset the patient: humble attitude in accepting the patient's accusations and utilization of the experience for the improvement of future practice]. PMID- 3650627 TI - [Questions and answers on clinical training. Variations in the advices by clinical nurses given to student nurses: listening to the student and exchange of ideas with clinical nurses]. PMID- 3650628 TI - [On defining the qualification of the professional nurse and visiting nurse: the definition of a professional nurse and visiting nurse. A discussion]. PMID- 3650629 TI - [A comment on the qualification of the professional nurse: a proposal for the creation of a one-year study period around 3 years after graduation]. PMID- 3650630 TI - [A comment on the qualification of the professional nurse: a current need to improve geriatric nursing capability]. PMID- 3650631 TI - [A comment on the qualification of the professional nurse: expansive and smooth human relationship as a prerequisite]. PMID- 3650632 TI - [A comment on the qualification of the professional nurse: a need for education comparable or superior to those required in other comparable professions]. PMID- 3650633 TI - [A comment on the qualification of the professional nurse: extension of the activities of emergency nursing]. PMID- 3650634 TI - [A comment on the qualification of the professional nurse: the position of the professional nurse is not necessarily above that of other nurses]. PMID- 3650635 TI - [A comment on the qualification of the visiting nurse: a requirement for a minimum of 2 years in clinical experience]. PMID- 3650636 TI - [A comment on the qualification of the visiting nurse: immediate tasks]. PMID- 3650637 TI - [A comment on the qualification of the visiting nurse: a need for more detailed education and training]. PMID- 3650638 TI - [A comment on the qualification of the visiting nurse: a proposal for the creation of management and nursing courses in training]. PMID- 3650639 TI - [A comment on the qualification of the visiting nurse: a proposal for the requirement of training lasting several months following certain clinical experience]. PMID- 3650640 TI - [A comment on the qualification of the visiting nurse: utilization of the nursing function in the primary care by practicing physicians]. PMID- 3650641 TI - [The attitudes of nursing students in terminal nursing, trends in their behaviors, and their relationship to MAS (manifest anxiety scale)]. PMID- 3650643 TI - [Bedside care without depending on the buzzer to call nurses]. PMID- 3650642 TI - [On man and nursing. Music. 8. Bodily and psychological actions--release of internal rhythm]. PMID- 3650644 TI - [Human engineering study of working hours in nursing: for better working patterns. 8. A comparison of three-(8 hours) and two-shift systems]. PMID- 3650645 TI - [Fatigue in clinical training in obstetrical nursing]. PMID- 3650646 TI - [Data collection in nursing research. 2. Means and methods of observation]. PMID- 3650647 TI - [Understanding of nursing as a network. 2. Re-organization of the nursing system having an activity network]. PMID- 3650648 TI - The reality of nursing cancer patients. PMID- 3650649 TI - The best laid plans. PMID- 3650650 TI - For ever and ever RCN. PMID- 3650651 TI - The Monday group. PMID- 3650652 TI - Professional trade unionism. PMID- 3650653 TI - Scenes from nursing life: psychiatric hospital. PMID- 3650654 TI - Loss of membership--lack of interest--apathy: problem plague nurses' associations across the region and country. Crisis is dangerous opportunity. PMID- 3650655 TI - Food irradiation. PMID- 3650656 TI - The role of the complaints unit. PMID- 3650657 TI - [Transmissibility of HIV infections via allogeneic transplants]. AB - HIV-infections can be transferred by blood and blood products, semen or organ transplants. For this reason, the WHO recommended a screening of all donors of blood, semen, tissues and organs. Those who belong to high-risk groups should be excluded from donations. If this recommendation should be also applied to cialit preserved auditory aussicles, this would probably mean the end of allogeneic transplantations of middle-ear surgery which are being performed daily. Therefore, we carried out experimental examinations with HIV-infected auditory aussicles in cialit. According to our results, it can be assumed that a virus destruction takes place via a cialit-treatment. The same applies to solvent-dried fascia as to auditory aussicles which have been preserved in the same way. Consequently, there is no objection to further application of these allogeneic transplants in respect to HIV-infections. PMID- 3650658 TI - Contrasting effects of early and late orchiectomy on hypertension and renal disease in fawn-hooded rats. AB - Fawn-hooded (FH) rats, primarily males, develop spontaneous low-renin hypertension associated with reduced urinary excretion of kallikrein as early as 2 months of age, followed by progressive glomerular sclerosis and proteinuria as early as 3 months of age. In the present study we determined the effects of early (5-7 weeks) or late (5 months) orchiectomy on the blood pressure and nephropathy of FH rats, compared to sham-operated (control) FH males. Early orchiectomy reduced significantly the progression of glomerular sclerosis and of proteinuria and ameliorated the hypertension but had no significant effect on excretion of urinary kallikrein. Late orchiectomy, in contrast, had no significant effect on the progression of glomerular sclerosis or proteinuria but did significantly reduce the blood pressure and marginally increase the excretion of urine kallikrein. These results suggest that (a) male sex hormones may play a role in the pathogenesis of hypertension and nephropathy in the FH rats and (b) renal disease in this strain progresses in spite of improvement in blood pressure. PMID- 3650659 TI - Pregnancy in diabetes. PMID- 3650660 TI - Growth and failure to grow. PMID- 3650661 TI - Infection with thrush. PMID- 3650663 TI - Marketing of baby milks. PMID- 3650662 TI - Limitations within the cervical cytology screening service. PMID- 3650665 TI - An interview with Ruth Ashton, General Secretary of the Royal College of Midwives. Interview by Norman Morris and Pat Scowen. PMID- 3650664 TI - Physiology and measurement of uterine activity and their clinical applications. PMID- 3650666 TI - Breastfeeding 1987--more than just health education. PMID- 3650667 TI - Sexual abuse of children. PMID- 3650668 TI - Contraception and lactation. PMID- 3650669 TI - The effects of anorexia nervosa on young children. PMID- 3650670 TI - Sexual abuse in children--a question of liaison. PMID- 3650671 TI - Perspectives on the nuclear arms race in the mid 1980s. PMID- 3650672 TI - The birth of a health visiting process. PMID- 3650673 TI - The management of bereaved mothers: what is best? PMID- 3650674 TI - Care and support of women who have experienced a stillbirth. PMID- 3650675 TI - What do you say? PMID- 3650676 TI - Grieving and caring--a student midwife's perceptions. PMID- 3650677 TI - False-negative ELISA result for HIV antibody due to an apparent prozone phenomenon. PMID- 3650678 TI - Human immunodeficiency virus antibody-testing. PMID- 3650679 TI - Antibodies to the human immunodeficiency virus in needles and syringes used by intravenous drug abusers. AB - The sharing of needles and syringes by intravenous drug abusers has been recognized as a critical factor in the transmission of the human immunodeficiency virus (HIV). In an attempt to reduce the sharing of needles and syringes among intravenous drug abusers, a pilot sterile needle-and-syringe exchange programme was established in an inner city neighbourhood in Sydney. The contents of exchanged syringes were screened for antibody to HIV by the enzyme-linked immunosorbent assay (ELISA); reactive and borderline samples were tested further by the Western Blot method. Of a sample of 300 needles-and-syringes that were exchanged, three (1%) needles-and-syringes were confirmed as containing antibody seropositive blood by both ELISA and Western Blot methods and thus as being potentially infectious. As only 70% of known positive-control syringes were detected in this study, the proportion of potentially infectious needles-and syringes that was found may have underestimated the proportion of infectious injection equipment that was returned. These findings highlight the importance of the removal of used needles and syringes from circulation in addition to the supply of sterile equipment. This method of monitoring exchanged needles-and syringes is suggested as a means to evaluate measures that are designed to reduce the transmission of HIV among intravenous drug abusers. The rapid implementation of sterile needle-and-syringe exchange programmes is imperative to stem the spread of HIV infection. PMID- 3650681 TI - "Super-negative" and potential false-negative results in anti-human immunodeficiency virus antibody testing with the Wellcozyme ELISA test kit. PMID- 3650680 TI - AIDS and the Grim Reaper campaign. PMID- 3650682 TI - A therapeutic model for grief resolution following perinatal death: a guide for nurses. PMID- 3650683 TI - Degrees for nurse teachers. PMID- 3650684 TI - Trends in Transatlantic nursing: recent and prospective. PMID- 3650685 TI - Developing a system for the continuous assessment of practical nursing skills. PMID- 3650686 TI - An illuminative approach to a formative evaluation of a college-based nursing program. PMID- 3650687 TI - Nursing education and professional role acquisition--theoretical perspectives. PMID- 3650688 TI - A comparison of three models of nursing. PMID- 3650689 TI - Incorporating hospice care in a community hospital NICU. PMID- 3650690 TI - Hospital to home: care of the child with a tracheostomy. PMID- 3650691 TI - Persistent pulmonary hypertension of the newborn: current trends in classification and diagnosis. PMID- 3650692 TI - Neonatal stress: physiologic adaptation and nursing implications. PMID- 3650693 TI - Think zinc. PMID- 3650694 TI - Vanadate-stimulated NADH oxidation in microsomes. AB - Addition of vanadate, stimulated oxidation of NADH by rat liver microsomes. The products were NAD+ and H2O2. High rates of this reaction were obtained in the presence of phosphate buffer and at low pH values. The yellow-orange colored polymeric form of vanadate appears to be the active species and both ortho- and meta-vanadate gave poor activities even at mM concentrations. The activity as measured by oxygen uptake was inhibited by cyanide, EDTA, mannitol, histidine, ascorbate, noradrenaline, adriamycin, cytochrome c, Mn2+, superoxide dismutase, horseradish peroxidase and catalase. Mitochondrial outer membranes possess a similar activity of vanadate-stimulated NADH oxidation. But addition of mitochondria and some of its derivative particles abolished the microsomal activity. In the absence of oxygen, disappearance of NADH measured by decrease in absorbance at 340 nm continued at nearly the same rate since vanadate served as an electron acceptor in the microsomal system. Addition of excess catalase or SOD abolished the oxygen uptake while retaining significant rates of NADH disappearance indicating that the two activities are delinked. A mechanism is proposed wherein oxygen receives the first electron from NAD radical generated by oxidation of NADH by phosphovanadate and the consequent reduced species of vanadate (Viv) gives the second electron to superoxide to reduce it H2O2. This is applicable to all membranes whereas microsomes have the additional capability of reducing vanadate. PMID- 3650696 TI - The crush syndrome. PMID- 3650695 TI - NADH-dependent polyvanadate reduction by microsomes. AB - NADH-dependent reduction of polyvanadate was observed by using rat liver microsomes as the enzyme source. The reduced vanadate form obtained was blue in color with a broad absorption maximum in the red region around 650 nm. Microsomes and phosphate anions were found to be essential for polyvanadate reduction. The rate and the extent of formation of blue color compound was dependent on the amount of vanadate present. Cytochrome b5 was found to be involved in this SOD insensitive reaction. The rate of disappearance of the blue-colored compound was dependent on concentration of NADH and was found to be sensitive to SOD. Catalase and Mn2+, which inhibit oxygen consumption accompanying NADH oxidation, increased both the rate and extent of the blue color compound formed. The results suggest that vanadate acts as an electron acceptor. PMID- 3650697 TI - [Task analysis: key to effective personnel management]. PMID- 3650698 TI - Nursing problems encountered with asynchronous independent lung ventilation. PMID- 3650699 TI - Objective: social continence. A nursing assessment. PMID- 3650700 TI - Protocols of care for the management of head-injured patients. PMID- 3650701 TI - [Triage of patients in the intensive care unit]. PMID- 3650702 TI - Groote Schuur Hospital: diploma in intensive nursing science. PMID- 3650703 TI - [The examination of the central nervous system]. PMID- 3650704 TI - [Quality assurance: standard in cardio-thoracic nursing]. PMID- 3650705 TI - Coarse nurse? PMID- 3650706 TI - Just managing. PMID- 3650707 TI - Health care in West India: the Charutar community and hospital. PMID- 3650708 TI - Access to the facts? PMID- 3650709 TI - Aortic endarterectomy: a nursing care study. PMID- 3650710 TI - Oxygen--luxury or necessity? Is there a need for post-operative oxygen in the recovery room? PMID- 3650711 TI - Inadvertent hypothermia--a research plan. PMID- 3650712 TI - An in-service training programme for recovery room nurses. PMID- 3650713 TI - Monitoring the levels of anaesthetic gases. PMID- 3650714 TI - The learner nurse in the recovery room--a personal comment. PMID- 3650715 TI - Stock rooms on wheels. PMID- 3650716 TI - Difficult intubation? PMID- 3650717 TI - UK edges slowly towards first trials of an AIDS vaccine. PMID- 3650718 TI - A charismatic health-care legislator: an interview with Pete Stark. Interview by Mitchell. PMID- 3650719 TI - Standard costing/productivity model for nursing. PMID- 3650721 TI - Political participation: how do nurses compare with other professional women? PMID- 3650720 TI - Innovative models for professional nursing practice. PMID- 3650722 TI - Expanding an established after-hour pediatric practice service. PMID- 3650723 TI - Presidential address: specialization. PMID- 3650724 TI - Risk management of medication errors. 2. PMID- 3650725 TI - Infection control for caregivers of AIDS patients (domiciliary). PMID- 3650726 TI - Lorazepam as a premedication for chemotherapy. PMID- 3650727 TI - Eleven hundred outpatient days of amphotericin B therapy. PMID- 3650729 TI - What's it like to be a quality assurance manager? PMID- 3650728 TI - The benefits of being sick. PMID- 3650730 TI - Ready for advancement. Career workshop. PMID- 3650731 TI - Job tension: how much is too much? PMID- 3650732 TI - How to avoid being a nurse defendant. PMID- 3650733 TI - Reaping the rewards of a home health care business. Interview by Lisa Z Cohen. PMID- 3650734 TI - You're the jury. PMID- 3650735 TI - 7 causes of fatigue and what to do about them. PMID- 3650736 TI - Battered women: the fight you can help them win. PMID- 3650737 TI - Liking yourself: five ways to boost you self-esteem. PMID- 3650738 TI - Test your skills: can you meet your patients' psychosocial needs? PMID- 3650739 TI - Ms. Roberts was in way over her head. PMID- 3650740 TI - Charting: how it can keep you out of court. PMID- 3650741 TI - Managing chronic cancer pain effectively. Part 2. What you need to do (continuing education credit). PMID- 3650742 TI - Death & dying. PMID- 3650743 TI - Fear of floating. PMID- 3650744 TI - [Conjugal violence: nursing intervention for the wives]. PMID- 3650745 TI - [Remarks on the profession]. PMID- 3650747 TI - [Confusion controlled]. PMID- 3650746 TI - [The Rochon commission--while we wait for the final report]. PMID- 3650748 TI - [Nursing records are worth their weight in gold]. PMID- 3650750 TI - Nursing service--nursing education: a collaborative venture. PMID- 3650749 TI - [Everything you should know about the International System of Units]. PMID- 3650752 TI - Disaster planning for hospitals. PMID- 3650751 TI - Will inactive nurses help solve the nursing shortage? PMID- 3650753 TI - The sick role. PMID- 3650754 TI - Legal significance of charting--Part I. PMID- 3650755 TI - Helping staff cope with grief. PMID- 3650756 TI - Violations of the state's nurse practice act: how big is the problem? PMID- 3650757 TI - Incentive programs: a way to cost containment. PMID- 3650758 TI - Toward a comprehensive personnel system: the reward system--Part V. PMID- 3650759 TI - Clarity is the key to productivity. PMID- 3650760 TI - A shortage of nurses: traditional approaches won't work this time. PMID- 3650761 TI - A method for training and checking interrater agreement for a patient classification study. PMID- 3650762 TI - Hyperbaric oxygen therapy and the critically burned patient. PMID- 3650763 TI - Impact of AIDS on hospitals: a challenge for the nurse manager. PMID- 3650764 TI - Oncology outpatient experience: a unique approach to staff development. PMID- 3650765 TI - The 'L' plated computer buff. PMID- 3650766 TI - Workplace incidents and A & E records. PMID- 3650767 TI - Monitoring for gases and vapours. PMID- 3650768 TI - Looking at dust. PMID- 3650770 TI - Thermal environment. PMID- 3650769 TI - Noise measurement. PMID- 3650771 TI - Employer's liability. PMID- 3650772 TI - Finland: a model for OH services? PMID- 3650773 TI - Nursing education in Finland. PMID- 3650774 TI - Jordan takes the plunge. PMID- 3650776 TI - OH and the Polish experience. PMID- 3650775 TI - Occupational health goes Dutch. PMID- 3650777 TI - Ontario's OH clinic. PMID- 3650778 TI - AIDS and employers. PMID- 3650779 TI - Wound management. 2. PMID- 3650780 TI - Competency: whose responsibility? PMID- 3650782 TI - Scholarships and loans for nursing education 1987-1988. PMID- 3650781 TI - LSNA competencies of BSN graduates: utilization and validation approaches. PMID- 3650783 TI - The initiator tRNA genes from Streptomyces rimosus. PMID- 3650784 TI - Nursing home reform: addressing critical staffing issues. PMID- 3650785 TI - A view to the future. PMID- 3650786 TI - Nursing: now, then, and maybe again. PMID- 3650787 TI - The federal role in nursing education. PMID- 3650789 TI - The tarnished opportunity. PMID- 3650788 TI - Reflections on nursing, 1987. PMID- 3650790 TI - ANA House of Delegates. PMID- 3650791 TI - Career advancement of nurse executives: planned or accidental? AB - This exploratory study has examined the effect of selected characteristics on the career advancement patterns of nurse executives in service and educational settings. The findings are not consistently in agreement with those of other researchers. For example, Hall et al. found that nearly two-thirds of nursing deans had planned their careers to attain that position. In this study, however, eighty-three percent of the respondents indicated that they had not planned their career advancement, but had simply taken opportunities that had come their way. The influence of others was important in the career advancement of these administrators. Many individuals, including faculty and nursing service colleagues, nursing directors, deans, and non-nursing administrators supported the respondents' personal and professional development through role modeling, teaching skills, and encouragement. Deliberate career planning and education in administration were, for the most part, lacking. Although the sample is too small to generate general conclusions about the universe of nurse executives, this does suggest that it is not uncommon for deans and service administrators to learn necessary skills on the job. PMID- 3650792 TI - Research on ethics in nursing: the state of the art. PMID- 3650793 TI - Sources of job satisfaction and dissatisfaction among baccalaureate staff nurses in hospitals. PMID- 3650794 TI - Eight- and twelve-hour shifts and well-being among hospital nurses. PMID- 3650795 TI - Theoretical nursing: today's challenges, tomorrow's bridges. PMID- 3650796 TI - Nursing theory: what it is and what it is not. PMID- 3650797 TI - Uncertainty and anxiety of hysterectomy patients during hospitalization. PMID- 3650798 TI - Fatal flaws. PMID- 3650799 TI - Difficulty: a neglected factor in health promotion. AB - A series of studies of likelihood of adopting risk-reducing or weight-reduction activities revealed that the perceived difficulty of adoption was a more powerful factor in likelihood of adoption than was a perceived effectiveness of the activities. This finding is significant because most intervention programs emphasize convincing clients of the effectiveness of their methods and treat difficulty as a given or a constant. These studies showed not only that difficulty varied, but also that the relationship between likelihood of adopting an activity and the perceived effectiveness and difficulty of the activity was multiplicative and, therefore, curvilinear. At low levels of difficulty, likelihood of adoption was high, but as difficulty increased, likelihood dropped rapidly. The relationship between effectiveness and likelihood, on the other hand, showed small increases in likelihood as effectiveness increased to moderate levels, with little increase at higher levels. These relationships were more pronounced among those for whom the target risk was highly relevant. One implication for practice is that a greater payoff will be realized by reversing the conventional focus of intervention and instead helping clients reduce the difficulty of adopting necessary activities. PMID- 3650800 TI - Re: 'Adult attention to infants in a newborn nursery'. PMID- 3650801 TI - Parsimony and model confirmation of the ADL Self-Care Scale for multiple sclerosis persons. AB - Data from a 52-item self-administered Activities of Daily Living (ADL) Self-Care Scale designed for persons diagnosed with multiple sclerosis (MS) were refactored for the purpose of achieving scale parsimony and clarifying interrelationships among ADL self-care behaviors. Analyses were based on 629 MS subjects. Principal component analysis and Varimax rotated factor analysis were used to achieve scale parsimony. The resultant 15-item scale was subjected to confirmatory factor analysis to determine relationships among factors, observed variables, and residual variances within the factor model. Modification of the initial factor model due to a less than satisfactory goodness-of-fit index (GFI) (0.848) resulted in the inclusion of four additional relationships between observed variables and a second factor and six paired relations among the residual variances. The modified factor model had a satisfactory GFI of 0.95. These findings support the development of a 15-item self-administered ADL Self-Care Scale. The scale can be used to screen ADL functional levels in MS persons or to monitor changes in their ADL over time. PMID- 3650802 TI - Theoretical modeling to predict physiological indicants of cardiac preventive behaviors. AB - The Preventive Behavior Model was tested and expanded to explore the influence of perceived barriers, benefits, health value orientations, and certain health care activities on physiological outcomes. Data from 41 subjects from a health screening program were analyzed. Four empirical models resulted, explaining 39%, 45%, 66%, and 47% of the variance in cholesterol, high density lipoprotein, systolic blood pressure, and diastolic blood pressure, respectively. Significant variables in the four models provide important clues for understanding factors that influence physiological outcomes of risk factor reduction. PMID- 3650803 TI - A meta-analysis of critical outcome variables in nonnutritive sucking in preterm infants. AB - The advantages and limitations of meta-analysis in clinical nursing research are explained and illustrated with five studies of nonnutritive sucking (NNS) in preterm infants. This article addresses steps of locating studies, systematic comparison of studies for like variables, and qualitative decisions needed before quantitative methods are applied to cumulate findings across studies. Several approaches of calculating effect size and confidence intervals were used to interpret the power of the treatment effect of NNS. On average, across the five NNS studies, NNS intervention reduced time to first bottle feeding by 2.9 days and days of hospitalization by 6.3 days. PMID- 3650804 TI - Patient and situational factors that affect nursing students' like or dislike of caring for patients. AB - The purpose of this study was to identify certain characteristics of the patient or the helping situation that evoke in nursing students positive or negative feelings about caring for patients. Causes nursing students spontaneously gave for their feelings about caring for patients were examined. Results provided some support for the perception that nurses may not be responsive to certain patients. The nursing students liked best caring for patients who were cheerful and communicative. They also liked to care for patients who were in pain, patients they viewed as needing high levels of nursing care, and patients who responded positively to their attempts to minister. PMID- 3650805 TI - Relation of the feeding cycle to neurobehavioral assessment in preterm infants: a pilot study. PMID- 3650806 TI - Reliability of maximal inspiratory pressure. PMID- 3650807 TI - The microcomputer: an alternative for data analysis. AB - Programs for data analysis available on microcomputers now rival those programs available for mainframes in terms of ease of use, accuracy, accessibility, and cost. Researchers should seriously consider the possibilities that exist for data analysis on both the microcomputer and the mainframe. An informed decision will allow best use of available resources. PMID- 3650808 TI - Translation of quantitative measures for use in cross-cultural research. PMID- 3650809 TI - Gardening can damage your health. PMID- 3650810 TI - Birthday honours: honourable mentions. PMID- 3650811 TI - Nursing diagnosis: days of judgement. PMID- 3650812 TI - Midwifery: birth control? PMID- 3650813 TI - Private lives. PMID- 3650814 TI - Parental understanding of congenital hip dislocation. PMID- 3650816 TI - Pressure points. PMID- 3650815 TI - Digitalis: an antidote after 200 years. PMID- 3650817 TI - From casualty to home. PMID- 3650818 TI - The nurse as counsellor. PMID- 3650819 TI - Helping people to stop smoking. PMID- 3650820 TI - Mental health: the journal for psychiatric nurses. PMID- 3650821 TI - Mental health. The Max Factor revolution. PMID- 3650822 TI - Mental health. Beyond these walls. PMID- 3650823 TI - Mental health. Getting to know you. PMID- 3650824 TI - Midwives' journal: RCM supplement. PMID- 3650825 TI - RCM supplement. Unequal equations? PMID- 3650826 TI - RCM supplement. To screen or not to screen? PMID- 3650827 TI - RCM supplement. Who carries the can? PMID- 3650828 TI - RCM supplement. Isolated, but not alone. PMID- 3650829 TI - Women's health: health in their own hands. PMID- 3650830 TI - Research: in search of funds. PMID- 3650831 TI - Child abuse: the new language of care. PMID- 3650832 TI - Never say die? PMID- 3650833 TI - Working abroad. American dream? PMID- 3650834 TI - Working abroad. Before you go. PMID- 3650835 TI - Working abroad. Voices of experience. PMID- 3650836 TI - Working abroad. A quick killing? PMID- 3650837 TI - Reporting on Griffiths. PMID- 3650838 TI - Health education: more than just mumbo jumbo. PMID- 3650839 TI - Staffing in secure units. PMID- 3650840 TI - Now, wash your hands! PMID- 3650841 TI - Mental handicap: nursing the well? PMID- 3650842 TI - Spotlight on children. PMID- 3650843 TI - Spotlight on children. Mouth care in cancer patients. PMID- 3650844 TI - Spotlight on children. Getting on line. PMID- 3650845 TI - Spotlight on children. Models for action. PMID- 3650846 TI - Race against time. PMID- 3650848 TI - The new Avengers. PMID- 3650847 TI - RCM President: brain waves. Interview by Andrew Cole. PMID- 3650849 TI - The confused elderly. Reaching for reality. PMID- 3650850 TI - The confused elderly. A living bereavement. PMID- 3650851 TI - The confused elderly. Risk or restraint? PMID- 3650852 TI - Obesity in an outpatient hypertension clinic. PMID- 3650854 TI - Stress in nursing. 2. What does stress do to you? PMID- 3650853 TI - Children in hospital: making it happy. PMID- 3650855 TI - Nurse/doctor relationships: doctors rule, OK? PMID- 3650856 TI - Nursing in Israel. Interview by Louise Reynolds. PMID- 3650857 TI - Helping hands. Somewhere to turn. PMID- 3650858 TI - Straight talking. PMID- 3650859 TI - No experience necessary. PMID- 3650860 TI - Personnel: somewhere over the rainbow. PMID- 3650861 TI - Prison life: inside story. PMID- 3650862 TI - Mistaken identity. PMID- 3650863 TI - Self-help. Home therapy for antibody-deficient patients. PMID- 3650864 TI - Self-help. In our own hands. PMID- 3650865 TI - Help-help. Examining the evidence. PMID- 3650866 TI - Why we should care in A & E. PMID- 3650867 TI - Nursing Aid. Getting rid of the medical memsahibs. PMID- 3650868 TI - Banking your own blood. PMID- 3650869 TI - Care of the 'geriatric prem' baby. PMID- 3650871 TI - Everyday ethics for nurses. Justice for all. PMID- 3650870 TI - Care of a child with a benign spinal tumour. PMID- 3650872 TI - Who'd be a nursing student? PMID- 3650873 TI - School of thought. PMID- 3650874 TI - The sky's the limit. Interview by Niall Dickson. PMID- 3650875 TI - Residential care: Nye Bevan would turn in his grave. PMID- 3650876 TI - Poll tax: polls apart. PMID- 3650877 TI - The prize is right. PMID- 3650878 TI - Sexuality. Sexual healing. PMID- 3650880 TI - Sexuality. Drugs and sexual function. PMID- 3650879 TI - Sexuality. And baby makes three. PMID- 3650881 TI - Scalp cooling to prevent alopecia. PMID- 3650882 TI - A process standard for oral care. PMID- 3650883 TI - Computers: keyboard rehabilitation. PMID- 3650884 TI - A welcome break. PMID- 3650885 TI - Systems of life. No 152. Senior systems. 17. PMID- 3650886 TI - First-year trials. PMID- 3650887 TI - Project 2000: who foots the bill? PMID- 3650888 TI - Equipment design: hidden talents. PMID- 3650889 TI - Finding employment. Give us a job! PMID- 3650890 TI - Finding employment. Smile: you're being interviewed. PMID- 3650891 TI - Adjusting to ileostomy. PMID- 3650892 TI - Behind the painted smile. PMID- 3650893 TI - Children of the slums. PMID- 3650894 TI - Coming home to an empty cot. PMID- 3650896 TI - Sexuality. Journey into the unknown. PMID- 3650895 TI - Helping hands. Living after loss. PMID- 3650897 TI - Quest. NT's educational supplement. PMID- 3650898 TI - Quest. An elective experience. PMID- 3650899 TI - Quest. Peer and self-assessment. PMID- 3650900 TI - How a wellness philosophy affects illness-oriented hospitals and operating rooms. PMID- 3650901 TI - Wellness and the operating room nurse. PMID- 3650902 TI - Chronobiology and institutional influences on the operating room nurse's level of wellness. PMID- 3650903 TI - Creating wellness-focused learning for staff and patients. PMID- 3650904 TI - Healthy individuals, healthy organizations. PMID- 3650905 TI - Innovations and excellence: the incidence of adult hypothermia in the postanesthesia care unit. PMID- 3650907 TI - Research: the big picture. PMID- 3650906 TI - Professional survival tips: communicating effectively with peers. PMID- 3650908 TI - Evaluation and utilization of transgenic animal models in studies of pancreatic cancer. Pancreas Cancer Working Group. PMID- 3650909 TI - The right to reproduce. PMID- 3650910 TI - Priorities in wound management: Part 1. PMID- 3650911 TI - Criteria for brain stem death. PMID- 3650912 TI - Promoting self-directed enquiry. PMID- 3650913 TI - How safe is sunbathing? PMID- 3650914 TI - Research awareness: its importance in practice. PMID- 3650915 TI - Advertising in health care. PMID- 3650916 TI - Pricing of nursing services. PMID- 3650917 TI - Third-generation cephalosporins: a review of new board spectrum antibiotics. PMID- 3650919 TI - Nurse fails to blow whistle on doctor. PMID- 3650918 TI - Factors affecting the secretion of submandibular salivary kallikrein in cats. AB - Glandular kallikrein has been assessed in submandibular saliva, homogenates and plasma by the fluorimetric substrate D-Val-Leu-Arg-7-amino-4 trifluoromethylcoumarin (AFC) and histochemically in tissue sections by the 4 methoxy-2-naphthylamide (MNA) analogue. Nerve stimulation was used to produce salivary secretion. Parasympathetic saliva contained low concentrations of kallikrein, independently of any circulating catecholamines from the adrenals. Sympathetic saliva contained very high concentrations of kallikrein; the amounts in individual drops rapidly reached a peak then declined gradually. Adrenergic blocking drugs during mixed parasympathetic and sympathetic stimulation showed that beta-adrenergic effects normally increase the secretion of kallikrein in response to the alpha-adrenergic influence from sympathetic nerve impulses. Small amounts of a glandular kallikrein-like activity are present in the plasma. Effluent blood from the submandibular gland before, during and after stimulation of either nerve gave no indication that submandibular kallikrein passes from the glandular compartment to the blood under conditions of unobstructed salivary flow. Excision of the chorda tympani indicated that parasympathetic nerve impulses are required for the normal resynthesis of submandibular kallikrein. The secretion of salivary kallikrein is essentially an exocrine function but its role in the saliva remains obscure. The results suggest that sudden mobilization of kallikrein may occur at times into the saliva and that a separate population of adrenergic axons, under separate central control, may pass to the striated ducts specially for this purpose. PMID- 3650920 TI - Borrowed servant doctrine: anesthesia death. Case in point: Fortson v. McNamara (508 So. 2d 35-FL). PMID- 3650921 TI - Legal case briefs for nurses. N.Y.: incident reports: legal distinctions. AL.: hospital holds newborn for ransom. PMID- 3650922 TI - Chronic illness: a small group approach. PMID- 3650923 TI - Caring: nurse-patient perceptions. PMID- 3650924 TI - Body and behavioral experiences in recovery from alcoholism. PMID- 3650925 TI - Respiratory rehabilitation: communication aids for the tracheotomized patient. PMID- 3650926 TI - [Serological survey on the prevalence of anti-HTLV-III antibodies in a psychiatric hospital]. PMID- 3650927 TI - [Imagination and reality]. PMID- 3650929 TI - [Formation of a nursing unit in Martinique]. PMID- 3650928 TI - [Rehabilitation in voiding. Supporting the self image of the aged]. PMID- 3650930 TI - [So that the adolescent may "read his illness in the text of his life"]. PMID- 3650931 TI - [Staphylococcal septicaemia]. PMID- 3650932 TI - [Did you say "appropriate role"?]. PMID- 3650933 TI - ["Attention: work in progress!" A general nurse tells.... Interview by Odile Burrus]. PMID- 3650935 TI - [Practical guide for the private duty nurse]. PMID- 3650934 TI - [Extra-uterine pregnancy]. PMID- 3650936 TI - [Exportable services. The French nursing services]. PMID- 3650937 TI - Strategizing today for tomorrow: the current scene; through the looking glass. PMID- 3650938 TI - Clinical leadership for staff nurses. PMID- 3650939 TI - Back to school--back to work: the risks and the rewards. Interview by Joan Pipher. PMID- 3650940 TI - [Iron salts]. PMID- 3650941 TI - [Antisepsis of the healthy skin]. PMID- 3650942 TI - [Complementary tests and multiple sclerosis]. PMID- 3650943 TI - [Aspects of the development of multiple sclerosis]. PMID- 3650944 TI - [Admission of a patient with multiple sclerosis]. PMID- 3650945 TI - [Multiple sclerosis. What do we know about it?]. PMID- 3650946 TI - [Treatment of thromboembolism]. PMID- 3650947 TI - [Treatment of chronic cor pulmonale]. PMID- 3650948 TI - [Management of tamponade]. PMID- 3650949 TI - [Study of care by the nursing personnel. Evaluation of care for better nursing]. PMID- 3650950 TI - [The week hospital, the day hospital]. PMID- 3650952 TI - [The employer-employee technical committee]. PMID- 3650951 TI - [Did you say "incontinence"?]. PMID- 3650953 TI - [Modes of onset of multiple sclerosis]. PMID- 3650954 TI - [Problems related to the risk of AIDS]. PMID- 3650955 TI - [Analysis from the Oslo Health Council: activities in home care nursing]. PMID- 3650956 TI - [Collaboration conditions: national conference says no to Norwegian Federation of labor--yes, to Joint Organization of Academicians]. PMID- 3650957 TI - [Guidelines for: nurses' responsibility for safety and health in the place of work]. PMID- 3650958 TI - [Working environment. One third more work-related disorders reported]. PMID- 3650959 TI - [Executive Board. The worst shortage of nurses is like a make-belief bugbear]. PMID- 3650960 TI - [Drug information. Calcium channel blockers]. PMID- 3650961 TI - [Working with safety happens in the best localities]. PMID- 3650962 TI - [Working environment. Nurses' responsibility for health and safety in their own place of work]. PMID- 3650964 TI - [Alternative treatment. Chiropractic can alleviate chronic suffering]. PMID- 3650963 TI - [Nurses in a lawsuit on freedom of speech]. PMID- 3650966 TI - [Tell me where you were born and I can tell you what you can die of]. PMID- 3650965 TI - [Working environment. It is the individual employee's responsibility that safety measures are in order. Interview by Lars Peter Bergqvist]. PMID- 3650967 TI - [Children's health. 22. We should be able to offer an alternative to help the street children]. PMID- 3650968 TI - [Education can improve nothing in framework]. PMID- 3650969 TI - [Key persons will prevent the dispersal of AIDS through education]. PMID- 3650970 TI - [Introduction to a discussion on developments in Danish living conditions]. PMID- 3650972 TI - [Psychiatric treatment as seen from a holistic viewpoint]. PMID- 3650971 TI - [Psychotherapy can return credibility to psychiatry]. PMID- 3650973 TI - [Personality incompatibility. The social/emotional aspects of a functional conflict]. PMID- 3650974 TI - [Solutions of nursing problems]. PMID- 3650975 TI - [A medic ... what kind of a person is that?]. PMID- 3650976 TI - [Attention to the section of chronic disease ... the management also]. PMID- 3650978 TI - [Why no action?]. PMID- 3650977 TI - [This is how patients can feel ... Pain, don't even mention it]. PMID- 3650979 TI - [Communication with the help of the kangaroo method]. PMID- 3650980 TI - [Air transport of patients]. PMID- 3650981 TI - [Ectopic pregnancy]. PMID- 3650982 TI - [The Amsterdam Integrated Cancer Center and the nurses cooperate in nursing discussion and counseling services]. PMID- 3650983 TI - [Learning to get better]. PMID- 3650984 TI - [Mourning, forms of mourning and mourning work]. PMID- 3650985 TI - [Between request for help and the answer]. PMID- 3650986 TI - [The nursing process and the written report]. PMID- 3650987 TI - Smart cards & networks: promote access to information. PMID- 3650988 TI - Educational readiness in hospitalized adults. PMID- 3650990 TI - Esophagogastrectomy for carcinoma of the esophagus. PMID- 3650989 TI - Alleviating the fears of pediatric patients. PMID- 3650991 TI - Are you a leader? PMID- 3650992 TI - The photographer in the operating room. PMID- 3650993 TI - The impact of postdischarge infection on surgical wounds. PMID- 3650994 TI - Cooperation is the watchword in the OR. PMID- 3650995 TI - Intraoperative awareness. PMID- 3650996 TI - Humanistic nurse administrators. PMID- 3650997 TI - Substance abuse: the nurse as the user. PMID- 3650998 TI - Be careful, they hear us. PMID- 3650999 TI - [How to teach the patient postural drainage]. PMID- 3651000 TI - [The preparation of the nurses in the university setting]. PMID- 3651001 TI - [A view of nurses' role and nursing care of female reproductive system cancers]. PMID- 3651003 TI - [Provision of public adaptation of the blind and deaf children]. PMID- 3651002 TI - [Nursing diagnosis]. PMID- 3651004 TI - [Nurse leaders of Turkey]. PMID- 3651005 TI - [Stopping chronic pain before it starts]. PMID- 3651006 TI - [Pressure sore prevention]. PMID- 3651007 TI - [Nurses eradicate leprosy]. PMID- 3651008 TI - [Hypertension]. PMID- 3651009 TI - [A positive view of nursing provided in Eastern Turkey]. PMID- 3651010 TI - [Hemodialysis]. PMID- 3651012 TI - [Stress]. PMID- 3651011 TI - [Steroid therapy and nursing care]. PMID- 3651013 TI - Profile of the Vermont registered nurse--1987. PMID- 3651014 TI - [Fire at the Viennese hotel "Am Augarten"--a contribution to the toxicology of combustion gas poisoning]. AB - The fire at the Vienna hotel "Am Augarten" (28.9 1979) caused 25 deaths. 24 victims died as a result of inhalation of fire gases; 10 of them also suffered 2nd and 3rd degree burns. In one case, death was due to internal injuries (sustained when jumping from a window). The fact that none of the bodies was charred facilitated identification. In all cases autopsy revealed the typical symptoms of inhalation of fire gases (soot deposition in the respiratory tract, presence of carboxyhaemoglobin in the blood). In public discussion the question was raised whether the inhalation of hydrogen cyanide (liberated from nitrogen containing natural or synthetic polymers by pyrolysis) was a contributory factor to the fatal outcome. The cyanide concentrations in blood samples measured by gas chromatography were below the toxic range in all cases. Chemical investigation comprised the determination of the carboxyhaemoglobin concentrations and the demonstration of volatile hydrocarbons in the air of the lungs. PMID- 3651015 TI - [Lipase standard on a pancreatin base for a turbidimetric test. Development and characterization]. PMID- 3651016 TI - [Sought-after experimental care for victims of torture--"an ethical shortcoming to not continue it". Interview by Monika Trozell]. PMID- 3651017 TI - [SIDA laboratory in Guinea-Bissau. SIDA wants to withdraw funding now that it has started to work. Interview by Anders Wahlund]. PMID- 3651018 TI - [Louise opened her own alternative maternal care. Interview by Monika Trozell]. PMID- 3651019 TI - [SHSTF should be in the lead for the new system in patient care activities]. PMID- 3651020 TI - [The working place with an ocean view]. PMID- 3651021 TI - [AIDS--a bad dream to live with. Interview by Viveka Holmertz]. PMID- 3651022 TI - [UN nurse--expert in foot blisters. Interview by Monika Trozell]. PMID- 3651023 TI - [She has gotten time for cancer patients]. PMID- 3651024 TI - ["The results are nevertheless acceptable"]. PMID- 3651025 TI - [Birgitta would rather work in Tromso. Interview by Jan Thomasson]. PMID- 3651026 TI - [Learn body language. Interview by Monika Trozell]. PMID- 3651027 TI - [Zimbabwe--here medicine man and psychiatric nurse work together]. PMID- 3651029 TI - [Voices critical of agreement]. PMID- 3651028 TI - [Medicine man's abilities recognized by the state]. PMID- 3651030 TI - [Strong resistance when we met at spring negotiations]. PMID- 3651031 TI - [Need protection against AIDS!]. PMID- 3651032 TI - [A road back to life. Interview by Viveka Holmertz]. PMID- 3651033 TI - [Many want to change to another job]. PMID- 3651034 TI - [Carin, Christina and Anna-Karin jumped off entirely. Jobs at a travel agency, bank and university studies]. PMID- 3651036 TI - [Australia's nurses also strike for higher wages]. PMID- 3651035 TI - [Where does professional responsibility end for department managers?]. PMID- 3651038 TI - [Difficult for new nurse to carry through those changes]. PMID- 3651037 TI - [Rotation and time to study relieves ICU personnel]. PMID- 3651039 TI - [Gunnar Hofring, County Association: "work with people should be appreciated more". Interview by Jan Thomasson]. PMID- 3651040 TI - [Ready to start!]. PMID- 3651041 TI - [Education for improved care to the seriously ill and dying]. PMID- 3651042 TI - [Carina's heart center invests in preventive care]. PMID- 3651043 TI - [Spain--legislation creates important market for illegal abortion]. PMID- 3651044 TI - [Agreement was the last straw]. PMID- 3651045 TI - [New liability committee will look beyond juridical brushwood. Interview by Viveka Holmertz]. PMID- 3651047 TI - [Art library in the hospital: "culture a self-evident right"]. PMID- 3651046 TI - [SHSTF endeavors to stop proposal on brain death. Interview by Jan Thomasson]. PMID- 3651048 TI - [Pictures awaken memories of life]. PMID- 3651049 TI - [Need substitute for supervision]. PMID- 3651050 TI - [That was a fiasco!--or--consultations which went up in smoke. Interview by Viveka Holmertz]. PMID- 3651051 TI - [Changes incentive for Inga-Lill. Interview by Monika Trozell]. PMID- 3651052 TI - [Reevaluation more than a matter of salary]. PMID- 3651053 TI - [Conflict in the thorax clinic gives rise to important question: what demands can one place upon a clinic director?]. PMID- 3651054 TI - [Daisy Project seeks to show us the future nursing environment this very day]. PMID- 3651056 TI - [Swedish support to Botswana's nurses]. PMID- 3651055 TI - [In the flood of proposals--extended nursing education and more mathematics]. PMID- 3651057 TI - [Courses for those who want to work in developing countries]. PMID- 3651059 TI - [End of the Dasis Project. Professions are sceptical about profitability estimates]. PMID- 3651058 TI - [Losing one's hair worst for cancer patients. Interview by John Gradowski]. PMID- 3651060 TI - [Flexitime in nursing--will it work?. Interview by Viveka Holmertz]. PMID- 3651061 TI - [Every 5th nurse risks becoming burned out]. PMID- 3651062 TI - [Wage-setting for midwives in the local area]. PMID- 3651063 TI - [This is how the society's moneys are used]. PMID- 3651064 TI - [Central Africa]. PMID- 3651065 TI - [Is the concept brain death necessary for organ transplantation?]. PMID- 3651066 TI - [Concept of brain death. Marika's opinion cannot be the majority]. PMID- 3651067 TI - [SHSTF not on the wrong track about concept of death]. PMID- 3651068 TI - [Concept of brain death. Organ donation or research on sequelae]. PMID- 3651069 TI - [Concept of death not simply a scientific question]. PMID- 3651070 TI - [Physicians want to check trial with the right to prescribe for district nurses]. PMID- 3651071 TI - [New method in documentation activities in the ward saves time, provides better parent contact and more knowledge]. PMID- 3651072 TI - [Night has a thousand thoughts. Interview by Viveka Holmertz]. PMID- 3651073 TI - [No new proceedings in dialysis lawsuit]. PMID- 3651074 TI - [Women have no time for the profession]. PMID- 3651075 TI - [She is a spider in the information web. Interview by Anika Agebjorn]. PMID- 3651076 TI - [TCO's Labor Committee: legislation conceivable for the introduction of 6-hour work days]. PMID- 3651078 TI - [Report on surveys of alternative medicine--closer association with nursing a possible result]. PMID- 3651077 TI - [County Council Association's attempt to stop shortening of work hours--gives harsh criticism]. PMID- 3651079 TI - [Siv chose homeopathy: chance for nurses at more independence. Interview by Monika Trozell]. PMID- 3651080 TI - [Are there A and B schools?]. PMID- 3651081 TI - [Many students are satisfied]. PMID- 3651082 TI - [Asa questions nursing planning as basis--one needs several ways in a profession]. PMID- 3651083 TI - [SHSTF: educational model has stood the test]. PMID- 3651084 TI - [Promises of job will attract youth]. PMID- 3651085 TI - [All applications come this way]. PMID- 3651086 TI - [Gladly a nurse--but first a reliable orientation. Interview by Anika Agebjorn]. PMID- 3651087 TI - [Judgment in the Supreme Court: not the instructor's responsibility]. PMID- 3651088 TI - [Halmstad--flagship of the health occupation colleges]. PMID- 3651090 TI - Reducing the complications of routine nasotracheal intubations. PMID- 3651089 TI - The impact of present testing on the certification process of nurse anesthetists. PMID- 3651091 TI - A qualitative analysis of anesthesia circuit filters: resistance and penetrance characteristics. PMID- 3651092 TI - The anesthetic considerations for the patient undergoing total laryngectomy. PMID- 3651093 TI - AANA journal course: Advanced scientific concepts: Update for nurse anesthetists. Part II--The renal system: physiology, pathophysiology and anesthesia management [continuing education]. PMID- 3651094 TI - HIV infection and international travel. AB - Screening international travelers for human immunodeficiency virus (HIV) antibodies does little to prevent the spread of the acquired immune deficiency syndrome. Individuals who are seropositive for HIV antibodies and wish to travel abroad will be subject to varying restrictions, depending on the severity of their illness and the entrance requirements for specific countries. International travel is not a risk factor for HIV infection, since routes of HIV transmission appear to be uniform worldwide. However, prudent precautions are recommended because international travel may modify an individual's risk profile. PMID- 3651095 TI - Factors associated with prevalent human immunodeficiency virus (HIV) infection in the Multicenter AIDS Cohort Study. AB - Interviews regarding medical history, life-style, specific drug taking and sexual activities, and physical examinations were administered to 4,955 homosexual men who volunteered for the Multicenter AIDS Cohort Study in Baltimore, Chicago, Los Angeles, and Pittsburgh. Overall, the prevalence of antibodies to human immunodeficiency virus (HIV) in these men was 38.0%. The factor most strongly associated with prevalent HIV infection according to a multiple logistic regression model was rectal trauma, a composite variable which included receptive anal fisting, enemas before sex, reporting of blood around the rectum, and the observation of scarring, fissures or fistulas on rectal examination. Receptive anal intercourse also was strongly associated with HIV infection in the model. The multivariate relative odds for HIV antibody positivity was 7.72 for the highest level of rectal trauma and 3.04 for receptive anal intercourse. Symptoms reported to occur in some persons who subsequently develop acquired immunodeficiency syndrome (AIDS) were frequent among HIV seropositive men (12.9%) but were reported in 8.4% of seronegative men as well. Generalized lymphadenopathy was observed significantly more often in seropositive men (48.8%) compared with seronegative men (11.4%). The prevalence of HIV antibodies was inversely related to the number of T-helper cells and directly related (to a lesser extent) to the number of T-suppressor cells. The results suggest that disruption of the rectal mucosa provides access by HIV to the blood stream and to specific immunologic cells. Since symptoms and generalized lymphadenopathy were often reported among seronegative men, they probably also occur among some seropositive men not currently progressing to AIDS. PMID- 3651096 TI - Why not treat all body substances as infectious? PMID- 3651097 TI - Nurses talk about the challenge of AIDS. PMID- 3651098 TI - A dialogue with excellence. PMID- 3651099 TI - Weaning from the ventilator: protocols that work. PMID- 3651100 TI - Weaning from the ventilator: in specific clinical situations. PMID- 3651101 TI - Weaning from the ventilator: weaning the unweabable. PMID- 3651102 TI - What child abuse really looks like. PMID- 3651103 TI - Boston: brains as well as beans: an AJN Jobfocus. PMID- 3651104 TI - Should we diagnose strengths? No: stick to the problems. PMID- 3651105 TI - Should we diagnose strengths? Yes: accentuate the positive. PMID- 3651106 TI - What do we need to know about pain? PMID- 3651107 TI - Surgeon General's report on acquired immune deficiency syndrome. PMID- 3651109 TI - Effects of kallikrein on the male reproductive system and its use in the treatment of idiopathic oligozoospermia with impaired motility. AB - A single-blind study on the effects of kallikrein in idiopathic oligozoospermia was carried out. 8 of the 16 patients admitted to the trial were treated with kallikrein 100 K.U. t.i.d., the remaining patients received vitamin E 100 mg t.i.d. Treatment lasted 120 days in both groups. Kallikrein led to an increase in sperm concentration, total sperm count and sperm penetration capacity. Patients receiving vitamin E failed to show any improvement. It is postulated that the increase in sperm concentration could be explained by the positive action of kallikrein on spermatogenesis, due to a stimulatory effect of the drug directly on the Sertoli cell function and on the circulation in the vascular system of the testis. PMID- 3651110 TI - The effect of kallikrein on spermatozoal ATP and other semen parameters. AB - Kallikrein promotes the release of kinins, which have been shown in in vitro studies to improve motility, viability and metabolism in human spermatozoa. The effects of kallikrein therapy on 25 males attending an infertility clinic was assessed, regarding endogenous spermatozoal ATP content, as well as other semen parameters. Thirteen of the 25 patients showed an improvement in either count, morphology, motility, viability, or a combination of these, after 3 months Kallikrein therapy. ATP levels in responders dropped by 58.8% (p less than 0.001). In nonresponders ATP levels did not change significantly. This indicates that improvement in spermatozoal parameters corresponds with increased ATP consumption, following Kallikrein therapy. PMID- 3651108 TI - [Catamnestic study of childless patients of the Department of Andrology of Hamburg-Eppendorf University Hosptal]. AB - By means of a questionnaire, we carried out a catamnestic study of 1419 patients with a complaint of infertility. 27 per cent of the replying patients reported about the birth of children. 343 patients (38%) reported about one or more conceptions. Compared with previous studies, this investigation shows better results of therapies. We interprete this to be caused in better possibilities of therapy, esp. the Kallikrein therapy. PMID- 3651111 TI - Neonatal intensive care unit bacteremia: emergence of gram-positive bacteria as major pathogens. AB - An outbreak of nosocomial Staphylococcus epidermidis bacteremia in a neonatal intensive care unit in 1981 was epidemiologically linked to use of Broviac central venous catheters (p = 0.05) and prompted a review of nosocomial infection surveillance data for the previous 6 years, which indicated a striking shift from gram-negative to gram-positive bacteria, especially coagulase-negative staphylococci, as major bloodstream pathogens. In a case-control study with 68 patients with bacteremia between 1979 and September 1981 and 64 control patients, stratified by birth weight, three risk factors were identified: use of Broviac central venous catheters, surgical procedures, and intravenous hyperalimentation. The risk factors varied with the birth weight category. In the group of cases and controls with birth weights less than 1500 gm, only the use of Broviac catheters, which are usually left in the superior vena cava for several weeks, was associated with subsequent bacteremia (odds ratio = 7.1, p = 0.001). These observations, as well as the temporal association of the introduction of Broviac catheters with the subsequent shifts in causes to gram-positive organisms, suggest that the long-term indwelling vascular access devices contributed greatly to the changing pattern. PMID- 3651112 TI - Epidemiologic methods for selective surveillance. AB - To allow time for problem-solving and staff education aimed at the prevention of future nosocomial infections, it is necessary for infection control practitioners to decrease the quantity of data-gathering activities and increase the quality of data analysis and action based on the data. A system by which certain high-risk patient groups and life-threatening infection sites are monitored by continuous surveillance every month, but other units and sites are selected on a rotating basis for periodic study, has been called "selective surveillance" and used at our 500-bed medical center for eight years. The system is backed by an essential third component: a network of inspections with prevalence studies, prospective studies of medical and surgical procedures, retrospective studies of sites with low endemic rates, and immediate investigations of clusters of infection. Success of this system is based on good daily communication with laboratory and nursing personnel and use of sound epidemiologic methods. PMID- 3651114 TI - Development of an infection control program in Kuwait. PMID- 3651113 TI - Hospital-acquired infections after arthroscopic knee surgery: a probable environmental source. PMID- 3651115 TI - Microbiologic effects of emollient on gloved hands. PMID- 3651116 TI - The infection control practitioner as expert witness. PMID- 3651117 TI - Patient with AIDS in nursing home. PMID- 3651119 TI - Nurses care for prisoners with AIDS. PMID- 3651118 TI - [Autoimmune thrombopenic purpura and AIDS-related syndromes. Preparing for surgery with immunoglobulins]. AB - A case is reported of autoimmune thrombocytopenic purpura in a narcotics addict with antibodies against human immune deficiency virus (HIV). Three points need stressing: 1) HIV is a new viral cause of autoimmune thrombocytopenic purpura, the first report of which dates from 1985; 2) this bleeding diathesis may be seen more often in normal anaesthetic practice because of the frequent association of intravenous toxicomania with anti-HIV antibodies and thrombocytopaenia. Thus, of the thirty cases detected in two years and followed by our Department of haematology, two were operated on in the orthopaedic unit; 3) the use of intravenous human gammaglobulins is of great interest each time the clinical situation requires a rapid increase in the platelet count, such as before surgery. The usual dose is 400 mg . kg-1 . j-1 for five consecutive days. The response to immunoglobulins is seen in two or three days; their efficacy, in the case described, lasted for five to seven days, this including the postoperative time. Booster doses were followed by a quick increase in platelet count. PMID- 3651120 TI - Special populations claim RN attention. PMID- 3651121 TI - NYSNA members to consider call to withdraw from ANA. PMID- 3651122 TI - Leaders plan and direct strategy in Congress. PMID- 3651123 TI - Inequities of health care 'market' challenge nurses. PMID- 3651124 TI - One ANA, indivisible. PMID- 3651125 TI - Cambodian refugees will benefit from nurse's travel. PMID- 3651126 TI - An ultrastructural morphometric analysis of elastase-treated hamster bronchi shows discharge followed by progressive accumulation of secretory granules. AB - An ultrastructural morphometric analysis of bronchial secretory cells was carried out on hamsters treated intratracheally with 300 micrograms of human neutrophil elastase (HNE) in 0.5 ml saline, saline alone, or left untreated. Five to 6 animals were killed at 2 h and at 3, 8, and 16 days after treatment. Electron micrographs were prepared from the hilar region of the left main intrapulmonary airway; 125 +/- 16 (mean +/- SE) granulated secretory cells extending from basement membrane to lumen were analyzed for each group. The number (Ng) and area (Ag) of granular profiles per cell, the area of cell profiles (Ac), and the volume density of secretory granules per cell (Vv) were determined using an electronic image analyzer. There were significant decreases in Ng, mean Ag, and Vv in the 2-h HNE group when compared with the saline group. Values of Ng, mean Ag, and Vv were similar for HNE and saline groups at 3 days, but were significantly increased at 8 and 16 days. The Ac of HNE-treated groups was similar to their saline control groups at all time points except at 16 days when the HNE-treated group enlarged to double that of its saline control group. An ultrastructural differential cell count showed a decrease in frequency of granulated secretory cells at 2 h and an increase at 8 and 16 days; there was an inverse change in the frequency of nongranulated secretory cells at these times. The proportion of ciliated, preciliated, and indeterminate cells remained constant over time in all treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651127 TI - [Clinical decision making. Quantitative approach to diagnostic and therapeutic problems in obstetrics]. PMID- 3651128 TI - Ignorance about AIDS testing hurts patients, nurses, physicians. PMID- 3651129 TI - Tissue expansion. A new modality in reconstructive surgery. PMID- 3651130 TI - Epikeratophakia. Correcting visual deficits with corneal tissue. PMID- 3651131 TI - Intraoperative radiation therapy. Procedures and protocols. PMID- 3651132 TI - Elderly patients. Perioperative nursing implications. PMID- 3651133 TI - Idiopathic radial tunnel syndrome. Surgical treatment and nursing care. PMID- 3651134 TI - Common management errors. Tips for experienced and new managers. PMID- 3651135 TI - Pain and ethnicity. How people of different cultures experience pain. PMID- 3651136 TI - Dealing with anger. Every manager's dilemma. PMID- 3651137 TI - Patient satisfaction in a hospital-based day surgery setting. PMID- 3651138 TI - Surviving the nursing shortage: making every nurse count. PMID- 3651139 TI - Is the nation's largest employer enforcing pay equity? PMID- 3651140 TI - Nursing shortage strategies. PMID- 3651142 TI - Managerial stroking. Motivating employees. PMID- 3651141 TI - Positioning questioned. PMID- 3651143 TI - Participatory planning. An interactive management approach. AB - Planning meetings are usually viewed as a means for accomplishing tasks, creating plans, exchanging information, or analyzing material. Although a large part of this article includes a description of work that resulted from planning meetings, the value of the meetings should not be overlooked. Working together on common problems at the hospital regenerated esprit de corps and served to remind individuals of their shared goals. The process fostered an appreciation of the constraints, objectives, and external demands of each professional group using the OR and helped explain seemingly arbitrary or irrational behavior. The meetings also forced tensions out into the open and helped defuse "hot" issues that might have been played out in the OR suite. Although most work units engage in some form of planning, there is a tendency to "get it over with" as quickly as possible until another crisis occurs. Another approach is to schedule group planning and design on a regular basis as a form of group catharsis. Given the high levels of stress that members of the OR are subjected to, this idea may make more than just good planning sense. PMID- 3651144 TI - Update on precautions nurses should take when caring for the AIDS patient. PMID- 3651145 TI - Families can watch surgery while they wait. PMID- 3651146 TI - Undocumented nursing care does not always indicate liability. PMID- 3651147 TI - Factors associated with adherence in hypertensive patients. PMID- 3651148 TI - Intra-abdominal pressure in CAPD patients. An editorial review with nursing implications. PMID- 3651149 TI - Use of play with the child with chronic illness. PMID- 3651150 TI - A systematic approach to heparin administration for pediatric hemodialysis. PMID- 3651152 TI - HIV or HTLV-III? PMID- 3651153 TI - Nursing and collaborative research. PMID- 3651151 TI - Protective action of elastase on changes in mechanical properties of vascular smooth muscles during atherosclerogenesis in hypercholesterolemic rabbits. AB - Effects of oral administration of elastase on changes in contractile responses of smooth muscle cells of the aorta and pulmonary artery were studied in rabbits fed a high-cholesterol diet. In rabbits on high-cholesterol diet, the acetylcholine (ACh)-induced endothelium-dependent relaxation was gradually decreased, and over 10 weeks on this diet, the relaxing responses were diminished, abolished or converted to contraction, while contractions produced by high-potassium (high-K) were enhanced and those produced by noradrenaline (NA) were decreased in sensitivity. In tissues from aged rabbits (2-8 years old), the ACh-induced relaxation was decreased while sensitivity to NA or high-K was elevated, in comparison with findings in young rabbits (3-4 months old). Oral administration of elastase together with high-cholesterol diet inhibited decreases in the ACh induced relaxation or the NA-contraction, but not the increase in high-K contraction. The elevated concentrations of cholesterol but not those of triglycerides in sera, were significantly lowered by elastase. These results provide evidence that elastase has a hypocholesterolemic action and a protective role in atherosclerosis. PMID- 3651154 TI - AIDS--an international perspective. PMID- 3651155 TI - The no frills dressing. PMID- 3651156 TI - Why publish? PMID- 3651157 TI - Crossing cultural boundaries: school nursing in Japan. PMID- 3651159 TI - Pre-natal education in the Illawarra. PMID- 3651158 TI - Planning control of grief. PMID- 3651160 TI - Nurse & the law. Coronial inquiries. PMID- 3651161 TI - Continuing education initiative. PMID- 3651162 TI - Ethics in focus. PMID- 3651163 TI - Nursing management of alcohol withdrawal. PMID- 3651165 TI - What's wrong with working in a nursing home? An analysis of nurses' comments. PMID- 3651164 TI - Paediatric bacterial meningitis. PMID- 3651166 TI - Nurse & the law. Personal morals vs professional codes. PMID- 3651167 TI - Sharing research ideas. PMID- 3651168 TI - The third age: SAM against the rest. PMID- 3651169 TI - Post-basic courses: a survey of research teaching. PMID- 3651170 TI - Paediatric AIDS. PMID- 3651171 TI - Nurse & the law. Shifting ground in public policy. PMID- 3651172 TI - Drug-induced skin reactions. PMID- 3651173 TI - The 'gateway to independence'. PMID- 3651174 TI - The action of neutrophil elastase on intact and oxidized (met)-enkephalin-arg6 gly7-leu8 peptide. AB - Neutrophil elastase has been found to cleave met-enkephalin-arg6-gly7-leu8 between met5 and arg6 thereby releasing the active opiate met-enkephalin. Oxidized met-enkephalin octapeptide is not attacked by this enzyme. These data suggest a potential role for neutrophil proteinases and oxidases in the regulation of opiate production in tissues. PMID- 3651175 TI - 2',3'-Dideoxy-2'-fluoro-ara-A. An acid-stable purine nucleoside active against human immunodeficiency virus (HIV). PMID- 3651176 TI - Identification of T-kininogen in rat urine. AB - Studies were carried out in order to characterize the kininogen in rat urine. Rat urine contained a component which was cross-reactive with antibody to rat plasma T-kininogen. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of rat urine revealed a single antigenic band corresponding to the molecular weight of plasma T-kininogen. Induction of acute inflammation in rats by an injection of lipopolysaccharide caused an increase in the urinary excretion of immunoreactive T-kininogen in parallel with an elevation of plasma T-kininogen. Kininogen partially purified from rat urine by affinity chromatography using S carboxymethylated papain-agarose liberated only T-kinin upon trypsinization, but not upon treatment with rat glandular kallikreins. From these results, we conclude that T-kininogen is the major kininogen present in rat urine. PMID- 3651177 TI - Effects of elastase on the stiffness and elastic properties of arterial walls in cholesterol-fed rabbits. AB - The effect of cholesterol feeding and elastase administration on the arterial stiffness and elastic properties was investigated in rabbits by pressure-diameter tests on excised thoracic aortas, common carotid and femoral arteries. Rabbits in groups RA and RB were fed 1% cholesterol diet for 14 weeks. Groups RC and RD were fed the cholesterol diet for the first 7 weeks, and then given regular chow for the last 7 weeks. In addition, rabbits in groups RB and RC were administered elastase daily for the last 7 weeks. Rabbits in group RE were fed the regular chow for 14 weeks and served as the control group. The arterial stiffness and the elastic modulus of wall material in the RA rabbits were generally higher than those in the control rabbits. Administration of elastase and/or feeding of the regression diet decreased the wall stiffness and elastic modulus significantly, although the effect of elastase did not appear clearly when used in combination with the regression diet. The cholesterol feeding decreased the ratio of thickness to wall radius, whereas the ratio was more or less increased by the elastase administration and/or the regression diet. PMID- 3651178 TI - The binding of acetaldehyde to the active site of ribonuclease: alterations in catalytic activity and effects of phosphate. AB - Ribonuclease A was reacted with [1-13C,1,2-14C]acetaldehyde and sodium cyanoborohydride in the presence or absence of 0.2 M phosphate. After several hours of incubation at 4 degrees C (pH 7.4) stable acetaldehyde-RNase adducts were formed, and the extent of their formation was similar regardless of the presence of phosphate. Although the total amount of covalent binding was comparable in the absence or presence of phosphate, this active site ligand prevented the inhibition of enzymatic activity seen in its absence. This protective action of phosphate diminished with progressive ethylation of RNase, indicating that the reversible association of phosphate with the active site lysyl residue was overcome by the irreversible process of reductive ethylation. Modified RNase was analysed using 13C proton decoupled NMR spectroscopy. Peaks arising from the covalent binding of enriched acetaldehyde to free amino groups in the absence of phosphate were as follows: NH2-terminal alpha amino group, 47.3 ppm; bulk ethylation at epsilon amino groups of nonessential lysyl residues, 43.0 ppm; and the epsilon amino group of lysine-41 at the active site, 47.4 ppm. In the spectrum of RNase ethylated in the presence of phosphate, the peak at 47.4 ppm was absent. When RNase was selectively premethylated in the presence of phosphate, to block all but the active site lysyl residues and then ethylated in its absence, the signal at 43.0 ppm was greatly diminished, and that arising from the active site lysyl residue at 47.4 ppm was enhanced. These results indicate that phosphate specifically protected the active site lysine from reaction with acetaldehyde, and that modification of this lysine by acetaldehyde adduct formation resulted in inhibition of catalytic activity. PMID- 3651179 TI - Reductions in breath ethanol readings in normal male volunteers following mouth rinsing with water at differing temperatures. AB - Blood ethanol concentrations were measured sequentially, over a period of hours, using a Lion AE-D2 alcolmeter, in 12 healthy male subjects given oral ethanol 0.5 g/kg body wt. Readings were taken before and after rinsing the mouth with water at varying temperatures. Mouth rinsing resulted in a reduction in the alcolmeter readings at all water temperatures tested. The magnitude of the reduction was greater after rinsing with water at lower temperatures. This effect occurs because rinsing cools the mouth and dilutes retained saliva. This finding should be taken into account whenever breath analysis is used to estimate blood ethanol concentrations in experimental situations. PMID- 3651180 TI - Clonidine in alcohol withdrawal: a pilot study of differential symptom responses following i.v. clonidine. AB - The effects of an i.v. bolus of clonidine (1.5 mg/kg) on withdrawal symptoms were studied in 7 male alcoholics, and compared with 7 normal controls. Clonidine reduced both subjective and objective measures of withdrawal but this only reached significance for scores of depression and muscle tension. In comparison with controls alcoholics in withdrawal showed reduced sedative effects of clonidine. PMID- 3651181 TI - Bias in a survey of drinking habits. AB - This paper presents data from a general population survey of three areas of Britain which manifest considerable differences in official rates of problem drinking, yet show similar patterns and levels of alcohol consumption. Consideration of various sources of bias (non-response, forgetting, selective under-reporting, and interviewer) suggest that they do not differentially influence self-reported alcohol consumption in the three areas. PMID- 3651182 TI - Factors associated with young adult alcohol abuse. AB - The present study examined correlates of alcohol abuse among university students which have been conceptually linked to the developmental transitions faced by this population. Individual and family developmental theories led to the hypothesis that sex role identity conflict and stresses within the student's family of origin would be positively related to alcohol abuse scores. As expected, an accumulation of family stresses was related to alcohol abuse scores for both men and women. However, for each sex only one of the four sex role conflict variables which were considered was significantly related to alcohol abuse scores. For women, this variable was femininity conflict, while for men it was affiliation conflict. PMID- 3651184 TI - Concerning the probability of our confidence in statistics. PMID- 3651183 TI - Alcohol and the elderly: relationships to illness and smoking. AB - A group of 33 semi-independent living nonagenarian men and a group of 32 65-75 year-old men of similar demographic characteristics, living at the California Veterans' Home, were compared in terms of alcohol use, past and present, and relationships to several somatic, mental and lifestyle aspects including smoking. The younger group had a higher prevalence of alcohol abuse and higher current alcohol intake (P less than 0.004). Higher alcohol intake related to greater smoking of cigarettes in the younger group. Alcohol tended to be related to an increased number of medical illnesses, and to increased use of major medications (P less than 0.005). There was an interactive effect between classes of alcohol use and scores on a mental status examination used to assess cognitive function (P less than 0.05). PMID- 3651185 TI - Neonatal status in relation to incision intervals, obstetric factors, and anesthesia at cesarean delivery. AB - Uterine incision to delivery interval has been suggested as a critical determinant of neonatal outcome; however, studies of skin incision and uterine incision to delivery intervals have usually not analyzed the contribution of obstetric factors relative to time factors in determining outcome. A group of 204 patients undergoing cesarean delivery were studied. Stepwise multivariate regression was used to examine the relative contribution of obstetric and anesthetic factors to Apgar scores and umbilical cord blood gases. Apgar scores and umbilical cord blood gases were significantly influenced by labor complications (fetal distress, meconium, and pre-eclampsia), infant weight, type of cesarean delivery (primary vs. repeat), and type of anesthesia. Skin incision and uterine incision to delivery intervals did not significantly contribute to Apgar scores nor umbilical cord blood gases when corrected for these factors. We conclude that careful attention to maternal status prior to cesarean delivery and optimal anesthetic management appear to be the most important factors for good neonatal outcome. Surgical techniques should be directed at gentle, atraumatic delivery of the fetus for the good of the fetus and the mother. PMID- 3651186 TI - Postdate pregnancies: a review of 46 perinatal deaths. AB - A review of 46 perinatal deaths was conducted using a 1982 to 1985 regional perinatal network database of 6701 delivered postdate (greater than or equal to 42 weeks gestation) infants. Perinatal mortality (6.9 per 1000 births) increased as gestational age advanced beyond 42 weeks, and was higher in young teenagers or mothers with some additional antenatal complications, such as hypertension. Meconium staining of the amniotic fluid, low Apgar scores, low birthweight, congenital malformations, and neonatal complications, including pneumothorax, meconium aspiration, and seizures, were associated with perinatal death. PMID- 3651187 TI - The effect of initial Apgar score on the birthweight-specific survival of the very low-birthweight infant. AB - Gestational age (GA) and birthweight (BW) specific neonatal survival statistics were generated to examine the possible effect of one-minute Apgar score on outcome in very low birthweight (VLBW) infants. BW-specific and GA-specific survival is enhanced when the one-minute Apgar score is 4 or more. The route of delivery seems to matter little, although the cesarean section rate is higher for VLBW infants. The data suggest that preconceived notions about adverse outcome for this group of infants could be improved by delivery in better condition. Similarly, our approach for using BW- and GA-specific outcome, which includes condition at birth, can provide a more useful basis for comparing between different populations, allowing for some assessments to be made concerning the quality of care. PMID- 3651188 TI - Obstetric diagnosis and perinatal mortality. AB - A multidisciplinary team composed of obstetricians, pediatricians, and pathologists examined the causes of 453 consecutive perinatal deaths, which occurred between 1978 to 1982. A clear distinction between obstetric diagnosis and infant cause of death was made, and a prinicpal obstetric and infant diagnosis was assigned to each death. Perinatal death rates by obstetric category were calculated. The rates varied from 6.1 per 1000 births in uncomplicated cases to 217.4 per 1000 births in isolated intrauterine growth retardation. The causes of perinatal death within obstetric categories were tabulated. Nonviability or the complications of prematurity (65%) were the leading causes of death when there was third-trimester bleeding, premature labor, or premature rupture of membranes. Anoxia (59%) was the most frequent cause of death when there was hypertension/pre-eclampsia or other uteroplacental insufficiency states. Death from congenital abnormality accounted for 17.7% of all perinatal deaths. A focus on the causes of perinatal death with obstetric diagnostic categories helps weigh the risk of prematurity versus the risk of anoxia in the management of high-risk gravidas. PMID- 3651189 TI - Placental pathology is not predictive for sudden infant death syndrome (SIDS). AB - A previous report has suggested an increased incidence of chorioamnionitis in the placentae of sudden infant death syndrome (SIDS) victims. To further evaluate placental pathology in SIDS, 27 cases were identified from coroner's records and matched to two control groups. Both control groups were matched for birthweight, gestational age, and season, with the second also matched for maternal race, infant sex, blood type B, and maternal parity. No significant increase in chorioamnionitis or other placental abnormalities were found in SIDS victims when controlling for prematurity, which is a factor related to chorioamnionitis. An increased incidence of vaginal bleeding (P less than 0.04) and possibly substance abuse or anemia at delivery was found in SIDS mothers. There were more premature and black infants found in the SIDS group compared with the general birth population, and also lower five-minute Apgar scores (P less than 0.02) compared to matched controls. Analysis of the second control group match, including infant Apgar scores, maternal hematocrit, maternal age, and complications of pregnancy and delivery, did not influence any of our conclusions. The data suggests that matching for prematurity may be important in identifying the strength of additional risk factors for SIDS, since the risk factors for SIDS and premature delivery are similar. PMID- 3651191 TI - Maternal response to daily fetal movement counting in primary care settings. AB - Maternal counting of fetal movement (FM) to assess fetal well-being was studied in 394 pregnancies followed by family physicians. Counting was well accepted, with 85% of women finding it reassuring and 91% wanting to include it in subsequent pregnancies. Eighty-eight percent of women reported counting five or more days per week. Thirteen women reported decreased activity a total of 20 times. A nonstress test (NST) was performed 20 times and an oxytocin challenge test (OCT) was performed four times as a result of these reports. One of the 20 reports of decreased activity was followed by a nonreactive NST and suspicious OCT, and led to the induction of a viable 38-week fetus. There were no stillbirths in the group and only one neonatal death of an anencephalic infant. PMID- 3651190 TI - Prognosis of hypertension first documented during labor. AB - In order to assess the prognosis of hypertension first documented during labor, an inception cohort of all women with hypertension complicating pregnancy was assembled. In this cohort, even extreme elevations of blood pressure, regardless of the degree of proteinuria, were not associated with either maternal or fetal adverse outcomes. Therefore, some degree of hypertension during labor may be physiologic. Matched pairs analysis demonstrated that intravenous (IV) magnesium sulfate, administered to prevent seizures, was associated with an excess number of primary cesarean sections. Given the excellent prognoses in patients with good antepartum care in whom hypertension is first documented during labor, the need for any preventive measures, or for antihypertensive or anticonvulsant treatment, should be reconsidered. PMID- 3651193 TI - Congenital disseminated herpes simplex virus type II infection in a premature infant. AB - A rare case of congenital herpes simplex virus type II infection is reported in a 25-week premature infant. Transmission of infection was thought to be transplacental, and the infection was rapidly fatal ex utero due to extensive antenatal disseminated disease. PMID- 3651192 TI - Does intravenous ritodrine therapy cause capillary endothelial damage? AB - The effects of intravenous (IV) ritodrine therapy on capillary endothelial damage and colloid osmotic pressure were examined in 15 patients in premature labor. Plasma fibronectin, a marker for capillary endothelial damage, did not change significantly after IV ritodrine therapy. Plasma colloid osmotic pressure was lowered following ritodrine therapy (P less than 0.05). Pretreatment plasma fibronectin levels in the study and control groups were similar. Interestingly, pretreatment colloid osmotic pressure in the study group was significantly lower than that of the control group (P less than 0.05). Our data suggest that there is no evidence of capillary endothelial damage following ritodrine therapy. Lower levels of plasma colloid osmotic pressure in patients with preterm labor, which are further reduced with IV ritodrine therapy, may predispose these patients to pulmonary edema. PMID- 3651194 TI - Pre-eclampsia, magnesium sulfate, and blood pressure evaluation during labor: a preliminary consideration. AB - The influences of uterine contractions and magnesium sulfate (MgSO4) infusion on blood pressure evaluation of the pre-eclamptic patient in labor have not been thoroughly investigated. Blood pressures were measured between and during contractions in 13 patients with pre-eclampsia, before and after MgSO4, and in 17 normotensive patients. Pre-eclampsia was associated with a mean 11 mm Hg increase in pulse pressure (P less than 0.001), which fell by 8 mm Hg following MgSO4 infusion (P less than 0.001). With pre-eclampsia, pressure increases up to 45/28 mm Hg were observed during contractions. Theoretically, reduced pulse pressure, resulting in decreased shearing force applied to vessel walls, could be a previously unrecognized therapeutic effect of MgSO4. Potentially dangerous pressure elevations could be missed by relying exclusively on diastolic values measured between contractions. PMID- 3651195 TI - Disseminated herpes simplex infection in an immunocompromised pregnancy: treatment with intravenous acyclovir. AB - In this article, we report a case of third-trimester disseminated herpes simplex virus (HSV) infection in an immunocompromised gravida who was treated with parenteral acyclovir. Rapid resolution of lesions occurred, and the fetus was delivered at term without evident abnormalities. Of the four previous reports on this therapy, there has been one maternal death and survival of all neonates. Acyclovir should be considered in the treatment of disseminated HSV infection in pregnancy. PMID- 3651196 TI - Iatrogenic caloric restriction in pregnancy and birthweight. AB - The effects on fetal growth of iatrogenic prescription for dietary restriction in pregnancy have been infrequently assessed, and results have suggested large decrements in birthweight. We therefore related maternal dietary restriction to fetal growth among participants in the National Collaborative Perinatal Project at the Columbia Presbyterian Medical Center in New York. There were 255 women who delivered term infants with birthweights under the 31st percentile (low birthweight), who were each matched to women who delivered heavier term infants, within ethnic and gestational age strata. On review of antenatal records, 198 women were identified who had received a physician's recommendation to restrict caloric intake to 1800 kcal/day or below. The odds ratio between caloric restriction and low birthweight was 0.88 (not significant [NS]). Rates of maternal weight gain were controlled by linear multiple regression analysis, since higher weight gain was associated both with the likelihood of having a diet prescribed and with higher birthweight. With control for weight gain, although the odds ratio was reversed, the change was of small magnitude and not statistically significant. We found no relationship between medical advice to limit caloric intake during pregnancy and intrauterine growth retardation. Since women asked to limit caloric intake continued to gain more weight than others, the results are consistent with lack of compliance with the dietary regimen. PMID- 3651197 TI - 7th International Congress on Circumpolar Health. June 8-12, 1987, Umea, Sweden, Abstracts. PMID- 3651198 TI - Results of a seat belt use law enforcement and publicity campaign in Elmira, New York. AB - In New York and other states in which seat belt use laws went into effect in the mid-1980s, belt use rates surged initially, then declined. This pattern of belt use also occurred in Canadian provinces that enacted laws in the mid-1970s; special enforcement programs reversed this trend. In late 1985 a three-week enforcement and publicity program was conducted in Elmira, New York. Belt use rates in Elmira were 49 percent before the program, 77 percent right after, and 66 percent two months later. In Glens Falls, a comparison city without a program, belt use declined from 43 percent to 37 percent during this interval. In a telephone survey after the campaign, Elmira respondents were more likely to say the belt use law was being strictly enforced and were more favorable toward it, compared to Glens Falls respondents. These data indicate that enforcement/publicity programs are an important and feasible method for increasing compliance with belt use laws. PMID- 3651199 TI - Shoulder belt use in four states with belt use laws. AB - Shoulder belt use was observed before and after belt use laws went into effect in New York, New Jersey, Illinois, and Texas. There were large increases in belt use rates in each state in the first month the laws were enforced. In the three states in which post-law observations were made more than once, belt use declined from the levels seen in the first month; rates generally dropped to less than 50 percent. This pattern of decline from initial use rates has also been found in other jurisdictions around the world. Combined enforcement and publicity campaigns have been shown to be capable of reversing this trend and to increase use rates to 65 percent or more. Such campaigns will be needed to maximize the effect of seat belt use laws in the United States. PMID- 3651200 TI - Changing patterns in motor vehicle crash mortality: 1940-1980. AB - Overall motor vehicle mortality rates in the United States varied little between 1940 (26 deaths per 100,000 per year) and 1980 (23 deaths per 100,000 per year). However, the distribution of motor vehicle deaths by age, sex, and road user status has changed considerably. Among the elderly there has been a substantial increase in motor vehicle death rates. The result of these changes, and of the altered age structure of the population, is that the number of years of life lost to motor vehicle crash injury before age 70 has increased 84 percent between 1940 and 1980. PMID- 3651201 TI - Development of models for on-board detection of driver impairment. AB - Two of the leading causes of automobile accidents are driver impairment due to alcohol and drowsiness. Apparently, a relatively large percentage of these accidents occur because drivers are unaware of the degree to which they are impaired. The purpose of this research was to develop models, utilizing changes in driver behavior, which could detect driver impairment due to alcohol, drowsiness, or the combination of alcohol and drowsiness, and which could be practically implemented in an automobile. A computer-controlled automobile simulator was used to simulate a nighttime highway driving scenario for six drivers who participated in each of four conditions: a control condition, an alcohol condition, a sleep-deprived condition, and a combined alcohol and sleep deprived condition. The results indicated that a useful on-board drowsiness detection device is possible and practical for highway driving. The results also showed that on-board alcohol impairment detection may be possible at levels below the legal driving limit in most states (BAC 0.1%). PMID- 3651202 TI - Initial deterrent effects of the crackdown on drinking drivers in the state of Arizona. AB - This paper reports the initial impact on motor vehicle crashes and casualties resulting from recent efforts to crackdown on drinking drivers in Arizona. Like similar efforts throughout the United States, Arizona lawmakers adopted tough, deterrence-based legislation as the state's chief response to heightened concern with the problem of alcohol-impaired driving. The impact of the new law was measured using interrupted time-series analysis of traffic data. The results indicated that the legal intervention had no deterrent effect. An examination of possible competing events suggested that significant deterrence of drinking and driving was achieved prior to introduction of the new law. Initiation of this effect was attributed to preexisting anti-drunk-driving publicity. PMID- 3651203 TI - Safety analysis in design--evaluation of a case study. AB - Safety analysis was applied in the design of a section at a paper mill. The case study involved analysis of layout, transport system, machines, and a number of different activities. The purpose of the analysis was to find measures to decrease occupational accidents. Three years after the installation was finished the occurrence of accidents was investigated. There was a 56% decrease in the number of accidents; the number of working days lost due to accidents was diminished by 75% as compared to 4 years preceding. The results of the safety analysis were also evaluated with respect to the accidents which had occurred. The methods for safety analysis seem to have been efficient in identifying hazards. The general conclusion of the study is that safety analysis can be an effective tool to decrease occupational accident risks. PMID- 3651205 TI - Emergency medical service systems in Belgium. PMID- 3651204 TI - [Changes in the content of membrane phospholipids of subcellular structures of skeletal muscle in halothane-induced malignant hyperthermia of the domestic pig]. PMID- 3651206 TI - [OPSI syndrome ("overwhelming post-splenectomy infection") as a late sequel of post-traumatic splenectomy in an adult]. PMID- 3651207 TI - [Deep hypothermia following an accident--a case report]. PMID- 3651208 TI - [The International System of Units in research and clinical practice]. PMID- 3651209 TI - [Coagglutination test for detecting human rotaviruses in feces. Comparison with the ELISA test]. PMID- 3651210 TI - [Risk factors for postnatal death]. PMID- 3651211 TI - [Arterial pressure in school children in Mexico City. Importance of tables of normal values]. PMID- 3651212 TI - [Comparative study of the behavior of hyperbilirubinemic and healthy newborn infants during the first month of life]. PMID- 3651213 TI - [Malignant rhabdoid tumor in infancy]. PMID- 3651214 TI - [Microtechnic for the determination of urinary 17-ketosteroids]. PMID- 3651215 TI - [Fictitious illnesses in pediatrics: a diagnostic challenge]. PMID- 3651216 TI - [Taeniasis-cysticercosis as a public health problem]. PMID- 3651217 TI - [Writing the values and abbreviations of the International System of Units]. PMID- 3651218 TI - [Weight loss in the first 15 days of life and increase in size at later ages]. PMID- 3651219 TI - [Clinical study of dermato/polymyositis with onset in childhood]. PMID- 3651220 TI - [Airborne fungi in Tabasco, Mexico]. PMID- 3651221 TI - [Ventricular puncture in the management of severe intraventricular hemorrhage]. PMID- 3651222 TI - [Thyroid function study in children]. PMID- 3651223 TI - [Bacterial meningitis]. PMID- 3651224 TI - [Acquired coagulation factor IX deficiency in a patient with idiopathic nephrotic syndrome]. PMID- 3651225 TI - [Enteric cyst of multiple localization]. PMID- 3651226 TI - [Drug dependence as a public health problem. Progress and perspectives of prevention]. PMID- 3651227 TI - Rats with nucleus basalis magnocellularis lesions mimic mnemonic symptomatology observed in patients with dementia of the Alzheimer's type. AB - College students, healthy elderly subjects, patients diagnosed with mild or moderate dementia of the Alzheimer's type, as well as rats with small or large lesions of nucleus basalis magnocellularis (NBM) were tested on an order memory task for a 6- or 8-item list of varying spatial locations. Similar patterns of order memory deficits as a function of serial order position were observed in rats with small or large NBM lesions and patients with mild or moderate dementia of the Alzheimer's type. The results provide support for the possibility that rats with NBM lesions might mimic the mnemonic symptomatology of Alzheimer's disease. PMID- 3651228 TI - Nutrients that modify the speed of internal clock and memory storage processes. AB - Two experiments assessed the effects of nutrients on timing behavior by rats. The nutrients were laced with saccharin and given to rats as a snack before training on a 20-s peak-interval procedure. The primary component of the snacks for four groups of 10 rats was lecithin (phosphatidylcholine), protein (casein), carbohydrate (sucrose), or a nonnutrient (saccharin). The primary measure of behavior was the time of the rat's highest response rate during a trial (peak time), which represented the interval during which the rat maximally expected food. With a lecithin snack, peak time was gradually shifted over sessions to a shorter time, remained shifted to the left of the normal function with additional testing, and then remained at the shorter time on two sessions after the snack was discontinued; with the protein snack, peak time was abruptly shifted to a shorter time, returned to normal with additional testing, and then rebounded to a longer time when the snack was discontinued; with a carbohydrate, snack peak time was abruptly shifted to a longer time, returned to normal with additional testing, and then rebounded to a shorter time when the snack was discontinued. The behavioral patterns produced by the nutrients were interpreted in terms of precursor effects on central neurotransmitter synthesis and release, psychological stages of an information-processing model, and mathematical parameters of a scalar timing theory. PMID- 3651229 TI - Dissociable effects of lesions to the dorsal or ventral noradrenergic bundle on the acquisition, performance, and extinction of aversive conditioning. AB - In six experiments we studied the effects of lesions to either the dorsal or ventral noradrenergic bundle on the acquisition and extinction of the conditioned emotional response (CER) as measured in a conditioned suppression paradigm. Infusions of the neurotoxin 6-hydroxydopamine (6-OHDA) into the trajectory of the dorsal noradrenergic ascending bundle (DNAB) impaired the acquisition of on-the baseline and off-the-baseline conditioned suppression. The acquisition impairment for on-the-baseline conditioning was also shown to still be present when training did not commence until 8 weeks following central noradrenergic depletion. However, in rats previously trained on the CER, DNAB lesions did not affect performance. There was also a small resistance to extinction following on-, but not off-the-baseline conditioning. The acquisition impairment was shown not to be because of an altered sensitivity to the footshock. In contrast, infusions of 6 OHDA into the ventral noradrenergic ascending bundle (VNAB) had no effect upon the acquisition of the CER in an on-the-baseline procedure, but retarded its extinction to a much greater extent. The results here are discussed in terms of other acquisition deficits shown by rats with DNAB lesions, and with reference to Gray's "anxiety" and Mason's "selective attention" theories of locus coeruleus function. PMID- 3651230 TI - Functional consequences of embryonic neocortex transplanted to rats with prefrontal cortex lesions. AB - In four experiments we reexamined the recent report by Labbe, Firl, Mufson, and Stein (1983) that fetal cortical tissue transplanted to an aspirative prefrontal cortical cavity in rats can ameliorate the learning impairments induced by the aspirative lesions. Healthy surviving grafts from young (E16) embryonic donors had no immediate effects on the rats' impairments in T-maze alternation, spatial navigation in the Morris swimming pool task, or locomotor activity, and they produced even greater impairments than the lesions alone when all three tests were conducted after longer (3-5 month) survival periods. Grafts taken from older (E21) donors did produce a short-lasting improvement in the T-maze alternation performance, replicating the previous report. However, this effect was not seen in the other two behavioral tests; the grafts survived poorly, and the beneficial effect was no longer apparent in the long-term tests. It is concluded that (a) functional benefits of embryonic cortical grafts are dependent on a precise combination of conditions rather than being a general phenomenon, and (b) the short-lasting recovery in delayed alternation performance is attributable to diffuse influences of the embryonic tissue on the lesioned host brain rather than to a reconnection of damaged circuitries. PMID- 3651231 TI - Double dissociation of effects on learning of medial versus lateral hyperstriatal lesions in pigeons. AB - Three experiments examined the effects of medial and lateral hyperstriatal lesions in two groups of pigeons. In Experiment 1, both hyperstriatal groups were impaired, relative to unoperated and operated control groups, in postoperative performance of preoperatively acquired serial reversal of both spatial and visual discriminations. The deficits of the two hyperstriatal groups appeared both quantitatively and qualitatively similar. Experiment 2 found that performance of spatial reversals was disrupted in the medial, but not in the lateral, hyperstriatal group by a long intertrial interval. Experiment 3 found that acquisition of simultaneous matching-to-sample was disrupted by lateral, but not by medial, hyperstriatal lesions; the lateral group also showed a lower rate of response to the sample stimulus than any of the other groups. Implications of these findings for current theories of hyperstriatal function are discussed. PMID- 3651232 TI - Motor neuronal function in old Aplysia is improved by long-term stimulation of the siphon/gill reflex. AB - As Aplysia age, motor neuronal (L7) elicited gill-pinnule contractions are significantly decreased, as is transmission at pinnule junctions. To determine whether this reduced function of L7 with increased age could be altered, the siphon/gill reflex, which involves the L7-pinnule pathway, was stimulated regularly in unrestrained old animals. Aplysia, more than 240 days old, were assigned randomly into trained and untrained groups. For more than 3 weeks, a 1 s, 25-g water jet stimulus was administered to the siphon of the trained animals 10 times per day at 20-min intervals. The duration of siphon withdrawal increased significantly during training. In semi-intact preparations, pinnule contractions and junctional transmissions were then measured during 3-s depolarized pulses to L7 (frequency range = 1-44 per 3-s interval). The trained animals had (a) significantly higher pinnule contractions, (b) a significantly greater increase in pinnule contractions elicited by increasing L7 spike rates, (c) significantly higher double-spike facilitation, and (d) significantly higher facilitation per spike across the four spike trains below or at pinnule contraction threshold. Long-term stimulation of the siphon/gill reflex in old Aplysia did not produce the same functional efficiency observed in mature Aplysia; nevertheless, the significant training-induced increases in both pinnule contraction and junction transmission indicate that a considerable level of plasticity still exists in an aging nervous system. Whether this long-term training of Aplysia retards the same processes responsible for the age-related decline in neuromuscular transmission or produces a compensatory change in other neuronal processes is discussed. PMID- 3651233 TI - Temporal aspects of ventromedial hypothalamic progesterone action in the facilitation of estrous behavior in the female rat. AB - Progesterone (P) action following estrogen priming is required normally for the facilitation of estrous behavior in female rats. Although mechanisms by which P exerts its influence on estrous responsiveness have not been elucidated, the primary site of action of P has been shown to be the ventromedial nucleus of the hypothalamus (VMN). The objective of the present series of experiments was to describe the temporal parameters of P action in the VMN in the facilitation of estrous behavior in estrogen-primed female rats. Subjects were female Long-Evans rats stereotaxically outfitted with 23-ga. guide cannulae directed towards the VMN. Crystalline P was applied directly to the brain tissue via bilateral 28-ga. insert cannulae, which could be inserted and removed easily through the guide cannulae. Animals were ovariectomized and estrogen primed with 5% estradiol Silastic capsules. They received a counterbalanced series of two experimental tests: one involving a manipulation with a P-filled implant, and another with a blank implant. In the first experiment, a significant increase in estrous responsiveness occurred only after 2 hr exposure of the VMN to P, whereas 4 hr were required for a full display of estrous behavior, including solicitation. In Experiment 2, P was lowered into the brain for either 1, 2, or 4 hr, and testing took place 4 hr after the lowering of the implant. It was found that 2 hr of P exposure was sufficient to facilitate full estrous responsiveness at 4 hr. In Experiment 3, it was revealed that the duration of estrous responsiveness was directly related to the time the P implant remained in the brain. In the fourth experiment, the time course of P retention in brain tissue, revealed by determination of 3H-progesterone levels in hypothalamus, agreed with the behavioral findings. Progesterone levels in the region of the VMN remained high while a P implant was in place, but declined rapidly after removal. A dual mechanistic hypothesis for P action in the facilitation of estrous behavior is presented. PMID- 3651234 TI - A systematic evaluation of the properties of self-stimulation train-duration response functions. AB - A series of experiments examined the characteristics of train-duration response functions and two statistics derived from these functions: train-duration thresholds and maximum rates. Train-duration response functions exhibited a steplike appearance. The slope of the train-duration curves was not influenced by either reward or performance manipulations, which suggests that the animals were not matching their response rates to changes in these factors along the steep part of the function. Substantial shifts in train-duration thresholds were observed following changes in the reward value of the brain stimulation, whereas maximum rates were affected by changes in factors such as response effort. The results of Experiments 1 through 6 demonstrate several similarities and differences between train-duration response functions and the reward summation functions generated with manipulations of stimulation frequency. The experiments described in this report provide convergent evidence for the validity of both of these approaches. PMID- 3651235 TI - Dietary self-selection of golden hamsters in response to acute food deprivation and chronic food restriction. AB - Adult male golden hamsters were maintained on either Purine Rat Chow (Chow diet) or a self-selection diet consisting of high-protein chow, pure fat, and pure carbohydrate (Choice diet). In Experiment 1, animals were deprived of food for single periods of up to 48 hr. Animals on the Chow diet did not increase intake at any time after deprivation; animals on the Choice diet selectively increased their consumption of fat-derived calories and increased their total caloric intake during the first 6 hr of refeeding, but not thereafter. The nature of the diet did not influence the rate at which animals regained weight following deprivation. In Experiment 2, hamsters were placed on food-restriction schedules (access to food either for 1 hr/day only or on alternate days only) until they lost 20% of starting body weight. Chow-fed animals demonstrated little or no change in food intake either during or after food restriction. Hamsters on the Choice diet consumed more calories and lost weight more slowly than did chow-fed animals during 1-hr/day feeding; intake of fat-derived calories was elevated during restriction. Choice hamsters increased total caloric intake only towards the end of the alternate-days restriction schedule. Choice hamsters were hyperphagic following both types of food-restriction schedules, but no increased preference for fat-derived calories was observed. Factors influencing food consumption of hamsters in response to deprivation and restriction are discussed. PMID- 3651236 TI - Short-term object recognition memory in the rat: nonmatching with trial-unique junk stimuli. AB - A delayed nonmatching-to-sample task with trial-unique stimuli (DNMS), similar to that used to test object recognition memory in primates, was adapted for use with rats. For each trial of the DNMS task, two stimuli were randomly selected from a pool of 250 small "junk" objects; one member of the pair was designated as the sample. On the first part of a trial, the rat traversed an elevated runway and displaced the sample for food reward. After a 10-s delay, the rat again traversed the runway to choose between the previously presented sample and the second member of the pair. Reward on the choice trial followed selection of the new object. Scores on the first day of DNMS were significantly above chance, and animals could consistently perform at approximately 75% accuracy. Extending the delay to 30 or 120 s lowered choice accuracy, but performance was still above chance. The DNMS taks for rats, unlike most other memory tests for rodents, does not require memory for spatial location. The similarity to tests used with primates should allow for more direct comparison of results of memory research across species. PMID- 3651237 TI - Feeding induced by ventricular bromocriptine and amphetamine: a possible excitatory role for dopamine in eating behavior. AB - The effects of intracerebroventricular (ICV) administration of the dopamine (DA) agonists, bromocriptine and d-amphetamine, on feeding and feeding-associated behaviors were examined. Male Wistar rats were injected ICV with 80-micrograms bromocriptine or its vehicle or with 10-micrograms d-amphetamine or saline. For 2 hr, the activity, duration of individual grooming, eating, and drinking bouts, and the amount of food and water consumed were recorded. Bromocriptine and amphetamine significantly increased the amount the animals ate and meal duration, but did not significantly affect the other observed behaviors (grooming, drinking, activity, or number of meals). The findings are interpreted as being consistent with the anhedonia hypothesis (Wise, 1982), in which DA is involved with the reinforcing components of external stimuli (i.e., food). PMID- 3651238 TI - Effects of antimitotic treatment on haematopoietic tissues in mice. AB - The antimitotic drug hydroxyurea was injected into mice twice daily for one, two, three or four consecutive days, and its effects assessed in bone marrow (BM) and spleen (SP). The number of nucleated cells decreased with the number of injections, reaching 25% of normal control values in SP and less than 10% in BM after four cycles. In contrast, the number of red blood cells (RBC) also dropped in SP, but increased in BM. Histological and morphometric studies showed that the increased number of RBC in BM could result from two major modifications in the marrow tissue: an expansion of sinusoids and a possible extravasation of cells from the marrow vasculature. PMID- 3651239 TI - Effect of silica on the genetic regulation of antibody responsiveness. AB - The high (H) and low (L) antibody responder lines of mice produced by selective breeding are characterized by different modifications in immunocompetent cell potentialities, according to the immunization procedure used for the selection process. In selections I and II, the difference in antibody responsiveness between H and L lines was clearly shown to depend mainly on macrophage function: the more rapid catabolism of antigens in L mice was the main cause of the low antibody production. In contrast, up to now, no difference has been observed between H and L mice of selections III and IV in terms of the macrophage accessory role. The administration of silica particles has a well known impairment effect on macrophage activity. Therefore, the effect of silica injection on the kinetics of antibody responses to selection antigens was compared in H and L mice of the four selections. Silica was given either intravenously or locally in one hind footpad 6 or 24 h before immunization by the same route. Silica treatment consistently improved antibody responsiveness in the L mice of selections I and II, but had no effect in the L mice of selections III and IV. The antibody responses of the H lines of the four selections were not substantially modified by silica injections. Therefore, the silica treatment reduced the interline difference in antibody responses in selections I and II only, by interfering with the expression of the genetic modification of macrophage activity. However, a similar effect was not obtained with other substances known to affect macrophages, including dextran sulphate or carrageenan. The results reported here are in agreement with the above-mentioned statement that the genetic modification of macrophage function plays a major role in the interline difference in selections I and II and is not involved in selections III and IV. PMID- 3651240 TI - Use of mannosylated liposomes for in vivo targeting of a macrophage activator and control of artificial pulmonary metastases. AB - From a mannosylated mycobacterial phospholipid, we prepared an original type of liposome which was taken up by macrophages by means of the mannose/fucose receptor. When a lipophilic immunomodulator, MDP-L-alanyl-cholesterol (MTP-CHOL) was included in such liposomes, they were able to activate WAG rat alveolar macrophages for cytotoxicity against syngeneic tumour cells in vitro. The presence of suboptimal levels of endotoxin was essential for this activation. Cytotoxic macrophages could also be induced in vivo by injecting immunomodulator loaded liposomes intravenously 24 h before harvesting macrophages. A decrease in experimental pulmonary colonies arising from i.v. injected tumour cells was observed following repeated administration of such liposomes. PMID- 3651241 TI - [Spectral analysis of the spatial distribution of the elements in proliferating cell populations]. PMID- 3651242 TI - [Changes in the rat intestinal mucosa after the in vivo administration of wheat germ agglutinin and gliadin]. PMID- 3651244 TI - Laser irradiation on chicken embryos. PMID- 3651243 TI - Further studies on functional differences between adult and neonatal blood. PMID- 3651245 TI - Verbal labelling effects on recall and detailed reconstruction of a complex visual stimulus. PMID- 3651246 TI - [The growth weight curve in 1st- and 2d-generation hypoxic white rats]. PMID- 3651247 TI - Relation between liver necrosis and intrahepatic cholestasis in rats poisoned with CCl4. PMID- 3651248 TI - [Microangio-architecture of the normal human spleen: histometric parameters]. PMID- 3651249 TI - [Schwann cells in acute and chronic Guillain-Barre syndrome]. PMID- 3651250 TI - ChAT-like immunoreactivity of the pedunculopontine tegmental neurons projecting to the somatosensory cortex in the rat. PMID- 3651251 TI - Melilotus alba permeable seeds in Liguria (Italy). PMID- 3651252 TI - [Evaluation of the protective activity of phosphatidylcholine in comparing lipid peroxidation processes]. PMID- 3651253 TI - Circadian rhythm of plasma cortisol in cirrhosis of the liver: relationship with liver plasma flow. PMID- 3651254 TI - [Erythrocyte deformability in rheumatoid arthritis]. PMID- 3651255 TI - Pituitary-thyroid and pituitary-testis axes in liver cirrhosis. PMID- 3651256 TI - Plasma prolactin in liver cirrhosis. PMID- 3651257 TI - [Appearance and maturation of mucosal secretion in the collecting ducts of the chicken metanephros: histochemical study]. PMID- 3651258 TI - [Effects of met-enkephalin on the transfer of C14 from alanine-C14 to glucose in the normal rat]. PMID- 3651259 TI - [Interaction of anti-inflammatory substances with the transport of 35SO4 in red blood cells]. PMID- 3651260 TI - [The ascorbic acid system in Vicia faba L]. PMID- 3651261 TI - Changing aspects in the treatment of squamous cell carcinoma of the oral tongue. AB - Two groups of patients were compared. In group 1, consisting of 304 patients treated from 1958 to 1972 (minimum observation time of 5 years), the local and regional control rate was 35 per cent. In group 2, consisting of 126 patients treated 1978 to 1983 (median observation time of 58 months), the local and regional control rate was 60 per cent (p less than 0.0001). The local and regional control rates were improved for all stages, but the differences were significant only for stages T1N0, T2N0, T3N0 and TXN2,3. The actuarial survival rates also showed improvement in group 2 patients. The incidence of treatment failure, with regard to the neck alone or tongue and neck combined, decreased from 51 per cent to 27 per cent with the newer techniques. The greatest improvement was observed in patients with T1N0 and T2N0 tumors. There was also a decrease in the failure rates in patients with the more advanced tumors. PMID- 3651262 TI - Head and neck cancer. Reliability of American Joint Committee's staging system as prognostic indicator. AB - The present American Joint Committee (AJC) staging system for the head and neck cancer does not satisfy the criteria as a prognostic or therapeutic indicator when patients are treated initially with radiation therapy. There are certain groups of patients allocated to advanced AJC stages where the prognosis is more favorable and, thus, should not be grouped with the poor prognosis stages. Recognition of these groups is important for any treatment planning or reporting of the end results. PMID- 3651263 TI - Non-Hodgkin lymphoma. Multivariate analysis of prognostic factors including fraction of S-phase cells. AB - In a material of 80 patients with non-Hodgkin lymphoma a multivariate analysis was carried out taking the following variables into account: Age, clinical stage, B-symptoms, morphologic diagnosis and fraction of S-phase cells in the tumour determined by flow cytometry. Clinical stage, proportion of cells in the S-phase, and age of the patient were significant independent prognostic factors. Morphologic malignancy grade and B-symptoms were not significant parameters in this analysis. It was concluded that DNA analysis with determination of the fraction of S-phase cells is a valuable complement to morphology in the evaluation of patients with non-Hodgkin lymphoma. In combination with the clinical stage it gives very good discrimination into groups with different prognoses. PMID- 3651265 TI - Radiation therapy of intrathoracic paraaortic lymph node metastases. Three dimensional treatment planning. AB - The elaboration of a CT-based three-dimensional radiation therapy plan is described, which is applicable for any location and extension of intrathoracic paraaortic lymph node metastases. Calculations for high energy photon beams from a 15 MeV linear accelerator have been performed. The treatment plan enables a high radiation dose in the target volume and adequate sparing of the spinal cord. PMID- 3651264 TI - Radiation pneumonitis and fibrosis following split-course radiation therapy for lung cancer. A radiologic and physiologic study. AB - Radiographic signs of radiation pneumonitis and fibrosis were assessed and pulmonary function monitored in lung cancer patients after two different split course radiation therapy schedules, one with a rest interval of 3 weeks and the other with a rest interval of 5 weeks, the total radiation dose being the same in both treatments (55 Gy/20 fractions/7 or 9 weeks). Post-mortem findings were analysed when available. Spirometric measurement of vital capacity, determination of diffusing capacity for carbon monoxide (DL) and alveolar volume with the single breath technique, and determination of regional distribution of lung perfusion by two different techniques, radiospirometry and gamma camera digital display following intravenous injection of 133Xe, were carried out before and at various times after the completion of irradiation. Of the physiologic parameters, only DL showed a significant decrease 6 as well as 9 months post-treatment (p less than 0.05). No difference between the two treatment schedules could be shown with regard to grade or time pattern of radiologic changes or decrease in DL. The findings suggest that measurement of DL may be of value in monitoring patients included in research protocols for radiation therapy of lung cancer as well as in selection of patients for this treatment. PMID- 3651266 TI - Radioactive iodine and cesium in travellers to different parts of Europe after the Chernobyl accident. AB - Thyroid uptake of 131I was measured in 130 volunteers following the nuclear power plant accident at Chernobyl in April 1986. Ninety of these volunteers had been travelling in different parts of eastern Europe at the time of or immediately after the accident while 40 persons were permanently in Sweden. Also, 28 additional healthy volunteers, living in Sweden, were chosen for a long-term follow-up of the time-course of 134Cs and 137Cs whole body uptake. The highest levels of 131I were found in persons having visited Poland (mean value 3.27 kBq +/- 3.68 SD, extrapolated to April 27) while persons that had stayed in other parts of eastern or northern Europe showed significantly lower levels (p less than 0.01). The whole body burdens of cesium radionuclides were barely detectable immediately after the accident but increased gradually throughout the observed period. After five months nine farmers from a high fallout area in central Sweden had reached mean values of 4.20 kBq (+/- 3.34 SD) of 134Cs and 137Cs while six nonfarmers from the Stockholm area showed significantly lower levels, 0.64 kBq (+/- 0.24 SD, p less than 0.05). The radiation doses from the observed amounts of iodine and cesium isotopes reported in this study reflect only a marginal addition to the already existing dose from the natural environmental background radiation. PMID- 3651267 TI - Effect of portal blood flow and intra-arterially injected starch microspheres on the passage of a labelled tracer through the liver. An experimental study in pigs. AB - Pig liver was used to study the influence of portal blood flow and degradable starch microspheres (DSM) on the passage of radiolabelled methylene-di phosphonate from the hepatic artery to the systemic circulation. When the portal vein was clamped abut 70 per cent of the labelled marker injected into the hepatic artery passed to the systemic circulation and the remaining 30 per cent passed when the portal vein was opened. When the flow of the hepatic artery was stopped, the portal blood flow alone drained about 65 per cent of the marker, which was given as a small volume injection into the hepatic artery. When both the arterial perfusion and the portal blood flow were closed the marker only slowly passed to the systemic circulation. DSM injected into the hepatic artery reduced the passage of the marker through the liver to 75 per cent of the reference level when the portal vein was open. When it was clamped this figure was reduced to about 25 per cent. The effect of DSM on the passage of the labelled marker was found to be dose dependent. It is suggested that the reduced passage of a labelled tracer given mixed with DSM is a useful measure of degree of arterial occlusion in the liver. However, because of the drainage via the portal system the passage cannot be completely inhibited. PMID- 3651268 TI - Treatment of malignant head and neck tumors during pregnancy--a report of 3 cases. PMID- 3651269 TI - Potentiation of the neuromuscular blockade produced by alcuronium with halothane, enflurane and isoflurane. AB - The potentiation of alcuronium by halothane, enflurane and isoflurane was investigated using electromyography. In the first study, cumulative dose-response curves were constructed in four groups of 10 patients anaesthetized with one of the inhalation agents and nitrous oxide, or with fentanyl and droperidol (control). All three agents reduced the ED50 of alcuronium; the effect was marked with isoflurane (P less than 0.005) but less so with halothane (P less than 0.05) and enflurane (ns). In the second part of the investigation, designed primarily to test the duration of action of alcuronium with each agent, a single bolus dose of alcuronium 0.2 mg kg-1 was given to four similar groups (n = 5). The duration of action was significantly prolonged by enflurane (P less than 0.01) and isoflurane (P less than 0.05), but not by halothane. The possible reasons for this are discussed. PMID- 3651270 TI - Electromyographic responses to small doses of suxamethonium in children after burns. AB - Integrated electromyographic studies in burned patients, and in normal controls, during the administration of small doses of suxamethonium (0.1 or 0.2 mg kg-1) have shown that the level of paralysis and the duration of paralysis are significantly increased in burn patients and that the effect is greater with larger burns. Repeated studies on patients using these small doses have shown that patients with burns pass through a phase of extreme sensitivity to the effects of suxamethonium, usually sometime between 4 and 12 days after the burn. PMID- 3651271 TI - Effect of halothane, enflurane and isoflurane on bronchomotor tone in anaesthetized ponies. AB - The effects of halothane, enflurane and isoflurane on bronchial calibre were investigated in five anaesthetized ponies using a computer-aided forced airflow oscillation technique to derive specific lower airways conductance (s.Glaw) and expiratory reserve volume (ERV). All the agents tended to increase s.Glaw (indicating bronchodilatation), but ERV was reduced by halothane and enflurane, and increased by isoflurane. It was concluded that the effects of these agents on bronchomotor tone were similar to those which occur in man. However, the reasons for the differences in their effects on ERV compared with those found in man remain to be determined. PMID- 3651272 TI - Autotransfusion: quality of blood prepared with a red cell processing device. AB - The quality of blood salvaged at operation and prepared with the Dideco Autotrans BT 795 autotransfusion device was compared with that of donor blood in 41 patients having cardiac surgery involving cardiopulmonary bypass. Saved blood had a higher haemoglobin concentration (17.3 v. 13.1 g dl-1; P less than 0.001), a higher 2,3-diphosphoglycerate concentration (5.3 v. 1.1 mmol litre-1; P less than 0.00001), higher white cell count (17.1 X 10(9) litre-1 v. 4.1; P less than 0.00001), higher pH (7.5 v. 6.6; P less than 0.00001) and a more physiological potassium concentration (5.4 v. 8.8 mmol litre-1; P less than 0.00001) than donor blood. Saved blood platelet count was 34.5 X 10(9) litre-1 compared with 146.24 X 10(9) litre-1 (P less than 0.00001) and its heparin concentration was 0.64 u. ml 1. We conclude that this autotransfusor is a useful aid to blood conservation, producing good quality red cells with relatively normal pH and potassium values. However, modification of the centrifugation and washing is required to lessen the high white cell count and heparin concentrations found in the saved blood. PMID- 3651274 TI - Phenotyping of individuals sensitive to suxamethonium. The Cholinesterase Research Unit at the Royal Postgraduate Medical School. AB - Four hundred and thirty blood samples from suxamethonium-sensitive individuals have been phenotyped by the Cholinesterase Research Unit following its transfer from Exeter to the Hammersmith Hospital. The distribution of genotypes has been shown to be similar to that found in Exeter. Screening for the Elk and Elj genes has not yielded any major differences in the gene frequencies of sensitive individuals, even during pregnancy. The uneven sex distribution of the patients, as well as other unusual points that have arisen, are discussed. A new gene for the biosynthesis of cholinesterase has probably been identified. PMID- 3651273 TI - Inhibition of rat fetal methionine synthase by nitrous oxide. An in vitro study. AB - The effect of in vitro exposure to nitrous oxide on rat fetal and maternal methionine synthase activity was investigated. Enzyme solutions were prepared from livers of fetuses and mothers on day 19 of gestation and exposed to air, 50% oxygen or 50% nitrous oxide in oxygen for periods up to 24 h. Normal activity of methionine synthase in the fetus was about 65% of that in the mother. Activity decreased by about 25% over 24 h when the enzyme was incubated at 37 degrees C in the presence of either air or 50% oxygen. Nitrous oxide produced a time-dependent decrease in activity which generally was similar for both fetal and maternal enzyme. After 24 h exposure to nitrous oxide, activity has decreased to 14 and 17% of fetal and maternal control values, respectively. PMID- 3651275 TI - Monitoring of axillary arterial pressure in a patient with Buerger's disease requiring clipping of an intracerebral aneurysm. AB - A 45-yr-old male with advanced Buerger's disease required surgical clipping of an intracerebral aneurysm. This case report emphasizes considerations of arterial pressure monitoring in a patient with advanced Buerger's Disease requiring a major surgical intervention. PMID- 3651276 TI - Massive intraoperative pulmonary embolism in a child. AB - An 11-yr-old girl suffered a massive pulmonary embolus during an operation to insert an artificial bladder sphincter. Forty minutes after the induction of anaesthesia, the heart rate increased and she became hypotensive and deeply cyanosed. A definitive diagnosis was not made during surgery, but she improved after 45 min of resuscitation with 100% oxygen, infusion of normal saline, ephedrine (total 45 mg) and intermittent external cardiac massage. The diagnosis was proved the next day by lung perfusion scan. There were no apparent risk factors. PMID- 3651277 TI - Anaesthesia, and atelectasis: the role of VTAB and the chest wall. PMID- 3651278 TI - Effects of ethanol on psychomotor performance. AB - Three separate doses of alcohol (0.2, 0.4 and 0.8 g kg-1) were given to eight volunteers and compared with the effects of a placebo. The order of administration was randomized and the study performed double-blind. A battery of psychometric tests sensitive to central nervous system depression was repeatedly performed for 3.5 h. Alcohol, even in the highest dose, had little effect on psychomotor performance. PMID- 3651279 TI - Comparison of the effects of atropine and glycopyrrolate on cognitive function following general anaesthesia. AB - Tests of orientation, concentration and short-term visual memory were used to assess 72 patients 1 day before, and 2 days after, elective major surgery. Patients were premedicated with papaveretum and either atropine or glycopyrrolate, before receiving a standard general anaesthetic. Those who had received atropine showed significant postoperative short-term memory deficit (P less than 0.01), but no change in orientation or concentration. Those who had been given glycopyrrolate showed no significant cognitive changes after surgery. As glycopyrrolate does not cross the blood-brain barrier freely, these findings support the involvement of central cholinergic mechanisms in the deterioration of cognitive function in the postoperative period. PMID- 3651280 TI - Use of simple tests to determine the residual effects of the analgesic component of balanced anaesthesia. AB - In order to evaluate simple means of determining the rate of recovery after general anaesthesia, the usefulness of the critical flicker fusion threshold test, the Maddox wing apparatus and the visual analogue scale were compared. The postanaesthetic recovery score was used as a reference. Two patient groups (n = 15 in each) received, in a randomized double-blind study, a similar balanced anaesthesia for Caesarean section, except that the analgesic component was either fentanyl 2.5 micrograms kg-1 i.v. or buprenorphine 7.5 micrograms kg-1 i.v. Maddox wing apparatus and visual analogue scale were sensitive enough to differentiate between the postanaesthetic residual effects of the two opioids, but critical flicker fusion threshold and, especially, postanaesthetic recovery score were insensitive in this respect. There was no difference between the two patient groups in mean arterial pressure and heart rate. Our results show that the residual effects of different kinds of opioids as an analgesic component of balanced anaesthesia can be differentiated using simple means like Maddox wing apparatus and visual analogue scales. PMID- 3651281 TI - Onset and recovery of atracurium and suxamethonium-induced neuromuscular blockade with simultaneous train-of-four and single twitch stimulation. AB - Single twitch and train-of-four stimulation were applied at 0.08 Hz to each ulnar nerve and the force of contraction of the adductor pollicis was recorded during onset of and recovery from neuromuscular blockade by suxamethonium 1 mg kg-1 or atracurium 0.4 mg kg-1. Times to 90% first twitch blockade of train-of-four were (mean +/- SEM) 0.82 +/- 0.08 and 1.98 +/- 0.18 min for suxamethonium and atracurium, respectively, compared with times to 90% single twitch blockade of 1.00 +/- 0.07 and 3.35 +/- 0.37 min, respectively (P less than 0.05 in both cases). Apparent onset time also depended on how long train-of-four stimulation had been applied before injection of atracurium. The mode of stimulation had little effect on time to 10% recovery. The results are consistent with stimulation-induced augmentation in muscle blood flow, which increased delivery of the drug to the neuromuscular junction. PMID- 3651282 TI - Living with radiation. PMID- 3651283 TI - Source of referral and its effect on gastric ulcer management. PMID- 3651284 TI - Who cares for the foreskin? PMID- 3651285 TI - What do we mean by catarrh? PMID- 3651286 TI - Low starting dose labetalol--a new approach for the elderly hypertensive. PMID- 3651287 TI - A severe, potentially fatal, interaction between tiaprofenic acid and nicoumalone. PMID- 3651288 TI - Attenuated cranial polyneuropathy. PMID- 3651289 TI - Spontaneous rupture of incisional hernia. PMID- 3651290 TI - Neuroleptic malignant syndrome. PMID- 3651291 TI - Antibiotics: a clinical update. PMID- 3651292 TI - The reactogenicity of rubella vaccine in a population of United Kingdom schoolgirls. PMID- 3651293 TI - Sublingual nifedipine--a safe and simple therapy for hypertensive emergencies. PMID- 3651294 TI - Parietal pleurectomy for simultaneous bilateral spontaneous pneumothorax. PMID- 3651295 TI - Death and other notable events in the course of infection. PMID- 3651296 TI - Treatment of growth retardation in childhood Crohn's disease. PMID- 3651297 TI - Diabetes mellitus and duodenal ulceration. PMID- 3651298 TI - Surgery for bleeding peptic ulceration in a district general hospital: morbidity and mortality in one year. PMID- 3651299 TI - Blood sugar and prognosis of myocardial infarction in the elderly. PMID- 3651300 TI - Treatment of hypernatraemic dehydration due to diarrhoea. PMID- 3651301 TI - Interactions with cardioactive drugs. PMID- 3651302 TI - Gall bladder necrosis in acute pancreatitis. PMID- 3651303 TI - Calf haematoma masquerading as veno-occlusive disease during anticoagulation. PMID- 3651304 TI - Community-acquired pneumonia. PMID- 3651305 TI - Transcutaneous oxygen measurement in paediatric respiratory disease. AB - We have measured simultaneous arterial (Pao2) and transcutaneous oxygen tension (tcPo2) in 13 children, aged 8 months to 10 years, with respiratory disease. A Radiometer TCM2 transcutaneous oxygen monitor was used. At an electrode temperature of 44 degrees C the regression equation was tcPo2 = 0.9 Pao2 -10 and at 44.5 degrees C tcPo2 = 0.9 Pao2 -8. The 95% confidence limits were +/- 13 torr at both temperatures. We also studied the usefulness of the method in monitoring trends in oxygenation in individual patients. In six children paired observations were made on five or more occasions and in these tcPo2 followed changes in Pao2 accurately. We conclude that this technique is not sufficiently reliable for predicting arterial values, but in individual patients it accurately reflects trends in oxygenation. PMID- 3651307 TI - Notification of tuberculosis in the south-west health region of Norway: incidence and trends. AB - A survey of tuberculosis notification from the south-west health region of Norway showed a decrease from 17.7 cases of tuberculosis per 100,000 population during 1969-1973 to 12.3 cases per 100,000 during 1979-1983. The notification rate linearly increased with age from the age of 20 years on a logarithmic scale. The downward trend in notification was less marked in the last 5-year period compared with the first 5-year period probably due to changes in notification procedures in 1976, an epidemic of tuberculosis in the health region and on oil platforms in the North Sea in 1980 and an increased immigration of people from areas with high incidence of tuberculosis. Tuberculosis of the extrathoracic lymph nodes was during 1979-1983 the most frequent location of non-respiratory tuberculosis. PMID- 3651306 TI - Comparative clinical and laboratory features of legionella with pneumococcal and mycoplasma pneumonias. AB - The clinical and laboratory features of 83 cases of community-acquired pneumococcal pneumonia (PP), 79 cases of legionella pneumonia (LP) and 62 cases of mycoplasma pneumonia (MP) have been compared. No unique features have been found in any group. Patients with MP were younger, were more likely to have had prior antibiotics before hospital referral, had a predominance of upper respiratory tract symptoms, low total white cell counts and lacked features of multisystem involvement. Multisystem features were common in both PP and LP with confusion, high fever, hyponatraemia, hypoalbuminaemia and abnormalities of liver function occurring more often in LP. A high leucocyte count was especially common in PP. Antibiotic therapy in community-acquired pneumonia must remain empirical until a definite microbiological diagnosis is made. PMID- 3651308 TI - Audit of work-load of physicians with a special interest in respiratory medicine. AB - A 6-month prospective survey was undertaken to assess the work-load of two consultant general physicians with special interest in respiratory medicine, one in a teaching hospital (TH) and the other in a district general hospital (DGH). The two firms dealt with similar numbers of inpatients of whom half had non respiratory disease. Eighty per cent of the outpatient work of both firms was respiratory disease. The TH firm saw more referrals from other consultants and referred more patients, especially to other physicians. Practical procedures performed, the proportion of patients seen by the consultant at first attendance and the range of both respiratory and general medical conditions seen by the two firms was similar. PMID- 3651309 TI - Peak expiratory flow in normal Ethiopian children and adults in Addis Ababa. AB - The peak expiratory flow rate was determined using the Wright peak flow meter in normal Ethiopian children and adults residing in Addis Ababa (altitude 2500 m). The sample studied was of 84 boys, 69 girls (4-17 years) and 177 men, 148 women (18-70 years). Normality was determined by history alone. Linear multiple regression analysis was used to construct prediction equations that depended upon height and age. The results serve as reference values specifically for Ethiopians residing at altitude. Comparison of the PEFR values determined in 47 Caucasians (22 males, 27 females) working in Addis Ababa, with those from a group of Ethiopians matched for age and height indicated that the mean PEFR was significantly greater in the Caucasians by 7.3% in males and by 8.2% in females. PMID- 3651310 TI - Variability and reversibility of the slow and forced vital capacity in chronic airflow obstruction. AB - The variability of the forced (FVC) and slow vital capacity (SVC) manoeuvres were compared in 33 adult patients with chronic airflow obstruction. The reversibility of the two manoeuvres to nebulized salbutamol were compared in 18 of the patients. Both manoeuvres had equally small variances both before and after bronchodilator. The degree of reversibility of the FVC was however significantly greater (P less than 0.05) than the SVC. Although both measurements are equally variable, the FVC has a greater capacity for reversibility, which may have clinical significance. PMID- 3651312 TI - An unusual local reaction to continuous subcutaneous infused terbutaline in unstable asthmatics. AB - Three out of nine unstable asthmatics whose asthma is subjectively and objectively better controlled on continuous subcutaneous terbutaline infusions (6 12 mg/24 hours) developed tender indurated subcutaneous swellings at the infusion site. In the two cases reported here in detail, histologically the lesions were areas of panniculitis and deep dermal collagen necrosis. Further investigation of the possible causative mechanism for these lesions--drug solution pH, osmolality, or impurities--suggests that impurities in the solution are the most likely cause. PMID- 3651311 TI - Bronchoscopy in patients with haemoptysis and normal chest roentgenograms. AB - We reviewed the records of 58 patients with haemoptysis and normal chest roentgenograms who underwent fibreoptic bronchoscopy. A diagnosis of malignancy was made in six patients at bronchoscopy. Three patients had bronchogenic squamous cell carcinoma, one a carcinoid tumour and two laryngeal carcinoma. Sputum for cytology was negative for malignant cells in all six patients. Follow up data were available for the other 52 patients for an average period of 55.7 +/ 29.6 (SD) months. Two patients had a subsequent diagnosis of bronchogenic carcinoma at 2 and 6 years after initial evaluation. Three patients died from conditions not related to pulmonary malignancy and the remaining patients followed a benign course. Our patients come from a predominantly male, elderly population of cigarette smokers. Among such patients, we conclude that bronchoscopy is indicated in the evaluation of those with haemoptysis and a normal chest roentgenogram. PMID- 3651313 TI - Fansidar hypersensitivity pneumonitis. AB - We report a subject who had Fansidar prescribed to him for the purpose of malaria prophylaxis. This agent is a combination of pyrimethamine and sulphadoxine. He subsequently developed severe hypersensitivity pneumonia and required mechanical ventilation. We believe that sulphadoxine was responsible for his illness. PMID- 3651314 TI - Bronchocentric granulomatosis and rheumatoid arthritis. AB - We report a 42-year-old patient with an 11-year history of rheumatoid arthritis (RA) who presented 8 years later with haemoptysis and was found to have multiple pulmonary opacities with histological features of bronchocentric granulomatosis (BCG). The association between BCG and RA is discussed and the literature is reviewed. PMID- 3651315 TI - Ocular toxicity following ethambutol in standard dosage. PMID- 3651316 TI - Sentence comprehension strategies in specifically language impaired children. PMID- 3651317 TI - The early utterances of preterm infants. PMID- 3651318 TI - Is otitis media a major cause of specific developmental language disorders? PMID- 3651320 TI - Intelligibility: a linguistic view. PMID- 3651319 TI - The development of conversational disability: a case study. PMID- 3651321 TI - Atypical dysarthria in Munchausen syndrome. PMID- 3651322 TI - Fine structural alterations induced in the rat hepatocyte by adrenalectomy: influence of deoxycorticosterone acetate or fasting. AB - Electron microscopy was used to investigate the changes induced by bilateral adrenalectomy (ADX) in rat hepatocytes. Animals were killed at 1 week post-ADX, either with or without a prior 24 h fast. Further studies were carried out at 4 to 5 weeks after ADX to investigate the effect of administering deoxycorticosterone acetate (DOCA) for 4 weeks on the ADX-induced alterations. At 1 week, fasting had a profound effect on the response of hepatocytes to ADX in that either fasting or ADX alone caused proliferation of smooth endoplasmic reticulum (ER) and reduced glycogen but did not alter the rough ER, while ADX together with fasting resulted in the total depletion of glycogen, the virtual absence of smooth ER and the disaggregation of the rough ER into single cisternae. In contrast to the changes seen at 1 week after ADX in unfasted animals, at 4 weeks the hepatocytes contained increased glycogen in large, dense areas and had a scanty smooth ER, suggesting that some endogenous source of steroid hormones active in carbohydrate metabolism becomes available in male ADX rats by this time. This interpretation was consistent with the finding that DOCA treatment of ADX rats prevented the glycogen accumulation seen at 4 weeks and also induced some smooth ER proliferation. PMID- 3651323 TI - Factors influencing the incidence and severity of swine-serum-induced bile duct lesion in mice. AB - The detailed histopathology of the swine-serum (SS)-induced bile duct lesion and some factors influencing the incidence and severity of the lesion were examined. The lesion was expressed as an eosinophilic and proliferative cholangitis affecting almost the full length of the biliary tract. It appears to be a useful new model of bile duct diseases. The co-existence of sufficient anti-SS antibody together with repeated injection of SS were necessary to produce this lesion. The lesion could be induced reproducibly by intraperitoneal injection of 0.05 to 0.2 ml of swine serum twice a week for 4 weeks in young BALB/c mice. PMID- 3651325 TI - A time course study of the changes that occur to the subcutaneous model of synovium following polyarthritogen. AB - The synovial-like structure lining the cavity of a subcutaneous air pouch in rats was examined macroscopically and microscopically for changes during the induction and progression of adjuvant polyarthritis. The earliest event observed was the infiltration of the lining by inflammatory cells which occurred about 6 days after inoculation with adjuvant. Deposition of fibrin and proliferation of blood vessels and connective tissue soon followed, associated with an even greater infiltration by inflammatory cells and the formation of oedema in the hyperplastic fibrous tissue. These changes resulted in a substantial thickening of the pouch wall (and consequently in air pouch skin thickness) that was most marked on day 9, when few rats had visible signs of joint swelling. As arthritis developed and became established (day 12-14), pouch wall thickness declined to below pre-adjuvant thickness. Histological changes were still evident but at a much reduced intensity. Challenge of pouches with tuberculin at various times showed reactivity of the delayed type, beginning not earlier than day 5 post adjuvant inoculation. Pouches however failed to respond to tuberculin or to the non-specific irritant carrageenan as arthritis developed. PMID- 3651324 TI - An assessment of the influence of antigen dose in two new models of chronic serum sickness glomerulonephritis in the rat. AB - Two new models of chronic serum sickness glomerulonephritis have been developed and characterized, using cationic and native bovine serum albumin (BSA). During this development, it has become apparent that there exists an optimum nephritogenic dose for native (anionic) BSA, above which the severity of glomerular changes diminishes; but for cationic BSA, higher doses consistently produce more severe lesions. This finding supports the theory that antigens of different charge are deposited in the glomerulus by different mechanisms. We have also found that cationic BSA circulates not in the blood plasma, but mainly bound to red cells. The two experimental models have proved to be more convenient and more consistent than those previously reported; the cationic BSA model also induces heavy proteinuria and the nephrotic syndrome. They will facilitate further studies of how antigen-antibody complexes are handled by the glomerulus in chronic immune complex disease. PMID- 3651327 TI - Oestrogen toxicity in the ferret. PMID- 3651326 TI - Platelet lymphocyte adherence in children after surgery. AB - There is limited data on the importance of the adherence phenomenon of platelets to lymphocytes. In the present study rosette formation and agglutination of lymphocytes with autologous platelets were observed in children after surgery. Lymphocytes and platelets were separated by 'Lymphoprep' solutions from heparinized blood. Platelet-lymphocyte agglutinates were prepared in the presence of inactivated fetal calf serum and were counted on slides. Platelet-lymphocyte agglutinates were found to be significantly elevated during the first post operative day. It is concluded that the enhancement of platelet adhesiveness to lymphocytes may be due to anaesthesia. PMID- 3651328 TI - Control of the immune response to contact sensitizing chemicals by cutaneous antigen-presenting cells. AB - The fate of 2,4-dinitrochlorobenzene, a potent contact sensitizing chemical, and 2,4-dichloronitrobenzene, a non-sensitizer, was compared following their application to the skin of BALB/c mice. Although both chemicals were able to bind to protein in vitro and were capable of being absorbed across mouse skin in vivo, only 2,4-dinitrochlorobenzene was able to bind to cells in the skin and to induce the movement of these cells from the epidermis into the dermis and ultimately into the draining lymph nodes. The sensitization potential of a chemical may therefore be dependent on its ability to associate with and stimulate the efflux of cutaneous antigen-presenting cells. PMID- 3651329 TI - Platelet hyperaggregability in a patient with Klinefelter's syndrome and leg ulcers. AB - We describe a patient with Klinefelter's syndrome complicated by recalcitrant leg ulcers, in whom marked platelet hyperaggregability was demonstrated and venous disease excluded. Androgen replacement therapy appeared to bring about healing of the patient's ulcers and was associated with reversal of the platelet abnormality. The possible role of androgen deficiency in the pathogenesis of leg ulceration is discussed. PMID- 3651330 TI - UVA-induced melanocytic lesions. AB - The occurrence of melanocytic lesions following PUVA therapy is well documented. We describe a patient who developed similar lesions after cosmetic use of a home sun-bed without psoralen administration. Histological examination showed increased numbers of large and sometimes atypical melanocytes, which may theoretically act as precursors for melanoma. PMID- 3651331 TI - Prurigo pigmentosa. AB - Prurigo pigmentosa is a rare dermatosis which is most common in Japan. Although the histological features are non-specific, the clinical appearance is striking and is dominated by gross reticular pigmentation. A Chinese patient with prurigo pigmentosa is described. PMID- 3651332 TI - Circulating anti-skin basement membrane zone antibodies in a patient with Goodpasture's syndrome. AB - We report the case of a patient with atypical bullous pemphigoid and haemoptysis in whom circulating IgG skin basement membrane zone antibodies were demonstrated. Six years later she developed acute renal failure due to Goodpasture's syndrome. This is the first case to raise the possibility of a link between epidermal and glomerular basement membrane antibodies. PMID- 3651333 TI - Elastic fibres in normal and sun-damaged skin: an immunohistochemical study. AB - Sun-exposed and sun-protected skin obtained at post mortem from the nape of the neck in 14 subjects was immunostained using antisera to elastin, lysozyme, amyloid P component, and the plasma protease inhibitors alpha-I antitrypsin, alpha-I antichymotrypsin and alpha-2 macroglobulin. Both the normal elastic fibres in sun-protected skin, and elastosis in sun-exposed skin were positively immunostained for elastin, lysozyme and amyloid P component. Collagen fibres were unstained. No immunostaining of normal elastic fibres or elastosis in the skin was obtained with antisera to alpha-I antitrypsin, alpha-I antichymotrypsin or alpha-2 macroglobulin. It was concluded that the elastosis in sun-exposed skin does contain elastic fibres. The absence of immunostaining for plasma protease inhibitors probably indicates that the elastic material is mature, and not newly formed. PMID- 3651334 TI - Galactose tolerance in patients with atopic cataracts. AB - Galactosaemia has been suggested as a contributory factor in the pathogenesis of some presenile and senile cataracts. To assess whether galactosaemia plays any part in the development of atopic cataracts a galactose tolerance test was carried out in eight atopic dermatitis patients whose cataracts had appeared between the ages of 12 and 39 years. In seven patients a normal result was obtained and in one the result was just above normal. Impaired galactose tolerance appears to have no role in the pathogenesis of atopic cataract. PMID- 3651335 TI - Quantitative studies on UVA-induced erythema in human skin. AB - The erythemal response of normal human skin to UVA and UVB radiation was measured objectively using a reflectance instrument in seven subjects, and a laser Doppler velocimeter in two subjects. UVA radiation was produced using a newly-developed high-intensity UVA lamp. The slope of the log dose-erythemal response curve for UVA at 24 h after irradiation was found not to differ significantly from that for UVB. The time course of UVA erythema was biphasic; erythema was present immediately after irradiation, fell to a minimum at about 4 h and then rose to a broad plateau between 6 and 24 h. The intensity of the early phase was dose-rate dependent, whereas that in the later phase depended on dose only. PMID- 3651336 TI - Ehlers-Danlos syndrome type I: a clinical and ultrastructural study of a family with reduced amounts of collagen type III. AB - Ehlers-Danlos syndrome (EDS) type I was diagnosed in an 18-year-old girl on the basis of marked skin hyperextensibility with generalized loose-jointedness, pigmented paper-tissue scars, and a pronounced tendency to bruising. Her father and one of her sisters showed a similar phenotype. Her mother was normal. Light microscopy of skin biopsies showed large, irregular collagen fibres in the father and daughter, with normal findings in the mother. Electron microscopy of the skin sections revealed a variation in diameter and shape of the collagen fibrils as well as slight dilatation of the rough endoplasmic reticulum of fibroblasts in father and daughter, but normal findings in the mother. Cultured fibroblasts did not show these changes. Measurements of collagen synthesis by fibroblast cultures showed that type III collagen levels were reduced to 50% of normal in the father and daughter, and were normal in the mother. The alpha I (III) proteins had a normal molecular weight, determined by SDS-PAGE electrophoresis. The phenotypes and biochemical results in the family members tested were compatible with autosomal dominant transmission. To our knowledge, this is the first report of a type III collagen deficiency in Ehlers-Danlos syndrome type I. The findings in this family, especially the pronounced bruising tendency, illustrate the heterogeneity within type I EDS. PMID- 3651337 TI - Tattoo removal using infra-red coagulation: a dose comparison. AB - Using an infra-red coagulator, 42 tattoos were treated using pulses of 1.125 s (27 tattoos) or 1.25 s (15 tattoos). Treatment failures occurred only in three professional tattoos. Amateur tattoos were satisfactorily treated in over 80% of cases regardless of dose. Deeper collagen necrosis occurred with 1.25 s, but scarring was clinically similar. Pre-treatment biopsy to assess pigment depth was of no value in selection of the optimum pulse duration and increased the complication rate. The possible mechanism of pigment removal is discussed. PMID- 3651338 TI - Polymorphonuclear leukocyte function in psoriasis vulgaris. AB - Polymorphonuclear leukocyte (PMN) migration was assessed in vitro using the agarose plate method in patients with psoriasis vulgaris, and compared with an age- and sex-matched control group. No significant difference was found between the two groups in the PMN response to the chemotactic substances F-Met-Leu-Phe (FMLP) or zymosan activated serum (ZAS). Equally, the chemokinetic or chemotactic potential of psoriatic serum did not differ from control serum. Our results do not support a primary abnormality of PMN function in psoriasis. PMID- 3651339 TI - A flow cytometric study of the significance of DNA aneuploidy in cutaneous lesions. AB - Aneuploidy has not to date been demonstrated in any entirely benign condition and thus is held to be implicit of neoplasia. DNA flow cytometry can be used to detect DNA aneuploidy rapidly. A technique has been developed to make possible flow cytometric analysis of formalin-fixed skin. The technique was validated by study of benign and pre-malignant dermatoses. Further studies were performed on skin conditions of questionable malignant potential. DNA aneuploidy was demonstrated in lichen sclerosus et atrophicus. Flow cytometry was unable to distinguish keratoacanthomas from squamous cell carcinomas. PMID- 3651340 TI - IgA anti-endomysial antibodies in dermatitis herpetiformis: correlation with jejunal morphology, gluten-free diet and anti-gliadin antibodies. AB - Circulating IgA-class anti-endomysium antibodies (EmA) can be detected by indirect immunofluorescence on monkey oesophagus sections. We found EmA in 22 (76%) of 29 patients with dermatitis herpetiformis (DH) on a normal, gluten containing diet. The highest frequency (100%) of EmA was observed in patients with sub-total villous atrophy. IgA-class antigliadin antibodies (AGA) were found using an ELISA method in 59% of 29 DH patients and in 86% of those with sub-total villous atrophy. There was a significant correlation between EmA titres and AGA levels in individual patients. Gluten-free diet (GFD) treatment caused a rapid decrease in EmA titres; only three of the 12 patients still showed raised EmA after 6-12 months on a GFD and two of these three had failed to adhere to a strict diet. In contrast, no decrease in EmA titres occurred in four patients maintained on a normal diet, and two of the three patients with initially negative EmA developed positive titres when continuing on a normal diet. These results show that both IgA-class EmA and AGA are good indicators of jejunal damage in DH. The rapid fall of EmA titres after gluten withdrawal indicates that this test is also useful for monitoring a patient's adherence to a GFD. PMID- 3651341 TI - Binding of 8-methoxypsoralen to human serum proteins and red blood cells. AB - Serum binding of 8-methoxypsoralen (8-MOP) was studied by equilibrium dialysis. In therapeutic concentrations, 8-MOP binding in serum was high, 91.4%, and constant, indicating concentration-independent kinetics. This binding involved the two main proteins, human serum albumin and alpha 1-acid glycoprotein, in a saturable process with one class of binding sites (n) and affinity constants (Ka) of 1.295 X 10(4) mol/l and 2.115 X 10(4) mol/l, respectively. Binding to lipoproteins and gamma globulins was negligible and non-saturable in therapeutic concentrations, with nKa values of 0.35, 0.024, 0.013 and 0.0004 mumol/l for VLDL, LDL, HDL and gamma globulins, respectively. Inhibition of 8-MOP serum binding was observed with salicylic acid and indomethacin, but not with diazepam, warfarin or erythromycin. Over a range of therapeutic concentrations, the ration of 8-MOP concentration in red blood cells (RBCs) and in serum was constant at 20.3% and three times higher than would be expected if a simple diffusion of the 8-MOP plasma free fraction (fu) occurred. According to the measured and calculated parameters, simulations of 8-MOP blood binding in pathological states (hypoalbuminaemia with or without inflammation) showed variations of fu which were partially 'buffered' by RBCs. Simulation of 8-MOP protein binding at cutaneous interstitial fluid level showed that fu is approximately 30% and permitted prediction of a decrease of fu available to the epidermis in case of local or systemic inflammation. This may imply an increase in the minimum phototoxic dose relevant for PUVA and explain some cases of 'poor' responsiveness of psoriatic patients to PUVA therapy. PMID- 3651342 TI - Sweat pore density on the fingertips of atopic patients. AB - Investigation of 18 patients with atopic eczema and 22 normal controls showed that women in both groups had significantly more sweat pore openings on their fingertips than men and that there were more glands per unit area on fingers 3 and 4 compared with the thumb and the first and second fingers. There was no significant difference in the number of sweat pores between normal and atopic individuals, although fingertip topography in the latter was disturbed. PMID- 3651343 TI - In vivo measurement of the keratolytic effect of salicylic acid in three ointment formulations. AB - The release and activity of salicylic acid from different ointment formulations was studied in vivo by staining the horny layer with silver nitrate and measuring the light reflectance profile over 56 h, after application of the ointment for 4 h. The peeling effect of an ointment containing 5% salicylic acid and 10% urea was tested and compared with 5% and 10% salicylic acid in petrolatum. It was shown that shedding from the stained sites was faster with the urea-containing preparation than with the classic petrolatum ointments. The method described can be used to assess the bioavailability of keratolytic agents incorporated in topical formulations. PMID- 3651346 TI - Immunophenotypic analysis of early mycotic lesions. PMID- 3651344 TI - Infantile myofibromatosis. Report of two cases in one family. AB - Two brothers with infantile myofibromatosis are reported. Both had cutaneous and skeletal myofibromas with spontaneous and complete healing of their cutaneous lesions. These cases suggest autosomal recessive inheritance of this rare disorder. PMID- 3651345 TI - Solar keratosis: fallacies in measuring remission rate and conversion rate to squamous cell carcinoma. PMID- 3651347 TI - Infusion of intra-arterial chemotherapy through superselective cerebral catheterization. PMID- 3651348 TI - Mary Glover Lecture--June 24, 1987. PMID- 3651349 TI - Malignant brain tumors: therapies and nursing interventions. PMID- 3651350 TI - Occupation and pregnancy outcome. AB - Over a two year period, 1982-4, 56067 women, delivered or treated for a spontaneous abortion in 11 Montreal hospitals covering 90% of such admissions, were interviewed in detail regarding their occupational, social, and personal characteristics in their most recent and past pregnancies--104,649 in all. These data were analysed in relation to four main adverse outcomes--spontaneous abortion, stillbirth (without defect), congenital defect, and low birth weight (less than or equal to 2500 g). For comparison with observed numbers, expected figures were calculated by logistic regression using up to eight potentially confounding variables. Sixty occupational groups in six main industrial sectors were examined in current and previous pregnancies, with tests for heterogeneity between these two estimates of risk. Women in managerial, health, and clerical sectors had little evidence of excess of any of the four outcomes, by contrast with those in sales, service, and manufacturing sectors. Substantial and statistically significant excesses of spontaneous abortion were observed in nursing aides, women in sales occupations and food and beverage service; of stillbirth in agriculture and horticulture, leatherwork, and certain sales occupations; of congenital defects in women in child care, certain service occupations, and the manufacture of metal and electrical goods; and of low birth weight in chambermaids, cleaners, and janitors, and in women employed in the manufacture of food and drink, metal and electrical goods, and clothing. PMID- 3651351 TI - Chemical exposures at work in early pregnancy and congenital defect: a case referent study. AB - Three hundred and one women who in their most recent pregnancy had given birth to an infant with an important congenital defect were individually matched with 301 women whose children were normal. Both cases and referents were drawn from a comprehensive survey of pregnancies in Montreal, 1982-4, and limited to women employed 30 or more hours a week until at least the 13th week of gestation. Occupational exposure to chemicals was investigated and the results classified without knowledge of case-referent status. In matched pair analysis the overall frequency of chemical exposure was higher in cases than referents (63:47), due to excesses in the cardiac and miscellaneous defect groups (ratios of 10:5 and 15:7 respectively). In analyses by nine chemical categories only exposure to aromatic solvents showed a clear excess (18:8; p approximately equal to 0.04), most evident in the urinary tract group (9:0). A comparison of cases and referents exposed to aromatic solvents showed that most of the excess was associated with toluene; the defects were varied but predominantly renal-urinary or gastrointestinal. PMID- 3651352 TI - Clinical and immunological investigations of respiratory disease in workers using reactive dyes. AB - A questionnaire survey of over 400 workers handling reactive dyes showed that over 15% had work related respiratory or nasal symptoms. Forty nine employees with symptoms were referred to chest clinics for detailed assessment. It was considered that in 19 the symptoms could be attributed to an irritant response to a variety of chemicals, including hydrochloric acid vapour, sulphur dioxide, and reactive dyes. Symptoms in 24 were attributed to an allergic reaction to a specific agent; in most (21) to one or more reactive dyes. Two patterns of allergic lower respiratory symptoms were identified; an immediate response of short duration and a longer lasting response, usually of several hours, sometimes accompanied by nocturnal asthma. A radioallergosorbent test (RAST) screen containing the most commonly used reactive dyes was used to detect specific IgE. Allergic symptoms to reactive dyes were strongly associated with specific IgE (17/21 employees) and atopy (18/21). Irritant symptoms were also associated with atopy (13/19) but only weakly associated with specific IgE (7/19). PMID- 3651353 TI - Relation between lung function, exercise capacity, and exposure to asbestos cement. AB - A group of 137 male workers with known exposure (mean 20 fibre years per millilitre) to asbestos cement who had symptoms or signs of pulmonary disease was studied together with a reference group of 49 healthy industrial workers with no exposure to asbestos. Lung function measurements were made at rest and during exercise. Evidence of lung fibrosis was found as well as of obstructive airways disease in the exposed group compared with the reference group. Asbestos cement exposure was related to variables reflecting lung fibrosis but not to variables reflecting airflow obstruction. Smoking was related to variables reflecting obstructive lung disease. Exercise capacity was reduced in the exposed workers and was related to smoking and to lung function variables, reflecting obstructive airways disease. There was no significant correlation between exercise capacity and exposure to asbestos cement. PMID- 3651354 TI - Ferruginous bodies and pulmonary fibrosis in dead low to moderately exposed asbestos cement workers: histological examination. AB - Histological slides from the lungs of 89 dead asbestos cement workers have been examined with respect to ferruginous bodies and fibrosis. The results have been compared with individually matched controls with no known exposure to asbestos, and related to asbestos exposure, expressed as duration of exposure and cumulative asbestos dose, and smoking habits. The asbestos cement workers studied had been employed for on average 15 years, with a mean cumulative dose of 26 fibre-years per ml (f-y/ml). Clear dose-response relations between exposure (duration of exposure and cumulative asbestos dose) and level of ferruginous bodies were found. An association was evident already at a low cumulative dose (1 10 f-y/ml). Fibrosis was more common and more pronounced among the exposed workers than among controls. An association between ferruginous bodies and fibrosis was also found. Among the controls, but not among exposed workers, there was an association between smoking history and fibrosis. PMID- 3651355 TI - Mortality due to respiratory cancers in the coke oven plants of the Lorraine coalmining industry (Houilleres du Bassin de Lorraine). AB - The main activity of the Houilleres du Bassin de Lorraine (Lorraine Collieries), employing 23,000 operatives and executives, is coalmining. The coke production is carried out by two coke oven plants with a workforce of respectively 747 and 552 workers. The coal coking process entails the emission of noxious products such as polycyclic aromatic hydrocarbons (PAH) from the ovens. The influence of occupational exposure on mortality due to respiratory cancers, and particularly to lung and upper respiratory and alimentary tracts cancer, was investigated among a cohort of 534 male workers from the two coke oven plants who had retired from work between 1963 and 1982. The job history of each subject has been precisely reconstructed by indicating the duration of exposure on the ovens, close to the ovens, and in maintenance occupations. The cohort mortality has been analysed according to the method of indirect standardisation with reference to the French male population and by a case-control study concerning the consumption of tobacco per cohort. The mortality due to lung cancer is 2.51 times higher than expected. This excess of mortality differs, but not significantly, between the two coke oven plants (standardised mortality ratio equals 3.05 and 1.75 respectively). It is not significantly higher among subjects exposed for more than five years, directly exposed on the ovens or working near the ovens or at maintenance occupations on the ovens (SMR = 2.78), than among those exposed for less than five years (SMR = 2.35) or those not exposed at all. Even taking into account the excess of mortality due to lung cancers in the Moselle district (1.6 time that of France), the excess of lung cancers does not seem to be explained by the regional factor, or by tobacco and alcohol consumption. Although no significant relation was offered between lung cancer and the duration of exposure to PAH, even when taking smoking habits into account, the carcinogenic role of occupational nuisances cannot be excluded. PMID- 3651356 TI - Studies of transferrin in serum of workers exposed to organic solvents. AB - Earlier studies have shown that determination of the serum concentration of different forms of transferrin (isotransferrins) may be used to detect hepatic effects caused by alcohol abuse. The isotransferrin variant with an isoelectric point of 5.7 has been compared with the total amount of serum transferrin in order to study hepatic effects caused by occupational exposure to organic solvents. Eighteen workers from a paint industry were tested before and after their holiday and compared with two different groups, a total of 60 subjects. The solvent workers had significantly higher values both before and after their holiday. This suggests that the effects on the liver caused by organic solvents are similar to those caused by alcohol abuse and that this is a long term effect. The level of exposure to organic solvents was below the Swedish threshold limit values. PMID- 3651357 TI - Ampullary cancer in chemical workers. PMID- 3651358 TI - Respiratory disability in ex-cotton workers. PMID- 3651359 TI - An enigma variation. PMID- 3651360 TI - Some observations on the relation between intraocular pressure reduction and the progression of glaucomatous visual loss. AB - A quantitative measure of visual field loss associated with kinetic perimetry in chronic open-angle glaucoma (COAG) is discussed. With this new technique an analysis of covariance is applied to a retrospective study of 41 COAG patients. It suggests that reduction of intraocular pressure may not be uniformly effective in controlling the progression of the disease. PMID- 3651361 TI - Postural response of intraocular pressure in chronic open-angle glaucoma following trabeculectomy. AB - Forty-six eyes with chronic open-angle glaucoma (COAG) and 24 eyes which had previously undergone trabeculectomy for COAG were studied and the postural response of the intraocular pressure compared with that of 70 normal eyes. In all three groups the greatest rise in intraocular pressure (IOP) occurred when the subject changed from the sitting to the lying position. In the control group this was never more than 2 mmHg in any subject. The rise was greater than 2 mmHg in 93% of the patients suffering from COAG who were treated medically and in 100% of the eyes of those on which trabeculectomy had been performed. The well recognised abnormal postural response of intraocular pressure in COAG appears both to be retained and to be unaffected in those eyes which have undergone trabeculectomy. PMID- 3651362 TI - Stickler's syndrome: a study of 12 families. AB - Stickler's syndrome is a congenital disease of connective tissue with considerable ocular and non-ocular lesions. This study reports 12 pedigrees (10 families and two isolated cases) and evaluates some peculiar ocular aspects not previously reported in the syndrome. PMID- 3651363 TI - Effects of the encircling procedure on the aqueous flow rate in retinal detachment eyes: a fluorometric study. AB - Fluorophotometry was carried out in nine cases of unilateral non-traumatic rhegmatogenous retinal detachment successfully treated by a combination of local buckling and an encircling procedure with a silicone band. After topical instillation of fluorescein the change in its concentration in the anterior chamber was followed, from which the loss rate of the dye from the anterior chamber (k0) and the cornea-aqueous transfer coefficient (kc.ca) were estimated. The thickness of the cornea and the anterior chamber volume were also measured, and the aqueous flow rate and the corneal endothelial permeability were calculated in individual eyes. The examinations performed 4-18 months after operation showed that the aqueous flow rate in the operated eye fell to 85 (SD 12)% of that in the fellow control eye (p less than 0.005). In the operated eye the anterior chamber volume also fell significantly, and the corneal endothelial permeability may have decreased. Ocular hypotension after the detachment surgery with encirclement was attributable to a decrease in the aqueous flow rate. PMID- 3651364 TI - Adenocarcinoma of retinal pigment epithelium. AB - This report describes a 41-year-old man with an intraocular tumour misinterpreted clinically as choroidal melanoma. The fluorescein angiographic features were not fully characteristic of uveal malignancy, and indeed histopathology revealed the diagnosis of adenocarcinoma of the retinal pigment epithelium. It is suggested that, in cases with the fundus and angiographic findings described here, the rare possibility of adenocarcinoma of retinal pigment epithelium should be kept in mind. Of particular interest were the changing pathological findings in the various parts of the tumour, which paralleled the fluorescein angiographic pattern. PMID- 3651365 TI - Diplopia after retinal detachment surgery. AB - Diplopia following retinal detachment usually responds to simple measures. Fifteen out of 311 cases developed diplopia lasting more than three months after conventional retinal detachment surgery. Binocular single vision was restored in 12 of the 15 cases (80%). The mean follow-up was four years. Diplopia was eliminated stepwise. If prisms were ineffective, our first surgical procedure was removal of the scleral buckle. If the retina was flat, we were prepared to remove the buckle early. When diplopia persisted after buckle removal, we proceeded to strabismus surgery. Our most consistent results followed strabismus surgery on the untreated eye. Prisms alone restored binocular single vision in six patients (40%), one of whom preferred to adopt a compensatory head posture. Removal of the scleral buckle restored binocular single vision in three patients (20%), with the help of a prism in one case and a compensatory head posture in another. Binocular single vision was restored after buckle removal and strabismus surgery in three further patients (20%), one requiring a prism in addition. Binocular single vision was not restored in three patients (20%). PMID- 3651366 TI - Leber's hereditary optic neuropathy: mitochondrial and biochemical studies on muscle biopsies. AB - Two patients with Leber's hereditary optic neuropathy underwent morphological and biochemical investigations of muscle biopsy samples from the biceps brachii. Although clinically there was no muscle weakness or atrophy, specific histochemical and electron microscopic examinations showed mild but distinct myopathic changes, including abnormal oxidative enzyme activities, aggregates of enlarged mitochondria in the subsarcolemmal regions, and disruptions of myofilaments. Biochemical analyses of mitochondria isolated from muscle samples did not show and deficiency in respiratory-chain enzyme complexes or defect in content of cytochromes. Leber's hereditary optic neuropathy is assumed to be a multisystem disorder involving skeletal muscle also. PMID- 3651367 TI - Optic disc drusen and episodic visual loss. AB - A case is reported in which recurrent episodes of visual loss occurred over a period of 26 years in a patient with bilateral optic disc drusen. Visual field loss was associated with episodes of ischaemic optic neuropathy. The possible mechanism is discussed. PMID- 3651368 TI - Quantification of macular ischaemia in sickle cell retinopathy. AB - Macular ischaemia has a central role in the pathophysiology and prognosis of retinal macular disease. We attempted to quantitate two of its major components as follows: vascular nonperfusion, by measuring the foveal avascular zone (FAZ), using fluorescein angiography; and functional damage, using automated perimetry of the central 30 degrees. Sickle cell disease was chosen for study because it was considered a prototype for a purely ischaemic retinopathy without an exudative component. We found that the FAZ measurement was reproducible and that the patients with maculopathy had statistically larger FAZs than the normal controls (p = 0.016, Wilcoxon rank sum test). In addition, scotomas measured by visual field perimetry were significantly larger in the sickle cell patients with maculopathy than in those without maculopathy. Our results showed that angiography and perimetry of the central 30 degrees were more sensitive tests for the detection of ischaemic macular disease than visual acuity and that macular ischaemia could be quantified by their use. PMID- 3651369 TI - A case of frosted branch angiitis. AB - We report a case of frosted branch angiitis in a 16-year-old-girl. She noted a sudden and severe visual disturbance in both eyes, without other systemic symptoms. Diffuse retinal oedema and unusual sheathing of retinal veins were characteristic in both fundi. Fluorescein angiography showed no occlusion of the sheathed retinal veins, but some paravenous extravasation of dye was found in the late phase. With high doses of systemic corticosteroids her fundi and visual acuity improved greatly, though the vessels continued to show severe narrowing. At three months the pattern visually evoked cortical potentials were found to be normal, while flash electroretinograms were absent. No systemic abnormality has been found to explain the aetiology of this condition. PMID- 3651370 TI - 'Rush' type retinopathy of prematurity: report of three cases. AB - Three premature infants observed to develop severe stage III retinopathy of prematurity (ROP) at 3 to 5 weeks of age received immediate treatment by cryoablation and photocoagulation, with good results. The critical importance of the ophthalmic examination of premature babies from the age of 2 weeks, so as not to overlook such cases of 'rush' type ROP is stressed and the difficulty involved in treating such small neonates is discussed. PMID- 3651371 TI - Foveomacular retinitis. PMID- 3651372 TI - Histological study of corneas preserved in two new media. AB - A new corneal preserving medium (K-Sol), developed by Kaufman and others, contains purified chondroitin sulphate, TC 199, HEPES buffer, and gentamicin. Another new medium (JM) containing bicarbonate-free glucose-phosphate Ringer solution and dextran 70 has been developed in Japan. New Zealand white rabbit corneas with scleral rims were stored in each medium at 4 degrees C for one or two weeks. The condition of the endothelium was evaluated histologically. Corneas preserved in both media were in good condition at the end of one week. Corneas preserved in K-Sol for two weeks showed fewer endothelial changes than similar tissue stored in JM for two weeks. Corneal swelling was also less in corneas preserved in K-Sol, than in corneas preserved in JM. PMID- 3651373 TI - Blindness in schoolchildren: importance of heredity, congenital cataract, and prematurity. AB - Of 99 children in the Royal Blind School, Edinburgh (which serves Scotland and part of N E England), 15 had optic atrophy (hydrocephalus 4, intracranial haemorrhage 2, prematurity 2, fetal distress 2, birth asphyxia 2, cerebral atrophy 1, cardiac arrest during hernia operation 1, and leukaemia 1). Fourteen had congenital cataract, 12 congenital retinal aplasia (Leber's congenital amaurosis) and 11 retinopathy of prematurity. There were small numbers in many other diagnostic categories, including three with non-accidental head injury. Mental retardation, spasticity, and nystagmus were frequent other correlates in all diagnostic categories. 'Very probably hereditary' was a conservative attribution in 36, while 'probable' seemed appropriate for 12-that is, almost 48% were hereditary. Only about 11 cases might have been prevented through genetic counselling, which testifies to the frequency of autosomal recessive hereditary disease, although no parents were consanguineous. PMID- 3651374 TI - Experimental posterior uveitis. I: A clinical, angiographic, and pathological study. AB - The clinical, angiographic, and histopathological features of experimental posterior uveitis in the black hooded Lister rat are described. This mild form of experimental allergic uveoretinitis (EAU) is induced by sensitisation with retinal S antigen in Freund's complete adjuvant, and the inflammation produced is confined to the posterior segment of the eye. This allows for the first time precise photographic and angiographic documentation of the evolution of clinical signs, because there is minimal clouding of the vitreous by inflammatory cells. Clinically the disease is characterised by the appearance of disc oedema and periphlebitis, followed by focal infiltrates in the deep retinal layers, with eventual atrophy of the pigment epithelium. Histologically, retinal vasculitis is associated with focal mononuclear cell infiltration and necrosis of the photoreceptor layers. This model closely resembles the clinical features of idiopathic retinal vasculitis seen in man. PMID- 3651375 TI - Corneal and intraocular penetration of topical and subconjunctival fusidic acid. AB - Corneal tissue absorption and intraocular penetration of fusidic acid were assessed in the rabbit after topical or subconjunctival application. Corneal tissue levels of fusidic acid one hour after the last topical application of the drug were well above the minimum inhibitory concentrations (MICs) for most Gram positive and many Gram-negative organisms. Adequate levels were achieved in the aqueous at one hour following the last topical application, but no significant levels were detected in the vitreous. The corneal tissue and aqueous levels declined at 12 and 24 hours following the last drug application, however, corneal tissue levels at 24 hours were considered to be above the MICs for most Gram positive organisms. A single subconjunctival injection of 100 mg of fusidic acid produced levels above the MICs of most organisms in the cornea, aqueous, and vitreous which persisted over 24 hours, but subconjunctival injection of fusidic acid at this concentration resulted in conjunctival necrosis and corneal decompensation. Fusidic acid penetrates well into avascular tissue and fully penetrates corneas with both intact and debrided epithelium, as evidenced by the intracameral drug levels. Good corneal penetration and absence of known topical toxicity make fusidic acid suitable for the treatment of microbial keratitis caused by susceptible organisms. PMID- 3651376 TI - Visual function and pattern visual evoked response in optic neuritis. AB - The disparity between clinical visual function and pattern visual evoked response (VER) was studied in 53 patients who had suffered an attack of optic neuritis (ON) more than six months before. The visual functions tested included Snellen visual acuity, colour vision, visual field, and contrast sensitivity. The effect of pattern presentation, check size, and luminance was tested by recording VERs with several stimulus configurations. VER amplitudes were found to be associated with the outcome of all four clinical tests, independently of check size, luminance, or the presentation method used. On the other hand VER latencies were hardly ever related to the results of any of the four clinical visual tests. These findings support the idea that VER amplitude provides information about visual spatial perception, while VER latency is more related to the extent of demyelination. PMID- 3651377 TI - Intracameral gnathostomiasis: a cause of anterior uveitis and secondary glaucoma. AB - Recognition of parasitic diseases by Western physicians is becoming increasingly important because of increased international travel and the recent influx of refugees from South east Asia. We describe two patients who presented with acute anterior uveitis and secondary glaucoma caused by intracameral third stage larvae of Gnathostoma spinigerum. The parasites were successfully removed, with preservation of good visual acuity. The initial infection may occur through consumption of contaminated water and/or raw or undercooked foods, while the eyes may be involved even years later. Accurate diagnosis and surgical removal of the parasites may save life. PMID- 3651378 TI - Histopathological characteristics of neodymium-YAG laser iridotomy in the human eye. AB - Light and electron microscopic studies of YAG laser iridotomies were performed in two human iridectomy specimens. Full-thickness defects were created and showed stromal and vascular necrosis. The light and electron microscopic configuration of the lesions was compatible with mechanical disruption from shockwaves. Thermal changes were absent in contrast to iridotomies created by argon laser photocoagulation. PMID- 3651379 TI - Clinical anophthalmos. AB - We report on 15 patients (10 boys, 5 girls) with clinical anophthalmos. Two of them had bilateral anophthalmos, 10 had systemic anomalies, and six had abnormalities of their remaining eye. Only two appeared to have an associated underlying aetiology. Fourteen patients underwent orbital reconstruction or socket enlargement with varying degrees of success. Our own experience suggests that unnecessary lid procedures should be avoided, but we recommend early prosthetic fittings. We feel that a multidisciplinary approach is necessary to attain useful rehabilitation. PMID- 3651380 TI - Ocular toxicity of anandron. PMID- 3651381 TI - pH-dependent stability and fusion of liposomes combining protonatable double chain amphiphiles with phosphatidylethanolamine. AB - We have prepared a series of novel double-chain amphiphiles with protonatable head groups, including acylated derivatives of various 2-substituted palmitic acids, amino acid conjugates of these species, and 1,2-dioleoyl-3 succinylglycerol. These species can be combined with phosphatidylethanolamine (PE) to prepare reverse-phase evaporation vesicles that are stable and trap hydrophilic solutes at pH 7. At weakly acidic pH values (as high as 6.5, depending on the titratable amphiphilic component), these pH-sensitive vesicles exhibit fusion, with a limited extent of contents mixing and extensive mixing of lipids, accompanied by leakage of aqueous contents. Protons and divalent cations show strong synergistic effects in promoting mixing of both lipids and aqueous contents between pH-sensitive vesicles prepared with any of a variety of double chain titratable amphiphiles. Calorimetric results indicate that the relative stabilities of different types of pH-sensitive liposomes at low pH cannot be simply correlated with the propensity of the lipids to form a hexagonal II phase under these conditions. Fluorescence measurements demonstrate that single-chain fatty acids, but not double-chain titratable amphiphiles such as N-acyl-2 aminopalmitic acids, are rapidly removed from pH-sensitive vesicles in the presence of other lipid vesicles, serum albumin, or serum. Additionally, pH sensitive liposomes containing double-chain titratable amphiphiles retain their aqueous contents better than do those containing single-chain amphiphiles in the presence of lipid membranes or albumin. Surprisingly, however, pH-sensitive vesicles of either type show retention of contents in the presence of serum that is comparable to that observed with vesicles composed purely of phospholipids. A model is proposed to explain these latter findings. PMID- 3651382 TI - Effects of cis and trans unsaturation on the structure of phospholipid bilayers: a high-pressure infrared spectroscopic study. AB - In order to compare the effects of cis and trans unsaturation on the structure and packing of phospholipid bilayers, infrared spectra of aqueous dispersions of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and 1,2-dielaidoyl-sn-glycero-3 phosphocholine (DEPC) were measured in a diamond anvil cell at 28 degrees C as a function of pressure up to 36 kbar. The infrared spectra indicate that DEPC and DOPC undergo pressure-induced liquid-crystalline to gel phase transitions at critical pressures of 0.7 and 5.2 kbar, respectively. Below their respective critical pressures, the infrared spectra of DOPC and DEPC are essentially indistinguishable, whereas above these pressures, there are very pronounced differences in the barotropic behavior of these two lipids. Specifically, at the 5.2-kbar transition in DOPC, there are significant changes in the frequencies, intensities, and widths of bands associated with the interfacial C = O groups, the olefinic CH = CH groups, and the terminal CH3 groups, whereas the corresponding bands of DEPC are, by contrast, relatively insensitive to the pressure-induced phase transition. The unusual band shape changes in DOPC are attributed to a unique packing arrangement of the oleoyl acyl chains required to accommodate the bent geometries of adjacent cis double bonds. Moreover, above 5 kbar in DEPC, well-defined correlation field splittings of the CH2 scissoring and rocking modes are observed, with magnitudes very similar to those observed at comparable pressures in saturated lipid systems. The absence of correlation field splittings of the corresponding bands of DOPC up to 36 kbar suggests that the bent oleoyl acyl chains are closely packed with all chains oriented parallel to each other. PMID- 3651383 TI - Mixed-chain phosphatidylcholine bilayers: structure and properties. AB - Calorimetric and X-ray diffraction data are reported for two series of saturated mixed-chain phosphatidylcholines (PCs), 18:0/n:0-PC and n:0/18:0-PC, where the sn 1 and sn-2 fatty acyl chains on the glycerol backbone are systematically varied by two methylene groups from 18:0 to 10:0 (n = 18, 16, 14, 12, or 10). Fully hydrated PCs were annealed at -4 degrees C and their multilamellar dispersions characterized by differential scanning calorimetry and X-ray diffraction. All mixed-chain PCs form low-temperature "crystalline" bilayer phases following low temperature incubation, except 18:0/10:0-PC. The subtransition temperature (Ts) shifts toward the main (chain melting) transition temperature (Tm) as the sn-1 or sn-2 fatty acyl chain is reduced in length; for the shorter chain PCs (18:0/12:0 PC, 12:0/18:0-PC, and 10:0/18:0-PC), Ts is 1-2 degrees C greater than Tm, and the subtransition enthalpy (delta Hs) is much greater than for the longer acyl chain PCs. Tm decreases with acyl chain length for both series of PCs except 18:0/10:0 PC, while for the positional isomers, n:0/18:0-PC and 18:0/n:0-PC, Tm is higher for the isomer with the longer acyl chain in the sn-2 position of the glycerol backbone. The conversion from the crystalline bilayer Lc phase to the liquid crystalline L alpha phase with melted hydrocarbon chains occurs through a series of phase changes which are chain length dependent. For example, 18:0/18:0-PC undergoes the phase changes Lc----L beta'----P beta'----L alpha, while the shorter chain PC, 10:0/18:0-PC, is directly transformed from the Lc phase to the L alpha phase. However, normalized enthalpy and entropy data suggest that the overall thermodynamic change, Lc----L alpha, is essentially chain length independent. On cooling, the conversion to the Lc phases occurs via bilayer gel phases, L beta', for the longer chain PCs or through triple-chain interdigitated bilayer gel phases, L beta, for the shorter chain PC 18:0/12:0-PC and possibly 10:0/18:0-PC. Molecular models indicate that the bilayer gel phases for the more asymmetric PC series, 18:0/n:0-PC, must undergo progressive interdigitation with chain length reduction to maintain maximum chain-chain interaction. The L beta phase of 18:0/10:0-PC is the most stable structure for this PC below Tm. The formation and stability of the triple-chain structures can be rationalized from molecular models. PMID- 3651384 TI - Biosynthesis and molecular cloning of sulfated glycoprotein 2 secreted by rat Sertoli cells. AB - Sulfated glycoprotein 2 (SGP-2) is the major protein secreted by rat Sertoli cells. Pulse-chase labeling shows that SGP-2 is synthesized as a cotranslationally glycosylated 64-kDa precursor that is modified to a negatively charged 73-kDa form before intracellular cleavage to the mature 47- and 34-kDa subunits. A plasmid cDNA library was constructed from immunopurified mRNA, and a recombinant clone containing the entire protein coding sequence of SGP-2 was isolated. The 1857-nucleotide cDNA consists of a 297-nucleotide 5' noncoding segment, a 1341-nucleotide coding segment, and a 219-nucleotide 3' noncoding sequence. The 5' noncoding region contains five ATG codons followed by four short open reading frames. The derived SGP-2 sequence has a molecular weight of 51,379 and contains six potential N-glycosylation sites. Proteolytic processing sites for the preproprotein were determined by amino-terminal sequencing of the isolated SGP-2 subunits. Northern blots show a wide tissue distribution for the 2.0-kb SGP-2 message, and computer sequence analysis indicates a significant relationship between SGP-2 and human apolipoprotein A-I. PMID- 3651385 TI - Interaction of trans-diamminedichloroplatinum(II) with DNA: formation of monofunctional adducts and their reaction with glutathione. AB - Bifunctional reactions with DNA are responsible for the toxic action of the cancer chemotherapeutic drug cis-diamminedichloroplatinum(II) (cis-DDP). Thiourea has previously been used to trap transient monofunctional adducts in DNA before they rearrange to the toxic lesions. In these studies, thiourea was used to quantify the monofunctional adducts produced by the ineffective isomer trans-DDP. Rather than trapping monofunctional adducts, thiourea labilized them from DNA. At short time periods, 85% of trans-DDP bound to double-stranded DNA as monofunctional adducts of deoxyguanosine. Rearrangement to bifunctional adducts in double-stranded DNA was 50% complete in 24 h but was much more rapid in single stranded DNA with 100% complete rearrangement in 24 h. The ineffectiveness of trans-DDP therefore results from a high proportion of monofunctional adducts in DNA that rearrange very slowly to toxic bifunctional adducts. The persistent monofunctional adducts react rapidly with glutathione, which would further reduce their potential toxicity by preventing them from rearranging to more toxic bifunctional adducts. PMID- 3651386 TI - Sequence context effects on 8-methoxypsoralen photobinding to defined DNA fragments. AB - The photoreaction of 8-methoxypsoralen (8-MOP) with DNA fragments of defined sequence was studied. We took advantage of the blockage by bulky adducts of the 3'-5'-exonuclease activity associated with the T4 DNA polymerase. The action of the exonuclease is stopped by biadducts as well as by monoadducts. The termination products were analyzed on sequencing gels. A strong sequence specificity was observed in the DNA photobinding of 8-MOP. The exonuclease terminates its digestion near thymine residues, mainly at potentially cross linkable sites. There is an increasing reactivity of thymine residues in the order T less than TT much less than TTT in a GC environment. For thymine residues in cross-linkable sites, the reactivity follows the order AT much less than TA approximately TAT much less than ATA less than ATAT less than ATATAA. Repeated A T sequences are hot spots for the photochemical reaction of 8-MOP with DNA. Both monoadducts and interstrand cross-links are formed preferentially in 5'-TpA sites. Our results highlight the role of the sequence and consequently of the conformation around a potential site in the photobinding of 8-MOP to DNA. PMID- 3651388 TI - Does the bifunctional uridylate synthase channel orotidine 5'-phosphate? Kinetics of orotate phosphoribosyltransferase and orotidylate decarboxylase activities fit a noninteracting sites model. AB - Uridylate synthase is a bifunctional protein that first forms orotidine 5' phosphate (OMP) from orotate via its orotate phosphoribosyltransferase activity (EC 2.4.2.10) and then converts OMP to uridine 5'-phosphate (UMP) via the OMP decarboxylase activity (EC 4.1.1.23). A computer modeling analysis of the experiments that led to the proposal [Traut, T.W., & Jones, M.E. (1977) J. Biol. Chem. 252, 8374-8381] that uridylate synthase channels intermediate OMP suggests that the experimental results do not demonstrate preferential use of OMP generated in the bifunctional complex as against exogenous OMP. This analysis shows that the experimentally observed amounts of [6-14C]UMP from [6-14C]orotate in the presence of various amounts of exogenous [7-14C]OMP agree well with the amounts predicted by the computer simulations. Thus we conclude that uridylate synthase does not channel OMP. Additionally, the subsequent suggestion that channeling of OMP occurs to protect the intermediate from degradation by a nucleotidase [Traut, T.W. (1980) Arch. Biochem. Biophys. 200, 590-594] seems unlikely. The appropriate computer simulation demonstrates that low transient levels of OMP and protection of the intermediate are provided for strictly by the kinetic parameters of orotate phosphoribosyltransferase, OMP decarboxylase, and the nucleotidase. Additionally, calculations show that, in both sets of published experiments, the concentration of transient OMP greatly exceeded the concentration of OMP decarboxylase active sites. Thus, channeling of OMP by the bifunctional complex cannot be invoked to explain the evolution of uridylate synthase, and that event must be the result of some other selective pressure. PMID- 3651387 TI - Infrared and Raman studies show that poly(dA).poly(dT) and d(AAAAATTTTT)2 exhibit a heteronomous conformation in films at 75% relative humidity and a B-type conformation at high humidities and in solution. AB - The decadeoxynucleotide d(AAAAATTTTT)2 in duplex form and the double-helical polynucleotide poly(dA).poly(dT) have been studied by Raman and infrared (IR) spectroscopy under a variety of environmental conditions. The IR spectra have been taken of cast films and compared to the IR spectra of the alternating poly(dA-dT), which shows clear B-genus and A-genus vibrational spectra under conditions of high (greater than 92%) and low (75%) relative humidity (RH). From the IR data, it is shown that d-(AAAAATTTTT)2 and poly(dA).poly(dT) adopt a B genus conformation in films with high water content. When the relative humidity of the film is decreased, the IR spectra reflect a gradual evolution of the geometry of both d(AAAAATTTTT)2 and poly(dA).poly(dT) into a form intermediate between the B genus and A genus, but the IR spectrum of a pure A genus has not been obtained. In these DNAs at 75% RH, the IR bands of adenosine have the same frequencies as those found in poly(dA-dT) at 75% RH where the local furanose conformation is C3' endo/anti, but the thymidine frequencies do not resemble those of poly(dA-dT) at 75% RH but rather those of poly(dA-dT) at high humidities. It is concluded that both poly(dA).poly(dT) and d(AAAAATTTTT)2 adopt a fully heteronomous duplex geometry in cast films at low humidity. For studies in aqueous solution the Raman effect was employed. As a model for the heteronomous conformation in solution, the duplex poly(rA).poly(dT) was used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651389 TI - Interaction of pancreatic phospholipases A2 and semisynthetic mutants with anionic substrates and substrate analogues. AB - Recently it was shown that porcine pancreatic phospholipase A2 aggregates in the presence of submicellar concentrations of anionic substrates [van Oort, M.G., Dijkman, R., Hille, J.D.R., & de Haas, G.H. (1985) Biochemistry 24, 7993-7999]. In the resulting complexes the enzyme displays very high catalytic activity. In this study the interaction process was further investigated by using pancreatic phospholipases A2 of different origins and several semisynthetic mutants in which one particular amino acid residue was substituted. By use of directing binding studies with a nondegradable anionic substrate analogue and monomolecular surface film kinetics on 1,2-didecanoyl-sn-glycerol 3-sulfate, it is shown that the aggregation process is controlled by the ionization state of the side chains of the amino acid residues at positions 6 and 17. PMID- 3651390 TI - 1-Aminocyclopropanephosphonate: time-dependent inactivation of 1 aminocyclopropanecarboxylate deaminase and Bacillus stearothermophilus alanine racemase by slow dissociation behavior. AB - 1-Aminocyclopropanephosphonate (ACPP) was synthesized, and its effects on the pyridoxal 5'-phosphate linked enzymes 1-aminocyclopropanecarboxylate (ACPC) deaminase from Pseudomonas sp. ACPC and alanine racemase from Bacillus stearothermophilus were studied. ACPP was found to be a potent inhibitor of both enzymes with Km/Ki ratios of 500 and 2000, respectively. Inhibition for both enzymes was characterized by slow-binding (second-order rate constants less than 150 M-1 s-1) slow-dissociating behavior. Analysis of the pre-steady-state kinetics revealed a kinetically detectable intermediate E.I complex in the inhibition mechanism for the racemase but not for the deaminase. The one-step deaminase inhibition (Formula: see text) mechanism had an association rate constant (k1) of 100 M-1 s-1, a value 10(6)-fold slower than diffusion, suggesting either a slow alignment of the inhibitor at the enzyme active site or, more likely, the same mechanism as followed by racemase but with an E.I to E.I conversion rate (k3) that is sufficiently fast on the steady-state time scale so as to hinder detection of the initial weakly associated E.I intermediate. The E to E.I transition for the deaminase was further monitored by ultraviolet-visible and circular dichroism (CD) spectroscopies and found to exhibit a time-dependent shift in the visible absorption spectrum lambda max from 418 nm for the native enzyme to 333 nm at steady state, again consistent with a rapid E to E.I and slow E.I to E.I behavior. A rate constant for the absorbance shift of 150 M-1 s-1 was consistent with the k1 calculated in the inhibition studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651391 TI - Ionization of isocitrate bound to pig heart NADP+-dependent isocitrate dehydrogenase: 13C NMR study of substrate binding. AB - Isocitrate and alpha-ketoglutarate have been synthesized with carbon-13 enrichment at specific positions. The 13C NMR spectra of these derivatives were measured as a function of pH. The magnitudes of the changes in chemical shifts with pH for free isocitrate and the magnesium-isocitrate complex suggest that the primary site of ionization is at the beta-carboxyl. In the presence of the enzyme NADP+-dependent isocitrate dehydrogenase and the activating metal magnesium, the carbon-13 resonances of all three carboxyls remain constant from pH 5.5 to pH 7.5. Thus, the carboxyls remain in the ionized form in the enzyme-isocitrate complex. The alpha-hydroxyl carbon resonance could not be located in the enzyme isocitrate complex, suggesting immobilization of this group. Magnesium produces a 2 ppm downfield shift of the beta-carboxyl but does not change the resonances of the alpha- and gamma-carboxyls. This result is consistent with metal activation of both the dehydrogenation and decarboxylation reactions. The 13C NMR spectrum of alpha-ketoglutarate remains unchanged in the presence of isocitrate dehydrogenase, implying the absence of alterations in geometry in the enzyme bound form. Formation of the quaternary complex with Mg2+ and NADPH leads to loss of the alpha-ketoglutarate resonances and the appearance of new resonances characteristic of alpha-hydroxyglutarate. In addition, a broad peak ascribed to the enol form of alpha-ketoglutarate is observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651392 TI - Photoaffinity labeling of rabbit muscle fructose-1,6-bisphosphate aldolase with 8 azido-1,N6-ethenoadenosine 5'-triphosphate. AB - Steady-state kinetic measurements have shown that 8-azido-1,N6-ethenoadenosine 5' triphosphate (8-N3-epsilon ATP) can be noncovalently bound to rabbit muscle fructose 1,6-bisphosphate aldolase with Ki = 0.075 mM at pH 8.5. This binding is purely competitive with substrate and occurs at the strong binding site for mononucleotides. Photoaffinity labeling of aldolase in the presence of 8-azido 1,N6-ethenoadenosine 5'-triphosphate results in inactivation of the enzyme. Aldolase is protected against modification in the presence of the inhibitors hexitol 1,6-bisphosphate or ATP. The labeling is saturable, and a good correlation is observed between the loss of enzymatic activity and the incorporation of 8-N3-epsilon ATP into aldolase. In addition, aldolase loses its ability to bind to phosphocellulose following modification. Digestion of labeled protein with trypsin, chymotrypsin, and cyanogen bromide revealed substantial modification of peptide 259-269. Thr-265 was identified as the residue that was covalently modified by 8-N3-epsilon ATP. On the basis of these results and other data we propose a model for the mononucleotide binding site. PMID- 3651393 TI - Locus of a histidine-based, stable trifunctional, helix to helix collagen cross link: stereospecific collagen structure of type I skin fibrils. AB - The loci of the three amino acid residues that contribute their prosthetic groups to form the stable, nonreducible, trifunctional intermolecular cross-link histidinohydroxylysinonorleucine in skin collagen fibrils were identified. Two apparently homogeneous three-chained histidinohydroxylysinonorleucine cross linked peptides were chromatographically isolated. They were obtained from a tryptic digest of denatured unreduced 6 M guanidine hydrochloride insoluble bovine skin collagen. Amino acid and sequence analyses demonstrated that the prosthetic groups of alpha 1(I)-chain Hyl-87, alpha 1(I)-chain Lys-16c, and alpha 2(I)-chain His-92 formed the cross-link. The latter results served to define the locus of the stable, nonreducible trifunctional moiety. Identical types of analyses were performed on the three-chained peptides isolated after bacterial collagenase digestion of the cross-linked tryptic peptides. This confirmed the initial identification and location of the three peptides linked by the cross link. In addition, data reported here provide for a correction of the micromolecular structure for the alpha 2(I) chain. Stereochemical considerations concerning this trifunctional cross-link's specific locus indicate that the steric relationships between the alpha chains of skin and skeletal tissue collagens are fundamentally different and the intermolecular relationships in skin fibrils are specific for skin. The same molecular relationships also indicate that histidinohydroxylysinonorleucine links three molecules of collagen. The stereochemistry of cross-linking for skin collagen is in accordance with and explains the X-ray findings of a 65-nm periodicity found for this tissue [Stinson, R. H., & Sweeny, P. R. (1980) Biochim. Biophys. Acta 621, 158; Brodsky, B., Eikenberry, E. F., & Cassidy, K. (1980) Biochim. Biophys. Acta 621, 162]. PMID- 3651394 TI - Use of consensus oligonucleotides for detecting and isolating nucleic acids encoding calcium binding domains of the troponin C superfamily. AB - Proteins belonging to the troponin C superfamily (troponin C, calmodulin, myosin light chains, and parvalbumin) are involved in a wide variety of cellular activities mediated by calcium ions. Most of these proteins bind ionic calcium, and all have calcium binding domains that are conserved to some extent at the nucleic acid level. We made use of the conservation in the third calcium binding domain to synthesize two consensus sequence oligonucleotide probes, one 43 bases and the other 25 bases long. By using cDNA and genomic clones encoding calmodulin, troponin C, parvalbumin, and the sea urchin Spec proteins, we show that these probes hybridize with nucleic acid sequences representing calcium binding domains. In an RNA gel blot analysis of embryonic RNA from the sea urchin Strongylocentrotus purpuratus, we show that transcripts which have previously been shown to encode troponin C like proteins hybridize with the consensus sequence probes. Screening sea urchin cDNA and genomic libraries with the 43-base consensus oligonucleotide shows that the probe can be used to isolate cloned nucleic acids. Two such genomic clones from a Lytechinus pictus library were isolated and characterized. One clone encodes part of an L. pictus calmodulin gene, and the other encodes a member of the superfamily that has not been characterized previously. The consensus oligonucleotides should be valuable probes in the diagnosis and isolation of nucleic acids encoding proteins of the troponin C superfamily. PMID- 3651395 TI - Dihydroxypropylation of amino groups of proteins: use of glyceraldehyde as a reversible agent for reductive alkylation. AB - The mode of derivatization of amino groups of proteins by glyceraldehyde, an aldotriose, depends on the presence or absence of reducing agent. In the presence of sodium cyanoborohydride, the Schiff base adducts of the aldehyde with the amino groups are reduced, and dihydroxypropylation of amino groups takes place (reductive mode). The reductively glycated lysine residue, N epsilon-(2,3 dihydroxypropyl)lysine, is a substituted alpha-amino alcohol. This alpha-amino alcoholic function of the derivatized lysine should be susceptible to periodate oxidation, and this oxidation is anticipated to result in the regeneration of the lysine residue. This aspect has been now investigated. Indeed, on mild periodate oxidation (15 mM periodate, 15 min at room temperature) of dihydroxypropylated ribonuclease A, nearly 95% of its N epsilon-(2,3-dihydroxypropyl)lysine residues were regenerated to lysine residues. The removal of the dihydroxypropyl groups by periodate oxidation could be accomplished within a wide pH range with little variation in the recovery of lysines. The possible usefulness of this reversible chemical modification procedure in the primary structural studies of proteins was investigated with a tryptic peptide of dihydroxypropylated streptococcal M5 protein, namely, DHP-T4. This 12-residue tryptic peptide contains one internal N epsilon-(dihydroxypropyl)lysine. The dihydroxypropylated peptide released most of its dihydroxypropyl groups on mild periodate oxidation. Redigestion of the periodate-treated peptide with trypsin generated the two expected peptides, demonstrating the generation of a trypsin-susceptible site. Reductive dihydroxypropylation of amino groups of RNase A resulted in the loss of its enzyme activity, the extent of inactivation increasing with the concentration of the glyceraldehyde used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651396 TI - Oxidation of tryptophans in an interhelical hydrophobic cluster of myoglobin alters the thermodynamics of the denaturation transition. AB - Model folding studies of sperm whale myoglobin have illustrated the presence of hydrophobic interfacial regions between elements of secondary structure. The specific oxidation of two tryptophan residues, in the A-H helix contact of sperm whale myoglobin, to the less hydrophobic oxindolylalanine residues is utilized to probe the contribution of hydrophobic packing density in this contact region. The acid denaturation of the modified protein is no longer a simple two-state process exhibiting the presence of stable intermediates. The relative stability of the intermediate is shown to be +5.3 kcal/mol less stable than native myoglobin. This value is consistent with the predicted relative stability, based upon electrostatic model calculations, of the docking of the A helix with a des-A helix myoglobin. The presence of stable intermediate structures in the denaturation pathway of the modified protein is consistent with the proposed role of hydrophobic interactions in damping structural fluctuations and statistical mechanical models of noncooperative protein unfolding. These results demonstrate the relationship between large-scale fluctuations and the frictional forces governing small-scale motions within the protein core. PMID- 3651397 TI - Complementary DNA cloning of complement C8 beta and its sequence homology to C9. AB - The complete amino acid sequence of mature C8 beta has been derived from the DNA sequence of a cDNA clone identified by expression screening of a human liver cDNA library. Comparison with the amino acid sequence of C9 shows an overall homology with few deletions and insertions. In particular, the cysteine-rich domains and membrane-inserting regions of C9 are well conserved. These findings are discussed in relation to a possible mechanism of membrane attack complex formation. PMID- 3651398 TI - Comparative phosphorescence and optically detected magnetic resonance studies of fatty acid binding to serum albumin. AB - The binding of free fatty acid to bovine serum albumin (BSA) and human serum albumin (HSA) was studied by phosphorescence and optical detection of triplet state magnetic resonance spectroscopy in zero applied magnetic field. We have found that oleic acid perturbs the excited triplet state of Trp-134 but not that of Trp-212 in BSA. The assignment is made by comparing the BSA results with those obtained from oleic acid binding to HSA. The phosphorescence 0,0 band as well as the zero-field splittings of Trp-134 undergoes significant changes upon binding of oleic acid to BSA. Shifts of the 0,0-band wavelength and of the zero-field splittings point to large changes in the Trp-134 local environment which accompany the complex formation. The shifts are progressive until 3-4 mol of oleic acid is added. The spectroscopic changes may be attributed to Stark effects caused by a protein conformational change near Trp-134 in the BSA-oleate complex. Oleic acid binding has a minimal effect on the triplet-state properties of the single Trp-214 of HSA. The binding specificity with regard to chain length and unsaturation is reflected by the differences in the Trp environment when BSA forms complexes with various fatty acids. PMID- 3651399 TI - Control of placental alkaline phosphatase gene expression in HeLa cells: induction of synthesis by prednisolone and sodium butyrate. AB - HeLa S3 cells produce an alkaline phosphatase indistinguishable from the enzyme from human term placenta. The phosphatase activity in these cells was induced by both prednisolone and sodium butyrate. Both agents stimulated de novo synthesis of the enzyme. The increase in phosphatase activity paralleled the increase in immunoactivity and biosynthesis of placental alkaline phosphatase. The fully processed phosphatase monomer in control, prednisolone-treated or butyrate treated cells was a 64.5 K polypeptide, measured by both incorporation of L [35S]methionine into enzyme protein and active-site labeling. The 64.5 K polypeptide was formed by the incorporation of additional N-acetylneuraminic acid moieties to a precursor polypeptide of 61.5 K. However, this biosynthetic pathway was identified only in butyrate-treated cells. In prednisolone-treated cells, the processing of 61.5 K to the 64.5 K monomer was accelerated, and the presence of the 61.5 K precursor could only be detected by either neuraminidase or monensin treatment. Phosphatase mRNA which comigrated with the term placental alkaline phosphatase mRNA of 2.7 kilobases was induced in the presence of either prednisolone or butyrate. Alkaline phosphatase mRNA in untreated HeLa S3 cells migrated slightly faster than the term placental alkaline phosphatase mRNA. Butyrate also induced a second still faster migrating alkaline phosphatase mRNA. Both prednisolone and butyrate increased the steady-state levels of placental alkaline phosphatase mRNA. Our data indicate that the increase in phosphatase mRNA by prednisolone and butyrate resulted in the induction of alkaline phosphatase activity and biosynthesis in HeLa S3 cells. Furthermore, both agents induced the expression of different alkaline phosphatase gene transcripts without altering its protein product. PMID- 3651400 TI - Oligomerization and ring closure of immunoglobulin E class antibodies by divalent haptens. AB - Cross-linking of antibodies constitutes a widespread initiation signal for their respective effector functions. Cross-linking IgE-class antibodies provide the triggering signal to mast cells for their degranulation process. To obtain a quantitative insight into these cross-linking processes, the interactions between a DNP-specific monoclonal antibody of the IgE class and a series of divalent DNP haptens with spacers of different length and flexibility have been studied by fluorescence titration experiments. These were analyzed by employing the theoretical model developed by Dembo and Goldstein [Dembo, M., & Goldstein, B. (1978) J. Immunol. 121, 345-353] in a fitting procedure. Equilibrium constants that describe the aggregation and ring-closure processes caused by divalent hapten binding have been used as free parameters. The intrinsic binding constants were determined by fluorescence titrations with corresponding monovalent haptens. The main results are the following: (1) The divalent haptens with a short and flexible spacer [i.e., N alpha, N epsilon-di-(DNP)-L-lysine,meso-bis[(DNP-beta Ala)amino]succinate, and bis[(DNP-tri-D-Ala)amino]heptane, having a maximal DNP DNP distance of gamma = 14, 21, and 45 A, respectively] effect aggregation of the antibodies mainly into closed dimers. (2) The divalent hapten family with long and rigid oligoproline spacers di(DNP)-Ahx-Asp-(Pro)n-Lys with n = 24, 27, and 33 (i.e., gamma = 100, 110, and 130 A) causes aggregation of the antibodies predominantly into closed dimers and trimers. The corresponding equilibrium constants of the respective ring-closure processes decrease significantly with longer spacer length. (3) Evidence was found that intramolecularly monomeric ring closure of the IgE antibodies is caused by haptens containing oligoproline spacers with n = 37 or 42 (gamma = 130-150 A). The equilibrium constant of the ring-closure process increases with spacer length. This increase in stability indicates a difference in the imposed strain. Furthermore, the latter results imply that the distance between the two binding sites of the IgE molecule lies in the range dictated by the rigid oligoproline part of the respective hapten's spacer, i.e., 115-130 A. (4) Nearly all oligomeric ring-closure processes proceed relatively slowly with an approximate lower limit of a half-life of 5-10 s. This slowing down of the aggregation and ring-closure processes most probably reflects steric factors. PMID- 3651401 TI - Is the binding of magnesium (II) to calmodulin significant? An investigation by magnesium-25 nuclear magnetic resonance. AB - Previous reports on the interaction between calmodulin (CaM) and Mg2+ range from no binding to a binding constant of 10(4) M-1 [for a summary, see Cox, J. A., Comte, M., Malnoe, A., Berger, D., & Stein, E. A. (1984) Met. Ions Biol. Syst. 17, 215-273]. In order to resolve the controversy, we used 25Mg NMR to study the binding of Mg2+ to apo-CaM, CaM.Ca2(2)+ (in which sites III and IV are occupied by Ca2+), CaM.La2(3)+ (in which sites I and II are occupied by La3+), and the two tryptic fragments of calmodulin, TR1C (containing sites I and II of CaM) and TR2C (containing sites III and IV of CaM). In each system, a "titration set" and a "temperature set" were obtained, and the spectral data were analyzed by total band-shape analysis to calculate the association constant (Ka) and off-rate (koff). As in the case of Ca2+ binding, sites I and II and sites III and IV were treated as two sets of equivalent sites, and a Ca2+/Mg2+ competition experiment suggested that Mg2+ competes with Ca2+ for the same sites. For both CaM.Ca2(2)+ and TR1C, moderately large Ka (2000 and 3500 M-1, respectively) and moderate off rates (koff = 2300 and 3000 s-1, respectively, at 25 degrees C) were observed. For both CaM.La2(3)+ and TR2C, binding of Mg2+ was weaker by a factor of ca. 10 (Ka = 300 and 200 M-1, respectively) while the off-rates were also moderate (koff = 3500 and 2200 s-1, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651402 TI - Polyamines and acetylpolyamines increase the stability and alter the conformation of nucleosome core particles. AB - The interactions of spermine (4+ charge at physiological pH), N1 acetylspermine(3+), spermidine(3+), N1- and N8-acetylsperimidine(2+), putrescine(2+), hexaamminecobalt(3+), and magnesium(2+) with nucleosome core particles have been examined by using thermal denaturation and circular dichroism. Tetra- and triamines were 2-3 times more effective than diamines at stabilizing core particles against thermal denaturation. Secondary effects were also observed, with acetylpolyamines slightly less effective than unmodified polyamines of equivalent charge. Hexaamminecobalt(3+) was less effective than the triamines, while magnesium had essentially no effect. This is surprising since magnesium is more effective than diamines at stabilizing naked DNA. All the cations tested altered the circular dichroism spectra of the core particles in the DNA region (284 nm). The peak at 284 nm was suppressed by tetra- and trivalent compounds to approximately twice the extent of divalent compounds. Magnesium appears to suppress the peak by a lesser extent than the diamines. This indicates that the DNA twist and/or folding is changed by these cations. A plateau of both thermal denaturation and circular dichroism effects was observed at cation concentrations where 30-40% of the total DNA negative charges could be neutralized by the added cations. We suggest that polyamine and histone acetylation function in concert to lower the stability and change the conformation of the nucleosome core, thus facilitating replication and transcription in vivo. PMID- 3651403 TI - Dynamic interactions between microtubules and artificial membranes. AB - We report that extensive adsorption of microtubule protein to liposomes occurs above the transition temperature of the phospholipid bilayer, occurs to phosphatidylcholine (PC) or phosphatidylserine (PS) vesicles, and is not affected by preincubation of microtubule protein with colchicine. Most importantly, we show that 51-63% of the tubulin adsorbed onto neutral (PC) phospholipid vesicles can be desorbed to form microtubules when buffer conditions are adjusted to favor microtubule assembly. By contrast, no microtubule assembly occurred with preadsorption of microtubule protein onto acidic (PS) phospholipid vesicles, suggesting irreversible binding. PMID- 3651404 TI - Synthesis of prodan-phosphatidylcholine, a new fluorescent probe, and its interactions with pancreatic and snake venom phospholipases A2. AB - A new fluorescent probe, prodan-PC, was synthesized by incubating thio-PC, a thiol ester analogue of phosphatidylcholine [1,2-bis(decanoylthio)-1,2-dideoxy-sn glycero-3-phosphocholine], with acrylodan, a fluorescent thiol-reactive reagent [6-acryloyl-2-(dimethylamino)naphthalene], in the presence of phospholipase A2, which served to generate lysothio-PC in situ. Prodan-PC (PPC) showed maximum absorption in ethanol at 370 nm. The fluorescence emission spectrum showed maximum emission at 530 nm in water and at 498 nm in ethanol. In the presence of a saturating amount of phospholipase A2, the emission maximum shifted to about 470 nm. PPC showed a critical micellar concentration around 5 microM, with evidence of premicellar aggregation above 1 microM. Binding of PPC to Crotalus adamanteus phospholipase A2 was evidenced by an increase in emission at 480 nm and an increase in fluorescence anisotropy. An apparent dissociation constant of 0.323 microM was calculated for this enzyme complex. Binding was dependent on the presence of calcium ion and was abolished by blocking the active site with p bromophenacyl bromide. Binding was also followed by energy transfer from tryptophan in the enzyme to PPC. Apparent dissociation constants for PPC complexes with phospholipases A2 from Naja naja naja and porcine pancreas and the prophospholipase A2 from porcine pancreas were 0.509, 0.107, and 0.114 microM, respectively. PPC was shown to inhibit the activity of pancreatic phospholipase A2 in thio-PC-sodium cholate mixed micelles. Inhibition studies were complicated because PPC can also serve as an activator of the snake venom enzymes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651405 TI - Interaction of acyl coenzyme A substrates and analogues with pig kidney medium chain acyl-coA dehydrogenase. AB - Several alkylthio coenzyme A (CoA) derivatives (from ethyl- to hexadecyl-SCoA) have been synthesized to probe the substrate binding site in the flavoprotein medium-chain acyl-CoA dehydrogenase from pig kidney. All bind to apparently equivalent sites with a stoichiometry of four per tetramer. A plot of log Kd vs: hydrocarbon chain length is linear from 2 to 16 carbons with a free energy of binding of 390 cal/methylene group. These data suggest an acyl-binding site of moderate hydrophobicity and imply that the observed substrate specificity of the medium-chain dehydrogenase is not achieved simply by the length of the hydrocarbon binding pocket. Extrapolation of the graph to zero chain length predicts a Kd of 1 mM for the CoA moiety. The difference between this value and the experimentally determined value of 206 microM may be attributed to a contribution from the ionization of the sulfhydryl group in CoASH. The interaction of several eight-carbon intermediates of beta-oxidation (trans-2- and trans-3-octenoyl-CoA and L-3-hydroxy- and 3-ketooctanoyl-CoA) with the dehydrogenase has also been studied. All but the L-3-OH derivative bind tightly to the enzyme (with Kd values in the 50-90 nM range) and are very effective inhibitors of the dehydrogenation of octanoyl-CoA. The trans-3-enoyl analogue produces an immediate, intense, long-wavelength band (lambda max = 820 nm), which probably represents a charge-transfer interaction between the delocalized alpha carbanion donor and oxidized flavin as the acceptor. The L-3-OH analogue is a reductant of the flavin, yielding 3-ketooctanoyl-CoA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651406 TI - Kinetics of product inhibition and mechanisms of lipoprotein lipase activation by apolipoprotein C-II. AB - The kinetics of product inhibition of bovine milk lipoprotein lipase (LPL) were studied in a system of emulsified trioleoylglycerol (TG) at different fixed initial concentrations of oleic acid [( OA]0) without a fatty acid (FA) acceptor. In the absence of apolipoprotein C-II (C-II), the apparent Vmax and the nH(TG) (the slope of the corresponding Hill plot for TG) of 1.82 decreased by about 52% and [TG]0.5 increased 13-fold by raising the [OA]0 to 0.3 mM. At low [OA]0, product inhibition was competitive with respect to TG: the nH(OA) averaged 1.1, and [OA]0.5 was increased about 2-fold by TG. At the higher [OA]0, nH(OA) was 3.5, and TG had no effect on [OA]0.5. In the presence of 3 micrograms/mL C-II, the apparent Vmax was 4.3-7.1-fold higher than in its absence, and the nH(TG) was 2.45. Both parameters decreased by only 20-25%, and [TG]0.5 increased only 3-fold at an [OA]0 of 0.3 mM. Conversely, nH(OA) decreased by 35% and [OA]0.5 increased 6-fold by increasing TG concentrations. Similar kinetics were observed with very low density lipoproteins (VLDL). At saturating TG and varying C-II concentrations, nH(C-II) was 1.78, and product inhibition was found to be competitive with respect to C-II. At the [OA]0 employed, the FA had no effect on enzyme binding to TG emulsions, and there was no evidence that LPL catalyzes the reverse reaction. It is concluded that (a) the LPL kinetics are those of a multisite enzyme that probably has three high-affinity binding sites for TG, two for C-II, and four for OA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651407 TI - Refinement of the solution structure of the DNA hexamer 5'd(GCATGC)2: combined use of nuclear magnetic resonance and restrained molecular dynamics. AB - The solution structure of the self-complementary DNA hexamer 5'd(GCATGC)2 comprising the specific target site for the restriction endonuclease Sph 1 is investigated by using nuclear magnetic resonance spectroscopy and restrained molecular dynamics. All the nonexchangeable proton resonances are assigned sequentially, and from time-dependent nuclear Overhauser enhancement measurements a set of 158 approximate interproton distances are determined. These distances are used as the basis of a structure refinement using restrained molecular dynamics in which the interproton distances are incorporated into the total energy function of the system in the form of an effective potential term. Two restrained molecular dynamics simulations are carried out, starting from classical B- and A-DNA [atomic root mean square (rms) difference 3.3 A]. In both cases convergence is achieved to essentially identical structures satisfying the experimental restraints and having a root mean square difference of only 0.3 A between them, which is within the rms fluctuations of the atoms about their average positions. These results suggest that the restrained molecular dynamics structures represent reasonable approximations of the solution structure. The converged structures are of the B type and exhibit clear sequence-dependent variations of helical parameters, some of which follow Calladine's rules and can be attributed to the relief of interstrand purine-purine clash at adjacent base pairs. In addition, the converged restrained dynamics structures appear bent with a radius of curvature of approximately 20 A. This bending appears to be due almost entirely to the large positive base roll angles, particularly at the Pyr Pur steps. Further, the global and local helix axes are not coincident, and the global helix axis represents a superhelical axis which the bent DNA, when extended into an "infinite" helix by repeated translation and rotation, wraps around. PMID- 3651408 TI - Refinement of the solution structure of the DNA decamer 5'd(CTGGATCCAG)2: combined use of nuclear magnetic resonance and restrained molecular dynamics. AB - The solution structure of the self-complementary DNA decamer 5'd(CTGGATCCAG)2 comprising the specific target site for the restriction endonuclease BamH1 is investigated by using nuclear magnetic resonance sectroscopy and restrained molecular dynamics. With the exception of the H5'/H5" sugar proton resonances, all the nonexchangeable proton resonances are assigned sequentially by using pure phase absorption two-dimensional nuclear Overhauser enhancement spectroscopy. From the time dependence of the nuclear Overhauser effects a set of 160 approximate interproton distances is determined and used as the basis of a structure refinement employing restrained molecular dynamics in which the interproton distances are incorporated into the total energy function of the system in the form of an effective potential term. Two restrained dynamics simulations are carried out, starting from classical B- and A-DNA [atomic root mean square (rms) difference 5.7 A]. In both cases convergence is achieved to very similar B-type structures with an atomic rms difference of 0.9 A which is comparable to the rms fluctuations of the atoms about their average positions. In addition, the rms difference between the experimental and calculated values of the interproton distances for both average restrained dynamics structures is approximately 0.3 A. These results suggest that the converged restrained molecular dynamics structures represent reasonable approximations of the solution structure. The average restrained dynamics structures exhibit clear sequence dependent variations of torsion angles and helical parameters. In addition, the structures exhibit a small bend of around 10-20 degrees at the second (TpG) and eighth (CpA) base pair steps. This can be attributed to the positive base roll angles and large base pair slide values at the two Pyr-Pur steps. The central core of the decamer comprising the six-base recognition site for BamH1 (GGATCC), however, is straight. PMID- 3651409 TI - Chemical determinants of DNA bending at adenine-thymine tracts. AB - DNA fragments having homopolymeric adenine-thymine tracts phased with the helix screw are known to be bent. According to our working model, adenine-thymine tracts adopt a polymorphic structure (H-DNA), and juxtaposition of H-DNA with B DNA results in bending at the junction between the two structures. We incorporated different base analogues in addition to the four ordinary bases into oligonucleotides; ligated multimers of oligonucleotide duplexes were run on polyacrylamide gels. By comparison of gel mobility data for different sequences, we identified factors both necessary and irrelevant for bending, corresponding to the formation of H-DNA. The 5-methyl group on pyrimidines is not essential, and the 2-amino group on purines interferes with the formation of H-DNA, either because it provides a third H bond between the bases or because it alters water structure in the minor groove. The strong base stacking of A may be an important contributing factor to stabilization of the anomalous DNA structure responsible for bending. PMID- 3651410 TI - Temperature-sensitive mutations of bacteriophage T4 lysozyme occur at sites with low mobility and low solvent accessibility in the folded protein. AB - Twenty-five different temperature-sensitive point mutations at 20 sites in the lysozyme gene of bacteriophage T4 have been identified. All of the mutations alter amino acid side chains that have lower than average crystallographic thermal factors and reduced solvent accessibility in the folded protein. This suggests that the amino acids with well-defined conformations can form specific intramolecular interactions that make relatively large contributions to the thermal stability of the protein. Residues with high mobility or high solvent accessibility are much less susceptible to destabilizing substitutions, suggesting that, in general, such amino acids contribute less to protein stability. The pattern of the sites of ts substitutions observed in the folded conformation of T4 lysozyme suggests that severe destabilizing mutations that primarily affect the free energy of the unfolded state are rare. These results indicate that proteins can be stabilized by adding new interactions to regions that are rigid or buried in the folded conformation. PMID- 3651411 TI - Cationic metals promote sequence-directed DNA bending. AB - A DNA segment of approximately 200 base pairs (bp) from Crithidia fasciculata kinetoplast minicircles was previously shown by electron microscopy (EM) to bend into a small circle due to its unique nucleotide sequence containing repeated blocks of 4-6 A's. When this segment was flanked by 207 bp of plasmid DNA on one side and 460 bp on the other, the resulting 890-bp DNA was found to appear either relatively straight or extremely bent as visualized by EM. The bend was located one-third the distance from one end. The fraction of molecules with the most extreme bend increased from approximately 2% to 50-60% following incubation of the DNA with increasing concentrations of Zn2+, Co2+, Ba2+, and Mn2+. These observations suggest that sequence-directed bending in DNA is an inducible and not a static phenomenon. Possible roles of transitions between the bent and straight conformations in the control of gene expression are discussed. PMID- 3651412 TI - Studies on the interaction of cupric isonicotinohydrazide with DNA. AB - The interaction of cupric isonicotinohydrazide (CuIIINH), an antiviral compound, with calf thymus DNA was investigated by circular dichroism (CD) and nuclear magnetic resonance (NMR). Gel electrophoresis of DNA incubated with CuIIINH showed cleavage of DNA to various extents. This cleavage was found to be time and concentration dependent. In the presence of CuIIINH the positive CD band at 274 nm disappeared and the negative band at 246 nm showed a decrease in the mean residual ellipticity value, indicating binding of CuIIINH to DNA. 31P NMR studies indicated that the binding of copper in CuIIINH is to the phosphate oxygen of the DNA backbone. The binding of CuIIINH was also found to be reversible. Addition of ethylenediaminetetraacetic acid to the CuIIINH-DNA complex resulted in breaking of the complex and restoring the original structural features of the B family of DNA in the resulting fragments. At the concentration level of CuIIINH employed, both CuSO4 and INH independently did not show any interaction with DNA. PMID- 3651413 TI - Wavelength dependence for the photoreactions of DNA-psoralen monoadducts. 1. Photoreversal of monoadducts. AB - We have studied the wavelength dependence for the photoreversal of a monoadducted psoralen derivative, HMT [4'-(hydroxymethyl)-4,5',8-trimethylpsoralen], in a single-stranded deoxyoligonucleotide (5'-GAAGCTACGAGC-3'). The psoralen was covalently attached to the thymidine residue in the oligonucleotide as either a furan-side monoadduct, which is formed through the cycloaddition between the 4',5' double bond of the psoralen and the 5,6 double bond of the thymidine, or a pyrone-side monoadduct, which is formed through the cycloaddition between the 3,4 double bond of the psoralen and the 5,6 double bond of the thymidine. As a comparison, we have also investigated the wavelength-dependent photoreversal of the isolated thymidine-HMT monoadducts. All photoreversal action spectra correlate with the extinction spectra of the isolated monoadducts. In the case of the pyrone-side monoadduct, two absorption bands contribute to the photoreversal with a quantum yield of 2 X 10(-2) at wavelengths below 250 nm and 7 X 10(-3) at wavelengths from 287 to 314 nm. The incorporation of the monoadduct into the DNA oligomer had little effect upon the photoreversal rate. For the furan-side monoadduct at least three absorption bands contribute to the photoreversal. The quantum yield varied from 5 X 10(-2) at wavelengths below 250 nm to 7 X 10(-4) at wavelengths between 295 and 365 nm. In contrast to the case of the pyrone-side monoadduct, the incorporation of the furan-side monoadduct into the DNA oligomer reduced the photoreversal rate constant at wavelengths above 285 nm. PMID- 3651414 TI - Wavelength dependence for the photoreactions of DNA-psoralen monoadducts. 2. Photo-cross-linking of monoadducts. AB - The photoreactions of HMT [4'-(hydroxymethyl)-4,5',8-trimethylpsoralen] monoadducts in double-stranded DNA have been studied with complementary oligonucleotides. The HMT was first attached to the thymidine residue in the oligonucleotide 5'-GAAGCTACGAGC-3' as either a furan-side monoadduct or a pyrone side monoadduct. The HMT-monoadducted oligonucleotide was then hybridized to the complementary oligonucleotide 5'-GCTCGTAGCTTC-3' and irradiated with monochromatic light. In the case of the pyrone-side monoadducted oligonucleotide, photoreversal was the predominant reaction, and very little cross-link was formed at all wavelengths. The course of the photoreaction of the double-stranded furan side monoadducted oligonucleotide was dependent on the irradiation wavelength. At wavelengths below 313 nm, both photoreversal and photo-cross-linking occurred. At wavelengths above 313 nm, photoreversal of the monoadduct could not be detected, and photo-cross-linking occurred efficiently with a quantum yield of 2.4 X 10( 2). PMID- 3651415 TI - pH-induced transitions in cholera toxin conformation: a fluorescence study. AB - Determination of the ratio of intrinsic fluorescence with dibrominated Bry 96 (F) relative to that with unbrominated Bry 96 (F0), at neutral pH and in the presence of 0.2 M NaCl, reveals that the A subunit of cholera toxin (CT A) has a somewhat higher affinity for this mild detergent than intact cholera toxin (CT) and its B subunit (CT B). Receptor (GM1 or oligo-GM1) binding has no influence on the very low detergent binding of CT and CT B. Activation of CT A by treatment with dithiothreitol (20 mM) also does not affect detergent binding. The weak hydrophobic nature of CT A is also reflected by the negative modulatory action of anionic phospholipids and deoxycholate on its mono-ADP-ribosyltransferase activity and the ability of the former to decrease its intrinsic fluorescence intensity in a salt-resistant way. Detergent binding of CT A is only slightly pH dependent whereas, upon lowering the pH, detergent binding to CT or CT B becomes significant. In the pH range 6.5-4.2 a gradual increase in detergent binding to CT and CT B occurs. In the narrow pH range 4.2-4.0 a sharp and time-dependent enhancement of brominated Bry 96 quenching is observed. The increase in detergent binding upon lowering the pH is fully reversible, salt dependent, and complete within 10 min (t1/2 = 2 min at 25 degrees C). Solute quenching experiments with the neutral polar quencher acrylamide reveal that upon lowering the pH to 5.0 a marked increase in the exposure of the lone Trp-88 residue in each beta polypeptide chain of CT B occurs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651416 TI - NMR study of the effect of sugar-phosphate backbone ethylation on the stability and conformation of DNA double helix. AB - Temperature variation studies of the imido proton NMR and 31P NMR resonances of the self-associated d(C-C-A-A-G-A-T-T-G-G) and d[C-C-A-A-G-p(Et)-A-T-T-G-G] duplexes (both the R and S diastereoisomers) and the heteroduplexes formed with their complementary strand d(C-C-A-A-T-C-T-T-G-G) were carried out in aqueous solution. Results demonstrate that phosphate backbone ethylation did not disrupt the interstrand hydrogen bonding involved in double-helix formation but perturbed the helix. The S isomer perturbed the duplex more than the R isomer. The line broadening patterns and faster fraying motion in the alkylated duplexes compared to those in the nonalkylated duplexes indicate that the perturbation introduced in the middle propagates along the backbone to the end of the duplex. PMID- 3651417 TI - Reaction of nitric oxide with heme proteins and model compounds of hemoglobin. AB - Rates for the reaction of nitric oxide with several ferric heme proteins and model compounds have been measured. The NO combination rates are markedly affected by the presence or absence of distal histidine. Elephant myoglobin in which the E7 distal histidine has been replaced by glutamine reacts with NO 500 1000 times faster than do the native hemoglobins or myoglobins. By contrast, there is no difference in the CO combination rate constants of sperm whale and elephant myoglobins. Studies on ferric model compounds for the R and T states of hemoglobin indicate that their NO combination rate constants are similar to those observed for the combination of CO with the corresponding ferro derivatives. The last observation suggests that the presence of an axial water molecule at the ligand binding site of ferric hemoglobin A prevents it from exhibiting significant cooperativity in its reactions with NO. PMID- 3651418 TI - Fluorescence lifetime distributions of 1,6-diphenyl-1,3,5-hexatriene in phospholipid vesicles. AB - The fluorescence emission properties of 1,6-diphenyl-1,3,5-hexatriene (DPH) in 1,2-dipalmitoyl-3-sn-phosphatidylcholine and 1,2-dimyristoyl-3-sn phosphatidylcholine multilamellar vesicles have been measured by using multifrequency phase fluorometry. The fluorescence decay of DPH in the phospholipid vesicles has been analyzed by assuming either that the decay is made up of a discrete sum of exponential components or that the decay is made up of one or more continuous distributions of lifetime components. The fit of the decay curve using exponentials required at least two terms, and the reduced X2 was relatively large. The fit using a continuous distribution of lifetime values used two continuous components. Several symmetric distribution functions were used: uniform, Gaussian, and Lorentzian. The distribution function that best described the decay was the Lorentzian. The full width at half-maximum of the Lorentzian distribution was about 0.6 ns at temperatures below the phase transition temperature. At the phospholipid phase transition and at higher temperatures, the distribution became quite narrow, with a width of about 0.1 ns. It is proposed that the lifetime distribution is generated by a continuum of different environments of the DPH molecule characterized by different dielectric constants. Below the transition temperature in the gel phase, the dielectric constant gradient along the membrane normal determines the distribution of decay rates. Above the transition, in the liquid-crystalline phase, the translational and rotational mobility of the DPH molecule increases, and the DPH experiences an average environment during the excited-state lifetime. Consequently, the distribution becomes narrower.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651419 TI - Stabilization of acetylcholine receptor secondary structure by cholesterol and negatively charged phospholipids in membranes. AB - Fourier-transform infrared (FTIR) spectroscopy was used to study the secondary structure of purified Torpedo californica nicotinic acetylcholine receptor (AChR) in reconstituted membranes. Functional studies have previously demonstrated that the ion channel activity requires the presence of both sterol and negatively charged phospholipids in membranes. The present studies are designed to test the hypothesis that the alpha-helical structure of AChR may be stabilized by specific lipid molecules (sterol and/or negatively charged phospholipids) and that these alpha-helices may be responsible for the formation of a potential ion channel. FTIR data show statistically significant (p less than 0.005) spectral changes due to cholesterol and negatively charged phospholipids, respectively. On the basis of standard curves describing the relationship between the spectral properties and the secondary structural contents of water-soluble proteins, the observed spectral change at 931 cm-1 can be interpreted as an apparent change in the alpha helix content from about 17% in the absence of sterols to about 20% in the presence of sterols, suggesting that protein-sterol interactions increase the helical structure of the AChR molecule. Similarly, the spectral change at 988 cm 1 can be interpreted as an apparent increase of beta-sheet content in the AChR molecule from about 20% to about 24% due to the presence of negatively charged phospholipids. Functional AChR in membranes thus appears to be correlated with higher alpha-helical and beta-sheet contents. It is concluded that one role of specific interactions between membrane protein and lipid molecules may be to maintain specific secondary structures necessary to support the ion channel function of AChR. PMID- 3651420 TI - Evidence for functional and structural multiplicity of pregnenolone-16 alpha carbonitrile-inducible cytochrome P-450 isozymes in rat liver microsomes. AB - Administration of pregnenolone-16 alpha-carbonitrile (PCN) to adult female rats caused a 2-fold increase in total liver microsomal cytochrome P-450 along with 5 7-fold increases in four in vitro monooxygenase activities considered diagnostic for the major PCN-inducible cytochrome P-450 isozyme. However, upon administration of chloramphenicol to PCN-treated rats, these monooxygenase activities could be resolved into three groups. Thus, the ability of the microsomes to convert triacetyloleandomycin to a metabolite that forms a spectral complex with the reduced heme iron was decreased by 80% by chloramphenicol, whereas only a 50% decrease was observed in the rate of conversion of (R) warfarin to its 9,10-dehydro metabolite and in the rate of 6 beta-hydroxylation of androstenedione. More strikingly, the 10-hydroxylation of (R)-warfarin was actually enhanced 2-fold by the chloramphenicol treatment. Fractionation studies were carried out on liver microsomes from PCN-treated adult male rats, and two highly purified cytochromes P-450, referred to as PCNa and PCNb, were recovered. PCNb was found to be identical in the sequence of the first 15 amino acid residues with a PCN-inducible isozyme, the complete amino acid sequence of which has recently been deduced in another laboratory [Gonzalez, F. J., Nebert, D. W., Hardwick, J. P., & Kasper, C. B. (1985) J. Biol. Chem. 260, 7435-7441]. The other isozyme, PCNa, differed in amino acid sequence in three of the first 15 positions from PCNb. Upon immunoblot analysis, polyclonal antibodies raised to PCNb also recognized PCNa. Thus, the PCN-inducible family of rat liver cytochrome P-450 comprises at least two separate proteins. PMID- 3651421 TI - Intrinsic fluorescence of elongation factor Tu in its complexes with GDP and elongation factor Ts. AB - The intrinsic fluorescence properties of elongation factor Tu (EF-Tu) in its complexes with GDP and elongation factor Ts (EF-Ts) have been investigated. The emission spectra for both complexes are dominated by the tyrosine contribution upon excitation at 280 nm whereas excitation at 300 nm leads to exclusive emission from the single tryptophan residue (Trp-184) of EF-Tu. The fluorescence lifetime of this tryptophan residue in both complexes was investigated by using a multifrequency phase fluorometer which achieves a broad range of modulation frequencies utilizing the harmonic content of a mode-locked laser. These results indicated a heterogeneous emission with major components near 4.8 ns for both complexes. Quenching experiments on both complexes indicated limited accessibility of the tryptophan residue to acrylamide and virtually no accessibility to iodide ion. The quenching patterns exhibited by EF-Tu-GDP and EF Tu X EF-Ts were, however, different; both quenchers were more efficient at quenching the emission from the EF-Tu x EF-Ts complex. Steady-state and dynamic polarization measurements revealed limited local mobility for the tryptophan in the EF-Tu x GDP complex whereas formation of the EF-Tu x EF-Ts complex led to a dramatic increase in this local mobility. PMID- 3651422 TI - Interaction of a fluorescent analogue of GDP with elongation factor Tu: steady state and time-resolved fluorescence studies. AB - A fluorescent derivative of GDP was prepared by the reaction of 2'-amino-2'-deoxy GDP with fluorescamine. This derivative binds tightly (KD approximately 4.5 X 10( 8) M) to elongation factor Tu (EF-Tu) from Escherichia coli. The emission properties, including spectra, polarizations, and lifetimes, for fluorescamine GDP free in solution and bound to EF-Tu are presented. Emission data on the fluorescamine-ethylamine conjugate are also given. A multifrequency phase and modulation lifetime study (using nine modulation frequencies over the range of 2 80 MHz) indicated that the emissions of these three systems were well characterized by single exponential decays corresponding to 1.45 ns for the fluorescamine-ethylamine derivative in buffer and to 7.74 and 11.03 ns for the fluorescamine-GDP derivative free in buffer and bound to EF-Tu, respectively. Multifrequency differential polarized phase fluorometry results indicated a rotational relaxation time of the protein-probe complex of approximately 88 ns; these data also indicated the lack of significant local motion for the probe. Addition of excess GDP to the EF-Tu-probe complex led to displacement of the fluorescamine-GDP derivative as evidenced by the change in both the steady-state and dynamic polarization values. The observed increase in fluorescence intensity upon displacement allowed us to follow the kinetics of the dissociation reaction; a dissociation rate constant of 5.0 X 10(-3) S-1 was determined. These results demonstrate the utility of this 2'-amino-2'-deoxy-GDP analogue as a probe of guanosine nucleotide dependent systems. PMID- 3651423 TI - Continuous monitoring of adenosine 5'-triphosphate in the microenvironment of immobilized enzymes by firefly luciferase. AB - The study of enzymes sequestered in artificial or biological systems is generally conducted by indirect methodology with macroscopic measurements of reactants in the bulk medium. This paper describes a new approach with firefly luciferase to monitor ATP concentration directly in the microenvironment of enzymes producing or consuming ATP. Upon addition of ATP to immobilized firefly luciferase, the onset of light production is slower than that observed with the soluble enzyme, due to a slower diffusion of ATP to the immobilized enzyme. With immobilized pyruvate kinase, a relative accumulation of ATP inside the beads is demonstrated, as measured with coimmobilized firefly luciferase. The accumulation of product (ATP) is enhanced when the bead suspension is not stirred. This ATP in the beads is relatively inaccessible to soluble hexokinase added to the bulk medium. Similarly, a rapid ATP depletion in the microenvironment of immobilized hexokinase is demonstrated. This microscopic event is kinetically distinguishable from the slower macroscopic depletion of substrate in the bulk medium. The rate of depletion in the microenvironment depends on the local activity of the immobilized enzyme but not on the total amount of enzyme in suspension, as does the macroscopic phenomenon. The theoretical principles for the interaction of diffusion and catalysis in these systems are briefly summarized and discussed. These results are relevant to various molecular mechanisms proposed for membrane bound enzyme action and regulation, derived from macroscopic kinetic measurements assuming a negligible diffusion control. PMID- 3651424 TI - Interaction of mono- and dianions with cyanase: evidence for apparent half-site binding. AB - Cyanase is an inducible enzyme in Escherichia coli that catalyzes bicarbonate dependent hydrolysis of cyanate. The dianions oxalate, oxalacetate, and malonate are slow-binding inhibitors of cyanase, and some monoanions such as azide and chloride also inhibit cyanase activity [Anderson, P. M., & Little, R. M. (1986) Biochemistry 25, 1621-1626]. The purpose of this study was to investigate the interaction of selected dianions and monoanions by kinetic and equilibrium dialysis binding studies in an effort to obtain information about the active site and catalytic mechanism. Measurement of the effectiveness of 30 different dianions as inhibitors of cyanase showed a significant degree of structural and/or isomeric specificity and considerable variation with respect to the slow binding nature of the inhibition. Oxalate and oxalacetate both show extreme slow binding inhibition at very low concentrations. Kinetic studies of the rate of inhibition of cyanase by oxalate showed that the reaction is pseudo first order with respect to oxalate concentration and the results are consistent with a pathway in which oxalate forms a complex with the enzyme in a rapid initial reversible step followed by a slow isomerization step leading to a complex with a very low dissociation constant. The rate of inhibition is significantly reduced by the presence of relatively low concentrations of either azide (analogue of cyanate) or bicarbonate. Equilibrium dialysis binding studies showed that the stoichiometry of binding at saturation for oxalate, malonate, chloride, and bicarbonate is about 0.5 mol of ligand bound/mol of subunit for each compound.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651425 TI - Substrate activity of synthetic formyl phosphate in the reaction catalyzed by formyltetrahydrofolate synthetase. AB - Formyl phosphate, a putative enzyme-bound intermediate in the reaction catalyzed by formyltetrahydrofolate synthetase (EC 6.3.4.3), was synthesized from formyl fluoride and inorganic phosphate [Jaenicke, L. v., & Koch, J. (1963) Justus Liebigs Ann. Chem. 663, 50-58], and the product was characterized by 31P, 1H, and 13C nuclear magnetic resonance (NMR). Measurement of hydrolysis rates by 31P NMR indicates that formyl phosphate is particularly labile, with a half-life of 48 min in a buffered neutral solution at 20 degrees C. At pH 7, hydrolysis occurs with P-O bond cleavage, as demonstrated by 18O incorporation from H2(18)O into Pi, while at pH 1 and pH 13 hydrolysis occurs with C-O bond cleavage. The substrate activity of formyl phosphate was tested in the reaction catalyzed by formyltetrahydrofolate synthetase isolated from Clostridium cylindrosporum. Formyl phosphate supports the reaction in both the forward and reverse directions. Thus, N10-formyltetrahydrofolate is produced from tetrahydrofolate and formyl phosphate in a reaction mixture that contains enzyme, Mg(II), and ADP, and ATP is produced from formyl phosphate and ADP with enzyme, Mg(II), and tetrahydrofolate present. The requirements for ADP and for tetrahydrofolate as cofactors in these reactions are consistent with previous steady-state kinetic and isotope exchange studies, which demonstrated that all substrate subsites must be occupied prior to catalysis. The k cat values for both the forward and reverse directions, with formyl phosphate as the substrate, are much lower than those for the normal forward and reverse reactions. Kinetic analysis of the formyl phosphate supported reactions indicates that the low steady-state rates observed for the synthetic intermediate are most likely due to the sequential nature of the normal reaction. PMID- 3651426 TI - Photoaffinity labeling of serum vitamin D binding protein by 3-deoxy-3-azido-25 hydroxyvitamin D3. AB - 3-Deoxy-3-azido-25-hydroxyvitamin D3 was covalently incorporated in the 25 hydroxyvitamin D3 binding site of purified human plasma vitamin D binding protein. Competition experiments showed that 3-deoxy-3-azido-25-hydroxyvitamin D3 and 25-hydroxyvitamin D3 bind at the same site on the protein. Tritiated 3-deoxy 3-azido-25-hydroxyvitamin D3 was synthesized from tritiated 25-hydroxyvitamin D3, retaining the high specific activity of the parent compound. The tritiated azido label bound reversibly to human vitamin D binding protein in the dark and covalently to human vitamin D binding protein after exposure to ultraviolet light. Reversible binding of tritiated 3-deoxy-3-azido-25-hydroxyvitamin D3 was compared to tritiated 25-hydroxyvitamin D3 binding to human vitamin D binding protein. Scatchard analysis of the data indicated equivalent maximum density binding sites with a KD,app of 0.21 nM for 25-hydroxyvitamin D3 and a KD,app of 1.3 nM for the azido derivative. Covalent binding was observed only after exposure to ultraviolet irradiation, with an average of 3% of the reversibly bound label becoming covalently bound to vitamin D binding protein. The covalent binding was reduced 70-80% when 25-hydroxyvitamin D3 was present, indicating strong covalent binding at the vitamin D binding site of the protein. When tritiated 3-deoxy-3-azido-25-hydroxyvitamin D3 was incubated with human plasma in the absence and presence of 25-hydroxyvitamin D3, 12% of the azido derivative was reversibly bound to vitamin D binding protein. After ultraviolet irradiation, four plasma proteins covalently bound the azido label, but vitamin D binding protein was the only protein of the four that was unlabeled in the presence of 25 hydroxyvitamin D3. PMID- 3651427 TI - Protein-ligand interaction. A calorimetric study of the interaction of oligosaccharides and hen ovalbumin glycopeptides with concanavalin A. AB - A calorimetric study is reported concerning the interaction between concanavalin A (Con A) and some oligosaccharides and glycopeptides hydrolyzed from hen ovalbumin. The measurements were carried out in acetate buffer, pH 4.5, where, by far, the prevailing form of the protein is the dimeric one [Kalb, A.J., & Lustig, A. (1968) Biochim. Biophys. Acta 168, 366; Dani, M., Manca, F., & Rialdi, G. (1981) Biochim. Biophys. Acta 667, 108]. The calorimetric technique allows the direct determination of the binding enthalpy delta H, degrees B, the evaluation of the apparent association constant K'B, and then the evaluation of the apparent free energy and entropy, delta G degrees' B and delta S degrees' B. Three groups of data have been collected in the present study. The first one concerns the interaction between concanavalin A and some mono- and disaccharides [methyl alpha glucopyranoside (alpha MGlup), methyl alpha-mannopyranoside (alpha MManp), D maltose, D-trehalose, and D-cellobiose]. The analysis of the data indicates that in these cases there are small favorable entropic and enthalpic contributions to the affinity. The stoichiometry of the reaction is 2 mol of ligand/mol of Con A dimer, the sites resulting being equivalent and noninteracting. Melezitose, the only trisaccharide studied, shows a different behavior: its affinity for Con A is higher as compared to the other oligosaccharides containing alpha-glucosyl residues and closer to that of methyl alpha-mannopyranoside. However, the stoichiometry is different, namely, 1 mol of ligand/dimer of Con A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651428 TI - A novel progesterone-induced messenger RNA in rabbit and human endometria. Cloning and sequence analysis of the complementary DNA. AB - Complementary DNAs (cDNAs) prepared from messenger RNAs (mRNAs) isolated from endometria of 5 day pregnant rabbits were inserted into the plasmid pBR322. A library of 2400 recombinant plasmid clones was prepared and screened by differential in situ hybridization with cDNAs prepared from mRNAs of rabbits either injected with progesterone or untreated by the hormone. Clones encoding uteroglobin were identified and discarded. Several progesterone-induced and progesterone-repressed clones were identified. One of them corresponded to a relatively frequent mRNA (0.2% of clones in the library) of 2300 nucleotides. The induction of this messenger RNA by progesterone was totally suppressed by the antagonist RU486. This compound displayed a limited agonistic activity when administered alone. A very small increase in mRNA concentration was observed after estradiol administration. The messenger RNA was also found in the liver (where it was constitutively expressed), the ovaries, and the Fallopian tubes of rabbits. A cross-hybridizing messenger RNA was detected in human endometrium during the luteal phase. Sequence analysis showed that the messenger RNA encoded a protein of 370 amino acids with a calculated molecular weight of 40,800. A search in Genbank and National Biomedical Research Foundation data banks showed no identity or marked similarity with previously published DNA or protein sequences. PMID- 3651429 TI - Analysis of long-chain bases in sphingolipids by positive ion fast atom bombardment or matrix-assisted secondary ion mass spectrometry. AB - The structures of long-chain bases are expressed as [CH2C(NH2) = CHR]+ (Z+) in the positive ion mode spectra obtained on fast atom bombardment (FAB) mass spectrometry or liquid-matrix-assisted secondary ion mass spectrometry (SIMS) [Benninghoven, A., Ed. (1983) Ion Formation from Organic Solids, Springer, Berlin]. This phenomenon is common to sphingolipids in general: glycosphingolipids [see reviews by Sweeley and Nunez [Sweeley, C. C., & Nunez, H. A. (1985) Annu. Rev. Biochem. 54, 765] and Kanfer and Hakomori [Kanfer, J. N., & Hakomori, S. (1983) Handb. Lipid Res. 3]] and phosphonosphingolipids [Hayashi, A., & Matsubara, T. (1982) in New Vistas in Glycolipid Research (Makita, A., Handa, S., Taketomi, T., & Nagai, Y., Eds.) p 103, Plenum, New York], inclusive. Phytosphingosine compounds show the same type of fragmentation without additional dehydration if a neutral matrix is used. A Z+ ion is easily detected in the lower mass region (m/z 200-400) as an even mass number fragment ion, and confirmation is made by means of B/E constant and B2/E constant linked scan techniques [Boyd, R. K., & Beynon, J. H. (1977) Org. Mass Spectrom. 12, 163; Boyd, R. K., & Shushan, B. (1981) Int. J. Mass Spectrom. Ion Phys. 37, 355; Macdonald, C. G., & Lacey, M. J. (1984) Org. Mass Spectrom. 19, 55]. [Principles of linked scannings are explicitly summarized by Jennings and Mason [Jennings, K. R., & Mason, R. S. (1983) in Tandem Mass Spectrometry (McLafferty, F. W., Ed.) p 197, Wiley, New York] besides the cited literature.] PMID- 3651430 TI - Oxygen binding constants for human hemoglobin tetramers. AB - High-precision studies of oxygen binding in hemoglobin (HbA0) solutions at near physiological concentrations (2-12 mM heme; pHs 7.0-9.1; various buffers) have led to an unanticipated result: an unmeasurably low contribution from the triply ligated species. We have obtained this result from new differential oxygen binding measurements for human hemoglobin through the use of a thin-layer apparatus, which enables study of solutions at high Hb concentrations. The effect of tetramer dissociation into dimers, which becomes significant at hemoglobin concentrations below 1 mM in heme, is avoided. The analysis of the binding reactions is thus cast in terms of tetramer-binding polynomial written with overall Adair equilibrium constants which directly reflect the contributions of intermediate ligated species. The unmeasurable contribution of the triply ligated species renders the equilibrium constants of the third and fourth stepwise reactions practically undeterminable. PMID- 3651431 TI - Allosteric interpretation of the oxygen-binding reaction of human hemoglobin tetramers. AB - An allosteric model is presented that provides a simple explanation for the low population of triply ligated species, relative to the other species, in the oxygenation of human hemoglobin tetramers as found in high-concentration studies [Gill, S. J., Di Cera, E., Doyle, M. L., Bishop, G. A., & Robert, C. H. (1987) Biochemistry (preceding paper in this issue)]. The model is a quantitative interpretation of the Perutz mechanism [Perutz, M. F. (1970) Nature (London) 228, 726-739] and is based on a number of structural and thermodynamic findings so far reported in the analysis of hemoglobin properties. Human hemoglobin is assumed to exist in two quaternary states: the T or low-affinity state and the R or high affinity state. An extreme chain heterogeneity in the T state is postulated so that oxygen binds only to the alpha chains. Nearest-neighbor interactions between the alpha chains may lead to cooperativity within the T state. The R state is noncooperative, and both the alpha and beta chains have equal oxygen affinity. PMID- 3651432 TI - Viscosity dependence of ethidium-DNA intercalation kinetics. AB - The kinetics of ethidium intercalation into double-stranded poly[d(G-C)] were investigated by use of repetitive pressure-jump chemical relaxation at 20 degrees C in low ionic strength (0.1 M NaCl) aqueous buffers containing either glycerol or methanol. The viscosity of the various solvents differed by more than an order of magnitude while other physical properties (e.g., dielectric constant) remained approximately constant. The single-reciprocal kinetic relaxation time (tau -1) increases linearly with DNA concentration. The observed association rate constant is lower in all organic-aqueous mixtures than in water and is inversely proportional to the viscosity. These results provide evidence for an additional step in the intercalation mechanism which is identified as an obligatory DNA conformational change preceding ethidium intercalation. From the data presented, the equilibrium constant of this local conformational change is approximately 10( 3), i.e., greatly favoring the structure incapable of intercalation. The corresponding kinetics were not directly determined; however, in order to be consistent with all of the data the forward and/or reverse rate constants of the conformational change must be larger than the rate of the intercalation reaction. Thus, it is proposed that the rate of the conformational change back to the nonintercalating B-DNA structure is greater than approximately 500 s-1, implying a rate of opening greater than approximately 0.5 s-1, in agreement with other hydrogen exchange and NMR data. The observed overall rate constant for the dissociation of ethidium is inversely proportional to the solvent density, possibly reflecting a dependence on the solvent free volume. The overall volume change of intercalation is less negative in the organic-aqueous solvent mixtures than in water. PMID- 3651434 TI - Thermotropic phase behavior of model membranes composed of phosphatidylcholines containing dl-methyl anteisobranched fatty acids. 1. Differential scanning calorimetric and 31P NMR spectroscopic studies. AB - The thermotropic phase behavior of aqueous dispersions of nine dl-methyl branched anteisoacylphosphatidylcholines was studied by differential scanning calorimetry and 31P nuclear magnetic resonance spectroscopy. The calorimetric studies demonstrate that these compounds all exhibit a complex phase behavior, consisting of at least two minor, low-enthalpy, gel-state transitions which occur at temperatures just prior to the onset of the gel/liquid-crystalline phase transition. In addition, at still lower temperatures, anteisobranched phosphatidylcholines containing fatty acyl chains with an odd number of carbon atoms show a major, higher enthalpy, gel-state transition, which was assigned to a conversion from a condensed to a more loosely packed gel phase. No such transition was observed for the even-numbered compounds in aqueous dispersion, but when dispersed in aqueous ethylene glycol, a major gel-state transition is clearly discernible for two of the even-numbered phospholipids. The major gel state transition exhibits heating and cooling hysteresis and is fairly sensitive to the composition of the bulk aqueous phase. 31P NMR spectroscopic studies indicate that the major gel-state transition is accompanied by a considerable change in the mobility of the phosphate head group and that, at temperatures just prior to the onset of the gel/liquid-crystalline phase transition, the mobility of the phosphate head group is comparable to that normally exhibited by the liquid-crystalline state of most other phospholipids. The temperatures at which the gel/liquid-crystalline phase transition occurs and the enthalpy change associated with this process are considerably lower than those of the saturated n acyl-PC's of comparable acyl chain length.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651433 TI - Ovothiols, a family of redox-active mercaptohistidine compounds from marine invertebrate eggs. AB - We have previously reported a novel thiol compound, 1-methyl-N alpha,N alpha dimethyl-4-mercaptohistidine, or ovothiol, present at high concentration in the eggs of the sea urchin Strongylocentrotus purpuratus [Turner, E., Klevit, R., Hopkins, P. B., & Shapiro, B. M. (1986) J. Biol. Chem. 261, 13056-13063]. Here we report two related compounds, 1-methyl-N alpha-methyl-4-mercaptohistidine, or ovothiol B, from the scallop Chlamys hastata, and 1-methyl-4-mercaptohistidine, or ovothiol A, from the starfish Evasterias troschelii. These two compounds, as well as the S. purpuratus compound now designated ovothiol C, were isolated from eggs or ovarian tissue by S-carboxymethylation with [3H]iodoacetic acid, ion exchange chromatography and ion-pairing high-pressure liquid chromatography. The structures of S-(carboxymethyl)ovothiols A and B were determined by 1H NMR, and that of ovothiol A was confirmed by comparison with authentic methylhistidine samples after desulfuration with Raney nickel. In the ovary of each species, the predominant methylation form of ovothiol accounts for at least 80% of the total 4 mercaptohistidine. The ovothiol concentration of the ovary far exceeds that of the testis or somatic tissues. The ovothiol C content of unfertilized S. purpuratus eggs is 1.14 mumol/10(6) eggs, equivalent to approximately 4.3 mM average concentration; the glutathione (GSH + GSSG) content is 0.9 mumol/10(6) eggs. In this species, high ovothiol levels persisted for the first 2 weeks of embryonic development. Ovothiol and glutathione account for virtually all of the trichloroacetic acid soluble-SH groups in the egg; these results are compared to several previous studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651435 TI - Thermotropic phase behavior of model membranes composed of phosphatidylcholines containing dl-methyl anteisobranched fatty acids. 2. An infrared spectroscopy study. AB - The thermotropic phase behavior of four members of the homologous series of dl methyl anteisobranched phosphatidylcholines was investigated by Fourier transform infrared spectroscopy. The odd-numbered phosphatidylcholines exhibit spectral changes in two distinct temperature ranges, while their even-numbered counterparts exhibit spectral changes within only a single temperature range. The high-temperature transition observed in the odd-numbered phosphatidylcholines and the single thermotropic event characteristic of the phase behavior of their even numbered counterparts are both identified as gel/liquid-crystalline phase transitions. The low-temperature event exhibited only by the odd-numbered phospholipids is identified as a gel/gel phase transition that involves changes in the packing mode of the acyl chain methylene groups, as well as changes in the conformation of the glycerol ester interface. These infrared spectroscopic data thus suggest that at low temperatures the odd-numbered methyl anteisobranched phosphatidylcholines form a highly ordered condensed phase similar to the Lc phases of the linear saturated n-acyl-phosphatidylcholines. A comparable condensed phase was not formed by the even-numbered anteisobranched phosphatidylcholines under similar conditions. The properties of the gel states of the even-numbered anteisoacylphosphatidylcholines were generally similar to those of the high-temperature gel states of their odd-numbered counterparts. Those gel states exhibit spectral characteristics indicative of hexagonally packed but relatively mobile acyl chains. The temperature-dependent changes in the spectral characteristics of these gel states were continuous and were not resolved into the discrete but overlapping transitions observed by differential scanning calorimetry. PMID- 3651436 TI - Mechanism and kinetics of merocyanine 540 binding to phospholipid membranes. AB - The physicochemical mechanism for merocyanine 540 (M540) binding to unilamellar phosphatidylcholine (PC) vesicles was examined by steady-state and dynamic fluorescence and fluorescence stopped-flow methods. At 530-nm excitation, aqueous M540 has an emission peak at 565 nm, which red shifts to 580 nm with formation of membrane-bound monomers (M); bound dimers (D) are nonfluorescent. Equilibrium fluorescence titrations show that 50% of total M540 partitions into the membrane to form D at [M540]/[PC] (Rm/p)_approximately 0.6. M and D concentrations are equal at Rm/p approximately 0.05. For Rm/p less than 0.1, M540 has a single fluorescence lifetime (tau), which decreases with Rm/p [tau-1 (ns-1) = 0.48 + 3.3Rm/p], indicating a rapid collisional rate between M to form D. Dynamic depolarization studies show that hindered rotation of M (r infinity = 0.13 at Rm/p = 0.006) becomes more rapid (rotational rate 0.2-1.9 ns-1) with increasing Rm/p (0.006-0.075). The efficiencies of energy transfer between n-(9-anthroyloxy) fatty acid probes (n = 2, 6, 9, 12, 16) and bound M540 suggest that M is oriented parallel to the phospholipids near the membrane surface; studies of efficiencies of n-AF quenching by D are consistent with an orientation of D perpendicular to the phospholipids. In stopped-flow fluorescence measurements in which M540 is mixed with PC vesicles, there is a rapid (1 ms) followed by a slower (10-50 ms) concentration-dependent fluorescence increase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651437 TI - Structure, dynamics, and thermodynamics of mismatched DNA oligonucleotide duplexes d(CCCAGGG)2 and d(CCCTGGG)2. AB - The structures and hydrogen exchange properties of the mismatched DNA oligonucleotide duplexes d(CCCAGGG)2 and d(CCCTGGG)2 have been studied by high resolution nuclear magnetic resonance. Both the adenine-adenine and thymine thymine mismatches are intercalated in the duplexes. The structures of these self complementary duplexes are symmetric, with the two strands in equivalent positions. The evidence indicates that these mismatches are not stably hydrogen bonded. The mismatched bases in both duplexes are in the anti conformation. The mismatched thymine nucleotide in d(CCCTGGG)2 is intercalated in the duplex with very little distortion of the bases or sugar-phosphate backbone. In contrast, the bases of the adenine-adenine mismatch in d(CCCAGGG)2 must tilt and push apart to reduce the overlap of the amino groups. The thermodynamic data show that the T-T mismatch is less destabilizing than the A-A mismatch when flanked by C-G base pairs in this sequence, in contrast to their approximately equal stabilities when flanked by A-T base pairs in the sequence d(CAAAXAAAG.CTTTYTTTG) where X and Y = A, C, G, and T [Aboul-ela, F., Koh, D., & Tinoco, I., Jr. (1985) Nucleic Acids Res. 13, 4811]. Although the mechanism cannot be determined conclusively from the limited data obtained, exchange of the imino protons with solvent in these destabilized heteroduplexes appears to occur by a cooperative mechanism in which half the helix dissociates. PMID- 3651438 TI - Reaction of Lactobacillus histidine decarboxylase with L-histidine methyl ester. AB - L-Histidine methyl ester inactivates histidine decarboxylase in a time-dependent manner. The possibility was considered that an irreversible reaction between enzyme and inhibitor occurs [Recsei, P. A., & Snell, E. E. (1970) Biochemistry 9, 1492-1497]. We have confirmed time-dependent inactivation by histidine methyl ester and have investigated the structure of the enzyme-inhibitor complex. Upon exposure to either 8 M guanidinium chloride or 6% trichloroacetic acid, unchanged histidine methyl ester is recovered. Formation of the complex involves Schiff base formation, most likely with the active site pyruvyl residue [Huynh, Q. K., & Snell, E. E. (1986) J. Biol. Chem. 261, 4389-4394], but does not involve additional irreversible covalent interaction between inhibitor and enzyme. Complex formation is a two-step process involving rapidly reversible formation of a loose complex and essentially irreversible formation of a tight complex. For the formation of the tight complex, Ki = 80 nM and koff = 2.5 X 10(-4) min-1. Time-dependent inhibition was also observed with L-histidine ethyl ester, L histidinamide, and DL-3-amino-4-(4-imidazolyl)-2-butanone. No inactivation was observed with glycine methyl ester or histamine. We propose that in the catalytic reaction the carboxyl group of the substrate is in a hydrophobic region. The unfavorable interaction between the carboxylate group and the hydrophobic region facilitates decarboxylation [Crosby, J., Stone, R., & Liehard, G. E. (1970) J. Am. Chem. Soc. 92, 2891-2900]. With histidine methyl ester this unfavorable interaction is no longer present; hence, there is tight binding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651439 TI - Purification and characterization of a carboxylesterase from the intestine of the nematode Caenorhabditis elegans. AB - The major intestinal esterase from the nematode Caenorhabditis elegans has been purified to essential homogeneity. Starting from whole worms, the overall purification is 9000-fold with a 10% recovery of activity. The esterase is a single polypeptide chain of Mr 60,000 and is stoichiometrically inhibited by organophosphates. Substrate preferences and inhibition patterns classify the enzyme as a carboxylesterase (EC 3.1.1.1), but the physiological function is unknown. The sequence of 13 amino acid residues at the esterase N-terminus has been determined. This partial sequence shows a surprisingly high degree of similarity to the N-terminal sequence of two carboxylesterases recently isolated from Drosophila mojavensis [Pen, J., van Beeumen, J., & Beintema, J. J. (1986) Biochem. J. 238, 691-699]. PMID- 3651440 TI - Steady-state and stopped-flow kinetic measurements of the primary deuterium isotope effect in the reaction catalyzed by p-cresol methylhydroxylase. AB - Steady-state kinetic studies for the reaction of the flavocytochrome p-cresol methylhydroxylase with the reducing substrates (S) p-cresol, 4-ethylphenol, and their corresponding alpha-deuteriated analogues are presented. The results from these experiments and those from studies involving various reoxidizing substrates support the proposed apparent ping-pong mechanism. With phenazine methosulfate (PMS) as the reoxidant for studies at pH 7.6 and 6 or 25 degrees C, the isotope effects on kcat are lower than the intrinsic isotope effect. The values for D(kcat/KS) are equal to the intrinsic effect for p-cresol at 25 degrees C and for 4-ethylphenol at both 6 and 25 degrees C. However, the value for this steady state parameter at 6 degrees C for p-cresol is lower than the intrinsic effect. The values for D(kcat/KPMS) are nearly equal to 1.0 under all conditions. In contrast, the steady-state kinetic analysis for the isolated flavoprotein subunit of p-cresol methylhydroxylase involving p-cresol and PMS as substrates indicates that a random-binding mechanism is operating. Additionally, several of the steady state parameters yield values for the apparent intrinsic isotope effect for the flavoprotein. The results of stopped-flow kinetic studies are also reported. At pH 7.6 the intrinsic isotope effect (Dk2) for the reduction of the enzyme by 4 ethylphenol is 4.8-5.0 at 25 degrees C and 4.0 at 6 degrees C. This technique yields a value for Dk2 of 7.05 at 6 degrees C and pH 7.6 for p-cresol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651441 TI - Mechanism for slow-binding inhibition of human leukocyte elastase by valine derived benzoxazinones. AB - Valine-derived benzoxazinones have been synthesized and found to be competitive, slow-binding inhibitors of human leukocyte elastase (HLE). Steady-state inhibition constants Ki are dependent on aryl substitution and reach a maximum of potency of 0.5 nM with the 5-Cl compound 6. UV-spectral data for the interaction of HLE and the unsubstituted inhibitor 3 indicate that the stable complex formed between enzyme and inhibitor is an acyl-enzyme that can either undergo ring closure, to reform intact benzoxazinone, or hydrolysis, to liberate an N acylanthranilic acid. "Burst" kinetic data, derived from the direct observation of the interaction of HLE and 3, are consistent with results of the inhibition of catalysis experiments. PMID- 3651442 TI - Redox properties of the quinoprotein methylamine dehydrogenase from paracoccus denitrificans. AB - Paracoccus denitrificans synthesizes a methylamine dehydrogenase that contains a covalently bound form of pyrroloquinoline quinone as a prosthetic group [Husain, M., & Davison, V.L. (1987) J. Bacteriol. 169, 1712-1717]. Anaerobic reductive titration of this enzyme with dithionite proceeded through a semiquinone intermediate with spectral properties quite distinct from those of the oxidized and reduced species. From these data the molar extinction coefficients were calculated at various wavelengths for the three redox states of this enzyme. The semiquinone was slowly reoxidized under aerobic conditions. The fully reduced enzyme was stable in the presence of oxygen and slowly reoxidized by ferricyanide. Reductive titration of methylamine dehydrogenase with methylamine proceeded directly to the fully reduced form of the enzyme without detectable formation of the semiquinone. Electrochemical titrations of the enzyme yielded an overall midpoint potential value for the two-electron couple (fully oxidized/fully reduced) of 100 +/- 4 mV and an n value of 2.15 +/- 0.15. PMID- 3651443 TI - GTP hydrolysis during microtubule assembly. AB - The GTP cap model of dynamic instability [Mitchison, T., & Kirschner, M.W. (1984) Nature (London) 312, 237] postulates that a GTP cap at the end of most microtubules stabilizes the polymer and allows continuing assembly of GTP-tubulin subunits while microtubules without a cap rapidly disassemble. This attractive explanation for observed microtubule behavior is based on the suggestion that hydrolysis of GTP is not coupled to assembly but rather takes place as a first order reaction after a subunit is assembled onto a polymer end. Carlier and Pantaloni [Carlier, M., & Pantaloni, D. (1981) Biochemistry 20, 1918] reported a lag of hydrolysis behind microtubule assembly and a first-order rate constant for hydrolysis (kh) of 0.25/min. A lag has not been demonstrated by other investigators, and a kh value that specifies such a slow rate of hydrolysis is difficult to reconcile with reported steady-state microtubule growth rates and frequencies of disassembly. We have looked for a lag using tubulin free of microtubule-associated protein at concentrations of 18.5-74 microM, assembly with and without glycerol, and two independent assays of GTP hydrolysis. No lag was observed under any of the conditions employed, with initial rates of hydrolysis increasing in proportion to rates of assembly. If hydrolysis is uncoupled from assembly, we estimate that kh must be at least 2.5/min and could be much greater, a result that we argue may be advantageous to the GTP cap model. We also describe a preliminary model of assembly coupled to hydrolysis that specifies formation and loss of a GTP cap, thus allowing dynamic instability. PMID- 3651444 TI - Charge recombination from the P+QA- state in reaction centers from Rhodopseudomonas viridis. AB - The rate of decay of the flash-oxidized primary electron donor, P+, from the state P+QA- was studied in reaction centers from Rhodopseudomonas viridis, containing only the primary menaquinone electron acceptor (QA). At 295 K, in 100 mM NaCl and in the presence of o-phenanthroline, the rate of recombination was 470 +/- 15 s-1 at pH 7 and 570 +/- 20 s-1 at pH 9. The rate at ambient temperatures varied somewhat with viscosity, pH and ionic strength. Between 310 K and 275 K, the temperature dependences of the rate, at pH 7 and pH 9, were linear in an Arrhenius plot, with apparent activation energies of 0.20 eV and 0.16 eV, respectively. At lower temperatures, however, the dependences deviated from this behavior. In 60% glycerol (pH 7) the recombination rate was 370 +/- 10 s-1 at 295 K. As the temperature was lowered, the rate decreased but leveled off to a value of 105 +/- 5 s-1 at 170 K and was independent of temperature from 170 K to 100 K. In 60% ethylene glycol, the temperature dependence was similar, but the rate fell to a minimum of 75 s-1 at 170 K and then increased slightly at lower temperatures; it finally became temperature independent, with a value of about 100 s-1, at 110 K. The overall temperature dependence is consistent with charge recombination by two competing pathways: a direct electron-tunneling process which dominates at low temperature (less than 250 K), and a thermally activated process via a higher energy state, M, which decays rapidly to the ground state. The indirect route dominates at high temperature (above 250 K). Taking into account the contribution from the low-temperature pathway, the activation energy (enthalpy) for the activated process, in aqueous buffer, was determined to be 0.25 eV (at pH 7) and 0.19 eV (at pH 9). A likely candidate for M is P+I- (PF), where I is the intermediate bacteriopheophytin electron acceptor, and energetic arguments are presented in favor of this assignment. If a rate of decay of P+I- to the ground state, derived from the experimental value, was used in the description of the thermally activated P+QA- recombination process, the free energy gap separating M and P+QA- could be estimated to be 0.27-0.28 eV, placing it about 0.95 eV above the ground state and 0.30 eV below the excited singlet state, P*.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3651445 TI - Phosphate-induced efflux of adenine nucleotides from rat-heart mitochondria: evaluation of the roles of the phosphate/hydroxyl exchanger and the dicarboxylate carrier. AB - Upon the addition of inorganic phosphate, isolated rat-heart mitochondria released endogenous adenine nucleotides. To elucidate the mechanism of this phosphate-induced efflux, we evaluated the relative roles of three inner mitochondrial membrane carriers: the adenine nucleotide translocase, the phosphate/hydroxyl exchanger, and the dicarboxylate carrier. Atractyloside (a specific inhibitor of the adenine nucleotide translocase) prevented this efflux, but did not inhibit mitochondrial swelling. Inhibitors of the phosphate/hydroxyl exchanger (200 microM n-ethylmaleimide and 10 microM mersalyl) did not inhibit phosphate-induced efflux. 200 microM mersalyl (which inhibited both the phosphate/hydroxyl exchanger and the dicarboxylate carrier) inhibited the rate of efflux approx. 65% Phenylsuccinate and 2-n-butylmalonate (inhibitors of the dicarboxylate carrier) partially inhibited phosphate-induced efflux and adenine nucleotide translocase activity. Mersalyl (200 microM) had no effect on adenine nucleotide translocase activity. Partial inhibition of the adenine nucleotide translocase by phenylsuccinate and butylmalonate could not explain the extent of inhibition of phosphate-efflux by these agents. Moreover, the rates of adenine nucleotide efflux in the presence of phenylsuccinate, butylmalonate, or mersalyl correlated well with the ability of these agents to inhibit succinate-supported respiration. We conclude that phosphate-induced efflux of adenine nucleotides from rat heart mitochondria occurs over the adenine nucleotide translocase, and that the site of action of the phosphate is not the phosphate/hydroxyl exchanger, but is likely the dicarboxylate carrier. PMID- 3651446 TI - Chloride dependence of the sodium-dependent glycine transport in pig kidney cortex brush-border membrane vesicles. AB - The Na+-dependent glycine uptake in pig kidney cortex brush-border membrane vesicles is specifically enhanced by the presence of Cl-. The Na+-independent glycine uptake is not affected by Cl-. Various anions tested could not substitute Cl- in the activation of the Na+-dependent glycine transport. Cl- is specifically required on the outer membrane side. The Na+-dependent glycine uptake is higher in the presence of an inwardly directed Cl- gradient than the one measured in the presence of equilibrated Cl-. The Na+-dependent glycine uptake depends on, and is saturable at increasing Cl- concentrations. By studying the activation of glycine uptake by Na+ in the presence and in the absence of Cl-, evidence was found that two different Na+-dependent glycine transport pathways are present in pig kidney cortex brush-border membrane vesicles. The kinetics of the glycine uptake measured in the presence of an inwardly directed NaCl gradient show the presence of two glycine transport systems, a low-affinity, high-capacity one and a high affinity, low capacity one. In the absence of Cl- the high-affinity, low-capacity transport is almost suppressed, thus indicating the presence of a high-affinity glycine transport system simultaneously dependent on both Na+ and Cl- ions. PMID- 3651447 TI - Glycoproteins in the whorls of membrane produced by oligodendroglia in culture. AB - Two glycoproteins of 99 kDa and 77 kDa which exhibit intense binding to wheat germ agglutinin have been purified from the whorls of membrane produced by oligodendroglia in culture. The whorls of membrane were isolated by gradient centrifugation from purified bovine oligodendroglia maintained in culture. The two glycoproteins were solubilized from the membranes using a non-ionic detergent and purified by Sephadex LH-60 chromatography, wheat germ agglutinin affinity chromatography, and SDS-polyacrylamide pore gradient gel electrophoresis. HPLC peptide mapping of the 99-kDa and 77-kDa glycoproteins revealed structural differences between the two proteins. Peptide mapping suggested that the 99-kDa glycoprotein from the whorls of membrane may be homologous to that from the plasma membranes. The 77-kDa glycoproteins from both sets of membrane may also be structurally related. Lectin binding studies showed that both glycoproteins from the whorls of membrane bound to wheat germ agglutinin, succinylated wheat germ agglutinin, concanavalin A, and lentil lectin, indicating the presence of high mannose and hybrid type oligosaccharide side-chains. PMID- 3651449 TI - Melittin induces HII phase formation in cardiolipin model membranes. AB - The interaction of melittin with bovine heart cardiolipin model membranes was investigated via binding assays, 31P-NMR, freeze-fracture electron microscopy, small angle X-ray diffraction and fluorescence based fusion assays. A strong binding (Kd less than 10(-7) M) appeared to be accompanied by the formation of large structures, resulting from a fusion process of extremely fast initial rate. As the melittin content is increased, bilayer structure is gradually lost and from a cardiolipin to melittin ratio of about 6 the lipid starts to organize itself in an hexagonal HII phase. At lower temperatures (T less than 40 degrees C) the coexistence of another structure is observed, characterized by a broad isotropic 31P-NMR signal and giving rise to sharp X-ray reflections, most probably a cubic phase, as suggested also be freeze-fracture images, showing orderly stacked particles. The results are discussed in relation to contrasting observations on the structural changes induced by melittin in the zwitterionic phospholipid system of dipalmitoylphosphatidylcholine (Dufourcq. J. et al. (1986) Biochim. Biophys. Acta 859, 33-48). The biological relevance of the observations with respect to the process of protein insertion into membranes is indicated. PMID- 3651448 TI - Comparison of the effects of inserted C40- and C50-terminally dihydroxylated carotenoids on the mechanical properties of various phospholipid vesicles. AB - We have measured the extent of incorporation of zeaxanthin (C40) and decaprenozeaxanthin (C50) in unilamellar vesicles of dimyristoylphosphatidylcholine (n-C14) and dipalmitoylphosphatidylcholine (n C16). The incorporation is larger when the molecular length of the carotenoid corresponds to the thickness of the phospholipid bilayer. Stereochemically pure 2,3-di-O-phytanyl-sn-glycero-1-phosphocholine was prepared by modification of the polar heads of the phospholipids of Halobacterium halobium. Vesicles of this branched-chain ether phospholipid incorporate poorly the carotenoids, whereas egg lecithin vesicles incorporate them better. Osmotic swelling and water permeability of vesicles, with or without carotenoids, were measured in a stopped flow, light-scattering system. The reinforcing effect (lower permeability and higher rigidity) of carotenoids at 1.5 mol% incorporation into diphytanylphosphatidylcholine vesicles is comparable to that of 5 mol% cholesterol; however, carotenoids have no measurable effect on the egg lecithin vesicles. These results imply that the reinforcement of the membrane depends on a subtle adjustment of the phospholipid-carotenoid system. PMID- 3651450 TI - Lipid specific penetration of melittin into phospholipid model membranes. AB - The relative depth of penetration of melittin into egg phosphatidylcholine and bovine heart cardiolipin model membranes was investigated using fluorescence spectroscopy techniques. The tryptophan intrinsic fluorescence shift suggests a more hydrophobic surrounding of this residue in cardiolipin, while the accessibility for charged and uncharged aqueous quenchers is decreased in the cardiolipin system when compared with the phosphatidylcholine-bound situation. A lipid incorporated hydrophobic, collisional quencher and a resonance energy transfer acceptor on the other hand are more effective in quenching the tryptophan fluorescence of cardiolipin bound melittin. The combination of these results is interpreted as prove of a deeper positioning of the tryptophan containing part of the peptide molecule in the cardiolipin system in comparison with the situation in phosphatidylcholine. Models that take this difference into account are presented, which try to explain the opposite effect of melittin binding to the two lipid systems with respect to supramolecular structure, as reported in the preceding article (Batenburg, A.M., Hibbeln, J.C.L., Verkleij, A.J. and De Kruijff, B. (1987) Biochim. Biophys. Acta 903, 142-154). PMID- 3651451 TI - The ripple phase of phosphatidylcholines: effect of chain length and cholesterol. AB - Saturated phosphatidylcholine (PC) bilayers display a rippled surface in the temperature region between the pre- and main transitions. Ripple repeat distance was measured from freeze-fracture electron micrographs. All of the lipids examined (C13PC to C16PC; C14C16PC and equimolar C14PC/C16PC) showed a bimodal distribution of ripple repeat distances with the two dominant values being in the ratio of 1:2. Within this series, chain length was a weak determinant of the actual repeat distance. The introduction of increasing concentrations of cholesterol eliminated the bimodal distribution and led to the appearance of a single distribution of increasing repeat distance and decreasing amplitude. Ripples disappeared above a cholesterol concentration of 15 mol%. These observations are discussed within the framework of a model which links the genesis of the ripples (vertical displacement of lipid molecules) to the trans gauche isomerization known to occur at the pre-transition. PMID- 3651452 TI - Nucleoside transporter of pig erythrocytes. Kinetic properties, isolation and reaction with nitrobenzylthioinosine and dipyridamole. AB - Rapid kinetic techniques were used to measure the transport of uridine in pig erythrocytes in zero-trans entry and exit and equilibrium exchange protocols. The kinetic parameters were computed by fitting appropriate integrated rate equations to the time-courses of transmembrane equilibration of radiolabeled uridine. Transport of uridine conformed to the simple carrier model with directional symmetry, but differential mobility of substrate-loaded and empty carrier. At 5 degrees C, the carrier moved about 30-times faster when loaded than when empty. Uridine transport was inhibited in a concentration-dependent manner by nitrobenzylthioinosine and dipyridamole and the inhibition correlated with the binding of the inhibitors to high-affinity binding sites on the cells (Kd about 1 and 10 nM, respectively). Thus, in its kinetic properties, differential mobility when empty and loaded, and sensitivity to inhibition by nitrobenzylthioinosine and dipyridamole, the transporter of pig erythrocytes is very similar to that of human erythrocytes. Also, the total number of high-affinity binding sites for nitrobenzylthioinosine and dipyridamole/cell were similar for the two cell types and the [3H]nitrobenzylthioinosine-labeled carrier of pig erythrocytes, just as that of human red cells, was mainly recovered in the band 4.5 protein fraction of Triton X-100-solubilized membranes. However, sodium dodecylsulfate-polyacrylamide gel electrophoresis of photoaffinity-labeled band 4.5 membrane proteins indicated a slightly higher molecular weight for the transporter from pig than human erythrocytes. We have also confirmed the lack of functional sugar transport in erythrocytes from adult pigs by measuring the uptake of various radiolabeled sugars. But in spite of the lack of functional sugar transport we recovered as much band 4.5 protein from pig as from human erythrocyte membranes. PMID- 3651453 TI - Loss of phospholipid asymmetry in dilauroylphosphatidylcholine induced plasma membrane vesicles from human platelets. AB - Incubation of human platelets with unilamellar vesicles composed of dilauroylphosphatidylcholine (DLPC) induces shedding of small vesicular structures from the platelet plasma membrane. No significant cell lysis is observed during the process of shedding. Isolated spicules contain the major membrane glycoproteins, Ib, IIb, and IIIa, which are used to define the sidedness of the spicule membrane. These glycoproteins are completely susceptible to chymotrypsin treatment, whereas cytoskeletal proteins are inaccessible towards this enzyme. This demonstrates that the spicule membranes have a right-side-out orientation in as far as membrane proteins are concerned. Isolated spicules were 30-fold more active than platelets in stimulating prothrombin conversion to thrombin by the prothrombinase complex (factors Xa, Va and Ca2+). The increased prothrombinase activity reflects an increased amount of phosphatidylserine in the outer leaflet of the spicule membrane. Protein analysis of platelet spicules and native platelets reveals a number of differences, the most conspicuous of which is the virtual absence of myosin in the spicule preparations. It is proposed that a lack of myosin produces a different cytoskeletal organization in the spicules. This enables phosphatidylserine to become exposed at the outer surface of the spicule membrane. PMID- 3651454 TI - Alternate models for shared carriers or a single maturing carrier in hexose uptake into rabbit jejunum in vitro. AB - The uptake (tissue accumulation) of three hexoses into rabbit jejunum was measured in a flux chamber in conditions of effective stirring. Glucose uptake was inhibited by galactose or 3-O-methylglucose: 1-40 mM galactose caused a progressive decline in glucose uptake; 1-5 mM 3-O-methylglucose inhibited glucose uptake but higher concentrations of 3-O-methylglucose had no further effect. When 1-40 mM 3-O-methylglucose was added to glucose plus galactose there was a further decrease in the uptake of glucose; adding 1-40 mM galactose to glucose plus 3-O methylglucose also produced a decrease in glucose uptake. Both glucose and 3-O methylglucose inhibited uptake of galactose but the pattern of inhibition varied between the two sugars. The uptake of 3-O-methylglucose was also inhibited by glucose and by galactose, but the uptake of 3-O-methylglucose in the presence of either galactose or glucose was no further reduced by adding the third hexose. Graphical analysis and analysis by non-linear regression both showed that neither the single Michaelis-Menten function, nor the single Michaelis-Menten-plus competitive-inhibition function was appropriate for any of these data. The results are consistent with the hypothesis that either there are multiple (at least three) intestinal carriers for hexoses; alternatively that there is a single carrier whose transport properties for the three hexoses change differentially during cell maturation and migration up the villus. PMID- 3651455 TI - Inhibition of alkaline phosphatase activity and D-glucose uptake in rat renal brush-border membrane vesicles by aminoglycosides. AB - The binding of aminoglycoside antibiotics to, and their effects on, the plasma membrane were studied using isolated rat renal brush-border membrane vesicles. Dibekacin was noted to bind with brush-border membrane vesicles having a single class of many binding sites. 3H-labeled dibekacin binding was inhibited competitively by unlabeled dibekacin, gentamicin or amikacin. The inhibition constants obtained from the Dixon plots followed the order of gentamicin approximately equal to dibekacin greater than amikacin. The alkaline phosphatase activity of brush-border membrane vesicles was inhibited by gentamicin significantly, as was also observed by a histochemical study. Sodium-dependent D glucose uptake by brush-border membrane vesicles was significantly inhibited by the addition of gentamicin. PMID- 3651456 TI - Carboxypeptidase Y digestion of band 3, the anion transport protein of human erythrocyte membranes. AB - The exposure of the carboxyl-terminal of the Band 3 protein of human erythrocyte membranes in intact cells and membrane preparations to proteolytic digestion was determined. Carboxypeptidase Y digestion of purified Band 3 in the presence of non-ionic detergent released amino acids from the carboxyl-terminal of Band 3. The release of amino acids was very pH dependent, digestion being most extensive at pH 3, with limited digestion at pH 6 or above. The 55,000 dalton carboxyl terminal fragment of Band 3, generated by mild trypsin digestion of ghost membranes, had the same carboxyl-terminal sequence as intact Band 3, based on carboxypeptidase Y digestion. Treatment of intact cells with trypsin or carboxypeptidase Y did not release any amino acids from the carboxyl-terminal of Band 3. In contrast, carboxypeptidase Y readily digested the carboxyl-terminal of Band 3 in ghosts that were stripped of extrinsic membrane proteins by alkali or high salt. This was shown by a decrease in the molecular weight of a carboxyl terminal fragment of Band 3 after carboxypeptidase Y digestion of stripped ghost membranes. No such decrease was observed after carboxypeptidase Y treatment of intact cells. In addition, Band 3 purified from carboxypeptidase Y-treated stripped ghost membranes had a different carboxyl-terminal sequence from intact Band 3. Cleavage of the carboxyl-terminal of Band 3 was also observed when non stripped ghosts or inside-out vesicles were treated with carboxypeptidase Y. However, the digestion was less extensive. These results suggest that the carboxyl-terminal of Band 3 may be protected from digestion by its association with extrinsic membrane proteins. We conclude, therefore, that the carboxyl terminal of Band 3 is located on the cytoplasmic side of the red cell membrane. Since the amino-terminal of Band 3 is also located on the cytoplasmic side of the erythrocyte membrane, the Band 3 polypeptide crosses the membrane an even number of times. A model for the folding of Band 3 in the erythrocyte membrane is presented. PMID- 3651457 TI - Measurement of intracellular chloride activity in mouse liver slices with microelectrodes. AB - Steady-state membrane potential (Vm) and intracellular Cl- activity (aCli) were measured with double-barreled Cl(-)-selective microelectrodes in mouse liver slices. In bathing solutions (33.8 degrees C) containing pyruvate, glutamate, fumarate, and glucose, Vm and aCli were -27.6 +/- 1.0 mV and 32.6 +/- 1.5 mM, respectively. This apparent value of aCli exceeded the level required for passive distribution of this ion (aCleq = 26.4 +/- 1.3 mM) by 6.2 +/- 1.0 mM. This difference was essentially unchanged in experiments where (i) Na+ was replaced by choline, (ii) HCO3- was removed, and (iii) Cl- was replaced by gluconate. These data argue against the presence of Na+- or HCO3(-)-coupled Cl- transport mechanisms in the plasma membrane of mouse liver cells. This implies that aCli is in fact at equilibrium and interference with the response of Cl(-)-selective microelectrodes by intracellular anions is responsible for the apparent difference between aCli and aCleq. We found that Cl(-)-selective microelectrodes containing Corning 477315 ligand are sensitive to taurocholate, a representative bile salt. Their selectivity to taurocholate is about 60-times their selectivity towards Cl-. This suggests that interference of bile acids at concentrations normally present in hepatocytes with determinations of aCli can account for the apparent difference aCli-aCleq. PMID- 3651458 TI - On the relationship between the dual specificity of the bovine brain phosphatidylinositol transfer protein and membrane phosphatidylinositol levels. AB - The phosphatidylinositol transfer protein from bovine brain has a remarkable specificity pattern with a distinct preference for phosphatidylinositol (PI) and a low affinity for phosphatidylcholine (PC). In this study we have determined the affinity of PI-transfer protein for PI relative to that for PC by measuring the binding of the fluorescent pyrene-labeled analogs of these phospholipids. From competition binding experiments it was estimated that the transfer protein has a 16-fold higher affinity for PI than for PC. This relative affinity together with the relative abundance of PI and PC, determines what proportion of the protein contains PI (e.g. 65% of the PI-transfer protein in the case of bovine brain). From measuring lipid transfer between donor vesicles consisting of equimolar amounts of PC and PI, and an excess of acceptor vesicles consisting of various ratios of PC and PI, we have observed that the relative rates of the PI-transfer protein-mediated transfer of PI and PC varies between 5 and 20. Kinetic analysis has indicated that PI-transfer protein carrying a PI molecule has different kinetic properties than the PI-transfer protein carrying a PC molecule. It will be discussed that because of the dual specificity, PI-transfer protein is ideally suited for maintaining PI levels in intracellular membranes. PMID- 3651459 TI - Changes in myoblast membrane electrical properties during cell-cell adhesion and fusion in vitro. AB - Characteristic of the process of myogenesis are the changes in the composition and organization of the cell membrane. While poorly understood, these changes have biochemical and biophysical relevance. Recently, changes in molecular order of the myoblast membrane which accompany differentiation in vitro have been observed (Santini, M.T., Indovina, P.L. and Hausman, R.E. (1987) Biochim. Biophys. Acta 896, 19-25). To further investigate these cell fusion processes we have examined additional physical parameters: conductivity and permittivity of the myoblast membrane during differentiation which reflect the molecular arrangement of the membrane. The determination of these parameters is possible because in the radio frequency range suspensions of cells in an electrolyte buffer show a characteristic conductivity dispersion due to the interfacial polarization. An analysis of our experimental data based on a 'single-shell' model showed that conductivity and permittivity of the membrane of pre- and post fusion myoblasts varied significantly and abruptly. The conductivity of the cell interior (cytosol) remained constant. We discuss the significance of the observed changes in these membrane parameters for myogenesis. PMID- 3651460 TI - Influence of anaesthetics on the movement of the mobile charges in the algal cell membrane of Valonia utricularis. AB - Voltage relaxation studies in the presence of anaesthetics were performed on cells of the giant marine alga Valonia utricularis using intracellular microelectrodes. From the decay of the initial membrane voltage which can be described by two relaxation processes the conclusion can be drawn that protein linked, mobile charges are present which are probably involved in turgor-pressure dependent potassium transport (Buchner, K.-H., Rosenheck, K. and Zimmermann, U. (1985) J. Membrane Biol. 88, 131-137). The anaesthetics halothane and chloroform were found to affect reversibly, procaine and tetracaine irreversibly the translocation rate k of the mobile charges at concentrations which were equal to (for halothane and chloroform) or significantly below (for procaine and tetracaine) clinical and nerve blocking levels. The concentration of the mobile charges Nt as well as the specific membrane resistance Rm and the specific membrane capacitance Cm remained unchanged in these concentration ranges. The data suggest a specific interaction of anaesthetics with specialized target sites of a transport protein to which the mobile charges are coupled. PMID- 3651461 TI - Physiological assay of liposome-mediated transport of a drug across Xenopus intestine: cell-liposome interaction. AB - (1) The antagonistic effect of atropine methyl bromide entrapped in liposomes on contraction of Xenopus intestine in vitro induced by acetylcholine was studied. The results provided some insight into cell-liposome interaction. (2) Acetylcholine (0.1 mM) was added to the medium in the bath (serosal solution), while liposomes containing atropine methyl bromide in their internal and external phases were added on the mucosal side of the intestine. Large multilamellar liposomes were prepared from egg lecithin (phosphatidylcholine, PC) and cholesterol in various molar ratios. Atropine methyl bromide had most effect in liposomes composed of PC and cholesterol in a ratio of 7:3, less in those with a ratio of 4:5, and none in those with a ratio of 9:1. These effects were parallel with the sizes of these liposomes, determined by quasi-elastic light-scattering; that is, the larger the liposomes, the greater was their effect. Addition (to the liposomes) of phosphatidic acid, the negative charge of which increases the distance between the lamellar layers, increased the effect, indicating that atropine methyl bromide in the space between lamellar layers was effective. Another type of liposomes in which atropine methyl bromide was present only in the external phase of liposomes was as effective as liposomes in which atropine methyl bromide was present in both the internal and external phases. (3) From these results the following new model for liposome-mediated stimulation of transport of atropine methyl bromide is proposed. Large multilamellar liposomes have structural defects in their external lamellae through which atropine methyl bromide in the mucosal solution can penetrate into the space between the external lamellar layers and move into intestinal cells through regions of fusion between the outermost layers of the liposomes and the cell membrane. PMID- 3651462 TI - 1-O-n-octyl-beta-D-glucopyranoside as a competitive inhibitor of Na+-dependent D glucose cotransporter in the small intestine brush-border membrane. AB - 1-O-n-Octyl-beta-D-glucopyranoside is a competitive inhibitor of the Na+ dependent D-glucose uptake into rabbit, rat and human intestinal brush-border membrane vesicles. The lack of effect on the equilibrium uptake demonstrates that the detergent does not act by rupturing the vesicles; no membrane leakiness was apparent at the concentrations of octylglucopyranoside used, since D-glucose uptake is not inhibited even in the absence of the Na+ gradient (in K+ solution). There is a competitive interaction between octylglucopyranoside and D-glucose, as shown by Dixon and by Hunter and Down plots. The selectivity of the detergent effect is confirmed by its modest influence on amino acid uptake. PMID- 3651463 TI - Factors affecting the reaggregation of rat brain microsomes solubilized with octyl glucoside and their relationship with the base-exchange activity of reaggregates. AB - Rat brain microsomal membranes disaggregated by exposure to octyl glucoside were recovered by centrifugation after dialytic removal of the detergent. The composition of the dialysis medium (divalent cations, pH) was important to this effect; indeed, the reaggregation process which occurred during the dialytic step required the presence of either Ca2+ or Mg2+ and a slightly acidic pH. The lipid protein/ratio and choline and ethanolamine base-exchange of recovered particles depended on the conditions of dialysis although their lipid composition did not. The lipid composition of membranes was also varied by adding PE or PC to octyl glucoside-microsome suspensions. This treatment produced reaggregates possessing a low content of cholesterol and varying PC/PE ratios. Both choline and ethanolamine base-exchange activities were related to this parameter. PMID- 3651464 TI - The transport of hydrophobic ions across lipid bilayers. AB - The three-capacitor model for hydrophobic ion adsorption in lipid membranes (Andersen, O.S., Feldberg, S., Nakadomari, H., Levy, S. and McLaughlin, S. (1978) Biophys. J. 21, 35-70) is extended to ion transport whereby electrostatic effects from the interfacially adsorbed hydrophobic space charge have been encountered. The phenomena of current saturation with increasing concentrations of hydrophobic ions in the bulk electrolyte and the associated increase of the time constant of current relaxation can be quantitatively understood on the basis of space charge limited currents as well as the nonexponential current decay. PMID- 3651465 TI - Co-solubility in binary phospholipid crystals. AB - Crystalline binary solid solutions of phosphatidylethanolamines are obtained when various fractions of compounds with different chain lengths are dissolved in chloroform and allowed to evaporate to dryness. Phase diagrams and electron diffraction measurements on chain mixtures with a difference of two or four methylene groups indicate that solubility is continuous, although non-ideal. Average molecular volume appears to increase according to Vegard's rule although deviations are noted. These deviations are similar to those observed for binary paraffin solids. Substitution of ether-links for ester-links in one component does not alter solubility behavior. In general the rules of solid solution formation appear to conform to those originally proposed by Kitaigorodskii [1961) Organic Chemical Crystallography, pp. 231-240, Consultants Bureau, New York). PMID- 3651466 TI - Cytochalasin inhibition of hexose transport by platelets. AB - Previously we described a two-transporter model (T1, T2) for galactose uptake by platelets (Horne, M.K. and Hart, J.S. (1986) Biochim. Biophys. Acta 856, 448 456). In the current work we have sought corroborative evidence for this model by studying the effects of cytochalasins on this transport system. Of the various cytochalasins tested, cytochalasin B was the most potent inhibitor (I) of galactose transport, whereas cytochalasin A was less inhibitory and dihydrocytochalasin B and cytochalasin E had no inhibitory effect. The same order of potency was observed for the inhibition of L-glucose diffusion into platelets. The mechanism of cytochalasin B inhibition was investigated in detail. Inhibition of T1 was competitive and required a higher concentration of cytochalasin B (Ki1 approximately 1.7 microM) than inhibition of T2, which was of a mixed type (Ki2 approximately 0.8 microM). The effect of cytochalasin B on T2 could be accounted for by a membrane alteration which enhanced the affinity of the transporter for galactose while simultaneously preventing passage of the TSI complex into the cell. Since a similar effect on membrane permeability would also explain cytochalasin B inhibition of L-glucose diffusion, it is hypothesized that cytochalasin B binds to a membrane structure shared by T2 and the passage for L glucose. The differences in cytochalasin B sensitivity and mechanism of inhibition manifested by T1 and T2 support our original hypothesis that galactose is indeed transported by kinetically distinct agencies and suggest that these may be physically distinct as well. PMID- 3651467 TI - Purification of a circulatory riboflavin carrier protein from pregnant bonnet monkey (M. radiata): comparison with chicken egg vitamin carrier. AB - A specific protein exhibiting immunological cross-reactivity with chicken egg white riboflavin carrier protein was detected by radioimmunoassay in the pregnancy sera of bonnet monkeys (Macaca radiata). This protein, which is capable of binding [14C]riboflavin, was purified by gel filtration on Sephacryl S-300, fast protein liquid chromatography on a Mono Q anion exchanger and chromatofocusing on Mono P columns. The isolated primate carrier protein was similar to its avian counterpart in terms of physicochemical characteristics, such as isoelectric point (pI less than or equal to 4), electrophoretic mobility, molecular weight (approx. 36,000) and ligand binding. These findings may account for the extensive immunological cross-reactivity observed between the two proteins and suggest that the two vitamin carriers may have similar function in terms of embryonic vitamin nutrition. PMID- 3651468 TI - Hydrophobic stabilization of chiton hemocyanins: effects of ureas, Hofmeister salts and pH on their dissociation. AB - The subunit dissociation of the hemocyanins from five members of the Polyplacophora families, Acanthochitonidae, Callistoplacidae, Chitonidae, Ischnochitonidae and Mopalidae, represented by the chitons Cryptochiton stelleri, Nutallina fluxa, Acanthopleura granulata, Stenoplax conspicua and Mopalia mucosa, respectively, have been investigated by light-scattering molecular-weight and ultracentrifugation methods, using the hydrophobic reagents of the urea series and the Hofmeister salt series as probes of the contact areas of the hemocyanin subunits. The polyplacophoran hemocyanins are decamers with molecular weights of (4.2-4.6) X 10(6). The effectiveness of dissociation by the ureas follows the order of increasing hydrophobicity of the reagent, i.e., urea, methyl-, ethyl-, propyl- and butylurea, as expected of hydrophobically stabilized subunit systems. The urea dissociation is found to be a two-step reaction: the dissociation of parent decamers to dimers followed by dissociation of the dimers to monomers. Analysis of the observed decrease in molecular weight requires the interaction with urea of about 27 to 35 apparent amino-acid groups (Napp) at the contact areas of the dimers, and a much larger number of apparent binding groups ranging from about 100 to 120 per monomer at the contact areas of the monomers. Fitting of the pH dissociation profiles of A. granulata, C. stelleri, M. muscosa and S. conspicua requires the participation of a much smaller number of amino-acid residues in the interaction with the probe-solvent components. The ionization or protonation of one acidic and one basic group per dimer, and five to eight acidic and basic groups per monomer is found to be adequate for the description of the two-step pH dissociation reaction. PMID- 3651469 TI - Linear Fe-C-O configuration in carbonyl 1-methylimidazole iron(II) porphyrin detected by XANES in dispersive mode. AB - The linear Fe-C-O configuration has been determined in the carbonyl 1 methylimidazole hindered iron(II) porphyrin derived from 'basket handle' complexes in which there are no constraints on the proximal imidazole. The structure at the iron site has been determined in toluene solution by fast measurements of XANES spectra, using the dispersive X-ray absorption method. PMID- 3651470 TI - Fibrinogen and the early stages of polymerization to fibrin as studied by dynamic laser light scattering. AB - Human fibrinogen and the polymerization of fibrin after activation by the enzymes, thrombin and Batroxobin, were studied by means of dynamic laser light scattering (DLS). The apparent diffusion constant, D, for fibrinogen was measured and has a value of (1.80 +/- 0.42) X 10(-7) cm2 X s-1. D was found to contain contributions from the translational diffusion constant (Dt) as well as from the rotational diffusion constant (Dr). A comparison between experimental and calculated values of Dr and Dt suggests that fibrinogen in the absence of added Ca2+ expresses a certain degree of flexibility, while it is straightened in the presence of added Ca2+. The time dependence of D showed periodic oscillations, while the average D values decreased with time. Thrombin and Batroxobin caused similar behaviour of D. The period length was related to the enzyme concentration, clotting time (Ct) and the rate of release of fibrinopeptide A (FPA). No periodic oscillations were observed in experiments where the enzyme was replaced by saline, or in experiments using a dysfunctional fibrinogen (fibrinogen Aarhus) which displayed slow rates of FPA-release and polymerization. We propose that the periodic oscillations in a system far from equilibrium may be explained by conformational changes occurring in the fibrinogen molecule during enzyme activation and polymerization. PMID- 3651471 TI - Terbium-binding properties of calsequestrin from skeletal muscle sarcoplasmic reticulum. AB - Calsequestrin (Mr = 40,000) is a calcium-binding protein (Kd = 1 mM, 50 sites/molecule) located within the terminal cisternae of the sarcoplasmic reticulum of skeletal muscle cells. The interaction of terbium, a calcium analog, with rabbit skeletal muscle calsequestrin was studied by fluorescence and circular dichroism spectroscopy. Direct measurement of terbium binding using a fluorescence assay for terbium revealed that calsequestrin bound approx. 30 mol of terbium per mol of protein with an affinity of approx. 7 microM. The fluorescence of terbium measured at 545 nm was enhanced dramatically upon binding to calsequestrin, reaching a maximum value at a terbium to protein ratio of 28. The excitation spectrum of protein-bound terbium and chemical modification studies revealed that energy transfer occurred between aromatic residues, including tryptophan and bound terbium. Terbium bound to calsequestrin could be removed by EGTA, or displaced by Ca2+ or La3+. In the presence of Ca2+ or La3+ terbium bound to calsequestrin with a higher apparent affinity and lower capacity. 0.1 M KCl or 5 mM MgCl2 had little effect on terbium binding. Terbium increased the intrinsic fluorescence of calsequestrin 2-fold, and increased the alpha-helical content of calsequestrin from 16 to 33%. Terbium binding induces the same conformational changes in calsequestrin as does calcium, confirming that terbium is a useful calcium analog in this system. PMID- 3651472 TI - Influence of phalloidin on both the nucleation and the elongation phase of actin polymerization. AB - Phalloidin, a heptapeptide from the mushroom Amanita phalloides, increased the velocity of actin polymerization, but slightly decreased the velocity of elongation (polymerization onto sonicated F-actin). A plot of log polymerization velocity vs. log actin concentration was less steep in the presence of phalloidin than in its absence, suggesting that the filament nucleus is smaller in the presence of phalloidin than in its absence. PMID- 3651473 TI - Influence of phalloidin on ATP hydrolysis during actin polymerization. AB - The influence of phalloidin on the ATP hydrolysis associated with actin polymerization was investigated. Whereas in the absence of phalloidin actin-bound ATP was totally hydrolyzed during polymerization, ATP hydrolysis was not complete after actin polymerization in the presence of phalloidin: 5-10% of ATP remained unhydrolyzed and disappeared only after 2 days. PMID- 3651474 TI - Studies on the subunit structure of textilotoxin, a potent neurotoxin from the venom of the Australian common brown snake (Pseudonaja textilis). AB - Textilotoxin is a presynaptic neurotoxin from the venom of the Australian common brown snake, Pseudonaja textilis. It has the highest lethality and is structurally the most complex of any known snake venom neurotoxin. It was resolved into its five non-covalently linked subunits in a single step by reverse phase HPLC. Two of the subunits were identical. The N-terminal amino-acid sequence and amino-acid composition of each subunit were determined. Subunit A was the only one found to possess phospholipase A activity. Separation of textilotoxin into its subunits was reversible and reformed textilotoxin had the same Mr and lethality in mice as the native toxin. Experiments with various unnatural combinations of subunits have led to interesting variations in lethality and Mr of the resulting complexes. PMID- 3651475 TI - Influence of the N-B transition of human serum albumin on the structure of the warfarin-binding site. AB - The fluorescence quantum yield of warfarin increased with the viscosity of the medium and showed good correlation with it. The internal rotation of the acetonylbenzyl group of a warfarin molecule may thus possibly decrease in a viscous medium. the fluorescence quantum yield of warfarin bound to human serum albumin increased with the pH of the medium in the pH range of 6.2-9.0. Fluorescence-emission maximum wavelengths of warfarin bound to human serum albumin indicated a small blue-shift with the pH of the medium and that of free warfarin in the absence of albumin also shifted slightly to a shorter wavelength with the viscosity of the medium. Warfarin is bound more strongly to human serum albumin at basic pH than at neutral pH, and the increase in the bound fraction of warfarin correlated well with the increase in the fluorescence quantum yield of bound warfarin in the same pH range. Thus, the structure of the warfarin-binding site in the B (base) form appears more spatially confined than that in the N (neutral) form. The motion of the warfarin molecule bound to its binding site on human serum albumin in the N-B transition may thus be more restricted at basic than at neutral pH, and this may possibly be the reason for the stronger binding of warfarin to human serum albumin in the B form. PMID- 3651476 TI - Raman and infrared spectra of toxin gamma from the venom of the scorpion Tityus serrulatus. AB - Toxin gamma is a basic, low-molecular-weight, neurotoxic protein, isolated from the venom of the Brazilian scorpion, Tityus serrulatus. Raman spectra (400-1800 cm-1 region) of this toxin in both the lyophilized state and in 0.1 M acetate buffer (pH 4.5) and the infrared spectrum (700-4000 cm-1 region) of a solid film were investigated. From the vibrational spectra, it can be concluded that the polypeptide backbone of toxin gamma consists of a mixture of the different secondary structures, with predominance of beta-sheet, followed by unordered structure and alpha-helix, with some evidence of beta-turn structures. The four disulfide bridges assume the gauche-gauche-gauche conformation of the CCSSCC fragments. The intensity ratio of the doublet at 853 and 828 cm-1 suggests that four out of the five tyrosine residues are exposed. The three tryptophan residues are exposed on the surface, and the single methionine residue assume the gauche gauche conformation. Toxin gamma retains full activity in the pH 4.5-7.5 range, but is almost completely inactivated at pH 11.5. PMID- 3651477 TI - Phosphorus-31 nuclear magnetic resonance of aspartate aminotransferase from chicken heart cytosol. AB - 31P-nuclear magnetic resonance and absorption spectra of cytosolic chicken aspartate aminotransferase (L-aspartate:2-oxoglutarate aminotransferase, EC 2.6.1.1) have been recorded in the pH range from 5 to 8.5. The 31P chemical shift was found to be pH-dependent with a pK of 6.85; the chemical shift change was 0.35 ppm. The pK value found by spectrophotometric titration of the enzyme proved to be about 6.0. The monoanion-dianion transition of the 5'-phosphate group of a model Schiff base of pyridoxal phosphate with 2-aminobutanol in methanol is accompanied by a change in the 31P chemical shift of 5.2 ppm. It is inferred that the phosphate group of the protein-bound coenzyme is in a dianionic form throughout the investigated pH range; the pH-dependence of the 31P chemical shift may be due to a conformational change at the active site. In the presence of 100 mM succinate, 6 mM aminooxyacetate or 25 mM cycloserine, the 31P chemical shift is insensitive to pH variations. PMID- 3651478 TI - Differences between HMG1 proteins isolated from normal and tumour cells. AB - The properties of the non-histone chromosomal high-mobility-group 1 (HMG1) proteins from rat liver and Guerin ascites tumour cells (GAT cells) were compared and showed the following differences: (1) five spots were missing in the peptide map of HMG1 from GAT cells in comparison with that of HMG1 from rat liver; (2) HMG1 from GAT cells was about 5-times more poly(ADP)-ribosylated; (3) HMG1 from GAT cells which was found acetylated in vivo and incorporated [14C]acetate in vitro, whereas no incorporation of the label was detected in HMG1 from rat liver; (4) HMG1 from GAT cells exhibited pronounced ability to form oligomers at physiological ionic strength, while HMG1 from rat liver was predominantly in monomeric form. This property of HMG1 from GAT cells was lost upon deacetylation. PMID- 3651479 TI - Crosslinking of isolated cytoskeletal proteins with hemoglobin: a possible damage inflicted to the red cell membrane. AB - Crosslinking of isolated red cell membrane cytoskeletal proteins and hemoglobin mediated by H2O2 was studied. The products of spectrin and hemoglobin interaction were demonstrated electrophoretically to be high-molecular-weight polypeptides crosslinked by nondisulfide covalent bonds. The molecular weight of the protein bands correlated with various combinations of spectrin and hemoglobin chains and the relative amount of the different products was dependent on the molar ratio of the interacting proteins. Free hemin caused spectrin crosslinking as well, but globin in the absence of hemin was inactive. Since the H2O2-mediated reaction resulted in reduction of the spectrin tryptophan fluorescence, the latter was used to monitor the reaction progress under various conditions. Both oxyhemoglobin and methemoglobin were found to be most efficient, whereas cyanmethemoglobin and hemichrome were relatively inactive. Analysis of the data implied that tryptophan oxidation as well as spectrin conformational changes follow an iron-induced crosslinking of the interacting proteins. Actin, the second major protein in the red cell cytoskeleton, behaved similarly to spectrin. The intrinsic fluorescence intensity of both G- and F-actin was decreased upon addition of H2O2 to the mixture of hemoglobin and each of the actin forms. SDS polyacrylamide gel electrophoresis revealed that G-actin crosslinked one or two hemoglobin chains. F-actin-hemoglobin interaction induced by H2O2 produced very high aggregates that could not penetrate the gel. It is suggested that crosslinking of cytoskeletal proteins in red cells containing membrane-associated hemoglobin provides a rationale for the loss of membrane flexibility. PMID- 3651480 TI - Redox properties of components I and IV of trout hemoglobins: kinetic and potentiometric studies. AB - Redox properties of component I and IV from trout hemoglobin (Salmo irideus) have been studied kinetically and at equilibrium. In the case of component I of trout hemoglobin, the mid-point potential (Eh) is pH independent below the acid alkaline transition (pKa approximately equal to 8.6) and decreases at higher pH, following the deprotonation of the water molecule. Similarly to human hemoglobin, the mid-point potential of component IV of trout hemoglobin is pH-dependent, but the redox Bohr effect is extended to more acid pH. Moreover, the cooperativity of the redox equilibrium process is higher than in human hemoglobin. These features parallel the oxygen-binding properties of the same hemoglobin components from trout hemolysate. Differently from human hemoglobin, the oxidation kinetics of the two hemoglobins from trout by potassium ferricyanide show markedly biphasic progress curves with pH-independent second-order rate constants. This behavior suggests a different energy barrier for the interaction with ferricyanide in the two types of subunit of both Hb components from trout. PMID- 3651481 TI - The hydrogenation of phospholipid-bound unsaturated fatty acids by a homogeneous, water-soluble, palladium catalyst. AB - The hydrogenation of unsaturated phospholipids by palladium di(sodium alizarine monosulphonate) activated for 5 min under H2 proceeded rapidly at 20 degrees C and 1 atm. H2. Multibilayer liposomes of dioleoyl- and dilinolenoylphosphatidylcholine were hydrogenated at similar rates while dilinoleoyl- and 1-palmitoyl-2-oleoylphosphatidylcholine were hydrogenated at slightly slower rates. The reduction of polyunsaturated fatty acids gave rise to a variety of natural and unnatural positional cis and trans isomers which were largely reduced further to saturated fatty acids as the hydrogenation continued. Dioleoylphosphatidylethanolamine was attacked by the catalyst more slowly at 20 degrees C than was the equivalent phosphatidylcholine molecular species. Experiments conducted using mixtures of phosphatidylethanolamine and phosphatidylcholine in varying proportions also suggested that phospholipids are slightly more susceptible to catalytic hydrogenation in the bilayer phase than in the hexagonalII phase. Understanding the sequence of hydrogenation reactions involving these one and two component lipid preparations is useful in interpreting the action of the palladium catalyst on living cells under the same mild conditions. PMID- 3651482 TI - Serum half-life, distribution, hepatic uptake and biliary excretion of alpha tocopherol in rats. AB - The serum clearance of alpha-[3H]tocopherol has been studied after intravenous injection of intestinal lymph labeled in vivo with radioactive alpha-tocopherol. The half-life of the injected alpha-[3H]tocopherol was approx. 12 min. Fractionation of plasma by ultracentrifugation 10 min after injection of lymph showed that 91% of the radioactive alpha-tocopherol remaining in plasma was located in chylomicrons (d less than 1.006 g/ml) and 7.8% in high-density lipoproteins (HDL, 1.05 less than d less than 1.21 g/ml). 2 h after administration of alpha-tocopherol, about 35% of the radioactivity recovered in plasma was associated with chylomicrons and approx. 51% with HDLs. alpha [3H]Tocopherol was initially taken up by the liver, which contained more than 50% of the injected radioactivity after 45-60 min. Separation of parenchymal and nonparenchymal cells demonstrated a preferential uptake of alpha-[3H]tocopherol by the parenchymal liver cells. After 24 h about 11% of the injected dose was recovered in the liver. Considering whole organs the liver, adipose tissue and skeletal muscle had the highest content of radioactivity after 24 h. Furthermore, about 14% of the administered dose was recovered in bile during 24 h draining. PMID- 3651483 TI - Effects of essential fatty acid deficiency on epidermal O-acylsphingolipids and transepidermal water loss in young pigs. AB - Linoleate-rich O-acylglucosylceramides and acylceramides are thought to be of major significance for the physical structure and function of the epidermal permeability barrier. In the present investigation, the effects of a linoleate free diet on O-acylsphingolipids and their associated functions were investigated. Starting at 5 days of age, male pigs were fed diets containing 12% of either lard or hydrogenated coconut oil. Transepidermal water loss was measured with an electrolytic water analyzer at weekly intervals. Pigs were killed at intervals, and epidermal lipids were isolated and analyzed. Fatty acid compositions were determined by gas-liquid chromatography (GLC). Within 2-3 weeks, pigs on the diet containing coconut oil began to display biochemical and physiological symptoms of essential fatty acid deficiency. Within 2 months, this group had extremely scaly skin and transepidermal water loss was elevated to five times that of controls. The progressive increase in transepidermal water loss correlated with replacement of linoleate by oleate in both acylceramide and acylglucosylceramide. The formation of lamellar granules and intercellular lipid sheets in the stratum corneum was not impaired in essential fatty acid deficiency as judged by electron microscopy. These results suggest that the linoleic acid normally found in the O-acylsphingolipids is not essential for formation of the epidermal membrane system. Rather, it appears that the nature of the ester-linked fatty acid in the O-acylsphingolipids regulates the permeability of this membrane system. PMID- 3651484 TI - Nucleation of cholesterol from vesicles isolated from bile of patients with and without cholesterol gallstones. AB - Bile was obtained from patients with and without cholesterol gallstones at surgery. Biliary vesicles were separated from micelles by gel filtration. The cholesterol/phospholipid ratio in vesicles was much higher than in micelles. Cholesterol crystals nucleated from vesicular fractions, but nucleation from the micellar fractions was slow or did not occur at all. Cholesterol nucleated from vesicles obtained from bile of control patients as rapidly (2.4 days +/- 0.7) as from patients with stones (2.4 days +/- 0.9) and there was no difference in the vesicular cholesterol/phospholipid ratio. The effect of alteration of the bile salt environment was studied by changing the concentration of sodium cholate in the eluting buffer. At low concentrations (5 mM) only vesicles were eluted from the column. These vesicles had a relatively low cholesterol/phospholipid ratio and cholesterol nucleated slowly from these vesicles. At higher concentrations the proportion of micelles increased. The proportion of vesicles decreased progressively but their cholesterol/phospholipid ratio increased and the nucleation time fell. These studies demonstrate that cholesterol nucleates from vesicles in the absence of micelles, that control vesicles are not protected by tightly bound antinucleating substances and that exposure of vesicles to micelles strips relatively more phospholipid than cholesterol from the vesicular fraction, resulting in vesicles with higher cholesterol/phospholipid ratios and shorter nucleation times. PMID- 3651486 TI - Age-related variations in acyl-CoA:retinol acyltransferase activity and vitamin A concentration in the liver and epidermis of hairless mice. AB - Since the factors regulating retinol esterification by acyl-CoA:retinol acyltransferase are poorly understood, we studied the age-related variations in acyl-CoA:retinol acyltransferase activity in hairless mice. Epidermis and liver were collected at intervals from birth to adolescence (0-6 weeks). Vitamin A was analyzed by high-performance liquid chromatography and acyl-CoA:retinol acyltransferase by an in vitro radioincubation assay of microsomes. Epidermal vitamin A (retinol plus retinyl esters) increased 8-10 times after birth and by the age of 3 weeks adult values were attained. This increase was accompanied by a 2-fold increase in acyl-CoA:retinol acyltransferase activity in the epidermis between 3 days and 6 weeks of age. In young animals the dependence of acyl CoA:retinol acyltransferase on exogenous co-substrate (palmitoyl-CoA) was also lower than in adult animals. Although a pronounced age-related accumulation of retinol was recorded in the liver, the activity of acyl-CoA:retinol acyltransferase did not increase with age and there was no change in the dependence of acyl-CoA:retinol acyltransferase on exogenous palmitoyl-CoA. PMID- 3651485 TI - Absorption and transport of base moieties of phosphatidylcholine and phosphatidylethanolamine in rats. AB - The absorption and transport of the base moieties of phosphatidylethanolamine (PE) and phosphatidylcholine (PC) which were fed to rats were compared. The major absorption site of ethanolamine-labeled PE was proximal jejunum while choline labeled PC was absorbed almost equally throughout the jejunum. Lysophospholipids, glycerophosphoryl bases and constituent bases were the main digested products in intestinal content. This shows that base-labeled phospholipids were hydrolyzed to water-soluble products as well as lysophospholipids before absorption. The radioactivities from both phospholipids existed mainly in their parent phospholipids and water-soluble products in the intestinal mucosa. The amounts of lymphatic transport of the radioactivities from choline-labeled PC and ethanolamine-labeled PE were 17% and 8%, respectively, at 8 h after administration. The liver in lymph-cannulated rats contained 23% and 48% radioactivity from PC and PE, respectively, suggesting that base moieties of phospholipids, especially PE, were transported mainly via a non-lymphatic route, probably the portal vein, to the liver, as water-soluble products. The radioactivity from both base-labeled phospholipids in the liver was distributed in the parent phospholipids and water-soluble fractions. Ethanolamine-labeled PE was also incorporated into PC in the liver. These results indicate that intestinal absorption and transport of the base moiety of dietary PC and PE are similar; however, their intestinal absorption site and the extent of their separation during transport between the lymphatic and portal systems differ markedly. PMID- 3651487 TI - Acylation of 1-alkenylglycerophosphoethanolamine and 1 acylglycerophosphoethanolamine in guinea-pig heart microsomes. AB - Although the acylation of 1-alkenylglycerophosphocholine in mammalian heart is well documented, the acylation of 1-alkenylglycerophosphoethanolamine in the heart was not reported. In this study, the presence of acyl CoA: 1 alkenylglycerophosphoethanolamine acyltransferase in the guinea pig heart microsomes was demonstrated. 1-Alkenylglycerophosphoethanolamine acyltransferase displayed a high degree of specificity towards acyl-CoA. The order of reactivity with acyl-CoA was found to be: linoleoyl much greater than arachidonyl greater than palmitoyl greater than stearoyl = oleoyl. 1-Acylglycerophosphoethanolamine acyltransferase in the microsomes also exhibited specificity towards acyl-CoA in the following manner: linoleoyl greater than arachidonyl much greater than palmitoyl greater than oleoyl greater than stearoyl. However, such specificity appeared to be dependent on acyl-CoA concentration. The acyl-CoA specificities of both enzymes did not correlate with the C-2 acyl distribution observed in the corresponding microsomal phospholipids. Our results suggest that in addition to the acyl specificity of the acyltransferases, intracellular concentrations of acyl-CoAs may also have an important role in determining the observed acyl patterns of the phospholipids. Based on the acyl specificities, pH profiles, and their responses to heat inactivation and thiol reagents, we conclude that 1 alkenylglycerophosphoethanolamine acyltransferase and 1 acylglycerophosphoethanolamine acyltransferase in guinea-pig heart microsomes are not the same enzyme. PMID- 3651488 TI - Parinaric acid as a sensitive fluorescent probe for the determination of lipid peroxidation. AB - The decrease in fluorescence of conjugated polyenic acyl chains is used as a sensitive assay for lipid peroxidation. The fatty acid cis-trans-trans-cis 9,11,13, 15-octadecatetraenoic acid (cis-parinaric acid) is introduced into liposomal membranes as free fatty acid or, by using the PC specific transfer protein from bovine liver, as 1-palmitoyl-2-cis-parinaroyl-sn-glycero-3 phosphocholine. The peroxidation process as monitored by the decrease in fluorescence intensity is compared with other peroxidation assay systems. Applications of the new assay system are discussed. PMID- 3651490 TI - Incubation of acetylated low-density lipoprotein with cholesterol-rich dispersions enhances cholesterol uptake by macrophages. AB - Incubation of J774 macrophages with mixtures of acetylated low-density lipoprotein (acLDL) and free cholesterol-rich phospholipid dispersions increases cellular cholesterol deposition 2-4-fold over that achieved with either acLDL or dispersions alone. Both free and esterified cholesterol accumulate in cells incubated with the mixture of acLDL and dispersions. A similar result is observed when acLDL is replaced by malondialdehyde-LDL. The enhanced deposition of cholesterol is not unique to J774 macrophages, as P388D1 macrophages also accumulate more cholesterol when incubated with the mixture of acLDL and dispersions than either particle alone. A preincubation of the particles for at least 6 h prior to incubation with cells is required in order to observe maximal cholesterol delivery. Both dispersion free cholesterol and phospholipid accumulate in J774 cells, suggesting that a complex is formed between acLDL and dispersions which results in a cholesterol-rich acLDL/dispersion particle. Partial purification of the acLDL-dispersion complex revealed increases in the size distribution of the particles compared to acLDL and increases in free cholesterol and phospholipid contents. Cholesterol uptake from the mixture of acLDL and dispersions was saturable and the enhanced cellular uptake of both cholesterol and phospholipid from the complex could be abolished by inhibitors of the scavenger receptor pathway. In addition to the receptor-mediated uptake of cholesterol from the acLDL-dispersion complex, it was observed that approx. 30% of the total cholesterol uptake from the complex was via non-specific components, including surface transfer. PMID- 3651489 TI - Participation of peroxisomes in the metabolism of xenobiotic acyl compounds: comparison between peroxisomal and mitochondrial beta-oxidation of omega-phenyl fatty acids in rat liver. AB - The peroxisomal beta-oxidation of omega-phenyl fatty acids (PFAs) as model compounds for xenobiotic acyl compounds was investigated. In isolated hepatocytes, omega-phenyllauric acid (PFA12) was chain-shortened to PFAs having an even number of carbon atoms in the acyl side chain. Associated with this reaction, H2O2 generation was observed, the rate of which was markedly enhanced by clofibrate treatment of rats. Also when using isolated peroxisomes, such a chain-shortening of PFA12 occurred, associated with stoichiometrical production of NADH and acetyl-CoA. The CoA-ester form of PFA12 as a substrate and NAD as a cofactor were required in this reaction, indicating the participation of peroxisomal beta-oxidation in the chain-shortening of PFA12. When using PFAs with various chain lengths, the rates of H2O2 generation measured as the peroxisomal beta-oxidation in isolated hepatocytes were similar to those with the corresponding fatty acids, whereas the rates of ketone body production measured as the mitochondrial beta-oxidation were much lower than that with any fatty acid examined. From the study with isolated mitochondria and purified enzymes, it was found that the mitochondrial beta-oxidation of PFAs was carnitine-dependent, and that the activities of carnitine palmitoyltransferase for PFA-CoAs are low. Moreover, the activities of acyl-CoA dehydrogenase for PFA-CoAs were lower than those for fatty acyl-CoAs, while the activities of acyl-CoA oxidase for PFA-CoAs were comparable to those for fatty acyl-CoAs. As a result, relatively long chain PFAs were hardly subjected to mitochondrial beta-oxidation. Based on the maximum enzyme activities of the beta-oxidation, which were measured by following acyl CoA-dependent NAD reduction in isolated peroxisomes and O2 consumption in isolated mitochondria, about 60% of the beta-oxidation of PFA12 in the rat liver was peroxisomal. In clofibrate-treated rats, the value reached about 85%. From these results it is concluded that the peroxisome is one of the important sites of degradation of xenobiotic acyl compounds. PMID- 3651491 TI - Reversal of cerulenin-induced inhibition of phospholipids and sterol synthesis by exogenous fatty acids/sterols in Epidermophyton floccosum. AB - Cerulenin, a specific inhibitor of fatty acids and sterol biosynthesis inhibited the growth of Epidermophyton floccosum, which was reversed when growth medium was supplemented with palmitic acid and sterols. Unsaturated fatty acids partially restored the growth. Cerulenin inhibited both phospholipid and sterol biosynthesis (60-70%) at the minimum inhibitory concentration (0.5 microgram/ml) as demonstrated by [32P]orthophosphoric acid and [14C]acetate incorporation into the respective lipids. Cerulenin-induced inhibition of phospholipid and sterol synthesis was dose dependent up to 0.5 microgram/ml. Exogenously supplied fatty acids and sterols restored the biosynthesis of phospholipids in cerulenin-treated cultures, while that of sterols was enhanced. The biosynthesis of both saturated and unsaturated fatty acids was inhibited by cerulenin. PMID- 3651492 TI - The transfer of lipids from protein-free lipoprotein models to human fibroblasts in culture. AB - Lipid microemulsions were prepared by sonication of mixtures of cholesteryl ester, triacylglycerol, phosphatidylcholine and cholesterol in aqueous dispersions and were purified by gel filtration. The resulting emulsion particles were characterized by differential scanning calorimetry, electron microscopy and analytical gel filtration and were shown to have the size and general organization of low-density lipoprotein. The lipid microemulsions were used as protein-free plasma lipoprotein models for studies of the receptor-independent transfer of lipids to human fibroblasts in culture. The transfer rate of [3H]cholesterol increased with the donor concentration and with the molar ratio between cholesterol and phosphatidylcholine in the donor particles. A maximal transfer value of 1 nmol per mg protein per h was obtained for cholesterol/phosphatidylcholine 1:1 particles. There was a profound temperature effect on the cholesterol transfer. The effect of altering the core lipid of the emulsion particles on the [3H]cholesterol transfer rate was small giving a somewhat higher rate with cholesteryl oleate and cholesteryl stearate than with cholesteryl linoleate. Addition of trioleoylglycerol to the cholesteryl ester core had no effect on the transfer rate. The transfer rate of palmitoyl[14C]oleoylphosphatidylcholine was found to be about 1/5 of that obtained for [3H]cholesterol. About 50% of the cell-associated [14C]cholesteryl oleate was found in the trypsin-releasable pool, while 25% was internalized by the cells at a rate of 0.06 nmol X mg-1 X h-1. Trioleoylglycerol was internalized at the same rate as the cholesteryl ester. Our data suggest that the lipoprotein lipid composition may play a role in the receptor-independent cellular uptake of cholesterol. PMID- 3651493 TI - Purification and characterization of a lipase from Staphylococcus aureus. AB - An extracellular lipase from Staphylococcus aureus (strain FN 37) was purified to homogeneity. A cell-free culture broth was subjected to ammonium sulphate precipitation, and the lipase was isolated from the resuspended pellet by adsorption chromatography on octyl-Sepharose. The purification was 957-fold, and the recovery of the octyl-Sepharose chromatography was about 100%. The specific activity of the purified lipase was 546 mU of lipase activity per micrograms protein. The purity of the final product was documented by SDS-polyacrylamide gel electrophoresis in which a homogeneous protein band of 43 kDa was found. In gel chromatography on Sephadex G-200 the lipase eluted as a homogeneous peak with an apparent molecular mass of 110 kDa, suggesting that the lipase may exist as an oligomer in physiological media. Analysis of the amino-acid composition revealed a predominance of polar, non-charged amino acids, with serine accounting for 24 mol% of the amino-acid residues. PMID- 3651494 TI - Positional specificity and substrate preference of purified Staphylococcus aureus lipase. AB - We have studied the substrate preference and specificity, including positional specificity, of a lipase purified from Staphylococcus aureus (strain FN 37). This extracellular bacterial enzyme is relatively insensitive to product inhibition, and hydrolyzes tri-, di- and monooleoylglycerol in emulsified and micellar form at similar rates and without marked substrate preference. The lipase lacks positional specificity, and the hydrolysis of triacylglycerol proceeds rapidly to free fatty acid and glycerol without accumulation of intermediary products. PMID- 3651495 TI - Modification of fatty acid composition of membrane phospholipid in hepatocyte monolayer with n-3, n-6 and n-9 fatty acids and its relationship to triacylglycerol production. AB - The objective of these studies with rat hepatocytes in primary culture was to establish that: (a) membrane phospholipids would become enriched with the specific fatty acid supplemented to the media and (b) hepatocyte monolayer triacylglycerol synthetic rates were dependent on the type of fatty acid enrichment of the membrane phospholipids. Hepatocytes cultured in the absence of media lipid developed a phospholipid fatty acid composition which is indicative of an essential fatty acid deficiency. The extensive rise in 18:1(n - 9) content indicated that delta 9-desaturase was active. The fatty acid composition of phosphatidylcholine, phosphatidylethanolamine and phosphatidylinositol in the microsomal- and mitochondrial-enriched fractions was highly dependent upon the type of fatty acid supplemented to the medium. Incorporation of fatty acids into phospholipids was rapid, and a new steady-state in fatty acid composition was achieved within approx. 36 h. Changes in the fatty acid composition of these hepatocyte phospholipid subclasses resulting from media supplementation with 18:2/20:4(n-6) or 20:5(n-3) were similar, but not identical, to changes which occurred in vivo as a result of consuming diets rich in 18:2(n-6) or 20:5(n-3). Hepatocyte lipogenesis was highly dependent upon the type of fatty acid supplemented to the medium. Prior conditioning with 16:0 increased triacylglycerol synthesis and secretion. Secretion of triacylglycerol was reduced by polyenoic fatty acid enrichment with 20:5(n-3) greater than 20:4/18:2(n-6). The suppression of triacylglycerol synthesis by 20:5(n-3) was due to an increased (P less than 0.05) diacylglycerol specific activity, which indicates that 20:5(n 3) suppression of hepatic triacylglycerol production may be caused in part by the inhibition of diacylglycerol acyltransferase. PMID- 3651496 TI - Regulation of cholesterol biosynthesis at a stage after the 3-hydroxy-3 methylglutaryl-CoA reductase step, in normal and leukemic (L2C) guinea pig lymphocytes. AB - Cholesterogenic activity in normal and leukemic guinea pig lymphocytes was measured by incorporation of labeled sodium acetate into cholesterol, after separation from other labeled metabolites. Our study is in agreement with the large difference previously found between the two kinds of cells at the 3-hydroxy 3-methylglutaryl-CoA reductase step, but it also shows that the difference is not as great as described earlier, when expressed in terms of the final product, cholesterol. This is mainly due to differences in the analytical methods. Our more detailed procedure showed a blockage of cholesterol synthesis in leukemic guinea pig lymphocytes (L2C cells) at the step of lathosterol (cholest-7-en-3 beta-ol) isomerization, and a higher plasma membrane permeability of these cells for sodium acetate, compared to normal cells. The lack of cholesterogenesis regulation by low density lipoproteins in L2C cells, previously reported after measuring 3-hydroxy-3-methylglutaryl-CoA reductase activity, was confirmed with regard to cholesterol itself, as well as the usual regulation of normal cells, which appeared to occur also at a post-hydroxymethylglutaryl-CoA step. PMID- 3651497 TI - Detection of protein-free lipoprotein analogues with an apolar lipid core by freeze-etch electron microscopy. AB - Freeze-fracture electron microscopy of protein-free lipoprotein analogues consisting of polar phospholipids with neutral lipid cores shows that these systems can exhibit novel, smooth crossfracture faces. Resolution of these features can be enhanced by etching techniques. This novel particle morphology provides a new procedure to characterize microemulsions composed of polar and neutral lipids. PMID- 3651498 TI - Effect of testosterone on purine synthesis de novo in rat perineal muscle in vivo. AB - We examined in vivo the influence of testosterone on purine synthesis de novo, in the levator ani and gastrocnemius muscles of the rat. The hypoxanthine, adenine and guanine contents and the rate of incorporation of [14C]formate into these purine bases were determined in castrated adult and prepubertal rats (groups 1 and 2) both before and after orchiectomy and, in the second case, at different times after testosterone treatment. Substantially similar behavior was found in both groups, with some specific differences. The results showed an increase in the basal levels after castration (except for a dramatic decrease in adenine and a rise in the Gua/Ade molar ratio in prepubertal rats) and a return to basal levels after hormone administration, which was also accompanied by variations in the Gua/Ade molar ratio. The kinetics of purine nucleotide synthesis de novo in vivo and, specifically, of the overall reactions: IMP formation from PRib-PP, IMP ---AMP and IMP----GMP, were followed by evaluating the incorporation curves of [14C]formate into hypoxanthine, adenine and guanine. Our results show that testosterone administration enhanced the incorporation rate and gave characteristic patterns: a diphasic cyclic oscillation of the Ade values in adult castrated rats, and single peaks having a specific shape in the other cases. The Gua/Ade labeling ratio was unchanged in castrated rats and increased in both groups during the first 5 days after testosterone treatment, after which values even fell below normal; in most cases, values overlapped the pattern of the Gua/Ade molar ratio. The specific profile of the curves indicated that testosterone initially accelerated the turnover of guanylic acid and in the second phase re-established the normal behavior and ratio of AMP and GMP formation. These results indicate that the 'inosinic branch point' was subject to regulation by testosterone. The profiles of the incorporation curves and of the Gua/Ade ratio were indicative of a primary and secondary response to hormone action. PMID- 3651499 TI - Sodium binding to and protonation of ATP: a multinuclear magnetic double resonance study at 8.46 tesla. AB - We show that the interaction of ATP with Na+ and H+, whether binding or dissociation, gives rise to exchange broadened 31P-NMR spectra at 8.4 T, pH 6.7 and 310 K. We interpret the effect as being due to a two-step conversion between two NMR-differentiated ATP pools. A quantitative analysis yields all involved equilibrium constants and some of the dynamic parameters. Our results help to understand previous studies of magnesium binding to ATP and the appearance of high-field in vivo 31P-NMR spectra. PMID- 3651500 TI - Biochemical and immunological properties of different electrophoretic forms of juvenile hormone esterase from Trichoplusia ni (Hubner). AB - The two major electrophoretic forms (pI 5.5, 5.3) of juvenile hormone esterase were independently isolated from hemolymph of larval Trichoplusia ni. A simple and rapid preparation procedure of poly(ethylene glycol) precipitation, Sephadex gel filtration and chromatofocusing is described. Analytical isoelectric focusing showed only one peak of juvenile hormone esterase activity in the respective purified samples, whereas there were four (two major) such peaks in the hemolymph. The amino acid composition of the two forms was similar. The comparison of peptides obtained after protein fragmentation by cyanogen bromide showed that juvenile hormone esterases A and B were very similar, although definitely not identical, in amino acid sequence. The immunological comparisons of juvenile hormone esterases suggested that the number of polyclonal antibody binding sites on both forms was the same. There were no detected differences between immunoreactive properties of juvenile hormone esterase from the hemolymph of different stages of larval maturation. The influence of the active site of the enzyme on its antigenic properties was studied by immunocompetition. The inactive, heat-denatured juvenile hormone esterase can only partially protect against inhibition of its activity by the antibodies, whereas an organophosphate inhibitor which covalently binds to the catalytic center of the enzyme did not change the immunoreactive properties in comparison to active juvenile hormone esterase from hemolymph. These data show that heat-denatured juvenile hormone esterase has lost at least one or more epitopes, but the catalytic site of the enzyme is distinct from the epitopes. PMID- 3651501 TI - Purification and partial characterization of a corticosteroid-binding globulin from hamster serum. AB - Our objective was to characterize and purify the corticosteroid-binding proteins in hamster pregnancy serum. When [3H]cortisol-labeled pregnancy and proestrous serum were subjected to native polyacrylamide gel electrophoresis, a single peak of specific steroid-binding activity was detected in each, with identical electrophoretic mobility. The steroid-binding affinity (Ka = 1.07.10(8) M-1 for cortisol) is typical of corticosteroid-binding globulin from other species, but the steroid-binding specificity (cortisol greater than testosterone greater than progesterone) is not. An ultraviolet photoaffinity-labeling protocol was developed using 17 beta-hydroxy-4,6-[1,2-3H]androstadiene-3-one ([3H]androstadienolone), permitting analysis of ultraviolet photoaffinity-labeled proestrous and pregnancy serum by two-dimensional polyacrylamide gel electrophoresis and fluorography. Both sera contained the same labeled protein species. Corticosteroid-binding globulin was purified from pregnancy serum by DEAE-cellulose chromatography followed by steroid affinity chromatography on androstadienolone-17 beta-hemisuccinate-ethylenediamine-AffiGel 10. The purified protein (Mr = 62,250; pI = 3.95; n = 1; Stokes radius = 3.5; S = 4-5) was determined to be a glycoprotein. When analyzed by gel filtration and two dimensional polyacrylamide gel electrophoresis, purified corticosteroid-binding globulin behaved the same as in unfractionated serum, and when ultraviolet photoaffinity-labeled with [3H]androstadienolone, purified corticosteroid-binding globulin produced the same fluorogram spot pattern seen in unfractionated serum. A specific corticosteroid-binding globulin antiserum was raised in rabbits, and this antiserum reacted with a single spot in Western blots of unfractionated serum. Thus, hamster pregnancy serum was determined to have one corticosteroid binding protein. This protein is identical to the corticosteroid-binding globulin found in proestrous serum, with a higher titer in pregnancy serum. No other steroid-binding component is observed in hamster serum. PMID- 3651502 TI - Immunological identification of a new component of Ascaris pyruvate dehydrogenase complex. AB - The pyruvate dehydrogenase complex was purified from Ascaris muscle both with and without MgCl2 treatment at the first stage of purification. The specific activity of complex purified with MgCl2 treatment was about 2-fold as high as that purified without it. In addition to three component enzymes, two unknown polypeptides of 46 and 41 kDa were found in the complex purified by the two procedures. The quantity of unknown polypeptide of 41 kDa was increased in the complex purified with MgCl2 treatment as compared with that without it. Antibodies against the three component enzymes were prepared. All the antibodies precipitated the two unknown polypeptides in addition to the three component enzymes in immunoprecipitation experiments. Antibody against the alpha-subunit of pyruvate dehydrogenase reacted with the 41 kDa polypeptide as well as the alpha subunit in the immunoblotting method. The unknown polypeptide of 46 kDa did not react with any antibody. These results suggest that the unknown 41 kDa polypeptide is a derivative of the alpha-subunit and that the unknown 46 kDa polypeptide is not a proteolytic-degradative product of component enzymes but is a component of the Ascaris pyruvate dehydrogenase complex. When the Ascaris complex was incubated with [2-14C]pyruvate in the absence of CoASH, only lipoate acetyltransferase was acetylated. In rat heart pyruvate dehydrogenase complex, lipoate acetyltransferase and another protein (referred to as component x or protein x) were acetylated. These results indicate that the unknown polypeptide of 46 kDa is a new component. PMID- 3651503 TI - Ubiquinone biosynthesis by the microsomal fraction from rat liver. AB - The distribution and biosynthesis of ubiquinone were investigated in vivo in rats and using liver slices. In addition to mitochondria, Golgi vesicles and lysosomes also contain large amounts of this lipid, and even the plasma membrane, peroxisomes and microsomes demonstrate easily measurable amounts. The spectral and chromatographic properties of microsomal ubiquinone were identical to those of its mitochondrial counterpart. When pentane was used to deplete beef heart submitochondrial particles of ubiquinone, NADH and succinate oxidase activities could be restored by reincorporation of microsomal ubiquinone. Injection of [3H]mevalonate into the portal vein of rats and incubation of liver slices with [3H]mevalonate and [3H]- and [14C]tyrosine demonstrated that labeling of mitochondrial ubiquinone was initially much lower than labeling of the microsomal lipid. Furthermore, intraportal injection of [3H]mevalonate resulted in the rapid appearance of labeled ubiquinone in the blood. These results indicate that ubiquinone is synthesized not only in mitochondria, but also on the endoplasmic reticulum of rat liver. PMID- 3651504 TI - The mono- and difucosyl blood group B glycosphingolipids of rat large intestine differ in type of core saccharide. AB - Two blood group B-active glycosphingolipids were isolated from rat large intestine and characterized by mass spectrometry, proton NMR spectroscopy and methylation analysis. The following structures were concluded: Gal alpha 1--- 3(Fuc alpha 1----2)Gal beta 1----3GlcNAc beta 1----3Gal beta 1----4Glc beta 1--- 1Cer and Gal alpha 1----3(Fuc alpha 1----2)Gal beta 1----4(Fuc alpha 1--- 3)GlcNAc beta 1----3Gal beta 1----4Glc beta 1----1Cer. The two glycolipids thus differ in their core saccharides (type 1 and type 2 chain, respectively) and therefore must have different pathways for biosynthesis. PMID- 3651505 TI - Metal-binding properties of the isolated glomerular basement membrane. AB - The nature of binding of metal cations to the glomerular basement membrane has been investigated using isolated bovine glomerular basement membrane. Highest affinity binding for a number of ions is attributable to the glycosaminoglycans (mostly heparan sulfate) of the membrane. Some ions, such as divalent Mn, Ca and Ni, have specific binding sites on these polymers, while for others the ion polyelectrolyte interaction is of a non-specific nature. Both structural and binding data indicate a linear charge density of close to unity for the heparan sulfate of the glomerular basement membrane, which at the ionic composition of the plasma filtrate corresponds to a polymer surface potential of about -45 mV. Several independent observations are better explained by a model of counter-ion condensation about the glycosaminoglycans than by conventional double layer theories. These include the valence dependence of ion binding, the sharp ejection of divalent ions at a critical concentration of La3+, and the relative insensitivity of 63Ni2+ binding to NaCl concentration in the neighbourhood of physiological ionic strength. In its interactions with metal ions, the glomerular basement membrane behaves like a dilute solution of polyelectrolytes. This conclusion has important consequences for the extent of charge reduction of the filtration barrier of the kidney, bathed as it is in an electrolyte solution of mainly monovalent salts. PMID- 3651506 TI - Inhibition of very-low-density lipoprotein secretion by chloroquine, verapamil and monensin takes place in the Golgi complex. AB - The effects of chloroquine, verapamil and monensin on secretion of very-low density lipoproteins (VLDLs) were studied in cultured rat hepatocytes. Maximum inhibition of VLDL-triacylglycerol secretion by 50-90% of control was reached at 200 microM chloroquine, 200 microM verapamil and 5 microM monensin, whereas no effect on cellular triacylglycerol synthesis was observed. The inhibition could be seen within 15 min and was reversible after washout of the drugs. Chloroquine and verapamil inhibited both cellular protein synthesis and protein secretion, whereas monensin reduced protein secretion without any effect on protein synthesis. Control experiments with cycloheximide revealed that intact protein synthesis was not necessary for secretion of VLDL-triacylglycerol during 2 h. Electron micrographs of cells treated with chloroquine, verapamil or monensin showed swollen Golgi cisternae containing VLDL-like particles. By morphometry, a more than 2-fold increase in volume fractions and size indices of Golgi complexes and secondary lysosomes was observed, except that monensin had no significant effect on these parameters of secondary lysosomes. These results suggest that the inhibition of VLDL secretion by chloroquine, verapamil and monensin which takes place in the Golgi complex might be due to disruption of trans-membrane proton gradients. An increase in pH of acidic Golgi vesicles may cause swelling and disturb sorting and membrane flow through this organelle. PMID- 3651507 TI - Definition of fibronectin-mediated uptake of gelatinized latex by liver slices and macrophages. AB - These studies show that both liver slices and macrophages carried out fibronectin concentration-dependent uptake of 125I-labeled gelatin-coated latex (test latex). Lack of phagocytosis of test latex by liver slices was shown directly by electron microscopy and indirectly by trypsin treatment, which caused the release of all test latex taken up in response to fibronectin. Inhibitors of phagocytosis did not alter this uptake. On the other hand, trypsin released only a portion of test latex from macrophages. Inhibitors of phagocytosis did not effect the released radioactive particles from macrophages but greatly reduced the trypsin-resistant radioactivity, taken as representing phagocytized particles. Opsonization of test latex with fibronectin did not require heparin but its association with liver slices occurred only in the presence of heparin. Macrophages, however, readily bound and internalized the opsonized test latex and heparin only potentiated these reactions. Gelatin competed with test latex for fibronectin for opsonization, but did not inhibit binding and phagocytosis of fibronectin-test latex complexes. Finally, soluble fibronectin-gelatin complexes did not compete for binding and phagocytosis of fibronectin-test latex complexes. Thus, fibronectin concentrated on the surface of latex is preferred for interaction with the fibronectin receptor of macrophages. Gelatin, however, was not essential for this reaction, because fibronectin directly coupled to latex was also readily taken up. PMID- 3651508 TI - Studies on the preferential incorporation of [3H]glycerol over [32P]phosphate into major phospholipids of human platelets. AB - It is well known that platelets readily incorporate radioactive glycerol, but not radioactive phosphate into phosphatidylcholine (PC) and phosphatidylethanolamine (PE) in vitro, thus not in accordance with de novo synthesis according to the Kennedy pathway. In attempts to understand the reason for the discrepancy, gel filtered platelets were incubated simultaneously with [32P]Pi and [3H]glycerol, and the specific and relative radioactivities of products and intermediates were determined. Both precursors were incorporated into phosphatidylinositol (PI) with a 32P/3H ratio similar to that in glycerol 3-phosphate (in accordance with the Kennedy pathway). However, PC and PE obtained a much lower ratio. The specific 32P radioactivity in phosphorylcholine was similar to that of the gamma phosphoryl of ATP and 650-times higher than that of PC. The specific 32P radioactivity of phosphorylethanolamine was 20-times less than that of phosphorylcholine. Both mass and 32P labelling of CDP-choline were below the detection limits. It is concluded that the incorporation of [32P]Pi into PC via phosphorylcholine is insignificant while the preferential incorporation of [3H]glycerol could be explained by exchange of diacyl[3H]glycerol in the reversible choline phosphotransferase (CDP-choline: 1,2-diacylglycerol cholinephosphotransferase) reaction. The same mechanism would explain the preferential incorporation of 3H over 32P into PE, although dilution of 32P at the phosphorylethanolamine stage would account for part of the feeble 32P incorporation. Although other mechanisms are also possible, our results clearly show that the appearance of [3H]glycerol in PC and PE is not a reliable method of monitoring de novo synthesis of these phospholipids. PMID- 3651509 TI - Nucleocytoplasmic protein traffic in single mammalian cells studied by fluorescence microphotolysis. AB - Fluorescence microphotolysis was employed to measure in single living cells the kinetics of nucleocytoplasmic transport and the coefficients of intracellular diffusional mobility for the nuclear non-chromosomal protein nucleoplasmin. Nucleoplasmin was isolated from Xenopus ovary and labeled fluorescently. By injection into Xenopus oocytes it was ascertained that fluorescent labeling did not interfere with normal nuclear accumulation. Upon injection into the cytoplasm of various mammalian cell types nucleoplasmin was rapidly taken up by the nucleus. In rat hepatoma cells the half-time of nuclear uptake was approx. 5 min at 37 degrees C; the nucleocytoplasmic equilibrium concentration ratio had a maximum of 6.5 +/- 1.4 and depended on the injected amount. Upon co-injection of ATPases or reduction of temperature to 10 degrees C a nucleocytoplasmic equilization but no nuclear accumulation was observed. Equilization was fast (time constant 65 s at 23 degrees C), similar to that of 10-kDa dextran permeating the nuclear envelope by simple diffusion through functional pores. Nucleoplasmin (160 kDa), however, is too large to permeate passively the nuclear envelope, which is apparent from the fact that its tryptic 'core' fragment (100 kDa) could not permeate the nuclear envelope. On the other hand, a large fluorescent protein, phycoerythrin (240 kDa), was targeted to the nucleus by conjugation with nucleoplasmin. In the nucleus-to-cytoplasm direction the nuclear envelope was completely impermeable to nucleoplasmin, independently of temperature or ATP depletion. Nucleoplasmin, its core fragment, phycoerythrin and the phycoerythrin-nucleoplasmin conjugate were mobile in both cytoplasm and nucleus. PMID- 3651510 TI - Changes in the polypeptide composition related to the growth response in chronically isoproterenol-stimulated mouse parotid glands. AB - The administration of isoproterenol induces DNA-synthesis mitosis and growth (increase in size) responses in mouse parotid glands. Both responses were uncoupled by means of daily stimulations with isoproterenol in such a way that the DNA-synthesis mitosis response was observed during the first 4 days only, whereas the growth response was continuous since the first stimulation until about day 12. In parallel to the chronic stimulation by isoproterenol, drastic changes in the polypeptide composition of parotid glands were observed. These modifications, consisting basically of the reduction in content of a couple of major poly peptides (polypeptides A and B) together with the reciprocal massive accumulation of five new polypeptides (polypeptides C, D, E, F and G), were also progressive and continuous along the chronic stimulation by isoproterenol, even after the disappearance of the DNA-synthesis mitosis response. Thus, a relationship between specific changes in the mouse parotid content of polypeptides A, B, C, D, E, F and G and the isoproterenol-induced growth response, rather than with the DNA-synthesis mitosis response, is suggested. The correlation is firmly supported by the progressive recovery of the normal polypeptide composition upon suspending isoproterenol treatment, which allows parotid glands to return to normal size parameters. PMID- 3651511 TI - Cardiotonic activities of pumiliotoxin B, pyrethroids and a phorbol ester and their relationships with phosphatidylinositol turnover. AB - The cardiotonic activities of pumiliotoxins, pyrethroids and sodium and calcium channel activators were assessed in vitro with spontaneously beating guinea pig atria. The ability of these compounds to stimulate phosphoinositide turnover was assessed in guinea pig cerebral cortical synaptoneurosomes. The activity of pumiliotoxins for both cardiotonic activity and phosphoinositide breakdown was strongly dependent on the structure and configuration of the side chain and there was a correlation between structure and activity in the two systems. Pyrethroids that had cardiotonic activity also induced phosphoinositide breakdown. Other sodium channel and calcium channel activators that induced phosphoinositide breakdown were also cardiotonic. It is suggested that phosphoinositide breakdown leading to inositol phosphates and diacylglycerols may represent a mechanism underlying the cardiotonic effects of certain agents. A phorbol ester, phorbol 12 myristate 13-acetate, that mimics the activation of protein kinase C elicited by diacylglycerols, had cardiotonic activity. PMID- 3651512 TI - Processing of different liposome markers after in vitro uptake of immunoglobulin coated liposomes by rat liver macrophages. AB - We compared the metabolic fate of [3H]cholesteryl[14C]oleate, [3H]cholesteryl hexadecylether, 125I-labeled bovine serum albumin and [3H]inulin as constituents of large immunoglobulin-coupled unilamellar lipid vesicles following their internalization by rat liver macrophages (Kupffer cells) in monolayer culture. Under serum-free conditions, the cholesteryl oleate that is taken up is hydrolyzed, for the greater part, within 2 h. This occurs in the lysosomal compartment as judged by the inhibitory effect of the lysosomotropic agents monensin and chloroquin. After hydrolysis, the cholesterol moiety is accommodated in the cellular pool of free cholesterol and the oleate is reutilized for the synthesis mainly of phospholipids and, to a lesser extent of triacylglycerols. During incubation in plasma, however, substantial proportions of both the cholesterol and the oleate are shed from the cells, predominantly in the unesterified form. When the liposomes are labeled with the cholesteryl ester analog [3H]cholesteryl hexadecylether only a very small fraction of the label is released from the cells, even in the presence of plasma. Similar to the label remaining associated with the cells, the released label is identified in that case as unchanged cholesteryl ether. The liposomal aqueous phase marker 125I labeled bovine serum albumin is also readily degraded intralysosomally and the radioactive label is rapidly released from the cells in a trichloroacetic acid soluble form. Also, as much as 20% of the aqueous phase marker [3H]inulin that becomes cell-associated during a 2-h incubation with inulin-containing liposomes, is released from the cells during a subsequent 4-h incubation period in medium or rat plasma. The usefulness of the various liposomal labels as parameters of liposome uptake and intracellular processing is discussed. PMID- 3651513 TI - Differences in the association of the progesterone receptor ligated by antiprogestin RU38486 or progestin ORG 2058 to chromatin components. AB - We assessed the hypothesis that due to variations in the conformation of the progesterone receptor induced by the antiprogestin RU38486 compared to the progestin ORG 2058, differences may result in the association of the receptor with some of the chromatin components. The physical properties of the receptor bound chromatin fragments released by micrococcal nuclease digestion were characterized by sucrose gradient sedimentation and by gel filtration on Agarose A-1.5m or Agarose A-5m columns. The nuclear fraction was isolated from T47D cells previously exposed to 0.1 microM [3H]RU38486 or 0.1 microM [3H]ORG 2058. Micrococcal nuclease digestion solubilized two receptor forms sedimenting at 4.4 S and 6.3 S for the antiprogestin bound receptor and only one receptor at 4.4 S for the progestin ligated receptor. High-salt buffer dissociated either the antiprogestin or the progestin-bound receptor to smaller receptor forms sedimenting at 3.5 S. Chemical cross-linking with the cross-linker 2 iminothiolane of the micrococcal nuclease solubilized receptor forms resulted in 6.7-S and 4.4-S forms sedimenting on 0.4 M KCl gradients for the antiprogestin and progestin ligated receptors, respectively. Stokes radii of 7.3 nm and 6.4 nm were determined by gel filtration in 0.4 M KCl for the 6.7-S and the 4.4-S receptor forms, respectively. Using the sedimentation coefficient and the Stokes radius, molecular weights of 202,000 and 116,000 were calculated for the antiprogestin and progestin ligated receptors. We conclude that the micrococcal nuclease solubilized antiprogestin ligated receptor is associated with additional or different chromatin components compared to the progestin bound receptor. PMID- 3651514 TI - Effects of isoproterenol-induced tachycardia on myocardial blood flow and glycogen in the fetal lamb. AB - In utero tachycardia is a cause of fetal congestive heart failure and fetal hydrops. We investigated the effects of isoproterenol-induced tachycardia (IIT) on cardiac output and its distribution, on myocardial blood flow and intramyocardial blood flow distribution as well as on regional myocardial glycogen in 8 chronically prepared, near-term fetal lambs and 3 control twins (for myocardial glycogen only). Blood flows were measured by the radioactive microsphere method, myocardial glycogen by an enzymatic method. In animals with IIT (heart rate 200-280), cardiac output (excluding lung flow) increased from 0.399 to 0.544 ml/g/tissue/min (+36%), blood flow to the carcass increased from 0.19 to 0.32 ml/g/tissue/min (+68%) and myocardium increased from 2.31 to 7.72 ml/g/tissue/min (+234%), while kidney blood flow decreased from 1.34 to 0.72 ml/g/tissue/min (-46%). The normal intramyocardial blood flow distribution and predominance of flow to the endocardium of both ventricles was preserved during IIT. In the three sets of twins, glycogen was lower in the right (RV) and left (LV) ventricular walls of each animal stressed by IIT (mean RV = 0.19, mean LV = 0.44) than of its unstressed twin (mean RV = 0.75, mean LV = 0.70). Furthermore, a metabolic acidemia (mean pH 7.21, mean BE -8.4) developed in the stressed animals. Although we were unable to demonstrate regional myocardial ischemia at the maximal fetal heart rates achieved by isoproterenol infusion, our data suggest that metabolic acidemia and myocardial glycogen depletion are consequences of severe inotropic and chronotropic stress in the fetal lamb. PMID- 3651515 TI - The newborn rabbit: a model for studying hypoxemia-induced renal changes. AB - The newborn rabbit was used as an experimental model for studying renal changes during normocapnic hypoxemia. Renal extraction of p-aminohippuric acid (PAH), as assessed in 15 normoxemic and 8 hypoxemic rabbits amounted to 54.6 +/- 3.7 and 45.7 +/- 4.6%, respectively (NS). Changes in glomerular filtration rate (GFR), and renal blood flow (RBF) as assessed by inulin and PAH clearances, respectively, were determined during normoxemia and subsequent hypoxemia in 8 additional anesthetized and mechanically ventilated newborn rabbits. Normocapnic hypoxemia (PaO2 = 38.6 +/- 2.1 mm Hg) induced a significant fall in GFR from 2.10 +/- 0.21 to 1.51 +/- 0.18 ml/kg/min (p less than 0.01), in filtration fraction (p less than 0.01) and U/P inulin ratio (p less than 0.01). RBF, renal vascular resistance and urine flow rate did not change significantly. In comparison with other immature animal species the newborn rabbit appears a valuable and inexpensive model for the study of acute hypoxemia-induced renal changes. PMID- 3651516 TI - Carnitine concentrations in the milk of different species and infant formulas. AB - Carnitine concentrations were measured in the milk of sheep, cows, goats, and horses, in human milk of term and preterm infants and in European infant formulas. There were significant species' differences in carnitine milk content. Acylcarnitine concentrations ranged from 13 to 47% of total carnitine. This may be related to differences in maternal and/or mammary gland metabolism. The concentration of long-chain acylcarnitine in milk was under 1% in all investigated species. In cow's milk, there was a decrease in acylcarnitine concentration during the first 2 months of lactation. In human milk, carnitine concentrations did not change during the 1st month postpartum, but maternal plasma carnitine concentrations increased and plasma concentrations of acylcarnitine were always lower than those in simultaneously sampled milk. Milk carnitine concentrations in mothers of premature infants were not different from those in mothers of term infants. European formulas based on cow's milk contained somewhat more carnitine than human milk. However, very low carnitine concentrations were found in soy-based or protein hydrolysate formulas. This may lead to nutritional carnitine deficiency in infants receiving these formulas without carnitine supplementation. PMID- 3651517 TI - Ketogenesis in hypoglycemic neonates. Carnitine and dicarboxylic acids in neonatal hypoglycemia. AB - Since hypoglycemic neonates do not exhibit compensative ketosis, we investigated the possible involvement of carnitine deficiency or omega-oxidation in neonatal hypoglycemia. In a first group of 49 neonates, serum free fatty acid, acetoacetate and beta-hydroxybutyrate concentrations were similar in hypoglycemic and normoglycemic neonates. Serum free carnitine concentrations did not show any difference in the hypoglycemic small-for-date infants (median 40 mumol/l, range 16-92 mumol/l) compared to the normoglycemic small-for-date infants (median 30 mumol/l, range 8-64 mumol/l). In a second group of 45 neonates, urinary excretion of dicarboxylic acids (adipic, suberic, sebaric and succinic acids) was similar in hypoglycemic infants compared to normoglycemic neonates. Despite the limitations of interpretation of free carnitine determination, these data do not suggest an impaired beta-oxidation by carnitine depletion or an enzymatic defect in hypoglycemic neonates. PMID- 3651518 TI - Effect of protein malnutrition and maternal caffeine intake on the growth of fetal rat brain. AB - Pregnant dams were divided into two subgroups on day 10 of gestation. Half were fed a 20% protein diet and the other half an 8% protein diet. A second group also subdivided was pair-fed with rats of the first group. Their diet was supplemented with caffeine in amount calculated to provide daily doses of 2 mg/100 g body weight. On days 18, 20, and 22 randomly selected dams were injected with 3H thymidine intraperitoneally and 1.5 h later their fetuses were delivered surgically in order to determine the rate of DNA synthesis along the gestation. The rest of the fetuses were delivered surgically on day 22. Pups' brains were rapidly removed and DNA, RNA, protein and 3H-thymidine uptake were studied. Average body weights of the fetuses in the caffeine-supplemented control group were smaller than those of the noncaffeine group. Effects of caffeine that were similar in both diet groups included a decrease in brain DNA content and concentration and an increase in brain protein content and concentration. However, the percent decrease and increase, respectively, was different depending on the nutritional status. DNA synthesis was not affected by malnutrition or caffeine supplementation on day 18 of gestation. Caffeine's effect on the rate of DNA synthesis was different on day 20 of gestation depending on nutritional status. Caffeine supplementation resulted in a decrease in DNA synthesis in both groups on day 22 of gestation. These data indicate that caffeine intake during pregnancy produces differential effects on fetal rat brain depending on dietary protein content. PMID- 3651519 TI - Postnatal development of uterine abnormalities in mice exposed to DES in utero. AB - Postnatal development of uterine abnormalities was examined in the offspring of mice given 4 daily subcutaneous injections of 2,000 micrograms diethylstilbestrol (DES) and of oil vehicle alone from days 15 to 18 of gestation. The prenatally DES-exposed mice (DES mice) exhibited a disorganization of the inner circular musculature of the uterus as early as at 5 days of age. Invaginations of the luminal epithelium into the stroma which began to form in 5-day-old control and 10-day-old DES mice developed into uterine glands at 10 and 15 days, respectively. The number of glands per uterine section was significantly reduced in DES mice as compared with the controls at 10-30 days. Stratification with or without squamous metaplasia (ST) was found in the luminal epithelium of DES mice at 20 days. Five groups each of DES mice and the controls ovariectomized (OVX) at 10 days were given 5 daily subcutaneous injections of 10(-4), 10(-3), 10(-2), 10( 1), and 1 microgram 17 beta-estradiol (E2) starting at 25 days. ST was never observed in OVX mice given prepubertal injections of any E2 dose, whereas in DES OVX mice aged 30 days, ST was produced by prepubertal injections of E2 doses higher than 10(-2) micrograms/day. Uterine responsiveness, weight gain and gland formation were significantly reduced in DES mice given prepubertal E2 injections compared to the controls. PMID- 3651520 TI - Kallikrein excretion: relationship with maturation and renal function in human neonates at different gestational ages. AB - Kallikrein excretion and renal function were studied on 37 one-day-old newborn infants (14 fullterm and 23 preterm infants). Preterm infants excreted less kallikrein (p less than 0.001), had lower creatinine clearance (p less than 0.02) and urinary osmolality (p less than 0.01). They had higher values on urinary volume (p less than 0.001), FENa (p less than 0.001), FEK (p less than 0.02), and free water clearance (p less than 0.01) than fullterm infants. The excretion of kallikrein correlated directly with gestational age (p less than 0.01) and body weight (p less than 0.01). No correlations were found with FENa, urinary volume, FEK or free water clearance. The values of kallikrein excretion were very low when compared with a young adult population. As kallikrein is synthesized in the distal nephron we advance as an hypothesis that the low levels of kallikrein excretion observed in newborns could be a reflection of immature distal tubular mass, and to the relative unresponsiveness of the distal nephron to hormones known to stimulate renal kallikrein such as aldosterone and antidiuretic hormone. PMID- 3651521 TI - Serum and lipoprotein lipids of fetal pigs and their dams during gestation as compared with man. AB - Serum and lipoprotein (LP) lipids were measured in fetal pigs and their dams during gestation. In the 2nd trimester (70 days of gestation), fetal lipids resembled those of their dams. Early in the 3rd trimester (90 days) total serum concentrations of cholesterol (CH), triglyceride (TG) and free fatty acids (FFA) were lower in fetuses than in sows (p less than 0.01), but the decreases were not expressed uniformly among the LP classes. By the middle of the 3rd trimester (100 days) fetal serum lipids had declined further, and the distribution of TG (but not CH) between the LP fractions was significantly different from the distribution in sows (p less than 0.01). Sow serum CH, TG and FFA varied, but did not change significantly from days 70 to 100 of gestation; there was a tendency for sow serum lipids to increase, particularly FFA. Distributions of TG and CH in sow LP were unchanged by pregnancy. Results suggest that independent fetal regulation of lipid metabolism develops during the last half of gestation, and that lipid metabolism (especially TG) may be altered during fetal life. Changes in sow lipids during gestation were much less pronounced than in humans, but fetal patterns were similar. PMID- 3651522 TI - Amino acid profiles during development of the fetal rat. AB - Umbilical blood venous-arterial differences for amino acids across the rat fetus show uptake of disproportionately large amounts of glutamine, alanine and lysine relative to their contribution to total body protein. Free amino acid concentrations in fetal liver tend to increase during development, but show a rapid adjustment to near-adult values within 24 h after birth. PMID- 3651523 TI - Transplacental stimulation of fetal lung maturation: effect of triiodothyronine in the female and male rabbit fetus. AB - We have recently demonstrated that intramuscular administration of triiodothyronine (T3) or thyroxine (T4) to the rabbit doe results in its transfer across the placenta. In this study we investigated the effect of maternally administered T3 upon the functional and morphologic fetal lung maturation. T3 (175 micrograms/kg) or the vehicle was injected intramuscularly into the New Zealand White rabbit does on days 25 and 26 of gestation. On day 27 of pregnancy, the does were killed and the fetuses were delivered. Maternal and fetal plasma T3, glucose and insulin and fetal plasma corticosteroid concentrations were determined. The functional pulmonary maturity was assessed by performing the pressure-volume hysteresis while morphologic maturity was established by histologic techniques. Enhanced functional as well as morphologic fetal lung maturation was observed in female as well as male fetuses in T3-treated animals. However, there was a significant increase in the fetal mortality after T3 treatment, and the duration of survival in the extrauterine environment on premature delivery was not prolonged. PMID- 3651524 TI - Effect of maternal fasting on ovine fetal and maternal branched-chain amino acid transaminase activities. AB - Activities of branched-chain amino acid transaminase were assayed in maternal skeletal muscle, liver and fetal skeletal muscle, cardiac muscle, liver, kidney and placenta obtained from fed and 5-day-fasted late gestation ewes. Very high activities were found in placenta; fetal skeletal muscle also had high activity. Fetal brain had intermediate activity, followed by cardiac muscle and kidney. Fetal liver possessed negligible activity. Activities were low in both maternal liver and skeletal muscle. Trends were seen for fasting to increase activities in fetal placenta, skeletal muscle, brain, kidney, heart and maternal liver, but these changes were statistically significant only for fetal brain and placental tissue. Fetal skeletal muscle activity was 100 times that of maternal skeletal muscle. These data imply differences in the metabolism of the branched-chain amino acids by fetal and adult ruminants and expand the thesis that branched chain amino acids are important to the metabolism of the ovine fetus. PMID- 3651525 TI - Effect of hypophysectomy on tissue glycogen concentrations in the fetal pig. AB - The glycogen content was estimated in the liver, lung, cardiac ventricle and skeletal muscle of fetal pigs which had been hypophysectomized between 69-84 days of gestation, decapitated between 35-42 days of gestation or left intact. Comparisons made preterm (103-108 days) or at term (112-114 days) indicated that both liver and skeletal muscle glycogen content were significantly lower in the absence of the fetal pituitary, whereas concentrations in the fetal lungs were significantly higher. There were no significant differences in cardiac glycogen content between hypophysectomized and intact fetuses. Plasma glucose concentrations in both umbilical artery and vein were similar, but plasma arterial fructose concentrations were significantly higher in the hypophysectomized fetuses. PMID- 3651526 TI - Epilepsy, frontal lobe, and personality. PMID- 3651527 TI - Normal cerebral asymmetry in bipolar patients. AB - Reversal of normal cerebral asymmetry has been reported to be more frequent in children with higher cortical dysfunction and in schizophrenics, in whom it has clinical significance as well. As there are few studies of bipolar patients, we attempted to determine if significant reversal would be found in a clearly diagnosed sample of bipolar patients. As technical differences may account for varying results, we used two previously reported methods and a modified technique. Correlations of computed tomography (CT) findings with neuropsychological variables (Halstead Reitan Battery and WAIS subtests) were also studied. Bipolars and controls did not differ on any CT measure, nor were there meaningful correlations between asymmetry and neuropsychological variables. If if is confirmed that schizophrenics have increased reversed cerebral asymmetry but bipolars do not, it may point to an important difference, as all other CT abnormalities initially described in schizophrenics are now also noted in bipolar patients. PMID- 3651528 TI - RS 86 in the treatment of Alzheimer's disease: cognitive and biological effects. AB - Twelve patients who met Research Diagnostic Criteria for Alzheimer's disease (AD) completed a double-blind crossover study comparing oral RS 86, a long-acting and specific muscarinic agonist, with placebo. Cognitive and noncognitive effects were assessed with the Alzheimer's Disease Assessment Scale (ADAS). RS 86 was found to improve ADAS test scores consistently (both cognitive and noncognitive subscales) in seven patients, with a clinically obvious improvement in only two patients. RS 86 produced a significant increase in peak nocturnal cortisol levels, and this increase correlated with improvement on ADAS testing. Similarly, there was a 38% increase in amplitude of the P300 evoked potential with RS 86. The biological findings suggest that RS 86 was effective only to the extent that it enhanced central cholinergic activity. PMID- 3651529 TI - Diminished mitogen-induced calcium uptake by lymphocytes from Alzheimer patients. AB - Recent studies demonstrate diminished calcium uptake by cultured skin fibroblasts from Alzheimer patients. To determine if altered calcium homeostasis is also present in tissue taken from Alzheimer patients, calcium homeostasis was assessed in mitogen-stimulated lymphocytes. Calcium uptake by lymphocytes from Alzheimer patients was 10%-15% lower (p less than 0.002) than that of lymphocytes from age matched controls. However, neither superficially bound nor total calcium was altered by Alzheimer's disease. These small differences in uptake may reflect larger differences in cytosolic calcium, in later calcium-mediated events, or in the response of particular subsets of lymphocytes. Their biological significance remains to be determined. PMID- 3651530 TI - Erythrocyte acetylcholinesterase in psychiatric disorders and controls. AB - Acetylcholinesterase (AChE) from erythrocytes was solubilized by Triton X-100. Size and charge heterogeneity of AChE was investigated by polyacrylamide gel electrophoresis (PAGE) and isoelectric focusing (IEF) in polyacrylamide gels in the presence of 0.5% (v/v) Triton X-100. There were no interindividual differences in these parameters in 46 psychiatric patients (schizophrenia, major affective disorder, personality disorder, dependency, dementia) and controls. The specific activity of solubilized AChE did not discriminate between controls and patients or between the diagnostic subgroups. PMID- 3651531 TI - Plasma MHPG levels in lactate and isoproterenol anxiety states. AB - It has been claimed that an increase in brain noradrenergic activity plays a role in panic disorder and that enhanced noradrenergic activity may be reflected by plasma levels of MHPG. We investigated plasma MHPG levels in panic disorder patients at baseline and during lactate- and isoproterenol-induced anxiety states. These infusions and 5% dextrose infusions were given to 10 panic disorder patients and 9 healthy control subjects. Each subject received all three infusions, double-blind, in random order, and at 1-week intervals. When compared to controls, plasma free MHPG levels in panic patients were not elevated at baseline, during lactate or isoproterenol infusions, at the point of panic, or up to 20 min after the onset of panic. MHPG values were also not elevated in subjects who panicked compared to those who did not. MHPG values were significantly lower in three patients who failed to panic with isoproterenol, but the patient panickers had MHPG values similar to those of controls. Significant correlations between MHPG levels and anxiety ratings were infrequent and could be accounted for by chance alone. These results did not support the noradrenergic model for panic anxiety states induced by lactate or isoproterenol. PMID- 3651532 TI - Dexamethasone nonsuppression and EEG abnormalities. PMID- 3651533 TI - Platelet MAO-B and endogenous MAO-A inhibitory activity in depressed patients: stability with electroconvulsive treatment. PMID- 3651534 TI - Plasma dopamine-beta-hydroxylase, HVA, MHPG, and conduct disorder in emotionally disturbed boys. PMID- 3651535 TI - Minor physical anomalies in violent adult inpatients. PMID- 3651536 TI - Carbamazepine in obsessive-compulsive disorder. PMID- 3651537 TI - Fetal metabolism and placental transfer of vasoactive intestinal peptide in sheep. AB - Vasoactive Intestinal Peptide (VIP) is a 28-amino-acid putative neurotransmitter that may have a role in the regulation of myometrial blood flow and uterine contractility. The chronically cannulated fetal sheep preparation was used to examine the fetal clearance and placental transfer of VIP. Metabolic Clearance Rate (MCR) and placental transfer of VIP were measured by alternate steady-state infusion of VIP into the mother and fetus. Plasma concentrations of VIP were measured by radioimmunoassay. MCR was similar in the pregnant (45 +/- 10 ml/kg/min) and nonpregnant ewes (35 +/- 5 ml/kg/min). However, compared to both pregnant and nonpregnant ewes, fetal MCR was significantly increased at 77 +/- 15 ml/kg/min, indicating highly developed clearance mechanisms in the fetus. VIP did not cross the placenta in either direction. Both the placenta and fetal liver metabolized VIP and contributed to the elevated fetal clearance of VIP. The results show that VIP in fetal tissue is unlikely to influence maternal uterine activity with any VIP-mediated effects emanating from maternal and/or placental sources. PMID- 3651538 TI - Detection of a progesterone-dependent secretory protein synthesized by cat endometrium. AB - Uterine flushings and culture media from endometrial explants incubated in the presence of radiolabeled amino acids were analyzed using one-(1-D) and two dimensional (2-D) gel electrophoresis to identify proteins synthesized by the endometrium and subsequently released into the uterine lumen. 1-D and 2-D analyses of uterine flushings and culture media of endometrial explants obtained from 7- to 11-day pregnant cats (pre-implantation) showed a Mr 30,000 protein that appeared on 2-D gels as a family of macromolecules with isoelectric points between 6.5 and 7.0. This family of macromolecules was also present in the culture media of implantation-site tissue obtained from 12- to 16-day pregnant cats and of nonimplantation-site endometrium obtained form 12- to 28-day pregnant cats. The Mr 30,000 protein was absent in uterine flushings and culture media from estrous and 3- to 5-day-pregnant cats. In ovariectomized, steroid-treated animals, the Mr 30,000 protein was only detected in flushings and media from those animals treated with progesterone, regardless of the presence or absence of estradiol-priming and/or simultaneous estradiol treatment. In daily flushings obtained from ovariectomized, steroid-treated cats equipped with an indwelling uterine catheter, the Mr 30,000 protein was absent during the 14 days of estradiol treatment and was first detected 3-4 days after the onset of estradiol plus progesterone treatment. This protein was not detected in serum from estrous, 9-day pregnant, ovariectomized, and ovariectomized, steroid-treated animals. This study shows that 1) a progesterone-dependent protein, with an approximate molecular weight of 30,000 and an isoelectric point of 6.5-7.0, first appears within the uterine lumen soon after the arrival of the blastocyst and continues to be present during implantation; 2) the synthesis and release of the Mr 30,000 protein is dependent on progesterone regardless of the presence or absence of estradiol; and 3) the onset of secretion of the Mr 30,000 protein requires 3-4 days of continuous progesterone treatment in the estradiol-primed cat. PMID- 3651540 TI - Rete testis fluid (RTF) proteins: purification and characterization of RTF albumin. AB - A major 68-kDa protein in ram rete testis fluid (RTF) is shown to be chemically and immunologically indistinguishable from albumin in ovine serum. Data obtained with two-dimensional gel electrophoresis of RTF demonstrate the presence of additional proteins with a molecular mass of 68 kDa that do not react with antisera against sheep serum albumin. Biochemical characteristics of albumin preparations isolated by immunoaffinity chromatography from ovine serum and from RTF were compared. Albumin from both sources had the same apparent molecular mass of 68 kDa, the same isoelectric point of approximately 4.2, and neither bound specifically to Concanavalin A. Analysis of tryptic peptide maps, obtained with reverse-phase high-pressure liquid chromatography, indicated no significant differences between digests of the two purified albumin preparations. Results indicate that RTF albumin and serum albumin are the same protein, which implies that RTF albumin may originate from serum. Albumin levels in RTF, collected from different rams and measured by radioimmunoassay, varied between 46 and 164 micrograms/ml, constituting between 11 and 17% of total RTF protein, while albumin levels in sheep plasma were 40,000 micrograms/ml. The protein composition of RTF is discussed in relation to the relative amounts of various components contributed by testis cells and the amounts derived from serum. PMID- 3651539 TI - Calmodulin inhibitors protect against cadmium-induced testicular damage in mice. AB - Recent reports showing that cadmium can interact with calmodulin and activate calmodulin-sensitive enzymes have lead us to examine the effects of calmodulin inhibitors on cadmium-induced testicular toxicity in mice. Male CF-1 mice were pretreated with the various calmodulin inhibitors or inactive analogs and then, one hour later, given CdCl2 X 2 1/2 H2O (32 mumoles/kg). After 24 hours, the mice were killed and the testes were removed and weighed. The extent of hemorrhaging was quantified by determining the absorbance of hemoglobin at 414 nm in the soluble fraction of testicular homogenates. Exposure to Cd2+ increased the mean testicular weight from 118 +/- 5 mg to 146 +/- 4 mg and the hemoglobin absorbance from 0.096 +/- 0.006 to 0.767 +/- 0.138. Pretreatment with the calmodulin inhibitors, trifluoperazine (40 mumoles/kg), chlorpromazine (40 mumoles/kg) or W 7 (140 mumoles/kg) greatly attenuated the CD2+-induced increase in both parameters, whereas pretreatment with chlorpromazine sulfoxide (140 mumoles/kg), pentobarbital (140 mumoles/kg), verapamil (80 mumoles/kg) or ethylenediaminetetraacetate (140 mumoles/kg) did not. These results indicate that calmodulin inhibitors can protect against certain toxic effects of cadmium and are consistent with the hypothesis that some of the effects of cadmium may result from the improper activation of calmodulin-dependent enzymes. PMID- 3651541 TI - Pinealectomy or superior cervical ganglionectomy do not alter reproduction in the wolf (Canis lupus). AB - Twelve wolves (6 male and 6 female) were used to study the role of the pineal in photoperiodic mediation of seasonal reproduction. Eight wolves were pinealectomized (PNX) or sham-pinealectomized (S-PNX) at 5 mo of age, and 4 were superior cervical ganglionectomized (SCGX) at 16 mo of age (2 males and 2 females per treatment). All attained puberty at the species-typical time, during their second breeding season, except 2 SCGX males that did not survive. Reproductive cycles of an additional male that was SCGX as an adult and the PNX and S-PNX wolves, followed for a minimum of 3 yr, did not differ from each other or from those of unoperated colony wolves on measures of serum testosterone and luteinizing hormone for males, or of serum estradiol and progesterone for females. Nor was the range of dates for ovulation different for treated vs. untreated females. Surgical transection of the olfactory tracts of 1 male and 1 female PNX wolf, inducing anosmia to control for the possibility of pheromonally synchronized cycles, also failed to alter the seasonality of these reproductive parameters. These results do not conform to the model of pineal mediation of sexual cycles for photoperiod-sensitive species. In spite of evidence for photoperiod influence, the wolf apparently relies on a system other than the pineal for seasonal control of reproduction. PMID- 3651542 TI - Stage-specific protein synthesis by isolated spermatogenic cells throughout meiosis and early spermiogenesis in the mouse. AB - Spermatogenic cells isolated from prepubertal and adult mice by unit gravity sedimentation have been used to examine proteins synthesized in a stage-specific manner throughout meiosis and early spermiogenesis. Preleptotene, leptotene/zygotene, and pachytene spermatocytes were isolated from 17-day-old mice. Adult pachytene spermatocytes and round spermatids were isolated from mature animals. These germ cells were then cultured in defined medium with [35S]methionine [( 35S]met) for 4-5 h. For each cell type, relative [35S]met incorporation was determined and labeled proteins were compared by two dimensional (2D) polyacrylamide gel electrophoresis and autoradiography. Levels of [35S]met incorporation by isolated germ cells correlate closely with previous autoradiographic estimates of protein synthesis during spermatogenesis (Monesi, 1967). Pachytene spermatocytes from prepubertal mice incorporate the highest levels of [35S]met, when expressed either as cpm/-10(6) cells or cpm/mg protein. Comparisons of 2D autoradiograms indicated that many proteins, including actin and tubulins, are synthesized at approximately equal levels in all stages examined. Other proteins, including heat-shock proteins and multiple plasma membrane constituents, are synthesized in a stage-specific manner in leptotene/zygotene spermatocytes, pachytene spermatocytes, and round spermatids. These studies define conditions for monitoring protein synthesis in isolated spermatogenic cells prior to the pachytene stage of meiosis, provide a 2D map of proteins synthesized at these earlier meiotic stages, and examine the synthesis of several proteins previously identified on 2D gels with biochemical and immunological methods. PMID- 3651543 TI - Isolation and biochemical characterization of the subunits of the rabbit sperm acrosome stabilizing factor. AB - The rabbit Acrosome Stabilizing Factor (ASF) is a glycoprotein synthesized in the corpus epididymis that demonstrates the ability to reversibly decapacitate sperm. Separation of the molecule into its individual subunits (92,000 Da and 38,000 Da) was accomplished via electroelution from polyacrylamide gels or via gel filtration on a Sephadex G-200 column in the presence of 0.1% sodium dodecyl sulfate. Column separation of the subunits revealed an entity of low molecular mass (500 daltons) associated with the ASF molecule. Amino acid compositional analysis of the subunits revealed the lack of cysteine and high glycine in the small subunit (38,000 Da) and high proline and glycine in the large subunit (92,000 Da). Lysine and aspartic acid were identified as the N-terminal amino acids for the large and small subunits, respectively. Identification of a 20 amino acid N-terminal sequence was accomplished for both of the subunits. Carbohydrate compositional analysis demonstrated that the small subunit contained N-asparagine-linked high mannose sugar chains while the large subunit contained N asparagine-linked complex sugar chains. Endoglycosidase-H and N-Glycanase treatment of ASF indicated that the small subunit appears to contain four high mannose chains and the large subunit contains three complex chains. PMID- 3651544 TI - Protein phosphorylation in intact bovine epididymal spermatozoa: identification of the type II regulatory subunit of cyclic adenosine 3',5'-monophosphate dependent protein kinase as an endogenous phosphoprotein. AB - An obstacle to the study of protein phosphorylation in mammalian spermatozoa has been the inability to incorporate sufficient amounts of 32Pi into cellular adenosine triphosphate (ATP) (Babcock et al., 1975). We report conditions under which 32Pi is effectively incorporated into the ATP of intact bovine spermatozoa. In the presence of a bicarbonate-buffered medium containing glucose, spermatozoa incorporated 32P into intracellular ATP in a time-dependent manner; after 2 h of incubation, the specific activity of [gamma-32P]ATP (2.3 X 10(4) cpm/nmol ATP) was estimated to be 50-65% of the specific activity of the intracellular phosphate pool. In the absence of glucose or other added substrates, the specific activity of [gamma-32P]ATP was 10-25% that of the specific activity observed in the presence of glucose. Washed spermatozoa incubated in carrier-free 32Pi for 2 h at 37 degrees C, and solubilized in a solution containing final concentrations of 6.8 M urea, 6% NP4O, and 5% beta-mercaptoethanol contained in excess of 40 32Pi-labeled proteins as assessed by two-dimensional polyacrylamide gel electrophoresis. Major phosphoproteins had approximate molecular weights of 93,000, 40,000, and 22,000. A different two-dimensional gel pattern was observed when cells were extracted with a solution containing 38.5 mM 2[N-cyclohexylamino] ethanesulfonic acid (CHES), pH 9.5/1.5% sodium dodecyl sulphate (SDS) at 100 degrees C. In contrast to the urea/Nonidet P-40 (NP40)/beta-mercaptoethanol extract, a 56,000 Mr phosphoprotein represented a major component while the 40,000 Mr and several of the 22,000 Mr polypeptides were markedly reduced in radioactive intensity. The 56,000 Mr species present in the CHES/SDS extract comigrated with the purified, phosphorylated regulatory subunit (RII) of cyclic adenosine 3',5'-monophosphate-dependent protein kinase from bovine heart. Antibodies to RII immunoprecipitated a 56,000 Mr, 32P-labeled polypeptide from the CHES/SDS extract that comigrated with purified, [32P] RII after two dimensional electrophoresis. RII, then, appears to represent one of the endogenous phosphoproteins of intact bovine epididymal spermatozoa. PMID- 3651545 TI - Penetration of zona-free hamster eggs by liposome-treated sperm from the bull, ram, stallion, and boar. AB - Spermatozoa from each of four rams, four stallions, and three boars (six semen samples) were treated with dilauroylphosphatidylcholine (PC12) liposomes and compared with control bull sperm to induce the acrosome reaction (AR) and study possible penetration of the sperm into zona-free hamster eggs. Diluted sperm were incubated with several concentrations of PC12 for 7 min at 39 degrees C prior to insemination of the hamster eggs in vitro. The sperm from the bull were diluted to 10(6) cells/ml, as previously studied. Sperm from the ram, stallion, and boar were diluted to 6 X 10(6) and 20 X 10(6) cells/ml. After addition to the eggs, the sperm concentration was reduced by 75 percent. Inseminated eggs were incubated with sperm for 3 h at 39 degrees C prior to being fixed, stained, and observed for sperm penetration. At an initial concentration of 6 X 10(6) cells/ml, bull sperm treated with 36.7 microM PC12 achieved an egg penetration rate of 92%, whereas under nearly identical conditions stallion spermatozoa achieved only 54% egg penetration. Under similar conditions, ram spermatozoa failed to penetrate eggs, but when the initial sperm concentration was increased to 20 X 10(6) cells/ml, sperm incubated with 51.1 microM PC12 achieved 52% egg penetration. Boar spermatozoa treated with PC12 at either sperm concentration failed to exhibit an AR or penetrate hamster eggs. In general, as PC12 concentration increased the percentage of sperm with an AR increased and sperm motility decreased. It is concluded that 1) PC12 liposomes are effective in inducing the AR in sperm from the bull, ram, and stallion, but under conditions tested are ineffective with boar sperm;(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651546 TI - Photoperiodic response in the male laboratory rat. AB - Normally photoperiodic laboratory rats can be induced to respond reproductively to a change in the length of the day by various experimental manipulations. One such paradigm that results in significant gonadal regression involves the treatment of rats with exogenous testosterone during exposure to short days. Studies were undertaken to assess various aspects of this model system including 1) the testicular response of testosterone-treated rats exposed to various photoperiods, 2) the time course for testicular regression under a short photoperiod, and 3) the role of the pineal gland as a mediator of the effects of day length on the neuroendocrine-gonadal axis. Photoperiods ranging in length from 2 to 22 h/24 h had no effect on testicular size in untreated rats. In contrast, while near normal testicular weights were maintained in laboratory rats treated with testosterone and exposed to 10 or more h of light per day, testicular regression occurred in rats implanted with testosterone-filled capsules and exposed to photoperiods of 8 or fewer h of light per day. Maximal testicular regression was reached in about 9 wk in testosterone-treated rats exposed to 6L:18D. Removal of the pineal gland totally blocked the inhibitory effects of exposure to short day lengths in testosterone-treated rats. These studies define some of the characteristics of an extant, but dormant, system for photoperiodic time measurement in the common laboratory rat and implicate a role for the pineal gland in this system. These experiments offer evidence that neuroendocrine factors that regulate continuous vs. seasonal reproductive patterns are malleable. Such flexibility in the photoperiodic response may also contribute to the evolution of seasonal to non-seasonal species and vice versa. PMID- 3651547 TI - Distribution and number of spermatozoa in the oviduct of the golden hamster after natural mating and artificial insemination. AB - A group of female hamsters was mated with males of proven fertility either several hours before or during ovulation. Another group of females was artificially inseminated several hours before ovulation. Females were killed at various times after the onset of mating or artificial insemination, oviducts were fixed and sectioned serially, and spermatozoa were counted individually as to their location in the oviduct. Regardless of the type or time of insemination, the vast majority of spermatozoa that entered the oviduct remained in the lower segments of the isthmus (the intramural and caudal isthmus) without ascending to the ampulla. The lower segments of the oviduct, particularly the caudal isthmus, appeared to be acting as a "sieve" and/or "sperm reservoir." In females mated or artificially inseminated prior to ovulation, virtually no spermatozoa reached the cephalic isthmus or ampulla until the commencement of ovulation. Although a few spermatozoa reached the ampulla by 1 h after the onset of mating, they were the exception rather than the rule. When females were mated during ovulation, spermatozoa spent a minimum of about 3 h in the caudal isthmus before ascending to the ampulla. The number of spermatozoa that entered the oviduct after artificial insemination was considerably lower than in naturally mated animals, but this low number was apparently large enough to ensure complete fertilization. PMID- 3651548 TI - Localization of relaxin in the pig follicle during preovulatory development. AB - The avidin-biotin immunoperoxidase method and antisera to purified porcine relaxin were used to localize relaxin in sections of follicles from pregnant mare's serum gonadotropin (PMSG)/human chorionic gonadotropin (hCG)-primed pigs during preovulatory development. Prepubertal pigs were treated i.m. with PMSG (750 IU) and 72 h later with hCG (500 IU) to induce follicular development and ovulation. Follicles were collected from untreated gilts or from gilts 24, 48, 60, 72, 84, 96, or 108 h after PMSG treatment. Light immunostaining in the theca interna was observed early in follicular development, at 48 and 60 h post-PMSG. At 72 h post-PMSG, relaxin immunostaining in the theca interna of the preovulatory follicle was more intense. After hCG treatment, the intense thecal immunostaining persisted and was apparent 84 and 96 h after PMSG. At about 6 h prior to expected ovulation (108 h post-PMSG), there was thinning of the follicle wall and a reduction in relaxin immunostaining in the theca interna. Immunoactive relaxin was not detected in follicles from untreated gilts, follicles 24 h post PMSG, small healthy or atretic follicles, or in granulosa cells, theca externa or ovarian stroma, at any of the time points studied. These studies support the hypothesis that the theca interna is the primary source of follicular relaxin and provide further evidence for a paracrine role for relaxin in the ovulatory process. PMID- 3651549 TI - Biochemical evidence that human placental lactogen and human chorionic gonadotropin are not stored in cytoplasmic secretion granules. AB - The intracellular storage sites for the human placental hormones placental lactogen (hPL) and chorionic gonadotropin (hCG) are unknown. To determine whether hPL and hCG are stored in cytoplasmic secretion granules, we have compared the localization of hPL and hCG in placental homogenates following differential and density-gradient centrifugations to those of prolactin (PRL) and luteinizing hormone (LH) in human and rat pituitary homogenates. In the differential centrifugation studies, 93.1 +/- 4.1% (mean +/- SE) of the hPL and 79.4 +/- 6.0% of the hCG were detected in the postmicrosomal supernatant of placental homogenates. In contrast, 95-98% of the hPRL and hLH in the pituitary homogenates were detected in particulate fractions. Following centrifugation on sucrose density gradients, particulate hPL and hCG were distributed diffusely throughout the gradients, while greater than 90% of the pituitary hormones sedimented as single peaks with densities of 1.22 g/cm3. When human placental and rat pituitary tissues were homogenized together prior to differential and density-gradient centrifugations, similar marked differences were observed between the distribution of the placental and pituitary hormones. These results strongly suggest that the placental hormones hPL and hCG, unlike pituitary PRL and LH, are not stored in large secretory granules. Differences in the intracellular storage sites of the hormones may explain, in part, differences in the regulation of peptide hormone secretion by placental and pituitary tissues. PMID- 3651550 TI - Elution and rebinding of gonadotropins to receptors in corpora lutea: comparisons among treatments and species. AB - Several treatment regimens have been used to dissociate bound gonadotropins from their target tissues to quantify numbers of occupied receptors. To compare the efficacy of these methods, we evaluated the ability of a number of treatments to elute bound gonadotropins from corpora lutea of various species. In addition, we examined the capacity of luteal tissue to rebind gonadotropins after efficacious elution (greater than 90% dissociation of bound gonadotropin). Particulate (20,000 g) preparations of luteal tissue from pseudopregnant rats and from nonpregnant pigs and rhesus monkeys were incubated with 125I-labeled human luteinizing hormone (hLH, NIH-LH-11) or 125I-labelled chorionic gonadotropin (hCG, CR119) for 20 h at 25 degrees C to occupy gonadotropin receptors. Heat treatment (60 degrees C) eluted greater than 80% of bound 125I-hLH from rat tissue within 30 min, but similar treatment dissociated only 35% of 125I-hLH bound to porcine tissue (p less than 0.01). Likewise, heat treatment eluted only 57% of 125I-hLH bound to macaque tissue. At 4 degrees C, the following treatments dissociated greater than 90% of specifically bound 125I-hLH from porcine and rat luteal particulates within 5 min: acetic acid (pH 2.3), formic acid (pH 2.3), propionic acid (pH 2.3), acetic acid: HCl (pH 2.3 and 3.3), and MgCl2 (4 M). After 1-2 h at 4 degrees C, exposure to urea (4 M) or acetic acid:HCl (pH 4.3) also eluted greater than 90% of bound 125I-hLH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651551 TI - The numbers of Sertoli cells in mature Holstein bulls and their relationship to quantitative aspects of spermatogenesis. AB - Testes from 37 Holstein bulls, 38-99 mo of age, were used to investigate the relationship of Sertoli cell number, Sertoli cell-germ cell ratios and other related factors to daily sperm production (DSP). DSP was assessed by enumeration of spermatids in testicular homogenates, whereas Sertoli cell and germ cell ratios were based on direct counts in 20 round Stage VIII seminiferous tubular cross sections per bull. Numbers of Sertoli cells were calculated as (total homogenization resistant spermatids:spermatid:Sertoli cell ratio)/0.394; the factor of 0.394 adjusted for the presence of homogenization resistant spermatids during only 39.4% of the spermatogenic cycle. Data were subjected to simple linear and second-order regression analyses. Positive linear relationships were observed between DSP and testicular parenchymal weight (p less than 0.005, R = +0.71), DSP per gram (p less than 0.005, R = +0.79), total Sertoli cells (p less than 0.005, R = +0.83), Sertoli cells per gram (p less than 0.01, R = +0.47) and the yield of Step 8 spermatids per Type A spermatogonium (p less than 0.05, R = +0.34). DSP was not related (p greater than 0.10) to the number of germ cells supported per Sertoli cell. Testicular parenchymal weight and DSP per gram were unrelated to each other (p greater than 0.10), but both were related (p less than 0.005) to the total Sertoli cell number (R = +0.61 and +0.62, respectively). Total number of Sertoli cells accounted for more of the variation in DSP between bulls (R2 = 68.2%) than did any other factor examined. It was suggested that total Sertoli cell number may be an important determinant of a bull's spermatogenic potential. PMID- 3651552 TI - Evidence that a decrease in testosterone negative feedback mediates the pubertal increase in luteinizing hormone pulse frequency in male ferrets. AB - Neuroendocrine mechanisms regulating luteinizing hormone (LH) secretion during puberty were investigated in intact male ferrets and ferrets castrated at 8 wk of age that received s.c. implants of either empty or testosterone-filled Silastic capsules. To synchronize puberty onset among individuals, ferrets were exposed to short days between 8 and 16 wk of age, and then transferred to long days. Testis growth began in intact ferrets soon after photoperiod transition. Blood samples were obtained at 11, 15, 19, and 23 wk of age. LH pulse frequency was low in intact ferrets at 11 and 15 wk of age (less than or equal to 0.27 pulses/h), but rose to 0.94 pulses/h by 23 wk of age. No age-related increase in LH pulse frequency was observed in untreated castrated ferrets. LH pulses were rare in testosterone-treated castrated ferrets at 11 and 15 wk of age; but by 23 wk of age, frequency rose to 0.33 pulses/h. Thus, testis maturation in ferrets is accompanied by a dramatic increase in LH pulse frequency. No steroid-independent developmental increase in LH pulse frequency occurs in castrated ferrets. Furthermore, doses of testosterone that prevent LH secretion in young castrated ferrets do not as effectively suppress LH pulses in older ferrets. These data suggest that a decrease in the efficacy of testosterone negative feedback mediates the pubertal rise in LH pulse frequency in male ferrets. PMID- 3651553 TI - A comparison of histological and non-histological indices of atresia and follicular function. AB - Histological indices of atresia for bovine follicles greater than or equal to 5 mm in diameter were compared with potential non-histological indices of atresia such as opaqueness of the exposed surface of non-excised follicles, concentrations of steroids in follicular fluid (FF) and specific binding of gonadotropins by granulosal cells. Each non-excised follicle was classified as clear (n=86), intermediate (n=79), or opaque (n=115), on the basis of the appearance of its exposed surface. A section of tissue from each follicle was evaluated histologically for atresia and assigned to one of the following categories: non-atretic, intermediately atretic, strongly atretic, or luteinized atretic. Concentrations of estradiol (E), progesterone (P), and testosterone (T) and capacity of granulosal cells to bind radioactive ovine follicle-stimulating hormone (oFSH) and human chorionic gonadotropin (hCG) were determined for each follicle. Overall incidence of atresia was similar for clear (n=66%), intermediate (60%), and opaque (72%) follicles. Opaque follicles, however, were more likely to be strongly atretic (42%) than were clear (21%) or intermediate (23%) follicles. Non-atretic and intermediately atretic follicles had similar concentrations of E, P, and T and similar capacities to bind gonadotropins. Strongly atretic and luteinized-atretic follicles contained a higher concentration of P, lower E, and a reduced capacity of granulosal cells to bind oFSH than non-atretic and intermediately atretic follicles. A ratio of P:E in FF greater than or equal to 10 usually (greater than 90%) indicated that a follicle was atretic. However, lesser ratios of P:E did not accurately indicate whether follicles were atretic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651554 TI - Intermittent stimulation and acceleration of puberty by urinary chemosignals in female mice (Mus musculus domesticus). AB - A sequence of 17 experiments was used to test the effects of intermittent stimulation with urinary chemosignals on the age of puberty in young female mice. The three chemosignals tested all accelerate the age of sexual maturation: urine from adult males, urine from females in estrus, and urine from females that are pregnant or lactating. The basic technique involved presenting the prepubertal females with 'Nestlets' on which the urine was placed. The 'Nestlets' were placed in the cages of the test females for a 15-min period, removed for a variable period, and then replaced in the cage for 15 min. In this manner it was possible to vary the number of exposures, the total length of exposure, and the total time period over which the exposures occurred. Control procedures, involving exposures of young females to cotton squares with water rather than urine placed upon them, resulted in no alterations in puberty relative to untreated females. For mice exposed to the urine-treated cotton squares, acceleration of puberty occurred with less total stimulus-exposure time when the stimulus was presented in short exposures over a number of hours than in previous investigations when the exposure to the urinary chemosignal occurred in a single block of time of one or two hours. For each of the three acceleratory chemosignals, there was a diminution of acceleratory effect when the ratio of total stimulus-exposure time to total exposure time grew smaller. This diminution was more pronounced for urine from pregnant or lactating females than for urine from males or from females in estrus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651555 TI - Viscoelasticity of packed erythrocyte suspensions subjected to low amplitude oscillatory deformation. AB - Concentrated adult erythrocyte suspensions were subjected to low amplitude oscillatory shear in a Weissenberg rheogoniometer equipped with a cone-and-plate assembly. The dynamic viscoelastic properties of the suspension were measured over a broad range of frequency by a numerical solution that accounted for fluid inertia. Variation of shear amplitude and cell volume percent, and comparison of buffered saline, plasma, and dextran as suspending media showed that the cellular elements had undergone small bending and shearing deformations. Studies of normal adult erythrocytes, hypotonically swollen cells, temperature-altered cells, and erythrocyte ghosts suggested that the method was evaluating membrane material properties. The normal membrane was found to exhibit a shear rate dependent elastic modulus that increased by more than a factor of 20 over a frequency range from 0.0076 Hz to 60 Hz. The membrane viscosity showed a substantial drop with frequency indicative of a frequency thinning phenomenon. At high frequency of deformation the viscous response of normal erythrocytes was no longer indicative of a membrane property due to the dominant influence of the internal hemoglobin solution. The studies generally supported the ability of the method to quantify relative membrane material properties and detect changes in membrane structure. PMID- 3651556 TI - Biological membrane modeling with a liquid/liquid interface. Probing mobility and environment with total internal reflection excited fluorescence. AB - Total internal reflection of exciting light, in combination with fluorescence intensity and polarization measurements, was used to selectively study fluorescent compounds adsorbed to the interface region between two immiscible liquids. A fluorometer was constructed which provided excitation at variable angles of incidence and allowed sensitive detection of polarized fluorescence emitted from the interface. The compound 4,4'-bis-1-phenylamino-8 naphthalenesulfonate (bis-ANS) was examined at a decalin/water interface and was found to possess remarkable affinity for the interface region with the bulk of the adsorbed molecule residing in the decalin phase. The adsorbed fluorophore displayed an apparent hindered rotation in the plane of the interface with a rotational diffusion coefficient 3- to 12-fold lower than that expected for bis ANS in solution. While other dyes examined were not found to be significantly surface active, the addition of cationic surfactant sufficed to induce adsorption of the anionic fluorophore 1-aminonaphthalene-3,6,8-trisulfonic acid. This fluoropore was found to reside in an aqueous environment when bound to the interface, and it also exhibited hindered rotation in the plane of the interface. As the concentrations of the dyes were increased, both adsorbed dyes exhibited polarization reductions consistent with excitation energy transfer. Adsorption of bis-ANS was reversed by addition of bovine serum albumin. The membrane protein cytochrome b5 was found not to bind at the decalin/water interface, indicating that interaction with lipid is required for its adherence to biological membranes. PMID- 3651557 TI - Phospholipid monolayers between fluid and solid states. AB - Monolayers of the phospholipid dimyristoyl phosphatidic acid on the surface of water have been studied by a combination of the new techniques of synchrotron x ray diffraction and fluorescence microscopy with classical surface pressure data. The pressure vs. area isotherm changes slope at the surface pressures pi c and pi s. The optical technique demonstrates that between pi c and pi s the fluid phase coexists with a denser "gel" phase. Electron diffraction data have shown that the gel phase has bond orientational order over tens of micrometers. However, the x ray data demonstrate that positional correlations extend only over tens of angstroms. Thus, the gel phase is not crystalline. Above pi s a solid phase is formed with a positional correlation range that is eight times longer for the chemically purest films. PMID- 3651558 TI - Mechanical equilibrium of thick, hollow, liquid membrane cylinders. AB - The mechanical equilibrium of bilayer membrane cylinders is analyzed. The analysis is motivated by the observation that mechanically formed membrane strands (tethers) can support significant axial loads and that the tether radius varies inversely with the axial force. Previously, thin shell theory has been used to analyze the tether formation process, but this approach is inadequate for describing and predicting the equilibrium state of the tether itself. In the present work the membrane is modeled as two adjacent, thick, anisotropic liquid shells. The analysis predicts an inverse relationship between axial force and tether radius, which is consistent with experimental observation. The area expansivity modulus and bending stiffness of the tether membrane are calculated using previously measured values of tether radii. These calculated values are consistent with values of membrane properties measured previously. Application of the analysis to precise measurements of the relationship between tether radius and axial force will provide a novel method for determining the mechanical properties of biomembrane. PMID- 3651559 TI - Pretranstional phenomena in phospholipid/water multilayers. AB - We have measured the water order in monodomain phospholipid samples using 2H nuclear magnetic resonance (NMR) and analyzed the splittings in terms of critical exponents. Our data and the model developed to interpret them in terms of fluctuations provide an explanation of the puzzling sharp reduction of water order near the chain-ordering phase transition. The temperature range of the fluctuations is approximately the same as that observed for increased 22Na+ efflux from phospholipid vesicles. PMID- 3651560 TI - The stall torque of the bacterial flagellar motor. AB - The bacterial flagellar motor couples the flow of protons across the cytoplasmic membrane to the rotation of a helical flagellar filament. Using tethered cells, we have measured the stall torque required to block this rotation and compared it with the torque of the running motor over a wide range of values of proton-motive force and pH. The stall torque and the running torque vary identically: both appear to saturate at large values of the proton-motive force and both decrease at low or high pH. This suggests that up to speeds of approximately 5 Hz the operation of the motor is not limited by the mobility of its internal components or the rates of proton transfer reactions coupled to flagellar rotation. PMID- 3651561 TI - Lateral interactions among membrane proteins. Valid estimates based on freeze fracture electron microscopy. AB - We consider the lateral distribution of intrinsic membrane proteins from the viewpoint of the statistical-mechanical theory of liquids. We connect the information in freeze-fracture electron micrographs--positions of proteins but not lipids or aqueous species--to a well developed theory of liquid mixtures. An algorithm, based on the Born-Green-Yvon integral equation, is presented for deducing forces between proteins from correlations among protein positions that are observed in micrographs. The algorithm is tested on simulated micrographs, obtained by Monte-Carlo methods, where forces between proteins are known analytically. We conclude that valid estimates of such forces, both attractions and repulsions, can be obtained from the positions of a few thousand proteins. PMID- 3651562 TI - Lateral interactions among membrane proteins. Implications for the organization of gap junctions. AB - We have studied the relationship between interprotein forces and the lateral distribution of proteins in disordered mouse liver gap junctions. Data on protein positions are obtained from freeze-fracture electron micrographs. Short-ranged correlations in observed positions are characteristic of interacting particles in a fluid state. An analysis derived from statistical mechanics allows the determination of the magnitude and functional form of interprotein forces. We find that jap junction proteins are mutually repulsive, in a manner consistent with electrostatics and excluded volume. This dictates that long-ranged protein aggregation into jap junction plaques cannot arise solely from interparticle interactions. An alternative is the balance of lateral pressures between the junction and the surrounding glycocalyx. This idea is quantified into a model. Junctional pressure arises from protein-protein interactions and is computed from a pressure equation based on the force and a radial distribution function describing order. The pressure from the glycocalyx is assumed to arise from mixing, electrostatic, and elastic interactions of sugar residues, and is described with terms from Flory-Krigbaum and McMillan-Mayer theories. The results of this modeling are in reasonable agreement with available experimental data. PMID- 3651563 TI - Uranyl acetate induces gel phase formation in model lipid and biological membranes. AB - The effect of uranyl acetate on the mesomorphic phase state of lipids in model membranes as well as in isolated biological membranes has been examined. As little as 0.8 mM (0.03% [wt/vol]) uranyl acetate induces a liquid crystal-to-gel phase transformation in egg phosphatidic acid, bovine brain phosphatidylserine, and in lysed chromaffin granule membranes. These results along with others in the literature indicate that the uranyl acetate used in samples for electron microscopy could alter membrane morphology. PMID- 3651564 TI - How to correctly match 175,000 neurites: two postulates for a quick solution. AB - I propose two postulates that allow precise matching of an indefinite number of neurites when repairing a transected nerve. The first one, based on the principle of de Saint-Venant, indicates how to keep nerve fibers in proper longitudinal alignment, by diverting stress to an appropriate distance from the tip of the stumps. The second postulate, based on the symmetrical mechanical resistance of the stumps, indicates how to restore correct transversal alignment of the fibers, by circularizing the severed nerve extremities. PMID- 3651565 TI - A transfer-function representation for regulatory responses of a controlled metabolic pathway. AB - A transfer-function representation for the response of a controlled metabolic pathway to the changes in influx and efflux rates of metabolites is formulated to describe analytically and approximately the regulatory behavior of the pathway around a steady state. The pathway model analyzed is an open and homogeneous system which consists of two consecutive enzymatic reactions catalyzed by an allosteric enzyme of Monod-Wyman-Changeux (MWC) dimeric model and a Michaelis Menten-type enzyme, respectively, and undergoes the feedback inhibition by the end product. The rate equation for the system (a system of ordinary differential equations) is linearized about a steady state, so that the responses of the reaction rates to the changes in influx rate of the substrate and efflux rate of the end product are expressed in a form of transfer function. The formulation leads to the transfer function for the response of production rate of the end product to the change in its efflux rate to clarify the regulatory response of feedback mechanism in controlled metabolic pathways. The relationship among the chemical species in the system at steady states also supports a reasonable assumption that the regulatory mechanisms in metabolic pathways are to control the production of end product against the change in its demand from the cellular environments. PMID- 3651566 TI - A universe for molecular modeling of self-replication. AB - An abstract two-dimensional universe is presented, in which self-replication can be modeled and studied by computer simulation. Two types of permanent elements (atoms) occupy squares of the universe. Atoms sharing a common square form a particle, with properties determined by its component atoms. Atoms, particles, and complexes of particles move and collide according to rules like those of classical mechanics. At a higher level of organization, the string of atoms in a particle is viewed as a program, whose execution can affect the space around the particle in ways similar to the operation of enzymes. Two systems that exhibit self-replication when embedded in the universe are demonstrated. The first is very simple showing elementary self-replication activity. The second is relatively elaborate and intended to show "on paper" how a collection of particle complexes could behave in a manner resembling mitosis in a simple cell. PMID- 3651567 TI - On the dynamics of controlled metabolic network and cellular behaviour. AB - The existence of elaborate control mechanisms for the various biochemical processes inside and within living cells is responsible for the coherent behaviour observed in its spatio-temporal organisation. Stability and sensitivity are both necessary properties of living systems and these are achieved through negative and positive feedback loops as in other control systems. We have studied a three-step reaction scheme involving a negative and a positive feedback loop in the form of end-product inhibition and allosteric activation. The variety of behaviour exhibited by this system, under different conditions, includes steady state, simple limit cycle oscillations, complex oscillations and period bifurcations leading to random oscillations or chaos. The system also shows the existence of two distinct chaotic regimes under the variation of a single parameter. These results, in comparison with single biochemical control loops, show that new behaviours can be exhibited in a more complex network which are not seen in the single control loops. The results are discussed in the light of a diverse variety of cellular functions in normal and altered cells indicating the role of controlled metabolic network as the underlying basis for cellular behaviour. PMID- 3651568 TI - A numerical model for blood oxygenation in the pulmonary capillaries--effect of pulmonary membrane resistance. AB - A study of the blood oxygenation in pulmonary capillaries is made by considering the transport mechanisms of molecular diffusion, convection and the facilitated diffusion due to the presence of haemoglobin. The resistance offered by the pulmonary membrane on the transport of gases has been incorporated. The resulting system of coupled, non-linear partial differential equations is solved numerically. It is found that, in the immediate neighbourhood of the entry, the amount of dissolved O2 decreases. This decreases further as the resistance offered by the pulmonary membrane increases. The rate of oxygenation of blood increases as the permeability coefficient for O2 (PO) increases. It is shown that the ideally permeable case for both O2 and CO2 can be approximated by taking PO approximately 10 cm/s. Further, it is shown that the oxygen takes longest and CO2 is the fastest to attain equilibration. The equilibration length increases as the resistance offered by the membrane increases. Finally, some of the pulmonary diseases such as pulmonary oedema and fibrosis have been analyzed. PMID- 3651569 TI - Medical and experimental mammalian genetics: a perspective. PMID- 3651570 TI - The inception of the North American Society of Biorheology and the growth of biorheology as an organized science. PMID- 3651571 TI - Platelet adhesion to fibrinogen-coated glass at an abrupt tubular expansion viewed with fluorescent video-microscopy. AB - The adhesion and detachment of human washed platelets was studied on the surface of the larger tube of a tubular expansion. Measurements were made within the vortex, at the reattachment point and downstream of the vortex. Fluorescent video microscopy of mepacrine labelled platelets was used to record data continuously. Flow was from the smaller to the larger tube at Reynolds numbers (based on upstream conditions) of 75.4 and 212.2. Measurements of the adhesion efficiency for initially contacting cells and an overall adhesion efficiency were made. These efficiencies decreased with increasing Reynolds number. There was a pattern of variability for both efficiencies with respect to position and Reynolds number which is consistent with the generation of the unstable flow at the reattachment point. PMID- 3651572 TI - Cell wall elastic constitutive laws and stress-strain behavior of plant vegetative tissue. AB - The appropriateness of several elastic constitutive laws for apple and potato cell walls is tested using uniform cell inflation data. Whole-tissue stress strain behavior under uniaxial loading is predicted from an analysis of the compression of a conglomerate of cells in a simple arrangement. PMID- 3651573 TI - Pulsatile flow of Casson's fluid through stenosed arteries with applications to blood flow. AB - The effects of non-Newtonian nature of blood and pulsatility on flow through a stenosed tube have been investigated. A perturbation method is used to analyse the flow. It is of interest to note that the thickness of the viscous flow region is non-uniform (changing with axial distance). An analytic relation between viscous flow region thickness and red cell concentration has been obtained. It is important to mention that some researchers have obtained an approximate solution for the flow rate-pressure gradient equation (assuming the ratio between the yield stress and the wall shear to be very small in comparison to unity); in the present analysis, we have obtained an exact solution for this non-linear equation without making that assumption. The approximate and exact solutions compare well with one of the exact solutions. Another important result is that the mean and steady flow rates decrease as the yield stress theta increases. For the low values of the yield stress, the mean flow rate is higher than the steady flow rate, but for high values of the yield stress, the mean flow rate behaviour is of opposite nature. The critical value of the yield stress at which the flow rate behaviour changes from one type to another has been determined. Further, it seems that there exists a value of the yield stress at which flow stops for both the flows (steady and pulsatile). It is observed that the flow stop yield value for pulsatile flow is lower than the steady flow. The most notable result of pulsatility is the phase lag between the pressure gradient and flow rate, which is further influenced by the yield stress and stenosis. Another important result of pulsatility is the mean resistance to flow is greater than its steady flow value, whereas the mean value of the wall shear for pulsatile flow is equal to steady wall shear. Many standard results regarding Casson and Newtonian fluids flow, uniform tube flow and steady flow can be obtained as the special cases of the present analysis. Finally, some applications of this theoretical analysis have been cited. PMID- 3651574 TI - Abstracts of the ninth annual meeting of the Japanese Society of Biorheology. Ehime, Japan, 13-15 June 1986. PMID- 3651575 TI - Poiseuille Award lecture. New trends in biorheology. AB - A trend of engineering approach to physiology is to predict physiological events with mathematical accuracy. In order to achieve this objective, it is necessary to know the structure of the organs and the mechanical properties of their components; i.e., the anatomy, histology, and rheology of the system. Then one must perform the analysis rationally, avoiding ad hoc assumptions as far as possible. To illustrate this aspiration, procedure, labor, and rewards, the case of pulmonary circulation is discussed. For cat lung, anatomical and rheological data were collected; biorheological analysis was done, and physiological experiments were compared with theoretical predictions. Satisfactory results were obtained. The case of flow under zone 2 condition, when "waterfall phenomenon" prevails, is especially interesting. We proved theoretically that any partial collapse of an interalveolar septum is unstable. Hence if a collapse is initiated in an interalveolar septum, the whole septum will be collapsed. From this theoretical result, the pressure-flow relationship is predicted and is shown to agree well with the experiment. New trends toward cell biology and molecular approach are evident in this meeting. Some anticipated trends are, however, still slow in coming. PMID- 3651576 TI - The theory of macromolecular networks. AB - Network theory has evolved from the simplest rubber materials and is just entering the biological area. The existing theories are studied and the modifications required for biological applications are reviewed. The issues involved are: the balance between entropy and internal energy, the rigidity and flexibility of molecules, the stability of the networks, the origin of the intermolecular forces and the entanglement problems of swelling and precipitation. PMID- 3651577 TI - Interactions between haemodynamic and biochemical factors causing transient ischaemic attacks and strokes. PMID- 3651578 TI - The actin system and the rheology of peripheral cytoplasm. PMID- 3651579 TI - Viscoelastic properties of whole blood. Influence of fast sedimenting red blood cell aggregates. AB - Red blood cell (RBC) aggregation is known to be of deciding influence on erythrocyte sedimentation-rate (ESR) and on whole blood viscoelastic properties. The rheological behaviour of blood collected from a control-group with normal ESR is compared to the viscoelastic behaviour of blood collected from two groups with high to very high ESR, whose individuals are suffering from chronical polyarthritis and Morbus Bechterew, respectively. The rheological properties are evaluated by means of an oscillating-flow capillary-rheometer where the viscous (eta') and elastic (eta") component of the complex viscosity (eta) is measured at a constant frequency of 2 Hz. Correcting for the varying hematocrit of the different blood samples according to an exponential equation, the viscoelastic data are found to be elevated in the groups with high ESR. For the viscous properties this is only due to the increase of the plasma viscosity. A correction for the plasma viscosity, however, shows that the viscous properties at low shear rates (2s-1) are significantly reduced, whereas elastic properties in a range of medium shear-rates (10s-1 to 50s-1) are significantly increased (P less than 0.001, t-test of Student). This result is discussed to be due to the high packing density of the RBC in fast sedimenting aggregates. High packing density reduces the effective volume of the RBC but increases the stiffness of the aggregates. PMID- 3651580 TI - Electrostatic free energy and spontaneous curvature of spherical charged layered membrane. AB - A biophysical model for the equilibrium curvature of a composite membrane element is derived taking into account the mechanical bilayer properties and the adjacent charged protein layers. The minimum of the total free energy density with respect to the curvature of such a membrane curved was estimated from the sum of the electrostatic free energy density of the charges of the membrane and the elastic surface energy density due to bending the lipid bilayer membrane. It was shown that the equilibrium curvature, i.e. the spontaneous curvature, of such a charged composite sandwich-like membrane depends inversely on the bending stiffness of the lipid membrane itself and directly on the charge amount inside and outside the membrane to the second power. Furthermore the geometric and electrostatic structure of the protein layers and the physico-chemical environment conditions are involved. Corresponding to the model developed a "standard RBC" membrane element has a negative spontaneous curvature, accounting for a discocyte RBC shape. The shape change from a discocyte to a more stomatocytic shape (increase in the negative spontaneous curvature) after reducing the charges in the glycocalyx is also explained within this model. PMID- 3651581 TI - Characteristics of secondary flow in steady and pulsatile flows through a symmetrical bifurcation. AB - Steady and pulsatile flow in a glass model simulating an arterial bifurcation was investigated by flow visualization techniques. Secondary flow generated at the bifurcation has a similar pattern to a vortex, called the horseshoe vortex, produced around a wall-based protuberance in a circular tube. The same flow disturbance was clearly observed during the decelerating phase of pulsatile flow. The vortex produces a stagnation point on the top and bottom wall just upstream from the bifurcation apex. When aluminium dust was suspended in the test fluid perfusing the blood vessel model, particles deposited over an area spreading from the stagnation point to the lateral corners of the bifurcation. Comparison between the present results and topographical patterns of atherosclerosis reported in the literature suggests that it is in such low shear regions that lipid deposition tends to occur most. PMID- 3651582 TI - Theory of filtration of mixed blood suspensions. AB - A theory is developed for the flow of suspensions of blood cells through filters in which the properties of the cells are defined by statistical distributions. It is shown that conditions are generally transient, and computational procedures are developed to compute the pressure drop and the fraction of the pores of the filter containing cells of various types as a function of time. The computations show a large influence of very small concentrations of stiff cells which gradually collect in the filter and effectively plug the filter during the time of a typical test. It is also shown that the mean value of the resistance offered by a cell population with a limited distribution of resistances is more important than dispersion of resistances about the mean in determining the observable pressure curve. Experimental data are presented demonstrating that the drug pentoxifylline reduces the stiffness of leukocytes. PMID- 3651583 TI - Flow characteristics of red cell containing fluids through pores. The effect of filter plugging, a mathematical model. AB - A mathematical model was developed that describes the effects of filter plugging on flow through 3 micron pore polycarbonate filters as a function of time, pressure, and cell concentration, both under stirring and nonstirring conditions. The mathematical constants for the model were derived from experimental data generated with a filtration apparatus, and were tested by using various concentrations of cells that are able to plug filter pores. A computer simulation program was written to test the model over a wide range of nonfilterable cell concentrations. PMID- 3651584 TI - The hemodynamic destruction of circulating cancer cells. AB - The blood-stream is the major disseminative route for metastasizing cancer cells, and metastases are generated when the cancer "microemboli" are trapped in the microcirculation. However, most circulating cancer cells are rapidly destroyed shortly before and/or after arrest. Traditionally, destruction is attributed to the cellular or humoral response of the host defense systems. A novel, non exclusive mechanism for cancer cell destruction has been proposed by Weiss and Dimitrov in which friction or adhesion between circulating cancer cells and capillary walls causes local vascular blockage, and the blood-pressure differentials normally existing over the entire length of a capillary are consequently applied over the length of the cancer cell. In a simple model, this pressure differential is expected to cause expansion of the cancer cell membrane, resulting in increases in tension above a critical level, with consequent membrane rupture and cell death. In vivo and in vitro experimental tests of this hypothesis are outlined. PMID- 3651585 TI - Dynamics of cancer cell interactions with microvasculature and interstitium. AB - Interactions of cancer cells with the microvasculature and the interstitium of non-malignant tissue were studied in a rabbit ear chamber preparation using intravital fluorescent microscopy. Injection of VX2 carcinoma cells into the auricular artery feeding the chamber led to mechanical entrapment, adhesion, and in some instances, extravasation of cancer cells. Implantation of VX2 cells in the interstitial space led to increases in the interstitial diffusion coefficients and the microvascular permeability. Our results are compared with those available in literature and directions for future research are pointed out. PMID- 3651586 TI - The role of platelets in metastasis. PMID- 3651587 TI - Leukocyte kinetics in the microcirculation. AB - The transport of leukocytes in the microcirculation is specific for the type, size, and the rheological and adhesive properties, the microanatomy of the host organ, and the hemodynamics. The adhesion to the endothelium is determined largely by the degree of activation via chemotactic factors. Leukocyte motion differs from that of red cells or platelets in several respects. When granulocytes enter into capillaries, they are deformed just like red cells. Under normal flow conditions, the time to deform at the entry to capillaries is typically 1,000 times larger than for the red cell, leading to temporary obstruction of the capillaries. After entry, granulocytes move with lower velocity than red cells which causes a cell train formation inside the capillary. At the venular side, the granulocyte is displaced from the center stream toward the endothelium by faster moving red cells. This process leads to systematic attachment of the granulocytes to the endothelium. At a reduced perfusion pressure or in the presence of locally elevated levels of chemotactic factors, the granulocytes may not be able to pass through the capillary network, which leads to microvascular obstruction. Organs with a narrow capillary network may thereby become filters for circulating granulocytes. This event is accompanied in many situations with damage to the host organ. PMID- 3651588 TI - Erythrocyte sedimentation rate. I. Volume fraction dependence in saline solution. AB - We have measured volume fraction dependence of the sedimentation curve of swine erythrocytes in a physiological saline solution at 10 degrees C, 20 degrees C, 30 degrees C and 40 degrees C. The sedimentation curves were found to consist of initial constant velocity region and final plateau region at the lower temperatures of 10 degrees C and 20 degrees C, while modified S-shaped curves were observed at the higher temperatures of 30 degrees C and 40 degrees C. The volume fraction dependence of the initial slope v of the sedimentation curve was fitted well to the following exponential type equation at all the temperatures: v = vs,exp (1 - H)exp[-(BH + CH2)] where vs,exp is the velocity in infinite dilution corresponding to the Stokes velocity and H is the volume fraction of erythrocytes. The volume fraction dependence of the relative velocity v/vs,exp was in close agreement with a semi-empirical equation derived for slurrys in the field of chemical engineering at the lower temperatures, while a small deviation between the observed and calculated curves was found at the higher temperatures. The volume fraction dependence of v at 20 degrees C was also analyzed on a theory recently developed by Oka. The explicit functional form of the medium up-flow factor phi (H) and the deformability factor f in the theory were determined using the experimental data. PMID- 3651589 TI - The apparent viscosity of aggregating and non-aggregating erythrocyte suspensions in the isolated perfused liver. AB - Vasodilated guinea pig livers were perfused with normal erythrocytes and echinocytes suspended in isoviscous high- and low-molecular-weight dextran solutions. The relative flow resistance of these suspensions and the oxygen uptake of the livers were then determined. The relative flow resistance of the echinocytes that were suspended in high-molecular-weight dextran, however, was significantly higher than that of any other red cell suspension. The oxygen uptake was independent of the perfusion media. It is proposed that high-molecular weight dextran induces echinocytes to attach to one another, and that this clumping together, and shape-transformation of red cells, hinders their flow in the vasodilated liver. PMID- 3651590 TI - Biorheology and fluid flux in swelling tissues. I. Bicomponent theory for small deformations, including concentration effects. AB - A theory for the rheological behavior and fluid flux in swelling tissues under small deformations is presented. Tissues are considered as bicomponent solid fluid mixtures. Concentration effects are included. The driving forces (body, surface and interactive), are discussed and their constitutive relationships to the tissue's deformation are specified. Mass and momentum balance equations are developed for each component and for the tissue as a whole. The concept of swelling stress emerges from the theory as an anisotropic generalization of the commonly used swelling pressure. It is shown to be a measure of the total chemical potential combining both mechanical and concentration effects. The theory shows that concentration effects modify the tissue's bulk stiffness in a manner consistent with experimental observations. PMID- 3651591 TI - Biorheology and fluid flux in swelling tissues, II. Analysis of unconfined compressive response of transversely isotropic cartilage disc. AB - The response of a cartilage disc to unconfined compressive loading under small deformations is analyzed. The cartilage is considered as a transversely isotropic bicomponent (solid-fluid) tissue. Concentration effects (commonly termed osmotic pressure) are accounted for. The tissue's permeability is taken to be isotropic. Its concentration force is assumed to vary linearly with volume. The analysis shows that if the tissue's fibrous structure is taken into consideration, then the instantaneous response to a step loading depends on the tissue's elasticity and on its concentration force. The subsequent creep response, under commonly used experimental conditions, has a time constant which depends on the concentration force and permeability, but independent of its elastic response. The equilibrium volume is predicted to depend only on the concentration force. Where data is available it confirms the model's predictions. It is concluded from the present analysis that inclusion of concentration effects and the tissue's fibrous structure has significant consequences in terms of the relative roles of the collagen fibers (solid) vs. the ground substance (fluid) in the response of the cartilage to compressive loading. PMID- 3651592 TI - Measurements of viscosity of synthetic erythrocyte suspensions. AB - Measurements were made of the viscosity of suspensions of synthetic erythrocytes composed of hemoglobin solutions encapsulated in liposomes, as a function of shear rate, temperature, suspension concentration, lipid membrane composition, and the viscosity of the suspending medium. It was found that the viscous behavior of the synthetic erythrocyte suspensions was non-Newtonian and nearly the same as that of suspensions of natural erythrocytes prepared similarly, with the major difference being that synthetic erythrocyte suspensions are somewhat more viscous. Suspensions of Fluosol FC-43 prepared similarly were found to be essentially Newtonian fluids, and substantially different and more viscous than either erythrocyte suspension. The higher viscosity of synthetic erythrocyte suspensions probably accounts for the ability of these suspensions to maintain normal systemic vascular resistance in transfusion experiments, in spite of the fact that synthetic erythrocytes are smaller than natural erythrocytes. PMID- 3651593 TI - Bulk modulus of dispersions of spherical shell structures taking into account interfacial tensions. AB - The bulk modulus of a dilutely dispersed system of spherical shell structures is obtained taking into account interfacial tensions at both the interfaces of the shell as follows: (Formula: see text) where Q = K'Km - delta K' delta MA3, Q' = K' delta K - delta K'KA3, Km = 3 kappa m + 4 microns - 2 gamma/a, delta K = 3 kappa m - 3 kappa - 2 gamma/a, delta M = 4 microns + 2 gamma/a, K = 4 microns + 3 kappa + 2 gamma/a, K' = 3 kappa' + 4 microns - 2 gamma'/a', delta K' = 3 kappa m- 3 kappa' + 2 gamma'/a', A = a'/a, a and a' are the outer and the inner radii of the shell, gamma and gamma' the interfacial tensions at r = a and r = a', in which r is the radial distance from the origin at the center of the shell structure, kappa and mu the bulk modulus and the rigidity of the medium, in which the prime and the subscripts m denote the quantities for the inside (r less than a') and the shell (a' less than r less than a) regions, respectively, and c the volume concentration of shell structures. PMID- 3651594 TI - A direct measuring capillary viscoelastometer for mucus. PMID- 3651595 TI - On diffusion in organized assemblies and in biological membranes. AB - The following paper is a brief presentation of problems related to the concepts of diffusion coefficient D and so-called viscosity eta used to characterize the cohesion of biological membranes. The first approach to this problem is a recall of the definition of D and eta in liquids. It appears that the models developed with exogenous probes to account for the diffusion-viscosity relationship are not verified in membranes. The existence of complex diffusional mechanisms, the influence of the size of the probe are presented. The results of a model calculation suggest that there is no direct correlation other than great simplifications, between the diffusion coefficient and viscosity. The calculations are then extended to actual biological assemblies and the influence of proteins on the motion of the probe considered. The limitations of the methods involving exogenous probes for determining the cohesion of biological membranes are discussed. PMID- 3651596 TI - Sixth International Congress of Biorheology. Symposium on Interactions of Cancer Cells with the Microvasculature. Vancouver, B.C., Canada, 27 July to 1 August 1986. Proceedings. PMID- 3651597 TI - Carrier testing in hemophilia B with an immunoassay that distinguishes a prevalent factor IX dimorphism. AB - Immunoassays with a monoclonal antibody (A-1) detect a prevalent dimorphism in plasma coagulation factor IX. The antibody was shown to react with a dimorphic segment of the normal factor IX sequence as follows. First, A-1 bound to isolated activation peptide (residues 146 through 180) prepared from activated factor IX from a normal plasma pool. Second, binding of recombinant factor IXs with A-1 or factor IX from normal individuals was strong only when they had Threonine (Thr) at position 148; factor IXs with the Alanine (Ala) allele at that position were far less reactive. Third, immunoblot reactivity of Escherichia coli fusion proteins containing known segments of the factor IX sequence restricted the epitope to residues 147 through 153. In 120 hemophilia B pedigrees, the Ala immunoassay allele frequency was 0.19 and did not differ from the Ala frequency in normal males. In 22 of 49 families, immunoassay testing was informative for classification of obligate or possible carriers. In one large family, 4 obligate carriers were heterozygous for the dimorphism and 3 of their 7 daughters were classified as carriers. In other families, when the affected member had less than 1 nmol/L factor IX antigen, heterozygosity for Thr/Ala alleles excluded the carrier state even when DNA studies were not informative. Strong linkage disequilibrium of Thr/Ala alleles with the common TaqI DNA polymorphism was found. Nineteen of 75 normal and hemophilic factor IX genes had the 1.3-kilobase (kb) fragment and coded for the Ala allele; the rest had the 1.8-kb fragment and coded for Thr. In selected families, the A-1 immunoassay is an inexpensive and rapid method to confirm and supplement restriction fragment length polymorphism analyses of DNA for carrier testing. PMID- 3651598 TI - Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP. AB - Chronic immune thrombocytopenic purpura (ITP) is due to platelet destruction by circulating antiplatelet antibody. Although autoantibodies against the platelet glycoprotein IIb/IIIa (GPIIb/IIIa) complex and GPIb have been demonstrated using various methods, practical assays for detection of platelet-associated or plasma autoantibodies have not been available. We studied 59 patients with chronic immune thrombocytopenic purpura in whom platelet-associated and plasma autoantibodies against the GPIIb/IIIa complex and GPIb were measured using a newly developed immunobead assay and a previously reported microtiter-well assay. Platelet-associated autoantibody was detected using the immunobead assay in 21 of 28 patients (75.0%; 13 with anti-GPIIb/IIIa, 8 with anti-GPIb). Plasma autoantibodies were noted in 34 of 59 patients (57.6%; 21 with anti-GPIIb/IIIa, 11 with anti-GPIb, and 2 with both). Positive results were noted in 30 of 59 patients using the immunobead assay and in only 14 of 59 using the microtiter well assay, suggesting that solubilization of the platelets prior to antibody addition, as in the microtiter-well assay, alters epitope stability. Of the 31 thrombocytopenic control patients studied, all gave negative results using both assays. We conclude that these clinically adaptable assays allow detection of autoantibodies in most patients with chronic ITP, confirming the presence of an autoimmune process. PMID- 3651599 TI - Survival after antilymphocyte globulin therapy for aplastic anemia depends on disease severity. AB - Sixty-four patients with aplastic anemia were treated with antilymphocyte globulin (ALG Merieux) between 1980 and 1985. The actuarial survival for all patients was 53% at 6 years, with 79% survival for nonsevere aplastic anemia (NSAA) and 36% for severe aplastic anemia (SAA). The neutrophil and platelet counts before treatment with ALG were highly predictive of survival, whereas sex, age, and etiology were not. Duration of disease prior to ALG treatment was inversely related to survival, although this was not statistically significant. Survival was closely associated with response to ALG, especially for patients with SAA. The response to one course of ALG was 33%. Eighteen patients who did not respond to an initial course of ALG received a second course; of these, four (22%) responded. The overall response to one or two courses of ALG was 40%. The mean RBC volume (MCV) measured after ALG treatment was a useful early indicator of response. Both the minimum lymphocyte count during ALG therapy and the mean lymphocyte count after therapy, however, were not significantly different between responders and nonresponders. The disappointing survival of patients with SAA in this study may reflect the poor clinical condition of severely affected patients referred to us and/or the presence of longstanding aplasia. The importance of studying a large series of patients with long-term follow-up to assess ALG in the treatment of aplastic anemia is shown by this investigation. PMID- 3651600 TI - The molecular species composition of phosphatidylcholine affects cellular properties in normal and sickle erythrocytes. AB - The phosphatidylcholine specific transfer protein (PCTP) from bovine liver was used to retailor the molecular species composition of phosphatidylcholine (PC) in the membrane of normal (AA) and sickleable (SS) human erythrocytes. Changes in molecular species composition of PC altered morphology as well as cellular deformability and stability as measured with ektacytometry. In normal cells, replacement of native PC with 1-palmitoyl,2-arachidonoyl PC (PAPC) resulted in a decrease in osmotic fragility with no change in hydration, whereas replacement with 1,2-dipalmitoyl PC (DPPC) led to an increased osmotic fragility and cellular hydration. Replacement of native PC by 1-palmitoyl,2-oleoyl PC (POPC) in normal cells had no apparent effect on these parameters. In contrast, replacement of native PC in sickle cells with either PAPC, DPPC or POPC led to cellular hydration. Facilitation of PC exchange between subpopulations of SS cells separated on buoyant density also led to cellular hydration. These observations suggest that the state of hydration of sickle cells can be modified by the fatty acyl composition of PC and illustrate a a role for the lipid core in the observed permeability changes in sickle erythrocytes. They also raise the interesting possibility that the state of cellular hydration of sickle cells may be modulated by altering the molecular species composition of the membrane phospholipids. PMID- 3651601 TI - Evidence that microenvironmental factors account for the age-related decline in neutrophil function. AB - We measured the function of neutrophils harvested from the supernatant of long term marrow cultures in which stromal cell cultures derived from young mice were recharged with hematopoietic cells from old mice and vice versa. The functions measured were superoxide generation and enzyme secretion (lysozyme and glucuronidase), following cell activation by either phorbol myristate acetate (PMA) or Formyl-methionyl-leucyl-phenylalanine (FMLP). In addition we measured cytosolic calcium concentration and its increase following activation by FMLP. In all culture combinations recharge resulted in the recovery of greater than 2 X 10(6) cells/flask (95% neutrophils, 98% viable). Histologic studies of cytoplasmic markers indicated that recovered neutrophils were derived from the stem cell population employed for recharge. For each neutrophil parameter measured, function was markedly improved when old hematopoietic stem cells were recharged onto a young stroma and was significantly diminished when young stem cells were recharged onto an old stroma. This applied to superoxide generation, basal and stimulated enzyme levels, and to basal cytosolic calcium concentration and its increase following activation by FMLP. These results indicate that when old hematopoietic stem cells proliferate in a young microenvironment, neutrophil function returns virtually to normal. Conversely, function diminishes when young stem cells proliferate in an old stroma. These findings demonstrate, for the first time, that neutrophil function is modulated by microenvironmental factors, hormonal, cellular, or matrix, which are decreased in the elderly. That an age related decline in function is extrinsic to the cell and is reversible has significance for the study of neutrophil function and of cellular aging and has potential therapeutic implications. PMID- 3651602 TI - Adenosine dialdehyde and nitrous oxide induce HL-60 differentiation. AB - Adenosine dialdehyde and nitrous oxide, specific S-adeno-sylhomocysteine hydrolase and methionine synthetase inhibitors, respectively, induced differentiation of the human promyelocytic cell line HL-60. Their effect did not appear to be mediated through changes in transmethylation or decreased S adenosylmethionine synthesis because (1) there was little correlation between the concentrations of adenosine dialdehyde that induced differentiation and those that changed the ratio of the intracellular concentrations of S adenosylmethionine to S-adenosylhomocysteine, and (2) inhibition of methionine adenosyltransferase by cycloleucine did not induce differentiation. The differentiation induced by adenosine dialdehyde was prevented by homocysteine and that by nitrous oxide was inversely related to the medium methionine concentration. This suggested that differentiation was secondary to decreased methionine synthesis. PMID- 3651603 TI - Chloramphenicol-induced bone marrow injury: possible role of bacterial metabolites of chloramphenicol. AB - To explore the potential role of some bacterial metabolites of chloramphenicol (CAP) in CAP-induced hematotoxicity, we examined their cytotoxic effects on bone marrow cells in vitro using a number of cytotoxicity parameters. Among the metabolites tested, dehydro-CAP (DHCAP) and p-nitrophenyl-2-amino-3 hydroxypropanone-HCI (NPAP) were more toxic than CAP. DHCAP was at least as toxic as nitroso-CAP. At concentrations of less than or equal to 10(-4) mol/L, DHCAP caused total irreversible inhibition of myeloid colony (CFU-GM) growth and 80% inhibition of DNA synthesis in human bone marrow. Incubation of human bone marrow cells with 10(-4) mol/L nitroso-CAP or DHCAP for 24 hours resulted in 75% and 65% cell death respectively. Although DHCAP was 10- to 20-fold more cytotoxic than CAP, it was only one third as effective in inhibiting mitochondrial protein synthesis, indicating that DHCAP exerts its toxic effect by alternate mechanisms. The cytotoxicity of DHCAP and its relative stability, compared to the unstable nitroso CAP, suggest that this bacterial metabolite of CAP, and possibly others, may play a significant role in CAP-induced hematotoxicity. PMID- 3651604 TI - Histone H1(0) is synthesized by human lymphocytic leukemia cells but not by normal lymphocytes. AB - Using a two-dimensional gel electrophoresis system (sodium dodecyl sulphate/acetic acid-urea-hexadecyltrimethylammonium bromide) coupled with fluorography, we investigated the synthesis of H1 isoproteins in leukemic cells obtained from peripheral blood of eight children suffering from acute lymphoblastic leukemia (ALL) (four T-ALL, three common ALL, and one B-ALL) and in normal peripheral lymphocytes. H1 was synthesized in leukemic cells but not in normal lymphocytes. Inhibition of DNA synthesis with hydroxyurea and 1-beta-D arabinofuranosylcytosine induced an increase of relative synthesis of H1(0) in leukemic cells but did not induce any detectable synthesis of H1 in normal lymphocytes. H1(0) synthesis was also undetectable in peripheral lymphocytes of leukemic children in complete remission after chemotherapy and in lymphocytes of a homozygotic twin of a leukemic patient. H1(0) may be a marker of malignant transformation of lymphocytes and as such could be of use for early detection of relapse in patients with acute lymphocytic leukemia in apparent complete remission. PMID- 3651606 TI - VP-16 in bone marrow purging. PMID- 3651605 TI - Acquisition of formyl peptide receptors during normal human myeloid differentiation. AB - By using a newly developed immune rosetting technique to isolate highly purified populations of myeloid precursor cells from normal human bone marrow and then inducing their differentiation with granulocyte and macrophage colony-stimulating factors (G/M-CSFs) in vitro, we studied the surface expression of chemotactic peptide receptors as the cells matured from the stage of the myeloblast to that of the mature, segmented neutrophil. We used ethylene glycol bis(succinimidyl succinate) to link N-formyl-Nle-Leu-Phe-Nle-[125I]iodo-Tyr-Lys to chemotactic peptide receptors on the surface of myeloid cells at sequential stages of maturation and then determined the density of receptor-radioligand complexes by autoradiography after sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Specific, saturable formyl peptide receptors were not detectable at the level of the myeloblast but gradually emerged through progressive stages of neutrophil maturation. The specific receptors for formyl peptide that appeared during cellular maturation had a mol wt of 55 to 70 kiloDalton (kD), corresponding to those present on the surface of peripheral blood neutrophils, and binding of the radioligand was highly specific in that it was completely inhibited by a 1,000-fold excess of F-Met Leu Phe. These data correlate with and provide insight into our recent observation that F-Met Leu Phe-induced membrane depolarization and transient increases in cytosolic free calcium are gradually acquired as neutrophils mature. This report represents to our knowledge the first description of the maturational development of chemotactic peptide receptor expression in normal human myeloid cells. PMID- 3651607 TI - Models of platelet formation. PMID- 3651608 TI - Expression of immunologic markers in megakaryoblasts. PMID- 3651609 TI - Genetic differences in hemoglobin influence on erythrocyte oxidative stress hemolysis. AB - The RBC from mice of certain inbred strains hemolyzed under oxidative stress (2.0 mmol/L hydrogen peroxide), whereas red cells from mice of other strains did not. In the experimental system human erythrocytes did not hemolyze. The rate of formation of malonyldialdehyde (a fatty acid oxidative breakdown product) was fourfold higher in hemolytic v nonhemolytic red cells. There was insufficient variation in the levels of glutathione, peroxidase activity or its substrate, reduced glutathione, to explain these hemolysis differences. On the other hand, the antioxidants butylated hydroxyanisole and hydroxytoluene, and histidine protected the hemolysis-prone red cells from breaking open. The hemolysis trait demonstrated autosomal recessive Mendelian inheritance. When using inbred, recombinant inbred, and congenic inbred mice, this hemolysis/nonhemolysis trait correlated 1:1 with the type of hemoglobin beta chain in the RBC. This experimental system is a potential model for investigating the role of hemoglobin in prehemolytic events. PMID- 3651610 TI - A unique 7p/12q chromosomal abnormality associated with recurrent abortion and hypofibrinogenemia. AB - Recurrent first trimester abortions led to evaluation of a 25-year-old woman. Studies revealed she had hypofibrinogenemia (68 mg/dL) without evidence of dysfibrinogenemia or increased fibrinogen turnover. She was also found to have a unique 46,XX, t(7;12) (p 15.2;q24.31) karyotype. Hypofibrinogenemia and identical chromosomal abnormalities were found in other members of her kindred. Southern blots of genomic DNA from the patient, her mother, and her daughter hybridized to human fibrinogen probes showed alpha, beta, and gamma fibrinogen genes to be present and without structural alterations when compared to normal controls. We conclude that the chromosomal abnormality and the hypofibrinogenemia are related but in an unclear manner. Because fibrinogen infusion in the proposita was associated with successful gestation, we also concluded that the chromosomal abnormality itself was not responsible for the repeated abortions but that fibrinogen concentration may be critical in securing implantation. PMID- 3651611 TI - Human leukocytes as viewed by stereo high-voltage electronmicroscopy. AB - Whole-mount preparations of adherent leukocytes were investigated by stereo high voltage electronmicroscopy (HVEM) to determine the organization of the cytoplast in unstimulated, motile, and phagocytosing cells. A highly ordered structured cytoplast is revealed. All cytoplasmic organelles are held within an intricate network of fine strands, termed the microtrabecular lattice (MTL), which appears more complex in neutrophils than eosinophils or monocytes. In neutrophils, the tendency of the MTL to expand and contract during cell movement and the responding deformability of the granules appear to influence granule shape. This pleomorphism in granule shape is particularly prominent in exceptionally elongated neutrophils that have not established directionality and demonstrate the appearance of having two leading lamellipodia. Results suggest that the morphology of neutrophil granules is influenced by cell motility, and may account for the pleomorphic populations of granules observed by standard transmission EM. Examination of the cytoskeleton of these elongated cells after detergent extraction reveals separation of the centrosome into two solitary centrioles, with each centriole surrounded by an aster of microtubules. A complex network of microfilaments, intermediate filaments, and microtubules is integrated within a thin area of cytoplasm separating the two cell bodies. Interaction between the MTL, microfilaments, intermediate filaments, and microtubules probably influences granule translocation in these elongated cells. Phagocytosis stimulates a reorganization of the cytoplast; all organelles are found in more central areas of the cytoplasm, bordered by a thin area of hyaloplasm. The MTL appears to limit cytoplasmic granules to a compartment around phagocytic vacuoles, which probably provides the framework for efficient phagolysosome fusion. PMID- 3651613 TI - On the mechanism and measurement of shape transformations of constant volume of human red blood cells. AB - A method is described for measuring the rate of disc-sphere transformations of constant volume by recording changes in the intensity and noise envelope of light transmitted through a stirred suspension of human red blood cells. We used this method to determine the rates and characteristics of disc-sphere transitions induced by various sphering agents (uranyl nitrate, rose bengal, Na glycocholate). It was found that, when sphered by any of these agents, cells spontaneously reverted to discs upon continued incubation in the presence of the agent. The rate of sphering was directly proportional and the rate of spontaneous reversal inversely related to the concentration of sphering agent used. Plasma added before an agent is added prevents subsequent sphering; plasma added after sphering had occurred accelerated reversal. During spontaneous reversal of the spheres to discs, sphering could again be induced prior to subsequent return to discs either by the addition of more agent or, in certain circumstances, by the addition of plasma. Spontaneous reversal of discs to spheres qualitatively correlates with the uptake rate of agent (rose bengal), the cells becoming discs as uptake is completed. Furthermore, establishment of temporary proton gradients across the membrane promotes sphering with return to discs as pH equilibrium takes place. Evidently, the spherical shape is a transient form representing the unequal distribution of agent across the membrane. The spherical form could thus be associated with a change in the relative surface energies between the outer and inner lipid leaflets, such as a difference in their relative surface areas, as hypothesized in the "bilayer couple" models. The molecular mechanism(s) underlying the action of sphering agents and protons may not be the same. PMID- 3651612 TI - Cinemicrography of human erythroblasts--direct measurement of generation time and delineation of their pedigrees. AB - To clarify the mode of erythropoiesis, the in vitro proliferation of single human erythroblasts was recorded continuously for 80 hours by time-lapse, phase contrast cinemicrography. Progenies from single erythroblasts were followed, their pedigrees were delineated, and their generation times were measured by counting the frames of the film. In one erythroblast pedigree, a daughter cell continued to divide three times to yield eight smaller erythroblasts; another daughter cell yielded four progenies, three of which abruptly lost most of their cytoplasm and became immobile. The generation time ranged from 15.8-30.0 hours (mean +/- SD: 23.3 +/- 4.8 hours), which corresponded to generation times calculated from in vivo data, such as the mitotic index, isotope labeling, or red cell turnover. Paired daughter cells showed very similar generation times. During succeeding mitoses, erythroblast size and nucleus/cytoplasma ratio decreased, cytoplasm darkened, and cell movement became more prominent. These studies on clonal cell proliferation using cinemicrography provide considerable information on the mechanism of hemopoiesis. PMID- 3651614 TI - Design, synthesis, and testing of potential antisickling agents. 6. Rheologic studies with active phenoxy and benzyloxy acids. AB - In vitro rheologic studies have been performed with homozygous sickle erythrocytes in the presence of phenoxy and benzyloxy antigelling agents. The results correlate with those obtained previously from a standard hemoglobin S solubility assay (C-sat) that monitors the inhibition of hemoglobin S polymerization in solution. The order of activity of compounds in both studies was found to be about the same. The rheologic assay monitors the reduction in pressure (130 mm Hg sickled vs 9 mm Hg nonsickled) needed to push erythrocytes through a 5 micron filter. Among the drugs studied, the antilipidemic drug Clofibrate reduced the filtration pressure by as little as 9%, and a derivative of the diuretic agent ethacrynic acid (Merck-595, 595) reduced it by as much as 94%. Human Serum Albumin (HSA) (0.1% wt/vol) drastically reduced the activity of the noncovalently-acting aromatic acids by requiring at least three times the concentration of drug to obtain similar reductions in pressure. Two covalently acting compounds, ethacrynic acid and Merck-595, 595, strongly increased the filterability of homozygous S erythrocytes at 1 and 3 mM drug concentrations even in the presence of HSA. No reason is given for the strong inhibitory effect of HSA at such high drug to HSA concentrations. PMID- 3651615 TI - Megakaryocyte fragments and the microtubule coil. AB - We have examined megakaryocyte process fragments that migrate out of bone marrow explants after a short period of incubation and assume a beaded form, consisting of 2 or more putative platelets. The fragmentation appears to occur in vivo and supports the proposal that platelet liberation does not always occur in a sequential manner from the distal ends of megakaryocyte processes. Transmission electron microscopy revealed that microtubules were generally oriented longitudinally in the process fragments. Rarely, a microtubule coil was found in a terminally located putative platelet. The observations favour the view that the marginal coil of microtubules, which is a characteristic of circulating platelets, does not usually form until after platelets have been liberated. PMID- 3651617 TI - Cellulase slide preparation of methylcellulose cultures of hemopoietic cells. AB - A technique is described for making slides of colonies grown in methylcellulose semisolid medium. The entire contents of a 0.5-ml culture in a 24-well plate is digested using 0.25 ml of a 1.08-mg/ml solution of cellulase dissolved in fetal calf serum. The methylcellulose is digested overnight, and the well contents are transferred to slides and are stained. Adherent colonies are recovered using a fetal calf serum solution containing trypsin and EDTA to flush any residue from the well; the recovered cells are transferred to slides and then stained. This method produces slides free of the darkly stained methylcellulose background that interferes with viewing colonies and studying individual cells. PMID- 3651616 TI - Haemopoietic progenitors in different parts of one femur perform different functions during regeneration. AB - Femoral haemopoietic tissue was divided into cells released by flushing and cells released by grinding and washing flushed femora. The flushed femur contained 5 times more nucleated cells than the ground femur, 40 times more macrophage colony forming cells and 6 times more developmentally late, day 8, and developmentally early, day 13, spleen colony-forming cells. However, the ground femur contained 2 times more developmentally early high proliferation potential colony-forming cells and 3 times more late ones. Haemopoietic regeneration of mice treated with fluorouracil was compared in samples obtained by flushing alone and grinding flushed femora. The number of nucleated cells recovered by flushing fell thirteen fold by the sixth day after administration of the drug and the number recovered by grinding fell six-fold by the eighth day. Developmentally early high proliferation-potential colony-forming cells which were recovered by grinding doubled their number in half the time taken by similar cells recovered by flushing. These observations are consistent with haemopoietic cells in different parts of the same bone performing different functions during regeneration. Large numbers of high-proliferation-potential colony-forming cells were not found in the circulation until 8 days after treatment with fluorouracil. Five days after mice had been treated with fluorouracil, when their blood forming systems were regenerating, early high-proliferation-potential colony-forming cells in one sample of marrow were derived from different founder cells than were late cells in the same sample. At the same time, early high-proliferation-potential colony forming cells in the ground sample of a femur were derived from different founder cells than were cells at the same stage of development in the flushed sample of the femur. These observations are consistent with the view that haemopoietic regeneration after treatment with fluorouracil is due to the growth of few founder cells whose progeny have migrated little within 5 days of drug treatment. PMID- 3651618 TI - The KKAy mouse: a model for the rapid development of glomerular capillary basement membrane thickening. AB - The renal tissue of 12-, 29-, 90- and 165-day-old genetically obese, hyperphagic, diabetic KKAy and age-matched nondiabetic C57BL/6 mice was morphometrically analyzed to characterize the development of peripheral glomerular capillary basement membrane thickening in the kidney of this animal model. Peripheral glomerular basement membrane (GBM) thickness was unremarkable in KKAy mice at 12 days of age (prior to onset of hyperinsulinemia) or at 29 days of age (after development of hyperinsulinemia). By 90 days of age, when the KKAy mice became severely hyperinsulinemic and hyperglycemic, the peripheral GBM thickness was greater (13%, p less than 0.002) in the diabetic compared with the nondiabetic mice. Furthermore, the peripheral GBM thickness was exacerbated (20%, p less than 0.001) by 165 days of age in the KKAy mice. The results of the present study suggest that peripheral glomerular capillary basement membrane thickening has an early onset and develops rapidly in the KKAy mouse in comparison with other diabetic animal models. Therefore, the KKAy mouse seems to be an appropriate model for further investigation of early structural and functional defects in the glomerular filtration barrier. PMID- 3651619 TI - Structure of lymphatic valves in the spinotrapezius muscle of the rat. AB - Lymphatic valves assure the forward propulsion of fluid along the lymphatic vessels. A description of valve function in skeletal muscle must be based on a knowledge of the valve morphology. To this end, histological sections of valves from lymphatic microvessels of the rat spinotrapezius muscle were examined with light microscopy. All of the approximately 50 valves studied from 20 rats had a bileaflet structure, with a buttress formed at each side of the valve by the fusion of opposing leaflets. This valve structure would allow the valve to close without inversion. There is no evidence for active smooth muscle action to open and close the valve. Since the Reynolds number of lymph flow is very small (about 0.0025), only pressure and viscous forces are available for valve closure. A particular mechanism based on the actual lymphatic valve structure is proposed. PMID- 3651620 TI - Collagen and elastin synthesis in the aorta of spontaneously hypertensive rats. AB - The biosynthesis of collagen and elastin was followed during the development of spontaneous hypertension in rats (SHR) of the Okamoto-Aoki strain. Strain-matched animals of the same age, which did not develop hypertension, served as controls. Both collagen and elastin synthesis (as revealed by specific hydroxyproline activity) was found to exceed control levels in the prehypertensive period, to decrease during the development of hypertension and to increase again in the period of the established hypertensive state. From the two main collagen types present, synthesis of collagen type III exceeded that of type I in the prehypertensive period (at the age of 4 weeks) and this relation was reversed during the period of established hypertension. It is suggested that (a) the vascular connective tissue metabolism in SHR differs from that in strain-matched controls, and (b) the reverse rate of collagen type III to collagen type I synthesis during hypertension development may be considered an adaptive response to the increasing pressure load which may alter the mechanical properties of the vessel wall. PMID- 3651622 TI - Joint meeting. Societas Europaea Physiologiae Clinicae Respiratoriae and the Societas Europae Pneumologica. Paris, 3-6 Sept. 1986. Book of abstracts. PMID- 3651621 TI - Noradrenaline content and release in the mesenteric artery of stroke-prone spontaneously hypertensive rats (SHRSP) and a new strain of SHRSP (M-SHRSP). AB - Adrenergic innervation in the main trunk of the mesenteric artery was studied in stroke-prone spontaneously hypertensive rats (SHRSP) as well as in a new strain of SHRSP (M-SHRSP) and was compared with that of normotensive Wistar Kyoto rats (WKY). Noradrenaline (NA) content and high K-induced NA release in the artery of 6-week-old SHRSP and M-SHRSP were greater than those in the artery of WKY. These results suggest that a higher adrenergic innervation of the artery might be involved in the development of hypertension in SHRSP and M-SHRSP. PMID- 3651623 TI - Carcinogenic and non-carcinogenic aromatic hydrocarbons in lipid membranes. A fluorescence study of pyrene and benzo[a]pyrene. AB - 1. The fluorescence behavior of a non-carcinogenic (pyrene) and a carcinogenic (benzo[a]pyrene) aromatic hydrocarbon was examined in the presence of a phospholipid bilayer membrane in the gel phase. 2. The monomer emission spectrum of pyrene in the membrane is very similar to that in micelles indicating a site near the aqueous surface region. Benzo[a[pyrene monomer spectra exhibit a red shift in the membrane relative to aliphatic hydrocarbon solvents. On the basis of spectral shifts in other homogeneous solvents, it is inferred that the carcinogen is located in the upper portion of the membrane acyl region, a more polarizable environment than the hydrocarbon core of the bilayer. 3. Analysis of the excimer to monomer emission intensity ratio as a function of probe molar ratio indicates that pyrene is much less soluble in the membrane than benzo[a]pyrene. 4. These results complement published EPR data which show that carcinogenic aromatic hydrocarbons cause structural changes in the membrane, while non-carcinogenic ones do not. These differences in membrane solubility and ability to alter membrane structure are discussed in the context of the different carcinogenic potencies of the hydrocarbons. PMID- 3651624 TI - Pulmonary structure and extravascular lung water after cardiopulmonary bypass. AB - 1. This paper describes the pulmonary alterations that occur after cardiopulmonary bypass (CPB) when a bubble oxygenator is used. 2. Two groups of patients who underwent myocardial revascularization were studied before and after CPB. The first group (7 patients with a bypass time of 130 +/- 17 min), when examined by light and electron microscopy showed platelet/neutrophil accumulation in the pulmonary parenchyma, endothelial lesions and interstitial edema. In the second group (10 patients with a bypass time of 123 +/- 37 min), extravascular lung water (EVLW) was measured by the thermal and green-dye dilution technique, and showed a significant increase immediately after CPB which lasted through the 1st and 2nd post-operative days. 3. No statistical correlation was found between the increase in EVLW and the plasma colloid oncotic pressure/pulmonary artery wedge pressure gradient, CPB time or intra-operative fluid balance. 4. Our results indicate an increase in pulmonary endothelium permeability after CPB when a bubble oxygenator is used. PMID- 3651625 TI - Standard dose 131I therapy for toxic multinodular goiter in an endemic goiter region. AB - 1. The effect of the standard 15 mCi dose of 131I on the thyroid function of 25 patients from an endemic goiter region with toxic multinodular goiter of different sizes was determined. 2. The patients were followed for 1 to 5 years and 7 months (mean: 2 years and 10 months). Eighteen patients were treated with the antithyroid drugs propylthiouracil or methimazole before 131I and seven only received 131I. 3. All but three patients achieved euthyroidism after a single dose of 131I. Two patients in the antithyroid treatment group became hypothyroid 2 months and 2 years after the isotope therapy, respectively. Pretreatment with antithyroid drugs did not significantly modify the effectiveness of 131I treatment. 4. This simplified dose regimen of 131I was effective in the treatment of hyperthyroidism caused by multinodular goiter in an endemic region, and the efficacy was independent of the size of the goiter. PMID- 3651626 TI - Clinical and hematological features of hemoglobin SC disease in Rio de Janeiro, Brazil. AB - 1. Thirty-two patients with hemoglobin SC (Hb SC) disease from Rio de Janeiro, Brazil, are described. Mean patient age at the time of study was 20 years, and average age at onset nine years. 2. The main complaint at presentation was bone or joint pains. Symptoms involved bone or joint pains in 72% of the patients, while 59% presented hepatomegaly and 50% splenomegaly. Mean hemoglobin level was 10.6 g/dl, erythrocyte count, 3.9 X 10(6)/mm3, and serum bilirubin, 1.4 g/dl. Reticulocytes and Hb F were 3.0% and 2.2%, respectively. 3. The characteristics of Hb SC disease observed in the present study did not differ significantly from those of other series studied elsewhere. This relative homogeneity of data is probably related to the physiopathological mechanism that promotes sickling in this condition. PMID- 3651627 TI - Hepatitis B virus infection in hemodialysis units: clinical features, epidemiological markers and general control measures. AB - 1. A total of 140 patients and 41 staff members were submitted to periodic testing for HBsAg from January 1979 to December 1984 at the Hemodialysis Unit of the University Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo. Twenty-two HBsAg-positive subjects were detected during this period, 15 of whom had acquired the hepatitis B virus (HBV) in the Unit (10 patients and 5 staff-members). 2. HBV prevalence was not uniform throughout the period of study, with an increase of hepatitis B cases occurring after September 1981 and reaching epidemic proportions which lasted until January 1983. 3. Among the preventive measures adopted, epidemiological alert, grouping patients and workers according to susceptibility or immunity to the infection, and setting up a separate area for the dialysis of infected patients appeared to be most important. 4. The use of HBV subtyping as an epidemiological marker permitted us to demonstrate that HBV was introduced into the Unit by chronic carrier patients and spread internally through the probable contamination of equipment and unit environment. PMID- 3651628 TI - The time-course of contractions induced by acetylcholine and barium in the vas deferens of normal and castrated guinea-pigs. AB - 1. The influence of castration on contraction of the guinea pig vas deferens induced by acetylcholine was investigated regarding facilitation of endogenous neurotransmitter release, changes in post-synaptic events and modification in acetylcholine metabolization. 2. Castration prolonged the duration of the isometric contraction of the vas deferens induced by acetylcholine (3 mM) but not the duration of that induced by barium chloride (10 mM). 3. Reserpinization (0.5 mg/kg) of normal and castrated guinea pigs did not change the time-course of acetylcholine-induced contraction in the vas deferens. 4. 4-Aminopyridine (0.05 mM) prolonged the contraction induced by acetylcholine and barium chloride. This effect was blocked by reserpine pretreatment, indicating that in the presence of 4-AP, both acetylcholine and barium release endogenous noradrenaline. Since there was no difference between the effects of 4-AP on organs from normal and castrated animals, prolongation of the acetylcholine-induced contraction is not related to an increase in neutransmitter release. 5. Total cholinesterase and acetylcholinesterase activities were reduced after castration and the time-course of carbachol contraction was not changed. Thus, this decrease in enzyme activity appears to play a relevant role in the prolongation of acetylcholine-induced contraction. PMID- 3651629 TI - Effect of Stevia rebaudiana on glucose tolerance in normal adult humans. AB - The effect of aqueous extracts of Stevia rebaudiana leaves on a glucose tolerance test was investigated in 16 normal volunteers. Aqueous extracts of 5 grams of leaves were administered to volunteers at regular 6-h intervals for 3 days. Glucose tolerance tests were performed before and after extract administration. A second group of 6 normal volunteers who ingested an aqueous arabinose solution was also studied to eliminate possible stress effects. The extract of Stevia rebaudiana increased glucose tolerance. The extract significantly decreased plasma glucose levels during the test and after overnight fasting in all volunteers. PMID- 3651630 TI - Macrophages stimulated with lipopolysaccharide release a selective neutrophil chemotactic factor: an in vivo demonstration. AB - Intraperitoneal injection of a chemotactic factor released by macrophage monolayers preincubated with endotoxin induced the migration of neutrophils but not of macrophages into the abdominal cavity of rats, whereas injection of carrageenin, thioglycolate or endotoxin stimulated the migration of both types of cells. PMID- 3651631 TI - Serum immunosuppressive acidic protein in patients with carcinoma of the gastrointestinal tract particularly the stomach. PMID- 3651632 TI - The vitreous and vitreoretinal interface. PMID- 3651633 TI - Vitreous changes in ocular inflammation. PMID- 3651634 TI - Vitreous changes and macular disease. PMID- 3651635 TI - The vitreous in idiopathic giant retinal breaks. PMID- 3651637 TI - Vitreous changes in retinal detachment. PMID- 3651636 TI - The vitreous: bird's eye view. PMID- 3651638 TI - The nursing crisis. PMID- 3651639 TI - Clinical examination of patients in the intensive care unit. AB - The severity of their illness ensures that many patients requiring intensive care have abnormal physical signs. Clinical examination remains a useful and effective way of detecting these and monitoring the patient's response to treatment. PMID- 3651640 TI - Fever in the intensive care unit. PMID- 3651641 TI - Rehabilitation in psychiatry. AB - Psychiatric rehabilitation is the process of enablement and enhancement of personal autonomy of individuals with chronic psychiatric disabilities. Its governing principles are those of common sense and sound psychiatric practice. These principles are outlined and some specific aspects of the process described. This article provides a brief guide and overview rather than a comprehensive account. PMID- 3651642 TI - Evaluation of anaesthetic depth. AB - The state of anaesthesia is one of unconsciousness, lack of awareness, amnesia and reflex suppression to noxious stimuli. The depth of anaesthesia is generally considered adequate if the patient neither moves in response to surgical stimulus nor shows any signs of autonomic reflexes. Anaesthesia is generally considered inadequate if the patient has recall after surgery! PMID- 3651643 TI - Management of the elderly surgical patient. AB - A substantial proportion of the work in most surgical specialties is now concerned with patients over 65 years of age and it seems inevitable that it will continue to increase in the future. PMID- 3651644 TI - Atrial rupture in osteogenesis imperfecta. PMID- 3651646 TI - The case for psychosurgery. PMID- 3651645 TI - An unusual case of gas gangrene. PMID- 3651647 TI - Sex therapy still in demand. PMID- 3651649 TI - Stroke units--fact not fiction. PMID- 3651648 TI - Hypercalcaemia in thyrotoxicosis--dogma questioned. PMID- 3651650 TI - Intrapleural Corynebacterium parvum. PMID- 3651651 TI - Art and style in medicine. PMID- 3651653 TI - Nursing care of AIDS patients. PMID- 3651652 TI - Consent for transplants. PMID- 3651654 TI - Changes in the incidence of schizophrenia? AB - In general, results of epidemiological studies on schizophrenia performed during the last century have the remarkable feature that no significant differences in expectancies and incidences have been found, neither between different populations nor over time. Recently, however, some studies have tended to show a noteworthy decrease in the incidence, as measured by statistics of first admissions. Possible sources of error are discussed, partly on the basis of recent Danish investigations. Although it is uncertain whether a true change in the incidence of schizophrenia has occurred, one feature is becoming evident: under modern treatment and care of schizophrenics the natural history of the disease is becoming increasingly different between the two sexes. This fact, in combination with one of the hardest facts in schizophrenia research, namely the higher age of onset in females, may be useful starting points for hypotheses on aetiology, or at least necessary components of such hypotheses. PMID- 3651655 TI - Koro and schizophrenia in Singapore. AB - A case of Koro is described in an elderly person with associated inguinal hernia and schizophrenia. Its aetiology and origin are traced in Chinese culture, to the Chin Dynasty. A nosology for the classification of Koro Syndrome is proposed. PMID- 3651656 TI - A standardised assessment of personality disorder in mental handicap. AB - Forty patients with mild or moderate mental handicap were assessed by two psychiatrists using the scale devised by Mann et al, 1981 which describes abnormalities of personality. Analysis by weighted Kappa showed excellent agreement for some items (introversion, hysterical explosive, sociopathic, anankastic and affective). This questionnaire may be useful in the evaluation of personality in the mentally handicapped. PMID- 3651657 TI - A case of 'lethal catatonia' in a 14-year-old girl. AB - A case of apparent 'lethal catatonia' in a 14-year-old girl is described; similarities with earlier descriptions are identified, although the precise cause of death in this case remains somewhat obscure. PMID- 3651658 TI - Cotard's syndrome in a mentally handicapped man. AB - A mentally handicapped man with Cotard's syndrome is described, and the usefulness of electroconvulsive therapy in his management discussed. Even the more uncommon psychiatric syndromes such as this can be found in people with lower intellectual functioning, with clinical features little modified. PMID- 3651659 TI - Senile dementia and parietal lobe dysfunction. AB - Two samples of patients suffering from senile dementia were administered the Kew tests for parietal lobe function and aphasia. No evidence emerged of any clinical heterogeneity; parietal lobe test performance was found to be more a function of degree of impairment rather than of age. PMID- 3651660 TI - Brain imaging in a case of Capgras' syndrome. AB - A patient developed Capgras' syndrome as part of an interictal psychosis of epilepsy; magnetic resonance imaging revealed bilateral subcortical lesions in occipitotemporal and frontal regions. These findings have implications for the postulated association between Capgras' syndrome and neuropsychological deficits, in particular prosopagnosia. PMID- 3651661 TI - Alcohol-related psychiatric emergencies: their characteristics and care at a walk in clinic. AB - Fifty cases attending a walk-in psychiatric emergency clinic with alcohol-related problems were studied retrospectively. Results confirm that this group represents a sizeable load on the clinic--about 15% of all assessments. Other psychiatric problems were common, and many patients had recently attempted or threatened suicide. PMID- 3651663 TI - The continuum of psychosis and the gene. PMID- 3651662 TI - Prolonged oculogyric crisis on addition of nifedipine to neuroleptic medication regime. AB - Extrapyramidal symptoms, including oculogyric crisis, are well recognised side effects of clopenthixol medication, but precipitation of prolonged oculogyric crisis on addition of nifedipine to an ongoing clopenthixol regime has not so far been reported. PMID- 3651664 TI - Gluten sensitivity in schizophrenia. PMID- 3651665 TI - Psychiatric disorder in the general hospital. PMID- 3651666 TI - Hydroxylated metabolites of tricyclic antidepressant in the elderly. PMID- 3651667 TI - Diagnostic valve of Schneider's first rank symptoms in schizophrenia. PMID- 3651668 TI - Koro in an Israeli man. PMID- 3651669 TI - Nuclear magnetic resonance brain imaging in chronic schizophrenia. AB - Patients with chronic schizophrenia were examined by nuclear magnetic resonance imaging of the brain. Subgroups of the syndrome with high positive or high negative symptom scores and ventricular dilatation were compared with each other and with normal controls in respect of regional spin lattice relaxation time (T1) changes. Significant differences were not observed between the schizophrenic subgroups and controls but there were significant differences between the subgroups themselves. The presence of tardive dyskinesia was associated with increased T1 of the basal ganglia. The significance of these results is discussed in relation to findings using other techniques. PMID- 3651670 TI - A self-rating scale for bulimia. The 'BITE'. AB - A new brief questionnaire, the Bulimic Investigatory Test, Edinburgh (BITE), for the detection and description of binge-eating is described. Data from two separate populations demonstrate satisfactory reliability and validity. The scale has measures of both symptoms and severity. All items in the DSM-III definition of bulimia and Russell's definition of bulimia nervosa are covered but the questionnaire is more than just an operationalised checklist of these diagnostic criteria. PMID- 3651671 TI - Suicide and parasuicide among further education students in Edinburgh. AB - During the period 1979-1982 the incidence of suicide and parasuicide for students aged 15-24 years was found to be lower than that of others of the same age in Edinburgh. A comparison of student parasuicides with matched non-student parasuicides shows similar parasuicide repetition rates, but some differences in respect of precipitants (twice as many students reporting no major event prior to the episode), agent of poisoning (analgesics more commonly used by students; hypnotics, tranquillisers and barbiturates, by controls), and social and clinical characteristics (a greater proportion of controls reporting parasuicide in the family, a criminal record and being the victim of violence). PMID- 3651672 TI - Influence of the day of the week and the weather on people using a telephone support system. AB - The calls to a telephone counselling service at Louvain, during a 21-month period, from one telephone zone were analysed. Data were studied in relation to the type of weather, which was recorded every day. Calls made by women about health and interpersonal problems showed a relationship to the weather, while calls apparently motivated by masturbation intentions from male callers increased when the weather improved. PMID- 3651673 TI - Measuring the rising tide. How many dementia cases will there be by 2001? AB - Numerous surveys have attempted to estimate the prevalence of dementia. Despite difficulties of measurement, evidence suggests figures may be lower than is generally realised. Factors which are likely to affect prevalence rates are discussed. Forthcoming changes in the demography of old age indicate that increases in the prevalence of dementia may have been seriously underestimated. PMID- 3651674 TI - The Present State Examination Change Rating Scale. AB - The development and use of a new psychiatric symptom change scale based on the Present State Examination (PSE)--the PSE Change Rating Scale--is described. The advantages of the PSE are retained (the extensive glossary, the diagnostic facility and the standardised interview technique) while improving its sensitivity to change and decreasing its administration time. The scale has been designed to prevent feedback of results and 'halo' effects: it has proved highly reliable in use across raters with different backgrounds and experience. The scale has been used to monitor drug effects on clinical state across a variety of diagnoses and examples of its use are given. PMID- 3651675 TI - The psychological effects of service in British Antarctica: a study using the General Health Questionnaire. AB - This study follows the psychological profile of a group of Antarctic explorers on a remote base in British Antarctica. Each month for 1 year the 60-item General Health Questionnaire (GHQ) was administered to the 12-man complement and the results compared to those of a control group. Three men resigned and left, 4 months later, at the end of winter. Their scoring showed marked differences from the others, including the highest scores in the severe depression factor scale. The GHQ was accepted by the men despite the intrusive threat it offered in such a small community; there was also a seasonal variation in scoring, with higher scores in the winter, and no evidence of long-term psychological sequelae in those who stayed. PMID- 3651676 TI - Influence of emotional distress among supporters on the outcome of psychogeriatric day care. AB - From a sample of consecutive referrals for psychogeriatric day care, the influence of the supporters' emotional distress and self-reported strain, together with the number of problems presented by the patient, was examined in relation to outcome, 6-7 months after initial attendance. A higher level of problems and the failure to achieve any reduction in reported distress were both found to contribute to the breakdown of community care and to the subsequent institutionalisation of the patient. Day hospital care was associated with a significant reduction in emotional distress for the majority of relatives, although for relatives whose distress was not alleviated by their dependents' attendance, admission to long-term care did produce such a reduction. PMID- 3651677 TI - Reliability of the psychosocial axes of DSM-III in an adolescent population. AB - Three psychosocial variables were rated independently by two clinicians for 140 adolescent referrals to a psychiatric unit. Overall, intraclass correlations for DSM-III Axis IV, Axis V and a psychosocial adversity index (PSAI) were respectively 0.44, 0.58 and 0.68. The main source of unreliability is probably the operational definitions, rather than their application by clinicians; indices similar to the PSAI may be preferable. PMID- 3651678 TI - Life events and mania. A special relationship? AB - Fifty patients in their first manic episode were compared retrospectively with groups of (a) manic patients in other than first admissions and (b) acute surgical cases. They were then followed up for 3-8 years. First manic admissions were linked to life events far more frequently--66% vs 20% and 8% respectively for the other groups. Within-group comparisons showed patients with life events were much younger. The link between life events and manic episodes appeared immediate and selective, a view further supported by the findings of the follow up. Later episodes precipitated by life events seem to require smaller amounts of stress. The possible role of life events in relation to mania is discussed. PMID- 3651679 TI - Hysterical personality disorder. The process of diagnosis in clinical and experimental settings. AB - A study of the case notes of 52 patients with a diagnosis of hysterical personality disorder showed that 27 had no recorded features of that condition, but were frequently described as aggressive, uncooperative, or attention-seeking. Although 60% were recorded as depressed, only 17% received antidepressant treatment. In an experimental study, the core traits of the disorder were found to have a low inter-rater reliability. Two patients, who had received hospital diagnoses of hysterical personality disorder, were shown to display behaviour that caused psychiatrists to make a diagnosis on wholly inadequate information. PMID- 3651680 TI - Deliberate self-harm and predictors of out-patient attendance. PMID- 3651681 TI - Khat-induced paranoid psychosis. PMID- 3651682 TI - Physical and psychological characteristics of five male bulimics. AB - The case histories of five men who met DSM-III criteria for bulimia and details of their physical characteristics are given. Various eating disorder questionnaires were administered and the results indicated that most of these instruments would not have identified the men as suffering from an eating disorder. The necessity of caution in asserting the prevalence of bulimia using these measures is emphasised. PMID- 3651683 TI - Capgras syndrome in a patient with dementia. PMID- 3651684 TI - A pilot study of phenelzine in the treatment of post-traumatic stress disorder. PMID- 3651685 TI - Electroconvulsive therapy and cognitive improvement in a very elderly depressed patient. PMID- 3651686 TI - Fictitious epilepsy associated with amnesia. PMID- 3651687 TI - Ephedrine psychosis rediscovered. PMID- 3651688 TI - Delusion parasitosis: successful non-pharmacological treatment of a folie-a-deux. PMID- 3651689 TI - Admission rates and lithium therapy. PMID- 3651690 TI - Psychotherapy and placebo. PMID- 3651691 TI - Suicide in physicians. PMID- 3651692 TI - Depression in school phobia. PMID- 3651693 TI - Psychiatric morbidity and the mentally handicapped. PMID- 3651694 TI - Allergic type response to trazodone. PMID- 3651695 TI - Obsessive-compulsive disorder--a complication of benzodiazepine withdrawal. PMID- 3651696 TI - Life events, vulnerability and onset of depression: some refinements. AB - A prospective study of 400 largely working-class women with children living at home has once again demonstrated the major importance of long-term severe threatening life events in provoking caseness of depression. However, it again shows that only about one out of five women experiencing such an event go on to develop depression at a case level. This paper demonstrates that more sensitive characterisation of severe events can greatly increase the size of this association. This is done both by improving the description of the event itself and by taking into account various ways in which the event can 'match' characteristics of the women present at the first interview, well before the occurrence of the event or any onset of depression. PMID- 3651697 TI - Prediction of outcome in depressive illness by the Newcastle Diagnosis Scale. Its relationship with the unipolar/bipolar and DSM-III systems. AB - The Newcastle scores of a group of 64 and subsample of 52 severely depressed inpatients were not normally distributed. Evidence for discontinuity in these distributions was adduced from the contrast in outcome between the endogenous and neurotic patients thus defined, the endogenous consistently doing better than the neurotic group. The unipolar/bipolar system failed to predict different results for endogenous and neurotic patients unless unipolar was subdivided into endogenous and neurotic subgroups. The DSM-III criteria for major depression and melancholia failed to identify subgroups of differing prognoses. PMID- 3651698 TI - Factor study of a psychiatric child rating scale. Based on ratings made by clinicians on child and adolescent clinic attenders. AB - Symptom rating sheets completed by psychiatrists over a 9-year period on 2602 intellectually normal child and adolescent clinic attenders were subjected to factor analysis (principal components). Two types of factor sets were derived, one for younger subjects (3-11 years) and another for older subjects (12-18). Both had three factors in common: conduct disturbance, relationship problems and emotionality, but differed on the fourth-developmental immaturity for the younger group, depression for the older. A factor solution was also derived for the whole clinic sample with three scales: conduct, emotionality and immaturity. Both types of factor solutions were subjected to MANOVA for age and sex effects, both of which proved to be of significant influence. Good correspondence was found between the symptom factors identified and conceptually similar clinical diagnoses. PMID- 3651699 TI - Female sex offenders. AB - Information on 19 women convicted of indecency and 62 women convicted of other sex offences was examined. Those convicted of indecency offences often had poor social skills and had a high incidence of mental illness, mental handicap and alcoholism. Two were convicted of indecent exposure, a rare offence in women. In 39 (63%) of the sex offences with individual victims, the victims were children and in 9 cases the offender was the mother or step-mother. In 25 cases the women were convicted of aiding and abetting a male offender. Of those convicted of indecent assault on persons under 16 and of gross indecency with children, 48% had a previous history of psychiatric disorder. PMID- 3651700 TI - No fixed abode. A comparison of men and women admitted to an East London psychiatric hospital. AB - There is little information available on psychiatric disorder in homeless women. This study compares clinical casenote information of all homeless women admitted to an East London psychiatric hospital from 1971-1980 inclusive, with information on a cohort of homeless men admitted during the same period. The results show that the women appear to have been socially more stable than the men prior to admission and yet they have less satisfactory admissions to hospital. Possible reasons for these apparent inconsistencies are discussed. PMID- 3651702 TI - The Nithsdale Schizophrenia Survey. VI. Relatives' expressed emotion: prevalence, patterns, and clinical assessment. AB - A review of all known schizophrenics (n = 142) in Nithsdale, Scotland, found 50% were living with relatives or friends. Of these, 32% had high contact with a relative showing high expressed emotion (EE); put another way, 87% of all Nithsdale schizophrenics were not living in a high contact/high EE family. Parents were more critical than spouses, and more showed emotional over involvement. A retrospective review showed a trend, not of statistical significance, towards a higher admission rate to in-patient care in patients from high EE homes. Of relatives believed by a consultant psychiatrist to be neither critical nor hostile, 80% fell into the low EE category, but only 44% thought hostile or critical belonged to the high EE category; that is, the clinician had a wider view of high EE than the Camberwell Family Interview. Relative's scores on a short patient-rejection scale were higher in high EE than in low EE relatives, but the wide scatter of scores suggested the scale could not be used to identify an individual relative with high EE. PMID- 3651701 TI - Late paraphrenia or the paraphrenias? A descriptive study with a 10-year follow up. AB - This study describes 47 cases of paranoid psychosis occurring for the first time after the age of 60. Cases were drawn from the Camberwell catchment area and were followed up for 10 years or until death. The clinical picture of patients showed few differences from those described in earlier studies. Subgroups are described with contrasting clinical features and differing outcome. The findings suggest that late paraphrenia is a heterogenous syndrome giving the appearance of a spectrum of overlapping conditions with paranoid delusions. PMID- 3651703 TI - Specific and non-specific effects of educational intervention with families living with a schizophrenic relative. AB - A brief educational intervention with families living with a schizophrenic relative is described and evaluated in terms of benefits for relatives' well being and patient recovery. Education led to considerable knowledge gains and to reductions in relatives' reported stress symptoms and fear of the patient. There was a trend for relatives to be more optimistic concerning their role in treatment. At 6 months follow-up, only knowledge gains were maintained; however, relatives' perceptions of family burden were significantly reduced. The evidence suggests that family education may be useful both as a cost-effective intervention in its own right and in facilitating a more receptive attitude to subsequent family intervention. PMID- 3651704 TI - Epidemiology of puerperal psychoses. AB - Computer linkage of an obstetric register and a psychiatric case register made it possible to investigate the temporal relationship between childbirth and psychiatric contact in a population of 470 000 people over a 12-year period: 54 087 births resulted in 120 psychiatric admissions within 90 days of parturition [corrected]. The 'relative risk' of admission to a psychiatric hospital with a psychotic illness was extremely high in the first 30 days after childbirth, particularly in primiparae, suggesting that metabolic factors are involved in the genesis of puerperal psychoses. However, being unmarried, having a first baby, Caesarian section and perinatal death were all associated with an increased risk of psychiatric admission or contact, or both, suggesting that psychological stresses also contribute to this high psychiatric morbidity. Women with a history of manic depressive illness, manic or depressive, had a much higher risk of psychiatric admission in the puerperium than those with a history of schizophrenia or depressive neuroses, and the majority of puerperal admissions met Research Diagnostic Criteria for manic or depressive disorder. Probably, therefore, puerperal psychoses are manic depressive illnesses and unrelated to schizophrenia. PMID- 3651705 TI - Characteristic plasma hormone changes in Alzheimer's disease. AB - A systematic endocrine investigation in dementia, depression and control subjects showed that plasma growth hormone (GH) was higher in the morning and plasma TSH concentrations were higher throughout the day in Alzheimer-type dementia (ATD) than in age-matched depressed patients (MDD), and plasma TSH concentrations were also higher throughout the day in female ATD compared with age-matched female control subjects. The increased plasma TSH concentrations could not be due to reduced negative feedback because plasma T3, T4 and rT3 were in the normal range. Plasma concentrations of oestrogen-stimulated neurophysin (ESN) were lower throughout the day in ATD compared with MDD and controls and lower in the morning compared with other dementias. The high plasma GH and TSH concentrations in ATD may reflect the reduced hypothalamic content of somatostatin in ATD, and the reduced concentrations of ESN may reflect reduced cholinergic activity in ATD brain. These selective hormonal changes provide a useful diagnostic test for Alzheimer's disease. PMID- 3651706 TI - Mania following head injury. AB - A case of mania subsequent to head injury is presented. The literature reporting cases of mania after head injury is reviewed. It is suggested that the concept of Secondary Mania be broadened to include cases occurring after head injury. It is also suggested that a true bipolar illness can be secondary. PMID- 3651707 TI - Oxygen saturation during electroconvulsive therapy. AB - Oxygen saturation was measured during anaesthesia and electroconvulsive therapy (ECT) using ear oximetry. Significant hypoxia occurred during some treatments; desaturation related to the number of ventilations performed after muscle relaxation and prior to the shock. Desaturation did not correlate significantly with seizure duration. These findings highlight the need for adequate oxygenation during ECT. PMID- 3651708 TI - Anorexia nervosa and gastric rugal hyperplasia. AB - A case of anorexia nervosa associated with gastric rugal hyperplasia in a 36-year old male is reported and some speculations are made about the relationship between these two conditions. PMID- 3651709 TI - A case of mosaicism with fragile-X and XXY components. AB - The case of a 63-year-old severely mentally handicapped man is reported with chromosomal mosaicism. His karyotype was established as mosaic 46XY/47XXY with the fragile site present in a proportion of cells of both cell-lines. He showed phenotypic features which could be related both to the fragile-X and Klinefelter's syndromes. PMID- 3651710 TI - Epilepsy and psychosis--ask the family. AB - Psychotic episodes and epilepsy can occur without mental retardation in tuberous sclerosis. The diagnosis may depend on elucidating the family history since physical signs may not be obvious. Establishing the diagnosis makes genetic counselling possible. PMID- 3651711 TI - An epidemic of suicide attempts by burning in a psychiatric hospital. AB - Three patients attempted suicide by burning in one ward of a psychiatric hospital in a period of less than 1 month. No such attempts had occurred there in the previous 9 years. The three patients were schizophrenics with depressive features who occupied the same room in the ward. It seems reasonable to suggest that at least the choice of method and the timing of these suicide attempts were influenced by imitation. Hospital staff should be especially aware of the influence of imitation in suicide in order to avert such undesired epidemics. PMID- 3651712 TI - Depression in the general population: comparability of survey results. PMID- 3651713 TI - Electroconvulsive therapy in the elderly. PMID- 3651714 TI - Delusional parasitosis. PMID- 3651715 TI - BITE: self-rating scale for bulimia. PMID- 3651716 TI - Comprehensive psychiatric community services for the severely disabled. PMID- 3651717 TI - Delineating social phobia. PMID- 3651718 TI - Clinical tests of memory as sensitive and specific signs of dementia. PMID- 3651720 TI - Caffeine and panic attacks. PMID- 3651719 TI - A test of the social support hypothesis. AB - As a test of the social support hypothesis, highly anxious primiparous mothers were assigned in the post-natal stage to either a professional intervention, a lay intervention or to a control group. It was hypothesised that those receiving an active intervention (be it lay or professional assistance) would become less anxious as a consequence of a central therapeutic ingredient--social support. Improvement was assessed by measuring state anxiety levels at baseline and at 12 months, while the degree to which therapists were incorporated into the social network was assessed by the Interview Schedule for Social Interaction (ISSI), given at baseline and at 12 months. While we established that anxiety levels were significantly lowered in those receiving the professional intervention and moderately (but not significantly) lowered in those receiving the lay intervention, ISSI scores for the separate groups appeared stable over the study. Reasons are considered why ISSI scores remained unchanged while intervention groups showed a reduction in anxiety levels. PMID- 3651721 TI - Hyponatraemia and lofepramine. PMID- 3651722 TI - Clomipramine and flupenthixol--additive antidepressants? PMID- 3651723 TI - Water intoxication and congenital neurosyphilis. PMID- 3651724 TI - Neuroleptic malignant syndrome and compulsive water drinking. PMID- 3651725 TI - Switch mechanism in affective illness and oral S-adenosylmethionine (SAM) PMID- 3651726 TI - Communicating with cancer patients. AB - In a prospective study, 100 cancer patients and their relatives were separately interviewed using a structured interview to examine whether the diagnosis of cancer should be communicated to patients and relatives; the reasons for doing so or not, the emotional reactions of patients and families; any change in the attitude of relatives; behaviour of patients and patient's expectation, on diagnosis, of the course of their illness. The majority of patients, who knew their diagnosis (71%), wanted to be told the truth. The majority of relatives wanted to know the truth themselves (81%) without the patients being told (77%). Patients did show immediate emotional reactions like anxiety and dejection, however they appeared to accept the diagnosis. Findings suggest that in an Indian setting the attitude of family members is more positive. The role played by sociocultural factors in the acceptance of the truth is discussed. PMID- 3651727 TI - Ethnic differences in self-poisoning. A comparison of West Indian and white groups. AB - The characteristics of West Indian patients admitted to a Birmingham hospital following deliberate self-poisoning were compared with those of White self poisoners. West Indian patients were more likely to be young, female and single. They were less likely to have previously self-poisoned, have received previous psychiatric treatment, or be suffering from a personality disorder or alcoholism, but were more often followed-up by a social worker. Rates of self-poisoning for those aged under 25 were similar but for those aged over 25 were lower for West Indians than Whites. PMID- 3651728 TI - Phenomenology of intoxication with toluene-based adhesives and butane gas. AB - The phenomenology of solvent inhalation was investigated comparing a group of young people who misused toluene (n = 31) with a group misusing butane (n = 12). Marked changes of mental state were invariable. Most users reported elevation of mood and hallucinations but a rich variety of phenomena was elicited. Nearly one quarter of subjects had the potentially dangerous delusion of believing they were able to fly or swim. In the toluene group thoughts were more likely to be slowed, time appeared to pass more quickly and tactile hallucinations were more commonly reported than in the butane group. Withdrawal phenomena and tolerance were also looked at. PMID- 3651729 TI - Patterns of use and related harm with toluene-based adhesives and butane gas. AB - The patterns of use and related harm of solvent inhalation were investigated in a group of young people who misused toluene (n = 31) and a group misusing butane (n = 12). The two groups were similar in terms of patterns of use and solvent related harm. The toluene users were more likely to sniff only in a group setting, probably because of the long duration of intoxication. The toluene group were more approving in their attitudes towards taking other drugs. PMID- 3651730 TI - Bulimia nervosa. The impact of pregnancy on mother and baby. AB - This study examines the impact of pregnancy on the reported eating behaviour of 20 untreated normal body weight bulimia nervosa women; it also reports foetal and obstetric abnormalities and indicates the initial eating habits of the infants. The prevalence of binge-eating and self-induced vomiting reduced sequentially during each trimester of pregnancy. By the third trimester 15 women (75%) had stopped all bulimic behaviour and in the remainder the disturbed eating was less severe. Symptoms tended to return in the puerperium and in nearly half the sample abnormal eating was more disturbed after delivery than before conception. However, the improvement associated with the pregnancy described by seven patients was maintained and for five it appears to have been curative. The common fear among pregnant bulimics that their abnormal eating behaviour may damage their unborn child cannot be dispelled by this study; the incidence of foetal abnormality (including cleft palate and cleft lip), multiple pregnancies and obstetric complications (including breech presentation and surgical intervention) was high. The nutrition and development of the infants was good although three mothers (15%) reported slimming their babies down within the first year. PMID- 3651731 TI - Suicide risk factors: a comparison of suicide attempters with suicide completers. AB - Fifty cases of attempted suicide were compared with 50 cases of completed suicide on variables reported to measure suicide risk: the seriousness of the attempt, and the circumstances in which the act occurred discriminated best. Depressive symptoms were more frequent in the suicide group and in the serious attempters' group than in the non-serious attempters' group. PMID- 3651732 TI - Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. AB - The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed. PMID- 3651733 TI - The prognosis of primary depressive illness. Its relationship to the dexamethasone suppression test. AB - We followed up 30 recovered depressives for an average of 2 years. At 18 months, despite prophylactic medication, 30% had relapsed. Persistent DST suppression during the index illness was found to be a predictor of good prognosis. PMID- 3651734 TI - Depression assessment in Brazil. The first application of the Montgomery-Asberg Depression Rating Scale. AB - Cross-cultural investigation in psychiatry is revealing the need for standardised instruments in diagnosing and assessing depression. Recently, a new instrument was developed to evaluate depressed patients, namely the Montgomery-Asberg Depression Rating Scale (MADRS). The present study introduced the MADRS in Brazil, comparing it to the Hamilton Depression Rating Scale, the Visual Analogue Mood Scale (a self-rating scale), and with the global clinical assessment of independent Brazilian psychiatrists. The results show correlation between MADRS and the three other assessments, indicating that it is a useful and operational instrument to evaluate depressed patients. They also support the application of the MADRS in cross-cultural studies of depression in Brazil and other countries. These results are critically discussed. PMID- 3651735 TI - Mental health and psychological well-being among the old and the very old living at home. AB - Using four brief assessment scales, profiles of mental health and psychological well-being were obtained from 507 old (aged 65-74 years) and 535 very old (aged 75+) individuals randomly sampled from the community. Assessments of dementia and depression were subsequently validated against diagnostic ratings made by experienced psychogeriatricians. Levels of agreement between psychometric and clinical ratings of dementia (kappa = 0.83) and depression (kappa = 0.66) were satisfactory. The old and very old groups reported similar levels of anxiety and personal disturbance, and showed a similar prevalence of depression. However, those aged 75+ showed higher levels of dementia and significantly lower levels of social involvement and morale. PMID- 3651736 TI - Comparison of the sensitivity of three instruments for the detection of cognitive decline in elderly living at home. AB - We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS] were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome. PMID- 3651737 TI - Detention in Broadmoor. Factors in length of stay. AB - When the length of stay of restricted patients admitted to Broadmoor under the legal category of psychopathic disorder was examined, the factor found to be of primary importance was the gravity of the admission offence. If the men's offences did not cause personal injury, they had a good chance of early release. Patients convicted of violent or sexual offences, and particularly those who attacked strangers, made up the great majority of the long-term group. For the mentally ill there was no relationship between length of stay and admission offence: instead the data suggested that severity and chronicity of illness were the main relevant factors. PMID- 3651738 TI - The impact of a liaison psychiatry service on patterns of referral in a general hospital. AB - A retrospective study of psychiatric referrals from a general hospital inpatient population was carried out for three separate years, 1973, 1976 and 1979. Reorganisation of the liaison service to the responsibility of one consultant team was associated with changes in referral rate and disposal. In particular, there was a significant increase in the referral rate of patients from medical and surgical wards who were not involved in acts of deliberate self-harm. PMID- 3651739 TI - Electrodermal responding and chlorpromazine treatment in schizophrenia. AB - Skin conductance level (SCL) and skin conductance responses (SCR) to a random series of tones were measured in 25 drug-free schizophrenic patients, 15 males and 10 female, before and after standard chlorpromazine treatment. The DSM-III diagnostic criteria were used for selecting subjects. Psychopathology was measured with the Brief Psychiatric Rating Scale. After treatment, patients showed an improved psychopathology and decreased SCL. There was a transition of patients to lower response categories: the number of responders decreased twice and the number of non-responders increased three times. Responders exhibited significantly higher SCL than non-responders and fast habituators were between the two groups. PMID- 3651740 TI - Abnormal intestinal permeability. An aetiological factor in chronic psychiatric disorders? AB - Abnormal intestinal absorption has been suggested as an aetiological factor in schizophrenia. A procedure for investigating intestinal permeability was carried out in a group of chronic psychiatric in-patients. A proportion of the subjects studied showed abnormal intestinal permeability which could not be attributed to established bowel disease. Patients who were receiving neuroleptic but not anticholinergic drugs were those most often showing abnormal intestinal permeability. This work is at an early stage of development but preliminary findings suggest that further investigations should be carried out to establish the circumstances in which changes in intestinal permeability may be associated with mental illness. PMID- 3651741 TI - Infantile autism in children of immigrant parents. A population-based study from Goteborg, Sweden. AB - A population-based study of infantile autism from western Sweden has been completed. Urban children with autism more often than age-matched children in the general population had immigrant parents from 'exotic' countries. No such trend was seen in rural children with infantile autism. PMID- 3651742 TI - Psychiatric vulnerability and cerebellar haemangioblastoma. A case report. AB - A case of cerebellar haemangioblastoma in described in a middle-aged woman with a history of multiple psychiatric admissions for depressive and psychosomatic symptomatology. The diagnosis was not made until a late stage, largely because of the knowledge of her psychiatric history and its particular slant. Similar psychiatric symptoms were present at the outset, colouring the emerging neurological picture. The clinical manifestations and management of cerebellar haemangioblastoma are described. PMID- 3651743 TI - Schizophreniform episode following measles infection. AB - A case of schizophreniform episode following measles infection in a 27-year-old woman is presented. The possibility that the clinical picture is a first description in the literature of an association between a schizophreniform episode and possible measles-induced allergic encephalitis is discussed. Other possible connections between measles infection and schizophreniform episode are also mentioned. PMID- 3651744 TI - Clonidine. An effective anti-manic agent? AB - Three patients suffering from bipolar affective disorder, manic phase, and who were resistant to conservative treatment were successfully treated with clonidine. This would support the nor-adrenergic hyperactivity theory of mania. The rapidity of action of clonidine and its lack of relatively serious side effects renders it a potential alternative to conventional anti-manic agents. PMID- 3651745 TI - The role of food substitutes in a token economy system. AB - Data from five behaviour management (token economy) units were analysed for periods of 10-20 weeks before and after the use of a food substitute (Complan), provided when insufficient tokens had been earned to buy a full- or part-meal. The efficacy of this form of negative punishment to control disturbed and aggressive behaviour was examined. No evidence was found to suggest that the contingent use of a food substitute made any contribution to the therapeutic process. PMID- 3651746 TI - A study of Schneider's first-rank symptoms of schizophrenia in Nigerian patients. AB - A prospective evaluation of Schneider's first-rank symptoms in 56 Nigerians with RDC schizophrenia gave a prevalence of 73%. The presence of first-rank symptoms was unrelated to schizophrenic subtypes, duration or severity of illness. While some of the symptoms correlate with age of patients, the pattern of inter correlations among them supports previous views about their empirical heterogeneity. PMID- 3651747 TI - Temperament, personality and personality disorder. PMID- 3651748 TI - Huntington's chorea. PMID- 3651749 TI - Anorexia and antidepressants. PMID- 3651750 TI - Life events and mania. PMID- 3651751 TI - Zinc in senile dementia. PMID- 3651752 TI - Khat-induced paranoid psychosis. PMID- 3651753 TI - Capgras' syndrome in a patient with dementia. PMID- 3651754 TI - ECT in the elderly. PMID- 3651755 TI - Admission rates and lithium. PMID- 3651756 TI - Psychiatric morbidity and the mentally handicapped. PMID- 3651757 TI - Is the positive-negative distinction in schizophrenia valid? PMID- 3651758 TI - Neuroleptic malignant syndrome (NMS) and tardive dyskinesia. PMID- 3651759 TI - Koro-like states. PMID- 3651760 TI - HIV and the psychiatric hospital. PMID- 3651761 TI - First admissions of native-born and immigrant patients to psychiatric hospitals. PMID- 3651762 TI - Manic depressive psychosis with mental retardation and flexion deformities: a clinical and cytogenetic study. AB - Five mentally handicapped patients are described in whom a bipolar manic depressive psychosis was associated with flexion deformities, involving principally the fingers. The effect of increasing degrees of retardation on the clinical presentation of the affective psychosis is discussed. Surgical treatment of the flexion deformity brought about considerable improvement in one patient. These five patients were further investigated cytogenetically using high resolution banding techniques. The results obtained were interesting but inconclusive. There would seem to be a definite place for further cytogenetic investigations of some of the more distinctive psychotic disorders using this technique. PMID- 3651763 TI - The influence of depression on the processing of personal attributes. AB - Depressed, schizophrenic and normal subjects were tested for incidental recall and recognition of lists of positive and negative personal attributes. It was hypothesised that depressives would show a deficit in recall and recognition of words of which they had been asked a self-referential encoding question, but would show equivalent performance to controls on words of which they had been asked an other-referential, semantic or structural encoding question. The experiment was designed to enable a decision to be made between two possible explanations of the expected deficit: Davis's (1979) suggestion that it is due to disorganisation of the self-schema in depression, and the hypothesis of Beck et al (1979) that depression is characterised by the predominance of a negative self schema. The expected deficit was observed on the recall but not on the recognition task. However, the precise pattern of the results raises problems for both of the above interpretations, and alternative explanations are considered. PMID- 3651764 TI - Lay explanations of delinquency: global or offence-specific? AB - Lay explanations of delinquency have been shown to be both complex and multidimensional and to vary according to factors such as respondent age and sex. However, previous research has treated crime as a global construct, although some studies have highlighted specific attitudes towards individual crimes such as violence and sexual assault. The first of the studies described here directly compared lay explanations for three types of crime-burglary, robbery and sexual assault. Using previously validated scales to assess lay explanation of crime, it was found that there were significant differences in the rated importance of the various scales for the three types of crime. Whilst burglary and robbery were most likely to be explained by failings in education and parenting, sexual assault was most strongly explained in terms of mental instability. Some variation according to age and sex of respondent was also found. A second experiment replicated several of these findings for the crimes of robbery and rape. The race of offender did not, however, significantly influence the explanations for these two offences. Finally, the potential implications of these results are briefly discussed. PMID- 3651765 TI - Commitments to help by children: effects on subsequent prosocial self attributions. AB - Children of both sexes and at several ages were or were not induced to make a commitment to help hospitalized children by sorting papers. The commitments occurred under either public or private circumstances. Later, the children discovered that the commitment to help would require that they give up their recess times (i.e. breaks). The willingness of subjects to live up to their commitments and the altruistic self-attributions resulting from those commitments were measured. It was found that, regardless of conditions, virtually all subjects were willing to give up recess time to help. However, their self attributions differed systemically with condition: only after making a private commitment to help did subjects come to see themselves as more altruistically oriented. Further, this effect appeared earlier for girls than for boys and persisted at least one month after the initial commitment. No such effects occurred for public commitments, suggesting that children as young as eight years were able to discount the self-relevant implications of prosocial commitments made under public scrutiny. PMID- 3651766 TI - Neural control of internal anal sphincter function. AB - The effect on anal tone of electrical stimulation of the presacral (hypogastric) sympathetic nerves has been studied in eight patients during abdominal rectopexy or restorative proctocolectomy. A sharp fall in anal pressure occurred in seven patients (mean fall 59 cmH2O; range 35-80 cmH2O). In one patient given a beta- and alpha-sympathetic blocking drug (labetalol 200 mg) intra-operatively, the anal pressure decreased by 15 cmH2O. These observations show that stimulation of the presacral sympathetic nerves causes relaxation of the internal anal sphincter and implies that these nerves may induce relaxation of the sphincter in vivo. The pathway of the recto-anal reflex has been studied intra-operatively in three patients undergoing rectal excision. The recto-anal reflex is present after presacral nerve blockade and after full mobilization of the rectum, but is abolished by circumferential rectal myotomy. The reflex has a local intramural pathway. This observation validates the assumption that absence of this reflex is a feature of aganglionosis, as in Hirschsprung's disease. PMID- 3651767 TI - Results of proctocolectomy for Crohn's disease. AB - Seventy-four patients have had a one-stage proctocolectomy for the management of Crohn's disease. Indications for operation were: acute colitis 28 per cent, chronic colitis 39 per cent, perianal disease 13 per cent, proctitis and perianal disease 8 per cent, bleeding 5 per cent, coexisting colonic malignancy 7 per cent. There were two hospital deaths (2.7 per cent), both associated with sepsis. Late deaths (n = 13) were most commonly associated with reoperations for recurrent disease (n = 3), cardiovascular disease (n = 4) and colorectal carcinoma (n = 1). Postoperative complications were principally associated with sepsis. Cumulative reoperation rates at 5 and 10 years were 19 and 24 per cent respectively. Recurrence was unrelated to the age of the patients, the duration of disease, or the presence of ileal disease at the time of colectomy. PMID- 3651768 TI - Unaltered risk of colorectal cancer within 14-17 years of cholecystectomy: updating of a population-based cohort study. AB - The incidence of colorectal cancer after cholecystectomy was analysed in a historical population-based cohort study comprising 16,439 patients who were completely followed up for 14-17 years after operation. The observed number of colorectal cancers (150) was lower than the expected number of 166.3 (relative risk (RR) = 0.90:95 per cent confidence limits 0.77-1.05) and the overall risk for colon cancer (RR = 0.95) did not differ significantly from that of rectal cancer (RR = 0.82). Separate analyses by sex, age at operation and duration of follow-up revealed relative risks close to or lower than unity. Some deviations indicating a substantially reduced risk might have been due to the play of chance alone. Our results contradict the idea both of a causal and of a non-causal association-through common aetiological factors-between surgically confirmed gallbladder disease and colorectal cancer. PMID- 3651769 TI - Natural history of anterior mucosal prolapse. AB - Case notes of 250 patients (M:F, 1:2.7; age 48.7 +/- 16.5 years) in whom anterior mucosal prolapse had been diagnosed, at one hospital between 1974 and 1976, were reviewed. The commonest symptoms were bleeding (56 per cent), pain (32 per cent) and a sense of prolapse (32 per cent). The prevalence of constipation was significantly higher among women (47 per cent) than men (29 per cent). Perineal descent was present in 20 per cent of cases and was significantly more frequently associated with excessive straining at defaecation (28 per cent) compared with patients in whom there was no history of excessive straining (12 per cent). Sixty six patients (26 per cent) experienced recurring symptoms over the 10 year period following presentation but did not deteriorate, while 28 patients (11 per cent) deteriorated. Deterioration was associated with a history of symptoms for longer than 1 year at the time of presentation, female sex, and the presence of perineal descent on clinical examination. The risk of developing perineal descent was less than 10 per cent over the 5 years after presentation while that of developing sphincter laxity among patients who had already developed perineal descent was 30 per cent over this period. Complete rectal prolapse occurred in 20 per cent (3/15) of patients with clinical perineal descent and sphincter laxity but was not seen in the absence of these signs. The results of treatment by submucosal phenol injection, mucosal rubber banding, or glycerine suppositories were the same. PMID- 3651770 TI - Implantation of a pressure cuff around the subphrenic oesophagus. AB - The possibility of implanting a pressure cuff around the subphrenic oesophagus as a barrier to reflux was tested in six pigs. The oesophagus tolerated cuff pressures from 48 to 95 cmH2O, corresponding to intra-oesophageal pressures from 27 to 75 cmH2O. The pigs with the perioesophageal cuff swallowed a solid diet without difficulty. However, dysphagia occurred in pigs kept alive for more than a month and the main reason was malfunction of the device because of surrounding fibrosis. This problem should be solved before implantation of the device in humans is attempted. PMID- 3651771 TI - Partial and complete sternotomy for blunt oesophagectomy. PMID- 3651772 TI - Edrophonium provocation test in the diagnosis of diffuse oesophageal spasm. AB - Criteria for diffuse oesophageal spasm(DOS) are dysphagia and chest pain with oesophageal manometry showing retention of peristalsis with the presence of synchronous contractions in response to wet swallows. Because of the intermittent nature of the symptoms, edrophonium was used as a provocative agent to increase diagnostic yield. Three hundred and ninety-six patients underwent transnasal manometry using a Gaeltec system of six internal transducers arranged at 5 cm intervals from the catheter tip; the majority of these patients received 10 mg edrophonium as an intravenous bolus. Reproduction of symptoms with typical manometry of DOS indicated a positive provocation test. There were no significant side effects. DOS was diagnosed in 34 patients who had either the typical manometry or a positive provocation test. Thirty of these patients received edrophonium. Twenty patients had baseline manometry which was diagnostic and ten of this group had a positive provocation test. The remaining 10 patients, who had normal baseline manometry, had positive provocation tests following the injection of edrophonium. Without edrophonium provocation testing, about a third of patients would not have been diagnosed as having DOS. PMID- 3651773 TI - Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children. AB - Nine patients with cystic hygroma were treated with a new sclerosing therapy consisting of intracystic injection of OK-432 (group A Streptococcus pyogenes of human origin). Favourable results including complete regression in eight patients and marked regression in one were observed within 2-3 months without serious side effects except for fever of 2-3 days' duration and local inflammatory reaction lasting for 3-4 days. Local inflammatory reaction did not cause any damage to the overlying skin and did not lead to scar formation. PMID- 3651774 TI - Intussusception in children 5-15 years of age. AB - Twenty cases of intussusception in children between the ages of 5 and 15 years were compared with intussusception in infancy and early childhood. They accounted for 18.5 per cent of all 108 children treated for intussusception in two large hospitals from 1964 to 1984. Diagnosis of intussusception was delayed, probably due to an unusual presentation. Fifty-five per cent had a definite predisposing factor precipitating the intussusception and 45 per cent had a small bowel intussusception, which warranted early surgical intervention. In the absence of contraindications no child should be disqualified from an attempt at hydrostatic reduction. After hydrostatic reduction careful follow-up is required to exclude an organic lesion, possibly by a small bowel follow-through meal. Surgery is indicated after hydrostatic reduction in case of chronically recurrent abdominal complaints. PMID- 3651775 TI - Serious hazard of plastic coding tape on surgical instruments. PMID- 3651776 TI - Mondor's disease as a presenting symptom of breast cancer. PMID- 3651777 TI - Record number of gallstones. PMID- 3651778 TI - Evaluation of the prognostic factors in gastric cancer: the effect of chemotherapy on survival. AB - This is a retrospective review of 328 consecutive patients with histologically confirmed gastric adenocarcinoma diagnosed in one centre between 1974 and 1984. Of these patients, 128 (39 per cent) had a curative resection, 32 (9.8 per cent) had a palliative resection, 33 (10.0 per cent) had a gastro-enterostomy, 26 (7.9 per cent) had a Celestin tube inserted, 58 (17.7 per cent) had a laparotomy alone, and 51 (15.5 per cent) had no surgical procedure. The 5 year survival was 11 per cent but all long term survivors were patients who had a curative resection. Using multivariate analysis the best predictor of survival after curative resection was the presence or absence of serosal involvement (P = 0.0004). Patients with a long history of presenting symptoms (greater than 6 months) survived longer than those with a short history (P = 0.001). The impact of chemotherapy on the survival of 202 patients with advanced gastric cancer was analysed by multivariate analysis. The median survival of the 50 patients receiving combination chemotherapy was better than that of the 152 who did not (median survivals 160 versus 71 days; P less than 0.001). When deaths occurring within 14 days of diagnosis were excluded, the significance value dropped to P = 0.02. Comparison of the groups treated between 1974 and 1979, when 8 per cent of 92 patients received chemotherapy, with 1980-1984, when 45 per cent of 110 patients received chemotherapy, showed no significant difference in survival. PMID- 3651779 TI - Relative contribution of bile and pancreatic juice duodenogastric reflux in gastric ulcer disease and cholelithiasis. AB - Bile acid concentrations, phospholipase A2 activity and pH in the stomach were measured in the fasting state and for 2 h after a fat-containing test meal in patients with an active gastric ulcer (GU), in patients with gallstones before and after cholecystectomy and in normal subjects. Fasting and peak postprandial bile acid concentrations in the stomach were low in all normal controls. Although high concentrations were found in many patients with GU (P less than 0.01), similar concentrations were found in many patients with radiologically non functioning gallbladders containing gallstones (NFG) (P less than 0.01) and also after cholecystectomy (AC) (P less than 0.01). Fasting intragastric phospholipase A2 activities were similar, and very high in GU and NFG patients compared with control subjects (P less than 0.01). High values were not found after cholecystectomy. There was no difference in pH profile or in postprandial phospholipase A2 between patient groups. Since patients with cholelithiasis or after cholecystectomy are not known to have an increased incidence of gastric ulceration, the significance of duodenogastric reflux in the aetiology of gastric ulcers must be questioned. If reflux does produce ulcers in GU patients then factors in addition to bile acid are probably involved. However, neither patterns of phospholipase A2 reflux nor pH profiles can explain the absence of gastric ulceration in those patients with gallstones who reflux large quantities of bile acid. PMID- 3651780 TI - Percutaneous transhepatic cholangioscopy. AB - Since 1983, percutaneous transhepatic cholangioscopy has been performed in 50 patients for both therapeutic and diagnostic purposes. Percutaneous transhepatic cholangioscopy was used to evaluate the nature of obstructive jaundice in 15 patients and bile duct stones were removed in 35 patients, 27 of whom also had intrahepatic duct stones. The overall success rate for stone removal was 80 per cent. Complications were few with no mortality. Emergency surgery was necessary in two patients, one for subphrenic haematoma, the other for a bile leak. Percutaneous transhepatic cholangioscopy is an effective and safe method for management of biliary stones and is a useful procedure for establishing the diagnosis of obstructive jaundice. PMID- 3651781 TI - Loss of substance in bile ducts treated by a new surgical endoprosthesis. AB - Three cases of loss of substance of the common bile duct in patients with neoplastic disease treated by a new surgical endoprosthesis are reported. In all patients a good biliary drainage was obtained without a biliary fistula. There were no complications related to this method. Long-term follow-up showed persistence of the good immediate results. Surgical endoprostheses might be an alternative in cases with peroperative loss of substance of the common bile duct in patients with neoplastic disease to hepato-enteric anastomoses. PMID- 3651782 TI - Pumping device for re-infusion excretions derived from a proximal jejunostomy or high output fistula. PMID- 3651783 TI - Role of Enterobius vermicularis in the aetiology of appendicitis. AB - An evaluation was made of the histological material obtained from all 1529 appendices removed during the last 5 years at Southmead Hospital, Bristol, in order to elucidate possible relationships between the incidence of Enterobius vermicularis and the origin of inflammation in the appendix. In total, 1419 appendices were removed as cases of clinical appendicitis and 110 in the course of another surgical procedure. E. vermicularis was identified in 2.7 per cent of patients with clinical appendicitis and was most commonly seen in appendices with either chronic inflammation or where the appendix was histologically normal. E. vermicularis was rarely associated with histological changes of acute appendicitis. No cases of E. vermicularis infestation occurred in appendices removed during the course of other surgical procedures. The results suggest that, although E. vermicularis may have a causal role in appendicular pain and chronic inflammation, it is rarely related to acute appendicitis. PMID- 3651784 TI - Comparison of the local and systemic effects of sepsis in predicting survival. AB - Progress in the study of sepsis has been hampered by the lack of a suitable system for grading its severity. Systems suggested for scoring sepsis have been based either on its systemic effects (APACHE II) or on a mixture of local and systemic variables (sepsis score). The APACHE II and sepsis scores were applied to patients with intra-abdominal sepsis of more than 3 days' duration, to determine if local or systemic factors were more important in predicting survival. Of 45 patients studied, 14 died. The sepsis score for non-survivors (median 21.5, range 11-32) was significantly higher than for survivors (median 14, range 10-26, P less than 0.05). There was overlap between the two groups, such that an individual score had no predictive value. The local component of the sepsis score was not significantly increased in non-survivors (P less than 0.05), but the systemic component was (P less than 0.05). The APACHE II score for non survivors (median 24, range 15-38) was significantly higher than for survivors (median 12, range 3-21), and correctly identified 13 of the 14 fatalities. Both the systemic and non-systemic components (age and chronic disease) were significantly higher among the latter. The APACHE II was more effective than the sepsis score in predicting survival. We conclude that any system used for scoring sepsis should be based on systemic rather than local effects. At present the APACHE II score is preferred. PMID- 3651785 TI - Fluoroscopic peroperative cholangiography: technique and associated radiation hazards. AB - The techniques specific to peroperative fluorocholangiography are discussed based on an experience of 632 cholangiograms and an estimation has been made of the associated radiation doses to staff and patients. Rapid and accurate information can be obtained during fluorocholangiography using appropriate techniques with acceptably low radiation hazards. PMID- 3651787 TI - Twenty-four-hour ambulatory oesophageal pH monitoring. PMID- 3651786 TI - Salvage autotransfusion in aortic surgery: initial studies using a disposable reservoir. AB - Transmission of disease by allogeneic transfusion can be avoided using several techniques by which a patient receives his own blood. Sixty patients undergoing aortic surgery consented to salvage interoperative autotransfusion. A mean of 895 ml shed blood was reinfused under full heparinization, representing 12-74 per cent of total blood loss. Bank blood requirements fell from 4.9 units to 3.4. No important haematological or clinical complications were noted (including coagulation studies) but haemolysis was detected 4 h postoperatively by plasma haemoglobin levels of 0.05 +/- 0.03 g/dl. This preliminary study confirms the applicability of salvage autotransfusion during elective vascular surgery by demonstrating an appreciable saving in bank blood transfusion (70 per cent). PMID- 3651788 TI - Non-specific acute abdominal pain. PMID- 3651789 TI - Perforated duodenal ulcers. PMID- 3651790 TI - Colon "cast" in a patient with ischaemic colitis. PMID- 3651791 TI - Secondary aorto-enteric fistulae. PMID- 3651792 TI - Hyperexcitability of cutaneous afferents during the supernormal period. Relevance to paraesthesiae. AB - The excitability of cutaneous afferents in the median nerve of 20 normal human subjects was investigated using a supramaximal conditioning stimulus and a submaximal test stimulus that produced an afferent volley of 20 to 40% of maximum. The intensity of the test stimuli was 1.1 to 1.25 times threshold for the first recruited axons (defined as a compound action potential of approximately 0.5 microV). The amplitude of the test volley did not reach the control amplitude until conditioning-test intervals of 3.4 ms. This was followed by a period of increased axonal excitability which reached a peak at intervals of 5 to 8 ms and declined gradually into a late phase of subnormality at 15 to 20 ms. The amplitude of the submaximal test potential was potentiated by, on average, 47% (range 9-146%) during the supernormal period. There were no significant changes in latency. The time course and the degree of potentiation were reproducible in the same subject on separate occasions. When the limb was cooled, the latency of the onset of supernormality was increased and the degree of supernormality was decreased and ultimately abolished. There was an inverse relationship between the degree of potentiation and the size of the test volley. High-frequency repetitive stimulation of the digital nerves for 10 min modified axonal excitability and produced spontaneous paraesthesiae that lasted for 20 min after the stimulation. Following this prolonged stimulus train, single submaximal stimuli evoked larger cutaneous afferent potentials than before the train, and the extent of the potentiation during the supernormal period was increased. It is concluded that prolonged repetitive stimulation of cutaneous afferents has two effects, one on axonal threshold, the second on the supernormal period. It is suggested that, in this experimental model, paraesthesiae result from ectopic impulses generated when axonal excitability is highest, namely at the peak of the supernormal period. PMID- 3651793 TI - Labial kinematics during speech in patients with parkinsonian rigidity. AB - Studies of orofacial motor control in Parkinson's disease (PD) have demonstrated that these subjects may exhibit hypokinesia and bradykinesia, as well as increased muscle tone. Yet the relationship between aberrations of orofacial movement and muscle rigidity remains unclear. Measures of labial muscle rigidity and movement were made for 12 parkinsonian and 9 age-matched control subjects. Displacement amplitude, peak instantaneous velocity, and movement time were evaluated during repetitive syllable productions. The results showed that while mean parkinsonian displacement amplitudes and velocities were lower than the normal control subjects, there was no statistical relationship between labial rigidity and the degree of movement abnormality. It is concluded that while rigidity may play a part in the overall disability, it does not sufficiently explain the labial articulatory difficulties associated with parkinsonism. This is in agreement with the literature on limb rigidity and movement aberrations in PD, suggesting that rigidity and bradykinesia may represent independent pathophysiological phenomena. PMID- 3651794 TI - Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. AB - Patients with single stroke lesions, verified by computerized tomography, involving either cortical tissue or restricted entirely to subcortical structures were examined for mood disorders. Those with left anterior lesions, either cortical or subcortical, had significantly greater frequency and severity of depression than patients with any other lesion location. A strong correlation between the severity of depression and proximity of the lesion to the frontal pole was observed for both left cortical and subcortical groups. Right hemisphere lesions did not show the same correlation with depression but were associated with a significantly higher incidence of undue cheerfulness. These findings demonstrate the importance of the location of subcortical lesions in poststroke mood disorders and suggest that anterior subcortical structures may play an important but lateralized role in the production or regulation of mood. PMID- 3651795 TI - The slow channel syndrome. Two new cases. AB - Two patients are described with a myasthenic syndrome that presented in early adult life. One patient had 2 asymptomatic first degree relatives with similar electrophysiological findings. Both patients had abnormal fatiguability, arm weakness being prominent; neither of them responded to anticholinesterase medication. An abnormal decrement at 3 Hz stimulation was present, and a single stimulus evoked a repetitive response. Electrophysiological studies on biopsied intercostal muscle showed miniature endplate potentials of normal amplitudes but with prolonged rise and decay times. Anticholinesterase staining (Case 1) was not reduced, and showed elongation of some endplates. Ultrastructural studies (Case 2) showed degeneration of junctional folds and diffusely thickened endplate basal lamina. Calcium deposits were not observed and myopathic changes were slight. The findings are consistent with a prolonged open time of the ACh-induced ion channel. PMID- 3651796 TI - Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. AB - Nineteen patients developed polyneuropathy complicating critical illness. They had been admitted to a critical care unit following intubation for cardiac or pulmonary disease and had developed sepsis and multiple organ failure. Approximately one month following intubation, failure to wean from the ventilator and limb weakness prompted neurological referral. Examination disclosed weakness and wasting of muscles and impaired tendon reflexes in most, but not all, patients. Electrophysiological studies in 17 patients revealed attenuated compound muscle and sensory nerve action potential amplitudes and widespread denervation on needle electromyography. Autopsy in 9 patients who died of their critical illness revealed widespread primary axonal degeneration of motor and sensory fibres, with extensive denervation atrophy of limb and respiratory muscles. Survivors recovered from the polyneuropathy three to six months following discharge. Seventeen of the patients were segregated by electrophysiological criteria into mild (8) and severe (9) polyneuropathy categories. An analysis of these two groups failed to reveal putative metabolic, drug, nutritional or toxic factors that might be responsible for the polyneuropathy. Our studies suggest that the mechanism may be a fundamental defect, still unknown, which causes dysfunction of all organ systems in this syndrome. PMID- 3651797 TI - Nonsystemic vasculitic neuropathy. AB - Among 65 patients with necrotizing vasculitis, 45 had systemic and 20 had nonsystemic vasculitic neuropathy. In nonsystemic vasculitic neuropathy, clinically only nerves are affected; there are no, or few, constitutional symptoms or serological abnormalities. The clinical and pathological features are those of an ischaemic neuropathy caused by a necrotizing vasculitis of small arterioles. These 20 patients had neuropathic symptoms for a median time of 11.5 yrs (range 1-35 yrs). The clinical pattern of neuropathy was that of multiple mononeuropathy in 13, asymmetric neuropathy in 4, distal polyneuropathy in 3, and sensory polyneuropathy in 1. As compared with their initial evaluation, 8 are now worse, 5 are better, 4 are approximately the same, and 3 are dead from unrelated causes. Prednisone was thought to prevent the development of new lesions in some cases. By contrast, of the 41 patients with systemic necrotizing vasculitis whose outcome is known, 12 are dead (median time, 1.5 yrs, range 3 months-8 yrs) and 29 are alive (median time, 6 yrs, range 6 months-22 yrs). PMID- 3651798 TI - Encephalopathy and myelinolysis after rapid correction of hyponatraemia. AB - Considerable controversy has followed the recent publication of studies indicating that central pontine myelinolysis is caused by rapid correction of hyponatraemia. Alternative suggestions have been that myelinolysis is due to uncorrected hyponatraemia, that it occurs only with over-correction of hyponatraemia or that it is due to coincidental hypoxia. The following experiments were undertaken to clarify the relationship between myelinolysis and derangements of serum sodium and their treatment. Severe hyponatraemia ([Na+] less than or equal to 122 mmol/l) was produced in three groups of rabbits by injection of vasopressin and 5% dextrose in water. Rabbits with severe uncorrected hyponatraemia sustained for seven days or more did not show myelinolysis at autopsy. Myelinolytic lesions did develop in 3 of 7 rabbits in a second group in which corrective infusion of hypertonic saline was administered after only three days of severe hyponatraemia. Neurological deterioration also occurred in rabbits in the third group which received hypertonic saline within 24h of developing severe hyponatraemia. In this group no lesions were apparent at autopsy. No animal became hypernatraemic with correction. These results indicate that even prolonged severe hyponatraemia does not lead to myelinolysis if it remains uncorrected, but that rapid correction of hyponatraemia, without over correction, can cause neurological disease. Accordingly, a rapid rise in serum sodium should be avoided. PMID- 3651799 TI - Chromaticity and achromaticity. Evidence for a functional differentiation in visual field defects. AB - In the visual field defects of 10 patients who had suffered lesions in the postgeniculate part of the primary visual projection, red-green discrimination and achromatic target detection was tested. In addition, 8 of these patients were tested for detection of red and green targets. Targets were presented on a low photopic achromatic background, so that the red and green targets differed from the background both in intensity and in wavelength, whereas the achromatic target differed in intensity only. Six patients showed evidence of discriminating between red and green targets, 5 patients could also detect the colour targets, but none could detect the achromatic one that was presented at the same retinal position. These results imply that wavelength and intensity information are treated differentially, and suggest that these patients possess residual colour opponent channels that subserve the defective part of the visual field. PMID- 3651800 TI - Residual vision in patients with retrogeniculate lesions of the visual pathways. AB - Twenty-five subjects have been studied who, as a result of damage to the striate cortex, were 'blind' in extensive areas (scotomata) of the visual fields. Of these 25 subjects, 5 exhibited residual vision in response to transient lights presented within the scotoma, which enabled them to locate the stimuli by hand reaching or by eye movements; the latter have been measured by electro oculography. The residual vision underlying their responses was characterized by low flicker-fusion and by sensitivity in detection of movement which increased as target speed was raised. Discrimination for the direction of target movement was poor, but spatial resolution in the discrimination of target displacement was essentially normal. The subjects were unable to recognize or discriminate the spatial structure of targets located within the 'blind' field, and the observed dissociation between spatial discrimination of displacement and pattern is examined in relation to the 'two systems' hypothesis of visual function. There is no obvious correlation between the extent of neuronal damage as revealed by CT scans and the existence of residual vision. PMID- 3651801 TI - Focal ischaemia caused by instability of cerebrovascular tone during attacks of hemiplegic migraine. A regional cerebral blood flow study. AB - During the course of hemiplegic migraine in 3 patients, changes in regional cerebral blood flow (rCBF) were recorded by the intracarotid 133Xe method and a 254 multidetector camera covering one hemisphere. The rCBF measurements were performed in conjunction with cerebral angiography. During repeated rCBF measurements all 3 patients developed focal hypoperfusion originating in the frontal lobe, subsequently spreading posteriorly to involve the precentral and postcentral regions. In 2 cases focal hyperperfusion appeared to precede the hypoperfusion. In association with the rCBF changes the patients developed transient motor and/or sensory deficits and subsequently severe headache. No signs of arterial occlusion were found. In the over and underperfused regions blood flow fluctuated rapidly because of instability of cerebrovascular tone, defined as transient constriction of the smallest cerebral vessels (arterioles) alternating with a normal calibre for these vessels and/or short periods of vasodilatation. It is considered to be a primary pathological condition of the vessels. When vasoconstriction was present the blood flow decreased to values consistent with ischaemia, which was probably the cause of the neurological deficits. On the basis of these observations and previous work from our laboratory we conclude that instability of cerebrovascular tone may cause focal ischaemia during the course of attacks of classical and hemiplegic migraine. PMID- 3651802 TI - Disordered auditory short-term memory in man and event-related potentials. AB - Four patients with conduction aphasia and impaired auditory but relatively preserved visual digit spans were tested in a task of short-term memory, a digit probe identification task, in both the visual and auditory modalities. Five age matched normal subjects served as controls. Behavioural measures of response accuracy and reaction time and scalp derived event-related potentials were determined as a function of the number of items to be remembered. These measures were also recorded in a task requiring the detection of infrequent stimuli ('oddball' paradigm). The patients' performance and event-related potential wave forms for the 'oddball' task were no different from those of the controls. In the digit probe identification tasks the patients showed a reduction in amplitude of a positive component at a latency of approximately 450 ms (P450) of the event related potential to correctly identified probes in the auditory modality. This component was within normal limits with visual testing. There was an inordinate increase in the patients' reaction time to auditory but not visual stimuli when the number of items to be remembered increased from one to three. Event-related potentials were also analysed as a function of speed of reaction time, position of the matching item in the stimulus presentation set and whether the probe was correctly identified as being in-set or out-of-set. Event-related potentials associated with fast reaction times in the auditory task when a single item was presented were no different between patients and controls, indicating that patients were capable of both performing normally and generating normal potentials on some trials. The data suggest that the deficit in auditory short term memory in these patients occurs during stimulus classification. PMID- 3651803 TI - Correlations of subcortical CT lesion sites and aphasia profiles. AB - We have analysed the aphasia profiles of 19 cases with subcortical infarction or haemorrhage. Several components of the aphasic syndromes, especially sentence length and grammatical form (together compromising fluency), ease of speech initiation, articulation, voice volume, and auditory comprehension, were individually isolated for correlation with CT lesion site. Each component had a specific lesion site correlation, and lesions in various deep periventricular white matter regions were the critical ones for all components of aphasia. Simple tabulation of lesions as cortical or subcortical, and restricting analysis to lesions of basal ganglia would both have proved inadequate to account for clinical findings. A review of 61 subcortical cases in the neurological literature for which CT and aphasia data were available supports these conclusions. PMID- 3651804 TI - Action-naming performance in four syndromes of aphasia. AB - This study examined the influence of two situational contexts on the action naming performances of 44 aphasic patients: single-word confrontation naming and naming within the context of connected speech. Subjects were evenly distributed among the syndromes of Broca's. Wernicke's, anomic, and conduction aphasia. The two naming tasks employed each comprised the same 18 target verbs. Naming performance was not systematically influenced by the particular naming task in any of the aphasia groups studied. However, for some individuals, particularly in the group of anomic aphasia, there were substantial performance discrepancies between scores obtained on the two different tasks. Correlations between scores on the confrontation-naming and picture-description tasks were highest for the Wernicke's aphasics, followed by the conduction, Broca's, and anomic aphasics. The extent to which action-naming error types could discriminate between the four groups of aphasics was examined. Results obtained in the present study were compared to results obtained in an earlier study on object-naming (S. Williams & G. Canter, 1982), Brain and Language, 17, 92-106). Discussion focuses on implications for the psycholinguistic processes involved in action versus object naming. PMID- 3651805 TI - Unilateral brain lesions in childhood: performance on the Revised Token Test. AB - Comprehension of connected language as assessed by the Revised Token Test (RTT) was studied in 17 children with left hemisphere lesions (LL) and 11 with right hemisphere lesions (RL). LL children's significantly lower performance on several subtests than left controls (LC) matched by age, sex, race, and social class appeared to be related to the memory demands of these subtests rather than the limited syntactic elements assessed by the RTT. LL subjects requested significantly more command repetitions than control or RL subjects and when a repetition was not requested LL subjects often responded with immediacy. Although RL children tended to perform lower than right matched controls (RC), these differences were not significant nor readily related to either the memory or specific linguistic structures assessed. RL subjects required fewer command repetitions than LL subjects and exhibited a significantly greater frequency of immediate responses than controls or LL subjects. While based on few children, a trend for LL children with retrorolandic lesions to perform more poorly than those with left prerolandic lesions was suggested. No systematic difference in performance was apparent for children with left cortical vs. left subcortical lesions or among discrete sites of lesions within the right hemisphere. Children with left lesions prior to 1 year of age performed no better and, in several instances, significantly poorer than LL patients sustaining lesions after 1 year of age. Among RL subjects, those sustaining lesions after 1 year of age had greater difficulty than those with lesion onset before 1 year of age, especially on linguistic elements which seemed to be dependent upon visual spatial properties. Further studies are needed to evaluate the comprehension of more complex linguistic structures among children with unilateral brain lesions as well as to study the role of more basic factors such as memory and attention in explaining the present findings. PMID- 3651806 TI - Articulatory and phonological deficits in short-term memory and their relation to syntactic processing. AB - The relationships between sentence comprehension deficits and deficits in the articulatory or phonological components of short-term memory were investigated. Nonfluent agrammatic patients showed very poor comprehension of syntax while a group of nonfluent patients who were not agrammatic showed good comprehension, despite both groups showing similar degrees of deficits in an articulatory component of memory. The results imply that a disruption of inner rehearsal has little consequence for auditory sentence comprehension, and that the syntactic comprehension deficits of the agrammatic patients could not be attributed to their memory deficit. A patient with a disruption in phonological storage showed good comprehension for many sentences, but was impaired when a difficult syntactic structure was encountered early in a sentence. It was proposed that phonological storage serves to hold words in a phonological form when sentence processing cannot keep pace with sentence input. Although a role for phonological storage was postulated, the impressive degree of syntactic processing that could be carried out by patients with very restricted memory spans implies that there is little overlap between the memory systems disrupted in these patients and the working memory system presumed to be involved in sentence comprehension. PMID- 3651807 TI - Comprehension in aphasia: a cross-linguistic study. AB - Broca's aphasics and normal controls were tested to determine relative sparing and impairment of word order, grammatical morphology, and semantic information in a sentence interpretation task. Patients were native speakers of English, German, or Italian, languages that vary drastically in the "cue validity" or information value of these three sources of information. Word order was selectively spared while grammatical morphology was selectively impaired in all three languages. Nevertheless, language-specific patterns of sentence interpretation remained in Broca's aphasics, even within the impaired morphological component, supporting an interpretation in terms of "accessing" rather than a "loss." Testing with Wernicke's aphasics, anomics, and some additional age-matched controls suggested that the selective vulnerability of morphology is not specific to agrammatic patients, at least in this paradigm. PMID- 3651808 TI - Spatial constraints on attention to speech in the blind. AB - When sighted persons try to identify one of two speech utterances coming from different directions, they display both a frontal position advantage, i.e., better recognition of inputs from the front than of those from the rear, and a right-side advantage, better recognition of inputs from the right than of those from the left. The present study demonstrates a dissociation of the two effects in blind subjects (N = 10) who showed no frontal position advantage together with a right-side advantage superior to that of control sighted subjects (N = 16). There was no systematic difference between congenitally blind subjects and noncongenitals. The absence of frontal position advantage in the blind is consistent with the notion that this effect originates in the habit of sighted listeners to orient toward the source of heard speech. The occurrence of at least normal right-side advantage in the blind does not support recent suggestions of reduced lateralization of language functions in such subjects. PMID- 3651809 TI - Word recognition and comprehension skills in hyperlexic children. AB - Five hyperlexic boys (4-5 to 10-1 years), who had been diagnosed with infantile autism or pervasive developmental delay in early childhood, were evaluated. Measures of intelligence, single-word recognition and comprehension, and picture naming were administered to determine the precocity or deficiency of reading recognition and comprehension, the underlying mechanisms of oral reading, and possible parallels with the acquired dyslexia subtypes. The results indicated that hyperlexia may be operationalized as unexpected reading precocity as compared to IQ; however, reading comprehension was not unexpectedly deficient. The phonological route to reading appeared to be preferred to the lexical route, and the overall pattern of performance most closely paralleled that of the surface dyslexic subtype. PMID- 3651810 TI - Strategic hand use preferences and hemispheric specialization in tactual reading: impact of the demands of perceptual encoding. AB - Four reading-related, information-processing tasks were administered to right handed blind readers of braille who differed in level of reading skill and in preference for using the right hand or the left hand when required to read text with just one hand. The tasks were letter identification, same-different matching of letters that differed in tactual similarity, short-term memory for lists of words that varied in tactual and phonological similarity, and paragraph reading with and without a concurrent memory load of digits. The results showed interactions between hand preference and the hand that was actually used to read the stimulus materials, such that left preferrers were significantly faster and more accurate with their left hands than with their right hands whereas right preferrers were slightly but usually not significantly faster with their right hands than with their left hands. In all cases, the absolute magnitude of the left-hand advantage among left preferrers was substantially larger than the right hand advantage among right preferrers. The results suggest that encoding strategies for dealing with braille are reflected in hand preference and that such strategies operate to modify an underlying but somewhat plastic superiority of the right hemisphere for dealing with the perceptual requirements of tactual reading. These requirements are not the same as those of visual reading, leading to some differences in patterns of hemispheric specialization between readers of braille and readers of print. PMID- 3651811 TI - Spinal inputs to the ventral dendrite of the teleost Mauthner cell. AB - Ascending excitatory inputs from the periphery to the ventral dendrite of the goldfish Mauthner (M)-cell are characterized in this report. Direct stimulation of the spinal cord, at strengths suprathreshold for antidromic activation of the M-axon, evoked a graded excitatory postsynaptic potential (EPSP) in the distal ventral dendrite of the cell. This localization was demonstrated by multiple intracellular recordings from the soma and dendritic loci. The EPSP had a relatively long latency (mean = 3.6 ms) and contained multiple components. Furthermore, the EPSP amplitudes were extremely sensitive to frequency, being reduced by more than 50% at frequencies of 1-2 Hz and maximal with interstimulus intervals of 30-60 s. The spinal input is, therefore, likely to be mediated by a polysynaptic pathway. Direct stimulation of the skin surface evoked similar EPSPs, in terms of latency, wave form, graded nature, frequency dependence and spatial distribution on the M-cell ventral dendrite. Thus, the spinal cord and skin inputs probably relay somatosensory information from the trunk to the M-cell ventral dendrite. This notion was further confirmed by an interaction study of the EPSPs evoked from the two sites. We also report that the ventral dendrite does not support active spike electrogenesis, as indicated by the spatial profile of the M-cell antidromic impulse amplitude. PMID- 3651812 TI - Relationships between interhemispheric cortical connections and visual areas in hooded rats. AB - The correlation between visual topography within striate and lateral extrastriate visual cortex and the pattern of callosal connections to those areas has been studied in gray rats. The procedure was to put multiple injections of horseradish peroxidase (HRP) into the occipital cortex of the right hemisphere. The cortical areas 17 and 18a in the left hemisphere were electrophysiologically mapped upon stimulation of the right eye. Reference lesions were placed at selected recording sites. Horizontal sections of the left cortex were reacted for the demonstration of HRP. This permitted the comparison of the visual and callosal maps in the same animal. Like in other mammals, the callosal projections coincide with the cortical representations of the vertical midline and the more central regions of the visual field. The heavy line of labelled neurons and terminations embedded within the primary callosal band at the 17/18a border coincides with the representation of the vertical meridian. It provides the boundary between V1 and the maps located lateral to it. In area 18a, the anterolateral is contained in its anterior half, whereas areas lateromedial and laterointermediate are contained in its posterior half. The acallosal 'island', caudal to the acallosal 'body', contains the map known as posterolateral. There are two laterolateral (LL) maps which coincide with the acallosal 'islands' lateral to the acallosal 'body'; laterolateral anterior is more rostral than LL and these are retinotopically organized as mirror images of each other. Lateral to LL, there is a suggestion of an additional map, which could correspond to a pararhinal area. These results may be useful to understand aspects of a basic mammalian plan in the organization of visual cortex. PMID- 3651813 TI - Genetic selection disrupts stability of mouse brain weight development. AB - Fuller Brain Weight Selection lines are well differentiated for 42-day brain weight and a high degree of genetic homogeneity for trait-relevant genes is indicated. Using these lines, random bred descendants of the foundation population and an inbred line, biometrical analysis of brain growth from birth to 23 days was attempted. While strain means differ as expected, within and between litter variances for genetically heterogeneous mice were typically no greater than for more genetically homogeneous selected lines. Possible explanations involving gestational age, intra-uterine and postnatal competition and ontogenetic buffering are discussed. PMID- 3651814 TI - Chronic bombesin treatment increased the [3H]spiperone binding, glutamate decarboxylase and choline acetyltransferase activity in the rat brain. AB - The effects of chronic bombesin (BBS) on [3H]spiperone (SPD) binding activity, choline acetyltransferase (ChAT), acetylcholinesterase (AChE) and glutamate decarboxylase (GAD) were investigated in the rat brain corpus striatum (CS). The chronic i.p. administration of BBS to rats increased: (1) the specific [3H]SPD binding to the striatal Pm (plasma membrane) (16%, P less than 0.03 and 34%, P less than 0.008 at 5 micrograms/kg respectively), (2) the specific GAD activity in the CS by 52% (5 micrograms/kg, n.s.) and 46% (10 micrograms/kg, P less than 0.05) respectively, (3) the specific ChAT activity in the CS by 54% (10 micrograms/kg, P less than 0.002), and (4) the specific AChE activity by 23% (10 micrograms/kg, P less than 0.02) after 14 days. It increased only: (1) the specific [3H]SPD binding by 29% (P less than 0.001, at 10 micrograms/kg) and (2) the specific GAD activity by 23% (P less than 0.015, 10 micrograms/kg), after 7 days. Neither ChAT nor AChE activity was affected after 7 days treatment of BBS at 10 micrograms/kg. In vitro study showed that BBS at 0.2 microM did not affect any of the neurochemical parameters examined in the CS. Thus, the changes in brain chemistry caused by chronic BBS were not due to direct effects of BBS but may be mediated through its metabolites or CCK release. Data indicate that the central effects of peripherally administered BBS are dependent on both the duration and the dosage of the drug treatment and that the dopaminergic and GABAergic systems seem to be more vulnerable to chronic BBS than the cholinergic system in the rat brain CS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651815 TI - The protective effect of hypothermia on hippocampal slices from guinea pig during deprivation of oxygen and glucose. AB - Using guinea pig hippocampal slice preparations, the effect of temperature on the electrical activity and the protective effect of hypothermia against deprivation of both oxygen and glucose were studied by recording field potentials of pyramidal cell layer (CA3-4 area) and by measuring the content of adenosine triphosphate (ATP), phosphocreatine (PCr) and lactate of each slice. Cooling the perfusion medium from 37 to 21 degrees C caused a decrease in the amplitude of field potentials, although the amplitude increased (120%) transiently at around 33 degrees C. The electrical activity ceased at around 22 degrees C. When the temperature was raised from 21 to 37 degrees C, the activity recovered reversibly. However, when the temperature was raised to above 38 degrees C, the amplitude decreased and disappeared irreversibly at 42 degrees C. During deprivation, energy consumption (total approximately P used; 2 X delta ATP + delta PCr + 1.3 X delta lactate) was suppressed by lowering the tissue temperature and the initial (0-2.5 min deprivation) energy use rate was calculated to be 42.2 at 37 degrees C, 22.8 at 28 degrees C and 7.0 at 21 degrees C (approximately P m mol/kg protein/min), respectively. From these values, Q10 was estimated to be 2.05. With regard to the protective effect of hypothermia, the critical survival time (period of deprivation of oxygen and glucose for the complete recovery in neural activity and the level of high energy phosphates) was 10 min at 37 degrees C, 15 min at 28 degrees C, and 45 min at 21 degrees C, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3651816 TI - Strychnine alters the fusiform cell output from the dorsal cochlear nucleus. AB - Anatomical and physiological evidence suggests that fusiform cells, the major output neurons of the dorsal cochlear nucleus (DCN), receive significant inhibitory input. Fusiform cells often display strongly non-monotonic rate intensity functions and pauser-buildup or buildup tone-evoked temporal responses, patterns which may be mediated by inhibitory neurotransmitters. Other neurons located within the fusiform cell layer or in the more superficial molecular layer display varied rate-intensity functions and temporal responses. Neurons displaying response properties characteristic of fusiform cells are sensitive to iontophoretic application of the inhibitory amino acid neurotransmitter, glycine. Application of the glycine receptor antagonist, strychnine, alters the non monotonic portion of the rate-intensity function at doses which do not alter spontaneous activity or near-threshold tone-evoked responses. These neurons are also sensitive to GABA and the GABAB agonist, (-)-baclofen, but are insensitive to the GABAA antagonist, bicuculline. DCN neurons which display monotonic rate intensity functions and temporal response properties different than those associated with fusiform cells are sensitive to bicuculline, (-)-baclofen, and GABA. These data suggest that a glycinergic input onto fusiform cells may control the non-monotonic nature of the response of these neurons near characteristic frequency and therefore may contribute significantly to the nature of the output of the DCN. PMID- 3651817 TI - Many ventral root afferent fibers in the cat are third branches of dorsal root ganglion cells. AB - The arrangement of the ventral root afferent fibers was investigated in anesthetized and paralyzed cats. Single unit activity was recorded from a fascicle of the distal stump of the cut S1 dorsal root. Activity was elicited by stimulating the distal stump of the cut S1 ventral root. Attempts were then made to collide this activity with that elicited by stimulation of the S1 spinal nerve. Single unit activity elicited by ventral root stimulation was recorded from a total of 33 axons. In 17 of these, the activity collided with that elicited by peripheral stimulation. These results indicate that more than half the sampled population of ventral root afferent fibers are branches of dorsal root ganglion cells that have at least 3 processes: one in the dorsal root, one in the ventral root and one in a peripheral nerve. In 10 of these units, the conduction velocity of each of 3 processes was determined using the collision technique. The conduction velocities differed in the processes of a given ganglion cell, with conduction in the ventral root process generally being the slowest. The change in conduction velocity along the length of the ventral root was examined by comparing latency differences for the unit activity elicited by ventral root stimulation at different sites in the same root separated by known distances. The conduction velocity was found not to be uniform along the course of the ventral root. In many cases, the conduction velocity slowed down as the fiber approached the spinal cord. We conclude from the present study that many ventral root afferent fibers are the third branches of dorsal root ganglion cells that also have processes in the dorsal root and in a peripheral nerve. The sizes of each of these 3 processes of the dorsal root ganglion cell may differ; the ventral root process tends to be the smallest and is usually unmyelinated. Furthermore, many of the ventral root afferent fibers may taper as they approach the spinal cord. PMID- 3651818 TI - Detection of propionic acid vapor by rats with lesions of olfactory bulb areas associated with high 2-DG uptake. AB - This study tested the functional significance of recent 2-deoxyglucose (2-DG) results demonstrating a discrete focus of activity in the olfactory bulb of rats exposed to the vapor of propionic acid. Rats with lesions that destroyed this area of the olfactory bulb performed as well as did sham operated and lesioned controls in detection of amyl acetate, butanol, geraniol, propionic acid, and on a test for propionic acid threshold. Our results demonstrate that an area of the olfactory bulb containing a major focus of metabolic activity induced by exposure to an odor can be removed without producing a deficit in the detection of that odor. PMID- 3651819 TI - Proglumide has access to brain and antagonizes the central satiety effect of cholecystokinin octapeptide in the dog. AB - Intra-third cerebroventricularly administered cholecystokinin octapeptide (CCK-8) decreased food intake through central mechanisms in the dog. Proglumide, administered intravenously, did enter into cerebrospinal (ventricular) fluid, and partially, but significantly, reversed this effect. CR1409, one of the newly synthesized glutaramic derivatives, blocked CCK-8-induced satiety more strongly than proglumide. These results indicate that systemic proglumide and CR1409 result in antagonism of the central CCK receptor for satiety in the dog. PMID- 3651820 TI - Electrophysiological analysis of the tecto-olivo-cerebellar (lobulus simplex) projection in the rat. AB - In albino rats the deep layers of the superior colliculus were stimulated, and climbing fiber responses of Purkinje cells were explored in the medial region of the lobulus simplex. They were identified in a strip (ca. 0.7-1.0 mm wide) in the most medial region of folium b. In the tectorecipient zone of the medial accessory olive antidromically evoked potentials from the lobulus simplex were recorded laterally to those from lobule VII. Evidence is presented that climbing fibers innervating the zone in the lobulus simplex are axon collaterals of the inferior olivary neurons which project to crus II. PMID- 3651821 TI - 8-Cyclopentyl 1,3-dimethylxanthine prolongs epileptic seizures in rats. AB - We tested the effects of 8-cyclopentyl-1,3 dimethylxanthine (8-CPT) on electrically induced seizures in rats. 8-CPT prolonged secondary seizures and converted partial seizures into generalized motor seizures, but did not affect primary seizure duration. Because 8-CPT is a potent and specific adenosine antagonist, these results add further support to the hypothesis that endogenous adenosine prevents the spread of epileptic seizures. PMID- 3651822 TI - Preferential relation of pallidal neurons to ballistic movements. AB - The activity of single globus pallidus neurons was recorded in monkeys trained to perform 5 different wrist movement tasks that were designed to dissociate several modes of movement. Most neurons had activity changes related to visually guided movements and not to self-paced movements. The greatest activity changes were seen during prompt, ballistic, step-tracking movements and several neurons were related only to ballistic movements. PMID- 3651823 TI - Phase shifting of CA1 and dentate EEG theta rhythms in hippocampal formation slices. AB - Carbachol-induced hippocampal EEG theta-rhythms were recorded simultaneously from the CA1 and dentate areas in rat hippocampal brain slices. Phase shifts ranging from 0 to 180 degrees between the CA1 and dentate theta generators were observed. The differences in slow wave theta phase relations between in vitro and in vivo preparations were interpreted as resulting from deafferentation of the hippocampal slices. PMID- 3651824 TI - Enhancement of recurrent inhibition of the spinal monosynaptic reflex by preceding stimulation of the medullary raphe in rats. AB - Recurrent inhibition of the spinal monosynaptic reflex (MSR) elicited by conditioning stimulation of the ventral root in anesthetized rats was weaker than both the recurrent inhibition of the disynaptic reflex and the inhibition of the MSR elicited by conditioning stimulation of the adjacent dorsal root. Among these 3 inhibitions, the recurrent inhibition of the MSR was enhanced to a markedly greater extent by a preceding stimulation of the medullary raphe nucleus than were the other inhibitions. The magnitude of the enhancement of the recurrent inhibition of MSR also was much greater when the medullary stimulation was delivered 20 ms prior to the ventral root activation, as compared with a 30-ms interval. Recurrent inhibition of the MSR was enhanced by intravenous injection of lysergic acid diethylamide (LSD); however, the enhanced effect on recurrent inhibition elicited by stimulation of the raphe nucleus was not attenuated by the drug. These results suggest that there is a non-serotonergic, descending pathway which is capable of modulating motor output solely by means of recurrent inhibition of the MSR. PMID- 3651825 TI - Cell partitioning and mixing in the formation of the CNS: analysis of the cortical somatosensory barrels in chimeric mice. AB - Development of structural units along clonal lines as demonstrated in some invertebrates is an elegantly simple way to proceed in the formation of tissues. The possibility of a related event occurring in mammalian neurogenesis, i.e. that discrete assemblies of cortical neurons may be presorted according to lineage during neuronal development, was examined in chimeric mice. These mice consist of cells of two genotypes. Genetically determined differences in beta-glucuronidase activity, detected by histochemical means, were used as the cell-marker to determine the genotypic origin of neurons. Individual 'barrels' of the mouse somatosensory cortex were examined, and each neuron classified as high (Gusb) or low (Gush) as to the expression of beta-glucuronidase activity. Neurons from the two genotypes were found to be distributed in the same proportion amongst all the barrels examined from a given animal. The distribution of like-genotype neurons in the barrels was similar to neighboring cortical areas. Furthermore, there was no evidence for unusual distributions of neurons from one genotype within a single barrel. Such evidence does not support the notion of a unique founder population of neurons for individual barrels (or groups of barrels), and supports the notion of extensive cell mixing and epi-genetic events in the determination of individual barrels in the mouse somatosensory cortex. PMID- 3651826 TI - Effect of iron and transferrin on pure oligodendrocytes in culture; characterization of a high-affinity transferrin receptor at different ages. AB - Oligodendrocytes in pure culture can grow on relatively low iron concentrations (0.1-0.3 microM), in the absence of transferrin; with micromolar concentrations of iron, toxic effects can be seen after one week in culture. When transferrin is added, the toxic effect of iron is increased. These properties account for the mode of selection of oligodendrocytes for pure cultures. Each oligodendrocyte presents between 1100 and 3600 receptor molecules, with a dissociation constant of 0.2-0.6 nM corresponding to a high affinity transferrin-binding site; these constants vary little with age in culture. These receptors may function as autoreceptors regulating transferrin synthesis by oligodendrocytes. PMID- 3651827 TI - Development of bilateral asymmetry in sensory innervation to lobster claws. AB - Sensory innervation to the paired claws of the lobster. Homarus americanus, was examined during their differentiation from a bilaterally symmetric state to an asymmetric state of a slender cutter and a stout crusher claw. This was done by estimating the total number and size distribution of axons in the second nerve root which provides most (approximately 90%) of the innervation to the claws and has few, bilaterally distributed motor axons. The paired claws which are undifferentiated and resemble each other in the 1st larval stage correspondingly have nerve roots that are bilaterally symmetric. In early juvenile (4th and 5th) stages when claw type is determined, as well as in subsequent (6th, 7th, 8th, 16th) juvenile stages when the claws gradually differentiate into cutter and crusher types, the paired homologous roots are also similar. It is only in adults that asymmetry in sensory innervation is seen with more axons in the crusher root than in its cutter counterpart. The difference in number of axons between the dimorphic claws is related to differences in surface area between the claws. Thus, bilateral asymmetry in sensory innervation is acquired by the continual but differential addition of axons to the paired claws. PMID- 3651828 TI - Postnatal development of geniculocortical projections in the tree shrew. AB - We examined the postnatal development of retrogradely labeled cells in the tree shrew lateral geniculate nucleus (LGN) following cortical injections of horseradish peroxidase. Results show that at birth (P0) when the LGN is still unlaminated: (1) the mature proportion of relay cells and interneurons already exists, (2) relay cells present are larger than interneurons, and (3) relay cells are topographically connected with the cortex. Aside from changes in absolute LGN soma size, the primary postnatal change noted (from P0 to P7) was an apparent decline in the relative width of the labeled LGN projection column, suggesting a refinement in topography. PMID- 3651829 TI - Obese (ob/ob) and diabetes (db/db) mutations: two factors modulating brain and peripheral tissue accumulation of estradiol in C57BL/KsJ mice. AB - The effect of two mutant genes for obesity (ob/ob) and diabetes (db/db) on the accumulation rate of radiolabeled estradiol was examined in female C57BL/KsJ mice. Mutant mice were match-paired with normal (+/?) animals at 16 weeks of age. All ob/ob and db/db mice exhibited overt obesity and hyperglycemia relative to normals. The distribution and uptake of the radiolabeled estradiol was subsequently examined in specified CNS and peripheral tissues. In all cases, the db/db and ob/ob mutant conditions resulted in a depressed cellular accumulation of radiolabeled estradiol in both CNS and peripheral tissues relative to normal mice. The ob/ob mutation resulted in a more severe depression of tissue estradiol uptake than did the db/db mutation. These studies indicate that the abnormal metabolic and hormonal states induced by the mutations, and not the mere presence of the genomic mutation itself, probably accounts for the depressed cellular affinity for gonadal steroids in these murine models. PMID- 3651830 TI - Ontogenesis of muscarinic receptors in cultured rat hippocampal cells. AB - The ontogeny of muscarinic cholinergic receptors was studied in primary cultures of dissociated rat hippocampal cells. The specific [3H]quinuclidinyl benzilate [( 3H]QNB) to intact cells was detected after two days in culture. Scatchard analysis revealed only a unique binding site at all of the days tested, with a very high affinity (0.205-0.253 nM) for the substrate. Specific binding kept increasing up to a level of 2035 fmol/mg protein after 15 days in culture. Protein content by itself also increased over time, reaching the highest level at 15 days (286 micrograms protein/35 mm plate). The cultured hippocampus can thus serve as a model system for the study of the development of muscarinic receptors in vitro. PMID- 3651831 TI - Morphological effects of chronic haloperidol administration on the postnatal development of the striatum. AB - The aim of this paper is to describe the morphological changes induced in the striatum after the administration of haloperidol during the first postnatal month, a period in which a lack of tolerance to treatment with neuroleptics has been reported. At the end of the treatment several morphological parameters were evaluated including neuron size and density and the synaptic profile areas of cross-sectioned dendrites and axon terminals. The results evidenced a loss of the smallest dendritic profiles without the rest of the parameters examined being affected. This response differs from the one observed in the adult rat striatum that does develop tolerance to haloperidol. It seems to more closely correspond to the changes found in the prefrontal cortex, a region that does not develop tolerance after chronic treatment with neuroleptics. PMID- 3651832 TI - Postnatal development of cell columns and their associated dendritic bundles in the lumbosacral spinal cord of the rat. I. The ventrolateral cell column. AB - The postnatal development of the ventrolateral dendrite bundle (LDB) in the rat lumbosacral cord was studied quantitatively with Golgi-Cox impregnation. At birth, motoneuronal perikarya and their dendrites were not fully developed, and had not begun to form bundles; varicose dendritic shafts radiated symmetrically from motoneurons. Dendrites contained numerous spines and growth cones. At 5 days, dendritic shafts began to arrange themselves longitudinally, and by 10 days of age, dendrite bundling was apparent. Dendritic growth and bundling appeared complete by two months of age. LDB formation was a dynamic process; rapid dendritic growth occurred in discrete phases with brief intervals of slower dendritic development between them. The mean number of secondary and tertiary dendrites, and the mean branch length of all orders progressively increased. Motoneurons of the LDB primarily innervate the pelvic musculature. Selective horizontal orientation of dendrites into discrete compact bundles suggests that the LDB may serve as a specialized receiving and integrating system for autonomic control over excretory and reproductive functions. It is interesting to note that in patients suffering from amyotrophic lateral sclerosis, motoneurons in the LDB are resistant to destruction. This finding suggests that motoneurons in the LDB may express unique features that protect them from certain disease processes. A better understanding of the developmental anatomical, physiological and biochemical properties of the LDB may provide insight into the treatment of patients with disease processes involving spinal cord and brainstem lower motoneurons. PMID- 3651833 TI - Postnatal development of cell columns and their associated dendritic bundles in the lumbosacral spinal cord of the rat. II. The ventromedial cell column. AB - Postnatal formation of the ventromedial dendrite bundle (MDB) in the rat lumboscral cord was examined quantitatively with Golgi-Cox impregnation. At birth, dendrites of motoneurons in the MDB had not achieved their total length, and had not begun to form bundles. Dendrites projected from the soma in a radially symmetric fashion. At 5 days, dendritic shafts reoriented into the longitudinal plane, and by 10 days of age dendrite bundling was apparent. Between day 1 and 60, primary, secondary and tertiary dendrites from motoneurons in the MDB increased both in number and in length, and the MDB became more compact and intertwined. Dendritic growth and bundling was complete by two months of age. The dendritic spatial arrangement of the MDB, as well as the LDB, may provide an important anatomical substrate for receiving appropriate developing axonal inputs. In turn, it is likely that specific incoming axonal inputs that arrive in this cell column early in development may signal the redirection of dendrites of ventromedial motoneurons into the longitudinal plane. PMID- 3651834 TI - Sexual differences in the dopaminergic control of luteinizing hormone secretion in the developing rat. AB - The aim of the present study was to compare the effect of haloperidol on the secretion of luteinizing hormone (LH) in male and female immature rats. At 12 days of age, haloperidol significantly released LH in females but not in males. The same results were obtained using sulpiride. The LH-releasing effect of haloperidol diminished with age; in 28-day-old rats it could not be evidenced. The influence of early organization of brain structures controlling LH secretion on this effect was then studied. Neonatally androgenized females failed to respond at 12 days of age and in neonatally castrated males the effect of haloperidol on LH followed the same pattern as in normal females. We conclude that the dopaminergic system plays an important inhibitory role in the control of LH in infantile females and not in males, and that this sexual difference depends on early differentiation of the brain. PMID- 3651835 TI - Convergence of hepatoportal osmotic and cardiovascular signals on preoptic thermosensitive neurons. AB - Effects of hepatoportal osmotic stimuli and changes in arterial blood pressure were studied on the neuronal activity of 24 thermosensitive and 47 thermally insensitive neurons of the preoptic and anterior hypothalamus (PO/AH) in the urethane-anesthetized rat. Infusion of hypertonic (3% NaCl, 9% mannitol) or hypotonic (water) solutions into the hepatic portal vein changes the activity in 59% of thermosensitive neurons and 13% of thermally insensitive neurons but the injection into the femoral vein did not. Changes in blood pressure induced by intravenous injection of vasoactive drugs altered the activity of thermosensitive neurons (75%) and thermally insensitive neurons (32%). Neurons having dual sensitivity to both osmotic and blood pressure were more frequently found among thermosensitive neurons (10/24) than among thermally insensitive neurons (4/47), chi 2(1) = 11.03, p less than 0.001. The convergence of osmotic and baro/volaemic information on thermosensitive neurons may provide explanations for thermoregulatory changes observed during dehydration and acute hypotension. PMID- 3651836 TI - Stimulation of the paraventricular nucleus area of the hypothalamus elevates urinary 6-hydroxymelatonin during daytime. AB - The paraventricular nucleus of the hypothalamus (PVN) is thought to be a part of the neural circuit comprising the melatonin rhythm generating system (MRGS). Electrical stimulation of the PVN during the early lights-on period significantly elevated urinary 6-hydroxymelatonin content to nearly 50% of night levels; stimulation during the lights-off period did not produce significant changes. In contrast to the effects of PVN stimulation, stimulation of surrounding brain areas was without effect at either time. This observation confirms the participation of the PVN in the MRGS. PMID- 3651837 TI - The hypothalamic suprachiasmatic nuclei: circadian patterns of vasopressin secretion and neuronal activity in vitro. AB - The suprachiasmatic nuclei (SCN) are intrinsic pacemakers which organize circadian rhythms in mammals. When the SCN of Long-Evans rats are surgically isolated and perifused in vitro, they retain the ability to express a 24 hr rhythm of neuronal firing rate. We find that the SCN are also capable of secreting the peptide vasopressin (VP) in a circadian pattern. The pattern of VP secretion is similar to that of SCN neuronal electrical activity measured during perfusate collection. The temporal profile of VP levels in SCN perfusate parallels that seen in cerebrospinal fluid, suggesting that the SCN might be both the pacemaker and a secretory contributor to this rhythm. PMID- 3651838 TI - Amastatin and bestatin-induced dipsogenicity in the Sprague-Dawley rat. AB - Intracerebroventricular application of the aminopeptidase inhibitor bestatin, but not amastatin, demonstrated a dose-dependent drinking response. Amastatin is a selective, but not totally specific aminopeptidase inhibitor that blocks aminopeptidase A, which cleaves acidic amino acids, while bestatin selectively blocks aminopeptidase B, which cleaves basic amino acids. Thus, amastatin's major action should be to inhibit angiotensin II (AII) to angiotensin III (AIII) conversion and bestatin's to block AIII degradation. Treatment with the angiotensin receptor antagonist, Sar, Thr-AII (sarthran), completely inhibited bestatin-induced drinking at two different doses. These results support a critical role for the brain-angiotensin system in the ongoing regulation of body fluid homeostasis and suggest an important role for angiotensin III in the brain. PMID- 3651839 TI - Electrochemistry in vivo: monitoring dopamine release in the brain of the conscious, freely moving rat. AB - Changes in electrochemical responses at stearate-modified and unmodified graphite paste electrodes were compared simultaneously by intrastriatal chronoamperometry in freely moving rats. Responses at the modified electrodes were unaffected by ascorbate administration, decreased by pergolide and increased by pargyline and haloperidol. The effects of haloperidol were reversed by gamma-butyrolactone but not by pargyline. In contrast, responses at the unmodified electrodes were increased by ascorbate or pergolide and decreased by pargyline. Haloperidol induced increases at these electrodes were rapidly reversed by pargyline. Responses of the two electrodes differed significantly in both magnitude and temporal characteristics after amphetamine administration. The results demonstrate that the modified electrodes can selectively monitor released dopamine in the freely moving animal, even when there are simultaneous, large changes in ascorbate and 3,4-dihydroxyphenylacetic acid. PMID- 3651840 TI - N,N-dipropargyl-2-phenylethylamine, a potential prodrug of 2-phenylethylamine: neurochemical and neuropharmacological studies in rat. AB - An evaluation of N,N-dipropargyl-2-phenylethylamine (DPGPEA) as a prodrug to increase brain levels of 2-phenylethylamine (PEA) was conducted in rats. A 0.1 mmol/kg (IP) dose of DPGPEA was administered and produced marked elevations of PEA levels in brain, liver and blood which were sustained for several hours. Ex vivo MAO inhibition data indicated DPGPEA to be an inhibitor of MAO-B, although the effect was much weaker than seen with tranylcypromine or pargyline. DPGPEA caused brain noradrenaline, dopamine and 3,4-dihydroxyphenylacetic acid levels to temporarily decrease significantly below controls. Concomitant increases in homovanillic acid and 5-hydroxyindole-3-acetic acid levels suggest that the PEA or N-propargylPEA formed and/or DPGPEA itself have significant effects on release and reuptake of neurotransmitters. DPGPEA was also shown to be metabolized to N propargyl-PEA, another prodrug of PEA, in vivo. PMID- 3651841 TI - Recordings from arterial pressure-sensitive units in the awake dog. AB - Recordings were made from units in or near nucleus ambiguus (NA) in the awake, drug-free dog while arterial pressure (AP) was increased and decreased nonpharmacologically by inflating occlusion cuffs that had been placed around the descending aorta and inferior vena cava, respectively. Units were recorded differentially through floating fine-wire electrodes that extended from vertically movable cannulas in a chronically implanted microdrive. Fifty-three percent of units recorded in or near NA were excited by increased AP, but were unresponsive to decreased AP. The remaining units were unresponsive to increased or decreased AP. About 25% of AP-sensitive units had activity patterns related to the cardiac cycle. AP-sensitive, cardiac cycle related units located in NA displayed several of the properties previously demonstrated for antidromically identified preganglionic parasympathetic cardiac motoneurons involved in baroreflex control of heart rate and rhythm. Recording from such neurons in the awake, neurologically intact, drug-free dog permits the fullest and most natural expression of neuro-cardiologic interactions and will allow the investigation of behavioral influences on autonomic and cardiovascular function. PMID- 3651842 TI - Effects of central application of naloxone on the skin temperature response in morphine-dependent rats. AB - This study was designed to identify if the surge in tail skin temperature (TST) observed following systemic administration of naloxone to morphine-dependent rats is mediated by a specific brain locus. Female rats were fitted with cannula located either in the preoptic area-anterior hypothalamus, locus coeruleus, or the frontal cortex. TST was monitored every 5 min for 60 min following central administration of naloxone (1-40 micrograms/0.4 microliters), in morphine dependent rats. Regardless of the central site of naloxone injection, TST was significantly increased 4-5 degrees C. A threshold dose of 20 micrograms/0.4 microliters (10 micrograms/0.2 microliters, bilaterally) of naloxone was identified to produce this surge in TST in all three brain regions. These results suggest that morphine dependency sensitizes several brain regions to administration of naloxone such that the narcotic antagonist produces a similar change in TST as is observed following its systemic administration. These data further support the use of our morphine-dependent rat model to study the central mechanisms of the menopausal hot flush, and provide additional evidence that the flush response is centrally mediated. PMID- 3651843 TI - The fetal baboon median eminence as a circumventricular organ: I. Transmission electron microscopy. AB - This investigation has focused upon a set of neuroanatomical correlates that underscore functional changes in the median eminence of the fetal baboon Papio anubis. Eight fetal primate brains were harvested at mid-gestation (100 days post coitus) and prepared for routine light and transmission election microscopic examination following ventriculo-cisternal perfusion with high osmolarity aldehyde fixatives. The median eminence and other adjacent circumventricular organs (CVO) were blocked and embedded in epon. Routine transmission electron microscopic examination revealed discreet regional differentiation and zonal maturation of the fetal baboon median eminence at 100 days post-coitus. The ependymal and hypendymal zones were anatomically separate from the underlying fibrous and palisade zones of the median eminence. The dominant cell type of the ependymal and hypendymal zones were tanycytes whose apical surfaces constituted the floor of the third cerebral ventricle. The distal processes of tanycytes terminated upon the abluminal basal lamina of well developed perivascular spaces in the contact zone of the fetal median eminence. Numerous axon profiles that harbored both dense core and microvesicles were also observed to terminate upon the system of perivascular spaces that contained numerous fenestrated capillaries. Sharing this common perivascular system were cells of the pars tuberalis that contained numerous secretory inclusions. These data strongly suggest that by mid-gestation the fetal primate median eminence is highly differentiated and may be capable of a wide range of functional activities in response to changes in the maternal-placental environment. The ultrastructural correlates of an active neuroendocrine axis are apparent at this period of development. PMID- 3651844 TI - Regulation of dopamine function in the prefrontal cortex of the rat by the thalamic mediodorsal nucleus. AB - Dopamine (DA) utilisation has been assessed in the medial bank of the prefrontal cortex (FCx) and the agranular insular cortex (AgCx) of the rat in response to unilateral manipulations of the thalamic mediodorsal nucleus (MD). The ratios of 3,4-dihydroxyphenylacetic acid (DOPAC):DA and 4-hydroxy-3-methoxyphenylacetic acid (homovanillic acid, HVA):DA are used as indices of DA utilisation and were shown to increase in the ipsilateral FCx following electrical stimulation of lateral MD. A similar response was observed 1 hr after an infusion of the excitotoxin sodium ibotenate into lateral MD, although in this case the increase in DA utilisation in FCx was bilateral. Longer periods of recovery after ibotenate treatment (2 day and 1 week) produced DA utilisation ratios that had returned to near control values and by 1 week a significant decrease was detected in HVA:DA of the contralateral FCx. All treatments had little effect on DA utilisation in AgCx, although there was a tendency towards enhanced ratios after electrical stimulation and short-term ibotenate injection. These findings suggest that stimulation of MD neurones may tend to activate the DA system in their convergent terminal regions of cortex. It is argued that these influences result from interactions at the level of the DA terminal rather than at the cell bodies of mesocortical DA neurones. PMID- 3651845 TI - [Biorhythms and drug therapy]. PMID- 3651846 TI - [The effect of antigenic bile protein fractions on the leukocyte migration inhibition test in chronic hepatopathies]. PMID- 3651847 TI - [Morphologic heterogeneity of the nodular-sclerotic variant of Hodgkin's disease]. PMID- 3651848 TI - [Levels of aldosterone in the blood of calves with an artificial heart (preliminary report)]. PMID- 3651849 TI - [Currently unrecognized tuberculosis]. PMID- 3651850 TI - [Hyperuricemia in a rural population group]. PMID- 3651851 TI - [The mechanism of myelin sheath formation]. PMID- 3651852 TI - [The course of pregnancy and residual nephrologic findings in women after EPH gestosis]. PMID- 3651853 TI - [Another family with hereditary angioedema]. PMID- 3651854 TI - [Use of computer technics for storing patient records in an inpatient hospital department]. PMID- 3651855 TI - [Rare forms of central respiratory failure]. PMID- 3651856 TI - [Relation between indicators of respiratory tract patency and intrapulmonary distribution of ventilation in patients with chronic obstructive bronchopulmonary disease after combined administration of aminophylline and fenoterol]. PMID- 3651857 TI - [The effect of verapamil on histamine and acetylcholine induced contraction of smooth muscle of the respiratory tract]. PMID- 3651858 TI - [Trends in passive modes of suicide]. PMID- 3651859 TI - Appreciating hypertension, quicksands and firm ground. PMID- 3651860 TI - Assessment of patients' opinions on personalized advice sheet given on leaving the ward after a myocardial infarction. PMID- 3651861 TI - Do we tell our coronary patients enough? PMID- 3651862 TI - Health care in China today. PMID- 3651864 TI - Expression of human choriogonadotropin-like material correlates with metastatic phenotype of R3230 AC rat adenocarcinoma. AB - Human choriogonadotropin (hCG)-like material has been found in variable amounts on the surface of cells of human and animal tumors. Intravenous injection of R3230 AC rat adenocarcinoma cells, one of the models investigated, results in multiple lung foci seeding. We analyzed the phenotypic diversity of this tumor by cloning and culturing two distinct cell subpopulations from a cell culture of this tumor, hereafter called OR or original cell culture. One was obtained after repeated exposure of the OR to increasing concentrations of concanavalin A and wheat germ agglutinin. A single clone was isolated and was named lectin-resistant (LR) cell line. The LR cells did not metastasize but maintained stable tumorigenicity and morphology over at least 10 passages. A second cell line was obtained by repeated passage and injection of cells from a single metastatic node. After repeating the process five times, a single clone of cells was selected from the final variant and was called lung metastatic (LM) cell line. The LM cultured cells maintained stable tumorigenicity, morphology, and metastatic properties for no more than 10 passages. OR, LR, and LM cells were assessed by their doubling time (DT), chromosome counts, and hCG immunocytochemistry. The results demonstrated that the LM cell line had a higher chromosome count than the LR and the OR cell lines, and its DT was the shortest. Immunocytochemistry of the transplanted OR neoplasm showed scattered expression of the hCG-like material. By the same techniques a complete lack of reactivity of the LR cells was found. However, almost all cells of the LM line were strongly positive for hCG-like material. After a few passages, the great majority of the LM cells also became unreactive. Our data demonstrate: (i) the existence of marked heterogeneity of the expression of hCG-like material in the primary tumor cell population; (ii) that the expression of hCG-like material correlates with the metastasizing capacity of the cells; and (iii) that there is a phenotypic instability for the expression of hCG-like material by tumor cells when maintained in vitro. PMID- 3651863 TI - Sequential combination chemotherapy of high-grade non-Hodgkin's lymphoma with 5 fluorouracil, methotrexate, cytosine-arabinoside, cyclophosphamide, doxorubicin, vincristine, and prednisone (F-MACHOP). AB - An intensive treatment program was developed to achieve durable remissions in a high proportion of previously untreated patients with advanced stages of diffuse high-grade non-Hodgkin's lymphoma (NHL). Fifty-six patients (15-68 years) received a course of F-MACHOP (5-fluorouracil, methotrexate, cytosine arabinoside, cyclophosphamide, doxorubicin, vincristine, and prednisone) every 3 4 weeks for 6 courses. Cycle active drugs were sequentially administered to expose rapidly proliferating tumor cells to the synergistic effects of these agents throughout the cell cycle. Forty-three patients achieved complete remission (77%) and 80% of the complete responders are projected to be alive and disease-free at 4 1/2 years (median follow-up 33 months). Up to 70% of all patients are predicted to be alive at 5 years. Bulky tumor, "B"-symptoms and lymphoblastic histology were poor prognostic factors, particularly when associated with clinically detectable disease after three courses. Toxicity included transitory myelodepression in most patients (2 septic deaths). This protocol provides effective and tolerable therapy for the majority of patients with advanced stages of diffuse aggressive NHL. PMID- 3651865 TI - Mode of estrogen action on cell proliferative kinetics in CAMA-1 cells. I. Effect of serum and estrogen. AB - Both serum and estrogen affect cell proliferation in CAMA-1 cells. Their effects on cell cycle kinetics are being investigated with partially synchronized cells following 48 hours of serum deprivation. By comparing the growth kinetics of synchronized (serum-deprived) cells with asynchronized (normal-fed) cells, we observed that there was a delay of cell proliferation for approximately 25 hr for synchronized cells and that estrogen only induced cell proliferation in serum supplemented culture. A serum protein (RPF), precipitated by ammonium sulfate, dialyzed in 3,500 daltons cut off membrane and reconstituted in culture medium, was shown to stimulate cell proliferation in a dose-related manner. In the absence of RPF, estrogen had no effect on cell growth and S-phase formation in serum-free medium, but significantly induced cell growth in the presence of RPF. Experiments conducted with a synchronized cell population showed that estrogen increased the proportion of G1 phase cells to enter S phase, shortened the G1 phase duration, and ultimately increased the proportion of mitotic cells per cycle. Collectively, these results show that (a) estrogen effects of cell proliferation in vitro requires a serum component, a "G1/S-promoting factor" and (b) estrogen-induced tumor growth is a result of an accelerated rate of G1/S transition and an increased number of dividing cells per cycle. The knowledge of the interaction of estrogen with the G1/S promoting factor on cell growth is of both fundamental and therapeutic importance. PMID- 3651867 TI - Ethical dilemmas in medicine. PMID- 3651866 TI - Radiation therapy and the role of red blood cell transfusion. AB - Based on a survey of fifty radiation therapy departments in this country revealing that a majority transfuse anemic cancer patients to a predetermined hemoglobin level prior to and during radiotherapy, a review of the literature was undertaken to assess whether the potential benefits of such a practice outweigh the very real risks (especially non-A, non-B hepatitis) associated with transfusions. Although the intent of transfusion is to increase tumor oxygenation and thereby reduce the number of radioresistant hypoxic cells, studies in laboratory animals do not support a relationship between the hemoglobin level and the percentage of hypoxic tumor cells in normovolemic anemia, both acute and chronic. Several large studies of carcinoma of the cervix agree that anemia is a poor prognostic feature at presentation and correlates with shorter survival and poorer control of local disease in those patients treated solely with radiation. These findings have been interpreted by many to reflect impairment of tumor oxygenation directly attributable to anemia in the poor responders and has been used to support the recommendation of blood transfusion. An alternative explanation for which considerable supporting data exist is that carcinoma of the cervix associated with anemia is, by nature, a biologically more aggressive subtype and portends a poorer prognosis for reasons other than anemia-related tumor hypoxia. It is concluded that the practice of routinely transfusing all chronically anemic cancer patients prior to radiation therapy is not justified. PMID- 3651868 TI - [Traumatic ruptures of the diaphragm]. PMID- 3651869 TI - [Use of midazolam in the cirrhotic patient candidate for visceral surgery. Clinical study apropos of 22 cases]. PMID- 3651870 TI - [Peridurography in peridural anesthesia. Clinical study apropos of 135 cases]. PMID- 3651871 TI - [3-week saturation with amiodarone before heart valve surgery. Study of postoperative rhythm disorders and plasma and myocardial levels of amiodarone]. PMID- 3651872 TI - [Ketoprofen and nefopam in postoperative analgesia after cesarean section]. PMID- 3651873 TI - [Optimization of oxygen delivery administered with a T-shaped device]. PMID- 3651874 TI - [Acute normovolemic hemodilution in total hip prosthesis interventions]. PMID- 3651875 TI - [Hemodilution technics and controlled hypotension in the surgery of the scoliotic spine]. PMID- 3651876 TI - [A protective sheath allows repeated removal of Swans-Ganz catheters]. PMID- 3651877 TI - [Thermodilution overestimates low cardiac output]. PMID- 3651878 TI - Computers and nursing. Cojoining. PMID- 3651879 TI - Development of an expert system prototype to generate nursing care plans based on nursing diagnoses. PMID- 3651880 TI - Using the microcomputer to give students personalized feedback on preparing patient health histories. PMID- 3651881 TI - Evaluation of gamma radiation levels for reducing pathogenic bacteria and fungi in animal sewage and laboratory effluents. AB - Sewage samples collected from animal wastes and from effluents at an animal disease laboratory were inoculated with known numbers of pathogenic organisms and subjected to various doses of gamma radiation from a 60Co source. Surviving test organisms were quantitatively determined by selective and enrichment techniques. The experiment was modeled as a quantal assay in which probit analysis was applied to obtain D10 values. The D10 value represents the irradiating dose required to reduce the population by 90%. The D10 value ranged from 13.4 krad for Campylobacter fetus to 156.6 krad for Streptococcus faecalis in animal sewage. However, the D10 value for the laboratory effluent was generally lower. Based on the estimated D10 values, the rating of the test organisms in decreasing order of radiosensitivity appeared as follows: Brucella abortus, Campylobacter fetus subsp. fetus, Campylobacter jejuni, Campylobacter coli, Campylobacter laridis, Mycobacterium fortuitum, Aspergillus fumigatus, Salmonella muenster, Candida albicans, Clostridium difficile and Streptococcus faecalis. If the D5 and D1 values were utilized, this listing would be only slightly altered. PMID- 3651882 TI - Experimental infection of piglets by aerosols of Rhodococcus equi. AB - The purpose of this study was to investigate experimental infection of the piglet as a model of Rhodococcus equi pneumonia in the foal. Three litters of eight piglets each were exposed to an aerosol of 3.4 X 10(7) R. equi per piglet per day for seven consecutive days. Over the next 23 days the piglets were observed for clinical signs of disease. Periodically after infection one piglet from each litter was killed, the lungs were cultured quantitatively for R. equi and the gross and microscopic pulmonary lesions were assessed. The only clinical evidence of disease was the occurrence of elevated temperatures in the infected piglets. Rhodococcus equi was slowly cleared from the piglets' lungs during the 23 days following aerosolization. Piglets sacrificed seven to ten days after aerosolization had the most extensive pulmonary lesions, consisting of severe consolidation of the cranioventral lobes. Microscopic examination revealed thickened interalveolar septa and alveoli containing many neutrophils and macrophages with intracytoplasmic Gram-positive coccobacilli. The pulmonary lesions in these piglets differed from those of naturally infected foals in that they were not characterized by macrophage-rich abscesses and the infection gradually resolved. PMID- 3651883 TI - Polyacrylamide gel electrophoresis of whole-cell preparations of Rhodococcus equi. AB - The whole-cell proteins of ten strains of Rhodococcus equi isolated from horses, pigs, or humans, including the type strain ATCC 6939, were examined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. The protein profiles of seven different capsular serotypes and the type strain were very similar when bacteria were cultured under the same conditions. Protein profiles were largely unaffected by incubation at two temperatures (30 degrees C, 37 degrees C) or times (12 h, 48 h). There were generally minor differences in protein profiles between strains grown in different media (brain heart infusion, nutrient, minca broths, tryptic soy-blood agar) with the marked exception of a prominent diffuse 17.5 kd protein which was expressed in nutrient broth. This protein was not produced by the type strain and was lost on repeated passage in vitro (50th, 100th passage) in two of three other strains examined. PMID- 3651884 TI - Antibody response of horses to Rhodococcus equi antigens. AB - The antigens extracted from strains belonging to seven capsular serotypes of Rhodococcus equi, as well as from two wild strains isolated from pneumonic foals, were examined. Whole-cell antigens and soluble products present in broth culture supernatants were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, electroblotted onto nitrocellulose, and stained with serum from hyperimmunized rabbits or foals. Foal sera used included sera from pneumonic animals with known titer to equi factors; from animals bled monthly on a farm with enzootic pneumonia, and from animals bled monthly on a farm with no history of R. equi pneumonia. The humoral response of foals to somatic antigen preparations was negligible, with few differences noted between sera from healthy, subclinically affected, and sick foals. The humoral response to R. equi broth culture supernatant products appeared more marked and was related to equi factor antibody titer. These findings suggest that the humoral response to R. equi whole-cell antigens is unimportant in protection against disease, which is consistent with the behavior of the organism as a facultative intracellular pathogen. PMID- 3651886 TI - Persistence of chloramphenicol residues in calf tissues. AB - Twenty-one 5 to 18 day old calves were administered 11 mg chloramphenicol in propylene glycol per kg body weight intramuscularly twice daily for three days. Groups of calves were euthanized with a barbiturate overdose at 5, 21, 42 and 70 days after the last dose was administered. Serum, kidney, analyzed for the drug using a quantitative gas chromatographic method with a detection limit of five parts per billion. After five days of withdrawal, chloramphenicol was detected in all the injection sites and in 6 out of 16 of the other samples. After 21 days of withdrawal, chloramphenicol was detected in all the injection sites and in one each of the serum, liver and muscle samples. After 42 days of withdrawal, chloramphenicol was detected in the injection sites only, and after 70 days of withdrawal it was not detected in any of the samples. PMID- 3651885 TI - Deposition and clearance of monodisperse aerosols in the calf lung: effects of particle size and a mucolytic agent (bromhexine) AB - Mucociliary clearance and retention of monodisperse aerosols of radiolabelled polystyrene particles of both 3.3 microns and 5 microns diameter were investigated in four healthy calves and two sick calves. The effect of the mucolytic agent bromhexine was also assessed at two dosage levels. There were significant differences (P less than 0.05) in clearance rate constant between calves, but similar patterns of clearance for each calf. These characteristics of mechanical lung clearance did not vary over a two month period. Values of clearance rate constant and percentage retention varied significantly (P less than 0.001) between the two different particle sizes, 5 microns particles giving faster clearance and lower retention of particles than 3.3 microns particles. Bromhexine at the recommended dose of 1.6 mg/kg 0.75 caused a significant (P less than 0.05) increase in clearance rate in both healthy and sick calves, but affected percentage retention only in sick calves. This study illustrates the variation in mucociliary clearance rates shown by individuals and also underlines the importance of particle size in aerosols used for studies of pulmonary deposition and clearance. The work also indicates that bromhexine may be of use in the therapy of respiratory disease in calves. PMID- 3651887 TI - Effects of infectious bovine rhinotracheitis virus infection on bovine airway reactivity. AB - The response of isolated tracheal and bronchial strips to isoproterenol in vitro was studied in eleven male Jersey calves. Clinical, microbiological and pathological evaluations of the calves were carried out. In calves exposed once or twice to infectious bovine rhinotracheitis virus, the relaxation threshold of the trachealis muscle to isoproterenol was significantly (p less than 0.05) impaired (threshold 5.0 X 10(-7) M, single exposure and 1.0 X 10(-7) M, double exposure), when compared with uninfected controls (threshold 1.0 X 10(-8) M). Single infection significantly impaired tracheal relaxation to isoproterenol doses from 1.0 X 10(-7) to 5.0 X 10(-4) M, and double infection significantly impaired tissue responses at drug doses from 1.0 X 10(-7) to 1 X 10(-4) M. Bronchial relaxation threshold was not significantly inhibited (p less than 0.05) in singly infected or doubly infected animals (threshold 5.0 X 10(-8) M and 1.0 X 10(-8) M, respectively), when compared with uninfected controls (threshold 1.0 X 10(-9) M). Single infection significantly impaired bronchial relaxation at isoproterenol doses from 1.0 X 10(-7) M to 5.0 X 10(-6) M while double infection significantly impaired relaxation only at 5.0 X 10(-7) M. The disruption of normal homeostatic bronchodilatory mechanisms may predispose animals infected with infectious bovine rhinotracheitis virus to secondary bacterial infections due to excessive airway constriction and subsequent compromise of lung defenses. PMID- 3651888 TI - Effect of dexamethasone on bovine leukocyte functions and bovine herpesvirus type 1 replication. AB - In an attempt to elucidate the mechanism whereby dexamethasone could reactivate bovine herpesvirus type-1 the effect of dexamethasone on virus replication and leukocyte functions was assessed. No effect was detectable on either virus yield or in vitro replication kinetics. In contrast, dexamethasone influenced several leukocyte functions thought to be of importance in antiviral defense and maintenance of latency. In vitro exposure of peripheral blood polymorphonuclear neutrophilic granulocytes of normal animals to dexamethasone depressed their migratory and cytotoxic activities, but had no effect on Fc- and complement receptor expression. Dexamethasone also depressed lectin-induced lymphocyte proliferation and interleukin-2 generation in a dose-dependent manner. When cows were treated repeatedly with dexamethasone and their leukocytes assayed, suppression of phytohemagglutinin-induced lymphocyte proliferation, interleukin-2 generation, natural cytotoxicity of mononuclear cells and polymorphonuclear neutrophilic granulocyte functions were observed. In contrast, concanavalin A induced lymphocyte proliferation was increased following treatment. PMID- 3651889 TI - Vesicular exanthema of swine virus: isolation and serotyping of field samples. AB - Virus isolation was attempted from 262 field samples of vesicular material collected during the outbreaks of vesicular exanthema of swine in the U.S.A. from 1952-54. Using primary swine kidney culture, viral cytopathogenic agents were isolated from 76.3% of the samples. However, an overall recovery rate of 82.1% was obtained after samples negative in tissue culture were inoculated intradermally in susceptible swine. All vesicular exanthema of swine virus isolates were identified as serotype B51 using complement fixation and serum neutralization tests. Two isolates did not react with antisera to known vesicular agents of swine and failed to produce vesicles or clinical signs of disease upon inoculation in swine. One vesicular exanthema of swine virus isolate from tissue of equine origin was pathogenic for swine but produced limited vesiculation at the site of intradermalingual inoculation in the tongue of a pony infected experimentally. Type B51 virus was reisolated from lesions produced in the pony and the pony became seropositive for virus type B51. PMID- 3651890 TI - Immune response in skunks to a vaccinia virus recombinant expressing the rabies virus glycoprotein. AB - Striped skunks (Mephitis mephitis) were vaccinated with a vaccinia virus recombinant expressing the rabies virus glycoprotein. Virus neutralizing antibodies to rabies virus were present at 14 days postvaccination by the following routes: scarification (6/6), intramuscular (4/4) and intestinal (5/8). Six out of seven skunks that ate vaccine filled baits had virus neutralizing antibodies at 28 days. When challenged intramuscularly with street virus, the survival rates were 5/7 for the bait-fed group, 4/8 for the intestinal group, 3/4 for the intramuscular group, 5/6 for the animals that were scarified, and 0/8 for controls. This is the first report of a high rate of immunization of skunks with a rabies vaccine administered orally. PMID- 3651891 TI - A tissue culture infection test in routine rabies diagnosis. AB - A cell culture infection test was developed for the isolation of rabies virus from field cases submitted for rabies diagnosis. The procedure involved the addition of a suspension of suspect brain tissue to a suspension of murine neuroblastoma cells in 96-well microtiter plates. The cultures were then incubated at 35-36 degrees C for four days at which time they were fixed, stained with a fluorescein-labelled hamster antirabies antibody conjugate and examined with a fluorescence microscope. Rabies antigen in cells was readily visible as brilliant, apple-green fluorescent particles. This technique was compared with the standard mouse inoculation test and was at least as sensitive to infection with small amounts of virus, required a much shorter test period and was substantially more economical than the mouse inoculation test. The new cell culture test is now in use at this laboratory, replacing the mouse inoculation test. PMID- 3651892 TI - Vaccination of rats and pigs against Trichinella spiralis spiralis using the subspecies, T. spiralis nativa. AB - Rats and pigs were vaccinated against Trichinella spiralis spiralis either by feeding infective larvae of the subspecies, Trichinella spiralis nativa in musculature or by gavage. The number of larvae established in the musculature of vaccinated nonchallenged and vaccinated challenged rats and pigs were negligible and statistically comparable, while highly significant infections were established in the nonvaccinated challenged rats and pigs. High vaccination doses of T. spiralis nativa gave virtually complete protection to challenge with T. spiralis spiralis in pigs. The results of one trial in rats with a lower vaccination dose of larvae suggest that there is a minimal vaccination dose of larvae required to elicit marked resistance to challenge. The low numbers of muscle larvae established due to the high vaccination doses of larvae confirm the low infectivity of the subspecies, T. spiralis nativa in rats and pigs. PMID- 3651893 TI - Attempted transmission to cattle of Anaplasma marginale from overwintered Dermacentor andersoni ticks. AB - Since the 1983 summer outbreak of anaplasmosis in southern Saskatchewan, the role of the tick, Dermacentor andersoni as an overwintering reservoir for Anaplasma marginale has been questioned. The purpose of this study was to determine if spring-collected ticks carried virulent A. marginale. Sixteen splenectomized calves were assigned randomly to two groups of 14 principals and two controls. Adult D. andersoni, collected in April from areas having high transmission rates of A. marginale, were confined to the ears of the principals by special bags and allowed to feed for eight days. The two control calves were subsequently challenged intravenously with blood from a calf infected with the Virginia strain of A. marginale. Principals and controls were monitored for 60 and 50 days postexposure respectively for signs of infection by clinical, hematological and serological procedures. None of the principals developed anaplasmosis but both control calves developed signs of disease. PMID- 3651894 TI - Guaifenesin alone or in combination with ketamine or sodium pentobarbital as an anesthetic in rabbits. AB - Guaifenesin was administered alone and in combination with ketamine or sodium pentobarbital to adult New Zealand white rabbits. A solution of 5% guaifenesin in 5% dextrose given intravenously at a dosage of 200 mg/kg, abolished the pedal, palpebral and corneal reflexes for up to 15 minutes with little influence on cardiopulmonary function. Guaifenesin (200 mg/kg, intravenously) and ketamine (50 mg/kg, intramuscularly) produced effective and safe surgical anesthesia for over 30 minutes. This combination mildly depressed respiratory rate but heart rate and arterial blood pressure were not significantly affected. Guaifenesin (200 mg/kg, intravenously) was combined with sodium pentobarbital (20 mg/kg, intravenously) to produce surgical anesthesia for a period of more than 30 minutes. This combination depressed respiratory rate, produced a tachycardia and decreased arterial blood pressure. PMID- 3651895 TI - Samoyed hereditary glomerulopathy: serial, clinical and laboratory (urine, serum biochemistry and hematology) studies. AB - Human hereditary nephritis refers to familial glomerular diseases which may progress to renal failure. Samoyed hereditary glomerulopathy has been shown previously to be a model for hereditary nephritis. Clinical and laboratory studies were performed to follow progression to renal failure in 44 dogs in a family with Samoyed hereditary glomerulopathy. Affected males appeared healthy for their first three months but then became progressively wasted. Proteinuria was detected between two to three months of age; after five months, urine protein electrophoresis showed pre-albumin, albumin and alpha and beta globulin peaks. From three months onward, a reduced glomerular filtration rate was detected. Serum albumin decreased while amylase, urea, creatinine and phosphate increased from four to five months of age. Death from renal failure occurred by 15 months. Carrier females also became thinner and developed proteinuria between two and three months of age, but neither renal failure nor death ensured. Hence, SHG progressed rapidly in affected males but not in carrier females. PMID- 3651896 TI - Effects of glycosaminoglycan polysulfate treatment on soundness, hyaluronic acid content of synovial fluid and proteoglycan aggregate in articular cartilage of lame boars. AB - Eighteen lame boars were equally assigned to two treatment groups based on initial bodyweight and leg soundness. The boars were injected intramuscularly with an aqueous solution of glycosaminoglycan polysulfate or saline on day 0, 5, 10, 15, 20 and 25 and killed on day 27. The glycosaminoglycan polysulfate treatment significantly (P less than 0.05) improved leg soundness score, and resulted in an increase (P less than 0.06) in the hyaluronic acid concentration of the cubitus joint synovial fluid, and an increase (P less than 0.05) in the proportion of aggregated proteoglycans in the articular cartilage of the medial femoral condyle. Feed intake, growth rate and articular cartilage soundness score for the cubitus and stifle joints were not significantly (P greater than 0.10) affected by the treatment. PMID- 3651897 TI - Embryotoxic effects of prenatal T-2 toxin exposure in mice. AB - Pregnant CD-1 mice were administered T-2 toxin by gastric intubation on day 11 of gestation at dosages of 0, 0.75 and 1.5 mg/kg. The T-lymphocyte dependent antibody response against sheep red blood cells which was evaluated in the offspring at six weeks of age was not affected by T-2 toxin exposure. Individual birth and weaning weights were not influenced by T-2 toxin, but the litter size was reduced in the high dose group, without affecting the number of implantation sites per dam. The number of female offspring produced by dams exposed to 1.5 mg/kg T-2 toxin was less compared to other treatment groups, suggesting that the female fetus was more susceptible to embryolethal effects of prenatal T-2 toxin exposure. These results suggest that prenatal T-2 toxin exposure is unlikely to be a significant health problem with respect to primary humoral immunity. At the dosages given, T-2 toxin produced substantial embryotoxicity without alteration in antibody production. The embryolethal effects are a primary limiting factor which may preclude the expression of any immunoteratological manifestations associated with humoral immunity under natural field conditions. PMID- 3651898 TI - Rapid postmortem gut autolysis in infant rats: a potential problem for investigators. AB - Experiments were designed to determine the rate and nature of postmortem autolysis in the gut of neonatal rats, as necessary baseline information for developing a model of human neonatal necrotizing enterocolitis. We studied 60 animals, including 33 Wistar rats, 18 Sprague-Dawley rats and nine CD-1 mice. The variables examined included age of the animals (2 or 14 days) and length of delay and holding temperature (20 degrees C or 37 degrees C) after sacrifice. At necropsy, bowel was rapidly removed and fixed for histopathological examination. In all instances, bowel removed immediately after sacrifice was normal whereas after delays as short as 30 minutes it was abnormal (P less than 0.001), becoming markedly so after 60 minutes. The prominent features were detachment and lysis of mucosal epithelial cells. The rate of autolysis was not altered in 14 day old animals or in carcasses held at 20 degrees C or 37 degrees C. Investigators of bowel injury syndromes in young rats should be aware that histopathological studies will be valid only if specimens held at room temperature are fixed within 15 minutes of death. PMID- 3651899 TI - Neutropenia in cats with the Chediak-Higashi syndrome. AB - Thirteen cats with Chediak-Higashi syndrome and 22 control cats from the same colony, were evaluated for neutropenia. The absolute neutrophil counts of the Chediak-Higashi syndrome cats were significantly less (P less than 0.05) than those of the control cats. It is concluded that Chediak-Higashi syndrome cats, like Chediak-Higashi syndrome humans, have a neutropenia associated with the other manifestations of the syndrome. Lysozyme activity which was undetectable in the serum of both Chediak-Higashi syndrome and control cats was not of use for determining if the neutropenia was the result of neutrophil destruction. PMID- 3651900 TI - Stimulation of thyroid hormone secretion by thyrotropin in beluga whales, Delphinapterus leucas. AB - Bovine thyroid stimulating hormone administered to three beluga whales, Delphinapterus leucas, was effective in producing an increase in circulating levels of triiodothyronine and thyroxine. A single dose of 10 I.U. of thyroid stimulating hormone resulted in a 145% increase in triiodothyronine and a 35% increase in thyroxine after nine hours in a whale tested within two hours after capture. The response was less pronounced in an animal tested with the same does on two occasions after four and eight weeks in captivity. In the third whale, 10 I.U. of thyroid stimulating hormone given on each of three consecutive days produced a marked increase in triiodothyronine and thyroxine. The elevation of thyroxine concentration persisted for at least two days after the last injection of thyroid stimulating hormone. A subsequent decrease in thyroxine to levels below baseline signalled the suppression of endogenous thyroid stimulating hormone. This preliminary study helps to establish a protocol for testing thyroid function in cetaceans. PMID- 3651901 TI - Detection of Trichinella spiralis nativa antibodies in porcine sera by ELISA using T. spiralis spiralis excretory-secretory antigen. AB - Enzyme-linked immunosorbent assay examination of sera from pigs vaccinated with T. spiralis nativa infective larvae and/or challenged with T. spiralis spiralis larvae using a T. spiralis spiralis excretory-secretory antigen showed a significant cross-reaction between the two species of Trichinella. Eight of 12 pigs vaccinated with a high dose of T. spiralis nativa reacted positively 28 days postvaccination while the remaining four pigs had high but negative ELISA optical density readings. Five of six pigs challenged with the homologous species reacted positively 28 days postchallenge but the sixth pig remained negative despite having a muscle infection of 5.6 larvae/g of musculature. PMID- 3651902 TI - Experimental Trichinella infections in ponies. AB - Light Trichinella infections were established in three ponies given 1000, 5000 and 25000 T. spiralis spiralis infective larvae respectively by stomach tube. A predilection site of infection in all ponies was the tongue. Anti-Trichinella antibodies were detected in all ponies by the enzyme-linked immunosorbent assay using a T. spiralis spiralis excretory-secretory antigen. The ponies given 5000 and 25000 infective larvae reacted positively on days 26 and 24 postinfection, respectively, using a criterion of greater than or equal to 5 X mean optical density readings of preinfection sera as positive. The pony given 1000 larvae did not react positively although antibodies were present as indicated by 3 X to 4 X mean optical density readings of preinfection sera. The results of this limited study indicate that the enzyme-linked immunosorbent assay cannot be used to certify horsemeat free of Trichinella since the presence of detectable antibody levels appears to be related to the magnitude of the infection and duration of the infection when the animal is tested. PMID- 3651903 TI - Experimental studies of infectious respiratory disease. PMID- 3651904 TI - Emergency department space. PMID- 3651905 TI - Transplanting organs from anencephalic infants. PMID- 3651906 TI - Doctors should write "no substitution" on some prescriptions, OMA decides. PMID- 3651907 TI - HIV seroconversion and sexual behaviour in a cohort of homosexual men. PMID- 3651908 TI - Public policies and the health of children. Committee on Child Welfare, Ontario Medical Association. PMID- 3651909 TI - Cardiopulmonary resuscitation revisited. PMID- 3651911 TI - Risks and benefits of elective hip replacement in the octogenarian. AB - We reviewed the records for 100 consecutive cases of elective hip replacement in 91 patients in their 80s (average age 82.8 years), all of whom lived in their own homes before surgery. In 92 cases the patients returned home, 59 within 3 weeks. The average duration of hospital stay was 20.1 days. In eight cases there were major complications, including three cases of myocardial infarction (one of them fatal) and two cases of pulmonary embolism (one of them fatal). In 15 cases there were moderate complications, including deep venous thrombosis (in 5) and urinary tract complications necessitating transurethral prostatectomy (in 2). In 44 cases there were minor complications, including the need for urinary catheterization (in 27) and brief periods of postoperative confusion (in 14). In 33 cases there were no complications; in 31 of these cases the patients returned directly home within 3 weeks. The preoperative risk rating of the American Society of Anesthesiologists (ASA) correlated well with the complication rates: the rates of major complications in cases with a rating of ASA class I, II or III were 0%, 6% and 15% respectively. In 49 of 52 cases in which the procedure had been performed more than 2 years previously, the patients were happy they had had the operation. PMID- 3651910 TI - Effects of training in cardiopulmonary resuscitation on competence and patient outcome. AB - Between 1981 and 1985 we carried out a study in two medium-sized nonteaching community hospitals to determine the rate of deterioration of knowledge and skills in cardiopulmonary resuscitation (CPR) among physicians and nurses, the accuracy of their perceptions of their knowledge and skills, the effects of practice on retention and the effect of CPR training on mortality. The participants' knowledge and skills were measured before training and immediately after, 6 months after and 12 months after training. Information on all attempts at CPR involving hospital staff was collected from medical records and from interviews with the participants. A total of 31 physicians and 54 nurses were followed during the study. Six months after training there was no difference in CPR knowledge or skills between the physicians and the nurses. In both groups CPR skills had deteriorated to near pretraining levels. By 6 months the physicians' knowledge had deteriorated to a level not significantly different from that before training. The nurses maintained a significant improvement in knowledge test scores at 12 months over those before training (p = 0.037). The physicians had an accurate perception of their knowledge but not their skills 6 months and 12 months after training, whereas the nurses did not accurately perceive either their knowledge or their skills after training. Experience with CPR did not contribute to post-training knowledge or skills in either group. There was no evidence that death rates were lower when basic life support (BLS) was begun by trained staff than when it was begun by untrained staff. The probability of survival was greater when BLS was begun within 4 minutes of arrest than when it was begun after 4 minutes, regardless of whether advanced cardiac life support was begun within 10 minutes. PMID- 3651912 TI - Continuing education through Telemedicine for Ontario. AB - Telemedicine for Ontario (TFO) is a continuing education program for health professionals. It is an interactive audio system, organized and operated by the five provincial medical schools, that is designed to offer otherwise unavailable educational programs to health professionals in northern or other isolated areas of Ontario. TFO has provided programs in three categories--medicine, nursing and allied health--and has covered a wide range of topics; the programs have been tailored to the stated needs and interests of the participants. By 1986 there were 199 sites throughout Ontario that participated regularly, and there were approximately 25,000 individual registrations in the 1985-86 seasons. Our results from this 3-year pilot study have indicated the feasibility of the medium and its acceptance by health professionals. The next stage of the program's evaluation will include analyses of its impact on clinical practice and on the health status of patients. PMID- 3651913 TI - An outbreak of hepatitis B in a nursing home. PMID- 3651914 TI - Symptomatic hepatitis B in an infant. PMID- 3651915 TI - Walk-in clinics: "as far as we're concerned, the patient is king". PMID- 3651917 TI - This software provides personalized instructions for emergency patients. PMID- 3651916 TI - Requesting organ donations: the hardest question to ask. PMID- 3651918 TI - The quest for a sexless language. PMID- 3651919 TI - Is psychiatry being harmed by involuntary hospitalization and treatment? PMID- 3651921 TI - Boxing. PMID- 3651920 TI - Years of life lost because of alcohol. PMID- 3651922 TI - Sexual abuse of children: an update. PMID- 3651923 TI - Teaching occupational health to medical undergraduates. PMID- 3651924 TI - A second look at the effects of supportive follow-up on smoking cessation. AB - In 1982 a report in CMAJ (1982; 126: 127-129) indicated that the addition of supportive follow-up appointments in a family practice increased the 6-month cigarette abstinence rate from 12% to 23%. We reanalysed the data by means of recognized standards for treatment success and found little evidence that the treatment had any reliable effect on attempts to quit that lasted at least 3 months: 8.5% and 4.8% of the groups with and without supportive follow-up respectively abstained for more than 3 months. We discuss a problem of the experimental design (longer evaluative follow-up for the control group than for the treatment group) and cost-benefit issues. PMID- 3651925 TI - Supportive follow-up for cigarette smokers in a family practice: issues of method, analysis and state of the art. AB - Kozlowski and Page have criticized a study published in 1982 in CMAJ on the effects of supportive follow-up on the rate at which patients quit smoking cigarettes. We agree with some of their general sentiments about the need for establishing a consensus on the evaluation of smoking cessation programs. More specifically, we defend the particular analysis originally used, given the state of knowledge and constraints on the study. We examine their main objections: the definition of successful cessation, the design of the study, the exclusion of patients lost to follow-up, the methods of statistical analysis used and the strength of more recent evidence on the usefulness of follow-up visits. We believe that the role of supportive follow-up deserves further evaluation. PMID- 3651926 TI - A smoking cessation intervention program for family physicians. AB - Family physicians are able to approach many patients who smoke but are often hesitant to help them quit. Lack of knowledge about effective interventions is a major reason for this hesitancy. The important components that have been tested in physician-initiated smoking cessation interventions are advice to quit, information about the risks of smoking and techniques for quitting, nicotine gum, setting a date for quitting and offers of supportive follow-up visits. We describe a cessation program developed for family physicians that incorporates these factors into three types of visits over a 2-month period: the challenge visit, which occurs during a regular office visit and focuses on advice and setting a date to quit; the quit-date visit, which involves instructing patients on the proper use of nicotine gum, if applicable, and confirming their desire to quit; and four supportive follow-up visits, which provide continuing encouragement for 2 months and allow physicians to monitor withdrawal symptoms, relapses and other problems. Such a program can be effectively incorporated into a general practice. PMID- 3651927 TI - Increased rates of illness and death from asthma in Canada. AB - Recent rates of illness and death from asthma in Canada and rates of hospital admission/separation for asthma were examined by age group and region. The death rates were higher in 1982-84 than in 1970-72, especially among those aged 15 to 34 years. Increases were also noted in hospital admission/separation rates, especially among those less than 15 years of age. Hospital admission/separation rates were highest in the Maritime provinces and Saskatchewan, whereas death rates were highest in Alberta and Saskatchewan. Examination of death certificates for coding errors and recoding of certificates to a single (8th) revision of the International Classification of Diseases indicated that changes in disease coding and errors in coding did not account for the significant increase in rates of death from asthma for those aged 15 to 34 years. These increases in rates of illness and death from asthma are unexplained and warrant further investigation. PMID- 3651928 TI - The diagnosis of dementia. AB - The diagnosis of dementia in the elderly has important personal and social consequences, and a small proportion of cases initially diagnosed may be reversible. An understanding of the operating characteristics and cost effectiveness of clinical signs and symptoms and of laboratory investigations in the diagnosis of dementia is needed to diagnose accurately yet contain costs. Using published criteria, we critically appraised the current scientific literature on the diagnosis of dementia. The articles that essentially satisfied our criteria suggested that duration and severity of dementia best predicted reversibility and the need for computed tomography of the head. A decision rule may be used to select among a number of investigations now advocated as routine in diagnosing dementia, with little or no risk of missing clinically significant diagnoses and with appreciable cost savings. The reversibility of dementia may not be as major an issue as previously believed, since most instances may be early, atypical presentations of Alzheimer-type dementia. PMID- 3651929 TI - Accidents involving off-road motor vehicles in a northern community. AB - The increasing number of accidents associated with off-road motor vehicles used for recreational purposes prompted this prospective study. During 1985 the records of victims of all motor vehicle accidents who were seen at the Hudson Bay Union Hospital, Hudson Bay, Sask., were studied; patients involved in on-road vehicle accidents were included for comparison. Emphasis was placed on age, vehicle type, mechanism of accident, injury severity and the use of safety features. Almost half of the victims of off-road vehicle accidents were under 16 years of age. The poor adherence to government legislation and manufacturer recommendations was evident in the number of people who did not wear helmets or use headlights. PMID- 3651930 TI - Neuromyopathy associated with amodiaquine hydrochloride. PMID- 3651932 TI - Recommendations for providing dialysis treatment to patients infected with human immunodeficiency virus. PMID- 3651931 TI - A case of acquired immune deficiency syndrome before 1980. PMID- 3651933 TI - The taxicab theory. PMID- 3651936 TI - Statement on influenza vaccination for the 1987-88 season. PMID- 3651935 TI - Sexual misconduct. PMID- 3651934 TI - PMI courses helping meet need for physician-managers. PMID- 3651937 TI - Drug legislation in the silly season. PMID- 3651939 TI - Improving drug labels. PMID- 3651938 TI - Propylthiouracil and breast-feeding. PMID- 3651940 TI - Searching for parasites in stool: once is usually enough. PMID- 3651941 TI - Fluoridation: why is it not more widely adopted? PMID- 3651942 TI - After "Eve": whither proxy decision-making? AB - One of the most difficult problems facing physicians is how to approach proxy decisions made on behalf of congenitally incompetent patients. The author considers two recent court cases that attempt to provide guidelines: Re Stephen Dawson, which opts for a substituted-judgement approach, and Eve v. Mrs E.) which injoins best-interests considerations. The author explores the impact of Eve v. Mrs. E. as superseding Re Stephen Dawson, considers its ethical implications and attempts to clarify the best-interests criterion by sketching some guidelines for its interpretation. In so doing, he tries to reconcile the two decisions by laying bare their common underlying ethical rationale. The author concludes by pointing out some ethically questionable implications of Eve v. Mrs. E. in the area of allocation of health care resources. PMID- 3651943 TI - Comparison of one- and two-dose regimens of influenza vaccine for elderly men. AB - In November and December 1984, 102 male residents of a long-term care facility (mean age 74.6 [extremes 59 and 97] years) received 0.5 ml of trivalent inactivated whole-virion influenza vaccine, containing 15 micrograms of the hemagglutinin of each of A/Philippines/2/82 (H3N2), A/Chile/83 (H1N1) and B/USSR/83. A second dose of the vaccine was administered to a subgroup of 55 randomly chosen subjects 8 weeks later. Serum samples were collected from all the subjects before and 4, 8, 12 and 16 weeks after administration of the first dose and were assayed for hemagglutinin-inhibiting (HAI) antibody to each of the three antigens. At 8 weeks there were significant increases (p less than 0.05) in the geometric mean titre of antibody and in the proportion of subjects with HAI antibody titres of 1:40 or more (except to the B/USSR antigen) in both groups. There were no differences between the groups at 8 weeks or at 16 weeks (8 weeks after administration of the second dose of vaccine) in the frequency of seroconversion, the geometric mean titre or the proportion of subjects with HAI antibody titres of 1:40 or more. Overall, 60%, 32% and 13% of the 102 subjects had titres of 1:40 or more to the A/Philippines, A/Chile and B/USSR antigens respectively at 16 weeks. The results suggest that a second dose of influenza vaccine given 8 weeks after the first does not enhance the immune response in elderly men and that a substantial proportion of this population remains unprotected against infection (having HAI antibody titres of less than 1:40) during the influenza season. PMID- 3651945 TI - Laboratory evidence of human viral and selected nonviral infections in Canada in 1986. PMID- 3651944 TI - Maternal and neonatal outcome in pregnancies with no risk factors. AB - Between November 1979 and April 1984, 790 consecutive pregnant women who considered themselves as having a "normal" pregnancy were followed in private practice from 9 weeks' gestation until 6 weeks post partum. The women had no pre existing disease or problem classified as a risk to the pregnancy at the time of their first visit, had a singleton pregnancy and gave birth at Notre-Dame Hospital, Montreal. Maternal complications occurred during the course of pregnancy in 181 women (23%). Complications were mostly related to obstetric conditions (10%), such as preterm labour, intrauterine growth retardation (IUGR) and antepartum hemorrhage, or to medical conditions (12%), the most prevalent of which was hypertension (77% of medical conditions). Neonatal complications occurred in 183 infants (23%). The corrected perinatal death rate was 2.5 per 1000. Prematurity, IUGR and dysmaturity/postmaturity accounted for nearly half of the complications. Hyperbilirubinemia occurred in 7% of the cases. Among women without any maternal complications during pregnancy, the frequency rate of neonatal complications was 19%, compared with 23% among the entire group of 790 women. Our results suggest that the absence of maternal complications does not protect the infant from a neonatal complication. Further refinement is needed to identify markers of obstetric, medical and neonatal complications in pregnancies with no risk factors. PMID- 3651946 TI - Statement on tetanus toxoid. PMID- 3651947 TI - La Maison Sarrazin: serenity before science. PMID- 3651948 TI - Why should doctors get involved in medical administration? PMID- 3651949 TI - Canadian Physicians for Life: "what we have here is a silent minority". PMID- 3651951 TI - Land settlements and health care: the case of the James Bay Cree. PMID- 3651950 TI - Epidemiology and interventions for native Canadians. PMID- 3651952 TI - A study of the nutritional status of an Inuit population in the Canadian high arctic. Part 1. Biochemical evaluation. PMID- 3651953 TI - A study of the nutritional status of an Inuit population in the Canadian high arctic. Part 2. Some dietary sources of vitamins A and C. PMID- 3651955 TI - Health services and water and sanitation services in the Northwest Territories: an examination of the present state of development and some thoughts for the future. PMID- 3651954 TI - The prevalence of diabetes in Indians and Caucasians living in southwestern Ontario. PMID- 3651956 TI - Impacts of a prenatal program for native women. PMID- 3651957 TI - Breastfeeding among Canadian Indians on-reserve and women in the Yukon and N.W.T. PMID- 3651958 TI - Seroepidemiological study for five different zoonotic parasites in northern Quebec. PMID- 3651960 TI - Accidental and intentional violent deaths among British Columbia native Indians. PMID- 3651959 TI - [Cancer in the Inuit of northern Quebec: results of a survey preliminary to the establishment of a cancer registry]. PMID- 3651962 TI - Education. PMID- 3651961 TI - [Dental health in school children in Riviere-du-Loup: follow-up 3 years after termination of the program]. PMID- 3651963 TI - The evolution of the clinical nurse specialist: response to the challenge of professional nursing practice. PMID- 3651965 TI - Executive practice. PMID- 3651964 TI - PREPARED for pregnancy: a counseling guide. PMID- 3651966 TI - Model activities for clinical nurse specialist role development. PMID- 3651967 TI - Clinical nurse specialist collaboration: development of a generic job description and standards of performance. PMID- 3651968 TI - Consultation. PMID- 3651969 TI - The role of the clinical nurse specialist consultant in organizational development. PMID- 3651970 TI - Legislation. PMID- 3651971 TI - Challenges for the clinical nurse specialist in the legal arena. PMID- 3651972 TI - Research. PMID- 3651973 TI - Fostering a research focus for the clinical nurse specialist. PMID- 3651974 TI - Cancer I: General aspects. PMID- 3651975 TI - Warrants of the Lieutenant Governor. PMID- 3651976 TI - Persons discharged from warrants of the Lieutenant Governor. AB - The authors compiled demographic, psychiatric, and criminological information on persons who were held on warrants of the Lieutenant Governor in Ontario. These warrants were vacated between the period 1969-1982. Of the entire population of 296 such persons, 46% were held as being Unfit to Stand Trial, 51% were Not Guilty by Reason of Insanity, and the remainder were Mentally Ill prisoners. Separate analyses were conducted with the Unfit sample. The average length of confinement on a warrant was 7 years. PMID- 3651977 TI - The detection of psychiatric morbidity and associated factors in patients with rheumatoid arthritis. AB - Eighty-six patients with a confirmed diagnosis of rheumatoid arthritis were surveyed to assess the extent of psychiatric morbidity as indicated by two screening questionnaires, the General Health Questionnaire and the Hospital Anxiety and Depression Scale. In addition to an investigation of the concordance of the screening questionnaires, a description of demographic characteristics and measures of disability were taken. Disability due to arthritis was indicated by measures of years of chronicity, pain, duration of morning stiffness, functional level, active treatment involvement, and presence of coexisting medical problems. The relationship of physical symptoms to level of psychiatric distress was investigated. Psychiatric cases were identified using recommended cut off scores on results of the screening questionnaires. GHQ cut off scores of 6/7 identified as "cases" 31.8% of the sample. HADS subscale cut off scores of 8/9 identified 21.4% of subjects with "anxiety" and 19.0% with "depression" scores in the morbid range. Nineteen percent of patients were found to have scores on both tests concurrently in the pathological range. PMID- 3651978 TI - The classification of disturbed personality functioning in early adolescence. AB - This study describes disturbed personality functioning in early adolescence. A non-clinical sample of 63 thirteen year olds underwent a semi-structured psychiatric interview as part of a longitudinal study investigating the relationship between competence in personality functioning and development. The presence of personality disturbance was determined by two psychiatrists who rated the adolescents on a personality functions scale. The raters then described the type of disturbance using Axis II of DSM-III as a guideline. Forty-six percent of the sample were found to have some degree of disturbed personality functioning. Of these, over one-half fell into a cluster comprised of avoidant, dependent, compulsive, or passive-aggressive types, while another third were characterized by antisocial tendencies. Severity of disturbance was not related to type of disturbance. Ratings of behaviour by teachers and parents supported the division of subjects with personality dysfunction into two broad groups: an anxious, fearful, "quiet" cluster; and a group of more "acting out", disturbing individuals. However, parents and teachers could not distinguish the "quiet" group from teenagers who were free of disturbed personality functioning. These data indicate that it is possible to classify a segment of a non-clinical population of young adolescents who had personality dysfunction using Axis II of DSM-III as a guideline. Furthermore, such a group of teenagers is not homogeneous. They distribute themselves into internalizing and externalizing clusters. PMID- 3651979 TI - Some issues in the diagnosis of depression in China. AB - In China, the diagnosis of depression is made much less frequently than in the West, likely because there is a somewhat lower prevalence rate and because of other factors related to culture and to the development of Chinese psychiatry. Some of the relevant factors are: 1) depressed patients often avoid seeking help because of the stigma of mental disorder; 2) many patients seek help from practitioners of Traditional Chinese Medicine; 3) depression is often diagnosed as schizophrenia because of diagnostic criteria that are broader for schizophrenia and narrower for affective disorder than in the West; and 4) somatization is more frequent in China and many depressives receive the label "neurasthenia". PMID- 3651980 TI - Does verbal abuse leave deeper scars: a study of children and parents. AB - This study investigating the effects of verbal abuse on children and their abused parents, tends to support the clinical impression that verbal abuse may have a greater impact for a longer period of time. Although there are very few pure forms of verbal abuse, there are some parents who use verbal abuse but would hit their children, neglect them, or involve them in sex. Verbal abuse may become an increasingly frequent form of controlling and disciplining children because of the increased awareness of physical abuse and because of the possible declining value of children. Verbal abuse may have a greater impact because the abused child has greater difficulty defending himself from the attack. Because children tend to identify with their parents, the verbal abuse by their parents becomes a way in which they then abuse themselves. PMID- 3651981 TI - Short-term economic change and the utilization of mental health facilities in a metropolitan area. AB - The relationship between economic change and mental disorder has been examined by several investigators over the past century. The purpose of this paper is to explore this basic relationship and determine its direction in a large Metropolitan area. A time series analysis was undertaken to investigate whether or not unemployment and indicators of mental health are related over time. Trends in the following four indicators of mental health were examined: 1. Number of admissions to all psychiatric facilities serving Metropolitan Toronto. 2. Number of admissions to one provincial psychiatric hospital (Queen Street Mental Health Centre) in Toronto, which serves a chronic population. 3. Number of discharges from Queen Street Mental Health Centre. 4. Number of admissions plus those assessed and not admitted to Queen Street Mental Health Centre. In order to assess the possible delayed effects of unemployment, correlation analyses were computed for several lag times. "Lag time" is defined here as the time delay between unemployment and its potential effects on mental health indicators. Lag times used were zero, three, six and twelve months. The best equation found was for a six month lag, indicating an inverse relationship; as unemployment increases, admissions and discharges decrease. Results suggest that there are no simple relationships between the dependent and independent variables. Observed trends may be due to much wider exogenous factors such as hospital capacity and changing admission criteria. PMID- 3651983 TI - Delusional disorder in mother and daughter: case report. AB - The occurrence of delusional disorder in a mother-daughter pair is described. The significance of this report is discussed in light of recent family studies of this disorder, and in reference to treatment implications. PMID- 3651982 TI - Hyperactivity and child abuse. AB - The role of a child in his/her physical abuse was reviewed with particular attention to hyperactive children. A retrospective analysis of the records of children referred to a university-based hyperactive children's clinic revealed that children both with and without Attention Deficit Disorder (ADD) were more often physically abused than children in the general population. The period prevalence of physical abuse in children with ADD did not differ significantly from that in children without ADD. This suggests that hyperactivity may either contribute to, or result from, physical abuse. PMID- 3651984 TI - Functional dysphonia in adolescence: two case reports. AB - Reports of functional dysphonia in children and adolescents under 16 years of age are few. Approximately a dozen cases have been reported in the English literature over the past 35 years. Most of the articles appear in journals related to the fields of speech, hearing and communication with a few in the Otorhinolaryngologic journals. Published papers in psychiatric journals dealing with voice or speech disorders are virtually nonexistent. In children and adolescents the two most common varieties are the Whispering Syndrome, which occurs predominantly in girls, and the Hysterical High Pitched Voice seen mostly in boys. This paper discusses these two varieties of functional dysphonia and presents a case example of each. PMID- 3651985 TI - Porphyria and psychosis: a case report. AB - This article reports the case of a 41 year old female with a history of acute intermittent porphyria who presented with exacerbation of a chronic psychotic illness. Though the evaluative studies for an acute porphyric episode were negative, psychological testing was consistent with an organic patchy cognitive decline. This finding is discussed in relation to the reported assymetric neuropathic lesions reported in porphyria. PMID- 3651986 TI - [Pediatric psychiatry and dermatology: presentation of a case of atopic dermatitis]. AB - As consultants in child psychiatry to the Dermatological service of a large pediatric hospital, the authors, like other clinicians, think that psychological factors have an effect upon the course of atopic dermatitis. They present the case of a child showing the existence of three important psychological factors. These are a closed parents-child relationship, conflict around aggressiveness and the meaning of somatic regressions. Finally, while referring to the literature, they discuss the way these factors might operate in the course of the disease. PMID- 3651987 TI - Borderline personality disorder. PMID- 3651988 TI - Letter from a Danish psychiatric resident. PMID- 3651989 TI - Addressing the needs and solutions to increase the use of low-cost screening mammography. PMID- 3651990 TI - American Cancer Society Workshop on Strategies to Lower the Cost of Screening Mammography. July 16-18, 1986, Annapolis, Maryland. PMID- 3651991 TI - The history and present status of radiographic screening for breast carcinoma. AB - Many of the perceived and actual difficulties in the creation of screening centers have been solved or are amenable to solution. The amount of radiation delivered to the breast during mammography no longer poses a significant risk and there is ample evidence that screening mammography can detect occult disease. While substantial evidence is lacking with respect to a decrease in mortality in patients under 50 years of age, there is an unequivocal gain in those over 50 years of age. Other concerns center around the number of trained radiologists available to interpret large numbers of screening mammograms, the use of lay screeners to minimize the physician shortage and the availability of instruction centers to educate those radiologists not formally trained in mammography. The question of quality control is closely tied to the training of the radiologist and must be addressed if screening centers are to function efficiently. All of the above are correctable to a greater or lesser degree, but the problem of cost remains. To survey all women over 40 years of age at a cost of $50.00 per examination would require an expenditure in excess of two billion dollars a year, a staggering sum even in the context of the economy of the 1980s. It is necessary that these costs be lowered if the full potential of a major cancer detection procedure is to be realized. This conference has both the responsibility and opportunity to perform a significant service for the women of the US. We ask all of you to devote your greatest ingenuity to achieving its major purpose, the development of a practical strategy for cost reduction in mammography. While it may not be possible to achieve all that we wish, the formulation of any reasonable plan to increase public access will be a major accomplishment. I remind you of a French aphorism: "The greatest crime is to do nothing because we fear we can only do a little." PMID- 3651992 TI - The role of the radiologist in mammography screening. PMID- 3651993 TI - The essentials of screening mammography. PMID- 3651994 TI - A successful effort to lower costs in screening mammography. PMID- 3651995 TI - Low cost mammography screening. Practical considerations with emphasis on mobile operation. PMID- 3651996 TI - Legal aspects of mammography screening. PMID- 3651997 TI - American Cancer Society: Cost of screening mammography. Issues, recommendations, and solutions. PMID- 3651998 TI - Predictive value of the early response to chemotherapy in high-risk stages II and III Hodgkin's disease. AB - A series of 60 patients with "high risk" Stage II and III Hodgkin's disease (B symptoms, or large mediastinal mass, or E lung disease) were staged without laparotomy and treated with combined modality treatment: mechlorethamine, vincristine, procarbazine, and prednisone (6 MOPP) plus radiotherapy. Patients were restaged after the first three courses of MOPP and the status of response to therapy at that time was called early response to chemotherapy (ERC). The rate of nitrogen mustard and procarbazine delivery (MRD) during the first three cycles of chemotherapy also was assessed. At the completion of the therapy patients were restaged and the final response was assessed. Fifty-two (86.7%) patients entered complete remission (CR). Forty-eight percent of the complete responders achieved CR in the first three courses of MOPP. Eight-year survival and disease-free survival (DFS) rates of the patients achieving CR were 71% and 73%, respectively. Survival and DFS were significantly better for the patients who achieved CR in the first three cycles of chemotherapy than for patients who entered CR at a later stage of therapy: 8-year survival 90% versus 55% (P = 0.00); 8-year DFS 87% versus 59% (P = 0.01). The attainment of a complete ERC was adversely affected by lymphocyte depletion (LD) histologic type (P = 0.01) and MRD less than 65% (P = 0.04). However, when a multivariate regression analysis was used, ERC was the only significant prognostic variable for survival and DFS and its predictive value was confirmed even after correction by MRD. These data suggest that the rapidity of response to chemotherapy could be an important prognostic factor in high-risk Stage II and III Hodgkin's disease. PMID- 3651999 TI - Adjuvant and neoadjuvant chemotherapy with dacarbazine in high-risk childhood melanoma. AB - Four of four children with clinical Stage II-IIIB childhood melanoma treated at The University of Texas System Cancer Center M.D. Anderson Hospital with surgical excision of gross disease and adjuvant or neoadjuvant chemotherapy with dimethyl triazeno-imidazole carboxamide (dacarbazine) were alive without evidence of disease at 2, 6, 9.5, and 10.5 years after treatment. In one of the four patients suspected pulmonary nodules developed shortly after the start of chemotherapy, but regressed completely with continued treatment. In another patient with a primary left wrist melanoma and palpable epitrochlear and axillary nodes, there was dramatic shrinkage of nodal disease during chemotherapy and subsequent biopsies were cytologically negative. The expected survival of children with this rare condition when diagnosed at a comparably advanced stage and treated primarily by surgery is 32% compared with the 100% survival in these four cases. Although dacarbazine has not been notably successful as adjuvant therapy in high risk adult melanoma, data from this small series is suggestive of an adjuvant effect in high-risk childhood melanoma and merits further study although the rarity of this condition may make a controlled trial difficult. PMID- 3652000 TI - Chemotherapy with mitoxantrone in combination with continuous infusion vinblastine for metastatic breast cancer. AB - The efficacy of mitoxantrone in combination with vinblastine was assessed in 156 patients with metastatic breast cancer who had been treated previously with one or multiple chemotherapeutic regimens. Mitoxantrone was given by random assignment, either as a 10 mg/m2 single intravenous dose or in five consecutive daily fractions of 2 mg?2. Vinblastine was given as a continuous intravenous infusion of 1.2 mg/m2 daily for 5 days. In 115 evaluable patients previously treated with doxorubicin, 21 objective responses (18%) and 11 minor responses (10%) were observed with similar distribution in the two treatment groups. Median time to progression was 27 weeks and 23 weeks, respectively. Eight (32%) of 25 patients who had not received doxorubicin achieved objective remissions and two (8%) had minor responses. Toxic effects were similar for the two treatment schedules. Major toxicities were myelosuppression and neutropenic fever. Other toxicities were mild. Cardiotoxicity, presumably caused by mitoxantrone, occurred in four patients. The combination of mitoxantrone and vinblastine appeared to offer no advantage over single-agent therapy, probably because of the dosage reduction required by the overlapping myelosuppressive toxicity. PMID- 3652001 TI - Intramedullary spinal cord metastasis in Hodgkin's disease. Rapid diagnosis and treatment resulting in neurologic recovery. AB - Intramedullary spinal cord metastases are uncommon in Hodgkin's disease and have a poor prognosis. This prognosis reflects the refractory or widely disseminated status of the disease at the time of development of neurological symptoms and difficulties in diagnosis. Computerized tomography and magnetic resonance imaging have enabled more rapid and specific diagnosis of spinal cord diseases. The authors report a patient who presented with Brown-Sequard syndrome due to intramedullary spinal cord infiltration from Hodgkin's disease. This patient was diagnosed promptly and with rapid initiation of radiation and chemotherapy, she has had neurologic recovery. PMID- 3652002 TI - Computed tomography and lymphography in the presurgical staging of early carcinoma of the uterine cervix. AB - The value of bipedal lymphography and computed tomography (CT) in the presurgical staging of early carcinoma of the uterine cervix was analysed in 62 patients by histologic examination of pelvic lymph nodes and parametrial extension at the time of surgery. Macroscopic invasion of the lymph nodes was detected in 33% of the patients by CT and in 17% by lymphography. Microscopic invasion was suspected in 9% by CT scan and in 38% by lymphography. Physical examination with measurement of the tumor diameter was more predictive for regional extension of the disease as compared to lymphography and CT. CT may detect subclinical parametrial invasion but overestimation of the extent of the disease is common. Bipedal lymphography and CT add only limited information to the routine presurgical staging of cancer of the uterine cervix. PMID- 3652003 TI - Hodgkin's disease in hairy cell leukemia. Phenotypic characterization of neoplastic cells. AB - A case of Hodgkin's disease (HD) in a patient with long-standing hairy cell leukemia (HCL) is reported. The diagnosis of HCL was confirmed by clinical features (chronic illness with marked splenomegaly) and hematopathologic findings (increase of characteristic hairy cells with tartrate-resistant acid phosphatase activity in peripheral blood and bone marrow). Cervical lymphadenopathy first appeared 6 years after the diagnosis of HCL, and histologic features of the node were characteristic of HD. As it was possible that the neoplastic cells of both lesions might have originated from a single clone, their phenotypic features were defined. The hairy cells were found to bear surface immunoglobulin, receptors for complement components, leukocyte common antigen, and antigen defined by LN-1 monoclonal antibody, whereas lymph node lesion was characterized as HD because the Reed-Sternberg-like cells were positive for Leu M1 antigen, lysozyme, alpha-1 antitrypsin, and nonspecific cross-reacting antigen. Since there was no evidence indicating a common clonal origin, it is more likely to consider that both lesions are derived from different clones. PMID- 3652004 TI - Stromal cell effects on clonal growth of tumors. AB - Clonal growth of tumor cell lines originating from a variety of solid tumors was studied. The seeding efficiency of these tumors in methylcellulose medium was in the range of 0.036 to 0.177. Stromal cell lines from mouse bone marrow as well as primary stromal cells from human bone marrow stimulated the growth of HCT and oat human carcinoma cells 32-fold and 25-fold, respectively. In contrast, these stromal cells inhibited the in vitro cloning of human and mouse sarcoma cell lines. Both activities of the stromal cells diffused through agar layers and operated across species barriers. Despite the diffusable nature of the factors involved, no biologic activity was observed in concentrated conditioned media prepared in the presence or absence of serum. Human foreskin fibroblasts tested under identical conditions, could neither stimulate nor inhibit the clonal growth of tumors. This preferential growth of tumor cells in the presence of tissue specific stroma may be used as an in vitro model for the study of the role of stromal cells in tumor cell spread. PMID- 3652005 TI - New subgrouping of small thyroid carcinomas. AB - Clinicopathologic findings on small thyroid carcinomas measuring 10 mm or less in diameter were analyzed in 78 thyroidectomied cases. The authors divided small thyroid tumors into two subgroups according to diameter: 0 less than or equal to 5 mm (classified as minute carcinoma) and 5 less than 0 less than or equal to 10 mm (classified as tiny carcinomas). Characteristics including sex, age, histologic type, extrathyroid invasion, and lymph node metastasis were examined in each subgroup. In patients with minute carcinoma, very few incidences of extrathyroid invasion and lymph node metastasis were found. However, these involvements, especially lymph node metastasis, were found more frequently in patients with tiny carcinoma. The incidence of cervical lymph node metastasis was 13% in minute carcinoma and 59% in tiny carcinoma. (P less than 0.01). These findings suggest the need for more careful observation and treatment of tiny carcinomas, especially with respect to lymph node metastasis. In accordance with World Health Organization (WHO) classification, the histologic types of thyroid carcinoma were classified into papillary and follicular carcinomas. The papillary carcinoma and follicular carcinoma ratios were compared between the two subgroups. The discovery rate of follicular carcinoma was significantly higher in minute carcinoma than in tiny carcinoma (P less than 0.005). This suggests that the papillary carcinoma/follicular carcinoma ratio (p/f) increases as the size of the carcinoma increases, and that follicular carcinoma is the "seed," or initial form, of thyroid cancer. The female-male ratio in small thyroid cancer suggests that there is no sex difference in carcinogenesis but that there is more probability for cancer development in the thyroid in women. PMID- 3652006 TI - Inflammation and/or necrosis of tumors cannot account for fever in most febrile patients with Hodgkin's disease. AB - Inflammation and/or necrosis (I/N) of the tumor are generally believed to be a cause of fever in patients with Hodgkin's disease. However, there have been few studies in the literature which can corroborate this common belief. Inflammation and/or necrosis were studied in biopsy specimens of 140 untreated patients with Hodgkin's disease (57 febrile and 83 afebrile). In 37 of the 140 tumors I/N were readily observed; 18 were from febrile patients, and 19 from afebrile. Thus, it is evident that I/N cannot account for fever in the majority of febrile patients, necessitating an alternative explanation. Among the patients with I/N of their tumor, fever occurred most often in male patients and in virtually all patients who had histologic types other than nodular sclerosis. However, it was peculiarly absent in the great majority of patients whose tumors were of the nodular sclerosis type. This paradoxic inverse correlation of fever with I/N of tumors in patients with the nodular sclerosing histologic type has not been described previously. PMID- 3652007 TI - A clinicopathologic and immunohistochemical study of 16 patients with small intestinal leiomyosarcoma. Limited utility of immunophenotyping. AB - Clinicopathologic data including immunophenotypic expression of 16 new cases of small intestinal leiomyosarcoma are presented. Patient age ranged from 27 to 87 years (mean, 61 years) with a 2.2:1 male-female ratio. Eighty-eight percent of tumors occurred distally, i.e., in the jejunoileum. Considerable histologic heterogeneity was noted including epithelioid, myxoid, and sclerotic variants. Stratification by histologic grade suggests important clinical subsets. Only in grade I tumors is surgical extirpation alone potentially curative. Grade II tumors are associated with meaningful survival usually measured in years, however, nearly all patients can be expected to die from their tumors. Grade III sarcomas are fully malignant and rapidly progressive: except for one case with limited follow-up, all patients with Grade III sarcomas died of disease with a mean survival of only nine months (median, 2 months). Immunostaining with antibodies directed against vimentin, muscle-specific actin, desmin, and S-100 protein were performed. Only antivimentin was uniformly reactive. Sixty-three percent of cases tested showed actin immunoreactivity, and no tumors revealed immunohistochemically detectable desmin or S-100 protein. Although many small bowel stromal sarcomas appear "poorly differentiated" by immunohistochemical methods presently available, that they are indeed leiomyosarcomas seems most likely from their intramural location and light histologic study. The limited utility of immunophenotyping and the importance of histologic grading are stressed. PMID- 3652008 TI - Acridine-orange flow cytometry of urinary bladder washings for the detection of transitional cell carcinoma of the bladder. The influence of prior local therapy. AB - Analysis of cellular DNA and RNA contents of 249 bladder irrigation specimens from 129 patients with a history of transitional cell carcinoma (TCC) of the bladder was performed using acridine-orange flow cytometry (FCM). Washings from patients with prior intravesical chemotherapy or radiation therapy were compared to those from patients with no history of treatment other than tumor resection to evaluate the reliability of FCM for the detection of tumor and the influence of prior local therapy on that reliability. Five FCM patterns were defined on the basis of DNA and RNA indexes in relationship to peripheral blood lymphocytes. FCM results were compared to cytologic findings in 237 cases, cystoscopic findings in 230 cases, and histologic data in 99 cases. Presence of a single diploid stem line was associated with absence of bladder tumor in 71% of cases from patients treated with surgery alone or with radiation therapy, but there was residual tumor in 53% of patients exposed to prior local chemotherapy. An elevated RNA content in a diploid cell population did not provide additional diagnostic information. Presence of an aneuploid stem line was associated with tumor in 85% of cases, regardless of prior therapy. Aneuploidy predicted the appearance of tumor in four of six patients with a negative cystoscopy. Tetraploidy (greater than 10% of total cell population) was associated with tumor in 79% of patients treated with surgery alone, whereas no tumor was found in more than 50% of patients who had undergone prior chemotherapy or radiation therapy. This study stresses the importance of prior treatment history in evaluating the results of DNA-FCM for bladder cancer. It demonstrates the unreliability of FCM diploid and tetraploid cell populations in patients previously treated by local chemotherapy or radiation. However, it also supports prior observations that DNA-aneuploidy and DNA-tetraploidy are useful for detecting and predicting bladder cancer in patients submitted to surgery alone. PMID- 3652009 TI - Use of nude mouse xenografts as preclinical screens. Characterization of xenograft-derived melanoma cell lines. AB - Cell lines derived from human melanoma xenografts were characterized for surface markers, karyotype abnormalities, and in vitro drug sensitivity. Xenografts were established using metastatic explants from untreated patients and passaged in nude mice. Cell lines were readily established from melanoma xenografts, and formed colonies when plated in semisolid media. The lines expressed human melanoma-associated and other surface antigens, human lactate dehydrogenase (LDH) isoenzymes, and contained only human chromosomes. They failed to express murine histocompatibility determinants and were negative for murine viruses by mouse antibody production assay. Karyotypes showed abnormalities of chromosomes 3, 6, and 7 similar to other melanomas. In vitro chemosensitivity profiles were compared using cell line and xenograft colony-forming assays. Values were similar for the original xenografts and their cell lines. Xenograft-derived human melanoma lines resemble other melanoma cell lines and primary melanomas with respect to surface antigens and karyotype abnormalities, and are appropriate models for studying in vitro drug sensitivity. When used as a model for transition from solid tumor to cell line, these studies suggest cell lines closely mirror in vitro chemosensitivities of parent tumor cells. However, occasional, unpredictable changes in sensitivity to some drugs occurs during this transition. PMID- 3652010 TI - Observations of serum trace elements in chronic lymphocytic leukemia. AB - Serum trace elements (STE) were measured in 50 patients with chronic lymphocytic leukemia (CLL) and 100 normal subjects. Copper was higher in patients than in controls (1.50 +/- 0.06 versus 1.10 +/- 0.02 micrograms/ml, P less than 0.001), increased steadily from Stage 0 to Stage 4 (P = 0.002), and correlated with the lymphocyte count and serum lactate dehydrogenase (P less than 0.01) but not with acute phase reactants. Zinc was lower in patients than in controls (0.94 +/- 0.03 versus 1.10 +/- 0.02 micrograms/ml, P less than 0.001). Zinc (NS), selenium (P = 0.039), and calcium (P = 0.033), were decreased in Stages 3-4 as compared to Stages 0-2. The copper-to-zinc ratio (CZR) increased continuously from Stage 0 to Stage 4 (P less than 0.001). Discriminant analysis between two groups, Stage 0-2 and Stage 3-4, based on serum copper, zinc, calcium, and protein levels, allowed for a correct classification of 94% of the patients. Moreover, the clinical staging of the remaining 6% was modified retrospectively according to the results of discriminant analysis. It was concluded that (1) serum copper and CZR are useful indices of the extent of disease, (2) they are independent of a nonspecific acute phase reaction, (3) STE determination could be helpful in the staging of a limited number of CLL patients, and (4) zinc deficiency could contribute to immune dysfunction in CLL. PMID- 3652012 TI - Microscopically oriented histologic surgery for head and neck mucosal cancer. AB - Frozen section directed surgery, called MOHS, has been successfully utilized in the resection of primary epidermoid tumors of the head and neck. For the 93 cases reviewed in this study, 70% had microscopically identified tumor 1 cm away from clinically evident disease. Tumor spread was along planes of least resistance, most commonly in the submucosa. Microscopically directed excisions were able to trace and remove these tumor extensions. Local control in 93 patients with 2-year follow-up was 91% and, with salvage of recurrences, was 95%. The authors' observations suggest three important concepts. First, epidermoid cancer of the head and neck grows as a continuous neoplasm. Second, this work casts serious doubt on the concept of "field cancerization" or multiple primaries as a cause of local recurrence. Third, conventional frozen section analysis of surgical margins is highly unlikely to discover microscopic extensions because many tumor extensions are thin, finger-like projections which require examination of the entire surgical margin to detect. PMID- 3652011 TI - Optic gliomas. A reanalysis of the University of California, San Francisco experience. AB - Thirty-eight cases of optic gliomas seen at the University of California, San Francisco, were reviewed. Two patients died in the postoperative period and were excluded from the follow-up analysis. Twenty-nine cases (76%) involved the optic chiasm, nine (24%) cases were confined to one optic nerve. Most tumors were slow growing and progressive although there were three cases of adult chiasmal gliomas which exhibited unusually aggressive behavior. The three cases are presented in detail. After a mean follow-up period of 9.4 years, the 10-year overall actuarial survival was 87%. Relapse-free survival was 55% at 10 years. Chiasmal tumors had a poorer prognosis compared to optic nerve tumors with 56% of chiasmal tumors recurring versus 22% of optic nerve tumors. Radiotherapy was beneficial in chiasmal gliomas, initially improving vision in 35% (6/17) and decreasing recurrence from 86% (6/7) without radiation therapy to 45% (9/20) with radiation therapy. Optic gliomas are not benign, self-limiting lesions, and therefore require treatment. Radiotherapy is effective in chiasmal gliomas and should be used early in the management of these tumors. No advantage to radiotherapy could be demonstrated for optic nerve gliomas, although the number of these cases analyzed was small. PMID- 3652013 TI - Spinal cord compression due to ethmoid adenocarcinoma. AB - Adenocarcinoma of the ethmoid sinus is a rare tumor which has been epidemiologically linked to woodworking in the furniture industry. It has a low propensity to metastasize and has not been previously reported to cause spinal cord compression. A symptomatic epidural spinal cord compression was confirmed on magnetic resonance imaging (MRI) scan in a former furniture worker with widely disseminated metastases. The clinical features of ethmoid sinus adenocarcinoma and neoplastic spinal cord compression, and the comparative value of MRI scanning in the neuroradiologic diagnosis of spinal cord compression are reviewed. PMID- 3652014 TI - Diagnostic reliability of combined physical examination, mammography, and fine needle puncture ("triple-test") in breast tumors. A prospective study. AB - A prospective study of 622 consecutively registered patients with 650 breast tumors was performed to appraise the reliability of combined physical examination, mammography, and fine-needle puncture (triple test) in the preoperative diagnosis of such tumors. All malignant as well as benign test results were confirmed by subsequent histologic examination. The diagnostic accuracy of the triple test at benign changes is comparable to that of histologic examination, but participation of experienced radiologists and cytologists as well as persons skilled in fine-needle puncture is required. Twenty-eight percent of the planned excisional biopsies were made superfluous by the fine-needle puncture, which immediately revealed the tumor as a cyst, abscess, or hematoma. For this reason, too, fine-needle puncture is recommended as a routine procedure. PMID- 3652015 TI - Spontaneous regression of gastric lymphoma. AB - Two cases of spontaneous regression of histologically diagnosed large cell lymphoma of the stomach are reported. Regressions occurred after nonspecific therapy including the H-2 antagonist cimetidine and were documented surgically. Spontaneous regression of intermediate and high-grade non-Hodgkin's lymphoma is distinctly uncommon. The possible role of cimetidine in these cases is discussed. PMID- 3652016 TI - The value of prophylactic antibiotics during the insertion of long-term indwelling silastic right atrial catheters in cancer patients. AB - Over a 3.5 year period from August 1982 to December 1985, 200 Hickman catheters (Evermed, Medina, WA) were inserted into patients at the King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia. One hundred sixty catheters were placed in patients with malignant disease, many of whom were immunosuppressed at the time of catheter insertion. Seventy of 160 (44%) patients received prophylactic antibiotics and 90 (56%) did not. The mean age of each group was 23 years (range, 2 to 70 years), and the patients in each group were statistically similar in sex, underlying disease, and routine preoperative hematologic and biochemical evaluation. Exit-site wound infections occurred in 50 of 90 (55.5%) patients who did not receive prophylaxis and in 12 of 70 (17%) patients who received prophylaxis (P less than 0.0001). There was no statistically significant difference in the incidence of tunnel and incision site infections. The mean duration of antibiotic prophylaxis was 2.9 days (SD, 1.2 days). Organisms cultured from catheter associated infections, included Staphylococcus epidermidis 36, S. aureus 30, Klebsiella pneumoniae 1, Pseudomonas aeruginosa 3, Escherichia coli 1, and diphtheroids non-CDC-JK 3. Vancomycin was used as antibiotic prophylaxis in 64 patients, Kefzol (Eli Lilly, Indianapolis, IN) in one, oxacillin in three, nafcillin in one, and Septra (Burroughs Wellcome, Research Triangle Park, NC) in one. The data indicate that the use of intravenous antibiotic prophylaxis significantly reduces exit site infection and may reduce both tunnel and incision site infection. Prophylactic antibiotic coverage should be provided to patients during insertion of long-term indwelling right atrial catheters. PMID- 3652017 TI - Thermal irritation and esophageal cancer in northern Iran. AB - The ingestion of hot food and beverages has repeatedly been postulated as a risk factor for cancer of the esophagus. Although several studies have been performed on the correlation of the consumption of hot tea and esophageal cancer, no research has heretofore documented, by actually measuring, the temperature at which the tea is consumed. Therefore, a tea temperature measurement study was carried out in the Caspian Littoral of Iran, where the frequency of esophageal cancer is the highest in the world. The study was conducted during a population food-habits survey in 1968 to 1969, which was performed before statistics were available regarding the incidence rate or geographic distribution of this disease in the region. Ten years later, when the results of the Caspian Cancer Registry were analyzed, the data from this nutritional study was compared with the regional distribution of esophageal cancer. A geographic correlation exists between the frequency of consumption of hot tea and the incidence of esophageal cancer. Seventy-two percent of the people in the low-risk region of esophageal cancer drank their tea at the relatively moderate temperature of below 55 degrees C, compared with only 3% in the high risk region. More importantly, 62% of the adult population in the high-risk region, as opposed to 19% in the low-risk region, drank their tea at a temperature of over 65 degrees C. In addition to the thermal irritation of hot tea, the following considerations cannot be ignored: the carcinogenicity role of tannins; the cancer-promoting effect of phenols; and the absorption facilitating role of hot tea. Alcohol and tobacco, the most important risk factors for cancer of the esophagus in many countries, play a negligible role in the cause of this disease in northern Iran. In this region, nutritional deficiencies--a special diet for pregnant women composed of sour pomegranite seeds, black pepper, and garlic; consumption of bread contaminated with silica fibre; and ingestion of opium and opium dross--combined with long lasting and daily thermal irritation of the esophagus with very hot tea play an important role in the development of this disease. The inhabitants of the high risk area consumed roughly 2.5 times more tea than their counterparts in the low risk area. In addition, the mean daily consumption of tea leaves per person (average) was 5.7 g and 3.8 g, respectively. PMID- 3652019 TI - American Cancer Society National Conference. Gynecologic cancer--1986. Atlanta, Georgia, September 17-19, 1986. Proceedings. PMID- 3652018 TI - National survey of patterns of care for testis cancer. AB - A national survey of testicular cancer documented recent trends in disease characteristics, treatment, and outcome, providing a basis for progress being achieved on a community basis. A long-term study of 3285 patients diagnosed between 1970 and 1975 was compared with a short-term study of 1887 patients diagnosed in 1983. An increase of the symptom of a lump in the testis from 23.1% to 31.2% and a mass as a sign of cancer from 44.5% to 53.8% suggests earlier detection of testis cancer by the patient and physician. Changes in the methods of diagnosis reflect the changing technology of tumor diagnosis. The 10-year survival rates for pathologic Stage I seminoma (82.6% of all seminomas) exceeded 96%. For pathologic Stage I nonseminomatous germ cell tumors (51.7% of all NSGCT), 10-year survival was 87.1%; whereas for Stage III (18.7% of all NSGCT) it was 22.1%. The impact of the important advances in chemotherapy is reflected in the increase of 1-year survival of Stage III NSGCT from 50.5% to 78.4%. Testis cancer can be cured in most patients. PMID- 3652020 TI - An era of therapeutic translation. AB - Diagnostic advances currently have exceeded therapeutic gain. The present, however, is a transition phase. Chemotherapy, for example, has become curative for some tumors in recent years, rather than merely palliative, due to the precision permitted by advances in molecular biology. At this time, acceleration in the basic oncologic sciences has surpassed therapeutic advance, but therapeutic translation has begun and we will require clinical scientists to increase the bridge from laboratory to bedside if we are to speed the contribution of the so-called biologic revolution to cancer control. PMID- 3652021 TI - End results, interhospital differences, and trends in patterns of care for gynecologic cancer. AB - Survival rates represent one measure of population-wide progress in cancer control. Data from the Surveillance, Epidemiology and End Results (SEER program of the National Cancer Institute (NCI) document that, during the 1970s, survival rates for several cancers improved. For the major gynecologic cancers and breast cancer, improvements are evident for some sites but, areas of decline also are observed. Black women in the US have a poorer survival rate than white women and the trend in recent years suggest that this gap may be widening. Comparisons of survival rates from comprehensive cancer centers and population-based rates indicate differences in outcomes associated with the treatment setting. Data from the American College of Surgeons (ACS) patterns of care surveys suggest substantial interhospital variability in cancer survival which is largely explained by characteristics of the patient populations served. Recent studies of patterns of care document major shifts in treatment practices in the US and provide insight concerning the rate at which treatment changes are adopted at the community level. PMID- 3652022 TI - Barriers and incentives for primary-care physicians in cancer prevention and detection. AB - The American Cancer Society (ACS) estimates that nearly a million new cases of cancer will occur and that approximately 500,000 lives will be lost in 1987. These figures may double by the year 2000 primarily because of our aging population, with age being the leading risk factor for cancer. It is believed that most cancers can either be prevented or treated successfully if they are diagnosed early. Primary-care physicians and other health professionals delivering information on prevention and performing early diagnostic studies in various ambulatory settings represent the key to the reduced complications and mortality of cancer by virtue of their position in the health care delivery system within communities. Barriers and incentives for delivering these all important health measures are examined and suggestions are made for their accomplishment. It is recommended that the primary thrust should be toward the development of methodology which will allow the primary care physician to institute these measures in his regular medical practice and to coordinate them with other health maintenance and early diagnostic activities in the ambulatory setting. PMID- 3652023 TI - The use of screening mammography. AB - Screening mammography, breast x-ray examination of women without any symptoms or signs of breast cancer, is a safe and efficacious procedure. Modern mammography, which is a low-dose radiographic examination, allows safe and correct diagnosis of about 90% of the cancers. Occult breast cancers, those found only with screening mammography, have a much lower rate of axillary node metastases and a much better prognosis, when compared with palpable breast cancers. With screening mammography, minimal breast cancers that are early in their development and have a remarkably improved prognosis can often be detected also. It is generally agreed that women with minimal cancers do not require mastectomies. PMID- 3652024 TI - Psychological evaluation and preparation of the patient and family. AB - The suspected and confirmed diagnosis of cancer places stress on the patient and the family. In addition to the feelings of helplessness, guilt, frustration, alienation, and vulnerability that a diagnosis of cancer provokes, the diagnosis of gynecologic cancer can exacerbate these feelings due to its relationship to the perceived physiologic core of femininity, sexuality, and motherhood. Evaluation of the patient's existing coping skills, perceived seriousness of the illness, anticipated loss of control over physical functioning, and available family support is an essential part of the treatment plan. Preparing the patient and family for diagnosis and treatment is enhanced by supportive intervention techniques such as provision of accurate information, exploration of the patient's fears and fantasies, restoration of degrees of control in the patient's life, and exposure to peer support groups. PMID- 3652025 TI - Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. AB - The surgical pathologic features of 621 patients with Stage I carcinoma of the endometrium are presented. All patients were treated with primary surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, selective pelvic and paraaortic lymphadenectomy and peritoneal cytology. An appreciable number of patients (144-22%) with Stage I cancers have disease outside of the uterus (lymph node metastasis, adnexal disease, intraperitoneal spread and/or malignant cells in peritoneal washings). Multiple prognostic factors particularly grade and depth of invasion are related to extrauterine disease. This study adds credence to the primary surgical approach with individualized postoperative therapy as indicated. PMID- 3652026 TI - Altered fractionation radiation therapy for gynecologic cancers. AB - Altered fractionation radiation therapy is one of the attempts to improve the therapeutic ratio in the hope of controlling locally advanced tumors by radiation therapy alone. This includes hypofractionation, split course fractionation, hyperfractionation, accelerated hyperfractionation, and others. Various fractionation schemes are reviewed in terms of dose and time modification for the management of various gynecologic malignancies. Of these, accelerated hyperfractionation with 10% to 15% dose reduction from conventional or traditional once daily radiation therapy appears to hold the most promise. One and one half Grays per fraction, two fractions per day were used for whole pelvis irradiation and 1.0 Gy per fraction, two fractions per day were used for whole abdomen irradiation with 4 hours between fractions, 5 days a week. Various gynecologic malignancies have been treated with these programs since 1982. Gray for Gray, tumors tend to regress more rapidly than, and the acute and late effects were quite similar to conventional once-daily radiation therapy with 1.8 Gy to 2.0 Gy per fraction. The accelerated hyperfractionation programs were generally well tolerated and deserve a randomized trial. PMID- 3652027 TI - Critical role of gonadal hormones on the genotoxic activity of the hepatocarcinogen DL-ZAMI 1305. AB - The DNA damaging capacity of the sex-dependent hepatocarcinogen beta-blocker DL-1 (2-nitro-3-methyl-phenoxy)-3-tert-butylamino-propan-2-ol (DL-ZAMI 1305) was evaluated in different sex hormonal conditions. A single injection of DL-ZAMI 1305 causes DNA damage in the liver of the female but not the male Wistar rat. When the hormonal environment of the female rat is converted to 'male type' by ovariectomy and 1 week of treatment with testosterone, DNA damage by DL-ZAMI 1305 is completely abolished. On the contrary, in male rats orchiectomy coupled to 17 beta-estradiol administration increases the amount of hepatic DNA damage by DL ZAMI 1305 to values similar to those observed in intact female rats. DL-ZAMI 1305 induces hepatic DNA damage also when administered to female Sprague-Dawley and Fisher 344 female rats. It is uneffective instead on the male rats of these strains. Moreover, in the female Fisher 344 rat phenobarbital pretreatment reduces the DNA damaging capacity of DL-ZAMI 1305. Our data indicate that the genotoxic activity of DL-ZAMI 1305 depends on the sex-hormonal status of the animal and that this is possibly due to a modulation of the microsomal mixed function oxidase system by sex hormones. PMID- 3652028 TI - The specific binding of transferrin to the murine fibroblast cell lines AKR-2B and its malignant counterpart AKR-MCA may be related to the transformed state. AB - The specific binding of radiolabelled transferrin to AKR-2B and AKR-MCA murine fibroblasts was studied. The binding of radioligand to both cell lines was specific, being displaced by excess of unlabelled transferrin but not myoglobin, or lactoperoxidase. Under equilibrium conditions the transformed line AKR-MCA bound significantly more radioactive transferrin (22.5 +/- 3.5 fmol/micrograms DNA) than the parental line AKR-2B (14.5 +/- 1.5 fmol/micrograms DNA). The differences in the amount of ligand bound was due to altered receptor numbers. Treatment of AKR-MCA and AKR-2B cells with DMF eliminated the difference in transferrin binding capacities. The maximum decrease in specific ligand binding to AKR-MCA cells brought about by the polar solvent was observed after 48 h. These data suggest an association between transferrin binding and the transformed state of AKR-2B fibroblasts. PMID- 3652029 TI - Tumour initiating activity of mancozeb--a carbamate fungicide in mouse skin. AB - Mancozeb is a protectant fungicide and is a polymeric complex of ethylene bis(dithiocarbamate)manganese (i.e. Maneb) with zinc salt. In this study, the tumour initiating ability of mancozeb has been observed by a 2-stage initiation promotion protocol in mouse skin. PMID- 3652030 TI - Azelaic acid as a competitive inhibitor of thioredoxin reductase in human melanoma cells. AB - Azelaic acid has been shown to inhibit thioredoxin reductase (TR) at the surface of guinea pig and human skin, on cultures of human keratinocytes, melanocytes, melanoma cells, murine melanoma cells (Cloudman S91), and on purified enzymes from Escherichia coli, rat liver, and human melanoma. Human melanoma cells are more resistant to inhibition by azelaic acid than murine melanoma or human melanocytes. Kinetic studies with pure TRs indicate that azelaic acid is a reversible competitive inhibitor. Fluorescence spectroscopy has been used to show that azelaic acid does not interfere with electron transfer from NADPH to FAD on TR. However, azelaic acid does inhibit electron transfer from the dithiolate active site of this enzyme. Inhibition by azelaic acid is pH-dependent, requiring the dissociation of both carboxylate groups, and also the dissociation of the active site dithiol groups. Binding studies with [14C]azelaic acid at different pHs, indicate that inhibition is first due to the formation of a thioester on the active thiolate groups followed by transacylation of a basic amino acid residue in the active site. A comparative study of TR inhibition by C6, C9, C10 and C12 saturated dicarboxylic acids was also determined on guinea pig skin in vivo. These homologous dicarboxylic acids gave greater inhibition with increasing size (i.e. mol wt.). PMID- 3652031 TI - Chronic effects on single and multiple oral and subcutaneous cadmium administrations on the testes of Wistar rats. AB - Thirty mature male Wistar rats were administered cadmium as CdCl2 X 1H2O in single doses of 50 mg/kg p.o. or 2.5 mg/kg i.p. or 10 weekly doses of 5 mg/kg p.o. or 0.25 mg/kg i.p., respectively. Ten males, each treated correspondingly with the vehicle, served as control groups. Some of the animals were necropsied after 12 and 18 months, respectively, the remainder were kept for up to 30 months. In a supplementary study 25 males were each treated once with 200 mg/kg p.o. or 2 mg/kg s.c. and 35 males with 100 mg/kg p.o. This experiment was terminated after 6 months. Animals having received 1 X 100 or 1 X 200 mg/kg p.o. or 1 X 2.0 or 1 X 2.5 mg/kg s.c. showed severe lesions of the whole testicular parenchyma with massive calcification of the necrotic tubuli and pronounced fibrosis of the interstitium. All animals receiving 2.5 mg/kg s.c. had a Leydig cell tumor in at least one of the testes. In 5 out of 15 animals surviving 18 months these tumors were classified as malignant (mean time of induction: 858 +/- 77 days). All the other tumors detected were not regarded as causally related to treatment. The results of the supplementary study indicate that with very high oral cadmium dosages Leydig cell tumors may be induceable. Since the massive lesion of the testes appears to be the prerequisite for the occurrence of induced Leydig cell tumors, a non-genetic mechanism is to be assumed in respect to the formation of these tumors. PMID- 3652032 TI - An antiproliferative salicylaldoximato type copper(II) chelate as an enhancer of the cytotoxicity of murine spleen cells to tumor cells in vitro. AB - The antiproliferative metal chelate bis(2,3,4 trihydroxybenzaldoxyimato)copper(II) (CuTRI2) was shown to distinctly enhance the cytotoxicity of the spleen effector cells of CBA/CA mice to YAC-1 tumor cells in vitro as measured using a 4-h 51Cr release test. The compound was either added directly to the assay system or the effectors were incubated in the presence of it for 2 h and washed before assay. The concentrations tested were 10, 20 and 40 mg/ml, the lowest concentration leading invariably to the strongest enhancement of cytotoxicity. The effector cells involved were very probably natural killer cells. The highest concentration had, if anything, a negative effect on the release of 51Cr from the target cells. In the same concentrations, CuTRI2 did not enhance the cytotoxicity of the spleen effector cells to K-562 tumor cells. Preliminary studies on the related chelate trans-bis(2,4 dihydroxybenzaldoximato)copper(II) are also reported. This paper is apparently the first report of a copper chelate that enhances the cytotoxicity of any sort of effector cells to tumor cells. PMID- 3652033 TI - Dose and flow dependence of 5-fluorouracil elimination by the isolated perfused rat liver. AB - The influences of dose and hepatic blood flow on the elimination of 5 fluorouracil (FUra) by the isolated perfused rat liver were investigated. FUra was injected into the perfusion reservoir and then serial blood samples were collected over 2-3 h. FUra concentration was determined chromatographically. In some experiments, the conversion of [2-14C]FUra to 14CO2 was also determined. With livers perfused at 20 ml/min, the initial decrease in plasma FUra concentration was linear with time (apparent zero-order kinetics); at concentrations below about 25 microM, the decrease became exponential (apparent first-order kinetics). Semilogarithmic plots of FUra concentration/dose versus time obtained with different doses were not superposable, consistent with saturable (Michaelis-Menten) elimination. Vmax and Km were 6-11 nmol/ml/min and 33-45 microM, respectively. Hepatic clearance during first-order elimination was close to 20 ml/min. About 84% of the dose was converted to CO2, indicating that catabolic metabolism was the principal route of elimination. As hepatic blood flow increased from 10 to 30 ml/min, Vmax was unchanged but Km decreased progressively from 84 to 32 microM, and clearance increased from 12 to 29 ml/min. It was concluded that hepatic FUra elimination is highly dependent upon both dose and blood flow. PMID- 3652034 TI - Expression of c-myb protooncogene and other cell cycle-related genes in normal and neoplastic human colonic mucosa. AB - The expression of c-myb, c-myc, histone H3, and ornithine decarboxylase genes was examined by Northern blot analysis in the normal and neoplastic mucosa of ten subjects affected by colon cancer. The mRNA levels of c-myb protooncogene were detected at low levels in all normal samples but were increased in the neoplastic mucosa of six cases in comparison to the normal counterpart. In five of these six cases the mRNA levels of c-myc, histone H3, and ornithine decarboxylase mRNAs were also increased, suggesting that there is a relation between the high expression of c-myb and the fraction of cycling neoplastic cells. PMID- 3652035 TI - Evaluation of a modeling system for S-phase estimation in breast cancer by flow cytometry. AB - Using software programs provided by Coulter Electronics, we have developed an analysis system that would address problems encountered in DNA flow cytometric analysis of heterogeneous solid tumor populations, especially where the G2-M phase of the diploid population contaminates the S-phase of the aneuploid population, causing an overestimation of cells in S phase. We used the PARA 1 and PARA 2 programs in concert and developed three analysis models: (a) for euploid tumors; (b) for hyperdiploid tumors with overlapping populations; and (c) for near-diploid aneuploid tumors. Our purpose in this paper is to determine the limits and reproducibility of this analysis system with an emphasis on tumors with overlapping populations. Aliquots of frozen, pulverized breast tumor tissue (50 to 100 mg), routinely used in the steroid receptor assay, were used for routine flow cytometric measurement of the DNA index and S-phase fraction. To determine the accuracy of the analysis when overlapping populations were present, we mixed an aneuploid breast cancer cell line with human blood lymphocytes in varying ratios. A 10% mixture of aneuploid cells, the lowest mixture tested, still allowed analysis results within 95% confidence limits. Reproducibility of the system was assessed on frozen breast tumor tissue by intra- and interassay variation studies measuring cell cycle parameters and coefficient of variation of the G0-G1 peak width. Within any sample the amount of variation (+/- 2 SD) for the G0-G1 value was +/- 4.40 for intraassay and +/- 4.60 for interassay, and the amount of variation for S phase was +/- 3.0 and +/- 3.2 for intraassay and interassay, respectively. There was no difference in the variation of estimates for G2-M (+/- 2.6 for both intra- and interassay). In this study, the coefficient of variation of the G0-G1 peak greater than 5% was defined as unacceptable for accurate analysis, with the conclusion that S-phase fractions in aneuploid tumors can be routinely analyzed in human breast tumor biopsies despite tumor cell heterogeneity. PMID- 3652036 TI - Enhancement of toxicity from N-(2-chloroethyl)-N'-cyclohexyl-N-nitrosourea in V79 spheroids by a nitrofuran. AB - Hypoxic cell radiosensitizers enhance the cytotoxicity of several common chemotherapeutic agents in vitro and in vivo. Although this process has generally been called sensitization, few studies have documented true potentiation. We have used Chinese hamster V79 spheroids to study chemosensitization and fluorescence activated cell sorting to specifically evaluate the roles of sensitizer binding and hypoxia in the effect. By using the median effect analysis to quantify the interactions of the agents, we conclude that marked potentiation can indeed be achieved. Somewhat greater potentiation was observed at increased depths within the spheroids, but the relative change was less than predicted on the basis of the decreasing oxygen tension. Further, increased toxicity did not necessarily lead to increased chemopotentiation, nor was potentiation directly related to the metabolism/binding of the nitrofuran. Thus, chemopotentiation is clearly a complicated process, highly dependent upon the sensitizer to antitumor drug ratio and the exposure conditions. PMID- 3652037 TI - Enhancing effect of a bay region methyl group on tumorigenicity in newborn mice and mouse skin of enantiomeric bay region diol epoxides formed stereoselectively from methylchrysenes in mouse epidermis. AB - The stereochemistry of diol epoxide formation in mouse epidermis upon topical application of [3H]-1R,2R-dihydroxy-1,2-dihydro-5-methylchrysene ([3H]-5-MeC 1R,2R-diol) and [3H]-6-MeC-1R,2R-diol, and the tumorigenicity in mouse skin and in newborn mice of the R,S,S,R and S,R,R,S enantiomers of 1,2-dihydroxy-3,4-epoxy 1,2,3,4-tetrahydro-5-methylchrysene (5-MeC-1,2-diol-3,4-epoxide), 5-MeC-7,8-diol 9,10-epoxide, and 6-MeC-1,2-diol-3,4-epoxide were examined. Analysis of tetraols and their derived tetraacetates present in mouse epidermis, 2 h after application of [3H]-5-MeC-1R,2R-diol or [3H]-6-MeC-1R,2R-diol, demonstrated greater than 90% stereoselectivity in formation of 5-MeC-1R,2S-diol-3S,4R-epoxide and 6-MeC-1R,2S diol-3S,4R-epoxide. Taken together with previous data, these results demonstrate that there is a high degree of stereoselectivity for formation of R,S,S,R enantiomers of 5-MeC- and 6-MeC-1,2-diol-3,4-epoxides in mouse skin. The results of the tumorigenicity studies in mouse skin and in newborn mice clearly demonstrated that 5-MeC-1R,2S-diol-3S,4R-epoxide was the most tumorigenic of the diol epoxide enantiomers tested; 6-MeC-1R,2S-diol-3S,4R-epoxide was inactive. The results of this study show that the high tumorigenicity of 5-MeC compared to 6 MeC is due to the remarkable tumorigenic activity of 5-MeC-1R,2S-diol-3S,4R epoxide which, in contrast to 6-MeC-1R,2S-diol-3S,4R-epoxide, has a methyl group in the same bay region as the epoxide ring. We propose that such methyl bay region diol epoxides of other carcinogenic methylated polynuclear aromatic hydrocarbons will also show unique tumorigenic properties. PMID- 3652038 TI - Effects of pharmacological concentrations of estrogens on proliferation and cell cycle kinetics of human breast cancer cell lines in vitro. AB - High dose estrogen therapy has been used effectively in the treatment of human breast cancer. To understand the mechanisms involved, the effects of high concentrations (5-100 microM) of estrogens were studied in estrogen receptor (ER) positive (T-47D and MCF-7) and ER negative (MDA-MB-330) human breast cancer cell lines in vitro. Inhibition of cellular proliferation was seen with the synthetic estrogen diethylstilbestrol (DES) at concentrations greater than 10 microM in each of the three cell lines. In T-47D cells DES was shown by clonogenic survival assays to be cytotoxic. This effect was evident in both plateau phase and exponentially growing cultures, in contrast to the effects of the antiestrogen tamoxifen, which has minimal effects on plateau phase cells. The effects of DES on the proliferation of exponentially growing cultures were accompanied by changes in cell cycle parameters which included an increase in the percentages of S-phase, G2 + M, and polyploid cells and a corresponding decrease in the percentage of G0-G1 cells. These changes, which contrasted with the known effects of tamoxifen, were not seen in the non- or slowly cycling plateau phase T-47D cells. Such results are consistent with two mechanisms of action of high dose estrogen in vitro: a cell cycle phase-specific effect and cell cycle-independent cytotoxicity. The stereoisomers 17 alpha-estradiol and 17 beta-estradiol had similar potency to DES in inhibiting cell proliferation and inducing these changes in cell cycle parameters in both MCF-7 and MDA-MB-330 cells. The high dose estrogen effect was ligand specific in that estrone and estriol were less potent than DES, 17 alpha-estradiol and 17 beta-estradiol in inhibiting cell proliferation, and the characteristic cell cycle changes were produced only by concentrations of estriol greater than 75 microM and not at all by estrone at concentrations up to 100 microM. The androgens testosterone and dihydrotestosterone were similar in effect to estrone. The cell cycle changes associated with estrogen-induced growth inhibition in vitro are identical to those observed during regression of ER positive but not ER negative human tumor xenografts in nude mice. However, the role of ER in mediating estrogen-induced regression of ER positive tumors in vivo remains undefined. PMID- 3652039 TI - Dose-related inhibition of colon carcinogenesis by dietary piroxicam, a nonsteroidal antiinflammatory drug, during different stages of rat colon tumor development. AB - The effect of four dose levels of piroxicam administered during different stages of colon tumor development was studied in male F344 rats to obtain a data base on the efficacy of piroxicam as an inhibitor of colon carcinogenesis. Piroxicam was added at levels of 25, 50, 75, and 150 ppm to the NIH-07 open-formula diet and fed to male F344 rats starting 1, 13, and 23 wk after the carcinogen administration. At 7 wk of age, while the animals were consuming the control diet, all animals except the vehicle-treated controls were given s.c. injection of azoxymethane (CAS:25843-45-2; 29.6 mg/kg body weight, once) to induce intestinal tumors. Forty wk after AOM injection, all animals were necropsied, and tumor incidences were compared among the various dietary groups. Colon tumor incidence (percentage of animals with tumors) was inhibited in a dose-dependent manner in rats fed the diets containing 25, 50, 75, and 150 ppm piroxicam starting 1 and 13 wk after carcinogen treatment. The colon tumor incidences in animals fed the diets containing 0, 25, 50, 75, and 150 ppm of piroxicam starting at 1 wk after carcinogen treatment were 89, 61, 58, 50, and 39%, respectively. When the diets containing 0, 25, 50, 75, and 150 ppm were fed 13 wk after carcinogen treatment, the colon tumor incidences were 89, 69, 69, 44, and 33%, respectively. Colon tumor multiplicity (tumors/animal; tumors/tumor-bearing animal) was also significantly inhibited in animals fed the diets containing 25 to 150 ppm piroxicam starting 1 and 13 wk after carcinogen administration. The number of colon tumors/animal was inhibited by about 80 to 84% in animals fed the 150 ppm piroxicam diet. When the diets containing different levels of piroxicam were fed 23 wk after carcinogen treatment, the colon tumor incidence was significantly inhibited in animals fed the 75 and 150 ppm piroxicam diets. The colon tumor incidences in animals fed the diets containing 0, 25, 50, 75, and 150 ppm were 89, 78, 67, 64, and 64%, respectively. The colon tumor multiplicity (colon tumors/animal) was slightly but significantly inhibited in animals fed the diets containing 25 to 150 ppm piroxicam. The results of this study demonstrate that increasing levels of piroxicam in the diet, when fed 1 or 13 wk after carcinogen insult, inhibit colon tumor incidence in a dose-dependent manner. PMID- 3652040 TI - Potentiation of halogenated pyrimidine radiosensitizers in human carcinoma cells by beta-lapachone (3,4-dihydro-2,2-dimethyl-2H-naphtho[1,2-b]pyran- 5,6-dione), a novel DNA repair inhibitor. AB - 3,4-Dihydro-2,2-dimethyl-2H-naptho[1,2,-b]pyran-5,6-dione (beta-lapachone) is a novel DNA repair inhibitor. It was tested for synergistic X-ray-induced lethality in combination with several halogenated pyrimidine radiosensitizers. Logarithmic phase growing human epidermoid laryngeal carcinoma (HEp-2) cells were allowed to incorporate pyrimidine analogues for 48 h (approximately two cell doublings) and then were X-irradiated and subjected to various posttreatments. beta-Lapachone synergistically increased the dose enhancement ratios (DERs) of all analogues screened, with the exception of the 2'-chloro derivative of 5-bromodeoxyuridine. For example, following 5-bromodeoxycytidine sensitization an X-ray DER value of 1.87 +/- 0.04 at 1% survival was increased to 3.51 +/- 0.42 due to a 4-h post-X irradiation exposure to 4 microM beta-lapachone. Do and Dq values for halogenated pyrimidine-sensitized human epidermoid laryngeal carcinoma cells were decreased 1.4- to 5.4-fold and 1.4- to 4.0-fold, respectively. beta-Lapachone had little effect upon the cytotoxicities of unirradiated human epidermoid laryngeal carcinoma cells whether or not they were previously exposed to any of the halogenated pyrimidine radiosensitizers. beta-Lapachone treatment following X irradiation of cells that had not incorporated a pyrimidine analogue exhibited DER values of 1.38 +/- 0.05 and 1.40 +/- 0.01 at 10 and 1% survival levels, respectively. beta-Lapachone enhanced the radiosensitization of deoxycytidine analogues to a greater extent than the structurally related deoxyuridine analogues. Greater DERs and lower Do and Dq values were found for deoxycytidine than for deoxyuridine analogue radiosensitizers following beta-lapachone treatment. This agent may improve presently used radiation therapies and enhance proposed strategies which utilize deoxycytidine analogue radiosensitization together with protection of normal tissues by tetrahydrouridine to achieve tumor selective radiotherapy. PMID- 3652041 TI - Oxygen dependence of binding of misonidazole to rodent and human tumors in vitro. AB - Misonidazole, a 2-nitroimidazole, has been shown to form metabolically induced adducts to cellular molecules at a very high rate in the absence of oxygen, and this rate decreases substantially as the oxygen concentration increases. Thus, it has considerable potential as a marker for hypoxic, radiation resistant cells in tumors. The dependence of the rate of adduct formation (binding) on oxygen concentration was studied for EMT6/Ed, Walker 256, and Dunning R3327-AT rodent tumors and for two human colon carcinomas, a human melanoma, and a human breast carcinoma. Fragments of these tumors were incubated with [14C]- or [3H]misonidazole in vitro at several oxygen concentrations and the quantity of misonidazole bound was determined from autoradiographs as a function of distance from the surfaces of the fragments. The Km of binding inhibition (oxygen concentration for half-maximal binding) for the tumors varied by a factor of 10. The range was centered on the range of values reported for the Km of cellular radioresistance (oxygen concentration for half-maximal radioresistance). The patterns of binding at depth within the tumor fragments indicated that gradients of cellular waste products and nutrients other than oxygen had minimal effects on binding. All tumors were capable of metabolizing oxygen to levels sufficiently low to yield the maximal binding rate, but the distance of penetration of oxygen varied, indicating a range of at least 4 in rates of oxygen consumption. The ratio of misonidazole bound by stromal tissue versus tumor cells ranged from 0.9 for a colon tumor to 0.3 for a breast tumor. These properties of misonidazole binding indicate that it should be a good marker for radiobiological hypoxia in tumors, providing adequate controls can be performed. PMID- 3652042 TI - Syngeneic monoclonal antibodies to B16 melanoma viral antigens. AB - Four stable IgM monoclonal antibody-producing hybridomas were generated by fusing mouse myeloma cells with spleen lymphocytes from C57BL/6 mice hyperimmunized against the syngeneic B16 melanoma. All four monoclonal antibodies (R31/15, R37/4, R37/6, and R37/7), in common with polyclonal antiserum from immunized mice, recognized antigens on the same complex of related cell surface molecules specified by endogenous AKR-type murine leukemia virus, designated the B16 gp/70/80/85 antigen complex. Reactivity with this antigen complex was demonstrated by radioimmunoprecipitation. Specificity for viral Mr 70,000 glycoprotein-related antigens was indicated by absorption of antibody activity by endogenous AKR virus and by inhibition of antibody binding to B16 melanoma cells by monospecific antiserum to murine leukemia virus Mr 70,000 glycoprotein. Neither polyclonal nor monoclonal antibodies recognized antigens on fish, guinea pig, swine, or human melanoma cell lines. Polyclonal antiserum reacted with several other mouse melanomas and with certain mouse lymphoma lines induced by, or harboring, endogenous murine leukemia viruses, but the monoclonal antibodies were unreactive except for recognition of antigens on Harding-Passey mouse melanoma cells by antibody R37/4 and on RL male 1 mouse lymphoma cells by antibody R37/7. Only monoclonal R37/7 was cytotoxic for cultured B16 melanoma cells in an antibody- and complement-dependent assay with guinea pig complement, although all antibodies were cytotoxic with rabbit complement. In reflecting the predominant humoral immune response to the B16 melanoma detected in syngeneic mice during tumor growth, these monoclonal antibodies will permit experimental amplification of that response to help determine how that immunity influences tumor growth and metastatic dissemination. PMID- 3652043 TI - Increase in intracellular Na+: transmembrane signal for rejoining of DNA strand breaks in proliferating lymphocytes. AB - Two early events in the mitogen-induced entry of murine splenocytes into proliferation are (a) a rapid rise in influx of Na+, causing its total internal concentration to increase by 42 +/- 7% within 2 h of culture with concanavalin A (Con A), and (b) rejoining of some 3000 DNA strand breaks per diploid genome within the same period. Con A did not induce rejoining in low Na+ (less than 9 mM) medium, but the process began directly when Na+ was added, at its usual concentration, to the growth medium. Incubation of cells with ouabain, an inhibitor of the Na+K+-ATPase, or monensin, a Na+ ionophore, caused an increase in the internal Na+ concentration in normal, but not in low, Na+ medium. In the former (but not in the latter) medium, both ouabain and monensin caused rejoining of the DNA strand breaks to occur in resting lymphocytes, i.e., in the absence of mitogen. Stimulation of splenocytes with Con A also resulted in a rapid but transient increase in the level of intracellular free Ca2+. This effect was also observed in the absence of extracellular Na+; however, deprivation of extracellular Ca2+ completely abolished this effect. Moreover, the intracellular free Ca2+ level was significantly higher in cells suspended in Na+-free buffer or medium. Since the Con A-induced rejoining of DNA strand breaks occurred in the absence of extracellular Ca2+ and removal of extracellular Na+ had no inhibitory effect on the Con A-induced increase in the level of intracellular free Ca2+, the Con A-stimulated repair could not have been mediated by the initial increase in Ca2+ influx. The early mitogen-induced increase in the internal Na+ concentration is a necessary and sufficient signal for the rejoining of breaks, an event that must occur before the proliferating lymphocytes can replicate their DNA. PMID- 3652044 TI - Pharmacokinetics of 4'-deoxy-4'-iodo-doxorubicin in plasma and tissues of tumor bearing mice compared with doxorubicin. AB - It has been reported that 4'-deoxy-4'-iodo-doxorubicin (4'-deoxy-4'-I-DX) displays, on experimental tumors, a spectrum of activity comparable to that of doxorubicin, is active when administered orally, is not cardiotoxic, and is cytotoxic to doxorubicin-resistant cells. We have investigated by high performance liquid chromatography the pharmacokinetics of this drug in comparison with doxorubicin by treating mice bearing colon 38 adenocarcinoma with equal doses of the two drugs i.v. 4'-Deoxy-4'-I-DX, unlike doxorubicin, is transformed into several metabolites. The 13-dihydro derivative is the major metabolite found; in tumor and in all the organs it accounts for 4-7% of the total fluorescent area under the curve, whereas in plasma and liver it accounts for 15 and 34%, respectively. 4'-Deoxy-4'-I-DX disappears from plasma with a terminal half-life of 5 h, which is half the terminal half-life of doxorubicin (11 h), and its efficiency of absorption after oral administration is 27%. Tissue concentrations of 4'-deoxy-4'-I-DX are initially highest in lung and spleen, whereas those of doxorubicin are highest in liver and kidney. 4'-Deoxy-4'-I-DX levels are higher than those of doxorubicin in tumor, spleen, lung, small intestine, brain, pancreas, and ovaries whereas they are similar in heart, liver, kidney, and bone marrow. The rate of elimination of the new analogue is higher than that of doxorubicin from the tumor and all the organs investigated except the liver. The area under the curve of 4'-deoxy-4'-I-DX is similar to that of doxorubicin in tumor and spleen, whereas it is three times lower in heart. This may explain the lack of cardiotoxicity of this new analogue, which is equiactive and equitoxic with doxorubicin on the experimental system tested. PMID- 3652045 TI - Radiolocalization of xenografted human lung cancer with monoclonal antibody 8 in nude mice. AB - A monoclonal antibody (MAb) 8 [immunoglobulin G3 (IgG3)], directed against a Mr 48,000 human lung cancer-associated antigen, was radiolabeled with either 125I or 131I, and its biodistribution was studied in nude mice bearing human lung cancer (TKB-2) over a 7-day period. 125I-labeled MAb 8 increased its binding to the tumor during the period, while the binding of 125I-labeled control IgG3 declined after initial uptake. At Day 7, percentages of injected dose of 125I-labeled MAb 8 bound to the tumor rose to 7.4%, which was a 4.4-fold increase from Day 1 and 16-fold binding of 125I-labeled control IgG3 at the same day. Tumor:blood ratios became 2.7:1 at Day 7, and tumor:liver, tumor:spleen, and tumor:kidney ratios were more than 9:1. Normal organs showed no significant uptake of 125I-labeled MAb 8, compared with those of 125I-labeled control IgG3. A clear image of the xenografted tumor was obtained at Day 5, and it further improved at Day 7, when 60% of whole body radioactivity was localized to the tumor. Autoradiography of the mouse with tumor confirmed the excellent localization of 125I-labeled MAb 8 to the tumor, although the radioactivity of the tumor was not uniformly distributed. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis showed that most of the radioactivity was present at the tumor in the form of degraded immunoglobulin. MAb 8 has a potential usefulness in the diagnosis and treatment of lung cancer. PMID- 3652046 TI - Inhibition of lymphoma invasion and liver metastasis formation by pertussis toxin. AB - We have examined whether pertussis toxin, an agent known to inhibit entry of normal lymphocytes into tissues, affects invasion and metastasis formation by malignant lymphoma and T-cell hybridoma cells. The toxin reduced invasion in vitro in hepatocyte cultures to 20% of control values. Inhibition was maximal after pretreatment for 2 h with approximately 100 ng/ml. The effect of pretreatment with 1 to 5 micrograms toxin/ml for 4 h persisted for at least 5 days, despite a more than 100-fold increase in cell number. The proliferation rate was not affected. Liver metastasis formation after tail vein injection of TAM2D2 T-cell hybridoma cells in syngeneic AKR mice, measured as liver weight, was reduced to 10 to 25% of controls after pretreatment of the cells for 4 h with 1 microgram pertussis toxin/ml. Metastasis to kidneys, ovaries, and lymph nodes was not, or less evidently, affected. With MB6A lymphosarcoma cells no effect was seen after treatment with 1 microgram/ml, but a significant reduction of the liver tumor burden to approximately 50% of controls was achieved by treatment with at least 5 micrograms toxin/ml. Spleen metastasis by MB6A cells was not affected. These results provide evidence for a similarity in invasion mechanisms of normal and malignant lymphoid cells, and they suggest that invasiveness is an important factor in the formation of lymphoma metastases, particularly in the liver. PMID- 3652047 TI - Quantitative neutron capture radiography for studying the biodistribution of tumor-seeking boron-containing compounds. AB - Biodistribution of two compounds presently considered for use in neutron capture therapy has been studied in mice carrying a transplantable Harding-Passey melanoma. A method is described by which quantitative assessment can be made of the boron distribution in whole-body sections of such animals. An alpha-particle sensitive film is placed in close contact with a freeze-dried section of an animal and exposed to neutrons. The tracks visible after etching are analyzed optoelectronically in fields of 0.6 X 0.6 mm2 and compared to standards of boron homogeneously distributed in liver homogenates. The dynamic range of this method is about two orders of magnitude in concentration, with a lower detection limit of 0.1 to 0.01 ppm 10B, depending on the rate of induction of spurious tracks by fast neutrons present in the neutron beam chosen. In a transplantable Harding Passey melanoma in mice, it was found that the sulfhydryl boron hydride Na2B12H11SH presently used for therapy of glioblastoma clears blood, muscle, and brain very rapidly. Its accumulation in tumors was persistent for more than three days. A higher tumor accumulation was observed with its disulfide, which has been suggested for neutron capture therapy. For both compounds, a marked heterogeneity of boron distribution within one tumor was found. PMID- 3652048 TI - Breast fluid cholesterol and cholesterol epoxides: relationship to breast cancer risk factors and other characteristics. AB - We measured levels of cholesterol and its oxidation products, 5,6 alpha- and beta epoxides and their common hydrolysis product cholestane triol, in breast fluids of women without breast disease, compared these levels to serum cholesterol levels, and explored associations of these breast fluid measurements with known breast cancer risk factors and other characteristics. Subjects were 105 women with no history of breast disease from whom breast fluid could be obtained by nipple aspiration. The four breast fluid measurements were significantly correlated with each other (P less than 0.0001) but none was correlated with serum cholesterol. In subsequent analyses restricted to breast fluid cholesterol and cholesterol beta-epoxide, cholesterol levels (but not beta-epoxide levels) increased with age and were higher in white than nonwhite women. Both measurements were low in women who were lactating, who were parous, or who had breast-fed. The lower levels among parous women persisted for at least 2 years postpartum or postlactation. Because breast fluid levels of cholesterol beta epoxide are reduced for some time following a birth or cessation of lactation, the alveolar-ductal systems of parous women presumably have less cumulative exposure to this potentially carcinogenic substance. This biochemical mechanism may, in part, explain the observed reduction of breast cancer risk associated with parity. PMID- 3652050 TI - Retrospective analysis of the prognostic significance of DNA content and proliferative activity in large bowel carcinoma. AB - In the present study we have evaluated the prognostic significance of ploidy levels and proliferative activity in 279 cases of large bowel carcinomas which were included in a surgical prospective randomized trial. Ploidy levels and proliferative activity were determined on nuclei isolated from paraffin-embedded tissues of 279 colorectal carcinoma patients, with a mean follow-up of 51.9 months. Product limit survival analysis demonstrated a borderline significant association (P = 0.0689 by generalized Breslow; P = 0.0336 by generalized Savage) between ploidy and survival, with a 75th quantile survival of 49.8 months for patients with diploid tumors and 35.9 months for patients with aneuploid tumors. After stratification for staging, Dukes' C cases showed a statistically significant association between tumor ploidy and survival (P = 0.0224 by generalized Breslow, P = 0.0110 by generalized Savage). Product limit survival analysis for proliferative activity and survival showed a similar outcome with the strongest association in Dukes's C stage of disease (75th quantile survival of 38.9 months for low proliferative and 18.0 months for high proliferative tumors). PMID- 3652049 TI - Genetic predisposition to bladder cancer: ability to hydroxylate debrisoquine and mephenytoin as risk factors. AB - The hypothesis that the frequency distribution of indices of oxidative drug metabolizing activity is different between patients with bladder cancer (n = 98) and age, sex-matched control subjects (n = 110) has been investigated. Urinary recovery ratios of debrisoquine and R/S ratios of mephenytoin have been measured in an 8-h urine sample after simultaneous administration of debrisoquine (10 mg) and racemic mephenytoin (100 mg). In addition, alcohol consumption, smoking habit, and acetylation phenotype (using 100 mg dapsone as a substrate) have been measured. Patients with bladder cancer were classified on histological criteria as having aggressive (Stage III) (34%) or nonaggressive (Stages I and II) (66%) disease. The median of the frequency distribution of the debrisoquine urinary recovery ratio in patients with aggressive bladder cancer was greater than in control subjects, and only four patients had recovery ratios lower than the mean of the control group. Using logistic regression analysis, efficient debrisoquine metabolism and a synergistic interaction between smoking and ethanol consumption were significant, independent risk factors, while S-mephenytoin hydroxylation and acetylation phenotype were not significant risk factors. In contrast, patients with non-aggressive bladder cancer had a significant, but weaker, association with rapid hydroxylation of S-mephenytoin, which was independent of a significant synergistic interaction between smoking and alcohol consumption. Acetylation phenotype and debrisoquine urinary recovery ratio were not associated with increased risk of nonaggressive cancer. These results are consistent with the concept that oxidative isozymes might be responsible for conversion of environmental agents to proximate bladder carcinogens in nonindustrial-related bladder cancer. They also suggest that different etiological factors are involved in the pathogenesis of aggressive and nonaggressive bladder cancer. PMID- 3652051 TI - Antitumor activity of pleural cavity macrophages and its regulation by pleural cavity lymphocytes in patients with lung cancer. AB - Antitumor activities of pleural cavity macrophages (PCM) and pleural cavity lymphocytes (PCL) in lung cancer patients were examined. The effect of coculture supernatants of PCL and autologous tumor cells on the cytostatic activity of macrophages was also examined. Cytostatic activity of PCM was not affected by an advance of metastasis to regional lymph nodes or increase of tumor size and difference of histological type. However, the cytostatic activity of PCM was markedly augmented when pleural invasion was limited to within the visceral pleura although it was low when pleural invasion was absent or extended beyond the visceral pleura. On the other hand, PCL did not exert any cytolytic activity against various tumor target cells. However, coculture supernatants of PCL and autologous tumor cells exhibited the activity of macrophage-activating factor against guinea pig peritoneal macrophages. Furthermore, the higher the cytostatic activity of PCM, the higher the macrophage-activating factor activity of the coculture supernatant of PCL and autologous tumor cells was. These results suggested that antitumor activity of PCM was controlled by specifically sensitized PCL through lymphokines. PMID- 3652052 TI - American Cancer Society workshop on tumor promotion and antipromotion. PMID- 3652053 TI - Estrogen receptor-binding affinity and cytotoxic activity of three new estrogen nitrosourea conjugates in human breast cancer cell lines in vitro. AB - The hypothesis that more selective antitumor activity may be achieved by cytotoxic agents which selectively bind to estrogen receptors (ER) in human cancer cells was tested. We have synthesized three nitrosourea derivatives of estradiol or hexestrol, and compared the ER binding affinity and cytotoxic activity of these compounds against ER-positive and -negative breast cancer cell lines in vitro. Specific binding to ER in the cytosol of MCF-7 human breast cancer cells was demonstrated in these conjugates: 17 alpha-CNU greater than 17 beta-CNU greater than HEX-CNU greater than lomustine (CCNU). The order of cytotoxicity of these derivatives against human breast cancer cells appeared to correlate with their binding affinity to ER. All three estrogen nitrosourea conjugates were more cytotoxic than CCNU, a clinically useful antitumor nitrosourea which does not bind to ER. The contribution of the estrogen moiety to the cytotoxicity of 17 alpha-CNU was demonstrated by the greater activity of the conjugate than that of a combination of estrogen and CCNU. However, cytotoxicity of these compounds against the receptor-positive MCF-7 and receptor-negative Evsa T human breast cancer cell lines was similar. The latter finding suggested that cytotoxicity of these conjugates may not be mediated through ER. The difference in stability of these nitrosourea conjugates in aqueous buffer may partly explain their differences in cytotoxicity. PMID- 3652054 TI - Actual versus ideal weight in the calculation of surface area: effects on dose of 11 chemotherapy agents. AB - This study of 2382 breast, 182 rectal, 817 colon, and 351 lung cancer patients treated with combination chemotherapy on eight phase III Eastern Cooperative Oncology Group protocols indicates that 69% would receive a higher dose of at least one drug if surface area were calculated from actual weight rather than from the minimum of actual and ideal weight. Forty-eight percent of the patients would have at least a 10% increase in drug dose based on actual weight. Only on the premenopausal adjuvant breast cancer protocol and among women on the rectal adjuvant study do the differences in dose based on actual rather than ideal weight increase significantly with age. On the postmenopausal adjuvant breast study and on the lung cancer study, the differences in dose decrease significantly with age. For all age decades and both sexes within each protocol, the mean differences between dose based on actual and dose based on ideal weights were on the same order as the rounding factors for the 11 drugs studied. From the literature on the effect of doses of common chemotherapies on leukopenia, it appears that the percent of hematologic toxicity would not be raised to unacceptable levels by using actual weight to set doses. PMID- 3652055 TI - High-dose intensity, circadian-timed doxorubicin and cisplatin adjuvant chemotherapy for bladder cancer. AB - Thirteen patients with transitional cell carcinoma of the bladder received monthly circadian-timed doxorubicin and cisplatin chemotherapy immediately after radical cystectomy. In five patients cancer had spread through the serosa of the bladder wall and/or into the perivesical fat (stage C). In eight patients cancer had spread to other pelvic tissues and pelvic lymph nodes (stage D1). Ten of these 13 patients showed no recurrence of disease after a median follow-up period of 3.5 years (range, 1 to greater than 5.5); these patients received no chemotherapy for a median duration of 3 years (range, 2-5). Two of the three patients who ultimately failed had local tumor recurrence which occurred much later than is the usual case (40 and 52 months). This circadian-timed two-drug regimen, given in full doses for nine courses as adjuvant treatment, delays and may prevent local and distant recurrence of stage C and D1 bladder cancer. PMID- 3652057 TI - Limited sampling model for vinblastine pharmacokinetics. AB - A limited sampling model was developed for vinblastine to estimate the total area under the concentration time curve (AUC) using only two timepoints. Detailed pharmacokinetic analysis (16 timepoints) was performed in 30 patients treated with a small bolus dose (3 mg/m2) of vinblastine. A model for the total AUC was developed by multiple linear regression, using the first 15 patients as the training data set: AUC = 38.0 C10 + 73.8 C36 - 12.9, where C10 and C36 represent the serum vinblastine concentration at 10 hours and 36 hours, respectively (r = 0.99, P less than 0.0001). The model was validated on the other 15 patients, the test data set (r = 0.94, P less than 0.0001), with a mean predictive error of 13%. Limited sampling models may facilitate large-scale pharmacodynamic studies of new anticancer drugs, in order to relate the estimated AUC to toxicity and/or response without the need for detailed pharmacokinetic analysis. PMID- 3652056 TI - Effects of the mode of administration of mitomycin on tumor and marrow response and on the therapeutic ratio. AB - The antineoplastic and toxic effects of mitomycin (MC) administered as a single pulse injection were compared with the effects of MC given as infusions over 2, 5, or 24 hours and with the effects of the drug administered in fractionated regimens incorporating 2-20 injections. The antineoplastic effects of MC were assessed using EMT6 mouse mammary tumors implanted in BALB/c mice; tumor response was assessed using both cell survival and tumor growth assays. The host toxicity of MC was assessed by measuring the survival of bone marrow stem cells (CFU-S) and by determining LD50/30's (which reflect primarily marrow injury). The survival curve for cells from tumors treated with varying doses of MC was exponential, with no shoulder which might suggest accumulation of sublethal lesions. No evidence was found that the tumor cells repaired MC damage when left in situ for up to 24 hours after treatment (repair of potentially lethal damage) or that the tumor repaired sublethal damage during times of up to 24 hours between drug treatments or during drug infusions. The responses of tumors treated with single injections of MC, with infusions over 2, 5, and 24 hours, with two injections separated by 5 or 24 hours, and with five daily injections were all similar. The survival curve for CFU-S from mice treated with varying doses of MC was exponential, with no shoulder which might suggest accumulation of sublethal lesions. LD50/30's were the same whether MC was administered as single injections, as infusions over 2, 5 or 24 hours, or as five daily fractions. Longer fractionated regimens, in which mice received daily injections, 5 days per week, for up to 4 weeks, produced less host toxicity but also less antineoplastic effect; the therapeutic ratio for the most protracted regimen tested was lower than that for single injections. The therapeutic ratios achieved with infusions and fractionated regimens were never greater than that obtained with a large single dose, confirming clinical impressions that infrequent, large doses of MC are an optimal method of treatment with this drug. PMID- 3652058 TI - Continuous venous infusion of doxorubicin in advanced sarcomas. AB - Seventeen patients with advanced sarcoma were treated with continuous venous infusion of doxorubicin for a mean of 118 days, achieving total doses up to 1097 mg/m2. Three partial responses and one minor response were obtained. Major toxic effects were stomatitis and hand-foot syndrome. There was a low incidence of leukopenia (18%) and clinical cardiotoxicity (11%). Continuous venous infusion is a safe means of administering doxorubicin, with a response rate similar to that observed with bolus doxorubicin in metastatic sarcoma. PMID- 3652059 TI - Efficacy of continuous high-dose metoclopramide in patients receiving daily cisplatin infusions. AB - Continuous high-dose metoclopramide (MCP), 2 mg/kg/24 hours, was administered for a period of 84-90 hours to 30 consecutive patients with various advanced solid malignancies receiving concomitantly a 3-day infusion of cisplatin. The latter was given at a dose of 40 mg/m2/day over 6 hours every day, in combination with doxorubicin and cyclophosphamide. Diphenhydramine and dexamethasone were also administered. This prolonged antiemetic therapy proved to be safe with only a 16% incidence (five of 30 patients) of extrapyramidal side effects not necessitating discontinuation of MCP. Also, antiemetic efficacy was demonstrated with 63% of the patients not experiencing any emesis. PMID- 3652060 TI - Weekly cyclophosphamide and alternate-day prednisone: an effective secondary therapy in multiple myeloma. AB - Intravenous or oral cyclophosphamide, 150-250 mg/m2 (500 mg maximum), once per week with alternate-day oral prednisone, 100 mg, was given to 57 myeloma patients resistant to melphalan and prednisone (MP). Seven responses in 28 primary MP resistant patients and ten responses in 29 secondary MP-resistant patients were observed. Previous response to MP was not a significant factor in predicting response to weekly cyclophosphamide and alternate-day prednisone. The results suggest that the regimen of weekly cyclophosphamide and alternate-day prednisone may be as effective as more aggressive regimens in the treatment of patients with myeloma who have failed MP therapy. However, a randomized trial would be required to determine the relative contributions of cyclophosphamide and prednisone to the effectiveness of this regimen. PMID- 3652061 TI - Phase II evaluation of spirogermanium in malignant melanoma: a Southwest Oncology Group Study. PMID- 3652062 TI - Second-line chemotherapy with tauromustine in metastatic breast cancer in postmenopausal women: a phase II study. PMID- 3652063 TI - Mitoxantrone extravasation injury. PMID- 3652064 TI - Infantile hydrocephalus and the slit ventricle syndrome in early infancy. AB - Slit ventricle syndrome is well known as a complication in the treatment of hydrocephalus by shunting. It is generally considered to be a chronic (but not acute) complication, occurring years after the shunt procedure; there has been no report of this syndrome occurring before 1 year of age. The authors present infantile cases that developed a severe form of this syndrome shortly after shunt procedures and discuss the pathophysiology in comparison to experience with older cases. The causative factor was thought to be extremely low intracranial pressure with resultant microcephalus created by double or multiple shunt placement. The condition resulted in rapid onset of coma and respiratory arrest, which was successfully treated by subtemporal decompression or placement of an antisiphon device, with insertion of a higher pressure valve. The specific characteristics of infantile hydrocephalus are analyzed in the light of this complication from a series of 58 treated infants. In a follow-up of over 1 year in 42 cases, analysis revealed that slit ventricle occurs most frequently in immature young infants shunted before 1 month of age (85.7% or 18/21 cases). In contrast, subdural hematoma after shunting is an extremely rare phenomenon in premature or mature neonates. Slit ventricles were thought to result from high intracranial compliance due to the softer brain and more markedly widened cranial sutures of infantile hydrocephalus in the younger age group. The functioning period of the initial shunt was also much shorter in younger infants, and this may be because the ventricular shrinkage to a slit can cause shunt malfunction with or without developing the slit ventricle syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652065 TI - A new instrument for noninvasive measurement of intracranial pressure through the anterior fontanel. I. Preliminary report. AB - A pressure sensor has been developed with which intracranial pressure of infants with open anterior fontanell can be measured. The sensor consists of a light, small strain-gauge transducer (Statham P-50, Gould, USA), supported by a thin phosphorus bronze sheet having a strong spring quality characteristic. The light and small assembly, which weighs only 2.55 g, allows lengthy, continuous measurement with little drift. It eliminates almost any gravitational component in the recorded pressure. The thermal influence is also minimal and the thermal equilibrium is reached within 10 min. The sensor is precise and accurate in a range from 0 to 500 mm H2O, with excellent linear response. This newly developed fontanel pressure sensor has been successfully applied without the need for surgical procedures previously required to measure intracranial pressure. PMID- 3652066 TI - Surgical experience with arteriovenous malformations in children. AB - The authors report their surgical experience with 15 cases of arteriovenous malformations in children operated on in the last decade. Subarachnoid hemorrhage was the main clinical manifestation in 12 patients. Epilepsy was a secondary feature in 3 of these. Cortical areas were involved in 7 cases while the other 8 had the malformation in medial or deep structures of the brain. No mortality occurred from surgery. A radical excision was achieved in 12 cases, while in 3 cases remnants of the lesion were shown by postoperative angiography. Nine patients recovered from surgery without neurological impairment. Two children with left-sided arteriovenous malformations showed mild speech disturbances and 2 others with midline lesions suffered from hypotonus and ataxia. PMID- 3652067 TI - Rare neonatal intracerebral hemorrhage. Two cases in full-term infants. AB - Intracranial hemorrhage in neonates is often found in either the subependymal area or the subdural space. The former is observed particularly in premature infants and is attributable to damage of the germinal matrix layer. The latter usually occurs in the vicinity of the falx and tentorium cerebri of full-term neonates and is thought to be caused by birth injury. Two cases of intracerebral hemorrhage in full-term newborn babies are reported. In both the hematoma was located at the left frontal area under the coronal suture. Angiograms revealed no causative signs, such as arteriovenous malformation, aneurysm or angioma. Observations on CT scans and during surgery led to the conclusion that the hemorrhages were caused by the moulding which forced the frontal bone to slip under the parietal bone at the coronal suture and then press on the fragile cerebral vasculature of the neonates, thus causing contusion. PMID- 3652068 TI - Cervical meningocele and associated spinal anomalies. AB - Simple meningoceles are infrequent forms of dysraphism and are often benign. They have been associated with other spinal anomalies. The uncommon cervical meningocele may have a higher propensity to be associated with other spinal anomalies. Four patients with cervical meningocele are presented with radiographic evaluation and clinical course. Multiple abnormalities were documented radiographically and operatively, including hydrocephalus, Chiari malformation, hydromyelia, lipomeningomyelocele, tethered cord, thickened filum terminale, diastematomyelia, Klippel-Feil syndrome, and thoracic hemivertebrae. Prior to the development of any late neurological abnormality from associated spinal anomalies, magnetic resonance imaging is recommended early in a child born with a simple meningocele. PMID- 3652070 TI - Diagnostic-therapeutic ventriculocystostomy. AB - Simple diagnostic-therapeutic ventriculocystostomy is described. Arachnoid, intracerebral, or intraventricular cysts are permanently connected with the ventricles by a Kifa red catheter with spirally situated holes. The pressure balance and the connection with a physiological space for resorption is maintained in this simple way. Twenty patients have been operated on over a 2 year period with good results. PMID- 3652069 TI - The CT (Hounsfield unit) number of brain tissue in healthy infants. A new reliable method for detection of possible degenerative disease. AB - It is difficult to correlate CT Hounsfield unit (H. U.) numbers from one CT investigation to another and from one CT scanner to another, especially when dealing with small changes in the brain substance, as in degenerative brain diseases in children. By subtracting the mean value of cerebrospinal fluid (CSF) from the mean value of grey and white matter, it is possible to remove most of the errors due, for example, to maladjustments, short and long-term drift, X-ray fan, and detector asymmetry. Measurements of white and grey matter using these methods showed CT H. U. numbers changing from 15 H. U. to 22 H. U. in white matter and 23 H. U. to 30 H. U. in grey matter in 86 healthy infants aged 0-5 years. In all measurements, the difference between grey and white matter was exactly 8 H. U. The method has proven to be highly accurate and reproducible. PMID- 3652071 TI - Calcium deposits on CSF shunts. Clinical observations and ultrastructural analysis. AB - CSF shunts removed from seven patients 5-12 years after placement were studied. Examination in each case revealed gritty mineral deposits adherent to the external surface. The deposits were further analyzed by routine histology, spectroscopy and scanning electron microscopy. These results and the clinical consequences of this calcification are discussed. Microdefects in the tubing may contribute to delayed calcification of Silastic shunt tubing. PMID- 3652072 TI - Recurrent sinus pericranii in a 14-year-old boy. AB - A case of symptomatic and recurrent sinus pericranii in a 14-year-old boy is presented. A blood-filled cyst was diagnosed after head trauma. The sinus pericranii was surgically removed. One year later the patient presented with blurred vision, headaches, and recurrence at a different site in the skull. PMID- 3652073 TI - Congenital benign extracranial teratoma in a Nigerian neonate. AB - The clinical, operative, and pathological findings associated with a huge extracranial teratoma in a Nigerian neonate are described. Especially noteworthy are the site and size of the tumor, the surgical treatment and the good prognosis. The child has remained well and developed normally 4 years after surgery. PMID- 3652074 TI - Structure of the serotype f polysaccharide antigen of Streptococcus mutans. AB - The structure of the serotype f polysaccharide antigen of Streptococcus mutans was determined by methylation analysis, periodate oxidation, and partial methanolysis, and the configuration of the anomeric linkages by 13C-n.m.r. spectroscopy, indicating the trisaccharide repeating unit----3)-alpha-L-Rhap-(1-- -2)-[alpha-D-Glcp-(1----3)]-alpha-L-+ ++Rhap- (1----. The structure of the backbone of the polysaccharide was confirmed by demonstrating immunological identity between the product of Smith degradation of the S. mutans serotype f antigen and the group A-variant streptococcal polysaccharide. PMID- 3652075 TI - Structure of a new hexasaccharide from the coaggregation polysaccharide of Streptococcus sanguis 34. AB - The major constituent of a coaggregation polysaccharide from Streptococcus sanguis 34 is a hexasaccharide, isolated as the alditol. The proposed structure is alpha-D-GalpNAc-(1----3)-beta-L-Rhap-(1----4)-beta-D-Glcp-(1----6) -beta-D Galf- (1----6)-beta-D-GalpNAc-(1----3)-D-Galol, based upon g.l.c.-m.s. of alditol acetates and partially methylated alditol acetates, f.a.b.-m.s., 1H-n.m.r. spectroscopy, g.l.c.-m.s. of trimethylsilylated (+)- and (-)-2-butyl glycosides, and cleavage by alpha-N-acetylgalactosaminidase. The structural deduction was facilitated by cleavage of the hexasaccharide at the furanoside linkage by 48% hydrogen fluoride, and reduction of the product, to yield alpha-D-GalpNAc-(1--- 3)-beta-L-Rhap-(1----4)-beta-D-Glcp-(1----6) -D-Galol. PMID- 3652076 TI - Application of new, high-sensitivity, 1H-13C-n.m.r.-spectral techniques to the study of oligosaccharides. AB - Four n.m.r. methods that are especially useful for characterization of oligosaccharides are applied to the trisaccharide alpha-Neu5Ac-(2----3)-beta-Gal (1----4)-Glc (1). Three of these are two-dimensional, heteronuclear methods that provide chemical-shift correlation maps having much higher sensitivity than was previously possible, because they rely on indirect observation of 13C via 1H detection. These methods are used to assign, completely, the 1H- and 13C-n.m.r. spectra of both anomers of the trisaccharide. In addition to these two dimensional methods, a one-dimensional method is used to measure 1H-1H coupling constants accurately within each sugar ring. The values of the coupling constants thus measured for 1 are evidence that the conformations of the individual sugar rings are not affected by linkage into the trisaccharide. PMID- 3652077 TI - Diabetic-atherogenic connection: a continuing puzzle. PMID- 3652078 TI - Aortic calcifications and their relationship to coronary heart disease and cardiovascular risk factors in patients with newly diagnosed non-insulin dependent diabetes and in nondiabetic subjects. AB - The prevalence of radiologically detectable aortic calcifications, the cross sectional area of the aortic arch, pulse wave velocity and cardiovascular risk factors were examined in 133 newly diagnosed non-insulin-dependent diabetic patients aged 45-64 years and in 144 randomly selected control subjects of the same age. In addition, the relationship between aortic calcifications and coronary heart disease was examined. Diabetic men tended to have more frequently calcifications in the abdominal aorta than nondiabetic men, whereas such a difference was not found between diabetic and nondiabetic women. No difference was observed between diabetic and nondiabetic subjects in the prevalence of calcifications of the aortic arch. Among cardiovascular risk factors, smoking was associated with calcifications of the abdominal aorta in diabetic and nondiabetic men. Ischemic ECG abnormalities at rest showed a statistically significant association with the presence of abdominal aortic calcifications in diabetic men. The cross-sectional area of the aortic arch increased with age in both in diabetic and in nondiabetic subjects and was larger in diabetic than in nondiabetic men. Diabetes did not show any significant effect on pulse wave velocity. An increased frequency of calcifications of the abdominal aorta and a dilatation of the aortic arch in newly diagnosed non-insulin-dependent men as compared with nondiabetic men is compatible with the view that an accelerated development of atherosclerotic lesions of large arteries starts already in an early, asymptomatic phase of this type of diabetes. PMID- 3652079 TI - Chronic Chagas' heart disease in the elderly: a clinicopathologic study. AB - A retrospective study of the medical records of our hospital from 1965 to 1985 was carried out to characterize for the first time chronic Chagas' heart disease in the elderly (more than 70 years old). A total of 25 patients (mean age = 76) were suitable for the study. Congestive heart failure, sudden cardiac death, thromboembolism and atypical chest pain were found in 68, 16, 8 and 8% of cases, respectively. Ventricular premature contractions (60%), right bundle branch block (32%), left anterior hemiblock (28%), atrial fibrillation (28%) and right bundle branch block associated with left anterior hemiblock (20%) were the ECG changes most frequently found. A morphological study was performed on 8 (32%) patients. All of them showed cardiac abnormalities, with apical aneurism being detected in 100% of cases. At autopsy, pulmonary embolism was observed in 3(37%) of these patients who presented with congestive heart failure, ventricular premature contractions and/or intraventricular conduction defect and/or atrial fibrillation. Thus, the characteristics of chronic Chagas' heart disease in the elderly are similar to those found in middle-aged patients. We suggest that these patients are important for the study of the pathogenesis of chronic Chagas' heart disease because they may have less aggressive pathophysiologic mechanisms than middle-aged patients. PMID- 3652080 TI - Ambulatory electrocardiographic monitoring in myotonic dystrophy (Steinert's Disease). A study of 22 patients. AB - Ambulatory electrocardiographic monitoring (AEM) was performed in 22 patients (range 13-62 years; mean age 38.2 +/- 12.7) with grades I, II and III of myotonic dystrophy in order to evaluate the occurrence of potentially dangerous cardiac arrhythmias and conduction disturbances. All patients had previously undergone echocardiographic examination to determine whether structure and function abnormalities were present. In 6 patients with normal resting electrocardiogram, AEM revealed: first degree A-V block (4 cases), class IVa Lown ventricular arrhythmias (3 cases) and episodes of atrial fibrillation (4 cases). In 2 of 3 cases with abnormal scalar electrocardiogram new abnormalities (first degree A-V block and further prolongation of P-R interval) were demonstrated by AEM. Only 1 patient had mild signs of left ventricular dysfunction at echo. Disorders of cardiac conduction and rhythm are characteristic of myotonic dystrophy and can predispose to severe cardiac events. In this respect AEM is shown to be an early and sensitive tool in identifying patients at risk. PMID- 3652081 TI - ST elevation in leads V1 to V4 caused by isolated right ventricular ischemia and infarction. AB - A patient with isolated right ventricular ischemia and infarction is presented. ST elevation in leads V1 to V4 mimicking anteroseptal myocardial infarction was recorded at admission and during episodes of chest pain later on. Noninvasive and invasive workup suggested isolated right ventricular infarction and ischemia due to an occluded small and nondominant right coronary artery. PMID- 3652082 TI - Effect of endurance training on Q-T interval and cardiac electrical stability in boys aged 10 to 14. Ventricular arrhythmias in trained boys. AB - In 30 highly trained boys aged 10-14 the prevalence of ventricular ectopic beats and Q-T interval duration were studied. In trained boys ECG Holter monitoring showed a higher even though not significantly different prevalence of ventricular arrhythmias than in 30 age-matched untrained controls. Ventricular ectopy was on the contrary lower than in a group of 30 adult athletes. Q-T corrected (Q-Tc) interval in the trained boys was longer than in the sedentary controls (p less than 0.001), while it was as long as in the adult athletes. No correlation was found between the degree of severity of ventricular ectopic beats and Q-Tc interval duration, heart rate or echocardiographic dimensional and functional findings. The clinical and prognostic importance of complex ventricular arrhythmias detected in healthy athletes remains to be elucidated. PMID- 3652083 TI - Biochemical investigation of possible lesions in human aorta that predispose to dissecting aneurysms: pyridinoline crosslinks. AB - Pyridinoline, a collagen specific covalent crosslink, was quantified in acid hydrolysates of human aorta using a non-equilibrium inhibition ELISA. The study was based on specimens from seven cases of aortic dissection and from seven control subjects whose death was unrelated to thoracic aortic dissection. There were no significant differences in the amounts or concentrations of pyridinoline in aortas with dissecting aneurysms compared with normal tissue, thus excluding the possibility of a causative relation between the degree of pyridinoline crosslinking of collagen molecules and dissection of the thoracic aorta. In all cases, however, the number of pyridinoline crosslinks per molecule of collagen in the ascending aorta and arch approached the theoretical maximum for lysyl derivatives and was as high as that present in cartilage. Thus in this region of the vessel pyridinoline represents the major stabilising crosslink of collagen. In contrast, the number of pyridinoline crosslinks per collagen molecule decreased maximally by a factor of 10 between the arch and the proximal regions of the descending thoracic aorta. This suggests a possible correlation between the rigidity of collagen fibres and the forces exerted on the aortic wall during diastole and systole. PMID- 3652084 TI - Rate of acetylcholine hydrolysis affects the phase dependency of cardiac responses to vagal stimulation. AB - The influence of the rate of acetylcholine hydrolysis on the magnitude and phase dependency of the cardiac chronotropic response to vagal stimulation was studied in anaesthetised dogs. In one group of animals the chronotropic response to tonic vagal stimulation varied directly with the dose of physostigmine. In a second group of animals one brief stimulus burst was delivered to the right vagus nerve during each cardiac cycle, and the timing (phase) of the stimulus was varied within the cycle. Before physostigmine was given the phase of the stimulus had a substantial influence on the chronotropic response. When each stimulus burst contained 6 pulses the response was changed from its minimum to its maximum value (mean (SEM) change 0.338(0.081) s) when the phase was shifted by a mean value of 0.091(0.031) s. After physostigmine (0.3 mg X kg-1) was given the change in response produced by a phase shift was much less pronounced. A mean shift in phase of 0.593(0.052) s was required to change the chronotropic response from its minimum to its maximum value, and the mean difference between the minimum and maximum response was only 0.140(0.032) s. Hence the rate of acetylcholine hydrolysis in the cardiac tissues is an important determinant of the phase dependency of the chronotropic response to repetitive vagal stimulation-that is, the slower the rate of hydrolysis the less the change in the chronotropic response elicited by a given change in stimulus timing. PMID- 3652085 TI - Inhibitory action of 711389-S on the electrical activity of rabbit sinoatrial node. AB - The effects of 711389-S (0.1-10 mumol.litre-1) on membrane potentials and currents of rabbit sinoatrial node preparations were studied using a conventional double microelectrode voltage-clamp method. The agent 711389-S decreased the heart rate, the maximum rate of depolarisation, and the amplitude of the action potential and increased the action potential duration in a dose dependent manner. The slope of the diastolic depolarisation was also reduced. Of the current systems of sinoatrial node, 711389-S depressed the slow inward current (Isi), the potassium outward current (IK), and the hyperpolarisation activated current (Ih) dose dependently. The kinetics of IK were not altered significantly by the drug. It is concluded that 711389-S does not have an effect on a single current system but that the drug exerts a depressant effect on the electrical activity of the sinoatrial node. PMID- 3652086 TI - Myocardial enzyme activities in patients with mitral regurgitation or mitral stenosis. AB - To determine the adaption of myocardial metabolism in mitral regurgitation and mitral stenosis, human papillary muscles obtained during open heart surgery were analysed to measure selective enzyme activities in energy metabolism. All enzyme activities were expressed per unit dry weight muscle, per unit alkali soluble protein, and per unit total creatine and the different results compared. The activities of enzymes concerned with mitochondrial energy production and energy transfer (namely, citrate synthase and mitochondrial creatine kinase) tended to be higher in papillary muscles from hearts with mitral regurgitation than in those with mitral stenosis. The activities of enzymes concerned with cytoplasmic energy production (creatine kinase MM, lactate dehydrogenase, and phosphofructokinase) did not show statistically significant differences between mitral regurgitation and mitral stenosis. The ratio of creatine kinase MB activity to total creatine content showed the greatest difference when papillary muscles from patients with mitral regurgitation and mitral stenosis were compared (31% higher in mitral regurgitation; p less than 0.001). The specific function of creatine kinase MB, which is located in cytoplasm, is not well defined. Creatine kinase MB activity increases with extreme endurance training of human skeletal muscle. Thus the higher creatine kinase MB activity in papillary muscle of mitral regurgitation may represent an adaptation to increased physical demand. PMID- 3652087 TI - Conducting pulmonary arteries: structural adaptation to extrauterine life in the pig. AB - A quantitative light microscopical and ultrastructural study of the elastic and large muscular pulmonary arteries of 30 Large White pigs aged from birth to 6 months yielded light microscopical measurements on 120 arteries and 62,560 ultrastructural assessments, which composed a computerised database. After birth mean arterial medial thickness and mean smooth muscle cell diameter decreased during the first 4 days (p less than 0.01). Mean interlamellar distance decreased, reaching its nadir at 1-3 weeks (p less than 0.01). All these features increased between 3 weeks and adulthood (p less than 0.01). In the smooth muscle cells synthetic rather than contractile organelles were dominant during the first 3 weeks. Between 3 weeks and adulthood, however, smooth muscle cell myofilament volume density increased (p less than 0.0001). At all ages the smooth muscle cells of the outer lamellar units of elastic arteries had a greater myofilament volume density than those of adluminal units (p less than 0.0001). The amount of connective tissue increased between 3 weeks and adulthood, collagen and basement membrane increasing preferentially (p less than 0.0001, p less than 0.05, respectively). Thus the conducting pulmonary arteries, like the peripheral resistance arteries, adapt structurally to extrauterine life. Remodelling occurred rapidly after birth, and then gradually during growth, as connective tissue was deposited and smooth muscle cells matured. PMID- 3652088 TI - Exercise induced augmentation of cellular and humoral autoimmunity associated with increased cardiac dilatation in experimental autoimmune myocarditis. AB - To determine the effects of exercise in experimental autoimmune myocarditis, guinea pigs immunised with heterologous heart protein (rat heart), Freund's complete adjuvant, and pertussis vaccine (treated group) were exercised on a treadmill for a total of 11 weeks and compared with non-exercise treated animals. In vivo heart rates and pressures, in vitro left ventricular pressure-volume relations, myocardial histology, circulating antiheart antibody, and in vitro lymphocyte stimulation were determined. Exercise resulted in increased cardiac dilatation in treated animals as assessed by in vitro left ventricular pressure volume relations compared with non-exercise treated animals (at 8 mmHg 1.41(0.17) ml.kg-1 vs 1.20(0.17) ml.kg-1 respectively, p less than 0.005). Exercise also resulted in increased concentrations of circulating antiheart antibody as assessed by radioimmunoassay (0.14(0.04) microgram vs 0.10(0.03) microgram respectively, p = 0.01), and increased lymphocyte activation to specific antigen (stimulation index 3.7(0.07) vs 2.4(1.0) respectively, p less than 0.001). Despite the associated augmentation of autoimmunity with cardiac dilatation, there were no differences in the histopathological findings between the exercised treated and the non-exercised treated animals either qualitatively or quantitatively (number of inflammatory cell microaggregates). This finding suggests that, although the immune system is important in experimental autoimmune myocarditis, the amount of inflammation and necrosis does not appear to correlate with the degree of left ventricular dilatation and presumed dysfunction. PMID- 3652089 TI - Extracardiac pressure and ventricular haemodynamics. AB - To investigate the relative influence of pericardial and intrathoracic pressures on left and right ventricular diastolic and systolic pressures two experimental groups were studied: group 1-10 open chest dogs with a controlled pericardial effusion; and group 2 - five closed chest dogs with a controlled pneumothorax at constant transpulmonary pressure and lung volume. In both groups right and left ventricular diastolic pressures were linear functions of external pressure with respective slopes of 0.71 and 0.39 for group 1 and 0.80 and 0.78 for group 2. The left ventricular slope of 0.39 indicates that left ventricular volume decreased more with increments in pericardial pressure since a slope of approximately 1.00 would be expected if the filling volume was invariant. Accordingly, the fall in left ventricular systolic pressure that occurred in both groups was two to three times greater in group 1. Right ventricular systolic pressure fell in group 1 whereas it increased in group 2. It is concluded that there are no major differences between the influence of either type of external pressure on right ventricular filing. In contrast, the left ventricle, and in particular the filling pressure gradient between the pulmonary circulation and the left ventricle, is more sensitive to pericardial pressure. PMID- 3652090 TI - Acute haemodynamic effect of taurine on hearts in vivo with normal and depressed myocardial function. AB - The acute haemodynamic effects of taurine were studied in normal and in beta blocker (propranolol) or calcium antagonist (diltiazem) treated rabbits and in rabbits with experimentally produced chronic aortic regurgitation. The administration of taurine (25 mg.kg-1) did not affect heart rate and left ventricular end diastolic pressure but produced significant increases in left ventricular dP/dtmax, cardiac output, and left ventricular systolic pressure in control hearts, indicating that intravascularly administered taurine substantially increased cardiac performance. In propranolol (1 mg.kg-1) treated rabbits taurine significantly improved left ventricular dP/dtmax and cardiac output, which were previously depressed by propranolol. Taurine had the same effect on diltiazem (1 mg.kg-1) treated rabbits. In rabbits with aortic regurgitation a bolus injection of taurine improved cardiac performance. Continuous infusion of taurine (100 mg.h-1) also produced a significant increase in left ventricular dP/dtmax. These results suggest that taurine has a unique action as an inotropic agent and that it may be useful in the treatment of patients with congestive heart failure. PMID- 3652091 TI - Mechanism of isoproterenol induced myocardial damage. AB - To study the harmful effects of isoproterenol on myocardium rats were injected with isoproterenol 10 or 0.1 mg.kg-1 or with isoproterenol 10 mg.kg-1 after an injection of propranolol 20 mg.kg-1. Endogenous phospholipase activity in heart homogenate and tissue adenosine triphosphate concentrations were determined 1, 7, and 15 h after isoproterenol injection. The activities of three segments (NADH cytochrome c reductase, succinate-cytochrome c reductase, and cytochrome c oxidase) of the electron transport chain in heart mitochondria were also measured in the same manner. In the group given isoproterenol 0.1 mg.kg-1 the tissue adenosine triphosphate concentration was decreased after 1 h but returned to control value after 15 h. No significant change in phospholipase activity or in the activities of the three segments in mitochondria was observed throughout the study. In the group given isoproterenol 10 mg.kg-1 the tissue adenosine triphosphate concentration was significantly decreased after 1 h and did not return to control values after 15 h. Phospholipase activity was increased and the activities of NADH-cytochrome c reductase and cytochrome c oxidase were significantly decreased after 15 h. The activity of succinate-cytochrome c reductase was not affected. In the propranolol group, pretreatment with propranolol protected against a reduction in adenosine triphosphate after isoproterenol 10 mg.kg-1. Propranolol also prevented activation of phospholipase and maintained the activities of the three segments of mitochondria throughout the study. In an in vitro study mitochondria prepared from intact rat hearts were incubated with 0.1 unit phospholipase A2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652092 TI - Left atrial filling in normal human subjects: relation between left atrial contraction and left atrial early filling. AB - Relations between left atrial contraction and left atrial early filling were studied in eight subjects with atypical chest pain from simultaneous left atrial pressure recordings and left atrial cineangiograms. The left atrial ejection phase was defined as the interval from the onset of the sharp systolic rise in left atrial pressure (a point) to the point of minimum left atrial volume (Vmin). The left atrial filling phase was divided into (a) the early filling phase, the period from Vmin to the nadir of left atrial pressure (x), and (b) the late filling phase, the period from x to the point of maximum left atrial volume (Vmax). During the early filling phase, when the left atrium filled as left atrial pressure diminished, approximately 37% of total atrial filling took place. There was a direct relation between left atrial volume measured at a and x points (r = 0.91, p less than 0.01). The extension fraction, measured as the ratio of filling volume during the early filling phase to minimum left atrial volume, was significantly correlated with ejection fraction, measured as the ratio of ejected volume (delta V) during ejection phase to left atrial volume at the a point (r = 0.97, r = 0.01). Both mean and peak filling rates of left atrial volume change during the early filling phase were directly proportional to the ejected volume, the ejection fraction, and the mean ejection rate of left atrial volume change during the ejection phase. Thus these results suggest that there is close interaction between left atrial contraction and left atrial early filling. PMID- 3652093 TI - Pulsed Doppler ultrasound compared with thermodilution for monitoring cardiac output responses to changing left ventricular function. AB - To determine the responsiveness of the pulsed Doppler technique to pacing and drug induced changes in left ventricular function 125 simultaneous cardiac output measurements by pulsed Doppler ultrasound and thermodilution were compared in 12 patients. The Doppler velocity frequencies were analysed using a signal averaging process and the validity of this method first tested in vitro. This showed almost perfect linearity of pulsed Doppler and electromagnetic flow determinations in a test rig. Although data points showed greater scatter in the clinical study, a highly significant linear relation between cardiac output measurements by pulsed Doppler and thermodilution was confirmed by regression analysis (r = 0.88, p less than 0.001). Certain mean values for cardiac output by the two techniques differed, however, by up to 0.9 litre.min-1. Despite this, changes in cardiac output in response to pacing, inotropic stimulation with dobutamine, and vasodilatation with nitrates were directionally similar, indicating a useful role for the pulsed Doppler technique in monitoring responses to treatment in the intensive care unit. Pulsed Doppler also provided a simple measure of left ventricular contractile function. Thus the inotropic response to dobutamine produced a significant rise in peak aortic flow velocity, and this variable was unaffected by either pacing or nitrate induced vasodilatation. PMID- 3652094 TI - Lack of effect of prior training on subsequent ischaemic and infarcting myocardium and collateral development in dogs with normal hearts. AB - To determine whether exercise training in animals with normal coronary arteries has a salutary effect on ischaemic myocardium, 24 dogs were randomly assigned to be either trained or confined to cages for three months. All dogs then underwent left thoracotomy for placement of indwelling right and left atrial and aortic catheters and a loose snare ligature around the proximal left circumflex coronary artery. Three days after operation control scintigrams were recorded after injection of thallous chloride-201 in animals running on a treadmill to achieve exercise heart rates of 220 beats.min-1. Four days later the snares were pulled to occlude the left circumflex artery and infarct size determined by measuring venous activity of creatine phosphokinase. Three days after infarction the first post-ligation scintigram was performed after thallium-201 injection in exercising animals. Exercise scans were repeated at 10 days and 2, 4, and 6 weeks after coronary ligation. During the final exercise study collateral blood flow was measured with radioactive microspheres. There was no difference in mean creatine phosphokinase appearance time, peak creatine phosphokinase activity, or measured infarct size between the trained and sedentary dogs. The ratio of thallium-201 activity in left circumflex artery or ischaemic area to left anterior descending artery or normally perfused myocardium fell from 100% before occlusion to 86.6% in the sedentary animals and 80.6% in the trained dogs three days after coronary ligation. Although these falls were significant (p less than 0.025 and p less than 0.005 respectively), there was no difference between groups. Over the next five and a half weeks the scintigraphic defect shrank as the thallium-201 ratio gradually increased, but changes were again similar in both groups. At six weeks there was little difference in exercise collateral flow to left circumflex artery myocardium and flow to normal myocardial tissue in cage confined and trained dogs. Therefore, no beneficial effect of exercise training in dogs with normal hearts could be seen on ischaemic or infarcting myocardium or coronary collateral development after coronary ligation. PMID- 3652095 TI - Role of increased cholinergic activity in reperfusion induced ventricular arrhythmias. AB - The effect of increased cholinergic activity on reperfusion induced ventricular arrhythmias was studied in alpha chloralose anaesthetised dogs by administering neostigmine during a 25 min occlusion of the anterior left descending coronary artery. The dogs were divided into five groups, each of 10 animals: the control group received only saline solution; group 1 neostigmine 0.03 mg.kg-1 iv at 20 min of coronary occlusion (that is, 5 min before reperfusion); group 2 atropine 0.4 mg.kg-1 iv at 10 min of coronary occlusion and neostigmine 0.03 mg.kg-1 iv at 20 min; and group 3 neostigmine 0.03 mg.kg-1 iv at 20 min of coronary occlusion and at the same time underwent atrial pacing at the same rate as that of the sinus node just before neostigmine administration. In group 4 heart rate was slowed (junctional rhythm) by destroying the sinus node at 20 min of coronary occlusion. The results obtained showed that ventricular tachycardia and fibrillation, which occur at the beginning of reperfusion, were significantly less frequent in group 1 (p less than 0.001) and in group 4 (p less than 0.001). The protective action of neostigmine was abolished by previous administration of atropine (group 2) and modified by preventing the decrease in the heart rate by atrial pacing (group 3). In group 3 ventricular tachycardia was more frequent but the incidence of ventricular fibrillation was reduced significantly compared with the control and atropine groups. Thus cholinergic activity has a protective role in reperfusion arrhythmias by decreasing the heart rate before release of the coronary occlusion and therefore reduces the incidence of ventricular fibrillation. PMID- 3652096 TI - Platelet induced aggravation of acute ischaemia in an isolated rabbit heart model. AB - In isolated coronary ligated rabbit hearts the effects of washed human platelets on the size of the epicardial ischaemic area and on recovery from ischaemia during 60 min of reperfusion was evaluated by endogenous NADH-surface fluorescence photography. Infusion of washed human platelets to non-ischaemic control hearts produced a decrease in left ventricular pressure to 64(3)% of control (n = 4), no change in global coronary flow rate, no retention of platelets (recovery 108(9)%), and no alteration in basal NADH-fluorescence. When platelets were infused into coronary ligated hearts, however, the size of the epicardial ischaemic area was significantly enhanced to 127(8)% (n = 5) of control. Moreover, this increase in size was negatively correlated with the recovery of platelets in the coronary effluent: the lower the recovery rate the larger the ischaemic area (y = 253-1.44x, r = -0.855, n = 15, p less than 0.001). When platelet infusion was stopped after 30 min the enlargement of the ischaemic area seemed to be reversible. When the coronary ligature was released, however, and the ischaemic myocardium reperfused the recovery from ischaemia was retarded in the platelet treated hearts as shown by functional (left ventricular pressure and flow) and metabolic (NADH-fluorescence) indices. Thus it is directly shown for the first time in an isolated in vitro heart preparation that platelets aggravate myocardial ischaemia. PMID- 3652097 TI - Evaluation of aortic wall distensibility by aortic pressure-dimension relation: effects of nifedipine on aortic wall. AB - The relation between aortic pressure and dimension was studied before and after nifedipine infusion in eight anaesthetised dogs. An electromagnetic flowmeter was positioned in the proximal ascending aorta and one pair of ultrasonic dimension gauges attached to the thoracic aorta. A Millar micromanometer was positioned just below the dimension gauges. A constrictor was placed around the thoracic aorta distal to the dimension gauges to produce an abrupt rise in aortic pressure for 15 s. After complete recovery nifedipine (0.75 micrograms.kg-1.min-1) was infused for 10 min and the same procedure repeated. The ratio (delta D:delta P) of the difference (delta D) between maximum and minimum dimensions (D) to the pulse pressure (delta P) and the percentage distensibility (delta D/delta P/minimum D) were decreased significantly after aortic constriction (0.037(0.013) to 0.019(0.004) mm.mmHg-1 and 0.247(0.075) to 0.121(0.033)%.mmHg-1, p less than 0.01, respectively), suggesting that these indices depend on afterload. Beat to beat mean pressure-dimension relations during the release of aortic constriction showed a convex upward curve and was fitted by an exponential function with a high correlation coefficient (r = 0.99). The slope of this relation was significantly reduced after nifedipine compared with before nifedipine (379(83) to 330(119) mmHg.cm-1, p less than 0.05), suggesting an increase in aortic distensibility by nifedipine. When mean aortic pressure or stroke volume before and after nifedipine was compared at the same mean dimension, which was reduced by 5% of the control mean dimension, stroke volume increased to 128%(p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652098 TI - On the possible role of long chain fatty acylcarnitine accumulation in producing functional and calcium permeability changes in membranes during myocardial ischaemia. AB - A radioisotope procedure was used to determine long chain fatty acylcarnitine concentrations in fractions of porcine myocardium that had been subjected to different periods of ischaemia (0, 1, 2, and 3 h). In myocardial tissue from non ligated hearts acylcarnitine concentrations were 0.32(0.03) and 1.53(0.04) nmol.mg-1 protein for homogenate and sarcolemma enriched membrane respectively, which indicates a preferential membrane localisation of long chain fatty acylcarnitine. Both the total and membrane acylcarnitine contents were increased about twofold after 2 h of ischaemia. The accumulation of long chain fatty acylcarnitine was not correlated temporally with changes in adenosine triphosphate dependent calcium uptake activity of homogenates (mainly a function of sarcoplasmic reticulum membranes), sodium gradient induced calcium uptake, and calcium permeability of sarcolemma preparations. Homogenate adenosine triphosphate dependent calcium uptake was decreased by 36% after 3 h of ischaemia. Sodium gradient induced calcium uptake was enhanced about twofold after 1 h of ischaemia, and calcium permeability of sarcolemmal vesicles was decreased by 20% after 3 h of ischaemia. After in vitro incubation of isolated sarcolemma membranes with (1-14C)-palmitoylcarnitine radiolabelled molecules that remained associated with the membrane even after repeated washing were incorporated. No changes were observed in the sodium gradient induced calcium uptake when less than 6 nmol (1(-14)C)- palmitoylcarnitine per mg sarcolemma protein were bound or incorporated into the lipid phase. This exceeded the maximal endogenous concentrations of 3.2(0.6) nmol long chain fatty acylcarnitine per mg sarcolemma protein observed during myocardial ischaemia. The results suggest that the intracellular increase in long chain acylcarnitine during almost zero myocardial flow is not critical to sarcolemmal sodium and calcium permeability and sarcoplasmic reticulum calcium pumping activity. PMID- 3652099 TI - Dissociation between early recovery of regional function and purine nucleotide content in postischaemic myocardium in the conscious dog. AB - Since abnormalities in regional myocardial function and nucleotide metabolism persist for a prolonged period after a brief coronary occlusion the temporal relation between the resolution of myocardial dysfunction and repletion of nucleotide pools in postischaemic myocardium was studied in conscious mildly sedated animals. In a second experiment 5-amino-4-imidazolecarboxamide riboside (AICAriboside) was infused in an attempt to influence myocardial function by altering the rate of adenine nucleotide synthesis. Conscious dogs mildly sedated with morphine underwent coronary occlusion for 15 min followed by reperfusion for 30 min or 12 h, at which time a myocardial sample was obtained for nucleotide analysis. Segment shortening averaged 62% of control values at 15 min of reperfusion and increased to 81% of control by 12 h of reperfusion (p less than 0.05). Adenine nucleotide content was 75(5)% of control after 30 min of reperfusion and did not change significantly over the next 12 h of reperfusion. Thus the early return of systolic function was not accompanied by a detectable increase in total adenine nucleotide content. In the second experiment a pronounced stimulation of the proximal purine nucleotide synthetic pathway occurred as evidenced by a 13-fold to 25-fold increase in inosine monophosphate content. One branch of the distal purine pathway was also stimulated as evidenced by complete repletion of guanine nucleotide pools, but the product of the other branch (adenine nucleotides) did not increase significantly. These results indicate a selective limitation of the distal adenine nucleotide synthetic pathway in postischaemic myocardium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652100 TI - An extravascular hydraulic system to control blood pressure by a feedback regulation of the venous return. AB - Since increases in blood pressure may be effectively controlled by hydraulic feedback by reducing the venous return through the inferior vena cava in proportion to the blood pressure this principle was applied using a totally implantable extravascular system consisting of a periaortic blood pressure sensor and a pericaval cuff around the inferior vena cava. The two cuffs were supported externally by hard skeletons, filled with water, and connected directly to each other. The two devices were tested separately and together in 10 anaesthetised mongrel dogs with normal and high blood pressure induced by a metaraminol infusion. With the periaortic sensor an increase in blood pressure of 100 mmHg caused a mean(SD) isotonic volume displacement of 0.41(0.11) ml, and an increase in the pericaval balloon energy content of 100 ml.mmHg-1 caused a fall in blood pressure of 37.8(18.3)%. The whole system prevented an excessive rise in blood pressure when metaraminol was infused, with a feedback gain of about 2.8. It is concluded that blood pressure can be maintained at acceptable levels despite strong hypertensive stimuli, by this system, without additional treatment with drugs or an external energy source. The system is totally implantable and is applied extravascularly so that no anticoagulation is needed. PMID- 3652101 TI - Adenine nucleotide degradation in the human myocardium during cardioplegia. AB - The tissue content of adenine nucleotides and their metabolites, inosine monophosphate, adenosine, hypoxanthine, and uric acid, were determined in biopsy specimens from the left ventricle of six patients during cardioplegia for open heart surgery. Biopsy specimens were collected immediately after the induction and at the end of cardioplegia (51-82 min) and were analysed by high performance liquid chromatography. After the induction of cardioplegia (cold potassium enriched solution) the left coronary artery was continuously perfused with cold (10 degrees C), potassium enriched, diluted blood. The adenosine triphosphate concentration decreased from 13 to 8 mmol.kg-1 dry muscle (p less than 0.01) during cardioplegia. Adenosine diphosphate and adenosine monophosphate concentrations were 6 and 3 mmol.kg-1 dry muscle respectively and remained unaffected. The adenosine concentration (0.3 mmol.kg-1 dry muscle) was three times higher than that of inosine monophosphate. Inosine concentrations increased from 0.8 to 2.7 mmol.kg-1 dry muscle (p less than 0.01) in parallel with the increase in hypoxanthine from 0.1 to 0.4 mmol.kg-1 dry muscle (p less than 0.01). The total adenine nucleotide pool decreased by 5 mmol.kg-1 dry muscle (p less than 0.01), whereas the corresponding increase in nucleotides and bases only was 2 mmol.kg-1 dry muscle. In conclusion, the adenosine triphosphate content and the adenine nucleotide pool were appreciably reduced during continuous cold blood cardioplegia as used in the present study. The tissue content of adenosine and further metabolites was considerably increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652102 TI - Cardiovascular response to orthostatic tilt in patients with severe congestive heart failure. AB - Baroreflex mediated haemodynamic responses and aortic pulsatile stretch were studied in patients with congestive heart failure due to ischaemia. Seven patients with severe congestive heart failure (baseline angiographic ejection fraction 21(3)% (mean(SEM); left ventricular end diastolic volume and pressure 351(43) ml and 22(3) mmHg respectively) were compared with seven control subjects whose angiographic ejection fraction was 74(3)%. Passive 45 degrees upright tilt was used to unload baroreceptors. Aortic pulsatile stretch (pulsatile distension as percentage of diastolic diameter) was calculated from echocardiographic measurements of aortic diameters. Upright tilt caused a significant decrease in cardiac filling pressures in patients with congestive heart failure, as in control subjects. During tilt control subjects had substantially increased systemic vascular resistance and heart rate and decreased stroke volume, but arterial pressure, cardiac index, and aortic pulsatile stretch were maintained constant. Patients with congestive heart failure developed peripheral vasodilatation, had no increase in heart rate, and failed to maintain arterial mean and systolic pressures in the tilted position. They had, however, maintained a constant pulse pressure and increased cardiac index, stroke volume, and aortic pulsatile stretch. The response to upright tilt in patients with congestive heart failure may be explained by faulty sympathetic reflexes, causing vasodilatation and hypotension rather than vasoconstriction, and a rise in stroke volume due to the decrease in afterload. PMID- 3652103 TI - Radionuclide angiographic study of the influence of dietary lipid supplements on cardiac function in the marmoset (Callithrix jacchus). AB - Radionuclide angiography was used to examine the influence of dietary fat on cardiac function in the common marmoset monkey (Callithrix jacchus jacchus) under barbiturate anaesthesia. Animals were fed for 6-8 months with a low fat (4.5%) reference diet or the same diet supplemented (12%) with sunflower seed oil or sheep fat. Although there was a tendency towards increased heart rate, left ventricular ejection fraction, peak ejection rate, and peak filling rate in both fat supplemented groups, significant increases in heart rate (+50%), peak ejection rate (+71%), and peak filling rate (+84%) were found with sheep fat supplementation, whereas only the vegetable oil supplement produced a significant improvement in left ventricular ejection fraction (+23%). There were no differences in resting blood pressure, and the main consequence of dietary fat supplementation was a major increase in apparent cardiac oxygen consumption (+58%) with the sheet fat diet, as determined by the pressure-rate index. Infusion of isoprenaline hydrochloride (0.2 microgram.kg-1.min-1) increased all indices of cardiac function towards common maxima. There were no differences in either the depth or duration of anaesthesia between dietary groups. It therefore is unlikely that this contributed to any of the observed dietary induced differences in cardiac function. It is suggested that dietary saturated animal fat increased cardiac work and oxygen consumption at rest to the extent that functional reserve to respond to stress was significantly diminished. Feeding a linoleic acid rich polyunsaturated vegetable oil supplement was, however, accompanied by evidence of some improvement in left ventricular ejection fraction. PMID- 3652104 TI - Evaluation of coronary collateral development by regional myocardial function and reactive hyperaemia. AB - The development of collateral vessels was induced by repeated brief left circumflex coronary artery occlusions in 11 conscious dogs. Subendocardial segment shortening in the central ischaemic area and the ischaemic marginal area and transmural wall thickening in the centre of the ischaemic area were measured together with circumflex coronary flow. Changes in regional myocardial function and reactive hyperaemia were determined daily. The rate of recovery of myocardial function after collateralisation was almost identical in both regions. Before myocardial contractility was restored reactive hyperaemia was greatly attenuated. These data strongly suggest that collateral flow is distributed uniformly over the ischaemic bed and that substantial areas of myocardial tissue at risk are salvaged from ischaemia as a result of effective collateral circulation. PMID- 3652106 TI - Response to upright exercise after myocardial infarction. AB - The left ventricular response to upright bicycle exercise was studied in 39 unselected, non-beta blocked patients (mean(SEM) age 54.2(1.7)yr) (mean(SEM) resting ejection fraction 41.9(2.3)%) 8-10 weeks after myocardial infarction. Nine healthy, age matched, sedentary adult men were studied for comparison (mean(SEM) age 49.8(0.9)yr). The stroke volume and cardiac output were measured by impedance cardiography at rest and after each 3 min workload until symptom limited maximum. The patients were separated into three groups based on stroke volume response to graded exercise. Group 1 (n = 14) had a normal stroke volume response to increasing heart rate. In group 2 (n = 13) stroke volume increased initially then decreased by greater than 15% at a heart rate greater than 100-105 beats.min-1. In group 3 (n = 12) stroke volume failed to increase during exercise. In group 1 cardiac output and mean arterial pressure increased whereas vascular resistance decreased during exercise in a normal fashion. Group 2 had an increased mean arterial pressure and systemic vascular resistance throughout exercise while heart rate increased in a similar fashion to group 1 until work of greater than 70 W was undertaken, at which time heart rate increased in a curvilinear fashion and cardiac output was attenuated. Group 3 had an attenuated cardiac output and a higher heart rate during exercise. In this group of patients systemic vascular resistance failed to decrease normally during exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652105 TI - Transient increase in release of adenosine during rapid cardiac pacing; transient effects on overdrive suppression of ventricular automaticity. AB - A study was designed to test the hypothesis that endogenous adenosine concentration may increase during episodes of rapid ventricular pacing and, by virtue of its negative chronotropic effects, contribute to the transient suppression of automaticity that follows the period of overdrive. Isolated, perfused, rat ventricular preparations were subjected to periods of 6.0 Hz overdrive stimulation while adenosine release, oxygen consumption, and subsequent suppression of automaticity were measured. At the end of a 1 min episode of overdrive oxygen consumption and adenosine release were significantly increased, and the initial beating rate after 1 min overdrive was suppressed. At the end of 10 min overdrive oxygen consumption was still increased but adenosine release had returned to control values. Suppression of automaticity after 10 min overdrive was similar to that after 1 min overdrive. The relative magnitude of suppression after 1 min overdrive was decreased by theophylline (10(-4) mol.litre-1), and increased by the adenosine deaminase inhibitor, EHNA (10(-5) mol.litre-1). Neither theophylline nor EHNA had any discernible influence on suppression after 10 min overdrive. It its therefore concluded that endogenous adenosine may contribute to the suppression of ventricular automaticity that follows a 1 min episode of overdrive, but because of the transient nature of the increase in adenosine during overdrive endogenous adenosine does not contribute to the suppression that follows prolonged overdrive. PMID- 3652107 TI - Ventricular interdependence and the transient response of the left ventricle to inspiration: a model study. AB - A mathematical model of the circulation was developed and used to study the transient variations in ventricular volumes with inspiration. The contributions of increased left ventricular afterload, ventricular interdependence, and reduced pulmonary venous flow to the initial decrease in left ventricular stroke volume were examined. Heart rate was kept constant. Right ventricular end diastolic volume increased rapidly, but transiently, with inspiration. Ventricular interdependence affected left ventricular function; it increased the magnitude of the decrease in left ventricular stroke volume, reduced the corresponding increase in end systolic volume, and appeared to be responsible for an initial decrease in end diastolic volume. Despite a 10% pooling of blood in the pulmonary circulation the decrease in pulmonary venous flow was small. It is suggested that the decrease in left ventricular stroke volume is caused both by the reduced intrathoracic pressure, which increases the afterload on the left ventricle, and by the increase in the diastolic elastance of the left ventricle caused by the increase in right ventricular volume (ventricular interdependence). The increased afterload reduces the effective ejection pressure, decreases the stroke volume, and increases the end systolic volume. The increase in left ventricular diastolic elastance, secondary to the increase in right ventricular volume, further reduces the stroke volume by increasing the left ventricular diastolic pressure at a given volume and thus decreases the end diastolic volume. PMID- 3652108 TI - Collateral blood flow after coronary occlusion: influence of barbiturate anaesthesia and thoracotomy. AB - A study was undertaken to determine whether barbiturate anaesthesia, with or without thoracotomy, adversely affects collateral blood flow during acute coronary artery occlusion. Twelve dogs were instrumented with an electromagnetic flow probe and pneumatic occluder on the left circumflex artery; seven days later, in the conscious state, complete coronary artery occlusion was induced for 8 min. Heart rate, mean aortic pressure, and subendocardial and subepicardial blood flow in the ischaemic zone were measured by radioactive microspheres before and 5 min into coronary artery occlusion. Measurements were repeated after pentobarbital 30 mg.kg-1 (n = 7) and after pentobarbital plus thoracotomy (n = 12). Compared with the conscious state, pentobarbital and thoracotomy produced a decrease in endocardial blood flow in the ischaemic zone (0.21(0.04) to 0.15(0.03) ml.min-1.g-1) and a modest redistribution from endocardium to epicardium (ratio of endocardial to epicardial flow 0.55(0.06) to 0.49(0.07) ml.min-1.g-1), coincident with an increase in heart rate from 127 to 178 beats.min-1 but no change in mean arterial pressure. Directionally similar, but smaller, changes occurred during anaesthesia without thoracotomy. To determine the role of tachycardia five of the animals were studied in the conscious state during a 50% increase in heart rate induced by atrial pacing. A similar decrease occurred in coronary blood flows as with anaesthesia. The results indicate that barbiturate anaesthesia and thoracotomy produce a diminution in collateral flow to ischaemic myocardium, together with an accentuation of its transmural maldistribution, and suggest that anaesthetic induced tachycardia is primarily responsible for these flow alterations. PMID- 3652109 TI - Can sinoaortic baroreceptor heart rate reflex sensitivity be determined from phase IV of the Valsalva manoeuvre? AB - A new time related method of analysing the sinoaortic baroreceptor heart rate reflex, which determines reflex latency as well as sensitivity, was used to compare the results obtained with a phenylephrine ramp method (P) with those obtained using the whole of phase IV of Valsalva (V1) and using the phase IV systolic blood pressure overshoot alone (V2). Twenty five subjects with large ranges of age and resting blood pressures were studied. Each performed two standardised Valsalva manoeuvres and received three bolus injections of phenylephrine sufficient to cause transient pressor responses of 20-30 mmHg. Mean sensitivity values with P (6.2(3.5) ms.mmHg-1) were greater than those with V1 (4.6(2.3) ms.mmHg-1, p less than 0.001) and less than V2 (7.8(4.0) ms.mmHg-1, p less than 0.001). However, linear regression analysis showed a correlation of P with V1 (r = 0.76, p less than 0.0001) and with V2 (r = 0.80, p less than 0.0001). Reflex latency with P (1084(427) ms) was less than V1 (2416(423) ms, p less than 0.0001) and V2 (1504(441) ms, p less than 0.0005). Reflex sensitivity results obtained using phase IV of Valsalva's manoeuvre are proportionately related to phenylephrine results, but large errors were introduced into the absolute values obtained when relatively small changes were made to the method of analysis. PMID- 3652110 TI - Sympathetically induced myocardial ischaemia causes the heart to release plasma kinin. AB - A recently developed highly sensitive radioimmunoassay method for detecting plasma kinin was used to re-evaluate the results of previous studies, in which plasma kinin had been measured with a bioassay method. To clarify the mechanism of plasma kinin release in global myocardial ischaemia the left main coronary artery was cannulated using a Griggs type autoperfusing cannula after pentobarbital anaesthesia in open chest dogs. The animals were divided into a non coronary constricted group (n = 4) and a moderately coronary constricted group (n = 7). Cardiac sympathetic nerve stimulation (10 V, 4 Hz, 2 ms duration) was given to both groups. Haemodynamic recordings and blood samples were taken before and after coronary constriction as well as after sympathetic nerve stimulation. The arterial and coronary sinus plasma kinin concentrations were determined with the new radioimmunoassay method. After sympathetic nerve stimulation apparent myocardial ischaemia occurred and the plasma kinin concentration in coronary sinus blood increased significantly in the constricted group. In the non constricted group, however, myocardial ischaemia did not appear and no significant change in coronary sinus plasma kinin concentrations was seen. These findings show that there was a pronounced release of plasma kinin from the heart when apparent myocardial ischaemia occurred. PMID- 3652111 TI - Time dependent conversion of creatine kinase MM isoforms in man. AB - Subforms of creatine kinase MM isoenzyme (isoforms, pI: MMA = 7.95, MMB = 7.76, MMC = 7.54) in human myocardium and serum were quantified by chromatofocusing. Creatine kinase MMA was a dominant isoform (greater than 94% of MM) in normal (n = 3) and in both infarcted and non-infarcted myocardium (n = 2). To investigate isoform conversion in vitro partially purified MMA was incubated with human plasma at 37 degrees C for 24 h (n = 5). Creatine kinase MMB (0%, 47%, 44% of MM at 0, 12, 24 h respectively) and MMC (0%, 22%, 42%) sequentially appeared in incubation media whereas MMA (100%, 31%, 14%) disappeared rapidly with a mean disappearance rate of -0.00169(0.00021)(SD) min-1. Individual differences in conversion velocity were small (SD less than 5%). To investigate isoform conversion in vivo serum isoforms were analysed in patients with acute myocardial infarction (n = 7). MMA was first dominant (A:B:C = 54:34:12%) in the early stage (6-9 h after the onset of chest pain) followed by MMB dominant (19:42:39%) in the middle stage (24-35 h), and MMC dominant (6:22:72%) in the late stage (54-60 h). Changes in isoform proportion were time dependent regardless of serum creatine kinase activity. These findings are consistent with canine isoform conversion reported previously except that in man the velocity of conversion was slower than in the dog. Thus analysis of serum creatine kinase MM isoforms may allow the onset of acute myocardial infarction to be precisely dated. Moreover, determination of MMA, the isoform native to myocardium with a short serum half life, may be useful in the prompt diagnosis of myocardial infarction. PMID- 3652112 TI - Local myocardial electrogram and potassium concentration changes in superficial and deep intramyocardium and their relations with early ischaemic ventricular arrhythmias. AB - Bipolar myocardial electrograms and extracellular potassium concentrations were simultaneously monitored using double barrelled probes during 30 min of acute ischaemia in 15 dogs in vivo. The responsiveness of the time from the onset of the limb lead electrocardiogram to the peak deflection of the local electrogram to extracellular potassium changes was more prominent in superficial intramyocardium than in deep intramyocardium, despite similar changes in potassium concentration in both layers. The changes in electrogram duration and amplitude were related to extracellular potassium concentration both in superficial and deep intramyocardium. Immediate phase ventricular arrhythmias (within the first 10 min of acute ischaemia) were characterised by delayed activity mainly due to an increase in the time to peak of the electrogram in superficial intramyocardium. In contrast, in dogs showing delayed phase arrhythmias (within 10-30 min of acute ischaemia) delayed activity associated with pronounced changes in potassium concentration and electrogram duration and amplitude were noted in deep intramyocardium. Thus the two phasic appearances of early ischaemic ventricular arrhythmias with different origins seem to be related to the features of the conduction pathway in superficial intramyocardium and the severe local electrogram changes associated with a pronounced increase in extracellular potassium concentration in deep intramyocardium. PMID- 3652113 TI - Ventricular fibrillation thresholds in Langendorff perfused rabbit hearts: all or none effect of low potassium concentration. AB - The median single pulse ventricular fibrillation threshold of 56 determinations in eight isolated rabbit hearts perfused with a Krebs-Henseleit solution was 36 mA, with a range from 12.5 to above 50 mA. The fibrillation threshold remained in the same range when the potassium concentration in the perfusing fluid was decreased from its normal 5.6 mmol.litre-1 to as low as 1.8 mmol.litre-1. A further decrease in potassium concentration reduced the fibrillation threshold to a median value of 1.6 mA in nine determinations on six hearts. With a 1.6 mmol.litre-1 potassium concentration, thresholds were in either the high or the low range depending on the individual heart. A pronounced shortening of refractory period and an earlier vulnerable period were associated with the sharp change in fibrillation threshold; the diastolic extrasystolic threshold, cycle length, and RT interval duration increased in a more linear manner as the potassium concentration was lowered. PMID- 3652114 TI - Properties of miniature postsynaptic currents during depolarization-induced release at a cholinergic neuroneuronal synapse. AB - 1. Miniature postsynaptic currents were analyzed at an inhibitory cholinergic neuroneuronal synapse in the buccal ganglion of Aplysia. Under double voltage clamp, it was possible to induce postsynaptic currents by long-duration depolarizations of the presynaptic neuron and to analyze these as the linear summation of individual miniature postsynaptic currents (MPSCs). The amplitude of these miniature currents (imin) was calculated from the ratio of the variance of the noise (E2) to the mean of the postsynaptic current (Im), according to Campbell's theorem, with imin = 2E2/Im. Their decay time (tau min) was obtained from the cutoff frequencies of the power spectra obtained from the noise. 2. Neither the conductance nor the decay time of MPSCs was voltage dependent. However, imin appeared to decrease when the quantal content of the response increased. Meanwhile, tau min increased slightly with Imin. 3. Carbamylcholine was injected into the neuropile and this led to a decrease in imin and a slight increase in tau min. 4. Power spectra obtained after the application of inhibitors of acetylcholinesterase (AChE), with or without curare, suggested that acetylcholine (ACh) does not accumulate during large depolarizations. 5. The possible origin of the nonlinear relationship between the variance and the mean of the postsynaptic currents is discussed. PMID- 3652115 TI - Ethanol-induced reduction of neuronal calcium currents in Aplysia: an examination of possible mechanisms. AB - 1. Experiments were performed to determine the mechanisms by which ethanol (EtOH) decreases the amplitude of voltage-dependent inward currents through calcium channels in Aplysia neurons. Voltage-clamp protocols used conditioning prepulses of varying amplitude, duration, and frequency, to examine the relationship between prior activity of the channel and EtOH action. Calcium and barium were used as charge carriers, allowing dissociation of effects due to inactivation of calcium channels from other perturbations resulting in the impediment of current flow through the open channel. 2. When Ba2+ was the charge carrier and channel activation was unconfounded by inactivation processes, the reduction of ICa produced by EtOH was independent of the voltage, frequency, or duration of conditioning prepulses. 3. When Ca2+ was the charge carrier, ICa was reduced as a function of conditioning prepulses, in three protocols used. EtOH enhanced this reduction, most probably because of its effects on the inactivation of ICa. Consistent with this interpretation, the time constant of decay of ICa was decreased, and recovery from inactivation was retarded by EtOH. 4. EtOH did not reduce ICa by a change in membrane surface potential, at least at low EtOH concentrations. 5. An analysis of the time course of development of ICa reduction by EtOH showed that it developed slowly, over a matter of minutes. 6. Our data indicate that EtOH does not reduce ICa by direct occlusion of the calcium channel. EtOH affects the inactivation of the calcium current, and this may occur by an action on the channel protein. PMID- 3652117 TI - [Let us not be indifferent to the smoking epidemic!]. PMID- 3652116 TI - Aging alterations in the modulation of central dopaminergic cilioinhibition by etorphine in the marine mussel, Mytilus edulis: decrease in the inhibition of presynaptic dopamine release. AB - 1. This report further demonstrates that etorphine influences presynaptic dopamine release, which in turn centrally modulates peripheral cilioinhibition. 2. In older animals cilioinhibition has become enhanced due to a lack of responsiveness to endogenous opioids which results in greater dopamine release, causing a higher level of cilioinhibition as demonstrated by challenging the visceral ganglia with etorphine or destroying the dopaminergic component with 6 hydroxydopamine. 3. Only the central cilioinhibitory, not the peripheral inhibitory response, mechanism appears to be altered in older animals. Thus, the alteration appears in the central integrative mechanisms involved with regulating ciliary activity. 4. The KCl-stimulated release of dopamine is unaltered in both young and old organisms, whereas the opiate inhibition of the KCl-stimulated release of dopamine is reduced in older organisms. Thus, the aging-associated alteration is associated with a specific process. 5. The reduction of opioid influence and the resulting enhanced cilioinhibitory activity may make the organisms more susceptible to environmental stress. PMID- 3652118 TI - [Harmful substances in tobacco smoke]. PMID- 3652120 TI - [Use of lasers in internal medicine]. PMID- 3652119 TI - [The effect of inhaled cigarette smoke on the development of isoprenaline-induced heart damage in rats]. PMID- 3652121 TI - [Treatment of the complications of atherosclerosis using lasers]. PMID- 3652122 TI - [Laser angioplasty of human coronary vessels. Initial experience in vitro]. PMID- 3652123 TI - [Thermal changes in the tissue near CO2 laser incisions]. PMID- 3652124 TI - [Morphology of laser-induced lesions in atherosclerotic plaques in the coronary vessels of human cadavers]. PMID- 3652125 TI - [Findings from the Chernobyl accident relevant to radiobiology]. PMID- 3652126 TI - [Cryptosporidiosis--a new disease in Czechoslovakia]. PMID- 3652127 TI - [Psychotropic drugs and their alternatives]. PMID- 3652129 TI - [Health sequelae of the alcohol dependence syndrome]. PMID- 3652128 TI - [Dependence on addictive substances as a social and health problem]. PMID- 3652130 TI - [Specific characteristics of alcohol-dependent patients]. PMID- 3652131 TI - [Alcoholic hepatitis]. PMID- 3652132 TI - [The effect of behavior type and alcohol consumption on the risk of ischemic heart disease]. PMID- 3652134 TI - [Prevention of obesity]. PMID- 3652135 TI - [Artificial sweeteners]. PMID- 3652133 TI - [Changes in protein parameters in the serum of patients with alcoholic liver diseases]. PMID- 3652136 TI - [Indications for the surgical treatment of obesity]. PMID- 3652137 TI - [Gastroplasty for reduction of body weight]. PMID- 3652138 TI - [Are reducing diets of 1 megajoule dangerous?]. PMID- 3652139 TI - [The coefficient of the energy requirements for running]. PMID- 3652140 TI - [Serologic examination of women from the Breclav District for tularemia and brucellosis]. PMID- 3652141 TI - [Listeriosis of the central nervous system in adults in the Western Slovakia region]. PMID- 3652142 TI - [Incidence of trichinellosis in Bardejov District in 1985. The ELISA reaction in the diagnosis of human trichinellosis]. PMID- 3652143 TI - [Bacterial meningitis caused by a conditionally pathogenic species of Neisseria]. PMID- 3652144 TI - [Vitamin B1 and magnesium in the erythrocytes of patients in a long-term dialysis program]. PMID- 3652145 TI - [Pharmacokinetic aspects of therapy with methenamine hippurate]. PMID- 3652146 TI - [New findings in the treatment of rheumatoid arthritis using methotrexate]. PMID- 3652148 TI - [Eye pathology after long-term dialysis treatment]. PMID- 3652147 TI - [Clinical problems with hormonally inactive adrenal tumors]. PMID- 3652149 TI - [Electroretinographic activity in the retina and levels of serum albumin]. PMID- 3652150 TI - [Pars plana vitrectomy in diabetics with advanced complications in other organs]. PMID- 3652151 TI - [Treatment of acute intermittent porphyria. The first use of Heme-arginate in Czechoslovakia]. PMID- 3652152 TI - [Use of analytical isoelectric focusing in polyacrylamide gel in the diagnosis of lipid and lipoprotein metabolism disorders]. PMID- 3652153 TI - Immunohistochemical localization of oxytocin and vasopressin in the adrenal glands of rat, cow, hamster and guinea pig. AB - The distribution of oxytocin and vasopressin in the adrenals of rat, cow, hamster and guinea pig has been studied by use of immunohistochemical techniques. In all the species studied the adrenal cortex contained both peptides; the staining in the zona glomerulosa being more intense than that in zona fasciculata or zona reticularis. The medulla, however, showed considerable species variation. In the cow, both peptides appear to be present in the adrenergic and noradrenergic cells, though staining was particularly prominent in cortical islands interspersed within the medullary tissue. In the rat, groups of medullary cells positive for both peptides were found, though it was not possible to associate these groups with particular chromaffin cell types. In the hamster oxytocin was present only in adrenaline-containing cells, whereas vasopressin was present in all medullary cells. The guinea pig medulla, which contains only adrenaline secreting cells, was positive for both peptides. The possibilities that vasopressin and oxytocin have an autocrine or paracrine role in functioning of the adrenal gland is discussed. PMID- 3652155 TI - Anionic sites in the basement membrane of the rat epididymal epithelium during ontogenesis and after testicular and gonadal tract lesions. AB - Anionic binding sites in the lamina densa of the basement membrane of the rat epididymal epithelium were demonstrated ultrastructurally with the use of cationized polyethyleneimine (PEI). Enzyme digestion with heparitinase removed the anionic sites, indicating that they consist largely of heparan sulfates. The anionic sites are present as early as the 16th day of gestation on the interstitial face of the lamina densa; later during gestation they are localized on both faces of the lamina densa without further modification after birth. The distribution of the anionic sites was identical all along the epididymal duct. After castration and ligation of efferent ducts or in the state of cryptorchidism the sites were more numerous and located inside the thicker portion of the lamina densa. These alterations were more prominent in the initial segment compared to the distal segments, suggesting a differential androgen dependence of the reactive sites and their patterns of distribution. PMID- 3652154 TI - Ultrastructural distribution of alpha-bungarotoxin binding sites in the suprachiasmatic nucleus of the rat hypothalamus. AB - The distribution of (125I) alpha bungarotoxin (alpha-BTX) binding sites in the suprachiasmatic nucleus (SCN) of the adult female rat was examined by electron microscopic autoradiography. The ultrastructural distribution of silver grains was analysed by line source, direct point count, and 50% probability circle methods. Real grain distribution was significantly different from that of randomly generated hypothetical grains. Line source analysis demonstrated two populations of sources: one associated with membranes, and one inside neuronal structures. Probability circle analysis of shared grains indicated that membrane bound-radioactive sources were mainly associated with axo-dendritic appositions. Only a small proportion of labeled neuronal interfaces exhibited synaptic differentiations in the plane of section. However, the compartment containing synaptic terminals was the most enriched when comparing real to hypothetical grains. Probability circle analysis of exclusive grains demonstrated that sources that were not associated with neuronal plasma membranes were likely to be within nerve cell bodies and dendrites. It is concluded that the majority of specifically labelled alpha-BTX binding sites in the SCN is membrane bound, and may be associated with axodendritic synaptic transmission. The presence of a significant proportion of the label in the soma and dendrites of suprachiasmatic neurons 24 h after ventricular infusion suggests that some of the labeled binding sites (junctional or nonjunctional) may be internalized within these two compartments. PMID- 3652156 TI - Reutilisation of tritiated thymidine in studies of regenerating skeletal muscle. AB - Two different aspects of tritiated thymidine (3H-Tdr) reutilisation in skeletal muscle were examined. Injection of a high dose (7 microCi/g) of 3H-Tdr into mice prior to crush injury of skeletal muscle resulted in heavy labelling (grain counts) of myotube nuclei 9 d later. In contrast, myotube nuclei were essentially unlabelled when a low dose (1 microCi/g) of 3H-Tdr was injected at similar times with respect to injury. It was concluded that labelling seen after the high dose was due to reutilisation of 3H-Tdr. (Such 3H-Tdr reutilisation can account for the results of Sloper et al. (1970) which previously supported the concept of a circulating muscle precursor cell.) When replicating muscle precursors were labelled directly with 3H-Tdr 48 h after injury, the percentages of labelled myotube nuclei and the distribution of nuclear grain counts were similar with either high or low dose. We also investigated whether the light labelling seen in regenerated myotube nuclei after 9 d, when 3H-Tdr had been injected before the onset of myogenesis (as found by McGeachie and Grounds 1987), was due to 3H-Tdr reutilisation or, alternatively, to proliferation of local cells in the wound which subsequently gave rise to muscle precursors. Labelling of myotube nuclei was compared in mice injected with 3H-Tdr either 2 h before, or 2 h after injury. In another experiment, mice were injected 12 h after injury and lesions sampled 1, 12 or 36 h later, to see whether local cells were replicating 12 h after injury and what labelled cells subsequently entered to wound.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652158 TI - Development of osteogenic tissue in diffusion chambers from early precursor cells in bone marrow of adult rats. AB - Diffusion chambers containing bone marrow cells from adult rats were implanted intraperitoneally into rat hosts and cultured in vivo for up to 64 days. Biochemical and histological analyses of the contents of the chambers demonstrate that a connective tissue consisting of bone, cartilage and fibrous tissues is formed by precursor cells present in marrow stroma. The amounts of osteogenic tissue and DNA are directly correlated with time of implantation and with number of cells inoculated. In the chambers there is initial formation of fibrous tissue which is strongly reactive to collagen type III, laminin and fibronectin. In areas of osteogenesis which appear later within this fibrous anlage, expression of collagen type III, laminin and fibronectin decrease and collagen types I and II increase in association with bone and cartilage respectively. Where osteogenesis does not develop, fibrous tissue continues to express collagen type III. The sequential expression of the different extracellular matrix components is similar to that previously observed during osteogenic differentiation in embryonic and adult developmental systems. It is concluded that the formation of fibrous and osteogenic tissues in diffusion chambers by precursor cells present in adult marrow, resembles the normal developmental process. PMID- 3652157 TI - Localization of the incorporation of 3H-galactose and 3H-sialic acid into thyroglobulin in relation to the block of intracellular transport induced by monensin. Studies with isolated porcine thyroid follicles. AB - The Na+/K+ ionophore monensin is known to arrest the intracellular transport of newly synthesized proteins in the Golgi complex. In the present investigation the effect of monensin on the secretion of 3H-galactose-labeled and 3H-sialic acid labeled thyroglobulin was studied in open thyroid follicles isolated from porcine thyroid tissue. Follicles were incubated with 3H-galactose at 20 degrees C for 1 h; at this temperature the labeled thyroglobulin remains in the labeling compartment (Ring et al. 1987a). The follicles were then chased at 37 degrees C for 1 h in the absence or presence of 1 microM monensin. Without monensin substantial amounts of labeled thyroglobulin were secreted into the medium, whereas in the presence of the ionophore secretion was inhibited by 80%. Since we have previously shown (Ring et al. 1987b) that monensin does not inhibit secretion of thyroglobulin present on the distal side of the monensin block we conclude that galactose is incorporated into thyroglobulin on the proximal side of this block. Secretion was also measured in follicles continuously incubated with 3H-galactose for 1 h at 37 degrees C in the absence or presence of monensin. In these experiments secretion of labeled thyroglobulin was inhibited by about 85% in the presence of monensin. Identically designed experiments with 3H-N acetylmannosamine, a precursor of sialic acid, gave similar results, i.e., almost complete inhibition of secretion of labeled thyroglobulin in the presence of monensin. The agreement between the results of the galactose and sialic acid experiments indicates that sialic acid, like galactose, is incorporated into thyroglobulin on the proximal side of the monensin block.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652159 TI - Effects of fetal versus postnatal sera upon adipose tissue stromal-vascular cells in primary culture. AB - This experiment was conducted to determine if serum factors are responsible for differences in cellularity of prenatal and postnatal pig adipose tissue as determined by in vitro measurement of cellular proliferation and enzyme histochemical metabolic development. Cellular proliferation of stromal-vascular cells derived from rat inguinal adipose tissue was measured by [3H]-thymidine incorporation. Coverslip cultures were used for analysis of histochemical differentiation. Cells were incubated in media containing 10% fetal bovine, fetal pig, mature pig, or various combinations of these sera. Fetal bovine serum promoted more [3H]-thymidine incorporation than fetal or postnatal pig sera. Fetal pig sera also stimulated more [3H]-thymidine incorporation than mature pig sera. Sera from adult pigs promoted differentiation and lipid filling of adipocytes. Fetal pig sera stimulated histochemical expression of enzymes, but did not induce lipid filling. Fetal bovine serum produced histochemically undifferentiated cells. Addition of fetal bovine serum to media containing mature pig sera reduced lipid accumulation and histochemical reactivity of cells. This effect of fetal serum was thus due to specific inhibition of lipid deposition and not substrate restriction. These experiments demonstrated that serum factors have a major influence on morphological development of fetal and postnatal adipose tissue. PMID- 3652160 TI - The dorso-lateral recess of the hypothalamic ventricle in neonatal rats. AB - Light and electron microscopy of the hypothalamic ventricle in neonatal rats demonstrate morphological specializations of the ventricular wall at the level of the premammillary region of the third ventricle. The morphological features are: (1) A ventricular recess that we have called the "hypothalamic dorso-lateral recess" (HDR). (2) The presence of intraventricular capillaries near the dorso lateral recess. (3) The HDR possessing a specialized ependymal lining; this consists of non-ciliated cells with short microvilli and bleb-like processes. (4) The existence of cerebrospinal fluid-contacting neurons within the HDR. (5) The presence of numerous phagocytic supraependymal cells. The HDR is not found in adult rats. This indicates that the dorso-lateral recess may play a physiological role during development. PMID- 3652161 TI - Localization of acetylcholinesterase in dissociated cell cultures of the carotid body of the rat. AB - The localization of acetylcholinesterase (AChE) was investigated at the cellular and subcellular levels in dissociated cell cultures of the carotid body of the neonatal rat, prepared by the methods of Fishman and Schaffner (1984). In the presence of iso-OMPA, which blocks nonspecific cholinesterase, staining was confined almost exclusively to glomus-cell clusters and occasional isolated cells. These clusters grow as discrete islands scattered throughout the culture and display typical catecholamine (CA) fluorescence as in vivo. AChE staining was abolished or reduced by the cholinesterase inhibitors eserine (30-100 microM), or (the poorly lipid soluble) echothiophate (8 microM). Processing of the same culture sequentially for the demonstration of both AChE and CA revealed that glomus-cell clusters and individual glomus cells were consistently positive for both. In electron micrographs AChE reaction product was associated intracellularly with the nuclear envelope and cytoplasm of glomus cells (identified by their characteristic dense cored granules), as well as extracellularly with the boundaries of contiguous glomus cells. Significantly, reaction product occurred in some glomus cell profiles that had both dense-cored and clear (cholinergic-like) vesicles. These findings are discussed in the context of a possible dual (adrenergic/cholinergic) function status of glomus cells in the rat's carotid body. PMID- 3652162 TI - Effects of ingested gossypol on the ultrastructure of rat ovarian follicles. AB - Ultrastructural changes were observed in the oocytes and granulosa cells of the ovarian follicles of sexually mature female rats treated daily for 60 days with gossypol acetic acid at a dosage known to induce sterility in male rats (20 mg/kg body weight, orally). The changes included an increased lysosomal population in the ooplasm and a reduced, poorly developed smooth endoplasmic reticulum in the granulosa cells. The latter changes suggest a suppression of the secretory activity of the granulosa cells. PMID- 3652163 TI - Merkel-neurite complexes in the fungiform papillae of two species of monkeys. AB - Merkel-neurite complexes in tongues of Japanese and cynomolgus monkeys were examined by means of light and electron microscopy. Merkel-neurite complexes were found preferentially in the epithelium of fungiform papillae located at the tip of the tongue. It appears that the anterior fungiform papillae of the monkey are highly adapted for both taste and mechanical sensation. PMID- 3652164 TI - Cystlike structures derived from the marginal cells of Rathke's cleft in rat pituitary grafts. AB - Hemipituitary glands from 30 rats were isotransplanted under renal capsules. At 1, 2, 4, 7 and 20 days after transplantation, the grafts were examined by light and electron microscopy. Two days after transplantation, the central area of graft showed necrosis; however, the peripheral area, where marginal cells of Rathke's cleft were ingesting the remnants of necrotic glandular cells, survived. Four days after transplantation, mitotic figures of marginal cells were observed. Seven days after transplantation, the damaged area of the graft disappeared, and Rathke's cleft was completely lined by marginal cells. Remnants of necrotic glandular cells were not seen in intercellular spaces or in the cytoplasm of marginal cells. Cystlike structures formed in the grafts; some were connected to Rathke's cleft by narrow cavities. The cavity-lining cells of the cysts were agranular and similar to those that lined Rathke's cleft. At 20 days after transplantation, granular cavity-lining cells appeared. It is suggested that marginal cells of immature rats can differentiate into granular cells. PMID- 3652165 TI - Synaptic changes in the terminals of rod photoreceptors of albino mice after partial visual cell loss induced by brief exposure to constant light. AB - Albino mice were exposed to constant light for 7 days and were then transferred to periodic light. After initial photic damage and partial cell loss, the remaining visual cells recovered and survived as a stable population. Regions of the outer nuclear layer containing 4-6 rows of nuclei were more affected than those containing 6-10 rows. Changes in the synaptic structures in the receptor terminals of these two regions were recorded after varying survival periods. Some of the rod terminals had multiple synaptic ribbons and larger numbers of horizontal cell processes and bipolar cell dendrites. The number of terminals with multiple ribbons increased during recovery in periodic light. Morphometry demonstrated that the perimeters of horizontal and bipolar cell processes within the rod terminals were significantly larger than those in age-matched control mice, especially 4 weeks after recovery; they remained significantly larger than controls after 2 and 3 months. We suggest that partial loss of rod cells within a group of cells that are synaptically related to a common bipolar or horizontal cell results in synaptic growth inside the terminals of the surviving cells. PMID- 3652166 TI - The localization of labelled fish prolactin in various tissues of rainbow trout (Salmo gairdneri). AB - Rostral lobes of the pars distalis from rainbow trout, Salmo gairdneri, were incubated in vitro in a medium containing 14C-labelled lysine. The labelled proteins in these lobes and medium were separated by polyacrylamide gel electrophoresis, the prolactin eluted from the appropriate band, and injected into intact trout. Following the injections, various tissues were dissected out and observed autoradiographically. There was no binding of labelled prolactin to tissues of pituitary gland, thyroid, pyloric caecum, stomach, pancreas or muscle. There was, however, significant labelling in liver, intestine, kidney, bladder, skin and gill. The binding of labelled chum salmon prolactin to these latter tissues in vitro was significantly reduced when unlabelled hormone was also added. PMID- 3652167 TI - Fetal expression of muscle-specific isoactins in multiple organs of the Wistar Kyoto rat. AB - Actin, a cytoskeletal and contractile protein, is expressed in six different isoforms that exhibit striking specificity. No studies have considered the muscle specific actin expression in multiple organ systems in the intact fetus. Using a monoclonal antibody (B4) which reacts specifically with the isoactins of the smooth and skeletal muscle our immunohistochemical study examined whole fetal body sections to follow the development of actin expression throughout the last third of gestation in the Wistar-Kyoto rat. B4 staining was exclusively localized to muscle, confirming its high specificity and its usefulness for studying the ontogeny of muscle-specific isoactins. At 15 days of gestation, B4 staining was detected in the heart, the thoracic aorta and the skeletal muscle of the chest wall. The distribution and intensity of staining in the heart were initially higher than in the aorta or skeletal muscle and remained unchanged throughout the remainder of gestation, suggesting that the maturation of cardiac actin expression is well developed, although not fully completed before birth. Expression of muscle-specific actins in skeletal muscle was age-dependent and correlated with the maturational changes of muscle cell precursors. B4 staining in the fetal kidney was not apparent until day 20 of gestation and was localized to the inner cortical vessels. in association with the most mature nephrons, suggesting a centrifugal maturation of the intrarenal vasculature. The intensity of B4 staining in most tissues including bronchi, bowel, diaphragm, chest wall muscle and peripheral and pulmonary arteries increased by the end of gestation. PMID- 3652168 TI - Neurofilament-like and glial fibrillary acidic protein-like immunoreactivities in rat and guinea-pig sympathetic ganglia in situ and after perturbation. AB - The presence of neurofilament (NF)-like and glial fibrillary acidic protein (GFAP)-like immunoreactivities was studied in sympathetic ganglia of adult rats and guinea pigs during normal conditions and after perturbation. In the superior cervical ganglion (SCG) of normal rats, many ganglion cells and nerve fibers show NF immunoreactivity. Some of these nerve fibers disappear after preganglionic decentralization of SCG; this indicates the presence of a mixture of pre- and postganglionic NF-positive nerves in the ganglion. Cuts in both pre- and postganglionic nerves result in a marked increase in GFAP immunoreactivity in SCG, whereas NF immunoreactivity increases in nerve cell bodies after preganglionic cuts. Only a few ganglion cells show NF immunoreactivity in the normal SCG of guinea pig. All intraganglionic NF-positive nerves are of preganglionic origin; decentralization abolishes NF immunoreactivity in these nerve fibers. The inferior mesenteric ganglion, the hypogastric nerves and colonic nerves in guinea pigs contain large numbers of strongly NF-immunoreactive nerve fibers. When the SCG of adult rat is grafted to the anterior eye chamber of adult rat recipients, both ganglionic cell bodies and nerve fibers, forming on the host iris from the grafted ganglion, are NF-positive. As only the perikarya of these neurons normally exhibit NF immunoreactivity, and the terminal iris arborizations are NF-negative, it appears that the grafting procedure causes NF immunoreactivity to become more widespread in growing SCG neurons. PMID- 3652169 TI - GABA-immunoreactive neurons in the photosensory pineal organ of the rainbow trout: two distinct neuronal populations. AB - The distribution of putative GABA-ergic neurons in the photosensory pineal organ of the rainbow trout was investigated by use of a specific antiserum against gamma-aminobutyric acid (GABA). GABA-immunoreactive (GABA-IR) neurons were located in the rostral portion of the pineal end-vesicle, presumably constituting a population of interneurons. GABA-IR neurons were also found in the pineal stalk. The axons of these neurons were traced along the pineal stalk toward the brain. The terminal areas of these axons could not be established. GABA-IR glial cells were observed in the pineal end-vesicle, but not in the pineal stalk. PMID- 3652170 TI - A comparison of cytosolic free Ca2+ in resting feline and rat ventricular myocytes. AB - The Ca2+-sensitive dye quin-2 was used to measure the cytosolic free Ca2+ (Cai2+) in suspensions of ventricular myocytes isolated from cat and rat ventricles. Following an isolation procedure that was similar for both species, the cells were loaded with quin-2 AM (25 microM) for 30 min at 37 degrees C. After two washes to remove extracellular dye, the cells were resuspended for fluorescence measurements. Extracellular Ca2+ was 2.0 mM. Resting Cai2+ in the rat (121 +/- 11 nM) was found to be significantly higher than in the cat (57 +/- 4 nM). These results are discussed in terms of known differences in excitation-contraction coupling between these two species. PMID- 3652171 TI - Quantitative analysis of the interaction between S-100 proteins and brain tubulin. AB - S-100 was shown to regulate the in vitro assembly of brain microtubule proteins (MTPs) in a Ca2+-mediated way by acting on both the nucleation and the elongation of microtubules (MTs). Here data will be shown suggesting that S-100 binds to tubulin. The binding is time-, temperature-, Ca2+-, and pH-dependent, and saturable with respect to S-100. At pH 6.75, the saturation curve is biphasic, displaying a high affinity component (dissociation constant, Kd1, approximately 0.1 microM) and a low affinity component (Kd2 approximately 3.8 microM). At pH 6.75, as the free Ca2+ concentration raises from 0 to 100 microM, the overall binding capacity increases from 0.065 to 0.66 mol S-100/mol tubulin dimer. This finding, together with the observation that the S-100 effect on MTP assembly is Ca2+-dependent at that pH, suggests that the S-100-induced inhibition of MTP assembly depends on S-100 binding to the low affinity sites on the tubulin molecule. The S-100 binding to tubulin is pH-dependent; as the pH raises from 6.75 to 8.3, both binding components are affected, the major changes consisting of an increase in the binding capacity and a decrease in the overall affinity. Moreover, as the pH raises, Ca2+ is no longer required for S-100 to bind to tubulin. S-100 also interacts with a component of whole MTPs (probably tubulin, on the basis of the above results). No S-100 binding to microtubule-associated proteins (MAPs) could be evidenced by the techniques employed in this study. On the contrary, some competition between S-100 and MAPs for binding sites or tubulin seems to occur. PMID- 3652173 TI - [Retrospective survey on the morbidity of neonatal tetanus in some areas]. PMID- 3652172 TI - Characteristics of the effect of S-100 proteins on the assembly-disassembly of brain microtubule proteins at alkaline pH in vitro. AB - The ability of S-100 proteins to inhibit the assembly of brain microtubule proteins (MTPs) in the presence of microM levels of Ca2+ increases as a function of pH. This seems to be due to an increasingly larger inhibitory effect of S-100 on the nucleation and, probably, on the elongation of microtubules (MTs) as the pH raises. In the presence of microM Ca2+ levels, the ability of S-100 to disassemble MTs also increases linearly with the pH, suggesting that the larger inhibitory effect of S-100 on MTP assembly at alkaline than at acidic pH may depend on both a decrease in the assembly rate and an increase in the disassembly rate. Also, S-100 inhibits the assembly of phosphocellulose-purified tubulin to a larger and larger extent as the pH raises. S-100 brings about its effect on MT assembly-disassembly probably by sequestering soluble tubulin, though additional mechanisms cannot be excluded. The present data are briefly discussed in relation to the role attributed to changes in intracellular pH in the regulation of the state of assembly of cytoplasmic MTs. PMID- 3652174 TI - [A serological survey of the tetanus antibody of the normal population in China]. PMID- 3652175 TI - [The epidemiological investigation of an outbreak of diphtheria in Shaodong County]. PMID- 3652176 TI - [The intrauterine and perinatal transmission of hepatitis B virus from carrier mothers to their infants]. PMID- 3652177 TI - [Logistic regression model analysis for the agents of primary hepatic carcinoma]. PMID- 3652178 TI - [Epidemiologic analysis of 221 cases of acute myocardial infarction]. PMID- 3652179 TI - [An investigation of the prevalence of epilepsy in three northwestern provinces of China]. PMID- 3652180 TI - [A study on storing monkey blood cells in freezers]. PMID- 3652182 TI - Hepatitis B virus markers in dental care personnel practising in Harare. PMID- 3652181 TI - Correlation studies between concentrations of glycosylated haemoglobins and lipids in non-insulin-dependent Nigerian diabetics. PMID- 3652183 TI - Maternity service in a general hospital. Part 1: Obstetrical data. PMID- 3652184 TI - Theophylline usage in patients with acute asthma presenting to a central hospital. PMID- 3652185 TI - Spontaneous rupture of the urinary bladder. PMID- 3652186 TI - Gravid uterus in an umbilical hernia--a report of two cases. PMID- 3652187 TI - Paroxysmal nocturnal haemoglobinuria. PMID- 3652188 TI - Ameloblastoma of the jaw: a rational approach to treatment. PMID- 3652189 TI - Malnutrition of children in rural Botswana. PMID- 3652190 TI - Some observations on anorectal malformations in Zimbabwe. PMID- 3652191 TI - Prevalence of antibodies to human serogroups of Yersinia enterocolitica in blood donors in Nigeria. PMID- 3652192 TI - A case report of the use of inflow occlusion and moderate hypothermia for a pulmonary valvotomy: anaesthetic and surgical management. PMID- 3652193 TI - Polymorphonuclear leukocytosis in patients with cholera. PMID- 3652195 TI - Primary health care and the essential drug list concept. PMID- 3652194 TI - Proprietary propranolol preparations. PMID- 3652196 TI - "Hemicrania continua"--new developments. PMID- 3652198 TI - "Hemicrania continua": the first bilateral case? AB - The patient reported had had a continuous headache involving the whole skull for 7 years. Many drugs had failed to relieve the pain, but with indomethacin the headache completely disappeared within 3 days. Nine months later the treatment was discontinued without any relapse. This variety of headache, not previously reported, was quite similar to the "hemicrania continua" except for its localization. PMID- 3652197 TI - "Hemicrania continua": a new clinical entity or a further development from cluster headache? A case report. AB - A case of "hemicrania continua" after cluster headache in the same subject is described. Indomethacin exerted an absolute, persistent effect on the present headache. Even though our data are insufficient to demonstrate a causal relation between the two forms of headache, they do suggest this real possibility. PMID- 3652199 TI - "Hemicrania continua": a case report. AB - The case of a 42-year-old woman with a 31-year history of continuous unilateral, pulsating headache with occasional exacerbations is described. Complete relief was obtained with 150 mg indomethacin daily. PMID- 3652200 TI - "Hemicrania continua": a third Norwegian case. AB - Another case of hemicrania continua is described--that of a 54-year-old woman, who for the past 3 years has had continuous, left-sided headache. Before this period she had non-continuous headache, otherwise resembling the present one, for 3-4 years. In the chronic stage, the headache fluctuates considerably. Indomethacin in a dosage of 150 mg/day abolishes the headache completely. In hemicrania continua, there may thus, as in chronic paroxysmal hemicrania, be a non-chronic stage, antedating the chronic one. The relative importance of the two stages cannot be assessed at present. PMID- 3652201 TI - Chronic paroxysmal hemicrania: orbital phlebography and steroid treatment. A case report. AB - A 62-year-old man with ankylosing spondylitis and with a 3-year history of chronic paroxysmal hemicrania is presented. Because of his ankylosing spondylitis naproxen was prescribed; this decreased the attacks of headache to about 50%. However, treatment with indomethacin and steroids eliminated the attacks completely, the former drug in 24 h but only when the drug was taken; the latter drug was completely effective after a week but with an effect that lasted half a year after the medication was stopped. Orbital phlebography showed changes similar to those previously observed in patients with Tolosa-Hunt syndrome and cluster headache. Venous vasculitis thus seems to be associated with all three disorders and may be a factor of etiologic significance. PMID- 3652202 TI - Chronic paroxysmal hemicrania in a South African black. A case report. AB - A 35-year-old black man with a 4-year continuous history of multiple paroxysms of unilateral temporal and ocular pain is reported. Multiple (that is, 15-20) attacks occurred in 24 h. There were no symptom-free periods. Mild exophthalmos, marked sweating, nasal congestion, and lacrimation were present on the affected side. There was no response to ergot preparations, steroids, or lithium but dramatic and sustained relief with indomethacin. PMID- 3652203 TI - Episodic paroxysmal hemicrania? AB - Cyclic remissions in chronic paroxysmal hemicrania (CPH) have been considered to be transitory phenomena inevitably leading to the chronic stage. This conclusion has precluded the possibility of paroxysmal hemicrania having an episodic counterpart. Six case histories presented here establish the persistence of cyclic patterns for a mean of 23 years of illness, thus suggesting that the "pre CPH" nomenclature may be presumptive, and, further, provide evidence for another classification: episodic paroxysmal hemicrania. PMID- 3652204 TI - Chronic paroxysmal hemicrania: a case report. Long-lasting remission in the chronic stage. AB - In a 38-year-old woman who had had CPH since the middle 1960s and had been successfully treated with indomethacin (dosage usually within the limits of 50 175 mg/day) for approximately 10 years, the requirement for indomethacin was gradually reduced to nought in the spring of 1985. She was then pain-free without indomethacin for almost 1 1/2 years. In the late fall of 1986 she had a 3-week exacerbation. In recent months, she again seems to have a slowly increasing, although clearly fluctuating, indomethacin requirement. Long-lasting remissions may thus appear even in the chronic stage. The remission could be a spontaneous one or it could in some way be related to the protracted indomethacin treatment; the authors favour the former possibility. The recurrence of symptoms after a while shows that the attack-generating potential has not been permanently extinguished by indomethacin. PMID- 3652205 TI - Orbital phlebography in patients with cluster headache. AB - Thirteen patients with cluster headache in an active stage were investigated with orbital phlebography. About 60% of the patients showed pathologic changes on the phlebograms, such as changes in the appearance of the superior ophthalmic vein. Five patients had pathologic changes on both sides and three patients on one side only. All patients with unilateral pathologic findings on orbital phlebography had the attacks on the same side. The phlebographic findings in these patients with cluster headache were very similar to those of patients with the Tolosa-Hunt syndrome. There is also some similarity in the symptoms in the two disorders. It has previously been suggested that the Tolosa-Hunt syndrome is caused by venous vasculitis, and the present findings to some extent support the idea that cluster headache may have the same etiology. PMID- 3652206 TI - Protein sequence of DMD gene is related to actin-binding domain of alpha-actinin. PMID- 3652207 TI - Alternative splicing in individual Aplysia neurons generates neuropeptide diversity. AB - The neuron R15 is a peptidergic cell within the abdominal ganglion of Aplysia that participates in two neural circuits governing physiological and behavioral programs. We have cloned and characterized the major gene product expressed in this neuron. The R15 cDNA encodes a polyprotein precursor that is cleaved to yield a set of small neuropeptides. One peptide, R15 alpha 1, may act on different target cells to generate distinct but complementary physiological alterations that contribute to a program of cardiovascular changes in Aplysia. We have found that the RNA encoding the R15 polyprotein is spliced differently in different neurons. Our results suggest that alternative splicing of RNAs encoding polyproteins may provide a mechanism to generate distinct but overlapping sets of peptides that govern distinct but related physiological or behavioral programs. PMID- 3652208 TI - Sequence analysis, cellular localization, and expression of a neuroretina adhesion and cell survival molecule. AB - A cDNA for purpurin, a secreted 20,000 dalton neural retina cell adhesion and survival protein, has been sequenced and expressed in mammalian cells. Purpurin mRNA is found in both embryonic and adult retina, but not the brain, heart, or liver. The protein is highly concentrated in the neural retina between the pigmented epithelium and the outer segments of the photoreceptor cells; it is synthesized by photoreceptor cells. The predicted purpurin sequence contains 196 residues, has approximately 50% sequence homology with serum retinol binding protein, and is a member of the alpha-2 mu-globulin superfamily. Purpurin binds retinol and may play a major role in retinol transport across the interphotoreceptor cell matrix. PMID- 3652209 TI - A common octamer motif binding protein is involved in the transcription of U6 snRNA by RNA polymerase III and U2 snRNA by RNA polymerase II. AB - The structure of a Xenopus U6 gene promoter has been investigated. Three regions in the 5'-flanking sequences of the gene that are important for U6 expression are defined. Deletion of the first, between positions -156 and -280 relative to the site of transcription initiation, reduces transcription to roughly 5% of its original level. Deletion of the second, between -60 and -77, abolishes transcription. These regions contain not only functional but also sequence homology to the previously defined distal and proximal sequence elements (DSE and PSE) of the Xenopus U2 promoter, although U2 is transcribed by RNA polymerase II and U6 by RNA polymerase III. Competition experiments show that at least the distal sequence elements of the two promoters bind to a common factor both in vivo and in vitro. Part of the sequence recognized by this factor is the octamer motif (ATG-CAAAT). A sequence similar to the common RNA polymerase II TATA box is also shown to have an effect, albeit minor, on U6 transcription. The U6 coding region contains a good match to the A box, part of all previously characterized RNA polymerase III promoters. Deletion of this region has no apparent effect on the efficiency or accuracy of U6 transcription. PMID- 3652210 TI - The in vitro transcription of the 7SK RNA gene by RNA polymerase III is dependent only on the presence of an upstream promoter. AB - Deletion analysis was carried out on the human 7SK RNA gene to map regions essential for in vitro transcription by RNA polymerase III. The sequence promoting transcription is located between 37 and 3 bp upstream of the 7SK RNA coding region. RNA polymerase III transcription of adjacent plasmid sequences can be directed by this promoter in the complete absence of the 7SK RNA coding region, indicating that no internal promoter sequences are required. Transcription is terminated by a stretch of T residues, typical of RNA polymerase III transcription. The promoter contains a TATA box at position -25, mutations within which dramatically reduce the efficiency of transcription. Upstream sequences from position -37 to -243 increase the promoter's efficiency. The promoter recognized by RNA polymerase III is structurally and functionally similar to the promoter of genes transcribed by RNA polymerase II. PMID- 3652211 TI - Ionic currents traversing cell clusters from carrot suspension cultures reveal perpetuation of morphogenetic potential as distinct from induction of embryogenesis. AB - Patterns of ionic currents accompanying shape and surface changes during growth of cell clusters from carrot suspension cultures were examined using a vibrating probe. Electrical polarity was established in clusters undergoing apparently disorganized proliferation in the presence of 2,4-dichlorophenoxyacetic acid (2,4 D). This electrical polarity is similar to that found in organized somatic embryos which form upon removal of 2,4-D, and implies that the proliferating clusters are actually suppressed embryos. This implication is further supported by observations using scanning electron microscopy. We conclude that the potential to undergo embryogenesis is present even before the 2,4-D is removed, but cannot be realized in the presence of the auxin. PMID- 3652212 TI - Affinity chromatography of embryonic inducing factors on heparin-Sepharose. AB - Mesoderm-inducing factors were extracted from chicken embryos and partially purified by chromatography on DEAE-cellulose. The DEAE-cellulose eluate was applied to heparin-Sepharose. Most of the proteins are not bound to heparin. The adsorbed proteins were eluted with a linear NaCl gradient. In totipotent gastrula ectoderm of amphibians the eluted proteins induce the differentiation of muscle and notochord as well as of large masses of renal tubules and blood cells. A possible relationship to fibroblast growth factors and angiogenesis factor is discussed. PMID- 3652213 TI - Proteoglycan biosynthesis in relation to differentiation of cord blood monocytes in vitro. AB - Human monocytes were obtained from umbilical cord blood and cultured in vitro. By morphological criteria, the neonatal monocytes developed into macrophage-like cells in the course of 3-5 days in culture. The cells were exposed to [35S]sulphate for 24 h, either from day 0-1 or day 9-10 in vitro. The 35S labelled macromolecules recovered were mainly associated with the medium fraction (approximately 75%) in both day 1 and day 10 cultures. These secretory macromolecules were demonstrated by the use of chondroitinase ABC-digestions to contain predominantly chondroitin sulphate proteoglycan (CSPG). [35S]galactosaminoglycan chains from day 10 cultures were more highly sulphated than the corresponding day 1 species due to the appearance of (glucuronosyl-4,6 diS-N-acetylgalactosamine) disulphated disaccharide units. The galactosaminoglycan chains in neonatal CSPG were found to increase in Mr during cultivation in vitro; from mean Mr of 20,400 to 30,200 (n = 5) in day 1 and day 10 medium proteoglycans, respectively. The corresponding Mr values for adult monocyte [35S]galactosaminoglycan chains were 21,300 and 22,800. On the basis of the concomitant changes in cellular morphology and glycosaminoglycan structure, it is concluded that neonatal monocytes, like monocytes from adults, differentiate into macrophage-like cells in vitro. PMID- 3652214 TI - Presence of a unique glycoconjugate on the surface of rat primordial germ cells during migration. AB - This investigation was undertaken to examine the chemical nature of components on the surface of primordial germ cells (PGCs) possibly related to their directed migration during development. To this end, lectins conjugated to horseradish peroxidase were used as specific histochemical probes to characterize the structure of PGC cell surface glycoconjugates and changes in their composition during and after their migration in the rat embryo. A lectin specific for terminal N-acetylgalactosamine (GalNAc) from Dolichos biflorus intensely stained the cell surface and a perinuclear region assumed to be Golgi zone of PGCs only during their migration. With one exception, no other site in the embryo stained with this lectin as migration proceeded. These observations suggest that the GalNAc-containing glycoconjugates on the surface of PGCs may be of functional importance in regulating the guidance and locomotion of these cells during the course of their extensive migration. PMID- 3652215 TI - Calcium sensitivity of cytoplasmic actomyosin from Physarum polycephalum following different purification procedures. AB - Cytoplasmic actomyosins purified from the acellular slime mold physarum polycephalum by application of two different procedures (Hatano and Tazawa, 1968; Kohama and Kendrick-Jones, 1986) were compared by SDS-PAGE and contraction experiments. In contrast to the 'Hatano actomyosin', 'Kohama actomyosin' contracts in a calcium sensitive manner, i.e., contraction occurs from zero calcium up to pCa4, and is inhibited at greater than or equal to pCa 3. Distinct differences in SDS gels are discussed. PMID- 3652216 TI - Erythrocyte ghost-mediated microinjection into cells in monolayer cultures: a highly efficient and low toxic technique. AB - We describe a technique by which macromolecules can be microinjected into mammalian cells in monolayer cultures. This technique employs erythrocyte ghosts as the vehicle for microinjection, calcium as attachment agent and polyethylene glycol as fusogen. The use of calcium allows a reduction of the time of exposure to polyethylene glycol, and results in a high injection efficiency and a high cell viability when followed by incubation in a buffer free of divalent cations. Injecting over 90% of the cells, a reduction of cell viability is not observed and the mitotic index is never lower than 2.3%. Light and electron microscopy suggest that erythrocyte ghost-cell fusion is only a short event. PMID- 3652217 TI - Studies on microplasmodia of Physarum polycephalum. VII. Adhesion-dependent changes in the organization of the fibrillar actin system. AB - Axenically-grown microplasmodia of the acellular slime mold Physarum polycephalum were used to study adhesion-dependent changes in the spatial organization of the cytoplasmic microfilament system. Results obtained by light- and electron microscopical techniques demonstrate the presence of a membrane-bound filament cortex in all microplasmodia, and the expression of additional cytoplasmic fibrils in specimens with tight contact to a substratum. The fibrils partly terminate in focal adhesion-sites and rather seem to serve a cytoskeletal than a contractile function. PMID- 3652218 TI - A hypothesis on the mechanism of polyethylene glycol (PEG)--mediated membrane fusion. PMID- 3652219 TI - Topographical relationship between the axonemal arrangement and the bend direction in starfish sperm flagella. AB - Since starfish spermatozoa have spherical heads, it is not easy to determine the topographical relationship of the axoneme to the directions of the flagellar bends, the principal, and the reverse bends as defined by Gibbons and Gibbons [J. Cell. Biol. 1972, 63:970-985]. The demembranated spermatozoa are known to take the quiescent "cane" shape with a sharp principal bend at the proximal region of the flagellum in the presence of high concentration of Ca2+. When such spermatozoa were placed on a grid for electron microscopy, fixed with osmic acid vapor, washed with distilled water, and negatively stained with uranyl acetate, the head of the spermatozoon was disrupted and dispersed disclosing the proximal centriole at the proximal end of the flagellum. The proximal centriole was always found on the concave side of the "cane"-shaped flagella. Electron microscopy of the serial thin sections of intact and demembranated spermatozoa revealed that the doublet microtubules numbers 5 and 6 were contained in the convex edge of the principal bend. PMID- 3652220 TI - [Kinetics of the biological activity of xenobiotics]. PMID- 3652221 TI - [In vitro and in vivo activity of anti-inflammatory agents from the aspect of QSAR]. PMID- 3652222 TI - [Data sets as the basis of a QSAR databank at the Institute for Hygiene and Epidemiology]. PMID- 3652223 TI - [Philosophical reflections on the pharmacy profession. III. Pharmaceutical chemistry]. PMID- 3652224 TI - [How shall we further improve prenatal care and decrease perinatal mortality and morbidity in Slovakia?]. PMID- 3652225 TI - [Psychosocial and ethical problems in andrology practice]. PMID- 3652226 TI - [Characteristics of placental function parameters in maternal liver diseases]. PMID- 3652227 TI - [Personal experience with a single administration of gentamycin and ampicillin for lower urinary tract bacteriuria]. PMID- 3652228 TI - [Anesthesia for gynecologic operations in elderly women]. PMID- 3652230 TI - [Abstracts of reports presented at the 36th Pharmacology Seminar. 27-30 August 1986, Olomouc]. PMID- 3652229 TI - [Evolution of gonadotropins and their cell receptors]. PMID- 3652231 TI - [Excessive activity of the external laryngeal muscles in hyperfunctional dysphonia]. PMID- 3652232 TI - [Diagnosis and therapy of perilymphatic fistulae]. PMID- 3652233 TI - [An objective test of hearing in children after mastoidectomy performed in infancy]. PMID- 3652234 TI - [Relation between iris color and noise-induced hearing loss]. PMID- 3652235 TI - [Incidence of false-positive tympanometric findings in secretory otitis media]. PMID- 3652236 TI - [Observations on the organization of audiometry facilities in workplaces with extreme noise levels]. PMID- 3652237 TI - [Extracranial vascular malformations with objective auditory tinnitus]. PMID- 3652238 TI - [Cysticercosis]. PMID- 3652239 TI - [Mucoepidermoid carcinoma of the tongue]. PMID- 3652240 TI - [Disseminated peritoneal leiomyomatosis]. PMID- 3652242 TI - [Myocardial damage in excessive oversaturation with iron in childhood]. PMID- 3652241 TI - [Malignant glandular schwannoma]. PMID- 3652243 TI - [Computer processing of autopsy data. I. Model]. PMID- 3652244 TI - [Computer processing of autopsy data. II. Use of the model]. PMID- 3652245 TI - [Clear cell tumors of the skin]. PMID- 3652246 TI - [Ganglioglioma of the pons and medulla oblongata]. PMID- 3652247 TI - [Major results of research in the field of nervous and mental disorders within the framework of the 7th 5-year National Plan of Basic Research]. PMID- 3652248 TI - [Adrenoleukodystrophy and adrenomyeloneuropathy--changes in the immunoglobulins in the cerebrospinal fluid]. PMID- 3652249 TI - [Changes in platelet function in patients with migraine]. PMID- 3652250 TI - [Electrodiagnosis of the carpal tunnel syndrome--significance of sensory fiber examination]. PMID- 3652251 TI - [Significance of computer tomography in the diagnosis of tumors in the chiasmic sellar region]. PMID- 3652252 TI - [A new approach to standardized preventive examinations in pediatrics]. PMID- 3652253 TI - [Health as a biosocial process]. PMID- 3652254 TI - [The standard preventive examination--standard recording of the child's health and diseases and its methodology]. PMID- 3652255 TI - [The chronically ill child in dispensary care]. PMID- 3652256 TI - [Concluding evaluation of health status in childhood--epicrisis]. PMID- 3652257 TI - [Verification of the new Record of Child Health Status and Morbidity within the practice of a general pediatrician]. PMID- 3652258 TI - [Experience of a district pediatrician with the new Record of Child Health Status and Morbidity]. PMID- 3652259 TI - [Further development of the proposed system of standardized preventive examinations in pediatrics]. PMID- 3652260 TI - [Changes in insulin resistance in diabetic children after treatment with an insulin pump]. PMID- 3652261 TI - [Orthopedic operations in children with cerebral palsy--the role of the pediatrician in the team care of these patients]. PMID- 3652262 TI - [Transitory hyperphenylalaninemia with a tetrahydrobiopterin synthesis deficiency]. PMID- 3652263 TI - [The physician and the computer. 7. Curves of biological phenomena]. PMID- 3652264 TI - [Diagnosis of cystic fibrosis]. PMID- 3652265 TI - [Education in communism within the professional and socio-political practice of pharmacy]. PMID- 3652266 TI - [The development of health services for the population of Eastern Bohemia]. PMID- 3652267 TI - [Analysis of the relation between economic conditions and the social environment to specific mortality from the most frequent causes of death]. PMID- 3652268 TI - [How to ensure the organization of care of patients with chronic pain syndromes]. PMID- 3652269 TI - [Possible prevention of psychologically-related death]. PMID- 3652270 TI - [The referral examination in general medicine as a process of mutual exchange of information]. PMID- 3652271 TI - [Planning in health institutions]. PMID- 3652273 TI - [The Main Task Commission of the Czechoslovak Ministry of Health: "Social Medicine, Research, Organization, and Management of Health Services" under the 7th and 8th 5 Year Plans]. PMID- 3652272 TI - [Standards of health service activities and expenditures in member countries of the Council of Mutual Economic Assistance]. PMID- 3652274 TI - [Computer tomography of fatty lesions in the mediastinum]. PMID- 3652275 TI - [Calculation of energy deposits in subcellular structures]. PMID- 3652276 TI - In vitro study of dactimicin (ST 900) against methicillin-susceptible and resistant staphylococci. AB - The current knowledge on the antimicrobial activity of dactimicin is poor and limited to the study of its activity against gram-negative bacilli. The new acquisition about the use of aminoglycoside antibiotics in infections due to Staphylococci, induced us to evaluate the behavior of this drug against methicillin-susceptible and -resistant Staphylococci, in comparison with fortimicin A and amikacin. Dactimicin (ST 900) shows good antibacterial activity and a strong bactericidal effect at MIC concentrations in all strains tested. PMID- 3652277 TI - New benzofuran-imidazoles as antimycotic agents. I. Synthesis and characterization. AB - With the aim of obtaining new drugs having antimycotic activity together with antibacterial and fewer side effects, we synthesized ten new benzofuran-2-yl imidazoles. PMID- 3652278 TI - New benzofuran-imidazoles as antimycotic agents. II. In vitro studies. AB - Ten new imidazole derivatives, benzofuran-imidazoles, were studied in vitro to establish their antimycotic activity against 70 fungal strains, in comparison with three known imidazoles and, for the dermatophytes only, griseofulvin. A very high inhibitory activity against dermatophytes was shown by five of the new substances. The other filamentous fungi and yeasts showed a more marked variation in their susceptibility. However a good sensitivity of some isolates of Candida albicans and other yeasts was seen. PMID- 3652279 TI - Sulbenicillin: pharmacokinetics and penetration into bronchial secretion in elderly patients. AB - This study evaluates the pharmacokinetics of sulbenicillin (alpha sulfobenzylpenicillin) in elderly subjects after single and multiple doses and the penetration into bronchial secretion in elderly patients with chronically superinfected bronchial pathology. Peak plasma levels were 53.34 micrograms/ml (group I); 55.80 and 57.82 micrograms/ml (group II) after 1 h. The half-life (t 1/2 beta) was 1.47 h (group I); 1.49 and 1.62 h (group II). Renal clearance was 6.68 l/h; 6.25 and 5.44 l/h; whereas the volume of distribution was 18.02 l; 17.84 and 17.21 l for groups I and II respectively. The mean percentage of the recovered active drug in urine over 12 h was 77.72% of dose. The mean peak reaching the bronchial secretion was 3.60 micrograms/ml at the 4th hour. The results of the multiple dose study indicated that there was no apparent change in the distribution or elimination kinetics of sulbenicillin after 2 g i.m. administration. Thus, the kinetics from the multiple dose study were in close agreement with those from the single dose study and no accumulation of sulbenicillin was observed. This study provided satisfactory results and confirmed the significant presence of sulbenicillin into bronchial secretions. PMID- 3652281 TI - Treatment of lower urinary tract infections in children: single dose fosfomycin trometamol versus pipemidic acid. AB - Fifty-one children suffering from symptomatic and asymptomatic recurrent urinary tract infections were treated at random in a comparative study. A single dose of 2 g fosfomycin trometamol was administered to 24 children (2 males and 22 females, mean age 6.7 +/- 3.3 yr) and two 200 mg doses of pipemidic acid (400 mg in children weighing more than 25 kg) were administered daily to 27 children (3 males and 24 females, mean age 6.6 +/- 3 yr) for 7 days. Bacteriological results showed that at the end of followup (1 month) urine was sterile in 17 out of 24 children treated with fosfomycin trometamol (70.8%) and in 19 out of the 27 children treated with pipemidic acid (70.3%). One persistant infection and six reinfections were observed in the follow-up period in the fosfomycin group and 8 reinfections in the pipemidic acid group, usually in patients with urinary complications. No side effects were reported. The microbiological study of feces showed that neither of the drugs caused the emergence of resistant bacteria. PMID- 3652282 TI - Relationships between chemical structure and adverse effects of antibacterial and antifungal agents. AB - Chemical structure and adverse effects are presented, including the side chains responsible for platelet inhibitory effects, hypoprothrombinemic effects, the disulfiram effect of some betalactams as well as the structures responsible for the hemotoxic effects of chloramphenicol, the digestive intolerance and hepatotoxic effect of some macrolides, the neurotoxic effects of quinolones, the nephrotoxicity of amphotericin, aminoglycosides, and polymyxin B - colistin. The conclusions to be derived by the prescribing physician are discussed in relation with these aspects. PMID- 3652280 TI - Azlocillin versus azlocillin plus amikacin in the treatment of severe infections in intensive care unit patients. AB - The authors wanted to verify if in clinical practice (Intensive Care Unit patients), the association of azlocillin with an aminoglycoside offers substantial advantages compared to use of azlocillin alone. Their results show that azlocillin alone is potent enough to be used in the treatment of severe infections. PMID- 3652283 TI - A 5-day regimen of cyclophosphamide, adriamycin, platinum (CAP) in refractory breast cancer. AB - The activity of the association of cis-platinum with Adriamycin and cyclophosphamide (CAP), as "rescue" chemotherapy for the treatment of refractory and relapsing advanced breast cancer, is presented. Of 42 evaluable patients, previously treated with chemotherapy +/- hormone therapy, 4 (9.5%) achieved a complete response, 15 (35%) had a partial response (CR + PR = 45%). Major toxicity observed was: nausea and vomiting in 95% of patients and leukopenia in 60%. PMID- 3652284 TI - Characterization of tannic acid metabolites formed in vitro by rat liver microsomes and assay of their carcinogenicity by the microsomal degranulation technique. AB - Tannic acid is converted to four metabolites on incubation with isolated rat liver microsomes. Bis-(3,4,5-trihydroxyphenyl)methanone (I); 3,4,6,7,9,10 hexahydroxy-2,11-epoxy-1,12-(epoxy-methano)-14H , 16H-benzo[b](1,4)benzodioxepino [3,2-g](1,4)benzodioxepin-14,16,17-trione (II) and 1,1,2-trimethyl-1-ethanyl-2 ylidene tris(3,4,5-trihydroxybenzoate) (III) were isolated from the post microsomal supernatant of the incubate while 6,12,18,26,27,29,31,33-octahydroxy 22,22-dimethyl-2,8,14,20-tet raoxapentacyclo (22.2.2.2(4,7).2(10,13).2(16,19) tetratriaconta-4,6,10,12,16,18,24,26,27,29,31,33-dodecene-3, 9,15,21,23-pentone (IV) was found attached with the microsomal fraction. Metabolite (III) was found to be a potential carcinogen on the basis of microsomal degranulation technique. PMID- 3652285 TI - The oxidation of benzo[a]pyrene-7,8-dihydrodiol mediated by lipid peroxidation in the rat intestine and the effect of dietary lipids. AB - This study has demonstrated that the microsomal fraction of the rat small intestinal mucosa has the capacity to catalyse the oxidation of benzo[a]pyrene(BP)-7,8-diol to BP-diol-epoxides (BPDEs) both by a mechanism involving the mixed-function oxidase system (NADPH-dependent) and as a result of the initiation of peroxidation of the membrane phospholipids by ferrous ions, ascorbate and ADP. The NADPH-dependent reaction was fastest in the proximal part of the intestine and resulted in the formation of approximately equal amounts of BPDE I and BPDE II. The lipid peroxidation-catalysed reaction favoured the production of BPDE I and was maximal in the middle region of the intestine, closely paralleling the rate of lipid peroxidation in the intestinal sections. Feeding rats on a cod liver oil diet, rich in C20:5 and C22:6, significantly increased the incorporation of these fatty acids into the microsomal fractions. This resulted in a greatly increased rate of lipid peroxidation in vitro and a significantly higher rate of lipid peroxidation-catalysed BP-7,8-diol oxidation compared to rats fed fat-free, mono-unsaturated lard or corn oil (58% C18:2) diets. Thus the rate of conversion of BP-7,8-diol to its ultimate carcinogenic forms during lipid peroxidation in the intestinal fractions of rats fed a polyunsaturated fat was quantitatively more important than the NADPH-catalysed reaction as measured in vitro. PMID- 3652286 TI - Metabolism and toxicity of anacrotine, a pyrrolizidine alkaloid, in rats. AB - The effects of anacrotine, a pyrrolizidine alkaloid (PA) which has the structure of senecionine with an additional 6-hydroxy group, have been investigated in weanling male rats. When anacrotine was given i.p. (100 mg/kg), pyrrolic metabolites reached a peak level in the liver during the first 0.5 h, then fell rapidly to a lower level which subsequently declined more slowly. Pyrrolic metabolites accumulated in the lungs during the first hour to a level which then remained relatively steady for at least 4 h. The lung level of pyrrolic metabolites after 2 h was about 39% of the liver level, compared with 16% in rats given senecionine. Anacrotine caused acute centrilobular necrosis and congestion of the liver when 125 mg/kg or more was given i.p., but oral doses (up to 180 mg/kg) caused relatively little liver necrosis. Enlarged hepatocytes developed during ensuing weeks, but these were moderate compared with the bizarre giant cells often associated with pyrrolizidine intoxication. In contrast, anacrotine produced much more severe lung damage than most other pyrrolizidine alkaloids. The lungs were affected by i.p. or oral doses well below those needed to produce acute liver damage. Pulmonary congestion and oedema, extensive necrosis of the pulmonary endothelium, and thickening of alveolar septae, developed within 2 days after dosing. After single i.p. doses of 60 mg/kg or more progressive consolidation of lung tissue often led to death after 2-5 weeks. Hearts showed myocardial necrosis of the right ventricular wall. Dehydroanacrotine, the putative reactive pyrrolic metabolite of anacrotine, given i.v. to rats, caused dose-related chronic lung and heart damage identical to that produced by anacrotine, but after lower doses (6-27 mg/kg); larger amounts caused acute lung damage. It is suggested that the severe lung damage in animals given anacrotine is due to dehydroanacrotine, formed in the liver. This metabolite is more stable than the pyrrolic derivatives of most other pyrrolizidine alkaloids, and it is thus able to reach the lungs in relatively large amounts. PMID- 3652287 TI - Studies on fungal products. XI. Isolation and structures of novel cyclic pentapeptides from Aspergillus sp. NE-45. PMID- 3652288 TI - Lipid A and related compounds. XI. New, efficient synthesis of lipid X. PMID- 3652289 TI - Design of new antidepressants, 4-anilinopyrimidine derivatives, based on quantitative structure-activity relationships. PMID- 3652290 TI - Saponins from Chinese folk medicine, "liang wang cha," leaves and stems of Nothopanax delavayi, Araliaceae. PMID- 3652292 TI - Serum pepsinogen levels in normal and experimental peptic ulcer rats measured by radioimmunoassay. PMID- 3652291 TI - Benzoylthiocholine derivatives as substrates for pseudocholinesterase: synthesis and application. PMID- 3652293 TI - Potentiation of host-mediated antitumor activity by a beta-glucan derived from mycelia of Cochliobolus miyabeanus. PMID- 3652294 TI - Studies on dissolution mechanism of drugs from ethylcellulose microcapsules. PMID- 3652295 TI - Gastric-acidity-controlled rabbits: control of gastric pH of rabbits by the use of antacids. PMID- 3652296 TI - Evaluation of crystallite orientation in tablets by X-ray diffraction methods. PMID- 3652298 TI - Technique of measuring rapid water penetration rate into tablets. PMID- 3652299 TI - Changes caused by included enzymes in the constituents of Solanum nigrum berries. PMID- 3652297 TI - Metabolism of 2,4-dinitrotoluene, 2,4-dinitrobenzyl alcohol and 2,4 dinitrobenzaldehyde by rat liver microsomal and cytosol fractions. PMID- 3652300 TI - Alkaline cleavage of ginsenosides. PMID- 3652301 TI - Structure of scuterivulactone D determined by two-dimensional NMR spectroscopy. A new diterpenoid from a Chinese crude drug "ban zhi lian" (Scutellaria rivularis Wall.). PMID- 3652302 TI - An antitumor morphinane alkaloid, sinococuline, from Cocculus trilobus. PMID- 3652303 TI - Synthesis of 5-fluoroarachidonic acid and its biotransformation to 5-fluoro-12 hydroxyeicosatetraenoic acid. PMID- 3652304 TI - [Adapting secondary nursing education to primary nursing]. PMID- 3652305 TI - [My experiences in performing as a responsible nurse]. PMID- 3652306 TI - [Analysis of the social requirements of nurses (I)]. PMID- 3652307 TI - [Biological cleaning procedure and the improvement of operating rooms]. PMID- 3652309 TI - [Pre- and post-operative care of children with congenital malformations of the anus]. PMID- 3652308 TI - [Using the SDS (self-rating depression scale) for observations on depression]. PMID- 3652310 TI - [Care of patients under high frequency jet ventilation]. PMID- 3652311 TI - [Stability of sodium nitroprusside solutions]. PMID- 3652312 TI - [Nursing of patients with venous infusion of sodium nitroprusside]. PMID- 3652313 TI - [Clinical results after proximal selective vagotomy (considerations on 42 cases)]. AB - The authors report the results of a 6-8 year follow-up of 42 patients treated by selective proximal vagotomy with pyloroplasty for gastric or duodenal ulcer disease. On the basis of Visick's classification, the patients broke down into the following categories: Cat. 1: 66.6%; Cat. 2: 26.1%; Cat. 3: 2.3%; Cat. 4: 4.7%, with 92.7% belonging to the first two categories. These data are in agreement with other data reported in the literature, and show no significant differences as compared to follow-up one year after surgery. PMID- 3652314 TI - [Esophageal localization of granulosa cell tumor (presentation of a clinical case)]. AB - The authors report on a case of granular cell tumour localized in the lower third of the thoracic oesophagus. The patient, a 49-year-old male, suffering from symptoms of dysphagia over the previous few months, was treated surgically by thoracotomy enucleation of the neoplasm. Despite its slow growth, this rare benign neoplasm, which probably originates in Schwann's sheath, is a candidate for endoscopic or surgical resection. PMID- 3652315 TI - [Reconstruction of the breast: critical evaluation of surgical technics]. AB - After reviewing the reasons for the increasingly widespread practice of breast reconstruction, the authors describe at some length the most reliable surgical techniques available and, on the basis of the results obtained, suggest an even broader range of indications for this type of surgical therapy. PMID- 3652316 TI - [Aminoglutethimide in the treatment of metastasizing breast carcinoma in old age]. AB - After first analyzing the basic pathophysiological aspects and the mechanism of action of aminoglutethimide, the authors report on their experience with the use of this steroid biosynthesis inhibitor in a group of geriatric patients with advanced cancer of the breast. After illustrating the results of their study, the authors conclude by stressing that the use of this drug appears to improve the quality of life of the patients with a significant increase in rates of complete or partial remission of the neoplastic disease. PMID- 3652317 TI - [Carcinoma of the colon. Statistico-epidemiologic study carried out at Casale Monferrato Hospital]. AB - The authors report here on the results of a statistical and epidemiological review of cases of carcinoma of the large bowel observed in the General Surgery Division of the Casale Monferrato Hospital. After supplying introductory data on the diffusion of the disease, risk factors and statistical aspects, the authors report data on 137 cases of large bowel carcinomatous neoplasms observed and treated over the period 1978-1984, complete with tables summarising the neoplastic localizations aid the types of operation performed. After calculating the operative mortality and both the absolute and relative survival rates, the authors analyze the results of the survey, comparing the findings obtained with those reported in the literature by various authors. PMID- 3652318 TI - [Unusual cause of post-traumatic hemoperitoneum: rupture of enterogenous cysts]. AB - Authors present a rare complication of multiple enteric cystes: hemoperitoneum. A little girl 4 years old was operated on by suspected acute appendicitis. The surgery showed hemoperitoneum by bleeding from broken (post-traumatic) paradigiunal cyst. Other 5 cystes were present near the first one. Authors review shortly some titles of bibliography about duplication of the alimentary tract and hemoperitoneum. PMID- 3652319 TI - [Postoperative treatment of medial meniscectomy with an elastic bandage of the Van Unen type]. AB - On the basis of a clinical review of a consecutive series of 27 medial meniscectomies of the knee, the authors report the results obtained by the systematic use of the Van Unen elastic bandage ii the post-operative period. The use of this technique would appear to be advantageous both as a means of speeding up functional recovery of the joint operated on and as a means of preventing complications of an arthrosynovitic type which are often secondary to early rehabilitation treatments. PMID- 3652320 TI - [Surgical treatment of obesity]. AB - Morbid obesity is a disease of modern society. Surgery is indicated when there is no endocrinopathy, medical treatment failed and Body Mass index (W/H2) is more than 40 (III degree obesity of Garrow). Many different methods were suggested in connection with the type of obesity, the associated diseases and the psychical state of the patient. Jejuno-ileal by-pass intend to produce a generic malabsorption syndrome. Personal experience is however good, possibly due to the blind loop jejunostomy that we always prepare as a conclusion of the operation and which gives an excellent support for the early post-operative time. PMID- 3652321 TI - [Update in transplant surgery with special reference to the problem of organ donation]. AB - The authors analyze the advances made and the current state of the art in transplant medicine and surgery, dealing at some length with the problems relating to organ donation. Particular attention is devoted to the provisions of law currently applicable in this field and those aspects currently under debate, comparing the situation in Italy with that obtaining elsewhere in Europe. The authors also focus on the need to make medical practitioners fully aware of the problem so as to achieve practical collaboration of the type possible today in West Germany. PMID- 3652322 TI - [Preoperative evaluation of the patient candidate for surgical intervention on the chest: methods of study and risk factors]. AB - The authors review the main methods designed to evaluate operability and surgical risk in candidates for chest surgery. They also report on their own experience with 135 cases operated on for thoraco-pulmonary diseases requiring surgery; in these cases, postoperative complications were studied in relation to various respiratory parameters evaluated differentially and as a whole prior to surgery. This study enabled the investigators to establish that patients with CV, FEV1, FEF25-75 and Tiffffeneau Index values below 60% of the respective theoretical reference values run a very substantial risk of postoperative complications, with a post-surgical morbidity rate of more than 60% in such patients. Similar risks are run by patients with VR values below 60% or above 120% of predicted values or with Emphysema Index values above 120% of predicted values. The author's experience with fractional bronchospirometry revealed that, in the high-risk patient sample, a predicted postoperative FEV1 value of only 800 ml/sec is a poorly selective limit. PMID- 3652323 TI - [Primary gastric lymphoma: our experience (clinical contribution)]. AB - The authors analyze a personal study population (11 cases) of primary gastric lymphoma. Whenever possible, more radical surgery was carried out even in severely debilitated patients. Polychemotherapeutic treatment was given after discharge. The mean postoperative survival was 35 months, and the 5-year survival rate was 27.2%. PMID- 3652324 TI - [Our experience in carcinoma of the stomach (clinico-statistical contribution)]. AB - The study population consisted of 168 patients suffering from gastric cancer. The authors conclude that the only way of achieving a satisfactory improvement in the long-term prognosis of this disease is by early diagnosis, greater involvement of general practitioners and rapid referral of patients to a digestive endoscopy unit. PMID- 3652325 TI - [Carbocalcitonin, a new synthetic calcitonin: clinical evaluation]. AB - Fifteen patients suffering from osteoporosis of different aetiology and receiving long-term carbocalcitonin treatment were studied in order to evaluate the tolerance of the drug. Only one of these patients, with intolerance of any type of calcitonin, was obliged to discontinue the treatment, tolerance being excellent in all the others. Blood-chemistry tests, performed at various intervals, revealed no significant changes. Though not part of the specific aim of the study, antalgic efficacy tests yielded excellent results. PMID- 3652326 TI - [Learning experiences for the education of student nurses in the cardiothoracic department]. PMID- 3652327 TI - Job satisfaction and dissatisfaction among registered nurse tutors. PMID- 3652328 TI - [Illness from a social-scientific perspective]. PMID- 3652330 TI - [Euthanasia--a spectrum of attitudes]. PMID- 3652329 TI - Computerized matron's report. The basis of a neonatal information-system. PMID- 3652331 TI - Profiling: a graphic representation of assessment. PMID- 3652332 TI - [Nursing group therapy for persons who attempted suicide]. PMID- 3652333 TI - [Crystallization of tears: a test of the quality of the lacrimal film?]. PMID- 3652334 TI - [Diagnostic imaging and dural fistula of the sphenoidal region: complementarity of magnetic resonance imaging and selective arteriography (1 case)]. PMID- 3652335 TI - [Detachment of the retinal after implantation of an artificial lens in the anterior chamber]. PMID- 3652337 TI - [Significant ptosis in the young child: timing of surgery]. PMID- 3652338 TI - [Report of a trip to the United States]. PMID- 3652336 TI - [Compressive optic neuropathies in eye disease associated with Basedow's disease. Therapeutic problems]. PMID- 3652339 TI - [Complications of phototherapy of macular edema in retinal vein occlusion]. PMID- 3652340 TI - [Eales' syndrome and photocoagulation. Apropos of 29 cases]. PMID- 3652341 TI - [Arterial macro-aneurysms. Use of the photocoagulation]. PMID- 3652342 TI - [Peripheral retinal pseudo-angiomatosis]. PMID- 3652344 TI - [Emergency implantation of a lens after perforation of the anterior lens capsule]. PMID- 3652343 TI - [Emergency treatment of the projection of caterpillar hairs into the cornea]. PMID- 3652345 TI - [Repair of the anterior segment]. PMID- 3652346 TI - [Vitrectomy in post-traumatic intravitreal hemorrhage]. PMID- 3652347 TI - [Hemorrhagic glaucoma and laser therapy]. PMID- 3652348 TI - [Procedure with an intraocular foreign body]. PMID- 3652349 TI - [Eye burn caused by sulfur monochloride]. PMID- 3652350 TI - [Emergencies and AIDS]. PMID- 3652351 TI - [New therapeutic approach to malignant glaucoma]. PMID- 3652352 TI - [Iridocyclosclerectomy for tumor of the ciliary body followed ultimately by cataract extraction and implantation of a lens]. PMID- 3652353 TI - [Value of postoperative phospholine in esotropias]. PMID- 3652354 TI - [Surgical modification of the insertion of the horizontal rectus muscles in alphabetic syndromes or vertical movement with oblique reinsertion of the horizontal rectus muscles]. PMID- 3652355 TI - [Color vision in aphakics and in pseudoaphakics]. PMID- 3652356 TI - [Ophthalmologic tests during deep diving to the saturation point]. PMID- 3652357 TI - [Eye disease associated with Basedow's disease and plasmapheresis]. PMID- 3652358 TI - [Seasonal and chronic allergic conjunctivitis in adults with children. Multicenter evaluation of the collyrium N-acetylaspartylglutamic acid (NAAGA) in ophthalmologic and allergy practices]. PMID- 3652359 TI - [Procedure in congenital microphthalmos. Apropos of 10 cases]. PMID- 3652360 TI - [Pseudoxanthoma elasticum and streaked multicolored fundus oculi]. PMID- 3652361 TI - [2 cases of mitochondrial cytopathy manifested ophthalmologically]. PMID- 3652362 TI - [Treatment of traumatic recurrent hyphema with sodium hyaluronate]. PMID- 3652363 TI - [Isolated macular hypoplasia]. PMID- 3652364 TI - [Occlusion of the lacrimal puncta as treatment in obstruction of the nasolacrimal duct]. PMID- 3652365 TI - [Diagnostic and therapeutic approach to ptosis, by disinsertion of the aponeurotic fascia of the retractor muscle]. PMID- 3652366 TI - [An undesirable effect of a beta-blocker]. PMID- 3652367 TI - [Electrophysiological examinations are sometimes useful]. PMID- 3652368 TI - [Diplopia disclosing an aberrant lacrimal gland]. PMID- 3652369 TI - [External oculomotor nerve paralysis in Hodgkin's disease]. PMID- 3652370 TI - [Malignant melanoma of the iris in a 16-year-old girl]. PMID- 3652371 TI - [Trabeculoretraction and anti-inflammatory agents]. PMID- 3652372 TI - [Perforating ocular injuries in children. Prognostic study apropos 79 cases]. PMID- 3652373 TI - [Ocular injuries in children]. PMID- 3652374 TI - [Implant-laser compatibility. Some considerations]. PMID- 3652375 TI - Biological and biochemical characterization of cell lines derived from initiation promotion transformed C3H/10T1/2 cells. AB - A two-stage transformation protocol was used to chemically transform the mouse embryo fibroblasts, C3H/10T1/2 Cl 8. To initiate the cells 0.37 microM 20 methylcholanthrene was used and 0.17 microM of the tumor promoter 12-O tetradecanoyl-phorbol-13-acetate was employed to complete the transformation process. Six weeks later transformed foci were identified and isolated by the ring-cloning technique. Altogether eight different foci were trypsinized resulting in a total of 12 morphologically transformed subclones. Three of these clones, designated TPA 41, TPA 42 and TPA 482, have been characterized in detail. Their growth morphologies were different. The TPA 482 cells grew in a criss-cross pattern with piled up foci, thus showing a characteristic type III morphology. The TPA 482 clone did not show cell-density growth inhibition and grew in soft agar. The TPA 41 and TPA 42 clones exhibited cell-density growth inhibition, grew as monolayers and formed only few colonies in soft agar. Late passages of the TPA 42 clone acquired growth characteristics similar to TPA 482. The C3H/10T1/2 Cl 8 and the TPA 41 cells were not tumorigenic when transplanted into syngeneic mice. TPA 482 cells were strongly tumorigenic, producing tumors in 6/6 mice in 21 days. The TPA 42 cells were also tumorigenic, the first tumors appearing after 4 weeks; all animals injected with TPA 42 cells had tumors after 8 weeks. All tumors observed appeared to be fibrosarcomas. Flow cytometric analysis indicated differences in DNA distributions between tumor cells grown in vitro and the tumors in vivo. Two-dimensional gel analysis of the total cellular and the nuclear proteins showed an increase in the TPA 42 and TPA 482 cells of an acidic 48,000 and a basic 83,000 mol. wt polypeptides, and a decrease of a neutral polypeptide of mol. wt 46,000, located in the nucleus of TPA 482 cells. PMID- 3652376 TI - The effects of low-energy 60-Hz environmental electromagnetic fields upon the growth-related enzyme ornithine decarboxylase. AB - People living in the industrial society of today are unavoidably exposed to low energy electromagnetic (EM) radiation. The potential risk to human health of such exposure has received much study. In this regard, numerous epidemiological studies have linked exposure to low-energy EM fields to increased cancer risk. We investigated the ability of low-energy 60-Hz EM fields to alter the activity of ornithine decarboxylase (ODC) in a number of established cell lines. The activity of ODC, the controlling enzyme in polyamine biosynthesis, has been shown to be elevated in growing cells or tissues and during the process of tumor promotion. A 1-h exposure to a 60-Hz EM field of an intensity of 10 mV/cm produced a 5-fold increase in ODC activity in human lymphoma CEM cells and a 2- to 3-fold increase in mouse myeloma cells (P3) relative to the unexposed cultures. Depending upon the cell type, ODC activity increased during the 1-h exposure period and remained elevated for several hours after the field exposure ended. In another series of experiments, fields of an intensity as low as 0.1 mV/cm for a 1-h period produced a 30% increase in the activity of ODC in Reuber H35 hepatoma cells grown in monolayer culture. In the H35 cells, continuous exposure to the 60-Hz EM field (10 mV/cm) for periods of 2 and 3 h resulted in either no increase in ODC activity (2 h) or a decrease in enzyme activity (3 h) compared to the unexposed control cultures. The data is discussed in relation to possible molecular mechanisms of field-cell interaction, the importance of the exposure intervals altering cellular ODC activity and the potential ability of 60-Hz EM fields to serve as a tumor promoting stimulus. PMID- 3652377 TI - Effect of snuff and nicotine on DNA methylation by 4-(methylnitrosamino)-1-(3 pyridyl)-1-butanone. AB - In this study we assayed the effects of snuff and nicotine on the DNA methylation by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), a powerful tobacco specific N-nitrosamine. Male F344 rats were pretreated for 2 weeks with either a solution of a snuff extract or 0.002% nicotine in the drinking water. Subsequently, the rats were given a single dose of NNK and the effects of snuff and nicotine on the methylation of guanine by NNK in the DNA of target organs of this carcinogenic nitrosamine were determined. Formation of 7-methylguanine in the liver, nasal mucosae and oral cavity and of O6-methylguanine in the liver and oral cavity was much lower in the rats pretreated with snuff extract than in those not pretreated. On the other hand, pretreatment of the rats with nicotine had no significant effect on the methylation of DNA by NNK nor on the elimination constants of NNK and its major metabolite 4-(methylnitrosamino)-1-(3-pyridly)-1 butanol. PMID- 3652378 TI - Modulation of a membrane-associated marker in progenitor cells of human pancreas carcinoma. AB - For the identification of early steps in the multiphasic process of human pancreas carcinogenesis we have developed a panel of monoclonal antibodies to normal and carcinogen-treated human pancreas cells. One of these, an IgG3 with strong affinity for a membrane-associated 46 kd protein (p-46) in progenitor cells of methylnitrosourea (MNU)-treated human pancreas, was purified by h.p.l.c. and used to study the modulation of this marker in human pancreas carcinogenesis. This protein was undetectable in adult human pancreas, appeared on the cell surface of a small subpopulation of human pancreas explants exposed to MNU, persisted in proliferating cells in hyperplastic foci, and was abundant in anaplastic cells in this model. This marker was associated with cytoplasmic and nuclear membrane of all cells in non-tumorigenic and tumorigenic cell lines derived from these explants. It was present in primary carcinomas of human pancreas but absent in normal pancreas adjacent to tumors. This p-46 marker appears to be organ and species specific since it was undetectable in other normal tissues and their neoplastic counterparts. PMID- 3652379 TI - N-methylation reduces the DNA-binding activity of 7H-dibenzo[c,g]carbazole approximately 300-fold in mouse liver but only approximately 2-fold in skin: possible correlation with carcinogenic activity. AB - N-methyl-dibenzo[c,g]carbazole (MeDBC) lacks the potent hepatocarcinogenic activity in mice characteristic for 7H-dibenzo[c,g]carbazole (DBC), while both compounds are local carcinogens, leading to papilloma and carcinoma formation in skin after topical application. Because DNA binding is considered an essential step in the initiation of chemical carcinogenesis, the DNA adduction by MeDBC was compared with that by DBC in mouse liver and skin via a 32P-postlabeling technique. Both compounds elicited chromatographically similar adducts in liver; however, the extent of total DNA binding of DBC was 343- and 265-fold greater than that of MeDBC 24 h after topical and i.p. administration, respectively, of a 37 mumol/kg dose. In skin, the adduct pattern elicited by either compound after topical application was different from that seen in liver, and three of four adducts derived from MeDBC were chromatographically distinct from those produced by DBC. Quantitative analysis revealed that total adduction in skin by DBC was 2.3-fold higher than by MeDBC. When the adduct levels were compared between liver and skin, topically applied MeDBC bound preferentially to skin versus liver DNA by a factor of 10, while the opposite was true for DBC. These data are in agreement with the carcinogenicity reported for DBC and MeDBC and support the hypothesis that the extent of covalent DNA modification by these compounds is associated with their biological activity. We conclude that an unsubstituted nitrogen is essential for the genotoxic activity of DBC in liver but not skin. The results also demonstrate the potential of the 32P-postlabeling assay in predicting the organotropism of closely related carcinogens. PMID- 3652380 TI - Substituted hydroxyphenanthrenes in opium pyrolysates implicated in oesophageal cancer in Iran: structures and in vitro metabolic activation of a novel class of mutagens. AB - Previous epidemiological and laboratory studies have indicated an association between the ingestion of opium pyrolysates, dietary deficiencies and the high incidence of oesophageal cancer in subjects in north-east Iran. Pyrolysates of opium, and particularly of morphine, a major opium alkaloid, were both shown to contain similar highly mutagenic substances that were also clastogenic in mammalian cells and which transformed hamster embryo cells in culture. We now report the isolation and characterization of nine of the most abundant mutagenic compounds present in morphine pyrolysates, using h.p.l.c, GC-MS and n.m.r. spectroscopy. The hitherto unknown compounds, all containing a hydroxyphenanthrene moiety, were identified as: I, 3-methyl-3H-naphth[1,2-e]indol 10-ol; II, 1,2-dihydro-3-methyl-3H-naphth[1,2-e]indol-10-ol; III, 1-methyl-1H naphth[2,1-g]indol-10-ol; IV, 2-methylphenanthro[3,4-d]-[1,3]oxazol-10-ol; V, 6 methylaminophenanthren-3-ol; VI, 2-methyl-3H-phenanthro[3,4-d]imidazol-10-ol; VII, 1,2-dimethyl-1H-phenanthro[3,4-d]imidazol-10-ol; VIII, 2,5-dimethyl-3H phenanthro[3,4-d]imidazol-10-ol; and IX, 2-ethyl-3H-phenanthro[3,4-d]imidazol-10 ol. Structures for the heterocyclic rings of compounds IV and VI to IX are tentative. Mutagenicity in Salmonella typhimurium TA98 in the presence of rat liver homogenates increased in the order listed and ranged over four orders of magnitude, IX being 1000 times more active than benzo[a]pyrene. Compounds I and VII were converted by rat liver 9000 g supernatant into phenols and dihydrodiols, implicating arene oxides as ultimate mutagens. The formation and reaction of these arene oxides was shown by trapping experiments in vitro with ethanethiol and subsequent characterization of the ethyl sulfide reaction products. The order of biological activity of compounds I-IX, dependent on the structure of the heterocyclic ring, suggests that carbocations, resonance-stabilized as quinone methides, are their ultimate reactive metabolites. Our results lend additional support to the role of opium pyrolysates as an etiological factor in oesophageal cancer in north-east Iran. PMID- 3652381 TI - MNNG-induced partial phenotypic reversion of Mer- cells. AB - The effect of pretreatment with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) on MNNG sensitivity of the surviving population was compared in two HeLa lines, one of the Mer+ phenotype (HeLa S3) and one of the Mer- phenotype (HeLa MR). Whereas MNNG pretreatment of HeLa Mer+ cells had no effect on the MNNG sensitivity of surviving cells, Mer- cells surviving a first exposure to MNNG became much more resistant to MNNG. Comparison of the sensitivity of individual HeLa MR clones with their MNNG-pretreated population and analysis of the composition of the pretreated population showed that the majority of cells surviving the MNNG pretreatment now displayed the Mer+ phenotype in respect to sensitivity to MNNG. One MNNG-resistant clone derived from a pretreated HeLa MR population (Cl 4) was characterized further. It had a similar sensitivity to the Mer+ line to all monofunctional alkylating agents, but was as sensitive as the Mer- line to the crosslinking agent chloroethylnitrosourea. Cl 4 cells, like the Mer- cells, did not repair O6-methylguanine (O6MeG). The results suggest that the two characteristics which are usually coupled with the Mer- phenotype--lack of O6MeG repair and hypersensitivity to MNNG--can be separated. PMID- 3652382 TI - Dietary zinc deficiency increases the methylbenzylnitrosamine-induced formation of O6-methylguanine in the esophageal DNA of the rat. AB - Dietary zinc deficiency in combination with environmental exposure to methylbenzylnitrosamine (MBN) is associated with an increased incidence of esophageal carcinoma in man. The proposed mechanism of MBN-induced esophageal carcinoma is through metabolic activation of MBN to form benzaldehyde, and a carbonium ion which methylates DNA. MBN is known to methylate DNA forming O6 methylguanine (O6-MeG) adducts. These adducts can induce guanine to adenine point mutations and such mutations are responsible for certain carcinogen-induced tumors. Rats maintained on a zinc-deficient diet exhibit an increased incidence of MBN-induced esophageal carcinoma when compared with ad libitum and pair-fed controls. The caloric restriction of the pair-fed controls was associated with a lower incidence of MBN-induced esophageal carcinoma than was observed in the ad libitum controls. These differences in tumor incidence were associated with alterations in the formation and clearance of MBN-induced esophageal O6-MeG. Weanling male Sprague-Dawley rats were raised on egg protein diets containing 2.3 p.p.m. zinc (low zinc) or 50 p.p.m. zinc (control). One group of control animals was fed the control diet ad libitum and a second group pair-fed the control diet to match the intake of the zinc-deficient group. After 3 weeks on the diets the animals were injected with a single dose of MBN (2.0 mg/kg b.w.) and levels of esophageal O6-MeG were determined after 1, 3, 6 and 24 h. O6-MeG was significantly higher in the zinc-deficient animals than in controls, with the pair-fed controls demonstrating O6-MeG levels lower than the ad libitum controls. Thus, dietary zinc deficiency results in significantly increased levels of MBN induced esophageal O6-MeG, and caloric restriction results in decreased levels of MBN-induced esophageal O6-MeG. These changes in esophageal O6-MeG may in part explain the increased incidence of MBN-induced esophageal carcinoma observed with dietary zinc deficiency. PMID- 3652383 TI - Magnetic semi-permeable polyethyleneimine microcapsules for monitoring of N nitrosation in the gastrointestinal tract. AB - Semi-permeable polyethyleneimine (PEI) microcapsules were developed recently for trapping unstable electrophilic products in the gastrointestinal tract. Their N nitrosation has been investigated in vitro and in vivo in the present study. At acid pH N-nitrosation was found to be linearly dependent on nitrite concentration, without a pH maximum. Up to 70% of the nitrosating agent was converted to N-nitroso products that were retained in the microcapsules and detected by a total N-nitroso assay procedure. Microcapsules prepared with different formulations (in order to vary membrane characteristics) provided a limit of detection in the range 1-10 nmol N-nitrosating agent and were also found to have a different capacity for N-nitrosation. Based on n.m.r. data it seems that such N-nitrosation is favoured by the incomplete protonation of this polyamine at acid pH and that nitrosation occurs at the least hindered secondary amine functions. Microcapsules were administered intragastrically in doses of 2 or 6 million to rats also receiving nitrite in the drinking water and were recovered magnetically from faeces. Relative to the maximum possible yield of N nitrosated microcapsules that could have been excreted within the first 24 h, the excretion (maximum 4.9%) was found to depend on number of capsules administered and the time of administration relative to access to nitrite. Although performed with only a few animals, these preliminary data indicate a performance possibly superior to existing endogenous nitrosation indicators, and a dual purpose system to trap both nitrosating agents and their direct-acting DNA-damaging N-nitroso products. PMID- 3652384 TI - Fecal mutagen fecapentaene-12 damages mammalian colon epithelial DNA. AB - Fecapentaenes are fecal mutagens that are naturally produced in the human colon and have been shown to be highly mutagenic in the Ames assay system. However to date no studies have been reported regarding the effects of fecapentaene in the target epithelium. In vivo studies with fecapentaene-12 (FP-12) using Fischer 344 rats in our laboratory indicate that a concentration of 10(-6) M FP-12 is capable of inducing a 2.7-fold increase (P less than 0.001) in [3H]-thymidine incorporation into DNA. Autoradiographic studies demonstrate a similar (2.6-fold) increase in the labelling index but an 8.8-fold reduction in the mitotic rate in colonic epithelial cells. Results of DNA single-strand breakage measurements show that in vivo treatment with FP-12 at concentrations of 1 microM introduces a 16 fold increase (P less than 0.001) in the number of alkali-labile sites over controls. Similar studies in in vitro assays indicate a linear trend in the number of alkali-labile sites over a range of concentrations varying from 1 nM to 1 microM. These findings indicate that the fecal mutagen FP-12 induces damage in situ to nucleic acids and thus may play a role in neoplastic transformation of the colon. PMID- 3652385 TI - Promotion of C3H/10T1/2 morphological transformation by polychlorinated dibenzo-p dioxin isomers. AB - Few of the seventy-five chlorinated dibenzo-p-dioxin isomers present in the environment have been adequately characterized for their carcinogenic potential. In previous studies we observed that the carcinogenic dioxin isomer 2,3,7,8 tetrachlorodibenzo-p-dioxin promoted cell transformation when continuously applied to C3H/10T1/2 cells initiated by treatment with N-methyl-N'-nitro-N nitrosoguanidine (MNNG). The current study was undertaken to evaluate the response of the C3H/10T1/2 cell transformation system to several other dioxin isomers of known carcinogenic potential. 1,2,3,6,7,8- and 1,2,3,7,8,9 hexachlorodibenzo-p-dioxin (HCDD) (1-1000 nM) and 2,7-dichlorodibenzo-p-dioxin (0.1-20 microM) failed to transform C3H/10T1/2 cells or to initiate transformation in cultures subsequently treated with the tumor promoter 12-O tetradecanoylphorbol-13-acetate. Continuous exposure of MNNG-initiated cultures to 2,7-DCDD (1-5000 nM) produced elevated but not statistically significant numbers of transformed foci at the highest dose tested. 1,2,3,6,7,8- and 1,2,3,7,8,9-HCDD were promoters of transformation when applied at concentrations greater than or equal to 12 and 40 pM, respectively, to C3H/10T1/2 cultures initiated with MNNG. Maximum responses for both HCDD isomers were attained at concentrations between 120 and 400 pM. These studies suggest that the C3H/10T1/2 cell transformation system may provide a relevant in vitro model for the identification and study of carcinogenic dioxin isomers. PMID- 3652386 TI - Subpopulations of human bronchial epithelial cells in culture respond heterogeneously to 12-O-tetradecanoylphorbol-13-acetate (TPA) and other modulators of differentiation. AB - A greater understanding of the processes involved in the control of proliferation and differentiation should provide insight into the mechanisms involved in carcinogenesis. Studies were undertaken to examine the effects of modulators of differentiation on the proliferation, colony forming efficiency (CFE), and cross linked envelope (CLE) formation of human bronchial epithelial (HBE) cells in culture. Treatment for 24 h with a low concentration of TPA (0.1 ng/ml) induced a 2-fold increase in CLE but little inhibition of CFE, suggesting that these two endpoints might be occurring independently of one another. Continuous culture in a low concentration of TPA (0.1 ng/ml) arrested growth in greater than 99% of the cells, but after 10-14 days, a few colonies were observed that were resistant to TPA. This TPA resistant subpopulation occurred at a frequency of less than 0.1% of the cells seeded into cultures. Short term treatment (24 h) with fetal bovine serum (FBS; 1-8%) or calcium (0.5-2 mM) resulted in 2-4 fold increases in CLE with no significant change in CFE. Continuous treatment with FBS or calcium for up to 5 days produced similar results. These findings suggest that different subpopulations of cells exist within cultures of HBE cultures, perhaps at different states of maturation, and that these subpopulations respond differently to modulators of differentiation. PMID- 3652387 TI - Possible dissociation of the phorbol ester-induced oxidant response and tumor promotion in the F1 offspring of SSIN x C57BL/6J mice. AB - The F1 progeny of a cross between 12-O-tetradecanoyl-phorbol-13-acetate (TPA) tumor promotion-sensitive SSIN mice and TPA promotion-resistant C57BL/6J mice were found to be sensitive to TPA as a tumor promoter. The tumor response was substantial, with an average of 15 papillomas per mouse and a 100% incidence following initiation with 400 nmol dimethylbenz[a]anthracene and promotion with 6.5 nmol (4 micrograms) TPA. To determine whether tumor promotability of the F1 mice correlates with other parameters believed to be associated with TPA responsiveness, oxidant generation, epidermal hyperplasia and edema were compared in the parents and F1 hybrids. The SSIN produced a strong hyperplastic response to TPA, the C57BL/6J a negligible response and the F1 hybrids a moderate response. In the SSIN, 6.5 nmol (4 micrograms) TPA caused an 18% increase in the water content of the skin (edema) while no change was seen for either the C57BL/6J or F1 hybrids. The oxidant response of the F1 hybrids to either TPA or phospholipase C was markedly less than that observed for the SSIN and was similar to the response previously observed for the C57BL/6J mice. These findings suggest that the oxidant response may not be an essential aspect of TPA tumor promotion. It may be related to the edema response, suggesting that at least this aspect of inflammation is not necessary for promotion. PMID- 3652388 TI - Mechanism of N-acetylcysteine (NAC) and other thiols as both positive and negative modifiers of MNNG-induced mutagenicity in V79 Chinese hamster cells. AB - Carcinogenic xenobiotics can be detoxified by nucleophilic thiols, which interact directly or through enzyme catalyzed reactions with electrophilic metabolites/compounds or metabolically produced oxidants. Formation of such conjugates is assumed to be a dominating competitive pathway reducing the mutagenic and carcinogenic effects of several known carcinogens. In the case of the potent carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) the situation is different since this carcinogen is transformed to reactive intermediates by nucleophilic agents such as thiols. As a consequence of this, the modulating effect of thiols has to be discussed in relation to the reaction kinetics of this nitroso compound. In this report we present data on the mutagenicity of MNNG which was enhanced by intracellular excess of glutathione, achieved by pre treatment with N-acetylcysteine, cysteine and glutathione. Depletion of GSH by treatment with diethylmaleate or buthioninesulfoximine resulted in a decreased mutagenic effect of MNNG. A decreased effect of MNNG was also obtained by extracellular excess of thiols. The modification of MNNG-mutagenicity was compared to the effect of thiols on the mutagenicity of N-methyl-N'-nitrosourea (MNU) in V79 Chinese hamster cells. No effect of the thiols could be detected on the mutagenicity of MNU, indicating that the intermediates of MNU and MNNG react, in agreement with the reaction kinetics, in favour of water and thiols become less important. The results indicate that the activation of MNNG to mutagenic intermediates is occurring within the cells. This activation is mediated by reaction of MNNG with thiols (and amines) and subsequent release of short-lived alkylating intermediates. The mutagenic effect of MNNG can be reduced or enhanced respectively by decreasing or increasing the intracellular thiol levels. As demonstrated with MNU, intracellular thiol concentrations (in milli/molar range), which is high enough to bring about the activation of MNNG, are not sufficiently high to protect DNA from damage by the alkylating intermediate. Extracellular levels of thiols 'protect' the cells simply by increasing the decomposition of MNNG in the treatment solution. PMID- 3652389 TI - Binding of 2-amino-3-methylimidazo[4,5-f]quinoline to hemoglobin and albumin in vivo in the rat. Identification of an adduct suitable for dosimetry. AB - Blood protein binding by the food-borne carcinogen 2-amino-3-methylimidazo[4,5 f]quinoline (IQ) was investigated using male Sprague-Dawley rats. Among the many blood proteins modified in rats dosed intragastrically with [3H(G)]IQ, hemoglobin and albumin were modified in a dose dependent fashion. Albumin bound 3-5 times more IQ than hemoglobin at doses from 2 to 150 mumol. IQ-modified serum albumin was enzymatically digested using Pronase and analyzed by h.p.l.c. Many peptide fragments containing radioactivity were detected but the low level of protein modification (0.01-0.04% of dose) prevented spectroscopic analyses of these adducts. An in vitro system containing hepatic microsomes metabolized IQ to a reactive species which could bind to serum albumin. One major adduct was formed at the cysteine residue using this activation system and was identical to an adduct isolated from in vivo-modified albumin. Chemical and spectroscopic analyses of the Pronase fragment proved the adduct was a tripeptide containing N2 cysteinesulfinyl-IQ. A chemically identical adduct was formed in vitro when N hydroxy-IQ was incubated with serum albumin. As much as 10% of the IQ bound to serum albumin in vivo was present as this sulfur-linked adduct based on h.p.l.c. analysis of the Pronase digest fragments and on the acid-labile activity which could be recovered as IQ. PMID- 3652390 TI - Possible mycological etiology of oral mucosal cancer: catalytic potential of infecting Candida albicans and other yeasts in production of N nitrosobenzylmethylamine. AB - Yeasts were isolated from 12 cases of oral precancerous lesions (leukoplakia and erythroleukoplakia) by sampling the lesion as well as normal mucosa of each patient, yielding 21 strains of Candida albicans belonging to 15 biotypes, two strains of C. tropicalis, one strain of C. parapsilosis and two strains of Torulopsis glabrata. Biopsies were obtained from the lesions for histologic examination. The catalytic potential of the yeast strains to form N nitrosobenzylmethylamine (NBMA) from the precursors N-benzylmethylamine and nitrite was assessed at pH 6.8. The NBMA produced was identified and quantitated by h.p.l.c. and confirmed by g.c.-m.s. Nitrosation rates were calculated as total nitrosamine subtracted the chemically produced nitrosamine, and related to number of yeast cells. The yeast strains differed in nitrosation potential (P less than 0.001), ranking from 0 to 1.2 micrograms NBMA/10(6) cells. Candida albicans strains, belonging to the biotypes 051, 147, 151, 153, 157 and 353, which constitute more rarely occurring biotypes, exhibited the highest nitrosation potential. Candida tropicalis, C. parapsilosis and T. glabrata were ranked lower. Strains with high nitrosation potential were generally isolated from lesions with more advanced precancerous changes. The yeast cells were present in the superficial part of the epithelium of the lesions as branching mycelium, and in some cases extending from the mucosal surface to the deeper epithelial cell layers. This might represent a fungal transportation system which could channel precursors in the saliva at the mucosal surface to the deeper part of the epithelium where the produced nitrosamine could be deposited. Thus, further evidence is provided supporting the hypothesis that certain strains of C. albicans and of other yeasts play a causal role in the development of oral cancer, by means of endogenous nitrosamine production. PMID- 3652392 TI - Thoracic peridural block in experimental endotoxin shock. AB - The influence of thoracic peridural block (PDB) on the metabolic and hemodynamic changes in endotoxin shock were investigated in rabbits. During the first 6 h of endotoxin shock, sensomotoric and sympathetic blockade distal to spinal segment T4 was achieved by intermittent administration of bupivacaine into a thoracic peridural catheter. The increase of plasma glucose, lactate, and free glycerol 2 h after endotoxin (50 micrograms/kg) administration was prevented by PDB. Animals with PDB had an accelerated clearance of glucose as indicated by a shorter plasma half-life of intravenously injected glucose (0.33 g/kg) 1 h after endotoxin administration. Hemodynamic parameters were measured during the first 210 min after endotoxin application. Compared with controls, PDB reduced mean arterial pressure and total peripheral resistance. PDB did not affect the initial increase of right ventricular pressure or the progressive decrease in O2 consumption and cardiac output after the endotoxin injection. The mortality at 24 h was not significantly reduced by the PDB (controls, n = 22: 68%; PDB, n = 21: 57%). The results demonstrate that thoracic PDB effectively blocks the sympathetic response in endotoxin shock. Hence, PDB causes peripheral vasodilatation, and, moreover, the metabolic data are consistent with an inhibition of the reactive glycogenolytic and lipolytic responses in shock. Although PDB altered the metabolic disturbances caused by endotoxin shock, mortality was not significantly affected. PMID- 3652391 TI - Chemopreventive and antineoplastic activity of N-homocysteine thiolactonyl retinamide. AB - N-homocysteine thiolactonyl retinamide was synthesized from trans retinoic acid and the free base of homocysteine thiolactone. In doses of 90-1800 mg/kg given i.p. in mixed lipid vehicle over nine weeks, the compound decreased to 60% of controls the number of lung tumors which was induced in A/J mice by 20 mg of ethyl carbamate. The highest dose also decreased the mean volume of lung tumors to 50% of controls, resulting in a total tumor volume of 30% of controls. Retinoic acid itself at 450 mg/kg was toxic, and no chemopreventive activity was observed. The free base and the lipophilic perchlorate salt of homocysteine thiolactone both increased the number of lung tumors to 114-117% of controls, indicating a co-carcinogenic effect. In C57BL/6N mice with transplanted MUO4 rhabdomyosarcoma, N-homocysteine thiolactonyl retinamide in a dose of 1000 mg/kg given over 11-21 days decreased the weight of the tumors to 30-70% of controls. These results show that N-homocysteine thiolactonyl retinamide has chemopreventive activity against chemical carcinogenesis and antineoplastic activity against a transplanted neoplasm. PMID- 3652393 TI - Plasma catecholamines following cecal ligation and puncture in the rat. AB - Peripheral sympathetic responses to septic peritonitis and developing septic shock were studied in conscious rats by measuring plasma catecholamines. Adult male Holtzman rats in the fasted state were subjected to anesthesia for implantation of carotid artery cannulae and were divided into three groups: (1) controls with cannulation only, (2) abdominal laparotomy control, and (3) cecal ligation and puncture (CLP) following cannulation. Arterial plasma levels of epinephrine were significantly (P less than .05) elevated at 5 h post-CLP whereas elevations at 16, 20, 24 and 41 h post-CLP were not significant. Plasma NE levels were significantly (P less than .05) elevated at 5, 16, 20, 24 and 41 h post-CLP. Adrenal medullary content of E was not different from control at 20 h following CLP, suggesting that adrenomedullary depletion could not account for low levels of plasma E during developing septic shock. Heart rate was significantly elevated (P less than .05) at 20 h post-CLP and was attenuated by (cardioselective) beta blockade. Mean blood pressure was not altered by CLP treatment. These findings are consistent with the interpretation that there are elevations in local nerve stimulated release of NE in peripheral tissues during septic peritonitis. PMID- 3652394 TI - Experimental gram-negative pneumonia produces a hyperdynamic septic profile. AB - General anesthesia (GA) and extensive surgery undertaken to reproduce a hyperdynamic septic shock syndrome (HSSS) may confound the observed effects of pure HSSS. A large animal model of HSSS without GA or surgery was created in sheep following production of a Pseudomonas pneumonia by direct bronchoscopic instillation into a dependent lobe using only light ketamine anesthesia. Cardiac output rose significantly (5.05 to 6.32 L/min) while SVR [1,421.4 to 1,000.5 dynes X s X cm(-5)] and mean BP (92.5 to 82.0 mmHg) fell in the septic animals. Systemic infection was confirmed by blood culture. This model reliably produces hyperdynamic sepsis without the confounding effects of GA or extensive surgery. PMID- 3652395 TI - White blood cell plugging and blood flow maldistribution in the capillary network of cat cerebral cortex in acute hemorrhagic hypotension: an intravital microscopic study. AB - The behavior of white blood cells (WBCs) in the capillary network of the cat brain was studied under normal conditions and during acute hemorrhagic hypotension. A small transilluminated area of the cerebral cortex was observed directly, and blood cells flowing through the capillary network were recorded on cinefilm using a high-speed cinecamera. The cell motion was analyzed on the projection screen using a frame-by-frame method. The time during which a single WBC remained at a capillary branching, ie, stagnant time (ST) was examined in detail. In hemorrhagic hypotension, ST was much longer than that in the normal condition. WBC plugging occurred at capillary branchings, and a nonuniform flow pattern (plasma-WBC-accumulated red blood cells [RBCs]) appeared in perfused capillaries. RBC velocity in capillaries was reduced. The ST level was increased significantly with a decrease in RBC velocity. These findings suggest that acute hemorrhagic hypotension may induce flow maldistribution in cerebral microcirculation. PMID- 3652396 TI - Effect of fibronectin supplementation in endotoxic shock in the dog. AB - An earlier study by our group demonstrated significant amelioration of hypotension, hypoglycemia, and acidosis in dogs treated with purified human plasma fibronectin prior to induction of endotoxic shock. The present study was completed to determine whether treatment with purified human plasma fibronectin 1 hr after induction of endotoxic shock would provide similar benefits. To this end, selected hemodynamic, pulmonary, acid-base, metabolic, hematological, and serum chemistry parameters were monitored for 6 hours in two groups of anesthetized dogs in Escherichia coli endotoxic shock. One group was given an intravenous injection of purified human plasma fibronectin, and the other received an equal volume of saline 1 hr after shock induction. Between-group analysis of the data revealed no significant differences between any parameter excepting modest differences in plasma glucose, albumin, alkaline phosphatase, and BUN concentrations. However, even these differences, although statistically significant, were sporadic and unimpressive. This study suggested that treatment of dogs with fibronectin during gram-negative endotoxic shock was not efficacious. PMID- 3652397 TI - Synchronous occurrence of spontaneous localized calcium release from the sarcoplasmic reticulum generates action potentials in rat cardiac ventricular myocytes at normal resting membrane potential. AB - Under certain conditions, spontaneous release of Ca2+ from the sarcoplasmic reticulum occurs in resting mammalian myocardium. In single rat ventricular myocytes, such spontaneous Ca2+ release appears localized rather than homogeneous. When the increase in cytosolic Ca2+ is present in a single locus within a cell, it causes a small depolarization, which, at the normal resting potential, is subthreshold for generating an action potential. However, when spontaneous Ca2+ release occurs simultaneously at more than a single discrete locus, the resultant sarcolemmal depolarization is augmented to levels that can induce an action potential, even when this depolarization begins at the normal resting membrane potential. Thus, the synchronous occurrence of multifocal localized increases in cytosolic Ca2+ due to spontaneous Ca2+ release from the sarcoplasmic reticulum within ventricular myocytes is a mechanism for "abnormal automaticity." PMID- 3652399 TI - Calcium and magnesium transport by in situ mitochondria: electron probe analysis of vascular smooth muscle. AB - The extent, time course, and reversibility of mitochondrial Ca2+ uptake secondary to cellular Ca2+ influx stimulated by massive Na+ efflux were evaluated by electron probe microanalysis of rabbit portal vein smooth muscle. Strips of portal vein were Na+ loaded for 3 hours at 37 degrees C in a K+-free 1 mM ouabain solution, after which rapid Na+ efflux was induced by washing with a Na+-free K+ Li+ solution (1 mM ouabain). Li+ washing Na+-loaded portal vein produced a large transient contraction accompanied by an increase (over 100-fold) in mitochondrial Ca2+ and also significant (p less than 0.05) increases in phosphorus and Mg2+. The Ca2+ loading of the mitochondria was reversed during prolonged Li+ wash, and by 2 hours, mitochondrial Ca2+, Mg2+, and phosphorus had returned to control levels. The maximal contractile response to stimulation remained normal, demonstrating that pathologic Ca2+ loading of mitochondria is reversible in situ and compatible with normal maximal force developed by the smooth muscle. Mitochondrial Ca2+ and phosphorus uptake were reduced but still significant when the Li+ wash contained 0.2 mM Ca2+ or when ouabain was omitted. The fact that mitochondrial Ca2+ loading accompanied submaximal contractions during 0.2 mM Ca2+ Li wash suggests "supranormal" affinity of mitochondria for Ca2+ and may be due, in part, to reverse operation of the mitochondrial Na+-Ca2+ exchanger. Mitochondrial Ca2+, Mg2+, and phosphorus uptake were eliminated when the Li+ wash was performed at 2 degrees C or when the wash contained no Ca2+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652398 TI - Forward and inverse electrocardiographic calculations using resistor network models of the human torso. AB - An automated method of modelling the electrical properties of the human thorax from horizontal section data such as computerized tomographic scans has been used to develop both forward and inverse transformations between epicardial and body surface potential distributions. Eleven torso models with varying geometry and organ configurations have been studied. For the forward calculations, a standard dipole-like source is placed along the axis of the heart. Inverse calculations are performed using a measured body surface potential distribution and are based on a division of the surface of the heart into 25 source regions, producing epicardial potentials on these regions. A regularization method is used to stabilize the inverse solutions. Both forward and inverse solutions show substantial differences between models. These findings imply that matching models with patient geometry may be necessary in order to use such solutions in a clinical setting. PMID- 3652400 TI - Contracture and the calcium paradox in the rat heart. AB - The role of contracture in the manifestation of calcium paradox-induced damage was examined using 2,3-butanedione monoxime (BDM) to inhibit myofibrillar activity. Calcium and sodium gain, loss of intracellular components, and changes in structure were monitored. If 30 mM BDM was added at the time of calcium repletion after 10 minutes of calcium-free perfusion, some protection was afforded, particularly at the early stages of calcium repletion. However, much greater protection was obtained if BDM was present during the final 2 minutes of calcium-free perfusion and throughout repletion. Sodium gain and loss of intracellular components were markedly attenuated, as was the incidence of severely contracted cells. Calcium gain, although significantly reduced during the period of repletion, was not abolished. After 10 minutes of repletion, a calcium content of 11.44 +/- 1.57 mumol/g dry wt was observed. This suggests that other noncontracture related routes of calcium entry are involved. If BDM is removed after 5 minutes of calcium repletion and perfusion is continued with BDM free perfusate, there is a rapid gain of sodium, further gain of calcium, loss of intracellular components and the cells contract severely, tearing away from neighboring cells. It is evident, therefore, that returning calcium to hearts after a period of calcium-free perfusion under conditions that significantly reduce the typical calcium paradox-associated damage does not necessarily repair the underlying defect. These results support the hypothesis that contracture induced sarcolemmal disruption may be responsible for the terminal manifestation of the calcium paradox. PMID- 3652401 TI - Sex differences in peripheral vascular adrenergic receptors. AB - Although the incidence of many vascular diseases differs in men and women, sex differences in vascular physiology have not been extensively examined in human in vivo studies. The present study compared finger blood flow responses of normal men and women with brachial artery infusions of adrenergic agonists and with other neurally and nonneurally mediated procedures. In response to phenylephrine and clonidine, men showed significant dose-related vasoconstriction while women did not. In response to isoproterenol, men showed significant dose-related vasodilation while women did not. There were no sex differences in response to intra-arterial nitroglycerin or digoxin or to reactive hyperemia, procedures that do not act through adrenergic receptors. These data show that the sensitivity and/or density of peripheral vascular adrenergic receptors is lower in women than in men. There were no sex differences in response to reflex vasoconstriction or to intra-arterial tyramine, suggesting that neurally released norepinephrine acts at alpha-adrenergic receptors that are spatially removed from those that respond to circulating catecholamines. PMID- 3652402 TI - Adenosine release by the isolated guinea pig heart in response to isoproterenol, acetylcholine, and acidosis: the minimal role of vascular endothelium. AB - The objective of this study was to determine the contribution of endothelial cells to adenosine appearing in venous effluent of isolated perfused guinea pig hearts. The adenine nucleotide pool of endothelial cells was selectively labelled by infusing 3H-adenosine (5 X 10(-8) M) into the heart for 30 minutes. Selective labelling of the endothelial adenine nucleotides was confirmed by measuring the relative specific activities of the nucleotides of coronary endothelial cells (removed from the heart by enzyme treatment). Endothelial ATP, ADP, and AMP had relative specific activities that were 49, 25, and 7 times higher, respectively, than their nucleotide counterparts in total myocardial tissue. Isoproterenol increased the release of both total adenosine and radioactive adenosine, but the relative specific activity of venous adenosine decreased dramatically. Acetylcholine, at a concentration that caused no change in left ventricular pressure but caused a decrease in coronary vascular resistance, increased the release of total adenosine. However, both radioactive adenosine release and the relative specific activity of venous effluent adenosine were decreased with acetylcholine. Infusion of hydrochloric acid caused a sustained reduction in left ventricular pressure and coronary vascular resistance. Total adenosine release fell within one minute and remained reduced during HCl. Radioactive adenosine release was elevated at 15 seconds but fell below control values at 2 minutes and remained reduced during steady-state acidosis. We conclude that the majority of the adenosine released in response to isoproterenol and acetylcholine originates from an unlabelled compartment, most likely the myocytes. Acidosis results in decreased release of adenosine from both the labelled endothelium and the unlabelled cells in the heart.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652404 TI - Discharge properties of group III and IV muscle afferents: their responses to mechanical and metabolic stimuli. AB - Static contraction of the hind limb muscles induced by electrical stimulation of the ventral roots has been firmly established to reflexly increase cardiovascular and ventilatory function. Moreover, Group III and IV afferents are known to compose the afferent arm of this reflex arc. The present experiments investigated the discharge properties of Group III and IV afferents whose activation is responsible for the pressor reflex response to static contraction. In general, we found that Group III afferents were more responsive to mechanical stimuli, such as distortion of their receptive fields and tendon stretch, than were Group IV afferents. In contrast, Group IV afferents were more responsive to ischemic contraction than were Group III afferents. In addition, equal percents of Group III and IV afferents were found to be stimulated by increasing interstitial potassium to levels that were similar to those found during muscular contraction. The afferents' response to potassium adapted within seconds, while the interstitial concentration of this ion remained elevated for several minutes. This rapidly adapting response casts doubt on the effectiveness of potassium as the metabolite that signals blood supply and demand in a working muscle are improperly matched. PMID- 3652403 TI - Diencephalic regulation of respiration and arterial pressure during actual and fictive locomotion in cat. AB - The purpose of this study was to examine by experimentation the hypothesis that the respiratory and circulatory responses during exercise are attributable to command signals that emanate from the suprapontine brain. We studied the relations between locomotion (exercise) and phrenic nerve activity and arterial pressure in cats that walked or ran on a treadmill and in animals during fictive locomotion, i.e., locomotor activity in motor nerves to legs. Anesthetized cats with intact brains and unanesthetized decorticated cats were used. All preparations exhibited spontaneous actual and fictive locomotion. Electrical stimulation or microinjection of picrotoxin, a GABA antagonist, of the subthalamic locomotor areas always caused locomotion to develop. Phrenic nerve activity and arterial pressure increased in proportion to the level of locomotor activity despite control or ablation of feedback signals from chemoreceptors and vagal receptors. Similar relations were measured during fictive locomotion despite the absence of muscular contraction and limb movement and the lack of change in metabolic rate. These findings provide experimental support for the central command hypothesis for the genesis of the respiratory hyperpnea and increased cardiovascular function that occur during exercise. We believe that the command signals emanate from the subthalamic locomotor area of the diencephalon. PMID- 3652405 TI - Control of lumbar sympathetic nerve traffic by vagal cardiopulmonary baroreflexes in renal hypertension. AB - Renal nerve traffic is inhibited during volume expansion mainly because of stimulation of vagal cardiopulmonary baroreflexes. These responses are impaired in rabbits with renal hypertension caused by impaired cardiopulmonary baroreflexes. Previous studies have suggested that there may be differences in the extent to which renal hypertension alters reflex control of lumbar as compared with renal sympathetic nerve activity. The goals of this study were to determine if the responses to volume expansion of lumbar sympathetic nerve traffic also are impaired in renal hypertension and if this abnormality, if present, is caused by abnormalities in the vagal cardiopulmonary baroreflex. Experiments were done in alpha-chloralose-anesthetized normotensive (n = 9) and renal hypertensive (n = 7; 1 kidney, 1 wrap) rabbits. Infusion of dextran in saline raised arterial and left atrial pressures in both groups and decreased lumbar nerve traffic by -4.4 +/- 0.4% mm Hg rise in arterial pressure in the normotensive group and by -1.5 +/- 0.1% mm Hg in the hypertensive group (p less than 0.01). These responses were nearly abolished by sinoaortic denervation in both groups. These data indicate that the responses of lumbar nerve traffic to volume expansion are impaired in renal hypertension; this is mainly because of impaired arterial baroreflexes since vagal cardiopulmonary baroreceptors have minimal influence on lumbar nerve traffic, even in normotensive rabbits. These findings for the lumbar nerves are strikingly different from those reported previously for reflex control of the renal nerves in both normotensive and hypertensive rabbits. PMID- 3652406 TI - Baroreflex control of renal nerve activity in conscious animals. AB - This study quantitates the effect of three different doses of vasopressin on the arterial baroreflex control of renal sympathetic nerve activity and heart rate. The lowest dose of vasopressin (0.4 mU/kg X min), which had no significant effect on resting mean arterial pressure, heart rate, or renal sympathetic nerve activity, increased the inhibitory influence of arterial baroreflexes on renal sympathetic nerve activity in response to an increase in pressure. During infusions of higher doses of vasopressin (1.5 and 3.0 mU/kg X min), which significantly decreased resting heart rate and renal sympathetic nerve activity but had no significant effect on mean arterial pressure, the mean arterial pressure-renal sympathetic nerve activity relation showed a significant decrease in maximum renal sympathetic nerve activity when compared with control. The highest dose of vasopressin resulted in a significant shift of the relation to the left toward lower pressures and in a decrease in maximum gain. The relation exhibited a parallel shift toward lower pressure, with no change in gain, at the higher dose of vasopressin. Based on these results, we conclude that vasopressin exerted a dose-related effect on arterial baroreflex such that lower doses of vasopressin may sensitize the central baroreflex neurons to afferent input, while the higher doses of vasopressin caused direct excitations of these neurons, resulting in a reduction in resting sympathetic outflow. PMID- 3652407 TI - Beta-adrenergic inotropic responsiveness of patients with heart failure: studies with intracoronary dobutamine infusion. AB - Although there is theoretical and indirect evidence to suggest that patients with severe congestive heart failure may have desensitization of myocardial beta adrenergic responsiveness, there is little direct evidence in patients. The purpose of this study was to determine whether myocardial beta-adrenergic inotropic responsiveness is reduced in patients with severe congestive heart failure and markedly elevated plasma norepinephrine levels. To assess myocardial beta-adrenergic inotropic responsiveness, the beta-adrenergic agonist dobutamine was infused directly into the left main coronary artery, and the change in +dP/dt was measured as an index of change in inotropic state. Eight patients with severe New York Heart Association functional Class III and IV congestive heart failure were compared with 4 patients without significant congestive heart failure. The increase in +dP/dt at an intracoronary dobutamine infusion rate of 25 micrograms/min in patients with severe congestive heart failure was significantly less than in the patients without heart failure (heart failure, 33 +/- 8%; no heart failure, 69 +/- 12%; p less than 0.05). Although the maximum intracoronary dobutamine infusion rate was substantially higher in patients with heart failure (94 +/- 25 micrograms/min) compared with patients without heart failure (38 +/- 7 micrograms/min), the increase in +dP/dt at maximum infusion rates was also significantly less in patients with heart failure (heart failure, 52 +/- 8%; no heart failure, 93 +/- 24%; p less than 0.05). Plasma norepinephrine concentration was normal in the 4 patients without heart failure and was markedly elevated (range, 307-3,967 ng/l) in the patients with severe heart failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652408 TI - Norepinephrine kinetics during orthostatic stress in congestive heart failure. AB - To evaluate the determinants of the plasma norepinephrine (NE) response to orthostatic stress, NE kinetics were measured during steady-state infusion of [3H]NE of high-specific activity for two consecutive 90-minute periods; the first was supine, and the second was during 60 degrees head-up tilt. In 6 normal subjects, plasma NE increased from 242 to 570 pg/ml, and NE clearance decreased from 1.43 to 1.00 l/min X M2. In 6 patients with congestive heart failure, there was no significant change in plasma NE during orthostatic stress. This has been interpreted previously to indicate that there was little activation of the baroreflex arc. In fact, NE clearance decreased from 1.08 to 0.79 l/min X M2; however, there was a decrease in NE spillover from 4.04 to 2.88 nmol/min X M2. A reduction of organ blood flow with tilt could be responsible for the reduced NE clearance by both groups, but the mechanism for the reduction in NE spillover with tilt in congestive heart failure is unclear. PMID- 3652409 TI - [Geographical distribution of Anopheles lesteri anthropophagus and its role in malaria transmission in Guangxi]. PMID- 3652410 TI - [Observations of the cidal effect of three kinds of synthetic pyrethroid chalks on bedbugs]. PMID- 3652411 TI - [Histological observation on cutaneous leishmaniasis produced by 2 species of Leishmania]. PMID- 3652412 TI - [Scanning electron microscopic observation on the daughter redia of Paragonimus westermani]. PMID- 3652413 TI - [Conversion of Schistosoma japonicum cercariae to schistosomula under the action of praziquantel]. PMID- 3652414 TI - [Host transfer of Paragonimus westermani among mice and its developmental changes]. PMID- 3652415 TI - [Clinical observation on the treatment of 300 cases of cysticercosis with albendazole]. PMID- 3652416 TI - [Malarial control measures and their effectiveness in the basic eradication of malaria in large area in Guizhou]. PMID- 3652417 TI - [Studies on immuno-diagnosis for Cysticercosis cellulosae. 1. Electrophoretic analysis of protein and antigenic preparation of Cysticercus cellulosae]. PMID- 3652418 TI - Achieving a smokefree society. PMID- 3652419 TI - Beat-to-beat changes in atrioventricular nodal excitability and its modulation by concealed conduction during functional 2:1 block in man. AB - An atrial pacing model of functional 2:1 block was used in 10 patients to investigate for the first time the electrophysiologic properties of the human atrioventricular node during intermittent conduction. By varying the terminal portion of the 2:1 atrial train and using the extrastimulus technique, we characterized atrioventricular nodal (AVN) conduction and refractoriness after five different methods of AVN activation: a conducted beat (method I), a conducted beat with omission of the prior blocked beat (method II), a blocked beat (method III), a blocked beat "converted" to one that conducts by omission of the prior conducted beat (method IV), and finally, 1:1 conduction at twice the cycle length of the 2:1 train (control method V). Observed AVN conduction times obeyed the following relationship: method I greater than method II greater than method V, indicating a cumulative effect of concealed penetration by the blocked beats. During 2:1 block, the AVN effective refractory period (ERP) alternated with a mean beat-to-beat difference of at least 100 msec, due mostly to marked ERP abbreviation during AVN activation by method III (vs both 2:1 train cycle length and activation by method V). Concealed penetration by the blocked beat prolonged AVN ERP for the propagated beat (vs that with methods II and V), but to a lesser extent than conduction time was increased. Moreover, the AVN recovery curve with method I was displaced upward and to the right compared with that with methods II to V.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652420 TI - Hierarchy of levels of ischemia-induced impairment in regional left ventricular systolic function in man. AB - We tested the hypothesis that different subsets of ischemia-induced wall motion disorders are characterized by specific patterns of abnormal regional left ventricular systolic function. Regional contraction was quantitatively assessed from two-dimensional echocardiograms by an automated integrative analysis considering the time course of wall motion during the entire contraction sequence in 20 patients with chronic myocardial infarction, in 13 patients with impending myocardial infarction (less than 2 hr after the onset of symptoms), and in nine patients during transient myocardial ischemia. Wall motion abnormalities were detected in all patients by the integrative analysis. In contrast, the sensitivity for detecting wall motion abnormalities was 80% during chronic infarction, 77% during impending infarction, and 56% during transient ischemia if only end-diastolic and end-systolic frames were compared for assessment of overall regional systolic function. There were distinct differences in the time course of abnormal wall excursion between the three groups. Chronic infarction was characterized by a monophasic contraction pattern, with abnormal synergy in regional contractile events occurring predominantly during early systole. In contrast, transient ischemia caused predominantly mid-to-late systolic abnormal synergy followed by late systolic shortening corresponding to a polyphasic contraction pattern. During impending infarction, an intermediate temporal contraction pattern was present with both early and mesosystolic abnormal synergy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652421 TI - Mechanism of mitral regurgitation in patients with myocardial infarction: a study using real-time two-dimensional Doppler flow imaging and echocardiography. AB - The aim of the present study was to elucidate the mechanisms of mitral regurgitation accompanying myocardial infarction. Severity and site of mitral regurgitation was evaluated by the real-time two-dimensional Doppler flow imaging technique in 81 patients with old myocardial infarction. The incidence of mitral regurgitation did not depend on the region of infarction. There was, however, a close relationship between the site of regurgitation and the region of infarction. In patients with mitral regurgitation spurting from the posteromedial area of the valve, the inferior wall was involved in infarction without exception and in some of these patients, the posteromedial papillary muscle was also found to be affected by myocardial infarction; in those with regurgitation spurting from the anterolateral area, the anterior wall showed asynergy. On the other hand in patients with mitral regurgitation spurting from the central area, the region of infarction varied. In these patients, however, the larger the diameter of the mitral anulus, the more severe the grade of regurgitation. The extent of asynergy was another factor related to the severity of mitral regurgitation. Both longitudinally and transversely, broad infarction leads to the enlargement of the mitral anulus. However, even if the mitral anulus is not so dilated, severe involvement of either commissural area results in severe mitral regurgitation from the same commissural side. Thus, there are two major causative factors of mitral regurgitation: (1) asynergy of the papillary muscle or the ventricle that results in mitral regurgitation located in the commissural area of the same side as asynergy, and (2) enlargement of mitral anulus, which results in regurgitation from the central area of the orifice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652422 TI - Predictors of efficacy of amiodarone and characteristics of recurrence of arrhythmia in patients with sustained ventricular tachycardia and coronary artery disease. AB - The value of serial electropharmacologic testing during long-term oral amiodarone therapy for prediction of long-term drug efficacy as well as characteristics of arrhythmia recurrence is controversial. One-hundred four consecutive patients with coronary artery disease and sustained ventricular tachyarrhythmias (VT) underwent initial electrophysiologic (EP) evaluation in the drug-free state and again after an amiodarone loading period of 25 +/- 14 days (mean +/- SD). Twenty six patients (25%) had no inducible ventricular tachyarrhythmia during therapy with amiodarone (VT control group), whereas arrhythmia inducibility persisted in the remaining 78 patients (VT noncontrol group). During 17.4 +/- 13.7 months of follow-up, two patients in the VT control group either had VT recurrence or died suddenly compared with 21 VT recurrences and eight sudden cardiac deaths in the VT noncontrol group (actuarial event rates at 36 months of 0.11 and 0.56, respectively, p = .0065). The cycle lengths of recurrent VT in these 21 patients in the VT noncontrol group were compared with those observed at final EP testing. A significant linear correlation was demonstrated (r = .76, p = .0001). Subgroup analysis of patients in the VT noncontrol group showed no EP predictors of outcome, including cycle length of induced VT. However, patients dying suddenly during the follow-up period had a higher prevalence of new or worsening congestive heart failure (75%) compared with patients with VT recurrence (19%) or those with no arrhythmic event (29%) (p less than .02).2off PMID- 3652423 TI - Pericardial effusion causes interstitial pulmonary edema in dogs. AB - The pulmonary effects of pericardial effusion were studied in eight anesthetized dogs, with emphasis on lung mechanics, O2 exchange, and extravascular thermal lung volume (ETV) accumulation, while warm saline was instilled into the pericardium to elevate pericardial pressure. The results were compared with those from four time-controlled and sham-operated dogs. ETV, as measured by a double indicator technique, increased from 8.1 +/- 0.8 ml/kg at a pericardial pressure of 0 mm Hg to 12.9 +/- 2.1 ml/kg at 11.0 mm Hg (p less than .01). In the control group, ETV increased from 6.5 +/- 0.7 to 8.2 +/- 0.5 ml/kg over an equal time span. This increase in ETV in the experimental dogs was inversely related to pulmonary compliance, which decreased by 29% as ETV increased (p less than .05), whereas in the time-controlled group of animals it decreased by 8.8%. Arterial PO2 did not deteriorate during the protocol in either group. Histologic examination showed increased interstitial fluid, but neither alveolar fluid nor septal edema, and gravimetric measurements of lung liquid were also consistent with interstitial fluid accumulation in experimental but not control animals. These findings are concordant with the clinical observation that alveolar edema is rarely seen in the presence of pericardial tamponade. Conceivably, progression from interstitial to alveolar edema did not occur both because of the low pulmonary blood flow that occurs as part of pericardial tamponade physiology and/or because the hydrostatic pressures were not elevated enough to produce higher rates of fluid transudation. PMID- 3652424 TI - Two-dimensional ultrasonic tissue characterization: backscatter power, endocardial wall motion, and their phase relationship for normal, ischemic, and infarcted myocardium. AB - To understand the possible differences in reflected ultrasonic energy from normal, ischemic, and infarcted myocardium, we studied 20 open-chest dogs with a commercially available two-dimensional ultrasonic scanner. Echocardiographic radiofrequency images of anterior myocardium were obtained serially during complete coronary occlusion for 2 hr (n = 15) or 5 hr (n = 10), or after temporary coronary clamping for 15 min with release for 1 hr (n = 5). We investigated two variables: the cyclic backscatter power and the phase difference among endocardial wall motion (EWM), cyclic backscatter power (BSP), and left ventricular pressure (LVP). The cyclic BSP decreased from a control (nonischemic) level of 5.1 +/- 0.8 to 2.3 +/- 0.7 dB during ischemia (up to 30 min after coronary ligation). The phase difference between the EWM and BSP progressed from a control (nonischemic) value of 38 +/- 20 to 115 +/- 23 degrees during ischemia. For the infarction period (2 to 5 hr after coronary ligation), the cyclic BSP progressively returned toward baseline control levels to 4.0 +/- 1.2 dB, but the phase had increased further to 170 +/- 28 degrees. The reperfusion study showed a similar decrease in cyclic BSP and an increase in phase after arterial clamping and both returned to near-normal nonischemic values upon arterial release. Simultaneous LVP recordings were performed to assess the phase contribution of endocardial dyskinesis to the total phase difference measurement. At 5 hr the dyskinesis had contributed 46% to the total phase difference, while the backscatter power contributed 54%. However, the EWM contribution occurred immediately while BSP contribution changed progressively during the 5 hr study period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652425 TI - Alterations in endocardial activation of the canine papillary muscle early and late after myocardial infarction. AB - Permanent coronary occlusion produces time-dependent changes in surviving subendocardial cellular properties. We compared the functional alterations in Purkinje (P) and ventricular muscle (VM) activation early (24 hr) and late (4 weeks or greater) after permanent coronary occlusion in an in vitro preparation of canine papillary muscle. High-density extracellular (1 to 2 mm resolution) and selected intracellular recordings were made in five animals early and seven animals late during stimulation of a free-running P strand. Activation patterns of P and VM layers from ischemic and unaffected papillary muscles were compared in the same animal. Average P layer conduction velocity was determined in normal and ischemic regions with the use of a linear array of recording and stimulating electrodes. Purkinje activation was altered little in the early phase of infarction, while healing was associated with a generalized 25% reduction in P layer conduction velocity and localized block and fragmentation of P waveforms. Intracellular recordings at sites of nonsynchronous P activation revealed electrotonic interaction between cell groups. At 24 hr, small groups of VM were present but with abnormal activation patterns in regions of necrosis with fragmented and delayed extracellular waveforms produced by partially uncoupled groups of cells. Local delay and block could be modulated by rate and site of stimulation. After healing, VM activation abruptly stopped at the visual infarct border, marked by a characteristic "end potential." These studies demonstrate important differences in the functional attributes of the P and VM layers studied early and late after coronary occlusion. Alterations in cell-to-cell relationships are likely very important in determining abnormalities of activation in both settings. PMID- 3652426 TI - Modulation of vascular capacitance by angiotensin and nitroprusside: a mechanism of changes in pericardial pressure. AB - The aim of the present study was to test the hypothesis that vasoactive drugs may modify left ventricular diastolic function by shifting blood between the systemic vascular bed and the heart, thereby changing pericardial and left ventricular pressure. The experiments were done in 10 open-chest, anesthetized, previously splenectomized dogs in which changes in pericardial surface pressure in response to intravenous sodium nitroprusside and angiotensin were related to changes in blood volume in the abdominal region. Blood volume was determined by blood pool scintigraphy (99mTc) and regions of interest were drawn in the liver and in the mesenteric area. Angiotensin was infused at rates that were adjusted to increase mean aortic pressure by 20 and 30 mm Hg, and nitroprusside was infused at rates to decrease mean aortic pressure by 30 and 50 mm Hg. Angiotensin increased pericardial pressure by 3 and 5 mm Hg at the respective doses and there were increments in left ventricular end-diastolic pressure (LVEDP) and left ventricular diameter (sonomicrometry). Angiotensin decreased blood volume in the mesenteric region by 14% and 17%, but did not significantly change blood volume in the liver region. Angiotensin increased portal venous pressure and decreased mesenteric blood volume, suggesting decreased mesenteric venous compliance. Nitroprusside had opposite effects: pericardial pressure was decreased by 5.5 and 6.5 mm Hg by the respective doses. The doses of nitroprusside increased blood volume in the mesenteric region by 14% and 20%, but did not significantly change blood volume in the liver region.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652427 TI - The functional border zone in conscious dogs. AB - Studies focusing on the functional border zone have been performed largely with anesthetized, open-chest preparations. Therefore, we instrumented 14 dogs at sterile surgery with sonomicrometers arrayed to measure systolic wall thickening across the perfusion boundary produced by circumflex coronary occlusion. We fitted sigmoid curves to the data to model the distribution of wall thickening impairment as a function of distance from the perfusion boundary, which was delineated with myocardial blood flow (15 micron diameter microspheres) maps. Using this approach, we defined the functional border zone as the distance from the perfusion boundary to 97.5% of the sigmoid curve's nonischemic asymptote. The lateral extent of the functional border zone, measured 10 min and 3 hr after occlusion, was 32 and 28 degrees of circumference, respectively. To evaluate the severity of nonischemic dysfunction, we measured average systolic wall thickening within the functional border zone. It was reduced from 3.69 +/- 1.10 (mean +/- SD) mm to 2.98 +/- 1.07 mm (p less than .01) and 2.74 +/- 1.12 mm (p less than .01) early and late after coronary occlusion. Thus, a narrow functional border zone was evident during circumflex coronary occlusion in conscious dogs. Its lateral extent was limited to approximately 30 degrees (similar to findings in open-chest, anesthetized dogs), severe dysfunction was restricted to the immediate vicinity of the perfusion boundary, and the average severity of nonischemic dysfunction within the functional border zone was mild. PMID- 3652428 TI - The physiologic basis of dobutamine as compared with dipyridamole stress interventions in the assessment of critical coronary stenosis. AB - Noninvasive cardiac imaging with echocardiography or thallium-201 scintigraphy utilizing pharmacologic agents as alternatives to exercise is gaining popularity. We investigated the physiologic rationale underlying the optimal choice of pharmacologic stress for functional versus perfusion imaging. With the use of an open-chest dog model, a critical stenosis of the left circumflex coronary artery was produced with total ablation of hyperemic response to a 15 sec period of complete occlusion. Regional left ventricular wall thickening was assessed by quantitative two-dimensional echocardiography. Regional myocardial blood flow was determined by microspheres in both the flow-restricted left circumflex area and the control area supplied by the left anterior descending artery. Eight dogs received 15 micrograms/kg/min dobutamine intravenously for 10 min, and nine dogs received 0.14 mg/kg/min dipyridamole intravenously for 4 min. Dobutamine induced wall thickening abnormalities in all dogs while dipyridamole induced dysfunction in only 55% of the animals studied (p less than .01). Subendocardial blood flow to the left circumflex area was unchanged after both dobutamine and dipyridamole when compared with baseline blood flow. However, subendocardial blood flow increased markedly after dipyridamole in the control area. Regional subendocardial blood flow ratio (left anterior descending/left circumflex) was 3.74 +/- 0.09 (mean +/- SEM) after dipyridamole versus 1.27 +/- 0.09 after dobutamine (p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652430 TI - Abstracts from the 60th scientific sessions. American Heart Association. Anaheim, November 16-19, 1987. PMID- 3652431 TI - Treatable drug overdoses. PMID- 3652429 TI - Cooperative mediation by serotonin S2 and thromboxane A2/prostaglandin H2 receptor activation of cyclic flow variations in dogs with severe coronary artery stenoses. AB - We have reported previously that thromboxane A2/prostaglandin (PG)H2 and serotonin independently mediate the occurrence of cyclic flow variations (CFVs) in a canine preparation of severe coronary artery narrowing. This may be due to an effect of these substances on platelets and/or the vascular wall. We tested the hypothesis that there is a cooperative effect between thromboxane A2/PGH2 and serotonin receptor stimulation in the development of CFVs in this animal preparation. After placement of a hard plastic cylindrical constrictor around the left anterior descending coronary artery, CFVs develop and are characterized by repetitive cycles of declines in coronary blood flow and abrupt increases in flow. In a control group of dogs, CFV frequency (cycles/hour) and severity (lowest coronary blood flow just before its restoration) did not change significantly over a 3 hr interval. In a second group of dogs, CFVs were established after constrictor placement, abolished with the serotonin (5HT2) receptor antagonist ketanserin, and reestablished by the continuous infusion of serotonin into the left atrium. Serotonin-induced CFVs were then abolished with a thromboxane A2/PGH2 receptor antagonist, SQ29,548, or a thromboxane synthetase inhibitor, dazoxiben (UK37,248). The relative specificity of the respective antagonists, SQ29,548 and ketanserin, was determined in canine platelets and rat aortic vascular strips. No significant cross-reactivity between ketanserin and SQ29,548 was found. Thus, the data obtained in these studies demonstrate a cooperative interaction between thromboxane A2/PGH2 and serotonin S2 receptors that contributes to the development of CFVs in this experimental preparation. PMID- 3652432 TI - Progress, reason, and fallacy in today's world of neurosurgery. PMID- 3652433 TI - Hydrogen peroxide vs normal saline lavage in experimental fecal peritonitis. PMID- 3652434 TI - Carcinoid myopathy. PMID- 3652435 TI - Primary malignant melanoma of the lower respiratory tract: endoscopic identification. PMID- 3652436 TI - A rapid enzymatic assay for total blood polyamines. AB - We have designed a rapid, reliable enzymatic assay for total blood polyamines, as based on the combination of substrate specificity of polyamine oxidase (PAO) from Aspergillus terreus and putrescine oxidase (PUO) from Micrococcus rubens. Quinone dye, derived from hydrogen peroxide generated in the oxidation reaction, is measured spectrophotometrically at 555 nm, and total amounts of putrescine (Put), cadaverine (Cad), spermidine (Spd), and spermine (Spm) can be readily determined. The minimum detection limit is about 0.4 mumol/L whole blood. Bilirubin, hemoglobin, reducing substances, and anticoagulants show no apparent interference. Analytical recovery averaged 98.5%. Within-run and between-day precisions ranged from 1.02% (61.04 mumol/L) to 2.84% (13.07) and 1.54% (50.67) to 3.27% (14.74), respectively. Results obtained with this method and those by high-performance liquid chromatography (HPLC) (r = 0.955) or the enzymatic differential method (r = 0.944) correlated well. In our opinion, this method is superior to other assays being used to determine blood polyamines. PMID- 3652437 TI - A method for the sequential colorimetric determination of serum triglycerides and cholesterol. AB - A simple spectrophotometric method for the sequential determination of triglycerides and cholesterol from a single serum sample was developed. In this two-stage procedure, the triglycerides and cholesterol esters are first hydrolysed to glycerol and free cholesterol respectively, with simultaneous scavenging of the liberated free fatty acids, a technique that ensures clarity of the sample. The glycerol is subsequently reacted to result in an intense red chromogen with a peak absorption maximum at 510 nm following a series of enzymic reactions. In the second stage, addition of cholesterol oxidase leads to oxidation of free cholesterol generated from the cholesterol esters in the first stage and the free cholesterol normally present in the sample, yielding in a similar fashion the identical red chromogen whose absorbance is also measured at 510 nm. Results obtained with the proposed method demonstrate good correlation with established individual procedures for triglycerides and cholesterol. PMID- 3652439 TI - Immunoturbidimetry: an attractive technique for the determination of urinary albumin and transferrin. AB - Immunoturbidimetry is a suitable technique for the determination of urinary proteins in clinical laboratories. We have developed immunoturbidimetric assays for the measurement of urinary albumin and transferrin which are adapted for the Cobas-BIO centrifugal analyzer. Linear range for the albumin assay was 6.25-167 mg/L and for the transferrin assay 1.66-6.66 mg/L. The analytical recoveries of albumin and transferrin averaged 96%. The addition of up to 50 g/L hemoglobin to urine did not interfere with the determination of either protein. Within-run and between-run imprecision for albumin assay was 2.2% and 3.2% at an albumin level of 140 mg/L, and 4.8% and 8.7% at an albumin level of 16 mg/L; for transferrin assay the respective imprecisions were 3.6% and 6.7% at transferrin concentration of 6 mg/L, and 5.2% and 11.1% at a transferrin concentration of 1.5 mg/L. Reference ranges for both assays were established using urines from 17 healthy individuals; albumin had a range of 0-22 mg/L and transferrin 0-1.9 mg/L. PMID- 3652438 TI - Determination of urinary homovanillic and vanillylmandelic acids from dried filter paper samples: assessment of potential methods for neuroblastoma screening. AB - Urinary homovanillic (HVA) and vanillylmandelic (VMA) acids were analyzed on 200 random urine samples from patients with neuroblastoma and controls, after the samples had been dried onto absorbent filter paper. The acids were determined quantitatively by gas chromatography (GC) and qualitatively by thin layer chromatography (TLC). The results were analyzed for correlation between liquid urine samples and urine dried on filter paper and between TLC and GC methods. A high overall correlation for HVA and VMA (99%) was found between liquid and dried filter samples analyzed by GC. The correlations were more significant for samples with elevated levels of these acids than for those with normal levels. Normalization of the results to the urinary creatinine concentration (UCr) is indicated due to variations in urine concentration. Results from TLC analysis showed a false positive rate of 3.5% and a false negative rate of 0.5% compared to GC analysis. This work suggests that a combination of a sensitive TLC method with a rapid quantitative GC method would be suitable for mass neuroblastoma screening in infants. PMID- 3652440 TI - Purification and characterization of immunosuppressive (IS) substance obtained from ascitic fluids of patients with gastrointestinal cancer. AB - An immunosuppressive substance was isolated from ascitic fluids of patients with advanced colon cancer by means of ammonium sulphate precipitation and preparative isoelectric focusing. This was a glycoprotein with an isoelectric point of pH 2.7 3.3, a molecular weight of about 52,000, and a sedimentation coefficient of 4.0S. The substance showed a single band on ordinary disc electrophoresis, but it was separated into several bands by gel isoelectric focusing, due to the structural variety of the sugar moiety. The results of physicochemical analysis indicate that the amino acid composition of this glycoprotein was indistinguishable from that of alpha 1-acid glycoprotein (alpha 1-AG), but its molecular weight, its carbohydrate content, and composition were distinctly different. Furthermore, this glycoprotein was found to have higher immunosuppressive activity than that of alpha 1-AG in both the in vitro and in vivo assays. This glycoprotein, which we called "IS substance," is a cancer-related substance synthesized in cancer patients. PMID- 3652442 TI - Clinical chemistry in The Netherlands. A selection of invited papers published in conjunction with the XIII International Congress of Clinical Chemistry and the VII European Congress of Clinical Chemistry. The Hague, The Netherlands, 28 June 3 July 1987. PMID- 3652441 TI - Evaluation of cyclosporine kit utilizing an iodinated tracer and double antibody precipitation. AB - Due to the increasing number of requests for Cyclosporine quantification, less time-consuming methods are being sought. A commercially available radioimmunoassay which utilizes an 125I-Cyclosporine tracer and double antibody precipitation to separate free and bound fraction is described. The assay was evaluated with standards prepared in-house as well as those supplied by the manufacturer. With both types of standards, the assay exhibited between-run coefficients of variation of less than 14.3%, recoveries near 100% and good parallelism. When the Cyclosporine values obtained with the 125I-RIA calibrated with standards provided in the kit were compared with those obtained with the RIA supplied by Sandoz, a relatively large proportional and constant error was noted. When the comparison was repeated, with the former assay being calibrated with standards prepared in-house, the magnitude of these errors was significantly reduced. With both types of standards the 125I-RIA exhibited good correlation with Cyclosporine values obtained by HPLC. This RIA is suitable for the relatively rapid quantification of Cyclosporine. PMID- 3652443 TI - Human serum sialo transferrins in diseases. AB - Using isoelectric focusing and crossed immunoelectrophoresis on ready-made Immobiline Dry Plates, pH 5-6, we were able to separate human serum transferrin in subfractions with different sialo acid content. The amount of these subfractions is significant different in sera of patients with diseases like CA, RA, haemochromatosis and in sera of pregnant women. PMID- 3652444 TI - Therapeutic drug monitoring of amitriptyline: impact of age, smoking and contraceptives on drug and metabolite levels in bulimic women. AB - Concentrations of amitriptyline (AT), nortriptyline (NT) and E-10 hydroxynortriptyline (E-10-OH-NT) were measured in 18 women with bulimia receiving 100 mg AT/day for at least 6 wk. After onset of treatment between days 36 and 57 there is a decrease in AT and an increase in E-10-OH-NT concentrations, probably due to an autoinductive effect on hydroxylation. The estimated mean (+/- SD; range; n) elimination half-life time of AT was 14.0 (+/- 7.8 h; 7.5-38.5 h; 14). On day 36, AT concentrations in females using oral contraceptives (OC) were higher than in non-users of OC, which indicates inhibition of AT metabolism by OC. In all smokers the E-10-OH-NT concentrations on day 36 were lower than in non smokers. Our findings suggest induction of N-demethylation and glucuronidation by smoke components. PMID- 3652445 TI - Urinary excretion of 2-methyl-2,3-butanediol and 2,3-pentanediol in patients with disorders of propionate and methylmalonate metabolism. AB - Urine samples from patients with propionic acidemia and from a patient with methylmalonic acidemia contained unknown non-acidic metabolites by gas chromatography/mass spectrometry after ethyl acetate extraction. It could be demonstrated by mass spectrometric studies and by synthesis of reference compounds that the major metabolite was 2-methyl-2,3-butanediol, while smaller amounts of 2,3-pentanediol were also present. These diols were present in abnormal amounts in these patients during attacks of metabolic decompensation. PMID- 3652446 TI - Pregnancy and guinea-pig isotransferrins--isolation and characterization of both isotransferrins. AB - Microheterogeneity patterns of pregnant and non-pregnant guinea-pig serum transferrin differ significantly. Using preparative isoelectric-focusing 'slow' and 'fast' isotransferrins were separated. Amino-acid and carbohydrate composition of these two fractions are presented. PMID- 3652447 TI - Urinary polyamines and their metabolites during new combination chemotherapeutic treatments of high grade non-Hodgkin lymphoma. AB - Nineteen patients with non-Hodgkin lymphoma of unfavourable histology (15 high grade and 4 intermediate grade) were treated with two new combination chemotherapeutic schemes. Except for one all were partial (8) or complete (10) responders to treatment. Polyamines were measured in every spontaneously voided urine sample. Pretherapeutically all (11) stage III and IV patients had borderline or increased urinary putrescine (Pu) and sum of isoputreanine, spermidine and spermine (sigma Isoputr,Sd,Sp), except for the non-responder. Except for one, all (8) stage I and II patients had normal urinary Pu and sigma Isoputr,Sd,Sp. Posttherapeutically patients with pretherapeutically increased sigma Isoputr,Sd,Sp returned to normal (5), borderline (2), or slightly increased (3) levels. The post-therapeutic achievement of normal or borderline sigma Isoputr,Sd,Sp was not necessarily connected with accomplishment of complete remission. From the start of therapy until clinical restaging, partially or completely responding stage III and IV patients excreted 5-234 mmol sigma Isoputr,Sd,Sp per mol of creatinine above the mean normal value plus 2 SD. For stage I and II patients and the clinical non-responder this parameter amounted to 0-5 mmol/mol of creatinine. Peaks in urinary Pu and sigma Isoputr,Sd,Sp follow-up curves were related in time to the administration of chemotherapeutics. For responding stage III and IV patients the rate of the decrease of sigma Isoputr,Sd,Sp levels paralleled the clinically observed rate of tumour load reduction. This study suggests that notably for non-Hodgkin lymphoma patients with high tumour loads the constant monitoring of polyamines can provide information on pretherapeutic spontaneous tumour cell loss, the efficacy of chemotherapeutic combinations, the kinetics-, and (within certain limitations) the extent of therapeutically induced tumour cell death. PMID- 3652448 TI - Laser diffraction ellipsometry of erythrocytes under controlled shear stress using a rotational viscosimeter. AB - An ektacytometric extension for the Contraves LS-30 viscosimeter is described, as well as the procedure to measure erythrocyte deformability and rouleau formation with this combination. The method error (coefficient of variation) for the measurements of the erythrocyte elongation index appeared to be less than 1%, while both intra- and interindividual variation were around 2%. Preliminary clinical experiments performed on blood from different patient groups (i.e., diabetes, uraemia, sickle cell anaemia) clearly demonstrated more rigid erythrocytes than normal. It can be concluded that it is possible now to analyse with 1 instrument: plasma viscosity, whole blood viscosity at shear rates from 0.01 to 236 s-1, erythrocyte deformability and rouleau formation. PMID- 3652449 TI - Analytical and clinical evaluation of commercial protein C assays. AB - Protein C deficiency is an important risk factor for thrombosis. Recently several commercial assays for this protein have become available. We evaluated two antigen and three activity assays in 50 healthy volunteers, 52 patients with deep venous thrombosis (DVT) proven by positive impedance plethysmography (IPG) and flebography, and 48 control patients referred to us for objective diagnosis of DVT but with repeatedly negative IPG. All subjects were less than 50 yr of age. Based upon assay performance, correlation of the assays, influence of heparin, and practical ease, an ELISA antigen assay and a chromogenic activity assay are recommended. The prevalence of protein C deficiency cannot be accurately determined from this study, because 3 DVT negative and 13 DVT positive patients were receiving coumarin therapy. However, based upon protein C:factor II antigen ratios, at least 7 of the DVT positive patients are likely to be protein C deficient. Protein C determination should, therefore, be considered in all DVT patients less than 50 yr of age. PMID- 3652450 TI - Immunoglobulin D in cerebrospinal fluid. AB - Immunoglobulin D (IgD) was measured by radioimmunoassay in paired cerebrospinal fluid and serum samples from patients with various neurological diseases. The IgD index was calculated for every patient and compared with the IgG index. An increased IgD index was found in 18 out of 41 patients suffering from multiple sclerosis and in 52 out of all 122 patients investigated. An increased IgD index did not always coincide with an increased IgG index. An increased IgD index suggests an abnormal intrathecal synthesis of this immunoglobulin within the central nervous system. We conclude that the determination of IgD in the cerebrospinal fluid yields additional information on immunological reactions within the central nervous system. PMID- 3652451 TI - Quantification of cholesterol nucleation promoting activity in human gallbladder bile. AB - We have developed a simple method to quantitate cholesterol nucleation promoting activity in bile. The method makes use of the fact that gallbladder bile of cholesterol gallstone patients contains potent nucleation promoting activity. Gallbladder bile samples were serially diluted, routinely from 1/25 to 1/6,400. The diluted samples were mixed with a supersaturated model bile and the nucleation time (NT) of the mixtures was determined. The greatest dilution that resulted in a significant shortening of the NT was called the nucleation promoting activity titre (NPAT). The determination is independent of the original lipid content of the bile sample. The NPAT was measured in 14 gallbladder bile samples derived from patients with cholesterol gallstones and 9 controls. In all samples promoting activity was found. In the samples from the stone patients the NPAT was significantly elevated as compared to the patients without cholesterol stones (p = 0.01). Our results suggest that the cholesterol saturation index and the activity of cholesterol nucleation promoting factors are the most important factors in the pathogenesis of cholesterol gallstone disease. Assessment of the NPAT allows the differentiation of groups of patients with a normal cholesterol saturation index who are at risk for gallstone formation due to a high NPAT. PMID- 3652452 TI - Prenatal diagnosis of Zellweger syndrome by measurement of very long chain fatty acid (C26:0) beta-oxidation in cultured chorionic villous fibroblasts: implications for early diagnosis of other peroxisomal disorders. AB - In this paper we show that cultured chorionic villous fibroblasts efficiently catalyse the peroxisomal beta-oxidation of hexacosanoic acid (cerotic acid), a saturated very long chain fatty acid containing 26 carbon atoms. Hexacosanoic beta-oxidation was found to be strongly impaired in cultured chorionic villous fibroblasts from a Zellweger foetus. This finding indicates that measurement of peroxisomal beta-oxidation can be used (in addition to measurement of acyl CoA:dihydroxyacetone phosphate acyltransferase, de novo plasmalogen biosynthesis, the amount of particle-bound catalase and phytanic acid oxidase) for prenatal diagnosis in the first trimester of Zellweger syndrome, infantile Refsum disease and neonatal adrenoleukodystrophy. The method should be equally applicable to the early prenatal diagnosis of disorders in which there is a deficiency of a single peroxisomal beta-oxidation enzyme. Such diseases include X-linked adrenoleukodystrophy (peroxisomal very long chain fatty acyl CoA ligase deficiency), 'pseudo-Zellweger syndrome' (peroxisomal 3-oxoacyl-CoA thiolase deficiency) and 'pseudo-neonatal adrenoleukodystrophy' (acyl-CoA oxidase deficiency). PMID- 3652453 TI - Alanine glyoxylate aminotransferase and the urinary excretion of oxalate and glycollate in hyperoxaluria type I and the Zellweger syndrome. AB - We have studied the urinary excretion of oxalate and glycollate in patients with the Zellweger syndrome and hyperoxaluria type I and have measured the activity of alanine glyoxylate aminotransferase (a peroxisomal enzyme in man) in the patients. In agreement with earlier reports we found that alanine glyoxylate aminotransferase was strongly deficient in liver from a hyperoxaluria type I patient, thus explaining the increased urinary excretion of oxalate and glycollate in these patients. In livers from Zellweger patients, however, in which morphologically distinguishable peroxisomes are absent, the enzyme was not deficient, which is in accordance with our finding that the urinary excretion of oxalate and glycollate was normal in these patients. PMID- 3652454 TI - X-linked adrenoleukodystrophy: defective peroxisomal oxidation of very long chain fatty acids but not of very long chain fatty acyl-CoA esters. AB - We investigated the peroxisomal fatty acid beta-oxidation system in liver and cultured skin fibroblasts from patients with X-linked adrenoleukodystrophy known to accumulate very long chain fatty acids. In order to examine whether the deficient peroxisomal oxidation of very long chain fatty acids in these patients results from a deficiency in one of the peroxisomal beta-oxidation enzyme proteins (acyl-CoA oxidase, bifunctional protein with enoyl-CoA hydratase and 3 hydroxyacyl-CoA dehydrogenase activities and 3-oxoacyl-CoA thiolase) we carried out immunoblotting experiments using antibodies directed against the peroxisomal beta-oxidation enzyme proteins from rat liver. Furthermore, we studied the oxidation of palmitoyl-CoA and lignoceroyl-CoA in homogenates of fibroblasts from the patients. The results indicate that the peroxisomal beta-oxidation enzyme proteins are not only present immunologically but also functionally active which suggests that the defect in X-linked adrenoleukodystrophy is, indeed, as recently suggested by Hashmi and coworkers (FEBS Lett 1986;196:247-250) at the level of a deficient peroxisomal activation of very long chain fatty acids. PMID- 3652456 TI - Determination of urinary cystine for monitoring anticystinuric therapy. AB - Cystine is assayed in urine by a method adapted from the procedure of Haux and Natelson (Clin Chem 1970;16:366-369) and modifications of the method, which improved its specificity, are presented. Assay imprecision (CV) at four different cystine concentrations (range: 0.042-1.658 mmol/l) varied from 23.1% to 3.7%. Analytical recovery was 94.6 +/- 6.0%. D-Penicillamine, alpha mercaptopropionylglycine, L-glutamine and metabolites, added to urine, had negligible effect on the results of the cystine assay. Samples were stable for 3 wk when stored at 4 degrees C or frozen. Cystine excretion (mmol/24 h) in apparently healthy persons ranged from 0.041 to 0.170 (mean +/- SD: 0.099 +/- 0.039). Cystine excretions are presented in patients treated with anticystinuric drugs. PMID- 3652455 TI - A symmetric dialysis method for the determination of free testosterone in human plasma. AB - We describe a symmetric dialysis (SYD) method for the determination of the fraction (fT), and the concentration (FT) of non-protein-bound testosterone (T) in human plasma. In SYD fT is estimated from the rate at which radiolabelled testosterone redistributes between two identical (undiluted) plasma aliquots separated by a dialysis membrane. We compared the effect of tracer contamination and sample dilution on FT as measured by SYD and equilibrium dialysis (EQD) in five plasma pools differing in Sex Hormone Binding Globulin (SHBG) and total T concentration. In addition, FT was calculated by computer simulation of the interaction between binding proteins and steroid hormones. With SYD relatively small decreases in FT were observed following two- to tenfold dilution (14.3 +/- 4.4%). A comparable decrease was calculated by computer simulation (13.3 +/- 2.2%). The apparent fall in FT as estimated by EQD was much larger (44.7 +/- 2.2%) and, contrary to assessment by SYD, this fall depended on the radiochemical purity of the 3HT-tracer. Moreover, since SYD allows the assessment of fT in undiluted samples, problems relating to the interference of buffer components with T-binding are circumvented. We conclude that SYD is to be preferred over EQD for the accurate and precise measurement of fT and consequently FT. PMID- 3652457 TI - Effect of ritodrine on thyroid hormone concentrations. AB - In a clinical study of 17 pregnant women treated with ritodrine, a beta-2 sympathomimetic agent used for tocolysis, thyroid hormone status was assessed longitudinally. This was done in order to verify the hypothesis that an increase in T3 levels could result from adrenergic stimulation, since propanolol, a beta blocking agent, has proved to decrease T3 levels in man. We have observed a significant increase in serum T3 concentrations 24-48 h after the start of the ritodrine treatment. The changes were only temporarely since one week after the start the serum T3 concentrations did not differ significantly from the pre treatment levels. A decrease in T3 levels was found after discontinuation of treatment. No significant changes were found in T4 and TSH concentrations excluding an influence in ritodrine therapy on the pituitary-thyroid axes. It was concluded that stimulation of type I deiodinase was responsible for the changes in T3. These beta-2-mimetic variations may explain, to a certain degree, the unwanted chronotropic cardiac side effects of ritodrine and necessitates much care in using this therapy in hyperthyroidic patients. PMID- 3652458 TI - beta-Aminoisobutyric acid as a marker of thymine catabolism in malignancy. AB - Urine from untreated patients with various tumours and controls has been examined for the excretion of beta-aminoisobutyric acid and uric acid. The patients were classified into four groups: I, beta-aminoisobutyric acid and uric acid both normal; II, beta-aminoisobutyric acid normal, uric acid elevated; III, beta aminoisobutyric acid elevated, uric acid normal; IV, beta-aminoisobutyric acid and uric acid both elevated. Uric acid was used as an indicator for tissue breakdown. Pseudouridine being a specific parameter for t-RNA degradation was estimated for comparison. Increased urinary concentrations of beta aminoisobutyric acid were frequently found in tumour patients, especially in patients with leukaemia and non-Hodgkin lymphoma. Tissue breakdown being the cause of the beta-aminoisobutyric aciduria could only be considered in part of the patients. Moreover, strongly elevated ratios of beta-aminoisobutyric acid to uric acid were found. Urinary patterns of pyrimidines and purines were determined in order to exclude other abnormalities. The results are discussed in relation to thymine metabolism and renal function. PMID- 3652459 TI - The effect of oral contraceptives on plasma-free and salivary cortisol and cortisone. AB - The effect of a low estrogen oral contraceptive (OC) on glucocorticoid levels in plasma and saliva as well as glucocorticoid binding was studied in 23 healthy women using 30 micrograms ethinyl estradiol (EE2) + 150 micrograms desogestrel (Marvelon) (II). Fifteen healthy females with normal menses served as controls (I). Blood and salivary samples were taken between 9.00 and 9.30 a.m. on the 18th day of menstrual or pill cycle. Assay accuracy had been optimised by applying extraction and chromatographic purification before radioimmunoassay (RIA) of cortisol and cortisone in both plasma and salivary samples. Free steroid assays were performed by applying the same procedure to equilibrium dialysates obtained after dialysing plasma against an equal volume of buffer, instead of measuring tracer distribution. Corticosteroid Binding Globulin (CBG) was measured by a commercial RIA. As expected, CBG as well as plasma total cortisol were elevated in the pill group. Interestingly both plasma free and salivary cortisol were higher than in controls (free cortisol I: 18.0 +/- 7.95 nmol/l; II: 32.3 +/- 9.03 nmol/l; salivary cortisol I: 9.2 +/- 3.88 nmol/l; II: 18.8 +/- 6.92 nmol/l. Salivary cortisol closely parallelled plasma free cortisol both within and between the groups, though at a much lower level (about 50%). Free cortisone was slightly lower in the pill group (I: 10.8 +/- 2.55 nmol/l; II 8.5 +/- 1.86 nmol/l) whereas salivary cortisone was 2.3 (I) and 4.4 (II) times higher than plasma free cortisone and tended to follow the plasma free and salivary cortisol pattern, both within and between the study groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652460 TI - A haemolytic assay for the measurement of C9 in human serum and cerebrospinal fluid. PMID- 3652461 TI - Alpha-coma: clinical and evoked potential studies. AB - Simultaneous brainstem auditory and somatosensory evoked potential studies to median nerve stimulation were performed in two comatose patients, having diffuse alpha-pattern in their EEGs. CT scan of the brain in both cases did not reveal any mass lesion. In Case 1, the clinical and evoked potential studies suggested a brain stem lesion, and in Case 2 there was diffuse encephalopathy, with asymmetric dysfunction of the brainstem as seen in the evoked potential patterns. The suggested separation of alpha-pattern into two distinct groups, based on the reactivity and the presence or absence of sleep activities, into brainstem and diffuse cortical lesions could not be supported by our evoked potential studies. Our study, based on the observations of the evoked potential studies, indicated that the reactivity to sensory stimulation and intermittent attenuation of diffuse alpha-like activity relate to the integrity of the ascending sensory inputs to the thalamus. In the absence of evoked potential data, the localization of lesion(s) in alpha-coma pattern may be imprecise. Moreover, the circadian sleep rhythms and the presence or absence of "sleep spindles" appeared to depend on the inputs of the ascending sensory pathways to the structures generating the sleep activities. The specific neuronal structures generating the alpha-pattern still remain unidentified; however, this pattern seems to be originating from the structures rostral to the mesencephalon, possibly in the thalamic-thalamocortical circuits. PMID- 3652462 TI - Small sharp spikes: possible relationship to epilepsy. AB - The incidence of SSS in epileptic patients was compared with that in nonepileptic patients. The former group showed a significantly higher value (8.6%) than the latter group (2.5%). Among seizure types, SSS were most closely related to complex partial seizures. Most of the epileptic patients with SSS showed definite anterior temporal spikes with time, and the outcome of SSS correlated with the clinical course of seizures. These findings suggest that SSS have a closer association with epilepsy, particularly of temporal lobe origin. Some features that were different between the epileptic and nonepileptic patients with SSS were found, including the age of occurrence, laterality and the level of consciousness when they appear in the EEG. PMID- 3652463 TI - Development of the beta activities in children: an EEG-topographical analysis. AB - We investigated the characteristics of beta activities during drowsiness and very light sleep in 61 children using topographical analysis. The average power of beta activities was posterior-dominant in infancy, and it became frontal-dominant as the age increased. These topographical changes occurred earlier in the low frequency bands than the high frequency bands. The total power of the high frequency bands was larger in infants, and with increasing age that of the low frequency bands predominated. The developmental changes of the beta activities considered to be induced by drugs were similar to those of children without drugs. PMID- 3652465 TI - Sleep and waking disturbances in epilepsy. AB - We compared sleep parameters during three-hour postprandial nap recordings in 10 normal controls and 28 seizure patients. Patients had significantly less sleep, longer sleep latency, more wakefulness, less drowsiness and lighter nonREM sleep, and lower sleep efficiency than controls. Generalized seizure patients had longer sleep latency, more arousals, and more (but very little) stage III sleep. Those with partial seizures had more stage II sleep and greater sleep efficiency. Patients on polypharmacy and phenobarbital therapy slept more, phenytoin patients had very short sleep latency but more wakefulness and less sleep efficiency; those taking clonazepam were also awake more and had lower sleep efficiency, while arousals during sleep were more frequent in patients on valproate and carbamazepine. The findings suggest that disturbed sleep, possibly related to aberrant arousal occasioned by generalized epilepsy or epileptogenic foci, is common in seizure patients, and may be related to interictal behavioral and cognitive symptoms. Polypharmacy may have an additive effect on sleep to prolong and disrupt it, while sedative anti-epileptic drugs may increase sleep and other anti-epileptic medications may have alerting effects or interfere with falling asleep. Generalized and partial seizure patients may have sleep disturbances of a different character, possibly reflecting generally altered cerebral excitability by afferent stimuli in the former situation, and the more localized effects of limbic or cortical hyperactivity in the latter. PMID- 3652464 TI - Computerized EEG profiles of haloperidol, chlorpromazine, clozapine and placebo in treatment resistant schizophrenia. AB - In this paper we have described early applications of computerized EEG techniques in psychopharmacology. Perhaps our most remarkable finding was there were practically no differences between very chronic drug free schizophrenic patients and normals, which contradicts much of the EEG imaging literature. To us, the most likely explanation is that most of the anterior slowing observed in other studies was due to contamination from orbital artifacts, which we took exceptional pains to remove. Lingering effects of neuroleptic medications may also have contributed. Alternatively, EEG deviations in schizophrenia may recede when the illness reaches a very chronic stage, although this hypothesis is less tenable. There were significant differences between placebo and the three neuroleptics in terms of increased amplitudes in the delta and theta frequency bands in the anterior head regions, which is compatible with data from other studies. These changes were most pronounced with clozapine and least prominent with haloperidol, with chlorpromazine occupying an intermediate position. This order happens to parallel their relative antiserotonergic, antihistaminic and anticholinergic properties. The latter may have been partially obscured by the addition of benztropine. In a subgroup of patients who were recorded under each of the treatment conditions, there were more fast frequencies with clozapine than with the other neuroleptics agreeing with Roubicek and Major. This could be a function of clozapine's increased adrenergic activity as reported by Ackenheil. An unexpected finding was that patients who responded to clozapine had higher amplitudes in the alpha spectrum, most pronounced in the left anterior quadrant, than did the nonresponders. These differences between responders and nonresponders obtained whether patients were on placebo, haloperidol or clozapine. Curiously, Buchsbaum et al. found that anxious patients who responded to benzodiazepines also had higher alpha amplitudes in the same brain regions, which differentiated them from nonresponders. These findings clearly warrant future scientific investigation. In this regard, the generalizability of our data is limited by the extremely chronic, treatment-resistant population studied. However, promising directions for further research in EEG and psychopharmacology have been identified. PMID- 3652466 TI - The cerebral electrical fields in cerebellar syndrome. AB - Cerebral electrical field mapping in a patient with a clinically pure cerebellar syndrome showed the field maximum at the Pz electrode position. Flash visual evoked potentials also showed, in addition to the occipital response, a late positive peak at 344 ms at Pz. The findings suggest that the Pz electrode may at times record far field activity from the cerebellum. PMID- 3652467 TI - Pattern-reversal visual evoked potentials: latency changes with gender and age. AB - Pattern-reversal visual evoked potentials were studied in 123 volunteers with ages ranging from 20 to 77 years. The major positive component (P100) showed a shorter mean latency but a higher mean amplitude for females than males. The age dependent increase in mean P100 latency was observed in the female group but not in the male group. The present data suggest that gender is more important than age in affecting the P100 latency. PMID- 3652468 TI - Vitamin D nutrition and vitamin D metabolism in the premature human neonate. AB - The effect of supplementation with daily doses of vitamin D2 (1000 IU or 3000 IU, 25-75 micrograms, 63-189 nmol) has been studied in 39 premature neonates, initial gestational age 25-32 weeks. The initial mean plasma 25-hydroxyvitamin D was 25.8 nmol/l (10.3 ng/ml) but in 12 infants, most of whom were born in the winter months, the level was less than 15 nmol/l (6 ng/ml), and in seven babies plasma 1,25-dihydroxyvitamin D was less than 48 pmol/l (20 pg/ml). These findings suggest a considerable degree of maternal vitamin D-deficiency. Maximum attained concentrations of 25-hydroxyvitamin D on treatment were 77.3 nmol/l (30.9 ng/ml), high dose and 86.8 nmol/l (34.7 ng/ml), low dose, the mean rate of increase was greatest during the first two weeks (2.2 nmol/l/d; 0.88 ng/ml/d) and declined over the next 4 weeks. Mean maximum concentrations of 1,25-dihydroxyvitamin D2 were 283 pmol/l, (121 pg/ml), high dose and 309 pmol/l (129 pg/ml), low dose. Apart from a minor contribution to the initial plasma 1,25-dihydroxyvitamin D concentration, no effect of gestational age could be discerned in any of the measured variables. The endogenous pool of 1,25-dihydroxyvitamin D3 decayed with a T 1/2 of 22.5 d, indicating that vitamin D supplementation of these infants was necessary to avoid vitamin D-deficiency. PMID- 3652469 TI - Role of endogenous opioids in reducing the frequency of pulsatile luteinizing hormone secretion induced by progesterone in normal women. AB - It is well-established that the frequency of LH pulses varies during the normal menstrual cycle with a significant reduction in frequency in the luteal phase. Previous studies have indicated that both progesterone and opioids are able to reduce the frequency of LH pulses and in this study we sought to clarify the possible interaction between progesterone, endogenous opioids and GnRH neurons. Sixteen normal women in the mid-follicular phase (days 8-12) were randomly allocated to a control or treatment group and LH pulsatility assessed on one or two occasions by taking blood samples at 15 min intervals over 8 h. For the control women, LH pulsatility was assessed on one occasion during a saline infusion. The treated women received progesterone (50-100 mg/d for 7 d) at the end of which LH pulsatility was assessed before and after a naloxone infusion (2 mg/h for 8 h). Mean +/- SEM LH pulse frequency in the control women was 4.9 +/- 0.5 pulses/8 h which was significantly decreased to 3.0 +/- 0.3 pulses/8 h (P less than 0.01) in the progesterone treated women but not different from 5.5 +/- 0.3 pulses/8 h in those also treated with naloxone. Mean +/- SEM LH pulse amplitude in the control women was 2.3 +/- 0.3 IU/l, which was significantly increased to 4.8 +/- 0.7 IU/l (P less than 0.05) in the progesterone treated group, and to 3.7 +/- 0.4 IU/l (P less than 0.05) in the progesterone-treated women after naloxone. We conclude that progesterone slows the frequency of LH pulsatility by increasing endogenous opioid activity in the hypothalamus which may in turn inhibit the firing rate of the GnRH neurons. PMID- 3652470 TI - Rapid improvement in visual field defects following bromocriptine treatment of patients with non-functioning pituitary adenomas. AB - The role of bromocriptine in the treatment of non-functioning pituitary tumours is not yet defined. Patients with these tumours who present with visual field defects usually undergo immediate surgery. Three consecutive patients are reported: each had rapid improvement in their visual field defects following bromocriptine 7.5 mg/d before surgery. Histological and immunohistochemical examination confirmed that their tumours were non-functioning chromophobe adenomas. Their responses indicate that bromocriptine may have a role in the management of some patients with non-functioning pituitary tumours. PMID- 3652471 TI - The diagnostic validity of local and total bone mineral measurements in postmenopausal osteoporosis and osteoarthritis. AB - Assessment of different forms of prevention and treatment of bone mineral loss depends upon valid and precise methods to assess bone mass. We have here studied four groups of women: 45 healthy premenopausal women, 37 healthy postmenopausal women, 21 women with osteoarthritis and 20 with hip fractures. Bone mass was measured in the spine and total body by dual photon absorptiometry and in two forearm sites (proximal and distal bone mineral content (BMC) by single photon absorptiometry. The long-term (1 year) reproducibility was 1.2% for proximal BMC, 1.6% for distal BMC, 5.5% for spinal BMC, and 2.1% for total body bone mass (TBBM). In the early postmenopausal years bone mass was mainly reduced in areas with a high content of trabecular bone. In elderly postmenopausal women and women with hip fractures bone mass was almost identical in all four sites studied. The osteoarthritic patients had an 18% reduction of bone mass in the forearms and in TBBM, whereas the spinal bone mass was only reduced by 6%. In all subgroups TBBM could be predicted from the forearm measurements with standard errors of estimates of 9-13%. When the osteoarthritic women were excluded spinal bone mass could be predicted from both forearm measurements with a standard error of 15% (r = 0.74). The distal forearm BMC seems to be a more accurate estimate of spinal bone mass than does the proximal measurement. Of the 20 patients with hip fracture 16 had a distal forearm value below the premenopausal normal range, whereas spinal bone mass was subnormal in only eight (P less than 0.05). We conclude that bone loss is universal in patients with hip fracture and measurements of forearm bone mass will meet most clinical and research demands. PMID- 3652472 TI - Does short-term fasting desensitize human somatotrophs to oral L-dopa stimulation? AB - To investigate whether short-term fasting influences hormone release from human somatotrophs and lactotrophs, two oral L-dopa tests, using 0.5 g L-dopa, were carried out in seven normal subjects. The first test was performed after an overnight fast (8 h), the second after an additional 48 h of total food withdrawal. Basal blood glucose declined by 21 +/- 2% (mean +/- SEM) between the two tests (P less than 0.001). Free T3 in serum (FT3) fell by 32 +/- 4% (P less than 0.001). GH responsiveness to L-dopa--as reflected by the GH incremental area (ng/ml X min)--decreased from 588 +/- 162 to 24 +/- 240 (P less than 0.02). The latter response area did not even differ significantly from zero. Food deprivation failed to affect the lactotrophs, inasmuch as similar PRL decremental areas (ng/ml X min) were obtained in response to L-dopa before (704 +/- 165) and after (686 +/- 128) the prolonged fast. In order to prevent blood glucose from falling significantly during the period of food deprivation eight additional normal subjects were given 9 small oral doses of glucose (each dose 0.5 g/kg) at regular intervals between the two L-dopa tests. This resulted in similar FT3 concentrations before and after the prolonged fast. Furthermore, glucose supplementation restored normal GH responsiveness to L-dopa, as evidenced by similar GH incremental areas before and after the glucose fast. These results imply that short-term fasting desensitizes human somatotrophs to exogenous L dopa. The finding that the decreased GH responsiveness returns to normal if a decline in FT3 is prevented by oral glucose supplementation, suggests that changes in FT3 might contribute to the abolished GH responsiveness to L-dopa in fasting. PMID- 3652473 TI - Gonadotrophin-secreting pituitary adenomas masquerading as primary ovarian failure. AB - Three women, 20-35 years old, appeared on initial presentation to have primary ovarian failure, because each had amenorrhoea or oligomenorrhoea and markedly supranormal serum concentrations of gonadotrophins. On further evaluation, however, each had ovaries that could secrete oestradiol normally, and one had normal oestradiol secretion without any treatment. Another secreted oestradiol normally only after reduction of her gonadotrophins following partial excision of a pituitary adenoma. The third secreted oestradiol normally only after exogenous oestrogens were administered to reduce her gonadotrophins and were then withdrawn. Each had an enlarged, contrast-enhancing pituitary gland by computed tomographic scan and a markedly supranormal serum concentration of glycoprotein alpha subunit. We conclude that each of these women had a gonadotrophin-secreting pituitary adenoma that masqueraded as primary ovarian failure. Their persistently supranormal serum gonadotrophins appear to have inhibited ovarian function. PMID- 3652474 TI - TSH response to domperidone. PMID- 3652475 TI - Comparison of intestinal calcium absorption and circulating 1,25-dihydroxyvitamin D levels in malignancy-associated hypercalcaemia and primary hyperparathyroidism. AB - The relation between circulating 1,25-dihydroxyvitamin D (1,25(OH)2D) levels and intestinal calcium absorption--as determined by an oral calcium load test--was studied in 16 patients with hypercalcaemia of malignancy (HM) and 16 with hypercalcaemic primary parathyroidism (HPT). In the HPT group serum calcium rose significantly after the oral calcium load and the increment correlated significantly with 1,25(OH)2D levels. While 1,25(OH)2D levels were raised to within the hyperparathyroid range in a number of HM patients, there was no correlation between change in serum calcium and 1,25(OH)2D level in the HM group and serum calcium did not rise significantly after the oral calcium load. HM patients with detectable or raised 1,25(OH)2D levels typically had few, or no, bone metastases in association with squamous lung cancers. A high proportion of these patients exhibited other aspects of hyperparathyroid-like activity such as increased renal tubular calcium reabsorption, depressed renal tubular phosphate reabsorption and elevated urinary cyclic AMP excretion. Conversely, HM patients with undetectable 1,25(OH)2D levels typically had extensive metastatic bone disease in association with breast carcinoma and were less likely to exhibit other hyperparathyroid-like features. It is postulated that in the former, the 'inappropriately' detectable or raised 1,25(OH)2D levels may have been due to enhanced renal 1 alpha-hydroxylase activity stimulated by the parathyroid hormone (PTH)-like effect of a non-PTH ectopic humoral mediator. In the latter the suppressed 1,25(OH)2D levels would be the predicted result of a non-humorally mediated hypercalcaemia. It is currently unclear why intestinal calcium absorption was depressed in all HM patients when 1,25(OH)2D levels were normal or raised in some cases. It is possible, however, that in HM there is 'end organ' resistance to the effects of 1,25(OH)2D due to a generalized malabsorptive process. PMID- 3652476 TI - Determination of enolase isozymes in various adrenal gland tumours. AB - Enolase isozymes (alpha enolase and gamma enolase) in the extracts of adrenal tumours (phaeochromocytoma, adenoma of primary aldosteronism and Cushing's syndrome, and neurinoma) were determined by means of enzyme immunoassay systems. The mean +/- SEM, respectively, of alpha and gamma enolase levels were 2.5 +/- 0.37 microgram/mg protein and 3.2 +/- 0.69 micrograms/mg protein for 9 phaeochromocytomas, 15.2 +/- 3.1 microgram/mg protein and 0.65 +/- 0.18 microgram/mg protein for three adenomas with primary aldosteronism, 10.8 +/- 3.0 micrograms/mg protein and 0.23 +/- 0.02 micrograms/mg protein for five adenomas causing Cushing's syndrome, and 3.8 +/- 0.88 micrograms/mg protein and 0.30 +/- 0.15 micrograms/mg protein for three neurinomas. Thus, the gamma enolase concentration in the extract of phaeochromocytoma was higher than that of other adrenal tumours. The serum level of gamma enolase was determined in 36 patients with adrenal tumours and 26 normal controls by radioimmunoassay. The mean +/- SEM for gamma enolase level was 5.4 +/- 0.3 ng/ml in normal controls, 9.1 +/- 0.9 ng/ml for 10 patients with phaeochromocytoma, 6.3 +/- 0.3 ng/ml for 11 with primary aldosteronism, 5.5 +/- 0.4 ng/ml for 11 with Cushing's syndrome, and 5.1 +/- 0.7 ng/ml for four with neurinoma. Thus, patients with phaeochromocytoma had a significantly higher serum gamma enolase levels than did those with tumours derived from adrenal cortex and normal controls. In patients with phaeochromocytoma, serum gamma enolase levels showed a significant positive correlation with urinary adrenaline levels (P less than 0.05), and after resection the elevated level of gamma enolase fell significantly (P less than 0.05) and returned to normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652477 TI - Anti-TSH antibody with high specificity to human TSH in sera from a patient with Graves' disease: its isolation from, and interaction with, TSH receptor antibodies. AB - A patient with thyrotoxic Graves' disease had an apparent measurable level of serum TSH (2.5 microU/ml) by double-antibody radioimmunoassay (RIA). The serum IgG bound with both [125I]human(h)TSH and [125I]bovine(b)TSH. The [125I]hTSH binding was more effectively displaced by human than bovine TSH, whereas [125I]bTSH binding was displaced exclusively by bTSH. Scatchard analyses revealed that [125I]hTSH binding showed two components, whereas [125I]bTSH binding had only one component. Serum TSH determined by RIA became undetectable 21 months after antithyroid drug treatment with a parallel decrease of [125I]hTSH binding IgG activity. Four thyrotrophin binding inhibitory immunoglobulins (TBII) from other patients did not interfere with the binding of the patient's serum to [125I]h- or bTSH. Furthermore, the in-vitro thyroid stimulating activities of three thyroid stimulating antibodies (TSAb) were not affected by the addition of this patient's IgG. On the other hand, this patient's Ig (3 mg/ml) abolished the in-vitro thyroid stimulation by bTSH (100 microU/ml), but did not affect that by hTSH (100 microU/ml). The anti-hTSH antibody, TSH receptor antibody and anti-bTSH antibody in the serum, which contains TSAb as well as anti-TSH antibodies, could be partially purified by hTSH-agarose and subsequently by guinea pig fat cell membrane affinity absorptions. However, the anti-hTSH antibody fraction obtained had both hTSH binding activity and thyroid stimulating activity, and this fraction did not show any inhibitory effect on the in-vitro thyroid stimulation of autologous TSH receptor antibody or hTSH. The possible significance of anti TSH antibodies is discussed. PMID- 3652478 TI - IgG subclass distribution of thyroid autoantibodies: a 'fingerprint' of an individual's response to thyroglobulin and thyroid microsomal antigen. AB - The IgG subclass distribution of autoantibodies to thyroglobulin and thyroid microsomal antigen was studied in 21 patients with Graves' disease during fluctuations in total IgG class autoantibody levels induced by various forms of therapy. In addition, changes in autoantibody subclass distributions were investigated during the natural course of Hashimoto's disease in seven patients taking thyroxine. The autoantibodies were principally of subclasses IgG1 and/or IgG4 in Graves' patients although IgG2 contributed significantly to thyroglobulin antibodies in 5/7 Hashimoto sera. In Graves' disease the distribution of microsomal and thyroglobulin antibodies among the IgG subclasses remained essentially unchanged over periods of 6 months-2 years whether autoantibody levels decreased during carbimazole therapy or increased transiently following 131Iodine treatment or subtotal thyroidectomy. Similar observations were made for thyroglobulin antibodies in Hashimoto patients studied over 2 1/2-4 years; furthermore, the IgG subclass distribution of microsomal antibodies was usually different from that of thyroglobulin antibodies in the same patient. These observations suggest that the microsomal and/or thyroglobulin antibody subclass distribution is characteristic for a particular individual and may be regarded as the 'fingerprint' of an individual's response to these thyroid autoantigens. PMID- 3652479 TI - Cholinergic muscarinic receptor blockade with pirenzepine abolishes slow wave sleep-related growth hormone release in young patients with insulin-dependent diabetes mellitus. AB - Cholinergic receptor blockade has been shown to abolish GH secretion in a variety of physiological and pharmacological situations in normal subjects. We have investigated the effect of pirenzepine on nocturnal GH secretion in young adult patients with Type I insulin-dependent diabetes mellitus. Five patients (three male, two female; aged 20-27 years) were studied in a randomized order on two days separated by at least 1 week. All patients showed episodes of slow wave sleep on each occasion and this was followed by peaks of GH release when placebo alone was administered (range of GH peaks 6-115 mU/l). In contrast, cholinergic muscarinic receptor blockade with pirenzepine (100 mg orally at 2200 and 2400 h) completely abolished nocturnal GH release in each individual without altering the occurrence of slow wave sleep itself. Mean plasma glucose levels at each sampling time between each study did not differ significantly. The ability to abolish nocturnal GH secretion may be important in the field of diabetes, since excess GH secretion is implicated in several acute metabolic and chronic microvascular complications of the disease. PMID- 3652480 TI - Effect of oral frusemide on diagnostic indices of thyroid function. AB - We studied the acute effect of standard therapeutic doses of oral frusemide on indices of thyroid function in 34 hospital in-patients with congestive cardiac failure. A transient decrease in total T4, elevation in the T3 resin uptake and consequent increase in the free T4 index (FT4I) were seen 2-5 h after ingestion of frusemide at a chronic morning dosage of 80, 120 or 250 mg. The FT4I pre-vs post-frusemide values after 250 mg of drug were 109 +/- 12 vs 129 +/- 18 (P less than 0.05) after 120 mg 92 +/- 14 vs 119 +/- 12 (P less than 0.01), and after 80 mg 102 +/- 6 vs 112 +/- 4 (P less than 0.01) (mean +/- SEM). Similar increases in apparent free T4 measured by an analogue tracer assay (free T4 RIA sol, Henning, Berlin) were seen after frusemide. In a time course study, the major change in the T3 uptake 120 min after frusemide ingestion correlated with the change in serum frusemide concentration. When frusemide was added to serum in vitro its influence was greatest in methods that involved least dilution of serum. In two of the patients difficulty in clinical assessment of thyroid status was compounded by the effect of oral frusemide on FT4I. We conclude that oral frusemide may influence biochemical assessments of thyroid function in patients with congestive cardiac failure. It is necessary to consider the time interval between ingestion of high doses of oral frusemide and blood sampling in evaluating such results. PMID- 3652481 TI - Leucocyte sodium transport in acromegaly. AB - The leucocyte sodium pump was studied in patients with active and treated acromegaly. The ouabain-sensitive 22Na+ efflux rate constant was significantly raised in active acromegaly (median 2.71 [range 2.33-3.20] vs 2.32 [1.55-3.67] h 1, P less than 0.008) and was lowered into the normal range with successful treatment. Plasma GH and insulin levels and skin fold thickness on the dorsum of the hand were positively correlated with this efflux rate constant (rs = 0.06 P less than 0.02; rs = 0.57, P less than 0.02; rs = 0.57 P less than 0.04, respectively). GH, in vitro, stimulated ouabain-sensitive efflux in leucocytes at a concentration of 25 mU/l. We propose that this action of GH may explain the sodium retaining and calorigenic effects and possibly the stimulation of amino acid uptake by the hormone. The activity of the leucocyte sodium pump in acromegaly may be associated with other indices of disease activity. PMID- 3652482 TI - Serial serum thyroglobulin measurements in the management of differentiated thyroid carcinoma. AB - Serum thyroglobulin (Tg) was measured on repeated occasions in 416 patients with differentiated thyroid cancer for up to 7 years after initial therapy. All patients had thyroidectomy and/or ablative 131I therapy and all measurements were done while patients were receiving T4 replacement. Tg was measured using a double antibody radioimmunoassay. Overall correlation between serum Tg concentration and presence or absence of cancer was 95.9%. At the time of initial measurement 295 patients had serum Tg less than 5 micrograms/l, and in latest analysis only 1.7% of these patients showed evidence of disease. Initially there were 19 patients of a total of 121 with serum Tg greater than 5 micrograms/l in whom no cancer was apparent. In eight of these 19 subjects recurrent or metastatic disease has been diagnosed up to 3.5 years after the first measurement indicating that in these cases serum Tg values were 'predictive'. Serum Tg appears to be a sensitive and specific means of detecting residual, recurrent or metastatic thyroid cancer and in most situations can replace routine, expensive and inconvenient radioactive thyroid scans; these should be performed when serum Tg values are elevated or when there is clinical evidence suggesting recurrence. PMID- 3652483 TI - Prevalence, natural history and surgical treatment of exophthalmos. AB - The 95% confidence limits of exophthalmometer measurements have been defined by a single observer in 105 individuals who had no known thyroid disease, and found to be 10.5-18.8 mm. Measurements in 308 patients with thyrotoxicosis have shown that exophthalmos (greater than 19 mm) of one or both eyes was present in 21.3% of the patients. Among the 122 thyrotoxic patients whose exophthalmometer measurements could be performed annually for 3-19 years after correction of the thyrotoxicosis (usually with 131I), exophthalmos remained stable in 78.7%, worsened in 15.6% and became less severe in 5.7% of the patients. Transantral decompression of the orbits was performed in 15 patients with rapid subjective improvement in all and reduction in exophthalmometer measurements of 3.6 +/- 0.5 (mean +/- SEM) mm, and no serious side-effects. In view of these findings, transantral decompression should be considered more frequently in the treatment of severe or cosmetically damaging exophthalmos. PMID- 3652485 TI - An assessment of posterior pituitary function in patients with Sheehan's syndrome. AB - Antidiuretic hormone (ADH) function was assessed in a group of 16 patients with Sheehan's syndrome and 17 controls. All patients were on adequate cortisone and thyroxine replacement therapy before testing. During the dehydration test the patients revealed an impairment of ADH function. The maximum urine osmolalities and the urine-plasma osmolality ratios were significantly lower in the patients with Sheehan's syndrome compared to controls (maximum urine osmolalities 633 +/- 38 (SEM) and 873 +/- 29 (SEM) mOsm/kg, respectively, P less than 0.001; urine plasma osmolality ratios 2.15 +/- 0.14 (SEM) and 3.01 +/- 0.10 (SEM), respectively, P less than 0.001). Plasma osmolalities were significantly higher in the patients (296.1 +/- 1.2 (SEM) and 290 +/- 0.9 (SEM), respectively, P less than 0.001). The patients took a longer period to achieve these maximum urine osmolalities. Three of the patients with Sheehan's syndrome were diagnosed as having diabetes insipidus since their maximum urine osmolalities were below 600 mOsm/kg and following desmopressin all three had an increment in urine osmolality which exceeded 9%. In addition these three patients had a maximum urine-plasma osmolality ratio below 1.9. Thus, it appears the patients with Sheehan's syndrome have an impairment of ADH function which manifests in some as diabetes insipidus. PMID- 3652484 TI - Endocrine aspects of pituitary stalk enlargement. AB - Four patients with various endocrine deficiencies of a predominantly hypothalamic nature are described, in whom computed topographic scans demonstrated pituitary stalk enlargement. In one, a disseminated papular skin eruption with regional pleomorphism and spontaneous regression appeared 4 years after the development of the initial symptoms of diabetes insipidus, and led to a diagnosis of xanthoma disseminatum, a rare type of histiocytosis. It is suggested that this patient's endocrine dysfunction is also due to histiocytic involvement of the hypothalamus and/or pituitary stalk. In view of the prolonged lapse of time between the initial endocrine manifestations and the eventual diagnosis, even though no cause is apparent in the other three patients, it is suggested that close follow-up be carried out to rule out such a possibility in patients with this endocrine radiological entity. PMID- 3652486 TI - Proceedings of the Symposium on Monoclonal Antibodies and Investigation of Renin Angiotensin Systems. Pont-a-Mousson, France, september 7-8, 1986. PMID- 3652487 TI - Heterogeneity of pseudoxanthoma elasticum: delineation of a new form? AB - Sixty-four patients with pseudoxanthoma elasticum (PXE) were investigated in a nationwide study within South Africa and Zimbabwe. Thirty-nine individuals formed a distinct clinical subgroup. These persons were found exclusively among people of Afrikaner descent, whose origins are mainly derived from Dutch and French Huguenot stock. This disorder was inherited as an autosomal recessive trait and presented mild to moderate cutaneous and cardiovascular manifestations. However, after the third decade of life severe visual impairment developed and culminated in blindness in 8 people by the age of 50. The cause of the visual defect was progressive extension of angioid streaks into the macula with neovascularization and haemorrhage. Laser therapy may have prevented further bleeding in 4 instances. The severity of ocular involvement contrasted with the mildness of the skin changes, and in this respect the condition seems to differ from previously delineated autosomal recessive forms of PXE. PMID- 3652488 TI - Incidence of familial dysautonomia in Israel 1977-1981. AB - The incidence of all diagnosed cases of familial dysautonomia in Israel among Ashkenazi Jews from 1977-1981 was 27/100,000 or 1/3703. This incidence is higher than that previously reported in Israel in 1967 or 8.3/100,000 (1/12,048) (Moses et al. 1967). It is also higher than that of North American Ashkenazi Jews in 1970, when the rate was 5-10/100,000 (1/10,000-20,000) (Brunt & McKusick 1970). This higher incidence could be explained by current awareness of the diagnosis, or by the emergence of more cases. PMID- 3652489 TI - Effect of combinations of antioxidants on oxygen radical-induced sister chromatid exchanges. AB - Oxygen radical scavengers significantly reduced the number of sister chromatid exchanges in Chinese hamster ovary cells exposed to an oxygen radical-generating enzyme system. When vitamin E was combined with these antioxidants, no genetic toxicity was observed. PMID- 3652490 TI - Dyslexia and chromosome 15 heteromorphism: negative lod score in a Danish material. AB - From a large Danish material of random families we selected families with dyslexia as reported by the families themselves and as recorded by a dyslexia institute. Among five "backcross families" studied for chromosome 15 polymorphisms we found only negative lod scores, and at theta = 0.10 a negative score of -3.42; i.e., in our material we did not find any confirmation of the indication of linkage between dyslexia and a chromosome 15 polymorphism found in part of their material by Smith et al. (1983, 1986). PMID- 3652491 TI - Hereditary hypotrichosis simplex of the scalp. AB - Hereditary hypotrichosis simplex of the scalp is a rare trait with onset in early childhood. This phenomenon has been reported only once previously, in a Spanish kindred. This communication describes a case in a Jewish-Yemenite kindred with 51 affected individuals and confirms autosomal dominant inheritance. PMID- 3652492 TI - A case of first trimester chromosomal mosaicism confined to the cultivation of the gestational products. AB - The advantages of the emergence and development of chorionic villi sampling (CVS) for early prenatal diagnosis are evident, but there are a host of new diagnostic problems caused by the use of extraembryonic tissues. We report a case in which 45X/46XY mosaicism was diagnosed by cultivation of chorionic villi and fetal cells. Direct chromosomal preparations of chorionic villi failed to diagnose the abnormality. PMID- 3652493 TI - Partial trisomy 3q syndrome inherited from familial t(3;9)(q26.1; p23). AB - A five-year-old girl was referred to prometaphase chromosome analysis because of mental retardation, facial dysmorphic features suggestive of Cornelia de Lange syndrome, cleft palate and additional minor congenital malformations of the cardiac system and fingers and toes. A familial balanced translocation (3;9)(q26.1; p23) was found. The karyotype of the proposita was 46,XX,der(9),t(3;9)(q26.1;p23). Thus the patient was trisomic for 3q26.1-qter and monosomic for 9p23-pter. The unbalanced chromosome constitution was not detected by standard Q-banding analysis shortly after birth. The karyotype was misdiagnosed as 46,XX,9(p+) in the proposita and her mother, and thought to be a normal variant of chromosome 9. The repeated cytogenetic study led to the diagnosis of the translocation and to the possibility of prenatal diagnosis in the translocation carriers. A survey of 22 published cases of dup(3q) showed that nearly 60% were secondary to familial balanced rearrangements with an excess of maternally derived abnormal chromosomes 3. Red blood cell galactose-1-phosphate uridyltransferase (GALT) activity was normal in the patient, consistent with previous assignment of the gene locus for GALT to 9p13 (Shih et al. 1982). PMID- 3652494 TI - Chromosome studies in IgA-deficient patients. AB - Chromosome analysis was performed in 17 children with IgA-deficiency. In two patients a constitutional structural chromosome abnormality was found. A ring chromosome 22 was seen in one, while in the other a mosaicism of ring chromosome 18/18p+ was observed. Both patients were mentally retarded and showed distinct congenital defects. From ten asymptomatic patients, spontaneous as well as X-ray induced chromosome instability was investigated. There was no increased spontaneous instability, and also after irradiation the induced chromosome damage was within normal control levels. A relationship between IgA-deficiency and X-ray hypersensitivity, as might be suggested by the frequently occurring coincidence of radiosensitivity and IgA-deficiency in ataxia telangiectasia patients, is not established. PMID- 3652495 TI - Microcephalic osteodysplastic dwarfism (type II-like) in siblings. AB - We report about two sibs showing a common pattern of birth defects, with a pedigree suggestive of autosomal recessive heredity. The main features are intrauterine growth failure with very low birthweight; disproportionate dwarfism with predominantly distal shortening of limbs; small cubitally inclined clenched hands; microcephaly with Seckel-like facies and delayed psychomotor development. X-ray findings include metaphyseal flare, V-shaped femoral metaphyses and bowing of forearms. Primordial microcephalic osteodysplastic dwarfism Type II is discussed. Metabolic and nutritional data are presented and discussed. PMID- 3652496 TI - X-linked myotubular myopathy: intrafamilial variability and normal muscle biopsy in a heterozygous female. AB - The myotubular myopathies are a heterogeneous group of muscle disorders in which x-linked, autosomal recessive, and autosomal dominant inheritance have been reported. Female carriers of x-linked myotubular myopathy have been reported to have abnormal muscle biopsies. We report a woman who had a normal muscle biopsy but who had 2 sons with myotubular myopathy by different fathers, indicating that a normal muscle biopsy of the mother cannot exclude x-linked inheritance. The quantity of fetal activity correlated with the severity of the disorder in this pedigree. PMID- 3652497 TI - The 'dirty neck'--a reticulate pigmentation in atopics. PMID- 3652498 TI - Screening for cataracts in patients with severe atopic eczema. PMID- 3652499 TI - The treatment of multiple angiokeratomata with the argon laser. PMID- 3652500 TI - Cutaneous calcinosis in erythromelanosis follicularis faciei et colli. PMID- 3652501 TI - Erythromelanosis follicularis faciei et colli. PMID- 3652502 TI - Reticular erythematous mucinosis syndrome. PMID- 3652503 TI - Human cutaneous myiasis--a review and report of three cases due to Dermatobia hominis. PMID- 3652504 TI - Primary biliary cirrhosis in a diabetic male with dermatitis herpetiformis. PMID- 3652505 TI - Juvenile plantar dermatosis--an 8-year follow-up of 102 patients. PMID- 3652506 TI - The treatment of linear morphoea with D-penicillamine. PMID- 3652507 TI - Congenital erythropoietic porphyria (Gunther disease). PMID- 3652508 TI - D-penicillamine induced dermopathy in Wilson's disease. PMID- 3652510 TI - Psoriasis--an index of disability. PMID- 3652509 TI - Hodgkin's disease presenting in the skin. PMID- 3652511 TI - Experimental allergic encephalomyelitis in rhesus monkeys: I. Immunological parameters in EAE resistant and susceptible rhesus monkeys. AB - Immunological parameters in rhesus monkeys, resistant and susceptible to experimental allergic encephalomyelitis (EAE), were studied. Monkeys immunized with complete Freund's adjuvant (CFA) alone and EAE resistant monkeys immunized with a low dose of bovine brain homogenate emulsified in CFA did not show significant fluctuations in numbers of granulocytes, lymphocytes and lymphocyte subsets (CD4; CD8; GM13, a subset of CD8) and anti-brain homogenate antibody titres remained low. EAE susceptible monkeys immunized with a high dose of myelin developed EAE significantly faster than monkeys immunized with a low dose of brain homogenate. During the induction phase all EAE susceptible monkeys, in contrast to the CFA controls and EAE resistant monkeys, showed an increase in the numbers of granulocytes and the CD4/CD8 ratios and had high antibody titres specific for the immunizing antigens. The most significant disease-related changes were observed after the onset of clinical signs. These included a granulocytosis, a lymphopenia and a decrease in the CD4/CD8 ratio, indicating a selective loss of CD4+ lymphocytes. A major difference between monkeys immunized with myelin and brain homogenate was the significant increase in the percentage of GM13+ lymphocytes after the onset of clinical signs in the latter group. Increases in the CD4/CD8 ratio and antibody titres during the induction phase may be prognostic factors for the subsequent development of EAE. PMID- 3652512 TI - Protective effect of myasthenic immunoglobulins against the lethal toxicity of alpha bungarotoxin. AB - Using a radioimmunological method performed in the presence and absence of the acetylcholine agonist decamethonium (DC), it was demonstrated that 98% of myasthenia gravis (MG) patients' sera (positive for anti-acetylcholine receptor (anti-AChR) antibody titres in the conventional assay) contain antibodies that block the binding of alpha bungarotoxin (alpha Bgt) to human AChR. The positive effect of myasthenic immunoglobulins against the alpha Bgt toxicity was revealed by a test devised to investigate the biological significance of these blocking antibodies in vivo in Balb/c mice. IgG from sera containing blocking antibodies, detected either directly or in the presence of DC, protected the mice treated (24 of 25); nevertheless no overt clinical signs of a myasthenic syndrome were observed. Control IgG, from normal human sera or from a systemic lupus erythematosus patient, provided no protection (22 dead out of 26). IgG from MG sera devoid of anti-AChR antibodies (eight out of eight) and IgG from serum containing anti-AChR antibodies but devoid of blocking antibodies offered no defence against alpha Bgt toxicity (13 dead out of 15). The pathological role of blocking antibodies, cell mediated immunity or other mechanisms is discussed. PMID- 3652513 TI - Variation of serum and intestinal gluten antibody specificities in coeliac disease. AB - Protein blotting techniques were used to investigate the gluten specificity of IgA and IgG antibodies in sera and intestinal aspirates from patients with coeliac disease and normal controls. Initially, discontinuous SDS polyacrylamide gel electrophoresis was used to separate the flour proteins. All normal and coeliac sera contained antibodies which bound to various of the gliadin proteins. In only a few sera was binding found to the high molecular weight glutenin subunits, while none was detected to the salt-soluble wheat proteins. Polyacrylamide gradient gel electrophoresis was then used to further separate the gliadin proteins. Almost all normal sera examined showed similar gliadin specificity, binding uniformly to all gliadin groups. While approximately a quarter of the coeliac sera showed even binding to all of the gliadin proteins, the majority showed antibody binding intensely to discrete groups of gliadin bands. We were unable to identify any gliadin band(s) which only bound antibodies from coeliac patients in comparison with normal subjects. The specificities of IgG and IgA serum antibodies were identical for each patient examined, but some differences between serum and intestinal IgA specificities were found for certain patients. PMID- 3652514 TI - Evaluation of the anti-cardiolipin antibody test: report of an international workshop held 4 April 1986. AB - Thirty laboratories from institutions in Britain, France, Italy, The Netherlands, New Zealand, Sweden and the USA participated in a workshop to evaluate the anti cardiolipin (aCL) test. Participants were asked to measure IgG and IgM aCL in seven samples on each of three separate days. The seven samples were prepared so that IgG and IgM aCL concentrations were known before distribution. Twenty-three of 30 laboratories measuring IgG aCL had significant regression slopes (P less than 0.001) when optical absorbance readings or counts per minute were compared with IgG aCL concentration. Twenty-four of 28 laboratories measuring IgM aCL had significant regression slopes (P less than 0.001). Coefficient of determination (R2) ranged from 81.1% to 98.7% for laboratories with valid IgG aCL assays and from 48.0% to 96.7% for valid IgM aCL assays. Valid assays had in common the use of 10% fetal calf or 10% adult bovine serum in PBS. Assays that were not valid had in common the use of PBS, PBS-Tween, or 0.3% gelatin as diluents. All laboratories with valid assays defined samples with high and moderate aCL levels as positive but there was no consensus about low positive samples. This study shows that properly performed ELISA or SRIA assays can be used to provide an accurate, reproducible, and quantitative measure of IgG and IgM aCL concentration in serum samples. PMID- 3652515 TI - Deficiency of immunity to Mycobacterium avium that can be restored by allogeneic lymphocytes. AB - A 3-year-old girl developed a disseminated Mycobacterium avium infection despite treatment with eight antimycobacterial drugs. She had no pre-existent general humoral or cellular immunodeficiency. In the course of the disease B lymphocyte areas in the lymphoid tissues were replaced by histiocytes and an IgM and IgA deficiency evolved. The patient still made antibodies to concomitant micro organisms and to transfused blood cells. Peripheral blood mononuclear cells (PBMC) had normal responses to mitogens and various antigens in vitro. However, she lacked any response to mycobacterial antigens, in vivo and in vitro. The defect appeared not to be dependent on immunosuppression by lymphocytes or monocytes or on deficient antigen presentation by monocytes. because a genetic origin could not be substantiated, acquired immunological paralysis for mycobacterial antigens was the most likely explanation. Addition of irradiated PBMC from her HLA-A, -B, -C and -DR phenotypically identical father, transferred a response to mycobacterial antigens of the patient's PBMC in vitro. We concluded that the disseminated M. avium infection was accompanied by a selective deficiency of the lymphocyte response to mycobacterial antigens which could be restored by allogeneic antigen responsive lymphocytes. PMID- 3652516 TI - IgG and IgE antibodies to Chironomidae in asthmatic patients. AB - IgG antibodies to Chironomidae and its correlations to radioallergosorbent and skin reactions were examined with the aim of clarifying the relationship between asthma and Chironomidae. The level of specific IgG antibody in asthmatic patients (0.698 +/- 0.034, n = 104) was significantly greater than that in normal subjects (0.367 +/- 0.032, n = 52) (P less than 0.01). The specific IgG level was not correlated to skin reaction, nor to IgE RAST scores. Specific IgG1 and IgG4 levels in asthmatic patients were significantly greater than in control subjects (n = 14) (P less than 0.01). PMID- 3652517 TI - Characterization of cell mediated immune responses to the hepatitis B core protein in man. AB - Eight donors immune to hepatitis B (HB) after natural infection were studied for their cell-mediated immune response to hepatitis B core (HBc) protein in vitro. Significant specific activation was observed in highly purified peripheral blood lymphocytes and T cells from these donors after 5-8 days of incubation with HBc protein. This in vitro response was modulated by monocytic cells and maximal 3H thymidine incorporation was elicited with low concentrations of the antigen (0.1 10 ng/ml). The cell-mediated immune reactivity towards HBc-protein was significantly (P less than 0.005) elevated compared to the envelope material of the virus (HBsAg) when analysed in the same donor population. In contrast, donors with plasma-derived hepatitis B vaccine induced immunity to HB exhibited only specific lymphocyte activation to HBsAg. These data indicate that the composition of immune responses conferring protection against HBV after natural infection is far more complex than after immunization with the hepatitis B vaccine. Further characterization of the cell-mediated immune response to HBc protein and its relation to protection against HBV seems warranted when strategies for new HB vaccines are being designed. PMID- 3652518 TI - Virulence-plasmid is associated with the inhibition of opsonization in Yersinia enterocolitica and Yersinia pseudotuberculosis. AB - Plasmid-cured variants of virulent strains of Yersinia enterocolitica and Y. pseudotuberculosis were obtained by selection after growth in calcium-deficient medium. To obtain antigen preparations consisting of whole bacteria the original plasmid-containing strains and the plasmid-cured variants were grown in conditions favouring expression of the temperature-inducible outer membrane proteins of Yersinia (YOP) (37 degrees C, calcium-deficient culture medium). The presence or absence of the YOP on the bacteria was verified by immunoblotting. Opsonophagocytosis of YOP-negative Yersinia preparations (YOP-) was compared to that of YOP-containing ones (YOP+) in human polymorphonuclear leukocyte (PMN) chemiluminescence (CL) assay. The attachment of complement C3b on the surface of the bacteria after opsonization with normal human serum was determined by using a fluorescent anti-C3c-antibody and flow cytometry. YOP+ bacteria resisted opsonization in the absence of specific antibodies, as indicated by diminished C3b-fixation on bacteria and weaker CL response. This implies that virulence plasmid-coded structures provide Y. enterocolitica and Y. pseudotuberculosis with an ability to avoid complement-mediated opsonization and phagocytosis. PMID- 3652519 TI - Serum IgG subclass deficiency in ataxia-telangiectasia. AB - Serum IgG subclass levels were determined using a competitive indirect immunoenzymatic assay with monoclonal antibodies in 16 patients with ataxia telangiectasia. Eight children had IgA deficiency, two had IgG and IgA deficiency and six patients showed no immunoglobulin class abnormality. However, IgG4 and IgG2 levels were undetectable or low in almost every patient. An IgG3 deficiency was associated with the IgG2-IgG4 defect in three patients with undetectable IgA. IgG1 was very low in one patient with a total IgG deficiency. There was no clear correlation between subclass levels and the occurrence of infections. PMID- 3652520 TI - The binding of immunoglobulin Fc to cationic proteins. AB - The interaction of cationic proteins with IgG, IgA and IgM were investigated by solid phase radioimmunoassay. All these immunoglobulins showed avid binding, IgM giving the strongest reaction, followed by IgA and then IgG. Fc fragments of IgG gave binding, but F(ab')2 fragments from the three main Ig classes did not, showing that the Fc region is the active part of the molecule. The effects of changes of ionic strength and pH are compatible with the interaction being ionic, and are similar to those seen between immunoglobulins and both Clq and cationic ion exchange gels. The addition of other serum proteins resulted in marked inhibition of the interaction. These phenomena are likely to have fundamental significance for the understanding of interactions of immunoglobulins in vivo and in vitro. PMID- 3652521 TI - Mouse anti-benzylpenicilloyl IgE monoclonal antibody: preparation, characterization and cross-reactivity. AB - Anti-benzylpenicilloyl (BPO-) monoclonal antibody of the IgE class was prepared from spleens of immune C57BL/6 mice whose sera reacted with BPO-hapten, penicillin G(PCG) polymer, cephalothin (CET)-hapten and CET polymer. Affinity chromatography experiments showed that the haptenic specificity of the IgE monoclonal antibody (designated BIE-13CE) was directed mainly to phenylacetyl portion of BPO group. BIE-13CE antibody reacted on passive cutaneous anaphylaxis (PCA) assay with BPO-hapten, CET-hapten, cephaloridine-hapten and CET polymer, but did not react with PCG polymer, ampicillin-hapten, or cefazolin-hapten. These results indicated that the sera of the immune C57BL/6 mice contained IgE antibodies capable of cross-reacting at the monoclonal antibody level with various forms of eliciting antigens and that the cross-reactivity of the antibody could be ascribed essentially to the structural similarity of acyl side chains of the antibiotics. The structure of the CET polymer is also discussed in terms of its PCA reactivity with the monoclonal antibody and analytical and spectral data of the polymer. PMID- 3652523 TI - Increased concanavalin A-binding capacity of immunoglobulin G purified from sera of patients with rheumatoid arthritis. AB - A solid phase radioimmunoassay was set up for direct measurement of the binding capacity of human IgG to three lectins recognizing different carbohydrates of the Fc domain, i.e. peanut agglutinin (PNA), Concanavalin A (Con A) and pokeweed mitogen (PWM) which mainly bind to beta-galactose, alpha-mannose and dimers of N acetyl-beta-glucosamine respectively. The mean specific binding of the 96 normal IgG tested to PNA and to PWM was statistically higher (P less than 0.001) than that to Con A, whereas no significant differences were observed between the mean specific bindings to PNA and to PWM. A statistically significant linear negative correlation could be established only between the relative bindings (expressed in percentage of the total binding to the three lectins) to PNA and to PWM (r = 0.65, P less than 0.001). The mean specific binding of IgG purified from 34 patients suffering from rheumatoid arthritis (RA) to PNA and to Con A was statistically higher (P less than 0.001) than that reached with PWM, whereas no significant differences were noted between their mean binding capacities to PNA and to Con A. When compared to normal IgG, only four out of 34 RA IgG exhibited a significantly higher binding capacity to PNA, whereas all but one RA IgG possessed a significantly higher binding capacity to Con A. Accordingly, the mean specific binding of RA IgG to Con A was significantly higher than that of normal IgG (P less than 0.001). Besides (and contrary to normal IgG), a statistically significant negative linear correlation was noted between the relative bindings of RA IgG to PNA and to Con A (r = -0.89, P less than 0.001). All the five RA IgG tested exhibited an abnormal circular dichroism. Our data suggest that, by altered steric conformation and glycosylation, mannosyl-residues of RA IgG become prominent or terminal or both, and are therefore able to react more effectively with Con A than normal IgG do. PMID- 3652522 TI - Impaired anti-pneumococcal antibody response in patients with AIDS-related persistent generalized lymphadenopathy. AB - Pre- and post-immunization serum antibodies to pneumococcal polysaccharides (PPS) and tetanus toxoid (TT) were measured in 25 patients with persistent generalized lymphadenopathy and serum antibodies to the human immunodeficiency virus (HIV). The increase in post-immunization anti-PPS antibodies was lower than 40% in 16/25 patients. Isotype analysis indicated that the IgM, IgA, IgG2, but not the IgG1 antibody responses were lower in patients that in healthy controls, whereas pre immunization values were similar. For TT, no difference was found between the patients and the healthy group in total and IgG1 antibody response whereas IgG4 response was lower in patients. No significant association was found between the defect in anti-PPS antibody response and associated thrush or constitutional symptoms or other immunological parameters. These findings suggest that defective response to a thymo-independent polysaccharide antigen is a distinctive consequence of HIV infection. PMID- 3652524 TI - Antibody affinity and IgG subclass of responses to tetanus toxoid in patients with rheumatoid arthritis and systemic lupus erythematosus. AB - Significant differences in both the affinity and IgG subclass of antibodies produced after immunization with tetanus toxoid have been demonstrated in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) compared to healthy controls. Patients with RA failed to show affinity maturation although they produced similar amounts of antibody to the controls. Some patients with SLE produced very high affinity antibodies although there was a wide spectrum of response. Antibodies to tetanus toxoid in controls were predominantly IgG1 and IgG4 but in RA and SLE there was either a restricted IgG1 response or a more general response in all the IgG subclasses. It is likely that these differences in response reflect the underlying disorders in immunoregulation present in patients with these diseases. PMID- 3652525 TI - Growth hormone treatment stimulates thymulin production in aged dogs. AB - Diminished thymic morphology and function and a decreased provocative growth hormone (GH) response are characteristic of normal ageing. We have previously demonstrated that bovine growth hormone (bGH) treatment of adult dogs tends to result in a rejuvenation of thymic morphology. The purpose of this study was twofold: (1) to determine concentrations of thymulin (a thymic hormone) in plasma from dogs of various ages, and (2) to evaluate the effect of bGH administration on plasma thymulin concentration and thymus morphology in 'middle-aged' and 'old aged' dogs. 'Young' (4 months), 'middle-aged' (33-55 months) and 'old-aged' (63 83 months) female beagles served as subjects for this study. Middle- and old-aged dogs were injected with either bGH or bovine serum albumin (control) for 1 month. Thymulin concentration in plasma was determined by the rosette-inhibition bioassay. An age-associated decline in the plasma concentration of thymulin was detected. Plasma thymulin concentration increased in every bGH-treated dog. In middle-aged but not old-aged dogs, bGH treatment resulted in rejuvenation of thymic morphological features as determined by stereological and histomorphological procedures. The results suggest that exogenous GH may be useful for restoration of some immune functions in aged individuals. PMID- 3652526 TI - Enhancement of monocyte class I and II histocompatibility antigen expression in man by in vivo beta-interferon. AB - Changes in monocyte cell-surface markers were assessed during treatment of patients with beta-interferon (beta-IFN). Immediately after isolation monocytes were analysed using monoclonal antibodies and flow cytometry. After 2 days of beta-IFN significant increases in major histocompatibility complex (MHC) related cell-surface products were observed while no changes in Leu-M3, a non-MHC associated monocyte-specific marker, were found. The most striking increases were (1) the percent of monocytes positive for HLA-DQ (mean increase = 19.7%); (2) the relative amount of monocyte-surface HLA-DR (mean increase = 10.1 mean fluorescence intensity (MFI) units); and (3) the relative amount of monocyte surface beta 2-microglobulin (mean increase = 7.7 MFI units). Increases in MHC expression over baseline were greater after 2 days of beta-IFN treatment than after 14 days of IFN. Thus beta-IFN, produced by recombinant DNA technology and purified to homogeneity, increased surface MHC expression on monocytes in vivo. Additionally, levels of 2-5A synthetase, a type-I IFN-induced enzyme, were significantly increased in patient peripheral blood mononuclear cells after treatment. Increases in 2-5A synthetase were found to correlate with increases in MHC expression suggesting a common mechanism for induction. Flow cytometry can in the future be used to correlate changes in MHC expression with therapeutic response. PMID- 3652527 TI - Jejunal plasma cells and in vitro immunoglobulin production in adult coeliac disease. AB - IgA, IgE, IgG and IgM plasma cells in small bowel mucosal biopsies from 15 controls, 16 untreated and 14 treated coeliac patients and five patients with selective serum IgA deficiency (four of whom also had coeliac disease) were quantified using an indirect immunoperoxidase technique. The IgA, IgG and IgM plasma cell counts were significantly increased in the untreated coeliac patients. The cell counts were intermediate in the treated coeliac group. These changes were in parallel to production in vitro of IgA and sIgA, IgG, and IgM by cultured mucosal biopsies from the same patients. The IgA deficient patients had very few mucosal IgA cells but elevated IgG and IgM plasma cell numbers; again these changes were reflected in the production in vitro of immunoglobulins. IgE plasma cell counts were very low in all patients and there were no differences between patient groups. The changes in cell counts and mucosal immunoglobulin production were not reflected in serum IgA, IgM and IgG concentrations but serum secretory IgA was significantly elevated in the untreated coeliac patients compared with controls, with the treated coeliac patients being intermediate. The raised mucosal plasma cell counts reflect the local mucosal production of immunoglobulin but not the immunoglobulin concentrations of serum, emphasising the importance of studying the immune function of the gut itself in coeliac disease rather than immunological abnormalities in serum. PMID- 3652528 TI - Clearance of soluble aggregates of human immunoglobulin G in healthy volunteers and chimpanzees. AB - Using aggregates of IgG (AIgG) obtained by heat aggregation of a 16 g% human IgG solution, we sought a method for measuring the function of the mononuclear phagocyte system with a probe that bears more resemblance to soluble immune complexes than erythrocytes coated with anti-rhesus IgG (EIgG). It was found that intravenous administration of 10 micrograms AIgG/kg body weight did not cause any detectable side effects in chimpanzees. In nine healthy volunteers, a dose of 10 micrograms AIgG/kg body weight was used without any adverse reactions. AIgG is cleared from the human circulation with a t1/2 of 26 +/- 8 min (mean +/- SD). The site of clearance is predominantly the liver, as shown by an average liver spleen uptake ratio of 230:100. In whole blood obtained from the volunteers, it was found that erythrocytes bound significant amounts of AIgG, suggesting that CR1 on erythrocytes is involved in the clearance of complement activating immune complexes in humans. In five of the volunteers, clearance studies with EIgG had been done in a previous study. EIgG was cleared from the circulation with a t1/2 of 30 +/- 6.2 min (mean +/- SD). The predominant site of clearance of EIgG was the spleen. These data indicate that sensitized red blood cells are cleared from the circulation differently from soluble IgG aggregates. PMID- 3652529 TI - Aberrant phagocyte function in Shwachman syndrome. AB - Polymorphonuclear leucocytes (PMN) of patients with Shwachman syndrome show impaired mobility in vitro. We took this finding a step further by studying chemotaxis and chemiluminescence responses of purified PMN and monocytes (MO) of seven patients with Shwachman syndrome. Chemiluminescence responses of the patients' PMN were significantly increased, and thus impaired mobility may have derived from auto-oxidation of PMN. Chemotaxis of purified PMN was not impaired in a membrane filter, but it did become impaired when PMN were remixed with autologous mononuclear (MN) cells or MO. These cells always increased the migration of PMN. Because the patients' cells were fully capable of increasing the migration of control PMN, the defect most probably involved PMN. This is in harmony with the finding that the patients' purified PMN showed depressed chemotaxis under agarose. This suggests that for detecting impaired chemotaxis of purified PMN the assay conditions were more optimal in the agarose test than in the filter test. Both chemotaxis and chemiluminescence responses of the patients' MO were depressed, and thus, the defects involving PMN and MO are separate. PMID- 3652530 TI - Characterization of different types of experimental autoimmune thyroiditis in the Buffalo strain rat. AB - We have compared features of experimental thyroiditis in the Buffalo strain rat induced by neonatal thymectomy, immunization with rat thyroglobulin (Tg) and complete Freund's adjuvant, and subcutaneous administration of trypan blue or 3 methylcholanthrene. The disease produced by neonatal thymectomy resulted in significantly worse thyroiditis and higher antibody levels than the other models and shared other features in common with Hashimoto's thyroiditis. In particular TSH levels were elevated, Tg antibodies had a restricted subclass distribution, the thyroid was infiltrated by both B cells and T cells (comprising equal numbers of W3/25 and Ox8 positive cells) and thyroid follicular cells were Ia antigen positive in some of the thymectomy group animals. In the other forms of thyroiditis, the thyroid infiltrate was mainly composed of macrophages or dendritic cells and B cells. Different pathogenic mechanisms are probably involved in these models; the disease produced by neonatal thymectomy shows the closest similarity to Hashimoto's thyroiditis. PMID- 3652531 TI - Neutralizing antibodies in HIV (HTLV-III) infection: correlation with clinical outcome and antibody response against different viral proteins. AB - Sequential serum samples, collected over a 2-3 year follow-up period, of 28 HIV infected individuals were tested for the presence of neutralizing antibodies against one HIV isolate, HTLV-IIIB, and titrated, by Western blotting, against different HTLV-III specific proteins. Neutralizing antibodies were found in 66% of the samples tested and highest neutralization titres observed in cases with lymphadenopathy syndrome. Antibody titres against the viral proteins also seemed to be highest in cases with LAS. Neutralization titres correlated well with antibodies to envelope glycoproteins gp41 and gp120 and to one of the core proteins, p17. An increase in neutralization titre during the follow-up period was associated with a stable clinical course. Furthermore, the occurrence of antibodies directed against the external envelope glycoprotein (gp120) in the initial serum sample correlated well with a stable clinical course. The results suggest that neutralizing activity in the serum, particularly that evoked against gp120, may have some prognostic significance, and that several distinct antigenic epitopes on the virus may be a target for neutralizing antibodies. PMID- 3652533 TI - Demonstration of an indomethacin-sensitive mechanism regulating immune reactivity in American cutaneous leishmaniasis patients. AB - We investigated some aspects of the regulation of the immune response that were sensitive to the effect of indomethacin (INDO), an inhibitor of prostaglandin synthesis, in 84 patients with American cutaneous leishmaniasis (ACL), and in normal controls. The patients were classified on the basis of clinical and histopathological criteria as suffering localized (LCL), mucocutaneous (MCL) or diffuse (DCL) forms of the disease. The responses in vitro to mitogens (PHA and Con A) and leishmanial antigens were evaluated in the presence or absence of INDO. It was found that the drug significantly increased in vitro the mitogenic stimulation by PHA of peripheral blood mononuclear cells from LCL, MCL and DCL patients, but the effect was less evident in the controls. Considering specific responses to leishmanial antigens, we showed that in the presence of INDO, these were significantly increased in LCL patients, but not in MCL or DCL. Also, only in LCL was an inverse correlation found between the initial response to leishmanial antigen and the increase caused by INDO. Significant correlations were found between the INDO-induced enhancement of PHA and Con A responses in the patient groups, but not in the controls. In LCL patients there was a significant correlation between the increases caused by INDO of the mitogen and antigen responses. It can be suggested that an indomethacin-sensitive (prostaglandin dependent) suppressor mechanism operates in LCL patients, that is possibly responsible for the modulation of the immune response against the parasite. In MCL, where this suppressive mechanism is apparently not functional, the response to the parasite is intense, and a possible consequence of this could be tissue damage. Our results indicate, however, that the anergy observed in DCL patients is not due to an involvement of prostaglandins in the suppression of the specific immune response. PMID- 3652532 TI - Immunochemical analysis of immune response to Chlamydia trachomatis in Reiter's syndrome and nonspecific urethritis. AB - Chlamydia trachomatis (Ct) has been proposed as a causative agent in Reiter's syndrome (RS) when an infection occurs in a susceptible host. To assess whether this susceptibility is reflected in a characteristic humoral immune response we compared patients with complicated (RS) and uncomplicated courses of nonspecific urethritis (NSU). Geometric mean titres of antibodies to C. trachomatis by immunofluorescence were 89.6 for RS, 80.0 for NSU and 16.0 for normals. 125I Protein A probing of immunoblotted antigens of C. trachomatis revealed no band unique to RS. 125I-anti-IgA probing of immunoblots demonstrated reactivity with the 59,000 dalton antigen in 11/11 RS and 2/6 NSU. The major outer membrane protein of C. trachomatis (40,000 daltons) bound immunoglobulin nonspecifically. There was no clearly differentiating feature between HLA-B27-positive and B27 negative RS. One sequentially studied patient revealed an augmentation in synovial fluid IgA reactivity during the course of disease. No pattern of humoral immune response to C. trachomatis could be regarded as specific for RS nor for HLA B27-positivity. The study did not identify a Reiter's-specific antigen in C. trachomatis but demonstrates the usefulness of applying blotting techniques to population studies of HLA modulation of immune response to infectious agents. PMID- 3652534 TI - Characterization of the human Goodpasture antigen. AB - The glomerular basement membrane antigen involved in Goodpasture syndrome was purified from human kidneys. The antigen was solubilized by collagenase digestion and purified by ion exchange chromatography, gel filtration and reversed phase HPLC. The monomer proteins (M1, M2*, and M3) were immunochemically compared with the corresponding bovine monomers and appeared to be identical. The Goodpasture reactivity was localized to the same monomer (M2*) as in bovine material. It could also be shown that eight out of nine patients with Goodpasture syndrome had circulating antibodies reacting with a crude collagenase digest of human glomerular basement membrane that could be inhibited by the active monomer peptide. The ninth patient had, besides antibodies to this peptide, antibodies to the 7S domain of type IV collagen. Further immunochemical studies indicate that all patients sera recognize the same site(s) on the monomer protein. Thus the major antigenic determinant(s) of Goodpasture syndrome resides in monomer M2* which is a constituent of the globular domain of collagen IV. PMID- 3652535 TI - Restriction of human IgG subclass expression in the population of auto-antibodies to glomerular basement membrane. AB - To study the possible relationship between individual subclass expression and pathogenesis of antibody-mediated disease, we examined the immunoglobulin-G subclass of antiglomerular basement membrane (GBM) antibodies, in the sera of 20 patients with auto-antibody mediated nephritis, as well as in a limited number of kidney eluates, using a solid phase radioimmunoassay and monoclonal antibodies specific for human IgG subclasses. Only anti-GBM antibodies of the IgG1 and/or IgG4 subclass were detectable, both in the circulation and in renal eluates. Recurrence of circulating anti-GBM antibody during convalescence occurred in two patients out of 49 studied sequentially for more than 12 months. In both cases only antibodies of a single subclass were involved. The recurrence of IgG1 antibody (which can fix complement and bind macrophages) was associated with clinical manifestations of disease, whereas the reappearance of IgG4 antibody (which cannot engage amplifiers of the inflammatory response) did not appear to be harmful. Thus, in anti-GBM auto-antibody mediated nephritis, clear restriction in the subclass of IgG auto-antibody occurs, and this may be important in disease expression. PMID- 3652536 TI - Quantitative evaluation of the terminal C5b-9 complement complex by ELISA in human atherosclerotic arteries. AB - A quantitative ELISA using monoclonal and polyclonal antibodies against neoantigens of the terminal C5b-9 complement complex was used to evaluate the presence of terminal complexes in 68 human arterial samples with or without atherosclerotic involvement. Plasma levels of SC5b-9 were directly compared with the corresponding levels eluted from the femoral arteries in six patients undergoing surgical procedures. The plasma concentration of SC5b-9 in these donors was in the range of 30-90 arbitrary units (AU)/ml, equivalent to 100-300 ng/ml SC5b-9 or 45-130 AU/100 mg plasma protein. All the arterial samples contained detectable amounts of C5b-9. The aortic normal and fatty streaks intimae presented a minimum mean value of 65 +/- 12 AU/100 mg total protein, in the range of normal plasma SC5b-9 levels. The corresponding media contained significantly higher amounts of terminal complexes (115 +/- 30 AU/100 mg protein). Markedly increased levels of C5b-9 were eluted from aortic intimal thickenings (350 +/- 100 AU/100 mg protein) and the corresponding media (300 +/- 53 AU/100 mg protein). Similar concentrations were found in aortic fibrous plaques (340 +/- 80 AU/100 mg protein). The observed correlation between C5b-9 levels and atherosclerotic alterations in arterial walls is suggestive of chronic complement activation with involvement of the terminal complement sequence at these sites. These processes may contribute to progression of the arteriosclerotic lesions. PMID- 3652537 TI - Heparin requirement in hemodialysis, a comparison between single-needle and two needle dialysis. PMID- 3652538 TI - Severe nephrotic syndrome with acute renal failure after fenbufen. PMID- 3652539 TI - Acute tubular necrosis associated with acute pyelonephritis and concomitant diclofenac therapy. PMID- 3652540 TI - Proguanil poisoning in a hemodialysis patient. PMID- 3652541 TI - Severe orthostatic hypotension due to Bartter's syndrome. PMID- 3652542 TI - The effect of pyridoxine supplementation on plasma pyridoxal-5'-phosphate levels in children with the nephrotic syndrome. AB - Nineteen children with low plasma pyridoxal-5'-phosphate (PLP) levels in the nephrotic syndrome due to a variety of histological entities were successfully supplemented with oral pyridoxine hydrochloride. A dose of approximately 2 mg/kg/day of pyridoxine hydrochloride was found to effect adequate plasma PLP levels in most cases. A significant (p less than 0.001) positive correlation (r = 0.83) was found between plasma albumin and PLP levels prior to supplementation and after supplementation both in relapse and remission. Although vitamin B6 repletion led to no demonstrable effect on the clinical course of the syndrome, in view of the possible role which vitamin B6 deficiency may play in defective immune response and thromboembolic phenomena, both being known complications of the nephrotic syndrome, the administration of vitamin B6 supplements is recommended in the active disease state. PMID- 3652543 TI - Measurement of renal functional reserve of the single kidney in man. AB - The renal functional reserve capacity (RFRC) and response of the single kidney to a low protein diet (LPD) were investigated. Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) were measured using a single injection of I125 Hippuran and Cr51 EDTA during a dopamine infusion (3 micrograms/kg/min) and after 2 weeks on a LPD (0.6 g/kg/day). Dopamine increased ERPF but the associated rise in GFR was not significant. There was a significant decrease in both ERPF and GFR on LPD. The change in GFR during dopamine infusion, but not during LPD, correlated inversely with baseline GFR. Dopamine and LPD had no effect on heart rate or blood pressure and LPD did not alter urinary sodium excretion. These results suggest that the single kidney lacks functional reserve capacity and that protein restriction may be useful in preserving long term function. PMID- 3652545 TI - EULAR symposium on seronegative polyarthritis. Rome, Italy, 16th-18th October 1986. Proceedings. PMID- 3652544 TI - Minimal change glomerulonephritis in the elderly--the role of renal biopsy. AB - We describe the case histories of three septuagenarians with nephrotic syndrome who would not have been thought likely to have had minimal change disease on clinical grounds. Yet in the three patients all non-sclerosed glomeruli were normal on light microscopy and glomerular immunofluorescence was negative. All three showed a good clinical response to steroids. It is clear from our findings that, in the elderly, clinical criteria are not a reliable guide to renal histology and may lead to a potentially treatable condition, minimal change nephropathy, being overlooked. Because of the high incidence of side effects, a trial of steroids in the elderly is hazardous. From the evidence given we conclude that renal biopsy, in adults with nephrotic syndrome, becomes increasingly useful with advancing age. PMID- 3652546 TI - Radiology of the seronegative spondyloarthropathies. PMID- 3652547 TI - Sacroiliitis in seronegative polyarthritis: CT analysis. AB - Sacroiliac joint abnormalities were evaluated by computed tomography (CT) in 29 patients with psoriatic arthritis and in 15 with colitic arthritis. CT showed a better sensitivity than conventional X-ray analysis in the evaluation of the articular space alterations in psoriatic and colitic arthritis as well as in detecting erosions and ankylosis of sacroiliac joints in patients with ankylosing spondylitis or psoriatic arthritis. Thus, CT appears a promising tool for the early detection of the pathological changes of sacroiliac joints. PMID- 3652548 TI - Roma locuta, causa non finita: parameters that need to be considered in revision of criteria for ankylosing spondylitis and seronegative polyarthritis. PMID- 3652549 TI - Extra-articular manifestations as markers of disease in seronegative spondylarthropathies. PMID- 3652550 TI - Significance of gut inflammation in the seronegative spondyloarthropathies. PMID- 3652551 TI - The effectiveness of cis-platinum, cyclophosphamide and melphalan in treating disseminated tumor cells in mice. AB - Both B16 melanoma and Lewis lung carcinoma growing in C57/Bl mice spontaneously metastasize to the lungs and other organs. When the tumors are grown in the mouse tail to a specific volume and amputated, the spontaneously disseminated tumor cells can then be independently treated. The effects of a single dose of cyclophosphamide (200 mg/kg), cis-platinum (6 mg/kg) and melphalan (10 mg/kg) on the appearance of pulmonary and other metastases were measured. The cis-platinum treatment was shown to reduce the number and incidence of metastases of both tumors at various times after treatment. The antimetastatic effectiveness of cis platinum against these two tumors was increased when 2.4 mg/kg was administered each day for five consecutive days after amputation of the primary. Cyclophosphamide, when administered at two-thirds maximum tolerated dose, had a small promoting effect on the number and incidence of pulmonary metastases of Lewis lung carcinoma, whereas, applied in the same dose, it had efficacy in the treatment of disseminated B16 melanoma and inhibited appearance of both pulmonary and lymph-node metastases. When melphalan was administered in single- and multiple-dose regimens, the number and incidence of metastases of both tumors increased at various times after primary tumor amputation. These data suggest that melphalan can promote the growth of disseminated tumor cells in both the lungs and other sites and that some systemic chemotherapies may result in promotion instead of suppression of metastatic disease. PMID- 3652552 TI - Effects of the pyrimido-pyrimidine derivative RX-RA 85 on metastatic tumor cell vascular endothelial cell interactions. AB - An important step in the metastatic process is the interaction of blood-borne malignant cells with the vascular endothelium. Among the agents that may interfere with this process are pyrimido-pyrimidines, such as RX-RA 85, developed originally as an antiplatelet agent. Using an endothelial cell momolayer attachment assay we have investigated the effects of RX-RA 85 on tumor cell and endothelial cell properties. Exposure of bovine aortic endothelial cells for 3 h to greater than 4 micrograms/ml RX-RA 85 produced toxic effects, resulting in vacuole formation, retraction and finally rounding up of the cells. Endothelial cells derived from different sources behaved dissimilarly; human brain, human meninges, mouse brain, mouse lung and rat lung endothelial cells were less sensitive to drug treatment than bovine aortic endothelial cells. RX-RA 85 treatment of bovine aortic endothelial cells increased B16-F1 melanoma cell adhesion. When B16-F1 cells were exposed to 4-8 micrograms/ml RX-RA 85, increased adhesion to the subendothelial matrix occurred, whereas exposure to higher drug concentrations (8-16 micrograms/ml RX-RA 85) decreased adhesion. Indirect immunofluorescence staining of cytoskeletal structures in B16-F1 cells adhering to and spreading on matrix revealed that the differential effects of RX-RA 85 on the organization of microtubules and microfilaments might explain the dose dependent differences in adhesion kinetics. PMID- 3652553 TI - Morphological analysis of metastatic potential and antimetastatic drug effects in mice bearing two lines of Lewis lung carcinoma. AB - Two lines of Lewis lung carcinoma with a different potential to metastasize spontaneously to the lungs have been examined for their cytological and histological characteristics. Metastatic potential appears to be related with parenchymal organization of the primary tumours, since large haemorrhagic areas containing detached tumour cells and the absence of endothelialized capillaries are observed only in the line with high metastatic potential. At the same time, the cytological characteristics of the cells of the two tumour lines are similar, and do not seem to be related with metastatic potential. After treatment with the selective antimetastatic drugs ICRF-159 and DM-COOK, and with DTIC, the histological appearance of the line with high metastatic potential becomes similar to that of the line with low metastatic potential. These data seem to indicate that the early phases of tumour spread occurring in the primary tumour are of relevance for metastatic potential and control by antimetastatic drugs, and suggest that for DTIC such antimetastatic action may participate to its clinical antitumour effects. PMID- 3652554 TI - Metastatic dissemination of 3LL variants after treatment with monoclonal antibody to a tumor-associated antigen. AB - Two tumor lines derived from 3LL (Lewis lung carcinoma) endowed with different metastatic potential and stable for their metastatic phenotype during serial in vivo passages, have been analysed for growth and dissemination following treatment with a monoclonal antibody. We have used a recently developed MoAb 135 13C to a tumor-associated antigen of murine lung carcinoma having an apparent molecular weight of 180,000 (TSP-180). The metastatic dissemination of the 3LL variants before and after treatment with the MoAb has been correlated with the expression on the cell surface of the MHC antigens (Db, Kb) and of the TSP-180 protein. The results of this study indicate that cell with high TSP-180 protein expression and MHC antigen expression have the greatest metastatic potential. Administration of MoAb 135-13C to tumor-bearing mice or i.v. injection of cells preincubated with the MoAb 135-13C increase the dissemination capacity of the variant endowed with lower metastatic potential while inducing a reverse effect on the high metastatic one. Studies on the MHC expression demonstrate that MoAb 135-13C treatment induces changes in the Db and Kb expression at level of secondary neoplasms. The results are discussed in view of the importance of the use of the metastatic variants to study therapeutic effect of specific targeting agent. PMID- 3652556 TI - Chronic pancreatitis associated with ulcerative colitis. AB - A twelve-year-old girl without apparent predisposing factors developed chronic pancreatitis, and 10 months later had fulminant onset of ulcerative colitis requiring a colectomy. This report strengthens the evidence for a relationship between pancreatitis and inflammatory bowel disease. PMID- 3652555 TI - Proton NMR examination of tumor cells of high or low metastatic potential. AB - Three rat 13762NF mammary adenocarcinoma clones and cell lines of different metastatic potentials (MTLn3, MTC, and MTPa) were studied for their proton nuclear magnetic resonance spectral characteristics as intact cells in vitro and after chloroform/methanol, neuraminidase, or ethanol treatments. The intact-cell spectral characteristics of the highly metastatic tumor cell clone MTLn3 were clearly distinguished from the less metastatic clone MTC or the parental MTPa cell line on the basis of spectral peaks in the range of 0.9 to 1.45 p.p.m. broad peaks near 2.0 p.p.m., and peaks in the range of 2.75 to 3.2 p.p.m. Glycoproteins are among the molecules known to have resonances in these upfield spectral regions, and these tumor cell subpopulations have previously been shown to possess characteristic quantitative differences in cell surface, metastasis associated glycoproteins. Treatment of the cells with neuraminidase or ethanol, or extraction with chloroform/methanol increased spectral detail and also revealed characteristic differences in spectral peaks between the tumor cell subpopulations. The identity of the cellular components responsible for these spectral characteristics are unknown, but some clearly arise from differences in the extractable lipids present in the tumor cell subpopulations. Further study will be required to determine if the spectral differences described in this preliminary report are directly related to the known biochemical characteristics of the highly metastatic clone, and if the observations have general relevance to metastatic potential or are a singular feature of these cells. However, these initial results suggest that manipulation of factors which allow unmasking of spectral detail combined with the use of prescribed tumor cell subpopulations may aid in using proton NMR to identify and define biochemical or structural differences related to the metastatic potential of tumor cells. PMID- 3652557 TI - The hyperornithinemia, hyperammonemia, homocitrullinuria syndrome: an ornithine transport defect remediable with ornithine supplements. AB - The primary defect in patients presenting with a history of protein intolerance, mental retardation, and epilepsy of variable degree, with the unique triad of hyperornithinemia, hyperammonemia, and homocitrullinuria (the HHH syndrome) has been postulated to be a defect in translocation of ornithine into the mitochondria. In a 12-year-old boy with the HHH syndrome, the hyperammonemia observed following a protein load was prevented when the same load was given orally with a 1 mmol/kg of ornithine-HCl. At a dosage level of 0.5 to 1.0 mmol/kg/day of ornithine HCl, administered in 3 divided doses with meals, the patient's protein tolerance improved. As pretreatment hyperammonemia reverted to normal levels, the patient was able to cope with increased dietary protein and his growth accelerated. During the 2-year interval of the study, the ornithine HCl supplements were withdrawn on 2 occasions, and within a week the hyperammonemia recurred. Whereas cultured fibroblasts from the HHH patient were capable of oxidizing U-14C-glutamate to 14CO2 as rapidly as normal cells. 1-14C ornithine or 5-14C-ornithine were oxidized at only 1/28 or 1/49 of the normal rate. Ultrastructural studies of the HHH cultured fibroblast mitochondria revealed distinctive alterations in size and shape; unusually long, branching, and "curling," HHH mitochondria also showed accelerated regressive changes. PMID- 3652558 TI - Palatopharyngeal incompetence in association with esophageal dysmotility, acquired glucocorticoid deficiency, and deficient tear production. AB - An 8 1/2-year-old male is described with the rare triad of acquired adrenal insufficiency, esophageal dysfunction, and alacrima. In addition, he had velopharyngeal insufficiency, which is a previously unreported feature of this syndrome. Although the pathophysiology of this disorder remains to be demonstrated, a defect may be present, linking hormone-receptor cyclic AMP mediated processes with abnormalities in parasympathetic and voluntary neuronal innervation or transmission. PMID- 3652559 TI - Obstetric analgesia and anesthesia. PMID- 3652560 TI - Pediatric gynecology. PMID- 3652561 TI - The value of morphometry in prediction of survival in oligodendrogliomas. AB - Nineteen out of 31 cases of well-differentiated oligodendrogliomas were selected on the basis of clinical and morphological parameters. The patients were divided into 3 groups according to the length of the survival period. In each case 8 clinical, 4 morphological and 3 morphometrical parameters were scored. The quantitative analysis of nuclei of oligodendroglioma cells, performed by means of an automated microscopic picture analyzer (Leitz-TAS), allowed the nuclear area, perimeter and roundness factor of 200 nuclei to be calculated for each case. Twenty-eight additional features were derived from the data obtained. The descriptive statistical analysis, based on Student's t-test and Chi-square test showed significant differences (p less than 0.05) with regard to the SD of the 10 largest values of the nuclear perimeter among the derived quantitative parameters. Among the clinical parameters, the increased intracranial pressure as a late complication was also significant. Multivariate analysis, based on Bayes theorem, allowed 89% of the cases to be allocated to the actual groups by means of 6 clinical parameters, 57% by means of 4 morphological parameters and 100% by means of a set of 3 morphometrical parameters. The morphometric data proved to be better discriminants than clinical and subjectively evaluated morphological parameters in low grade oligodendrogliomas. PMID- 3652562 TI - Diffuse leptomeningeal gliomatosis: report of three cases. AB - Leptomeningeal gliomatosis is reported in three patients in whom the tumor involved the central nervous system diffusely. Clinically, these patients presented with varying combinations of both non-localizing and focal symptoms and neurologic signs. Most notable were meningismus, vomiting, headache, altered level of consciousness and papilledema. Laboratory findings included high CSF protein, high CSF pressure and hydrocephalus but no direct evidence of neoplasia. All three patients received surgical treatment for hydrocephalus. Brains were swollen on gross examination with leptomeningeal thickening resulting from diffuse infiltration of tumor cells in the leptomeninges. In two of the patients small parenchymal gliomas in the brain were probably the source of the meningeal tumor. PMID- 3652563 TI - Fatal non-missile head injury: a cohort study of patients with and without an intracranial hematoma. AB - Brain damage in fatal non-missile head injury is outlined in 100 cases with and in 100 cases without an intracranial hematoma. The patients with intracranial hematomas were significantly older, and had a higher incidence of lucid interval and of unilateral diffuse brain swelling but a lower incidence of ischemic lesions in the cerebral cortex and of bilateral diffuse brain swelling than the patients with no hematoma. Cases with unilateral hematomas and cases with unilateral diffuse brain swelling had significantly more severe ipsilateral cerebral contusions. PMID- 3652565 TI - The shoulder joint. An arthroscopist's perspective of anatomy and pathology. AB - Arthroscopy has had a great impact on shoulder surgery by adding another dimension to the surgical anatomy. The present benefits of arthroscopy of the shoulder include the establishment of an accurate diagnosis in the glenohumeral joint, subacromial space, and acromioclavicular joint. Various pathologic entities can be visualized. The efficacy and end results of several arthroscopic surgical procedures are under investigation. Patient selection, the pathologic diagnosis, and end results are important considerations in evaluating newly devised arthroscopic methods of treatment of shoulder syndromes. PMID- 3652564 TI - Recurrent transient anterior subluxation of the shoulder. The "dead arm" syndrome. AB - The recurrent transient anterior subluxation (the "dead arm" syndrome) is an accepted clinical syndrome seen most commonly in young athletes or individuals whose arms have been forcefully hyperextended in elevation and external rotation. Care must be taken to differentiate other causes of painful shoulder. With an accurate diagnosis, the results of conservative or operative treatment are most favorable. If surgical treatment is carried out, careful layer-by-layer dissection is required to properly identify and correct anatomic abnormalities. PMID- 3652566 TI - Suprascapular nerve entrapment. Diagnosis and treatment. AB - Nine patients were found to have suprascapular nerve entrapment confirmed by electromyographic studies after the diagnosis was suspected. Eight patients who had a surgical release of the suprascapular ligament had good and excellent results. Except in rare cases, a positive electromyogram (EMG) including a delayed nerve conduction (using a coaxial needle) is necessary confirming evidence of the need for surgical treatment. The recommended surgical technique involves detaching the trapezius muscle from the spine of the scapula and opening the space overlying the suprascapular ligament. The trapezius is retracted cephalad while the supraspinatus is retracted caudad. This exposure avoids injury to the spinal accessory nerve and promotes a rapid rehabilitation. Suprascapular nerve entrapment should be suspected and included in the differential diagnosis of ill-defined shoulder pain. PMID- 3652567 TI - Conservative open anterior acromioplasty. AB - The records of 29 consecutive patients treated by a pure, open, anterior acromioplasty were reviewed retrospectively. Excluded from consideration were patients with the following pathologic diagnoses or histories: (1) previously attempted acromioplasty on the same shoulder; (2) intraoperatively confirmed rotator cuff tear; (3) any surgically treatable biceps tendon or acromioclavicular abnormality; (4) lost to follow-up study. Three different techniques were employed to perform the acromioplasties. The first technique required partial deltoid origin detachment with an osteotome. The second technique spared the deltoid origin, while again using an osteotome to perform the acromioplasty. The third technique also spared the deltoid origin but used a high-speed burr to perform the acromioplasty. Evaluated in terms of patient satisfaction, residual pain, length of convalescence, suboptimal results, and complications, the first technique proved to be the least effective. The second technique produced early, excellent results. The third technique, in which a burr was employed through an intact deltoid origin, was most effective; technically, the method was also relatively simple and reliable. PMID- 3652568 TI - Percutaneous posterolateral discectomy. Anatomy and mechanism. AB - The evacuation and decompression of the herniated lumbar disc through a sheath inserted dorsolaterally represents a new concept in the treatment of radiculopathy associated with disc herniation. Only a small portion of the spinal nerve before its decent and positioning anterior to the transverse process is subject to insult by an instrument introduced into the intervertebral disc through a posterolateral approach. The chance of injury to the spinal nerve is further minimized when the instruments are introduced a distance of approximately 9-10 cm from the midline, parallel to the vertebral plates, and penetrating the annulus at 10 o'clock or 2 o'clock. The rapid decline of intradiscal pressure after dorsolateral fenestration of the annulus appears to be an important factor in the relief of sciatic pain following percutaneous posterolateral discectomy. The evacuation and decompression of an extruded intervertebral disc with a straight instrument may not be possible. Patients with sequestered disc require laminectomy. PMID- 3652569 TI - Nonunion following two-level anterior cervical discectomy and fusion. AB - Nonunion is a potential complication of anterior cervical discectomy and fusion (ACDF). There are reports that cite the prevalence of nonunion for two-level ACDF with various fusion techniques, but they do not recommend treatment alternatives. Pseudarthrosis after a two-level ACDF occurred in a 69-year-old man. Posterior cervical wiring and autograft resulted in a successful fusion anteriorly and posteriorly. Posterior fusion augments stability, enhances the potential for eventual anterior fusion, avoids the risks of an additional anterior procedure, and is an excellent therapeutic alternative to a second anterior attempt at stabilization. PMID- 3652570 TI - Influence of the Wilmington brace on spinal decompensation in adolescent idiopathic scoliosis. AB - The Wilmington brace is a custom-molded thoracolumbosacral orthosis for decompensated adolescent idiopathic curves. Using the roentgenographic measurement of Rudicel and Renshaw, 71 patients with pretreatment curves that were decompensated greater than 1.0 cm were investigated in detail. The average follow-up period was two years. There was no correlation between pretreatment Cobb angle and the magnitude of spinal decompensation. Pretreatment decompensation averaged 1.9 cm for 22 thoracic curves, 2.5 cm for 32 thoracolumbar-lumbar curves, and 2.4 cm for 17 double-structural curves. Overall, decompensation was improved in 50 patients (70%). Improvement in spinal decompensation averaged 1.4 cm for thoracic, 1.4 cm for thoracolumbar-lumbar, and 1.5 cm for double-structural curves, with decompensation in 27 patients (38%) measuring less than 1.0 cm at follow-up evaluation. An increase in spinal decompensation, averaging 1.2 cm, was found in 6% (one thoracic, two thoraco lumbar-lumbar, and one double-structural curve). Spinal compensation is favorably influenced in the majority of patients treated with Wilmington brace for adolescent idiopathic scoliosis. PMID- 3652571 TI - Operative treatment of Medial epicondyle fractures in children. AB - Thirty-one patients with fractures of the medial epicondyle displaced more than 2 mm were evaluated an average of four years after their injury. Twenty-three patients had good results regardless of the degree of displacement or the presence of an elbow dislocation. One patient, had a poor result due to a technical error in pin placement. The remaining seven patients had the fracture fragment trapped in the joint and did worse, with three poor results. There was no correlation between range of motion and degree of displacement, length of immobilization, time from injury to surgery, presence of a dislocation, or open versus percutaneous treatment. Operative treatment of medial epicondyle fractures displaced greater than 2 mm gave consistently good results with a good range of motion, good stability, no ulnar nerve symptoms, and no deformity. PMID- 3652572 TI - Capitellocondylar total elbow arthroplasty. Two-to eight-year experience. AB - A series of 35 capitellocondylar total elbow arthroplasties was performed on 29 patients. The average patient age at the time of surgery was 58 years (range, 28 71 years). Follow-up study averaged 5.6 years (range, 2-8 years). The complication rate was 57%. There were three infections, three dislocations, and two intraoperative fractures. Transient ulnar nerve palsy occurred in nine patients, postoperative hematomas in two patients, and intraoperative perforation of the ulna cortex in one patient. Aseptic loosening occurred around the humeral component of one elbow. No ulnar components developed aseptic loosening. Range of motion increased in all planes, except extension. Pain relief was achieved in all but one patient. There were no unstable elbows. PMID- 3652573 TI - Ischemic necrosis of the femoral head. Correlation of magnetic resonance imaging and histologic sections. AB - Magnetic resonance (MR) images were correlated with matched histologic sections of a resected ischemic necrotic femoral head and neck. Preoperative radiographs had revealed Stage 3 ischemic necrosis. Preoperative MR images disclosed foci of abnormally low signal intensity alternating with normal-appearing foci of high signal intensity. Surgical resection of the femoral head and neck was followed by MR imaging and pathologic sectioning, fixation, and staining, enabling the individual sections to be compared with the postoperative MR slices. A subchondral focus of diminished signal intensity was shown to represent saponified fat and consisted of a transudate of proteinaceous material with probable calcifications. The subjacent region of normal, high signal intensity represented "mummified" fat. The next lower stratum of diminished signal intensity was composed of fibrous and vascular tissues and histiocytic infiltrates that had extensively or completely replaced the fatty marrow. PMID- 3652574 TI - Survey of prophylaxis against venous thromboembolism in adults undergoing hip surgery. AB - Venous thromboembolic disease (VTED) is the most common and potentially the most serious immediate postoperative complication of hip surgery. Prophylaxis of VTED remains controversial and its practice is widely variable. Since the last survey of VTED prophylaxis as practiced by American orthopedists, published in 1974, the literature has expanded tremendously and the number of orthopedists has doubled. The authors surveyed 10% of American orthopedists and the chiefs of training programs and/or major teaching hospitals to assess current practices. The average practicing orthopedist responding was 44-years-old and had performed 17.6 total hip arthroplasties and treated operatively 30.6 hip fractures per year during the last five years. The average responding chief surgeon, was 49 years old and had performed 49 total hip arthroplasties and treated operatively 20.5 hip fractures per year during the last five years. Most surgeons use pharmacologic prophylaxis or external pneumatic compression for total hip arthroplasty patients (84.4%) and hip fracture patients (74%). Warfarin has been tried and abandoned by 50% of all respondents, largely because of bleeding complications. Aspirin was the most popular agent. However, more than 25% of the respondents stated that at least one of their patients who had elective total hip arthroplasties had died of pulmonary embolism during the last five years. PMID- 3652575 TI - Delayed postbacteremic prosthetic joint infection. AB - Deep infection of a prosthetic joint is a devastating complication. One proposed mechanism of late prosthetic joint infection involves hematogenous spread from an extraarticular focus of infection. Two cases clearly demonstrate hematogenously acquired prosthetic joint infections, one caused by Clostridium perfringens and the other by Streptococcus pneumoniae. These cases were unusual in that a long asymptomatic period intervened between the primary bacteremic illness and the subsequent prosthetic infection. Patients with prosthetic joints who develop bacteremic infection at extraarticular sites should be treated promptly and aggressively with appropriate antibiotics. Prophylactic antibiotics should be strongly considered in the patient with a prosthetic joint who undergoes procedures likely to be associated with a bacteremia. Transient arthralgias at the time of bacteremia may represent the onset of the joint infection and should not be overlooked or attributed a priori to the patient's underlying arthritic or medical condition. PMID- 3652576 TI - The clinical relevance of instrumented testing for ACL insufficiency. Experience with the UCLA clinical knee testing apparatus. AB - An instrumented clinical testing device developed at UCLA records a continuous anteroposterior force versus displacement curve of the tibia with respect to the femur at 20 degrees of flexion. Laxity and stiffness are calculated from the response curve. With this device, 95% of normal knees have an anterior laxity less than 7.5 mm and a side-to-side difference less than 2 mm. In contrast, an anterior cruciate ligament (ACL) absent knee has a mean anterior laxity of 10 mm and a mean side-to-side difference of 5 mm. In a small group of patients with an intraarticular ACL substitution using the medial or lateral one-third of the patellar tendon, laxity and stiffness of the injured knees were returned to within the normal range and remained constant three years after surgery. In a group of 76 patients treated with ACL substitution using the torn meniscus, 51% of the patients still had an anterior laxity outside the normal range 3.5 years after surgery. In a preliminary study of 19 patients receiving a Gore-Tex synthetic ACL substitution, 55% of the patients still had a side-to-side difference greater than 2 mm two years after the procedure. These studies illustrate the advantages of impartial, objective measurements of knee stability. Laxity and stiffness values can supplement, but never replace, a thorough patient examination and patient history. As sports medicine matures as a scientific discipline, improved instrumented test devices may ultimately provide a standardized means for reporting knee stability parameters. PMID- 3652577 TI - The relationship between dead arm syndrome and thoracic outlet syndrome. AB - A relationship exists between anterior shoulder subluxation and thoracic outlet syndrome that is responsible for the more florid symptoms of dead arm syndrome (DAS) in some patients. This relationship was demonstrated in eight of 27 patients (30%) in a consecutive series of Bankart operations for treatment of subluxation. The mechanism is associated with a disturbance in the kinesiology of the shoulder-joint complex that alters the position of the scapula relative to the rib cage and neurovascular supply to the upper limb. Therapy is directed toward restoration of the stability of the glenohumeral joint so that normal biomechanics can be reestablished. In advanced stages of thoracic outlet syndrome, however, DAS may initially require surgical decompression of the nerves and vessels. Careful attention to postural mechanics is essential for rational diagnosis and treatment of DAS. PMID- 3652578 TI - Femoral component geometry. A factor in total hip arthroplasty durability. AB - The theoretically conceived geometric design for femoral components, including a longer length, an extended width, and a stiffer modulus, is expressed in the clinical design of the Buck-32 prosthesis. This prosthesis was used in 110 patients with 122 hip arthroplasties between 1975 and 1979, giving a follow-up period of five to nine years (average, 7 years). Femoral loosening requiring revision surgery occurred in 2.3% of the patient population. Radiolucencies were noted in 24% of the cases but were progressive in only 17%. Complications were minimal, as were bone changes about the prosthetic units. There is clinical evidence in the literature, substantiated by this study, that geometric design does influence the durability of a cemented femoral component. PMID- 3652579 TI - A method of determining the angular malalignments of the knee and ankle joints resulting from a tibial malunion. AB - Malalignments of the knee and ankle joints resulting from tibial angular malunion can be determined using mathematical analysis. The angular deformity of the tibia is equal to the sum of the angular malalignments formed by the knee and ankle joints in relation to the horizontal plane. These malalignments are not equal. A larger percentage of the deformity is reflected inferiorly as the deformity approaches the ankle joint. A table was formulated to provide the corresponding degrees of joint malalignment (knee and ankle) for tibial angular deformities at different positions along the tibia. The analysis provides a useful tool to quantify the knee and ankle joint malalignments secondary to tibial angular malunion. Although designation of prognosis at different degrees of angular deformity is beyond the scope of this study, it does provide improved correlation between tibial angular deformities and the clinical outcome, e.g., degenerative arthroses of the adjacent joints, in future studies on tibial fractures. PMID- 3652580 TI - Total knee arthroplasty following patellectomy. AB - Eleven patients with a previous patellectomy and primary total knee arthroplasty (TKA) had chart reviews, recent clinical examinations, evaluation of roentgenograms, rating of knee arthroplasty on a standard scale, and quantitation of quadriceps and hamstring torque using an isokinetic dynamometer. Good to excellent results were present in only five of the 11 knees studied, compared with 11 of 11 patients in a control group with intact patellae. Quadriceps and hamstring torque and strength were diminished relative to the control groups. Factors that correlated with a success or failure of TKA in patients with previous patellectomy included: number of previous knee operations, three or less; presence of severe arthritic changes roentgenographically; and quadriceps performance of greater than 40 ft-lb at 30 degrees/second testing speed. Patients without patellae who lack these favorable prognostic factors for a successful TKA should be strongly considered for bracing or primary arthrodesis, rather than knee arthroplasty. PMID- 3652581 TI - Contralateral compensation with knee impairment. AB - Knee motion of four healthy teenagers was unilaterally impaired by means of cast braces. Computerized analysis from video recording of walking was used to study the compensatory effects and to compare them with six patients. Restricted knee flexion caused little change in stance-phase knee motion on the restricted side. The unimpaired knee displayed exaggerated stance phase flexion and phase shifts, which in turn produced pelvic vaulting. The forces on the braces were high. Impairments to extension produced bilateral crouch without loss of flexion extension patterns within the limits of the impairment. Fatigue was more prominent than with blocks to flexion. Circumduction was found to be overrated as a compensation for stiff-leggedness. Lateral shift to the well side, combined with freezing of the well-side stance adduction, was a frequently used effective clearance mechanism. Phasic changes in motion of many body parts may combine to produce low-level pelvic displacement, especially when clinical weakness is present. Shortened stride length is the most sensitive indicator of this phenomenon. Graphs of individual joint motion do not easily convey the important phasic relationships that are fundamental to that motion and to the interpretation of its effects. Stick figures were better for analysis of this aspect of motion analysis, even though they are more subjective. PMID- 3652582 TI - Limited posterolateral surgical approach to the knee for excision of osteoid osteoma. AB - An 18-year-old man suffered four years of undiagnosed knee pain until a CAT scan revealed an epiphyseal osteoid osteoma of the tibia located subchondrally, just medial to the proximal tibiofibular joint. A nidus in this location is not easily accessible, and its proximity to the joint surface raised concerns about damage to the tibial plateau. To facilitate excision of the tumor, cadaveric dissections were performed to develop a limited posterior approach to the proximal, lateral portion of the tibia. The CAT scan was used to calculate the precise dimensions of the tumor and its relation to the posterior tibial cortex and the proximal tibiofibular joint. With the use of the exposure developed in the laboratory and the calculations derived from the CAT scan, the tumor could be excised by removing a single block of bone 15 mm3. Intraoperative radiographs confirmed the presence of the nidus within the excised block of bone. This case report reaffirms the frequent difficulties and tardiness in diagnosing osteoid osteomas and the need to include these tumors in the differential diagnosis of knee pain and epiphyseal lesions. Before CAT scans were used, the working diagnoses were torn meniscus, juvenile rheumatoid arthritis, and bone hemangiomatosis. PMID- 3652583 TI - Destructive monarticular arthritis secondary to anticoagulant therapy. AB - Hemarthrosis secondary to anticoagulant therapy is a well-known clinical problem. The pathologic process usually occurs in large joints and is reversible with the discontinuation of the anticoagulant medication. The condition presented for consideration here is unusual for two reasons. First, it is relatively uncommon for the ankle joint to be involved. Second, the destructive arthritis progressed after the medication was discontinued. Resting the involved joint until symptoms subside is often adequate treatment for anticoagulant-induced hemarthrosis. In an 84-year-old man, an arthrodesis was necessary to achieve a symptom-free ankle joint. Hemarthrosis secondary to anticoagulant medication may not be a benign disease process. PMID- 3652584 TI - Medical and economic parameters of motorcycle-induced trauma. AB - A retrospective study was conducted on all patients injured in a motorcycle accident who were admitted to the authors' institution during a one-year period. The 71 patients evaluated averaged 26 years of age; 79% were men, 75% were not wearing a helmet, and 24% were legally intoxicated. Sixty-six percent required surgical intervention and 36% a second procedure. There were 167 fractures, with an average of 2.4 per patient. The 27 patients requiring a blood transfusion averaged 10.5 units per patient. Motorcyclists not wearing a helmet had an increased risk of head injury (p less than .01). Those with head injuries had an increased need for intensive care (p less than .0001) and a ventilator (p less than .001). Patients with head injuries more commonly sustained fractures about the shoulder (p less than .015) than fractures to the lower extremity (p less than .005). The average hospital stay was 13 days, with a cost of $16,408 per patient. The cost was significantly higher in patients with a head injury ($21,945) than in patients without a head injury ($11,941). Patients sustaining a head injury were less likely to return to baseline functioning (p less than .001). PMID- 3652585 TI - Postoperative course of patients treated with iliac osteocutaneous free flaps. A two- to five-year follow-up study. AB - The clinical and radiologic course was reviewed in seven patients treated with an iliac osteocutaneous free flap (iliac flap) for treatment of large bone defects in the tibia and first metacarpal bone and overlying skin. Application of the iliac flap was followed by free bone grafting in four patients and aesthetic surgery in four patients. All patients obtained solid bony union and good skin coverage; none had complaints upon walking. An iliac flap was useful as a salvage procedure for the treatment of massive defect of bone and skin in extremities, especially in the lower one-third of the lower leg. Transient osteoporosis occurred before osteosclerosis and bony union. Bone remodeling with change in the trabecular pattern preceded transformation from cancellous to cortical bone. PMID- 3652586 TI - Behavior of an external fixation frame incorporating an angular separation of the fixator pins. A finite element approach. AB - A finite element model has been developed to simulate the deformation that occurs at the fracture site of an externally fixed bone as a result of applied bending, compression, and torsional loads. The pin configuration in this model is constructed to allow an angular separation of the fixator pins. The mechanical effect of this angular separation and of the distribution of the pins along the fixator bar is examined. The model shows that an angular separation of the pins provides a more symmetric deformation of the fracture site when a bending load is applied in different directions to the bone and thereby protects a fracture from excessive movement in any direction. The torsional stability of an external fixation frame is considerably increased by incorporating an angular separation of the pins. The model also shows that the most stable configuration for the fixator uses a wide separation of the pins along the fixator bar. PMID- 3652587 TI - Management of open fractures with sterilization of large, contaminated, extruded cortical fragments. AB - The literature provides surprisingly little guidance for the management of Grade III open fractures with large extruded segments of long bones. A 10-cm segment of femoral diaphysis was reimplanted successfully in a 24-year-old man with a comminuted segmental open fracture. For basic information, laboratory studies were performed to determine the relative efficacies of various methods of sterilization of contaminated bovine metatarsals. Bovine bone segments were given one of the following treatments: (1) saline rinse; (2) povidone-iodine scrub/saline rinse; (3) povidone-iodine scrub/autoclaving; (4) povidone-iodine scrub/thimerosal immersion; (5) povidone-iodine scrub/povidone-iodine immersion; or (6) chlorhexidine gluconate scrub antibiotic solution immersion. The segments were then cultured. Only the povidone-iodine/autoclave and chlorhexidine gluconate/orthopedic antibiotic solution treatments were 100% effective in eliminating bacterial growth. Contaminated extruded segments of long bones can be adequately sterilized for reimplantation by surgical cleansing with chlorhexidine gluconate followed by brief soaking in antibiotic solution. PMID- 3652588 TI - Noncommercial fabrication of antibiotic-impregnated polymethylmethacrylate beads. Technical note. AB - Antibiotic-impregnated polymethylmethacrylate (PMMA) beads were fabricated by means of injections in specially designed molds to produce small and large beads. In vitro concentrates from these beads for 30 days were found to release tobramycin in an exponential function. PMID- 3652589 TI - Optimum pore size for bone cement fixation. AB - The interface shear properties of porous coated Ti-6Al-4V alloy embedded in bone cement were examined as a function of pore size. Cylindric Ti-6Al-4V alloy push out specimens were coated with two layers of spheric powders having particle size ranges of 297-420 microns, 420-500 microns, 595-707 microns, and 850-1400 microns. Sintering resulted in mean pore sizes of 165, 285, 345, and 550 microns, respectively, and porosities in the range of 40%-44%. There was a statistically significant difference between the mean pore sizes obtained from the four particle size ranges. There were no differences between the mean porosities. The porous-coated specimens were embedded in bone cement and mechanical push-out testing was performed. Non-coated specimens having a satin surface finish were also embedded in bone cement and tested. The noncoated metal specimens displayed an interface shear strength of 4.2 +/- 0.4 MPa, whereas the shear strengths for the porous-coated specimens were significantly higher and increased as pore size increased. The mean interface shear strengths determined were 17.0 +/- 2.1 MPa (165 microns pore size), 18.1 +/- 2.3 MPa (285 micron pore size), 23.6 +/- 1.7 MPa (345 microns pore size), and 25.4 +/- 3.4 MPa (550 microns pore size). Significant differences in shear strength for the porous-coated specimens were found between the two smaller particle sizes and the two larger particle sizes. As pore size increased from 285 microns to 345 microns, a statistically significant increase in shear strength from 18.1 MPa to 23.6 MPa was observed. PMID- 3652590 TI - Osteoid osteoma of the femoral neck stimulating an inflammatory synovitis. AB - The case report presents a nine-year-old child with an osteoid osteoma of the femoral neck, simulating an inflammatory synovitis. Osteoid osteoma is a common benign bone tumor. However, when intracapsular lesions occur they may pose a diagnostic challenge. Nonspecific clinical signs and symptoms, such as inflammatory synovitis, joint effusion, and soft tissue swelling, may pose a problem in diagnosis and treatment. The delay in diagnosis can range from six months to two years. When the hip is involved, the patient may have nonspecific pain, limp, restricted motion, and thigh atrophy. An accurate diagnosis may be difficult to elicit, requiring detailed history and physical examination and culminating in the use of computed tomography. PMID- 3652591 TI - Rotator interval lesion. AB - Arthrography and surgical exploration reveal the pathogenesis of a painful shoulder syndrome characterized by inferior instability in the rotator interval (RI). The RI is the space between the subscapularis and the adjacent supraspinatus interval. Two types of RI lesions can be identified. Type I, a contracted state, is characterized by inflammatory changes in superficial bursal area. In Type II, an unstable condition is associated with extensive inflammation of deeper tissues in the RI. In a series of 101 patients, including 106 shoulders with RI lesions, surgical repair of the RI was performed with the shoulder in an externally rotated position. This position ensured a close fit of the supraspinatus and the subscapularis attachments. Of 78 shoulders evaluated in a follow-up study, 96% were graded good or excellent, and 4% poor. This investigation presents evidence for the importance of diagnosis and treatment of RI lesions in patients with persistent pain in the shoulder. PMID- 3652592 TI - Incomplete thickness rotator cuff tears diagnosed by subacromial bursography. AB - Incomplete thickness rotator cuff tears (ITRCT) adjacent to the bursal sac were diagnosed preoperatively by subacromial bursography and confirmed by surgical exposure. There were five men and one woman with an average age of 41.8 years. The preoperative duration of shoulder pain ranged from four to 36 months (average, 15.8 months). Clinical manifestations included crepitus and a painful arc in five of the six cases. Glenohumeral arthrography was normal in all cases. Subacromial bursography, subsequently performed, revealed pooling of the contrast medium in a torn area of the bursal side of the rotator cuff in all cases. Surgical treatment was recommended after the failure of conservative treatment for three to ten months. The surgical treatment consisted of both anterior acromioplasty and tendon suture. Wedge resection and shoelace suture repair of the tendon produced satisfactory results in all cases followed for ten to 72 months (average, 44.3 months). ITRCT adherent to the bursal sac were noted in 2.4% of a cadaver survey. Subacromial bursography can be a useful diagnostic procedure for this specific entity in subacromial impingement syndrome. PMID- 3652593 TI - The frozen shoulder. Diagnosis and management. AB - The differentiation between the stiff and painful shoulder without any joint capsule involvement and with capsule involvement (true adhesive capsulitis) must be established before a rational treatment can be prescribed. Arthrography establishes the correct diagnosis of adhesive capsulitis. Treatment of the stiff and painful shoulder is through prevention and exercise. The treatment of adhesive capsulitis includes prevention, exercises, manipulation, and capsulotomy. Each treatment method is determined by specific criteria. Arthroscopy is not useful for either diagnosis or treatment of adhesive capsulitis but may be useful for recognition of the four stages of the disease. PMID- 3652594 TI - A functional analysis of shoulder fusions. AB - Seventeen shoulder fusions with relatively normal musculature were analyzed with particular interest to the ability of the fused extremity to perform activities of daily living. Joints fused for paralysis were excluded. No patient was able to work overhead or with arms abducted as required for activities such as hammering, house painting, or climbing a ladder. Many patients had difficulty functioning at head level for hygienic purposes. Many were unable to perform functions behind the back, although waist-level function approached normal. The position of rotation was the most critical factor in approaching optimum function. Fusions in positions of internal rotation reduced the ability to comb hair, wash the face, or to otherwise use the hand at head level. Fusion in a position of excessive external rotation made it impossible for the patient to reach the opposite axilla or belt buckle. There was a range of acceptability of abduction of forward flexion that did not appear to compromise the eventual functional result. The recommended position is 25 degrees to 40 degrees abduction, 20 degrees to 30 degrees flexion, and 25 degrees to 30 degrees of internal rotation. Even at the ideal position, shoulder fusion produces significant limitations in function. For patients with painful, nonfunctional shoulders who need arthrodesis, these limitations should be clearly discussed, along with the pros and cons of surgical treatment in general. PMID- 3652595 TI - The acromioclavicular joint in rheumatoid arthritis. AB - The acromioclavicular (AC) joint was clinically and roentgenographically examined in 49 rheumatic patients with painful shoulders. Clinically, the AC joint was tender and painful in about one-third of the shoulders. Roentgenographically, AC changes were encountered in 85% of the shoulders. The AC joint destruction was frequently associated with the glenohumeral joint disease. There was a time dependent progression of subchondral bone erosion, tapering, and osteolysis of the acromial end of the clavicle corresponding to the duration and/or severity of the rheumatoid disease. PMID- 3652596 TI - The natural history of night terrors. AB - Night terrors are a sleep disorder, resulting from a partial arousal during slow wave sleep. They usually occur within 2 hours of sleep onset and are characterized by agitation and unresponsiveness to external stimuli. Nineteen children (ten males, nine females) with onset of night terrors before age 7.5 years were studied by means of a questionnaire. Mean observation time (time from onset age to age at survey) was 8.5 years, but longer than 10 years in nine subjects. Seventy percent of the children had their initial frequency of night terrors as their peak frequency, with a tendency for shorter duration of the parasomnia in this group. Children with onset age less than 3.5 years may be expected to attain a peak frequency of at least one episode per week. Children with onset after 3.5 years, but before 7.5 years, may expect to attain a peak frequency of 1-2 episodes per month. There was a mean duration of 3.9 years, with a tendency for longer duration in children with positive family histories of sleep walking. Fifty percent stopped by age 8 years; 36 percent continued into adolescence. No common abnormal behavioral profile or psychopathology was found. Common precipitants of attacks were not identified. PMID- 3652597 TI - Family interactions surrounding feedings of infants with nonorganic failure to thrive. AB - Family interactional processes surrounding infant feedings in 34 consecutive cases of nonorganic failure to thrive (NFT) admitted to a university teaching hospital are reported. Observations of family interactions for 90 minutes, including one feeding, yielded clinically useful information not readily available from other sources. Behaviors that supported inadequate feedings were reliably identified in 79 percent of the families. Failure of mothers to appropriately respond to their infants' cues, coupled with few signs of emotional attachment, were present in only 26 percent of cases, and inadequate child-care knowledge and skills in only 6 percent. Thus, widely held conceptual models explained perpetuation of inadequate feedings in only 32 percent of cases. Instead, sibling rivalry, displaced maternal anger, and undermined mother were among the problems found. Assessments of family members' interactions surrounding feedings have the potential to enhance the current management of NFT. PMID- 3652598 TI - Malassezia furfur fungemia in infancy. AB - Malassezia furfur was recovered from blood cultures obtained through an indwelling line in seven severely ill infants hospitalized in a neonatal intensive care unit. While two of the patients were asymptomatic, the other patients had signs and symptoms compatible with sepsis. One patient had evidence of endocarditis. PMID- 3652600 TI - The initial family interview: clinical practice suggestion. PMID- 3652599 TI - Proptosis, skull infarction, and retro-orbital and epidural hematomas in a child with sickle cell disease. AB - A Saudi child with homozygous sickle cell disease (SS) presented with bilateral periorbital swelling, right-sided proptosis, skull bone infarcts, and retro orbital and epidural hematomas. The findings of skull bone infarcts, retro orbital and epidural hematomas are rare in patients with sickle cell disease. PMID- 3652601 TI - Galactosemic nephropathy in the rat. AB - The effect of 30% galactose feeding on kidney function and structure was compared to the effect of streptozotocin-induced diabetes in the rat. In the galactose-fed rats there was increased urine volume (500%), creatinine clearance (40%), urinary albumin excretion (100%), urinary N-acetyl glucosaminidase (600%) and relative kidney weight (21%). These changes were similar to that observed in streptozotocin-induced diabetic animals. Galactitol in the kidney cortex of galactose-fed rats was increased 4 times similar to that observed for sorbitol in the streptozotocin-induced diabetic animals. Glycosylated hemoglobins were also increased in both galactose-fed animals and streptozotocin-treated animals. These data suggest that galactose feeding may be a useful model for investigating some aspects of diabetic nephropathy. PMID- 3652602 TI - The relationship of plasma aldosterone-binding globulin to blood pressure regulation in young adults with cystic fibrosis. AB - Findings of increased secretion rate and decreased metabolic clearance rate (MCR) of aldosterone in patients with cystic fibrosis of the pancreas (CF) and our own evidence on the association of increased aldosterone-binding globulin (ABG) binding and decreased MCR in essential hypertension (EH) inspired us to investigate the plasma aldosterone, with the inclusion of protein-binding variables, in CF patients. (1) The percentage of plasma aldosterone specifically bound to ABG was measured in 55 young adults with CF in addition to total plasma aldosterone, total plasma corticosteroids and for comparison of corticosteroid binding globulin (CBG)-binding capacity. (2) The percentage of ABG-bound plasma aldosterone was found to vary with the seasonal change in temperature and the hepatic function of CF patients. Many of the CF patients, particularly during spring, summer and fall, had elevated plasma ABG-bound aldosterone which would be expected to result in low MCR. This binding was less elevated during cooler weather, suggesting that ABG-bound aldosterone is participating in the adaptation to warmer weather by probably increasing extrarenal sodium retention, thereby preventing a fall of blood pressure (BP) to pathologically low levels. A significant correlation was consequently found between the ABG capacity and the ambient temperature. (3) CF patients with low liver function had significantly lower protein binding of aldosterone and only slightly lower CGB capacity, presumably due to disturbed protein synthesis by the liver. (4) In some patients, elevated total plasma aldosterone and total corticosteroids were found, probably as a result of an adaptation to excessive sweat losses of sodium and the consequent contraction of intravascular volume. (5) Our findings also demonstrated a positive correlation between plasma ABG-bound aldosterone and both systolic and diastolic BP. PMID- 3652603 TI - Aminoglutethimide therapy in breast cancer: relationship of blood levels to drug related side effects. AB - Aminoglutethimide (AG) is now an established agent for producing a 'medical adrenalectomy' in patients with breast cancer. A number of annoying symptoms can occur in some patients placed on this medication. It has been suggested that the expression of symptoms may be related to the ability of the patient to acetylate AG to N-acetyl aminoglutethimide (NAG). Using high-pressure liquid chromatography (HPLC), we examined blood levels of AG and NAG in patients with breast cancer and compared the levels to the expression and frequency of drug symptoms. 43% of patients examined were judged to be slow acetylators in that 92% of the drug remained unacetylated irrespective of the dose administered. There was no significant correlation between acetylator status (rapid vs. slow) and the frequency of drug symptoms noted. In contrast, there was a significant correlation between the level of AG itself and the frequency of symptoms. 80% of patients with blood levels exceeding 12 mg/l had drug-related symptoms while only 36% of patients with levels below 8 mg/l showed symptoms (chi 2 p less than 0.05). 67% of patients with NAG levels in excess of 4 mg/l had symptoms. These findings indicate the presence of slow and rapid acetylators of AG in a breast cancer population and the importance of determining blood levels of the drug to minimize the onset of drug-related symptoms in some patients without losing drug efficacy. PMID- 3652604 TI - Protein phosphorylation patterns in human blood serum. AB - Phosphorylation of human blood serum proteins by endogenous kinases shows biphasic kinetics. During the early phase mostly beta-globulins are phosphorylated, while during the late phase alpha-globulins are also phosphorylated. In SDS-polyacrylamide gel electrophorograms, 32P-labelled peptides of 6, 14.3, 20, 23, 34, 37 and 40 kilodaltons were detected. No differences in phosphorylation pattern were observed in the sera of patients with various pathological conditions, under the experimental conditions employed. PMID- 3652605 TI - Facial aesthetic surgery: art, anatomy, anthropometrics, and imaging. PMID- 3652606 TI - Concepts for the plastic surgeon from art and sculpture. AB - The concepts gleaned from the world of artists and sculptors can be profitably used by the plastic surgeon in both aesthetic and reconstructive surgery. Judgment and taste are learned skills; talent is important but not primary. PMID- 3652607 TI - Anthropometrics and art in the aesthetics of women's faces. AB - Attractiveness of the face is not an abstract conception but a quantitatively well-defined anatomic quality. Harmony, disharmony, and disproportion of the face depend on the quality of the relationships between individual measurements of the craniofacial complex. The statistical expression of this relationship is the proportion index. A proportionate face, one with its proportion indices located within the normal range (mean +/- 2 SD), is healthy but not necessarily attractive. In an attractive face the proportion indices are in an optimal relationship, statistically in the range of mean +/- 1 SD. The existence of such a range ensures the great variability possible even among attractive faces. Disproportion, or even mild disharmony in a sensitive area of the face (orbits, nose, lips), reduces the aesthetic quality of the face. Restoration of harmony demands correction of the disproportionate relationships, which is achieved by appropriate changes in the measurements. Norms of measurements and proportion indices found in attractive faces serve as guides in calculating changes. Ethnic differences in North American Caucasian women proved not to be of major concern when planning aesthetic correction. PMID- 3652608 TI - Craniofacial biostereometrics. AB - We believe that biostereometrics can be useful to the craniofacial surgeon in providing a highly accurate, reproducible diagnostic and presurgical tool that is inexpensive and noninvasive. It can help visualize complex pathologic bony abnormalities, resolve ambiguous CT scans, and predict soft-tissue changes secondary to alterations in bony contours when used in conjunction with CT scans and cephalograms. PMID- 3652609 TI - Interactive computer graphics: a new technology to improve judgment in rhinoplasty. AB - A teaching system has been developed that employs interactive computer graphics to simulate the surgical experience of rhinoplasty, allowing the surgeon to experiment within a model of nasal behavior. The ability to experiment without risk and to safely learn the laws governing nasal behavior should augment the development of surgical judgment in rhinoplasty. PMID- 3652610 TI - Precision nasal profileplasty with life-sized slide projections, calibrated xerograms, and intraoperative measurements. AB - Full-scale photographic projections and xerographic cephalograms are useful aids in obtaining precision alterations of the nasal profile line. PMID- 3652611 TI - Anthropometric landmarks for precision planning in rhytidectomy. AB - Anthropometric landmarks provide a reference system that lends increased precision, consistency, and refinement to face lifts and related procedures. PMID- 3652612 TI - 3-D CT images for facial implant design and manufacture. AB - This article discusses the principles, methods, and benefits of CT scans and 3-D imaging for the custom design of facial implants for aesthetic and reconstructive surgery. PMID- 3652613 TI - The anatomy of the skin and fascial layers of the face in aesthetic surgery. AB - The superficial musculo-aponeurotic system (SMAS) has been described as a discrete fascial layer that divides the subcutaneous fat into two distinct layers. The authors discuss the anatomic significance of this system in facial aesthetic surgery. PMID- 3652614 TI - Artistry in aesthetic surgery. Aesthetic perception and the subunit principle. AB - We "see" what we perceive. The visual process of seeing and the psychology of perception are examined. A method of facial reconstruction emphasizing the restoration of subunits to maintain expected contours and landmarks is derived. PMID- 3652615 TI - Facile identification of the facial nerve branches. AB - The buccal, mandibular, zygomatic, and temporofrontal branches of the facial nerve are easily located by the surgical methods reported herein. The buccal and mandibular branches can be safeguarded during parotid, submaxillary gland, mandibular, or double-layer face lift surgery by these nerve location techniques. PMID- 3652616 TI - Isolation of a post-binding inhibitor of insulin action from the sera of non insulin-dependent diabetics. AB - We have reported that sera from a majority of patients with non-insulin-dependent diabetes mellitus (NIDDM) inhibit insulin-stimulated lipogenesis (3-3H-glucose conversion to 3H-lipid) in rat adipocytes to a greater extent than control sera or sera from patients with insulin-dependent diabetes mellitus (IDDM). This effect was apparently due to a circulating, low molecular weight (Mr) substance soluble in acid/ethanol and resistant to proteases. We now describe the further characterization of this inhibitor isolated uniquely from NIDDM sera. Size exclusion chromatography of acid/ethanol extracts of sera on a Bio-Rad P2 column revealed the presence of a Mr 300-400 inhibitor of insulin-stimulated lipogenesis in 32 (70%) of 46 NIDDM sera but not in 9 IDDM or 12 control sera. NIDDM sera that contained the low Mr inhibitor had significantly elevated haemoglobin A1c levels compared with those without the inhibitor (14.1 +/- 2.6% vs 11.5 +/- 2.7%, p less than 0.001). In rat adipocytes, the low Mr inhibitor at a dilution equivalent to 1:40 unextracted serum, reduced maximal insulin-stimulated lipogenesis by 33%, 14C-6-glucose oxidation by 70% and 14C-1-glucose oxidation by 25%. In contrast, insulin-stimulated 2-deoxy-D-(1-3H) glucose uptake was unaffected. In the presence of the inhibitor, insulin sensitivity (insulin dose required for half-maximal response) was unchanged for lipogenesis but decreased for 14C-6-glucose oxidation and increased for 14C-1-glucose oxidation. In the presence of control sera, the low Mr inhibitor decreased basal lipogenesis (a measure of serum insulin-like activity) and its effect on insulin-stimulated lipogenesis was unaltered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652617 TI - Ultrastructure of lymphocyte subsets and of activated lymphocytes in type 1 diabetes as defined by monoclonal antibodies and the immunogold technique. AB - The ultrastructure of peripheral blood lymphocyte subsets and activated lymphocytes from 5 patients with recent onset insulin-dependent diabetes as identified by monoclonal antibodies (CD4, CD8 and 4F2) and labelled with gold coupled goat anti-mouse IgG are described and depicted. Electron microscopy revealed no differences in appearance between investigated lymphocyte subsets at the single cell level. Activated lymphocytes as defined by an early activation antigen (4F2) do not always have a characteristic appearance nor do they show morphological signs of activation in all cases. We would conclude that it is not possible to recognize different lymphocyte subsets based only on their ultrastructure. PMID- 3652618 TI - The natural history of foot pressure abnormalities in neuropathic diabetic subjects. AB - The pressures under the feet of 39 subjects with diabetic neuropathy were initially assessed during walking using an optical pedobarograph. The upper limit of normality for pressure readings in non-diabetic subjects had previously been established as 10 kg/sq.cm. These subjects were then followed for a mean period of 3 years after which foot pressure studies were repeated. 39 feet had abnormal results when initially studied, compared with 33 at the follow-up study (p = NS). However, changes in the distribution of pressure under the metatarsal heads were seen in 13 feet, while 20 feet showed changes in abnormal pressures under the same site. Recurrent metatarsal ulcers occurred in 6 feet during the study, with 5 occurring at documented sites of high pressure. It is concluded that important changes in the distribution and level of pressures under diabetic neuropathic feet occur during a relatively short time. As it has previously been demonstrated that increased foot pressures are associated with foot ulceration, it is important for the orthotist to re-assess the feet regularly to establish whether significant changes in pressure distribution that might warrant new insoles or footwear have occurred. PMID- 3652619 TI - Canine diabetes mellitus has a seasonal incidence: implications relevant to human diabetes. AB - A 3 year survey of practicing veterinarians in the State of Wisconsin revealed a strong seasonal variation (peak incidence in January and February) for spontaneous canine diabetes mellitus (SCDM) in pet dogs. This seasonal incidence was quite similar to that observed in insulin-dependent diabetes mellitus (IDDM) in humans. SCDM is etiologically heterogeneous, it has dissimilar etiologies as compared to IDDM, and it is unlikely that viral infections play a causal role. For these reasons, it is concluded that the finding of a similar seasonal incidence in SCDM and IDDM suggests that the seasonal incidence of IDDM most likely represents the effects of, as yet undefined, stresses which precipitate the diabetic state in humans and dogs with pre-existent islet dysfunction of varying causes. PMID- 3652620 TI - Dietary triggers of insulin-dependent diabetes in the BB rat. AB - Environmental "triggers" (including viruses, toxins and dietary factors) have been implicated in the pathogenesis of insulin-dependent diabetes mellitus. Data have suggested a possible role for cow's milk protein (CMP) as a trigger of diabetes. To study this further, 86 BB rats were divided into 2 groups during the weaning period (days 13-25): Group A received rat chow without CMP; Group B, rat chow with 1% CMP added. Each group was subdivided afterwards into 2: Groups A1 and B1 received chow without CMP; Groups A2 and B2, chow with CMP. Animals weaned with chow containing CMP (B1 and B2) had a higher incidence of diabetes (66%) than those weaned without (A1 and A2; 29%, p less than 0.001). The incidence in both B1 and B2 was significantly greater than in either A1 or A2 (p less than 0.05). The highest incidence of diabetes occurred in male rats weaned on rat chow with CMP (90%), the incidence being significantly higher than female rats weaned with (43%) or without CMP (18%) and males weaned without CMP (39%). Thus, it appears that (a) the presence of cow's milk protein in the diet increases the incidence of diabetes in the BB rat; (b) the critical time for exposure to CMP appears to be the weaning period; and (c) male rats appear to be more susceptible to the development of diabetes than female rats, when exposed to this trigger. This supports the hypothesis that dietary triggers may play an important role in the expression of diabetes in the susceptible host and that its prevalent action occurs early in life. PMID- 3652621 TI - Multifactorial evaluation of blood pressure fall upon hospitalization in essential hypertensive patients. AB - 1. Studies were prospectively performed on 72 hospitalized patients with essential hypertension. Blood pressure was normalized within 1 week of admission in 33 patients (group I), but did not decrease in 39 patients (group II). To determine the factors that differentiate group I from group II, cardio-renal haemodynamic and endocrinological indices were evaluated using multivariate analysis. 2. Systolic, diastolic and mean blood pressures on admission were higher in group II (P less than 0.001), whose optic fundi showed more severe changes (P less than 0.001). Although group II had greater left ventricular posterior wall thickness (P less than 0.02), left ventricular mass index (P less than 0.05) and systemic vascular resistance (P less than 0.01) on echocardiography, their cardiac index and ejection fraction were comparable with those of group I. 3. Renal blood flow (P less than 0.05) and glomerular filtration rate (P less than 0.01) were lower in group II than in group I. Renal vascular resistance was more elevated (P less than 0.01) in group II than in group I. 4. After severe sodium depletion and ambulation, group I showed a greater increase in plasma noradrenaline and adrenaline (P less than 0.05). On multivariate analysis, those with lower systolic blood pressure, better renal function and more reactive sympathetic nervous system were discriminated as group I. 5. These data suggest that group I patients have lower systolic blood pressure on admission, greater sympathetic reactivity and better renal function, all of which contribute to their spontaneous blood pressure fall after admission. PMID- 3652623 TI - Fatty acid synthesis and triacylglycerol accumulation in rat liver after chronic ethanol consumption. AB - 1. Liver slices from chronically alcohol-fed rats incubated with 3H2O showed less than half the fatty acid synthesis rates of pair-fed controls. Addition of 50 mmol/l ethanol or of 10 mmol/l lactate and 1 mmol/l pyruvate to the incubation medium did not alter the fatty acid synthesis rates in either groups. Hepatic fatty acid synthesis rates measured in vivo with 3H2O were also significantly reduced in alcohol-fed rats. 2. Time-course experiments showed that after 1 week on the ethanol diet hepatic fatty acid synthesis rates in vitro were similar to control rats, although the liver triacylglycerol content was significantly increased. From the second week of feeding, fatty acid synthesis rates were significantly lower in alcohol-fed rats and the liver triacylglycerol content progressively increased compared with controls. 3. Fatty acid synthase activity in liver cytosolic fractions were similar to controls in the alcohol-fed group after 1 week of feeding but were significantly lower in alcohol-fed rats from the second week onwards. 4. These results indicate that hepatic triacylglycerol accumulation after alcohol feeding is not due to increased fatty acid synthesis. The reduced fatty acid synthesis observed is a consequence of triacylglycerol accumulation. PMID- 3652622 TI - The effect of intravenous frusemide on urine dopamine in normal volunteers: studies with indomethacin and carbidopa. AB - 1. The urine dopamine response to intravenous frusemide (30 mg) was investigated in 15 salt replete male volunteers. The effects of oral indomethacin (100 mg) and oral carbidopa (100 mg) given before intravenous frusemide were studied in the same group of subjects. 2. Frusemide produced a significant increase in urine dopamine output within 15 min. 3. Indomethacin attenuated the natriuretic and renin responses to frusemide, but did not alter urine dopamine output. 4. Carbidopa lowered urine dopamine to undetectable levels, but did not significantly affect the natriuretic and renin responses to frusemide. 5. We conclude that urine dopamine excretion after frusemide is not directly related to increased sodium excretion or renin response and it is not mediated by the prostaglandins. In addition, dopamine does not contribute to the renal actions of frusemide under normal conditions. PMID- 3652624 TI - Permeability of the rat small intestine to carbohydrate probe molecules. AB - 1. Absorption of carbohydrate probe molecules from ligated loops of rat small intestine was studied. Absorption was determined by measuring recovery of molecules in the urine, corrected for incomplete recovery after intravenous injection, and was examined for correlation with several parameters of molecular dimension. 2. Absorption depended on molecular volume rather than relative molecular mass, molecular radius or molecular area. 3. Molecules with a molecular volume below 225 X 10(-3) nm3 were absorbed to a greater extent than larger molecules, and absorption was affected critically by molecular volume, small changes in volume producing considerable variation in absorption. 4. Absorption of larger molecules was not affected by changes in volume within the range 362 X 10(-3)-1128 X 10(-3) nm3. 5. These findings support the concept that there are at least two aqueous diffusion pathways across the intestinal mucosa. small molecules diffusing through a small channel of finite dimension, compatible with a transcellular aqueous pore, whilst large molecules diffuse through a less frequent pathway of considerably larger dimensions. PMID- 3652625 TI - Disturbance of acid-base balance in the young spontaneously hypertensive rat. AB - 1. The acid-base status of young spontaneously hypertensive rats (SHR) was compared with that of Wistar-Kyoto rats (WKY) in the steady state, after acid loading and after blood pressure had been maintained at normal levels from weaning. Whole blood ionized calcium was measured simultaneously. 2. In the prehypertensive stage (4 weeks of age), plasma bicarbonate was significantly lower in SHR than in WKY, while blood pH did not differ significantly. 3. After 6 weeks of age, blood pH and plasma bicarbonate were significantly lower in both anaesthetized and conscious SHR than in corresponding WKY. After 7 days administration of NH4Cl in the drinking fluid, both parameters decreased significantly in both strains and the difference in pH remained constant (0.05 pH unit, P less than 0.01). 4. In none of the groups investigated did non-pH adjusted ionized calcium differ significantly between the SHR and WKY. 5. Prevention of the development of hypertension in SHR by hydralazine treatment from weaning did not increase pH or bicarbonate compared with untreated SHR, indicating that the metabolic acidosis in the SHR was not a consequence of raised blood pressure. 6. Disturbance in acid-base balance may be involved in the pathogenesis of raised blood pressure in this animal model of genetic hypertension. PMID- 3652626 TI - Measurement of secretion in nasal lavage. AB - 1. The amount of admixture in nasal lavage fluids was determined by addition of 99mTc labelled albumin, providing a correction factor for measurements of cellular material and humoral substances in nasal lavage return as well as a quantitative measure of nasal secretions. 2. Albumin was chosen as marker molecule, since only negligible amounts were absorbed or adsorbed to the mucosa during the nasal lavage. 3. Labelling of the albumin with 99mTc ensured an accuracy of measurements only limited by the precision of the weighing. The isotope allowed for the determination of the amount of admixed secretion to be carried out on the whole sample of lavage fluid, thereby avoiding the necessity of complete admixture between marker and lavage fluid which would be pertinent to marker molecules measured chemically. The radiation from a nasal lavage is minimal and the procedure is fully acceptable for repeated use in humans. 4. The nasal lavage technique adopted allowed the return of 99.2% (median value) of the instilled volume. The area irrigated was visualized on a gamma-camera, and was demonstrated to cover an area larger than the area reached by challenge from a pumpspray, i.e. a large part of the nose, yet not the oropharynx. 5. A dose related increase in nasal secretion harvested by the nasal lavage in 10 persons challenged with histamine chloride could be demonstrated by this technique. 6. It is concluded that the use of 99mTc-albumin in a nasal washing provides a safe, simple and quick method for determination of the admixed nasal secretion with a remarkable degree of accuracy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652627 TI - Deferoxamine-induced bone changes in haemodialysis patients: a histomorphometric study. AB - 1. The histological effects of deferoxamine therapy were assessed on transiliac bone biopsies taken after double tetracycline labelling from 16 uraemic patients undergoing chronic haemodialysis, all having aluminium deposits in bone. Eight patients had osteomalacia, five had an "aplastic" bone lesion and three a high bone turnover with a marked increase in osteoid volume. 2. Deferoxamine was administered intravenously once a week at doses ranging from 1 to 6 g for a mean duration of 7.6 +/- 3.3 (SD) months. 3. Deferoxamine therapy was associated with significant reductions in stainable aluminium deposits, osteoid volume, osteoid surfaces and thickness index of osteoid seams. The osteoblastic osteoid surfaces as well as the bone formation rates also increased significantly. 4. A rise in resorption parameters and in serum parathyroid hormone levels was observed in patients with osteomalacia. The percentage reductions in stainable aluminium and in osteoid volume were correlated with the degree of hyperparathyroidism. 5. These data show that deferoxamine therapy reduces stainable bone aluminium and improves bone mineralization in low turnover osteomalacia and that the presence of hyperparathyroidism is associated with an increased response to deferoxamine therapy. PMID- 3652628 TI - Relationship between hepatic levels of glutathione and sulphobromophthalein retention in hyperthyroidism. AB - 1. Sulphobromophthalein (BSP) retention and liver glutathione levels were studied in uncomplicated hyperthyroid patients. 2. BSP retention was increased in 52.5% of the subjects at admission (n = 40) and in 28% of the cases after 3 months of propylthiouracil treatment (300-400 mg/day) (n = 25). 3. Hepatic levels of glutathione were measured in six patients and significant inversed power correlation with BSP retention was observed (r = 0.968, P less than 0.001). 4. These data support the contention that the alteration of the BSP retention observed in hyperthyroidism could be due to a decreased availability of hepatic glutathione for conjugation. PMID- 3652629 TI - Blood pressure in the puerperium. PMID- 3652630 TI - Measurement of dead-space volume. PMID- 3652631 TI - Evidence for large intestinal control of potassium homoeostasis in uraemic patients undergoing long-term dialysis. AB - 1. The role of the large intestine in the maintenance of K+ balance in uraemic patients established on long-term dialysis was studied with a rectal dialysis technique in 14 normal subjects, ten normokalaemic patients undergoing chronic ambulatory peritoneal dialysis (CAPD), and seven patients undergoing haemodialysis. Dietary K+ intakes in the normal subjects, CAPD patients and haemodialysis patients were 80-100 mmol/24 h, 70-80 mmol/24 h and 60-70 mmol/24 h, respectively. 2. At an initial intraluminal K+ concentration of 45 mmol/l, rectal K+ secretion in the CAPD patients (2.4 +/- 0.4 mumol h-1 cm-2) was greater than in normal subjects (1.2 +/- 0.2 mumol h-1 cm-2, P less than 0.02). Under similar conditions, rectal K+ secretion was also greater in the haemodialysis patients than in normal subjects, both predialysis (3.7 +/- 0.4 mumol h-1 cm-2, P less than 0.001) and postdialysis (2.4 +/- 0.5 mumol h-1 cm-2, P less than 0.05), even though haemodialysis decreased plasma K+ concentration from 5.3 +/- 0.1 mmol/l to 3.5 +/- 0.2 mmol/l (P less than 0.001). 3. There were no significant differences in rectal Na+ absorption, rectal potential difference, plasma aldosterone concentration, or total body K+ content (measured by whole-body counting of 40K), between the normal subjects and either the CAPD or the haemodialysis patients. 4. These results indicate that K+ homoeostasis is maintained in uraemic patients undergoing long-term dialysis by a combination of K+ losses during dialysis, and enhanced large intestinal K+ excretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652633 TI - The effects of posture on abnormalities of forearm venous tone in women with pregnancy-induced hypertension. AB - 1. Forearm venous tone was measured in the left lateral supine position and in response to passive leg elevation in a group of women with pregnancy-induced hypertension and compared with a group of normotensive pregnant women and a group of non-pregnant women. 2. The women with pregnancy-induced hypertension were venoconstricted in the supine position compared with the normal pregnant women (P less than 0.002). There was no difference in forearm venous tone between the women with pregnancy-induced hypertension and the non-pregnant women. 3. In response to passive leg elevation the women with pregnancy-induced hypertension venodilated (P less than 0.002) whereas there was no change in forearm venous tone in the normotensive pregnant women and the non-pregnant women. There was no change in blood pressure in any of the women after 35 min of leg elevation. 4. These results demonstrate that the abnormal venous vasoconstriction that occurs in women with pregnancy-induced hypertension in the supine position is corrected by passive leg elevation, a manoeuvre which leads to an increase in central blood volume. PMID- 3652632 TI - Influence of the sympathetic nervous system and vasopressin on the blood pressure lowering effect of nifedipine in deoxycorticosterone acetate-salt hypertensive rats. AB - 1. The role of the sympathetic nervous system and the effect of vasopressin (AVP) on the hypotensive action of nifedipine (Nf) were evaluated in conscious, unrestrained normotensive and DOCA-salt hypertensive rats. 2. The hypotensive response to Nf was much greater in DOCA rats than in the controls. 3. Solitary blockade of the sympathetic nervous system or AVP, did not alter the Nf effect in either DOCA or control rats. However, a combination clearly diminished the effect of Nf in the DOCA group, but enhanced it in the controls. The inhibition of angiotensin II (ANG II) augmented the hypotensive effect of Nf in control animals, but not in the DOCA rats. The percentage fall in blood pressure with Nf was much the same in both groups after the combined inhibition of the sympathetic nervous system and AVP. 4. The enhanced hypotensive action of Nf in DOCA rats may be dependent on the hyperactivity of the sympathetic nervous system and AVP, which facilitates calcium influx, and in the normotensive animals the depressor response to Nf may relate to blockade of the calcium influx, independent of the sympathetic nervous system, AVP and ANG II. PMID- 3652634 TI - Evidence for an inhibitor of leucocyte sodium transport in the serum of neonates. AB - 1. In confirmation of previous studies, serum obtained from cord blood demonstrated endogenous digoxin-like immunoreactivity (EDLI). Sera from pregnant women in the third trimester also demonstrated EDLI, which disappeared after delivery. 2. Cord serum inhibited the total sodium efflux rate constant of a mixed leucocyte preparation when compared with the effect of control serum. This inhibition resulted from a depression of the ouabain-sensitive (sodium pump) component of the rate constant. 3. An ultrafiltrate of the serum (mol. wt. less than 30,000) also inhibited ouabain-sensitive leucocyte sodium transport when compared with filtrate obtained from control serum. 4. DHA-S Dehydroepiandrosterone sulphate (DHA-S) and cortisone, both present in high concentration in cord serum, demonstrated EDLI but did not affect leucocyte sodium transport in the cells of normal subjects. 5. DHA-S had no effect on sodium transport or vasoconstrictor activity in human omental resistance vessels. 6. It is concluded that EDLI of cord serum is associated with sodium transport inhibitory activity. This is unlikely to be attributable to DHA-S or cortisone. PMID- 3652635 TI - Loop-acting diuretics do not bind to Tamm-Horsfall urinary glycoprotein. AB - 1. Binding between the radiolabelled loop-acting diuretics ([14C]frusemide, [14C]ethacrynic acid and [3H]bumetanide) and human Tamm-Horsfall glycoprotein or human serum albumin in vitro was evaluated by equilibrium dialysis. 2. The diuretic action and binding to urinary Tamm-Horsfall glycoprotein of the radiolabelled diuretics in vivo, after intravenous administration, were examined in rabbits. 3. In vitro, all three radiolabelled diuretics bound strongly to human serum albumin, but not to Tamm-Horsfall glycoprotein. 4. Radiolabelled frusemide and bumetanide, but not ethacrynic acid, caused a diuresis in rabbits, but no binding between the drugs and Tamm-Horsfall glycoprotein was seen in vivo. 5. Binding to Tamm-Horsfall glycoprotein does not appear to be an important mechanism in the action of loop diuretics. PMID- 3652636 TI - The CFU-C assay in patients with neutropenia and, in particular, drug associated neutropenia. AB - One-hundred and four patients with a diagnosis of aplastic anaemia (28) or neutropenia (76) referred to our laboratory for assessment of granulopoiesis were studied. Bone marrow myeloid progenitor cell (CFU-C) frequency was measured and in 85 patients, inhibitor studies with either in-vitro drug addition or plasma co culture were performed. Of 28 patients with aplastic anaemia, 22 (79%) had low numbers of CFU-C, while four (14%) had numbers within the normal range and two (7%) had elevated progenitor cell frequency. In contrast, of the 76 patients with neutropenia who were studied only 29 (38%) had low CFU-C numbers, 33 (43%) had a CFU-C frequency within the normal range and 14 (18%) had elevated CFU-C numbers. Thirty-nine patients had ingested potentially myelotoxic drugs and in eight of these it was possible to demonstrate drug associated inhibition of CFU-C proliferation in vitro. The drugs most commonly associated on a historical basis with myelosuppression were chloramphenicol, antimalarials, sulphonamides, anticonvulsants and nonsteroidal anti-inflammatory agents. PMID- 3652637 TI - Protein C response to induction and withdrawal of oral anticoagulant treatment. AB - Protein C activity and antigen levels have been related to clotting activities of factors VII and X during the induction and withdrawal periods of oral anticoagulant treatment. Both factor VII and protein C activities fell rapidly during induction but factor VII showed a more rapid and much more marked depression than protein C. In contrast, reductions in factor X were much slower. Protein C antigen, although depressed rapidly at the initiation of treatment, did not subsequently fall to the same degree as protein C activity. The ratio of activity to antigen became progressively smaller. On discontinuation there was a reversal of the pattern but with two important differences. Firstly, there was evidence of an excessive rise ('rebound') of factor VII compared with the steady state levels in these patients; and secondly there was a surprisingly slow return of protein C to normal levels after the oral anticoagulant was withdrawn (levels were still below normal on day 4). These observations lend support to gradual withdrawal of oral anticoagulants after a period of long-term administration. The results suggest that after discontinuation of long-term anticoagulants patients may have increased coagulability up to four days. PMID- 3652638 TI - Blood cell values in healthy Hong Kong Chinese adults. AB - Haemoglobin concentration and other blood cell indices were determined in a Coulter counter (Model S-Sr) in order to establish a reference range for healthy Hong Kong Chinese adults. The mean values for all the blood cell indices were significantly higher (P less than 0.0005) in males than in females, except for MCHC where there was no difference. In males, there was a statistically significant age-related decrease in RBC counts and Hb concentration, whereas MCV showed a statistically significant increase with age. The WBC counts also showed a statistically significant increase with age. In females, however, all the blood cell indices remained relatively unchanged up to 70 years of age, after which there was a drop in the RBC counts (P less than 0.01), PVC (P less than 0.05) and Hb concentration, the latter not reaching statistical significance. The MCH, however, increased after 70 years of age (P less than 0.05). The reference ranges derived for healthy Hong Kong Chinese adults are of a similar order of magnitude to those already published. PMID- 3652640 TI - Bone marrow granulocyte reserve in chronic benign idiopathic neutropenia. AB - Fifteen patients with chronic benign idiopathic neutropenia (CBIN) with neutrophil counts less than 1.0 X 10(9)/1 have been studied. The mean age was 33 years (range 23-50) comprising 11 females and 4 males. Bone marrow cellularity was normal except in two patients who showed slight reduction and one who had a slight increase. Bone marrow differential counts were normal apart from a small increase in the percentage of promyelocytes and reduction in the myeloid/erythroid ratio in some patients. Peripheral blood counts showed no 'compensatory' monocytosis. Epinephrine stimulation tests showed no evidence of excess neutrophil margination. After endotoxin administration there was a one- to two-fold increase in neutrophil counts in three patients, a three-fold increase in three patients and a greater than four-fold increase in the remaining nine patients. The findings suggest that the benign course of CBIN is not due to excess neutrophil margination nor to compensatory monocytosis, but that at least one mechanism includes a functionally adequate release of neutrophils to the peripheral blood under conditions of stress with subnormal delivery of neutrophils under basal conditions. The variability in responses to endotoxin suggests that CBIN is not entirely homogeneous with respect to mechanism. The findings of relatively normal bone marrow cellularity and differential counts and a normal or substantial neutrophil response to endotoxin appear characteristic. They may help predict a benign clinical course in neutropenic patients and assist diagnosis of the CBIN variant of idiopathic neutropenia. PMID- 3652639 TI - Evidence of drug metabolism by macrophages: possible role of macrophages in the pathogenesis of drug-induced tissue damage and in the activation of environmental procarcinogens. AB - After interaction with human macrophages derived from blood, bone marrow or spleen, solutions of sodium phenobarbitone, phenytoin sodium and chlorpromazine hydrochloride showed reduced cytotoxicity towards K562 cells. The reduction in cytotoxicity was partially suppressed in the presence of tetrahydrofurane, an inhibitor of cytochrome P450. These data suggest that macrophages are capable of metabolizing certain drugs, probably via a cytochrome P450-dependent mechanism. The present findings raise the possibility that some drug-induced blood dyscrasias are caused by metabolism of the drug by bone marrow macrophages and the consequent release of relatively short-lived molecules which are toxic to adjacent haemopoietic cells. The generation of cytotoxic molecules during drug metabolism by macrophages may also be responsible for drug-induced damage to other macrophage-rich tissues. In addition, since cytochrome P450-dependent reactions seem to occur within macrophages, these cells may activate environmental procarcinogens and thus plays a role in carcinogenesis and leukaemogenesis. PMID- 3652641 TI - Report of the Platelet and Granulocyte Serology Working Group, 1986. AB - A blind trial conducted amongst 29 laboratories revealed that the overall incidence of 'false-positive' results in tests for anti-platelet antibodies was greater for heat-treated serum and plasma samples than for untreated samples. PMID- 3652642 TI - An evaluation of the Cell-Dyn 1000. AB - The Cell-Dyn 1000 is a new eight parameter fully automatic cell counter. This was evaluated following the ICSH guidelines. Scientific evaluation was generally satisfactory, largely conforming to the manufacturer's specifications. A number of potential microbiological safety hazards were noted; many could be overcome by minor modifications. Throughput and start-up/close-down times were acceptable. However, the reliability of the tested machine was felt to be less than satisfactory although this may be corrected by further minor machine modifications. PMID- 3652643 TI - Hairy cell leukaemia in two brothers. AB - Two cases of hairy cell leukaemia (HCL) presenting in brothers with a 14 year interval are described. Familial HCL has been described previously in two kinships but not in the UK. Both brothers had worked as car mechanics for some time but apart from this no other recognized shared environmental or genetic risk factors were identified. PMID- 3652644 TI - Mediastinal extramedullary erythropoiesis in hereditary spherocytosis. AB - Evidence of thoracic extramedullary erythropoiesis has been noted before but it is considered rare in the course of chronic haemolytic anaemia. We report an adult who was admitted for splenectomy because of hereditary spherocytosis (HS). The evidence of a large mediastinal mass before surgery led us, after isotopic scanning using 111Indium transferrin, to suspect extramedullary erythropoiesis; this was confirmed by cytology during surgery. The utility of 111Indium transferrin as a bone marrow tracer is also noted. PMID- 3652645 TI - Guidelines for compatibility testing in hospital blood banks. A joint publication of the British Society for Haematology and the British Blood Transfusion Society. AB - The aims of this report are to present minimum guidelines for antibody screening and compatibility testing. In view of the high incidence of antibody detection failures found in recent international external proficiency trials, the Working Party does not advocate the omission of the anti-human globulin (AHG) test in the compatibility procedure for patients with negative antibody screens until such time as blind test trials demonstrate a much higher standard of test performance. The approach of these guidelines is mainly advisory, although details of important principles and techniques are given. The design of procedures for emergency situations is particularly difficult as, in the overall interests of the patient, sensitivity may have to be compromised. In this situation two pitfalls must be avoided--the issue of ABO incompatible blood because of inadequate and rushed procedures on the one hand, and failure to supply blood before the patient becomes irreversibly shocked on the other. An element of flexibility must therefore be allowed which requires a high level of training and an understanding of the clinical situation. PMID- 3652646 TI - Therapeutic drug monitoring--II: Patient care and applications. PMID- 3652647 TI - Phonological blocking in the tip of the tongue state. PMID- 3652648 TI - Sentence matching and overgeneration. PMID- 3652649 TI - Sentence matching and well-formedness. PMID- 3652650 TI - Object permanence in five-month-old infants. PMID- 3652651 TI - On beyond zebra: the relation of linguistic and visual information. PMID- 3652652 TI - Clinical importance of cefoxitin-resistant Bacteroides fragilis isolates. AB - Resistance to cefoxitin among species of the Bacteroides fragilis group of organisms has remained low (8%-10%) in a multicenter nationwide survey. However, a statistically significant increase in the percentage of B. fragilis group organisms resistant to cefoxitin was found at Tufts-New England Medical Center from 1981 to 1982. Non fragilis species accounted for most of the resistance. The presence of cefoxitin resistance in B. fragilis isolates correlated with resistance to other antibiotics. The presence of cefoxitin-resistant B. fragilis group organisms also correlated with the presence of other cefoxitin-resistant bacteria. No difference could be detected in therapeutic outcome of patients with cefoxitin-sensitive or cefoxitin-resistant B. fragilis group organisms, regardless of treatment with cefoxitin or other antibiotics. PMID- 3652653 TI - Bacteremia due to Neisseria cinerea: report of two cases. AB - We report two cases of bacteremia due to Neisseria cinerea. One was a 2.5-yr-old boy with otitis media and pneumonia, who responded to treatment with amoxicillin. The other was a 47-yr-old man with underlying ethanol abuse who developed severe polymicrobial sepsis due to apparent intraabdominal disease. This man died despite extensive antimicrobial therapy. PMID- 3652654 TI - Comparison of methods for processing dialysate in suspected continuous ambulatory peritoneal dialysis-associated peritonitis. AB - Three methods of processing dialysate from patients on continuous ambulatory peritoneal dialysis and with suspected peritonitis were compared: (a) direct inoculation of 10 ml of dialysate into an Isolator tube, (b) direct inoculation of 5 ml of dialysate into each of two Bactec blood culture bottles (NR 6A and 7A), and (c) centrifugation of 50 ml upon receipt in the laboratory and culture of the sediment. A diagnosis of peritonitis was made in 33 of 52 suspected episodes. Pathogens were recovered by Isolator in 26 of the 33 specimens, by Bactec in 21, by centrifugation in 25, and by any method in 27. Time to detection of positivity was the same for Isolator and Bactec in 20 of 21 cases and for Isolator and centrifugation in 21 of 24 cases. Identification was available 24-48 hr earlier with Isolator than with centrifugation in three of 24 cases and 24 hr earlier with Isolator than Bactec in 20 of 21 cases. PMID- 3652655 TI - Postcesarean wound infection by Mycoplasma hominis in a patient with persistent postpartum fever. AB - Mycoplasma hominis was isolated in pure culture from a wound infection following delivery by cesarean section. The importance of recognizing this organism as a potential pathogen of the female genital tract is emphasized. Two commercially available isolation systems that allow the recovery of this organism are also described. PMID- 3652656 TI - Single-dose surgical prophylaxis using ticarcillin/clavulanic acid (Timentin): a prospective, randomized comparison with cefotaxime. AB - Single 3.1-g dose surgical prophylaxis with ticarcillin/clavulanic acid (Timentin) was compared to single-dose cefotaxime. Among 224 evaluable cases, the Timentin associated wound infection rate (0.7%), nonwound infectious morbidity (8.8%), adverse reactions (1.9%), and total costs ($14.15) were not statistically different than that of the control drug. The beta-lactamase [corrected] inhibitor combination reported herein should be considered along with other beta-lactams [corrected] for use as a cost-effective, single-dose surgical prophylaxic agent on a wide variety of operative procedures. PMID- 3652657 TI - Insulin-like growth factor I, somatomedin C, induces the synthesis of tropoelastin in aortic tissue. AB - The action of IGF-I (insulin-like growth factor I) on the synthesis of tropoelastin in chick embryonic aortae was examined. Maximal and selective stimulation of the relative (40%) and absolute (145%) rates of tropoelastin synthesis over control occurred at an IGF-I concentration of 100 ng/ml of medium. Parallel to the increase in synthesis was a 92% increase in the amount of tropoelastin activity per 100 ng of poly (A)+ RNA translated in a cell-free system. The relative rate of tropoelastin synthesis achieved at maximal stimulation is greater than that observed during normal aortic embryogenesis. The stimulatory action of the hormone on elastin synthesis appears to be at a pretransitional level perhaps involving increased transcription or stabilization of the tropoelastin mRNAs. These results suggest that IGF-I may play a key role in the regulation of elastogenesis in arterial tissue. PMID- 3652658 TI - Age-related changes of the dermatan sulfate containing small proteoglycans in bovine tendon. AB - Sulfated proteoglycans of fetal, newborn and adult bovine tendon are extracted with neutral salt and then with 4 M guanidine HCl in the presence of proteinase inhibitors. Dermatan sulfate containing small proteoglycans are separated from chondroitin sulfate rich proteoglycans by CsCl-gradient centrifugation, by affinity chromatography using concanavalin A and by molecular sieve chromatography. These proteoglycans are comprised of a core protein with an average Mr of about 53,000 on polyacrylamide gel electrophoresis with SDS and of dermatan sulfate side chains with Mr 25,000-38,000 by gel chromatography. The tryptic peptides patterns observed in the small proteoglycans from newborn calf and adult bovine tendon are identical but are distinct from those of embryonic calf tendon. The patterns of the tryptic peptides of the core proteins from embryonic calf tendon are similar to those from the dermatan sulfate proteoglycans of calf skin. These results indicated that genetically independent genes of the core proteins from dermatan sulfate proteoglycans in tendon tissues were expressed by aging. PMID- 3652660 TI - Characterization of acid-soluble type I collagen in solution by viscosity measurements. I. Some evidence about adsorption on the glass material and about electrostatic and ionic bondings in the molecular self assembly process. AB - The evidence of a adsorption phenomenon of the acid-soluble collagen molecules on the glass material is shown. A way of calculation is proposed from viscosimetric measurements. It could be pointed out that a small amount corresponding to 4 to 5% of the collagenous concentration is involved in such a adsorption process, at 25 degrees C. This adsorption phenomenon is temperature-dependent and weakened by a previous NaOH-treatment of the collagen solutions. It is confirmed that intermolecular associations may take place in acidic conditions and they are minimized for a pH range corresponding to the pK area of aspartic and glutamic acid residues. The influence of temperature showed that ionic interactions are reinforced by hydrophobic effects. The modification of the ionization and the removal of the telopeptidic regions from the native molecules are responsible for the decrease in these associations. On the other hand, it was shown that the relative flexibility of the molecule may explain the modifications in the (eta) values depending on the pH and ionic-strength conditions for the molecular solutions. PMID- 3652659 TI - The influence of dissolved calcium salts on the degradation of hard-tissue collagens by lysosomal cathepsins. AB - Bone, calvaria and dentine collagens were incubated with crude preparations of lysosomal cathepsins obtained from liver, spleen and bone cells. Degradation was most rapid near or below pH 4 and the rate of degradation was increased two-to four-fold in the presence of 50-75 mM CaCl2. This concentration of Ca2+ ions was close to the saturating level of ions released from calcium hydroxyapatite in the pH range 3.5-4.0. Purified cathepsins B and L were very much less effective than the crude extracts in degrading the hard-tissue collagens. Cathepsin B was equally sensitive to the inclusion of 50 mM CaCl2 but cathepsin L activity was only slightly increased. The activating effect of Ca2+ ions was not specific as Mg2+ ions were equally effective. A partially-purified preparation of cathepsin N gave results similar to those obtained for the crude, mixed enzyme preparations. Spleen and bone cell extracts were much more effective than those of liver despite a lower content of cathepsins B and L. These findings suggest that a third enzyme, cathepsin N, which is known to be more abundant in spleen than liver, had contributed more of the collagenolytic activity in the spleen and bone cell extracts. Therefore in osteoclastic bone resorption the major collagen degrading enzyme could be cathepsin N. Tendon collagen was degraded very rapidly by the crude and pure preparations of lysosomal cathepsins in the CaCl2-free buffers. However, when 50 mM CaCl2 was included in the incubation mixtures the reaction was strongly inhibited. The effect of the added CaCl2 appeared to be on the substrate since the activity of cathepsins B and L, was depressed by CaCl2 in the fluorimetric peptidase assays for these enzymes. PMID- 3652661 TI - Polar-apolar characteristics and fibrillogenesis of glycosylated collagen. AB - To find the effect of carbohydrate on collagen fibrillogenesis, type I skin collagen was glycosylated by glycosyltransferase, and type II cartilage collagen was deglycosylated by glycosidase. The secondary structures remained unchanged, but the tertiary structures were altered, as shown by increased TNS fluorescence of the bound probe in the glycosylated form. Since TNS binds preferentially to the hydrophobic region of a protein molecule, glycosylation caused an apparent increase in the available hydrophobic sites for the dye. Glycosylation also resulted in a longer lag time and a slower growth rate of fibrillogenesis, although the amount of fibrils formed was unchanged. Deglycosylation resulted in a shorter lag time and an increased rate of fibrillogenesis. Neither glycosylation nor deglycosylation changed the stability of the molecule, as was evident from the melting temperature. PMID- 3652662 TI - Packaging and delivery of bone induction factors in a collagenous implant. AB - Extracts of demineralized rat bones which contained factors stimulating bone induction were reconstituted with highly purified human type I collagen to provide a suitable and easily manipulated delivery system for surgical implantation. When implanted subcutaneously in rats, the implants governed and delineated the dimensions of the resulting bony tissue. It is proposed that this implant system has clinical application in the filling of osseous defects within the scope of orthopaedic and oral and maxillofacial surgery. It is presented here as a potential improvement over conventional implant materials without osteoinductive properties. PMID- 3652663 TI - Characteristics of the homeless mentally disordered population in Fresno County. AB - A survey of a sample comprising 9.5% of the estimated homeless mentally disordered population of Fresno County was conducted as a needs assessment for a treatment program proposal. Eighty percent of the sample were found to meet the criteria for a psychiatric diagnosis as determined by a standardized interview. Of these, 34% were rated severely impaired and urgently in need of treatment. An additional 33% were rated moderately impaired so that treatment would be of substantial benefit. Survey data are presented of the samples' priorities concerning primary needs, preferred locale for treatment and services, type of personnel with whom they would feel most comfortable, and most important problems. PMID- 3652664 TI - Outpatient clinic therapist attitudes and beliefs relevant to client dropout. AB - One hundred and seventy-three psychotherapists from 43 Midwestern mental health clinics responded to a survey which addressed therapists' attitudes and beliefs on service delivery topics relevant to client premature therapy termination. Therapists' responses were contrasted with known client and service delivery data. Therapists preferred a treatment duration longer than that expected by clients, overestimated actual treatment length, underestimated actual dropout rates and cited dislike of therapy or the therapist less often than clients did as reasons for premature termination. Causes of therapists' overestimates of treatment length and continuance, and their relevance to the dropout problem, were discussed. PMID- 3652665 TI - Developing a comprehensive community care system for the mentally ill/mentally retarded. PMID- 3652666 TI - Culture-specific substance abuse prevention for blacks. PMID- 3652667 TI - Strategies for cutback management in community mental health centers. AB - The purpose of this study was to investigate administrative strategies which community mental health center directors were utilizing to confront declining financial resources. Thirty-two out of a total of 41 area directors in North Carolina who met certain criteria were the subjects, and their responses to a thirty item questionnaire were analyzed. Four strategies were both utilized and perceived as being effective: (1) increased efficiency of services; (2) increased efforts to obtain fees for service; (3) more economical modes of treatment; and (4) service reduction, but this strategy was recommended only as a last resort if all other strategies fail. PMID- 3652668 TI - The prevalence and significance of medical illness among chronically mentally ill outpatients. AB - The prevalence and significance of medical illnesses were examined in a sample of chronically mentally ill patients from an urban community mental health program. Eighty-eight percent had at least one significant medical illness, 51% had at least one previously undiagnosed illness and 53% were judged to be in need of some form of medical attention. The bulk of these illnesses were typical of primary care problems. In terms of causal significance, nearly as many medical illnesses appeared to be the result of the psychiatric disorder (18%) as vice versa (22%). Community mental health programs should make provisions for the medical needs of patients in comprehensive management programs. PMID- 3652670 TI - XIIth International Complement Workshop. September 18-21, 1987, Chamonix, France. Abstracts. PMID- 3652669 TI - Selecting a rating scale for evaluating services to the chronically mentally ill. AB - A multi-attribute utility analysis employing ideal outcome measure criteria was applied to seven brief rating scales in order to identify the best performing instrument. A variety of judgmental data were collected from therapists working in mental health service agencies and from evaluation research experts to contrast the performance of the seven rating scales on criteria for selecting outcome measures developed by an NIMH task force. Transformations of the performance data were weighted in accordance with priorities assigned to the criteria by the task force. Comparing the sums of the weighted scores across scales, two rating scales emerged as preferred selections for monitoring the effectiveness of programs that serve the chronically mentally ill. PMID- 3652671 TI - Quantitative evaluation of arterial pulsatile flow and pressure, applying impedance plethysmography to a human arterial model incorporating anatomical branching and scale. AB - This paper presents the theoretical basis of a new noninvasive method for obtaining arterial pulsatile flow and pressure. The proposed technique uses a model of the human arterial system based on the anatomical branching structure of the arterial tree. Arteries are divided into segments represented by uniform thin walled elastic tubes with realistic arterial dimensions and wall properties. A simple mathematical model equivalent to electrical transmission lines is developed which is able to fit the electrical impedance plethysmograph waveform produced by the subjects throughout the complete cardiac cycle. Ensemble averaging is suggested as an option for processing of the impedance data. This technique provides artifact-free impedance data which enables the model to be used during exercise as well as quiet breathing. The proposed model provides an enhanced capability for measuring pulsatile blood flow and pressure in both clinical and research applications. PMID- 3652672 TI - Microcomputer-based programs for calculating mean and variance residence time by the method of prospective areas. AB - A published package of microcomputer-based pharmacokinetic programs has been expanded to include programs to calculate mean and variance above the residence time (MRT and VRT) using the method of prospective areas. Three programs, one for plasma concentration time data, one for urinary excretion data, and one for in vitro dissolution data, are available. All programs were tested with the data obtained from original articles or from simulated theoretical data. These programs were written in a modular fashion in such a way that they form an integrated software package. In conjunction with the programs previously developed, the user can choose/select how extensively the data are to be analyzed without reentry of data. This is particularly important since proper pharmacokinetic data analysis can only be made by using different calculations with different assumptions. Graphic display and linear regression subroutines are included in each module to simplify operation for the user. The modular design also facilitates modifications, upkeep, and accommodation to new methods of calculation. PMID- 3652673 TI - A program which determines mutagenic concentrations of chemical carcinogens via a diffusion bioassay. AB - A computer program implementing a mathematical model for determining mutagenic concentrations of chemical carcinogens was developed. The mathematical model describes the experiment in which a droplet of a suspected carcinogen is put at the center of a petri dish containing a bacterial lawn in an agar gel. After a period of incubation during which the chemical diffuses outward, one observes a concentric ring of mutants around the center. The largest radius at which mutation occurs, r mut, corresponds to the lowest (threshold) concentration of the chemical sufficient to produce bacterial mutation. Given a series of initial concentrations of a chemical and the resulting r mut's, the program computes and reports the threshold concentration and the decay time of the chemical. The program is also used as a method to determine the lowest mutagenic concentration for a particular time of exposure. PMID- 3652674 TI - A microcomputer-based system for processing 31-phosphorus nuclear magnetic resonance spectra from studies of cardiac metabolism in immature hearts. AB - We designed an interactive microcomputer-based digital data processing system for analysis of 31-phosphorus nuclear magnetic resonance (31P-NMR) spectra from studies of cardiac metabolism in immature and neonatal hearts. This system included a digitizing tablet (Kurta Series Two), a microcomputer (IBM PC XT) and a graphics plotter (Hewlett-Packard 7470A) used in conjunction with a Nicolet 1280 NMR signal processing computer. We obtained 31P spectra from isolated perfused rabbit hearts with a Nicolet NT-200 4.7 Tesla superconducting NMR spectrometer operated in the pulsed Fourier transform mode. The small size of the hearts resulted in increased noise in spectra and demanded comparison of methods used to quantitate changes in inorganic phosphorus, phosphocreatine and ATP during ischemic stress. We performed microcomputer operations and interfacing functions with a software package written in BASIC. This system simplified documentation, data filing and statistical data processing. Our microcomputer system displayed and made hard copies of digitized spectra and results of analyses. Errors in data entry were rectified directly with this program. Consistent data reduction improved the precision of the physiological results and reduced the influence of noise on 31P spectra from neonatal hearts weighing about 0.5 g. The system flexibility extends its application to NMR spectra analysis for other in vivo organ systems, and signal processing in other biological research. PMID- 3652675 TI - Knowledge-based decision support for general practitioners: an integrated design. AB - Most decision-support systems (DSSs) in medicine have been developed in hospital environments, for use in hospitals. Only a few are designed for use by general practitioners (GPs) in primary care. The work reported in this paper aims to (a) design DSSs for GPs in primary care, taking into consideration that primary care is the first level in a health care organization, where the reasons for the patients attendance are seen in a social context; and (b) integrate three approaches-Hypertext, Knowledge-Based Systems and Online Library-since any one of these will not suffice for the varying needs of GPs. PMID- 3652676 TI - The relevance of creativity for psychiatric therapy and rehabilitation. PMID- 3652677 TI - Intake diagnoses: how representative? PMID- 3652678 TI - Quality of interpersonal relationships: the most characteristic DSM-III BPD criterion. PMID- 3652679 TI - Criminal behavior and post-traumatic stress disorder in Vietnam veterans. PMID- 3652680 TI - Borderline empathy and borderline pathology: constitutional considerations. PMID- 3652681 TI - Beck's cognitive theory of depression: convergence of constructs. PMID- 3652682 TI - Difficulty walking as a symptom of panic disorder. PMID- 3652683 TI - Consultation-liaison outcome evaluation system (CLOES): resident or private attending physicians' concordance with consultants' recommendations. PMID- 3652684 TI - Distinguishing narcissistic and borderline personality disorders using DSM-III criteria. PMID- 3652686 TI - Itching from wool fibres in atopic dermatitis. AB - In 24 girls with atopic dermatitis and a history of irritation to wool, more intense itching was provoked on normal skin on the abdomen by a material with coarse wool fibres (36 microns) than with thinner fibres (20 microns). The probability of the materials causing itching could be predicted by the girls by handling the materials. PMID- 3652685 TI - Allergic and irritant contact dermatitis from falcarinol and didehydrofalcarinol in common ivy (Hedera helix L.). AB - Experimental and chemical investigations revealed that common ivy (Hedera helix susp. helix) contains 3 compounds which are powerful irritants and moderate sensitizers. Only 2 of these constituents, falcarinol and didehydrofalcarinol, are present in the plant during the whole year. Besides Panax ginseng and Schefflera arboricola, this is the third species of the Araliaceae in which these polyacetylenic sensitizers have been found. Falcarinol and didehydrofalcarinol also occur in Hedera helix subsp. canariensis. 4 patients have been patch tested. Even in low concentrations (0.03%), the main allergen falcarinol elicited strong reactions in all of them. One of the authors became sensitized during the investigations. PMID- 3652687 TI - Contact allergy to cosmetics: causative ingredients. AB - Of 1781 patients with contact dermatitis seen during a period of 6 years (1981 1986), 75 (4.2%) had allergy to cosmetic products. The face was most frequently affected. In many cases, the dermatitis was limited to the eyelids (18.7%) or the face (40.0%). Skin care products (moisturizing and cleansing cream/lotion/milk) accounted for more than half (52.3%), followed by nail cosmetics (8.0%), shaving preparations (8.0%) and deodorants (6.8%). The ingredients most often responsible were fragrances (45.1%), followed by the preservative Kathon CG (11.0%) and the emulsifier oleamidopropyl dimethylamine (9.8%). In 14 patients (18.7%), patch tests with the responsible cosmetic product were negative. In them, the diagnosis was made by use tests and/or repeated open application tests. Compulsory declaration of ingredients on cosmetic product labels in the EEC, analagous to the USA situation, would be of great benefit both to patients and to physicians. PMID- 3652688 TI - Contact dermatitis to lauryl pyridinium chloride and benzoxonium chloride. PMID- 3652689 TI - Unusual allergic contact dermatitis to aromatic amines. PMID- 3652690 TI - Unusual sensitization to black rubber. PMID- 3652691 TI - Contact sensitivity to newsprint: a rare manifestation of coal tar allergy. PMID- 3652692 TI - Erythema multiforme-like and purpuric eruption due to contact allergy to proflavine. PMID- 3652693 TI - Allergic contact dermatitis to D & C yellow 11 in a hair cream. PMID- 3652694 TI - Contact thermography--towards the Sherlock Holmes magnifying glass for solving allergic and irritant patch test reactions? PMID- 3652695 TI - Artificial limb dermatitis. PMID- 3652696 TI - Oral challenge with food additives. AB - A randomized, placebo-controlled oral challenge with food additives (preservatives and food colorings) was carried out in 101 patients with eczema of undetermined origin who suspected that the intake of certain foods aggravated their dermatitis. 37 reacted to 1 or more of the food additives but not to a placebo, while 16 reacted to the placebo, or both the placebo and food additives. 48 had no reactions. The difference between the number of reactions to the food additives and the number of reactions to the placebo was not statistically significant. The reactions could be reproduced in only 1/3 of those challenged twice. It was not possible to correlate the reactions to food additives to reactivity to specific foodstuffs containing the same additives. If intolerance to food additives is suspected, an elimination diet seems warranted, regardless of whether the patient reacts to oral challenge with food additives. PMID- 3652697 TI - Patch test results with standard allergens over a decade. AB - The results of 10 years of patch testing with standard allergens are reported. An increase of sensitivity was found in nickel. Sensitivity to chromate had decreased. Sex and age differences in the incidence of allergy to metals were analysed. Nickel allergy appeared to be more common among women and was of most importance in the younger age groups. PMID- 3652698 TI - Photo-contact dermatitis from ketoprofen. PMID- 3652699 TI - Hand dermatitis and contact sensitivity in twins. PMID- 3652700 TI - Allergy to spermicidal lubricant in a contraceptive. PMID- 3652701 TI - Patch testing in children. PMID- 3652702 TI - IPPD contact allergy from an orthopedic bandage. PMID- 3652703 TI - Incidence and relevance of patch testing to quinoline-mix. PMID- 3652704 TI - Hidden contact allergy to formaldehyde in imidazolidinyl urea. PMID- 3652705 TI - Synchronous versus nonsynchronous high-frequency jet ventilation: effects on cardiorespiratory variables and airway pressures in postoperative patients. AB - In order to compare the differences of high-frequency jet ventilation (HFJV) synchronized with the cardiac cycle (sync) to that nonsynchronized with the cardiac cycle (async), ten stable postoperative ICU patients, without heart failure, in sinus rhythm were ventilated randomly in either mode. The async mode was HFJV at 100 cycle/min, while the sync mode was HFJV triggered by the R-wave of the ECG tracing. The heart rate ranged between 64 and 127 beat/min. Synchronization was studied at one of two periods, sync 0 and sync 60. Sync 0 consisted of inspiration triggered by the R-wave, with jet ventilation occurring early in systole; sync 60 represented a 60% delay of the time between the succeeding R-waves, with jet ventilation occurring in mid-diastole. There was no significant difference in the cardiorespiratory data when async was compared to either sync 0 or sync 60. Therefore, in these patients without heart failure, the selection of async vs. either sync mode appeared to have neither adverse nor beneficial hemodynamic effects. PMID- 3652706 TI - Endotracheal administration of surfactant in very low birth weight infants with respiratory distress syndrome. AB - This study was designed to evaluate whether the ventilatory maneuvers associated with surfactant replacement would, per se, influence oxygenation in newborn infants with severe respiratory distress syndrome. Eight patients (700 to 1400 g), all requiring mechanical ventilation with fraction of inspired oxygen greater than 0.6, were included in the trial; four were randomized to receive surfactant, and the others served as controls. Porcine surfactant (2 ml/kg; phospholipid concentration, 100 mg/ml) was instilled via a naso-endotracheal tube at end expiration and dispersed into the lungs during a period of standardized "sighing" mediated by the ventilator: two prolonged ventilatory cycles (10 sec each) with an inspiration/expiration ratio of 4:1, followed by a 6-min ventilation with a frequency of 60 breath/min and an inspiration/expiration ratio of 4:1. Control babies received no surfactant but were otherwise subjected to the same ventilatory maneuvers. Surfactant-treated infants showed a rapid increase in transcutaneous oxygen associated with improved lung aeration in chest x-rays; the response was transient in three babies and persistent in one. No improvement was observed in control babies. We conclude that the beneficial effect of surfactant replacement cannot be attributed to the ventilatory maneuvers associated with the instillation procedure. PMID- 3652707 TI - Serial cardiovascular variables in survivors and nonsurvivors of human septic shock: heart rate as an early predictor of prognosis. AB - Forty-eight septic shock patients with positive blood cultures had conventional serial hemodynamic evaluations until recovery or death to identify early cardiovascular variables that predicted outcome. There were 19 (40%) survivors and 29 nonsurvivors. At the initial evaluation, both survivors and nonsurvivors demonstrated an elevated cardiac index (CI), low systemic vascular resistance index (SVRI), and normal stroke volume index. However, only an initial heart rate (HR) less than 106 beat/min significantly predicted survival. Twenty-four hours after the onset of shock, both an HR less than 95 beat/min and an SVRI greater than 1529 dyne.sec/cm5.m2 predicted survival. Comparing the hemodynamic profiles from the initial to the 24 h time point, a decrease in HR greater than 18 beat/min or a decrease in CI greater than 0.5 L/min.m2 predicted survival. Twenty two deaths occurred in the first week of study, of which 18 (82%) were due primarily to low SVRI and four (18%) to low CI. Seven deaths occurred after 1 wk, all of which were due to multiple organ failure. PMID- 3652708 TI - ICU pneumonias: a multi-institutional study. AB - We conducted a prospective multi-institutional study of nosocomial and community acquired pneumonias in 1378 patients admitted to the ICUs of six hospitals. We also investigated 1005 of these patients who were intubated and mechanically ventilated for a reason other than pneumonia, the risk of developing pneumonia, and the relationship between the incidence of pneumonia and the length of time during which the patients were mechanically ventilated. A bacteriologic diagnosis was made in 38% of the nosocomial and 21% of the community-acquired pneumonias. The total mortality rate was 40%; 47% of the patients with nosocomial and 17% of the patients with community-acquired pneumonias died. Because it was difficult to make an etiologic diagnosis in two-thirds of the cases, the treatment had to be based on an assumed causative organism. PMID- 3652709 TI - Detrimental effect of reverse triiodothyronine in hemorrhagic shock. AB - To examine whether reverse triiodothyronine (rT3), generally considered devoid of biological activity, could influence outcome in circulatory collapse, 23 anesthetized mongrel dogs were subjected to hemorrhagic shock. In 10 dogs, 15 micrograms/kg of rT3 were administered iv 30 min before hemorrhage. In 13 other dogs, an equal volume of saline was injected. The dogs were bled rapidly to a mean arterial pressure of 40 mm Hg, and after 60 min the reservoir line was clamped for 30 min. The shed blood was then reinfused over 30 min. After one hour of hemodynamic monitoring, the dogs were returned to the kennel and observed for at least 3 days. During shock there were few significant intergroup hemodynamic metabolic differences. In the control group, six of 13 dogs died, whereas nine of ten dogs given rT3 died (p less than .03). This study strongly suggests that rT3 exerts detrimental biological activity in canine hemorrhagic shock. Hence, rT3 may play a causative role in the euthyroid sick ("low T3") syndrome. PMID- 3652710 TI - Slow versus rapid closed-chest cardiac compression during cardiopulmonary resuscitation in puppies. AB - The recommended rates for closed-chest cardiac compressions during CPR are based on physiologic variations with increasing age rather than experimental data. Using puppies, we compared mean arterial pressure, cardiac index (CI), and cerebral blood flow (CBF) at a slow (40/min, group 1) and a rapid (120/min, group 2) rate. CBF was measured in all experiments by N2O uptake before and during CPR from cardiac arrest induced with KCl. Both CI and CBF were measured in half of the subjects with radiolabeled microspheres. Groups 1 and 2 were similar in terms of baseline mean weight, mean arterial pressure, CI, CBF, and arterial and venous blood gases. During resuscitation for group 1, the mean CI was 221 ml/min . m2, and the mean CBF was 4 ml/100 g . min determined by N2O uptake (2 ml/100 g.min by microspheres); in group 2, the respective means were 248 ml/min . m2 and 4 ml/100 g . min with both techniques. The values for mean CI and CBF (N2O or microspheres) did not differ significantly at either rate of compression. The N2O uptake and microsphere techniques for measuring CBF correlated closely during spontaneous cardiac contractions and mechanical chest compressions. We conclude that a) closed-chest cardiac compressions at either rate studied provided inadequate CBF, and b) the N2O uptake and microsphere techniques give similar measures of CBF under conditions of normal and low flow. PMID- 3652711 TI - Recommendations for program content for fellowship training in critical care medicine. Task Force on Guidelines. Society of Critical Care Medicine. PMID- 3652712 TI - Recommendations for the qualifications of a director of a fellowship training program in critical care medicine. Task Force on Guidelines. Society of Critical Care Medicine. PMID- 3652713 TI - Accreditation without certification: critical care training in Canada. PMID- 3652714 TI - Educational objectives for critical care training in Canada. Royal College of Physicians and Surgeons of Canada. PMID- 3652715 TI - Pulmonary embolus-induced disseminated intravascular coagulation. AB - Pulmonary embolus as a cause of disseminated intravascular coagulation has only recently been recognized. The hemorrhagic disorder reported in the past was associated with little or no bleeding. We report a case of pulmonary embolus associated with life-threatening disseminated intravascular coagulation. PMID- 3652716 TI - Emergency airway clot removal in acute hemorrhagic respiratory failure. AB - Three cases of respiratory failure and severe hypoxemia caused by blood clot obscuring the central airway are described. A technique to clear the airway using a no. 6 Fogarty balloon-tip embolectomy catheter inserted through a flexible fiberoptic bronchoscope was used in all three cases. Marked improvement and stabilization occurred while definitive therapy was undertaken. PMID- 3652717 TI - Autonomic dysfunction in severe tetanus: magnesium sulfate as an adjunct to deep sedation. AB - We studied the use of continuous iv magnesium (Mg) infusion to control the sympathetic crises in a patient with severe tetanus characterized by pronounced autonomic nervous system instability. Our results suggested that Mg is a useful adjunct to the CNS depressants traditionally used. This therapy controlled the sympathetic crises and also suppressed the release of catecholamines, although Mg infusions alone appeared to be inadequate therapy. PMID- 3652718 TI - Comparison of thermodilution cardiac output measured by different computers. PMID- 3652719 TI - Minimizing work of a breathing through endotracheal tubes. PMID- 3652720 TI - Impedance pneumography for apnea detection. PMID- 3652721 TI - Factors affecting the survival of mouse embryos cryopreserved by vitrification. AB - Preimplantation stage mouse embryos have been used to examine the response of a simple multicellular system to cryopreservation by the complete vitrification of the suspension. Successful vitrification requires the use of a solution of cryoprotectants that is sufficiently concentrated to supercool and solidify into a glass at practicable cooling rates. Factors that influence the survival of embryos include the concentration and composition of the vitrification solution, the procedure used to equilibrate embryos in this solution, the cooling and warming conditions, and the procedure used to dilute embryos from the vitrification solution. High rates of survival are obtained when embryos are dehydrated prior to vitrification in solutions composed of saline plus multimolar concentrations of either mixtures of permeating cryoprotectants (e.g. dimethyl sulphoxide-acetamide-propylene glycol) or single permeating cryoprotectants (propylene glycol or glycerol). Full permeation of cryoprotectants into the cells is not necessary and may lead to chemical toxicity and osmotic injury. Partial permeation and osmotic shrinkage concentrates the endogenous cytoplasmic macromolecules and greatly increases the likelihood of intracellular vitrification. Vitrification is a practical approach for embryo cryopreservation and offers new opportunities to examine fundamental aspects of cryoprotection and cryoinjury in the absence of freezing. PMID- 3652722 TI - Perfusion of rabbit kidneys with solutions containing propane-1,2-diol. AB - Propane-1,2-diol (propylene glycol, PG) permeates more rapidly than glycerol, has a strong glass-forming tendency, and appears to have a low toxicity. It is therefore attractive as a potential cryoprotectant for renal preservation. In this paper we compared the effect on subsequent function, of exposing rabbit renal cortical slices to 1 M PG or glycerol in a range of vehicle solutions and we demonstrated a remarkably low toxicity of PG at this concentration. Rabbit kidneys were then perfused with solutions containing PG up to a maximum concentration of 3 M, after which the cryoprotectant was removed and the function of cortical slices prepared from the perfused kidneys was assessed. Marked differences in perfusion characteristics were found between PG and glycerol and between different vehicle solutions for PG, but the two most suitable perfusates, both containing about 100 mM mannitol, permitted normal function in slices prepared after removal of PG. These results indicate that, with an appropriate vehicle perfusate, exposure to PG up to a concentration of 3 mol/liter has remarkably little effect upon vascular resistance and the renal cortical functions measured. PMID- 3652723 TI - Effects of low-molecular-weight fractions (LMWF) from milk, egg yolk, and seminal plasma on freezability of bovine spermatozoa. AB - The effects of the dialyzable fractions from bovine seminal plasma, egg yolk, and milk and of two buffer systems (TEST and sodium citrate) on post-thaw sperm motility were studied. Each basic salt solution was used in the experimental design. These solutions were used as extender systems in combination with egg yolk and glycerol. After collection, semen samples were extended (1:20), cooled to 5 degrees C in 1.5 hr, and frozen in 0.5-cc French straws after 3 hr of equilibration. Post-thaw samples were assayed for percentage of motile cells immediately after thawing and after 4 hr of incubation at room temperature (22 degrees C). Egg yolk (25%) provided the same protection as did the combination of colloidal material present in the skim milk-yolk extenders. The use of TEST as a buffer provided significantly higher (P less than 0.01) sperm post-thaw motility than milk salts or Na citrate. Sperm survival in extenders containing high concentrations of seminal plasma and/or egg yolk salts was significantly lower (P less than 0.01). Spermatozoa frozen in the presence of 6% glycerol resulted in sperm motility significantly (P less than 0.05) higher than that of spermatozoa frozen with 3% glycerol. However, no difference was observed between these two concentrations when TEST solution was used. PMID- 3652724 TI - Factors affecting the removal of low-molecular-weight fractions (LMWF) from egg yolk and seminal plasma in extended semen by dialysis: effect on post-thaw sperm survival. AB - Three factors affecting dialysis of bovine semen were studied. These factors were (1) dialysis rates of egg yolk, seminal plasma, and glycerol, (2) temperature (37 degrees C, 5 degrees C, and while cooling from 37 to 5 degrees C), and (3) dialysis ratios between retentate and dialysate (1:1, 1:10, 1:20, 1:50, and 1:100). Ninety percent of the low-molecular-weight fraction (LMWF) from seminal plasma, egg yolk, and glycerol was removed from the retentate in a 2-hr period at 5 degrees C, and only slight changes were detected after the third hour of dialysis. Temperature affected dialysis and was faster at 37 degrees C. It was also found that a 1:20 dialysis ratio was sufficient to obtain 90% clearance of the LMWF. The effect of sperm dilution ratio, dialysis ratio, and exchange of the LMWF from egg yolk and/or seminal plasma for buffer systems was also studied. An improvement in post-thaw motility of spermatozoa (P less than 0.05) was obtained when the LMWF from both seminal plasma and egg yolk were replaced. A third experiment was conducted to study the effect of different combinations between the buffer systems, TEST and Na citrate, in the dialysate. The results indicated that a 1:1 combination of iso-osmotic solutions (320-325 mOsm/Kg, pH 7.0) between these two buffers, with 5% glycerol (v/v), yielded significant (P less than 0.05) sperm post-thaw motility as compared with the individual use of TEST-glycerol or Na citrate-glycerol. Dialyzed samples also yielded sperm post-thaw motility higher than that of the nondialyzed samples. Colloidal materials in the dialysate did not affect survival of spermatozoa. PMID- 3652725 TI - Dialysis of bovine semen and its effect on fresh and freeze-thawed spermatozoa. AB - The effect of the removal of the low-molecular-weight fraction (LMWF, less than 12,000-14,000 Da) from the seminal plasma present in extended semen by dialysis and by centrifugation (1,376g for 20 min at 5 degrees C) were compared with the current methods of freezing bovine semen. Significantly higher sperm post-thaw motility (P less than 0.05) was obtained in the dialyzed samples than with the other two methods. The appropriate time and temperature for dialysis of semen was also studied. Semen aliquots were dialyzed (1:50, retentate:dialysate) for 30 min, 1 or 2 hr at 5 degrees C, and during the cooling process from 37 to 5 degrees C over a 2-hr period. Superior sperm motility (P less than 0.05) in prefreeze and post-thawed samples was observed when semen was dialyzed for 1 or 2 hr during the cooling process as compared with that of semen dialyzed at 5 degrees C. A third experiment was conducted to establish the effect of the use of dialysis bags of different molecular weight cutoffs (MWCO) on sperm motility. Semen samples were dialyzed (1:50) during the cooling process in dialysis bags of 1,000, 3,500, 6,000-8,000, 12,000-14,000, 25,000, and 50,000 MWCO. No statistical differences (P greater than 0.05) in sperm post-thaw motility were found after evaluation of the number of cells that passed through the Sephadex filter and all the dialyzed values obtained were significantly (P less than 0.05) superior to the results obtained with no dialysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652726 TI - Quantitative cryomicroscopic analysis of intracellular freezing of granulocytes without cryoadditive. AB - Purified human granulocytes were frozen in isotonic saline at different constant cooling rates down to -60 degrees C and subsequently thawed on the thermally defined cryostage of a cryomicroscope. Cells monitored on videotape were examined with respect to cooling rate threshold, type, and temperature of intracellular ice formation during cooling and recrystallization during warming. Two apparently different mechanisms of intracellular ice formation (iif) were distinguished during cooling, i.e., "twitching" (no visible ice front) and "darkening" (diffuse ice front). Both types of iif are related to cooling rate and hence also to dehydration. Cooling rate thresholds and temperatures of intracellular recrystallization were determined. It was found that twitching iif occurs just about 6.3 to 7.4 degrees C above the homogeneous nucleation temperature, suggesting that it might be catalyzed by nucleators present within the cells. Darkening iif, on the other hand, was observed at much higher temperatures, i.e., 23.4 to 28.3 degrees C above the homogeneous nucleation temperature, which could possibly indicate a nucleation induced by extracellular ice crystals (at a cooling rate of 30 degrees K/min, however, darkening iif was observed to occur at a temperature lower than that required for twitching iif). The proposed mechanisms of cryoinjury are related to membrane integrity measurements presented in M. W. Scheiwe, Ch. Korber, and S. Englich, Cryo-Letters, 5, 300-306, 1984. PMID- 3652727 TI - Aggregate formation in fresh and frozen human granulocytes. PMID- 3652728 TI - Neuronal development. Part IV. Cellular and molecular differentiation. PMID- 3652729 TI - Paracoccidioidomycosis. PMID- 3652730 TI - Cold-induced skin injuries. PMID- 3652731 TI - Nail, skin, and scleral pigmentation induced by minocycline. AB - Minocycline-induced cutaneous and nail bed discoloration, although uncommon, should be closely watched for during treatment. The initial changes may be subtle and may mimic other processes that may deceive both patient and physician. Patients should be counseled about the remote possibility of pigmentation with the understanding that any such changes should resolve upon discontinuation of the drug. The time required for resolution depends upon the degree of pigmentation and may take longer than a year in extensive cases. PMID- 3652732 TI - Eruptive vellus hair cysts. AB - Eruptive vellus hair cysts are an apparent developmental anomaly of vellus hair follicles that result in an asymptomatic papular eruption characteristically located on the anterior chest in young patients. A case of eruptive vellus hair cysts in reported, and the clinical and histologic findings are reviewed. PMID- 3652733 TI - Unusual severe nail involvement in dermatomyositis. AB - An unusual case of nail involvement in dermatomyositis in which complete loss of several toenails was the only cutaneous sign of the disease is reported for its clinical interest. PMID- 3652734 TI - Diagnostic techniques for hair disorders. Part I: Microscopic examination of the hair shaft. AB - For the patient who presents with a hair disorder, a host of diagnostic techniques are available in addition to history, physical examination, and laboratory assessment. Microscopic hair shaft examination is presented as a technique for establishing a definitive diagnosis. PMID- 3652735 TI - Diagnosis and management of the hair loss patient. AB - Telogen effluvium, alopecia areata, traction/chemical alopecia, and androgenetic alopecia account for more than 90 percent of all causes of hair loss in patients presenting to the dermatologist's office. A thorough understanding of these hair diseases will enable the practicing dermatologist to effectively manage the vast majority of patients who present with scalp hair loss. PMID- 3652736 TI - Effects of thyroxine on mitochondrial morphology and uptake of 35S in embryonic chicken livers. AB - Ultrastructural analyses of reactions of mitochondria in hepatocytes of chicken embryos to low levels of exogenous thyroxine (T4) reveal that such reactions (overall swelling accompanied by disruption of crest geometry) first take place at about 10 days of incubation, T4 having been administered on the 6th day. Physically altered mitochondria may be seen after 11-12 days of incubation but are no longer evident by 13 days. Correlated with the initial evidence of T4 effects on mitochondria at 10 days of incubation is a spurt in hepatocyte proliferation. The time correlation observed between T4 induced mitochondrial changes in morphology and abrupt increases in rates of cell proliferation, suggests that liver nuclear receptors for thyroxine are unavailable prior to 9-10 days of incubation. Golgi complexes within the hepatocytes appear to be especially active in the production of electron-opaque vesicles from at least the 8th day of incubation to 11-12 days. Uptake of 35S (probably into chondroitin sulphates) was found to be fifteen times greater on the 8th day of incubation than at 15 days. This correlates with the period of heightened activity of the Golgi complex. In livers exposed to T4 on the 6th day, uptake of 35S was higher on the 9th and 10th days of incubation as compared to controls. PMID- 3652737 TI - Oscillations in bovine erythrocyte membrane free thiols. AB - Oscillations in the level of bovine erythrocyte membrane-SH groups available for DTNB are described. The concentrations of slow- and fast-reactive thiols and the kinetic properties of slow and fast reactions between -SH and DTNB revealed two kinds of cyclic changes. Oscillations of short (about 3 h) and long (about 14 h) duration were studied and the possible implications of these variations in membranes are discussed. PMID- 3652738 TI - Amyloid fibril formation in the bovine mammary gland: an ultrastructural study. AB - Bovine mammary secretory tissue was examined histologically to determine the origin of amyloid fibrils and their mode of deposition. Spherical bodies of amyloid fibrils found in alveolar lumina and epithelium were closely associated with epithelial and monocytoid cells. Small bundles of parallel fibrils were observed within and between alveolar epithelial cells, and large spherical bodies occasionally developed in these positions, protruding into the luminal space. Bundles of parallel fibrils at the periphery of amyloid bodies in the alveolar lumen appeared to develop from the apical epithelial plasma membrane or in the cytoplasm just within the cell border. Bundles of parallel amyloid fibrils were also observed in slight indentations in the plasma membrane of monocytoid cells. In some cases, the point of contact between single fibrils and the plasma membrane was not discerned, and fibrils appeared continuous with the cytoplasm. The alveolar lumina appeared to be the major site of amyloid body formation. It is suggested that epithelial and monocytoid cells elaborate a soluble precursor which polymerizes into fibrils at the plasma membrane and in the peripheral cytoplasm, or is secreted by the cell and polymerizes extracellularly. PMID- 3652740 TI - Nocturnal hypoxemia in COPD. PMID- 3652739 TI - Canada goose posterior lobe pituicytes: seasonal ultrastructural changes in relation to axonal release of neurosecretion. AB - Changes in ultrastructure of the posterior lobe pituicytes during six phases (Spring premigratory, Spring postmigratory, breeding, moulting, Fall premigratory and Fall postmigratory) of the annual life cycle of the migratory Canada goose, were studied. Pituicyte nuclear volume in females was significantly greater than that in males during the Spring premigratory and moulting phases. In the Fall postmigratory phase, nuclear volume in males was greater than that in females. During Spring premigratory phase, the axonal endings in males contained fewer neurosecretory granules (NSG) than those in the Fall postmigratory phase. In females, however, the number of NSG was relatively more than that in males in the Spring premigratory phase but fewer in the moulting phase. Nuclear volume is correlated with pituicyte function in releasing NSG containing arginine vasotocin (AVT) from axonal endings. The significance of AVT release is discussed in relation to initiation of reproductive and migratory behaviour, and to osmotic and metabolic regulation. PMID- 3652741 TI - Rigorous evaluation. Greater need than ever. PMID- 3652742 TI - On the pathogenesis of unstable angina. PMID- 3652743 TI - Airflow obstruction in sarcoidosis. PMID- 3652744 TI - Listening to our patients takes on new meaning. PMID- 3652746 TI - Nocturnal oxyhemoglobin desaturation in COPD patients with arterial oxygen tensions above 60 mm Hg. AB - We studied 152 COPD patients with a daytime PaO2 greater than or equal to 60 mm Hg using formal polysomnography (EEG, airflow, respiratory muscle movement, ear oximeter) to detect the presence of nocturnal, nonapneic, oxyhemoglobin desaturation. Nine subjects were disqualified by the unexpected discovery of sleep apnea, as were another eight because they could not sleep in the laboratory setting. Of the remaining 135 subjects, 37 (27 percent) desaturated below a baseline sleep saturation of 90 percent for five minutes or more, reaching a nadir saturation of at least 85 percent. Anthropomorphic, pulmonary function, and historic factors comparing desaturators and nondesaturators failed to separate the groups. Awake PaO2 at rest in the desaturators was significantly lower than in the nondesaturators. The PaCO2 was higher in the desaturators. Reversibility of the desaturation phenomenon was demonstrated in three patients during subsequent polysomnographic studies following periods of clinical improvement. Continuous oxyhemoglobin monitoring during sleep remains the only reliable tool for detecting nocturnal desaturation. PMID- 3652747 TI - Coronary arteriographic lesion of unstable angina. AB - The morphology of the coronary arteriographic lesions in 109 patients with coronary disease was correlated with their clinical history. Unstable angina, characterized by new onset of angina, angina at rest, or an increase in frequency or ease of precipitation of attacks within the previous two months, was present in 73 patients (group A). The other 36 patients had no history of instability within two months (group B). "Type T" lesions, defined as eccentric narrowing with jagged irregular borders with overlapping or undermined areas, or intraluminal filling defects circumferentially outlined by contrast material were found in 73 percent of group 1 vs 47 percent of group B (p less than 0.01). The presence of these angiographic lesions suggests that a ruptured atherosclerotic plaque and/or thrombus commonly plays a role in the etiology of unstable angina. PMID- 3652745 TI - The UCLA population studies of chronic obstructive respiratory disease. 9. Lung function changes associated with chronic exposure to photochemical oxidants; a cohort study among never-smokers. AB - Two cohorts of never-smoking residents of Los Angeles were studied on two occasions five years apart. One cohort (N = 1,099) lived in a community with moderate levels of photochemical pollution and low levels of other pollutants, and the second (N = 1,117) lived in a community with very high levels of photochemical oxidant and relatively high levels of sulfates and particulates. Studies included measurement of forced expiratory volumes and flow rates and single-breath nitrogen washout, as well as use of a standardized questionnaire. The data represent 47 percent of 2,340 and 58 percent of 1,935 residents, respectively, of the original community samples. Mean baseline spirometry and nitrogen washout for those who were and those who were not retested were similar, reflecting the fact that loss to follow-up was primarily due to changes of residence. In the more polluted area there were significantly worse lung function test results for both men and women at baseline and significantly more rapid deterioration at follow-up. Mean changes in nitrogen washout were significantly greater in the more polluted community for both sexes and for all age groups including children. Most of the spirometric test results showed significantly more rapid decline among adults in the more polluted community. These results are consistent with the hypothesis that chronic exposures to a mix of photochemical oxidants, sulfates and particulates are associated with increased loss of lung function, which is especially marked among tests that reflect function of the small airways. PMID- 3652748 TI - Changes in breathing and the pharynx after weight loss in obstructive sleep apnea. AB - The effect of weight loss following dietary restriction on disordered breathing on the pharyngeal airway is controversial in patients with obstructive sleep apnea (OSA). We therefore prospectively studied eight patients before and after dietary-induced weight loss. Mean weight loss was 20.6 kg +/- 12.8 SD. After weight loss there were significant improvements in PO2 and PCO2 measured during wakefulness, and in the number of desaturation episodes per hour of sleep, average desaturation per episode, and number of movement arousals. The number of apneas and hypopneas significantly decreased in six of eight patients. There was a significant correlation between body mass index and number of disordered breathing events. Nasopharyngeal collapsibility and pulse flow resistance decreased in awake patients after weight loss. We conclude that moderate weight loss in obese patients with OSA improves oxygenation during both sleep and wakefulness, decreases the number of disordered breathing events in many patients, decreases the collapsibility of the nasopharyngeal airway. PMID- 3652750 TI - Magnetic resonance imaging of blood flow in thoracic vessels of patients with impaired left ventricular function. AB - In order to test the ability of magnetic resonance (MR) in the detection of pathologic flow conditions in man, we imaged 10 normal volunteers and 10 patients with congestive heart failure (CHF) with ECG-gated MR. We used a single spin-echo sequence on a transverse plane through the main vessels of the upper chest. The analysis of the variation of the mean signal intensity vs time from the ascending aorta (AA), descending aorta (DA), and pulmonary artery (PA) of the ten normal volunteers on the TE = 30 ms images, showed a common pattern characterized by an end-diastolic intraluminal signal not present in other moments of the cardiac cycle. On the contrary, in patients with CHF, we did not observe the systolic disappearance of the intraluminal MR signal. The main difference between CHF patients and control subjects was found in the DA where an abnormally high signal intensity was present for the whole cardiac cycle. The MR imaging can offer blood flow information underlying the behavior of intraluminal signal intensity and could provide functional information in patients with heart failure. PMID- 3652749 TI - Respiratory effects of cocaine "freebasing" among habitual users of marijuana with or without tobacco. AB - Use of cocaine by smoking its alkaline precursor ("freebasing") has become increasingly prevalent. Recent studies of small numbers of cocaine users suggest that freebasing frequently causes cough, dyspnea, and abnormalities in diffusing capacity (DCO), although these findings could have been due to concomitant use of other drugs. We therefore evaluated the relationship between cocaine use by freebasing and chronic respiratory symptoms and lung dysfunction in a large sample of habitual smokers of marijuana with or without tobacco who denied intravenous drug abuse. The findings suggested that, among habitual marijuana smokers, "moderate" cocaine smoking damaged both large and small airways, as reflected by functional changes that were independent of concomitant marijuana use and appeared to be synergistic with the effects of tobacco. On the other hand, no adverse influence of cocaine smoking on the pulmonary microcirculation was demonstrated in our sample of freebase users. PMID- 3652751 TI - Serial evaluation of cardiac function with aortic regurgitation caused by serious aortic lesions. A preliminary comparative study with isolated chronic aortic incompetence. AB - Clinical and hemodynamic appearances of aortic regurgitation caused by serious aortic lesions (AR-Ao-group) seemed more deteriorated than those with isolated chronic aortic regurgitation (AR-group). Often postoperative course and operative outcome are smooth and satisfactory in the AR-Ao-group. To support this observation, serial changes of left ventricular (LV) function and LV sphericity were evaluated before and after operation in ten cases in the AR-Ao-group and compared with those in the AR-group. Before operation, there were no significant differences in LV function between the two groups. Postoperative improvement of LV sphericity and LV function were statistically better in the AR-Ao-group. The LV function reserve was considered sufficiently retained in the AR-Ao-group. Results with this study supported that clinical observation. Therefore, the total correction, at the same time of aortic incompetence and aortic lesions is recommended. PMID- 3652752 TI - Transthoracic needle biopsy of lung in nonhospitalized patients. AB - To confirm the safety of transthoracic needle biopsy of the lung (TNB) in the outpatient setting, we reviewed our experience with 106 such procedures over three years. We compared the operating characteristics and morbidity with the 65 similar procedures we were asked to perform on hospitalized patients during the same period. Outpatients did not differ from inpatients in mean age, sex, incidence of clinically apparent COPD, size and location of lesion, or number of needle passes. The operating characteristics of the biopsy were the same for the two groups. Pneumothorax occurred in 29 (27 percent) of 106 outpatient and 26 (40 percent) of 65 inpatient TNBs. Few pneumothoraces not present upon completion of biopsy developed during four hours of observation or later. The requirement for chest tube drainage was similar for both groups, 5.7 and 4.6 percent, respectively. With appropriate caution, TNB can be performed safely on an outpatient basis and the cost of an uncomplicated procedure reduced by 27 percent. PMID- 3652753 TI - Lack of effect of hydration on sputum production in chronic bronchitis. AB - Patients with chronic lung disease productive of sputum are generally encouraged to drink a large amount of fluid to facilitate sputum production. This clinical practice has not been tested systematically. Twelve outpatients with chronic obstructive pulmonary disease in clinically stable condition who had daily sputum production were asked in random sequence: 1) to drink one glass of fluid every waking hour after supper and upon waking the next morning (hydration), 2) to drink no fluid after supper and upon waking the next morning (dry), and 3) to drink fluid ad lib (ad lib). Each morning sputum collection was started upon waking and continued for four hours. The differences in volume, elasticity of sputum, respiratory symptoms, and ease of expectoration were not significant. We conclude that moderate hydration and dehydration have no effect on volume expectorated, the elasticity of sputum, respiratory symptoms or forced expiratory volume in one second. PMID- 3652754 TI - Prostaglandin E1 as a screening vasodilator in primary pulmonary hypertension. AB - Pulmonary vasodilators are variably efficacious in primary pulmonary hypertension (PPH). None has consistently improved hemodynamics enough to obviate the need for complex and potentially hazardous testing of several vasodilators. Prostaglandin E1 (PGE1), a potent, short-acting pulmonary vasodilator, was administered to seven patients with PPH in order to determine whether PGE1 could accurately predict the hemodynamic and gas exchange effects of other commonly used vasodilators. Prostaglandin E1, nifedipine and hydralazine were administered to the patients while measuring pulmonary and systemic hemodynamics and arterial blood gases. Prostaglandin E1 was easily titrated but was inconsistent as a predictor of the effects of the other vasodilators with respect to pulmonary artery pressure, cardiac output and adverse effects on arterial oxygenation. This study suggests that patients with PPH must still receive carefully monitored trials of several vasodilators to determine whether there is a beneficial response and to select the appropriate treatment. PMID- 3652755 TI - Microprocessor exercise physiology systems vs a nonautomated system. A comparison of data output. AB - Several microprocessor exercise physiology systems have been introduced recently. Comparison of the data output between these systems and more traditional nonautomated systems has not been reported extensively. Twelve normal adult men were exercised in random sequence on different days on a Sensormedics MMC Horizon system, the Medical Graphics Corporation System 2000, and a nonautomated system. heart rate, minute ventilation, tidal volume, respiratory frequency, oxygen consumption, and carbon dioxide production were compared at each level of work during a maximal incremental test and during a constant work load test. The overall data output between the three systems was comparable. However, minute ventilation was consistently higher on the Medical Graphics system, oxygen consumption was consistently lower on the Horizon system, and a technical error was discovered in the Medical Graphics system which resulted in a systematic overestimation of carbon dioxide production. Different methods of analyzing the data from the same test (60-s average, 15-s average, breath-by-breath, and 8 breath average) resulted in differences of up to 20 percent in the maximal values. This was greater than the differences between the three systems. Despite the comparability of the data output, important differences did exist which can be potentially significant when data output from one system are compared to predicted normal values obtained under different conditions. PMID- 3652756 TI - Pulse oximetry for tapering supplemental oxygen in hospitalized patients. Evaluation of a protocol. AB - In a randomized study, we determined the clinical and financial effects of replacing arterial blood gas measurements with finger pulse oximeter readings during the process of tapering supplemental oxygen in hospitalized patients. The 16 patients in the control group, whose management followed conventional practice in our hospital, received a total of 57 arterial blood gas measurements during the 6.6 (mean) days it took for them to taper to their discharge supplemental oxygen level (usually room air). The 13 patients randomized to the oximeter study group had their arterial oxygen saturation monitored by pulse oximetry. The physicians of patients in the oximeter group were at liberty to obtain arterial blood gas determinations during the study if they desired. The oximeter study group had fewer (p less than 0.005) arterial punctures for blood gas measurements (total of 16 for the group) and fewer (p less than 0.001) days on supplemental oxygen (mean of 2.7 days per patient). We conclude that substituting noninvasive pulse oximetry for arterial blood gas measurements during reductions of supplemental oxygen shortened the days of oxygen use and decreased the number of arterial blood gas determinations in our patients. In addition to reducing the discomfort to patients, the use of oximetry was of financial benefit in that it reduced medical personnel time, blood gas analyzer use, and duration of oxygen administration. PMID- 3652757 TI - Pneumatocele formation in adult pneumonia. AB - Pneumatocele formation is unusual in adult pneumonia, particularly in pneumococcal pneumonia. We report three cases of pneumatocele formation in adults, including one with probable pneumococcal pneumonia. All three patients were severely ill and two expired. Although they are usually asymptomatic, pneumatoceles may enlarge and compress the adjacent lung and mediastinum. This occurred in two patients causing respiratory insufficiency and cardiovascular compromise. The placement of a chest tube into the enlarging pneumatocele resulted in successful decompression. PMID- 3652758 TI - A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. AB - As part of an on-going population-based study of patients hospitalized with acute myocardial infarction (MI) in all 16 hospitals in the Worcester, Massachusetts Standard Metropolitan Statistical Area, temporal trends in the use of the pulmonary artery (PA) catheter were examined. Three thousand two hundred and sixty-three patients with validated acute MI during the calendar years 1975, 1978, 1981 and 1984 comprised the study population. There has been a consistent and significant increase in PA catheter use in patients with acute MI over time, from 7.2 percent in 1975, 13.8 percent in 1978, 14.8 percent in 1981 to 19.9 percent in 1984 (p less than .001). Ninety-six percent of patients undergoing PA catheter investigation had either congestive heart failure (CHF), hypotension or cardiogenic shock. For the combined time periods, the in-hospital case fatality rate (CFR) for patients in CHF with a PA catheter was 44.8 percent compared to 25.3 percent for patients without a PA catheter (p less than .001). For patients with hypotension and a PA catheter, in-hospital CFR was 48.3 percent compared to 32.2 percent for hypotensive patients not receiving a PA catheter (p less than .001). In contrast, for patients in cardiogenic shock the in-hospital CFR was 74.4 percent for those receiving a PA catheter as compared to 79.1 percent for patients in shock not receiving a catheter. The use of a PA catheter was associated with an increased length of hospital stay irrespective of the development of acute clinical complications. Long-term prognosis for discharged hospital survivors who had a complicated MI, for up to a five-year follow-up period was similar whether the patient did or did not receive a PA catheter during the acute period of hospitalization. In conclusion, we could not demonstrate a beneficial effect associated with the use of the PA catheter on selected patient outcomes, including in-hospital and long-term prognosis and average hospital stay, in this community-wide study of patients hospitalized with acute MI. PMID- 3652759 TI - Death by pulmonary artery flow-directed catheter. Time for a moratorium? PMID- 3652760 TI - Angina pectoris and bilateral diffuse infiltrates. Lymphoplasmacytoid lymphoma. PMID- 3652761 TI - The uncertain relation between coronary artery disease and anginal pain. PMID- 3652762 TI - Exercise test for identification of the high risk patient. PMID- 3652763 TI - Wenckebach block in the distal conduction system complicating a non-Q wave acute myocardial infarction. PMID- 3652764 TI - Eruptive abdominal pain. Chylomicronemia. PMID- 3652765 TI - Air embolism complicating percutaneous thin needle biopsy of lung. AB - Percutaneous thin needle biopsy, a widely used method for diagnosis of lung conditions, is generally safe and effective. A near-fatal air embolism is reported that occurred during percutaneous thin needle aspiration biopsy of the lung. Successful treatment was accomplished by hyperbaric oxygen therapy. Physicians should be aware of this possible complication and identify the location of the nearest chamber for possible transfer. PMID- 3652766 TI - The utility of Osler's nodes in the diagnosis of infective endocarditis. AB - The etiology of Osler's nodes remains controversial. We describe a patient with endocarditis in whom Streptococcus sanguis was grown from the biopsy of such a lesion. Bacterial embolic events are likely to be the major pathogenetic event in the development of Osler's nodes, and recognition of the etiology of infective endocarditis may be found through biopsy of them. PMID- 3652767 TI - Q fever inflammatory pseudotumor of the lung. AB - A 36-year-old man presented with malaise, myalgia, fever, and weight loss. Liver function tests were moderately abnormal and chest x-ray film revealed an irregular mass in the right lower lobe. Bronchoscopy with cytology was not helpful. Serology revealed markedly elevated titers to Q fever. The mass was presumed to represent the presence of a Q fever pseudotumor. The patient responded to therapy with resolution of symptoms and chest x-ray film and decrease in titers to Q fever. PMID- 3652768 TI - Pneumomediastinum after self-dilation of the esophagus. AB - Pneumomediastinum following esophageal perforation is a known complication of Eder Puestow dilation for esophageal stenosis. This is the first reported case of esophageal perforation and pneumomediastinum occurring after instrumental self dilation of a stenotic esophageal lesion. The observed 0.02 percent perforation rate in this patient (compared to the reported 0.3 percent in Eder Puestow "hetero"-dilation) makes the Eder Puestow auto-dilation procedure seem justifiable in a well-trained and well-informed patient. PMID- 3652769 TI - A new tube for single lung ventilation. AB - A recently developed endotracheal tube with a movable bronchial blocker (Univent tube) was used for single lung ventilation. A total of 50 intubations were undertaken for a wide variety of thoracic procedures. Each case was analyzed with respect to ease or difficulty of intubation, tube dislodgment, efficacy of lung collapse, and adequacy of single lung ventilation. Successful, safe selective intubation was accomplished in all cases. PMID- 3652770 TI - Standard limb lead QRS concordance during wide QRS tachycardia. A new surface ECG sign of ventricular tachycardia. AB - The differentiation of ventricular tachycardia from supraventricular conducted with aberration constitutes a perennial challenge. We report a new surface ECG clue, hitherto undescribed, the presence of which, during wide QRS tachycardia, indicates that the tachycardia in question is ventricular rather than supraventricular with aberrant conduction. PMID- 3652771 TI - Diagnosing cervical aortic arch. PMID- 3652772 TI - Helium/oxygen therapy. PMID- 3652773 TI - Primary biliary cirrhosis in a patient with interstitial lung fibrosis. PMID- 3652774 TI - Cocaine and MI. PMID- 3652775 TI - HpD-PDT for cancer treatment in bronchology. PMID- 3652776 TI - Inferior vena caval defects and the venous circulation. PMID- 3652777 TI - Tuberculosis and the acquired immunodeficiency syndrome. PMID- 3652778 TI - Aqueous-organic solvent extraction of water-insoluble protein from ragweed pollen. AB - A water-insoluble material was obtained from either short ragweed (Ambrosia elatior) or false ragweed (Franseria acanthicarpa) pollen extracted by organic solvent (50% N,N-dimethylformamide). Further investigation of this water insoluble material showed it contained at least five proteins. Two of them were isolated and shown to possess antigenicity as well as allergenicity. RFA2 contains carbohydrate and is a glycoprotein. RFB2 not only possesses antigenic determinants found in the water-soluble antigens AgE, AgK and Ra3, but also contains a separate and unique antigenic determinant. Immunodiffusion tests of RFB2, isolated from false ragweed and short ragweed, showed immunological identity. This communication further supports the suggestion that aqueous-organic solvent systems may be useful for the extraction of the biologically-active protein components from short ragweed pollen which can not be obtained with the currently used standard aqueous buffer system. PMID- 3652779 TI - [Study of the natural killer cell activity in lung cancer patients]. AB - A total of 50 lung CA patients and 20 normal persons as control were included in our study. We obtained lymphocytes from heparinized blood by Ficoll-Hypaque gradient method and after incubation with Cr51 labelled K562 cells at concentrations of 100: 1, 50:1, 12.5:1 for four hours, we calculated the cytotoxicity activity of NK cells. Significant impairment was noted in the comparison of NK cytotoxicity between stage III-M1 lung CA patients (n = 28) and the control group (n = 20) (E/T; 50:1, 29.55 +/- 24.20% vs 49.83 +/- 14.46%, p less than 0.001; E/T: 25:1, 10.23 +/- 7.19% vs 27.66 +/- 6.06%, p less than 0.001). 4 cases in stage I underwent surgery, the NK cytotoxicity before the operation was noted to be low, E/T: 25:1, 9%, 11%, 14% and 19% respectively. After the operation, the NK cytotoxicity was increased to 33%, 35%, 42% and 44% respectively. 3 stage I lung CA patients has continuously followed up, 2 relapsed cases had decreased NK cytotoxicity to 22% and 25%. These results indicated that the NK cytotoxicity assay was impaired in stage III-M1 lung CA and also suggested that it may act as a therapeutic guide for the results of the operation. PMID- 3652780 TI - [Specific circulating immune complexes in patients with hepatitis B]. AB - Antigen specific hepatitis B surface antigen circulating immune complexes (HBsAg CICs) were measured in 109 cases of hepatitis B with positive HBsAg (among them, 49 cases were acute and 60 cases were chronic hepatitis), 96 cases of asymptomatic hepatitis B surface antigen carriers, and 95 cases of normal blood donors. The mean concentration (ng/ml) of HBsAg-CICs was 303.50 +/- 357.70, 319.26 +/- 334.35 and 179.66 +/- 234.26 for the first three groups respectively; and was negative in normal groups. The concentration of HBsAg-CICs were significantly higher in acute and chronic group when compared with the asymptomatic carrier's group, (p less than 0.02 and p less than 0.01, respectively). Longitudinal series studies showed a close correlation between the levels or changes of HBsAg-CICs and the activity of the disease; patients with persistent HBsAg-CICs had a poor prognosis; and this were true not only in acute but also in chronic hepatitis patients. The mean concentration of HBsAg-CICs was higher in patients with positive hepatitis B e antigen (HBeAg) than in negative; but lower in patients with hepatitis B e anti-body (anti-HBe) positive than in negative. The higher prevalence of HBsAg-CICs in sera among asymptomatic HBsAg carriers in our study might be related to the prevalence of HBeAg among Chinese carriers. Further more, because HBsAg-CICs was related to the activity and prognosis of hepatitis B, it is worthwhile reconsidering whether so called "healthy" carriers were really healthy when their sera HBsAg-CICs tested positive. PMID- 3652781 TI - [A simple latex slide text for detection of cholera toxin]. AB - A latex agglutination inhibition test was developed for detection of cholera toxin. Cell-free extract was at first neutralized with anti-cholera toxin, then the latex particles having coupled covalently with cholera toxin were added to detect the presence of cholera toxin. The test was performed on glass slide. Using this method, the concentration of cholera toxin as low as 1.25 micrograms/ml can be detected within 2 minutes at room temperature. Procedure for covalent conjugation of cholera toxin to polystyrene latex particles was simple and the conjugation preparations were stable at 4 degrees C for at least 6 months. PMID- 3652782 TI - [Urinary tract infections and microbiological characteristics of Proteus penneri isolated in Taiwan]. AB - Proteus penneri has been reported to be involved in urinary tract infections and calculi formation. We analyzed 2,265 positive urine cultures from patients hospitalized in Taipei Veterans General Hospital, Taiwan and found that 47 patients (2.1%) were infected by P. penneri. Most of the patients were male with age over sixty and had been treated with various kinds of antibiotics. Most of the patient's urine were collected by catheter. They were alkaline (pH 8.0) and contained amorphous phosphate, triple phosphate and protein. All the isolates of P. penneri in Taiwan showed beta-hemolysis and slight swarming on sheep blood agar plate, and exhibited a green color on upper layer of sulfide-indole-motility medium after addition of Kovacs indole reagent. Except for nitrate reduction and N2 production, the biochemical characteristics of the P. penneri isolated in Taiwan were similar to those of P. penneri isolated otherwise. The Taiwan isolates of this organism were highly susceptible to cefotaxime, cefotazidime, cefotizoxime, moxalactam, nalidixic acid; but were resistant to ampicillin, carbenicillin, cefonicid, cefoperazone, ceftriaxone, cephalexin, cephapirin, chloramphenicol, clindamycin, gentamicin, nitrofurantoin, oxacillin, piperacillin, tetracycline, tobramycin, trimethoprim-sulfamethoxazole, vancomycin, and cephalothin. PMID- 3652783 TI - [Contamination of seafood by Vibrio parahaemolyticus in Taiwan]. AB - From October 1984 to September 1985, a total of 770 seafood samples, collected from the retail markets of 8 coastal cities in Taiwan, were tested for the contamination of Vibrio parahaemolyticus. The results showed that 352 samples (45.7%) were contaminated by V. parahaemolyticus. The detection frequencies of various samples were as follows: 40.0% fish samples, 22.3% fish fillets, 44.4% shrimps and 47.8% crabs of the crustacea group, 68.7% bivalve shellfish and 31.9% non-bivalve shellfish of the mollusca group. Bivalve shellfish samples showed the highest detection frequency and counts. By the analysis of variance, cities and sample items affected the detection frequency and counts of V. parahaemolyticus. Positive statistical correlation was found between the counts of V. parahaemolyticus and temperature variation in some cities, whereas the detection frequency of V. parahaemolyticus was not relative to the temperature variation in each city. 182 isolates from different types of seafood reacted with K antisera. Of those serotypes, K17 showed the highest detection frequency in the serological test. All of our isolates showed negative reaction for the Kanagawa test. PMID- 3652784 TI - [Campylobacter pyloridis in active chronic gastritis and peptic ulcer]. AB - From Oct. 1986 to Jan. 1987, a total of 74 patients presenting for endoscopy were studied. These included 30 cases of active chronic gastritis and 44 cases of peptic ulcer. Biopsy specimens were taken during the endoscopy and sent to the laboratory for Campylobacter pyloridis culture within 2 hours. The culture was done by inoculated with chocolate agar, Brucella agar and 0.2% urea broth for urease activity. Results showed that, 53% (16/32) of active chronic gastritis, 77% (10/13) of gastric ulcer and 84% (26/31) of duodenal ulcer were positive for Campylobacter pyloridis. The specificity and sensitivity of urease positive rate are 64% and 90% respectively. It is higher as compared with bacteria culture. In addition, we found that 10 days would be needed for the routine culture and identification of this organism. But it took only 30 minutes to 6 hours for urease activity test. Therefore, we suggested that urease activity test could be a rapid diagnostic method for detecting Campylobacter pyloridis. PMID- 3652785 TI - Eosinophilic gastroenteritis: report of two cases. AB - Eosinophilic gastroenteritis is a rare disease, not previously been reported on Taiwan. Two male cases are reported. One was 19 years old and the other one was 54 years old. Both patients responded to corticosteroid therapy. PMID- 3652786 TI - [Interepithelial lymphocytes of small intestine]. AB - The small intestine is a tissue which maintains contact with the external environment constantly. It receives antigenic stimulation and is attacked by various microorganisms at day and day base. The animals are then in danger without an efficient immune system of the gastrointestinal tract. The evidence described by this paper in the areas of morphology, position, structure, physiological phenomenon and immunologic functions, indicates strongly that IEL is a group of cells with important immunologic activities. In the last decade, technology to purify IEL has been improved, thereby enhancing immunologic research on this cell dramatically. Results disclose that immunologic activities such as ADCC, SCMC, NK, NC and CC are present in the IEL population. The surface maker studies on IEL in addition to the discovery of GML subpopulation further prove the immunologic importance of IEL. It is therefore believed at the present time that IEL is a combination of cells gathered at the intestinal mucosa in order to fulfill various local immunologic activities. PMID- 3652787 TI - [Approaches in thoracic surgery]. PMID- 3652788 TI - [Thymoma--a retrospective study of 48 cases]. AB - Of the 48 thymomas operated on between 1968 and 1985 50% were associated with myasthenia gravis, in 25% diagnosis was made due to accidental X-ray findings. In the staging according to Masaoka et al. [10] the following distribution was noted: I:22, II:5, III:18, IV:3. The 5-year survival rate of the 37 curatively resected patients was 78.5% (stage I: 88.6%, stage III: 55.6%). No stage III patient with residual tumor survived more than 2 years. Predominantly epithelial tumors had a significantly worse prognosis as compared to those with lymphocytic predominance. None of the 4 patients with category II thymoma survived more than 15 months. Association with myasthenia proved to have a negative prognostic influence in stage I and II patients. Frequency of local recurrences and metastases is documented. The value of irradiation and chemotherapy is discussed. PMID- 3652789 TI - [Reoperations in persistent and recurrent secondary hyperparathyroidism]. AB - Forty-seven reoperations for persistent or recurrent secondary hyperparathyroidism (HPT) in 29 patients are reported. The patients are part of a group of 181 patients operated on for secondary HPT between 1975 to 1986. Most reoperations were performed in the neck (26 operations in 17 patients). The main cause were remaining parathyroid glands in the mediastinum (9 patients), followed by normally localized glands in the neck, which had not been discovered during previous operations. In 7 patients a hyperplasia of the autografted tissue was the reason for recurrent disease. They were treated by resection of the autograft. In 10 other patients autologous cryopreserved parathyroid tissue was reimplanted because of persistent postoperative hypoparathyroidism. PMID- 3652790 TI - [Facilitating transanal stapling anastomosis by a guiding tube]. PMID- 3652791 TI - [The external supramalleolar flap]. PMID- 3652792 TI - [Surgical management of the acute complications of sigmoid diverticula. Apropos of 186 cases]. PMID- 3652793 TI - [Extensive paralysis of the upper limb. Functional classification and palliative treatment]. PMID- 3652795 TI - [The arteriography of the hip in question. Apropos of 219 cases]. PMID- 3652794 TI - [Does the exclusion of pancreaticojejunal anastomosis reduce the mortality of cephalic duodenopancreatectomy?]. PMID- 3652796 TI - [Role of sympathectomy in the treatment of causalgia]. PMID- 3652797 TI - [A new view of host-tumor relations. Study of the adrenal-posterior pituitary system in the digestive cancer patient]. PMID- 3652798 TI - [Lipoaspiration of subcutaneous lipoma]. PMID- 3652799 TI - [Surgical treatment of severe post-radiation intestinal complications. The experience of the Gustave-Roussy Institute]. PMID- 3652800 TI - [Isolated luxation of the lumbar spine. Apropos of 4 cases]. PMID- 3652802 TI - [Anatomo-clinical study of 63 malignant tumors of the small intestine]. PMID- 3652801 TI - [Treatment of breast cancer in women over 70. Is chemo-hormone-radiotherapy an alternative to surgery?]. PMID- 3652803 TI - [Ambulatory surgery in breast pathology. Analysis of 605 surgically treated cases]. PMID- 3652804 TI - [Our experience with the Surgitron, an ultrasonic aspirator in pelvic lymph node excision]. PMID- 3652805 TI - [Prophylactic use of antibiotics in gynecologic abdominal surgery: a prospective study of 234 cases]. PMID- 3652806 TI - [Use of prophylactic antibiotics in total abdominal hysterectomy]. PMID- 3652807 TI - [Analysis of 527 cases with incidental appendectomy in gynecologic operation]. PMID- 3652808 TI - [The post-operative retained urethral catheter and urinary tract infection in gynecological surgery]. PMID- 3652809 TI - [Hyperthyroidism during pregnancy: clinical analysis of 56 cases]. PMID- 3652810 TI - [Oxytocin titer and uterine activity in induced labor]. PMID- 3652811 TI - [Preliminary report of plasma antithrombin III in pregnant women]. PMID- 3652812 TI - [Uses of the nipple stimulation contraction stress test in high-risk pregnancy]. PMID- 3652813 TI - [Clinical evaluation of the antepartum nipple stimulation test]. PMID- 3652814 TI - [Retrograde study on the incidence of hydatidiform mole in 240,000 women in Jiangxi Province]. PMID- 3652815 TI - Evidence for the existence of a nucleolar skeleton attached to the pore complex lamina in human fibroblasts. AB - This work deals with the types of nuclear skeletal structures obtained from human fibroblast nuclei isolated by different procedures. It is confirmed that, in somatic vertebrate cells, the pore complex-lamina is always observed, whereas the presence of internal nucleolar and extranucleolar residual structures depends upon the method of nuclear isolation used. Furthermore, the results reported here argue for the existence of a nucleolar skeleton different from the nucleolar matrix often observed in different cell types by other investigators. The conditions of nuclear isolation which allow us to visualize this nucleolar skeleton without any other internal residual structures are described. The attachment of the nucleolar skeleton to the lamina suggested by the present data is considered in relation to the in situ position of nucleoli near the nuclear envelope. PMID- 3652816 TI - Supernumerary chromosome variation and heterochromatin distribution in the endemic New Zealand frog Leiopelma hochstetteri. AB - Specimens of the endemic New Zealand frog Leiopelma hochstetteri from Tapu on North Island were found to have six, nine or ten supernumerary chromosomes in their karyotypes. In comparison with previously published data, these results further indicate probable geographic variation in supernumerary chromosome number between populations. Increased numbers of supernumeraries in these frogs is correlated with apparent decrease of centromeric heterochromatin in the five large metacentric chromosomes of the karyotype, as detected by C-banding. Meiosis was abnormal in a male with a high number of supernumeraries. In lampbrush preparations from a single female with one supernumerary univalent, the supernumerary often had a denser, beaded appearance in comparison with the regular bivalents. Evidence is consistent with the notion that these supernumerary chromosomes may have arisen from centromeric fragments. PMID- 3652817 TI - Cytological evidence that the Sxr fragment of XY,Sxr mice pairs homologously at meiotic prophase with the proximal testis-determining region. AB - Self-pairing of the Y chromosome at prophase of meiosis in XY,Sxr male mice appears to take place in many cells to the exclusion of pairing between the Y and the X. This phenomenon offers an explanation for the high level of X-Y separation seen in these males at prophase of meiosis, additional separations being evident, however, when metaphase I (MI) cells are examined. A minority of prophase cells show the Y paired both autologously and with a sub-terminal region of the X which could be the normal pairing region. The balloon-like configurations observed when self-pairing occurs suggest that the distal Sxr fragment is inverted on the Y chromosome of Sxr carrier males in relation to the normal proximal testis determining (Td)-containing region. PMID- 3652818 TI - High resolution G-banded chromosomes of the mouse. AB - High resolution G-banded mouse chromosomes were prepared using an actinomycin D and acridine orange pretreatment protocol, resulting in late prophase mouse chromosomes which reveal over twice the number of bands as compared with mid metaphase. These elongated chromosomes, described here in detail and used to construct a precise schematic representation of the late prophase banding patterns, should be generally useful in high resolution mouse chromosome analysis. PMID- 3652821 TI - [Cold pressure test apexcardiography in the diagnosis of coronary artery diseases]. PMID- 3652819 TI - Immunocytochemical labelling of the kinetochore of human synaptonemal complexes, and the extent of pairing of the X and Y chromosomes. AB - An immunocytochemical method was used to label the kinetochores on human synaptonemal complexes. Synaptonemal complex spreads were labelled with autoimmune CREST serum, followed by a second antibody labelled with colloidal gold, and examined by electron microscopy. Clusters of gold particles were found at discrete sites which were identified as kinetochores on the autosomal synaptonemal complexes, as well as on the XY pair. This method was used to investigate the extent of pairing of the human X and Y chromosomes at pachytene. Our observations confirm earlier work, based purely on measurements, that the pairing of the sex chromosomes sometimes extends beyond the centromere of the Y chromosome into the long arm. At the same time we showed that the centromeric indices of the X and Y at pachytene are highly variable, so that measurements alone are not sufficient to estimate the degree of pairing of the sex chromosomes. PMID- 3652820 TI - Three-dimensional reconstruction of a human metaphase chromosome from electron micrographs. AB - A complete human metaphase chromosome has been reconstructed from a series of electron microscopical projections obtained by tilting the specimen stage at 3 degree intervals from -60 to +60 degrees. The reconstructed structure is about 3.0 microns long, 1.6 micron wide, and 0.8 micron thick. The mass distribution was fairly homogeneous within the chromatids and neither a hollow nor a dense core was observed. The distribution and course of fibers observed are most consistent with a looping model of chromosome structure. PMID- 3652822 TI - [Evaluation of left ventricular function after acute myocardial infarction with the electrocardiogram]. PMID- 3652823 TI - [Comparison between the determination of excreted urea nitrogen and nitrogen balance of patients with chronic renal failure]. PMID- 3652824 TI - [Incorporation of thymic peptide in the combined treatment of severe subacute hepatitis]. PMID- 3652825 TI - [Preliminary study on the determination of nuclear DNA content of gastric cancer and precancerous lesions with microspectrophotometry]. PMID- 3652826 TI - [Erythrocyte magnesium in patients with chronic cor pulmonale]. PMID- 3652827 TI - [Distribution and clinical significance of lymphocyte subsets in patients with chronic aplastic anemia]. PMID- 3652828 TI - [Should thymol turbidity tests be abandoned]. PMID- 3652829 TI - [Clinical diagnosis and treatment of smooth muscle tumors of the stomach: an analysis of 42 cases]. PMID- 3652830 TI - [Sjogren's syndrome and Lymphoproliferation]. PMID- 3652831 TI - [A study of 217 cases of IGA nephropathy]. PMID- 3652832 TI - [Parameters of human growth hormone (hGH) levels reflecting the activity of acromegaly]. PMID- 3652833 TI - [Preliminary study on triple acid-base disorders]. PMID- 3652834 TI - [Pulmonary surfactant levels in oleic acid-induced respiratory distress syndrome of adult rabbits]. PMID- 3652835 TI - [A study of Kaschin-Beck disease and HLA]. PMID- 3652836 TI - [Bone marrow growth pattern in myelodysplastic syndromes]. PMID- 3652837 TI - [Preliminary study on bone marrow histopathology in myelodysplastic syndromes]. PMID- 3652838 TI - [Changes in circulatory thromboxane B2 and 6-keto-prostaglandin F1 alpha in acute myocardial infarction]. PMID- 3652839 TI - [Clinical significance of bedside cardiopulmonary monitoring]. PMID- 3652840 TI - [Clinical analysis of 42 cases of uremic lung]. PMID- 3652841 TI - [Primary malignant lymphoma of the gut: a retrospective clinicopathologic study of 67 cases]. PMID- 3652842 TI - [Extra-articular manifestations of rheumatoid arthritis]. PMID- 3652843 TI - [A commentary on jurisprudence principles in forensic psychiatry]. PMID- 3652844 TI - [Legal bases of forensic psychiatry: a discussion of the 15th clause of the Penal Law of China]. PMID- 3652845 TI - [Clinical picture and analysis of schizophrenics by psychiatric expert testimony]. PMID- 3652846 TI - [A preliminary analysis of 210 cases with forensic psychiatric appraisement]. PMID- 3652847 TI - [A trial of the MMPI of 100 criminals]. PMID- 3652848 TI - [Epidemiologic study of mental disorders of the aged in the urban district of Beijing]. PMID- 3652849 TI - [A preliminary study on platelet aggregation activity in two kinds of mental disease]. PMID- 3652850 TI - [Presumative role of platelets in the development of prolonged cerebral vasospasm following subarachnoid hemorrhage]. PMID- 3652851 TI - [Inhibitory effect of anisodine on platelet aggregation and adhesion]. PMID- 3652852 TI - [Hematomyelia caused by vascular malformation: a clinicopathological report of a case]. PMID- 3652853 TI - [Toxicological studies on tetrachlorvinphos]. PMID- 3652854 TI - [Analysis on the rate of F-/Ca++ in drinking water and its toxic effect in inhabitants]. PMID- 3652855 TI - [Laboratory studies on the factors affecting the toxigenicity of Flavobacterium farinofermentans nov. sp]. PMID- 3652856 TI - [A matrix expression for the calculation of the cross product difference]. PMID- 3652857 TI - [Iron nutritional status of young female workers in the Shanghai First Silk Factory]. PMID- 3652858 TI - [Cancer among fur workers]. PMID- 3652860 TI - [Toxicological study of phaseolus vulgaris poisoning]. PMID- 3652859 TI - [Quantitative analysis of biochemical components and inorganic elements in coal miners' lung carcinoma tissue]. PMID- 3652861 TI - [A survey on Trichinella spiralis infection of hogs and rats, with special reference to their relationship]. PMID- 3652862 TI - [Studies on the spermotoxicity of thallium carbonate in drinking water and its effect on the reproductive function of mice]. PMID- 3652863 TI - [Intake of nitrate, nitrite and total ascorbic acid in adults in Changsha]. PMID- 3652864 TI - [Experimental studies on antidotes for the insecticides bancol and nereistoxin acute poisoning]. PMID- 3652865 TI - [Study of sanitary standards of exposure to sunlight for residential buildings in Beijing areas]. PMID- 3652866 TI - [DDT and ethanol potentiation of the hepatotoxicity of CCl4]. PMID- 3652867 TI - [Blocking effect of sea buckthorn juice on the nitrosation of morpholine in vitro]. PMID- 3652868 TI - [Studies on gaseous fermentation of sweetened condensed milk caused by hyperglycophilic torulopsis]. PMID- 3652869 TI - [The effect of environmental EMF on the health of juveniles and children and its protection]. PMID- 3652870 TI - [The effect of sunlight in the habitat on the immune power of mice]. PMID- 3652871 TI - [Studies on the indirect haemagglutination test with Leptospira]. PMID- 3652872 TI - [Splenic cysts: report of 9 cases]. PMID- 3652873 TI - [Long-term results of intestinal plication for treating and preventing adhesive intestinal obstructions]. PMID- 3652874 TI - [Relation between the inferior cornu of the thyroid cartilage and the point of entry of the recurrent laryngeal nerve into the larynx and its clinical significance]. PMID- 3652875 TI - [Value of irrigation with a lidocaine solution in tissue transplantation]. PMID- 3652876 TI - [Anatomy of the malleolar tunnel and malleolar tunnel syndrome]. PMID- 3652877 TI - [Use of free flap grafts in reconstructive surgery: report of 130 cases]. PMID- 3652878 TI - [Clinical use of the lateral leg flap: report of 4 cases]. PMID- 3652879 TI - [Repair of traumatic soft tissue defects of the leg with skin or myocutaneous flaps]. PMID- 3652880 TI - [Fluorosis associated with compression of the spinal cord and cauda equina]. PMID- 3652881 TI - [Treatment of burns caused by voice and light-displaying agents]. PMID- 3652882 TI - [Re-replacement of a mitral valve: report of 10 cases]. PMID- 3652883 TI - [Surgical treatment of cor triatriatum]. PMID- 3652884 TI - [Diagnosis and surgical treatment of tuberculosis of the paraesophageal mediastinal lymph nodes]. PMID- 3652885 TI - [Experimental and clinical study of changes in glucocorticoid receptors during septic shock]. PMID- 3652886 TI - The inadequacy of published random control trials of antibacterial prophylaxis in colorectal surgery. AB - Fifty-six papers published between 1979 and 1986 that tested regimens of antibacterial bowel preparation before elective colorectal operations were studied using a numerical score devised for assessing publications of random control clinical trials. A maximum score of 100 was allotted: 50 for 15 aspects of design, 30 for ten aspects of analysis, and 20 for eight aspects of presentation. The 56 papers scored from 33 to 89, (mean, 61.6, standard deviation, 11.9). Only 13 (23 percent) reached a score of more than 70. The most frequent errors in design were the use of placebos in the control group (27 percent) and faulty methods of randomization (36 percent). Errors in analysis resulted in penalization of more papers than any other aspect; these included the almost universal omission of confidence limits, confusion of exclusions and withdrawals (46 percent), not recording the fate of withdrawals (80 percent) and incorrect use of statistical tests (55 percent). Ten papers reported results showing important clinical differences that did not achieve statistical significance, but only two mentioned the Type II error. Defects in presentation were less frequently encountered; the most common were inaccessibility of raw data (66 percent), lack of sufficient information to allow replication of methods (43 percent), and the drawing of firm conclusions from shaky data (50 percent). It was particularly disappointing that no evidence of improvement in the standard of these reports over the seven years studied was found. PMID- 3652887 TI - Surgery for ulcerative colitis in the pediatric population. Indications, treatment, and follow-up. AB - To evaluate the outcome of surgery for ulcerative colitis in pediatric and adolescent patients, the experience at the Cleveland Clinic Foundation was reviewed retrospectively. Fifty-nine percent of the patients presented with acute toxic colitis and sepsis; 94 percent underwent staged procedures with creation of a temporary or permanent ileostomy. Sepsis was the most frequent postoperative complication (38 percent), and accounted for all three deaths (5 percent). Long term disability was minimal, and 90 percent of the patients were fully active at the time of follow-up. PMID- 3652888 TI - The value of routine preoperative urologic evaluation in patients with colorectal carcinoma. AB - Routine preoperative intravenous pyelography was performed in a series of 105 consecutive male patients with rectal or rectosigmoid carcinomas who were totally free of urinary symptoms. Abnormal findings were present in 26 percent of those patients. Postoperative intravenous pyelograms were performed in 61 patients. Twenty-one percent of patients with negative preoperative intravenous pyelograms and 42 percent of patients with positive preoperative intravenous pyelograms had abnormal findings in the postoperative intravenous pyelograms. Preoperative cystoscopy was performed in 52 patients. Thirty-one percent of patients with negative preoperative intravenous pyelograms and 76 percent of patients with positive preoperative intravenous pyelograms had abnormal cystoscopic findings. The overwhelming majority of cystoscopic findings in patients with negative preoperative intravenous pyelograms were not related to the primary tumor. The findings of this prospective study suggest that routine preoperative intravenous pyelography is indicated in patients with rectosigmoid or rectal tumors without symptoms related to the urinary tract. Postoperative intravenous pyelography is indicated only in patients with positive preoperative intravenous pyelograms. Preoperative cystoscopy is indicated when the preoperative intravenous pyelogram is positive and especially if intravenous pyelography findings are suggestive of bladder-wall defect or extrinsic pressure. PMID- 3652889 TI - Radioimmunoguided surgery using the monoclonal antibody B72.3 in colorectal tumors. AB - The authors have developed a hand-held gamma-detecting probe (GDP) for intraoperative use that improves the sensitivity of external radioimmunodetection. Radiolabeled monoclonal antibody (MAb) B72.3 was injected in six patients with primary colorectal cancer and 31 patients with recurrent colorectal cancer an average of 16 days preoperatively. The GDP localized the MAb B72.3 in 83 percent of sites. The technique, known as a radioimmunoguided surgery (RIGS) system did not alter the surgical procedure in patients with primary colorectal cancer but did alter the approach in 26 percent (8/31) of patients with recurrent colorectal cancer. Two patients avoided unnecessary liver resections and two underwent extraabdominal approaches to document their disease. The RIGS system may influence the short-term morbidity and mortality of surgery for colorectal cancer. Larger series and longer follow-up are needed to determine whether the RIGS system confers a survival advantage to the patient with colorectal cancer. PMID- 3652890 TI - Rectal reservoir reduction procedures for internal rectal prolapse. AB - Forty-four patients presenting with painful outlet constipation had internal rectal intussusception documented by cinedefecography. Rectal reservoir reduction by multiple elastic ligation or staple excision of redundant mucosa effectively improved bowel function and outlet symptoms in the majority of patients. Rectal reduction procedures were performed under intravenous sedation with antibiotic coverage, no postoperative sepsis, and a single case of significant postoperative bleeding. Associated abnormalities on defecography were unaffected. PMID- 3652891 TI - Perianal Bowen's disease and associated malignancies. Results of a survey. AB - In 1959, Graham and Helwig reported that 80 percent of patients with Bowen's disease developed associated cutaneous or internal malignancies. Subsequent to the publication of this report, extensive and invasive workup of patients with Bowen's disease became the standard of practice. The authors' personal experience with perianal Bowen's disease suggested a substantially lower correlation between that disease and associated malignancies. Therefore a survey was initiated by contacting active members of the American Society of Colon and Rectal Surgeons to investigate further. Analysis of 106 cases demonstrated a lower incidence of associated malignancies (4.7 percent) subsequent to diagnosis of perianal Bowen's disease. The data further indicated, however, that these patients are at risk to develop recurrent Bowen's disease (9.4 percent) and invasive carcinoma (5.7 percent). It is concluded that an extensive and invasive workup of patients with perianal Bowen's disease is not indicated and that the patient's greatest risk is development of recurrent or invasive disease. PMID- 3652892 TI - Treatment of pneumatosis coli with metronidazole. Endoscopic follow-up of one case. AB - A case of pneumatosis cystoides intestinalis in the large bowel with complete resolution after eight weeks of metronidazole treatment is reported. This symptomatic case, with an acute onset classified as the primary (idiopathic) type, became asymptomatic after a few days and was followed until complete endoscopic and radiologic resolution. No recurrence was noticed during 15-month follow-up. This lends support to the assumption that anaerobic bacteria contribute to the etiopathogenesis of this condition. The choice of metronidazole as an easy ambulatory therapy is encouraged. PMID- 3652893 TI - Localized giant pseudopolyposis of the colon in ulcerative colitis. Report of a case. AB - Localized giant pseudopolyposis of the colon is a rare complication of both ulcerative colitis and Crohn's disease. It is not regarded as being premalignant, but it may masquerade clinically as a malignancy. This report presents a case and reviews others reported in the literature. PMID- 3652894 TI - Colonic anastomotic disruption in myasthenia gravis. Report of two cases. AB - Anticholinesterases are the mainstay in the treatment of myasthenia gravis. They are also used in the reversal of neuromuscular blocking agents used during general anesthesia. Their use in gastrointestinal surgery, especially involving anastomosis of the distal ileum or colon, has been implicated in anastomotic disruptions. This paper discusses the controversy in the use of reversal agents (anticholinesterases) in colon surgery and specifically in patients with myasthenia gravis. PMID- 3652895 TI - Carbohydrate malabsorption is minimal in school-age cystic fibrosis children. AB - Fifteen school-age cystic fibrosis children, participating in a year-long nutritional management study, were hospitalized at six-month intervals for balance studies during which they continued "free-choice" diets and their usual enzyme supplementation. Stools were analyzed for fat and protein by conventional methods and for carbohydrate using a recently validated anthrone method. Despite persistent fat and protein malabsorption, less than 1% of ingested carbohydrate was lost intact in the stools. Comparison of baseline and placebo balance studies showed fecal excretion of carbohydrate to be independent of intake, in contrast to the fat and protein results. Using a thin-layer chromatography method capable of detecting microgram quantities of urinary organic acids, no short-chain fatty acids were detected in the stool. Further exploration of carbohydrate as a dietary energy source for this patient group with increased energy demands should be pursued. PMID- 3652896 TI - Passage of salivary amylase through the stomach in humans. AB - With an inhibitor assay technique rates of passage of salivary and pancreatic isoamylase through the jejunum were measured in six healthy volunteers after different liquid, intragastric meals. In all subjects and in 13/17 experiments, more than 2500 units of salivary amylase were passed over 200 postcibal minutes. Salivary amylase comprised 13.8 +/- 3.9% (mean +/- SEM) of the total amylase and appeared predominantly as single, distinct peak. The inhibitor method was validated by isoelectric focusing (r = 0.988; P less than 0.001; N = 7). The frequency of detection of salivary amylase in gastric or jejunal samples fell as gastric pH fell below 3.0. In vitro, amylase was inactivated in gastric juice as pH fell between 3.8 and 3.3. Salivary amylase accounted for 11% of total amylase output in a normal and 27% in an achlorhydric subject after a hamburger meal. We conclude that amylase should not be measured in postprandial studies of pancreatic secretion in humans without correction for salivary amylase. PMID- 3652897 TI - Changes in colorectal function in patients with chronic colonic pseudoobstruction. AB - Motility studies of the lower bowel, radiology to exclude other gastrointestinal involvement, and rectal biopsies were carried out in 11 patients, age 21-60 years, with isolated chronic colonic pseudoobstruction. Repeated plain abdominal x-rays during symptomatic periods revealed massive gaseous colonic distension in all. Seven patients had the primary form while four patients had an underlying disease which could have been responsible for the chronic colonic pseudoobstruction. Lower bowel motility was decreased in patients with the primary form. Rectal wall elasticity was increased in both the primary and secondary form. Some of the abnormalities measured may suggest myogenic abnormalities of the sigmoid or rectal wall. No specific neural or muscular morphologic defect was identified in colonic transmural sections in eight patients except in the patient with Hirschsprung's disease. Five of seven patients with primary colonic pseudoobstruction achieved symptomatic relief only after subtotal colectomy and ileoproctostomy. PMID- 3652898 TI - Milk protection against experimental ulcerogenesis in rats. AB - The antiulcer activity in pasteurized/homogenized bovine milk and a lipid extract of this milk was tested in an attempt to isolate and identify the active component. Using 0.6 N HCl as a damaging agent in pylorus-ligated rats, the protective property of milk appeared to be related to its phospholipid content and not its protein constituents. With intact (non-pylorus-ligated) rats, milk had demonstrable protective activity against 0.6 N HCl, as well as 100% ethanol and 160 mM taurocholic acid. The increasing phospholipid concentrations in skim, whole, and buttermilk paralleled their antiulcer efficacy. A lipid extract of whole milk showed significant protection against 0.6 N HCl when given alone or following indomethacin treatment. Measurements of the contact angle (hydrophobicity) of the gastric surface showed that it was maintained near control levels in the presence of 0.6 N HCl, if rats were first pretreated with milk. These results are consistent with the possibility that surface-active lipids in dairy milk, such as phospholipids, may account for a significant portion of milk's antiulcer activity by maintaining the hydrophobicity of the luminal surface of the gastric mucosa in the presence of a damaging agent. PMID- 3652899 TI - Hepatic artery aneurysm simulating a cystic mass of the pancreas. PMID- 3652900 TI - Migrating action potential complexes in a patient with secretory diarrhea. AB - A 70-year-old woman with secretory diarrhea was studied with a novel technique of recording small intestinal myoelectrical activity which allowed us to obtain long, uninterrupted records of slow waves and spikes at eight or more different intestinal levels simultaneously. Typical migrating action potential complexes (MAPCs) were observed, consisting of spike bursts that extended over more than one slow wave and migrated distally at the same propagation velocity as the slow waves. This motility pattern occurred frequently during the period the patient presented with secretory diarrhea and disappeared with the disappearance of the diarrhea. It was observed only once in a series of 10 normal control subjects. This is the first report on MAPC activity in man and on the association of this myoelectrical pattern with secretory diarrhea in man. PMID- 3652901 TI - Hepatocanalicular injury associated with vitamin A derivative etretinate. An idiosyncratic hypersensitivity reaction. AB - A patient with pustular psoriasis developed jaundice, peripheral blood eosinophilia, and biochemical evidence of hepatocanalicular dysfunction four weeks after the initiation of etretinate therapy. A liver biopsy specimen showed bile duct damage, a periportal inflammatory infiltrate composed of neutrophils, eosinophils and lymphocytes, canalicular cholestasis, and focal hepatocyte necrosis. Clinical exclusion of other possible etiologic factors coupled with near resolution of the biochemical abnormalities within six weeks after complete discontinuation of the drug indicates that etretinate may induce an idiosyncratic hypersensitivity reaction. This is the first report to document etretinate associated bile duct injury. PMID- 3652902 TI - Pneumothorax: complication of enteral feeding tube placement. PMID- 3652903 TI - Effect of natural progesterone treatment during pregnancy on fetal testosterone and sexual behavior of the male offspring in the mouse. AB - The effect of maternal exposure to progesterone upon the fetal pituitary-gonadal axis and the sexual behavior of the male offspring of mice were studied. Daily injection of progesterone from days 14 to 16 of pregnancy reduced testosterone production in the fetus but caused a significant increase in circulating LH levels. Progesterone-exposed males showed no alteration in anogenital distance or in body weight at any time from birth to adulthood. At 80-90 days of age males from control and progesterone-exposed groups did not differ from each other in testis and seminal vesicle weights. However, in the latter group, there was a marked reduction in the percentage of males that displayed mount, intromission and ejaculation patterns. These findings indicate that in utero exposure to pharmacological doses of progesterone that do not cause abnormalities of male internal and external genitalia may interfere with masculine behavior in adulthood. This alteration could partially be due to diminished peripheral testosterone levels during the prenatal period. PMID- 3652904 TI - Tissue-specific and developmentally regulated transcription of the insulin-like growth factor 2 gene. AB - Transcription of the rat and human IGF-2 gene loci is unusually complex. The pattern of expression of these genes varies both between tissues and within a given tissue during different stages of development. Alternative splicing or possibly transcriptional initiation events generate variant IGF-2 mRNAs that contain different 5'-untranslated leader sequences. These leader exon sequences are shared with non-IGF-2 mRNAs. Certain noncoding IGF-2 gene sequence elements are transcribed extensively and are found in multiple copies elsewhere in the human genome. Furthermore, IGF-2 mRNA levels are particularly high in a variety of human malignancies. PMID- 3652905 TI - Mouse glutathione S-transferase Ya subunit: gene structure and sequence. AB - A mouse glutathione S-transferase gene encoding the Ya subunit was isolated and sequenced. The gene spans about 11 kb, contains seven exons, and encodes an mRNA of 841 nucleotides. Promoter elements, TATA and CAAT box sequences, were located 32 and 70 nucleotides upstream from the initiation of transcription site. The mRNA coding sequences of the mouse gene were highly homologous to a rat liver Ya mRNA species detected by cDNA cloning. The mouse Ya gene produces a 223-amino acid polypeptide that differs from the 222-amino-acid rat Ya by 10 amino acid substitutions and a carboxyl terminus Phe-Lys-Ile-Gln instead of Phe-Lys-Phe. A genomic clone containing the last three exons of the rat Ya gene was also isolated, sequenced, and compared with the mouse Ya gene. An extensive sequence conservation (70-80%) in the 50 to 200 bases of introns at the exon-intron junctions as well as in the region beyond the cleavage-polyadenylation site of pre-mRNA was observed. PMID- 3652906 TI - Isolation of rat testis cDNAs encoding an insulin-like growth factor I precursor. AB - We have characterized rat testis cDNAs encoding insulin-like growth factor I (IGF I) precursor to facilitate studies of IGF-I expression in the male reproductive system. Two clones, P2 and P3, with inserts of 786 and 1200 bp, respectively, were isolated from a lambda gt11 library of rat testis cDNAs. The longest open reading frame of cDNA P2 predicts a 153-amino-acid residue IGF-I precursor that has only 11 amino acid substitutions compared with a human IGF-IA precursor encoded by a human liver mRNA. Three substitutions are within the predicted rat IGF-I sequence: a Pro for Asp in the B domain, an Ile for Ser in the C domain, and Thr for Ala in the D domain. Only two substitutions distinguish the predicted rat sequence from a mouse liver IGF-IA precursor: Thr for Ala in the signal peptide and Ala for Ser in the D domain. P2 hybridizes with poly(A)+ mRNAs of 7.5, 4.7, 1.7, and 1.2-0.9 kb in rat liver and testis. The other testis cDNA, P3, appears to represent a partially processed rat IGF-I mRNA precursor. By comparing the sequence of cDNA P2 with that of cDNA P3 and a 2.3-kb rat IGF-I genomic fragment, we predict exon splice sites within the codon for residue 26 and between residues 86-87 of the rat IGF-I precursor. Both of the predicted splice sites align with exon-intron junctions in the human IGF-I gene. We conclude, therefore, that IGF-I is synthesized as a precursor in the rat testis and that the structure of IGF-I genes, mRNAs, and precursors are highly conserved across species. PMID- 3652907 TI - DNA sequence of the human apolipoprotein B gene. AB - The sequence of the human apolipoprotein B gene comprises 43 kb divided into 29 exons, one of which is unusually long and contains 7572 bp. Comparison of the gene sequence with four complete and three partial cDNA sequences published elsewhere reveals a total of 60 nucleotide substitutions and 39 amino acid substitutions and one small deletion in the signal peptide. PMID- 3652908 TI - Efficient saturation mutagenesis of a pentapeptide coding sequence using mixed oligonucleotides. AB - Site-directed mutagenesis using oligonucleotides that are degenerate at a specific codon was employed to construct a set of mutations in a pentapeptide sequence targeting cytosolic proteins to lysosomes during serum withdrawal. Low temperature annealing of the mixed oligonucleotides to single-stranded phage DNA and a genetic selection for the DNA strand carrying the mutations were utilized. The use of mixed oligonucleotides by this technique provides an economical means of generating a large set of substitution mutations. A single codon can be changed to codons for most other amino acids in one step. This approach eliminates the need for restriction enzyme cleavage sites flanking the target for mutagenesis and, therefore, is useful for targeting mutations to any DNA fragment cloned into an appropriate single-stranded bacteriophage. PMID- 3652909 TI - Electroretinographic responses to the addition of nitrous oxide to halothane in rats. AB - The electroretinograms of 20 anesthetised but spontaneously breathing rats (Wistar) were recorded over a period of 60 minutes. Two anesthetical procedures were applied to each of these rats respectively: (I) halothane/nitrous oxide/oxygen (2% halothane in 0.81 N2O: 0.41 O2/min) and (II) halothane/nitrogen/oxygen (2% halothane in 0.81 N2: 0.41 O2/min). From the 10th up to the 60th min of anesthesia the ERG amplitudes decreased gradually (I: a wave 17% and b-wave 14%; II: a-wave 15% and b-wave 12%). Body temperature was experimentally maintained at nearly 37.0 degrees C. Under considerable diminution in both procedures the frequency of respiration was significantly higher under procedure I in the first 20 minutes only. Under procedure I the b-wave amplitudes were significantly higher in contrast to procedure II. This occurred at all applied stimulus intensities (6; 24; 100; 400 and 1600 Lux at the cornea). The a wave amplitudes and the peak times of the a- and b-waves did not show any significant differences between the two experimental conditions. These ERG responses to nitrous oxide in addition to halothane are discussed on the basis of the respiratory, circulatory and cerebral effects of these anesthetics. PMID- 3652910 TI - Testing visual perception of three-dimensionally moving objects (dynamic stereoscopy). AB - In the past decade, visual requirements in the field of stereoscopy have considerably increased in a number of professions, as well in present-day traffic and sports. As a result of a statement of the WHO (1984) viz. that for prevention of accidents the testing of static vision only is insufficient, and that dynamic vision too should be a subject of investigation, a test for measuring dynamic stereoscopic visual acuity has been devised. With the help of two synchronously rotating prisms, a stereo test consisting of four bars is transposed into an apparent circumduction movement which is presented at different velocities. Stereoscopy under static and dynamic conditions do not run a parallel course. Dynamic stereoscopy is significantly influenced by age, but not by sex. PMID- 3652911 TI - [Pulmonary tumors induced by diethylnitrosamine in mice]. AB - High incidence pulmonary tumors induced in the mice by diethylnitrosamine were studied as to their morphology and pathogenesis. Under the light microscope, the induced pulmonary adenomas may be divided into three types: solid, papillary and mixed adenomas. Ultrastructural study showed that some adenomas were derived from the Type II pneumonocytes, some from Clara cells and more than a half of the adenomas possessed the common features of both. The author terms the latter bi phase differentiated adenoma, which is characterised by the presence of a lot of the lamellar bodies and electron dense granules in the cytoplasm as well as transitional from between the two. The bi-phase differentiated adenoma is firstly considered as originating form the Clara cells, secondly from the anaplastic cells in the bronchiolar epithelium. Ultrastructural study indicates that the lamellar bodies are probably derived from the multivesicular bodies and/or electron dense granules. The malignant change of the adenomas goes into malignancy resembling the bi-phase differentiated adenomas in the ultrastructure. The lung carcinomas of the mice are similar to those which occur in the human being. PMID- 3652912 TI - [Establishment of a human pulmonary adenocarcinoma cell line Lu-YePa and its biological characteristics]. AB - This paper presents the establishment of a human pulmonary adenocarcinoma cell line Lu-YePa and its biological characteristics. The primary cells of Lu-YePa cell line were derived from a twenty six year old patient with poorly differentiated adenocarcinoma of the lung. After 36 days' culture, transfer was made and the cells proliferated steadily and rapidly afterwards. The doubling time was 34.6 hours. Mitotic index reached 49.5% on day 5. Chromosome number was subtriploid with the mode of 62. The large submetacentric marker chromosome was presented in 68% of cells. PAS positive granules were found in the cytoplasm. The study of concanavalin A condensation, electron microscopic observation, heterotransplantation and plating efficiency indicates that Lu-YePa cells are concordant with the human pulmonary adenocarcinoma cells in morphology and biological behavior. PMID- 3652914 TI - [CT-guided percutaneous fine needle aspiration cytodiagnosis of pancreatic and periampullary tumors]. AB - CT guided percutaneous fine needle aspiration cytodiagnosis was performed on 30 patients with pancreatic and periampullary tumors in China-Japan Friendship Hospital from November 1984 to January 1986. In our series, 9 pancreatic head cancers, 4 pancreatic body and tail cancers, 5 ampullary cancers had positive cytodiagnosis (100%-18/18). 2 of 3 (67%) duodenal cancers and 6 of 7 (86%) the distal common bile duct cancers were positive by cytodiagnosis. 2 pancreatitis were negative (100%). The positive rate by CT guided diagnosis was 93.3% (28/30). In the same period, ultrasonically guided percutaneous fine needle aspiration cytodiagnosis was performed on 30 patients with pancreatic and periampullary tumors, a correction rate of diagnosis was 67%. CT guided procedure is more accurate than that ultrasonically guided. PMID- 3652913 TI - [Clinical analysis of 140 patients with periampullary carcinoma]. AB - From 1964 to 1984, 140 patients were treated by operation in our hospital with the diagnosis of periampullary carcinoma established by exploration or pathology. 86 patients were male and 54 were female. The age ranged from 29 to 73 years. 126 (90%) of them were over forty, pancreatoduodenectomy was performed in 60 patients. The resection rate was 42.9%. The operation mortality was 11.7%. Pancreatoduodenectomy gave a mean postoperative survival of 22 months. The longest survival was 13 years 10 months, palliative choledochoenterostomy or gastro-enterostomy was done in 66 patients with a mean survival of 5.2 months. 14 patients were given laparotomy only with a mean survival of 4 months. In this paper, the diagnosis of periampullary carcinoma, early postoperative complications of pancreatoduodenectomy and prognosis are discussed. PMID- 3652915 TI - [Multiple primary lung cancer]. AB - From November 1957 to June 1984, 30 patients with multiple primary lung cancer were diagnosed, basing on clinical features, diagnostic means, histologic type, treatment and prognosis. Out of 3,815 cases of resected primary lung cancer, the incidence of multiple primary cancer was 0.8%. There were 10 synchronous and 20 metachronous cases. There were 17 unilateral, only 1 simultaneous bilateral and 12 contralateral after resection of cancer in the opposite lung. Four of the 10 synchronous cases were definitely diagnosed preoperatively. Among the 20 metachronous cases, 9 were definitely diagnosed as a second primary lesion and the other 11 were proved by thoracotomy. Pathologically, 19 had identical types (15 squamous cell and 4 adenocarcinoma) but 11 had double types (9 squamous cell + adenocarcinoma, 2 squamous cell + anaplastic). The average survival of these 30 patients was 27.1 months, that in the synchronous group was 29 months and that in the metachronous group was 26.2 months. The 5 year survival rate of the synchronous cases was 35%, that of the metachronous cases was 42%. The clinicopathological criteria of multiple primary lung cancer, early diagnostic and operative procedure are also discussed. PMID- 3652917 TI - [Surgical treatment of thyroid cancer]. AB - From 1957 to 1980, 151 patients with thyroid cancer were treated by surgery in our hospital. Papillary adenocarcinoma was predominant (53%), followed by undifferentiated (23%) and follicular types (20%). The diagnosis, established only according to the clinical symptoms and 131I scan, gave a high misdiagnosis rate (44%). The misdiagnosis could also be made on the operation. The causes are: 1) limitation of 131I scan in diagnostic specificity; 2) lack of vigilance for thyroid cancer; 3) neglecting the subtle histological changes during the operation; 4) failure in submitting the frozen section. Fine needle aspiration cytology is emphasized in order to improve the preoperative diagnostic accuracy. Lobectomy and modified neck dissection are the most common modalities of operation for papillary and follicular cancers. The 5 year survival rates were 74% and 50% respectively. Modified neck dissection increased the 5 year survival up to 85%. Undifferentiated cancer could be treated, at best, by palliative treatment. The authors believe that a rational radical operation should be performed according to the pathological type, biological behavior and stage of the lesion, followed by adjuvant endocrine and/or isotope therapy, which could improve the treatment result. PMID- 3652916 TI - [Short-term result of non-Hodgkin's lymphoma treated by the COMP regimen]. AB - From March 1982 to November 1984, 31 patients with non-Hodgkin's lymphoma were treated by COMP regimen. 15 (48%) had stage III and IV lesions. This regimen consisted of cyclophosphamide 600 mg IV weekly, vincristine 2 mg IV weekly, methotrexate 20 mg IM weekly and prednisone 30 mg PO daily for 2-3 weeks. Then, there was an interval of 2 weeks and the same therapy was repeated. 27 patients had more than 3 cycles. Of the 31 patients, 22 gave objective response with an overall response rate of 71%. Among the 22 patients without prior treatment, 10 (45.5%) achieved complete remission (CR) and 8 (36.3%) partial remission (PR)- the overall response rate was 81.8%. 4 (44%) of 9 patients with prior chemotherapy responded to COMP regimen (1 CR and 3 PR). The treatment was well tolerated. There were only 9 patients with leukocyte count below 4000 and none of them ever below 2000. One patient had a transient elevation of serum glutamic pyruvic transaminase, which dropped to normal very quickly after interruption of the treatment. COMP regimen was as effective as COPP (procarbazine replacing methotrexate) regimen in non-Hodgkin's lymphoma. Hence, it could be considered as a common regimen for advanced non-Hodgkin's lymphoma and used to treat the patients refractory to certain chemotherapeutic agents. PMID- 3652918 TI - [Diagnosis and surgical treatment of primary mediastinal tumors]. AB - This paper presents the diagnosis and surgical treatment of 60 patients with mediastinal tumors proven by pathology. The pathological types were: 36.7% teratodermoid tumor, 33.3% thymoma, 10% mediastinal cyst, 8.3% neurogenic tumor, 5% intrathoracic goiter and 6.7% other rare tumors. Fourty two of the 44 patients with benign tumors underwent resection. Of the 16 patients with malignant tumors, only 7 had the tumor removed, and the rest 9 were given exploration and biopsy. The majority of teratodermoid tumors was benign but perforation and infection added the difficulties to operation. The most common complication of thymoma was myasthenia gravis which comprised 35% in this study. The relation between thymoma and myasthenia gravis is intricate. The benign thymoma was much better in the resectability and survival rate than the malignant thymoma. Finally, the differential diagnosis between the benign and malignant thymomas is discussed. A rare case of malignant thymoma complicated by hypertrophic osteoarthropathy is reported in detail. PMID- 3652919 TI - [Focal metastatic symptom as the initial presentation of lung cancer--report of two autopsied cases]. AB - From 1956 to 1985, autopsy was done on 17 lung cancer patients in our hospital. There were two patients with focal metastasis as the presenting symptom without any primary cancer manifestations. One patient was admitted for severe right epigastric pain followed by severe pain in the left epigastrium. The chest film revealed nothing except some indefinite inflammatory lesions in the left upper lung. The patient died of uremia in 6 months. A primary carcinoma of 2 cm in diameter in the left lower lung was found on autopsy, which widely spread to the right lung, ovaries, upper segment of the left ureter, peribronchial and periaortic lymph nodes. Histological diagnosis was poorly differentiated adenocarcinoma. The other patient had destruction of the sphenoid bone with cranial nerve paralysis and hypothalamic syndrome at first. The primary cancer, a poorly differentiated adenocarcinoma of 2 X 3 X 1.5 cm in size, was found in the right upper lung on autopsy. Focal metastatic symptom as the initial presentation of lung cancer is rare. These tumors, as small lesions, frequently occur in the peripheral part of the lung. However, the site in which the presenting symptom develops may not necessarily be the place prone to metastasis. The presenting symptom, in turn, would depend upon the tendency of causing symptoms in the involved site. The author suggests that careful searching and identifying of the pulmonary lesion be routinely done for patients with metastatic carcinomatous symptoms only. PMID- 3652920 TI - [Induction of 48 kD protein in rat thymocytes during heat shock]. PMID- 3652921 TI - [Identification of catalytic centers in a decarboxylating element of muscle pyruvate dehydrogenase]. PMID- 3652922 TI - [Inhibition by remantadine of the influenza virus-induced reduction in the rate of osmotic lysis of chicken erythrocytes]. PMID- 3652923 TI - Cytostatic activity of naturally isolated isomers of secalonic acids and their chemically rearranged dimers. AB - Six different secalonic acids were tested for cytostatic activity against cultured mouse leukaemia L1210 cells. Secalonic acids B and E showed rather weak activity but the other four isomers showed quite strong activity, especially secalonic acids A and D which were slightly more active than adriamycin. The chemically rearranged 2,4'-dimer of secalonic acid A showed almost the same activity as the naturally isolated 2,2'-dimer, but the activity of the 4,4'-dimer was much stronger than that of both the 2,2'-dimer and adriamycin. Interestingly, in a mouse bone marrow stem cell assay, secalonic acids F and G showed almost the same toxicity as adriamycin, but secalonic acids A and D showed rather weak toxicity. Similarly, the 2,2'-dimer of secalonic acid A showed almost the same toxicity as adriamycin, but the toxicity of the 2,4'- and 4,4'-dimers was weaker than that of the 2,2'-dimer and also that of adriamycin. PMID- 3652924 TI - Rational design of bis-intercalating drugs as antitumour agents: importance of rigidity in the linking chain. AB - Ditercalinium (NSC 366241), a dimer of 10-methoxy-7H-pyrido[4,3-c]carbazole quaternarized on the pyridine nitrogen by a rigid bis(1,1'-ethyl)-4,4' bipiperidine linking chain, is endowed with antitumour properties and bis intercalates with high affinity into DNA. New dimers have been designed in the same series to evaluate the importance of the rigidity of the linking chain for pharmacological activity. The dimers, characterized by one and two additional methylene groups between the two piperidine rings of the linking chain, remain as active as ditercalinium. However, a third additional CH2 group between the two piperidine rings leads to an inactive dimer. Relationships between the different pharmacological activities of the drugs and their intercalation complexes with DNA were investigated using viscosimetry, absorption spectroscopy and NMR analyses. PMID- 3652925 TI - Potentiation of the therapeutic activity of cyclophosphamide by an original N acyldehydroalanine. AB - Research work is currently in progress with the aim of improving the efficacy and/or reducing the toxicity of cancer treatments. The present communication reports on the effect of an original molecule, N-(ortho methoxyphenylacetyl)dehydroalanine, known as AD20. In a protocol in which L1210 leukaemic cells, AD20 and cyclophosphamide were injected i.p. into BDF1 mice, the association CP-AD20 was more active than CP alone at therapeutic or subtherapeutic doses of CP. If the doses of CP were higher than its optimum therapeutic dose, the association CP-AD20 was more toxic than CP alone. The positive effect of AD20 was also observed when AD20 was given i.v. or when the leukaemic cells were implanted s.c., CP always being injected i.p. Taking into account its low toxicity, AD20 exhibits interesting properties that could support its development as an adjuvant for cancer chemotherapy. PMID- 3652926 TI - Kinetics of platinum in cancer patients treated with cisplatin at different doses. AB - In previous work the authors observed that platinum (free and bound) does not seem to accumulate in the peripheral compartment following the administration of two courses of cisplatin (cis-DDP) therapy (65 mg/m2) in patients with mammary and ovarian cancer. The aim of the present work was to study the disposition of platinum (Pt) after a higher dose of cis-DDP, to verify the rate of free drug penetration into the tissue and to observe changes in protein binding relative to the dose. cis-DDP, at the dose of 100 mg/m2, was administered i.v. over 60 min to patients with lung cancer. Serum and urine were collected before infusion and at various intervals afterwards. The plasma and urine levels of Pt were determined by flameless atomic absorption spectrophotometry, using a Varian model AAS 1475 GTA 95. Serum levels were analysed by a two-compartment open pharmacokinetic model. After the higher dose there was a substantial increase in central volume Pt and slight increase in peripheral volume Pt as compared with levels observed previously at the lower dose. In some subjects receiving high doses elimination half-life decreased and total body clearance increased, while in others these kinetic parameters were unchanged in comparison with those observed after a low dose. Protein binding seems to influence the persistence of platinum in the vascular space, modifying to a minor degree tissue penetration of the drug. PMID- 3652927 TI - The effect of local anaesthetics on noncholinergic-nonadrenergic (NCNA) responses of the gut. AB - The newly synthesized carbamate local anaesthetics (heptacaine and BK-141) affected the NCNA responses of different segments of the guinea-pig small (jejunum, ileum) and large (colon, taenia coli) intestine in a similar manner to the classic local anaesthetics (procaine and trimecaine). The sensitivity of NCNA responses to the action of local anaesthetics was, in order: primary contraction greater than rebound contraction greater than primary relaxation. The action of the carbamate local anaesthetics resembled that of trimecaine more than that of procaine. The results presented suggest that different Ca2+ channels participate in primary and rebound contraction and that local anaesthetics affect the receptor-operated Ca2+ channels in lower concentrations than the voltage dependent ones. PMID- 3652928 TI - Thiazolidine-4-carboxylic acid toxicity and glutathione levels in various organs of the rat. AB - Thiazolidine-4-carboxylic acid (TC) (a precursor of intracellular cysteine) was administered to rats at 50 mg/kg and at 400 mg/kg by an i.p. route and at 800 mg/kg per os, and the levels of glutathione (GSH) in gastric mucosa, gastric wall and liver were determined. GSH levels in the eyes were measured after oral administration of TC. No changes in GSH levels were observed at 50 mg/kg from 1 to 48 h. An initial increase of liver GSH levels was followed by a decrease (up to 12 h) at 400 mg/kg i.p. After oral administration of 800 mg/kg an initial increase of GSH levels in the liver and gastric mucosa was followed by a decrease (up to 24 h); the GSH levels in the gastric wall showed a persistent decrease. No significant changes were seen in the GSH levels of the eyes. PMID- 3652929 TI - Effect of levo-acetylcarnitine on P300-like potentials of the normal monkey. AB - Endogenous components of evoked potentials resembling P300 in human beings were sequentially studied in four cynomolgus monkeys (Macaca fascicularis using an auditory "oddball" paradigm, after classical conditioning training. When robust P300-like signals were obtained, each animal underwent further recording sessions in which a placebo, L-carnitine or L-acetylcarnitine (LAC) was injected. Only LAC induced an amplitude increment of P300 waves in all the animals and a latency decrement in two animals. Furthermore a transient effect with amplitude reduction on the primary cortical auditory evoked potentials (AEP) both to rare and frequent tones was also recorded in all the animals. This effect resembled the AEP amplitude reduction induced by physostigmine administration. The findings suggest an effect of LAC on normal processes accompanying cognition. PMID- 3652930 TI - Effects of naloxone and coffee on anterior pituitary hormones. AB - Both naloxone, a specific opiate antagonist, and caffeine and other components of coffee powders show influences on opiate receptors and on the secretion of some pituitary hormones. In order to study the possible effect of naloxone and coffee on the secretion pattern of hypophyseal hormones in man, experiments were performed in normal volunteers using either naloxone or coffee alone or both substances. Five healthy normal males, aged 25-30 years, received on three separate occasions and in random order: (i) coffee (4 cups of Italian style "espresso" coffee); or (ii) naloxone 12 micrograms/kg i.v.; or (iii) coffee plus naloxone simultaneously. The results show that naloxone given alone did not modify basal plasma PRL, GH, TSH, FSH or cortisol levels but significantly increased basal LH concentrations. On the other hand, the absorption of four cups of coffee did not modify the values of any of the hormones studied. The combination of the two drugs (coffee + naloxone) did not alter the response of the hormones studied to naloxone alone. It was concluded that coffee drinking, at least in these experimental conditions, does not appear to have any influence on anterior pituitary hormone secretion. Naloxone, on the other hand, is able to stimulate LH secretion even at very low doses. PMID- 3652931 TI - The effect of pirozadil on plasma lipids and lipoproteins in 1185 hyperlipidaemic subjects. Multicentre study in general practice in Spain. AB - The lipid-lowering agent pirozadil was tested in 1185 hyperlipidaemic subjects during a 2-4 months' intake. Plasma triglycerides were found to decrease by 30.8%. The reduction of plasma cholesterol (by 20.8%) was mainly due to a fall in low-density lipoprotein cholesterol by 23.7%, while high-density lipoprotein cholesterol increased up to 32.2%. Pirozadil was effective and well-tolerated in patients with both hypercholesterolaemia and hypertriglyceridaemia. PMID- 3652932 TI - Evaluation of a therapeutic drug monitoring program for theophylline in a teaching hospital. AB - Studies concerning the value of therapeutic drug monitoring programs for theophylline have yielded contradictory findings. This study employed a prospective, single-blind, randomized, crossover design to evaluate the effect of a therapeutic drug monitoring program for theophylline. There were 410 serum theophylline assays performed in 169 patients. The average number of assays drawn incorrectly and the average number of assays used inappropriately were significantly reduced (from 1.87 to 1.32 and from 2.07 to 1.45, respectively) with therapeutic drug monitoring. When the program was withdrawn, no statistically significant change resulted, and when the program was reinstituted, there was improvement in audit criteria performance but the change was not statistically significant. Although the savings from the program would equal the cost in the first year, cost savings would be anticipated in the future. PMID- 3652933 TI - Cardiopulmonary arrest following barium enema examination with glucagon. AB - This is a case report of a patient who presented to the hospital's ambulatory radiology suites for a barium enema to evaluate guaiac-positive stools. The patient, after receiving glucagon 0.5 mg iv and a small amount of rectally administered barium sulfate, experienced an "itchy tingling" feeling, vomited, became diaphoretic, and had a cardiopulmonary arrest. Despite a prompt response by the cardiac arrest team, the patient could not be resuscitated. This case demonstrates the potential for serious reactions during this procedure. PMID- 3652934 TI - Prazosin-induced first-dose phenomenon possibly associated with hemorrhagic stroke: a report of three cases. AB - A small initial dose of prazosin ranging from 0.5 to 1 mg has been recommended to avoid the first-dose phenomenon characterized by a sudden and severe drop in blood pressure after the administration of the first dose of prazosin. However, even with an initial dose of 0.5 mg, hypotension with consciousness disturbance developed in three hypertensive patients with recent cerebral hemorrhage. We present this report to alert physicians and pharmacists about the potential risk of the first-dose phenomenon even at the recommended initial doses of prazosin in hypertensive patients who have suffered a recent stroke. PMID- 3652935 TI - Iodinated glycerol-induced hypothyroidism. AB - This report describes an adverse reaction to iodinated glycerol, an organic form of iodine prescribed as a mucolytic-expectorant. In a patient with a previous history of severe potassium iodide-induced hypothyroidism, administration of iodinated glycerol resulted in mild subclinical hypothyroidism. There is one report in the literature of goiter resulting from iodinated glycerol and physicians should be aware of the potential for hypothyroidism with this agent. Iodinated glycerol should be added to the list of iodine-containing organic compounds that interfere with thyroid function. PMID- 3652936 TI - Introduction to pharmacoepidemiology. PMID- 3652937 TI - Determination of the drug information needs of the medical staff of a Nigerian hospital following implementation of clinical pharmacy services. AB - The types and frequency of questions asked of clinical pharmacists introducing clinical pharmacy services in the internal medicine wards of a Nigerian university hospital and the degree of compliance with pharmacists' recommendations were studied. Three faculty pharmacists collected data in two 30 working day study periods, separated by a year. Totals of 197 questions (an average of 6.57 +/- 1.33 questions/working day) and 271 questions (an average of 9.03 +/- 1.10 questions/working day) were answered by the pharmacists in the first and second study periods, respectively. Pharmacists recommended changes in patient-specific drug therapy that were implemented 52 percent and 69 percent of the time in the first and second study periods, respectively. The most common type of drug information request concerned the presence or the likelihood of an adverse drug reaction. Continuous interaction between pharmacists and physicians in the patient-care setting results in a better appreciation of the pharmacist's role as drug information consultant, and the consequence of this is a high degree of compliance with pharmacists' recommendations. PMID- 3652938 TI - Control of hyperaldosteronism by ketoconazole. PMID- 3652939 TI - Lidocaine serum concentrations following endoscopy. PMID- 3652941 TI - Drug information needs. PMID- 3652940 TI - Minoxidil-associated pericardial effusion. PMID- 3652942 TI - Alprazolam withdrawal. PMID- 3652943 TI - Theophylline activity in late asthmatic response. PMID- 3652944 TI - Tobramycin pharmacokinetics in cystic fibrosis. PMID- 3652945 TI - Guar gum: of help to diabetics? PMID- 3652946 TI - [HIV infection and pregnancy: consequences for mother and child]. PMID- 3652947 TI - [Avoidable risks in the drug treatment of very old patients]. AB - Among 196 patients with a mean age of 80 years there were, at the time of hospitalization, 12.2% who had been prescribed wrong or partly even high-risk medication drugs, some of which carried a high risk. Among 694 prescriptions 4.2% were faulty. The faults consisted of failure to take account of impaired renal function, contraindications, accompanying illnesses, and misinterpretation of side-effects. 80% of these prescriptions were for diuretics, psychoactive and antiarrhythmic drugs, digitalis and hypnotics. The number of faulty prescriptions on discharge was 1.4%. In all, the average number of prescribed drugs had decreased from 3.5 on admission to 2.9 on discharge. This retrospective study demonstrates that the manner of prescribing for elderly patients needs to be handled more critically and rationally. PMID- 3652948 TI - [Neuroendocrine effects on one's awareness of the action of the heart]. AB - Heart rate under mental and physical stress and the incidence of cardiac arrhythmias (by 24-hour ECG monitoring) as well as their awareness of these two types of cardiac activity were analysed in 11 insulin-dependent diabetics (manifestation before the age of 40 years) with autonomic neuropathy, five patients with hyperthyroidism and 13 healthy subjects. In hyperthyroidism the heart rate was increased as was the incidence of ventricular premature systoles; spontaneous variations and exercise-induced adaptation in heart rate were preserved. In diabetic neuropathy spontaneous heart-rate variations were absent, but adaptation reactions to mental and physical stress were normal. Patients of both groups had an impaired awareness of normal and arrhythmic cardiac activity. Lack of vagal inhibition in diabetic neuropathy and noradrenergic activation in hyperthyroidism may be the respective causative factors in the described disorders of regulation and awareness. PMID- 3652949 TI - [First laser irradiation of a bile duct carcinoma under endoscopic control]. AB - For the first time a hepatic-duct carcinoma was treated palliatively with percutaneous endoscopic Neodym-YAG laser irradiation. This enlarged the lumen of the bile duct encased by tumour. The method can be combined with prosthetic as well as radiotherapeutic procedures. The equipment consists of an ordinary choledochoscope and a laser apparatus. The choledochoscope merely needs minimal technical modification of the outer valve of its working channel. Biopsies under endoscopic control make it possible to obtain tissue samples adequate for histological examination before treatment is begun. PMID- 3652950 TI - [Is cardiac involvement found also in European erythema migrans borreliosis?]. AB - During an infection with Borrelia burgdorferi two men (aged 59 and 61 years, respectively) developed long-lasting cardiac arrhythmias which proved difficult to treat (tachycardias; in one patient due to atrial fibrillation, and also nodal arrhythmias). The cardiac signs completely regressed after specific antibiotic treatment, supporting the view that the cardiac involvement was due to borrelia infection, as is known to have occurred with Lyme disease reported from the USA. PMID- 3652952 TI - [Cystic kidney]. PMID- 3652953 TI - [Physicians' journals]. PMID- 3652951 TI - [Ergometry in the diagnosis of hypertension]. PMID- 3652954 TI - [Biliary drainage in the rendezvous procedure]. PMID- 3652955 TI - [Kala-azar originating in Ischia]. AB - Four weeks after returning from a holiday on Ischia, a 53-year-old man fell ill with nocturnal sweating, fever, severe general malaise and hepatosplenomegaly. Sternal marrow and liver punctures revealed an infection with Leishmania donovani, i.e. Kala-Azar. Characteristic features were hyperplasia of the plasma cells in the bone marrow and liver, together with lymphoplasmocytoid cell wash out and polyclonal IgG proteinaemia. Treatment with pentamidine (Lomidine) was unsatisfactory, while all manifestations of the disease regressed after two courses of sodium stibogluconate (Pentostam), although the hypergammaglobulinaemia and hyperproteinaemia disappeared only slowly. The plasma cell hyperplasia in conjunction with the hypergammaglobulinaemia, which suggest multiple myeloma, is interpreted as a result of antibody formation by the chronic parasitic infection. Together with storage-cell hyperplasia it is also taken to be the cause of the peripheral leukopenia and thrombocytopenia. PMID- 3652956 TI - [Diagnosis and pathophysiology of sleep apnea syndrome]. PMID- 3652957 TI - [Recommendations on the diagnosis of respiratory allergy in practice. German League for the Prevention of Respiratory Diseases]. PMID- 3652958 TI - [Coagulation level in sclerosing treatment of esophageal varices]. PMID- 3652959 TI - [HIV and Kaposi's sarcoma]. PMID- 3652960 TI - [Hypertension and sports]. PMID- 3652961 TI - Nature and distribution of the morphogen DIF in the Dictyostelium slug. AB - The Dictyostelium slug contains a simple anterior-posterior pattern of prestalk and prespore cells. It is likely that DIF, the morphogen which induces stalk cells, is involved in establishing this pattern. Previous work has shown that a number of distinct species of DIF are released by developing cells and that cell associated DIF activity increases rapidly during the slug stage of development. In this paper we describe a comparison of the DIF extracted from slugs with the DIF released into the medium. Analysis by high-pressure liquid chromatography (HPLC) using different solvent systems shows that the major species of DIF activity extracted from slugs coelutes with DIF-1, the major species of released DIF and is similarly sensitive to sodium borohydride reduction. Since DIF specifically induces the differentiation of prestalk cells, the anterior cells of the slug, it could be anticipated that DIF is localized in the prestalk region. We have therefore determined the distribution of DIF within the slug. Migrating slugs from strain V12M2 were manually dissected into anterior one-third and posterior two-third fragments and the DIF activity extracted. Surprisingly, we found that DIF was not restricted to the prestalk fragment. Instead there appears to be a reverse gradient of DIF in the slug with at least twice the specific activity of total DIF in the prespore region than in the prestalk region. PMID- 3652962 TI - The establishment of the embryonic-abembryonic axis in the mouse embryo. AB - The influence of cell division order on the establishment of the embryonic abembryonic axis (EA axis) of the mouse embryo was investigated. Aggregate embryos were constructed in which a labelled cell (or pair of cells) was combined with a group of unlabelled cells all of which were up to one cell cycle earlier or later in their progress through development to the blastocyst stage. The aggregates were cultured first to the nascent blastocyst stage and then to the expanded blastocyst stage. The positions of the progeny of the labelled cells in relation to the nascent blastocoel and to the orientation of the embryonic abembryonic axis were recorded. It was concluded that cell division order does influence the establishment of the EA axis, early dividing cells tending to be associated with the nascent blastocoel and the site of the nascent blastocoel tending to mark the site of the abembryonic pole. However, the influence of division order was diminished by a requirement for intercellular cooperation during blastocoel formation and by a counteracting influence of division order arising from its effects on the allocation of cells to the inner cell mass. PMID- 3652963 TI - The morphogenesis of the chick primary corneal stroma. I. New observations on collagen organization in vivo help explain stromal deposition and growth. AB - The primary stroma of the avian cornea contains collagen fibrils in orthogonal array. While investigating the processes underlying its morphogenesis, we have found that stromal organization is not as expected in three important respects. First, the fibrils are not uniform: those near the epithelium (newly laid down) have a maximum diameter of about 20 nm (mean: 17.7 nm), while those near the endothelium (laid down for approx. 40 h) have diameters up to 40 nm (mean: 22.8 nm). Fibrils thus grow rapidly to 20 nm and then continue to enlarge slowly, presumably by diffusion of collagen molecules from the epithelium. Second, the collagen, although orthogonally organized, does not contain layers of parallel fibrils. Instead, SEM observation shows that only a few fibrils lie in a parallel array before this short-range order is broken by orthogonal fibrils in the same plane. Furthermore, fibrils in corneas that had been freeze dried but not critical-point dried for SEM were widely spaced and the intervening gaps were filled by an extensive matrix that was probably composed of the proteoglycans known to be in the stroma. Third, we have shown experimentally that the stromal undulations seen in sections are not present in vivo but are shrinkage artifacts: the less corneas were shrunk for SEM preparation, the less pronounced were the stromal undulations. We also noted that, even after the distortions required for the stroma to undulate, the constituent fibrils remained orthogonally organized. These results give insight into the mechanisms underlying stromal morphogenesis and growth. The observations on the growth of collagen fibrils and on collagen organization show that stromal deposition is a more stochastic process than previously thought and, hence, provides support for the view that a complex self assembly mechanism underlies both fibrillogenesis and the generation of orthogonal organization. The experiments on, and the analysis of, stromal folding show that fibrils slide over one another as undulations form, with the extensive matrix of hydrated proteoglycans being the likely lubricant. This fluidity of the stromal components probably explains how growth can occur without the structure being distorted. PMID- 3652964 TI - Experimental analysis of the extension of the dorsal marginal zone in Pleurodeles waltl gastrulae. AB - The capacity for extension of the dorsal marginal zone (DMZ) in Pleurodeles waltl gastrulae was studied by scanning electron microscopy and grafting experiments. At the onset of gastrulation, the cells of the animal pole (AP) undergo important changes in shape and form a single layer. As gastrulation proceeds, the arrangement of cells also changes in the noninvoluted DMZ: radial intercalation leads to a single layer of cells. Grafting experiments involving either AP or DMZ explants were performed using a cell lineage tracer. When rotated 90 degrees or 180 degrees, grafted DMZ explants were able to involute normally and there was extension according to the animal-vegetal axis of the host. In contrast, neither single nor bilayered explants from AP involutes completely, and neither extends when grafted in place of the DMZ. Furthermore, when inside of the host, these AP grafts curl up and inhibit the closure of the blastopore. Once transplanted to the AP region, the DMZ showed no obvious autonomous extension. DMZs cultured in vitro showed little extension and this only from the late gastrula stage onward. Removal of blastocoel roof blocked involution to a varied extent, depending on the developmental stage of the embryos. From these results, it is argued that differences could well exist in the mechanism of gastrulation between anuran and urodele embryos. That migrating mesodermal cells play a major role in urodele gastrulation is discussed. PMID- 3652965 TI - Cell polarity during wound healing in an insect epidermis. AB - The insect integument displays uniform posterior orientation of cuticular denticles or bristles formed by the epidermal cells. We want to understand how cell polarities become uniformly oriented in the plane of the epidermal sheet. Here we test whether directed cell migration disturbs the orientation of denticles. Burning a circular area of epidermal cells beneath the cuticle causes cells to migrate into the resulting wound and the cuticle pattern observed after the subsequent moult depends on the time interval between burning and ecdysis. After a short wound-healing period cuticular protrusions tend to point away from the wound. With increasing would healing periods they tend to point more and more towards the wound centre. These results suggest that the migrating cells tend to orient cuticular protrusions in the direction of cell movement while continued cell movement will bend nascent cuticular protrusions outwards. Cell shape may also determine denticle orientation. I propose that the asymmetric localization of cell components known to determine the orientation of cell migration may also determine denticle orientation in insect epidermal cells. PMID- 3652966 TI - Spinal neurite reabsorption and regrowth in vitro depend on the polarity of an applied electric field. AB - Retraction and regrowth of frog neural tube neurites have been studied in vitro in control cultures and in the presence of a small, continuously applied electrical field. In control cultures, some degree of retraction was seen in 39% of neurites while 7% were reabsorbed completely. Reabsorption of anodal-facing neurites was at least twice as common, with 67% showing some retraction and 17% almost totally reabsorbed. Cathodal-facing neurites were spared from retraction. Following extreme reabsorption of anodal-facing neurites, reversal of the electric field promoted regeneration in 47% (9/19) of cases studied. growth cone morphology also was determined by the polarity of the applied field. Anodal facing growth cones had fewer filopodia than cathodal-facing growth cones sharing the same cell body. Field reversal induced a polarity-specific change in filopodia number on individual growth cones: a shift from anodal to cathodal increased filopodia numbers and vice versa. Some possible mechanisms involved and the significance of these results are discussed. PMID- 3652967 TI - Purified bovine AMH induces a characteristic freemartin effect in fetal rat prospective ovaries exposed to it in vitro. AB - To determine whether anti-Mullerian hormone (AMH) is responsible for the gonadal lesions observed in bovine genetic females united by placental anastomoses to male twins (freemartins), prospective ovaries of fetal rats were exposed to purified bovine AMH in vitro. In cultures initiated at 14 days p.c. and maintained 3 to 10 days, AMH consistently induced a characteristic 'freemartin effect', namely reduction of gonadal volume, germ cell depletion and differentiation, in the gonadal blastema, of epithelial cells with large clear cytoplasm linked by interdigitations, resembling rat fetal Sertoli cells. These cells tend to become polarized and form cords, delineated by a continuous basal membrane containing laminin and fibronectin. Such structures, resembling developing seminiferous cords, were not detected in control ovarian cultures. These data strongly suggest that AMH is the testicular factor responsible for triggering the morphological abnormalities of freemartin gonads. PMID- 3652968 TI - Identity of cells containing apolipoprotein B messenger RNA, in 6- to 12-week postfertilization human embryos. AB - Apolipoprotein B (Apo B) mRNA has been localized by in situ hybridization to various cell types in the liver, gut and yolk sack of the 6- to 12-week postfertilization human conceptus. In the fetal liver it is probable that the immature hepatocytes contain Apo B mRNA. In the yolk sack, the Apo B cDNA probe hybridizes mainly to the large endodermal cells and in the fetal gut the epithelium seems responsible for the majority of Apo B mRNA production. The fetal brain did not show any detectable hybridization to the Apo B probe. Unlike the situation seen in the adult, immunoprecipitation experiments demonstrated that only the B100 form of the protein was synthesized and secreted by the liver, gut and yolk sack at this early stage of human development. PMID- 3652969 TI - An analysis of cell shape and the neuroepithelial basal lamina during optic vesicle formation in the mouse embryo. AB - The optic vesicle develops as an evagination of the cephalic neural folds. We have examined the early development of the optic vesicle in Swiss Webster mice using correlated transmission electron microscopy (TEM), scanning electron microscopy (SEM), light microscopic (LM) measurements of cell shape changes, immunohistochemical localization of basal lamina (BL) components (type IV collagen, laminin and heparan sulphate proteoglycan (HSPG)) and ultrastructural analysis of the BL. Like the neuroepithelium in other regions, the low columnar cells of the neural plate in the future optic vesicle region become high columnar, then wedge shaped following constriction of the cell apices to form the C-shaped vesicle. In this region, the cells elongate 2 times their initial height before the neural tube closes, then shorten 20% as the vesicle is completed. Cell apices decrease in width by about one half during vesicle formation. Deposition of BL components was initially even, with type IV collagen and laminin reduced in deposition in regions of outpouching. At later stages the linear, even distribution of all four components was re-established. Ultrastructural analysis confirmed the BL discontinuity and re-establishment and correlated the observed cell shaping alterations with apparent increases in the number of microtubules (during elongation) and microfilaments (during apical constriction). The number of apical intercellular junctions also appeared to increase in number during optic vesicle formation, possibly providing stability and coordination to the evagination process. PMID- 3652970 TI - Determinative properties of muscle lineages in ascidian embryos. AB - Blastomeres removed from early cleavage stage ascidian embryos and reared to 'maturity' as partial embryos often elaborate tissue-specific features typical of their constituent cell lineages. We used this property to study recent corrections of the ascidian larval muscle lineage and to compare the ways in which different lineages give rise to muscle. Our evaluation of muscle differentiation was based on histochemical localization and quantitative radiometric measurement of a muscle-specific acetylcholinesterase activity, and the development of myofilaments and myofibrils as observed by electron microscopy. Although the posterior-vegetal blastomeres (B4.1 pair) of the 8-cell embryo have long been believed to be the sole precursors of larval muscle, recent studies using horseradish peroxidase to mark cell lineages have shown that small numbers of muscle cells originate from the anterior-vegetal (A4.1) and posterior animal (b4.2) blastomeres of this stage. Fully differentiated muscle expression in isolated partial embryos of A4.1-derived cells requires an association with cells from other lineages whereas muscle from B4.1 blastomeres develops autonomously. Clear differences also occurred in the time acetylcholinesterase activity was first detected in partial embryos from these two sources. Isolated b4.2 cells failed to show any muscle development even in combination with anterior-animal cells (a4.2) and are presumably even more dependent on normal cell interactions and associations. Others have noted an additional distinction between the different sources of muscle: muscle cells from non-B4.1 lineages occur exclusively in the distal part of the tail, while the B4.1 descendants contribute those cells in the proximal and middle regions. During the course of ascidian larval evolution tail muscle probably had two origins: the primary lineage (B4.1) whose fate was set rigidly at early cleavage stages and secondarily evolved lineages which arose later by recruitment of cells from other tissues resulting in increased tail length. In contrast to the B4.1 lineage, muscle development in the secondary lineages is controlled less rigidly by processes that depend on cell interactions. PMID- 3652971 TI - Regional specification within the mesoderm of early embryos of Xenopus laevis. AB - We have further analysed the roles of mesoderm induction and dorsalization in the formation of a regionally specified mesoderm in early embryos of Xenopus laevis. First, we have examined the regional specificity of mesoderm induction by isolating single blastomeres from the vegetalmost tier of the 32-cell embryo and combining each with a lineage-labelled (FDA) animal blastomere tier. Whereas dorsovegetal (D1) blastomeres induce 'dorsal-type' mesoderm (notochord and muscle), laterovegetal and ventrovegetal blastomeres (D2-4) induce either 'intermediate-type' (muscle, mesothelium, mesenchyme and blood) or 'ventral-type' (mesothelium, mesenchyme and blood) mesoderm. No significant difference in inductive specificity between blastomeres D2, 3 and 4 could be detected. We also show that laterovegetal and ventrovegetal blastomeres from early cleavage stages can have a dorsal inductive potency partially activated by operative procedures, resulting in the induction of intermediate-type mesoderm. Second, we have determined the state of specification of ventral blastomeres by isolating and culturing them in vitro between the 4-cell stage and the early gastrula stage. The majority of isolates from the ventral half of the embryo gave extreme ventral types of differentiation at all stages tested. Although a minority of cases formed intermediate-type and dorsal-type mesoderms we believe these to result from either errors in our assessment of the prospective DV axis or from an enhancement, provoked by microsurgery, of some dorsal inductive specificity. The results of induction and isolation experiments suggest that only two states of specification exist in the mesoderm of the pregastrula embryo, a dorsal type and a ventral type. Finally we have made a comprehensive series of combinations between different regions of the marginal zone using FDA to distinguish the components. We show that, in combination with dorsal-type mesoderm, ventral-type mesoderm becomes dorsalized to the level of intermediate-type mesoderm. Dorsal type mesoderm is not ventralized in these combinations. Dorsalizing activity is confined to a restricted sector of the dorsal marginal zone, it is wider than the prospective notochord and seems to be graded from a high point at the dorsal midline. The results of these experiments strengthen the case for the three signal model proposed previously, i.e. dorsal and ventral mesoderm inductions followed by dorsalization, as the simplest explanation capable of accounting for regional specification within the mesoderm of early Xenopus embryos. PMID- 3652972 TI - The growth rate of sensory nerve fibres in the mammalian embryo. AB - I have used a novel quantitative electron microscopic method to determine the rate at which nerve fibres grow towards their targets during development. The rate of recruitment of nerve fibres to the maxillary nerve of the mouse embryo was determined by counting the number of axon profiles in the nerve sectioned close to its emergence from the trigeminal ganglion at closely staged intervals throughout its early development. The rate of change of fibre number with distance along this nerve was determined by counting the number of axon profiles at intervals along the nerve at stages during the period that fibres are growing to their targets. From these two parameters, both of which were linear functions during the midperiod of fibre recruitment to the nerve, it has been possible to calculate that embryonic sensory nerve fibres grow to their peripheral targets at the surprisingly slow rate of just over 20 micron h-1. PMID- 3652973 TI - The effect of dimethylsulphoxide on the microtubular system of the mouse oocyte. AB - The effect of dimethylsulphoxide (DMSO) on the organization of the microtubular system of the mouse oocyte has been examined. Exposure to DMSO causes the immediate appearance of multiple, cold-resistant microtubular asters associated with the foci of pericentriolar material (PCM) normally present in the oocyte. More prolonged exposure to DMSO leads to progressive disassembly of the spindle, and as a result dispersal of the chromosomes and polar PCM foci occurs, and tubulin polymerization becomes confined to PCM-organized asters. Those astral microtubules located between the PCM foci and the cortex of the oocyte appear to be particularly stable, resulting in the development of lengthening radial bundles of microtubules between the PCM and the surface and the progressive movement of the PCM foci towards the centre of the cell. In contrast, after activation of the oocyte the microtubules generated in the presence of DMSO remain located in a cortical mesh. The effects of DMSO do not appear to be fully reversible in most oocytes. We discuss the implications of these results both for the cytoplasmic organization of the oocyte and zygote, and for the attempts at cryopreservation of human oocytes for therapeutic use in infertility programmes. PMID- 3652975 TI - Positional signalling and the development of the humerus in the chick limb bud. AB - The positional signal model for specification of the cartilaginous elements in limb development has been tested by examining the effect on the humerus of grafting a polarizing region to different positions along the anteroposterior axis of the limb bud at stage 16. The humerus between the host and grafted polarizing region was largely normal though there were variations in width, particularly the distal epiphysis. The humerus often showed mirror-image symmetry along the anteroposterior axis. When the grafted polarizing region was in a very anterior position, there were a few cases where a second humerus developed. Anterior to the graft an additional humerus often developed. This was associated with the splitting of the bud into two domains. It is suggested that these results are not consistent with a positional signal model and that an additional mechanism involving an isomorphic prepattern may be involved in the specification of the cartilaginous elements. PMID- 3652974 TI - When and how does cell division order influence cell allocation to the inner cell mass of the mouse blastocyst? AB - Aggregate 8-cell embryos were constructed from four 2/8 pairs of blastomeres, one of which was marked with a short-term cell lineage marker and was also either 4 h older (derived from an early-dividing 4-cell) or 4 h younger (derived from a late dividing 4-cell) than the other three pairs. The aggregate embryos were cultured to the 16-cell stage, at which time a second marker was used to label the outside cell population. The embryos were then disaggregated and each cell was examined to determine its labelling pattern. From this analysis, we calculated the relative contributions to the inside cell population of the 16-cell embryo of older and younger cells. Older cells were found to contribute preferentially. However, if the construction of the aggregate 8-cell embryo was delayed until each of the contributing 2/8 cell pairs had undergone intercellular flattening and then had been exposed to medium low in calcium to reverse this flattening immediately prior to aggregation, the advantage possessed by the older cells was lost. These results support the suggestion that older cells derived from early dividing 4-cell blastomeres contribute preferentially to the inner cell mass as a result of being early-flattening cells. PMID- 3652976 TI - Formation of primary and secondary myotubes in rat lumbrical muscles. AB - Numbers of myoblasts, primary myotubes and secondary myotubes in developing rat embryo hindlimb IVth lumbrical muscles were counted at daily intervals up until the time of birth, using electron microscopy. Motoneurone death at the spinal cord level supplying the lumbricals was assessed by counting axons in the 4th lumbar ventral root. Death of the motoneurones that supply the intrinsic muscles of the hindfoot was monitored by comparing the timecourse of development of total muscle choline acetyltransferase activity in control embryos with that in embryos where motoneurone death was inhibited by chronic paralysis with TTX, and by counting axons in the mixed nerve trunks at the level of the ankle at daily intervals. Condensations of undifferentiated cells marking the site of formation of the muscle were seen on embryonic day 15 (E15). Primary myotubes began to appear on E16 and reached a stable number (102 +/- 4) by E17. Secondary myotubes first appeared two days later, on E19, and numbered 280 at the time of birth (E22). The adult total of about 1000 muscle fibres, derived from both primary and secondary myotubes, was reached at postnatal day 7 (PN7) so considerable generation of secondary myotubes occurred after birth. There was a linear correlation between the number of undifferentiated mononucleate cells in a muscle and the rate of formation of secondary myotubes. The major period of motoneurone death in lumbar spinal cord was during E16-E17, when axon numbers in the L4 ventral root fell from 12,000 to 4000, but a discontinuity in the curve of muscle ChAT activity versus time indicated that death in the lumbrical motor pool occurred during E17-E19, after all primary myotubes had formed and before generation of secondary myotubes began. We suggest that motoneurone death, by regulating the final size of the motoneurone pool, regulates the ratio of secondary to primary myotube numbers in a muscle. PMID- 3652977 TI - Neural determination of muscle fibre numbers in embryonic rat lumbrical muscles. AB - The generation and development of muscle cells in the IVth hindlimb lumbrical muscle of the rat was studied following total or partial denervation. Denervation was carried out by injection of beta-bungarotoxin (beta-BTX), a neurotoxin which binds to and destroys peripheral nerves. Primary myotubes were generated in denervated muscles and reached their normal stable number on embryonic day 17 (E17). This number was not maintained and denervated muscles examined on E19 or E21 contained many degenerating primary myotubes. Embryos injected with beta bungarotoxin (beta-BTX) on E12 or E13 suffered a partial loss of motoneurones, resulting in a reduced number of axons in the L4 ventral root (the IVth lumbrical muscle is supplied by axons in L4, L5 and L6 ventral roots) and reduced numbers of nerve terminals in the intrinsic muscles of the hindfoot. Twitch tension measurements showed that all myotubes in partly innervated muscles examined on E21 contracted in response to nerve stimulation. Primary myotubes were formed and maintained at normal numbers in muscles with innervation reduced throughout development, but a diminished number of secondary myotubes formed by E21. The latter was correlated with a reduction in number of mononucleate cells within the muscles. If beta-BTX was injected on E18 to denervate muscles after primary myotube formation was complete, E21 embryo muscles contained degenerating primary myotubes. After injection to denervate muscles on E19, the day secondary myotubes begin to form, E21 muscles possessed normal numbers of primary myotubes. In both cases, secondary myotube formation had stopped about 1 day after the injection and the number of mononucleate cells was greatly reduced, indicating that cessation of secondary myotube generation was most probably due to exhaustion of the supply of competent myoblasts. We conclude that nerve terminals regulate the number of secondary myotubes by stimulating mitosis in a nerve-dependent population of myoblasts and that activation of these myoblasts requires the physical presence of nerve terminals as well as activation of contraction in primary myotubes. PMID- 3652978 TI - The formation of the area centralis of the retinal ganglion cell layer in the chick. AB - In adult domestic chickens, the neurones in the retinal ganglion cell layer are very unevenly disposed such that there is a sixfold increase in neurone density from the retinal edge to the retinal centre. The formation of the high ganglion cell-density area centralis was studied on chick retinal wholemounts from the 8th day of incubation (E8) to 4 weeks after hatching (4WAH). The density of viable neurones and the number and the distribution of pyknotic neurones in the ganglion cell layer were estimated across the whole retina. Between E8 and E10, the distribution of neurones in the ganglion cell layer was anisodensitic with 53,000 mm-2 in the centre compared to 34,000 mm-2 in the periphery of the retina. Thereafter, a progressively steeper gradient of neurone density developed, which decreased from 24,000 mm-2 in the retinal centre to 6000 mm-2 at the retinal periphery by 4WAH. Neuronal pyknosis in the ganglion cell layer was observed between E9 and E17. From E11 onwards, consistently more pyknotic neurones were found in the peripheral than in the central retina. It was estimated that over the period of cell death approximately twice as many neurones died per unit area in the retinal periphery than in the centre. Retinal area measurements and estimation of neurone densities in the ganglion cell layer after the period of neurone generation and neurone death indicated differential retinal expansion, with more expansion in the peripheral than in the central retina. These observations allow us to conclude that the formation of the area centralis of the chick retina involves (1) slightly higher cell generation in the retinal centre, (2) higher rate of cell loss in the retinal periphery and (3) differential retinal expansion. PMID- 3652979 TI - In vitro analysis of glucose metabolism and embryonic growth in postimplantation rat embryos. AB - The glucose metabolism and embryonic development of rat embryos during organogenesis was studied using embryo culture. Glucose uptake and embryonic growth and differentiation of 10.5-day explants (embryos + membranes) were limited by the decreasing glucose concentration, but not the increasing concentration of metabolites, in the culture media during the second 24 h of a 48 h culture. No such limitations were found on the embryonic development of 9.5-day explants during a 48 h culture although glucose uptake was slightly reduced at very low concentrations of glucose. From the head-fold stage to the 25-somite stage of development, glucose uptake was characteristic of the stage of development of the embryo and not the time it had been in culture. Embryonic growth of 9.5-day explants was similar to that previously observed in vivo. Glucose uptake by 9.5-day explants was dependent on the surface area of the yolk sac and was independent of the glucose concentration in the culture media (within the range of 9.4 to 2.5 mM). The proportion of glucose converted to lactate was 100% during the first 42h of culture then fell to about 50% during the final 6h. The protein contents of both the extraembryonic membranes and the embryo were dependent on the glucose uptake. PMID- 3652980 TI - Cytogenetic analysis of first cleavage fertilized mouse eggs following in vivo exposure to ethanol shortly before and at the time of conception. AB - In this study, the chromosome constitution of mouse eggs exposed in vivo to a dilute solution of ethanol during specific stages of the first and second meiotic divisions was determined at the first cleavage mitosis. Exposure to ethanol prior to the completion of the second meiotic division induced an incidence (7-10%) of aneuploidy involving only one chromosome in 98% of malsegregation events. This investigation provides indirect evidence that ethanol may induce aneuploidy by disrupting the functioning of the meiotic spindle. Karyological analyses of chromosome spreads prepared at the first cleavage metaphase suggest that only a small proportion of the total chromosome complement may be induced to undergo malsegregation. PMID- 3652981 TI - Metallothionein gene regulation in the preimplantation rabbit blastocyst. AB - Expression of metallothionein (MT) genes in the preimplantation rabbit blastocyst was analysed by determination of the levels of MT mRNA and relative rates of MT synthesis. MT was found to be constitutively expressed at low levels in the blastocyst. Exposure of the day-6 blastocyst to zinc ions in vitro rapidly increased the level of MT gene expression in a dose-dependent manner, with a ten fold induction in the relative rate of synthesis at 400 microM-Zn2+. Ion-exchange chromatography of pulse-labelled blastocyst protein showed that the relative rates of synthesis of both MT-I and MT-II were markedly increased following zinc treatment, with MT-I being the predominant isometallothionein. Zinc induction of MT synthesis in the blastocyst was also detected on day 4 of gestation just after the morula-to-blastocyst transition. In contrast to the zinc effects on MT, in vitro exposure to 10 microM-Cd2+ resulted in a large induction of MT mRNA but only a modest increase in the relative rate of MT synthesis. Cadmium was found to be toxic to the day-6 blastocyst, and 10 microM-Cd2+ induced an acute stress response as indicated by a dramatic induction of heat-shock protein (HSP-70) gene expression. PMID- 3652982 TI - The pattern of innervation in serially duplicated axolotl limbs: further evidence for the existence of local pathway cues? AB - The innervation of the biceps muscle was examined in regenerated and vitamin A induced serially duplicated axolotl forelimbs using retrograde transport of horseradish peroxidase. The regenerated biceps muscle becomes innervated by motor neurones in the same position in the spinal cord as the normal biceps motor pool. In previous experiments in which the innervation of a second copy of a proximal limb muscle was examined in serially duplicated limbs (Stephens, Holder & Maden, 1985), the duplicate muscle was found to become innervated by motor neurones that would normally have innervated distal muscles. In the present study, the innervation of the second copy of biceps was examined under conditions designed to encourage nerve sprouting from 'correct' biceps axons. Following either partial limb denervation or denervation coupled with removal of the proximal biceps, the second copy of the muscle was still innervated by inappropriate motor neurones, which again would normally innervate distal limb muscles. These results are interpreted as evidence for the necessity for an appropriate local environment for axonal growth to allow reformation of a correct pattern of motor innervation in the regenerated limb. PMID- 3652983 TI - Mode of action of ammonia and amine on rRNA synthesis in Xenopus laevis embryonic cells. AB - Recently, we found that rRNA synthesis in dissociated embryonic cells of Xenopus laevis is selectively inhibited by ammonium salts added to their surrounding medium. Similar effects were also observed in cells treated with amines. In this report, we analysed in more detail the effects of an ammonium salt and trimethylamine on rRNA synthesis in Xenopus embryonic cells cultured under several different conditions. Results obtained showed that ammonia and trimethylamine inhibit formation of 40S pre-rRNA, without inducing breakdown (wastage) or aberrant processing of the 40S pre-rRNA. Such inhibitory effects were also shown not to be due to interference with cellular ATP level. Furthermore, we found that the effects of both ammonium salt and trimethylamine were completely abolished when Na+ in the culture medium of the testing cells was replaced by choline ions. These results favour the view that the inhibition of rRNA synthesis by ammonia and amine is realized at the transcriptional level or at the step before the formation of 40S pre-rRNA, most probably via a slight increase of intracellular pH, but not via an inhibition in energy-generating systems. PMID- 3652984 TI - The differing effects of occipital and trunk somites on neural development in the chick embryo. AB - In all higher vertebrate embryos the sensory ganglia of the trunk develop adjacent to the neural tube, in the cranial halves of the somite-derived sclerotomes. It has been known for many years that ganglia do not develop in the most cranial (occipital) sclerotomes, caudal to the first somite. Here we have investigated whether this is due to craniocaudal variation in the neural tube or crest, or to an unusual property of the sclerotomes at occipital levels. Using the monoclonal antibody HNK-1 as a marker for neural crest cells in the chick embryo, we find that the crest does enter the cranial halves of the occipital sclerotomes. Furthermore, staining with zinc iodide/osmium tetroxide shows that some of these crest-derived cells sprout axons within these sclerotomes. By stage 23, however, no dorsal root ganglia are present within the five occipital sclerotomes, as assessed both by haematoxylin/eosin and zinc iodide/osmium tetroxide staining. Moreover, despite this loss of sensory cells, motor axons grow out in these segments, many of them later fasciculating to form the hypoglossal nerve. The sclerotomes remain visible until stages 27/28, when they dissociate to form the base of the skull and the atlas and axis vertebrae. After grafting occipital neural tube from quail donor embryos in place of trunk neural tube in host chick embryos, quail-derived ganglia do develop in the trunk sclerotomes. This shows that the failure of occipital ganglion development is not the result of some fixed local property of the neural crest or neural tube at occipital levels. We therefore suggest that in the chick embryo the cranial halves of the five occipital sclerotomes lack factors essential for normal sensory ganglion development, and that these factors are correspondingly present in all the more caudal sclerotomes. PMID- 3652986 TI - Ventral duplication of the autopod: chemical induction by methoxyacetic acid in rat embryos. AB - Administration of 2-methoxyethanol to pregnant rats on day 12 of gestation induced ventral duplication of the autopod, presumably via its oxidative metabolite, methoxyacetic acid. Morphological observations indicate that the limb bud periderm is severely damaged by methoxyacetic acid so that large patches of this structure are actually missing during an extended period of limb bud development. A high concentration of methoxyacetic acid (10 mM) was found in the extraembryonic fluid and we postulate that the damage to the periderm was initiated from this extraembryonic exposure. The ventral duplication of the autopod is thought to arise through an attempt by the embryo to repair the periderm lesion. PMID- 3652985 TI - The formation of mesodermal tissues in the mouse embryo during gastrulation and early organogenesis. AB - Orthotopic grafts of [3H]thymidine-labelled cells have been used to demonstrate differences in the normal fate of tissue located adjacent to and in different regions of the primitive streak of 8th day mouse embryos developing in vitro. The posterior streak produces predominantly extraembryonic mesoderm, while the middle portion gives rise to lateral mesoderm and the anterior region generates mostly paraxial mesoderm, gut and notochord. Embryonic ectoderm adjacent to the anterior part of the streak contributes mainly to paraxial mesoderm and neurectoderm. This pattern of colonization is similar to the fate map constructed in primitive streak-stage chick embryos. Similar grafts between early-somite-stage (9th day) embryos have established that the older primitive streak continues to generate embryonic mesoderm and endoderm, but ceases to make a substantial contribution to extraembryonic mesoderm. Orthotopic grafts and specific labelling of ectodermal cells with wheat germ agglutinin conjugated to colloidal gold (WGA-Au) have been used to analyse the recruitment of cells into the paraxial mesoderm of 8th and 9th day embryos. The continuous addition of primitive-streak-derived cells to the paraxial mesoderm is confirmed and the distribution of labelled cells along the craniocaudal sequence of somites is consistent with some cell mixing occurring within the presomitic mesoderm. PMID- 3652987 TI - Changes in ploidy level of epidermal cells during last larval instar of the tobacco hornworm, Manduca sexta. AB - The relative DNA content of Manduca sexta abdominal epidermal nuclei during the final larval instar was measured by cytophotometry of whole-mount preparations of the epidermis. In the middle intrasegmental region, epidermal cells showed a ploidy level of 4C to 32C on the day of ecdysis. During the subsequent period of feeding, the proportion of higher ploidy cells, such as 16C and 32C, increased. This situation remained until the day of apolysis preceding pupal cuticle formation when mitoses reduced the cells to 2C, 4C, 8C and 16C, except for the pupal pock-mark cells, which increased to 32C or 64C. Metaphase cells showed various ploidy levels, correlated with the size of their mitotic figures. By contrast, in the anterior and posterior margin of a segment where no mitoses occurred, the cells continued to increase in ploidy throughout the instar. PMID- 3652988 TI - Factors modulating mouse lens epithelial cell morphology with differentiation and development of a lentoid structure in vitro. AB - The morphological and cellular changes that occur with differentiation and development of a lentoid structure from cultured mouse lens epithelial cells have been found to be dependent on the presence of lens capsule in association with the cells. The development of the 'lentoid body' is a multiphase process involving cell replication, synthesis of mucosubstances and a basement collagen membrane, cell aggregation and differentiation. Stage-specific synthesis of lens proteins confirms that the genes regulating normal differentiation in vivo are operating in the in vitro system. The hydrated collagen gel studies described in this report demonstrate that the cuboidal morphology and apical-basal polarity of the lens epithelial cells are dependent on their relationship with the lens capsule. Following a replicative phase the cells assume a mesenchyme-like morphology and migrate into the gel. Trypsinized cells freed from the lens capsule replicate but form colonies on the surface of the gel. The implications of these results are discussed with respect to previous observations made on normal lens development and the abnormalities associated with the congenital cataractous embryonic lens. PMID- 3652990 TI - Brachial muscles of dystrophic chick embryos atypically sustain interaction with thoracic nerves. AB - Previous analyses of experimental chick embryos of normal lineage demonstrate the inability of brachial muscles to sustain a successful union with foreign nerves derived from a thoracic neural tube segment transplanted to the brachial region at day 2 in ovo (day 2E). The present experiments were performed to determine if mutant chick embryos afflicted with hereditary muscular dystrophy would respond similarly to this experimental manipulation. Using the same criteria applied to our analysis of experimental normal embryos, our results demonstrated that dystrophic brachial muscles were capable of maintaining a compatible union with foreign thoracic nerves throughout the experimental period analysed. Significant muscle growth occurred, intramuscular nerve branches were maintained, motor endplates formed and wing motility was equivalent to that of unoperated dystrophic embryos. Thus, foreign nerves rejected by normal brachial muscles were accepted by brachial muscles of the mutant dystrophic embryo. PMID- 3652989 TI - Positional reorganization in compound janus cells of Tetrahymena thermophila. AB - The janus mutations of Tetrahymena thermophila convert the large-scale organization of the dorsal surface of the cell into a mirror-image of the ventral surface, which is characterized by a second, abnormal, oral apparatus and by contractile vacuole pores to the left of the second oral area rather than the usual right. This conversion could be due either to a local change in the response to an unaltered positional system or to a more global reorganization of the system itself. janus homopolar doublets were used to distinguish between these two alternatives. Homopolar doublets can be made by fusing two similarly oriented cells in side-by-side parabiosis. Non-janus homopolar doublets typically possess two sets of normal oral structures with contractile vacuole pores to the right of each of them. In janus doublets, there are up to four sets of oral structures, with the abnormal oral structures located between the two sets of normal oral structures; contractile vacuole pores are situated to the right of the normal oral areas and to the left of the abnormal oral structures. Non-janus homopolar doublets are known to propagate their compound condition for a number of cell divisions, but also to regulate toward the singlet state through a progressive reduction in number of ciliary rows followed by loss of one of the two sets of major cell surface structures. janus homopolar doublets go through a corresponding regulation. As a consequence, the location of the abnormal oral structures relative to the normal ones is more variable in janus doublets than in janus singlets. Sometimes the abnormal oral structures shift to a position close to their normal counterparts and then the intervening CVP sets disappear. There is evidence for occasional fusion of an abnormal oral area with an adjacent normal oral apparatus, a condition that may be transitional to the singlet state. These observations are inconsistent with the idea of a fixed positional system and strongly suggest a global reorganization of the surface pattern in a manner consistent with predictions of an intercalation model that was first proposed to explain the regulation of non-janus doublets to singlets. PMID- 3652991 TI - Formation of pattern in regenerating tissue pieces of Hydra attenuata. IV. Three processes combine to determine the number of tentacles. AB - The tentacles in hydra have characteristics of both spacing patterns and number regulating patterns in that their number under some circumstances changes with the size of the animal and under others does not. To determine which type of processes could yield these results, an extensive analysis was undertaken of the size parameters pertinent to tentacle formation. To do this pieces of tissue, varying in shape and spanning a 30-fold size range, were excised and allowed to regenerate into complete animals. Three separate mechanisms were found to combine which resulted in the final number of tentacles: (1) the spread of the two-part head pattern to produce a competent band of tissue of a given size where the tentacles could form; (2) initiation of tentacle-forming centres by a spacing mechanism and (3) growth of the tentacles to a size proportional to the size of the animal. PMID- 3652992 TI - The effect of the zone of polarizing activity (ZPA) on the anterior half of the chick wing bud. AB - Removal of the posterior half of the chick wing bud between stages 17-22 results in failure of the anterior distal tissue to survive and differentiate. This observation has been interpreted in terms of a requirement by the anterior half of a factor supplied by the posterior half of the limb containing the zone of polarizing activity (ZPA). This relationship has been tested by grafting ZPA tissue to the posterior surface of the anterior half after posterior half removal. Grafts made proximally on the cut surface did not significantly improve survival and development, nor did the ZPA prevent the expansion of the cell death in the ANZ beyond its normal boundaries into the distal mesenchyme. However, when grafted distally the ZPA inhibited cell death in the apical mesenchyme and caused the anterior mesenchyme to change its normal prospective fate (radius and digit 2). In all these cases, in addition to digit 2, digit 3 and frequently also digit 4 differentiated. The anterior half went on to develop a full set of digits and zeugopod parts in almost 50% of cases, although no skeleton resulting from this regulation of the anterior half had totally size regulated. These results demonstrate a developmental 'rescue' effect by the ZPA, and further support the view that the ZPA has a central and unique function in normal limb bud development, controlling survival and differentiation of the mesenchyme along the anteroposterior axis. PMID- 3652993 TI - Cell- and tissue-specific monoclonal antibodies in eggs and embryos of the ascidian Halocynthia roretzi. AB - To obtain specific immunological probes for studying molecular mechanisms involved in the early embryonic development of ascidians, we have produced monoclonal antibodies directed against a homogenate of larvae of the ascidian Halocynthia roretzi. Among these, we have screened monoclonal antibodies that specifically recognize cells and/or tissues of the embryo. Characterization of six epidermis-specific monoclonal antibodies (including larval tunic-specific and larval fin-specific), three muscle-specific antibodies, two endoderm-specific antibodies, one notochord-specific antibody and two monoclonal antibodies that specifically recognize trunk-lateral cells suggests that these monoclonal antibodies may be useful as markers for analysing molecular mechanisms involved in specification of these cells. Seven monoclonal antibodies characteristically stain intercellular materials of the developing embryo and may therefore be valid for studying cellular construction of the embryo. Furthermore, monoclonal antibodies that recognize components of follicle cells, perivitelline space and sperm have also been established. PMID- 3652994 TI - Dorsal root ganglia grafts stimulate regeneration of denervated urodele forelimbs: timing of graft implantation with respect to denervation. AB - Amphibian forelimb regeneration is a nerve-dependent process; nerves presumably release one or more neurotrophic factors that stimulate blastema cell division. To date several candidate molecules/factors have been shown to stimulate macromolecular synthesis and/or mitosis but sustained cell cycle activity and blastema development have not been achieved. Because dorsal root ganglia (DRG) implants are capable of promoting regeneration of denervated adult newt limbs (Kamrin & Singer, 1959), we have evaluated the DRG stimulation of regeneration in denervated limbs of adult newts and larval axolotls; two alternative timing strategies were tested as a step toward defining bioassay parameters that best reflect neurotrophic activity. The frequency of regeneration in denervated adult newt limbs was compared after providing DRG before or at the time of denervation (to maintain neurotrophic and cell cycle activity) versus DRG implantation at various postdenervation times (to resupply neurotrophic activity and restimulate suppressed cell cycle activity). The results show that denervated adult newt limbs regenerated most frequently using the maintenance strategy, but as the denervation interval was extended in the restimulation strategy, the frequency of regeneration declined. Larval axolotl limbs responded positively in both maintenance and restimulation DRG-grafting protocols. These results suggest that the efficacy of DRG stimulation of regeneration in adult newts was related to the relative number of blastema cells present at the time of denervation and the proliferative status of the blastema cells; bioassays with denervated adult newt limbs should be designed with these constraints in mind. Because such constraints are not as problematic with the larval axolotl, this species may provide the best opportunity for further defining bioassay parameters related to the neurotrophic stimulation of regeneration. PMID- 3652995 TI - A probabilistic model of mosaicism based on the histological analysis of chimaeric rat liver. AB - The analysis of pattern development in mosaic and chimaeric animals has provided insight into a number of developmental problems. In order to aid the understanding of the dynamics of the development of mosaic tissues, a computer simulation of the generation of a mosaic tissue was created using simple probabilistic decisions. Results of quantitative analysis of the simulated mosaicism were compared with chimaeric liver. Chimaeric animals were produced by morula aggregation between histologically distinguishable strains of congenic rats. The livers of these animals revealed a pattern of patchy mosaicism unrelated to either acinar or lobular architecture of the organ. Independent quantifiable parameters were correlated and compared between the simulation and chimaeric liver tissue. This analysis showed that extensive cell migration is not required to develop finely variegated mosaic tissue and that the patterns of mosaicism observed could have resulted from tissue development in which as few as three reiterated decisions were required. First, the simulation established anlagen of two cell types of various specified proportions with randomly chosen placement. Second, in each generation of the simulation the order in which the cells divided was established randomly. Third, there was a random choice of the direction of placement of the daughter cell. The quantitative relationships between the proportion of cell types, the area of patches and the number of patches per unit area was consistent between the simulation and the chimaeric tissue. PMID- 3652996 TI - Homarine (N-methylpicolinic acid) and trigonelline (N-methylnicotinic acid) appear to be involved in pattern control in a marine hydroid. AB - A morphogenetically active compound has been isolated from tissue extract of Hydractinia echinata and identified to be N-methylpicolinic acid (homarine). When applied to whole animals, homarine prevents metamorphosis from larval to adult stage and alters the pattern of adult structures. The concentration of homarine in oocytes is about 25 mM. During embryogenesis, metamorphosis and early colony development the overall homarine content does not change. Adult colonies contain a fourfold lower homarine concentration than larvae. The polyp's head contains twofold more homarine than the gastric region and the stolons. A second, similarly active compound, N-methylnicotinic acid (trigonelline), has also been identified in Hydractinia tissue at concentrations about one-third that of homarine. Incubation of larvae in 10 to 20 microM-homarine or trigonelline prevents head as well as stolon formation. If the compounds are applied in a pulse during metamorphosis, a large part of the available tissue forms stolons. Since microM concentrations of homarine and trigonelline are morphogenetically active, whereas mM concentrations are present in the tissue it appears that both substances are stored within the tissue. PMID- 3652997 TI - Reformation of the pattern of neuromuscular connections in the regenerated axolotl hindlimb. AB - Retrograde neuronal tracing with horseradish peroxidase (HRP) was used to determine the position in the spinal cord of motor neurone pools innervating muscles in the regenerated axolotl hindlimb. This method allows a detailed analysis of the accuracy of reformation of neuromuscular connections. The results show that regenerated distal limb muscles are reinnervated by motor neurones in the same region of the cord as those that innervate normal control distal limb muscles but that proximal muscles are innervated by a mixture of motor neurones in a normal position and motor neurones in a region of the spinal cord that normally supplies innervation to distal limb muscles. This difference between the reinnervation of proximal and distal limb muscles suggests that axons destined for proximal muscles may not enter distal limb territory during reinnervation of the regenerated limb. PMID- 3652998 TI - Effects of zinc deficiency on morphogenesis of the fetal rat eye. AB - Maternal zinc deficiency during pregnancy results in a high frequency of fetal eye malformations in the Long-Evans rat. In this study we examine the development of the eye from days 12 through 21 of gestation in conceptuses of dams fed deficient or adequate levels of zinc and also examine maternal plasma and conceptus zinc concentrations during this period. Dams were fed diets containing 0.5 (0.5 Zn group), 4.5 (4.5 Zn group), or 100 (100 Zn AL group) micrograms zinc per gram diet ad libitum, or 100 micrograms zinc g-1 diet in amounts restricted on a daily basis to the intake of matched animals from the 0.5 Zn group (100 Zn RI group). Conceptuses were removed and maternal plasma was collected on days 12, 14, 16, 19 and 21 of gestation. Maternal plasma and conceptus zinc concentrations reflected maternal dietary zinc level, with dam plasma Zn concentrations in the order of 0.5 Zn group less than 4.5 Zn group less than 100 Zn group on all days. A similar pattern held for embryo/fetus zinc, except for days 19 and 21, at which times the 0.5 Zn and 4.5 Zn fetuses had similar zinc concentrations. Histological examination of the developing eye of 0.5 Zn fetuses on days 12 and 14 revealed that invagination of the optic cup was often deficient, and that closure of the choroid fissure did not occur, resulting in colobomata and retinal folding visible at term. A very few fetuses were found at term to be anophthalmic or have only remnants of ocular tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3652999 TI - Development of erythroid colony-forming cells in rat fetal spleen: apparent lack of sensitivity to an in vivo corticosteroid excess as compared to fetal liver. AB - The development of splenic erythroid colony-forming cells from rat embryos in the last 4 days of intrauterine life was examined after 2 and 7 days in a methylcellulose culture system. The number of 2- and 7-day erythroid colonies decreased sharply between, respectively, days 20 and 21 of gestation and days 19 and 20. Concomitantly, a maturation of proerythroblasts and basophilic erythroblasts to mature erythroblasts was detected on smears of splenic cellular suspensions. The effect of a corticosteroid excess induced by a maternal laparotomy was tested on spleen and liver cultures from the same control or experimental fetuses. The ratio of the number of 2-day to the number of 7-day erythroid colonies did not differ in experimental and control splenic cultures, but in liver cultures was significantly lower at days 19 and 20 in experimental than in control cultures. PMID- 3653000 TI - Ethanol-induced inhibition of pinocytosis and proteolysis in rat yolk sac in vitro. AB - Pinocytic capture of 125I-labelled polyvinylpyrrolidone and of formaldehyde denatured 125I-labelled bovine serum albumin by 17.5-day rat visceral yolk sacs incubated in vitro was rapidly and strongly inhibited by low concentrations (0.01 and 0.05%, v/v) of ethanol. The induced inhibition of pinocytosis was readily reversible, but a marked lag was observed before ethanol-exposed tissue regained its full proteolytic capacity towards the exogenous protein. These observations suggest that the acute administration of ethanol to a pregnant rat may give rise to concentrations of ethanol in the maternal blood and/or uterine fluid that induce dysfunction of the yolk sac. In late gestation such inhibition of yolk-sac function may interfere with the transfer of passive immunity across the yolk sac. If similar dysfunction is induced earlier in gestation, in the period before the chorioallantoic placenta is functional, this could cause a transient period of inhibition of histiotrophic nutrition that may be important to the pathogenic mechanism of action of ethanol as a teratogen. PMID- 3653001 TI - Haemocytes secrete basement membrane components in embryonic locusts. AB - Several monoclonal antibodies raised against a glycoprotein-enriched fraction of adult muscle membranes of Locusta migratoria selectively stain particles within haemocytes and basement membrane in developing locust embryos. Haemocytes containing immunoreactive particles are found associated with areas where basement membrane is being laid down. The underlying ectoderm does not show immunoreactivity. We conclude that haemocytes contribute to basement membrane formation in embryonic locusts. PMID- 3653002 TI - Interactions between somite cells: the formation and maintenance of segment boundaries in the chick embryo. AB - We have investigated the interactions between the cells of the rostral and caudal halves of the chick somite by carrying out grafting experiments. The rostral half sclerotome was identified by its ability to support axon outgrowth and neural crest cell migration, and the caudal half by the binding of peanut agglutinin and the absence of motor axons and neural crest cells. Using the chick-quail chimaera technique we also studied the fate of each half-somite. It was found that when half-somites are placed adjacent to one another, their interactions obey a precise rule: sclerotome cells from like halves mix with each other, while those from unlike halves do not; when cells from unlike halves are adjacent to one another, a border is formed. Grafting quail half-somites into chicks showed that the fates of the rostral and caudal sclerotome halves are similar: both give rise to bone and cartilage of the vertebral column, as well as to intervertebral connective tissue. We suggest that the rostrocaudal subdivision serves to maintain the segmental arrangement when the mesenchymal sclerotome dissociates, so that the nervous system, vasculature and possibly vertebrae are patterned correctly. PMID- 3653003 TI - Ciliary band formation in the doliolaria larva of Florometra. II. Development of anterior and posterior half-embryos and the role of the mesentoderm. AB - We report the results of cutting experiments on embryos of the crinoid Florometra serratissima, which produce, in the doliolaria stage, a striped pattern of ciliary bands. Embryos at gastrula and post-hatching elongation stages were divided into anterior and posterior fragments. Complementary fragments express parts of the total pattern without adding extra pattern elements, i.e. the pattern is a mosaic. Some fragments elongate which, from an examination of internal structures, we interpret as due to the elongation and displacement of the mesenteric sac. The number of pattern elements expressed correlates with degree of elongation and internal landmarks correlate with certain external pattern features. This suggests that the pattern mosaic may reside in the internal tissues, i.e. in the mesentoderm, but we are as yet unable to prove this. The results are discussed with reference to the roles of tissues of different germ layer origin in related embryos, including vertebrates, in which the mesentoderm has a significant instructive role. PMID- 3653004 TI - Genes that control dorsoventral polarity affect gene expression along the anteroposterior axis of the Drosophila embryo. AB - At least 13 genes control the establishment of dorsoventral polarity in the Drosophila embryo and more than 30 genes control the anteroposterior pattern of body segments. Each group of genes is thought to control pattern formation along one body axis, independently of the other group. We have used the expression of the fushi tarazu (ftz) segmentation gene as a positional marker to investigate the relationship between the dorsoventral and anteroposterior axes. The ftz gene is normally expressed in seven transverse stripes. Changes in the striped pattern in embryos mutant for other genes (or progeny of females homozygous for maternal effect mutations) can reveal alterations of cell fate resulting from such mutations. We show that in the absence of any of ten maternal-effect dorsoventral polarity gene functions, the characteristic stripes of ftz protein are altered. Normally there is a difference between ftz stripe spacing on the dorsal and ventral sides of the embryo; in dorsalized mutant embryos the ftz stripes appear to be altered so that dorsal-type spacing occurs on all sides of the embryo. These results indicate that cells respond to dorsoventral positional information in establishing early patterns of gene expression along the anteroposterior axis and that there may be more significant interactions between the different axes of positional information than previously determined. PMID- 3653005 TI - Binding of zona pellucida proteins to a boar sperm polypeptide of Mr 53,000 and identification of zona moieties involved. AB - Experiments have been carried out to identify proteins on boar spermatozoa that bind to components of the zona pellucida. Polypeptides in sodium deoxycholate extracts of boar spermatozoa and in whole seminal plasma have been separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, transferred onto nitrocellulose sheet by electroblotting and probed with 125I-labelled heat solubilized zona pellucida from pig oocytes or ovulated eggs. Zona proteins bound avidly and consistently to a polypeptide of Mr 53,000 on blots of capacitated and noncapacitated sperm and weakly to polypeptides of Mr 67,000, 38,000 and 18,000. On blots of seminal plasma the 125I-labelled probes bound to two polypeptides of Mr 65,000 and 19-24,000. Identification of the zona proteins that were binding to the aforementioned proteins on blots showed that all the major zona pellucida glycoproteins were involved, including those acquired from oviduct secretions. Binding of 125I-ovulated zona pellucida to the polypeptide of Mr 53,000 also occurred in extracts of testicular and epididymal boar spermatozoa. The results are discussed in relation to sperm-egg recognition in the pig. PMID- 3653006 TI - Epithelial-mesenchymal interactions in the development of chick facial primordia and the target of retinoid action. AB - The development of the chick face involves outgrowth of buds of tissue, accompanied by the differentiation of cartilage and bone in spatially defined patterns. To investigate the role of epithelial-mesenchymal interactions in facial morphogenesis, small fragments of facial tissue have been grafted to host chick wing buds to continue their development in isolation. Fragments of the frontonasal mass give rise to typical upper-beak-like structures: a long central rod of cartilage, the prenasal cartilage and an egg tooth. Meckel's cartilage, characteristic of the lower beak, develops from fragments of the mandible. Removal of the ectoderm prior to grafting leads to truncated development. In fragments of frontonasal mass mesenchyme only a small spur of cartilage differentiates and there is no outgrowth. The mandible is less affected; a rod of cartilage still forms but the amount of outgrowth is reduced. Retinoid treatment of chick embryos specifically affects the development of the upper beak and outgrowth and cartilage differentiation in the frontonasal mass are inhibited. The mandibles, however, are unaffected and develop normally. In order to investigate whether the epithelium or the mesenchyme of the frontonasal mass is the target of retinoid action, recombinations of retinoid-treated and untreated facial tissue have been grafted to host wing buds. Recombinations of retinoid treated frontonasal mass ectoderm with untreated mesenchyme develop normally whereas recombinations of untreated ectoderm with retinoid-treated mesenchyme lead to truncations. The amount of outgrowth in fragments of mandibular tissue is slightly reduced when either the ectoderm or the mesenchyme has been treated with retinoids. These recombination experiments demonstrate that the mesenchyme of the frontonasal mass is the target of retinoid action. This suggests that retinoids interfere with the reciprocal epithelial-mesenchymal interactions necessary for outgrowth and normal upper beak development. PMID- 3653007 TI - Lithium inhibits morphogenesis of the nervous system but not neuronal differentiation in Xenopus laevis. AB - Xenopus embryos treated with 100 mM-lithium from the 2- to 4-cell stage to the early blastula stage (4h) failed to neurulate and developed without a discernible anteroposterior axis. The internal structure of defective embryos was grossly disorganized, but immunohistochemical staining with cell-type-specific antibodies revealed differentiated nerve and muscle cells. Quantitative assay in tissue cultures from control and acutely abnormal lithium-treated embryos showed that neural differentiation was enhanced and muscle differentiation unaffected. The embryos took up about 0.5 mM-lithium at threshold, maximal effects resulted at 2 3 mM. Most of the lithium was extruded from the cells into the blastocoel fluid, where lithium reached 17 mM. The threshold intracellular concentration was about 150 microM. Lithium uptake rose steeply as the osmotic/ionic strength of the bathing medium increased. Sodium, potassium and lithium were equally able to increase the permeability of the embryo. However, sodium ions enhanced, while potassium ions interfered with, the uptake of lithium. Treatment with lithium at progressively later stages reduced the developmental defects and neural differentiation returned to normal levels. The uptake of lithium did not decline concomitantly. We conclude that lithium does not inhibit neural induction, but interferes with dorsal patterning. The sensitivity of the embryo to lithium is determined by developmental stage. The very low, effective intracellular concentrations may be important in understanding the mechanism of lithium generated defects. PMID- 3653008 TI - Temporal and regional changes in DNA methylation in the embryonic, extraembryonic and germ cell lineages during mouse embryo development. AB - This paper shows stage- and tissue-specific global demethylation and remethylation occurring during embryonic development. The egg genome is strikingly undermethylated and the sperm genome relatively methylated. Following a loss of genomic methylation during preimplantation development, embryonic and extraembryonic lineages are progressively and independently methylated to different final extents. Methylation continues postgastrulation and hence could be a mechanism initiating, or confirming, differential programming in the definitive germ layers. It is proposed that much of the methylation observed in somatic tissues acts to stabilize and reinforce prior events that regulate the activity of specific genes, chromosome domains or the X chromosome (in females). Fetal germ cell DNA is markedly undermethylated and we favour the idea that the germ lineage is set aside before the occurrence of extensive methylation of DNA in fetal precursor cells. PMID- 3653009 TI - The development of XO gynogenetic mouse embryos. AB - Diploid gynogenetic embryos, which have two sets of maternal and no paternal chromosomes, die at or soon after implantation. Since normal female embryos preferentially inactivate the paternally derived X chromosome in certain extraembryonic membranes, the inviability of diploid gynogenetic embryos might be due to difficulties in achieving an equivalent inactivation of one of their two maternally derived X chromosomes. In order to investigate this possibility, we constructed XO gynogenetic embryos by nuclear transplantation at the 1-cell stage. These XO gynogenones showed the same mortality around the time of implantation as did their XX gynogenetic counterparts. This shows that the lack of a paternally derived autosome set is sufficient to cause gynogenetic inviability at this stage. Autosomal imprinting and its possible relation to X chromosome imprinting is discussed. PMID- 3653010 TI - Dynamics of the control of body pattern in the development of Xenopus laevis. IV. Timing and pattern in the development of twinned bodies after reorientation of eggs in gravity. AB - The mesendodermal anatomy of twinned larval axes is described in relation to the normal single pattern, when twinning has been caused by experimental tilting of eggs before first cleavage. The formation of two origins for gastrulation movements (dorsal lips) and their relatively rapid spread and coalescence to give a circular blastopore, is a predictor of twin formation in individual embryos after treatment. The anatomy of twins where development has been disturbed from the outset in this way is appreciably different from that induced by the later operation of second dorsal lip implantation. It is also variable in a systematic way. The total sizes of cellular allocations to individual notochords and prechordal head patterns are enhanced above normal if they arise relatively close together in the tissue, but significantly reduced if they arise far apart. These and other features of twinned patterns due to precleavage disturbance are discussed in terms of what they might indicate about the physicochemical nature of the body positional system. The results confirm that by a variety of rather simple, nonsurgical manipulations the relative amounts of territory in the egg devoted to different parts of the body can be greatly influenced. PMID- 3653011 TI - Topographical control of cell behaviour. I. Simple step cues. AB - The photolithographic techniques of the microelectronics industry have allowed us to fabricate patterned plastic substrata to investigate contact guidance of animal tissue cells. The reactions of cells to single steps on a substratum were examined using time-lapse videorecording and scanning electron microscopy. BHK cells and chick embryonic neural cell processes exhibited gradual inhibition of crossing steps with a concomitant increase in alignment at steps dependent on increasing step height. Comparison of these cells' reactions, with those of chick heart fibroblasts and rabbit neutrophils, at a 5 micron step revealed that the influence of topography is also dependent on cell type, the neutrophils being relatively unaffected. The presence of an adhesive difference at a series of steps altered BHK cells' reactions such that the frequency of crossing was dependent on the direction of approach to a step. Although our data are consistent with Dunn & Heath's proposal (1976) that the inflexibility of the cytoskeleton of a moving cell's protrusion is the cellular property determining such reactions to topography, we have found that, on encountering a topographical feature, the response of a cell may be predictable on a probabilistic basis, i.e. the topographical feature reduces the probability of a cell making a successful protrusion and contact in a given direction, that even the largest features tested did not act as absolute barriers to cell locomotion since a small proportion of a population of cells were able to overcome them, and that other guidance cues could significantly alter a cell's response. Even in situations where it is not the primary cue in directing cell locomotion, topographical control may be an important factor during morphogenesis since it must, at the very least, influence the efficiency of other cues. PMID- 3653012 TI - [Education of the workers and their participation in occupational health programs]. AB - In addition to being exposed to the variables and factors that affect the health of the entire population, workers are vulnerable to other risk factors of a biological, chemical, physical, psychosocial and biotechnological nature. These factors cause work-related accidents and occupational and other work-related diseases. Biological factors may be present at workplaces and can spread rapidly in a dense population such as that of an industrial community. Chemical factors can cause acute intoxication and chronic and prepathological conditions, and physical factors include vibrations and ionizing and non-ionizing radiation. The risks related to posture, physical exertion, fatigue and stress can impair the health of healthy individuals and aggravate existing conditions in the handicapped and predisposed individuals. Finally, work practices increase the incidence of some pathological conditions. It is important to study these factors because when they are well understood they can be eliminated or controlled, and their possible harmful effects avoided. This is why prevention needs to be studied in the setting of a functional dynamic. Professionals in the field of prevention, which must include sociologists and psychologists, must train workers with the help of appropriate educational technology. Workers must participate actively in work programs, along with employers and organizations that represent them. The setting for joint participation in the field of prevention and workers' health--the enterprise in which measures are being promoted, and at the regional and national levels for framing standards and regulations, determining general policies, drawing up labor statutes, and setting up institutions for control and surveillance--imposes on the parties (particularly workers and organizations representing them) a series of rights and obligations that require training for proper observance. The author notes in particular that participation in prevention work means that workers must be given instruction in occupational health. Proper and effective training must impart an understanding of the risks, their consequences, the relationship between exposure, disease and health, and the techniques for the elimination and control of unhealthy, toxic, dangerous and uncomfortable situations, as well as an understanding of health promotion and well-being. This training must be provided by the public administration, and especially, by the institutions responsible for education, the drafting of laws and regulations, advisory services, research, and surveillance of conditions in all working situations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3653013 TI - [A program for the preparation of educational materials]. AB - The article describes a program for the development of educational materials using PC computers. The program may help a teacher plan a course. The teacher can use it to formulate the general and specific course objectives, analyze the content of the objectives and materials, classify the instructional materials to be learnt and sequence the materials to be used by means of a computer. The program also allows student replies to be recorded and the results of the applications to be revised. PMID- 3653014 TI - [Determination of human resources needs from task analysis]. AB - This study describes the problem in the health field of integrating teaching and services, since there is no clear definition of the functions and tasks of manpower required in services nor a specification of how the manpower must be trained in the educational system. As an example of a systematic analysis of the problem, the study cites a research project carried out in Mexico, whose objectives were: to develop a technique to determine the kind and number of health personnel that must be trained; to provide a link between the training units and health service institutions and to try to integrate the curricula of each of the categories of health personnel. The subsequent stages give a detailed description of the task analysis process. At the educational level, the information obtained leads to the development of curricula more relevant to national needs; at the institutional level, it leads to the introduction of standards of evaluation for a better analysis of services and to the establishment of services with more extensive coverage. Another advantage is that the system can be used at the regional level without duplicating the model for each locality. In addition, the information produced is conducive to the development of curricula that provide for the lateral and vertical mobility of manpower. PMID- 3653015 TI - [Exploratory study of centers of educational technology in health. Case study, Costa Rica]. PMID- 3653016 TI - [The processes of work and health/disease: a dialectic relationship]. AB - The premise of the authors is that social sciences allow a vision of man as a whole, without separating the biological, psychological and social aspects. In the historical dimension, individuals do not act as isolated entities, but rather as social groups; and it is only from this standpoint that behaviour, events and institutions may be fully understood. The role played by man as a social being is determined by the culture in which he is born and matures as an adult. To understand the health-disease process, it is necessary to go beyond the purely biological approach, where the individual becomes sick basically because of organic disorders, and to look at health problems from the standpoint of the social sciences, which are based theoretically on a broader conception of the individual, allowing an examination of his historical, emotional, and social make up. The health-disease process is affected by different phenomena whose frequency and intensity vary with time and space; according to the individual level, social class or population group; and economic and social factors. From the relationship between biological, and psychological and social forces, different trends emerge. Some are ecological; others conclude that disease is a social phenomenon in its essence, and biological in its form. This article links the health-disease phenomenon with the labor process and thus places it in the context of occupational health, a field where the social sciences have made their mark. The authors later analyze this process. It is necessary to know all its characteristics, modalities and manifestations, and to discover the final connection between the occupation and the individual, as the only way to have a deeper understanding of the relationship between the labor and health-disease processes. PMID- 3653017 TI - Nursing assessment and general care of the gynecological patient. AB - This article explains the steps necessary for quick and effective triage and care of the gynecological patient. Because these patients may be emotionally upset, the ER nurse must make every attempt to reassure and calm the patient while at the same time prepare her for treatment. PMID- 3653018 TI - Obstetric and gynecologic emergencies. PMID- 3653019 TI - Abdominal and pelvic pain. AB - Complaints of abdominal and pelvic pain account for a large number of Emergency Department presentations. Unfortunately, the subjective, often ambiguous, complaint of pain may represent a broad spectrum of pathology ranging from relatively benign disorders to acute, life-threatening illness. It is the duty of the Emergency Department physician to separate the potentially lethal disorders from the less acute illnesses, a task that this article aims to make easier. PMID- 3653021 TI - Emergency delivery: prehospital care, emergency department delivery, perimortem salvage. AB - The incidence of high-risk conditions complicating pregnancy is greater than one would suspect. Many times a pregnancy does not become high risk until labor starts. Prehospital and Emergency Department protocol should be directed at getting the mother to the labor and delivery suite as soon as possible. Most complications resulting in maternal-fetal morbidity and mortality are handled best in that setting. Prehospital and Emergency Department personnel should, however, be prepared to handle imminent delivery because it cannot be avoided when it occurs. Emergency Department personnel also should be familiar with the technique of perimortem cesarean delivery and use this technique when indicated for fetal-maternal salvage. PMID- 3653020 TI - Vaginal bleeding. AB - Vaginal bleeding is one of the most common gynecologic symptoms for which the patient will come to the Emergency Department. It is usually associated with psychologic distress and can be frightening to the patient. Vaginal bleeding can be the first sign of life-threatening medical disorders such as carcinoma, bleeding disorders, and trophoblastic disease. As with bleeding from other sources, it is not uncommon for a patient with significant vaginal bleeding to lose large amounts of circulating volume. These facts make it essential that the emergency physician deal quickly and effectively with this symptom. PMID- 3653022 TI - Emergency treatment of menstrual disorders in a nonpregnant woman. AB - Women who present to the Emergency room with menstrual-related problems are a common occurrence. In this article, we will concern ourselves with common problems that the nonpregnant woman in the reproductive years may present to the emergency room, including symptoms such as vaginal bleeding, painful menses, or premenstrual syndrome. Although the treatment within the emergency room is temporizing in nature, to better understand these problems and their appropriate management, these areas will be discussed as to their etiology, treatment, and prognosis. PMID- 3653023 TI - Emergency treatment of adnexal masses in a nonpregnant woman. AB - Both benign and malignant adnexal masses can present as an emergency. Differential diagnosis, as well as practical clinical maneuvers to differentiate the two, and initial treatment are discussed in this article. PMID- 3653025 TI - Similarity of the clearance rates of free alpha-subunit and alpha-subunit dissociated from intact human chorionic gonadotropin, despite differences in sialic acid contents. AB - It is well known that the MCR of proteins can be influenced by their carbohydrate structure; i.e. the presence of terminal galactose on proteins results in uptake by hepatic receptors for galactose-terminated glycoproteins. Thus, a protein with its galactose residues covered or removed exhibits a far longer half life in plasma than one with its galactose residues exposed. The free alpha-subunit of human CG (hCG) has been shown to have a different carbohydrate composition than does the alpha-subunit dissociated from the intact hormone. In our laboratory, analysis of alpha-subunits isolated from pregnancy urine indicated that the alpha subunit dissociated from hCG (hCG alpha) contains primarily monosialylated oligosaccharides, whereas the free alpha-subunit contains more than one sialic acid per oligosaccharide. This difference in the degree of sialylation prompted us to examine the clearance rates of these two subunits. Accordingly, free alpha and hCG alpha were purified by affinity chromatography and labeled with 125I. The labeled subunits were injected iv into rats and serum samples were removed at various time intervals over a 2-h period. The amount of [125I]alpha-subunit remaining in the serum was determined by immunoprecipitation using an antiserum to hCG alpha. The disappearance curves for the two subunits were indistinguishable and could be analyzed by a biexponential model. The t 1/2 of the faster component was 5 min, while the t 1/2 of the slower component was 74 min. In order to determine whether or not terminal galactose was present on either the hCG alpha or the free alpha-subunit, the labeled molecules were subjected to lectin column chromatography using Ricin or peanut lectin linked to agarose. Both of these lectins bind galactose but have different specificities with respect to the penultimate sugar. Both subunit preparations contained only minor amounts of material which could bind or either lectin. However, after desialylation, both hCG alpha and free alpha bound extensively to Ricin, indicating the presence of penultimate galactose residues in both. We conclude that terminal galactose residues are not present on the oligosaccharides of either hCG alpha or free alpha-subunits, and that the difference observed in the sialic acid contents of the two subunits does not affect their rates of clearance. PMID- 3653024 TI - 19-Hydroxylation and aromatization of androgens in the developing rat brain. AB - Androgen aromatization in the human placenta proceeds through two successive hydroxylations at C-19, the products of which are then virtually completely converted to estrogens. In the neonatal rat brain, however, 19-hydroxylation has been shown to exceed significantly subsequent aromatization, suggesting that formation of 19-hydroxylated androgen metabolites might be important in brain differentiation in this species. Using [19-3H3]androstenedione, we found that the surplus activity of 19-hydroxylase relative to aromatase was independent of age, sex, and androgen substrate concentration, despite 100-fold differences in tissue aromatase activity during the course of development. In addition, the surplus 19 hydroxylation was not affected by several agents which otherwise decreased or increased the activity of the aromatase enzyme, including metyrapone, KCN, and cytochrome P-450 reductase, the latter indicating that the failure of the 19 hydroxylated products to proceed to aromatization was not due to a deficit of reducing equivalents. 19-Hydroxylation of androgens in the rat brain is a quantitatively significant metabolic pathway in this tissue, although present data do not confirm the existence of a steroid C-19 hydroxylase in the brain separate from that involved in aromatization. PMID- 3653026 TI - Age-related decrease of growth hormone and prolactin gene expression in the mouse pituitary. AB - The effects of aging on pituitary GH, PRL, and alpha-tubulin messenger RNA (mRNA) levels were measured in 3-, 12-, and 27-month-old male C57BL/6J mice by dot-blot hybridization. The amount of GH and PRL mRNA in the pituitary deceased dramatically with age. However, total poly(A+) RNA (mRNA), as measured by hybridization with radioactively labeled oligo-(dT), was not altered during aging. In addition, there were no age-related changes in the level of alpha tubulin mRNA. Thus, the effects of aging on GH and PRL mRNA levels are specific; the levels of the majority of cellular mRNAs are not altered with age. GH and mRNA levels decreased 35% between 3 and 12 months (P less than 0.05) and a total of 75% after 27 months (P less than 0.01). PRL mRNA levels decreased 65% between 12 and 27 months (P less than 0.01), although there was no significant decrease before 12 months. Whereas T3 is the most potent regulator of GH gene expression, we did not detect any significant age-related change in serum T3 levels. These results suggest that factors other than T3 play a role in the age-related decline in GH and PRL gene expression. PMID- 3653027 TI - Transuterofetoplacental conversion of pregnenolone to progesterone in antiestrogen-treated baboons. AB - The present study was designed to characterize the dynamics of progestin metabolism peripherally and across the uterus during normal baboon pregnancy and to determine whether the decline in placental progesterone (P4) production which results from administration of the antiestrogen ethamoxytriphetol (MER-25) to baboons reflects a decrease in conversion of pregnenolone (P5) to P4 and thus delta 5-3 beta-hydroxysteroid dehydrogenase activity. To examine this possibility, the conversion of [3H]P5 to [3H]P4 was determined by the constant infusion method on day 100 (midgestation) and day 175 (near term) of gestation in baboons that received MER-25 (25 mg/day X kg BW, po) on days 95-100 or 140-175 (term = 184 days). Baboons were sedated with ketamine HCl, then received a constant iv infusion of [3H]P5 (1.0 mu Ci/0.388 ml X min) and [14C]P4 (0.2 mu Ci/0.388 ml X min for 110 min. Radiolabeled progestins were purified from blood samples withdrawn from saphenous, uterine, and umbilical vessels, and the MCR of P4 and P5, uterine extraction of P5, and transfer constants (rho) for the peripheral, transuterofetoplacental, and transuteroplacental conversion of P5 to P4 were determined. The formation of P4 from P5 by incubates of placental cells obtained on day 175 from untreated and MER-25-treated baboons was also assessed. During normal baboon pregnancy the mean (+/- SE) % P5 extracted (i.e. metabolized) by the uterus was 31.0 +/- 3.3 at midgestation and 45.7 +/- 5.6 late in gestation. Peripheral and transuterofetoplacental rho values of P5 to P4 in untreated baboons were 6.9 +/- 1.8% and 37.3 +/- 7.9%, respectively, at midgestation and 6.1 +/- 0.6% and 46.8 +/- 10.1%, respectively, near term. The transuteroplacental rho of P5 to P4 was only slightly lower than the transuterofetoplacental values, indicating minimal conversion of P5 to P4 by the fetus. The peripheral contribution of P5 production to the total production rate of P4 at term in baboons was 1%. The contribution of uteroplacental conversion of P5 to P4 to the total conversion of P5 to P4 at midgestation was estimated to be 22%. MER-25 caused a 53% decline (P less than 0.01) in serum P4 concentrations from a mean (+/- SE) of 12.5 +/- 2.4 ng/ml during the pretreatment period to 5.4 +/- 0.3 ng/ml between days 140 and 175 of gestation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3653028 TI - Characterization and hormonal regulation of estrogen binding proteins in the MTW 9B transplantable rat mammary tumor. AB - A two-component estrogen (E2)-binding system has been characterized in the E2 independent MTW-9B rat mammary tumor by Scatchard analysis, sucrose gradient analysis, and isoelectric focusing. One cytosol receptor protein (type I) conforms to the classical estrogen receptor with a high affinity (Kd = 0.45 nM) for E2 and limited binding capacity [maximum binding (Bmax) = 53 fmol/mg protein]. The second component (type II) demonstrates a high number of sites (Bmax = 164 fmol/mg protein) and low E2-binding affinity (Kd = 22.3 nM). The type I and type II E2-binding components were shown to sediment on sucrose gradients at 9.6S and 4.5S, respectively, and to focus at isoelectric points of 6.6 and 8.0, respectively. The addition of 0.4 M KCl to the homogenization buffer converted the high affinity receptor species to a form that cosedimented and cofocused with the low affinity E2-binding protein. When tumors were grown in intact male rats, the ratio of the type II to the type I protein, as assessed by sucrose gradient analysis, increased 4.5-fold relative to that in tumors from intact females. Concomitantly, the Kd values of the type I and type II proteins were increased 9- and 2-fold, respectively, and the Bmax of the type I protein was decreased. No changes in the ratios of the E2-binding proteins were observed in tumors grown in ovariectomized female or castrated male rats; however, the Kd for both proteins was increased in tumors from the latter group. Relative to that in intact females, tumor growth was retarded in intact male rats, but was unaffected by ovariectomy or castration. These studies demonstrate that the presence of the low affinity E2-binding protein does not necessarily predict E2 responsiveness. While the role of the type II cytosolic protein has not yet been established, it is possible that it could act as a reservoir for E2, which is required to activate specific biochemical functions such as progesterone receptor synthesis. Alternatively, it could be a nonactivated, perhaps norphosphorylated, form of the E2 receptor which binds E2 with only a very low affinity. PMID- 3653030 TI - Developmental expression of the angiotensinogen gene in rat embryos. AB - Angiotensin II is a potent octapeptide vasoconstrictor and regulator of cardiovascular and electrolyte homeostasis. Angiotensinogen, the protein precursor of angiotensin II, is synthesized by the liver and many other organs of the adult rat. To determine whether angiotensin may be present in early fetal development we analyzed rat embryonic tissues (chorionic membranes, head, and body) for the expression of the angiotensinogen gene during days 11-21 of embryogenesis. Angiotensinogen mRNA was detected at low levels in embryo bodies and yolk sac placenta from day 11 of gestation. An initial rise in the level was noted on day 13, reaching a plateau from day 17 of gestation to birth. Angiotensinogen mRNA levels of the embryonic head were about 10-fold less than those of the body on days 17-19 and increased to levels similar to those of the body on days 20-21. Angiotensinogen mRNA levels of the yolk sac placenta were about 20-fold higher than those in the embryonic body, but no angiotensinogen mRNA was detected in the chorioallantoic placenta. Angiotensinogen mRNA from both embryos and yolk sac placenta was larger by about 200 bases than the mRNA obtained from adult rat liver; this was shown to be a consequence of both the utilization of more distal polyadenylation sites and a longer poly(A) tract. These observations suggest the possibility of a biological function for angiotensinogen in the early development of the rat, and that polyadenylation site selection may alter the functional expression of the angiotensinogen gene in a developmentally specific manner. PMID- 3653029 TI - Proenkephalin gene expression in the PC12 pheochromocytoma cell line: stimulation by sodium butyrate. AB - The differentiation promoter sodium butyrate increases the content of Met5 enkephalin-Arg6-Gly7-Leu8 (Met5-enk-RGL)-immunoreactive peptides in PC12 pheochromocytoma cells, which, unlike mature adrenomedullary chromaffin cells, contain exceedingly low levels of opioid peptides. These butyrate-induced enkephalin-immunoreactive peptides, which are specific products of the proenkephalin gene, consist principally of two high mol wt forms of amino terminally extended Met5-enk-RGL. These high mol wt peptides, with apparent mol wt of 20,000 and 10,000, are approximately the same size as the two major immunoreactive peptides found in adult New England Deaconess Hospital rat adrenal. The low mol wt Met5-enk-RGL-immunoreactive peptide found in butyrate treated cells is similar in size to authentic Met5-enk-RGL, which is not found in the adrenal medulla of the adult rat. When PC12 cells are grown as a tumor in vivo, the amount of Met5-enk-RGL-immunoreactive peptide increased only slightly above the level found in control cells grown in vitro and consisted exclusively of the highest mol wt immunoreactive species. In PC12 cells, the butyrate stimulated elevation in the content of Met5-enk-RGL-immunoreactive peptides may involve changes in transcription, since the peptide increase is preceded by a 2- to 3-fold increase in the level of proenkephalin mRNA. These results suggest that the PC12 cell line may be useful for investigating those factors that control the initial expression and processing of proenkephalin-derived peptides during embryogenesis. PMID- 3653031 TI - Estradiol stimulation of glucose transport in rat uterus. AB - Glucose transport in rat uterus was investigated in order to determine whether the stimulation of transport by estradiol was the result of an increase in the amount of glucose transport protein in plasma membranes. In cycling rats, transport was highest during proestrus, the day on which serum estradiol concentrations are highest. In ovariectomized rats, the stimulation of transport was estrogen specific and was nearly complete within 2-3 h after injection of 0.1 microgram estradiol per animal. Estradiol stimulation resulted in a 2- to 3-fold increase in Vmax of 2-deoxy-D-glucose transport with no significant change in Michaelis-Menten constant (Km). Inhibition of the stimulation by cycloheximide or actinomycin D could not be demonstrated, although cycloheximide treatment did cause an increase in the basal rate of transport up to that observed with estradiol treatment. Upon polyacrylamide gel electrophoresis followed by Western blotting, a single protein in uterine plasma membranes reacted with a rabbit antiserum made against purified human erythrocyte glucose transport protein. This protein, believed to be the glucose transport protein, had a mol wt of 49,000 and appeared as a broad band as expected for a glycoprotein. It was found by a protein A-linked immunoassay that the amount of transport protein in uterine plasma membranes was 3.2 +/- 0.4% of the amount in human erythrocyte ghosts. Estradiol treatment had no effect on this value. These data suggest that the stimulation of glucose transport by estradiol occurred by an increase in the intrinsic activity of the transport protein rather than by an increase in the amount of transport protein in plasma membranes. PMID- 3653032 TI - Effects of the progesterone antagonist RU486 on ovarian activity in the rat. AB - Adult female rats were treated for 2 or 4 weeks with the progesterone antagonist RU486 to study its effect on the regulation of ovarian function. In rats with 5 day ovarian cycles, the vaginal cyclicity disappeared. Uninterrupted vaginal cornification emerged within 4 days after the start of treatment and cornification persisted for the whole period of treatment. It took more than 2 weeks after cessation of 2-4 weeks of treatment before 5-day vaginal cycles reappeared. Ovarian weights increased rapidly resulting from the accumulation of large numbers of corpora lutea. In addition, the ovaries developed occasional follicular cysts which could reach an extremely large size (2 mm or more). Analysis of serial histological sections of ovaries, combined with plasma concentrations of estradiol-17 beta and progesterone, indicated cyclic ovulation and corpus luteum formation together with persistence of functional activity of already existing and newly formed corpora lutea. RU486 seems to have the unique property of dissociating cessation of luteal activity and ovulation in rats. After treatment with RU486, pituitary enlargement and mammary gland alveolar development were observed. It is hypothesized that these effects result from unopposed estrogen action on PRL secretion. The effects of RU486 are reversible: 4 to 5 weeks after the end of treatment ovarian activity seems normal (as evidenced by reduction of ovarian weights and 5-day vaginal cycles) except for the presence of occasional large follicular cysts which may require longer periods for their regression. PMID- 3653033 TI - Species-specificity of corticosteroid receptors in hamster and rat brains. AB - In vitro cytosolic receptor binding assays and autoradiographical procedures have shown the localization and properties of two corticoid receptor types in the brain of the rat, a species in which corticosterone (B) is the predominant circulating glucocorticoid. The present study was designed to examine the localization, heterogeneity, and binding specificity of corticosteroid receptors in the brain of the hamster, a species which secretes B and cortisol (F), the latter being the predominantly circulating form. Our results show that two corticoid receptor systems can also be distinguished in the hamster brain. The type I receptor has an almost exclusive localization in the hippocampal region and the amounts measured in hypothalamic or whole brain (without the hippocampus) were negligible. The type II receptor, on the other hand, has a wider distribution in the brain. Scatchard and Woolf analyses of the binding data revealed that the hamster type I receptor has similar affinity to both F and B [dissociation constant (Kd) 0.9 nM]. In contrast the rat type I binds with higher affinity to B (Kd, 0.9 nM) than to F (Kd, 2.2 nM). The hamster type II binds to F with much higher affinity (Kd, 2.9 nM) than does the rat type II to F (Kd, 20.1 nM). This was similarly observed, although less pronounced in the binding of the hamster type II and the rat type II to B (Kd, 0.5 and 3.9 nM, respectively). Analysis of relative binding affinity of each receptor type gave the following results. Hamster type I: F greater than B much greater than aldosterone (ALDO) greater than dexamethasone (DEX); rat type I: B greater than F greater than ALDO greater than DEX; hamster type II: B greater than DEX greater than F much greater than ALDO; rat type II: DEX greater than B much greater than F much greater than ALDO. Graded doses of F or B given sc to adrenalectomized animals result in differential occupancy of the two receptor systems. In hamster, 1.0 microgram F vs. 1.0 mg B/100 g BW is required to occupy 80% of type I site. The rat shows the opposite (1.0 microgram B vs. 5.0 to 10.0 mg F/100 g BW to occupy type I to the same extent). The hamster type II is 80-90% occupied by an equal dose of F or B (1.0 mg/100 g BW) whereas in the rat, F at 5-10 mg/100 g BW (doses 5-10 times that of B) is required to achieve this same occupancy. This data demonstrate the PMID- 3653034 TI - Inhibitory effect of the ovaries on neonatal androgen imprinting of growth hormone secretion in female rats. AB - The effect of neonatal androgen treatment on the GH secretory pattern was examined in intact and ovariectomized adult female rats. Neonatal ovariectomy or sham operation was performed at 1-2 days of age; thereafter, the animals were immediately given testosterone propionate (250 micrograms) or vehicle. Other rats, also treated neonatally with testosterone, were ovariectomized 15-22 days before blood sampling. Plasma GH was measured in blood samples obtained from indwelling intraatrial cannulae every 20 min for 8 h when the animals were 100 140 days old. Plasma GH secretory patterns were analyzed by a pulse analysis computer program (PULSAR). Neonatal testosterone treatment did not affect the GH secretory pattern of female rats with intact ovaries. In contrast, neonatal androgen treatment enhanced GH pulse height as well as mean GH concentration in neonatally ovariectomized female rats to levels comparable to those in intact male rats. Neonatal testosterone administration also significantly increased GH pulse height and mean plasma GH concentration in female rats that were ovariectomized during adulthood. However, the GH secretory pattern of ovariectomized female rats given testosterone neonatally still differed markedly from that of normal males, in that GH pulses occurred less regularly and baseline levels were higher. Pituitary GH content and concentration in neonatally ovariectomized female rats were increased to levels indistinguishable from those in male rats by neonatal testosterone treatment. No significant effect of neonatal testosterone was observed in sham-operated females. Neonatal ovariectomy decreased basal plasma GH levels, but did not affect plasma GH pulse height or pituitary GH levels. The serum estradiol concentration was markedly decreased in ovariectomized female rats, but was unchanged in sham-operated rats given neonatal testosterone, raising the possibility that serum estradiol secretion mediated the antagonistic effect of the ovaries on neonatal androgen imprinting. These results indicate that the presence of ovaries can prevent the stimulatory effect of neonatal androgen exposure on GH storage and secretion in adult female rats. PMID- 3653035 TI - Cortisone, testosterone, and aldosterone reduce levels of nerve growth factor messenger ribonucleic acid in L-929 fibroblasts. AB - Previous studies have shown that steroid hormones reduce concentrations of nerve growth factor (NGF) in medium conditioned by L-929 fibroblasts (L cells). In this study, we extend those observations and have measured in L cells the effects of hormone treatment on mRNA encoding NGF. L Cells were grown for 3 days in the presence or absence of hormones. NGF in conditioned medium was measured by NGF RIA; NGF mRNA was measured in cell extracts by Northern blot analysis. Cortisone reduced NGF levels in conditioned medium below the limit of detection of the RIA (less than 10% of control values) with an ED50 of 5 X 10(-9) M; NGF mRNA was reduced to 12% of control levels with an ED50 of 1 X 10(-8) M. Reductions in mRNA were maximal within 3 h and were completely reversed 12 h after removal of the hormone. Levels of NGF in conditioned medium were also undetectable in cultures treated with testosterone, and mRNA levels were reduced by 80%; the ED50 for both effects was 4 X 10(-9) M. Aldosterone (1 X 10(-6) M) reduced NGF to below detectable levels and NGF mRNA by 70%. Progesterone and thyroid hormone had no effect on NGF or NGF mRNA. 17 beta-Estradiol reduced levels of NGF in medium by 50%, but had no detectable effect on levels of NGF mRNA. These results suggest that cortisone, testosterone, and aldosterone decrease NGF levels in L cell conditioned medium by reducing the cellular content of NGF mRNA. PMID- 3653036 TI - Decreased potency of glucagon on transformed-induced MDCK cells does not reflect an alteration of adenylate cyclase components. AB - The selective loss of glucagon sensitivity of transformed MDCK cells can be restored by differentiation inducers, a process which requires RNA and protein synthesis and glycosylation. Although the glucagon dose-response curve of normal MDCK cells resembled that of liver and kidney (Kact = 10 nM), the transformed induced cells were 10-fold less sensitive to the hormone [activation constant (Kact) = 100 nM]. Additionally, the stimulation of cAMP synthesis by a glucagon fragment (glucagon) in transformed-induced cells was greatly reduced compared to normal cells. The adenylate cyclase regulatory components of transformed-induced MDCK cell membranes seemed unaltered compared to the parental line. Both contained equivalent amounts of cholera and pertussis toxin substrates, and soluble extracts were equally capable of reconstituting isoproterenol responsiveness of S49 cyc- membranes. However, membrane fusion studies demonstrated that the glucagon sensitivity of transformed-induced membranes could not be reconstituted with heterologous membranes. When donor transformed-induced membranes (with inactivated adenylate cyclase) were fused with acceptor HeLa membranes (normally unresponsive to glucagon and prostaglandin E), such hybrids were unresponsive to glucagon, although responsiveness to prostaglandin E was evident. Parallel hybrids with normal MDCK membranes were responsive to both glucagon and prostaglandin E. This difference could not be explained by an inhibitory effect of transformed-induced membranes on receptor-adenylate cyclase coupling under the fusion conditions: the ability of these membranes to serve as an acceptor for the reconstitution of vasoactive intestinal peptide responsiveness was identical to that of normal MDCK cells. The data suggest that the glucagon sensitivity induced in transformed MDCK cells differs significantly from that of the parental line. However, these differences cannot be explained by alterations of transformed-induced membrane components relevant to the coupling of hormone receptors to adenylate cyclase. PMID- 3653037 TI - Processing of growth hormone by rat adipocytes in primary culture: differentiation between release of intact hormone and degradative processing. AB - Rat adipocytes in primary culture have been used to study the intracellular processing of GH. These classic target cells for GH have been shown to process GH through two pathways: a nondegradative pathway which resulted in the rapid release of intact GH, and a slower, degradative pathway which involved the degradation of GH and release of degraded ligand. Differentiation between the two pathways was on the basis of differences in their kinetics and temperature dependence. The present study has investigated the relative characteristics of the two pathways further. Incubation of [125I]human GH ([125I]hGH)-preloaded adipocytes with extracellular unlabeled hGH (400 ng/ml) resulted in an increase in the absolute amount of [125I]hGH released. The increased amount of [125I]hGH released was all intact. Extracellular, unlabeled hGH had no effect on the rate or amount of degraded [125I]hGH released. This suggests that the nondegradative pathway is sensitive to the number of internalized hormone-receptor complexes and that GH which is not immediately degraded or stored in the degradative pathway, is redirected and processed via the faster non-degradative pathway. Ammonium chloride (known to inhibit the lysosomal degradation of many polypeptide hormones) markedly inhibited the absolute amount of [125I]hGH released from preloaded adipocytes. This inhibition was due to an effect on the release of degraded [125I]hGH. NH4Cl had no effect on the rate or amount of intact [125I]hGH released. Finally, it was found that dinitrophenol and sodium fluoride (agents known to deplete cellular energy) inhibited the release of degraded GH but not intact GH suggesting that the degradative pathway involves an energy-dependent step, most likely the fusion of hormone-containing vesicles with the lysosomal membrane. The mechanism of release of intact hormone by energy-independent means is not yet known. These data indicate that the processing of GH by cultured rat adipocytes is complex and involves at least two independently regulated pathways, a predominant degradative route and a nondegradative route. Further studies are required to assess the possible roles of these pathways in the metabolic actions of GH in adipocytes. PMID- 3653038 TI - Localization and characterization of insulin receptors in rat brain and pituitary gland using in vitro autoradiography and computerized densitometry. AB - In order to identify likely sites of action in insulin in rat brain we have used the technique of in vitro autoradiography and computerized densitometry to map, characterize, and quantify its receptors in coronal and sagittal sections. A discrete and characteristic distribution of insulin receptor binding was demonstrated, with specific binding representing 92% of total binding. Displacement and specificity competition curves in olfactory bulb are typical for authentic insulin receptors, and computer analysis indicates a single class of binding site with a dissociation constant (Kd) 0.48 nM for choroid plexus and 0.44 nM for olfactory bulb external plexiform layer. Insulin receptor density is maximum in the choroid plexus, and high in the external plexiform layer of olfactory bulb. Structures of the limbic system and hypothalamus reveal moderate to high insulin receptor density, particularly the lateral septum, amygdala, subiculum, hippocampal CA1 region, mammillary body, and arcuate nucleus. Moderate insulin receptor density occurs in regions of cerebral cortex and cerebellum, and moderate to low binding occurs in discrete brainstem and midbrain structures. Insulin binding in the pituitary gland is greatest in the anterior lobe, with clear distinction from intermediate and posterior lobes. The circumventricular organs and the thalamus show low insulin binding. We conclude that insulin receptors are widespread throughout rat brain, with concentration in regions concerned with olfaction, appetite, and autonomic functions. The distribution is distinct from other neuropeptides and not related to either vascularity or cell density. A common feature of regions rich in insulin receptors is that they contain dendritic fields receiving rich synaptic input. Whether insulin plays a specific neurotransmitter or metabolic role in these sites remains unclear, but these studies have provided detailed information on potential sites of action of insulin in the brain, and will allow further studies to examine insulin receptor function in specific brain regions. PMID- 3653040 TI - Effects of vasoactive intestinal polypeptide on acetylcholine stimulation of rat submandibular gland. AB - Studies were carried out on the role of vasoactive intestinal polypeptide (VIP) in the regulation of secretion and blood flow in the rat salivary gland. The first experiments to investigate the spontaneous secretory pattern revealed a clear diurnal fluctuation with a significant increase at night, so that the subsequent experiments were performed during the daytime where the secretion was consistently low. Intravenous administration of VIP at a dose smaller than 40 pmole caused a dose-dependent vasodilatory response, but at a high dose such a local effect was hampered by a decrease in systemic blood pressure. VIP potentiated the acetylcholine chloride (AcCho)--evoked salivary secretion, but VIP (0-100 pmole/kg) alone did not cause salivary secretion. Atropine reduced the salivary secretion evoked by AcCho and VIP, and the blood flow change evoked by AcCho. However, the blood flow change evoked by VIP was not affected by atropine. Hexamethonium exerted no significant effect on the response to administration of AcCho or VIP. The results indicate that VIP has a significant vasodilatory action and cooperates with AcCho in the regulation of salivary secretion in the rat, and VIP effects are atropine resistant, as in other species of animals. PMID- 3653039 TI - Thyroid function and antimicrosomal antibody during the course of silent thyroiditis. AB - The thyroid function and antithyroidal antibody were studied in 17 patients with silent thyroiditis unrelated to pregnancy. The antimicrosomal hemagglutination antibody (MCHA) was negative in ten of them (group I) and was positive in seven (group II). At one month after the thyrotoxicosis, thyroid function became normal in both groups. At two months after the onset of thyrotoxicosis, in group I T4 (8.1 +/- 1.8 micrograms/dl, Mean +/- SD), T3 (113 +/- 25 ng/dl) and TSH were normal. At that time T4 (2.8 +/- 2.2 micrograms/dl) was significantly decreased (p less than 0.001) compared with those of group I and the levels of TSH were strikingly increased in 6 patients in group II. The level of T3 (96 +/- 29 ng/dl) in group II was not different from that of group I. Therefore MCHA was negative in patients who did not develop hypothyroidism and MCHA was positive in patients who developed hypothyroidism. The development of hypothyroidism two months after thyrotoxicosis and positive MCHA are correlated. The Tg was elevated in 7 out of 13 patients (54%) with negative antithyroglobulin hemagglutination antibody and in the remainder was normal during thyrotoxicosis. The discrepancy between the level of Tg and thyroid hormones was discussed. PMID- 3653041 TI - Acute suppurative thyroiditis in appearance of unusual neck mass. AB - We report on three adult cases of acute suppurative thyroiditis due to infection through a piriform sinus fistula. In these cases, the lesion did not exhibit the clinical symptoms characteristic of acute suppuration, but appeared as an unusual neck mass. Repeated barium meal roentgenograms, however, demonstrated the internal fistula in two of the three cases. Acute suppurative thyroiditis may not be so rare even in adults. When acute suppurative thyroiditis occurs in adults with scanty symptoms of acute suppuration, the piriform sinus fistula could easily go undetected. Recognition of acute suppurative thyroiditis in adults per se seems to be important for correct diagnosis. PMID- 3653042 TI - Transient nephrogenic diabetes insipidus associated with acute hepatic failure in pregnancy. AB - A 29-year-old nullipara was admitted at 31 weeks' gestation because of toxemia. She noted gradually polyuria, severe thirst, malaise, nausea and anorexia. A water-deprivation test and administration of aqueous vasopressin confirmed the diagnosis of nephrogenic diabetes insipidus. At 33 weeks' gestation, blood chemistry studies revealed moderately elevated transaminase levels and hyperuricemia. Male twins were delivered by vacuum extraction at 35 weeks' gestation. After delivery, she became drousy and icterus appeared. Acute hepatic failure with marked hyperuricemia was diagnosed. She was treated with glucose solution with glucagon and soluble insulin, branched chain amino acids, gabexate mesilate, lactulose and famotidine. Her consciousness cleared rapidly and all laboratory data became normal by 15 days postpartum. The urine volume was about 5 liters per day from the first to sixth postpartum day. The diuresis decreased after the eighth postpartum day. Rare pregnancy complicated by transient nephrogenic diabetes insipidus and acute hepatic failure is discussed. PMID- 3653043 TI - Effect of altered inflation on pulmonary uptake of methylglyoxal bis(guanylhydrazone). AB - The effects of increased pulmonary ventilation on uptake of an exogenous, nonmetabolized polyamine analog, methylglyoxal bis(guanylhydrazone) [MGBG] were investigated in rat lungs perfused in situ with buffer containing 4.5% bovine serum albumin, 5.6 mM glucose and plasma levels of amino acids. The perfusate was equilibrated and the lungs were ventilated with warmed, humidified O2/N2/CO2 (20:75:5). A 28% increase in lung inflation rapidly accelerated MGBG uptake at low (1.5 microM) but not at high (50 microM) substrate concentration, a change which appeared to reflect a decrease in the apparent Km of the uptake pathway. This effect was not associated with acute alterations in pulmonary vascular permeability or resistance, nor with instability of the preparations. Taken with observations made previously, these results suggest that deformation of the tissue by increased inflation may account for increased MGBG uptake by lungs from rats subjected to partial pneumonectomy. PMID- 3653044 TI - Platelet activating factor stimulates secretion of mucin by explants of rodent airways in organ culture. AB - Platelet activating factor (PAF; 1-o-alkyl-2-0-acetyl-sn-glycero-3-phosphocholine 3-phosphocholine) a potential mediator of anaphylaxis, stimulates secretion of mucin by explants of trachea from four separate rodent species (guinea pig, rat, rabbit, ferret) in organ culture. Enhanced secretion is not a result of cell damage or release of histamine by cells within the explants (e.g., platelets). It is inhibited by equimolar concentrations of the potent PAF-receptor antagonist, Ro 19-3704. PAF provokes production of immunoreactive peptidyl leukotrienes (ir LTC4, LTD4, LTE4) within the explants. The stimulatory effect of PAF on mucin secretion is blocked by equimolar concentrations of nordihydroguiaretic acid (NDGA) a "mixed" inhibitor of both cyclo- and lipoxygenase pathways of arachidonic acid metabolism. Leukotrienes are localized within tracheobronchial epithelium by immunohistochemical staining, and physical removal of epithelium from explants inhibits production of leukotrienes in vitro under nonstimulated conditions and after exposure to PAF. In addition, the stimulatory effect of PAF on mucin secretion is not altered by FPL-55712, a receptor antagonist of LTD4. These results are consistent with the hypothesis that PAF stimulates secretion of mucin by activating biosynthesis of lipoxygenase products (e.g., peptidyl leukotrienes) within epithelial cells of the respiratory mucosa. PMID- 3653045 TI - Immunohistochemical demonstration of cytochrome P-450 monooxygenase in Clara cells throughout the tracheobronchial airways of the rabbit. AB - The nonciliated bronchiolar epithelial (or Clara) cell is considered the primary pulmonary site of cytochrome P-450-dependent monooxygenase activity. Despite the general conception that Clara cells are restricted to bronchioles, we have previously shown that a nonciliated cell with the cytological features of the Clara cell predominates throughout rabbit tracheobronchial airways. The present study was designed to determine if the cytochrome P-450 monooxygenase system has the same distribution. Trachea, terminal bronchioles and 3 generations of bronchi were selected by microdissection from fixed lungs of adult specific-pathogen-free rabbits. Serial sections of paraffin-embedded tissue were stained with either Alcian blue/periodic acid Schiff's (AB/PAS) or with antisera to one of the following: cytochrome P-450 form 2, form 5, or NADPH-dependent cytochrome P-450 reductase. The majority of nonciliated epithelial cells lining all 5 airway generations were PAS+ and AB-. Nonciliated cells in all 5 airway generations reacted positively with all three antisera. The primary deposition site was the apical portion of nonciliated cells. Other sites included ciliated surfaces and vascular endothelium. Reaction products from all three antisera had the same localization pattern. We conclude that (1) the cytochrome P-450 monooxygenase system is distributed throughout the tracheobronchial airways of the rabbit and (2) the Clara cells of the trachea and bronchi are functionally, as well as structurally, similar to those of the bronchioles. PMID- 3653046 TI - Autoradiographic studies of the distribution of 35sulfate label in ferret trachea: effects of stimulation. AB - Na2(35)SO4 is among the common isotopic mucin precursors used to label airway secretory cells and monitor their active discharge in response to drugs. Previous work has established that 35S is taken up by multiple cell types in the trachea, yet there is no direct evidence linking 35S release with secretory activity by any specific cell type. In this study, we have used autoradiography to identify the sites of uptake and release of 35S in ferret trachea. Confirming work performed in other species, we found uptake sites include surface epithelium (ciliated and goblet cells), submucosal glands (serous and mucous cells) and cartilage. Extending these findings using a "pulse-chase" protocol, we found that 35S turns over very rapidly in ciliated but not submucosal gland cells or cartilage. Specific grain density over epithelium declined from 0.12 +/-0.006 grains/micron 2 immediately after the pulse to 0.05 +/- 0.004 grains/micron 2 at 4 h. In contrast, corresponding figures for the glands and cartilage showed no spontaneous loss of label during the same period. At 4 h, when the epithelium contained very little 35S label, we exposed tracheal rings in vitro to neurotransmitter receptor agonists (bethanechol, phenylephrine, and isoproterenol; all at 10(-5) M). Counts in the medium (determined by scintillation spectrometry) increased 2-3 times in response to each agonist. These increases were prevented by preincubating tracheal rings with appropriate antagonists. Autoradiography showed that stimulated glands contained many fewer silver grains than untreated or antagonist-blocked glands. In contrast, neither cartilage nor epithelium showed decreased labeling after stimulation. These results indicate that (a) sulfated glycoconjugates turn over rapidly in the tracheal epithelium and may account for much sulfated material spontaneously released into organ culture medium and into the tracheal lumen, and (b) 4 h after Na2(35)SO4 incubation, the major source of 35S-labeled macromolecules released from ferret trachea by neural agonists is the submucosal glands. PMID- 3653047 TI - Observations on the effect of morphine on thalamocortical excitability in the cat. AB - The acute effects of morphine on the thalamocortical augmenting response in the cat were evaluated. The thalamocortical augmenting response was elicited by delivering pairs of pulses to the ventrolateral thalamus and recording from ipsilateral sensorimotor cortex. A biphasic, dose-related, naloxone-attenuable effect on the augmenting response elicited by pulse pairs was observed. Although the clinical significance of those morphine-induced changes is currently uncertain, they can be correlated with the convulsant and anticonvulsant effects of different doses of morphine. PMID- 3653048 TI - Brainstem experimental seizures produced by microinjections of carbachol. AB - Microinjections of 2-10 micrograms of carbachol into the mesencephalic reticular formation (MRF) and pontine reticular formation (PRF) of rats consistently induced local electroencephalographic seizures. These seizures had organized, rhythmical patterns and were long lasting. They spread powerfully and bilaterally between the MRF and PRF and also to the hippocampus and cortex. The electroencephalographic seizures were accompanied by severe, long-lasting convulsions. These convulsions were clonic and bilateral, started in the head area and progressed rostro-caudally to become generalized to the entire body. Other nonconvulsive behaviors were activated by the seizures. Immobility and catalepsy were the most frequent nonconvulsive correlates of the brainstem carbachol seizures. PMID- 3653049 TI - Timing of seizure recurrence in adult epileptic patients: a statistical analysis. AB - Seizure diaries were maintained prospectively in 24 epileptic patients (19 with partial complex, three with partial simple, and three with primary generalized seizures) who were selected consecutively, had stable seizure patterns, were reliable historians, and were known to be compliant with medications. Diaries were maintained for an average of 237 days (range, 61-365), and an average of 18 seizures were recorded per patient (range, 5-76). Seizure patterns were analyzed by using the methods appropriate for a time series of events (point process). Two patients had a decreasing trend in seizure frequency. For 12 patients, seizure occurrence was indistinguishable from that of a Poisson process. The remaining 10 patients had an exponential distribution of seizure intervals, but did not fit other criteria for a Poisson process; 3 of these showed evidence for seizure clustering; none showed evidence for a seizure cycle. It is concluded that the pattern of seizure occurrence in most epileptic people is random, but in approximately 50%, it is not occurring according to a Poisson process. These observations indicate that seizure cycling and/or clustering are not common in epileptic patients, but do not exclude the possibility that seizures have been precipitated by some randomly occurring event, such as sleep deprivation or increased stress. PMID- 3653050 TI - Human hippocampal seizure spread studied by depth and subdural recording: the hippocampal commissure. AB - Eleven patients had seizures with unilateral temporal lobe onset recorded with simultaneous bilateral medial temporal depth electrodes and neocortical (subdural) electrodes at least on the side of seizure onset. Of a total of 55 seizures, four had simultaneous onset in neocortex and hippocampus, and 51 had onset in unilateral hippocampus. None originated solely in temporal neocortex. Three reproducible patterns of seizure spread from hippocampus were defined in which seizures spread initially to ipsilateral neocortex (32 seizures), spread first to contralateral hippocampus (13 seizures), or spread simultaneously to ipsilateral neocortex and contralateral hippocampus. Although the region of hippocampus in which seizures arose was constant, patterns of spread sometimes varied in the same patient. When contralateral neocortical involvement occurred, it was after or with contralateral hippocampus but never before. These results suggest the existence of an operational hippocampal commissure in humans. PMID- 3653051 TI - Methohexital activation of epileptogenic foci during acute electrocorticography. AB - Methohexital was used as an activating agent in 62 patients undergoing focal cortical resections of epileptogenic foci and in six patients undergoing chronic electroencephalogram (EEG)/video monitoring with intracranial strip electrodes. In 87% of cases, methohexital caused selective activation of the epileptogenic focus during acute electrocorticography (ECoG). This activation appeared to be specific for the epileptogenic focus and did not cause epileptiform spiking from adjacent nonepileptogenic cortex. This ECoG activation occurred whether patients received local or general anesthesia. Sixty-five percent of patients demonstrated adequate activation with as little as 25 mg of drug. Methohexital is a safe and reliable method of activating epileptogenic foci during acute ECoG recordings and can decrease the time for ECoG recordings during surgery. PMID- 3653052 TI - Controlled release carbamazepine: cognitive side effects in patients with epilepsy. AB - The treatment of epilepsy with carbamazepine (CBZ) may be hampered by cognitive side effects. These side effects are thought to be related to pharmacokinetic properties of the drug. The serum concentration of CBZ is characterized by rapid absorption and a short half-life, which may lead to a considerable fluctuation of the level between doses. Cognitive defects may result from peak levels: short periods with high serum concentration. In a single-blind crossover design, cognitive performance was compared in three conditions. All patients were first tested in the steady state of conventional CBZ. The patients were then assigned randomly to either CBZ-controlled release (CR) or a condition in which conventional CBZ was administered in the same tablet form and dose frequency as CR. Psychological tests were administered four times daily, immediately after the serum samples were taken. A nonmedication control group was tested following the same test scheme to obtain standards for the evaluation of changes in performance during the day. A systematic tendency was found toward higher test performance in the CR condition. This is especially evident for tests of memory and accuracy of visual information processing. The results of the repeated test procedure show that the smoothing effect of the CR condition on serum concentration fluctuations results in a more stable pattern of cognitive functioning during the day. PMID- 3653053 TI - Carbamazepine-induced nonepileptic myoclonus in a child with benign epilepsy. AB - Myoclonic jerks involving the proximal limb musculature and tic-like movements (sniffing, coughing, or sighing) were observed in an 11-year-old boy with benign occipital epilepsy treated with carbamazepine (CBZ). The involuntary movements disappeared a few days after withdrawal of CBZ and reappeared with CBZ reintroduction. Plasma CBZ levels were always within the therapeutic range. Polygraphic studies failed to show any electroencephalogram (EEG) changes during myoclonic jerks. Appearance of nonepileptic myoclonus in epileptic children treated with CBZ should be carefully evaluated to prevent worsening of the clinical picture. The coexistence of other involuntary movements (tics) could suggest the correct diagnosis. PMID- 3653054 TI - Computed tomography in adult-onset epileptic seizures in a city hospital population. AB - Computed tomography (CT) was performed on 155 patients from a city hospital population who developed seizures after age 20. CT was normal in 58 (37.4%) and abnormal in 97 patients (62.6%). A focal abnormality was seen in 71 patients (45.8%). Lesions potentially correctable by surgery were found in 24 patients (15.4%). As expected, the occurrence of abnormal CTs was higher (73%) in patients with partial seizures. Although CT is undeniably useful in evaluating the cause of seizures, no demonstrable lesion was found in a relatively large number of patients (37.4%). PMID- 3653055 TI - Disappearing CT lesions in epilepsy. AB - A striking but reversible computed tomographic (CT) lesion corresponding to seizure activity is reported in a series of 46 epileptic patients. None of these patients had evidence of tuberculosis or cysticercosis, and all were treated with antiepileptic drugs only. Maximal radiological changes occurred in the area of maximal epileptic discharge; however, multiple lesions were seen in three cases. The CT lesion reappeared with recurrence of the ictus in four cases during follow up, and this, too, disappeared after complete arrest of the seizures. The clinical, CT scan, and other investigatory findings suggest that the seizures may occasionally cause a CT-demonstrable focal abnormality, probably cerebral edema, a consequence of abnormal vascular permeability. Awareness of this radiological entity should avoid misdiagnosis of cerebral tumor, infarction or tuberculoma in patients with seizure disorder. PMID- 3653056 TI - Transient focal abnormalities of neuroimaging studies during focal status epilepticus. AB - We report transient changes in computed tomography (CT) and magnetic resonance imaging (MRI) scans in a patient with focal status epilepticus, referred to us with a tentative diagnosis of neoplasm based on CT and angiographic findings. EEG seizures originated independently from each temporal-occipital area, predominantly from the right. Previous EEGs had shown almost exclusively right temporo-occipital epileptogenic activity. MRI showed increased signal intensity, and CT showed decreased right hemisphere attenuation without enhancement. One month later, there was resolution of the radiological and clinical abnormalities. The transient CT and MRI changes probably represented focal cerebral edema, developing during focal status epilepticus. Lack of change in the left hemisphere probably reflected the quantitative difference in epileptic activity. Clues to the diagnosis of focal edema due to status include: (1) changes on electrical and imaging studies that correlate anatomically with the clinical status, and (2) resolution of abnormalities with appropriate seizure control. In patients with suspected seizure disorders, electrical and clinical data should be correlated before interpretation is made of focal lesions seen by neuroimaging techniques. PMID- 3653057 TI - Periodic lateralized epileptiform discharges--long-term outcome in adults. AB - We reviewed the long-term outcome of 39 adults whose electroencephalograms (EEGs) showed acute periodic lateralized epileptiform discharges (PLEDs). Parameters studied included outcome, presence or absence of a seizure disorder (both prior to and subsequent to the PLEDs), seizure type and frequency, and etiology of the PLEDs. The mortality rate was 41%, as 16 of 39 patients died during their hospitalization or within 2 months of discharge. Of the 23 survivors, 7 (30%) had a significant decline in their ability to provide self-care. A recent stroke (13 patients, 33%) was the most frequent cause of PLEDs. In this subgroup particularly, poor outcome, i.e., death or functional decline, was common (10 of 13 patients). Thirty-six patients had seizures just prior to or during the hospitalization when PLEDs were observed; focal motor seizures were the most common type (n = 22). Patients with a history of seizures prior to the occurrence of PLEDs continued to have seizures following discharge. In addition, 4 of 9 patients with new onset seizures associated with PLEDs had subsequent seizures. PMID- 3653058 TI - The exact ictal and interictal duration of electroencephalographic neonatal seizures. AB - The temporal behavior of neonatal seizures caused by diverse acute encephalopathies in 42 patients with 487 seizures was studied. All 487 seizures were confirmed by typical ictal electroencephalogram (EEG) patterns. Neonatal seizures are relatively brief events, which usually last about 2 min. They are recurrent and are separated by interictal recovery periods of variable duration, on the average, about 8 min. Solitary prolonged seizures are rare and do not represent the usual behavior of neonatal seizures. PMID- 3653059 TI - Epilepsy in adolescence: implications for the development of personality. AB - Sixteen adolescent children with onset of epilepsy between the ages of 1 and 12 years and 16 control children were investigated by interview, self-esteem scales, and the Thematic Apperception Test (TAT). Children with epilepsy had a significantly larger discrepancy between the self-image and the ideal self-image than did the control children. TAT indicated the body and self-image is poorer, the unknown and the risk of acting out more threatening, the sex identity less stable, and the defense not as adaptive as the control group. Persons suffering from epilepsy are often stigmatized. One explanation could be the influence of epilepsy on the development during adolescence of the basic trust of their bodies and of themselves. PMID- 3653060 TI - Memory function and verbal learning ability in patients with complex partial seizures of temporal lobe origin. AB - A variety of experimental paradigms have been utilized to study verbal learning and memory ability in patients with epilepsy. One commonly used paradigm, the free recall of a list(s) of related or unrelated words, has revealed a variety of performance anomalies in patients with complex partial seizures (CPS) of temporal lobe origin, but published studies have varied markedly in important methodological details, making it difficult to interpret discrepant findings as well as to assess the generalizability of results. The purpose of this investigation was to simultaneously inquire into several aspects of verbal learning and memory function that have been reported or hypothesized to be compromised in individuals with CPS of left temporal lobe origin. Thirty patients with CPS of lateralized temporal lobe onset [15 left temporal (LT) and 15 right temporal (RT)] were compared with 15 matched controls (NC) on several measures derived from the California Verbal Learning Test (CVLT), i.e., verbal learning ability, immediate free recall, presence of retroactive interference effects, semantic organization, retrieval efficiency, and recognition memory. Compared to RT and NC groups, the LT patients manifested poorer verbal learning ability, impaired immediate memory, and increased difficulty in the retrieval of verbal material from memory store. Compared to NC subjects, the LT group showed poorer semantic organization in their verbal learning and recall. The RT and NC groups were essentially similar in all respects. Finally, the clinical utility of these findings were investigated, and a series of decision rules designed to separate LT from RT patients was derived. PMID- 3653061 TI - Spelling errors made by children with mild epilepsy: writing-to-dictation. AB - Errors and corrections made by 64 mildly epileptic children of at least average intelligence who were attending ordinary elementary schools when writing in response to dictation (writing-to-dictation) were assigned to one of 28 descriptive error categories. Numbers and types of errors were compared with those obtained in 630 form-matched, healthy control subjects (Wilcoxon's two sample test, less than or equal to 0.01). Epileptic children made significantly more errors than control subjects. Separate error categories had no diagnostic power. The groups could not be distinguished on the basis of skill-related errors. However, performance errors (erroneous deviations from the intended product), were found to be made more frequently by epileptic children. Epileptic children made more corrections and also left more errors uncorrected than control children. No relationship could be established with illness variables. Deficient problem-solving strategies, probably resulting from emotional concomitants of epilepsy, may explain the results. PMID- 3653062 TI - Differential response of growth hormone, cortisol, and prolactin to seizures and to stress. AB - Plasma concentrations of growth hormone (GH), cortisol, and prolactin (PRL), following a spontaneous generalized seizure in epileptic men were compared with similar measurements made in nonepileptic, stressed men to determine the role of stress in the hormonal response to seizures. Nonepileptic, nonstressed men served as control subjects. GH concentrations increased significantly within 60 min postictally, and as expected, so did cortisol and PRL. A subgroup of alcoholic patients exhibited a smaller GH response to seizures. Stressed patients had significantly less elevated cortisol and PRL plasma values, but no rise of GH. The data suggest that neurogenic stimuli responsible for the postictal release of GH, cortisol, and PRL are, at least in part, independent of stress mechanisms and that GH response is blunted in alcoholic patients. PMID- 3653063 TI - The effects of estrogen, progesterone, and ionized calcium on seizures during the menstrual cycle of epileptic women. AB - Previous research suggested a positive relationship between levels of serum estrogen and seizures, a negative relationship between levels of serum Ca++ and seizures, and a negative relationship between serum levels of estrogen and Ca++. This study sought a relationship between levels of serum estrogen, ionized calcium, progesterone, and its possible effect on seizures during the menstrual cycle of epileptic women. The negative relationship between serum estrogen and Ca++ was confirmed. However, a study of 15 institutionalized epileptic women, all with a diagnosis of primary generalized epilepsy, demonstrated that fewer seizures occurred in midcycle (when estrogen levels were elevated and Ca++ levels were decreased) than at other stages of the menstrual cycle. This is suggestive of a protective (anticonvulsant) aspect of the hypothalamo-hypophyseal negative feedback system, previously unreported. PMID- 3653064 TI - Monitoring of workers occupationally exposed to pesticides in grape gardens of Andhra Pradesh. AB - Studies were undertaken to investigate the effect of pesticides on workers employed in grape gardens of Andhra Pradesh. The data obtained on the reproductive performance showed an increase in the incidence of abortions and stillbirths. Out of 12 employed couples in grape gardens, 2 were found to be sterile. Cytogenetic studies revealed a significant increase in chromatid breaks and gaps in chromosomes of peripheral blood in workers exposed to pesticides. In addition, a high frequency of satellite associations was recorded in these workers. PMID- 3653065 TI - Effect of sodium fluoride on antibody formation in rabbits. AB - In the present study, the role of sodium fluoride on antibody formation in rabbits is assessed. Sixteen female albino rabbits were divided into four groups and were treated as follows: Group I: Animals immunized with transferrin and used as controls for group II; Group II: Animals immunized with transferrin and administered orally NaF (10 mg/kg body weight) daily for 9 months; Group III: Animals immunized with transferrin and served as controls for group IV; and Group IV: Animals administered with NaF at a dose of 10 mg/kg body weight daily for 9 months and then immunized with transferrin and fluoride treatment continued for another 9 months. Rabbits were bled just prior to immunization and subsequent bleeding was at weekly intervals. Circulating anti-transferrin titers were estimated. DNA and protein synthesis was determined by incorporating [3H]thymidine and [14C]leucine, respectively. The present report demonstrates that sodium fluoride inhibits antibody formation in rabbits. There is a threshold level of fluoride (0.78 ppm) in circulation which is responsible for the inhibitory effect on antibody formation. Inhibition of DNA and protein synthesis by NaF is also demonstrated. It is concluded that fluoride inhibits the antibody formation by decreasing the proliferation of lymphocytes and by inhibiting the protein synthetic ability of immunocytes. PMID- 3653066 TI - A model for predicting crocidolite fiber size distributions. AB - To minimize the problems of sample mass inconsistency associated with limited fiber counts, a model has been developed to predict the particle size distribution for crocidolite asbestos fibers with lengths exceeding the median log length value. With this model, it is possible to predict the dimensions of many more fibers than it is practical to measure by typical electron microscopic techniques. Thus, sample mass extrapolations, required for animal implantation studies, can be based on a much larger number of particles, reducing error that could occur, for example, from the presence of one or two very large particles. The model assumes a linear relationship between length and width. The number of fibers predicted in each length category is determined from the measured data. Particle lengths were randomly chosen within size classes, and the corresponding widths were predicted using the model. The similarity of the predicted population to the actual population was tested by comparing the width distributions using the chi-square test at the 90% confidence level. Model populations ranging from 250 to 10,000 particles were predicted. Those populations with 2500 or more fibers were similar to the actual sample in their size characteristics. Predicted populations in excess of 7500 fibers were required to produce consistent sample masses. PMID- 3653067 TI - Mineral particles in the lungs of subjects resident in the Rome area and not occupationally exposed to mineral dust. AB - We studied the inorganic particulate contained in the lung parenchyma of 10 subjects (5 males and 5 females) resident in an urban area and not occupationally exposed to dusts. A total of 17 mineral types were identified, along with 16 metal elements in the form of oxides and sulfides. Approximately 70% of the minerals were made up of phyllosilicates, in particular clay, mica, and talc; three metal elements, Fe, Al, and Ti, accounted for more than 75% of the recovered oxide particles. The mean concentration of the observed inorganic particles was approximately 1.8 X 10(5) pp/mg dry tissue. No significant differences were observed in terms of total particulate concentration in the various areas of the lungs and between the right and left lung. Instead we observed a larger concentration of fibrous particles in the upper lobes. The analysis of the data made it possible to determine the presence of a high degree of correlation between the concentrations of silicates and the concentrations of metal oxides and sulfides, implying the existence of a ubiquitous environmental source of these mineral particles. The frequent observation of tremolite fibers is remarkable. This finding, confirmed elsewhere, indicates that the magnitude of the sources of these fibers in the environment, constituted by contaminated talc dusts, has been underestimated until today. PMID- 3653068 TI - Asbestos bodies or fibers and the diagnosis of asbestosis. AB - A committee of the College of American Pathologists has proposed that the diagnosis of asbestosis requires fibrosis in respiratory bronchiolar walls and the presence of asbestos bodies (ABs) in tissue sections. To determine whether histologic ABs reliably reflect asbestos fiber concentrations in asbestosis, we compared the concentration of ABs in histologic sections to concentrations of ABs and fibers in tissue extracts of 14 asbestos workers with nonspecific interstitial fibrosis. ABs in histologic sections and extracts correlated well, r = 0.95. Counted and classified by electron microscopy, electron diffraction, and X-ray spectroscopy, commercial amphibole fibers (r = 0.94) also correlated well with ABs, but noncommercial amphiboles (r = -0.02) or chrysotile (r = 0.29) did not. In five subjects with a high percentage of noncommerical amphibole fibers, fewer than 0.5 histologic ABs/cm2 were present despite a total amphibole concentration that was similar to that in subjects with more histologic ABs. We conclude that ABs will be scarce or absent in histologic sections from some subjects with asbestosis, and that for such subjects, extracts of asbestos fibers should yield over 500,000 total amphibole fibers/g dry lung to signify that interstitial fibrosis may be caused by asbestos. PMID- 3653069 TI - Cytotoxic effect of uranium dioxide on rat alveolar macrophages. AB - Alveolar macrophages obtained by bronchial lavage were used to assess the response of these cells to cultivation in media containing increasing concentrations of particulate UO2. The characteristic time course of uranium effects on alveolar macrophages was determined by analyzing cell viability and incorporation of uranium particles. This study reveals the ability of alveolar macrophages to phagocytize uranium particles despite the high toxicity the metal exerts on cell membranes. However, lethal effects soon become evident. Ultrastructural analysis showed uranium particles confined within membrane bound vacuoles or free in the cytoplasm. Marked ultrastructural alterations consistent with cell death were frequently observed. The elimination of the first biological barrier hinders the scavenging of particulate contaminants in alveolar spaces, thus favoring the translocation to target organs. PMID- 3653070 TI - Comparative effects of ten dithiocarbamate and thiuram compounds on tissue distribution and excretion of lead in rats. AB - Combined treatment of rats with lead and disulfiram is known to cause increased levels of lead in brain and potentiation of the neurotoxicity of lead. Ten dithiocarbamate and thiuram compounds, including disulfiram, were compared for their efficacies in influencing tissue distribution of a trace dose of intravenously injected lead plus 203Pb in rats. The tested compounds were sodium diethyldithiocarbamate (DEDTC), sodium dimethyldithiocarbamate (DMDTC), tetraethylthiuram disulfide (disulfiram), a complex of zinc and manganese ethylenebisdithiocarbamate (mancozeb), manganese ethylenebisdithiocarbamate (maneb), sodium monomethyldithiocarbamate (metham), zinc propylene bisdithiocarbamate (propineb), tetramethylthiuram disulfide (thiram), zinc ethylenebisdithiocarbamate (zineb), and zinc dimethyldithiocarbamate (ziram). Pronounced effects on tissue distribution of lead were seen after peroral and subcutaneous administration of DEDTC, DMDTC, disulfiram, metham, thiram, and ziram. After peroral administration there was an increased uptake of lead in brain, liver, lung, and spleen and a decreased uptake in femur compared to control rats receiving only lead. Thiram was the most effective compound in enhancing lead uptake in brain, causing a 100-fold increase in 203Pb concentration at 72 hr survival. After subcutaneous administration, metham caused the highest increase in brain concentration of 203Pb. Fecal excretion of lead, which is the main excretory pathway, was decreased after peroral administration of disulfiram, ziram, and thiram to about 20% of the excretion in control rats at 48 hr. Urinary excretion of lead was significantly decreased in all the treated groups except the group treated with zineb. The effects on tissue distribution and excretion can be explained by in vivo formation of lipophilic complexes between lead and these compounds or their metabolites facilitating the transport of lead through cell membranes and the blood-brain barrier. Zineb, maneb, propineb, and mancozeb did not cause similar effects on the tissue distribution of lead. The results of this study show that interactions can occur between lead and DEDTC, DMDTC, disulfiram, metham, thiram, and ziram, resulting in increased levels of lead in brain and probably potentiation of the neurotoxic effects of lead. PMID- 3653071 TI - Lymphocyte proliferative responses to mitogens in rats having an ancestry of a perinatal iodine-131 insult. AB - The possible existence of a genealogical memory consisting of altered lymphocyte proliferative responses to a perinatal iodine-131 insult has been investigated in two generations of inbred Fischer F344 rat offspring. The studies which involved exposure to the radioiodine during late pregnancy with concentrations ranging from 1.85 MBq (50 microCi) to 7.4 MBq (200 microCi) revealed that only the peripheral blood T lymphocytes of the first generation male animals were significantly affected. These animals were found to possess T lymphocytes which exhibited increased proliferative responses expressed toward the mitogens concanavalin A and phytohemagglutin; however, no significant changes were noticeable in their B cell population following exposure to lipopolysaccharide. Neither the first generation females nor the male and female offspring of the second generation developed through sibling interbreeding seemed to be affected, this was unlike the cellular, humoral, and natural immunity which had previously been observed to be changed in both the second and third generation animals. These observations suggest that the effects of the radiation insult upon immunocompetency as measured by lymphocyte proliferation do not appear to be inherited. PMID- 3653072 TI - Deriving the generic structure of the fibronectin type II domain from the prothrombin Kringle 1 crystal structure. AB - The proposed homology between the fibronectin type II domain and the Kringle domains of blood clotting and fibrinolytic proteins has been examined in three dimensions by substituting the type II sequence into the bovine prothrombin Kringle 1 tertiary structure, determined by X-ray crystallographical methods at 3.8 A. Structural substitution of aligned amino acids of the type II domains and the Kringle produces a compact chain fold and deletions and insertions in the type II sequence are accommodated within the modelled structure. This confirms the structural homology between the two domains and verifies the sequence alignment and common evolution of the type II and Kringle units. The two structures contain homologous hydrophobic cores, centered around the two disulphide bridges which link conserved beta-type strands. Gross differences between the two domains occur in exterior loops and potential functional sites in these regions of the type II structures as found in fibronectin, Factor XII and seminal fluid protein PDC-109 are proposed. We suggest that the domains evolved from a common ancestral protein comprising the hydrophobic core and disulphide arrangement which later diverged to bind different macromolecules through adaptation of the external loops. PMID- 3653073 TI - Multiple nuclear proteins in liver cells are bound to hepatitis B virus enhancer element and its upstream sequences. AB - The transcriptional enhancer element in the hepatitis B virus (HBV) genome displays tissue-specific activity, suggesting that this element interacts with cellular specific factors. Using a nitrocellulose filter binding assay and DNase I footprinting, we have found that liver cell-specific nuclear proteins are bound to the HBV enhancer element (the E site) and its adjacent sequences. Four DNase I protected sites were revealed, all contain a sequence motif resembling the sequence of the SV40 enhancer core element. Evidence is provided to show that: (i) these sites are protected by at least three distinct nuclear proteins and (ii) the presence of some of these proteins is dependent on the differentiation stage of the liver cells. Interestingly an octamer sequence found in the E site appears also in the promoter region of several liver-specific genes, which suggests that the E site and its corresponding binding protein(s) determine the tissue-specific expression of the HBV enhancer element. PMID- 3653074 TI - The properties of a new polymerase III transcription factor reveal that transcription complexes can assemble by more than one pathway. AB - We have resolved a previously unidentified factor (TFIIID) that is required for in vitro transcription of polymerase III templates. Our ability to resolve factor D from each of the other components of the transcription machinery (polymerase and transcription factors IIIB and IIIC) allowed us to test the capacity of these separated components to form stable complexes with tRNA genes. We find that none of the individual components binds detectably to tRNA genes, but that certain combinations of transcription factors do bind. Our results show that TFIIID is essential for binding and that formation of a full transcription complex can proceed by either of two different pathways. PMID- 3653075 TI - A new mouse TCR V gamma gene that shows remarkable evolutionary conservation. AB - We have identified a new mouse T-cell receptor V gamma gene segment, V gamma 4.4, which frequently undergoes rearrangements in AKR thymomas, and at a lower frequency in fetal thymocytes. V gamma 4.4 is the fourth and the most 5' V gene segment in the gamma 4 cluster, being 7.3 kb from V gamma 4.3. Surprisingly, V gamma 4.4 is more homologous to eight human V gamma genes than to the other mouse V gamma genes. It has only a 38% nucleotide and 21% amino acid sequence homology to the most homologous mouse V gamma gene (V gamma 4.1), whereas these homologies to the human V gamma 8 gene are as high as 68% and 48% respectively. PMID- 3653076 TI - The human homologue of the mouse t-complex gene, TCP1, is located on chromosome 6 but is not near the HLA region. AB - Southern blot analysis indicates that there are four sequences in the human genome related to the mouse t-complex gene Tcp-1. All four genes were cloned and partial sequencing showed that one of them was a functional gene, and the other three were pseudogenes. The human sequences were all approximately 90% related to each other and 82-89% related to the mouse Tcp-1a sequence. Human TCP1 cDNA clones from both fibrosarcoma and B cell lines confirmed that there was a single expressed gene. mRNA transcripts of different sizes were accounted for by two different polyadenylation signals. The human TCP1 gene shared some amino acid substitutions with the mouse t-complex allele (Tcp-1a) which were not found in Tcp-1b. The functional human TCP1 gene was mapped, using a panel of somatic cell hybrids, as well as in situ analysis, to the long arm of chromosome 6 at 6q23 qter and thus is not closely linked to the HLA complex on the short arm. For this reason and others it is unlikely that there is a human equivalent of the mouse t complex. PMID- 3653077 TI - Identification of a testis-specific gene from the mouse t-complex next to a CpG rich island. AB - We have used an approach based on the observation of CpG-rich regions near the 5' end of many genes to screen a panel of cosmids derived from the t-complex and tested candidate sequences for evidence of transcription in a number of different mouse tissues. One gene so identified is expressed specifically in testicular germ cells and maps to a subregion of the t-complex also containing loci involved in transmission ratio distortion and male sterility. The transcript is first detected during the pachytene stage of the first meiotic division, but is expressed in highest levels in the later haploid spermatogenic stages. Sequence analysis verified the existence of a CpG-rich element on the 5' end of the gene and predicts a unique protein species with no significant homologies to those previously determined. PMID- 3653078 TI - A processed gene coding for a sarcomeric actin in Xenopus laevis and Xenopus tropicalis. AB - A processed gene potentially coding for a sarcomeric actin has been identified in Xenopus laevis and in the more primitive species X. tropicalis. The peptides encoded in these two species differ by two out of 377 amino acid residues. On the basis of the amino acid substitutions, the encoded peptide was identified as an alpha-skeletal actin in X. laevis and as an alpha-cardiac actin in X. tropicalis. Northern blot analysis and S1 mapping experiments suggest that in X. tropicalis the gene is expressed in embryos and adult heart. In X. laevis, transcripts homologous to this gene were found in embryos and in adult tissues, but predominantly in skeletal muscle rather than in heart. PMID- 3653079 TI - Nuclei act as independent and integrated units of replication in a Xenopus cell free DNA replication system. AB - We have used a novel approach to investigate the control of initiation of replication of sperm nuclei in a Xenopus cell-free extract. Nascent DNA was labelled with biotin by supplementing the extract with biotin-11-dUTP, and isolated nuclei were then probed with fluorescein-conjugated streptavidin. Flow cytometry was used to measure the biotin content of individual nuclei and their total DNA content. This showed that incorporation of the biotinylated precursor increases linearly with DNA content. Haploid sperm nuclei replicate fully to reach the diploid DNA content over 2-6 h in the extract. Synthesis stops once the diploid DNA content is reached. Different nuclei enter S phase at different times over greater than 1.5 h, although they share the same cytoplasmic environment. Nuclei reach their maximum rates of synthesis soon after entry into S phase and some replicate fully in less than 0.5 h, resembling the rates of replication observed in the intact egg. These results indicate that initiations are coordinated within each nucleus such that the nucleus is the fundamental unit of replication in the cell-free system. PMID- 3653080 TI - Periodic DNA synthesis in cell-free extracts of Xenopus eggs. AB - Cell-free extracts prepared from unfertilized eggs of Xenopus laevis support DNA synthesis on sperm pronuclei. Continuous labelling studies using [3H]dCTP and pulse labelling studies using [32P]dCTP demonstrate that synthesis occurs in short bursts of 40 min, which are punctuated by periods of 20-40 min during which no synthesis occurs. Density substitution experiments using bromodeoxyuridine demonstrate that this synthesis involves the initiation of replication and reveals that re-initiation events can occur following multiple bursts of replication. The periodic properties of these extracts are sensitive to protein synthesis inhibitors. PMID- 3653081 TI - Protection by fentanyl against cardiac dysrhythmias during induction of anaesthesia. AB - The effect of fentanyl on electrocardiographic changes during anaesthetic induction was studied in 113 adults and 77 children. The adults were pretreated with fentanyl 1, 2 or 3 micrograms kg-1 and the children received fentanyl 1 or 2 micrograms kg-1 as pretreatment. The control groups received no pretreatment. Two minutes after the pretreatment, thiopentone 5 mg kg-1 was injected followed by succinylcholine 1.5 mg kg-1 before laryngoscopy and intubation. In control adults, ventricular ectopic beats (VEB) occurred in 26% of the patients whereas fentanyl in all doses totally prevented them. In children, the incidence of VEB was 22% in the control group whereas both doses of fentanyl prevented the occurrence of VEB. In any doses, fentanyl did not prevent the prolongation of QT interval after succinylcholine. PMID- 3653082 TI - Effects of a low dose of pancuronium on oxygen consumption during sustained muscular exercise. AB - The effects of a low dose of pancuronium on muscular performance were studied in six healthy volunteers. Three dynamic exercise tests at increasing levels of power were performed by each subject on two consecutive days using an ergometric bicycle. To assess muscular function, oxygen consumption was measured in a steady state at each level of power output. Pancuronium 6-8 micrograms kg-1 or placebo was administered i.v. in a double-blind fashion before the second test each day. Plasma pancuronium levels were measured 8 min after administration but even with pancuronium clearly detectable in the plasma no significant differences were found either in oxygen consumption or in the haemodynamic measurements made. The authors conclude that such doses of non-depolarizing neuromuscular blocking agents do not disturb oxygen consumption during dynamic muscular exercise and are therefore unlikely to have a significant effect on muscular function. PMID- 3653083 TI - Diclofenac versus pethidine in the treatment of pain after hysterectomy. AB - A double-blind study was performed in 63 patients to compare diclofenac (a non steroidal anti-inflammatory drug), pethidine and placebo with regard to efficacy and tolerability in the treatment of pain after abdominal hysterectomy. The compounds were injected post-operatively and the duration of pain relief was chosen as the parameter of efficacy. Pain intensity was measured on a visual analogue scale by the patient and according to a six-point scale by the investigator. Diclofenac gave significantly longer pain relief than pethidine or placebo. Few side-effects were reported after diclofenac and placebo, and post operative bowel paralysis tended to be shorter with diclofenac. PMID- 3653084 TI - Bupivacaine accentuates the cardiovascular depressant effects of verapamil in conscious dogs. AB - To investigate the potential risk of regional anaesthesia in a verapamil-treated patient, the cardiovascular effects of a combined intravenous infusion of bupivacaine and verapamil were studied in seven conscious and chronically instrumented dogs and were compared to those obtained when each drug was infused separately in the same animals. During verapamil infusion, the decrease in arterial pressure and myocardial contractile force, and the increase in heart rate were constant during the infusion. The lengthening of PR interval correlated with the plasma level of verapamil. During infusion of bupivacaine alone, there was an increase in heart rate and arterial pressure at the end of infusion, whereas the initial depression of myocardial contractile force was compensated. PR interval remained unchanged throughout the infusion of bupivacaine. During combined infusion of bupivacaine and verapamil, there was a time-dependent decrease in heart rate, arterial pressure and myocardial contractile force. A further increase in PR interval correlated with verapamil plasma concentrations which were higher than when verapamil was infused alone; bupivacaine plasma levels were in the same range as during bupivacaine infusion alone. Short periods of second-degree atrioventricular block developed in three out of the seven dogs but no relation was found between QT interval and heart rate in the whole group. Calcium chloride during bupivacaine-verapamil returned heart rate, arterial pressure and myocardial contractile force to their control values within 5 min. Atrioventricular block disappeared and PR interval was shortened following administration of calcium. Bupivacaine and verapamil have additive cardiovascular effects which lead to atrioventricular conduction dysfunction. The effects, at these doses, are reversed by calcium chloride. PMID- 3653085 TI - Bronchoscopy and nitrous oxide pollution. AB - The purpose of the investigation was to assess the extent of nitrous oxide pollution during bronchoscopy (rigid ventilation bronchoscope) and further to elucidate the possible reduction in air pollution during local scavenging of leaking gas by a suction catheter placed in the pharynx. The study included 14 adult patients. The leakage of anaesthetic gas was 11.4 +/- 3.2 l min-1 and the median value of the nitrous oxide concentration in the breathing zone of the endoscopist was greater than 300 ppm. Air pollution could not be reduced significantly by scavenging with a suction catheter. The use of inhalation anaesthetics is therefore inadvisable during bronchoscopy in adults unless sufficient anaesthetic scavenging can be established. Other ways of reducing air pollution are discussed and the use of total intravenous anaesthesia or local anaesthesia is advocated. PMID- 3653086 TI - Ketamine-induced dysrhythmia and its antagonism: a case report. AB - Ketamine is normally considered as being anti-dysrhythmic. A case report is presented here in which small subanaesthetic doses of ketamine were administered to reinforce spinal analgesia. Initial doses were followed by a dysrhythmia, which appeared to be repeatedly counteracted by further small doses of the drug. The cardiac pharmacology of ketamine is discussed, as is the relevance of the chance finding of mitral valve prolapse. PMID- 3653087 TI - Acute laryngeal obstruction in a patient with chronic bronchitis. AB - An unusual case of acute respiratory obstruction due to a laryngeal cyst is described. The mixed inspiratory and expiratory nature of this obstruction is discussed, and its implications for diagnosis and anaesthetic management. Alternative forms of management, especially those of transtracheal insufflation and transtracheal ventilation, and their possible complications are considered. PMID- 3653088 TI - Predicting metabolic cost of running with and without backpack loads. AB - In the past, a mathematical equation to predict the metabolic cost of standing or walking (Mw) was developed. However, this equation was limited to speeds less than 2.2 m.s-1 and overestimated the metabolic cost of walking or running at higher speeds. The purpose of this study was, therefore, to develop a mathematical model for the metabolic cost of running (Mr), in order to be able to predict the metabolic cost under a wide range of speeds, external loads and grades. Twelve male subjects were tested on a level treadmill under different combinations of speed and external load. Speed varied between 2.2 to 3.2 m.s-1 using 0.2 m.s-1 intervals and external loads between 0-30 kg with 10 kg intervals. Four of the subjects were also tested at 2 and 4% incline while speed and load remained constant (2.4 m.s-1, 20 kg). The model developed is based on Mw and is proportionately linear with external load (L) carried as follows: Mr = Mw 0.5 (1-0.01L)(Mw -15L-850), (watt) The correlation coefficient between predicted and observed values was 0.99 (P less than 0.01) with SER of 7.7%. The accuracy of the model was validated by its ability to predict the metabolic cost of running under different conditions extracted from the literature. A highly significant correlation (r = 0.95, P less than 0.02, SER = 6.5%) was found between our predicted and the reported values. In conclusion, the new equation permits accurate calculation of energy cost of running under a large range of speeds, external loads and inclines. PMID- 3653089 TI - Physical work capacity and effect of endurance training in visually handicapped boys and young male adults. AB - The purpose of the present study was to evaluate the relationship between several physical fitness parameters and eyesight divided into 3 grades in visually handicapped boys and young male adults, and to investigate the effect of mild exercise training on physical and psychic symptoms as well as cardiorespiratory fitness. Four subjects were totally blind (TB), 6 were semi-blind (SB) and 27 had amblyopia (AM). Physical fitness tests consisted of maximal oxygen uptake (Vo2max), maximal pedalling speed and power, maximal stepping rate, and isometric knee extension strength. Compared with AM and SB groups, the TB group was inferior in all physical fitness parameters. Especially, Vo2max, in TB (26 ml.kg 1.min-1) was about 56% of that in age-matched Japanese sighted subjects and was significantly low compared with the AM and SB groups. Both muscle strength and maximal pedalling power corresponded to about 50% that of the age-matched sighted group. Six SB and 4 TB students (mean = 17.7 years) were trained for 6 weeks on a bicycle ergometer at an intensity of 50% VO2max. Training was undertaken for 3 days per week and maintained for 60 min per session. After training, physical and psychic symptoms determined by the Cornell Medical Index improved significantly. These results indicate that low physical work capacity in visually handicapped boys and young male adults is due to the lack of physical activity, and that mild endurance training is effective in improving physical and psychic symptoms as well as cardiorespiratory fitness. PMID- 3653090 TI - VO2 kinetics in subjects differing in aerobic capacity: investigation by spectral analysis. AB - The power-VO2 transfer functions of 38 subjects differing in aerobic capacity have been determined on the basis of breath-by-breath total oxygen uptake (VO2,t) measurements during light cycle ergometer exercise (lactic acid concentrations below 2 mmol.l-1). At constant pedalling frequency (1 Hz) pseudorandom binary sequences (PRBS) of workload were used as the testing signal. The VO2,t response was analysed by autocorrelating the ergometer power input and crosscorrelating the power input and VO2,t output. From the spectra of these functions the amplitude ratios and phase relationships were computed for the first six harmonics of the PRBS fundamental (14 mrad X s-1). We found that differences in aerobic capacity are associated with significant differences in the amplitude plots of the VO2 transfer function. PMID- 3653091 TI - Effects of two high-intensity intermittent training programs interspaced by detraining on human skeletal muscle and performance. AB - The purpose of this study was to investigate the effects of repeated high intensity intermittent training programs interspaced by detraining on human skeletal muscle and performances. First, nineteen subjects were submitted to a 15 week cycle ergometer training program which involved both continuous and high intensity interval work patterns. Among these 19 subjects, six participated in a second 15-week training program after 7 weeks of detraining. Subjects were tested before and after each training program for maximal aerobic power and maximal short-term ergocycle performances of 10 and 90s. Muscle biopsy from the vastus lateralis before and after both training programs served for the determination of creatine kinase (CK), hexokinase, phosphofructokinase (PFK), lactate dehydrogenase (LDH), malate dehydrogenase, 3-hydroxyacyl-CoA dehydrogenase (HADH) and oxoglutarate dehydrogenase (OGDH) activities. The first training program induced significant increases in all performances and enzyme activities but not in CK. Seven weeks of detraining provoked significant decreases in maximal aerobic power and maximal 90s ergocycle performance. While the interruption of training had no effect on glycolytic enzyme markers (PFK and LDH), oxidative enzyme activities (HADH and OGDH) declined. These results suggest that a fairly long interruption in training has negligeable effects on glycolytic enzymes while a persistent training stimulus is required to maintain high oxidative enzyme levels in human skeletal muscle. The degree of adaptation observed after the second training program confirms that the magnitude of the adaptive response to exercise-training is limited. PMID- 3653092 TI - Effects of reduced frequency breathing on arterial hypoxemia during exercise. AB - It is uncertain that exercise with reduced frequency breathing (RFB) results in arterial hypoxemia. This study was designed to investigate whether RFB during exercise creates a true hypoxic condition in arterial blood by examining arterial oxygen saturation (SaO2) directly. Six subjects performed ten 30 s periods of exercise on a Monark bicycle ergometer at a work rate of 210 W alternating with 30 s rest intervals. The breath was controlled to use 1 s each for inspiration and expiration, and two trials with different breathing patterns were used; a continuous breathing (CB) trial and an RFB trial consisting of four seconds of breath-holding at functional residual capacity (FRC). Alveolar oxygen pressure during exercise showed a slight but significant (p less than 0.05) reduction with RFB as compared to CB. However, a marked increase in alveolar-arterial pressure difference for oxygen (A-aDO2) (p less than 0.05) with RFB over CB resulted in a marked (p less than 0.05) reduction in arterial oxygen pressure. Consequently, SaO2 fell as low as 88.8% on average. Additional examination of RFB with breath holding at total lung capacity showed no increases in A-aDO2 in spite of the same amount of hypoventilation as compared with that at FRC. These results indicate that RFB during exercise can result in arterial hypoxemia if RFB is performed with breath-holding at FRC, this mechanism being closely related to the mechanical responses due to lung volume restriction. PMID- 3653093 TI - A 7-week follow-up study of the behaviour of testosterone and cortisol during the competition period in rowers. AB - Nine rowers (six men of the regional and three women of the national top class) participated in the study. During 7 consecutive weeks of the competition period serum testosterone (T), SHBG, cortisol (C) and urea were determined at the same time every morning under fasting conditions. From the concentrations of T and SHBG the free testosterone fraction (T/SHBG) was calculated, and from the concentrations of T and C the ratio of T/C was derived. The object of the investigation was to gather information on a potentially altered anabolic catabolic hormone relationship dependent upon the intensity of the individual training periods. All rowers showed a continuous decrease in T, T/SHBG and T/C during the observation period. A week of regenerative training halted the decrease. In two of the oarsmen who discontinued their training after 2 and 3 weeks respectively, T, T/SHBG and T/C showed a normalization in the following weeks. In all subjects the concentrations of urea increased during the first 2 weeks and decreased during the subsequent weeks of intense training and competition. The findings suggest an increase in catabolic activity in periods of intensive physical strain, including competitions. Regenerative phases of training seem to reduce the anabolic-catabolic imbalance. PMID- 3653094 TI - Tympanic temperatures during hemiface cooling. AB - In adult men the left half of the head was covered with thick heat insulation, and the right hemiface was cooled by spraying a mist of water, and vigorous fanning. The subjects were immersed up to the waist in warm water (42 degrees) to achieve hyperthermia. In control sessions the subjects were rendered slightly hypothermic by preliminary exposure to cold. Under the hypothermic condition during right skin cooling, the right Tty remained low as compared with oesophageal temperature, while the left Tty was raised. Under the hyperthermic condition right hemiface cooling maintained not only the right Tty lower than oesophageal but also, to a lesser extent the left Tty, while the skin on the left side was close to core temperature. This latter result cannot be explained by conductive cooling from the skin to the tympanic membrane and implies a vascular cooling of the left Tty originating from the other side of the head. It is concluded that selective cooling of the brain takes place during hyperthermia. The main mechanism is forced vascular convection, but conductive cooling also occurs. PMID- 3653096 TI - Effects of exercise training on plasma catecholamines and blood pressure in labile hypertensive subjects. AB - Plasma catecholamine concentrations (norepinephrine, NE; epinephrine, E) were measured along with heart rate (HR) and blood pressure (BP) at rest in supine (20 min) and standing (10 min) positions and in response to cycle ergometer exercise (5 min; 60% estimated maximal aerobic power) in 12 hypertensive patients before and after 20 weeks of aerobic training on cycle ergometer (six males, one female) or by jogging (five males). In a control group of labile hypertensive patients (five males, two females), estimated maximal aerobic power as well as HR and BP at rest in the supine and standing positions and in response to exercise were not modified from the first to the second evaluation (43 +/- 4 vs 43 +/- 5 ml.kg 1.min-1). In comparison estimated maximal aerobic power significantly increased in both training groups (cycle: 38 +/- 4 to 43 +/- 4; jogging: 38 +/- 3 to 46 +/- 4 ml.kg-1.min-1). However HR and BP were not modified following training, except for small reductions in systolic (18.9 to 18 kPa: 142 to 135 mmHg) and diastolic pressures (13.3 to 12 kPa: 100 to 90 mmHg) (p less than 0.05) at standing rest in the cycle group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653095 TI - Enhanced brain protection during passive hyperthermia in humans. AB - Selective brain cooling during hyperthermia by emissary venous pathways from the skin of the head to the brain has been reported both in animals and humans. Heat protection of the brain extends tolerance to high deep body temperature in animals, and may be enhanced in humans if the head is cooled. In order to quantify to what extent brain protection could be obtained by face fanning, 9 non anesthetized human volunteers were placed in ambient conditions as close as possible to those of passive therapeutic hyperthermia. Face-fanning maintained tympanic temperature 0.57 degrees C lower than esophageal temperature, and improved comfort. External head cooling techniques enhancing physiological brain cooling can therefore be useful for the protection of the human brain during heat stress or passive therapeutic hyperthermia. PMID- 3653097 TI - Musculoskeletal capacity of employees aged 44 to 58 years in physical, mental and mixed types of work. AB - The musculoskeletal capacity of 60 women and 69 men, average age 52.3 +/- 3.7 years was determined, including measurements of anthropometry, maximal isometric trunk flexion and extension, sit-ups, isometric hand grip strength and back mobility. According to the job and to cluster analysis, the subjects were divided into three dominating work groups; physical, mental, and mixed groups. The results showed significant differences in right hand grip strength of the women and in the number of sit-ups by men among the three work groups (p less than 0.05). The differences between the other tests were not significant, although the physical group in the women and either the physical or the mixed group in the men had systematically the lowest mean values in almost all tests. It is concluded that jobs with mainly physical demands do not guarantee superior musculoskeletal capacity in older employees. PMID- 3653098 TI - Physiological and biomechanical comparison of roller skating and speed skating on ice. AB - Eight well trained marathon skaters performed all-out exercise tests during speed skating on ice and roller skating. To compare these skating activities in relation to the concept of training specificity, relevant physiological (VO2, VE, RER and heart rate) and biomechanical variables (derived from film and video analysis) were measured. There were no significant differences between oxygen uptake (50.5 +/- 8.0 and 53.3 +/- 6.7 ml.min-1.kg-1), ventilation (102.4 +/- 11.2 and 116.0 +/- 11.1 1.min-1) or heart rate (174 +/- 12.2 and 176 +/- 14.5 min-1) between speed and roller skating. In roller skating a higher RER (1.16 +/- 0.1 cf. 1.05 +/- 0.1) was found. Power, work per stroke and stroke frequency were equal. Due to a higher coefficient of friction the maximal roller skating speed was lower. The effectiveness of push-off and parameters concerning the skating techniques showed no differences. In roller skating a 7.5% higher angle of the upper leg in the gliding phase occurred. It is speculated that the blood flow through the extensor muscles might be higher in roller skating. It is concluded that roller skating can be considered as a specific training method which may be used by trained speed skaters in the summer period. PMID- 3653099 TI - Variations in skinfold thickness during de-acclimatisation and re-acclimatisation to high altitude. Relation to body fat content. AB - Skinfold thickness, body weight, body water, anthropometric measurements and segment volumes were determined in 28 young and healthy Indian soldiers on return to Delhi (200 m) after staying for more than 24 months at high altitude (3500 m). The measurements were made on the 2nd day and after 3 weeks. Ten subjects were then randomly selected from this group and returned by air to the high-altitude station, and the measurements were repeated on the 3rd and 12th day of their reinduction. Though body weight and total body water increased marginally on transfer to the lower altitude, body density remained more or less unchanged. There were significant increases in the thickness of skinfolds, even when body density had increased. During this period hand and foot volumes decreased significantly. Despite significant increases in thoracic skinfold thickness, the torso volume decreased slightly. On returning to high altitude, the soldiers lost body weight, were hypohydrated and showed reduced skinfold thickness. Fat losses calculated on the basis of reduction in skinfold thickness were far in excess of those calculated from losses in body weight and in total body water. As the reduced skinfold thickness was unrelated to changes in body water content at high altitude, it seems that such reductions are due to redistribution of blood in the skin. From the results of these investigations it is concluded that variations in skinfold thickness during acclimatisation to high altitude do not accurately represent the changes in body fat content. PMID- 3653100 TI - Thermoregulation in hyperhydrated men during physical exercise. AB - The influence of hyperhydration on thermoregulatory function was tested in 8 male volunteers. The subjects performed cycle exercise in the upright position at 52% Vo2max for 45 min in a thermoneutral (Ta = 23 degrees C) environment. The day after the control exercise the subjects were hyperhydrated with tap water (35 ml X kg-1 of body weight) and then performed the same physical exercise as before. Total body weight loss was lower after hyperhydration (329 +/- 85 g) than during the control exercise (442 +/- 132 g), p less than 0.05. The decrease in weight loss after hyperhydration was probably due to a decrease in dripped sweat (58 +/- 64 and 157 +/- 101 g, p less than 0.05). With hyperhydration delay in onset of sweating was reduced from 5.8 +/- 3.2 to 3.7 +/- 2.0 min (p less than 0.05), and rectal temperature increased less (0.80 +/- 0.20 and 0.60 +/- 0.10 degrees C, p less than 0.01). The efficiency of sweating was higher in hyperhydrated (81.4%) than in euhydrated subjects (57.1%), p less than 0.01. It is concluded that hyperhydration influences thermoregulatory function in exercising men by shortening the delay in onset of sweating and by decreasing the quantity of dripped sweat. As a result, the increases in body temperature in hyperhydrated exercising men are lower than in normally hydrated individuals. PMID- 3653101 TI - Control of sweating in man after work-induced thermal load and symmetrically applied cooling. AB - To examine the compensatory effects of work-induced thermal load and symmetrically applied local cooling on local sweat rates, two kinds of experiment were carried out on eight male subjects in a climatic chamber: 1) Experiments at 36 degrees C ambient temperature with a work load of about 25 W by the right leg. 2) Experiments at 36 degrees C ambient temperature with a work load of about 25 W by the right leg as in 1., but with additional compensatory cooling of the left leg controlled throughout by heat balance calculations at 75-85 W, equal to the heat produced in the working leg, the necessary air temperature being dependent on local sweat rate. Work load without cooling brought about a significant increase in core temperatures, metabolism, heart rate and local sweat rates. With unchanged local skin temperatures local sweat rate increase was higher in the working leg. Therefore the existence of muscle thermoreceptors should be assumed, the afferent information from which is processed and weighted in a different way to that provided by skin receptors. Work load combined with additional cooling reduced local and mean skin temperatures and heart rate, but had no significant influence on core temperature or metabolism. However, local sweat rate was generally lower in both thighs, with a major reduction in the cooled leg confirming control of local sweat rate by local temperature.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653102 TI - Sequence-specific 1H-NMR assignments in rat-liver metallothionein-2. AB - As a basis for the determination of the metal-coordination topology and the three dimensional fold of the polypeptide chain, sequence-specific assignments were obtained for the 1H nuclear magnetic resonance (NMR) spectrum of metallothionein 2 from rat liver. The 1H spin systems of the 20 metal-bound cysteines were identified from comparison of two metal-homogeneous protein preparations obtained by reconstitution of the apometallothionein-2 with 113Cd2+ and 112Cd2+, respectively. The identification of the spin systems for the remaining amino acid residues and sequential assignments were then obtained with two-dimensional 1H NMR experiments at 500 MHz. The assignments are complete except for two backbone amide protons, which were not observed, and the side-chain hydrogen atoms beyond beta CH2 for all eight lysines. The chemical shifts are presented at pH 7.0 and 25 degrees C. PMID- 3653103 TI - The double-stranded RNA-dependent protein kinase is also activated by heparin. AB - The double-stranded(ds)-RNA dependent protein kinase from human cells is a Mr 68,000 protein (p68 kinase), the level of which is enhanced significantly in cells treated with interferon. When activated by dsRNA, the p68 kinase becomes autophosphorylated. The phosphorylated p68 kinase then can catalyze the phosphorylation of exogenous substrates, such as eIF2 and histone. The second phosphorylation step can take place in the absence of dsRNA. Here we show that, besides dsRNA other polyanions, especially heparin, can also activate the p68 kinase for the autophosphorylation reaction. Heparin activation of the p68 kinase is reversible since it can be prevented by addition of antithrombin III, heparin binding protein. However, when antithrombin III is added after autophosphorylation of the p68 kinase then phosphorylation of histone is not affected. The p68 kinase binds to heparin-Sepharose. Further evidence that the p68 kinase can be activated by heparin was provided by photoaffinity labeling with 8-azido-[alpha-32P]ATP. This ATP analog can bind to the p68 kinase only in the presence of heparin or dsRNA. Thus suggesting that the activation of the p68 kinase triggers a conformational modification allowing the binding of ATP. Basic proteins, histone and protamine, prevent the activation process induced by heparin. This is probably due to binding of these basic proteins to heparin and thus sequestering the activator of the protein kinase. PMID- 3653104 TI - Three different proteins exhibiting NAD-dependent acetaldehyde dehydrogenase activity from Alcaligenes eutrophus. AB - The existence of three different proteins exhibiting NAD-dependent acetaldehyde dehydrogenase activity was confirmed in Alicaligenes eutrophus. The fermentative alcohol dehydrogenase, which also exhibits acetaldehyde dehydrogenase activity, is one of these proteins. The other two proteins were purified from A. eutrophus N9A mutant AS4 grown on ethanol applying chromatography on DEAE-Sephacel and triazine-dye affinity media. Acetaldehyde dehydrogenase II, which amounts to about 14% of the total soluble protein in cells grown on ethanol, was purified to homogeneity. The relative molecular masses of the native enzyme and of the subunits were 195,000 or 56,000, respectively. This enzyme exhibits a high affinity for acetaldehyde (Km = 4 microM). Acetaldehyde dehydrogenase I amounts only to less than 1% of the total soluble protein. The relative molecular masses of the native enzyme and of the subunits were 185,000 and 52,000, respectively. This enzyme exhibits a low affinity for acetaldehyde (Km = 2.6 mM). Antibodies raised against acetaldehyde dehydrogenase II did not react with acetaldehyde dehydrogenase I. Two different strains, A. eutrophus N9A mutant AS1, which represents a different mutant type and can utilize both ethanol or 2,3 butanediol, and the type strain of A. eutrophus (TF93), which can utilize ethanol, form two acetaldehyde dehydrogenases during growth on ethanol, too. As in AS4, one of these enzymes from each strain amounted to a substantial portion of the total soluble protein in the cells. These major acetaldehyde dehydrogenases were purified from both strains; they resemble acetaldehyde dehydrogenase II isolated from AS4 in all relevant properties. Antibodies against the enzyme isolated from AS4 gave identical cross-reactions with the enzymes isolated from AS1 and TF93. PMID- 3653106 TI - Relationship between tuberculous scar and carcinomas of the lung. AB - Results of a transversal case-control study are reported which shows that there is a statistically significant association between tuberculous scars and carcinoma of the lung. Accordingly the possibility of malignancy has to be kept in mind when radiological or scintigraphic scanning reveal the presence of lung scars. PMID- 3653105 TI - 1,2-Dioctanoylglycerol but not 1-oleoyl-2-acetylglycerol inhibits agonist-induced platelet responses. Dependence of effects on extent of 45-kDa protein phosphorylation and agonist type. AB - 1. The effect of the membrane-permeable diacylglycerol analogues, 1,2 dioctanoylglycerol (Oco2Gro) and 1-oleoyl-2-acetyl-glycerol (OleAcGro) on agonist induced platelet activation processes were compared with those of the phorbol ester, phorbol 12-myristate 13-acetate (PMA), using appropriately labelled washed human platelets. 2. Pre-treatment (10-300 s) with Oco2Gro (15-60 microM) or PMA (16 nM) before addition of thrombin (0.2 U/ml) or, addition of these agents 10-20 s after thrombin, resulted in a significant reduction (20-80%) in the extent of thrombin-induced intracellular Ca2+ ([Ca2+]i) mobilisation and arachidonate/thromboxane B2 release. OleAcGro (62-125 microM) had no effect on thrombin-induced [Ca2+]i elevations but had a slight (15%) inhibitory effect on thrombin-induced arachidonate release with a 5-min pre-incubation. Addition of Oco2Gro, PMA or OleAcGro on their own caused no rise in [Ca2+]i levels or arachidonate release. 3. Collagen (20 micrograms/ml) induced substantial arachidonate release without a detectable rise in [Ca2+]i. Pretreatment (10-300 s) with Oco2Gro (15-60 microM), PMA (16 nM) or OleAcGro (62 microM) before collagen addition or addition of these agents 30-60 s after collagen addition resulted in a significant potentiation of arachidonate release (1.2--2-fold over control), even though thromboxane B2 formation in response to collagen was inhibited in the presence of Oco2Gro or PMA. 4. Both Oco2Gro and PMA had dual effects on 5-hydroxytryptamine secretion induced by thrombin or collagen. Short pre-incubations (less than 2 min) with these agents caused a potentiation of sub maximal agonist-induced secretion, while not affecting secretion induced by maximal agonist concentrations. With longer pre-incubation times (5-15 min) however, a significant reduction in the level of agonist-induced secretion in the presence of Oco2Gro or PMA was observed. Inhibition of secretion was also observed in platelets treated with indomethacin (10 microM), suggesting that inhibition of thromboxane B2 formation alone does not account for inhibition of 5 hydroxytryptamine secretion. OleAcGro had no inhibitory effects on agonist induced secretion even though it potentiated it (with less than 2-min incubations) at sub-maximal agonist concentrations. 5. Time courses of phosphorylation of a 45-kDa protein, a marker of protein kinase C activation, in 32P-labelled platelets showed that while Oco2Gro (60 microM) and PMA (16 nM) caused a 4--5-fold increase in 32P-labelling of this protein over a 5-min incubation period, OleAcGro (62-125 microM) caused a 1.5-fold increase in labelling which was only maintained for a 10--30-s period.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3653107 TI - Staging of the abdominal extent of renal carcinoma by computed tomography. AB - To assess the accuracy of CT in diagnosis and staging of renal cell carcinoma, the surgical findings and CT scans were compared retrospectively in 21 patients. In 17 cases diagnosed as renal cell carcinoma by CT criteria, 14 were verified at surgery and accurate staging information was given in 11. In four cases renal cell carcinoma was given as a differential diagnosis by CT and none had the tumour. PMID- 3653108 TI - Evaluation of pleural and pericardial effusions by magnetic resonance imaging. AB - MR examinations of 36 patients with pleural and/or pericardial effusions were retrospectively evaluated. The purpose of this study was to determine of MR imaging is capable of differentiating between pleural and pericardial effusions of different compositions using standard electrocardiogram (ECG)-gated and non gated spin echo pulse sequences. Additional data was obtained from experimental pleural effusions in 10 dogs. The results of this study indicate that old hemorrhages into the pleural or pericardial space can be differentiated from other pleural or pericardial effusions. However, further differentiation between transudates, exudates and sanguinous effusions is not possible on MR images acquired with standard spin echo pulse sequences. Respiratory and cardiac motion are responsible for signal loss, particularly on first echo images. This was documented in experiments in dogs with induced effusions of known composition; "negative" T2 values consistent with fluid motion during imaging sequences were observed in 80% of cases. However, postmortem studies of the dogs with experimental effusions showed differences between effusions with low protein concentrations and higher protein concentrations. We conclude from our study that characterization of pleural and pericardial effusions on standard ECG-gated and non-gated MR examinations is limited to the positive identification of hemorrhage. Motion of the fluid due to cardiac and respiratory activity causes artifactual and unpredictable changes in intensity values negating the more subtle differences in intensity associated with increasing protein content. PMID- 3653109 TI - MRI of the breast--histopathologic correlation. AB - 132 solid breast masses have been examined at our institution by MR and have consequently been histopathologically correlated. T1- and T2-weighted SE and multi-echo sequences have been evaluated visually. It was found that signal intensities of tissues on T2-weighted images correlated with the contents of fibrosis, cells or water. Thus in some lesions (which consisted of different tissue components), a characteristic internal structure was visible on T2 weighted images, reflecting their histopathologic structure. Corresponding to their different composition, differences of signal intensity have also been noted between those fibroadenomas with a high contents of fibrosis and all other well circumscribed breast lesions (fibroadenomas, carcinomas). However, for the majority of lesions with irregular contours a discrimination based on signal intensities or calculated T1- and T2-values did not seem possible. This overlap can also be explained by the macroscopically similar composition (amount of fibrosis, water or cells) of benign and malignant irregular lesions. PMID- 3653110 TI - Image quality of mammographic systems. AB - The image quality in mammography was evaluated for all the 56 equipment-image receptor combinations used in Finland with two phantoms containing test objects of three types and different sizes. We obtained 2-8 fold variations for the smallest sizes of the three objects (specks, fibres and masses) visible in the X ray images and 3.0-3.7 fold variations for an "image score". The smallest speck, fibre and mass sizes visible in the radiographs were 0.24, 0.75 and 0.5 mm, respectively. An unacceptable image quality was obtained in 36% of the studied cases. A recommendation is presented. PMID- 3653111 TI - Radiologic aspects of lunatomalacia. AB - A radiological classification of lunatomalacia, based upon the chronological radiologic manifestations in 93 patients is presented. Compression fractures were not seen as the initial event. Fifty-seven per cent of the patients had a short ulna (ulna minus variant). The presence of ulna minus variant was especially observed in the younger patients. In 16 patients suffering from a lunate fracture and in 20 patients with lunate or perilunate luxations, lunatomalacia did not develop. Immobilization as treatment of the disorder resulted in a progressive course in all patients, but one, an 8-year-old girl. The lesion of the lunate was arrested and tended to heal following radial osteotomy in all patients. PMID- 3653112 TI - Radiation doses to the eye lenses in computed tomography of the orbit and the petrous bone. AB - Standard CT examinations of the orbit and the petrous bone were simulated with a tissue-equivalent human skull phantom on a Somatom DR 2 scanner. The orientation of the scan planes and the scan parameters including thickness, number of slices and mAs were varied according to the assumed diagnostic problems. The total radiation doses in the region of the eye lenses were measured with thermoluminescent dosimeters. If the globes are located within the X-ray field, the total radiation doses received by the lenses increased with the number and the thickness of the slices and the mAs. The highest radiation doses were found in contiguous thin-section scans of the orbit in axial (52 mGy) or direct coronal (47 mGy) orientation. In cases where the globes were located outside the X-ray field, the radiation doses received by the eye lenses could be reduced by a factor of 16, resulting in only 3.1-3.4 mGy for a complete axial study of the inner ear. Recommendations are given how to reduce the radiation exposure to the eye lenses without loss of diagnostical information. PMID- 3653113 TI - Computed tomography of leiomyosarcoma of the inferior vena cava. AB - Leiomyosarcoma of the inferior vena cava is a rare lethal malignancy. The authors report the seventy-sixth case of the literature and the sixth displayed by computed tomography. CT is presently the radiological modality of choice to localize the site and extension of the tumour, but a cavogram must also be obtained since it displays, much better than CT, the collateral veins and gives a synthetic longitudinal view of the tumour. PMID- 3653114 TI - Diagnosis of herniated nucleus pulposus by digital spinal phlebography with false negative CT and/or radiculosaccography. AB - Saccoradiculography, spinal phlebography or NMR can be performed in cases of discrepancy between CT and clinical symptoms. We believe that the introduction of DSA must generate a renewed interest in spinal phlebography for cases with radicular syndrome and normal CT. PMID- 3653115 TI - Computed tomography in diagnosis of broncholithiasis. AB - A case of broncholithiasis detected by computed tomography is presented. The entity of broncholithiasis and its imaging modalities are briefly reviewed. PMID- 3653116 TI - Pseudocyst in splenic hilus with splenic vein thrombosis. Case presentation and review. AB - Pseudocyst of the pancreas involving the spleen is a rare event; occlusion of splenic vein is even rarer. The mortality rate of these complications is high and therefore necessitates early diagnosis. Nuclear medicine, ultrasound and computed tomography are helpful, but definitive diagnosis is done by selective celiac or splenic artery arteriography. A case of splenic vein thrombosis due to pancreatic pseudocyst is presented and the literature on splenic involvement by pseudocyst is reviewed. PMID- 3653117 TI - Anomalous inferior vena cava with lumbar vein thrombosis: CT diagnosis. AB - A case of thrombosis of the ascending right lumbar vein in a patient with infrahepatic interruption of the inferior vena cava and azygos-hemiazygos continuation is reported and the CT findings are described. PMID- 3653118 TI - Coarctation of the aorta: review of 362 operated patients. Long-term follow-up and assessment of prognostic variables. AB - 362 patients operated upon for coarctation of the aorta from 1961-1980 were analyzed retrospectively. Age at operation was less than 2 years in 74 (group A) and greater than or equal to 2 years in 288 patients (group B). Associated cardiovascular malformations were common, especially in group A patients. Early mortality was 12.2% for group A and 1.4% for group B patients. 336 patients were followed for 6 months to 21 years (mean 8.9 years). Late mortality was 0.8% per patient year. Associated cardiac defects and postoperative hypertension were responsible for most of the late deaths. Late reoperations were performed because of aortic valve disease, residual coarctation (with persistent hypertension) and aortic aneurysms at the site of anastomosis. The incidence of hypertension decreased from 82.5% preoperatively to 33.5% at discharge from the hospital. It decreased further during follow-up in patients operated less than 10 years of age, but remained constant in the older patients. In conclusion, morbidity and mortality after operative repair of coarctation are determined mainly by (1) associated cardiac malformations, and (2) postoperative hypertension. Patients with isolated coarctation and postoperative normal blood pressure have an excellent prognosis. Patients operated upon from between 2-9 years of age carry the lowest risk for residual coarctation and late postoperative hypertension. PMID- 3653119 TI - Long-term follow-up in 185 patients after mitral valve replacement with the Lillehei-Kaster prosthesis. Overall results and prosthesis-related complications. AB - A follow-up was carried out in 185 patients after mitral valve replacement with the Lillehei-Kaster prosthesis. Fifty-eight males and one hundred and twenty seven females provided a total of 876 years of observation. The operative mortality amounted to 13% for the total series and to 9.3% after elective surgery. The long-term survival for the total series was 67% after five years and 56% after 10 years. The great majority of survivors showed a marked improvement in functional capacity and a significant decrease in heart volume. In spite of long-term anticoagulant treatment thromboembolic events were the most frequent valve-related complications. Thrombosis of the valve occurred in eight patients and appeared to decrease with a change in the orientation of the valve. The percentage of patients free from thromboembolic events amounted to 76 +/- 5% after ten years. The percentage of patients free from valve-related morbidity and mortality was 66 +/- 5% after ten years. Valve related death accounted for 18% of all deaths and 26% of all late deaths. Fracture of the prosthesis was never encountered. These results compare favourably with those obtained with the Starr Edwards' or the Bjork-Shiley prostheses. PMID- 3653120 TI - Retrograde catheterization of left ventricle through mechanical aortic prostheses. AB - Twenty-three patients who had undergone aortic valve replacement with a mechanical aortic valve prosthesis (ball-valve: 17, tilting-disc: 6) were investigated by retrograde left ventricular catheterization using a 6 F pigtail catheter. Twelve of these 23 patients also had had combined aortic and mitral valve replacement. To assess the magnitude of the catheter-induced aortic regurgitation and its effect on left ventricular and mitral valve function, 10 patients (group 1) were simultaneously investigated by the transseptal route (8 patients) or direct left ventricular puncture. The 13 other patients (group 2) were studied only by the retrograde crossing of the aortic valve prosthesis. In group 1, placement of the catheter across the valve induced an increase in heart rate (+12%), in left ventricular end-diastolic pressure (from 17.2 +/- 9.6 to 33.3 +/- 12.0 mmHg), a decrease in aortic systolic (-19%) and diastolic (-25%) pressures, and left ventricular systolic pressure (-10%). Transvalvular aortic pressure gradient increased from 15.4 +/- 8.2 to 23 +/- 12.1 mmHg. Pre- and post crossing pressure gradients were linearly correlated (r = 0.93). Left ventricular end-diastolic volume increased slightly but significantly (+9%), ejection fraction remained unchanged. Pre- and post-crossing regurgitation fractions were linearly related (r = 0.98). Hence, the magnitude of catheter-induced aortic regurgitation averaged 27% whether or not a pre-crossing regurgitation was noted. In group 2, retrograde crossing of the aortic valve prosthesis induced similar hemodynamic changes. There were no catheterization-related complications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653121 TI - Radionuclide evaluation of aortic regurgitation: assessment of ventricular function by Fourier phase analysis. AB - Forty patients with chronic isolated aortic regurgitation were studied by phase analysis of equilibrium radionuclide ventriculography to see whether this technique could detect changes in left ventricular (LV) function before the onset of symptoms. This technique was compared to the radionuclide ejection fraction and echocardiography. The severity of LV volume overload was assessed using the radionuclide regurgitant index. Patients with clinically severe aortic regurgitation had severe volume overload (high regurgitation index), increased echocardiographic left ventricular dimensions and significantly increased phase spread (loss of synchrony of wall motion) compared to mild and moderate groups. All but one had well maintained global left ventricular function assessed by the ejection fraction. All seven patients with definite symptoms had a marked increase in phase spread and severe volume overload. PMID- 3653122 TI - Haemodynamic effects of diltiazem at rest and during exercise in patients with previous myocardial infarction. AB - A single blind study between placebo and diltiazem (25 mg i.v. single dose) was carried out on 20 male patients with previous myocardial infarction and without exertional ischaemia. Patients, 50 +/- 6.1 (mean +/- SD) years of age, underwent a right heart catheterization with Seldinger's percutaneous approach and brachial or radial artery percutaneous catheterization. Haemodynamic variables were recorded in the supine position after catheterization in baseline conditions at rest, after a warming-up period of 6 min, before and after a first and second exercise test with stepwise increments of 25 W per 3 min. Before the second exercise test, either placebo or diltiazem (25 mg) was injected intravenously in 3 min. In comparison with placebo, diltiazem significantly reduced resting blood pressure (P less than 0.001) and systemic vascular resistance (P less than 0.001) and increased cardiac index (P less than 0.01); during exercise it also reduced the mean pulmonary arterial pressure (P less than 0.05), pulmonary wedge pressure (P less than 0.05), total pulmonary resistance (P less than 0.02), and increased the stroke volume (P less than 0.05). The present study demonstrated that intravenous diltiazem did not induce a significant rise in cardiac index but reduced the afterload and slightly reduced the preload. Diltiazem also reduced myocardial oxygen consumption and decreased blood pressure, mean right atrial pressure and slightly decreased the heart rate. PMID- 3653123 TI - Prognostic value of an electrocardiogram at rest and exercise test in patients admitted with suspected acute myocardial infarction, in whom the diagnosis is not confirmed. AB - The prognosis following discharge in 217 patients admitted with suspected acute myocardial infarction (AMI) due to chest pain, but in whom AMI was not confirmed, was related to the electrocardiogram (ECG) at rest and a symptom-limited exercise test. The patients were followed for 12 to 24 months, (median 14 months). The end point was a cardiac event, i.e. non-fatal AMI or cardiac death. The prognosis after discharge was only slightly better than in a comparable group of patients with confirmed AMI (P = 0.05). The percentages without a cardiac event after one year were 91.3 and 86.1, respectively. Impaired prognosis was found in patients with negative T waves or ST depression at rest or with ST--T abnormalities or angina pectoris during exercise. Patients with ST depression or elevation, Q wave or intraventricular block at rest. ST abnormalities during exercise or both constituted a high-risk group. The prognosis was significantly better for patients without these entities. The percentage without a cardiac event after one year was 86.9 and 97.6, respectively. It is concluded that patients in whom AMI is not confirmed have a high risk of cardiac events following discharge. Signs of ischaemic heart disease in the ECG at rest and during exercise can be used to identify high and low risk patients. PMID- 3653124 TI - Fundamental differences between the standard 12-lead electrocardiograph and the modified (Mason-Likar) exercise lead system. AB - A comparison of the standard 12-lead electrocardiograph with the Mason-Likar lead system widely used for exercise stress testing shows that the two are not 'essentially identical' as was originally claimed. Placement of the limb electrodes onto the torso distorts the electrocardiograph causing a rightward shift of the mean QRS axis, a significant reduction in R-wave amplitude in leads I and aVL, and a significant increase in R-wave amplitude in leads II, III and aVF; the R-wave amplitude of the chest leads is also altered. The so-called 'inferior' leads on the exercise electrocardiography are probably modified anterior/inferior leads, since their R-wave amplitudes correlate closely with those of antero-lateral chest leads. The inferior surface of the heart is not represented in isolation on the exercise electrocardiograph, thus explaining the reported inability of the exercise test to predict the location of coronary artery disease and high incidence of false negative tests in patients with ischaemia limited to the inferior cardiac surface. PMID- 3653125 TI - Relationship between myocardial norepinephrine content and left ventricular function--an endomyocardial biopsy study. AB - To analyze the relationships between left ventricular function, catecholamine concentrations in plasma and myocardium, and morphological alterations, 20 patients were studied. Fifteen patients had idiopathic dilated cardiomyopathy, and 5 had normal left ventricular function. All patients underwent right ventricular endomyocardial biopsy to determine muscle fibre thickness, percent volume fraction of interstitium, and myocardial catecholamine content. Blood was sampled to measure plasma catecholamine concentrations, and left ventricular cineangiography was performed to determine global ejection fraction. In a simple correlation analysis a significant correlation was found between left ventricular ejection fraction and myocardial norepinephrine content (r = 0.80, P less than 0.001). Left ventricular ejection fraction was negatively correlated with plasma epinephrine concentration (r- = 0.53, P less than 0.02), and with muscle fibre thickness (r = -0.50, P less than 0.03). Myocardial norepinephrine concentration was negatively correlated with plasma epinephrine (r = -0.62, P less than 0.01). Multiple linear regression analysis revealed a strong correlation between myocardial norepinephrine depletion and left ventricular dysfunction, which was independent of all other variables. These data suggest that myocardial norepinephrine depletion determined from right ventricular endomyocardial biopsies strongly correlates with left ventricular dysfunction in idiopathic dilated cardiomyopathy, and seems to be independent of the degree of muscle fibre hypertrophy, volume fraction of interstitium, and of the increased sympathetic tone. PMID- 3653126 TI - Time course of vagal effects studied in clinical electrocardiograms. AB - We consider the transient effects of brief bursts of vagal stimulation on cardiac excitation and conduction as manifested in the clinical electrocardiogram. We hypothesize that such vagal effects may be more frequent than commonly recognized and that they may account for some types of arrhythmias that are commonly ascribed to other mechanisms. We first briefly review the direct chronotropic and dromotropic effects of brief vagal stimulus bursts in animals and man. We next consider the effects of brief vagal bursts on heart period in various arrhythmias in man, particularly ventriculophasic sinus arrhythmia with various degrees of A V block, and various patterns of A-V dissociation. We illustrate these points with numerous clinical ECGs from our patient population, and with other cases from the literature. We next consider the effects of brief vagal bursts on A-V conduction time, and illustrate this with clinical cases of: (a) prolongation of A-V conduction after premature beats, (b) 'supernormal' A-V conduction, (c) Wenckebach periodicities, and (d) alternation of A-V conduction times. We review the evidence that brief vagal bursts are generated in vivo, and are a naturally occurring reflex phenomenon. We therefore suggest that such brief vagal effects should perhaps be considered more commonly when ascribing mechanisms to some complex and often difficult to interpret arrhythmias. PMID- 3653127 TI - Autoantibodies in hypertrophic cardiomyopathy and their clinical significance. AB - Data concerning autoantibodies in hypertrophic cardiomyopathy are rare and controversial and only the results of indirect immunofluorescence methods are available in the literature. The aim of this study was to determine the frequency and clinical significance of autoantibodies in hypertrophic cardiomyopathy by means of the Western blot which is a highly sensitive immunological technique. Sera from twelve (48.0%) of the whole group of 25 patients with hypertrophic cardiomyopathy reacted with actin from the HeLa extract. The incidence of anti actin antibodies in sera from 23 ischaemic heart disease patients was 13.0% (P less than 0.025) and in 37 apparently healthy subjects was 8.1% (P less than 0.001). When samples were assayed on the actomyosin prepared from Xenopus laevis muscle, sera of 14 (56.0%) of the patients exhibited actin positivity while the positivity in ischaemic heart disease and in healthy subjects was found to be 13.0 and 13.5%, respectively (P less than 0.001). Presence of anti-actin antibodies was related to the functional and clinical status and the progression of the disease. Anti-actin antibodies were found more frequently in medically treated patients. These data suggest that anti-actin antibodies are probably not directly involved in the pathogenesis of hypertrophic cardiomyopathy, but their detection might be useful as an additional marker of disease severity. PMID- 3653128 TI - Deleterious effects of low-dose oestrogen therapy on coronary status in patients with prostatic cancer. AB - The effects of oestrogen therapy and of orchidectomy on coronary status, as reflected by exercise ECG-testing before and after one year of treatment, were assessed in a randomized study of patients (N = 100) with prostatic cancer. Oestrogen was given as polyestradiol phosphate 80 mg i.m. per month in combination with 150 micrograms ethinylestradiol p.o. per day. There were no significant inter-group differences in conventional risk factors or in pre treatment exercise test results. Twelve months after the start of therapy the oestrogen group showed a significantly greater depression of the ST-segment during maximal exercise in leads CH2 (P less than 0.0005) and CH5 (P less than 0.01) compared with the pre-treatment depression. Twenty-five per cent (N = 13) of the patients in the oestrogen group suffered cardiovascular complications during the year of therapy, whereas no such complications were observed in the orchidectomy group. However, even the patients in the oestrogen group who had not suffered cardiovascular complications had significantly greater depressions of the ST-segment during exercise both in lead CH2 (P less than 0.0005) and in CH5 (P less than 0.05). There was no significant change in the ST-segment level in the orchidectomy group twelve months after surgery. In summary, we found evidence of an induction of myocardial ischaemia during treatment with exogenous oestrogens at low dosage in patients with prostatic cancer. This deleterious effect of oestrogen on the coronary status argues against oestrogen therapy, since oestrogen has not been shown to be more beneficial than orchidectomy against prostatic carcinoma. PMID- 3653129 TI - Nd-YAG laser-induced injury in dog myocardium: optical and ultrastructural study of early lesions. AB - To characterize myocardial lesions induced by Nd-YAG laser in vivo, laser pulses were delivered on the epicardial surface of beating dog hearts. Acute lesions were studied at the optical and ultrastructural levels. The size of the lesions depended on the power of the laser beam. Tissue vaporization could be avoided if total delivered energy did not exceed 350 J. Laser energy induced different types of myocardial necrosis distributed in concentric layers of coagulation necrosis, and contraction band necrosis. Thus, laser energy can produce controlled irreversible lesions without crater formation. These effects may be of use in the treatment of arrhythmias. PMID- 3653130 TI - Myocardial bridging of the left anterior descending coronary artery without relation to the site of hypertrophy in hypertrophic cardiomyopathy. AB - Myocardial bridging of the left anterior descending coronary artery producing complete systolic occlusion was demonstrated in a patient with hypertrophic cardiomyopathy, who had localized myocardial hypertrophy in the lateral left ventricular wall outside the territory of that artery. Although a cause and effect relationship between systolic compression of the coronary artery and myocardial hypertrophy has previously been postulated in hypertrophic cardiomyopathy, the lack of relation between the site of the myocardial bridging and the region of the left ventricular hypertrophy in our patient suggests that the myocardial bridging of the left anterior descending coronary artery may not be related to the pathogenesis of asymmetric septal hypertrophy. PMID- 3653131 TI - Fifth joint meeting of the working groups of the European Society of Cardiology. 5-10 September, 1987, Santiago de Compostela, Spain. Abstracts. PMID- 3653132 TI - Benign congenital hypotonia. A clinical study in 43 children. AB - The clinical features and short-term follow-up of benign congenital hypotonia (BCH) were studied in a group of 43 children. All children were referred for the evaluation of delayed motor performance during the first year of life. The hypotonia was mild in 35 children and moderate in 8. A "sitting-on-air" posture was found in 26 children (60%), and bottom shuffling (scooting) in 8 (19%). Thirty-six children were followed to the end of their third year of life. At this age minor neurological abnormalities could be found in 16 (44%) including hypotonia in 7, clumsy gait in 11 and speech delay in 3. In 30% of the cases there was a family history of delayed motor achievements. However, no significant differences were found between familial and non-familial cases regarding either clinical presentation or residual neurological findings. In view of the similarity in the clinical presentation of different causes of infantile hypotonia, the syndrome of BCH should be recognized. In such cases, because of the expected benign course, invasive diagnostic procedures may be withheld while the child is kept under follow-up, and be considered only in cases without complete recovery. PMID- 3653133 TI - Calcium homeostasis in premature infants and treatment of early hypocalcaemia by 1,25-dihydroxycholecalciferol. AB - We studied calcium homeostasis and the serum calcium response to oral 1,25 dihydroxycholecalciferol [1,25 (OH)2D3] at a low pharmacological dosage of 0.1 microgram/kg daily in 14 early hypocalcaemic asymptomatic neonates. Seven hypocalcaemic neonates were not treated. In hypocalcaemic neonates serum PTH levels were normal, the urinary C-AMP response after PTH stimulation was poor and plasma 1,25 (OH)2D3 was low. Treatment with 1,25(OH)2D3 resulted in a rapid increase of serum calcium. The increase was more rapid in neonates treated with 1,25(OH)2D3 than in untreated subjects. A similar result was obtained in one of a pair of identical twins. These results suggest that a low dose of 1,25(OH)2D3 is effective in treating neonatal hypocalcaemia. However, the response was delayed for 48 h. The reason for this delay is not clear. PMID- 3653134 TI - The time of separation of the umbilical cord. AB - The time of separation of the umbilical cord was studied in 911 neonates. The mean time of separation was 7.4 days (SD 3.3, range 1-29 days). We sought a possible relationship between the time of cord separation and various factors in the perinatal period. Cord separation was delayed when antibiotics needed to be administered to the neonate because of sepsis, when the infant was born prematurely, delivered by Caesarean section or had a low birth weight. The cord separated slightly earlier in female than in male infants. None of the infants studied suffered from omphalitis and it would appear that "delayed" separation of the cord is not always necessarily accompanied by severe leucocyte dysfunction. PMID- 3653135 TI - Early diagnosis of ABO haemolytic disease of the newborn. AB - To assess the usefulness of cord blood tests in diagnosing ABO-haemolytic disease of the newborn (ABO-HDN), 132 term, adequate for gestational age (AGA) neonates were evaluated. The tests studied and their significant results were: quantitative elution test (greater than or equal to 1/16), direct Coombs test (positive), bilirubin concentration (greater than or equal to 4 mg/dl). In none of the 56 O+ newborn infants delivered by O+ women were the results of any test positive. Of the 76 A+ and B+ newborn infants delivered by O+ women, 17 (22%) developed ABO-HDN. When the combined result of any two tests was positive, the sensitivity, the specificity and the positive predictive accuracy for the diagnosis of ABO-HDN was higher than for any one of the isolated tests. The probability that ABO-HDN was present when the results of at least two cord blood tests were positive was 70%, and the probability that ABO-HDN was not present when less than two cord blood tests gave positive results was 93%. It is suggested that the combination of quantitative elution test, bilirubin concentration and direct Coombs test in the cord blood is useful for an early diagnosis of ABO-HDN. PMID- 3653136 TI - IgM antibody to hepatitis B core antigen in children with chronic type B hepatitis. AB - IgM antibody to hepatitis B core antigen (anti-HBc IgM) was investigated by an antibody-capture radioimmunoassay (serum dilution 1:4000) in serum samples from 31 untreated children with chronic hepatitis B who were followed prospectively for 1-7 years. At the start, all patients were positive for hepatitis B e antigen (HBeAg), and anti-HBc IgM was detected in 23 cases, including 15 out of 16 with chronic active hepatitis and 7 out of 14 with chronic persistent hepatitis. A significant positive correlation was found between anti-HBc IgM levels and severity of liver damage (P less than 0.05), while an inverse relationship was found between anti-HBc IgM levels and distribution of hepatitis B core (HBcAg) antigen in the liver as detected by immunofluorescence. In fact 75% of anti-HBc IgM positive patients showed a focal HBcAg pattern (less than 40% positive nuclei), whereas 87% of antibody negative cases exhibited a diffuse HBcAg expression (more than 60% stained nuclei). During follow-up, seroconversion from HBeAg to anti-HBe with subsequent remission of liver disease occurred in 82% of patients presenting with detectable levels of anti-HBc, including three out of seven cases with chronic persistent hepatitis, but in none of the cases that were initially negative (P less than 0.01). These results indicate that during the natural course of chronic hepatitis B in children, anti-HBc IgM levels in serum reflect the degree of host immune response to infected hepatocytes. The close correlation between anti-HBc IgM seropositivity and seroconversion from HBeAg to anti-HBe suggests that anti HBc IgM may have a prognostic value during the follow up of children with chronic HBeAg positive hepatitis B. PMID- 3653137 TI - A case control study of necrotizing enterocolitis occurring over 8 years in a neonatal intensive care unit. AB - The perinatal histories of 27 newborn infants with NEC were compared to those of 54 infants of equivalent birth weight who did not have NEC during an 8-year study period to see if possible predisposing factors were independent of the confounding effect of birth weight. No differences were observed in gestational age, degree of intrauterine growth retardation, premature rupture of membranes, perinatal asphyxia, skin temperature at admission, haematocrit, presence or absence of respiratory distress syndrome, umbilical catheter placement, start and type of feeding or presence of positive blood cultures. Prematurity is the greatest risk factor predisposing to the development of NEC and the perinatal problems which precede the onset of NEC are common among all premature infants. PMID- 3653138 TI - Immunological and haematological changes during high-dose immunoglobulin therapy in an infant with autoimmune neutropenia. AB - High-dose immunoglobulin (HD-Ig) therapy was given to an infant with autoimmune neutropenia (AIN), and antineutrophil autoantibodies (ANAA). The patient's absolute neutrophil count in peripheral blood increased from 300/mm3 to 3000 4000/mm3 7 days after treatment. Although the neutrophil count gradually decreased thereafter, transient increases were observed after each single booster infusion repeated at 3-week intervals. By continuing this treatment, clinical symptoms were markedly alleviated, and the patient's susceptibility to infection was reduced. The increase in neutrophils showed a positive correlation with the increase in serum IgG, and with the increase in the ratio of the T helper/T suppressor cells. The neutrophil-bound IgG level and serum lysozyme level were decreased after HD-Ig therapy. PMID- 3653139 TI - Neonatal limb gangrene and renal vein thrombosis. Case report with review of literature. AB - A 3-day-old male infant born to a non-diabetic mother was admitted to the University Hospital with gangrene of the right forearm and some gangrenous patches of the left forearm. This was associated with left renal vein thrombosis. Screening tests for coagulation disorders gave normal results. The gangrenous right forearm was amputated and subsequently grafted. The skin lesions of the left forearm were successfully grafted. The renal system recovered well on supportive measures. The course of hospitalization and subsequent follow-up assessment at 3 months of age were satisfactory. PMID- 3653140 TI - Hypercalcaemia in cerebellar medulloblastoma: pathogenesis of solid tumour associated hypercalcaemia. AB - A 7-year-old boy developed acute, severe hypercalcaemia following the partial excision of a cerebellar medulloblastoma. The serum calcium level was extremely high (19.8 mg/100 ml), but a skeletal survey revealed no apparent bone metastatic lesions; such lesions were only detected by X-ray 3 weeks after the onset of hypercalcaemia. Hypercalcaemia was promptly resolved by intravenous mithramycin administration, before which the serum parathyroid hormone level, 1,25-(OH)2 vitamin D level and the nephrogenous cyclic AMP level were low. However, the relation between serum calcium levels and urinary calcium excretions indicated that renal calcium reabsorption was increased in association with hypercalcaemia, suggesting that a parathyroid hormone-like effect was operative on the renal tubules. It is possible that a combination of increased bone resorption by metastatic tumour cells and renal tubular handling of calcium presumably mediated by tumour-produced humoral factors was responsible for the acute development of severe hypercalcaemia in this patient with medulloblastoma. PMID- 3653141 TI - Urinary homocystine levels in a newborn infant with cystathionine synthase deficiency. AB - A boy with homocystinuria due to cystathionine synthase deficiency was found to have hypermethioninaemia by neonatal blood screening, but was not diagnosed as homocystinuric until 3 months of age because urinary homocystine was not detected by the cyanide-nitroprusside test or on two examinations with a sensitive amino acid autoanalyser. These findings indicate that tests for urinary homocystine should be made repeatedly with an amino acid autoanalyser in newborn infants with hypermethioninaemia until the enzyme defect is identified. PMID- 3653142 TI - Iatrogenic false aneurysm of the brachial artery in an infant. AB - A 1-month-old infant was referred for a rapidly expanding mass at the left elbow. Angiography showed contrast extra-vasation from the brachial artery in a 4 X 3 cm pseudo-aneurysm. This false aneurysm was treated surgically with good result. It is probable that accidental arterial puncture during repeated veni punctures in the neonatal period for determination of bilirubinaemia was responsible for pseudo-aneurysm of the brachial artery. PMID- 3653143 TI - "Acquired" congenital diaphragmatic hernia. AB - A case of late presentation of left congenital diaphragmatic hernia (CDH) in a boy of 9 months is reported. A chest X-ray taken after (premature) birth gave normal results; hence this type of CDH is called "acquired". Not being associated with pulmonary hypoplasia, this condition is difficult to diagnose. The patient presented as an emergency and the initial diagnosis was tension pneumothorax. This resulted in the insertion of a chest tube, fortunately without damage to the herniated stomach and spleen. Doubling upward of the tip of the nasogastric tube led to the correct diagnosis. After successful repair of the diaphragm the child made a full recovery. PMID- 3653144 TI - Erroneous diagnosis of fetal alcohol syndrome in a patient with ring chromosome 6. PMID- 3653145 TI - Blood-cerebrospinal fluid barrier in schizophrenic patients. AB - A total of 15 young white male patients newly diagnosed as schizophrenic (DMS III) were examined for signs of blood-cerebrospinal fluid (CSF) barrier alteration and CNS IgG synthesis. Of the 15 patients, 8 exhibited signs of increased blood-CSF barrier permeability. There was a high correlation between the ratio for CSF/serum albumin concentration and the CSF total protein concentration. Local IgG synthesis in the CNS was not detected in any of the patients. PMID- 3653146 TI - A linear mathematical model for computerized analyses of mood curves. An empirical investigation on mood courses in depressive and schizophrenic inpatients. AB - The repetitious measurement of actual mood alterations becomes more and more common in research oriented psychiatric departments. In this article a new method for the mathematical description and statistical evaluation of time series data is presented. This computerized approach is less restrictive than other procedures and seems to be very appropriate to the complex structure of time series. First results on mood courses of depressive and schizophrenic patients are presented to demonstrate the usefulness and validity of this new method. PMID- 3653147 TI - Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric ward. A path analysis study of the importance of patient involvement in treatment planning. AB - Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric treatment programme were analysed using a path analysis method. The programme used two models of treatment planning, one with and one without active participation of the patient in formulating a written treatment contract. A causal structural model, which explained 23% of the variance in the model, was used in the final analysis. The results indicated a positive relationship between a cooperation contract procedure and the level of expectations of improvement as well as high ratings of the importance of the patients own effort in treatment. The level of expectations of improvement were related to the symptom level at discharge and global improvement during treatment, indicating a better treatment outcome for the patients of the cooperation contract group, while the importance of own effort was not related to treatment outcome. Symptoms at discharge were mainly determined by symptoms at admission and global improvement, and also by expectations of improvement, initial psychic status and social background. The explained variance was 63%. Satisfaction with treatment was mainly determined by global improvement, symptoms at discharge and expectations of improvement. The explained variance was 60%. It is concluded that attention to patient expectations of improvement viewed as an important intermediate variable, is related to a an improvement in treatment outcome. PMID- 3653148 TI - Are there differences between borderline and other personality disorders? AB - Using the method of blind retrospective evaluation of clinical records, 26 DSM III borderline and 27 DSM-III nonborderline personality disorders were compared. Apart from the younger age of borderline patients, no really important differences emerged between the groups in the sociodemographic and clinical variables studied. It is possible that differences between borderline and nonborderline personality disorders are limited to the different phenomenology as defined by the respective diagnostic criteria. The borderline diagnosis proves to be a workable tool for further explorations, although its clinical justification remains to be demonstrated. PMID- 3653150 TI - Determination of the optimum period of interview for retrospective collection of data. An empirical study based on reported and documented outpatient contacts of depressive patients. AB - On the basis of reported and documented data on outpatient contacts of depressive patients, the reliability of data on the use of services, and the possibilities and sources of errors in the retrospective collection of data are presented and discussed. The results show an increase in errors the longer the period of inquiry is removed from the time of interview. The retrospective collection of data about ambulatory care more than 6 months ago has to be questioned from a reliability point of view. The correct dating of outpatient contacts succeeds substantially more reliably when questioned about periods of 3 months than about monthly periods, which leads to implications for the definition of patterns of care. PMID- 3653149 TI - Congophilic angiopathy with cerebrospinal symptoms. AB - A patient is reported who developed the first symptoms of spinal motor neuron affection 20 years prior to his death at the age of 79. In the course of the disease dementia and spasticity of the legs occurred. The patient died of metastasizing carcinoma of the colon. The autopsy revealed amyloid angiopathy of the brain and cervical spinal cord, corresponding to the clinical symptomatology. So far, 11 cases of amyloid angiopathy have been reported in which dementia was preceded by dysarthric speech, ataxia and/or spasticity of the legs. We assume that these cases represent a distinct nosological entity, different from a variant course of Alzheimer's disease. The atypical symptomatology may cause problems in the diagnosis of amyloid angiopathy of the CNS. PMID- 3653151 TI - Characteristics of delusional experience. AB - The characteristics of delusional experience were examined in a mixed group of 55 patients considered to be deluded; 11 belief characteristics were assessed by self-rating: conviction, preoccupation, interference, resistance, dismissibility, absurdity, self-evidentness, reassurance seeking, worry, unhappiness and pervasiveness. Only on level of conviction did no subject show a low score; on other dimensions there was considerable inter-subject variability. A principal components analysis indicated 4 components: distress, belief strength, obtrusiveness and concern. It is argued that delusions are most usefully regarded as multi-dimensional and, while characterised by conviction, vary considerably on other important dimensions. PMID- 3653152 TI - Impact of shortened hospitalization on outcome parameters. AB - Due to administratively mandated changes in the reimbursement system for inpatient treatment, average length of hospital stay in a geropsychiatric hospital unit decreased by approximately 20% within 1 year. The impact of this change on selected key parameters of effective therapeutic management are analyzed. Three 90-day periods were compared, one before, two after the reduction in length of stay. It was found that postdischarge referrals to facilities with a higher level of restrictiveness than prior to hospitalization increased significantly from Period 1 to Period 2, but returned to the original level in Period 3. These findings were confirmed when data were corrected for changes in the diagnostic composition of the respective samples. Patients who lacked natural support systems were more likely to be referred to a postdischarge setting of greater restrictiveness than before the admission. This finding remained constant. Readmission figures increased by 5% immediately after introduction of the decreased average length of stay (Period 2). When corrected for diagnostic composition, early recidivism also returned to original level in Period 3. Patients' insurance status appeared unrelated to any of the measured variables. Some observations on the composition of the diagnostic mosaic among admissions over time and the relations between diagnostic categories and average length of stay are included. PMID- 3653154 TI - Psychosomatic aspects of children's consultations in primary care. AB - Family doctors identified psychological factors associated with the presenting complaint in 17% of children aged 7 to 12 years attending their care. When compared with other children attending within the same age group, children said by their doctors to show associated psychological factors tended to present with psychosomatic-type symptoms (bed-wetting, asthma, skin rashes, abdominal pains, blackouts and headaches) and to make more use of medical services (both hospital and primary care). Our findings suggest that the families from which these children came had relatively high surgery attendance rates and more mothers with health problems. More of these families were regarded by the doctors as being under stress, and there were indications that concern about the children and their schooling was particularly common amongst the parents. Exploration of parental concerns about their children's health and about educational expectations would appear specially indicated in these cases. PMID- 3653153 TI - Serum and CSF cholinesterase activity in various kinds of dementia. AB - The activity of acetyl- and butyrylcholinesterase was determined in serum and CSF of controls and patients suffering from different types of dementia. A statistically significant decrease in the activities of both esterases was observed in CSF of demented patients, however, primary degenerative and vascular dementia did not differ in their CSF cholinesterase levels. Compared to age matched controls the serum butyrylcholinesterase activity was also significantly lowered in the overall dementia group. No typical serum and CSF cholinesterase isoenzyme pattern was found for dementia or any of its subgroups. It is concluded that the cholinesterase levels reflect metabolic alterations associated with dementia as a collective group but cannot be used for differential diagnosis of subgroups. PMID- 3653156 TI - Effects of portacaval shunt on the cholesterol metabolism of genetically hypercholesterolemic rats ("Rico' strain). AB - The effects of portacaval anastomosis on the biodynamics of cholesterol in male adult rats of a genetically hypercholesterolemic strain (Rico) were studied using an isotopic equilibrium method. Animals received a sucrose-rich semipurified diet. In both hypercholesterolemic rats and controls, portacaval anastomosis decreased plasma cholesterol levels (27%), liver weight (35-43%) and total cholesterol content in liver and body pools. Rico rats were characterized by (1) a high input rate of newly synthesized cholesterol (internal secretion) (25.3 +/- 1.9 vs. 16.2 +/- 1.5 mg/day/rat in controls) related to increased hepatic cholesterogenesis, and (2) a high rate of cholesterol transformation into bile acids, while other parameters remained unchanged. Portacaval anastomosis decreased the internal secretion of cholesterol in Rico rats (20.1 +/- 2.0 mg/day/rat). Since the activity of the gut for cholesterol synthesis as shown by the fecal external secretion (cholesterol biosynthesized by the gut and directly eliminated in the gut and feces) was not modified, it is assumed that the reduction of internal secretion induced by portacaval anastomosis results from decreased hepatic cholesterogenesis. PMID- 3653155 TI - A surgical model of fulminant hepatic failure in the rabbit: different effects of end-to-side versus small-diameter side-to-side portacaval shunt. AB - We developed a rabbit model of fulminant hepatic failure by way of a two-staged total liver devascularisation procedure. For the first-stage procedure (portosystemic shunting), the clinical, biochemical and electro-encephalographic courses in 6 rabbits (group I) with an end-to-side portacaval shunt (ETS-PCS), 6 rabbits (group II) with a small-diameter side-to-side portacaval shunt (STS-PCS) and 6 rabbits (group III) with the same STS-PCS and 48 h of pretreatment with oxytetracycline were investigated and compared to 6 sham rabbits (group IV). The limited survival, the fall in clotting factors and the rapid development of hyperammonaemia with encephalopathy within 48 h in group I point to ETS-PCS associated ischaemic liver necrosis. Group II showed improved survival, but was associated with portosystemic encephalopathy. Rabbits in group III survived portosystemic surgery without development of marked encephalopathy. In all animals of group III, the second-stage procedure (tightening of the loose ligature around the afferent hepatic vessels) could be performed, and a suitable model of fulminant hepatic failure was obtained. PMID- 3653157 TI - Acute responses of blood ketone body ratio following devascularization and revascularization of rabbit liver. AB - Acute changes associated with anhepatic and revascularized state were analyzed in relation to mitochondrial energy metabolism in rabbits. Fifteen minutes after the induction of anhepatic state, the ketone body ratio in the arterial blood decreased markedly from 0.833 to 0.229. The ketone body concentration also decreased to 24% of the normal value. The blood ketone body ratio and concentration remained low during the next 45 min. Pyruvate and lactate levels and the pyruvate/lactate ratio in the arterial blood changed very little during the 60-min anhepatic state. In a revascularization model following a 15-min anhepatic state, the ketone body concentration rose rapidly and then declined gradually, finally attaining a constant level at 30 min. The decreased blood ketone body ratio recovered to 0.55 at 30 min, and achieved steady state thereafter. Mitochondrial phosphorylative activity and hepatic energy charge showed almost normal levels 60 min after revascularization following the 15-min anhepatic state. These results indicate that the rapid metabolic alterations associated with the anhepatic and revascularized state can be accurately determined by measuring the arterial blood ketone body ratio, and they suggest that the ketone body ratio may serve as a convenient parameter for the evaluation of liver viability in pathological states such as operative ischemia or liver transplantation. PMID- 3653158 TI - Expansion of various types of ileal reservoirs in situ. An experimental study in rats. AB - In experiments on rats four types of ileal reservoirs were constructed and left to expand in situ. After 3 months the volumes and tissue weights of the various reservoirs were compared. The reservoir types were: two loops, isoperistaltic (type I), two loops, antiperistaltic (type II), three loops, S-shaped (type III) and "four loops', double-folded U loop (Kock pouch) (type IV). There was a considerable volume increase in all types of reservoir as well as a marked increase in their tissue weight. The expansion of the reservoirs in groups III and IV was significantly greater than that in groups I and II. The difference in expansion could possibly be explained by the greater radius in three- and four loop reservoirs compared with two-loop reservoirs if Laplace's law is applied to this process. According to this law the tension in the wall of a tube increases with increasing radius. PMID- 3653159 TI - Endoscopic evaluations of potentially ulcerogenic drugs. A new in vivo porcine test model. AB - A new test model in living pigs is presented. The model is easy to manage and, in contrast with other test models, it is unnecessary to euthanize the animals. The animals keep their value and can be slaughtered later. We advise the use of only one period of 'pill-feeding', because more periods will stress the animals and probably inhibit normal weight gain. We suggest this model as the method of choice in the evaluation of local ulcerogenic effects of drug substances in oral pharmaceutical formulations. An endoscopic evaluation in vivo of the ulcerogenic effect of potassium chloride in different microencapsulated preparations, wax matrix formulations, a liquid preparation, and a noncoated reference formulation showed one of the microencapsulated preparations to induce a significantly lesser degree of gastric mucosal damage than did all the other preparations. The gastric injury following a slow-release iron preparation and alprenolol (Aptine) was similar to that following the slow-release and the wax-matrix preparations of potassium chloride. Potassium chloride mixture caused gastric mucosal damage to the same extent as the other commonly used preparations of potassium chloride. Potassium chloride supplement causes gastric mucosal damage, but the results from the present in vivo porcine test model suggest that the severity of the injury seems to be a matter of appropriate drug formulation. PMID- 3653160 TI - Functional recovery of the exocrine pancreas in rats after partial resection. AB - The function of the exocrine pancreas was studied in rats in which more than 50% of the glandular tissue had been resected 1 (n = 16) or 6 (n = 20) weeks before initiation of the study. Sham-operated animals served as controls (n = 15). After partial pancreatectomy, the weight and DNA content of the remaining gland increased significantly (p less than 0.001), and the digestive enzymes: DNA content ratio was temporarily elevated. The glandular tissue secreted relatively less fluid, bicarbonate and digestive enzymes than in control animals, but the outputs increased significantly (p less than 0.001) during the observation period. After 6 weeks, only the fluid and bicarbonate secretion was still reduced. It is concluded (a) that the pancreatic function recovers after partial resection; (b) that the enzyme output of the remaining glandular tissue decreases temporarily; (c) that the enzyme content of the gland thereby increases, and (d) that the function of the acinar cells recovers faster than that of the ductular system. PMID- 3653161 TI - Are antireflux procedures indicated in patients with small pyelonephritic kidneys? AB - Antireflux surgery was successfully performed in 16 adults and children with bilateral or unilateral vesicoureteral reflux associated with a small pyelonephritic kidney. Although in 14 cases of the preoperative 131I-Hippuran clearance of the affected unit was less than 100 ml/min/1.25 m2, in 10 cases renal function was stabilized or slightly improved postoperatively. Only 1 child showed a severe deterioration of renal function. All 16 patients were cured of their acute pyelonephritis. Surgical correction of the reflux had no beneficial effect on renal size or renal scars. Urinary tract infection was eliminated in 12 of the 16 cases. It can be concluded that a small pyelonephritic kidney associated with a vesicoureteral reflux should not be removed even if its isotopic clearance is less than 100 ml/min. PMID- 3653162 TI - Vesicoureteral reflux in adults: a review of 95 patients. AB - Ninety-five adult patients with primary vesicoureteral reflux were reviewed concerning the presenting symptoms, radiological findings, associated renal damage, treatment and results of follow-up. We found a relatively high incidence of reflux in adult males. Although urinary tract infection and flank pain were the most common presentation, others had a wide variety of complaints not directly attributable to reflux. Renal anomalies were present in 37 patients. We found surgical correction of reflux useful in preventing infection, and recommend it especially in young women who may become pregnant. PMID- 3653163 TI - Basket extraction--its place in the current treatment of the lower ureteric stone: clinical experience. AB - 120 basket extractions have been tried in 115 patients suffering from lower ureteric stones. We used Dormia baskets as well as Johnson baskets. In 83% of the cases the stone has been removed. The present study was conducted in order to trace a possible connection between the success rate of extraction and the duration of symptoms or the size of the stone. Whereas the chances of success in case of a basket extraction performed within 3 months amount to 90%, the success rate drops to 66% once this period of 3 months has expired. Stones smaller than 10 mm (greatest diameter) are removed in 86% of extractions. Stones measuring 10 mm or more, only in 50%. The role of the cross diameter is mentioned. The place of basket extraction in the treatment of lower ureteric stone is discussed. PMID- 3653164 TI - Adjuvant radiation therapy in patients upstaged to stage C or D1 disease after radical prostatectomy. AB - We administered adjuvant radiation therapy to 56 selected patients with carcinoma of the prostate whose disease was upstaged to stage C or D1 after radical prostatectomy and pelvic lymphadenectomy. The complications associated with radiation therapy were minimal. The local recurrence rate was 2% after mean follow-ups of 67 and 53 months for patients with stage C and D1 disease, respectively. The actuarial 5-year survival rate free of disease was 76% for patients with stage C and 72% with stage D1 a cancer. Further exploration of the role of adjuvant radiation therapy in the treatment of patients with pathological stage C or D1 a disease is warranted. PMID- 3653166 TI - Primary neoplasm of the ureter: a review of twenty-eight cases. AB - Twenty-eight patients with primary ureteral neoplasms of which 7 of a benign type were reviewed retrospectively. Sixteen of these patients underwent segmental resection, with a 2-year survival of 81% and with no ureteral recurrence. Eleven other patients underwent a complete nephroureterectomy with bladder cuff excision with a subsequent 2-year survival of 63.6%. We believe that segmental resection is indicated in all low-grade and low-stage lesions and with a small chance of recurrence. PMID- 3653165 TI - Embolization and postinfarction nephrectomy in patients with primary metastatic renal adenocarcinoma. AB - In a phase-II study of the EORTC GU Group 34 patients with metastatic renal cell carcinoma were treated by angioinfarction and delayed nephrectomy. The mortality of the procedure was 5.8%. One patient had a complete remission. 80% of the patients showed progression within 6 months after nephrectomy. The median survival of the patients was 25 weeks, 65% of the patients died within 1 year after nephrectomy. PMID- 3653167 TI - Free tunica vaginalis patch in urethroplasty. An experimental study. AB - The management of urethral strictures is a challenge for surgery. In the present study the value of tunica vaginalis tissue for urethroplasty was investigated. 30 male rabbits were divided into two groups. In group I (11 animals) a urethral defect was covered with a tunica vaginalis patch (n = 6) or was left uncovered (n = 5). In group II (19 animals) a preoperative urethral stricture was induced by electrocoagulation through a urethroscope. The strictured urethra was plastied with tunica vaginalis (n = 9) or preputial (n = 10) patches. The results were analyzed after a period of 2 weeks to 5 months with radiographic, macroscopic and microscopic methods. The tunica vaginalis graft showed its superiority over the preputial graft: only 1 postoperative short stricture from 15 plasties (6 normal and 9 strictured urethrae) was found in the plastied group, whereas 2 strictures from 10 plasties were seen in the preputial patch group. In the urethral defect group, strictures were seen in 2 of 5 animals. The mesenchymal tunica vaginalis epithelium was covered with thin transitiocellular-like epithelium resembling transitiocellular layers. The present study supports the earlier findings on the use of tunica vaginalis tissue in urethroplasty. PMID- 3653168 TI - Trace element investigations in kidney stone patients. AB - 31 different trace elements were analyzed in 24 kidney stones using the atomic absorption method. Where a significant trace element content in the concrements was detected, blood, urine and hair from the stone patients were investigated with respect to their trace element concentrations. In calcium stones mainly Fe, Pb, Sr and Zn and in organic stones As, Fe and Zn were found. No correlation could be found between the trace element content in stones, blood and urine. The hair of a woman with high As content in her stone contained a normal As concentration. PMID- 3653169 TI - Struvite crystal formation by Corynebacterium group D2 in human urine and its prevention by acetohydroxamic acid. AB - After 24 h incubation of human urine experimentally inoculated with Corynebacterium group D2, struvite crystals appeared with an increase in pH and ammonium concentration as well as a decrease in the urea concentration. These changes were prevented by the addition of variable concentrations of acetohydroxamic acid. From these results it seems that the prevention of such crystal formation by Corynebacterium group D2 could be due to the inhibition of its urease activity besides acetohydroxamic acid having a significant antimicrobial activity, principally when tested in human urine. These effects were dose-related. PMID- 3653170 TI - A case of successful replantation of testis after autohemicastration. AB - A case of autohemicastration in a 19-year-old patient with schizophrenia is reported. Orthotopic replantation of the testis under local hypothermia was performed. One pair of arterial, two pairs of venous vessels and vas deferens ends were anastomosed micro-surgically end-to-end. Surgical reinnervation of the testis was carried out. Peculiarities the operation technique, expediency of local hypothermia and surgical reinnervation of the testis in replantation are discussed. PMID- 3653171 TI - Transitional cell carcinoma of the kidney with extension into the inferior vena cava. AB - A case of transitional cell carcinoma of the kidney, invading the inferior vena cava, is presented. Preoperative diagnosis is almost impossible and frozen section is necessary to decide the type of surgery. Radical surgery with removal of thrombi was performed in our patient but was obviously not helpful. The value of aggressive surgery is not clear. This may be the 6th case in the literature. PMID- 3653172 TI - Lack of efficacy of lymphoscintigraphy in detecting axillary lymph node metastases from breast cancer. AB - Preoperative detection of metastases in regional lymph nodes should constitute a fundamental step towards a better management of breast cancer. The National Cancer Institute of Milan has traditionally been engaged in this particular problem, that is, the search for a new imaging technique for detecting lymph nodal metastases from breast cancer. In 1984 axillary lymphoscintigraphy was performed on 26 patients with operable breast cancer by periareolar injection of 100 mu Ci of 99mTc sulphur microcolloid. The regional lymph nodes were identified as spot areas and a comparison was made between the number of primary draining axillary lymph nodes and their pathological examination. In only 2 of the 26 patients have more than 3 spot areas been revealed by axillary scintiscan, but this finding did not correspond to metastatic invasion. The lymphoscintigraphy pattern of the other 24 patients did not suggest any pathological condition. From our experience the method does not appear to help either a precise diagnosis of breast disease or the definition of the extent of mammary cancer. PMID- 3653173 TI - Circadian time dependence of murine tolerance for the alkylating agent peptichemio. AB - Since the extent of host toxicity of cytostatics is considerably affected by dosing time, a chronopharmacologic approach was undertaken for optimizing the therapeutic index of the alkylating agent, peptichemio (PTC). In 4 studies involving a total of 463 male B6D2F1 mice, a highly statistically significant circadian rhythm characterized murine tolerance for PTC (8 or 10 mg/kg/day i.v. X 3 days). Six circadian stages were explored (3, 7, 11, 15, 19 and 23 Hours After Light Onset--HALO). Day-40 survival rate varied between 20% (PTC at 3 HALO) and 55% (PTC at 15 HALO) (chi 2 = 16.7; P less than 0.01). In each study, body weight loss was maximal in mice injected with PTC at 3 HALO and minimal in those treated at 15 HALO (P less than 0.01). In a further study involving 96 male B6D2F1 mice, the toxicity of PTC on several target tissues (bone marrow, spleen, small bowel, colon, liver, kidney and lungs) was investigated by histology and leukocyte count as a function of drug dosing time. A circadian rhythm in the susceptibility of the bone marrow, the spleen and the intestinal tract was demonstrated. Optimal murine tolerance for PTC resulted from dosing it at 15 HALO, e.g. in the first half of the activity span. PMID- 3653174 TI - Late deaths and second primary malignancies among long-term survivors of childhood cancer: an Italian multicentre study. AB - A multicentre registry of children who had been successfully removed from therapy for some common childhood cancers (Hodgkin's disease, non-Hodgkin's lymphoma, neuroblastoma, nephroblastoma, acute lymphatic leukaemia and other leukaemias) was established in Italy in 1981. The present study describes mortality and occurrence of second primary malignancies (SPMs) among 1467 children who were alive when the registry was established. Follow-up ended on December 31, 1983 for mortality and 1 year later for the occurrence of SPMs. Sixty-seven deaths were recorded, 11 of which were due to causes other than progression of the original disease. Eleven incident SPMs were identified (i.e. 3 acute myeloid leukaemias, 3 thyroid carcinomas, 1 bilateral breast carcinoma, 1 liver malignant mesenchymoma, 1 astrocytoma, 1 chondrosarcoma and 1 osteosarcoma) corresponding to an incidence rate of 2.1/1000 patient-years at risk. Anecdotal reports were collected regarding 2 further SPMs (a thyroid carcinoma and a myeloid leukaemia) as well as several benign tumours, including 2 mammary fibroadenomas. PMID- 3653175 TI - Modulation of natural killer cell activity by tamoxifen in stage I post menopausal breast cancer. AB - Tamoxifen, an antiestrogen which competes for the estrogen receptor, modulates natural killer cell activity in vivo. Seventeen post-menopausal stage I breast cancer patients received tamoxifen for 1 month and a statistically significant increase in NK activity was demonstrated (P = 0.0005). There was a small incremental shift in the number of Leu-11b positive cells. These data demonstrate that tamoxifen functions as a biological response modifier. PMID- 3653176 TI - Type of alcoholic beverage and cancer of the upper respiratory and digestive tract. AB - The study concerns a series of 2443 French men with cancer of the upper respiratory and digestive tract (tongue, buccal cavity, oropharynx, hypopharynx, larynx supraglottis, larynx glottis and epilarynx). Each patient was examined in the Head and Neck Department of the Institut Curie in Paris. For each of them, data on the consumption of tobacco and alcohol was obtained with specification of the type of alcoholic beverage: wine, beer, cider, aniseed spirit or 'pastis', fortified wines, and whisky. The relationship between the type of alcohol consumed, and the precise location of cancer, was studied using a case-control approach, controlling for the total amount of alcohol consumed. Among mouth cancer cases, a higher proportion of wine consumers was observed. For the 'larynx supraglottis' location, more drinkers of aniseed spirit were found than expected. Among glottic cancer cases, more than expected usually drank whisky or fortified wine. Those results suggest that different alcoholic beverages may not produce the same effect. This could be in accordance with the fact that the discrepancy between France and other countries in the incidence of upper respiratory and digestive tract is greater for some locations (mouth or pharynx) than for others. PMID- 3653177 TI - Non-Hodgkin's lymphomas in the elderly: prospective studies with specifically devised chemotherapy regimens in 66 patients. AB - The results of 2 consecutive and prospective trials with specifically devised chemotherapy regimens in elderly patients (pts) with non-Hodgkin's lymphoma (NHL) are reported. Between August 1979 and September 1984, 66 pts aged 70 or older (median 75 years) with NHL entered 2 consecutive trials, the former with single agent teniposide 100 mg/m2 i.v. weekly (41 pts), the latter with etoposide and prednimustine (E + P), 100 mg/m p.o. for 5 days every 21 days (25 pts). Forty five pts were previously untreated, 21 previously treated. Forty-seven pts were of the intermediate and high grade groups according to the Working Formulation; 19 pts were of the low grade; 57 pts were stages III and IV, 9 pts were stages I and II. The median performance status was 70 (range 30-100). The objective response rate in the 66 evaluable pts is 53% with 38% CR; the 3-year overall, disease-free and CR survivals are 21, 12 and 40% respectively. The objective response rate in the 45 previously untreated pts is 58% with 42% CR; the 3-year overall, disease-free and CR survivals are 24, 16 and 58% respectively. The overall toxicity was mild. Severe toxicity (grade III and IV according to WHO criteria) was observed only in 16/498 courses (3.2%), with 1 toxic death (grade IV leucopenia). We experienced the usefulness of a properly orientated clinical approach to elderly pts with NHL. We suggest that a combination regimen like E + P, suitable for oral administration, may be safely employed in a large fraction of pts with NHL. PMID- 3653178 TI - Thyroid function in patients with breast cancer. AB - Thyroid function was evaluated in 58 patients with breast cancer and compared with data obtained from an age-matched control group of healthy women. Thyroid antibodies at low levels were present in 29 patients (50%): 21 patients (36%) had thyroid stimulating antibodies at low activity. Ten patients (17%) had thyroglobulin antibodies compared with 3 in the control group (P less than 0.05). Nine of 10 patients with thyroglobulin antibodies had microsomal antibodies as well. Two patients had only microsomal antibodies. Additionally 10 autoimmune antibodies were determined. These were, however, either absent or present in low concentrations in serum. Independent of the stage of disease, no differences were demonstrated between patients and controls in serum levels of triiodothyronine, thyroxine, free T3 index, free T4 index, thyroid stimulating hormone, and thyroglobulin. In conclusion, we found an increased frequency of thyroid autoantibodies in euthyroid patients with breast cancer compared with healthy controls suggesting a possible relation between this disease and autoimmune thyroid disease. PMID- 3653179 TI - Patient treatment preference in advanced breast cancer: a randomized cross-over study of doxorubicin and mitozantrone. AB - Twenty-two patients with advanced breast cancer participated in a randomized cross-over study of one cycle each of doxorubicin followed 3 weeks later by mitozantrone or vice versa. Before further treatment, patients selected which drug they wished to continue. Of 18 patients completing the study, 13 chose to continue mitozantrone, 2 doxorubicin and 3 had no preference (P = 0.007). Patients were told to assume similar efficacy of the two drugs and drug preference was based primarily on side-effects. Patient self-assessment of quality of life and physician assigned toxicity scores both indicated that nausea and vomiting, appetite and alopecia were significantly worse following doxorubicin than after mitozantrone. Except for alopecia, no significant period or carry-over effects were noted although the power of the study to detect such interactions was low. This study design may prove useful in enabling patients to select their preference between two treatments of similar efficacy. PMID- 3653180 TI - Phase II trial of VP16-213 in squamous cell carcinoma of the head and neck. PMID- 3653181 TI - VP-16 in advanced soft tissue sarcoma: a phase II study of the EORTC soft tissue and bone sarcoma group. PMID- 3653182 TI - Clinical trials in advanced breast cancer. PMID- 3653183 TI - Mechanisms of tumor promotion: possible role of inhibited intercellular communication. PMID- 3653184 TI - Recent improvements in the human tumor cloning assay for sensitivity testing of antineoplastic agents. PMID- 3653185 TI - Comparison of in vivo and in vitro drug sensitivities of Lewis lung carcinoma and P388 leukaemia to analogues of amsacrine. AB - The activity of several clinical agents (5-fluorouracil, methotrexate, adriamycin, daunorubicin, mitoxantrone and amsacrine) and of a number of analogues of amsacrine, including the 4-methyl,5-(N-methyl)carboxamide derivative (CI-921) which is at present in clinical trial, has been compared in vivo against Lewis lung carcinoma (LL) and P388 leukaemia in mice, and against corresponding cell lines in cell culture. All derivatives were active against i.p. inoculated P388 leukaemia whereas only some were active against i.v. inoculated LL cells. The relative in vitro activities in the two cell lines, as measured by growth inhibition (IC50) assays, varied from equitoxic to 26-fold more active with P388 cells than with LL cells. The in vivo activity of these drugs against i.v. inoculated LL relative to i.p. inoculated P388 could be predicted with a high degree of significance from the ratio of in vitro activities in the 2 cell lines. However, this correlation did not appear to reflect cell line selectivity alone, since, when P388 cells were inoculated i.v. rather than i.p., drug sensitivity closely matched that of the LL tumour. This observation suggests a dominant role for pharmacological variables in determining the in vivo activity of amsacrine analogues, and underlines the importance of standardising tumour site in the determination of antitumour spectrum. Nevertheless, the correlation of selective in vitro toxicity for cultured LL cells with high activity against remotely implanted tumours demonstrates the utility of in vitro tests in identifying amsacrine analogues with improved clinical potential. PMID- 3653186 TI - Advanced ovarian cancer: three-year results of a 6-8 month, 2-drug cisplatin containing regimen. AB - Fifty-two patients with advanced (stage III and IV) ovarian cancer were treated with a regimen of cisplatin (100 mg/m2 over 5 days) and cyclophosphamide (600 mg/m2/day 4). Treatment was repeated every 3-4 weeks for 6-8 months and followed by second look surgery. The median follow up for this single institution study (1980-1984) is 36 months. The median progression-free survival (projected) is 24 months and the median overall survival (projected) is 37 months in this group of patients with unfavorable pretreatment characteristics: median age: 61, median performance status (ECOG) 2, poorly-differentiated tumors: 60%, extensive residual tumors (greater than 2 cm): 65%. Pretreatment performance status was the only independent predictor for prolonged survival. Pathologically documented complete responses were observed in 23% of all patients and 43% of the patients who underwent second-look surgery (28 patients). Neurotoxicity from this regimen was substantial: it occurred in 65% of cases, was severe in 17% and was often not entirely reversible. The results with this intensive 2-drug cisplatin-containing regimen compare favorably to other more complex regimens in the literature. It is possible that the 'dose intensity' of cis-platinum may be the most important element of current therapeutic regimens in ovarian cancer. PMID- 3653187 TI - Cisplatin and 5-fluorouracil combination chemotherapy in advanced and/or metastatic colorectal carcinoma: a phase II study. AB - The possible synergism of cisplatin (P) and 5-fluorouracil was studied in 38 consecutive patients with advanced or metastatic colorectal carcinoma. Cisplatin 60 mg/m2 i.v.q. 4 weeks and fluorouracil 600 mg/m2 i.v. weekly were administered for at least 2 cycles, on an out-patient basis, to 24 males and 14 females with a median age of 57 years and a median PS of 80 (Karnofsky). Evaluable lesions were: primary unresectable tumor in 2 patients, local recurrence in 11, liver, lung, bone and soft tissue metastases in 21, 7, 2 and 3 patients respectively. With a median number of 3 cycles administered to 35 evaluable patients, 6 partial responses, 16 unchanged and 13 progressions were observed. Responses were observed in the liver (2 patients), lungs (1) and soft tissues (3). Median remission duration was 15 weeks, median duration of 'unchanged' was 12 weeks. The overall median survival was 24 weeks (30.5 weeks for responders and 22.5 weeks for non-responders). Six patients were pretreated with chemotherapy not containing cisplatin (mainly adjuvant 5-FU). None of them responded. Toxicity was very tolerable with moderate nausea, vomiting and alopecia in the majority of the patients; bone marrow toxicity was generally mild with no blood transfusions required, no complications of myelosuppression (sepsis or bleeding) and no chemotherapy-related deaths. In this experience the combination of low dose cisplatin with fluorouracil, does not appear to significantly enhance 5-FU toxicity and the response rate is not superior to that reported with 5-FU alone. However, better designed schedule combinations with optimal doses, sequences and exposure time of the 2-drug regimen, seem necessary to obtain the biochemical events that support the potentiation. PMID- 3653188 TI - Increased tumorigenicity of polyploid Ehrlich variants during growth in vivo is associated with karyotypic changes. AB - In previous studies, treatment of Ehrlich ascites tumors (EAT) with either Sendai virus, Herpes virus or neuraminidase produced variants that differed significantly from EAT in both tumorigenicity and karyotype. In this study, less tumorigenicity variants of EAT were isolated by culturing in media containing low concentrations of serum or without serum. In contrast to the relative stability of tumorigenicity in such variants cultured in vivo, the tumorigenicity of these variant clones passaged in vivo was variable, depending on the variant clone. During growth in vivo, 3 variant clones independently isolated from serum-free medium, low serum-containing medium and after neuraminidase treatment produced markedly heterogeneous tumors, and after 4 passages the tumors were about 1000 times more tumorigenic than the initial variants. In generating new tumors, the tumors always segregated chromosomes. The banded chromosome analysis of a variant clone isolated from serum-free medium and its malignant tumor showed that most of the chromosomes segregated from the clone were normal types. On the other hand, the tumorigenicity of Herpes virus-induced variants was unchanged during growth in vivo. PMID- 3653189 TI - Reversal of cancer chemotherapeutic resistance by amphotericin B--A broad phase I II pilot study. AB - In order to determine if it was possible to reverse clinically evident chemotherapeutic drug-resistance, 51 evaluable patients received chemotherapy (in doses and schedules on which they had previously demonstrated tumor progression) together with amphotericin B (AMB). AMB was given in 1-, 2-, or 4-day courses. There was 1 complete response (2%), and 5 partial responses (10%). Response rates tended to be higher in the 4-day treatment program (23%) than in the 1- or 2-day AMB treatment schedules (8%). Toxicity was that expected with chemotherapy (myelosuppression), or AMB alone (fever, chills, and reversible mild azotemia). We conclude that AMB is only infrequently able to reverse clinical drug resistance, but that this might have palliative effects in a small number of patients in whom other standard chemotherapeutic drugs lack clinical effectiveness. PMID- 3653190 TI - Isolation and characterization of DNA from the plasma of cancer patients. AB - Ten out of 37 patients with advanced malignant diseases were found to have extractable amounts of DNA in their plasma whereas no DNA could be detected in 50 normal controls. After its purification from the original nucleoprotein complex, DNA plasma levels ranging from 0.15 to 12 micrograms/ml were measured, the lowest concentration detectable with our method being 0.1 microgram/ml. Knowing from recovery experiments performed with 32P-DNA that the loss of DNA during the extraction procedure is about 65%, the real concentration of DNA in the plasma corresponds to about 3 times the given figures. The purified DNA was shown to be double-stranded and composed of fractions ranging from 21 kb to less than 0.5 kb, as determined by agarose gel electrophoresis. All these fractions hybridized with a 32P-labelled human DNA probe indicating the human origin of the bulk of the circulating DNA. IN CONCLUSION: the finding of extractable amounts of DNA in the plasma of 27% of the investigated cancer patients, and its absence from the controls, suggests some correlation with malignancy. PMID- 3653191 TI - Malignant lymphoma: monitoring of tumour status in 273 patients using a monoclonal antibody, 'B5', reacting with autologous erythrocytes. AB - The value of the B5 antigen haemagglutination test has been assessed in 273 patients with malignant lymphoma--141 with non-Hodgkin's lymphoma (NHL) and 132 with Hodgkin's disease (HD). Of those patients who were in remission after treatment, 41/155 (26%) showed B5 positivity: this compares to an incidence of 20% (122/551) in a wide range of non-tumour bearing individuals. In contrast, those patients with persistent disease, or in relapse, showed a much higher incidence of B5 positivity (84%; 99/118). Serial monitoring of 113 patients showed that B5 status often changed as tumour status changed, becoming more negative with remission, and more positive in relapse. Use of the B5 test in conjunction with erythrocyte sedimentation rate (ESR) gave an increased specificity for active disease in that 87% (35/40) of those who were B5-positive together with a raised ESR had active disease: of those patients who were both B5 negative and had normal ESR, 9 out of 108 (8%) had active disease. These findings suggest a role for the B5 test, combined with the ESR, in the monitoring of patients with malignant lymphoma. PMID- 3653193 TI - Comparison of the immunocytochemical assay (ER-ICA) and the biochemical assay for estrogen receptor in human breast cancer cell lines. AB - Estrogen receptor content of 8 cell lines from non-malignant human breast tissues was determined by an immunocytochemical assay using the Abbott ER-ICA monoclonal kit. The results were in accordance with those obtained by the conventional radiochemical (DCC) assay. Primary cultures of breast tissues are suggested as an important field for in situ application of the ER-ICA. PMID- 3653192 TI - Ovarian function and adjuvant chemotherapy for early breast cancer. AB - The effect of cyclophosphamide, methotrexate and fluorouracil (CMF) on ovarian function has been studied in 74 pre-menopausal patients with operable breast cancer. After median follow-up of 47 months, 50, 70 and 80% of 35 patients receiving CMF became permanently amenorrhoeic within 3, 6 and 12 months respectively; in contrast, only 5 in the no treatment (control) group of 39 patients became permanently amenorrhoeic within 12 months. Younger patients (less than 35 years) were more likely to retain or regain menstrual function while on or after CMF treatment. Estimation of ovarian and pituitary hormones in a subset of these women showed that CMF treatment was associated with a decrease in serum oestradiol and progesterone and an increase in serum follicle stimulating hormone and luteinizing hormone to post-menopausal levels. These hormonal changes are consistent with the induction of amenorrhoea during CMF treatment and the absence of resumption of menstrual function after completion of treatment suggests that CMF causes permanent ovarian ablation in a majority of these patients. PMID- 3653194 TI - Serum protects HeLa cells from antiestrogen effects in culture. AB - The effect of nafoxidine and tamoxifen on HeLa cells is reported in this study. The two antiestrogens showed no effect on HeLa cells when grown in the presence of fetal calf serum, the cytotoxic effects were observed only under serum-free conditions. BSA also protected the HeLa cells from antiestrogen effects. The effect of nafoxidine and tamoxifen on different established cell lines and a primary culture of rat skin fibroblasts has been studied. PMID- 3653195 TI - Differential DNA cross-linking and cytotoxicity in PHA-stimulated human lymphocytes exposed to melphalan, m-L-sarcolysin and peptichemio. AB - DNA interstrand, as well as DNA protein cross-linking, was more efficient in phytohaemagglutinin-stimulated human lymphocytes exposed to m-L-sarcolysin as compared to melphalan at equivalent concentrations of the drug. The cellular uptake of m-L-sarcolysin was more efficient as compared to melphalan. With peptichemio, a mixture of 6 peptides containing m-L-sarcolysin, an intermediate level of DNA cross-linking was found. The differences in DNA cross-linking between the 3 drugs were parallel to differences in cytotoxicity. Peptichemio has been ascribed anti-metabolic properties in addition to the alkylating properties conferred by its m-L-sarcolysin content. In the phytohaemagglutinin-stimulated lymphocytes, however, the effect of peptichemio seems linked to its capacity for DNA cross-linking. PMID- 3653196 TI - Prognosis of breast cancer with axillary node metastases after surgical treatment only. AB - Out of 753 patients with breast cancer treated with radical mastectomy from 1968 to 1970 at the National Cancer Institute of Milan, Italy, 308 had histologically proven positive nodes. The number of positive nodes was not dependent on the location of the primary tumour, its diameter and the patient's age. Extracapsular invasion was related to the number of positive nodes at a statistically significant level: P value 2 X 10(-9). Survival was influenced by the number of positive nodes and extension of metastases beyond their capsule and age. Each of these criteria had an independent impact on survival. Three subgroups with different prognosis were identified in patients older than 40: (a) with a single involved node and 69.9% 10 year survival rate, (b) patients with two or more nodes with metastatic deposit still confined within node capsule and 47.4% 10 year survival rate, (c) patients with two or more involved nodes and extracapsular invasion and 25.3% 10 year survival rate. In patients younger than 40 no subgroup was identified: this group had an intermediate 10 year survival rate (50.9%). The authors conclude that there is a need (a) of re-consideration of the prognosis of patients with positive nodes and (b) to agree on the definition of "high-risk patients". PMID- 3653197 TI - Development of MeCCNU-resistance in clonally derived lines of Lewis lung carcinoma. AB - The development of resistance to MeCCNU in four clonal lines of Lewis lung carcinoma derived from lung colonies has been examined. Treatment of the clones with 15 mg/kg MeCCNU once in each in vivo passage resulted in a rapid reduction in tumour responsiveness to this drug. This shows that MeCCNU resistance can arise at rates which may be applicable in spontaneous tumours and their metastases. Karyotypic heterogeneity was evident very early after isolation of the clones and this has potentially important implications for the experimental use of clones and for the features of metastatic disease. Karyotype analysis of one of the clones at each passage suggested that development of resistance was associated with the selection of a single sub-population of tumour cells but the kinetics of resistance development cannot be totally explained in terms of this simple selection. PMID- 3653198 TI - Estrogen and progesterone receptor content of primary and secondary breast carcinoma: influence of time and treatment. AB - ER and PgR concentrations were assayed in primary and secondary breast carcinoma specimens from patients classified into 3 groups: (1) both specimens excised on the same occasion (61 patients); (2) specimens obtained on separate occasions with no intervening treatment (43 patients); (3) specimens obtained on separate occasions with intervening chemotherapy and/or irradiation (25 patients). There were highly significant linear correlations (P less than 0.001) between the concentrations of ER (expressed as log10) in primary and secondary specimens in all groups. The relationship between PgR concentrations in primary and secondary specimens in groups 1 and 2 was highly significant, although there appeared to be a greater tendency for loss of PgR in sequential, than in simultaneous secondary biopsies. When expressed in terms of hormone receptor status (HRS), the same rate of discordance was observed in groups 1 and 2 (30% when concentrations were expressed in terms of cytosol protein). In group 1 the major cause of discordance was the occurrence of receptor +ve secondaries in association with receptor -ve primaries, possibly because of the high cellularity of many involved axillary nodes. In group 2, the major cause of discordance was the occurrence of receptor ve secondaries derived from receptor +ve primaries. In both groups discordance in PgR status was more frequent than in ER status. In group 3, overall discordance in HRS was 24% and was due equally to ER and PgR; however, the high concordance rate for PgR was probably due to the fact that the tumours were initially PgR ve, and the secondaries were also -ve. These results confirm that ER content tends to be stable, even after long periods of time and the administration of chemotherapy and/or irradiation. Progesterone receptor content is much less stable, and may decrease during quite short time intervals even in the absence of treatment. PMID- 3653199 TI - Changes in testicular cancer in Scotland. AB - There are two purposes to this paper. Firstly to describe the temporal pattern of germ-cell testicular cancers in Scotland, both as a single entity and as the histological sub-types (pure) seminoma and teratoma. Incidence rates rose by over 50% between 1959 and 1984, with the rates of seminoma increasing only marginally and the majority of the overall increase accounted for by the substantial increase observed among the sub-type teratoma. Secondly, to investigate the impact of new therapies on the mortality rate from germ-cell testicular cancer in Scotland in the light of improvements in survival rate reported during the last 25 years from clinical trials and clinical series. Noticeable changes have occurred in the temporal pattern of mortality which cannot be explained by changes in incidence. The ever-widening gap between the increasing incidence rate and the declining mortality rate, particularly apparent in the high-risk age group 15-44, indicates an improving prognosis for patients with this malignancy in Scotland. PMID- 3653200 TI - Clinical and pharmacokinetic phase I trial with the diethylaminoester of flavone acetic acid (LM985, NSC 293015). AB - The diethylaminoester of flavone acetic acid (LM985) is a new anticancer agent with curative effects against slow growing murine tumors. Thirty-one adult patients with solid tumors received a total of 57 courses of LM985 given on days 1 and 8 every 4 weeks. The drug was given as a short infusion (1-2 hr) at doses ranging from 120 to 1900 mg/sq.m/day. The dose-limiting toxicity consisted of acute expressive aphasia; this neurotoxicity usually appeared at the end of the infusion and resolved spontaneously within a few minutes to 1 hr after the end of the infusion. In some patients, neurotoxicity was avoided by reducing the infusion rate. Neurotoxicity was observed in 5 out of 6 patients receiving 960 mg/sq.m over 1 hr and in 3 out of 3 patients receiving 1900 mg/sq.m over 2 hr. The drug did not induce any significant myelosuppression. Other side-effects were very mild and consisted mainly of occasional nausea and/or vomiting at all dose levels. One patient with breast cancer resistant to several hormonal and chemotherapy regimens had stable disease for 6 months. LM985 was detected in plasma in very small concentrations (0-2.5 micrograms/ml) but there was extensive formation of flavone acetic acid (peak concentration ranging between 8.3 and 64 micrograms/ml). A dose of 1500 mg/sq.m on days 1 and 8 every 4 weeks could be recommended for phase II studies with LM985; however, since LM985 is a prodrug of flavone acetic acid, phase II studies with LM985 should not be activated prior to the completion of the ongoing phase I trials with flavone acetic acid, which may be devoid of the acute toxicity of LM985. PMID- 3653201 TI - The correlation between the spread of metastases by level in the axillary nodes and disease-free survival in breast cancer. A multifactorial analysis. AB - Axillary lymph nodes were separated from 492 radical or modified radical mastectomies for primary breast cancer and examined according to their anatomical level corresponding to their position along the theoretical pathway of lymph drainage from the breast. The patterns of metastasis and the relationship between metastatized levels and disease-free survival were investigated to see whether complete axillary dissection is necessary for the staging and the planning of adjuvant therapy in breast cancer. Progressive involvement from level I (proximal) to level III (distal) was found in 206 specimens (80.8% of tumors with axillary metastases), while discontinuous or "skip" metastases were present in 49 (19.2%), including 38 (14.9%) with positive nodes at level II or III but not at level I. "Skip" metastasis was more frequent when fewer than four nodes were positive, and not related to either the size of the primary tumor or its location. The effect of age, menopausal status, tumor size, node status, number of positive nodes, anatomic level of axillary node involvement, estrogen and progesterone receptors, and adjuvant therapies on disease-free survival was evaluated using a multivariate proportional hazard model and life table analysis. This showed that disease-free survival was strongly related to the number of positive nodes (P less than 0.001), tumor size (P = 0.001) and level of node involvement (P = 0.01) as independent prognostic factors. Moreover, the subset of patients with four or more positive nodes and involvements of level III had a higher risk of recurrence (25% recurrence-free patients 5 years after mastectomy). The high frequency of "skip" metastases and the prognostic value of both the level of involvement and the number of metastatic nodes suggest that a complete axillary dissection is needed in the surgical management of breast cancer to obtain all the data useful in the planning of adjuvant therapy. PMID- 3653202 TI - The effect on human neuroblastoma spheroids of fractionated radiation regimes calculated to be equivalent for damage to late responding normal tissues. AB - Multicellular tumour spheroids (MTS) are a useful in vitro model of human cancer. An experiment was designed to assess the likely therapeutic advantage of hyperfractionation--a proposed strategy in radiotherapy. A cell line (NB1-G) derived from human neuroblastoma was grown as MTS. This MTS line is radiosensitive with low capacity for repair of sublethal radiation damage. These properties make NB1-G a suitable line to test the theoretical advantage of hyperfractionation. MTS were irradiated using alternative fractionated regimens, with fraction sizes varying from 0.5 to 4 Gy. In each experiment, the total dose was chosen to make the regimens theoretically isoeffective for damage to late responding normal tissues (calculated using the linear-quadratic mathematical model with alpha/beta = 3 Gy). The radiation responses of MTS were evaluated using the end-points of regrowth delay and "proportion cured". Regimens using smaller doses per fraction were found to be markedly more effective in causing damage to neuroblastoma MTS, as assessed by either end-point. These experimental findings support the proposal that hyperfractionation should be a therapeutically advantageous strategy in the treatment of tumours whose radiobiological properties are similar to those of the MTS neuroblastoma line NB1-G. PMID- 3653203 TI - Prevention and reversal by a non-polar arotinoid (Ro 15-0778) of 3,4-benzpyrene- and cigarette smoke condensate-induced hyperplasia and metaplasia of rodent respiratory epithelia grown in vitro. AB - A non-polar arotinoid, Ro 15-0778, has been investigated for its effect on carcinogen-induced changes in rodent respiratory epithelia in organ culture. In neonatal rat tracheas and fetal mouse lungs grown in vitro, 3,4-benzpyrene and cigarette smoke condensate induce an increased proliferation of epithelial cells associated with a loss of secretory activity and of ciliary function. These changes persist in the absence of carcinogens in explants transferred to control medium. Ro 15-0778 alone has no influence on the normal epithelial growth rate or normal differentiation. However, if combined with either benzpyrene or smoke condensate, the arotinoid antagonizes the carcinogen-induced hyperplasia and metaplasia. During simultaneous treatment, it prevents the increase in mitosis and the loss of secretory activity or ciliary function. In explants pretreated with benzpyrene or cigarette smoke condensate, Ro 15-0778 reverses the high proliferation rate and restores secretory differentiation and ciliary function. The compound is of experimental and clinical interest, since--in contrast to most retinoids--it lacks the signs and symptoms of the classical hypervitaminosis A syndrome. It may be justified to consider it for the treatment of early precancerous changes of the bronchial tree. PMID- 3653205 TI - Improved subjective tolerability of interferon by combination with prednisolone. PMID- 3653204 TI - Phase II trial of anaxirone (1,2,4-triglycidylurazol, TGU) in patients with advanced ovarian carcinoma: an EORTC Gynecological Cancer Cooperative Group Study. AB - Sixteen patients with advanced ovarian carcinoma were treated with anaxirone (1,2,4-triglycidylurazol, TGU), 600 mg/m2 every 4 weeks. Anaxirone was the second or later line of therapy. All patients had evaluable tumors and evidence of failure of prior therapy. None of the patients responded. Two had stabilization of the disease for 4 months. In one patient WHO grade 4 leukopenia and grade 4 thrombocytopenia were observed after the second TGU cycle starting on day 41 and persisted until the patient died due to tumor progression (day 50). No patient experienced thrombophlebitis. PMID- 3653206 TI - Technical structure of a radiotherapy protocol. AB - Multi-institutional cooperative group trials require conformity to a uniform set of therapeutic guidelines so that all patients entered on the study are treated the same regardless of which participating center enters the case. This can come about only if an unambiguous, clearly defined treatment program is included in the protocol. Examples of confusing protocol guidelines from recent Group studies demonstrate how well-meaning participants can inadvertently deviate from study requirements. The Quality Assurance Review Center has developed an outline for the radiotherapy component of a study which has alleviated this problem considerably. PMID- 3653207 TI - Second primary cancers in the lung in head and neck cancer patients: a challenge. PMID- 3653208 TI - Delay in diagnosis of colorectal cancer. PMID- 3653209 TI - In vitro chemosensitivity testing of flavone acetic acid (LM975; NSC 347512) and its diethylaminoethyl ester derivative (LM985; NSC 293015). AB - The antitumor effect of flavone acetic acid, LM975, and its diethylaminoethyl ester derivative, LM985, was studied in four human malignant cell lines [WiDr, a colon carcinoma; LICR (LON) HN-3, a tongue carcinoma; MCF7, a breast carcinoma; K 562, a leukemia] using a colorimetric assay based on the reduction of dimethylthiazol-2-yl-diphenyltetrazolium. The cell lines were exposed continuously for 4-6 days to drug concentrations ranging between 0.1 and 500 micrograms/ml. For LM975, the concentrations inhibiting the growth of the various cell lines by 50% were 200 +/- 10, 97 +/- 7, 171 +/- 16 and greater than 500 micrograms/ml for LICR (LON) HN-3, WiDr, MCF-7, and K-562, respectively. The corresponding concentrations for LM985 were 151 +/- 3, 36 +/- 4, 86 +/- 3 and 140 +/- 18 micrograms/ml, respectively. The difference between LM985 and LM975 was statistically significant for the WiDr and LICR (LON) HN-3 lines. We also evaluated the cytotoxic activity of the two agents on normal human marrow myeloid progenitor cells in a colony-forming assay. Continuous exposure to the drugs gave a dose-dependent inhibition. The concentrations inhibiting the growth by 50% were 76 +/- 31 micrograms/ml for LM975 and 134 +/- 41 micrograms/ml for LM985. One hour incubation with either compound had no toxic effect on the myeloid progenitor cells. In conclusion, LM975 and LM985 do not appear to have a specific cytotoxicity for tumor cells. Our results indicate that, in vitro, toxicity on bone marrow myeloid progenitor cells is concentration dependent. Considering the low plasma concentration found in man after i.v. administration of LM985, our observations correlate well with the absence of drug-induced myelosuppression in patients. PMID- 3653210 TI - Effects of radical mastectomy on prolactin blood levels in patients with breast cancer. AB - The role played by PRL in human breast cancer is still obscure. Several observations, however, demonstrated that antitumor therapies for breast cancer are associated with changes in PRL secretion, clinical significance of which remains to be determined. The present investigation was carried out to further clarify the effects of mastectomy on PRL levels in breast cancer women. The study included 34 patients at clinical stage T1-2N0-2M0 treated with radical mastectomy. In each patient, venous blood samples were drawn before, and 15 days, 1 month, 45 days, 2 months and 3 months after surgery to determine PRL serum levels. As controls, 14 women surgically treated for reasons other than neoplastic disease were included in the study. Mastectomy was followed by hyperprolactinemia in 18 of the 34 cases (52.9%). PRL remained elevated for at least 1 month, and it became normal within 2 months. On the contrary, no PRL increase was seen in controls. Among breast cancer women, PRL increase was irrespective of the type of surgery, the histology of the tumor and the menopausal status. In contrast, PRL increase was significantly higher in patients without node involvement and with negative hormonal receptors, with respect to that observed in cases with node involvement and positive receptors, respectively. The mechanisms by which mastectomy induces enhanced PRL secretion are still obscure. They might depend, however, on changes in feed-back systems operating in the regulation of PRL secretion, due to the removal of a target organ for PRL itself. Longitudinal studies, by evaluating the percentage of relapse either in patients with surgery-induced hyperprolactinemia or in those with normal hormonal values, will be needed to clarify the prognostic significance of the enhanced PRL secretion induced by mastectomy. PMID- 3653211 TI - Experimental hyperthermic treatment of a human colon carcinoma xenograft. The thermal sensitivity of the tumour microcirculation. AB - The effect of hyperthermia on the microcirculation of a human colon tumour growing in a 'sandwich' observation chamber in immune-suppressed rats was investigated. Evaluation of the effect was based on microscopic observation, measurement of the relative flow rate of the blood in the capillaries of the tumour and photographic recording. The results indicated that moderate hyperthermia (3 h at 42.5 degrees C) has a destructive effect on the microcirculation of the tumour, followed the next day by severe necrosis. These results indicate that this human colon carcinoma xenograft has--for the endpoints that were investigated--a heat sensitivity that is comparable with rodent tumours. PMID- 3653212 TI - Human breast cancer in the athymic nude mouse: cytostatic effects of long-term antiestrogen therapy. AB - We have investigated the effects of long-term estrogen withdrawal or tamoxifen therapy of MCF-7 human breast cancer cells growing in the athymic nude mouse to clarify mechanisms by which endocrine therapy inhibits tumor growth. Estrogen withdrawal with or without tamoxifen inhibited MCF-7 tumor growth, but did not cause significant regression, even after 4 months of treatment. Serial histologic studies of treated tumors revealed a reduction in mitotic rate but no significant gross or ultrastructural cytopathic changes. Treated tumors did show a modest increase in stromal fibrosis as well as occasional cytoplasmic or nuclear vacuolization, perhaps indicating early cytopathic effects. Cell viability was confirmed by cloning tumor cells in soft agar; cloning efficiency in treated tumors was similar to that in controls. Tumor fragments from treated mice were also viable and formed tumors when transplanted into estrogen-supplemented but not estrogen-deprived mice indicating continued hormone dependence. When estrogen deprived or tamoxifen-treated mice were replenished with estrogen, cell proliferation was reactivated and tumor growth resumed. After 3-4 months of endocrine therapy, tumors began to regrow despite continued treatment suggesting the conversion to hormone independence. These studies suggest that in this model system, estrogen withdrawal and antiestrogen therapy work primarily by cytostatic rather than cytocidal mechanisms. PMID- 3653213 TI - Flavone acetic acid (NSC 347512) induces haemorrhagic necrosis of mouse colon 26 and 38 tumours. PMID- 3653215 TI - Medical management of prostate cancer. A satellite symposium of the 3rd International Congress on Hormones and Cancer. Nice, France, 2-4 September 1987. Abstracts. PMID- 3653214 TI - Implantable infusion system and thoracic venous thromboses. PMID- 3653216 TI - Special education referrals as an index of teacher tolerance: are teachers imperfect tests? PMID- 3653217 TI - Improving reading comprehension by using paragraph restatements. PMID- 3653218 TI - Why it is difficult to characterize the underlying cognitive deficits in special education populations. PMID- 3653219 TI - Integration versus cooperation: a commentary on "educating children with learning problems: a shared responsibility". PMID- 3653220 TI - Capable of achievement and worthy of respect: education of handicapped students as if they were full-fledged human beings. PMID- 3653221 TI - Parent attitudes about working conditions of their adult mentally retarded sons and daughters. PMID- 3653222 TI - A comparison of nine calcium ion antagonists and propranolol: exercise tolerance, heart rate and ST-segment changes in patients with chronic stable angina pectoris. AB - The effects of nine calcium ion antagonists on exercise tolerance, heart rate and ST-segment changes were compared with those of propranolol in two hundred and eighty patients with established chronic stable angina pectoris. These patients participated in clinical trials for anti-anginal efficacy against placebo, using identical methods and similar protocols, but the comparison reported here was retrospective. The trials were all fixed dose, and the dose was determined by previous upward titration to arrive at an average maximal tolerance level. All the drugs except prenylamine increased the exercise tolerance significantly when compared with placebo. Maximal ST-segment depression on exercise was reduced during treatment with propranolol while treatment with the calcium ion antagonists had no significant effect. The time to the development of 1 mm ST segment depression was prolonged by all the drugs. Nifedipine, PY-108-068 and nicardipine increased the resting heart rate whereas verapamil, diltiazem, gallopamil, KB-944, prenylamine and tiapamil produced a slight reduction. Propranolol produced a highly significant reduction in the resting and maximal heart rates and the rate-pressure product, whereas gallopamil increased the rate pressure product by +8% and prenylamine reduced it by -10%. At the doses used, diltiazem, gallopamil and verapamil produced a greater increase in exercise tolerance than did propranolol, while the other drugs were inferior. None of the calcium ion antagonists matched the increase in the time taken to develop 1 mm ST segment depression with propranolol, although the results with verapamil and gallopamil were close. The calcium ion antagonists are effective antianginal agents which produce their effects by mechanisms which are very different to the beta-adrenoreceptor blocking agents. PMID- 3653223 TI - Assessment of 'once daily' verapamil for the treatment of hypertension using ambulatory, intra-arterial blood pressure recording. AB - A new, slow release formulation of verapamil, "verapamil o.d." was administered to 12 patients with essential hypertension. Drug administration was started at a dose of 240 mg and increased to 480 mg after 2 weeks of treatment if the cuff blood pressure response was unsatisfactory. The drug reduced the daytime intra arterial blood pressure significantly from 180.7/106.8 mm Hg to 157.3/89.4 mm Hg. The daytime heart rate fell from 88.1 to 71.8 beats/min. The night-time blood pressure decreased from 155.7/87.2 mm Hg to 140.5/75.3 mm Hg. The nocturnal heart rate decreased from 62.8 to 57 beats/min. Hourly plots of mean systolic and diastolic pressure showed a significant reduction of systolic pressure for 21 of 24 h and of diastolic pressure for all 24 h following a single morning dose. The drug modified the absolute blood pressure and heart-rate response during both forms of exercise, but did not alter the magnitude or rate of blood pressure change. The tilt-test produced no evidence of postural hypotension. Only one patient experienced any side effects whilst taking the drug. These results indicate good 24-h blood pressure control and reduced exercise blood pressure levels during treatment with this new formulation of verapamil. The reduced frequency of drug administration should improve patient compliance with treatment of hypertension. PMID- 3653224 TI - 7-Ethoxyresorufin deethylase (EROD) in human liver--the effect of alcoholic liver disease. AB - We have investigated the effect of alcoholic liver disease (ALD) on the metabolism of 7-ethoxycoumarin 0-deethylase in human liver microsomes. EROD activity was significantly reduced in tissue from ALD patients who smoked, compared to smoking controls. A similar trend was seen in non-smokers. These results have implications for the metabolism of environmental carcinogens. PMID- 3653225 TI - Bioavailability and elimination of nitrendipine in liver disease. AB - Twenty one patients with liver disease (cirrhosis 11, chronic hepatitis 5 and acute hepatitis 5) and 6 healthy volunteers were given a single i.v. dose of nitrendipine 5 mg. Afterwards nitrendipine 20 mg once daily were administered orally for seven days. With the intravenous injection a significant increase in the AUC and elimination half-life of nitrendipine was found in patients with cirrhosis as compared to the normal volunteers. After chronic oral dosing, the area under the plasma concentration-time curve, AUC (0-24), was 94.5 ng ml-1 h and the plasma clearance CL was 1380.6 ml/min in the healthy controls; in patients with cirrhosis the AUC (0-24) h was significantly greater at 309.4 ng ml 1 h and CL had fallen to 686.6 ml/min. Considerable accumulation of nitrendipine was also found in the patients with chronic hepatitis. Nitrendipine could not be detected in urine from any of the subjects. Blood pressure and heart rate were not significantly influenced by the treatment in the various groups investigated. Antipyrine clearance in the patients with cirrhosis was correlated with the nitrendipine plasma clearance. Thus, accumulation of nitrendipine has been demonstrated in the patients with cirrhosis and chronic hepatitis. PMID- 3653226 TI - Studies on the metabolism of perhexiline in man. AB - We have studied the disposition of perhexiline and its two major metabolites, M1 and M3, in healthy volunteers and in patients with biliary T-tube drains after cholecystectomy. In healthy volunteers the genetic control for impaired hepatic oxidation is identical for debrisoquine, sparteine, and perhexiline. Poor metabolizers demonstrate markedly reduced production and excretion of the major metabolite, M1. Their production of M3 is also reduced, but to a lesser degree than for M1, confirming substrate stereoselectivity by hepatic oxidases. Biphasic urinary elimination of M1 and M3 is seen in intact extensive oxidizers, whereas only the first phase is apparent in patients with biliary T-tube drainage. This suggests the possibility of enterohepatic recycling of these compounds, which may account for their prolonged elimination. More than 90% of an ingested dose of perhexiline maleate remains unaccounted for at 24 h after ingestion, even in extensive metabolizers. A careful, radiolabelled tissue-distribution study is warranted to elucidate the complicated metabolic fate of perhexiline. PMID- 3653227 TI - The pharmacokinetics of yohimbine in man. AB - The kinetic disposition of yohimbine was examined in eight young male subjects following a single oral dose of 10 mg yohimbine hydrochloride. The drug was rapidly absorbed (absorption half-time 0.17 +/- 0.11 h) and rapidly eliminated from the plasma (elimination half-life 0.60 +/- 0.26 h). This clearance of yohimbine from plasma was constant over approximately 10 elimination half-lives, suggesting that distribution into a second pharmacokinetically distinct compartment was not responsible for the rapid decline in plasma yohimbine levels. Urinary excretion and the partitioning of the drug into red blood cells (RBC) was investigated. In the 24 h following oral administration of the drug, virtually no yohimbine was eliminated in the urine (0.35 +/- 0.50% of the administered dose). Furthermore, only 20% of blood-borne yohimbine was located in RBC. These results suggest that yohimbine is eliminated primarily through metabolism since the rapid plasma clearance of yohimbine was not the result of renal elimination or sequestration by RBC. PMID- 3653228 TI - Ranitidine pharmacokinetics in continuous ambulatory peritoneal dialysis. AB - Ranitidine kinetics in renal failure were evaluated in six patients undergoing continuous ambulatory peritoneal dialysis (CAPD). On separate occasions each patient received either 50 mg intravenously (i.v.) or 150 mg orally of ranitidine HCl. Following i.v. administration, the plasma concentration vs time curve was best described by a two compartment model with firstorder elimination. The mean +/- SD distribution and elimination rate constants were 2.47 +/- 0.78 and 0.098 +/- 0.013 h, respectively. The area under the serum concentration vs time curve after the i.v. dose was 5979 +/- 2870 micrograms X h X l-1, resulting in a mean volume of distribution of 76.8 l and a total body clearance of 126 ml X min-1. Following oral administration the observed maximum plasma concentration was 904 +/- 483 micrograms X l-1 at 4.2 +/- 1.8 h, and the bioavailability was 69.7 +/- 35.6%. The peritoneal clearance of ranitidine was 3.2 +/- 0.7 and 2.6 +/- 0.6 ml X min-1 for the i.v. and oral groups, respectively. The amount of drug removed by dialysis was 561.2 +/- 336.2 micrograms for the i.v. and 1197.1 +/- 602.3 micrograms for the oral group. Four patients in the i.v. group had urine output during the study period with renal ranitidine clearance values of 9.9 +/- 9.9 ml X min-1. Two patients in the oral group had urine output and corresponding renal ranitidine clearance values of 5.1 and 20.1 ml X min-1. A dosage regimen for ranitidine is proposed based on ranitidine kinetics in patients undergoing CAPD. PMID- 3653229 TI - The pharmacokinetics of single high doses of dexamethasone in cancer patients. AB - We have given single high doses of dexamethasone phosphate by intravenous infusion as an antiemetic to 15 cancer patients receiving regimens containing cisplatin and/or doxorubicin. The patients received graded doses of dexamethasone phosphate, in the range 40-200 mg, dependent upon nausea and vomiting scores, during up to three consecutive cycles of cancer chemotherapy. Plasma and urine concentrations of dexamethasone (dexamethasone alcohol) were measured by HPLC. The plasma concentration - time data were described by an open two-compartment model. The pharmacokinetic variables were independent of the dose of dexamethasone over the range studied. The terminal half-time was 4.0 +/- 0.4 h and the total body clearance was 3.5 +/- 0.4 ml X min-1 X kg-1. The volume of the central compartment and the total apparent volume of distribution were 0.23 +/- 0.03 and 1.0 +/- 0.1 l X kg-1 respectively. Approximately 8% of the dose was excreted into the urine as dexamethasone. PMID- 3653230 TI - Prescribing digoxin in geriatric units: the unexplained variability in dosage requirements. AB - Some physicians regard patients of Geriatric Units as a homogeneous population with respect to digoxin dosage requirements. Others advocate the use of pharmacokinetic models in prescribing digoxin for the elderly. Sixty in-patients of Geriatric Units were studied and the results compared with those previously obtained from 129 patients of other adult Units; all were receiving maintenance digoxin. For each patient the dose required to achieve a mean steady-state serum digoxin concentration of 1.6 nmol X l-1, the standardized dose, was calculated, assuming proportionality between the dose given and the concentration achieved. A mean of four estimates of standardized dose for each individual was used in the analysis. Threefold ranges of standardized dose covered the requirements of approximately 85% of patients both of Geriatric Units (62.5 to 187.5 micrograms per day) and of other adult Units (125 to 375 micrograms per day). The variables, serum creatinine concentration, sex, age, and body weight were of relatively little value in predicting the standardized dose for the patients in Geriatric Units. There was a sub-group of these in-patients for whom the standardized dose was extremely large. PMID- 3653231 TI - Pharmacokinetics and systemic availability of the antihypertensive agent indoramin and its metabolite 6-hydroxyindoramin in healthy subjects. AB - We have studied the pharmacokinetics and absolute systemic availability of indoramin (50 mg) given orally in solution or as a tablet with reference to intravenously administered drug (0.15 mg/kg) in 9 healthy volunteers. After intravenous administration the median apparent volume of distribution was 6.3 l X kg-1, plasma clearance was 20.0 ml X min-1 X kg-1, and terminal half-time was 4.1 h. When given by tablet indoramin was absorbed with moderate rapidity, with a median tmax of 1.5 h. The median systemic availability was 24%. After oral administration in solution the drug was more rapidly absorbed, with a median tmax of 1.0 h (p less than 0.01). The median systemic availability was 43% (15-85%). Plasma concentrations of an active metabolite, 6-hydroxyindoramin, after single oral doses in either dosage form, were of a similar order to those of unchanged drug and fell with similar rapidity. After intravenous administration, however, concentrations of the metabolite were negligible. PMID- 3653232 TI - Bioavailability of disopyramide in normal volunteers using unbound concentration. AB - The pharmacokinetics of disopyramide were determined in 10 healthy volunteers after a 300 mg oral dose and again after a 2 mg/kg i.v. dose. The unbound clearance was 599 ml/min and the unbound renal clearance 310 ml/min. The terminal elimination rate constant of unbound drug was 0.180 h-1 after the i.v. dose and 0.203 h-1 after the oral dose. The absorption rate constant was 0.53(-1) and the maximum peak concentration occurred after 3.2 h. The bioavailability was 0.809 using the area under the unbound plasma concentration time curve. Although a saturable plasma protein binding was found in all subjects the bioavailability using the total concentration, in contrast to theoretical expectations, showed the same value (0.813) as the unbound concentrations. PMID- 3653233 TI - Pharmacokinetics and absolute bioavailability of salbutamol in healthy adult volunteers. AB - Salbutamol was administered to sixteen healthy male volunteers intravenously and by mouth in liquid, tablet, and capsule form using a Latin-Squares design. Pharmacokinetic parameters from intravenous data were similar to previously reported values obtained with oral administration, with a mean terminal half-life of 3.8 h and a mean clearance of 439 ml X min-1 X 1.73 m-2. Peak plasma concentrations of 10-20 ng X ml-1 were obtained 1-3 h following oral administration. The absolute bioavailability of each of the oral preparations was 44%. While statistically significant differences in lag time and time to peak concentration were noted among the various oral preparations, the drug is rapidly absorbed in all three dosage forms and the observed differences are unlikely to be of clinical significance. PMID- 3653234 TI - Differential efficacy of mebendazole and albendazole against Necator americanus but not for Trichuris trichiura infestations. AB - The effect of single oral doses of albendazole 600 mg and mebendazole 1 g given to 56 and 60 men, respectively, with T. trichiura and/or N. americanus infestation has been studied. Both albendazole and mebendazole cured more than 90% of T. trichiura infestations, but only albendazole (95%) and not mebendazole (21%) had a high cure rate for N. americanus infestations. Thus, albendazole is the preferred benzimidazole derivate for the mass treatment of subjects with T. trichiura and/or N. americanus infestations. PMID- 3653235 TI - Kinetics of disopyramide in decreased hepatic function. PMID- 3653236 TI - Effects of tramadol on motor and sensory responses of the spinal nociceptive system in the rat. AB - The analgesic agent, tramadol, was tested on motor and sensory responses of the nociceptive system in rats. The tail-flick response to radiant heat was dose dependently depressed by tramadol (1-10 mg/kg i.p.), and the antinociceptive effect of the drug was reduced by naloxone in the same range of doses that antagonized the effect of morphine. Tramadol (100 micrograms) microinjected into the periaqueductal grey (PAG) prolonged the tail-flick latency and this effect was abolished by naloxone (0.2 mg/kg i.p.). Aminophylline (25 mg/kg i.p.) did not prevent the antinociceptive effect of tramadol (5 mg/kg i.p.). Tramadol (20 and 40 mg/kg injected i.v.; 100 and 200 micrograms injected intrathecally (i.t.); 100 micrograms injected into the PAG) depressed both the spontaneous activity in ascending axons and their activity due to stimulation of afferent C fibres and co activation from afferent A delta fibres in the sural nerve. Naloxone injected i.v. at a dose (0.2 mg/kg) that had proven fully effective against the effects of morphine antagonized only the effect on spontaneous activity caused by i.v. injection of tramadol. A high dose of naloxone (1 mg/kg i.v.) not only abolished the depression of spontaneous activity caused by an i.t. injection of tramadol (200 micrograms) but also significantly reduced (but did not abolish) the activity in ascending axons evoked from afferent C fibres while the depression of co-activation from afferent A delta fibres remained unchanged. Aminophylline (50 micrograms i.t.) failed to abolish the depression by tramadol of ascending nociceptive activity. The activity elicited in ascending axons by stimulation of afferent A beta fibres was not changed by i.t. injection of tramadol (200 micrograms), which was evidence that the antinociceptive effect of tramadol is not due to a local anaesthetic action. It is concluded that tramadol produces its antinociceptive and analgesic effects through spinal and supraspinal sites of action. Since the effects of tramadol and morphine differ in some respects, it must be assumed that they are due to binding to different opiate receptors or that some of the effects of tramadol are not mediated by opiate receptors alone. PMID- 3653237 TI - Effects of intracerebroventricular pirenzepine on muscarinic discriminations in rats. AB - In rats, mixed M1/M2 muscarinic ligands induce a discrimination which is of central origin and selectively mediated by either one or both muscarinic receptor subtypes. In the present study we examined the effects of intracerebroventricular (i.c.v.) pirenzepine, a relatively selective M1 receptor antagonist which does not cross the blood-brain barrier, on muscarinic discriminations. Groups of six rats were trained to discriminate, in a two-lever operant task, either 0.062 mg/kg subcutaneous (s.c.) scopolamine or 0.075 mg/kg s.c. oxotremorine. When the rats had been well trained in the procedure, the discriminative effects of various i.c.v. muscarinic ligands were examined. Scopolamine (1.5-12 micrograms i.c.v.), but not pirenzepine (20-40 micrograms i.c.v.), generalized to s.c. scopolamine. Oxotremorine (0.75-6 micrograms i.c.v.) generalized to s.c. oxotremorine. Scopolamine (12 micrograms i.c.v.), but not pirenzepine (20-40 micrograms i.c.v.), antagonized the oxotremorine cue. These results suggest that activation of the M1 receptor is not the prominent component of muscarinic stimulus control. PMID- 3653238 TI - Hypothermia induced in mice by intracerebroventricular injection of tryptamine: involvement of the 5-HT1 receptor. AB - The effect on the body temperature of mice of tryptamine administered by intracerebroventricular (i.c.v.) injection was studied. Tryptamine given i.c.v. produced a significant hypothermia above a dosage of 5 nmol. The hypothermic effect of tryptamine was inhibited by methysergide whereas ketanserin and p chlorophenylalanine did not affect it. These data demonstrate that the hypothermia induced by tryptamine i.c.v. is produced by direct activation of the 5-HT1 receptor. PMID- 3653239 TI - Changes induced by diazepam in the synaptic vesicle size of rat phrenic nerve terminals. AB - The effect of diazepam (Valium), administered by i.p. injection on the cross sectional area of synaptic vesicle profiles of the endplate-rich area of the rate diaphragm was studied by electron microscopy at 15-180 min after treatment. In the dose range of 0.25-10 mg/kg, diazepam induced a significant increase of the size of the synaptic vesicles. This increase was dose-related within a certain margin, dependent on the treatment time, while the effect of each dose increased significantly with the period after treatment. At 2.5-10 mg/kg a maximum seemed to be reached at 90 min. PMID- 3653240 TI - Anesthetics produce differential actions on the discharge activity of a single neuron. AB - The effects of 26 anesthetic agents were studied on the rhythmical discharge activity of a single isolated neuron (crayfish stretch receptor). Many of these agents produced concentration-dependent biphasic responses (excitation and depression), and some also induced altered discharge patterns (burst activity). The dominant effect of a few of the anesthetics was excitation (e.g. alphaxolone); depression (e.g. decanol); or burst activity (e.g. benzocaine). A correlation was found to exist between equieffective concentrations in the perfusate and membrane/buffer partition coefficients; however, this general phenomenon does not provide an explanation for the biphasic or differential responses. These results demonstrate that selective interactions occur at the level of the single neuron, and suggest the existence of recognition sites in neuronal membranes which can discriminate structural differences of anesthetics. PMID- 3653241 TI - The benzodiazepine triazolam: direct and GABA depressant effects on cultured mouse spinal cord neurons. AB - Whole-cell and outside-out patch clamp recordings were used to study the effects of the benzodiazepine triazolam at the membrane of mouse spinal cord neurons in cell culture. At 1 microM, triazolam reversibly increased the membrane conductance of about half of the spinal cord cells tested, the average increase being 24 +/- 4%. Depolarizations evoked by successive applications of gamma aminobutyric acid (GABA) to the spinal cord cell membrane were attenuated by 1 microM triazolam in about half of the neurons tested. At 1-10 microM, triazolam also reduced the charge transfer triggered by GABA in outside-out patches of spinal cord cell membrane. In contrast, 10 microM diazepam potentiated charge transfer by the GABA receptor complexes. Triazolam apparently acts as an inverse agonist at benzodiazepine receptors expressed on spinal cord cells in culture. The well known anxiolytic effects of this drug are presumably mediated by benzodiazepine receptor types not assayed in the present experiments. PMID- 3653242 TI - Effects of acetylcholine agonists and antagonists on yawning and analgesia in the rat. AB - The ability of acetylcholine muscarinic agonists, injected subcutaneously (s.c.) to elicit yawning and analgesia (tail-flick response) in rats was examined. Yawning was elicited by physostigmine, RS86 and pilocarpine with an inverted 'U' shaped dose-response relationship; maximal effects occurred at 0.1, 0.5 and 2.0 mg/kg respectively. Neostigmine (0.05-0.2 mg/kg); arecoline (0.5-2.0 mg/kg); bethanecol (0.1-10 mg/kg) and McN-A-343 (5-20 mg/kg) had marginal or no activity. In contrast, dose-related analgesia was obtained following oxotremorine (0.01-0.3 mg/kg) and arecoline (0.5-4.0 mg/kg) and physostigmine (0.1-0.4 mg/kg), RS86 (0.25-2.5 mg/kg) and pilocarpine (0.5-8.0 mg/kg). The effects of acetylcholine antagonists on physostigmine-induced yawning and physostigmine-induced analgesia were also investigated. Following their s.c. injection, trihexyphenidyl, atropine, dicyclomine, secoverine and methylatropine but not pirenzepine, inhibited both yawning and analgesia; there were clear differences in their potencies on the two responses. Pirenzepine, intracerebroventricularly (i.c.v.), inhibited yawning (ED50 value 5.7 micrograms/rat) but not analgesia (3-100 micrograms/rat). The results are discussed in terms of a possible functional differentiation of central muscarinic receptors. PMID- 3653243 TI - Reserpine-induced supersensitivity in adenylate cyclase preparations from guinea pig heart. AB - The effects of a reserpine treatment inducing supersensitivity to the cardiac effects of agonists (2.5 mg/kg per day for 2 days) was studied on guinea-pig cardiac adenylate cyclase (AC) activity. Reserpine treatment had no effect on basal or Gpp(NH)p (10(-7) M)-stimulated activities. Histamine (2 X 10(-6) and 10( 4) M) stimulation of guinea-pig AC was not influenced by the reserpine treatment. Epinephrine stimulation of AC was affected by reserpine and was characterized by an upward shift of the epinephrine dose-response curve with no change in the epinephrine EC50. The results indicate that the enhancement of cyclic AMP production is an important factor in the reserpine-induced cardiac supersensitivity to beta-adrenoceptor agonists. PMID- 3653244 TI - Involvement of A2 adenosine receptors in spinal mechanisms of antinociception. AB - Preliminary investigations suggest that spinal adenosine induces significant behavioral effects and may interact with descending antinociceptive systems stimulated by morphine administered intracerebroventricularly (i.c.v.). In the present study, rank order potencies for antinociception induced by adenosine agonists administered intrathecally (i.t.) were determined. Interactions of adenosine agonists (i.t.) with morphine (i.c.v.)-induced antinociception were also examined. Dose-dependent antinociception, as measured in tail flick and hot plate assays, was observed in mice administered adenosine or adenosine agonists i.t. Rank order potencies were 5'-N6-ethylcarboxamidoadenosine (NECA) greater than N6-(R-phenylisopropyl)-adenosine (R-PIA) greater than 2-chloroadenosine (CADO) greater than N6-(S-phenylisopropyl)-adenosine (S-PIA) greater than adenosine. Rank order potencies were identical for adenosine agonist (i.t.) synergism with morphine (i.c.v.)-induced antinociception. Further, i.t. injections of NECA or nitrobenzylthioinosine (NBI), an adenosine reuptake inhibitor, were able to potentiate morphine (i.c.v.)-induced antinociception. Hind limb paralysis induced by high doses of adenosine agonists (i.t.) was dissociated from antinociceptive effects. Rank order potencies determined in our studies support involvement of A2 adenosine receptors in spinal mechanisms of antinociception. In addition, these results confirm spinal adenosine interactions with antinociceptive systems stimulated by i.c.v. injections of morphine. PMID- 3653245 TI - Nifedipine delays the acquisition of tolerance to ethanol. AB - Rats were trained to remain on a motor-driven belt until they reached a criterion of not exceeding 1% error (1.2 s off the belt) in a 2 min trial. Upon completion of training, animals were treated with nifedipine and/or ethanol and were tested for degree of impairment after an i.p. injection of 2 g/kg ethanol solution on test days. Chronic nifedipine treatment enhances the acute ethanol effects on motor impairment and delays the acquisition of tolerance to ethanol. Results suggest modification of brain calcium channel activities could delay the development of tolerance to ethanol and may prevent ethanol-induced organic brain damage. PMID- 3653246 TI - Central cholecystokinin octapeptide reduces glucose utilization in subcortical but not cortical rat brain. AB - Cholecystokinin octapeptide was administered intraventricularly to laboratory rats in a behaviorally active dose. Quantitative regional glucose utilization was assessed as a measure of neuronal activity using [14C]2-deoxyglucose. CCK-8 reduced glucose utilization in selected subcortical nuclei, but left most areas of cortex unaffected. The subcortical nuclei were chiefly extrapyramidal systems. The diminutive pharmacologic action on cortical neuronal activity implies CCK-8 may act here as a neuronal modulator, in concert with other central transmitters, rather than having prominent singular actions. PMID- 3653247 TI - Interference by the novel PAF-acether antagonist WEB 2086 with the bronchopulmonary responses to PAF-acether and to active and passive anaphylactic shock in guinea-pigs. AB - The interaction between the triazolothienodiazepine WEB 2086 and the in vitro and in vivo bronchopulmonary effects of PAF-acether and active/passive anaphylaxis in the guinea-pig was studied. WEB 2086 (1-100 nM) inhibited PAF-acether (10-100 ng) induced bronchoconstriction and TXB2 release from isolated and perfused guinea pig lungs without affecting the response to 100 micrograms arachidonic acid. In addition, 1-10 microM WEB 2086 significantly reduced antigen-induced TXB2 and histamine release from lungs from actively and passively sensitized guinea-pigs. In the presence of the lipoxygenase inhibitor nordihydroguaiaretic acid (NDGA), mepyramine, methysergide, indomethacin and atropine, WEB 2086 (20-50 microM) inhibited by 30-40% the residual contraction of lung parenchyma strips from guinea-pigs actively sensitized by 0.1-10 micrograms antigen. In vivo, WEB 2086 (0.1-1 mg/kg) reversed or abolished the bronchoconstriction, hypotension, thrombocytopenia and leukopenia evoked by perfusion of PAF-acether (3 or 44 ng/kg per min). At 3 mg/kg, WEB 2086 also markedly decreased the bronchoconstriction and leukopenia induced by 100 micrograms/kg antigen in mepyramine (5 micrograms/kg)-treated passively sensitized guinea-pigs. In contrast, WEB 2086 was ineffective against active anaphylaxis in vivo. These results demonstrate that WEB 2086 antagonizes the bronchopulmonary effects due to PAF-acether and to anaphylactic shock in the guinea-pig. PMID- 3653248 TI - Pharmacological analysis of the variation in behavioural responses to tryptamine in five strains of mice. AB - The effects of tryptamine on behaviour were studied in five strains of mice. There were significant strain differences in the intensity of the 5-HT syndrome (head weaving and hindlimb abduction) and head twitch responses. The intensity of the 5-HT syndrome correlated significantly with the brain tryptamine content, although the occurrence of head twitch was unrelated. The 5-HT2 receptor antagonist, ketanserin, antagonized the head twitch responses elicited by tryptamine without affecting the head weaving or hindlimb abduction. Metergoline, an antagonist of both the 5-HT1 and 5-HT2 receptors, strongly inhibited both the 5-HT syndrome and the head twitch responses in all five strains. [3H]5-HT and [3H]ketanserin binding in the frontal cortex of the five strains of mice was also studied. The number of [3H]5-HT binding sites did not differ among the five strains of mice although there was a noticeable difference in the number of [3H]ketanserin binding sites. These results suggest that the 5-HT syndrome and the head twitch responses induced by tryptamine are linked separately with the 5 HT1 and 5-HT2 receptors, respectively. The strain differences in the tryptamine induced 5-HT syndrome can be explained by the different levels of brain tryptamine. The differences in the head twitch responses in the mice are probably derived from the differences in the 5-HT2 receptor binding sites in the brain and the content of brain tryptamine. PMID- 3653249 TI - Interaction of narcotic antagonist naltrexone with nicotinic acetylcholine receptor. AB - The interactions of naltrexone with the nicotinic acetylcholine receptor were studied electrophysiologically using the frog sciatic nerve-sartorius muscle and biochemically using membranes from the electric organ of Torpedo ocellata. At nanomolar concentrations naltrexone increased the peak amplitude of endplate currents with little change in the decay time constant. At micromolar concentrations there was a concentration-dependent depression of endplate current and miniature endplate current amplitudes and decay time constants. Decay time constant depression was enhanced with hyperpolarization. Only marginal curvature was induced in peak endplate current amplitude versus membrane voltage plots by naltrexone. Naltrexone had no effect on single channel conductance but decreased open channel lifetime, according to fluctuation analysis. Naltrexone alone (less than or equal to 3 microM) did not impair binding of [125I]alpha-bungarotoxin to the receptor in a fast pre-equilibration assay, but increased the ability of acetylcholine to displace [125I]alpha-bungarotoxin. The drug displaced the agonist-stimulated binding of [3H]perhydrohistrionicotoxin to the channel site. Biphasic functional changes in neuromuscular transmission can be attributed to an allosteric mechanism with increased agonist binding to the nicotinic receptor at nanomolar concentrations and caused a non-competitive blockade of the ionic channel at micromolar concentrations. PMID- 3653250 TI - Effects of guinea pig neurotensin ([Ser7]neurotensin) on gastrointestinal smooth muscle. AB - Guinea pig neurotensin differs from other mammalian neurotensin by the substitution of proline by serine at position 7. [Ser7]neurotensin produced a concentration-dependent contraction of the guinea pig oesophagus and rat fundus, a biphasic effect (initial relaxation followed by more sustained contraction) on the guinea pig stomach corpus, duodenum and longitudinal muscle of the ileum and a relaxation of the guinea pig colon and rat ileum. The potencies (EC50) and % maximum contraction compared with the maximum effect produced by either histamine or acetylcholine of [Ser7]neurotensin and neurotensin were not significantly different in any tissue studied. PMID- 3653251 TI - Induction of motility and alteration of surface membrane polypeptides in lymphocytes by contact with autologous and allogeneic fibroblasts. AB - Contact with cultured fibroblasts induced and maintained motile behavior in autologous and allogeneic human lymphocytes. After 3 h of contact with fibroblasts, 50 +/- 19% of the autologous lymphocytes were motile and after 24 h the corresponding figure was 49 +/- 18%. On a plastic surface the number of motile lymphocytes in the same individuals generally persisted below 15%. SDS PAGE of iodine-labeled lymphocytes indicated that contact with fibroblasts but not with plastic for a 3-h period caused the appearance of a 300-kda band and the disappearance of several bands of lower molecular weight. During the course of T lymphocyte activation by concanavalin A or allogeneic cells on a plastic surface, the number of motile forms did not reach a maximum (30 to 50% in separate individuals) until after 2 to 4 days in culture. Thus, in terms of both rate of development and number of motile forms, the fibroblast-dependent motility mechanism was more effective than conventional lymphocyte activation to blast transformation. Conditioned medium from fibroblasts did not induce motile behavior in the lymphocytes and did not provoke alteration of surface membrane polypeptides as revealed by iodination. Fibroblasts also triggered lymphocyte locomotion in serum-free medium, but their triggering effect was enhanced markedly by serum. The development and maintenance of lymphocyte motility required protein synthesis. These data suggest that during contact with fibroblasts lymphocytes acquire locomotor capacity by a mechanism different from activation to blast transformation. PMID- 3653252 TI - In situ factors affecting stability of the DNA helix in interphase nuclei and metaphase chromosomes. AB - The data from earlier cytochemical studies, in which the metachromatic fluorochrome acridine orange (AO) was used to differentially stain single vs double-stranded DNA, suggested that DNA in situ in intact metaphase chromosomes or in condensed chromatin of G0 cells is more sensitive to denaturation, induced by heat or acid, than DNA in decondensed chromatin of interphase nuclei. Present studies show that, indeed, DNA in permeabilized metaphase cells, in contrast to cells in interphase, when exposed to buffers of low pH (1.5-2.8) becomes digestible with the single-strand-specific S1 or mung bean nucleases. A variety of extraction procedures and enzymatic treatments provided evidence that the presence of histones, HMG proteins, and S-S bonds in chromatin, as well as phosphorylation or poly(ADP)ribosylation of chromatin proteins, can be excluded as a factor responsible for the differential sensitivity of metaphase vs interphase DNA to denaturation. Cell treatment with NaCl at a concentration of 1.2 N and above abolished the difference between interphase and mitotic cells, rendering DNA in mitotic cells less sensitive to denaturation; such treatment also resulted in decondensation of chromatin visible by microscopy. The present data indicate that structural proteins extractable with greater than or equal to 1.2 N NaCl may be involved in anchoring DNA to the nuclear matrix or chromosome scaffold and may be responsible for maintaining a high degree of chromatin compaction in situ, such as that observed in metaphase chromosomes or in G0 cells. Following dissociation of histones, the high spatial density of the charged DNA polymer may induce topological strain on the double helix, thus decreasing its local stability; this can be detected by metachromatic staining of DNA with AO or digestion with single-strand-specific nucleases. PMID- 3653253 TI - Hyaluronic acid production and hyaluronidase activity in the newt iris during lens regeneration. AB - The process of lens regeneration in newts involves the dedifferentiation of pigmented iris epithelial cells and their subsequent conversion into lens fibers. In vivo this cell-type conversion is restricted to the dorsal region of the iris. We have examined the patterns of hyaluronate accumulation and endogenous hyaluronidase activity in the newt iris during the course of lens regeneration in vivo. Accumulation of newly synthesized hyaluronate was estimated from the uptake of [3H]glucosamine into cetylpyridinium chloride-precipitable material that was sensitive to Streptomyces hyaluronidase. Endogenous hyaluronidase activity was determined from the quantity of reducing N-acetylhexosamine released upon incubation of iris tissue extract with exogenous hyaluronate substrate. We found that incorporation of label into hyaluronate was consistently higher in the regeneration-activated irises of lentectomized eyes than in control irises from sham-operated eyes. Hyaluronate labeling was higher in the dorsal (lens-forming) region of the iris than in ventral (non-lens-forming) iris tissue during the regeneration process. Label accumulation into hyaluronate was maximum between 10 and 15 days after lentectomy, the period of most pronounced dedifferentiation in the dorsal iris epithelium. Both normal and regenerating irises demonstrated a high level of endogenous hyaluronidase activity with a pH optimum of 3.5-4.0. Hyaluronidase activity was 1.7 to 2 times higher in dorsal iris tissue than in ventral irises both prior to lentectomy and throughout the regeneration process. We suggest that enhanced hyaluronate accumulation may facilitate the dedifferentiation of iris epithelial cells in the dorsal iris and prevent precocious withdrawal from the cell cycle. The high level of hyaluronidase activity in the dorsal iris may promote the turnover and remodeling of extracellular matrix components required for cell-type conversion. PMID- 3653254 TI - Casein gene expression in mouse mammary epithelial cell lines: dependence upon extracellular matrix and cell type. AB - The COMMA-D mammary cell line exhibits mammary-specific functional differentiation under appropriate conditions in cell culture. The cytologically heterogeneous COMMA-D parental line and the clonal lines DB-1, TA-5, and FA-1 derived from the COMMA-D parent were examined for similar properties of functional differentiation. In monolayer cell culture, the cell lines DB-1, TA-5, FA-1, and MA-4 were examined for expression of mammary-specific and epithelial specific proteins by an indirect immunofluorescence assay. The clonal cell lines were relatively homogeneous in their respective staining properties and seemed to represent three subpopulations found in the heterogeneous parental COMMA-D line. None of the four clonal lines appeared to represent myoepithelial cells. The cell lines were examined for expression of beta-casein mRNA in the presence or absence of prolactin. The heterogeneous COMMA-D line, but none of the clonal lines, was induced by the presence of prolactin to produce significantly increased levels of beta-casein MRNA. The inducibility of beta-casein in the COMMA-D cell line was further enhanced by a reconstituted basement membrane preparation enriched in laminin, collagen IV, and proteoglycans. Individual matrix components of laminin, fibronectin, heparan sulfate, heparan, or hyaluronic acid were not effective as substrata for the induction of beta-casein mRNA. These results support the hypothesis that the functional response of inducible mammary cell populations is a result of interaction among hormones, multiple extracellular matrix components, and specific cell types. PMID- 3653256 TI - Stimulation of growth of primary cultured adult rat hepatocytes without growth factors by coculture with nonparenchymal liver cells. AB - DNA synthesis of adult rat parenchymal hepatocytes alone in primary culture can be stimulated only by the addition of humoral growth factors to the culture medium. However, when parenchymal hepatocytes were cocultured with nonparenchymal liver cells from adult rats, their DNA synthesis was markedly stimulated in the absence of added growth factors or calf serum. DNA synthesis of parenchymal hepatocytes was not stimulated by conditioned medium from nonparenchymal liver cells and was greatest when the parenchymal cells were plated on 24-h cultures of nonparenchymal liver cells. A dead feeder layer of nonparenchymal cells was almost as effective as a feeder layer of viable nonparenchymal cells. These results suggest that the stimulation of DNA synthesis in parenchymal hepatocytes was not due to some soluble factors secreted by nonparenchymal liver cells but to an insoluble material(s) produced by the nonparenchymal liver cells. This insoluble material(s) was collagenase- and acid-sensitive, suggesting that it was a protein containing collagen. The effect of nonparenchymal liver cells was specific: coculture with hepatoma cells, liver epithelial cells, or Swiss 3T3 cells did not stimulate DNA synthesis in parenchymal hepatocytes. Added insulin and epidermal growth factor showed additive effects with nonparenchymal cells in the cocultures. These results suggest that DNA synthesis in parenchymal hepatocytes is stimulated not only by various humoral growth factors but also by cell-cell interaction between parenchymal and nonparenchymal hepatocytes, possibly endothelial cells. This cell-cell interaction may be important in repair of liver damage and liver regeneration. PMID- 3653255 TI - Mitochondrial genomes in intraspecies mammalian cell hybrids display codominant or dominant/recessive behavior. AB - A unique type of nonstochastic mitochondrial DNA (mtDNA) segregation was found in mammalian cells. In human cell hybrids isolated from the fusion of HeLa cells with 23, GM639, A549, or 293 cells, HeLa mtDNA was always lost from the hybrids, whereas both parental mtDNAs were maintained in hybrids of HeLa X 143BTK-. Similar phenomena were observed in mouse cell hybrids isolated by the fusion of cells with different mtDNA types. Types 1, 2, and 3, can be distinguished from each other by restriction fragment-length polymorphisms. The mouse cell hybrids between cells with type 1 and type 2 mtDNA always lost type 2 mtDNA, whereas the hybrids between cells with type 2 and type 3 mtDNA retained both types stably. These observations suggest that either a codominant or a dominant/recessive relationship may be present in intraspecies mitochondrial genomes of human and mouse cells. When the mitochondrial genomes in cell hybrids are codominant, stochastic segregation occurs while nonstochastic segregation occurs when they are in the dominant/recessive relationship. These concepts may help elucidate organelle heredity in animals. PMID- 3653257 TI - Mutant with diphtheria toxin receptor and acidification function but defective in entry of toxin. AB - A mutant of Chinese hamster ovary cells, GE1, that is highly resistant to diphtheria toxin was isolated. The mutant contains 50% ADP-ribosylatable elongation factor 2, but its protein synthesis was not inhibited by the toxin even at concentrations above 100 micrograms/ml. 125I-labeled diphtheria toxin was associated with GE1 cells as well as with the parent cells but did not block protein synthesis of GE1 cells even when the cells were exposed to low pH in the presence or absence of NH4Cl. The infections of GE1 cells and the parent cells by vesicular stomatitis virus were similar. GE1 cells were cross-resistant to Pseudomonas aeruginosa exotoxin A and so were about 1000 times more resistant to this toxin than the parent cells. Hybrids of GE1 cells and the parent cells or mutant cells lacking a functional receptor were more sensitive to diphtheria toxin than GE1 cells. These results suggest that entry of diphtheria toxin into cells requires a cellular factor(s) in addition to those involved in receptor function and acidification of endosomes and that GE1 cells do not express this cellular factor. This character is recessive in GE1 cells. PMID- 3653258 TI - Relationship between cytoplasmic pH and proliferation during exponential growth and cellular quiescence. AB - Flow cytometry was used to measure intracellular pH (pHi) on an individual cell basis during exponential and plateau phases of growth. In all three cell lines examined a range of pHi values was associated with exponential growth. When cells from the extremes of the pHi distribution were sorted using a fluorescence activated cell sorter and then restained for cellular DNA content, it was found that the higher pHi values were associated with enrichment of the S, G2, and M phases of the cell cycle, with a corresponding increase in the percentage of G1 cells at the lower pH1 range, suggesting cell-cycle dependence of pHi. It has been shown previously (I. W. Taylor and P. Hodson, 1984, J. Cell Physiol. 121, 517) that PMC-22 human melanoma cells are capable of entering a distinct pH dependent quiescent state in response to the acidification of the growth medium which occurs naturally during growth to plateau phase. Simultaneous measurement of pHi and external pH showed that under these conditions pHi was maintained at control values down to an external pH of approximately 6.5, below which cytoplasmic acidification took place. This fall in pHi coincided with the onset of the transition to quiescence. Individual quiescent cells (defined by failure to incorporate bromodeoxyuridine during a 24-h exposure) could not be identified as such on the basis of a low pHi, suggesting that the probability of cell cycling is reduced by lowering pHi. Those cells which remained in cycle showed a markedly reduced rate of DNA synthesis, but a cell-cycle phase distribution similar to that in exponential growth, indicating that prolongation of all cell cycle phases is an additional factor influencing overall population growth. The external pH at which both of these effects on cell proliferation kinetics took place in vitro is similar to that which occurs regionally within solid tumors, suggesting that pH effects could play a significant role in determining tumor cell growth in vivo. PMID- 3653259 TI - Pathway of urokinase-type plasminogen activator induction in the T47D and LLC-PK1 cell lines. AB - Induction of urokinase-type plasminogen activator (uPA) in response to either reagents activating cAMP-dependent protein kinase (cAMP-PK) or the calcium ion phospholipid-dependent kinase (C-kinase) was compared in the LLC-PK1 and T47D cell lines. The two cell lines exhibited quantitatively different responses to calcitonin, to the phosphodiesterase inhibitor isobutylmethylxanthine, and to the adenylate cyclase activator forskolin. Both showed activation of cAMP-PK in response to all these reagents, with T47D cells displaying a greater extent of activation. T47D cells, however, failed to produce uPA in response to calcitonin, forskolin, or the cAMP analog 8-bromo-cAMP, whereas LLC-PK1 cells produced high levels of uPA in response to all these agents. Both cell lines responded to phorbol esters in terms of uPA induction, though to differing extents. Phorbol myristate acetate (PMA) was shown conclusively not to activate cAMP-PK in either cell line, even at concentrations 10-fold higher than those promoting maximal uPA induction. It was concluded that phorbol ester-mediated induction of uPA does not involve cAMP or cAMP-PK activation. These results are discussed in relation to proposed models concerning the role of cAMP-PK in uPA induction. PMID- 3653260 TI - Modification of MCDB 110 medium to support prolonged growth and consistent high cloning efficiency of diploid human fibroblasts. AB - In preparation for studies on the growth factor requirements of normal and transformed human fibroblasts, we have developed a serum-free medium that supports vigorous long-term serial subculture of diploid human fibroblasts and allows them to form large-sized colonies with high efficiency (40 to 60%) when plated at cloning density (2 to 5 cells/cm2). This medium, which is a modification of Ham's MCDB 110 base medium with its serum replacement supplements, is relatively easy to prepare and the cost of the serum replacements is approximately the same as that of fetal bovine serum supplied at 10%. The ingredients of "Supplement B" of MCDB 110 medium were added in an ethanol solution, rather than in the form of liposomes, and were combined with bovine serum albumin (0.5%), a lipid carrier. Gelatin and fetuin were included as attachment factors instead of polylysine. Bioassays indicated that none of the ingredients in the medium were contaminated with either epidermal growth factor or platelet-derived growth factor. In this modified serum-free medium, which we have designated McM+SR1, diploid human fibroblasts grew for 21 days at the same rate as in the base medium, McM, supplemented with 10% FBS (i.e., 21 population doublings). During the next 20 days, they underwent 15 population doublings which was 75% of the rate of cells growing in the medium containing serum. PMID- 3653261 TI - Detection of sugar-binding sites in the fibrillar and the granular components of the nucleolus: an experimental study in cultured mammalian cells. AB - The intranucleolar distribution of sugar-binding sites (i.e., lectin-like molecules) was analyzed in segregated nucleoli of actinomycin D-treated HeLa cells. The detection of sugar-binding sites was performed by incubation either of permeabilized nuclei in the presence of fluorescein-labeled neoglycoproteins or of ultrathin sections cut through in situ-fixed nuclei in the presence of gold labeled neoglycoproteins. In the former case, the fluorescent nucleolar components were identified by comparison with the nucleolar components of similarly treated cells observed in electron microscopy. For the first time, this study reveals the presence of sugar-binding sites in both the fibrillar and the granular components of the nucleolus. In view of the data already reported on the biochemical composition of the nucleolus, some of our results led us to conclude that the nucleolar sugar-binding sites are lectin-like proteins. These proteins could be associated with preribosomes since the nucleolus is the site of both synthesis and stockage of ribosomal precursors. Some results from this study, however, show that the possibility of a relationship between some lectins and a structural component cannot be excluded. PMID- 3653262 TI - Cytodifferentiation of polar plant cells: formation and turnover of endoplasmic reticulum in root statocytes. AB - By application of cytochalasin D (10 micrograms/ml) the distribution and turnover of endoplasmic reticulum (ER) in root statocytes of cress (Lepidium sativum L.) was studied. After 7 min of incubation, the distal ER complex, in 20-h-old control statocytes consisting of stacked cisternae, was disintegrated and redistributed. The amyloplasts sedimented into the most distal part of the cell. When the incubation time was increased up to 4 h, ER was formed near the nucleus and accumulated at the proximal cell pole. Thus microfilaments are suggested to be involved in (i) stabilization of the distal ER complex and (ii) the ER translocation from the forming site into the distal cell pole. By morphometric measurements the volume of story II (story III) statocytes was calculated to be 2400 microns3 (3000 microns3), containing an ER area of 1824 microns2 (2400 microns2). From the net ER formation rate of 5.2 microns2/min (story II) and 4.6 microns2/min (story III) and the net decrease rate of 23 microns2/min (story II) and 39.2 microns2/min (story III), a total ER formation rate of about 27 microns2/min (story II) and 43 microns2/min (story III) was estimated. PMID- 3653263 TI - Effects of dimethyl sulfoxide (DMSO) on microfilament organization, cellular adhesion, and growth of cultured mouse B16 melanoma cells. AB - Cell shape is involved in a variety of cellular activities including proliferation, adhesion, migration, and transformation. Agents known to promote differentiation, such as retinoic acid, butyrate, and dibutyryl cyclic AMP, induce marked alterations in cell shape which are often accompanied by changes in cell functions. In this paper we study the effects of the differentiating polar solvent dimethyl sulfoxide (DMSO) on cytoskeleton, adhesion, and growth properties of cultured mouse B16 melanoma cells. DMSO induced a progressive reorganization of the cytoskeleton which was fully developed in 4 days of continuous exposure to the agent. DMSO-treated cells developed thick and regularly oriented microfilament bundles of the stress fiber type ending at vinculin-rich areas of focal contact between the ventral membrane and the substratum (interference reflection microscopy-dark adhesion plaques). Such a rearrangement of the cytoskeleton resulted in increased adhesion to the substratum and inhibition of cell growth in comparison to control untreated cells. Cells which became highly flattened and tightly adherent after exposure to DMSO for 4 days progressively reverted their phenotype to that of control untreated cells within 3 days of DMSO withdrawal. Namely, they lost stress fibers and adhesion plaques, became rounded and less adherent, and increased their growth rate. These results indicate that DMSO can change the transformed appearance of B16 mouse melanoma cells to a phenotype which is typical of a variety of nontransformed cells in culture. PMID- 3653264 TI - Histone gene expression remains coupled to DNA synthesis during in vitro cellular senescence. AB - Despite a decrease in the extent to which confluent monolayers of late compared to early passage CF3 human diploid fibroblasts can be stimulated to proliferate, the time course of DNA synthesis onset is similar regardless of the in vitro age of the cells. A parallel and stoichiometric relationship is maintained between the rate of DNA synthesis and the cellular levels of histone mRNA independent of the age of the cell cultures. Furthermore, DNA synthesis and cellular histone mRNA levels decline in a coordinate manner after inhibition of DNA replication by hydroxyurea treatment. These results indicate that while the proliferative activity of human diploid fibroblasts decreases with passage in culture, those cells that retain the ability to proliferate continue to exhibit a tight coupling of DNA replication and histone gene expression. PMID- 3653265 TI - Nutrition and fetal brain maturation. I. Responses in vitro and in vivo. AB - The glycolytic enzyme enolase increases during the perinatal period of brain development and was utilized as a marker for examining the effect of culture environment on differentiation of cells from 20-day fetal rat brain. Enolase activity in cell cultures increased from 0.91 +/- 0.03 (Day 0) to 2.11 +/- 0.10 mumol/min/mg protein (Day 6). Comparable levels were not reached in vivo until neonatal pups were 15 days old. The in vitro increase was inhibited by both cycloheximide and actinomycin D. Enolase activity in the cells responded to alterations in both incubation media and homologous serum. After 6 days in culture, cells incubated in rat serum (10%) added to MEM or RPMI produced twice as much enolase activity as cells incubated similarly in Ham's medium, i.e., 1.96 +/- 0.09 and 1.85 +/- 0.21 vs 1.02 +/- 0.09, P less than 0.001. Results of a comparable magnitude were obtained when fetal calf serum replaced adult rat serum, but enolase production was somewhat lower when newborn calf serum replaced adult rat or fetal calf serum. When cells were incubated for 6 days with graded concentrations of adult rat serum (2.5-15%), enolase activity increased progressively. The pattern of enolase response suggests that the fetal rat brain cell model described herein will provide a sensitive probe with which to gain insight into nutrition and fetal brain development. PMID- 3653266 TI - Reconstitution of human epidermis in vitro is accompanied by transient activation of basal keratinocyte spreading. AB - Frozen human cadaver skin obtained from the skin bank was thawed and incubated in serum-free medium for 1-2 days, after which the original epidermis could be removed mechanically. Transmission electron microscopic observations showed that the dermal matrix remaining behind contained intact bundles of collagen fibrils but no live cells and that a continuous lamina densa persisted in the basement membrane region. Indirect immunofluorescence analyses demonstrated linear staining of the basement membrane region by antibodies against laminin and type IV collagen and discontinuous staining with antibodies against fibronectin. Scanning electron microscopic observations revealed a normal topographical arrangement of dermal matrix papilla and interspersed crypts on the surface of the matrix. Epidermal cells placed on the dermal matrix attached in 1-2 h and spread by 24 h. After 1 week of culture the epidermis was reconstituted, at which time approximately 30% of the epidermal cells were basal keratinocytes and the remainder were more differentiated keratinocytes. A high degree of differentiation of the reconstituted epidermis was shown by the formation of hemidesmosomes along the basement membrane, the formation of desmosomes characterized by intercellular dense lines, and the presence of a cell layer containing keratohyalin granules. At various times during epidermal reconstitution, cells were harvested and tested in short-term assays for adhesion to fibronectin substrata. During the first several days there was a transient activation of basal keratinocyte spreading analogous to the modulation of keratinocyte spreading that we have observed during epidermal reconstitution in vivo. PMID- 3653267 TI - Hyperosmolarity-induced stress proteins in chick embryo fibroblasts. AB - The effects of a short exposure of chick embryo fibroblasts to a hyperosmolar medium on monovalent cation content, rate of protein synthesis, and polypeptide pattern expression were studied. The hyperosmolar shock gave an immediate and pronounced inhibition of the protein-synthesis rate temporally related to a marked alteration of the intracellular Na+ content. Following the return of the cells to an osmolar environment, the internal Na+ content quickly resumed its previous level, while the recovery of the protein-synthesis rate was more gradual. During the recovery period, there was enhanced expression of at least 12 proteins. The 4 major induced proteins exhibited apparent molecular weights of 96, 87, 70, and 48 kDa. A reduction in the synthesis of five protein bands including three large polypeptides of 220, 160, and 140 kDa was also observed. A comparison with the 3 major proteins induced by a 44 degrees C heat shock indicated an apparent similarity with only two of the hyperosmolarity-inducible polypeptides. Moreover, evidence has been also obtained of the close similarity between the 96 and 75 kDa glucose-regulated proteins and the 96 and 75 kDa proteins inducible by a hyperosmolar shock or by a continuous hyperosmolar treatment, respectively. The kinetics of the stress-proteins appearance indicated nonsimultaneous induction. The presence of actinomycin D during the exposure of the cells to the stress and the recovery period suggested that the expression of some hyperosmolarity-enhanced proteins is regulated at the transcriptional level. PMID- 3653268 TI - The regulation of sterol metabolism by cell interactions. AB - Total and free cholesterol levels in C6 glial cells are regulated by a cell interaction-dependent mechanism that operates independently of exogenous cholesterol and serum lipoproteins. This mechanism, which is activated by changes in culture density, coordinately regulates the activities of HMG-CoA reductase and acyl-CoA:cholesterol acyltransferase (ACAT). Both enzyme activities are low in sparse density cultures, rise as density increases from sparse to moderate, and decrease with further density increases. When culture density is abruptly elevated, both enzyme activities decay rapidly and with biphasic kinetics. Neither enzyme phosphorylation nor diffusible cytosolic factors appear to be directly involved in density suppression of HMG-CoA reductase. Studies with human fibroblasts that are defective in LDL receptor function demonstrate that density regulation does not require a functional LDL receptor. Extracellular matrix and soluble factors have also been ruled out as intercellular mediators. The specific growth rate of C6 cultures changes with density in the same manner as sterol metabolism. The possibility that growth and sterol metabolism are regulated by a common cell interaction-dependent mechanism is discussed. PMID- 3653269 TI - Serotonin-accumulating cells in the iris-ciliary body and cornea of various species. AB - Serotonin was biochemically shown to be present in the iris-ciliary body of the frog, pigeon, goldfish and guinea-pig eyes at a concentration of between 55 and 95 ng per g. The aqueous fluid, in contrast, had no measurable serotonin, though a small amount of dopamine was present. Immunohistochemistry of the iris-ciliary body and cornea of all species failed to demonstrate the localization of serotonin. However, when tissues were first incubated with exogenous serotonin and then processed immunohistochemically for the localization of serotonin, positive staining was observed. Serotonin-accumulating fibres were present in the corneal stroma of the frog, pigeon and guinea-pig but not in the goldfish. In this species only a few unidentified non-neural cells in the corneal epithelium took up exogenous serotonin. The evidence of serotonin-accumulating fibres in the frog, rat or goldfish iris-ciliary body complex was not conclusive. This contrasted with the pigeon iris-ciliary body where there were some delicate fibres in the epithelium layers which take up exogenous serotonin. It is however, in the guinea-pig iris-ciliary body that the serotonin-accumulating cells are most numerous with fibres being situated in the muscular and epithelial areas. The distribution of tyrosine-hydroxylase immunoreactivity and serotonin accumulating fibres in the guinea-pig iris-ciliary body was similar. The rat tissue also demonstrated a perfuse distribution of tyrosine-hydroxylase-positive fibres but lacked clear serotonin-accumulating fibres. The serotonin-accumulating fibres, therefore, do not give an indication of catecholaminergic fibres in all species. PMID- 3653270 TI - Biochemical and histochemical evidence for lysosomal proteases in rodent lenses. AB - The lysosomal proteases cathepsin B and dipeptidyl peptidase II (DPP II) were identified biochemically in the supernatant fraction of rat and guinea-pig lens homogenates, using as substrates CBZ-Arg-Arg-4-methylcoumarin-7-amide (AMC) (5 microM, pH 6.0, 37 degrees C for cathepsin B, and Lys-Ala-AMC or Lys-Pro-AMC (5 microM, pH 5.5, 37 degrees C) for DPP II. Cathepsin B-like activity was totally inhibited by the specific inhibitor lepeptin (0.1 mM); while DPP-II-like activity was partially inhibited by Tris (10 mM) or puromycin (0.1 mM), which are specific for DPP II, and by phenylmethylsulphonyl fluoride (PMS-F), an inhibitor of serine class proteases. DPP-II-like activity also was demonstrated histochemically. The histochemical preparations consisted of cryostat sections (6 micron) of glutaraldehyde-fixed rat lenses, incubated in medium containing cacodylic acid NaOH (0.05 M), Lys-Pro-4-methoxy-2-naphthylamide (MNA) or Lys-Ala-MNA (1 mM), and 0.1% w:v Fast Blue B salt (pH 5.5, 37 degrees C). Control sections were treated with medium in which the substrates were replaced by Lys-Ser-MNA (1 mM), which is not acted upon by DPP II; or medium containing PMS-F (1 mM). Sections treated with experimental medium containing Lys-Pro-MNA showed intense enzymatic activity throughout the epithelium and bow region. In the bow region and superficial cortex activity was mostly granular, suggesting a lysosomal localization. Histochemical activity was reduced partially by inclusion of PMS-F, and totally by substituting Lys-Ser-MNA for Lys-Pro-MNA. PMID- 3653271 TI - The effect of colchicine on the diurnal variation of phagocytosis in mouse retinal pigment epithelium. AB - The effect of colchicine on the fine structure of the retinal pigment epithelium (RPE) was investigated morphometrically in ICR mice bred in a condition of 12-hr light: 12-hr dark cycle since birth. In untreated mice, the number of phagosomes in RPE, containing packets of rod outer segment (ROS) discs, increased maximally at 1.5 hr after light onset, and progressively declined to the bottom value at around the time of lights off. Intraperitoneal injection of mice with colchicine (1 mg per 100 g body weight) prior to a peak of phagocytosis (4 hr before light onset) resulted in a marked increase in the number of phagosomes and a clustering of lysosomes in the apical cytoplasm of RPE and a decrease in the number of microtubules. The colchicine treatment also induced the dispersion of mitochondria from a basal cytoplasmic portion to the whole cytoplasmic area. These changes became dominant at 8 hr after the treatment and continued thereafter for a period of 12 hr. On the other hand, when colchicine was given during the period in which phagocytosis is inactive (8 hr after light onset), it induced only a slight increase in the number of phagosomes which recovered to the normal level earlier than the above. Clustering of lysosomes and dispersion of mitochondria continued to the same extent as in mice treated with colchicine at 4 hr before light onset. It was suggested that the effect of colchicine on the phagocytosis of ROS by RPE might depend on the functional state of RPE during the lighting cycle. PMID- 3653272 TI - Effect of light history on rod outer-segment membrane composition in the rat. AB - Albino rats were born and raised through 12 weeks of age in 12L:12D regimes of 5, 300- or 800-lx illuminance. Upon killing, the animals' retinas were examined for the following: (1) rhodopsin of whole retina and isolated rod outer-segment membrane; (2) retinal morphology, including outer segment length and outer nuclear layer area; and (3) outer-segment membrane lipid biochemistry. The three groups of animals show significant differences with respect to one another for nearly every parameter measured. Rod outer-segment membranes of rats raised in dim cyclic light (5 lx) have high rhodopsin packing densities, high levels of polyunsaturated fatty acids, and low cholesterol levels in comparison with animals raised in brighter illuminances (300- or 800 lx). The mole ratio of phospholipid to rhodopsin in the outer-segment membrane of rats raised in 5-lx cyclic light is only 43% of that of rats raised in 800-lx cyclic light. The difference between these two groups of animals for docosahexaenoic acid is greater than three times, with dim light-reared animals showing higher levels. These rats (5 lx-reared) have less cholesterol in their photoreceptor outer segments, 6.6 mol% compared with 19.7 mol% for animals from the 800-lx regime. In all cases, rats from the intermediate rearing illuminance (300 lx) exhibit intermediate membrane composition values. It is likely that these differences in membrane composition illustrate a profound effect of light history on photoreceptor function. PMID- 3653273 TI - Effect of light history on retinal antioxidants and light damage susceptibility in the rat. AB - Albino rats were born and raised to 12 weeks of age in 12L:12D light regimes of 5, 300 or 800 lx. Upon killing, the activities of the following glutathione enzymes were measured in the neuroretina: (1) glutathione peroxidase; (2) glutathione-S-transferase; and (3) glutathione reductase. Also measured were vitamin E, ascorbic acid, and the levels of oxidized and reduced glutathione. Animals raised in 800-lx cyclic light have a significant increase in the retinal activities of the three glutathione enzymes over activities measured in animals raised in the two dimmer regimes. The retinal level of vitamin E, measured per nmol of lipid phosphorus, is directly and significantly correlated with rearing illuminance (P less than 0.05). The same is true of retinal ascorbic acid, which shows a 30% increase in the 800-lx-reared rats over the level of those raised in the intermediate light regime (300 lx). Some of the animals from each group were exposed to 2000 lx for 24 hr to determine if correlations existed between the levels of retinal antioxidants listed above and susceptibility to light damage. Animals raised in 5-lx cyclic light lost almost all of their photoreceptors as a result of the exposure. Rats raised in 300-lx cyclic light lost a small but significant number (ca. 20%), while those raised in 800 lx sustained no light damage. Electroretinographic evaluation supports these morphometrical findings. PMID- 3653274 TI - An in vivo and in vitro study of the embryonic and adult lop mutant congenital cataractous lens. AB - A detailed histological study of the embryonic and adult congenital cataract Lop mouse lens has been made. A comparison with the congenital cataract (CatFr) mouse lens has shown that the full range of lens anomalies noted in the congenital cataractous mice are very similar. However, the Lop mutant demonstrates these defects to a greater degree in both the embryonic and adult stages. The lens epithelial cells of the Lop adult lens have been cultured to ascertain their in vitro phenotype. These studies have shown that the proliferation pattern and population doubling level are similar to that of the CatFr lens epithelial cells. A comparison with non-cataractous mouse lens epithelial cells demonstrates that the congenital cataractous mice lens epithelial cells have a very limited life span in vitro. An increase in the nuclear diameter with population doubling level was observed in the cultured mouse lens epithelial cells. PMID- 3653275 TI - Distribution of aromatic and fluorescent compounds within single human lenses. AB - The concentration of the free aromatic amino acids tryptophan and tyrosine, the antioxidant uric acid and some unidentified compounds have been determined in the water-soluble extracts of parts from clear and nuclear-cataractous human lenses. With age (29-90 years) and cataract formation, associated with increasing nuclear pigmentation, no significant changes were observed in content of tryptophan, tyrosine and uric acid. Furthermore, these compounds did not show variation in distribution within the lens. An unidentified fluorophore, excitation and emission maxima of 345 and 425 nm, respectively, increases significantly in content with nuclear cataract formation, especially in the nucleus. Another unidentified, presumably aromatic compound shows a striking age-related decrease. PMID- 3653276 TI - Eicosanoids as a new class of ocular hypotensive agents. 1. The apparent therapeutic advantages of derived prostaglandins of the A and B type as compared with primary prostaglandins of the E, F and D type. AB - The classic primary prostaglandins (PGs), as well as some of their analogs and derivatives, are potent ocular hypotensive agents. The present studies show that A and B PGs, which are derived from PGs of the E type by dehydration and isomerization, have a much greater ocular hypotensive potency than the primary PGs of the E, F or D type. A single application of 5 micrograms of PGA2 to the cat eye in a 25-microliters volume of aqueous vehicle solution yielded a greater and more prolonged ocular hypotensive effect than as much as 100 micrograms of topically applied PGF2 alpha. As little as 1 microgram of PGA2 had a significant ocular hypotensive effect that was enhanced by three or more consecutive daily applications of the same dose. This IOP reduction, which remained significant for several days after the last of 10 daily treatments, was not associated with biomicroscopically detectable flare or invasion of the anterior chamber by cells. Although PGF2 alpha and, to a much lesser extent, PGE2 have a miotic effect in cats, PGs of the A and B type did not cause significant miosis even at doses 50- to 100-fold greater than the minimum dose required to yield significant ocular hypotension. PGA2 retained its ocular hypotensive potency when stored in an aqueous solution at room temperature for four months. The conjunctival hyperemia caused by 5 micrograms or 10 micrograms of A or B type PGs on rabbit eyes was milder and shorter in duration than that caused by the same doses of PGE2 or PGF2 alpha. These findings suggest that derived PGs, especially PGs of the A type, may have a therapeutic advantage over primary PGs for the treatment of ocular hypertension and glaucoma. PMID- 3653277 TI - Effects of visible-light irradiation on vitreous structure in the presence of a photosensitizer. AB - Sensitized photo-induced changes of vitreous structure were investigated using both in vivo and in vitro model systems. In the former, rabbit eyes were injected with the photosensitizer riboflavin, and in the latter, calf vitreous samples were treated with riboflavin or Methylene Blue prior to irradiation with white light. The active species of oxygen, i.e. singlet oxygen, superoxide anion, hydroxyl radical and hydrogen peroxide, generated by the photodynamic action of the sensitizer, caused significant liquefaction of the calf vitreous in vitro. There was little liquefaction of the rabbit vitreous in vivo, suggesting the presence of a protective mechanism in vivo. hyaluronidase induced significantly greater liquefaction in vitro than either Methylene Blue or riboflavin. This study suggests that loss of gel vitreous structure can result from extensive depolymerization of hyaluronidase by hyaluronidase and less drastic conformation and molecular weight changes in the photosensitized reactions. Although light induced liquefaction was less marked than enzyme-induced liquefaction, the mechanism of the former is more pertinent to age-related vitreous synchysis. PMID- 3653278 TI - Protection from light damage by ocular pigmentation: analysis using experimental chimeras and translocation mice. AB - Experimental mouse chimeras and Cattanach's translocation mice, both with alternating pigmented and non-pigmented cells of the retinal pigment epithelium (RPE), have been exposed to various periods of constant fluorescent light. Photoreceptor degeneration was always more severe in the central retina than in the peripheral retina, and it was independent of the pigmentation phenotype of the immediately overlying RPE. The findings suggest that although RPE melanosomes lower total retinal irradiance by absorption of light, they do not provide direct protection from light damage for the immediately underlying photoreceptor cells by a biochemical mechanism as previously suggested. PMID- 3653279 TI - Lysosomal enzyme activities in cultured trabecular-meshwork cells. AB - We examined the lysosomal enzyme levels in cultured trabecular meshwork cells. Histochemical studies revealed that bovine trabecular meshwork cells stained prominently for acid lipase, acid phosphatase, and acid esterase activities. Following phagocytic challenges, such as incubations with latex microspheres or zymosan particles, lysosomal enzyme staining was visibly enhanced. The uptake of foreign particles by trabecular-meshwork cells was evident. Data from biochemical assays for acid lipase, cholesteryl esterase, and acid esterase confirmed the histochemical findings. These results indicate that trabecular meshwork cells are actively phagocytic in culture and that lysosomal enzyme levels in these cells may be modulated by phagocytic challenge. PMID- 3653280 TI - An estimate of the human lens epithelial cell size in vivo. AB - There are few previous estimates of the size of the human lens epithelium. In this study the lens epithelium is measured by specular reflex photography with a macro camera. The results are corrected for cornea magnification. One hundred subjects were studied ranging in age from 11 to 75 and including 20 diabetics and 18 subjects with cataract. The results show a range of epithelial cell diameters from 8-21 microns with 97% of the measurements lying in the 9-17 microns range. Pleomorphism is marked. The mean cell size was 12.7 microns. Large differences exist in mean cell size between individuals, but no correlation was found with age, diabetes or cataract. PMID- 3653281 TI - Age-related alterations in vitamin A metabolism in the rat retina. AB - Vitamin A plays a central role in visual transduction and in maintaining the structural integrity of the retina. It is possible that age-related alterations in vitamin A metabolism in the eye could contribute to the impairment of visual function that occurs during senescence. Therefore, investigations were conducted to determine whether the metabolism of this vitamin in the rat retina was altered during aging. Pigmented rats aged 12-, 22-, and 32 months were dark-adapted, and one eye from each animal was enucleated under dim red light. The neural retinas were separated from the retinal pigment epithelium (RPE)-choroid-scleral complexes, and the amounts and forms of vitamin A in both tissues were determined. The animals were then fully light-adapted, and the same measurements were performed on the tissues from the remaining eye of each rat. A number of age related alterations in the vitamin A composition and content of the retina and RPE were observed. The most pronounced of these changes were significant increases in the ratios of retinyl palmitate to retinyl stearate with advancing age in both the neural retina and RPE. The total vitamin A ester contents of the RPEs increased during senescence in the dark-adapted state, but not in the light adapted state. Retinyl ester levels in the neural retinas, on the other hand, did not differ significantly between 12- and 32-month-old animals in either the light adapted or dark-adapted states. The amounts of all-trans retinol in the neural retinas decreased during aging, mainly in the dark-adapted state, whereas aging had no influence on RPE all-trans retinol content. The age-related alterations in metabolism of vitamin A that these observations reflect may be related to certain changes in visual function that occur during senescence. PMID- 3653282 TI - High glucose concentrations inhibit protein synthesis in retinal pigment epithelium in vitro. AB - There is mounting evidence suggesting functional and structural alterations in the retinal pigment epithelium (RPE) in experimental and clinical diabetes. In this study we examined the effect of high glucose concentrations on human RPE cells in vitro. After 24-hr incubation in media supplemented with glucose (19.5 mM, 25.5 mM, and 45.5 mM) and prepared both with and without osmotic adjustment, there was no significant effect on [3H]thymidine or [3H]uridine incorporation into TCA-precipitable material. There was, however, a significant decrease in [35S]methionine incorporation which became more marked with increasing glucose concentrations. This could not be attributed to increased osmolarity caused by the additional glucose as it occurred in isosmolar high glucose media. 3-O-methyl glucose, a non-metabolized glucose analog, did not have the same effect, suggesting that metabolism of glucose may be important. Resolution of newly synthesized proteins by gel electrophoresis and autoradiography suggests a generalized decrease in protein synthesis. These data suggest that elevated glucose levels cause a significant metabolic alteration in RPE cells in vitro. PMID- 3653283 TI - Purification and characterization of an aminopeptidase from bovine cornea. AB - An aminopeptidase from bovine cornea has been extensively purified by gel filtration and ion-exchange chromatography. The purified enzyme with a molecular weight of 96,000 showed broad substrate specificity. All of the various aminoacyl bonds were hydrolyzed optimally at pH 6.5. The purified enzyme showed hydrolytic activity towards bioactive peptides such as enkephalins, bradykinin, and angiotensin-II. The enzyme was inhibited by bestatin, amastatin, puromycin, bacitracin, sulfhydryl reagents and metal chelators. Only Co2+ stimulated the enzyme whereas other heavy metal ions were toxic. The gross properties of the corneal enzyme resemble those of an aminopeptidase III isolated from bovine lens. PMID- 3653284 TI - Quantitative studies on Langerhans cells in mouse corneal epithelium following infection with herpes simplex virus. AB - Dendritic Langerhans cells (LCs) were identified in flat-mount preparations of mouse corneal epithelium after staining for ATPase activity. They were found predominantly in the limbus, but after inoculating the cornea with HSV1 strain SC16 LC, numbers increased both in the limbus and the central cornea. Numbers of LCs reached a maximum on day 8 and if severe keratitis was present remained high at least until day 22. A small but significant increase in LCs was also found in the opposite, uninoculated eye in mice with severe damage in the inoculated eye. After HSV inoculation on the snout, 60% of mice had corneal disease in the eye on the inoculated side; in such mice corneal LCs were at a maximum 18 days after inoculation. The increase in LC numbers was similar whether inoculation was into the cornea or in the snout. After corneal inoculation the cells were distributed fairly evenly over the corneal surface, with accumulations limited to epithelial ulcers. However, after inoculation on the snout, numerous clusters were seen over the epithelial surface, often surround by epithelium devoid of LCs. PMID- 3653285 TI - Antisera to synthetic peptides of MIP26K as probes of changes in opaque vs. transparent regions within the same human cataractous lens. AB - Material from opaque vs. transparent areas of the same cataractous lens have been quantitatively analysed using polyclonal antisera to synthetic peptides of MIP26K. The results of this radioimmunoassay demonstrate MIP26K changes in the anterior region, but not posterior or equatorial region, of three out of four cataractous lenses analysed. PMID- 3653286 TI - Maintenance of retinyl ester synthetase activity in cultured human retinal pigment epithelial cells. PMID- 3653287 TI - Water gradients across bovine lenses. PMID- 3653288 TI - Human lens epithelial cells in culture: a quantitative evaluation of growth rate and proliferative capacity. AB - Human lens epithelial (HLE) cells were explanted into medium containing different concentrations of foetal calf serum (FCS) and serum substitute. The proliferation of cells was measured as a function of time in culture and the growth parameters (growth rate and proliferative capacity) were determined by the application of the Gompertz growth function. Human lens epithelial cells have a limited growth capacity in culture of five to seven population doublings and this decreases with age. The population doubling level (PDL) was determined empirically and from fits of the Gompertz equation. The values of the PDL determined experimentally and theoretically are compared for a series of different culture conditions. Exposure of the cells to raised levels of FCS caused a reduction in proliferative capacity; the PDL decreased from 6.3 to 5.5 when the serum was raised to 50% although the growth rate increased. Serum substitute caused a decrease in the growth rate without changing the proliferative capacity and also altered the cellular morphology. It is hoped that the method described will have applications to the study of posterior capsule opacification following extracapsular cataract extraction and phacoemulsification and will aid in the development of preventive therapies. PMID- 3653289 TI - Spectroscopic studies on the mixed disulfide formation of lens crystallin with glutathione. AB - Mixed disulfide was formed through thiol-disulfide exchange reaction of lens crystallin with oxidized glutathione (GSSG). The reaction was monitored by isoelectric focusing (IEF) and DTNB [5,5'-dithiobis(2-nitrobenzoic acid)] assay. The effects on protein conformation were studied by circular dichroism (CD) and fluorescence. The DTNB shows 22% and 49% decrease of SH groups after the exchange reaction in alpha-crystallin and gamma-crystallin, respectively. The exchange reaction was further shown by an acidic shifting in IEF pattern. The near ultraviolet CD shows a slight decrease in the GSSG-treated crystallins. The fluorescence measurements of the SH specific probe IANBD, 4-(N-iodoacetoxy)ethyl N-methylamino-7-nitrobenz-2-oxa-1,3-diazole, indicate that the surface SH groups were oxidized in the GSSG-treated samples. The labeling with amine selectively reactive probe FITC, fluorescein-5-isothiocyanate, indicates an increase of amine reactivity with mixed disulfide formation. Polarization measurements show that bound FITC probes are in a less rigid structure in the mixed disulfide rich crystallin. All these results point out that the formation of mixed disulfide partially unfolds protein. PMID- 3653290 TI - Covalent changes at the N- and C-terminal regions of gamma crystallin during aging of the normal human lens. AB - Polyclonal antisera have been made to synthetic peptides corresponding to the N- and C-terminal regions of the putative gamma 1-2 gene from human lens. These antisera are specific for gamma crystallin, showing no cross-reactivity with any polypeptides of the alpha- and beta-crystallin fractions. Western blot analysis demonstrates a dramatic decrease in the binding of these antisera to gamma crystallin during aging of the normal human lens, while identical analysis with polyclonal antisera to the major cyanogen bromide fragment (19,000 MW) of human gamma crystallin shows little, if any, change during aging. Together, these demonstrate that antisera to synthetic peptides of the N- and C-terminal regions of the gamma 1-2 gene are very specific probes that can demonstrate extensive covalent modification from both ends of the gamma crystallin molecule during aging of the normal human lens. PMID- 3653291 TI - Stromal reaction and repair after corneal alkali wound in the rabbit: a quantitative microradiographic study. AB - The corneal stromal reaction and repair were studied after alkali wound in the rabbit. The wound was followed for 6 months. The size and opacity of the wound were followed in the slit lamp and photographically. Morphology and dry mass or water content were studied using quantitative microradiography. The size of the wound opacity diminished throughout the observation period. The density of the opacity varied with the stromal water content. An increased water content as well as large variation in water content caused increased opacity. The corneal edema, determined already after 1 hr, was not detectable by 1 week using quantitative microradiography. Subsequently, an extensive edema developed, water accumulation being most marked in the posterior part of the cornea. After 8 weeks, an increase in interlamellar dry mass content could be determined as a sign of a stromal healing process. Stromal thickness and dry mass content had returned to normal values by 6 months. PMID- 3653292 TI - Cultured trabecular-meshwork cells: immunohistochemical and lectin-binding characteristics. AB - We examined the extracellular matrix formation and lectin-binding properties of cultured trabecular-meshwork cells established from cynomolgus monkey and bovine eyes. Using an avidin-biotin complex method, we found that the extracellular matrix in both the monkey and bovine cultures stained intensely with antibodies to fibronectin, type IV collagen, and laminin. These materials were especially prominent when the cultured monkey trabecular-meshwork cells aggregated in clusters, manifesting their close anatomic relationship to trabecular beams. Cell surface and intracellular lectin-binding properties were studied using eight biotinylated lectins: concanavalin A (Con A), peanut agglutinin (PNA), Ricinus communis agglutinin (RCA), Dolichos biflorus agglutinin (DBA), soy bean agglutinin (SBA), Phaseolus vulgaris (PHA), wheat germ agglutinin (WGA), and Ulex europaeus agglutinin I (UEA I). Both monkey and bovine trabecular-meshwork cells showed positive cell surface and intracellular binding to Con A, WGA, and PHA. Only moderate cell-surface staining was observed with RCA, and no visible staining occurred with PNA, DBA, SBA, and UEA-1. PMID- 3653293 TI - Accessibility of low-molecular-weight crystallins to ammonia and hydrogen chloride gases. AB - Low-molecular-weight crystallin was isolated from bovine lenses. Its purity was established by high-pressure liquid chromatography (HPLC) and sodium dodecyl sulfate (SDS)-gel electrophoresis. The amino-acid composition, in general, and the total available acidic and basic sites, in particular, were obtained by amino acid analysis. The accessibility of low-molecular-weight crystallins to ammonia and hydrogen chloride vapor was obtained by high vacuum vapor sorption. The sorption and desorption isotherms were analysed regarding the gas uptake at different vapor pressures. The amount of ammonia and hydrogen chloride irreversibly sorbed and retained as well as the hysteresis imply high accessibility of crystallins to the polar gases. The results indicate that molecular self aggregation of low-molecular-weight crystallins in solid state occurs mostly through hydrophobic domains. PMID- 3653294 TI - Slit-lamp studies of the rhesus monkey eye: II. Changes in crystalline lens shape, thickness and position during accommodation and aging. AB - Changes in crystalline lens shape and axial thickness, anterior chamber depth and anterior cornea-posterior lens distance during accommodation induced by corneal iontophoresis of carbachol or electrical stimulation of the Edinger-Westphal nucleus were studied in 25 living, surgically aniridic rhesus monkey eyes, aged 1 25 years. Intraocular distances and anterior and posterior lens surface curvatures were evaluated from slit-lamp Scheimpflug photographs; distances were also determined by A-scan ultrasonography. With increasing accommodation, both lens surfaces become more sharply curved, the lens thickens and the anterior chamber shallows, while the posterior lens surface remains fixed relative to the cornea. Within statistical limits, the respective curvature and distance changes are the same for a given dioptric accommodation induced by either stimulation technique. The respective intraocular distance-accommodation relationships are identical whether derived from photographic or ultrasonographic measurements. Temporal and contralateral reproducibility of all measurements is excellent. Each parameter-accommodation relationship is strikingly linear in all eyes, although above 20 D the slopes of the lens surface curvature-accommodation relationships may have decreased. The curvature change per D of accommodation averages approximately 20% more for the posterior than for the anterior lens surface. There is relatively little interindividual variation in the slope of each relationship despite the significant interindividual differences in age and accommodative amplitude, indicating that the relationships are independent of age. However, when extrapolated back to the non-accommodated resting state, the data indicate that the lens thickens, both its surfaces become more sharply curved, and the anterior chamber shallows with age in adult greater than 5 years, while opposite trends are seen in younger animals. PMID- 3653295 TI - The uptake of horseradish peroxidase by the conjunctival epithelium of the guinea pig. AB - It has been suggested that in immediate hypersensitivity of the guinea-pig conjunctiva, induced by the topical application of an antigen, the antigen is selectively taken up by the conjunctiva-associated lymphoid tissue. We tested this hypothesis by applying horseradish peroxidase (HRP) to the guinea-pig conjunctiva and studying its uptake by light- and electron microscopy. As early as 30 min after the application of the HRP, precipitate indicating the presence of HRP could be seen in the epithelial cells in membrane limited granules in the non-lymphoid and lymphoid epithelium. There was no selective uptake of HRP by the lymphoid-associated epithelial cells. We hypothesize that the epithelial cells of the conjunctiva, in contrast to those of the small intestine, phagocytose antigen and transfer it directly to the substantia propria of the conjunctiva for local immunologic processing. PMID- 3653296 TI - Analysis of vitreous and aqueous levels of hyaluronic acid: application of high performance liquid chromatography. PMID- 3653297 TI - Movement of melatonin across the retinal pigment epithelium. PMID- 3653298 TI - Multiple lineage colony growth from human marrow in plasma clot diffusion chambers. AB - Marrow cells from ten healthy adult donors were cultured in plasma clot diffusion chambers implanted intraperitoneally into mice. Host animals were conditioned by two injections of phenylhydrazine and 600 cGy of x-rays. Cultures (5 X 10(4) cells/chamber) were continued for between 2 and 40 days and the chambers were retransplanted into new host animals every 5 days. Following termination of cultures, plasma clots were stained with benzidine-hematoxylin and analyzed microscopically. Erythroid, neutrophil, monocyte, eosinophil, megakaryocyte, mixed, undifferentiated, and fibroblastoid colonies were grown with neutrophil, erythroid, monocyte, and eosinophil colonies being the most frequent. A total of between 25 and 60 colonies was observed per chamber at any time point. PMID- 3653299 TI - Dose of inhaled budesonide required to produce clinical suppression of plasma cortisol. AB - Increasing dose of budesonide, each dose given for a minimum of 1 month, were administered via a Nebuhaler to 14 patients. Two consecutive abnormally low fasting morning plasma cortisol values, taken 2 weeks apart, were accepted as evidence of hypothalamo-pituitary-adrenal (HPA) hypofunction. Data from nine of the 14 patients entering the study were available for analysis. One patient developed HPA hypofunction while inhaling 2.4 mg budesonide per day and another retained normal HPA function on a dose of 12 mg. In the remaining patients, intermediate doses resulted in suppression, or the patients were withdrawn unsuppressed for other reasons (n = 3). The results in this small patient sample suggest that budesonide administered via the Nebuhaler in doses up to 1.6 mg daily does not significantly affect plasma cortisol. PMID- 3653300 TI - Adenosine deaminase activity, not diagnostic for tuberculous pleurisy. AB - We have measured adenosine deaminase (ADA) in pleural effusions of 95 patients, using a method optimalised for rapid determination on a Hitachi 705 analyzer. High ADA activity was found in four of the five patients with tuberculous pleurisy, in four of the seven with empyema and in three of the seven patients with mesothelioma. One patient with very high serum ADA activity due to liver disease also had a high activity in the pleural effusion. Low activity was found in all patients with other neoplastic pleural effusions, parapneumonic pleural effusions, transudates, and in pleural effusions due to some other diseases. We conclude that in a country with a low tuberculosis incidence a high ADA activity in pleural effusion in neither sensitive nor specific enough to rely on the diagnosis of tuberculous pleurisy. Routine determination of ADA is not recommended; in selected cases, however, it may be useful. PMID- 3653301 TI - Pleural fluid lactate in pleural effusion. AB - Pleural fluid lactate (PFL) and blood lactate (BL) concentrations were simultaneously measured in samples from 46 patients with pleural effusion. PFL exceeded 6 mmol/l in all 15 patients with pyogenic bacterial pleurisy but in only 5 of the other 31 patients. We have found that a PFL-BL difference greater than or equal to 6 mmol/l has a sensitivity of 100% and a specificity of 93.8% in detecting pyogenic pleural effusions. Results are available within 1 h of sample collection, so that PFL-BL difference may become a useful aid in the early assessment of pleural effusions. PMID- 3653302 TI - Post-mortem concentrations of salbutamol, terbutaline and theophylline in asthma patients. AB - The concentrations of theophylline, terbutaline and salbutamol in post-mortem blood samples from 68 patients (17-85 years old) with asthma or chronic obstructive lung disease, 54 of whom had died of asthma, were analysed. Information on recent prescriptions was obtained for 61 patients. There was agreement between prescription and drug analysis in the blood in 87% of the patients with regard to theophylline and in 92% for salbutamol and terbutaline combined. Theophylline levels were generally low; 30 patients had concentrations below 25 mumol/l and only three above 110 mumol/l (therapeutic interval 55-110 mumol/l). Both salbutamol and terbutaline were detected in most samples. Fourteen patients had blood concentrations above 200 nmol/l. No definite explanation for these high values could be found. The majority of patients who died from asthma had low drug levels and had not been prescribed corticosteroids. PMID- 3653303 TI - Rapidly progressive interstitial lung disease in a hard metal coating worker undergoing hemodialysis. PMID- 3653304 TI - Postcoital severe exacerbation of asthma requiring mechanical ventilation. PMID- 3653305 TI - Remission of pulmonary alveolar proteinosis during antituberculous chemotherapy. PMID- 3653306 TI - Unilateral phrenic nerve paralysis caused by osteoarthritis of the cervical spine. PMID- 3653307 TI - Role of the ventrolateral region of the nucleus of the tractus solitarius in processing respiratory afferent input from vagus and superior laryngeal nerves. AB - The role of respiratory neurons located within and adjacent to the region of the ventrolateral nucleus of the tractus solitarius (vlNTS) in processing respiratory related afferent input from the vagus and superior laryngeal nerves was examined. Responses in phrenic neural discharge to electrical stimulation of the cervical vagus or superior laryngeal nerve afferents were determined before and after lesioning the vlNTS region. Studies were conducted on anesthetized, vagotomized, paralyzed and artificially ventilated cats. Arrays of 2 to 4 tungsten microelectrodes were used to record neuronal activity and for lesioning. Constant current lesions were made in the vlNTS region where respiratory neuronal discharges were recorded. The region of the vlNTS was probed with the microelectrodes and lesions made until no further respiratory related neuronal discharge could be recorded. The size and placement of lesions was determined in subsequent microscopic examination of 50 micron thick sections. Prior to making lesions, electrical stimulation of the superior laryngeal nerve (4-100 microA, 10 Hz, 0.1 ms pulse duration) elicited a short latency increase in discharge of phrenic motoneurons, primarily contralateral to the stimulated nerve. This was followed by a bilateral decrease in phrenic nerve discharge and, at higher currents, a longer latency increase in discharge. Stimulation of the vagus nerve at intensities chosen to selectively activate pulmonary stretch receptor afferent fibers produced a stimulus (current) dependent shortening of inspiratory duration. Responses were compared between measurements made immediately before and immediately after each lesion so that changes in response efficacy due to lesions per se could be distinguished from other factors, such as slight changes in the level of anesthesia over the several hours necessary in some cases to complete the lesions. Neither uni- nor bi-lateral lesions altered the efficacy with which stimulation of the vagus nerve shortened inspiratory duration. The short latency excitation of the phrenic motoneurons due to stimulation of the superior laryngeal nerve was severely attenuated by unilateral lesions of the vlNTS region ipsilateral to the stimulated nerve. Neither the bilateral inhibition nor the longer latency excitation due to superior laryngeal nerve stimulation was reduced by uni- or bi-lateral lesions of the vlNTS region.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3653308 TI - Prefrontal unit activity during a delayed oculomotor task in the monkey. AB - 1. Unit activity was recorded in the prefrontal cortex of Rhesus monkeys during performance of a delay task with two motor components, an ocular saccade and an arm movement, following a complex pattern of auditory and visual stimuli. A special feature of the paradigm was that onsets of the different sensory stimuli, orienting saccade and arm movement were dissociated in time at predetermined time intervals. 216 task-related units were recorded. Discussion of the data focuses on two groups of cells the activity of which is modified by the saccade: the signal-related pre-saccadic tonic cells and the post-saccadic tonic cells. 2. Activity of signal-related pre-saccadic tonic cells was initiated with the onset of peripheral stimuli, visual and/or auditory, and terminated with an orienting saccade. Spatial selectivity was a feature of most units. They seemed to encode the region of space cued by the stimulus. 3. Many units were visually responsive. Activation of these depended both upon retinal locus of the stimulus and the requirement they imposed on subsequent behavior. Termination of their activity demanded foveation of some visual targets, not necessarily the one which had initiated their response. 4. The majority of these signal-related pre-saccadic tonic cells responded to onset of auditory stimuli. The termination of tonic activity in these cells with foveation of the region in space from which the signal originated suggests a spatial memory process that is no longer used when the visual fixation response can signal equivalent spatial information.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653309 TI - Hypothalamic multiunit activity and LH secretion in conscious sheep. AB - The relationship between the pulsatile secretion of luteinizing hormone (LH) and multiunit activity (MUA) in the median eminence and retrochiasmatic area (RCh-ME) of the hypothalamus was investigated within 13 conscious, ovariectomized ewes during the anoestrous season. Eight of the ewes had been treated with oestradiol to reduce their LH pulse frequency. To test whether the activity had been recorded from sites involved in the control of GnRH release, we electrically stimulated the sites studied with the recording electrode and used the LH responses to classify the animals retrospectively for analysis of the MUA data. Following stimulation, LH secretion was either stimulated (Group STIM, n = 5 ewes), inhibited (Group INHIB, n = 4) or showed no response (Group NR, n = 4). Statistical analysis of the MUA data revealed that the onset of LH pulses was associated with an increase in cell activity in STIM ewes and a decrease in activity in both Group INHIB and Group NR ewes. Histological examination revealed that the electrodes were located near the midline in Group STIM ewes, but 1.25 or 2 mm lateral of the midline in Groups NR and INHIB, respectively. We concluded that the MUA in the RCh-ME probably reflects the activity of cells with fibres or terminals involved in the control of GnRH release. Activity which increased at the onset of LH pulses was detected in medial areas of the RCh-ME and may reflect the activity of GnRH neurones. The activity which decreased at the onset of LH pulses in lateral areas of the RCh-ME suggests that both stimulatory and inhibitory inputs may be involved in the release of GnRH pulses. PMID- 3653310 TI - Responses of single neurons in cat auditory cortex to time-varying stimuli: linear amplitude modulations. AB - Single neurons in the auditory cortex of anesthetized cats were examined quantitatively for their sensitivity to the sound pressure level of characteristic frequency (CF) tone pulses, and to 6 dB, linear modulations in the amplitude of a continuous CF carrier tone. The direction and rate of amplitude modulation (AM), and the carrier level on which it was imposed, were manipulated parametrically. Studied with amplitude modulations, the majority of neurons responded only to intensity increments. The minimum carrier level upon which an amplitude modulation was able to evoke spike discharges was typically comparable to the tone pulse threshold SPL. For many neurons, an "intensity increment response area", i.e., the domain of AM rate and carrier level conjunctions within which a 6 dB AM was able to evoke discharges, could be delimited. For many neurons, preferred rate of AM drifted from high to low with increases in the carrier level on which the modulation was imposed. The most vigorous responses to AM stimuli often occurred when the carrier levels were associated with the rising slope or the peak of the tone pulse rate intensity function. It may be possible to understand the general form of AM response areas in terms of short-term adaptation, the disposition of excitatory and inhibitory tone pulse response areas, and the spectra of the AM stimuli used. PMID- 3653311 TI - Neuronal sources of theta rhythm in the entorhinal cortex of the rat. I. Laminar distribution of theta field potentials. AB - The laminar distribution of theta (theta) field potentials in the entorhinal cortex (EC) was investigated in paralysed and locally anesthetized rats injected with physostigmine in order to induce theta rhythm. Electrode penetrations through the medial, intermediate and lateral subdivisions of the EC showed in all cases: 1. the presence of theta rhythm from layer VI to layer III approximately in phase with CA1 theta rhythm; 2. an amplitude minimum between the outer third of layer III and the inner half of layer I; and 3. a phase-reversed theta rhythm in layers II-I with an amplitude maximum in the outer half of layer I. Results indicate the existence of neuronal sources of theta rhythm in the EC. PMID- 3653312 TI - Neuronal sources of theta rhythm in the entorhinal cortex of the rat. II. Phase relations between unit discharges and theta field potentials. AB - The discharge patterns and layer distribution of entorhinal cortex (EC) units were investigated in paralysed and locally anesthetized rats injected with physostigmine in order to induce theta (theta) rhythm. Entorhinal unit activity and field potentials were recorded simultaneously with the same micropipette. Hippocampal CA1 theta rhythm was used as reference. Statistical analysis included auto- and cross-correlations and interval histograms. Results showed: a. the existence of rhythmic and non-rhythmic cells, both tending to fire in a constant phase relationship with theta rhythm; b. in all EC subdivisions, most rhythmic cells were located in superficial cell layers (II-III); c. on the average, rhythmic cells from the medial EC fired synchronously; d. non-rhythmic cells tended also to fire synchronously but with an opposite phase relationship with respect to rhythmic neurons. Although a complex organization in the rhythmicity of EC units is revealed, it is concluded that the neuronal sources of theta activity in the EC are located in superficial cell layers, and it is strongly suggested that the EC output through the perforant path may rhythmically modulate the discharge pattern of hippocampal pyramidal and dentate granule cells. PMID- 3653313 TI - Cortical mapping and laminar analysis of the cutaneous and proprioceptive inputs from the rat foreleg: an extra- and intra-cellular study. AB - The foreleg proprioceptive and cutaneous representations, in the Sm cortex of urethane-anesthetized rats was studied. Natural or electrical stimulations and stretches of single forearm muscles were used. Multiunitary, unitary or intra cellular recordings were performed in the contra-lateral Sm cortex. The aims of the study were: 1- to compare the proprioceptive and cutaneous maps 2- to analyse the characteristics of the unitary responses and 3- to study the laminar distribution of cutaneous and muscular inputs. It is shown that: 1- the proprioceptive and cutaneous representations overlapped, except in the anterior part where only proprioceptive (mainly articular) responses were obtained. The representation of each stretched muscle extended over the whole cutaneous area, showing a total overlap between inputs from these muscles. 2- 46% of the intracellularly recorded cells (n = 215) responded to peripheral stimulation, and 30.7% were influenced by (at least) muscle stretch. The majority of excited cells showed cross-modal convergence, and among neurons responding to muscle stretch, 60% received inputs from the two muscles stretched. Two categories of EPSPs were found, and four neurons responded to cutaneous or muscular stimulation with a burst. 19% of the responding cells were inhibited by peripheral--mainly cutaneous -stimulation. 3- Excited neurons were recorded in all layers, with just over half located in layer IV, whereas IPSPs were obtained mainly in layer V. The cells excited by cutaneous and muscular inputs (convergent neurons) were preponderant in layers IV to VI. This work shows that the cutaneous and muscular inputs reach the same area in Sm cortex, and that a majority of excited cells are "convergent". The results are not in favor of an area 3a (by analogy with cats and monkeys) in the rat. PMID- 3653314 TI - Inferior olive excitability after high frequency climbing fibre activation in the cat. AB - 1. Climbing fibre responses (CFRs) were evoked by limb nerve stimulation and recorded from the cerebellar surface in barbiturate anaesthetized cats. Climbing fibres were activated at frequencies of usually 2.5-7.5 Hz for periods of 15-30 s, after which the stimulation frequency was reduced to below 1 Hz. 2. The high frequency stimulation induced a strong depression of CFR-amplitude, lasting up to 60 s. The magnitude of this depression was dependent on both the frequency and the duration of the high-frequency stimulation. 3. The depression occurred in the c1, c2 and c3 zones of the pars intermedia and in the x zone in the vermis but not in the b zone in the vermis. 4. Recordings of olivary reflex responses demonstrated that the depression occurred in the inferior olive. 5. It is suggested that the inhibition of the inferior olive occurs because the high frequency stimulation leads to a disinhibition of neurones in the interpositus nucleus which inhibit the olivary neurones. PMID- 3653315 TI - Activity of Purkinje cells and interpositus neurones during and after periods of high frequency climbing fibre activation in the cat. AB - The activity of cerebellar Purkinje cells and interpositus neurones was recorded during and after periods of high frequency (2.5-7.5 Hz) climbing fibre activation in barbiturate-anaesthetized cats. 1. During the high frequency conditioning stimulation, the Purkinje cell simple spike (SS) firing was initially silenced in all zones studied. After a few seconds, the SS reappeared and the frequency increased to well above that of the control level after approximately 10 s. Thereafter, the SS rate started to decline so that, after 15-20 s, the Purkinje cells fired no more SS. This SS silence lasted up to 60 s, whether or not the stimulation was continued. 2. The Purkinje cells responded with a complex spike (CS) to every stimulus. If the high-frequency stimulation lasted for at least 15 s, the spontaneous CS discharge of the Purkinje cells in the c1, c2, and c3 zones was suppressed after the conditioning stimulation had ended. This suppression lasted for approximately the same length of time as the SS silence. In the b zone, however, no CS suppression was observed. 3. Interpositus neurones displayed an increased discharge rate after periods of conditioning stimulation, thus displaying a mirror image of the Purkinje cell SS firing. 4. The behaviour of the neurones agrees well with the behaviour predicted by an hypothesis of the olivo cerebello-olivary loop (Andersson and Hesslow 1987). 5. The results suggest that the cerebello-olivary projection is topographically organized and matches the microzonal organization in the olivo-cerebellar projection. PMID- 3653316 TI - Neurosecretory axon regeneration into intrahypothalamic neural lobe allografts: neurophysin immunohistochemistry and fine structure. AB - Neural lobe allografts placed stereotactically into the hypothalamo neurohypophysial tract between the paraventricular and supraoptic nuclei were investigated between 5 and 70 days post-transplantation (dpt). They contained temporally increasing numbers of neurophysin-positive axons. At the fine structural level, endogenous neurosecretory axons had virtually disappeared from successful (vascularized) grafts by 5 dpt. At this time, single host neurosecretory axons and especially numerous growth cones were associated with pituicyte processes and/or scalloped basal lamina scaffolds. Axon terminals containing neurosecretory granulated vesicles and microvesicles were present only occasionally at 5 dpt but became much more numerous subsequently. These terminals were associated with pituicytes and abutted the parenchymal basal lamina of pericapillary connective tissue spaces. In addition, beginning at 10 dpt, neurolemmocyte-like cells were associated with neurosecretory axons. At 70 dpt, the fine structural characteristics of grafted neural lobes were virtually indistinguishable from those of intact controls, except for the presence of occasional areas of more extensive connective tissue, nonfenestrated capillaries and neurolemmocyte-like cells. PMID- 3653317 TI - Reacquisition of classical conditioning after removal of cerebellar cortex. AB - We trained rabbits with white noise and light conditioned stimuli and a face shock unconditioned stimulus for classical conditioning of the nictitating membrane response and then removed the ipsilateral cerebellar cortex by aspiration. Larsell's hemisphere lobule VI was completely removed in 5 rabbits; the pattern of degeneration in the inferior olive matches the projections to HVI reported in experiments with horseradish peroxidase. All rabbits showed an initial abolition of conditioned responses but then relearned within two days. This indicates that cerebellar cortical lobule HVI normally is involved but is not necessary for classical conditioning. PMID- 3653318 TI - Mechanical response properties of ventroposterior medial thalamic neurons in the alert monkey. AB - The properties of trigeminal cutaneous thalamic neurons were explored in alert cynomolgous monkeys to determine receptive field and response characteristics. Two monkeys received juice reward for sitting quietly while an investigator probed the monkey's face with mechanical stimuli. Extracellular single unit recordings were made from the ventroposterior medial thalamic nucleus (VPM), and mechanical response properties were evaluated for each cell having an extraoral cutaneous receptive field. Of 89 cells examined, 90% responded best to innocuous tactile stimulation, and were classified as low threshold. The other 10%, classified as wide dynamic range, showed a graded response to increasingly intense stimuli, with a maximum discharge to noxious pinch. Of the low threshold neurons, most exhibited excitatory responses, with about half being rapidly adapting and the others slowly adapting. The spontaneous activity of 11% of the low threshold neurons was inhibited by stimulation of the neuron's receptive field. There was no systematic difference in receptive field size for the various types of neurons, but the receptive fields of wide dynamic range cells were smaller than those previously observed in trigeminopthalamic neurons of the medullary dorsal horn. The wide dynamic range and inhibitory low threshold neurons were located primarily in the caudal third of VPM, while the excitatory low threshold neurons were located throughout. In summary, response characteristics of VPM neurons show more diversity in the alert monkey than has been reported in paralyzed and/or anesthetized animals. PMID- 3653319 TI - Synaptic organization of olfactory inputs and local circuits in the entorhinal cortex: a current source density analysis in the cat. AB - The distribution of the olfactory afferents within the ventrolateral part of the entorhinal cortex (EC) was studied by means of field potentials evoked by stimulation of the olfactory bulb (OB) and the olfactory cortex (PPC). Depth profiles of the field potentials evoked by OB or PPC stimulation were studied using current source density analysis. After OB or PPC stimulation an early superficial sink-deep source configuration was found, which some time later reversed into a superficial source-deep sink. Both OB and PPC activated mainly the superficial dendrites of the cells of layers II and III. In layers II and III evidence for strong recurrent inhibition was found, using double pulse stimulation. The results indicate that there exists a common basic design of the synaptic organization of the olfactory areas of the base of the brain extending to the EC. PMID- 3653320 TI - Selective neuronal discharge in monkey putamen reflects intended direction of planned limb movements. AB - Single cell activity was recorded from the putamen in rhesus monkeys (Macaca mulatta) performing limb movements made both with and without a preceding preparatory "set" concerning the impending direction of movement. The monkeys were trained to perform an elbow step-tracking task, each trial of which required the subject to make two sequential movements that were virtually identical in terms of their direction, amplitude, velocity and muscle pattern. The first movement was preceded by a foreperiod, the "pre-instruction" period, during which the monkey could not predict the direction (flexion/extension) of the forthcoming movement. The second movement was also preceded by a variable foreperiod, the "post-instruction" period, but during this interval the monkey was aware of the impending direction of movement because it was always required to match that of the first movement. To dissociate the directions of motor set (and limb movement) from the patterns of tonic (and phasic) muscular activation associated with task performance, some trials included the application of torque loads that either opposed or assisted the movements required by the behavioral paradigm. Two principal forms of task-related activity were observed among the 232 putamen neurons (all located within the region of arm representation) whose discharge patterns showed significant relations to one or more features of the behavioral paradigm. "Movement-related" neurons (178/232, 76.7%) discharged selectively in association with either flexion or extension movements of the elbow. "Set related" neurons (47/232, 20.3%) manifested sustained, selective changes in discharge throughout the post-instruction period, while the monkey was required to maintain a preparatory set concerning the impending direction of movement. Extensive limb and axial EMG recordings showed no evidence of task-related activity patterns comparable to those that characterized the set-related neurons, and scleral search coil recordings showed no relationship between set-related neuronal activity and either the direction of gaze or the direction and timing of eye movements during task performance. Only a small percentage (7/232, 3.0%) of the task-related neurons showed both movement- and set-related activity. In most cases (37/47, 79%), set-related activity was directionally selective, with the magnitude of discharge reflecting the impending direction of movement.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3653321 TI - Cross-orientation inhibition in cat is GABA mediated. AB - Visual evoked potentials (VEPs) were recorded from cat cortex (area 17) before, during and after application of the GABA blocker bicuculline (iontophoretic or topical). The stimuli comprised a test sinusoidal grating, and a mask grating oriented either parallel or orthogonal to the test. Both test and mask alternated in contrast at different temporal frequencies. VEPs were averaged in synchrony with the test contrast reversal, so the mask did not contribute directly to the averaged VEP response. Before application of bicuculline, both parallel and orthogonal masks attenuated the amplitude of VEPs and changed the phase response, but in different ways. Orthogonal masks lowered the slope of the contrast response curve without affecting extrapolated threshold, while parallel masks caused the curve to shift to the right. Orthogonal masks increased the phase advance, while parallel masks eliminated it. During application of bicuculline, neither parallel nor the orthogonal masks attenuated VEP amplitudes. The results suggest that although the mechanisms for the action of parallel and orthogonal masks are clearly distinct, both are mediated by the GABA-ergic inhibitory system. Given this evidence, measurement of VEP contrast response curves may provide a simple non-invasive technique for monitoring visual inhibition in humans. PMID- 3653322 TI - Influence of event anticipation on postural actions accompanying voluntary movement. AB - The central organization of anticipatory postural adjustments was investigated by examining the influence of preparatory set on the temporal relationship between postural and arm (focal) muscle activation. Surface EMG was recorded from the right tibialis anterior, lateral gastrocnemius, anterior deltoid and posterior deltoid muscles when pushing or pulling on a stiff handle. Preparatory set was manipulated by informing the subject of the upcoming direction of responding with a 80, 50 or 20% certainty. This created high, neutral and low levels of preparatory set, respectively. All six subjects showed activation of postural muscles in advance of focal muscles for both push and pull responses. However, only three subjects showed the expected effect of preparatory set on reaction time performance, i.e., an increase of reaction time with decreasing response probability. For these three subjects, the time between the activation of postural and focal muscles was the same for the high and neutral levels of preparatory set, but increased with a low level of preparatory set. The increased postural-focal latency for the low preparatory set condition was due to a longer delay for the activation of the focal muscles but not the postural muscles. This finding suggests that anticipatory postural adjustments and the activation of focal muscles are triggered by separate motor commands. PMID- 3653323 TI - Neuronal activity preceding self-initiated or externally timed arm movements in area 6 of monkey cortex. AB - Several lines of evidence suggest that the supplementary motor area (SMA) and the premotor cortex (PM) may participate in neuronal mechanisms for the initiation of movements. We recorded the impulse activity of single neurons in monkeys that were trained in two behavioral tasks employing, respectively, self-initiated and externally timed movements. Neurons in both areas were activated up to 2.6 s in advance of self-initiated, reward-related arm reaching movements. In the externally timed task, changes occurred during light instructions that preceded movements by 2 s. Neurons also responded to the trigger stimulus for movement. In view of similar premovement activity in the basal ganglia, these cortical regions appear to be parts of a distributed neuronal system for movement initiation. PMID- 3653324 TI - Is direction selectivity of cat area 17 cells always independent of contrast and dependent on short-distance interactions? AB - In a study of area 17 of the paralysed and anesthetized cat it was found that for a small subgroup of cells with peripherally located receptive fields (11/123), the direction selectivity was critically dependent on the use of high contrast stimulation. By covering parts of the receptive field with a mask, it was found that in some cells the suppression of responses to movement in the non-preferred direction was due to the presence of a suppressive area located just outside the discharge region. Direction selective suppression was present only when a high contrast bar (light or dark) crossed this area before entering the discharge region. PMID- 3653325 TI - Hypothalamic afferent connections mediating adrenocortical responses that follow hippocampal stimulation. AB - This study identified some neural pathways which mediate the adrenocortical responses that follow hippocampal stimulation. The increase in plasma corticosterone following dorsal hippocampus stimulation, in rats with electrodes chronically implanted under pentobarbital anesthesia, was blocked by dorsal fornix and lateral septal lesions and by small posterior hypothalamic deafferentation. Fimbria transection, lateral septal lesions, and posterior hypothalamic deafferentation, but not midbrain reticular formation lesions, also blocked the adrenocortical responses to ventral hippocampus stimulation. Our present and previous studies indicate that the dorsal and ventral hippocampal effects on the hypothalamus, which increase plasma corticosterone concentrations, are mediated by the dorsal fornix and fimbria, respectively, as well as by the lateral septum. A posterior hypothalamic input, which does not involve the medial forebrain bundle or the midbrain reticular formation is also essential for the activation of this response. PMID- 3653327 TI - Periodicity in the Hoffmann reflex recovery curve. AB - Hoffmann (H) reflex recovery curves were recorded from the soleus muscles of 10 healthy adult subjects with a view to further elucidating the pattern of facilitation of the motoneuron pool. Specific consideration was given to the possible existence of periodicity in facilitation of the motoneuron pool following a subthreshold conditioning H-reflex stimulus. The reliability of the recovery curves was also examined. The recovery curves, which utilized a 50% maximal test response, revealed the well established early facilitation (peak at 10 ms) followed by a later facilitation commencing 50 to 70 ms after the conditioning stimulus. In addition, there was evidence of peaks in excitability of the motoneuron pool occurring at 70 to 75 ms, 125 to 150 ms, and about 250 ms. The reliability of the periodicity in the recovery curve was established by examining the subjects on two separate occasions and investigating the effect of the number of measurements made within each day. Although there was considerable inter- and intrasubject variability in the form of the recovery curves, both within days, and between days, the overall group data showed a remarkably consistent periodicity for the first 350 ms following the conditioning stimulus. Methodological considerations that are important for observing the periodicity in the recovery curve were identified. These included an adequate number of measurements (test reflexes) per data point in the recovery curve, adequate sampling rate, and conditioning and test stimulus intensity. The clinical significance of these results resides in the possible contributions of the peripherally triggered periodic facilitation to rhythmic phenomena such as clonus and physiologic tremor. PMID- 3653326 TI - Anticonvulsant effect of intracortical, chronic infusion of GABA in kindled rats: focal seizures upon withdrawal. AB - The behavioral and electrographic effects of chronic (7 days), localized infusion of GABA (100 micrograms/microliter) into the somatomotor cortex of fully amygdala kindled rats is reported. The animals were stimulated once daily until a stage 5 (generalized clonic seizure) was obtained for five consecutive days. After determination of a stable seizure triggering threshold, the rats were implanted with osmotic minipumps (1 microliter/h for 7 days) connected to previously implanted bilateral cannulae. Amygdala stimulation was continued for 14 successive days. GABA infusion reduced the motor seizure without significantly modifying the limbic afterdischarge. This effect lasted until termination of drug application, with recovery of stage 5 convulsions on the following 3 to 5 days. No effects were observed in saline-infused animals or in rats with unilateral GABA treatment. Upon cessation of GABA treatment (removal of the osmotic devices by day 7 postimplantation), spontaneous epileptic discharges localized to the infusion sites appeared. In some animals, the abnormal activity was accompanied by behavioral signs of myoclonus. This cortical hyperexcitability lasted 2 to 24 h, with complete recovery afterward. These data indicate that two types of focal epilepsy may coexist independently in the same animal and provide confirmation of previous observations in the monkey on the existence of a "GABA-withdrawal syndrome" after chronic, focal infusion of the amino acid. PMID- 3653328 TI - Diversity in periodic pattern of firing in human hippocampal neurons. AB - Firing periodicity was examined in human hippocampal neurons using autocorrelation analysis. Extracellular single-unit activities were recorded from the anterior hippocampus through fine platinum microelectrodes, and the typical firing pattern in an entire recording period was reconstructed statistically in autocorrelograms (average number of firings analyzed: 5639.0 +/- 968.1 SE, range: 1158 to 31,203; number of single-unit trains was 57). Three types of periodic firing were identified as highly consistent. The first pattern consisted of a random recurrence of high-frequency action potentials (100 to 300 Hz) and was observed as an intermittent burst. In this burst, the first 10 to 30 ms after the onset of the burst was the patterned firing of several action potentials, suggesting that the generation of this stereotyped portion of the burst is primarily due to intrinsic membrane characteristics. The second pattern was the continuous rhythmical firing with a lower frequency ranging from 1 to 30 Hz. The third pattern was a clustered rhythmical firing in which a series of short rhythmical firings recurred with regular intervals; the frequency of short rhythmical firing varied from 6.7 to 17 Hz between neurons, and the interval of the regular recurrence of these rhythmical firings ranged from 0.5 to 10 s among neurons. These firing periodicities not only cover a cellular rhythm in the theta frequency reported in the lower mammalian hippocampus but also appear to be more diverse than those previously reported for hippocampal neurons in the animal literature. PMID- 3653330 TI - Role of the corpus callosum and hippocampal commissure on transfer phenomenon in amygdala-kindled cats. AB - Forebrain-bisected cats underwent kindling at primary and secondary amygdala sites. The behavioral effect of amygdala kindling was then examined according to the extent of the surgical lesion in the forebrain commissures. Bisection of the corpus callosum with or without lesion of the hippocampal commissure modified both kindling and kindled symmetrical generalized seizure into a lateralized and asymmetrical form. Lesion of the hippocampal commissure was correlated with the loss of the expected positive transfer effect at the secondary amygdala site. These results suggest that whereas the corpus callosum plays a major role in patterning convulsive generalization and generalized convulsion, the hippocampal commissure is involved in mediation of the transhemispheric positive transfer effect. Evidence of a callosal inhibitory influence on amygdala kindling was not obtained. PMID- 3653329 TI - Nerve regeneration in synthetic and autogenous interfascicular grafts. II. Morphometric analysis. AB - Cross-sectional areas at different levels, number of axons, maximal diameters, and number and maximal diameters of vessels were measured comparing autologous transplants with synthetic implants and nonlesion controls in a rat nerve regeneration model. The corresponding electrophysiologic data have been reported earlier in this journal. Although similar in many aspects, transplants led to the overall more reliable and slightly superior results, still lacking a substantial percentage of numerical qualities found in normal nerve, at least within the 3 month regeneration in this study. PMID- 3653331 TI - Projections from lateral reticular nucleus neurons to trigeminal motor nucleus revealed by antidromic activation in rabbits. AB - In anesthetized rabbits, electrophysiological experiments were conducted to determine if neurons of the lateral reticular nucleus that modified their activity during masticatory movements project directly into the trigeminal motor nucleus. Of the 125 neurons tested, 50 responded to stimulation of the trigeminal motor nucleus; of these, 22 were antidromically excited. Among this last population, 9 were antidromically driven also by cerebellar stimulation. In these neurons the antidromic response evoked from one structure collided with the response antidromically evoked from the other, thus indicating that both potentials are from the same neuron projecting to the trigeminal motor nucleus and the cerebellum. The remaining 28 neurons responding to stimulation of the trigeminal motor nucleus were orthodromically activated with a wider range of latencies. The possible significance of these findings in the organization of the rhythmic masticatory movements is briefly discussed. PMID- 3653332 TI - A noninvasive technique to assess completeness of spinal cord lesions in humans. AB - The effect of scalp stimulation delivered through electrodes overlying the motor cortex was evaluated in five healthy subjects and six patients with traumatic spinal cord injury. The latency to the onset of the electromyographic response was measured in the biceps brachii and abductor pollicis brevis muscles. In all the patients, latencies to the muscle (biceps brachii) whose innervation originated above the lesion were in the normal range; whereas, latencies to the muscle (abductor pollicis brevis) whose innervation originated below the lesion were prolonged. Electromyographic signals were recorded in muscles which showed no voluntary motor activity. No lateral differences in latencies were found in healthy subjects; however, in the patients, significant differences were obtained between the right and left abductor pollicis brevis muscles. The results of this study demonstrate that the spinal cord of patients with a lesion deemed to be clinically complete, contains nerve fibers which descend through the lesion and are capable of conveying impulses leading to muscle contraction. PMID- 3653333 TI - Contralateral intramuscular acupuncture-like electrical stimulation differentially changes the short-latency responses to muscle stretch. AB - Measurements were made from the human first dorsal interosseous and extensor digitorum communis muscles of the surface electromyographic activity reflexly produced by brief stretch of the muscle. For the first dorsal interosseous muscle, reflex EMG activity was also produced by electrical stimulation of the ulnar nerve at the wrist. The procedures were carried out before, during, and after 25 min of nonspecific, low-frequency electrical stimulation to the contralateral arm delivered through intramuscular electrodes. Control stimulation was delivered subcutaneously. The EMG recorded during a maintained contraction was rectified, filtered, and averaged. Two reflex components (M1 and M2) of the EMG response to muscle stretch or ulnar nerve stimulation were investigated. During nonspecific intramuscular stimulation to the contralateral arm, M1 responses of the extensor digitorum communis were depressed, initially by 37%. The effect began to fade during stimulation but extended beyond it. Reflex responses were elicited alternately by brief stretch of the first dorsal interosseus muscle and by electrical stimulation of the ulnar nerve in the same experiment. Nonspecific intramuscular stimulation to the contralateral arm depressed the M1 response to stretch, but had no effect on the M1 response to electrical stimulation. It is concluded that nonspecific intramuscular electrical stimulation reduces the amplitude of the M1 component of the response to brief stretch of contralateral muscle, either through depression of fusimotor activity or inhibition of oligosynaptic pathways that contribute to the early reflex response. PMID- 3653334 TI - Developmental abnormalities of mouse cerebellum induced by intracisternal injection of ochratoxin A in neonatal period. AB - Ochratoxin A, one of the food-contaminating mycotoxins, is known to impair brain development in mammals. Slc:ICR mice were treated intracisternally with a single dose of 5 micrograms ochratoxin A on day 0, 1, 2, 4, 5, or 7 after birth, in order to examine the direct effects of ochratoxin A on cerebellar development. The mice in each group were killed at 30 days of age, and the brains examined by light microscopy. Body and total brain weights were reduced (7 to 15%) in the treated groups. Cerebellar weight was also significantly reduced (18 to 27%) in all treated groups. In mice treated on day 0, 1, or 2, the layered structure of the vermis was well preserved, but some animals treated on day 4, 5, or 7 had cerebella with disarranged cortical structure. The number of folia decreased and the foliation index showed a significant decrease in the groups treated on days 0, 1, and 2. PMID- 3653335 TI - Trophic control of cholinesterase activity in a testosterone-dependent muscle of the rat. II. Effects of testosterone administration. AB - The effects of testosterone on the weight, protein content, and acetylcholinesterase (AChE) activity were investigated in the hormone-dependent levator ani and nondependent extensor digitorum longus and soleus muscles from normal or castrated male rats. In either group some muscles were also chronically denervated. Testosterone propionate treatment (3 mg/week for 2 weeks, s.c.) of normal rats increased the weight and protein content of the levator ani, respectively, by 19% and 63%; the muscle AChE was not affected. Protein content, but not the weight of the normal extensor digitorum longus and soleus was also increased after testosterone; AChE was reduced by 20% in the extensor digitorum longus and unaltered in the soleus. In castrated rats, testosterone reversed the levator ani atrophy and slowed down the decay of AChE, but it did not restore the normal enzyme activity. Testosterone did not prevent the atrophy and AChE decrease induced by denervation of either muscle. The weight and protein content of the denervated levator ani from castrated rats were increased by testosterone to the values found in denervated muscles from normal rats; AChE in the same muscles was not increased. The results confirm that separate mechanisms regulate protein synthesis and AChE in the rat levator ani. AChE is mainly regulated by neural factors which in turn appear to be influenced by circulating androgens. Similar hormonal influence on the muscle AChE was not detected in the extensor digitorum longus and soleus muscles. PMID- 3653336 TI - Leishmania donovani metacyclic promastigotes: transformation in vitro, lectin agglutination, complement resistance, and infectivity. AB - Freshly transformed Leishmania donovani amastigotes from hamster spleen were used to establish axenic cultures at high density in a modified Grace's medium, which was only partly replenished when cultures were fed. Small, free-swimming, highly active stationary phase promastigotes with a short cell body and long flagellum were induced in this medium. The freshly transformed stationary phase promastigotes so induced were less able to bind peanut agglutinin, had more than 40-fold increased resistance to killing by normal human serum, and 15-fold increased infectivity both in vivo and in vitro when compared to freshly transformed logarithmic phase or long term culture promastigotes. These short form promastigotes may correspond to the metacyclic promastigote forms in the sand fly vector. PMID- 3653337 TI - Brugia pahangi: inhibition of protein synthesis. AB - The effects of inhibitors of protein synthesis and electron transport on the incorporation of [14C]leucine and [35S]methionine into protein by the filarial worm Brugia pahangi have been investigated. Cycloheximide inhibits the accumulation of both [14C]leucine and [35S]methionine by the worms and their incorporation into protein. In addition, inhibitors of electron transport and some anti-parasitic compounds also significantly inhibit filarial protein synthesis. Antimycin A and cyanide inhibit [14C]leucine incorporation into protein 63 and 72%, respectively, without affecting either motility or lactate production. Interestingly, the anti-malarial compounds chloroquine and quinacrine also significantly inhibit both accumulation and incorporation of [14C]leucine by B. pahangi. In addition, fluorographs of sodium dodecyl sulfate-polyacrylamide gels of homogenates from filariids incubated in [35S]methionine and cycloheximide with and without chloramphenicol indicate that there is a discrete population of proteins, possibly mitochondrial in origin, that are synthesized in the presence of cycloheximide and are not inhibited by chloramphenicol. PMID- 3653338 TI - Schistosoma mansoni: measurement of Na+ ion activity in the tegument and the extracellular spaces using ion-selective microelectrodes. AB - Ion-selective microelectrodes were used to measure sodium ion activity (aNa) in the tegument and interstitial spaces in adult male Schistosoma mansoni. In RPMI 1640, aNa averaged 31 +/- 13 mM in the tegument, a value significantly less than that in the bathing medium. In the interstitial spaces, it averaged 72 +/- 17 mM, a value nearly the same as that in the bathing medium. In hypo- or hyperosmotic media, aNa in the interstitial spaces varied by a value commensurate with change in aNa in the medium, but aNa in the tegument was changed by only a small amount. Monensin (10 microM), low temperature (20 C), and ouabain (0.3 to 10 microM) all caused significant increases in aNa in the tegument. Hypo- and hyperosmotic media produced initial weight changes followed by gradual recovery back toward original weights. It is concluded that the schistosome is a volume regulating osmoconformer with osmolality of the extracellular fluid approximating that of the bathing medium, but that within the tegument of the parasite, Na+ concentration is controlled by active transport processes. PMID- 3653339 TI - Enhancement of fluorescence of pyrene-containing lipids by polar media, detergents and phospholipids. AB - The fluorescence intensities of a medium-chain fatty acid and of several amphiphilic lipids, each containing pyrene in covalent linkage, were enhanced considerably by: 1) Dissolving in mixtures of a polar solvent (e.g. methanol, ethanol, tetrahydrofuran or dimethylsulfoxide) and water; for each individual compound, a certain ratio of solvent to water provided maximal fluorescence intensity. 2) Incorporating into micelles of reduced Triton X-100; an excess of detergent was used so that, statistically, only one molecule of lipid resided in one micelle of the Triton X-100. 3) Incorporating into liposomes of egg phosphatidylcholine; maximal fluorescence was observed using a large excess of phosphatidylcholine. When related to the fluorescence intensities in chloroform/methanol (2:1, by vol.) or water, the enhancement of fluorescence in the above three systems was about 2-6-fold or up to 60-fold, respectively. PMID- 3653340 TI - Casein and lactose concentrations in milk of 31 species are negatively correlated. AB - Casein and lactose concentrations in milks of various species vary by at least 1 2 orders of magnitude, yet no single species secretes both components at either the high or the low end of the ranges. This pattern of variation could result from evolutionary adaptations in a single secretory mechanism. PMID- 3653341 TI - Separation of canavanine and canaline by high performance liquid chromatography. AB - The plant amino acid canavanine and its hydrolytic product canaline were successfully separated and identified by Reverse Phase High Performance Liquid Chromatograph (RP-HPLC). This procedure was used to demonstrate the arginase mediated cleavage of canavanine to yield canaline and urea, and the subsequent formation of a Schiff's base complex between canaline and pyridoxal phosphate. Both aforementioned reactions were demonstrated by RP-HPLC. PMID- 3653342 TI - Dynamics of excretion of urinary chemosignals in the house mouse (Mus musculus) during the natural estrous cycle. AB - The volatile fraction of urinary metabolites was investigated chromatographically at five different stages of the natural estrous cycle. A very substantial endocrine dependency has been noted for 11 compounds: 4 ketones, 2 acetate esters, 3 dihydrofuran isomers, dehydro-exo-brevicomin, and 2,5-dimethylpyrazine. The compounds were structurally verified through combined gas chromatography/mass spectrometry. PMID- 3653343 TI - T-2 toxin effect on rat aorta: cellular changes in vivo and growth of smooth muscle cells in vitro. AB - Rats were injected intraperitoneally with T-2 toxin and their aortas were studied by light and electron microscopy. The growth of smooth muscle cell explants taken from the tunica media of aortas of similarly treated animals was observed. A single large dose (2 mg/kg) or four injections of 0.3 mg/kg T-2 toxin caused damage and occasional necrosis of endothelial cells, accumulation of basement membrane-like material in the intima, and swelling and activation of smooth muscle cells in the tunica media. Three or more weeks after the last injection of 0.3 mg/kg T-2 toxin the endothelial cells were normal but an excess of fragmented intimal basement membrane-like material persisted and smooth muscle cells were still activated. Outgrowths from explants of aortic tunica media taken within 1 week of the last dose of T-2 toxin showed marked inhibition of smooth muscle cell growth. Three or more weeks after the toxin, the explants showed significantly increased outgrowths. These findings suggest that T-2 toxin causes early endothelial and smooth muscle cell injury accompanied by inhibition of smooth muscle cell growth in culture. This is followed by stimulation of the proliferative capacity of smooth muscle cells in vitro. If a similar mechanism is operative in vivo, it could explain the chronic vascular changes observed after limited exposure to T-2 toxin. PMID- 3653344 TI - Comparison among lipid constituents in native LDL, ultra-water-soluble LDL, and vessel wall, and their significance in arteriosclerosis. AB - The lipid constituents in native low-density lipoproteins (LDL), ultra-water soluble LDL (UWS-LDL), and aortic intimal tissues were compared. These lipoproteins were obtained from healthy persons and patients with atherosclerotic diseases. Also, aortic intimas were separated from arterial walls obtained within 5 hr after the donor's death. (1) From the native LDL, cholesterol esters (CE), triglycerides (TG), small amounts of free fatty cid (FFA), free cholesterol (CF), and phospholipids (PL) were demonstrable by iodine vapor on TLC, but from UWS-LDL the above lipids plus a new lipid (spot X) were observed between TG and FFA on TLC. And also, an unknown spot with the same Rf value as spot X was recognized on TLC of lipid extract from the atherosclerotic lesion, but not from the normal intima. (2) The production of spot X in UWS-LDL is probably related to the oxidation of lipids in native LDL. Also, the spot X in UWS-LDL and the spot X in the atherosclerotic lesions are probably related to the oxidation of CE in these lipids. (3) The existence of UWS-LDL is important to the initiation and probably the progression of atherosclerosis. PMID- 3653345 TI - Antigen-specific circulating immune complexes in Coxiella burnetii-infected guinea pigs. AB - An antigen-specific conglutinin-binding assay was developed with artificial immune complexes of Coxiella burnetii and an enzyme-linked immunosorbent assay for the detection of circulating immune complexes. Sera from guinea pigs infected with C. burnetii were examined by this assay, and the percentages of infected guinea pigs with C. burnetii antigen-specific circulating immune complexes were 71, 93, 74, 65, 49, and 27%, respectively, from the first to sixth week after infection. C. burnetii antigen eluted from circulating immune complexes by acid dissociation was detected by counterimmunoelectrophoresis. The antigen-specific conglutinin binding assay was specific, sensitive, and reproducible for assay of circulating immune complexes. PMID- 3653346 TI - Dynamic changes in insulin-like growth factor I immunoreactivity correlate to repair events in rat ear after freeze-thaw injury. AB - The distribution of the trophic peptide insulin-like growth factor I (IGF-I) in the rat ear was mapped after freeze-thaw injury. Immunocytochemical methods and antisera specific to human IGF-I were used. In the ear of normal adult rats scattered basal epidermal cells and a few cells in the underlying connective tissue and elastic cartilage expressed IGF-I immunoreactivity. Within 1 day after injury and reaching maximum in 3 days, all epidermal cells became stained as did invading macrophages and some of the other inflammatory cells. Concomitantly, there were hypertrophic changes. The staining leveled off after 1-2 weeks. Perichondrial cells became IGF-I immunoreactive in increasing frequency during the first week, reached maximal intensity and frequency in 2 weeks, and remained stained for at least 4 weeks. New cartilage was formed concomitantly on both sides of the old one. It is proposed that IGF-I is a substance of general importance for cell maintenance and tissue repair. PMID- 3653347 TI - Role of glycosaminoglycan and fibronectin in endothelial cell growth. AB - This study was undertaken to clarify the biological significance of fibronectin and GAG synthesized in human endothelium. The synthesis of GAG and fibronectin was proved morphologically and biochemically in endothelial cells. The conditioned media of fibroblasts and smooth muscle cells have promoted endothelial cell proliferation and production of extracellular matrix in the endothelium. These results suggest that the extracellular matrix which is composed of fibronectin and GAG may play an important role in endothelial cell regeneration. PMID- 3653348 TI - Protection from N-nitrosodimethylamine-mediated liver damage by indole-3 carbinol. AB - Indole-3-carbinol (I-3-C) was examined for its ability to protect mice against 24 hr N-nitrosodimethylamine (NDMA)-mediated hepatotoxicity. NDMA (20 mg/kg body weight) alone produced extensive hemorrhagic and centrolobular necrotic lesions, with a necrotic severity index of 3.0 +/- 0.4 (scale of 0-5). Treatment with 50 mg/kg body weight of I-3-C by gavage, 1 hr prior to NDMA, substantially protected against hemorrhagic lesions. Furthermore, I-3-C lowered the NDMA-mediated tissue necrotic index to 1.5 +/- 0.3, by reducing the extent of tissue necrosis rather than the severity in the necrotic region. Release of liver enzymes into the blood correlated with the histopathology; I-3-C reduced NDMA-mediated elevated activities of plasma alanine transaminase and ornithine transcarbamylase by 84 and 51.3%, respectively. Although no changes in nonprotein sulfhydryls were evident at 24-hr after NDMA, ascorbate levels were reduced to 40% of control values. However, treatment with I-3-C prior to NDMA prevented the decline in tissue ascorbate concentrations. In vitro, I-3-C was found to be a type II ligand for cytochrome P-450, with a Ks value of 237 microM. However, if such binding occurs in vivo, it does not protect against the approximately 60% decrease in hepatic cytochrome P-450 or the 80% decrease in NDMA demethylase I activity produced by NDMA. Since I-3-C slightly enhances cytochrome P-450 content and NDMA demethylase activity, the histopathologic protection by I-3-C must be due to factors other than inhibiting metabolic activation of NDMA. PMID- 3653349 TI - Repair of chronic hyperoxic lung injury: changes in lung ultrastructure and matrix. AB - We studied changes in lung ultrastructure, fibronectin, and collagen during repair of chronic hyperoxic lung injury induced by exposure of rats to 85% oxygen for 14 days. Morphologically, the most persistent changes were in the alveolar interstitium. After 28 days of repair, the extracellular matrix volume was still twofold normal. Total interstitial cell numbers also remained high and interstitial myofibroblast number actually doubled between Days 7 and 14. These changes contrast markedly with repair of acute lung injury induced by 100% oxygen (Thet et al. (1986) Exp. Lung Res. 11, 209-228) in which matrix volume and interstitial myofibroblast number increased initially but then returned to normal. Biochemically, tissue-associated fibronectin was high initially and peaked at 3 days before slowly declining. Tissue collagen content began to increase after the peak in fibronectin content and was over 150% of controls at 28 days; this correlated with an increase in visible collagen fibers. We conclude that changes in lung morphology and matrix after chronic hyperoxic lung injury are more persistent than after acute hyperoxic lung injury and result in a greater degree of chronic interstitial fibrosis. PMID- 3653350 TI - Acute sensitivity of BHT-induced alveolar toxicity to a diquat challenge in murine lungs. AB - In this study we investigated the effects of a mild toxic challenge at selected points in time on the nonspecific cellular events that occurred in acutely damaged pulmonary alveoli. Swiss-Webster mice were treated with butylated hydroxytoluene (BHT, 400 mg/kg ip) and sacrificed at Days 1, 3, and 5 thereafter; either 24 or 48 hr prior to each sacrifice, the herbicide diquat was administered (4 mg/kg ip) as a challenge to the ongoing cellular events in the pulmonary alveoli. Standard morphometric techniques were used at both the levels of light and electron microscopy to evaluate the alveolar response to BHT and diquat treatments. Following BHT, early type I epithelial and endothelial damage triggered inflammatory changes in alveolar septa. Proliferation and differentiation of type II pneumocytes, aiming at the regeneration of the respiratory epithelium, ensued and peaked at Day 3. Treatment with diquat alone caused mild inflammatory changes and hypertrophy of type II pneumocytes, in the absence of necrosis of any alveolar cell type. The pinpoint administration of diquat in the early days following treatment with BHT significantly disorganized the temporal pattern of alveolar reaction. Diquat enhanced epithelial and endothelial damage only if administered before the onset of BHT-induced injury. Afterwards, the alveolar response to the combined effects of BHT and diquat could not be predicted from their known individual effects. Treatment with diquat modified either proliferation or differentiation of type II pneumocytes, depending upon time along the BHT schedule. Inflammatory and interstitial reactions were lowered when diquat was given at Days 1 and 3 post-BHT, but potentiated when given at Day 4. The results document time-related changes in the sensitivity of damaged and regenerating alveolar cells to a mild exogenous chemical challenge. They may further indicate that low levels of urban and industrial toxicants might influence pulmonary alveolar events in individuals made more susceptible by acute or chronic respiratory diseases. PMID- 3653351 TI - Growth promotion by silk sutures in the urinary bladder of rat. AB - A silk suture in the urinary bladder of rats induces tumorous growths of urothelia. Whether these tumorous growths are due to initiation or due to promotion by the suture remains unknown. A 3-O silk suture was therefore placed in the bladders of rats for 4 or 8 weeks. After removal of the suture and a period of recovery, the bladders of these and sham-operated control rats were exposed to N-methyl-N-nitrosourea (MNU) in order to examine whether the effects of the suture were reversible following its removal from the bladder. In addition, the bladder mucosa was exposed to either MNU or Ringer's solution followed by placement of the silk suture in the bladder wall in order to examine promotor activity of the suture. The tumor incidence induced by MNU was little influenced by the prior temporary placement of the suture in the bladder wall, thus indicating a reversibility of the effects of the suture. The placement of the silk suture in the bladder wall that had a prior exposure to MNU resulted in a significant incidence of invasive tumors. All these results are consistent with the fact that a silk suture in the bladder acts as a promoter but not as an initiator. PMID- 3653352 TI - Biotyping of micelial fungus cultures by the killer system. AB - Based on the occurrence of the yeast killer phenomenon in hyphomycetes, the toxic effect of 37 selected killer yeasts was studied on eleven strains of Pseudallescheria boydii, six strains of Aspergillus niger, 18 strains of Penicillium camemberti and nine strains of Sporothrix schenckii. The demonstration of different biotypes within the species of P. boydii and P. camemberti proves that the killer system also is a practical and effective method for epidemiological studies among hyphomycetes. Based on the system used, it was not possible to observe markedly different biotypes among the A. niger and S. schenckii strains studied. The first evidence that an isolated, concentrated (50X) and partially purified yeast killer toxin may display a lethal activity against mycelial fungus cultures is also given in this paper. PMID- 3653353 TI - Hypertension and indicators of coronary heart disease in Wallis Polynesians: an urban-rural comparison. AB - A comparative study of hypertension, and indicators of and risk factors for coronary heart disease was undertaken in samples of rural Wallisians of Wallis Island, and first generation Wallisian migrants in the urban centre of Noumea, New Caledonia. Approximately 20% of the adult population of the two communities was included in the study. Higher mean blood pressure and hypertension prevalence in Wallisians in Noumea compared to those in Wallis was documented. There was no significant rise in blood pressure with age in rural Wallisian males. Wallisians in Noumea tended to be more obese than those in Wallis (particularly females). Although differences in the extent of obesity appeared to explain some of the differences in blood pressure between populations of Wallis and Noumea, other environmental factors (such as salt intake) are probably important. There was a trend for a higher prevalence of Q wave changes on the ECG in urbanized Wallisians compared to their rural counterparts. There was no significant or consistent differences in plasma lipid concentrations between the two groups. The prevalence of diabetes was 7 and 4 times higher in Noumea compared to Wallis for males and females respectively. Differences in diabetes and hypertension prevalence are more likely to account for the variation in ischaemic heart disease than plasma lipid levels. PMID- 3653354 TI - Plasmid profiles of Legionella spp. isolates, Italy. AB - Plasmid analysis and restriction-endonuclease digestion were used to study 54 clinical and environmental Legionella strains. Plasmids with approximate molecular masses of 40, 50, 70, and 90 megadaltons (Mdal) have been isolated from L. pneumophila serogroup 1 strains. One L. jordanis strain contained two plasmids of 25 and 70 Mdal. Restriction analysis of clinical and related hospital environmental isolates resulted in identical patterns. Geographic diversity is shown for strains of different origin. PMID- 3653355 TI - Sequential health effect study in relation to air pollution in Bombay, India. AB - A health study done for 4 years in 4129 subjects from 3 urban (high, medium and low according to SO2 levels) and a rural community showed a higher morbidity with raised levels. Initially in the respective 4 areas standardised prevalences (in percent) were: for dyspnoea 7.3, 6, 3.2 and 5.5; for chronic cough 5.1, 2.7, 1.7 and 3.3; for intermittent cough 15.6, 5.8, 0.4 and 3.7 and frequent colds 18.0, 20.8, 12.1 and 11 percent. The diagnosis of chronic bronchitis was done in 4.5, 4.5, 2.3 and 5.0 percent and cardiac disorders 6.8, 4.3, 8.2 and 2.7 percent in respective 4 areas. After 3 years, 55-60% of urban and 44% of rural subjects were reassessed. Several minor symptoms, besides above ones were related closely to the urban air pollutant profile. Increased greenery protected only at lower levels of pollution. Initial lung functions were best in "urban low" area but in all urban areas, yearly declines were larger than in rural subjects. A cross sectional study for effect of slums in 4 areas on 22272 subjects revealed generally higher morbidity in slum residents, particularly in "urban medium" area for frequent colds, cough and dyspnoea. Daily health diaries maintained in 2232 subjects revealed high morbidity in 2 more polluted areas; monthly trends correlated to SO2 and S.P.M. and daily fluctuations with SO2 revealed a threshold between 50 to 100 micrograms/CM/day. There were greater mortality (S.M.R.) in cardiorespiratory and malignant diseases related to pollution. The major factors affecting morbidity were pollution, nutrition, occupation, smoking and age. PMID- 3653356 TI - Two issues concerning the analysis of grouped data. AB - Simple statistical models are used to illustrate two important issues arising in the analysis of grouped data. The consequences are explored of grouping continuous data and analyzing the resulting contingency table. Specifically, an expression for the loss of power is derived when and odds ratio is used to assess risk measured by a continuous variable. Also explored are the consequences of employing correlation and regression coefficients to analyze summary variables derived from grouped data (ecologic data). An expression is given that demonstrates the magnitude of a bias (ecologic fallacy) resulting from analyzing a specific type of grouped data. PMID- 3653357 TI - Socioeconomic status and hypertension in children of two state schools in Naples, Italy: preliminary findings. AB - Most epidemiologic studies have shown a relationship between high blood pressure and socioeconomic status in childhood. Systolic and diastolic pressure were measured in 296 schoolboys and 338 schoolgirls aged 10 to 13 years. The presence of known and suspected risk factors for hypertension was evaluated by a standardized questionnaire consisting of two sections: one completed by the subjects and another by their parents. Descriptive analysis showed a lack of association between socioeconomic background, parental educational levels and childhood hypertension, a relatively strong association between a sedentary style of life and hypertension (p less than 0.001) and a statistically significant influence of maternal or paternal history of hypertension or diabetes in the sample studied (p less than 0.05). However, when all the variables were assessed by multiple correspondence analysis, two nuclei of schoolchildren were delimited. One was composed of hypertensive children with family histories of hypertension and/or diabetes mellitus who lead sedentary lives, live in large dwellings with a low crowding index and whose parents are better educated. The second nucleus was composed of normotensive subjects with opposite characteristics. The data obtained indicate that there may be a relationship between blood pressure in children and the socioeconomic status and educational level of their parents and suggest that these factors may have an impact on the child's blood pressure at a relatively young age. PMID- 3653358 TI - A step towards using urinary nitrogen as a tool for validating 24-hour dietary recall interviews. AB - In an active population, can urinary nitrogen output provide a satisfactory basis for estimating protein intake without preliminary screening to rule out metabolic disease? A successful demonstration would justify comparing average protein intake for active groups derived from 24-hour recall interviews with that obtained from 24-hour urine specimens. This could then be a practical test of the hypothesis that 24-hour recall data provide valid estimates for groups. Volunteers (45) from a university population limited their diet for four days to a commercially prepared liquid diet and provided a 24-hour urine specimen beginning on the morning of the fourth day. For men, average daily intake of protein was 112.8 grams and the estimated intake based on urinary nitrogen was 114.5. Corresponding data for women were 84.6 and 83.9. Screening for metabolic disease seems unnecessary but persons restricting their intake to less than their caloric needs will have their protein intake overestimated on the basis of urinary nitrogen measurement. PMID- 3653359 TI - Viridans streptococci septicemia in cancer patients: a clinical study. AB - Viridans streptococci septicemia was documented in ten cancer patients, 7 of whom were neutropenic (less than 1000/mmc). Pneumonia was presumed to be the source of bacteremia in six patients. Viridans streptococci isolated from sputum culture in an immunocompromised host must be regarded as the potential etiological agent, then further characterized and checked for antibiotic sensitivity. PMID- 3653360 TI - Hepatitis B virus DNA detection in serum and the prevention of post-transfusion hepatitis. PMID- 3653361 TI - Intravenous gammaglobulin therapy for thromboneutropenic neonates of mothers with systemic lupus erythematosus. AB - i.v. IgG therapy was used to treat thromboneutropenia in 2 male neonates of mothers with SLE. The mothers of both neonates were thrombocytopenic but not neutropenic during the last 3 months of their pregnancies. Anti-platelet and anti neutrophil IgG directed against platelets and neutrophils from the neonates were detected in the sera of both mothers. The platelet and neutrophil counts increased significantly with i.v. IgG therapy in both neonates. i.v. IgG therapy is a safe and effective regimen for passive immune thromboneutropenia. PMID- 3653362 TI - Hereditary sideroblastic anaemia and autosomal inheritance of erythrocyte dimorphism in a Dutch family. AB - Size distribution curves of red blood cells were used to detect the presence of microcytes in peripheral blood of members of a Dutch family with hereditary sideroblastic anaemia. 22 of 49 members of this family have a bimodal erythrocyte volume distribution curve and a dimorphic blood picture. The pattern of inheritance of this morphological abnormality is clearly autosomal. It is suggested that the study of red blood cell size distribution curves may add valuable information on the pattern of inheritance in other families with hereditary sideroblastic anaemia. PMID- 3653363 TI - In vitro and in vivo behavior of 111In-labelled platelets: an experimental study of healthy male volunteers. AB - The aim of this study was to obtain a critical evaluation of a simple method for labelling platelets with 111In-oxine. All experiments were carried out on healthy volunteers. 65 +/- 7 (SD) % of the platelets in collected blood were labelled and reinjected. As compared to control experiments, only in response to a low final ADP concentration (1.0 mumol/l) did 111In-labelled platelets show reduced in vitro aggregability. The mean platelet volume for 111In-labelled platelets was slightly lower than the mean platelet volume in whole blood. The results for initial platelet recovery and platelet mean lifespan closely agreed with those of other studies in which considerably higher platelet extraction from whole blood was obtained. After injection, the splenic uptake and blood disappearance of 111In-labelled platelets followed a monoexponential function with almost identical rate constants. By compartmental analysis of the equilibration of platelets between blood and spleen, the splenic blood flow was estimated to be 4.8 +/- 1.9 (SD) % of the total blood volume/min; the intrasplenic platelet transit time was 9.7 +/- 1.6 (SD) min, and the exchangeable splenic platelet pool 31 +/- 8 (SD) %. Highly significant relationships were present between the splenic blood flow and the splenic platelet pool size, as well as between the splenic blood flow and the initial platelet recovery. It is concluded that the requirements for adequate interpretation of platelet kinetics are well met with the present method for harvesting and labelling of platelets. PMID- 3653364 TI - Pathophysiological classification of acquired bone marrow failure based on quantitative assessment of erythroid function. AB - Bone marrow failure encompasses a broad spectrum of disorders including aplastic, dysmyelopoietic and myelophtisic anemias. In the present study, these anemias were characterized according to the degree of erythroid proliferation and efficiency of erythropoiesis. Total erythropoietic activity was evaluated in 43 patients by measuring the erythron transferrin uptake (ETU). It averaged 20% of basal (range 3-43%) in 13 patients with severe aplastic anemia, 75% of basal (range 60-103%) in 3 patients with extensive bone marrow infiltration by neoplastic cells, 131% of basal (range 50-217%) in 16 patients with refractory anemia, and 452% of basal (range 63-720) in 11 patients with idiopathic refractory siderobastic anemia. Respective efficiencies of erythropoiesis were 74% in aplastic anemia, 70% with bone marrow infiltration, 46% in refractory anemia, and 14% in sideroblastic anemia. Based on the ETU, patients could be categorized into absolute marrow failure, relative marrow failure, and adequate erythropoietic response to anemia. This simple determination of proliferating activity of the erythroid marrow can provide useful information on the pathophysiology of marrow failure and a basis for the selection of therapeutic approaches. PMID- 3653365 TI - Zinc status in polycythaemia. AB - Zinc and iron status have been measured in three groups of polycythaemic patients managed by venesection: polycythaemia rubra vera, secondary polycythaemia and idiopathic erythrocytosis. Zinc status was assessed from the concentration of zinc in polymorphonuclear cells (PMN) and plasma. The mean PMN zinc value was lower than that of age-matched controls (polycythaemics 57.5 +/- 2.3 micrograms/10(10) PMN, n = 26; controls 68.9 +/- 5.2 micrograms/10(10) PMN, n = 9; means +/- SEM, p less than 0.05). The difference was most marked in polycythaemia rubra vera; the patients were iron-deficient. The reduced PMN zinc levels may indicate that polycythaemic patients managed by repeated venesection are zinc-deficient. This may contribute to some nonspecific symptoms of polycythaemia and to recurrent infections in the hypoxic patients. PMID- 3653366 TI - Survival following combination chemotherapy in advanced high grade non-Hodgkin's lymphomas: relation to proliferative activity of the lymphoma cells. AB - In 18 untreated adult patients (median age 62.5 yr) with advanced non-Hodgkin's lymphoma of unfavourable histology, thymidine labelling indices (LIs) of the lymphoma cells were assessed. The patients were treated with combination chemotherapy and have been followed for 29-60 (median 52) months or until death. The survival curve had a steep fall during the first 2 yr. Between 2-5 yr after treatment there was a flattening of the curve and survival seemed to be similar to the survival expected for a Swedish population matched for age and sex. 11 patients died with 2 yr and 7 patients have survived for a longer period. Age, histopathologic classification and clinical stages were comparable in short-term and long-term survivors and treatment was not more aggressive for the long-term survivors. The LIs were significantly higher (median 8.2) in short-term survivors than in the long-term survivors (median 1.4). Long-term survival following combination chemotherapy of advanced NHL of unfavourable histology seems to be achieved mainly in patients with a low proliferative activity of the lymphoma cells. It is suggested that in NHL a high proliferative activity may facilitate the generation of new mutants and that some of these are spontaneously resistant to various chemotherapeutic drugs. PMID- 3653367 TI - Red cell membrane alteration involving protein 4.1 and protein 3 in a case of recessively inherited haemolytic anaemia. AB - We present 2 siblings with a severe congenital haemolytic anaemia. Red cells displayed a variety of abnormal shapes, including leptocytes, schizocytes and elliptocytes. Repeatedly, skeletal protein 4.1 appeared reduced by 30%. The 4.1a/4.1b ratio was normal despite the haemolytic state. No change could be detected in spectrin, nor in sialoglycoproteins. Band 3 was denser, narrower and displaced downward. The parents, who are consanguineous, were devoid of any obvious biochemical abnormality; however, their red cells were not normal. These 2 cases with reduced protein 4.1 clearly depart from 4.1 (-) hereditary elliptocytosis. The possibility of an altered binding of protein 4.1 to some other membrane component is discussed. PMID- 3653368 TI - Antioxidant system and serum trace elements in alpha-thalassaemia and Hb Lepore trait. AB - Erythrocyte antioxidant enzymes, superoxide dismutase, catalase and glutathione peroxidase were found to be significantly high in subjects with alpha thalassaemia and Hb Lepore trait, as a consequence of the increased oxidant stress which is known to exist in these conditions. Among the serum trace elements present in these enzymes, selenium was increased in subjects with Hb Lepore trait and significantly low in those with alpha-thalassaemia trait, while selenium erythrocyte content was significantly increased in alpha-thalassaemic subjects. PMID- 3653369 TI - Neutrophil dysfunctions in thalassaemia major: the role of cell iron overload. AB - The susceptibility to infections was recorded in 13 patients with beta thalassaemia major (T.P.). The following parameters were also investigated in their polymorphonuclear neutrophils (PMN): nitro blue tetrazolium (NBT) reduction, heated yeast and Escherichia coli phagocytosis, Escherichia coli killing and myeloperoxydase activity. These results were compared to those obtained in healthy controls (H.C.). The Perls's reaction was performed on PMN and graded according to a scoring system with the aim of quantifying the iron intoxication of PMN. Phagocytosis and Perls's reaction of PMN from H.C. were also studied after 20 h of incubation with thalassaemic serum. 6 T.P. out of 13 developed septicaemia during their lifetime and in all 9 septicaemic episodes were noted. Phagocytosis was greatly impaired, disclosing both cellular and serum abnormalities. The mean percentage of Perls's positive PMN was 13% in T.P., contrasting with the constant negative reaction in H.C. The incubation of PMN from H.C. with serum from T.P. induced the simultaneous appearance of a phagocytosis defect and of a positive Perl's reaction. It was concluded that in beta thalassaemia major the phagocytosis of PMN was altered due to a combination of serum and cellular abnormalities and that both may be related to the iron overload. PMID- 3653370 TI - Whole blood folate values in pernicious anaemia: relation to treatment. AB - 27 patients with pernicious anaemia, followed for a long period, were consecutively treated with three different vitamin B12 preparations, while during intervening period no therapy was given until signs of B12 deficiency developed. After vitamin B12 treatment, a peak whole blood folate value some 70% higher than the starting value was noted after about 75 d in patients treated with B12 injections and after about 165 d in perorally treated patients. During the same time significantly increased whole blood folate/plasma folate ratio was noted. In most of the patients, whole blood folate declined from peak to plateau level in about 150 d and thereafter remained almost unchanged until signs of cobalamin deficiency developed. The mean time from peak to plateau values was significantly longer in "long-reactors" than in "short-reactors". Higher peak and plateau values were noted in patients with neuropathy and mucosal symptoms, as compared to patients with hypersegmentation. PMID- 3653371 TI - Platelet aggregability and platelet volume in the postoperative course: problems in the platelet aggregation test derived from the measurement of platelet volume. AB - Platelet count, aggregability and volume in the postoperative course of 20 patients were examined. Platelet count was decreased on the 1st postoperative d, and increased on the 7th and 14th d compared with the preoperative value. The maximal aggregation rate of platelets induced by ADP was decreased on the 3rd postoperative d, and then recovered to the preoperative level. In contrast, platelet volume was only slightly increased on the 3rd postoperative d. In this study, there was no correlation between platelet aggregability and platelet volume in PRP. We have proposed one parameter, 'platelet concentration ratio' (platelet concentration in PRP/platelet concentration in whole blood). In the postoperative course, this concentration ratio changed depending on platelet volume, and possibly on other conditions of blood such as hematocrit, viscosity and specific gravity. The concentration ratio influenced the subpopulations of platelets in PRP. Platelet aggregation tests may be performed using PRP in which platelet subpopulations differ from those in whole blood, especially in the postoperative state. PMID- 3653373 TI - The value of staging bone marrow trephine biopsy in Hodgkin's disease. AB - A retrospective study of pre-treatment bone marrow biopsies was undertaken to examine the value of bone marrow staging in Hodgkin's Disease. Bone marrow biopsy revealed infiltration in 40 out of 613 cases, (6.5%). These patients were not significantly different from stage 4 patients without marrow involvement with regard to age, sex, anaemia or survival. Peripheral blood lymphopenia and lymphocyte depleted histopathological type were more common in patients with marrow involvement. Bone marrow biopsy altered individual patient management in less than 1% of 613 patients and can no longer be recommended as part of the routine staging in Hodgkin's Disease. PMID- 3653372 TI - Glucocorticoid receptor in multiple myeloma. AB - Glucocorticoid receptor levels of myeloma cells were quantitated in 7 patients with multiple myeloma. In 4 patients, glucocorticoid receptor levels were less than 10 fmol/10(6) cells. In 3 patients, receptor levels were from 17.6 to 21.4 fmol/10(6) cells. We further examined the correlation between glucocorticoid receptor levels and effect of dexamethasone on 14C-thymidine incorporation and cell viability using 2 myeloma cell lines, OPM-1 and OPM-2, established from a patient with multiple myeloma. Glucocorticoid receptor levels of OPM-1 and OPM-2 were 8.5 fmol/10(6) cells and 63.2 fmol/10(6) cells, respectively. The sensitivity of OPM-1 to dexamethasone in these studies was lower than that of OPM 2. These results suggest the possibility that the low level of glucocorticoid receptor in myeloma cells may be important for predicting a poor response to glucocorticoid therapy. PMID- 3653374 TI - The effect of an isoprenaline infusion on the splenic blood flow and intrasplenic platelet kinetics. AB - The effect of a constant isoprenaline infusion on the venous platelet count, splenic blood flow and intrasplenic platelet kinetics was investigated in 6 healthy male volunteers. The study was carried out using autologous 111In labelled platelets and dynamic gamma camera imaging of the initial distribution of radiolabelled platelets between blood and splenic platelet pool. The isoprenaline infusions were administered i.v. over 30 min in a dose of 0.03 micrograms/kg/min. These infusions significantly increased the splenic blood flow and the size of the exchangeable splenic platelet pool. Concomitantly, there was a decrease of labelled as well as unlabelled platelets in the peripheral blood. The intrasplenic platelet transit time was not affected. Before start of infusion, the splenic blood flow was 6.1 +/- 2.9 (SD) % of total blood volume/min and the splenic platelet pool size 34 +/- 9 (SD) %. During infusion the corresponding values were 8.7 +/- 3.9 (SD) and 41 +/- 11 (SD), respectively. It is concluded that an i.v. infusion of isoprenaline enhances splenic pooling of platelets as a result of an increase in splenic blood flow. PMID- 3653375 TI - Human immunodeficiency virus (HIV) associated non-Hodgkin's lymphomas in Denmark: report of three cases. AB - High grade malignant non-Hodgkin's lymphoma (NHL) was the presenting manifestation of the acquired immunodeficiency syndrome (AIDS) in 3/81 reported cases of AIDS in Denmark (by April 2, 1986). Asymptomatic HIV infection, 1 and 5 yr prior to the onset of lymphoma, was documented in 2 cases. 1 patient became infected by Factor VIII treatment, 2 were male homosexuals. 2 patients had an uncommon tumour presentation in the oral cavity, 1 patient presented with an abdominal mass. The histologic subtypes were immunoblastic (2), and small noncleaved cell, Burkitt's (1). Helper/suppressor T-cell ratio was decreased at onset of lymphoma in 2 cases. All 3 patients have died, 4, 6, and 24 months after diagnosis of NHL. Only 1 patient died of NHL, 1 died of an unclassified pneumonia and the third developed progressing supranuclear HIV-associated polyneuropathy without evidence of CNS lymphoma. Thus, high grade malignant B-cell NHL is a regular initial manifestation of AIDS, and may develop after years of asymptomatic HIV infection. PMID- 3653376 TI - Lethal skin cancers in hairy cell leukemia (two case reports). AB - 2 patients with hairy cell leukemia (HCL) complicated by multiple cutaneous and other malignancies are described. The second malignancies behaved in a much more aggressive fashion than would be expected in an immunocompetent population, and were lethal in both patients. The literature regarding second malignancies in immune compromised patients, and in HCL in particular, is reviewed. PMID- 3653377 TI - RES phagocytosis in beta-thalassemia. PMID- 3653378 TI - Resistant multiple myeloma treated with mitoxantrone in combination with vincristine and prednisolone (NOP-regime) PMID- 3653379 TI - Platelet reactivity, fibrinogen and smoking. PMID- 3653380 TI - Frequency of iron deficiency in Budd-Chiari syndrome. PMID- 3653381 TI - Alpha-interferon therapy in refractory angioimmunoblastic lymphadenopathy. PMID- 3653382 TI - Plasmapheresis for idiopathic thrombocytopenic purpura unresponsive to intravenous immunoglobulin. PMID- 3653383 TI - [Quinolizidine derivatives with antimicrobial activity]. AB - Thirty quinolizidinyl derivatives, together with two dialkylaminoalkyl analogues, were tested at concentration up to 160 mg/l for antimicrobial activity against 17 microrganisms, including gram-positive and gram-negative strains, Mycobac, tuberculosis, Trichom, vaginalis, fungi and yeasts. The most common activity found is that against Mycobac, tuberculosis, followed by that against gram positive strains; several compounds [(I a), (I b), (I c), (II a), (III a), (VIII e), (XIX e), (XXI e)] exhibit a good or a very high level of activity. Concerning the gram-negative bacteria, activity is found only against Escherichia coli and is random and usually slight, as is that against fungi, yeasts and protozoa. Compounds (I a), (III a) and (XXI e) are of interest for their high activity and for their broad spectrum of activity, while compound (X e) is peculiar for its selectivity against Mycobac. tuberculosis. PMID- 3653384 TI - Esters of N-methyl-N-(2-hydroxyethyl or 3-hydroxypropyl)-1,3,3-trimethylbicyclo [2.2.1]heptan-2-endo-amine with hypotensive activity. AB - The synthesis of title compounds by reaction of fenchone nitrimine with 2 aminoethanol and 3-aminopropanol, followed by stereospecific NaBH4 reduction of the resulting imines, Eschweiler-Clarke reductive methylation and esterification with aliphatic and aromatic acyl chlorides is described. Some esters showed an appreciable hypotensive activity in rats. Effects on heart rate and antiarrhythmic activity in rats, as well as infiltration anesthesia in mice, are also reported. PMID- 3653386 TI - [C-alkylpiperazines. XII. Synthesis and diuretic activity of compounds structurally related to clopamide]. AB - The synthesis and diuretic activity were reported of a series of N1-(4-chloro-3 sulfamoylbenzamide)-N4-alkylpiperazines, 2-methyl- and cis-2,6-dimethyl substituted, structurally related to clopamide, as well as of two N4-alkyl-N1-(4 chloro-3-sulfamoylbenzoyl)-2-methyl-1,2,3, 4-tetrahydroquinoxalines. In the piperazine series the presence of methyl group in position 2 and 6 of the piperazinic ring was found to increase the diuretic potency of the C-unmethylated compound. PMID- 3653385 TI - 4,5-Dimethylangelicin effects on lymphocytes with and without UV-radiation. AB - Compared to the linear derivative 8-methoxypsoralen (8-MOP) the angular structured furocoumarin 4,5'-dimethylangelicin (4,5'-DMA) causes smaller photosensitization effects (loss of viability, inhibition of phytohemagglutinin (PHA)-induced transformation rate and E-rosette formation of T-cells, respectively) on cultured human lymphocytes. When 4,5'-DMA or 8-MOP are added to the cultures without additional UV-irradiation, increased or decreased PHA stimulation rates are observed, respectively. In addition, 4,5'-DMA is able to reduce the binding of sheep erythrocytes to lymphocytes in a higher degree than 8 MOP. These findings suggest different action mechanisms on cytoplasma membranes and intracellular structures of lymphocytes by different furocoumarins. PMID- 3653388 TI - [The phytoiatric antifungal activity of various derivatives of 2 iodobenzanilides]. AB - Some 2'-thioalkyl-2-iodobenzanilides and N-substituted 2-iodobenzanilides were prepared, in order to test their antimycotic activity against representative plant parasites. The substances (I----XI) were subjected to in vitro tests for antimycotic activity. The N-phenyl-2-iodobenzanilide (XI) proved to have very interesting activity. PMID- 3653387 TI - Ethyl 2-([5,6-dihydro-7-(1H-imidazol-1-yl)-2-naphthalenyl]oxy)- 2 methylpropanoate as a new potent oxyisobutyrate hypolipidaemic with unusual features. AB - Some compounds containing the N-imidazolyl and the ethyl oxy-isobutyrate groups linked to a naphthalene ring structure and some related analogues were synthesized and tested for hypolipidaemic activity. Ethyl 2-([5,6- dihydro-7-(1H imidazol-1-yl)-2-naphthalenyl]oxy)- 2-methylpropanoate (V) proved to be a strong hypolipidaemic agent, several times more potent than clofibrate. Structural requirements for activity and differences from clofibrate analogues are discussed. PMID- 3653389 TI - Correlation analysis in a set of X-benzyltrimethylammonium derivatives with antimuscarinic activity. AB - The results of a pharmacological investigation on a series of meta-substituted benzyltrimethylammonium salts possessing an antimuscarinic activity are reported. Correlative analysis shows that the pharmacodynamic activity is a function of the hydrophobic-lipophilic parameter associated with the substituent. PMID- 3653390 TI - [Synthesis and antiplatelet aggregating activity of several thiopyranylidene ketones and benzylidene indanones]. AB - Some new aryl thiopyranylidene ketones and benzylidene indanones with various substituents on the benzene ring were synthesized and their inhibitory activities in vitro on human platelet aggregation were assayed. The 2-[(2,5 dimethoxyphenyl)methylene] indan-1-one is the most potent inhibitor (about seventeen times more active than aspirin, against arachidonic acid, and twenty four times against collagen). PMID- 3653391 TI - Assignment of hyperfine shifted haem methyl carbon resonances in paramagnetic low spin met-cyano complex of sperm whale myoglobin. AB - The hyperfine shifted resonances arising from all four individual haem carbons of the paramagnetic low-spin met-cyano complex of sperm whale myoglobin have been clearly identified and assigned for the first time with the aid of 1H-13C heteronuclear chemical shift correlated spectroscopy. Alteration of the in-plane symmetry of the electronic structure of haem induced by the ligation of proximal histidyl imidazole spreads the haem carbon resonances to 32 ppm at 22 degrees C, indicating the sensitivity of those resonances to the haem electronic/molecular structure. Those resonances are potentially powerful probes in characterizing the nature of haem electronic structure. PMID- 3653392 TI - Surface enhanced resonance Raman scattering as a probe of the spin state of structurally related cytochromes P-450 from rat liver. AB - Surface enhanced resonance Raman scattering (SERRS) was observed from structurally related drug-induced rat liver cytochromes P-450 adsorbed on a silver colloid. Careful control of pH and the sequence of addition of components to the so1 is required to prevent protein denaturation at the surface due to conversion to P-450's biologically inactive form P-420 or haem loss. A low-spin P 450 (PB3a), a mixed low- and high-spin P-450 (PB3b) and a predominantly high-spin P-450 (MC1a) were investigated. Spectra recorded in the 1300-1700 cm-1 frequency region, containing the oxidation state marker v4 at 1375 cm-1 (Fe3+) and spin state markers v10 (1625 cm-1, high-spin; 1633 cm-1, low-spin) and v19 (1575 cm-1, high-spin; 1585 cm-1, low-spin) were used to differentiate between the spin states of the various forms of cytochrome P-450. As well as the established spin state marker bands, the intensity of a band at 1400 cm-1 appeared to depend on the high-spin content. Thus, with this method SERRS from silver colloids can be used to determine spin states of related cytochromes P-450 in dilute solution (10(-8)M) and may be of value in studies of protein-substrate interactions. PMID- 3653393 TI - Sequence conservation in the 3'-untranslated regions of neurone-specific enolase, lymphokine and protooncogene mRNAs. AB - The C-terminal protein-coding and the entire 3'-untranslated regions of a cDNA corresponding to human neurone-specific enolase mRNA have been sequenced. The 3' untranslated region is 892 bases long and shows a high degree of homology with the 3'-untranslated region of rat neurone-specific enolase mRNA. This sequence conservation is not seen in non-neuronal enolase mRNAs. Features of the conserved sequence include an A-rich region approx. 250 bases from the stop codon at a point corresponding to the polyadenylation signal site in non-neuronal enolase mRNA, and a repeating ATTT sequence. This unusual motif in eukaryotic mRNAs has previously been reported in the 3'-untranslated regions of lymphokine and protooncogene mRNAs. PMID- 3653394 TI - Elevation of pHi is not an essential step in calcium mobilisation in fura-2 loaded human platelets. AB - Human platelets were co-loaded with the fluorescent indicators BCECF and fura-2 to measure pHi and [Ca2+]i and incubated with aspirin to block cyclooxygenase. Either pHi and shape change and aggregation or pHi and [Ca2+]i were measured simultaneously in the same stirred cuvette, at 37 degrees C. In Hepes-buffered saline containing 1 mM Ca2+, mean resting pHi was 6.98 +/- 0.01 (SE, n = 59). Changes of pHi up to +/- 0.35 units, imposed by additions of NH4Cl, CO2 or nigericin, produced no shape change or aggregation and only insignificant changes in [Ca2+]i. Sufficient thrombin to raise [Ca2+]i over 1 microM and cause rapid shape change and aggregation increased pHi by no more than 0.05 units, and the increase in pHi lagged behind the elevation of [Ca2+]i. We conclude that changes in pHi do not form a necessary or sufficient component of the pathways leading to receptor-mediated Ca2+ mobilisation or the stimulation of shape change or aggregation. PMID- 3653395 TI - Calcium-activated membrane depolarization via modulation of chloride efflux from parietal cells during gastrin stimulation. AB - In the isolated parietal cell the following observations were made: gastrin led to an increase in cytoplasmic free Ca2+ concentration ([Ca2+]i) even in the absence of medium Ca2+ and to transient membrane depolarization in both the absence of the medium Ca2+ and the fura-2-loaded cell. The incorporated Ca2+ chelator BAPTA inhibited the gastrin-induced membrane depolarization. The magnitude of depolarization caused by gastrin was unchanged on removal of medium Na+. Furosemide but not tetraethylammonium inhibited the gastrin-induced depolarization. The results suggest that the Ca2+ released from the store(s) induces membrane depolarization, possibly via modulation of a Cl- efflux across the luminal surface during gastrin stimulation. PMID- 3653396 TI - Fructose 2,6-bisphosphate and glucose 1,6-bisphosphate in rabbit erythroid cells during differentiation. AB - Fructose 2,6-bisphosphate concentration and 6-phosphofructo-2-kinase activity markedly decrease during differentiation of rabbit erythroid cells, being higher in erythroblasts (654 +/- 97 pmol/10(9) cells; 238 +/- 81 U mu/10(9) cells) than in reticulocytes (40 +/- 15 pmol/10(9) cells; 11 +/- 3 U mu/10(9) cells) and much higher than in mature erythrocytes (10 +/- 0.8 pmol/10(9) cells; 2 +/- 1 U mu/10(9) cells). The enzymatic activities involved in glucose 1,6-bisphosphate metabolism also decrease, but the levels of aldohexose 1,6-bisphosphates remain essentially constant during differentiation of erythroid cells. PMID- 3653398 TI - Short and long term influence of phenothiazines on liver peroxisomal fatty acid oxidation in rodents. AB - Evidence is given that phenothiazines depress hepatic peroxisomal fatty acid oxidation in vivo. After oral administration to rats thioridazine and chlorpromazine inhibit peroxisomal beta-oxidation, evaluated by H2O2 production, during 2 weeks. In mice, this effect could not be demonstrated. However, in both species VLCFA are increased after short and long term drug administration. Electron microscopy reveals the presence of membranous structures in liver cytoplasm or lysosomes. The inhibition by thioridazine of peroxisomal beta oxidation does not lead to hepatic peroxisome proliferation. The activities of enzymes related to fatty acid breakdown are not increased and liver peroxisomes are microscopically normal. PMID- 3653397 TI - A new 5'-non-coding region for human placental insulin-like growth factor II mRNA expression. AB - A human placenta cDNA library was screened for insulin-like growth factor II (IGF II). Four clones were selected, which exhibited an IGF-II cDNA coding sequence identical to those previously described for human adult liver IGF-II cDNA. Extensive sequence diversity was observed in the 5'-non-coding region, probably resulting from differential intron splicing. PMID- 3653399 TI - Inactivation of the catecholamine transporter during the preparation of chromaffin granule membrane 'ghosts'. AB - The activity of the catecholamine transporter of chromaffin granules and the binding to these vesicles of reserpine, a transporter inhibitor, decrease during ghost preparation. In contrast, the number of binding sites of dihydrotetrabenazine, another transporter ligand, is constant. Dihydrotetrabenazine thus binds to an inactive transporter whereas reserpine binds only to active vesicles. Inactivation occurs during lysis of the granules, possibly because of an incomplete resealing. The turnover number of the transporter, determined by dividing the uptake activity by the density of dihydrotetrabenazine binding sites, has a maximal value (140 molecules/min) in intact granules. The reserpine to dihydrotetrabenazine binding ratio (10-25%) is an estimate of the proportion of correctly resealed vesicles. PMID- 3653400 TI - Developmental changes in the lateral diffusion of Leydig cell membranes measured by the FRAP method. AB - A simple method for isolation and fluorescence labelling of Leydig cells (L cells) from rat testes was developed. Lateral diffusion coefficients of both lipid and protein membrane fluorescent probes were measured by the method of fluorescence recovery after photobleaching (FRAP). Age-dependent changes in diffusibility of membrane lipids and proteins were discovered. PMID- 3653401 TI - Effects of substitution of putative transmembrane segments on nicotinic acetylcholine receptor function. AB - Mutants of the Torpedo nicotinic acetylcholine receptor in which each of the putative transmembrane segments of the alpha-subunit is replaced by the hydrophobic transmembrane segment of the vesicular stomatitis virus glycoprotein or of the human interleukin-2 receptor have been produced in Xenopus oocytes by cDNA manipulations. Functional analysis of these mutants shows that the hydrophobic segment M4 can be replaced by foreign transmembrane sequences without loss of channel activity. It is also suggested that the hydrophobic segments M1, M2 and M3 and the amphipathic segment MA are important for efficient expression of the acetylcholine receptor on the cell surface and that the specific amino acid sequence of segment M2 may be involved in channel activity. PMID- 3653402 TI - Primary structure of alpha-bungarotoxin. Six amino acid residues differ from the previously reported sequence. AB - alpha-Bungarotoxin (alpha-BuTx) was isolated from the venom of the Formosan banded krait (Bungarus multicinctus). The amino acid sequence was determined by a combination of conventional methods. In contrast to the sequence of alpha-BuTx reported by Mebs et al. ([1971) Biochem. Biophys. Res. Commun. 44, 711-716], our results revealed the presence of Ser-Pro-Ile, Pro-His and Gln-Arg at positions 9 11, 67-68 and 71-72 from the amino-terminal, respectively, and not Ile-Pro-Ser, His-Pro and Arg-Gln as reported previously. PMID- 3653403 TI - Amino acid sequence of a 32-residue region around the thiol ester site in duck ovostatin. AB - To obtain the amino acid sequence at the thiol ester site in duck ovostatin for comparisons with other proteins, the native ovostatin was labeled with 14CH3NH2 at the reactive thiol ester site. The modified protein was reduced, carboxymethylated, and digested with trypsin. 14C-labeled peptides isolated by gel filtration with Sephadex G-50, ion-exchange chromatography on DEAE-cellulose and HPLC were subjected to automated sequence analysis, and the stretch of 32 amino acid residues containing the 14CH3NH2-binding site were determined. A comparison of this sequence with the corresponding sequences in alpha 2 macroglobulin, and complement components C3 and C4 revealed 72, 31 and 34% homology, respectively. The results indicate that ovostatin is a close relative to plasma alpha-macroglobulins and may share a common ancestor with C3 and C4. PMID- 3653404 TI - Mitochondrial aldehyde dehydrogenase. Homology of putative targeting sequence to that of carbamyl phosphate synthetase I revealed by correlation of cDNA and protein data. AB - Comparison of existing protein and cDNA data for human liver mitochondrial aldehyde dehydrogenase reveals deviations in two segments. They are shown to correspond exactly to localized frameshifts in the cDNA data, which are likely to have three reading errors. After correction of the cDNA frameshifts, a deduced amino acid sequence corresponds exactly to the data established at the protein level. In addition, extension of the shifted frame into the cDNA corresponding to the mitochondrial leader sequence allows reinterpretation of that sequence. The new leader sequence is consistent with characteristics of such segments of other mitochondrial protein pro-forms. Furthermore, the sequence displays a homology, when centered around the cleavage site, with the leader sequence of rat liver carbamyl phosphate synthetase I, suggesting a novel similarity between mitochondrial targeting sequences of two different enzymes. PMID- 3653405 TI - Acetylated N-terminal structures of class III alcohol dehydrogenases. Differences among the three enzyme classes. AB - The protein chains of mammalian alcohol dehydrogenases typically lack free alpha amino groups. The blocked N-terminal regions of the class III type of the rat (ADH-2), human (chi chi) and horse enzymes were isolated by digestions with proteases, and characterized by mass-spectrometry supplemented with chemical analysis of the peptides and their redigestion fragments. Results were confirmed by synthesis of the corresponding peptides, followed by chromatographic comparisons of the native and synthetic products. The N-terminal regions of the three class III alcohol dehydrogenase subunits are homologous but differ from the class I and II enzymes in both the exact start position and the amino acid sequence, which suggests that different N-terminal structures are typical for each of the three classes. PMID- 3653406 TI - Metabolic stability of the fucose in rat transferrin. AB - The metabolic behaviour of the chitobiose core fucose that is a natural constituent of a large proportion of rat transferrin molecules was studied in rats comparatively to that of the polypeptide portion of the glycoprotein by using appropriate labels ([3H]fucose and 125I) and affinity chromatographic techniques (lentil-Sepharose). No evidence was obtained to suggest that this residue is cleaved from the glycan in significant amounts before removal of the entire glycoprotein for catabolism. Similarly, [14C]fucose linked to GlcNAc residues in the antennae of human asialotransferrin was being eliminated in pigeons at the same rate as the polypeptide itself. It is concluded that in spite of transferrin's exposure to the cellular milieu, the fate of its fucose is distinctly different from that of the same in plasma membrane glycoproteins. PMID- 3653407 TI - The 3'-orf protein of human immunodeficiency virus 2 shows sequence homology with the bel3 gene of the human spumaretrovirus. AB - The primary amino acid sequence within a domain of 89 residues of the central part of the 3'-orf protein (p27 3'-orf) of human immunodeficiency virus (HIV-2) shares homology with the middle and carboxy-terminal portion of the bel3 gene product of human spumaretrovirus (HSRV). In addition, a limited region of the tat protein of HIV-2 but not HIV-1 shows a 28% degree of homology to the deduced protein sequence of the bel1 gene product of HSRV. Comparison between the viral sequences suggests that the 3'-orf and bel1 gene product of HSRV could serve similar functions to those in HIV-2. PMID- 3653408 TI - Protein kinase C and cAMP-dependent protein kinase induce opposite effects on actin polymerizability. AB - Protein kinase C phosphorylated muscle and non-muscle monomeric actin more efficiently than filamentous actin in vitro. By sedimentation assay, the ratio of phosphorylated to unphosphorylated actin was much higher in sedimentable actin than in the non-sedimentable form, suggesting that phosphorylated actin was more readily incorporated into F-actin than unphosphorylated actin. In contrast, actin phosphorylated by cAMP-dependent protein kinase was found to have weaker polymerizability than the unphosphorylated form. The phosphopeptide mapping pattern of actin phosphorylated by protein kinase C was different from that of actin phosphorylated by cAMP-dependent protein kinase. Thus, both the protein kinases phosphorylate actin differently and induce opposite effects on actin polymerizability. PMID- 3653409 TI - Cytoskeletal protein synthesis and organization in cultured mouse osteoblastic cells. Effects of cell density. AB - The most abundant cytoskeletal proteins synthesized in mouse endosteal osteoblastic cells were identified employing two-dimensional polyacrylamide gel electrophoresis and immunoblotting. The relative rate of synthesis of the proteins were measured on radioautograms of detergent-soluble and -insoluble lysates of the cells labeled with [35S]methionine. Doubling initial cell density induced a 10-45% reduction in the de novo synthesis of actin, alpha-actinin, vimentin and beta-tubulins with no change in alpha-tubulins. Increasing cell density caused a 45% decrease in the polymerized form a actin with no change in the unpolymerized fraction, suggesting a correlation of alteration of the organization and synthesis of proteins. PMID- 3653410 TI - Histone acetyltransferase activity during the cell cycle. AB - Histone acetyltransferase activity was measured in isolated nuclei during the synchronous cell cycle of the myxomycete Physarum polycephalum. Nuclei were incubated with [14C]acetyl-coenzyme A and an excess of exogenous calf thymus histones. The activity is periodic during the cell cycle; it rises during the S phase to reach a maximum in the early G2-period with a decline in mid and late G2. Comparison of the pattern of enzyme activity with the in vivo acetylation of histones during the cell cycle reveals that the enzyme activity does not wholly determine the acetylation state, indicating that other factors, including possibly the structural state of chromatin, are responsible for the observed cell cycle pattern of in vivo histone acetylation. PMID- 3653411 TI - Inhibition of insect juvenile hormone synthesis by phorbol 12-myristate 13 acetate. AB - The synthesis of insect juvenile hormone III (JH III) by isolated corpora allata of the cockroach Diploptera punctata incubated in vitro is inhibited by phorbol 12-myristate 13-acetate (PMA), phorbol 12,13-dibutyrate and 1-oleyl-2 acetylglycerol. 4 alpha-Phorbol 12,13-didecanoate and diolein are inactive. The inhibitory effect of phorbol 12-myristate 13-acetate is fully reversed by 2E,6E farnesol or by 2E,6E-farnesoic acid. It is highest in corpora allata that are past their peak in secretory activity or that have been inhibited by injections of 20-hydroxyecdysone. This effect of phorbol esters implicates protein kinase C in the regulation of insect corpus allatum activity. PMID- 3653412 TI - The cell-free interaction between chromaffin granules and plasma membranes: an in vitro model for exocytosis? PMID- 3653413 TI - Prolactin secretion and menstrual function after long-term bromocriptine treatment. AB - Long-term bromocriptine treatment was discontinued in 75 hyperprolactinemic women. Bromocriptine had been given for up to 65 months (median, 24 months). Treatment was reinstituted in 42 women (56%) after 1 to 3 months, mainly because of increasing prolactin levels. Thirty-three women (44%) were followed up for 6 months or more without treatment. Menstrual bleeding occurred in 19 of the 33 women (58%) after 6 months without treatment. The mean prolactin concentration in this group had decreased more than 60% compared with pretherapy concentrations. In 18 of the 42 women who had bromocriptine therapy again, treatment was discontinued a second time. Six of these patients have regular menstrual bleeding. Long-term bromocriptine treatment seems to induce long-standing normalization of prolactin secretion in patients with hyperprolactinemia. PMID- 3653414 TI - The effect of the ergoline derivative, CU 32-085, on prolactin secretion in hyperprolactinemic women. AB - Twelve hyperprolactinemic women were administered the alpha aminoergoline derivative, CU 32-085 (Sandoz, Inc., East Hanover, NJ), in order to determine its effect on prolactin (PRL) secretion. The mean pretreatment serum PRL level was 145.0 +/- 11.5 ng/ml. Significant declines of serum PRL occurred with total daily doses of CU 32-085 of 0.1 to 0.5 mg (P less than 0.001). The magnitude of response to therapy was dose-related. In six patients, PRL levels were reduced to less than 25 ng/ml; this effect lasted at least 24 hours after intake of a single dose. In the other six patients, the response was less dramatic. No subjects developed adverse cardiovascular side effects. The results of this study demonstrate that CU 32-085 exhibits a clinically significant dopaminomimetic action on PRL secretion in hyperprolactinemic women. PMID- 3653416 TI - Mature and immature oocytes in large and medium follicles after clomiphene citrate and human menopausal gonadotropin stimulation without human chorionic gonadotropin. AB - After ovarian stimulation with clomiphene citrate combined with human menopausal gonadotropin, 24 large (greater than 16 mm) and 16 medium (7 to 15 mm) human follicles were classified according to plasmatic estradiol (E2), luteinizing hormone (LH), and histology of the follicle and oocytes (in thin sections). An asynchronism of several hours between the stage of development of the largest and large cohort follicles is observed; overripeness of oocyte cumulus complex (OCC) is revealed. An asynchronous response to gonadotropins in granulosa and cumulus is also seen in the cohort of medium follicles of the same ovary, but not resumption of nuclear maturation of the oocyte. The efficiency of these oocytes after fertilization is discussed. PMID- 3653417 TI - The role of gamete intrafallopian transfer (GIFT) in the treatment of oligospermic infertility. AB - Gamete intrafallopian transfer (GIFT) was used to treat 32 couples where the male partner was oligospermic (less than 12 X 10(6) motile spermatozoa per milliliter of semen). Initially, 100,000 motile spermatozoa were transferred per fallopian tube and no pregnancies were achieved in 11 cases. The technique was then modified so that a maximal number of motile spermatozoa were transferred (range, 0.11 to 0.90 X 10(6) spermatozoa) and 6 of 21 (29%) pregnancies resulted, with 325,000 spermatozoa being the lowest number associated with pregnancy. It appears that the modified GIFT technique, whereby an increased number of motile spermatozoa are replaced with the oocytes, is an effective therapy in the treatment of oligospermic infertility. PMID- 3653415 TI - Early pregnancy termination with antiprogestins: a comparative clinical study of RU 486 given in two dose regimens and Epostane. AB - Mifepristone, (RU 486, Roussel Uclaf, Romainville, France), a progesterone (P) receptor blocking agent, and Epostane, (WIN 32,729, Sterling-Winthrop, Guildford, United Kingdom), a P synthesis inhibitor, were compared for their ability to terminate early human pregnancy. Seventy-eight healthy women, with a gestational length of less than 49 days from the last menstrual period and who requested termination of pregnancy, were recruited to the study. The patients were randomly allocated to three treatment regimens: (1) Mifepristone 25 mg bid for 7 days; (2) Mifepristone 50 mg bid for 7 days; and (3) Epostane 200 mg qid for 7 days. The results of the study confirmed that both compounds are potent abortifacients in early human pregnancy. No difference in efficacy was seen between the two dose regimens of Mifepristone, which both resulted in 61% complete abortions. Seventy three percent aborted completely in the Epostane group. Subjective side effects, especially nausea, were more common in the women treated with Epostane, but no serious side effects were seen. PMID- 3653418 TI - The value of oocyte reinsemination in human in vitro fertilization. AB - The value of oocyte reinsemination in human in vitro fertilization (IVF) was evaluated in this study. Two groups of 25 cycles each were studied. In group 1 cycles, insemination of mature/questionably mature oocytes (judged by cumulus and corona cell appearance) at 6.5 hours postcollection yielded a fertilization rate of 42.3%. This value was significantly lower than that obtained with reinsemination (70.8%). In group 2, questionably mature oocytes were treated as immature and inseminated 24 to 30 hours postcollection. The fertilization rate of mature eggs in group 2 was 68.2%, with a reinsemination success rate of 40%. Triploidy rates and cleavage rates of mature eggs, fertilized either at initial insemination or reinsemination and of fertilized immature eggs, were similar within group 1 and group 2 cycles. In group 1, two pregnancies resulted from transfer of embryos arising solely from successful reinsemination, with one infant delivered. These results indicate that reinsemination offers a useful adjunct for IVF in cases where fertilization failure occurs. PMID- 3653419 TI - The effect of polyploidy on embryo cleavage after in vitro fertilization in humans. AB - The effect of polyploidy on the early development of human embryos is unknown. This study compares the early development of 90 polyploid and 275 diploid human embryos conceived in vitro. Between May 1983 and January 1986, 3081 oocytes were recovered during 631 cycles of laparoscopy for in vitro fertilization (4.9 oocytes/cycle); 1924 oocytes (62.4%) fertilized. There were 90 oocytes with more than two pronuclei (4.7% of fertilized oocytes), identified in 72 cycles (11.4% of cycles). In these cycles, the proportion of diploid oocytes (n = 275) that cleaved (cleavage rate) (92.7%) was significantly greater than the proportion of polyploid oocytes (n = 90) that cleaved (65.5%) (P less than 0.001). The cleavage rate for all diploid oocytes (n = 1834) was 90.4%. There was no significant difference in the stage of development (number of blastomeres; mean +/- standard deviation [SD]) on the day of embryo transfer between diploid (4.3 +/- 2.1) and polyploid (4.1 +/- 2.1) embryos that cleaved, but a plot of the frequency distribution of cleavage stages revealed that significantly more polyploid than diploid embryos had an uneven number of blastomeres at that time (33% versus 8%, respectively; P less than 0.001). Polyploidy confers an immediate developmental disadvantage; one third of polyploid embryos fail to cleave, and those that do divide demonstrate more asynchronous divisions. PMID- 3653420 TI - Fertilization and cleavage rates of heparin-exposed human oocytes in vitro, and the effect of heparin on the acrosome reaction. AB - Fertilization and cleavage rates were compared in 1024 heparin-exposed and nonexposed human oocytes recovered from 183 consecutive in vitro fertilization (IVF) cycles. Heparinized Ham's F-10 medium, (Gibco, Grand Island, NY) 1.0 ml (2.0 mg heparin/ml) was added to bloody follicular fluid; clear follicular aspirates did not receive heparin. Fertilization and cleavage rates for heparin exposed (n = 714) and nonexposed (n = 310) oocytes were not significantly different: 63.9 versus 61.6% fertilized (chi 2 = 0.472); 89.3 versus 87.4% of fertilized eggs cleaved (chi 2 = 0.445). A subset of 100 patients, each contributing both heparin-exposed and nonexposed oocytes, also was evaluated. Fertilization and cleavage rates were not significantly different: 59.1 versus 60.8% fertilized (chi 2 = 0.192); 87.6 versus 87.2% of fertilized oocytes cleaved (chi 2 = 0.014). A modified triple stain was used to evaluate the acrosome reaction rate of sperm that had been coincubated with 76 oocytes from ten patients. There was no significant difference in the proportion of viable acrosome-reacted sperm following incubation with heparin-exposed (1.9 +/- 1.0%) versus nonexposed (2.3 +/- 1.2%) (mean +/- standard deviation [SD]) oocytes. The addition of heparin to follicular fluid at the time of oocyte recovery for IVF has no apparent effect on fertilization or cleavage in vitro, nor any influence on the acrosome reaction. PMID- 3653421 TI - Stress and semen quality in an in vitro fertilization program. AB - While a greater understanding is emerging of the psychological stresses of infertility treatment, little is known about the specific effects of these stresses upon the quality of the semen sample used at the fertilization stage in an in vitro fertilization and embryo transfer (IVF-ET) program. This study evaluated two semen profiles for each of 500 couples on IVF treatment. The first semen sample was collected in the couple's pre-IVF workup, and the second sample was given by husbands after ovum aspiration, and used to inseminate the eggs in vitro. Comparisons of samples revealed that sperm density, total sperm count, and both quantitative and qualitative sperm motility were significantly lower in the second sample presented for IVF. For 91% of cases, there was no change across samples in assigned fertility index categories. However, 14 cases revealed a deterioration, falling from normal to pathologic, while 21 cases changed in semen character from normal in IVF workup to severely pathologic in IVF treatment. For these cases, the incidence of total fertilization failure in the procedure also dramatically increased. Several steps are discussed in the better management of patients with such declines in semen quality. PMID- 3653423 TI - Semen quality before and after processing by a swim-up method: relationship to outcome of intrauterine insemination. AB - Twenty-five couples with normal semen analyses and postcoital tests of less than or equal to 3 motile sperm/high-power field were treated by intrauterine insemination (IUI) with sperm prepared by a swim-up method. Eight women conceived (32%). Influence of semen parameters both before and after swim-up, patient age, and duration of infertility on outcome of IUI was assessed with logistic discriminant analysis. The percent motility of sperm after swim-up allowed significant differentiation of pregnant and nonpregnant patients (P = 0.0009). For patients with greater than 79% motility after swim-up, discrimination provided by post-swim-up motility (P = 0.0063) was enhanced by inclusion in the analysis of either total number of motile sperm used for insemination (P = 0.0021) or sperm concentration after swim-up (P = 0.0019), Predictions of nonpregnancy and pregnancy were correct at rates of 93.3 and 70%, respectively. There were no significant differences between semen parameters of conception and nonconception cycles of patients who conceived. PMID- 3653422 TI - Fertilization of human oocytes by microinjection of a single spermatozoon under the zona pellucida. AB - The authors report a method of micromanipulation for the insertion of a single spermatozoon under the zona pellucida of human oocytes that results in a high rate of fertilization without damage to the oocyte. Spermatozoa were exposed to calcium-depleted medium containing strontium chloride for 20 to 24 hours before resuspension in medium containing calcium to induce capacitation. Single spermatozoa treated in this way were injected under the zona pellucida of morphologically mature oocytes and fertilization was confirmed by electron microscopy. Five of seven oocytes manipulated within 9 hours of aspiration from the follicle and 3 of 12 oocytes manipulated 23 to 28 hours after recovery from the follicle fertilized. This technique has profound implications for the possible treatment of severe male infertility. PMID- 3653424 TI - Dysplasia of the fibrous sheath: an ultrastructural defect of human spermatozoa associated with sperm immotility and primary sterility. AB - A study of a group of five patients presenting with primary sterility and showing severe sperm immotility is presented. Most spermatozoa in these patients showed rigid, short, thick, and/or irregular tails and 95 to 100% were immotile. Electron-microscopy disclosed a common pattern of flagellar abnormalities. There was a dysplastic development of the fibrous sheath, which appeared hyperplastic and disorganized. The axoneme was either missing or grossly distorted. In a few instances, a normal flagellum could be identified. Similar alterations also were detected in maturing spermatids, suggesting that the described defect develops during spermiogenesis. Two of the five patients had recurrent bronchial and sinusal infections and bronchiectasis, suggesting the possible existence of an associated abnormality in respiratory cilia. The existence of a common ultrastructural defect affecting most spermatozoa, its presence in two brothers, and the possibility of association with immotile respiratory cilia point to the existence of a syndrome (namely the "dysplasia of the fibrous sheath") of possible familial transmission. PMID- 3653426 TI - The effect of peritoneal macrophage incubates on the spermatozoa assay. AB - PFM have been implicated as a possible cause of infertility in endometriosis. Previous work from our laboratory has indicated that medium incubated with PFM caused a significant decrease in sperm penetration when added to the sperm penetration assay (SPA). To further delineate this finding, medium incubated with killed macrophages, heat-inactivated medium, and various concentrations of macrophage media were added to the SPA. Analysis of the data implied that there is a 1.536% decrease in penetration for every 1% increase in the concentration of PFM medium. Heat-inactivated medium and medium incubated with dead PFM both produced penetrations statistically different from the control. We conclude that medium incubated with PFM is capable of decreasing sperm penetration as measured in the SPA in a dose-dependent fashion. Furthermore, the substance responsible for this decrease appears to be heat-stable and released from dead as well as live macrophages. PMID- 3653425 TI - Monitoring follicular maturation through measurement of urinary estrogen excretion by latex agglutination inhibition reaction. AB - We evaluated the clinical utility of the MS 8601 kit, which is a new method of measurement of estrogens in urine. Changes in daily urinary estrogen excretion measured with the kit were highly correlated with that in daily serum E2. This kit was sensitive enough to detect the rises in estrogens in the follicular phase not only in women with normal menstrual cycle, but also in hMG-hCG treated patients. PMID- 3653427 TI - The effect of peritoneal fluid from patients with endometriosis on murine sperm oocyte interaction. AB - It has been demonstrated that PF contains some factor or factors that interfere with effective gamete interaction as determined by an in vitro animal assay. PF from patients with mild endometriosis has an increased activity of this substance and/or additional inhibitory factors. In endometriosis, this peritoneal fluid factor or factors appear to be filterable and to a significant degree heat labile. This observation may be of importance in explaining subfertility associated with early stages of endometriosis. PMID- 3653428 TI - Peritoneal fluid and pregnancy occurrence. PMID- 3653429 TI - Smoking and seminal fluid index. PMID- 3653431 TI - The influence of age on some ocular basement membranes. AB - (1) Changes with age in the Young's modulus of elasticity of human lens capsule and Bruch's membrane have been determined. In lens capsule the modulus decreases with age whereas in Bruch's membrane it increases. (2) Changes with age in the hydraulic conductivity of the human lens capsule and Bruch's membrane have also been determined and again show opposite changes with age. In the former membrane the hydraulic conductivity increases while in the latter it decreases. (3) The ageing changes in the respective membranes indicate that, in man, some time after 100 years in all cases the lens capsule would have a similar hydraulic conductivity to lenses with advanced cataract, while in the same subject Bruch's membrane would have lost its permeability to water. PMID- 3653430 TI - Cerebral ageing. PMID- 3653432 TI - Physiological changes in the cornea of the ageing eye. AB - Donor human corneas were studied in vitro for the viability of their endothelia. Endothelial ionic permeability (measured by electrical conductivity) and bicarbonate pump activity (measured by short circuit current) were recorded. Paired corneas were used to monitor post-mortem deterioration times and drug therapy immediately prior to death noted, when possible, to identify any possible effect on tissue performance. Donor age was correlated with some loss of endothelial pump capability. In adults it seems that pump capability deteriorates with a half time decay of 72 years (correlation coefficient, 0.69). Typically, between 60 and 90 years, endothelial pump capability may drop from 32 mu amps.cm 2 to 22 mu amps.cm-2, although at any particular age, the natural variation is +/ 6 mu amps.cm-2. Over the same period, endothelial permeability does not deteriorate and there is a suggestion that the endothelial cells may even tighten up with ageing, thereby partially compensating for the suggested ageing diminution in metabolic pump capability. There is no obvious age threshold for endothelial deterioration. The use of paired corneas revealed a 50 per cent loss in endothelial barrier function per 4.8 days of storage, and less than 5 per cent loss of pump capability over a similar period. The eyes were stored whole in a moist chamber at 0-4 degrees C. A significant group of donor eyes had a markedly reduced pump capability which was not age related. The patients had had terminal drug treatments which included digoxin and furosemide. PMID- 3653433 TI - Age-related changes of the corneal endothelium and stroma as seen in vivo by specular microscopy. AB - Two age-related changes of the human cornea are revealed in vivo by specular microscopy, (1) loss (and enlargement) of endothelial cells and (2) wrinkling of the posterior corneal layers when the cornea is applanated. A comparison of the rate of loss of cells and the effect upon the morphology of the endothelium as determined in several studies, indicates that cell loss and enlargement are rapid in the first year of life, slower up to the age of about 25 years, and fairly stable thereafter. In some individuals the remaining cells appear to enlarge regularly and in others irregularly. Posterior wrinkles on applanation of the cornea occur in the adult cornea only, and suggest an increasing rigidity of the stroma with increasing age. PMID- 3653434 TI - Age-related depletion of the cell population in the human trabecular meshwork. AB - The number of cells in the human trabecular meshwork was assessed for counting meshwork cell nuclei in semithin Araldite sections cut in the meridonal plane. The counts of nuclei decreased with increasing age and the decrease was associated with all regions of the meshwork. The appropriate regression equation and a mean length for meshwork nuclei was used to estimate cell numbers. At 20 years of age the estimated cell number for the whole meshwork was 763,000 which decreased to 403,000 cells by 80 years with a loss rate of 6,000 cells per year. PMID- 3653435 TI - Senescent vision: is it all the fault of the lens? AB - Visual decrement correlated with age is often attributed to a progressive deterioration in the optical quality of the ocular media, notably the crystalline lens. Experimental evidence is presented to test the extent to which this hypothesis can be sustained. Recent data on lenticular scatter are shown to be useful in the visualisation and photography of cataract in man. PMID- 3653436 TI - The effect of light on the lens related to age. PMID- 3653437 TI - The ageing retina: physiology or pathology. AB - The human retina is a unique component of the nervous system in that throughout life it is continuously exposed to optical radiation between 400 and 1400 nm. The physiology of the ageing retina and the regression in visual performance with age cannot therefore be studied in isolation, or discriminated, from the life long cumulative effects of radiant exposure. This paper describes the spectrum of age related changes in the retina as they merge imperceptibly between declining visual function and overt pathology. PMID- 3653438 TI - Ageing and the spatiotemporal discrimination performance of the visual system. AB - Visual ageing is generally associated with a decline in spatial vision for stationary stimuli, especially those which are of high spatial frequency. Some, but probably not all of this loss can be attributed to apparently normal age related changes in the ocular media that attenuate and scatter incident light. The loss in the temporal resolving capacity of the senescent visual system is even more prominent and appears to be due almost completely to neural mechanisms, including alterations in the functioning of both the 'transient' and 'sustained' types of visual channel. The losses with age in both spatial and temporal vision are highly consistent with the type and degree of visual problems elderly persons report that they experience in carrying out daily tasks. Further research will be needed to determine the mechanisms which underlie these changes as well as to determine the degree to which they can be remedied. PMID- 3653439 TI - Epidemiology of eye disease in the elderly. AB - Most of the estimated 40 million blind individuals in the world are in the older age groups. Data on blindness and visual impairment are primarily from blindness registries and prevalence surveys in different countries throughout the world. The quality of these data vary tremendously from one country to another, and comparability of the results from different studies is difficult. However, all studies indicate an increase in the prevalence of visual loss and blindness with increasing age. Cataract is the most prevalent eye disease in the world and is a major cause of visual loss in developing as well as in developed countries. Other major eye diseases in the elderly include age related macular degeneration, glaucoma, and diabetic retinopathy. A number of risk factors have been suggested for cataract, age related macular degeneration, and glaucoma, yet few have been well established. Certain factors for these conditions are similar, including age, hypertension, prolonged exposure to sunlight, and nutritional factors such as Vitamin E. Epidemiologic studies are needed to define the risk factors for these different eye diseases with the goal of decreasing risk of disease and possible disease prevention, as well as developing better estimates of the magnitude of the problems of visual loss and eye diseases in the elderly. PMID- 3653440 TI - 50th Bowman lecture. 'Blood is thicker than water'. Some haemorheological aspects of ocular disease. PMID- 3653441 TI - Retinopathy of prematurity in the United Kingdom. AB - Retinopathy of prematurity (ROP) continues to be a problem for some preterm infants who survive the neonatal period. We review changes which have occurred in the premature infant population and methods of ophthalmological examination since the last survey of ROP in the United Kingdom was conducted between 1951 and 1953. We have analysed data from a retrospective study, and from our current prospective survey of ROP in the East Midlands, to determine the age at onset of acute ROP. The results show that the ophthalmoscopically visible signs of ROP develop over a narrow postmenstrual age range suggesting that acute ROP occurs only after the retina and/or its vasculature have reached a certain stage of development. PMID- 3653442 TI - Videofluoroscopy in macular disease. AB - Fluorescein Angiography has contributed immensely to our understanding and management of macular disease. Ridley first introduced the concept of television ophthalmoscopy and in 1973 Van Heuven and Schaffer reported the value of videofluoroscopy using a low light level system and an image intensifier. Major advances in electronic imaging technology since then have permitted high quality videofluoroscopy to be developed in particular the integral silicone intensified tube (SIT) allowed ultra low light levels to be recorded. A videofluorography system has been in routine use in our department for the last six years and we have found it to have certain advantages over conventional photography in macular disease. In this presentation we demonstrate some of these. PMID- 3653443 TI - Aiming criteria for neodymium-YAG laser trabeculotomy. A clinico-pathological study. AB - Recently reported clinical and experimental studies have shown that pulsed neodymium-YAG laser trabeculotomy may reduce intraocular pressure but not in all cases. We report a clinico-pathological study designed to delineate the aiming criteria required to produce a fistula between the anterior chamber and the canal of Schlemm. In summary, the aiming beam must be centred on the reflecting surface of the gonioscopic contact lens, and aimed at the posterior trabecular meshwork. This study also indicates that the energy levels required to produce a discrete trabeculotomy in vivo are similar to those determined by in vitro studies. PMID- 3653444 TI - The shape factor in radial keratotomy. AB - The corneal contour as defined by the shape factor was found by photokeratoscopy both before and after radial keratotomy to reduce myopia. In 51 eyes with mean pre-operative myopia of -5.67 DS there was a mean reduction of -5.23 DS, and the shape factor became negative in all cases. A relationship was found between the pre-operative myopia and the shape factor, and the size of optical zone to be left untouched when attempting to achieve emmetropia. The importance of taking shape factor into account when forming the surgical plan was made apparent by retrospective study of the surgery performed. PMID- 3653445 TI - The epidemiology of herpes zoster. AB - The epidemiology of Zoster is analysed by means of data acquired from the Zoster Clinic at Moorfields and the RCGP Research Unit. It complements and extends previous surveys, using much larger and consistent data, showing the effects of age, sex and season. The behaviour in the population as a whole and the pathogenesis are discussed; a model is proposed to explain the characteristics of some of the data, particularly the effects of age and non-specific stresses. PMID- 3653446 TI - Ocular injuries associated with the use of airguns. AB - Sixty patients with eye injuries resulting from the use of airguns were admitted to a large eye hospital over an 11-year period. The typical patient was a young male teenager; 70 per cent of patients were under the age of 17, the age at which it is legally permissible to own an air weapon. In 4 cases the missile lodged in the ocular adnexae, in 18 cases there was a penetrating eye injury and in 38 patients blunt nonpenetrating eye injury. The prognosis for visual recovery was poor especially following penetration of the globe; visual acuity was reduced to 6/60 or less in 40 per cent of all eyes and in 18 per cent the injured eye was excised. PMID- 3653447 TI - Removal of rust rings, comparing electric drill and hypodermic needle. PMID- 3653448 TI - Brown FK and the colouring of smoked fish--a risk-benefit analysis. AB - A risk-benefit analysis of using Brown FK to colour smoked fish is presented with reference to the available toxicological information. Both the application of the dye itself and the process of smoking can result in the presence in the food of potentially toxic compounds. However, at present it is impossible to ascertain whether or not the use of the dye causes an overall decrease in the levels of such compounds due to the corresponding reduction in the severity of smoking. Recommendations are made for further investigations the results of which will facilitate an appraisal of the possible hazards of adding Brown FK to fish prior to smoking. PMID- 3653449 TI - In vivo determination of the caloric value of gum arabic in the male rat- biological data. AB - Sprague-Dawley male rats were given normal diets (UAR A 03) containing various amounts of gum arabic, sucrose and lignin for eight consecutive weeks. The caloric values of the diets were derived by utilizing the indirect method comparing the slopes from food consumption and weight gain curves. While the data obtained from sucrose diets showed that these diets caused a clear incremental effect on energy production with respect to both test animals and controls, and data from lignin diets were found to produce a negative effect on energy yields, gum arabic diets produced results indicating that at certain levels of intake, gum arabic may contribute energy values slightly superior to those of lignin (0 cal-g), possibly between zero and 1 cal/g. However, it was not found possible to attribute a clear-cut quantitative caloric value to this additive from data obtained in this study. PMID- 3653450 TI - Migration from food contact plastics. Part I. Establishment and aims of the PIRA project. AB - In the European Community regulatory approaches adopted by individual Member States to the control of food contact plastics differ markedly and, as a result, the European Commission has identified a need for harmonized legislation in this sector. The Commission requested its Scientific Committee for Food to advise on the toxicity of monomers and other starting substances used in the production of such plastics and the Committee's report has recently been published. It is apparent that, although some monomers have been studied in depth, for many little or no information was available to the Committee on either the levels migrating into food or their likely toxic effects. The Committee has requested that such information be provided within 3 years. Following discussions between the UK Ministry of Agriculture, Fisheries and Food, PIRA and companies involved in either the manufacture or use of food contact plastics, a Project has been established at PIRA to develop sensitive analytical procedures for the relevant UK-required monomers and to provide the required migration data. As a second part to this project the methodology for determining overall migration is being examined with a view to resolving existing experimental difficulties. The first analytical methods to be developed in the project are those for the determination or terephthalic acid and isophthalic acid. Residual levels of these monomers in plastics and the quantities migrating into food simulants and food have been shown to be very low. PMID- 3653452 TI - The occurrence of aflatoxins in peanuts imported into Czechoslovakia for human consumption. AB - Results of 492 analyses for aflatoxin in raw shelled peanuts imported into Czechoslovakia during 1982-1984 are presented. Most samples (55.3%) had aflatoxin content less than the detection limit of the radioimmunochemical screening method (0.8 micrograms/kg). Further analyses showed that 239 out of 410 samples of roasted peanuts contained aflatoxin below the detection limit. Only 1.9% of all peanut samples were found to have contamination level more than 5 micrograms/kg aflatoxin. The highest levels of aflatoxin observed were in a raw peanut sample containing 202.1 micrograms/kg and in a roasted peanut sample containing 32.6 micrograms/kg. PMID- 3653451 TI - The simultaneous determination of diacetoxyscirpenol and T-2 toxin in fungal cultures and grain samples by capillary gas chromatography. AB - A method for the quantitative determination of the toxic fungal products diacetoxyscirpenol and T-2 toxin is described. Initially intended for the screening of fungal cultures grown on maize, it has subsequently been used successfully for the analysis of maize and oat grain samples. The method involves extraction with aqueous methanol followed by a two-stage clean-up procedure utilizing a commercial kieselguhr column and a silica gel cartridge. The heptafluorobutyryl derivatives of the trichothecenes, including neosolaniol monoacetate used as an internal standard, are separated on a 25 m X 0.32 mm SE-30 fused silica capillary column and measured with a 63Ni electron capture detector. The quantitative detection limit was found to be of the order of 200 ng/g (ppb) with an average recovery from maize of 88% for both toxins. The method was found to be rapid and practical with the advantage that the kieselguhr packing material could be easily regenerated and re-used. The method was compared with those reported in the literature which are currently in use. PMID- 3653453 TI - Oxytetracycline residues in rainbow trout analysed by a rapid HPLC method. AB - A rapid and sensitive HPLC method was developed for the determination of oxytetracycline in fish tissues (muscle and liver) based on a clean-up and concentration procedure on Sep-Pak C18. At a coastal fishfarm rainbow trout (Salmo gairdneri) suffering from Vibrio anguillarum were treated with 75 mg oxytetracycline per kg fish and day for ten days. Oxytetracycline residues above the limit of determination (0.005 micrograms/g) were found in fish 82 days after treatment. The recoveries from spiked tissues were about 60% and 70% for muscle and liver, respectively. PMID- 3653454 TI - Excretion of oxytetracycline in eggs after medication of laying hens. AB - The kinetics of oxytetracycline elimination into eggs were determined separately for albumen and yolk after oral administration through either drinking water (0.1 0.25 and 0.5 g/l for 5 days) or feed (300 and 600 ppm for 7 days) or after intramuscular injections (3 X 15 mg/kg body weight and 3 X 30 mg/kg body weight), 24 hours apart. Residues were assayed by a microbiological agar diffusion method, with Bacillus cereus as test-organism. The detection threshold was 0.07 micrograms/g for albumen and 0.2 micrograms/g for yolk. In all cases, the elimination period lasted longer for the yolk; it varied between 0 and 10 days after treatment was discontinued, according to administration routes and dosages. The conditions of oxytetracycline utilization in laying hens are discussed. The oral route only might be used to adhere to the proposals presented by the Joint FAO/WHO Expert Committee on Food Additives. PMID- 3653455 TI - Lead, chromium, tin, iron and cadmium in foods in welded cans. AB - The levels of lead, chromium, tin, iron and cadmium in fruit and vegetables in welded tinplate cans were determined by atomic absorption spectrophotometry. The levels found were compared with those in foods in soldered tinplate cans and fresh foods. The results show that the lead levels in foods in welded cans were much lower than those in similar foods in soldered cans. Foods in unlacquered welded cans contain much more lead, chromium and tin than foods in lacquered welded cans. The cadmium and iron levels in canned fruit and vegetables in welded cans were similar to those found in the corresponding fresh foods. PMID- 3653456 TI - [Functions of polymorphonuclear granulocytes in recurrent dermatomycoses]. PMID- 3653457 TI - [Status of diaper dermatitis in the eczema group]. PMID- 3653458 TI - Protection against long ultraviolet radiation: topical browning agents and a new outlook. PMID- 3653460 TI - Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis--the usefulness of home therapy. AB - Treatment of palmoplantar hyperhidrosis was carried out with a conventional galvanic generator in 40 patients and with a newly developed iontophoresis apparatus, which is suited for home treatment, in 31 patients. The new apparatus is operated by a rechargeable energy source or by batteries and is disconnected from the electrical net during treatment. It conforms to most recent safety regulations as approved by Underwriter's Laboratory. Hyperhidrosis was completely controlled after 10-12 treatments as revealed by quantitative gravimetric measurements of sweat rates and semiquantitative estimation of starch iodine paper imprints. There was no apparent difference in efficacy between the two apparatuses. Not only hyperhidrosis was abolished, but associated symptoms, such as lividity of palms or soles, acral hypothermia and edema of fingers or toes, also subsided. Skin temperature on palms rose from 29.7 +/- 1.8 degrees C before treatment to 32.2 +/- 1.4 degrees C thereafter. Maintenance treatment was continued on an average for 14 months, in 4 patients for more than 3 years. No loss of efficacy was found during that period. Side effects were minimal and depended upon amperage used. Only slight discomfort during treatment and mild short-lasted skin irritation were observed. Long-term side effects did not occur. PMID- 3653459 TI - Protection of photosensitized rats against long ultraviolet radiation by topical application of compounds with structures similar to that of dihydroxyacetone. AB - Dihydroxyacetone (DHA), a browning agent, protects photosensitive rats and humans against long ultraviolet radiation (UVA, 320-400 nm) and visible (blue) light. The photoprotective efficacy of DHA and structurally similar compounds was assessed as prevention of edema in the paws of psoralen-sensitized rats, after exposure to blacklight fluorescent lamps. Methylglyoxal produced a yellow-brown color and provided nearly the same protection as DHA, whereas monohydroxyacetone did not color the skin and afforded little or no protection. Glyceraldehyde provided a moderate amount of protection, which was enhanced by prior exposure of the agent to alkaline pH. A solution of 5-hydroxymethylfurfuraldehyde was yellow and provided minimal protection by staining the skin rather than browning it. We conclude that the ability to produce a brown color in skin is a useful criterion for screening compounds for photoprotective efficacy against UVA radiation. PMID- 3653461 TI - Dithranol: further investigations on the structure-activity-relationship. The new series of the 10-mono-alkyldithranol derivatives. AB - The in vitro stability of 10-ethyldithranol (1,8-dihydroxy-10-ethyl-9(10H) anthracenone) and its effects on healthy and psoriatic skin is investigated. 10 Ethyl-dithranol as a representative of the new class of 10-alkyldithranol derivatives neither stains nor irritates and has no antipsoriatic activity at all. This is due to the relatively stable substituent at carbon 10 which enables the fast oxidation processes necessary for the antipsoriatic effect. Therefore, antipsoriatically active dithranol derivatives require a free or easily liberated 10-position and hence the so-called 'minimum structure of antipsoriatic anthrones' keeps its validity. PMID- 3653462 TI - Two years of follow-up of oral ketoconazole therapy in 60 cases of pityriasis versicolor. AB - In a series of 60 patients (42 males, 18 females) with widespread lesions of pityriasis versicolor, 200 mg of oral ketoconazole was administered daily for a period of 24 days. Routine laboratory examinations, including microscopic and Wood's light examinations, were performed prior to initiation of treatment and twice during the treatment period as well as 3 and 6 months, and 1 and 2 years after completion of treatment. In 95% of the patients the clinical cure was maintained after 3 months but after 6 months it was still present in only 80% and after one year in only 57%. At the end of two years 60% showed relapse of the disorder. In 75% hypopigmented macules persisted after 6 months but without microscopic evidence of the fungus. No side effects were reported. It is evident that oral ketoconazole is effective in maintaining a clinical cure mainly during the first 3 months after treatment. The question as to whether side effects might appear with a more prolonged course of the drug should be given serious consideration before continuation of treatment is contemplated. PMID- 3653463 TI - Domoprednate, a new nonhalogenated topical steroid: comparison to hydrocortisone butyrate. AB - Thirty-nine patients with mainly psoriasis vulgaris and atopic dermatitis were treated for 4 weeks with 0.1% domoprednate and hydrocortisone butyrate ointment according to a right-left, randomized design. Various assessments of efficacy only revealed marginal, but statistically insignificant differences. Patients' preferences for one of the two treatment favored domoprednate in 20 cases and hydrocortisone butyrate in 12 cases; 6 cases were ties (p greater than 0.2). The efficacy of domoprednate, a new, nonhalogenated topical steroid, is evidently at least of the same order as that of the hydrocortisone butyrate, and the tolerance of the two ointments is equally good. PMID- 3653465 TI - Laser treatment of port wine stains. PMID- 3653464 TI - Single nodule on the glans penis: metastatic lesion from an unusual carcinoma of the prostate. AB - An inflammatory nodule developed on the glans penis of a 79-year-old man. Histological examination confirmed the diagnosis of metastasis from a carcinoma of the prostate. This case is of interest in view of the rarity of this metastatic localization and the very unusual microscopic pattern of the primary cancer (epidermoid carcinoma). PMID- 3653466 TI - Multiple sclerosis and autoimmune skin bullae: a case of pemphigus vulgaris. PMID- 3653467 TI - Methotrexate-induced liver cirrhosis. A follow-up. AB - Studies on serial liver biopsies from 25 patients with methotrexate-induced liver cirrhosis, taken from 1 to 13 years after cirrhosis was established, confirm that this type is not of aggressive nature. When evaluated blind no progression was found in most of the later biopsies. Alcohol and previous use of hepatotoxic drugs such as the combination of arsenics and vitamin A seem to have been contributing factors to cirrhosis formation. PMID- 3653469 TI - Extensive necrobiosis in metastatic Crohn's disease. AB - This report is on a 33-year-old female patient with Crohn's disease of the intestine and nonhealing leg ulcers which histologically showed the typical noncaseating epithelioid granulomas of sarcoid structure defining the so-called 'metastatic Crohn's disease'. Furthermore, as a very rare pattern, extensive necrobiotic areas surrounded by sarcoid granulomas were observed. PMID- 3653468 TI - Rapid response of transient acantholytic dermatosis to selenium sulfide treatment for pityriasis versicolor. AB - The observation of a 51-year-old male patient with transient acantholytic dermatosis (TAD) is briefly reported. The discrete eruption, composed of erythematous escoriated papules and papulovesicles, moderately itching, was located on the back and chest, more permanent during the summer season. The biopsy revealed suprabasal acantholysis and Darier-like elements. Lesions of pityriasis versicolor, confirmed by microscopic examination and fluorescence in Wood's light, were intermingled with TAD in the same patient. A topical treatment with selenium sulfide brought TAD lesions to the disappearance in 1 week. Comments are made in relation with the possibility of Malassezia furfur to induce acantholytic phenomena. PMID- 3653470 TI - New microsurgical concepts. Posterior and anterior segments. 20th anniversary meeting of the International Ophthalmic Microsurgery Group. Hamburg, September 16 20, 1986. PMID- 3653471 TI - Chemical and physical aspects of clinically applied silicones. AB - In conclusion, one can state that silicones are one of the most inert materials available for use in medical field today. They meet all the requirements for implants, summarized in table V, and can be considered as the ideal material for intraocular use, provided that the polymer is absolutely pure and free of any kind of residues. For silicone rubbers the following specifications have to be fulfilled: the material has to be free of reactive prepolymers and of catalyzers, the filler should be of the same chemical nature as the basic material and should be chemically bound to the backbone of the polymer, to avoid any kind of migration out of the polymer. For silicone oils, the following criteria are desirable: the oil has to be practically free of low molecular components, mainly cyclohexanes, the molecular weight distribution should be as small as possible and the oil should be free of catalysts. PMID- 3653472 TI - The Hanna radial microkeratome: presentation and first experiment. PMID- 3653473 TI - Management of melanomas of cornea and limbus. PMID- 3653474 TI - Fibrin adhesive in microsurgery of the anterior segment of the eye. PMID- 3653475 TI - Hydrodissection of the lens at surgery. PMID- 3653476 TI - Congenital glaucoma: long-term results of surgery. PMID- 3653477 TI - Q-switched Nd-YAG laser goniotomy in developmental glaucoma. PMID- 3653478 TI - Subscleral Scheie operation for advanced glaucoma. AB - The subscleral Scheie procedure is most effective in advanced glaucoma patients with IOP of 35 mm Hg or more and in those patients in need of a secondary or tertiary procedure. The surgical technique is described. PMID- 3653479 TI - Refixation of the ciliary body after traumatic cyclodialysis. AB - In 10 eyes a direct refixation of the ciliary muscle to the scleral sporn with many 10 X 0 nylon sutures very close to each other has been performed after a traumatic cyclodialysis. In all 10 eyes the intraocular pressure could be normalized between 12 and 18 mm Hg, the visual acuity recovered in all cases and the signs of ocular hypotony disappeared at the anterior and posterior segment. The follow-up ranged from 6 months to 4 1/2 years. The extent of cyclodialysis ranged from 30 to 120 degrees. In 5 eyes the direct cyclopexy was performed within 10 days after the traumatic cyclodialysis and in 5 eyes after 2-3 months, which was not important for the visual recovery. Intraoperatively no complications were seen and postoperatively in only 4 eyes a temporary increase of intraocular pressure was noted. PMID- 3653480 TI - Indications for Healon installation in microsurgery of complicated retinal detachments. PMID- 3653481 TI - Care of microsurgical instruments. PMID- 3653482 TI - Microsurgical techniques combined with vitrectomy in the treatment of retinal detachment. PMID- 3653483 TI - Retinal detachment in axial myopia. AB - A retrospective review of the complications of extracapsular cataract extraction in 127 cases followed between August 1980 and February 1985 is presented. The incidence of retinal detachment in eyes with axial length greater than 25.00 mm was found to be 9.59%, while no detachments occurred in eyes less than 25.00 mm. All of the patients with detached lenses were male. Extracapsular cataract extraction, an intact capsule, and placement of a posterior chamber lens do not prevent retinal detachment. A male with an axial length greater than 25.00 mm is more predisposed to develop a retinal detachment following cataract extraction and should therefore be counseled regarding the symptoms of retinal detachment and followed with careful ophthalmoscopy. PMID- 3653484 TI - Redefinition of high myopia: the relationship of axial length measurement to myopic pathology and its relevance to cataract surgery. AB - Owing to growing confusion over the true incidence of RD in HM after cataract surgery, a new definition for HM has been formulated based on measurement of axial length. Of 38 noncataractous phakic eyes with treated RD, 45% were found to have axial lengths more than 1 mm longer than would be expected from the eye's refraction. Of 180 moderate to highly myopic eyes examined 2 years after extracapsular extraction with lens implantation, 2 were found to have developed RD. Using the historic definition for HM by refraction (spectacle equivalent of 6.0 dptr or more), the incidence of RD was found to be 1/62 eyes (1.6%) but using the improved definition of axial length 26.5 mm or more, the incidence was found to be 2/49 eyes (4.1%). Both these studies suggested that axial length, in addition to myopic pathology, is a factor associated with RD and that a definition of HM based on axial length is more appropriate than that based on refraction. PMID- 3653486 TI - Preselectable intensity distribution in large-area laser coagulation by electronically controlled beam deflection. PMID- 3653485 TI - Microsurgery for retinal detachment repair. AB - Microsurgery for RD repair has brought about significant improvement in the management of easy RD as well as difficult and desperate cases. At present, prevention of severe PVR remains the only major problem in the management of rhegmatogenous RD. PMID- 3653487 TI - A new laser for ophthalmic surgery. PMID- 3653488 TI - A new laser for collagen wounding in corneal and strabismus surgery--a preliminary report. PMID- 3653489 TI - Integrated YAG laser microsurgical microscope. PMID- 3653490 TI - The economics of Ne-YAG laser treatment. PMID- 3653491 TI - Argon laser microsurgery of the lid. PMID- 3653493 TI - Lethal lung hypoplasia in infants after prolonged rupture of membranes. AB - A retrospective study to detect the frequency of lethal lung hypoplasia in 48 cases with prolonged rupture of membranes (greater than 7 days) before 34 weeks' gestation was made. Fourteen infants died (29%), but only four deaths (8.3%) were due to lung hypoplasia. Three infants with lung hypoplasia had their membranes ruptured before 20 weeks' gestation and showed echoscopically a persistent oligohydramnios, as did the one with rupture at 26 weeks. Neither the duration of rupture of membranes nor the gestational age at the time of rupture showed any influence on the occurrence of lung hypoplasia. The rupture of membranes before 20 weeks' gestational age with resulting persistent oligohydramnios will certainly lead to lung hypoplasia. PMID- 3653492 TI - Intrapartum fluid administration and sodium concentration in maternal and umbilical cord plasma. AB - Maternal and umbilical cord plasma sodium concentrations at delivery following routine labour ward management in uncomplicated pregnancies were studied. Three groups, each consisting of 16 patients, were recruited during labour. One group received 5% dextrose solution for administration of oxytocin. Another group received Hartmann's solution with epidural analgesia. The remaining group received no fluid (controls). There was no difference in the maternal and umbilical cord plasma sodium concentrations between patients who received 5% dextrose solution or Hartmann's solution and controls. Mild hyponatraemia (plasma sodium between 131 and 134 mmol/l) was common in all groups of mothers but severe hyponatraemia (less than 130 mmol/L) was rare. Similarly transplacental hyponatraemia was uncommon. There was no correlation between maternal plasma sodium concentration and the amount of fluid given. It was concluded that intravenous 5% dextrose solution and Hartmann's solution given during labour would not lead to significant hyponatraemia in the mother or fetus if the volume given was less than 0.6 litre. PMID- 3653494 TI - Secretion of cefoxitin in breast milk following short-term prophylactic administration in caesarean section. AB - In this study we investigated whether cefoxitin administered prophylactically to the mother in caesarean section could be demonstrated in breast milk. For this purpose 25 samples of breast milk were obtained from 18 patients to whom either 2 or a total of 4 g of cefoxitin had been administered during and following caesarean section. Cefoxitin was determined by means of a modified HPLC method and appeared demonstrable in only one case in a concentration of 0.9 micrograms/ml. On these grounds nursing need not be advised against when prophylactic cefoxitin is briefly administered to the mother during and following caesarean section. PMID- 3653495 TI - Insertion forces with intrauterine devices: implications for uterine perforation. AB - The force required to insert a Copper 7, Multiload Copper or Nova T IUD was measured in 197 successful and 25 unsuccessful insertion attempts. These forces were compared with the forces required to perforate freshly obtained uterine specimens with a metal uterine sound and Dalkon shield device, as well as with the clinically tested devices. The mean insertion forces for the Copper 7, Nova T and Multiload Copper devices were 1.502 N, 2.134 N and 4.041 N respectively, while the mean insertion pressures (N/mm2) were 0.203, 0.209 and 0.122 respectively. The mean in vitro fundal perforation forces with metal sounds was 20.7 N and with the Dalkon shield 31.6 N. The Copper 7, Multiload Copper and Nova T IUDs achieved mean in vitro forces of 5.75 N, 9.2 and 8.1 N respectively, without causing perforation. Primary uterine perforation at the time of insertion of these devices appears unlikely. PMID- 3653496 TI - Transient diabetes insipidus of pregnancy. AB - The history is presented of a near-term patient with transient diabetes insipidus. Because of the demonstrated positive response to dDAVP it is argued that increased vasopressinase activity may have been involved. PMID- 3653497 TI - Management of pregnancy in mothers with spina bifida. AB - Pregnancy complicated because of maternal spina bifida remains uncommon. With more aggressive surgical management in the 1960s these patients are now in adulthood and achieving pregnancies. In this series all four patients were delivered by caesarean section. As most patients have undergone extensive urological surgery great care is required at operation to avoid trauma to the urinary tract. PMID- 3653498 TI - Comparative efficacy of nicardipine hydrochloride and propranolol in the treatment of hypertension. AB - Nicardipine hydrochloride and propranolol were compared for antihypertensive efficacy and safety in a 14-week randomized, double-blind, crossover study. After taking placebo for 4 weeks, patients received either nicardipine (30 mg three times a day) or propranolol (40 mg three times a day) for 4 weeks, then placebo for 2 weeks and, finally, were crossed over to the alternative active medication for 4 weeks. Both drugs substantially reduced blood pressure. Statistically significant treatment effects favouring nicardipine were observed for supine and standing diastolic and systolic blood pressures. As expected, heart rate decreased significantly with propranolol, but not with nicardipine. Of the 33 patients evaluated for safety, 18 reported adverse experiences (two while taking placebo) that were assessed as probably related to the drugs under study. Symptoms related to vasodilation were reported more frequently during nicardipine treatment and respiratory complaints were more frequent in patients given propranolol. PMID- 3653499 TI - Tissue and serum concentrations of amoxycillin and clavulanic acid in patients having reconstructive vascular surgery. AB - Fifteen patients received amoxycillin/clavulanic acid combination intravenously at anaesthetic induction as part of a three-dose schedule of antibiotic prophylaxis for vascular surgery. After 30 min, the mean serum concentration of amoxycillin was 39.9 mg/l and clavulanic acid was 9.3 mg/l. Mean amoxycillin tissue concentrations in fat, 5.1 mg/l; vein, 7.5 mg/l; and artery, 4.8 mg/l, were lower than serum values. Mean clavulanic acid concentrations were: fat, 0.7 mg/l; vein, 1.2 mg/l; and artery, 1.6 mg/l. At the end of surgery, the serum amoxycillin level was always greater than 6 mg/l and clavulanic acid greater than 2 mg/l, which were both still within the therapeutic range. Concentrations in fat had declined by the end of the surgery ranging from 0.76 to 5.2 mg/l for amoxycillin and from 0.03 to 0.6 mg/l for clavulanic acid, there being almost none detected in four cases. Serum and tissue concentrations of both compounds 30 min after injection were sufficient to inhibit the growth of 97% of pathogenic organisms recovered from the skin of 135 vascular surgical patients. In a few cases tissue levels of the compounds were below inhibitory concentrations for coliforms and anaerobes at the time of skin closure, although they were still effective against most Gram-positive organisms. Amoxycillin/clavulanic acid combination is suitable antibiotic prophylaxis for vascular surgery. PMID- 3653500 TI - Efficacy of ribavirin aerosol treatment for respiratory syncytial virus bronchiolitis in infants. AB - The therapeutic efficacy of ribavirin, an anti-viral agent with a broad spectrum of activity, was studied in 14 infants with bronchiolitis which, in seven cases, was caused by a respiratory syncytial virus infection. The drug was administered for 5-6 days using an aerosol in periods of either 4 or 6 h with an interval of either 4 or 2 h between administrations. The body temperature of patients with fever returned to normal by day 3 of therapy. A significant decrease in the respiratory rate occurred by day 2 when there was also a marked improvement in the subjective and objective symptomatology. The most significant clinical improvements occurred in infants presenting a respiratory syncytial virus antigen in nasal wash specimens. This suggests therapeutic selectivity by ribavirin for (or a more pronounced sensibility of) this virus. PMID- 3653501 TI - Ciprofloxacin in the treatment of urinary tract infections. AB - Twenty patients (15 males; five females) aged 11-70 years, with urinary tract infections were treated with one 250 mg tablet of ciprofloxacin every 12 h for 5 10 days. Clinical response to this treatment was the complete disappearance of symptoms in 85% of cases and the elimination of the micro-organism responsible for infection. In only three patients, who all had urinary calculus in addition to an infection, clinical failure of the therapy occurred and the causative micro organism persisted. Tolerance to the therapy was excellent in this study, no adverse reactions connected with the treatment being reported. PMID- 3653502 TI - Effects of intravenous erythromycin lactobionate in respiratory infections. AB - The antibiotic erythromycin lactobionate given intravenously acts almost exclusively on Gram-positive bacteria. Even at high plasma and tissue concentrations there is an almost total absence of side-effects. It could be considered, therefore, as first choice in the treatment of patients with infectious respiratory diseases. Most of the 40 patients admitted to the present study were elderly and all had either acute or chronic and becoming acute respiratory disease. Their clinical symptoms and levels of phlogosis improved on treatment with erythromycin lactobionate without any interruption of therapy due to side-effects and toxicity. The absence of unfavourable pharmacological interactions further enhances the usefulness of the drug. In view of the excellent response to monotherapy with erythromycin lactobionate and the few groups of resistant bacteria found in those cases when it was possible to check, it was not considered necessary to investigate any synergistic association with other antibiotics. It can be concluded, therefore, that therapy with erythromycin lactobionate in patients with infective respiratory disease is favourable and patients show excellent tolerability. PMID- 3653503 TI - Peptide sequencing of the chick oviduct progesterone receptor form B. AB - The progesterone receptor form B has been isolated to apparent homogeneity from large scale preparations of laying hen oviduct cytosol. The quantities obtained were sufficient to monitor the separation of tryptic peptides on HPLC columns. Using a multi-dimensional microbore HPLC peptide purification protocol, several peptides were isolated in homogeneous form and sequenced up to 34 steps at the sub-40 pmol level using a gas phase sequenator. One of the peptides showed a striking homology with sequences of the putative steroid binding domain of the human glucocorticoid receptor; this region is also conserved in the human and chick estrogen receptor. PMID- 3653504 TI - Binding and action of glucocorticoids and mineralocorticoids in rabbit mammary gland. Exclusive participation of glucocorticoid type II receptors for stimulation of casein synthesis. AB - In order to ascertain whether the effect of corticoids upon casein synthesis in pregnant rabbit mammary gland culture is due to interactions with classical glucocorticoid or type I (mineralocorticoid) receptors we have demonstrated the existence of both types of receptors in the tissue and have studied the effects of aldosterone and the specific glucocorticoid agonist RU 28362 upon casein synthesis in tissue culture. Both compounds significantly stimulated prolactin induced casein synthesis. On dose-response studies RU 28362 proved to be as active as dexamethasone, cortisol was active at intermediate concentrations and aldosterone was the least active. The three glucocorticoids were able to stimulate DNA synthesis in the tissue, but aldosterone had no effect. Finally, RU 486, a potent glucocorticoid antagonist, blocked the action of aldosterone and the other corticoids upon casein synthesis, whereas spironolactone, a mineralocorticoid antagonist, was unable to do so. These results demonstrate that the stimulatory effect of corticoids upon casein synthesis in pregnant rabbit mammary tissue culture is mediated through classical (type II) glucocorticoid receptors. Transferrin accumulation in the tissue was not modified by any treatment, indicating that the action of the steroids was specific for casein, and not a general stimulation of protein synthesis. PMID- 3653505 TI - Detection of estrogen receptor mRNA in human uterus. AB - We transcribed a cDNA clone of the human estrogen receptor (ER) with T7 RNA polymerase. The 32P-cRNA transcript complementary to ER mRNA was hybridized to poly(A)+ RNA from human uterus and revealed a single band of approximately 4.2 kilobases. No hybridization was seen with the cRNA probe of the opposite orientation. Hybridization of total RNA from calf and rat uterus yielded a single band at approximately 3.8 kilobases for both species. Total RNA from rat spleen did not hybridize. A 35S-labeled cRNA probe was prepared for in situ hybridization of ER mRNA in human uterus and spleen. Autoradiographic signal was present over endometrial epithelium, stromal cells of the lamina propria, and smooth muscle cells of the myometrium but was absent from sections of spleen. The ER mRNA hybridization label was located over cytoplasm and nuclei of uterine target cells. PMID- 3653506 TI - Calcitonin induces ornithine decarboxylase in various rat tissues. AB - A single dose of synthetic salmon calcitonin administered to rats (20 MRC U/kg body weight) stimulated the activity of ornithine decarboxylase in the brain, liver, kidney, testis and ovaries by 3-, 15-, 5-, 2- and 2-fold respectively after 4 h of the treatment. The increase in the enzyme activity in the brain, testis and ovaries was accompanied by a comparable increase in the enzyme protein content. Hepatic and renal ornithine decarboxylase concentration increased only by 2-fold. These results suggest that calcitonin influences polyamine biosynthesis through a tissue-specific regulation of the activity and/or the number of ornithine decarboxylase molecules. PMID- 3653507 TI - Sequencing of cDNA inserts encoding aromatase cytochrome P-450 (P-450AROM). AB - Two cDNA inserts complementary to mRNA encoding aromatase cytochrome P-450 (P 450AROM) have been isolated and characterized by restriction mapping and sequencing. The overlapping sequence encoded by these inserts is identical, and a putative heme-binding region has been identified. In addition, the open reading frame contains the sequences of all four cysteine-containing tryptic peptides isolated by Chen et al. (1986) from purified cytochrome P-450AROM. The inserts differ in the use of alternative poly A-addition signals, which is consistent with the presence of two major species of mRNA in human placenta, of 3.0 and 2.4 kb, which hybridize to these inserts. The identity of sequence between the two inserts and the likely presence of alternative poly A-addition signals, is suggestive that only one form of cytochrome P-450AROM is encoded by these mRNA species. PMID- 3653508 TI - Proteoglycan metabolism associated with mouse metanephric development: morphologic and biochemical effects of beta-D-xyloside. AB - Morphology and de novo incorporation of [35S]sulfate into proteoglycans were studied in fetal mouse kidneys at the onset of organogenesis. Branching morphogenesis and nephron development in organ culture and in vivo were associated with de novo synthesis of chondroitin-SO4 and heparan-SO4 proteoglycans. The role of proteoglycan metabolism in metanephrogenesis was then studied by analysis of the effects of p-nitrophenyl-beta-D-xylopyranoside (beta-D xyloside) on renal development and proteoglycan metabolism. Incubation of fetal kidneys in beta-D-xyloside at concentrations of 1.0 and 0.5 mM, but not at 0.1 mM, caused inhibition of ureteric branching and markedly diminished synthesis of a large Mr 2.0 X 10(6) Da chondroitin-SO4 proteoglycan. Incorporation of [35S]sulfate was stimulated at all beta-D-xyloside concentrations, reflecting synthesis of xyloside initiated dermatan-35SO4 chains. In contrast to dramatic effects on chondroitin-SO4 synthesis and ureteric branching, beta-D-xyloside had no effect on heparan-SO4 synthesis or on development of the glomerulus and glomerular basement membrane. We thus characterize the proteoglycans synthesized early in the course of renal organogenesis and describe observations which suggest an association between metabolism of chondroitin-SO4 proteoglycan and development of the ureter. PMID- 3653509 TI - Junctions between lens cells in differentiating cultures: structure, formation, intercellular permeability, and junctional protein expression. AB - We previously described cultures of chick embryo lens cells which displayed a marked degree of differentiation. In this report, the junctions found between the lens fiber-like cells in the differentiated "lentoids" are characterized in several ways. Thin-section methods with electron microscopy first demonstrated that numerous, large junctions between lentoid cells accompanied the other differentiated features of these cells. Freeze-fracture techniques, including quantitative analysis, then revealed that (a) junctional particles were loosely arranged as is typical of fiber cells, (b) the population of individual junctional areas in culture was indistinguishable from that found in 10- to 12 day chick embryo lenses, and (c) apparent junction formation occurred during the development of the lens cells, with lacy arrays of particles being associated with fiber-like junctions. In addition, gap junctions with hexagonally packed particles, typical of lens epithelial cells, largely disappeared during the course of differentiation. Injection of tracer dyes into lentoid cells resulted in rapid intercellular movement of dye, consistent with functional cell-to-cell channels connecting lentoid cells. During the development of the lens cells in culture, as junction formation occurred, an increase of approximately eight-fold in MP28 protein was observed within the cells. These combined results indicate that (a) extensive lens fiber junctions and functional cell-to-cell channels are found between differentiated lentoid lentoid cells in vitro, (b) lens fiber junctions appear to form during the course of lens cell differentiation in culture, (c) a significant increase occurs in the putative junctional protein before the cultures are highly developed, (d) the increased levels of MP28 and junction formation may be required for the full expression of the differentiated state in the lens fiber cell, and (e) this culture system should prove to be valuable for additional experiments on lens junctions and for other studies requiring the development of lens fiber cells in vitro. PMID- 3653510 TI - Perturbation of cranial neural crest migration by the HNK-1 antibody. AB - The HNK-1 antibody recognizes a carbohydrate moiety that is shared by a family of cell adhesion molecules and is also present on the surface of migrating neural crest cells. Here, the effects of the HNK-1 antibody on neural crest cells were examined in vitro and in vivo. When the HNK-1 antibody was added to neural tube explants in tissue culture, neural crest cells detached from laminin substrates but were unaffected on fibronectin substrates. In order to examine the effects of the HNK-1 antibody in vivo, antibody was injected lateral to the mesencephalic neural tube at the onset of cranial neural crest migration. The injected antibody persisted for approximately 16 hr on the injected side of the embryo and appeared to be most prevalent on the surface of neural crest cells. Embryos fixed within the first 24 hr after injection of HNK-1 antibodies (either whole IgMs or small IgM fragments) showed one or more of the following abnormalities: (1) ectopic neural crest cells external to the neural tube, (2) an accumulation of neural crest cell volume on the lumen of the neural tube, (3) some neural tube anomalies, or (4) a reduction in the neural crest cell volume on the injected side. The ectopic cells and neural tube anomalies persisted in embryos fixed 2 days postinjection. Only embryos having 10 or less somites at the time of injection were affected, suggesting a limited period of sensitivity to the HNK-1 antibody. Control embryos injected with a nonspecific antibody or with a nonblocking antibody against the neural cell adhesion molecule (N-CAM) were unaffected. Previous experiments from this laboratory have demonstrated than an antibody against integrin, a fibronectin and laminin receptor caused defects qualitatively similar to those resulting from HNK-1 antibody injection (M. Bronner-Fraser, J. Cell Biol., 101, 610, 1985). Coinjection of the HNK-1 and integrin antibodies resulted in a greater percentage of affected embryos than with either antibody alone. The additive nature of the effects of the two antibodies suggests that they act at different sites. These results demonstrate that the HNK-1 antibody causes abnormalities in cranial neural crest migration, perhaps by perturbing interactions between neural crest cells and laminin substrates. PMID- 3653511 TI - Type X collagen synthesis by cultured chondrocytes derived from the permanent cartilaginous region of chick embryo sternum. AB - In the developing chick embryo sternum, type X collagen is synthesized by chondrocytes from the cephalic region (presumptive mineralization zone) but not by chondrocytes from the caudal region (permanent cartilaginous zone) (Gibson et al., 1984, J. Cell Biol. 99, 208-216). To distinguish between two possibilities, the presence of a nonpermissive microenvironment in the permanent cartilage or the intrinsic inability of caudal chondrocytes to become hypertrophic, type X producing cells, we have isolated chondrocytes from the caudal third of stage 44 chick embryo sterna and grown them in suspension on agarose-coated dishes. We have found that in these conditions chondrocytes from the caudal zone differentiate to hypertrophic chondrocytes and synthesize large amount of type X collagen, as revealed by the electrophoretic pattern of labeled proteins made in vitro and by slot blot analysis of mRNAs with specific cDNA probes. PMID- 3653512 TI - Developmental expression of crystallin genes: in situ hybridization reveals a differential localization of specific mRNAs. AB - The time and place of the accumulation of alpha A-, beta B1- and gamma-crystallin RNA in the developing rat lens have been studied by in situ hybridization. alpha A- and gamma-crystallin RNA were first detected in the lens vesicle, while beta B1-crystallin RNA could be seen only after elongation of the primary fiber cells. Both beta B1- and gamma-crystallin RNA were confined to the fiber cells of fetal lenses, while alpha A-crystallin mRNA could also be detected in the epithelial cells. A quantification of the hybridization pattern obtained in the differentiation zone of the newborn rat lens showed that alpha A-crystallin RNA is concentrated in the cortical zone. alpha B-crystallin mRNA has the same distribution pattern. beta B1-crystallin RNA was relatively poorly detectable by in situ hybridization in both fetal and newborn rat lenses. The grain densities obtained with this probe increased from the periphery of the lens toward the interior, indicating that beta B1-crystallin RNA accumulated during differentiation of the secondary fiber cells. A similar accumulation pattern was obtained for gamma-crystallin mRNA, but, unexpectedly, this RNA could also be detected in the elongating epithelial cells. Our results show that gamma crystallin RNA starts to accumulate as soon as visible elongation of epithelial cells occurs, during differentiation of the primary as well as the secondary fiber cells. PMID- 3653513 TI - Formation of calyx-like contacts preferentially on appropriate target neurons in culture. AB - The availability of culture systems for both Edinger Westphal and ciliary ganglion neurons has made it possible to examine the interactions in culture between two populations of vertebrate neurons that synapse in vivo. In the chick, Edinger Westphal neurons provide the sole presynaptic input to the ciliary ganglion and, through this projection, are responsible for the control of lens curvature (accommodation), iris constriction, and possibly smooth muscle function in the choroid layer of the eye. When embryonic chick Edinger Westphal and ciliary ganglion neurons were combined in culture and stained for enkephalin-like immunoreactivity to visualize Edinger Westphal terminals, stained calyx-like contacts were observed that resemble the calyciform terminals formed between Edinger Westphal processes and ciliary neurons in the ciliary ganglion in vivo. Although stained calyx-like contacts could also be found in Edinger Westphal alone and ciliary ganglion-alone cultures, many more were observed when the two cell types were cultured together. The increase depended specifically on the ciliary ganglion neurons since substitution of either dorsal root ganglion or sympathetic ganglion neurons for them in the cocultures did not increase the number of calyx-like contacts staining positive for enkephalin over those present in cultures of Edinger Westphal neurons alone. When Edinger Westphal neurons were grown simultaneously with dorsal root and ciliary ganglion neurons, calyx-like contacts with enkephalin-like immunoreactivity were found to terminate preferentially on the latter. These findings suggest that vertebrate neurons can form morphologically specific contacts preferentially on appropriate target cells in culture in the absence of many of the potential cues present in the intact tissue. PMID- 3653515 TI - Growth pattern of pioneering chick spinal cord axons. AB - The early growth pattern of axons in the embryonic chick spinal cord was studied by electron microscopy. Serial perisagittal thin sections were obtained from the lateral margins of spinal cords of stage 17 (S17) and S19 embryos. A simple stereotypic pattern of axonal growth was found. Axons originated from a dispersed population of presumptive interneurons located along the lateral spinal cord margin. They first grew ventrally in a nonfasciculative pattern and later turned at right angles and grew in a fasciculative manner longitudinally in the ventrolateral fasciculus. Growth along the circumferential pathway was analyzed in detail by reconstructing individual axons and growth cones from the S17 specimen. Most circumferential axons, regardless of their site of origin, grew in a parallel orientation, and each of their growth cones projected ventrally. This pattern suggested that circumferential growth cones were guided at many, if not all, points along their path. Study of the region in front of these seven growth cones, however, revealed no apparent structural basis for their guidance. Alternative guidance mechanisms are discussed. In conjunction with previous studies (e.g., Windle and Baxter, 1936; Lyser, 1966), these findings suggest that the circumferential-nonfasciculative and the longitudinal-fasciculative patterns of axonal growth are the two fundamental patterns followed by most early forming axons in the brain stem and spinal cord of all higher vertebrates. PMID- 3653514 TI - Evidence for simultaneous derepression of messenger RNA and the guanine nucleotide exchange factor in fertilized sea urchin eggs. AB - Translational control was studied in extracts of Lytechinus pictus eggs and zygotes. We showed that neither mRNA nor initiation factors alone limit translation in these lysates; rather they are together rate limiting. Added globin mRNA was translated in egg and zygote lysates but overall protein synthesis did not increase significantly as the added RNA competed with the endogenous message. The lysates mimicked the in vivo response, since microinjection of globin mRNA into L. pictus eggs similarly competed with endogenous mRNAs. A number of translational components were used to determine if they would stimulate protein synthesis in these lysates. The addition of globin polyribosomes increased the level of protein synthesis. The majority of this increase was due to reinitiation of the globin mRNA, and under these conditions the level of endogenous protein synthesis in both egg and zygote extracts did not change. The addition of crude initiation factors alone did not appreciably alter the rate of protein synthesis in the egg lysates. However, in the presence of added mRNA, these initiation factors stimulated translation two- to fourfold. Of all the initiation factors tested, only the guanine nucleotide exchange factor (GEF, eIF-2B, RF) significantly increased protein synthesis when globin mRNA was present. The addition of an unfractionated initiation factor preparation further stimulated protein synthesis in the presence of added GEF and mRNA, suggesting that a component other than mRNA and GEF was also limiting in these egg lysates. Other initiation factors, including eIF-2, eIF-4A, eIF-4B, and eIF-4F, did not substitute for the component in the unfractionated initiation factor preparation. We propose that alkalinization of the cytoplasm and the subsequent activation of initiation factors and mRNAs contribute to the large stimulation of protein synthesis in echinoid eggs after fertilization. Furthermore, we discuss the possibility that the increase in NADPH at the expense of NAD+, which occurs within 3 min after fertilization, may lead to the activation of GEF. PMID- 3653516 TI - Differential adhesivity of neuroepithelial cells and pioneering circumferential axons. AB - To determine the initial growth pattern of pioneering axons and investigate the factors that may influence their guidance, the lateral margin of a stage 16+ chick brachial spinal cord was examined in serial thin sections. The specimen was prepared with hypertonic fixative which partially shrank the tissue and increased extracellular space. The retention of surface contact after shrinkage was used as an index of the relative adhesiveness between cells in situ. Six axons and growth cones were found within the reconstructed tissue; five were oriented dorsoventrally and one apparent motor neuron growth cone was oriented radially. The five circumferential axons originated from presumptive interneurons distributed in a dispersed pattern along the neural tube lateral wall. Four terminated with growth cones, and each extended a short distance (less than 30 microns) ventrally along the outer margin. No contact was found between these nonfasciculating axons or growth cones. Thus, the earliest intracentral axons appear to grow dorsoventrally from the outset with no appreciable wandering. Morphological features that may indicate their mechanism of guidance, including preformed cellular guides, extracellular channels, contact with basal lamina, and intercellular junctions were not found. The preferential retention of surface contact between adjacent endfeet, as well as between pioneering circumferential axons and neuroepithelial cells, suggests that these particular surfaces are mutually adherent. These findings are consistent with a proposed dorsal-to ventral adhesive gradient mechanism of circumferential axonal guidance. PMID- 3653517 TI - Synthetic peptides that mimic the adhesive recognition signal of fibronectin: differential effects on cell-cell and cell-substratum adhesion in embryonic chick cells. AB - Although fibronectin has been implicated in cell-cell as well as cell-substratum interactions, most experimentation has focused on cell-substratum interactions of fibroblasts. We have examined the effect of the specific peptide GRGDS derived from the cell-binding sequence of fibronectin upon cell-cell and cell-substratum interactions using embryonic cells and tissues. Embryonic chick segmental plate cells undergo compaction (i.e., increased cell-cell adhesion) during the early stages of somitogenesis. Fibronectin has been implicated in this increase in cell cell interaction. In contrast, precardiac mesoderm undergoes directional migration upon a fibronectin-rich substratum, exhibiting both cell-cell and cell substratum interactions. The segmental plate cells, which are the precursors of embryonic somites, normally show very little cell-cell or cell-substratum interaction in culture. These cells exhibit a striking increase in intercellular adhesion, but exhibit no cell-substratum adhesion, in the presence of relatively low concentrations of the fibronectin-derived peptide GRGDS. Somite cells, which normally exhibit both cell-cell and cell-substratum adhesion in culture, show complete inhibition of cell-substratum adhesion in the presence of this peptide. Precardiac mesoderm, which normally exhibits both cell-cell and cell-substratum adhesion in culture, shows a marked inhibition of both processes in the presence of GRGDS. Since the finding that a monovalent competitive inhibitor of fibronectin binding can stimulate cell-cell adhesion was unexpected, we propose a "trigger" hypothesis, whereby the peptide recognition signal acts as a specific signal or trigger for the morphogenetic process of compaction. There is a striking specificity to this effect, since synthetic peptides with even conservative changes in the amino acid sequence have no effect. Finally, we find that under certain conditions the effect of the specific peptide is lost in 6-8 hr and the cells resume cell-substratum interactions or, in the case of the segmental plate cells, revert from the compacted state and exhibit a substantial decrease in cell-cell adhesion. Our studies indicate the diversity of cell and tissue responses possible when even a single peptide inhibitor of adhesion, and we have identified the first known activating effect of a fibronectin peptide on cell behavior and differentiation. PMID- 3653518 TI - Localization of polysialoglycoprotein as a major glycoprotein component in cortical alveoli of the unfertilized eggs of Salmo gairdneri. AB - Polysialoglycoprotein (PSGP, 200 kDa), first isolated by S. Inoue and M. Iwasaki in 1978 (Biochem. Biophys. Res. Commun. 83, 1018-1023) from unfertilized eggs of rainbow trout, has been shown to comprise a unique class of glycoproteins associated with the exocytosis of cortical alveoli. In 1986, 200-kDa PSGP was shown to undergo proteolytic depolymerization to 9-kDa PSGP on egg fertilization (activation) and there was an indication that 200-kDa PSGP may possibly be a component of cortical alveoli (J. Biol. Chem. 261, 5256-5261). In this paper we present evidence demonstrating that PSGP is actually a component of cortical alveolus. First, a cortical alveolus-rich fraction (CA fraction) was obtained by low-speed centrifugation of the homogenate of unfertilized eggs of rainbow trout. The 200-kDa PSGP was found to be a major component extractable with buffered saline from the CA fraction by chemical analysis of isolated materials. Treatment of the eggs to induce parthenogenetic activation resulted in all cases in the loss of both cortical alveoli and PSGP in the CA fraction. Second, perivitelline space fluid was isolated from the activated eggs of rainbow trout and analyzed, and 9-kDa PSGP was confirmed to be present as a major proteinaceous component. Third, following incubation of the eggs in water for activation, the time course of the appearance of 9-kDa PSGP and the breakdown of 200-kDa PSGP was observed. The formation of 9-kDa PSGP was detected in the eggs after 1 min of incubation and its level rose rapidly, attaining a maximum at 7 min after incubation. During this period, there was a concomitant fall in the level of 200-kDa PSGP. This formation and rapid increase in 9-kDa PSGP correspond directly to the time course of cortical alveolus exocytosis in activated chum salmon eggs recently studied by scanning electron microscopy. PMID- 3653519 TI - Embryonic corneal epithelial interaction with exogenous laminin and basal lamina is F-actin dependent. AB - Between the third and sixth day of embryonic development, the avian corneal epithelium produces both a basal lamina and the primary corneal stroma composed of 20 orthogonally arranged layers of collagen fibrils. If the epithelium is removed by enzyme treatment from the basal lamina and stroma, the basal cell surface extends cell processes (blebs) which contain disorganized actin filaments and the epithelium decreases production of collagen. When placed on extracellular matrix or on Millipore filters in media containing soluble matrix molecules, the epithelium retracts the blebs, forms an organized basal actin cortical mat, and doubles its production of collagen. In the current investigation, we provide evidence for the hypothesis that organization of the RER by the actin cytoskeleton mediates this stimulation of collagen production. Laminin-treated epithelia and epithelia isolated with the basal lamina intact were treated with an actin-disrupting drug, cytochalasin D. Actin aggregates occur throughout the epithelium, the RER becomes disorganized, and the increase in collagen production expected to result from addition of laminin does not take place. Morphometrical analysis of the distribution of RER in the basal compartment of control and cytochalasin-treated epithelia shows that the decrease in collagen production is accompanied by displacement of the RER from the basal area of the cells, suggesting that attachment of RER to the intact actin cytoskeleton is essential to maintenance of normal RER organization and function. We also found that laminin-mediated bleb retraction requires intact actin microfilaments, whereas bleb extension does not, and that nocodazole does not inhibit bleb extension or retraction. PMID- 3653521 TI - Retinoic acid rapidly reduces cartilage matrix synthesis by altering gene transcription in chondrocytes. AB - Retinoic acid can alter the differentiation of a variety of cell types, including chondrocytes. This action may explain the high incidence of craniofacial and limb defects resulting from exposure to retinoic acid during development, and may be the basis for the compound's inhibition of a chondrosarcoma tumor in vivo. In order to understand the mechanism of action of retinoic acid, we studied the expression of chondrocyte-specific proteins as well as other proteins that indicate a shift in the differentiated phenotype of the cell following exposure to retinoic acid. After 48 hr of exposure to retinoic acid chondrocytes stopped synthesizing the chondrocyte-specific pro alpha 1 (II) chain of collagen II and a 370-kDa precursor protein of a cartilage-specific proteoglycan. Instead, the cells synthesized increased amounts of fibronectin and the pro alpha 1 chain of collagen III. These changes could be detected as early as 12 hr after treatment. In addition, the steady-state levels of specific mRNA transcripts coding for these differentiation markers correlated with their protein synthesis levels. Also, nuclear runoff experiments indicated that retinoic acid down regulated transcription of the collagen II gene, while stimulating collagen III gene transcription. These observations suggest that retinoic acid may alter the expression of the chondrocyte phenotype by selectively changing the normal pattern of gene expression. PMID- 3653520 TI - Development of a muscle actin specified by maternal and zygotic mRNA in ascidian embryos. AB - In this investigation, we characterize the embryonic and adult actins and describe the embryonic expression of a muscle actin in the ascidian Styela. Two dimensional polyacrylamide gel electrophoresis showed that embryos, tadpole larvae, and adult organs contain three major and two minor isoforms of actin. Two of the major isoforms, which are present in the mantle, branchial sac, alimentary tract, and gonads of adults and in eggs, embryos, and heads and tails of tadpoles, are likely to be cytoplasmic actins. The third major isoform, which was enriched in the mantle and branchial sac of adults and localized primarily in the tails of tadpoles, is a muscle actin. The muscle actin isoform was not detected in eggs and early embryos. Radioactivity incorporation studies showed that the cytoplasmic actins were synthesized throughout early development, but muscle actin synthesis was first detected between the 16- and 64-cell stages, 2-3 hr after fertilization. Two lines of evidence indicate that embryonic muscle actin synthesis is directed in part by maternal mRNA. First, poly(A)+ RNA isolated from unfertilized eggs directed the synthesis of muscle actin in an mRNA-dependent reticulocyte lysate. Second, muscle actin was synthesized in anucleate egg fragments. Arguments are also presented that muscle actin synthesis is not directed exclusively by maternal mRNA. It is concluded that embryonic and adult Styela exhibit actin heterogeneity, that one of the actin isoforms is a muscle actin, and that the muscle actin is synthesized during embryogenesis under the direction of maternal and zygotic mRNA. PMID- 3653522 TI - Programmed death of peripheral pioneer neurons in the grasshopper embryo. AB - The Ti1 pioneer neurons arise at the distal tip of the metathoracic leg in the grasshopper embryo, and are the first neurons in the limb bud to extend axons to the central nervous system (C. M. Bate (1976) Nature (London) 260, 54-56; H. Keshishian (1980) Dev. Biol. 80, 388-397). By providing a neural pathway along which growth cones of later arising neurons migrate, these pioneer axons establish the route of one of the major nerve trunks in the leg (Keshishian, 1980; R. K. Ho and C. S. Goodman (1982) Nature (London) 297, 404-406; D. Bentley and H. Keshishian (1982) Science 218, 1082-1088). Here, we demonstrate that at the 55-59% stage of development, the two Ti1 pioneer neurons undergo programmed death. The role which these pioneers serve in establishing a nerve route appears to be their only function, and may be important for the normal development of the peripheral nervous system. The Ti1 pioneers provide an example of a previously hypothesized class (J. W. Truman (1984) Annu. Rev. Neurosci. 7, 171-188) of programmed neuron death: obsolete neurons whose function was developmental rather than behavioral. PMID- 3653523 TI - Subcortical rotation in Xenopus eggs: an early step in embryonic axis specification. AB - The amphibian egg undergoes a rotation of its subcortical cytoplasm relative to its surface during the first cell cycle. Nile blue spots applied to the egg periphery move with the subcortical cytoplasm and make rotation directly observable (J.-P. Vincent, G.F. Oster, and J. C. Gerhart (1986). Dev. Biol. 113, 484). We have previously shown that the direction of rotation accurately predicts the orientation of the embryonic axis developed by the egg. This suggests an important role for subcortical rotation in axis specification. In this report, we provide two kinds of experimental evidence for the essential role of rotation, and against a role for other concurrent cytoplasmic movements such as the convergence of subcortical cytoplasm toward the sperm entry point in the animal hemisphere. First, dispermic eggs develop only one embryonic axis, which is oriented accurately in line with the direction of the single rotation movement and not with the two convergence foci that form in the animal hemisphere. Rotation probably modifies the vegetal, not animal, hemisphere since axial development is normal in dispermic eggs despite highly altered animal subcortical movement. Second, we show that the amount of rotation correlates with the extent of dorsal development. UV irradiation of the vegetal hemisphere, or cold shock of the egg, inhibits rotation effectively. When there is no rotation, there is no dorsal development. On average within the egg population, increasing amounts of rotation correlate with the increasingly anterior limit of the dorsal structures of the embryonic body axis. However, individual partially inhibited eggs vary greatly in the amount of axis formed following a given amount of movement. Furthermore, the egg normally rotates more than is necessary for the development of a complete axis. These findings suggest that rotation, although essential, does not directly pattern the antero-posterior dimension of the body axis, but triggers a response system which varies from egg to egg in its sensitivity to rotation. This system is artificially sensitized by exposure of the egg to D2O shortly before rotation. We show that D2O-treated eggs produce extensive axes despite very limited rotation, often developing into hyperdorsal embryos. However, like normal eggs, they depend on rotation and cannot form dorsal structures if it is eliminated. PMID- 3653524 TI - Control of isotubulin expression during neuronal differentiation of mouse neuroblastoma and teratocarcinoma cell lines. AB - Mouse neuroblastoma and teratocarcinoma constitute adequate cellular systems to study the expression of tubulin isoforms during early as well as later steps of neuronal differentiation. Tubulin heterogeneity is extensively analyzed using both isoelectric focusing and two-dimensional electrophoresis. Multipotential embryonal carcinoma cells express mainly one alpha-tubulin isoform (alpha 1) and three beta-tubulin isoforms: a major one (beta 3) and two minor ones (beta 4 and beta 5). Early events of neuronal differentiation are shown to induce the expression of an additional beta-tubulin isoform, beta'1, which is encoded by a specific mRNA. Neurite extension further increases tubulin heterogeneity and leads to the appearance of post-translationally modified isoforms: beta'2 in neuroblastoma and alpha 2 in teratocarcinoma cells. beta' 2 is shown to derive from the above mentioned beta'1 by phosphorylation, while alpha 2 is probably an acetylated form of the common alpha 1-tubulin. These results show that specific changes in tubulin heterogeneity are induced at different steps of neuronal differentiation and are controlled both at the transcriptional (or post transcriptional) and post-translational levels. PMID- 3653525 TI - The spike component of the fertilization potential in the toad, Bufo japonicus: changes during meiotic maturation and absence during cross-fertilization. AB - Immature oocytes of the toad, Bufo japonicus, inseminated between first- and second-meiotic metaphase, exhibited polyspermy. Monospermy occurred when the oocytes had reached second-meiotic metaphase. Electrical recording during insemination of the immature oocyte showed fast-rising and slow-rising spikes followed by a gradual shift to a positive membrane potential. The number of fast spikes in each oocyte corresponded well with the number of sperm observed in cytological sections. Mature oocytes elicited one fast spike followed by a rapid rise to a positive plateau. Ion-substitution experiments indicated that, like the plateau, the initial fast spike is mediated mainly by increased permeability of the oocyte plasma membrane to halides such as Cl- or I-. When inseminated with sperm of the newt, Cynops pyrrhogaster, mature Bufo oocytes exhibited polyspermy accompanied by a gradual hyperpolarization and a slowly developing positive plateau, without the fast spike that occurs in self-species fertilization. These results indicated that the spike component of the fertilization potential can be dissociated from the plateau component, and may be elicited by different mechanisms. PMID- 3653526 TI - Blood-brain barrier choline transport is reduced in diabetic rats. AB - The kinetics of blood-brain barrier (BBB) choline transport in streptozocin induced diabetic rats were compared with those of age-matched vehicle-injected control rats. The brain uptake index (BUI) of choline in diabetic rats (13.9 +/- 1.1%) was significantly lower than that in control rats (22.6 +/- 0.7%) (P less than .05). This alteration in brain choline uptake appeared to occur in long standing (9 wk) diabetes. Thus, acute hyperglycemia and diabetes mellitus for shorter periods (3 wk) did not significantly alter the BUI of choline. Insulin (8 U/kg) treatment for 5 days did not alter BUI in diabetic rats (12.9 +/- 0.9%). The maximal velocity of BBB choline transport (Vmax) in diabetic rats (0.14 +/- 0.07 nmol . min-1 . g-1) was significantly lower than the Vmax in control rats (2.2 +/- 0.8 nmol . min-1 . g-1) (P less than .05). The Km of choline transport in diabetic rats (120 +/- 70 microM) was modestly but not significantly lower than that in control animals (400 +/- 160 microM). Similarly, the constant of the nonsaturable component of the transport (Kd) in diabetic animals (0.5 +/- 0.07 microliter . min-1 . g-1) was not significantly different from that in control rats (0.9 +/- 0.3 microliter . min-1 . g-1). The data indicate that diabetes mellitus in rats is associated with a decreased BBB choline transport. PMID- 3653527 TI - Effect of high-dose omeprazole administration on histamine storage and formation in canine gastric mucosa. AB - The effect of a high dose of omeprazole on the plasma gastrin response to feeding and gastric mucosal histamine formation and storage in the dog has been studied. Tissue from the oxyntic gland area was obtained by introduction of an endoscope through a gastric fistula, and biopsies were taken before, after 4 weeks of oral administration of omeprazole and 1 month after withdrawal of the drug. Omeprazole administration increased the basal plasma concentration of gastrin and induced a substantial increase in the feeding response. Histidine-decarboxylase activity was significantly increased after 4 weeks of omeprazole administration, whereas no effect was found on histamine content and mucosal mast cell density. One month after drug withdrawal, the enzyme activity had returned to pretreatment levels. PMID- 3653528 TI - Proglumide stimulates basal pancreatic secretion in the conscious rat. AB - The effect of proglumide, a glutaramic acid derivative, on pancreatic secretion was examined in vivo in the conscious rat with and without the return of bile pancreatic juice (BPJ) to the intestine. Intravenous infusion of both 300 and 60 mg/kg proglumide significantly decreased protein output in a dose-related manner during BPJ diversion, but did not completely abolish the pancreatic hypersecretory response to BPJ diversion. Conversely, during basal secretion with BPJ being returned to the intestine, 300 mg/kg/h of proglumide increased the protein output. Dibutyryl cyclic GMP infused simultaneously with proglumide did not abolish the stimulatory effect of proglumide on basal secretion. It was concluded that proglumide inhibits pancreatic protein output during stimulated secretion by means of the luminal feedback mechanism but increases protein output during basal (BPJ returned) secretion in the conscious rat. PMID- 3653529 TI - Effect of cisapride on the gastro-oesophageal function in normal human subjects. AB - The aim of this study was to investigate oesophageal peristalsis and gastro oesophageal function in normal subjects after 4 days of cisapride 10 mg p.o. 3 times/day and 10 mg 1.5 h before the investigation. The study was carried out in a double-blind cross-over design with coded cisapride or placebo tablets. Basal sphincter pressure increased after cisapride (p less than 0.002). The peristaltic pressure amplitude in the oesophageal body as well as the duration and velocity of the peristaltic pressure wave were measured after wet swallows. No changes were found. Intragastric pH was unchanged after cisapride. No effect was found on the result of a standard acid clearing test. Plasma concentration of cisapride did not correlate with any of the other variables. Oral cisapride increases fasting gastro-oesophageal sphincter pressure, but does not influence oesophageal peristalsis, acid clearing or intragastric pH in normal subjects. PMID- 3653530 TI - Vitamin A status in 137 patients with Crohn's disease. AB - Serum retinol and serum carotene concentrations were determined over a 6-month period in 137 outpatients with Crohn's disease. Serum retinol measurements were within the reference range for all patients at each assessment period, while serum carotene levels were low in about one quarter of the patients. Of the 56 patients who completed 48-hour stool collections, 41% had stool fat values exceeding the reference value. Serum retinol concentrations were not significantly correlated with the serum carotene concentrations, with the 48-hour stool fat content, or with the Crohn's disease activity. In contrast serum retinol concentrations were correlated with the dietary levels of vitamin A. Serum carotene concentrations were inversely correlated with the stool fat content but were not related to Crohn's disease activity or dietary levels of carotene or total vitamin A. Thus: (1) serum retinol concentrations were normal in this moderately large group of patients with Crohn's disease and did not reflect a low dietary vitamin A intake by 34% of the population; (2) serum carotene levels were frequently low in patients with Crohn's disease, possibly due to the presence of steatorrhea, but were not related to low dietary intakes of carotene or to active Crohn's disease, and (3) a low serum level of carotene does not indicate that the patient is at risk of developing vitamin A deficiency. PMID- 3653531 TI - Fatty acid composition in serum lipids and adipose tissue in patients with morbus Crohn after ileal resection. AB - In 36 patients with Crohn's disease who had been operated with ileal resection but were in a stable clinical condition, the fatty acid composition in the circulation and in adipose tissue was correlated to resection length. Fatty acid composition was also compared to data from a group of randomly selected healthy men and women of similar age. In plasma Crohn patients had reduced circulating levels of unsaturated fatty acids. On the other hand, increased proportions of these fatty acids were found in adipose tissue. It is unlikely that in this group of patients these data are unspecific reflections of disease activity. A more reasonable explanation seems to be an increased demand for precursors of local prostaglandin synthesis in the remaining bowel. PMID- 3653532 TI - Effect of ranitidine on the absorption of aspirin. AB - Six healthy male volunteers received 1 week's pretreatment with ranitidine, 150 mg twice daily, and placebo in a double-blind cross-over trial. On the 8th day, each volunteer received 1 g of aspirin in order to study the pharmacokinetics of this nonsteroidal anti-inflammatory drug. The results of this study suggest that ranitidine does not induce clinically significant alterations to the kinetics of a single dose of aspirin in healthy males. PMID- 3653533 TI - Effect of an apple brandy from Normandy and of ethanol on epithelial cell proliferation in the esophagus of rats. AB - The effects on cell population kinetics in the distal esophagus of an apple brandy from Normandy (Calvados), of ethanol diluted at a similar concentration, and of saline were investigated in rats. Animals were killed at 0, 6, 12, 18 and 24 h after a single intraesophageal instillation, and at 3 weeks after chronic administration of these solutions. In vivo labeling with [3H]-thymidine and autoradiography were carried out to determine the proliferative parameters. Vincristine sulfate was used to increase metaphase figures during the chronic experiment. Instillation of saline did not modify the parameters under study. Single instillations of both apple brandy and 56 degrees ethanol were followed by a significant increase in labeling (p less than 0.01) and mitotic indices (p less than 0.01). Chronic administration of both apple brandy and 56 degrees ethanol increased the labeling index (p less than 0.01) as well as the metaphase index (p less than 0.01). The proliferative responses after the apple brandy and after 56 degrees ethanol were similar in amplitude. These data suggest that ethanol alone may explain the mitogenic effect of Calvados in the esophagus. PMID- 3653534 TI - Predictive value of ABR in infants and children with moderate to profound hearing impairment. AB - Click and 500 Hz tone pip ABR thresholds obtained in infancy were compared to pure-tone thresholds in 25 preschool-aged patients with moderate to profound hearing impairments. The electrophysiologic thresholds obtained in infancy were generally lower than the recent audiometric thresholds. Clicks best predicted the lowest pure-tone threshold within the 1 to 8 kHz range. The 500 Hz tone-pip thresholds were closest to the lowest of 250 Hz and 500 Hz pure-tone thresholds. Regression analyses involving audiometric and electrophysiologic thresholds and 95% confidence intervals of the differences between their means provide a basis for behavioral threshold prediction in this patient group. PMID- 3653535 TI - Auditory brain stem responses to high-frequency tone bursts in normal-hearing subjects. AB - ABR and behavioral thresholds and ABR latencies were measured from six normal hearing subjects in response to tone bursts, having frequencies of 9,000 to 16,000 Hz. In general, ABR thresholds were higher than behavioral thresholds; however, the differences were typically less than those observed for lower frequencies. Wave V latency-intensity functions were less dependent on frequency for these stimuli than they were for lower frequency stimuli. This may be due to the fact that higher frequencies are represented over a very narrow area of the cochlea and that minor variability in the measurement of latencies might obscure small differences in latency as a function of frequency. In general, these data suggest that ABRs can be measured in response to high-frequency stimuli and that these measurements may have clinical utility, especially when monitoring ototoxic effects in difficult-to-test patients. PMID- 3653536 TI - Standardization of four videotaped tests of speechreading ranging in task difficulty. AB - Repeated measures are needed to assess speechreading ability of prospective cochlear implant candidates and to follow their progress over the course of treatment. To perform such measures, high quality color videotaped versions of four speechreading tests were constructed using a male and a female speaker. Materials were selected to provide gradations in task difficulty ranging from responses to questions with the topic known, to verbatim repetition, to abstraction of information from a spoken paragraph in order to answer questions. The tests were: (1) NAL/West Haven modification; (2) Iowa-Keaster, Forms A and B; (3) CID Everyday Sentences; and (4) Gold Rush Paragraph. The tapes were standardized by presentation to young adult normal subjects. Results indicated that a range of performance could be measured by using the present tests as a battery, although the anticipated ranking of tests was not obtained. PMID- 3653537 TI - Simulation of sensorineural hearing impairment. AB - A hearing loss simulation system (HELOS) was designed and constructed to simulate various aspects of sensorineural hearing impairment. The theoretical bases for HELOS were several threshold and suprathreshold auditory phenomena typically exhibited by people with sensorineural hearing losses. In addition to providing differential attenuation of acoustic signals across the frequency range, HELOS simulated loudness recruitment, loudness discomfort thresholds, reduced dynamic range, and reduced frequency selectivity. Three basic audiometric configurations were chosen to investigate the effects of the aforementioned components of a sensorineural hearing impairment on the auditory perception of speech. They were: (1) a sloping high-frequency hearing loss; (2) a flat, severe hearing loss; (3) a severe/profound hearing loss. The battery of tests administered to a group of normal-hearing adults consisted of pure-tone audiometry and PB-word recognition tests, as well as vowel and consonant identification tests. For comparable audiometric configurations, the results from the speech-perception tests were in good agreement with the published results of similar tests administered to persons with sensorineural hearing losses. PMID- 3653538 TI - A developmental study of bone conduction auditory brain stem response in infants. AB - Two studies, vibrator placement and masking, were performed to evaluate the developmental aspect of bone conduction auditory brain stem response (ABR) in human infants. Subject groups included newborns, 1-yr-olds, and adults. In the vibrator studies, ABRs were obtained from placements of the bone conduction vibrator on the frontal, occipital, and temporal bones. Results showed that temporal placements in neonates and 1-yr-olds produce significantly shorter wave V latencies of ABR than frontal or occipital placements. In adults, differences of wave V latencies from various vibrator placements were comparatively small. In the masking studies, ABRs were acquired from vibrator placements at the temporal bone in the presence of ipsilateral air conducted masking noise from the experimental groups. Results showed that interaural attenuations of bone conduction click stimuli are the largest in neonates, somewhat smaller from 1-yr olds, and the smallest in adults. The findings of this research strongly suggest that temporal placements for bone conduction ABR should be used, in some instances, when testing infants and 1-yr-olds. The results of this study support the proposition that bone conduction ABR is a feasible and reliable diagnostic tool in testing infants. PMID- 3653539 TI - Philosophical controversies in audiology: an allegory. PMID- 3653540 TI - The China connection: West meets East. PMID- 3653541 TI - Meeting the Ethiopian challenge. PMID- 3653542 TI - Canadian nurses in Kuwait help develop emergency care. PMID- 3653543 TI - X-ray vision: a Rotary project in Dominica. PMID- 3653544 TI - Disciplinary procedures: the case of a radiological technician. Part 2. PMID- 3653545 TI - National comparative standards: a priority for evaluating resource utilization. PMID- 3653546 TI - St. Vincent's day hospital: an important link with the community. PMID- 3653547 TI - Primary nursing model fosters staff's autonomy and accountability. PMID- 3653548 TI - Foothills teaches patients to take charge of their health. PMID- 3653549 TI - Facilities and the community. PMID- 3653550 TI - Technology acquisition in a selected sample of Ontario hospitals. Part 1. PMID- 3653551 TI - Upgrading information systems: a cooperative effort in Newfoundland. PMID- 3653552 TI - Maintaining equipment: an inside job? PMID- 3653553 TI - An administrative perspective on implementing the MIS Guidelines. PMID- 3653554 TI - Health technology assessment: implications for policymakers. PMID- 3653555 TI - Wrongful dismissal: employer beware. PMID- 3653556 TI - The political reality of health care. PMID- 3653557 TI - Hospital-based research: creating a climate of excellence. PMID- 3653558 TI - The NHRDP: providing support for health care researchers. PMID- 3653560 TI - The HLA-D associations of type 1 (insulin-dependent) diabetes in Punjabi Asians in the United Kingdom. AB - Type 1 (insulin-dependent) diabetes is less common in Asian Indians than in white Caucasoids. Forty-five Punjabi Asians with Type 1 diabetes and 96 racially matched control subjects were HLA-DR typed. DR3 was increased in diabetic patients vs control subjects (82% vs 38%, p less than 10(-5)) with relative risk 7.7 and etiological fraction 0.72. DR4 was increased in diabetic patients vs control subjects (31% vs 7%, p less than 0.003) with relative risk 5.7 and etiological fraction 0.26. DR2 showed a negative association (relative risk 0.19, etiological fraction -0.28), as did DR7 (relative risk 0.21, etiological fraction -0.33). HLA-DQ beta-chain gene probing using restriction enzyme BamHI in 43 diabetic patients and 90 control subjects showed that the DR1-associated 6.2 and 3.2 kb fragments were less common in diabetic patients than in the control subjects (12% vs 36%, p less than 0.02). A 12 kb fragment was associated with DR4 in both diabetic patients and control subjects. DR3 is the major susceptibility factor for Type 1 diabetes in Punjabi Asians and DR4 is a second marker. Gene probing indicates that the same DR4 subset is associated with the condition as in white Caucasoids. DR1 and its associated DQ beta restriction fragments are reduced in Asian Type 1 diabetic patients making it unlikely that DR1 haplotypes carry a predisposing factor in this racial group. We conclude that the genetic component of Type 1 diabetes in Punjabis shows differences from that of the white Caucasoid population and that the lower frequency of DR4 in this population may contribute to the lower prevalence of Type 1 diabetes. PMID- 3653559 TI - Central role for sodium in the pathogenesis of blood pressure changes independent of angiotensin, aldosterone and catecholamines in type 1 (insulin-dependent) diabetes mellitus. AB - We studied 73 Type 1 (insulin-dependent) diabetic patients, 18 to 50 years of age, with a diabetes duration of more than five years. Group 1: normal urinary albumin excretion below 30 mg per 24 h (n = 19); group 2: microalbuminuria, 30 300 mg per 24 h (n = 36); and group 3: diabetic nephropathy, above 300 mg per 24 h (n = 18). Fifteen nondiabetic persons matched for sex and age served as control subjects. The sodium intake evaluated on the basis of 24-h urine sodium excretion was similar in patients and control subjects. Blood pressure in groups 1 and 2 and control subjects was below 160/95 mmHg. The blood pressure was increased in group 3 as compared with the other groups (systolic/diastolic 161 +/- 22/101 +/- 9 mmHg vs 131 +/- 13/84 +/- 10, mean +/- SD, p less than 0.0001). Exchangeable sodium was increased in patients (p less than 0.01) and correlated to the mean blood pressure (n = 70, r = 0.41, p less than 0.01). Extracellular volume was increased in patients (p less than 0.05), whereas plasma volume was normal. Supine serum angiotensin II was suppressed in the patients (p less than 0.001). A negative correlation was found between mean blood pressure and supine serum aldosterone (n = 68, r = -0.24, p less than 0.05), and exchangeable sodium and aldosterone (n = 66, r = -0.36, p less than 0.002) in all patients. The catecholamine levels were also suppressed or normal in the patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653561 TI - Prevalence and causes of microscopic haematuria in type 1 (insulin-dependent) diabetic patients with persistent proteinuria. AB - The prevalence and causes of microscopic haematuria were examined in all Type 1 (insulin-dependent) diabetic patients with persistent proteinuria (diabetes duration greater than or equal to 5 years) attending the outpatient clinic at Hvidore Hospital during 1985. One hundred eighty-four patients (69F/115M) out of 1024 Type 1 patients had persistent proteinuria (18%). Microscopic haematuria was defined as greater than or equal to 3 erythrocytes per high power field in two or more sterile urine samples. Twenty-three Type 1 patients with persistent proteinuria (7F/16M, aged 35.4 +/- 13 years) had microscopic haematuria (12.5%). No significant changes were found between the group with and without microscopic haematuria: blood pressure 148/89 +/- 22/11 versus 145/91 +/- 20/11 mmHg, duration of diabetes when persistent albuminuria occurred 17 +/- 8 versus 20 +/- 10 years, serum creatinine 99 +/- 24 versus 98 +/- 31 mumol/l, simplex retinopathy 61 versus 54%, proliferative retinopathy 39 versus 42%, and no signs of retinopathy 0 versus 4%. Kidney biopsy was performed in 13 out of the 23 patients with microscopic haematuria. Diabetic glomerulosclerosis was present in all 13 patients, but 9 patients had a non-diabetic renal disease superimposed (mesangioproliferative glomerulonephritis (n = 5), membranous glomerulonephritis (n = 3) and sarcoidosis (n = 1). Microscopic haematuria is a rare finding, frequently reflecting superimposed non-diabetic glomerulopathies, in Type 1 diabetic patients with diabetic nephropathy and well preserved kidney function. PMID- 3653562 TI - Tyrosine kinase activity of insulin receptors from an insulin-resistant patient with leprechaunism. AB - Defects in insulin receptor function can impair the response of target cells to insulin. Previously we have described an insulin resistant patient (leprechaun/Ark-1) with qualitative abnormalities in insulin binding suggestive of a structural defect in her insulin receptors. In the present work, we have studied the tyrosine kinase activity associated with insulin receptors from cultured Epstein-Barr virus-transformed lymphocytes. In studies of insulin receptors from leprechaun/Ark-1, we observed that both the magnitude and the dose dependency of insulin's effect to stimulate the tyrosine kinase activity were normal. This suggests that the defect causing this patient's insulin resistance is independent of the receptor-associated tyrosine kinase. In the course of these studies, we noted that an anti-receptor antiserum (B-d) had a markedly decreased ability to immunoprecipitate insulin receptors from leprechaun/Ark-1. This observation further supports our previous conclusion that the insulin receptor from leprechaun/Ark-1 is abnormal in structure. Moreover, it emphasizes the importance of choosing anti-receptor antisera which are equally effective at immunoprecipitating receptors from both patients and normal subjects when the anti-receptor antisera are employed as reagents in investigations of receptors from insulin-resistant patients. PMID- 3653563 TI - Evaluation of the fructosamine test for the measurement of plasma protein glycation. AB - Repeated estimation of plasma protein glycation by the fructosamine assay gave more variable results than expected from analytical variability (coefficient of variation approximately 2%). Fructosamine results obtained on plasma samples drawn at different times of the day differed by up to 1 mmol/l, corresponding to a coefficient of variation of greater than 10%. As a consequence, the information concerning averaged glycaemia of a fructosamine determination is subject to an uncertainty of 7.8 mmol/l. Fructosamine concentrations were linearly related to the protein concentration. Correction for the protein concentration decreased this variability; however, factors other than protein concentration, such as lipid content, also influence results of fructosamine determinations. PMID- 3653564 TI - Promotion of diabetes onset by stress in the BB rat. AB - The purpose of the present study was to address the question of whether environmental stress affects the age of onset and incidence of overt insulin dependent diabetes mellitus in an animal model of human Type 1 (insulin dependent) diabetes. Thirty-five diabetes prone BB rats of both sexes were divided into two groups: experimental animals were exposed to multiple, concurrent, and unpredictable environmental stressors, while littermate controls were exposed to a standard lab environment. Groups were housed in two separate, sound attenuated, independently ventilated, and restricted rooms. By age 150 days, experimental group animals had developed overt diabetes at a significantly earlier age. PMID- 3653565 TI - Heterogeneity of diabetes mellitus. PMID- 3653566 TI - Toxicity of N-methyl-2-pyrrolidone (NMP): teratogenic, subchronic, and two-year inhalation studies. AB - Pregnant rats were exposed to N-methyl-2-pyrrolidone (NMP) at atmospheric concentrations of 0.1 and 0.36 mg/liter for 6 hr/day on Days 6 through 15 of gestation. Except for sporadic lethargy and irregular respiration in several rats the first 3 days of exposure, there were neither abnormal clinical signs nor pathological lesions in the maternal rats. Exposure did not affect either the outcome of pregnancy or embryonal growth rate. No abnormal development was detected in the vital organs and skeletons of the fetuses. Rats were exposed to an aerosol-vapor mixture of NMP at concentrations of 0, 0.1, 0.5, and 1.0 mg/liter for 6 hr/day, 5 days/week for 4 weeks. At 0.1 and 0.5 mg/liter exposure levels, rats did not show any significant clinical signs or pathological lesions. However, lethargy, respiratory difficulty, and excessive mortality were found in rats exposed to 1.0 mg/liter. These rats had focal pneumonia, bone marrow hypoplasia, and atrophy of lymphoid tissue in the spleen and thymus. These lesions were reversible in surviving rats following 2 weeks of recovery. Increases in the relative and absolute numbers of neutrophils were observed during exposure at 1.0 mg/liter, but returned to normal limits after 2 weeks of recovery. Rats were exposed to vapor of NMP at concentrations of 0, 0.04, or 0.4 mg/liter for 6 hr/day, 5 days/week for 2 years. Male rats at 0.4 mg/liter showed slightly reduced mean body weight. No life-shortening toxic or carcinogenic effects were observed in rats exposed for 2 years to 0.04 or 0.4 mg/liter of NMP. PMID- 3653568 TI - Acetylcholinesterase prophylaxis against organophosphate toxicity. AB - Fetal bovine serum acetylcholinesterase (FBS-AChE) protected mice from multiple LD50 doses of organophosphorus (OP) nerve agents. Mice were injected intraperitoneally (ip) with up to 3.3 mg (11,000 U) of FBS-AChE which exhibited a relatively long serum half-life and appeared well tolerated. The enzyme protected mice from the OP ethyl-S-2-diisopropylamino-ethylmethylphosphonothiolate (VX) with a stoichiometry equal to approximately 2 moles of enzyme active site per mole of VX. FBS-AChE, at a lower enzyme OP ratio, protected mice from 2 LD50s of the nerve agent methylphosphonofluoridic acid 1,2,2,-trimethylpropyl ester (soman) when used in conjunction with atropine and 2[(hydroxyimino)methyl]-1 methylpyridinium chloride. It is concluded that sequestration of highly toxic OPs by administration of AChE occurs in mice and suggests a new approach to treatment of OP intoxication. PMID- 3653567 TI - Comparative inhalation toxicity of nickel subsulfide to F344/N rats and B6C3F1 mice exposed for 12 days. AB - Groups of F344/N rats and B6C3F1 mice were exposed to aerosols of nickel subsulfide (Ni3S2) 6 hr/day for 12 days not including weekends. Actual exposure concentrations were within 3% of target (target = 10.0, 5.0, 2.5, 1.2, 0.6, and 0.0 mg Ni3S2/m3). Nickel lung burdens of exposed rats and mice increased linearly with exposure concentration. Two male rats and all mice exposed to 10.0 mg Ni3S2/m3 died before the end of the exposures. Exposure to Ni3S2 had no effect on the natural killer cell activity of mouse spleen cells. Lesions in rats and mice related to inhalation of Ni3S2 were found in the nasal epithelium, lung, and bronchial lymph nodes. The most extensive lesions were found in the lung and included necrotizing pneumonia. Emphysema developed in rats exposed to 5.0 or 10.0 mg Ni3S2/m3, while fibrosis developed in mice exposed to 5.0 mg Ni3S2/m3. Degeneration of the respiratory epithelium and atrophy of the olfactory epithelium of the nose occurred in rats exposed to as low as 0.6 mg Ni3S2/m3 and mice exposed to 1.2 mg/m3. Results indicate that inhalation exposure of rats and mice to Ni3S2 aerosol concentrations near the current threshold limit value (TLV) for nickel compounds (1 mg/m3 for Ni metal and roasting fume and dust and 0.1 mg/m3 as Ni for soluble compounds) can produce lesions in the respiratory tract. Atrophy of lymphoid tissues (spleen, thymus, and bronchial lymph nodes) was found in animals of the highest exposure concentration. Degeneration of the testicular germinal epithelium was also observed in mice and rats that survived 5.0 or 10.0 mg/m3 exposure concentrations. PMID- 3653569 TI - Determination of erythrocyte life span in F-344, Wistar, and Sprague-Dawley rats using a modification of the [3H]diisopropylfluorophosphate ([3H]DFP) method. AB - The use of [3H]diisopropylfluorophosphate [( 3H]-DFP) to measure erythrocyte survival is well documented; however, the procedure has not been widely used in animal research primarily because it is more labor intensive than other methods. The [3H]DFP method was modified to simplify the preparation of samples for scintillation counting by using whole blood and to allow for small-volume serial blood sampling of individual animals. Eight-week-old F-344, Wistar, and Sprague Dawley rats received 20 microCi [3H]DFP via the jugular vein. The latter two strains served to validate the procedure as significant data exist on the erythrocyte life spans of these rats. The red cell life span of the F-344 rat has not been previously investigated. Blood samples were collected from a tail vein at 8 days post-labeling and approximately three times per week until Day 33. Whole blood samples were individually prepared for scintillation counting. Blood radioactivity, corrected for sampling loss, was expressed as a percentage of the total activity at the time of initial sampling. Data were analyzed using the least-squares method of linear regression. Results, expressed as a mean erythrocyte life span in days (+/- 1 SE), for each strain were 66.3 +/- 1.6 for F 344, 59.8 +/- 2.2 for Wistar, and 61.0 +/- 1.3 for Sprague-Dawley rats. The results for the Wistar and Sprague-Dawley rats were in good agreement with published data for these strains, thus validating the modified [3H]DFP method for erythrocyte life span determination. In addition, the red cell life span of the F 344 rat was shown to be comparable with other rat strains. PMID- 3653570 TI - Effects of subchronic inhalation exposure of mice to a high-boiling coal liquid. AB - Mice (CD-1) were exposed to aerosol concentrations of 0.0, 0.03, 0.14, or 0.69 mg/liter of heavy distillate (HD), a high-boiling coal liquid from the solvent refined coal (SRC)-II process. Exposures were for 6 hr/day, 5 days/week for 13 weeks. Particle sizes ranged between 1.6 and 1.8 micron, mass median aerodynamic diameter, with a geometric standard deviation range of 1.9-2.5. Growth for high dose males was significantly less than that of the control group. Compared to controls, weights of liver were significantly higher and those of ovaries and thymus significantly lower; these changes were significant on both absolute and relative weight bases. The number of red blood cells, volume of packed red cells, and hemoglobin concentration for animals from the high-dose group were significantly lower than those of controls. Microscopic examination of organ sections showed focal hepatic necrosis and nonspecific hepatopathy. Additionally, olfactory epithelial degeneration occurred in a dose-dependent manner. Results from this study indicated that exposure to HD caused adverse effects at the high dose and that these changes were either less severe or absent in middle-dose group mice. Comparison of these results with those for rats indicated that with rats the biological effects were more severe and present at lower doses than was observed for mice. PMID- 3653571 TI - A 90-day inhalation toxicity study of raw shale oil in Fischer 344 rats. AB - The potential health effects of a raw shale oil were evaluated in a 90-day inhalation study in Fischer 344 rats. Groups of 15 male and 15 female rats were exposed 6 hr/day, 5 days/week for 13 weeks to aerosol concentrations of 0, 56, 120, or 492 mg/m3. In the high-dose group, 10 males and 7 females died prior to the termination of the study, most within the first 5 weeks of the experiment. A dose-dependent suppression in weight gain was seen in all of the shale oil exposed groups. The failure to gain weight was associated with a variety of clinicopathologic abnormalities, including a dose-related decrease in red and white blood cells, with lowered plasma protein levels and increased serum alkaline phosphatase, and with total bilirubin levels in males. The exposure of the test animals to aerosolized raw shale oil was also associated with inflammatory and hyperplastic lesions in the lungs and upper respiratory tract, atrophy of the thymus and thymic-dependent portions of the peripheral lymphoid system, and bone marrow. These changes demonstrate that inhalation of raw shale oil aerosol can produce major organ toxicity similar to that found after exposure to other unrefined oil products. PMID- 3653572 TI - Skin tumorigenic potential of crude and refined coal liquids and analogous petroleum products. AB - The skin tumorigenic potential of seven complex hydrocarbon mixtures was determined: a coal-derived raw blend composed of light and heavy oils, a low- and high-severity hydrotreated product of that blend, and naphthas and fuel oils from the raw blend or from natural petroleum. Male and female C3H/Bdf mice were exposed three times per week to each test mixture by dermal application of 50 microliters of neat, 50, or 25% (w/v) preparations. Room, vehicle, and benzo[alpha]pyrene control groups were run concurrently. The raw blend produced an almost 100% incidence of skin tumors at all three doses while tumorigenicity was considerably decreased by hydrotreating the blend both in terms of incidence and onset. The tumorigenicities of the naphthas and fuel oils derived from the raw blend or from petroleums were low relative to that of the parent mixture. Although tumorigens in the raw blend were much reduced by hydrotreatment, tumorigenicity of the other agents did not parallel the content of polycyclic aromatic hydrocarbons known to be good tumor initiators. PMID- 3653573 TI - Cytoprotective effects of modulators of oxidative xenobiotic metabolism in precocene II-induced hepatotoxicity. AB - This investigation was conducted to evaluate the effects of modulation of several phase I xenobiotic-metabolizing enzyme activities on the expression of precocene II-induced hepatotoxicity. Precocene II (175-200 mg/kg) was given intraperitoneally to male Sprague-Dawley rats that had been exposed previously to inducers (phenobarbital and 3-methylcholanthrene) or inhibitors (SKF 525-A and cimetidine) of oxidative xenobiotic metabolism. Hepatic damage was measured both biochemically (leakage of aspartate aminotransferase and alanine amino transferase into the serum) and histologically. Significant protection from precocene II-induced hepatotoxicity was observed in all treated animals regardless of whether the modulator employed was an inducer or an inhibitor of microsomal oxidative enzymes. These results indicate that the level of activity of various forms of cytochrome P-450 significantly influences the severity of hepatic necrosis induced by precocene II. Furthermore, these results suggest that inducible non-P-450 factors, such as glutathione S-transferases, may be important in modulating precocene II-induced hepatotoxicity. PMID- 3653574 TI - The clearance of manganese chloride in the primate. AB - Two macaque monkeys inhaled trace amounts of 54MnCl2 for 30 min. Subsequently the chest, head, and fecal radioactivity were monitored for over a year. The chest data curve required a sum of three exponential terms, with half-times ranging from 0.2 to 187 days, to attain a satisfactory fit. Head levels peaked 40 days after acute inhalation exposure and remained elevated for over a year. The excretion of manganese through the feces was best described by a sum of two exponentials. One had a half-time of less than 1 day and the second had a half time of 50 to 60 days. A third macaque received a 6-week continuous exposure to 54Mn through a subcutaneous osmotic pump. With this route, manganese clearance from the head occurred at a faster rate than after acute inhalation exposure. Fecal elimination following continuous subcutaneous exposure resembled that following acute inhalation. Kinetic analyses suggested that the long half-times of manganese in the head following inhalation reflected both slow disappearance from the head and replenishment from other depots. PMID- 3653575 TI - Contaminant and nutrient concentrations of natural ingredient rat and mouse diet used in chemical toxicology studies. AB - The NIH-07 open formula natural ingredient rat and mouse ration is the standard diet for chemical toxicity and carcinogenicity studies conducted for the National Toxicology Program (NTP). Contaminant and nutrient concentrations were determined in 2 to 94 lots of this diet used in the NTP toxicology studies. All nutrient concentrations were equivalent to or greater than the requirements for rats and mice as set forth by the National Research Council. Aflatoxins, Hg, chlorinated hydrocarbons except methoxychlor, organophosphates except malathion, estrogenic activity, and Salmonella sp. were not present at the detectable levels. Fluorine, As, Cd, Pb, Se, N-nitrosodimethylamine, N-nitrosopyrrolidine, N nitrosomorpholine, nitrate, nitrite, butylated hydroxyanisole, butylated hydroxytoluene, ethylene dibromide, methoxychlor, malathion, and trypsin inhibitor activity were present at or above the detectable levels. Five lots of diet had nitrosamine content of 100 to 273 ppb and 7 lots had 2.08 to 3.37 ppm of Pb. All other lots of NIH-07 diet used for NTP toxicology studies contained low levels of the contaminants. After determination of the contaminant concentrations in the 94 lots of diet and the contaminant concentrations in natural ingredients used in formulating NIH-07 diet, maximum allowable levels of contaminants were established and a flexible scoring system for acceptability of each lot of diet for chemical toxicology studies was developed. By prescreening ingredients such as fish meal for heavy metals and nitrosamines, and applying the flexible scoring system proposed, more than 95% of the lots of NIH-07 diet produced during the last 3 years had scores of greater than or equal to 95 out of 100 points and were considered acceptable for toxicology studies. PMID- 3653576 TI - Urinary enzymes and protein patterns as indicators of injury to different regions of the kidney. AB - Acute experimental models of renal damage to the proximal tubular, glomerular, and papillary regions of the rat were produced by administration of hexachloro 1:3-butadiene (HCBD), puromycin aminonucleoside (PAN), and 2-bromoethylamine (BEA), respectively. Several routine indicators of nephrotoxicity, the enzymes alkaline phosphatase and N-acetyl-beta-glucosaminidase, and the molecular weight of protein excretion were determined on urine samples. Tubular damage produced by HCBD or BEA was discriminated both quantitatively and qualitatively from glomerular damage produced by PAN. The latter was characterized by a pronounced increase in protein excretion, especially proteins with molecular weight greater than 40,000 Da. In contrast, protein excretion in tubular damage was raised only slightly and characterized by excretion of proteins of a wide range of molecular weights. Proximal tubular damage caused by HCBD and papillary damage caused by BEA were distinguished both by conventional urinalysis (volume and specific gravity) and by measurement of the two urinary enzymes. Alkaline phosphatase and glucose were markedly and transiently elevated in proximal tubular damage and N acetyl-beta-glucosaminidase showed a sustained elevation in papillary damage. It is concluded that both selective urinary enzymes and the molecular weight pattern of urinary proteins can be used to provide diagnostic information about the possible site of renal damage. PMID- 3653577 TI - Histopathology of acute toxic responses in selected tissues from rats exposed by inhalation to methyl bromide. AB - To determine and characterize the histological changes induced in selected tissues from the Fischer 344 rat by acute inhalation exposure to methyl bromide (MeBr), groups of 10 male rats (11-13 weeks old) were exposed to 0, 90, 175, 250, or 325 ppm MeBr 6 hr/day for 5 days. Animals were anesthetized with phenobarbital then perfusion-fixed 1-2 hr after the last exposure or in extremis (325 ppm, 4 days) with Karnovsky's fixative and selected tissues were processed for light microscopy. With the exception of the nasal passages, tissues were selected on the basis of previous studies with methyl chloride (MeCl). The nose was examined as part of ongoing research of nasal toxicity in this laboratory. The principal clinical signs, confined to the 250 and 325 ppm groups, were diarrhea, hemoglobinuria, and, in a few cases, gait disturbances and convulsions. A dose dependent vacuolar degeneration of the zona fasciculata of the adrenal glands, cerebellar granule cell degeneration, and nasal olfactory sensory cell degeneration were seen in all concentration groups except at 90 ppm. Cerebral cortical degeneration and minor alterations in testicular histology were seen only in the 325 ppm group. Hepatocellular degeneration was confined to the 250 and 325 ppm groups. No changes were seen in the kidneys or epididymides. This study demonstrates that MeBr has similar target organs to MeCl suggesting that similar mechanisms of toxicity may be operational. However, important differences in the nature of cellular responses to these chemicals may facilitate studies on their mechanisms of actions. PMID- 3653578 TI - [Alcoholism and heroin dependence]. PMID- 3653579 TI - [Monitoring treatment with oral anticoagulants in non-hospitalized patients]. PMID- 3653580 TI - [Hypertension in pregnancy: therapeutic aspects]. PMID- 3653581 TI - [Recurrent bronchopneumonitis with cascading metabolic decompensation (mental confusion, glucose decompensation, hyperazotemia) in a diabetic subject with probable cancer of the prostate and bone metastasis in lumbar site. Clinical case]. PMID- 3653582 TI - Pressure-dependent vasoactive effects of histamine in the coronary circulation. AB - Twenty-one isolated, perfused, spontaneously rhythmic guinea pig hearts (Langendorff preparation) were used to investigate the effects of coronary perfusion pressure (CPP) on the coronary vasoactive response to a continuous infusion of histamine. Heart rate (HR), coronary perfusate flow (CPF), left ventricular pressure, dp/dtmax, oxygen extraction, and myocardial oxygen consumption (MVO2) were measured at constant CPP of 40 (n = 9), 53 (n = 6), and 65 cm H2O (n = 6) in the absence and presence of continuous intracoronary infusion of histamine [0.9 +/- 0.2 microgram/(min X g)]. At 40 cm H2O histamine caused significant coronary vasodilation. At 65 cm H2O histamine caused significant coronary vasoconstriction. At an intermediate pressure of 53 cm H2O histamine had no effect on CPF. At all three pressures HR, left ventricular pressure, dp/dtmax, and oxygen extraction increased significantly in response to histamine. MVO2 was unchanged by histamine at 65 cm H2O (flow was reduced but extraction increased. MVO2 increased modestly but significantly at 53 cm H2O (12% increase; flow unchanged but extraction increased), and increased prominently at 40 cm H2O (50% increase; flow and extraction increased). We conclude that the coronary vascular effects of continuously infused histamine are dependent on the preexisting, steady-state level of CPP in the isolated perfused guinea pig heart. PMID- 3653583 TI - Conversion of phosphatidylglycerol to lyso(bis)phosphatidic acid by alveolar macrophages. AB - We report here studies of the synthesis of lyso(bis)phosphatidic acid [L(b)PA] by normal and BCG-elicited rabbit alveolar macrophages. This study was prompted by our earlier observations that 1) alveolar macrophages did not synthesize L(b)PA de novo despite its abundance in these cells, 2) BCG-elicited cells contained only one-quarter the amount of L(b)PA as normal cells, and 3) the turnover of arachidonate in L(b)PA led to hydroxyeicosatetraenoic acid and leukotriene synthesis. We found that exogenous phosphatidylglycerol (PG) was specifically converted to L(b)PA by both types of cells although BCG-elicited cells had only one-quarter the synthetic capacity of normal cells. Other phospholipids were found to become cell associated but were not significantly metabolized. Both glycerol moieties and the phosphate were incorporated into the product L(b)PA. However, substitution of the ester with an alkyl linkage in position 1 blocked the conversion of PG to L(b)PA. Most of the alkylphosphatidylglycerol was converted to phosphatidylcholine and phosphatidylethanolamine. This result implied that catabolism of the acyl group in position 1 was essential for L(b)PA synthesis. Because alveolar macrophages are present in a surfactant-rich milieu, we suggest that surfactant provides a source of PG for macrophage synthesis of L(b)PA in situ. It is interesting that the surfactants from rabbits challenged with BCG have a significant decrease in PG content. PMID- 3653584 TI - [Equilibrium angioscintigraphic evaluation of sequential changes in right ventricle function in patients with lower myocardial infarct and ischemic co involvement of the right ventricle: long-term study]. AB - The purpose of this study was to define the sequential changes in global and regional right ventricular function, using equilibrium gated radionuclide angiography, following transmural inferior myocardial infarction (IMI) and associated ischemic right ventricular involvement. 24 patients with IMI underwent radionuclide angiography within 72 hours of onset of chest pain; subsequent studies were done at 13 +/- 5 days and at 6 +/- 2 months. Scintigraphic evidence of ischemic right ventricular involvement was defined by depression of right ventricular ejection fraction (less than 40%) and regional wall motion abnormalities (hypo-a-dyskinesia of right ventricular free wall). Significant improvement of global right ventricular ejection fraction was observed in 15 patients at the second study, and in 21 patients at the third study. Right ventricular regional wall motion showed similar improvement from the initial to the final studies. Significant changes in right ventricular function occurred without concurrent changes in global and regional left ventricular ejection fraction. We concluded that patients with IMI and ischemic right ventricular involvement show frequently improvement of global and regional right ventricular function over time. This changes tend to occur early and without significant modifications in left ventricular function. The good prognosis observed in our patients, despite the high incidence of in hospital complications, might be related to the improvement of right ventricular function. PMID- 3653585 TI - [Late aortic dissection after aortic valve substitution. Considerations on 5 operative cases]. AB - This study analyses the clinical course of five patients who developed acute ascending aortic dissection 45.8 months (17-87 months) after aortic valve replacement (AVR) and underwent reoperation in our Department. All except one had aortic insufficiency with mild dilatation of the ascending aorta. No evidence of aortic wall degeneration was present at the time of AVR. Prostheses implanted were: Hancock 2, St. Jude 2, Bjork-Shiley 1. Associated procedures (coartectomy, coronary artery by-pass) were carried out in two patients. The dilated aorta was managed at the first operation by longitudinal resection in 3 of them. Emergent aortic dissection repair was performed: in 3 cases with composite graft according to the Bentall procedure, in one case with non valved dacron conduit and in the last case with teflon patch. Histological examination of the dissected aortic wall showed elastic fiber degeneration like cystic medial necrosis. Three patients survived surgical repair and are doing well at 22.4 months of mean post operative follow-up. Surgical strategy of this complication is discussed; particular emphasis is given to the method of treatment of ascending aorta dilatation during AVR. PMID- 3653586 TI - [Transposition of the great vessels with interventricular defect and stenosis of the left ventricular efflux channel: anatomical correction by the intraventricular repair technic]. AB - New technique of anatomical correction of transposition of the great arteries (TGV) with ventricular septal defect (VSD) and pulmonary stenosis (PS) without using a prosthetic conduit was reported by Lecompte in 1982. We analyse our recent experience with this procedure in three patients and we describe the main advantages and the wide surgical indications with reference to the Rastelli procedure. PMID- 3653587 TI - [Determination of the transvalvular gradient using continuous wave Doppler in patients with mitral stenosis. Correlation with the hemodynamic method]. AB - In order to assess the reliability of Doppler echocardiography in the determination of mean mitral gradient 38 consecutive patients (pts) affected by rheumatic mitral valve stenosis (MS) were analyzed by continuous wave Doppler echocardiography (CWD). Cardiac catheterization (CATH) was performed within 24 hours from echocardiographic examination. The mean diastolic mitral gradient (MG) at CATH was calculated by planimetry from simultaneously recorded left ventricular and pulmonary artery wedge pressure. The maximal velocity profile through the mitral valve was used to calculate pressure gradient by CWD. A mean mitral gradient was calculated for each patient by the planimetered velocity profile throughout diastole. MG determined by CATH ranged from 6 to 31 mmHg (mean 15.2 +/- 6.0); MG determined by CWD ranged from 4 to 18 mmHg (mean 10 +/- 3.7). The correlation between CWD and CATH by linear regression analysis was: y = 0.53 X + 1.8; r = 0.85; p less than 0.001. Mean % error of CWD in the assessment of MG was 34.7%. In conclusion this study indicates that CWD seems systematically underestimate MG with respect to CATH. The identification of CWD flow tracings "optimal" for analysis could not represent the maximal velocity of transmitral jet, which is a complex three dimensional entity. In addition non-simultaneous determinations of gradient and day-to-day variations in cardiac output may account for discrepancies between CWD and CATH measurements. PMID- 3653588 TI - [Doppler study of porcine bioprosthesis at the mitral site]. AB - Twenty-nine asymptomatic patients with porcine (9 Liotta, 8 Carpentier, 8 Hancock and 4 Xenomedica) mitral prosthesis without clinical findings of prosthetic dysfunction and with normal M-mode and two-dimensional echocardiography were studied with pulsed and continuous wave Doppler. The following parameters of prosthetic function were evaluated: 1) maximum velocity (Vmax); 2) mean pressure gradient; 3) pressure half-time (P 1/2 t); 4) functional prosthetic area or Doppler orifice area (DOA); 5) mitral prosthetic regurgitation (MR); 6) tricuspid regurgitation (TR), if associated. P 1/2 t reproducibility was tested. For the study of the bioprosthetic function the transducer was located in apical position with the best alignment between ultrasonic beam and flow direction in the apical four-chamber view. The best acoustic signal was the guide to an optimal Doppler recording, analyzed for calculations. In 26 patients without MR at Doppler examination Doppler data were as follows: Vmax 1.6 +/- 0.2 m/sec (1.2-2 m/sec); mean pressure gradient: 4.4 +/- 2.7 mmHg (1.4-13 mmHg); P 1/2 t = 94.2 +/- 19.8 msec (55-140 msec); DOA = 2.4 +/- 0.6 cm2 (1.5-4 cm2). Mild unsuspected MR was detected in 3 patients, but the other parameters did not differ from those of the other 26 patients. TR was found in 10 patients. The degree of reproducibility of P 1/2 t was 0.92. Only the P 1/2 t value was longer among Hancock and Liotta or Xenomedica bioprosthesis (p = 0.005). Furthermore P 1/2 t was longer in the patients with longer follow-up periods than in the others (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653589 TI - [Echocardiographic aspects of false intraventricular tendons]. AB - A series of 4260 consecutive echocardiographic examinations, performed in 5 Cardiological Centers was examined, identifying 125 intraventricular false tendons (FTs) in 100 cases (55 normals and 45 with heart disease) of whom 31 were female and 69 male, aged 3 to 82 years. An anatomo-morphological study was possible in 9 cases, dead for stroke or heart failure, on autopsy, and in 7, on heart surgery. A phonocardiogram was performed in all normals and in 20 patients. On echocardiography, FTs appeared as an echo-producing string-like structure, straight between the septum and the ventricular free wall, mobile during the cardiac cycle, without systolic thickening and any relation with the atrioventricular valvular apparatus. The prevalence of FTs was 2.3%; it was 3.2% to 5.3% in younger people. FTs were located in the right ventricle (4 cases), left ventricle (95 cases) or in both (1 case). Their site was left apical (45 FTs), right apical (2 FTs), right (3 FTs) and left (20 FTs), upper septum-to-free wall (55 cases). In 1 case hypertrophy of trabeculae of the left ventricle was detected. FTs were single (79 cases), double (19 cases), multiple (2 cases), short (42 cases), long (58 cases), thick (45 cases) and thin (55 cases). They showed a membrane-like motion (thick FTs-45 cases) and a valve-like motion (thin FTs-55 cases). Innocent murmur was detected in 50 of 55 normals and related to thin FTs. Of 16 cases examined anatomically and histologically, FTs were fibrous in their distal portion and fibro-muscular in the proximal one in 12 cases, whereas they were entirely fibrous-muscular in 4 cases. The site and location of FTs detected by echo were confirmed by anatomy in all cases. In 4 cases other 9 FTs, not detected on echocardiography, were found. These data suggest that echocardiography is a useful tool to detect intraventricular FTs and differentiate them from other echo-producing structures. Although a relationship between FTs and heart disease has not been found, their presence could be responsible of innocent murmur in many normal subjects. PMID- 3653590 TI - Efficacy of diltiazem in variant angina. Results of a double-blind crossover study in CCU by Holter monitoring. The possible occurrence of a withdrawal syndrome. AB - The short and long term efficacy of diltiazem, a calcium-entry blocker, has been evaluated in a group of ten patients with Prinzmetal's variant angina admitted to a CCU. In the short term part of the study, after a run-in period, diltiazem 60 mg tid and placebo were administered alternatively during 4 randomized 72 hour periods. Response was assessed using continuous Holter monitoring, measuring the frequency of transient ischemic attacks. During the run-in period the number of episodes/day/patient was 16.1. No episodes of transient ST segment elevation were recorded during both periods of diltiazem treatment in 3 patients and during one of the two periods in 4. For the group as a whole the number of episodes during the first placebo period was not statistically different from that during the run in period (208 versus 161). No statistically significant difference was also found in 8 patients comparing the number of episodes during the second placebo period and the run-in period (166 versus 101). During each period of diltiazem treatment an highly significant reduction in the number of episodes was observed (43 and 5, p = .006 and p = .02). Two patients did not complete the study protocol. Both patients had a worsening of angina during the first placebo period following diltiazem treatment. One of them developed an acute myocardial infarction. The possible occurrence of a rebound phenomenon after withdrawal of diltiazem seems to be indicated, in 6 patients, by a significant increase in the number of ischemic episodes recorded during the placebo period following active treatment in respect to the number during the first placebo period (159 versus 73, p = .04).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653591 TI - [Comparative evaluation using an ergometric test of the efficacy of the 3 major calcium antagonists on exertion stable angina]. AB - Nifedipine, diltiazem and verapamil are three effective calcium-antagonists in the treatment of angina pectoris. We compared their effects on effort angina to evaluate whether one of them is more efficacious. The data were collected from 42 patients (37 males, 5 females; mean age 51 +/- 4) entering one of 3 different trials; the beginning of all trials comprised a two-week, single blind, placebo run-in phase. An exercise stress test was performed at the end of this period and it was considered as basal test for the statistical analysis. Then the 42 patients were divided in 3 groups of 14 and entered a double-blind, randomized phase of drug treatment. The 3 groups started 3 parallel trials: 1) placebo/nifedipine 60 mg/day; 2) placebo/verapamil 360 mg/day; 3) placebo/diltiazem 240 mg/day. The duration of each trial was of 6 weeks (3 weeks of treatment with placebo and 3 weeks with active substance). Exercise stress tests were performed at the end of each phase of the trials, and the resulting data were compared with the data of the test performed at the end of run-in period. Parameters evaluated were: heart rate, blood pressure and rate pressure product at basal conditions, at submaximal and peak exercise; moreover we considered workload, maximal ST segment depression, total exercise duration and frequency of exercise-induced angina. Verapamil reduced rate pressure product at basal condition; all three drugs reduced rate pressure product at submaximal exercise, but a significant statistical difference was found only for verapamil and diltiazem.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653592 TI - [Anomalous origin of the left coronary from the trunk of the pulmonary artery. Description of a clinical case]. AB - The case of a 32 year old woman with anomalous origin of the left coronary artery from the pulmonary trunk is reported, in whom, for technical difficulties, the surgical correction has been limited to artery ligation. After surgery, there was a complete clinical improvement and normalization of the stress electrocardiogram. Nevertheless, radioisotopic studies--exercise Thallium 201 scintigraphy and radionuclide ventriculography--disclosed a poor left ventricular function. It is possible to suppose that the prolonged perfusion deficit resulted in an extensive area of myocardial fibrosis. PMID- 3653593 TI - [Ebstein disease and pregnancy]. AB - Three patients with Ebstein's disease became pregnant 11 times, 6 of which ended as spontaneous abortion, 2 newborn deaths and 3 successful term pregnancies. Ventricular overloading, arterial hypoxemia and arrhythmias are the major physiopathologic determinants. The ventricular overloading is the most important risk factor for the mother, so as the hypoxemia and the arrhythmias for the fetus. Pregnancy in these patients must be considered at high risk, and a close cardiologic assess with continuous hormonal controls of fetus maturity during the last trimester should be done. A team including obstetricians, cardiologists and anesthesiologists is suggested for the care of these patients in the view of a successful outcome. PMID- 3653594 TI - [Reflections after the National Congress of Cardiology]. PMID- 3653595 TI - [Early peak of CPK in acute myocardial infarct: a marker of clinical instability?]. AB - The evaluation of the CPK-peak time (CPK-p) during Acute Myocardial Infarction (AMI) is now considered as a reliable method to identify ischemic myocardial tissue reperfusion both spontaneous and pharmacologically-induced. The purpose of this study is to assess the clinical significance of this index over a non selected group of patients (pts) affected by a first episode of AMI looking for some variables possibly connected with it. This study includes 114 pts hospitalized in our Unit Coronary Care (UCC) and diagnosed as affected by AMI and not treated with anticoagulant and/or fibrinolytic drugs. They were divided according to CPK-p into 2 groups: group A (23 pts, 18M 5F, mean age 64.2 +/- 10.1y; CPK-p 11.9 +/- 3.3h, AMI Anterior 14/AMI Inferior 9) and group B (91 pts, 85M 6F, mean age 64 +/- 10.3y; CPK-p 25.7 +/- 4.5h, AMI Anterior 50/AMI Inferior 41). Moreover, a third group C has been studied including pts with similar clinical characteristics who underwent thrombolysis by intravenous infusion of Streptokinase (48 pts, 39M 9F, mean age 62.7 +/- 10.6y; CPK-p 15.2 +/- 7h, AMI Anterior 28/AMI Inferior 20). For each pt CKP-p has been evaluated as well as the pre-UCC time (T-pc), the maximum value of released CPK (CPK-max), the incidence of new coronary events such as angina, re-AMI, sudden death detected between the 1st (NEC-I) and the 6th month (NEC-II) after the acute event.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653596 TI - [The course of residual stenosis after intracoronary thrombolysis]. AB - Clinical outcome after coronary thrombolysis are strictly related to the residual stenosis. However, the natural history of this lesion is largely unknown. To assess this topic we evaluated 25 patients who had coronary recanalization by urokinase in acute myocardial infarction. Serial coronary angiograms were taken immediately after fibrinolytic therapy, before hospital discharge and 1 year later. Angiographically detected coronary reocclusion and/or new ischemic events were exclusion criteria. Angiographic analysis was performed at a five-fold magnification. The followings were specifically evaluated: a) vessel contours at the site of the residual stenosis; b) luminal diameter reduction; c) presence of intraluminal filling defects. RESULTS: the vessel narrowing progressively improved from the acute phase (percent of stenosis 92 +/- 7) to the hospital discharge (82 +/- 8%, p less than .01) and to 1 year follow-up (76 +/- 11%, p less than .001 vs hospital discharge). Moreover, the residual stenosis appears to be "complicated" in early period (irregular contours with superimposed thrombus), but become regular and "uncomplicated" at follow-up examination (smooth contours, hourglass configuration, no intraluminal filling defects). IN CONCLUSION: a) the residual coronary stenosis is a dynamic process and may improve at follow-up examination; b) a practical approach to the management of the residual stenosis must take in account the natural history of the lesion to give a correct indication for coronary surgery or PTCA. PMID- 3653597 TI - [Value of the isovolumetric index in the diagnosis of ischemic cardiopathy with normal left ventricular volume and ejection fraction]. AB - Purpose of this study was to assess if the isovolumic index (IVI%) was able to detect the presence of critical coronary artery disease (CAD) in a group of 43 patients with anginal chest pain and normal left ventricular volumes and ejection fraction. The left ventricular function was before evaluated with invasive method and then the IVI% was allowed in every patient. The IVI% was able to recognize early abnormalities of isovolumetric phases of the left ventricle and differentiated normal subjects (IVI% = 40.07 +/- 2.82) from patients with CAD (IVI% = 60.87 +/- 12.49; p less than 0.01). The only parameter of left ventricular function invasively calculated able to separate normal patients from patients with significant CAD were the muscular stiffness of the left ventricle (p less than 0.01). PMID- 3653599 TI - [Usefulness of exertion tests in the evaluation of the effectiveness of antihypertensive therapy]. AB - Aim of this study was to assess the reliability of blood pressure (BP) response to exercise compared with the occasional BP measurements in evaluating the efficacy of an antihypertensive therapy. We have studied 40 subjects (22 M, 18 F mean age 33.3 +/- 6.6) with essential hypertension (19 with mild hypertension, 8 with moderate hypertension, 13 with severe hypertension). Every patient underwent a maximum graded exercise test in the supine position on a bicycle ergometer before starting the antihypertensive treatment. An exercise test was repeated with the same procedure after resting BP had been normalized for at least six months. Both systolic and diastolic BP at peak exercise were significantly reduced (systolic BP from 212.13 +/- 25.79 mmHg to 194.38 +/- 21.58 mmHg; diastolic BP from 128.00 +/- 16.52 to 114.1 +/- 11.02 mmHg) during the second test. An excessive BP increase (above the 95% confidence limits of the BP response to exercise in a group of normotensives) was observed in 32 subjects during the first test. A "hypertensive" response to stress persisted in 13 subjects during the second test even if the resting BP values were normalized. Our data support the value of stress testing in both the evaluation of the hypertensive patient and the assessment of the individual response to treatment. PMID- 3653598 TI - [Usefulness of the electrophysiologic study in the prognostic evaluation of patients with syncope of uncertain origin]. AB - Recurrent, sudden temporary loss of consciousness is a common clinical problem: in the absence of electrocardiographic monitoring during a syncopal episode (S), abnormalities demonstrated by an electrophysiological study (ES) may suggest the etiology of S. We have performed a complete ES in 53 Pts (M. 38-F. 15, mean age 63 y.) with recurrent unexplained S (3.8 S/pt) by means of a standardized protocol. Group I: 30 Pts (mean age 65 y, 3.6 S/pt) with structural heart disease. Thirteen of these had abnormal ES findings: inducible ventricular tachycardia in 6, prolonged HV interval in 7 (with bundle branch block), very fast atrial flutter in one. Group II: 23 Pts (mean age 61 y., 3, 9 S/pt), without organic heart disease. The ES was abnormal in 14 Pts showing a prolonged HV interval in 11 (with bundle branch block), an intrahisian block in 1 and an inducible AV nodal tachycardia with heart rate greater than 200/m' in one. Only the Pts with abnormal ES were treated according to their condition with amiodarone or with an implantable pacemaker. Three PTs with C.H.D. and normal ES successfully underwent by-pass surgery. During the follow-up (20 months) therapy based on ES provided symptomatic relief (no S) in 25 of 26 Pts with abnormal electrophysiological study. Syncope persisted in 4 of 26 Pts in whom ES did not define a mechanism of S. No sudden death in any Pt. CONCLUSIONS: ES was, therefore, of diagnostic value in more than half of the patients with syncope of unknown cause and long-term treatment based on ES was successful in the prevention of S (remission rate of 93% in patients treated with amiodarone or pacemaker). PMID- 3653601 TI - [2-dimensional echocardiography in infarct of the right ventricle: correlation with clinical, hemodynamic and scintigraphic findings]. AB - Right ventricular wall motion was studied in 18 patients hospitalized for acute myocardial infarction by means of cross-sectional echocardiography. Diagnosis of right ventricle myocardial infarction was made on the basis of clinical, electrocardiographic, hemodynamic criteria, respectively present in 66%, 80% and 66% of our patients. Echocardiographic criteria of right ventricle infarction were: 1) right ventricle dilatation; 2) segmental or global right ventricle wall motion abnormalities; 3) paradoxical motion of interventricular septum; 4) tricuspid insufficiency; 5) inferior cava vein dilatation with paradoxical respiratory pattern. Seven patients were studied by means of radionuclide techniques, that confirmed right ventricle infarction in 6 patients. We conclude that: 1) the most accurate echocardiographic views for right ventricle wall motion study are subcostal views and, in particular, the subcostal short-axis (OAS 60 degrees); 2) those patients (12/18) with a specific echocardiographic pattern for right ventricle infarction presented a specific clinical and hemodynamic picture; 3) those patients (6/18) with only segmental right ventricular wall motion abnormalities presented an aspecific clinical and hemodynamic picture. Moreover we showed that an improvement of right ventricular wall motion was observed in some cases within a few days of the infarction. Further observations are needed to assess the frequency and late prognosis of acute right ventricle infarction. PMID- 3653600 TI - Extracardiac malformations and congenital heart disease: frequency and patterns of associations. AB - Congenital Heart Malformations (CHM) can be present together with Extracardiac Malformations (ECM) in a single individual, however the frequency and the patterns of associations are not well defined because the casistics of the literature are little comparable. The diagnosis of CHM has been demonstrated with cardiac catheterization in any case. Between January 1st, 1976 and December 31st, 1983 cardiac catheterization has been performed in 1012 children and 971 of them were affected by Congenital there was at least one ECM as well (group B); 311 ECM were present in group B. VSD (p less than 0.05) and Atrioventricular Septal Defects (AV.SD) (p less than 0.01) resulted associated with ECM while T.F. (p less than 0.05) and isolated TGA (p less than 0.01) showed the tendency to occur in isolation. VDS resulted associated with gastrointestinal anomalies (p less than 0.05), AV.SD with T21 (p less than 0.001), aortic valve (p less than 0.05) and supra-valve (p less than 0.001) stenosis with Nervous System abnormalities. Pulmonary stenosis showed little tendency to occur together with T21 (p less than 0.05). PMID- 3653602 TI - Heterogeneity of left ventricular wall dynamics in normal hearts and in chronic aortic regurgitation. A two-dimensional echocardiographic study. AB - The variation in shape, in the global and regional function of the left ventricle (LV) was quantitated by using Two-Dimensional Echocardiography (TDE) in 20 normal subjects (N) (17 males, 3 females, with a mean age of 21.2 years, age range 15 to 34) and compared to 20 patients with aortic regurgitation (AR) (14 males, 6 females with a mean age of 31 years, age range 16 to 51). The left ventricle was subdivided into two TDE short axis cross-sections at the papillary muscle (PM) and at the mitral valve (MV) level. Wall motion was assessed by the following indices; endocardial systolic fractional area change (FAC), wall thickening (Wth) and circumferential fiber shortening (S). The ejection fraction (EF), the diastolic (EID) and systolic eccentricity index (EIS), the end-diastolic volume (EDV), the end systolic volume (ESV) and the LV mass (M) were estimated using a 4 chamber apical view. Measurements of sectional cavity areas, muscle areas and endocardial perimeters were obtained twice independently by two observers using a computer aided system, to achieve the final results as the mean of the 4 measurements. Paired t-test showed a statistically significant variation between PM and MV for FAC in N (p less than 0.001). A statistically significant difference (p less than 0.01) was found for EID between N and AR. The EIS was not significantly different in the two groups. In AR a significant difference was found between EID and EIS (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653604 TI - [Echocardiographic diagnosis of left ventricular myxoma. Description of a case and review of the literature. Myxomas of the left ventricle]. AB - A case of left ventricular myxoma diagnosed by echocardiography and successfully removed by left ventriculotomy is reported. This is a 21 year old male, with the few symptoms which simulating an hypertrophic cardiomyopathy in contrast to the large size of the tumour. It is possible that myxomas are responsible for sudden death. Therefore, in presence of new cardiac signs kind and relevance, the possibility of a myxoma should be considered. The diagnosis can be easily ruled out (or confirmed) by echocardiography, which represents a valuable tool in the diagnosis of myxomas. PMID- 3653603 TI - [Hemodynamic effects of diltiazem in the subacute stage of myocardial infarct treated by thrombolysis]. AB - Since Ca++-overloading is a major problem after myocardial reperfusion we studied the effects of Diltiazem on the left ventricular diastolic function in the early days following coronary thrombolysis. Twelve patients who had myocardial reperfusion by intracoronary urokinase in acute myocardial infarction were admitted to the study. Previous infarct, cardiogenic shock or late thrombolysis (greater than 4 h from symptoms onset) were exclusion criteria. All subjects were evaluated at control cardiac catheterization 5-8 days after the acute ischemia. Simultaneous left ventricular angiography and high-fidelity pressure recordings by means of a tip-micromanometer and angiographic catheter were performed at rest and after intravenous Diltiazem administration (16 mg over 2' + 0.008 mg/Kg/min). Indexes of myocardial relaxation and early ventricular filling were impaired at rest but improved significantly after Diltiazem (Tab. II). Isovolumic relaxation period fell from 92 +/- 8 msec to 77 +/- 12 msec (p less than .01), T constant of isovolumic pressure decay decreased from 61 +/- 7 msec to 55 +/- 7 msec (p = ns), first-third of filling rate increased from 64 +/- 7% to 79 +/- 6% (p less than .01). On the other hand, indexes of left ventricular compliance were altered after coronary reperfusion (left ventricular end-diastolic compliance 17 +/- 13 mmHg-1. 10(-3), modulus of chamber stiffness .045 +/- .008) but but did not change after calcium-blocker therapy. In conclusion, post-thrombolysis diastolic function is severely impaired at rest, probably because of raised intracellular Ca++ and delayed asynchronous relaxation. Diltiazem improves energy-dependent early diastole, but does not affect ventricular compliance. PMID- 3653605 TI - The short-term effects of an intervention programme on the modifications of plasma lipids in workers. The pilot study. AB - The purpose of the pilot study was to determine the effectiveness of a medical intervention program in the reduction of plasma lipids in a group of hyperlipemic persons. Two groups were compared in this study over a one year period. The groups consisted of a group of hyperlipemic persons with TG levels greater than 150 mg% and a second group with plasma lipids within normal limits. The plasma lipids concerned in this study were cholesterol, triglycerides, and HDL-C. The group of hyperlipemic subjects received intense nutritional counselling while the normal subjects received only printed guidelines to normal healthy nutrition. The results of this study, confirm positive results obtained by other intervention programs. A substantial reduction in TG levels was observed in 37.7% of the hyperlipemic group while 14.1% of the normal group had considerable increases in their TG levels during this one year study period. The results of the serum lipid surveys proved the high interyear correlation for both HDL-C and TC, but a very much weak interyear correlation for TG. PMID- 3653606 TI - Effect of smoking on serum immunoglobulins and cellular blood constituents in healthy individuals. AB - The purpose of this paper was to study a possible link between smoking and systemic immunological abnormalities, which could have been eventually the common ground for chronic degenerative processes Blood samples were taken from 319 apparently healthy men from 19-45 years of age. Mean values of hemoglobin were slightly higher in smokers than in nonsmokers but the difference appeared to have been insignificant. In contrast, the erythrocyte counts in nonsmokers were significantly higher. Although all types of white cells were in larger numbers among smokers only neutrophilic granulocytes and lymphocytes were substantially higher than in the group of nonsmokers. In nonsmokers mean value of IgG and IgA were about 10% higher than in smokers. The same pattern was observed for serum globulin alpha 2. The clear dose-response relationship was observed for neutrophilic granulocytes, erythrocyte counts and IgG level. PMID- 3653607 TI - [Nasal and bronchial respiratory pathology in a group of workers exposed to phthalic anhydride]. AB - Each subject answered a questionnaire, and was submitted to respiratory function tests, bronchial challenge with methacholine and ultrasonic "fog", specific challenge with fumes and powder of PA, measuring nasal and bronchial resistances at the same time by means of a plethysmograph. Serum specific IgE against PA were assessed by the method E.L.I.S.A. Inhalation of "fog" induced a positive nasal response (i.e. nasal resistance increase greater than 70% from baseline) in 73.7% of the subjects, whereas only 3 subjects had a positive bronchial response; specific challenge with PA induced a positive nasal response in 75% out of the subjects, whereas a positive bronchial response was observed in only one subject. 22.7% of the subjects had bronchial hyperreactivity to methacholine. In none of the subjects specific IgE against PA were detectable. We conclude that PA acts as an aspecific irritative agent of airways, particularly of nasal airways. PMID- 3653608 TI - Blood and hair lead levels in 6-year old children according to their parents' occupation. AB - Some authors found higher lead levels in children whose parents are occupationally exposed to the metal, which is probably carried home with dirty work clothes. In order to verify the relevance of the risk in tile-workers' children we examined 3 groups of 5-7 years old children whose parents were: a) tile workers employed in lead areas; b) tile workers not employed in lead areas; c) workers not occupationally exposed to lead (control group). We found that lead workers children had PbB and PbH significantly higher than control children although all PbB values were lower than 30 micrograms/dl. Nevertheless this observation suggests that major attention must be paid to individual preventive measures, such as the change of work clothes and good personal hygiene after every work shift. PMID- 3653609 TI - [Bronchopneumopathy caused by wheat flour: analysis of clinical cases]. AB - We studied 31 subjects exposed to wheat (mean work duration: 33 years) with chronic bronchopulmonary disease. 19 subjects complained of chronic cough and phlegm, 5 of symptoms of bronchoconstriction not associated to chronic cough and phlegm; 7 subjects complained of oculo-rhinitis. Subjects with symptoms of bronchoconstriction had a longer mean age and work duration than the other ones. Pulmonary function tests showed a slight decrease of mid-expiratory flow rate with respect to reference values. Skin reactivity to common allergens and to allergenic extracts of wheat flour and grain was low, but a relevant number of dubious responses (weal: 3-4 mm) to specific allergens was observed. Bronchial hyperresponsiveness to methacholine or bethanechol was observed in 17 out of 30 subjects, and a positive response to occupational-type specific bronchial provocative test (sBPT) was elicited in 10 out of 30 subjects. There was a low relationship between positive response to sBPT and symptoms of bronchoconstriction or skin reactivity to specific allergens. These observations suggest that a high prevalence of chronic bronchitis and/or chronic airway limitation is showed in workers long-term exposed to wheat flour, in front of a low prevalence of skin reactivity to flour and grain. Occupational-type sBPT might induce in these patients a non immunological positive response to wheat flour by means of a not completely known mechanism. PMID- 3653610 TI - [Hyperlipidemia findings in workers in an oil refinery]. AB - During a cross sectional epidemiologic study the cholesterol and triglyceride plasmatic levels were measured in 207 workers employed in an oil refinery. Our results show high levels both for cholesterol and triglyceride. Emphasis has been laid on the serious dietary and hygienic problems for these workers. The finding of hyperlipidemia as well as obesity and over-weight do not seem to be related to exposure to any occupational chemical hazard. PMID- 3653611 TI - [Neo-Hippocratic medicine]. PMID- 3653612 TI - [Leukocyte disorders in neonatal septicemia]. PMID- 3653613 TI - [Urinary elimination of dopamine during the human menstrual cycle]. PMID- 3653614 TI - [Excretion of dopamine in the female climacteric]. PMID- 3653615 TI - [Campylobacter pylori: toward the recognition of a new pathogen?]. PMID- 3653617 TI - [Study of malabsorption of lactose by the hydrogen breath test in a population of 70 Tunisian adults]. AB - Lactose malabsorption was studied by the hydrogen breath-test in 23 adults suffering from irritable bowel syndrome (group A) and in 47 healthy subjects (group B). The concentration of hydrogen in end-expired alveolar samples was measured after ingestion of 25 g of lactose. Among the 70 subjects, 6 (8.5 p. 100) were not hydrogen producers and were excluded from the study. Lactose malabsorption was shown in 51 of the remaining 64 subjects (79.6 p. 100). Among these 51 patients, 36 were healthy and 15 had an irritable bowel syndrome. The frequency of lactose malabsorption among the 43 healthy hydrogen producers was 83 p. 100. This value is similar to those observed in other studies (greek and italian). Our results suggest that lactose malabsorption is frequent among the tunisian adult population. PMID- 3653616 TI - [Campylobacter pylori and gastric mucosa: histological and bacteriological study and preliminary results of an epidemiological survey in the area of Nantes]. AB - The aims of this study were to: a) evaluate the prevalence of Campylobacter pylori (CP) in patients referred to a gastroenterology unit for upper digestive tract endoscopy, b) compare the results of histologic (Warthin-Starry method) and bacteriologic (direct and culture) examinations, c) correlate the presence and abundance of CP with the "activity" of chronic gastritis as assessed by antral and fundic specimens, and d) report the preliminary results of an epidemiological survey in the area of Nantes, France. CP was observed in 30 of the 64 patients studied (46 p. 100 of cases), and was significantly associated with chronic gastritis of either the superficial or interstitial (87 vs. 12 p. 100 of patients positive and negative, respectively for CP studies, p less than 10(-9], and preatrophic and/or atrophic types (40 vs. 12 p. 100 of patients positive and negative, respectively, for CP studies, p less than 0.01). CP was also present in 7 of 10 patients with duodenal ulcers and in 4 to 6 with gastric ulcers. Histologic and bacteriologic studies gave concordant results in 94 p. 100 of cases, and had the same sensitivity for diagnosis. Patients positive for CP studies had a statistically significant increased incidence of epigastric burns, and, at endoscopic examination, their fundic area appeared congestive more frequently. CP were dictated in both the antrum and fundus, but lesions of chronic gastritis were more prominent in the former. There was a statistically significant correlation between the degree of inflammation observed in the lamina propria and the number of CP present in the same area (antrum and fundus).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653618 TI - [Lesions of the area of Oddi's sphincter: incidence and association with biliary and pancreatic lesions in a series of 109 autopsies]. AB - One hundred and nine successive post mortem examinations have been performed with a peculiar attention to the gross and microscopic features of the sphincter of Oddi. Biliary lesions were present in 24 cases and pancreatic lesions in 7 cases. According to previous histologic descriptions, a group of 18 pathologic sphincters of Oddi was selected. Biliary lesions were not more common in this group (28 p. 100) than in the group with a normal sphincter of Oddi (21 p. 100) and inversely, there were no more lesions of the sphincter of Oddi in the group with biliary lesions (21 p. 100) than in the group without biliary lesions (15 p. 100). Chronic pancreatitis was more frequently associated with an abnormal sphincter of Oddi, but in these cases, another associated disease could explain pancreatitis (alcoholism, hemochromatosis). Pathologic lesions of the sphincter of Oddi are frequent and usually latent. These features are not simple anatomic variations because five cases were undoubtedly pathologic with an important thickening of the sphincter and a fibro-adenomatosic pattern. This study shows that sclerosing odditis does exist but is rare. PMID- 3653619 TI - [Acute respiratory distress caused by pancreatico-bronchial fistula in acute pancreatitis. Apropos of 2 cases]. AB - The adult respiratory distress syndrome (ARDS) is a frequent feature of acute pancreatitis. Amylase and lipase values were determined in samples of bronchial secretions in two patients with endotracheal intubation and under supportive ventilation for severe hypoxemia occurring during the course of acute pancreatitis. A pancreatico-bronchial fistula was suggested in both cases. In one case, an endoscopic retrograde pancreatography was performed and demonstrated a fistula between the pancreatic body and the left bronchial tree. Arterial pH values decreased following pancreatography. Splenopancreatectomy was performed in one case, and necrosectomy associated with left pulmonary lobectomy in the other. Documented cases of pancreaticobronchial fistulas have been rarely reported to date. A retrospective study of 10 patients with ARDS was made among 32 patients undergoing laparotomy for objectively recognized necrotizing pancreatitis. A pancreatico-bronchial fistula could be incriminated in three cases. This 30 p. 100 prevalence has to be re-evaluated in the light of serial determinations of amylase and lipase levels in patients with ARD and endotracheal intubation in the course of pancreatic disease. In these patients, high levels of amylase and lipase in bronchial secretions, the use of iso-osmolar X-ray colloids could be helpful in protecting the alveolar membrane against osmolar injury during pancreatography. PMID- 3653620 TI - [Bucco-pharyngeal and esophageal localizations in Crohn's disease]. AB - A case of upper esophageal stenosis associated with pharyngeal lesions in Crohn's disease is reported. The esophageal stricture was intractable by endoscopic dilatation. This patient was managed successfully by total esophagectomy. The left colon was used to replace the esophagus through a posterior mediastinal route. Histologically, the lesions were epithelioid granulomas with ulcerative fissurations and submucosal lymphoid nodules and were suggestive of Crohn's disease involving the upper esophagus and pharynx only. Similar cases involving only the upper digestive tract with pathologic proof have not yet been reported in the literature. PMID- 3653621 TI - [Concentration of explosive colonic gases after preparation by polyethylene glycol solution]. PMID- 3653622 TI - [A case of acute obstructive pancreatitis of uncommon origin]. PMID- 3653623 TI - [Turner's syndrome, angioma and thrombopenia]. PMID- 3653624 TI - [Iodine-131 metaiodobenzylguanidine and carcinoid tumors]. PMID- 3653625 TI - [Acute hepatitis caused by dihydralazine]. PMID- 3653626 TI - [Isolated gallbladder metastasis of malignant melanoma disclosed by cholecystitis]. PMID- 3653627 TI - Dissolution of pancreatic stones by oral trimethadione in a dog experimental model. AB - Experiments were conducted to develop a dissolution therapy for human pancreatic calculi in a dog experimental model of pancreatic calculi surgically prepared. On plain x-ray films of the abdomen, pancreatic calculi appeared in 19 of 39 dogs within 12 mo after operation. The antiepileptic agent trimethadione was given orally to 13 dogs at a dose of 1.0-1.5 g daily. Pancreatic calculi disappeared in 13 of 15 observations. The scanning electron microscopy, the elemental analysis, and the powder x-ray diffractometry of pancreatic calculi in this model revealed that the calculi closely resembled human pancreatic calculi, consisting mainly of a calcite of calcium carbonate. There was no histologic finding suggesting drug toxicity in the liver, the kidney, and the blood. Pancreatic calculi in 6 control dogs without the treatment neither disappeared nor diminished spontaneously. The oral treatment with trimethadione may have potential for dissolving human pancreatic calculi. PMID- 3653628 TI - Natural history of untreated colonic polyps. AB - The natural history of untreated colonic polyps is uncertain. A retrospective review of Mayo Clinic records from a 6-yr period just before the advent of colonoscopy identified 226 patients with colonic polyps greater than or equal to 10 mm in diameter in whom periodic radiographic examination of the colon was elected over excisional therapy. In all patients, follow-up of polyps spanned at least 12 mo (mean, 68 mo; range, 12-229 mo) and included at least two barium enema examinations (mean, 5.2; range, 2-17). During the follow-up period, 83 polyps (37%) enlarged. Twenty-one invasive carcinomas were identified at the site of the index polyp at a mean follow-up of 108 mo (range, 24-225 mo). Actuarial analysis revealed that the cumulative risk of diagnosis of cancer at the polyp site at 5, 10, and 20 yr was 2.5%, 8%, and 24%, respectively. In addition, 11 invasive cancers were found at a site remote from the index polyp during the same follow-up period. These data further support the recommendation for excision of all colonic polyps greater than or equal to 10 mm in diameter. Periodic examination of the entire colon is recommended in this group of patients to identify neoplasms arising at a site remote from the index polyp. Although this study has limitations inherent to any retrospective analysis, comparable prospective data are unlikely to be available in the future because of the current widespread availability of colonoscopy. PMID- 3653629 TI - Tissue-specific gene expression results from a purine- and pyrimidine-free diet and 6-mercaptopurine in the rat small intestine and colon. AB - Dietary purines and pyrimidines are not considered to have a nutritional role, much less a direct effect on the functioning of the gastrointestinal tract. We found that a dramatic decrease in adult rat small intestinal and colonic total ribonucleic acid (RNA) results from the removal of dietary purines and pyrimidines or the administration of 6-mercaptopurine. Ribonucleic acid hybridization analysis indicated specific decrease of the messenger ribonucleic acid (mRNA) for the purine salvage enzymes hypoxanthine-guanine phosphoribosyl transferase and adenine phosphoribosyl transferase in the small intestine and proximal colon but not in the liver of animals fed a diet lacking purines and pyrimidines. Levels of intestinal and hepatic beta-actin mRNA transcripts were generally not depressed by either diet or by the administration of 6 mercaptopurine. Liver hypoxanthine-guanine phosphoribosyl transferase and adenine phosphoribosyl transferase mRNAs were unaffected by the change in diet but were lowered by the administration of 6-mercaptopurine. These data indicate that nutrition and 6-mercaptopurine affect both total RNA, and individual mRNA concentrations at specific sites in the gastrointestinal tract. These findings are of potentially great significance because the regulation of intestinal total RNA levels and purine salvage mRNAs by both 6-mercaptopurine and a purine- and pyrimidine-free diet suggests a potential mechanism by which dietary components differentially control specific proteins synthesized in the body. These findings may be related to the efficacy of 6-mercaptopurine as well as so-called elemental diets as therapeutic agents in chronic inflammatory bowel disease (i.e., Crohn's disease). PMID- 3653630 TI - Antroduodenal resistance to flow in the control of duodenogastric bile reflux during fasting. AB - Our objectives in this study were (a) to determine the role of antroduodenal resistance in the control of fasting duodenogastric bile reflux in the dog and (b) to elucidate the contribution of the pylorus both to resistance and to reflux. Thus, we measured simultaneously throughout the interdigestive motor cycle (a) antroduodenal pressure activity by manometry, (b) antroduodenal resistance by a pneumatic resistometer, and (c) bile acid concentrations in duodenal and gastric juices. Experiments were performed in 15 conscious dogs (9 with pylorus intact and 6 with extramucosal pyloric myotomy). We found that antroduodenal resistance was lowest during phase I, increased gradually during phase II, and peaked during phase III (linear trend, p less than 0.001). Duodenogastric bile reflux was low during phase I, peaked during late phase II, and decreased again during phase III (quadratic trend, p less than 0.05). Therefore, variations in net resistance and reflux were differently related to the phases of the interdigestive motor complex. Pyloric myotomy significantly decreased antroduodenal resistance (linear trend different from control, p less than 0.001), but had no significant effect on duodenogastric bile reflux. We conclude (a) that changes in net antroduodenal resistance do not regulate duodenogastric bile reflux and (b) that the pylorus is an important determinant of antroduodenal resistance, but has no major role in the control of fasting duodenogastric bile reflux. PMID- 3653631 TI - Local control of canine gastric mucosal blood flow. AB - The hemodynamic responses to venous pressure elevation and the effect of metabolic stimulation on reactive hyperemia and autoregulation were assessed in chambered segments of the canine gastric corpus perfused by a pressurized reservoir. Arteriovenous oxygen difference, mucosal pH, and total, mucosal, and muscularis blood flow were monitored continuously. Pentagastrin increased acid secretion, oxygen consumption, and both total and mucosal blood flow. Before and after pentagastrin, the magnitude of reactive hyperemia was correlated with the occlusion duration. During stepwise reductions in perfusion pressure, oxygen consumption was relatively constant and blood flow-independent over most of the pressure range. Mucosal blood flow was well maintained except at the lowest perfusion pressure. Pentagastrin did not enhance autoregulation in the mucosa or muscularis, but did enhance the autoregulation of total blood flow. A myogenic vasoconstriction occurred during 20-mmHg venous pressure elevations. Our results indicate that both metabolic and myogenic mechanisms regulate the gastric mucosal circulation. PMID- 3653632 TI - Effect of bile acids on hepatic protoporphyrin metabolism in perfused rat liver. AB - To determine the effect of bile acids on hepatic protoporphyrin metabolism, balance studies were performed in isolated perfused rat livers. Hepatic protoporphyrin metabolism was found to increase linearly as a function of protoporphyrin dose in livers infused with and without taurocholate (0.7 mumol/min), but their rates differed significantly. Employing a standard 1500 nmol protoporphyrin bolus dose, infusions (0.7 mumol/min) of taurocholate, glycocholate, deoxycholate, and chenodeoxycholate, but not tauroursodeoxycholate or ursodeoxycholate, increased protoporphyrin metabolism 1.7- to 2.7-fold over control (0 bile acid) values. Bile acid infusion ranging from 0.175 to 1.4 mumol/min confirmed that both taurocholate and chenodeoxycholate increased protoporphyrin disposal significantly more than ursodeoxycholate. For all bile acids, the increase of protoporphyrin metabolism was most pronounced between biliary bile acid excretion rates of 10-50 nmol/min.g liver. These data indicate that (a) bile acids facilitated protoporphyrin metabolism, (b) bile acid structure influenced the effect, and (c) ursodeoxycholate may not be a prime candidate to study the role of bile acids in the treatment of protoporphyria. PMID- 3653633 TI - Recurrent abdominal pain as the sole manifestation of hereditary angioedema in multiple family members. AB - This paper describes a previously unreported finding of abdominal pain as the only lifelong manifestation of hereditary angioedema in multiple family members. This diagnosis was obscured by the absence of cutaneous, oropharyngeal, and respiratory involvement. Barium studies performed during painful attacks showed transient intestinal wall edema which, along with abnormalities in the C4 level and C1 esterase inhibitor activity, confirmed the diagnosis. It is important that hereditary angioedema be recognized in its various forms so that invasive procedures can be avoided and prophylactic therapy can be administered. PMID- 3653634 TI - Absence of intestinal synthesis of apolipoprotein B-48 in two cases of abetalipoproteinemia. AB - Previous studies have reported that the absence of chylomicron, very-low-density lipoprotein, and low-density lipoprotein in abetalipoproteinemia is a consequence of apoprotein B (apo B) deficiency. Although the absence of apo B from the intestine has been shown by immunofluorescence, the antiserum used was raised against low-density lipoprotein apo B. Therefore, the precise nature of the underlying defect remains unknown, given that the postulated gene mutation could prevent the synthesis of the molecular form of apo B specific for chylomicrons, apo B-48, or produce an unstable aberrant form of apo B particle. This report concerns 2 girls aged 5.5 and 4.75 with well-documented clinical and biological manifestations of the disease in whom there was no immunologically detectable plasma apo B-48 and apo B-100. Their cultured jejunal explants incubated with [14C]palmitate showed slight decrease in the esterification of triglycerides, phospholipids, and cholesteryl esters. However, only traces of triglycerides and small amounts of cholesteryl esters were found in the culture medium in contrast to phospholipids, which were readily exported. Protein synthesis as assessed by [3H]leucine incorporation by explants was normal and only modestly diminished in the fat chylomicronlike fraction floated from the sonicated explants. However, there was no radioactivity at the electrophoretic position of apo B-100 and apo B 48. Immunologic confirmation of the absence of these two apoproteins was obtained by Western blots. These data confirm the hypothesis that in certain cases of abetalipoproteinemia the intestinal defect results from the lack of synthesis of apo B-48. PMID- 3653635 TI - Expression of human immunoglobulin G subclasses in inflammatory bowel disease. PMID- 3653636 TI - Bile acids in reflux esophagitis. PMID- 3653637 TI - Measuring variceal pressures. PMID- 3653638 TI - Acute appendicitis associated with diesel fuel. PMID- 3653639 TI - Gastrointestinal features of Yersinia enterocolitica infection. PMID- 3653640 TI - Motility studies in patients with severe chronic constipation. PMID- 3653641 TI - About mechanism(s) of indomethacin gastric damage. PMID- 3653642 TI - Esophageal motility disturbances in alcoholics. PMID- 3653643 TI - Studies on the mechanism of bowel disturbance in ulcerative colitis. AB - The transit of a radiolabeled meal through the gastrointestinal tract and stool output were measured in 62 patients with ulcerative colitis, subdivided according to the activity and extent of their disease. The results were compared with those from 20 sex-matched normal subjects. Mouth-to-cecum transit was significantly slower than normal in all patient groups although gastric emptying was normal. Whole gut transit was not accelerated in any group of patients. An abdominal x ray taken 48 h after ingesting the meal showed that patients with active colitis had proximal colonic stasis, whereas transit through the rectosigmoid region was rapid. Stool weights and frequencies were higher in patients with active colitis than in patients with quiescent disease. Patients with active colitis also passed smaller amounts of stool during each bowel movement, suggesting that they experienced a desire to defecate at lower rectal volumes. These results indicate that (a) diarrhea in ulcerative colitis is associated with rectosigmoid irritability rather than rapid transit and (b) caution should be used when treating active colitis with antidiarrheal drugs that could further retard proximal colonic transit. PMID- 3653644 TI - Identification of muscarinic M2 receptors on single muscle cells of the human and guinea pig intestine. AB - Muscle cells were isolated from the longitudinal muscle layer of guinea pig and human jejunum and used to identify the muscarinic receptor subtype (M1 or M2) that mediates contraction. Single muscle cells were anchored to the ceiling of a minichamber and their contraction was measured in response to acetylcholine, alone and in combination with three muscarinic antagonists: atropine, 4 diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP), and pirenzepine. Estimates of the inhibitory dissociation constants (Ki) were closely similar in human and guinea pig muscle cells (atropine 2.5-5 X 10(-11) M, 4-DAMP 1.9-2.9 X 10(10) M, and pirenzepine 8.2-9.5 X 10(-8) M). Thus, pirenzepine, a preferential M1 antagonist, was 1900-3280 times less potent than atropine and 279-500 times less potent than 4-DAMP. Comparative measurements on longitudinal muscle strips from guinea pig jejunum confirmed the greater potency of atropine and 4-DAMP relative to pirenzepine. Inactivation of muscarinic receptors on single muscle cells with dibenamine showed that only a small fraction of receptors was responsible for the response to acetylcholine. It was concluded that intestinal muscle cells contain a large reservoir of muscarinic M2 receptors that exhibit considerable spareness and heterogeneity. PMID- 3653645 TI - Gastric electromechanical and neurohormonal function in anorexia nervosa. AB - The gastrointestinal motor function in patients with anorexia nervosa is poorly understood, although it may be relevant to the pathophysiology of the disorder. We have undertaken a multidisciplinary study of 8 patients with anorexia nervosa and 8 age- and sex-matched controls. We have characterized their gastrointestinal and neurohormonal function by measuring (a) gastric electrical activity, (b) antral phasic pressure activity, (c) gastric emptying of solids and liquids, and (d) hormonal and autonomic function. Patients with anorexia nervosa at the time of the initiation of therapy presented with (a) increased episodes of gastric dysrhythmia (mean percentage of dysrhythmic time: 9.75 patients vs. 0.48 controls during fasting, p less than 0.02; 7.21 patients vs. 0.18 controls postcibally, p less than 0.001), (b) impaired antral contractility (mean motility index, 12.8 patients vs. 14.2 controls, p less than 0.002), (c) delayed emptying of solids, (d) decreased postcibal blood levels of norepinephrine and neurotensin (levels of beta-endorphin, insulin, glucagon, gastric inhibitory polypeptide, gastrin, cholecystokinin, and human pancreatic polypeptide were normal), and (e) impaired autonomic function (resting diastolic blood pressure and skin conductance were decreased and the response to the cold pressor test was dampened). Differences between patient and control groups were statistically significant. We conclude that patients with anorexia nervosa present multiple gastrointestinal abnormalities involving control mechanisms as well as target organs. PMID- 3653646 TI - Treatment of vitamin E deficiency during chronic childhood cholestasis with oral d-alpha-tocopheryl polyethylene glycol-1000 succinate. AB - Treatment of vitamin E deficiency during chronic childhood cholestasis is hampered by the poor intestinal absorption of available oral preparations of vitamin E when bile flow is severely impaired; thus parenteral vitamin E has been the only effective therapy for many children with this problem. We studied the intestinal absorption, efficacy, and safety of a water-soluble oral form of vitamin E, d-alpha-tocopheryl polyethylene glycol 1000 succinate (TPGS), in 22 children (7 mo to 19 yr old) with severe cholestasis and vitamin E deficiency who were unresponsive to massive oral doses (100-200 IU/kg.day) of dl-alpha tocopherol. The results of oral vitamin E tolerance tests showed that TPGS was well absorbed in virtually all study subjects, that TPGS intestinal absorption was superior to that of dl-alpha-tocopherol, and that TPGS absorption in teenage children with chronic cholestasis was similar to that of normal adults. In addition, 1.7% +/- 1.6% (mean +/- SD) of the administered polyethylene glycol 1000 contained in the TPGS was absorbed and excreted in the urine of the 13 subjects analyzed, compared with 3.0% +/- 1.3% in 4 normal adults. A chronic oral dose of 15-25 IU/kg.day of TPGS corrected the biochemical vitamin E deficiency state over 1-19 mo (mean, 10.6 mo) of TPGS therapy. No clinical or biochemical evidence of gastrointestinal, renal, hepatic, or hematologic toxicity was demonstrated. This study suggests that TPGS administered orally in a dose of 15 25 IU/kg.day may be a safe and effective form of vitamin E for prevention and correction of vitamin E deficiency during severe childhood cholestasis. PMID- 3653647 TI - Gastroduodenal mucosal hemodynamics by endoscopic reflectance spectrophotometry. AB - The reflectance spectrophotometric technique measures an index of mucosal hemoglobin concentration and an index of oxygen saturation by spectral analysis of light reflected from the mucosal surface. Using a commercially available unit, a technique for obtaining reproducible endoscopic measurements with acceptable intraobserver and interobserver variability was developed in the anesthetized dogs. The reflectance spectrophotometric finding that experimentally induced prehepatic portal hypertension did not affect gastric mucosal blood flow was confirmed by hydrogen gas clearance measurements. Endoscopic studies in patients with active duodenal ulcer disease revealed a higher index of mucosal hemoglobin concentration and a normal index of oxygen saturation (i.e., an increase in blood flow) at the margin of the ulcer compared with the adjacent normal appearing mucosa. PMID- 3653648 TI - Perendoscopic gastric pH determination. Simple method for increasing accuracy in diagnosing chronic atrophic gastritis. AB - The endoscopic diagnosis of chronic atrophic gastritis is often underestimated, and most of the procedures adopted to increase diagnostic accuracy are time consuming and complex. In this study, we evaluated the usefulness of the determination of gastric juice pH by means of litmus paper. Values obtained by this method correlate well with gastric acid secretory capacity as measured by gastric acid analysis (r = -0.64, p less than 0.001) and are not affected by the presence of bile. Gastric juice pH determination increases sensitivity and other diagnostic parameters such as performance index (Youden J test), positive predictive value, and post-test probability difference by 50%. Furthermore, the negative predictive value is very high, the probability of missing a patient with chronic atrophic gastritis with this simple method being 2% for fundic and 15% for antral atrophic change. We conclude that gastric juice pH determination, which substantially increases diagnostic accuracy and is very simple to perform, should be routinely adopted. PMID- 3653649 TI - Percutaneous transhepatic cholecystic ultrasonic lithotripsy. PMID- 3653650 TI - Percutaneous transhepatic cholangioscopic ultrasonic lithotripsy (PTCS-USL) in the treatment of retained or recurrent intrahepatic stones. PMID- 3653651 TI - Percutaneous transhepatic electrohydraulic lithotripsy under endoscopic control. PMID- 3653652 TI - Repeated balloon dilation of a severe colonic stricture. PMID- 3653653 TI - Obesity and the gastric balloon: a comprehensive workshop. Tarpon Springs, Florida, March 19-21, 1987. PMID- 3653654 TI - The role of lithotripsy in biliary stone disease. PMID- 3653655 TI - Should liver biopsies be relegated to the radiology suite? PMID- 3653656 TI - Therapeutic endoscopy of the biliary tract. PMID- 3653657 TI - Hairy esophagus contributing to dysphagia. PMID- 3653658 TI - Heterotopic sebaceous glands in the esophagus. PMID- 3653659 TI - Iatrogenic splenic trauma--a rare complication following esophageal dilation. PMID- 3653660 TI - Ventricular ectopy during colonic lavage. PMID- 3653662 TI - Necrotizing fasciitis and percutaneous endoscopic gastrostomy. PMID- 3653661 TI - Colonoscopy and continuous ambulatory peritoneal dialysis. PMID- 3653663 TI - Autopsy findings after PEG. PMID- 3653664 TI - Endoscopic management of postsphincterotomy hemorrhage. PMID- 3653665 TI - [Child development following severe intrauterine growth retardation--results of follow-up studies]. AB - 94 prenatally severely dystrophic newborn (year of birth: 1970 to 1982) of the Department of Gynaecology of the University of Cologne were catamnestically investigated when they 2 to 12 years of age; follow-up examinations were performed by paediatricians, neurologists, EEG specialists and by test psychology. In more than one-half of the children followed up in this manner delays in early childhood development were seen; there were no conspicuous differences between the two groups (classified according to years of birth). On comparing the age brackets 1970-1975 and 1976-1982 about one-third of the children in both groups presented at follow-up clearly evident signs of retarded growth. In 32% of the children born between 1970 and 1975 mostly mild neurological deficits or slight impairments of nerve function were observed, whereas in the 1976-1982 group this figure was 26%. The incidence of cerebral pareses was 7% and 9%, respectively. Disturbances of fine motor response were most frequently seen. Mild to moderate EEG changes occurred in both patient groups at about the same rate of incidence (34% and 32% respectively); one child in each group presented with definitely pathological electroencephalographic findings. Pathological test psychology results were seen in 38% (1970-1975) and 21% (1976-1982) of the followed-up children; the tests employed were the Gottingen form reproduction test in children born between 1970 and 1975 and the Denver development test in the younger children born between 1976 and 1982.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653666 TI - [Experiences with prenatal diagnosis of sickle cell anemia and thalassemias in the first trimester of pregnancy: various aspects for the obstetrician]. AB - After an extensive educational campaign for the medical community in the area of the Westf. Wilhelms-University Munster five pregnancies at risk for sickle cell anemia and thalassemias were investigated during the first trimester of pregnancy. Following chorionic villi sampling in one case a sickle cell anemia and in two other cases a beta-thalassemia could be excluded. In two additional cases a homozygous beta-thalassemia was proven and in one of the cases the first trimester diagnosis was confirmed in the second trimester by fetal blood sampling. Because of the migration patterns in Europe there is currently a considerable demand for prenatal diagnosis of beta-thalassemias in West-Germany after proper information of the population at risk. PMID- 3653667 TI - [Spontaneous labor in the 38th week of pregnancy under intermittent hemodialysis treatment of the mother. Alloimmune thrombocytopenia of the newborn infant]. AB - Uncomplicated pregnancies and spontaneous deliveries of term infants are rare if mothers are treated by haemodialysis because of terminal renal insufficiency. Pregnancies under these circumstances mostly end in abortion or stillbirth; live births are mostly delivered by Caesarean section. Independent of the mother's basic disease the infant of this case was born at 38 weeks spontaneously with a neonatal alloimmune thrombocytopenia, which is analogous to Rh-haemolytic disease of the newborn. PMID- 3653668 TI - [Functional disorders of the lower urinary tract following radical abdominal and vaginal surgery of cervix cancer]. AB - To establish the prevalence and extent of lower urinary tract dysfunction after radical surgery for cervical cancer, we evaluated 121 patients who underwent surgery between 1978 and 1984. 91 women underwent radical abdominal hysterectomy for disease in stage Ib or IIb; 30 patients underwent radical vaginal hysterectomy for stage Ib disease. Evaluation, at 12-72 months postoperatively, included pelvic examination, urinary history (explored via a specially designed questionnaire), measurement of residual urine, urine culture, and urodynamic studies. All patients underwent urethrocystoscopy and intravenous urography. Results showed 36 patients completely free of complaints, namely, 17 (18.7%) after radical abdominal hysterectomy and 19 (64%) after the vaginal produce. 85 patients (70%) had complaints, most commonly difficult spontaneous micturition (81.4% after abdominal, 17% after vaginal surgery). Other pathologic conditions were identified as follows: stress incontinence in 52.8% of patients after abdominal and 24% after vaginal surgery; impaired bladder sensation in 48.4% after the abdominal procedure but in only 13% after the vaginal; residual urine volume exceeding 10% of maximum bladder capacity in 13.2% after abdominal surgery (range: 40-220 ml) and 24.2% after vaginal surgery (range: 30-200 ml); significant bacteriuria in 21 patients (23%) after abdominal hysterectomy and 3 patients (9%) after vaginal. Urodynamic studies showed that, after abdominal surgery, bladder compliance was normal in 41.8% of patients, high in 39.6%, and low in 18.7%. After vaginal surgery, bladder compliance was normal in 66% of patients and abnormal in 34%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653669 TI - [Cytologic anamnesis of patients with invasive cervix cancer]. AB - 25 patients with invasive cervical carcinoma were asked about their historical data by means of a questionnaire. 7 women (28%) had undergone routine gynaecological examination with PAP smear at least two years before the diagnosis of invasive carcinoma. At the time of clinical admission, symptoms such as postcoital bleeding or metrorrhagia were found in these women as often as in those who had never undergone gynaecological investigation. But in the latter group of patients, stages II and III of the tumour were seen in a twofold higher rate of incidence. After reviewing the PAP smears it is considered that a faulty smear technique was the main reason for failure of prophylaxis. Screening errors committed by the cytologist were less frequent. PMID- 3653670 TI - [Resorption of progesterone through the intact skin of the breast in comparison with other body regions]. AB - In healthy female volunteers the percutaneous absorption of progesterone from an ointment is studied comparing the absorption in the breast skin and that of other regions (thigh, abdomen). Before and certain times after the application progesterone serum levels are measured. A significant increase of mean serum levels (1 to 1.9 ng/ml) ist observed after application to the breast, while it is missing after application to other sites. Individual values of progesterone levels show a distinct peak after 30-120 min following application to the breast, while it lacks in three cases following other application. Serum peaks do not depend on the skin thickness as determined by ultrasound measurement. Percutaneous treatment with progesterone obviously is easier to perform using the breast skin than that of other regions. PMID- 3653671 TI - [A transdermal therapeutic system for hormonal therapy of climacteric deficiency pictures. A multicenter study]. AB - In an open study 112 women with menopausal symptoms were treated with a transdermal therapeutic system delivering estradiol at a rate of 25, 50 or 100 micrograms per day resp. The study, which was to measure the therapeutic efficacy and systemic and local tolerability, lasted 3 months. At the end of the treatment period 46% of the women were completely free of symptoms and a further 46% very much improved. In 64% the hot flushes disappeared entirely and in the remaining women their frequency and intensity, with a few exceptions, were markedly diminished. Nocturnal bouts of sweating were completely prevented in 67% of those complaining of this symptom. Pollakiuria improved in 93%. Before commencement of the therapy 24 patients felt unwell; during the study only two. The proportion of women who felt well or very well rose from 36% to 83%. The systemic tolerability was rated good or excellent by 97% of patients and in no case was it rated poor. Blood pressure and body weight were not affected. The local tolerability was considered good or very good by 80% of the women; it was poor in 5 cases (4.6%) and only in one case did it lead to discontinuation of the therapy. Ninety percent of the participants wanted to continue treatment beyond the duration of the study. PMID- 3653672 TI - [Experiences with selective catheter embolization of the internal iliac artery in life-threatening hemorrhage from uterine cancers]. AB - Patients with heavily bleeding cervical or endometrial carcinomas were treated by embolisation. A catheter was placed into the internal iliac artery via the femoral artery. By the use of Gianturco-Anderson-Wallace springs, selective embolisation was performed distally to the superior gluteal or iliolumbar artery. Five patients between the age of 42 to 86 years (four cervical carcinomas, one endometrial carcinoma) were treated by embolisation. In four patients bleeding stopped after treatment. One patient died after further haemorrhage. Only minor side effects were seen. Thus, surgical ligature of the internal iliac arteries seems to be a thing of the past. Nevertheless, catheter embolisation should be performed only after alternative methods had been tried. PMID- 3653673 TI - Responsiveness to noradrenaline of longitudinal and circular smooth muscles of cat caecum during the postnatal period. AB - 1. The changes in the responsiveness of the isolated longitudinal and circular smooth muscles from cat caecum to adrenergic agents during the postnatal period were studied by the effect of noradrenaline (0.01-100 mumol) on the smooth muscle tone and phasic contractions. 2. Noradrenaline (10 mumol) contracted the preparations of longitudinal and circular muscles isolated from cats between 15 and 60 days postnatal via stimulatory alpha 1-adrenoceptors. 3. Noradrenaline applied cumulatively (0.01-100 mumol) produced a concentration-determined but age independent inhibitory effect on the phasic contractions of longitudinal muscle and exercised a concentration- and age-determined effect on the phasic activity of circular muscle. 4. The adrenoceptors of cat caecum are not differentiated until 60 days postnatal. PMID- 3653674 TI - Effects of methylcellulose on hepatic glutathione levels and plasma ALAT following single oral administration to male Bom:NMRI mice. AB - 1. A single p.o. dose of 1% w/v methylcellulose 0.013 ml/kg was given to male Bom:NMRI mice using untreated animals as controls. 2. A circadian fluctuation was seen in the hepatic glutathione levels (GSH) of both the methylcellulose and untreated animal group. 3. The methylcellulose administration did not affect the hepatic GSH or plasma ALAT level compared to untreated animals. 4. Histological examination did not reveal any abnormalities of the stomach wall, liver or kidney during the 12 hr trial period. 5. Male Bom:NMRI mice treated with 1% w/v methylcellulose can be considered representative of untreated controls in short term experiments studying liver GSH and plasma ALAT levels. PMID- 3653675 TI - Effects of disopyramide on the isolated rabbit aorta and pulmonary artery. AB - 1. Disopyramide (8 X 10(-5)-4 X 10(-4) M) contracted the rabbit aortic strips and this could be prevented by verapamil or by omitting Ca2+ from Krebs solution. 2. Disopyramide (1.5-6 X 10(-5) M) significantly potentiated the contractile response of the rabbit aortic strips to noradrenaline, clonidine and methoxamine but not that of potassium chloride. 3. Disopyramide (2-6 X 10(-5) M) attenuated the contractile response of the rabbit pulmonary artery to transmural electrical stimulation but potentiated response to noradrenaline. Similar results were observed with the portal vein. 4. The relaxant effect of acetylcholine, on the rabbit aortic ring precontracted with noradrenaline, was blocked by disopyramide while the relaxant effect of adenosine-5'-triphosphate (ATP) was not blocked. PMID- 3653677 TI - Anorectic effect of ephedrine. AB - 1. Different doses of ephedrine (3.1-50 mg kg-1) were given intraperitoneally to rats and found to decrease food intake dose-dependently. 2. The anorectic effect of ephedrine was decreased by animal pretreatment with pimozide, but phenoxybenzamine, propranolol and methergoline did not decrease the response. 3. The results show that the anorexia produced by ephedrine may be due to indirect dopaminergic mechanism of the drug. PMID- 3653676 TI - Comparative effects of BHA and ascorbic acid on the toxicity of 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) in rats. AB - 1. The abilities of BHA and ascorbic acid to prevent the toxic manifestations of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were examined in female Sprague-Dawley rats. 2. Rats treated with BHA were partially protected from TCDD-induced lipid peroxidation, inhibition of glutathione peroxidase activity, and losses in liver, thymus and body weights. 3. Ascorbic acid had no effect on TCDD-induced alterations in glutathione peroxidase and aryl hydrocarbon hydroxylase activities, or body, liver and thymus weight changes. Ascorbic acid was unable to protect against the lethality of TCDD. 4. Some of the toxic manifestations of TCDD may be mediated by reactive oxygen species and free radical processes. PMID- 3653678 TI - Domination of a strong antagonist over a weak one in paradoxical responses to cholinolytics in a parasympathetically denervated human salivary parotid gland: atropine and metacine as agonists, and chlorosyle as partial agonist. AB - 1. Chlorosyle, a modified asymmetric and somewhat heavier cholinolytic, produces a lower, by its level, paradoxical salivary effect in the human denervated parotid gland than atropine and metacine. 2. When chlorosyle acts in combination with atropine and metacine, the former inhibits the effect of the latter two and only the chlorosyle effect dominates. 3. Using atropine and metacine, which are complete agonists, chlorosyle, in this situation, plays the role of a partial agonist. PMID- 3653679 TI - The role of group structure in the action of some morpholinium chloride derivatives on model systems. AB - Effects of morpholinium chlorides, which exhibit fungicidal activity, on model lipid systems is discussed. It was shown by means of DSC and BLM techniques that for different salts possessing alkyl chains of identical length, the interaction with lipids depends strongly on the polar head charge and the structure of the salt. The results obtained and conclusions drawn can be useful in explaining the possible mechanism of the biological effectiveness of the compounds tested; this is suggested by the observation that salts tested showed the same sequence of activity in both biological tests and model experiments. PMID- 3653680 TI - Effects of sulfhydryl reagents on Na+-Ca2+ exchange in rat brain microsomal membranes. AB - Effects of six thiol reagents with different physico-chemical properties were tested on the Na+-dependent 45Ca2+ transport into the rat brain microsomal membrane vesicles. The mercurials p-chlormercuribenzoate and Mersalyl effectively inhibited 45Ca2+ uptake with IC50 values in the order of 10(-4) mol X l-1 in the medium. N-ethylmaleimide and its more lipophilic analog N-(4-(2 benzoxazolyl)phenyl)maleimide were much less effective at the same concentrations. 2,2'-dithiodipyridine markedly reduced 45Ca2+ uptake already at concentrations below 10(-4) mol X l-1, whereas 5,5'-dithiobis-2-nitrobenzoate in a concentration range 10(-6)-10(-3) mol X l-1 was a weak inhibitor. Inhibitory effects of the most potent inhibitors p-chlormercuribenzoate and 2,2' dithiodipyridine were readily reversed by 1 mmol X l-1 dithiothreitol. The results suggest that free SH groups of membrane polypeptides are involved in the functioning of the Na+-Ca2+ exchanger in the nerve tissue cell membranes. PMID- 3653681 TI - The role of calcium in the generation of membrane potential oscillations in Nitella cells. PMID- 3653682 TI - [Transmission of amber mutants of bacteriophage T4. IV. The frequency of the phenomenon of temperature sensitivity of replication in non-permissive cells of amber mutants for the head genes]. AB - Dependence of multiplication of 42 single and double amber mutants in 16 phage head genes on the incubation temperature was studied in the cells of non permissive host. For amber mutants in 6 head genes the birst size decreases by several orders, with the increase of the incubation temperature. Among amber mutants of the above mentioned genes, mutants in genes 4 and 65 can be distinguished as those with considerably large burst size at low temperature. Phage head genes form the groups, according to temperature sensitivity of multiplication of amber mutants. These groups, together with corresponding groups of phage tail genes, constitute common temperature-sensitive and non-sensitive gene groups on the phage genomic map. PMID- 3653683 TI - [Systemic reorganization of the architectonics of polytene chromosomes in the onto- and phylogenesis of malarial mosquitoes. II. Species specificity in the pattern of chromosome relations with the nuclear envelope of nutrient ovarian cells]. AB - Essential differences in the architecture of the chromosomes between the 7 species of Anopheles maculipennis complex are found. The system of chromosomes' attachment to the nuclear envelope is invariant within particular species, each of the species studied, together with homosequential A. maculipennis and A. subalpinus differing one from another. The spatial organization of nutrse ovarian cell chromosomes in experimental hybrids (A. maculipennis X A. subalpinus and A. sacharovi X A. matrinius) shows species-specificity pattern of parental species. Thus, the spatial organization of interphase nucleus is the invariant species sign, and from the author's point of view, this phenomenon is due to penetration of new type mutations--systemic mutations (according to Richard Goldschmidt), directly connected with speciation. PMID- 3653684 TI - [Immunoglobulin (IgG) allotypes of the American mink with Aleutian disease]. AB - Mink Aleutian disease (AD) is characterized by intensive proliferation of B lymphocytes and hypergammaglobulinemia. Populational distribution of five genetic immunoglobulin markers (light chain allotype L1 and C gamma-allotypes H2, H3, H6 and H8) in minks of different coat color (Sapphire, Standard and Topaz) was studied. The groups of infected minks differed significantly from healthy ones in the distribution of the H3 allotype: the frequencies of some phenotypes--H3, H6, H8 and L1, H3, H6, H8 (Sapphire, Standard). H2, H3, H6, H8 and L1, H2, H3, H6, H8 (Sapphire) were increased significantly. At the same time, the frequencies of H6, H8; L1, H6, H8 and H2, H6, H8; L1, H2, H6, H8 were decreased in the AD population. The preferential stimulation of proliferation of the H3 + B lymphocyte clones is suggested. PMID- 3653686 TI - Differences in or near the responder region of complete and partial mouse t haplotypes. PMID- 3653687 TI - The probability of establishment of an advantageous mutant in a subdivided population. PMID- 3653685 TI - Heterogeneity of human haptoglobin alpha chains detected by two-dimensional gel electrophoresis. PMID- 3653688 TI - Quantitative variation and chromosomal location of satellite DNAs. PMID- 3653689 TI - Heritable variation and heterozygosity under a balance between mutations and stabilizing selection. PMID- 3653690 TI - Additive variance and average effect with partial selfing. PMID- 3653691 TI - Selection for growth on normal and reduced protein diets in mice. I. Direct and correlated responses for growth. PMID- 3653692 TI - A rapid method for cloning and sequencing variable-region genes of expressed immunoglobulins. AB - A rapid procedure is described for cloning immunoglobulin V region genes from cells that express them. cDNA is synthesized from mRNA template using primers homologous to the immunoglobulin constant-region genes. Blunt-ended, double stranded cDNA is obtained by sequential addition of enzymes to a single tube. The cDNA is inserted directly into the M13 vector, which is screened by plaque lifting for the presence of specific inserts. Screening probes can be generated from 32P-labeled single-stranded cDNAs generated from primers different from those used for cloning, or alternatively, from previously cloned V or C gene segments. The ease of cloning a cDNA V region is directly related to the abundance of Ig-specific mRNA within the cell of interest. This method minimizes the number of steps and the time needed to obtain accurate and complete sequences of any expressed Ig V region gene. PMID- 3653693 TI - Atypical presentations of cardiovascular disorders in the elderly. AB - Despite the high prevalence of cardiac disease in the elderly, specific cardiac disorders are often missed or misdiagnosed in this age group. Not uncommonly, the clinical manifestations are significantly different from those in the younger patient with the same disorder. The classical findings of aortic valve stenosis may not be present and the disorder is frequently misdiagnosed as mitral valvular incompetence. Mitral valve prolapse, usually considered a benign disorder in the young and middle-aged, may present with heart failure in the elderly, and mitral valve surgery may be necessary. Instead of angina pectoris, dyspnea may be the first manifestation of coronary artery disease in the elderly. Acute myocardial infarction may be silent or present in an atypical manner with abdominal distress, acute signs of cerebral insufficiency, or dyspnea. PMID- 3653694 TI - Practical considerations in managing Alzheimer's disease: II. A geriatrics panel discussion. AB - Almost as trying as Alzheimer's disease is for patients and families are the frustrations physicians experience in considering its treatment. The apparent lack of "anything to do" can discourage physicians from attempting anything more than perfunctory management of these cases. Nevertheless, the expert panelists that Geriatrics convened for this discussion at the Mount Sinai Medical Center in New York found themselves able to outline a significant primary care role in managing Alzheimer's and, further, to discern hope for more effective future treatment in recent research breakthroughs. PMID- 3653695 TI - Geriatric foot disorders: how to avoid undertreating them. AB - Because the primary care physician often is the first health professional the elderly patient will consult about a foot problem--and because many conservative therapeutic measures are available and should be attempted before resorting to surgery--the primary care office can be an appropriate setting for foot care for the elderly. A brief review of foot anatomy is given, followed by a discussion of common disorders of the foot and conservative treatment measures. PMID- 3653696 TI - Influenza, pneumonia, tetanus: how effective is vaccination? AB - The rationale for immunizing older adults with influenza, pneumococcal, and tetanus-diphtheria vaccines is derived largely from epidemiological data indicating a heightened susceptibility to these illnesses within this population. The authors provide supportive information relevant to the routine use of these vaccines in adults aged 65 or older. PMID- 3653697 TI - The 'osteoarthritis' that was curable. PMID- 3653698 TI - Second joint meeting on cerebral metabolism in aging and neurological disorders. ESN, European Society for Neurochemistry. WFN, World Federation of Neurology. Baden/Vienna, August 28-30, 1986. Proceedings. PMID- 3653699 TI - Dopamine action and disorders of neurotransmitter balance. AB - Disorders of neurotransmitter balance are observed in Parkinson's disease, pharmacotoxic psychosis and depression. The dopamine-serotonin ratio is reduced to about 20% in Parkinson and pharmacotoxic patients in the caudate nucleus and in the substantia nigra. The serotonin content in these brain areas is lowered only to about 50% in comparison to that of the control, whereas the dopamine level is reduced to 85% in Parkinson patients. This dopamine deficiency has been substituted by exogenous supply of L-dopa in combination with decarboxylase and monoaminooxydase inhibitors. First evidence is presented that L-dopa can be replaced, at least partially, by iron in form of a ferriascorbate complex. This iron compound improves the symptoms of Parkinson's disease to almost the same extent as L-dopa. PMID- 3653700 TI - The cholinergic system in aging. AB - A morphometric analysis of neuronal loss during normal aging was performed in the nucleus basalis Meynert complex of the basal forebrain (Nbm) (nucleus septi medialis, nucleus of Broca's diagonal band, nucleus basalis) and the ciliary ganglion, a peripheral cholinergic structure, in patients free of neurological and psychiatric illness. As a basis for morphometric evaluation of the Nbm complex, a three-dimensional reconstruction of this complex structure was made. Neuronal counts in the Nbm complex and the ciliary ganglion remained stable up to the age of 60 or 50 years, respectively. After this age the number of neurons declined moderately in ciliary ganglion in all cases studied as well as in the Nbm complex in some cases (-20 and -25%, respectively, at about 90 years of age). In 3 out of 8 cases older than 60 years, neuronal counts in the Nbm complex were not reduced, so that no significant decline in neuronal number is apparent from the mean values of the 17 cases studied. No age-related changes were found in the neuronal distribution amongst the different subgroups of Nbm neurons using the alternative nomenclature of Mesulam et al. [J. comp. Neurol. 214: 170-197, 1983]. Our results provide no evidence that the cortical cholinergic projection system and peripheral cholinergic neurons might be especially vulnerable during normal aging. The severe degeneration of the cholinergic cortical projection system in SDAT is probably caused by mechanisms different from those acting during normal aging. PMID- 3653701 TI - Immunological factors in neuronal degeneration with particular reference to motor neurone disease. AB - Cellular and humoral immunoreactivity to neuronal antigens was investigated in patients with motor neurone disease (MND). Lymphocytes from patients with MND and normal healthy controls were cultured with a membrane fraction prepared from cultured spinal cord neurones. 4 out of 14 patients with MND and 0 out of 9 normal controls showed a significantly increased stimulation index. An enzyme linked immunoabsorbent assay (ELISA) was established to detect antibodies to synaptic membrane fraction prepared from human motor cortex. Sera from MND patients showed a significantly increased immunoglobulin binding with respect to normal control sera. Antineuronal antibody production by MND lymphocytes was studied by using Epstein-Barr virus transformation followed by fusion with a mouse myeloma cell line. Antibody-producing clones were isolated. This procedure would allow a more detailed analysis of the antineuronal antibody production in MND. PMID- 3653703 TI - Ischemia in aged brain. AB - A 15-min complete cerebral ischemia, and repetitive ischemic insults of 15-min duration each cause changes in brain cortical glucose and energy metabolism which are similar in quality but different in quantity. Abnormalities in glycolytic flux, lactate production, cessation of oxidation and energy production were found to be more pronounced with advancing age, thus indicating a reduced biological plasticity of the brain to meet emergency conditions. Repeatedly occurring ischemic insults may damage energy metabolism in particular. PMID- 3653704 TI - Energetic state of aged brain during hypoxia. AB - Synaptosomes isolated from the forebrain of rats of different ages (20, 60, 100 and 140 weeks of age) and incubated in Krebs-Henseleit-Hepes pH 7.4 buffer (for 10 min at 24 degrees C) were utilized to define the redox state of the intramitochondrial NAD couple (delta Gox-red) and the phosphorylation state of adenine nucleotide system (delta GATP). The free-energy change (delta delta G) for the coupled reactions was calculated. The animals were subjected for 10 min to different degrees of in vivo hypoxia (52 greater than or equal to PaO2 greater than or equal to 11 mm Hg). In synaptosomes isolated from the forebrain of animals submitted to moderate degrees of hypoxia, the trend of delta delta G was quite similar to that observed in normoxia. In synaptosomes isolated from the forebrain of rats submitted to severe degrees of hypoxia, the delta delta G was markedly altered as function of both aging and severity of hypoxemia. The extensive delta delta G changes were largely supported by alteration of the phosphorylation state of adenine nucleotides. However, in synaptosomes from severely hypoxic rats, aging affected the redox state, too. PMID- 3653702 TI - Intralaminar distribution of neurotransmitter-related enzymes in cerebral cortex of Alzheimer's disease. AB - The intralaminar distribution of choline acetyltransferase, galactocerebrosides, gangliosides and proteins were determined in frontal (Brodmann's area 9) and temporal (Brodmann's area 22) cortices from subjects with autopsy-proven Alzheimer's disease and controls matched for sex, age and postmortem delay. In normal brain choline acetyltransferase (CAT) activity was higher in the II and IV layers in the temporal cortex, while in frontal cortex CAT activity was relatively high in the II-III layer, appearing as a single peak. The intracortical distribution of galactocerebrosides normally shows a trend to a higher activity from the pial surface to white matter either in frontal or temporal cortices. Higher concentrations of gangliosides were associated with the cell body layers in either frontal or temporal cortices. In either frontal and temporal cortices from 5 patients with Alzheimer's disease the pattern of intralaminar distribution of CAT activity was completely disrupted and it was significantly lower than in all cortical layers of the controls. Galactocerebrosides concentration was significantly decreased in the lower layers (IV, V and VI) in both frontal and temporal cortices and ganglioside sialic acid concentration was also decreased in the Alzheimer brain consistently in the lower (III-IV) layers of the frontal and temporal cortices. These observations indicate a widespread involvement of cholinergic activities through all cortical layers. However, the selective decrease in galactocerebroside concentration in the lower layers (IV-VI) suggests a selective loss of ascending fibers from subcortical nuclei. The decreased concentration of ganglioside sialic acid in lower layers suggests a selective axodendritic degeneration in these laminae of frontal association and temporal cortex in Alzheimer's disease. PMID- 3653705 TI - Nuclear magnetic resonance as a tool to study brain metabolism. AB - Nuclei which are most appropriate for nuclear magnetic resonance (NMR) spectroscopy in biological systems include, in decreasing sensitivity, 1H, 19F, 23Na, 31P, 13C and 15N. Proton NMR has achieved remarkable prominence in imaging of the brain, and though clinical 1H spectroscopy is still in its infancy, current developments indicate that it will provide interesting information on brain metabolism. The naturally abundant form of phosphorus (31P) has proved particularly useful in studies on energy metabolism in metabolically perturbed states in the brain in vivo and in vitro. Dynamic studies on turnover rates of ATP and creatine phosphate can be performed using saturation transfer techniques. The use of 13C to follow intermediary metabolism shows great potential, even though it is a relatively insensitive nucleus and has only 1% natural abundance. 19F is a highly sensitive and naturally abundant nucleus. When covalently attached to various chelators, it provides a most sensitive method for accurate measurement of many cations of biological importance, by virtue of the chemical shift of the 19F on binding of the cation to the chelator. PMID- 3653706 TI - Nuclear magnetic resonance imaging in the aging brain. AB - 43 patients aged over 55 years with different clinical diagnoses but with the common aspect of impairment of the cognitive functions underwent a 0.5 Tesla magnetic resonance imaging (MRI) investigation in order to obtain further information about the pathological causes underlying the clinical syndromes. The occurrence of white matter signal alterations (periventricular lucency) and of multifocal ischemic areas represented the most frequent and atypical finding. Independently of the clinical focal symptomatology, these data might well represent a marker of a diffuse tissue sufferance due to a chronic mild cerebral hypoperfusion. The incidence of similar findings in 'normal' elderly subjects must be assessed before giving them a definite relevance in the evaluation of the pathological aging. PMID- 3653708 TI - Using simulation activities to understand elderly aphasic speech disorders. PMID- 3653707 TI - Dementia without cholinergic deficit. AB - We examined the role of cholinergic system in multi-infarct dementia (MID) by measuring acetylcholinesterase (AChE) activities in cerebrospinal fluid (CSF) of clinically diagnosed MID patients, Alzheimer's disease (AD) patients and controls. In spite of the similar clinical severity of dementia, MID patients had unaltered AChE levels, whereas AD patients had significantly reduced AChE levels in CSF when compared to controls. In the autopsy study we analyzed choline acetyltransferase (ChAT) levels in four cortical brain areas from clinically and neuropathologically studied AD patients, demented non-AD patients and controls. ChAT activities in the cerebral cortex in non-AD patients were on the same level as in controls, but AD patients had a marked loss of ChAT activity in all four cortical brain areas studied. Although cholinergic deficit is a usual phenomenon associated with cognitive failure, severe dementia can exist without cholinergic dysfunction. PMID- 3653709 TI - Jacks of all trades: masters of none? PMID- 3653710 TI - A service/learning model for interdisciplinary teamwork in health and aging. PMID- 3653711 TI - Medications, behavior and the elderly: a continuing education program for board and care facility operators. PMID- 3653712 TI - Knowledge and bias about aging by nursing home administrators. PMID- 3653713 TI - The McMaster model for geriatric undergraduate experience. PMID- 3653714 TI - Education for gerontological social workers: problems and prospects. PMID- 3653715 TI - Attitudes of different professional groups toward geriatric patients. PMID- 3653716 TI - Classification of proliferative diabetic retinopathy. AB - Using panretinal fluorescein angiography, three patterns (A, B, C) of capillary nonperfusion were identified in 308 eyes with proliferative diabetic retinopathy. Statistical analysis showed that there was a significant association with different retinal complications and clinical parameters. Pattern A (83.7%: midperipheral location of capillary nonperfusion) occurs in type I and II diabetes and is associated with early retinal neovascularization and focal macular edema. Pattern B (8.1%: capillary exclusions disseminated on the whole retina) is typical of young type-I diabetics and is complicated by early disc new vessels and ischemic maculopathy. Pattern C (8.1%: capillary nonperfusion confined to the peripheral retina) is observed in type-I diabetic females and associated with multiple, retinal new vessels, without maculopathy. This study also demonstrated that eyes with pattern B retinal ischemia respond less well to laser treatment than eyes with other pattern types. Various pathogenetic factors could lead to these three distinct types of proliferative diabetic retinopathy. PMID- 3653717 TI - Phacoemulsification and implantation of posterior chamber intraocular lens in eyes with quiescent proliferative diabetic retinopathy. AB - A phacoemulsification procedure, combined with an "in-the-bag" lens implantation, was performed on ten eyes that once had proliferative diabetic retinopathy (PDR). The ten eyes were in eight patients who had a 20-plus year history of either type I or type II diabetes mellitus. All eyes had reached the "quiescent" state of diabetic retinopathy 2-13 years before the cataract surgery through either argon laser pan retinal photocoagulation and/or pars plana vitrectomy. Nine of ten eyes remained completely free of retinal neovascularization and rubeosis iridis, with follow-up periods between 1.5 and 5 years. One eye has been lost to recurrent vitreous hemorrhages and an inoperable retinal detachment. PMID- 3653718 TI - Improvement in efficacy of corticosteroid therapy in an animal model of proliferative vitreoretinopathy by pretreatment. AB - Intraocular injection of the corticosteroid triamcinolone acetonide reduces the incidence of retinal detachment in rabbit eyes injected with tissue-cultured fibroblasts. When the steroid was injected simultaneously with the cells, a reduction of retinal detachment from 93% (control) to 75% (treated) was achieved on day 28. When the steroid was injected 24 h preceding cell injection, the reduction of retinal detachment was from 85% (control) to 43% (treated). The development of retinal detachment is caused by proliferation of injected fibroblasts. Reduction of this proliferation is probably achieved partially through direct inhibition of mitosis, but more important may be the reduction of the reactive inflammatory process. PMID- 3653719 TI - Surgical therapy for stage V retinopathy of prematurity. A two-step approach. AB - Between February 1985 and February 1986, ten eyes from a larger series of infants operated on for stage V retinopathy of prematurity were seen with the open funnel type of retinal detachment and vascularly active eyes. We have developed a technique for these eyes involving two-step treatment. The first step is cryotherapy to the avascular peripheral retina which rarely detaches, even in stage V retinopathy of prematurity, followed by lensectomy, vitrectomy and membrane peeling. This technique has allowed us to operate on these ten eyes much earlier than would generally have been possible if the eyes were allowed to become vascularly inactive on their own. We were able to achieve anatomic reattachment of zone 1 as described in the International Classification of Retinopathy of Prematurity in 80% of these eyes. Light perception or better visual function was achieved in 70%, with 30% of the eyes capable of grasping brightly colored unlit objects of 1 in. (2.5 cm) in diameter. This represents a marked improvement in both anatomic and visual results. We feel that this improvement is due to the earlier treatment by lensectomy, vitrectomy and membrane peeling seemingly allowed by pretreating with cryotherapy. In addition, close attention was paid to the refractive status in visual stimulation during the postoperative period. PMID- 3653720 TI - Pars plana vitrectomy for retinal detachment with unseen retinal holes. AB - A study was made of a consecutive series of 47 cases of rhegmatogenous retinal detachment treated by pars plana vitrectomy in which no holes were identified preoperatively. The view of the fundus during preoperative examination varied from being totally clear to completely obscured by media opacities. The role of pars plana vitrectomy in finding retinal holes peroperatively is considered. The incidence of discovering holes and the locations of those found at the time of surgery are presented. The significance of these findings is discussed. Where the preoperative view was good and the extent of proliferative vitreoretinopathy (PVR) did not exceed grade C2, retinal reattachment was achieved in 75% of the cases. A review made of a similar group of patients treated with conventional retinal buckling before the introduction of pars plana vitrectomy revealed that successful retinal reattachment was achieved in 70% of cases. The study concludes that pars plana vitrectomy, while being necessary for cases of rhegmatogenous retinal detachment when the view of the retina is obscured, will not always reveal the presence of a retinal break. If the preoperative view of the retina was good and the extent of PVR did not exceed grade C2, pars plana vitrectomy did not seem to offer obvious advantages over conventional buckling procedures. PMID- 3653721 TI - Recovery of the blood-aqueous barrier after topical chemical irritation in the rabbit eye. AB - An acute irritative response in the rabbit eye, taking the form of a rise in the intraocular pressure (IOP), miosis, and breakdown of the blood-aqueous barrier, was elicited by topical application of 1% neutral formaldehyde. The peak rise in IOP was 22.1 +/- 2.5 mmHg and occurred within 14.2 +/- 1.9 min, after which IOP returned to normal values in 45.4 +/- 5.2 min. An increased amount of i.v. injected Evans Blue was found in the aqueous humour when injected 15 min after the irritation (119.0 +/- 21.2 micrograms/ml, compared with 2.1 +/- 1.4 micrograms/ml in intact eyes; P less than 0.001), and the protein concentration in the aqueous humour was also increased, to 11.3 +/- 1.4 mg/ml (P less than 0.001). When Evans Blue was injected 60 min after the irritation, no statistically significant difference was found from normal in the amounts (13.7 +/- 7.8 micrograms/ml) in the aqueous humour, although the protein concentration in the aqueous humour was again found to be elevated (7.9 +/- 1.6 mg/ml, P less than 0.01). Histologically, the Evans Blue was shown to leak through both the ciliary and the iris barriers at 15 min. At 60 min only occasional Evans Blue leakage was demonstrated between the nonpigmented epithelial cells and only minor fluorescence was seen in iris stroma. The histological findings were in good agreement with Evans Blue analyses in the aqueous humour. The miosis lasted over 60 min in the formaldehyde-treated eyes. After sympathectomy the rise in IOP was more rapid at the beginning of the response, suggesting greater sensitivity of the sympathectomized eyes to the irritative stimuli.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653722 TI - Nystagmus and subnormal electroretinographic response in nonketotic hyperglycinemia. AB - We examined ophthalmologically two siblings with nonketotic hyperglycinemia who had negligible activities of glycine cleavage system in the liver. Both had jerky nystagmus. The elder brother had a normal electroretinographic response, while the younger brother's response was subnormal. There may be a close association of subnormal electroretinographic response and hyperglycinemia, because glycine can act as an inhibitory neurotransmitter in the retina. PMID- 3653723 TI - Posterior vitreous separation and retinal detachment induced by macrophages. AB - Macrophages, which migrate into the vitreous in conditions such as vitreous hemorrhage and penetrating ocular injury, may contribute to the development of intravitreous cellular proliferation and posterior vitreous separation. To investigate this possibility, activated macrophages were harvested from the peritoneal cavity and injected into the vitreous of rabbits. As early as 8 days after macrophage injection, posterior vitreous separation and glial epiretinal membrane formation began to occur. Two weeks after injection, vitreous strands that approached the optic disc and medullary rays were evident; fibroblasts proliferated over the disc or rays and induced retinal detachment. These findings support the hypothesis that macrophages in the vitreous may, in part, mediate cellular proliferation and posterior vitreous separation. PMID- 3653724 TI - Olfactory neuroblastoma metastatic to the eye. AB - A case of olfactory neuroblastoma metastatic to the choroid is reported and described. Histologically, the tumor consisted of islands of small round cells, many of them surrounding blood vessels in a 'pseudorosette' pattern. Numerous mitotic figures were present. Transmission electron microscopy reveals neuritic processes containing neurosecretory granules and microtubules, features characteristic of olfactory neuroblastoma. This is the first published case of an olfactory neuroblastoma demonstrating intraocular metastasis. PMID- 3653725 TI - VEP pattern after photostress: an index of macular function. AB - Eighty-seven subjects were examined by means of visual evoked potentials (VEPs) to evaluate the recovery time of the amplitude of the pattern VEP after photostress. Twenty-eight subjects were normal and 59 patients were affected by carotid occlusive disease, vascular retinopathies with and without macular involvement, and connective tissue diseases treated with antimalarial drugs. This examination method emphasizes visual dysfunction in a stage where ophthalmological changes are absent or minimal and therefore may be a useful test for the investigation of macular function. PMID- 3653726 TI - Electric responses of the human retina to moving stimuli. AB - Electric responses were recorded in the eyes of two normal subjects in response to a checkerboard pattern moving one square backwards and forwards (2 deg 44') at speeds varying between 13.5 and 2700 deg/s. The recorded waveforms suggest that a low-speed range (up to 250 deg/s) associated with increasing low-frequency response components can be distinguished from a high-speed range accompanied by increasing high-frequency wavelets. The range of velocities used is compared with target speeds employed in previous psychophysical and retinal single-unit recordings. PMID- 3653727 TI - Intraoperative use of pure perfluoropropane gas in the management of proliferative vitreoretinopathy. AB - A single-step technique for fluid-gas exchange with pure perfluoropropane gas in proliferative vitreoretinopathy (PVR) is described. The technique was used in 38 eyes of 38 patients. Permanent and total retinal reattachment, with a minimum follow-up of 6 months after gas disappearance, was achieved in 24 eyes (63%). The anatomical success rate was 80.9% (17/21 eyes) in PVR grade C and 41% (7/17 eyes) in PVR grade D. Twenty-two of the successful eyes (92%) underwent a single operation. Thirteen of the successful eyes (54%) obtained final visual acuities of 0.1 or better. Severe increase of intraocular pressure postoperatively, due to overestimation of the intraocular space available for gas expansion, is a potential risk of the technique. This risk should be avoided by means of preoperative evaluation of the vitreous cavity volume with A-scan ultrasonography and intraoperative measurement of the intraocular fluid volume displaced by scleral buckling. PMID- 3653728 TI - Classification of the stages of proliferative vitreoretinopathy in a refined experimental model in the rabbit eye. AB - Eighty-four rabbit eyes injected intravitreously with tissue-cultured fibroblasts following gas compression of the vitreous were examined clinically over a period of 1 month. Detailed clinical descriptions of the extent of retinal changes were recorded. Clinical landmarks were determined and arranged into a new classification of this model of proliferative vitreoretinopathy (PVR). The proposed classification will allow easier communication between research groups using this model to study the treatment and prevention of PVR. PMID- 3653729 TI - Tearing of retinal pigment epithelium after glaucoma surgery. AB - Tearing of the retinal pigment epithelium following trabeculectomy for chronic open-angle glaucoma in two patients is reported. In one patient, the tear was diagnosed on the 4th postoperative day. It started a few disc diameters above the temporal vascular arcade, crossed the temporal part of the macula and extended to the equator in the lower temporal periphery. At the acute stage, hypotonia and exudative retinal detachment were found. In the other patient, the tear was equatorial extending from the upper nasal to the lower nasal quadrant. At the acute stage, hypotonia and choroidal detachment, but no exudative retinal detachment, were present. After 1 year, the retina was flat in both eyes and no further complications were noted. PMID- 3653730 TI - 40th annual scientific meeting of the Gerontological Society of America. November 18-November 22, 1987, Washington, DC. Abstracts. PMID- 3653731 TI - [Experimental studies of the effect of propranolol on the metabolism of the human placenta with regard to the production of lactic and pyruvic acids]. PMID- 3653732 TI - [Production of progesterone and 17 beta-estradiol by the granulosa cells of the graafian follicles of normal and polycystic ovaries in tissue culture]. PMID- 3653733 TI - [Effect of artificial ventilation on the level of the prostacyclin metabolite 6 ketoprostaglandin F1 alpha in the plasma of newborn infants]. PMID- 3653734 TI - [Vitamin C levels in trophoblasts from pregnancies terminated by spontaneous and induced abortion]. PMID- 3653735 TI - [Libido in women with various endocrinological disorders]. PMID- 3653736 TI - [Cytogenetic studies of married couples examined because of habitual abortions in the wife]. PMID- 3653737 TI - [Ectopic pregnancy in the Wielkopolska region 1980-1985. II. Therapeutic management of ectopic pregnancy]. PMID- 3653738 TI - [Clinical evaluation of newborn infants delivered by cesarean section before and after rupture of fetal membranes]. PMID- 3653739 TI - [A case of wearing an intrauterine contraceptive device for unusually long time]. PMID- 3653740 TI - [A case of endometrial adenoacanthoma in a 40-year-old woman]. PMID- 3653741 TI - [Properties of human oocyte-granulosa cell complexes]. PMID- 3653742 TI - Evaluation of Ritodrine effect on glucose utilisation in perfusion of the human placenta "in vitro". PMID- 3653743 TI - [Induction of labor: necessity, convenience or ... uncertainty?]. PMID- 3653744 TI - [Chronic glomerulonephritis in the clinical picture of EPH gestosis]. PMID- 3653746 TI - [Evaluation of FSH, LH and prolactin levels in women with secondary amenorrhea in relation to the reaction to progesterone and duration of the disorder]. PMID- 3653745 TI - [Plasma volume and its effect on the fate of the fetus in pregnancy complicated by hypertension]. PMID- 3653747 TI - [Physiological hemodilution in pregnancy in the interpretation of exertion physiology]. PMID- 3653748 TI - [Selected elements of physical exertion physiology as the introduction to physiopathology in obstetrics and perinatology. II. Factors in the physiological regulation of energy metabolism during physical exertion. Neurohumoral regulation: the endocrine system]. PMID- 3653749 TI - [Malacoplakia of the female genital organs]. PMID- 3653750 TI - Proliferative instability and experimental carcinogenesis at colonic anastomoses. AB - The possibility that proliferative instability around a healing anastomosis promotes carcinogenesis was tested in 234 male Sprague-Dawley rats. Animals received the first of five weekly injections of azoxymethane (total dose 50 mg/kg) either immediately after transection of the descending colon or at 2, 4, 8, and 12 weeks later; controls received handling of the bowel alone. Crypt cell proliferation was assessed by autoradiography following 3HTdR injection. An overall increase in tumour yields in all transection groups was due solely to the frequent presence of anastomotic tumours. Changes in crypt morphometry and labelling index were most marked in crypt positions 1-10 away from the anastomosis. Crypts at this site increased in height at 2, 4, and 8 weeks (p less than 0.001) but returned to normal values by 12 weeks. Likewise, labelling index was increased at 2, 4, and 8 weeks (p less than 0.001) and remained higher at 12 weeks (p less than 0.05). Increased crypt cell proliferation in the immediate vicinity of an apparently 'healed' colonic anastomosis may explain its persisting susceptibility to carcinogenesis. PMID- 3653751 TI - Formation of a fibrin based gelatinous coat over repairing rat gastric epithelium after acute ethanol damage: interaction with adherent mucus. AB - A gelatinous coat, heterogeneous in appearance, was formed over damaged rat gastric mucosa recovering from acute ethanol injury. This coat, in places 1.6 mm thick (median thickness 680 microns), was 10 times thicker than the translucent layer of adherent mucus (median thickness 70 microns) covering the undamaged mucosa. Immunohistochemistry and periodic acid Schiff staining showed this gelatinous coat to be predominantly a fibrin gel with an exterior layer rich in mucus and necrotic cells. The plasma clotting time was significantly decreased in vitro by pig gastric mucus gel and soluble mucus glycoprotein (90% and 13% respectively) suggesting that in vivo the mucus layer remaining after epithelial damage could act as a template for fibrinogen-fibrin conversion. These results show that a fibrin based gelatinous coat, quite distinct from the adherent mucus layer and with considerable protective potential could be formed over the repairing rat gastric mucosa after acute ethanol damage. PMID- 3653752 TI - Inhibition of the effect of serotonin on rat ileal transport by cisapride: evidence in favour of the involvement of 5-HT2 receptors. AB - Cisapride is a synthetic drug which binds, in vitro, to type 2 serotonin receptors. We examined the influence of serotonin and cisapride on ion transport across intestinal mucosa in vitro and studied the effect of cisapride on the response to serotonin. Segments of ileum of male Sprague-Dawley rats were stripped of muscle layers and mounted in flux chambers. The addition of serotonin (10(-8) to 10(-4) M) to the serosal aspect of the mucosa caused a rapid, dose dependent rise in short circuit current and transmural potential difference. Cisapride alone (5 X 10(-5) M), when added to the mucosal and serosal surfaces, had no effect on the short circuit current, transmural potential difference, resistance, or sodium and chloride fluxes across the mucosa. It did, however, inhibit the response of the mucosa to serotonin (10(-5) M) in a dose dependent manner and blocked it completely at a concentration of 5 X 10(-5) M. Serotonin (5 X 10(-5) M) increased serosal to mucosal flux of chloride from 12.6 +/- 0.8 to 15.2 +/- 0.6 mumol/cm2/h (p less than 0.025), thus reducing net chloride absorption from 4.65 +/- 0.81 to 1.49 +/- 1.04 mumol/cm2/h (p less than 0.05). This effect was completely blocked by cisapride (5 X 10(-5) M). In summary, cisapride inhibits the effect of serotonin on rat ileal ion transport, probably by blocking type 2 serotonin receptors. PMID- 3653753 TI - Adaptation of hydrogen analysis to measure stomach to caecum transit time in the rat. AB - Excreted hydrogen analysis was used to measure stomach to caecum transit time of the head of a test meal in 120 rats fed by gavage. Results were compared with the distribution of a labelled test meal in the gastrointestinal tract of rats killed at different time intervals after gavage. Values for stomach to caecum transit were compatible with the distribution of labelled meals in 91% of animals, although in the remainder the hydrogen concentration had not risen even though food residues were in the caecum when the animals were killed. The technique gave reproducible results; the coefficients of variation for four studies carried out in each of six animals varied between 4 and 14%. A meal consisting of homogenised baked beans had a significantly shorter stomach to caecum transit time (88.1 +/- 4.5 min; mean +/- SE; n = 21; p less than 0.001) than an equivalent volume of Complan/lactulose (180.9 +/- 8.7 min; n = 13). This technique was used to investigate the effect of ileal infusion of a fat emulsion (20% Intralipid) via a chronically implanted intestinal cannula on the stomach to caecum transit time of a bean meal, in a series of paired studies carried out in six rats. Stomach to caecum transit time was significantly delayed during ileal infusion of 20% Intralipid compared with the control infusion of an isotonic saline solution (218.3 +/- 21 min v 106.7 +/- 33 min Intralipid v saline; n = 6; p less than 0.001). PMID- 3653754 TI - Relationship between gastric emptying of a solid meal and emptying of the gall bladder before and after vagotomy. AB - Little is known of the temporal and quantitative relationships between emptying of the stomach and of the gall bladder in patients with duodenal ulcer before and after vagotomy. A non-invasive double isotope technique was used to investigate these relationships in 27 patients with a duodenal ulcer, before and after operation-truncal vagotomy and pyloroplasty (TV + P; n = 15) and highly selective vagotomy (HSV; n = 12). A further 25 patients were studied after operation (TV + P, n = 20: HSV, n = 5). 99Tcm-EHIDA was used as the biliary tracer and 113Inm bran as the gastric content tracer. In patients with a duodenal ulcer before surgery and in 16 of the 17 patients studied after HSV, the patterns of gall bladder emptying were similar to those previously found in normal subjects. In 60% of patients after TV + P, patterns of gall bladder emptying were altered and the onset of gall bladder emptying was significantly delayed (p less than 0.001) compared with unoperated patients and patients with a HSV. The rate of gall bladder emptying did not correlate with the rate of gastric emptying in any of the patients studied. These observations suggest that TV + P, but not HSV, causes considerable alteration in coordination of gall bladder and gastric emptying. PMID- 3653755 TI - Modulation of human upper gastrointestinal motility by rectal distension. AB - The effects of rectal distension on upper gastrointestinal motility were investigated in six healthy subjects. On a control day, gastric and duodenal motor activity was recorded for nine hours of fasting and for four hours after a meal, duodeno-caecal transit being assessed in both interdigestive and digestive states. Motor activity and transit were also measured on a test day during which the rectum was distended for one hour during fasting and for one hour postprandially. Control and test days were randomised. During fasting, rectal distension increased the incidence of migrating motor complexes (0.8 +/- 0.3 v 0.5 +/- 0.2 h; p less than 0.01) and reduced the duodenal phase 2 motility index to 66 +/- 45% of that observed on the control day (p less than 0.01). Further, duodeno-caecal transit time was increased by rectal distension (99 +/- 30 v 71 +/ 35 min; p less than 0.05). Postprandially, the period of rectal distension was marked by a reduction in the duodenal motility index to 24 +/- 13% of that observed during the comparable period on the control day (p less than 0.001) and a concomitant increase in duodeno-caecal transit time (113 +/- 22 v 80 +/- 17 min; p less than 0.01). We conclude that upper gastrointestinal motor activity, the effector of luminal transit, may be profoundly influenced by stimulation of distal afferents. PMID- 3653756 TI - Distribution of the 10,000 molecular weight calcium binding protein along the small and large intestine of man. AB - The distribution of the 10,000 molecular weight calcium binding protein along the human small and large intestine was studied using an enzyme linked immunoadsorbent assay. Small intestinal mucosal samples were obtained from the duodenal bulb, the second and third part of the duodenum and at about 50 cm intervals from jejunum and ileum of five whole small intestines of necro-kidney donors. Mucosal samples of caecum, colon ascendens, and transversum were also investigated. The amount of calcium binding protein per milligram of cytosolic protein increased throughout duodenum to reach the maximum in the proximal segment of jejunum and then declined steadily to nearly undetectable levels in ileum. In the colon no 10,000 molecular weight CaBP was detectable. The distribution of CaBP along the small and large intestine of man is thus parallel to the efficiency of the active calcium absorption of human intestine. PMID- 3653757 TI - Twenty four hour oesophageal acidity in achalasia before and after pneumatic dilatation. AB - Radiotelemetric ambulatory 24 hour oesophageal pH measurement was carried out in 17 patients with symptomatic manometrically proven achalasia before and after pneumatic dilatation. Before dilatation an abnormally high percentage acid exposure time was present but typical episodes of gastro-oesophageal reflux occurred in only one patient. In nine patients who had a oesophageal food residue these values were significantly greater than those found in the remaining patients without retained food. Analysis of oesophageal food residues revealed that the low pH was predominantly caused by lactic acid. These findings indicate that preoperative oesophageal pH studies do not offer a valid means of selection of patients in whom an antireflux procedure should be combined with cardiomyotomy. Repeat studies one week after pneumatic dilatation showed a fall in the acid exposure time in patients with initial food residue presumably resulting from improved oesophageal emptying after treatment. A significant rise in acid exposure time after dilatation was seen in those patients without initial food residue presumably resulting from gastro-oesophageal reflux after therapeutic disruption of the lower oesophageal sphincter. Troublesome symptoms of gastro-oesophageal reflux were, however, uncommon after bag dilatation. PMID- 3653758 TI - Telenzepine is at least 25 times more potent than pirenzepine--a dose response and comparative secretory study in man. AB - Telenzepine is an analogue of pirenzepine with a higher potency and similar selectivity for M1-receptors in animals. In this placebo controlled, double blind, randomised study mean peptone stimulated gastric acid secretion (mean +/- SEM) of 10 male healthy subjects (58 +/- 6 mmol H+/3 h for placebo) was significantly and dose dependently inhibited by oral telenzepine (2 mg: 31 +/- 5, 3 mg: 23 +/- 5, 5 mg: 21 +/- 4 mmol H+/3 h). Telenzepine 3 and 5 mg were significantly stronger than pirenzepine 50 mg orally (37 +/- 8 mmol H+/3 h). Mean percentage acid inhibition was 37% for pirenzepine, and 48, 61, and 64% for 2, 3, and 5 mg telenzepine, respectively. Basal and peptone stimulated gastrin release was unaffected. Mean salivary output per three hours declined moderately from 156 +/- 45 g (placebo) to 136 +/- 45 g with pirenzepine and significantly to 88 +/- 28 g, 95 +/- 39 g and 39 +/- 13 g with telenzepine 2, 3, and 5 mg, respectively. There was a parallel effect on Na+, K+, Ca++ and amylase output in saliva. Near point vision was not altered by either drug. Pulse rates were lowered by both substances. Complaints of dry mouth were more frequent with telenzepine 5 mg. On a molar basis telenzepine proved to be a 25 and 50 times more potent inhibitor of gastric and salivary secretion, respectively. PMID- 3653759 TI - Emphysematous gastritis after acute pancreatitis. AB - A case of emphysematous gastritis associated with extensive gastric infarction after acute pancreatitis and acute renal failure is described. This complication was diagnosed on a plain abdominal radiograph and confirmed endoscopically. Extensive gastric and hepatic infarction was seen at necropsy. PMID- 3653760 TI - Fine needle biopsy: effect of needle size. PMID- 3653761 TI - Essential fatty acids and peptic ulcer disease. PMID- 3653762 TI - Colorectal carcinoma in ulcerative colitis. PMID- 3653763 TI - Recurrent endometrial stromal sarcoma resembling intravenous leiomyomatosis. AB - A case of recurrent low-grade endometrial stromal sarcoma (endolymphatic stromal myosis) presenting as an intracardiac neoplasm is reported. Pronounced leiomyomatous differentiation was noted in the recurrence. This together with the gross pathology closely resembled intravenous leiomyomatosis. PMID- 3653764 TI - A study of cryosurgery and the CO2 laser in treatment of carcinoma in situ (CIN III) of the uterine cervix. PMID- 3653765 TI - Phase II trial of vinblastine in previously treated patients with ovarian cancer: a Southwest Oncology Group Study. AB - Sixty-eight patients with relapsing, epithelial type ovarian carcinoma were entered into a Phase II study of vinblastine. Vinblastine was administered as a continuous intravenous infusion over 5 days at a starting dose of 1.7 mg/m2/day every 3 weeks. There were 44 fully evaluable and 6 partially evaluable patients. Forty-one of these patients had had only one prior treatment regimen. Grade 3 or 4 leukopenia occurred in 12 patients (24%), but Grade 3 or 4 thrombocytopenia occurred in only 2 patients. There were two clinical complete responses of 18- and 36-week durations and one partial response of 6 weeks for an overall response rate of 7%. We conclude that vinblastine, administered in optimal dose and schedule, has little clinical activity in previously treated patients with ovarian cancer. PMID- 3653766 TI - Randomized phase II studies of cisplatin and a combination of cyclophosphamide doxorubicin-cisplatin (CAP) in patients with progestin-refractory advanced endometrial carcinoma. AB - Between May 1980 and September 1983, 30 progestin-refractory patients with metastatic endometrial carcinoma were assigned at random to treatment groups receiving either cisplatin (CDDP) 60 mg/m2 every 3 weeks or a combination of cyclophosphamide, doxorubicin, and cisplatin every 4 weeks in doses of 400, 40, and 40 mg/m2, respectively. Those who failed cisplatin were then offered cyclophosphamide 500 mg/m2 plus doxorubicin 40 mg/m2 every 3 weeks. Reduced doses were utilized in both of the combination regimens for patients who had received extensive pelvic radiation. Of the 14 patients initially receiving cisplatin alone, 3 experienced objective tumor regression. One of these three and one other who failed primary cisplatin therapy later responded favorably to cyclophosphamide plus doxorubicin as secondary treatment. Among the 16 patients who took all three drugs simultaneously (CAP) 5 experienced objective partial tumor regression. Survival experience for these relatively late-stage patients has been uniformly poor, with only 7 and 12% surviving at 2 years after beginning CDDP and CAP, respectively. Thus, while cisplatin is clearly an active agent against endometrial carcinoma, its therapeutic index as a single drug or in combination (CAP) is not adequate to preclude new-agent Phase II studies early in patients with advanced disease. PMID- 3653767 TI - The use of a human endometrial carcinoma cell line (RL-95) for in vitro testing of chemotherapeutic agents. AB - RL-95, a moderately well-differentiated adenosquamous endometrial carcinoma cell line, can be used as a model for testing chemotherapeutic agents in vitro. Cells are grown in T-75 flasks, transferred to scintillation vials, and grown for 24 hr. Following this, medium is removed and new medium containing Adriamycin (Adr) and cis-platinum (CP) is added. Effects of the two drugs are measured by cell counts and DNA synthesis. To measure DNA synthesis, cells are incubated with [3H]thymidine (3H-THY) for up to 24 hr. Decreased DNA synthesis is reflected in decreased 3H-THY uptake. Cell kill is obtained with levels of drugs that are clinically achievable. Evidence is presented for increased cytotoxicity with concomitant, rather than sequential, chemotherapy. Results are also confirmed by testing the agent on MCF-7, a well-known breast cancer cell line. The results indicate that (1) endometrial carcinoma responds to Adriamycin and cis-platinum chemotherapeutic agents in vitro, and (2) RL-95 can be used as a model for testing varying concentrations, time of exposure, and combinations of chemotherapeutic agents. PMID- 3653768 TI - Preoperative radiotherapy for early endometrial carcinoma. AB - A retrospective study was undertaken to compare the use of one versus two preoperative radium systems for early endometrial carcinoma. The charts of 73 patients treated between 1977 and 1980 were reviewed. No difference was noted between the two groups when compared for stage, grade, depth of myometrial invasion, and histologic type of tumor. One of thirty-eight (2.6%) patients in the one-radium group developed an isolated central recurrence; there were no central recurrences in the two-radium group. Total duration of therapy and total hospitalization for the one-radium versus the two-radium group were 17.6 and 15.3 days versus 77.0 and 17.3 days, respectively. Follow-up ranged from 48 to 84 months. Corrected survival figures are comparable to 94.6% for the one-radium group versus 100% for the two-radium group. These data suggest comparable effectiveness and morbidity between the two treatment regimens, with the single radium application more efficient and cost effective. PMID- 3653769 TI - The evaluation of postoperative irradiation in patients with early-stage ovarian cancer. AB - This is a retrospective study of 127 patients with ovarian carcinoma stage I, II, and III with no or minimal residual disease postoperatively. Patients were treated with radiotherapy by the moving strip technique from 1970 through 1984. The 5-year actuarial survival rate was 73%. Analysis was made on subgroups such as a complete versus incomplete staging procedure, stage, histopathology, grade, and amount of residual tumor. In this study, grade is a significant prognostic indicator (survival in grade 1 versus grade 2 and 3 tumors was statistically different (P less than 0.005). Stage 1 and 2 patients do better than stage 3 patients. Residual tumor does not influence survival rate. The disease-free survival of patients with serous cystadenocarcinoma is better than that of patients with mucinous cystadenocarcinoma (P less than 0.004). The incidence of severe complications was 4%. PMID- 3653770 TI - Experience with pelvic washings in stage I and II endometrial carcinoma. AB - Pelvic washings for cytologic analysis have become an accepted diagnostic procedure in the management of endometrial carcinoma. A retrospective study was performed in 163 consecutive patients with FIGO Stage I and II endometrial carcinoma to assess the significance and value of the washings. Abnormal results were obtained in 5.5% of patients. Patients with FIGO grade 3 lesions were significantly most likely to have abnormal washings (P less than 0.05). Significant association was not observed with stage, depth of myometrial invasion, extrauterine spread, histologic subtype, prior hormone usage, or hormone receptor status. Multivariant analysis indicated that, for Stages I and II combined and for Stage I alone, FIGO grade 3 was most predictive of poor survival (P less than 0.01). The postoperative therapy of only 2 patients (1.2%) was altered by the results of the pelvic washings and only one of these patients has survived. No patients have had recurrent disease (median follow-up 31 months) in the peritoneal cavity with negative washings unless two or more other adverse prognostic factors were present. It is concluded that pelvic washings have a limited role in the clinical management of Stage I and II endometrial carcinoma. PMID- 3653771 TI - Fine-needle aspiration biopsy in the management of cervical carcinoma following primary therapy. AB - Thirty-five fine-needle aspiration biopsies (FNAB) in 30 patients who had previously received primary therapy for cervical carcinoma are reported. There were 22 positive FNABs, and in 11 cases the positive FNAB definitely changed the patient's planned therapy. There were no complications due to FNAB in these 30 patients. FNAB has an important role in follow-up and management of patients with cervical carcinoma. PMID- 3653772 TI - Radical hysterectomy and pelvic lymphadenectomy for stage IB carcinoma of the cervix: 21 years experience. AB - From September 1971 through December 1982, 153 patients with Stage IB carcinoma of the cervix underwent radical hysterectomy and pelvic lymphadenectomy at two of the teaching hospitals of the Uniformed Services University of the Health Sciences. Records were retrospectively analyzed and independent pathologic review was performed. All surgical procedures were performed by fellows or senior residents under the direct supervision of the gynecologic oncology staff of the Walter Reed Army Medical Center or the Naval Hospital, Bethesda, Maryland. In this series, IB carcinoma was defined as squamous carcinoma clinically confined to the cervix with invasion greater than 5 mm from the basement membrane or any adenocarcinoma confined to the cervix. The average age of the patients was 38.3 years. The histologic types were squamous in 72%, adenocarcinoma in 16%, and adenosquamous in 10.5%. The mean operating time was 5 hr and 40 min with an average blood loss of 1800 cc. There were two ureterovaginal and two vesicovaginal fistulae for an overall fistula rate of 2.6%. Actuarial survival for these 153 patients is 84%. This extends the previous series of R. C. Park, W. E. Patow, R. E. Rogers, and E. A. Zimmerman, Obstet. Gynecol. 41, 117-122 (1973) of 122 cases collected from 1961 to September 1971 to 275 cases. In comparing the two time periods, no significant differences were found in operative technique or complications, but there was a change in the incidence of adenocarcinoma and mixed cell types and a difference in survival. A relatively higher incidence of more aggressive tumors may indicate the need for different therapeutic approaches in the future. PMID- 3653773 TI - The role of second-look laparotomy in treatment of epithelial ovarian cancer. AB - Forty-two patients underwent a second-look laparotomy to assess response to systemic chemotherapy for epithelial ovarian cancer. In 20 cases the operation showed no histologic evidence of disease. None of these cases received additional treatment at the time of negative second-look laparotomy. There has only been one recurrence noted in an average follow-up interval of 38.5 months. The remaining 22 cases did have residual carcinoma and 16 have developed progressive carcinoma despite secondary treatment. We found second-look laparotomy to be a safe and reliable assessment tool. However, we could not demonstrate a medical benefit from the procedure. PMID- 3653774 TI - The distribution and prognostic implications of steroid receptors in endometrial carcinomas. AB - Estradiol receptors (ER) were measured in 71 and progesterone receptors (PR) in 62 primary endometrial carcinomas. ER were found in 62 (87%) and PR in 56 (90%) of the tumors. Fifty-six tumors were ER+/PR+ and 4 were ER-/PR-. The frequency of receptor positive tumors was not significantly correlated to histological grade. Highly differentiated tumors were, however, more often ER and PR rich (greater than or equal to 30 fmole/mg protein) as compared to poorly differentiated tumors. The median ER and PR values for grade I tumors were also significantly higher than for grade III tumors. No significant differences were found in the frequency of patients with ER or PR rich tumors in the different FIGO or surgical stages. The receptor status was not related to depth of myometrial infiltration. Recurrence rates and death rates were significantly higher in patients with PR poor as compared to those with PR rich tumors. This prognostic information could not be shown for ER. PMID- 3653775 TI - [Breech presentation--an obstetric problem]. PMID- 3653776 TI - [Diagnostic and therapeutic consequences of round lesions of the benign type in the breast]. PMID- 3653777 TI - [Perioperative one-shot prevention with metronidazole in gynecology]. PMID- 3653778 TI - [Diagnosis and therapy of non-carcinomatous diseases of the vulva]. PMID- 3653779 TI - [Diagnosis and therapy of carcinomatous diseases of the vulva]. PMID- 3653780 TI - Lectin receptors on preimplantation mouse embryos. The solidity of lectin binding. AB - Receptor sites for 7 FITC-conjugated lectins were examined on preimplantation mouse embryos at various stages of development: zygotes; 2; 6-8 cells; morulae; blastocyst; expanded blastocyst, and isolated inner cell mass. In order to determine the solidity of the binding, the embryos were incubated with lectins, washed and incubated for an additional time with the specific hapten sugar. Receptor sites for all 7 lectins were found on the cell surface of all preimplantation mouse embryonic stages examined. The binding was found to be specific. The solidity of the lectins' binding to the receptors was found to be high, since it could not be removed by the corresponding sugar hapten. PMID- 3653781 TI - The effect of a single dose of human chorionic gonadotropin at proestrus on embryonic mortality, fetal growth and gestation length in the rat. AB - The noxious effect of a single dose of 20 IU human chorionic gonadotropin (hCG) given at proestrus on embryonic and fetal survival as well as on fetal weight was studied. Fetal survival varied between 43.6 and 67.6%; the mortality rate was highest before implantation. The surviving fetuses of rats treated with hCG between days 17 and 20 of pregnancy weighed significantly less than controls. Embryonic mortality and fetal growth retardation could be prevented by giving anti-hCG monoclonals 28 or 45 h after hCG administration, but not when anti-hCG was given 69 or 93 h after hCG. 5 IU hCG did not induce embryonic or fetal mortality. On the other hand, 80 IU hCG increased the mortality to 100%; this was entirely due to preimplantation loss. It is speculated that due to a long metabolic half-life of hCG, the steroid metabolism is disturbed, causing implantation failure and/or delay of implantation. By day 21 of pregnancy, however, the fetuses of the hCG-treated rats had made up greatly for the growth retardation; they were born after a similar gestation length and with a similar birth weight as the pups of control rats. PMID- 3653782 TI - Dating of the endometrium by microhysteroscopy. AB - In 173 consecutive cases of hysteroscopy, the microhysteroscope was brought into contact with the anterior part of the fundus uteri. The vascular pattern of the endometrium was then visualized and photographed. As the vascularization of the endometrium changes during the menstrual cycle, a dating of the endometrium was made based on the blood vessel pattern. An endometrial biopsy was taken in each case. Hysteroscopically we were able to define five different phases in the menstrual cycle: early proliferative, late proliferative, early secretory, late secretory, and premenstrual-menstrual phase. Histopathological examination confirmed the hysteroscopical diagnosis of the phases in 72, 69.7, 81.3, 53.8 and 70%, respectively. PMID- 3653783 TI - Parenteral and oral cyproterone acetate treatment in severe hirsutism. AB - In the present study a parenteral treatment regimen with cyproterone acetate was compared with the high dose peroral administration in patients with severe hirsutism. Two groups consisting of 10 patients each performed treatment with either 100 mg cyproterone acetate perorally for the first 10 days of the menstrual cycle or received a monthly implant of 300 mg cyproterone acetate intramuscularly applied on the first day of each cycle. In addition, contraception was performed with Diane in both patient groups. 9 treatment cycles were followed by a posttreatment period of 3 months. Hair parameters and serum androgens were monitored regularly. No significant differences of testosterone, androstenedione, dehydroepiandrosterone-sulfate and prolactin serum levels became evident between both cyproterone acetate regimens. Measurements of facial hair diameters revealed a better reduction for the parenteral application. Also the improvement of dermatological parameters was more prominent in the parenteral treatment group. The good effects of a medium dose parenteral application against higher dose peroral treatment thus was documented. The lack of significant differences of androgenic suppression in both regimens turns up the question if different metabolism at the cellular level may be responsible for that phenomenon. PMID- 3653784 TI - Effect on ovulation of surgically induced endometriosis in rabbits. AB - To study the effect of endometriosis on follicular rupture, endometrial tissue was autografted to New Zealand White rabbits. Endometrium was surgically implanted into the peritoneal cavity or into the rectus muscle. Human chorionic gonadotropin was administered to induce ovulation. During three subsequent laparotomies, the number of corpora lutea and stigmata were counted. The viability of the implants was demonstrated histologically. Ovaries were removed during the last laparotomy and ovarian serial sections were examined. In rabbits with peritoneal induced endometriosis, the percentage of stigmata/corpora lutea was significantly decreased. Macroscopic study was confirmed by histological examination. Indeed, a high incidence of entrapped oocytes was found in rabbits with peritoneal endometriosis. Extraperitoneal endometriosis had no effect on ovulation. Our data demonstrated that endometriosis induced a failure of follicular rupture. After endometriumectomy, no failure to ovulate was observed, suggesting that the effect of endometriosis on the ovulation disappeared with excision of endometrial implants. PMID- 3653785 TI - Endometrial carcinoma: 128 cases at stages I and II. AB - The authors have re-examined 146 patients with stage I and II endometrial carcinoma according to pathological findings. An understaging of FIGO classification of 9.8% and 14.2% in stages I and II, respectively, was found. Also evaluated was the influence of some risk factors (histologic grade, myometrial infiltration) on survival rates which was highly significant for both stages I and II. Surgery was the main form of treatment with an operability rate higher than 90%. The bilateral salpingo-oophorectomy appeared to improve the survival at stage I, 85.8% versus 63.6%, while postoperative external radiotherapy (ERT) seemed to be ineffective. PMID- 3653786 TI - Immunohistochemical evidence for preserved innervation of the human cervix during pregnancy. AB - Morphological evidence for a denervation of the human myometrium during pregnancy has previously been demonstrated. In the present study the innervation of the human cervix has been investigated in nonpregnant, early pregnant and term pregnant women. An indirect immunofluorescence method, using an antiserum to the Schwann cell specific S-100 protein, was applied to document the distribution of nerve fibers in cervical tissue biopsies. In nonpregnant, as well as in pregnant women, the cervix was by far more densely innervated than the rest of the uterus. No obvious difference in nerve density was observed between nonpregnant, early pregnant and term pregnant women, and still during labor the innervation appeared morphologically preserved. It is suggested that the segmental difference in innervation of the human uterus (corpus versus cervix) may have specific importance for myometrial and cervical contractility during pregnancy and parturition. PMID- 3653787 TI - Is the collagen content reduced when the fetal membranes rupture? A clinical study of term and prematurely ruptured membranes. AB - In 15 patients experiencing premature rupture of the fetal membranes (PROM) and in 15 control subjects having delivered spontaneously at term, the collagen content of the membranes was determined by the hydroxyproline method. From each patient two membrane specimens were obtained, one from the rupture margin and another from the membranes in close relation to the placental margin. No significant difference in the collagen content was demonstrated between the two groups of patients. Moreover, no significant difference was observed comparing the collagen content within the paired membrane specimens of each patient in each group. Neither was there any obvious change in the membrane collagen content in relation to clinical signs of chorioamnionitis or microbiological findings. It is concluded that changes in the collagen content of the fetal membranes bear no significance as to the etiology of PROM, neither is such a change involved in the mechanism of membrane rupture at term. PMID- 3653788 TI - Postnatal changes in colloid osmotic pressure in premature infants: in healthy infants, in infants with respiratory distress syndrome, and in infants born to mothers with premature rupture of membranes. AB - Colloid osmotic pressure (COP) of blood plasma during the first 4 days of life was measured in 63 neonates: 16 healthy preterm infants, 36 infants with respiratory distress syndrome (RDS), and 11 infants born to mothers with premature rupture of membranes. The relation between COP and total protein content of blood was significant in all groups over times from 1-3 h to 96 h. COP rose significantly by the age of 3 h compared to COP of umbilical cord plasma in all groups investigated. Infants with RDS showed a significant increase in COP during the investigation period. In healthy preterm infants the increase was less significant. In infants with RDS there was a negative correlation between changes in COP and body weight not seen in the other groups investigated. COP in neonates seems to reflect the compartmentation between vascular and interstitial spaces. Measurement of COP could be clinically useful in assessing hemodynamic adaptation after birth and also in assessing edema formation and water balance in infants with RDS. PMID- 3653789 TI - Altered monocyte functions in patients with angioimmunoblastic lymphadenopathy. AB - Monocyte function was investigated in ten patients with angioimmunoblastic lymphadenopathy (AILD). Although spontaneous migration, phagocytosis and opsonisation of monocytes were unimpaired, the chemotactic response and erythrocyte-antibody-rosette (EA-rosette) formation were decreased significantly. The migratory response of normal monocytes was inhibited on preincubation with serum from AILD patients. It is suggested that the immune abnormality in AILD, previously thought to involve T-B and natural killer lymphocytes, extends to the monocyte-macrophage system. PMID- 3653790 TI - Marked changes in red cell volume response to isotonic glucose solution during storage. AB - The changes of erythrocyte-volume caused by isotonic hexose solutions, glucose and galactose, during storage were studied. Blood was stored for 13 weeks at 4 degrees C. The determinations were carried out using a newly developed blood cell volume analyzer which can measure the continuous changes in cell volume. The erythrocyte volume gradually increased and reached a plateau after 13 weeks of storage. The percent volume increase in hexose solutions markedly decreased during the first 4 weeks of storage. These changes may have been due to denaturation of the membrane protein responsible for hexose permeation during storage. PMID- 3653791 TI - Alpha, beta thalassemia produces high levels of Hb Bart's in newborns and high HbA2 in adults. PMID- 3653792 TI - The posterior zygomatic fissure in skulls of different human races. PMID- 3653793 TI - The left medial basal segmental bronchus in human lung. PMID- 3653794 TI - Skeletopy of the origin of major branches of the abdominal aorta and of bifurcation of the aorta. PMID- 3653795 TI - Morphology of the gastrocnemius muscle of the calf in the Nigerians. PMID- 3653796 TI - The interosseous muscles of manus and pes in coypu. PMID- 3653797 TI - Postnatal growth of the pelvic bone in aurochs. PMID- 3653798 TI - Cortical vascularization of the femoral, tibial and fibular bones during prenatal development. PMID- 3653799 TI - Microscopic studies of the sinus node in the heart of dogs. PMID- 3653800 TI - [Pharmacological studies on pinacidil, a new antihypertensive agent. (3). Studies on the vasodilating effects in isolated monkey arteries and the peripheral hypotensive mechanism in SHR]. AB - Vasodilating effects of pinacidil in isolated monkey arteries were compared with those of nifedipine and hydralazine, and the relationship of the central nervous system to hypotensive and positive chronotropic effects of pinacidil in SHR was also studied. In arterial strips contracted with prostaglandin F2 alpha, the relaxant potencies of pinacidil were in the order of mesenteric = femoral greater than basilar = middle cerebral arteries, whereas those of nifedipine were middle cerebral = basilar = coronary greater than femoral arteries, and those of hydralazine were femoral greater than middle cerebral = coronary arteries. In pithed SRH, the hypotensive effect of pinacidil was dose-related, similar to hydralazine. Intravenous administration of 0.1 and 0.3 mg/kg of pinacidil in SHR demonstrated remarkable hypotension, whereas intracerebroventricular administration of the same doses did not show any significant effects. Therefore, the central autonomic nervous systems did not seem to take part in the hypotensive effects of pinacidil. The hypotension by intravenous administration of pinacidil in SHR was followed by an increase in heart rate. The increase in heart rate in conscious SHR was more marked than that in anaesthetized SHR. In pithed SHR, pinacidil did not show positive chronotropic effects even with the larger dose of 3 mg/kg, i.v. Propranolol pretreatment inhibited the increase in heart rate produced by pinacidil. These results show that activation of efferent sympathetic nerves via the baroreceptor. The peripheral hypotensive mechanism of pinacidil was supported by the present results. PMID- 3653801 TI - [Electrophoretic properties of mitochondrial monoamine oxidase in monkey liver]. AB - Monkey liver monoamine oxidase (MAO) was predominantly the B-form enzyme from the observed differences in substrate specificities and differences in sensitivities to MAO inhibitors. It is known that a MAO inhibitor, pargyline, binds to MAO irreversibly in the molar ratio of 1:1. 3H-pargyline was used as a marker to determine the existence of MAO. The molecular weight of MAO in monkey liver mitochondria was investigated by SDS-polyacrylamide gel electrophoresis after solubilization of 3H-pargyline binding mitochondria with 6% sodium dodecyl sulphate (SDS). The subunit molecular weight was found to be 60,000. The molecular weight determined from the electrophoretic mobility on several concentrations of gels by disc gel electrophoresis in the absence of SDS was found to be 120,000. These results indicate that monkey liver mitochondrial MAO exists as a dimer. Isoelectric focusing of the enzyme after solubilization with 0.1% Triton X-100 and 0.75% Triton X-100 and 0.75% Lubrol showed that it had a pI value near 6.5. Similar pI values were obtained for enzyme preparations solubilized with 0.75% Triton X-100 after treatment with phospholipase A or methylethylketone. These results suggest that the pI value of MAO in monkey liver mitochondria does not depend on the properties of detergents used to solubilize the enzyme preparation. PMID- 3653802 TI - [Effect of terodiline hydrochloride in isolated rabbit detrusor]. AB - Effect of terodiline on isolated rabbit and guinea pig detrusor was investigated in comparison with that of flavoxate and oxybutynin. Terodiline (10(-6) M) parallelly shifted the dose-response curve for carbachol in rabbit detrusor to the right, and high doses of terodiline (3 X 10(-6)-3 X 10(-5) M) inhibited the maximal contraction. Flavoxate (10(-5) M or more) also inhibited the maximal contraction. Oxybutynin (10(-8) M or more) shifted the dose-response curve to the right, but did not affect the maximal contraction. At 3 X 10(-6) M or more, terodiline dose-dependently inhibited the Ca-contraction of rabbit detrusor. While the contraction of rabbit detrusor induced by electrical field stimulation was inhibited by atropine (3 X 10(-7) M) or nifedipine (3 X 10(-6) M) by 35% or 73%, respectively, the combination of atropine (10(-7) M) and nifedipine (10(-6) M) abolished it. Oxybutynin (3 X 10(-7) M) inhibited it by about 30%; terodiline (10(-6) M or more) and flavoxate (10(-5) M or more) dose-dependently inhibited it, and abolished at 10(-4) M and 3 X 10(-4) M, respectively. Terodiline inhibited the 1-quinuclidinyl-[phenyl-4-3H]-benzilate binding to the microsomal fraction of guinea pig urinary bladder, brain, atria and ileum dose-dependently, and it had similar affinity among these fractions. Terodiline (3 X 10(-6) M or more) inhibited the 45Ca uptake to minced guinea pig urinary bladder dose dependently, but did not influence the 45Ca efflux even at 10(-4) M. Flavoxate (10(-4) M) only slightly inhibited the 45Ca uptake.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653803 TI - [Immunological action of neurotropin (5). Effect of neurotropin on immunosuppression caused by stress]. AB - Neurotropin is an extract isolated from the inflamed skins of rabbits inoculated with Vaccinia virus. A study was carried out to examine the effect of Neurotropin on the immunosuppressions caused by stress. Mice were restrained for 16 hr per day for 2 consecutive days. Under this condition, the immune responses such as PFC and DTH to SRBC, T cell-dependent antigen, were markedly suppressed. Moreover, the phagocytic activity of macrophages were also suppressed. Neurotropin was found to restore such suppressions of both T cell response and phagocytosis in stressed mice. These results suggest that the effect of Neurotropin on depressed immunity in stressed mice were not only restoration of T cell function but also phagocytic activity of macrophages. Neurotropin had no effect on intact immune responses without stress. This suggests that Neurotropin can be used as an effective immunomodulator. PMID- 3653805 TI - Morphometric variations of the family Sphyraenidae from the South-eastern part of the Mediterranean Sea. PMID- 3653804 TI - Changes in the Golgi apparatus during hind limb regeneration in larval and metamorphic stages of Bufo regularis Reuss. PMID- 3653806 TI - The lateral sensory canal system in the head of Ambassis ranga (Cuv. et Val.). PMID- 3653807 TI - Study of the miracidium of Cotylophoron indicum Stiles et Goldberger, 1910. PMID- 3653808 TI - Spermatogenesis in the marine hermaphrodite teleost fish Sparus aurata. PMID- 3653809 TI - Seasonal changes in the testis of the marine teleost fish Sparus aurata. PMID- 3653810 TI - Cytological and cytochemical seasonal changes in the testis of the marine hermaphrodite fish Sparus aurata. PMID- 3653811 TI - Argyrophilic granules in the excretory ductal cells of the human submandibular glands. PMID- 3653812 TI - Histological and cytological studies of development of the oocyte of Poecilocerus pictus Fabr. (Acrididae, Orthoptera). PMID- 3653813 TI - Histochemistry of the olfactory epithelium of a hillstream fish, Botia dario (Ham.). PMID- 3653814 TI - Histomorphology of the olfactory organs of a freshwater mud-eel, Amphipnous (= Monopterus) cuchia (Ham.). PMID- 3653815 TI - Morphology and anatomy of the olfactory organs of a silver carp, Hypophthalmichthys molitrix (Val.). PMID- 3653816 TI - Morphology and anatomy of the olfactory organs of a marine fish, Sphyraena jello (C.). PMID- 3653817 TI - Effect of penicillin on metamorphosis of the tadpole of Bufo regularis Reuss. PMID- 3653818 TI - The hypothalamo-hypophysial vascular relationship in the Indian freshwater catfish Mystus vittatus (Bloch). PMID- 3653819 TI - Baboon diet: a five-year study of stability and variability in the plant feeding and habitat of the yellow baboons (Papio cynocephalus) of Mikumi National Park, Tanzania. AB - The habitat and plant feeding of 64 well-habituated, individually identified adult male and female yellow baboons was studied for 5 years at Mikumi National Park, Tanzania. Variation across the years showed that a study of only one or two years would have been incomplete and misleading. The list of baboon food species obtained from Mikumi is considerably larger and more diverse than any previously reported. One to six plant parts were eaten from each of more than 180 species. The 25 most common tree genera all contained species used for food. Of the 50 most common grass, shrub and herb genera, 93% included plant foods. Using months in which a species was eaten during at least one year of the study, 21 staple species were eaten during a mean of 8.86 months and 7 were eaten in all 12 months. Although many foods were from commonly available plant species, 15 such species were only rarely eaten. The number of parts of a species eaten per month and an estimate of the amounts eaten per month both varied with temperature and rainfall, being lowest near the end of the cool, dry season. There were substantial differences from year to year in the timing and amount of food production of many species; nevertheless, the same broad feeding pattern was repeated in each of the 5 years of the study. Despite yearly variation in food availability, 14 or more staples and other common foods were eaten in any given month. If crops of many of these foods were to fail, a large number of less commonly eaten species could be substituted. Baboons are eclectic feeders that appear to be optimizing their diet by selective feeding from among a wide array of available foods in an ever-changing floristic environment. PMID- 3653820 TI - Potential reversibility of skeletal effects in rats exposed in utero to caffeine. AB - Groups of Osborne-Mendel rats, killed at three time intervals following mating, were studied to determine whether prenatal skeletal ossification delays observed following low-level caffeine administration represent transient or persistent ossification problems. Group A litters were killed on gestation day 20; group B neonates were killed on post-natal day 0; and group C pups were killed on post natal day 6. Within each group, dose levels of 0, 0.018, 0.036 or 0.07% caffeine in distilled water were available ad lib. to groups of 30-60 dams from gestation day 0 to day 20. Average daily caffeine consumption was 24.7-29.0 mg/kg body weight for the 0.018% group, 42.7-48.8 mg/kg body weight for the 0.036% group and 70.6-75.1 mg/kg body weight for the 0.07% group. In group A litters, the mean number of viable foetuses was significantly less in the mid-dose and high-dose animals than in the controls. In the same group, the average number of foetuses per litter with at least one sternebral ossification delay was increased significantly in all treated groups and the average number of foetuses per litter with at least two sternebral variations was significantly increased in the mid- and high-dose groups. The percentages of litters containing foetuses with at least two and at least three sternebral variations and the average number of foetuses per litter with at least three sternebral variations were significantly increased only in the high-dose group. Foetuses from the mid- and high-dose groups also had significant increases in certain skeletal defects, namely missing centra and reduced ossification of the dorsal arch. Foetuses from the high-dose group also had significant increases in bipartite supraoccipital, and reduced ossification of the hyoid, metacarpals and metatarsals. In group B, day 0 neonates from all treated groups showed a significantly increased incidence of delayed sternebral ossification (average number of foetuses per litter with one or more missing, incomplete or bipartite sternebrae). The percentages of litters containing neonates with delayed sternebral ossification were also increased significantly in all treated groups. Neonates from the 0.07% level in group B also exhibited a significant increase in the incidence of supernumerary rib bud, and in reduced ossification of the metacarpals, metatarsals and calcaneus bones. Significant increases were also seen, in group B, in the low- and mid-dose animals, respectively, in supernumery rib bud and in reduced ossification of the metatarsals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3653821 TI - Studies in the guinea-pig stomach on the formation of N-nitrosomethylurea, from methylurea and sodium nitrite, and its disappearance. AB - The formation of N-nitrosomethylurea (NMU) from methylurea (MU) and sodium nitrite in the guinea-pig stomach and the disappearance of NMU from the stomach were studied using a previously described method for NMU determination (Yamamoto et al. Fd Chem. Toxic. 1986, 24, 247). Guinea-pigs were used since they have only glandular stomachs and the pH of the gastric juice (1-2) is similar to that of humans. NMU was relatively stable in the isolated gastric contents of this species. When 2 mumol NMU was injected into the pylorus-ligated stomach of fasting guinea-pigs, about 50 and 37% of the NMU remained at 20 and 30 min, respectively. Some 19 and 42% remained 30 min after NMU was given orally by stomach tube to fasting and feeding guinea-pigs, respectively. NMU was detected in most blood samples irrespective of the administration procedure, but it disappeared rapidly from the blood after iv injection. Nitrite disappeared rapidly from the pylorus-ligated stomach, residual nitrite being less than 20% of the dose in 2.5 min. when 7.5 mumol MU and 15 mumol NaNO2 were co-injected into the ligated stomach, 3.1 mumol NMU was detected 10 min after the injection, followed by a gradual decrease. When MU and NaNO2 were given orally to the animals, 0.7-1.0 mumol NMU was detected in the stomach 10 min after the treatment. Thus NMU was shown to be formed readily in the stomach of the guinea pig and to be absorbed from the stomach into the blood. PMID- 3653822 TI - Rubratoxin B mycotoxicosis in the Syrian hamster. AB - The LD50 for rubratoxin B dissolved in dimethylsulphoxide and administered to Syrian golden hamsters by ip injection was 0.4 (0.2-0.8) mg/kg body weight. The greatest number of deaths occurred 6-24 hr after administration. Gross alterations consisted of congestion of the liver, spleen and kidneys and histopathological alterations involved congestion of the spleen and congestion and mild degenerative changes in hepatocytes. In a second study, rubratoxin B was administered ip daily for 1 wk at doses of 25, 50 and 75% of the ip LD50. Mortality was greatest in the 50 and 75% dose groups. Toxicity was cumulative with multiple doses. Gross alterations were similar to those found in the LD50 study. Histopathological alterations included renal tubular degeneration and necrosis and focal necrosis of hepatocytes. The morphopathogenesis of lesions following a single ip LD50 dose was evaluated in a third study. Histopathological alterations were limited to the kidney and were characterized by renal tubular degeneration and necrosis. Renal lesions were first seen at 2 hr after administration and increased in severity to a maximum at 20 hr. Tubular regeneration was first seen at 24 hr and was found to the end of the test period (72 hr). Serum activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and serum concentrations of total and indirect bilirubin were increased by 8 hr after dosing and returned to control values by the end of the test period. In a fourth study, rubratoxin B was administered ip daily for 1 wk at a dose of 25% of the ip LD50. Gross alterations were similar to those in the other studies. Histopathological alterations included progressive renal tubular degeneration and necrosis. Serum activities of AST and ALT and concentration of blood urea nitrogen (BUN) were progressively increased with increasing numbers of doses. Urinalysis indicated progressive renal tubular damage. PMID- 3653823 TI - Long-term in vivo carcinogenicity study of phenytoin (5,5-diphenylhydantoin) in F344 rats. AB - The carcinogenicity of phenytoin was studied in F344/DuCrj rats. Phenytoin was mixed with powdered basal diet at levels of 0 (control), 0.025 or 0.05% and groups of 50 male and 50 female rats were administered these doses ad lib. for 2 yr. Survival of the treated male and female rats was similar to that of the corresponding controls. There was a dose-related decrease in mean body weight of treated female rats, but body weights of treated male rats were similar to those of controls. A variety of tumours developed in all groups including the control group, but all of the neoplasms that were observed were histologically similar to known spontaneous tumours in this strain of rats and no statistically significant increase in the incidence of any particular tumour type was evident in the treated groups of either sex. Nor was there any evidence of accelerated tumour induction in any phenytoin-treated group. Thus, it is concluded that under the conditions used in this experiment phenytoin had no carcinogenic potential in F344 rats. PMID- 3653824 TI - Failure of short-term in vitro mutagenicity tests to predict the animal carcinogenicity of hair dyes. AB - A number of hair-dye chemicals that have given positive results in various short term mutagenicity tests have shown no clear evidence of carcinogenicity in animal bioassays. Commercial HC Blue No. 1 and its analogues HC Red No. 3 and HC Blue No. 2 are all mutagenic in the Ames test but only the HC Blue No. 1 is carcinogenic in animals. A carcinogenicity study in mice was carried out on both a commercial sample of HC Blue No. 1 and a highly purified sample which was negative in a battery of short-term tests for mutagenic activity. Both samples, administered at 0.3% in the diet for up to 24 months, were carcinogenic to mice, inducing hepatocellular carcinomas in greater than or equal to 89% of the mice examined. Therefore the presence of mutagenic impurities is not responsible for the carcinogenicity of commercial HC Blue No. 1. Discrepancies between the results of mutagenicity and carcinogenicity tests on hair dyes and other chemicals are discussed, and the value of short-term mutagenicity tests for assessing chemical safety is questioned. PMID- 3653825 TI - The effect of thiram on the germ cells of male mice. AB - The effects of thiram or tetramethylthiuram disulphide on the germ cells of Swiss albino male mice were evaluated by analysing spermatocytes (derived from treated spermatogonia) for chromosomal aberrations and by the sperm-head morphology assay. The total doses tested were 80, 200 and 320 mg/kg body weight given by gavage in three consecutive daily doses, the top dose being slightly below the LD50 of thiram. There was a significant increase in the frequency of numerical chromosomal aberrations and abnormal sperms in mice treated with thiram at all dose levels. Such results could have implications for man in that they suggest that undue exposure to thiram could result in the birth of human infants with numerical chromosomal aberrations. PMID- 3653826 TI - [Changes in the therapy of operable breast cancer. Treatment of small breast cancer and preinvasive stages]. PMID- 3653827 TI - [Miglitol in the treatment of the insulin-dependent diabetic patient. Improved metabolic control and excellent tolerance]. PMID- 3653828 TI - [Renaissance of macrophages. Macrophages in many cells--activity permits inference for clinical prognosis]. PMID- 3653829 TI - [Non-Hodgkin's lymphoma. Critical analysis of its classification, clinical aspects, course and prognosis]. PMID- 3653830 TI - [Family physician and self-help groups. 2: Initiation and management of verbal self-help groups by the family physician]. PMID- 3653831 TI - [Regional perfusion in heart failure. Changed distribution of blood flow caused by vasodilators]. PMID- 3653832 TI - [Does nitrate endanger our health?]. PMID- 3653833 TI - [Ambulatory programmed blood pressure determination over a 24-hours period]. PMID- 3653834 TI - [Pathologico-anatomical peculiarities of ischemic heart disease in females]. AB - In 364 women who died of myocardial infarction, autopsy was performed to assess the extent of chronic ischemic heart disease. The mean age at the time of death at 70.5 years was higher than that of men who died of myocardial infarction; only 4% of the women were less than 50 years of age. In all cases, there were severe arteriosclerotic changes in all coronary arteries. Three-forths of the patients had luminal narrowing of more than 50%, one-forth less than 50%. Accordingly, with respect to morphology, for acute myocardial infarction as cause of death, there were no differences between the sexes. The muscle mass averaging 440 g was less than that reported for comparable studies in men. In 59 women less than 50 years of age with complaints consistent with angina pectoris and angiographically documented normal coronary arteries, left ventricular biopsies were examined for evidence of chronic ischemic heart disease. In ten patients changes in the terminal vascular beds were found which were considered to be compatible with small vessel disease and in 19 patients there were microscars and a fibrotic pattern as seen in chronic ischemic heart disease. Twelve patients had scarring and fibrosis similar to that seen after myocarditis and 18 patients had a round cell myocarditis without evidence of involvement of the terminal vascular beds. Thus, heart muscle biopsies appear to be of value in the diagnosis of changes in peripheral arterial beds. PMID- 3653835 TI - Cardiovascular risk factors and mortality in women. AB - Men and women are subject to similar environmental influences but women have a markedly longer life expectancy, the difference in which is still increasing. In general, the level of saturated fat intake appears the most important determinant of life expectancy and it seems likely that this factor is even responsible for regional differences within a given country. In both men and women in Western populations, serum cholesterol levels are much higher than in Oriental populations. Women have higher total serum cholesterol than men in the age groups below 20 and over 50 years and this discrepancy may play a crucial role in the development of arteriosclerosis. Women also have markedly higher HDL-cholesterol levels than men in Western countries. Other important factors possibly accounting for the difference in life expectancy are the facts that in women less than 50 years of age, blood pressure is lower than in men and in women, smoking is much less prevalent. Overall, however, serum lipid levels and intake of saturated fat have a lesser influence on mortality in women than in men and, accordingly, they are lower predictors of mortality. PMID- 3653836 TI - [Social conditions and ischemic heart disease in the female]. AB - In the development of ischemic heart disease (IHD) in women, there are a variety of factors which, possibly, may exert an influence. The recognition of such factors must be considered prerequisite to a preventive approach to the disease. Possible relationships between socio-economic conditions, in particular education level and occupation as well as marital status and number of children, with manifestations of IHD or presence of risk factors have been studied. Recently, results have been published from the Cottbus Prevention Study/GDR (CGPPS), the World Health Organization Project Eberbach-Wiesloch/FRG and US-American analyses (NHANES II). On evaluation of available data and assessment of the coronary risk profile in women, it should be taken into consideration that comparison is encumbered by the facts that the studies did not employ uniform definitions of socio-economic classification, risk factors and IHD and that they were subject to differing historical developments. Similar to that observed in men, arterial hypertension and overweight was seen significantly more frequently in women factory workers and rural women than in their more sophisticated counterparts. As in other studies, the prevalence of hypercholesterolemia in women did not differ among the socio-economic stratifications. The number of smokers was significantly higher in those at the upper levels of education than in women factory workers and rural women or office workers and housewives. There was an inverse relationship between the level of education and mean arterial blood pressure. There was no relationship, however, between income and cholesterol levels. In women working at the lower levels of employment, there was a higher incidence of IHD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653837 TI - [New aspects in the diagnosis of ischemic heart disease in females]. AB - To investigate still uncertain aspects of the diagnosis of ischemic heart disease (IHD) in women, between 1969 and 1984, repeated exercise studies were performed in 706 asymptomatic women (between the ages of 17 and 63 years). On observation of pathologic ST-segment depression of more than 0.1 mV, the exercise study was repeated after administration of 0.8 mg nitroglycerin. Pathologic ST-segment depression was seen in 310 women (44%). In 217 patients (31%), nitroglycerin had no effect (NTG negative); in 93 women (13%), there was normalization of the ST segment changes (NTG positive). Additionally, in selected subgroups of patients, pulmonary artery pressure was measured at rest and during exercise and ECG mapping performed (n = 114); radionuclide ventriculograms (n = 64) and 201 thallium scintigrams (n = 99) were obtained and coronary angiography (n = 85) was performed. In the NTG-negative women, ejection fraction, myocardial perfusion and coronary arteries were normal. NTG-positive women had lower mean ejection fractions but still within normal limits and indications of impaired myocardial perfusion. High-grade coronary stenoses were found in 25%. No patient with pathologic ST-segment depression had mitral valve prolapse. NTG-positive women had significantly more risk factors than NTG-negative women. In the former group, pulmonary artery pressure measurements showed pathologic exercise hemodynamics, only in 25% of whom IHD with significant stenosis was found to be the cause. For this condition, differential diagnostic considerations include cardiomyopathy or small vessel disease. PMID- 3653838 TI - [Angiography findings following myocardial infarct in young females: the role of oral contraceptives]. AB - In 173 women less than 50 years of age with myocardial infarction, angiographic evidence of coronary sclerosis was observed in only 108 (62%). Completely normal coronary arteries were found in 15 patients (9%) and in 50 patients (29%) an isolated poorly delineated stenosis was found in the presence of otherwise completely normal coronary arteries. Of the 65 patients with myocardial infarction but without typical coronary sclerosis, 47 (72%) were taking oral contraceptives at the time of infarction. In 60% of the oral contraceptive users with infarction, angiographically, there was no evidence of typical coronary sclerosis. With the exception of cigarette smoking, the number of atherogenic risk factors in these patients was low such that myocardial infarction during treatment with oral contraceptives may possibly represent a separate disease entity distinguishable from coronary sclerosis. In support of this, in some cases, repeat angiography demonstrated spontaneous regression of the isolated stenosis. Etiologically, possible thromboembolic vascular occlusion has been assumed. In women in the premenopausal years, coronary sclerosis is uncommon and usually associated with a substantial number of atherogenic risk factors. In this case, 29% of the women had used oral contraceptives, the causal role of which remains uncertain. Even though oral contraceptive use is associated with a higher risk of myocardial infarction, apparently, it cannot be regarded as a typical atherogenic risk factor. PMID- 3653840 TI - Defenses and recovery from schizophrenic episodes. PMID- 3653839 TI - Unsuspected multiple personality disorder: an uncommon source of protracted resistance, interruption, and failure in psychoanalysis. AB - Multiple personality disorder (MPD) is being recognized with increasing frequency. A great imitator, it may be encountered among patients who appear to have a wide range of other diagnoses, and have been in treatment for years without the presence of MPD being discovered. Nine of 241 MPD patients interviewed by the author, 3.7%, had been accepted for psychoanalysis. In only one case had the diagnosis been appreciated by the analyst prior to his accepting the patient for analytic treatment. Four patients were profoundly resistant and or inaccessible to analysis for protracted periods. In one of these cases the diagnosis became clear and successful analysis was concluded, but three analyses ended unsuccessfully with the diagnosis still unknown. Two patients' analyses were interrupted due to abrupt regressive events initially perceived to indicate severe ego weakness incompatible with sustaining an analytic process, but later appreciated as signs of MPD. In three cases it appeared that the patients' being accepted for analysis triggered the emergence of the dissociative process, and either the patient or the analyst decided to pursue a different form of therapy. Unsuspected MPD appears to account for a small percentage of stalemates, failures, interruptions, and early flights from analysis. PMID- 3653841 TI - Comparison of psychiatric diagnoses in three populations. AB - This report examines the differing types of psychiatric diagnoses served by different institutions as a result of differing social or institutional forces. Four-hundred-eighty-eight emotionally disturbed subjects from three different groups (competency to stand trial, chronic pain, and social security disability (SSI) applicants) were compared across psychiatric diagnostic categories. After adjusting for age, race, sex, education and marital status significant differences were found in the categories of affective disorders, schizophrenia, personality disorders and drug abuse. Interaction between institution and diagnosis is discussed. PMID- 3653842 TI - The significance of borderline and schizotypal overlap. AB - Admission and mean 14-year follow-up Global Assessment Scale functioning were studied in 237 inpatients meeting DSM-III criteria for borderline (BPD) and schizotypal (SPD) personality disorders and compared to major affective disorder, schizophrenia and other diagnoses. BPD patients also meeting criteria for SPD functioned more poorly than other BPD or SPD patients at admission but improved their functioning at follow-up. Two BPD and SPD criteria which were associated with good follow-up functioning in BPD with SPD patients were found to predict poor admission functioning but good follow-up functioning in 18 of 237 former inpatients regardless of diagnosis. PMID- 3653843 TI - Depression, anxiety and the dexamethasone suppression test in hospitalized prepubertal children. AB - Because of the methodologic differences and limited data, the sensitivity and specificity of the dexamethasone suppression test in children are in question. In our study we used 0.5 mg of dexamethasone and a 4 p.m. cortisol sample to perform the DST on 32 hospitalized prepubertal children diagnosed by a structured interview (DICA) and DSM-III criteria. Cortisols differed significantly by ANOVA among principal diagnoses, with highest values in children with major depression (MDE) or separation anxiety (SAD) and lowest in those with behavior disorders (BD). Using 5.0 micrograms/dl as a cutoff value for positive DST, MDE and SAD are positively and BD negatively associated with positive DST results. Rating scales for anxiety and depression showed no significant association with cortisol level. We conclude that the DST in this sample shows excellent sensitivity but its specificity is limited to distinguishing depressed or anxious children from those with pure behavior disorder. PMID- 3653844 TI - Cognitive deficits of older adults identified by the Expanded Word Association Test. PMID- 3653845 TI - Lithium side effects in elderly bipolar outpatients. AB - A group of 19 geriatric bipolar lithium patients were interviewed in order to assess the incidence, bothersomeness and intensity of medication side effects. The role of subject variables was also examined. Most often reported side effects included excessive thirst, hand tremor, excessive urination and dry mouth. Although many side effects were experienced, these effects were generally tolerated with minimal intensity and bothersomeness. Results indicate that with proper precautions and monitoring, lithium can be safely administered to geriatric bipolar patients. PMID- 3653846 TI - Serum and urinary estrone sulfate during the menstrual cycle, measured by a direct radioimmunoassay, and fate of exogenously injected estrone sulfate. AB - Serum and early-morning urinary levels of estrone sulfate during the menstrual cycle were measured by a direct radioimmunoassay without hydrolysis. These levels were high and showed prominent peaks [serum, 2.67 +/- 0.37 ng/ml (mean +/- SE); urine, 5.82 +/- 2.3 micrograms/l] around the day of the preovulatory estradiol-17 beta peak, and increased again during the luteal phase. Following intravenous injection of estrone sulfate, serum estrone sulfate, estrone and estradiol-17 beta were measured. The conversion of estrone sulfate to estrone and/or estradiol 17 beta was very small during their transit in the general circulation. PMID- 3653847 TI - Estrogen and progestin receptors in intracranial tumors. AB - Tissue samples from 17 intracranial tumors were analysed for the cytosolic estrogen and progestin receptor concentration. Three of the four meningiomas were progestin receptor-positive, but all were estrogen receptor-negative. All the four meningioma patients were postmenopausal women. The intracranial metastasis of a mammary carcinoma contained both estrogen and progestin receptors. Low progestin receptor concentration was found in an astrocytoma of a postmenopausal women. In addition, the presence of estrogen and progestin receptors was studied in four prolactinomas, two glioblastomas, two oligodendrogliomas, two mixed-cell carcinomas and one astrocytoma. All these tumors were estrogen and progestin receptor-negative. PMID- 3653848 TI - Dual dose-related action of peripherally administered morphine on cold-stimulated thyrotropin secretion in male rats. AB - Cold-induced increase of thyrotropin (TSH) release was found to be inhibited after 10 or 20 mg/kg morphine sulfate (MO) injected intraperitoneally 30 min before the transfer of adult male rats from 30 to 4 degrees C for 60 min (i.e. 90 min before sacrifice). In contrast, lower doses of MO such as 2.5 and 5 mg/kg were found to stimulate the cold-induced TSH release under the same conditions. Such a cold-induced TSH release stimulated by lower doses of MO was found to be inhibited by intraperitoneal injection of 2 or 4 mg/kg naloxone (NX) 30 min before MO injection (i.e. 120 min before sacrifice) in a dose-dependent manner, while the same doses of NX were without effect on the levels of TSH after higher doses of MO. It is suggested that these effects may depend on different sensitivities of various hypothalamic loci involved in mediating either a stimulation or inhibition of TSH release. PMID- 3653849 TI - Hepatic encephalopathy: lack of changes of gamma-aminobutyric acid content in plasma and cerebrospinal fluid. AB - The aim of the study was to verify the role of gamma-aminobutyric acid in the pathogenesis of hepatic encephalopathy occurring in cirrhotic patients by attempting to correlate plasma and cerebrospinal fluid content of authentic gamma aminobutyric acid with the neurological manifestations of hepatic encephalopathy. For this purpose, plasma and cerebrospinal fluid gamma-aminobutyric acid levels were measured by means of mass fragmentography in 17 cirrhotic patients with hepatic encephalopathy and in 6 cirrhotics without neurological symptoms. Moreover, in all patients, a second sample was obtained during the clinical course of hepatic encephalopathy. The mean plasma and cerebrospinal fluid gamma aminobutyric acid levels were not different in patients with or without hepatic encephalopathy and did not change during the evolution of the neurological symptoms. The lack of changes in the gamma-aminobutyric acid content in plasma and cerebrospinal fluid during hepatic encephalopathy is in contrast with the hypothesized importance of increased entry into the brain of gamma-aminobutyric acid in the pathogenesis of hepatic encephalopathy. PMID- 3653850 TI - Inhibition of human cationic glutathione S-transferase by nonsubstrate ligands. AB - Inhibition of a major hepatic form of human cationic glutathione S-transferase by bilirubin, biliverdin, indocyanine green and chenodeoxycholic acid was investigated as a function of pH (range = 6.5 to 9.1). Changes in pH had little effect on the extent of inhibition by indocyanine green. However, inhibition by bilirubin, biliverdin and chenodeoxycholic acid was found to be pH-dependent, with markedly less inhibition at the high values of pH. The reduced inhibition at the high values of pH could not be ascribed to a failure of the enzyme to bind the nonsubstrate ligand. Instead, the complete inhibition observed at pH 6.5 became partial (hyperbolic) inhibition at pH 9.1. This behavior can be ascribed to the binding of the nonsubstrate ligands at a site other than the active site, i.e., at high values of pH there is formation of an enzyme-substrate-inhibitor complex which still retains considerable catalytic activity. At physiologic values of pH (7.0), the human transferase was completely inhibited by saturating concentrations of the tested nonsubstrate ligands. This is in contrast to our previous studies performed with the rat transferases where, although inhibition also was affected by buffer pH, some forms of the enzyme retained significant catalytic activity at pH 7.0 despite high concentrations of nonsubstrate ligands. We conclude that the ability of the human cationic glutathione S-transferases to serve as enzymes of detoxification in the presence of high intracellular concentrations of nonsubstrate ligands may be significantly reduced, and this may render the cholestatic liver unusually susceptible to injury by toxic electrophiles. PMID- 3653851 TI - Acinar redistribution and heterogeneity in transport of the organic cation rhodamine B in rat liver. AB - We studied a possible acinar heterogeneity in the transport of organic cations, using rhodamine B as model compound. Employing perfusions of isolated rat livers in the ante- and retrograde mode and quantitative fluorescence microscopy, Zones 1 and 3 were shown to be equally efficient in taking up rhodamine B. Ten minutes after injection in an antegrade perfusion, 95% of the dose was localized in the portal half of the acinus. Fifty minutes later, however, the amount of rhodamine B in Zone 1 had been reduced to 23%; 30 and 31% were in Zones 2 and 3, respectively, and the medium concentration was doubled. Thus, unchanged rhodamine B appeared to be transported downstream within the liver, either via the medium or directly from cell to cell, finally resulting in a relatively higher rhodamine B concentration in Zone 3. To obtain additional data, we designed a perfusion setup in which the zones could be studied separately. In both zones, the amount excreted into the medium was about 30 times the amount excreted into bile. Intracellular sequestration of rhodamine B and the rate constant for sinusoidal secretion were higher in Zone 3, while the sinusoidal uptake rates were equal; biliary excretion was higher in Zone 1. Acinar distribution changed with time because rhodamine B, primarily accumulated in Zone 1, was secreted into the sinusoids and taken up again by downstream cells. The finally higher rhodamine B concentration in Zone 3 was caused by a zonal heterogeneity in intracellular sequestration and sinusoidal secretion of rhodamine B. PMID- 3653852 TI - Elevation of chemotactic factor inactivator in alcoholic liver disease. AB - Defective regulation of neutrophil chemotaxis occurs in patients with alcoholic liver disease. One potent mediator of neutrophil chemotaxis is the complement derived neutrophil chemoattractant, C5a, which can be inhibited by a serum protein, chemotactic factor inactivator. We hypothesized that chemotactic factor inactivator elevation might, in part, explain the defective neutrophil chemotaxis seen in patients with alcoholic hepatitis. To test this hypothesis, sera were collected from 22 patients with alcoholic hepatitis and 9 normal controls, and evaluated for the antigenic presence of chemotactic factor inactivator using an ELISA test. Chemotactic factor inactivator levels were found to be markedly elevated in patients with alcoholic hepatitis (162 +/- 24 micrograms per ml) compared to normals (60 +/- 3 micrograms per ml, p less than 0.01). Subdividing the hepatitis patients revealed that the elevation of chemotactic factor inactivator was found to be greatest in those patients with mild alcoholic hepatitis (prothrombin time within normal limits and bilirubin less than or equal to 5 mg per dl, 256 +/- 44 micrograms per ml, p less than 0.001), while the group with the severest hepatic dysfunction (prolonged prothrombin time and bilirubin greater than 5 mg per dl) did not differ significantly from controls (71 +/- 11 micrograms/ml, p less than 0.2). Importantly, the inhibition of C5a-induced chemotactic activity by partially purified chemotactic factor inactivator correlated with antigenic amounts of chemotactic factor inactivator in serum (r = 0.63, p less than 0.05). The C5a inhibitory activity in sera obtained from patients with alcoholic hepatitis coprecipitated with chemotactic factor inactivator when serum was precipitated by ammonium sulfate precipitation (45 to 64% saturation).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3653853 TI - The possible occurrence of "alcoholic hepatitis" in a patient with bulimia in the absence of diagnosable alcoholism. AB - A case of a 20-yr-old female with possible "alcoholic hepatitis" and a mixed micro/macronodular cirrhosis occurring in association with overt bulimia and a history of anorexia nervosa, but without any objective evidence of either alcoholism or alcohol abuse, is reported. The possible factors that may have contributed, either alone or in combination, to produce this unusual occurrence are discussed. PMID- 3653854 TI - Bile salt shift from albumin to high-density lipoprotein in cholestasis. AB - The distribution of [3H]taurocholate between albumin and the lipoproteins of serum of patients with various diseases in which lipoprotein metabolism and/or bile salt concentrations were altered and of healthy control subjects was investigated by means of the density gradient centrifugation method. 1. In control sera, bile salts distribute mainly between albumin and high-density lipoprotein. An amount of 19.7 +/- 3.6% (mean +/- S.D., n = 6) of the total serum bile salts was found in the high-density lipoprotein fraction of the density gradient. 2. In sera of nonicteric patients, the distribution pattern of [3H]taurocholate in the fractions of the density gradient showed no essential differences to normal serum. The relative amounts of taurocholate in the albumin containing fractions and the high-density lipoprotein fractions were dependent on the concentrations of albumin and high-density lipoprotein. 3. In sera of deeply jaundiced patients, the distribution pattern of [3H]taurocholate showed two distinct peaks in the high-density lipoprotein density range, one of which codistributed with high-density lipoprotein2 and the other with a high-density fraction of high-density lipoprotein3 in the density range of 1.19 to 1.23 gm per ml. The distribution of [3H]taurocholate between albumin and high-density lipoprotein was markedly shifted toward high-density lipoprotein. No [3H]taurocholate association with lipoprotein X was observed. 4. Bilirubin was found to cause a shift of taurocholate from albumin to high-density lipoprotein in vitro. It is proposed that bilirubin is responsible, at least in part, for the observed shift in icteric sera. PMID- 3653855 TI - A population study on the prevalence of gallstone disease: the Sirmione Study. AB - The prevalence of gallstone disease (cholelithiasis and previous cholecystectomy for gallstones) in the population of the town of Sirmione, Italy, examined by ultrasonography, was 6.7% in men and 14.6% in women, ranging from 18 to 65 yr of age (overall prevalence = 11%). The prevalence of cholelithiasis in the same age span was 6.9% (4.5% in men and 8.9% in women). Prevalence of cholelithiasis increased with age in both sexes. Twenty-two percent of gallstone subjects suffered from biliary pain vs. 2% of subjects without gallstones. No difference was observed in the frequency of nonspecific symptoms between subjects with and without gallstones. Of the 132 gallstone subjects, 108 (82%) were not aware of having gallstones prior to the study. Prevalence of gallstone disease was found to be higher in obese and hypertriglyceridemic subjects and to increase with the number of pregnancies. PMID- 3653856 TI - Transferrin receptors in hemochromatosis. PMID- 3653857 TI - Nomenclature for pigment gallstones. PMID- 3653858 TI - Non-Hodgkin's lymphoma of unfavourable histology: a multivariate analysis of factors predicting the response to CHOP. AB - Forty-eight patients with de novo non-Hodgkin's lymphoma (NHL) of unfavourable biology received CHOP as first-line chemotherapy. A complete remission (CR) was achieved in 64.5 per cent patients. Overall 4-year projected survival was 48 per cent with a median follow-up of 40.5 months. Two pretreatment characteristics, high LDH serum levels and bulky abdominal disease, were negatively associated with survival at the proportional hazards regression model and were used to calculate each patient's relative-risk. Such analysis allowed to identify two prognostic subgroups according to their outcome to CHOP. Firstly, a high-risk subgroup that showed an 8 per cent CR rate, most patients dying within the first year after diagnosis. Secondly, a low-risk subgroup that showed an 83.5 per cent CR rate and a 4-year project survival of 66 per cent. From the above results two major conclusions can be drawn: (1) the CHOP combination is an effective treatment for unfavourable NHL patients with a low relative-risk and (2) new therapeutic approaches should be explored for NHL patients with a high relative risk at diagnosis. PMID- 3653860 TI - 1986 FAS ratios document hospitals' troubles. PMID- 3653861 TI - Liability insurance crisis hits nursing industry. PMID- 3653859 TI - Management of stage I-II diffuse aggressive non-Hodgkin's lymphoma of the Waldeyer's ring: combined modality therapy versus radiotherapy alone. AB - Twenty five patients with stage I and II diffuse aggressive non-Hodgkin's lymphoma of the Waldeyer's ring were reviewed. There were 19 patients with diffuse histiocytic, 4 diffuse lymphocytic poorly differentiated and 2 diffuse mixed lymphoma. Their median age was 51 years. There were 12 males and 13 females. Eight patients had stage I, and 17 had stage II disease. There was a significantly higher incidence of involvement of the left side of the Waldeyer's ring compared to the right (p = 0.0251). Fifteen patients received radiotherapy alone, and ten had radiotherapy and chemotherapy. The median durations of follow up were 42 (range 8-162) and 44 (range 8-97) months respectively. All patients had complete remission but 9 patients (36 per cent) subsequently had relapse of their lymphomas. Stomach was the commonest site of relapse (44 per cent). The disease free survival and overall survival at 5 years were 59 per cent and 57 per cent respectively. Higher relapse rate was observed in the radiotherapy alone group (60 per cent) as compared to the combined modality therapy group (0 per cent). Patients who received combined modality therapy had significantly superior 5 years disease free survival (100 per cent versus 32 per cent, p less than 0.01) and overall survival (81 per cent versus 40 per cent, p less than 0.05). After radiotherapy alone, patients with stage II disease appeared to have a high relapse rate than those with stage I disease (70 per cent versus 40 per cent) but the difference did not reach statistical significance due to small sample sizes. The histological subtypes did not appear to affect their prognosis. All patients with stage I and II diffuse aggressive non-Hodgkin's lymphoma of the Waldeyer's ring should have gastrointestinal barium studies at initial staging, and a prospective randomised study on these patients comparing radiotherapy alone and combined modality therapy should be performed. PMID- 3653862 TI - Hospital parking facilities: how safe are they? PMID- 3653863 TI - Kids' Klinic provides option for working parents. PMID- 3653864 TI - Billboards recruit travelers for work. PMID- 3653865 TI - Right-to-know rules cover hospital employees. PMID- 3653866 TI - Tort reform study isn't enough, critics contend. PMID- 3653867 TI - Developing policies on employees with AIDS. PMID- 3653868 TI - Physician data bank details still undisclosed. PMID- 3653869 TI - Congress addresses trauma network problems. PMID- 3653870 TI - What's ailing health care?. Interview by Michele Robinson. PMID- 3653871 TI - Hospital shares risk of pharmacy management. PMID- 3653872 TI - Vendor performance rated fair by hospitals. PMID- 3653873 TI - New imaging tool developed by researchers. PMID- 3653874 TI - Is MRI suitable for hospital environments? PMID- 3653875 TI - Congenital 17 alpha-hydroxylase deficiency: a clinicopathologic study. AB - The histopathologic features of the adrenal glands in three cases of congenital 17 alpha-hydroxylase deficiency are described in relation to clinical and endocrine findings. Diffuse or nodular adrenocortical hyperplasia, particularly in the zonae fasciculata and reticularis, was observed in all cases examined. The hyperplastic adrenal cortices were composed of cells with morphologic features of hypercorticism and hyperstimulation. Myelolipomatous lesions were detected in two cases. These morphologic findings were consistent with excessive adrenocorticotropic hormone secretion in this disorder. In all the cases examined, the plasma aldosterone concentration was within normal limits, and plasma renin activity was suppressed prior to dexamethasone treatment. Morphologically, however, hyperplasia of the cells with abundant mitochondria and smooth endoplasmic reticulum seemed to involve the zona glomerulosa. Nonencapsulated nests of hypertrophied cortical cells in periadrenal tissue were remarkable in one case. From these morphologic findings, we postulated hyperfunction of the zona glomerulosa as well as involvement of corticosteroids from the zona glomerulosa in the pathophysiology of this disorder. PMID- 3653876 TI - The pathology of non-Hodgkin's lymphoma of childhood: II. Reproducibility and relevance of the histologic classification of "undifferentiated" lymphomas (Burkitt's versus non-Burkitt's). AB - The Children's Cancer Study Group conducted prospective clinical trials of 608 children with non-Hodgkin's lymphoma from 1977 to 1983. In 1980, significant differences in survival of children with disseminated disease correlated with histologic diagnosis and the randomized treatment employed. A pathology reproducibility review showed the lymphoblastic lymphoma cases to be virtually 100 per cent distinguishable histologically from the nonlymphoblastic lymphomas (Burkitt's, non-Burkitt's, and "histiocytic"). However, diagnostic reproducibility of the pathologist-of-record was 59 per cent in the Burkitt's and non-Burkitt's lymphoma group. Therefore, 159 cases, agreed on by the pathologist of-record and the "lymphoma panel" as Burkitt's (77 cases) or non-Burkitt's lymphoma (82 cases) and designated as the "reference diagnosis," were blindly reviewed twice each by two hematopathologists to yield the "review diagnoses." Consensus agreement was achieved in 67 per cent of cases overall, 82 per cent of Burkitt's and 54 per cent of non-Burkitt's lymphoma. Using the "reference diagnoses," we found that the relative frequency of Burkitt's and non-Burkitt's lymphoma was associated with the extent of disease at diagnosis (P = 0.06) but not with other prognostic factors. Despite the difficulties in histologic classification, analyses that used either "reference diagnoses" or "consensus review diagnoses" and that were adjusted for extent of disease consistently demonstrated significantly shorter event-free survival for patients having Burkitt's lymphoma; their failure rate was four times that for patient's with non Burkitt's lymphoma. Newer cell biologic techniques hopefully will enhance histopathologic distinctions that remain the basis for diagnosis. PMID- 3653877 TI - Sjogren's syndrome-like illness associated with the acquired immunodeficiency syndrome-related complex. AB - Three cases of Sjogren's syndrome-like illness occurring in patients with the acquired immunodeficiency syndrome (AIDS)-related complex (ARC) are described. All three patients were male. Positive serologic tests for the human immunodeficiency virus (HIV) were documented in two; the third patient was a prison inmate with a history of drug abuse. The lymphoid infiltrate seen in these cases resembled morphologically the features of persistent generalized lymphadenopathy. One patient complained of dry eyes and arthralgias. Autoimmune phenomena including lupus-like anticoagulant, immune thrombocytopenic purpura, and others have been reported in patients with AIDS and ARC. The occurrence of Sjogren's syndrome in ARC provides further evidence for autoimmune phenomena arising in the severely damaged immune system of ARC patients. Atypical Sjogren's syndrome now requires evaluation for ARC. Proposed criteria for identifying these patients are as follows: 1) young age (less than 40 years); 2) male sex (less than 10 per cent of non-ARC patients are male); 3) homosexuality or bisexuality, or other high-risk groups for AIDS; 4) generalized lymphadenopathy (also seen in rheumatoid arthritis); 5) negative test for rheumatoid factor despite generalized lymphadenopathy; 6) salivary gland lymphoid infiltrate showing features of persistent generalized lymphadenopathy. Patients with such features should be studied for HIV antibodies and other evidence of autoimmune phenomena in order to define more precisely the nature of this new Sjogren's-like illness. PMID- 3653878 TI - Microtubular aggregates in rough endoplasmic reticulum in Crohn's disease. PMID- 3653879 TI - Cytoplasmic surface activity in leukemic bone marrow cells. PMID- 3653880 TI - Credibility in science and The New York Times. PMID- 3653881 TI - Autopsy-related initiatives in the United States: current status and suggestions for the future. PMID- 3653882 TI - Unusual tumefactive spindle-cell lesions in the adrenal glands. PMID- 3653883 TI - Familial retinoblastoma (mother and son) with 13q14 deletion. AB - We present here the first familial cases (a mother and son) of dominantly inherited retinoblastoma with a 13q14 deletion [46,XY or XX, del(13)(q14.1q21.2)]. Their esterase D activities in red blood cells were as low as 50% of the normal control and the haplotype of esterase D was a type 1-0 in the mother and a type 2-0 in the son. They had peculiar facies characterized by a high forehead, low and broad nasal root, a short and bulbous nose, a long philtrum, and open mouth with a thin upper lip, and prominent earlobes. Chromosome and esterase D analysis should be performed in patients with retinoblastoma even if retinoblastoma seems to be transmitted through an autosomal dominant inheritance. This family indicates that one of the causes of dominantly inherited retinoblastoma is a chromosome deletion of part of the 13q14 band whether it is detectable by chromosome analysis or not. PMID- 3653884 TI - Variation in the frequency and type of sperm chromosomal abnormalities among normal men. AB - The chromosomal constitution of 1582 human sperm from 30 normal men of proven fertility was investigated after sperm penetration of hamster eggs. A minimum of 30 sperm chromosome complements were analysed per donor so that the distribution and variation in the frequency and type of sperm chromosomal abnormalities could be assessed. The mean frequency of sperm chromosomal abnormalities in individual men was 10.4% (+/- 6.0%) with a range of 0-24.7%. For numerical abnormalities the mean was 4.7% (+/- 2.9%) with a range of 0-10% and for structural abnormalities the mean was 6.2% (+/- 6.0%) with a range of 0-23.1%. The 95% confidence intervals for the mean of an individual male were 0-10.5% for numerical abnormalities, 0-18.2% for structural abnormalities, and 0-22.4% for total abnormalities. There was a significant excess of hypohaploid complements compared with hyperhaploid complements. Since hypohaploid complements could be caused by technical artefact, a conservative estimate of aneuploidy was obtained by doubling the frequency of hyperhaploid sperm, yielding an estimate of 2.4% aneuploidy. The proportion of X-bearing (53%) and Y-bearing (47%) sperm did not differ significantly. These results were compared to the other two large studies of sperm chromosome complements from normal men. PMID- 3653885 TI - The fragile site (17)(p12): induction by AT-specific DNA-ligands and population cytogenetics. AB - The rare fragile site at 17p12 can be induced in lymphocyte cultures with the AT specific DNA-ligands distamycin A, DAPI, Hoescht 33258 and berenil. The optimum culture conditions for the experimental induction of fra(17)(p12) were studied. There are indications that fra(17)(p12) is a late-replicating chromosome region in which AT-rich DNA is located. The fragile site also occurs spontaneously in cell cultures of most fra(17)(p12) carriers. A population screening of 250 unselected individuals showed that the frequency of carriers heterozygous for fra(17)(p12) is 2%. The results are compatible with a population being in Hardy Weinberg equilibrium with respect to fra(17)(p12) and its non-fragile allelomorph. Neither the heterozygous nor the homozygous condition of fra(17)(p12) have any deleterious effects. PMID- 3653886 TI - Two different forms of beta myosin heavy chain are expressed in human striated muscle. AB - We have found evidence for two beta-like myosin heavy chains in humans, one cardiac and one skeletal. The cDNA sequences of the cardiac beta myosin heavy chain cDNA clone pHMC3 and the skeletal beta-like myosin heavy chain cDNA clone pSMHCZ, were compared to each other. It was found that the 3' untranslated regions as well as 482 nucleotides specifying the carboxyl coding region, were 100% homologous. Further examination revealed that the skeletal clone pSMHCZ diverges from the human cardiac beta myosin heavy chain cDNA clone pHMC3 at the 5' end. We present evidence in this report which indicates that the cardiac beta myosin heavy chain mRNA is expressed in skeletal muscle tissues. The human cardiac beta myosin heavy chain cDNA clone, pHMC3, which codes for a portion of the light meromyosin section of the myosin heavy chain, was used as a probe for S1 nuclease mapping studies with RNA derived from cardiac tissue, smooth muscle and skeletal muscle tissues consisting of fast-twitch, slow-twitch and mixed fast and slow-twitch muscle fibres. Two probes were used to examine the expression of the mRNA. One probe (406 nucleotides) constitutes the 3' untranslated region and a portion of the coding region of the beta cardiac myosin heavy chain cDNA clone, which is 100% homologous to pSMHCZ, the skeletal cDNA clone. The other constitutes the majority of the coding region (1017 nucleotides) of the cardiac clone pHMC3 in which the first 216 nucleotides from the labelled end are 100% homologous to the skeletal clone pSMHCZ. In the soleus muscle, which is rich in slow-twitch type I muscle fibres, the expression of the cardiac beta myosin heavy chain mRNA was very prominent. In gastrocnemius muscle, a mixed fibre muscle, the expression of this mRNA was detected to a lesser degree than that for the soleus muscle. In vastus lateralis and vastus medialis, which consist of predominantly type II, fast-twitch fibres, there were trace amounts of the cardiac beta myosin heavy chain mRNA. When expression of this mRNA was tested in smooth muscle tissue none could be detected. PMID- 3653887 TI - A cytogenetic study directly from chorionic villi of 140 spontaneous abortions. AB - Spontaneous abortions were studied by analyzing chromosomes directly from chorionic villi. The frequency and the type of anomalies detected among 140 abortuses are in good agreement with those observed by others using conventional tissue cultures. Abnormal karyotypes were found in 48.6% of the cases. Trisomy predominated (66.2%), followed by polyploidy (22.1%), monosomy X (7.4%), and structural anomalies (4.4%). Among the trisomies, the most prevalent were of chromosome 22 (22.2%), 16 (22.2%), and 13 (9.5%). The relative frequencies of trisomies, monosomy X, and the different chromosomes involved in trisomies seem to differ between our study and those in which tissue cultures were analyzed. Our low frequency of 45,XO karyotypes and the shift to trisomies of chromosomes whose involvement increases steeply with maternal age are considered due to the approximately 3 year higher mean maternal age in our sample. The sex ratio (male to female) in chromosomally abnormal abortuses was 1.28, which is nearly identical to the 1.2 found in earlier studies. Surprisingly, in chromosomally normal abortions males were significantly outnumbered by females (sex ratio 0.76). Since maternal cell contamination cannot have influenced the sex ratio in our study, we consider it worthwhile to investigate whether failures associated with X inactivation are responsible for pregnancy wastage of some euploid female conceptuses. Knowledge of the karyotypes may serve as a prerequisite for the investigation of non-chromosomal genetic causes of pregnancy wastage. PMID- 3653888 TI - A Y/5 translocation in a 45,X male with cri du chat syndrome. AB - In a patient described as a 45,X male with cri du chat syndrome, combined cytogenetic and molecular methods revealed Y euchromatic material to be translocated onto the short arm of one chromosome 5, resulting in a chromosome der(5)(5qter----5p14::Yp11.31----Ypter). The translocated Y euchromatin comprised only the distal short arm including the pseudoautosomal region and the so-called deletion intervals 1 and 2. A review of 45,X males from the literature showed that; most of them carry a paternally transmitted Y/autosome translocations; resulting in various autosomal deletions. Depending on the segment concerned, the deletion led to congenital malformations. PMID- 3653889 TI - A comparative mapping study of fragile sites in the human and murine genomes. AB - Fragile sites on murine chromosomes were induced by the antimetabolites methotrexate (MTX), fluorodeoxyuridine (FdU), and aphidicolin (APD). To facilitate chromosome identification the analysis was performed on chromosomes of a CD/CD mouse that possesses nine pairs of Robertsonian translocation chromosomes of known arm composition. The pattern of induced fragile sites was rather similar for the different antimetabolites used. Many of them, e.g., 2B, 3B, 5B and 9D, are included in Giemsa-negative bands. On the X chromosome a fragile site was mapped to the region XC/D. Comparative mapping data with human fragile sites have been informative in most instances. Conservation of synteny within known linkage groups seems very likely. PMID- 3653890 TI - Confined chorionic mosaicism in prenatal diagnosis. AB - Confined chorionic mosaicism, detected commonly on chorionic villus sampling (CVS) and occasionally in cultured amniotic fluid cells, is described in five pregnancies that showed confined chorionic mosaicism for trisomies 12, 13, 14, 17 and a marker chromosome. Cytogenetic findings in these pregnancies support the conclusion that within chorion some chromosomal mosaicism are confined to the trophectoderm derivatives while others to the extra-embryonic mesoderm. The etiology of confined chorionic mosaicism is discussed in relation to a significant role of multiple cell lineages contributing to the early development of placenta. The need is indicated for the use of both direct and long-term cultures in CVS prenatal diagnosis, and for the confirmatory testing of fetal blood or amniotic fluid in cases where mosaicism is detected in chorionic villi. PMID- 3653891 TI - Follow-up 20 years later of 34 Klinefelter males with karyotype 47,XXY and 16 hypogonadal males with karyotype 46,XY. AB - A 20-year follow-up study of 50 hypogonadal males has been made. Of these 34 had Klinefelter's syndrome with the karyotype 47,XXY and 16 had the karyotype 46,XY. These males have been examined at mean ages of 27 and 37 and in the present study at a mean age of 47. At the first examination the following conditions were found in the Klinefelter males to a significantly higher degree than in the hypogonadal males with 46,XY: immaturity, below average school performance, few or no friends, previous mental illness, little energy and initiative, few or no spare time interests, occupation as an unskilled labourer. Psychological testing showed a full scale IQ of 103 in the Klinefelter males and 115 in the hypogonadal males. The follow-up studies have shown that in spite of these findings the Klinefelter males have managed far better than could have been expected at the time of the first investigation. The improvement in a number of conditions such as mental health, working capacity, social adjustment, relations with other people, and activity level was considerable between the ages of 27 and 37. The present examination shows a further improvement at the age of 47 with the only significant difference between the Klinefelter males and the hypogonadal males with 46,XY being a higher frequency of single Klinefelter males. The present examination also showed that there was no significant difference between the two groups in occupation, working capacity, social adjustment, mental and physical disorders or criminality. The results of the examination at the mean age of 27 would probably have been considerably more favourable for the Klinefelter males if diagnosis had been made in childhood, and information, counselling, support and hormone treatment had been given from an early age. The fact that the great majority of the Klinefelter males have managed quite well in spite of this and that no remarkable differences were found between them and a control group is of great importance for genetic counsellers, especially for prenatal counsellers. Up until now, in 75% of cases in which sex chromosome abnormalities, including Klinefelter's syndrome, have been diagnosed prenatally in Denmark abortion has been induced. We believe this is mainly due to insufficient information about the many positive aspects of the development of individuals with sex chromosome abnormalities. PMID- 3653892 TI - Premature centromere division (PCD): a dominantly inherited cytogenetic anomaly. AB - We describe a family with an increased frequency of cells with premature centromere division (PCD) of all chromosomes in four phenotypically normal individuals. This familial PCD phenomenon is apparently different from the well described PCD of the X chromosome and from the centromere splitting in cells of patients with Roberts syndrome. Implications for genetic counseling are discussed. PMID- 3653893 TI - Lack of genetic polymorphism in human skeletal muscle enzymes of the tricarboxylic acid cycle. AB - Skeletal muscle mitochondrial forms of the tricarboxylic acid cycle enzymes were examined for genetic variance. The methods used revealed no genetic variants. PMID- 3653894 TI - Gd(+)Cuiaba, a new rare glucose-6-phosphate dehydrogenase variant presenting normal activity. AB - A 33-year-old Brazilian male of Portuguese extraction was found to have a new glucose-6-phosphate dehydrogenase variant, herein named Gd(+)Cuiaba. The enzyme variant is characterized by normal activity, normal electrophoretic mobility, high Km for glucose-6-phosphate, high Ki for NADPH, decreased thermal stability, normal utilization of substrate analogues and normal pH curve. PMID- 3653895 TI - Zinc and genital infections. AB - The zinc status of 19 patients with chronic or recurrent genital infections and 18 patients with non-recurrent genital infections was assessed by measuring plasma and leucocyte zinc concentrations. Neither group of patients had plasma or leucocyte zinc concentrations that differed significantly from those of matched healthy controls. Each of six patients with chronic candidiasis had anergy to candidal antigen, as shown by delayed cutaneous hypersensitivity to intradermal injection of the antigen, but their zinc status was normal. This study provided no evidence of zinc deficiency in this small number of patients with acute non recurrent or chronic recurrent genital infections. PMID- 3653896 TI - Aortic regurgitation due to syphilis: unusual case. AB - A 28 year old man developed signs and symptoms of left ventricular failure and was found to have gross aortic regurgitation. He underwent an aortic valve replacement, and histology showed changes characteristic of syphilis. Both the age of this patient and the mode of presentation were atypical of cardiovascular syphilis. PMID- 3653897 TI - Antibodies to Chlamydia trachomatis. PMID- 3653898 TI - Follow up study of sexually transmitted disease (STD), sexual practice and human immunodeficiency virus (HIV) serology in homosexual men attending an STD clinic. PMID- 3653899 TI - Evaluation of a geriatric rehabilitation unit. PMID- 3653900 TI - Pastoral care--a ministry of love. PMID- 3653901 TI - Distribution of transferrin and group-specific component subtypes among Parsis of India. AB - Transferrin and group-specific component subtypes were studied by isoelectric focusing of sera from 253 Parsis in India. The frequencies of TfC1, TfC2, TfC3 and TfC4 were found to be 0.8083, 0.1719, 0.019 and 0.0020, respectively. TfB was present in a frequency of 0.0059. The frequencies of Gc alleles were found to be 0.4478 for GcIF, 0.3875 for GcIS and 0.1647 for Gc2. The gene frequency of GcIF was rather high in comparison with Iranian and Indian populations. PMID- 3653902 TI - Properdin factor B polymorphism in four Sardinian villages. AB - A sample of healthy unrelated individuals was typed for properdin factor B (Bf) polymorphism in four Sardinian villages. Two villages, Desulo and Tonara, are located in the highlands; the other two, Orosei and Galtelli, are located in the lowlands. No heterogeneity was found between the highland and the lowland villages, whereas a significant difference was found between the Sardinian villages and continental Italy. The allele Bf-F1 shows the highest gene frequency so far observed. Typically Sardinian is the gametic association (haplotype) HLA A30, Cw5, B18, BfF1, DR3. PMID- 3653903 TI - Further considerations of difficulties of estimating familial risks from pedigree data. AB - In elucidating the etiology of complex diseases through various epidemiologic and genetic analyses, it is necessary to define the expected risks for each member of a pedigree collected through an affected individual. It is shown that several factors are to be considered without which such expected risk estimates may be biased. The presence of secular trends in disease incidence introduces a bias in familial relative risk estimates, the magnitude and direction of which may be judged from the nature of the secular trends and the age and cohort composition of the individuals included in the study. Nonrandom follow-up time of the relatives, on the contrary, produces a bias in relative risk estimates, the magnitude and direction of which cannot be ascertained without any prior assumption about the distribution of follow-up time. In addition, competing causes of diseases and risk heterogeneity among different relatives and among families are also sources of indeterminate biases, which must be removed in order to interprete the results of relative risk studies and segregation analysis of discrete disease traits. PMID- 3653904 TI - Genetic polymorphism of delta-aminolevulinate dehydrase in several population groups in Israel. AB - The genetic polymorphism of red cell delta aminolevulinate dehydrase (ALADH) has been investigated in several population groups in Israel: Ashkenazi Jews, non Ashkenazi Jews from North Africa, Egypt, Turkey, Iraq, Iran, Yemen and the Balkans, and Arabs. The distribution of the ALADH genes was not homogeneous (chi 2 = 36.83; d.f. = 8; p less than 0.0005). A significantly higher frequency of the ALADH2 gene was observed among the Ashkenazi Jews (0.2021) than among the non Ashkenazi Jews and Arabs (gene frequencies 0.0825-0.1290) or all the other population samples so far studied (Liberia, Japan, Italy, Germany and Spain). PMID- 3653906 TI - Genetic polymorphism of PIF proteins in a Japanese population. AB - Phenotype and gene frequencies of PIF (parotid isoelectric focusing variant) were determined in a series of individuals from eastern Japan. Among 422 unrelated individuals examined, 391 (92.66%) of PIF+ and 31 (7.34%) of PIF- phenotypes were observed; the gene frequencies were PIF+ = 0.729 and PIF- = 0.271. PMID- 3653905 TI - Group-specific component (Gc) subtypes in the Indian subcontinent. AB - From populations of the Indian subcontinent Gc subtypes were investigated in 14 socio-culturally diverse groups. The tribal populations showed a greater differentiation at this locus than the caste and Muslim groups. This marked difference between tribal populations is likely to be due to their breeding structure and historical affiliation, although a possible effect of natural selection cannot be ruled out. PMID- 3653907 TI - Vibration of polarographic oxygen electrodes by piezoelectric elements: a method of reducing flow artifacts. PMID- 3653908 TI - Electrical characteristics of chronically implanted platinum-iridium electrodes. PMID- 3653909 TI - The rectification properties of an electrode-electrolyte interface operated at high sinusoidal current density. PMID- 3653910 TI - A prototype inverse solution in one-dimension to find the origin of excitation, strand radius, intracellular resistivity, or distance from the surface. PMID- 3653911 TI - The EMG-force model of electrically stimulated muscles: dependence on control strategy and predominant fiber composition. PMID- 3653913 TI - An emulator system for developing improved elbow-prosthesis designs. PMID- 3653912 TI - An evaluation of methods for neuromagnetic image reconstruction. PMID- 3653914 TI - Programmable pneumatic generator for manipulation of intrathoracic pressure. PMID- 3653915 TI - Optimal electrode configurations for external cardiac pacing and defibrillation: an inhomogeneous study. PMID- 3653916 TI - Simulations and sensitivity analysis of the vestibulo-ocular reflex. PMID- 3653917 TI - Application of a neuroelectric model to electrocutaneous sensory sensitivity: parameter variation study. PMID- 3653918 TI - Feasibility study of batteryless temperature transponders using miniature microwave cavity resonators. PMID- 3653919 TI - Antigenic requirements for activation of MHC restricted responses. PMID- 3653920 TI - Assessment of renal biochemical and histopathological parameters in predicting reversibility of cis-platinum nephrotoxicity. PMID- 3653921 TI - Epidemiologic characteristics of treated oral cancer patients detected in a house to-house survey in Kerala, India. PMID- 3653922 TI - Breast carcinoma in a young girl. PMID- 3653923 TI - Retinoblastoma--current concepts of treatment. PMID- 3653924 TI - International Conference on Tumor Necrosis Factor and Related Cytotoxins. September 14-18, 1987, Heidelberg, Federal Republic of Germany. Abstracts. PMID- 3653925 TI - Tumour cell killing by tumour necrosis factor: inhibition by anaerobic conditions, free-radical scavengers and inhibitors of arachidonate metabolism. AB - Previous work on the mechanism of tumour-cell killing by the macrophage product tumour necrosis factor (TNF) is consistent with a free radical-induced process. In this study, free-radical involvement was sought by (i) investigating the effects on TNF cytolysis of anaerobic conditions, free-radical scavengers and inhibitors of two potential pathways of free-radical generation (oxidative phosphorylation and arachidonate metabolism) and (ii) looking for increased malonyldialdehyde (MDA) production in TNF-treated cells (MDA is a free radical induced lipid peroxidation product). Although TNF cytolysis of L929 cells was inhibited by anaerobic conditions, only limited effects were seen with free radical scavengers. Suppression of arachidonate metabolism by steroids effectively inhibited TNF cytolysis but the mitochondrial poison rotenone did not. There was a marked, but late, increase in MDA production in TNF-treated cells. Overall, these results indicate that if free radicals are involved it is at a late stage in the cytolytic process. However the most striking observation in this study is that arachidonate metabolism is an essential link in the cytolytic process. PMID- 3653926 TI - Maternal dietary antigens and the immune response in the offspring of the guinea pig. AB - Guinea-pig dams and their litters were raised on either a cow's milk protein containing diet (MCD) or a milk-free diet (MFD). At 8 weeks of age all litters were challenged i.p. with 50 micrograms milk whey-protein concentrate (V67) and 100 mg A1(OH)3 in saline. The immune response was estimated 2 weeks later as the serum IgG antibody titres against V67, beta-lactoglobulin (beta-LG) and alpha lactalbumin (alpha-LA) using enzyme-linked immunosorbent assay (ELISA) and the tracheal Schulze-Dale response to these antigens. Feeding milk protein antigen to dams from birth and during pregnancy induces antigen-specific hyporesponsiveness (tolerance) in their offspring, despite no direct contact between the offspring and the milk proteins. Tolerance seems to be induced by the antigen itself since withdrawal of the MCD 10 days before delivery reduced tolerance in the offspring. No tolerance was produced in the offspring of dams fed the antigen from 3 months of age (adult). beta-LG appears to be a major antigen in milk whey while alpha-LA is a minor one since there was almost no antibody or tracheal response to alpha LA in any of the animals tested. The results indicate that maternal antigen experience and antigens present during pregnancy are important for the subsequent immune response to these antigens in offspring. PMID- 3653927 TI - Phagocytosis of target particles bearing C3b-IgG covalent complexes by human monocytes and polymorphonuclear leucocytes. AB - Immunoglobulin G (IgG) provides an efficient acceptor site for nascent C3b, and complement activation on the surface of IgG-coated bacteria has been shown to generate significant numbers of C3b-IgG complexes. We have studied the relative efficiency of IgG alone, C3b-IgG complexes, and similar densities of IgG and C3b residues deposited independently, in mediating ingestion of sheep erythrocyte (E) targets by human phagocytes. Human 125I-C3b covalently bound to rabbit anti Forssman IgG was generated as described elsewhere (Fries et al., 1985). E,EIgMC4b, or EIgMC4b3b (prepared with IgM antibody and purified complement components) were sensitized with radiolabelled anti-Forssman IgG or C3b-IgG heterodimers to generate targets bearing IgG alone, C3b-IgG covalent complexes, or C3b and IgG in equivalent numbers but not bound to each other. Phagocytosis by monocytes and polymorphonuclear leucocytes (PMN) of targets bearing C3b-IgG was markedly enhanced relative to those bearing IgG alone, especially at levels of less than 2000 opsonin residues/target cell. Uptake of C3b-IgG-bearing targets was also significantly more resistant to competitive inhibition by ambient monomeric IgG. Phagocytosis of EIgMC4b + C3b-IgG by monocytes was superior to the uptake of either EAC4b + IgG or EAC4b3b + IgG bearing equivalent amounts of C3b and IgG not in covalent complex (P less than 0.05, n = 10). Similar results were obtained with PMN. Thus, generation of C3b-IgG complexes in vivo may not only promote complement activation and enhance C3b deposition, but also produce a compound opsonic residue which is a more potent promoter of phagocytosis than an equal number of C3b and IgG residues randomly distributed relative to each other. PMID- 3653928 TI - Increased fucosylation of glycolipids in a human leukaemia cell line (K562-Clone I) with decreased sensitivity to NK-mediated lysis. AB - A subpopulation of human lymphoid cells called natural killers is able to lyse certain normal and neoplastic targets in an in vitro cytotoxicity assay. The molecules which enable them to recognize sensitive cells, or permit tumour cells to escape remain unknown. In the studies described here we have compared some of the plasma membrane characteristics of a NK-sensitive human leukaemia cell line (K562) with those of a partially resistant subclone derived from it (K562-Clone I). Gel electrophoresis of cell-surface proteins radiolabelled by lactoperoxidase catalysed iodination, periodate-borohydride tritiation, or biosynthetically by incubation with [3H]fucose did not reveal any reproducible differences between the sensitive and resistant lines. However, analysis of glycolipids showed that Clone I incorporated significantly more fucose than did the parental line, and that it synthesized a minor population of complex structures not found in the original K562. A subclone of Clone I (Clone I-Con Ar1), made resistant to the toxic effects of concanavalin A, became sensitive once again to NK, and showed the parental glycolipid profile. These results suggest that the Clone I line, selected for resistance to NK, may have altered one or more of its intermediate oligosaccharides or pathways of fucose incorporation into glycolipid, and points to one process by which a tumor cell might modulate its surface to escape recognition by natural killers. PMID- 3653929 TI - Development of heterologous radioimmunoassay for Indian carp and murrel gonadotropin hormone. PMID- 3653930 TI - Effect of pinealectomy on thyroidal 131I uptake during different phases of gonadal cycle of the Indian catfish Heteropneustes fossilis (Bloch). PMID- 3653931 TI - Effect of exogenous fatty acids on ethambutol susceptibility of sensitive and resistant Mycobacterium smegmatis ATCC 607. PMID- 3653932 TI - Fluoride supplementation and skeletal calcium turnover in rats. PMID- 3653934 TI - Effects of urethane on mitosis of chick embryo primitive erythrocytes. PMID- 3653933 TI - Effects of in vivo cadmium administration to rats on certain functional parameters of isolated erythrocytes. PMID- 3653935 TI - Antioxidant protection mechanism of chick bone marrow: effects of toxicant induced stress. PMID- 3653936 TI - Effects of Vipera lebetina (Turanica C.) venom on electrocardiogram of Swiss albino mice by heart rate variability technique. PMID- 3653938 TI - Serological and biochemical identification of HLA-Aw33 subtypes. AB - In the present study, we show, on the basis of serology, absorption experiments, and one-dimensional isoelectric focusing, that the well-defined HLA-Aw33 antigen can be separated into two subtypes, provisionally called Aw33.1 and Aw33.2, which differ in race distribution and linkage disequilibrium. PMID- 3653937 TI - Carbohydrate moieties of rat MHC class I antigens. AB - The rat major histocompatibility complex class I antigens RT1.Au and RT1.Eu from the u haplotype and RT1. An from the n haplotype were labeled with 14C-asparagine or with 3H-fucose, mannose, galactose, and N-acetylglucosamine. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis showed complete removal of radioactivity from the sugar-labeled antigen heavy chains by digestion with glycopeptidase F, an enzyme that removes N-linked glycans completely. High performance liquid chromatography analysis of the tryptic digests of the mixed sugar-labeled and asparagine-labeled antigens demonstrated that all the sugar labeled peptides were coincident with asparagine-labeled peptides. The An antigen showed three glycopeptides, each of which had different amounts of sugar radioactivity. The antigens Au and Eu showed two glycopeptides with different amounts of radioactivity but at identical positions in the two antigens. Antigen Eu had an additional glycopeptide with a lower amount of radioactivity. The positions of the glycopeptides from the Au and Eu antigens were different from those of the An antigen. The peptide profiles of the 14C-asparagine-labeled Au and Eu antigens demonstrated distinct differences between the molecules. The results of this study show that: (a) all the glycans on rat class I antigens are N-linked, as they are on H-2 and HLA class I antigens; (b) there are compositional differences among the glycans in each of the three antigens; (c) the glycosylation pattern of the rat class I antigens is similar to that of the mouse class I antigens, which contain two or three glycans, in contrast to that of the human class I antigens, which contain only one glycan; and (d) the antigens Au and Eu from the same haplotype are more closely related to each other than they are to the An antigen. PMID- 3653939 TI - Identification of HLA-B44 subtypes associated with extended MHC haplotypes. AB - The HLA class I antigen B44 is found in each of two different extended major histocompatibility haplotypes (allele combinations of HLA-B, HLA-DR, and complement genes BF, C2, C4A, and C4B in linkage disequilibrium). Using isoelectric focusing, two variants of HLA-B44 were identified. The basic variant was found in all cell lines with the extended haplotype HLA-B44, DR7, FC31, and the acidic variant in all cell lines with the extended haplotype HLA-B44, DR4, SC30. The occurrence of each antigen variant with a unique extended haplotype explains previous observations concerning the nonrandom association of B44 variants with DR antigens. PMID- 3653941 TI - Neuraminidase-1 variation among mice carrying t chromosomes. PMID- 3653940 TI - Polymorphism and mapping of the class II genes in the rat: RT1.B, RT1.D, and RT1.H, a new DP-like region. AB - The major histocompatibility complex of the rat (RT1) encodes the class II molecules involved with antigen presentation and cell to cell communication. The organization of these class II genes has been studied by Southern blot hybridization using genomic DNA from inbred and recombinant rat strains digested with various restriction endonuclease and hybridized under stringent conditions with probes for mouse class II and human class II genes. Analysis of the restriction fragment length polymorphisms has mapped the class II genes relative to each other. We have confirmed the order of the alpha- and beta-chain genes in the RT1.B region, mapped the RT1.D region relative to RT1.B and showed that it has alpha- and beta-chain loci, and identified a new HLA-DP-like locus, RT1.H, to the RT1.A side of RT1.B. The RT1.H alpha and RT1.H beta genes map to the region around the recombination point in R22, and there appears to be a hot spot of recombination in RT1.H. The H beta and D beta genes have high levels of polymorphism; B beta, B alpha, and H alpha have intermediate levels of polymorphism, and D alpha has a low level of polymorphism. PMID- 3653942 TI - Variability analysis of the human and mouse T-cell receptor beta chains. PMID- 3653943 TI - Ly-33: a new lymphocyte alloantigen controlled by a gene linked to Ly-17 locus on mouse chromosome 1. PMID- 3653944 TI - Mapping of A3 and A2 polymorphic determinants on hybrid HLA antigens. PMID- 3653945 TI - A new BF variant (BF S11) with information for orientation of MHC class III genes. PMID- 3653946 TI - Goitre in PHC Paud and Khadakwasla: preliminary communication. PMID- 3653947 TI - Emergency admission in one surgical unit. PMID- 3653948 TI - Impact of vitamin A on childhood mortality. PMID- 3653949 TI - Programme for the prevention of blinding malnutrition. PMID- 3653950 TI - Zinc deficiency in neonates. PMID- 3653951 TI - Indian childhood cirrhosis: copper ingestion, penicillamine treatment and prevention. PMID- 3653952 TI - Copper metabolism and Indian childhood cirrhosis. PMID- 3653953 TI - Therapy of pseudomonal infections. PMID- 3653954 TI - Monitoring nutrient intakes in India. PMID- 3653955 TI - Maternal risk factors in intrauterine malnutrition. PMID- 3653956 TI - Anthropometry for assessment of nutritional status. PMID- 3653958 TI - Riboflavin and hemoglobin status of urban school boys: relationship with income, diet and anthropometry. PMID- 3653957 TI - Etiology of rickets in India. PMID- 3653959 TI - Weaning: when, what and why. PMID- 3653960 TI - Screening tests for vitamin A deficiency. PMID- 3653961 TI - Neonatal screening for congenital hypothyroidism in a developing country: problems and strategies. PMID- 3653962 TI - Why mucous plugs commonly cause left lung collapse? PMID- 3653963 TI - Oesophageal impaction of a foreign body. PMID- 3653965 TI - Laryngeal foreign body in a neonate. PMID- 3653964 TI - Chondroblastoma--two contrasting presentations. PMID- 3653966 TI - Oral calcium treatment lowers blood pressure in renovascular hypertensive rats by suppressing the renin-angiotensin system. AB - The effects of calcium supplementation on blood pressure and its mechanisms were investigated in two-kidney, one clip renovascular hypertensive rats. Two series of experiments were performed: one was begun just after renal artery constriction, the other after the onset of hypertension. Calcium supplementation significantly attenuated the development of hypertension (systolic blood pressure: 183 +/- 8 vs 130 +/- 2 mm Hg) and was found to abate existing renovascular hypertension (systolic blood pressure: from 183 +/- 8 to 151 +/- 4 mm Hg). Calcium treatment did not cause significant alterations in fluid intake, urine volume, or urinary sodium excretion in either study. However, increased plasma renin activity and plasma aldosterone concentration were suppressed to the basal levels at the end of 3 weeks of calcium treatment (14 +/- 3 vs 8 +/- 2 ng angiotensin I/ml/hr; 530 +/- 50 vs 380 +/- 40 pg/ml). Blood pressure of calcium treated renovascular hypertensive rats responded poorly to blockade of the renin angiotensin system with captopril injection and angiotensin II analogue (saralasin) infusion. Further, in rats with chronic established renovascular hypertension, calcium treatment attenuated the enhanced pressor response to norepinephrine, but not to angiotensin II. These results suggest that the blood pressure-lowering actions of calcium supplementation are related primarily to suppression of renin secretion and secondarily to alteration of pressor response to norepinephrine in two-kidney, one clip renovascular hypertensive rats. PMID- 3653967 TI - Assessment of the permeability of the blood-retinal barrier in hypertensive rats. AB - We assessed the permeability surface area products at the blood-retinal barrier and blood-brain barrier to sucrose (molecular weight, 340) and microperoxidase (molecular weight, 2000) following acute hypertension induced by metaraminol in Wistar-Kyoto rats (controls) and during chronic hypertension in spontaneously hypertensive rats. In acute hypertension, the permeability surface area product for sucrose was increased at the blood-retinal barrier and at the blood-brain barrier over control values (p less than 0.02), and the vessels became leaky to microperoxidase. In chronic hypertension, the permeability of the blood-retinal barrier to sucrose was increased over that in control animals (p less than 0.02), whereas the permeability of the blood-brain barrier was unaffected. Neither barrier leaked microperoxidase. These results indicate that the blood-brain barrier and the blood-retinal barrier are similarly affected in acute hypertension and that in chronic hypertension, the blood-brain barrier is unaffected whereas the blood-retinal barrier is rendered more permeable to small, but not large, solutes. PMID- 3653968 TI - Improved myocardial efficiency in the working perfused heart of the spontaneously hypertensive rat. AB - We assessed the relationship between determinants of myocardial oxygen demand- wall stress, peak rate of change of pressure and heart rate--and measured myocardial oxygen consumption over a range of loading conditions in the perfused, working heart of 6-month-old spontaneously hypertensive rats (SHR) and control Wistar-Kyoto rats (WKY). Two isolated heart preparations, an aortic-ejecting heart and an isovolumically contracting preparation with and without isoproterenol (10(-7)M) added, were employed. Under a constant perfusion pressure of 110 mm Hg, the heart rate, developed wall stress, and peak rate of change of pressure were not different between the two groups, but coronary flow and myocardial oxygen consumption were significantly lower in the SHR. Systolic values of myocardial high energy phosphate compounds (adenosine 5'-triphosphate, phosphocreatine) and myocardial lactate in the two preparations were not significantly different between SHR and WKY. Following adenosine infusion at maximum developed pressure (isovolumic preparation), both SHR and WKY demonstrated preservation of coronary reserve. These results indicate that cardiac hypertrophy represents a compensatory adaptation with improved mechanical efficiency in the 6-month-old SHR when maximally stressed and may be related to the shift from V1 to V2 and V3 isomyosin phenotypes that was observed in the hypertensive animals. PMID- 3653969 TI - Inhibition of muscle sympathetic nerve activity in humans by arginine vasopressin. AB - Arginine vasopressin, a potent vasoconstrictor, does not raise arterial pressure in normal humans even at pathophysiological plasma levels. To examine whether the pressor effect of vasopressin in humans is buffered by baroreceptor reflex inhibition of sympathetic nerve activity, we recorded postganglionic muscle sympathetic nerve activity directly from the peroneal nerve in 12 normal men before, during, and after a 20-minute intravenous infusion of vasopressin, 4 ng/kg/min, that increased mean plasma concentrations from 6.2 +/- 0.6 to 320 +/- 68 (SE) pg/ml. During the first 5 minutes (n = 8), mean arterial pressure increased from 91 +/- 3 to 97 +/- 4 mm Hg (p less than 0.05) and integrated sympathetic nerve activity decreased from 271 +/- 45 to 156 +/- 33 units (p less than 0.05). At 15 minutes (n = 12), arterial pressure did not differ from control values whereas forearm vascular resistance fell (p less than 0.05) and central venous pressure and heart rate increased (p less than 0.05). Sympathetic nerve activity remained below control levels throughout the infusion (202 +/- 31 vs 254 +/- 40 units before infusion; p less than 0.05). An effect of vasopressin on ganglionic transmission was excluded, since the sympathoexcitatory response to apnea was not attenuated during vasopressin. Thus, pathophysiologic levels of vasopressin in humans cause inhibition of muscle sympathetic nerve activity that is not due to a ganglionic blocking action. The sympathoinhibition may be caused in part by the modest increases in mean arterial and central venous pressures and attendant stimulation of arterial and cardiac baroreceptors. The reflex decrease in sympathetic nerve activity would be expected to buffer the direct vasoconstrictor effects of vasopressin. PMID- 3653971 TI - Consequences of worksite hypertension screening. Changes in absenteeism. AB - To confirm reports of increased absenteeism after worksite hypertension screening, we performed a three-stage blood pressure screening among 5888 self selected heterogeneous workers at 11 electronics plants using standardized screening and labeling procedures. A total of 296 subjects with mean systolic blood pressure of 140 mm Hg or greater or diastolic blood pressure of 90 mm Hg or greater on all three occasions were considered to have sustained hypertension. From the untreated normotensive subjects matched for eight sociodemographic and occupational variables, we prospectively selected one to three controls for each sustained hypertensive subject. Uncorrected absenteeism rates for sustained hypertensive subjects increased 22% from baseline in the postscreening year. Correction by logarithmic transformation for skewed distributions and by rates for matched controls for temporal trends reduced these changes to statistical insignificance with high statistical power. Several subgroups exhibited trends to increased absenteeism. At 12-month follow-up, the blood pressure of the sustained hypertensive subjects showed mean decreases of 12.6/6.7 mm Hg (p less than 0.0001) after the majority had received pharmacological antihypertensive treatment. These results suggest that worksite hypertension screening and labeling produce insignificant absenteeism change overall among self-selected heterogeneous work force populations. PMID- 3653970 TI - Do hypertensive patients have a different diurnal pattern of electrolyte excretion? AB - Studies generally indicate that excretion of sodium, potassium, and water is greater during the day than during the night. To determine whether hypertensive patients exhibit this same pattern of excretion, diurnal variations in excretion of sodium, potassium, creatinine, and water were examined in 107 hypertensive men and women from a clinical trial on control of hypertension by nonpharmacological means--the Hypertension Control Program. Each participant provided two carefully timed 24-hour urine collections divided into daytime and overnight specimens. The median ratios of 24-hour to 8-hour overnight excretion were 2.84, 3.95, 2.99, and 2.77 for sodium, potassium, creatinine, and water, respectively. Thus, more than half of this hypertensive group exhibited a greater rate of sodium and water excretion during sleep than during daytime hours, a reversal of the usual pattern. When the group was subdivided based on age, sex, race, trial randomization group, use of diuretics, and hypertension severity, women had significantly lower ratios of 24-hour to overnight excretion for sodium and water than men and blacks had significantly lower 24-hour to overnight ratios for water and potassium than whites. When the 24-hour to overnight ratios for these hypertensive patients were compared with those for a group of 30 men and women with high-normal blood pressure, those with high-normal blood pressure had significantly larger ratios for sodium and water excretion than the hypertensive group. The results of this study suggest that hypertensive patients may have a different diurnal pattern of sodium and water excretion than normotensive subjects and that further research is needed to clarify this issue. PMID- 3653972 TI - Blood pressure response to potassium supplementation in normotensive adults and children. AB - To investigate the effect on blood pressure of a modest increase in dietary potassium intake, 38 healthy, free-living families were enrolled in a study involving 4 weeks of potassium supplementation. This was preceded by collection of five baseline measurements of blood pressure and urinary electrolyte excretion and followed by a 4-week recovery period. Although there was a significant increase in urinary potassium excretion during supplementation in both adults and children (p less than 0.001), there were no significant changes in systolic, diastolic, or mean arterial blood pressure. Height and weight increased significantly in children (p less than 0.001), and weight increased in adults (p less than 0.01) over the course of the study. Multivariate analysis of variance of blood pressure controlling for these confounding variables failed to reveal any effect of the potassium supplementation on blood pressure. These results suggest that increasing intake of dietary potassium alone in a healthy, free living normotensive population is unlikely to have a discernible effect on blood pressure. PMID- 3653973 TI - Association of haptoglobin with sodium sensitivity and resistance of blood pressure. AB - Sodium sensitivity and resistance of blood pressure were examined in 117 normotensive and 85 hypertensive subjects by means of a protocol using rapid extracellular fluid volume expansion with intravenously administered saline (2 L over 4 hours) followed by a day of low dietary sodium intake (10 mEq) and volume contraction induced by a diuretic (furosemide, 120 mg orally). Genetic markers were also examined. Both hypertensive and normotensive subjects with haptoglobin 1-1 phenotype were significantly more (p less than 0.05) likely to be sodium sensitive than were those with 2-1 or 2-2 phenotypes, and subjects with 2-2 phenotypes were more apt to be sodium-resistant. A second population was examined in which both adults and children with haptoglobin 1-1 phenotype were found to have significantly (p less than 0.05) higher casual systolic and diastolic blood pressures. These two studies independently confirm a relationship between haptoglobin phenotypes and blood pressure and suggest an environmental factor (sodium) as well. PMID- 3653975 TI - Within-visit blood pressure changes in outpatient clinic. PMID- 3653974 TI - Pregnancy hypertension, blood pressure during labor, and blood lead levels. AB - Pregnancy hypertension, blood pressure during labor, and the umbilical cord blood lead concentration were assessed in 3851 women for whom additional demographic, medical, and personal information was available. Lead levels correlated with both systolic (Pearson r = 0.081, p = 0.0001) and diastolic (r = 0.051, p = 0.002) blood pressures during labor. The incidence of pregnancy hypertension increased with lead level. Multivariate models of pregnancy hypertension and systolic blood pressure as a function of maternal age, parity, hematocrit, ponderal index, race, and diabetes were improved by including lead as a predictor variable. At these observed levels of exposure (mean blood lead, 6.9 +/- 3.3 [SD] micrograms/dl), lead appears to have a small but demonstrable association with pregnancy hypertension and blood pressure at the time of delivery, but not with preeclampsia. PMID- 3653976 TI - Production of chemotactic factor for lymphocyte by digestion of IgG with a highly purified polymorphonuclear leukocyte neutral thiol proteinase. AB - In the present study, we purified a neutral thiol proteinase from dog PMN leukocytes and indicated that the proteinase elaborated the chemotactic factor for lymphocytes by cleavage of IgG. The neutral thiol proteinase was purified about 744-fold by ion-exchange chromatographies and affinity chromatography, and the final preparation was over 70% pure. After incubation of dog IgG with the proteinase, three distinct protein peaks were seen by the gel filtration on Sephadex G-200. Only the third peak, perhaps a dialyzable peptide, showed a significant chemotactic activity for dog lymphocytes. PMID- 3653977 TI - In vitro incubation of low-density lipoproteins with inflammatory cells causes enhanced degradation by macrophages in culture. AB - Utilizing the polyvinyl sponge-implant model, we have reported in vivo modification of low-density lipoproteins (LDL) isolated from interstitial inflammatory fluid (IF) of the rabbit. Further studies on the metabolism of IF LDL by resident mouse peritoneal macrophages (MPM), demonstrated enhanced uptake and degradation of these modified lipoproteins by scavenger mechanisms. Based upon these studies, we attempted to examine the mechanisms of these observed in vivo modifications in IF-LDL by in vitro incubation of plasma LDL with inflammatory fluid subfractions. Incubation of LDL with inflammatory cells at 37 degrees C resulted in an increased anodal electrophoretic mobility and alteration in apolipoprotein (APO) composition. Subsequent incubation of this modified plasma LDL with MPM resulted in a significant increase in cell surface binding and an increase in the appearance of degradation products in the medium. The formation of lipid peroxides, measured as thiobarbituric acid-reacting substances (T Bars), increased with the time of LDL incubation with inflammatory cells. Conversely, incubation of LDL with cell-free, lipoprotein-deficient IF (LPDIF, d greater than 1.210 g/ml) significantly inhibited LDL degradation by MPM. LPDIF did not alter the electrophoretic mobility of LDL or result in the appearance of T Bars in the medium. These results implicate peroxidative reactions associated with an inflammatory response as mediators of the in vivo modifications in IF-LDL which facilitates enhanced uptake via the scavenger receptor in MPM. PMID- 3653978 TI - Involvement of inflammatory leukocytes in hepatic induction of T-kininogen in rat. AB - Hepatic synthesis as well as plasma levels of T-kininogen, a protein precursor of T-kinin (Ile-Ser-bradykinin), increase in rats following the induction of acute inflammation. Studies have been undertaken to elucidate an involvement of inflammatory leukocytes in the acute-phase response of T-kininogen. Peritoneal exudate cells (PEC) were prepared from rats six days after the intraperitoneal injection of Freund's complete adjuvant. By transfer of these leukocytes into the peritoneal cavity of normal rats, plasma kininogen levels of these recipients increased about threefold after one day. Secretion of kininogen from rat hepatocytes in primary culture was enhanced about twofold by coculturing with PEC. A similar effect was also obtained by adding culture supernatant of these leukocytes into hepatocytes, and the increased levels of kininogen in culture medium of hepatocytes was due to the increased levels of T-kininogen. From these results, it was concluded that leukocytes in the inflammatory site, probably macrophages, release some substance(s) which stimulate(s) the hepatic synthesis of T-kininogen. PMID- 3653979 TI - Suppression of human polymorphonuclear leukocyte phagocytosis by adenosine analogs. AB - The effects of adenosine analogs on human polymorphonuclear leukocyte (PMN) phagocytosis to latex beads or sheep red blood cells were investigated in an in vitro experiment. The purine compounds such as N6-phenylisopropyladenosine (PIA), 5'-N-ethylcarboxamido-adenosine (NECA), an A2 adenosine receptor agonist, and adenosine as high as 2 mM had no effect on PMN phagocytosis. In contrast, 2',5' dideoxyadenosine (DDA), a P-site adenosine receptor agonist, and 5' methylthioadenosine (MTA), a naturally occurring purine nucleoside, caused profound inhibition of phagocytic function of PMNs in a dose-dependent manner. Dipyridamole, which blocks purine nucleoside uptake, reversed the suppression due to MTA. Theophylline, an R-site receptor antagonists did not prevent the effect of MTA. These results suggested that phagocytosis of PMNs is suppressed by stimulation of the P-site adenosine receptors. PMID- 3653980 TI - Gold compounds alter distribution of protein kinase C activity in human neutrophils. AB - Slow translocation of protein kinase C was observed by both auranofin and gold sodium thiomalate pretreatment of neutrophils. Both gold compounds failed to influence the activity of this enzyme directly when cell-free studies were performed. In intact neutrophils incubated with 5.1-20.3 microM auranofin, protein kinase C activity decreased in the cytosol in a time- and dose-dependent manner. Concomitantly, the levels of the membrane-associated protein kinase C were significantly elevated, although the amount of activity recovered could not account for that lost from the cytosol. Gold sodium thiomalate (5.0 microM-0.505 mM) demonstrated similar effects but with lesser potency than auranofin. In confirmation of previous results, phorbol myristate acetate (PMA), a cellular stimulus, also induced the translocation of protein kinase C. Key differences were that the reaction was rapid (occurring within minutes after PMA addition) and that relative recovery of kinase activity from the particulate fraction was fourfold greater. The relationship between gold compound-mediated kinase C redistribution and inhibition of neutrophil responses remains to be elucidated. PMID- 3653981 TI - Immunosuppressive effects of Centipeda periodontii: selective cytotoxicity for lymphocytes and monocytes. AB - We have examined soluble sonic extracts prepared from several strains of Centipeda periodontii for their ability to alter human lymphocyte function. These organisms were isolated from subgingival plaque of patients with periodontal disease. We found that sonicates from several, but not all, strains of C. periodontii caused a dose-dependent inhibition of lymphocyte responsiveness to concanavalin A, phytohemagglutinin, pokeweed mitogen, and formalinized Staphylococcus aureus. Inhibition was associated with a concomitant decrease in cell viability assessed by trypan blue exclusion, 51Cr release, and electron microscopy. The maximal number of dead cells was observed 20 to 24 h after exposure to the sonic extract. Susceptible cells include human lymphocytes (both B and T), monocytes, and erythrocytes, whereas polymorphonuclear cells, murine L 929 fibroblasts, and sheep erythrocytes were not affected. Preliminary characterization of the cytotoxic activity indicates that it is heat labile and trypsin sensitive and has an Mr of 60,000. It has been proposed that impaired host defense may play a pivotal role in the pathogenesis of periodontal diseases. The data presented in this paper suggest that immunosuppression (local or systemic or both) could be initiated by C. periodontii. This immunosuppression may alter the nature and consequences of host-parasite interactions, thereby enhancing the pathogenicity of C. periodontii itself or some other opportunistic organism. PMID- 3653982 TI - Functional capacity of marginated and bone marrow reserve granulocytes. AB - Marginated and bone marrow reserve granulocytes were obtained from young healthy volunteers after subcutaneous administration of aqueous epinephrine (0.4 ml/m2) or intravenous administration of hydrocortisone sodium succinate (250 mg), respectively. These leukocytes were compared with circulating granulocytes for the ability to adhere to surfaces, migrate in a random fashion, respond to chemoattractants, interact with autologous serum opsonins, and phagocytize and kill five common bacterial pathogens. As contrasted with circulating neutrophils, marginated cells had enhanced phagocytic and killing capacity for some pathogens, whereas adherence, random migration, chemotaxis, and chemiluminescence for the two cell populations were equivalent. Bone marrow reserve cells demonstrated increased activity for three functional mechanisms; chemotaxis for these cells averaged 21% higher than that for circulating cells, and phagocytosis was 32% higher, with 6 to 17% greater killing of the five bacterial species studied. All of these differences were statistically significant (P less than 0.05). Random migration and interaction with serum opsonins were unchanged in bone marrow granulocytes. These enhanced functional properties of neutrophils which are outside of the circulating pool may represent important host defense mechanisms during episodes of bacterial infection. PMID- 3653983 TI - Bacteroides gingivalis-Actinomyces viscosus cohesive interactions as measured by a quantitative binding assay. AB - There is limited evidence, mostly indirect, to suggest that the adherence of Bacteroides gingivalis to teeth may be enhanced by the presence of gram-positive dental plaque bacteria like Actinomyces viscosus. The purpose of this study was to carry out direct quantitative assessments of the cohesion of B gingivalis and A. viscosus by using an in vitro assay modeled on the natural sequence in which these two species colonize the teeth. The assay allowed comparisons to be made of the adherence of 3H-labeled B. gingivalis 2561 and 381 to saliva-coated hydroxyapatite beads (S-HA) and A. viscosus WVU627- or T14V-coated S-HA (actinobeads) in equilibrium and kinetics binding studies. A series of preliminary binding studies with 3H-labeled A. viscosus and parallel studies by scanning electron microscopy with unlabeled A. viscosus were conducted to establish a protocol by which actinobeads suitable for subsequent Bacteroides adherence experiments could be prepared. By scanning electron microscopy, the actinobeads had only small gaps of exposed S-HA between essentially irreversibly bound A. viscosus cells. Furthermore, B. gingivalis cells appeared to bind preferentially to the Actinomyces cells instead of the exposed S-HA. B. gingivalis binding to both S-HA and actinobeads was saturable with at least 2 X 10(9) to 3 X 10(9) cells per ml, and equilibrium with saturating concentrations was reached within 10 to 20 min. B. gingivalis always bound in greater numbers to the actinobeads than to S-HA. These findings provide direct measurements supporting the concept that cohesion with dental plaque bacteria like A. viscosus may foster the establishment of B. gingivalis on teeth by enhancing its adherence. PMID- 3653984 TI - Protective secretory immunoglobulin A antibodies in humans following oral immunization with Streptococcus mutans. AB - Ingestion of a vaccine containing killed Streptococcus mutans, originally isolated from each volunteer, daily for 10 consecutive days induced increased levels of specific secretory immunoglobulin A (sIgA) antibodies to S. mutans cells and two cell surface proteins, glucosyltransferase and surface antigen I/II, in parotid saliva and tears of four healthy males and in parotid saliva, tears, colostrum, and milk of a pregnant woman. In addition, these antibodies inhibited glucosyltransferase activity. Both IgA1 and IgA2 antibodies were induced. The levels of IgA antibodies in all secretions remained significantly above preimmunization levels for more than 50 days after oral administration of antigen. A second series of immunizations for 7 consecutive days resulted in even higher levels of sIgA antibodies, which peaked earlier and persisted longer than those observed after the primary immunizations. No increase in levels of antibodies in serum were detected in any subject. Antibodies reactive with human heart and kidney antigens could not be detected in saliva, tears, colostrum, milk, or serum samples collected at any time during the immunization regimen. The numbers of viable S. mutans organisms in dental plaque and whole saliva decreased after each series of immunizations, which correlated with increased levels of IgA antibodies in saliva, suggesting that IgA antibodies in saliva were responsible for the reduced adherence of this bacterium. These results indicate that ingested S. mutans antigen induces secretion of specific IgA1 and IgA2 antibodies in saliva, tears, colostrum, and milk, providing further evidence for the existence of a common mucosal immune system. PMID- 3653986 TI - Susceptibility of pathogenic and nonpathogenic Naegleria spp. to complement mediated lysis. AB - The susceptibility of four species of Naegleria amoebae to complement-mediated lysis was determined. The amoebicidal activity of normal human serum (NHS) and normal guinea pig serum (NGPS) for Naegleria amoebae was measured by an in vitro cytotoxicity assay. Release of radioactivity from amoebae labeled with [3H]uridine and visual observation with a compound microscope were used as indices of lysis. Highly pathogenic mouse-passaged N. fowleri was less susceptible to the lytic effects of NHS and NGPS than the weakly pathogenic, axenically grown N. fowleri or N. australiensis and the nonpathogenic amoebae N. gruberi and N. lovaniensis. However, both pathogenic and nonpathogenic Naegleria spp. depleted complement as assessed by total hemolytic activity. Treatment of serum with EDTA, heat (56 degrees C, 30 min), cobra venom factor, or antibody to C3 or C9 complement components decreased the amoebicidal activity of NHS. The presence of specific agglutinating antibody to N. fowleri enhanced the amoebicidal activity of NGPS for N. fowleri. PMID- 3653987 TI - Production of a unique cytotoxin by Campylobacter jejuni. AB - Campylobacter jejuni is an important diarrheal pathogen worldwide; the mechanisms by which it causes disease remain unclear. Because of its association with inflammatory diarrhea, we postulated that C. jejuni might produce a cytotoxin similar to that produced by Shigella sp., enterohemorrhagic Escherichia coli O157, or Clostridium difficile. Filtrates of 12 polymyxin-treated isolates of C. jejuni were placed on HeLa cells (sensitive to Shiga toxin cytotoxicity) and Chinese hamster ovary (CHO) cells. Of 12 isolates of C. jejuni tested, 5 killed 50% of the cells at greater than or equal to 1:4 dilutions of filtered suspensions of 10(9) bacteria per ml; killing was similar in HeLa and CHO cells (the CHO cells being insensitive to Shiga cytotoxin). One isolate produced a titer of 1:32 to 1:128. The relative potency in HeLa cells was comparable to that of E. coli strains that produce intermediate amounts of Shiga-like toxin. The other seven strains showed no cytotoxic effect, nor did the control diluents, polymyxin B, or supernatants of C. jejuni not treated with polymyxin B. Sonication also released active cytotoxin, but slightly less well than did polymyxin. The cytotoxic effect was dose dependent. Concentration of the C. jejuni in suspension by 10-fold before treatment with polymyxin B resulted in a 10-fold increase in the 50% cytotoxic dose. The cytotoxin effect was not neutralized by Shiga toxin immune serum against either Shiga-like toxin I or II or by anti-Clostridium difficile antiserum. The C jejuni cytotoxin was partially labile to trypsin (0.25%) and to heating to greater than or equal to 60 degrees C. Cytotoxicity was retained in Scientific Products dialysis tubing D1615-1 (Mr cutoff, 12,000 to 14,000). Some isolates of C. jejuni release a substance lethal to HeLa or CHO cells in vitro that is distinct from Shiga-like or Clostridium difficile toxin. This cytotoxin may contribute to the colonic mucosal invasive process that characterizes C. jejuni enteritis. PMID- 3653985 TI - Nonoxidative antimicrobial effects of human polymorphonuclear leukocyte granule proteins on Chlamydia spp. in vitro. AB - Proteins from isolated granules of human polymorphonuclear leukocytes were assessed for their nonoxidative microbicidal effect on chlamydiae by two different methods: a radioisotope assay for elementary body integrity and a biological assay for inclusion development. Crude granule extract, which consisted of a mixture of all granule proteins, caused a 20 to 30% decrease in infectivity and a 52% decrease in infectivity when incubated with Chlamydia psittaci CAL-10 and Chlamydia trachomatis serovar E, respectively. To define more specifically the components that were damaging to chlamydiae, crude granule extract was subjected to Sephadex G-75 column chromatography and isolated granule fractions were obtained. Only fractions containing lysozyme as the major component consistently caused reductions in infectivity of C. trachomatis elementary bodies. In contrast, fractions collected after the lysozyme fraction, containing proteins with molecular masses of 13,000 daltons or less, had detrimental effects on C. psittaci infectivity. Additional experiments using highly purified human polymorphonuclear leukocyte lysozyme confirmed its infectivity-reducing action upon C. trachomatis but not upon C. psittaci. PMID- 3653988 TI - Effect of immunization on experimental Bacteroides gingivalis infection in a murine model. AB - BALB/c mice were immunized with an invasive (A7A1-28) or noninvasive (381) Bacteroides gingivalis strain, Bacteroides intermedius, or Ringer solution. All immunized mice were subsequently challenged with the invasive B. gingivalis strain and examined for septicemia or secondary spread of the infection or both. Mice immunized with the invasive B. gingivalis strain localized the infection to the challenge site. Mice immunized with the noninvasive B. gingivalis strain, B. intermedius, or Ringer solution developed spreading infections. These data suggest that immunization with an invasive B. gingivalis strain can alter the course of subsequent infections. PMID- 3653989 TI - Sensory-neural hearing loss during combined noise and vibration exposure. An analysis of risk factors. AB - A detailed analysis of risk factors for the development of sensory-neural hearing loss (SNHL) was carried out on 122 forest workers. These forest workers were selected from a larger group (n = 217) by restricting the age range to 30-55 years. The hearing threshold of the left ear at 4000 Hz was measured and the effect of age, exposure, systolic and diastolic blood pressure (DBP), presence of vibration-induced white finger (VWF), tobacco smoking and use of earmuffs were evaluated in multiple linear regression analysis. Robinson's nonlinear model was used to evaluate the rate of hearing loss. Aging was the major risk factor and it explained 15.4% of the variance of the SNHL. The presence of VWF was the second most important single risk factor and explained a further 5.2% of the SNHL. Elevation of DBP correlated significantly with SNHL and explained an additional 4.1% of the SNHL. These main factors were able to explain about 26% of the spread of SNHL. Additional factors in the analysis, e.g. smoking, systolic blood pressure, did not significantly contribute to the genesis of SNHL. When Robinson's model was applied to the SNHL data, on a group basis, we did not observe any exaggerated risk of hearing loss due to combination of noise and vibration. In combined exposure subjects with VWF as well as subjects with enhanced DBP will run a higher risk for SNHL. PMID- 3653991 TI - Urinary chlorophenols in sawmill workers. AB - The concentration of urinary chlorophenol was assayed for 230 sawmill workers. Information on the work tasks was obtained through questionnaires from occupational health centres. The workers were divided into three groups on the basis of the type of exposure: (1) those with skin absorption as the main route, (2) those with skin and respiratory route of equal importance and (3) those with respiratory tract as the main route. The concentrations of urinary chlorophenol were higher in workers with skin absorption as the main route (median concentration: 7.8 mumol l-1; range 0.1 to 210.9 mumol l-1) than in those with both routes of equal importance (1.4 mumol l-1; range 0.1 to 47.8 mumol l-1, P less than 0.001) or in those with mainly respiratory route (0.9 mumol l-1; range 0.1 to 13.3 mumol l-1, P less than 0.001). The urinary chlorophenol concentration was below 15 mumol l-1 in all workers with the lungs as the main absorption route. In nine out of 112 workers whose main absorption route was the skin, the urinary chlorophenol values were above 50 mumol l-1. Six were loaders when the through-dipping method was used. In two of them urinary chlorophenol concentrations were as high as 170.8 and 210.9 mumol l-1. These results emphasize the need to develop and use simple methods of protection against skin contact with chlorophenols. PMID- 3653990 TI - Cancer morbidity in Swedish shipyard workers 1978-1983. AB - The cancer morbidity in 3787 shipyard workers was studied between 1978 and 1983. In these shipyards the use of asbestos was abandoned in 1972. The overall cancer morbidity was found to be similar to that of the male population of the same city, but there were four cases of mesothelioma. There were 11 cases of lung cancer, as opposed to 9.8 expected cases. Men with both heavy and long exposure to asbestos had no increased risk of lung cancer. The occurrence of pleural plaques was not associated with the risk of developing cancer. PMID- 3653992 TI - Biological assessment of exposure to antimony and lead in the glass-producing industry. AB - The oxide of trivalent antimony is used in the glass-producing industry as a refining agent and as a glass colouring. The batch contains up to 2% Sb2O3, a substance which has shown carcinogenic properties in animal experiments. The internal levels of antimony and lead in blood (SbB and PbB) as well as the excretion with the urine (SbU and PbU) were determined by hydrid and electrothermal atomic absorption (HY-AAS and ET-AAS), respectively. In addition, measurements of airborne Sb2O3-concentrations were performed. The 109 volunteers were employed in four different fields: melting area, batch bunker, glass-washing area, and transport/maintenance. Differences between the concentrations of antimony and lead in blood and urine with respect to the fields of activity were evaluated statistically. The highest values of airborne Sb2O3, with up to 840 micrograms/m3 (TWA), were detected in the batch bunker. Correspondingly, significantly enhanced SbU-values from 1.5 to 15.7 micrograms/l (median: 5.0 micrograms/l) were found in specimens collected from the batch mixers. In the same group, the lead excretion (PbU) with values from 9 to 110 micrograms/l (median: 43 micrograms/l) was also found to be the highest. Due to the fast renal excretion of antimony, the determination of SbU is useful for biological monitoring. PMID- 3653993 TI - Psychological performance, toluene exposure and alcohol consumption in rotogravure printers. AB - A psychological test battery was administered to a group of 43 rotogravure printers exposed to toluene (mean age 41 years, mean duration of exposure 22 years) and to a referent group comprising 31 offset printers of the same age. Eighteen of the rotogravure printers and one of the referents were heavy drinkers of alcohol. The test battery included tests for verbal and visual cognition and memory, perceptual motor speed, and psychomotor abilities. A vocabulary test (Synonyms) was used as a measure of initial intelligence. Performances in the two groups were compared, and descriptive data analyses were made in four subgroups formed according to toluene exposure and drinking habits. The rotogravure printers performance was inferior to the referents in tests measuring visual cognitive abilities. The mean test performances in the subgroups indicated that the difference in drinking habits did not explain the differences: the heavy drinkers tended to perform better than those with more moderate drinking habits. An antagonistic interaction between toluene and alcohol was suggested by intact performances among the heavy drinkers with high exposure (n = 8). The question deserves to be investigated further. PMID- 3653994 TI - Variation of lung function during the workshift among cotton and jute workers. AB - Cotton and jute dust exposure is known to induce reversible airway obstruction. We compared 50 exposed workers to 99 non exposed workers for the prevalence of respiratory symptoms and ventilatory impairment, and for variations in pulmonary function after five working days and after inhalation of salbutamol. The prevalence of respiratory symptoms was not significantly different between the two groups. Pulmonary function was not different on Monday morning, however, significant differences were observed on Friday afternoon. The exposed workers had a lower flow rate at 75% of exhaled forced vital capacity than controls (P less than 0.01). Salbutamol induced greater bronchodilatation in the exposed group. Comparison with a control group is necessary to take into account the change in pulmonary function. Repeated tests, combined with pharmacological tests, are able to differentiate the lung function pattern of exposed and non exposed workers. PMID- 3653995 TI - The organic solvent syndrome. A comparison of cases with neuropsychiatric disorders among painters and construction workers. AB - A study was conducted to investigate the existence of a "specific" neurotoxic effect due to long-term exposure to organic solvents. A comparison was made regarding diagnoses, symptoms and other relevant medical data between persons receiving a disability pension on the basis of a neuropsychiatric disorder selected from an exposed (painters) and non-exposed (construction workers) trade organization. Information was collected from their medical files at the occupational health department. Concerning diagnoses and symptoms, no significant differences were found between exposed and non-exposed patients. No indications were found for the existence of a "typical" complex of symptoms associated with exposure to organic solvents among painters in The Netherlands. The number of reported symptoms was not related to the duration of exposure, thus lending no support for a dose-effect relationship. If a neurotoxic effect does exist among Dutch painters, it is of a non-specific type and not clearly distinguishable from other mental disorders. PMID- 3653996 TI - Occupational chronic exposure to metals. I. Chromium exposure of stainless steel welders--biological monitoring. AB - External and internal chromate exposure of 103 stainless steel welders who were using manual metal are welding (MMA), metal inert gas welding (MIG) and both methods, were measured by ambient and biological monitoring. At the working places the maximum chromium trioxide concentrations were 80 micrograms/m3. The median values were 4 micrograms/m3 (MMA) and 10 micrograms/m3 (MIG). The median chromium concentrations in erythrocytes, plasma and urine of all welders were less than 0.60, 9.00 and 32.50 micrograms/l. For biological monitoring purposes, chromium levels in erythrocytes and simultaneously in plasma seem to be suitable parameters. According to our results, chromium levels in plasma and urine in the order of 10 and 40 micrograms/l seem to correspond to an external exposure of 100 micrograms chromium trioxide per cubic metre, the technical guiding concentration (TRK-value). Chromium concentrations in erythrocytes greater than 0.60 micrograms/l indicate an external chromate exposure greater than the TRK-value. PMID- 3653997 TI - Discomforts and laboratory findings in workers exposed to sulfur dioxide. AB - In a broom manufacturing factory the authors performed microclimatic measurements, measurements of sulfur dioxide concentration and dust content. Workers (n = 190) were polled regarding discomforts characteristic of sulfur dioxide effects. Sulfates were determined in urine of 56 subjects, and methemoglobin and sulfhemoglobin were determined in blood. Sulfates were determined in 43 controls and methemoglobin and sulfhemoglobin were determined in 39 controls. Sulfur dioxide concentration in work environment ranged from 17.1 to 149.4 mg/m3 in winter and from 0 to 0.75 mg/m3 in summer. The exposed workers complained most often of coughing (94.2%), dyspnea (91.0%), burning in nose, eyes and throat (from 74.7 to 83.7%), substernal pain (75.3%), sore throat (74.7%), tearing (64.7%), etc. Sulfate concentrations were found to be statistically significantly higher (P less than 0.01) in urine of workers exposed to sulfur dioxide than in the controls. Methemoglobin concentrations were also significantly higher in blood of the exposed workers, whereas no difference was found in concentrations of sulfhemoglobin. PMID- 3653998 TI - Allergic reactivity of Parthenium hysterophorus (Santa Maria feverfew) pollen: an unrecognized allergen. AB - Parthenium hysterophorus (PH), a member of the Asteraceae, is a ubiquitous weed found in great profusion in the United States Gulf coast area. A plant survey carried out in Texas Gulf coast demonstrated that around Corpus Christi, PH is the most prevalent weed. We have studied known ragweed-sensitive patients living in Austin and Corpus Christi, by radioallergosorbent test (RAST) analysis for PH and Ambrosia psilostachya (AP; western ragweed). Nine of ten patients from Austin were RAST-positive to PH and AP; 8 of the 10 patients had positive scores to both pollen extracts. All of the 8 patients from Corpus Christi were positive to both PH and AP. The Austin group showed a significant correlation between AP and PH RAST scores while no correlation between RAST values was seen in the Corpus Christi group. RAST inhibition analysis in this highly selected population did reveal patients that had true sensitivity to PH pollen alone or who were sensitive to both PH and AP pollen. This suggests that in areas where it is highly prevalent PH pollen is an overlooked cause of allergic disease. PMID- 3653999 TI - Nasal mucosal mast cells and histamine in hay fever. Effect of topical glucocorticoid treatment. AB - Symptomatic seasonal allergic rhinitis has previously been found to be associated with a redistribution of mast cells from the subepithelial stroma to the epithelial lining and the surface of the nasal mucosa. The present study was designed in order to elucidate the interaction between topical glucocorticosteroids, effective in the treatment of allergic rhinitis, and the migration of mast cells described earlier. Six patients treated prophylactically in the nose with budesonide were studied. Imprints and biopsies from the nasal mucosa were taken 2-3 weeks before and 2-3 weeks into the birch pollen season. The biopsies were used for light microscopy and tissue histamine determination. The morphologic studies showed, also in the actively treated patients, an increased number of metachromatically stained cells on the nasal mucosal surface of the same order of magnitude as previously reported for untreated patients. We did, however, find a decrease in the histamine content of the nasal mucosa, which was not associated with a decrease in the number of mast cells. Together with similar previous findings in the unstimulated allergic nasal mucosa these results suggest that glucocorticosteroids induce a decrease in the mast cell histamine pool, possibly due to an inhibition of the intracellular synthesis of histamine. This effect might contribute to the clinically beneficial effect of topical glucocorticosteroids in the treatment of hay fever. PMID- 3654000 TI - Immunomodulatory effects of orally-administered saponins and nonspecific resistance against rabies infection. AB - We present evidence that orally fed Quillaja saponins offer nonspecific resistance to mice against rabies viral infection. Adoptive transfer of spleen cells and thymocytes from animals preconditioned with saponin (SAP), inactivated rabies antigen (AG), or a mixture of AG+SAP has offered significant protection against an intracerebral challenge with live rabies virus. Levels of serum rabies neutralizing antibodies in the different groups of recipient animals did not correlate with the respective survival rates. Culture supernatants of concanavalin A-stimulated spleen cells from animals fed SAP or AG+SAP induced marked T cell and B cell proliferation, and also greatly enhanced the plaque forming cell activity of unprimed spleen B cells. Irrespective of the presence or absence of rabies-specific antibodies, sera from animals fed a mixture of AG+SAP induced significant levels of cell proliferation and augmented phytohemagglutinin (PHA)-induced responsiveness of spleen lymphocytes in vitro. The addition of sera from animals fed AG alone resulted in inhibition of cell proliferation and suppressed PHA-induced responses. PMID- 3654001 TI - Macrophage activation by Micropolyspora faeni does not suppress anamnestic pulmonary immunologic reactivity. AB - Determinants of lung immunologic response to antigens are not known, but could include alveolar macrophage (AM) activation. We tested the ability of AM activation to modify the anamnestic response by administering bovine serum albumin (BSA) intratracheally, activating AM (by intratracheal Micropolyspora faeni), and then exposing rabbits again to intratracheal BSA. We compared the results from 4 groups of animals: intratracheal administration of either 50 mg M. faeni or normal saline and later administration of either intratracheal or intramuscular BSA. M. faeni administered intratracheally increased the number of AM. These AM were activated (increased phagocytosis of IgG-coated particles). We found no difference in the amount of antibody in either lavage fluid or serum or in antigen-induced pulmonary parenchymal and hilar node lymphocyte proliferation among these 4 groups. PMID- 3654002 TI - Crawfish and lobster allergens: identification and structural similarities with other crustacea. AB - Antigenic and allergenic components in crawfish and lobster extracts were studied using crossed immunoelectrophoretic techniques. Crossed immunoelectrophoresis with rabbit antisera revealed 23 antigens in crawfish and 17 antigens in lobster extracts. Both extracts exhibited structural similarities in antigens mutually and with other crustacea in cross-line immunoelectrophoresis. Crossed radioimmunoelectrophoresis (CRIE) demonstrated 6 crawfish and 4 lobster allergens when individual or pooled sera from radioallergosorbent test (RAST)-positive crustacea-sensitive subjects were used. Since radiostaining was also observed with sera from RAST-negative nonsensitive subjects, specificity of IgE binding was tested using CRIE-inhibition. Preincubation of RAST-positive sera with crawfish or lobster extract decreased radiostaining in CRIE, while no changes occurred when using control sera. These results confirmed the presence of IgE mediated mechanisms in seafood allergy and demonstrated a number of shared antigenic determinants among crustacea allergens. PMID- 3654003 TI - Humoral immune response to cow's milk in children with cow's milk allergy. Relationship to the time of clinical response to cow's milk challenge. AB - In 47 infants and children aged 4-66 months with clinically proven cow's milk allergy and in a group of age-matched controls, serum IgG, IgA and IgM cow's milk specific antibodies were determined with ELISA assays while IgE cow's milk specific antibodies were measured with Pharmacia RAST. The patients were divided into three separate groups according to the time of clinical response to a standardized cow's milk challenge protocol. Immediate reactions (less than 45 min after challenge), which were mainly accompanied by urticarial skin eruptions, were associated with elevated IgE milk-specific antibody levels, indicating the involvement of an immediate hypersensitivity mechanism. Alternatively, intermediate reactions (1-20 h after challenge), which were mainly accompanied by vomiting and diarrhea, were not IgE-mediated. In the late reactions (greater than 20 h after challenge) both eczematous and gastrointestinal reactions were seen. Patients with eczematous eruptions also showed elevated IgE milk-specific antibody levels. IgG milk-specific antibody levels were similar in each of the patient groups but all groups were significantly lower than in the controls. Levels of IgA and IgM milk-specific antibodies were similar in patients and controls. The results indicate that different immunopathogenic mechanisms are operative in these subgroups of patients with cow's milk allergy. PMID- 3654004 TI - Activation of the alternative pathway of human complement by sulfhydryl compounds of analytic and therapeutic use. AB - Thiol-containing drugs (dimercaprol, dimercaptopropanesulfonate, captopril, penicillamine, N-acetylcysteine) and the standard reducing agent beta mercaptoethanol, activate the alternative pathway of complement as shown by in vitro experiments. Depending on the substance tested, at concentrations of 0.5-5 mM, cleavage products of C3 and factor B were demonstrable in serum by immunoelectrophoresis. The regulatory protein factor I proved to be very sensitive to thiols; this observation offers an explanation for the alternative pathway activating effect of these substances. At concentrations of thiols that initiate the alternative pathway, the classical pathway was not or only to a minor extent activated; however, the activity of C2, C5 and one or several of the components C6-9 was directly affected. Alkylation of the thiol group of the compounds tested, abrogated their effects on the complement system. PMID- 3654005 TI - Variability of antigenicity/allergenicity in different strains of Alternaria alternata. AB - Biochemical and immunological properties were studied in crude mould extracts from 10 different strains of Alternaria alternata. The mould strains were grown on completely synthetic medium and harvested under identical conditions. The biochemical and immunological analyses (protein content, carbohydrate content, IEF, RAST-inhibition, CIE/CRIE and the content of a major allergen) showed significant variations between the individual strains of A. alternata. 32 antigens were identified in the CIE pattern of A. alternata and 19 different allergens were identified in CRIE analysis (1 major, 7 intermediate and 6 minor allergens). There was a significant variation in the content of the major A. alternata allergen (Ag-8, partially identical to Alt-I) between the different individual strains. Furthermore, a considerable variation in the content of Ag-8 was observed for a specific strain cultivated at different occasions under identical cultivation conditions during a time period of 3 years. PMID- 3654006 TI - Allergenic cross-reactivity of egg-white and egg-yolk proteins. An in vitro study. AB - The radioallergosorbent test (RAST) and RAST inhibition test were used to examine cross-allergenicity amongst the major hen's egg-white and egg-yolk proteins. Using ovalbumin as a reference allergen to compare cross-reactivity, it was apparent that the proteins conalbumin, ovomucoid and lysozyme substantially inhibited binding to ovalbumin discs of IgE in the sera of patients clinically hypersensitive to egg. The converse situation with conalbumin, ovomucoid and lysozyme on the discs and ovalbumin as the inhibitor also resulted in significantly decreased levels of IgE binding to the proteins on the discs. It was also demonstrated that cross-reactions occurred between ovalbumin and the yolk protein, apovitellenin I. Cross-reaction was also observed surprisingly when egg lysozyme was on the disc and the milk protein allergen alpha-lactalbumin was used as the inhibitor. The demonstration of cross-reaction between all of these proteins may signify that there are a number of common allergenic determinants on these egg proteins, thus providing a molecular basis for the phenomenon of cross reactivity. PMID- 3654007 TI - Cellular composition of peripheral lymph and skin of sheep defined by monoclonal antibodies. AB - The surface phenotype of cells in peripheral lymph collected from afferent lymphatics leading to the popliteal lymph node of sheep was determined using a panel of monoclonal antibodies (mAbs). The majority of lymphocytes (83.5%) expressed the sheep pan-T cell antigen and only 13.3% bore surface immunoglobulin molecules. All peripheral T cell subsets occurring in sheep were detected; 50.2% of lymphocytes were positive for mAb SBU-T4 (T helper), 7.3% were positive for mAb ST-8 (T cytotoxic), and 8.4 and 43.0% expressed T subset markers recognized by mAbs 197 and T-80, respectively. Major histocompatibility complex (MHC) class I antigens were detected on 71.1% of lymphocytes and MHC class II antigens on 21.8%. The macrophage/veiled cells found in peripheral lymph did not express lymphocyte subset markers but were positive for MHC class I and II antigens, the sheep homologue of T6 antigen, leukocyte common antigen and mAb 175 (myeloid/erythroid). Macrophage-like cells occurring in the epidermis of skin taken from the lower hindleg gave positive staining reactions to the same mAbs which stained the macrophage/veiled cells in peripheral lymph. These results illustrate differences between the migration of lymphocyte subsets through nonlymphoid as compared to lymphoid tissues and point to a possible developmental or migratory relationship between the macrophage-like cells in skin and those in afferent popliteal lymph. PMID- 3654008 TI - Drugs as allergens: the molecular basis of IgE binding to thiopentone. AB - Using an immunoassay developed for the detection of thiopentone-reactive IgE antibodies, the combining site specificities of such antibodies found in sera of patients who experienced life-threatening anaphylactic reactions to the drug were studied. The antibody combining sites from one patient were complementary to the region of the thiopentone molecule containing a thio group at position 2 of the barbiturate ring. The allergenic determinant recognized by IgE antibodies from another patient encompassed a secondary pentyl group and an ethyl group attached to position 5 on the other side of the barbiturate ring. Thus, it is already clear that there is more than one allergenic determinant on the thiopentone molecule with the capacity to provoke IgE formation and drug-induced allergic reactions. PMID- 3654009 TI - Effects of antigen challenge on intestinal permeability and morphology in rats immunized with gliadin or ovalbumin. AB - In this study we have investigated the possible effects of a local immune response on the intestinal permeability and morphology in rats. The animals were immunized subcutaneously by small doses of gliadin or ovalbumin. Immunization with gliadin led to small but significantly increased levels of IgA and IgM antibodies, similar to those reported for patients with coeliac disease. Immunization with ovalbumin gave significantly increased antibody levels of IgE, IgG, IgA and IgM. Subsequent antigen provocations by oral administration of gliadin (1 mg), together with fluorescein isothiocyanate-labelled dextran (molecular weight 3,000 daltons) as permeability marker, resulted in an increased intestinal permeability for this marker. This alteration of the intestinal permeability was qualitatively similar to that previously reported for patients with coeliac disease. Antigen provocation with ovalbumin caused a decreased permeability for both dextran and different-sized polyethylene glycols, but first at a dose of 40 mg. Direct antigen administration (gliadin or ovalbumin) into a ligated part of the ileum gave qualitatively similar but less pronounced permeability changes when compared with the effects obtained after oral administration of the respective antigen. However, neither gliadin nor ovalbumin challenge led to any ultrastructural changes of the intestinal wall. In summary, we have been successful in inducing specific antibody responses towards gliadin in rats and increased intestinal permeability upon gliadin provocation without any coexisting morphological alterations. PMID- 3654010 TI - Endotoxin-induced auto-immunity in mice. I. Time and dose dependence of production and serum levels of antibodies against bromelain-treated mouse erythrocytes and circulating immune complexes. AB - Injection of mice with endotoxin results in the formation of auto-antibodies and the appearance of soluble immune complexes in the blood. In this study the relationship between the production and serum levels of autohaemolysins and circulating immune complex titres was investigated. Immune complexes were detected by a solid-phase C1q-binding assay and found to contain antibodies of the IgM, but not of the IgG class. Individual mice showed marked differences as to their splenic plaque-forming cells, serum autohaemolysin, and circulating immune complex responses, both in kinetic studies and dose-response experiments. The dissociation between production and serum levels of auto-antibodies was ascribed to extrasplenic synthesis or a disproportionate production per plasma cell. The independent behaviour of the circulating immune complex response could, at least partially, be attributed to differential complement-dependent clearance from the circulation. The implications of our findings for the laboratory diagnosis of auto-immunity at the blood level are being discussed. PMID- 3654011 TI - Immunogenicity of hapten-carrier conjugates associated with liposomes. AB - Immunogenicity of liposome-entrapped hapten-carrier conjugates was studied in guinea pigs. Animals immunized intravenously with a subimmunogenic dose of a hapten-carrier complex entrapped in liposomes exhibited cutaneous anaphylactic reactions to the hapten, even when the liposomes were treated with trypsin, but not delayed hypersensitivity (DH) reactions to the carrier. Animals immunized with a mixture of empty liposomes and antigen showed anaphylactic reactions to the hapten that appeared to be elicited by antigen adsorbed on the outer membrane of liposomes. The induction of anaphylaxis to the hapten by liposome-associated antigen was not due to an adjuvant property of liposomes. DH reactions to the carrier after injection of a liposome-entrapped subimmunogenic dose of a hapten carrier conjugate could be observed only after activation of macrophages by Bacillus Calmette-Guerin. PMID- 3654012 TI - Proliferation of Sertoli cells during development of the human testis assessed by stereological methods. AB - Sertoli cells were studied using stereological methods in testes obtained from five children who were stillborn, and 31 individuals between 3 months and 40 years of age, who had suffered from sudden, unexpected death. The mean nuclear volume of the Sertoli cells, the numerical density of Sertoli cells, and the total number of Sertoli cells per individual were determined by point- and profile-counting of 0.5 micron sections. The nuclear volume of Sertoli cells increased from a median of 120 microns3 (range 53-130) during the period of 3 months to 10 years to 210 microns3 (170-260) in adults (greater than 25 years). The numerical density of Sertoli cells decreased from a median of 1200 X 10(6)/cm3 (870-1400) during childhood (3 months to 10 years) to 140 X 10(6)/cm3 (110-260) in adults (greater than 25 years). The total number of Sertoli cells per individual increased significantly from a median of 260 X 10(6) (130-520) during the late foetal period to 1500 X 10(6) (850-2900) in individuals from 3 months to 10 years of age. A further increase was found during puberty as the number of Sertoli cells in adults (greater than 25 years) was 3700 X 10(6) (2500 5600). These results indicate that significant qualitative and quantitative changes in the population of Sertoli cells take place after birth. PMID- 3654013 TI - Salivary testosterone levels in infertile men. AB - Salivary testosterone levels were measured in 18 normal men, 29 oligospermic and six azoospermic subjects, using a specific and sensitive radioimmunoassay (RIA). There was a significant reduction (P less than 0.001) in salivary testosterone levels in the group of oligospermic (0.266 +/- 0.086 nmol/l) and azoospermic (0.234 +/- 0.055 nmol/l) subjects when compared with controls (0.348 +/- 0.070 nmol/l). A good correlation was found between salivary and plasma testosterone levels in normal (r = 0.62, P less than 0.01) and infertile men (r = 0.58, P less than 0.01). This study demonstrates that salivary testosterone levels, a non invasive means of sample collection, may be used for evaluation of androgen status in male infertility. PMID- 3654014 TI - Enhancement of Leydig cell testosterone secretion by isolated seminiferous tubules during co-perifusion in vitro: comparison with static co-culture systems. AB - The aim of this study was to identify an in-vitro test system for the reproducible demonstration of a modulatory effect of isolated seminiferous tubules (s-tubules) on testosterone production by purified rat Leydig cells. Co incubation of s-tubules with various numbers of Leydig cells had no significant effect on basal and hCG-stimulated testosterone production over 4-24 h incubation. In contrast, addition of s-tubule conditioned medium (STCM) to Leydig cells enhanced both basal and hCG-stimulated testosterone production over 5 h, but this effect was variable in magnitude and was not completely reproducible. Co perifusion of isolated s-tubules with Percoll-purified Leydig cells for 6 h produced significant and consistent increases in Leydig cell testosterone secretion compared with Leydig cells perifused on their own. In six experiments, s-tubules enhanced Leydig cell testosterone secretion by 26 +/- 5% (P less than 0.001) in the absence of LH stimulation and by 48 +/- 11% following pulsatile stimulation with 1 ng/ml ovine LH (oLH). The presence of s-tubules enhanced (P less than 0.01-0.001) testosterone secretion by Leydig cells in response to pulses of oLH at doses ranging from 0.1 to 10 ng/ml, but the magnitude of enhancement was greatest with 0.1 and 1 ng/ml doses. These stimulatory effects were not explained by Leydig cell contamination or by testosterone leakage from the isolated s-tubules. Co-perifusion of Leydig cells with isolated epididymal tubules as a control tissue had no significant effect on LH-stimulated Leydig cell testosterone production. Stimulatory effects of s-tubules on Leydig cell testosterone secretion were observed at a 'physiological' ratio of s-tubules to Leydig cells (200 cm tubules/3 million cells) and was mediated by a humoural agent(s), since perifusion of s-tubules and Leydig cells in series gave similar results to co-perifusion of these tissues. This system proved to be robust and, in contrast to static culture systems, gave highly reproducible results, which should allow detailed investigation of the dynamic interactions between s-tubules and Leydig cells and the hormonal control of these events. PMID- 3654015 TI - Comparative anti-fertility effects of gossypol enantiomers in male hamsters. AB - The enantiomers of gossypol have been tested as male oral anti-fertility agents in hamsters. As determined by fertility tests the (-) isomer was fully active at half the effective dose of the racemate, whereas the (+) isomer exerted no anti fertility effect. PMID- 3654016 TI - Continuous light environment has no effect on the circadian testosterone rhythm, spermatogenesis or fertility of the marmoset (Callithrix jacchus). AB - Maintenance of adult male marmosets in continuous light for 60 days had no effect on the circadian rhythmicity of plasma testosterone levels, spermatogenesis or fertility. The results indicate that photoperiodicity is not the environmental determinant that regulates reproduction in male marmosets. PMID- 3654017 TI - Advances in sensory devices for medicine. PMID- 3654018 TI - Quantitative analysis of mitogen-stimulated cellular proliferation: effect of concanavalin A and thymosin interaction. AB - Studies of mitogen stimulated lymphocyte proliferation have shown that considerable variation exists in the magnitude of response to specific mitogens. No standard method has been devised which would permit comparisons of the non linear proliferation response between groups. In this study a mathematical correlation between mitogen stimulation and cellular response is defined using concanavalin A as the mitogen. A logistic equation was derived by least sum of squares regression analysis. The dose response relationship of concanavalin A stimulated peripheral blood mononuclear cell proliferation was natural logarithmic. A computing program was designed to accomodate any calculation related to proliferation assays. The efficacy of this program and the adequacy of the equation were confirmed after they were tested in thymosin fraction 5 treated cellular proliferation experiments. This study demonstrates a quantitative method for the comparisons of immunological proliferation response among groups. PMID- 3654019 TI - Chronotopocardiography: a new method for presentation of orthogonal electrocardiograms and vectorcardiograms. AB - A mathematical model was developed to express and visualize signals from 3 orthogonal ECG (vectorcardiographic (VCG) leads as areas of activation on a spherical surface approximating to the walls of the cardiac ventricles, called the image surface. A computer program was compiled for presentation of orthogonal ECGs in the form of a series of instantaneous maps of cardiac activation, as well as chronotopocardiograms displaying the topography and the duration of activation on the image surface on two summary maps. PMID- 3654020 TI - On the dimension of the cortical EEG. AB - A correlation dimension was estimated for the EEG recorded from the rabbit's thalamus. The calculations carried out with use of two different algorithms led to equivocal results. The dominant, deterministic nature of the EEG was ascertained. PMID- 3654021 TI - A computer-aided three-dimensional reconstruction of brain structures using high level computer graphics. AB - This paper describes how line drawings and continuous tone shaded images of a three-dimensional solid model of a brain structure are generated using a powerful general purpose computer graphics package. The model is built from a series of serial sections. We developed a software interface to convert the data entered by a section oriented way into a brain structure oriented file. We point out particularly the modular approach which consists of separating the tasks on small microcomputers or on bigger machines according to their computing cost. An example of a thalamic structure in a stereotaxic referential is presented. PMID- 3654022 TI - Aortic and mitral balloon valvuloplasty: emergence of a new percutaneous technique. PMID- 3654023 TI - Surgical correction for one pulmonary artery arising from ascending aorta--report of five cases. AB - Over a 10-year period we encountered 5 infants with a pulmonary artery branch arising from ascending aorta. Surgical re-implantation of this vessel was carried out at ages 2.5, 5, 8, 9, and 19.5 months. Pre-operative cardiac catheterization demonstrated severely raised pulmonary artery pressures in all, equal to systemic in 3, and suprasystemic in 2. Four patients had origin of the right pulmonary artery from ascending aorta with a left aortic arch, and the remaining patient had an anomalous left pulmonary artery associated with a right-sided aortic arch. All patients had substantial reduction in pulmonary artery pressures immediately following surgery. One patient died 18 days post-operatively from extensive lung disease. In all 4 of the survivors, post-operative cardiac catheterization (11 to 85 months after surgery) has shown a drop in pulmonary artery pressures. One patient has been left with mildly elevated systolic values but normal diastolic levels. In 2 of the children, mild stenosis has been found at the site of reimplantation of the pulmonary artery. This anomaly should always be considered as a cause in the setting of a large left to right shunt with tricuspid incompetence and severe right ventricular hypertrophy. Prompt surgical repair, after confirmation of the diagnosis, should prevent death from heart failure or the development of irreversible pulmonary vascular disease. PMID- 3654024 TI - Continuous wave Doppler assessment of patients subjected to pulmonary balloon valvoplasty. AB - To evaluate the role of Doppler ultrasound in accurately quantitating patients with valvar pulmonary stenosis, we studied 30 patients (20 patients undergoing balloon pulmonary valvoplasty before and after the procedure, and 10 patients who had previously undergone pulmonary balloon valvoplasty) by Doppler echocardiography and cardiac catheterization. The peak systolic gradient was calculated by the two methods within 24 hours of each other. The maximal velocity of blood flow was obtained by non-imaging, continuous wave Doppler ultrasound examination performed from various parasternal and subcostal positions and the valve gradient was calculated using a modified Bernoulli's equation. Transpulmonary peak systolic gradient calculated by Doppler examination ranged from 9 to 159 mm Hg (mean 54.8 +/- 34.5 mm Hg) and correlated well with values obtained at cardiac catheterization (r = 0.94, P less than 0.001). Thus our study shows that accurate quantification of pulmonary valve stenosis can be reliably undertaken non-invasively utilizing Doppler echocardiography. PMID- 3654025 TI - Balloon valvoplasty in calcific aortic stenosis: a therapeutic alternative. AB - Percutaneous balloon valvoplasty was used to treat calcific aortic stenosis in 3 women aged 73, 67 and 61 years, respectively. We approached through the left brachial artery in the first case and the right femoral artery in the other two. An 18 mm balloon was used in all cases, the systolic gradient being reduced from 50, 180 and 48 to 7, 50 and 35 mm Hg, respectively. A mild and transitory systemic embolization was observed in one case. Aortic regurgitation was not present in two patients either before or after valvoplasty. In the other case, a grade 1/6 murmur indicative of regurgitation prior to the procedure increased to a grade 2/6 afterwards. A small and localized aortic dissection was present in one case but disappeared in the control angiography performed 11 days later. PMID- 3654026 TI - Quantitative study of the mitral valve in chronic rheumatic heart disease. AB - A quantitative study of the mitral valve and its tension apparatus was carried out in 54 cases of pure mitral stenosis, 13 cases of mitral stenosis with incompetence, both diseased groups due to rheumatism, and 25 normals. In the group with pure mitral stenosis, the annular size was unaltered but the annular attachment of the mural leaflet was decreased. The average circumference of the orifice was 27 mm. The leaflet length increased by 24%. In the group with mitral stenosis with incompetence, the annular size was increased by 18%. The average circumference of the orifice was 39 mm, but no significant increase in the length of the leaflets was found. The rough zone of the aortic leaflet in pure mitral stenosis is disproportionately increased, indicating greater apposition during closure. In pure mitral stenosis, the cords were severely affected as compared to combined lesion. They were totally absent in 18.5% of cases while this lesion was restricted to the aortic leaflet in 37%. The commissural, paracommissural and paramedial cords were not seen in 75, 60, and 72%. The main cords were not seen in 50% of cases. In the combined lesion, cords attached to the aortic leaflet only were absent in 7.69%. The commissural, paracommissural and paramedial cords were absent in 33, 39, and 23%, respectively. The main cords were absent in only 19%. The reduction in lengths of the cords is more marked in cases with pure stenosis. We conclude that the mitral valve is better preserved in the group having stenosis with incompetence, the incompetence being the result of a larger annulus and orifice with normal leaflets and shorter tendinous cords. In pure mitral stenosis, the incompetence through a small orifice is prevented by the longer leaflets, particularly the aortic. PMID- 3654027 TI - The pathology of balloon pulmonary valvoplasty. AB - The pulmonary valve was examined following balloon dilation of pulmonary valve stenosis in six children. Stenosis was due to commissural fusion in two. In these patients, cineangiography showed that the valve was slightly thickened and "domed" during systole. Balloon valvoplasty produced complete separation of fused commissures in one and partial separation in the other. Commissural splitting is likely to be the most common mechanism of relief of pulmonary stenosis by balloon dilation. Incomplete separation could account for the partial reduction of the gradient in most children treated with this technique. Four children had pulmonary valve dysplasia. Balloon valvoplasty did not produce haemodynamic improvement or morphological changes that were identifiable at the time of surgical correction. Tearing of pulmonary valve tissue and avulsion of pulmonary cusps were not seen in this series. PMID- 3654028 TI - The efficacy of isosorbide-5-mononitrate on effort-induced electrocardiographic ischemic changes in patients with angina pectoris. AB - The efficacy of isosorbide-5-mononitrate 40 mg twice a day was tested in 10 patients suffering from effort-induced angina pectoris. Patients were studied with ergometer testing 6 hours after drug administration on the first treatment day, and again 8 and 12 hours after medication at 3 weeks and 6 months of therapy. At comparable and maximal workloads the patients expressed significantly less ST segment depression on treatment than prior to treatment. No tolerance was observed. Isosorbide-5-mononitrate treatment was demonstrated to have a beneficial effect on exercise tolerance in patients suffering from stable angina in effort. PMID- 3654029 TI - Familial atrial myxomas. AB - This report describes atrial myxomas present in a mother and her daughter. The mother had biatrial tumors while that of the daughter was in the left atrium. We examined 48 relatives all of whom had normal hearts. PMID- 3654030 TI - Quinidine-induced torsade de pointes suppressed by paroxysmal atrial fibrillation. AB - A 74-year-old patient is presented in whom quinidine-induced torsade de pointes was abolished by the onset of atrial fibrillation with a fast ventricular response. Heart rate acceleration during atrial fibrillation shortened the Q-T interval from 0.68 on admission to 0.44 milliseconds when sinus rhythm was re established. This resulted in the suppression of paroxysms of polymorphous ventricular tachycardia. PMID- 3654031 TI - Inverse relationship of religious orthodoxy and myocardial infarct in Jerusalem: related to water immersion? PMID- 3654032 TI - Drug interaction for plasma protein binding: physostigmine and other drugs. AB - Physostigmine (Phy) has gained prominence recently because of its use in the treatment of Alzheimer's disease and also as a prophylactic agent in the treatment of organophosphate intoxication. Since Alzheimer's disease is usually confined to the older population, the patients generally receive more than one medication. The present study examined whether Phy is displaced from the plasma protein binding site in vitro by a number of commonly prescribed drugs used in this patient population, using therapeutic range of blood levels. The binding of Phy to plasma proteins decreased in the presence of quinidine (3-15 micrograms/ml), from 45.5-5.3%, furosemide (1-100 micrograms/ml) from 45.5-28.4%, acetaminophen (10-160 micrograms/ml) 48.8-37.9%, theophylline (6.67-80 micrograms/ml) 52.2-43.7%, verapamil (0.1-0.5 micrograms/ml) 44.8-34.9%. However, imipramine (0.05-0.2 micrograms/ml), chlorpromazine (0.1-2 micrograms/ml) and propranolol (0.02-0.04 micrograms/ml) did not affect the binding of Phy irrespective of whether the plasma samples were preincubated with Phy or not. The binding of Phy to alpha 1-acid glycoprotein (50 mg/dl), gamma-globulin (1.3 mg/dl) and low density lipoprotein (0.83 mg/ml) was very small (less than 15%), contributing to about one-third of the total plasma protein binding. It appears that the binding of Phy to human plasma proteins was altered to a significant degree in the presence of quinidine, furosemide, acetaminophen, theophylline and verapamil. Free fraction of Phy in plasma has increased which could lead to greater toxicity of Phy. PMID- 3654033 TI - Distribution of methotrexate in human blood in vitro: independence of temperature, pH and drug concentration. AB - Distribution of methotrexate (MTX) in blood samples from a single donor as a function of incubation time, temperature, pH and drug concentration was investigated. Equilibrium, as expressed by the cell/plasma (C/P) partition ratio, was reached rapidly and was constant for 5 to 30 min following incubation. The C/P ratio was unaffected by temperature variations in the 4 to 37 degrees C range, pH variations from 7.06 to 7.82 and varying drug concentrations from 5 X 10(-5) M to 5 X 10(-10) M. Contradicting an earlier investigation, this implies that MTX can be monitored in plasma or serum samples without undue worries about hitherto unexplained and unusual distribution kinetics for this drug in blood. PMID- 3654034 TI - Cimetropium bromide, a new antispasmodic agent, has no hemolytic effects in humans. AB - Many agents have been reported to cause hemolytic anemia in glucose-6-phosphate dehydrogenase (G6PD) deficient subjects. We investigated whether cimetropium bromide, a new antispasmodic drug, can be safely given to these patients. In the first study, ten healthy volunteers were given 50 mg, p.o. 3 times per day, before meals for 1 week. Blood samples were drawn before and after treatment and stimulation of the hexose monophosphate shunt (HMS) was evaluated. No significant stimulation of HMS was observed. In a second study, 12 G6PD-deficient patients with spastic colon were given cimetropium bromide and placebo according to a double blind, cross-over design. None of the patients showed any significant abnormalities in any of the several hematologic parameters tested. PMID- 3654035 TI - What biological specimen should be used for therapeutic cyclosporine monitoring? PMID- 3654037 TI - Acne keloidalis nuchae. A transepithelial elimination disorder. AB - In four cases of acne keloidalis nuchae, varying stages of transepithelial elimination were observed histologically, suggesting that acne keloidalis represents a transepithelial elimination disorder akin to perforating folliculitis. PMID- 3654036 TI - Erythema nodosum leprosum. PMID- 3654038 TI - Congenital smooth-muscle hamartoma. AB - Congenital smooth-muscle hamartomas are rare, benign tumors of the skin. Since their original description in 1969, 16 case reports have appeared in the literature, with 7 cases reported within the last year. We describe the 17th patient with this lesion and have included a review of the literature. In addition, we describe three morphologic types of smooth muscle cells-the pale cells, dark cells, and intermediate cells-found on electron microscopy, and the features that support our belief that these may reflect different stages of maturity of the smooth-muscle cells. In addition to the smooth muscle, bundles of nerve fibers (both unmyelinated and myelinated) appear to be an intrinsic part of the lesion, as are the prominent vellus hairs. Congenital smooth muscle hamartoma thus appears to be an organoid nevus. PMID- 3654039 TI - Human tattoo. Electron microscopic assessment of epidermis, epidermal-dermal junction, and dermis. AB - Ultrathin serial sections of human biopsy specimens, taken at 24 hours, 1 month, and 1, 3, and 40 years post-tattooing were examined under the electron microscope. The ink particles found in cells were measured and compared with control ink particles embedded in agar. Freshly tattooed skin showed an inflammatory reaction followed by ultrastructural necrosis. The time of healing, about 1 month from introduction of ink to complete healing, has been divided into three phases: inflammatory reaction and necrosis, formation of basement membrane, and normal epidermis and dermis. Once the skin showed normal ultrastructure, ink particles were found only in dermal fibroblasts. PMID- 3654040 TI - Basal cell epithelioma arising in a patient with Hailey-Hailey's disease. PMID- 3654041 TI - Annular elastolytic giant-cell granuloma. PMID- 3654043 TI - Crusted scabies in a diabetic alcoholic. PMID- 3654042 TI - Development of epidermal cysts following chronic dermabrasion. PMID- 3654044 TI - Headaches. Evaluation and therapy. AB - We have found that patients with chronic ongoing headaches can be treated effectively. The judicious use of an appropriate prophylactic medication combined with counseling, biofeedback and relaxation therapy, physical therapy, and/or stress management can result in the amelioration of the problem in many headache sufferers. PMID- 3654046 TI - Treatment of female androgenic alopecia with cimetidine. PMID- 3654045 TI - Minoxidil and tail-like effect. PMID- 3654047 TI - Expression of liver fluke antigens by mouse cells. PMID- 3654048 TI - The life cycle of Dollfusinus frontalis, a brachylaimid trematode of small mammals (Insectivora and Rodentia). PMID- 3654049 TI - The humoral immune response of sheep to antigens from larvae of the sheep blowfly (Lucilia cuprina). PMID- 3654050 TI - Ultrastructure of secretory cells in the gut of the cattle-tick Boophilus microplus. PMID- 3654051 TI - Ovine coccidiosis: pathology of Eimeria ovinoidalis infection. PMID- 3654052 TI - Ovine coccidiosis: observations on "oocyst patches" and polyps in naturally acquired infections. PMID- 3654053 TI - Sensory receptors of the miracidium of Gigantocotyle explanatum (Trematoda:Paramphistomidae). PMID- 3654054 TI - Ultrastructural and histochemical observations on the foregut and gut caeca of Gigantocotyle explanatum, Gastrothylax crumenifer and Srivastavaia indica (Trematoda:Paramphistomidae). PMID- 3654055 TI - Ultrastructural and cytochemical observations on the tegument of three species of paramphistomes (Platyhelminthes:Digenea) from the Indian water buffalo, Bubalus bubalis. PMID- 3654056 TI - Ultrastructural and cytochemical studies on the ventral pouch of Gastrothylax crumenifer (Digenea:Paramphistomidae). PMID- 3654057 TI - The developmental antigens of Nematospiroides dubius. PMID- 3654058 TI - Electron microscopy of three cases of choroid malignant melanomas. AB - Ultrastructural study, by Scanning and Transmission Electron Microscopy, of three choroidal melanomas allows us to depict main features and cellular types of melanomas and to discuss our results with precedent studies. One case of balloon cell tumor shows an unusual (from unknown genesis) substance, intra- or extracellularly located, but always near pigment cells expansions. PMID- 3654059 TI - The effect of diet on the ophthalmological, clinical and biochemical aspects of Richner-Hanhart syndrome: a morphological ultrastructural study of the cornea and the conjunctiva. AB - Type II tyrosinemia (Richner-Hanhart syndrome) is a familial aminoacid disorder, clinically characterized by ocular changes (keratitis), palmo-plantar hyperkeratosis, no constant mental changes with mental deterioration, abnormal urinary excretion and high serum tyrosine level in consequence of the absence of tyrosine-aminotransferase. Almost 20 families have been described in the literature of which 50% are of Italian origin, suggesting that this disorder is particularly frequent in our country. We report a family with 2 affected members with typical clinical and biochemical findings (keratitis, palmo-plantar hyperkeratosis, abnormal urinary and serum tyrosine concentrations), not suffering from mental retardation. Clinical symptoms completely disappeared after the decrease of urinary and serum tyrosine levels following a tyrosine- and phenylalanine-free diet. These cases are compared with those reported in literature, and the usefulness of diet for the improvement of clinical and metabolic symptoms is discussed. PMID- 3654060 TI - The Nd:YAG laser 1.3 u wavelength: in vitro effects on ocular structures. AB - We evaluated the in vitro effects of the 1.3 u wavelength of a Nd:YAG laser using a fiberoptic delivery system, with or without sapphire tips on ocular tissue. Conjunctival and retinal adhesions were achieved best with a noncontact technique compared with a contact method. PMID- 3654062 TI - Vasculitis in acute streptococcal glomerulonephritis. AB - Four children are described with a severe acute streptococcal glomerulonephritis. Olyguria, long term renal failure, arterial hypertension, nephrotic syndrome, unconsciousness, marked anemia, abdominal pain and gastrointestinal bleeding were the most prominent findings. The renal biopsy revealed a diffuse endocapillary glomerulonephritis with crescents and vasculitis. One patient had demonstrated multiorgan vasculitis. The patients were managed by conventional methods, three of them received anticoagulants of whom, two association of prednisolone cyclophosphamide. All recovered. PMID- 3654061 TI - Effects of an erbium: YAG laser on ocular structures. AB - We evaluated the effects of the erbium:YAG laser (2.9 micron wavelength) on ocular structures. Energy was successfully transmitted through a fiberoptic bundle for intraocular and extraocular applications. The wavelength was strongly absorbed by ocular tissues, producing ablations with minimal thermal damage. Our results indicated that the erbium:YAG laser may have potential uses as a photoablative tool to reshape the corneal surface and as a surgical knife. PMID- 3654063 TI - Continuous arteriovenous hemofiltration in infants. AB - Renal replacement therapy is sometimes necessary in small infants with acute renal failure or severe metabolic disorders. Of the available methods hemodialysis and peritoneal dialysis are not always feasible in small infants. We used continuous arteriovenous hemofiltration as renal replacement therapy in five small infants. This report describes the technique and efficiency of this new extracorporal treatment modality. Azotemia and hypervolemia can be controlled easily by spontaneous or suction supported arteriovenous hemofiltration. Furthermore it allows adequate parenteral nutrition in anuric infants and eliminates toxic products in amino acid disorders. Arteriovenous hemofiltration is well tolerated by small infants and can be performed in every pediatric intensive care unit. PMID- 3654064 TI - Gram-negative septicemia caused by providencia stuartii. AB - The role of urologic disease and manipulation of the genito-urinary tract in the pathogenesis of gram-negative bacteremia has been long recognized. Among these organisms, species of providencia genus have been increasingly reported. We describe a 17-year-old male paraplegic who developed septic shock due to Providencia Stuartii following urinary tract manipulation and responding to medical therapy. This is unusual as most cases with septic shock from providencia species will succumb. It is important to review this case since providencia species appear to be increasingly common in paraplegic patients. PMID- 3654065 TI - The effect of the gradient of vascular permeability on fluid and plasma protein exchange in the mesenteric microcirculation. AB - The present work is a theoretical analysis of the intramural and transmural flows of fluid and plasma proteins. The transvascular fluxes are treated on the basis of a phenomenological approach resulting from the irreversible thermodynamics. The concept leads to a generalization of the well known Starling equation for the fluid exchange and to an additional equation which accounts for the exchange of plasma proteins. The key element in the theory is the incorporation of axial variations of the vascular permeability in the model. Numerical results are obtained for the cat mesentery taking into account the particular angioarchitecture of that tissue. The strength of the present model lies in the precise localization of the transvascular fluxes which results from the differential treatment of the fluid dynamic and mass transfer problem. The results confirm vital microscopic findings of various authors that fluid filtration and the plasma exchange occur predominantly on the arteriolar and venular side of the microcirculatory bed. In contrast, the exchange in the capillaries is relatively small regardless of the actual value of the gradient of permeability. In the organ specific situation studied, the transvascular fluxes are directed outward everywhere to the tissue. The general effect of the vascular gradient of permeability is to enhance the local transvascular fluxes on the venous side. PMID- 3654066 TI - Cessation and onset of muscle capillary flow at simultaneously reduced perfusion and transmural pressure. AB - The effect of simultaneously reduced perfusion and transmural pressure on muscle capillary flow was investigated in the tensor plagiopatagii muscle of unanesthetized bats. Perfusion and transmural pressure were simultaneously changed by suction applied to a sealed box containing the body of the bat, while the wing with the muscle under observation outside the box was exposed to atmospheric pressure. Flow ceased in almost all of the muscle capillaries at box pressures ranging from -46 to -96 mmHg (n = 40; median value: -66 mmHg). When flow in the muscle had ceased, flow was still present at a reduced level in capillaries on top of the muscle and in the web. No signs of obstruction to flow in the feeding or collecting vessels were found. The results are not in accordance with the phenomena causing cessation of flow as predicted by the theories of critical closure or interfacial tension. To restore flow in the muscle capillaries suction to the box had to be reduced by 14 mmHg (medium value; range 4 to 35 mmHg). The latter data conforms to the possible existence of yield stress in small vessels. PMID- 3654067 TI - Effects of changes in systemic hematocrit on the microcirculation in rat cremaster muscle. AB - This work aimed to establish how changes in systemic hematocrit ranging from 0.33 to 0.55, affect capillary red cell velocity (measured by the dual-slit correlator method), capillary volume flow, capillary density and arteriolar diameter. These microcirculatory parameters were determined on rat cremaster muscles surgically prepared for in vivo visualization and bathed with a modified Krebs-Henseleit solution. A significant rise in mean red cell velocity and mean volume flow rate in capillaries was found after hemodilution, and a significant drop after hemoconcentration. A large reduction in the number of capillaries with low flow rate was shown after hemodilution; an opposite effect was found after hemoconcentration. The number of capillaries containing erythrocytes did not change significantly in either state. However after hemoconcentration, the number of capillaries containing stationary erythrocytes was significantly larger. Arteriolar diameter did not alter significantly after either hemodilution or hemoconcentration. We conclude that, in the cremaster muscle, hematocrit is an important rheological factor that determines capillary flows without involving arteriolar regulation. PMID- 3654068 TI - A quantitative study of the exchange microvasculature of muscles from the human foot and hand. AB - In this study, transmission electron microscopy has been used to make a quantitative assessment of the exchange surface area of the microvessels of skeletal muscle from the human foot and hand. The numbers of capillaries per unit area of skeletal muscle were found to be similar in the foot (47.9 X 10(3) SEM +/ 7.5 X 10(3) cm-2) and the hand (49.3 X 10(3) SEM +/- 9.0 X 10(3) cm-2). However, the capillaries of the foot appeared significantly larger than those of the hand, having a mean diameter of 5.4 +/- 0.1 microns compared with 4.4 +/- 0.2 microns in the hand. Measurement of total capillary exchange surface area (SA) from low power (X 3000) electron micrographs of muscle samples from 11 subjects gave values of SA of 93.9 +/- 5.9 cm2/g tissue (n = 5) in the foot and 83.8 +/- 5.4 cm2/g tissue in the hand (n = 6). High power electron micrographs (X 21,600) of individual vessels showed the walls of the capillaries of the feet to be significantly thicker than those of the hand. The increase in wall thickness was mainly due to a 40% increase in the width of the basement membrane, which had a mean width of 221 +/- 16 nm in the hand and 312 +/- 34 nm in the foot. PMID- 3654069 TI - Analysis of microvascular network in bulbar conjunctiva by image processing. AB - A digital image processing procedure has been developed for obtaining quantitative morphometric data on the microcirculatory network in the human bulbar conjunctiva. Highlights of this semi-automated approach include: 1. extraction of morphometric information that cannot be readily obtained by manual methods--length, diameter, and diffusion distributions; 2. speed and consistency in data generation--only 10 minutes are required to scan and to analyze 6.7 mm2 of conjunctiva microvasculature. The variation was less than 5% when images of the same area in the same eye were subjected to analysis at different times; 3. avoid the human bias factor--the data obtained by repeated analysis of the same negative varied by less than 0.02%. PMID- 3654070 TI - Macromolecular permeability increase following incomplete ischemia in the hamster cheek pouch and its inhibition by terbutaline. AB - The microvascular permeability increase during the reperfusion after incomplete ischemia in the everted hamster cheek pouch preparation was measured by intravital microscopy. FITC-dextran 1500,000 was given i.v. as tracer of macromolecular leakage. Incomplete ischemia of the left cheek pouch was obtained by occlusion of the ipsilateral carotid artery, its external branch and the contralateral external carotid artery. Reperfusion after thirty minutes of incomplete ischemia resulted in a fully reversible increase in the number of FITC dextran leakage sites (leaks) from 0 to 68 +/- 18 in 7 hamsters. The response to a second period of ischemia, starting one hour after the first ischemia period, was significantly smaller (9 +/- 5 leaks). Local treatment with terbutaline (10( 6) M), a beta 2-receptor agonist, abolished the permeability response to ischemia almost completely (0.5 +/- 0.3 leaks, n = 6). Local application of histamine (2 X 10(-6) M) at the end of the experiments gave a response that was in accordance with that seen in hamsters not subjected to ischemia. These results were compared with those obtained from previous studies in our laboratory with a complete ischemia model and it appears as these two methods, incomplete and complete ischemia, give similar results. PMID- 3654072 TI - Abstracts presented at the annual meeting of the British Microcirculation Society, London, U.K., April 2-3, 1987. PMID- 3654071 TI - Vital microscopic studies on the capillary distribution of leukocytes in the rat cremaster muscle. AB - Leukocyte capillary distribution was studied with vital fluorescence microscopy in the rat cremaster muscle. Ten terminal arterioles, each in a different animal, with 2 to 7 capillaries and with a total leukocyte flux ranging from 97 to 571 cells, were analysed. Nonparametric statistics was used for the analyses of the experimental data. In order to characterize the pathways for leukocyte flux in the networks, the leukocyte concentration for each capillary was calculated in relation to the network inflow leukocyte concentration and to the bifurcation inflow leukocyte concentration. The study shows a strong positive correlation between the relative capillary leukocyte concentration and the capillary volume flow and the position of the capillary in the network, respectively. There was no correlation between the relative capillary leukocyte concentration and capillary branching angle. A relative leukocyte concentration above unity, indicating an enrichment of leukocytes, was found in capillaries with a high volume flow and in capillaries located at the downstream end of the arterioles. In addition, the analyses show a very strong correlation between capillary volume flow and the position of the capillary along the arteriole, the capillaries located at the downstream end having the highest volume flows. In conclusion, the present study provides evidence for the existence of volume flow dependent preferential pathways for leukocyte passage across the capillary network in the rat cremaster muscle. PMID- 3654073 TI - Adaptation, stimulus color, and the human electroretinogram. AB - (1) The human electroretinogram was recorded using two procedures that were designed to change the ratio of photopic to scotopic activity. (2) With the first procedure, responses were recorded with patterns that alternated with an asymmetrical time period to produce two average responses, one of which was more adapted than the other. (3) The second employed symmetrical alternation, but red and blue stimulation were used. (4) The electroretinogram was larger in responses to patterns of low spatial frequency for all conditions. The evoked potential, which was recorded simultaneously, was larger at intermediate frequencies. (5) The electroretinogram must be mediated before the antagonistic receptive field organization. (6) Sensitivity of electroretinogram with blue stimuli was higher than those with red at low spatial frequency. The possible scotopic contribution was discussed. PMID- 3654074 TI - Auditory P3 correlates of phonemic and semantic processing. AB - Auditory evoked potentials were recorded in twelve healthy subjects using phonemic and semantic word tasks. The late positive component (P3), analogous to tonal P300, varied as a function of cognitive task with increased latency and amplitude associated with semantic processing. These data are consistent with levels of processing theories in which semantic analysis is associated with a greater elaboration of stimulus evaluation. PMID- 3654075 TI - Topography of human intelligence across race: factorial comparison of black-white WAIS-R profiles for criminal offenders. AB - Comparison of intellectual functioning across racial groups is an important scientific issue with broad interdisciplinary implications. A large random sample (N = 275) of Black and White incarcerated individuals were studied to evaluate the topography of intelligence across race. Principal factor analyses yielded the general intelligence-g factor along with specific Verbal Comprehension and Perceptual Organization dimensions. All three of these structural components were highly congruent between Whites and Blacks. Theoretical implications of these data include: (1) evidence of qualitatively equivalent intellectual functioning across race, (2) justification of a verbal-performance dichotomy of adult intelligence across racial groups, and (3) support for construct validity of adult intellectual assessment across race. PMID- 3654076 TI - Allometry and asymmetry in the dog brain: the right hemisphere is heavier regardless of paw preference. AB - The allometric relationship between brain and body size and asymmetry in the weight of the cerebral hemispheres were studied in dogs. A regression analysis of the brain versus body weight revealed an allometric relationship according to the power function Y = kXa. The right cerebral hemisphere was found to be significantly heavier than the left. This finding was not associated with paw preference. In accordance with previous studies, it was concluded that the right biased asymmetry in the weight of the cerebral hemispheres may be a common feature of the mammalian brain. Functional implications of the results were discussed with regard to the right hemisphere specializations. PMID- 3654077 TI - Developmental versus individual differences in the ability of the hemispheres to operate independently. AB - We have claimed that the ability to use the two cerebral hemispheres independently improves during early adolescence: Adults benefited from division of conflicting tasks between the hemispheres (Liederman & Meehan, in press; Merola & Liederman, 1987), whereas 10-year-old children did not (Merola & Liederman, 1985). The current research was undertaken to rule out the possibility that differences in the degree of hemispheric independence between adults and children were due to: (a) differences in overall performance or (b) differences in cognitive ability. The performance of ten adults was reduced to that of the 10 year-olds (by inserting a visual mask between trials). Nonetheless, 90% of the adults showed hemispheric independence, whereas only 50% of the children did. In addition, when high scholastic aptitude children were compared to adults, the difference in hemispheric independence remained. A causal model indicated that age and scholastic aptitude have unique effects upon hemispheric independence. Thus, there are both developmental and individual differences in the degree of hemispheric independence. PMID- 3654078 TI - A comparative factor analysis of the WISC-R by sex and age with learning disabled children. AB - WISC-R data were factor analyzed for a sample of 980 learning disabled subjects aged 9 through 14. Separate analyses were conducted for the total sample, males only, females only, and age-level groupings. The three-factor solution (Verbal Comprehension, Perceptual Organization, and Freedom from Distractibility), previously identified in normal samples, was found to be appropriate for the learning disabled subjects in the present study for the total sample and the sex and age groupings. The Verbal Comprehension factor emerged as the most robust followed by Perceptual Organization and Freedom from Distractibility. PMID- 3654079 TI - Relationship between cognitive and morphological asymmetry in dementia of the Alzheimer type: a CT scan study. AB - In this study we investigated the association between morphological asymmetry and patterns of cognitive ability in dementia of Alzheimer's type (DAT). Digitized CT scans were used to estimate volumetric parameters of the brain. The volume of the cranium, brain parenchyma, the subarachnoid space, and lateral ventricles was computed. The volume of the subarachnoid space was used as an index of cortical atrophy, while the ventricular volume served as an estimate of subcortical atrophy. Asymmetry indices were computed for all structures as the difference between left and right volume divided by their average and multiplied by 100. Cognitive asymmetry index was computed by dividing the difference between VIQ and PIQ of the Wechsler Adult Intelligence Scale (WAIS) by their average and multiplying by 100. After statistically controlling for cranial asymmetry, hemispheric asymmetry was found to correlate positively with cognitive asymmetry. The correlation was somewhat greater for male than for female patients. Asymmetry of both cortical and subcortical atrophy correlated negatively with cognitive asymmetry. PMID- 3654080 TI - L-dopa in uremic patients with the restless legs syndrome. AB - Restless legs syndrome (RLS) is a poorly understood, often distressing condition that is particularly prevalent among patients with chronic renal failure. A wide variety of medications have been used to treat RLS with variable results. In order to evaluate the efficacy of carbidopa/levodopa therapy, eight consecutive uremic patients with RLS on maintenance hemodialysis were treated with doses ranging from 25/100 to 25/250 twice daily. Six of eight patients obtained satisfactory relief which has continued for 3 months follow-up. Carbidopa levodopa appears to be an effective opinion in management of RLS in patients with chronic rental failure. PMID- 3654081 TI - Chronic autonomic failure and the endogenous opioid system. PMID- 3654082 TI - Phenelzine in migraine headaches. PMID- 3654083 TI - Denying behavior: throwing experience out. AB - A recent paper (Skarda, 1986) from a distinguished laboratory of experimental neurophysiology denies the classical concept of neural representation. According to this essay, which is itself a critique of a basic neuroscientific assumption as implied in a new book about the mind-brain problem, it is wrong to suppose that patterns of neural activity represent anything. Representations should be replaced by "self-organizing neural processes that achieve a certain end-state of interaction between the organism and its environment in a flexible and adaptive manner." Although this alternative wording is neither surprising nor radical, and would prove acceptable to most biologists as an adequate description of one important aspect of organized cellular activity, its author's dogmatic denial of "representation" as a metaphor for other important aspects of living behavior seems both surprising and unnecessary. PMID- 3654084 TI - Cerebral cysticercosis presenting as progressive dementia. AB - Cysticercosis is a parasitic infestation that commonly affects the central nervous system. This is a report of an elderly man who presented with progressive dementia, labelled as Alzheimer's in whom diffuse cerebral cysticercosis was subsequently demonstrated. The dementia responded favorably to treatment with steroids and mebendazole. This report demonstrates the importance of excluding cerebral cysticercosis as a treatable cause of progressive dementia. PMID- 3654085 TI - Kepinski's information metabolism, Carnot's principle and information theory. AB - The generalized Carnot principle introduced by Brillouin provides a link between negentropy and information, but does not take into account the information stored in the brain, which is clearly excluded by the author. Further step in the generalization of Carnot's principle, which includes information turnover in the brain was accomplished by Kepinski in his theory of the metabolism of energy and information. According to Schrodinger, life processes require a supply of negentropy rather than energy stored in the food, more precisely, e.g., in glucose utilized by the brain, since energy is conserved, whereas negentropy is dissipated. The information (communication) channel transmits maximum information when the band width of the transmitted frequency is limited, and much less information when the restriction concerns the transmitted power, or energy. This can explain a considerable decrease in the information metabolism observed in depressive patients, whose life dynamics and, consequently, the amount of energy available for information metabolism is severly lowered. Thus, the fall in information metabolism is more pronounced in depression than in not too late phases of schizophrenia. As appears from Fonberg's studies the amygdaloid nucleus is responsible for the life dynamics. In different types of neuron code change is a significant parameter, which was so strongly stressed by Kepinski. Other problems discussed in the paper include: selection of information and its structural localization, localization of particular phases of information metabolism and their phylogenetic significance. PMID- 3654086 TI - Kepinski's functional structures, Kohonen's topological structures, aphasia and apraxia. AB - The concept of functional structures was introduced by Kepinski. At the Second Scandinavian Congress on Image Analysis in 1981 Kohonen provided evidence that the map of signals has the same topological order as the map of reactions. These topological concepts can be applied also to logical structures. The same is true also of functional structures described by Kepinski in schizophrenia, which may be created or destroyed, but their topological order remains unaltered. Functional structures change in obscuration and in hallucinogen-induced psychodelic states. Fixed pathological structures characterized by an altered topological order occur in paranoia. In the case of amnestic aphasia single elements of the topological functional structures fall out-these elements represent terms which patient is unable to recall. In motor aphasia, on the other hand, damage concerns the topological functional structures of speech related movements. In sensory aphasia damage concerns topological functional structures in the sensory area. In Goldstein's amnestic apraxia there is a loss of some elements of the topological functional structures governing the movements. In ideational apraxia the damage concerns topological functional structures representing entire sets of motor function and especially their creation. In ideomotor apraxia the respective topological functional structures are retained, albeit inaccessible, due to a disturbance in the motor association. In motor apraxia the damage seems to concern the topological functional structures governing precise movements and located at a lower level, i.e., closer to the effector. Constructive apraxia seems to result from the disturbed creation of the respective functional structures. Similarly the hypermotility of a maniacal type has a smooth and purposeful character, as far as the relation to a particular situation is concerned, which suggests that the respective topological functional structures are preserved. On the other hand, in the hyperkinetic phase of catatonic schizophrenia, in which the patient performs sequences of incoherent aimless movements without any relation to the current situation and environment, these structures are supposedly altered. PMID- 3654087 TI - The opioid system and the reversibility of the dementia in normal pressure hydrocephalus. PMID- 3654088 TI - Handedness and psychophysics: weight and roughness. AB - A sample of 20 men (10 right-handed, 10 left-handed) was selected. Using the method of constant stimuli, the number of correct responses and the differential threshold for weight and roughness for both hands, were studied. The findings were: (1) In the weight test, the number of correct responses was greater and the differential threshold lower in the right-handed than in the left-handed subjects, and the preferred hand was superior to the nonpreferred hand for both groups; (2) In the roughness test, the number of correct responses was greater and the differential threshold lower for the nonpreferred hand. Implications of these findings with regard to our present knowledge of handedness organization are analyzed. PMID- 3654089 TI - Cerebral blood flow evidence of right frontal activation in attention demanding tasks. AB - Having noticed a consistent activation of right frontal areas during several visuospatial tasks, we retrospectively examined data from 121 regional cerebral blood flow (rCBF) studies conducted under a variety of conditions involving different stimuli, response modes and task requirements. These were compared to scans conducted while subjects were at rest. Significant hemispheric differences were found for all tasks combined in the frontal regions, where right flow was greater than left, especially in more demanding tasks. This finding suggests a very general role for the right hemisphere in attention or vigilance. PMID- 3654090 TI - Low level lead exposure and neuropsychological functioning in blue collar males. AB - To examine the interrelationships between normal aging, occupational lead exposure, and cognitive functioning, a comprehensive battery of neuropsychological tests was administered to 288 randomly-selected lead-exposed workers and 181 demographically-similar nonexposed controls. Contrary to previous reports, those workers with current blood-lead levels in the low to moderate range (less than 50 micrograms/dl) were found to perform as well as controls on measures of learning, memory, attention, visuospatial ability, and general intelligence. They differed from controls only on one measure of psychomotor speed and manual dexterity, the Grooved Pegboard Test, and these between-group differences were restricted to the older lead workers. It is likely that these results are secondary to lead-mediated neuromuscular damage. There is little support for the view that older adults with current blood lead levels in the low to moderate range are at risk for developing significant CNS dysfunction, even though they may have had a past history of excessively high blood lead levels. PMID- 3654091 TI - Patterns of interhemispheric correlation during human communication. AB - Correlation patterns between the electroencephalographic activity of both hemispheres in adult subjects were obtained. The morphology of these patterns for one subject was compared with another subject's patterns during control situations without communication, and during sessions in which direct communication was stimulated. Neither verbalization nor visual or physical contact are necessary for direct communication to occur. The interhemispheric correlation patterns for each subject were observed to become similar during the communication sessions as compared to the control situations. These effects are not due to nonspecific factors such as habituation or fatigue. The results support the syntergic theory proposed by one of the authors (Grinberg Zylberbaum). PMID- 3654092 TI - The programming and execution of movement sequences in Parkinson's disease. AB - Parkinsonian and neurologically normal subjects performed a finger-tapping task in which different sequence lengths had to be executed as rapidly as possible. For each response sequence, reaction time (RT), inter-tap-intervals (ITIs) and error patterns were recorded. It was found that the RT-sequence length relationship as well as the group ITI data were different for the two groups, indicative of impaired programming in the Parkinsonian subjects. This conclusion was supported by a relative dissociation of the first and subsequent taps and by a pattern of progressively increasing errors with longer tap sequences in the Parkinsonians. PMID- 3654093 TI - Inducing comprehension in the bilateral poor reader. AB - The comprehension effects of changes in the spatial configuration of prose were examined with reading disabled children who differed in laterality preference. Specifically, 24 learning disabled boys were presented with prose materials in a standard, phrased, and backward (right to left) fashion. Measures of comprehension showed that text in the phrased and backward conditions differentially facilitated comprehension for the more bilateral subjects but had little effect on more right lateralized subjects. The results were discussed in terms of the instructional implications of alterations in the visual-spatial arrangement of prose materials for bilateral readers. PMID- 3654094 TI - Endogenous potentials evoked in simple cognitive tasks: scalp topography. AB - The scalp topography of endogeneous potentials was studied during a series of simple cognitive tasks in the auditory modality. P3 and Slow Wave showed the expected task correlates of being larger to rare than to frequent tones, and larger when attended than ignored, but N2 was not clearly measurable due to overlap with P2 and P3. Overall, across all task conditions, P3 was larger at sites over the right hemisphere than the left, particularly for sites near the midline (F3, F4, C3, C4, P3, P4). P3 was present (though smaller) to rare omitted stimuli in a tone series, as well as to tones presented at long, random intervals (3 to 9 s) in a simple counting task. P3 was very large to novel, unique, nontarget auditory stimuli, and had a somewhat different distribution to these stimuli than to targets, suggesting a difference in the underlying intracranial generators. Except for these novel nontarget sounds, P3 showed a consistent topography across tasks in spite of differences in amplitude. PMID- 3654095 TI - The career paths of nursing graduates from Chelsea College, University of London. AB - This study aimed to identify the career paths and future career plans of nursing graduates from Chelsea College, University of London. Self-completion questionnaires were sent to the 1981, 1982 and 1983 graduates (N = 54). Employment patterns immediately after and 1, 2 and 3 yr after graduation are described. Most graduates selected careers in nursing, up to 3 yr after graduation. Hospital based clinical posts were most popular and many undertook further clinical courses. The long- and short-term career plans of graduates employed as nurses and those no longer nursing are described. Most graduates indicated that they intended to remain in nursing in the long term. PMID- 3654096 TI - Maternity nurses: how parents see us. PMID- 3654097 TI - Graduate nurses in Northern Ireland: their career paths, aspirations and problems. AB - This paper is based on a survey of graduates from the B.Sc. in Nursing studies at the New University of Ulster (now the University of Ulster). Six cohorts, those entering between 1975 and 1980, were sent a postal questionnaire. The results cover the careers of these graduates and also describe their problems and their aspirations. The findings confirm those of other studies in relation to the clinical orientation of graduate nurses. Some respondents had positive views about graduate status, others had experienced prejudice and even hostility. Most respondents intended to pursue a lifetime career in nursing. PMID- 3654098 TI - Preparation of community health nursing leaders for social action. AB - Indiana University School of Nursing graduate Department of Community Health Nursing has been preparing community health nurses for primary health care practice, as defined by the World Health Organization since 1978. The faculty are committed to preparing community health nursing leaders for social action aimed at improving the health of the community in both the Department's major in the master's programme and its new major in the doctoral programme. The core curricula for these majors in both programmes are presented. The master's curricula is based on integrating public health principles with those of community development. The doctoral major builds on this base of primary health care practice with a curriculum focused on the contribution of community health nursing to public and health policy. The graduates of the master's programme are prepared to work with community groups as a social force in promoting the health of the community. The graduates of the new doctoral major entitled "Health Policy and the Health of the Community" are being prepared as community health nursing leaders with expertise in health care policy and the legislative process with a focus on issues related to nursing and community health. These graduates will be able to function within the broader community, including national and international settings. Based on experiences in graduate education in community health nursing recommendations are made for the response graduate nursing education must make in order to prepare appropriate leaders who can work toward the goal of improving the community's health. PMID- 3654099 TI - Testing the validity of categories in a theoretical perspective on chronic illness. AB - The purpose of this study was to analyze differences in future time perspective, loneliness and perceived maternal expressiveness between adolescents who were chronically ill with cystic fibrosis and adolescents who were reportedly healthy. The sample consisted of 30 adolescents with cystic fibrosis who were matched on selected variables with 30 healthy adolescents. They responded to the Heimberg Future Time Perspective Inventory, the Revised UCLA Loneliness Scale, and the Perceived Maternal Expressiveness Scale. The three hypotheses were tested using the t-test. Since none of the hypotheses was supported, the validity of the categories was questioned. Theoretical and practical implications are addressed. PMID- 3654100 TI - Nursing education and social constraints: an indepth analysis. AB - This paper summarizes the results of a study analyzing the social, economic and political factors affecting the nursing education system in the Federal Republic of Germany (F.R.G.). Using a hermeneutic-dialectical approach the researcher examined the circumstances surrounding the conceptualization, implementation and non-continuation of an experimental program for the university education of nurse instructors in the F.R.G.--the first university program in nursing in the country. Paulo Freire's model of oppressed group behavior was found to be useful in making sense of the data and was drawn on to outline the characteristics of a nursing education that is 'freeing', that is, which which leads to the development of critical consciousness in nurses. PMID- 3654101 TI - Serum selenium, vitamin A, vitamin E and cholesterol concentrations in Finnish and Japanese postmenopausal women. AB - Serum concentrations of vitamins A and E, selenium, and cholesterol were measured in 30 Finnish and 30 Japanese postmenopausal women. While both groups had identical serum vitamin A levels, the other serum factors differed significantly between the groups, the Finns having higher serum vitamin E and cholesterol and lower serum selenium levels. Adjusted to serum cholesterol, which correlated significantly with vitamin E in both groups, the vitamin E levels were, however, similar in the groups. The differences in the serum levels of these nutritional factors may be associated with the differences in the risk of coronary heart disease and cancer between Finnish and Japanese populations. PMID- 3654102 TI - Effect of simulated hypoxia (7620 m, 6 h) on hepatic microsomal drug metabolising enzymes activity in rats given ethanol and vitamin A. AB - The hepatic MFO activity has been studied in rats exposed to acute hypoxia given single dose of ethanol (3 g/kg body weight) alone or along with 10,000 I.U. of vitamin A. The cytochrome P-450 was found to be depressed on ethanol administration in rats. Hypoxic exposure of rats given ethanol with or without vitamin A, however, restored the depressed cytochrome P-450 activity. Cytochrome c-reductase, on the other hand, was increased on administration of ethanol with or without vitamin A supplementation. Exposure to hypoxia did not have any additional effect on cytochrome c-reductase activity. Aminopyrine-N-demethylase was depressed on ethanol administration. Vitamin A administration further depressed this enzyme. Hypoxic exposure, however, did not restore this enzyme level. Aniline hydroxylase was not affected by ethanol administration, vitamin A supplementation and hypoxic exposure. Thus, mixed function oxidase system appears to be differently affected on ethanol administration, vitamin A supplementation and hypoxic exposure suggesting that these effectors have different loci of interaction in microsomal structure and/or in its micromileau of cofactors. PMID- 3654103 TI - Interaction of ethanol and acute hypoxia (7620 m) on vitamin A distribution in rat organs. AB - The effect of a moderate dose of ethanol (3 g/kg body weight) and acute hypoxia (282 mmHg pressure) for 6 h on vitamin A content of rat tissue has been investigated. In addition, to find the effect of ethanol administration and hypoxic exposure on freshly absorbed vitamin A, a tracer dose of 3H-retinyl acetate was administered prior to hypoxic exposure. The results indicate that ethanol and hypoxia interfere in the transfer of vitamin A stored as well as freshly absorbed, from intestine to liver. When ethanol administered rats were exposed to hypoxia, the secretion of vitamin A from liver is also disturbed. The vitamin A metabolism in the tissues like kidney and lung are affected adversely on ethanol administration and/or hypoxic exposure. This could be due to interference in the transfer of vitamin A from intestine to liver and secretion of vitamin A from liver into plasma. PMID- 3654104 TI - Use of 3,4-didehydroretinol to assess vitamin A status in rats. AB - The acetate and palmitate esters of 3,4-didehydroretinol (DR; vitamin A2 alcohol) have been synthesized and characterized. When administered orally in corn oil to female rats, DR was present in the serum as the alcohol, but primarily as esters in the liver. As total stores of retinol (R; vitamin A1 alcohol) decrease, the ratio of DR to R in the serum markedly increases. The ratio of DR to R in serum was greater than 0.27 at liver vitamin A1 palmitate values of less than 3 micrograms/g, 0.05-0.14 at 3-19 micrograms/g, and less than 0.04 at greater than or equal to 20 micrograms/g. Thus, the ratio of DR to R in the serum at a suitable interval after the administration of dehydroretinyl acetate may aid in assessing marginal vitamin A status. DR was not demonstrably converted to R in these studies. PMID- 3654105 TI - Increasing the breaking strength of wounds exposed to preoperative irradiation using vitamin E supplementation. AB - This study investigated if the prophylactic administration of vitamin E, an antioxidant, normalizes the healing of wounds exposed to preoperative ionizing radiation. Vitamin E was given intraperitoneally to three experimental groups of rats every other day at doses of 10, 20 or 40 International Units (IU) until a total dose of 30, 60 or 120 IU respectively was administered. There were three control groups: non-irradiated control, irradiated, non-supplemented control and irradiated, sesame oil-supplemented control. Two days following the last vitamin E or sesame oil injection 600 Rads of local radiation was delivered to the area of wounding. Two hours following the radiation treatment five centimeter long incisions were made in the area of radiation. There was no difference in the growth of the rats. Radiation exposure significantly reduced the breaking strength (g/5 mm wound) of the wounds compared to non-irradiated controls. With increasing levels of vitamin E there was an increase in the breaking strength of wounds (Y = 360.0 + 0.64 X, SE = 0.27, p less than 0.01). This study provides evidence suggesting that vitamin E may help normalize the breaking strength of wounds that receive preoperative irradiation. PMID- 3654106 TI - Differences in muscular changes in rats with vitamin E and with selenium deficiency. AB - The recti muscles of rats with vitamin E deficiency and with selenium deficiency were examined by electron microscopy and compared. In vitamin E deficiency, the first changes occurred in blood vessels and in the extracellular components. The endothelium contained many vacuoles and less cytoplasmic organelles. The basal lamina of the endothelium appeared thicker. As it progressed, vitamin E deficiency caused abnormal pigment granules, mitochondrial degeneration, decreased numbers and irregular arrangement of muscle fibers, and irregular arrangement of z bands. On the other hand, selenium deficiency caused no abnormal changes in the recti muscles. These results suggest that selenium plays a different role from that of vitamin E which is an antioxidant. PMID- 3654107 TI - Vitamin K1 binding protein in milk. AB - Cow's milk has been shown to contain a protein complex which is able to bind vitamin K1 in a reversible manner. This binding property has been investigated by the celite method which consists in creating a dynamic equilibrium between the adsorbent, the celite and the protein complex for the ligand (vitamin K1). Based on competition experiment, the binding is specific and the vitamin K1 binding protein complex has a molecular weight equal to or higher than 7.5 X 10(2) KD. PMID- 3654108 TI - Acute thiamin deficiency: a morphometric and cell proliferation study of jejunum epithelial cell. AB - The effect of acute thiamin deficiency on the jejunum epithelial cell was investigated in rats. The following results were obtained: The animals in the thiamin deficiency group (ATD) started to show a significant body weight loss from the 17th day in relation to pair fed controls (PFC). The length of the villus, depth and the cell population of the crypt from ATD animals were significantly decreased as compared to PFC. Crypt cell production rate (CCPR) was similar in both groups. However, even with epithelial hypoplasia, CCPR was maintained in thiamin-deficient animal, probably due to the presence of immature villus cells, which may reduced chalone and thus cause crypt to be more proliferative. PMID- 3654109 TI - Obtention of a photo-induced adduct between a vitamin and an essential aminoacid. Binding of riboflavin to tryptophan. AB - Studies in animals have suggested that the products of the irradiation of tryptophan in the presence of riboflavin may play a role in the development of hepatic dysfunction during parenteral nutrition. In this paper we describe the formation of an adduct between tryptophan and riboflavin obtained as a consequence of an anaerobic irradiation of these compounds. Through the use of molecular sieves and of an ion-exchange resin it was possible to separate the photo-adduct from the dimer riboflavin and other reaction products. The various fractions were characterized on the basis of their absorption and emission spectra. Also used were measures of anisotropy of fluorescence emission in order to characterize the derived adduct. PMID- 3654110 TI - Effect of pyridoxine deficiency in the neuronally mature rat. AB - Pyridoxine deficiency was induced in neuronally mature rats by combination of dietary deprivation and ingestion of 4-deoxypyridoxine. Overt signs of deficiency were evident. At this time the activity of glutamic acid decarboxylase as also the content of serotonin decreased in several areas of the brain. Catecholamine contents were unchanged from controls. Light microscopic observations indicated no difference in CNS myelin between the deficient and control animals. There was no difference between deficient and control groups in their auditory evoked responses. PMID- 3654111 TI - Folylpolyglutamate synthetase activity in regenerating rat liver. AB - Regenerating liver of hepatectomized rat showed marked changes in folylpolyglutamate pattern. The activity of folylpolyglutamate synthetase, investigated at various times after the operation, showed a slight increase at 12 h, reached its highest value at 36 h and, for all the time studied, remained at the upper level as compared with controls. These results may contribute to explain the higher incorporation in regenerating liver of 3H folic acid into folylpolyglutamates at a higher number of glutamate residues and is consistent with the hypothesis that the addition of glutamate represents a control step in folate coenzyme synthesis and consequently of one-carbon metabolism. PMID- 3654112 TI - Modifications of hemato-biological parameters in pregnant women in a migrating population in northern Cameroon: prevalence of anemia, iron and folates deficiencies. AB - The wholesale displacement of a population can have nutritional consequences for the migrants. With this in mind, the prevalences of anemia and of iron and folic acid deficiencies were studied in a group of 90 pregnant women living in northeast Benoue, an area situated in northern Cameroon where a development project was initiated in 1973. This project aimed at moving a population from the extreme northern highlands to the fertile valley of the Benoue. The following hemato-biological parameters were measured: hemoglobin, hematocrit, mean cell hemoglobin concentration, plasma iron, transferrin saturation, serum concentrations of folates, prealbumin, transferrin, protides and their fractions. The investigation showed that anemia, as well as iron and folic acid deficiencies, were rare when using World Health Organization criteria. The anemia prevalence, judged on a hemoglobin level of less than 11 g per 100 ml, is 8%, iron deficiency prevalence is 10% (plasma iron level below 50 micrograms per 100 ml), and folic acid deficiency prevalence is 3% (serum folic acid level below 3 ng per ml). However, 40% of the pregnant women had a level of transferrin saturation below 15%. In non deficient subjects, we observed a decrease between the first and second trimesters of pregnancy in hemato-biological parameters linked to anemia or to nutritional status (hemoglobin, hematocrit, plasma iron, transferrin saturation, prealbumin). The nutritional conditions in the area appeared sufficient to prevent deficiencies which are frequently observed in pregnant women in Africa. PMID- 3654113 TI - Nutritional status of the elderly in Naples. AB - Nutritional status (anthropometry, food habits, thiamin and riboflavin status) has been evaluated in 136 (70 males and 66 females) free living healthy elderly individuals (age range 65-69 yrs) from the district of San Carlo Arena that can be considered representative of the sociocultural and economic level of the city of Naples. By assuming as reference values those of middle aged individuals, 50 percent of elderly men and 85 percent of elderly women showed different degree of excess body fat. As far as food habits are concerned legumes, vegetables and fruit daily intake was quite high whilst alcohol consumption was low. Furthermore milk and eggs intake was low and infrequent. Although prevalence of excess body weight was high, total daily energy intake was found to be equal or slightly above dietary recommendations for the elderly. Diet composition showed a high protein intake whilst CHO and fat intake was slightly below recommendations. Micronutrients' intake was insufficient for calcium in 10 percent of both males and females and for iron in 20 percent of men and 40 percent of women. Niacin intake was low in about 50 percent of both men and women. Thiamin nutritional status was found low in 20 percent of men and women and riboflavin status in 40 percent of men and 20 percent of women. In conclusion obesity and overweight are very frequent in an urbanized sample of free living healthy elderly individuals of Naples. On the other hand serum calcium and iron and some vitamin deficiency is not uncommon. The composition of the diet seems to be also poor in some micronutrients. PMID- 3654114 TI - Nutritional status of non institutionalized elderly people in north Italy. AB - The nutritional status of some elderly people - 313 non institutionalized and 37 assisted by public organization - was investigated. As regards weight, muscle and fat area, BMI and fat %, lower values were found for assisted people. The mean daily nutrient intakes in assisted people are below the recommended values for all nutrients, except fats; free living people have higher intakes of protein and fat, and lower intakes of thiamin and retinol equivalents. About 10% and 15% of non institutionalized people showed respectively an inadequate thiamin and riboflavin nutritional status (determined by alpha ETK and TPP levels and by alpha EGR and FAD levels); a worse situation was found for assisted people. Vitamin B6 levels appear adequate for all the population tested. PMID- 3654115 TI - Can the mineral elements intakes recommended for the French population be provided by a balanced diet? AB - The minerals intakes provided by a diet with a balanced amount of proteins, lipids and carbohydrates are slightly superior to those supplied by the usual diet. However, the micronutrients whose intakes provided by the usual diet are insufficient for some population groups (women for instance) remain "at risk" even with a balanced diet (fluorine, zinc, iron and copper). This conclusion is not altered when taking account of drinks. This study shows that it is the intake energetic level which seems to be the first factor contributing to the recommended minerals intakes. PMID- 3654116 TI - Influence of methionine supplementation of lactating rat diets on vitamin milk contents. PMID- 3654117 TI - Ascorbic acid concentrations in serum and urine of the grey seal (Halichoerus grypus) on Sable Island. PMID- 3654118 TI - Surgical scrubs. PMID- 3654120 TI - Bedside containers. PMID- 3654119 TI - Homosexuality in institutionalized retardates. PMID- 3654121 TI - Will the real infection rate please stand? PMID- 3654122 TI - The impact of postdischarge infection on surgical wound infection rates. AB - We undertook a study of postdischarge infections to assess the reliability of a surgical wound surveillance program in a 930-bed teaching hospital. During a six month period, a subset of operations performed each day was randomly selected and patients interviewed by telephone one month postsurgery using a standard set of questions. The infection rate for all patients contacted directly postdischarge was 5.4%, whereas the surgical wound infection rate determined for all procedures through the standard hospital program was 1.5%. For day-surgery patients, who are not routinely followed in the hospital surveillance program, 8 (7.8%) of 103 patients contacted had infection. Thus, the overall surgical infection rate determined in this study was over three times higher than that calculated using standard surveillance. A reliable method for identifying postdischarge wound infections is necessary to ensure accurate surgical wound infection rates. PMID- 3654123 TI - The incidence of nosocomial pneumonia following urgent endotracheal intubation. AB - The risk of nosocomial pneumonia following emergency or urgent endotracheal intubation was studied prospectively. Pneumonia developed in 35 of 78 (45%) patients within three days of intubation. No differences in age, sex, underlying illness, respiratory infection, or antibiotic use were found between those with or without pneumonia. There were also no differences in the frequency of complications occurring during intubation. Patients developing pneumonia tended to have the same organisms isolated from the sputum at the time of intubation and at the time of diagnosis of pneumonia (9 of 20 were identical, 5 differed by a single organism). Sputum cultures taken at the time of intubation were helpful in predicting the subsequent pathogens in patients who developed pneumonia. There were no differences in mortality between patients with (29%) and without (28%) pneumonia. Emergency endotracheal intubation appears to contribute to the overall incidence of nosocomial pneumonia. PMID- 3654124 TI - Community hospital surgeon-specific infection rates. AB - A one-year prospective study of surgeon-specific nosocomial infection rates was done in two community hospitals. Hospital A (93 beds) and Hospital B (158 beds) have nearly identical surgical staffs. Unified criteria for the diagnosis of infections, methods of data collection, and coding were used. Data were processed with an IBM 370 computer using Statistical Analysis System (SAS). Each surgeon received semiannual reports of 1) overall infection rate by site, 2) number of surgical wound infections by wound class and type of procedure, 3) pathogens for each deep and incisional infection, and 4) quarterly wound infection rates by wound class. Analysis of reports revealed high Class I surgical wound infection rates for both general and orthopedic surgeons. One person in each group had inordinately high infection rates. These data serve as an objective incentive to reduce surgical wound infections, identify individual problems, and suggest surgical privileges be evaluated by performance. PMID- 3654125 TI - Shoe covers and tacky mats. PMID- 3654126 TI - A study on the incidence of postoperative infections and surgical sepsis in a university hospital. AB - Reported are the results of a study on the incidence of nosocomial surgical infections in ten wards of the university hospital A. Gemelli, Rome. One thousand, five hundred five patients were studied and the overall incidence of surgical infections was 8.7%. Factors that influenced infection rates included age, immunosuppressive diseases, and immunosuppressive therapy. We assessed the inutility of antibiotic prophylaxis in clean operations and its usefulness in clean operations with insertion of prostheses or other devices. The importance of the duration of preoperative hospitalization and of the length of the operation were also noted. The most frequent etiological agents proved to be Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. The average hospital stay for patients with surgical infection was more than double that of patients with no infection (25.7 days v 11.7 days). PMID- 3654128 TI - I.v. filter debate continues. PMID- 3654127 TI - Staphylococcus aureus mediastinitis: prognostic usefulness of an early medicosurgical therapy. AB - Six cases of acute Staphylococcus aureus mediastinitis after median sternotomy were reported. Five resulted from an asymptomatic disseminator of S aureus present in the operating room. Each case was characterized by an acute bacteremic phase, occurring after a mean interval of 8.2 +/- 1.7 days after the surgical procedure; within 24 to 36 hours all patients had a temperature above 39 degrees C, toxic appearance, and marked leukocytosis. Pericicatricial inflammation was moderate, instability of the sternum was present in only two patients, and chest roentgenogram was not helpful in making an early diagnosis. No risk factor for mediasinitis in connection with the perioperative or postoperative periods was noted in cases compared with a control group of 103 patients. All strains of S aureus were susceptible in vitro to the antibiotic regimen used in prophylaxis. All patients underwent early surgical reopening of the mediastinum within 47 +/- 15 hours after the first sign of acute mediastinitis. Mediastinal debridement and continuous irrigation-suction with dilute povidone-iodine solution were associated with intravenous antistaphylococcal therapy for a period of four to six weeks. All patients survived and no recurrence was observed, a finding we think due to early diagnosis and aggressive medicosurgical therapy. PMID- 3654129 TI - Skin tests for tuberculosis. PMID- 3654130 TI - Determinants of Legionella pneumophila contamination of water distribution systems: 15-hospital prospective study. AB - We conducted a prospective environmental study for Legionella pneumophila in 15 hospitals in Pennsylvania. Hot water tanks, cold water sites, faucets, and showerheads were surveyed four times over a one-year period. Sixty percent (9/15) of hospitals surveyed were contaminated with L pneumophila. Although contamination could not be linked to a specific municipal water supplier, most of the contaminated supplies came from rivers. Parameters found to be significantly associated with contamination included elevated hot water temperature, vertical configuration of the hot water tank, older tanks, and elevated calcium and magnesium concentrations of the water (P less than 0.05). This study suggests that L pneumophila contamination could be predicted based on design of the distribution system, as well as physicochemical characteristics of the water. PMID- 3654131 TI - Nosocomial transmission of hepatitis A in an adult population. AB - Nosocomial transmission of hepatitis A from patients to staff members is an unusual event. Recently, several cases of occupational transmission of hepatitis A to health care workers have been reported in the literature. Most of these have occurred as a result of transmission from an infected child to a staff member involved in his or her care. We report an additional case of transmission of hepatitis A from an infected adult to a staff member and review the literature regarding nosocomial hepatitis A transmission. The review emphasizes several points that nearly all instances of nosocomial transmission of hepatitis A have in common, including the role of asymptomatic infection, the timing of hospitalization, and the fact that index patients often have an underlying illness that obscures the early diagnosis of hepatitis A. In addition, several other areas of controversy with respect to hepatitis A are discussed. PMID- 3654132 TI - Quantity of soap as a variable in handwashing. AB - The purposes of this study were to assess the effect of two quantities (1 mL or 3 mL) of four different handwashing products on reductions in log colony-forming units (CFU) from the hands and to determine the amount of liquid soap used for handwashing by personnel in one hospital. First, 40 subjects were assigned by block randomization to one of four handwashing products (4% chlorhexidine gluconate in a detergent base, two alcohol hand rinses, and a liquid, nonantimicrobial soap) to be used in either 1 mL or 3 mL amounts per wash. Each subject washed his or her hands 15 times per day for five days. After one and five days of handwashing there were significant reductions over baseline in log CFU between handwashing products (P less than 0.001). Additionally, subjects using 3 mL of antiseptic soap had significantly greater reductions in log CFU than those using 1 mL (P less than 0.001). Among subjects using control liquid soap there was no such dose response. Second, a survey of 47 members of a hospital nursing staff from nine specialty areas and ten individuals in the general population was conducted to measure amounts of two liquid soaps used for handwashing. Amount of soap ranged from 0.4 to 9 mL per handwash. Personnel working in clinical areas where patients were at high risk for nosocomial infection used significantly more soap than did others (P less than 0.05). We conclude that quantity of soap used for handwashing is one variable influencing the microbial counts on hands, and that the quantity of soap used by health care personnel varies considerably. PMID- 3654133 TI - The hygienic situation in 56 German, 33 Austrian, and 25 Belgian intensive care units. PMID- 3654134 TI - Handwashing agents. PMID- 3654135 TI - Ambulatory cataract surgery. PMID- 3654136 TI - D-penicillamine and beta-aminopropionitrile effects on experimental filtering surgery. AB - We studied the effect of two compounds, beta-aminopropionitrile (BAPN) and D penicillamine on the success of experimental glaucoma filtering surgery in cynomolgus monkeys. All animals had laser-induced glaucoma and underwent punch sclerectomy operations. Eyes treated with BAPN or D-penicillamine maintained successful filtration for at least 3 days longer than nondrug-treated controls. This effect, while statistically significant (P less than 0.05), was temporary. The lack of more substantial improvement in prolonging filtering patency may have resulted from an inadequate effective drug concentration. Alternatively, these drugs may have limited potency because their action on new collagen synthesis affects only a minor component of the healing process that causes filter failure. PMID- 3654137 TI - Eicosanoids as a new class of ocular hypotensive agents. 2. Comparison of the apparent mechanism of the ocular hypotensive effects of A and F type prostaglandins. AB - It has recently been shown that derived prostaglandins (PGs) of the A and B types are much more potent ocular hypotensive agents than primary PGs of the E, F, or D type. The purpose of this study was to determine whether two representatives of these structurally different PGs, namely PGA2 and PGF2 alpha-1-isopropyl ester (PGF2 alpha IE), reduce intraocular pressure (IOP) of the feline eye by similar or dissimilar mechanisms. Aqueous humor flow rate was determined by a fluorophotometric technique, Schiotz electronic tonography was used to measure outflow facility and venomanometry was done to measure episcleral venous pressure. Although at the doses used, both PGF2 alpha IE (2.5 micrograms/eye) and PGA2 (5.0 micrograms/eye) caused significant IOP reduction within 2.5 hr after their topical application, neither caused a significant decrease in aqueous humor flow rate, a significant increase in outflow facility or a change in episcleral venous pressure. It was concluded, therefore, that both of these PGs reduce IOP by an apparently similar mechanism, presumably by increasing uveoscleral outflow. PMID- 3654138 TI - Electrical parameters of the isolated monkey ciliary epithelium and effects of pharmacological agents. AB - The electrical properties of the isolated monkey ciliary epithelium (CE) were determined in an Ussing-type chamber. In a Hepes, HCO3- buffered solution, transepithelial potential difference (PD), short-circuit current (SCC) and electrical resistance (Rt) were -2.5 mV (aqueous-side negative), 8.5 microA and 246 omega, respectively. Epinephrine (0.01 mM) increased the SCC and PD across the isolated monkey CE when added to the aqueous-side bathing solution but was without effect when added to the blood-side bathing solution. Forskolin (0.01 mM) increased the SCC and PD when added to the bathing solution on either side. A disulfonic stilbene, DIDS (0.1 mM), reduced the SCC and PD when added to the aqueous-side bathing solution but was without effect when added to the blood-side bathing solution. Ouabain (0.1 mM) added to the aqueous-side produced a transient stimulation followed by a gradual inhibition of the SCC and PD. On the blood side, ouabain directly inhibited the SCC and PD towards zero. Although the general electrical properties were similar to those of the isolated rabbit iris ciliary epithelium, there were differences in the effects of these pharmacological agents on the electrical properties. PMID- 3654140 TI - In vivo effects of 5-FU on ocular surface epithelium following corneal wounding. AB - We evaluated the dose relationship between the antiproliferative and toxic effects of 5-fluorouracil (5-FU) on the ocular surface epithelium following experimental corneal epithelial wounding in rabbits. Central corneal epithelial defects 8 mm in diameter were made using n-heptanol. 5-FU (0.05 mg, 0.5 mg, or 5.0 mg per day in divided doses) or saline was applied topically for up to 18 days beginning on the day of wounding. The animals were sacrificed at 1, 7 or 14 days after wound closure. The effect on the ocular surface epithelium was assessed by observation of the clinical and histological appearance, and determination of the rate of corneal epithelial defect closure, corneal epithelial mitotic rate and conjunctival goblet cell frequency. A daily dose of 0.05 mg of topical 5-FU for 18 days had no discernable clinical or histopathological effect compared to wounded, saline treated controls. Treatment with 0.5 mg daily prevented the high mitotic rate typically noted 1 day immediately following defect closure, yet had no significant effect on clinical appearance, histological appearance, or healing rate. Daily topical application of 5.0 mg of 5-FU reduced the corneal epithelial mitotic rate to approximately 1% of the wounded controls, with persistent epithelial defects occurring in 22% of the eyes in this group. In those eyes which did heal, the corneal epithelium was markedly thinner than controls 1 day after defect closure. Fourteen days after healing, epithelial thickness in this group varied from 2 to 13 cells across each cornea, with the thickest area occurring centrally and tapering gradually to the limbus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654139 TI - Human trabecular meshwork cells in culture: morphology and extracellular matrix components. AB - This study demonstrates the presence of laminin and collagen type IV in the extracellular space of human trabecular meshwork (HTM) cells in culture and its absence in cultures of fibroblasts from sclera adjacent to the outflow pathway. These basement membrane components can be detected by standard immunohistochemical techniques. Positive staining for these macromolecules is found only after the HTM cells have reached confluence. The presence of laminin and human collagen type IV in the early passages can serve as additional criteria for identification of HTM cells in culture. These cells provide a useful experimental system for studying the effects of drugs and other factors on the synthesis of components of the extracellular matrix. PMID- 3654141 TI - Protein processing in lens intercellular junctions: cleavage of MP70 to MP38. AB - Membrane protein MP70 is a component specifically of lens fiber 16-17 nm junctions. SDS-PAGE analysis of membrane preparations made separately from the sheep lens equatorial region (outer cortex), inner cortex and central region (nucleus) showed abundant MP70 in the young fibers in the outer cortex and drastically reduced levels of MP70 in the older fibers deeper in the lens. MP70 was cleaved to MP38 and thereby lost the epitope to monoclonal anti MP70 (6-4-B2 C6, Kistler et al J Cell Biol 101:28, 1985). This cleavage is fiber age-related and is effected by a calcium-dependent, lens-endogenous protease. PMID- 3654142 TI - Lens protein composition, glycation and high molecular weight aggregation in aging rats. AB - Because of minimal or no turnover, lens proteins are subjected to substantial post-translational modifications which in turn disrupt lens architecture and change the optical properties leading to senile cataract formation. Progressive glycation is believed to have the potential to initiate the changes that are conducive to lens opacification. Fisher 344 rats were systematically followed from juvenile to older and aged phases of their life to study the relationship between lens glycation and high molecular weight (HMW) aggregate formation as well as quantitative and qualitative changes in lens crystallins. Levels of glycated proteins were quantified by affinity chromatography. Changes in lens crystallin composition and HMW aggregate formation were monitored by molecular sieve HPLC, further confirmed by SDS-PAGE and IEF techniques. As the age advances HMW and insoluble proteins increase with a concomitant disappearance of gamma crystallins from soluble fraction. This disappearance of gamma-crystallins coincided with increased glycation (approximately 2-fold higher in insoluble fraction) and decreased sulfhydryl groups from soluble fraction. It appears that lens protein glycation, disappearance of gamma-crystallins and sulfhydryls from soluble fraction and increase of insoluble fraction and HMW aggregate are interrelated. PMID- 3654143 TI - In vivo studies on cataracts using the Scheimpflug slit lamp camera. AB - We conducted reproducibility studies on an in vivo objective method of documenting cataracts: Scheimpflug photography using the Topcon SL 45 camera. Normal and cataractous lenses were photographed and the photographs digitized and analyzed using a Perkin Elmer microdensitometer attached to a PDP 11 and Vax 11/780 computer. Linear densitometry was performed through the center of the lens. We found very good reproducibility. The intraclass correlation for the mean densities in the nucleus was 0.95: that is, intra- and interobserver variability accounted for only 5% of the overall variability. For the anterior cortex, intraclass correlation was 0.88 and for posterior cortex it was 0.84. This method may be useful, within limits, in future clinical trials of anticataract medications. PMID- 3654144 TI - Cysteamine induces cataracts in newborn rats. AB - Daily subcutaneous injections of cysteamine (CSH) administered to neonatal rats for 6 to 11 days cause dense bilateral cataracts that are evident at eye opening and that are permanent. CSH has been previously shown to induce protein cross linking by the formation of abnormal disulfide bonds. It is hypothesized that the same mechanism underlies its cataractogenic effect; as such, CSH may be a useful agent in the study of models of senile cataract formation in humans. PMID- 3654145 TI - On the threshold radiant exposure for keratitis solaris. AB - Marked inflammation of the cornea (keratitis solaris) is often observed after exposure to strong solar radiation, especially in high altitudes and snow-covered terrain. Using the action spectrum and the solar spectrum, the radiant exposure causing keratitis solaris was calculated for a horizontal surface. The parameters selected were altitude, season, ozone content and albedo. The radiant exposure of the eye increases approximately 16-fold, comparing terrain without snow-cover and terrain with snow-cover. Radiant exposures in clinically observed cases of keratitis solaris were calculated to range from 1200 to 5600 Jm-2. A discussion on these figures with regard to threshold doses shows a significant difference between long-term exposure to solar radiation and short-term exposure to artificial sources. PMID- 3654146 TI - The effect of corneal contact lenses on the oxygen tension in the anterior chamber of the rabbit eye. AB - The oxygen tension in the aqueous humor in the anterior chamber of rabbit eyes was measured continuously with a polarographic electrode. The normal oxygen tension in the anterior chamber was 23 +/- 2 mm Hg (mean +/- SD, n = 4). A contact lens was then placed on the cornea for at least 10 min and the drop in oxygen tension recorded. A hard polymethylmethacrylate lens reduced the oxygen tension by 16 +/- 4 mm Hg, and a larger hydroxyethylmethacrylate soft lens (Soflens) decreased oxygen tension by 17 +/- 4 mm Hg (mean +/- SD, n = 4). Comparable statistically significant decreases were seen with the Permalens, Polycon II, and Silcon lenses. Only the elastofilcon A lens (Silsoft) did not decrease the oxygen tension in the anterior chamber significantly. PMID- 3654147 TI - Adrenergic decentralization modifies the circadian rhythm of intraocular pressure. AB - The effect of unilateral decentralization on the circadian rhythm of IOP was examined in rabbits to determine whether postganglionic sympathetic nerves to the eye can play a role in regulating the circadian rhythm of IOP in the absence of input from the central nervous system. Decentralization produced a marked reduction of the dark phase increase of IOP, but had little effect on IOP during the light phase. Therefore, circadian signals from the central nervous system, which contribute to the dark phase increase of IOP, arrive at the cervical ganglia by way of preganglionic fibers of the sympathetic chain and travel to the eye through postganglionic adrenergic nerves. PMID- 3654148 TI - Comparison of cancer chemotherapeutic agents in asynchronous and synchronous 9L cells. AB - The cytotoxic activity of various chemotherapy agents was investigated in asynchronous populations of cultured 9L rat brain tumor cells, and as a function of their position in the cell cycle. Representative drugs from the classes of DNA active agents, alkylating agents, spindle poisons, and antimetabolites were tested. The ability to induce cell lethality in asynchronous populations as a function of drug concentration varied for 1 hr pulse exposures. In order of decreasing cytotoxic activity, DHAQ was the most effective, followed by VCR, VDS, VBL, ADR, BCNU, cis-DDP, BLM, DBD, RZ, and HU. The effect of chemotherapy agents on synchronous 9L cells obtained by mitotic selection also varied with respect to the individual agent and was cell cycle-dependent. Survival age-responses ranged from being minimal to demonstrating significant fluctuations as a function of cell cycle position. For all agents except ADR and HU, the sensitivity of G1 phase was greater than S phase. RZ exhibited essentially a flat age-response. Comparison of the cell cycle age-responses of chemotherapeutic agents to those exhibited by the cytotoxic modalities of radiation and hyperthermia demonstrate several unique differences. PMID- 3654149 TI - The colony inhibition of a new chemotherapeutic agent (KW2152) against human lung cancer cell lines. AB - The human tumor colony assay was used to evaluate the effect of a new chemotherapeutic agent (KW2152) on colony inhibition of four non-small cell lung cancer cell lines and a mouse cell line. With continuous exposure experiments, KW2152 induced greater than or equal to 70% colony inhibition of PC-7 (human adenocarcinoma), PC-10 (human squamous cell) and PC-13 (human large cell) at a drug concentration of 10 mcg/ml. In one hour exposure experiments, KW2152 caused a significant reduction in colony formation (less than or equal to 30% of control) only at the highest concentration tested (100 mcg/ml). KW2152 showed significant in vitro activity against human non-small cell lung cancer cell lines. Due to these promising results, it was suggested that KW2152 should be evaluated in clinical trials. PMID- 3654150 TI - The PIT method: an automated in vitro technique for drug toxicity testing. AB - An automated in vitro technique for drug toxicity testing is described. Human tumor cells were cultured for 2 days in 96-well microtiter plates before the addition of serial dilutions of drugs. At day 5 the cultures were terminated by the addition of a solution containing propidium iodide, ink and triton X-100 (PIT). Triton X-100 lysed all cells, which were subsequently stained by the DNA specific fluorescing propidium iodide. The ink effectively quenched all background fluorescence. The plates were read on a computer controlled automated microscope with a photomultiplier. The results showed a linear relationship between cell number and fluorescence intensity. Reproducible dose-response curves were obtained for 6 drugs tested. A computer program calculated ID50 values, making use of adequate growth and no-growth controls. PMID- 3654151 TI - New application of a stabilized active cyclophosphamide derivative (mafosfamide, ASTA Z 7654)--immunogenic properties of lymphatic leukemia L 1210 cells treated in vitro with the drug. AB - Lymphatic leukemia L 1210 cells were treated in vitro with various concentrations of Mafosfamide--a stabilized active derivative of cyclophosphamide (4 hydroxycyclophosphamide). L 1210 cells treated with Mafosfamide (L 1210-MAF cells) were used for vaccination of semisyngeneic CD2F1 mice against L 1210 leukemia. These cells do not grow in vivo but are viable in the test with trypan blue. L 1210-MAF cells, obtained by treatment of L 1210 cells two times with 50 micrograms/ml or 100 micrograms/ml of Mafosfamide, and injected into the mice induced resistance against L 1210 leukemia in these animals. L 1210 cells treated two times with higher concentration of Mafosfamide (200 micrograms/ml or 400 micrograms/ml) did not give this effect. PMID- 3654152 TI - Mitoxantrone in the treatment of advanced non-squamous carcinoma of the cervix (a phase II trial of the gynecologic oncology group). AB - Twenty-five evaluable patients with advanced non-squamous carcinoma of the uterine cervix were treated with mitoxantrone 12 mg/m2 every three weeks. All patients had good performance status and measurable disease and only 11 had received prior chemotherapy. One complete and one partial response were noted among 15 patients with no prior chemotherapy while no responses were seen in 11 previously treated patients. The major toxicity was myelosuppression; other toxicity was mild. The median progression-free interval was 2.1 months and median survival 4.3 months. Mitoxantrone displays minimal activity in patients with advanced non-squamous carcinoma of the cervix. PMID- 3654153 TI - Phase II trial of N-methylformamide in advanced head and neck cancer. AB - Eighteen patients with advanced epidermoid carcinoma of the head and neck were entered into a phase II trial of N-Methylformamide (NMF), 800 mg/M2 IV daily for 5 days every 4 weeks. Seventeen patients had received prior radiation therapy and 11 were previously treated with chemotherapy. No complete or partial responses were observed. The major toxicity was gastrointestinal. Fifty percent of patients experienced nausea and vomiting or reversible hepatotoxicity with greater than a 3-fold elevation of liver enzymes. Mild reversible myelosuppression occurred in 2 patients. NMF in this dose and schedule was not a useful agent to treat recurrent epidermoid carcinoma of the head and neck. PMID- 3654154 TI - Adolescent pregnancy in Iowa. PMID- 3654155 TI - Teenage pregnancy. A roundtable discussion. PMID- 3654156 TI - Pelvic inflammatory disease in adolescents. PMID- 3654157 TI - Teenage pregnancies. PMID- 3654158 TI - Antidotes in the treatment of acute poisoning. PMID- 3654159 TI - Reporting the cause of death. PMID- 3654160 TI - Factors associated with neonatal deaths in very low birth weight infants. PMID- 3654162 TI - Behavioural deviance in an Irish urban and rural town sample. PMID- 3654161 TI - Interaction of verapamil with atracurium and reversal of combined neuromuscular blockade with edrophonium and neostigmine. PMID- 3654164 TI - Preventable mortality in Northern Ireland. PMID- 3654163 TI - A very mobile intra-abdominal mass. PMID- 3654165 TI - Cerebral dysfunction in the newborn (1974-1983) and outcome to one year. PMID- 3654166 TI - The increase in the suicide rate in Ireland. PMID- 3654167 TI - Blood samples in newborn infants. PMID- 3654168 TI - European Symposium on Epidemiology of Multiple Sclerosis. Milano, 20-21 March 1986. Proceedings. PMID- 3654169 TI - Value of otoneurological tests in the staging of multiple sclerosis. AB - We looked for correlations between otoneurological findings and neurological signs in multiple sclerosis (MS). 41 patients were tested for: spontaneous and caloric nystagmus, horizontal pursuit eye tracking, full-field optokinetic nystagmus and eye movements. The findings were compared with the course of the disease (progressive or remitting), age at onset of MS and disability, in order to test the predictive value of this type of test. The correlation between otoneurological abnormalities and lesion site is very high for brainstem lesions. Subclinical brainstem lesions were detected in 66% of patients with optic neuritis only and in 42% of those with spinal cord involvement only. Eye movement disorders are more frequent (p less than 0.1) in disease of long duration. The vestibular examination was altered in 100% of patients with clinically definite and probable MS, in 91% of those with possible and in 80% of those with suspected MS. No specific otoneurological pattern was identified. No significant correlation with age at onset or with disability was found. PMID- 3654170 TI - Multimodal evoked potentials in multiple sclerosis: a contribution to diagnosis and classification. AB - The adoption of multimodal evoked potential procedures for the diagnosis and classification of multiple sclerosis is recommended as capable of revealing subclinical lesions of the central nervous system. The CSF test is also helpful, though in a different way. We present the results obtained by VEP, BAEP, SEP median and SEP-tibial examinations and by CSF analysis (OB+) in a group of 189 MS patients, of whom 103 were diagnosed as definite. 58 as probable and 28 as suspected MS cases according to McDonald and Halliday, criteria. EPs frequently displayed clinically silent lesions, enabling us to reclassify 14 of the 37 potentially reclassifiable subjects (37.8%). The CSF test (OB+) allowed the reclassification of 31 out of the 58 reclassifiable cases (53.4%). In the present report we discuss the usefulness of the two methods. PMID- 3654171 TI - Does delay in acquiring childhood infection increase risk of multiple sclerosis? AB - Multiple sclerosis (MS) appears to be more common in technically advanced countries than in underdeveloped regions, and migration from one area to another at a young age affects the risk of acquiring MS. One way of explaining both the peculiar frequency distribution and the effect of migration while young is to postulate that an infection early in life decreases the chance of central demyelination. However, no specific infection has been implicated consistently. Alternatively, an aberrant host response to infection in childhood might induce central demyelination. Thus, the aberrant host response could be age-dependent. In seeking associations between age of infection and risk of MS, we observed a direct relationship: where childhood diseases were acquired early in life, the frequency of MS in that population was low; where childhood diseases tended to occur nearer adolescence, MS frequency in that population was high. Since immune responsiveness to antigenic challenges matures through early adolescence, we reason that early infection might be protective and that delay in acquiring childhood infections might increase the risk of developing MS. Indeed, in experimental models, the chance of inducing chronic relapsing central demyelination is increased by using adolescent rather than newborn or mature animals. In this paper, epidemiologic evidence showing the strong association between age of infection and risk of MS is presented. PMID- 3654172 TI - Serial recording of VEPs to different stimuli in multiple sclerosis patients. AB - VEPs to different spatial frequencies (1,2,4 cycles per degree) and different stimulus configurations (vertical, horizontal gratings and checkerboard) were recorded in 47 Multiple Sclerosis patients and a corresponding group of control subjects. Serial recordings were performed in periods of 1-6 years. We show that the highest diagnostic yield in MS is for VEPs of higher spatial frequency than 1 cpd, and that vertical gratings give reliable results when high spatial frequencies are used, whereas checkerboard stimuli elicit consistent VEPs only when the check size is 30'-15' of arc of visual angle. The use of fine vertical grating patterns dissipates controversies dependent on "W" shaped VEPs. PMID- 3654173 TI - Assessment of visual function in MS patients: comparative study of some diagnostic tests. AB - Optic pathways are frequently involved in Multiple Sclerosis (MS). However, in some cases the involvement is asymptomatic or gives rise to only slight visual disturbances without alterations of visual acuity or of clinically evident visual field defects. In these cases several diagnostic tests permit an objective evaluation of the visual dysfunction. The aim of this study is to compare the value of contrast sensitivity test (CST), pattern reversal visual evoked potential (VEP), ophthalmoscopy, Goldmann perimetry in 45 MS patients with normal visual acuity. Examination of contrast sensitivity was carried out with a simple two-alternative forced choice test estimating the spatial frequency of 4 cycles/degree. The VEP was performed with a pattern reversal checkerboard at a spatial frequency of 1 and 2 cycles/degree. Fundus examination was abnormal in 12 patients; visual field defects were detected in 16 patients. 32 patients (71.1%) had abnormal CST in one or both eyes. VEP for the 30' checks was abnormal in 32 cases (71.1%) and that for the 15' checks in 36 cases (80.0%). All but 4 patients (91.2%) had one or more abnormal tests. All patients with abnormal perimetry and/or fundus examination had also CST and/or VEP altered. It is apparent that CST and VEP reveal a significant proportion of abnormalities in the visual system that have not been revealed by routine neuroophthalmological examination. PMID- 3654174 TI - Multiple sclerosis diagnosis: magnetic resonance imaging compared with other instrumental examinations. AB - Examination by magnetic resonance imaging (MRI), evoked potentials (EP) and cerebrospinal fluid (CSF) analyses was carried out on 97 definite, 20 probable and 40 possible multiple sclerosis (MS) patients (McAlpine's clinical criteria). MRI of only 4 transverse brain sections at the level of the ventricles and the analysis of the first 4 echoes showed periventricular or parenchymal lesions, or both, in 114 of the 117 definite and probable MS, and in 25 of the possible MS. MRI was more sensitive than the CSF analyses or EP; abnormalities more frequently appeared in known MS, and clinically asymptomatic lesions were seen. The MRI abnormalities were not, however, MS-specific; they were present in other neurological patients; none posed a question of differential diagnosis from MS. Complementary examinations, and especially MRI, should be a valuable adjunct for MS diagnosis, as long as the findings are viewed in the clinical context. PMID- 3654175 TI - Inter and intra-observer reliability in Kurtzke scoring systems in multiple sclerosis. AB - Of the various scoring systems employed to assess the neurological status in Multiple Sclerosis (MS), the Kurtzke functional system and disability status scale are the most used even for international comparisons. In order to assess inter- and intra-observer variability in the employment of Kurtzke's scale, 70 patients with definite MS were scored by 4 neurologists independently: 40 subjects were assessed using the Kurtzke scoring system and 30 patients using the Kurtzke system as modified by the Italian Multicenter MS Case-Control Study Group. Each of the patients was examined by one of the 4 neurologists in turn and in the presence of the other three. The same neurological examination was scored again after 1 month by the same neurologists. Agreement was estimated using the weighted Kappa index. The results indicated a high level of concordance both for intra- and inter-observer comparisons on all the items. No significant difference in reliability was found using the two scales examined. PMID- 3654176 TI - Cooperative Italian study on multiple sclerosis and risk factors: a case-control study. The Coordinating Center and the Neurological Centers of the Cooperative Group. AB - The main aims of this study were to investigate: the supposed relationship between multiple sclerosis (MS) and migration and consider it in terms of causality (ethnic origin, multiple moves); the possible association of MS with some viral infections supposed to be cause/s of MS (measles, herpes virus type 1 and 2, mononucleosis); the association with some other variables possibly related to the disease (alcohol consumption, occupational exposure to neurotoxic agents, tonsillectomy). The cases were hospitalized MS patients, diagnosed since 1 December 1983, from 19 provinces of Italy, followed up at least every six months. Two sets of controls were recruited randomly: neurological controls from the same department as the cases and non neurological controls from other departments of the same hospital. The history of exposure to risk factors was taken by skilled interviewers using a standardized questionnaire. On 30 September 1985, 1253 patients had been enrolled in the interview study: 280 cases, 581 neurological and 392 non neurological controls. The study is under way. PMID- 3654177 TI - A multicenter study of the incidence of multiple sclerosis in Italy: design of the study. AB - Italy, extending from 37 degrees to 46 degrees North latitude is usually classified as a medium risk area for Multiple Sclerosis (MS). However, the results of prevalence studies carried out in Italy indicate ratios from 7.2 to 65.3/100.000. The difference between these prevalence figures may be explained in part by methodological and local regional problems; however real differences from area to area cannot be excluded. The Section of Neuroepidemiology of the Italian Society of Neurology organized a Multicenter Study of the Incidence of Multiple Sclerosis in Italy in January 1982. The period selected was 1 January 1971-31 December 1980. 14 different centers have participated in the study, each investigating one area. The aims of the study are to evaluate incidence of MS in different areas of Northern, Central and Southern Italy and to investigate the effects on the risk of some variables (latitude, altitude, migration, socio economic and urban-rural factors). The design of the study and the methodological problems are considered in this paper. PMID- 3654178 TI - Morbidity and mortality of patients with multiple sclerosis. PMID- 3654179 TI - Clinical data bank at the University Department of Neurology, Bern, Switzerland: basis for an epidemiological study of multiple sclerosis in a high prevalence area. AB - Clinical and laboratory data for over 1000 patients with definite multiple sclerosis living on prevalence day January 1st, 1986 in the Swiss Canton of Bern, a geographically heterogeneous region, are analysed retrospectively by means of a specially developed computer system. The consequent application of the "Minimal Record of Disability" (MRD) as proposed by the IFMSS forms the basis of data sampling. Details of clinical aspects gained from these records are presented together with an account on the applicability of this system in collaborative epidemiological investigations, for which the now ongoing prospective study based on the aforementioned retrospective one at our Institution may serve as an example. PMID- 3654181 TI - Prognostic value of cerebrospinal fluid electrophoresis in optic neuritis and suspected multiple sclerosis. AB - The prognostic significance of cerebrospinal fluid electrophoresis and IgG-index has been investigated in 44 patients, of whom 10 had optic neuritis and 34 suspected, possible or probable multiple sclerosis. The predictive value of CSF oligoclonal banding for future disease dissemination is very high in the suspected multiple sclerosis subgroup, where after a follow-up of 4.4 years, 7 out of 7 band-positive patients displayed further disease activity. The absence of CSF oligoclonal bands seems to carry a relatively benign short-term (follow-up 3.4 years) prognosis in suspected MS cases. PMID- 3654180 TI - The Multiple Sclerosis Cooperative Etiological Study in Italy: preliminary analysis of CSF findings. AB - 295 newly diagnosed Multiple Sclerosis (MS) patients were investigated for interdependence of CSF abnormalities: leukocyte count, CSF/serum albumin ratio, CSF IgG index and intrathecal synthesis of oligoclonal IgG. Only 7% of patients had no CSF abnormality. The most frequent abnormal finding was the presence of intrathecal synthesis of oligoclonal IgG. Polyacrylamide isoelectric focusing appeared more sensitive than agarose electrophoresis for the detection of abnormal CSF fractions. CSF IgG index had low negative and high positive predictive value when compared with electrophoretic methods. Suspected MS had the lowest frequency of abnormal CSF parameters. Patients with oligoclonal CSF bands (OB+) did not differ in age, sex, disease duration or annual bout rate from patients without oligoclonal bands (OB-). CSF leukocyte count was higher in OB+ than in OB- patients. Low CSF cell count was a hallmark of progressive disease. In OB+ patients CSF cell count correlated with CSF IgG index during the first five years of disease and declined with increasing disease duration. In later disease phases CSF IgG index correlated negatively with CSF/serum albumin ratio. 5 years follow-up of this series of patients is in progress to assess the diagnostic and prognostic values of CSF abnormalities in Multiple Sclerosis. PMID- 3654182 TI - N-CAM in cerebrospinal fluid: a marker of synaptic remodelling after acute phases of multiple sclerosis? AB - We made a longitudinal study of the cerebrospinal fluid (CSF) neural cell adhesion molecule (N-CAM) content of 20 multiple sclerosis (MS) patients in an acute phase, and 10 in a non-acute phase. Both groups were compared with a control group of 23 subjects without neurological diseases. All MS patients were subjected to two or three lumbar punctures for collection of CSF samples, once a week. N-CAM analysis was performed by an enzyme-linked immunosorbent assay (ELISA) method. Comparison of N-CAM concentrations of the first CSF samples from each MS group with the control group values showed statistically different (lower) levels in the non-acute phase MS patients. Furthermore, a statistically significant increase of CSF N-CAM emerged from a comparison of the values of the first, second, and third samples of the acute phase MS patients group. This increase paralleled the patients' clinical improvement. PMID- 3654183 TI - Selection of electrophysiological tests in patients with suspected multiple sclerosis. AB - If we accept the criteria set by McDonald and Halliday and by the Boston University WorkShop that one of the two lesions in patients with multiple sclerosis may be determined by electrophysiological tests and if we recognize that medical economics sets a limit to indiscriminate use of tests for clinical purposes, we need to pay particular attention to the selection of diagnostic tests. If we accept that certain anatomical predilections of plaques at the onset of multiple sclerosis correlate to a limited extent with long-term prognosis as suggested by Kurtzke, Rosati and Visscher, particularly with the relation to the disability and mortality, we need to pay more attention to the discovery of symptoms and signs as soon as possible utilizing clinical and laboratory data. As of now, the frequency of symptoms and signs at the onset of multiple sclerosis, with minor variations, seem to indicate that motor signs (pyramidal and cerebellar) head the list. Electrophysiological tests are specific for certain anatomical systems. The sensitivity of each test varies, but in most series electrooculography and electronystagmography offer the greater sensitivity. This is because of the significant interconnections between the pyramidal, cerebellar, vestibular and the oculomotor systems. This report underlines the importance of these two electrophysiological tests for the diagnosis of suspected multiple sclerosis. PMID- 3654184 TI - The contribution of evoked potentials to the diagnosis of demyelinating diseases. AB - Examination of evoked potentials can be a useful diagnostic tool in the diagnosis and evaluation of patients with Multiple Sclerosis (MS). A description of the most frequently used EPs is given: BAEP, checkerboard VEP and short latency median nerve SSEP, together with an impression of their sensitivity. It is obvious that more clinical trials are necessary to evaluate also the other EP modalities before a balanced conclusion about the usefulness of EPs in MS can be formulated. PMID- 3654185 TI - Prior physical and sexual abuse in women with chronic headache: clinical correlates. PMID- 3654186 TI - The role of MRI in the evaluation of a migraine population: preliminary data. PMID- 3654187 TI - Coexistent internal ophthalmoplegia and cluster headache. PMID- 3654188 TI - Plasma and platelet methionine-enkephalin levels in chronic cluster patients during an acute headache episode. PMID- 3654189 TI - Differential prevalence rates for headaches: a function of stress and social support? PMID- 3654190 TI - A short-term trial of an analogue of eel-calcitonin in headache. PMID- 3654191 TI - Migraine, large pupils, mitral valve prolapse and emotional disturbances: an autonomic disorder. PMID- 3654193 TI - Tests of thyroid function in chronic headache patients. PMID- 3654192 TI - Pharmacological treatment of primary headache: analysis of current practice from a drug utilization study. PMID- 3654194 TI - I.v. verapamil and negative results. PMID- 3654195 TI - Food sensitivity or analgesic withdrawal? PMID- 3654196 TI - Efficacy, side effects and tolerance compared during headache treatment with three different calcium blockers. PMID- 3654197 TI - The natural history of episodic cluster headache. PMID- 3654198 TI - Stroke in migraine as a consequence of propranolol. PMID- 3654199 TI - Oculomotor ophthalmoplegic migraine in an infant. PMID- 3654200 TI - Nimodipine in episodic cluster headache: results and methodological considerations. PMID- 3654201 TI - Migraine is not a platelet disorder. PMID- 3654202 TI - [Comments on reversible nonhormonal contraception in the male]. AB - The development of substances that could be employed as male contraceptives would be of worldwide importance. As yet, however, it has not proved possible to find a substance which provides reliable contraception during use, whose effects are reversible following discontinuation, and which has minimal side-effects. Furthermore, the possibility of mutagenic effects and adverse effects on libido or sexual potency must be excluded and systemic application must be possible. The drugs gossypol, alpha-chlorohydrin and hexose derivates, which are presented in detail in this article, partly fulfil these requirements but are still a long way from representing an ideal compound for use as a male contraceptive. However, studies of these drugs may indicate ways of achieving the ultimate goal. The drugs showed interesting properties, which suggest that they may be used for purposes other than male contraception. PMID- 3654203 TI - [Capillary microscopy in connective tissue diseases]. AB - Based on the results of a capillary microscope study on 43 patients with connective tissue disorders, the characteristic morphological abnormalities observed in the capillaries of the nail fold are presented. A high correlation was found between the pattern of changes in the capillaries and the individual connective tissue diseases. The diagnostic and prognostic usefulness of this easily performed in vivo technique is discussed in particular with regard to patients with Raynaud's phenomenon. PMID- 3654204 TI - [Tricholemmal keratosis and tricholemmal cancer]. AB - Three cases of tricholemmal keratosis and two of tricholemmal carcinoma are reported. All patients were female and the age range was from 71 to 83 years. These rare tumors occur on the face and are obviously the result of long-standing actinic skin damage. Clinically, verrucous hyperkeratosis or cornu cutaneum (keratosis) are observed and in the case of tricholemmal carcinomas, ulcerated tumor nodules. Histologically pale, glycogen-rich polygonal cells with signs of tricholemmal keratinization without the presence of a granular cell layer are characteristic features. Tricholemmal keratoses exhibit no atypia or only a mild form; however, carcinoma in situ may occasionally develop. In contrast, tricholemmal carcinomas are characterized by increased pleomorphia, an increase in the rate of mitosis, and an invasive growth pattern. The prognosis is favourable. PMID- 3654205 TI - [Familial congenital hypotrichosis with "uncombable hair," retinal pigmentary dystrophy, juvenile cataract and brachymetacarpia: another entity of the ectodermal dysplasia group]. AB - A new ectodermal dysplasia syndrome is reported in a family of Caucasian ancestry. The syndrome consists of congenital hypotrichosis with "uncombable hair", juvenile cataract, retinal pigmentary dystrophy, oligodontia and brachymetacarpia, and is inherited as an autosomal dominant trait. PMID- 3654206 TI - [Recurrent exanthema in cryofibrinogenemia]. AB - Report on a 50-year-old patient with cryofibrinogenemia, suffering from a recurrent exanthema induced by cold exposure.